洁古曰。七表脉者。是客邪来伤主。乃阴乘阳也。其证若身热（外阳）恶寒。（内阴）是
外阳而内阴见也。七表脉。但热而不恶寒者。（表里俱属阳）是内外皆阳也。七表证。
自汗恶风。却得八里脉者。（阳证见阴脉）当用麻黄（散其阳邪）桂枝（实其阴分）各半汤。如八里
证。自汗恶风。得七表脉。（阴证见阳脉）亦用桂枝麻黄各半汤。有汗不恶风者。（腠理虚）
黄白芍汤。无汗不恶寒者。（正邪）葱豉汤。脉如浮滑而长为三阳。禁不可发
汗。经曰。阳实阴虚。汗出而死。
凡外感之邪。皆为客邪也。其病自外而入。循外踝上背络颠顶。以入腹。
人身之背属阳。腹属阴。阳气被外邪所乘。而阳气不能外卫。其证发热
恶寒者。是外阳而内阴也七表证。发热不恶寒者。是内外皆阳也。七表
证自汗恶风。却见八里脉者。是阳证得阴脉也。主弱而客强。故用麻黄
而兼桂枝各半汤。一以实其表而助阳。一以扶其标而泄阴也。八里证。
外不发热。自汗恶风。而脉是七表之脉。此为阴证见阳脉。内阳而外阴
也。当扶阳而祛阴。故用桂枝兼麻黄各半汤也。有汗不恶风者。是阳中
虚邪所致。要实其腠理。故用黄 白芍汤。无汗不恶寒者。或只发热。此
为实邪。故用葱豉汤。脉若浮滑而长。此是三阳俱病。半表半里之证。不
可发汗。恐误发汗。亡阳而死。故经曰。阳盛阴虚。汗出则死也。
按评云。此一段只体贴注解。议论会悟外。阴内阳。外阳内阴之理。内外
或皆阴。内外或皆阳。脉属阴属阳。证属阴属阳。如此推测。自然不误。
仲景曰。脉浮当汗。三阳当汗者。谓阳中有阴。夫表者。是阳分也。脉浮。亦阳
分也。浮脉客阴也。故当发汗。且阳中有阴者。阳乃荣卫之分。客阴自外而
入居之。故宜耗出而发去之。经曰。在上者因分而越之。此说非谓阳中有
形迹之阴。是阳中客邪之阴证。居其表也。
当发汗之证。是尺寸俱浮。阳中有阴也。客邪也。标病也。表之表也。客邪
自外而入。在荣之外卫之间。故脉浮宜发汗而耗去之经曰。在上者因
而越之是在太阳也。太阳自颠顶而上。其邪循背而行于上。可以越而
去之。此所谓客邪未入于内也。是无形之阴邪。居其表者。故仲景之法。
当汗而愈焉。
按仲景论中。凡脉浮当汗。又三阳俱病。不可汗。但阳分中有客邪。即当
汗。何以为客。阴在阳分中也。假如七表之脉。外证发热恶寒。又无汗或
作烦渴烦躁。只审其但兼恶寒可汗。不兼恶寒。三阳中皆阳也。不可汗。
慎之慎之。
夫三阳之表。是三阳标也。无形经络受客阴。乃表之表也。乃阳中阳分也。
宜发其客阴之邪。（别本其字作去字）故前说阳中有阴当汗。
三阳者。太阳阳明少阳也。三阳之标邪。在太阳之上。尚未入阳明少阳。
其证头身背痛。为无形中阴邪也。无形经络受客邪。乃表之表。宜发去
客邪。而阳分中之客阴。因汗而愈。洵不诬矣。
若是三阳之里。是三阳本也。主有形受邪。膀胱与胃是也。既受在有形之
处。惟宜利小便。下大便则愈。此乃阳中之阴也。此说言主。前说言客。若不
穷主客邪正之理。必伤人命。
三阳之里。谓病入阳明本也。阳中客阴传入于胃。主有形受邪。谓邪入。
于胃中糟粕也。胃与膀胱俱在有形之处。胃中饮食变化而成糟粕。其
受盛之物。乃成受邪之物也。岂不为有形之邪耶。故宜下大便而利小
便也。所谓阳中之阴。非客阴也。是主病也。本病也。明其主客之理。自不
误治之矣。
三阴当下者。夫三阴者藏也。外无所主。内无所受。所主者皮毛血脉肌肉
筋骨耳。无所受者。无所受盛也。在三阴经络中。有邪者是为无形。乃阴中
之阳。可汗而已。是经络无形受客邪。当发汗去之。为三阴标之病也。
三阴属里。夫三阴受邪。必归于太阴。而复还于阳明。何也。太阴从标本
而化。归于受盛之官。变化出焉。为有形迹之阴邪。自当下之而愈。若是
无形中所受。乃三阴标之病也。外有所主者。谓脉尚系弦紧洪滑等。至
七表之脉也。病虽传里。而经络之中。尚为客邪也。是三阴之标。未入三
阴之本者。若入三阴之本。则所受盛矣。经曰。无形之邪。乃阴中之阳。故
曰可汗。谓还当解表。不可擅下也。至于三阴之本。当下之证。解见下文。
三阴本者。藏也。盛则终归于胃。是有形病也。当自各经络中药入胃去之。
此乃三阴当下也。是为阴中之阴。可下而愈。此为主之阴。非是客邪之阴
也夫客主共论。阴中有阳。当下去之者。阴中者主也。有阳者客邪也。言阴
经中受阳邪。染于有形物中。不得出者可下。
三阴之本。本之本也。里之里也。里证若盛。则燥渴。其脉必实。是客阴归
于阳明。为有形迹之阴。乃主中之阴。非客邪之阴也。经曰。经络中受阳
邪。更染于有形物中。其阳邪积于脏腑不得出者。故当下之而愈也。
略说八里。乃阳乘阴也。其证身凉四肢厥。恶热。是外阴而内阳也。但寒不
热不渴者。是内外皆阴也。仲景云。厥深热亦深。厥微热亦微。口伤烂赤。因
发汗得之。
八里之证。病在乎内。阳邪乘于阴经。邪入三阴也。阳邪客阴也。三阴经
络。主阴也。客阳传于主中之阴。故曰阳乘阴也。故证身凉不发热。四肢
属阳。但阴盛阳盛。故四肢冷厥。而又恶寒者。是阴中有阳。为外阴而内
阳也。若是四肢冷厥。不恶寒。不作渴。是内外皆寒。内外纯阴之证也。仲
景云。热深厥亦深。热微厥亦微。口伤烂赤者。此又一阳证也。乃阳盛阴
虚。因医家误发汗而致之者。内经曰。三阴可温。而不可汗者宜也。
夫七表八里。发汗吐下。治伤寒必当仔细论之。七表八里。互相交变。乃坏
证。来（此节疑有脱简）理脉中。一说六脉交变。浮滑长为三阳。乃阳中有阴。沉涩短为
三阴。乃阴中有阳。当审察表里。分其内外。以辨虚实。治从标本。万举万当。
治伤寒要分辨阴阳虚实标本轻重之法。七表八里。互相交变。不可不
细论之。六脉交变。浮滑长为阳脉。沉涩短为阴脉。三阴三阳。两相交而
两相变。有阳变而为阴。有阴变而为阳者。如七表证。而得八里之脉。此
阳证见阴脉。为坏证也。八里证而得七表之脉。此阴证见阳脉。可以生
也。阳中有阴。阴中有阳。变化无穷。可不认其阴阳虚实表里标本而治
之也哉。
夫标本者。太阴有标本之化。少阴亦然。（阴字乃阳字之讹。）太阳标热而本寒。从此生
七表。少阴标寒而本热。从此生八里。太阴标本皆阴。少阳标本皆阳。惟阳
明与厥阴。不从标本。从乎中也。此举六气之标本也。
太阳标热而本寒者。太阳属君火。故标热本寒者。谓应膀胱。膀胱属水。
所以本寒。少阳胆经。禀肝木。木中有火。所以标本皆阳。阳明属胃。燥土
也。谓四脏寒热之气。皆归于土。而能变化。所以无标本之应。土居中央。
故曰从乎中也。从此生七表也。太阴标寒而本热者。太阴湿土。为柔和
之土也。土中有湿气而生焉。故曰标寒。而又与阳明胃之燥土。同归一
经。所以本热也。少阴有标本之化者。少阴属肾。标应膀胱水。本应三焦
火。水与火交。所以有标本之化。厥阴属胆。厥阴胆经。居于左胁。故不从
标本。而木气只干脾胃。禀于两关。故曰从乎中也。从此生八里也。所谓
六气之标本者。温风寒外来之邪。从标而入者。燥湿暑。内生之邪。从本
而出者。
按六微旨大论云。少阳之上。火气治之。中见厥阴。阳明之上。燥气治之。
中见太阴。太阳之上。寒气治之。中见少阴。厥阴之上。风气治之。中见少
阳。少阴之上。热气治之。中见太阳。太阴之上。湿气治之。中见阳明。所谓
本也。本之下。中之见也。见之下。气之标也。本标不同。气应异象。
叔和所载者。是七表八里。九道脉诀。二十四道脉之标本也。皆有从标从
本。从乎中。假令太阳少阴。各有标本之化。太阳脉浮。少阴脉沉。此乃浮沉交。
叔和所载。七表八里。时为伤寒虚实而设。又立九道脉。诸天地九九之
数。共成为二十四道脉之标本也。标以明其表阴也。本以明其里阳也。
中能变化。从乎中土也。所谓太阳少阴。各有标本之化者。阳浮而动。故
阳邪为天行之气。阴沉而静。故阴从中土而出。标入于本。而本能变化。
故浮与沉交。要不越乎二十四道脉之标本也。
内经曰。若从标本论之。是为长短交。长以发汗。短以下长曰阳明。短曰太
阴。长者阳明。当解表利小便。短者太阴。当下。土郁则夺之。令无壅碍。故长
脉发之。短脉下之者。是滑与涩交。滑居寸而热。涩居尺而寒。滑居尺而热。
涩居寸而寒。涩脉居尺寸。皆损气。滑居尺寸皆助阴阳。内经云。脉滑曰生。
脉涩曰死。此是三阴三阳。变化表里。略举数端。随脉条下。尽穷其理。有不
尽者。于各部脉说内详之。
伤寒脉滑曰生。脉涩曰死。三阴三阳。表里交变。滑脉为阳。涩脉为阴。有
阳证而得阳脉者。有阴证而得阴脉者。有阳证而得阴脉者。有阴证而
得阳脉者。阴阳变化。则脉有滑与涩交。是为阴阳中交变。至若长与短
交。是为表里中变化。浮与沉交。亦是为表里中交变。类而推之。于滑涩
交。总之滑者吉。涩者凶。不过一表里虚实阴阳。互相交变而已。此论略
说数端。最尽其理。学人当神而明之自然了于心矣。
七表脉
洁古说：七表脉，是客邪侵袭损伤主气，属于阴乘阳。其症状若表现为身热（外阳）恶寒（内阴），这是外阳而内阴的表现。七表脉中，只有发热而不恶寒的，（表里都属于阳），这是内外皆阳。七表证中，自汗、恶风，却出现八里脉的，（阳证见到阴脉），应当使用麻黄汤（发散阳邪）、桂枝汤（充实阴分）各半汤。如果是八里证，自汗、恶风，却出现七表脉的，（阴证见到阳脉），也使用桂枝麻黄各半汤。有汗但不恶风的，（腠理虚弱），用黄白芍汤；无汗但不恶寒的，（正气与邪气相争），用葱豉汤。脉象如浮滑且长，属于三阳病，禁止发汗。经书说：阳实阴虚，发汗会导致死亡。
凡是外感之邪，都是客邪。病邪从外部进入，沿着外踝上行至背部，联络头顶，再进入腹部。人体的背部属阳，腹部属阴。阳气被外邪所乘，导致阳气不能在外护卫，其症状为发热、恶寒的，这是外阳而内阴，属于七表证。发热而不恶寒的，这是内外皆阳，也是七表证。自汗、恶风，却出现八里脉的，这是阳证得到阴脉。因为主气弱而客邪强，所以使用麻黄兼桂枝各半汤。一方以充实体表而助阳，另一方以扶持标症而泄阴。八里证，外部不发热，自汗、恶风，而脉象是七表脉，这是阴证见到阳脉，内阳而外阴。应当扶助阳气而祛除阴邪，所以使用桂枝兼麻黄各半汤。有汗但不恶风的，这是阳中虚邪所致，需要充实腠理，所以用黄白芍汤。无汗但不恶寒的，或者只发热，这是实邪，所以用葱豉汤。脉象如果浮滑而长，这是三阳俱病，属于半表半里的证候，不可发汗，恐怕误发汗导致亡阳而死。所以经书说：阳盛阴虚，发汗就会死。
按语评论说：这一段只是体贴注解，议论领悟之外，在于阴内阳、外阳内阴的道理。内外或皆阴，内外或皆阳，脉属阴属阳，证属阴属阳，如此推测，自然不错误。
仲景说：脉浮当发汗。三阳当发汗的，是指阳中有阴。所谓表，是阳分。脉浮，也是阳分。浮脉是客阴，所以应当发汗。况且阳中有阴的，阳是营卫之分，客阴从外部进入占据其中，所以宜耗散排出并发出它。经书说：在上者因势利导而越之。这种说法并非指阳中有有形迹的阴，而是指阳中客邪的阴证，居于表位。
应当发汗的证候，是寸关尺三部脉都浮，阳中有阴，是客邪，是标病，是表中之表。客邪从外部进入，在荣气的外卫之间，所以脉浮宜发汗而耗散去除它。经书说：在上者因势利导而越之，这是在太阳经。太阳从头顶而上，邪气沿着背部行于上部，可以越而去之。这所谓客邪未进入内部，是无形的阴邪，居于表位，所以仲景的法度，应当发汗而痊愈。
按仲景论述中，凡脉浮当发汗，又说三阳俱病不可发汗。只要阳分中有客邪，就应当发汗。什么是客？阴在阳分中就是客。假如七表脉，外证发热恶寒，又无汗或出现烦渴烦躁，只需审察是否兼有恶寒，可发汗；如果不兼恶寒，三阳中皆属阳，不可发汗。慎之又慎。
夫三阳之表，是三阳的标，无形经络受客阴，乃是表中之表，乃阳中之阳分。宜发其客阴之邪。（别本“其”字作“去”字）。所以前说阳中有阴当发汗。
三阳，即太阳、阳明、少阳。三阳的标邪，在太阳之上，尚未进入阳明、少阳。其症状为头身背痛，为无形的阴邪。无形经络受客邪，乃是表中之表，宜发去客邪，而阳分中的客阴，因发汗而痊愈，确实无误。
如果是三阳之里，是三阳的本，主有形受邪，膀胱与胃是。既然受邪在有形之处，只宜利小便，通大便则愈。这是阳中之阴。此说言主，前说言客。若不穷究主客邪正的道理，必伤人命。
三阳之里，谓病入阳明本。阳中客阴传入于胃，主有形受邪，谓邪进入胃中糟粕。胃与膀胱都在有形之处，胃中饮食变化而成糟粕，其受盛之物，乃成受邪之物，岂不为有形之邪吗？所以宜下大便而利小便。所谓阳中之阴，不是客阴，是主病，是本病。明其主客的道理，自然不会误治。
三阴当下者。夫三阴是藏，外无所主，内无所受。所主的是皮毛、血脉、肌肉、筋骨等。无所受者，是无所受盛。在三阴经络中，有邪者是为无形，乃阴中之阳，可发汗而已。是经络无形受客邪，当发汗去除它，为三阴标的病。
三阴属里。夫三阴受邪，必归于太阴，而复还于阳明。为什么呢？太阴从标本而化，归于受盛之官，变化出焉，为有形迹之阴邪，自当下之而愈。若是无形中所受，乃三阴标的病。外有所主的，谓脉尚系弦紧洪滑等，至七表脉。病虽传里，而经络之中，尚为客邪，是三阴之标，未入三阴之本者。若入三阴之本，则所受盛矣。经书说：无形之邪，乃阴中之阳，所以说可发汗，谓还应当解表，不可擅自攻下。至于三阴之本，当下之证，解释见下文。
三阴之本，是藏，盛则终归于胃，是有形病，应当从各自经络中药入胃去之。此乃三阴当下也，是为阴中之阴，可下而愈。这是主之阴，不是客邪之阴。夫客主共论，阴中有阳，当下去之者，阴中者是主，有阳者是客邪。言阴经中受阳邪，染于有形物中，不得出者可下。
三阴之本，是本之本，里之里。里证若盛，则燥渴，其脉必实，是客阴归于阳明，为有形迹之阴，乃主中之阴，非客邪之阴。经书说：经络中受阳邪，更染于有形物中，其阳邪积于脏腑不得出者，故当下之而愈。
略说八里，乃阳乘阴也。其症状身凉四肢厥冷，恶热，是外阴而内阳。但寒不热不渴的，是内外皆阴。仲景说：厥深热亦深，厥微热亦微。口伤烂赤，因发汗得之。
八里之证，病在乎内，阳邪乘于阴经，邪入三阴。阳邪客阴，三阴经络主阴，客阳传于主中之阴，故曰阳乘阴。故症状身凉不发热，四肢属阳，但阴盛阳盛，故四肢冷厥，而又恶寒的，是阴中有阳，为外阴而内阳。若是四肢冷厥，不恶寒，不作渴，是内外皆寒，内外纯阴之证。仲景说：热深厥亦深，热微厥亦微。口伤烂赤者，此又一阳证，乃阳盛阴虚，因医家误发汗而致之。内经说：三阴可温，而不可汗者宜也。
夫七表八里，发汗吐下，治伤寒必当仔细论之。七表八里互相交变，乃坏证。（此节疑有脱简）理脉中，一说六脉交变。浮滑长为三阳，乃阳中有阴；沉涩短为三阴，乃阴中有阳。当审察表里，分其内外，以辨虚实，治从标本，万举万当。
治伤寒要分辨阴阳虚实标本轻重之法。七表八里互相交变，不可不细论之。六脉交变，浮滑长为阳脉，沉涩短为阴脉。三阴三阳，两相交而两相变，有阳变而为阴，有阴变而为阳者。如七表证，而得八里之脉，此阳证见阴脉，为坏证。八里证而得七表之脉，此阴证见阳脉，可以生也。阳中有阴，阴中有阳，变化无穷，可不认其阴阳虚实表里标本而治之哉。
夫标本者，太阴有标本之化，少阴亦然。（“阴”字乃“阳”字之讹）。太阳标热而本寒，从此生七表；少阴标寒而本热，从此生八里。太阴标本皆阴，少阳标本皆阳。惟阳明与厥阴，不从标本，从乎中也。此举六气之标本。
太阳标热而本寒者，太阳属君火，故标热；本寒者，谓应膀胱，膀胱属水，所以本寒。少阳胆经，禀肝木，木中有火，所以标本皆阳。阳明属胃，燥土也，谓四脏寒热之气，皆归于土，而能变化，所以无标本之应。土居中央，故曰从乎中也。从此生七表。太阴标寒而本热者，太阴湿土，为柔和之土也，土中有湿气而生焉，故曰标寒。而又与阳明胃之燥土，同归一经，所以本热。少阴有标本之化者，少阴属肾，标应膀胱水，本应三焦火，水与火交，所以有标本之化。厥阴属胆，厥阴胆经，居于左胁，故不从标本，而木气只干脾胃，禀于两关，故曰从乎中也。从此生八里。所谓六气之标本者，温风寒外来之邪，从标而入者；燥湿暑，内生之邪，从本而出者。
按《六微旨大论》说：少阳之上，火气治之，中见厥阴；阳明之上，燥气治之，中见太阴；太阳之上，寒气治之，中见少阴；厥阴之上，风气治之，中见少阳；少阴之上，热气治之，中见太阳；太阴之上，湿气治之，中见阳明。所谓本也。本之下，中之见也；见之下，气之标也。本标不同，气应异象。
叔和所载者，是七表八里、九道脉诀、二十四道脉之标本。皆有从标、从本、从乎中。假令太阳、少阴，各有标本之化。太阳脉浮，少阴脉沉，此乃浮沉交。叔和所载七表八里，时为伤寒虚实而设，又立九道脉，诸天地九九之数，共成为二十四道脉之标本。标以明其表阴，本以明其里阳，中能变化，从乎中土。所谓太阳少阴各有标本之化者，阳浮而动，故阳邪为天行之气；阴沉而静，故阴从中土而出。标入于本，而本能变化，故浮与沉交，要不越乎二十四道脉之标本。
内经说：若从标本论之，是为长短交。长以发汗，短以下。长曰阳明，短曰太阴。长者阳明，当解表利小便；短者太阴，当下。土郁则夺之，令无壅碍。故长脉发之，短脉下之者，是滑与涩交。滑居寸而热，涩居尺而寒；滑居尺而热，涩居寸而寒。涩脉居尺寸，皆损气；滑居尺寸，皆助阴阳。内经云：脉滑曰生，脉涩曰死。此是三阴三阳，变化表里，略举数端，随脉条下，尽穷其理，不尽者，于各部脉说内详之。
伤寒脉滑曰生，脉涩曰死。三阴三阳，表里交变。滑脉为阳，涩脉为阴。有阳证而得阳脉者，有阴证而得阴脉者，有阳证而得阴脉者，有阴证而得阳脉者。阴阳变化，则脉有滑与涩交，是为阴阳中交变。至若长与短交，是为表里中变化；浮与沉交，亦是为表里中交变。类而推之，于滑涩交，总之滑者吉，涩者凶，不过一表里虚实阴阳，互相交变而已。此论略说数端，最尽其理，学人当神而明之，自然了于心矣。
七表脉
Jieguo stated: The seven superficial pulses (Qibiao Mai, seven types of superficial pulses indicating exterior syndromes) represent the invasion of pathogenic factors damaging the host qi, which is Yin encroaching upon Yang. If the symptoms manifest as fever (exterior Yang) and aversion to cold (interior Yin), this indicates an exterior Yang and interior Yin presentation. In cases of seven superficial pulses where there is only fever without aversion to cold, (both the interior and exterior belong to Yang), indicating that both interior and exterior are Yang. For seven superficial syndrome presenting with spontaneous sweating and wind aversion, yet accompanied by eight interior pulses (Bali Mai, eight types of interior pulses indicating interior syndromes), (a Yang syndrome presenting with Yin pulses), one should use Mahuang Guizhi Banxia Tang (Half-and-Half Decoction of Ephedra, Cinnamon Twig, and Pinellia) composed of half doses of Mahuang Tang (Ephedra Decoction) (to disperse Yang pathogens) and Guizhi Tang (Cinnamon Twig Decoction) (to tonify Yin). If it is an eight interior syndrome with spontaneous sweating and wind aversion, but presenting with seven superficial pulses, (a Yin syndrome presenting with Yang pulses), one should also use Mahuang Guizhi Banxia Tang. For those with sweating but no wind aversion, (due to deficient Couli / interstices), use Huangbai Shaoyao Tang (Huangbai and White Peony Root Decoction); for those without sweating but no aversion to cold, (due to conflict between righteous Qi and pathogens), use Congchi Tang (Scallion and Fermented Soybean Decoction). If the pulse is floating, slippery, and long, it belongs to the Three Yang channels; sweating therapy is contraindicated. The Classics state: When Yang is excess and Yin is deficient, inducing sweat will lead to death.
All external contracted pathogens are considered guest pathogens. The disease enters from the exterior, traveling up along the lateral malleolus to the back, connecting to the vertex, and then entering the abdomen. The human back belongs to Yang, and the abdomen belongs to Yin. When Yang Qi is invaded by external pathogens and cannot defend the exterior, resulting in fever and aversion to cold, this is an exterior Yang and interior Yin presentation, characteristic of the seven superficial syndrome. Fever without aversion to cold indicates both interior and exterior are Yang, also a seven superficial syndrome. Spontaneous sweating and wind aversion appearing with eight interior pulses indicate a Yang syndrome receiving Yin pulses. Since the host is weak and the guest pathogen is strong, one uses Mahuang combined with Guizhi Banxia Tang. One aspect solidifies the exterior and assists Yang, while the other supports the branch and drains Yin. In an eight interior syndrome, with no external fever, spontaneous sweating, and wind aversion, but presenting with seven superficial pulses, this is a Yin syndrome presenting with Yang pulses, indicating interior Yang and exterior Yin. One should support Yang and dispel Yin, thus using Guizhi combined with Mahuang Banxia Tang. Sweating without wind aversion is caused by deficiency and evil within Yang, requiring the solidification of the Couli (interstices), hence the use of Huangbai Shaoyao Tang. No sweating without aversion to cold, or merely fever, indicates excess pathogens, hence the use of Congchi Tang. If the pulse is floating, slippery, and long, this indicates disease in all Three Yang channels, representing a half-exterior half-interior syndrome; sweating therapy is prohibited. Erroneous sweating may lead to the loss of Yang and death. Thus, the Classics state: Excess Yang and deficient Yin, inducing sweat leads to death.
The commentary notes: This section provides detailed annotation, elucidating the principles of Yin inside/Yang outside and Yang inside/Yin outside. Whether interior and exterior are both Yin or both Yang, whether the pulse belongs to Yin or Yang, and whether the syndrome belongs to Yin or Yang, such deduction ensures accuracy.
Zhongjing stated: A floating pulse indicates the need for sweating. The Three Yang channels require sweating when there is Yin within Yang. The "exterior" refers to the Yang division. A floating pulse also belongs to the Yang division. Floating pulse represents guest Yin, hence sweating is indicated. Regarding "Yin within Yang," Yang refers to the Ying (Nutrient) and Wei (Defensive) divisions. Guest Yin enters from the exterior and occupies this space, so it should be dispersed and expelled via sweating. The Classics state: "For those above, induce vomiting or expulsion." This does not refer to tangible Yin within Yang, but rather to a Yin syndrome of guest pathogens residing at the exterior.
Syndromes requiring sweating present with floating pulses at the Cun, Guan, and Chi positions, indicating Yin within Yang, representing guest pathogens, branch diseases, and the exterior of the exterior. Guest pathogens enter from outside, residing between the exterior defense of Ying Qi; thus, a floating pulse indicates the need for sweating to disperse them. The Classics state: "For those above, induce expulsion." This applies to the Taiyang channel. Taiyang rises from the vertex, and pathogens travel along the back upwards, allowing for expulsion via sweating. This signifies that guest pathogens have not entered internally; they are formless Yin pathogens residing at the exterior. Therefore, Zhongjing's method dictates recovery through sweating.
According to Zhongjing's discussions, a floating pulse generally requires sweating, yet he also states that when all Three Yang channels are diseased, sweating is prohibited. However, if there is a guest pathogen in the Yang division, sweating is indicated. What constitutes a guest? Yin residing in the Yang division is a guest. For example, with seven superficial pulses, if external symptoms include fever and aversion to cold, plus absence of sweating or irritability/thirst, one must examine if aversion to cold is present. If aversion to cold is present, sweating is allowed; if not, and all Three Yang are purely Yang, sweating is prohibited. Exercise extreme caution.
The exterior of the Three Yang is their branch. Formless meridians receiving guest Yin constitute the "exterior of the exterior," which is the Yang within Yang. It is appropriate to expel the guest Yin pathogen. (Another version reads "remove" instead of "its"). Hence, the previous statement that "Yin within Yang requires sweating."
The Three Yang are Taiyang, Yangming, and Shaoyang. The branch pathogens of the Three Yang are located above Taiyang and have not yet entered Yangming or Shaoyang. Symptoms include headache, body pain, and back pain, representing formless Yin pathogens. Formless meridians receiving guest pathogens constitute the "exterior of the exterior"; it is appropriate to expel the guest pathogens, and the guest Yin within the Yang division will resolve through sweating, which is indeed correct.
If it is the interior of the Three Yang, it is their root, primarily involving tangible organs receiving pathogens, specifically the Bladder and Stomach. Since the pathogens reside in tangible locations, treatment should focus on promoting urination and bowel movements for recovery. This is Yin within Yang. This statement refers to the Host (Zhu), whereas the previous referred to the Guest (Ke). Failure to thoroughly understand the principles of Host/Guest and Righteous/Pathogenic will inevitably harm life.
The interior of the Three Yang refers to disease entering the root of Yangming. Guest Yin from Yang transmits to the Stomach, involving tangible reception of pathogens, meaning pathogens enter the fecal matter in the stomach. The Stomach and Bladder are in tangible locations. Food and drink processed in the Stomach become fecal matter; the substances received become the objects of pathogenic invasion, constituting tangible pathogens. Therefore, purgation of bowels and promotion of urination are indicated. The so-called "Yin within Yang" here is not guest Yin, but Host disease or Root disease. Clarifying the Host/Guest principle prevents misdiagnosis.
For Three Yin syndromes requiring purgation: The Three Yin are Zang organs, having no external mastery and no internal reception. They govern skin, hair, blood vessels, muscles, sinews, and bones. "No internal reception" means no capacity to receive and store. Pathogens in the Three Yin meridians are formless, representing Yang within Yin, and can be treated with sweating. Formless pathogens in meridians should be expelled via sweating, constituting branch diseases of the Three Yin.
Three Yin belong to the interior. When Three Yin receive pathogens, they must return to Taiyin and then revert to Yangming. Why? Taiyin transforms according to its Branch and Root, returning to the official of reception and transformation, producing tangible Yin pathogens, which should be purged for recovery. If the reception is formless, it is a branch disease of the Three Yin. External manifestations include pulses such as wiry, tight, surging, or slippery, reaching the seven superficial pulses. Although the disease has transmitted inward, pathogens still reside in the meridians as guest pathogens, constituting the branch of the Three Yin, not yet entering the root. If it enters the root of the Three Yin, it becomes received/stored. The Classics state: "Formless pathogens are Yang within Yin," hence "sweating is allowed," meaning one should still resolve the exterior and not arbitrarily purge. As for Three Yin root syndromes requiring purgation, explanations follow below.
The root of Three Yin is the Zang. Excess eventually returns to the Stomach, constituting tangible disease. Medicines should enter the Stomach from respective meridians to eliminate it. This is the indication for purgation in Three Yin, representing Yin within Yin, recoverable by purgation. This is Host Yin, not guest Yin. Discussing Host and Guest together: Yin contains Yang. Those requiring downward elimination due to being within Yin are the Host; the Yang component is the guest pathogen. This refers to Yang pathogens invading Yin meridians and contaminating tangible substances, making them unreleasable except by purgation.
The root of Three Yin is the root of the root, the interior of the interior. If interior syndromes are severe, there is dryness and thirst, and the pulse must be excess. This indicates guest Yin returning to Yangming, forming tangible Yin, which is Yin within the Host, not guest Yin. The Classics state: "Yang pathogens received in meridians further contaminate tangible substances; when these Yang pathogens accumulate in Zang-Fu and cannot exit, purgation is required for recovery."
Briefly discussing Eight Interior pulses: This is Yang encroaching upon Yin. Symptoms include cool body and cold limbs, aversion to heat, indicating exterior Yin and interior Yang. Only cold, no heat, no thirst indicates both interior and exterior are Yin. Zhongjing said: "The deeper the cold extremities, the deeper the heat; the slighter the cold extremities, the slighter the heat." Mouth ulcers and redness result from erroneous sweating.
Eight interior syndromes involve internal disease, where Yang pathogens invade Yin meridians, entering the Three Yin. Yang pathogens invade Yin; Three Yin meridians govern Yin. Guest Yang transmits to Host Yin, hence "Yang encroaching upon Yin." Symptoms include cool body without fever. Limbs belong to Yang, but due to Yin excess or Yang excess, limbs are cold and厥 (cold extremities). If accompanied by aversion to cold, it is Yin containing Yang, i.e., exterior Yin and interior Yang. If limbs are cold and 厥 without aversion to cold or thirst, it is both interior and exterior cold, a pure Yin syndrome. Zhongjing said: "Heat deep, extremities deep; heat slight, extremities slight." Mouth ulcers and redness represent another Yang syndrome, caused by Yang excess and Yin deficiency due to physician's erroneous sweating. The Inner Canon states: "Three Yin may be warmed, but should not be sweated."
Regarding Seven Superficial and Eight Interior pulses, sweating, vomiting, and purgation must be carefully discussed in treating Cold Damage. Seven Superficial and Eight Interior pulses interact and transform, leading to complicated syndromes. (This section likely has missing text). Regarding pulse analysis, some say six pulses interact. Floating, slippery, and long pulses indicate Three Yang, representing Yang within Yin; sinking, choppy, and short pulses indicate Three Yin, representing Yin within Yang. One must examine exterior/interior, distinguish internal/external, differentiate deficiency/excess, and treat according to Root/Branch for success.
Treating Cold Damage requires distinguishing Yin/Yang, Deficiency/Excess, Root/Branch, and severity. Seven Superficial and Eight Interior pulses interact; this must be discussed in detail. Six pulse interactions: Floating, slippery, and long are Yang pulses; sinking, choppy, and short are Yin pulses. Three Yin and Three Yang intersect and transform; Yang transforms into Yin, and Yin into Yang. For instance, a Seven Superficial syndrome presenting with Eight Interior pulses is a Yang syndrome with Yin pulses, a complicated syndrome. An Eight Interior syndrome presenting with Seven Superficial pulses is a Yin syndrome with Yang pulses, which can survive. Yang contains Yin, Yin contains Yang; transformations are infinite. How can one treat without recognizing Yin/Yang, Deficiency/Excess, Exterior/Interior, and Root/Branch?
Root and Branch: Taiyin has Root-Branch transformation; Shaoyin is similar ("Yin" character is an error for "Yang"). Taiyang Branch is Heat, Root is Cold, generating Seven Superficial pulses. Shaoyin Branch is Cold, Root is Heat, generating Eight Interior pulses. Taiyin Root and Branch are both Yin; Shaoyang Root and Branch are both Yang. Only Yangming and Jueyin do not follow Root/Branch but follow the Middle. This illustrates the Root/Branch of the Six Qi.
Taiyang Branch Heat, Root Cold: Taiyang belongs to Sovereign Fire, hence Branch Heat. Root Cold corresponds to the Bladder, which belongs to Water, hence Root Cold. Shaoyang Gallbladder meridian inherits Liver Wood; Wood contains Fire, hence Root and Branch are both Yang. Yangming belongs to Stomach, Dry Earth. It is said that the cold/heat Qi of the four Zang organs returns to Earth and transforms, hence no specific Root/Branch correspondence. Earth resides centrally, hence "following the Middle." This generates Seven Superficial pulses. Taiyin Branch Cold, Root Heat: Taiyin is Wet Earth, a gentle Earth. Moisture arises within Earth, hence Branch Cold. It shares the same meridian with Yangming Stomach's Dry Earth, hence Root Heat. Shaoyin has Root-Branch transformation: Shaoyin belongs to Kidney, Branch corresponds to Bladder Water, Root corresponds to Sanjiao Fire. Water and Fire intersect, hence Root-Branch transformation. Jueyin belongs to Gallbladder (Note: Text says Jueyin belongs to Gallbladder, but traditionally Jueyin is Pericardium/Liver; text implies Jueyin Gallbladder meridian located in left hypochondrium, hence does not follow Root/Branch, but Wood Qi affects Spleen/Stomach, inheriting from both Guan positions, hence "following the Middle." This generates Eight Interior pulses. Regarding the Root/Branch of Six Qi: Warmth, Wind, Cold are external pathogens entering via Branch; Dryness, Dampness, Summer-heat are internal pathogens exiting via Root.
According to the *Treatise on the Great Meaning of the Six Microcosms*: Above Shaoyang, Fire Qi governs, intermediate sees Jueyin; above Yangming, Dryness Qi governs, intermediate sees Taiyin; above Taiyang, Cold Qi governs, intermediate sees Shaoyin; above Jueyin, Wind Qi governs, intermediate sees Shaoyang; above Shaoyin, Heat Qi governs, intermediate sees Taiyang; above Taiyin, Dampness Qi governs, intermediate sees Yangming. This is the Root. Below the Root is the Intermediate manifestation; below the Intermediate is the Branch Qi. Root and Branch differ, Qi responds with different phenomena.
He Shuhe recorded the Root/Branch of Seven Superficial, Eight Interior, Nine Pulse Categories, and Twenty-Four Pulse Types. All involve following Branch, Root, or Middle. For example, Taiyang and Shaoyin each have Root-Branch transformations. Taiyang pulse is floating, Shaoyin pulse is sinking; this is the intersection of floating and sinking. He Shuhe's Seven Superficial and Eight Interior were established for Cold Damage deficiency/excess, adding nine pulse categories. Combined with the number of Heaven and Earth (nine times nine), they form the twenty-four pulse types' Root/Branch. Branch clarifies exterior Yin; Root clarifies interior Yang; Middle enables transformation, following Central Earth. Regarding Taiyang and Shaoyin Root-Branch transformations: Yang floats and moves, so Yang pathogens are heavenly traveling Qi; Yin sinks and is quiet, so Yin emerges from Central Earth. Branch enters Root, and Root transforms, hence floating and sinking intersect, not exceeding the twenty-four pulse types' Root/Branch.
The Inner Canon states: Discussing from Root/Branch perspective, this is Long-Short interaction. Long indicates sweating; Short indicates purgation. Long is Yangming, Short is Taiyin. Long (Yangming) requires resolving exterior and promoting urination; Short (Taiyin) requires purgation. When Earth is stagnant, drain it to remove obstruction. Hence, Long pulse induces sweating, Short pulse induces purgation. This is Slippery-Choppy interaction. Slippery at Cun indicates Heat; Choppy at Chi indicates Cold; Slippery at Chi indicates Heat; Choppy at Cun indicates Cold. Choppy pulse at Cun/Chi damages Qi; Slippery pulse at Cun/Chi assists Yin/Yang. The Inner Canon says: Slippery pulse indicates life; Choppy pulse indicates death. This illustrates Three Yin/Three Yang transforming Exterior/Interior. Briefly listing several points, following pulse categories to exhaust principles.未尽者, see detailed explanations in respective pulse sections.
In Cold Damage, Slippery pulse indicates life, Choppy pulse indicates death. Three Yin/Three Yang, Exterior/Interior interact. Slippery pulse is Yang, Choppy pulse is Yin. There are Yang syndromes with Yang pulses, Yin syndromes with Yin pulses, Yang syndromes with Yin pulses, and Yin syndromes with Yang pulses. Yin-Yang transformation causes Slippery-Choppy interaction, representing Yin-Yang internal interaction. Long-Short interaction represents Exterior-Interior change; Floating-Sinking interaction also represents Exterior-Interior interaction. By analogy, regarding Slippery-Choppy interaction, generally Slippery is auspicious, Choppy is ominous. It is merely the mutual interaction of Exterior/Interior, Deficiency/Excess, and Yin/Yang. This discussion briefly covers several points, exhausting the principles. Students should comprehend it spiritually and naturally understand it in heart.
Seven Superficial Pulses