朱氏全生集曰。自霜降后至春分前。天令严寒。水冰地冻。其杀属之气。人触犯之。即
时病者。为正伤寒。若虽冬月而天令温暖。感之则为冬温。如至春分节后。天令温暖。感之
而病者。为温病。若虽至春分而天令尚寒。人有感寒而病者。亦伤寒也。若夏至后。天道
壮热。人感邪而病。其脉洪大。为热病。若四五六七八月之间。天道忽有暴寒。人感之而为
病者。乃时行寒疫也。若四时天令不正。感而为病。长幼相似。复能传染者。此名时气。即
时疫也。非伤寒比也。又云。冬时感受寒邪而不即病。伏于身中。至春变为温病。至夏变为
热病。夫温热二病。乃冬月伏寒之所变。既变之后。不得复言寒矣。此外又有风温、湿温。
一皆发热。状类伤寒。故医家通以伤寒称之。其通称伤寒者。因发热传变。皆相类也。至于
用药。则不同矣。此数种乃仲景所未论。又在痉湿 三项之外。必须辨之。
王肯堂治一孕妇。春夏之交患温病。头痛发热。不恶寒而渴。未及疗治。胎堕。去血无
算。昏眩欲绝。王令以麦门冬斤许。入淡竹叶、香豉煎。频饮之。汗出而愈。盖用劳复法治
张路玉治徐君育。素禀阴虚多火。且有脾约便血证。十月间患冬温。发热咽痛。里医用
麻黄、杏仁、半夏、枳橘之属。遂喘逆。倚息不得卧。声飒加哑。头面赤热。手足逆冷。右
手寸关虚大微数。此热伤手太阴气分也。与葳蕤、甘草等药不应。为制猪肤汤一瓯。令隔汤
顿热。不时挑服。三日声清。终剂而痛如失。
又治郑墨林室。素有便红。怀妊七月。正肺气养胎时。而患冬温。咳嗽咽痛如刺。下血
如崩。脉较平时反觉小弱而数。此热伤手太阴血分也。与黄连阿胶汤二剂。血止后。去黄连
加葳蕤、桔梗、人中黄。四剂而安。
又治黄以宽。风温十余日。壮热神昏。语言难出。自利溏黑。舌胎黑燥。唇焦鼻煤。先
前误用发散消导药数剂。烦渴弥甚。张石顽曰。此本伏气郁发。更遇于风。遂成风温。风温
脉气本浮。以热邪久伏少阴。从火化。发出太阳。即是两感。变患最速。今幸年壮质强。已
逾三日六日之期。证虽危殆。良由风药性升。鼓激周身元气。皆化为火。伤耗真阴。少阴之
脉。不能内藏。所以反浮。考诸南阳先师。元无治法。而少阴例中。则有救热存阴。承气下
之一证。可借此以迅扫久伏之邪。审其鼻息不鼾。知肾水之上源未绝。无虑其直视失溲也。
时歙医胡晨敷在坐。同议凉膈散加人中黄、生地黄。服后下溏粪三次。舌胎未润。烦渴不减
此杯水不能救车薪之火也。更与大剂凉膈。大黄加至二两。兼黄连、犀角。三下方能热除
于是专用生津止渴。多服而愈。
又治陆中行室。年二十余。腊月中旬。患咳嗽。挨过半月。病热少减。新正五日。复咳
倍前。自汗体倦。咽喉干痛。至元夕。忽微恶寒发热。明日转为腹痛自利。手足逆冷。咽痛
异常。又三日则咳唾脓血。张诊其脉。轻取微数。寻之则仍不数。寸口似动而软。尺部略重
则无。审其脉证。寒热难分。颇似仲景厥阴例中麻黄升麻汤证。盖始本冬温。所伤原不为重
故咳至半月渐减。乃勉力支持岁事。过于劳役。伤其脾肺之气。故咳复甚于前。至望夜忽
憎寒发热。来日遂自利厥逆者。当是病中体疏。复感寒邪之故。热邪既伤于内。寒邪复加于
外。寒闭热邪。不得外散。势必内奔而为自利。致邪传少阴厥阴。而为咽喉不利。唾脓血也
虽伤寒大下后。与伤热后自利不同。而寒热错杂则一。遂与麻黄升麻汤。一剂。肢体微汗
手足温暖。自利即止。明日诊之。脉亦向和。嗣后与异功生脉合服。数剂而安。
许学士云。故人王彦龙。作毗陵仓官。季夏时。病胸项多汗。两足逆冷。谵语。医者不
晓。杂进药。已经旬日。予诊之。其脉关前濡。关后数。予曰。当作湿温治之。盖先受暑后
受湿也。难经曰。湿温之脉。阳濡而弱。阴小而急。濡弱见于阳部。湿气搏暑也。小急见于
阴部。暑气蒸湿也。暑湿相搏。是名湿温。先以白虎加人参汤。次白虎加苍术汤。头痛渐退
足渐温。汗渐止。三日愈。此证属贼邪。误用药。有死之理。有人难曰。何名贼邪。予曰
难经云五邪。有实邪、虚邪、正邪、微邪、贼邪。从后来者为虚邪。从前来者为实邪。从
所不胜来者为贼邪。从所胜来者为微邪。自病者为正邪。又曰。假令心病。中暑得之为正邪
中湿得之为贼邪。今心先受暑而湿邪乘之。水克火。从所不胜。斯谓之贼邪。五邪中之最
张路玉治范振麟。大暑中。患厥冷自利。六脉弦细芤迟。按之欲绝。舌色淡白。中心黑
润无胎。口鼻气息微冷。阳缩入腹。而精滑如冰。问其所起之由。因卧地昼寝受寒。是夜连
走精二度。忽觉颅胀如山。坐起晕倒。便四肢厥逆。腹痛自利。胸中兀兀欲吐。口中喃喃妄
言。与湿温之证不殊。医者误为停食感冒。与发散消导药。服后胸前头项汗出如漉。背上愈
加畏寒。而下体如冰。一日昏愦数次。此阴寒挟暑。入中手足少阴之候。缘肾中真阳虚极。
所以不能发热。遂拟四逆加人参汤。用人参一两。熟附三钱。炮姜二钱。炙甘草二钱。昼
夜兼进。三日中进六剂。决定第四日寅刻回阳。是日悉屏姜、附。改用保丸。人参五钱。黄
三钱。炙甘草二钱。加麦门冬二钱。五味子一钱。清肃膈上之虚阳。四剂食进。改用生料
六味加麦冬、五味。每服用熟地八钱。以救下焦将竭之水。使阴平阳秘。精神乃治。
喻嘉言治黄起潜春月病温。头面甚红。谓曰。望八老翁。下元虚惫。阳浮于上。与在表
邪相合。所谓戴阳之证也。阳已戴于头面。不知者更行表散。则孤阳飞越。危殆立至矣。此
证只有陶节庵立法甚妙。以人参、附子等药。收拾阳气归于下元。而加葱白透表以散外邪。
如法用之即愈。万不宜迟。渠骇为偏僻之说。更医投以表药。顷刻阳气升腾。肌肤粟起。又
顷刻寒颤切牙。浑身冻裂而逝。
喻嘉言治金鉴春温已二旬外。壮热不退。谵语无伦。皮肤枯燥。胸膛板结。舌卷唇焦。
身蜷足冷。二便略通。半渴不渴。面上一团黑滞。从前汗下和温之法。历试不效。喻曰。此
证与两感伤寒无异。内经原谓六日死。因春温证不传经。故虽邪气留连不退。犹可多延几日
待元气竭绝乃死。观其阴证阳证两下混在一区。治阳则碍阴。治阴则碍阳。与两感病情符
合。仲景原无治法。惟论序有发表攻里。本自不同之说。即师其意。以麻黄附子细辛两解在
表阴阳之邪。果然皮间透汗而热全清。再以附子泻心汤两解在里阴阳之邪。果然胸前柔活。
人事明了。诸证俱退。次日即索粥。以后竟不需药。只此二剂而起一生于九死。快哉。
震按此条立法甚巧。惜不载脉象若何。然读嘉言春温论。自述收功反掌。并笑人见热烦
枯燥之证而不敢用附子者之愚。则脉不必论耶。又云。冬不藏精之春温。初发时未必脉微数
惟不用麻附细辛、麻附甘草二方。驯至脉微且数。而汗下温皆不能救。见解独辟。又周禹
载曰。温疫大法。以证为则。毋专以脉为据。亦必有所见而云然也。
一人夏月远行劳倦。归感热证。下痢脓血。身如燔炙。舌黑而燥。夜多谵语。林北海视
之曰。此阳明病也。不当作痢治。但脉已散乱。忽有忽无。状类虾游。殆不可治。其家固请
用药。林曰。阳明热甚。当速解其毒。在古人亦必急下之以存真阴之气。然是证之源。由于
劳倦。阳邪内灼。脉已无阴。若骤下之。则毒留而阴绝。死不治矣。勉与养阴。以冀万一。
用熟地一两。生地、麦冬、归、芍、甘草、枸杞佐之。戒其家曰。汗至乃活。服后热不减。
而谵语益狂悖。但血痢不下。身有微汗。略出即止。林诊之。则脉已接续分明。洪数鼓指。
喜曰。今生矣。仍用前方。去生地加萸肉、丹皮、山药、枣仁。连服六帖。谵妄昏热不减。
其家欲求更方。林执不可。又二日。诊其脉始敛而圆。乃用四顺清凉饮子加熟地一两。大黄
五钱。下黑矢而诸证顿愈。越二日。忽复狂谵发热。喘急口渴。举家惶惑。谓今必死矣。林
笑曰。岂忘吾言乎。得汗即活矣。此缘下后阴气已至。而无以鼓动之。则营卫不洽。汗无从
生。不汗则虚邪不得外达。故内沸而复也。病从阳入。必从阳解。遂投白术一两。干姜三钱
甘草一钱。归、芍各三钱。尽剂。汗如注。酣卧至晓。病良已。
震按此证疑难在于初末。初期脉类虾游。若援张景岳证实脉虚之说而用参、术、姜、附
则必死。末后狂热复发。若引吴又可余邪注胃之说而用白虎承气亦必危。此案见解用药俱佳
然其得生处。在于养阴而血痢顿止。脉即应指耳。中间连服六帖。谵妄昏热不减。幸不见
手足厥冷。尤幸不至声喑不语。绝谷不食也。则以脉之敛而圆故也。但白术一两干姜三钱以
治狂热喘渴。殊难轻试。
徽人江仲琏。冒寒发热。两项臃肿如升大。臂膊磊块无数。不食不便。狂躁发渴。诊其
脉浮数无序。医作伤寒发毒治。高鼓峰曰。误矣。此燥逐风生也。用大剂疏肝益肾汤。熟地
加至二两许。五剂而肿退便解。十剂而热除食进。再用补中益气汤加麦冬、五味。调理而愈
震按今之所谓伤寒者。大概皆温热病耳。仲景云。太阳病发热而渴不恶寒者为温病。在
太阳已现热象。则麻桂二汤必不可用。与伤寒迥别。内经云。热病者皆伤寒之类也。是指诸
凡骤热之病。皆当从伤寒例观。二说似乎不同。因审其义。盖不同者在太阳。其余则无不同
也。温热病只究三焦。不讲六经。此是妄言。仲景之六经。百病不出其范围。岂以伤寒之类
反与伤寒截然两途乎。叶案云。温邪吸自口鼻。此亦未确。仲景明云。伏气之发。李明之
王安道俱言冬伤于寒。伏邪自内而发。奈何以吴又可温疫论牵混耶。惟伤寒则足经为主。
温热则手经病多。如风温之咳嗽息鼾。热病之神昏谵语。或溏泻粘垢。皆手太阴肺手厥阴心
胞络手阳明大肠现证。甚者喉肿肢掣。昏蒙如醉。躁扰不宁。齿焦舌燥。发斑发颐等证。其
邪分布充斥。无复六经可考。故不以六经法治耳。就予生平所验。初时兼挟表邪者最多。仍
宜发散。如防、葛、豉、薄、牛蒡、杏仁、滑石、连翘等。以得汗为病轻。无汗为病重。如
有斑。则参入蝉蜕、桔梗、芦根、西河柳之类。如有痰。则参入土贝、天虫、栝蒌、橘红之
类。如现阳明证。则白虎承气。少阳证则小柴胡去参、半。加花粉、知母。少阴证则黄连阿
胶汤、猪苓汤、猪肤汤。俱宗仲景六经成法有效。但温热病之三阴证多死。不比伤寒。盖冬
不藏精者。东垣所谓肾水内竭。孰为滋养也。惟大剂养阴。佐以清热。或可救之。养阴如二
地、二冬、阿胶、丹皮、元参、人乳、蔗浆、梨汁。清热如三黄、石膏、犀角、大青、知母
芦根、茅根、金汁、雪水、西瓜、银花露、丝瓜汁。随其对证者选用。若三阴经之温药。
与温热病非宜。亦间有用真武理中者。百中之一二而已。大抵温热病。最怕发热不退。及痉
厥昏蒙。更有无端而发晕。及神清而忽间以狂言者。往往变生不测。遇此等证。最能惑人。
不比阳证阴脉。阳缩舌卷撮空见鬼者。易烛其危也。要诀在辨明虚实。辨得真方可下手。然
必非刘河间吴又可之法所能救。平素精研仲景伤寒论者。庶有妙旨。至如叶案之论温热。有
邪传心胞。震动君主。神明欲迷。弥漫之邪。攻之不解。清窍既蒙。络内亦痹。豁痰降火无
效者。用局方至宝丹。或紫雪。或牛黄丸。宗喻氏芳香逐秽宜窍之说。真足超越前贤。且不
蹈用重药者。一匙偶误。覆水难收之弊也。此翁聪明诚不可及。今所选之案虽少。而诸法毕
备。亦足为学人导夫先路矣。
《朱氏全生集》说：从霜降之后到春分之前，天气严寒，水结冰地冻，人触犯了这种肃杀之气，立即发病的，称为正伤寒。如果虽然是冬天但天气温暖，感受了邪气而发病的，称为冬温。到了春分节气之后，天气温暖，感受邪气而发病的，称为温病。如果虽然到了春分但天气仍然寒冷，有人感受寒邪而发病的，也是伤寒。夏至以后，天道酷热，人感受邪气而发病，脉象洪大，称为热病。在四、五、六、七、八月之间，天气突然有暴寒，人感受它而发病的，是时行寒疫。如果四季气候不正，人感受它而发病，老少症状相似，又能互相传染的，这名叫时气，也就是时疫。这与伤寒不同。又说，冬天感受寒邪而不立即发病，潜伏在体内，到春天变为温病，到夏天变为热病。温病和热病，都是冬天潜伏的寒邪所变成的。既然已经变化，就不能再说是寒邪了。此外还有风温、湿温，都表现为发热，症状类似伤寒，所以医生们通称它们为伤寒。之所以通称伤寒，是因为发热传变的过程都相似。至于用药，则完全不同了。这几类疾病是张仲景没有详细论述的，又在痉病、湿病、暍病三项之外，必须加以辨别。
王肯堂治疗一位孕妇，在春夏之交患温病，头痛发热，不怕冷而且口渴，来不及治疗，胎儿流产，失血极多，昏眩几乎晕厥。王肯堂让她用麦门冬一斤左右，加入淡竹叶、香豉煎煮，频繁饮用，出汗后痊愈。这是用治劳复的方法。
张路玉治疗徐君育，素体阴虚火旺，且有脾约便血的症状。十月间患冬温，发热咽痛，内科医生使用麻黄、杏仁、半夏、枳壳、橘皮之类的药物，导致气喘逆乱，倚靠呼吸无法躺下，声音嘶哑加重，头面赤热，手足逆冷，右手寸关脉虚大微数，这是热邪伤了手太阴肺经的气分。给予葳蕤、甘草等药无效，于是配制猪肤汤一碗，令隔水加热，不时挑服，三天声音清亮，服药完毕疼痛消失。
又治疗郑墨林之妻，素有大便出血，怀孕七月，正值肺气养胎之时，却患冬温，咳嗽咽痛如针刺，下血如崩漏，脉象比平时反而小弱而数，这是热邪伤了手太阴肺经的血分。给予黄连阿胶汤两剂，血止后，去掉黄连，加入葳蕤、桔梗、人中黄，四剂后病情安定。
又治疗黄以宽，风温十余日，高热神志昏迷，语言难出，自利大便稀黑，舌苔黑燥，嘴唇焦裂，鼻煤色。先前误用发散消导药数剂，烦渴更加严重。张石顽说：这本来是伏气郁结而发，更遇风邪，遂成风温。风温的脉气本来浮，因为热邪久伏少阴，从火化，发出太阳，即是两感证，变患最快。现在幸好年壮体质强，已超过三日、六日的危险期，证候虽危殆，良由风药性升，鼓激周身元气，都化为火，伤耗真阴，少阴之脉不能内藏，所以反见浮脉。考察张仲景先师，原本没有治法，而在少阴例中，则有救热存阴、承气下之一证，可借此来迅速扫除久伏之邪。审视其鼻息不鼾，知道肾水之上源未绝，不用担心出现直视失禁的情况。当时歙县医生胡晨敷在场，共同商议用凉膈散加人中黄、生地黄。服用后下稀粪三次，舌苔未润，烦渴不减，这是杯水车薪，不能救车薪之火。改用大剂凉膈散，大黄加至二两，兼用黄连、犀角，三下方能热除。于是专用生津止渴药，多服而愈。
又治疗陆中行之妻，二十多岁，腊月中旬，患咳嗽，挨过半月，病热稍减。正月初五日，咳嗽加倍于前，自汗体倦，咽喉干痛。到除夕夜，忽然轻微恶寒发热，第二天转为腹痛自利，手足逆冷，咽痛异常。又三天则咳唾脓血。张路玉诊其脉，轻取微数，寻之则仍不数，寸口似动而软，尺部略重则无。审视其脉证，寒热难分，颇像张仲景厥阴例中的麻黄升麻汤证。大概开始本是冬温，所伤原不为重，所以咳嗽到半月逐渐减轻，乃勉力支持过年事务，过于劳役，伤了脾肺之气，所以咳嗽又甚于从前。到望夜忽然憎寒发热，次日就自利厥逆，应当是病中身体疏懈，又感受寒邪的缘故。热邪既伤于内，寒邪复加于外，寒闭热邪，不得外散，势必内奔而为自利，致使邪气传入少阴厥阴，而为咽喉不利，唾脓血。虽然与伤寒大下后，以及伤热后自利不同，但寒热错杂是一样的。于是给予麻黄升麻汤，一剂，肢体微汗，手足温暖，自利即止。第二天诊脉，也趋向平和。此后与异功散、生脉散合服，数剂后安定。
许学士说：故人王彦龙，任毗陵仓官，季夏时，病胸项多汗，两足逆冷，谵语。医生不懂，杂进药物，已经十天。我诊察他，脉象关前濡，关后数。我说：当作湿温治。盖先受暑后受湿。《难经》说：湿温之脉，阳部濡而弱，阴部小而急。濡弱见于阳部，是湿气搏结暑气；小急见于阴部，是暑气蒸腾湿气。暑湿相搏，名叫湿温。先用白虎加人参汤，次用白虎加苍术汤，头痛渐退，足渐温，汗渐止，三天痊愈。此证属于贼邪，误用药，有死理。有人问：什么叫贼邪？我说：《难经》云五邪，有实邪、虚邪、正邪、微邪、贼邪。从后来者为虚邪，从前来者为实邪，从所不胜来者为贼邪，从所胜来者为微邪，自病者为正邪。又说：假令心病，中暑得之为正邪，中湿得之为贼邪。今心先受暑而湿邪乘之，水克火，从所不胜，斯谓之贼邪。是五邪中最厉害的。
张路玉治疗范振麟，大暑中，患厥冷自利，六脉弦细芤迟，按之欲绝，舌色淡白，中心黑润无苔，口鼻气息微冷，阳缩入腹，精滑如冰。问其起因，因卧地昼寝受寒，是夜连走精二度，忽觉颅胀如山，坐起晕倒，便四肢厥逆，腹痛自利，胸中兀兀欲吐，口中喃喃妄言，与湿温之证不殊。医生误为停食感冒，给予发散消导药，服后胸前头项汗出如漉，背上愈加畏寒，而下体如冰，一日昏愦数次，此阴寒挟暑，入中手足少阴之候。缘肾中真阳虚极，所以不能发热。于是拟四逆加人参汤，用人参一两，熟附子三钱，炮姜二钱，炙甘草二钱，昼夜兼进，三日中进六剂，决定第四日寅刻回阳。是日悉屏姜、附，改用保元丸，人参五钱，黄芪三钱，炙甘草二钱，加麦门冬二钱，五味子一钱，清肃膈上之虚阳，四剂食进。改用生料六味丸加麦冬、五味，每服用熟地八钱，以救下焦将竭之水，使阴平阳秘，精神乃治。
喻嘉言治疗黄起潜，春月病温，头面甚红，说：这位老人将近八十岁，下元虚惫，阳浮于上，与在表邪相合，所谓戴阳之证也。阳已戴于头面，不知者更行表散，则孤阳飞越，危殆立至矣。此证只有陶节庵立法甚妙，以人参、附子等药，收拾阳气归于下元，而加葱白透表以散外邪。如法用之即愈，万不宜迟。他惊骇为偏僻之说，换医生投以表药，顷刻阳气升腾，肌肤粟起，又顷刻寒颤切牙，浑身冻裂而逝。
喻嘉言治疗金鉴，春温已二十多天，壮热不退，谵语无伦，皮肤枯燥，胸膛板结，舌卷唇焦，身蜷足冷，二便略通，半渴不渴，面上一团黑滞，从前汗下和温之法，历试不效。喻嘉言说：此证与两感伤寒无异，《内经》原谓六日死，因春温证不传经，故虽邪气留连不退，犹可多延几日，待元气竭绝乃死。观其阴证阳证两下混在一区，治阳则碍阴，治阴则碍阳，与两感病情符合。张仲景原无治法，惟论序有发表攻里，本自不同之说。即师其意，以麻黄附子细辛汤两解在表阴阳之邪，果然皮间透汗而热全清。再以附子泻心汤两解在里阴阳之邪，果然胸前柔活，人事明了，诸证俱退，次日即索粥，以后竟不需药，只此二剂而起一生于九死，快哉。
俞震按：此条立法甚巧，可惜不载脉象如何。然而读嘉言春温论，自述收功反掌，并笑人见热烦枯燥之证而不敢用附子者之愚，则脉不必论耶？又说：冬不藏精之春温，初发时未必脉微数，惟不用麻黄附子细辛、麻黄附子甘草二方，驯至脉微且数，而汗下温皆不能救，见解独辟。又周禹载曰：温疫大法，以证为则，毋专以脉为据，亦必有所见而云然也。
一人夏月远行劳倦，归感热证，下痢脓血，身如燔炙，舌黑而燥，夜多谵语。林北海视之曰：此阳明病也，不当作痢治。但脉已散乱，忽有忽无，状类虾游，殆不可治。其家固请用药。林北海说：阳明热甚，当速解其毒，在古人亦必急下之以存真阴之气。然是证之源，由于劳倦，阳邪内灼，脉已无阴，若骤下之，则毒留而阴绝，死不治矣。勉强给予养阴药，以冀万一。用熟地一两，生地、麦冬、当归、芍药、甘草、枸杞佐之。告诫其家人说：汗至乃活。服后热不减，而谵语益狂悖，但血痢不下，身有微汗，略出即止。林北海诊之，则脉已接续分明，洪数鼓指，喜曰：今生矣。仍用前方，去生地加萸肉、丹皮、山药、枣仁，连服六帖，谵妄昏热不减。其家欲求更方，林北海执不可。又二日，诊其脉始敛而圆，乃用四顺清凉饮子加熟地一两，大黄五钱，下黑矢而诸证顿愈。越二日，忽复狂谵发热，喘急口渴，举家惶惑，谓今必死矣。林北海笑曰：岂忘吾言乎，得汗即活矣。此缘下后阴气已至，而无以鼓动之，则营卫不洽，汗无从生，不汗则虚邪不得外达，故内沸而复也。病从阳入，必从阳解。遂投白术一两，干姜三钱，甘草一钱，当归、芍药各三钱，尽剂，汗如注，酣卧至晓，病良已。
俞震按：此证疑难在于初末。初期脉类虾游，若援张景岳证实脉虚之说而用参、术、姜、附，则必死。末后狂热复发，若引吴又可余邪注胃之说而用白虎承气，亦必危。此案见解用药俱佳，然其得生处，在于养阴而血痢顿止，脉即应指耳。中间连服六帖，谵妄昏热不减，幸不见手足厥冷，尤幸不至声喑不语，绝谷不食也，则以脉之敛而圆故也。但白术一两干姜三钱以治狂热喘渴，殊难轻试。
徽州人江仲琏，冒寒发热，两项臃肿如升大，臂膊磊块无数，不食不便，狂躁发渴。诊其脉浮数无序，医生作伤寒发毒治。高鼓峰说：误矣。此燥逐风生也。用大剂疏肝益肾汤，熟地加至二两许，五剂而肿退便解，十剂而热除食进。再用补中益气汤加麦冬、五味，调理而愈。
俞震按：今之所谓伤寒者，大概皆温热病耳。张仲景云：太阳病发热而渴不恶寒者为温病，在太阳已现热象，则麻桂二汤必不可用，与伤寒迥别。《内经》云：热病者皆伤寒之类也。是指诸凡骤热之病，皆当从伤寒例观。二说似乎不同，因审其义，盖不同者在太阳，其余则无不同也。温热病只究三焦，不讲六经，此是妄言。张仲景之六经，百病不出其范围，岂以伤寒之类反与伤寒截然两途乎？叶天士案云：温邪吸自口鼻，此亦未确。张仲景明云：伏气之发，李明之、王安道俱言冬伤于寒，伏邪自内而发，奈何以吴又可温疫论牵混耶？惟伤寒则足经为主，温热则手经病多，如风温之咳嗽息鼾，热病之神昏谵语，或溏泻粘垢，皆手太阴肺、手厥阴心包络、手阳明大肠现证。甚者喉肿肢掣，昏蒙如醉，躁扰不宁，齿焦舌燥，发斑发颐等证，其邪分布充斥，无复六经可考，故不以六经法治耳。就予生平所验，初时兼挟表邪者最多，仍宜发散，如防风、葛根、豉、薄、牛蒡、杏仁、滑石、连翘等，以得汗为病轻，无汗为病重。如有斑，则参入蝉蜕、桔梗、芦根、西河柳之类。如有痰，则参入土贝母、天虫、栝蒌、橘红之类。如现阳明证，则白虎承气；少阳证则小柴胡去参、半，加花粉、知母；少阴证则黄连阿胶汤、猪苓汤、猪肤汤，俱宗张仲景六经成法有效。但温热病之三阴证多死，不比伤寒，盖冬不藏精者，东垣所谓肾水内竭，孰为滋养也？惟大剂养阴，佐以清热，或可救之。养阴如二地、二冬、阿胶、丹皮、元参、人乳、蔗浆、梨汁；清热如三黄、石膏、犀角、大青、知母、芦根、茅根、金汁、雪水、西瓜、银花露、丝瓜汁。随其对证者选用。若三阴经之温药，与温热病非宜，亦间有用真武理中者，百中之一二而已。大抵温热病，最怕发热不退，及痉厥昏蒙，更有无端而发晕，及神清而忽间以狂言者，往往变生不测，遇此等证，最能惑人，不比阳证阴脉，阳缩舌卷撮空见鬼者，易烛其危也。要诀在辨明虚实，辨得真方可下手。然必非刘河间、吴又可之法所能救，平素精研张仲景《伤寒论》者，庶有妙旨。至如叶天士之论温热，有邪传心胞，震动君主，神明欲迷，弥漫之邪，攻之不解，清窍既蒙，络内亦痹，豁痰降火无效者，用局方至宝丹，或紫雪，或牛黄丸，宗喻氏芳香逐秽宜窍之说，真足超越前贤，且不蹈用重药者，一匙偶误，覆水难收之弊也。此翁聪明诚不可及，今所选之案虽少，而诸法毕备，亦足为学人导夫先路矣。
The *Zhu Shi Quan Sheng Ji* states: From after Frost's Descent (Shuangjiang) to before Spring Equinox (Chunfen), the weather is severely cold, water freezes and the ground hardens. If one encounters this killing energy and falls ill immediately, it is called Zheng Shanghan (True Cold Damage). Although it is winter, if the weather is warm and illness occurs due to pathogenic invasion, it is called Dongwen (Winter Warmth). After the Spring Equinox, if the weather is warm and illness occurs due to pathogenic invasion, it is called Wenbing (Warm Disease). Even if Spring Equinox has arrived, if the weather remains cold and someone falls ill due to cold invasion, it is also Shanghan. After Summer Solstice (Xiazhi), when the heavenly heat is intense, if one contracts a pathogen and falls ill with a flooding pulse (Hongmai), it is called Rebing (Heat Disease). Between the fourth, fifth, sixth, seventh, and eighth months, if there is sudden severe cold and one falls ill upon contraction, it is a Shixing Hanyi (Seasonal Cold Epidemic). If the seasonal climate is abnormal throughout the four seasons, causing illness where young and old present similar symptoms and transmission occurs, this is named Shiqi (Seasonal Qi), which is equivalent to Shiyi (Seasonal Epidemic). This is not comparable to Shanghan. It is also said that if cold pathogens are contracted in winter but do not cause immediate illness, they lie dormant in the body and transform into Wenbing in spring and Rebing in summer. Both Wenbing and Rebing are transformations of latent cold from winter. Once transformed, they can no longer be referred to as cold. Additionally, there are Fengwen (Wind Warmth) and Shiwen (Damp Warmth), both presenting with fever and symptoms resembling Shanghan; thus, physicians generally refer to them all as Shanghan. The reason for this general term is that the progression of fever and transmission are similar. However, the medication used differs completely. These several types were not discussed by Zhang Zhongjing and fall outside the categories of Jing (Spasm), Shi (Dampness), and Ye (Heat Stroke); they must be distinguished carefully.
Wang Kentang treated a pregnant woman who contracted Wenbing during the transition between spring and summer. She suffered from headache, fever, aversion to cold was absent, and thirst. Before treatment could be administered, she miscarried, losing an immeasurable amount of blood. She became dizzy and nearly fainted. Wang prescribed Mai Men Dong (Ophiopogon Root) in large quantities, decocted with Dan Zhu Ye (Lophatherum Leaf) and Xiang Chi (Fermented Soybean), to be drunk frequently. Sweating ensued, and she recovered. This utilized the method for treating post-illness relapse due to overexertion.
Zhang Luyu treated Mr. Xu Yu, whose constitution was inherently Yin-deficient with abundant fire, and who had a history of Pi Yue (Spley Restriction) with bloody stools. In October, he contracted Dongwen, presenting with fever and sore throat. Internal medicine physicians administered herbs such as Ma Huang (Ephedra), Xing Ren (Apricot Seed), Ban Xia (Pinellia), Zhi Ke (Aurantium Fructus), and Ju Pi (Tangerine Peel). Consequently, he developed wheezing and counterflow qi, unable to lie down even leaning on support. His voice became hoarse and weak, his head and face red and hot, and his hands and feet cold. The Cun and Guan positions of the right wrist showed a deficient, large, slightly rapid pulse. This indicated Heat damaging the Qi aspect of the Hand Taiyin Lung Meridian. Treatment with Yu Zhu (Polygonatum Rhizome) and Gan Cao (Licorice) failed. Zhang then prepared Zhu Fu Tang (Pig Skin Decoction), one bowl, heated via water bath, and administered small amounts frequently. After three days, his voice cleared, and pain ceased upon completion of the dose.
He also treated the wife of Zheng Molin, who had a history of rectal bleeding. At seven months pregnant, during the time when Lung Qi nourishes the fetus, she contracted Dongwen. She suffered from cough, sore throat like needle pricks, and profuse lower bleeding resembling a flood. Her pulse was smaller, weaker, and more rapid than usual. This indicated Heat damaging the Blood aspect of the Hand Taiyin Lung Meridian. Two doses of Huang Lian E Jiao Tang (Coptis and Donkey-Hide Gelatin Decoction) stopped the bleeding. Then, Huang Lian was removed, and Yu Zhu, Jie Geng (Platycodon Root), and Ren Zhong Huang (Human Feces Honeycomb) were added. Four doses brought stability.
He also treated Huang Yikuan, who had suffered from Fengwen for over ten days. He presented with high fever, coma, difficulty speaking, spontaneous diarrhea with black loose stools, black dry tongue coating, cracked lips, and coal-like discoloration of the nose. Previously, several doses of dispersing and digesting herbs had been mistakenly used, worsening irritability and thirst. Zhang Shiwen stated: "This originates from latent Qi stagnating and erupting, compounded by Wind, resulting in Fengwen. The pulse of Fengwen is naturally floating because Heat has lain dormant in Shaoyin, transforming via Fire, and emerging in Taiyang, constituting Lianggan (Double Exposure). Changes occur most rapidly. Fortunately, he is young and strong, having passed the critical third and sixth day periods. Although critical, the ascending nature of Wind herbs stimulated the Yuan Qi throughout the body, converting it to Fire and consuming True Yin. Thus, the Shaoyin pulse cannot remain internalized, appearing floating. Examining Master Zhang Zhongjing, there is no specific treatment method listed, but within the Shaoyin examples, there is a case of saving Heat and preserving Yin using Chengqi (Gut Purging) methods. We can borrow this to swiftly sweep away long-dormant pathogens. Observing that his nasal breathing is not stertorous indicates the source of Kidney Water is not exhausted; we need not fear vertical staring or incontinence." Physician Hu Chenfu from Xi County was present, and together they decided to use Liang Ge San (Cool the Upper Chamber Powder) plus Ren Zhong Huang and Sheng Di Huang (Rehmannia Root). After ingestion, three episodes of loose black stool occurred, but the tongue coating remained unmoistened and thirst persisted. This was like pouring a cup of water on a burning cartload of fire. A larger dose of Liang Ge San was used, increasing Da Huang (Rhubarb) to two taels, combined with Huang Lian and Xi Jiao (Rhinoceros Horn). Only after three doses did the heat clear. Subsequently, only fluids-generating and thirst-quenching medicines were used in large quantities until recovery.
He also treated the wife of Lu Zhongxing, in her early twenties. In mid-winter, she contracted cough. Half a month later, the fever subsided slightly. On the fifth day of the new year, coughing doubled, accompanied by spontaneous sweating, fatigue, dry painful throat. By New Year's Eve, she suddenly experienced mild aversion to cold and fever. The next day, abdominal pain and spontaneous diarrhea developed, with cold hands and feet and extreme sore throat. Three days later, she coughed up pus and blood. Zhang palpated her pulse: lightly felt slightly rapid, deeply still not rapid; Cun position seemed moving but soft, Chi position disappeared under slight pressure. Assessing pulse and symptoms, cold and heat were indistinguishable, resembling the Ma Huang Sheng Ma Tang (Ephedra and Asarum Decoction) pattern in Zhang Zhongjing's Jueyin examples. Initially, it was Dongwen, not severely damaging, so cough decreased gradually over half a month. However, forcing herself to handle year-end affairs led to excessive labor, damaging Spleen and Lung Qi, causing cough to worsen again. Suddenly, at full moon night, aversion to cold and fever appeared, followed by diarrhea and Jue Ni (Cold Extremities) the next day. This was likely due to body laxity during illness and subsequent cold invasion. Heat damaged internally, cold invaded externally; cold closed heat, preventing external dispersion, forcing it inward causing diarrhea, transmitting to Shaoyin and Jueyin, leading to throat obstruction and expectoration of pus and blood. Although different from diarrhea after severe purgation in Shanghan or heat damage, the mixture of cold and heat is identical. Ma Huang Sheng Ma Tang was administered. One dose resulted in slight sweating, warming of extremities, and cessation of diarrhea. Next day, pulse harmonized. Subsequently, Yi Gong San (Wonderful Skill Powder) and Sheng Mai San (Generate the Pulse Powder) were taken together; several doses brought stability.
Scholar Xu stated: My friend Wang Yanlong, serving as Granary Official in Piling, in late summer, suffered from excessive sweating on chest and neck, cold feet, and delirium. Physicians did not understand and administered mixed drugs for ten days. I palpated him: pulse was Ru (Soft) anterior to Guan, Shu (Rapid) posterior to Guan. I said: Treat as Shiwen (Damp Warmth). First received Summer Heat, then Dampness. The *Nan Jing* states: The pulse of Shiwen is Ru and weak in Yang positions, small and urgent in Yin positions. Ru and weak in Yang positions indicate Dampness clashing with Summer Heat; small and urgent in Yin positions indicate Summer Heat steaming Dampness. Summer Heat and Dampness clashing is named Shiwen. First use Bai Hu Jia Ren Shen Tang (White Tiger Plus Ginseng Decoction), then Bai Hu Jia Cang Zhu Tang (White Tiger Plus Atractylodes Macrocephala Decoction). Headache receded, feet warmed, sweat stopped, cured in three days. This syndrome belongs to Zei Xie (Thief Pathogen). Mismedication leads to death. Someone asked: What is Thief Pathogen? I said: *Nan Jing* mentions five pathogens: Shi (Excess), Xu (Deficiency), Zheng (Correct), Wei (Minor), Zei (Thief). Coming from behind is Xu Xie; coming from ahead is Shi Xie; coming from the organ one cannot overcome is Zei Xie; coming from the organ one can overcome is Wei Xie; originating from self disease is Zheng Xie. Also: Assuming Heart disease, contracting Summer Heat is Zheng Xie; contracting Dampness is Zei Xie. Now Heart first received Summer Heat, then Dampness attacked. Water overcomes Fire, coming from the organ one cannot overcome, hence called Zei Xie. It is the most severe of the five pathogens.
Zhang Luyu treated Fan Zhenlin. During great heat, he suffered from cold extremities and diarrhea. Six pulses were Xian (Wiry), Xi (Fine), Kou (Hollow), Chi (Slow), vanishing upon pressure. Tongue pale white, center black moist without coating. Breath from mouth and nose slightly cold, Yang retracted into abdomen, essence slippery like ice. Inquiry revealed origin: sleeping on ground during day caught cold; that night seminal emission occurred twice. Suddenly felt head swelling like a mountain, fainted upon sitting up, limbs cold, abdominal pain, diarrhea, nausea, muttering nonsense. Similar to Shiwen. Physicians mistook it for food stagnation and cold invasion, giving dispersing and digesting herbs. After ingestion, sweat poured from chest, neck, and head; back felt colder, lower body icy. Fainted several times a day. This is Yin Cold carrying Summer Heat entering Hand and Foot Shaoyin. Due to extreme deficiency of True Yang in Kidney, unable to generate heat. Prescribed Si Ni Jia Ren Shen Tang (Counterflow Plus Ginseng Decoction): Ren Shen (Ginseng) 1 tael, Shu Fu Zi (Prepared Aconite) 3 qian, Pao Jiang (Baked Ginger) 2 qian, Zhi Gan Cao (Honey-fried Licorice) 2 qian. Administered day and night, six doses in three days. Determined Yang would return at Yin hour on fourth day. That day, ginger and aconite were stopped, switching to Bao Yuan Wan (Preserve Origin Pill): Ren Shen 5 qian, Huang Qi (Astragalus) 3 qian, Zhi Gan Cao 2 qian, Mai Men Dong 2 qian, Wu Wei Zi (Schisandra) 1 qian, to clear deficient Yang above diaphragm. Four doses improved appetite. Switched to Sheng Liu Wei Wan (Six Ingredient Pill with Rehmannia) plus Mai Dong and Wu Wei Zi, using Shu Di Huang (Prepared Rehmannia) 8 qian per dose to save draining Water of Lower Jiao, balancing Yin and Yang, restoring spirit.
Yu Jiayan treated Huang Qiqian. In spring, he contracted Warmth. Head and face very red. Yu said: An octogenarian, lower origin deficient and exhausted, Yang floats upward, combining with exterior pathogens. This is Dai Yang (Floating Yang) syndrome. Yang already floats to head and face; those unaware may apply exterior dispersants, causing solitary Yang to fly away, leading to imminent danger. Only Tao Jian'an's method is excellent: use Ren Shen and Fu Zi to gather Yang back to lower origin, adding Cong Bai (Green Onion White) to penetrate exterior and scatter pathogens. Follow method, recover quickly. Do not delay. He was shocked by this unconventional view, changed doctors, took exterior dispersants. Instantly Yang surged, skin goosefleshed, then shivering teeth-chattering, body froze and burst, dying instantly.
Yu Jiayan treated Jin Jian. Chunwen (Spring Warmth) had lasted over twenty days. High fever unrelenting, delirious speech, dry skin, stiff chest, curled tongue, cracked lips, curled body, cold feet, bowel/bladder slightly open, partial thirst, dark stagnant complexion. Previous methods of sweating, purging, harmonizing, and warming failed repeatedly. Yu said: This syndrome is no different from Lianggan Shanghan. *Nei Jing* originally said death on sixth day. Because Chunwen does not transmit meridians, although pathogen lingers, life can be extended until Yuan Qi exhausts. Observing Yin and Yang syndromes mixed, treating Yang hinders Yin, treating Yin hinders Yang, matching Lianggan pathology. Zhang Zhongjing had no specific method, only stating in preface that releasing exterior and attacking interior are fundamentally different. Following this intent, use Ma Huang Fu Zi Xi Xin Tang (Ephedra, Aconite, and Asarum Decoction) to resolve exterior Yin-Yang pathogens simultaneously. Indeed, sweat penetrated skin, heat cleared completely. Then use Fu Zi Xie Xin Tang (Aconite Bitter Heart Decoction) to resolve interior Yin-Yang pathogens simultaneously. Indeed, chest softened, consciousness returned, symptoms retreated. Next day requested porridge, required no further medicine. Only two doses saved a life from nine deaths. Joyous.
Zhen notes: This prescription is clever, unfortunately pulse image not recorded. However, reading Jiayan's Chunwen treatise, he claims success easily and mocks those afraid to use Fu Zi for heat, irritability, and dryness. Thus, pulse discussion might be unnecessary? He also says: Chunwen from Winter failing to store Essence may not initially show micro-rapid pulse. Only by not using Ma Huang Fu Zi Xi Xin or Ma Huang Fu Zi Gan Cao formulas does it deteriorate to micro-rapid pulse, where sweating, purging, and warming fail. Unique insight. Zhou Yuzai also said: General principles of Warm Epidemics rely on symptoms, not solely on pulse; one must have observed this to claim it.
A man traveled far in summer, fatigued, returning with Heat syndrome. Dysentery with pus and blood, body burning hot, black dry tongue, night delirium. Lin Beihai examined him: This is Yangming Bing (Yangming Disease), should not be treated as dysentery. But pulse is scattered, intermittent, resembling shrimp swimming, likely untreatable. Family insisted on medication. Lin said: Yangming Heat is severe, must quickly resolve toxin. Ancients would urgently purge to preserve True Yin Qi. However, this case originates from fatigue, Yang pathogen burning internally, pulse lacks Yin. If purged abruptly, toxin remains, Yin cuts off, death is inevitable. Reluctantly gave Yin-nourishing meds for a chance. Used Shu Di Huang 1 tael, assisted by Sheng Di Huang, Mai Men Dong, Dang Gui (Angelica Sinensis), Bai Shao (White Peony Root), Gan Cao, Gou Qi Zi (Goji Berry). Warned family: Recovery depends on sweating. After ingestion, heat did not decrease, delirium worsened, but bloody dysentery stopped, slight sweat appeared briefly then ceased. Lin palpated: pulse connected clearly, flooding and rapid, beating fingers. Joyfully said: He will live. Still used previous formula, removed Sheng Di Huang, added Yu Rou (Cornus Fruit), Dan Pi (Moutan Bark), Shan Yao (Dioscorea), Suan Zao Ren (Ziziphus Seed). Taken six doses, delirium and heat unchanged. Family wanted change, Lin refused. Two days later, pulse gathered and rounded. Used Si Shun Qing Liang Yin Zi (Four Smooth Cooling Drink) plus Shu Di Huang 1 tael, Da Huang 5 qian. Passed black stool, symptoms resolved. Two days later, sudden recurrence of wild delirium, fever, panting, thirst. Family panicked, believing death certain. Lin laughed: Did you forget my words? Recovery comes with sweat. This is because after purging, Yin Qi arrived, but nothing stirred it, so Ying and Wei did not harmonize, no sweat generated. Without sweat, empty pathogen cannot exit, boiling internally recurs. Disease entered via Yang, must resolve via Yang. Prescribed Bai Zhu (Atractylodes Macrocephala) 1 tael, Gan Jiang (Dried Ginger) 3 qian, Gan Cao 1 qian, Dang Gui and Bai Shao 3 qian each. Finished dose, sweat poured, slept soundly till dawn, illness largely healed.
Zhen notes: Difficulty lies in beginning and end. Beginning pulse resembles shrimp swimming; applying Zhang Jingyue's theory of solid disease/deficient pulse using Ren Shen, Bai Zhu, Gan Jiang, Fu Zi would cause death. End fever recurrence; applying Wu Youke's theory of residual pathogen in Stomach using Bai Hu Tang or Cheng Qi Tang would endanger. Case insights and medication excellent. Survival due to Yin nourishment stopping dysentery, pulse responding. Middle six doses, delirium/heat unchanged, fortunate no cold extremities, especially no aphonia or refusal to eat, due to gathering/rounded pulse. However, Bai Zhu 1 tael and Gan Jiang 3 qian for wild fever/panting/thirst is hard to trial lightly.
Jiang Zhonglian from Huizhou, exposed to cold with fever, temples swollen like large cups, arm lumps numerous, no eating/bowel movement, wild agitation, thirst. Pulse floating, rapid, disordered. Physicians treated as Shanghan toxicity. Gao Gugeng said: Error. This is Dryness driving Wind generation. Used large dose Shu Gan Yi Shen Tang (Soothe Liver Enrich Kidney Decoction), Shu Di Huang increased to approx. 2 taels. Five doses reduced swelling, bowel moved. Ten doses cleared heat, appetite returned. Then Bu Zhong Yi Qi Tang (Tonify Middle Augment Qi Decoction) plus Mai Dong and Wu Wei Zi, regulated and cured.
Zhen notes: Today's so-called Shanghan is mostly Warmth diseases. Zhang Zhongjing said: Taiyang Bing with fever, thirst, no aversion to cold is Wenbing. Since Heat signs appear in Taiyang, Ma Huang Tang and Gui Zhi Tang are absolutely contraindicated, distinct from Shanghan. *Nei Jing* says: Heat diseases are all categories of Shanghan. Refers to all sudden heat illnesses should be viewed via Shanghan examples. Two sayings seem different; examining meaning, difference lies only in Taiyang, rest is same. Warmth diseases only investigate San Jiao, ignore Liu Jing (Six Meridians), this is absurd talk. Zhang Zhongjing's Six Meridians encompass all diseases; how can Shanghan category be completely separate? Ye Tianshi cases say: Warm pathogen enters via mouth/nose, this is inaccurate. Zhang Zhongjing clearly states: Latent Qi eruption. Li Mingzhi and Wang Andao both say: Winter injury by cold, latent pathogen eruptates from inside. How to confuse with Wu Youke's *Wen Yi Lun*? Only Shanghan focuses on Foot meridians; Warmth involves many Hand meridians. e.g., Fengwen cough/snoring, Rebing coma/delirium, or loose sticky stool, all manifest Hand Taiyin Lung, Hand Jueyin Pericardium, Hand Yangming Large Intestine. Severe cases: throat swelling, limb twitching, confusion like drunkenness, restlessness, scorched teeth/dry tongue, macules, parotitis. Pathogen distributes widely, no longer traceable by Six Meridians, hence Six Meridians method not used. Based on my experience, initial stages often involve exterior pathogens, still suitable for dispersing: Fang Feng (Saposhnikovia), Ge Gen (Kudzu), Chi (Fermented Soybean), Bo He (Mint), Niu Bang Zi (Arctium), Xing Ren, Hua Shi (Talc), Lian Qiao (Forsythia). Sweating indicates light disease, no sweat indicates heavy. If macules, add Chan Tui (Cicada Slough), Jie Geng, Lu Gen (Reed Rhizome), Xi He Liu (Tamarisk Twig). If phlegm, add Tu Bei Mu (Fritillaria Thunbergii), Tian Chong (Silkworm), Gua Lou (Trichosanthes), Ju Hong (Tangerine Peel). If Yangming signs, Bai Hu or Cheng Qi; Shaoyang signs, Xiao Chai Hu Tang minus Ren Shen/Ban Xia, add Hua Fen (Glehnia), Zhi Mu (Anemarrhena); Shaoyin signs, Huang Lian E Jiao Tang, Zhu Ling Tang, Zhu Fu Tang. All follow Zhang Zhongjing's Six Meridides established methods effectively. However, Warmth diseases' San Yin syndromes often die, unlike Shanghan. Because those who failed to store Essence in winter, as Dongyuan said, Kidney Water internally exhausted, who nourishes? Only large dose Yin nourishment aided by Heat clearing may save. Yin nourishment: Er Di (Two Rehmannias), Er Dong (Two Ophiopogons/Polygonatums), E Jiao, Dan Pi, Yuan Shen (Scrophularia), Human Milk, Sugarcane Juice, Pear Juice. Heat clearing: San Huang (Three Rheum/Coptis/Scolecodendron), Shi Gao (Gypsum), Xi Jiao, Da Qing Ye (Isatis Leaf), Zhi Mu, Lu Gen, Mao Gen (Imperata Rhizome), Jin Zhi (Willow Juice), Snow Water, Watermelon, Yin Hua Lu (Honeysuckle Dew), Si Gua Zhi (Luffa Juice). Select according to syndrome. Warm herbs for San Yin meridians are unsuitable for Warmth diseases; occasionally Zhen Wu Tang or Li Zhong Tang used, one or two in hundred. Generally, Warmth diseases fear unrelenting fever, spasm/Jue Ni, coma/confusion. Also sudden dizziness, or clear mind with intermittent wild speech, often unpredictable changes. Such cases confuse most, unlike Yang syndrome/Yin pulse, retracted Yang, curled tongue, grasping air, seeing ghosts, which are easier to identify as critical. Key is distinguishing Deficiency/Excess; true distinction allows treatment. Must not rely on Liu Hejian or Wu Youke methods. Those who meticulously study Zhang Zhongjing's *Shanghan Lun* will find profound wisdom. Regarding Ye Tianshi's discussion on Warmth: if pathogen transmits to Pericardium, shaking Sovereign, spirit confused, diffuse pathogen resists attack, clear orifices blocked, collaterals obstructed, if resolving phlegm/clearing fire fails, use Ju Fang Zhi Bao Dan (Bureau Formula Treasure Pill), or Zi Xue (Purple Snow), or Niu Huang Wan (Calculus Bovis Pill), following Yu's theory of aromatic elimination of turbidity opening orifices. Truly surpasses former sages, avoiding risks of heavy medications where one spoon error is irreversible. This gentleman's intelligence is indeed unsurpassable. Though selected cases few, methods complete, sufficient to guide learners.