小便难；发其汗者，必谵语；加烧针者，则耳聋难言；但吐下之，则遗矢便利，如此疾者，宜服葳蕤汤。又治
温热病方十∶
（一）治肝腑脏温病，阴阳毒，颈背双筋牵，先寒后热，腰强急缩，目中生花方。（栀子、豆豉、柴胡、
鲜生地、大青、芒硝、
白术、桂心、生姜、石膏。）
（二）治肝腑脏温病，阴阳毒，先寒后热，颈筋挛牵，面目赤黄，身中强直方。（元参、细辛、栀子、黄芩、
升麻、芒硝、石膏、竹叶、车前草。）
（三）治心腑脏温病，阴阳毒，战掉不安，惊动方，（大青、黄芩、栀子、知母、芒硝、麻黄、元参、石膏、
生葛根、生地黄。）
（四）治脾腑脏温病，阴阳毒，头重颈直，皮肉痹，结核隐起方。（大青、羚羊角、升麻、射干、芒硝、
栀子、寒水石、元参。）
（五）治肺腑脏温病，阴阳毒，咳嗽连续，声不绝，呕逆方。（麻黄、栀子、紫菀、大青、元参、葛根、桂
心、甘草、杏仁、前胡、石膏。）
（六）治肾腑脏温病，身面如刺，腰中欲折，热毒内伤方。（茵陈、栀子、芒硝、苦参、生葛、鲜生地、石
膏、葱白、豆豉。）
（七）治温毒攻胃，下黄赤汁，及烂肉汁，赤滞下，伏气腹痛，诸热毒方。（栀子、豆豉、薤白。）
（八）治温病后劳复，或食或饮，或动作方。（栀子、豆豉、石膏、鼠屎。）
（九）治温病后，食太饱不消，劳复脉实者方。（栀子、豆豉、鼠屎、大黄。）
（十）治温病后，劳复，气欲绝方。（麦冬、甘草、大枣、竹叶、粳米。）
又曰∶凡热病新瘥后，食坚实难消之物，胃气尚虚弱，不能消化，必更结热，适以药下之，则胃气虚冷，
大利难禁，不下之必死，下之复危，皆难救也。热病及大病之后，多坐此死，不可不慎也。故凡温热病新瘥后，
但得食糜粥，宁少食令饥，慎勿饱，不得他有所食，虽思之勿与之也。引日转久，可渐食羊肉白糜若羹汁，雉
兔鹿肉不可食，猪狗肉亦然。又当静卧，慎
勿早起梳头洗面，非但体劳。亦不可多言语，用心使意劳烦。凡此皆令人劳复。余劳尚可，女劳则死，当吐舌
数寸，或吐涎而死。故温病新瘥，未满百日，气力不平复，而犯房室，名为阴阳易之病，皆难治多死。此思邈之
论温热也。
王氏外台秘要曰∶……温热病，头痛，骨肉烦疼，口燥心闷者……外寒内热者，或已下之，余热未尽者，
或热病自得利，有虚热烦渴者，宜服古今录验知母解肌汤。或已下及自得下，虚热未歇者，除麻黄，加知母葛
根。病热未除，因而梦泄者，除麻黄，加白薇、人参各二钱，则止。冬温未即病，至春被积寒所折，不得发，
至夏热，其春寒解，冬温毒始发出。肌中斑烂隐疹如锦纹，而咳心闷，呕吐清汁，眼赤口疮，下部亦生疮，宜
服古今录验漏芦橘皮汤，得下为佳。下后余症未除，更服葛根橘皮汤。温毒发斑，赤斑者五死一生，黑斑者十
死一生，宜服备急黑奴丸。若渴，但与水，须臾当寒，寒讫便汗，则解。日移五丈不觉，更服一丸。此疗六日
胸中当大热，口噤，名坏病，医所不疗，服此丸多瘥。若但温毒发斑，宜服肘后黑膏，使毒从皮中出，则愈。
温病有热，饮水暴冷而呃者，宜服短剧茅根汤，枇杷叶饮子亦效，茅根橘皮汤尤佳。肺腑脏热，暴气斑点，宜
服删繁香豉汤。温毒病吐下后，有余热而渴，宜服深师芍药汤。此 孙之论温热也。
朱氏类证活人书云∶夏至以前，发热恶寒，头疼身痛，其脉浮紧者，此名温病也。病由冬伤于寒，伏至
夏至以前，发为温病，盖因春温暖之气而发也。治法解肌汤最良。热多者，烦渴发热，不恶寒，或虚烦，并竹
叶石膏汤次第服之。脉尺寸俱浮，头疼身热，常自汗出，体重，其息必喘，四肢不收，默默但欲眠，此名风温
也。其人素伤于风，因复伤于热，风热相薄，即发风温。主四肢不收，头疼身热，当自汗出不解，治在少阴厥
阴，不可发汗。发汗即谵言独语，内烦躁扰，不得卧，若惊痫，目乱无精。疗之者复发其汗，如此死者，医杀
之也。治法宜葳蕤汤。若身灼热者，知母干葛汤；渴甚者，栝蒌根汤；脉浮身重汗出者，汉防己汤。两胫逆冷，
满腹满，多汗，头目痛苦，妄言，此名湿温也。病由湿热相薄，则发湿温。其脉阳濡而弱，阴小而急，治在太
阴，不可发汗。汗出必不出言，耳聋，不知痛所在，身青面色变，名曰重 。如此死者，医杀之也。白虎加苍
术汤主之。初春病患肌肉发斑瘾疹如锦纹，而咳心闷，但呕清汁，此名温毒也。温毒发斑者，冬时触冒疹毒，
至春始发。病初在表，或已发汗吐下，而表证未罢，毒瓦斯不散，故发斑，黑膏主之。又有冬月温暖，人感乖戾
之气，冬未即病，至春或被积寒所折，毒瓦斯不得泄，至天气暄热，温毒始发，则肌肉斑烂瘾疹如锦纹，而咳心
闷，但呕清汁，葛根橘皮汤主之，黄连橘皮汤尤佳。病患先热后寒，尺寸脉俱盛，此名温疟也，白虎加桂枝汤
主之。久不愈者，服疟母煎丸，当自愈。夏月发热恶寒，头疼，身体肢节痛重，其脉洪盛者，此名热病也。病由
冬伤于寒，因暑气而发为热病。治法桂枝石膏汤主之，栀子升麻汤亦可选用。此奉议之论温热也。
刘河间伤寒六书云∶有表而热者，谓之表热；无表而热者，谓之里热。凡表里俱热之症，或半在表，或半
在里，汗之不可，吐之又不可，法当和解；用凉膈、天水二散合服，水煎解之。或表热多、里热少，天水一，凉
膈半；或里热多、表热少，凉膈一，天水半，合和解之。若仍不能退其热者，用黄连解毒汤，直清里热。热势
更甚者，大柴胡合大承气汤下之，双除表里之热，大柴胡合三一承气汤亦佳。下症未全，不可下者，用白虎汤，
或知母石膏汤。其症初起，有暴发而为热者，病在心肺，宜用局方雄黄解毒丸。有里病积热者，病在肾肝，宜用局方妙
香
丸。如上焦热而烦者，宜用牛黄散。但上焦热，无他症者，宜用桔梗汤。中焦有湿热，不能食而热者，脾虚也，
宜以藿、朴、白术、陈皮之类治之。中焦有实热，能食而热者，胃实也，宜以栀子黄芩汤或三黄丸之类治之。
脏腑热极，大便闭结者，宜用大黄牵牛散。若病久憔悴，寝汗发热，五脏齐损，瘦弱虚烦，肠 下血，骨蒸痿
弱，四肢无力，不能运动者，此久热骨蒸也，病在下焦肝肾，宜养血益阴，热能自退，当归、生地合钱氏地黄
丸之类。如热入血室，发狂不认人者，宜用牛黄膏以宣解之。如阳狂奔走骂詈，不避亲疏，此阳有余，阴不足，
宜用当归承气汤下之。若两胁肋热，或一身夜热，或日晡肌热者，皆为血热也，四顺饮子主之，若小便闭而不
通，脐下状如复碗，痛闷不可忍者，乃肠胃干涸，膻中气不下，三焦气不化也，宜用八正散加沉香、木香，令
气通达，小便自通。此守真之论温热也。
李氏此事难知云∶冬伤于寒，春必温病，盖因房室劳伤与辛苦之人，腠理开泄，少阴不藏，肾水涸竭而
得之。无水则春木无以发生，故为温病。至长夏之时，时强木长，因绝水之源，无以滋化，故为大热病也。……邪
之所感，浅者其病轻而易治，深者其病重而难治，尤深者其病死而不治。此东垣之论温热也。
朱氏脉因证治云∶因房劳辛苦之过，腠理开泄，少阴不藏，触冒冬时杀厉之气，严寒之毒，中而即病，
曰伤寒。不即病，寒毒藏于肌肤之间，至春变为温病，至夏变为热病，皆热不得发泄，郁蒸于内，遇感而发，
虽曰伤寒，实为热病，死症甚多。
（一）温病二三日，体热腹满头痛，饮食如故，脉直而疾者，八日死。
（二）温病四五日，头痛腹满而吐，脉来细劲，十二日死。
（三）温病八九日，头身不痛，目不赤，身不变而反利，脉来牒牒，按之不弹手，时大，心下坚，十七日
死。
（四）温病汗不出，出不至足者死。
（五）温病厥汗出，肾脉强急者生，虚缓者死。
（六）温病下痢，腹中痛甚者死。
（七）热病七八日，不汗躁狂，口舌暴燥焦黑，脉反细弱、或代者死。
（八）热病得汗，脉躁者死，脉转大者死。
（九）热病七八日，脉不躁，喘不数，后三日中有汗，不汗者四日死。
（十）热病脉涩小疾，腹满膨胀，身热不得大小便死。
（十一）热病脉浮大绝，喘而短气，大衄不止，腹中疼死。
（十二）热病脉浮洪，肠鸣腹满，四肢清，注泄死。
（十三）热病脉绝动疾，便血，夺形肉，身热甚死。
（十四）热病脉小疾，咳喘眩悸，夺形肉，身热死。
（十五）热病腹胀，便血，脉大，时时小绝，汗出而喘，口干，视不见者死。
（十六）热病脉转小，身热甚死。
（十七）热病脉转小，身热甚，咳而便血，目陷妄言，循衣缝，躁扰不卧死。
（十八）热病呕血，咳而烦满，身黄腹胀，泄不止，脉绝死。
（十九）热病螈 ，狂走不能食，腹满，胸痛引腰脊，呕血死。
（二十）热病不知所痛，不能自收，口干阳热甚，阴颇有寒者死。
（二十一）热病在肾，口干渴，舌燥黄赤，日夜饮水不知，腹大胀尚饮，目无精光者死。
（二十二）热病喘咳唾血，手足腹肿，面黄，振栗不言，名肺绝死，丁日死（后仿此）。
（二十三）热病头痛，呕宿汗，呕逆吐血，水浆不入口，狂妄，腹大满，名脾绝死。
（二十四）热病烦满骨痛，嗌肿不可咽，欲咳不能咳，歌笑而哭，名心绝死。
（二十五）热病僵卧，足不安地，呕血，血妄行，遗屎溺，名肝绝死。
（二十六）热病喘悸吐逆，骨痛短气，目视不明，汗如珠，名肾绝死，此丹溪之论温热也。
王氏溯洄集云∶伤寒，以病因而为病名∶温病、热病，以天时与病形而为病名。伤寒即发于天令寒冷之
时，而寒邪在表，闭其腠理∶故非辛甘温之剂，不足以散之，此仲景桂枝、麻黄等汤之所以必用也。温病、热
病，后发于天令暄热之时，伏热自内而达于外，郁其腠理，无寒在表，故非辛凉或苦寒或酸苦之剂，不足以解
之。此仲景桂枝、麻黄等汤独治外者之所以不可用，而后人所处水解散、大黄汤、千金汤、防风通圣散之类兼
治内外者之所以可用也。夫即病之伤寒，有恶风恶寒之证者，风寒在表，而表气受伤故也；后发之温病、热病，
有恶风恶寒之证者，重在风寒新中，而表气亦受伤故也。若无新中之风寒，则无恶风恶寒之证，故仲景曰∶太
阳病发热而渴，不恶寒者，为温病。温病如此，则知热病亦如此。……且温病、热病，亦有先见表证而后传里
者。盖伏热自内达外，热郁腠理，不得外泄，遂复还里而成可攻之证，非如伤寒从表而始也。或者不悟此理，
乃于春夏温病、热病而求浮紧之脉，不亦疏乎！殊不知紧为寒脉，有寒邪则见之，无寒邪则不见也。其温病、
热病或见紧脉者，乃重感不正之暴寒，与内伤过度之冷食也。岂其本
然哉！夫温病、热病之脉，多在肌肉之分而不甚浮，且右手反盛于左手者，诚由郁热在内故也。其或左手盛或
浮者，必有重感之风寒，否则非温病、热病，自是暴感风寒之病耳！凡温病、热病，若无重感，表证虽间见，
而里病为多，故少有不渴者。斯时也，法当治里热为主，而解表兼之，亦有治里而表自解者。余每见世人治温热
病，虽误攻其里，亦无大害；误发其表，变不可言。此足以明其热之自内达外矣。其间有误攻里而致大害者，
乃春夏暴寒所中之新感症，邪纯在表，未入于里故也，不可与温病、热病同论。……虽然，伤寒与温病、热病，
其攻里之法，若果是以寒除热，固不必求异，其发表之法，断不可不异也。若温病、热病被时行不正之气所发，
及重感异气而变者，则又当观其何时何气，参酌而治，尤不可例以仲景即病伤寒药通治也。此安道之论温热也。
汪氏证治要诀云∶温与热有轻重之分，故仲景云∶若遇温气，则为温病，更遇温热，则为温毒。热比温为
尤重故也。苟但冬伤于寒，至春而发，不感异气，名曰温病，病稍轻。温病未已，更遇温气，变为温毒；亦可
名曰温病，病较重。此伏气之温病也。又有不因冬月伤寒，至春而病温者，此特春温之气，可名曰春温，如冬
之伤寒，秋之伤湿，夏之中暑相同。此新感之温病也。以此观之，是春之病温，有三种不同∶有冬伤于寒，至春
发为温病者；有温病未已，更遇温气，则为温病，与重感温气相杂而为温病者；有不因冬伤于寒，不因更遇温
气，只于春时感春温之气而病者。若此三者，皆可名为温病，不必各立名色，只要辨其病源之不同而已。此石
山之论温热也。
王氏伤寒准绳云∶从立春节后，其中无暴大寒，又不冰雪，而有人壮热为病者，此属春时阳气发于外，
冬时伏寒，变为温病。按活人所云∶温病有二∶其用升麻解肌汤者，乃正伤
寒太阳证，恶寒而不渴者，特以其发于温暖之时，故谓之温病尔；其用竹叶石膏汤者，乃仲景所谓渴不恶寒之
Difficulty in urination; if diaphoresis (sweating therapy) is applied, delirium will inevitably occur; if burning needle therapy is added, deafness and difficulty in speech will result; if only emesis or purgation is used, fecal and urinary incontinence will ensue. For such conditions, Yu Zhi Tang (Jade Bamboo Decoction) is appropriate. Additionally, ten formulas for treating Warm-Heat diseases are recorded:
(1) Formula for treating Liver Warm-Heat disease, Yin-Yang Toxicity, with牵引 (pulling/tightening) of the tendons on both sides of the neck and back, initial chills followed by fever, stiffness and contraction of the waist, and visual disturbances described as seeing flowers before the eyes. (Ingredients: Gardenia, Fermented Soybean, Bupleurum, Fresh Rehmannia Root, Isatis Leaf, Mirabilite, Atractylodes Macrocephala, Cinnamon Twig Heart, Fresh Ginger, Gypsum.)
(2) Formula for treating Liver Warm-Heat disease, Yin-Yang Toxicity, with initial chills followed by fever, spasm and pulling of the neck tendons, red-yellow complexion, and rigidity of the body. (Ingredients: Scrophularia Root, Asarum, Gardenia, Scutellaria Root, Cimicifuga Rhizome, Mirabilite, Gypsum, Bamboo Leaf, Plantago Seed/Herb.)
(3) Formula for treating Heart Warm-Heat disease, Yin-Yang Toxicity, with tremors, restlessness,惊动 (startle/agitation). (Ingredients: Isatis Leaf, Scutellaria Root, Gardenia, Anemarrhena Rhizome, Mirabilite, Ephedra Stem, Scrophularia Root, Gypsum, Raw Kudzu Root, Raw Rehmannia Root.)
(4) Formula for treating Spleen Warm-Heat disease, Yin-Yang Toxicity, with heavy head and stiff neck, numbness of skin and flesh, and subcutaneous nodules. (Ingredients: Isatis Leaf, Antelope Horn, Cimicifuga Rhizome, Belamcanda Rhizome, Mirabilite, Gardenia, Aragonite, Scrophularia Root.)
(5) Formula for treating Lung Warm-Heat disease, Yin-Yang Toxicity, with continuous coughing, unceasing voice, and vomiting with reflux. (Ingredients: Ephedra Stem, Gardenia, Aster Tataricus Root, Isatis Leaf, Scrophularia Root, Kudzu Root, Cinnamon Twig Heart, Licorice Root, Apricot Seed, Peucedanum Root, Gypsum.)
(6) Formula for treating Kidney Warm-Heat disease, with sensations like pricks on the body and face, feeling that the waist is about to break, caused by internal injury from Heat-Toxin. (Ingredients: Artemisia Capillaris, Gardenia, Mirabilite, Sophora Root, Raw Kudzu Root, Fresh Rehmannia Root, Gypsum, Green Onion White, Fermented Soybean.)
(7) Formula for treating Warm-Toxin attacking the Stomach, discharging yellow-red fluid, rotting flesh-like fluid, bloody dysentery, abdominal pain due to latent Qi, and various Heat-Toxin conditions. (Ingredients: Gardenia, Fermented Soybean, Allium Macrostemon Bulb.)
(8) Formula for treating relapse due to overexertion after Warm-Heat disease, or relapse due to improper diet, drinking, or physical activity. (Ingredients: Gardenia, Fermented Soybean, Gypsum, Rat Feces.)
(9) Formula for treating relapse due to overexertion after Warm-Heat disease, where food was consumed excessively and not digested, and the pulse is excess/solid. (Ingredients: Gardenia, Fermented Soybean, Rat Feces, Rhubarb.)
(10) Formula for treating relapse due to overexertion after Warm-Heat disease, where Qi is nearly exhausted. (Ingredients: Ophiopogon Tuber, Licorice Root, Jujube, Bamboo Leaf, Rice Grain.)
It is further stated: After a heat disease has just healed, if one consumes solid, hard-to-digest foods, and the Stomach Qi remains weak and unable to digest them, heat will inevitably re-accumulate. If purgatives are then administered, it will cause Stomach Qi deficiency and cold, leading to severe diarrhea that cannot be controlled; if not purged, death is certain; if purged, the condition becomes critical again, making rescue difficult. Many die after heat or major illnesses due to this negligence; caution is essential. Therefore, after a Warm-Heat disease has just healed, one should only consume rice gruel, preferring to eat little and remain slightly hungry, avoiding fullness, and refraining from other foods, even if desired. After some time, mutton, white rice gruel, or soup can be gradually introduced. Pheasant, rabbit, and deer meat should not be eaten, nor pork or dog meat. One should lie quietly and avoid getting up early to comb hair or wash the face, as this causes physical fatigue. One should also avoid excessive talking and mental exertion. All these lead to relapse due to overexertion. General overexertion may be bearable, but sexual overexertion leads to death, characterized by the tongue protruding several inches or vomiting saliva until death. Thus, if sexual intercourse occurs within 100 days of recovering from a Warm-Heat disease, while strength has not fully recovered, it is called "Yin-Yang Exchange" disease, which is difficult to treat and often fatal. This is Sun Simiao’s discussion on Warm-Heat diseases.
Wang Tao’s *Waitai Miyao* states: ...For Warm-Heat disease presenting with headache, irritability and pain in bones and flesh, dry mouth, and chest oppression... for those with external cold and internal heat, or where residual heat remains after purgation, or where natural bowel movement has occurred leaving deficient heat with irritability and thirst, Gu Jin Lu Yan Zhi Mu Jie Ji Tang (Ancient and Modern Recorded Mother Root Muscle-Releasing Decoction) is suitable. If purgation or natural purgation has occurred and deficient heat persists, remove Ephedra Stem and add Anemarrhena Rhizome and Kudzu Root. If fever persists and nocturnal emission occurs, remove Ephedra Stem and add Glehnia Root and Ginseng Root, each 2 qian, to stop it. Winter-Warmth disease may not manifest immediately; if suppressed by accumulated cold in spring, it waits until summer heat resolves the spring cold, at which point winter warmth toxin emerges. Rashes and hidden rashes appear like brocade patterns on the skin, accompanied by cough, chest oppression, vomiting clear fluid, red eyes, oral ulcers, and sores in the lower body. Gu Jin Lu Yan Lou Lu Ju Pi Tang (Ancient and Modern Recorded Agrimony and Tangerine Peel Decoction) is suitable, with purgation being ideal. If residual symptoms persist after purgation, Ge Gen Ju Pi Tang (Kudzu Root and Tangerine Peel Decoction) should be taken. For Warm-Toxin causing macules, red macules indicate five deaths to one survival, black macules ten deaths to one survival; Bei Ji Hei Nu Wan (Emergency Black Slave Pill) is suitable. If thirsty, give water; shortly thereafter, chills will occur, followed by sweating, resolving the disease. If five zhang of sun movement passes without change, administer another pill. This treats "Huai Bing" (Ruined Disease) characterized by intense chest heat and locked jaw after six days, which doctors usually cannot treat; this pill often cures it. For simple Warm-Toxin macules, Zhou Hou Hei Gao (Elbow Emergency Black Plaster) is suitable to expel toxin through the skin. For Warm-Heat disease with sudden hiccups after drinking cold water, Duan Ju Mao Gen Tang (Short Drama Imperata Root Decoction) is suitable; Bi Pa Ye Yin Zi (Loquat Leaf Drink) is also effective, and Mao Gen Ju Pi Tang (Imperata Root and Tangerine Peel Decoction) is especially good. For Lung organ heat with sudden qi spots, Shan Fan Xiang Chi Tang (Eliminate Complexity Fragrant Fermented Bean Decoction) is suitable. For Warm-Toxin disease with residual heat and thirst after emesis/purgation, Shen Shi Shao Yao Tang (Deep Master Peony Decoction) is suitable. This is Sun Simiao’s discussion on Warm-Heat diseases.
Zhu Gong’s *Lei Zheng Huo Ren Shu* states: Before Summer Solstice, fever with chills, headache, body pain, and floating-tight pulse is named Warm-Heat disease. The cause is winter cold invasion, lying latent until before Summer Solstice, triggered by spring warmth. The best treatment is Jie Ji Tang (Muscle-Releasing Decoction). For high heat, irritability, thirst, fever, no chills, or deficient irritability, Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) should be taken sequentially. If pulses at Cun and Chi positions are both floating, with headache, fever, spontaneous sweating, heaviness, panting, flaccid limbs, silence, and desire to sleep, it is named Feng Wen (Wind-Warmth). This occurs when the person is constitutionally injured by wind and re-injured by heat; wind and heat interact, triggering Wind-Warmth. Main symptoms include flaccid limbs, headache, fever, spontaneous sweating that does not resolve. Treatment focuses on Shaoyin and Jueyin meridians; diaphoresis is contraindicated. Diaphoresis leads to delirious speech, internal irritability, inability to lie down, resembling epilepsy, with chaotic vision and lack of spirit. If treated by inducing sweat again, death results; this is physician-induced homicide. The appropriate treatment is Yu Zhi Tang. If the body is scorching hot, Zhi Mu Gan Ge Tang (Anemarrhena and Raw Kudzu Decoction) is used; for severe thirst, Gua Lou Gen Tang (Trichosanthes Root Decoction); for floating pulse, heaviness, and sweating, Han Fang Ji Tang (Han Fangji Decoction). If calves are cold, abdomen is full, sweating is profuse, head/eyes are painful, and there is delirium, it is named Shi Wen (Damp-Warmth). Caused by damp-heat interaction. Pulse is superficially soggy/weak and deep/small/urgent; treatment focuses on Taiyin; diaphoresis is contraindicated. Diaphoresis leads to muteness, deafness, unawareness of pain, cyanosis, and color changes, named Zhong Yue (Severe Heat Stroke). Death results; this is physician-induced homicide. Bai Hu Jia Cang Zhu Tang (White Tiger plus Atractylodes Decoction) is primary. In early spring, patients with macules/rashes like brocade, cough, chest oppression, and vomiting clear fluid have Wen Du (Warm-Toxin). Wen Du macules arise from winter toxin exposure, manifesting in spring. Initially in the exterior; if emesis/purgation fails to resolve exterior signs and toxin remains, macules appear; Hei Gao (Black Plaster) is primary. Alternatively, winter warmth allows abnormal qi invasion; if suppressed by spring cold, toxin remains until summer heat releases it, causing similar symptoms; Ge Gen Ju Pi Tang (Kudzu Root and Tangerine Peel Decoction) is primary, Huang Lian Ju Pi Tang (Coptis and Tangerine Peel Decoction) is better. Patients with initial heat followed by chills, strong Cun-Chi pulses have Wen Nue (Warm-Malaria); Bai Hu Jia Gui Zhi Tang (White Tiger plus Cinnamon Twig Decoction) is primary. Chronic cases use Nue Mu Jian Wan (Malaria Mass Decoction Pill). In summer, fever/chills, headache, limb pain/heaviness, and surging pulse indicate Re Bing (Heat Disease), caused by winter cold triggered by summer heat. Gui Zhi Shi Gao Tang (Cinnamon Twig and Gypsum Decoction) is primary; Zhi Zi Sheng Ma Tang (Gardenia and Cimicifuga Decoction) is optional. This is Feng Yi (Zhu Gong)’s discussion on Warm-Heat diseases.
Liu Hejian’s *Shang Han Liu Shu* states: Exterior heat is called Biao Re (Exterior Heat); interior heat without exterior signs is called Li Re (Interior Heat). For simultaneous exterior-interior heat, or half-exterior/half-interior, neither diaphoresis nor emesis is suitable; harmonization is required. Use Liang Ge San (Cooling the Diaphragm Powder) and Tian Shui San (Heavenly Water Powder) combined. Ratio depends on heat distribution: more exterior heat uses 1 part Tian Shui to 0.5 part Liang Ge; more interior heat uses 1 part Liang Ge to 0.5 part Tian Shui. If heat persists, Huang Lian Jie Du Tang (Coptis Detoxification Decoction) clears interior heat directly. For severe heat, Da Chai Hu Tang (Major Bupleurum Decoction) combined with Da Cheng Qi Tang (Major Order the Qi Decoction) purges both exterior and interior heat; Da Chai Hu Tang combined with San Yi Cheng Qi Tang is also good. If purge indications are incomplete, do not purge; use Bai Hu Tang (White Tiger Decoction) or Zhi Mu Shi Gao Tang (Anemarrhena and Gypsum Decoction). For acute onset heat affecting Heart/Lung, Ju Fang Xiong Huang Jie Du Wan (Official Bureau Realgar Detoxification Pill) is suitable. For chronic interior heat accumulation affecting Kidney/Liver, Ju Fang Miao Xiang Wan (Official Bureau Wonderful Incense Pill) is suitable. For upper jiao heat with irritability, Niu Huang San (Buffalo Horn Powder) is suitable. For isolated upper jiao heat, Jie Geng Tang (Platycodon Decoction) is suitable. For middle jiao damp-heat with anorexia and heat (Spleen deficiency), use Huo Xiang, Hou Po, Bai Zhu, Chen Pi. For middle jiao excess heat with appetite (Stomach excess), use Zhi Zi Huang Qin Tang (Gardenia and Scutellaria Decoction) or San Huang Wan (Three Yellows Pill). For extreme organ heat with constipation, Da Huang Qian Niu San (Rhubarb and Morning Glory Seed Powder) is suitable. For chronic wasting, night sweats, heat, five-organ damage, emaciation, deficient irritability, intestinal bleeding, bone-steaming, weakness, and immobility, this is chronic bone-steaming heat affecting Lower Jiao Kidney/Liver; nourish blood and yin using Dang Gui, Sheng Di combined with Qian Shi Di Huang Wan (Qian’s Rehmannia Pill). For heat entering Blood Chamber with madness and misidentification, Niu Huang Gao (Buffalo Horn Paste) is suitable. For wild running and cursing (excess Yang, deficient Yin), Dang Gui Cheng Qi Tang (Angelica Order the Qi Decoction) purges. For hypochondriac heat, nightly body heat, or afternoon muscle heat, this is Blood Heat; Si Shun Yin Zi (Four Smooth Infusion) is primary. For urinary retention with suprapubic distension like an inverted bowl and unbearable pain, due to dry intestines/colon and stagnant Qi in Danzhong/Sanjiao, Ba Zheng San (Eight Uprights Powder) plus Chen Xiang, Mu Xiang promotes Qi flow and urination. This is Shou Zhen (Liu Wansu)’s discussion on Warm-Heat diseases.
Li Shi’s *Ci Shi Nan Zhi* states: Winter cold invasion leads to Spring Warm-Heat disease, often due to sexual exhaustion or hard labor opening pores, failing to store Shaoyin, depleting Kidney Water. Without water, Spring Wood cannot generate, causing Warm-Heat. By Late Summer, Wood grows strongly but lacks Water source, causing Great Heat Disease. ...Superficial pathogens cause mild/easy-to-treat disease; deep pathogens cause severe/difficult disease; extremely deep pathogens are fatal/incurable. This is Dong Yuan (Li Gao)’s discussion on Warm-Heat diseases.
Zhu Shi’s *Mai Yin Zheng Zhi* states: Due to sexual/labor exhaustion opening pores and failing to store Shaoyin, exposure to winter killing cold/toxin causes immediate Shang Han (Cold Damage). If not immediate, cold toxin hides in skin/flesh, transforming into Warm-Heat in Spring and Heat Disease in Summer. Heat cannot vent, stagnates internally, and erupts upon trigger. Though called Shang Han, it is actually Heat Disease with many fatalities.
(1) Warm-Heat day 2-3: body heat, abdominal fullness, headache, normal diet, straight/fast pulse → death on day 8.
(2) Warm-Heat day 4-5: headache, abdominal fullness, vomiting, thin/tough pulse → death on day 12.
(3) Warm-Heat day 8-9: no head/body pain, eyes not red, body unchanged but loose stools, pulsating pulse non-elastic on pressure, occasionally large, epigastric hardness → death on day 17.
(4) Warm-Heat: no sweat, or sweat not reaching feet → death.
(5) Warm-Heat with cold extremities and sweat: strong/tense Kidney pulse → survival; weak/slow pulse → death.
(6) Warm-Heat with dysentery and severe abdominal pain → death.
(7) Heat Disease day 7-8: no sweat, agitation/manic, sudden dry/black tongue, fine/weak or intermittent pulse → death.
(8) Heat Disease with sweat: rapid pulse → death; pulse becomes large → death.
(9) Heat Disease day 7-8: pulse not rapid, panting not frequent, sweat within next 3 days → survival; no sweat → death on day 4.
(10) Heat Disease: choppy/small/fast pulse, abdominal fullness/bloating, fever, inability to pass stool/urine → death.
(11) Heat Disease: floating/extreme pulse, panting/shortness of breath, massive epistaxis, abdominal pain → death.
(12) Heat Disease: floating/surging pulse, borborygmus, abdominal fullness, cold limbs, profuse diarrhea → death.
(13) Heat Disease: absent/rapid pulse, hematochezia, emaciation, severe fever → death.
(14) Heat Disease: small/fast pulse, cough/wheeze/dizziness/palpitations, emaciation, fever → death.
(15) Heat Disease: abdominal distension, hematochezia, large pulse, intermittent small pulse, sweating/panting, dry mouth, blindness → death.
(16) Heat Disease: pulse becomes small, severe fever → death.
(17) Heat Disease: pulse becomes small, severe fever, cough/hematochezia, sunken eyes, delirium, picking at clothes, restlessness/insomnia → death.
(18) Heat Disease: hematemesis, cough/irritability/fullness, jaundice, abdominal distension, intractable diarrhea, absent pulse → death.
(19) Heat Disease: convulsions, manic running, anorexia, abdominal fullness, chest pain radiating to back, hematemesis → death.
(20) Heat Disease: unaware of pain, inability to control body, dry mouth/excessive Yang heat, significant Yin cold → death.
(21) Heat Disease in Kidney: dry mouth/thirst, dry/yellow-red tongue, drinking day/night without relief, abdominal distension despite drinking, lifeless eyes → death.
(22) Heat Disease: panting/cough/spitting blood, edema of hands/feet/abdomen, yellow face, trembling/muteness → Lung Exhaustion death, dies on Ding day.
(23) Heat Disease: headache, vomiting old sweat/reflux/vomit blood, inability to drink, mania, abdominal fullness → Spleen Exhaustion death.
(24) Heat Disease: irritability/fullness, bone pain, throat swelling/swallowing difficulty, urge to cough but cannot, singing/laughing/crying → Heart Exhaustion death.
(25) Heat Disease: rigid lying, feet unable to touch ground, hematemesis, erratic bleeding, fecal/urinary incontinence → Liver Exhaustion death.
(26) Heat Disease: panting/palpitations/reflux, bone pain/shortness of breath, blurred vision, pearl-like sweat → Kidney Exhaustion death. This is Dan Xi (Zhu Zhenheng)’s discussion on Warm-Heat diseases.
Wang Shi’s *Su Hui Ji* states: Shang Han is named by etiology; Wen Bing/Re Bing are named by season and manifestation. Shang Han occurs in cold weather, cold pathogen in exterior closing pores; requires Acrid-Sweet-Warm agents (e.g., Zhongjing’s Gui Zhi/Ma Huang Tangs) to disperse. Wen Bing/Re Bing occur in warm weather, latent heat reaches exterior from inside, blocking pores without exterior cold; requires Acrid-Cool, Bitter-Cold, or Sour-Bitter agents to resolve. Thus, Zhongjing’s exterior-only formulas are unsuitable, while later formulas like Shui Jie San, Da Huang Tang, Qian Jin Tang, Fang Feng Tong Sheng San (treating interior/exterior) are suitable. Immediate Shang Han with aversion to wind/cold indicates exterior Cold-Wind damaging Wei Qi. Delayed Wen Bing/Re Bing with aversion to wind/cold indicates new Cold-Wind invasion damaging Wei Qi. Without new invasion, no aversion exists; hence Zhongjing says: Taiyang disease with fever/thirst and no aversion is Wen Bing. Heat Disease follows similarly. ...Wen Bing/Re Bing may show exterior signs first then transmit inward. Latent heat reaches exterior, blocks pores, fails to vent, returns inward forming attackable syndrome, unlike Shang Han starting from exterior. Seeking floating-tight pulse in Spring/Summer Wen Bing/Re Bing is erroneous; tight pulse indicates cold. Tight pulse in Wen Bing/Re Bing implies secondary acute cold or cold food injury, not inherent. Wen Bing/Re Bing pulses are typically in muscle layer, not very floating, and Right hand stronger than Left due to internal heat. Left dominance/float indicates secondary Cold-Wind; otherwise, it is acute Cold-Wind, not true Wen Bing/Re Bing. Generally, Wen Bing/Re Bing without secondary invasion has more interior than exterior signs, so thirst is common. Treatment prioritizes clearing interior heat, assisting exterior release; sometimes clearing interior resolves exterior. I observe physicians harming patients by wrongly purging interior (less harmful) vs. wrongly inducing sweat (catastrophic), proving heat originates internally. Harm from purging interior occurs only in new Cold-Wind cases (pure exterior, not entered interior), distinct from Wen Bing/Re Bing. ...Although interior purging for heat removal is similar between Shang Han and Wen Bing/Re Bing, exterior release methods must differ. If Wen Bing/Re Bing is triggered by epidemic qi or secondary pathogenic factors, treatment must consider timing and qi nature, not universally applying Zhongjing’s immediate Shang Han formulas. This is An Dao (Wang Lv)’s discussion on Warm-Heat diseases.
Wang Shi’s *Zheng Zhi Yao Jue* states: Wen and Re differ in severity; Zhongjing says: encountering Wen Qi causes Wen Bing; encountering additional Warmth causes Wen Du. Re is heavier than Wen. If winter cold invades and manifests in Spring without other pathogens, it is Wen Bing (milder). If Wen Bing continues and encounters Wen Qi, it becomes Wen Du (heavier). This is Latent Qi Wen Bing. If not caused by winter cold but manifests in Spring due to Spring Warmth Qi, it is Chun Wen (Spring Warmth), analogous to Winter Cold, Autumn Damp, Summer Heat. This is New Invasion Wen Bing. Thus, Spring Wen Bing has three types: 1) Winter cold manifesting in Spring; 2) Persistent Wen Bing exacerbated by Wen Qi; 3) Direct Spring Warmth invasion without winter cold. All are termed Wen Bing; differentiation lies in etiology. This is Shi Shan (Wang Ji)’s discussion on Warm-Heat diseases.
Wang Ken-tang’s *Shang Han Zhun Sheng* states: After Start of Spring, without extreme cold or ice, if someone has high fever, it belongs to Spring Yang emerging externally, transforming winter latent cold into Wen Bing. According to *Huo Ren*, Wen Bing has two types: 1) Using Sheng Ma Jie Ji Tang: correct Shang Han Taiyang syndrome, aversion to cold without thirst, named Wen Bing because it occurs in warm season; 2) Using Zhu Ye Shi Gao Tang: corresponds to Zhongjing’s “thirst without aversion to cold,”