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The *Shanghan Lun* (Treatise on Cold Damage) categorizes syndromes into the Six Channels for differentiation, with formulas differing in their functions of releasing the exterior (Jie Biao) and purging the interior (Gong Li). There are numerous annotations and commentaries, all interpreting the principles following the original text, or each expressing unique insights, refuting one another. If one investigates the source and principles, there is often a lament of attending to one aspect while neglecting another. Why? Because times and circumstances change, geography varies between north and south, and human constitutions differ in strength. In recent times, seasonal exogenous diseases mostly resemble cold damage, while true typical cold damage is rare. These diseases resembling cold damage include Spring Warmth (Chun Wen), Summer Heat (Xia Re), Damp-Warmth (Shi Wen), Autumn Dryness (Qiu Zao), and Winter Warmth (Dong Wen). Although Zhang Zhongjing stated that cold damage encompasses five types, and distinguished methods such as warm dispersal (Wen San), acrid dispersal (Xin San), purgation (Gong Xia), and harmonization (He Jie), later generations with shallow understanding failed to grasp these meanings deeply. They merely adhered to rigid rules regarding meridian transmission and fixed days, leading to many cases of misdiagnosis and delay.

Especially in recent years, amidst famine and the aftermath of war, epidemics (Yi Li) have arisen, spreading through contagion. One must not rigidly adhere to fixed days. In my treatment of epidemic diseases, using large doses of purgative methods has often yielded effective results. This is because the pathogenic factors of this disease are mostly inhaled through the eyes and nose. Patients often present with weak and faint pulses in both hands. Those unaware of the condition might interpret this as pulse deficiency (Mai Xu) and dare not use purgatives. However, they do not know that after purgation removes the pathogen, the pulse returns to normal. At the onset of this syndrome, symptoms often include aversion to cold and cold limbs, yellow and greasy tongue coating, dull consciousness, or spontaneous diarrhea due to pathogenic heat forcing downward. The amount of stool is minimal, which easily confuses physicians. One must observe the presence and degree of turbid and greasy tongue coating to determine the severity of purgation. It is common to see one layer of turbidity removed only for another to appear. For mild cases, two to three doses suffice; for severe cases, eight to nine doses. Treatment continues until the turbid coating disappears completely and the pulse becomes calm and non-irritable. Purgation may still be necessary to prevent recurrence. One must understand that this pathogen is the most malignant qi in heaven and earth, and evil must be eradicated thoroughly. The primary formula is Da Cheng Qi Tang (Major Order of the Spleen Decoction), modified according to symptoms. The lightest modification involves using solely Yuan Ming Fen (Natrii Sulfas / Mirabilite). The general rule is to complete treatment within three "hou" (periods of approximately nine days). If delayed beyond three hou, red watery stools will inevitably occur, indicating rotting intestines and stomach, leading to certain death. This is my verified experience: use purgation based on the stagnation and greasiness of the tongue coating, specifically dry coatings without fluids. If there is no turbid coating on the tongue, even if high fever is present, purgation must not be used. This is my empirical secret method. However, it differs from non-epidemic warmth diseases and should not be confused to mislead others.

Warmth (Wen Re) refers to the normal climatic patterns of heaven and earth. The Classics state: "If one is injured by cold in winter, one will suffer from warmth in spring." Normally, although winter is externally freezing, yang qi hides internally. If the weather is sunny and dry with little rain or snow, yang qi loses its hidden state, causing Winter Warmth (Dong Wen). The treatment should use Cong Chi Tang (Scallion and Fermented Soybean Decoction) plus Da Bei Mu (Fritillariae Bulbus), Huang Qin (Scutellariae Radix), Lian Qiao (Forsythiae Fructus), Yin Hua (Lonicerae Japonicae Flos), Niu Bang Zi (Arctii Fructus), Gan Cao (Glycyrrhizae Radix), and Jie Geng (Platycodonis Radix). Since spring is the beginning of the year and severe cold has not fully receded, one must still guard against latent cold pathogens. Only when spring qi rises and liver wood qi penetrates does wind-yang transform into warmth, known as Wind-Warmth (Feng Wen). Its nature is close to dryness and often affects the Upper Jiao (Upper Burner), causing fever, cough, chest tightness, and shortness of breath. The appropriate method is to use light clearing and dispersing agents, such as Bo He (Menthae Haplocalycis Herba), Niu Bang Zi, Jie Geng, Xing Ren (Armeniacae Semen Amarum), Da Bei Mu, and Gua Lou Pi (Trichosanthis Pericarpium). If prolonged and untreated, the pathogen enters the Ying (Nutrient) level. Misusing acrid-warm formulas often leads to epistaxis (Nu Xue) and hemoptysis (Ke Xue), potentially developing into consumption (Lao). If the pathogen enters the Stomach, presenting with yellow and dry tongue coating, urgent purgation is required. In early summer, as heat increases, one should follow this formula but increase the dosage of clearing herbs. During late summer when damp-earth governs, one should dry dampness and clear heat, treating with Cang Zhu Qi Hu Tang. By deep autumn, when dryness prevails, symptoms like fever, cough, and sore throat require distinguishing between cold-transformation and heat-transformation based on weather coolness or warmth. Medications differ between moistening-warm and sweet-cold categories; this is the treatment for Autumn Dryness. If heat enters the Stomach, causing constipation and dark urine, with yellow, scorched, and greasy tongue coating, urgent purgation to preserve yin fluids is necessary. Do not delay, as damaged qi and weakness can lead to critical conditions.

In recent years, warmth diseases among seasonal exogenous illnesses are predominant. It is regrettable that treatment methods still follow acrid-warm approaches, resulting in patients dying from medical errors rather than the disease itself, which is common. I偶然ly encountered the newly published "Six Books," compiled by Tao Jie'an of Yuhang. His intent was to modify established methods with original creativity, adding and subtracting from Zhang Zhongjing's collected works. While this innovation is not without merit, he unfortunately failed to clarify the principles behind warmth symptoms. Upon careful study, I found his selections imprecise and explanations vague. How could this exhaust the sources of biological generation and transcend the scope of cold damage? Thus, working day and night, I carefully examined the order of seasonal transformation and referenced the causes of excessive Six Excesses (Liu Yin). Suddenly, I gained clarity. Not presuming my writing is rough or unpolished, I recorded the pathology of various chapters to avoid forgetting them. I submit this for the judgment of wise scholars within and outside the realm, hoping for early correction, so that my gratitude may be as deep as that towards a teacher.

Zhao Lan notes: Warmth is the normal qi of the four seasons; Warm Epidemic is the malignant qi of heaven and earth. Normal qi is treated with normal methods; malignant qi is treated with峻猛 (severe/strong) methods. This follows natural logic and trend. Mr. Yuan's treatment of epidemics heavily utilized purgation to eradicate evil thoroughly, which secretly aligns with Wu Youke's methods. Although they lived in different regions, the syndromes they treated were largely similar. Mr. Yuan determined the severity of expelling pathogens by observing the thickness of turbid tongue coating; he also clarified that warmth and plague are distinct and should not be confused to mislead people. Moreover, Mr. Yuan's heart for saving the world was urgent, prioritizing caution and prudence. His scholarship was profound, surpassing Wu Youke. Although Wu had the Nine Transformations method, he did not elucidate pathology clearly. Although his book circulated, confusing plague with warmth caused much error, making it insufficient as a standard. Some say it is regrettable that they lived in separate counties and could not discuss truths face-to-face. If Yuan and Wu had discussed together, Wu would not have confused his theories, and the principles of warmth would not have waited for Ye Tianshi to elucidate.

Alas! Worldly affairs have fortune and misfortune. Wu's book was printed and circulated early, while Yuan's book remained unknown. This is because Mr. Yuan had lofty ambitions and sought no fame, nor was he from a professional medical lineage. This book was merely a diary from that time. As he wrote in his own record: "Not daring to presume my rough and unpolished writing, I recorded casually to avoid forgetting." This shows he only recorded pathology and clinical experiments. His language was unadorned, revealing his character. Because Mr. Yuan was a senior figure in our county, and I assisted his great-grandson in compiling the county gazetteer, I obtained this book. Over half of the characters were eaten by insects. I specially re-copied it to prevent it from being submerged. Lacking other versions for collation, I kept the original text unchanged, daring not alter a single word. Where doubts exist, I added notes to clarify.

Recorded respectfully by junior scholar Zhao Guanlan at the guest room of Thirty-Six Lakes Pavilion, two days after the Mid-Autumn Festival in the Wuwu year of Xianfeng.