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Yang Ruhou stated: The syndrome of "latent fire cold" (Fuhuo Ganmao) has recently become prevalent. People often fail to recognize it clearly, leading to mild cases becoming severe and severe cases becoming critical. This syndrome was not explicitly defined in ancient texts but was mixed with discussions on Cold Damage (Shanghan) and Warm Diseases (Wenre), causing later generations to often treat it incorrectly. Therefore, its principles must be reiterated. The dryness qi of autumn is inhaled through respiration into the lungs, transmitted into the blood vessels, where fire toxins accumulate and circulate within the blood. Upon entering winter, the atmospheric cold becomes stern, suppressing the fire toxins inside. Constrained by the cold, the blood vessels tighten, sweat pores close, and blood pressure rises, resulting in alternating chills and fever, dizziness or headache, bitter taste in the mouth, dry tongue, chest fullness, and body pain. People often fail to examine this carefully and instead use acrid-dry wind-dispelling herbs such as Qianghuo (Notopterygii Rhizoma et Radix), Chaihu (Bupleuri Radix), Baizhi (Angelicae Dahuricae Radix), Gegen (Puerariae Lobatae Radix), Xixin (Asari Radix et Rhizoma), Jingjie (Schizonepetae Herba), and Fangfeng (Saposhnikoviae Radix). The wind fans the fire, further intensifying the flames. Consequently, hot blood and fire toxins force abnormal circulation, accelerating the process and producing myriad complications. This leads to slightly scorched skin, ruptured blood vessels, and dangerous conditions such as sand spots (Shaban), rashes (Zhen), and throat bi (Houbi). Mild cases may last for months without healing, while severe cases may result in death.

Yang Ruhou stated: In Winter-Warmth (Dongwen), the pulse is surging at the Cun position and rapid at the Chi position, or solid and large. Symptoms include restlessness, vomiting and regurgitation, fever, aversion to cold absent, headache, heaviness of the body, facial edema, cough, sore throat, and diarrhea. This occurs when one contracts warmth due to unseasonably warm weather in winter. When Winter-Warmth presents with fever and slight aversion to cold, absence of sweating, and irritability, it is because the person first contracted warm qi and was then suppressed by severe cold. According to the first description, unseasonable warmth arriving before its time constitutes an aberrant qi. Only those who failed to store essence during winter have depleted Kidney qi and insecure interstices (Couli); thus, warm qi attacks them, causing disease. According to the second description, contracting warm qi and then being suppressed by severe cold results from sudden cold damaging Yang, leaving cold pathogenic factors on the exterior, hence the slight aversion to cold, which differs from the first case involving only fever. These all belong to Winter-Warmth. If exterior pathogenic factors account for one or two parts, interior heat must account for eight or nine parts, leading to successive outbreaks of macules (Yinzhen) and scarlet fever-like rashes (Dansha). Moreover, since latent summerheat (Fushu) and latent dryness (Fuzao) coexist in winter, one must not assume it is Cold Damage merely because it is winter, nor hastily use herbs like Mahuang (Ephedrae Herba), Guizhi (Cinnamomi Ramulus), Qianghuo, Chaihu, Jingjie, and Fangfeng to stir wind and fan fire, thereby increasing the intensity of the flames.

Zhou Yuzai stated: Winter-Warmth is no different from Spring-Warmth, differing only in the seasonal timing.

Ye Tianshi stated: Since entering winter, sudden cold has damaged Yang. Exogenous febrile diseases presenting with fever, headache, body pain, vomiting, and nausea must originate from the Taiyang (Greater Yang) channel. If there is thirst and desire to drink water, this indicates interior heat; pure exterior-releasing methods should not be used.

He also stated: If winter should be cold but the climate is warm, causing Yang qi to fail to submerge and leaking when it should be stored, disease will occur, named Winter-Warmth.

Lu Jiuzhi stated: Febrile diseases occurring in winter are Winter-Warmth. Zheng-Sanghan (Standard Cold Damage) formulas containing Guizhi and Mahuang should not be used. However, there are cases requiring Shigao (Gypsum Fibrosum), Zhizi (Gardeniae Fructus), Huangqin (Scutellariae Radix), and Lian (Coptidis Rhizoma).

Lei Shaoyi stated: Ancient sages said that when winter should be cold but is instead warm, possessing the climate out of season, and people contract it immediately falling ill, this is called Winter-Warmth. For those engaged in hard physical labor who sweat during exertion, warm qi attacks the exterior. For those who failed to store essence in winter and have insufficient Kidney meridian qi, warm qi attacks the interior. Although Winter-Warmth manifests in winter, its treatment method is radically different from Cold Damage. Warmth causes qi to dissipate, while cold causes qi to converge; these two natures are opposite. Misusing acrid-warm herbs leads to successive complications. Symptoms include headache with sweating, cough, thirst, aversion to heat rather than cold, facial edema, sore throat, or chest pain. If the Yang pulses are floating, slippery, and forceful, it indicates warm pathogens invading the Lung meridian; acrid-cool exterior-releasing methods should be used, adding Qiaofiao (Forsythiae Fructus) and Xiangbei (Fritillariae Thunbergii Bulbus). If thirst is severe, warm pathogens have entered the Stomach fu organ; add Lugeng (Phragmitis Rhizoma) and Huafen (Trichosanthis Radix). If diarrhea occurs and Yin pulses are floating-less but slippery, warm pathogens have sunk into the interior; cool-clearing and pathogen-extruding methods should be used, adding Gegen and Huangqin. If heat worsens significantly, consciousness becomes confused, delirium occurs, and the tongue coating turns black, the condition is difficult to treat. One may attempt heat-removing and orifice-opening methods; Zixue Dan (Purple Snow Pill) can also be used. Various complications cannot be fully listed; one must emulate methods from various Warm Disease categories.

Another question was asked: Winter-Warmth presents with fever and no aversion to cold. If there is aversion to cold, what disease is it? The answer is: Aversion to cold in Winter-Warmth occasionally occurs, usually because warm qi was first contracted and then invaded by severe cold. Cold is on the exterior and warmth is in the interior. Acrid-warm exterior-releasing methods should be used first to dispel cold pathogens, followed by cool-clearing interior-heat methods to clear the warm qi. Another question: Both Cold Damage (Shanghan) and Cold Exposure (Maohan) present with aversion to cold. How to distinguish them? Answer: Cold Damage and Cold Exposure have no thirst in the initial stage; this distinguishes them. Question: If warm pathogens develop into Winter-Warmth, but if mild ones lie latent and do not manifest, what disease is it? Answer: Latent and unmanifested, they will transform into Warm Toxin (Wendu) in the following spring. In treating seasonal diseases, new exogenous pathogens and latent qi must be clearly distinguished to avoid significant errors.

Chen Lianfang stated: Winter-Warmth belongs to new contraction. If it lies latent and does not manifest, it will certainly become Warm Toxin in the following spring.