（改门人过子春稿）
外感不外六淫，民病当分四气，若不辨其源流，安能分其名目。如阳春发泄，民病多温，是温即热之渐，
热即火之本，以寒治热，千古常经。独是火必为烦，而又有阴极发躁之类乎烦者，而烦不能凭。热必致
燥，而又有氤氲抑遏，津不上供之类乎燥者，而燥不足据。热必逼乱神明，神识昏昧，而又有熏蒸蒙蔽
之昏昧，有类乎逼乱神明者，而昏昧不堪信。殊不知阴极之燥，必足冷戴阳。抑遏而津不上供之燥，必
渴而不能饮，蒙蔽之昏昧，必有一种迷沉之状。惟是其烦也壮热，其渴也能饮，苔黄或焦或红，以致神
昏发痉，其昏痉之至，皆如前状，由渐而来，是非连翘犀角羚羊玄参菖蒲至宝之类不为功。或曰、温热
之状，固已知其大概矣。湿之与温，本不相类，独是化热化火化燥之后，便与温病无异，不有确证，何以
诊断。曰、湿性蒸腾，多汗出而热不解。湿每阻气，烦则必兼胸闷恶心，热耗清津，而脾胃仍苦湿渍，必渴
而不能任饮，舌燥干霉，必饮仍喜暖，或不索饮。其神昏也，必类迷沉。夫以有汗不解辨其热，以胸闷辨
其烦，以不能饮辨其渴，以喜暖或不索饮辨其燥，以沉迷辨其昏乱，按此审察，又何虑临症而眩惑哉。
况乎同一齿垢也，温邪之齿垢，自有唇朱舌绛便秘之相兼。湿温之齿垢，绝无数症之毕现，虽有舌绛，
而近根或两边必有一种垢滞之形，如坑砂之 固牢结，习俗相沿，谓之 苔。盖一由水涸于火，火极
而似水，一由湿裹其热，熏蒸而浊结，浊结成瓣，齿亦垢矣。同一舌燥也，温邪则欲求救于饮，湿温则无
藉乎饮。同一汗出也，温邪则汗出而热解，或汗出而大渴大热，湿温则汗出而热蒸蒸。有一定之见象，
自有一定之主名，有一定之主名，自有一定之治法耳。
按本篇 当作 ，牢固之意。前原案中沿抄已久，悉仍其旧。补录于此，以备参考。（文涵志）
（修改门人过子春的草稿）
外感病不外乎六淫之邪，民众患病应当区分四时之气。如果不辨别病因的源流，怎么能分辨疾病的名称呢？比如阳春时节阳气发泄，民众多患温病，所谓“温”就是热的开端，“热”就是火的根本，用寒凉药治疗热证，是千古不变的常法。
只是火邪必然导致烦躁，但又有因阴极而发躁、类似烦躁的情况，这种烦躁不能仅凭此来判断。热邪必然导致燥象，但又有因湿气氤氲郁遏、津液不能上承而类似燥象的情况，这种燥象不足以作为依据。热邪必然逼迫扰乱神明，导致神识昏昧，但又有因湿热熏蒸蒙蔽清窍导致的昏昧，这与热扰神明导致的昏昧相似，但不能轻信。
殊不知，阴极产生的燥象，必然伴有足冷、戴阳（虚阳上浮）的表现；湿气郁遏导致津液不能上承的燥象，必然表现为口渴但不能饮水；湿热蒙蔽导致的昏昧，必然有一种迷沉呆滞的状态。只有那种壮热、口渴能饮水、舌苔黄或焦或红，以致神昏发痉，且其昏痉的发展过程如前所述由轻渐重而来的，才属于温热重症，非用连翘、犀角、羚羊角、玄参、石菖蒲、至宝丹之类的药物不能奏效。
有人问：温热病的状况，我已经知道大概了。湿与温，本来不相类似，只是在化热、化火、化燥之后，便与温病没有区别了，如果没有确切的证据，如何诊断呢？我说：湿性蒸腾，多汗出而热不退。湿邪容易阻滞气机，烦躁时必然兼有胸闷、恶心；热邪耗伤清津，但脾胃仍受湿邪浸渍，必然表现为口渴但不能大量饮水，舌面干燥生霉，即使想喝水也喜欢喝温水，或者不想喝水。其神昏状态，必然像迷沉呆滞一样。凭借有汗而热不解来辨别热邪，凭借胸闷来辨别烦躁，凭借不能饮水来辨别口渴，凭借喜欢喝温水或不索求饮水来辨别燥象，凭借沉迷呆滞来辨别昏乱，按照这些进行审察，又何必担心临症时感到困惑眩惑呢？
况且同样是齿垢，温邪导致的齿垢，自然伴有嘴唇红润、舌质绛红、便秘等兼症。湿温病导致的齿垢，绝不会同时出现上述多种症状，虽然舌质绛红，但在舌根或两侧必然有一种垢滞的形状，像坑砂一样牢固结聚，习俗相沿，称之为“䪼”苔（注：原文此处缺字，据文意及后文注释补为“䪼”，意为牢固）。这一个是由于水涸于火，火极似水；一个是由于湿包裹着热，熏蒸而浊气结聚，浊气结成瓣状，牙齿也就有了垢腻。同样是舌燥，温邪患者想要通过饮水来求救，湿温病患者则不需要依赖饮水。同样是出汗，温邪患者出汗后热退，或者出汗后大渴大热，湿温病患者则是出汗后热气蒸蒸上升。有固定的征象，自然有固定的主治病名；有固定的主治病名，自然有固定的治疗方法罢了。
按：本篇中的“ ”字当作“䪼”，意为牢固之意。前原案中沿袭抄写已久，全部保留旧貌。在此补录于此，以备参考。（文涵志）
(Modification of the draft by disciple Guo Zichun)
Exogenous diseases are nothing but the pathogenic factors of the Six Evils (Liu Yin, 六淫). Diseases among the people should be differentiated according to the Four Qi (Si Qi, 四气) of the seasons. If one does not distinguish the source and flow of the etiology, how can one differentiate the names of the diseases? For instance, in the spring when yang qi is venting out, people often suffer from Warm diseases (Wen Bing, 温病). "Warm" is the gradual onset of Heat (Re, 热), and "Heat" is the root of Fire (Huo, 火). Using Cold (Han, 寒) to treat Heat is an eternal principle.
However, Fire pathogen inevitably causes irritability (Fan, 烦), yet there are cases of restlessness resembling irritability due to Extreme Yin (Ji Yin, 极阴) manifesting as false heat; such irritability cannot be relied upon for diagnosis alone. Heat pathogen inevitably leads to Dryness (Zao, 燥), yet there are cases resembling dryness due to turbid dampness obstructing and suppressing, preventing body fluids (Jin Ye, 津液) from ascending; such dryness is insufficient as evidence. Heat pathogen inevitably forces chaos upon the Spirit (Shen, 神), causing confusion of consciousness; yet there is confusion caused by steaming and muddying obstruction, which resembles the confusion caused by forcing chaos upon the spirit, but this confusion cannot be trusted blindly.
One must not ignore that dryness caused by Extreme Yin must be accompanied by cold feet and Floating Yang (Dai Yang, 戴阳). Dryness caused by dampness suppression preventing fluid ascent must present as thirst without desire to drink. Confusion caused by muddying obstruction must present with a state of lethargic sinking. Only when there is robust high fever, thirst with ability to drink, yellow or scorched or red tongue coating, leading to coma and convulsions, where the progression of coma and convulsions comes gradually as described above, can it be deemed a severe Warm-Heat condition. Such conditions require herbs like Lianqiao (Forsythiae Fructus), Xijiao (Rhinocerotis Cornu - *Note: Substitute with Tapir Horn or Buffalo Horn clinically*), Lingyangjiao (Saigae Tataricae Cornu), Xuanshen (Scrophulariae Radix), Shichangpu (Acori Tatarinowii Rhizoma), and Zhibao Dan (Treasure of Life Pill) to achieve efficacy.
Someone might ask: The manifestations of Warm-Heat diseases, I already know generally. Dampness and Warmth are originally dissimilar. However, after transforming into Heat, Fire, and Dryness, they become indistinguishable from Warm diseases. Without definitive signs, how can one diagnose? I say: Dampness has a steaming nature, often presenting with sweating but unresolved fever. Dampness often obstructs Qi mechanism; irritability must be accompanied by chest tightness and nausea. Although Heat consumes clear fluids, the Spleen and Stomach remain suffering from damp infiltration; thus, there is thirst but inability to bear drinking. The tongue may be dry and moldy, yet if drinking occurs, warm water is preferred, or there is no desire to drink at all. The coma presents as lethargic sinking. By using "sweating without fever resolution" to identify Heat, "chest tightness" to identify irritability, "inability to drink" to identify thirst, "preference for warm water or no desire to drink" to identify dryness, and "lethargic sinking" to identify confusion, one can examine accordingly. Why worry about being confused during clinical practice?
Moreover, regarding dental plaque/fur on teeth: Dental fur caused by Warm pathogen naturally accompanies vermilion lips, crimson tongue, and constipation. Dental fur caused by Damp-Warmth never presents with all these symptoms simultaneously. Although the tongue may be crimson, near the root or on both sides, there must be a form of turbid stagnation, firmly bound like sand in a pit, traditionally referred to as "Bang Tai" (Hard/Firm Coating). This is because one case is due to water exhausted by fire, where extreme fire resembles water; the other is due to dampness wrapping heat, steaming and turbidly binding. Turbid binding forms flakes, making the teeth appear coated. Regarding dry tongue: Warm pathogen patients seek relief through drinking; Damp-Warmth patients do not rely on drinking. Regarding sweating: Warm pathogen patients have fever resolve after sweating, or experience intense thirst and high fever after sweating; Damp-Warmth patients have steaming-upward heat after sweating. With fixed signs, there are fixed disease names; with fixed disease names, there are fixed treatment methods.
*Editor's Note: The character " " in this text should be read as "Bang" (䪼), meaning firm/solid. It has been copied incorrectly in previous original cases for a long time. All are kept as old versions here. Recorded here for reference.* (Wen Hanzhi)