（一）夫精者，身之本也。故藏于精者，春不病温。（《金匮真言论》）
张隐庵曰∶神气血脉皆生于精，故精乃生身之本。能藏其精，则血气内固，邪不外侵，故春不病温。
吴鞠通曰∶不藏精三字须活看，不专主房劳说，一切人事之能摇动其精者皆是。即冬日天气应寒，而阳不潜藏，如
春日之发泄，甚至桃李反花之类亦是。
陆九芝曰∶《金匮真言论》云∶夫精者，身之本也。故藏于精者，春不病温。所谓精者，指一身津液由于水谷所化。
水谷之精气，和调于五脏，洒陈于六腑，为后天生身之本，其下遂以精与汗互言之。吾试以经解经，此即经言食气入胃，
散精于肝，淫精于脉，输精于皮毛之数精字也；亦即经言饮入于胃，游溢精气，上输于脾，脾气散精，上归于肺，水精
四布，五经并行之数精字也。又岐伯论温病曰∶人所以汗出者，汗生于谷，谷生于精，邪气之得汗者，邪却而精胜也。
又曰∶汗者，精气也。则精即是汗。
（二）冬伤于寒，春必病温。（《生气通天论》）
马元台曰∶冬伤于寒者，至春必为温病。盖冬时严寒，中之即病者，谓之伤寒；其有伤于寒，而不即病者，至春阳
气发生，邪从内作，故为温病之证。夫曰温者，寒非纯寒而有热，热非纯热而有寒，正以前此而冬则为寒，后此而夏则
为热，则此春时乃为温病也。
叶子雨曰∶冬至一阳渐生，人身之阳气内盛，被冬日严寒杀厉之气所折，深浃于肌髓之间，至春日，内伏郁结之阳
气为外邪触发，伏气既得发泄，遇天气之阳热，两热相干，发为温病。
（三）凡病伤寒而成温者，先夏至日为病温，后夏至日为病暑。暑当与汗出，勿止。（《热论》）
叶子雨曰∶古医经以伤寒为外感之通称，故云凡病伤寒而成温。然天地阴阳之邪，随人身气化感召。冬至后一阳渐
生，人身所伏之阳热，为严寒折遏，感春阳之气而发者为病温；夏至一阴生，人身所伏之阴气，感亢热之气而发者为病
暑。盖春温夏暑，随气而化，亦随时而命名也。暑当与汗出，勿止者，暑虽热邪，热盛则蒸湿，湿与热搏，故暑病多汗；
治暑之法，不可禁止其汗也。
柳宝诒曰∶经言凡病伤寒，是伤寒不必专于冬时，即三时感寒，亦能郁化为温也。其称夏至后为病暑，则暑即温之
变名，尤不可指为另是一邪。而此独分别言之者，因伏气发于夏至以后，其治病略有不同。盖温病忌汗，恐其伤阴；若
时交长夏，则汗出必多，而邪气亦随汗而出，又未可以汗多而遽止之也。
（四）气虚身热，得之伤暑。（《刺志论》）
马元台曰∶气本虚矣，而身反热，盖得之伤暑故也。惟热伤气，故伤暑则身热也。
（五）人一呼脉三动，一吸脉三动而躁，尺（廖平曰∶尺为皮之误）热曰病温。（《平人气象论》）
马元台曰∶一呼脉当再动，而今则三动；一吸脉当再动，而今则三动；则一呼一吸总为一息，为六动矣。《脉诀》
以为数脉。《难经》亦以为离经脉。是六至而躁，躁者，动之甚也。今尺脉躁动，当尺有热。尺部者，下部也，主肾水
不足，其病为温。
（六）尺（廖平曰∶尺为皮之误）肤热甚，脉盛躁者，病温也。其脉盛而滑者，病（《甲乙经》病作汗）且出也。（《论
疾诊尺篇》）
马元台曰∶尺之皮肤热甚，其脉盛躁，当为温病也。其脉虽盛，不至于躁，而带滑者，则病当自出矣。
吴鞠通曰∶尺肤热甚，火烁精也；脉盛躁，精被火煎沸也；脉盛而滑，邪机向外也。盖温病必伤金水二脏之津液，
尺之脉属肾，尺之穴属肺，此处肌肉热，故知为病温也。
薛生白曰∶尺肤热者，其身必热；脉甚躁者，阳邪有余，故当为温病。若脉虽盛而兼滑者，是脉已不躁，而正气将
复，故不久当愈。出，渐愈之谓。
（七）诸治热病，以饮之寒水，乃刺之；必寒衣之，居止寒处，身寒而止也。（《刺热论》）
章虚谷曰∶以其久伏之邪，热从内发，故治之必先饮寒水，从里逐热；然后刺之，从外而泄；再衣以寒，居处以寒，
身寒热除而后止。
柳宝诒曰∶治热以寒，一定之理。今人于温病初发，见用凉解，而即言其遏邪者，彼固未明此理也。
王孟英曰∶今人不读《内经》，虽温热暑疫诸病，一概治同伤寒，禁其凉饮，浓其衣被，闭其户牖，因而致殆者，
我见实多。然饮冷亦须有节，过度则有停饮、肿满、呕利等患，更有愈后手指、足缝出水，甚至脚趾脱落，即俗所谓脱
脚伤寒也。
叶子雨曰∶治热病，饮以寒水，欲其热自内达外也；必寒衣寒处者，皆避温就凉之意耳。然肆饮寒凉，流弊滋多。
孟英此注，颇具卓见，读者鉴诸。
（八）病温虚甚死。（《玉版论要篇》）
柳宝诒曰∶经言藏于精者，春不病温，则凡病温者，其阴气先虚可知。使或虚而未至于甚，则养阴透邪治之如法，
犹可挽回。若病温者而至虚甚，则热邪内讧，阴精先涸，一发燎原，不可治矣。
吴鞠通曰∶病温之人，精血虚甚，则无阴以胜温热，故死。
（九）热病已得汗，而脉尚躁盛，此阴脉之极也，死；其得汗而脉静者生。（《热病篇》）
马元台曰∶此言热病汗后脉躁者死，反是则生也。热病已得汗，脉宜静，今反躁盛者，此乃阴经之脉衰弱已极，故
有阳脉而无阴脉也，其人主于死。若得汗之后，而脉遂能静，则有阴以配阳，必能以有生矣。
（十）热病者，脉尚盛躁，而不得汗者，此阳脉之极也，死；脉盛躁，得汗静者生。（《热病篇》）
马元台曰∶此言热病脉盛而不得汗者死，反是则生也。热病脉躁盛宜得汗，今反不得汗者，此乃阳经之脉衰弱已极，
故表虚而不能发汗也，其人主于死；若脉躁盛而汗出脉静者，必能以有生矣。
(1) Jing (Essence) is the root of the body. Therefore, those who can preserve their Jing will not suffer from Warm diseases in spring. (From *Jingui Zhenyan Lun* / Discourse on the True Sayings of the Golden Casket)
Zhang Yin'an stated: Shen (Spirit), Qi, Blood, and Mai (Pulse) all originate from Jing. Thus, Jing is the root that generates the body. If one can preserve their Jing, then Qi and Blood will be solidified internally, and pathogenic factors cannot invade externally; hence, one will not suffer from Warm diseases in spring.
Wu Jutong stated: The phrase "not preserving Jing" must be interpreted flexibly; it does not refer exclusively to sexual excess. Any human activity or circumstance that can agitate and deplete one's Jing falls under this category. For instance, although winter weather should be cold, if Yang Qi fails to hide and instead dissipates like in spring, even causing peaches and plums to bloom out of season, this also belongs to this category.
Lu Jiuzhi stated: *Jingui Znenyan Lun* says: "Jing is the root of the body. Therefore, those who preserve their Jing will not suffer from Warm diseases in spring." The "Jing" referred to here indicates the fluids of the entire body, which are transformed from food and drink. The essence of food and drink harmonizes within the five Zang organs and spreads throughout the six Fu organs, serving as the postnatal root for nourishing the body. The classic text subsequently uses "Jing" and "Han" (Sweat) interchangeably. I attempt to explain the classics with the classics: these are the multiple instances of "Jing" mentioned in the text stating, "The qi of food entering the stomach scatters its essence to the Liver, overflows into the vessels, and transports essence to the skin and hair"; and also the instances stating, "When water enters the stomach, it overflows with essence, transports upward to the Spleen, the Spleen scatters the essence, which returns upward to the Lung; water essence distributes in four directions, and the five channels proceed together." Furthermore, when Qibo discussed Warm diseases, he said: "The reason humans sweat is that sweat is born from grain; grain is born from Jing. When pathogenic factors are expelled via sweat, it means pathogens have retreated and Jing has prevailed." He also said: "Sweat is Jing essence." Thus, Jing is equivalent to sweat.
(2) Injury by Cold in winter leads inevitably to Warm diseases in spring. (From *Shengqi Tongtian Lun* / Discourse on the Vital Energy Connecting with Heaven)
Ma Yuantai stated: Injury by Cold in winter results in Warm diseases in spring. Generally, during the severe cold of winter, if illness occurs immediately upon injury, it is called Shanghan (Cold Damage); however, if one is injured by Cold but does not fall ill immediately, when Yang Qi arises in spring, the pathogen acts from within, thus manifesting as a Zheng (Syndrome) of Warm disease. The term "Warm" implies that the Cold is not purely Cold, nor is the Heat purely Heat. Precisely because it was Cold in the preceding winter and will become Hot in the subsequent summer, this period in spring is termed Warm disease.
Ye Ziyu stated: After the Winter Solstice, a trace of Yang gradually arises. The Yang Qi within the human body becomes abundant internally but is suppressed by the killing and harsh Qi of winter's severe cold, penetrating deep into the muscles and marrow. In spring, the internally latent and stagnant Yang Qi is triggered by external pathogens. Once the latent Qi is released and encounters the Yang heat of the weather, the two heats interfere with each other, resulting in Warm disease.
(3) All cases where Shanghan evolves into Warm disease: those occurring before the Summer Solstice are called Warm disease; those occurring after the Summer Solstice are called Shu (Summerheat) disease. In Shu disease, sweating should be allowed and not stopped. (From *Re Lun* / Discourse on Heat)
Ye Ziyu stated: Ancient medical classics used "Shanghan" as a general term for external contraction, hence the statement "All cases where Shanghan evolves into Warm disease." However, the pathogenic factors of Yin and Yang in heaven and earth induce disease according to the transformation of Qi in the human body. After the Winter Solstice, a trace of Yang gradually arises; the latent Yang heat in the body, suppressed by severe cold, is triggered by the Qi of spring Yang, resulting in Warm disease. After the Summer Solstice, a trace of Yin gradually arises; the latent Yin Qi in the body, triggered by excessive heat, results in Shu disease. Essentially, Spring Warmth and Summer Heat transform according to Qi and are named according to time. "In Shu disease, sweating should be allowed and not stopped" means that although Shu is a Heat pathogen, excessive heat steams Dampness, and Dampness combats Heat; therefore, Shu disease often involves profuse sweating. The treatment principle for Shu disease is not to prohibit sweating.
Liu Baoyi stated: The scripture says "All cases where Shanghan," implying that Shanghan is not limited to winter; contracting Cold in any of the other three seasons can also stagnate and transform into Warm disease. Referring to illness after the Summer Solstice as Shu disease indicates that Shu is merely a variant name for Warm disease and should certainly not be identified as a completely different pathogen. The reason for distinguishing them here is that latent Qi erupts after the Summer Solstice, and the treatment method differs slightly. Generally, Warm disease contraindicates diaphoresis (inducing sweating) for fear of damaging Yin; however, during the long summer, sweating is inevitable and profuse, and pathogens exit with the sweat. One should not abruptly stop sweating simply because it is profuse.
(4) Qi deficiency accompanied by bodily heat is caused by injury from Shu (Summerheat). (From *Cizhi Lun* / Discourse on Needle and Meridian)
Ma Yuantai stated: Although Qi is inherently deficient, the body is paradoxically hot; this is due to injury from Shu. Only Heat damages Qi; thus, injury from Shu results in bodily heat.
(5) If in one exhalation the pulse beats three times, and in one inhalation the pulse beats three times and is rapid/agitated, and the Chi (wrist/radial) area is hot, this is Warm disease. (From *Pingren Qixiang Lun* / Discourse on the Normal Physiological Signs)
Ma Yuantai stated: Normally, the pulse beats twice per exhalation, but now it beats three times; normally, it beats twice per inhalation, but now it beats three times. Thus, in one full breath (exhalation plus inhalation), it beats six times. The *Maijue* (Pulse Classic) considers this a Shu (Rapid) pulse. The *Nanjing* (Classic of Difficult Issues) also considers it a Li Lei (Departing) pulse. Six beats per breath with agitation indicates vigorous movement. Current agitation of the Chi pulse indicates heat in the Chi region. The Chi region refers to the lower part, governing Kidney Water insufficiency; the disease manifests as Warm disease.
(6) If the Chi skin is very hot and the pulse is full and agitated, it is Warm disease. If the pulse is full and slippery, the disease will resolve through sweating. (From *Lun Ji Chi Pian* / Discourse on Diagnosing Diseases by Inspecting the Arms, Note: Liao Ping states "Chi" is a typo for "Pi" [Skin])
Ma Yuantai stated: If the skin at the Chi position is very hot and the pulse is full and agitated, it should be Warm disease. If the pulse is full but not agitated, and instead slippery, the disease will resolve spontaneously.
Wu Jutong stated: Very hot Chi skin indicates Fire scorching Essence; a full and agitated pulse indicates Essence being boiled by Fire; a full and slippery pulse indicates the pathogenic mechanism moving outward. Generally, Warm disease inevitably damages the Jin-Ye (Body Fluids) of the Metal (Lung) and Water (Kidney) organs. The Chi pulse belongs to the Kidney, and the Chi acupoint/skin area belongs to the Lung. Heat in the muscle tissue here indicates Warm disease.
Xue Shengbai stated: Heat in the Chi skin implies the whole body is hot; an extremely agitated pulse indicates excess Yang pathogen, thus indicating Warm disease. If the pulse is full yet slippery, it means the pulse is no longer agitated and Zheng Qi (Upright Qi) is recovering, so recovery will occur soon. "Chu" (Exit/Resolve) refers to gradual recovery.
(7) In treating Heat diseases, allow the patient to drink cold water, then apply acupuncture; ensure they wear cool clothing and reside in cool places, stopping only when the body feels cool. (From *Ci Re Lun* / Discourse on Needling Heat)
Zhang Xugu stated: Because the long-latent pathogen releases Heat from within, treatment must first involve drinking cold water to drive Heat out from the interior; then apply acupuncture to vent Heat from the exterior; finally, dress in cool clothes and reside in cool places, stopping only when the body is cool and Heat is eliminated.
Liu Baoyi stated: Treating Heat with Cold is an established principle. Nowadays, when treating early-stage Warm disease with cooling and resolving methods, some claim it suppresses the pathogen; these individuals fail to understand this principle.
Wang Mengying stated: Nowadays, people do not read the *Neijing*. Regardless of whether the disease is Warm-Heat, Summerheat, or Epidemic Toxin, they treat it uniformly as Shanghan, prohibiting cold drinks, thickening clothing and bedding, and closing doors and windows, leading to danger. I have seen many such cases. However, drinking cold liquids must be moderated; excess leads to fluid retention, distension, vomiting, and diarrhea. There are also cases where, after recovery, water oozes from fingers and toe webs, or even toes fall off, commonly known as "Toe-Dropping Shanghan."
Ye Ziyu stated: Treating Heat disease by drinking cold water aims to guide Heat from the interior to the exterior; wearing cool clothes and residing in cool places is intended to avoid warmth and seek coolness. However, indiscriminate consumption of cold substances leads to many adverse effects. Wang Mengying's commentary shows profound insight; readers should take note.
(8) Warm disease with extreme deficiency leads to death. (From *Yuban Lunyao Pian* / Essential Discourse on the Jade Tablet)
Liu Baoyi stated: The scripture says, "Those who preserve Jing will not suffer from Warm diseases in spring," implying that anyone suffering from Warm disease clearly has prior Yin Qi deficiency. If the deficiency is present but not extreme, proper treatment with nourishing Yin and venting pathogens can still save the patient. However, if Warm disease progresses to extreme deficiency, Heat pathogens rebel internally, Yin Essence dries up first, and the situation becomes uncontrollable like a prairie fire, making it incurable.
Wu Jutong stated: In patients with Warm disease, if Jing and Blood are extremely deficient, there is no Yin to overcome the Warm-Heat pathogen, leading to death.
(9) In Heat disease, if sweating has occurred but the pulse remains rapid and full, this is the extreme depletion of Yin pulses, indicating death; if the pulse becomes calm after sweating, it indicates survival. (From *Re Bing Pian* / Discourse on Heat Diseases)
Ma Yuantai stated: This passage states that Heat disease with an agitated pulse after sweating leads to death, whereas the opposite leads to survival. After sweating in Heat disease, the pulse should be calm; if it is instead rapid and full, it signifies that the Yin channel pulses are extremely depleted, leaving only Yang pulses without Yin support, indicating death. If the pulse calms after sweating, Yin can coordinate with Yang, ensuring survival.
(10) In Warm disease, if the pulse remains full and agitated but no sweat is produced, this is the extreme depletion of Yang pulses, indicating death; if the pulse is full and agitated but becomes calm after sweating, it indicates survival. (From *Re Bing Pian* / Discourse on Heat Diseases)
Ma Yuantai stated: This passage states that Heat disease with a full pulse but inability to sweat leads to death, whereas the opposite leads to survival. In Heat disease, a rapid and full pulse should be accompanied by sweating; if sweating fails to occur, it signifies that the Yang channel pulses are extremely depleted, causing exterior deficiency and an inability to produce sweat, indicating death. If the pulse is rapid and full but becomes calm after sweating, survival is assured.