牙乃骨之精。今燥者骨热也。此说近凿。又沈氏曰。当以辛凉解表。甘寒清里。即后人所用香茹散之类。亦非是。
盖此证。清凉（如黄连石膏之类。）渗利（如五苓之类。）温中。（如大顺散之类。）俱非所适。但香薷实解暑之圣药。
或加一味于润补方中。（如黄 汤。生脉散之类。）未必不为佳。
太阳中热者。 是也。
按此条与前条。即中 虚实之别。而 证之理。无出于此二端。徐氏注上条曰。此即洁古所谓。静而得之。为
中暑。为阴证也。注此条曰。动而得之。为中热。为阳证也。误矣。（洁古所谓中暑。即夏月伤凉之病。张介宾名
为阴暑。虽俱名曰暑。其实非暑邪也。又热论所谓病暑者。亦是伤寒。以时而异其名耳。不可援以注本经也。）
又按山海经。北嚣之山。鸟名 HT 。食之已 。庄子杂篇则阳曰。夫冻者假衣于春。 者反冬乎冷风。又
方氏曰。 。伤暑也。史记。禹扇 。淮南子。武王荫 人于樾下。左拥而右扇之。是也。
太阳中 。身热疼重。而脉微弱。
按赵氏。周氏。有中 统论。欠核。不录。
云岐子伤寒保命集曰。太阳中 者。身热而烦。汗欲出。反饮冷水。灌之汗不能出。水行皮中。而脉微弱。表
有水也。当发其汗。宜升麻汤。升麻。葛根。芍药。甘草。（各一两）上锉细。每服一两。水三盏煎服。
〔余述〕仲景之以痉湿 。合为一篇。厥有旨哉。夫天之气。风寒暑湿燥也。其令之有愆。与人之有虚。皆相
感为病。而风寒二气。伤人最伙。故着伤寒论。以尽其理。而他气之伤人。自表而入者。举之于杂病论。此篇即是
也。然则宜云燥湿 。而除燥不言者。何也。盖燥之一气。为秋之令。而未见其伤人如风寒暑湿者。是论之所以不
及此也。（内经言秋伤于湿。而不言秋伤于燥。又言燥胜则干者。亦非秋燥之谓。而所谓燥湿寒暑者。是地之燥湿。
而非天气之燥湿。后世有燥疫及秋燥病等说。要是门外揣摩。不足信也。）但痉则以内燥。而招外邪。然其情机。
则稍异于风寒。故与湿 为篇。益足以知秋燥之不为病矣。且夫痉也。湿也。 也。其脉因证治。纤悉具备如此。
则知殆是仲景之旧面。而非后人所节略矣。
牙齿是骨骼精气的外在表现。现在出现干燥，说明骨骼内部有热。这种说法过于穿凿附会。另外沈氏说，应当用辛凉药物解表，甘寒药物清里，就像后人使用的香薷散之类方剂。但这也不对。
大概这个证候，使用清凉药（如黄连、石膏之类）、渗利药（如五苓散之类）或温中药（如大顺散之类），都不适宜。只有香薷确实是解除暑邪的圣药。
或者在润补方剂中加入一味香薷（如黄汤、生脉散之类），未必不是好办法。
按：这一条与前一条，即是中暑与中热的虚实区别，而中暑证的机理，不出这两端。徐氏注释上一条说：这是张洁古所说的“静而得之”，称为中暑，属于阴证。注释这一条说：“动而得之”，称为中热，属于阳证。这是错误的。（张洁古所谓的中暑，即夏季因贪凉受寒的病证，张介宾称之为阴暑，虽然都叫暑，其实并非暑邪所致。又《热论》所谓病暑者，也是伤寒，只是因季节不同而名称各异罢了，不可引用这些来注释本经。）
又按《山海经》，北嚣山有一种鸟名叫HT，吃了它可以治愈中暑。《庄子·杂篇·则阳》说：受冻的人向春天借衣服，中暑的人反而希望冬天的冷风。又方氏说：中暑，即伤暑。《史记》记载大禹摇扇，淮南子记载武王在树荫下为中暑的人撑伞扇风，说的就是这个道理。
太阳中湿病，身体发热且疼痛沉重，而脉搏微弱。
云岐子在《伤寒保命集》中说：太阳中湿病，身体发热且烦躁，汗欲出却出不来，反而想喝冷水，灌服冷水后汗仍不能出，水气行于皮中，导致脉搏微弱，这是表有水气。应当发汗，宜用升麻汤。药材包括：升麻、葛根、芍药、甘草（各一两）。将药材切碎细筛，每次服用一两，加水三盏煎煮服用。
〔余述〕张仲景将痉病、湿病、中湿合为一篇，其中自有深意。天的气候，有风、寒、暑、湿、燥五种，如果气候失常，加上人体正气虚弱，就会相互感应而致病。其中风和寒两种邪气，伤人最多，所以著《伤寒论》以穷尽其理。而其他邪气伤人，从体表而入的，都收录在《金匮要略》（杂病论）中，本篇即是其中之一。那么按理应该讲燥、湿、中湿，为何除去燥而不提呢？大概燥这一气，是秋季的主令，但未见它像风、寒、暑、湿那样严重伤人，所以论述中没有涉及。（《内经》说秋伤于湿，而不说秋伤于燥；又说燥胜则干，指的也不是秋燥，而是指地之燥湿，而非天气之燥湿。后世有燥疫及秋燥病等说法，那都是门外汉的揣测，不足信。）但是痉病是由于体内津液枯燥而招致外邪，然而其病情机理，则稍异于风寒，所以将其与湿病、中湿合为一篇，更足以证明秋燥不会单独致病。况且痉病、湿病、中湿，它们的脉象、症状和治疗，如此详尽完备，可知这大概是张仲景的原貌，而不是后人节略删减的结果。
The teeth are the external manifestation of the essence of bones. Dryness now indicates heat within the bones. This interpretation is overly speculative. Furthermore, Shen stated that one should use acrid-cool herbs to release the exterior and sweet-cold herbs to clear the interior, similar to the Xiangru San (Elsholtzia Decoction) used by later generations. However, this is also incorrect.
Generally, for this syndrome, cooling herbs (such as Huanglian [Coptidis Rhizoma] and Shigao [Gypsum Fibrosum]), diuretic herbs (such as Wuling San [Five-Ingredient Powder with Poria]), or warming middle-jiao herbs (such as Dashun San [Great Harmony Decoction]) are all unsuitable. Only Xiangru (Elsholtiae Herba) is truly a supreme remedy for resolving summerheat.
Adding a single dose of Xiangru to moistening and tonifying formulas (such as Huang Tang or Shengmai San [Generate the Pulse Decoction]) might well be an excellent approach.
Taiyang Zhongre (Summerheat Stroke in Taiyang Channel) refers to Zhongshu (Heatstroke).
Note: This clause and the preceding one illustrate the distinction between deficiency and excess in Zhongshu (Heatstroke) and Zhongre (Summerheat), covering the fundamental principles of these syndromes. Xu annotated the preceding clause as follows: "This corresponds to Jiegu's concept of 'acquired from stillness,' termed Zhongshu (Heatstroke), which is a Yin syndrome." He annotated this clause as: "Acquired from movement, termed Zhongre (Summerheat), which is a Yang syndrome." This is erroneous. (Jiegu's "Zhongshu" actually refers to illness caused by cold injury during summer due to excessive cooling, which Zhang Jiebin named Yinshu (Yin Summerheat). Although both are called "summerheat," they are not caused by summerheat pathogen. Additionally, the "illness of summerheat" mentioned in *Lun* (Treatise on Cold Damage) also refers to Shanghan (Cold Damage), merely named differently according to the season; it cannot be cited to annotate this classic.)
Furthermore, according to *Shan Hai Jing* (Classic of Mountains and Seas), there is a bird on Beixiao Mountain named HT; consuming it can cure Zhongshu (Heatstroke). In the *Zhuangzi*, Chapter "Ze Yang": "Those who are frozen borrow clothes from spring; those suffering from summerheat seek the cold wind of winter." Fang stated: "Zhongshu is injury by summerheat." The *Records of the Grand Historian* records Yu fanning himself; *Huainanzi* records King Wu shading people under trees and fanning them. These refer to this condition.
In Taiyang Zhongshi (Dampness Strike in Taiyang Channel), the body feels hot and heavy with pain, while the pulse is weak and faint.
Note: Zhao and Zhou have comprehensive discussions on Zhongshi (Dampness Strike), but they lack precision and are not recorded here.
Yun Qi Zi in *Shanghan Baoming Ji* (Preservation of Life Collection for Cold Damage) states: "In Taiyang Zhongshi (Dampness Strike), the body is hot and vexed. Sweat wants to emerge but does not. The patient desires to drink cold water. After pouring cold water, sweat still fails to emerge. Water moves within the skin, resulting in a weak pulse, indicating water retention at the exterior. One should induce sweating. Shengma Tang (Cimicifugae Decoction) is appropriate. Ingredients: Shengma (Cimicifugae Rhizoma), Gegen (Puerariae Lobatae Radix), Shaoyao (Paeoniae Radix), Gancao (Glycyrrhizae Radix et Rhizoma) — each 1 liang. Coarsely crush the herbs. Take 1 liang per dose, decoct in 3 cups of water, and take orally."
[Additional Remarks] Zhang Zhongjing combined Jing (Stiffness/Spasm), Shi (Dampness), and Zhongshi (Dampness Strike) into one chapter, which holds profound significance. The climate of heaven consists of Wind, Cold, Summerheat, Dampness, and Dryness. When climatic conditions are abnormal and human constitution is deficient, they interact to cause disease. Among these, Wind and Cold harm humans the most, hence the *Shanghan Lun* (Treatise on Cold Damage Disorders) was written to exhaust their principles. Other pathogens entering from the exterior are categorized in the *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet), and this chapter is part of that collection. Then why discuss Dampness and Dampness Strike but omit Dryness? It is because Dryness is the dominant qi of Autumn, yet it has not been seen to harm humans as severely as Wind, Cold, Summerheat, and Dampness; thus, the treatise does not cover it. (*Neijing* states "Autumn injury by Dampness" but not "Autumn injury by Dryness"; it also says "Dryness predominates leading to dryness," referring not to Autumn Dryness but to terrestrial dryness rather than celestial dryness. Later theories such as Dry Epidemic and Autumn Dryness Disease are mere speculations by outsiders and are not credible.) However, Jing (Stiffness) arises from internal dryness attracting external pathogens, though its pathological mechanism differs slightly from Wind and Cold. Therefore, combining it with Dampness and Dampness Strike further proves that Autumn Dryness does not independently cause disease. Moreover, the pulses, symptoms, and treatments for Jing (Stiffness), Shi (Dampness), and Zhongshi (Dampness Strike) are so meticulously detailed that it can be inferred this is likely Zhang Zhongjing's original text, rather than an abbreviated version by later editors.