伏气温病，有兼风兼寒兼湿兼毒之不同；伏气热病，有兼暑兼湿兼燥之不同。惟伏暑之邪，古无是说，至深秋而发
者，始见于叶氏《指南》。霜未降者轻，霜既降者重，冬至尤重。然竟有伏至来春始发者，由于秋暑过酷，冬令仍温，
收藏之令不行，中气因太泄而伤，邪热因中虚而伏，其绵延淹滞，较《指南》所论更甚。调治之法则尤难，非参 所能
托，非芩连所能清。惟藉轻清灵通之品，缓缓拨醒其气机，疏通其血络，始可十救一二。若稍一呆钝，则非火闭，即气
脱矣。
伏气温病，自里出表，乃先从血分，而后达于气分。故起病之初，往往舌润而无苔垢。但察其脉软，而或弦或微数，
口未渴，而心烦恶热，即宜投以清解营阴之药。迨邪从气分而化，苔始渐布，然后再清其气分可也。伏邪重者，初起即
舌绛咽干，甚有肢冷脉伏之假象，亟宜大清阴分伏邪，继必浓腻黄浊之苔渐生，此伏邪与新邪先后不同处。更有伏邪深
沉，不能一齐外出者，虽治之得法，而苔退舌淡之后，逾一二日，舌复干绛，苔复黄燥，正如抽蕉剥茧，层出不穷，不
比外感温邪，由卫及气，自营而血也。秋月伏暑证，轻浅者邪伏膜原，深沉者亦多如此。苟阅历不多，未必知其曲折乃
尔也。
伏气温病，本冬伤于寒。后人论伤寒由表入里，温病自上而下，欲撇去伤寒，独开生面以论温，而不自知其无知妄
作，不但于仲景经文，未明经旨，并于《内》、《难》二经所论温病，概不符合。此乃无根之学说，不足道也。仲景论伤
寒∶有寒邪伤经，由经传经者；有寒邪伤表，由表入里者。寒邪入里，先入胸为胸满；由心而入心下为心下痞；由心下
而入腹中为胀满。其病皆自上而下。伏气温病，本冬伤于寒，寒邪伏于骨与肩背之膂筋，至春，病随气化，由筋骨而出
走肌肉，化为温病；由肌肉外达皮毛，发为热病。伏寒化温，自里出表，乃人身之气，随时变化使然。所谓自上而下者，
乃人之胃气，不能使邪气外解，则邪气入里，由上焦而入中焦，甚则深入下焦。其病由卫入营，由表入里也。夫病之所
以由表入里，自上而下者，皆人之气化使然，非病能使然。寒邪从毛窍入，温邪亦从毛窍入，不得以温邪为从口鼻入，
不能从毛窍入也。何也？人之口鼻呼吸，毛窍亦呼吸，病气随呼吸入人身，固无分乎寒与温也。惟瘟疫传染，地气为病，
秽浊气味，由口鼻入耳。
伏气者，正邪也。冬以寒为正邪；春以风为正邪；夏以暑为正邪；长夏新秋以湿为正邪。正邪能伏，虚邪、实邪、
微邪、贼邪，皆不能伏也。六气伤人，合于四时，只论风寒暑湿，而不及燥火。何也？以燥火二气不能伏，故燥为秋之
正邪，而置之不论。喻嘉言未明经旨，为补秋燥一条，不知燥伤肺金，其病即发为燥咳，不能伏至冬令而后咳嗽也。
按燥气有二，有火燥，有寒燥。火燥伤人，其气不能伏；寒燥伤人，结为 瘕，为疝气，日久不愈，亦伏气病也。
嘉言欲补秋燥一条，当言疝瘕，不当言咳嗽也。
伏气温病，有兼夹风邪、寒邪、湿邪、毒邪的不同；伏气热病，有兼夹暑邪、湿邪、燥邪的不同。只有伏暑之邪，古代没有这种说法，直到深秋才发作的，才开始见于叶天士的《临证指南医案》。霜降之前发病的较轻，霜降之后发病的较重，冬至前后发病尤其严重。然而竟然有潜伏到来年春季才发作的，这是由于秋季暑气过于酷烈，冬季气候依然温暖，收藏的时令功能不能正常行使，中气因此过度耗泄而受伤，邪热因中气虚弱而潜伏，其病情缠绵停滞，比《指南》中所论述的更为严重。调理治疗的法则尤为困难，非人参所能托举（扶正），非黄芩、黄连所能清解（清热）。只能借助轻清灵通的药物，缓缓唤醒其气机，疏通其血络，才可以十中救一二。如果用药稍显呆板迟钝，就会导致火邪内闭，或者气脱了。
伏气温病，是从体内向体表传变，乃先从血分开始，然后达于气分。所以在起病之初，往往舌质润泽而没有苔垢。只要诊察其脉象软弱，或者弦细，或者微数，口不渴，但心烦怕热，就应当投用清解营阴的药物。等到邪气从气分转化，舌苔才开始逐渐布满，然后再清解其气分就可以了。伏邪严重的，起病时即见舌质深红、咽干，甚至有四肢冰冷、脉搏沉伏的假象，亟需大清阴分中的伏邪，随后必然出现浓腻黄浊的舌苔，这是伏邪与新感外邪先后不同的地方。更有伏邪深沉，不能一齐向外透发的，虽然治疗得法，但在舌苔退去、舌色转淡之后，过了一两天，舌复又干燥深红，苔复又黄燥，正如抽蕉剥茧，层出不穷，不像外感温邪，由卫分及气分，由营分入血分那样规律。秋季的伏暑证，轻浅的是邪气伏于膜原，深沉的也多如此。如果没有丰富的阅历，未必知道其中的曲折竟是这样。
伏气温病，本是冬季感受寒邪所致。后人论述伤寒是由表入里，温病是自上而下，想要撇开伤寒，独创新面来论述温病，却不知道自己无知妄作，不但对张仲景的经文，没有明白经旨，并且与《内经》、《难经》二经所论述的温病，一概不符合。这是无根的学说，不值得谈论。张仲景论述伤寒：有寒邪伤及经脉，由一经传至另一经的；有寒邪伤及体表，由表入里的。寒邪入里，先进入胸中导致胸满；由心进入心下导致心下痞塞；由心下进入腹中导致胀满。这些病症都是自上而下的。伏气温病，本是冬季感受寒邪，寒邪潜伏在骨骼与肩背的膂筋中，到了春季，病情随气化而变化，由筋骨而出走肌肉，化为温病；由肌肉外达皮毛，发为热病。伏寒化温，自里出表，是人身之气随时变化使然。所谓自上而下的，是指人的胃气不能使邪气外解，则邪气入里，由上焦而入中焦，甚则深入下焦。其病由卫分入营分，由表入里。疾病之所以由表入里，自上而下，都是人之气化使然，不是病本身能使然。寒邪从毛窍进入，温邪也从毛窍进入，不能认为温邪只从口鼻进入，不能从毛窍进入。为什么呢？人的口鼻呼吸，毛窍也呼吸，病气随呼吸进入人体，本来就不分寒邪与温邪。只有瘟疫传染，地气致病，秽浊气味，是从口鼻进入的。
伏气，指的是正邪。冬季以寒为正邪；春季以风为正邪；夏季以暑为正邪；长夏和新秋以湿为正邪。正邪能够潜伏，虚邪、实邪、微邪、贼邪，都不能潜伏。六气伤人，合于四时，只论风寒暑湿，而不提及燥火。为什么呢？因为燥火二气不能潜伏，所以燥是秋季的正邪，而被置之不论。喻嘉言没有明白经旨，为了补述秋燥一条，不知道燥伤肺金，其病即刻发为燥咳，不能潜伏到冬季后才咳嗽。按燥气有两种，有火燥，有寒燥。火燥伤人，其气不能潜伏；寒燥伤人，结为瘕聚，为疝气，日久不愈，也是伏气病。喻嘉言想要补述秋燥一条，应当说疝瘕，不应当说咳嗽。
Fu-wen Bing (Warm Disease with Latent Pathogen) may be complicated by Wind, Cold, Dampness, or Toxin; Fu-qi Re Bing (Heat Disease with Latent Pathogen) may be complicated by Summerheat, Dampness, or Dryness. Only the pathogen of Fu-shu (Latent Summerheat) was not discussed in ancient texts; cases manifesting in late autumn first appeared in Ye Tianshi's *Linzheng Zhinan* (Guidelines for Clinical Practice). Cases occurring before frost are mild; those after frost are severe, and those around Winter Solstice are particularly severe. However, there are cases that remain latent until spring to manifest, caused by excessive summer heat in autumn and warm weather in winter, which prevents the normal storage function. The Middle Qi is injured due to excessive leakage, and the pathogenic heat becomes latent due to Middle Qi deficiency. The lingering and stagnant nature of these cases is more severe than what is discussed in *Zhinnan*. The principles of regulation and treatment are especially difficult; they cannot be supported solely by Renshen (Ginseng Root), nor cleared solely by Huangqin (Scutellaria Root) and Lianzi (Lotus Plumule). Only by using light, clear, and agile substances to slowly awaken the Qi mechanism and unblock the blood collaterals can one save one or two out of ten. If the medication is slightly rigid or dull, it will lead to Fire closure or Qi collapse.
Fu-wen Bing emerges from the interior to the exterior, starting from the Blood level and then reaching the Qi level. Therefore, at the onset, the tongue is often moist without coating. As long as the pulse is soft, possibly wiry or slightly rapid, the mouth is not thirsty, but there is mental restlessness and aversion to heat, one should administer herbs that clear and resolve Ying Yin (Nutritive Yin). When the pathogen transforms via the Qi level, the coating gradually spreads, and only then should the Qi level be cleared. In severe cases of latent pathogens, the tongue is crimson and the throat dry at onset, even presenting false signs of cold limbs and deep, hidden pulse. It is urgent to heavily clear the latent pathogen in the Yin level. Subsequently, a thick, greasy, yellow, and turbid coating will gradually appear; this is the difference between latent pathogens and newly acquired pathogens. Furthermore, some latent pathogens are so deep that they cannot all emerge at once. Even with correct treatment, after the coating recedes and the tongue turns pale, after one or two days, the tongue becomes dry and crimson again, and the coating becomes yellow and dry again. This is like pulling silk from a cocoon, emerging endlessly, unlike exogenous warm pathogens which move from Wei to Qi, and from Ying to Xue. In autumn Fu-shu cases, mild ones have pathogens latent in Mo-yuan (Membrane Source), and deep ones are mostly similar. Without extensive clinical experience, one might not know such complexities.
Fu-wen Bing originates from Cold injury in winter. Later theorists argued that Shanghan (Cold Damage) moves from exterior to interior, while Wenbing (Warm Diseases) moves from top to bottom, attempting to discard Shanghan and create a new framework for Wenbing, unaware of their own ignorance and reckless fabrication. They not only failed to understand Zhang Zhongjing's scriptures but also contradicted the discussions on Warm Diseases in *Neijing* (The Inner Canon) and *Nanjing* (Classic of Difficult Issues). This is an unfounded theory, unworthy of discussion. Zhang Zhongjing discussed Shanghan: there are cases where Cold pathogen injures the meridians and transmits from one meridian to another; there are cases where Cold pathogen injures the exterior and enters the interior. When Cold pathogen enters the interior, it first enters the chest causing chest fullness; from the heart entering the epigastrium causing epigastric stuffiness; from the epigastrium entering the abdomen causing distension. These diseases all proceed from top to bottom. Fu-wen Bing, originating from winter Cold injury, has Cold pathogen latent in the bones and the Li-jin (muscles/tendons of the back). In spring, the disease follows Qi transformation, moving from bones and tendons into muscles, transforming into Wenbing; from muscles reaching the skin and hair, manifesting as Rebing (Heat Disease). Latent Cold transforming into Warmth, moving from interior to exterior, is due to the changes of human Qi with time. What is called "top to bottom" refers to the Stomach Qi failing to resolve the pathogen externally, causing the pathogen to enter the interior, moving from Upper Jiao to Middle Jiao, and even deeply into Lower Jiao. The disease moves from Wei to Ying, from exterior to interior. The reason diseases move from exterior to interior, from top to bottom, is due to human Qi transformation, not the disease itself. Cold pathogen enters through hair pores; Warm pathogen also enters through hair pores. One cannot assume Warm pathogen enters only through mouth and nose and not through hair pores. Why? Human mouth and nose breathe, and hair pores also breathe. Pathogenic Qi enters the body with respiration, regardless of whether it is Cold or Warm. Only in epidemic infections, where Earth Qi causes disease, do foul and turbid odors enter through the mouth and nose.
Fu-qi refers to Zheng-xie (Orthodox Pathogens). In winter, Cold is the Zheng-xie; in spring, Wind is the Zheng-xie; in summer, Summerheat is the Zheng-xie; in Changxia (Long Summer) and early autumn, Dampness is the Zheng-xie. Zheng-xie can become latent; Xu-xie (Deficiency Pathogen), Shi-xie (Excess Pathogen), Wei-xie (Minor Pathogen), and Zei-xie (Robber Pathogen) cannot become latent. The Six Qi injuring humans aligns with the four seasons, discussing only Wind, Cold, Summerheat, and Dampness, omitting Dryness and Fire. Why? Because Dryness and Fire cannot become latent. Thus, Dryness is the Zheng-xie of autumn and is left unmentioned. Yu Jiayan did not understand the scriptural intent and added a section on Autumn Dryness, not realizing that when Dryness injures Lung Metal, the disease immediately manifests as Dry Cough, and cannot lie latent until winter to cause coughing. According to analysis, there are two types of Dryness Qi: Huo-zao (Fire Dryness) and Han-zao (Cold Dryness). Huo-zao injuring humans, its Qi cannot become latent; Han-zao injuring humans, forms Jia-mass (abdominal masses) and Shan-qi (hernia). If unresolved for a long time, it is also a Fu-qi disease. If Yu Jiayan wanted to add a section on Autumn Dryness, he should have discussed Shan-Jia (hernia and masses), not Cough.