六經辯證

吳宇琛

SUM WU

Sum Wu

Registered Chinese Medicine Practitioner

Bachelor of Health Science in Traditional Chinese Medicine (UTS)

Bachelor of Science Majoring in Psychology (UOW)

Specialising in pain management and mental wellbeing through Tradition Chinese medicine in combination with modern science in mental health, dieting and nutrition.

吳宇琛，澳洲政府註冊中醫師、針灸師，五龍崗大學心理學學士、悉尼科技大學中醫系學士，擅長用傳統針灸理傷手法和中藥治療各種新舊損傷痛症，特別採用中醫中藥和現代心理學、營養學相結合調理治療各種慢性病和亞健康。

六經辨證

The 6 Stages Theory 

Pattern diagnosis and progression of common cold and similar diseases.

感冒及類似疾病的病症診斷及發展

吳宇琛

SUM WU

What is a common cold? In TCM we can generally separate a common cold into either wind cold or wind heat syndrome. How can this be differentiated with viral infections such as influenza?

Common cold is due to virus such as rhinovirus while influenza is from the influenza A and B virus. They have similar symptoms but are actually slightly different. The flu has worse symptoms and can cause diarrhoea and vomiting. Generally an upper respiratory virus won’t affect the intestine such as stomach bug but can happen in low chances.

什麼是普通感冒？中醫一般將普通感冒分為風寒感冒和風熱感冒。如何將其與流感等病毒感染區分開來？

普通感冒是由病毒引起的，例如鼻病毒，而流感是由甲型和乙型流感病毒引起的。它們的症狀相似，但實際上略有不同。流感症狀更嚴重，會引起腹瀉和嘔吐。一般上呼吸道病毒不會影響腸道，例如胃病，但發生的可能性很小。

The Six Stages (Liu Jing) theory developed during the Han Dynasty by Zhang Zhong Jing in Traditional Chinese Medicine is a diagnostic framework used to understand the progression of disease caused by external pathogens, particularly cold. This theory, which originates from the classical text “Shang Han Lun,” describes how illness moves through the body’s energetic layers from the most superficial to the deepest levels. Each stage is associated with a specific set of symptoms and treatment strategies aimed at restoring balance and health. Cold damage can progress level by level or in some causes directly affect certain layers.

中醫六經理論由張仲景於漢代創立，是一種診斷框架，用於瞭解由外部病原體（尤其是寒邪）引起的疾病的進展。該理論源自古典文獻《傷寒論》，描述了疾病如何從最淺層到最深層穿過人體的能量層。每個階段都與一組特定的症狀和治療策略相關，旨在恢復平衡和健康。

The six stages are divided into three Yang stages and three Yin stages, representing the body’s external and internal defences, respectively. The yang stages are early stage issues while yin stages are considered late stage issues.

這六個階段分為三個陽階段和三個陰階段，分別代表人體的外部和內部防禦. 陽階段是早期問題，陰階段被視為後期問題。

1. Taiyang (太陽)

This is the most superficial stage and represents the body’s first defense against external pathogens, often cold and wind. The Taiyang stage affects the Bladder and Small Intestine meridians.

This stage occurs when the Wind is still on the Exterior of the body.

這是最淺顯的階段，代表著身體對外部病原體（通常是寒冷和風）的第一道防線。太陽階段影響膀胱和小腸經。

當風仍然在身體外部時，就會發生此階段。

Symptoms are the result of an attack of Wind and Cold (or, more rarely, Heat and/or Dampness). The three key characteristic symptoms at this stage are headaches with accompanying neck and shoulder stiffness, aversion to cold and a floating pulse. It can also include general discomfort and pain as well as fever with chills characteristic of the early stages of cold and flu.

症狀是風寒（或較罕見的熱和/或濕）侵襲的結果。此階段的三個主要特徵症狀是頭痛，伴隨頸部和肩部僵硬、畏寒和脈浮。它還可能包括全身不適和疼痛以及感冒和流感早期特有的發燒和寒戰。

For such invasion to occur one already needs to be in a weakened state with one’s pores not able to sufficiently ward off external Pathogenic Factors.

要發生這種侵襲，人體必須處於虛弱狀態，毛孔無法充分抵禦外界致病因素。

• Symptoms: Chills, mild fever, aversion to cold, headache, stiff neck, and possibly sweating.
• Treatment: Focuses on releasing the pathogen from the surface through sweating and dispersing wind-cold using herbs such as Ma Huang Tang or acupuncture points along the Bladder and Small Intestine meridians.
• 症狀：畏寒、低熱、畏寒、頭痛、頸部僵硬、可能出汗。
• 治療：重點是通過出汗和散去風寒，使用麻黃湯等草藥或按壓膀胱經和小腸經的穴位，釋放體表病原體。

2. Yangming (陽明)

This stage, which can develop from both the Greater Yang and the Lesser Yang stages, is a penetration of an External Pathogen to the level of the Stomach and Large Intestine Channels.

If the invading Pathogen might have originally been Cold, this pattern is now resolutely characterized by Heat with symptoms such as fever, a preference for cold drinks and food, extreme thirst and excessive perspiration.

此階段可從大陽和少陽階段發展而來，是外部病邪滲透至胃經和大腸經的階段。

如果入侵的病邪最初是寒邪，那麼此病證現在的特點就是熱邪，症狀包括發燒、喜歡冷飲和食物、極度口渴和大量出汗。

• Description: This stage occurs when the pathogen has penetrated deeper, affecting the Stomach and Large Intestine meridians. It is characterized by an abundance of heat.
• Symptoms: High fever, profuse sweating, extreme thirst, a red face, irritability, and a strong pulse.
• Treatment: Clearing heat and draining fire through methods such as cooling herbs like Bai Hu Tang or acupuncture points that help eliminate excess heat.
• 描述：此階段發生在病原體滲透較深，影響胃經和大腸經絡時。其特點是熱氣旺盛。
• 症狀：高燒、大量出汗、極度口渴、面紅、煩躁、脈搏強勁。
• 治療：通過白虎湯等清涼草藥或有助於消除多餘熱量的穴位等方法清熱瀉火。

3. Shaoyang (少陽)

At this stage the External Pathogen has penetrated to the level of the Gallbladder and Triple Warmer Channels. Its main characteristic is that it’s a stage that oscillates between the Bright Yang and Greater Yang stages and alternatively takes symptoms from both. Such oscillations are characteristic of diseases like malaria and typhoid fevers that show alternating heat and chills, and a cyclic recurrence of symptoms.

此時外邪已滲透至膽經和三焦經。其主要特點是，在陽明和大陽之間來回波動，交替出現兩種症狀。這種波動是瘧疾和傷寒等疾病的特徵，這些疾病表現為寒熱交替，症狀週期性復發。

• Description: This is an intermediate stage where the pathogen oscillates between the external and internal layers of the body, affecting the Gallbladder and Triple Burner meridians.
• Symptoms: Alternating chills and fever, bitter taste in the mouth, dry throat, nausea, irritability, and fullness in the chest.
• Treatment: Harmonizing the interior and exterior by using herbs such as Xiao Chai Hu Tang and acupuncture points along the Shaoyang channels.
• 描述：這是病原體在身體內外層之間來回波動的中間階段，影響膽經和三焦經。
• 症狀：寒熱交替，口苦，咽乾，噁心，煩躁，胸悶。
• 治療：使用小柴胡湯等中藥和少陽經穴位調和內外。

4. Taiyin (太陰)

This is the first of the Yin stages. At this stage what’s mainly affected is the Spleen Channel. If yang disease left untreated it can go into this level, or cold damage penetrating into spleen and stomach or due to improper diet affecting yang qi.

In terms of symptoms patients typically experience classic signs of Spleen Yang Deficiency such as a feeling cold, a lack of appetite, diarrhoea and fatigue.

這是陰虛的第一個階段。在這個階段，主要受影響的是脾經。

就症狀而言，患者通常會出現脾陽虛的典型症狀，例如感覺寒冷、食欲不振、腹瀉和疲勞。

• Description: When the disease penetrates deeper, it affects the body’s internal organs, particularly the Spleen and Lungs, leading to cold and deficiency.
• Symptoms: Abdominal fullness, poor appetite, diarrhea, fatigue, and a pale complexion.
• Treatment: Warming and tonifying the Spleen and Lung to support digestion and energy production, using formulas like Li Zhong Wan or acupuncture points to strengthen the digestive system.
• 描述：當疾病深入人體較深層，會影響人體的內臟，特別是脾臟和肺臟，導致寒冷和虛弱。
• 症狀：腹脹、食欲不振、腹瀉、疲勞和面色蒼白。
• 治療：溫補脾肺以促進消化和能量產生，使用理中丸等方劑或穴位來增強消化系統。

5. Shaoyin (少陰)

The Lesser Yin stage is a still deeper stage where the disharmony mainly affects the Kidney Channel.

少陰階段是更深的階段，不和諧主要影響腎經。

• Description: This stage reflects a deeper imbalance between the Heart and Kidney organs, where either cold or heat can dominate, leading to deficient Yin or Yang.
• Symptoms (Cold): Cold limbs, fatigue, aversion to cold, desire to sleep, weak pulse.
  Symptoms (Heat): Irritability, insomnia, dry mouth, dark urine.
• Treatment: In the cold type, warming and nourishing Yang using Si Ni Tang is recommended, while in the heat type, cooling and nourishing Yin with Huang Lian E Jiao Tang is used.
• 描述：此階段反映心腎器官之間更深層次的不平衡，寒熱均可佔主導地位，導致陰虛或陽虛。
• 症狀（寒）：四肢畏寒、乏力、怕冷、想睡、脈細弱。
• 症狀（熱）：煩躁、失眠、口乾、尿黃。
• 治療：寒型建議使用四逆湯溫補陽，熱型建議使用黃連阿膠湯降熱補陰。

6. Jueyin (厥陰)

The last Yin stage is where the disharmony is associated with the Pericardium and Liver.The symptoms are a mix of Heat above (thirst, feeling of energy rising, pain and heat sensation of heart region) and Cold below (no desire to eat, cold limbs, vomiting).

最後一個陰階段，是心包和肝臟失和。症狀是上熱（口渴、能量上升感、心臟區域疼痛和發熱）和下寒（不想吃東西、四肢寒冷、嘔吐）的混合。

• Description: This is the final and deepest stage, often involving extremes of heat and cold. It affects the Liver and Pericardium meridians and can manifest as a combination of both deficiency and excess.
• Symptoms: Sensation of heat in the upper body and cold in the lower body, thirst, hunger without desire to eat, vomiting, diarrhea, and weakness.
• Treatment: Restoring balance between Yin and Yang, focusing on harmonizing the extremes with herbs like Wu Mei Wan or acupuncture that regulates the Liver and Pericardium meridians.
• 描述：這是最後也是最深的階段，通常涉及極熱和極冷。它影響肝經和心包經，並可能表現為虛實結合。
• 症狀：上身熱，下身冷，口渴，饑餓而不想吃東西，嘔吐，腹瀉和虛弱。
• 治療：恢復陰陽平衡，重點是用烏梅丸等草藥或調節肝經和心包經的針灸來協調極端。

如有疑問想咨詢吳宇琛中醫師，可以在微信或whatsapp搜索0404836368，加吳宇琛中醫師微信或whatsapp，也可以發短信或致電0404836368作語音留言，吳宇琛中醫師有空就會回復。

（吳宇琛中醫師，澳大利亞政府註冊中醫師、針灸師，五龍崗大學心理學學士、悉尼科技大學中醫系學士，悉尼好思維松軒藥行主治中醫師，澳大利亞中醫骨傷專科學院副院長，本文僅供參考，具體診療應諮詢專業人士。）