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If there were sound theoretical principles and authentic clinical experience, it would be perfectly acceptable to establish a new school of thought distinct from what the ancients said. However, the new theory must be able to corroborate with the ancient theories. If it contradicts what the ancients said, one must first demonstrate that the ancients' theories were incomplete and prove their errors. Those who superficially revere the ancients but internally oppose them, using this to deceive the world and accumulate wealth, are indeed numerous and not worth severe blame; however, if they write books to pass down to posterity, their crimes are unforgivable.

Now, in the *Shangjiao Pian* (Upper Jiao Chapter) of *Wenbing Tiaobian* (Systematic Differentiation of Warm Diseases), it states: "All warm diseases begin in the Shangjiao (Upper Jiao), involving the Hand-Taiyin Lung Meridian." Wu Jutong himself provided a commentary: "Historically, it has only been said that the Bladder governs the exterior, which likely does not fully elucidate the meaning. The Lung is the interior counterpart of the skin and hair; does it not govern the exterior? ... Warm diseases enter through the mouth and nose, moving from top to bottom. The nose connects to the Lung, so it begins in the Hand-Taiyin." This statement is profoundly misguided. I believe that when the ancients discussed Zang-Fu organs and Jing-Qi (Meridian Qi), they made a distinction. Zang-Fu organs are physical entities, whereas Jing-Qi refers to physiological functional activities. When the Six Evils invade the human body causing disease, the discussion pertains to functional activities rather than physical entities. The *Neijing* (Inner Canon) states: "When pathogenic wind arrives, it is swift as wind and rain (the term 'pathogenic wind' here applies regardless of whether it comes from the northwest or southeast). Therefore, skilled physicians treat at the level of the skin and hair; next, at the level of the muscle tissue; next, at the level of sinews and vessels; next, at the level of the Fu organs; and finally, at the level of the Zang organs. Treating diseases of the Zang organs results in half dying and half surviving. Thus, pathogenic qi from Heaven harms the Zang organs; cold and heat from food and water harm the Fu organs; and dampness from Earth harms the skin, flesh, sinews, and vessels." This passage is intimately connected with the preceding sections on Yin-Yang and the directions East, South, West, and North. It refers to "the changes of alternating superiority of Yin and Yang, which constitute the manifestations of disease." Saying "treat the skin and hair" means the disease is located in the skin and hair, not referring to the Lung's correspondence, but to the outermost layer of the body. "Next, the muscle tissue" indicates slight progression, not referring to the Spleen's correspondence. "Next, the sinews and vessels" indicates deeper progression, not referring to the Liver's correspondence. "Next, the Fu organs" indicates entering the interior. "Finally, the Zang organs" indicates the deepest level of the interior. If one were to consider the skin and hair as the Lung's correspondence, the muscle tissue as the Spleen's correspondence, and the sinews and vessels as the Liver's correspondence, then whose correspondence would the Fu organs be? This is untenable. Furthermore, if one considers the skin and hair as the Lung's correspondence, it implies that when pathogenic wind harms humans, it first affects the Lung, then transmits to the Spleen, then to the Liver, and finally to the Fu organs. Verifying actual clinical practice, neither Cold Damage nor Warm Diseases follow this pattern, making this argument even more untenable. Therefore, commentators on the *Shanghan Lun* (Treatise on Cold Damage) who immediately equate the Taiyang channel with the Bladder, I absolutely cannot agree with. In my lectures, when explaining Taiyang Disease, I directly state that Taiyang refers to the outermost layer of the body. Today, those who claim all warm diseases begin in the Shangjiao and involve the Hand-Taiyin—what is this saying?

Secondly, the inexplicable notion is that Cold Damage enters through the pores, while Warm Diseases enter through the mouth and nose. Wu Jutong likely considered the theory that Warm Diseases enter through the mouth and nose to be his most brilliant insight, unaware that this theory is absolutely untenable. Let us scrutinize it layer by layer:
(1) The *Neijing* states that all febrile diseases belong to the category of Cold Damage, and all pathogenic winds harming humans begin at the skin and hair. Now, saying they enter through the mouth and nose, emerging from the interior to the exterior, implies that Warm Diseases fall outside the scope of the *Neijing*'s phrase "all febrile diseases."
(2) Since it says they enter through the mouth and nose, and the nose connects to the Lung, thus involving the Hand-Taiyin; then the mouth connects to the Spleen, so why not involve the Foot-Taiyin?
(3) The classic states that pathogenic qi from Heaven harms the Zang organs. Here, treating the skin and hair implies the potential to harm the Zang organs, which is the manifestation of the disease. It states that cold and heat from food and water harm the Fu organs; this truly refers to entry via the mouth. Experimental verification confirms this: drinking ice water causes diarrhea; contact with filth causes cholera; airborne microbial transmission causes various epidemics. These truly enter via the mouth and nose. If one claims that pathogenic qi from Heaven also enters via the mouth and nose, there is no evidence for this in the *Neijing*.
(4) Wu Jutong stated that the Wind Strike mentioned in Cold Damage refers to the cold wind of the Northwest. His concept of Warm Diseases involves wind as the mother of fire, coming from the Southeast as a warming wind that thaws ice. Cold wind enters through the pores; warm wind enters through the mouth and nose. From what classic does this come, and what is the rationale? It is truly astonishing. Merely examining the first article of *Wenbing Tiaobian*, its untenability is already evident as described above. Yet, those who align themselves with Wu Jutong mark the text heavily with circles and dots, praising it endlessly. Do they think the people of the world and future generations can all be deceived? Is this not overly cautious? (*Wenbing Mingli*)

Chai Daibo notes: 1. The above is the full text of Volume 2 of *Wenbing Mingli*, with the title added by the author. This article discusses the original meaning of the Sanjiao (Triple Burner) in Traditional Chinese Medicine (TCM) quite clearly. Yun Tieqiao's purpose was to first clarify the original meaning of the TCM Sanjiao, and then to prove that Wu Jutong's Sanjiao theory was fabricated. Wu Jutong believed that Warm Diseases move from top to bottom, while Cold Damage moves from exterior to interior. Zhang Juying criticized this as "delirious nonsense." Who is right and who is wrong is worthy of discussion. The Ye School (followers of Ye Tianshi) does not deny that Warm Diseases include both latent-onset and acute-onset types. Latent-onset Warm Diseases do not necessarily start from the top, which is quite clear. Does acute-onset Warm Disease always first affect the Lung? Taking damp-warmth affecting the Foot-Taiyin and Foot-Yangming meridians first as an example suffices to disprove this. Based on this, Yun's criticism of Wu Jutong's Sanjiao theory, stating that the very first article is untenable, is reasonable.

2. In ancient TCM, the physiology and pathology of the brain were attributed to the Heart. After Wang Qingren proposed that mental functions reside in the brain rather than the heart, later physicians regarded this as a major contribution to TCM. Yun stated: "Delirious speech being a disease of the Pericardium is merely an assumption without practical basis. Attributing it to brain confusion is debatable." This aligns with Wang Qingren's viewpoint. The Ye School often attributes delirious speech in febrile diseases to "reverse transmission to the Pericardium." From a modern perspective, this pathological explanation seems less reasonable than Yun's. Additionally, regarding the *Yingwei Shenghui Pian* (Chapter on the Meeting of Ying and Wei Qi), the original text reads "penetrates the diaphragm," but Yun mistakenly read it as "penetrates the intestines."

Pathology and Nomenclature of Warm-Heat Diseases. The subcategories of Warm-Heat Diseases found in *Wenbing Tiaobian* include nine types: Fengwen (Wind-Warmth), Wenre (Warm-Heat), Wenyi (Warm Epidemic), Wendu (Warm-Toxicity), Shuwen (Summerheat-Warmth), Shiwen (Damp-Warmth), Qiuzao (Autumn-Dryness), Dongwen (Winter-Warmth), and Wenmie (Warm-Malaria). The self-commentary states: Fengwen occurs in early spring when Yang Qi begins to open, governed by Jueyin, where wind carries warmth. Wenre occurs in late spring and early summer when Yang Qi expands, and warmth intensifies into heat. Wenyi involves epidemic pestilential qi, often mixed with turbidity, affecting households uniformly like forced labor. Wendu involves various warmth pathogens carrying toxicity, with excessive turbidity. Shuwen occurs in midsummer, representing the heat aspect of summerheat. Shiwen occurs in late summer and early autumn, where dampness generates heat, representing the damp aspect of summerheat. Qiuzao refers to the dry and fierce qi of Autumn Metal. Dongwen occurs when winter should be cold but is instead warm, Yang fails to store, and people contract warmth. Wenmie occurs when Yin Qi is first damaged, followed by summerheat, causing Yang Qi to flare alone. The aforementioned explanations seem understandable but are actually not. Distinguishing Fengwen and Wenre by early versus late spring, and by the opening versus expansion of Yang Qi, leaves unclear at what degree of expansion it becomes Wenre, and whether illnesses occurring in mid-spring are Fengwen or Wenre. Despite the explanation, they remain indistinguishable. Regarding "mixed with turbidity" and "excessive turbidity," both involve turbidity; why is one called Wenyi if epidemic, and Wendu if not? The phrase "heat aspect of summerheat" is poorly phrased. How does the dry qi of Autumn Metal relate to febrile diseases? Self-categorization and self-differentiation fail to clarify anything. Without investigating the principles of disease or detailing symptoms, one cannot speak precisely, resorting instead to literal interpretations and vague discussions.

This book discusses Warm Diseases, as listed in the previous chapter, including only six types: Wenre, Chunwen (Spring-Warmth), Shuwen, Shiwen, Shangshu (Summerheat Injury), and Shire (Damp-Heat). There are no other names such as Dongwen, Qiuzao, or Wenmie. Why the discrepancy with common usage? This is because they are summarized based on disease principles and symptoms, avoiding superfluous categories that confuse people. One should now deduce pathology from disease patterns and summarize disease names from pathology.

Predecessors argued that Cold Damage moves from exterior to interior, while Warm Diseases move from interior to exterior. Lu Jiuziya held this view, which is untenable. Both Cold Damage and Warm Diseases are external contractions. Zhongjing stated that fever with thirst and aversion to cold absent characterizes Warm Disease, prefacing the clause with "Taiyang Disease," revealing its meaning. So how to distinguish them? The difference lies only in aversion to cold versus absence thereof, and presence versus absence of sweating. Any illness presenting with fever, aversion to cold, and no sweating is Cold Damage, regardless of season. Fever without aversion to cold, or with very short duration of aversion, and with sweating, is Warm Disease. In Spring, it is called Chunwen; in Summer, Shuwen; in Late Summer, Shiwen. This so-called Warm Disease is still Cold Damage, a disease contracted due to Cold injury, as detailed below.

In winter, external air is cold. To survive in cold air, subcutaneous blood vessels and skin contract, pores close tightly, and Defensive Qi becomes dense. Body heat concentrates in the outer layer to resist external cold. When injured by Cold, the Cold Pathogen cannot penetrate deeply and remains at the outer layer, causing shivering and aversion to cold. According to the second cause of fever, whole-body heat rushes to the surface to expel the pathogen. When body temperature exceeds the appropriate amount, fever ensues. Logically, high internal heat should be dissipated through sweating. However, because Cold Pathogen is at the exterior and pores are closed, resistance increases, preventing release. Thus, high fever, aversion to cold, and no sweating occur. This is the principle of the Taiyang Syndrome of Cold Damage. If Cold Pathogen remains at the exterior unresolved, it transforms into dryness and transmits inward. Once the Cold Pathogen penetrates the superficial layer, aversion to cold ceases and aversion to heat begins. With the first line of defense broken, the focus shifts from exterior to interior. The body initiates regulatory mechanisms to dissipate heat, pores open, and spontaneous sweating occurs. Due to fluid loss from sweating, thirst arises. This is the principle of the Yangming Syndrome of Cold Damage.

If external air is mild, similar to body temperature, the opening and closing of pores is less critical. Injury by Cold allows the Cold Pathogen to penetrate deeply. Heat concentrates at the surface for resistance, causing fever. Pores tend to be open; due to high heat, spontaneous sweating occurs. Although Cold Pathogen affects the outer layer, typically causing chills, the weak resistance of the outer layer means the Cold Pathogen stays at the exterior for a very short time, resulting in brief aversion to cold. Moving past the exterior, the focus shifts to the interior. This is the principle of Warm Disease.

The Yangming Syndrome of Cold Damage and Warm Disease follow the same pathway. In one case, Cold Pathogen passes through Taiyang, lingers there for several days, then transforms into dryness and transmits inward to Yangming. In the other, Cold Pathogen passes through Taiyang and directly enters Yangming. Thus, Warm Disease begins in Yangming.

Why does Cold injuring the superficial layer linger in Taiyang in one case and go directly to Yangming in another? This is due to differences in seasons and Six Qi. Winter injury by Cold causes shivering, aversion to cold, fever, and no sweating, as explained above. Spring is associated with Wind, which is mild. Skin and pores are not as tight as in winter. When Cold invades, it combines with Wind transformation and goes directly to Yangming, causing fever and sweating, known as Chunwen. If spring weather remains freezing, failing to warm up as expected, skin and pores remain tight, retaining the ability to resist cold air. Then Cold injures the body, repelled at the exterior, causing aversion to cold, fever, and no sweating; this remains Cold Damage. If winter weather is mild, warming before the season ends, body temperature and external air temperature are similar. Defense against cold is less important. Cold invades and goes directly to Yangming, becoming Warm Disease with fever and sweating. Pathologically, this is conflated with Chunwen, so there is no need to establish a separate name for Dongwen.

In summer, external air is hot, higher than body temperature. Skin and pores do not need to resist but require discharge. Thus, in summer heat, sweating discharges heat to regulate body temperature. The defenses are lowered, and borders are vulnerable. Injury by Cold causes fever and sweating. With no surface resistance, slight aversion to cold quickly turns to fever. This is Shuwen. In Late Summer, climate includes Dampness transformation. Injury by Cold resulting in heat is called Shiwen, with pathology identical to Shuwen.

Readers must understand that the opening and closing of skin and pores regulates body temperature, and this function is highly sensitive. In severe winter cold, although pores are closed, intense labor or running raises body temperature, causing pores to open and sweat to discharge heat. Conversely, in summer heat, although pores are open, excessive exposure to coolness causes pores to close to reject cold. Understanding this principle, it is not surprising that Chunwen occurs in winter, nor exceptional that Cold Damage occurs in summer. Therefore, fever, no sweating, and aversion to cold in summer are treated similarly to Winter Cold Damage. Fever, sweating, and no aversion to cold in winter are treated similarly to Spring Chunwen.

Thus, aversion to cold vs. none, and sweating vs. none, are the key distinctions between Cold Damage and Warm Disease. Fever arises from the first and second principles. Damp-Heat and Summerheat Injury correspond to Dampness and Heatstroke in the *Shanghan Lun*. They are seasonal epidemics in summer. Fever due to Damp Pathogen is commonly confused as Shiwen. Fever arises from the third principle, and the pathology is completely different from the previous ones. Detailed below:

Air contains slightly over 20% oxygen, slightly under 80% nitrogen, and trace carbon dioxide. Oxygen is essential for life. Upon inhalation, external air reaches the alveoli, where oxygen enters the blood via capillaries. Simultaneously, useless carbon dioxide is exhaled. Continuous respiration maintains health. In summer, air is thin, and oxygen proportion is low. Insufficient oxygen intake, combined with heavy sweating due to heat leading to viscous blood and reduced stored oxygen, causes respiratory difficulty and chest tightness/asphyxia. Respiratory inefficiency impairs heat dissipation. In heatstroke, internal heat cannot dissipate externally, resulting in fever, heavy sweating, chest tightness. This is the pathology of Summerheat Injury.

One might ask: Sweating dissipates heat; why is there still fever despite heavy sweating? Why doesn't heat dissipate with sweat? Answer: Summer is governed by Dampness. Air has high moisture content, hindering external heat dissipation. Heavy sweating leads to dry blood and thirst, prompting drinking to自救 (self-rescue). Although much water is drunk, urine output remains low due to heavy sweating. Thus, heat cannot dissipate via sweat nor be excreted via urine. Lung respiration becomes crucial for heat dissipation. Due to insufficient oxygen, breathing becomes difficult, leading to panting. Body heat still cannot dissipate externally. Hence, fever, sweating, panting, fullness, and chest tightness are special symptoms of Summerheat Injury. Typically, only high fever with no sweating causes panting, as seen in Mahuang Tang or Xiao/Big Qinglong Decoction cases. However, in Summerheat Injury, panting occurs despite sweating, for the reasons stated. Based on this pathology, resting in a cool place during heavy summer sweating prevents illness. Hard labor or long-distance walking increases body temperature. External high heat further raises body temperature. Impaired skin evaporation and poor respiration prevent heat dissipation, causing illness. Thus, Warm-Heat pathology can be understood without lengthy explanation. If complicated by Damp Pathogen, the presentation differs slightly. Fever, heavy sweating, and chest tightness are common to both. The difference: Summerheat Injury presents with red, moist tongue and deficient-rapid pulse; Damp-Heat presents with moist tongue, white coating, and soggy-soft pulse. This is the general distinction.

As explained above, Warm-Heat pathology and symptoms are interpreted through physiological functions. Though not exhaustive, the main points are covered. In contrast, the explanations in *Wenbing Tiaobian* are entirely fictitious. In its preface and examples, it claims that although designed for Warm Diseases, it can support Cold Damage. Cold Damage takes Zhongjing as its ancestor, referencing other works. For Warm Diseases, one should study ambiguities in this book, aiming to rival Zhongjing. It also states that the Six Channels of *Shanghan Lun* move from exterior to interior, shallow to deep, requiring horizontal reading. This book discusses Sanjiao from top to bottom, shallow to deep, requiring vertical reading, creating a complementary vertical-horizontal relationship. This is simply delirious nonsense. (*Wenre Huohuo*)

Chai Daibo notes: Whether the Ye School's classification and naming of Warm-Heat Diseases are appropriate is debatable in some aspects. For instance, Autumn-Dryness: dialectically, there are Warm-Dryness and Cool-Dryness. If Cool-Dryness can transform into heat, Autumn-Dryness should belong to the Warm Disease category. Similarly, narrow-sense Cold Damage is not always purely cold throughout. Why exclude it from Warm Diseases? Regarding Malaria, dialectically, there are Warm-Malaria and Cold-Malaria. If heat-dominant syndromes qualify as Warm Diseases, then Wind-Cold, Dysentery, Jaundice, Lung Distension, etc., which have heat-dominant syndromes, could also be classified as Warm Diseases. Looking at *Wenbing Tiaobian*, the Ye School indeed did this, leading to increasingly complex Warm Disease content. Also, Fengwen and Dongwen: generally, "Fengwen occurring in winter is called Dongwen," resulting in one disease, two names, overlapping nomenclature, which is unsatisfactory. The Ye School ignores these issues, but Mr. Zhang was dissatisfied and criticized them, dividing Warm Diseases into six types. Whether six types are optimal is debatable, but Mr. Zhang's spirit of not following tradition blindly and exploring new naming conventions is commendable.

Differentiating Warm-Heat Diseases in Taiyang Cold Damage

The Master said: Warm-Heat Disease is a disease biased towards extensive heat, i.e., the patient's reaction is biased towards hyperactivity. It is not that there is an actual Warm-Heat Pathogen. Hyperactive reactions correspond to the Yangming stage among the five stages. Cold Damage can encompass Warm-Heat; Warm-Heat occupies only one segment of Cold Damage. Acrid-Cool releasing the exterior is suitable only when the exterior is closed and interior Qi is abundant. Contemporary physicians recklessly use cooling agents. Although the exterior may resolve, many suffer damage to healthy Qi. It is like border alerts prompting air strikes; under urgent bombing, good and bad are destroyed together. Though the strong enemy is annihilated, our people are harmed. It is like treating stagnation-induced diarrhea with heavy purgatives; once stagnation is removed, diarrhea stops, but Healthy Qi is severely damaged, leading to middle-Jiao deficiency with indigestion or intestinal cold with frequent loose stools. Giving Acrid-Cool releasing the exterior when Qi is not abundant is similar. The exterior resolves via Acrid-Dispersing, but is injured by Cooling-Attacking. Moderate resistance becomes inadequate due to clearing the exterior; further clearing leads to insufficient resistance. Thus, contemporary physicians treating exterior diseases often face lingering, difficult-to-cure conditions because Cold-Cool agents damage Healthy Qi.

For Taiyang Cold Damage, Acrid-Warm releasing the exterior resolves the exterior without damaging Healthy Qi. Acrid-Cool releasing the exterior resolves the exterior but damages Healthy Qi. If the Warm-Heat disease pattern is essentially excessive resistance in Yangming, why would one dislike Cooling agents?