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Warming method refers to warming the middle jiao (Middle Burner). When the zang organs are invaded by cold, warming agents must be used. The Classics state: "For cold, use heat," which is correct. However, there are cases where failure to use warming when indicated causes harm; there are cases where using warming when not indicated causes harm; there are cases where warming is indicated but applied incorrectly causing harm; and there are cases where warming is indicated but applied without considering the patient's constitution, syndrome, or season, causing harm. These situations require careful examination.

Among pathogenic factors in heaven and earth, none is more severe than Cold Damage (Shanghan). If the pathogen enters from the exterior, employing a warming and dispersing method initially will naturally eliminate the disease. If it does not enter from the exterior but directly invades the Yin meridians, it is called "Direct Invasion of Cold" (Zhong Han). Symptoms include aversion to cold, cold extremities, cold breath from mouth and nose, spontaneous cold sweating, vomiting and diarrhea, acute abdominal pain, cold extremities with absent pulse, and passage of undigested food in stool. When various cold syndromes appear together, the treatment principle is to warm. Alternatively, if cold-dampness infiltrates, causing stiffness and cramping of the four limbs leading to painful Bi syndrome, warming and dispersing is also appropriate. This constitutes "warming when indicated."

However, there are cases where warming is not indicated yet employed. Why? For instance, when Heat pathogens from Cold Damage transmit inward, presenting with dry mouth and throat, constipation, delirium, as well as macules, jaundice, mania, epistaxis, hematemesis, and hematochezia, warming is contraindicated, which goes without saying. If heat has penetrated deeply, with progressive cold extremities, dry tongue, yet no thirst, or accompanied by heat-induced diarrhea, coma, and weak qi, or with a choppy pulse that is imperceptible, complexion like smoke-stained, body emaciated like dead wood, silent upon approach, and appearing as if spirit is departing, even with depletion of blood and fluids causing tendon vessel cramping, where only the lips, mouth, teeth, and tongue remain dry and unrelieved, this is a sign of True Heat and False Cold. Laypeople do not understand the principle of excessive damage being controlled by counteracting forces; mistakenly administering hot agents leads to collapse upon ingestion. Furthermore, internal accumulation of stagnant heat causing apparent aversion to cold; damp-heat distension with cold skin; summerheat causing vexation with deficient pulse and spontaneous sweating; dryness damaging Lung Metal causing flaccidity and weakness—all these are unsuitable for warming. Also, yin deficiency with fine and rapid pulse, where yang invades yin causing hematemesis, should not be warmed; warming leads to adverse conditions. This is what is meant by "warming when not indicated."

However, there are cases where warming is indicated but applied improperly. Why? If one contracts Cold Damage in winter, one warms and disperses it. If one contracts Wind in winter, one warms and resolves it. If cold-phlegm obstructs, one warms and opens it. If injured by cold food, one warms and eliminates it. In cases of sudden severe pain from direct cold invasion with hard stool, if warming medicines fail, one uses hot purgatives. During summer months, if one seeks coolness and drinks cold beverages, suddenly contracting cold, warming is still required. For those with deficiency and cold, one warms and tonifies. If cold lodges in the Middle Jiao, Lizhong Tang (Regulate the Middle Decoction) is used to warm. If cold lodges in the Lower Jiao, Sini Tang (Frigid Extremities Decoction) is used to warm. In cases where extreme yin repels yang to the exterior and warming fails, Baitong Tang (White Tongue Decoction) added with human urine and pig gallbladder bile is used for counter-assistance, as stated in the Classics: "Use heat due to cold application." For true deficiency with cold and decline of Mingmen Fire (Gate of Vitality), one must tonify true yang. Taipu (Zhang Jingyue) said: "In severe cold, if heating does not produce warmth, it is lack of fire; one must tonify the Heart." Here, "Heart" refers to the Mingmen, as mentioned in the Neijing: "Beside the seventh vertebra lies the Small Heart." Books state: "Benefiting Heart Yang allows circulation even in cold; nourishing Kidney Yin allows treatment even in heat." However, physicians distinguish between Warming-Nature (Re Wen) and Gentle-Warmth (Wen Cun). Ginseng, Atractylodes, Angelica, and Atractylodes macrocephala have mild nature, representing Gentle-Warmth, like the gentle sun in spring. Aconite, Ginger, and Cinnamon Twig have pungent-hot nature, representing Warming-Nature, like the fierce sun in summer. One can approach the gentle sun anytime; one should only approach the fierce sun when ice is melting and snow is thawing. There are also cases of exterior and interior cold. Initially using warming medicine removes interior cold instantly, but if exterior pathogen remains, it may transmit to meridians, transforming from initial cold-interior to later heat-interior. If one does not weigh the season and syndrome, first saving with warming then harming with further warming, error occurs. Also, direct invasion of Three Yin without exterior pathogen, where excessive warming generates heat after cold retreats, changes the course entirely. Thus, precision in warming is crucial.

However, there is warming without considering the patient. For those with qi deficiency and lack of fire, whose yang is inherently weak, if attacked by exogenous cold, heavy doses of warming agents are suitable and multiple doses cause no harm. But for those with inherent excess fire who dislike pungent-warm herbs, or those with history of yin deficiency and bleeding, warming is contraindicated. Even with new cold invasion, warming should not be excessive; stop when symptoms resolve, without finishing the dose. This suits the patient. Regarding syndrome: for severe cold, slight warming suffices; for mild cold, excessive heat causes hyperactivity. Warming and tonifying may be combined or separate. For both deficiency and cold, combine them. For cold without deficiency, use only warming. Danxi said: "For sudden cold pain with food stagnation, Guizhi Tang (Cinnamon Twig Decoction) and Fuzi (Aconite Root) may be used, but Ren Shen (Ginseng Root) should not be used immediately." Generally, warming is tonifying. I follow this: first warm with Ginger and Cinnamon Twig; if deficiency is confirmed, then assist with Ginseng and Atractylodes. This yields consistent results. This illustrates weighing the syndrome in warming.

Regarding season: in midsummer, warming agents should be light; in deep winter, they should be heavy. Yet, sometimes in midsummer, severe deficiency-cold occurs, cured by decocted paste of Ginseng and Aconite. This is "abandoning season for syndrome." For example, after Frost Descent, Baihu Tang (White Tiger Decoction) is forbidden. Yet, in Yangming syndrome with steaming fever, spontaneous sweating, delirium, irritability, and thirst for cold drinks, even during snowstorms, Baihu Tang has been used successfully, provided it is not overused. This shows weighing the season in warming, and cooling methods can be inferred similarly.

Recently, physicians favor warming-tonification and strictly prohibit cooling. They say: "Yang is the gentleman, Yin is the petty person." And: "Yangming is the gentleman; faults are known." Knowing allows remedy, which is acceptable. But medicine treats disease; turning to treat the medicine itself aggravates disease into danger. As stated: "Guizhi Tang swallowed, if yang is excess, danger ensues; Chengqi Tang entering stomach, if yin is excess, collapse follows." Life and death hinge like flipping a hand; rescue often fails. Benevolent doctors should grieve at this. I hope physicians think carefully, discern principles accurately, and prescribe moderately, ensuring drugs balancing yin and yang achieve harmony. This is good treatment. Alas! How can one not strive?