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The *Classic* states: All conditions of dryness, withering, drying up, stiffness, and skin cracking or peeling belong to Dryness. Dryness is the transformation of Lung Metal, corresponding to the Autumn season. There are two causes for Dryness: one is due to Cold; the clear and austere winds of autumn cause the dampness of summer to become dry at this time, which is what is meant by "Wind overcomes Dampness"; the other is due to Heat; during summer, heat is abundant and moisture moistens it, but in autumn, when the moisture recedes while the heat remains, Dryness results, which is what is meant by "Nothing dries things more than Fire." Those caused by Heat are indeed Heat, but even those caused by Cold are not necessarily not Heat. Why? Because the Autumn season governs descending and gathering, Yang Qi enters inwardly, and Cold Qi binds externally. Therefore, whenever it becomes cool in autumn, people often feel that the breath from their mouth and nose is hot; this is the principle. This refers to Dryness caused by celestial timing. If, however, it is due to loss of blood or body fluids, or Kidney deficiency with flourishing Fire, leading to various manifestations, then these belong to human factors. Externally, there is skin cracking, withering, and roughness; superiorly, there is scorching dryness of the nose and throat; inferiorly, there is dryness and obstruction of urination and defecation; in the limbs, there is flaccidity and weakness (caused by Blood failing to nourish the sinews); in the pulse, there is choppy, deficient, and declining quality. Treatment employs sweet and cold moistening agents to clear the Lungs and nourish the source of water, so that Blood may be sufficient and fluids full, moistening the entire body. Zaozao Yangrong Tang (Moisturizing Dryness and Nourishing Blood Decoction), Da Bu Dihuang Wan (Great Tonification of Rehmannia Pill), Qingliang Yinzi (Cooling and Refreshing Infusion), Daozhi Tongyou Tang (Guiding Stasis and Opening the Secluded Decoction), Run Chang Wan (Moistening Intestines Pill) [see Constipation], and Bazheng San (Eight Corrective Powder) [see Strangury] can all be selected according to the syndrome. The *Inner Classic* often says "Autumn injury by Dampness," which is a theory of Six Qi transformations, attributing Damp Earth to the three periods of Start of Autumn, End of Heat, and White Dew; nevertheless, injuries by Dryness are more common.

(Warm Malaria, Wind-Warmth, Warm-Toxicity, Damp-Warmth)
Warmth is the Qi of Spring Yang. When spring arrives, Yang Qi activates. Humans respond to this, and the Yang Qi within the body also activates. Once exposed to external invasion by Wind-Cold, which closes the Cou Li (pores and interstices), this Qi cannot ascend and diffuse, thus stagnating and transforming into Heat. This is no different from fever caused by Wind-Cold injury in winter. However, there is a distinction between aversion to cold and lack thereof. In winter, Yang Qi hides, causing exterior Yang deficiency, hence fear of cold; in spring, Yang Qi ascends and diffuses, causing exterior Yang abundance, hence no fear of cold. For cases without sweating, dispersal is indicated. However, in winter, when Yang is weak, acrid-warm herbs may be used; in spring, when Yang is abundant, acrid-cool herbs are appropriate. Zhang Zhongjing's Mahuang Tang (Ephedra Decoction) was established only for Winter Cold Damage and should not be indiscriminately applied to this syndrome. The *Classic* states: "Injury by Cold in winter leads to Warmth diseases in spring." It also states: "Failure to store essence in winter leads to Warmth diseases in spring." Furthermore: "For all Cold Damage illnesses that transform into Heat, those occurring before the Summer Solstice are Warmth diseases, and those after are Summer-Heat diseases." Cheng Jiaoqian stated that in "Winter injury by Cold," the character "Cold" should be interpreted as "Kidney." Since Kidney Water belongs to Winter and its nature is Cold, ancient physicians often referred to the Kidney as Cold, just as they referred to the Liver as Wind and the Spleen as Dampness; careful reading of past medical texts will reveal this. "Winter injury by Cold..." refers to the consumption of Kidney Water, where Yin Essence leaks out and fails to store. Yin deficiency leads to Fire flaming upward. When Spring Yang activates, its blazing momentum is unstoppable. Once constrained by Wind-Cold, Warm-Heat diseases arise. But does this happen only to those who fail to store essence? Even in healthy individuals, when Spring Yang ascends, many contract diseases due to Wind-Cold constraint. The *Jin Jian* (Golden Mirror of Medicine) states that those who can store essence have mild disease, while those who cannot have severe disease; this is correct. Some say: The *Classic* mentions Warm Malaria, stating it arises from Wind-Cold in winter, with Qi hiding in the bone marrow. By spring, Qi erupts greatly (Cold constrained transforms into Fire/Heat, which emerges as Warm Malaria due to Spring Yang, meaning Warmth disease before the Summer Solstice). The pathogen cannot exit on its own (the sentence likely implies "if"), and upon encountering Summer-Heat, the brain marrow is scorched, muscles waste away (indicating heat reaching the bones), and Cou Li open (these five sentences indicate that if the pathogen cannot erupt in spring, it erupts in summer, meaning Summer-Heat disease after the Summer Solstice). Or, through exertion, the pathogen exits with sweat. This disease hides in the Kidney, emerging from inside to outside sequentially. In such cases, Yin is deficient and Yang is abundant; abundance brings Heat; decline (of Heat) causes Qi to return inward; inward return makes Yang deficient; deficiency brings Cold. (Excessive emission of Yang Qi leads to exterior deficiency and fear of cold; exterior fear of cold causes Qi to contract and return inward; inward return makes the exterior even more deficient, hence Cold.) Clearly, this speaks of touching Cold in winter. How dare you criticize Cheng's interpretation? I reply: The *Book of Rites* states that words do not have only one meaning, but each has its appropriate context. Seek the appropriate meaning for each. Wind-Warmth is the severe form of Spring-Warmth. Zhang Zhongjing said: Taiyang disease with fever, thirst, and no aversion to cold (in winter Cold Damage, this is a Yangming Channel syndrome) is called Heat Disease (in spring cold damage, the pathogen is in the Taiyang channel, presenting this syndrome immediately, without needing to transmit to Yangming, thus identifying it as Spring-Warmth). After sweating (sweating dissipates heat, recovery should follow), if the body feels burning hot, it is named Wind-Warmth (severe heat, treated with releasing exterior agents, intensifies like wind fanning fire). Wind-Warmth presents with floating pulses at both cun and chi positions, spontaneous sweating (Wind-Warmth originally has sweating due to intense interior heat evaporating fluids, which is heavier than Spring-Warmth with less interior heat and no sweating), heaviness of the body (high fever damages Qi, lacking Qi to move causes heaviness), excessive sleepiness, snoring nasal breathing (heat congestion confuses the spirit), and difficulty speaking (Qi damage causes reluctance to speak). If purgatives are misapplied, there is difficult urination (loss of Yin, depletion of the source), fixed staring (essence fails to nourish the eyes), and urinary incontinence (Yin fails to guard internally). If fire therapy is misapplied, slight jaundice appears (fire upon fire, heat-dampness desires to cause jaundice, but heat exceeds dampness, hence slight yellowing); severely, it resembles convulsive epilepsy (extreme heat generates wind), with occasional clonic spasms (sinews scorched by heat, drying and contracting). If fumigated with fire, one error prolongs the illness, a second error hastens death. Generally, Wind-Warmth contraindicates sweating, is unsuitable for purging (if interior heat is not solid), and especially contraindicates fire therapy. Shuangjie San (Double Resolution Powder) minus Mahuang (Ephedra), plus Guizhi (Cinnamon Twig) and Shigao (Gypsum) should be used (I believe Guizhi need not be added). For Spring-Warmth without sweating, although resolving the exterior is suitable, clearing the interior must also be combined. Shuangjie San allows for modifications based on the severity of exterior vs. interior patterns (Shuangjie San is a combination of Fangfeng Tongsheng San and Liuyi San; the *Jin Jian* calls it miraculous, and it can be used with modifications). Although this formula contains Xiaoshi (Mirabilite) and Dahuang (Rhubarb), nothing clears heat faster, and the dosages are limited, preventing excessive purgation without harm. Ancients said: Misapplying purgatives in Warm-Heat syndromes is tolerable, but misapplying sweating is dangerous. Use Xiaoshi and Dahuang if indicated, remove them if not; this depends on clinical judgment. For Wind-Warmth with excessive sweating and a deficient pulse, use Guizhi Tang (Cinnamon Twig Decoction) combined with Renshen Baihu Tang (Ginseng White Tiger Decoction). Warmth disease complicated by Summer-Heat is named Warm-Toxicity; treatment follows the above principles. Damp-Warmth is Warmth disease complicated by Dampness. Its symptoms include: heaviness of the body, chest fullness, excessive sweating, and coldness in both calves. Baizhu Tang (White Tiger Decoction) plus Cangzhu (Atractylodes Rhizome) and Fuling (Poria) is used.