(一)喻嘉言《尚论篇》,阐发仲景《伤寒论》,殊畅也。《医门法律》阐发《金匮要略》,殊贯也。虽皆有所粉本,
然学广才张,心灵笔古,以各成其妙者也。至《尚论》温病云∶会《内经》之旨,以发仲景不宣之秘。且谓仲景略于治
温,而法度错出于治伤寒中,因《内经》云∶冬伤于寒,春必温病,此一大例也。冬不藏精,春必病温,此一大例也。
既冬伤于寒,又冬不藏精,至春月同时病发,此一大例也。奉此三例以论温证而详其治,然后与仲景三阳三阴之例,先
后合符。盖冬伤于寒,邪藏肌肤,即邪中三阳之谓也;冬不藏精,邪入阴藏,即邪中三阴之谓也。嘉言之论如此,予谓
温病无阴阳之分也。何也?冬有温气先开发人之腠理,而寒得以袭之,所谓邪之所凑,其气必虚,惟不藏精之人,而后
虚也。虚则寒伤其经,经必少阴者,以少阴藏本虚也。然所伤原微,且冬月大水当令,其权方盛,微邪不敢抗衡,但卧
榻之侧,岂容他人鼾睡,惟有阻彼生意,暗烁精髓。至于春,时强木长,而水不足以供其资,始则当春而温,木旺水亏,
所郁升发,火气燔灼,病温而已矣。其所伤者寒也;所病者温也;所伏者少阴也;所发者少阳也。故病必有阳而无阴,
药必用寒而远热,黄芩汤(黄芩、芍药、甘草、大枣)其主治也。则嘉言之论温,有阴有阳,如伤寒三阴经可用辛热者,
予曰否否不然也。(《春温病论》)
(二)冬伤于寒,春必病温,是言所感者本寒也。王叔和云∶从立春节后,其中无暴大寒,又不冰雪,有人壮热为
病者,此属春时阳气发外,冬时伏寒变为温病,此亦明言寒也。变字大妙,嘉言以为非,予独以为确,寒气内伏,郁久
而发,自成热矣。伤寒寒也,暂袭营间,不久而为大热,况迟之又久耶,为热乃自然之理,但不言变,不足以教天下也。
然何以不言热而言温,以春行温令故也。如李明之所云∶冬伤于寒者,冬行春令也。当冬而温,火胜而水亏矣。水既亏,
则所胜妄行,土有余也。所生受病,金不足也;所不胜者侮之,火太过也。火土合德,湿热相助,故为温病。然由明之
所言,是冬温而感之即病者也,非伏寒也,非变也。不然必无冬温一证也而后可,既有冬温,则有是气,已有是证矣。
由其言以悉冬温,便可垂论不磨,若论春温不免贻昧千古矣。《经》曰∶逆冬气,则少阴不藏。不藏,则寒邪得而入之,
伤于肌肤,伏于骨髓。始知冬为藏精之时,惟逆冬气,遂使少阴之经气不闭,复遭非时之暖,致令开泄,忽然严寒骤返,
不免受伤,故受伤者,仍是寒邪也。因先被温令开泄,似乎喜寒,且所伤不甚,故不即病,而潜伏于少阴也。然所以不
病于冬,而病于春者,正因水在冬为旺时,邪伏于经,且俯首而不敢抗,内郁既久,已自成热,至行春令,开发腠理,
阳气外泄,肾水内亏,至春三月,而木当生发,孰为鼓舞,孰为滋养,生化之源既绝,木何赖以生乎?身之所存者温也,
时强木长,故为温病。予故以彼论冬时之感温非是,而此论冬月之伏寒最精。愚性甚拙,何敢好议先贤,但以为必如此,
方与冬温两不相阻,且与仲景论温热,必推本自始,动曰伤寒之旨,无悖云耳。(《春温病论》)
(三)门人问曰∶伤者寒也,何以病温?答曰∶伤寒非病寒乎?而何以热也。寒郁营间,不一二日而成大热,况伏
藏于内者数十日之久耶。夫既邪伤肌肉,何以得入少阴经中?盖惟不藏精,则少阴先病,故邪伤者少阴也。春属木则自
内发出,无论兼太阳或阳明,总无不由少阳,何也?彼少阳行春令也。然既从少阴矣,何仲景专云太阳病?盖太阳与少
阴相表里也,故以发热为太阳也。曰不恶寒,明无表症也,则其热自内出,无外邪郁之也。然则仲景复言太少合病者,
见发热不恶寒,或兼有耳聋,胁满证也。言三阳合病者,以脉大属阳明,而多眠则热聚于胆也。不言法者,总以黄芩汤
为主治也。乃嘉言复谓∶有发表三、五次,而外证不除;攻里三、五次,而里证不除。以为在表也,又似在里;以为在
里也,又似在表。此温疫证,感天地人湿气、热气、尸气、邪入口鼻,溷淆三焦者相近,与春温全不相涉也。愚故及之,
以破后学之惑。(《春温病论》)
(四)门人复问曰∶春温亦间有一、二表症者乎?曰∶有之。伏气之病,虽感于冬,然安保风之伤人,不在伏气将
发未发之时乎?但兼外感者,必先头痛,或恶寒而后热不已,此新邪引出旧邪来也。或往来寒热,头痛而呕,稍愈后浑
身壮热为病者,此正气又虚,伏发更重也。总之,无外证者,以黄芩汤为主治,兼外感者,必加柴胡或以本经药轻解,
必无发汗之理。故仲景云∶发汗已,身灼热者,名曰风温。谓误用辛热之药,既辛散以劫其阴,复增热以助其阳,遂使
热更炽,脉俱浮,有如此之危证也。以及误下误火,严加戒谕者,舍黄芩汤,别无治法也。(《春温病论》)
(五)温病、热病之脉,或见浮紧者,乃重感不正之暴寒,寒邪束于外,热邪结于内,故其脉外绷急而内洪盛也。
或不识脉形,但见弦脉,便呼为紧而妄治之。盖脉之盛而有力者,每每兼弦,岂可错认为紧,而误以为寒乎!夫温热病
之脉,多在肌肉之分而不甚浮,且右手反盛于左手者,诚由怫郁在内故也。其左手盛或浮者,必有重感于风寒,否则非
温热病,自是非时暴寒耳。(《温热病脉论》)
(六)温热病,亦有先见表证,而后见里证者。盖怫郁自内达外,热郁腠理之时,若不用辛凉发散,则邪不得外泄,
遂还里而成可攻之证,非如伤寒从表而始也。或有不悟此理,乃于春夏温热病,而求浮紧之脉,不亦疏乎。(《温热病脉
论》)
(七)热病即伏寒也。彼冬伤于寒,发于春为温病,发于夏为热病。何彼发于春,此发于夏耶?盖感之轻重不同,
人之强弱亦异,而触发亦异,有因饥饱力役者,有因房室劳伤者,故春时虽行风木之令,使气血不致大亏,感触亦有先
后,不即发也。至夏则阳气尽泄,火令大行,正属湿土寄旺,尔时邪乌肯伏?故其发源皆自少阴,热病由出之途自阳明,
温病由出之途自少阳,虽所合之经不一,要不离乎阳明、少阳者,各因时令之气也。且为日既迟,为热愈炽,此仲景所
以用石膏辛凉胃热,以知母荡涤肾火,用甘草、粳米维持中气也。名汤曰∶白虎者,白属金属凉;风从虎且猛。人逢闷
热烦燥无可奈何之际,忽然狂风荐至,偃草扬波,火轮火树,不顿成清凉世界而称快乎。(《夏热病论》)
(一)喻嘉言的《尚论篇》,阐发张仲景的《伤寒论》,非常通畅。《医门法律》阐发《金匮要略》,非常连贯。虽然二者都有依据的底本,但因为他们学识广博、才华施展,心思灵巧、笔法古朴,从而各自成就了其精妙之处。至于《尚论篇》中关于温病的论述说:领会《黄帝内经》的宗旨,来发挥张仲景未曾宣示的秘密。并且认为张仲景在治温病方面简略,而治疗方法混杂出现在治伤寒的内容中,依据《黄帝内经》所说:冬天受寒邪侵袭,春天必定发生温病,这是一个大规律。冬天不能藏精,春天必定患温病,这也是一个大规律。既冬天受了寒邪,又冬天没有藏住精气,到了春天同时发病,这又是一个大规律。遵循这三个规律来讨论温证并详细阐述其治疗,然后与张仲景三阳经和三阴经的规律,前后符合。大概冬天受寒邪,邪气藏在肌肤,就是邪气侵入三阳经的意思;冬天不藏精,邪气进入阴脏,就是邪气侵入三阴经的意思。喻嘉言的论述如此,我认为温病没有阴阳之分。为什么呢?冬天有温气先开发人的腠理(皮肤纹理及汗孔),而寒邪得以侵袭,所谓邪气聚集的地方,正气必然虚弱,只有不藏精的人,才会导致虚弱。虚弱则寒邪损伤经脉,经脉必定是少阴经,因为少阴经的本脏原本就虚。然而所受的邪气原本轻微,且冬月大水当令,其势力正盛,微弱的邪气不敢抗衡,只是在卧榻之侧,岂容他人安睡,只能阻碍那生机,暗中销烁精髓。到了春天,时令强盛木气生长,而水不足以供给其滋养,起初应当春季而温,木旺水亏,所郁结之气升发,火气燔灼,就是温病了。其所伤害的是寒邪;所发生的病是温病;所潜伏的是少阴经;所发作的是少阳经。所以病一定有阳而无阴,用药必定用寒凉而远离温热,黄芩汤(由黄芩、芍药、甘草、大枣组成)是其主治方剂。那么喻嘉言论述温病,说有阴有阳,像伤寒三阴经可用辛热药物一样,我说不对不对,完全不是这样。(出自《春温病论》)
(二)“冬天受寒邪侵袭,春天必定患温病”,这是说所感受的本原是寒邪。王叔和说:从立春节后,其中没有突然的大寒,也没有冰雪,如果有人出现壮热病症,这属于春时阳气发散于外,冬时潜伏的寒邪变为温病,这也明确说了是寒邪。“变”字非常精妙,喻嘉言认为不对,我独自认为确切,寒气内伏,郁结久了而发作,自然成为热了。伤寒是寒邪,暂时侵袭营分之间,不久就成为大热,何况拖延很久呢,成为热乃是自然的道理,只是不说“变”字,不足以教导天下人。然而为什么不说热而言温,是因为春天施行温和的时令缘故。如李明之所云:冬天受寒邪,是冬天施行春天的时令。应当在冬天而温暖,火胜而水亏了。水既然亏损,则被克制的土气妄行,土有余了。所生的金气受病,金不足了;所不胜的火气侮之,火太过了。火土合德,湿热相助,所以成为温病。然而根据李明之所言,这是冬天温暖而感邪即病的人,不是伏寒,也不是变。不然的话,一定没有“冬温”这一证候才可以,既然有冬温,就有这种气候,已有这种证候了。通过他的言论来详尽了解冬温,就可以留下不朽的论述,如果讨论春温不免贻误千古了。《黄帝内经》说:违背冬气,则少阴不藏。不藏,则寒邪得以进入,伤于肌肤,潜伏于骨髓。才知道冬天是藏精的时候,只有违背冬气,遂使少阴经的气机不闭藏,又遭遇非时的暖热,致使开泄,忽然严寒骤返,不免受伤,所以受伤的,仍然是寒邪。因为先前被温令开泄,似乎喜欢寒冷,且所伤不重,所以不立即发病,而潜伏于少阴经。然而之所以不在冬天发病,而在春天发病的原因,正是因为水在冬天为旺盛之时,邪气潜伏于经脉,且俯首不敢对抗,内郁既久,已自然成热,到了施行春令,开发腠理,阳气外泄,肾水内亏,到了春季三个月,而木气当生发,谁去鼓舞,谁去滋养,生化之源既然断绝,木气靠什么来生长呢?身体所存留的是温气,时令强盛木气生长,所以成为温病。所以我以为他论述冬天感受温邪是不对的,而这里论述冬天月伏寒是最精辟的。我本性很笨拙,怎敢喜好议论先贤,只是认为必须这样,才与冬温两不相阻,且与张仲景论述温热,必推究根本自始,动不动就说伤寒的宗旨,没有违背罢了。(出自《春温病论》)
(三)门人问:受伤的是寒邪,为什么会得温病?回答:伤寒不就是病寒吗?那为什么会发热呢。寒邪郁结在营分之间,不到一两天就成为大热,何况潜伏藏匿在体内几十天之久呢。既然邪气伤了肌肉,怎么会进入少阴经中?盖因为只有不藏精,则少阴经先病,所以受伤的邪气是在少阴经。春天属木则从内部发出,无论兼太阳经或阳明经,总无不经过少阳经,为什么呢?因为少阳经施行春令。然而既然从少阴经了,为什么张仲景专门说太阳病?盖因为太阳经与少阴经相表里,所以以发热表现为太阳病。说不恶寒,明确没有表症,那么其热自然从内部发出,没有外邪郁结。然而张仲景又说太少合病,是见到发热不恶寒,或者兼有耳聋、胁满的症状。说三阳合病,是因为脉大属于阳明经,而多眠则是热聚于胆腑。不说治法,总以黄芩汤为主治方剂。然而喻嘉言又说:有发表三四五次,而外证不除;攻里三四五次,而里证不除。认为在表,又像在里;认为在里,又像在表。这与温疫证,感受天地人的湿气、热气、尸气、邪气入口鼻,混淆三焦的情况相近,与春温完全不相涉。我因此提及这些,以破除后学的疑惑。(出自《春温病论》)
(四)门人又问:春温也有偶尔有一两个表症的吗?答:有的。伏气之病,虽然感受于冬天,但是怎么保证风邪伤人,不在伏气将要发作未发作的时候呢?只是兼有外感者,必定先头痛,或者恶寒而后热不止,这是新邪引出旧邪。或者往来寒热,头痛而呕吐,稍愈后浑身壮热为病者,这是正气又虚,伏邪发作更重。总之,没有外证者,以黄芩汤为主治方剂,兼有外感者,必定加柴胡或以本经药物轻解,必定没有发汗的道理。所以张仲景说:发汗后,身灼热的,名叫风温。是说误用辛热药物,既辛散以劫夺其阴液,又增热以助其阳气,遂使热更炽盛,脉象都浮,有如此之危重证候。以及误下误火,严厉告诫劝谕的,除了黄芩汤,别无治法。(出自《春温病论》)
(五)温病、热病的脉象,有时见浮紧的,乃是再次感受不正的暴寒,寒邪束缚于外,热邪结聚于内,所以其脉象外部绷急而内部洪盛。或者不认识脉形,只见弦脉,便呼为紧脉而胡乱治疗。盖脉象盛大而有力量者,每每兼有弦象,岂可错认为紧脉,而误以为是寒邪!夫温热病的脉象,多在肌肉之分而不甚浮,且右手反盛于左手者,确实是由于怫郁在内故也。其左手盛或浮者,必定有再次感受风寒,否则就不是温热病,自然是非时暴寒罢了。(出自《温热病脉论》)
(六)温热病,也有先见表证,而后见里证的。盖怫郁从内部达于外部,热郁结于腠理之时,若不用辛凉发散,则邪气不得外泄,遂返回内部而成可攻下的证候,不像伤寒从表开始。或者有不领悟此理,乃在春夏温热病,而求浮紧之脉,不也太疏忽了吗。(出自《温热病脉论》)
(七)热病就是伏寒。那冬天受寒邪侵袭,发于春天为温病,发于夏天为热病。为什么它发于春天,这个发于夏天呢?盖因为感受的轻重不同,人的强弱也不同,而触发也不同,有因饥饱力役者,有因房室劳伤者,所以春时虽然施行风木的时令,使气血不致大亏,感触也有先后,不立即发作。到了夏天则阳气尽泄,火令大行,正值湿土寄旺,那时邪气哪里肯潜伏?所以其发源皆自少阴经,热病由出的途径自阳明经,温病由出的途径自少阳经,虽然所合的经脉不一,但不离乎阳明经、少阳经的,各因时令之气也。且日子既长,发热越炽盛,这就是张仲景所以用石膏辛凉清胃热,以知母荡涤肾火,用甘草、粳米维持中气的缘故。名为汤曰:白虎者,白属金属凉;风从虎且猛。人逢闷热烦躁无可奈何之际,忽然狂风荐至,偃草扬波,火轮火树,不顿成清凉世界而称快乎。(出自《夏热病论》)
(1) Yu Jiayan's *Shanglun Pian* (Treatise on Re-examination), elucidating Zhang Zhongjing's *Shanghan Lun* (Treatise on Cold Damage Disorders), is exceptionally clear. *Yimen Falü* (Medical Laws and Guidelines) elucidating *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet), is exceptionally coherent. Although both have foundational texts as their basis, due to their broad learning and expanded talent, agile minds, and ancient-style writing, they each achieved their own subtleties. Regarding the discussion on warm diseases in *Shanglun*, it states: comprehending the purport of *Huangdi Neijing* (Yellow Emperor's Inner Canon) to reveal secrets not expounded by Zhang Zhongjing. It also claims that Zhang Zhongjing was brief in treating warm diseases, and his methods were mixed into those for treating cold damage disorders, based on the statement in *Huangdi Neijing*: "If one is injured by cold in winter, one will surely suffer from warm diseases in spring"; this is a major principle. "If one fails to store essence in winter, one will surely suffer from warm diseases in spring"; this is another major principle. "If one is injured by cold in winter, and also fails to store essence in winter, leading to simultaneous onset of disease in spring"; this is yet another major principle. Following these three principles to discuss warm syndromes and detail their treatment, and then aligning them with Zhang Zhongjing's principles of the Three Yang and Three Yin meridians, ensuring consistency between past and present. Generally, being injured by cold in winter means evil qi hides in the skin and muscles, which refers to evil invading the Three Yang meridians; failing to store essence in winter means evil enters the Yin viscera, which refers to evil invading the Three Yin meridians. Yu Jiayan's argument is thus. I argue that warm diseases do not have a distinction of Yin and Yang. Why? Because in winter, warm air first opens the human couli (skin texture and pores), allowing cold to invade. As the saying goes, where evil gathers, Qi must be deficient. Only those who fail to store essence become deficient. Deficiency leads to cold damaging the meridians; the meridian damaged must be Shaoyin, because the root of Shaoyin is originally deficient. However, the initial injury is slight, and during winter, water is dominant and its power is strong. Slight evil dares not resist, but like someone sleeping beside you, how can others rest? It only obstructs vitality and secretly consumes essence. When spring arrives, wood energy grows strongly, but water is insufficient to nourish it. Initially, warmth appears in spring; wood is prosperous while water is deficient, causing stagnant Qi to ascend and flourish, fire burns fiercely, resulting in warm disease. What was harmed is cold; what manifests is warm disease; what lies latent is Shaoyin; what erupts is Shaoyang. Therefore, the disease involves Yang but not Yin, and medication must use cold natured herbs while avoiding heat natured ones. Huangqin Tang (Coptis Decoction) is the primary treatment. Thus, Yu Jiayan's discussion on warm diseases includes both Yin and Yang, similar to how cold damage affecting the Three Yin meridians may use acrid-warm herbs. I say no, absolutely not. (From *Chunwen Binglun*)
(2) "Injured by cold in winter, suffering from warm disease in spring" refers to the original pathogen being cold. Wang Shuhe stated: After the Beginning of Spring solar term, if there is no sudden severe cold or ice/snow, and someone suffers from high fever, this belongs to the outward emission of Yang Qi in spring, where latent cold from winter transforms into warm disease. This clearly indicates cold. The character "transform" (bian) is excellent. Yu Jiayan disagrees, but I firmly agree. Cold qi lying latent internally, after long stagnation, erupts and naturally becomes heat. Shanghan (cold damage) involves cold temporarily invading the Ying (nutritive) level, soon becoming high heat. How much more so after a long delay? Becoming heat is natural logic. Not using the word "transform" fails to instruct the world. But why speak of "warm" instead of "heat"? Because spring enacts the command of warmth. As Li Mingzhi said: Being injured by cold in winter means winter enacts the command of spring. Warmth occurs when it should be cold; fire prevails while water is deficient. Since water is deficient, the element controlled by water (earth) acts recklessly, making earth excessive. The element produced by earth (metal) suffers disease, making metal deficient. The element controlling earth (wood) insults it, making wood excessive. Wood and earth combine virtue, damp-heat assist each other, thus forming warm disease. However, according to Li Mingzhi, this describes contracting illness immediately upon feeling warm in winter, not latent cold, nor transformation. Otherwise, the syndrome of "Winter Warmth" would not exist. Since Winter Warmth exists, there is this climate and this syndrome. Using his words to fully understand Winter Warmth allows for immortal theories; discussing Spring Warmth would mislead future generations. The Classic says: Violating winter Qi causes Shaoyin not to store. If not storing, cold evil enters, injuring skin and muscles, lying latent in bone marrow. One realizes winter is the time for storing essence. Only by violating winter Qi does Shaoyin Jing Qi fail to close, encountering unseasonal warmth, causing opening and leakage. Suddenly returning severe cold inevitably causes injury. Thus, the injured party is still cold evil. Because previously opened by warmth, it seems to prefer cold, and the injury is slight, so it does not manifest immediately but lies latent in Shaoyin. Why does it not manifest in winter but in spring? Precisely because water is prosperous in winter, evil lies latent in the meridians, bowing down不敢 resisting. Internally stagnant for a long time, it naturally becomes heat. Upon entering spring commands, opening couli, Yang Qi leaks out, Kidney Water is internally deficient. In the three months of spring, wood generates. Who encourages? Who nourishes? With the source of generation exhausted, how can wood grow? What remains in the body is warmth. With seasonal strong wood growth, it becomes warm disease. Therefore, I consider his theory of winter warmth contraction incorrect, while this theory of winter latent cold is most precise. My nature is clumsy; how dare I debate sages? I merely believe this way avoids contradiction with Winter Warmth, and aligns with Zhang Zhongjing tracing warm/heat diseases to their origin, often citing the purport of cold damage, without deviation. (From *Chunwen Binglun*)
(3) A disciple asked: The injury is by cold, why does it result in warm disease? Answer: Is Shanghan not a disease of cold? Then why is there heat? Cold stagnant in the Ying level becomes high heat in one or two days. How much more so after lying latent internally for dozens of days? If evil injures muscles, how does it enter the Shaoyin Meridian? Only by failing to store essence does Shaoyin disease first occur; thus the injured evil is in Shaoyin. Spring belongs to Wood, emitting from within. Regardless of concurrent Taiyang or Yangming, it always passes through Shaoyang. Why? Because Shaoyang enacts the spring command. Yet since it originates from Shaoyin, why does Zhang Zhongjing specifically mention Taiyang disease? Because Taiyang and Shaoyin are exterior-interior pairs; thus fever presents as Taiyang disease. Saying "no aversion to cold" clearly indicates no exterior syndrome; thus heat emerges from within, without external evil stagnation. However, Zhang Zhongjing mentions Tai-Shao combined disease, seeing fever without aversion to cold, or accompanied by deafness and hypochondriac fullness. Mentioning Three-Yang combined disease, because large pulse belongs to Yangming, and excessive sleep indicates heat gathering in the Gallbladder. No specific method is stated, generally using Huangqin Tang as the main treatment. Yet Yu Jiayan states: There are cases where releasing the exterior three or five times fails to remove exterior symptoms; purging the interior three or five times fails to remove interior symptoms. Believing it is in the exterior, yet seeming in the interior; believing it is in the interior, yet seeming in the exterior. This resembles plague syndromes, contracted from heaven, earth, and human dampness, heat, corpse qi, and evil entering mouth/nose, confusing the Sanjiao. It has nothing to do with Spring Warmth. I mention this to dispel confusion among later learners. (From *Chunwen Binglun*)
(4) A disciple asked again: Does Spring Warmth occasionally present with one or two exterior symptoms? Answer: Yes. Diseases of latent Qi, although contracted in winter, how can we guarantee wind evil does not attack humans when latent Qi is about to erupt but has not yet done so? If concurrent with external contraction, there must first be headache, or aversion to cold followed by persistent fever. This is new evil drawing out old evil. Or alternating chills and fever, headache with vomiting, followed by whole-body high fever after slight improvement. This indicates righteous Qi is deficient again, and latent eruption is heavier. In summary, without exterior symptoms, Huangqin Tang is the main treatment. With concurrent external contraction, one must add Chaihu (Bupleurum) or lightly resolve using herbs from the relevant meridian. Sweating therapy is definitely not indicated. Thus Zhang Zhongjing said: After sweating, if the body burns hot, it is named Fengwen (Wind-Warmth). This warns against mistakenly using acrid-warm drugs, which acridly disperse and plunder Yin, while increasing heat to aid Yang, causing heat to blaze further, pulses all floating, leading to such critical syndromes. Along with warnings against mistaken purgation and moxibustion/fire therapy, apart from Huangqin Tang, there is no other treatment method. (From *Chunwen Binglun*)
(5) Pulses of warm disease and heat disease may appear floating and tight. This is due to secondary contraction of violent cold. Cold evil binds externally, heat evil knots internally, hence the pulse is tense externally and surging internally. Or, if one does not recognize pulse forms, seeing a wiry pulse and calling it tight, leading to reckless treatment. Pulses that are vigorous and forceful often accompany wiriness. How can one mistake it for tight and wrongly assume cold? The pulse of warm-heat diseases mostly resides in the muscle layer and is not very floating. Moreover, the right hand pulse is often stronger than the left, truly due to internal stagnation. If the left hand pulse is strong or floating, there must be secondary contraction of wind-cold; otherwise, it is not a warm-heat disease, but simply unseasonal violent cold. (From *Wenre Bing Mailun*)
(6) Warm-heat diseases also sometimes show exterior symptoms first, followed by interior symptoms. Stagnation spreads from inside to outside. When heat stagnates in the couli, if acrid-cool dispersants are not used, evil cannot vent outward, returning inward to form syndromes suitable for purgation. This differs from Shanghan which starts from the exterior. Those who do not comprehend this logic, seeking floating-tight pulses in spring-summer warm-heat diseases, are indeed negligent. (From *Wenre Bing Mailun*)
(7) Heat disease is latent cold. Injury by cold in winter erupts in spring as warm disease, and in summer as heat disease. Why does it erupt in spring for one and summer for the other? Because the severity of infection differs, human strength varies, and triggers differ. Some are triggered by hunger/fullness or labor, some by sexual exhaustion. Thus, although spring enacts the wind-wood command, preventing massive depletion of Qi and blood, contact has timing differences, so it does not erupt immediately. By summer, Yang Qi is fully exhausted, fire command dominates, coinciding with the flourishing of damp-earth. At that time, how could evil lie latent? Its source originates from Shaoyin. The pathway for heat disease exits via Yangming; the pathway for warm disease exits via Shaoyang. Although the involved meridians vary, they do not depart from Yangming and Shaoyang, depending on the seasonal Qi. Furthermore, the longer the duration, the fiercer the heat. This is why Zhang Zhongjing uses Shigao (Gypsum) to acridly-cool stomach heat, Zhimu (Anemarrhena) to cleanse kidney fire, and Gancao (Licorice) plus Jingsmi (Rice) to maintain Middle Qi. Named Baihu Tang (White Tiger Decoction): White belongs to Metal and coolness; wind comes from the tiger and is fierce. When people face stifling heat and irritability helplessly, suddenly a fierce wind blows, bending grass and waving waves. Fire wheels and fire trees instantly turn into a cool world, bringing relief. (From *Xiare Binglun*)