【纲】仲景曰。阳脉洪数。阴脉实大者。更遇温热。变为温毒。
【目】成无己曰。此前热未已。又感温热者也。阳主表。阴主里。洪数实大。皆热也。两热相
合。变为温毒。
朱肱曰。初春发斑咳嗽为温毒。
吴绶曰。冬有非节之暖。名曰冬温。此实时行之气也。若发斑者。又曰温毒。而亦时气发斑也。
又伤寒坏病。阳脉洪数。阴脉实大。更遇温热。变为温毒。其病最重。此因前热多日不解。更感
温热之气而为病。故曰重也。若无汗者。三黄石膏汤汗之。自汗者。人参白虎汤主之。烦热错语
不得眠。表热又盛。更加柴胡。内实大便秘。三黄泻心汤。或大柴胡汤加芒硝。若斑出如锦纹。多
难治也。宜人参化斑汤、元参升麻汤、大青四物汤。
陶华曰。温毒者。冬月感寒毒异气。至春始发也。表症未罢。毒瓦斯未散故有发斑之候。心下烦
闷。呕吐咳嗽。后必下利。寸脉洪数。尺脉实大。为病则重。以阳气盛故耳。通用元参升麻汤。
【纲】仲景曰。发汗已。身灼热者。名曰风温。其症脉浮。汗出。身重多眠。
【目】许叔微曰。脉尺寸俱浮。头疼身热。常自汗。体重。其息必喘。其形不仁。嘿嘿但欲眠
者。风温症也。复发其汗者死。宜葳蕤汤。
李 曰。太阳病。发汗则身凉。如发汗身犹灼热者。乃风温也。当春温气大行。又感风邪所致。
惟风伤卫。四肢缓纵不收者瘫痪。惟温伤气。气昏而鼻息不利。语言蹇涩。身热。自汗多眠。治
在心火肝木二经。忌汗下针。误汗则身必灼热。甚则烦渴谵语。若下则遗溺。针则耳聋。惟清肌解
表为佳。宜葳蕤汤、败毒散。或小柴胡加桂枝微汗之。渴甚者。栝蒌根汤。喘者。金沸草汤加杏仁、
细辛、五味子。误汗。防己黄 汤。谵语独语。直视遗尿者。不治。
楼全善曰。其病不独见于春间。故另立风温门。
柯琴曰。此正与内经伏寒病温不同处。太阳中暑。亦有因于伤寒者。虽渴而仍恶寒。太阳温病。
反不恶寒而渴者。是病根不因于寒而因于风。发热者病为在表。法当汗解。然不恶寒。则非麻桂
所宜矣。风与温相搏。发汗不如法。风去而热反炽。灼热者。两阳相熏灼。转属阳明之兆也。
[General Principle] Zhang Zhongjing stated: If the Yang pulse is surging and rapid (Hongshu), and the Yin pulse is full and large (Shida), and this condition is further complicated by exposure to warm pathogenic factors, it transforms into Warm Toxicity (Wendu).
[Commentary] Cheng Wuji stated: This refers to a situation where previous heat has not yet subsided, and the patient is subsequently infected with warm pathogens. Yang governs the exterior, and Yin governs the interior. Surging, rapid, full, and large pulses all indicate Heat. The combination of two types of heat transforms into Warm Toxicity.
Zhu Gong stated: In early spring, the appearance of macules (rash) accompanied by coughing is termed Warm Toxicity.
Wu Shou stated: Unseasonably warm weather in winter is called Winter Warmth (Dongwen), which belongs to the category of epidemic Qi (Shiqi). If macules appear, it is also called Warm Toxicity, representing an epidemic rash. Furthermore, in deteriorated conditions following Cold Damage (Shanghan), if the Yang pulse is surging and rapid and the Yin pulse is full and large, and the patient encounters warm pathogens, it transforms into Warm Toxicity. This disease is the most severe because the previous heat has persisted for many days without resolution, and subsequent infection with warm Qi causes the illness; hence it is termed severe. If there is no sweating, treat with Sanhuang Shigao Decoction (Three Yellows and Gypsum Decoction) to induce sweating. If there is spontaneous sweating, administer Renshen Baihu Tang (Ginseng and White Tiger Decoction). If there is vexation, fever, delirious speech, insomnia, and intense surface heat, add Bupleuri Radix (Chaihu). If internal excess presents with constipation, use Sanhuang Xiexin Tang (Three Yellows and Heart-Draining Decoction) or Dachaihu Tang (Major Bupleurum Decoction) with added Natrii Sulfas (Mangxiao). If the macules appear like brocade patterns, the prognosis is difficult. Suitable formulas include Renshen Huaban Tang (Ginseng and Macule-Resolving Decoction), Yuanshen Shengma Tang (Scrophulariae and Cimicifugae Decoction), and Daqing Siwu Tang (Isatidis and Four Substances Decoction).
Tao Hua stated: Warm Toxicity arises from contracting cold-toxic alien Qi in winter, which manifests in spring. When exterior symptoms have not resolved and toxic Qi has not dispersed, macules may appear. Symptoms include epigastric vexation, vomiting, coughing, followed inevitably by diarrhea. A surging and rapid pulse at the Cun position and a full and large pulse at the Chi position indicate a severe disease due to hyperactive Yang Qi. The general formula is Yuanshen Shengma Tang.
[General Principle] Zhang Zhongjing stated: After inducing sweating, if the body remains burning hot, it is named Wind-Warmth (Fengwen). Its symptoms include a floating pulse, sweating, heavy body, and excessive sleepiness.
[Commentary] Xu Shuaiwei stated: When pulses at both hands are floating at all positions, accompanied by headache, body heat, frequent spontaneous sweating, heaviness of the body,必 wheezing breathing, numbness of the form, silence, and a desire only to sleep, this is the syndrome of Wind-Warmth. Inducing sweating again leads to death. Weirui Tang (Juncus Decoction) is suitable.
Li stated: In Taiyang Disease, sweating should result in cooling of the body. If the body remains burning hot after sweating, it is Wind-Warmth. This occurs when warm Qi is prevalent in spring and wind pathogens are contracted. Only wind damaging Wei-Qi leads to flaccidity and paralysis of the four limbs. Only warmth damaging Qi leads to mental clouding, nasal obstruction, slurred speech, body heat, spontaneous sweating, and somnolence. Treatment focuses on the Heart Fire and Liver Wood meridians. Sweating, purging, and acupuncture are contraindicated. Mistaken sweating causes burning heat, potentially leading to vexation, thirst, and delirium. Mistaken purging leads to urinary incontinence. Mistaken acupuncture leads to deafness. Clearing muscle-layer heat and releasing the exterior is the best approach. Suitable formulas include Weirui Tang, Baidu San (Detoxifying Powder), or Xiaochaihu Tang (Minor Bupleurum Decoction) with added Cinnamomi Ramulus (Guizhi) to induce slight sweating. For severe thirst, use Gualougen Tang (Trichosanthis Root Decoction). For wheezing, use Jinfecao Tang (Boilweed Decoction) with added Armeniacae Semen Amarum (Xingren), Asari Radix (Xixin), and Schisandrae Fructus (Wuweizi). For mistaken sweating, use Fangji Huangqi Tang (Stephania and Astragalus Decoction). Delirious speech, muttering, fixed gaze, and enuresis are untreatable.
Lou Quanshan stated: This disease is not limited to spring; therefore, a separate section for Wind-Warmth was established.
Ke Qin stated: This differs from the "latent cold causing warmth" described in the Neijing. Taiyang Sunstroke can also result from Cold Damage; although thirsty, the patient still fears cold. In contrast, Taiyang Warm Disease presents with thirst but no fear of cold, indicating the root cause is wind, not cold. Fever indicates the pathogen is in the exterior, requiring diaphoresis. However, since there is no fear of cold, Mahuang Tang (Ephedra Decoction) and Guizhi Tang are inappropriate. When wind and warmth combine, improper sweating may expel the wind but intensify the heat. Burning heat signifies the scorching effect of two Yang pathogens, indicating a transition to Yangming Disease.