《金鉴》云∶经曰∶冬伤于寒,春必病温,至夏为热病。热病者,乃冬伤正令之微寒,未即病也。倪氏
谓∶交立夏以来,久伏之气,随时令之热而触发,故初病即发热汗出,口渴心烦,不恶寒而反恶热,脉来洪大
之象,是为热病也。《医通》曰∶邪非外来,故但热而不恶寒,热自内发,故口燥渴而多引饮,其邪既郁为
热,不得复言为寒。合而观之,热病因伏气者了然,然较晚发更发于晚,比诸温更伏于深。初起之时,宜用
清凉透邪法。热势不衰,继用清凉荡热法。倘有恶寒相兼,脉象举取浮紧,是有夏时暴寒所加,寒在外而热在
里,先用辛温解表法,以透其外,外邪得透,再用清凉之剂,以荡其里热也。设无浮紧之脉,又无恶寒之证,
误用辛温之方,耗伤津液者,宜用清热保津法加西洋参、石膏治之。倘或兼之恶风,微微汗出,脉象举
取浮缓,此表有风邪所加,风在外而热在里,当用辛凉解表法,
先解其外也。至于舌苔化燥,谵语昏狂,急用清凉荡热法加紫雪丹治之。发斑者,加黄连、栀子;发疹者,
加荷叶、牛蒡。须知热病最易伤阴,当刻刻保阴为要,辛温劫液之剂,勿浪用也。
霉湿之为病,在乎五月也。芒种之后,逢丙入霉,霉与梅通,其时梅熟黄落,乍雨乍晴,天之日下逼,
地之湿上蒸,万物感其气则霉,人感其气则病。以其气从口鼻而入,即犯上中二焦,以致胸痞腹闷,身热有
汗,时欲恶心,右脉极钝之象,舌苔白滑。以上皆霉湿之浊气,壅遏上中气分之证,非香燥之剂,
不能破也。拟以芳香化浊法,俾其气机开畅,则上中之邪,不散而自解也。倘或连朝风雨,人冒之者,即患身
痛腰疼,恶寒发热,此邪由太阳之表,而入于少阴之里,即《内经》所谓雨气通于肾也,宜乎表里两解,拟
以二活同祛法。倘兼腹痛泄泻,再加煨葛、木香治之。
或问曰∶湿土之令,始于大暑,终于白露。今论霉湿在乎芒种之后,夏至节中,斯时相火司令,不论火而
论湿,得非矛盾乎?答曰∶湿土之令,在于夏末秋前,盖按《内经》六气之主政也。然而土寄于四季之末,四
时皆有湿病,总当因时制宜,不必拘于常例。即如春日阳和,夏日炎热,秋日燥烈,冬日温暖,
何湿之有?惟其春雨潇潇,夏雨淋淋,秋雨霏霏,冬雨纷纷,人感之者,皆为湿病。今专论霉湿在乎五月,
以其乍雨乍晴,湿中有热,热中有湿,与诸湿之病颇异,故列霉湿为一门。
The *Yizong Jinjian* (Golden Mirror of Medical Tradition) states: The classics say, "If one is injured by cold in winter, one will inevitably suffer from warm diseases in spring, which become febrile diseases by summer." Febrile disease refers to the slight cold encountered during the normal seasonal climate of winter, which does not cause immediate illness. Mr. Ni believes that after entering Lixia (Start of Summer), the long-latent pathogenic qi is triggered by the heat of the season. Therefore, at the onset, there is fever, sweating, thirst, and irritability; there is no aversion to cold but rather an aversion to heat, and the pulse presents a surging (Hong) quality. This is what is called febrile disease. *Yitong* (Comprehensive Essentials of Medicine) says: The pathogen is not exogenous, so there is only heat without aversion to cold; the heat originates internally, causing dry mouth, thirst, and excessive drinking. Since the pathogen has stagnated and transformed into heat, it can no longer be described as cold. Synthesizing these views, febrile disease caused by latent qi becomes clear; however, it manifests later than late-onset warm diseases and lies deeper than ordinary warm diseases. At the initial stage, the method of clearing heat and venting pathogens (Qingliang Touxie Fa) should be used. If the heat intensity does not subside, proceed with the method of clearing heat and purging fire (Qingliang Dangre Fa). If accompanied by aversion to cold and a floating-tight pulse upon light palpation, this indicates an attack by sudden cold in summer, where cold is on the exterior and heat is on the interior. First, use the method of releasing the exterior with acrid-warm herbs (Xinwen Jiabiao Fa) to vent the exterior pathogen. Once the exterior pathogen is vented, use cooling agents to purge the interior heat. If there is no floating-tight pulse and no aversion to cold, and if acrid-warm formulas were mistakenly used, depleting body fluids, one should use the method of clearing heat and preserving fluids (Qingre Baojin Fa), adding Xi Yang Shen (American Ginseng Root) and Shi Gao (Gypsum Fibrosum). If accompanied by aversion to wind and slight sweating, with a floating-slow pulse upon light palpation, this indicates an attack by wind on the exterior, with wind on the outside and heat on the inside. One should use the method of releasing the exterior with acrid-cool herbs (Xinliang Jiabiao Fa) to first resolve the exterior. As for dry tongue coating, delirium, and manic confusion, urgently apply the method of clearing heat and purging fire (Qingliang Dangre Fa) with Zi Xue Dan (Purple Snow Pill). For eruption of macules, add Huang Lian (Coptidis Rhizoma) and Zhi Zi (Gardeniae Fructus); for eruption of papules/rash, add He Ye (Nelumbinis Folium) and Niu Bang Zi (Arctii Fructus). It must be known that febrile disease easily damages Yin; therefore, protecting Yin at all times is paramount. Do not recklessly use acrid-warm agents that consume fluids.
The disease of moldy dampness occurs in the fifth month. After the Mangzhong (Grain in Ear) solar term, when Bing days arrive, it enters the "Mei" (moldy) season. "Mei" is homophonous with "Plum"; at this time, plums ripen and turn yellow, weather alternates between rain and sunshine, the sun's heat presses down from above, and earth's dampness steams up from below. All things affected by this qi become moldy, and humans affected by this qi fall ill. Because this qi enters through the mouth and nose, it initially invades the Upper Jiao (Upper Burner) and Middle Jiao (Middle Burner), leading to chest oppression, abdominal fullness, body heat with sweating, frequent nausea, a very blunt right pulse, and a white slippery tongue coating. These are all signs of turbid qi from moldy dampness obstructing the Qi aspect of the Upper and Middle Jiao. Only aromatic-drying agents can break this obstruction. It is proposed to use the method of aromatic transformation of turbidity (Fangxiang Huazhuo Fa) to open and smooth the Qi mechanism, so that the pathogens in the Upper and Middle Jiao will resolve spontaneously without forced dispersal. If there are consecutive days of wind and rain, and people are exposed to it, they may suffer from body pain, lower back pain, aversion to cold, and fever. This is because the pathogen enters from the Taiyang (Greater Yang) exterior into the Shaoyin (Lesser Yin) interior, as stated in the *Neijing*: "Rain qi corresponds to the Kidney." It is appropriate to resolve both the exterior and interior simultaneously, proposing the method of expelling both Qiang Huo (Notopterygii Rhizoma et Radix) and Du Huo (Angelicae Pubescentis Radix). If accompanied by abdominal pain and diarrhea, add Wei Ge Gen (Prepared Kudzu Root) and Mu Xiang (Aucklandiae Radix).
Someone asks: The command of Damp Earth begins at Dashu (Great Heat) and ends at Bailu (White Dew). Now, discussing moldy dampness occurring after Mangzhong and during the XiaZhi (Summer Solstice) festival, when Ministerial Fire is in command, discussing dampness instead of fire seems contradictory. I reply: The command of Damp Earth is indeed at the end of summer and beginning of autumn, according to the Six Qi governance in the *Neijing*. However, Earth is entrusted to the end of each of the four seasons, so damp diseases exist in all seasons. One must always adapt to the specific time and circumstances, not being bound by general rules. Just as spring is mild, summer hot, autumn dry, and winter warm, where is the dampness? But when spring rains drizzle, summer rains pour, autumn rains flutter, and winter rains fall, humans contracting these rains all suffer from damp diseases. Now, specifically discussing moldy dampness in May, because the weather alternates between rain and sunshine, with dampness containing heat and heat containing dampness, which differs significantly from other damp diseases, moldy dampness is listed as a separate category.