经云冬伤于寒,春必病温。又曰冬不藏精,春必病温。同一病温耳,而必别之曰是为伤于寒,是为不藏精,其义何
居?曰此皆伏气之为病也。伤寒甚者,冬时即病;微者不即病,其气伏匿于肌腠及少阴,至春阳气开泄,触动伏气而为
病,此一例也。西洋医谓潜伏期不过十四日,无冬伤寒至春乃病之理,不思痘疹、麻疹,为先天之毒,有潜伏至十余年、
二三十年者,由冬及春,一刹那间耳,能决其必无是病乎?不藏精之说,注家谓不专主阴精而言,如冬应寒不寒、桃李
反花之类。夫气候不寒,阳邪早发,消铄阴液,肾精内亏。至春阳气舒张,或新邪引触伏邪为病,人与天地同一气耳。
气候不和,感触蕴藏,日积月累,而病以生,此又一例也。《经》又曰∶先夏至日为病温,后夏至日为病暑。暑即热也。
夏至以前,气候和煦,故感之者随时令而病温;夏至以后,气候酷热,故感之者随时令而病暑。温者较热为微,热者较
温为重。此又一例也。温热虽随时令而变迁,究之,病重于温则为热,又不可谓夏至以前必无热病也。东洋医学谓人为
温血动物,以热度表测算,通常在摄氏寒温计三十六·五度与三十七·五度之间。温特尔里希氏以三十七度五分,乃至
三十八度,名为次热;三十八度,乃至三十八度五分,名为轻热;三十八度五分,乃至三十九度五分,名为中热;三十
九度五分,乃至四十度五分,名为高热;四十度五分以上,名为剧热。但至四十度以上,患者必无生望。其以华氏热度
表九十八度起算者,规例亦同。夫次热、轻热,即温病之类也。高热、剧热,即热病之类也。观此而温与热之名义,涣
然冰释矣。
The *Classic of Difficult Issues* (Huangdi Neijing) states: "If one is injured by cold in winter, one will inevitably suffer from warm disease in spring." It also says: "If one fails to store essence in winter, one will inevitably suffer from warm disease in spring." Although both refer to suffering from warm disease, why must they be distinguished as being caused by "injury by cold" versus "failure to store essence"? What is the rationale? The answer is that these are all cases of latent pathogenic qi (pathogenic factors lying dormant within the body). In severe cases of cold damage (Shanghan), illness occurs immediately during winter; in mild cases, illness does not occur immediately. Instead, the pathogenic qi lies dormant in the muscle-coupling (the space between skin and muscle) and the Shaoyin channel. When yang qi opens and disperses in spring, it stirs up the latent pathogenic qi, causing illness. This is the first scenario. Western medicine posits that the incubation period does not exceed fourteen days, denying the logic of contracting cold in winter and falling ill in spring. This view lacks deep reflection on diseases like smallpox and measles, which stem from congenital toxins and can remain latent for ten to thirty years. The transition from winter to spring is but a fleeting moment; how can one definitively rule out such illnesses? Regarding the concept of "failure to store essence," commentators argue that it does not exclusively refer to yin essence. For instance, if winter should be cold but is not, or if peach and plum trees blossom out of season, these are examples. If the climate is not cold, yang pathogens emerge early, consuming and depleting yin fluids, leading to an internal deficiency of kidney essence. When spring arrives and yang qi expands, new pathogens may trigger latent pathogens, causing illness. Humans share the same qi with heaven and earth. Disharmony in climate, through contact and accumulation over time, eventually gives rise to disease. This is the second scenario. The *Classic* further states: "Diseases occurring before the Summer Solstice are called warm diseases; those occurring after are called summerheat diseases." Summerheat is heat. Before the Summer Solstice, the climate is mild and warm, so those who contract it develop warm disease according to the seasonal change. After the Summer Solstice, the climate is intensely hot, so those who contract it develop summerheat disease according to the seasonal change. Warm disease is milder than heat disease, while heat disease is more severe than warm disease. This is the third scenario. Although warm and heat conditions vary with the seasons, fundamentally, if the condition is more severe than warm disease, it is classified as heat disease. One cannot claim that there are absolutely no heat diseases before the Summer Solstice. Eastern medicine considers humans as homeothermic animals. Measured by a thermometer, normal body temperature typically ranges between 36.5°C and 37.5°C. Winternitz defined subfever as 37.5°C to 38°C; light fever as 38°C to 38.5°C; moderate fever as 38.5°C to 39.5°C; high fever as 39.5°C to 40.5°C; and extreme fever as above 40.5°C. However, once body temperature exceeds 40°C, the patient has no hope of survival. The rules using the Fahrenheit scale starting from 98°F are identical. Subfever and light fever correspond to warm disease categories; high fever and extreme fever correspond to heat disease categories. Observing this, the meanings of "warm" and "heat" become clear as ice melting.