帝曰∶其病两感于寒者,其脉应与其病形何如?岐伯曰∶两感于寒者,病一日,则巨阳与少阴俱病,则头
痛口干而烦满;二日,则阳明与太阴俱病,则腹满身热,不欲食,谵语;三日,则少阳与厥阴俱病,则耳聋
囊缩而厥,水浆不入,不知人,六日死。帝曰∶五脏已伤,六腑不通,营卫不行,如是之后,三日乃死,何
也?岐伯曰∶阳明者,十二经脉之长也,其血气盛,故不知人三日,其气乃尽,故死矣。
此又申明两感病状,必死之理也。阴阳两经内外俱受邪,故一日而至三日,则邪遍阴阳六经。帝谓既已邪
遍六经,内外五脏
已伤,故不知人事,六腑不通,故水浆不入,而营卫之气已不行矣,又必待三日方死何也。岐伯言阳明胃经,
气血俱盛,邪虽遍于内外,阳明气血未尽,至第六日气尽方死也。
帝曰∶热病已愈,时有所遗者,何也?岐伯曰∶诸遗者,热甚而强食之,故有所遗也。若此者,皆病已
衰,而热有所藏,因其谷气相薄,两热相合,故有所遗也。帝曰∶治遗奈何?岐伯曰∶视其虚实,调其逆从,
可使必已。帝曰∶病热当何禁之?岐伯曰∶病热少愈,食肉则复,多食则遗,此其禁也。
病初愈,余热藏于血气中而不觉,因食助气,则两热相合,故食肉病必复发,多食谷则邪遗留,致淹缠不
能脱体,故当戒口,稀粥调理为要也。
黄帝问道:两感于寒的病证,其脉象与病症表现是怎样的?岐伯回答说:两感于寒的病证,发病第一天,太阳经与少阴经同时受病,就会出现头痛、口干、心中烦闷胀满的症状;第二天,阳明经与太阴经同时受病,就会出现腹部胀满、全身发热、不想吃东西、说胡话(谵语)的症状;第三天,少阳经与厥阴经同时受病,就会出现耳聋、阴囊收缩、四肢厥冷、水浆不能入口、神志昏迷不知人事的症状,到了第六天就会死亡。黄帝问道:五脏已经受损,六腑气机不通,营卫之气运行停滞,在这种情况下,还要过三天才会死亡,这是为什么呢?岐伯回答说:阳明经是十二经脉的主宰,它的血气最旺盛,所以虽然神志昏迷三天,但阳明经的气血还没有完全耗尽,直到第六天气血竭尽,人也就死了。
这段文字进一步阐明了两感病的症状及其必然死亡的机理。阴阳两经内外同时受到邪气侵袭,所以从第一天到第三天,邪气就遍布阴阳六经。黄帝认为既然邪气已经遍布六经,内外五脏都已受伤,所以神志昏迷不知人事;六腑气机不通,所以水浆不能入口,而营卫之气也已经停止运行了,为什么还要等到第六天才死亡呢?岐伯解释说,阳明胃经的气血都很旺盛,虽然邪气已经遍布内外,但阳明经的气血尚未耗尽,直到第六天气血才完全竭尽,人因此死亡。
黄帝问道:热病已经痊愈,但时常有遗留症状的情况,是怎么回事?岐伯回答说:凡是遗留症状的,都是因为热势正盛时勉强进食,所以导致病情遗留。像这种情况,都是疾病的热势已经衰退,但余热潜伏在体内,因为食物进入后产生的谷气与体内的余热相互搏结,两热相合,所以导致了遗留症状。黄帝问道:治疗遗留症状应该怎么办?岐伯回答说:观察病证的虚实,调理气机的逆乱或顺从,就可以使疾病必定痊愈。黄帝问道:患热病时应当禁忌什么?岐伯回答说:热病稍微好转时,吃肉会导致疾病复发,吃得过多会导致病情遗留,这就是需要禁忌的地方。
疾病刚刚痊愈,余热的邪气潜伏在血气之中而未被察觉,因为进食助长了谷气,导致谷气之热与余热相合,所以吃肉类食物疾病必定复发,多吃谷物则导致邪气遗留,致使病情缠绵难以摆脱,所以应当注意饮食禁忌,以喝稀粥进行调理最为重要。
The Yellow Emperor asked: In cases of *Lianggan* (Two-Channel Cold Invasion), what are the corresponding pulse and clinical manifestations? Qibo replied: In cases of *Lianggan* (Two-Channel Cold Invasion), on the first day, the Taiyang Channel (Greater Yang) and Shaoyin Channel (Lesser Yin) are both affected, resulting in headache, dry mouth, and vexation with fullness. On the second day, the Yangming Channel (Bright Yang) and Taiyin Channel (Greater Yin) are both affected, resulting in abdominal fullness, generalized fever, anorexia, and delirious speech. On the third day, the Shaoyang Channel (Lesser Yang) and Jueyin Channel (Terminal Yin) are both affected, resulting in deafness, retraction of the testicles, cold extremities, inability to take in fluids or food, unconsciousness, and death by the sixth day. The Yellow Emperor asked: If the five Zang organs are damaged, the six Fu organs are obstructed, and the Ying (Nutritive) and Wei (Defensive) Qi are not circulating, why does death occur three days after these conditions arise? Qibo replied: The Yangming Channel is the leader of the twelve meridians, and its blood and Qi are abundant. Therefore, even though the patient is unconscious for three days, it is only when the Qi of this channel is exhausted that death occurs.
This passage further elucidates the symptoms of *Lianggan* disease and the rationale for its fatal outcome. When both Yin and Yang channels are invaded internally and externally, the pathogenic factor spreads through all six channels of Yin and Yang from the first to the third day. The Yellow Emperor reasoned that since the pathogen has spread through all six channels, the internal and external Zang organs are damaged causing unconsciousness; the Fu organs are obstructed preventing intake of fluids; and the Ying and Wei Qi have ceased to circulate. Why, then, must one wait until the sixth day for death? Qibo explained that the Stomach meridian of Yangming possesses abundant Qi and Blood. Although the pathogen pervades the interior and exterior, the Qi and Blood of Yangming have not yet been exhausted; death occurs only on the sixth day when this Qi is fully depleted.
The Yellow Emperor asked: After a febrile disease has healed, there are sometimes residual symptoms. What causes this? Qibo replied: Residual symptoms occur because the patient forces themselves to eat while the heat is still intense. In such cases, although the main heat of the disease has subsided, residual heat remains latent within the body. This residual heat combines with the Qi generated from food (Grain Qi), and the two heats merge, resulting in residual symptoms. The Yellow Emperor asked: How should residual symptoms be treated? Qibo replied: One must assess the deficiency or excess of the condition and regulate the rebellious or smooth flow of Qi, which will ensure recovery. The Yellow Emperor asked: What dietary prohibitions apply during febrile diseases? Qibo replied: When the fever has slightly subsided, consuming meat may cause recurrence of the disease, and overeating may lead to residual symptoms; these are the prohibitions.
When a disease has just healed, residual pathogenic heat may remain latent in the blood and Qi without being noticed. Food intake boosts Grain Qi, causing it to combine with residual heat. Consequently, eating meat will likely cause the disease to recur, while excessive consumption of grains leads to lingering pathogens, resulting in a protracted illness that is difficult to resolve. Therefore, dietary restrictions are essential, and regulating the diet with thin rice gruel is paramount.