雄按∶此与下编相传为陈、薛所着。究难考实。姑从俗以标其姓字。俟博雅正之。
盖闻外感不外六淫，而民病当分四气。治伤寒家，徒守发表攻里之成方，不计辛热苦寒之贻害，遂使温热之旨，蒙
昧不明，医门缺典，莫此甚焉。祖恭不敏，博览群书，广搜载籍，而恍然于温热病之不可不讲也。《内经》云∶冬不藏精，
春必病温。盖谓冬令严寒，阳气内敛，人能顺天时而固密，则肾气内充，命门为三焦之别使，亦得固腠理而护皮毛。虽
当春令升泄之时，而我身之真气，则内外弥纶，不随升令之泄而告匮，纵有客邪，安能内侵？是《内经》所以明致病之
原也。然，但云冬不藏精，而不及他时者，以冬为水旺之时，属北方寒水之化，于时为冬，于人为肾。井水温而坚冰至，
阴外阳内，有习坎之义。故立言归重于冬，非谓冬宜藏而他时可不藏精也。
雄按∶喻氏云∶春夏之病，皆起于冬，至秋
冬二时之病，皆起于夏，夏月藏精，则热邪不能侵，与冬月之藏精，而寒邪不能入者无异也。故丹溪谓夏月必独宿淡味，
保养金水二脏，尤为摄生之仪式焉。即春必病温之语，亦是就近指点，总见里虚者表不固，一切时邪，皆易感受。学人
可因此而悟及四时六气之为病矣。
雄按∶此论冬不藏精，春易病温之理甚通，惟不知有伏气为病之温，是其蔽也。陈氏
此篇与鞠通《条辨》，皆叶氏之功臣，然《幼科要略》明言有伏气之温热，二家竟未细绎，毋乃疏乎？二家且然，下此者
更无论矣。《难经》云∶伤寒有五，有伤寒。
雄按∶麻黄汤证是也。有中风。
雄按∶桂枝汤证是也。有风温。
雄按∶冬温春温之外受者。有热病。
雄按∶即暑病也，又谓之 。有湿温。
雄按∶即暑兼湿为病也，亦曰湿热。夫统此风寒湿热之
邪，而皆名之曰伤寒者，亦早鉴于寒脏受伤，外邪得入，故探其本而皆谓之伤寒也。
雄按∶仲景本论，治法原有区别，
界画甚严，后人不察，罔知所措，多致误人，兹余辑此专论，以期了然于学人之心目也。独是西北风高土燥，风寒之为
病居多。
雄按∶亦不尽然。东南地卑水湿，湿热之伤人独甚。从来风寒伤形，伤形者定从表入。湿热伤气，伤气者不尽
从表入。故治伤寒之法，不可用以治温热也。夫温者，暖也、热也，非寒之可比也。风邪外束，则曰风温。湿邪内侵，
则曰湿温。纵有微寒之兼袭，不同栗冽之严威，是以发表宜辛凉，不宜辛热。清里宜泄热，不宜逐热。
雄按∶亦有宜逐
者，总须辨证耳。盖风不兼寒，即为风火，湿虽化热，终属阴邪。
雄按∶湿固阴邪，其兼感热者，则又不可谓之阴矣。
自昔仲景着书，不详温热，遂使后人各呈家伎，漫无成章。而凡大江以南，病温多而病寒少。
雄按∶北省温病，亦多于
伤寒。投以发表不远热，攻里不远寒诸法，以致死亡接踵也。悲夫！
雄按∶篇中非伏气之说，皆为节去，弃瑕录瑜，后
皆仿此。
风温为病，春月与冬季居多。或恶风，或不恶风，必身热，咳嗽，烦渴，此风温证之提纲也。
自注。春月风邪用事，冬初，气暖多风。
雄按∶冬暖不藏，不必定在冬初也。故风温之病，多见于此，但风邪属阳，
阳邪从阳，必伤卫气。人身之中，肺主卫。又胃为卫之本，是以风温外薄，肺胃内应。风温内袭，肺胃受病。其温邪之
内外有异形，而肺胃之专司无二致。故恶风为或有之证，而热、渴、咳嗽，为必有之证也。三复仲景书，言温病者再，
一则曰“太阳病，发热而渴，不恶寒者为温病”，此不过以不恶寒而渴之证，辨伤寒与温病之异，而非专为风温叙证也。
雄按∶此言伏气发为春温，非冬春所感之风温。故曰太阳病，以太阳为少阴之表也。再则曰∶发汗已，身灼热者，名曰
风温。夫灼热因于发汗，其误用辛热发汗可知，仲景复申之曰∶风温为病，脉阴阳俱浮，自汗出，身重，多眠睡，鼻息
必鼾，语言难出。凡此，皆误汗劫液后变见之证，非温病固有之证也。续云∶若被下者，直视失溲；若被火者，发黄色，
剧则如惊痫状，时 ；若火熏之，一逆尚引日，再逆促命期。亦止详用下、用火之变证，而未言风温之本来见证也。
雄按∶此言温病误汗，热极生风，故曰风温，乃内风也。非冬春外感之风温，陈氏不知有伏气春温之病，强为引证，原
可删也。然病之内外虽殊，证之属温则一。姑存之以为后学比例。然从此细参，则知风温为燥热之邪，燥令从金化，燥
热归阳明，故肺胃为温邪必犯之地。且可悟风温为燥热之病，燥则伤阴，热则伤津，泄热和阴，又为风温病一定之治法
也，反此即为逆矣。用是不辞僭越，而于仲景之无文处求文，无治处索治，叙证施治，列为条例，知我罪我，其在斯乎？
雄按∶外感温病，仲圣虽未言，而叶氏已详论矣。
风温证，身热畏风，头痛咳嗽，口渴，脉浮数，舌苔白者，邪在表也。当用薄荷、前胡、杏仁、桔梗、桑叶、川贝
之属，凉解表邪。杨云∶前胡、桔梗，一降一升，以泄肺邪。诚善，然桔梗宜少用。
自注风属阳邪，不挟寒者为风温。阳邪必伤阳络，是以头痛畏风；邪郁肌表，肺胃内应，故咳嗽、口渴、苔白；邪
留于表，故脉浮数。表未解者当先解表，但不同于伤寒之用麻、桂耳。
雄按∶何西池云∶辨痰之法，古人以黄稠者为热，稀白者为寒，此特言其大概，而不可泥也。以外感言之，伤风咳
嗽，痰随嗽出，频数而多，色皆稀白，误作寒治，多致困顿。盖火盛壅逼，频咳频出，停留不久，故未至于黄稠耳？迨
火衰气平，咳嗽渐息，痰之出者，半日一口，反黄而稠。缘火不上壅，痰得久留，受其煎炼使然耳。故黄稠之痰，火气
尚缓而微；稀白之痰，火气反急而盛也。此皆当用辛凉解散，而不宜于温热者，推之内伤亦然。孰谓稀白之痰，必属于
寒哉？总须临证细审，更参以脉，自可见也。
风温证∶身热，咳嗽，自汗，口渴，烦闷，脉数，舌苔微黄者，热在肺胃也。当用川贝、牛蒡、桑皮、连翘、橘皮、
竹叶之属，凉泄里热。
此温邪之内袭者，肺热，则咳嗽汗泄。胃热，则口渴烦闷。苔白转黄，风从火化，故以清泄肺胃为主。
雄按∶苔黄不甚燥者，杨云∶故条中言微黄，亦具见斟酌。治当如是。若黄而已干，则桑皮、橘皮，皆嫌其燥，须
易栝蒌、黄芩，庶不转伤其液也。
风温证∶身灼热，口大渴，咳嗽烦闷，谵语如梦语，脉弦数，干呕者，此热灼肺胃，风火内旋。当用羚羊角、川贝、
连翘、麦冬、石斛、青蒿、知母、花粉之属，以泄热和阴。
此温邪袭入肺胃之络，灼烁阴津，引动木火，故有烦渴呕逆等证，急宜泄去络中之热，庶无风火相煽，走窜包络之
虞。
雄按∶嗽且闷，麦冬未可即授，嫌其滋也，汪按。徐洄溪谓麦冬能满肺气。非实嗽所宜是也。以为大渴耶。已有知
母、花粉，足胜其任矣。木火上冲而干呕，则青蒿虽清少阳，而嫌乎升矣。宜去此二味，加以栀子、竹茹、枇杷叶，则
妙矣。杨云∶议药细极微芒，读者不可草草读过。
风温证∶身热，咳嗽，口渴，下利，苔黄，谵语，胸痞，脉数，此温邪由肺胃下注大肠。当用黄芩、桔梗、煨葛、
豆卷、甘草、橘皮之属，以升泄温邪。
大肠与胃相连属，与肺相表里，温邪内逼，下注大肠则下利，治之者宜清泄温邪，不必专于治利。按《伤寒论》∶“下
利谵语者，有燥矢也，宜大承气汤”，是实热内结，逼液下趋，必有舌燥苔黄刺，及腹满痛证兼见，故可下以逐热。若温
邪下利，是风热内迫，虽有谵语一证，仍是无形之热，蕴蓄于中，而非实满之邪，盘结于内，故用葛根之升提，不任硝、
黄之下逐也。汪按。升提亦所不任。
雄按∶伤寒为阴邪，未曾传腑化热，最虑邪气下陷，治必升提温散，而有早下之戒。温热为阳邪，火必克金，故先
犯肺，火性炎上，难得下行。若肺气肃降有权，移其邪由腑出，正是病之去路，升提胡可妄投？杨云∶小儿患疹，必下
利，与此正同。故温病多有发疹者，误升则邪入肺络，必喘吼而死？既云∶宜清泄其邪，不必专于治利矣。况有咳嗽胸
痞之兼证，岂葛根、豆卷、桔梗之所宜乎？当易以黄连、桑叶、银花。须知利不因寒，润药亦多可用。仲圣以猪肤、白
蜜治温病下利，《寓意草》论肺热下利最详，学人宜究心焉。且伤寒与温热，邪虽不同，皆属无形之气。伤寒之有燥矢，
并非是气结，乃寒邪化热，津液耗伤，糟粕炼成燥矢耳。温热病之大便不闭为易治者，以脏热移腑，邪有下行之路，所
谓腑气通则脏气安也。设大便闭者，热烁胃津，日久亦何尝无燥矢宜下之证哉？惟伤寒之大便不宜早解，故必邪入于腑，
始可下其燥矢。温热由肺及胃，虽不比疫证之下不嫌早，而喜其便通，宜用清凉，故结成燥矢者较少耳。忆嘉庆己卯春，
先君子病温而大便自利，彼时，吾杭诸名医咸宗陶节庵书以治伤寒，不知所谓温证也，见其下利，悉用柴葛升提，提而
不应，或云是漏底证，渐投温补，病日以剧，将治木矣。父执翁七丈，忘其字矣。似是“立贤”二字。荐浦上林先生来
视，浦年甚少，诊毕，即曰是温证也，殆误作伤寒治，而多服温燥之药乎？幸而自利不止，热势尚有宣泄，否则早成灰
烬，奚待今日耶？即用大剂犀角、石膏、银花、花粉、鲜生地、麦冬等药，嘱煎三大碗，置于榻前频频灌之。药未煎成
之际，先笮蔗浆恣饮之。诸戚长见方，相顾莫决，赖金履思丈力持煎其药，至一周时服竣，病有起色，遂以渐愈。时（雄）
年甫十二，聆其言而心识之，逾二年先君捐馆，（雄）糊口远游，闻浦先生以善用清凉，为众口所铄，乃从事于景岳，而
以温补称。枉道徇人，惜哉然！（雄）之究心于温热，实浦先生有以启之也。浦今尚在，因其远徙于乡，竟未遑往质疑义
为恨，附记于此，聊志感仰之意云尔。
风温证∶热久不愈，咳嗽，唇肿，口渴，胸闷，不知饥，身发白疹如寒粟状，自汗脉数者，此风邪挟太阴脾湿，发
为风疹。杨云∶白疹乃肺胃湿热也，与脾无涉，亦与风无涉。用牛蒡、荆芥、防风、连翘、橘皮、甘草之属凉解之。
风温本留肺胃，若太阴旧有伏湿者，风热之邪，与湿热相合，流连不解，日数虽多，仍留气分，由肌肉而外达皮毛，
发为白疹。盖风邪与阳明营热相并，则发斑。与太阴湿邪相合，则发疹也。又有病久中虚，气分大亏而发白疹者，必脉
微弱而气倦怯，多成死候，不可不知。汪按∶前说即白如水晶色之白 ，后说即白如枯骨之白 也。
雄按∶白疹即白 也，虽挟湿邪久不愈而从热化，且汗渴脉数，似非荆防之可再表，杨云∶此湿亦不必用橘皮之燥。
宜易滑石、苇茎、通草，杨云∶精当。斯合凉解之法矣。若有虚象，当与甘药以滋气液。
风温证∶身热，咳嗽，口渴，胸痞，头目胀大，面发泡疮者，风毒上壅阳络。当用荆芥、薄荷、连翘、元参、牛蒡、
马勃、青黛、银花之属，以清热散邪。
此即世俗所谓大头病也，古人用三黄汤主治。然风热壅遏，致络气不宣，头肿如斗，终不若仿普济消毒饮之宣络涤
热为佳。汪按∶方附见九十五。
风温证∶身大热，口大渴，目赤唇肿，气粗烦躁，舌绛齿板，痰咳，甚至神昏谵语，下利黄水者，风温热毒，深入
阳明营分，最为危候。用犀角、连翘、葛根、元参、赤芍、丹皮、麦冬、紫草、川贝、人中黄，解毒提斑，间有生者。
杨云∶葛根、麦冬俱与证不甚登对。
此风温热毒，内壅肺胃，侵入营分，上下内外，充斥肆逆。若其毒不甚重，或气体壮实者，犹可挽回，否则必坏。
风温毒邪，始得之，便身热口渴，目赤咽痛，卧起不安，手足厥冷，泄泻，脉伏者，热毒内壅，络气阻遏。当用升
麻。杨云∶凡涉咽痛者，一用升麻，则邪入肺络，必喘吼而声如曳锯，陈氏想未之见耳。黄芩、犀角、银花、甘草、豆
卷之属，升散热毒。
此风温毒之壅于阳明气分者，杨云∶仍是肺病。即仲景所云阳毒病是也，五日可治，七日不可治。乘其邪犯气分，
未入营阴，故可升散而愈。
风温证∶身热自汗，面赤神迷，身重难转侧，多眠睡，鼻鼾，语难出，脉数者，温邪内逼，阳明精液劫夺，神机不
运。用石膏、知母、麦冬、半夏、竹叶、甘草之属，泄热救津。
鼻鼾、面赤，胃热极盛。人之阴气，根据胃为养，热邪内灼，胃液干枯，阴气复有何资，而能渗诸阳灌诸络，是以筋
骨懈怠，机关失运，急用甘凉之品以清热濡津，或有济也。
雄按∶宜加西洋参、百合、竹沥。
风温证∶身热痰咳，口渴神迷，手足 ，状若惊痫，脉弦数者，此热劫津液，金囚木旺。当用羚羊、川贝、青蒿、
连翘、知母、麦冬、钩藤之属，以息风清热。
肺属金而畏火，赖胃津之濡养，以肃降令而溉百脉者也。热邪内盛，胃津被劫，肺失所资。木为火之母，子能令母
Wang Shixiong's commentary: This section and the following are traditionally attributed to Chen Pingbo and Xue Shengbai. However, it is difficult to verify this with certainty. For now, I shall follow common practice and list their surnames, awaiting correction from scholars of broad learning and elegance.
I have heard that exogenous diseases are not beyond the Six Evils (Liu Yin), yet illnesses among the people should be distinguished according to the Four Qi (seasonal climates). Physicians treating Shanghan (Cold Damage) merely adhere to established formulas for releasing the exterior and purging the interior, without considering the harm caused by acrid-hot or bitter-cold herbs. Consequently, the principles of Warm Diseases (Wen Bing) remain obscured and unclear; there is no greater deficiency in medical classics than this. Although I am unskilled, having read extensively and searched widely through records, I have suddenly realized that Warm Diseases must be studied. The *Neijing* states: "If one does not store essence during winter, one will inevitably contract a Warm Disease in spring." This means that during the severe cold of winter, Yang Qi is stored inward. If one can conform to the natural rhythm and maintain solidity, Kidney Qi will be充盈 (full) internally. Mingmen acts as an envoy for the Sanjiao (Triple Burner), thereby securing the Couli (pores) and protecting the skin and hair. Even when the spring season arrives—a time of rising and dispersing—my body's True Qi circulates internally and externally, preventing depletion due to this dispersal. Thus, even if external pathogens invade, how can they penetrate deeply? This explains the etiology of disease as elucidated in the *Neijing*. However, it mentions only failing to store essence in winter, neglecting other seasons, because winter is when Water Qi is prosperous, corresponding to the transformation of Northern Cold Water. In terms of seasons, it is winter; in terms of the human body, it corresponds to the Kidneys. Well water remains warm while thick ice forms; Yin is on the outside, Yang on the inside, embodying the meaning of the Kan hexagram. Therefore, emphasis is placed on winter, not implying that only winter requires storing essence while other seasons do not.
Wang Shixiong's commentary: Yu Jia Yan stated: "Diseases in spring and summer all originate in winter; diseases in autumn and winter all originate in summer. If one stores essence in summer, heat pathogens cannot invade, just as storing essence in winter prevents cold pathogens from entering. Thus, Zhu Danxi said that in summer, one must live alone and eat bland food to nourish the Metal (Lung) and Water (Kidney) organs, which serves as a model for health preservation. Even the phrase 'spring brings warm diseases' points proximally, indicating that those with internal deficiency have insecure exterior defenses, making them susceptible to all seasonal pathogens. Students may thus comprehend the pathogenic effects of the Six Qi across the four seasons."
Wang Shixiong's commentary: This discussion on why failing to store essence in winter leads to warm diseases in spring is very logical, but it fails to recognize Warm Diseases caused by latent pathogens (Fu Qi), which is its limitation. Chen's essay and Wu Jutong's *Tiaobian* are both merits of Ye Tianshi's school, yet *Youke Yaolüe* explicitly mentions latent warm-heat diseases, neither of which these two authors elaborated upon carefully. Is this not negligence? If even they were so, later scholars need not be mentioned. The *Nan Jing* states: "Shanghan encompasses five types: there is Shanghan..."
Wang Shixiong's commentary: Referring to Mahuang Tang syndrome. There is Zhongfeng...
Wang Shixiong's commentary: Referring to Guizhi Tang syndrome. There is Fengwen (Wind-Warmth)...
Wang Shiong's commentary: Referring to external contraction of Dongwen (Winter-Warmth) and Chunwen (Spring-Warmth). There is Rebing (Heat Disease)...
Wang Shixiong's commentary: This is Shubing (Summerheat Disease), also known as Shushi (Summerheat-Dampness). There is Shiwen (Damp-Warmth)...
Wang Shixiong's commentary: This refers to diseases caused by Summerheat combined with Dampness, also called Shi-Re (Damp-Heat). Unifying these Wind-Cold, Damp-Heat pathogens under the name Shanghan is because it was long recognized that when Cold injures the Zang organs, external pathogens enter. Thus, investigating the root, they are all called Shanghan.
Wang Shixiong's commentary: Zhang Zhongjing's original treatise had distinct treatment methods with strict boundaries. Later physicians failed to observe this, leading to confusion and frequent errors. I compile this specific treatise to clarify matters for students. However, in the Northwest, winds are high and soil dry, so Wind-Cold diseases are predominant.
Wang Shixiong's commentary: Not entirely so. In the Southeast, the land is low and waters damp; Damp-Heat injures people particularly severely. Historically, Wind-Cold injures the Form (Xing); injuries to form always enter from the exterior. Damp-Heat injures Qi; injuries to Qi do not necessarily enter from the exterior. Therefore, methods for treating Shanghan cannot be used for Warm Diseases. "Wen" means warmth or heat, incomparable to Cold. When Wind pathogens bind the exterior, it is called Fengwen. When Damp pathogens invade internally, it is called Shiwen. Even if slight Cold accompanies them, it differs from biting frost. Hence, releasing the exterior should use Acrid-Cool herbs, not Acrid-Hot. Clearing the interior should vent Heat, not purge Heat aggressively.
Wang Shixiong's commentary: There are cases where purging is appropriate, but differentiation of symptoms is essential. Generally, Wind without Cold becomes Wind-Fire. Although Damp may transform into Heat, it ultimately belongs to Yin pathogens.
Wang Shixiong's commentary: Damp is indeed a Yin pathogen, but if accompanied by Heat, it cannot be called Yin.
Since ancient times, Zhang Zhongjing's writings did not detail Warm Diseases, causing later generations to display their own skills without coherent structure. South of the Great River, Warm Diseases are more common than Cold Diseases.
Wang Shixiong's commentary: In northern provinces, Warm Diseases also outnumber Cold Diseases. Using methods like "releasing the exterior without avoiding Heat, purging the interior without avoiding Cold" has led to continuous deaths. How sad!
Wang Shixiong's commentary: Sections in this chapter not related to latent pathogens have been removed, preserving the valuable and discarding the flawed. The following follows this pattern.
Fengwen disease is most common in spring and winter. Some patients experience aversion to wind, others do not, but all present with fever, cough, and irritability with thirst. This constitutes the outline of Fengwen syndrome.
Self-note: In spring, Wind Qi dominates; in early winter, the air is warm and windy.
Wang Shixiong's commentary: Winter warmth leading to failure to store essence is not limited to early winter. Thus, Fengwen is common then. However, Wind is a Yang pathogen; Yang pathogens affect Yang levels, inevitably injuring Wei Qi. In the human body, the Lung governs Wei Qi. The Stomach is the root of Wei Qi. Therefore, when Fengwen presses externally, the Lung and Stomach respond internally. When Fengwen invades internally, the Lung and Stomach are diseased. Although the manifestation of Warm pathogens differs internally and externally, the Lung and Stomach share the same primary responsibility. Thus, aversion to wind is an occasional symptom, whereas fever, thirst, and cough are mandatory symptoms. Repeatedly studying Zhongjing's books, he mentions Warm Disease twice. First: "Taiyang disease, with fever and thirst but no aversion to cold, is Warm Disease." This merely distinguishes Shanghan from Warm Disease based on the absence of aversion to cold and presence of thirst, not specifically describing Fengwen.
Wang Shixiong's commentary: This refers to Spring-Warmth arising from latent pathogens, not the Wind-Warmth contracted in winter/spring. It says Taiyang disease because Taiyang is the exterior of Shaoyin. Second: "After sweating, if the body burns with heat, it is named Fengwen." The burning heat results from sweating, indicating the erroneous use of Acrid-Hot diaphoretics. Zhongjing reiterates: "In Fengwen, pulse is floating at both cun and chi positions, spontaneous sweating, heavy body, excessive sleepiness, snoring breath, and difficulty speaking. All these are post-error symptoms after sweating depletes fluids, not inherent symptoms of Warm Disease." He continues: "If treated with purgatives, eyes stare straight and incontinence occurs; if treated with fire therapy, jaundice develops; severely, it resembles convulsions; if smoked with fire, one error prolongs life, a second hastens death." These detail complications of purgation and fire therapy, not the original presentation of Fengwen.
Wang Shixiong's commentary: This describes Wind-Warmth resulting from extreme heat generating internal wind after erroneous sweating, hence called Fengwen (internal wind). It is not the external Wind-Warmth of winter/spring. Chen's ignorance of latent Spring-Warmth led him to force this citation, which could have been deleted. However, although internal and external diseases differ, both belong to Warmth. I retain it as a reference for students. Careful study reveals Fengwen is a Dry-Heat pathogen. Dryness transforms via Metal, Dry-Heat returns to Yangming. Thus, Lung and Stomach are the sites attacked by Warm pathogens. One can realize Fengwen is a Dry-Heat disease; Dryness injures Yin, Heat injures Fluids. Venting Heat and harmonizing Yin is the fixed treatment for Fengwen; opposing this is adverse. Therefore, I dare to overstep, seeking text where Zhongjing omitted it, seeking treatment where none existed, listing syndromes and treatments as regulations. Whether I am blamed or praised lies here.
Wang Shixiong's commentary: Although Zhongjing did not discuss exogenous Warm Diseases, Ye Tianshi detailed them.
Fengwen syndrome: Fever, aversion to wind, headache, cough, thirst, floating-rapid pulse, white tongue coating indicate pathogen at the exterior. Use Bohe (Mint), Qianhu (Peucedani Radix), Xingren (Apricot Seed), Jiegeng (Platycodon Root), Sangye (Mulberry Leaf), Chuanbei (Fritillaria Bulb) etc., to cool-release exterior pathogens. Yang noted: Qianhu and Jiegeng descend and ascend respectively to vent Lung pathogens. This is good, but Jiegeng should be used sparingly.
Self-note: Wind is a Yang pathogen; without Cold, it is Fengwen. Yang pathogens injure Yang collaterals, causing headache and aversion to wind; pathogens stagnate in muscle-surface, Lung-Stomach respond internally, causing cough, thirst, white coating; pathogens remain at exterior, causing floating-rapid pulse. If exterior is unresolved, release it first, but not using Mahuang (Ephedra) and Guizhi (Cinnamon Twig) as in Shanghan.
Wang Shixiong's commentary: He Xichi said: To differentiate phlegm, ancients considered yellow-thick as Heat and white-thin as Cold. This is general and should not be rigidly applied. Regarding exogenous diseases, Wind-Cold cough produces frequent, abundant, thin-white phlegm. Misdiagnosing as Cold causes distress. Likely, excessive Fire oppression causes frequent coughing and expulsion, leaving little time for phlegm to thicken. Later, as Fire subsides and cough stops, phlegm appears less frequently but becomes yellow and thick because it stays longer and is refined by residual heat. Thus, yellow-thick phlegm indicates slower, milder Fire; thin-white phlegm indicates urgent, vigorous Fire. Both require Acrid-Cool dispersal, not Warm-Hot herbs. This applies to internal injuries too. Who says thin-white phlegm must be Cold? One must examine closely clinically and correlate with pulse.
Fengwen syndrome: Fever, cough, spontaneous sweating, thirst, irritability, rapid pulse, slightly yellow tongue coating indicate Heat in Lung and Stomach. Use Chuanbei, Niubangzi (Arctii Fructus), Sangbaipi (Morus Bark), Lianqiao (Forsythia Fruit), Juapi (Tangerine Peel), Zhuye (Bamboo Leaf) etc., to cool-purge interior Heat.
This is internal invasion by Warm pathogens. Lung Heat causes cough and sweating; Stomach Heat causes thirst and irritability. Coating turns from white to yellow as Wind transforms into Fire. Treatment focuses on clearing Lung and Stomach.
Wang Shixiong's commentary: If coating is yellow but not dry, Yang noted the text specifies "slightly yellow" showing caution. Treatment should be as described. If yellow and already dry, Sangbaipi and Juapi are too drying; replace with Gualou (Trichosanthes Fruit) and Huangqin (Scutellaria Root) to avoid damaging fluids.
Fengwen syndrome: Burning fever, severe thirst, cough, irritability, delirious speech resembling dreams, wiry-rapid pulse, dry retching indicate Heat scorching Lung and Stomach, internal rotation of Wind-Fire. Use Lingyangjiao (Antelope Horn), Chuanbei, Lianqiao, Maidong (Ophiopogon Root), Shihu (Dendrobium Stem), Qinghao (Artemisia Annua), Zhimu (Anemarrhena Rhizome), Huafen (Trichosanthes Root) etc., to vent Heat and harmonize Yin.
This is Warm pathogens invading Lung-Stomach collaterals, scorching Yin fluids, stirring Wood-Fire. Symptoms include irritability, thirst, vomiting. Urgently vent collateral Heat to prevent Wind-Fire from fanning each other and disturbing the Pericardium.
Wang Shixiong's commentary: With cough and fullness, Maidong should not be given immediately due to its cloying nature. Wang noted: Xu Huxi said Maidong fills Lung Qi, unsuitable for excess cough. If severe thirst, Zhimu and Huafen suffice. For dry retching due to Wood-Fire rushing up, Qinghao clears Shaoyang but is ascending. Remove these two; add Zhizi (Gardenia Fruit), Zhuru (Bamboo Shavings), Pipaye (Loquat Leaf) for better effect. Yang noted: Medication analysis is extremely subtle; readers must not skim.
Fengwen syndrome: Fever, cough, thirst, diarrhea, yellow coating, delirium, chest stuffiness, rapid pulse indicate Warm pathogens descending from Lung/Stomach to Large Intestine. Use Huangqin, Jiegeng, Weige (Prepared Kudzu Root), Doujuan (Soybean Sprouts), Gancao (Licorice Root), Juapi etc., to ascend and vent Warm pathogens.
Large Intestine connects to Stomach and is exterior-interior with Lung. Internal pressure from Warm pathogens causes diarrhea. Treatment should clear Warm pathogens, not solely treat diarrhea. According to *Shanghan Lun*: "Diarrhea with delirium indicates dry feces; use Dachengqi Tang." This is excess Heat binding internally, forcing fluids downward, accompanied by dry tongue, yellow prickly coating, abdominal fullness/pain, allowing purgation to drive out Heat. If Warm pathogen causes diarrhea, it is internal pressure from Wind-Heat. Despite delirium, it is formless Heat accumulating internally, not solid accumulation. Thus, use Ge Gen's ascending action, not Xiaoshi (Mirabilite) or Dahuang (Rhubarb) for purging. Wang noted: Ascending is also inappropriate.
Wang Shixiong's commentary: Shanghan is Yin pathogen, rarely transforming to Heat in Fu organs; fear of pathogen sinking requires ascending/warming dispersion and warns against early purgation. Warm diseases are Yang pathogens; Fire conquers Metal, attacking Lung first. Fire flares upward, hard to descend. If Lung Qi descends properly, moving pathogens via Fu organs is the exit route; ascending herbs should not be used rashly. Yang noted: Children with rashes often have diarrhea, similar here. Thus, many Warm diseases present with rashes; erroneous ascending sends pathogen into Lung collaterals, causing wheezing death. Since it says clear/vent pathogens, not specifically treat diarrhea, and with cough/chest stuffiness, are Ge Gen, Doujuan, Jiegeng appropriate? Replace with Huanglian (Coptis Rhizome), Sangye, Yinhua (Honeysuckle Flower). Note: Diarrhea not due to Cold allows moistening herbs. Zhongjing used Zhufu (Swine Skin) and Bami (White Honey) for Warm disease diarrhea; *Yuyi Cao* details Lung Heat diarrhea thoroughly; students should study this. Although Shanghan and Warm diseases differ in pathogens, both involve formless Qi. Shanghan's dry feces result from Cold transforming to Heat, consuming fluids, refining waste—not Qi knotting. Warm disease constipation is easier to treat because organ Heat transfers to Fu, providing an exit; "Fu Qi free, Zang Qi safe." If constipated, prolonged Heat scorching Stomach fluids eventually creates dry feces requiring purgation. Shanghan forbids early purgation until pathogen enters Fu. Warm disease moves Lung to Stomach; unlike epidemics where early purgation is acceptable, it prefers bowel movement via cooling, so dry feces formation is rare. Recall Jiamao Spring of Jiaqing era, my father had Warm disease with spontaneous diarrhea. Hangzhou doctors followed Tao Jian'an's Shanghan methods, unaware of Warm disease. Seeing diarrhea, they used Chaihu and Ge Gen to ascend. When ineffective, some called it "leaky bottom," gradually adding Warm tonics, worsening condition. Father's friend, Uncle Weng (name forgotten, possibly Li Xian), recommended Mr. Pu from Pushang. Young, he diagnosed Warm disease, suspecting misdiagnosis as Shanghan led to excessive Warm-Hot drugs. Fortunately, persistent diarrhea allowed Heat to vent; otherwise, he would have perished. I prescribed large doses of Xijiao (Rhinoceros Horn - substitute with Shui Niu Jiao Buffalo Horn), Shigao (Gypsum), Yinhua, Huafen, Xianshengdi (Fresh Rehmannia Root), Maidong etc., decocted in three bowls, administered frequently. Before decoction finished, sugarcane juice was given freely. Elders hesitated, but Jin Lusiz insisted on brewing. After one week, condition improved, then recovered. I was twelve, memorized his words. Two years later, father died. I traveled for livelihood, hearing Mr. Pu was slandered for using Cooling, then switched to Zhang Jingyue's Warm Tonics. Regrettable! My study of Warm diseases was inspired by Mr. Pu. He lives in rural area; I regret not consulting him. Record this to express gratitude.
Fengwen syndrome: Prolonged fever, cough, swollen lips, thirst, chest fullness, loss of appetite, white rash like goosebumps, spontaneous sweating, rapid pulse indicate Wind pathogen combining with Taiyin Spleen Dampness, manifesting as Wind Rash. Yang noted: White rash is Lung-Stomach Damp-Heat, unrelated to Spleen or Wind. Use Niubangzi, Jingjie (Schizonepeta Spike), Fangfeng (Saposhnikovia Root), Lianqiao, Juapi, Gancao etc., to cool-release.
Fengwen stays in Lung/Stomach. If Taiyin has latent Damp, Wind-Heat combines with Damp-Heat, lingering in Qi level, reaching skin from muscles, causing white rash. Wind combining with Yangming Ying Heat causes macules; combining with Taiyin Damp causes rash. Also, late-stage deficiency with Qi depletion causes white rash; weak pulse and fatigue indicate fatal prognosis. Wang noted: Former refers to crystal-clear white rash; latter to bone-dry white rash.
Wang Shixiong's commentary: White rash, though Damp-Heat persists and transforms to Heat, with sweating/thirst/rapid pulse, suggests Jingjie/Fangfeng are inappropriate for further releasing. Yang noted: Damp need not be treated with drying Juapi. Use Huashi (Talcum), Weijing (Reed Rhizome), Tongcao (Tetrapanax Pith) for precision, fitting Cool-Release method. If deficiency exists, use Sweet herbs to nourish Qi/Fluids.
Fengwen syndrome: Fever, cough, thirst, chest stuffiness, swollen head/eyes, facial pustules indicate Wind-Toxin obstructing Yang collaterals. Use Jingjie, Bohe, Lianqiao, Yuanshen (Polymnia Root), Niubangzi, Mabo (Amanita Mushroom), Qingdai (Indigo Naturalis), Yinhua etc., to clear Heat and scatter pathogens.
This is the popular "Big Head Disease." Ancients used Sanhuang Tang. But Wind-Heat obstruction blocks Collateral Qi, causing massive head swelling. Better to imitate Puji Xiaodu Yin to vent collaterals and wash out Heat. Wang noted: Formula attached to item 95.
Fengwen syndrome: High fever, severe thirst, red eyes, swollen lips, rough breathing, irritability, crimson tongue with stiff teeth, phlegm cough, even coma/delirium, yellow watery diarrhea indicate Wind-Warmth-Toxin penetrating Yangming Ying level, critical condition. Use Xijiao, Lianqiao, Ge Gen, Yuanshen, Chishao (Red Peony Root), Danpi (Moutan Bark), Maidong, Zicao (Arnebia Root), Chuanbei, Renzhonghuang (Human Waste Charcoal) to detoxify and raise macules; survival possible.
Yang noted: Ge Gen and Maidong do not match syndrome well.
This is Wind-Warmth-Toxin blocking Lung/Stomach, invading Ying level, filling upper/lower/internal/external. If toxin mild or constitution strong, recovery possible; otherwise, deterioration.
Wind-Warmth-Toxin initially presents with fever, thirst, red eyes, sore throat, restlessness, cold limbs, diarrhea, hidden pulse, indicating Heat-Toxin blocking internally, obstructing Collateral Qi. Use Shengma (Cimicifuga Rhizome). Yang noted: For sore throat, Shengma sends pathogen into Lung collaterals, causing wheezing death; Chen likely hasn't seen this. Huangqin, Xijiao, Yinhua, Gancao, Doujuan etc., ascend and vent Heat-Toxin.
This is Wind-Warmth-Toxin blocking Yangming Qi level. Yang noted: Still Lung disease. Equivalent to Zhongjing's Yangdu Disease. Treatable in 5 days, not 7. Exploit pathogen in Qi level before entering Ying/Yin, allowing ascending/dispersing cure.
Fengwen syndrome: Fever, spontaneous sweating, red face, mental confusion, heavy body difficult to turn, excessive sleepiness, snoring, difficulty speaking, rapid pulse indicate Warm pathogens pressing internally, Yangming Essence/Fluids depleted, Shen mechanism stagnant. Use Shigao, Zhimu, Maidong, Banxia (Pinellia Tuber), Zhuye, Gancao etc., to vent Heat and save fluids.
Snoring/red face indicate extreme Stomach Heat. Yin relies on Stomach for nourishment. Internal Heat scorches Stomach fluids dry; Yin lacks resources to irrigate Yang/Collaterals, causing muscle weakness and joint dysfunction. Urgently use Sweet-Cool herbs to clear Heat and moisten fluids for salvation.
Wang Shixiong's commentary: Add Xiyangshen (American Ginseng), Baihe (Lily Bulb), Zhuli (Bamboo Juice).
Fengwen syndrome: Fever, phlegm cough, thirst, mental confusion, limb spasms resembling convulsions, wiry-rapid pulse indicate Heat depleting fluids, Metal imprisoned, Wood flourishing. Use Lingyang, Chuanbei, Qinghao, Lianqiao, Zhimu, Maidong, Gouteng (Uncaria Ramulus) etc., to extinguish Wind and clear Heat.
Lung belongs to Metal, fears Fire, relies on Stomach fluids for descent and irrigation. Excess Heat consumes Stomach fluids, Lung loses support. Wood is Mother of Fire; Child makes Mother