（春温 风温 湿温 冬温 温毒附）
温为春气，其病温者，因时令温暖，腠理开泄，或引动伏邪，或乍感异气，当春而发，为春温。其因冬
月伤寒，至春变为温病者，伏邪所发，非寒毒藏于肌肤，亦非伤寒过经不解之谓。王叔和、云岐子之说，吴又
可、柯韵伯已辩之。乃由冬藏不密，肾阴素亏，虚阳为寒令所遏，仍陷入阴中，至春则里气大泄，木火内
燃，始见必壮热烦冤，口干舌燥，经所谓∶冬不藏精，春必病温也。故其发热而渴，不恶寒，脉数盛，右倍
于左。温病脉多在肌肉之分，不甚浮，右倍于左者，热郁在内也。大异伤寒浮紧之脉。若左脉盛或浮，必重感
风寒，否则非温症，是非时暴寒耳。此热邪自内达外，最忌发汗。温热病无寒在表，若误与表散，必至躁热闷
乱，以至于死。宜辛凉以解表热，葱白香豉汤。苦寒以泄里热，黄芩汤。里气一通，自然作汗，若舌干便秘，
凉膈散。或协热下利，葛根黄连黄芩汤。咽痛，桔梗汤。心烦，黄连阿胶汤。此伏邪自内发，无表症也。其不
由伤寒伏邪，第从口鼻吸入而病温者，异气所感，邪由上受，首先犯肺，手太阴。逆传心包，手厥阴。或留三
焦。手少阳。叶香岩谓温由吸受，乃手经为病，非如伤寒足六经主治。且伤寒多变症，温热久在一经不移，以
此为辨。夫肺主气，温邪伤肺，胸满气窒者，宜辛凉轻剂，杏仁、桔梗、栝蒌、栀皮、枳壳、连翘。挟风，
加薄荷、牛蒡。挟湿，加芦根、滑石。或透湿于热外，或渗湿于热下，俾风湿不与热相
搏，则不贻风温湿温之患。如辛凉散风，甘淡驱湿，热势不解，则入心营，而血液受劫，咽燥舌黑，烦渴不寐，
或见斑疹者，宜清解营热，犀角、生地、麦冬、石斛、竹叶、元参、沙参、青蒿。兼透斑，牛蒡、山栀、连翘、
银花、丹皮、赤芍。斑出热不解者，胃津亡也，主以甘寒。重则玉女煎，轻则梨皮、蔗浆之类。若邪入心包，
神昏谵语，目瞑而内闭者，宜芳香逐秽，宣神明之窍，驱热痰之结。牛黄丸、至宝丹。盖热气蒸灼，弥漫无形，
若药味重浊，直走肠胃，全无病膈矣。若气病不传血分，而邪留三焦，宜分消其上下之势。如杏仁、浓朴、茯
苓等，或温胆汤。因其仍在气分，犹可冀其战汗解，或转疟也。若三焦不得从外解，必致里结肠胃，宜用下法。
承气汤加元明粉。若脘痞胸痛，泻心汤、小陷胸汤。若腹胀满或痛，邪已入里，必验其舌，或灰黄，或老黄，
或中有断纹，皆当下之。承气汤加槟榔、青皮、枳实之属。其病温复感风者，为风温，必阳脉浮滑，阴脉濡弱。
风属阳，温化热，两阳熏灼，先伤上焦，上焦近肺，肺气既阻，致头胀脘痞，身热汗出，宜微苦以清降，微
辛以宣通。杏仁、香豉、郁金、栝蒌、橘红、山栀、薄荷、牛蒡。忌辛散劫津。葳蕤汤去麻黄、羌活、木香。
若风温误汗，身灼热者，脉阴阳俱浮，自汗身重，多眠鼻鼾，语言难出，危症也。急用蔗浆、麦冬、白芍、生
地、炙草、玉竹、阿胶之属。误下误火熏亦危。其病温而湿胜者，为湿温，身热头重，胸满呕恶，足胫冷。
苍术白虎汤，或滑石、芦根、苡米、茯苓、半夏。其冬行春令，袭温气而成病者，为冬温。盖本秋燥之余气，
故发热咳嗽，喉肿咽干，痰结，甚则见血。与伤风之痰，一咳即上者不同。其脉虚缓，或虚大无力。亦有先病
冬温，更加暴寒，寒郁热邪，则壮热头痛，自汗喘咳，阳旦汤加桔梗、茯苓。切忌风药升举其邪，致咳愈剧，
热愈甚，遂变风温灼热以死。亦忌辛散，致咽喉不利，痰唾脓血。加减葱白香豉汤调之。若兼风寒外袭，葱豉
汤加羌活、紫苏。寒邪盛，汗不出而烦扰者，葱豉汤加少许麻黄、石膏。若冬温误汗，致发斑毒者，升麻葛根
汤加犀角、元参。如昏愦谵妄者，大便泻，手足冷，不治。其病温更遇时毒者，为温毒，脉浮沉俱盛，烦闷
呕咳，甚则狂言下利
而发斑。凡烦闷躁热，起卧不安，皆发斑候也。伤寒温疫诸症，失于宣解，邪蕴胃腑，发出肌表。热毒内攻，
陷入营分，乃发斑毒，黄连解毒汤。斑不透者，犀角大青汤。凡红赤为胃热，人参化斑汤。紫为胃伤，犀角地
黄汤。黑为胃烂，不治。鲜红起发者吉，紫色成片者重，黑色者凶，青色者不治。由失表者求之汗，由失下
者取乎攻。火盛清之，毒盛化之，营气不足，助其虚而和之托之。其轻者则有疹痧，细碎如粟，主治不外肺胃
二经，宜辛凉或甘寒淡渗等法，皆温症中所宜细审者。
〔春温〕温热病，不可作伤寒正治，而用大汗大下，初病憎寒发热头痛，葱豉汤，得汗则解。温邪化热
伤肺，上焦气阻，用辛凉轻剂，栀、豉、芩、翘、杏、桔、花粉、郁金之属。呕吐，黄芩汤加半夏、生姜。
湿邪内搏，热迫下泄稀水，枳壳、赤苓、芦根、苡米、滑石之属。脘中痞痛，宜从开泄，宣通气滞，杏、蔻、
橘、半、蒌、桔之属。上焦气热烁津，凉膈散。散其无形之热，勿用血药滋腻。热伤胃津，石膏、竹叶、生地、
麦冬。其热邪专在气分，必得战汗，或大渴索饮，饮后热达腠开，邪从汗解，但脉象和缓，虽肤冷 非脱症。
战汗后，脉急疾，躁扰不卧，肤冷汗出，乃为气脱之候。更有邪胜正虚，经一再战汗而愈者。叶氏《温热论》
云∶肺主气属卫，心主血属营，临症者，卫之后方言气，营之后方言血。邪在卫汗之，辛凉开肺，便是汗剂。
到气方可清气，入营犹可透热转气，如犀角、元参、羚羊角之类。入血乃恐耗血动血，直须凉血散血。如生地、
丹皮、阿胶、赤芍之类。否则前后不循缓急之法，动手便错，且湿邪为害，面色白者，须顾其阳气，湿胜则阳微
也。虽湿邪化热后，法应清凉，然到十分之六七，不可过用寒凉，恐成功反弃，何也？湿热一去，阳亦衰微也。
面色苍者，须顾其津液，清凉到十分之六七，往往热减身寒，不可遽谓虚寒而投补剂，恐炉焰虽熄，灰中有火
也。凡温热病，救阴易，通阳难。救阴不在血，而在津与汗；通阳不在温，而在利小便，较杂症自不同也。如
三焦不得从外解，则热结于腑，必舌灰黄，或老黄，乃下之。小承气汤加减。伤寒热邪在里，下之猛；此多湿
邪内搏，下之轻。伤寒大便溏，为邪已尽；湿温病大
便溏，为邪未尽。至大便硬，慎不可再攻，以屎燥为无湿也。若舌苔黄不浓而带滑者，热未伤津，犹可清热透
表。若苔薄而干者，津伤也。宜禁苦寒，以甘寒轻剂治，若热传营，舌色必绛，深红色。其绛色中兼黄白色者，
气分之邪未尽，泄卫透营，两和可也。纯绛鲜泽者，胞络受病也。宜犀角、鲜生地、连翘、郁金、石菖蒲等。
舌色绛而粘腻，似苔非苔，湿热熏蒸为痰，将闭心胞也，急加芳香逐之，醒头兰、藿香、郁金、菖蒲，以开其
闭，恐昏厥为痉也。平昔心虚有痰，外热一陷，里络就闭，非郁金、菖蒲所能开，须牛黄丸、至宝丹。舌绛
而干燥者，火邪劫营，凉血清火为要。舌绛而有碎点黄白者，当生疳也；大红点者，热毒乘心也，用黄连、
金汁。色绛而不鲜，干枯而痿者，此肾阴涸，急以阿胶、鸡子黄、地黄、天冬等救之，缓则不及矣。舌独中心
绛干者，胃热而心营受烁也，清胃方中加入清心之品，否则延及舌尖，为火盛津干也。舌尖绛独干，此心火上
炎，用导赤散利其腑。苔白而薄，外感风寒也，当疏散之。白而干薄，肺津伤也，用麦冬、花露、芦根汁，轻
清之品。白苔绛底者，湿遏热伏也，当先泄湿透热，防其就干也，再从里透于外，则变润矣。舌生芒刺，上焦
热极也，以绢蘸薄荷汁揩之，即退者轻，旋生者险。舌苔不燥，自觉闷极者，脾湿盛也。舌苔粘腻，吐出浊沫
者，口必甜味，此为脾痹。乃湿热与谷气相搏。用醒头草，即佩兰。芳香辛散以逐之，即退。若苔如碱，胃中宿
滞，挟秽浊郁伏，当急急开泄，否则闭结中焦，不能从募原达出矣。舌黑而滑者，水来克火，为阴症，宜温之。
若见短缩，为肾气竭，欲救之，如人参、五味子。勉希万一。舌黑而干者，津枯火炽，急泻火补水。舌淡红无
色，或干而色不荣，胃津伤，气不化液也，炙甘草汤。勿用寒凉。舌色紫而暗，扪之湿，乃热传营血，或素有
瘀伤宿血在胸膈，为热所搏，宜加散血之品，琥珀、丹参、桃仁、丹皮之属。不尔，瘀血与热结，阻遏正气，遂
变如狂发狂症。舌胀大不能退场门者，脾湿胃热，郁极化风而毒延口也，用大黄磨汁，入当用剂内，舌胀自消。
其舌白如粉滑，四边色紫绛者，温疫病初入募原，未归胃腑，急急透解，莫待传陷而为险恶症。妇人病温有娠
者，保胎为要，古法
用四物汤加减。护胎法，用伏龙肝研细，调涂脐下三寸，干即易之。热极，用井底泥涂，或青布浸冷盖腹。
产后慎用苦寒，察其邪可从上中解者，从症用之，勿犯下焦，恐血去多，邪易内陷也。至经水适来适断，热
陷血室，与瘀血结，少腹必满痛，小柴胡汤去参、枣，加丹皮、延胡、桃仁、归尾、楂肉。挟寒，加桂心。
气滞加香附、陈皮、枳壳。若谵语如狂，血结者，身必重，宜去瘀通络。若延久上逆心包，胸痛不可按，
是血结胸也。海蛤散加桃仁。
〔风温〕温症感风，寸口脉大，肺受热烁，宜辛凉清上，杏、贝、栀、蒌、花粉、沙参、桑叶之属。身
痛脘痹，肺气不舒，栀、豉、杏、蒌、郁金、橘红之属。头胀咳嗽，懊 痞满，芩、蒌、栀、豉、枳、桔、
桑叶、郁金、贝母之属。热灼劫阴，烦躁，麦冬、白芍、蔗浆、生地、阿胶之属。余参春温治法。
〔湿温〕伤于湿，又中暑，暑挟湿邪，郁蒸为热，其脉寸濡而弱，尺小而急，身痛头重，妄言自汗，两胫
逆冷，湿遏阳气。忌发汗。汗之名重 ，必死。苍术白虎汤。胸满，香薷饮加半夏、苍术。头胀耳聋，邪与
气混也，正气散去腹皮、白术、姜、枣，加连翘、银花、牛蒡子。小便不利，大便反快，五苓散合白虎汤或天
水散。
〔冬温〕冬气温暖，感而即发，身热头痛，不恶寒，面肿咳嗽，咽痛下利，阳旦汤加减。忌风药升举，初
感头痛身热，葱豉汤。咽痛，甘桔汤。风寒外袭，葱豉汤加羌活、苏叶。余参春温治法。
〔温毒〕病温更遇时毒，面赤斑如锦纹，咽痛烦躁，黄连解毒汤。自汗而渴，胃热发斑者，人参化斑汤。
斑已透，热不退者，犀角大青汤去黄芩、升麻，加生地、人参、柴胡。误用热药，邪毒深陷，发为狂乱，面赤眼
红，舌黑鼻煤，下利脉洪数者，消斑青黛饮。忌下药，惟便秘躁渴，可微下之，大柴胡汤。凡斑疹初见胸背两
胁，点大为斑，粒小为疹。斑属血多，疹属气多。或阳症误用热药，或当下不下，或下后不解，皆能致之。不
可发汗，重令开泄，更增斑烂。斑紫点小，心胞热也。点大而紫，胃中热也。斑黑而光亮，热毒盛也。黑而晦者
死，若黑而晕脚红者，火
内伏，用清凉发散，间有转红成可救者。凡斑疹，皆邪气外透，发出宜神情清爽，为外解里和，如斑疹出而
昏者，正不胜邪，或胃津内涸。有白泡如水晶者，湿邪郁于卫分，汗不彻故也。当理气分之邪，若毒壅，消
毒犀角饮，大青四物汤。
(Chunwen, Fengwen, Shiwen, Dongwen, Wendu Appendix)
Wen (Warmth) pathogen corresponds to the climate of spring. Diseases caused by Wen arise because the seasonal warmth causes the Couli (skin pores and interstices) to open, either activating latent pathogens within the body or suddenly contracting abnormal Qi. Manifesting in spring, it is called Chunwen (Spring Warmth). Cases where winter Cold damage transforms into a Warm disease by spring are due to the eruption of latent pathogens; this is not cold toxin hiding in the skin and muscles, nor is it the continuation of Shanghan (Cold Damage) beyond its meridian stages. The theories of Wang Shuhe and Yun Qizi have already been refuted by Wu Youke and Ke Yunbo. This occurs because of insufficient storage of Essence during winter, leading to a chronic deficiency of Kidney Yin. The deficient Yang is suppressed by the cold command but remains trapped in the Yin aspect. By spring, the internal Qi leaks significantly, causing Liver Wood and Heart Fire to burn internally. Symptoms inevitably include high fever with vexation, dry mouth and tongue, as stated in the classic: "If one does not store Essence in winter, one will suffer from Warm diseases in spring." Therefore, there is fever with thirst, aversion to cold is absent, and the pulse is rapid and vigorous, with the right side being twice as strong as the left. The pulse of Warm diseases often resides in the muscle level and is not very floating. The right pulse being stronger than the left indicates heat stagnating internally. This differs greatly from the floating-tight pulse of Shanghan. If the left pulse is strong or floating, it must be due to a secondary contraction of Wind-Cold; otherwise, it is not a Warm disease but rather an abrupt cold at an inappropriate season. Since this heat pathogen moves from the interior to the exterior, sweating methods are strictly contraindicated. Warm diseases lack exterior Cold; if mistaken for such and treated with dispersing agents, it will lead to restlessness, heat, confusion, and even death. One should use pungent-cool herbs to resolve exterior heat, such as Congbai Xiangchi Tang (Scallion White and Fermented Soybean Decoction). Use bitter-cold herbs to drain interior heat, such as Huangqin Tang (Scutellaria Decoction). Once the interior Qi flows freely, sweat will occur naturally. If the tongue is dry with constipation, use Liangge San (Cool the Diaphragm Powder). If accompanied by heat-induced diarrhea, use Gegen Huanglian Huangqin Tang (Kudzu, Coptis, and Scutellaria Decoction). For sore throat, use Jiegeng Tang (Platycodon Decoction). For mental restlessness, use Huanglian Ejiao Tang (Coptis and Donkey-Hide Gelatin Decoction). These cases involve latent pathogens erupting from the interior without exterior symptoms. Those not arising from Shanghan latent pathogens but contracted via inhalation through the nose and mouth are caused by abnormal Qi. The pathogen enters from above, first attacking the Lung, which belongs to the Hand-Taiyin Meridian. It may reverse-transmit to the Pericardium, belonging to the Hand-Jueyin Meridian, or remain in the Triple Burner, belonging to the Hand-Shaoyang Meridian. Ye Tianshi stated that Warm pathogens enter via inhalation and affect the Hand meridians, unlike Shanghan which primarily affects the Foot meridians. Furthermore, while Shanghan presents with many transforming syndromes, Warm diseases tend to remain in one meridian for a long time, which serves as a diagnostic distinction. The Lung governs Qi; when Warm pathogens injure the Lung, causing chest fullness and Qi obstruction, use mild pungent-cool formulas such as Xingren (Apricot Seed), Jiegeng (Platycodon Root), Gualou (Trichosanthes Fruit), Zhizi Pi (Gardenia Bark), Zhike (Aurantium Fruit), and Lianqiao (Forsythia Fruit). If complicated by Wind, add Bohe (Mint) and Niubangzi (Arctium Fruit). If complicated by Dampness, add Lugen (Reed Rhizome) and Huashi (Talcum). Alternatively, vent the Dampness outside the Heat or渗 (percolate) the Dampness below the Heat, preventing Wind-Damp from combusting with Heat, thus avoiding complications of Fengwen (Wind-Warmth) or Shiwen (Damp-Warmth). If using pungent-cool to scatter Wind and sweet-bland to expel Dampness fails to resolve the heat, the pathogen enters the Ying (Nutritive) level, damaging Blood. Symptoms include dry throat, black tongue, vexation, thirst, insomnia, or appearance of macules and papules. Treat by clearing Ying-level heat using Xijiao (Rhinoceros Horn - *Note: Substitute with Water Buffalo Horn clinically*), Shengdi (Rehmannia Root), Maidong (Ophiopogon Tuber), Shihu (Dendrobium Stem), Zhuye (Bamboo Leaf), Xuanshen (Scrophularia Root), Shashen (Glehnia Root), and Qinghao (Sweet Wormwood). To help vent macules/papules, add Niubangzi, Zhizi, Lianqiao, Yinhua (Honeysuckle Flower), Danpi (Moutan Cortex), and Chishao (Red Peony Root). If heat persists after macules appear, it indicates depletion of Stomach Yin; treat with sweet-cold methods. Severe cases use Yuni Jian (Jade Woman Decoction); mild cases use Pear Skin and Sugarcane Juice. If the pathogen enters the Pericardium, causing coma and delirium with internal closure, use aromatic herbs to dispel turbidity and open the orifices of the Spirit, resolving heat-phlegm clumps. Use Niuhuang Wan (Calculus Bovis Pill) or Zhibao Dan (Precious Treasure Pill). Because heat steams diffusely and formlessly, heavy/turbid medicines would merely travel to the intestines and stomach, failing to reach the Diaphragm pathology. If Qi-level disease does not transmit to the Blood level but the pathogen remains in the Triple Burner, differentiate and eliminate the pathogenic factors from upper and lower aspects. Use Xingren, Houpo (Magnolia Bark), Fuling (Poria), etc., or Wendan Tang (Warm Gallbladder Decoction). Since it remains in the Qi level, one may hope for resolution via Zhanhan (Battle Sweat) or transformation into Malaria. If the Triple Burner cannot resolve externally, it will inevitably bind internally in the intestines and stomach; use purgative methods. Chengqi Tang (Major/Minor Order the Qi Decoction) plus Yuanmingfen (Mirabilite). If epigastric stuffiness and chest pain occur, use Xiexin Tang (Drain the Epigastrium Decoction) or Xiao Xianxiong Tang (Minor Chest Trap Decoction). If abdominal distension or pain occurs, the pathogen has entered the interior; examine the tongue coating. If grey-yellow, old yellow, or cracked, purgatives are indicated. Chengqi Tang plus Binglang (Areca Seed), Qingpi (Green Tangerina Peel), and Zhishi (Immature Bitter Orange). When Warm disease is complicated by Wind, it is called Fengwen. The Yang pulse is floating-slippery, and the Yin pulse is soggy-weak. Wind is Yang, Warmth transforms into Heat; the two Yangs scorch, injuring the Upper Jiao first. Proximity to the Lung causes Lung Qi obstruction, leading to head distension, epigastric stuffiness, body heat, and sweating. Use slightly bitter herbs to clear and descend, and slightly pungent herbs to diffuse and unblock. Use Xingren, Xiangchi, Yujin (Curcuma Rhizome), Gualou, Juhong (Tangerina Peel), Zhizi, Bohe, Niubangzi. Avoid pungent dispersants that consume Jin-Ye (Body Fluids). Use Weiyu Tang (Weiyu Decoction) removing Mahuang (Ephedra), Qianghuo (Notopterygium Rhizome), and Muxiang (Aucklandia Root). If Fengwen is mistakenly sweated, resulting in burning heat, floating pulses on both sides, spontaneous sweating, heaviness, somnolence, snoring, and difficulty speaking, it is a critical condition. Urgently use Sugarcane Juice, Maidong, Baishao (White Peony Root), Shengdi, Zhigancao (Honey-fried Licorice), Yuzhu (Polygonatum Rhizome), and Ejiao (Donkey-Hide Gelatin). Mistaken purgation or moxibustion/fumigation is also dangerous. When Warm disease is complicated by excessive Dampness, it is called Shiwen. Symptoms include body heat, heavy head, chest fullness, nausea/vomiting, and cold calves. Use Cangzhu Baihu Tang (Atractylodes and White Tiger Decoction), or Huashi, Lugen, Yimi (Coix Seed), Fuling, and Banxia (Pinellia Tuber). When winter follows spring weather patterns, contracting Warm Qi, it is called Dongwen (Winter Warmth). Likely stemming from residual Autumn Dryness, symptoms include fever, cough, swollen throat, dry throat, phlegm accumulation, and even hemoptysis. This differs from Wind-Cold cough where phlegm rises immediately upon coughing. The pulse is deficient-slow or deficient-large and forceless. Some cases involve initial Dongwen complicated by abrupt cold, where cold traps heat, causing high fever, headache, spontaneous sweating, wheezing, and cough. Use Yangdan Tang plus Jiegeng and Fuling. Strictly avoid Wind herbs that lift the pathogen, which worsens cough and heat, potentially leading to death from Fengwen burning heat. Also avoid pungent dispersants that cause throat obstruction and purulent sputum. Regulate with Jiajian Congbai Xiangchi Tang (Modified Scallion and Fermented Soybean Decoction). If complicated by external Wind-Cold, use Congchi Tang plus Qianghuo and Zisu (Perilla Leaf). If Cold is severe with no sweat and restlessness, use Congchi Tang with a small amount of Mahuang and Shigao (Gypsum). If Dongwen is mistakenly sweated, causing macule-toxin, use Shengma Gegen Tang (Cimicifuga and Kudzu Decoction) plus Xijiao and Xuanshen. If coma/delirium occurs with diarrhea and cold extremities, it is untreatable. When Warm disease encounters epidemic toxins, it is called Wendu. The pulse is vigorous on both floating and deep levels. Symptoms include vexation, oppression, nausea, cough, delirium, diarrhea, and macules. Vexation, restlessness, and inability to lie still are precursors to macules. In Shanghan and Warm Epidemic diseases, failure to ventilate and resolve leads to pathogen accumulation in the Stomach Fu organs, emerging on the skin surface. Internal attack by heat toxin sinking into the Ying level causes macule-toxin. Treat with Huanglian Jiedu Tang (Coptis Detoxification Decoction). If macules do not emerge fully, use Xijiao Daqing Tang (Rhinoceros Horn and Isatis Decoction). Reddish macules indicate Stomach Heat; use Renshen Huaban Tang (Ginseng Macule-Resolving Decoction). Purple indicates Stomach injury; use Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction). Black indicates Stomach rot; untreatable. Fresh red rising macules are auspicious; purple成片 (patchy) macules are severe; black are ominous; green are untreatable. For missed exterior release, seek sweating; for missed purgation, seek attacking. For excess Fire, clear it; for excess Toxin, transform it; for deficient Ying Qi, tonify deficiency and support/resist. Mild cases present as rashes/sha, fine like millet seeds, mainly affecting Lung and Stomach meridians. Treat with pungent-cool, sweet-cold, or bland-percolating methods, all requiring careful examination in Warm diseases.
[Chunwen] Warm diseases must not be treated as standard Shanghan with drastic sweating or purging. Initial chills, fever, and headache are treated with Congchi Tang; resolution comes with sweat. When Warm pathogen transforms into heat injuring the Lung and obstructing Upper Jiao Qi, use mild pungent-cool formulas such as Zhizi, Chichi, Huangqin, Lianqiao, Xingren, Jiegeng, Huafen (Trichosanthes Root), and Yujin. For vomiting, use Huangqin Tang plus Banxia and Shengjiang (Fresh Ginger). For internal Dampness combusting with heat causing watery diarrhea, use Zhike, Chiling (Red Poria), Lugen, Yimi, and Huashi. For epigastric stuffiness/pain, use opening/draining methods to diffuse Qi stagnation: Xingren, Kourén (Cardamom), Juhong, Banxia, Gualou, Jiegeng. For Upper Jiao heat scorching fluids, use Liangge San to dissipate formless heat; avoid cloying blood-tonifying herbs. For heat injuring Stomach Yin, use Shigao, Zhuye, Shengdi, and Maidong. If heat stays exclusively in the Qi level, resolution requires Zhanhan (Battle Sweat) or intense thirst. After drinking, heat reaches the Couli, opens them, and the pathogen exits via sweat. If the pulse becomes harmonious/slow, even with cool skin, it is not collapse. Post-Zhanhan, if the pulse is rapid, restlessness prevents sleep, and skin is cold with sweat, it indicates Qi collapse. In cases of pathogen excess and Zheng (Upright Qi) deficiency, repeated Zhanhan may lead to recovery. Ye Tianshi's *Wenre Lun* states: The Lung governs Qi and belongs to Wei (Defensive); the Heart governs Blood and belongs to Ying (Nutritive). Clinically, after Wei comes Qi, and after Ying comes Blood. For pathogen in Wei, induce sweat with pungent-cool to open the Lung. Only at the Qi level can one clear heat. At the Ying level, one can still vent heat out to the Qi level using Xijiao, Xuanshen, Lingyangjiao (Antelope Horn), etc. At the Blood level, fear of consuming/moving blood requires cooling blood and dispersing stasis using Shengdi, Danpi, Ejiao, and Chishao. Otherwise, ignoring urgency leads to error. Regarding Dampness: if the face is pale, protect Yang, as Dampness excess weakens Yang. Even after Dampness transforms into heat requiring cooling, stop at 60-70% intensity; overuse of cold/bitter herbs may ruin success because eliminating damp-heat also eliminates Yang. If the face is dark/cyan, protect Jin-Ye; cooling to 60-70% may reduce heat and cause chill; do not mistake this for deficiency-cold and administer tonics, lest "embers remain in ashes." Generally, rescuing Yin is easier than unblocking Yang. Rescuing Yin lies not in Blood but in Jin-Ye and Sweat; unblocking Yang lies not in warming but in promoting urination, differing from miscellaneous diseases. If the Triple Burner cannot resolve externally, heat binds in the Fu organs, indicated by grey-yellow or old-yellow tongue coating; use purgatives. Modify Xiao Chengqi Tang. Shanghan heat in the interior requires strong purgation; here, internal Dampness requires mild purgation. In Shanghan, loose stool means pathogen is exhausted; in Shiwen, loose stool means pathogen remains. Do not purge again once stool hardens, as dry stool indicates absence of Dampness. If tongue coating is yellow-thin and slippery, heat has not injured Jin-Ye; clear heat and vent exterior. If thin and dry, Jin-Ye is injured; avoid bitter-cold, use sweet-cold mild agents. If heat transmits to Ying, tongue turns crimson (deep red). If crimson with yellow-white patches, Qi-level pathogen remains; vent Wei and Ying simultaneously. Pure bright crimson indicates Pericardium involvement; use Xijiao, fresh Shengdi, Lianqiao, Yujin, Shichangpu (Acorus Rhizome). Crimson tongue with sticky/coating-like texture indicates damp-heat steaming into phlegm, about to close the Pericardium; urgently add aromatics like Xing Tou Lan (Pellitory/Patchouli), Huoxiang (Patchouli), Yujin, Changpu to open closure, fearing convulsion/coma. For chronic Heart deficiency with phlegm, external heat sinking closes interior collaterals; Yu Jin and Changpu are insufficient; use Niuhuang Wan or Zhibao Dan. Crimson and dry tongue indicates fire robbing Ying; cool blood and clear fire. Crimson with yellow/white spots indicates impending aphthous ulcers; large red dots indicate heat-toxin attacking the Heart; use Huanglian and Jinzhi (Willow Ash Juice). Crimson but dull, dry, and flaccid indicates Kidney Yin exhaustion; urgently rescue with Ejiao, Jizihuang (Chicken Egg Yolk), Dihuang (Rehmannia), Tiandong (Asparagus Tuber), or it will be too late. Center of tongue crimson and dry indicates Stomach heat scorching Heart Ying; add Heart-clearing herbs to Stomach-clearing formula, or it spreads to the tip indicating fire excess and fluid dryness. Tip only crimson and dry indicates Heart Fire flaming upward; use Daochi San (Guide Out Redness Powder) to benefit the Bladder. Thin white coating indicates external Wind-Cold; disperse. Thin, dry white coating indicates Lung Jin-Ye injury; use Maidong, Floral Dew, and Lugen juice (light/clear agents). White coating with crimson base indicates Dampness suppressing hidden heat; first drain Dampness and vent heat to prevent drying, then vent from interior to exterior to moisten. Tongue prickles indicate extreme Upper Jiao heat; wipe with silk dipped in Mint juice. Rapid disappearance is mild; rapid regrowth is dangerous. Non-dry coating with extreme stifling sensation indicates Spleen Dampness excess. Sticky coating with turbid foam and sweet taste indicates Pi Bi (Spleen Obstruction) from Damp-heat combusting with grain Qi. Use Xing Tou Cao (Pellitory/Patchouli/Acorus mix), specifically Peilan (Agastache), aromatic and pungent to disperse. Alkali-like coating indicates retained food/stagnation in Stomach mixed with turbid pathogens; urgently open/draining is needed, otherwise middle Jiao closes, preventing exit from Mu Yuan (Source of Pathogen). Black and slippery tongue indicates Water overcoming Fire (Yin syndrome); warm it. Shortening indicates Kidney Qi exhaustion; rescue with Renshen (Ginseng) and Wubeizi (Schisandra Berry) for a slim chance. Black and dry tongue indicates fluid exhaustion and blazing fire; urgently drain fire and nourish water. Pale red/colorless or dry/unlustrous tongue indicates Stomach Jin-Ye injury and Qi failing to transform fluids; use Zhigancao Tang (Honey-fried Licorice Decoction). Avoid cold/bitter herbs. Purple-dark tongue, moist to touch, indicates heat transmitting to Ying/Blood or pre-existing chest diaphragm stasis combusted by heat; add blood-dispersing herbs like Hupo (Amber), Danshen (Salvia), Taoren (Peach Kernel), Danpi. Otherwise, stasis combines with heat, blocking Zheng Qi, leading to mania. Swollen tongue unable to retract indicates Spleen Dampness and Stomach Heat transforming into Wind-Toxin spreading to the mouth; use ground Dahuang (Rhubarb) juice added to the formula to reduce swelling. White powder-like slippery coating with purple-crimson edges indicates early stage of Warm Epidemic at Mu Yuan, not yet in Stomach; urgently vent/resolve to prevent dangerous transmission. For pregnant women with Warm disease, protecting the fetus is paramount; ancient method uses Siwu Tang (Four Substances Decoction) modified. Fetal protection: grind Fulonggan (Dragon's House Earth) finely, mix, apply 3 cun below umbilicus, change when dry. Extreme heat: apply well-bottom mud or cold wet blue cloth to abdomen. Postpartum: cautiously use bitter-cold; if pathogen can be resolved from Upper/Middle, treat accordingly; avoid Lower Jiao to prevent excessive blood loss and pathogen sinking. During menstruation onset/cessation, heat sinks into Blood Chamber, binding with stasis, causing hypogastric fullness/pain. Use Xiaochaihu Tang (Minor Bupleurum Decoction) removing Renshen and Dazao (Jujube), adding Danpi, Yanhu (Corydalis), Taoren, Guiwei (Angelica Tail), Zharon (Hawthorn). If complicated by Cold, add Guixin (Cinnamon Bark). For Qi stagnation, add Xiangfu (Cyperus), Chenpi (Tangerina Peel), Zhike. If delirium/mania with blood binding, body heaviness indicates need to remove stasis and unblock collaterals. If prolonged, ascending to Pericardium causing unbearable chest pain, it is Blood Binding in the Chest; use Haige San (Clam Shell Powder) plus Taoren.
[Fengwen] Warm disease complicated by Wind presents with large Cun Kou (Radial artery) pulse, Lung scorched by heat. Use pungent-cool to clear the Upper Jiao: Xingren, Beimu (Fritillaria Bulb), Zhizi, Gualou, Huafen, Shashen, Sangye (Mulberry Leaf). Body pain and epigastric obstruction due to Lung Qi discomfort: Zhizi, Chichi, Xingren, Gualou, Yujin, Juhong. Head distension, cough, restlessness, and fullness: Huangqin, Gualou, Zhizi, Chichi, Zhike, Jiegeng, Sangye, Yujin, Beimu. Heat scorching and robbing Yin causing vexation: Maidong, Baishao, Sugarcane Juice, Shengdi, Ejiao. Refer to Chunwen treatment methods for others.
[Shiwen] Injury by Dampness combined with Summerheat, where Summerheat carries Dampness, stagnates and steams into heat. Pulse: Cun soggy-weak, Chi small-rapid. Symptoms: body pain, heavy head, delirium, spontaneous sweating, cold calves (Dampness suppressing Yang). Sweating is contraindicated; forced sweating leads to death. Use Cangzhu Baihu Tang. Chest fullness: Xiangru Yin (Elsholtzia Decoction) plus Banxia and Cangzhu. Head distension and deafness (pathogen mixing with Qi): Zhengqi San remove Fupi (Tangerina Peel), Baizhu (Atractylodes), Jiang, Zao, add Lianqiao, Yinhua, Niubangzi. Urinary difficulty with loose stool: Wuling San combined with Baihu Tang or Tianshui San.
[Dongwen] Winter warmth, contracting and manifesting immediately. Symptoms: fever, headache, no aversion to cold, facial swelling, cough, sore throat, diarrhea. Use Yangdan Tang modified. Avoid Wind-lifting herbs. Initial headache/fever: Congchi Tang. Sore throat: Ganjie Tang. External Wind-Cold: Congchi Tang plus Qianghuo and Zisu. Refer to Chunwen treatment methods for others.
[Wendu] Warm disease encountering epidemic toxins. Face red with brocade-like macules, sore throat, vexation: Huanglian Jiedu Tang. Spontaneous sweating with thirst, Stomach heat causing macules: Renshen Huaban Tang. Macules emerged but heat persists: Xijiao Daqing Tang remove Huangqin and Shengma, add Shengdi, Renshen, Chaihu (Bupleurum). Mistaken use of hot drugs causes deep pathogen/toxin invasion, mania, red face/eyes, black tongue, sooty nose, diarrhea, surging-rapid pulse: Xiaoban Qingdai Yin (Macule-Resolving Indigo Decoction). Purgatives are generally contraindicated; only for constipation/restless thirst, mildly purge with Dachaihu Tang. Initially appearing on chest/back/flanks: large spots are Ban (macules), small grains are Zhen (papules). Ban involves more Blood; Zhen involves more Qi. Caused by Yang syndrome mistreated with hot drugs, missed purgation, or unresolved post-purgation. Do not sweat; forcing openness worsens macule erosion. Small purple spots indicate Pericardium heat; large purple spots indicate Stomach heat. Black shiny macules indicate盛 (excess) heat-toxin. Black dull macules indicate death; black with red halo indicates hidden fire, treat with cooling/dispersing, occasionally turning red and salvageable. All macules/papules represent pathogen venting outward; clarity of spirit indicates exterior resolution and interior harmony. Coma upon emergence indicates Zheng failing against pathogen or internal Stomach Jin-Ye exhaustion. Crystal-like white blisters indicate Dampness stagnating in Wei level due to incomplete sweating; regulate Qi-level pathogen. If toxin congestion, use Xiaodu Xijiao Yin (Detoxifying Rhinoceros Horn Drink) or Daqing Siwu Tang.