治时行瘟疫。壮热恶风。头痛体疼。鼻塞咽干。咳嗽。涕唾稠粘。
柴胡（去苗） 干葛 荆芥（去梗） 赤芍药 石膏（各一钱半） 前胡（去苗） 升麻 桑白皮 黄芩（各一钱）
上作一服。水二钟。生姜三片。豆豉二十粒。煎至一钟。不拘时服。
琥按上方。乃治少阳阳明病温。兼散手太阴风热之剂。
或问。赵氏医贯治温病。谓温病不恶寒。则知其表无寒邪矣。曰渴。则知其肾水干枯矣盖缘其人素有火者。冬时寒
气虽伤。不能深入。藏于肌肤历时既久。火为寒郁于中。将肾水熬煎枯竭甲。阳木也。藉癸水而生。肾水既枯。至春。
时强木旺。无以为发生之本。故发热而渴。余以六味地黄丸滋其水。以柴胡辛凉之药。舒其木郁。随手而应。其说是邪。
非邪。余答云。此其说虽发明温病之源。实推展李东垣之意。然六味地黄丸料煎汤。岂治温病之药邪。此为乡愿乱德。
其说似是而非者也。或又问云。然则治温病之方。将何药以滋肾水邪。余又答云。肾水枯当急救肺金。金清。则水自滋。
温为春令。春木胜。则病温。金清则旺。而风木之邪自平。以上诸方中药。如葳蕤白薇石膏知母茅根栝蒌根。谓非色白
入肺。清凉助金之药乎。况温病发热而渴。火郁之气盛也。火盛。必先烁金。所以古方治阳明病温。实清肺之药居多。
清肺金者。滋肾水也。且热渴已极。先治其标。赵氏反用六味丸料。以益水之源。是为迂。而不切于病情者也。犹云活
人甚众。吾不信矣。
或问。庞安时论温病。有四时自受乖气。而成腑脏阴阳温毒者。则春有青筋牵。夏有赤脉KT 秋。有白气狸。（音
郁与郁同）冬有黑骨温。四季有黄肉随证别。五脏各有方治。其说然欤。余答云。素问但言冬伤于寒。春必病温。又仲
景伤寒例云。其冬有非节之暖者。名曰冬温。其于夏秋二时。未闻有所谓温病也。今庞氏于四时之月。创造五色奇证。
以骇人心目。近今以来。未见有人得此等病者。所以花溪虞氏特起而议之。至今总论一书。亦渐淹没而不传也。
（琥）总按上温病方论一卷。乃春时感温气而成病。即内经所云。先夏至为病温者是也。病源千金外台等书。皆以
温病为温疫。云此病因岁时不和。温凉失节。人感乖戾之气而生病。病气转相染易。乃至灭门。延及外人。无收视者。
此系大瘟大疫。如东垣用普济饮子。治大头伤寒者是。非仲景论中所云温病也。温病间或。相染。不至灭门绝户。恐俗
医不知而互相错认。故于卷后并及之云。
【准绳】柴胡升麻汤
治疗时行瘟疫。高热，怕风。头痛，身体疼痛。鼻塞，咽喉干燥。咳嗽。鼻涕和唾沫稠厚粘稠。
柴胡（去苗） 干葛 荆芥（去梗） 赤芍药 石膏（各一钱半） 前胡（去苗） 升麻 桑白皮 黄芩（各一钱）
以上药物作为一剂服用。加水二钟，生姜三片，豆豉二十粒，煎煮至一钟。不拘泥于特定时间服用。
琥按：上述方剂，是治疗少阳阳明病温（温热性质的疾病），兼有疏散手太阴肺经风热作用的方剂。
有人问：赵氏《医贯》治疗温病，认为温病不恶寒，就知道体表没有寒邪了；说口渴，就知道肾水干枯了。大概是因为这个人素来体内有火，冬季寒气虽然侵袭，但不能深入，潜伏在肌肤之间，历时既久，火被寒邪郁结在体内，煎熬肾水使其枯竭。甲木（肝）也，依靠癸水（肾水）而生，肾水既然枯竭，到了春季，时令强盛之木气旺盛，没有作为生发的根本，所以发热而口渴。我用六味地黄丸滋养其水，用柴胡等辛凉的药物，舒展其木气的郁结，随手见效。这种说法对吗？不对吗？我回答说：这种说法虽然阐明了温病的源头，实际上是推展李东垣的意思。然而，用六味地黄丸的药材煎汤，难道是治疗温病的药物吗？这是乡愿式的乱德行为，这种说法似是而非。又有人问：那么治疗温病的方子，将用什么药来滋补肾水呢？我又回答说：肾水枯竭应当急救肺金，肺金清肃，则肾水自然滋生。温病属于春令，春木胜则病温，肺金清肃则旺盛，而风木之邪自然平息。以上诸方中的药物，如葳蕤、白薇、石膏、知母、茅根、栝蒌根，难道不是色白入肺、清凉助金的药物吗？况且温病发热而口渴，是火郁之气盛的表现。火气盛，必定先灼伤肺金，所以古方治疗阳明病温，实际上清肺的药物居多。清肺金，就是滋肾水。而且热渴已经极重，先治其标症。赵氏反而用六味地黄丸的药材，来益水之源，这是迂腐而不切实际的病情判断。还说救活的人很多，我不相信了。
有人问：庞安时论温病，有四时自受乖戾之气，而成腑脏阴阳温毒的说法，则春季有青筋牵，夏季有赤脉KT（音同“郁”与“郁”相同），秋季有白气狸，冬季有黑骨温，四季有黄肉，随证辨别，五脏各有方治。这种说法对吗？我回答说：《素问》只说冬伤于寒，春必病温。又《伤寒例》说，如果冬天有不正常的温暖，名叫冬温。对于夏秋两季，没听说过有所谓的温病。现在庞氏在四个月的月份里，创造五色奇证，用来惊骇人心目。近来以来，没见到有人得这种病。所以花溪虞氏特别起来议论它。至今总论一书，也逐渐淹没而不流传了。
（琥）总按：上面温病方论一卷，乃是春季感受温气而成病，即《内经》所说的，夏至之前发病的叫温病。《病源》《千金》《外台》等书，都把温病当作温疫，说这个病因岁时不和，温凉失节，人感受乖戾之气而生病。病气转相传染，甚至灭门，延及外人，没有能收摄视线的（指无法阻挡）。这是大瘟大疫，如东垣用普济消毒饮子，治疗大头伤寒的是。不是仲景论述中所说的温病。温病偶尔互相传染，不至于灭门绝户。恐怕俗医不知道而互相错认，所以在卷后一并提及。
[Zhunsheng] Chaihu Shengma Decoction
Treats epidemic plague. High fever, aversion to wind. Headache, body pain. Nasal congestion, dry throat. Cough. Thick and sticky nasal discharge and sputum.
Chai Hu (Bupleuri Radix, removed sprouts) Gan Ge (Puerariae Lobatae Radix) Jing Jie (Schizonepetae Spica, removed stems) Chi Shao Yao (Paeoniae Radix Rubra) Shi Gao (Gypsum Fibrosum) [each 1 qian] Qian Hu (Peucedani Radix, removed sprouts) Sheng Ma (Cimicifugae Rhizoma) Sang Bai Pi (Mori Cortex) Huang Qin (Scutellariae Radix) [each 1 qian]
Take the above as one dose. Add water two zhong, three slices of fresh ginger, twenty grains of fermented soybean. Decoct until one zhong remains. Take at any time without restriction.
Hu notes: The above formula is a preparation for treating Shaoyang-Yangming Warm Disease (warm-heat type illness), with the additional function of dispersing Wind-Heat from the Hand-Taiyin Lung Meridian.
A question arises: Zhao's *Yi Guan* treats Warm Disease, stating that since Warm Disease does not involve aversion to cold, it is known that there is no Cold pathogen on the exterior; if there is thirst, it is known that Kidney Water is dried up. This is likely because the person inherently has internal Fire. Although Winter Cold Qi invades, it cannot penetrate deeply but stays in the skin and muscles. After a long time, Fire is constrained by Cold within, boiling and depleting Kidney Water. Jia Wood (Liver) relies on Gui Water (Kidney Water) for growth. Once Kidney Water is depleted, when Spring arrives, the strong Wood Qi of the season becomes excessive, lacking the root for generation, thus causing fever and thirst. I use Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) to nourish its Water, and use Chai Hu and other acrid-cool medicines to soothe the stagnation of Wood Qi, achieving immediate results. Is this theory correct? Incorrect? I reply: Although this theory elucidates the origin of Warm Disease, it actually extends the ideas of Li Dongyuan. However, decocting the ingredients of Liu Wei Di Huang Wan—is this really medicine for treating Warm Disease? This is the conduct of a hypocrite, a theory that seems plausible but is incorrect. Another asks: Then, what medicine should be used in formulas for treating Warm Disease to nourish Kidney Water? I reply again: When Kidney Water is depleted, one must urgently rescue Lung Metal. If Lung Metal is clear, Water will naturally nourish itself. Warm Disease belongs to the Spring season; when Spring Wood prevails, Warm Disease occurs. If Lung Metal is clear and prosperous, the Wind-Wood pathogen will naturally subside. Among the medicines in the aforementioned formulas, such as Yu Zhu (Polygonati Odorati Rhizoma), Bai Wei (Cynanchi Atrati Radix), Shi Gao (Gypsum Fibrosum), Zhi Mu (Anemarrhenae Rhizoma), Mao Gen (Imperatae Rhizoma), Gua Lou Gen (Trichosanthis Radix)—are they not white-colored herbs entering the Lung, cooling and assisting Metal? Moreover, Warm Disease presents with fever and thirst, indicating abundant Qi of constrained Fire. When Fire is excessive, it first scorches Lung Metal. Therefore, ancient formulas for treating Yangming Warm Disease mostly contain herbs that clear the Lung. Clearing Lung Metal is equivalent to nourishing Kidney Water. Furthermore, when heat and thirst are extreme, one should treat the branch symptoms first. Zhao instead uses the ingredients of Liu Wei Di Huang Wan to benefit the source of Water, which is pedantic and irrelevant to the actual condition. He claims many have been saved; I do not believe it.
Another asks: Pang Anshi discusses Warm Disease, mentioning that receiving aberrant Qi in the four seasons can lead to Fu-Zang Yin-Yang Wen Du (Warm Toxin). Thus, in Spring there is "Green Sinew Pull," in Summer "Red Pulse KT" (pronounced 'Yu', same as Yu), in Autumn "White Qi Li," in Winter "Black Bone Warmth," and in the four seasons "Yellow Flesh." Differentiating by symptoms, each Zang organ has its own prescription. Is this theory correct? I reply: *Su Wen* only states that injury to Cold in Winter leads to Warm Disease in Spring. Also, Zhang Zhongjing's *Shanghan Li* says that abnormal warmth in winter is named Winter Warmth. Regarding Summer and Autumn, no so-called Warm Disease has been heard of. Now Pang creates five-color strange syndromes for the four seasons to shock people's minds and eyes. Recently, no one has been seen suffering from such diseases. Therefore, Yu from Huaxi specifically rose to debate it. To date, his general treatise has gradually become submerged and untransmitted.
(Hu) General Summary: The volume of Warm Disease formulas above refers to illness caused by contracting Warm Qi in Spring, which corresponds to the *Neijing*'s statement that illness occurring before the Summer Solstice is called Warm Disease. *Bing Yuan*, *Qian Jin*, *Wai Tai*, and other books all equate Warm Disease with Warm Epidemic, stating that this disease arises from disharmony of the seasons, irregularities in warmth and coolness, where humans contract aberrant Qi and become ill. The pathogenic Qi transmits through contact, even leading to the extinction of families and affecting outsiders, unstoppable. This constitutes a major plague/epidemic, such as using Pu Ji Xiao Du Yin Zi (Great Relief Detoxification Decoction) to treat Da Tou Shang Han (Big Head Cold) as used by Dongyuan. This is not the Warm Disease discussed in Zhongjing's treatises. Warm Disease occasionally spreads through contact but does not lead to family extinction. Fearing that vulgar physicians might not know and confuse them, I mention this at the end of the volume.