内经云。热病者。皆伤寒之类也。盖六气为病。皆能发热。故善治伤寒者。必能穷究
六淫之气。凡温热暑湿疫疠之类伤寒者。无不一一辨晰明白。而施治各当。要知
能治类症。即是能治伤寒。以类症实居伤寒之八九也。今将类症治法列于后。庶
几温热暑湿之症。不致混入伤寒正病之治。其于伤寒。思过半矣。
邵评∶伤寒症。邪从肌表而入。先表后里。从六经辨症。用足经药辛温表散。温热
暑疫。邪由口鼻吸受。宗三焦认症。从手经用药。忌用足经辛温药。如此。温暑与
伤寒。方不相混。
凡天时晴燥。温风过暖。感其气者。即是风温之邪。阳气熏灼。先伤上焦。其为病也。
身热汗出。头胀咳嗽。喉痛声浊。治宜辛凉轻剂解之。大忌辛温汗散。古人治风温。
有葳蕤汤、知母葛根汤。内有麻黄、羌活等药。皆不可用。
风温吸入。先伤太阴肺分。右寸脉独大。肺气不舒。身痛胸闷。头胀咳嗽。发热口渴。
或发痧疹。主治在太阴气分。栀豉、桑杏、蒌皮、牛蒡、连翘、薄荷、枯芩、桔梗、桑叶之类。
清之解之。痰嗽加贝母。声浊不扬加兜铃。火盛脉洪加石膏。咽痛加射干。饱闷加
川郁金、枳壳。干咳喉燥。加花粉、蔗浆、梨汁。咽喉锁痛。加莱菔汁。
邵评∶温邪由肺而入于胃。热伤肺胃之津。病在上中二焦。故用大清肺胃热邪。
生津润燥为主。治上中二焦之良法。
如发热口糜气秽者。此温邪劫伤肺胃之津也。宜生地、石膏、知母、麦冬、花粉、
钗斛、梨皮之类主之。
如肺胀喘急。胸痛气秽者。此温邪伤肺。欲酿内痈也。急用活水芦根、桃仁、苡仁、栝
蒌皮、冬瓜子、空沙参、黑元参、连翘之类清之。
邵评∶热邪蕴于肺。郁结不宣。气痰滞血瘀。欲酿肺痈。故见胸疼喘急。痰气秽臭
之症。用千金苇茎汤。宣肺痹而行血降气。加味以清化肺热为治。
此手太阴轻症也。若手少阴厥阴二经。当于温热症内合参之。
邵评∶以上邪初在肺。其势尚轻。若肺邪不解。传入心营及心包络经。则入里而
病重矣。后温热症内所列各条。治法相通。当合参之。
The *Neijing* (Inner Canon) states: "Febrile diseases all belong to the category of Shanghan (Cold Damage)." Generally, pathogenic factors from the Six Qi can cause fever. Therefore, a skilled practitioner of Shanghan must thoroughly investigate the Six Excesses (Six Pathogenic Factors). For any febrile-heat, summerheat-dampness, or epidemic pestilence conditions that resemble Shanghan, one must distinguish them clearly and apply appropriate treatments. It is essential to understand that being able to treat these similar syndromes is equivalent to being able to treat Shanghan, as such similar syndromes actually constitute eight or nine-tenths of Shanghan cases. The treatment methods for these similar syndromes are listed below, so that febrile-heat and summerheat-dampness conditions will not be confused with the standard treatment of primary Shanghan. In this way, one's understanding of Shanghan will be more than half complete.
Shao's Commentary: In Shanghan syndromes, the pathogen enters from the muscle surface, affecting the exterior first and then the interior. Differentiation is based on the Six Channels (Liu Jing), and herbs acting on the Foot Meridians are used for acrid-warm exterior-releasing dispersion. In contrast, for febrile-heat and summerheat epidemics, the pathogen is inhaled through the mouth and nose. Differentiation follows the San Jiao (Triple Burner) pattern, and herbs acting on the Hand Meridians are used. One must avoid using acrid-warm herbs acting on the Foot Meridians. In this manner, treatments for warm-summerheat and Shanghan will not be confused.
When the weather is clear and dry, and the warm wind is excessively mild, contracting this climatic qi constitutes the Wind-Warmth (Feng Wen) pathogen. Yang qi steams and scalds, damaging the Upper Jiao first. The manifestations include: body heat, sweating, head distension and pain, cough, sore throat, and hoarse or turbid voice. Treatment should employ a light acrid-cool formula to resolve the condition. It is strictly forbidden to use acrid-warm diaphoretic dispersants. Ancient practitioners treated Wind-Warmth with formulas such as Weiyu Tang (Weiyu Decoction) and Zhimu Gegen Tang (Anemarrhena and Pueraria Decoction); however, since these contain herbs like Mahuang (Ephedrae Herba) and Qianghuo (Notopterygii Rhizoma et Radix), they should not be used.
Wind-Warmth inhaled damages the Taiyin Lung division first. The right Cun pulse alone becomes large; Lung qi is constrained, leading to body pain, chest fullness, head distension and pain, cough, fever, thirst, or the eruption of sand-rash (Sha Zhen). The primary treatment focuses on the Qi level of the Taiyin. Formulas such as Zhizi Chitang (Gardenia and Fermented Soybean Decoction) or Sangxing Tang (Mulberry Leaf and Apricot Seed Decoction) are used, along with herbs like Loupi (Fructus Trichosanthis Pericarpium), Niubangzi (Arctii Fructus), Lianqiao (Forsythiae Fructus), Bohe (Menthae Haplocalycis Herba), Kuqing (Scutellariae Radix prepared by frying), Jiegeng (Platycodonis Radix), and Sangye (Mori Folium). These clear heat and resolve the exterior. If phlegm-cough worsens, add Beimu (Fritillariae Bulbus); if voice is hoarse and indistinct, add Doudinghua (Asteris Flos); if fire is excessive and the pulse is surging, add Shigao (Gypsum Fibrosum); if there is sore throat, add Shegan (Belamcandae Rhizoma); if there is fullness and oppression, add Chuan Yujin (Curcumae Radix) and Zhike (Aurantii Fructus Immaturus); if there is dry cough and throat dryness, add Huafen (Trichosanthis Radix), Zhejiang (Sacchari Sinarum Liquor), and Lizhi (Pyrus Sinkiangensis Fruit Juice); if there is severe throat pain resembling a lockjaw sensation, add Laifu juice (Raphani Fructus Juice).
Shao's Commentary: Warm pathogens enter from the Lung to the Stomach. Heat damages the fluids of the Lung and Stomach. The disease location is in the Upper and Middle Jiao. Therefore, the main treatment is to vigorously clear heat from the Lung and Stomach and generate fluids while moistening dryness. This is an excellent method for treating the Upper and Middle Jiao.
If there is fever, oral ulceration (mouth rot), and foul breath, this indicates that the warm pathogen has robbed the fluids of the Lung and Stomach. Treatment should primarily use Dihuang (Rehmanniae Radix), Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma), Maidong (Ophiopogonis Tuber), Huafen (Trichosanthis Radix), Dachishihu (Dendrobii Caulis), and Lipi (Pyrus Sinkiangensis Pericarpium).
If there is lung distension, rapid panting, chest pain, and foul breath, this indicates that the warm pathogen has damaged the Lung and is about to form an internal abscess (Fei Yong / Lung Abscess). Urgently use fresh Luzhu Gen (Phragmitis Rhizoma), Taoren (Persicae Semen), Yiren (Coicis Semen), Loupi (Fructus Trichosanthis Pericarpium), Dongguazi (Benincasae Semen), Kongshenshen (Glehniae Radix), Hei Yuanshen (Scrophulariae Radix), and Lianqiao (Forsythiae Fructus) to clear heat.
Shao's Commentary: Heat pathogens accumulate in the Lung, becoming stagnant and unable to disperse. Qi stagnation, phlegm obstruction, and blood stasis occur, leading to the formation of Lung Abscess. Hence, symptoms such as chest pain, rapid panting, and foul-smelling sputum appear. Use Qianjin Weijing Tang (Million-Golden-Vessel Stem Decoction) to unblock Lung bi (obstruction), move blood, and descend qi. Additions should focus on clearing and transforming Lung heat.
This is a mild syndrome of the Hand-Taiyin Lung Meridian. If the Hand-Shaoyin Heart Meridian or Hand-Jueyin Pericardium Meridian are involved, refer to the sections on Warm-Thermal diseases for comprehensive analysis.
Shao's Commentary: The above describes pathogens initially located in the Lung, where the pathogenic force is still mild. If the Lung pathogen does not resolve, it transmits to the Ying (Nutrient) level of the Heart and the Pericardium Meridian, entering the interior and causing severe disease. The treatment methods listed later in the Warm-Thermal disease sections are consistent with these principles and should be referenced comprehensively.