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Yu Jiayan’s discussion on Spring-Warmth (Chunwen) disease presents three cases: one where “winter injury by cold leads to warmth disease in spring”; another where “failure to store essence in winter leads to warmth disease in spring”; and a third where “both cold injury and failure to store essence occur.” In my view, the *Jingui Yaolue* states: Major pathogens (wind) strike the exterior, while minor pathogens (cold) strike the interior. Major pathogens are like widespread wind; though vast in scope, their force is weak. Minor pathogens are like wind through cracks in doors and windows; though small, their qi is sharp. Because they are sharp, they penetrate deeply into the interior; because they are small, they remain hidden without being perceived. The phrase “winter injury by cold” refers to cold received in winter, which is originally subtle rather than severe. Due to the inability to hibernate and store (zhe cang), the pathogen lies deep within. After lying latent for a long time, the cold transforms into heat. When spring arrives and human qi ascends and floats, the pathogen emerges with it, resulting in fever and thirst. Thus, “winter injury by cold” is the cause of spring warmth diseases; whereas “failure to store essence in winter” is the source of winter cold exposure! Yu Jiayan’s division into three examples actually describes only one phenomenon but forces artificial distinctions, making the discourse verbose and the logic obscure.

Wang Shuhe’s claim that “cold poison hides in the skin and muscles” is erroneous. Yu Jiayan also stated that “winter cold injury hides in the skin and muscles, manifesting only upon sensing the warmth of spring.” Skin and muscles are governed by the Yangming Stomach meridian. I believe the skin and muscles are not places where pathogens hide, nor does the Yangming stomach suffer from cold without manifesting disease. Only the Shaoyin Kidney, being Yin, encounters Cold Pathogen, which is also Yin; Yin meeting Yin allows for hiding without immediate manifestation. Therefore, the pathogen of Cold Damage (Shanghan) transmits sequentially from Taiyang to the Three Yin meridians; the pathogen of Warmth disease transmits from Shaoyin to the Three Yang meridians. How can it be said to hide in the skin, muscles, and stomach?

Yu Jiayan claimed: Zhang Zhongjing treated warmth syndromes using Guizhi Tang (Cinnamon Twig Decoction) whenever releasing exterior agents were used, indicating an intention to induce slight sweating rather than profuse sweating. He further stated: For warmth disease lasting two or three days, Mahuang Fuzi Xixin Tang (Ephedra, Aconite, and Asarum Decoction) or Mahuang Fuzi Gancao Tang (Ephedra, Aconite, and Licorice Decoction) should be used to reach deep into the Kidney, leading out the external pathogen, thereby curing severe cases. This is Yu Jiayan’s subjective speculation, not Zhang Zhongjing’s original principles. Warmth pathogens cannot be cured by dispersal alone; even if exterior symptoms exist, can they be released with acrid-warm herbs? Moreover, Guizhi Tang is designed for Cold Damage exterior syndromes where the interior is harmonious. Warmth pathogens originate from the interior, and the exterior is not yet diseased; using Guizhi would merely assist the warmth pathogen and retain the disease qi. Furthermore, since warmth disease involves latent cold transforming into heat, and Shaoyin essence has already been depleted, using acrid-warm herbs and Aconite (Fuzi) severs the root and aids collapse. Even if one argues that Shaoyin has cold as its substance and heat as its manifestation, and that non-warm methods cannot disperse pathogens entering this domain, when warmth disease erupts, the cold has already turned to heat, and its tendency to emerge is naturally strong without needing guidance. Those who fail to emerge must have exhausted Yin essence; otherwise, how could there be those who do not emerge? Yu Jiayan forcibly cites scriptures to fit his own ideas, misleading himself and others, requiring clarification!

Yu Jiayan stated: “Winter injury by cold” is governed by the Taiyang Bladder meridian; “failure to store essence in winter” is governed by the Shaoyin Kidney meridian. This matches the case of Lianggan Cold Damage (Two-Fold Contraction of Cold), where Taiyang is affected on the first day and simultaneously involves Shaoyin, presenting with headache, dry mouth, irritability, thirst, and fullness, with no discrepancy. I hold that warmth disease involves the combination of old and new pathogens, but does not involve simultaneous exterior and interior contraction. Warmth disease arises from latent Qi; while Shaoyin possesses latent Qi, it is uncertain whether Taiyang can harbor latent Qi. If it cannot lie latent, the pathogen manifests immediately upon infection, constituting Cold Damage, not Warmth disease.

Yu Jiayan said: Shaoyin is a Yin organ with scant blood; thus, forcing sweat from Shaoyin may cause blood to flow from the ears, eyes, mouth, and nose in severe cases, leading to alarming collapse; in mild cases, it causes difficult urination and impending desiccation. Whenever I use Guizhi Tang, I always add Shengdi Huang (Rehmanniae Radix) to compensate for the insufficiency of Baishao (White Peony Root), and the efficacy is evident. This argument is excellent and slightly corrects previous errors. Since warmth disease onset injures Yin Qi first, if exterior resolution is required, it must be combined with herbs that nourish Yin and clear heat. Former sages added Tongbian (Child’s Urine) to Congchi Tang (Scallion and Fermented Soybean Decoction), and added Shengdi Huang and Maidong (Ophiopogonis Radix) to Zhichi Tang (Gardenia and Fermented Soybean Decoction), following this same principle.

He also said: Nowadays, people see symptoms of excessive heat causing irritability and dryness and dare not use Fuzi (Prepared Aconite Lateral Root), fearing it will aid heat with heat. Little do they know that in individuals failing to store essence, Kidney Yang fails to stir, preventing Jin Ye (Body Fluids) from ascending, resulting in external dryness. Upon using Fuzi to assist Yang, Yin Essence ascends to the Yang positions, like adding fire to the bottom of a pot, causing steam to rise and moisture to return instantly. These words contain profound truth, but applying them to warmth disease has drawbacks. Dryness caused by Yin stagnation differs vastly from dryness caused by Yin exhaustion; a misprescription leads to immediate death or life, so careful examination is essential!