（一）冬伤于寒，春必温病。盖因房室劳伤，与辛苦之人腠理开泄，少阴不藏，肾水涸竭而得之。无水则春木无以
发生，故为温病；至长夏之时，时强木长，因绝水之源，无以滋化，故为大热病也。伤寒之源如此。《四气调神论》曰∶
逆冬气，则少阴不藏，肾气独沉。广成子云∶无劳汝形，无摇汝精。《金匮真言》曰∶夫精者，身之本也。故藏于精者，
春不病温。注云∶冬不按跷，精气伏藏，阳不妄升，故春不病温。又《经》云∶不妄作劳。又云∶不知持满。又云∶水
冰地坼，无扰乎阳。又云∶无泄皮肤，使气亟夺。启玄子云∶肾水王于冬。故行夏令，则肾气伤，春木王而水废，故病
于春也。逆冬则伤肾，故少气以奉春生之令也。是以春为温病，夏为热病，长夏为大热病，其变随乎时而已，邪之所感，
浅者其病轻而易治，深者其病重而难治，尤深者其病死而不治。（《伤寒之源》）
（二）冬伤于寒者，冬行秋令也。当寒而温，火胜而水亏矣。水既已亏，则所胜妄行，土有余也。所生受病，水不
足也；所不胜者侮之，火太过也。火土合德，湿热相助，故为温病。使民腠理开泄，少阴不藏，惟房室劳伤辛苦之人得
之。若此者，皆为温病。所以不病于冬，而病于春者，以其寒水居卯之分，方得其权，大寒之令复行于春，腠理开泄，
少阴不藏，房室劳伤辛苦之人，阳气泄于外，肾水亏于内，当春之月，时强不长，无以滋生化之源，故为温病耳。故君
子周密于冬，少阴得藏于内，腠理以闭拒之，虽有大风苛毒，莫之能害矣。何温病之有哉？人肖天地而生也，冬时阳气
俱伏于九泉之下，人之阳气俱藏于一肾之中，人能不扰乎肾，则六阳安静于内，内既得以安，外无自而入矣。此伤寒之
源，非天之伤人，乃人自伤也。伤于寒者皆为病热，为伤寒气乃热病之总称，故曰伤寒，知寒受热邪明矣。六阴用事于
冬，阳气在内，周密闭藏可矣。反劳动之而泄于外，时热已伤于水矣。至春之时，木当发生，阳已外泄，孰为鼓舞？肾
水内竭，孰为滋养？此两者同为生化之源，源既已绝，水何赖以生乎？身之所存者，独有热也，时强木长，故为温病矣。
（《冬伤于寒，春必温病》）
（一）冬季感受寒邪，春季必然发生温病。这通常是因为房事过度导致劳损，以及从事辛苦劳作之人的腠理（皮肤毛孔及肌肉间隙）开泄，致使少阴经气不固藏，肾水枯竭而引发此病。体内无水，则春季木气无法生发，因此形成温病；到了长夏时节，时令之气强盛如木气生长，但因断绝了水源，无法滋养化生，所以演变为大热病。伤寒的源头正是如此。《四气调神大论》说：违背冬季养藏之气，就会导致少阴不藏，肾气独沉。广成子说：不要使你的形体劳累，不要动摇你的精气。《金匮真言论》说：精，是生命的根本。所以能固藏精气的人，春季不会患温病。注解说：冬季不按跷（按摩肢体），精气伏藏于内，阳气不妄升，所以春季不患温病。又《内经》说：不要妄作劳役。又说：不知道保持满溢的状态（指保精）。又说：当水冰地裂之时，不要扰动阳气。又说：不要使皮肤开泄，导致正气频繁耗夺。启玄子（王冰）说：肾水在冬季旺盛。所以如果施行夏令之法，就会损伤肾气，等到春季木气旺盛时，因肾水废竭，故而在春季发病。违背冬令就会伤肾，导致元气不足，无法顺应春季生发的命令。因此，春季为温病，夏季为热病，长夏为大热病，其变化随季节时令而定。邪气感知的深浅不同，浅者病情轻而易治，深者病情重而难治，尤其深的则病死不治。（出自《伤寒之源》）
（二）所谓“冬伤于寒”，是指冬季行用了秋季的令气。本该寒冷却温暖，导致火气胜而水气亏。水气既然已亏，则其所克制的土气妄行有余；其所生的木气受病，是因为水不足；其所不胜的火气来侮，是因为火太过。火与土合德，湿热相助，所以形成温病。这使得民众腠理开泄，少阴不藏，只有那些因房事过度、劳损辛苦的人才会得此病。像这种情况，都称为温病。之所以不在冬季发病而在春季发病，是因为寒水居于卯分（东方木位），正当其权，大寒的令气复行于春季，腠理开泄，少阴不藏，那些因房事过度、劳损辛苦的人，阳气外泄，肾水内亏，正值春季，时令之气强盛但木气不长，无法滋生化之源，所以成为温病。因此，君子在冬季周密保养，少阴得以在内固藏，腠理闭合拒邪，即使有大风苛毒，也不能伤害他。哪里会有温病呢？人效法天地而生，冬季阳气都潜伏在九泉之下，人的阳气都藏在肾脏之中，人如果不扰动肾脏，则六阳安静于内，内部既已安宁，外部邪气自然无从侵入。这就是伤寒的源头，并非天伤人，而是人自伤。伤于寒邪最终都表现为热病，“伤寒”是伤寒气乃热病的总称，所以说伤寒，可知寒邪受热邪所化是很明显的。六阴用事于冬季，阳气在内，周密闭藏即可。反而劳动它使其外泄，此时热气已经伤了水气。到了春季，木气应当生发，但阳气已外泄，谁来鼓舞生机？肾水内竭，谁来滋养？这两者同为生化之源，源既已断绝，水靠什么产生呢？身体所存的，只有热罢了，时令强盛木气生长，所以成为温病。（出自《冬伤于寒，春必温病》）
(1) Contracting cold in winter inevitably leads to warm diseases in spring. This is often caused by sexual exhaustion and the open pores (skin pores and interstitial spaces) of those engaged in hard labor, resulting in the failure of the Shaoyin channel to store essence, leading to the depletion of kidney water. Without water, the wood qi cannot generate in spring, thus giving rise to warm diseases; by the time of late summer, when the seasonal qi is strong like growing wood, the source of water is cut off and cannot nourish transformation, resulting in severe heat diseases. Such is the origin of cold damage diseases. The *Si Qi Tiao Shen Lun* states: "Violating the qi of winter causes Shaoyin not to store, and kidney qi sinks alone." Guangchengzi said: "Do not exhaust your form, do not shake your essence." The *Jinkui Zhenyan* states: "Essence is the root of the body." Therefore, those who store essence will not suffer from warm diseases in spring. The commentary notes: "If one does not perform massage on the limbs in winter, essence remains hidden, yang qi does not ascend recklessly, hence no warm disease in spring." Furthermore, the *Classic* says: "Do not exert yourself recklessly." It also says: "Do not know how to maintain fullness." And: "When water freezes and earth cracks, do not disturb yang." And: "Do not let the skin open, causing frequent loss of qi." Qixuanzi (Wang Bing) stated: "Kidney water prospers in winter." Thus, if one acts according to summer regulations, kidney qi is injured; when wood qi prospers in spring, water fails, so illness occurs in spring. Violating winter harms the kidneys, leading to shortness of qi and inability to fulfill the command of spring generation. Hence, spring brings warm diseases, summer brings heat diseases, and late summer brings severe heat diseases; their variations follow the seasons. The shallower the pathogen's penetration, the lighter the disease and easier to treat; the deeper, the heavier and harder to treat; extremely deep cases are fatal and incurable. (From *Shanghan Zhi Yuan*)
(2) "Contracting cold in winter" refers to autumnal regulations being applied in winter. When it should be cold but is warm, fire prevails and water is deficient. Since water is deficient, the element it controls (earth) acts recklessly with excess; the element it generates (wood) suffers disease due to water insufficiency; the element that overcomes it (fire) insults it due to fire excess. Fire and earth combine their virtues, assisting damp-heat, thus forming warm diseases. This causes people's pores to open and Shaoyin not to store; only those suffering from sexual exhaustion and hard labor contract this. Such cases are all called warm diseases. Why do they not manifest in winter but in spring? Because cold-water resides in the Mao sector (East/Wood), holding authority, and severe cold commands return in spring. Pores open, Shaoyin does not store; for those exhausted by sex and labor, yang leaks outward, kidney water depletes inward. In spring, when seasonal qi is strong but wood does not grow, lacking the source to nourish transformation, warm diseases arise. Therefore, gentlemen preserve carefully in winter, allowing Shaoyin to store within, pores close to reject pathogens; even with fierce winds and toxic agents, harm cannot occur. How could there be warm diseases? Humans emulate heaven and earth; in winter, yang qi hides in the deepest springs, and human yang qi hides in the kidneys. If one does not disturb the kidneys, the six yang channels remain quiet internally; once internal peace is achieved, external pathogens have no entry. This is the source of cold damage diseases; it is not heaven harming humans, but humans harming themselves. Those injured by cold ultimately manifest as heat diseases; "cold damage" is the general term for heat diseases caused by cold qi injuring the body, so saying "cold damage" makes it clear that cold transforms into heat pathogenic factors. Six yin governs winter, with yang inside, requiring tight closure and storage. Instead, labor disturbs it, causing leakage outward; at this time, heat has already damaged water. By spring, wood should generate, but yang has leaked out—who will inspire growth? Kidney water is depleted internally—who will nourish? These two are the sources of generation; once the source is cut, what sustains water? What remains in the body is only heat; with strong seasonal qi and growing wood, warm diseases arise. (From *Dong Shang Yu Han, Chun Bi Wen Bing*)