经云∶风为百病之长也,以其能统诸气耳。夫春令之风,多兼温气;夏令之风,多兼暑气;秋令之风,
多兼湿气;冬令之风,多兼寒气。今风寒之病,不论于冬,而论于春令者,盖以风为重也,如冬令之风寒,
以寒为重可知,若此别之,在春令辛温不宜过剂,在冬令辛热亦可施之,所以前人用药宜分四时,洵
非谬也。是论风寒者,缘于初春尚有余寒,所至之风,风中夹寒,人感之者,即寒热头痛,汗出不多,或
咳嗽,或体 ,脉来浮大,或兼弦紧是也,宜以辛温解表法治之。然此病较当春之寒疫稍轻,较冬令之伤寒
则更轻矣,治之得法,不难一、二剂而瘳,但当审其兼证为要,如兼痰者,益以苓、夏,兼食者,加入
神、楂,随证减增,庶几有效。
春应温而过热,是为非时之气,所感之风,风中必夹热气,故名风热病耳。此不但与风温为两途,抑
且与热病为各异。盖风温、热病,皆伏气也;风热之邪,是新感也。其初起寒微热
甚,头痛而昏,或汗多,或咳嗽,或目赤,或涕黄,舌起黄苔,脉来浮数是也,当用辛凉解表法为先;倘恶
寒头痛得瘥,转为口渴喜饮,苔色黄焦,此风热之邪,已化为火,宜改清热保津法治之;倘或舌燥昏狂,或
发斑发疹,当仿热病门中之法治之。或问曰∶尝见昔贤所谓春应温而反寒,是为非时之气;今先生谓
春应温而过热,亦为非时之气。昔今之论,何其相反?请详悉之。答曰∶昔贤之论,固非有谬;丰之鄙论,
亦有所本。今谓春应温而过热,即《金匮》所谓至而太过,《礼记》所谓春行夏令
也;昔贤谓春应温而反寒,即《金匮》所谓至而不去,《礼记》所谓春行秋令也。
《内经》说:风是各种疾病的先导,因为它能统领其他邪气。春季的风,多兼夹温气;夏季的风,多兼夹暑气;秋季的风,多兼夹湿气;冬季的风,多兼夹寒气。现在讨论风寒病,不在冬季论述,而在春季论述,是因为以“风”邪为主。如果是冬季的风寒,以“寒”邪为主是显而易见的。这样区分开来,在春季使用辛温药物不宜过量,在冬季使用辛热药物也可以施用,所以前人用药应当分四季不同,确实不是谬论。这里所说的风寒病,是因为初春尚有余留的寒气,所吹来的风中夹带着寒气,人感受了这种邪气,就会出现恶寒发热、头痛、出汗不多,或者咳嗽,或者身体酸痛(注:原文“体 ”疑似缺字,结合语境及常见症状推测为“体痛”或“身重”,此处依文意译为身体不适/疼痛),脉象浮大,或者兼见弦紧脉,适宜用辛温解表法治疗。然而这种病比当春季节的寒疫稍轻,比冬季的伤寒则更轻了,治疗得当,不难一、二剂药就能痊愈,但必须仔细审查其兼夹证候是关键,如果兼有痰湿,加入茯苓、半夏;如果兼有食积,加入神曲、山楂,根据证候增减药物,才可能有效。
春季本应温暖却过热,这属于非时之气(不合时令的气候),所感受的风中必然夹带热气,所以称为风热病。这不仅与风温病不同,而且与热病也各异。因为风温、热病,都是伏气温病(体内潜伏的邪气发作);而风热之邪,是新感外邪(即时感受的外邪)。它初起时轻微恶寒而发热较重,头痛且昏沉,或者汗多,或者咳嗽,或者眼睛发红,或者鼻涕黄稠,舌苔发黄,脉象浮数,应当先用辛凉解表法治疗;如果恶寒头痛减轻,转为口渴喜欢饮水,舌苔黄而焦燥,这是风热之邪已经化为火邪,应当改用清热保津法治疗;如果出现舌干、神志昏乱狂躁,或者出现斑疹,应当仿照热病门中的方法治疗。有人问:曾经见到前贤所说春季本应温暖却反而寒冷,这是非时之气;现在先生您说春季本应温暖却过热,也是非时之气。过去和现在的论述,为什么相反?请详细解释。回答说:前贤的论述,固然没有错误;我雷丰的浅薄见解,也是有依据的。我现在说的春季本应温暖却过热,就是《金匮要略》所说的“至而太过”,《礼记》所说的“春行夏令”;前贤说的春季本应温暖却反而寒冷,就是《金匮要略》所说的“至而不去”,《礼记》所说的“春行秋令”。
The *Neijing* states: "Wind is the chief of all diseases, for it can command the other qi." The wind of spring often combines with warm qi; the wind of summer often combines with summer-heat qi; the wind of autumn often combines with dampness qi; the wind of winter often combines with cold qi. Now, when discussing Wind-Cold disease, we discuss it in spring rather than winter because the emphasis is on "Wind." If it were winter's Wind-Cold, the emphasis on "Cold" would be obvious. By distinguishing them thus, using acrid-warm medicines in spring should not be excessive, while using acrid-hot medicines in winter is also applicable. Therefore, the ancients' principle that medication should vary by the four seasons is indeed not erroneous.
The Wind-Cold discussed here arises because residual cold remains in early spring. The wind blowing at this time carries cold within it. When humans contract this pathogen, symptoms include aversion to cold and fever, headache, scanty sweating, or cough, body aches/discomfort, a floating and large pulse, or a pulse that is additionally wiry and tight. It is appropriate to treat it with the Acrid-Warm Exterior-Resolving method. However, this condition is slightly milder than the Cold Plague (Han Yi) typical of spring, and even milder than the Cold Damage (Shang Han) of winter. With proper treatment, recovery is not difficult within one or two doses. The key is to carefully examine concurrent syndromes: if phlegm is present, add *Poria* (Fuling) and *Pinellia* (Banxia); if food stagnation is present, add *Medicated Leaven* (Shenqu) and *Hawthorn* (Shanzha). Adjusting the prescription according to the syndrome will likely yield efficacy.
When spring should be warm but becomes excessively hot, this constitutes an "out-of-season climate" (Fei Shi Zhi Qi). The wind contracted under such conditions must carry heat, hence it is named Wind-Heat Disease. This differs not only from Wind-Warmth (Feng Wen) but also from Heat Disease (Re Bing). Wind-Warmth and Heat Disease are both latent qi diseases (Fu Qi), whereas Wind-Heat pathogen is a newly acquired external contraction (Xin Gan). Initially, there is slight aversion to cold but significant fever, headache with mental cloudiness, profuse sweating, or cough, red eyes, yellow nasal discharge, yellow tongue coating, and a floating-rapid pulse. The primary treatment should be the Acrid-Cool Exterior-Resolving method. If aversion to cold and headache subside, turning into thirst with a desire to drink, and the tongue coating becomes yellow and scorched, this indicates the Wind-Heat pathogen has transformed into Fire. The treatment should then change to Clearing Heat and Preserving Fluids. If dry tongue, delirium, or macules/papules appear, one should follow the methods outlined in the Heat Disease chapter.
A question arises: "I have seen the ancients state that spring should be warm but turns cold, which is out-of-season climate; yet you, Sir, say spring should be warm but becomes too hot, which is also out-of-season climate. Why do these past and present theories seem contradictory? Please explain in detail."
The answer is: "The ancients' theory is certainly not wrong; my humble opinion is also based on authority. What I call 'spring should be warm but becomes too hot' corresponds to what the *Jingui Yaolue* calls 'arrival but excessive' (Zhi Er Tai Guo) and what the *Liji* calls 'Spring executing Summer commands.' What the ancients called 'spring should be warm but turns cold' corresponds to what the *Jingui Yaolue* calls 'arrival but non-departure' (Zhi Er Bu Qu) and what the *Liji* calls 'Spring executing Autumn commands.'"