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(Modification of the draft by disciple Guo Zichun)

Exogenous diseases are nothing but the pathogenic factors of the Six Evils (Liu Yin, 六淫). Diseases among the people should be differentiated according to the Four Qi (Si Qi, 四气) of the seasons. If one does not distinguish the source and flow of the etiology, how can one differentiate the names of the diseases? For instance, in the spring when yang qi is venting out, people often suffer from Warm diseases (Wen Bing, 温病). "Warm" is the gradual onset of Heat (Re, 热), and "Heat" is the root of Fire (Huo, 火). Using Cold (Han, 寒) to treat Heat is an eternal principle.

However, Fire pathogen inevitably causes irritability (Fan, 烦), yet there are cases of restlessness resembling irritability due to Extreme Yin (Ji Yin, 极阴) manifesting as false heat; such irritability cannot be relied upon for diagnosis alone. Heat pathogen inevitably leads to Dryness (Zao, 燥), yet there are cases resembling dryness due to turbid dampness obstructing and suppressing, preventing body fluids (Jin Ye, 津液) from ascending; such dryness is insufficient as evidence. Heat pathogen inevitably forces chaos upon the Spirit (Shen, 神), causing confusion of consciousness; yet there is confusion caused by steaming and muddying obstruction, which resembles the confusion caused by forcing chaos upon the spirit, but this confusion cannot be trusted blindly.

One must not ignore that dryness caused by Extreme Yin must be accompanied by cold feet and Floating Yang (Dai Yang, 戴阳). Dryness caused by dampness suppression preventing fluid ascent must present as thirst without desire to drink. Confusion caused by muddying obstruction must present with a state of lethargic sinking. Only when there is robust high fever, thirst with ability to drink, yellow or scorched or red tongue coating, leading to coma and convulsions, where the progression of coma and convulsions comes gradually as described above, can it be deemed a severe Warm-Heat condition. Such conditions require herbs like Lianqiao (Forsythiae Fructus), Xijiao (Rhinocerotis Cornu - *Note: Substitute with Tapir Horn or Buffalo Horn clinically*), Lingyangjiao (Saigae Tataricae Cornu), Xuanshen (Scrophulariae Radix), Shichangpu (Acori Tatarinowii Rhizoma), and Zhibao Dan (Treasure of Life Pill) to achieve efficacy.

Someone might ask: The manifestations of Warm-Heat diseases, I already know generally. Dampness and Warmth are originally dissimilar. However, after transforming into Heat, Fire, and Dryness, they become indistinguishable from Warm diseases. Without definitive signs, how can one diagnose? I say: Dampness has a steaming nature, often presenting with sweating but unresolved fever. Dampness often obstructs Qi mechanism; irritability must be accompanied by chest tightness and nausea. Although Heat consumes clear fluids, the Spleen and Stomach remain suffering from damp infiltration; thus, there is thirst but inability to bear drinking. The tongue may be dry and moldy, yet if drinking occurs, warm water is preferred, or there is no desire to drink at all. The coma presents as lethargic sinking. By using "sweating without fever resolution" to identify Heat, "chest tightness" to identify irritability, "inability to drink" to identify thirst, "preference for warm water or no desire to drink" to identify dryness, and "lethargic sinking" to identify confusion, one can examine accordingly. Why worry about being confused during clinical practice?

Moreover, regarding dental plaque/fur on teeth: Dental fur caused by Warm pathogen naturally accompanies vermilion lips, crimson tongue, and constipation. Dental fur caused by Damp-Warmth never presents with all these symptoms simultaneously. Although the tongue may be crimson, near the root or on both sides, there must be a form of turbid stagnation, firmly bound like sand in a pit, traditionally referred to as "Bang Tai" (Hard/Firm Coating). This is because one case is due to water exhausted by fire, where extreme fire resembles water; the other is due to dampness wrapping heat, steaming and turbidly binding. Turbid binding forms flakes, making the teeth appear coated. Regarding dry tongue: Warm pathogen patients seek relief through drinking; Damp-Warmth patients do not rely on drinking. Regarding sweating: Warm pathogen patients have fever resolve after sweating, or experience intense thirst and high fever after sweating; Damp-Warmth patients have steaming-upward heat after sweating. With fixed signs, there are fixed disease names; with fixed disease names, there are fixed treatment methods.

*Editor's Note: The character " " in this text should be read as "Bang" (䪼), meaning firm/solid. It has been copied incorrectly in previous original cases for a long time. All are kept as old versions here. Recorded here for reference.* (Wen Hanzhi)