太阳病。发热而渴。不恶寒者。为温病。
此温病之的证也。温病者。冬春之月。温暖太甚。所谓非节之暖。人感之而即病者也。此正是
伤寒对照处。伤寒变乃成热。故必传经而后渴。温邪不待传变。故在太阳而即渴也。伤寒阳为寒郁
。故身发热而恶寒。温病阳为邪引。故发热而不恶寒也。然其脉浮。身热头痛。则与伤寒相似。所
以谓之伤寒类病云。
若发汗已。身灼热者。名曰风温。风温为病。脉阴阳俱浮。自汗出。身重多眠睡。鼻息必鼾。
语言难出。若被下者。小便不利。直视失溲。若被火者。微发黄色。剧则如惊痫。时螈 。若火熏
之。一逆尚引日。再逆促命期。
此风温之的脉的证也。亦是伤寒反照处。伤寒寒邪伤在表。汗之则邪去而热已。风温温与风得
汗之
则风去而温胜。故身灼热也。且夫风温之病。风伤阳气而温损阴气。故脉阴阳俱浮。不似伤寒之阴
阳俱紧也。风泄津液。而温伤肺气。故自汗出身重。不同伤寒之无汗而体痛也。多眠睡者。热胜而神昏也。鼻
息鼾。语言难出者。风温上壅。凑于肺也。是当以辛散风而凉胜温。乃不知而遽下之。则适以伤脏阴
而陷邪气。脏阴伤。则小便难目直视。邪气陷。则时复失溲也。被火如温针灼艾之属。风温为阳邪
。火为阳气。以阳遇阳。所谓两阳相熏灼。其身必发黄也。然火微则薰于皮肤。而身发黄色。火剧
则逼入心脏。而如发惊痫。且风从火出。而时时螈 。乃所以为逆也。若已被火而复以火熏之。是谓
逆而再逆。一逆尚延时日。再逆则促命期。此医家之大罪也。仲景示人风温温病之大戒加此。
按伤寒序例云、从霜降以后。至春分以前。凡有触冒霜露。体中寒即病者。谓之伤寒。至冬有
非节之暖者。名曰冬温。冬温之毒。与伤寒大异。从立春节后。其中无暴大寒。又不冰雪。而有人壮热
为病者。此属春时阳气发外。冬时伏寒。变为温病。从春分以后。至秋分节前。天有暴寒者。皆为
时行寒疫也。又曰。若更感异气。变为他病者。当根据坏证病而治之。若脉阴阳俱盛。重感于寒者。
变为温疟。阳脉浮滑。阴脉濡。弱者。更遇于风。变为风温。阳脉洪数。阴脉实大者。更遇温热。
变为温毒。温毒为病最重也。阳脉濡弱。阴脉弦紧者。更遇温气。变为温疫。夫所谓冬温寒疫者。
皆非其时而有其气。即所谓天行时气也。所谓变为温病者。乃是冬时伏寒。发于春时。阳气即春温
也。所谓变为温疟者。本是温热之病。重感新寒。热为寒郁。故为疟也。所谓变为风温者。
前风未绝。而后风继之。以阳遇阳。相得益炽也。所谓变为温毒者。前
热未已。而又感温热。表里皆热。蕴隆为患。故谓毒也。所谓变为温疫者。本有温病。而又感厉气
。故为温疫也。夫治病者。必先识病。欲识病者。必先正名。名正而后证可辨。法可施矣。惜乎
方法并未专详。然以意求之。无不可得。在人之致力何如耳。
Taiyang disease (disease of the Taiyang channel) presenting with fever and thirst, without aversion to cold, is classified as Warm Disease (Wenbing).
This constitutes the definitive syndrome of Warm Disease. Warm Disease refers to illness contracted immediately upon exposure to excessive warmth during winter or spring months, known as "warmth out of season." This serves as a direct contrast to Cold Damage (Shanghan). In Cold Damage, heat transformation occurs only after transmission through channels; thus, thirst appears only after the pathogen has transmitted. In contrast, Warm pathogens do not require transmission to generate heat; hence, thirst manifests while the pathogen is still in the Taiyang stage. In Cold Damage, Yang Qi is constrained by Cold, resulting in fever accompanied by aversion to cold. In Warm Disease, Yang Qi is stimulated by the pathogen, resulting in fever without aversion to cold. However, since the pulse is floating, and there is fever and headache, it resembles Cold Damage, hence it is termed a "Cold Damage-like disease."
If sweating therapy is administered and the body remains scorching hot, it is named Wind-Warmth (Fengwen). The pathology of Wind-Warmth presents with a floating pulse at both the Yin and Yang positions, spontaneous sweating, heaviness of the body, excessive sleepiness, snoring during respiration, and difficulty speaking. If purgation is mistakenly applied, it leads to difficult urination, fixed staring of the eyes, and involuntary loss of urine and stool. If fire therapy (such as moxibustion or warm needle) is mistakenly applied, mild cases result in yellowing of the skin, while severe cases resemble convulsive epilepsy with periodic spasms. If fire fumigation is added to previous fire therapy, one error may prolong the illness, but a second error will hasten death.
These are the definitive pulse and syndrome manifestations of Wind-Warmth. This also serves as a counterpoint to Cold Damage. In Cold Damage, Cold pathogen attacks the exterior; sweating eliminates the pathogen, and the heat subsides. In Wind-Warmth, Wind and Warmth combine; sweating removes the Wind, but the Warmth prevails, resulting in scorching heat. Furthermore, Wind damages Yang Qi, while Warmth injures Yin Qi, causing the pulse to be floating at both Yin and Yang positions, unlike the tight pulse seen in Cold Damage. Wind causes leakage of body fluids, and Warmth injairs Lung Qi, leading to spontaneous sweating and body heaviness, differing from the anhidrosis and body pain of Cold Damage. Excessive sleepiness indicates mental confusion due to overwhelming heat. Snoring and difficulty in speech indicate Wind-Warmth obstructing the upper jiao and accumulating in the Lungs. The correct treatment should involve acrid dispersants to expel Wind and cooling agents to overcome Warmth. Instead, if purgatives are rashly used, they injure the Yin of the Zang organs and trap the pathogen inward. Injury to Zang Yin results in difficult urination and fixed staring; entrapment of the pathogen leads to occasional incontinence. Fire therapies, such as warm needles or moxa, involve Fire (Yang) treating Wind-Warmth (also Yang). This is described as "two Yangs fuming and burning," inevitably causing jaundice. Mild fire steams the skin causing yellowing; severe fire forces the pathogen into the Heart, resembling epilepsy. Moreover, Wind arising from Fire causes periodic spasms, constituting a therapeutic error ("Ni"). If fire therapy is followed by fire fumigation, it is "error compounded by error." One error delays recovery; two errors shorten life. This is a grave sin for physicians. Zhang Zhongjing emphasizes these major prohibitions regarding Wind-Warmth and Warm Disease.
According to the Preface of *Shanghan Lun*: From Frost's Descent until Spring Equinox, illness caused by exposure to frost and cold is called Cold Damage. Non-seasonal warmth in winter is called Winter-Warmth (Dongwen), whose toxicity differs greatly from Cold Damage. After Start of Spring, if there is no sudden severe cold or ice/snow, yet high fever occurs, this belongs to Warm Disease, where latent Cold from winter transforms due to the outward expansion of Spring Yang. From Spring Equinox to Autumn Equinox, sudden cold spells are called Seasonal Cold Epidemic (Shixing Hanyi). It is further stated: If additional abnormal qi is contracted, transforming into other diseases, treat according to the compromised syndromes. If the pulse is full and rapid at both Yin and Yang positions, and Cold is re-contracted, it transforms into Warm Malaria (Wen Nue). If the Yang pulse is floating and slippery, and the Yin pulse is soft and weak, and Wind is encountered, it transforms into Wind-Warmth. If the Yang pulse is surging and rapid, and the Yin pulse is solid and large, and Warmth is encountered, it transforms into Warm Toxin (Wendu), which is the most severe form. If the Yang pulse is soft and weak, and the Yin pulse is wiry and tight, and Warm Qi is encountered, it transforms into Warm Epidemic (Wenyi). Winter-Warmth and Seasonal Cold Epidemics arise when qi exists out of season, referred to as "Heavenly Traveling Seasonal Qi." Transformations into Warm Disease stem from latent winter Cold emerging in spring, associated with Spring Warmth. Transformations into Warm Malaria occur when a pre-existing Warmth disease is re-exposed to new Cold, suppressing Heat within Cold, resulting in Malaria. Transformations into Wind-Warmth occur when prior Wind lingers and subsequent Wind follows; Yang meets Yang, intensifying the condition. Transformations into Warm Toxin occur when prior Heat persists and Warmth is additionally contracted, creating interior-exterior Heat accumulation, termed "Toxin." Transformations into Warm Epidemic occur when pre-existing Warm Disease is combined with Pestilential Qi. Physicians must first identify the disease; to identify the disease, one must correctly name it. Only with correct naming can syndromes be distinguished and treatments applied. Regrettably, specific methods are not detailed exclusively, but through intellectual deduction, all can be understood, depending on the practitioner's diligence.