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Spring is warm, summer is hot, autumn is cool, and winter is cold; this is the normal order of seasonal climate changes. Injury by these normal seasonal climates constitutes a regular disease of the four seasons; however, if injured by abnormal climatic factors (epidemic qi) contrary to the season, disaster ensues.

When it should be cold but turns warm, Winter-Warmth Disease occurs; when it should be warm but turns cold, Cold-Epidemic injury occurs. Epidemics spread among people of all ages through transmission. One must recognize the annual climate (Yunqi) and employ sweating or purging methods for effective treatment.

[Note] Diseases in winter are typically Cold Damage (Shanghan); in spring, Wind Injury (Shangfeng); in summer, Summerheat Disease (Shu Bing); in autumn, Malaria (Nue Ji). These are common diseases corresponding to the normal climate of the four seasons. If spring should be warm but turns cold, summer should be hot but turns cool, autumn should be cool but turns hot, and winter should be cold but turns warm, this represents "having the qi of one season at the wrong time," causing epidemic disasters. When winter should be cold but turns warm, leading to Cold Damage disease, it is named Winter-Warmth (Dong Wen). When spring should be warm but turns cold, leading to Cold Damage disease, it is named Cold-Epidemic (Han Yi). If the climate of a specific period is irregular, affecting both the elderly and the young who infect each other, it is named Plague/Epidemic (Wen Yi). In treating such diseases, one must discern whether the annual climate is excessive or deficient, the overcoming and recovery of the Six Excesses (Liu Yin), the strength or weakness of the person, and the cold or heat of the zang-fu organs. Assessing the severity, one may use either sweating or purging methods. For mild cases, Liu Wansu's Shuangjie San (Double-Resolution Powder) is used; for severe cases, Li Gao's Ersheng Jiuku Wan (Two-Saints Rescue-Bitterness Pill) is employed. Treatment should follow the syndrome differentiation.

Injury by Cold in winter leads to Warmth Disease in spring; Heat Disease in summer often stems from early deficiency of Yin. Symptoms include floating pulse, headache, fever, thirst, and absence of aversion to cold; this is the etiology. If there is no sweat, Liu Wansu's Two-Resolution method (Shuangjie Tang) applies; if there is sweat and intense internal heat, clearing or purging methods should be sought early. Failure to treat promptly leads to coma, mania, and various heat syndromes. If there are no obvious exterior or interior signs, treatment should be adjusted according to the Six Meridians with flexible judgment, achieving divine efficacy.

[Note] The Classics state: "Injury by Cold in winter leads to Warmth Disease in spring, which becomes Heat Disease in summer." Heat Disease belongs to the category of Cold Damage. "Injury by Cold in winter" refers to contracting slight normal Cold in winter without immediate onset of disease. "Early deficiency of Yin" refers to individuals who fail to store essence during winter, or those engaged in hard labor whose sweating disrupts internal and external consolidation. This damages Kidney Yin in winter, leaving Yang heat unopposed. Thus, upon encountering slight pathogenic factors in spring, internal heat is triggered, burning fiercely and uncontrollably. Hence, thirst and absence of aversion to cold occur immediately upon onset. For initial cases with no sweat and exterior signs, Liu Wansu's Shuangjie Tang method is applicable. For cases with sweat and intense internal heat, either clearing or purging methods should be used urgently to drain Yang heat and rescue Yin. Delayed treatment allows coma, mania, and other heat syndromes to arise, making rescue impossible. "No signs" refers to the absence of obvious exterior or interior syndromes; treatment should be modulated according to the progression through the Six Meridians, achieving spiritual mastery.