诊病之诀，在知表、里、虚、实、逆、从六字。第欲临诊时知之明，必于读书时知之豫
。
夫仲景之辨表、里二字亟矣，而喜言统治者或不信，谓《灵》、《素》论症，概以六经
脏腑
为别，何尝有所谓表、里者？不知两经为针法设，不为药法设。针法在取穴，但审其何经、
何脏、何腑，而巨刺、缪刺诸法已可施，不以表、里为汲汲也。若药法则清轻宜表，重浊宜
里，如此而已。且其为气，化于胃、运于脾、布于肺，如饮食然，断无专走一经之理。故必
分表、里，而后汗、吐、下、补诸法，各如其轻清、重浊之性以为用。仲景之词，所以异于
《灵》、《素》者此尔！
至于虚、实，则有二义∶邪在为实，邪不在为虚一也；邪结为实，邪不结为虚二也。皆
为泻邪地，非为用补地。试取诸经论读之，当不以余言为谬。
至于逆、从二字，则色、脉、证、治皆有之。须先审定其病，而后可言也。神而明之，
死生可决已。
两经于一切身热之诊，皆称热病。是以《素》则劳风、肾风同评于温后；《灵》则如虫
、如
疸并列于热中。至其散见他篇，尤不可胜数。盖以可诊者言，不以所因者言，其可专以伤寒
之成温者言乎？夫为身热一证，举其尤而穷其类，尤者详之，类者附之，固当如是，与仲景
论伤寒而及似伤寒之 湿 同意。浅人每论温热，举两经热论，或采之或剩之，果有当于病
源否也。其言暑者，只作“热”字解，《素·通天》因于暑及骨空立而暑解等，并不指夏令
之热。如后世所云，或采通天论之言，列于夏病，真不得经旨也。其言温者只作“蕴”字解
，《素·热病》先夏至者为病温云者，意以夏至后天气热，人易于感则言热，夏至前天气未
热
，人无所感，故止就所蕴者名之。而言温则仍取乎本义，非如近世训为小热也。不观今之病
春温者乎，赫赫炎炎，岂是小热？读书不明义例，古法于是尽湮矣。
诊断疾病的诀窍，在于掌握表、里、虚、实、逆、从这六个字。然而想要在临诊时明察秋毫，必须在读书时就预先透彻理解。
张仲景（Zhang Zhongjing）对“表”、“里”二字的辨析非常急切重要，但喜欢谈论统治原则的人往往不信服，认为《灵枢》和《素问》论述病症，一概以六经（Six Channels）和脏腑为区分标准，哪里有所谓的“表”、“里”呢？他们不知道这两部经典是为针法设立的，而不是为药法设立的。针法关键在于选取穴位，只需审察是哪条经、哪个脏、哪个腑，那么巨刺（Giant Puncture）、缪刺（Counter Puncture）等方法就可以施行了，并不急于区分表里。如果是药法，则气味清轻的药物适宜作用于表，气味重浊的药物适宜作用于里，道理就是这样。而且药物的气，在胃中化生，由脾运化，向肺布散，就像饮食一样，绝对没有专门只走一条经脉的道理。所以必须分清表里，然后汗法（Sweating Method）、吐法（Vomiting Method）、下法（Purgation Method）、补法（Tonification Method）等各种治法，才能各自根据其清轻或重浊的特性来发挥作用。这正是张仲景的言辞与《灵枢》、《素问》不同的地方！
至于“虚”、“实”，有两种含义：一是邪气存在为实，邪气不存在为虚；二是邪气结聚为实，邪气不结聚为虚。这两种情况都是针对泻除邪气的，不是针对使用补法的。试着研读各篇经文，就不会认为我的话是荒谬的了。
至于“逆”、“从”二字，在色、脉、证、治各方面都有体现。必须先审定清楚疾病，然后才能谈论。若能神妙地阐明其理，生死预后便可决断。
《灵枢》和《素问》对于一切身体发热的诊断，都称为热病（Heat Disease）。因此，《素问》中将劳风（Labor Wind）、肾风（Kidney Wind）一同评价于温病之后；《灵枢》中将如虫行感、黄疸并列于热中。至于散见于其他篇章的，更是数不胜数。大概是从可以诊断的角度来说，而不是从病因角度来说的，难道能专门用伤寒转化为温病的情况来概括吗？对于身体发热这一症状，列举最典型的并穷尽其类别，典型的详细论述，同类附记其后，本来就应该这样，这与张仲景论述伤寒而涉及类似伤寒的湿病（Dampness）是同一用意。浅薄之人每每讨论温热病，列举两经的热论，有的采纳有的删减，果真符合病源吗？他们所说的“暑”，只作“热”字解释，《素问·通天》篇中“因于暑”以及《骨空论》中“暑解”等，并不指代夏令的炎热。如果像后世所说的那样，或者采纳《通天》篇的话，将其列为夏季疾病，那就真正误解了经旨。他们所说的“温”，只作“蕴藏”解释，《素问·热病》中说“先夏至日为病温”，意思是夏至后天气热，人容易感受外邪所以叫热；夏至前天气未热，人无所感受，所以仅就体内所蕴藏的邪气来命名。说“温”仍然取它的本义，不像近代解释为小热。不看现在患春温病的人吗？那热度赫赫炎炎，难道是小热吗？读书如果不明白义例，古法于是全部湮没了。
The key to diagnosing diseases lies in understanding the six characters: Exterior (Biao), Interior (Li), Deficiency (Xu), Excess (Shi), Reversal (Ni), and Compliance (Cong). However, to perceive clearly during clinical practice, one must have thoroughly understood them in advance while studying.
Zhang Zhongjing emphasized the distinction between "Exterior" and "Interior" urgently; however, those who prefer discussing governing principles often do not believe this, arguing that *Ling Shu* and *Su Wen* differentiate symptoms primarily by the Six Channels (Liu Jing) and Zang-Fu organs, asking where there is any mention of "Exterior" or "Interior"? They fail to realize that these two classics were established for acupuncture methods, not for herbal medicine. Acupuncture focuses on selecting acupoints; it only requires examining which channel, Zang organ, or Fu organ is involved, so that techniques such as Giant Puncture (Ju Ci) and Counter Puncture (Miu Ci) can be applied, without urgently distinguishing between Exterior and Interior. In contrast, herbal medicine dictates that light and clear substances are suitable for the Exterior, while heavy and turbid substances are suitable for the Interior. This is the principle. Furthermore, the qi of herbs transforms in the Stomach, is transported by the Spleen, and distributes via the Lungs, similar to food and drink; there is absolutely no logic for them to travel exclusively along a single channel. Therefore, one must distinguish between Exterior and Interior so that therapies such as Sweating (Han), Vomiting (Tu), Purgation (Xia), and Tonification (Bu) can function according to their respective light/clear or heavy/turbid natures. This is precisely why Zhang Zhongjing's terminology differs from that of *Ling Shu* and *Su Wen*.
Regarding "Deficiency" and "Excess," there are two meanings: first, presence of pathogenic factors constitutes Excess, absence constitutes Deficiency; second, accumulation of pathogenic factors constitutes Excess, non-accumulation constitutes Deficiency. Both refer to conditions requiring the draining of pathogens, not the application of tonification. One should read the relevant chapters to verify that my words are not absurd.
Regarding "Reversal" and "Compliance," these concepts appear in complexion, pulse, signs/symptoms, and treatment. One must first accurately determine the disease before discussing these aspects. If one can mystically illuminate these principles, life and death prognoses can be decided.
Both *Ling Shu* and *Su Wen* refer to all diagnoses involving body heat as Heat Disease (Re Bing). Thus, in *Su Wen*, Labor Wind (Lao Feng) and Kidney Wind (Shen Feng) are evaluated together after Warmth (Wen); in *Ling Shu*, sensations like insects crawling and Jaundice (Dan) are listed alongside Heat Within (Re Zhong). Those scattered in other chapters are too numerous to count. Generally, this classification is based on what can be diagnosed, not on etiology; how can it be exclusively defined by Cold Damage (Shang Han) transforming into Warmth? For the symptom of body heat, listing the most typical cases and exploring their categories—detailing the typical and appending the similar—is indeed appropriate. This aligns with Zhang Zhongjing’s discussion of Shang Han which includes Dampness (Shi) resembling Shang Han. Superficial scholars often discuss Warm-Heat (Wen Re) diseases by citing the Heat Treatises of both classics, adopting some and discarding others, but does this truly accord with the source of disease? When they speak of "Shu" (Summerheat), they interpret it merely as "Heat"; passages in *Su Wen · Tong Tian* such as "affected by Shu" and "Shu Jie" in *Gu Kong Lun* do not refer to summer heat. To classify them as summer diseases based on *Tong Tian* is to fundamentally misunderstand the canonical intent. When they speak of "Wen," they interpret it as "accumulation/hidden." The statement in *Su Wen · Re Bing* "diseases occurring before the Summer Solstice are called Wen" implies that after the Summer Solstice, weather is hot, making people susceptible to external pathogens, hence termed "Heat"; before the Summer Solstice, weather is not yet hot, so people are less susceptible, thus naming it based on internal accumulation. "Wen" retains its original meaning, unlike modern interpretations defining it as "mild heat." Do we not observe patients suffering from Spring Warmth (Chun Wen)? Their fever is intense and blazing; how could this be mild heat? If one does not understand the principles and examples when reading, ancient methods will be entirely lost.