伤寒热病同看脉。满子透关洪拍拍。出至风门过太阳。一日之中见脱厄。
过关微有慢腾腾。直至伏时重候觅。
张世贤曰。寒者。冬气也。冬时严寒万类深藏。君子固密。不伤于寒。触冒
之者。乃名伤寒。伤寒不即病者。其寒毒藏于肌肤中。至夏至前。变为温
病。夏至后。变为热病。然其发起。皆伤寒所致也。故看脉之法相同。洪拍
拍。即洪惊也。伤寒之病。一日巨阳。二日阳明。三日少阳。四日太阴。五日
少阴。六日厥阴。六日传经已毕。其病当愈。七日不愈。邪应复传。其脉洪
大。而通过三关。从风门穴而出。过于太阳之经。其邪欲散。一日之中。当
得汗而愈矣。其脉过关微带缓慢。其邪至太阳亦迟。日间不汗。直至伏
时再等候其汗也。伏时。即临卧时也。承日中而言。
掌内迢迢散漫行。干瘥疼疔多未的。（他本无此二句）大凡当日问程途。迟数洪微更
消息。
张世贤曰。伤寒热病未汗。脉须浮洪。既汗脉当安静。散漫之脉。不汗而
愈。其平复未可全许也。愚按伤寒一证。谓之大病。与杂病不同。变幻多
端。疑似不一。学人须要整等时日。另下工夫。潜心仲景之书。熟玩节庵
之论。访之时贤。执之专门。庶不负为人之司命也。岂古人立三百九十
七法。一百一十三方。反不如今人之便捷也。奈今之医者。不读仲景之
书。不采诸贤之论。几句油腔。一味活套。便曰我能治伤寒矣。及乎临证。
则茫无所措。强以杂病之法治之。所以当汗不汗。不当汗而汗。当下不
下。不当下而下。误人岂浅鲜哉。即以古人尚论之。亦尺有所短。寸有所
长。伤寒一证。乃仲景所长。非叔和所长也。夫孔子非不知乐也。但不若
师旷之聪耳。孔子非不知射也。但不若养由之神耳。叔和非不知伤寒
也。但不若仲景之圣耳。故叔和于伤寒数则。不甚畅明。或以年远。颇有
错简。此正不必为叔和讳也。予故于此诀。亦不敢为诠释。姑存之以俟
后之高明者。
伤寒与热病在诊脉时应同等看待。脉象满溢透关，洪大有力如拍击状。脉气出于风门穴，经过太阳经。若在一日之内见到脱厄之象（指邪气将解或病情转折的关键时刻）。
脉气过关时略微显得缓慢从容。直到傍晚时分再仔细寻察脉象。
张世贤说：寒，是冬季的气候特征。冬季严寒，万物深藏，君子应严密防护，不使受寒。若是触犯冒犯寒气，这才称为伤寒。受了寒邪但没有立即发病的，其寒毒潜伏在肌肤之中，到夏至之前，转变为温病；夏至之后，转变为热病。然而它们的发起，都是由伤寒引起的。所以诊脉的方法相同。“洪拍拍”，即“洪惊”之意。伤寒的病传变规律是：第一天传巨阳经，第二天传阳明经，第三天传少阳经，第四天传太阴经，第五天传少阴经，第六天传厥阴经。六天传经完毕，病应当痊愈。如果第七天还不愈，邪气应当再次传变。此时脉象洪大，并通过三关，从风门穴而出，越过太阳经。此时邪气欲散，一日之内，应当通过发汗而痊愈。如果脉气过关时略微带有缓慢之象，说明邪气到达太阳经也较迟缓，白天不出汗，直到傍晚时分再等待其出汗。傍晚，就是临睡的时候，相对于中午而言。
脉气在掌内遥远地散漫运行，身体干枯、病后虚弱、疼痛、疔疮等大多未确切诊断。（其他版本没有这两句）大凡当日询问病程远近，需仔细斟酌脉象的迟、数、洪、微。
张世贤说：伤寒热病在未发汗前，脉象应当浮洪；既已发汗，脉象应当安静平和。出现散漫无根的脉象，即使看似不药而愈，也不能完全断定其已平复康复。我认为伤寒这一证候，被称为大病，与普通杂病不同，变化多端，疑似情况不一。学习者必须整段时日，另外下功夫，潜心研读张仲景的著作，熟读节庵（李中梓号）的论述，向当时的名医请教，坚守专门之学，才不辜负作为医生救死扶伤的职责。难道古人设立的三百九十七法、一百一十三方，反而不如今人便捷吗？无奈现在的医者，不读张仲景的书，不采纳各位贤者的论述，只凭几句油滑套话，一味机械套用，便说自己能治伤寒了。等到临证时，则茫然不知所措，强行用治疗杂病的方法来治疗。所以当汗而不汗，不当汗却汗下，当下而不攻下，不当下却攻下，误人性命难道还少吗？即以古人的观点来评论，也是尺有所短，寸有所长。伤寒这一证候，是张仲景的专长，不是王叔和的专长。孔子并非不懂音乐，只是不如师旷听力敏锐；孔子并非不懂射箭，只是不如养由基射术神奇；王叔和并非不懂伤寒，只是不如张仲景圣明。所以王叔和在伤寒方面的论述，不够通畅明了，或许因为年代久远，颇有竹简错乱之处。这正不必为王叔和避讳。所以我在这部歌诀中，也不敢妄加诠释，暂且保留它，以期待后来高明的人来完善。
Pulse diagnosis for Shanghan (Cold Damage) and Rebing (Heat Disease) should be treated with equal importance. The pulse is full, penetrating the three passes, vast (Hong) and forceful like a beating drum. It emerges from the Fengmen point and traverses the Taiyang meridian. If within one day, signs of "Tuo E" (a critical turning point or resolution of pathogenic factors) appear.
When the pulse crosses the passes, it may appear slightly slow and leisurely. One must carefully seek its characteristics until the evening hours.
Zhang Shixian stated: Cold is the qi of winter. In winter, when it is bitterly cold, all things hide deeply. A gentleman maintains strict defense and does not suffer from cold. Those who are exposed to and offended by cold are said to have contracted Shanghan. If one contracts cold pathogens but does not fall ill immediately, the cold toxicity hides within the skin and muscles. Before the Summer Solstice, this transforms into Wenbing (Warm Disease); after the Summer Solstice, it transforms into Rebing (Heat Disease). However, their onset is caused by Shanghan. Therefore, the method of pulse diagnosis is the same. "Hong Paipa" refers to the Hong (Vast) pulse, also known as "Hong Jing." The transmission of Shanghan follows a daily pattern: on the first day, it affects the Juyang (Taiyang) meridian; on the second day, Yangming; on the third day, Shaoyang; on the fourth day, Taiyin; on the fifth day, Shaoyin; and on the sixth day, Jueyin. After six days, the transmission through the meridians is complete, and the disease should heal. If it does not heal on the seventh day, the pathogen should transmit again. At this stage, the pulse is vast and large, passing through the three passes, emerging from the Fengmen point, and crossing over the Taiyang meridian. The pathogen is about to scatter, and within one day, sweating should occur leading to recovery. If the pulse crossing the passes shows a slight slowness, it indicates that the pathogen reaches the Taiyang meridian slowly. If there is no sweating during the day, one must wait until the evening time for sweating to occur. "Fushi" refers to the time before sleep, in contrast to midday.
The pulse qi wanders remotely and diffusely within the palm; conditions such as dryness, post-illness weakness, pain, and ding sores are often not accurately diagnosed. (These two lines are absent in other editions.) Generally, one must inquire about the duration of the illness on the current day and carefully deliberate upon the pulse qualities of Chi (Slow), Shu (Rapid), Hong (Vast), and Wei (Fine).
Zhang Shixian stated: For Shanghan and Rebing before sweating, the pulse must be Floating and Vast; after sweating, the pulse should be calm and quiet. A diffuse and rootless pulse suggests that although recovery might seem imminent without medication, one cannot fully guarantee that the patient has completely returned to health. I opine that Shanghan is considered a major disease, distinct from miscellaneous diseases. It undergoes numerous transformations and presents various ambiguous symptoms. Students must dedicate substantial time and effort, study the works of Zhang Zhongjing with deep concentration, familiarize themselves with the discussions of Jie'an (Li Zhongzi), consult contemporary experts, and adhere to specialized knowledge. Only then will they live up to their responsibility as physicians saving lives. Are the 397 methods and 113 prescriptions established by the ancients really less convenient than those of modern practitioners? Regrettably, many modern physicians do not read Zhang Zhongjing’s books nor adopt the theories of previous sages. Relying only on slick phrases and rigid formulas, they claim to treat Shanghan. Yet, when facing clinical cases, they are at a loss and forcibly apply treatments for miscellaneous diseases. Thus, they fail to induce sweating when necessary, induce sweating when inappropriate, fail to purge when needed, and purge when unnecessary. How could such errors not cause significant harm? Even evaluating ancient figures, there are strengths and weaknesses. Shanghan is Zhang Zhongjing’s specialty, not Wang Shuhe’s. Confucius did not lack knowledge of music, but his hearing was not as acute as Shi Kuang’s; Confucius did not lack skill in archery, but his accuracy was not as divine as Yang Youji’s; Wang Shuhe did not lack understanding of Shanghan, but his sagacity was not as profound as Zhang Zhongjing’s. Therefore, Wang Shuhe’s discussions on Shanghan are not entirely clear, possibly due to textual corruption from long ages past. There is no need to conceal these faults for Wang Shuhe. Thus, I dare not provide interpretations for this verse here, but rather preserve it, awaiting future scholars of high caliber to refine it.