《难经》七传传其所胜,间传传其所生,皆止言五传。注家不得其说,以心复传肺数之
,其
实止得六传,无七传,且间传之如环无端,何尝不如是。而经独以传其所胜为七传也,揆之
于理,殊觉牵强。窃谓“七”字,当为“次”字声之误也。古音去声、入声不甚分别。如《
书》康诰勿庸以次汝封。“次”字《荀子》引作即之比。何以言之?《素》玉机真脏及标本
病传两篇,于传其所胜者,皆谓之次传,无言七传者。且标本病传篇末,明云诸病以次是相
传,如是者皆有死期,不可刺,间一脏止及至三、四脏者,乃可刺也。其义与真脏“风者百
病之长也”以下至“此病之次也”数段甚合。然则传其所胜者之为次传,经有明文,乃病传
之定例,《难经》原文必不误,后人传写误耳!《千金方》卷七,经云次传、间传是也,亦
其一证。又《难经》于间传言如环无端者,乃就一脏之传其所生而卒言之,与《素问》本无
不合。而徐氏泥《素问》、《难经》之文,以相驳诘,真多事也。
古者于冬月触冒正邪之寒及夏月中时行之寒,皆称伤寒,故仲景存或已发热、或未发热
两者
于伤寒条。已发热者,时行之寒;未发热者,正邪之寒。意在统一,使人易识耳!至《巢源
》始别伤寒,
时气为二门,而于小儿伤寒候并列两寒,
特以一语示别,曰时行伤寒,亦简且审。唐人乃曰天行热病,天行实时行。但
“时气”二字之义,本兼四时为主,而“时气”二字之名,若惟热病独擅,其为语似混。然
历考志乘,凡疫皆在春、夏、秋三时,而夏尤多。仲景自春分至秋分有非时暴寒,皆为时行
寒疫之言。益信古者于夏月触冒正邪之暑及冬月中时行之暑,皆称伤暑。《素》形气虚实气
虚身热之伤暑,不必专以夏言也。仲景始别之以中 、冬温两名,然温病《难经》不指定何
脉,仲景止略陈其症状,则是所发无定,不必其尽发热恶寒也。凡咳嗽、肿痈皆得有之,仲
景虽不明言,其散见于《千金》、《外台》者,可举一二以推。盖“伤暑”二字之义,虽得
兼通夫四时,而“伤暑”二字之名,不得概施之冬月。此古今称谓之所由异也。
《难经》中提到的“七传”是指传其所胜(五行相克),而“间传”是指传其所生(五行相生),这两种传变方式都只涉及五脏的循环。注家们无法理解其中的道理,认为心再传回给肺,这样计算下来,实际上只有六次传变,并不存在所谓的“七传”。况且“间传”如同圆环一样没有起点和终点,怎么会不是这样呢?然而经文唯独将“传其所胜”称为“七传”,这与常理相比,显得非常牵强。我私下认为,“七”字应该是“次”字的音误。古音中去声和入声的区别并不明显。例如《尚书·康诰》中说“勿庸以次汝封”,这里的“次”字在《荀子》中被引用为“即之比”。为什么这么说呢?因为《素问》中的《玉机真脏论》和《标本病传论》两篇,对于“传其所胜”的情况,都称之为“次传”,从未有过“七传”的说法。而且《标本病传论》末尾明确说道:“诸病以次是相传,如是者皆有死期,不可刺;间一脏止及至三、四脏者,乃可刺也。”这一含义与《真脏脉论》中从“风者百病之长也”到“此病之次也”等几段文字的意思非常吻合。既然经文中明文规定“传其所胜”称为“次传”,这是疾病传变的固定法则,《难经》的原文必然没有错误,只是后人抄写时产生了讹误!《千金方》卷七中也提到“次传”、“间传”,这也是一个证据。另外,《难经》中提到“间传”如环无端,是针对某一脏腑“传其所生”的过程而言的,这与《素问》原本并无不合之处。而徐氏拘泥于《素问》和《难经》的文字,互相驳斥质问,真是多此一举。
古代人在冬天触犯正邪之气所致的寒邪,以及夏天感染时行之寒邪,都统称为伤寒,所以张仲景在伤寒条文中保留了“或已发热、或未发热”两种情况。已经发热的,属于时行之寒;尚未发热的,属于正邪之寒。这样做是为了统一概念,使人们容易识别。到了《诸病源候论》,才开始将伤寒与时气分为两个门类,并在小儿伤寒候中将两种寒邪并列,特意用一句话来区分,称为“时行伤寒”,既简洁又审慎。唐人则称之为“天行热病”,“天行”即时行。但是,“时气”二字的本义本是以四季为主,而“时气”这一名称,却似乎被热病独占,这种说法显得有些混淆。然而,历考各种志书记载,凡是疫病都发生在春、夏、秋三个季节,而夏季尤其多。张仲景指出从春分到秋分期间的非时暴寒,都属于时行寒疫的说法。这更加证实了古人将夏天触犯正邪之气所致的暑邪,以及冬天感染时行之暑邪,都统称为伤暑。《素问·生气通天论》中提到“气虚身热”的伤暑,并不一定专指夏季。张仲景开始将其区分为“中暍”(中暑)和“冬温”两个名称,然而《难经》对温病没有指定特定的脉象,张仲景也只是简要陈述其症状,这说明温病的发病没有定式,不一定都是发热恶寒。凡是有咳嗽、肿痈等症状的都可能出现这种情况,虽然张仲景没有明确说明,但从散见于《千金方》、《外台秘要》的内容中,可以举出一二来推断。大概“伤暑”二字的含义,虽然可以兼通四季,但“伤暑”这一名称,不能一概用于冬季。这就是古今称谓不同的原因所在。
The *Nan Jing* (Classic of Difficult Issues) states that "seven transmissions" refers to transmission to what it overcomes (Wu Xing mutual restriction), while "intermittent transmission" refers to transmission to what it generates (Wu Xing mutual generation). Both types of transmission involve only the five Zang organs. Commentators, unable to grasp the logic, argued that if the Heart transmits back to the Lung, the count would actually stop at six transmissions, with no such thing as a "seven transmission." Moreover, since "intermittent transmission" is like a ring without beginning or end, how could it not be so? Yet the classic text uniquely refers to "transmission to what it overcomes" as "seven transmission," which seems quite forced when measured against reason. I privately believe that the character "seven" (Qi) is likely a phonetic error for "successive" (Ci). In ancient pronunciation, the departing tone (Qu Sheng) and entering tone (Ru Sheng) were not sharply distinguished. For instance, in the *Book of Documents* (Shang Shu), chapter *Kang Gao*, it says "Do not use [force], but arrange your enfeoffment successively" (Wu Yong Yi Ci Ru Feng). The character "Ci" is cited in *Xunzi* as "Ji Zhi Bi." Why do I say this? Because in two chapters of the *Su Wen* (Basic Questions)—*Yu Ji Zhen Zang Lun* (Treatise on the Jade Machine and True Viscera) and *Biao Ben Bing Chuan Lun* (Treatise on Root and Branch Disease Transmission)—the case of "transmission to what it overcomes" is always referred to as "successive transmission" (Ci Chuan), never "seven transmission." Furthermore, the end of the *Biao Ben Bing Chuan Lun* explicitly states: "When diseases transmit successively, there will be a fixed time of death, and acupuncture should not be used; if one Zang organ is skipped, limiting the transmission to three or four Zang organs, then acupuncture may be used." This meaning aligns very well with several passages in the *Zhen Zang* chapter, from "Wind is the chief of all diseases" to "This is the successive nature of disease." Since the classic texts explicitly state that "transmission to what it overcomes" is called "successive transmission," this is the established rule for disease transmission. The original text of the *Nan Jing* must be correct, and the error lies in later copying! Volume 7 of the *Qian Jin Fang* (Essential Prescriptions Worth a Thousand Gold) also mentions "successive transmission" and "intermittent transmission," which serves as further evidence. Additionally, when the *Nan Jing* speaks of "intermittent transmission" being like a ring without end, it is referring to the process of one Zang organ transmitting to what it generates, which is fundamentally consistent with the *Su Wen*. Xu Shi’s rigid adherence to the texts of the *Su Wen* and *Nan Jing*, using them to refute each other, is truly unnecessary.
In ancient times, cold pathogens contracted in winter from proper evil (Zheng Xie) and cold pathogens contracted in summer from epidemic trends (Shi Xing) were both collectively termed Shang Han (Cold Damage). Therefore, Zhang Zhongjing preserved both "already having fever" and "not yet having fever" in the Shang Han clauses. Those with existing fever belong to epidemic cold; those without fever belong to proper evil cold. The intent was unification, making it easier for people to recognize. It was not until the *Chao Yuan Fang* (Source of Pathological Changes) that Shang Han and Shi Qi (Seasonal Qi) were separated into two categories. In the section on pediatric Shang Han, both types of cold were listed side by side, distinguished specifically by the phrase "Shi Xing Shang Han" (Epidemic Cold Damage), which was concise and prudent. Tang dynasty physicians began calling it Tian Xing Re Bing (Heavenly Movement Heat Disease), where "Tian Xing" is synonymous with "Shi Xing." However, the original meaning of the term "Shi Qi" encompassed all four seasons, whereas the name "Shi Qi" seemed to be monopolized by heat diseases, creating some confusion. Nevertheless, historical records indicate that epidemics occurred in spring, summer, and autumn, with summer being particularly prevalent. Zhang Zhongjing stated that non-seasonal sudden cold between the Spring Equinox and Autumn Equinox belongs to Shi Xing Han Yi (Epidemic Cold). This further confirms that ancients referred to summer heat pathogens contracted from proper evil and winter heat pathogens contracted from epidemic trends collectively as Shang Shu (Summerheat Injury). The *Su Wen* (Chapter *Sheng Qi Tong Tian Lun*) mentions "Qi deficiency with body heat" as Shang Shu, indicating that Shang Shu is not exclusively limited to summer. Zhang Zhongjing began distinguishing these conditions into Zhong Yue (Heat Stroke/Summerheat Strike) and Dong Wen (Winter Warmth). However, the *Nan Jing* does not specify a particular pulse for Wen Bing (Warm Diseases), and Zhang Zhongjing only briefly described their symptoms, implying that the onset is not fixed and does not necessarily involve fever and aversion to cold. Conditions such as coughing and swelling/abscesses can also present similarly. Although Zhang Zhongjing did not explicitly state this, examples can be inferred from scattered references in the *Qian Jin Fang* and *Wai Tai Mi Yao*. Essentially, while the meaning of "Shang Shu" can apply to all four seasons, the term itself cannot be broadly applied to winter. This explains the difference in nomenclature between ancient and modern times.