问温病始于《内经》何条？仲景接言者几条？后人治温每与伤寒混者在何处？自汉以
来论温病者几家？叶天士出而直接刘河间，以三焦论治而治温之法始详，其理安在？上焦之
治不外肺卫心营，肺卫心营见证能详述欤？治肺卫者何方？治心营者何方？兼治者何方？中
焦之病在阳明经府，见证分别何在？白虎承气变化几方？此外尚有何法？脾脏独不传欤？下
焦之病在肝肾，宜详见证治当何方？近日治温多宗叶氏，叶氏之阙失者何在？吴氏之得失安
在？与叶氏可互参欤？其详晰书之。
天有六气∶风、寒、暑、湿、燥、火，惟火有二，曰君曰相。风湿与燥无不兼温，惟寒水与
温相反。然伤寒者必病，热温病亦多矣哉。阴阳应象大论曰∶“重阴必阳，重阳必阴，故曰∶
冬伤于寒，春必病温。”自汉以后，医家皆未注明，因以温病为伤寒伏气，遂以温病与伤寒同
治由。其不知，“故曰”二字从上句来也。若曰∶冬日严寒重阴者必伤人之阳，而病在阳；春日
大热重阳者必伤人之阴，而病在阴。故曰∶在冬则名伤寒，在春则名温病，仲景《伤寒论》剖
别分明，曰∶“太阳病，发热、无汗、恶寒、脉浮而紧者，曰伤寒，发热而渴、不恶寒者曰温病；
发汗已，身灼热者名曰风温。”然则伏气竟不病乎？曰温病之原有三∶一曰伏气，指春温兼
咳，温疟春初恶寒之病而言；二曰主气，六元正纪大论曰∶辰戌年初之气民病温厉，寅申丑
未岁以次而推，此客气也，若每年主气，春夏之交，时令大热，热气感人，岂无温病；三曰戾
气，凶荒兵乱之后，与非其时，而有其气，皆曰戾气。戾气成瘟，沿门相传，又可所谓瘟疫也。
明乎此，而伤寒与温病可以不混。宋元以来诸名家，不知温病伤寒之辨，如庞安常《卒病
论》、朱肱《活人书》、韩祗和《微旨》、王实之《证治》、刘守真之《伤寒医览》、《伤寒直格》、张
子和《伤寒心镜》等书，每以伤寒之法治温病，用麻桂等方于心不安，别立通圣、九味羌活、
双解等方，甚至辛温药中加苦寒，皆非理也。近时论温病者张景岳、吴又可、喻嘉言三家。
景岳以“温病为伤寒”，无足论。喻氏有火症断不至化为寒病之说，分晰极清，而亦用辛温辛
热之药，是但能治春初伏气之温，而忘乎主气之温病也，又可直断温热之原非风寒所中，一
以辟秽为治。彼当崇祯凶荒兵火之时，但能治戾气之瘟疫，忘乎伏气主气之温病也。两家详
于治温者，各执已见，不能融会贯通，如此后之治温病者，将何从取法哉？幸也，叶天士出
而剖晰分明，谓∶“伤寒从表入，自太阳经膀胱始，当从六经论传变。温邪自口鼻入，自手太
阴肺经始，当从三焦论重轻，伤寒必困其阳，当温散以救阳，得汗而寒解。温病必烁其阴，
当辛凉以救阴，得汗而温亦解。”大纲之眉目既清，三焦之治可按部而理矣。试言上焦温
邪，首先犯肺，逆传心包。肺主卫，心主营。肺卫见证∶舌白、咳嗽、口渴、脉右大微、恶寒，甚
则发疹，当以辛凉之品，轻则银翘、竹叶、蒡桔、重则石膏、知母、元参；心营见证∶舌红或
黑，神气模糊或见血，甚则见 ，当以清营之
剂，轻则芩、连、丹、栀、赤芍，重则犀角、牛黄、麝、玳、紫雪，此皆上焦见证也。方主卫者银翘
散两方、白虎汤化三方；主营者犀角地黄汤，又合银翘汤、五汁饮、栀豉汤，清寒清营牛黄、
至宝、紫雪共，约治上焦者十方。次言中焦阳明为市，病至四五日后必传阳明，而况平日积
滞者最多积在腑，则温热亦引而传于腑，其见证∶胸痞拒按、口燥，脉沈实，承气症也。然而
变化者十余方，胃实肠虚，用大黄而去芒硝（为小承气）；胃虚肠实，用芒硝而去大黄（为
柴胡芒硝）；肠胃实而不痞，轻用硝黄去朴实（为调胃承气）；虚者加三参（为新加黄龙）；兼
上焦者，加瓜蒌、杏仁、石膏∶兼心营者，大黄汤化牛黄丸；兼小肠小便不通，大黄同芩、连、
丹、地苦泄之液；涸甚者，硝黄同元参、地麦合用，名增液。皆承气变法也。若在经见证，脉
必洪大浮躁，白虎三法外，又有竹叶、石膏化 汤两方，此皆中焦见证化方也。若伤脾者必
发黄，其病最急，茵陈栀子大黄汤急救法也。下焦之病见于肝者、痉厥见于肾者、烦而不寐
治痉者，宜龟甲、鳖甲、牡蛎、阿胶等。治烦者，黄连、阿胶、地芍共约十方，皆从定风珠复脉、
黄连、阿胶数方变化。壮火盛者，不得用定风珠复脉。邪少虚多者，不得用黄连、阿胶。除
虚痉，不得用青蒿、鳖甲。若夫，叶氏阙失在无消食消痰。盖温病初起，岂无夹食，当用保和
之类；岂无胸满夹痰，当用陷胸之类者，叶氏方中独阙。而芳香化秽、甘寒生津二法，实足
为温病死中求活之方。故吴又可能荡涤而短于养津；香化能治黎霍而不能治高梁。叶天士
能柔和而短于消痰，消食能治高梁而不能治黎霍，此定论也。在今日读两公书者，去其偏
而救其弊，何不可互参欤？
问∶治病必先定病名，而后可按证立方。王叔和虽不能自立温病之方，而伤寒例中立
温病名目九条，能一一分晰其见证欤！吴又可着《瘟疫论》，瘟温二字能详辨欤？温病始于上
焦，能言其所以然欤？温病之因与伤寒分别处安在？明乎死症之所以然，而后可救其生。温
病之死法有几？能历历详言之欤？温病不用麻黄发汗者曷故？而冬温病萎蕤法独用麻黄
者曷故？何者为 ？何者为疹？能详其所生所发之源欤？或曰宜托，或曰宜化，能剖其宜
托宜化之故欤？医家以实事应人之求，了然于心者，先当了然于手。
温病有风温，有温热，有温疫，有温毒，有暑温，有湿温，有秋燥，有冬温，有温疟共九
条。王叔和以一切外感叙于伤寒例中，悉以伤寒法治之，贻惠无穷。今按∶风温者，初春阳气
始开，厥阴令行，风夹温也；热者，春未夏初，阳气弛张，温盛为热也；温疫者，厉气流行多
兼秽浊，家家如是，若役使然也；温毒者，诸温夹毒，秽浊太甚也；暑温者，正夏之时，暑病之
偏于热者也；湿温者，长夏初秋，湿中生热，即暑病之偏于湿者也；秋燥者，秋金燥烈之气
也；冬温者，冬应寒而反温，阳不潜藏，民病温也；温疟者，阴气先伤，又因于暑，阳气独发
也。《瘟疫论》一书，又可特论瘟疫一端，瘟字从温之半，仍属热病，但只指厉气为病耳，不
可以统治四时之温病也。试言温病起手太阴之故∶夫天地一阴阳也，若在时节一寒暑也，
而寒暑之成由风变也。自秋而冬，风从西北方来，乃 栗之寒风，寒必伤阳。膀胱足太阳府
也。寒邪郁遏阳气，而为头痛恶寒之伤寒。自春而夏，风从东南方来，乃解冻之温，风温必
伤阴。肺经手太阴藏也，温邪郁遏阴气，而为咳嗽、自汗、口渴、身热之温病。故伤寒从太阳
经肌表始，由表而里；温病从太阴上焦始，由上而下。一纵一横，而寒热之病情彰矣。故曰∶
水火者，阴阳之征兆也；南北者，阴阳之极致也。天地之阴阳和平，而万物生；人身之阴阳
和平，而百病却。一有所偏，即为病。偏于水者病寒，偏于火者病热。烛其病在水也，温之
热之；烛其病在火也，凉之寒之。各救其偏，以底于平，而医之能事毕矣。虽然不明乎温病，
所以死之故，将何以救其生？夫温病死状大略不外五条∶一曰火势燎原，血从上溢，肺之化
源绝者死；二曰热入心营，心神内闭，内闭外
脱者死；三曰阳明太实，土克水者死；四曰肝郁发黄，黄极则窍为闭，秽浊塞窍者死；五曰
在下焦者，无非销烁津液，涸尽而死也。明乎此，病既了然于心，药可了然于手下矣。若夫
温病发汗不用麻黄之故，可罕譬而知之。今夫冬令严寒，西北令行也。西北风为主风，见之
不雨，风转东南而雨来矣。春夏温暖，东南令行也，东南风为主风，见之不雨，风转西北而
雨至矣。人之汗，以天地之雨名之，夏令安得用辛温之麻黄发表之药乎？且夫汗也者，以阳
气为运用，以阴津为材料。阴津有余，阳气不足，又为寒邪杀厉之气所搏，不能自出，必用
麻桂辛温味薄急走之药，以运其阳气而汗始出，故《伤寒》一书始终以救阳气为主。若阳气
有余，阴津不足，又为温热升发之气所烁，而汗自出，或不出必用羔、知、冬、地辛凉甘润之
品培养其阴津为材料，以为正汗之地。故治温病者，始终以救阴津为主，至萎蕤用麻黄。虽
感冬时之温，仍有冷风外束也，故以石膏治温，麻黄达表，或温病而误发太阳经之汗，其
人热甚，血燥不能蒸汗，温邪郁于肌表血分，必发 疹，不知手经本是逆传。手太阴病不
解，本有必传手厥阴心包络之理，故温病中发疹者十八九，发 者十二三。 乃纯赤大片，
为肌肉病，胃主肌肉，胃病也，赤为营色，故化以石膏、知母，亦可加犀角、元参，所谓主以咸
寒佐以苦甘法也。若夫疹系红点，高起系血络中病，肺病也，当主以银蒡芳香透络，薄翘辛
凉解肌，甘竹地元参甘寒清血，一皆主以化法为正。彼吴又可出一托里举 法，用归升柴芷
山甲温燥之品。当春夏阳升时更升阳气，能不畏其烁津液乎？此不通经文之过也，宜戒用
之。
（一）论寒暑由乎风变及寒风伤阳、温风伤阴之故，询是特识。（二）论温病发汗不用麻
黄或用麻黄一节，理明辞畅。（三）叶氏《温热论》中有琐碎小点淡红色，非属阴 即属虚
之说，似宜补托，如加减复脉之类亦托法也。若又可之托里举 、温燥升发，断不可从。
王旭高注。
问∶温病上焦肺卫心营外，尚有何证何方？中焦脾胃外，尚有何证何方？下焦肝肾外，
尚有何证何方？今人论舌苔较细，古人能分辨其见证欤？甘寒、苦寒、咸寒能分辨其当用欤？
辛凉与香化用法，能言其故欤？古人每用败毒散起首，或陶节庵柴葛解肌，其宜安在？其禁
安在？今人每用吴氏达原饮起首，其宜安在？其禁安在？白虎、承气、复脉三方之禁，能详言
欤？小儿麻疹之类，与 疹同源欤？妇人胎前产后之温病，丹溪谓宜先补气血，景岳谓宜急
清外邪内食，能独出手眼欤？平日明白辨之，临时庶应手用之。
上焦营卫外，有夹痰证，咳喘、苔腻、脘闷、宜小陷胸汤；有夹饮症，烦躁、面红、苔黄，
宜大陷胸汤；有膈间症，舌微黄、寸盛、懊 、欲呕，宜栀豉汤；痰涎涌甚者，宜瓜蒂散；有液
涸症，口渴、白沫，宜五汁饮。中焦脾胃外，下后汗自出，下既伤阴，汗又泄阴，当复其阴，宜
益胃汤；下后无汗，脉数，宜清燥汤加沙参、梨汗、牡蛎，懊 、小便不利，宜栀子柏皮汤，渴
饮舌燥、发黄，茵陈蒿汤；证未可下，小溲短，宜冬地三黄汤。下焦肝肾外，少阴心烦不得
卧，宜黄连阿胶汤；阴中伏热夜甚者，宜青蒿鳖甲汤；瘀血漱水便黑者，宜犀角地黄汤；少
腹坚满蓄血，宜桃仁承气抵当；便脓血者，宜桃花粥；少阴胸满心烦者，宜猪肤汤；咽痛者，
甘桔汤；少阴咽疮，苦酒汤。
试言舌苔∶舌绛不渴夜甚，乃入营的候（清营），绛而中心黄者，当气血两清（玉女）；
纯绛鲜红，急涤心包（清营牛黄）；中心干绛，两清心胃（化斑元犀）；尖独干绛，专泄火腑
（冬地三黄）；舌绛而干，当濡胃阴（五汁）；绛而枯萎，急用胶黄；干绛无色，急投复脉。以上
仍宜脉症合参。若舌绛，兼有白苔或黄白相兼，邪仍在气分；绛而滑苔，湿热熏蒸，忌血药
腻补，邪必难解。若夫温家用方，经云∶风淫于内，治以辛凉，佐以苦甘；热淫于内，治以咸
寒，佐以甘苦。甘寒，如麦、地、石膏、梨蔗之
属；苦寒如芩、连、知、柏、山栀。盖咸寒保肾水而安心体（犀角金汁），苦寒通火腑而泻心火
（连栀黄柏）。甘寒则养胃液而保肺阴，加以芳香化秽浊而利机窍（麝香、冰片、郁金、雄黄），
是从仲景温化之外立一凉化法门，搜剔络中之秽最为微妙。活人败毒散、柴葛解肌汤，是
冷风外罩肌肉、温邪内伏于里，其症必先恶寒、骨节烦疼。立此法者，先去其新感之寒，再
理其温。然而阴亏者宜禁，自汗者宜禁。若夫吴氏之达原饮，达募原之邪，其见症所谓厌厌
慑慑、苔如白粉然，惟强壮物理者宜之，液枯者禁，火重者亦禁，白虎之禁，脉沉细者禁，不
渴者禁，汗不出者禁。承气非实热蔽锢、血气俱结者，不可用。复脉之用在邪少虚多，阴虚
欲痉、壮火尚甚者禁之。若小儿麻疹、 痧与温邪之疹无异，皆属热邪犯肺。但疹之限期最
迫，只有三日。前人有痘宜温、疹宜凉之论，实为确见。惟温疹，更甚于小儿之风热疹，当先
以辛凉清解，后以甘凉收功。今夫春升秋降，天地之常理也。况病温者，下焦之精气本虚，
当春升之令，下虚之体再升，其少阳主气能无下竭上厥乎？治温疹者，忌麻黄四河柳之辛温
伤肺，尤忌羌防柴葛之表散升提，误用必致喘咳欲厥。救其误者，仍宜用辛凉之品加苦桔旋
问：温病始于《内经》的哪一条？张仲景接着论述了几条？后人治疗温病常与伤寒混淆的地方在哪里？自汉代以来，论述温病的医家共有几家？叶天士出现后直接继承了刘河间的学说，以三焦来论治，从而使治疗温病的方法详尽起来，其原理是什么？上焦的治疗不外乎肺卫和心营，肺卫和心营的证候能详细叙述吗？治疗肺卫用何方？治疗心营用何方？兼治的用何方？中焦的病在阳明经和腑，证候分别在哪里？白虎汤和承气汤变化出几方？此外还有什么方法？脾脏难道不传变吗？下焦的病在肝肾，应当详细叙述证候和治疗用何方？近日治疗温病多宗法叶氏，叶氏的缺失在哪里？吴鞠通的得失在哪里？与叶氏可以互相参考吗？请详细书写。
天有六气：风、寒、暑、湿、燥、火，只有火有两种，叫君火和相火。风湿和燥无不兼带温热，只有寒水与温热相反。然而患伤寒的一定是病，患热性温病的也多了。《阴阳应象大论》说：“重阴必阳，重阳必阴，所以说：冬天受寒，春天必定得温病。”自汉代以后，医家都没有注明，因此把温病当作伤寒伏匿之气，于是用治疗伤寒的方法来治疗温病。他们不知道，“所以说”二字是从上句来的。如果说：冬日严寒重阴时必定伤人的阳气，而病在阳；春日大热重阳时必定伤人的阴气，而病在阴。所以说：在冬天名叫伤寒，在春天名叫温病。张仲景《伤寒论》剖析区别分明，说：“太阳病，发热、无汗、恶寒、脉浮而紧的，名叫伤寒；发热而口渴、不恶寒的，名叫温病；发汗后，身体灼热的，名叫风温。”那么伏匿之气竟然不得病吗？回答说：温病的来源有三种：一是伏气，指春温兼咳嗽、温疟初春恶寒的病而言；二是主气，《六元正纪大论》说：辰戌年初之气民众患温疫，寅申丑未岁依次推演，这是客气，如果每年的主气，春夏之交，时令大热，热气感人，难道没有温病吗？三是戾气，凶荒兵乱之后，非其时而有的气候，都叫戾气。戾气形成瘟疫，沿门相传，这又叫做瘟疫。明白这些，那么伤寒与温病就可以不混淆了。宋元以来各位名家，不知道温病与伤寒的区别，如庞安常《卒病论》、朱肱《活人书》、韩祗和《微旨》、王实之《证治》、刘守真《伤寒医览》、《伤寒直格》、张子和《伤寒心镜》等书，每用治疗伤寒的方法治疗温病，用心不安于使用麻黄、桂枝等方，另外创立通圣散、九味羌活汤、双解散等方，甚至在辛温药中加入苦寒药，都不合理。近时论述温病的有张景岳、吴又可、喻嘉言三家。景岳认为“温病就是伤寒”，不值得讨论。喻氏有火症断不会化为寒病的说法，分析极清楚，但也使用辛温辛热的药，这只是能治疗初春伏气的温病，而忘记了主气的温病。吴又可直接断定温热的根源不是风寒所中，一味以辟秽为治。他处于崇祯年间凶荒兵火之时，只能治疗戾气的瘟疫，忘记了伏气和主气的温病。两家详细论述治疗温病的，各执己见，不能融会贯通，如此后代治疗温病的人，将取法谁呢？幸好叶天士出现而剖析清晰，说：“伤寒从表入，自太阳经膀胱开始，应当从六经论传变。温邪从口鼻入，自手太阴肺经开始，应当从三焦论轻重，伤寒必定困阻阳气，应当温散以救阳气，得汗而寒解。温病必定灼烁阴液，应当辛凉以救阴液，得汗而温亦解。”大纲的眉目既然清楚，三焦的治疗就可以按部而理了。试述上焦温邪，首先犯肺，逆传心包。肺主卫，心主营。肺卫见证：舌白、咳嗽、口渴、脉右大微、恶寒，甚至发疹，应当用辛凉的药，轻则银翘散、竹叶、牛蒡子、桔梗，重则石膏、知母、玄参；心营见证：舌红或黑，神气模糊或见血，甚至见斑，应当用清营的剂，轻则黄芩、黄连、丹皮、栀子、赤芍，重则犀角、牛黄、麝香、玳瑁、紫雪，这都是上焦见证。方主卫的有银翘散两方、白虎汤化三方；主营的有犀角地黄汤，又合银翘汤、五汁饮、栀豉汤，清寒清营的有牛黄、至宝、紫雪共约十方。次述中焦阳明为市，病到四五日后必传阳明，何况平日积滞者最多积在腑，则温热也引而传于腑，其见证：胸痞拒按、口燥，脉沉实，是承气症。然而变化者十余方，胃实肠虚，用大黄而去芒硝（为小承气汤）；胃虚肠实，用芒硝而去大黄（为柴胡芒硝汤）；肠胃实而不痞，轻用硝黄去枳朴（为调胃承气汤）；虚者加三参（为新加黄龙汤）；兼上焦者，加瓜蒌、杏仁、石膏；兼心营者，大黄汤化牛黄丸；兼小肠小便不通，大黄同黄芩、黄连、丹皮、生地苦泄之液；津液枯竭严重的，硝黄同玄参、生地、麦冬合用，名增液汤。都是承气变法。若在经见证，脉必洪大浮躁，白虎三法外，又有竹叶、石膏化竹叶石膏汤两方，这都是中焦见证化方。若伤脾者必发黄，其病最急，茵陈蒿汤、栀子大黄汤急救法也。下焦的病见于肝者、痉厥见于肾者、烦而不寐，治痉者，宜龟甲、鳖甲、牡蛎、阿胶等。治烦者，黄连、阿胶、生地、芍药共约十方，皆从定风珠复脉汤、黄连阿胶汤数方变化。壮火盛者，不得用定风珠复脉汤。邪少虚多者，不得用黄连阿胶汤。除虚痉，不得用青蒿、鳖甲汤。至于，叶氏的缺失在于无消食消痰之法。盖温病初起，难道没有夹食，当用保和丸之类；难道没有胸满夹痰，当用陷胸汤之类，叶氏方中唯独缺少。而芳香化秽、甘寒生津二法，实在足以成为温病死中求活的方。所以吴又可可能荡涤而短于养津；芳香化秽能治霍乱而不能治膏粱厚味之疾。叶天士能柔和而短于消痰，消食能治膏粱厚味之疾而不能治霍乱，这是定论。在今日读两位公书的，去掉其偏颇而补救其弊端，有什么不可以互相参考的呢？
问：治病必先确定病名，然后才可以按证立方。王叔和虽然不能自立温病的方，但在《伤寒例》中立温病名目九条，能一一分辨其证候吗！吴又可著《瘟疫论》，瘟温二字能详细辨别吗？温病始于上焦，能说其所以然吗？温病的因与伤寒分别处在哪里？明白死症的所以然，然后才可以救其生。温病的死法有几？能一一详细说吗？温病不用麻黄发汗的原因是什么？而冬温病萎蕤法独用麻黄的原因是什么？什么是斑？什么是疹？能详细说明其生发的源头吗？有人说宜托，有人说宜化，能剖析宜托宜化的原因吗？医家用实事回应人的请求，心里了然的，先要在手上了然。
温病有风温，有温热，有温疫，有温毒，有暑温，有湿温，有秋燥，有冬温，有温疟共九条。王叔和把一切外感叙于伤寒例中，全用伤寒法治之，贻害无穷。现在按：风温者，初春阳气始开，厥阴令行，风夹温也；温热者，春末夏初，阳气弛张，温盛为热也；温疫者，厉气流行多兼秽浊，家家如是，若役使然也；温毒者，诸温夹毒，秽浊太甚也；暑温者，正夏之时，暑病之偏于热者也；湿温者，长夏初秋，湿中生热，即暑病之偏于湿者也；秋燥者，秋金燥烈之气也；冬温者，冬应寒而反温，阳不潜藏，民病温也；温疟者，阴气先伤，又因于暑，阳气独发也。《瘟疫论》一书，吴又可特论瘟疫一端，瘟字从温之半，仍属热病，但只指厉气为病耳，不可以统治四时之温病也。试述温病起手太阴的缘故：夫天地一阴阳也，若在时节一寒暑也，而寒暑之成由风变也。自秋而冬，风从西北方来，乃凛冽之寒风，寒必伤阳。膀胱足太阳府也。寒邪郁遏阳气，而为头痛恶寒之伤寒。自春而夏，风从东南方来，乃解冻之温，风温必伤阴。肺经手太阴藏也，温邪郁遏阴气，而为咳嗽、自汗、口渴、身热之温病。故伤寒从太阳经肌表始，由表而里；温病从太阴上焦始，由上而下。一纵一横，而寒热之病情彰矣。故曰：水火者，阴阳之征兆也；南北者，阴阳之极致也。天地之阴阳和平，而万物生；人身之阴阳和平，而百病却。一有所偏，即为病。偏于水者病寒，偏于火者病热。烛其病在水也，温之热之；烛其病在火也，凉之寒之。各救其偏，以底于平，而医之能事毕矣。虽然不明乎温病，所以死之故，将何以救其生？夫温病死状大略不外五条：一曰火势燎原，血从上溢，肺之化源绝者死；二曰热入心营，心神内闭，内闭外脱者死；三曰阳明太实，土克水者死；四曰肝郁发黄，黄极则窍为闭，秽浊塞窍者死；五曰在下焦者，无非销烁津液，涸尽而死也。明乎此，病既了然于心，药可了然于手下矣。若夫温病发汗不用麻黄的缘故，可罕譬而知之。今夫冬令严寒，西北令行也。西北风为主风，见之不雨，风转东南而雨来矣。春夏温暖，东南令行也，东南风为主风，见之不雨，风转西北而雨至矣。人之汗，以天地之雨名之，夏令安得用辛温之麻黄发表之药乎？且夫汗也者，以阳气为运用，以阴津为材料。阴津有余，阳气不足，又为寒邪杀厉之气所搏，不能自出，必用麻黄、桂枝辛温味薄急走之药，以运其阳气而汗始出，故《伤寒》一书始终以救阳气为主。若阳气有余，阴津不足，又为温热升发之气所烁，而汗自出，或不出必用知母、麦冬、生地辛凉甘润之品培养其阴津为材料，以为正汗之地。故治温病者，始终以救阴津为主，至萎蕤用麻黄。虽感冬时之温，仍有冷风外束也，故以石膏治温，麻黄达表，或温病而误发太阳经之汗，其人热甚，血燥不能蒸汗，温邪郁于肌表血分，必发斑疹，不知手经本是逆传。手太阴病不解，本有必传手厥阴心包络之理，故温病中发疹者十八九，发斑者十二三。斑乃纯赤大片，为肌肉病，胃主肌肉，胃病也，赤为营色，故化以石膏、知母，亦可加犀角、玄参，所谓主以咸寒佐以苦甘法也。若夫疹系红点，高起系血络中病，肺病也，当主以银花、牛蒡芳香透络，薄荷辛凉解肌，甘草、竹茹、玄参甘寒清血，一皆主以化法为正。彼吴又可出一托里举斑法，用当归、升麻、柴胡、白芷、山甲温燥之品。当春夏阳升时更升阳气，能不畏其烁津液乎？此不通经文之过也，宜戒用之。
（一）论寒暑由乎风变及寒风伤阳、温风伤阴的缘故，确实是特识。（二）论温病发汗不用麻黄或用麻黄一节，理明辞畅。（三）叶氏《温热论》中有琐碎小点淡红色，非属阴虚即属虚之说，似宜补托，如加减复脉之类亦托法也。若吴又可之托里举斑、温燥升发，断不可从。王旭高注。
问：温病上焦肺卫心营外，尚有何证何方？中焦脾胃外，尚有何证何方？下焦肝肾外，尚有何证何方？今人论舌苔较细，古人能分辨其证候吗？甘寒、苦寒、咸寒能分辨其当用吗？辛凉与香化用法，能说其故吗？古人每用败毒散起首，或陶节庵柴葛解肌，其宜安在？其禁安在？今人每用吴氏达原饮起首，其宜安在？其禁安在？白虎、承气、复脉三方之禁，能详言吗？小儿麻疹之类，与斑疹同源吗？妇人胎前产后之温病，丹溪谓宜先补气血，景岳谓宜急清外邪内食，能独出手眼吗？平日明白辨之，临时庶应手用之。
上焦营卫外，有夹痰证，咳喘、苔腻、脘闷，宜小陷胸汤；有夹饮症，烦躁、面红、苔黄，宜大陷胸汤；有膈间症，舌微黄、寸盛、懊恼、欲呕，宜栀豉汤；痰涎涌甚者，宜瓜蒂散；有液涸症，口渴、白沫，宜五汁饮。中焦脾胃外，下后汗自出，下既伤阴，汗又泄阴，当复其阴，宜益胃汤；下后无汗，脉数，宜清燥汤加沙参、梨汁、牡蛎，懊恼、小便不利，宜栀子柏皮汤，渴饮舌燥、发黄，茵陈蒿汤；证未可下，小溲短，宜冬地三黄汤。下焦肝肾外，少阴心烦不得卧，宜黄连阿胶汤；阴中伏热夜甚者，宜青蒿鳖甲汤；瘀血漱水便黑者，宜犀角地黄汤；少腹坚满蓄血，宜桃仁承气汤、抵当汤；便脓血者，宜桃花粥；少阴胸满心烦者，宜猪肤汤；咽痛者，甘桔汤；少阴咽疮，苦酒汤。
试述舌苔：舌绛不渴夜甚，乃入营的候（清营），绛而中心黄者，当气血两清（玉女煎）；纯绛鲜红，急涤心包（清营汤、牛黄丸）；中心干绛，两清心胃（化斑汤、犀角地黄汤）；尖独干绛，专泄火腑（冬地三黄汤）；舌绛而干，当濡胃阴（五汁饮）；绛而枯萎，急用阿胶、黄连；干绛无色，急投复脉汤。以上仍宜脉症合参。若舌绛，兼有白苔或黄白相兼，邪仍在气分；绛而滑苔，湿热熏蒸，忌血药腻补，邪必难解。若夫温家用方，经云：风淫于内，治以辛凉，佐以苦甘；热淫于内，治以咸寒，佐以甘苦。甘寒，如麦冬、生地、石膏、梨蔗之属；苦寒如黄芩、黄连、知母、黄柏、山栀。盖咸寒保肾水而安心体（犀角、金汁），苦寒通火腑而泻心火（连翘、山栀、黄柏）。甘寒则养胃液而保肺阴，加以芳香化秽浊而利机窍（麝香、冰片、郁金、雄黄），是从仲景温化之外立一凉化法门，搜剔络中之秽最为微妙。活人败毒散、柴葛解肌汤，是冷风外罩肌肉、温邪内伏于里，其症必先恶寒、骨节烦疼。立此法者，先去其新感之寒，再理其温。然而阴亏者宜禁，自汗者宜禁。若夫吴氏之达原饮，达募原之邪，其见症所谓厌厌慑慑、苔如白粉然，惟强壮物理者宜之，液枯者禁，火重者亦禁，白虎之禁，脉沉细者禁，不渴者禁，汗不出者禁。承气非实热蔽锢、血气俱结者，不可用。复脉之用在邪少虚多，阴虚欲痉、壮火尚甚者禁之。若小儿麻疹、痧与温邪之疹无异，皆属热邪犯肺。但疹之限期最迫，只有三日。前人有痘宜温、疹宜凉之论，实为确见。惟温疹，更甚于小儿之风热疹，当先以辛凉清解，后以甘凉收功。今夫春升秋降，天地之常理也。况病温者，下焦之精气本虚，当春升之令，下虚之体再升，其少阳主气能无下竭上厥乎？治温疹者，忌麻黄、河柳之辛温伤肺，尤忌羌活、防风、柴胡、葛根之表散升提，误用必致喘咳欲厥。救其误者，仍宜用辛凉之品加苦桔梗、旋覆花
Question: In which clause of the *Neijing* (Inner Canon) does warm disease originate? How many clauses did Zhang Zhongjing follow up on? Where do later practitioners confuse the treatment of warm disease with cold damage? Since the Han dynasty, how many physicians have discussed warm disease? When Ye Tianshi appeared, he directly inherited Liu Hejian's teachings and used the Sanjiao (Triple Burner) to discuss treatment, thereby making the methods for treating warm disease detailed. What is the principle behind this? The treatment of the Upper Jiao does not go beyond the Lung Wei (Defensive) and Heart Ying (Nutritive). Can you detail the manifestations of Lung Wei and Heart Ying? Which formula treats Lung Wei? Which treats Heart Ying? Which treats both? The diseases of the Middle Jiao are in the Yangming channels and fu organs; where do their manifestations differ? How many variations of the Baihu Tang (White Tiger Decoction) and Chengqi Tang (Purgative Decoction) are there? Besides these, what other methods exist? Does the Spleen not transmit? The diseases of the Lower Jiao are in the Liver and Kidney; one should detail the manifestations and treatments. Recently, most treat warm disease following Ye's methods. Where are Ye's deficiencies? What are Wu Juzhong's gains and losses? Can they be cross-referenced with Ye's? Please write in detail.
Heaven has six Qi: Wind, Cold, Summerheat, Dampness, Dryness, Fire. Only Fire has two types, called Ministerial Fire and Sovereign Fire. Wind-Dampness and Dryness invariably combine with Warmth, whereas only Cold-Water is opposite to Warmth. However, those who contract cold damage certainly become ill, and those with heat-type warm diseases are also numerous. The *Da Lun on Yin-Yang and Phenomena* states: "Extreme Yin transforms into Yang, extreme Yang transforms into Yin. Thus it is said: If one is injured by Cold in winter, one will inevitably suffer from Warm Disease in spring." Since the Han dynasty, physicians have failed to clarify this, regarding warm disease as latent qi from cold damage, and thus treating warm disease with the same methods as cold damage. They did not understand that the phrase "thus it is said" derives from the preceding sentence. If one says: In winter, severe cold and extreme Yin must injure a person's Yang, resulting in disease in Yang; in spring, intense heat and extreme Yang must injure a person's Yin, resulting in disease in Yin. Therefore, in winter it is named Cold Damage, and in spring it is named Warm Disease. Zhang Zhongjing's *Shanghan Lun* (Treatise on Cold Damage) distinguishes them clearly, stating: "Taiyang disease, with fever, no sweating, aversion to cold, and floating-tight pulse, is named Cold Damage; fever with thirst and no aversion to cold is named Warm Disease; after inducing sweating, if the body becomes burning hot, it is named Wind-Warmth." Then does latent qi never cause disease? The answer is: There are three origins of warm disease: First, latent qi, referring to Spring-Warmth with cough, and warm malaria with aversion to cold in early spring; second, dominant qi, the *Liu Yuan Zheng Ji Da Lun* states: In the first phase of Chen-Xu years, people suffer from warm epidemics, deduced sequentially for Yin-Shen-Chou-Wei years; this is transient qi. If considering annual dominant qi, during the transition of spring and summer, when seasonal heat is intense and affects humans, can there be no warm disease? Third, pestilential qi, occurring after famine or war, when climate does not match the season, all are called pestilential qi. Pestilential qi forms plagues, spreading door-to-door, which is also called epidemic plague. Understanding this, cold damage and warm disease can be distinguished.
Since the Song and Yuan dynasties, various masters did not distinguish between warm disease and cold damage. Books such as Pang Anchang's *Zubing Lun*, Zhu Gong's *Huo Ren Shu*, Han Zhihe's *Weizhi*, Wang Shizhi's *Zhengzhi*, Liu Shouzhen's *Shanghan Yilan* and *Shanghan Zhige*, and Zhang Zihe's *Shanghan Xinjing* each used cold damage methods to treat warm disease. Feeling uneasy using Mahuang and Guizhi formulas, they established new formulas like Tongsheng San, Jiuwei Qianghuo Tang, and Shuangjie San, even adding bitter-cold herbs to acrid-warm ones, which is unreasonable. Recent discussions on warm disease involve three families: Zhang Jingyue, Wu Youke, and Yu Jiayan. Jingyue's view that "warm disease is cold damage" is not worth discussing. Jiayan stated that fire syndromes would never transform into cold diseases, analyzing very clearly, yet still using acrid-warm and acrid-hot medicines. This only treats early spring latent qi warm disease, forgetting dominant qi warm disease. Youke directly asserted that the origin of warmth-heat is not caused by wind-cold, focusing solely on dispelling filth. Living during the Chongzhen era's famine and war, he could only treat pestilential plagues, forgetting latent and dominant qi warm diseases. Both families detailed treatments for warm disease but held differing views without integration. How should later practitioners take example? Fortunately, Ye Tianshi appeared and clarified: "Cold damage enters from the exterior, starting from the Taiyang Bladder channel, and transmission should be discussed via Six Channels. Cold damage must obstruct Yang, requiring warming and dispersing to rescue Yang; sweating resolves cold. Warm pathogen enters via mouth and nose, starting from the Hand-Taiyin Lung channel, and severity should be discussed via Sanjiao. Warm disease must scorch Yin, requiring acrid-cool to rescue Yin; sweating resolves warmth." With the outline clear, Sanjiao treatment can be managed systematically.
Discussing Upper Jiao warm pathogen, it first attacks the Lung and reversely transmits to the Pericardium. Lung governs Wei, Heart governs Ying. Lung Wei manifestations: white tongue coating, cough, thirst, slightly large right pulse, aversion to cold, possibly rashes. Treat with acrid-cool agents: mild cases use Yinqiao San, Zhuye, Niubangzi, Jiegeng; severe cases use Shigao, Zhimu, Xuanshen. Heart Ying manifestations: red or black tongue, confused spirit or bleeding, possibly macules. Treat with Ying-clearing agents: mild cases use Huangqin, Huanglian, Danpi, Zhizi, Chishao; severe cases use Xijiao, Niuhuang, Shexiang, Dai Mao, Zixue. These are Upper Jiao manifestations. Formulas governing Wei include Yinqiao San (two variants) and Baihu Tang (three variants); formulas governing Ying include Xijiao Dihuang Tang, combined with Yinqiao Tang, Wuzhi Yin, Zhichi Tang, and clearing agents like Niuhuang, Zhibao, Zixue, totaling about ten formulas for the Upper Jiao.
Next, the Middle Jiao Yangming is the market. By the 4th-5th day, disease must transmit to Yangming, especially if there is prior accumulation in the fu organs, leading warm-heat to transmit to the fu. Manifestations: chest fullness and tenderness upon pressure, dry mouth, deep-solid pulse, indicating Chengqi syndrome. Variations include over ten formulas: Stomach solid/intestine empty uses Dahuang without Mangxiao (Xiao Chengqi Tang); Stomach empty/intestine solid uses Mangxiao without Dahuang (Chaihu Mangxiao Tang); Intestines/stomach solid without fullness uses mild Xiaoshi/Huanglian removing Zhishi/ Houpo (Tiaowei Chengqi Tang); Deficiency adds Sanshen (Xinji Huanglong Tang); Combined with Upper Jiao adds Gualou, Xingren, Shigao; Combined with Heart Ying uses Dahuang Tang transformed with Niuhuang Wan; Combined with Small Intestine urinary obstruction uses Dahuang with Huangqin, Huanglian, Danpi, Shengdi bitter-draining liquid; Severe fluid depletion uses Xiaoshi/Huanglian with Xuanshen, Shengdi, Maidong, named Zengye Tang. All are Chengqi variations. If in the channel, pulse is surging-large and floating-impatient. Besides Baihu methods, there are Zhuye/Shigao transformed formulas. These are Middle Jiao variations. If Spleen is injured, jaundice appears, an urgent condition treated urgently with Yinchenshao Tang and Zhizi Dahuang Tang.
Lower Jiao diseases manifest in the Liver; spasms/collapse manifest in the Kidney; irritability with insomnia. Treating spasms uses Guijia, Biejia, Muli, Ejiao, etc. Treating irritability uses Huanglian, Ejiao, Shengdi, Shaoyao, totaling about ten formulas, varying from Dingfeng Zhu Fumai Tang and Huanglian Ejiao Tang. If vigorous fire is excessive, Dingfeng Zhu Fumai Tang is contraindicated. If pathogen is minor and deficiency major, Huanglian Ejiao Tang is contraindicated. To exclude false spasms, Qinghao Biejia Tang is contraindicated. Ye's deficiency lies in lacking digestion-promoting and phlegm-resolving methods. Early warm disease often involves food retention, requiring Baohe Wan type; chest fullness with phlegm requires Xianxiong Tang type, which Ye omitted. Aromatic transformation of filth and sweet-cool generation of fluids are sufficient for saving lives in critical warm disease. Wu Youke excels at purging but lacks fluid nourishment; aromatic transformation treats cholera but not rich diet disorders. Ye Tianshi is gentle but lacks phlegm resolution; digestion treats rich diet disorders but not cholera. This is a definitive conclusion. Today, reading both works, removing bias and remedying flaws allows cross-reference.
Question: Determining disease name is prerequisite for prescribing. Wang Shuhe could not establish independent warm disease formulas but listed nine warm disease items in *Shanghan Li*. Can you detail their manifestations? Wu Youke's *Wenyi Lun*: can you distinguish Wen and Yi? Why does warm disease start in the Upper Jiao? How does its etiology differ from cold damage? Understanding death causes enables saving life. How many death patterns exist in warm disease? Explain in detail. Why is Mahuang not used for sweating in warm disease? Why does Dongwen (Winter Warmth) use Mahuang in Weirui method? What are macules (Ban)? What are rashes (Zhen)? Detail their origins. Some say promote eruption, some say resolve. Analyze reasons. Physicians must understand principles before applying them.
There are nine types of warm disease: Fengwen, Wenre, Wenyi, Wendu, Shuwen, Shiwen, Qiuzao, Dongwen, Wenmie. Wang Shuhe categorized all external pathogens under cold damage, causing endless harm. Now: Fengwen occurs in early spring when Yang opens and Jueyin rules, wind combines with warmth. Wenre occurs late spring/early summer when Yang expands, warmth intensifies to heat. Wenyi involves pestilential qi spreading with filth, affecting households uniformly. Wendu involves warmth combining with toxicity, excessive filth. Shuwen occurs in mid-summer, heat-bias of summerheat. Shiwen occurs in late summer/early autumn, heat generated from dampness, damp-bias of summerheat. Qiuzao is autumn metal's dry-intense qi. Dongwen is winter本该 cold but turns warm, Yang fails to hide, people get warm disease. Wenmie involves prior Yin injury plus summerheat, Yang fires alone. *Wenyi Lun* specifically discusses plague; 'Wen' is half of 'Yi', still heat disease, but refers only to pestilential qi, not all four-season warm diseases.
Why does warm disease start in Hand-Taiyin? Heaven and Earth are Yin-Yang; seasons are Cold-Heat, formed by Wind changes. Autumn to Winter, wind comes from Northwest, biting cold wind, injuring Yang. Bladder is Foot-Taiyang Fu. Cold pathogen obstructs Yang, causing headache and aversion to cold (Cold Damage). Spring to Summer, wind comes from Southeast, thawing warmth, wind-warmth injuring Yin. Lung is Hand-Taiyin Zang. Warm pathogen obstructs Yin, causing cough, spontaneous sweating, thirst, fever (Warm Disease). Thus, cold damage starts from Taiyang exterior, moving interiorly; warm disease starts from Taiyin Upper Jiao, moving downward. One vertical, one horizontal, clarifying cold-heat conditions. Water/Fire are signs of Yin/Yang; North/South are extremes. Balance generates life; imbalance causes disease. Water-bias causes cold, Fire-bias causes heat. Warm cold, cool heat to restore balance.
However, without understanding death causes, how to save life? Five death patterns: 1. Fire raging, blood vomiting, Lung source exhausted. 2. Heat entering Ying, heart spirit closed, internal closure/external collapse. 3. Yangming excessive, Earth overcoming Water. 4. Liver stagnation jaundice, orifices blocked by filth. 5. Lower Jiao fluid exhaustion. Knowing this, treatment becomes clear.
Regarding sweating without Mahuang: Winter cold, Northwest wind dominates. No rain until wind shifts Southeast bringing rain. Spring/Summer warmth, Southeast wind dominates. No rain until wind shifts Northwest. Human sweat is like heaven's rain. How can acrid-warm Mahuang be used in Summer? Sweat relies on Yang for movement and Yin fluid for material. If Yin excess/Yang deficiency + cold attack, Mahuang/Guizhi acrid-warm thin-pungent fast-moving drugs move Yang to produce sweat. *Shanghan* always rescues Yang. If Yang excess/Yin deficiency + warm-heat scorching, sweat may occur spontaneously or not. Use Zhimu, Maidong, Shengdi acrid-cool sweet-moist to nourish Yin for normal sweat. Treating warm disease always rescues Yin fluid. Weirui uses Mahuang because winter warmth still has cold wind binding exterior. Shigao treats warmth, Mahuang reaches exterior. If warm disease mistakenly induces Taiyang sweating, high heat, dry blood cannot vaporize sweat, warm pathogen stays in muscle/blood, causing macules/rashes. Hand channels reverse transmit. Hand-Taiyin unresolved transmits to Hand-Jueyin Pericardium. 80-90% develop rashes, 20-30% macules. Macules are pure red large patches, muscle disease (Stomach governs muscle), red is Ying color. Resolve with Shigao, Zhimu, add Xijiao, Xuanshen, salty-cold main, bitter-sweet assistant. Rashes are red raised dots, blood vessel disease (Lung disease). Main with Yinhua/Niubang aromatic penetrating collaterals, Bohe acrid-cool resolving muscle, Gancao/Zhuru/Xuanshen sweet-cool clearing blood. Main resolution method. Wu Youke's promoting eruption method uses Danggui, Shengma, Chaihu, Baizhi, Shan Jia warm-dry ascending. In spring/summer Yang rising, further raising Yang scorches fluids. This violates classics, avoid.
(1) Discussion on Cold/Heat changing by Wind, Cold Wind injuring Yang, Warm Wind injuring Yin is unique insight. (2) Discussion on sweating without/with Mahuang is clear. (3) Ye's *Wenre Lun* mentions small pale red spots, either Yin deficiency or deficiency, suggesting tonification/support like Ji Jian Fumai Tang. Wu Youke's promoting eruption/warm-dry ascending is unacceptable. Note by Wang Xugao.
Question: Besides Upper Jiao Lung Wei/Heart Ying, what other syndromes/formulas? Besides Middle Jiao Spleen/Stomach? Besides Lower Jiao Liver/Kidney? Modern tongue diagnosis is detailed; can ancients distinguish manifestations? Can Sweet-Cool, Bitter-Cool, Salty-Cool be distinguished for usage? Explain Acrid-Cool vs Aromatic Transformation usage. Ancients used Baidu San initially, or Tao Jian'an Chai Ge Jie Ji Tang. When appropriate? Contraindications? Moderns use Wu's Dayuan Yin initially. Appropriate? Contraindications? Contraindications for Baihu, Chengqi, Fumai? Are pediatric measles similar to macules/rashes? Pre/post-natal warm disease in women: Danxi said tonify Qi/Blood first; Jingyue said clear external pathogen/internal food urgently. Unique perspective? Distinguish daily for timely application.
Upper Jiao besides Ying/Wei: Phlegm retention (cough/wheeze, greasy coating, epigastric stuffiness) -> Xiao Xianxiong Tang; Fluid retention (irritability, red face, yellow coating) -> Da Xianxiong Tang; Diaphragm syndrome (slightly yellow tongue, strong Cun pulse, restlessness, nausea) -> Zhichi Tang; Profuse phlegm/saliva -> Gouti San; Fluid exhaustion (thirst, white foam) -> Wuzhi Yin.
Middle Jiao besides Spleen/Stomach: Post-purging spontaneous sweating (purge injures Yin, sweat leaks Yin) -> restore Yin, Yigeng Tang; Post-purging no sweat, rapid pulse -> Qingzao Tang plus Shashen, Lizhi, Muli; Restlessness, urinary difficulty -> Zhizi Baipi Tang; Thirst/dry tongue/jaundice -> Yinchenshao Tang; Not ready for purge, short urine -> Dongdi Sanhuang Tang.
Lower Jiao besides Liver/Kidney: Shaoyin irritability/insomnia -> Huanglian Ejiao Tang; Hidden heat worse at night -> Qinghao Biejia Tang; Blood stasis rinsing water/black stool -> Xijiao Dihuang Tang; Lower abdomen hard/full blood retention -> Taoren Chengqi Tang, Didang Tang; Pus/blood stool -> Taohua Zhou; Shaoyin chest full/irritability -> Zhufu Tang; Sore throat -> Ganjie Tang; Shaoyin throat ulcer -> Kujiu Tang.
Tongue coating: Crimson tongue, no thirst, worse at night -> Ying level (Qingying); Crimson center yellow -> Clear Qi and Ying (Yunü Jian); Pure crimson bright red -> Purge Pericardium (Qingying, Niuhuang); Center dry crimson -> Clear Heart/Stomach (Huaban, Xijiao); Tip dry crimson -> Drain Fire Fu (Dongdi Sanhuang); Crimson dry -> Moisten Stomach Yin (Wuzhi); Crimson withered -> Ejiao, Huanglian urgently; Dry crimson colorless -> Fumai Tang urgently. Combine with pulse/symptoms. Crimson with white/yellow coating -> Pathogen still in Qi. Crimson slippery coating -> Damp-heat steaming, avoid blood tonics, pathogen hard to resolve.
Warm disease formulas: Classic says "Wind invading interior, treat with acrid-cool, assist with bitter-sweet; Heat invading interior, treat with salty-cold, assist with sweet-bitter." Sweet-cool: Maidong, Shengdi, Shigao, Lizhe. Bitter-cool: Huangqin, Huanglian, Zhimu, Huangbai, Zhizi. Salty-cold protects Kidney Water/calms Heart (Xijiao, Jinzhi). Bitter-cool drains Fire Fu/Heart Fire (Lianqin, Zhizi, Huangbai). Sweet-cool nourishes Stomach fluid/protects Lung Yin. Add aromatic transforming filth/opening orifices (Shexiang, Bingpian, Yujin, Xionghuang). This establishes Cool Transformation outside Zhongjing's Warm Transformation, subtly clearing collaterals. Huoren Baidu San, Chai Ge Jie Ji Tang are for cold wind wrapping muscle/warm pathogen inside, symptoms start with aversion to cold/body ache. Method removes new cold then treats warmth. Contraindicated in Yin deficiency/spontaneous sweating. Wu's Dayuan Yin targets Semimembranosus pathogen, symptoms listless, coating like white powder, suitable for robust, contraindicated in fluid dryness/fire excess. Baihu contraindicated in deep-thin pulse/no thirst/no sweat. Chengqi not for non-solid heat/blood-Qi knotting. Fumai for minor pathogen/major deficiency, contraindicated in Yin deficiency spasms/vigorous fire.
Pediatric measles/macules/rashes are same source, heat invading Lung. Rash deadline is strict, only three days. Ancient theory: Pox needs warmth, rash needs cooling is correct. Warm rash is worse than pediatric wind-heat rash, first acrid-cool clear/resolve, then sweet-cool conclude. Spring rises/Autumn falls is natural law. Warm disease patients have deficient Lower Jiao essence/Qi. During Spring rise, lower deficiency rising leads Shaoyang dominant Qi to exhaust below/collapse above. Treating warm rash avoids Mahuang/Liu branch acrid-warm injuring Lung, especially Qianghuo, Fangfeng, Chaihu, Gegen ascending/dispersing, causing asthma/collapse. Rescue errors with acrid-cool plus Kujiegeng, Xuanfuhua.