汗也者,合阳气阴精蒸化而出者也。《内经》云∶人之汗,以天地之雨名之。盖汗之为物,以阳气
为运用,以阴精为材料。阴精有余,阳气不足,则汗不能自出,不出则死;阳气有余,阴精不足,多能自
出,再发则痉,痉亦死;或熏灼而不出,不出亦死也。其有阴精有余,阳气不足,又为寒邪肃杀之气
所抟,不能自出者,必用辛温味薄急走之药,以运用其阳气,仲景之治伤寒是也。伤寒一书,始终以
救阳气为主。其有阳气有余,阴精不足,又为温热升发之气所铄,而汗自出,或不出者,必用辛凉以
止其自出之汗,用甘凉甘润培养其阴精为材料,以为正汗之地,本论之治温热是也。本论始终以救
阴精为主。此伤寒所以不可不发汗,温热病断不可发汗之大较也。唐宋以来,多昧于此,是以人各
着一伤寒书,而病温热者之祸及矣。呜呼!天道欤?抑人事欤?
原文云∶或问天有六气──风、寒、暑、湿、燥、火,风、寒、暑、湿,经皆揭病出条例以立论,而不揭
燥火,燥火无病可论乎?曰∶《素问》言春伤于风,夏伤于暑,秋伤于湿,冬伤于寒者,盖以四气之在
四时,各有专令,故皆专病也。燥火无专令,故不专病,而寄病于百病之中;犹土无正位,而寄王于
四时辰戌丑未之末。不揭者,无病无燥火也。愚按此论,牵强臆断,不足取信,盖信经太过则凿之
病也。春风,夏火,长夏湿土,秋燥,冬寒,此所谓播五行于四时也。经言先夏至为病温,即火之谓;
夏伤于暑,指长夏中央土而言也;秋伤于湿,指初秋而言,乃上令湿土之气,流行未尽。盖天之行
令,每微于令之初,而盛于令之末;至正秋伤燥,想代远年湮,脱简故耳。喻氏补之诚是,但不当硬改
经文,已详论于下焦寒湿第四十七条中。今乃以土寄王四时比燥火,则谬甚矣。夫寄王者,湿土
也,岂燥火哉!以先生之高明,而于六气乃昧昧焉,亦千虑之失矣。
汗,是阳气与阴精共同蒸腾气化而排出的体液。《黄帝内经》说:人的汗,可以用天地的雨水来命名。大概汗这种物质,依靠阳气来推动运行,以阴精作为生成材料。如果阴精有余而阳气不足,汗就不能自行排出,若不排出就会死亡;如果阳气有余而阴精不足,汗往往能自行排出,但若再次发汗就会导致痉挛,痉挛也会致死;或者因热邪熏灼导致汗不出,汗不出同样会致死。那些阴精有余、阳气不足,又受到寒邪肃杀之气的郁结,导致汗不能自行排出的情况,必须使用气味辛温、质地轻薄且药势急走的药物,来激发运用其阳气,这就是张仲景治疗伤寒的方法。《伤寒论》一书,始终以防救阳气为主旨。那些阳气有余、阴精不足,又受到温热升发之气煎熬,导致汗自行排出或无法排出的情况,必须使用辛凉的药物来制止其自发的出汗,使用甘凉、甘润的药物来滋养补充作为汗液材料的阴精,从而建立正常的汗出机制,这就是本书(《温病条辨》)治疗温热病的方法。本书始终以保护阴精为主旨。这就是为什么伤寒病不可以不发汗,而温热病绝对不可发汗的大致原则。唐宋以来,许多人不明白这个道理,因此每个人都撰写关于伤寒的书籍,结果导致患温热病的患者遭受祸害。唉!这是天道使然呢?还是人为失误呢?
原文问道:有人问天有六气——风、寒、暑、湿、燥、火,风和寒、暑、湿,经典都明确列出病症并设立条例进行论述,却不单独列出燥和火,难道燥和火没有相关的病症可以论述吗?回答说:《素问》说春天受风邪伤害,夏天受暑邪伤害,秋天受湿邪伤害,冬天受寒邪伤害,这是因为四种气候在四季中各有其主导时令,所以各自对应特定的疾病。燥和火没有独立的主导时令,所以不单独致病,而是寄寓在各种疾病之中;就像土没有固定的正位,而是寄旺于辰、戌、丑、未四个时辰的末尾一样。不单独列出,是因为认为没有单独的燥火病。我认为这个论点牵强附会、主观臆断,不值得相信,这大概是过于迷信经典而导致的穿凿附会的毛病。春风、夏火、长夏湿土、秋燥、冬寒,这就是所谓的将五行分布到四季中。经文说“夏至前发生的病称为温”,指的就是火邪;“夏天受暑邪伤害”,指的是长夏中央土的气化而言;“秋天受湿邪伤害”,指的是初秋时节,那是夏季令行的湿土之气流行尚未结束的缘故。大概天时的行令规律,通常在时令刚开始时微弱,而在时令结束时旺盛;至于到了真正的秋季感受燥邪,我想是因为年代久远、竹简脱漏的缘故罢了。喻嘉言对此进行补正确实正确,但不应当强行修改经文,这一点在下焦寒湿第四十七条中已有详细论述。现在却用土寄旺于四季来类比燥火,那就谬误得很了。所谓寄旺于四季的是湿土,难道是燥火吗!凭先生如此高明,却在六气的问题上如此糊涂,这也是千虑之一失啊。
Perspiration is the body fluid excreted through the steaming and transformation of Yang Qi (Yang Energy) and Yin Essence (Yin Fluids). The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "Human perspiration is named after the rain of heaven and earth." Essentially, perspiration relies on Yang Qi for its movement and operation, while Yin Essence serves as its material basis. If there is an excess of Yin Essence but a deficiency of Yang Qi, perspiration cannot occur spontaneously; failure to perspire leads to death. If there is an excess of Yang Qi but a deficiency of Yin Essence, perspiration may occur spontaneously, but excessive sweating can lead to spasms (Jing), which is also fatal. Alternatively, if heat pathogen scorches the body preventing sweat from emerging, this too is fatal. In cases where there is an excess of Yin Essence and a deficiency of Yang Qi, compounded by the condensing effect of cold pathogenic factors, making spontaneous perspiration impossible, one must use pungent-warm herbs with light flavors and rapid action to stimulate Yang Qi. This is the method used by Zhang Zhongjing in treating Cold Damage (Shanghan). The *Treatise on Cold Damage* (*Shanghan Lun*) consistently focuses on rescuing Yang Qi. Conversely, in cases where there is an excess of Yang Qi and a deficiency of Yin Essence, exacerbated by the scorching effect of warm-heat rising energy, leading to spontaneous or absent perspiration, one must use pungent-cool herbs to stop spontaneous sweating, and sweet-cool/sweet-moist herbs to nourish and replenish Yin Essence as the material for normal perspiration. This establishes the mechanism for proper sweating. This is the method used in this treatise (*Wenbing Tiaobian*) for treating Warm-Heat diseases. This treatise consistently focuses on preserving Yin Essence. These are the general principles explaining why Cold Damage requires inducing sweating, whereas Warm-Heat diseases absolutely contraindicate inducing sweating. Since the Tang and Song dynasties, many have misunderstood this, leading each author to write their own books on Cold Damage, thereby causing harm to patients suffering from Warm-Heat diseases. Alas! Is this due to the Way of Heaven, or human error?
The original text asks: "Someone asks: Heaven has Six Qi—Wind, Cold, Summer-Heat, Dampness, Dryness, and Fire. Classics explicitly list symptoms and establish rules for Wind, Cold, Summer-Heat, and Dampness, but do not explicitly list Dryness and Fire. Does Dryness and Fire have no diseases to discuss?" The answer is: The *Suwen* (Basic Questions) states that spring injury by Wind, summer injury by Summer-Heat, autumn injury by Dampness, and winter injury by Cold exist because these four climatic factors have specific governing seasons, thus corresponding to specific diseases. Dryness and Fire lack independent governing seasons; therefore, they do not cause isolated diseases but rather manifest within various other diseases. This is analogous to Earth (Spleen/Stomach in Five Elements theory) lacking a fixed position, instead flourishing at the end of the Chen, Xu, Chou, and Wei hours. They are not listed separately because it was believed there were no distinct Dryness/Fire diseases. I consider this argument forced and speculative, unworthy of trust. It stems from over-reverence for classics leading to pedantic interpretation. Spring Wind, Summer Fire, Long Summer Damp-Earth, Autumn Dryness, Winter Cold—this is what is meant by distributing the Five Phases across the four seasons. When the classic says "diseases occurring before the Summer Solstice are called Warm," it refers to Fire. "Summer injury by Summer-Heat" refers to the central Earth of Long Summer. "Autumn injury by Dampness" refers to early autumn, when the damp-earth qi of the preceding season has not yet fully dissipated. Generally, heavenly commands are weak at the beginning of a season and strong at the end. Regarding "true autumn injury by Dryness," I believe this omission is due to lost bamboo slips over long ages. Yu Jiayan's correction is indeed correct, but he should not have forcibly altered the classic text, as detailed in Article 47 of Lower Jiao Cold-Dampness. To now compare Dryness and Fire to Earth flourishing across all four seasons is highly erroneous. What flourishes across the four seasons is Damp-Earth, not Dryness and Fire! Despite Mr.'s brilliance, his confusion regarding the Six Qi is indeed a rare oversight.