帝曰∶其两感于寒者，其脉应与其病形何如？岐伯曰∶两感于寒者，一日太阳与少阴俱病，则
头疼发热，口干而烦满；二日阳明与太阴俱病，则腹满身热，不欲食，谵语；三日少阳与厥阴俱病
，则耳聋、囊缩而厥，水浆不入，不知人，六日死。又云∶天之邪气，感则害人五脏，以知内外两
感，脏腑俱病。欲解表则有里，欲攻里则有表，表里概不能一治，故死。感之浅者，犹或可治，宜
冲和灵宝饮，或大羌活汤治之。次察形证，如里证急者，大柴胡汤或调胃承气汤微攻之；表证急者
，柴葛解肌汤或小柴胡汤微解之；若下利身痛，四肢厥冷，脉沉，邪传阴经，宜四逆汤或理中汤分
轻重温之。
足太阳膀胱经∶头痛项强，脊腰膝痛，恶寒拘急，身热无汗为表实，根据主方。得病微热谵语，
小便不利，热结膀胱，宜桂苓饮。小便利而小腹急胀，为蓄血证。看大便黑，口渴饮水不欲咽，桃
仁承气汤下去黑血；热甚汗出，至颈而还，渴欲饮水，小便不利，必发黄，宜茵陈五苓散（五苓加茵）
。汗后口渴鼻塞，表未解，烦躁目瞑，必衄血成流，病解；不成流，再微汗。
足阳明胃经∶目痛鼻干不眠，身热微畏寒，自汗舌干，脉微洪长，属阳明表证本病。舌苔白滑
，葛根汤加柴胡、黄芩；不退，生地芩连汤。以后大渴舌黄苔，属经证，如神白虎汤；渴甚倍石膏
，加天粉、黄连、竹叶。潮热自汗，扬手揭被，大便秘、转矢气（臭屁也），或自利秽水，胸痞，舌黄
苔，乃阳明标病，大柴胡汤；未效，六乙顺气汤。舌苔黑燥如芒刺，重用大黄、芒硝；未效加用，
失用则死。表未清，里又剧，大柴胡汤。热甚，三黄石膏汤。睛红，三黄巨胜汤。
足少阳胆经∶耳聋胁痛，干呕口苦，寒热往来，微畏寒，汗少，舌白苔，脉浮弦者，为少阳经
病。胆无出入之路，在半表半里，禁汗、吐、下，宜柴胡双解饮和解。以后身热耳聋，胸满呕渴，
舌黄苔，自利，脉弦，为标病，只宜小柴胡加黄连、竹茹、枳实。二便秘少加大黄。
足太阴脾经∶腹满咽干，舌黄苔，手足温，身黄，小便涩，大便秘，腹痛，脉沉有力，为本病
，宜桂枝大黄汤下。以后头汗至颈而还，口渴小便赤，大便实，身目黄，脉沉实为标病，宜茵陈大
黄汤。如
不渴、呕吐，大便通利，小便清长，舌红润，脉沉无力，手足厥冷，宜加味理中汤。或先属阳证，
因体虚下之太过，虚邪传入阴经，寒证悉具，理中汤温补。
足少阴肾经∶口燥咽干，舌苔边黄、中黑，大便秘或清水，脉沉实有力，此热邪传少阴本病，
调胃承气汤微下之。以后谵语便秘，绕脐硬痛，烦躁大渴，脉反沉疾，此热邪传入少阴标病，宜大
承气汤急下之。本经有热邪传入冲脉，干于血分，血热妄行，逆上则呕血，迫下则便血。外证神昏
谵语，舌燥无苔，如火炙猪腰子，脉沉涩、或洪数，宜生地黄连阿胶汤或归地养荣汤。以上皆热邪
传肾，水涸为病，非真阴证也。本经恶寒厥逆，蜷卧不渴，吐泻、腹疼身重，脉沉迟属脏寒，宜回
阳救急汤温补。
足厥阴肝经∶胸腹胀满，消渴饮水，谵语烦躁，便秘或下清水，舌干，黄黑燥苔，脉沉实有力
，此热邪传入厥阴本病，宜六乙顺气汤下。以后有前证，手足反冷，或乍温，乃热深厥亦深，非寒
厥也。脉沉实有力为标病，大承气汤急下之。本经口吐涎沫，四肢逆冷，过乎肘膝，不渴，小腹痛
，脉沉迟。此本经真阴证，急宜回阳救急汤、茱萸四逆汤温之。
六经中惟少阴肾经疑似难明，脉俱沉。沉而有力为阳，大黄、芒硝攻下；沉而无力为阴，附子
、姜、桂温补。一毫千里，杀人反掌，临时细心并外证参酌。阳证似阴、阴证似阳等十二证，古书
皆各分条立论，初学最难剖析。（宏）极欲后人易解，姑汇为二论，虽然大同小异，用药寒热轻重
，临床细加详察。
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，第一天太阳经与少阴经同时发病，就会出现头痛、发热、口干且烦闷胀满；第二天阳明经与太阴经同时发病，就会出现腹部胀满、全身发热、不想进食、说胡话；第三天少阳经与厥阴经同时发病，就会出现耳聋、阴囊收缩和四肢厥冷，水浆不能入口，神志昏迷不知人，到了第六天就会死亡。又说：天的邪气，侵入就会伤害五脏，由此可知内外两感是脏腑都患病。想要解表则里有病，想要攻里则表有病，表里都不能单独治疗，所以会死亡。感受邪气较浅的，或许还可以治疗，适宜用冲和灵宝饮，或者大羌活汤来治疗。其次观察形证，如果里证紧急，用大柴胡汤或调胃承气汤轻微攻下；如果表证紧急，用柴葛解肌汤或小柴胡汤轻微解表；如果出现腹泻、身体疼痛、四肢厥冷、脉沉，这是邪气传入阴经，适宜用四逆汤或理中汤分别根据轻重进行温补。
足太阳膀胱经：头痛项强，脊背腰膝疼痛，恶寒拘急，身热无汗属于表实证，依据主方治疗。得病后微热说胡话，小便不利，热结在膀胱，适宜用桂苓饮。小便通利而小腹胀急，是蓄血证。看大便发黑，口渴想喝水但不想咽下，用桃仁承气汤攻下排出黑血；热盛出汗，汗止于颈部，口渴想喝水，小便不利，一定会发黄，适宜用茵陈五苓散（五苓散加茵陈）。发汗后口渴鼻塞，表证未解，烦躁闭目，一定会鼻衄血流出来，病可解除；如果不流血，再轻微发汗。
足阳明胃经：眼睛痛、鼻子干、失眠，身热微畏寒，自汗舌干，脉微洪长，属于阳明表证的本病。舌苔白滑，用葛根汤加柴胡、黄芩；不退烧，用地黄芩连汤。之后出现大渴、舌黄苔，属于经证，用如神白虎汤；渴得厉害加倍石膏，加天花粉、黄连、竹叶。潮热自汗，扬手掀被，大便秘结、放臭屁，或者自行泻下秽浊稀水，胸膈痞闷，舌黄苔，这是阳明标病，用大柴胡汤；无效，用六乙顺气汤。舌苔黑燥像芒刺，重用大黄、芒硝；无效再加用，误用不用就会死亡。表证未清，里证又严重，用大柴胡汤。热盛，用三黄石膏汤。眼睛红，用三黄巨胜汤。
足少阳胆经：耳聋胁痛，干呕口苦，寒热往来，微畏寒，汗少，舌白苔，脉浮弦，是少阳经病。胆没有出入的路径，在半表半里，禁止发汗、催吐、攻下，适宜用柴胡双解饮和解。之后身热耳聋，胸满呕吐口渴，舌黄苔，自利，脉弦，是标病，只适宜用小柴胡汤加黄连、竹茹、枳实。二便不通量少加大黄。
足太阴脾经：腹部胀满咽干，舌黄苔，手足温暖，身黄，小便涩滞，大便秘结，腹痛，脉沉有力，是本病，适宜用桂枝大黄汤攻下。之后头汗至颈部而止，口渴小便赤，大便实，身目发黄，脉沉实是标病，适宜用茵陈大黄汤。如果不渴、呕吐，大便通利，小便清长，舌红润，脉沉无力，手足厥冷，适宜用加味理中汤。或者先前属于阳证，因为体质虚弱攻下太过，虚邪传入阴经，寒证全部具备，用理中汤温补。
足少阴肾经：口燥咽干，舌苔边黄、中间黑，大便秘结或清水样便，脉沉实有力，这是热邪传入少阴本病，用调胃承气汤轻微攻下。之后说胡话便秘，绕脐硬痛，烦躁大渴，脉反而沉疾，这是热邪传入少阴标病，适宜用大承气汤急下。本经有热邪传入冲脉，干扰血分，血热妄行，向上逆则呕血，向下迫则便血。外证神昏说胡话，舌燥无苔，像火烤过的猪腰子，脉沉涩、或洪数，适宜用生地黄连阿胶汤或归地养荣汤。以上都是热邪传肾，水枯竭为病，不是真阴证。本经恶寒厥逆，蜷卧不渴，吐泻、腹痛身重，脉沉迟属于脏寒，适宜用回阳救急汤温补。
足厥阴肝经：胸腹胀满，消渴饮水，说胡话烦躁，便秘或下清水，舌干，黄黑燥苔，脉沉实有力，这是热邪传入厥阴本病，适宜用六乙顺气汤攻下。之后有前面的症状，手足反而冷，或者突然温暖，这是热深厥亦深，不是寒厥。脉沉实有力是标病，用大承气汤急下。本经口吐涎沫，四肢逆冷，超过肘膝，不渴，小腹痛，脉沉迟。这是本经真阴证，急宜用回阳救急汤、茱萸四逆汤温之。
六经中只有少阴肾经疑似难明，脉象都沉。沉而有力为阳，用大黄、芒硝攻下；沉而无力为阴，用附子、姜、桂温补。差之毫厘谬以千里，杀人只在反掌之间，临时细心并参考外证斟酌。阳证似阴、阴证似阳等十二种证候，古书都分别列条论述，初学者最难剖析。（宏）极想让后人容易理解，暂且汇集成两篇论述，虽然大同小异，用药寒热轻重，临床时仔细详察。
Yellow Emperor asked: In cases of Lianggan (simultaneous contraction of exterior and interior meridians by cold pathogen), what are the corresponding pulse and clinical manifestations? Qibo replied: In cases of Lianggan, on the first day, the Taiyang (Greater Yang) and Shaoyin (Lesser Yin) meridians are affected simultaneously, resulting in headache, fever, dry mouth, and vexation with fullness; on the second day, the Yangming (Yang Brightness) and Taiyin (Greater Yin) meridians are affected simultaneously, resulting in abdominal fullness, generalized fever, anorexia, and delirium; on the third day, the Shaoyang (Lesser Yang) and Jueyin (Terminal Yin) meridians are affected simultaneously, resulting in deafness, retraction of the genitals, and cold extremities, inability to take food or fluids, unconsciousness, leading to death on the sixth day. It is also stated that external pathogenic qi from heaven damages the five zang organs when contracted, indicating that simultaneous exterior-interior contraction involves both fu and zang organs. If one attempts to release the exterior, the interior is compromised; if one attempts to purge the interior, the exterior is compromised. Since neither exterior nor interior can be treated independently, death ensues. For those with shallow contraction, treatment may still be possible, using Chonghe Lingbao Yin (Harmonizing and Spiritual Elixir Decoction) or Da Qianghuo Tang (Major Notopterygium Decoction). Subsequently, observe the syndromes: if interior syndrome is urgent, use Da Chaihu Tang (Major Bupleurum Decoction) or Tiaowei Chengqi Tang (Regulating the Stomach and Directing Downward Decoction) for mild purgation; if exterior syndrome is urgent, use Chaige Jieji Tang (Bupleurum and Kudzu Muscle-Releasing Decoction) or Xiao Chaihu Tang (Minor Bupleurum Decoction) for mild release. If there is diarrhea, body pain, cold extremities, and a deep pulse, indicating transmission of pathogen to yin meridians, use Sini Tang (Frigid Extremities Decoction) or Lizhong Tang (Regulate the Middle Decoction) for warming supplementation based on severity.
Foot-Taiyang Bladder Meridian: Headache, neck stiffness, pain in the spine, lower back, and knees, aversion to cold with spasms, fever without sweating indicates Exterior Excess syndrome; treat according to the principal formula. If slight fever and delirium occur after onset, with difficult urination and heat binding in the bladder, Gui Ling Yin (Cinnamon Twig and Polyporus Decoction) is indicated. If urination is clear but there is lower abdominal urgency and distension, it is Blood Stasis syndrome. If stool is black, with thirst for water but reluctance to swallow, Tao Ren Chengqi Tang (Peach Kernel Directing Downward Decoction) should be used to expel black blood. If heat is severe with sweating stopping at the neck, thirst for water, and difficult urination, jaundice will certainly develop; Yinchen Wuling San (Artemisia Capillaris and Five-Ingredient Powder with Poria) is indicated. After sweating, if there is thirst, nasal congestion, unresolved exterior syndrome, vexation, closing eyes, and epistaxis flowing freely, the disease resolves; if not, induce mild sweating again.
Foot-Yangming Stomach Meridian: Eye pain, dry nose, insomnia, fever with slight aversion to cold, spontaneous sweating, dry tongue, and slightly surging-long pulse belong to the primary disease of Yangming Exterior syndrome. If the tongue coating is white and slippery, Ge Gen Tang (Kudzu Decoction) added with Chai Hu (Bupleuri Radix) and Huang Qin (Scutellariae Radix) is used; if ineffective, Sheng Di Huang Qin Lian Tang (Rehmannia, Scutellaria, and Coptis Decoction) is used. Later, if there is extreme thirst and yellow tongue coating, it belongs to the meridian syndrome, using Rushen Baihu Tang (Divine White Tiger Decoction); if thirst is severe, double the dose of Shi Gao (Gypsum Fibrosum), add Tian Hua Fen (Trichosanthis Radix), Huang Lian (Coptidis Rhizoma), and Zhu Ye (Bambusae Folium). Tidal fever, spontaneous sweating, tossing covers, constipation, passing foul flatus, or spontaneous passage of foul watery stool, chest oppression, and yellow tongue coating indicate Yangming secondary disease; Da Chaihu Tang is used. If ineffective, Liu Yi Shun Qi Tang (Six-Ethyl Regulating Qi Decoction) is used. If the tongue coating is black, dry, and prickly like thorns, heavily use Da Huang (Rhei Radix et Rhizoma) and Mang Xiao (Natrii Sulfas); if ineffective, add more; failure to use them leads to death. If exterior is not cleared and interior is severe, Da Chaihu Tang is used. If heat is severe, San Huang Shigao Tang (Three Yellows and Gypsum Decoction) is used. If eyes are red, San Huang Juseng Tang (Three Yellows and Sesame Decoction) is used.
Foot-Shaoyang Gallbladder Meridian: Deafness, hypochondriac pain, dry retching, bitter taste, alternating chills and fever, slight aversion to cold, scanty sweating, white tongue coating, and floating-wiry pulse indicate Shaoyang meridian disease. The gallbladder has no direct exit or entry, residing in the half-exterior half-interior region; sweating, vomiting, and purging are prohibited. Use Chaihu Shuangjie Yin (Bupleurum Dual-Solving Decoction) for harmonization. Later, if there is fever, deafness, chest fullness, vomiting, thirst, yellow tongue coating, spontaneous diarrhea, and wiry pulse, it is secondary disease; only Xiao Chaihu Tang added with Huang Lian, Zhu Ru (Bambusae Caulis in Taenia), and Zhi Shi (Aurantii Fructus Immaturus) is suitable. Add Da Huang if bowel and urinary passages are obstructed with little output.
Foot-Taiyin Spleen Meridian: Abdominal fullness, dry throat, yellow tongue coating, warm hands and feet, jaundice, difficult urination, constipation, abdominal pain, and deep-forceful pulse indicate primary disease; Gui Zhi Da Huang Tang (Cinnamon Twig and Rhubarb Decoction) is used for purgation. Later, if head sweat stops at the neck, thirst, red urine, solid stool, jaundice of body and eyes, and deep-solid pulse indicate secondary disease; Yinchen Da Huang Tang (Artemisia Capillaris and Rhubarb Decoction) is used. If there is no thirst, vomiting, free bowel movements, clear long urine, pink-red tongue, deep-weak pulse, and cold extremities, Jiawei Lizhong Tang (Modified Regulate the Middle Decoction) is indicated. Or, if initially yang syndrome, due to excessive purgation in a weak constitution, causing deficiency pathogens to transmit to yin meridians with complete cold symptoms, Lizhong Tang is used for warming supplementation.
Foot-Shaoyin Kidney Meridian: Dry mouth and throat, yellow edges and black center tongue coating, constipation or watery stool, and deep-forceful pulse indicate heat pathogen transmitting to Shaoyin primary disease; Tiaowei Chengqi Tang is used for mild purgation. Later, if there is delirium, constipation, hard pain around the umbilicus, vexation, extreme thirst, and rapid-deep pulse, it indicates heat pathogen transmitting to Shaoyin secondary disease; Da Chengqi Tang (Major Directing Downward Decoction) is used for urgent purgation. If heat pathogen transmits to the Chong vessel affecting the blood level, causing reckless blood movement, upward reversal causes hematemesis, downward pressure causes hematochezia. External signs include coma, delirium, dry tongue without coating resembling a roasted pig kidney, deep-choppy or surging-rapid pulse; Sheng Di Huang Lian E Jiao Tang (Rehmannia, Coptis, and Donkey-Hide Gelatin Decoction) or Gui Di Yang Rong Tang (Angelica and Rehmannia Nourishing Nutrient Decoction) are indicated. All above are due to heat pathogen transmitting to kidney, exhausting water, not true yin syndrome. If there is aversion to cold, cold extremities, curling up without thirst, vomiting/diarrhea, abdominal pain, heavy body, and deep-slow pulse, it belongs to zang cold; Huiyang Jiuji Tang (Restore Yang Rescue Emergency Decoction) is used for warming supplementation.
Foot-Jueyin Liver Meridian: Chest and abdominal fullness, extreme thirst drinking water, delirium, vexation, constipation or watery stool, dry tongue, yellow-black-dry coating, and deep-forceful pulse indicate heat pathogen transmitting to Jueyin primary disease; Liu Yi Shun Qi Tang is used for purgation. Later, if previous symptoms persist but hands and feet become cold or suddenly warm, this is "deep heat leads to deep cold" (reversal cold), not true cold. Deep-forceful pulse indicates secondary disease; Da Chengqi Tang is used for urgent purgation. If there is salivation, cold extremities exceeding elbows and knees, no thirst, lower abdominal pain, and deep-slow pulse, this is true yin syndrome of this meridian; Huiyang Jiuji Tang and Zhuyu Sini Tang (Evodia and Frigid Extremities Decoction) are urgently needed for warming.
Among the six meridians, only Shaoyin Kidney Meridian is ambiguous and difficult to clarify, with all pulses being deep. Deep and forceful indicates yang; use Da Huang and Mang Xiao for purgation. Deep and weak indicates yin; use Fu Zi (Aconiti Lateralis Radix Preparata), Jiang (Zingiberis Rhizoma), and Gui (Cinnamomi Ramulus) for warming supplementation. A difference of a hair leads to a thousand miles error; killing happens in the flip of a hand. One must carefully consider externally observed signs concurrently. Twelve syndromes such as "yang syndrome resembling yin" and "yin syndrome resembling yang" are discussed separately in ancient texts, making them hardest for beginners to analyze. (Hong) desiring ease of understanding for later generations, these have been compiled into two discussions. Although largely similar with minor differences, the temperature and weight of medications require careful clinical observation.