刺法论帝曰∶余闻五疫之至，皆相染易，无问大小，病状相似，不施救疗，如何可得不相移
易者？岐伯曰∶不相染者，正气存内，邪不可干。避其毒瓦斯，天牝（天牝，鼻也。老子谓玄牝之门。
毒瓦斯从鼻来，可嚏之从鼻而出。）从来，复得其往，气出于脑，即不干邪。气出于脑，即先想心如日。
欲将入疫室，先想青气自肝而出，左行于东，化作林木。次想白气自肺而出，右行于西，化作戈甲。
次想赤气自心而出，南行于上，化作焰明。次想黑气自肾而出，北行于下，化作水。次想黄气自脾
而出，存于中央，化作土。五气护身之毕，以想头上如北斗之煌煌，然后可入疫室。
阳明脉解篇帝曰∶病甚则弃衣而走，登高而歌，或至不食数日，逾垣上屋。所
上之处，皆非其素所能也，病反能者，何也？岐伯曰∶四肢者，诸阳之本也，阳盛则四肢实，实
则能登高也。帝曰∶弃衣而走者，何也？岐伯曰∶热盛于身，故弃衣而走也。帝曰∶其妄言骂詈、
不避亲疏而歌者，何也？岐伯曰∶阳盛则使人妄言骂詈、不避亲疏而不欲食，不欲食故妄走也。
（此言胃病皆邪气之盛也。邪盛故热盛，热盛故阳盛，阳盛故三者之病由此矣。）
热论篇帝曰∶热病已愈，时有所遗者，何也？岐伯曰∶诸遗者，热甚而强食之，故有所遗也。
若此者，皆病已衰而热有所藏，因其谷气相薄两热相合，故有所遗也。帝曰∶治遗奈何？岐伯曰∶
视其虚实，调其逆从，可使必已也。帝曰∶病热当何禁之？岐伯曰∶病热少愈，食肉则复，多食
则遗，此其禁也。（此言病之所以遗者，由于强食，而有治之之方，复有禁之之要也。遗者，病已
愈而邪气未尽衰，若有所遗而在也。禁者，禁于未遗之先也。肉性热而难化，尤当禁也。）
评热病论帝曰∶有病温者，汗出辄复热而脉躁疾，不为汗衰，狂言不能食，病名为何？岐伯曰∶
病名阴阳交，（阴阳之气不分别也。）交者死也。帝曰∶愿闻其说。岐伯
曰∶人所以汗出者，皆生于谷，谷生于精。今邪气交争于骨肉而得汗者，是邪却而精胜也，精胜则
当能食而不复热。复热者，邪气也。汗者，精气也。今汗出而辄复热者，是邪盛也。不能食者，精
无俾也。（精气不能使之食也。）病而留者，其寿可立而倾也。且夫热病曰∶汗出而脉尚躁盛者死。今脉
不与汗相应，（脉躁疾，不为汗衰。）此不胜其病也，其死明矣。狂言者是失志，失志者死。今见
三死，（身热不能食，一也。脉躁盛者，二也。狂言者，三也。）不见一生，虽愈必死也。
《灵枢》热病篇曰∶热病已得汗出，而脉尚躁，喘且复热，勿刺，喘甚者死。
又曰∶热病已得汗，而脉尚躁盛，此阴脉之极也，死。
刺热篇曰∶肝热病者，小便先黄，腹痛多卧，（肝经之脉，环阴器，抵少腹而上，故有是症。）身热。
热争（邪与正争。）则狂言及惊，胁满痛，手足躁，不得安卧。（肝经之脉，从少腹上挟胃贯膈，布胁肋，
循喉咙之后，络舌本，故见此症。肝之病发为惊骇，故病则惊。胃不和，则卧不安，木来乘土，故不得
安卧。）庚辛甚，（金克木也。）甲乙大汗，（本经气旺之日。）气逆则庚辛死。
（以其气逆甚也。上三句，总言其甚其死，必以克我之日；得汗而愈，必以自得其位之日。后四段
放此。）刺足厥阴、少阳。其逆则头痛员员，脉引冲头也。（肝经脉，自舌本，循喉咙之后，上出额，
与督脉会于巅。故病气逆则如是也。员员者，靡定也。）
松峰曰∶此专引经义，刺法不赘。
心热病者，先不乐数日，（邪入经络，则神不安，故不乐。）乃热。热争则卒心痛。烦闷善呕，头
痛面赤无汗。（心脉起于心中，其支别者，从心系上挟咽。小肠之脉，直行者，循咽下膈抵胃。其
支别者，从缺盆循颈上颊，至目外 。故兼见诸症。心在液为汗，今病热，故无汗以出耳。）
壬癸甚，（克。）丙丁大汗。（气旺。）气逆则壬癸死。刺手少阴、太阳。
脾热病者，先头重颊痛，烦心颜青欲呕，（胃脉起于鼻交 中，下循鼻外，入上齿中，还出挟口，
环唇，下交承浆，却循颐后下廉，出大迎，过客主人，循发际，至额颅。故先头重颊痛颜
青也。脾之脉，其支别者，复从胃别上膈，注心中。其直行者，上膈挟咽。故烦心欲呕也。）身热。
热争则腰痛不可用俯仰，腹满泄，两颔痛。（胃脉支别者，起胃下口，循腹里，下至气街中而合，以下
髀关。气街者，腰之前，故腰痛也。脾脉入腹，属脾络胃，入胃之脉，自交承浆，却循颐后下廉，
出大迎，循颊车。故腹满泄而两颔痛也。）甲乙甚，戊己大汗。气逆则甲乙死。刺足太阴、阳明。
肺热病者，先淅然厥，起毫毛，恶风寒，舌上黄，（肺主皮毛，热中之，则先淅然恶风，起毫毛也。
肺脉起于中焦，下络大肠，还循胃口。今肺热入胃，胃热上升，故舌上黄。）身热。热争则喘咳，痛走
胸膺背，不得太息，头痛不堪，汗出而寒。（肺居膈上，气主胸膺，在变动为咳，背为胸中之府，故喘咳，
痛走胸膺不得太息。肺之络脉，上会耳中，今热气上薰，故头痛不堪，汗出而寒。）丙丁甚，庚辛大汗。
气逆则丙丁死。刺手太阴、阳明，出血如豆，立已。
肾热病者，先腰痛 膀胱脉，循肩 内，挟脊抵腰中，又腰为肾之府，故痛。 （ ，脊梁后骨。） ，
苦渴数饮，（ ，音行。 ，音酸，酸痛也。肾脉自循内踝之后，上 内，出 内廉。又直行者，从
肾上贯肝膈，入肺中，循喉咙挟舌本。）身热。热争则项痛而强， 寒且酸，足下热，不欲言。（膀
胱脉，从脑出，别下项。肾脉起于小指之下，斜趋足心，出于然骨之下，循内踝之后，别入跟中，以
上内。又其直行者，从肾上贯肝膈，入肺中，循喉咙挟舌本，故见诸症。）其逆则项痛员员澹澹然。
戊己甚，壬癸大汗。气逆则戊己死。刺足少阴、太阳。（员员，靡定也。澹澹，无意味也。）
又曰∶肝热病者，左颊先赤。心热病者，颜先赤。脾热病者，鼻先亦。肺热
病者，右颊先赤。肾热病者，颐先赤。病虽未发，见赤色者刺之，名曰治未病。（以面之部位应五脏。）
又曰∶治诸热病，以饮之寒水乃刺之，必寒衣之，居止寒处，身寒（热退身凉也。）而止也。（乃可
以止针。）
余曾见一小儿患瘟热邪深重，弃衣而走，昼夜靡宁，手足不闲，翻动器皿，掏拨什物，寻得凉水
一瓮，且浴且饮，一日后，随热退身凉而愈。松峰记。
刺法自有专门，以此数段中义蕴有关于瘟疫，故采录之，非讲刺法也。
热论篇帝曰∶今夫热病者，皆伤寒之类也。或愈或死，其死皆以六七日间，其愈皆以十日以上者
何也？岐伯曰∶巨阳者，诸阳之属也，（太阳六经之长，总摄诸阳。）其脉连于风府，故为诸阳主气
也。人之伤于寒也，则为病热，热虽盛不死。其两感于寒而病者，必不免于死。一日巨阳受之，（巨阳，
太阳也。）故头项痛，腰脊强。二日
阳明受之，阳明主肉，其脉挟鼻络于目，故身热目痛而鼻干不得卧也。三日少阳受之，少阳主胆，
其脉循胁络于耳，故胸胁痛而耳聋。三阳经络皆受病，而未入于脏者，故可汗而已。四日太阴受之，
太阴脉循布胃中，络于嗌，故腹满而嗌干。五日少阴受之，少阴脉贯肾络于肺，系舌本，故口燥舌
干而渴。六日厥阴受之，厥阴脉循阴器而络于肝，故烦满而囊缩。三阴三阳五脏六腑皆受病，荣卫不
行，五脏不通则死矣。其未满三日者，可汗而已，其满三日者，可下而已。
松峰曰∶此《内经》、《伤寒》传经之正例也。瘟疫虽与伤寒不同，但邪在膜原，正当经胃交关
之所，半表半里。其热淫之气，浮越于某经即显某经之症，专门瘟疫者，又不可不知也。（汗下又
不可泥定三日。）
经曰∶其冬有非节之暖者，名曰冬温。冬温之毒与伤寒大异。冬温复有先后，
更相重沓，亦有轻重，为治不同。
松峰曰∶冬暖，来年入夏必病，当时病者却少。
阴阳应象大论曰∶冬伤于寒，春必温病。
松峰曰∶《云笈七签》中引作冬伤于汗，甚妙。盖言冬时过暖，以致汗出，则来年必病温。
余细体验之，良然。冬日严寒，来春并无瘟疫，以其应寒而寒，得时令之正故耳。且人伤于寒岂能
稽留在身，俟逾年而后病耶？
金匮真言论曰∶夫精者，身之本也。故藏于精者，春不病温。
松峰曰∶藏精者，百病不生，岂第不病温而已哉。
论疾诊尺篇曰∶尺肤热甚，脉盛躁者，病温也。其脉盛而滑者，病且出也。
松峰曰∶出字谓邪不入里，将解散也。
张仲景温病篇曰∶太阳病，发热而渴不恶寒者，为温病；发汗已，身灼热者，名风温。风温为
病，脉阴阳俱浮，自汗出，身重，多眠睡，鼻息必鼾，（音旱。鼻息如雷。）语言难出。（自发汗已
至此，言大发其汗之害。）若被下者，小便不利，直视失溲。
（脏气不固，故失溲。此四句言误下之害。）若被火者，微发黄色，剧则如惊痫，时螈 。（痫，
音闲。俗云羊羔风，其声如羊。螈 ，音炽纵，抽拉发搐。此四句言用火逼汗，劫取之害。）若火薰
之，一逆尚引日，再逆促命期。（表热无寒，故不宜汗。里热无实，故不宜下。表里俱热，尤不宜火。
若误汗、下、火劫则逆，一逆尚可延引时日，再逆第二次，则阴立亡而死。）
经曰∶春应暖而复大寒，夏应热而反大凉，秋应凉而反大热，冬应寒而反大温，此非其时而有其
气，是以一岁之中，长幼之病多相似者，此则时行之气也。
刘南瑛曰∶四时气候不正为病，谓之时症，与伤寒、温、暑、寒疫等症不同，唯秋从未见有病者。
《素问》∶四时不节，则生大疫。
《伤寒论》曰∶阳脉洪数，阴脉实大，遇温热变为温毒。（阳主表，阴主里，洪数实大皆热
也。两热相合，变为温毒。）
又曰∶温病之脉，行在诸经，不知何经之动也，各随其经所在而取之。（瘟病
由不正之气散行诸经，难别何经所受，必审其病之属于何经，而后可以施治。）
热病须得脉浮洪，细小徒自费神功，（阳病当得阳脉。细小，阴脉也。属死症，不治。）汗后
脉静当便瘥，喘热脉乱命应终。（汗后邪退即生，邪盛即死。）
松峰曰∶热病而脉细小，虽云不治，然有脉厥者，不在此例。
阳毒健乱四肢烦，面赤生花作点斑。狂言妄语见神鬼，下痢频多喉不安。汗出遍身应大瘥，鱼口
开张命欲翻。有药不辜（负也。）但与服，能过七日始能安。（阳症宜汗解，如失汗则邪传入脏，故
有健乱等危症。病传在里不当汗，又加之遍身自汗，口如鱼口开张者死。能过七日乃过经，阳热退，
方有可救之理。）
松峰曰∶七日能安之说，不过言方有可救之理，非云愈也，总不可泥。
热病未汗，脉须浮洪；既汗，脉当安静。倘有散漫之脉或不汗而愈，（不汗而愈，谓之干瘥。）其平
复未可全许也。
瘟疫，众人一般病者是。又谓之天行时疫。治法有三，宜补、宜散、宜降。热甚者，宜服童便。
松峰曰∶补者，如四损不可正治及老幼与本来虚弱者是也。（四损解，见诸论中。）散者，清
凉解散是也。（瘟症不宜温散。）降者，从大小便驱逐其邪是也。
瘟家之脉散难名，随其脉状分诸经。若浮而大按无力，补中带表随时宁。
松峰曰∶浮大无力，本虚怯脉，何以知其为瘟疫乎？必应以瘟脉、（洪数而浮。）瘟症参之，方
为无弊。脉状状字，指病症与色、与声而言。
疫症关系，全在虚实二字。实者易治，虚者难治，以元气本虚，邪不易解。若治挟虚者，而
不知托散，但知攻邪，愈攻则愈虚，愈虚则断无有不死者。
松峰曰∶虚实二字，三种疫病皆有之，即瘟中亦有虚实，但热多而无寒耳。
瘟疫之来无方，然召之亦有其故，或人事之错乱，天时之乖违，尸气之缠染，毒瓦斯之变蒸，皆
能成病。症既不同，治难画一。瘟疫多火热之气，蕴蓄于房户，则一家俱病；蕴蓄于村落，则一乡
俱病；蕴蓄于市廛，则一城俱病；蕴蓄于道路，
则千里皆病。故症虽多，但去其火热之气，而少加祛邪逐秽之品，未有不可奏效者也。
凡治瘟疫宜清利者，非只一端，盖火实者宜清，气实者宜行，食滞者宜消，痰甚者宜化，皆
所谓清利也。凡此数者，滞去则气行，而表邪自解，然宜用于实邪等证，而本非虚证之所宜。其有
虚中挟实者，不妨少为清解。
凡瘟疫宜下者，必阳明邪实于腑，而秘结腹满，或元气素强，胃气素实者，方可下，若大便虽数
日不行，而腹无胀满，及大便无壅滞不通之状，或连日不食而脐腹坦然，软而无碍，此阳明胃腑本
无实邪，切不可妄下以泄中气。盖诸误之害，下为尤甚，不可忽也。
周翰光曰∶与急症急攻，并注意逐邪等论，当合看，务要因时制宜，变通不拘也。
虽古法云瘟病在三阳者多，三阴者少，然亦不可拘泥。
《刺法论》中黄帝问道：我听说五种疫病流行时，都会相互传染，无论年龄大小，病症表现相似。如果不进行救治治疗，怎样才能做到不互相传染呢？岐伯回答说：之所以不互相传染，是因为人体正气充足存在于体内，邪气就无法侵犯。避开毒气，毒气从鼻子（天牝，即鼻。老子所说的玄牝之门。毒气从鼻子进入，可以通过打喷嚏从鼻子排出。）进来，又要让它从原路回去，气息出于脑部，就不会被邪气干扰。气息出于脑部，就要先想象心脏像太阳一样明亮。如果要进入疫室，先想象青色之气从肝脏发出，向左运行到东方，化作林木。接着想象白色之气从肺脏发出，向右运行到西方，化作戈甲兵器。接着想象红色之气从心脏发出，向南运行到上方，化作火焰光明。接着想象黑色之气从肾脏发出，向北运行到下方，化作水。接着想象黄色之气从脾脏发出，存留于中央，化作土。五气护身的意念完成后，再想象头顶像北斗星那样光辉灿烂，然后才可以进入疫室。
《阳明脉解篇》中黄帝问道：病情严重时，病人会扔掉衣服乱跑，登上高处唱歌，甚至到了几天不吃东西，翻越墙垣、爬上屋顶的地步。所上的地方，都是他平时做不到的，病情反而能这样做，是什么原因呢？岐伯回答说：四肢是诸阳经的根本，阳气旺盛则四肢充实有力，充实有力就能登高。黄帝问：扔掉衣服乱跑，是什么原因呢？岐伯说：身体热盛，所以扔掉衣服乱跑。黄帝问：胡言乱语、骂人、不顾亲疏关系而唱歌，是什么原因呢？岐伯说：阳气旺盛使人胡言乱语、骂人、不顾亲疏而不想吃东西，不想吃东西所以胡乱走动。（这里说的是胃病都是邪气旺盛所致。邪气盛所以热盛，热盛所以阳盛，阳盛所以这三种病由此产生。）
《热论篇》中黄帝问道：热病已经痊愈，但时常有遗留症状，是什么原因呢？岐伯说：所有遗留症状，都是因为热势很盛却勉强进食，所以有遗留症状。像这种情况，都是病情已经衰退但热邪有所潜藏，因为食物谷气与余热相搏结，两热相合，所以有遗留症状。黄帝问：治疗遗留症状怎么办？岐伯说：观察虚实，调理逆顺，可以使病必愈。黄帝问：患热病应当禁忌什么？岐伯说：热病稍有好转，吃肉就会复发，多吃就会遗留症状，这是禁忌。（这里说的病之所以遗留，是由于勉强进食，而有治疗的方法，又有禁止的要诀。遗留，是指病已好但邪气未尽衰，好像还有残留。禁，是指在未遗留之前禁止。肉性热且难消化，尤其应当禁止。）
《评热病论》中黄帝问道：有人患温病，出汗后随即又发热，脉搏躁动疾速，不因出汗而减弱，胡言乱语不能进食，这病叫什么名字？岐伯说：这病名叫阴阳交，（阴阳之气混杂不分。）交的预后死亡。黄帝说：我想听听其中的道理。岐伯说：人之所以出汗，都源于水谷精微，水谷精微生于精气。现在邪气在骨肉间交争而得到汗出，这是邪气退却而精气胜利，精气胜利就应当能进食且不重新发热。重新发热的，是邪气。汗出的，是精气。现在出汗后随即又发热，这是邪气盛。不能进食，是精气得不到补充。（精气不能使之进食。）病邪滞留不去，寿命很快就会终结。而且热病说：出汗后脉搏还躁动旺盛的会死。现在脉搏不与汗出相应，（脉搏躁动疾速，不因出汗而减弱。）这是不胜任疾病的表现，死亡是明显的。胡言乱语是失志，失志的会死。现在见到三种死征，（身热不能食，是一。脉搏躁盛的，是二。胡言乱语的，是三。）不见一种生机，即使暂时好转也必定死亡。
《灵枢》热病篇说：热病已经出汗，但脉搏还躁动，气喘且重新发热，不要针刺，气喘严重的会死。
又说：热病已经出汗，但脉搏还躁动旺盛，这是阴脉的极点，会死。
《刺热篇》说：肝热病患者，小便先变黄，腹痛多卧，（肝经的脉，环绕生殖器，抵少腹而上，所以有此症。）身热。正邪相争，则胡言乱语及惊骇，胁肋满痛，手足躁动，不得安卧。（肝经的脉，从少腹上挟胃贯膈，布胁肋，循喉咙之后，络舌本，所以见此症。肝病发作表现为惊骇，所以病则惊。胃不和，则卧不安，木来乘土，所以不得安卧。）逢庚辛日加重，（金克木。）逢甲乙日大汗，（本经气旺之日。）气逆则逢庚辛日死。
（因为气逆甚。上三句，总言其重及其死，必以克我之日；得汗而愈，必以自得其位之日。后四段仿此。）针刺足厥阴、足少阳经。气逆则头痛头晕，脉气牵引冲头。（肝经脉，自舌本，循喉咙之后，上出额，与督脉会于巅顶。所以病气逆则如此。员员，指不定貌。）
心热病患者，先有不快乐数日，（邪入经络，则神不安，所以不快乐。）然后发热。正邪相争则突然心痛。烦闷容易呕吐，头痛面赤无汗。（心脉起于心中，其支别者，从心系上挟咽。小肠的脉，直行者，循咽下膈抵胃。其支别者，从缺盆循颈上颊，至目外眦。所以兼见诸症。心在液为汗，今病热，所以无汗以出耳。）逢壬癸日加重，（克。）逢丙丁日大汗。（气旺。）气逆则逢壬癸日死。针刺手少阴、手太阳经。
脾热病患者，先头重颊痛，心烦颜青想呕吐，（胃脉起于鼻交頞中，下循鼻外，入上齿中，还出挟口，环唇，下交承浆，却循颐后下廉，出大迎，过客主人，循发际，至额颅。所以先头重颊痛颜青也。脾的脉，其支别者，复从胃别上膈，注心中。其直行者，上膈挟咽。所以烦心欲呕也。）身热。正邪相争则腰痛不可俯仰，腹满泄泻，两颔痛。（胃脉支别者，起胃下口，循腹里，下至气街中而合，以下髀关。气街者，腰之前，所以腰痛也。脾脉入腹，属脾络胃，入胃之脉，自交承浆，却循颐后下廉，出大迎，循颊车。所以腹满泄而两颔痛也。）逢甲乙日加重，逢戊己日大汗。气逆则逢甲乙日死。针刺足太阴、足阳明经。
肺热病患者，先淅然恶寒，毫毛竖起，怕风冷，舌苔黄，（肺主皮毛，热中之，则先淅然恶风，起毫毛也。肺脉起于中焦，下络大肠，还循胃口。今肺热入胃，胃热上升，所以舌上黄。）身热。正邪相争则喘咳，痛走胸膺背，不能深吸气，头痛不堪，出汗而怕冷。（肺居膈上，气主胸膺，在变动为咳，背为胸中之府，所以喘咳，痛走胸膺不能深吸气。肺的络脉，上会耳中，今热气上薰，所以头痛不堪，出汗而怕冷。）逢丙丁日加重，逢庚辛日大汗。气逆则逢丙丁日死。针刺手太阴、手阳明经，出血如豆粒大，立刻就好。
肾热病患者，先腰痛，膀胱脉，循肩内，挟脊抵腰中，又腰为肾之府，所以痛。（ ，脊梁后骨。） ，苦渴数饮，（ ，音行。 ，音酸，酸痛也。肾脉自循内踝之后，上 内，出 内廉。又直行者，从肾上贯肝膈，入肺中，循喉咙挟舌本。）身热。正邪相争则项痛而强， 寒且酸，足下热，不想说话。（膀胱脉，从脑出，别下项。肾脉起于小指之下，斜趋足心，出于然骨之下，循内踝之后，别入跟中，以上内。又其直行者，从肾上贯肝膈，入肺中，循喉咙挟舌本，所以见诸症。）气逆则项痛头晕澹澹然。
逢戊己日加重，逢壬癸日大汗。气逆则逢戊己日死。针刺足少阴、足太阳经。（员员，不定貌。澹澹，无意味也。）
又说：肝热病患者，左颊先红。心热病患者，颜面先红。脾热病患者，鼻先亦红。肺热病患者，右颊先红。肾热病患者，下巴先红。病虽未发作，见红色的就针刺，这叫治未病。（以面之部位应五脏。）
又说：治疗各种热病，用喝冷水然后针刺，必须穿凉衣，居住在凉爽处，身体凉（热退身凉也。）才停止。（才可以停针。）
我曾见过一个小孩患瘟热邪气深重，扔掉衣服乱跑，昼夜不停，手脚不停，翻动器皿，掏拨杂物，寻得一瓮凉水，边洗边喝，一天后，随着热退身凉而痊愈。刘松峰记。
刺法自有专门学问，因为这几段中的义蕴关系到瘟疫，所以采录它，不是讲刺法。
《热论篇》黄帝问道：现在的热病，都属于伤寒一类。有的痊愈有的死亡，死亡的都在六七天之间，痊愈的都在十日以上，是什么原因呢？岐伯说：巨阳，是诸阳的统领，（太阳六经之长，总摄诸阳。）它的脉连于风府，所以为诸阳主气。人受寒邪侵袭，就变成热病，热虽然盛但不死。如果两感于寒邪而病的，一定不免于死。第一天巨阳受病，（巨阳，就是太阳。）所以头项痛，腰脊强直。第二天阳明受病，阳明主肉，它的脉挟鼻络于目，所以身热目痛而鼻干不能卧。第三天少阳受病，少阳主胆，它的脉循胁络于耳，所以胸胁痛而耳聋。三阳经络都受病，而未入于脏的，所以可以发汗而愈。第四天太阴受病，太阴脉循布胃中，络于咽喉，所以腹满而咽喉干。第五天少阴受病，少阴脉贯肾络于肺，系舌本，所以口燥舌干而渴。第六天厥阴受病，厥阴脉循阴器而络于肝，所以烦满而阴囊收缩。三阴三阳五脏六腑都受病，营卫不行，五脏不通就会死。病程未满三天的，可以发汗而愈，病程满三天的，可以攻下而愈。
刘松峰说：这是《内经》、《伤寒论》传经的正例。瘟疫虽然与伤寒不同，但邪气在膜原，正当经胃交关之处，半表半里。其热淫之气，浮越于某经就显现某经的症状，专门研究瘟疫的人，又不可不知道。（汗法和下法又不可以拘泥于三日。）
经书说：冬天有非季节的暖热，名叫冬温。冬温的毒气与伤寒大不相同。冬温又有先后，更相重叠，也有轻重，治疗方法不同。
刘松峰说：冬暖，来年入夏必生病，当时生病的人却少。
《阴阳应象大论》说：冬天受寒，春天必患温病。
刘松峰说：《云笈七签》中引作冬天受汗，非常妙。大概说是冬天时候过暖，以致出汗，则来年必患温病。我仔细体验，确实如此。冬日严寒，来春并无瘟疫，因为它应寒而寒，得时令之正的缘故。况且人受寒怎么能稽留在身上，等到过了一年才生病呢？
《金匮真言论》说：精，是身体的根本。所以藏精的人，春天不患温病。
《论疾诊尺篇》说：尺肤热甚，脉搏盛躁的，是患温病。脉搏盛而滑的，病将要外出（痊愈）。
张仲景《温病篇》说：太阳病，发热而渴不恶寒的，是温病；发汗后，身体灼热的，名叫风温。风温为病，脉阴阳俱浮，自汗出，身重，多眠睡，鼻息必鼾，（音旱。鼻息如雷。）语言难出。（自发汗后至此，言大发其汗的危害。）如果被误用下法，小便不利，直视失禁。
（脏气不固，所以失禁。这四句言误下的危害。）如果被用火疗，轻微发黄，严重则像惊痫，时时抽搐。（痫，音闲。俗云羊羔风，其声如羊。螈 ，音炽纵，抽拉发搐。这四句言用火逼汗，劫取的危害。）如果用火熏，一次误治还能拖延时日，再次误治加速死亡。（表热无寒，所以不宜汗。里热无实，所以不宜下。表里俱热，尤其不宜火。如果误汗、下、火劫则逆，一次误治尚可延引时日，再次误治第二次，则阴立亡而死。）
经书说：春天应暖而复大寒，夏天应热而反大凉，秋天应凉而反大热，冬天应寒而反大温，这不是其时而有其气，因此一年之中，长幼之病多相似的，这就是时行之气。
刘南瑛说：四时气候不正致病，叫时症，与伤寒、温、暑、寒疫等症不同，唯独秋天从未见有病者。
《素问》：四时不节，则生大疫。
《伤寒论》说：阳脉洪数，阴脉实大，遇温热变为温毒。（阳主表，阴主里，洪数实大皆热也。两热相合，变为温毒。）
又说：温病的脉，行在诸经，不知哪经发动，各随其经所在而取之。（瘟病由不正之气散行诸经，难辨何经受邪，必审其病属于何经，而后可以施治。）
热病须得脉浮洪，细小徒自费神功，（阳病当得阳脉。细小，阴脉也。属死症，不治。）汗后脉静当便瘥，喘热脉乱命应终。（汗后邪退即生，邪盛即死。）
阳毒健乱四肢烦，面赤生花作点斑。狂言妄语见神鬼，下痢频多喉不安。汗出遍身应大瘥，鱼口开张命欲翻。有药不辜（负也。）但与服，能过七日始能安。（阳症宜汗解，如失汗则邪传入脏，故有健乱等危症。病传在里不当汗，又加之遍身自汗，口如鱼口开张者死。能过七日乃过经，阳热退，方有可救之理。）
刘松峰说：七日能安的说法，不过是说方有可救之理，不是说痊愈，总之不可以拘泥。
热病未汗，脉须浮洪；既汗，脉当安静。倘有散漫之脉或不汗而愈，（不汗而愈，谓之干瘥。）其平复未可全许也。
瘟疫，众人一般病的是。又叫天行时疫。治法有三，宜补、宜散、宜降。热甚的，宜服童便。
刘松峰说：补，如四损不可正治及老幼与本来虚弱者是。（四损解，见诸论中。）散，是清凉解散。（瘟症不宜温散。）降，是从大小便驱逐其邪。
瘟家之脉散难名，随其脉状分诸经。若浮而大按无力，补中带表随时宁。
刘松峰说：浮大无力，本是虚怯脉，怎么知道它是瘟疫呢？必须以瘟脉、（洪数而浮。）瘟症参之，才没有弊端。脉状状字，指病症与色、与声而言。
疫症关系，全在虚实二字。实的易治，虚的难治，因为元气本虚，邪气不易解。如果治疗挟虚者，而不知托散，只知道攻邪，愈攻则愈虚，愈虚则断无有不死的。
刘松峰说：虚实二字，三种疫病皆有之，即瘟中亦有虚实，但热多而无寒耳。
瘟疫之来无方，但召之亦有其故，或人事之错乱，天时之乖违，尸气之缠染，毒瓦斯之变蒸，都能成病。症既不同，治难画一。瘟疫多火热之气，蕴蓄于房户，则一家俱病；蕴蓄于村落，则一乡俱病；蕴蓄于市廛，则一城俱病；蕴蓄于道路，则千里皆病。所以症虽多，但只要去除其火热之气，而少加祛邪逐秽之品，未有不可奏效的。
凡治瘟疫宜清利的，不只一端，盖火实的宜清，气实的宜行，食滞的宜消，痰甚的宜化，都所谓清利。凡此数者，滞去则气行，而表邪自解，然而宜用于实邪等证，而本非虚证之所宜。其有虚中挟实的，不妨少为清解。
凡瘟疫宜下的，必阳明邪实于腑，而秘结腹满，或元气素强，胃气素实的，方可下，若大便虽数日不行，而腹无胀满，及大便无壅滞不通之状，或连日不食而脐腹坦然，软而无碍，此阳明胃腑本无实邪，切不可妄下以泄中气。盖诸误之害，下为尤甚，不可忽也。
周翰光说：与急症急攻，并注意逐邪等论，当合看，务要因时制宜，变通不拘也。
虽然古法说瘟病在三阳的多，三阴的少，但也不可拘泥。
In the *Ci Fa Lun* (Treatise on Needling Methods), the Yellow Emperor asked: I have heard that when the five plagues arrive, they all infect each other, regardless of age, and the symptoms are similar. If no treatment is provided, how can one avoid mutual infection? Qibo replied: Those who do not get infected are those whose Zheng Qi (Upright Qi/Vital Energy) is preserved within, so that Xie Qi (Evil/Pathogenic Factors) cannot invade. Avoid the toxic vapors; these vapors enter through the nose (Tian Ping, meaning nose. Laozi referred to it as the gate of the mysterious female. Toxic vapors enter via the nose and can be expelled by sneezing). To prevent them from taking hold, let the Qi return to its source, exiting through the brain, thus preventing interference by pathogenic factors. For Qi to exit through the brain, one must first visualize the heart like the sun. Before entering a plague chamber, one should first visualize green Qi emanating from the Liver, moving left to the East, transforming into forests and trees. Next, visualize white Qi emanating from the Lung, moving right to the West, transforming into weapons and armor. Next, visualize red Qi emanating from the Heart, moving south to the upper region, transforming into bright flames. Next, visualize black Qi emanating from the Kidney, moving north to the lower region, transforming into water. Next, visualize yellow Qi emanating from the Spleen, remaining in the center, transforming into earth. After completing the visualization of the Five Qi protecting the body, visualize the head shining brightly like the Big Dipper, and only then may one enter the plague chamber.
In the *Yangming Mai Jie Pian* (Chapter on Explaining the Yangming Meridian), the Yellow Emperor asked: When the disease is severe, the patient discards clothes and runs, climbs high places and sings, or goes without food for several days, climbing over walls and roofs. These places are beyond their usual capabilities, yet the disease enables them to do so. What is the reason? Qibo replied: The four limbs are the root of all Yang meridians. When Yang is excessive, the four limbs become solid and strong, enabling one to climb high. The Yellow Emperor asked: Why discard clothes and run? Qibo said: Heat is excessive in the body, hence discarding clothes and running. The Yellow Emperor asked: Why talk nonsense, curse, and sing without regard for intimacy or distance? Qibo said: Excessive Yang causes people to talk nonsense, curse, disregard relationships, and lose appetite. Due to loss of appetite, they walk aimlessly. (This refers to stomach diseases caused by excessive pathogenic factors. Excess pathogens lead to heat excess, heat excess leads to Yang excess, and thus these three conditions arise.)
In the *Re Lun* (Treatise on Heat), the Yellow Emperor asked: After a heat disease has healed, why do residual symptoms sometimes occur? Qibo replied: All residual symptoms occur because the patient forces themselves to eat while the heat is still intense. In such cases, although the disease has subsided, heat remains hidden. The Qi of food grains clashes with this residual heat, and the two heats combine, causing residual symptoms. The Yellow Emperor asked: How to treat residual symptoms? Qibo replied: Observe deficiency and excess, regulate reversal and normalcy, and the disease will surely heal. The Yellow Emperor asked: What should be forbidden during a heat disease? Qibo replied: When a heat disease slightly improves, eating meat causes relapse, and overeating causes residual symptoms. This is the prohibition. (This explains that residuals result from forced eating, providing both treatment methods and prohibitions. "Residual" means the disease seems cured but pathogenic factors remain. "Prohibition" means forbidding actions before residuals occur. Meat is hot in nature and hard to digest, especially to be avoided.)
In the *Ping Re Bing Lun* (Treatise on Evaluating Heat Diseases), the Yellow Emperor asked: There is a person suffering from a warm disease who sweats and immediately fever returns, with a rapid and restless pulse that does not subside with sweating. They speak deliriously and cannot eat. What is this disease called? Qibo replied: This disease is called Yin-Yang Jiao (Intersection of Yin and Yang), where Yin and Yang Qi are mixed and indistinguishable. "Jiao" implies death. The Yellow Emperor requested an explanation. Qibo said: Human sweating originates from grain, which generates Jing (Essence). Now, if pathogens struggle in the flesh and bones and sweat results, it means pathogens are retreating and Jing is victorious. Victory of Jing should allow eating and prevent recurrent fever. Recurrent fever indicates pathogenic dominance. Sweat represents Jing/Essence. Sweating followed by immediate fever indicates pathogenic excess. Inability to eat means Jing lacks support (Essence cannot facilitate digestion). If the disease lingers, life is imperiled. Furthermore, heat diseases state: sweating followed by a still restless and vigorous pulse indicates death. Here, the pulse does not correspond to the sweat (pulse is rapid/restless and does not subside with sweat), indicating the body cannot overcome the disease; death is evident. Delirious speech indicates loss of Zhi (Will/Spirit); loss of Will leads to death. Seeing three signs of death (fever with inability to eat, rapid/vigorous pulse, delirium) and no sign of life, even if temporary improvement occurs, death is inevitable.
The *Ling Shu* (Spiritual Pivot) *Re Bing Pian* states: If a heat patient sweats but the pulse remains restless, accompanied by asthma and recurrent fever, do not needle; severe asthma indicates death. It also states: If a heat patient sweats but the pulse remains vigorous, this is the extreme of Yin pulses, indicating death.
The *Ci Re Pian* (Treatise on Needling Heat) states: In Liver Heat Disease, urination turns yellow first, abdominal pain occurs, and the patient lies down often (the Liver meridian circles the genitalia and ascends to the lower abdomen, causing these symptoms), along with body heat. During Zheng-Zheng (struggle between righteous and pathogenic Qi), delirium and惊骇 (fright) occur, along with hypochondriac fullness and pain, restlessness of hands and feet, and inability to sleep peacefully (the Liver meridian ascends from the lower abdomen, passes through the diaphragm, spreads over the hypochondrium, follows the throat behind, and connects to the tongue root, causing these symptoms. Liver disease manifests as fright. Disharmony of the Stomach leads to restless sleep; Wood overacting on Earth causes inability to rest). Symptoms worsen on Geng-Xin days (Metal overcomes Wood) and improve significantly on Jia-Yi days (when the Liver meridian Qi is prosperous). If Qi rebels, death occurs on Geng-Xin days (due to severe Qi rebellion. The preceding sentences summarize severity and death occurring on days overcoming the organ; recovery with sweat occurs on days of the organ's prosperity. The following paragraphs follow this pattern). Needle the Foot Jueyin and Foot Shaoyang meridians. If Qi rebels, headache and dizziness occur, with pulse sensation pulling towards the head (the Liver meridian originates at the tongue root, follows the throat behind, emerges above the forehead, and meets the Du vessel at the vertex. Thus, rebellious Qi causes this. "Yuan Yuan" means undulating/unstable).
Song Feng stated: This specifically cites canonical principles regarding needling; further details on needling are omitted.
In Heart Heat Disease, the patient feels unhappy for several days (pathogens entering meridians disturb Shen [Spirit], causing unhappiness), followed by fever. During Zheng-Zheng, sudden heart pain occurs. There is vexation, frequent vomiting, headache, red face, and absence of sweat (the Heart meridian originates in the heart; its branch ascends alongside the pharynx. The Small Intestine meridian descends through the diaphragm to the stomach; its branch ascends the neck to the cheek and outer canthus, explaining these combined symptoms. The Heart governs sweat; in heat disease, sweat fails to emerge). Symptoms worsen on Ren-Gui days (overcoming) and improve significantly on Bing-Ding days (prosperous Qi). If Qi rebels, death occurs on Ren-Gui days. Needle the Hand Shaoyin and Hand Taiyang meridians.
In Spleen Heat Disease, there is initial heaviness of the head and cheek pain, mental vexation, bluish complexion around the mouth, and desire to vomit (the Stomach meridian starts at the nose, descends outside the nose, enters the upper teeth, curves around the lips, meets at Chengjiang, descends along the jawline to Daying, passes Guest Master, follows the hairline to the forehead. Hence initial head/cheek heaviness and bluish complexion. The Spleen meridian branch separates from the stomach, ascends the diaphragm to the heart; its main line ascends the diaphragm alongside the pharynx. Hence mental vexation and desire to vomit), along with body heat. During Zheng-Zheng, lower back pain prevents bending or stretching, abdominal fullness, diarrhea, and pain in both jaws (the Stomach meridian branch starts below the stomach, runs inside the abdomen to Qichong, descending to Bituan. Qichong is anterior to the waist, causing back pain. The Spleen meridian enters the abdomen, belongs to the Spleen and connects to the Stomach; its path from Chengjiang descends along the jawline to Daying and Chejia. Hence abdominal fullness, diarrhea, and jaw pain). Symptoms worsen on Jia-Yi days and improve significantly on Wu-Ji days. If Qi rebels, death occurs on Jia-Yi days. Needle the Foot Taiyin and Foot Yangming meridians.
In Lung Heat Disease, there is initial chills, goosebumps, aversion to wind and cold, and a yellow coating on the tongue (the Lung governs skin and hair; heat invading causes chills and goosebumps. The Lung meridian originates in the middle Jiao, connects to the Large Intestine, and loops around the stomach. Lung heat entering the stomach causes stomach heat to rise, resulting in a yellow tongue coating), along with body heat. During Zheng-Zheng, asthma and cough occur, pain radiates to the chest, epigastrium, and back, inability to take deep breaths, unbearable headache, sweating with chills (the Lung sits above the diaphragm, Qi governs the chest/epigastrium, changes manifest as cough; the back is the mansion of the chest, causing asthma/cough and pain. Lung collaterals meet in the ear; rising heat causes headache. Sweating with chills occurs). Symptoms worsen on Bing-Ding days and improve significantly on Geng-Xin days. If Qi rebels, death occurs on Bing-Ding days. Needle the Hand Taiyin and Hand Yangming meridians; bleed until bean-sized drops appear, and relief is immediate.
In Kidney Heat Disease, there is initial lower back pain (the Bladder meridian runs along the shoulder interior, alongside the spine to the waist; the waist is the mansion of the Kidney, hence pain). There is bitter thirst and frequent drinking (pain/soreness in the legs. The Kidney meridian follows behind the medial malleolus, ascends the medial leg, and emerges at the medial knee. Its main line ascends from the Kidney, pierces the Liver and Diaphragm, enters the Lung, follows the throat alongside the tongue root). Body heat ensues. During Zheng-Zheng, neck pain and stiffness occur, chills with soreness, heat in the soles of the feet, and reluctance to speak (the Bladder meridian exits the brain, branches down the neck. The Kidney meridian starts below the little toe,斜趋 (slants towards) the sole, emerges below Ran Gu, follows behind the medial malleolus, enters the heel, and ascends the medial leg. Its main line ascends from the Kidney, pierces the Liver and Diaphragm, enters the Lung, follows the throat alongside the tongue root, causing these symptoms). If Qi rebels, neck pain with dizziness and palpitations occur. Symptoms worsen on Wu-Ji days and improve significantly on Ren-Gui days. If Qi rebels, death occurs on Wu-Ji days. Needle the Foot Shaoyin and Foot Taiyang meridians. ("Yuan Yuan" means undulating; "Dan Dan" means meaningless/palpitations).
It is also stated: In Liver Heat Disease, the left cheek reddens first. In Heart Heat Disease, the face reddens first. In Spleen Heat Disease, the nose reddens first. In Lung Heat Disease, the right cheek reddens first. In Kidney Heat Disease, the chin reddens first. Even if the disease has not fully manifested, if redness is seen, needle it; this is called treating disease before it arises (matching facial areas to the Five Zang organs).
It is also stated: To treat various heat diseases, drink cold water, then needle. Wear cool clothing, reside in cool places, until the body is cool (heat recedes, body cools), then stop needling.
I once witnessed a child suffering from severe epidemic heat with deep pathogens, discarding clothes and running day and night without rest, moving hands and feet constantly, overturning vessels, and rummaging through items. Finding a jar of cool water, he bathed in it and drank it. After one day, as the heat receded and the body cooled, he recovered. Recorded by Song Feng.
Needling methods have their own specialized field. These excerpts are recorded because their implications relate to epidemics, not to teach needling techniques.
In the *Re Lun*, the Yellow Emperor asked: Current heat diseases are all of the Shang Han (Cold Damage) type. Some recover, some die; deaths usually occur within six or seven days, recoveries after ten days. Why? Qibo replied: Ju Yang (Great Solar/Taiyang) is the chief of all Yang meridians (the leader of the Six Yang meridians, commanding all Yang). Its vessel connects to Fengfu, making it the master of Yang Qi. When humans are injured by Cold, they develop heat diseases; even if heat is severe, it is not fatal. However, those suffering from Liang Gan Yu Han (simultaneous contraction of Cold by two meridians) will inevitably die. On the first day, Ju Yang is affected (Ju Yang is Taiyang), causing headache, stiff neck, and rigid spine. On the second day, Yangming is affected; Yangming governs flesh, its vessel runs alongside the nose and connects to the eyes, causing body heat, eye pain, dry nose, and insomnia. On the third day, Shaoyang is affected; Shaoyang governs the Gallbladder, its vessel runs along the flanks and connects to the ears, causing hypochondriac pain and deafness. If the three Yang meridians and their collaterals are diseased but have not entered the Zang organs, sweating can cure it. On the fourth day, Taiyin is affected; Taiyin vessel runs through the stomach and connects to the throat, causing abdominal fullness and dry throat. On the fifth day, Shaoyin is affected; Shaoyin vessel pierces the Kidney, connects to the Lung, and ties to the tongue root, causing dry mouth, dry tongue, and thirst. On the sixth day, Jueyin is affected; Jueyin vessel runs along the genitalia and connects to the Liver, causing irritability, fullness, and retraction of the scrotum. When all Three Yin and Three Yang, Five Zang, and Six Fu organs are diseased, Ying and Wei Qi cease to circulate, and obstruction of the Five Zang leads to death. If less than three days have passed, sweating can cure it; if three days or more have passed, purgation can cure it.
Song Feng stated: This is the correct example of meridian transmission in the *Nei Jing* and *Shang Han Lun*. Although epidemics differ from Shang Han, the pathogen resides in the Mo Yuan (Membrane Source), at the junction of the meridians and Stomach, half-exterior and half-interior. The excessive heat Qi floats to a specific meridian, manifesting its symptoms. Specialists in epidemics must understand this. (Sweating and purgation should not be rigidly applied based on the three-day rule.)
The Classics state: Unseasonably warm weather in winter is called Dong Wen (Winter Warmth). The toxicity of Dong Wen is vastly different from Shang Han. Dong Wen has early and late stages, overlapping, with varying severity and treatments.
Song Feng stated: Winter warmth leads to illness in the following summer; few fall ill at the time.
The *Yin Yang Ying Xiang Da Lun* states: Injury by Cold in winter leads to Wen Bing (Warm Disease) in spring.
Song Feng stated: The *Yun Ji Qi Qian* cites this as "Injury by Sweat in Winter," which is profound. It suggests that excessive warmth in winter causes sweating, leading to Warm Disease the following year. My careful experience confirms this. Severe cold in winter results in no epidemics in spring because it conforms to seasonal norms. Moreover, how can Cold remain in the body for a year before causing disease?
The *Jin Gui Zhen Yan Lun* states: Jing (Essence) is the root of the body. Therefore, those who preserve Jing will not suffer from Warm Disease in spring.
Song Feng stated: Those who preserve Jing are free from all diseases, not just Warm Disease.
The *Lun Ji Zhen Chi Pian* states: If the skin of the chi position is very hot and the pulse is vigorous and restless, it is a Warm Disease. If the pulse is vigorous and slippery, the disease is about to exit (resolve).
Song Feng stated: "Exit" means the pathogen does not enter the interior but is about to dissipate.
Zhang Zhongjing's *Wen Bing Pian* states: Taiyang disease with fever, thirst, and aversion to cold absent is Wen Bing; after sweating, if the body becomes burning hot, it is named Feng Wen (Wind Warmth). In Feng Wen, the pulse is floating and vigorous on both Cun and Chi positions, spontaneous sweating occurs, the body feels heavy, there is excessive sleepiness, nasal breathing is snoring-like, and speech is difficult. (From post-sweating onwards, this describes the harm of excessive sweating.) If mistakenly treated with purgation, urination becomes difficult, eyes stare fixedly, and incontinence occurs. (Loss of Zang Qi fixation causes incontinence. These four lines describe the harm of mistaken purgation.) If treated with fire therapy, mild cases turn yellow; severe cases resemble epilepsy with convulsions. (Epilepsy sounds like a lamb bleating. Convulsions involve jerking. These four lines describe the harm of forcing sweat with fire.) If fumigated with fire, one mistake delays death, a second mistake accelerates it. (Exterior heat without cold makes sweating inappropriate. Interior heat without excess makes purgation inappropriate. Exterior and Interior heat together make fire therapy highly inappropriate. Mistaken sweating, purgation, or fire coercion are errors; one error may prolong life, a second error leads to immediate death of Yin.)
The Classics state: Spring should be warm but is severely cold; Summer should be hot but is severely cool; Autumn should be cool but is severely hot; Winter should be cold but is severely warm. This is having the Qi out of season, causing similar illnesses among young and old throughout the year; this is the Qi of Shi Xing (Seasonal Epidemic).
Liu Nanying stated: Illnesses caused by irregular four-season climates are called Shi Zheng (Seasonal Patterns), distinct from Shang Han, Wen, Shu, and Han Yi. Autumn rarely sees such illnesses.
The *Su Wen* states: Irregularities in the four seasons generate great epidemics.
The *Shang Han Lun* states: A洪数 (Vigorous-Rapid) Yang pulse and 实大 (Solid-Large) Yin pulse, encountering warmth, transform into Wen Du (Warm Toxicity). (Yang governs exterior, Yin governs interior; Vigorous-Rapid and Solid-Large are all heat. Two heats combine to form Warm Toxicity.)
It also states: The pulse of Warm Disease travels through the various meridians; knowing which meridian is activated is difficult. Treat according to the affected meridian. (Epidemic pathogens disperse through various meridians due to abnormal Qi, making it hard to identify the affected meridian. One must determine the meridian involved before treating.)
Heat diseases require a floating-vigorous pulse; a fine-small pulse wastes effort uselessly (Yang diseases should have Yang pulses. Fine-small are Yin pulses, indicating terminal cases, untreatable). After sweating, a quiet pulse indicates recovery; asthma-heat with a chaotic pulse indicates impending death. (Post-sweat, quiet pulse means survival; chaotic pulse means death.)
Song Feng stated: Heat diseases with fine-small pulses are generally considered untreatable, except in cases of Pulse Jue (Pulse Collapse), which is an exception.
Yang Du (Yang Toxin) causes limb agitation and vexation, red face with floral spots, delirium, seeing spirits/demons, frequent dysentery, and throat discomfort. Generalized sweating should indicate major recovery; if the mouth opens like a fish's gills, death is imminent. If medicine is available and administered, surviving seven days brings peace. (Yang patterns suit sweating; failure to sweat allows pathogens to enter Zang, causing critical symptoms. Internal transmission contraindicates sweating. Generalized sweating plus open-mouth breathing indicates death. Surviving seven days means passing the meridian stage, Yang heat retreats, and rescue is possible.)
Song Feng stated: The "seven days to peace" notion merely implies a chance of rescue, not cure. Do not adhere to it rigidly.
For heat diseases, before sweating, the pulse must be floating-vigorous; after sweating, the pulse should be quiet. If a scattered pulse appears, or if recovery occurs without sweating (called Gan Chai/Dry Recovery), full recovery cannot be guaranteed.
Epidemics, where everyone falls ill similarly, are also called Tian Xing Shi Yi (Heavenly Travel Seasonal Epidemic). Treatment methods include tonification, dispersion, and descent. For severe heat, drinking human urine (Tong Bian) is suitable.
Song Feng stated: Tonification applies to Si Sun (Four Damages) where direct treatment is contraindicated, and to the elderly, young, or inherently weak. Dispersion refers to clearing heat and resolving the exterior (Epidemics should not use warm dispersion). Descent involves expelling pathogens via stool and urine.
The pulse of epidemic patients is scattered and hard to name; classify by meridian based on pulse characteristics. If floating and large but weak upon pressure, combine tonification with exterior resolution according to timing.
Song Feng stated: Floating-large-weak is typically a deficient-pulse. How to identify it as an epidemic? It must be correlated with Wen Mai (Epidemic Pulse: Vigorous-Rapid-Floating) and Wen Zheng (Epidemic Symptoms) to be accurate. "Pulse characteristics" refers to symptoms, complexion, and voice.
The key to epidemic diseases lies in the two characters: Xu (Deficiency) and Shi (Excess). Excess is easy to treat; deficiency is difficult because Yuan Qi (Primal Qi) is fundamentally weak, making pathogen expulsion hard. Treating deficiency-with-excess without supporting and dispersing, but only attacking pathogens, leads to greater deficiency and inevitable death.
Song Feng stated: Deficiency and Excess apply to all three types of epidemics, including Wen, though Wen is mostly heat without cold.
Epidemics come without fixed direction, but their arrival has causes: human disorder, climatic deviation, corpse qi contamination, or toxic vapor transformation. Since symptoms vary, treatment cannot be uniform. Epidemics are mostly Fire-Heat Qi accumulating in houses (affecting families), villages (affecting townships), markets (affecting cities), or roads (affecting thousands of miles). Thus, despite varied symptoms, removing Fire-Heat Qi and adding mild pathogen-expelling and filth-removing herbs yields efficacy.
Treating epidemics with Qing Li (Clearing and Purging) involves multiple aspects: Clear Heat for Fire Excess, Move Qi for Qi Stagnation, Digest for Food Retention, Transform Phlegm for Severe Phlegm. Removing stagnation moves Qi and resolves exterior pathogens. However, this suits Excess patterns, not Deficiency. For Deficiency-with-Excess, mild clearing and resolving may be used.
Purgation for epidemics is indicated only for Yangming Excess in the Fu organs, with constipation and abdominal fullness, or in those with strong Yuan Qi and robust Stomach Qi. If stool is retained for days but the abdomen is not full, or if there is no blockage, or if the patient hasn't eaten for days but the umbilical/abdominal area is soft and unobstructed, there is no Yangming Excess. Do not blindly purge to drain Middle Qi. Among errors, purgation is most harmful; do not neglect this.
Zhou Hanguang stated: Combine this with discussions on urgent attack for acute conditions and pathogen expulsion. Adapt to circumstances and remain flexible.
Although ancient texts state that epidemics affect the Three Yang meridians more than the Three Yin, do not adhere to this rigidly.