五气失常，素称六淫，六淫是寒、暑、燥、湿、风，火。六淫之中，原无温邪之说，但自叶天士倡言“温邪上受”，“温邪"之说，遂大行于世。这样，，六淫实际上是变成了七淫。如果说温邪本不在六淫之外，即包括暑邪、火邪而言，则暑邪、火邪、温邪、热邪，名目愈多，概念愈混，内涵重叠，定义混淆，此六淫原只五气，言六本已不通(火除烧伤外，不能成为外感的病因，此古人早已疑之，陆九芝答袁生问，迂回曲折，实多牵强，连服膺其学的章巨膺都感到不满。1981年第4期山东中医学院学报上亦有专文论此，故不复赘言)，今又添出温邪一项，于中医病因学，实无裨益。人体对正常的气候变化，自能适应，若非太热，太寒，太湿，太燥，一般不足以干扰机体的调节及抗病能力，绐戾气致病形成有利条件。温暖的气候，于人体最适，决不能象寒、暑、燥、湿、风那样，剌激、干扰机体的正常生理活动，而引起疾病。故称温为邪，谓“春月受风，其气已温”，“温邪上受”，“温邪夹风”，实比把风寒等诱因当病因的说法更无稽。温热家所谓由温邪引起的温病，实际上无非是机体反抗戾气产生了应激亢进之表现，故即所谓小风温，亦；非真由温邪所引起，也非温邪夹风所造成，而实是风载戾气，吸入口鼻，犯肺为病。为病之后，因机体反应亢进，辨证属热，所以判断为“小风温”；如为病之后，机体反应不急亢，辨证属寒，就可以判断为“小伤寒”。雷少逸鉴于感冒类病大都由冒风受寒疲劳等诱起，故认为风温、春温也是受寒邪所引起。但诚如祝味菊说：“叶氏之视温热也，以为实有温热之邪也，以为温热之邪，于法宜用寒凉也。”故“其处方虽有前后缓急之法，而赏用清凉，其揆一也。唯其主观以为温邪当凉，故曰‘虽在吴人阳微之体，亦当应用清凉，’明知阳微过清必死，故又曰‘清凉到六七分，即不可过于寒凉，恐成功反弃也。’总是立名不正，遂令其言不顺。”祝氏认为：这是叶氏学说中最不可取部分，亟宜正之。惜此书流布不广，其说尚未为人们所注重。
从临床实践来看，由于温热家视外感病中机体应激亢进的热化症状，是病邪性质属温所造成，不是看作是戾气与内热重之素因互相作用的机体反应，故不但视麻，桂如蛇蝎(认为温邪化热最速，用之犯以温治温之戒)，而且畏柴、葛如虎(认为温邪最易伤阴，用之犯劫竭阴津之戒)，用药自设藩篱，蹄子变窄，遂流于轻清平淡一支。实际上，麻、桂、柴、葛，都是外感解表之要药，虽其温升之性于机体应激亢进及阴虚体质不相宜，但药用群队，方有相制，如果立法不误，只要妥为配伍，原可扬长抑短(如麻黄杏仁石膏甘草汤以麻黄配石膏，一柴胡饮以柴胡配生地，就可用于治热病及阴虚之外感)，而其宣郁热、散外邪之力，远非桑叶、薄荷、豆豉、豆卷类所可比。须知治寒则以麻黄配桂枝，治热则以麻黄配石膏，此是先人已效之成法。治阴虚犯感，辟拘经限药之非，以柴胡配生地；治应激亢进，或以柴胡配知、膏(如一柴胡饮)，或以羌活合公英(如羌蒡蒲薄汤)，则是后人别开生面之活法。然拘于温邪之说者，对麻、桂、柴、葛类药，常不敢轻用，甚危言耸听，竟说：“少用一剂柴胡即多活一人性命，”“弃而不用，亦保全性命之一道。”①其于辛凉之解表药畏之若是，则于辛温之品，可知矣！另一方面，又每将小风温之治，如桑菊饮，银翘散类之药法，竟移作为一切温病初起之治规，此所以陆九芝有“伤寒一证，至天士而失传，温热一证，亦至天士而失传”之激言也。
三、关于病名
伤风本为中医固有之病名，宋·陈言《三因极一病证方论》、明，皇甫中《明医指掌》以及《景岳全书》、《金匮钩玄》等医著中，均载此病。但后世论外感之专著，如吴鞠通之《温病条辨》及俞根初之《通俗伤寒论》等书中，反不见了伤风之病名。唯彼书虽不用其名而并不遗其实，仅一囊括于风温中，一改称为小伤寒而已。章太炎深不满于病名之乱改，他说；“夫病之治疗，古今或容有异，若以病状定病名，此不能违古而妄更，”这种见解是很有道理的。叶天士所谓“温邪上受，首先犯肺，”“挟风加薄荷、牛蒡之属"的温病，吴鞠通所说；“太阴风温，但咳，身不甚热，微渴者，辛凉轻剂桑菊饮主之”的风温，实际上即风热感冒，不是仲景书中的温病与风温，所以吴氏说是小病，然这正如章太炎先生所说，是悬牛头，卖马脯。伤风这个病名并没有什么不好，笔者赞同谢诵穆的主张：“症状可复核，病名当统一”，伤寒家不应因伤风由受寒而诱发，便不称其为伤风而竟称其为伤寒，温热家亦不应因伤风辨证属风热型，便不称其为伤风而竟称其为温病。有如对象是鹿，其名约定俗成，本已确定，后人妄更，或称为马，或称为牛，反重新就马，牛之名作争论，宁非笑谈。或谓伤风之辨证属寒者称为小伤寒，伤风之辨证属热者称为小风温，其定名从辨证而有据，较笼统称为伤风更入细。其实凡病辨证，莫不有寒热之分，若因此而将一病名分为二名，实竟反因证而忘病。清后医家，或称伤风为伤寒，或称伤风为风温，仅因辨证有寒热之不同，遂使一病变生数名，致反生寒、温之纷争，此则徒乱后人之耳目，故不足以为训。从上述可知，杜撰温邪，是混淆病名之基，而混淆病名，又成寒热争执之因，故欲息二派之争，宜辟温邪说之谬，并即从正名始。
下再举一近人医案析议之，以作为本文之结尾。
“杨XX，女，28岁，入院前四天，气温骤降，患者洗澡当风受凉，次日出现恶寒重，发热轻，流清涕，头痛，无汗，口不渴等，体温38℃，经用复方氨基比林，201注射剂治疗，体温不降。入院前一天恶寒虽减轻，而发热加重，体温达40℃。入院时患者感发热重，微恶风寒，口渴，流浊涕，咽微痛，小便微黄，大便正常，无恶心呕吐及咳嗽，查体：呈急性热病容，咽部轻度充血，舌红苔薄黄，脉浮数。诊断为感冒后期，风寒化热。治当辛凉解表，故以银翘散治之。三天后，体温下降至正常，诸证消失。”②
按：此病在受凉后而发，初起诱因未解，体温调节障碍，故出现寒重热轻，流清涕，口不渴等症状，此时若由伤寒家诊，必诊为伤寒，必谓病因为寒邪。然谓病因为寒邪，实是以诱因为病因。尔后诱因渐解，机体应激亢进，故出现热重寒轻，流浊涕，口渴等症状，此时若由温热家诊，必诊为温病，必谓病因为温邪，盖审证测因，从证溯因，断为温邪致病，这在温热家来说，是极其自然的。如有人以初起曾受凉以诘之，崇信《时病论》之说者，亦可用雷氏谓风温、春温均由感寒诱发来解释。即此一例，已可见寒邪、温邪之说，纯属主观之推论。恽铁樵说：“今有一病于此，甲医曰是伤寒也，乙医曰是温病也，病家茫然不知所从，取决于余，余曰伤寒有五，是温病乃五种伤寒之一，二说皆是，病家益无所适从，则延西医。”在病因病名问题上，伤寒家与温热家，如各存门户之见，于同一对象，彼此凭主观臆测作争论，就恐怕难以征信于病人，恽氏所说的那种情况，是宜当引起我们注意的。而上一病例，若采吴又可、祝味菊诸家之说解释之，则其病名为伤风，其病因为戾气，其诱因为受凉，其病机为初起体温调节障碍，尔后应激机能亢进，……若是之议，始为医理之正。医者若能跳出寒、温二派之圈子，信必以余言为不诬1
参考文献
①转引自《本草害利》，中国古籍出版社，1982
②谢薇西，寒邪在表亦可化热，四川中医，(1)：8，1984
从伤寒名实谈到“仲景书略于治温”说“经云凡热病者皆伤寒之类，有清以前，此议勿失。”但到叶吴之后，该派中人，为与仲景学说分庭抗礼，说：“仲景之书专论伤寒，此六气中之一气耳，其中有兼言风者，亦有兼言温者，然所谓风者，寒中之风，所谓温者，寒中之温，以其书本论伤寒也。”(《温病条辨》)该派中人，既于《伤寒论》“专为伤寒而设，未尝遍及于六淫”，而自叔和以下，“大约皆以伤寒之法，疗六气之疴，御风以絺，指鹿为马，殆试而辄困”(同上)，故“怀救世之心”，“抗志以希古人”，而撰《温病条辨》等著作。迄秦之桢作《伤寒大白》，说仲景书“惟有冬月正伤寒治法，而不及春夏秋三时之证，”又谓南方无真伤寒，全是温热。这样一来，《伤寒论》已经过时，是最明白不过的了。
对此，陆九芝，章巨膺等人激烈反对，并认为“正伤寒之名，是大题目。”孔子说；“名不正，言不顺”，所以《世补斋世书》特著“伤寒有五论”三篇，反复驳辩，认为：“仲景伤寒论之寒字，即难经伤寒有五之伤寒字，非二日伤寒之伤寒字也。”陆氏“慨自沿习之久，莫不以伤寒有五之大纲，为专治二日伤寒之一种，一若但见论中有桂枝麻黄，不见论中有膏黄芩连者。”乃反复强调，“伤寒论中方，大半皆治温治热方”，“凡温热之治，即当求诸伤寒之论者无疑矣。”雷少逸也继之而写了一篇“伤寒书统治六气论"，指出：“汉长沙著伤寒论，以治风寒暑湿燥火之邪，非仅为寒邪而设"，“此显明六气统治之书，而今以为专治寒邪，则误甚矣。”陆九芝认为程郊倩谓“伤寒犹宁国嘉兴之有府，伤寒病犹宁国嘉兴之有县，”这样用府属关系作比喻，颇足解颐。陆氏还以五金、公侯等作比喻，他说，“以五金言，一曰金，二曰银，三曰铜，四日铁，五日锡。五金之中，其一日金，伤寒论非五金之统称耶。”因这一问题，道理很容易明白，故吾绍派医家，多不屑琐言之，惟言简意咳，对此说得最为明白，如俞根初在《通俗伤寒论》中，开宗明义就说：“伤寒，外感百病之总名也。”何廉臣则谓伤寒论之寒字，只当得邪字看。所以一部伤寒论，也就是一部外感论，或则说是伤邪论。再从辨治方面来说，“古今之病，不外寒热两途，古今之治，不外温清两法，”伤寒论既是统论六气之书，所以恽铁樵说：“伤寒以《伤寒论》为准，温病亦当以《伤寒论》为准。凡《伤寒论》中祖方，用辛凉不参以温药者，皆是治温病之方。”这话有一定道理，后人诋为复古，有失公允。近人每谓陆、恽等人之抨击叶吴，是复古，叶吴等人之对抗仲景，是革新，实则迄陆氏之世，叶氏学说之统治中医对外感热病之研究，已达百年之久，叶氏已被人捧上亚圣之位，陆氏“处叶吴学说积威之下而作大举之驳击”，正是要求变革的思想所促使。
以上就是清以来关于伤寒的名实之争，这一争议问题，是非曲直，颇为明显。这场争论，实际上也只有一派驳斥，而并没有另一派人出来反驳，所以，无可否认：说《伤寒论》只论狭义伤寒，这是叶吴学说中一个最明显的错误。现在普遍认为伤寒有广狭二义，即叶派中人亦不再否定，说明后一派对伤寒名实的正确论述，已为举世所公认。但近代仍有不少人认为：“《伤寒论》详于治寒，略于治温。”并说：“一部伤寒论，重在救阳，而温热论，重在救阴。”这是名实之争后的余波，是一派败北之后采用新瓶装旧酒的另一时髦说，究其意，无非仍是说《伤寒论》是一部论寒的书罢了，实则这些说法，比起硬说《伤寒论》是一部论狭义伤寒的书来，固已退了步，但是否合符实际，还需加以商讨。如果详与略是作古今比，则后世之运用温法，比《伤寒论》也早有长足之进展，并不是只有运用清法，才已经青出于蓝。后来者居上，是事物发展之必然规律，因何不说《伤寒论》详于治温、略于治寒，而偏说详寒略温呢？如果是单就《伤寒论》说，则清温两法，实在很难说那一法独详，那一法独略。陆九芝认为医之主寒主温，用药往往受大司天之影响，“凡湿寒、寒湿之运，则以能用麻桂姜附为长，风、燥两火之运，则以能用芩连膏黄为长。”“仲景所值气运为风为火”，“所以仲景特用东方苍龙，西方白虎，北方元武，而独不用南方之朱雀也。"因为仲景之世，时医习用乌附辛热，为治多误，“故仲景以桂枝麻黄之温，治中风伤寒之病，即以葛根芩连白虎柏皮栀豉之清，治温热湿温之病。凡遇温热即用寒凉。其谓仲景但知秋冬，不识春夏者，(固)不足与论仲景，”即谓仲景“详于治寒，略于治温"者，恐亦未真知仲景者。试观仲景之治太阳病，麻黄配桂枝，固用于治寒，麻黄配石膏，即用于治热，麻杏石甘汤、麻黄连翘赤小豆汤、桃，核承气汤等全是治温之方。治少阳病之二柴胡汤，以性寒之柴胡、黄芩为主药，是清温合用，也看不出独重治寒，勿略治温之迹象。治太阴病之有加芍药、大黄者，治少阴病之有黄连阿胶汤及治厥阴病之用白头翁汤等，俱属有目共睹，对阳明病独重治温，尤其不在话下。伤寒论中之黄芩汤、陷胸汤，茵陈蒿汤、栀子豉汤以及白虎、承气，竹叶石膏等，都是后世治温病之常用方，所以，单就《伤寒论》说，实在很难找出重寒略温之证据。若倘谓是说于我们重视后世治温之经验发掘有利，则于我们重视仲景治温大法之发掘不利。故但明此论之所从出，即可知此说之原无稽。无稽之说，其可少息乎！
伤寒正名辨
When the Qi of the five phases (Wu Qi, Five Phases) becomes abnormal, it is traditionally called the Six Excesses (Liu Yin). The Six Excesses refer to Cold, Summerheat, Dryness, Dampness, Wind, and Fire. Within the theory of the Six Excesses, there was originally no concept of "Warmth Pathogen" (Wen Xie). However, since Ye Tianshi advocated the view that "Warmth Pathogen enters from above," the concept of "Warmth Pathogen" became widely popular. In this way, the Six Excesses effectively became the Seven Excesses. If one argues that Warmth Pathogen was never outside the Six Excesses, but rather included Summerheat Pathogen and Fire Pathogen, then with Summerheat, Fire, Warmth, and Heat pathogens, the nomenclature becomes increasingly numerous, concepts more confused, connotations overlapping, and definitions blurred. The Six Excesses originally corresponded only to the Five Qi; referring to them as "Six" was already logically flawed (apart from burns, Fire cannot be an etiology for exogenous diseases; the ancients had long suspected this. Lu Jiuzhi's response to Yuan Sheng was circuitous and forced, causing even Zhang Juying, a devoted follower of his learning, to feel dissatisfied. A special article discussing this appeared in the 4th issue of *Journal of Shandong College of Traditional Chinese Medicine* in 1981, so further elaboration is omitted). Adding "Warmth Pathogen" now offers no benefit to Traditional Chinese Medicine (TCM) etiology. The human body naturally adapts to normal climatic changes. Unless conditions are excessively hot, cold, damp, or dry, they generally do not interfere with the body's regulatory and disease-resisting capabilities, thereby creating favorable conditions for pathogenic factors (Li Qi) to cause disease. Warm climate is most suitable for the human body and cannot stimulate or interfere with normal physiological activities like Cold, Summerheat, Dryness, Dampness, or Wind, nor can it cause disease. Therefore, calling "Warmth" a pathogen, stating "Wind received in spring carries warm Qi," "Warmth Pathogen enters from above," or "Warmth Pathogen combined with Wind," is actually more absurd than treating inducing factors like Wind-Cold as the primary etiology. What the Warmth School calls Warm Diseases caused by Warmth Pathogen are essentially manifestations of the body's hyperactive stress response against Li Qi. Thus, even what is called "Minor Wind-Warmth" is not truly caused by Warmth Pathogen or Warmth Pathogen combined with Wind, but rather by Wind carrying Li Qi, which is inhaled into the mouth and nose, invading the Lung to cause disease. After illness onset, due to the body's hyperactive response, syndrome differentiation belongs to Heat, leading to the judgment of "Minor Wind-Warmth"; if the body's response is neither urgent nor hyperactive after onset, and syndrome differentiation belongs to Cold, it can be judged as "Minor Cold Damage." Lei Shaoyi, noting that cold-like illnesses are mostly induced by exposure to wind, catching cold, or fatigue, believed that Wind-Warmth and Spring-Warmth were also caused by catching Cold Pathogen. But as Zhu Weiju stated: "Ye regarded Warmth diseases as having actual Warmth-Heat pathogens, believing that for such pathogens, the treatment method should employ Cold-Cooling herbs." Thus, "although his prescriptions have methods of sequence and urgency, he favors using Cooling agents, and the principle remains the same. Because he subjectively believed Warmth Pathogens require Cool treatment, he said 'Even in individuals from Wu region with weak Yang, Cooling agents should be applied,' knowing fully well that overusing Cold on weak Yang leads to death, he added 'Cooling should stop at six or seven parts; do not use excessive Cold, lest success be abandoned.' Due to incorrect naming, his words lack coherence." Zhu considered this the least acceptable part of Ye's theory, urgently needing correction. Unfortunately, this book did not circulate widely, and its views were not paid much attention to.
From a clinical perspective, because the Warmth School viewed the heat-transforming symptoms of hyperactive stress response in exogenous diseases as caused by the pathogen's nature being Warm, rather than seeing them as the body's reaction to the interaction between Li Qi and pre-existing internal Heat, they regarded Ephedrae Herba (Mahuang, 麻黄) and Cinnamon Twig (Guizhi, 桂枝) as venomous snakes and scorpions (believing Warmth Pathogen transforms into Heat fastest, and using these violates the taboo of treating Warmth with Warmth). They feared Bupleuri Radix (Chaihu, 柴胡) and Puerariae Radix (Gegen, 葛根) as tigers (believing Warmth Pathogen easily injins Yin fluids, and using these violates the taboo of depleting Yin fluids). This self-imposed restriction narrowed their therapeutic approach, leading them down the path of light, clear, and bland remedies. In reality, Mahuang, Guizhi, Chaihu, and Gegen are essential drugs for resolving the exterior in exogenous diseases. Although their warming and ascending properties are unsuitable for hyperactive stress responses and Yin-deficient constitutions, when combined in formulas, they mutually constrain each other. If the treatment principle is correct and compatibility is proper, their strengths can be utilized while weaknesses mitigated (e.g., Mahuang Xingren Shigao Gancao Tang uses Mahuang paired with Shigao; Yi Chaihu Yin uses Chaihu paired with Shengdi, both applicable for treating Heat diseases and exogenous diseases in Yin-deficient individuals). Their power to vent depressed Heat and scatter external pathogens far surpasses that of Mulbai Folium (Sangye, 桑叶), Menthae Haplocalycis Herba (Bohe, 薄荷), Fermented Soybean (Douchi, 豆豉), and Sojae Preparata (Doujuan, 豆卷). It must be understood that for Cold patterns, Mahuang is paired with Guizhi; for Heat patterns, Mahuang is paired with Shigao. These are established effective methods of predecessors. For treating exogenous invasion with Yin deficiency, breaking free from rigid meridian restrictions, Chaihu is paired with Shengdi; for treating hyperactive stress response, Chaihu is paired with Zhimu and Shigao (as in Yi Chaihu Yin), or Qianghuo is combined with Gongying (as in Qiangbang Pubo Tang). These represent innovative flexible methods developed by later generations. However, those constrained by the theory of Warmth Pathogen often dare not lightly use Mahuang, Guizhi, Chaihu, or Gegen, resorting to alarmist statements such as "Using one dose less of Chaihu saves one life," or "Abandoning their use is also a way to preserve life."① If they fear Xin-Liang (Acrid-Cool) exterior-resolving drugs to this extent, how much more so would they fear Xin-Wen (Acrid-Warm) substances! On the other hand, they often transplant the herbal methods of Minor Wind-Warmth treatments, such as Sangju Yin and Yinqiao San, as the standard protocol for all initial stages of Warm Diseases. This is why Lu Jiuzhi made the passionate remark: "The syndrome of Cold Damage was lost after Ye Tianshi; the syndrome of Warm Disease was also lost after Ye Tianshi."
III. Regarding Disease Names
Shangfeng (Wind Injury/Cold) is an inherent disease name in TCM. It is recorded in medical works such as Chen Yan's *San Yin Ji Yi Bing Zheng Fang Lun* (Song Dynasty), Huangfu Zhong's *Ming Yi Zhi Zhang* (Ming Dynasty), as well as *Jing Yue Quan Shu* and *Jin Gui Gou Xuan*. However, in later specialized books on exogenous diseases, such as Wu Juztong's *Wen Bing Tiao Bian* and Yu Genchu's *Tong Su Shang Han Lun*, the disease name Shangfeng disappears. Although these books do not use the name, they do not omit the substance, merely encompassing it within Fengwen (Wind-Warmth) and renaming it Xiaoshanghan (Minor Cold Damage). Zhang Taiyan was deeply dissatisfied with the arbitrary alteration of disease names, stating: "Treatment methods for diseases may differ between ancient and modern times, but if disease names are determined based on symptom presentation, one cannot violate ancient standards and arbitrarily change them." This viewpoint is very reasonable. The Warm Disease described by Ye Tianshi as "Warmth Pathogen enters from above, first invading the Lung," and "combined with Wind, add Bohe and Niubangzi," and the Fengwen described by Wu Juztong as "Taiyin Fengwen, characterized by cough alone, slight fever, and mild thirst, treated with the light Acrid-Cool agent Sangju Yin," are actually Wind-Heat Common Colds, not the Warm Diseases and Fengwen found in Zhang Zhongjing's writings. Therefore, Wu referred to them as minor diseases. Yet, as Mr. Zhang Taiyan said, this is hanging a cow's head but selling horse meat. There is nothing wrong with the disease name Shangfeng. I agree with Xie Songmu's proposition: "Symptoms can be verified; disease names should be unified." The Cold Damage School should not refuse to call it Shangfeng simply because it is induced by catching cold, instead calling it Shanghan; nor should the Warmth School refuse to call it Shangfeng just because syndrome differentiation classifies it as Wind-Heat type, instead calling it Wenbing. It is like an object being a deer; the name is customary and established. If later generations arbitrarily change it, calling it a horse or a cow, and then argue over the names of horses and cows, is it not a joke? Some argue that Shangfeng differentiated as Cold is called Xiaoshanghan, and Shangfeng differentiated as Heat is called Xiaofengwen, so the naming is evidence-based according to syndrome differentiation, making it more detailed than the general term Shangfeng. In fact, all syndrome differentiation involves distinctions between Cold and Heat. Dividing one disease name into two based on this actually causes one to forget the disease itself due to the syndrome. Later Qing dynasty physicians, some calling Shangfeng Shanghan and others Fengwen, merely because of Cold/Heat differences in differentiation, caused one disease to generate multiple names, leading to disputes between Cold and Warm schools. This merely confuses later generations and should not serve as a model. From the above, it is clear that fabricating the concept of Warmth Pathogen is the basis for confusing disease names, and confusing disease names becomes the cause of Cold-Heat disputes. To settle the dispute between the two schools, one must debunk the fallacy of the Warmth Pathogen theory and begin with correcting names.
Below, I present another recent medical case for analysis, serving as the conclusion of this article.
"Yang XX, female, 28 years old. Four days before admission, the temperature dropped sharply. The patient caught a chill while bathing in the wind. The next day, she presented with severe aversion to cold, mild fever, runny clear nasal discharge, headache, absence of sweating, and no thirst. Body temperature was 38°C. Treatment with Compound Aminopyrine Injection failed to lower the temperature. One day before admission, although aversion to cold decreased, fever intensified, reaching 40°C. Upon admission, the patient felt severe fever, slight aversion to wind and cold, thirst, turbid nasal discharge, slight sore throat, slightly yellow urine, normal bowel movements, no nausea/vomiting, and no cough. Physical examination showed an acute febrile appearance, mild pharyngeal congestion, red tongue with thin yellow coating, and floating-rapid pulse. Diagnosed as late stage of common cold, transforming from Wind-Cold to Heat. Treatment required Acrid-Cool exterior resolution, so Yinqiao San was prescribed. Three days later, body temperature returned to normal, and all symptoms disappeared."②
Commentary: This illness occurred after exposure to cold. Initially, the inducing factor was unresolved, causing thermoregulatory dysfunction, resulting in symptoms like severe cold/mild fever, clear nasal discharge, and no thirst. At this stage, a physician from the Cold Damage School would diagnose Shanghan and attribute the etiology to Cold Pathogen. However, attributing the etiology to Cold Pathogen is essentially mistaking the inducing factor for the etiology. Subsequently, as the inducing factor gradually resolved, the body's stress response became hyperactive, leading to symptoms like severe fever/mild cold, turbid nasal discharge, and thirst. At this stage, a physician from the Warmth School would diagnose Wenbing and attribute the etiology to Warmth Pathogen, naturally inferring Warmth Pathogen etiology from syndrome differentiation. If questioned about the initial cold exposure, proponents of *Shi Bing Lun* could explain it using Lei's theory that Wind-Warmth and Spring-Warmth are induced by catching cold. This single case reveals that the theories of Cold Pathogen and Warmth Pathogen are purely subjective deductions. Yun Tieqiao stated: "If there is a disease here, Doctor A says it is Shanghan, Doctor B says it is Wenbing, and the patient is confused and asks me. I say Shanghan has five types, and Wenbing is one of the five types of Shanghan. Both statements are correct, leaving the patient even more lost, so they go to a Western doctor." On issues of etiology and disease names, if the Cold Damage and Warmth Schools maintain sectarian views and argue subjectively about the same object, it is difficult to gain patient trust. The situation described by Yun should attract our attention. If the previous case were explained using the theories of Wu Youke, Zhu Weiju, and others, the disease name would be Shangfeng, the etiology Li Qi, the inducing factor cold exposure, and the pathogenesis initial thermoregulatory dysfunction followed by hyperactive stress function... Such discussion aligns with correct medical principles. If physicians can step out of the Cold/Warm school circles and believe my words are not false...
References
① Quoted from *Ben Cao Hai Li*, China Ancient Books Publishing House, 1982.
② Xie Weixi, Cold Pathogen on the Exterior Can Also Transform into Heat, *Sichuan Journal of TCM*, (1): 8, 1984.
Discussing the Name and Reality of Shanghan and the Claim that "Zhongjing's Book Neglects Treating Warmth": "The Classic states: All Heat diseases belong to the category of Shanghan. Before the Qing Dynasty, this argument should not be lost." However, after Ye and Wu, members of that school, seeking to rival Zhongjing's theory, claimed: "Zhongjing's book specifically discusses Shanghan, which is just one of the Six Qi. It occasionally mentions Wind and Warmth, but the Wind mentioned is Wind within Cold, and the Warmth mentioned is Warmth within Cold, because the book primarily discusses Shanghan." (*Wen Bing Tiao Bian*). Since these members believed *Shang Han Lun* was "specifically designed for Shanghan and did not cover the Six Excesses," and that since He Huanzhong (Shuhe) onwards, "roughly everyone used Shanghan methods to treat diseases of the Six Qi, defending against Wind with [incorrect] strategies, pointing at a deer and calling it a horse, failing whenever tested" (ibid.), they "harbored a heart to save the world" and "aspired to emulate the ancients," thus writing *Wen Bing Tiao Bian* and other works. When Qin Zhizhen wrote *Shang Han Da Bai*, he claimed Zhongjing's book "only contains treatment methods for true Shanghan in winter months, neglecting spring, summer, and autumn syndromes," and asserted there is no true Shanghan in the South, only Warmth diseases. Thus, it became obvious that *Shang Han Lun* was outdated.
Lu Jiuzhi and Zhang Juying strongly opposed this, considering "correcting the name of Shanghan" a major issue. Confucius said: "If names are not correct, language is not in accordance with truth." Therefore, *Shi Bu Zhai Cong Shu* specially published three articles on "Shanghan Has Five Types," repeatedly refuting the claim: "The character 'Han' in Zhongjing's *Shang Han Lun* refers to the 'Shanghan' in *Nan Jing*'s 'Shanghan Has Five Types,' not the specific 'Shanghan' of two days' duration." Lu lamented that due to long-standing habit, "everyone took the general principle of 'Shanghan Has Five Types' as a specific treatment for two-day Shanghan, as if seeing only Guizhi and Mahuang in the text, but not Shigao, Huangqin, Huanglian." He repeatedly emphasized, "Most formulas in *Shang Han Lun* are for treating Warmth and Heat," and "Undoubtedly, treatments for Warmth and Heat should be sought in the discussions of Shanghan." Lei Shaoyei followed with an article "Shanghan Treatise Governs the Six Qi," pointing out: "Zhangsha [Zhang Zhongjing] of the Han Dynasty wrote *Shang Han Lun* to treat pathogens of Wind, Cold, Summerheat, Dampness, Dryness, and Fire, not just for Cold Pathogen," "This is clearly a book governing the Six Qi, yet now it is thought to be exclusively for Cold Pathogen, which is a great error." Lu Jiuzhi found Cheng Jiaoqian's metaphor "Shanghan is like the Prefecture of Ningguo/Jiaxing, Shanghan Disease is like the County of Ningguo/Jiaxing" amusing. Lu also used metaphors of the Five Metals and Nobles, saying, "Regarding the Five Metals: Gold, Silver, Copper, Iron, Tin. Among the Five Metals, Gold is first. Is *Shang Han Lun* not the collective term for the Five Metals?" Since the logic is easy to understand, many physicians of the Shao School disdain trivial explanations, preferring concise clarity. Yu Genchu, in *Tong Su Shang Han Lun*, explicitly states: "Shanghan is the general name for all hundred diseases of exogenous origin." He Lianchen stated that the character 'Han' in *Shang Han Lun* should be read as 'Pathogen'. Thus, *Shang Han Lun* is essentially a treatise on exogenous diseases, or a treatise on injury by pathogens. From the perspective of differentiation and treatment: "Ancient and modern diseases do not exceed Cold and Heat pathways; ancient and modern treatments do not exceed Warming and Clearing methods." Since *Shang Han Lun* governs the Six Qi, Yun Tieqiao said: "Shanghan takes *Shang Han Lun* as the standard; Wenbing should also take *Shang Han Lun* as the standard. Any ancestral formula in *Shang Han Lun* using Acrid-Cool without mixing in Warm herbs is a formula for treating Wenbing." This statement has merit; later critics calling it retrogression are unfair. Recent people often claim Lu and Yun's attack on Ye and Wu is retrogression, while Ye and Wu's confrontation with Zhongjing is innovation. In reality, by Lu's time, Ye's theory had dominated TCM research on exogenous febrile diseases for nearly a century, and Ye had been elevated to a quasi-sage status. Lu's "major rebuttal under the accumulated prestige of Ye and Wu's theory" was driven by the desire for reform.
The above summarizes the debate on the name and reality of Shanghan since the Qing Dynasty. The rightness and wrongness of this controversy are quite clear. This debate essentially involved one side refuting, without the other side responding. Therefore, it is undeniable that claiming "*Shang Han Lun* only discusses narrow-sense Shanghan" is a glaring error in Ye and Wu's theory. It is now generally accepted that Shanghan has broad and narrow meanings, and even members of the Ye school no longer deny this, indicating that the latter school's correct exposition on Shanghan's name and reality is universally recognized. However, many modern scholars still believe: "*Shang Han Lun* details treating Cold but neglects treating Warmth," and say: "One volume of *Shang Han Lun* focuses on saving Yang, while *Wen Bing Lun* focuses on saving Yin." This is a remnant wave after the name-reality debate, a fashionable new bottle for old wine adopted by the defeated faction. Its essence is still saying *Shang Han Lun* is a book about Cold. While these claims retreat from the hard assertion that it is solely about narrow-sense Shanghan, whether they fit reality requires discussion. If 'detail' and 'neglect' are compared historically, later generations' application of Warming methods has progressed significantly compared to *Shang Han Lun*; it is not only Clearing methods that have surpassed the original. Latercomers surpassing predecessors is an inevitable law of development. Why not say *Shang Han Lun* details treating Warmth and neglects treating Cold, rather than detailing Cold and neglecting Warmth? If speaking solely of *Shang Han Lun*, it is hard to say whether Clearing or Warming methods are uniquely detailed or neglected. Lu Jiuzhi believed physicians' preference for Cold or Warm treatments is often influenced by the Great Si Tian (Cosmic Climate): "In cycles of Damp-Cold or Cold-Damp, proficiency in using Mahuang, Guizhi, Jiang, and Fu is advantageous; in cycles of Wind, Dryness, and Dual Fire, proficiency in using Huangqin, Huanglian, Shigao, and Huangbo is advantageous." "Zhongjing experienced Wind and Fire qi cycles," "Therefore, Zhongjing specifically used Azure Dragon of the East, White Tiger of the West, Black Tortoise of the North, but did not use Vermilion Bird of the South." Because in Zhongjing's era, contemporary doctors habitually used Wutou and Aconite (Wu Fu) and Acrid-Warm substances, leading to many errors in treatment, "thus Zhongjing used the warmth of Guizhi and Mahuang to treat Wind Strike and Shanghan, and used the cooling of Gegen, Huangqin, Huanglian, Baihu, Baipi, Zhizi, and Douchi to treat Warmth and Damp-Warmth. Whenever encountering Warmth, he used Cold-Cooling. Those who claim Zhongjing only knew Autumn/Winter and did not know Spring/Summer are certainly unworthy of discussing Zhongjing," and those who claim Zhongjing "detailed treating Cold and neglected treating Warmth" likely do not truly know Zhongjing. Observe Zhongjing's treatment of Taiyang Disease: Mahuang paired with Guizhi is indeed for Cold, but Mahuang paired with Shigao is for Heat. Mahuang Xingren Shigao Gancao Tang, Mahuang Lianqiao Chixiaodou Tang, Taohe Chengqi Tang, etc., are all formulas for treating Warmth. Er Chaihu Tang for Shaoyang Disease uses Chaihu and Huangqin (Cold-natured) as main herbs, combining Clearing and Warming, showing no sign of exclusively valuing Cold treatment while neglecting Warmth. Taoyin Disease treatments adding Shaoyao and Dahuang, Shaoyin Disease treatments including Huanglian Ejiao Tang, and Jueyin Disease treatments using Baitouweng Tang are all evident. Valuing Warmth treatment exclusively for Yangming Disease is beyond doubt. Huangqin Tang, Xianxiong Tang, Yinchen Hao Tang, Zhizi Chi Tang, Baihu Tang, Chengqi Tang, and Zhuye Shigao Tang in *Shang Han Lun* are all commonly used formulas for treating Warm Diseases in later generations. Therefore, speaking solely of *Shang Han Lun*, it is difficult to find evidence of valuing Cold and neglecting Warmth. If one argues this helps us value later experiences in treating Warmth, it hinders our excavation of Zhongjing's great methods for treating Warmth. Thus, understanding the origin of this theory reveals its baselessness. Can such baseless talk cease!
Correcting the Name of Shanghan