千金方曰。风温之病。脉阴阳俱浮。汗出体重。其息必喘。其形
状不仁。默默欲眠。下之者。小便难。发其汗者。必谵语。加烧针者。
则耳聋难言。但吐之。则遗矢便利。如此疾者。宣服葳蕤汤。活人书
曰。脉尺寸俱浮。头痛身热。常自汗出。体重。其息必喘。四肢不欲
收。嘿嘿但欲卧者。风温也。病患素伤于风。因复伤于热。风热相搏。
则发风温。主四肢不收。头疼身热。常自汗出。不解。治在少阴厥阴。
不可发汗。汗出则谵语。独语内烦。躁扰不得卧。若惊痫。目乱无精。
治者复发其汗。如此死者。医杀之也。活人书曰。风温不可发汗。宜
葳蕤汤。风温身灼热者。知母葛根汤。风温加渴甚者。栝篓根汤。风
温脉浮。身重汗出。汉防己汤。
活人书曰。初春病患。肌肉发斑瘾疹。迹如锦纹。或咳心闷但呕
者。此名温毒也。温毒发斑者。冬时触冒寒毒。至春始发。病初在表。
症如伤寒。或已发汗吐下而表症未罢。毒瓦斯不散。或发斑。黑膏主
之。(成疮者自作疮毒治。不可用黑膏。)又有冬月温暖。人感乖戾之
气。冬未即病。至春或被积寒所折。毒瓦斯不泄。至天气暄热。温毒始
发。则肌肉斑烂。瘾疹如锦文。内攻心闷。但呕清汁。葛根橘皮汤主
之。雍曰。不必初春春夏。皆发其斑。与伤寒不同。瘾疹如锦文而不
作疮烂者是也。其发疮脓烂者。实时行热毒豌豆疮也。二者初症。皆
先有表证如伤寒。又有瘾疹赤白二种。初无表症。暴感温气而作。其
毒轻浅。风尸之类也。又有一种遍身如锦。初亦无表症。暴感而作。
如丹如疹。其毒亦轻。皆详见小儿疮疹后斑疮瘾疹论辨中。
雍曰。仲景言风温温毒二症。又与二说不同。仲景之言曰。伤寒
过十三日以上。不间。尺寸陷者。大危。若更感异气。变为他病者。当
根据后坏病症而治之。若阳脉浮滑。阴脉濡弱者。更过于风。变为风
温。阳脉洪数。阴脉实大者。更遇温热。变为温毒。温毒为病最重。此
乃伤寒后四种坏病。此病最为重也。又非但前所谓风温温毒而已。
其用药亦当不同。然则仲景所言。伤寒坏病、中风、温毒也。诸家所
言者。冬春自感风温温毒也。其治之轻重。不得不异也。四种坏病
中。又有湿温一症。见第八卷不可汗门中。
雍曰。天行温疫。虽症不多。用药亦多端。如千金方言辟温疫
气。并断温疫相染诸方。及千金翼弹鬼丸、神明白散、太乙流金散、
萤火丸等方。前人虽尝选用。更尝缺省。收其遗逸用之。大抵治疫尤
要先辨寒温。然后用药。取阴阳表里之在伤寒也。故庞安常又述其
治寒疫诸方。盖以赤散、解圣散之类。皆宜治寒疫。若施之瘟疫。则
益热矣。
The *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold) states: In the disease of Wind-Warmth (Fengwen, wind-heat syndrome), the pulse is floating at all three positions (Cun, Guan, Chi). There is sweating and heaviness of the body; respiration must be wheezy or panting. The physical condition presents with numbness or lack of sensation. The patient remains silent and desires sleep. If purgation (downward draining) is applied, urination will become difficult. If diaphoresis (sweating-inducing treatment) is applied, delirium will certainly occur. If burning needle therapy is added, deafness and difficulty in speech will result. If emesis (vomiting-inducing treatment) is applied alone, fecal incontinence will occur. For such diseases, Wei Rui Tang (Jade Bamboo Decoction) should be administered.
The *Huo Ren Shu* (Book to Save Lives) states: When the pulse is floating at both the Cun and Chi positions, accompanied by headache, fever, frequent spontaneous sweating, bodily heaviness, panting, flaccidity of the four limbs (inability to flex them), silence, and a desire to lie down, this is Wind-Warmth. The patient has previously been injured by wind pathogen, and subsequently injured by heat pathogen. Wind and heat contend with each other, resulting in Wind-Warmth. The main symptoms are flaccidity of the four limbs, headache, fever, and frequent spontaneous sweating that does not resolve. Treatment focuses on the Shaoyin (Lesser Yin) and Jueyin (Terminal Yin) channels. Sweating-inducing treatments must not be used. If sweating is induced, delirium will occur, along with muttering internally, irritability, restlessness, and inability to sleep. It may resemble convulsive disorders, with eyes wandering and lacking spirit. If the physician induces sweating again, causing death, it is the physician who kills the patient. The *Huo Ren Shu* further states: Wind-Warmth cannot be treated with sweating methods; Wei Rui Tang is suitable. For Wind-Warmth with burning heat, Zhi Mu Ge Gen Tang (Anemarrhena and Pueraria Decoction) is used. For Wind-Warmth with severe thirst, Gua Lou Gen Tang (Trichosanthes Root Decoction) is used. For Wind-Warmth with a floating pulse, heaviness, and sweating, Han Fang Ji Tang (Stephania Tetrandra Decoction) is used.
The *Huo Ren Shu* states: In early spring, if patients develop macules and papules on the skin resembling brocade patterns, or experience cough, chest oppression, and vomiting only, this is named Wen Du (Warm-Toxin). Warm-Toxin manifesting as macules arises because cold-toxin was contracted in winter but did not manifest until spring. Initially, the pathology is in the exterior, presenting like Taiyang Cold Damage (Shanghan). Or, after sweating, vomiting, or purging, the exterior syndrome has not resolved, and the toxic qi has not dispersed, leading to macules; Hei Gao (Black Plaster) is the primary treatment. (If sores have formed, treat as local carbuncles/sores; do not use Hei Gao.) Additionally, if winter weather is warm, people may contract aberrant qi. The disease does not manifest immediately in winter. By spring, if suppressed by accumulated cold, the toxic qi cannot vent. When the weather becomes hot, Warm-Toxin finally manifests, causing skin maceration, papules like brocade patterns, internal chest oppression, and vomiting clear fluid; Ge Gen Ju Pi Tang (Pueraria and Tangerine Peel Decoction) is the primary treatment. Guo Yong states: Macules do not necessarily appear only in early spring or summer; this differs from Cold Damage. These cases present with papules like brocade patterns but without ulceration. Cases with pus-filled ulcers are actually Smallpox (Tian Hua, infectious exanthem caused by heat-toxin). Both types initially present with exterior syndromes similar to Cold Damage. There are also red and white forms of papules that appear suddenly due to warm qi without initial exterior symptoms; their toxicity is mild, belonging to the category of Feng Shi (Wind Corpse). Another type presents with the whole body resembling brocade, appearing suddenly without initial exterior symptoms, looking like erysipelas or rashes; its toxicity is also mild. These are detailed in the discussion on macules and papules following pediatric exanthems.
Guo Yong states: Zhang Zhongjing’s description of Wind-Warmth and Warm-Toxin differs from the aforementioned views. Zhang Zhongjing said: If Cold Damage persists beyond thirteen days without remission, and the Cun and Chi pulses sink, it is a critical danger. If further exposure to different pathogens causes transformation into other diseases, one must treat according to the subsequent "Huai Bing" (ruined/deteriorated disease) protocols. If the Yang pulse (Cun) is floating and slippery, and the Yin pulse (Chi) is soggy and weak, it indicates an additional wind pathogen transforming into Wind-Warmth. If the Yang pulse is surging and rapid, and the Yin pulse is substantial and large, it indicates encountering warm-heat transforming into Warm-Toxin. Warm-Toxin is the most severe among these diseases. This constitutes one of the four types of Huai Bing following Cold Damage, which is extremely serious. It is not merely the Wind-Warmth and Warm-Toxin mentioned earlier. The medication must also differ. Thus, what Zhang Zhongjing refers to are Cold Damage Huai Bing, Wind Stroke, and Warm-Toxin; whereas what various schools refer to are Wind-Warmth and Warm-Toxin contracted spontaneously in winter and spring. The severity of treatment must therefore differ. Among the four Huai Bing, there is also a syndrome called Shi Wen (Damp-Warmth), found in Volume 8 under the section on non-sweating methods.
Guo Yong states: Tian Xing Wen Yi (Epidemic Warmth), although presenting with few symptoms, requires diverse medications. For example, the *Qianjin Fang* discusses formulas to ward off epidemic qi and prevent contagion, as well as formulas from the *Qianjin Yi Fang* such as Dan Gui Wan (Ghost-Bouncing Pill), Shen Ming Bai San (Divine Clarity White Powder), Tai Yi Liu Jin San (Great One Flowing Gold Powder), and Ying Huo Wan (Firefly Pill). Although predecessors selected some of these, many were omitted here; I have collected the遗逸 (lost/omitted) ones for use. Generally, treating epidemics requires first distinguishing between cold and warmth before prescribing, drawing upon the principles of Yin-Yang and Exterior-Interior in Cold Damage. Therefore, Pang Anchang described his formulas for treating Cold Epidemics (Han Yi). Formulas like Chi San (Red Powder) and Jie Sheng San (Savior-Resolving Powder) are suitable for Cold Epidemics. If applied to Warm Epidemics (Wen Yi), they would exacerbate the heat.