《内经》云∶天有四时五行，以生长收藏，以生寒暑燥湿风。夫此五气，原以化生万物，而人或感之为病者，非天
气有偶偏，即人气有未和也。《难经》云∶伤寒有五，有中风、有伤寒、有湿温、有热病、有温病。此五气感人，古人皆
谓之伤寒。故仲圣着论，亦以伤寒统之，而条分中风、伤寒、温病、湿、 五者之证治，与《内经》《难经》渊源一辙，
法虽未尽，名已备焉。《阴符经》云∶天有五贼，见之者昌。后贤不见，遂至议论愈多，至理愈晦，或以伤寒为温热，或
以温热为伤寒，或并疫于风温，或并风温于疫，或不知有伏气为病，或不知有外感之温，甚至并暑 二字而不识，良可
慨已！我曾王父随笔中，首为剖论。兹雄不揣愚昧，以轩岐仲景之文为经，叶薛诸家之辩为纬，纂为《温热经纬》五卷。
其中注释，择昔贤之善者而从之，间附管窥，必加“雄按”二字以别之。俾读者先将温、暑、湿、热诸病名了然于胸中，
然后博览群书，庶不为其所眩惑，而知所取舍矣。非敢妄逞意见，欲盖前贤，用质通方，毋嗤荒陋。
咸丰二年壬子春二月海宁王士雄书于潜斋
《素问·生气通天论》曰∶冬伤于寒，春必温病。
张仲景曰∶冬时严寒，万类深藏，君子固密，则不伤于寒。
雄按∶伤而即病者为伤寒，不即病者为温热。
章虚谷曰∶冬寒伏于少阴，郁而化热，乘春阳上升而外发者为实证。
《金匮真言论》曰∶夫精者，身之本也。故藏于精者，春不病温。
王启元曰∶精气伏藏，则阳不妄升，故春无温病。
尤拙吾曰∶冬伤于寒者，春月温病之由；而冬不藏精者，又冬时受寒之源也。
吴鞠通曰∶不藏精非专主房劳说，一切人事之能动摇其精者皆是。即冬时天气应寒，而阳不潜藏，如春日之发泄，
甚至桃李反花之类亦是也。
章虚谷曰∶经论温病，有内伏而发外者，有外感随时而成者。其由内伏发外者，又有虚实二证，上条为实证，此条
为虚证也。
《热论篇》曰∶凡病伤寒而成温者，先夏至日者为病温，后夏至日者为病暑。暑当与汗出，勿止。
王启元曰∶此以热之微甚为义也。阳热未盛，故曰温；阳热大盛，故曰暑。
杨上善曰∶冬伤于寒，轻者夏至以前发为温病，重者夏至以后发为暑病。
林观子曰∶少阴真气既亏，邪必深入，郁久化热，自内而出。《伤寒序例》云∶暑病者热极重于温，是暑病者其实热
病也。
沈尧封曰∶伤寒有五，热病乃其一耳，余论俱散失矣。
章虚谷曰∶此言凡病伤寒，则不独指冬时之寒也。盖寒邪化热，随时皆有也。
雄按∶《脉要精微论》曰∶彼春之暖，为夏之暑。夫暖即温也，热之渐也。然夏未至则不热，故病发犹曰温。其首先
犯肺者，乃外感温邪。若夏至后则渐热，故病发名曰暑。盖六月节曰小暑，六月中曰大暑，与冬至后之小寒、大寒相对
待，是病暑即病热也。乃仲圣以夏月外感热病名曰 者，别于伏气之热病而言也。《说文》云∶ ，伤暑也。《汉书·武
帝纪》云∶夏大旱，民多 死。故暑也、热也、 也，皆夏令一气之名也。后人不察，妄腾口说，甚至讲太极，推先天，
非不辨也，其实与病情无涉，而于医理反混淆也。
淦按∶此言其常也，然春时亦有热病，夏日亦有温病。温，热之轻者也；热，温之重者也。故古人往往互称。
《刺热篇》曰∶肝热病者，小便先黄，腹痛，多卧，身热。热争则狂言及惊，胁满痛，手足躁，不得安卧。庚辛甚，
甲乙大汗，气逆则庚辛日死。刺足厥阴、少阳，其逆则头痛员员，脉引冲头也。
吴鞠通曰∶肝病小便先黄者，肝脉络阴器。又肝主疏泄，肝病则失其疏泄之职，故小便先黄也。腹痛多卧，木病克
脾土也。热争，邪热盛而与正气相争也。狂言及惊，手厥阴心包病也。两厥阴同气，热争则手厥阴亦病也。胁满痛，肝
脉行身之两旁，胁其要路也。手足躁，不得安卧，肝主风，风淫四末。又木病克土，脾主四肢，木病热必吸少阴肾中真
阴，阴伤故骚扰不得安卧也。庚辛金日，克木故甚，甲乙肝木旺时，故汗出而愈。气逆，谓病重而不顺，其可愈之理，
故逢其不胜之日而死也。厥阴、少阳并刺者，病在脏兼泻其腑也。逆则头痛以下，肝主升，病极而上升之故。自庚辛日
甚以下之理，余脏仿此。
心热病者，先不乐，数日乃热。热争则卒心痛，烦闷善呕，头痛面赤，无汗。壬癸甚，丙丁大汗，气逆则壬癸死。
刺手少阴、太阳。
吴鞠通曰∶心病，先不乐者，心包名膻中，居心下，代君用事，经谓膻中为臣使之官，喜乐出焉。心病，故不乐也。
卒心痛，凡实痛皆邪正相争，热争故卒然心痛也。烦闷，心主火，故烦。膻中气不舒，故闷。呕，肝病也。木火同气，
热甚而肝病亦见也。且邪居膈上，多善呕也。头痛，火升也。面赤，火色也。无汗，汗为心液，热闭液干，汗不得通也。
章虚谷曰∶人身生阳之气，根于肾脏，始发于肝木，木生火、火生土、土生金、金生水、水又生木，如是生生不息，
则安和无患也。邪伏血气之中，必随生阳之气而动，动甚则病发。然其发也，随气所注而无定处，故《难经》言温病之
脉，行在诸经，不知何经之动也。如仲景所论，或发于阴经，或发于阳经，正合《难经》之言也。今《内经》按生气之
序，首列肝，次以心、脾、肺、肾，以明邪随生气而动，其于不定之中，自有一定之理，足以印证《难经》、仲景之言，
而轩、岐、越人、仲景之一脉相承，更可见矣。
脾热病者，先头重，颊痛，烦心，颜青，欲呕，身热。热争则腰痛，不可用俯仰，腹满泄，而颔痛。甲乙甚，戊己
大汗，气逆则甲乙死。刺足太阴、阳明。
吴鞠通曰∶脾病，头先重者，脾属湿，土性重，经谓湿之中人也。首如裹，故脾病头先重也。颊，少阳部也。土之
与木，此负则彼胜，土病而木病亦见也。烦心，脾脉注心也。颜青、欲呕，亦木病也。腰痛不可用俯仰，脾病则胃不能
独治，阳明主合同束而利机关，故痛而至于不可俯仰也。腹满泄，脾经本病。颔痛，亦木病也。
肺热病者，先淅然厥，起毫毛，恶风寒，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。丙丁甚，庚辛大汗，气逆则丙丁死。刺手太阴、阳明，出血如大豆，立已。
吴鞠通曰∶肺病，先恶风寒者，肺主气，又主皮毛。肺病则气 郁，不得捍卫皮毛也。舌上黄者，肺气不化，则湿
热聚而为黄苔也。章虚谷曰∶若外邪初感而非内热，其苔必白。喘，气郁极也。咳，火克金也。胸膺，背之腑也。皆天
气主之。肺主天气，肺气郁极故痛也。走者，不定之词，不得太息，热闭肺脏也。头痛不堪，亦天气 郁，热不得泄，
直上冲脑也。郁热而腠开汗出，其热暂泄则寒也。略参章氏。
肾热病者，先腰痛 酸，苦渴数饮，身热。热争则项痛而强， 寒且酸，足下热，不欲言，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。
吴鞠通曰∶肾病，腰先痛者，腰为肾之府，又肾脉贯脊，会于督之长强穴， ，肾脉入跟中以上 内，太阳之脉，
亦下贯 内， 即 也。酸，热铄液也。苦渴数饮，肾主五液而恶燥，病热则液伤而燥，故苦渴而饮水求救也。项，太
阳之脉，从颠入络脑，还出别下项。肾病至于热争，脏病甚而移之腑，故项痛而强也。 寒，热极为寒也。足下热，肾
脉从小指之下，邪趋足心涌泉穴，病甚而热也。不欲言，有无可奈何之苦也。邪气上逆，则项更痛，员员澹澹，一身不
能自主，难以形状之病也。略参章氏。
肝热病者，左颊先赤。心热病者，颜先赤。脾热病者，鼻先赤。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。
章虚谷曰∶此更详五脏热邪未发，而必先见于色之可辨也。左颊、颜、鼻、右颊、颐，是肝、心、脾、肺、肾脏之
气，应于面之部位也。病虽未发，其色先见，可见邪本伏于气血之中，随气血流行而不觉，更可印证《难经》所云∶温
病之脉，行在诸经，不知何经之动也。故其发也，必随生气而动。则先见色于面，良工望而知其邪动之处，乘其始动，
即刺而泄之，使邪势杀而病自轻，即《难经》所云∶随其经之所在而取之者，是为上工治未病也。用药之法，亦可类推
矣。
治诸热病，以饮之寒水，乃刺之。必寒衣之，居此寒处，身寒而止。
章虚谷曰∶以其久伏之邪，热从内发，故治之必先饮寒水，从里逐热，然后刺之，从外而泄。再衣以寒，居处以寒，
身寒热除而后止。
雄按∶今人不读《内经》，虽温、热、暑、疫诸病，一概治同伤寒，禁其凉饮，浓其衣被，闭其户牖，因而致殆者，
我见实多。然饮冷亦须有节，过度则有停饮、肿满、呕利等患，更有愈后手指、足缝出水。速投∶米仁三两，茯苓三两，
白术一两，车前五钱，桂心一钱，名驱湿保脱汤。连服十剂，可免脚趾脱落。此即谚所谓“脱脚伤寒也”，亦不可不知。
若饮冷虽多，而汗出亦多，必无后患。
太阳之脉，色荣颧骨，热病也。荣未交，曰今且得汗，待时而已。与厥阴脉争见者，死期不过三日，其热病内连肾。
章虚谷曰∶此明外感与伏邪互病之证也，与《热论篇》之两感，同中有异。彼则内外同时受邪，内外俱病，故不免
于死。此则外感先发，伏邪后发者可生。若同发则死期不过三日也。云太阳之脉者，邪受太阳经脉，即一日巨阳受之，
头项痛、腰脊强者是也。色荣颧骨者，鲜荣色赤，见于颧骨也。盖颧者骨之本，骨者肾所主，肾脏伏热之邪已动，循荣
血见色于颧也。荣未交，今且得汗，待时而已者，言太阳经脉外受之邪，与荣血中伏热之邪，尚未相交，今且使其得汗，
先解外邪，所谓未满三日，可汗之是也。其内伏之邪后发，待脏气旺时可已。如肾热病待壬癸日得大汗而已也。又如所
云见赤色者刺之，名治未病亦可也。倘与厥阴经脉病证争见，则肾肝皆有邪热内发，其势必与太阳外邪连合而不可解，
故比之两感，死期更速，不过三日也。盖两感病起于经，必待胃气尽六日方死。此则其热病内连肾脏，本元即绝，故死
速也。
少阳之脉，色荣颊前，热病也。荣未交，曰今且得汗，待时而已。与少阴脉争见者，死期不过三日。
章虚谷曰∶上言肝热病者，左颊先赤，肝为厥阴，胆为少阳，相表里者也。外邪受于少阳经脉，而肝脏伏热之色，
荣于颊前。若外内之邪尚未相交，今且使其得汗以解外，其内发之热，可待脏气旺时而已。若与少阴经脉病证争见，则
肝连肾热，而内外邪势，必交合难解，死期不过三日也。大抵外内之邪，发有先后而不交合，尚可解救，故要紧在“荣
未交”一句，下文病名“阴阳交”，亦即荣已交之义也。经文止举太阳、少阳两证，不及阳明、太阴合病者，余窃度之，
以阳明之腑，可用攻泻之法，不至必死。非同太阳、少阳、厥阴，其邪连合而无出路，则必死也。
《评热病篇》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∶名阴阳交，
交者死也。
叶香岩曰∶交者阴液外泄，阳邪内陷也。
尤拙吾曰∶交，非交通之谓，乃错乱之谓也。阴阳错乱而不可复理，攻其阴则阳捍之不得入，攻其阳则阴持之不得
通，故曰交者死也。郭氏谓即是两感病，然两感是阴阳齐病，而非阴阳交病也。
章虚谷曰∶阴阳之气，本来相交而相生者，今因邪势弥漫，外感阳分之邪，与内发阴分之邪，交合为一，而本元正
气绝矣，故病名阴阳交。交者死，非阴阳正气之相交也。下衣冠文物其所以然之理。
人之所以汗出者，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。汗出者，精气也。今汗出而辄复热，是邪胜也。不能食者，精无俾也。病而留者，其寿可立而倾也。
且夫《热论》曰∶汗出而脉尚躁盛者死。今脉不与汗相应，此不胜其病也，其死明矣。狂言者，是失志，失志者死。今
见三死，不见一生，虽愈必死也。
章虚谷曰∶汗生于谷，谷生于精者，谓由本元精气，化水谷以生津液，发而为汗，邪随汗泄，则邪却而精胜也。精
气胜则当能食，以化水谷，其邪已泄，则不复热矣。乃复热者，邪气未去也。其所出之汗，精气徒泄也，故汗出而辄复
热，是精却而邪胜也。所以不能食，精无俾也。俾者，倚借之谓，其病虽留连，其寿可立待而倾也。古论云∶汗出而脉
躁盛者死，正谓其精却而邪不去也。若邪去而精气存，脉必静矣。今脉与汗不相应，则精气不胜邪气也，其死明矣。且
狂言是失志，失志者死，一也。汗出复热，精却邪胜，二也。汗与脉不相应，三也。今见三死证，不见一生证，虽似愈
必死也。
雄按∶温证误作伤寒治，而妄发其汗，多有此候。
《内经》说：天有四季和五行，用来生长、繁荣、收敛、收藏，从而产生寒、暑、燥、湿、风五种气候。这五种气，原本是用来化生万物的，而人如果感受它们而生病，不是天气偶然偏胜，就是人气（人体正气）不和顺。《难经》说：伤寒有五类，包括中风、伤寒、湿温、热病、温病。这五种邪气伤人，古人都称之为伤寒。所以张仲景撰写论著，也用伤寒来统括，并分条论述中风、伤寒、温病、湿、暍（中暑）五者的证治，与《内经》《难经》渊源相同，虽然方法未尽完善，但名称已具备。《阴符经》说：天有五贼（指五行之气的克制关系），能认识它的人昌盛。后世贤者未能洞察，导致议论越来越多，真理越来越晦暗，有的把伤寒当作温热，有的把温热当作伤寒，有的把疫病并入风温，有的把风温并入疫病，有的不知道有伏气温病，有的不知道有外感温病，甚至连“暑”字都不认识，实在令人感慨！我的祖父在随笔中，首先对此进行了剖析论述。现在我不自量力，以黄帝、岐伯、张仲景的文章为经，叶天士、薛雪等各家辨析为纬，编纂成《温热经纬》五卷。其中的注释，选择前代贤者好的部分加以采纳，偶尔附上我个人的浅见，一定加上“雄按”二字以示区别。使读者先将温、暑、湿、热各种病名了然于胸，然后博览群书，才不会被其所迷惑，知道如何取舍。不敢妄逞己见，想要掩盖前贤，以此请教通晓医理之人，请勿嘲笑我的荒疏浅陋。
咸丰二年壬子春二月海宁王士雄写于潜斋
《素问·生气通天论》说：冬天伤害了寒气，春天一定会发生温病。
张仲景说：冬季严寒，万物深藏，君子固密（保养好身体），就不会受寒邪伤害。
王士雄按：受伤后立即发病的叫伤寒，不立即发病的叫温热。
章虚谷说：冬天的寒气潜伏在少阴经，郁结而化热，趁着春天阳气上升而向外发散的，属于实证。
《金匮真言论》说：精，是身体的根本。所以能藏精的人，春天不得温病。
王启元说：精气伏藏，则阳气不妄升，所以春天没有温病。
尤拙吾说：冬天伤于寒，是春天温病的缘由；而冬天不藏精，又是冬天受寒的根源。
吴鞠通说：不藏精不仅仅指房劳过度，一切人事活动能动摇其精的都是。即使冬天天气应该寒冷，而阳气不潜藏，像春天一样发泄，甚至出现桃李反季开花的情况，也是这样的道理。
章虚谷说：经文论述温病，有内伏而向外发的，有外感随时而成的。由内伏向外发的，又有虚实两种证候，上一条是实证，这一条是虚证。
《热论篇》说：凡是患伤寒而变成温病的，先夏至日发病的叫病温，后夏至日发病的叫病暑。暑病应当随汗出而解，不要止住汗。
王启元说：这是以热的轻重来定义。阳热未盛，所以叫温；阳热大盛，所以叫暑。
杨上善说：冬天伤于寒，轻的在夏至以前发作成为温病，重的在夏至以后发作成为暑病。
林观子曰：少阴真气既然亏损，邪气必然深入，郁久化热，从内而出。《伤寒序例》说：暑病的热极重于温，所以暑病其实是热病。
沈尧封说：伤寒有五，热病只是其中之一，其余的论述都散失了。
章虚谷说：这里说的凡病伤寒，不仅仅指冬天的寒邪。大概寒邪化热，随时都可能发生。
王士雄按：《脉要精微论》说：那春天的温暖，是夏天的暑气的基础。暖就是温，是热的渐进。然而夏天未到就不热，所以发病还叫温。其中首先犯肺的，是外感温邪。如果夏至后就逐渐变热，所以发病名叫暑。大概六月节叫小暑，六月中叫大暑，与冬至后的小寒、大寒相对待，所以病暑就是病热。然而张仲景将夏季外感热病命名为“暍”，是为了区别于伏气温热病而言的。《说文》说：暍，是伤暑。《汉书·武帝纪》说：夏天大旱，百姓多因暍而死。所以暑、热、暍，都是夏令一气之名。后人不明察，胡乱口说，甚至讲太极，推先天，并非不辨是非，其实与病情无关，反而混淆了医理。
淦按：这里说的是常理，然而春天也有热病，夏天也有温病。温，是热的轻症；热，是温的重症。所以古人往往互称。
《刺热篇》说：肝热病患者，小便先黄，腹痛，嗜睡，身热。热争（邪正相争）则胡言乱语及惊厥，胁部满痛，手足躁动，不能安卧。庚辛日加重，甲乙日大汗出可愈，气逆则庚辛日死。针刺足厥阴肝经、足少阳胆经，若气逆则头痛头晕，脉气上冲头部。
吴鞠通说：肝病小便先黄的，因为肝脉络阴器。又肝主疏泄，肝病则失去疏泄的功能，所以小便先黄。腹痛嗜睡，是木病克脾土。热争，是邪热盛而与正气相争。胡言乱语及惊厥，是手厥阴心包经的病。两厥阴同气，热争则手厥阴也病了。胁部满痛，肝脉行于身体两旁，胁是其要路。手足躁动，不能安卧，肝主风，风淫于四肢末端。又木病克土，脾主四肢，木病热必吸吮少阴肾中的真阴，阴伤故骚扰不能安卧。庚辛金日，克木故加重，甲乙肝木旺时，故汗出而愈。气逆，谓病重而不顺，其可愈的道理，所以逢其不胜之日而死。厥阴、少阳并刺的，是病在脏兼泻其腑。逆则头痛以下，肝主升，病极而上升的缘故。自庚辛日加重以下的道理，其他脏腑仿照此理。
心热病患者，先心情不乐，数日后才发热。热争则突然心痛，烦闷喜欢呕吐，头痛面赤，无汗。壬癸日加重，丙丁日大汗出可愈，气逆则壬癸日死。针刺手少阴心经、手太阳小肠经。
吴鞠通说：心病，先不乐的，心包名为膻中，居心下，代君行事，经文说膻中为臣使之官，喜乐由此发出。心病，所以不乐。卒心痛，凡是实痛都是邪正相争，热争所以突然心痛。烦闷，心主火，所以烦。膻中气不舒，所以闷。呕，是肝病。木火同气，热甚而肝病也显现。且邪居膈上，多喜欢呕吐。头痛，是火升。面赤，是火色。无汗，汗为心液，热闭液干，汗不得通。
章虚谷说：人身生阳之气，根于肾脏，始发于肝木，木生火、火生土、土生金、金生水、水又生木，如此生生不息，则安和无患。邪伏在血气之中，必随生阳之气而动，动甚则病发。然而其发，随气所注而无定处，所以《难经》说温病的脉，行在诸经，不知是哪一经在动。如仲景所论，或发于阴经，或发于阳经，正合《难经》之言。现在《内经》按生气之序，首列肝，次以心、脾、肺、肾，以明邪随生气而动，其于不定之中，自有一定之理，足以印证《难经》、仲景之言，而轩辕、岐伯、扁鹊、仲景一脉相承，更可见矣。
脾热病患者，先头重，颊痛，心烦，面色青，想吐，身热。热争则腰痛，不能用俯仰，腹满泄泻，且颔痛。甲乙日加重，戊己日大汗出可愈，气逆则甲乙日死。针刺足太阴脾经、足阳明胃经。
吴鞠通说：脾病，头先重的，脾属湿，土性重，经文说湿中人，首如裹，所以脾病头先重。颊，是少阳部位。土与木，此负则彼胜，土病而木病也显现。心烦，脾脉注心。面色青、想吐，也是木病。腰痛不可用俯仰，脾病则胃不能独治，阳明主合同束而利机关，所以痛至于不可俯仰。腹满泄，是脾经本病。颔痛，也是木病。
肺热病患者，先淅然恶寒，起毫毛，恶风寒，舌上黄，身热。热争则喘咳，痛走胸膺、背，不能深呼吸，头痛不堪，汗出而寒。丙丁日加重，庚辛日大汗出可愈，气逆则丙丁日死。针刺手太阴肺经、手阳明大肠经，出血如大豆大小，立刻痊愈。
吴鞠通说：肺病，先恶风寒的，肺主气，又主皮毛。肺病则气郁，不能捍卫皮毛。舌上黄的，肺气不化，则湿热聚而为黄苔。章虚谷说：如果是外邪初感而非内热，其苔必白。喘，是气郁极。咳，是火克金。胸膺，是背之腑。皆天气主之。肺主天气，肺气郁极故痛。走，是不定之词，不能深呼吸，是热闭肺脏。头痛不堪，也是天气郁，热不得泄，直上冲脑。郁热而腠开汗出，其热暂泄则寒。略参章氏。
肾热病患者，先腰痛酸软，苦渴数饮，身热。热争则项痛而强，髀寒且酸，足下热，不欲言，其逆则项痛头晕晃荡。戊己日加重，壬癸日大汗出可愈，气逆则戊己日死。针刺足少阴肾经、足太阳膀胱经。
吴鞠通说：肾病，腰先痛的，腰为肾之府，又肾脉贯脊，会于督脉之长强穴，髀，肾脉入跟中以上腨内，太阳之脉，亦下贯腨内，腨即腓肠肌。酸，是热铄液。苦渴数饮，肾主五液而恶燥，病热则液伤而燥，故苦渴而饮水求救。项，太阳之脉，从颠入络脑，还出别下项。肾病至于热争，脏病甚而移之腑，故项痛而强。髀寒，热极为寒。足下热，肾脉从小指之下，邪趋足心涌泉穴，病甚而热。不欲言，有无可奈何之苦。邪气上逆，则项更痛，头晕晃荡，一身不能自主，难以形状之病。略参章氏。
肝热病患者，左颊先红。心热病患者，颜面先红。脾热病患者，鼻先红。肺热病患者，右颊先红。肾热病患者，颐先红。病虽未发，见赤色者刺之，名叫治未病。
章虚谷说：这更详细地说明了五脏热邪未发，而必先见于色的可辨别性。左颊、颜、鼻、右颊、颐，是肝、心、脾、肺、肾脏之气，应于面之部位。病虽未发，其色先见，可见邪本伏于气血之中，随气血流行而不觉，更可印证《难经》所说：温病的脉，行在诸经，不知是哪一经在动。所以其发，必随生气而动。则先见于面色，良工望而知其邪动之处，乘其始动，即刺而泄之，使邪势杀而病自轻，即《难经》所说：随其经之所在而取之的，是为上工治未病。用药之法，亦可类推。
治疗各种热病，用喝冷水，然后针刺。必须穿寒衣，居住在寒处，身寒热除而后止。
章虚谷说：因其久伏之邪，热从内发，所以治之必先饮寒水，从里逐热，然后刺之，从外而泄。再衣以寒，居处以寒，身寒热除而后止。
王士雄按：今人不读《内经》，虽温、热、暑、疫各种病，一概治同伤寒，禁止凉饮，加厚衣被，关闭门窗，因而致死的，我见的确实很多。然而饮冷也须有节制，过度则有停饮、肿满、呕利等患，更有愈后手指、足缝出水。速投：米仁三两，茯苓三两，白术一两，车前五钱，桂心一钱，名叫驱湿保脱汤。连服十剂，可免脚趾脱落。这就是谚语所说的“脱脚伤寒”，也不可不知。若饮冷虽多，而汗出亦多，必无后患。
太阳之脉，色荣颧骨，是热病。荣未交，说现在若能得汗，等待时辰即可痊愈。若与厥阴脉争见，死期不超过三天，其热病内连肾。
章虚谷说：这是说明外感与伏邪互病的证候，与《热论篇》的两感，同中有异。彼则是内外同时受邪，内外俱病，所以不免于死。此则是外感先发，伏邪后发者可生。若同发则死期不超过三天。云太阳之脉者，邪受太阳经脉，即一日巨阳受之，头项痛、腰脊强者是。色荣颧骨者，鲜荣色赤，见于颧骨。盖颧者骨之本，骨者肾所主，肾脏伏热之邪已动，循荣血见色于颧。荣未交，今且得汗，待时而已者，言太阳经脉外受之邪，与荣血中伏热之邪，尚未相交，现在使其得汗，先解外邪，所谓未满三日，可汗之是。其内伏之邪后发，待脏气旺时可已。如肾热病待壬癸日得大汗而已。又如所说见赤色者刺之，名治未病也可。倘与厥阴经脉病证争见，则肾肝皆有邪热内发，其势必与太阳外邪连合而不可解，故比之两感，死期更速，不过三天。盖两感病起于经，必待胃气尽六日方死。此则其热病内连肾脏，本元即绝，故死速。
少阳之脉，色荣颊前，是热病。荣未交，说现在若能得汗，等待时辰即可痊愈。若与少阴脉争见，死期不超过三天。
章虚谷说：上面说肝热病患者，左颊先红，肝为厥阴，胆为少阳，相表里。外邪受于少阳经脉，而肝脏伏热之色，荣于颊前。若外内之邪尚未相交，现在使其得汗以解外，其内发之热，可待脏气旺时而已。若与少阴经脉病证争见，则肝连肾热，而内外邪势，必交合难解，死期不超过三天。大抵外内之邪，发有先后而不交合，尚可解救，故要紧在“荣未交”一句，下文病名“阴阳交”，亦即荣已交之义。经文只举太阳、少阳两证，不及阳明、太阴合病者，我私下推测，以阳明之腑，可用攻泻之法，不至必死。非同太阳、少阳、厥阴，其邪连合而无出路，则必死。
《评热病篇》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：名阴阳交，交者死。
叶香岩说：交者阴液外泄，阳邪内陷。
尤拙吾说：交，非交通之意，乃错乱之意。阴阳错乱而不可复理，攻其阴则阳捍之不得入，攻其阳则阴持之不得通，所以说交者死。郭氏谓即是两感病，然两感是阴阳齐病，而非阴阳交病。
章虚谷说：阴阳之气，本来相交而相生者，现在因邪势弥漫，外感阳分之邪，与内发阴分之邪，交合为一，而本元正气绝矣，故病名阴阳交。交者死，非阴阳正气之相交。下衣冠文物其所以然之理。
人之所以汗出者，皆生于谷，谷生于精。现在邪气交争于骨肉而得汗者，是邪却而精胜。精胜，则当能食而不复热。复热者，邪气也。汗出者，精气也。现在汗出而辄复热，是邪胜。不能食者，精无俾。病而留者，其寿可立而倾。且夫《热论》说：汗出而脉尚躁盛者死。现在脉不与汗相应，此不胜其病，其死明矣。狂言者，是失志，失志者死。现在见三死，不见一生，虽愈必死。
章虚谷说：汗生于谷，谷生于精者，谓由本元精气，化水谷以生津液，发而为汗，邪随汗泄，则邪却而精胜。精气胜则当能食，以化水谷，其邪已泄，则不复热。乃复热者，邪气未去。其所出之汗，精气徒泄，故汗出而辄复热，是精却而邪胜。所以不能食，精无俾。俾者，倚借之意，其病虽留连，其寿可立待而倾。古论说：汗出而脉躁盛者死，正谓其精却而邪不去。若邪去而精气存，脉必静。今脉与汗不相应，则精气不胜邪气，其死明。且狂言是失志，失志者死，一也。汗出复热，精却邪胜，二也。汗与脉不相应，三也。现在见三死证，不见一生证，虽似愈必死。
王士雄按：温证误作伤寒治，而妄发其汗，多有此候。
The *Neijing* (Inner Canon) states: Heaven has four seasons and five elements, which are used for growth, flourishing, gathering, and storing, thereby generating the five climatic factors: cold, heat, dryness, dampness, and wind. These five qi originally serve to transform and generate all things; when humans contract diseases from them, it is either due to an occasional bias in heavenly qi or a lack of harmony in human qi. The *Nan Jing* (Classic of Difficult Issues) states: There are five types of Shanghan (Cold Damage), including Zhongfeng (Wind Strike), Shanghan, Shiwen (Damp-Warmth), Rebing (Heat Disease), and Wenbing (Warm Disease). When these five pathogens affect humans, the ancients all referred to them as Shanghan. Therefore, Zhang Zhongjing, in his treatises, also subsumed them under Shanghan, and systematically discussed the syndromes and treatments for Zhongfeng, Shanghan, Wenbing, Dampness, and Ye (Summerheat Injury), following the same lineage as the *Neijing* and *Nan Jing*. Although the methods were not fully perfected, the nomenclature was established. The *Yinfu Jing* (Scripture of the Dark Talisman) states: Heaven has five thieves [referring to the controlling relationships of the five elements]; those who perceive them prosper. Later scholars failed to perceive this, leading to increasing debates and obscuring the profound truths. Some equated Shanghan with Warmth, others equated Warmth with Shanghan; some merged Epidemic diseases into Wind-Warmth, others merged Wind-Warmth into Epidemics; some were unaware of diseases caused by latent qi, while others were unaware of externally contracted warmth; some did not even recognize the term "Shu" (Summerheat). This is truly lamentable! My grandfather first analyzed this in his casual writings. Now, I, Xiong, presuming my own ignorance, take the texts of Xuanyuan, Qibo, and Zhang Zhongjing as the warp, and the arguments of Ye Tianshi, Xue Xue, and other experts as the weft, compiling the *Wenre Jingwei* (A Classic on Warm Diseases) in five volumes. In the annotations, I select the best parts from past sages and occasionally add my own limited insights, clearly marking them with "Xiong An" (Xiong's Note) to distinguish them. This aims to enable readers to first clearly understand the names of Warmth, Summerheat, Dampness, and Heat diseases in their minds, so that when they extensively study various books, they will not be confused but will know how to select and discard. I dare not arrogantly display my opinions to cover up the achievements of past sages; rather, I offer this for discussion with those knowledgeable in medicine, hoping you will not ridicule my ignorance.
Written by Wang Shixiong of Haining at Qianzhai in the second month of spring, Renzi year, Xianfeng 2nd Year.
The *Suwen · Shengqi Tongtian Lun* says: If one is injured by cold in winter, one will inevitably suffer from Warm Disease in spring.
Zhang Zhongjing said: In winter, when severe cold prevails and all things hide deeply, if gentlemen maintain their solidity and closeness [protect their body], they will not be injured by cold.
Xiong's Note: Those who fall ill immediately after injury are suffering from Shanghan; those who do not fall ill immediately are suffering from Warmth/Heat diseases.
Zhang Xugu said: Winter cold lies latent in the Shaoyin channel, stagnates and transforms into heat, and when spring yang qi rises, it erupts outward; this is an Excess syndrome.
The *Jingui Zhenyan Lun* says: Essence is the root of the body. Therefore, those who store essence well will not suffer from Warmth in spring.
Wang Qiyuan said: When essence and qi lie latent, yang does not rise recklessly, so there is no Warmth disease in spring.
You Zhuowu said: Being injured by cold in winter is the cause of Warmth disease in spring; however, failing to store essence in winter is the source of contracting cold during winter.
Wu Jutong said: Failing to store essence does not solely refer to sexual excess; any human activity that can shake one's essence counts. Even if the weather in winter should be cold, if yang qi does not hide but instead vents out like in spring, resulting in abnormal blooming of peaches and plums, this is also such a case.
Zhang Xugu said: The classics discuss Warmth diseases as having two origins: those that lie latent internally and erupt outward, and those formed by external contraction according to the season. Among those erupting from internal latency, there are both Excess and Deficiency syndromes. The previous passage refers to an Excess syndrome, while this passage refers to a Deficiency syndrome.
The *Re Lun Pian* says: For all diseases turning into Warmth due to Shanghan, those occurring before the Summer Solstice are called Warm Disease, and those occurring after the Summer Solstice are called Summerheat Disease. Summerheat should resolve with sweating; do not stop the sweat.
Wang Qiyuan said: This defines based on the intensity of heat. When yang heat is not yet vigorous, it is called Warmth; when yang heat is extremely vigorous, it is called Summerheat.
Yang Shangshan said: Winter injury by cold results in mild cases erupting as Warmth disease before the Summer Solstice, and severe cases erupting as Summerheat disease after the Summer Solstice.
Lin Guanzi said: Since the true qi of Shaoyin is deficient, pathogenic factors must penetrate deeply, stagnate for a long time, transform into heat, and emerge from within. The *Shanghan Xuli* states: Summerheat disease is hotter than Warmth; thus, Summerheat disease is essentially a Heat disease.
Shen Yaofeng said: There are five types of Shanghan, and Rebing (Heat Disease) is just one of them; the discussions on the others have been lost.
Zhang Xugu said: Here, "all diseases becoming Shanghan" does not refer exclusively to winter cold. Generally, cold pathogens transforming into heat can occur at any time.
Xiong's Note: The *Maiyao Jingwei Lun* states: The warmth of spring is the basis for summer heat. Warmth is indeed Wen (Warmth), the gradual onset of heat. However, since it is not hot before summer arrives, the disease is still called Warmth. When it first attacks the Lung, it is an external contraction of Warmth pathogens. After the Summer Solstice, it gradually becomes hot, hence the disease is named Summerheat. Specifically, the minor heat solar term is in the sixth lunar month, and major heat is in the middle of the sixth month, corresponding to minor and major cold after the Winter Solstice. Thus, Summerheat disease is Heat disease. However, Zhang Zhongjing named external heat diseases in summer "Ye," distinguishing them from latent Qi Heat diseases. The *Shuowen* states: Ye means Summerheat injury. The *Book of Han · Annals of Emperor Wu* states: During a great summer drought, many people died of Ye. Therefore, Shu, Re, and Ye are all names for the single qi of summer. Later generations, failing to investigate, spread wild talk, discussing Taiji and prior heaven principles. While not without distinction, this has nothing to do with clinical conditions and instead confuses medical theory.
Gan's Note: This describes the normal pattern, yet there are Heat diseases in spring and Warmth diseases in summer. Warmth is the mild form of Heat; Heat is the severe form of Warmth. Hence, ancients often used them interchangeably.
The *Cire Pian* says: Patients with Liver Heat disease first experience yellow urine, abdominal pain, excessive sleeping, and fever. When heat contends [pathogen vs. healthy qi], they may speak wildly and startle easily, experience flank fullness and pain, restlessness in hands and feet, and inability to lie down peacefully. Symptoms worsen on Geng/Xin days, resolve with profuse sweating on Jia/Yi days, and death occurs on Geng/Xin days if qi rebels. Treat by needling the Foot Jueyin and Foot Shaoyang channels. If qi rebels, headache and dizziness occur due to pulse qi rushing to the head.
Wu Jutong said: In Liver disease, yellow urine appears first because the Liver channel connects to the genitalia. Also, the Liver governs free flow; Liver disease causes loss of this function, leading to yellow urine. Abdominal pain and lethargy result from Wood pathology attacking Spleen Earth. Heat contention means pathogenic heat is strong and contending with healthy qi. Wild speech and startling indicate Hand Jueyin Pericardium disease. Since both Jueyin channels share similar qi, heat contention affects the Hand Jueyin as well. Flank fullness and pain occur because the Liver channel runs along the sides of the body, and the flank is a key pathway. Restlessness and inability to sleep arise because the Liver governs Wind, and wind invades the extremities. Furthermore, Wood pathology attacks Earth; the Spleen governs the limbs. Liver heat draws upon the true yin of the Kidney (Shaoyin); yin damage causes agitation and insomnia. On Geng/Xin Metal days, Wood is controlled, so symptoms worsen. On Jia/Yi Wood days, Wood is prosperous, so sweating leads to recovery. "Qi rebellion" refers to severe illness where the course is unfavorable; thus, death occurs on days when the affected element is overcome. Needling both Jueyin and Shaoyang treats the Zang organ disease by draining its paired Fu organ. Rebellion causing headache below the head occurs because the Liver governs ascending; extreme illness causes upward movement. The logic for worsening on Geng/Xin days applies similarly to other organs.
Heart Heat disease patients first feel unhappy, developing fever after several days. When heat contends, they experience sudden heart pain, vexation, oppression, frequent vomiting, headache, red face, and anhidrosis. Symptoms worsen on Ren/Gui days, resolve with profuse sweating on Bing/Ding days, and death occurs on Ren/Gui days if qi rebels. Treat by needling the Hand Shaoyin and Hand Taiyang channels.
Wu Jutong said: In Heart disease, unhappiness arises because the Pericardium, named Danzhong, resides below the heart and acts on behalf of the monarch. The classic states Danzhong is the official of the minister, from which joy and pleasure emanate. Heart disease causes unhappiness. Sudden heart pain occurs because all excess pain involves pathogen-healthy qi contention; heat contention causes sudden heart pain. Vexation stems from the Heart governing Fire. Oppression arises from stagnant Qi in Danzhong. Vomiting relates to Liver disease; Wood and Fire share similar qi, so severe heat manifests Liver pathology. Additionally, pathogens residing above the diaphragm often cause vomiting. Headache results from Fire rising. Red face reflects the color of Fire. Anhidrosis occurs because sweat is the fluid of the Heart; heat closure and fluid depletion prevent sweating.
Zhang Xugu said: The vital yang qi of the human body roots in the Kidneys, originates in Liver Wood, generates Fire, Earth, Metal, Water, and back to Wood, cycling endlessly to ensure peace and safety. Pathogens lying latent in blood and qi move with this vital yang qi; intense movement triggers disease. However, the eruption has no fixed location depending on where the qi flows. Thus, the *Nan Jing* states that the pulse of Warmth disease travels through various channels, making it hard to identify which channel is active. As discussed by Zhang Zhongjing, eruptions may occur in Yin or Yang channels, aligning with the *Nan Jing*. The *Neijing*, listing organs in the order of generation (Liver, Heart, Spleen, Lung, Kidney), clarifies that pathogens follow the generation of qi. Within this variability, there is inherent logic, corroborating the *Nan Jing* and Zhang Zhongjing, further demonstrating the continuous lineage from Xuanyuan, Qibo, Bian Que, and Zhang Zhongjing.
Spleen Heat disease patients first experience heavy head, cheek pain, mental distress, bluish complexion, desire to vomit, and fever. When heat contends, they experience lower back pain preventing flexion and extension, abdominal fullness, diarrhea, and chin pain. Symptoms worsen on Jia/Yi days, resolve with profuse sweating on Wu/Ji days, and death occurs on Jia/Yi days if qi rebels. Treat by needling the Foot Taiyin and Foot Yangming channels.
Wu Jutong said: In Spleen disease, heaviness of the head occurs because the Spleen belongs to Dampness, and Earth nature is heavy. The classic states dampness envelops the head, hence Spleen disease causes heavy head. The cheek corresponds to the Shaoyang region. Earth and Wood have a competitive relationship; Spleen disease manifests Wood pathology. Mental distress occurs because the Spleen channel connects to the Heart. Bluish complexion and desire to vomit also indicate Wood pathology. Lower back pain preventing movement occurs because Spleen disease impairs the Stomach's ability to function independently; Yangming governs joint flexibility, so pain prevents flexion/extension. Abdominal fullness and diarrhea are primary Spleen channel diseases. Chin pain also indicates Wood pathology.
Lung Heat disease patients first experience chills, goosebumps, aversion to wind and cold, yellow tongue coating, and fever. When heat contends, they experience wheezing and coughing, pain radiating to the chest, back, and sternum, inability to take deep breaths, unbearable headache, sweating followed by chills. Symptoms worsen on Bing/Ding days, resolve with profuse sweating on Geng/Xin days, and death occurs on Bing/Ding days if qi rebels. Treat by needling the Hand Taiyin and Hand Yangming channels; bleeding until bean-sized drops appear brings immediate relief.
Wu Jutong said: In Lung disease, aversion to wind/cold occurs because the Lung governs qi and skin/hair. Lung disease causes qi stagnation, failing to protect the skin/hair. Yellow tongue coating results from Lung qi failing to transform, leading to damp-heat accumulation. Zhang Xugu added: If initially contracted from external pathogens rather than internal heat, the coating would be white. Wheezing indicates extreme qi stagnation. Coughing results from Fire overcoming Metal. The chest/back area is governed by heavenly qi. The Lung governs heavenly qi; extreme Lung qi stagnation causes pain. "Radiating" implies unpredictability. Inability to breathe deeply indicates heat closing the Lung. Unbearable headache results from stagnant heavenly qi and trapped heat rushing upward to the brain. Stagnant heat opens pores, causing sweating; temporary heat release leads to chills. Referencing Zhang's notes.
Kidney Heat disease patients first experience lower back pain and soreness, bitter thirst with frequent drinking, and fever. When heat contends, they experience neck pain and stiffness, thigh coldness and soreness, heat in the soles of the feet, reluctance to speak, and if rebellious, dizzy neck pain. Symptoms worsen on Wu/Ji days, resolve with profuse sweating on Ren/Gui days, and death occurs on Wu/Ji days if qi rebels. Treat by needling the Foot Shaoyin and Foot Taiyang channels.
Wu Jutong said: In Kidney disease, lower back pain occurs first because the waist is the mansion of the Kidneys, and the Kidney channel penetrates the spine, meeting the Du vessel at Changqiang. The thigh coldness/soreness relates to the Kidney channel entering the heel and moving up the calf, as does the Taiyang channel. Soreness results from heat consuming fluids. Bitter thirst and frequent drinking occur because the Kidneys govern the five fluids and dislike dryness; heat disease damages fluids, causing dryness and thirst. Neck pain and stiffness occur because the Taiyang channel enters the brain from the crown and descends to the neck; severe Zang disease transferring to the Fu organ causes this. Thigh coldness represents extreme heat manifesting as cold. Heat in the soles occurs because the Kidney channel starts below the little toe and moves toward Yongquan point in the sole; severe disease causes heat. Reluctance to speak reflects helplessness. Upward rebellion of pathogens causes worse neck pain and dizziness, a condition difficult to describe. Referencing Zhang's notes.
Liver Heat disease patients show redness on the left cheek first. Heart Heat disease patients show redness on the forehead first. Spleen Heat disease patients show redness on the nose first. Lung Heat disease patients show redness on the right cheek first. Kidney Heat disease patients show redness on the chin first. Even if the disease has not erupted, needling those showing redness is called "Treating Disease Before It Arises."
Zhang Xugu said: This details how Five Zang Heat pathogens manifest visibly on the face before eruption. The left cheek, forehead, nose, right cheek, and chin correspond to the Qi of Liver, Heart, Spleen, Lung, and Kidney respectively. The fact that color appears before symptoms confirms that pathogens lie latent in blood and qi, moving unnoticed with circulation. This corroborates the *Nan Jing*: "The pulse of Warmth disease travels through various channels, unknown which is active." Thus, eruption follows the generation of qi. Seeing facial color changes allows skilled physicians to identify the site of pathogen movement and needle/drain it early, reducing pathogenic force and lightening the disease. This aligns with the *Nan Jing*: "Treat according to the location of the channel," representing the superior physician's "Treating Disease Before It Arises." Medication principles can be inferred similarly.
To treat various Heat diseases, drink cold water, then apply acupuncture. One must wear cold clothing, reside in cool places, and continue until the body feels cool and heat subsides.
Zhang Xugu said: Because long-latent pathogens generate heat from within, treatment must first involve drinking cold water to drive heat from the interior, followed by needling to vent from the exterior. Then, wearing cold clothes and residing in cool places ensures heat removal.
Xiong's Note: Modern practitioners who do not read the *Neijing* treat all Warmth, Heat, Summerheat, and Epidemic diseases identically to Shanghan, prohibiting cold drinks, thickening clothing/bedding, and closing windows, leading to many deaths. I have witnessed this frequently. However, drinking cold liquids requires moderation; excess causes fluid retention, edema, vomiting, and diarrhea. Post-recovery, water may exude from fingers and toe webs. Quickly administer: Coix Seed (Yi Yi Ren) 3 liang, Poria (Fu Ling) 3 liang, Atractylodes Macrocephala (Bai Zhu) 1 liang, Plantago Seed (Che Qian Zi) 5 qian, Cinnamon Bark (Gui Xin) 1 qian, named "Qu Shi Bao Tuo Tang" (Dampness-Expelling Preservation Decoction). Taking ten doses consecutively prevents toe detachment. This is known as "Toe-Detaching Shanghan" and must be known. If cold drinks are consumed in large amounts but sweating is also profuse, there will be no sequelae.
Taiyang channel pulse, with redness shining on the zygomatic bone, indicates Heat disease. If the shine has not intersected [with internal pathogens], saying "if sweat is obtained now, wait for the appropriate time," it resolves. If competing with Jueyin pulse signs, death occurs within three days; the Heat disease connects internally to the Kidney.
Zhang Xugu said: This clarifies the syndrome of external contraction interacting with latent pathogens, differing slightly from the "Simultaneous Cold Damage" in the *Re Lun Pian*. In simultaneous cold damage, external and internal pathogens strike simultaneously, causing dual illness and inevitable death. Here, if external contraction strikes first and latent pathogens erupt later, survival is possible. If they erupt simultaneously, death occurs within three days. "Taiyang channel pulse" means the pathogen affects the Taiyang channel, causing headache, stiff neck, and back stiffness on the first day. "Redness on zygomatic bone" means bright red color appears on the cheekbones. The cheekbone is the root of bone, governed by the Kidneys. Latent heat in the Kidneys has moved, traveling through nutritive blood to manifest on the cheek. "Shine not intersected... wait for time" means the external pathogen on the Taiyang channel and the latent heat in nutritive blood have not yet combined. Obtaining sweat now resolves the external pathogen ("within three days, use sweating"). The internal latent pathogen erupts later, resolving when the Zang qi is prosperous (e.g., Kidney Heat resolving with sweating on Ren/Gui days). This also aligns with "needling when color appears, called Treating Disease Before It Arises." If competing with Jueyin signs, both Kidney and Liver have internal heat, combining with external Taiyang pathogen, making resolution impossible. Compared to simultaneous cold damage, death is faster (within three days). Simultaneous cold damage starts in channels and takes six days for Stomach qi to exhaust before death. Here, Heat disease connects to Kidneys, destroying the root, causing rapid death.
Shaoyang channel pulse, with redness shining on the front of the cheek, indicates Heat disease. If the shine has not intersected, saying "if sweat is obtained now, wait for the appropriate time," it resolves. If competing with Shaoyin pulse signs, death occurs within three days.
Zhang Xugu said: Previously, Liver Heat showed redness on the left cheek; Liver is Jueyin, Gallbladder is Shaoyang, they are exterior-interior partners. External pathogen affects Shaoyang channel, while Liver latent heat shines on the cheek. If external and internal pathogens have not intersected, sweating resolves the exterior, and internal heat resolves when Zang qi is prosperous. If competing with Shaoyin signs, Liver heat connects to Kidney heat, making external/internal pathogens combine and hard to resolve, causing death within three days. Generally, if external and internal pathogens erupt sequentially without combining, rescue is possible. The key phrase is "shine not intersected." The subsequent disease name "Yin-Yang Intersection" implies the shine has intersected. The text only cites Taiyang and Shaoyang, omitting Yangming and Taiyin combinations. I speculate that Yangming Fu organs can be treated with purgation, avoiding certain death. Unlike Taiyang, Shaoyang, and Jueyin, where pathogens combine with no exit, leading to certain death.
The *Ping Re Bing Pian* asks: Emperor: There is a Warmth patient whose fever returns immediately after sweating, with rapid and restless pulse unrelieved by sweat, accompanied by wild speech and inability to eat. What is the disease name? Qibo: It is called Yin-Yang Intersection; intersection means death.
Ye Tianshi said: Intersection means yin fluids leaking outward and yang pathogens sinking inward.
You Zhuowu said: Intersection does not mean communication, but disorder. Yin and Yang become disordered and irreparable; attacking yin makes yang resist entry, attacking yang makes yin block passage. Thus, intersection means death. Guo claimed it is simultaneous cold damage, but simultaneous cold damage is concurrent Yin-Yang illness, not Yin-Yang intersection.
Zhang Xugu said: Yin and Yang qi naturally intersect and generate each other. Now, due to rampant pathogens, external Yang-pathogen and internal Yin-pathogen merge, cutting off the root healthy qi. Hence, Yin-Yang Intersection. "Intersection means death" refers to pathological merging, not healthy interaction. Below explains the rationale using metaphors of clothing and artifacts.
Humans sweat because sweat is generated from grain, and grain is transformed from essence. Now, if sweat occurs while pathogens contend in flesh and bone, it means pathogens are retreating and essence is victorious. If essence is victorious, the patient should be able to eat and not relapse into fever. Relapsing fever indicates pathogen victory. Sweat indicates essence loss. Now, sweating followed immediately by fever indicates pathogen victory. Inability to eat means essence has no support. If the disease lingers, life is imperiled instantly. Furthermore, the *Re Lun* states: Death occurs if pulse remains rapid and vigorous after sweating. Now, the pulse does not correspond to the sweat, indicating the body cannot overcome the disease; death is clear. Wild speech indicates loss of Will (Zhi); loss of Will means death. Now seeing three death signs and no life sign, even if seeming recovered, death is certain.
Zhang Xugu said: "Sweat from grain, grain from essence" means original essence transforms grain into fluids, emitting sweat; pathogens exit with sweat, retreating as essence wins. Winning essence allows eating to transform grain; expelled pathogens mean no fever. Relapsing fever means pathogens remain. Sweating merely depletes essence, hence fever returns; essence retreats, pathogens win. Inability to eat means essence lacks support ("Bi" means reliance). Though the disease lingers, life ends quickly. Ancient theory: "Death if pulse vigorous after sweat" precisely means essence retreats and pathogens remain. If pathogens leave and essence remains, pulse calms. Now pulse and sweat mismatch, meaning essence cannot overcome pathogens; death is clear. Wild speech (loss of Will) is death sign one. Fever return after sweat (essence retreat, pathogen win) is death sign two. Pulse-sweat mismatch is death sign three. Seeing three death signs, no life sign, certain death even if seemingly recovering.
Xiong's Note: Warmth conditions mistakenly treated as Shanghan, with reckless sweating, often present this syndrome.