千金方曰。风温之病。脉阴阳俱浮。汗出体重。其息必喘。其形
状不仁。默默欲眠。下之者。小便难。发其汗者。必谵语。加烧针者。
则耳聋难言。但吐之。则遗矢便利。如此疾者。宣服葳蕤汤。活人书
曰。脉尺寸俱浮。头痛身热。常自汗出。体重。其息必喘。四肢不欲
收。嘿嘿但欲卧者。风温也。病患素伤于风。因复伤于热。风热相搏。
则发风温。主四肢不收。头疼身热。常自汗出。不解。治在少阴厥阴。
不可发汗。汗出则谵语。独语内烦。躁扰不得卧。若惊痫。目乱无精。
治者复发其汗。如此死者。医杀之也。活人书曰。风温不可发汗。宜
葳蕤汤。风温身灼热者。知母葛根汤。风温加渴甚者。栝篓根汤。风
温脉浮。身重汗出。汉防己汤。
活人书曰。初春病患。肌肉发斑瘾疹。迹如锦纹。或咳心闷但呕
者。此名温毒也。温毒发斑者。冬时触冒寒毒。至春始发。病初在表。
症如伤寒。或已发汗吐下而表症未罢。毒瓦斯不散。或发斑。黑膏主
之。（成疮者自作疮毒治。不可用黑膏。）又有冬月温暖。人感乖戾之
气。冬未即病。至春或被积寒所折。毒瓦斯不泄。至天气暄热。温毒始
发。则肌肉斑烂。瘾疹如锦文。内攻心闷。但呕清汁。葛根橘皮汤主
之。雍曰。不必初春春夏。皆发其斑。与伤寒不同。瘾疹如锦文而不
作疮烂者是也。其发疮脓烂者。实时行热毒豌豆疮也。二者初症。皆
先有表证如伤寒。又有瘾疹赤白二种。初无表症。暴感温气而作。其
毒轻浅。风尸之类也。又有一种遍身如锦。初亦无表症。暴感而作。
如丹如疹。其毒亦轻。皆详见小儿疮疹后斑疮瘾疹论辨中。
雍曰。仲景言风温温毒二症。又与二说不同。仲景之言曰。伤寒
过十三日以上。不间。尺寸陷者。大危。若更感异气。变为他病者。当
根据后坏病症而治之。若阳脉浮滑。阴脉濡弱者。更过于风。变为风
温。阳脉洪数。阴脉实大者。更遇温热。变为温毒。温毒为病最重。此
乃伤寒后四种坏病。此病最为重也。又非但前所谓风温温毒而已。
其用药亦当不同。然则仲景所言。伤寒坏病、中风、温毒也。诸家所
言者。冬春自感风温温毒也。其治之轻重。不得不异也。四种坏病
中。又有湿温一症。见第八卷不可汗门中。
雍曰。天行温疫。虽症不多。用药亦多端。如千金方言辟温疫
气。并断温疫相染诸方。及千金翼弹鬼丸、神明白散、太乙流金散、
萤火丸等方。前人虽尝选用。更尝缺省。收其遗逸用之。大抵治疫尤
要先辨寒温。然后用药。取阴阳表里之在伤寒也。故庞安常又述其
治寒疫诸方。盖以赤散、解圣散之类。皆宜治寒疫。若施之瘟疫。则
益热矣。
《千金方》说：风温这种病，脉象寸关尺三部都浮，出汗且身体沉重，呼吸必定气喘，肢体麻木不仁，沉默想睡觉。如果误用下法，会导致小便困难；误用发汗法，必定出现胡言乱语；加用烧针疗法，则会导致耳聋、言语不利；如果误用催吐法，则会导致大小便失禁。对于这样的疾病，应当服用葳蕤汤。
《活人书》说：脉象尺寸部都浮，头痛身热，经常自汗出，身体沉重，呼吸必定气喘，四肢不想收引（松弛无力），沉默只想躺着，这是风温病。病人素来受风邪伤害，又再次受热邪伤害，风热相互搏结，就引发风温病。主要症状是四肢弛缓不收，头痛身热，经常自汗出而病不解。治疗重点在少阴经和厥阴经，不可使用发汗法。如果发汗，会出现胡言乱语，独自说话内心烦躁，躁动不安无法入睡，甚至像惊痫一样，眼睛昏花无神。如果医生再次发汗，导致死亡的，是医生害死了病人。《活人书》又说：风温不可发汗，适宜用葳蕤汤。风温身体灼热的，用知母葛根汤。风温口渴严重的，用栝楼根汤。风温脉浮，身体重、出汗的，用汉防己汤。
《活人书》说：初春时节患病，肌肉出现斑点和瘾疹，痕迹像锦缎花纹，或者咳嗽、心中闷胀但呕吐的，这名叫温毒。温毒发斑，是因为冬天时触冒寒毒，到春天才发作。病初起在表，症状像伤寒。或者已经经过发汗、催吐、攻下，但表证未解除，毒气不散，或者出现发斑，用黑膏主治。（如果已经形成疮疡的，按自身疮毒治疗，不可用黑膏。）又有冬天天气温暖，人感受了乖戾之气，冬天没有立即发病，到春天又被积寒所遏制，毒气不能宣泄，等到天气变暖炎热，温毒才开始发作，于是肌肉斑烂，瘾疹如锦纹，内攻导致心闷，只呕吐清汁，用葛根橘皮汤主治。郭雍说：不一定非要在初春或春夏季节才发斑，这与伤寒不同。那些瘾疹如锦纹但不形成疮疡溃烂的，就是此类。那些发疮脓液溃烂的，是实行的热毒豌豆疮（天花）。这两种病的初期症状，都有类似伤寒的表证。还有瘾疹有赤白两种，初期没有表证，突然感受温气而发作，其毒性轻浅，属于风尸之类。又有一种遍身如锦缎花纹，初期也没有表证，突然感受而发作，像丹毒又像疹子，其毒性也轻，这些都详见于《小儿疮疹后斑疮瘾疹论辨》中。
郭雍说：张仲景所说的风温和温毒两种病症，又与前人的说法不同。张仲景的话说：伤寒过了十三天以上，病情没有间断（持续加重），寸关尺脉象沉陷的，是大危之症。如果再感受异气，变成其他疾病的，应当根据后面的坏病症状来治疗。如果阳脉（寸脉）浮滑，阴脉（尺脉）濡弱的，是更兼受风邪，变成了风温；阳脉洪数，阴脉实大的，是更遇温热邪气，变成了温毒。温毒作为疾病最为严重，这乃是伤寒后的四种坏病之一，此病最为沉重。又不只是前面所说的那种风温温毒而已。其用药也应当不同。那么张仲景所言的，是伤寒坏病、中风、温毒等；各家所言的，是冬春季节自感的风温温毒。它们治疗的轻重程度，不得不有所差异。在四种坏病中，还有一种湿温病，见第八卷不可汗门中。
郭雍说：天行温疫，虽然症状不多，但用药也有很多种类。如《千金方》中说辟除温疫气的，以及断绝温疫传染的各种方剂，还有《千金翼方》中的弹鬼丸、神明白散、太乙流金散、萤火丸等方剂。前人虽然曾经选用，但有时也省略了，这里收集其遗漏遗逸的方剂加以使用。大抵治疗疫病尤其要先辨别寒温，然后用药，取法于阴阳表里在伤寒中的运用。所以庞安常又叙述他治疗寒疫的诸方，大概因为赤散、解圣散之类的方剂，都适宜治疗寒疫。如果施用于瘟疫（温疫），就会更加助热了。
The *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold) states: In the disease of Wind-Warmth (Fengwen, wind-heat syndrome), the pulse is floating at all three positions (Cun, Guan, Chi). There is sweating and heaviness of the body; respiration must be wheezy or panting. The physical condition presents with numbness or lack of sensation. The patient remains silent and desires sleep. If purgation (downward draining) is applied, urination will become difficult. If diaphoresis (sweating-inducing treatment) is applied, delirium will certainly occur. If burning needle therapy is added, deafness and difficulty in speech will result. If emesis (vomiting-inducing treatment) is applied alone, fecal incontinence will occur. For such diseases, Wei Rui Tang (Jade Bamboo Decoction) should be administered.
The *Huo Ren Shu* (Book to Save Lives) states: When the pulse is floating at both the Cun and Chi positions, accompanied by headache, fever, frequent spontaneous sweating, bodily heaviness, panting, flaccidity of the four limbs (inability to flex them), silence, and a desire to lie down, this is Wind-Warmth. The patient has previously been injured by wind pathogen, and subsequently injured by heat pathogen. Wind and heat contend with each other, resulting in Wind-Warmth. The main symptoms are flaccidity of the four limbs, headache, fever, and frequent spontaneous sweating that does not resolve. Treatment focuses on the Shaoyin (Lesser Yin) and Jueyin (Terminal Yin) channels. Sweating-inducing treatments must not be used. If sweating is induced, delirium will occur, along with muttering internally, irritability, restlessness, and inability to sleep. It may resemble convulsive disorders, with eyes wandering and lacking spirit. If the physician induces sweating again, causing death, it is the physician who kills the patient. The *Huo Ren Shu* further states: Wind-Warmth cannot be treated with sweating methods; Wei Rui Tang is suitable. For Wind-Warmth with burning heat, Zhi Mu Ge Gen Tang (Anemarrhena and Pueraria Decoction) is used. For Wind-Warmth with severe thirst, Gua Lou Gen Tang (Trichosanthes Root Decoction) is used. For Wind-Warmth with a floating pulse, heaviness, and sweating, Han Fang Ji Tang (Stephania Tetrandra Decoction) is used.
The *Huo Ren Shu* states: In early spring, if patients develop macules and papules on the skin resembling brocade patterns, or experience cough, chest oppression, and vomiting only, this is named Wen Du (Warm-Toxin). Warm-Toxin manifesting as macules arises because cold-toxin was contracted in winter but did not manifest until spring. Initially, the pathology is in the exterior, presenting like Taiyang Cold Damage (Shanghan). Or, after sweating, vomiting, or purging, the exterior syndrome has not resolved, and the toxic qi has not dispersed, leading to macules; Hei Gao (Black Plaster) is the primary treatment. (If sores have formed, treat as local carbuncles/sores; do not use Hei Gao.) Additionally, if winter weather is warm, people may contract aberrant qi. The disease does not manifest immediately in winter. By spring, if suppressed by accumulated cold, the toxic qi cannot vent. When the weather becomes hot, Warm-Toxin finally manifests, causing skin maceration, papules like brocade patterns, internal chest oppression, and vomiting clear fluid; Ge Gen Ju Pi Tang (Pueraria and Tangerine Peel Decoction) is the primary treatment. Guo Yong states: Macules do not necessarily appear only in early spring or summer; this differs from Cold Damage. These cases present with papules like brocade patterns but without ulceration. Cases with pus-filled ulcers are actually Smallpox (Tian Hua, infectious exanthem caused by heat-toxin). Both types initially present with exterior syndromes similar to Cold Damage. There are also red and white forms of papules that appear suddenly due to warm qi without initial exterior symptoms; their toxicity is mild, belonging to the category of Feng Shi (Wind Corpse). Another type presents with the whole body resembling brocade, appearing suddenly without initial exterior symptoms, looking like erysipelas or rashes; its toxicity is also mild. These are detailed in the discussion on macules and papules following pediatric exanthems.
Guo Yong states: Zhang Zhongjing’s description of Wind-Warmth and Warm-Toxin differs from the aforementioned views. Zhang Zhongjing said: If Cold Damage persists beyond thirteen days without remission, and the Cun and Chi pulses sink, it is a critical danger. If further exposure to different pathogens causes transformation into other diseases, one must treat according to the subsequent "Huai Bing" (ruined/deteriorated disease) protocols. If the Yang pulse (Cun) is floating and slippery, and the Yin pulse (Chi) is soggy and weak, it indicates an additional wind pathogen transforming into Wind-Warmth. If the Yang pulse is surging and rapid, and the Yin pulse is substantial and large, it indicates encountering warm-heat transforming into Warm-Toxin. Warm-Toxin is the most severe among these diseases. This constitutes one of the four types of Huai Bing following Cold Damage, which is extremely serious. It is not merely the Wind-Warmth and Warm-Toxin mentioned earlier. The medication must also differ. Thus, what Zhang Zhongjing refers to are Cold Damage Huai Bing, Wind Stroke, and Warm-Toxin; whereas what various schools refer to are Wind-Warmth and Warm-Toxin contracted spontaneously in winter and spring. The severity of treatment must therefore differ. Among the four Huai Bing, there is also a syndrome called Shi Wen (Damp-Warmth), found in Volume 8 under the section on non-sweating methods.
Guo Yong states: Tian Xing Wen Yi (Epidemic Warmth), although presenting with few symptoms, requires diverse medications. For example, the *Qianjin Fang* discusses formulas to ward off epidemic qi and prevent contagion, as well as formulas from the *Qianjin Yi Fang* such as Dan Gui Wan (Ghost-Bouncing Pill), Shen Ming Bai San (Divine Clarity White Powder), Tai Yi Liu Jin San (Great One Flowing Gold Powder), and Ying Huo Wan (Firefly Pill). Although predecessors selected some of these, many were omitted here; I have collected the遗逸 (lost/omitted) ones for use. Generally, treating epidemics requires first distinguishing between cold and warmth before prescribing, drawing upon the principles of Yin-Yang and Exterior-Interior in Cold Damage. Therefore, Pang Anchang described his formulas for treating Cold Epidemics (Han Yi). Formulas like Chi San (Red Powder) and Jie Sheng San (Savior-Resolving Powder) are suitable for Cold Epidemics. If applied to Warm Epidemics (Wen Yi), they would exacerbate the heat.