世之治伤寒者,每误以温热治之,而治温热者,又误以伤寒治之,此辨之不明也。即明其为温热病矣,
而又有新感、伏气之不同。前哲发明新感温热者,如叶氏香岩之论温二十则、陈氏平伯之风温病篇、吴氏鞠通
之温病条辨、张氏凤逵之治暑全书,立说非不精详,然皆为新感温暑而设,非为伏气温热而言,即江本载薛生
白湿温病篇,亦属暑湿相搏之一种。他如张石顽伤寒绪论、周禹载温热暑疫全书、陈素中寒温条辨,虽辨明伏
气温热,惜皆语焉而不详。以予所见,专论伏气温热能各症精详者,自北山此书始。兹先述其总论,存其精而
补其缺,约十有三。
温热,伏气病也,通称伏邪。病之作,往往因新感而发,所谓新邪引动伏邪也。因风邪引动而发者,曰风温,
或曰风火。因寒邪引动而发者,曰冷温,或曰客寒包火。因暑邪引动而发者,曰暑温,或曰暑热。因湿邪引
动而发者,曰湿温,或曰湿遏
热伏。若兼秽毒者,曰温毒;其症有二∶一为风温时毒,一为湿温时毒。此以兼症别其病名也。其发于春者,
曰春温,或曰春时晚发。发于夏者,曰夏温,或曰热病。发于秋者,曰秋温,或曰秋时晚发,或曰伏暑。发于
冬者,曰冬温,或曰伏暑、冬发。此以时令别其病名也。其病萌于春,盛于夏,极于秋,衰于冬,间亦有盛发
于春冬者,然总以盛发于夏秋为多。
何则?春冬空气清洁,轻气多而炭气少,故其为病亦清邪多而浊邪少。除新感症外,即有因伏邪而病,纯
热无寒者,但为温病而已;兼寒者,但为冷温而已;兼风者,但为风温而已。虽间有时行温毒,然亦以风毒居多,
夏秋空气最浊,水土郁蒸之气,每被日光吸引而蒸发,发于首夏者曰霉雨蒸,发于仲秋者曰桂花蒸;其为病也,
皆水土秽气杂合而成,人但以暑湿赅其病之本,贪凉饮冷赅其病之标。而不知夏秋水土郁蒸,湿中有热,热中
有湿,浊热粘腻,化生霉菌,故谓之湿温,亦谓之湿热,西医谓之霉毒瓦斯;害人最广,变症最繁,较之风温、
冷温、暑温、三症,尤多而难治。
英医合信氏云∶空气干热不伤人,惟湿热最伤人,因低洼地土,或蕴有死水之潜热,或积有腐烂之草木
(此即水土秽气化生霉菌之原因),后得六十度热表之日光,接连晒之,其霉毒瓦斯乃勃发。故在东南热地,夏秋
之交,其毒尤甚,可见湿温、湿热为有形粘腻之邪,西医不为无见。呜呼!人在气交之中,一身生气,终日与
秽气相争战,实则与微生物相争战,不知不觉中伏许多危险之机,可不惊且惧哉!
Those who treat *Shanghan* (Cold Damage) often mistakenly apply treatments for *Wenre* (Warm-Heat diseases), and those who treat *Wenre* often mistakenly apply treatments for *Shanghan*; this is due to unclear differentiation. Even if it is clearly identified as a *Wenre* disease, there are differences between *Xingan* (Newly Acquired/Immediate Onset) and *Fuqi* (Latent Pathogen). The predecessors elucidated theories on *Xingan Wenre*, such as Ye Tianshi's (Ye Xiangyan) "Twenty Rules on Warmth," Chen Pingbo's "Chapter on Wind-Warmth Disease," Wu Jutong's "Systematic Identification of Warm Diseases," and Zhang Fengkui's "Complete Book on Treating Summerheat." Their theories were not imprecise or undetailed, yet they were all established for *Xingan Wenshu* (Newly acquired warmth and summerheat), not for *Fuqi Wenre*. Even the chapter on Damp-Warmth by Xue Shengbai, included in Jiang Benzai's collection, belongs to a type where summerheat and dampness struggle with each other. Others, such as Zhang Shiwen's "Introduction to Shanghan," Zhou Yucai's "Complete Book on Warmth, Heat, Summerheat, and Epidemics," and Chen Suzhong's "Differentiation of Cold and Warmth," although clarifying *Fuqi Wenre*, unfortunately remain vague and undetailed. In my opinion, the first book to specifically discuss *Fuqi Wenre* with precision regarding various symptoms is Mr. Beishan's work. Here, I first present its general theory, preserving its essence and supplementing its deficiencies, totaling thirteen points.
*Wenre* is a *Fuqi* disease, commonly referred to as *Fuxie* (Latent Pathogen). Its onset often occurs triggered by a new external contraction, known as "new pathogen activating latent pathogen." When triggered by wind pathogen, it is called *Fengwen* (Wind-Warmth) or *Fenghuo* (Wind-Fire). When triggered by cold pathogen, it is called *Lengwen* (Cold-Warmth) or *Ke Han Bao Huo* (External Cold Enveloping Fire). When triggered by summerheat pathogen, it is called *Shuwen* (Summerheat-Warmth) or *Shure* (Summerheat-Heat). When triggered by dampness pathogen, it is called *Shiwen* (Damp-Warmth) or *Shi E Re Fu* (Dampness Suppressing and Heat Lying Hidden). If complicated by foul toxins, it is called *Wendu* (Warm-Toxin); its symptoms are of two types: one is *Fengwen Shidu* (Wind-Warmth Seasonal Toxin), and the other is *Shiwen Shidu* (Damp-Warmth Seasonal Toxin). This distinguishes disease names based on accompanying symptoms. Those occurring in spring are called *Chunwen* (Spring-Warmth) or *Chunshi Wanfa* (Late Onset in Spring). Those occurring in summer are called *Xiawen* (Summer-Warmth) or *Rebing* (Heat Disease). Those occurring in autumn are called *Qiuwen* (Autumn-Warmth) or *Qiushi Wanfa* (Late Onset in Autumn), or *Fushu* (Latent Summerheat). Those occurring in winter are called *Dongwen* (Winter-Warmth) or *Fushu, Dongfa* (Latent Summerheat, Winter Onset). This distinguishes disease names based on seasonal timing. The disease germinates in spring, flourishes in summer, peaks in autumn, and declines in winter; occasionally it may peak in spring and winter, but generally, it peaks most frequently in summer and autumn.
Why? In spring and winter, the air is clean, with more light/clear qi and less heavy/turbid qi; thus, the pathogens are mostly clear and few turbid ones. Apart from *Xingan* symptoms, even if illness arises from *Fuqi*, pure heat without cold is merely *Wenbing* (Warm Disease); accompanied by cold is merely *Lengwen*; accompanied by wind is merely *Fengwen*. Although occasionally there are epidemic *Wendu*, wind toxin predominates. In summer and autumn, the air is most turbid; the stagnant and steaming qi of water and soil is often attracted and evaporated by sunlight. Occurring in early summer, it is called *Meiyu Zheng* (Moldy Rain Steaming); occurring in mid-autumn, it is called *Guihua Zheng* (Osmanthus Flower Steaming). The resulting illness is formed by a mixture of turbid foul qi from water and soil. People tend to generalize the root of the disease as summerheat-dampness and the manifestation as greed for coolness and drinking cold substances. They do not realize that in summer and autumn, the stagnant steaming of water and soil means dampness contains heat, and heat contains dampness; the turbid heat is sticky and greasy, generating mold spores. Hence it is called *Shiwen* (Damp-Warmth) or *Shiqi* (Damp-Heat); Western medicine calls it *Meidu Was* (Mold Toxic Gas). It harms the most people, produces the most complex variations, and is far more numerous and difficult to treat than *Fengwen*, *Lengwen*, and *Shuwen*.
British physician Hobson stated: Dry-hot air does not harm people; only damp-heat harms people most. This is because low-lying land may harbor latent heat from stagnant water, or accumulate rotting vegetation (this is the cause of water-soil foul qi generating mold spores). Later, exposed to sunlight at sixty degrees [temperature], causing the mold toxic gas to erupt vigorously. Therefore, in the hot regions of the southeast, during the transition between summer and autumn, the toxicity is particularly severe. This shows that *Shiwen* and *Shiqi* are tangible, sticky, and greasy pathogens; Western medicine has some insight into this. Alas! Humans exist within the intersection of qi; our vital qi struggles daily against foul qi, which is essentially a struggle against microorganisms. Unknowingly, we harbor many dangerous mechanisms; can we not be alarmed and fearful?