伤寒温病各不同气素问生气通天论阴阳之要阳密乃固阳强不能密阴气乃绝因于露风乃生寒热是以冬伤于寒春必病温
金匮真言论精者身之本也故藏于精者春不病温冬伤于寒即冬不藏精之变文也阳生于春而长于夏收于秋而藏于冬冬时地下
之温暖者阳气之密藏也人于此际宜顺天时以藏阳气蛰藏者肾精之职精密则阳藏矣冬不藏精阳气疏泄天当极寒之际人行盛
暑之令相火炎蒸精液消亡是谓冬伤于寒此缘冬时肾精不秘阳飞火腾伤其寒水蛰藏之令气非感冒寒邪冬时不病也一交春夏
木火司气内热愈增偶因风露侵伤郁其内热则为温病（春为温病夏为热病时令不同名目虽殊实一证也）病因外感而根原内
伤感在经络而伤在脏腑故病传三阳即内连三阳之腑病传三阴即内连三阴之脏在脏在腑但热无寒以其原有内热因表郁而里
发也六日经尽则脏腑经络表里皆热故曰三阴三阳五脏六腑皆受病也（素问热论语）伤寒中风本无内热但因风寒外感而发
病在经络不在脏腑阳盛而后传阳明之腑阴盛而后传太阴之脏其视温病之热自内发者不同而病传阳腑则为热病入阴脏则为
寒（名曰病入实里气之自病也）其视温病之表里皆热者亦不同也叔和混热病于伤寒（叔和叙例引热病之文以释伤寒寒热
病论）遂致后来传经为热之讹注伤寒者数十百家无不背仲景而遵叔和一论之误遗祸千古此虽叔和之谬而实后人之愚仲景
伤寒昭如日星后人一字不解无怪其狐惑于邪说也（仲景而后医法失传非第伤寒杂病亦尔祖派已讹孙支愈缪庸妄接踵不可
胜数也）
伤寒与温病，各自禀受的气机素来不同。《素问·生气通天论》指出：“阴阳的关键在于阳气致密则阴精固守；若阳气亢盛而不能致密，阴气就会枯竭。”又因暴露于风邪，所以产生寒热病症。因此，冬天感受寒邪，春天必定发生温病。
《金匮真言论》说：“精气是身体的根本。”所以，冬季能固藏精气的人，春天就不会患温病。“冬天感受寒邪”这句话，其实是“冬天不能固藏精气”的另一种表述。阳气在春季生发，在夏季生长，在秋季收敛，在冬季闭藏。冬季地下之所以温暖，是因为阳气在深处严密地闭藏着。人在这个时候应当顺应天时，以闭藏阳气。蛰伏闭藏是肾精的职责，精密闭藏才能使阳气潜藏。如果冬天不能固藏精气，阳气就会疏泄外越。此时正值天地极寒之际，人体却如同行走在盛夏的命令之下，相火炎上蒸腾，导致精液消亡，这就叫做“冬天感受寒邪”。这并非因为冬天时肾精不固秘、阳气飞越、火热腾升而损伤了寒水蛰藏的时令之气，也不是因为感冒了寒邪而在冬天发病。一旦进入春夏季节，木火当令，体内的内热更加增加，偶然因为风露侵袭损伤，郁遏住体内的内热，从而形成温病（春天称为温病，夏天称为热病，虽然时令不同、名称各异，但实际上是同一种证候）。病因虽然是外感引发，但根源在于内伤。病邪伤害经络，实则伤害脏腑。所以病邪传入三阳经，就是内连三阳之腑；病邪传入三阴经，就是内连三阴之脏。病位在脏或在腑，只有发热而没有恶寒，这是因为原本体内就有内热，因为表气郁闭而导致里热发越出来。六天经脉之气运行完毕，则脏腑经络的表里都受热邪影响，所以说“三阴三阳、五脏六腑都受到病邪侵害”（出自《素问·热论》）。
伤寒和中风本来没有内热，只是由于风寒外感而发病，病位在经络而不在脏腑。阳气偏盛后才会传入阳明之腑，阴气偏盛后才会传入太阴之脏。这与温病的热邪从内部发出来的情况不同。病邪传入阳腑则表现为热病，传入阴脏则表现为寒病（名为病入实里，是气机自身的病变）。这与温病表里皆热的情况也是不同的。王叔和将热病混同于伤寒（王叔和在《叙例》中引用关于热病的文章来解释伤寒，著有《寒热病论》），于是导致后世出现“传经变为热病”的错误观点。注释《伤寒论》的有几十家，无不背离张仲景的原意而遵循王叔和的理论。这一理论的错误遗祸千古。这虽然是王叔和的谬误，但实际上也是后人的愚昧。张仲景的《伤寒论》清晰如日月星辰，后人却一个字也不理解，难怪他们会被邪说所迷惑。（自张仲景之后，医法失传，不仅仅是《伤寒杂病论》，祖辈的流派已经讹误，子孙分支更加荒谬，庸俗狂妄之人接踵而至，数不胜数。）
Cold damage (Shanghan) and warm disease (Wenbing) originate from different qi natures. *Suwen: Shengqi Tongtian Lun* states: "The key to yin and yang is that when yang is dense, it secures; if yang becomes excessive and cannot be dense, yin qi will perish." Exposure to wind leads to cold-heat disorders. Therefore, injury by cold in winter results in warm disease in spring.
*Jingui Zhenyan Lun* says: "Essence (Jing) is the root of the body." Thus, those who store essence well in winter do not suffer from warm disease in spring. "Injury by cold in winter" is a variant expression for "failure to store essence in winter." Yang qi generates in spring, grows in summer, harvests in autumn, and stores in winter. The warmth underground during winter is due to the dense storage of yang qi. At this time, humans should follow the natural timing to store yang qi. Hibernation and storage are the functions of kidney essence (Shen Jing); precise storage allows yang qi to remain hidden. If essence is not stored in winter, yang qi leaks out. Although heaven experiences extreme cold, the human body acts under the command of midsummer heat, with ministerial fire (Xiang Huo) blazing and evaporating, causing the consumption of essence fluids. This is termed "injury by cold in winter." This is not because kidney essence failed to secure itself in winter, causing flying yang and soaring fire to injure the cold-water hibernating command, nor is it because catching cold pathogens causes disease in winter. Once entering spring and summer, when wood and fire govern the qi, internal heat increases further. Occasionally, invasion by wind and dew damages the body, stagnating the internal heat, thereby forming warm disease (called warm disease in spring, hot disease in summer; although seasons and names differ, the syndrome is essentially the same). The etiology involves external contraction but originates from internal injury. Pathogens affect meridians but ultimately injure zang-fu organs. When pathogens transmit to the three yang channels, they connect internally to the three yang fu organs; when transmitting to the three yin channels, they connect internally to the three yin zang organs. Whether in zang or fu, there is only heat without chills, because there was originally internal heat which, due to exterior stagnation, erupts from the interior. After six days, completing the meridian cycle, both zang-fu organs and meridians, interior and exterior, are affected by heat. Thus, it is said that "the three yin and three yang, five zang and six fu organs all receive disease" (*Suwen: Relun*).
Cold damage (Shanghan) and wind strike (Zhongfeng) originally lack internal heat; they arise solely from external contraction of wind-cold, affecting meridians rather than zang-fu organs. Excess yang transmits later to the fu organ of Yangming; excess yin transmits later to the zang organ of Taiyin. This differs from warm disease where heat erupts from within. Transmission to yang fu organs results in hot diseases; transmission to yin zang organs results in cold conditions (termed 'disease entering solid interior,' a self-disease of qi). This also differs from warm disease where both exterior and interior are hot. Wang Shuhe confused hot disease with cold damage (citing texts on hot disease to explain cold damage in his *Xu Li*, author of *Hanre Bing Lun*), leading to the erroneous view among later generations that transmitted stages become hot diseases. Dozens of commentators on *Shanghan* deviated from Zhang Zhongjing's original intent, following Wang Shuhe's theory. This theoretical error has caused disaster for millennia. Although this is Wang Shuhe's fallacy, it is also the ignorance of later generations. Zhang Zhongjing's *Shanghan Lun* is as clear as the sun and stars, yet later generations did not understand a single word, no wonder they were bewildered by false doctrines. (After Zhang Zhongjing, medical methods were lost; not only *Shanghan Zabing Lun*, but ancestral lineages became erroneous, and descendant branches even more absurd. Vulgar and妄 (arbitrary) practitioners followed one after another, innumerable.)