天时∶太虚曛翳，大明不彰，炎火行，大暑至，山泽燔燎，材木流津，广厦腾烟，土浮霜卤，
止水乃减，蔓草焦黄，风行惑言，（风热交炽，人言乱惑。）湿化乃后。火本旺于夏，其气郁，
故发于申未之四气。四气者，阳极之余也。
民病∶少气，（壮火食气。）疮疡痈肿，（火能腐物。）胁腹胸背，头面四肢， 愤胪胀，
疡（阳邪有余。）呕逆，（火气冲上。）螈 （火伤筋。）骨痛，（火伤骨。）节乃有动，（火
伏于节。）注下（火在肠胃。）温疟，（火在少阳。）腹暴痛，（火实于腹。）血溢流注，（火入
血分。）精液乃少，（火烁阴分。）目赤（火入肝。）心热，（火入心。）甚则瞀闷，（火炎上焦。）
懊，（火郁膻中。）善暴死，（火性急速，败绝真阴。）此皆火盛之为病也。
治法∶火郁发之。发者，发越也。凡火郁之病，为阳为热。其脏应心与小
肠三焦，其主在脉络，其伤在阴。凡火所居，有结聚敛伏者，不宜蔽遏，故因其势而解之散之，升
之扬之，如开其窗，如揭其被，皆谓之发，非仅发汗也。
连翘解毒饮 （治水郁为疫，乃脾肾受伤，以致斑黄面赤，体重烦渴，口燥面肿，咽喉不利，
大小便涩滞。）
青黛（八分） 元参（一钱） 泽泻（一钱，盐炒） 知母（一钱） 连翘（一钱，去隔）
童便一大盅，水二盅，煎一盅，冷研五瘟丹服。
竹叶导赤散 治君火郁为疫，乃心与小肠受病，以致斑淋吐衄血，错语不眠，狂躁烦呕，
一切火邪等症。
生地（二钱） 木通（一钱） 连翘（一钱，去隔） 大黄（一钱） 栀子（一钱） 黄芩
（一钱） 黄连（八分） 薄荷（八分）
水煎，研化五瘟丹服。（五瘟丹，见前诸方，其余泻黄泻肝，凉膈泻白等散，习见方书，兹
不录。）
锦按∶临症而不洞悉三才，不足以言医，而唯疫疠之疾，其于天时也，犹不可以不讲焉。观
世俗之言瘟疫者，动曰时症可以知之矣。夫医而系之以时，明乎实天作之孽，而非人力之所能为
也。故其来也无方，其去也无迹，迅若飘风，疾若掣电，虽富贵怡养之人，深堂大厦，息偃在床，
而亦有莫能免者焉。夫人之肢体气血，时时与天地相通，故天地之 气，感于人之身而病成焉矣。
倘疗之不得其法，生死即在目前。岂可苟焉而已哉。治疫者，必先明乎化水化火之微，客气主气
之异，司天在泉之殊致，五郁六气之分途，既已，胸有成竹矣。及遇疫气之来，而复观天时之雨
寒燠，地理之高下燥湿，人身之老幼虚实，病之或在表，或在里，或在半表半里，或在经络，
或在脏腑，或在上，或在中，或在下，或日数之多寡与病势之浅深，或致病之由与得病之日，或既
病而曾否服药，或服药而有无差误，更参以望闻问切，一一详审于胸中，而后再稽诸运气以济其
变，而治疫之能事始毕焉已。不然者，若遇表症而止知苏散，
遇里症而止知攻击，非不时亦弋获，终属偶然之会，而非若窥见垣一方者之百发百中也。彼夫阴
阳术数之家，遇冠昏丧葬，出行修造之事，其于孤虚王相，尚且择焉而必精，核焉而必详，况医
道乃人命攸关，而顾可置运气而不讲乎。所虑者，执于一偏而胶柱鼓瑟耳。若能不离乎此而不泥
乎此，方为善言运气者也。其言某年应用某药，不过言其大概。治疫者，仍当审症以投剂，岂可尽
恃乎此而不知变通乎。至于星宿之分野，九州之方域，在瘟疫发源书中，多杂引□经以尽其致，
兹一概不录。以其谈理过于玄杳，正无须乎若是之钩深索隐也。
天时：天空昏暗不明，太阳的光芒无法显现，炎火之气盛行，大暑到来，山泽之间如同焚烧燎原，树木流淌汁液，高大的屋宇中腾起烟雾，土壤上浮起霜卤般的盐碱，静止的水流减少，蔓生的草类焦黄枯萎，风势吹动使人言语惑乱（风热交炽，人言乱惑），湿气化生随之滞后。火气本应在夏季旺盛，但其气机郁结，因此发作于申、未两个时辰对应的四之气阶段。所谓四之气，是阳气极盛之后的余气。
民众患病：气短少力（壮火食气），疮疡痈肿（火能腐物），胁部、腹部、胸部、背部、头部、面部及四肢出现愤满胀滞（阳邪有余），呕吐逆气（火气冲上），抽搐痉挛（火伤筋），骨痛（火伤骨），关节发生动摇（火伏于节），腹泻下注（火在肠胃），温疟（火在少阳），腹部突然剧痛（火实于腹），血液溢出并流注于各处（火入血分），精液减少（火烁阴分），眼睛发红（火入肝），心中烦热（火入心），严重时出现神志昏蒙闷乱（火炎上焦），心中懊恼烦闷（火郁膻中），容易突然死亡（火性急速，败绝真阴）。这些都是火气亢盛导致的疾病。
治法：火郁应当用发散的方法治疗。“发”，即发越之意。凡是火郁的病症，属于阳证、热证。其脏腑对应心与小肠、三焦，病位主要在脉络，损伤在于阴分。凡是火气停留之处，有结聚收敛潜伏的情况，不应当被遮蔽遏制，所以要顺着病势来解除它、疏散它、提升它、发扬它，就像打开窗户一样，就像掀开被子一样，这些都称为“发”，不仅仅指发汗这一种方法。
连翘解毒饮（用于治疗水郁引发的疫病，这是脾肾受伤，导致出现斑疹发黄、面色赤红、身体沉重、烦躁口渴、口燥面肿、咽喉不利、大小便涩滞等症状。）
配方：青黛（八分）、元参（一钱）、泽泻（一钱，盐炒）、知母（一钱）、连翘（一钱，去隔）。
用法：童便一大盅，水二盅，煎至一盅，冷后研碎五瘟丹服用。
竹叶导赤散 用于治疗君火郁结引发的疫病，这是心与小肠受病，导致出现斑疹、淋证、吐血衄血、胡言乱语、失眠、狂躁烦呕，以及一切火邪等症候。
配方：生地（二钱）、木通（一钱）、连翘（一钱，去隔）、大黄（一钱）、栀子（一钱）、黄芩（一钱）、黄连（八分）、薄荷（八分）。
用法：水煎，研化五瘟丹服用。（五瘟丹，见前文诸方，其余如泻黄散、泻肝散、凉膈散、泻白散等常见方书所载方剂，此处不再收录。）
锦按：临证治病如果不透彻了解天、地、人三才之道，不足以谈论医学；而对于瘟疫这类疾病，更不可以不讲求天时因素。看世俗谈论瘟疫的人，动不动就说通过时令症状就可以知道了。医生如果将疾病与时令联系起来，就明白了这是上天降下的灾祸，而非人力所能完全掌控的。所以它的到来没有固定的方向，离去也没有痕迹，迅速如狂风，疾速如闪电，即使是富贵且善于调养的人，住在深堂大厦之中，卧床休息，也有不能免除的。人的肢体气血，时刻与天地相通，所以天地之气感应到人身而致病。如果治疗不得当，生死就在眼前。怎么可以马虎了事呢？治疗疫病，必须先明白化水化火的微妙之处，客气主气的差异，司天在泉的不同影响，五郁六气的不同途径。做到这些之后，心中就有把握了。等到疫气来临时，再观察天时的雨寒暖热，地理的高低燥湿，人体的老幼虚实，病邪是在表、在里、在半表半里、还是在经络、脏腑，或在上、在中、在下，或者病程日数的多少与病势的浅深，致病的原因与得病的时间，已经生病后是否曾服药，服药是否有差错，再结合望闻问切，一一在胸中详细审视，然后再参考运气学说以应对变化，治疗疫病的能事才算完成。否则的话，如果遇到表证只知道解表发散，遇到里证只知道攻下攻击，虽然有时也能侥幸获得疗效，终究只是偶然的巧合，而不是像窥视墙内情况那样百发百中。那些阴阳术数之家，遇到婚丧嫁娶、出行修造之事，对于孤虚王相等择日之术，尚且选择时必须精确，核查时必须详尽，何况医道关乎人命，难道可以置运气学说而不讲吗？所担心的是，固执于一偏之见而拘泥不变罢了。如果能不离乎此又不拘泥于此，才是善于谈论运气的人。他们说的某年应用某药，不过是说个大概。治疗疫病，仍应当审察症状来投药，怎么能完全依赖这个而不知变通呢？至于星宿的分野，九州的方域，在瘟疫发源书中，大多杂引经典以尽其致，这里一概不录。因为其中谈理过于玄妙深奥，正不需要如此钩深索隐。
Weather and Climate: The vast sky is darkened and obscured, the great brightness (Sun) fails to shine. Fiery heat prevails, and intense summer heat arrives. Mountains and marshes seem scorched and burning, timber flows with sap, tall mansions emit rising smoke, soil floats with frosty saltiness, stagnant water diminishes, creeping grass turns scorched and yellow, wind blows causing confusion in speech (wind and heat intertwine fiercely, leading to chaotic human discourse), and damp transformation lags behind. Fire naturally prospers in summer, but its qi is constrained; thus, it erupts during the fourth Qi period corresponding to the Shen and Wei hours. The fourth Qi represents the residual energy after extreme yang.
People's Diseases: Shortness of breath and lack of vital energy (vigorous fire consumes qi), sores, ulcers, carbuncles, and swelling (fire can rot matter), distension and fullness in the hypochondrium, abdomen, chest, back, head, face, and limbs (excess of yang pathogenic factors), vomiting and rebellious qi (fire qi rushes upward), convulsions and spasms (fire damages sinews), bone pain (fire damages bones), joint movements or tremors (fire hides in joints), diarrhea and downward discharge (fire in intestines and stomach), warm malaria (fire in Shaoyang), sudden severe abdominal pain (fire excess in abdomen), hemorrhage and blood flowing into various parts (fire enters the blood level), depletion of essence and fluids (fire scorching the yin level), red eyes (fire enters the Liver), heart heat (fire enters the Heart), severe cases involve mental cloudiness and oppression (fire flares up to the Upper Jiao), profound restlessness and regret (fire constrained in the Pericardium region), prone to sudden death (fire nature is rapid, destroying true yin). These are all diseases caused by excessive fire.
Treatment Methods: Constrained fire should be treated by dispersing and venting it. "Dispersing" means venting outward. All diseases of constrained fire belong to Yang and Heat patterns. Their associated Zang-Fu organs are the Heart and Small Intestine, and the San Jiao (Triple Burner); their primary location is in the collaterals and vessels, and the injury affects Yin. Wherever fire resides, if there is accumulation, gathering, or concealment, it should not be suppressed or blocked. Therefore, one must resolve, scatter, elevate, and promote it according to its trend, like opening a window or lifting a quilt. All these are referred to as "dispersing," which does not merely mean inducing sweating.
Lianqiao Jiedu Yin (Used for epidemics caused by Water Constraint, resulting from Spleen and Kidney damage, leading to symptoms such as yellowish macules, reddish face, heavy body, irritability, thirst, dry mouth, facial swelling, throat discomfort, and difficult urination and defecation.)
Ingredients: Qingdai (Indigo Naturalis, 8 fen), Yuanshen (Scrophulariae Radix, 1 qian), Zexie (Alismatis Rhizoma, 1 qian, stir-fried with salt), Zhimu (Anemarrhenae Rhizoma, 1 qian), Lianqiao (Forsythiae Fructus, 1 qian, septa removed).
Administration: One large cup of child's urine, two cups of water, decocted to one cup. Take cold, mixed with powdered Wuwen Dan.
Zhuye Daochi San Used for epidemics caused by constraint of Ministerial Fire (Jun Huo), resulting from disease in the Heart and Small Intestine, leading to symptoms such as macules, strangury, hematemesis, epistaxis, delirium, insomnia, mania, irritability, vomiting, and all other fire-pathogen syndromes.
Ingredients: Shengdi (Rehmanniae Radix, 2 qian), Mutong (Akebiae Caulis, 1 qian), Lianqiao (Forsythiae Fructus, 1 qian, septa removed), Dahuang (Rhei Radix et Rhizoma, 1 qian), Zhizi (Gardeniae Fructus, 1 qian), Huangqin (Scutellariae Radix, 1 qian), Huanglian (Coptidis Rhizoma, 8 fen), Bohe (Menthae Haplocalycis Herba, 8 fen).
Administration: Decoct in water, dissolve Wuwen Dan, and take. (Wuwen Dan is described in previous formulas; other common prescriptions such as Xiehuang San, Xiegan San, Liangge San, and Xiebai San found in standard texts are not recorded here.)
Jin's Commentary: In clinical practice, without a thorough understanding of Heaven, Earth, and Humanity (San Cai), one cannot speak of medicine. Especially for epidemic diseases, one must study the influence of celestial timing. Secular discussions on plagues often claim that knowing the seasonal symptoms is sufficient. Linking medicine to time clarifies that these are heavenly calamities, beyond mere human control. Thus, they arrive without fixed direction and depart without trace, swift as gales and fast as lightning. Even those who are wealthy and well-nourished, living in deep halls and large houses, resting in bed, may not escape. Human limbs and Qi-Blood constantly communicate with Heaven and Earth; therefore, when Heavenly Qi interacts with the human body, disease arises. If treatment is improper, life and death hang in the balance. How can one be negligent? Treating epidemics requires first understanding the subtleties of transforming Water and Fire, the differences between Guest Qi and Host Qi, the distinct influences of Si Tian and Zai Quan, and the separate paths of the Five Constraints and Six Qi. Once mastered, one has confidence. When epidemic Qi arrives, one must observe weather (rain, cold, warmth), geography (altitude, dryness, humidity), and the patient's constitution (age, deficiency, excess). Determine if the pathogen is in the Exterior, Interior, Half-Exterior Half-Interior, Collaterals, or Zang-Fu; whether it is Upper, Middle, or Lower; the duration of days and depth of pathology; the cause of illness and date of onset; whether medication was taken previously and if errors occurred. Combine this with Observation, Auscultation/Olfaction, Inquiry, and Palpation, scrutinizing everything mentally. Then, consult the Theory of Five Movements and Six Qi to adapt to changes, completing the task of treating epidemics. Otherwise, merely using dispersants for Exterior syndromes or purgatives for Interior syndromes may occasionally succeed but is merely chance, not the certainty of seeing inside the wall. Practitioners of Yin-Yang and numerology carefully select auspicious dates for weddings, funerals, travel, and construction based on concepts like Gu Xu and Wang Xiang. Since medicine concerns life and death, how can one ignore the Theory of Five Movements and Six Qi? The danger lies in being dogmatic and rigid. One should adhere to principles without being bound by them. Statements about specific herbs for specific years are general guidelines. Epidemic treatment must still rely on syndrome differentiation. As for star constellations and regional divisions, plague origin texts often cite classics extensively; these are omitted here as their theories are too obscure and do not require such deep digging.