雷少逸曰∶考诸大家论春温者,惟嘉言与远公,精且密矣。嘉言以冬伤于寒,春必病温,为一例;冬不藏精,春必
病温,又为一例;既伤于寒,且不藏精,至春同时并发,又为一例。举此三例,以论温病,而详其治。远公所论,都是
春月伤风之见证,分出三阳若何证治,三阴若何证治。观二家之论,可谓明如指掌。然宗嘉言,不合远公,宗远公,不
合嘉言,反使后人无从执法。其实嘉言之论,遵经训分为三例,意在伏气;远公之论,皆系伤风见证,意在新感。总之,
春温之病,因于冬受微寒,伏于肌肤而不即发;或因冬不藏精,伏于少阴而不即发;皆待来春加感外寒,触动伏气乃发
焉。即《经》所谓冬伤于寒,春必病温,冬不藏精,春必病温是也。其初起之证,头身皆痛,寒热无汗,咳嗽口渴,舌
苔浮白,脉息举之有余,或弦或紧,寻之或滑或数,此宜辛温解表法为先;倘或舌苔化燥,或黄或焦,是温热已抵于胃,
即用凉解里热法;如舌绛齿燥,谵语神昏,是温热深踞阳明营分,即宜清热解毒法,以保其津液也;如有手足 ,脉
来弦数,是为热极生风,即宜祛热息风法;如或昏 不知人,不语如尸厥,此邪窜入心包,即宜祛热宣窍法。春温变幻,
不一而足,务在临机应变可也。
陈莲舫曰∶此因新感之寒邪,触动伏气而病春温也。春温初起,寒热无汗,此表有寒邪也。故可用辛温解表法。否
则切忌温散,幸勿尝试,以伤其津液。春温变证可畏,治之者,当慎于初病之时。
杨如侯曰∶太阴之为病,脉不缓不紧而动数,或两寸独大,尺肤热,头痛,身热,口渴,午后热甚,名曰温病。如
恶寒无汗,此系春月因寒触动伏气而发也。如恶风,或不恶风,自汗咳嗽,此系春月因风触动伏气而发也。仲景论温病
属之太阳者,指伏气而言。谓冬伤于寒,寒邪伏于少阴,迨至来春,寒化为热,由里达表,而浮越于太阳也。后人论温
病属之太阴者,指新邪引动伏气而言;谓温邪由口鼻而入,自上而下,鼻通于肺,凡病温者,始于上焦,在手太阴也。
故曰∶太阴之为病,脉不缓不紧而动数。脉不缓,则知非太阳中风矣;脉不紧,则知非太阳伤寒矣。然头痛身热微恶风
寒,犹有与伤寒中风相混之处,于何辨之?于脉动数,口渴,尺肤热,午后热甚辨之。盖冬月伏寒,至春已变为温;或
因春感于寒,触发里气而病焉;或因春感于风,触发里气而病焉。此乃新邪引动伏邪,新邪在表,伏邪在里,必先辛凉
以解表邪,继进苦寒以清里热。不得认为风寒,而恣用辛温,以煽其火,而助之焰也。
Lei Shaoyi stated: Examining the discussions on Spring-Warmth (Chunwen) by various masters, only Jiayan (Yu Chang) and Yuan Gong were precise and meticulous. Jiayan categorized "winter injury by cold, spring must result in warmth disease" as one example; "winter failure to store essence, spring must result in warmth disease" as another example; and "both injured by cold and failing to store essence, occurring simultaneously in spring" as a third example. By presenting these three examples to discuss warmth diseases, he detailed their treatments. Yuan Gong's discussions focused entirely on the clinical manifestations of wind injury in spring, distinguishing how to diagnose and treat the Three Yang meridians (Taiyang, Yangming, Shaoyang) and the Three Yin meridians (Taiyin, Shaoyin, Jueyin). Observing the arguments of these two schools, one could say they are as clear as pointing at one's palm. However, adhering solely to Jiayan contradicts Yuan Gong, and adhering solely to Yuan Gong contradicts Jiayan, thereby leaving later generations without a standard for treatment. In fact, Jiayan's argument follows the classic teachings by dividing into three examples, aiming at "latent qi" (pathogenic factors lying dormant within the body); Yuan Gong's arguments all pertain to the clinical signs of "newly acquired" (immediate external pathogenic invasion), aiming at new acquisition. In summary, Spring-Warmth disease arises because slight cold was contracted in winter, lying dormant in the skin and muscles without immediate onset; or due to failure to store essence in winter, lying dormant in the Shaoyin meridian without immediate onset; both await the arrival of spring when exposed to external cold, which stirs up the latent qi, causing the disease to manifest. This is exactly what the *Classic* (Huangdi Neijing) says: "Winter injury by cold leads to warmth disease in spring; winter failure to store essence leads to warmth disease in spring." At the initial stage, symptoms include pain in the head and body, aversion to cold with fever and anhidrosis, cough, thirst, floating white tongue coating, and pulse that is abundant upon light pressure, either wiry (Xian) or tight (Jin), and slippery (Hua) or rapid (Shu) upon heavy pressure. In such cases, acrid-warm exterior-releasing method should be used first. If the tongue coating becomes dry, yellow, or scorched black, it indicates that warm-heat has reached the Stomach, requiring immediate use of cool-clearing interior-heat method. If the tongue is crimson, teeth are dry, delirium occurs, and consciousness is clouded, it indicates that warm-heat deeply occupies the Ying (Nutrient) level of Yangming, requiring heat-clearing and detoxification method to preserve body fluids. If there are convulsions of the hands and feet with a wiry and rapid pulse, this is extreme heat generating wind, requiring heat-dispelling and wind-extinguishing method. If there is coma with loss of consciousness, muteness resembling corpse rigidity (Shijue), this indicates evil Qi has penetrated the Pericardium, requiring heat-dispelling and orifice-opening method. The transformations of Spring-Warmth are endless; one must adapt flexibly according to the situation.
Chen Lianfang stated: This occurs when newly acquired cold evil stirs up latent qi, causing Spring-Warmth disease. At the onset of Spring-Warmth, there is aversion to cold, fever, and anhidrosis, indicating cold evil on the exterior. Therefore, acrid-warm exterior-releasing method can be used. Otherwise, warm-dispersing methods must be strictly avoided; do not attempt them, lest they damage body fluids. The complicated manifestations of Spring-Warmth are terrifying; practitioners must exercise caution during the initial stage of the disease.
Yang Ruhou stated: The disease of Taiyin presents with a pulse that is neither slow nor tight but rapid, or the cun positions on both sides are exclusively large, heat in the chi skin, headache, body fever, thirst, and worse fever in the afternoon, named Warmth Disease. If there is aversion to cold and anhidrosis, this is caused by cold stirring up latent qi in spring. If there is aversion to wind, or no aversion to wind, spontaneous sweating, and cough, this is caused by wind stirring up latent qi in spring. Zhang Zhongjing attributed warmth disease to Taiyang, referring to latent qi. He meant that winter cold injury causes cold evil to lie dormant in Shaoyin; until spring arrives, the cold transforms into heat, moving from interior to exterior, and floating outward to Taiyang. Later scholars attributed warmth disease to Taiyin, referring to new evil stirring up latent qi; meaning warm evil enters via mouth and nose, descending from above; the nose connects to the Lung, so all warmth diseases begin in the Upper Jiao, affecting Hand-Taiyin Lung Meridian. Thus it is said: The disease of Taiyin presents with a pulse that is neither slow nor tight but rapid. A pulse that is not slow indicates it is not Taiyang Wind Strike (Zhongfeng); a pulse that is not tight indicates it is not Taiyang Cold Damage (Shanghan). However, headache, body fever, and slight aversion to wind and cold still have similarities with Cold Damage and Wind Strike; how to distinguish them? Distinguish by rapid pulse, thirst, heat in chi skin, and worse fever in the afternoon. Generally, winter latent cold transforms into warmth by spring; or due to spring cold sensation triggering internal qi causing disease; or due to spring wind sensation triggering internal qi causing disease. This is new evil stirring up latent evil; new evil is on the exterior, latent evil is in the interior. One must first use acrid-cool to release exterior evil, then proceed with bitter-cold to clear interior heat. Do not mistake it for wind-cold and recklessly use acrid-warm methods, which would fan the flames and assist the fire.