（论文已见首篇总例）
（冬为伤寒 春为温病 夏为暑病 秋为疟 一岁长幼病相似为疫 多眠多汗脉浮为风温 一身尽痛为湿 身反张为痉）
吴 夫伤寒之病自霜降之后天令大寒而感之者乃伤寒也若天令温暖而感之者为冬温也如至春天令温暖有人壮热为
病者乃温病也若天令尚寒冰雪未解而感寒者亦曰伤寒也若三月至七八月之间天道忽有暴寒而感之者此名时行寒疫也若
夏至后壮热脉洪者谓之热病也如四时天令不正感而为病长幼相似互相传染者谓之时行之气也夫时气者一曰时疫盖受天
地疫疠之气而为病乃非寒也又有温疟风温温毒温疫中风伤风中湿风湿中暑中 湿温等证一皆发热状似伤寒故医家通以
伤寒称之者为发热传变皆相类也至于用药则不同矣但发表解肌有差别尔盖冬月伤寒者人之着寒而即病也若不即病至春
变为温病至夏变为热病温病热病乃因伏寒为变既变不得复言其寒矣其寒疫乃天时之暴寒与冬时之严寒又有轻重之不同
时气自是天行疫疠之气又非寒比也温病乃山泽蒸气暑病乃炎日之火风乃天之贼邪伤于人者也有中者为重伤者为轻温疟
风温等病又是伤寒坏证更感异气所变各有其因不同岂可通以伤寒称而治之如不识其名妄行治疗本中暑作热病治之湿温
作风温治之虚实混淆是非紊乱夭人天年可不慎哉
凡四时伤寒通宜补散故丹溪治伤寒多用补中益气汤气虚者四君子汤加发散剂血虚者四物汤加发散剂东垣 治风湿用
补中益气加羌活防风升麻 本苍术海藏治风湿无汗者用神术汤有汗者用白术汤治刚痉用神术汤加羌活麻黄治柔痉用白
术汤加桂心 术治风湿用白术汤随证加药治中 脉弦细芤迟者用黄 汤此皆与仲景所谓辛苦之人触冒之病伤寒同意也
丹 仲景论伤寒而未及乎中寒先哲治冒大寒昏中者用附子理中汤其议药则得之矣曰伤曰中未有议其异同者夫伤寒
有即病有不即病因其旧有郁热风寒外束肌腠自密郁发为热病邪循经而入由渐而深初用麻黄桂枝等微表而安以病体不甚
虚也若中寒则仓卒感受其病即发而暴因其腠理疏豁一身受邪难分经终无热可发温补自解此气大虚不急治则死矣伤风伤
暑伤湿亦如伤寒之渐入也中风中暑中湿亦如中寒之暴受也除伤寒外杂病之治可一隅反之矣
（相关论述已见于本书首篇的总例中）
（冬季感受寒邪称为伤寒，春季感受温邪称为温病，夏季感受暑邪称为暑病，秋季发作疟疾称为疟疾，一年内无论老少患病症状相似者称为疫病；嗜睡、多汗、脉浮称为风温；全身疼痛称为湿病；身体反张抽搐称为痉病。）
吴崑说：伤寒之病，是在霜降之后，天气大寒时感受寒邪而立即发病的，这才叫伤寒。如果天气温暖时感受邪气而发病的，叫做冬温。到了春天，天气温暖，有人出现高热而发病的，这是温病。如果天气仍然寒冷，冰雪未融化时感受寒邪的，也叫做伤寒。如果在三月到七八月之间，天道突然有暴寒，人感受此寒邪而发病的，这叫时行寒疫。如果在夏至之后，出现高热、脉象洪大的，叫做热病。如果四季气候失常，人感受邪气而发病，且老少症状相似、互相传染的，叫做时行之气。所谓时气，也叫时疫，是因为接受了天地间的疫疠之气而致病，这并非寒邪所致。又有温疟、风温、温毒、温疫、中风、伤风、中湿、风湿、中暑、中湿温等证候，这些都表现为发热，症状类似伤寒，所以医家通称它们为“伤寒”，是因为它们的发热和传变过程都相似。但是用药则不同，只是在发表解肌的方法上有差别罢了。
冬天的伤寒，是人受寒后立即发病的。如果不立即发病，到了春天就变为温病，到了夏天就变为热病。温病和热病是由于伏藏的寒邪发生变化所致，一旦变化，就不能再说它是寒邪了。寒疫是天气的暴寒与冬季的严寒相比，又有轻重的不同。时气自然是天行流行的疫疠之气，又不同于寒邪。温病是由于山泽间的蒸气，暑病是由于烈日下的火风，这些都是天之贼邪伤害人体。有中于重者和中于轻者之分。温疟、风温等疾病，又是伤寒误治后的坏证，再次感受异气所变，各有其不同的病因，怎么能通统以伤寒称呼并治疗呢？如果不认识这些名称，妄行治疗，把中暑当作热病治，把湿温当作风温治，虚实混淆，是非紊乱，折损人的寿命，能不谨慎吗？
凡是四时的伤寒，通常适宜用补益兼发散的方法治疗。所以朱丹溪治疗伤寒多用补中益气汤，气虚者用四君子汤加发散药，血虚者用四物汤加发散药。李东垣治疗风湿用补中益气汤加羌活、防风、升麻、本苍术。王海藏治疗风湿无汗的用神术汤，有汗的用白术汤；治疗刚痉用神术汤加羌活、麻黄；治疗柔痉用白术汤加桂心、白术；治疗风湿用白术汤随证加减药物；治疗中湿脉象弦细芤迟的用黄芪汤。这些都与张仲景所说的辛苦之人触冒邪气所患的伤寒道理相同。
张仲景论述伤寒，但未涉及中寒。先贤治疗因冒犯大寒而昏厥的中寒患者，使用附子理中汤，他们在议药方面是正确的。但是关于“伤”和“中”是否有区别，前人没有讨论过。伤寒有即病的，也有不即病的。因为体内原有郁热，风寒外束肌腠，使毛孔闭塞，郁积而发为热病，邪气循经而入，由浅入深。初起用麻黄、桂枝等轻微发汗即可安愈，因为此时病体不甚虚弱。如果是中寒，则是仓促感受寒邪，病立即发作且猛烈，因为腠理疏豁，一身受邪，难以分经，最终无法发热，必须用温补法才能解除。这是因为正气大虚，如果不急治就会死亡。伤风、伤暑、伤湿也像伤寒一样逐渐深入。中风、中暑、中湿也像中寒一样暴烈受邪。除了伤寒之外，其他杂病的治疗也可以由此举一反三了。
(The relevant discussions can be found in the general examples at the beginning of this book.)
(Winter cold damage is called Shanghan (Cold Damage); spring warm disease is called Wenbing (Warm Disease); summer heat disease is called Shubing (Summer Heat Disease); autumn malaria is called Nue (Malaria); when people of all ages suffer from similar illnesses within a year, it is called Yi (Epidemic); excessive sleepiness, profuse sweating, and floating pulse are called Fengwen (Wind-Warmth); whole-body pain is called Shi (Dampness); body opisthotonos is called Jing (Spasm).)
Wu Kun stated: The disease of Shanghan (Cold Damage) occurs when one contracts cold pathogenic factors immediately after the Frost Descent solar term due to severe cold weather; this is truly Shanghan. If one contracts pathogens during warm weather, it is called Dongwen (Winter Warmth). When spring arrives and the weather is warm, if someone suffers from high fever, this is Wenbing (Warm Disease). If the weather remains cold with ice and snow unmelting, and one contracts cold, it is also termed Shanghan. Between the third month and July or August, if there is a sudden cold snap and one contracts it, this is named Shixing Hanyi (Seasonal Cold Epidemic). After the Summer Solstice, if one presents with high fever and a surging pulse, it is called Rebing (Heat Disease). If the climate of the four seasons is abnormal, causing illness that spreads among people of all ages similarly, it is called Shixing Zhiqi (Seasonal Pathogenic Qi). This "Shixing" is also known as Shiyi (Seasonal Epidemic), caused by contracting epidemic pestilential qi from heaven and earth, which is not cold in nature. There are also conditions such as Wen Nue (Warm Malaria), Fengwen (Wind-Warmth), Wendu (Warm Toxin), Wenyi (Warm Epidemic), Zhongfeng (Stroke/Attack by Wind), Shangfeng (Injury by Wind), Zhongshi (Attack by Dampness), Fengshi (Wind-Dampness), Zhongshu (Attack by Summer Heat), and Zhong Wenwen (Attack by Warm-Dampness). All these present with fever and resemble Shanghan; thus, physicians generally refer to them as Shanghan because their fever and progression are similar. However, the medication differs, specifically in the methods of releasing the exterior and resolving the muscle layer.
Shanghan in winter refers to illness occurring immediately upon exposure to cold. If it does not occur immediately, it transforms into Wenbing in spring and Rebing in summer. Wenbing and Rebing result from latent cold transforming; once transformed, it can no longer be considered cold. Shixing Hanyi involves sudden cold weather compared to the severe cold of winter, differing in severity. Shixing Zhiqi is naturally the epidemic qi circulating in the heavens and earth, distinct from cold. Wenbing arises from vapors of mountains and marshes; Shubing arises from the fire-wind of scorching suns; these are "thieves of heaven" harming humans. Some cases are severe, others mild. Wen Nue and Fengwen are often complications (Huai Zheng) of mismanaged Shanghan, changed by contracting different pathogens, each having distinct causes. How can they all be indiscriminately treated as Shanghan? If one fails to recognize these names and treats blindly—for example, treating Zhongshu (Summer Heat Attack) as Rebing, or Zhong Wenwen as Fengwen—one confuses deficiency and excess, creating chaos and shortening life. Must one not be cautious?
Generally, for Shanghan in the four seasons, supplementation combined with dispersal is appropriate. Therefore, Zhu Danxi treated Shanghan mostly using Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction); for Qi deficiency, Sijunzi Tang (Four Gentlemen Decoction) plus dispersing agents was used; for Blood deficiency, Siwu Tang (Four Substances Decoction) plus dispersing agents was used. Li Dongyuan treated Fengshi (Wind-Dampness) using Buzhong Yiqi Tang plus Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Shengma (Cimicifugae Rhizoma), and Bencaozhu (Atractylodis Chinensis Rhizoma). Wang Haizang treated wind-dampness without sweat using Shenzhu Tang (Divine Skill Decoction) and with sweat using Baizhu Tang (Atractylodes Macrocephala Decoction); for Gangjing (Stiff Spasm), he used Shenzhu Tang plus Qianghuo and Mahuang (Ephedrae Herba); for Roujing (Flaccid Spasm), he used Baizhu Tang plus Guixin (Cinnamomi Cortex) and Baizhu (Atractylodis Macrocephalae Rhizoma); for wind-dampness, he used Baizhu Tang modified according to symptoms; for dampness attack with wiry, fine, hollow, or slow pulses, he used Huangqi Tang (Astragali Decoction). These align with Zhang Zhongjing's principles regarding Shanghan contracted by hardworking individuals exposed to pathogens.
Zhang Zhongjing discussed Shanghan but did not address Zhonghan (Cold Attack). Ancients treated Zhonghan characterized by fainting due to exposure to extreme cold using Fuzi Lizhong Tang (Aconite Decoction to Regulate the Middle). Their pharmacological reasoning was sound, yet they did not discuss the differences between "Shang" (Injury) and "Zhong" (Attack). Shanghan may manifest immediately or be delayed. Due to pre-existing internal stagnation of heat, external wind-cold constrains the skin and pores, trapping heat which then manifests as a heat disease, entering meridians gradually and deepening. Initially, mild diaphoresis with Mahuang or Guizhi (Cinnamomi Ramulus) suffices because the body is not significantly deficient. In contrast, Zhonghan results from sudden contraction of cold; the disease manifests abruptly and violently. Because the pores are open and the whole body is affected, meridian differentiation is difficult, and there is typically no fever; warming and tonification are required for resolution. This indicates severe deficiency of Qi; without urgent treatment, death ensues. Shangfeng (Wind Injury), Shangshu (Summer Heat Injury), and Shangshi (Dampness Injury) progress gradually like Shanghan. Zhongfeng (Wind Attack), Zhongshu (Summer Heat Attack), and Zhongshi (Dampness Attack) occur suddenly like Zhonghan. Beyond Shanghan, treatments for miscellaneous diseases can be inferred by analogy.]