医之道难矣哉。凡病伤寒最重。温热尤烈。伤寒仅在一时。温热暑疫。每发三季。为
时既久。病者益多。苟不明其源。溯流不得清也。不辨其类。疗治不得当也。则温热
暑疫。皆热证也。燎原之下。竟乏清凉一滴。人无今昔。性有异同。神酣往圣。志切琳
。俊以一隙微明。静中索照焉。夫上古圣人。首重色脉。以营之未交已交。定人生
死。片言已毕。中古圣人。专论谷气盛衰。定人生死。片言已毕。仲景叔季圣人也。既
立方论。复出不尽之脏。纬以膀胱之伤与绝。定人生死。先后合符。了无剩义矣。乃
仲景于伤寒论中。温热森森。具载黄芩、白虎等汤。是其治也。后之学人。苟能引伸
此意。便可变化不穷。神明千载。不能细察其理。反执以为治伤寒之法。盍思本汤
既无外解之功。又无内夺之力。圣人立法。果何谓乎。自晋以来。疑鬼疑蜮。陋湿无
巳。如崔文行解温。用白术、乌头、细辛、桔梗四味。更加附子。名老君神明散。更加萤
火。名务成子萤火丸。热药相投。以火济火。谁其辨诸。如仲景书。谓太阳病发热不
恶寒而渴者。为温病。朱肱活人书。谓发热恶寒。头疼身痛者。为温病。已悖圣训矣。
又云。春秋发斑咳嗽为温病。至风温治在少阴。其所立五方。如葳蕤汤、知母葛根
汤、防己汤、栝蒌根汤、葛根龙胆汤。风火相炽。燔灼无休。复改圣散子。仍用附子。表
里香燥同之。东坡先生在黄州时。颇称其效。岂知朱肱已三易其方。用败毒散而
远热药。然厥功奚减厥罪。吴氏谓伤寒坏病。更遇温热为温病。洁古老人。伤寒名
家也。其子云岐。以伤寒过经不解者为温病。指叔和之言。为仲景之文。赵嗣真谓
仲景云重感异气。变为温病。汪机谓仲景云遇温气为温病。遇温热为温毒。竟不
顾圣经之载于方策者。何曾有此一语。巢氏病源。遵崔文行解散法。一日用摩膏
火灸。二日针灸解散。三日复汗之。四日用藜芦丸、瓜蒂散吐之。五六日解未了了
者复针之。七日热已入胃。鸡子汤下之。遂使庞安常自撰微言。一以和解为主。奉
为灵宝。少移则蹶。巢庞比匪何极。李思训亦宗和解。王海藏称其当宋全盛。明哲
莫逾。拟非其伦矣。丹溪长于温热。善用凉药。温热遇之。自能解散。要非有斟酌于
其间也。东垣不善外感。长于内伤。乃从内经悟出冬温春温二义。诚暗中一大炬。
嘉言极口欢颂。真先得我心者矣。迨刘河间伤寒直格。于热病每多入理深谈。然
混在正伤寒中。在人眼光采择。不免金屑杂于泥沙者欤。至明季方中行着伤寒
条辨。可谓直登仲景之堂。独开生面。惜其论温热。亦分阴分阳。似可用热。遂为嘉
言所宗。嗟乎。病名温热。自需寒凉。乃千百年来。盈庭聚讼。先后支吾。阳春寡和于
汉庭。埙篪迭奏于晋室。良由来派不清。复无面墙体认。诚习焉而不察耳。不然。岂
诸公各自名家。乃甘悖圣矩如是耶。若夫夏月暑证。即金匮中湿 气蒸之病也。
洁古东垣。以动静分阴阳。动而得之为阳。用白虎。静而得之为阴。用大顺、冷香诸
剂。岂知夏月杲杲炎威。有阳无阴。动静不甚相远。惟多食冰果冷物。及恣意房帏。
致伤太阴少阴者。热药可以暂用。岂得视温热之味。为通行之药乎。漕宪北海林
夫子。为一代伟人。医学宗匠。俊立雪程门。三五年间。极蒙提命。因授所刻明计部
张凤逵治暑书。申明理蕴。精确不磨。虽有小疵。不掩大德。诚可振聋 于千古者
也。至叔和云四时不正之气。感则为疫。不知非时不为厉气。仅为寒疫。而大疫之
沿门阖境。传染相同者。允在兵荒之后。尸浊秽气。充斥道路。人在气交。感之而病。
气无所异。人病亦同。所以月令于孟春。掩骼理 。不敢或后者。圣王早虑及此耳。
非徒泽及枯骨也。后世治疫之法。未有定见。如嘉言上焦如雾。升逐解毒。中焦如
沤。疏逐解毒。下焦如渎。决逐解毒。俟其营卫既通。乘势追拔。勿使潜滋暗长于未
尽之时。此固不易之论。然求其反复尽义。变态直穷。老长吴又可之言。别无根据傍
也。俊幸生明备。不安苟且。日引光明之藏。志披榛莽之途。辑仲景伤寒论。三注金
匮。补注之余。先将温热暑疫四证。厘订经文。采集方论。无背圣法。有合病情。各自
成帙。蒙藩宪丁夫子。因戊午年时疫盛行。悯编户之疾苦。如恫 之乃身。遂下询
疫所自始。与所为治。恻然叹曰。嗟乎。安得明此理者数十辈。循行救治。俾在火轮
火树。梦魇心迷者。一旦提置冰山雪宝之中。奚止饮醍醐而称快哉。命急付枣。以公同志。
康熙己未辜月吴门周扬俊禹载识
The Way of medicine is indeed difficult. Among all diseases, Shanghan (Cold Damage) is the most severe, while Wenre (Warmth-Heat) is even more fierce. Shanghan typically occurs in a specific season, whereas Wenre, Shu (Summerheat), and Yi (Epidemic) diseases often manifest across three seasons. Because their duration is long, the number of patients increases. If one does not understand their origin, the flow cannot be clarified; if one does not distinguish their categories, treatment will not be appropriate. Thus, Wenre, Shu, and Yi are all Heat syndromes. It is like under a prairie fire, lacking even a drop of coolness. People regardless of ancient or modern times have similar natures, yet spirits immerse in the sages of old, with aspirations reaching towards perfection. With my meager insight, I seek illumination in stillness.
The sages of antiquity first valued complexion and pulse, determining life and death based on whether Ying (Nutritive Qi) had converged or not, concluding in a few words. The sages of the middle ages specifically discussed the flourishing and decline of Gu Qi (Grain Qi) to determine life and death, also concluding in a few words. Zhang Zhongjing was a sage of the later era; he established formula theories and supplemented the unfinished Zang-Fu organ theories, using the injury and extinction of the Bladder as a weft thread to determine life and death, aligning with previous methods without omission. However, in his *Treatise on Cold Damage*, Zhang Zhongjing described Wenre clearly, detailing formulas such as Huangqin Tang (Scutellaria Decoction) and Baihu Tang (White Tiger Decoction), which constituted his treatment method. Later scholars, if they could extend this meaning, could achieve infinite variations and divine wisdom over millennia. Yet, failing to carefully examine the principles, they stubbornly regarded these as methods for treating Shanghan. Why not consider that these formulas originally lack exterior-resolving efficacy and interior-purging power? What did the Sages intend by establishing these laws?
Since the Jin Dynasty, people have been suspicious and superstitious, remaining shallow and damp without end. For instance, Cui Wenxing explained Warmth-Heat by using Baizhu (Atractylodis Macrocephalae Rhizoma), Wutou (Aconiti Radix), Xixin (Asari Radix et Rhizoma), and Jiegeng (Platycodonis Radix), adding Fuzi (Aconiti Lateralis Radix Praeparata), named Laojun Shenming San (Old Lord's Divine Spirit Powder); adding Yinghuo (Lampyridis), it was named Wuchengzi Yinghuo Wan (Wuchengzi's Firefly Pill). Using hot herbs for heat conditions is like adding fuel to fire; who can discern the right from wrong? In Zhang Zhongjing's book, it states that Taiyang disease presenting with fever, aversion to cold absent, and thirst is called Wenbing (Warm Disease). Zhu Gong in *Huoren Shu* (Book of Living People) stated that fever, aversion to cold, headache, and body pain constitute Wenbing. This already contradicts the Sage's teachings. It further claims that macules and cough appearing in spring and autumn are Wenbing, and Fengwen (Wind-Warmth) is treated in the Shaoyin channel. His five formulas, such as Weirui Tang (Rehmannia Decoction), Zhimu Gegen Tang (Anemarrhenae and Puerariae Decoction), Fangji Tang (Stephaniae Decoction), Gualougen Tang (Trichosanthis Radix Decoction), and Gegen Longdan Tang (Puerariae and Gentianae Decoction), involve wind and fire blazing endlessly. He modified Shengsanzi, still using Fuzi, applying aromatic-dry herbs to both exterior and interior. Mr. Dongpo praised its efficacy when in Huangzhou. Little did he know that Zhu Gong changed the formula three times, using Baidu San (Deficiency-Toxin Powder) and avoiding hot herbs. Yet, how could his merit offset his fault? Wu Shi believed that complicated Shanghan encountering warmth becomes Wenbing. Jiegu Laoren (Old Man Jiegu) was a master of Shanghan; his son Yunqi considered Shanghan that failed to resolve after passing through meridians as Wenbing. They cited Shuhe's words as Zhongjing's text. Zhao Sizhen claimed Zhongjing said re-exposure to different pathogens changes the condition to Wenbing. Wang Ji claimed Zhongjing said encountering warm qi is Wenbing, and encountering warm heat is Wendu (Warm Toxin). They disregarded what was recorded in the Classics. Where was such a phrase?
Chao Yuanfang's *Zhubing Yuanhou Lun* followed Cui Wenxing's dispersal method: day one used massage ointment and moxibustion; day two used acupuncture and moxibustion to disperse; day three induced sweating again; day four used Licui Wan (Veratrum Pill) and Gouti San (Cucumeris Fructus Powder) to induce vomiting; days five and six used acupuncture if unresolved; day seven, if heat entered the stomach, used Egg Soup to purge. This led Pang Anchang to write *Weiyan*, prioritizing harmonization, regarding it as a spiritual treasure, where slight deviation causes collapse. Comparing Chao and Pang, the evil is extreme. Li Sixun also advocated harmonization; Wang Haicang praised him as unsurpassed in wisdom during the Song Dynasty's peak, but this comparison is inappropriate.
Danxi excelled in Warmth-Heat, skillfully using cooling herbs, allowing Warmth-Heat to naturally disperse upon encounter, though not necessarily due to precise moderation between them. Dongyuan was weak in external contractions but strong in internal injuries; he deduced the concepts of Winter-Warmth and Spring-Warmth from the *Neijing*, truly a great torch in the dark. Jiayan enthusiastically praised him, truly one who understood my heart first. When Liu Hejian's *Shanghan Zhige* discussed heat diseases with deep reasoning, it mixed them with standard Shanghan, leaving selection to the reader's eye, akin to gold dust mixed with mud. In the late Ming, Fang Zhongxing wrote *Shanghan Tiaobian*, arguably entering Zhongjing's hall directly and opening new grounds. Unfortunately, his discussion on Warmth-Heat divided Yin and Yang, suggesting heat herbs might be usable, thus becoming a model for Jiayan. Alas! Named Warmth-Heat, it naturally requires cold-cooling herbs, yet for thousands of years, debates raged, hesitating back and forth. High songs found few echoes in the Han court, while musical harmony prevailed in the Jin court. Indeed, because the lineage was unclear and comprehensive understanding was lacking, people became accustomed without noticing. Otherwise, why would masters deviate so blatantly from the Sage's rules?
Regarding Summerheat syndromes in summer, they are diseases of dampness steaming as described in *Jinkui Yaolue*. Jiegu and Dongyuan distinguished Yin and Yang by movement and stillness: dynamic acquisition is Yang, treated with Baihu Tang; static acquisition is Yin, treated with Dashun San (Great Smooth Powder) and Lengxiang Yinzi (Cool Fragrance Decoction). Who knew that in summer's blazing heat, there is Yang without Yin, and movement/stillness are not far apart? Only when excessive consumption of ice fruits/cold items or reckless sexual activity injures the Taiyin and Shaoyin channels should heat herbs be temporarily used. How can Warmth-Heat herbs be treated as universal remedies?
Lin Fuzi, the Canal Transport Commissioner of Beihai, was a great man and medical master. I stood in snow at his gate for study, receiving guidance for three to five years. He therefore provided me with his printed edition of Zhang Fengkui's *Treating Summerheat Book* from the Ming Dynasty, clarifying principles with precision. Though having minor flaws, it does not obscure its great virtue, truly awakening deafness and blindness for millennia.
Shuhe stated that abnormal Qi of the four seasons, when contracted, becomes Yi (Epidemic). He did not realize that non-seasonal Qi is not a lethal pathogen, only Cold Yi. Major epidemics spreading door-to-door and infecting entire regions occur after war and famine, where corpse filth fills roads. Humans in the Qi intersection contract illness; the Qi is no different, yet humans fall ill similarly. Hence, the *Monthly Ordinances* in early spring cover bones and arrange remains, fearing no delay, as Sage Kings foresaw this, not merely to benefit dead bones. Later methods for treating Yi lacked definitive views. For example, Jiayan stated: Upper Jiao is like mist, ascending to expel toxins; Middle Jiao is like fermentation, draining to expel toxins; Lower Jiao is like a drain, purging to expel toxins. Wait until Ying and Wei connect, then pursue extraction, preventing latent growth. This is an unchangeable theory, yet seeking thoroughness and variation, Old Wu Ke's words lack support.
Fortunately born in a bright era, unwilling to settle for mediocrity, I daily draw from the treasury of light, aiming to clear the thorny path. I compiled Zhongjing's *Shanghan Lun*, annotated *Jinkui* three times, and after supplementary notes, first sorted the scriptures for Warmth, Heat, Summerheat, and Yi syndromes, collecting formulas and theories, adhering to Sage methods and fitting clinical conditions, forming separate volumes. Thanks to Prefect Ding, who, witnessing the epidemic in the Wuwu year, pitied the people's suffering as if it were his own, inquired about the origin and treatment of the epidemic, sighing compassionately: "Alas! How can we get dozens of those who understand this principle to circulate and treat, placing those suffering in hellish heat and confusion into icy coolness, bringing relief beyond description?" He ordered urgent printing to share with colleagues.
Recorded by Zhou Yangjun Yuzai of Wumen, Zhengmonth of Jiwu Year, Kangxi Era.