赵嗣真曰∶按仲景论，谓冬月冒寒，伏藏于肌肤而未即病，因春温气所变则为热。夫变者，改
易之义也。至此则伏寒各随春夏之气改变为温，为热。既变之后，不得复言其为寒也。所以仲景云
温病不恶寒者，其理可见矣。《活人书》发于温病曰阳热未盛，为寒所制。岂有伏寒既已变而为温，
尚可言寒能制其阳热邪？又于热病曰阳热已盛，寒不能制。亦不当复言其为寒也。盖是春夏阳热已
变，其伏寒即非有
寒能制其阳热尔。外有寒邪能折阳热者，乃是时行寒疾，仲景所谓春分以后，秋分节前，天有暴寒，
为时行寒疾是也。三月四月，其时阳气尚弱，为寒所折，病热则轻。五月六月，阳气已盛，为寒所
折，病热则重。七月八月，阳气已衰，为寒所折，病热亦微。是知时行寒疾与温热二病，所论阳气
盛衰，时月则同。至于论暴寒之寒，与伏寒已变之寒，自是相违。名不正则言不顺矣。仲景又云其
病与温及暑病相似，但治有殊耳，要在辩其病源。寒、热、温三者之殊，则用药之冷热判然矣。赵
氏为《活人书》释疑曰∶《活人书》之可疑者甚多，仲景论亦有可疑者。如白虎汤，仲景既云表不
解者不可与之，白虎加人参汤证，一曰恶风，一曰恶寒，岂非表不解而复用白虎何耶？盖恶风曰微，
则但见于背而不至甚于恶寒；曰时时，则时或乍寒而不常，是表证已轻，非若前证脉浮紧，发热无
汗全不解者。此则加之大热大渴，所以用白虎而无疑也。又曰∶仲景论太阳病，得之八九日，如疟
状，发热恶寒，热多寒少，其人不呕，清便欲自可，一日二三度发，脉微缓者，为欲愈；若脉微而
恶寒者，此阴阳俱虚，不可更发汗，更下，更吐也；面色反有赤色者，未欲解也，以
其不能得小汗出，其身必痒，宜桂枝麻黄各半汤。仲景之意，盖以得病之八九日，如疟状，发热恶
寒，热多寒少十六字为自初至今之证，下文乃是以后拟病防变之辞，当分三截看。若其人不呕，清
便欲自可，一日二三度发，脉浮缓，为欲愈。此一节，乃表和无病。而脉微者，邪气微缓也，阴阳
同等，脉证皆向安之兆，可不待汗而欲自愈。若脉微而恶寒者，此阴阳俱虚，不可更汗，更下，更
吐之。此一节，宜温之。若面色反有赤色者，未欲解也，以其不能得小汗出，其身必痒，宜桂枝麻
黄各半汤。此一节，必待汗而愈也。《活人书》不详文意，却将其人不呕，清便欲自可九字本是愈
之证，反以他证各半汤汗之。又将不可汗、吐、下证及各半汤证语句，并脱略而不言。取此证而用
彼药，汗其所不当汗，何也？若是，可见仲景文法多如此，学人必须反复详玩，熟观其意，其例自
见，则治不差。故赵氏嗣真曰∶仲景之书，一字不同，则治隔霄壤。读之者可不于片言只字以求其意欤。
赵嗣真说：考察张仲景的论述，认为冬季感受寒邪，潜伏在肌肤之间而没有立即发病，到了春季因温气的影响而转化为热证。所谓“变”，就是改变的意思。到了这个时候，潜伏的寒邪会随着春夏季的气候改变而转化为温病或热病。既然已经转化，就不能再称其为寒病了。所以张仲景说温病不恶寒，其中的道理就可以明白了。《活人书》在论述温病时说阳气热势尚未旺盛，被寒邪所制约。难道潜伏的寒邪既然已经转化为温病，还能说寒能制约其阳热吗？又在论述热病时说阳气热势已经旺盛，寒不能制约。也不应当再说它是寒病了。这是因为春夏季阳气热势已经转化，潜伏的寒邪就不再具有寒能制约阳热的性质了。另外有寒邪能够折损阳气热势的情况，那是时行寒疾，也就是张仲景所说的春分以后、秋分以前，天气突然寒冷，导致时行寒疾。三月四月，此时阳气尚弱，被寒邪折损，患病发热则较轻。五月六月，阳气已经旺盛，被寒邪折损，患病发热则较重。七月八月，阳气已经衰退，被寒邪折损，患病发热也轻微。由此可知，时行寒疾与温热两种疾病，所论述的阳气盛衰规律和月份是相同的。至于论述暴寒之寒与潜伏寒邪已转化之寒，自然是相互矛盾的。名分不正，言语就不顺当。张仲景又说这些病症与温病及暑病相似，但治疗方法不同，关键在于辨别疾病的根源。寒、热、温三者的区别，用药的冷与热就判然不同了。
赵氏为《活人书》解释疑惑说：《活人书》中可疑的地方很多，张仲景的论述也有可疑之处。比如白虎汤，张仲景既然说表证未解者不可使用，那么白虎加人参汤证中，一个说恶风，一个说恶寒，这难道不是表证未解却再次使用白虎汤吗？大概恶风程度轻微，只出现在背部且不至于比恶寒更严重；说是“时时”，则是时而发冷并非持续不断，这是表证已经减轻，不像前一种证候脉浮紧、发热无汗完全未解除那样。这种情况下加上大热大渴的症状，所以使用白虎汤就没有疑问了。又解释说：张仲景论述太阳病，得病八九日，像疟疾一样，发热恶寒，热多寒少，病人不呕吐，大小便基本正常，一天发作两三次，脉象微缓的，是想要痊愈；如果脉微且恶寒，这是阴阳俱虚，不可以再发汗、攻下或催吐；面色反而发红，说明病未解除，因为不能得到小汗出，身体必定发痒，适宜用桂枝麻黄各半汤。张仲景的本意，大概是把得病八九日、像疟疾一样、发热恶寒、热多寒少这十六个字作为从发病至今的证候，下文则是针对后续病情变化进行预防性描述的言辞，应当分三段来看。如果病人不呕吐，大小便基本正常，一天发作两三次，脉浮缓，是想要痊愈。这一段，是表气和顺无病。而脉微，是邪气微弱缓和，阴阳平衡，脉象和证候都是趋向安宁的征兆，可以不待发汗而自愈。如果脉微且恶寒，这是阴阳俱虚，不可以再发汗、攻下或催吐。这一段，适宜用温法。如果面色反而发红，说明病未解除，因为不能得到小汗出，身体必定发痒，适宜用桂枝麻黄各半汤。这一段，必须通过发汗才能痊愈。《活人书》没有详细理解文意，反而将“不呕吐，大小便基本正常”这九个字本是欲愈的证候，错误地用其他证候配合各半汤来发汗。又将不可汗、吐、下的证候和各半汤证的语句，一并省略而不提及。取这个证候却用那个药，发了不该发的汗，为什么呢？如果是这样，可见张仲景的文章写法大多如此，学习者必须反复仔细研读，熟看其用意，其体例自然显现，治疗就不会出差错。所以赵氏嗣真说：张仲景的书，一个字不同，治疗效果就相差如天地之别。读书的人能不在一言半语中探求其深意吗？
Zhao Sizhen stated: Examining Zhang Zhongjing's treatise, it is said that in winter, one catches cold pathogens which lie dormant in the skin and muscles without causing immediate illness. Due to the warming qi of spring, this transforms into a heat syndrome. The term "transform" (bian) implies alteration. At this stage, the latent cold pathogens change according to the spring and summer qi into warm diseases or heat diseases. Once transformed, they can no longer be referred to as cold diseases. Thus, Zhang Zhongjing's statement that warm diseases do not present aversion to cold becomes understandable. *The Book of Vitality* (Ren Shu), when discussing warm diseases, states that yang-heat is not yet abundant and is constrained by cold. How could it be said that if latent cold has already transformed into warmth, cold can still constrain its yang-heat? Furthermore, in discussing heat diseases, it states that yang-heat is already abundant and cannot be constrained by cold. It should not be described as a cold disease again. This is because during spring and summer, the yang-heat has already transformed, and the latent cold no longer possesses the property of constraining yang-heat.
However, there are cases where external cold pathogens can suppress yang-heat; these are termed epidemic cold diseases (Shi Xing Han Ji). This refers to what Zhang Zhongjing called epidemic cold diseases occurring after the Spring Equinox and before the Autumn Equinox, caused by sudden cold weather. In the third and fourth months, when yang qi is still weak, suppression by cold results in milder heat symptoms. In the fifth and sixth months, when yang qi is abundant, suppression by cold results in more severe heat symptoms. In the seventh and eighth months, when yang qi is declining, suppression by cold results in slight heat symptoms. Therefore, it is known that the discussion on the waxing and waning of yang qi applies similarly to both epidemic cold diseases and warm/heat diseases. However, the nature of sudden cold (Bao Han) differs fundamentally from the nature of latent cold that has already transformed. If names are not correct, words are not in order. Zhang Zhongjing also stated that these diseases resemble warm diseases and summerheat diseases, but their treatments differ significantly; the key lies in distinguishing the disease origin. The distinctions among cold, heat, and warm dictate clearly whether the medication used should be cooling or warming.
Mr. Zhao explained doubts regarding *The Book of Vitality*: There are many questionable points in *The Book of Vitality*, and even some in Zhang Zhongjing's treatise. For instance, regarding Baihu Tang (White Tiger Decoction), Zhang Zhongjing explicitly stated it should not be used if the exterior syndrome is unresolved. Yet, in the syndrome for Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng), one text mentions aversion to wind, while another mentions aversion to cold. Does this not imply using Baihu Tang despite an unresolved exterior? Generally, aversion to wind is mild, appearing only on the back and not as severe as aversion to cold; "occasional" chills mean they come and go intermittently, indicating the exterior syndrome has lightened, unlike the previous syndrome with floating-tight pulse, fever, and absence of sweating which remained completely unresolved. In such cases, accompanied by high fever and intense thirst, the use of Baihu Tang is unquestionable.
He further explained: Regarding Zhang Zhongjing's discussion on Taiyang Disease (Taiyang Bing), after eight or nine days, presenting like malaria with fever and aversion to cold, where heat predominates over cold, the patient does not vomit, bowel movements and urination are relatively normal, attacks occur two or three times a day, and the pulse is slightly slow, this indicates impending recovery. If the pulse is faint and there is aversion to cold, this indicates deficiency of both yin and yang, and one must not induce sweating, purge, or emetic therapy. If the face appears reddish, the disease is not resolving because small amounts of sweat cannot be produced, leading to body itching; Guizhi Mahuang Ge Ban Tang (Cinnamon Twig and Ephedra Half-Dose Decoction) is appropriate. Zhang Zhongjing's intent was likely to treat the sixteen characters—"eight or nine days, like malaria, fever and aversion to cold, heat more than cold"—as the cumulative syndrome from onset to now. The following text serves as preventive advice for potential changes, which should be read in three parts.
If the patient does not vomit, bowel movements and urination are normal, attacks occur two or three times a day, and the pulse is floating and slow, it indicates impending recovery. This section signifies harmonious exterior with no pathogenic disturbance. A faint pulse here means the pathogen is weakening and slowing down; yin and yang are balanced, and both pulse and symptoms show signs of approaching peace, suggesting spontaneous recovery without inducing sweat. If the pulse is faint and there is aversion to cold, this indicates deficiency of both yin and yang, precluding sweating, purging, or emesis. This section requires warming treatment. If the face is reddish, indicating non-resolution due to inability to produce sweat and resulting body itching, Guizhi Mahuang Ge Ban Tang is indicated. This section requires sweating for recovery.
*The Book of Vitality* failed to comprehend the textual meaning, mistakenly treating the nine characters "no vomiting, normal bowel and urinary functions"—which originally indicated recovery—as a syndrome requiring the half-dose decoction for sweating. It omitted the statements regarding contraindications for sweating, emesis, and purging, as well as the indications for the half-dose decoction. Applying the wrong medicine to this syndrome and inducing sweat inappropriately, why would one do so? This demonstrates that Zhang Zhongjing's writing style often follows such patterns. Students must repeatedly study carefully, familiarize themselves with the underlying intent, and the principles will become clear, ensuring accurate treatment. Thus, Zhao Sizhen remarked: In Zhang Zhongjing's works, a difference of one character leads to a therapeutic outcome as different as heaven and earth. Must readers not seek the meaning within every word and phrase?