圣王御世，春无愆阳，夏无伏阴，秋无凄风，冬无苦雨。乃至民无夭札，物无疵疠，太
和之
气，弥满宇宙，安有所谓温疫哉？然而周礼傩以逐疫，方相氏掌之，则温疫之由来久矣。古
人元旦汲清泉以饮芳香之药，上已采兰草以袭芳香之气，重涤秽也。后汉张仲景着《伤寒论
》，欲明冬寒春温夏秋暑热之证，自不能并入疫病以混常法。然至理已毕具于脉法中，叔和
不为细绎，乃谓更遇温气变成温疫，又谓春应温而反大寒，夏应热而反大凉，秋应凉而反大
热，冬应寒而反大温，非其时而有其气，是以一岁之中，长幼多病相似者，此时行之疫气也
。又谓从春分节以后至秋分节以前，天有暴寒，皆为时行寒疫，是皆使人不能无疑者耳。盖
四时不正之气，感之者，因而致病，初不名疫也，因病致死，病气尸气，混合不正之气，斯
为疫矣。以故鸡温死鸡，猪温死猪，牛马温死牛马。推之于人，何独不然。凡饥馑兵凶之际
，人体虚乏，所以温疫病盛行，大率春夏之交为尤甚，因温暑温热之气交结互蒸，人在其中
，无隙可避，故沿门合境，受之者，无不浑身壮热，眩晕呕逆，病如一类。况乎共室连床，
邪秽尤易相亲，尸虫载道，呼吸即能相染哉。是以盛夏温热之病，即藏湿热在内。一人受之
，即为湿温，一方遍传，温为疫也。然世俗所称大头瘟者，头面腮颊肿如瓜瓠是也；虾蟆
瘟者，喉痹失音，颈节胀大是也；瓜瓠瘟者，胸胁高起，呕汁如血是也；疙瘩瘟者，遍身红
肿，发块如瘤者是也；绞肠瘟者，腹鸣干呕，水泄不通是也；软脚瘟者，便清泄白，足重难
移是也。小儿痘疹尤多，以上疫证，倘不明治法，咸委之劫运，谓非医者之罪耶？观仲景于
平脉篇中云∶寸口脉阴阳俱紧者，法当清邪中于上焦，浊邪中下焦，清邪中上，故名洁也。
浊
邪中下，故名浑也。阴中于邪，内必栗也。凡二百六十九字，阐发奥理，全非伤寒所有之事
，乃邪疫从入之门，受病之总，人自不识耳。篇中大意，谓人之鼻气通于天，故阳中雾露之
邪为清邪，从鼻息而上入于阳，入则发热头痛项强颈挛，正与俗称大头瘟，虾蟆瘟之说符也
。人之口气通于地，故水土之邪，为饮食浊味，从口舌而下入于阴，入则人必先内栗，足膝
逆冷，便溺妄出，清便下重，脐筑揪痛，正与俗称绞肠瘟、软脚瘟之说符也。然从鼻口所入
之邪，必先注于中焦，以次传布上下。故中焦受邪，因而不即治。则胃中为浊，营卫不通，
血凝不流，其病变即在中焦，俗称瓜瓠瘟、疙瘩瘟等证，则又阳毒痈脓，阴毒遍身青紫之类
是也。凡伤寒之邪先行身之背，次行身之前。由外廓而入，故邪在表者，汗之即散。邪在里
者，下之即解。温疫之邪。则直行中道，散漫三焦，故虽表之不散，攻之复合，此疫证与伤
寒表里诸法，所以略无干涉也。治者于未病前，先饮芳香正气药，使邪不能入。邪即入，则
以逐秽为第一义，斯又得焉。上焦如雾，升而逐之。中焦如沤，疏而逐之；下焦如渎，决而
逐之；各兼以解毒，使营卫既通，乘势逐拔，病安从奈我哉。
圣明的君主治理天下，春天没有过盛的阳气，夏天没有潜伏的阴气，秋天没有凄厉的风，冬天没有苦寒的雨。以至于百姓没有早夭或突发疾病，万物没有病虫害，太和之气（指天地间和谐冲和之气）充满宇宙，哪里会有所谓的温疫呢？然而《周礼》中记载用傩舞来驱逐疫鬼，由方相氏掌管，这说明温疫由来已久。古人在元旦汲取清泉饮用芳香的药物，在上巳节采集兰草熏染身体以沾染芳香之气，都是为了洗涤污秽。后汉张仲景撰写《伤寒论》，想要阐明冬季受寒、春季温暖、夏季秋季暑热等证候，自然不能将疫病混入常规治法中。然而其中的道理其实已经完备地包含在脉法中，王叔和没有仔细推究，反而说再次遇到温气就会变成温疫，又说春天应该温暖却反而大寒，夏天应该炎热却反而大凉，秋天应该凉爽却反而大热，冬天应该寒冷却反而大温，不是那个季节却有那个季节的气候，因此一年之中，老少多病相似，这是时行之疫气。又说从春分节气以后到秋分节气以前，天有突然的寒冷，都是时行的寒疫，这些都让人产生疑问。大概四季不正之气，感染它的人，因而致病，起初并不称为疫，因为生病致死，病气和尸气混合不正之气，这才成为疫。所以鸡得温病死鸡，猪得温病死猪，牛马得温病死牛马。推及到人，难道唯独不同吗？凡是饥荒战乱之际，人体虚弱匮乏，所以温疫病盛行，大体春夏之交最为严重，因为温暑温热之气交结互相蒸腾，人在其中，没有缝隙可以躲避，所以沿门合境，感染的人，无不浑身高热，眩晕呕吐逆气，病状如同一种。何况同住一室床榻相连，邪秽更容易相互亲近，尸体上的虫载满道路，呼吸之间就能相互传染。因此盛夏温热之病，就是体内蕴藏湿热。一个人感染它，就成为湿温，一方普遍传播，温就成为了疫。然而世俗所称的大头瘟，是头面腮颊肿胀像瓜瓠一样；虾蟆瘟，是喉痹失音，颈部关节肿胀变大；瓜瓠瘟，是胸胁高起，呕吐汁液如血；疙瘩瘟，是遍身红肿，发出肿块像瘤子；绞肠瘟，是腹鸣干呕，水泻不通；软脚瘟，是大便清稀泄出白色物质，脚沉重难以移动。小儿痘疹尤其多，以上这些疫证，如果不明白治疗方法，都归结为劫运，这难道不是医者的罪过吗？看张仲景在平脉篇中说：寸口脉阴阳俱紧的，按照法则应当是清邪中伤上焦，浊邪中伤下焦，清邪中于上部，所以名叫洁。浊邪中于下部，所以名叫浑。阴经受邪，内部必定战栗。凡二百六十九字，阐发深奥的道理，完全不是伤寒所具有的事情，乃是邪疫进入的门径，患病的总纲，人们自己不认识罢了。篇中的大意，是说人的鼻气通于天，所以阳经被雾露之邪侵袭称为清邪，从鼻息而上进入阳经，进入则发热头痛项强颈挛，正与俗称大头瘟、虾蟆瘟的说法相符。人的口气通于地，所以水土之邪，是饮食浊味，从口舌而下进入阴经，进入则人必先内战栗，足膝逆冷，大小便妄出，大便下重，脐部筑痛揪痛，正与俗称绞肠瘟、软脚瘟的说法相符。然而从鼻口进入的邪气，必须先注入中焦，依次传布上下。所以中焦受邪，因为不立即治疗，则胃中化为浊，营卫不通，血液凝滞不流，其病变就在中焦，俗称瓜瓠瘟、疙瘩瘟等证，则是又属于阳毒痈脓，阴毒遍身青紫之类。凡是伤寒的邪气先行走在身体背部，其次行走在身体前面。由外廓而入，所以邪在表的，发汗即散。邪在里的，攻下即解。温疫的邪气，则直行中道，散漫三焦，所以虽然发汗不能解散，攻下反而聚合，这就是疫证与伤寒表里诸法，所以毫无干涉的原因。治疗者在未病之前，先饮用芳香正气药，使邪气不能进入。邪气即使进入，则以驱逐秽浊为第一要义，这又是得当的。上焦如雾，升提而驱逐它；中焦如沤，疏通而驱逐它；下焦如渎，决泄而驱逐它；各自兼以解毒，使营卫既已通畅，乘势驱逐拔除，病怎么能奈我何呢。
When a sage king governs the world, spring has no excessive Yang Qi (Yang Energy), summer has no latent Yin Qi (Yin Energy), autumn has no desolate winds, and winter has no bitter rains. Consequently, people do not suffer premature death or sudden illness, and plants and animals are free from pests and diseases. The Taihe Qi (Harmonious Vital Energy) fills the universe; how could there be such a thing as Warm Epidemic (Wen Yi)? However, the *Rites of Zhou* records the use of Nuo dance to drive away epidemic spirits, managed by the Fangxiang Shi (Officer of Exorcism), indicating that warm epidemics have existed for a long time. In ancient times, on New Year's Day, people drew clear spring water to drink aromatic medicines, and during the Shangsi Festival, they gathered orchids to熏染 their bodies with aromatic scents, aiming to cleanse filth. Zhang Zhongjing of the Later Han Dynasty wrote the *Treatise on Cold Damage* (*Shanghan Lun*), intending to clarify syndromes caused by winter cold, spring warmth, and summer/autumn heat. Naturally, he could not merge epidemics into these conventional methods. Yet, the underlying principles were already fully contained within the pulse diagnosis methods. Wang Shuhe failed to analyze them carefully, instead claiming that encountering warm Qi again transforms it into a warm epidemic. He also stated that spring should be warm but is unexpectedly very cold, summer should be hot but is unexpectedly very cool, autumn should be cool but is unexpectedly very hot, and winter should be cold but is unexpectedly warm. When the climate does not match the season, leading to similar illnesses among people of all ages throughout the year, this is referred to as the epidemic Qi of the time. Furthermore, he claimed that between the Spring Equinox and the Autumn Equinox, sudden cold weather constitutes a "time-run cold epidemic," which raises doubts. Generally, the abnormal Qi of the four seasons causes disease upon infection, initially not called an epidemic. It becomes an epidemic only when death occurs, and the Qi of the disease and corpse mix with the abnormal Qi. Thus, chickens die of chicken plague, pigs of pig plague, and cattle/horses of cattle/horse plague. By analogy, why would humans be different? During famines and wars, human bodies are weak and deficient, so warm epidemics prevail, especially during the transition from spring to summer. The intermingling and steaming of warm, summer-heat, and warm-dry Qi leave no escape for people within it. Consequently, along every door and across every neighborhood, those infected suffer uniformly from high fever, dizziness, vertigo, vomiting, and nausea, presenting similar symptoms. Moreover, living in shared rooms with adjacent beds facilitates the proximity of pathogenic filth, and pathogens carried on corpses can transmit through respiration. Therefore, warm diseases in midsummer imply internal damp-heat accumulation. If one person contracts it, it becomes Damp-Warmth (Shi Wen); if it spreads widely in a region, warmth becomes an epidemic. Secularly known as "Big Head Plague" (Da Tou Wen), characterized by swelling of the head, face, cheeks, and jaw like a gourd; "Toad Plague" (Xia Ma Wen), characterized by throat obstruction, loss of voice, and neck swelling; "Gourd Plague" (Gua Hu Wen), characterized by chest and hypochondriac distension and vomiting blood-like fluid; "Lump Plague" (Ge Da Wen), characterized by generalized redness and swelling with tumor-like nodules; "Intestine-Twisting Plague" (Jiao Chang Wen), characterized by abdominal borborygmus, dry retching, and watery diarrhea without relief; and "Soft Leg Plague" (Ruan Jiao Wen), characterized by clear white loose stools and heavy, immobile legs. Pediatric smallpox/rubella cases are particularly numerous. Regarding these epidemic syndromes, if treatment methods are unknown and cases are dismissed as fate, is this not the fault of physicians? Observing Zhang Zhongjing in the *Ping Mai Pian* (Chapter on Equal Pulse): "If the Cun Kou pulse is tight in both Yin and Yang positions, according to the method, Clear Pathogens attack the Upper Jiao, and Turbid Pathogens attack the Lower Jiao. Clear pathogens attacking above are named 'Clean'; Turbid pathogens attacking below are named 'Muddy.' If Yin meridians are attacked by pathogens, internal chills must occur." These 269 characters elucidate profound principles entirely absent from *Cold Damage*, representing the entry points of epidemic pathogens and the general overview of disease, which people fail to recognize. The main idea of the chapter states that nasal Qi connects with Heaven; thus, fog and dew pathogens attacking Yang meridians are "Clear Pathogens," entering via the nose upwards into Yang, causing fever, headache, stiff neck, and cervical spasms, matching the secular descriptions of Big Head Plague and Toad Plague. Oral Qi connects with Earth; thus, soil and water pathogens, being turbid flavors from diet, enter downwards via the mouth and tongue into Yin, causing internal chills, cold feet and knees, involuntary urination and defecation, tenesmus, and umbilical pain, matching the secular descriptions of Intestine-Twisting Plague and Soft Leg Plague. However, pathogens entering via nose and mouth first inject into the Middle Jiao, then spread up and down. If the Middle Jiao is attacked and not treated immediately, stomach turbidity arises, Ying and Wei (Nutritive and Defensive Qi) become obstructed, and blood coagulates and stagnates. The pathology lies in the Middle Jiao, corresponding to secular Gourd Plague and Lump Plague, which are akin to Yang Toxicity with abscess/pus and Yin Toxicity with generalized cyanosis. Cold Damage pathogens typically travel along the back first, then the front, entering from the exterior. Thus, pathogens in the Exterior are resolved by sweating; pathogens in the Interior are resolved by purgation. In contrast, Warm Epidemic pathogens move directly along the central pathway and diffuse through the Three Jiao. Therefore, sweating fails to disperse them, and purgation may cause them to aggregate. This explains why epidemic treatments differ fundamentally from the exterior-interior methods of Cold Damage. Physicians should administer aromatic Qi-regulating medicines before onset to prevent pathogen entry. If pathogens enter, expelling filth is the primary principle. The Upper Jiao is like mist; elevate and expel it. The Middle Jiao is like fermentation vats; unblock and expel it. The Lower Jiao is like drainage ditches; drain and expel it. Each method should incorporate detoxification. Once Ying and Wei circulate freely, seizing the momentum to expel the pathogen renders the disease powerless against us.