Library

The *Nan Jing* (Classic of Difficult Issues) discusses Shi Wen (Damp-Heat) by mentioning pulse conditions but not symptoms; the *Mai Jing* (Pulse Classic) discusses Shi Wen by mentioning symptoms but not pulse conditions. Why is this? Since in the *Nan Jing*, Shi Wen belongs to Shang Han (Cold Damage, a category of exogenous febrile diseases), there must necessarily be symptoms such as headache and fever. Furthermore, because its pulse at the Yang position is Ru (Soft) and Ruo (Weak), one can deduce that the condition of feeling warm pathogenic factors first, resulting in heat in the Chi (Cun Cun) position and thirst, is included therein; because the pulse at the Yin position is Xiao Ji (Small and Urgent), one can deduce that the condition of feeling damp pathogenic factors later, resulting in body pain and stiffness/tethering, is included therein: although symptoms are not explicitly stated, they can be inferred. This is completely different from what the *Mai Jing* describes as feeling damp pathogenic factors first and then heat pathogenic factors. When dampness is felt later, it floats on the exterior, and the treatment method is similar to that for cold patterns but with reduced intensity. "Xiao Ji" is a diminished manifestation of Jin (Tight). Xu Shuwei's Cang Zhu Bai Hu Tang (Atractylodis Rhizoma and White Tiger Decoction) uses Cang Zhu (Rhizoma Atractylodis) to dissipate dampness and Bai Hu Tang (White Tiger Decoction) to treat warmth, which fits perfectly, because this type of Shi Wen emphasizes the warmth pathogen. When dampness is felt first, it sinks into the interior, and the treatment method is the same as for general dampness diseases; therefore, there will be cold calves and fullness in the chest and abdomen, and the pulse should be Chen (Deep). How can it be treated generally with Bai Hu Tang? Head and eye pain and delirious speech indicate that dampness is severe in the interior and is about to combine and transform with the subsequently felt heat; therefore, sweating (diaphoresis) is contraindicated, as it would cause exterior deficiency and exacerbate interior pathology, so how could Cang Zhu be used? Because this type of Shi Wen, although belonging to the Middle Jiao (Middle Burner), emphasizes dampness. Observing their respective emphases, the difference between the two is significant. Zhu Fengyi merged them simply because their names were the same; thus, it is clear that Zhu Fengyi is not worthy of discussing Shang Han with him. (The judgment for San Feng Wen [Three Wind Warmth] follows this principle.)

The *Nei Jing* (Inner Canon) defines Wen Nue (Warm Malaria) as fever preceding chills, opposing Han Nue (Cold Malaria) where chills precede fever, and defines Dan Nue (Suffocating Malaria) as fever without chills. In the *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet), both Dan Nue and Wen Nue present with only warmth/fever and no chills, yet commentators fail to distinguish between them. I argue that the naming of Nue (Malaria) was originally established in contrast to Wen (Warmth/Warm Disease). If one contracts cold pathogens in winter or non-seasonal warmth, and it manifests in spring, and the presentation is harmonious, it is called Wen; if one contracts summerheat pathogens in summer or non-seasonal cold, and it manifests in autumn, and the presentation is harsh/cruel, it is called Nue. Nue includes Han Nue, Wen Nue, and Wu Han Nue (Non-chill Nue). If one first experiences Wen symptoms and then contracts spring cold, the internal heat is suppressed by the external cold, and due to exterior excess, there is no chills. It is called Wen Nue because it combines two disease entities into one name. In Zhang Zhongjing's writings, when mentioning Wen or Nue, he must mention Wen Nue; this is the standard style of his writing. The difference from the *Nei Jing* is that the *Nei Jing* focuses on Nue, whereas Zhang Zhongjing focuses on Wen; thus, what they discuss involves warmth. However, regarding Dan Nue, both the *Nei Jing* and Zhang Zhongjing focus on Nue; thus, what they discuss differs. But here, regarding this Wen Nue, the character "Zhe" (者) should be read as "Ye" (也), connecting with the preceding text, meaning that both Dan Nue and Wen Nue are suitable for treatment with Bai Hu Jia Gui Zhi Fang (White Tiger plus Cinnamon Twig Formula). Otherwise, from the section on Bie Jia Jian Wan (Turtle Shell Decoction to Reduce Accumulations) onwards, formulas and discussions are listed together side-by-side; why does the Dan Nue section have discussion but no formula? The version of *Jin Gui* annotated by Xu Lingtai also states Bai Hu Jia Gui Zhi Tang (White Tiger plus Cinnamon Twig Decoction); this is the principal formula for Wen Nue and Dan Nue.