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Chunwen (Spring-Warmth Disease) is a condition caused by the failure of storage during winter. Ancient practitioners believed that cold pathogenic factors from winter lie latent within, hiding in the Shaoyin (Lesser Yang) channel, and manifest in the Shaoyang (Lesser Yang) channel when spring arrives, because the Wood energy of spring corresponds internally to the Liver and Gallbladder. The cold pathogen lies deep and has transformed into heat; therefore, former sages used Huangqin Tang (Scutellaria Decoction) as the principal formula, employing bitter-cold herbs to directly clear internal heat. Heat lying latent in the Yin aspect is strengthened in its Yin nature by bitter flavors, which constitutes the orthodox treatment. It must be understood that warm pathogens are contraindicated for dispersing methods, and their treatment differs from that of sudden external infections. If an external pathogen is contracted first, thereby stirring up latent internal heat, one must first use acrid-cool herbs to resolve the new external pathogen, followed by bitter-cold herbs to clear the internal heat.

There are two types of Chunwen disease: One type occurs when cold pathogenic factors are contracted in winter but do not cause immediate illness; instead, the latent pathogen transforms into heat and manifests externally in spring; this is named Chunwen. The other type occurs when the spring climate is excessively hot, and the body contracts seasonal pathogens leading to illness; this is Chunwen that manifests immediately upon contraction. The method for distinguishing symptoms is as follows: For Chunwen caused by latent qi, the initial stage presents with fever without chills and thirst, indicating the pathogen originates from within and moves outward. For Chunwen that manifests immediately upon contraction, the initial stage presents with slight chills, followed by fever without chills, indicating the pathogen attacks the Lung and Defensive-Wei levels from outside.
Attached quote from Lu Pingyi of the time:
The five qi (Wind, Cold, Summer-Heat, Dampness, Dryness) all have distinctions between new contraction and latent pathogen; only the Cold pathogen uniquely transforms into heat to emerge, while the other pathogens emerge retaining their original nature; this is the difference.

Yu Dongfu stated: What is currently referred to as Shanghan (Cold Damage) is generally Warm-Heat disease. Zhang Zhongjing said: "Taiyang disease presenting with fever, thirst, and aversion to cold absent, is Wenbing (Warm Disease)." Since heat signs appear already at the Taiyang stage, the formulas Mahuang Tang (Ephedra Decoction) and Guizhi Tang (Cinnamon Twig Decoction) absolutely cannot be used, which is distinctly different from Shanghan. The *Neijing* states: "All heat diseases belong to the category of Shanghan." This refers to observing any acute febrile disease according to the principles of Shanghan. These two statements seem different, but upon examining their meaning, the difference lies only in the Taiyang stage; otherwise, there is no difference. To claim that Warm-Heat disease only investigates the Sanjiao (Triple Burner) and does not discuss the Six Channels is absurd talk. Zhang Zhongjing's Six Channels encompass all hundred diseases; how could diseases belonging to the Shanghan category be completely separated into two distinct paths? Ye Tianshi's medical cases state: "Warm pathogens enter through the mouth and nose." This is also inaccurate. Zhang Zhongjing clearly stated that the manifestation of latent qi comes from within, as did Li Dongyuan and Wang Andao, who both said that injury to cold in winter causes latent pathogens to emerge from within. How can Wu Keyi's *Wenyi Lun* (Treatise on Pestilential Qi) be mixed in? Only Shanghan disease primarily involves the Foot meridians, whereas Warm-Heat disease frequently involves the Hand meridians. For example, coughing and stertorous breathing in Fengwen (Wind-Warmth), or coma and delirium in Rebing (Heat Disease), or loose stools with sticky filth, are manifestations of the Hand-Taiyin Lung Meridian, Hand-Jueyin Pericardium Meridian, and Hand-Yangming Large Intestine Meridian. In severe cases, symptoms include sore throat, limb convulsions, confusion resembling drunkenness, restlessness, scorched teeth, dry tongue, skin eruptions, and mumps-like swelling. At this point, the pathogen is distributed and filling the body, no longer traceable by the Six Channels, hence the Six Channel treatment method is not applied. Based on my lifelong experience, cases initially complicated by exterior pathogens are most common, and dispersing methods are still appropriate, using herbs such as Fangfeng (Saposhnikovia Root), Gegen (Kudzu Root), Chidou (Fermented Soybean), Bohe (Mint), Niubangzi (Arctium Fruit), Xingren (Apricot Seed), Huashi (Talcum), and Lianqiao (Forsythia). Sweating indicates mild disease, while absence of sweating indicates severe disease. If skin eruptions appear, add Chantui (Cicada Slough), Jiegeng (Platycodon Root), Lugeng (Reed Rhizome), and Xihe Liu (Tamarisk Branch); if phlegm is present, add Tubei (Fritillaria Bulb), Jiangcan (Silkworm), Gualou (Trichosanthes Fruit), and Juhong (Aged Tangerine Peel); if Yangming syndrome appears, use Baihu Chengqi Tang (Shigypsum, Dahuang, Zhimu, Gancao, Fresh Lotus Leaf, Mangxiao); if Shaoyang syndrome appears, use Xiaochaihu Tang (Chaihu, Banxia, Renshen, Gancao, Huangqin, Shengjiang, Dazao), removing Renshen and Banxia, and adding Huafen (Trichosanthes Root) and Zhimu; [Huang notes: For Shaoyang syndrome due to Warmth and Summer-Heat, Lei Shaoyi's Qingying Hanmie Fa (Lianqiao, Zhuye, Biandouyi, Qinghao, Muzei, Huangqin, Qingpi, Xiguacuiyi) is more stable;] if Shaoyin syndrome appears, use Huanglian Ejiao Tang (Huanglian, Fuling, Ejiao), Zhu Ling Tang (Zhuling, Fuling, Zexie, Huashi, Ejiao), or Zhufu Tang [Zhufu, Baifen (Stannum Oxide, also known as Lead Powder), Baimi]; all follow Zhang Zhongjing's established Six Channel methods and are effective. However, Shaoyin (Three Yin) syndromes in Warm-Heat disease often result in death, unlike Shanghan. This is because those who failed to store essence in winter suffer from exhaustion of Kidney Water internally, as described by Li Dongyuan; who then provides nourishment? Only large doses of Yin-nourishing herbs, assisted by heat-clearing herbs, may save them. Yin-nourishing herbs include Dihuang (Rehmannia Root), Donghua (Asparagus Root), Ejiao, Danpi (Moutan Bark), Xuanshen (Scrophularia Root), Renru (Human Milk), Zheshuang (Sugarcane Juice), Lizhi (Pear Juice); heat-clearing herbs include Sanhuang (Huanglian, Huangqin, Dahuang), Shigypsum, Xijiao (Rhinoceros Horn), Daqingye (Isatis Leaf), Zhimu, Lugeng, Maogen (Imperata Rhizome), Jinzhi (Gold Filtrate), Xueshui (Snow Water), Xigua (Watermelon), Yinhualu (Honeysuckle Dew), Sigua Zhi (Luffa Juice), selected according to the specific syndrome. Warm-tonifying herbs for the Three Yin channels are not suitable for Warm-Heat disease. Occasionally, Zhenwu Tang (Fuzi, Baizhu, Fuling, Baishao, Shengjiang) or Lizhong Tang (Baizhu, Renshen, Ganjiang, Gancao) are used, but this happens in only one or two out of a hundred cases. Generally, Warm-Heat disease fears most persistent fever, as well as spasms, convulsions, and mental confusion. There are also cases of unprovoked dizziness, or lucidity interrupted by sudden delirium, where changes often become unpredictable. Such conditions are most confusing to physicians, unlike Yang syndromes with Yin pulses, retraction of genitals, curling of the tongue, grasping at empty air, or seeing ghosts, which make the danger easier to discern. The key principle lies in distinguishing deficiency from excess; only when the diagnosis is precise can treatment begin. However, this cannot be cured by the methods of Liu Hejian or Wu Keyi; only those who have meticulously studied Zhang Zhongjing's *Shanghan Lun* will grasp the profound insights. Regarding Ye Tianshi's discussion of Warm-Heat disease, when pathogens transmit to the Pericardium, disturbing the Sovereign Mind, causing near-confusion of spirit, and diffuse pathogens resist attack, clearing orifices remain blocked, collaterals close internally, and phlegm-resolving and fire-reducing methods fail, one should use Ju Fang Zhibao Dan (Xijiao, Dai Mao, Hupo, Zhusha, Xionghuang, Longnao, Shexiang, Niuhuang, Anshixiang, Yinpiao, Jinping), or Zixue (Huangjin, Hanshuishi, Shigypsum, Huashi, Cishi, Xijiao, Lingyangjiao, Chenxiang, Muxiang, Shengma, Xuanshen, Gongdingxiang, Gancao, Puxiao, Xiaoshi, Shexiang, Chensha), or Niuhuang Wan (Niuhuang, Huanglian, Dahuang, Maidong, Zhusha, Shexiang, Zhizi, Yaxiao, Chuanxiong, Huangqin, Gancao), following Yu Jiayou's theory of aromatic purification to expel turbidity and open orifices. This truly surpasses former sages and avoids the弊 (drawback) of using heavy medicines where a single spoonful error leads to irreparable consequences.
Huang notes: Yu's argument is accurate and unshakable. Among these, he mentions unprovoked dizziness and lucidity interrupted by sudden delirium, where changes often become unpredictable. Because in this condition, the spirit is half-lucid and half-obscure, observing the tongue color as pale red approaching purple, with very thin coating or no coating, the time of death usually falls within five days. I have witnessed this repeatedly in clinical practice. In Western medicine, this condition is attributed to bacterial invasion of the medulla oblongata nerves.