也。如李明之所云∶冬伤于寒者，冬行春令也。当冬而温，火胜而水亏矣。水既亏，则所胜妄行，土有余也；
所生受病，
金不足也；所不胜者侮之，火太过也。火土合德，湿热相助，故为温病。然由明之所言，是冬温而感之即病者
也，非伏寒也，非变也。不然必无冬温一证也。而后可既有冬温，则有是气，已有是证矣。由其言以悉冬温，
便可垂论不磨。若论春温，不免贻昧千古矣。《经》曰∶逆冬气，则少阴不藏，不藏则寒邪得而入之。伤于肌
肤，伏于骨髓，始知冬为藏精之时。惟逆冬气，遂使少阴之经气不闭，复遭非时之暖，致令开泄，忽然严寒骤
返，不免受伤。故受伤者仍是寒邪也。因先被温令开泄，似乎喜寒，且所伤不甚，故不即病而潜伏于少阴也。
然所以不病于冬而病于春者，因水在冬为旺时，邪伏于经，俯首而不敢抗，郁久成热；至行春令，开发腠理，
阳气外泄，肾水内亏，木当生发，孰为鼓舞？孰为滋养？生化之源既绝，木何赖以生乎？身之所存者温也，
故为温病。余故以彼论冬时之感温非是，而此论冬月之伏寒最精。○凡温病之发，因暴寒者居多；热病之发，
兼暑 者为甚。热病由出之途自阳明，温病由出之途自少阳。虽所合之经不一，要不离乎阳明少阳者，各因时
令之气也。○喻嘉言《尚论》温病云云，予谓温病无阴阳之分。何也？冬有温气，先开发人之腠理，而寒得以袭
之，所谓邪之所凑，其气必虚。惟不藏精之人而后虚也，虚则寒伤其经。经必少阴者，以少阴脏本虚也。然所
伤原微，且冬月寒水当令，其权方盛，微邪不敢抗衡。但卧榻之侧，岂容他人鼾睡？惟有阻彼生意，暗烁精髓，
至春时强木长，而水不足以供其资，始则当春而温，木旺水亏，所郁升发，火气燔灼，病温而已矣。其所伤者，
寒也；所病者，温也；所伏者，少阴也；所发者，少阳也。故病必有阳而无阴，药必用寒而远热，黄芩汤其
主治也。则嘉言之论温有阴有阳，如伤寒三阴经可用辛热者，予曰否。否，不然也。○门人问曰∶伤者寒也，
何以病温？答曰∶伤寒非病寒乎？何以热也？寒郁营间，不一、二日而成大热，况伏藏于内者数十日之久耶？
夫既邪伤肌肉，何以得入少阴？盖惟
不藏精，则少阴先病，故邪伤者，少阴也。春属木，则自内发出，无论兼太阳、阳明，总无不由少阳。何也？
彼少阳行春令也。然既从少阴矣，何仲景专云太阳病？盖太阳与少阴相表里，故以发热为太阳也。因不恶寒，
明无表证，则其热自内出，无外邪郁之也。然则仲景复言太少合病者，见发热不恶寒，或兼有耳聋胁满证也；
言三阳合病者，以脉大属阳明，而多眠则热聚于胆也。不言法者，总以黄芩汤为主治也。乃嘉言复谓有发表三、
五次，而外证不除；攻里三、五次，而里证不除；以为在表也，又似在里；以为在里也，又似在表。此与温
疫证感天地人湿气、热气、尸气，邪入口鼻，混淆三焦者相近；与春温全不相涉也。愚故及之，以破后学之惑。
○门人复问曰∶春温亦间有一、二表证乎？曰∶有之。伏气之病，虽感于冬，然安保风之伤人，不在伏气将发
未发之时乎？但兼外感者，必先头痛、恶寒而后热不已，此新邪引出旧邪来也；或往来寒热，头痛而呕，稍愈
后浑身壮热为病者，此正气又虚，伏发更重也。总之，无外证者，以黄芩汤为主治；兼外感者，必加柴胡，或
以本经药轻解，必无发汗之理。故仲景云∶发汗已，身灼热者，名曰风温。谓误用辛热之药，既辛散以劫其阴，
复增热以助其阳，遂使热更炽，脉俱浮。有如此之危证，以及误下、误火，严加戒谕者，舍黄芩汤，别无治法
也。（周禹载）
温病，热自内出，发热而渴，不恶寒；风温，内外热交加之，自汗、身重、多眠诸证。此有轻重、死生之
分，医者当以有汗、无汗为辨别之大要，亦即以可汗、不可汗为救治之大权。晋、唐以还，名贤辈出，纷纷议
论，似犹未识温病与风温为何病，汪机谓春温之证有三，吴绶谓风温为伤寒坏证，云岐子谓汗下不愈而过经者
为温病。此皆叔和更感异气，变为他病，当根据坏病而治之之语，为作俑也。夫误治不愈之病，为坏病也。温病、
风温，当春令而发，岂是坏病？若必待过经不愈，始辨其为温病，则病温
者万无一生矣。且《内经》所谓温病，即为热病。以身热言，则谓之热；以时令言，则谓之温。故曰∶凡病伤
寒而成温者，先夏至日为病温；后夏至日为病暑。王叔和不曰风温重于温病，而曰暑病热重于温。又曰∶五、
六月为寒所折，热病则重。恐暑月所发之热，未必重于春时所发之热；而暑月所冒之寒，更未必重于春时所发
之热也。朱奉议曰∶夏至以前，发热恶寒，头痛体痛，脉浮紧者，温病也，则是误以夏至前伤寒为温病矣。
李东垣曰∶冬伤于寒，冬行春令也。不寒而温，火胜水亏也。寒水之令，复行于春，时强木长，故为温病。
则是误以冬伤于温，至春复寒为温病矣。奉议又谓∶风温治在少阴、厥阴，不可发汗。此语洵足翼《经》而制
风温六方，陶节庵宗之。然惟栝蒌根汤允当耳。其余葳蕤、知母诸汤，用葳蕤、知母、石膏、白薇善矣，不知
何故用麻黄、羌活发汗药？又不知何故合用白芷、升麻阳明药？又不知何故杂用木香、南星辛燥药？岂其欲以
风温与温病、温疫、冬温数者同治欤？若防己汤之用防己、白术，无乃误以风温为湿温欤？王海藏谓∶葳蕤汤
有麻黄，不可用，宜用白术汤。然则白术汤果可治风温欤？刘河间以寒药治热病，为得《内经》饮寒水，乃刺
之，必寒衣之，居止寒处，身寒而止之义，而于温病、风温漫无分别。且欲以三十方尽伤寒之变证，以一下
尽治热之大法，则亦未免粗疏也。庞安常和解，因时于夏至前后，一以和解为主，颇得治在少阳、厥阴之旨。
盖亦有见于风温之难治，而迁延以需变也；而顷刻危亡者，则有所不救矣。然则风温遂不可治乎？曰∶贵辨之
早耳！治不可逆，逆则坏，坏则不救矣。《刺热论》曰∶病虽未发，见赤者，刺之，名曰治未病。又曰∶热
甚，为五十九刺。仲师之青龙、白虎，神矣！得此意而推之，可以应用于不穷。盖治温病，宜于发散中重加清
凉；治风温，不可于清凉中重加发散也。（程扶生）
冬伤于寒，春必病温者，重在冬不藏精也。盖烦劳多欲之人，
阴精久耗，入春则里气大泄，木火内燃，燔燎之势直从里发。始见必壮热烦冤，口干舌燥，主治以存津液为第
一。黄芩汤坚阴却邪，即此义也。再者，在内之温邪欲发，在外之新邪又加，葱豉汤最为快捷方式。至于因循贻
误，或因气燥津枯，或致阴伤液涸，挽救诸法，如人参白虎汤、黄连阿胶汤、玉女煎、复脉法；余则治痉厥以
甘药缓肝，昏闭用幽芳开窍，热痰之投温胆，蓄血而论通瘀。○风为天之阳气，温乃化热之邪，两阳熏灼，先伤
上焦，种种变幻情状，不外手三阴为病薮，头胀、汗出、身热、咳嗽，必然并见，当与辛凉轻剂清解为先，大
忌辛温消散，劫烁津液。太阴无肃化之权，救逆则有蔗汁、芦根、玉竹、门冬之类；若苦寒沉降，损伤胃口，
阳明失循序之司，救逆则有复脉、建中之类。此证骤变则为痉厥，缓变则为虚劳；主治之方，总以甘药为要，
兼寒兼温，在人通变可也。（《临证指南》）
温邪上受，首先犯肺，逆传心包。肺主气属卫，心主血属营。辨营卫气血，虽与伤寒同，若论治法，则
与伤寒异。盖伤寒之邪，留恋在表，然后化热入里；温邪则变热最速。未传心包，邪尚在肺，肺主气，其合皮
毛，初用辛凉轻剂，挟风加薄荷、牛蒡之属，挟湿加芦根、滑石之流。或透风于热外，或渗湿于热下，不与热
相搏，势必孤矣。不尔，风挟温热而燥生，清窍必干，水主之气不能上荣，两阳相劫也。湿与温合，蒸郁而蒙
痹于上，清窍为之壅塞，浊邪害清也。其病有类伤寒，但伤寒多变证，温热虽久，总在一经不移。○前言辛凉散
风，甘淡驱湿，若病不解，是渐欲人营也。营分受热，则血液被劫，心神不安，夜寤无寐，或斑点隐隐，即撤
去气药。如从风热陷入者，用犀角、竹叶之属；从湿热陷入者，用犀角、花露之品参入凉血清热方中。若加烦
躁、大便不通，金汁亦可加入；老年或素体寒者，以人中黄代之，急急透斑为要。若斑出热不解者，胃津亡也，
主以甘寒，重则如玉女煎，轻则如梨皮、蔗浆。或其人肾水素亏，虽未及下焦，先自
彷徨矣，必验之于舌，于甘寒之中加入咸寒，务在先安未受邪之地，恐其陷入耳。若其邪始终在气分留连者，
可冀其战汗透邪，法宜益胃，令邪与汗并，热达腠开，邪从汗出。解后胃气空虚，当肤冷一昼夜，待胃气还，
自温暖如常矣。盖战汗而解，邪退正虚，阳从汗泄，故渐肤冷。此时宜令病者安卧，以待阳气来复，旁人勿
惊惶呼唤，扰其元神。但诊其脉，若虚软和缓，虽倦卧不语，汗出肤冷，却非脱证；若脉急疾，躁扰不卧，便
为脱证矣。更有邪盛正虚，不能一战而解，停一二日，再战汗出而愈者，不可不知。○再论气病有不传血分，而
邪留三焦，亦如伤寒中少阳病者。彼则和解表里之半，此则分消上下之势，随证变法，如杏、朴、苓等，或温
胆汤之走泄。因其仍在气分，犹可望其战汗之门户、转疟之机括。○大凡看法，卫之后方言气，营之后方言血。
在卫，汗之可也；到气，才可清气；乍入营分，犹可透热仍转气分而解，如犀角、元参、羚羊等是也；已入于
血，就恐耗血动血，亟须凉血养血，如生地、丹皮、阿胶、赤芍等是也。若不循缓急之法，虑其动手便错耳。
且吾吴湿邪害人最广，如面色白者，须要顾其阳气，湿胜则阳微也；法应清凉，用到十分之六七，即不可过，
恐湿热一去，阳亦微也。面色苍者，须要顾其津液，清凉到十分之六七，往往热减身寒者，不可便云虚寒而骤
投补剂，恐炉烟虽熄，灰中有火也。须细察精详，少少与之，慎勿直率而往。○又有酒客，里湿素盛，外邪入里，
与之相搏，在阳旺之躯，胃湿恒多；在阴盛之体，脾湿不少。然其化热则一。热病救阴犹易，通阳最难。救
阴不在补血，而在养津与汗；通阳不在温，而在利小便。○再论三焦之邪，不从外解，必成里结。里结者何在？
阳明胃与大肠也，固须用下法。但伤寒热邪在里，劫灼津液，下之宜猛；此多湿邪内搏，下之宜轻。伤寒大便
溏，为邪已尽，不可再下；湿温大便溏，为邪未尽，必大便硬，不可再攻，以矢燥为无湿矣。再人之体，脘在
腹上，位处于中，按之痛，或自痛，或
痞胀，当用苦泄，以其入腹近也。○妇人病温，与男子同，但多胎前产后，及经水适来适断。凡胎前病，古人
皆用四物加减，恐邪害妊也。如热极，用井底泥，蓝布浸冷，覆盖腹上，皆是护胎之意，但要看其邪之可解处。
用血腻之药不灵，又当审察，不可固执。然须步步保护胎元，恐正损邪陷也。至于产后，方书谓慎用苦寒，恐
伤其阴。然亦要辨其邪能从上中解者，稍从证用之，亦无妨，不过勿犯下焦。且属虚体，当如虚怯人病邪而治，
况产后当血气沸腾之际，最多空窦，邪易乘虚内陷，为难治也。○再若经水适来适断，邪陷少阳血室，仲景立
小柴胡汤，提出所陷热邪，参、枣扶持胃气，以冲脉隶属阳明也。此惟虚者为合法。若邪热陷入，与血搏结者，
又当宗陶氏小柴胡去参、枣，加生地、桃仁、山楂肉、丹皮或犀角等。若本经血结，少腹满痛者，则用本方去
甘药加延胡、归尾、桃仁之属，气滞加香附、陈皮、枳壳等。然热陷血室之证，多有谵语如狂，与阳明胃热相
似，此种病机，最须辨别。（《指南续刻》）
温病如何？《经》曰∶不恶寒而渴者是也。不恶寒，则知其表无寒邪矣；曰渴，则知其肾水干枯矣。盖
缘其人内素有火，冬时触冒寒邪，惟其有火在内，寒邪不能深入，伏藏于肌肤，自冬至春，历时既久，火为
寒郁，肾水煎枯。盖甲木，阳木也，藉癸水而生。肾水既枯，至此时强木旺，无为发生滋润之本，故发热而渴。
海藏谓新邪唤出旧邪，非也。若复有所感，表当恶寒矣。予以地黄汤滋其肾水，以柴胡舒其木郁，随手而应。
（《赵氏医贯》）
《内经》论伤寒而反发热者，有三义∶有当时即发者，曰人伤于寒，则为病热也；有过时发热者，曰冬
伤于寒，春必病温也；有随时易名者，曰凡病伤寒而成温者，先夏至日为病温，后夏至日为病暑也。夫病温暑，
当时即病者，不必论。凡病伤寒而成者，虽由于冬时之伤寒，而根实种于其人之郁火。内经曰∶藏于精者，
春不病温。此明冬伤于寒，春必病温之源。先夏至为
病温，后夏至为病暑。此明冬不藏精，夏亦病温之故。夫人伤于寒，则为病热，其恒耳。此至春夏而病者，以
也。正如李明之所说：冬天感受寒邪，是因为冬季出现了春季的气候特征（冬行春令）。在应当寒冷的冬季却出现温暖天气，这是火气偏胜而肾水亏虚。肾水既然亏虚，那么被肾水所克制的脾土就会妄行有余；生助肾水的肺金就会不足受病；克制肾水的肝木就会反侮肾水，导致火气太过。火与土结合其德性，湿热相互助长，所以形成温病。然而根据李明之的说法，这是指冬天感受温气随即发病的情况，并非伏藏寒邪，也不是由寒变热而来。如果不是这样，就一定不会有“冬温”这一证候了。既然有了冬温，就说明有这种气候，也就有了相应的证候。通过他的言论可以详尽了解冬温，就可以确立不可磨灭的论述。如果用来论述春温，难免会贻误千古。《黄帝内经》说：违背冬季闭藏的规律，少阴肾气就不能固藏，不固藏则寒邪得以侵入。寒邪伤及肌肤，伏藏在骨髓中，这才知道冬季是闭藏精气的时节。只有违背冬季闭藏之气，使得少阴经气不能闭藏，又遭遇非时的暖热，致使腠理开泄，忽然严寒骤返，不免受到损伤。所以受伤者仍然是寒邪。因为先前被温令开泄，似乎喜欢寒冷，且所受伤害不重，所以不立即发病而潜伏在少阴经。然而之所以不在冬天发病而在春天发病，是因为水在冬季为旺盛之时，邪气伏藏在经脉中，俯首不敢抗争，郁积久了化热；到了施行春令的时候，开发腠理，阳气外泄，肾水内里亏虚，肝木应当生发，谁来鼓舞？谁来滋养？生化之源既然断绝，肝木靠什么生长呢？身体所存留的是温热之气，所以称为温病。所以我认为他论述冬天感受温气是不对的，而这里论述冬天伏藏寒邪最为精辟。○凡是温病发作，因暴寒引起的居多；热病发作，兼夹暑气的更为严重。热病从阳明经外出，温病从少阳经外出。虽然所合的经脉不同，但总离不开阳明和少阳，这是各因时令之气所致。○喻嘉言在《尚论篇》中说温病……我认为温病没有阴阳之分。为什么呢？冬天有温气，先开发人的腠理，而寒邪得以侵袭，所谓邪气聚集的地方，正气必然虚弱。只有不藏精气的人才会虚弱，虚弱则寒邪损伤经脉。经脉必定涉及少阴，是因为少阴脏本来就虚。然而所受的邪气原本轻微，且冬季月寒水当令，其权势正盛，微邪不敢抗衡。但是床榻之侧，岂容他人鼾睡？只能阻碍那生机，暗中销烁精髓，到了春天强木生长，而水不足以供给其资养，起初表现为当春而温，木旺水亏，所郁积的升发之气，火气燔灼，就是温病了。其所伤害的是寒邪；所表现的病症是温病；所伏藏的部位是少阴；所发作的部位是少阳。所以病症必定属阳而无阴，用药必定用寒凉而远离温热，黄芩汤是其主治方剂。那么嘉言论述温病有阴有阳，像伤寒三阴经可用辛热药物一样，我认为不对。不对，不是这样的。○门人问：受伤的是寒邪，为什么病变成温病？回答：伤寒不就是病寒吗？为什么会发热呢？寒邪郁结在营分之间，一两天就形成大热，何况伏藏在内几十日之久呢？既然邪气伤了肌肉，怎么能进入少阴？大概因为只有不藏精，少阴先病，所以受伤的其实是少阴。春属木，则从体内发出，无论兼夹太阳、阳明，总无不经过少阳。为什么呢？因为少阳主行春令。既然已经涉及少阴，为什么张仲景专门说太阳病？大概因为太阳与少阴相表里，所以以发热表现为太阳病。因为不恶寒，明确没有表证，那么热自然从内出，没有外邪郁结。然而仲景又说太少合病，是见到发热不恶寒，或者兼有耳聋胁满的症状；说三阳合病，是因为脉大属于阳明，而多眠则是热聚于胆。不说治法，总以黄芩汤为主治。然而嘉言又说有发表三四五次，而外证不除；攻里三四五次，而里证不除；以为在表，又像在里；以为在里，又像在表。这与瘟疫证感受天地人的湿气、热气、尸气，邪气入口鼻，混淆三焦的情况相近；与春温完全不相涉。我因此提及这些，以破除后学的疑惑。○门人又问：春温也有偶尔有一两个表证吗？回答说：有的。伏气致病，虽然感于冬天，但怎么保证风邪伤人，不在伏气将发未发的时候呢？只是兼有外感的，必须先头痛、恶寒然后热不退，这是新邪引出旧邪；或者往来寒热，头痛而呕，稍愈后浑身壮热成为病症的，这是正气又虚，伏邪发作更重。总之，没有外证的，以黄芩汤为主治；兼有外感的，必须加柴胡，或者用本经药物轻解，一定没有发汗的道理。所以仲景说：发汗后，身体灼热的，名叫风温。是说误用辛热药物，既用辛散劫夺阴液，又增加热势以助长阳气，遂使热更炽盛，脉象都浮。有如此危险的证候，以及误下、误火，严厉告诫的，除了黄芩汤，别无治法。（周禹载）
温病，热从内出，发热而口渴，不恶寒；风温，内外热交加之，自汗、身重、多眠等各种症状。这有轻重、死生的区别，医生应当以有汗、无汗作为辨别的大要，也以可汗、不可汗作为救治的大权。晋朝、唐朝以来，名贤辈出，纷纷议论，似乎还没有认识温病与风温是什么病，汪机说春温的证候有三种，吴绶说风温是伤寒的坏证，云岐子说汗下不愈而过经的为温病。这都是王叔和更感异气，变为他病，应当根据坏病而治疗的言语，开了这个头。夫误治不愈的病，叫做坏病。温病、风温，当春令而发，难道是坏病？如果一定要等到过经不愈，才辨明其为温病，那么得温病的人万无一生了。而且《内经》所说的温病，就是热病。以身热来说，就叫热；以时令来说，就叫温。所以说：凡是病伤寒而成温的，先夏至日为病温；后夏至日为病暑。王叔和不说风温重于温病，而说暑病热重于温。又说：五、六月为寒所折，热病则重。恐怕暑月所发的热，未必重于春时所发的热；而暑月所冒的寒，更未必重于春时所发的热。朱奉议说：夏至以前，发热恶寒，头痛体痛，脉浮紧的，是温病，那就是误把夏至前的伤寒当作温病了。李东垣说：冬伤于寒，冬行春令。不寒而温，火胜水亏。寒水之令，复行于春，时强木长，所以为温病。那就是误把冬伤于温，至春复寒当作温病了。奉议又说：风温治在少阴、厥阴，不可发汗。这话确实足以辅助《内经》而制定风温六方，陶节庵遵循它。然而只有栝蒌根汤恰当罢了。其余葳蕤、知母诸汤，用葳蕤、知母、石膏、白薇很好，不知道为何用麻黄、羌活发汗药？又不知道为何合用白芷、升麻阳明药？又不知道为何杂用木香、南星辛燥药？难道是想把风温与温病、温疫、冬温数者同治吗？若防己汤之用防己、白术，岂不是误把风温当作湿温吗？王海藏说：葳蕤汤有麻黄，不可用，宜用白术汤。那么白术汤果真可以治风温吗？刘河间用寒药治热病，符合《内经》饮寒水，乃刺之，必寒衣之，居止寒处，身寒而止的意义，而对于温病、风温漫无分别。而且想用三十方尽治伤寒的变证，以一下尽治热的大法，则未免粗疏。庞安常主张和解，因时在夏至前后，一以和解为主，颇得治在少阳、厥阴的宗旨。大概也是有见于风温之难治，而迁延以需变也；而顷刻危亡的，则有所不救了。那么风温就不可治吗？回答说：贵在辨别得早！治疗不可逆，逆则坏，坏则不救了。《刺热论》说：病虽未发，见赤色的，刺之，名叫治未病。又说：热甚，用五十九刺。仲师的青龙、白虎，神妙啊！得此意而推之，可以应用无穷。大概治温病，宜于发散中重加清凉；治风温，不可于清凉中重加发散。（程扶生）
冬伤于寒，春必病温，重在冬天不藏精。大概烦劳多欲之人，阴精久耗，入春则里气大泄，木火内燃，燔燎之势直从里发。始见必壮热烦冤，口干舌燥，主治以存津液为第一。黄芩汤坚阴却邪，即此义也。再者，在内之温邪欲发，在外之新邪又加，葱豉汤最为快捷方式。至于因循贻误，或因气燥津枯，或致阴伤液涸，挽救诸法，如人参白虎汤、黄连阿胶汤、玉女煎、复脉法；余则治痉厥以甘药缓肝，昏闭用幽芳开窍，热痰之投温胆，蓄血而论通瘀。○风为天之阳气，温乃化热之邪，两阳熏灼，先伤上焦，种种变幻情状，不外手三阴为病薮，头胀、汗出、身热、咳嗽，必然并见，当与辛凉轻剂清解为先，大忌辛温消散，劫烁津液。太阴无肃化之权，救逆则有蔗汁、芦根、玉竹、门冬之类；若苦寒沉降，损伤胃口，阳明失循序之司，救逆则有复脉、建中之类。此证骤变则为痉厥，缓变则为虚劳；主治之方，总以甘药为要，兼寒兼温，在人通变可也。（《临证指南》）
温邪上受，首先犯肺，逆传心包。肺主气属卫，心主血属营。辨营卫气血，虽与伤寒同，若论治法，则与伤寒异。盖伤寒之邪，留恋在表，然后化热入里；温邪则变热最速。未传心包，邪尚在肺，肺主气，其合皮毛，初用辛凉轻剂，挟风加薄荷、牛蒡之属，挟湿加芦根、滑石之流。或透风于热外，或渗湿于热下，不与热相搏，势必孤矣。不尔，风挟温热而燥生，清窍必干，水主之气不能上荣，两阳相劫也。湿与温合，蒸郁而蒙痹于上，清窍为之壅塞，浊邪害清也。其病有类伤寒，但伤寒多变证，温热虽久，总在一经不移。○前言辛凉散风，甘淡驱湿，若病不解，是渐欲入营也。营分受热，则血液被劫，心神不安，夜寤无寐，或斑点隐隐，即撤去气药。如从风热陷入者，用犀角、竹叶之属；从湿热陷入者，用犀角、花露之品参入凉血清热方中。若加烦躁、大便不通，金汁亦可加入；老年或素体寒者，以人中黄代之，急急透斑为要。若斑出热不解者，胃津亡也，主以甘寒，重则如玉女煎，轻则如梨皮、蔗浆。或其人肾水素亏，虽未及下焦，先自彷徨矣，必验之于舌，于甘寒之中加入咸寒，务在先安未受邪之地，恐其陷入耳。若其邪始终在气分留连者，可冀其战汗透邪，法宜益胃，令邪与汗并，热达腠开，邪从汗出。解后胃气空虚，当肤冷一昼夜，待胃气还，自温暖如常矣。盖战汗而解，邪退正虚，阳从汗泄，故渐肤冷。此时宜令病者安卧，以待阳气来复，旁人勿惊惶呼唤，扰其元神。但诊其脉，若虚软和缓，虽倦卧不语，汗出肤冷，却非脱证；若脉急疾，躁扰不卧，便为脱证矣。更有邪盛正虚，不能一战而解，停一二日，再战汗出而愈者，不可不知。○再论气病有不传血分，而邪留三焦，亦如伤寒中少阳病者。彼则和解表里之半，此则分消上下之势，随证变法，如杏、朴、苓等，或温胆汤之走泄。因其仍在气分，犹可望其战汗之门户、转疟之机括。○大凡看法，卫之后方言气，营之后方言血。在卫，汗之可也；到气，才可清气；乍入营分，犹可透热仍转气分而解，如犀角、元参、羚羊等是也；已入于血，就恐耗血动血，亟须凉血养血，如生地、丹皮、阿胶、赤芍等是也。若不循缓急之法，虑其动手便错耳。且吾吴湿邪害人最广，如面色白者，须要顾其阳气，湿胜则阳微也；法应清凉，用到十分之六七，即不可过，恐湿热一去，阳亦微也。面色苍者，须要顾其津液，清凉到十分之六七，往往热减身寒者，不可便云虚寒而骤投补剂，恐炉烟虽熄，灰中有火也。须细察精详，少少与之，慎勿直率而往。○又有酒客，里湿素盛，外邪入里，与之相搏，在阳旺之躯，胃湿恒多；在阴盛之体，脾湿不少。然其化热则一。热病救阴犹易，通阳最难。救阴不在补血，而在养津与汗；通阳不在温，而在利小便。○再论三焦之邪，不从外解，必成里结。里结者何在？阳明胃与大肠也，固须用下法。但伤寒热邪在里，劫灼津液，下之宜猛；此多湿邪内搏，下之宜轻。伤寒大便溏，为邪已尽，不可再下；湿温大便溏，为邪未尽，必大便硬，不可再攻，以矢燥为无湿矣。再人之体，脘在腹上，位处于中，按之痛，或自痛，或痞胀，当用苦泄，以其入腹近也。○妇人病温，与男子同，但多胎前产后，及经水适来适断。凡胎前病，古人皆用四物加减，恐邪害妊也。如热极，用井底泥，蓝布浸冷，覆盖腹上，皆是护胎之意，但要看其邪之可解处。用血腻之药不灵，又当审察，不可固执。然须步步保护胎元，恐正损邪陷也。至于产后，方书谓慎用苦寒，恐伤其阴。然亦要辨其邪能从上中解者，稍从证用之，亦无妨，不过勿犯下焦。且属虚体，当如虚怯人病邪而治，况产后当血气沸腾之际，最多空窦，邪易乘虚内陷，为难治也。○再若经水适来适断，邪陷少阳血室，仲景立小柴胡汤，提出所陷热邪，参、枣扶持胃气，以冲脉隶属阳明也。此惟虚者为合法。若邪热陷入，与血搏结者，又当宗陶氏小柴胡去参、枣，加生地、桃仁、山楂肉、丹皮或犀角等。若本经血结，少腹满痛者，则用本方去甘药加延胡、归尾、桃仁之属，气滞加香附、陈皮、枳壳等。然热陷血室之证，多有谵语如狂，与阳明胃热相似，此种病机，最须辨别。（《指南续刻》）
温病如何？《内经》说：不恶寒而渴的就是。不恶寒，就知道表无寒邪了；曰渴，就知道肾水干枯了。大概因为其人内有素有火，冬天时触冒寒邪，只因为其有火在内，寒邪不能深入，伏藏于肌肤，自冬至春，历时既久，火为寒郁，肾水煎枯。盖甲木，阳木也，藉癸水而生。肾水既枯，至此时强木旺，无为发生滋润之本，故发热而渴。海藏说新邪唤出旧邪，是不对的。如果复有所感，表当恶寒了。我用地黄汤滋其肾水，以柴胡舒其木郁，随手而应。（《赵氏医贯》）
《内经》论伤寒而反发热者，有三义：有当时即发者，曰人伤于寒，则为病热也；有过时发热者，曰冬伤于寒，春必病温也；有随时易名者，曰凡病伤寒而成温者，先夏至日为病温，后夏至日为病暑也。夫病温暑，当时即病者，不必论。凡病伤寒而成者，虽由于冬时之伤寒，而根实种于其人之郁火。内经曰：藏于精者，春不病温。此明冬伤于寒，春必病温之源。先夏至为病温，后夏至为病暑。此明冬不藏精，夏亦病温之故。夫人伤于寒，则为病热，其恒耳。此至春夏而病者，以
... As Li Mingzhi stated: "Winter injury by cold" occurs when winter exhibits the characteristics of spring (winter acting as spring). When it is warm in winter, fire is excessive and water is deficient. Since water is deficient, the element controlled by water (Earth) acts recklessly and becomes excessive; the element that generates water (Metal) suffers disease and becomes insufficient; the element that controls water (Wood) insults it, leading to excessive fire. Fire and Earth combine their virtues, with damp-heat assisting each other, thus forming Warm Disease (Wen Bing). However, according to Li Mingzhi's statement, this refers to contracting warmth immediately upon exposure in winter, not latent cold, nor transformation from cold. Otherwise, there would be no such syndrome as "Winter Warmth." Once Winter Warmth exists, there must be this climate and consequently this syndrome. Through his words, one can fully understand Winter Warmth, establishing an unshakable theory. If applied to discuss Spring Warmth, it would mislead for generations. The *Classic* states: "Violating the Qi of winter causes Shaoyin [Kidney] to fail to store; failing to store allows Cold Evil to enter." Injury to the skin and muscles, lying latent in the bone marrow, reveals that winter is the time for storing essence. Only by violating the Qi of winter does the Qi of the Shaoyin meridian fail to close; encountering non-seasonal warmth causes the pores to open. Sudden return of severe cold inevitably causes injury. Thus, the injured party is still Cold Evil. Because previously opened by warmth, it seems to prefer cold, and the injury is slight, so it does not manifest immediately but lies latent in Shaoyin. Yet why does it manifest in spring rather than winter? Because Water is prosperous in winter, evil lies latent in the meridians, bowing its head and daring not resist; stagnation over time transforms into heat. When spring commands arrive, opening the pores, Yang Qi leaks outward, Kidney Water is internally deficient, Liver Wood should sprout, but who encourages it? Who nourishes it? With the source of generation cut off, how can Wood rely on it to grow? What remains in the body is warmth, hence called Warm Disease. Therefore, I consider his discussion on winter contraction of warmth incorrect, while this discussion on winter latent cold is most precise. ○ Generally, the onset of Warm Disease is mostly due to sudden cold; the onset of Heat Disease is more severe when combined with Summerheat. Heat Disease exits via the Yangming channel, while Warm Disease exits via the Shaoyang channel. Although the involved meridians differ, they generally do not depart from Yangming and Shaoyang, depending on the seasonal Qi. ○ Yu Jiayan in *Shanglun* discusses Warm Disease... I believe Warm Disease has no Yin-Yang distinction. Why? Winter warmth first opens the pores, allowing Cold Evil to invade, as stated: "Where evil gathers, Qi must be deficient." Only those who do not store essence become deficient; deficiency allows Cold Evil to damage the meridians. The meridians must involve Shaoyin because the Shaoyin Zang is inherently deficient. However, the initial injury is slight, and in winter, Cold Water rules with strong authority, so slight evil dares not contend. But just as one cannot tolerate another snoring beside one's bed, the vital energy is obstructed, and essence is secretly consumed. By spring, strong Wood grows, but Water is insufficient to support it. Initially presenting as warmth in spring, with Wood excess and Water deficiency, the stagnant ascending energy causes Fire to blaze, resulting in Warm Disease. The injured factor is Cold; the manifested disease is Warmth; the latent site is Shaoyin; the eruptive site is Shaoyang. Thus, the disease is necessarily Yang without Yin, treatment must use Cold herbs and avoid Hot ones, with Huangqin Tang as the primary formula. Therefore, Jiayan's argument that Warm Disease has both Yin and Yang, similar to using Pungent-Hot herbs for the Three Yin meridians in Cold Damage, I say is incorrect. No, it is not so. ○ A disciple asked: "The injury is by Cold, why does the disease become Warm?" I answered: "Is Cold Damage not a disease of Cold? Why does it become hot? Cold stagnates in the Ying level, becoming intense heat in one or two days; how much more so after lying latent inside for dozens of days?" Since the evil injured the muscles, how did it enter Shaoyin? It is precisely because failing to store essence causes Shaoyin to be diseased first; thus, what is injured is Shaoyin. Spring belongs to Wood, so it emerges from within. Regardless of whether it combines with Taiyang or Yangming, it invariably passes through Shaoyang. Why? Because Shaoyang governs the spring command. Since it involves Shaoyin, why does Zhang Zhongjing specifically mention Taiyang disease? Because Taiyang and Shaoyin are exterior-interior pairs, so fever manifests as Taiyang disease. Since there is no aversion to cold, clearly there is no exterior syndrome, so the heat naturally comes from within, without external evil stagnation. However, Zhongjing also mentions Tai-Shao combined disease, observing fever without aversion to cold, or accompanied by deafness and hypochondriac fullness; he mentions San-Yang combined disease because a large pulse belongs to Yangming, and excessive sleep indicates heat gathering in the Gallbladder. He does not specify methods, generally taking Huangqin Tang as the main treatment. Yet Jiayan says that releasing the exterior three or five times fails to remove exterior symptoms; purging the interior three or five times fails to remove interior symptoms; thinking it is in the exterior, yet seeming in the interior; thinking it is in the interior, yet seeming in the exterior. This is similar to Epidemic Toxin contracting Heaven-Earth-Human Dampness, Heat, and Corpse Qi, entering mouth and nose, confusing the Triple Burner; it has nothing to do with Spring Warmth. I mention this to dispel the confusion of later learners. ○ A disciple again asked: "Does Spring Warmth occasionally have one or two exterior symptoms?" I said: "Yes. Diseases of latent Qi, although contracted in winter, how can we guarantee that Wind Evil does not injure the person when the latent Qi is about to erupt but has not yet done so? However, when combined with external contraction, headache and aversion to cold must precede persistent fever; this is new evil drawing out old evil. Or alternating chills and fever, headache with vomiting, followed by high fever after slight improvement; this is righteous Qi being deficient again, causing the latent eruption to be heavier. In summary, without exterior symptoms, Huangqin Tang is the main treatment; with external contraction, Chaihu must be added, or light resolution using channel-specific herbs; sweating methods are absolutely contraindicated. Thus Zhongjing said: 'After sweating, if the body burns with heat, it is named Fengwen.' This means mistakenly using Pungent-Hot herbs, which pungently disperse and plunder Yin, while increasing heat to assist Yang, making the heat fiercer and pulses floating. With such critical conditions, as well as mistaken purgation and moxibustion, strict warnings are given. Apart from Huangqin Tang, there is no other treatment method." (Zhou Yuzai)
Warm Disease, heat emerges from within, presenting with fever and thirst, without aversion to cold; Fengwen presents with internal and external heat superimposed, spontaneous sweating, heaviness of the body, and excessive sleep. There is a distinction in severity and life/death outcomes. Physicians must take the presence or absence of sweat as the key to differentiation, and the possibility or impossibility of sweating as the major principle of rescue. Since the Jin and Tang dynasties, numerous sages have emerged, discussing endlessly, seemingly failing to recognize what Warm Disease and Fengwen are. Wang Ji stated there are three types of Spring Warmth; Wu Shou stated Fengwen is a deteriorated state of Cold Damage; Yun Qizi stated that diseases persisting past the meridian stages despite sweating and purging are Warm Diseases. All these originated from Wang Shuhe's statement that contracting different Qi changes the disease, and one should treat based on the deteriorated state. A disease that fails to heal due to mistreatment is called a deteriorated state (Huai Bing). Can Warm Disease and Fengwen, erupting during the spring command, be considered deteriorated states? If one must wait until the disease persists past the meridian stages to identify it as Warm Disease, then those with Warm Disease would have no chance of survival. Moreover, the *Neijing* states that Warm Disease is Heat Disease. Speaking of body heat, it is called Heat; speaking of the season, it is called Warmth. Thus it says: "All diseases transforming from Cold Damage into Warmth occur before the Summer Solstice as Warm Disease; after the Summer Solstice as Summerheat Disease." Wang Shuhe did not say Fengwen is more severe than Warm Disease, but that Summerheat Disease heat is more severe than Warmth. He also said: "In the fifth and sixth months, if restrained by cold, Heat Disease becomes severe." I fear that heat erupting in summer may not necessarily be more severe than heat erupting in spring; and cold contracted in summer is certainly not more severe than heat erupted in spring. Zhu Fengyi said: "Before the Summer Solstice, fever with aversion to cold, headache, body pain, and floating-tight pulse constitute Warm Disease." This mistakes pre-Solstice Cold Damage for Warm Disease. Li Dongyuan said: "Winter injury by cold, winter acting as spring. Not cold but warm, fire exceeds water. The command of Cold Water reappears in spring, strong Wood grows, thus becoming Warm Disease." This mistakes winter injury by warmth, returning to cold in spring, as Warm Disease. Fengyi further stated: "Fengwen is treated in Shaoyin and Jueyin, sweating is contraindicated." This statement indeed supports the *Classic* and formulated the six formulas for Fengwen, which Tao Jian'an followed. However, only Gualou Gen Tang is appropriate. For the other formulas like Weirui and Zhimu decoctions, using Weirui, Zhimu, Shigao, and Baiwei is good, but why use Mahuang and Qianghuo (sweating herbs)? Why combine Baizhi and Shengma (Yangming herbs)? Why mix Muxiang and Nanting (pungent-dry herbs)? Is it to treat Fengwen together with Warm Disease, Epidemic Warmth, and Winter Warmth? If Fangji Tang uses Fangji and Baizhu, is it not mistaking Fengwen for Damp-Warmth? Wang Haicang said: "Weirui Tang contains Mahuang, it should not be used; Baizhu Tang should be used instead." Then can Baizhu Tang truly treat Fengwen? Liu Hejian used Cold herbs to treat Heat Disease, aligning with the *Neijing*'s meaning of drinking cold water, pricking, wearing cold clothes, dwelling in cold places, until the body feels cold. However, he made no distinction between Warm Disease and Fengwen. Furthermore, wanting to treat all variations of Cold Damage with thirty formulas, and all Heat treatments with purgation alone, is somewhat crude. Pang Anchang advocated harmonizing, focusing on the period around the Summer Solstice, primarily using harmonizing methods, which roughly captures the essence of treating Shaoyang and Jueyin. Perhaps he saw the difficulty in treating Fengwen and delayed to await changes; however, for cases of imminent danger, there is no rescue. So, is Fengwen untreatable? I say: It depends on early differentiation! Treatment must not be reversed; reversal leads to deterioration, and deterioration is incurable. The *Laci Re Lun* states: "Even if the disease has not erupted, if redness is seen, prick it; this is called treating before disease." It also states: "When heat is severe, use fifty-nine pricks." Zhongshi's Qinglong and Baihu formulas are divine! Applying this logic allows endless application. Generally, treating Warm Disease requires adding significant cooling to dispersing methods; treating Fengwen must not add significant dispersing to cooling methods." (Cheng Fusheng)
"Winter injury by cold, spring must contract Warmth" emphasizes winter failure to store essence. Generally, those who are fatigued and lustful have long depleted Yin essence. Entering spring, the interior Qi leaks greatly, Wood and Fire ignite internally, and the blazing force erupts directly from within. Initially presenting with high fever, vexation, dry mouth, and dry tongue, the primary treatment is to preserve fluids. Huangqin Tang solidifies Yin and expels evil, embodying this principle. Secondly, when internal Warmth evil desires to erupt and external new evil adds to it, Congchi Tang is the quickest method. Regarding delays due to negligence, or due to Qi dryness and fluid depletion, or causing Yin injury and fluid exhaustion, rescue methods include Renshen Baitu Tang, Huanglian Ejiao Tang, Yunnv Jian, and Fu Mai Fa; others include treating spasms and convulsions with Sweet herbs to soothe Liver, treating coma and closure with aromatic openings, treating Phlegm-Heat with Wendan Tang, and treating Blood Stasis with blood-invigorating methods. ○ Wind is the Yang Qi of Heaven, Warmth is the pathogen transforming into Heat. Two Yangs scorching, first injuring the Upper Jiao. Various changing conditions all center on the Hand Three Yin meridians as the source of disease. Head distension, sweating, body heat, and coughing must appear together. One should first use mild Pungent-Cold agents to clear and resolve. Strongly avoid Pungent-Warm dispersants that plunder fluids. If Taiyin lacks the power of descending and transforming, rescue measures include Sugarcane juice, Reed rhizome, Yuzhu, and Maidong; if Bitter-Cold sinking damages the stomach appetite, and Yangming loses its sequential governance, rescue measures include Fu Mai and Jianzhong formulas. This condition suddenly changes into spasms/convulsions, or slowly changes into deficiency consumption; the governing formulas always prioritize Sweet herbs, combining Cold and Warm according to the physician's adaptability. (*Lin Zheng Zhi Nan*)
Warmth evil enters from above, first attacking the Lung, and reversely transmitting to the Pericardium. Lung governs Qi and belongs to Wei (Defensive); Heart governs Blood and belongs to Ying (Nutritive). Differentiating Ying, Wei, Qi, and Blood is similar to Cold Damage, but regarding treatment methods, it differs. The evil of Cold Damage lingers at the exterior, then transforms into heat and enters the interior; Warmth evil transforms into heat most rapidly. Before transmitting to the Pericardium, the evil remains in the Lung. Lung governs Qi and connects to skin and hair. Initially use mild Pungent-Cold agents; if complicated by Wind, add Bohe and Niubang; if complicated by Dampness, add Lugen and Huashi. Either vent Wind outside the Heat, or drain Dampness below the Heat, so it does not clash with Heat, inevitably isolating it. Otherwise, Wind carrying Warmth creates Dryness, clear orifices will dry up, the Qi of Water cannot ascend to nourish, and two Yangs mutually plunder. Dampness combining with Warmth steams and obstructs upwards, blocking the clear orifices, turbid evil harming clarity. The disease resembles Cold Damage, but Cold Damage has many variable syndromes, whereas Warmth, even if prolonged, remains in one meridian without shifting. ○ Previously mentioned Pungent-Cold dispersing Wind, Sweet-Bland driving Dampness. If the disease does not resolve, it is gradually entering the Ying level. Ying level receiving heat plunders Blood, disturbing the Spirit, causing night waking and insomnia, or faint rashes. Immediately withdraw Qi-level herbs. If entering from Wind-Heat, use Xijiao and Zhuye; if entering from Damp-Heat, use Xijiao and Flower Dew in Blood-Cooling and Heat-Clearing formulas. If adding restlessness and constipation, Jinzi can be added; for elderly or constitutionally cold persons, Renzhonghuang substitutes it. Urgently resolve the rash is essential. If rash erupts but heat does not resolve, Stomach fluids are exhausted. Primary treatment is Sweet-Cold; severe cases like Yunnv Jian, mild cases like Pear skin and Sugarcane juice. If the person's Kidney Water is chronically deficient, although not yet reaching the Lower Jiao, anxiety arises first. Verify with the tongue. Add Salty-Cold to Sweet-Cold. Ensure securing areas not yet invaded by evil, fearing invasion. If the evil lingers in the Qi level throughout, one may hope for Battle Sweat to vent the evil. Method should benefit the Stomach, allowing evil to exit with sweat, heat reaches pores, evil exits with sweat. After resolution, Stomach Qi is empty, skin may feel cold for a day and night. Wait for Stomach Qi to return, naturally warming as usual. Because battle sweat resolves, evil retreats and Righteous Qi is deficient, Yang leaks with sweat, hence gradual skin cold. At this time, let the patient rest peacefully, awaiting Yang Qi recovery. Do not startle or call out, disturbing the Primordial Spirit. Only examine the pulse. If weak, soft, and slow, although tired and silent, sweating and cold skin, it is not Collapse Syndrome; if pulse is rapid and urgent, restless and unable to lie down, it is Collapse Syndrome. More importantly, when Evil is excessive and Righteous Qi deficient, unable to resolve in one battle, stopping one or two days, then battling sweat erupts and heals; this must be known. ○ Again discussing Qi diseases not transmitting to Blood level, but evil lingering in Triple Burner, similar to Shaoyang disease in Cold Damage. That resolves half-exterior/half-interior; this divides and eliminates upper/lower tendencies, changing methods according to syndrome, such as Xing, Po, Ling, or Wendan Tang draining. Because it remains in Qi level, one can still hope for the portal of battle sweat or the mechanism of malaria conversion. ○ Generally, view it as: after Wei, speak of Qi; after Ying, speak of Blood. In Wei, sweating is acceptable; arriving at Qi, only then clear Heat; newly entering Ying, still can vent heat back to Qi level for resolution, such as Xijiao, Xuanshen, Lingyang; already entered Blood, fear consuming and moving Blood, urgently need Cooling Blood and Nourishing Blood, such as Shengdi, Mudanpi, Ejiao, Chishao. If not following the method of urgency, fear making mistakes upon action. Moreover, our Wu region Dampness harms people most widely. For those with white complexion, must protect Yang Qi; Dampness excess leads to Yang weakness. Method should be Cooling, but stop at 60-70%, do not exceed, fearing once Damp-Heat is gone, Yang also becomes weak. For those with dark complexion, must protect Fluids. Cooling to 60-70%, often heat decreases and body feels cold; do not immediately claim Deficiency-Cold and suddenly administer tonics, fearing although stove smoke is extinguished, embers still have fire. Must observe carefully and meticulously, give little by little, beware of reckless advancement. ○ Also, wine drinkers have inherent internal Dampness. External evil enters interior, clashing with it. In Yang-prosperous bodies, Stomach Dampness is abundant; in Yin-excess bodies, Spleen Dampness is considerable. However, their transformation into Heat is the same. Treating Heat Disease to save Yin is relatively easy; communicating Yang is most difficult. Saving Yin is not about tonifying Blood, but nourishing Fluids and managing Sweat; communicating Yang is not about warming, but about promoting urination. ○ Again discussing Triple Burner evil not resolving from exterior must form interior knotting. Where is the interior knotting? Yangming Stomach and Large Intestine. Purging method is necessary. But Cold Damage Heat evil in interior plunders fluids, purging should be fierce; this case mostly has internal Dampness clashing, purging should be mild. Cold Damage loose stool means evil is exhausted, do not purge again; Damp-Warmth loose stool means evil is not exhausted, must have hard stool, do not attack again, as dry feces indicate no Dampness. Again, the human body, epigastrium is above abdomen, located in middle, pressing causes pain, or spontaneous pain, or fullness, should use Bitter Draining, as it is near the abdomen. ○ Women suffering Warmth are same as men, but often involve pre/post-natal periods and menstrual flow starting/stopping. For pre-natal disease, ancients used Siwu Decoction modifications, fearing evil harms pregnancy. If heat is extreme, use well-bottom mud, blue cloth soaked in cold water covering abdomen, all are protecting fetus intentions, but look at where evil can be resolved. Using Blood-greasy herbs ineffective, must examine, do not be stubborn. However, must step-by-step protect fetal origin, fearing Righteous damage and evil sinking. As for post-partum, medical books say cautiously use Bitter-Cold, fearing injuring Yin. But also distinguish if evil can resolve from Upper/Middle, slightly follow syndrome using them, no harm, just do not offend Lower Jiao. And belonging to deficient body, treat like deficient person with evil, moreover post-partum is when Blood-Qi boils, having many empty spaces, evil easily sinks inward by deficiency, difficult to treat. ○ Again if menstrual flow starts/stops, evil sinks into Shaoyang Blood Chamber. Zhongjing established Xiaochaihu Tang to extract sunk Heat evil, Ginseng and Jujube support Stomach Qi, because Chong Meridian belongs to Yangming. This is suitable only for deficiency. If Heat evil sinks, clashing with Blood, follow Tao's Xiaochaihu removing Ginseng/Jujube, adding Shengdi, Taoren, Hawthorn flesh, Mudanpi or Xijiao etc. If original channel Blood stasis, lower abdomen full/painful, use this formula removing Sweet herbs adding Yanhu, Guowei, Taoren etc., Qi stagnation add Xiangfu, Chenpi, Zhike etc. However, Heat sinking Blood Chamber syndrome often has delirium like madness, similar to Yangming Stomach Heat, this pathology must be distinguished. (*Zhinan Xuke*)
How is Warm Disease? The *Classic* says: "Not aversion to cold but thirsty is it." Not aversion to cold, knowing no Cold Evil at exterior; saying thirsty, knowing Kidney Water is dried up. Generally because the person has internal Fire, touching Cold Evil in winter. Because there is Fire inside, Cold Evil cannot penetrate deep, lying latent in skin and muscles. From winter to spring, time passes long, Fire is constrained by Cold, Kidney Water is boiled dry. Jia Wood is Yang Wood, relying on Gui Water to generate. Since Kidney Water is dried up, when strong Wood is prosperous, there is no root for generation and nourishment, thus fever and thirst. Haicang said new evil calls out old evil, which is incorrect. If further affected, exterior should have aversion to cold. I use Dihuang Tang to nourish Kidney Water, Chaihu to soothe Wood stagnation, responding instantly. (*Zhao Shi Yi Guan*)
*Neijing* discusses Cold Damage but contrary fever has three meanings: There is immediate onset, saying "Man injured by Cold, then becomes Heat Disease"; There is delayed onset, saying "Winter injury by Cold, Spring must contract Warmth"; There is changing name with time, saying "All diseases becoming Warmth from Cold Damage, before Summer Solstice is Warm Disease, after Summer Solstice is Summerheat Disease." For Warmth/Summerheat, immediate onset need not discuss. All diseases becoming Warmth from Cold Damage, although due to winter Cold Damage, the root is actually planted in the person's stagnant Fire. *Neijing* says: "Storing Essence, Spring does not contract Warmth." This clarifies the source of Winter injury by Cold, Spring Warmth. Before Summer Solstice Warm Disease, after Summer Solstice Summerheat Disease. This clarifies Winter failure to store Essence, Summer also contracts Warmth. Man injured by Cold, becomes Heat Disease, is constant. This to Spring/Summer disease, by