寸口诸微亡阳诸濡亡血诸弱发热诸紧为寒诸乘寒者则为厥郁冒不仁以胃无谷气脾涩不通口急不能言战而栗也
成 卫阳也微为卫气微故云亡阳荣血也濡为荣气弱故云亡血弱为阴虚虚则发热紧为阴胜故为寒诸乘寒者则阴阳
俱
虚而为寒邪乘之也寒乘气虚抑伏阳气不得宣发遂成厥也郁冒为昏冒不知仁也不仁为强直而无觉也为尸厥焉以胃无谷气
致脾涩不通于上下故使口急不能言其曰战者寒在表也栗者寒在里也
问曰濡脉何以反适十一头师曰五脏六腑相乘故令十一
成 濡弱者气血也往反有十一头头者五脏六腑共有十一也
问曰何以知乘腑何以知乘脏师曰诸阳浮数为乘腑诸阴迟涩为乘脏也
成 腑阳也阳脉见者为乘腑也脏阴也阴脉见者为乘脏也阳濡而弱则乘于腑阴濡而弱则乘于脏
伤寒方药虽成氏注释颇为明晰而未能尽药性之奥故特以仲景一百一十三方中所用九十种药性采诸家之说以发明
之学人诚能熟玩而详究焉则长沙用药制方之遗意庶几不昧而亦可以引而伸之触类而长之矣
（味之薄者阴中之阳味薄则通酸苦咸平是也）
麻黄 气温 味苦辛气味俱薄阳也升也无毒手太阳之剂入足太阳经走手少阴经阳明经药发太阳少阴经汗
〔垣〕轻可
去实麻黄葛根之属是也六淫有余之邪客于阳分皮毛之间腠理闭拒荣卫气血不行故谓之实二药轻清成象故可去之麻黄微
苦其形中空阴中之阳入足太阳寒水之经其经循背下行本寒而又受外寒故宜发汗去皮毛气分寒邪以泄表实若过发则汗多
亡阳或饮食劳倦及杂病自汗表虚之证用之则脱人元气不可不禁〔海〕麻黄治卫实之药桂枝治卫虚之药二物虽为太
阳证药
其实荣卫药也心主荣为血肺主卫为气故麻黄为手太阴肺之剂桂枝为手少阴心之剂伤寒伤风而咳嗽用麻黄桂枝即汤液之
源也珍 仲景治伤寒无汗用麻黄有汗用桂枝历代名医解释皆随文傅会未有究其精微者时珍常绎思之似有一得与昔人所
解不同云津液为汗汗即血也在荣则为血在卫则为汗夫寒伤荣荣血内涩不能外通于卫卫气闭固津液不行故无汗发热而憎
寒夫风伤卫卫气外泄不能内护于荣荣气虚弱津液不固故有汗发热而恶风然风寒之邪皆由皮毛而入皮毛者肺之合也肺主
卫气包罗一身天之象也是证虽属乎太阳而肺实受邪气其证时兼面赤怫郁咳嗽有痰喘而胸满诸证者非肺病乎盖皮毛外闭
则邪热内攻而肺气愤郁故用麻黄甘草同桂枝引出荣分之邪达之肌表佐以杏仁泄肺而利气汗后无大热而喘者加以石膏朱
肱活人书夏至后加石膏知母皆是泄肺火之药是则麻黄汤虽太阳发汗重剂实为发散肺经火郁之药也腠理不密则津液外泄
而肺气自虚虚则铺其母故用桂枝同甘草外散风邪以救表内伐肝木以防脾佐以芍药泄木而固脾泄东所以补西也使以姜枣
行脾之津液而和荣卫也下后微喘者加浓朴杏仁以利肺气也汗后脉沉迟者加人参以益肺气也朱肱加黄芩为阳旦汤以泻肺
热也皆是脾肺之药是则桂枝虽太阳解肌轻剂实为理脾救肺之药也〔修治〕去芦及根节锉细以流水煮二三沸掠去上
沫不尔
使人心烦服麻黄自汗不止者以冷水浸头发仍以根节煎汤止之凡服麻黄药须避风不尔病复作也
细辛 气温味大辛气浓于味阳也无毒少阴经药手少阴引经之药〔垣〕 治少阴头痛如神当少用之独活为使
温阴经散水寒以去内寒治邪在里之表故仲景少阴证用麻黄附子细辛汤也〔易老〕治少阴头痛太阳则羌活少阴则细
辛阳明则白芷厥阴则川芎吴茱萸少阳则柴胡用者随经不可差细辛香味俱细而缓故入少阴与独活相类〔修治〕拣去
双叶者以瓜水浸一宿晒干铡细用
柴胡 气平味微苦气味俱轻阳也升也无毒少阳经厥阴经引经之药除虚劳烦热解肌热去往来寒热早晨潮热妇人
产前产
后必用之药善除本经头痛非他药能止治心下痞胸膈痛〔海〕在经主气在脏主血前行则恶热却退则恶寒惟气之微寒
味之薄
者故能行经能去脏腑内外俱之既能引清气上行而顺阳道盖以少阳之气初出地之皮为嫩阳故以少阳当之〔修治〕去
芦铡细
竹筛齐之用
葛根 气平味甘无毒阳明经引经药足阳明经行经的药治脾胃虚而渴除胃热解酒毒〔陶〕生葛捣汁饮解
温病
发热〔颂〕仲
景治伤寒有葛根汤以其主大热解肌发腠理故也〔洁〕升阳生津脾虚作渴者非此不除勿多用恐伤胃气张仲景治太阳
阳
明合
病桂枝汤内加麻黄葛根又有葛根黄芩黄连解肌汤是用此以断太阳入阳明之路非即太阳药也头颅痛如破乃阳明中风可用
葛根葱白汤为阳明仙药若太阳初病未入阳明而头痛者不可便服升麻葛根发之是反引邪气入阳明为引贼破家也〔珍〕
本草
十剂云轻可去实麻黄葛根之属盖麻黄乃太阳经药兼入肺经肺主皮毛葛根乃阳明经药兼入脾经脾主肌肉所以二味药皆轻
扬发散而所入迥然不同也〔修治〕铡细竹筛齐之用
升麻 气平味苦甘味薄气浓阳中之阴也无毒阳明经本经药〔垣〕能解肌肉间热此手足阳明经伤风之的
药也若补脾胃非
此为引用不能补若得葱白白芷之类亦能走手足阳明太阴发散本经风邪元气不足者用此于阴中升阳气上行升麻入足阳明
若初病太阳证便服升麻葛根发出阳明经汗或失之过阳明经燥太阳经不可解必传阳明矣投汤不当非徒无益而又害之也朱
氏云瘀血入里若衄血吐血者犀角地黄汤乃阳明经圣药也如无犀角以升麻代之升麻犀角性味相远不同何以代之盖以升麻
止是引地黄及余药同入阳明耳仲景云太阳病若发汗若利小便重亡津液胃中干燥因转属阳明其害不可胜言又云太阳KT
KT无汗者葛根汤发之若KT KT 自汗者表虚也不宜用此朱氏用升麻者以表实无汗也〔修治〕刮去黑皮去腐烂
里白者佳
锉细竹筛齐之始可用
葱白 气平味辛无毒瓦斯浓味薄升也阳也入手太阴足阳明经专主发散以通上下阳气故活人书治伤寒头痛如破用
连须葱
白汤主之张仲景治少阴病下利清谷里寒外热厥逆脉微者白通汤主之内用葱白若面色赤者四逆汤加葱白腹中痛者去葱白
成无己解之曰肾恶燥急食辛以润之葱白辛温以通阳气也〔珍〕葱乃释家五荤之一生辛散熟甘温外实中空肺之菜也
肺病宜食之肺主气外应皮毛其合阳明故所治之证多属太阴
阳明皆取其通气发散之功通气故能解毒及理血病气者血之帅也气通则血活矣故金疮等用之皆有殊效
瓜蒂（甜瓜蒂也） 气寒味苦有毒病如桂枝证头不痛项不强寸脉微浮胸中痞硬气上冲咽喉不得息者此为胸中有
寒也当
吐之太阳中 身热疼重而脉微弱此夏月伤冷水水行皮中也宜吐之少阳病头痛发寒热脉紧不大是膈上有痰也宜吐之病胸
上诸实郁郁而痛不能食欲人按之而反有浊唾下利日十余行寸口脉微弦者当吐之懊 烦躁不得眠未经汗下者谓之实烦当
吐之宿食在上脘者当吐之并宜以瓜蒂散主之惟诸亡血虚家不可与瓜蒂散也〔成〕高者越之在上者涌之故越以瓜蒂
香豉之
苦涌以赤小豆之酸酸苦涌泄为阴也〔垣〕难经云上部有脉下部无脉其人当吐不吐者死此饮食内伤填塞胸中食伤太
阴风木
生发之气伏于下宜瓜蒂散吐之素问所谓木郁则达之也吐去上焦有形之物则木得舒畅天地交而万物通矣若尺脉绝者不宜
用此恐损真元令人胃气不复也〔珍〕瓜蒂乃阳明经除湿热之药故能引去胸脘痰涎头目湿气皮肤水气黄胆湿热诸证
甜瓜蒂
以团而短者良若长如瓠子者此名菜瓜不可用也气足时其蒂自然落在蔓上采得系屋东有风处吹干用
桔梗 气微温味苦辛甘有小毒味浓气轻阳中之阴升也入手太阴肺经气分及足少阴经治咽喉痛利肺气〔洁〕
桔梗清肺气利咽喉其色白故为肺部引经与甘草同行为舟楫之剂如大黄苦泄峻下之药欲引至胸中至高之分成功须用辛甘
之剂升之譬如铁石入江非舟楫不载所以诸药有此一味不能下沉也〔珍〕朱肱活人书治胸中痞满不痛用桔梗枳壳取
其通肺利膈下气也张仲景伤寒论治寒实结胸用桔梗贝母巴豆取其温中消谷破积又治肺痈唾脓用桔梗甘草取其苦辛清肺甘
温泻火又能排脓血补内漏其治少阴证二三日咽痛亦用桔梗甘草取其苦辛散寒甘平除热合而用之能调寒热也后人易名甘桔
汤通治咽喉口舌诸病宋仁宗加荆芥防风连翘遂名如圣汤去芦米泔浸一宿焙干锉片竹筛齐用
寸口脉微，是阳气亡失的表现；脉濡，是阴血亡失的表现；脉弱而发热，是阴虚生热的表现；脉紧，是寒邪盛的表现。凡是寒邪侵袭人体，就会导致四肢厥冷、头昏目眩、肢体麻木不仁。这是因为胃中缺乏水谷精气，脾运化涩滞、气机不通，导致口唇拘急不能言语，身体战栗发抖。
成无己注：卫阳之气微弱，所以称为亡阳；营血虚弱，所以称为亡血；脉弱表示阴虚，虚则生热；脉紧表示阴胜，所以为寒。所谓“诸乘寒者”，是指阴阳俱虚，寒邪趁机侵袭。寒邪乘袭气虚之处，压抑伏匿阳气，使其不得宣发，从而形成厥证。郁冒是指神志昏蒙不知人事；不仁是指肢体强直且没有知觉，这属于尸厥一类。因为胃中没有水谷之气，导致脾气涩滞，上下气机不通，所以出现口急不能言语。所谓的“战”，是因为寒邪在表；所谓的“栗”，是因为寒邪在里。
问：为什么濡脉反而能对应十一头（指五脏六腑）？
答：这是因为五脏六腑相互影响，所以令其对应十一头。
成无己注：濡和弱代表气血的状态。往来变化有十一头，“头”指的是五脏六腑共有十一个。
问：如何知道病邪侵犯的是腑？如何知道病邪侵犯的是脏？
答：凡是阳脉浮数，就是病邪侵犯腑；凡是阴脉迟涩，就是病邪侵犯脏。
成无己注：腑属阳，见到阳脉就是病邪侵犯腑；脏属阴，见到阴脉就是病邪侵犯脏。如果脉象濡弱，则是邪气侵犯腑；如果脉象濡弱，则是邪气侵犯脏。
虽然《伤寒论》的方药已有成无己的注释，解释颇为清晰，但未能穷尽药性的奥妙。因此，特别从张仲景一百一十三首方剂中所使用的九十种药物中，采集各家学说，以阐明其药性。学者如果能熟读玩味并详细研究，那么长沙太守张仲景用药制方的遗意或许就不会被埋没，并且可以由此引申，触类旁通。
（气味薄的药物，属于阴中之阳。味薄则能通利，酸、苦、咸平的药物即属此类。）
麻黄：气温，味苦辛，气味都薄，属阳，主升，无毒。是手太阳经的药剂，入足太阳经，走手少阴经和阳明经。药物能发散太阳经和少阴经的汗。
[李杲] 轻扬的药物可以去实邪，如麻黄、葛根之类。六淫有余之邪客居在阳分皮毛之间，腠理闭拒，营卫气血不行，所以称为实邪。这两味药轻清成形，所以可以去除此邪。麻黄味微苦，形状中空，属阴中之阳，入足太阳寒水之经。该经循行背部下行，本属寒而又受外寒侵袭，所以适宜发汗，以去除皮毛气分的寒邪，宣泄表实。如果发汗过度，会导致汗多亡阳。或者对于饮食劳倦及杂病自汗、表虚的证候，使用麻黄则会耗脱人的元气，不可不谨慎。
[张元素] 麻黄是治疗卫分实邪的药物，桂枝是治疗卫分虚邪的药物。这两味药虽然常用于太阳证，但实际上是调理营卫的药物。心主营，主血；肺主卫，主气。所以麻黄是手太阴肺经的药剂，桂枝是手少阴心经的药剂。伤寒伤风而咳嗽，用麻黄、桂枝，这就是汤液的源头。
[李时珍] 张仲景治疗伤寒无汗用麻黄，有汗用桂枝。历代名医的解释都是随文附会，没有探究其精微之处。我时常思考，似乎有所心得，与昔人解释不同。津液化为汗，汗即是血。在营则为血，在卫则为汗。寒邪伤营，营血内涩，不能外通于卫，卫气闭固，津液不行，所以无汗、发热而憎寒。风邪伤卫，卫气外泄，不能内护于荣，荣气虚弱，津液不固，所以有汗、发热而恶风。然而风寒之邪皆由皮毛而入，皮毛是肺的合应处。肺主卫气，包罗一身，像天的形象。这个证候虽然属于太阳，但肺实际上受了邪气。其证候时常兼见面赤怫郁、咳嗽、有痰、喘促而胸满等症状，这不是肺病吗？大概皮毛外闭，则邪热内攻，肺气愤郁，所以用麻黄、甘草同桂枝，引出营分之邪，达之于肌表，佐以杏仁泄肺而利气。发汗后如果没有大热但仍有喘症，加上石膏。朱肱《活人书》说夏至后加石膏、知母，这些都是泄肺火的药物。由此可见，麻黄汤虽然是太阳经发汗的重剂，实际上是发散肺经火郁的药物。如果腠理不密，则津液外泄，肺气自然虚弱。虚则补其母，所以用桂枝同甘草，外散风邪以救表，内伐肝木以防脾（注：此处原文逻辑较复杂，意指调和肝脾），佐以芍药泄木而固脾，泄东（肝）所以补西（肺）。使姜枣运行脾的津液来调和营卫。下法后微喘的，加厚朴、杏仁以利肺气。发汗后脉沉迟的，加人参以益肺气。朱肱加黄芩为阳旦汤，以泻肺热。这些都是脾肺经的药物。由此可见，桂枝虽然是太阳经解肌的轻剂，实际上是理脾救肺的药物。
[修治] 去掉芦头和根节，锉细，用流水煮二三沸，掠去上面的沫，否则会使人心烦。服用麻黄后汗不止的，用冷水浸头发，仍以根节煎汤止汗。凡服用麻黄药，必须避风，否则病会复发。
细辛：气温，味大辛，气浓于味，属阳，无毒。是少阴经的药，手少阴经的引经药。
[李杲] 治疗少阴头痛效果如神，应当少量使用，以独活为使药。温散阴经的水寒之气，以去除内寒。治疗邪气在里的表证，所以张仲景治疗少阴证时用麻黄附子细辛汤。
[易老] 治疗少阴头痛，太阳经用羌活，少阴经用细辛，阳明经用白芷，厥阴经用川芎、吴茱萸，少阳经用柴胡。使用者根据经络选用，不可差错。细辛香味都细微而缓和，所以入少阴经，与独活类似。
[修治] 拣去双叶的，用瓜水浸泡一夜，晒干，铡细备用。
柴胡：气平，味微苦，气味都轻，属阳，主升，无毒。是少阳经、厥阴经的引经药。除虚劳烦热，解肌热，去往来寒热，早晨潮热。是妇人产前产后必用的药物。善于消除本经头痛，不是其他药能比的。治疗心下痞、胸膈痛。
[张元素] 在经主要调气，在脏主要调血。前行则恶热，却退则恶寒。只有气微寒、味薄的药物，才能行经，能去除脏腑内外之邪。既能引导清气上行而顺从阳道，盖因少阳之气初出地面，皮层嫩阳，所以以少阳当之。
[修治] 去掉芦头，铡细，用竹筛齐整备用。
葛根：气平，味甘，无毒。是阳明经的引经药，足阳明经的行经药。治疗脾胃虚弱而口渴，除胃热，解酒毒。
[陶弘景] 生葛捣汁饮用，可解温病发热。
[苏颂] 张仲景治疗伤寒有葛根汤，因为它主治大热，解肌发腠理。
[张洁古] 升阳生津。脾虚作渴的，不用此药不能消除。不要多用，恐怕损伤胃气。张仲景治疗太阳阳明合病，桂枝汤内加麻黄、葛根。又有葛根黄芩黄连解肌汤，是用此药来阻断太阳传入阳明的路径，它不是单纯的太阳经药。头颅痛如破，乃阳明中风，可用葛根葱白汤，这是阳明经的神仙药。如果太阳初病未入阳明而头痛，不可立即服用升麻、葛根发散，这是反引邪气入阳明，如同引贼破家。
[李时珍] 《本草十剂》说：轻可去实，如麻黄、葛根之类。麻黄是太阳经药，兼入肺经，肺主皮毛；葛根是阳明经药，兼入脾经，脾主肌肉。所以这两味药都是轻扬发散，但所入经络截然不同。
[修治] 铡细，用竹筛齐整备用。
升麻：气平，味苦甘，味薄气浓，属阳中之阴，无毒。是阳明经的本经药。
[李杲] 能解肌肉间的热，这是手足阳明经伤风的对症药物。如果要补脾胃，非此药作为引经药不能补。如果得到葱白、白芷之类，也能行走手足阳明、太阴经，发散本经风邪。元气不足的人使用此药，是在阴中升举阳气上行。升麻入足阳明经。如果初病太阳证就服用升麻、葛根发出阳明经汗，或者失误过多，阳明经燥，太阳经不可解，必定传变到阳明了。投汤不当，不仅无益，反而有害。朱氏说瘀血入里，如果有衄血、吐血的情况，犀角地黄汤是阳明经的圣药。如果没有犀角，可以用升麻代替。升麻和犀角性味相差很远，不同，为什么要代替？大概是因为升麻只是引导地黄及其他药物一同进入阳明经罢了。张仲景说：太阳病，如果发汗，如果利小便，重伤津液，胃中干燥，因而转属阳明，其害不可胜言。又说：太阳病无汗的，用葛根汤发汗；如果自汗的，是表虚，不宜用此。朱氏用升麻，是因为表实无汗。
[修治] 刮去黑皮，去掉腐烂部分，里面白色的为佳。锉细，用竹筛齐整后才可使用。
葱白：气平，味辛，无毒，瓦斯浓味薄，主升，属阳。入手太阴、足阳明经。专门主发散，以通上下阳气。所以《活人书》治疗伤寒头痛如破，用连须葱白汤主治。张仲景治疗少阴病下利清谷、里寒外热、厥逆脉微的，用白通汤主治，内用葱白。如果面色赤的，用四逆汤加葱白。腹中痛的，去掉葱白。成无己解释：肾恶燥，急食辛以润之。葱白辛温，以通阳气。
[李时珍] 葱是释家五荤之一。生吃辛散，熟吃甘温。外实中空，是肺的菜。肺病宜食之。肺主气，外应皮毛，其合阳明。所以所治疗的证候多属太阴、阳明，都取其通气发散之功。通气故能解毒及理血病。气是血的统帅，气通则血活。所以金疮等症使用都有特殊疗效。
瓜蒂（甜瓜蒂）：气寒，味苦，有毒。病状如桂枝证，头不痛，项不强，寸脉微浮，胸中痞硬，气上冲咽喉不得息，这是胸中有寒，应当吐之。太阳中暑，身热疼重而脉微弱，这是夏月伤冷水，水行皮中也，宜吐之。少阳病头痛发寒热，脉紧不大，是膈上有痰，宜吐之。病胸上诸实，郁郁而痛，不能食，欲人按之而反有浊唾，下利日十余行，寸口脉微弦者，当吐之。懊憹烦躁不得眠，未经汗下的，谓之实烦，当吐之。宿食在上脘的，当吐之。并宜以瓜蒂散主治。只有各种亡血、虚家不可给予瓜蒂散。
[成无己] 高者越之，在上者涌之。所以用瓜蒂、香豉之苦涌吐，以赤小豆之酸，酸苦涌泄为阴。
[李杲] 《难经》说：上部有脉，下部无脉，其人当吐，不吐者死。这是饮食内伤，填塞胸中，食伤太阴风木生发之气，伏于下，宜瓜蒂散吐之。《素问》所谓木郁则达之。吐去上焦有形之物，则木得舒畅，天地交而万物通。如果尺脉绝的，不宜用此，恐怕损伤真元，令人胃气不复。
[李时珍] 瓜蒂是阳明经除湿热的药，所以能引去胸脘痰涎、头目湿气、皮肤水气、黄疸湿热诸证。
甜瓜蒂：以团而短者为良。如果长如瓠子的，此名菜瓜，不可用。气足时，其蒂自然落在蔓上。采得系屋东有风处吹干备用。
桔梗：气微温，味苦辛甘，有小毒。味浓气轻，属阳中之阴，主升。入手太阴肺经气分及足少阴经。治疗咽喉痛，利肺气。
[张洁古] 桔梗清肺气，利咽喉。其色白，故为肺部引经药。与甘草同行，为舟楫之剂。如大黄苦泄峻下之药，想引至胸中至高之分成功，必须用辛甘之剂升之。譬如铁石入江，非舟楫不载。所以诸药有此一味，不能下沉。
[李时珍] 朱肱《活人书》治疗胸中痞满不痛，用桔梗、枳壳，取其通肺利膈下气。张仲景《伤寒论》治疗寒实结胸，用桔梗、贝母、巴豆，取其温中消谷破积。又治疗肺痈唾脓，用桔梗、甘草，取其苦辛清肺，甘温泻火，又能排脓血补内漏。其治疗少阴证二三日咽痛，亦用桔梗、甘草，取其苦辛散寒，甘平除热。合而用之，能调寒热。后人改名为甘桔汤，通治咽喉口舌诸病。宋仁宗加荆芥、防风、连翘，遂名如圣汤。去芦，米泔浸一夜，焙干，锉片，用竹筛齐整备用。
The pulse at the cunkou position that is faint indicates the loss of Yang Qi; a soggy (Ru) pulse indicates the loss of Blood; a weak pulse accompanied by fever indicates deficiency-heat arising from Yin deficiency; a tight pulse indicates an excess of Cold. When Cold pathogenic factors invade, they lead to Jue (cold extremities), Yu Mao (dizziness and confusion), and Bu Ren (numbness and lack of sensation). This occurs because the Stomach lacks Grain Qi, the Spleen's transformation is sluggish with blocked Qi mechanism, resulting in tightness of the mouth preventing speech, trembling, and shivering.
Cheng Wuji annotated: The Wei (Defensive) Yang Qi is faint, hence termed "loss of Yang"; the Ying (Nutritive) Blood is weak, hence termed "loss of Blood"; a weak pulse signifies Yin deficiency, and deficiency generates heat; a tight pulse signifies Yin excess, thus indicating Cold. "Various invasions by Cold" refers to a state where both Yin and Yang are deficient, allowing Cold pathogenic factors to take advantage. Cold invading areas of Qi deficiency suppresses and traps the Yang Qi, preventing its dissemination, thereby forming Jue syndrome. Yu Mao refers to mental confusion and unconsciousness; Bu Ren refers to stiffness and insensibility of the limbs, which belongs to the category of Corpse Jue. Because the Stomach lacks Grain Qi, causing the Spleen's Qi to become sluggish and the upper and lower mechanisms to be unconnected, tightness of the mouth and inability to speak occur. The term "Zhan" (trembling/shivering) indicates Cold in the Exterior; "Li" (shuddering/trembling) indicates Cold in the Interior.
Question: Why does the Ru (soggy) pulse correspond to the "Eleven Heads"?
Answer: Because the Five Zang and Six Fu organs influence each other, it corresponds to the Eleven Heads.
Cheng Wuji annotated: Ru and Weak pulses represent the state of Qi and Blood. The variations involve eleven heads; "Heads" refers to the total of five Zang and six Fu organs.
Question: How can one know if the pathogen has invaded the Fu organs? How can one know if it has invaded the Zang organs?
Answer: If the pulse is Floating and Rapid (Yang pulses), the pathogen has invaded the Fu organs; if the pulse is Slow and Choppy (Yin pulses), the pathogen has invaded the Zang organs.
Cheng Wuji annotated: Fu organs belong to Yang; seeing Yang pulses indicates invasion of the Fu organs. Zang organs belong to Yin; seeing Yin pulses indicates invasion of the Zang organs. If the pulse is Ru and Weak, the pathogen invades the Fu; if the pulse is Ru and Weak, the pathogen invades the Zang.
Although Cheng Wuji's annotations on Shanghan formulas are quite clear, they do not exhaust the mysteries of herb properties. Therefore, I have specifically collected theories from various schools regarding the ninety herbs used in Zhang Zhongjing's 113 formulas to elucidate their properties. If scholars can study these carefully, the intentions behind Zhang Changsha's prescription making will not be lost, and one can extend this knowledge through analogy.
(Herbs with thin flavor belong to Yang within Yin. Thin flavors promote circulation; Sour, Bitter, Salty, and Neutral herbs fall into this category.)
Ephedrae Herba (Mahuang, 麻黄): Temperature is Warm; Flavor is Bitter and Acrid. Both Qi and Flavor are thin, belonging to Yang, ascending, non-toxic. It is a formula for the Hand-Taiyang channel, enters the Foot-Taiyang channel, travels to the Hand-Shaoyin and Yangming channels. It induces sweating from the Taiyang and Shaoyin channels.
[Li Gao] Light herbs can dispel excess. Examples include Mahuang and Gegen. When excess pathogens from the six climatic factors lodge in the Yang aspect between the skin and hair, closing the pores and blocking Ying and Wei Qi and Blood, it is called Excess. These two herbs are light and clear, thus capable of removing this excess. Mahuang is slightly bitter and hollow, representing Yang within Yin. It enters the Foot-Taiyang Water channel. This channel runs down the back; it is inherently Cold and receives external Cold, so inducing sweat is appropriate to release Cold pathogens from the skin and Qi level, draining exterior excess. Over-sweating leads to excessive sweating and loss of Yang Qi. For cases of spontaneous sweating due to dietary/labor fatigue or miscellaneous diseases with exterior deficiency, using Mahuang will deplete Yuan Qi; caution is required.
[Zhang Yuansu] Mahuang treats Wei Excess; Guizhi Tang (Cinnamon Twig Decoction) treats Wei Deficiency. Although often used for Taiyang syndrome, they actually regulate Ying and Wei. Heart governs Ying/Blood; Lung governs Wei/Qi. Thus, Mahuang is a Hand-Taiyin Lung herb, and Guizhi Tang is a Hand-Shaoyin Heart herb. For cough due to Shanghan or Fengshang, using Mahuang and Guizhi Tang is the source of decoctions.
[Li Shizhen] Zhang Zhongjing used Mahuang for anhidrosis (no sweat) and Guizhi Tang for hyperhidrosis (sweating). Past physicians explained this merely according to the text without exploring the essence. I have pondered this and found insights differing from predecessors. Body fluids transform into sweat; sweat is blood. In Ying, it is blood; in Wei, it is sweat. Cold injuring Ying causes internal stagnation of Ying Blood, preventing connection to Wei, while Wei Qi closes and solidifies, stopping fluid flow, leading to no sweat, fever, and aversion to cold. Wind injuring Wei causes Wei Qi to leak externally, failing to protect Ying internally, leading to Ying deficiency, insecure fluids, resulting in sweating, fever, and aversion to wind. However, Wind-Cold enters via the skin and hair, which are the exterior of the Lung. The Lung governs Wei Qi and envelops the body like Heaven. Although this syndrome belongs to Taiyang, the Lung actually receives the pathogen. Symptoms often include red face, oppression, cough, phlegm, wheezing, and chest fullness—is this not a Lung disease? Generally, closed skin and hair allow pathogenic heat to attack inward, causing Lung Qi stagnation. Thus, Mahuang and Gancao (Licorice Root) combined with Guizhi Tang draw out Ying-level pathogens to the muscle surface, assisted by Xingren (Apricot Seed) to drain Lung and benefit Qi. After sweating, if there is no high fever but wheezing remains, add Shigao (Gypsum). Zhu Gong's *Huoren Shu* states adding Shigao and Zhimu after Summer Solstice are drugs to drain Lung fire. Thus, although Mahuang Tang is a heavy sweating agent for Taiyang, it is essentially a drug to disperse Lung Fire Stagnation. If pores are not tight, fluids leak externally, and Lung Qi becomes deficient. Deficiency requires tonifying the mother, so Guizhi Tang combined with Gancao disperses Wind externally to save the exterior and controls Liver Wood internally to protect the Spleen. Assisted by Shaoyao (Peony Root) to drain Wood and secure the Spleen, draining East (Liver) to supplement West (Lung). Ginger and Jujube move Spleen fluids to harmonize Ying and Wei. After purgation, if slight wheezing occurs, add Houpo (Magnolia Bark) and Xingren to benefit Lung Qi. After sweating, if pulse is Deep and Slow, add Renshen (Ginseng) to benefit Lung Qi. Zhu Gong added Huangqin (Scutellaria Root) to create Yangdan Tang to drain Lung heat. These are all Spleen and Lung herbs. Thus, although Guizhi Tang is a light muscle-relieving agent for Taiyang, it is essentially a Spleen-regulating and Lung-saving drug.
[Processing] Remove rhizome and root joints, chop finely. Boil in running water for 2-3 boils, skim off foam; otherwise, it causes heart vexation. If sweating continues after taking Mahuang, immerse hair in cold water or decoct root joints to stop sweating. Avoid wind when taking Mahuang, or the illness will recur.
Asari Radix (Xixin, 细辛): Temperature is Warm; Flavor is Pungent. Qi is denser than flavor, belonging to Yang, non-toxic. It is a Shaoyin channel herb and a guiding herb for the Hand-Shaoyin channel.
[Li Gao] Treats Shaoyin headache effectively; use in small doses. Use Du Huo (Angelica Pubescens Root) as guide. Warms Yin channels, disperses Water-Cold to remove internal Cold. Treats pathogen in the interior-exterior, so Zhang Zhongjing uses Mahuang Fuzi Xixin Tang (Ephedra, Aconite, and Asari Decoction) for Shaoyin syndrome.
[Yi Lao] For Shaoyin headache, use Qianghuo (Notopterygium Root) for Taiyang, Xixin for Shaoyin, Baizhi (Angelica Dahurica Root) for Yangming, Chuanxiong (Ligusticum Rhizome) and Wuzhuyu (Evodia Fruit) for Jueyin, Chaihu (Bupleurum Root) for Shaoyang. Choose according to channel. Xixin has subtle fragrance and flavor, entering Shaoyin, similar to Du Huo.
[Processing] Select single-leaf specimens, soak in melon water overnight, dry, chop finely.
Bupleuri Radix (Chaihu, 柴胡): Temperature is Neutral; Flavor is Slightly Bitter. Both Qi and Flavor are light, belonging to Yang, ascending, non-toxic. It is a guiding herb for Shaoyin and Jueyin channels. It removes deficiency labor vexation-heat, relieves muscle heat, resolves alternating chills and fever, morning tidal fever. It is essential for women before and after childbirth. It excellently removes headache of its own channel, superior to other herbs. Treats epigastric stuffiness and chest/hypochondriac pain.
[Zhang Yuansu] In the channel, it governs Qi; in the Zang, it governs Blood. Moving forward causes aversion to heat; retreating causes aversion to cold. Only herbs with mild Cold Qi and thin Flavor can travel channels and remove pathogens inside and outside organs. It guides Clear Qi upward following the Yang pathway. Since Shaoyang Qi emerges from the earth like tender young Yang, it corresponds to Shaoyang.
[Processing] Remove rhizome, chop finely, sieve uniformly.
Puerariae Lobatae Radix (Gegen, 葛根): Temperature is Neutral; Flavor is Sweet, non-toxic. It is a guiding herb for the Yangming channel and a traveling herb for the Foot-Yangming channel. Treats Spleen/Stomach deficiency with thirst, clears Stomach heat, resolves alcohol toxicity.
[Tao Hongjing] Raw Gegen crushed and juiced drinks resolve Wenbing (Warm Disease) fever.
[Su Song] Zhang Zhongjing uses Gegen Tang (Kudzu Decoction) for Shanghan because it treats major heat, relieves muscle, and opens pores.
[Zhang Jiegu] Raises Yang and generates fluids. For thirst due to Spleen deficiency, nothing else works. Do not overuse to avoid damaging Stomach Qi. Zhang Zhongjing treats Taiyang-Yangming concurrent disease by adding Mahuang and Gegen to Guizhi Tang. There is also Gegen Huangqin Huanglian Tang (Kudzu, Scutellaria, and Coptis Decoction) to relieve muscle, using Gegen to block the path from Taiyang entering Yangming; it is not purely a Taiyang drug. Headache like breaking is Yangming Fengzhong, suitable for Gegen Congbai Tang (Kudzu and Scallion Decoction), a divine drug for Yangming. If Taiyang initial disease has not entered Yangming but has headache, do not immediately use Shengma (Cimicifuga Rhizome) and Gegen to disperse; this reversely guides pathogens into Yangming, like inviting thieves to ruin the house.
[Li Shizhen] *Bencao Shiji* says: Light herbs remove excess, e.g., Mahuang and Gegen. Mahuang is a Taiyang herb, entering Lung (governs skin/hair); Gegen is a Yangming herb, entering Spleen (governs muscles). Both are light and dispersing, but enter different channels.
[Processing] Chop finely, sieve uniformly.
Cimicifugae Rhizoma (Shengma, 升麻): Temperature is Neutral; Flavor is Bitter and Sweet. Flavor is thin, Qi is dense, belonging to Yin within Yang, non-toxic. It is a primary herb for the Yangming channel.
[Li Gao] Relieves heat in muscles; it is the specific herb for Wind injury to Hand/Foot Yangming channels. To tonify Spleen/Stomach, it must be used as a guide. With Congbai (Scallion White) or Baizhi, it can travel Hand/Foot Yangming and Taiyin channels, dispersing Wind pathogens of its own channel. For insufficient Yuan Qi, use this to raise Yang Qi from Yin. Shengma enters Foot-Yangming. If Taiyang initial disease takes Shengma/Gegen to induce Yangming sweat, or errs excessively, Yangming becomes dry, Taiyang cannot resolve, and transmission to Yangming occurs. Incorrect decoction is harmful. Zhu Shi says for Blood stasis entering interior with nosebleed/vomiting blood, Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) is a holy drug for Yangming. If Xijiao is unavailable, Shengma can substitute. Though Shengma and Xijiao differ greatly in nature/flavor, Shengma only guides Dihuang and other herbs into Yangming. Zhang Zhongjing said: Taiyang disease, if sweated or urinated heavily, loses fluids, Stomach dries, turning to Yangming—this harm is immeasurable. Also: Taiyang no sweat uses Gegen Tang; self-sweating is exterior deficiency, unsuitable for this. Zhu Shi uses Shengma for exterior excess with no sweat.
[Processing] Scrape black skin, remove rot, white interior is best. Chop finely, sieve uniformly before use.
Allii Fistulosi Bulbus (Congbai, 葱白): Temperature is Neutral; Flavor is Pungent, non-toxic. Qi is dense, flavor is thin, ascending, Yang. Enters Hand-Taiyin and Foot-Yangming channels. Specifically governs dispersion to connect upper and lower Yang Qi. Thus, *Huoren Shu* treats severe Shanghan headache with Lianxu Congbai Tang (Scallion White Decoction). Zhang Zhongjing treats Shaoyin disease with clear stool diarrhea, interior Cold/external Heat, Jue cold, faint pulse using Baitong Tang (White Connective Decoction), using Congbai internally. If face is red, use Sini Tang (Frigid Extremities Decoction) plus Congbai. If abdominal pain, remove Congbai. Cheng Wuji explains: Kidney dislikes dryness, urgently eats Pungent to moisten. Congbai is Pungent-Warm to connect Yang Qi.
[Li Shizhen] Cong is one of the Five Strong Smells in Buddhism. Raw is Pungent-dispersing, cooked is Sweet-Warm. Outer solid, inner hollow, a vegetable of the Lung. Lung disease benefits from eating it. Lung governs Qi, exterior corresponds to skin/hair, combines with Yangming. Thus, treated syndromes mostly belong to Taiyin/Yangming, utilizing its Qi-connecting and dispersing power. Connecting Qi detoxifies and regulates Blood. Qi is the commander of Blood; connecting Qi activates Blood. Thus, effective for golden wounds etc.
Cucumeris Fructus (Goudi, 瓜蒂 - Melon Peduncle): Temperature is Cold; Flavor is Bitter, toxic. Syndrome like Guizhi Tang pattern but no head pain, stiff neck, cunkou pulse slightly floating, epigastric stuffiness/hardness, Qi rushing to throat preventing breathing—this is Cold in Chest, should induce vomiting. Taiyang Zhongshu (Heatstroke) with body heat/pain/heaviness and faint pulse is Summer Cold Water injury, water in skin, should vomit. Shaoyang disease with headache/chills/fever, tight/small pulse is Phlegm above diaphragm, should vomit. Syndromes of excess in upper chest, depression/pain, inability to eat, pressing feels like turbid saliva, diarrhea >10 times/day, cunkou pulse slightly wiry—should vomit. Vexation/restlessness insomnia without prior sweating/purging is Real Vexation, should vomit. Food retention in Upper Jiao should vomit. All suitable for Goudi San (Melon Peduncle Powder). Contraindicated for Blood-loss or Deficient patients.
[Cheng Wuji] High things rise; upper things surge. Use bitterness of Goudi/Xiangchi to surge, acidity of Chixiaodou (Red Bean) to drain/surge, Bitter-Surge-Drain is Yin.
[Li Gao] *Nanjing* says: Pulse above present, below absent, person should vomit; if not, death. This is food injury blocking chest, damaging Taiyin Wood growth Qi, lying below. Use Goudi San to vomit. *Suwen* says: Wood stagnation should be reached. Vomiting有形 (formable) objects from Upper Jiao allows Wood to flourish, Heaven/Earth interact, ten thousand things flow. If Chi pulse is absent, do not use, fearing damage to True Yuan and Stomach Qi.
[Li Shizhen] Goudi is a Yangming channel herb removing Damp-Heat, thus guiding phlegm-fluids from chest/stomach, dampness from head/eyes, water from skin, Jaundice/Damp-Heat.
Sweet Melon Peduncle: Round and short is good. Long like bottle gourd is Cai Gua (Vegetable Melon), unusable. Pick when Qi is sufficient, naturally falls on vine. Hang in east windy place to dry.
Platycodonis Radix (Jiegeng, 桔梗): Temperature is Slightly Warm; Flavor is Bitter, Pungent, Sweet, slightly toxic. Flavor is dense, Qi is light, Yin within Yang, ascending. Enters Hand-Taiyin Lung Qi level and Foot-Shaoyin channel. Treats sore throat, benefits Lung Qi.
[Zhang Jiegu] Jiegeng clears Lung Qi, benefits throat. White color makes it a Lung guiding herb. With Gancao, it acts as a boat/oar. Like Dahuang (Rhubarb Root), a harsh descending drug, to reach high chest, need Pungent-Sweet ascending agents. Like iron in river, needs boat. Without this herb, other drugs cannot sink.
[Li Shizhen] Zhu Gong's *Huoren Shu* treats chest stuffiness without pain using Jiegeng/Zhi Ke (Aurantii Fructus) to open Lung and descend Qi. Zhang Zhongjing's *Shanghan Lun* treats Cold Solid Jiechest using Jiegeng/Mubei (Fritillaria Bulb)/Badou (Croton Seed) for warming center, digesting grain, breaking accumulation. Treats Lung Abscess with pus using Jiegeng/Gancao for Pungent-Bitter clearing Lung, Sweet-Warm draining fire, expelling pus/blood, repairing internal leaks. Treats Shaoyin syndrome day 2-3 sore throat using Jiegeng/Gancao for Pungent-Bitter dispersing Cold, Sweet-Neutral clearing heat. Combined, they regulate Cold/Heat. Later named Ganjie Tang, treating all throat/mouth diseases. Emperor Renzong added Jingjie (Schizonepeta), Fangfeng (Saposhnikovia), Lianqiao (Forsythia), naming Rusheng Tang. Remove rhizome, soak in rice water overnight, bake, slice, sieve uniformly.