Library

Translation:
It is said: In Wind-Warmth disease, both the Cun (inch) and Chi (cubit) pulses are floating. This occurs because the patient has previously been injured by Wind pathogen, and subsequently injured by Heat pathogen; when Wind and Heat contend with each other, it becomes Wind-Warmth disease. Its external manifestations include flaccidity of the four limbs (inability to hold or move them), fever with spontaneous sweating, headache, panting, thirst, drowsiness, or heavy body with numbness. One must absolutely avoid inducing sweating; if sweating is induced erroneously, it will lead to delirium, irritability, and eyes lacking luster. The pathology involves the Shaoyin (Lesser Yin) and Jueyin (Terminal Yin) meridians. Wengyu Tang (Reed Rhizome Decoction), Renshen Baidu San (Ginseng Detoxification Powder), or Xiaochaihu Tang (Minor Bupleurum Decoction) may be selected for use.

Commentary: Among the external manifestations of Warm diseases, severe adverse signs such as flaccidity of the four limbs represent the most critical stage of Warm disease. Mild cases are termed Warm disease, while severe cases are termed Wind-Warmth disease; this is the name of the illness. Zhu Nanyang once mentioned this. To claim that "previous injury by Wind, subsequent injury by Heat, and their contention resulting in Wind-Warmth" is not an accurate theory. Stating that "sweating should not be induced" is the key principle for regulating Warm diseases.

Lin's Note: Tao Shi vigorously debated the distinctions between Warm and Summer-heat diseases but was ignorant of Yin-Yang latent Qi (pathogenic factors hidden within the body). Furthermore, he indiscriminately conflated the Warm diseases caused by miscellaneous Qi recorded in the *Nan Jing* (Classic of Difficult Issues) (in ancient times, there was no character for 'plague'; 'Warm' equaled 'Plague'), failing to distinguish between Warm and Plague diseases. No wonder he clung to formulas like Chai Ge Jie Ji Tang (Bupleurum and Kudzu Muscle-Releasing Decoction) and Renshen Baidu San, thereby misleading later generations of students.

The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: Due to Summer-heat, there is sweating; if vexed, there is panting and loud breathing; if calm, there is excessive talking. Jiegu (Zhang Yuansu) further stated: Contracted while at rest, it is Zhongshu (Heatstroke); contracted during activity, it is Zhongre (Heat Injury). Zhongshu belongs to Yin syndromes, while Zhongre belongs to Yang syndromes. In Zhang Zhongjing's *Shanghan Lun* (Treatise on Cold Damage), one syndrome called Zhongye (Heatstroke) refers to Summer-heat disease. The pulse is deficient and weak, accompanied by vexation, thirst desiring drinks, body heat, and spontaneous sweating. This is likely due to physical exhaustion leading to deficiency, allowing Summer-heat pathogen to invade the Wei (Defensive) level. It is appropriate to treat with tonifying agents such as Dongyuan Qingshu Yiqi Tang (Dongyuan Clearing Summer-heat and Boosting Qi Decoction) until recovery. Another syndrome called Rebing (Heat Disease) refers to Zhongre. The pulse is surging and tight/full, accompanied by headache, body heat, dry mouth, and mental agitation. This is likely due to Cold pathogen contracted in winter, accumulating until summer onset, combined with Summer-heat to form a severe Heat condition. It is appropriate to regulate with cooling agents such as Huanglian Jiedu Tang (Coptis Detoxification Decoction), Baihu Tang (White Tiger Decoction), or Jiedu Tang until recovery. Zhongshu is described as a disease caused by Yin syndrome and internal injury. Zhongre is feared to be a disease caused by external contraction. Speaking of Yin and Yang, is it not clearly distinguished here? Students should reflect further.

Commentary: Summer-heat and Heat are essentially the same Qi. Contracting Summer-heat and becoming ill with Heat cannot originally be divided into two distinct Qi; there is only a difference in severity between "Zhong" (direct strike) and "Shang" (injury). Danxi proposed three terms: Mao (encounter), Zhong (strike), and Shang (injury). Upon careful consideration, they all amount to Summer-heat injury. The most severe cases are termed "Zhong." As for "Mao," it need not be discussed, as there is already specific differentiation for Cold Damage syndromes dividing Yin and Yang. Summer-heat syndromes belong to Fire, often manifesting with vigorous and intense symptoms, generally termed Yang, seemingly having no Yin counterpart. Only when the invasion is deep, occurring suddenly after a long duration, presenting with coma, unconsciousness, closed eyes, and faint respiration, does it resemble a Yin syndrome. However, this is actually due to extreme Fire causing Qi stagnation, abundant Phlegm blocking Qi, obstruction of Zang-Fu organs, and blockage of the throat, representing Yang excess rather than Yin. If even Yin and Yang syndromes cannot be distinguished, how much more so is it inappropriate to distinguish between Summer-heat and Heat?

Lin's Note: Here, criticizing Huaxi for distinguishing Yin and Yang based on Summer-heat and Heat is correct. However, he claims Summer-heat is a condition of extreme Fire, indistinguishable from Heat. Then, using Liuhe Tang (Six Harmonies Decoction) as the main formula for treating Summer-heat, is it truly suitable to use drying and heating herbs such as Houpo (Magnolia Bark), Sharen (Amomum Fruit), Huoxiang (Patchouli Herb), and Banxia (Pinellia Tuber) for Fire-Heat conditions? This is self-contradictory and shows a profound lack of thought. Ultimately, it stems from a failure to understand the mutual root of Yin and Yang, leading to errors from the outset. In recent times, Wang Mengying rigidly held that Summer-heat is merely Fire pathogen without dampness, also due to not reading the *Neijing* and blindly copying one school's theory, writing rashly.