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。
五脏生阳之气，始于肝木，木生火，火生土，土生金，金生水，水又生木，如是生生不息，则安健无病，
义详禀赋源流门首节矣。若邪伏于血气之中，必随生阳之气而动，动甚则病发。故其发也，随气流行，亦无定
处，所以《难经》言温病之脉，行在诸经，不知何经之动也，各随其经之所在而取之。故必观其现
证，方知其邪发于何经。今经文按生气之序，以列其证，故首列肝，次以心、脾、肺、肾也。如仲景所论，邪
之传变，亦无一定，正可与经参合互证，以明其理也。假如邪热由心经而发，则先不乐数日，即懊 也；热争
气逆，则卒然心痛而更烦闷；犯胃，则呕；心与小肠为表里，小肠经脉上头面，热邪由里出表，故头痛面赤；
腠理闭，则无汗。壬癸，水也，小肠为丙火，心为丁火，水克火，故壬癸则病甚；丙丁自旺，得大汗而解；如
其气逆，则壬癸水旺火绝而死矣。刺手少阴心、太阳小肠经，以泄其邪也。或曰∶此篇分五脏热病，岂无从外
传里之邪，而子尽解作伏邪内发可乎？余曰∶外邪传里，如前篇所云一日太阳受之，以至六日厥阴受之，已历
历详明矣。此篇云小便先黄，心先不乐数日，乃热等，皆先现里证，而后发病，岂非从内而发之伏邪乎？且前
篇论热邪所遗，当禁肉食，其义理已尽矣，乃又言凡病伤寒而成温者一节，本此篇之提纲也。其云肝热病以下，
即明先夏至日病温之证，温甚即为热病也。后人不审以《刺热》名篇，将提纲割列前篇，细观文义，实同赘辞。
盖篇首既言人之伤于寒也，则为病热，而义理发挥已尽，乃又言凡病伤寒而成温，岂非赘乎？可知其要义在先
夏至、后夏至两句，是专论伏邪随气候变病之理。由此观之，岂非为此篇之提纲，由后人割裂所误哉！更观此
篇下文总结云∶肝热病者，左颊先赤一节，教人乘伏邪未发，而见其色现即刺之，名曰治未病，岂不尤为可证
乎？且此言五脏之病，必得旺气时日，而邪始能由里达表，汗出而解，正与彼之自太阳传厥阴者，有一出一入
之分，故此特标肝热病、心热病，正明其邪由里出表，与彼之自表传里，为对待文本也。奈何读者、注者，皆
茫然不辨，亦疏忽甚矣。更有昧者，谓无伏邪发病之理，则于此等经义，不必与言矣。
患有心热病的人，先会有几天心情不愉快，随后出现发热；当邪热与正气相争时，会突然感到心痛、烦闷、容易呕吐、头痛、面色发红、无汗。在壬癸日（水旺之日）病情加重，在丙丁日（火旺之日）若出大汗则病愈；如果气机逆乱，则在壬癸日可能死亡。治疗应针刺手少阴心经和手太阳小肠经的穴位。
五脏生发阳气之气，始于肝木，木生火，火生土，土生金，金生水，水又生木，如此生生不息，身体就能安康无病，这一道理在《禀赋源流》章节开头已有详细说明。如果邪气潜伏在血气之中，必然随着生发阳气之气而变动，变动剧烈则疾病发作。所以它的发作，随着气机流行，也没有固定的位置，因此《难经》说温病的脉象，运行在各条经脉中，不知道是哪条经脉的气机在动，应当根据各经脉所在的位置来选取穴位治疗。所以必须观察其现存的证候，才能知道邪气是从哪条经脉发出的。现在这篇经文按照生气（五行相生）的顺序，来排列各种证候，所以首先列出肝病，其次是心、脾、肺、肾。正如张仲景所论述的，邪气的传变也没有一定规律，正可以与本经相互参照印证，以阐明其中的道理。假如邪热从心经发出，那么先心情不愉快几天，就是心中懊恼；热邪相争导致气机逆乱，就会突然心痛并且更加烦闷；邪气侵犯胃腑，就会呕吐；心与小肠互为表里，小肠经脉上行至头面，热邪由里出表，所以出现头痛、面色发红；腠理闭塞，所以无汗。壬癸属水，小肠属丙火，心属丁火，水克火，所以在壬癸日病情加重；丙丁属火且旺盛，通过出大汗而病解；如果气机逆乱，那么壬癸水旺而火绝，就会导致死亡。针刺手少阴心经和手太阳小肠经的穴位，是为了泄除邪气。有人问：这篇分别论述五脏热病，难道没有从外部传入内部的邪气，而你全都解释为伏邪从内部发出可以吗？我说：外邪传入内部，像前篇所说第一天太阳经受邪，直到第六天厥阴经受邪，已经详细明确地说明了。这篇说小便先发黄，心先心情不愉快几天，然后才发热等，都是先出现里证，然后才发病，这难道不是从内部发出的伏邪吗？而且前篇论述热邪遗留下来的情况，应当禁止吃肉类，其中的义理已经阐发尽了，却又说凡是患伤寒而变成温病的一段，这是本篇的提纲。其中说的肝热病以下，就是明确先夏至日患温病的证候，温病严重就成为热病。后人不加审察，因为篇名叫做《刺热》，将提纲割裂列在前篇，仔细观看文义，实在如同多余的言辞。既然篇首既说人受寒邪侵袭，就会得热病，而义理发挥已经尽致，却又说凡是患伤寒而变成温病，这难道不是多余的吗？可知其要义在于“先夏至”、“后夏至”两句，是专门论述伏邪随着气候变化而发病的道理。由此看来，这难道不是作为本篇的提纲，被后人割裂所造成的错误吗？再看本篇下文总结说：患肝热病的人，左脸颊先发红一节，教导人们趁着伏邪未发，看到面色显现就进行针刺治疗，这叫作“治未病”，这难道不是更有力的证明吗？况且这里所说的五脏之病，必须等到旺气的时日，邪气才能由里达表，出汗而病解，这与彼处所说的从太阳传到厥阴的情况，有一个由内出外、一个由外入内的区别，所以特别标举肝热病、心热病，正是为了说明邪气由里出表，与彼处所说的自表传里，形成对待的文本关系。奈何读者、注者，都茫然不能分辨，也太疏忽了。更有见识浅陋的人，认为没有伏邪发病的道理，那么对于这些经文义理，就不必与他们谈论了。
Patients suffering from Heart Heat Disease (Xin Re Bing) first experience several days of unhappiness, followed by fever. When heat struggles with righteous qi (Zheng Qi), sudden heart pain, irritability, frequent vomiting, headache, flushed face, and anhidrosis (absence of sweating) occur. The condition worsens on Ren-Gui days (days associated with Water), and if profuse sweating occurs on Bing-Ding days (days associated with Fire), the disease resolves. If qi mechanism becomes rebellious, death may ensue on Ren-Gui days. Treatment involves needling the Hand-Shaoyin (Heart) and Hand-Taiyang (Small Intestine) meridians.
The vitalizing yang qi of the five zang organs begins with Liver Wood; Wood generates Fire, Fire generates Earth, Earth generates Metal, Metal generates Water, and Water generates Wood again. This continuous cycle ensures health and absence of disease, a principle detailed in the opening section of the "Origin of Constitution" chapter. If pathogenic factors lie dormant within blood and qi, they inevitably move along with the vitalizing yang qi; when movement is vigorous, disease manifests. Thus, its manifestation follows the flow of qi without a fixed location. Therefore, the *Nan Jing* states that the pulse of warm diseases travels through various meridians, making it unclear which meridian's qi is moving; one should select points according to the location of each affected meridian. Hence, observing current symptoms is necessary to determine which meridian the pathogen originates from. This text arranges symptoms according to the sequence of generating qi (Wu Xing Sheng cycle), listing Liver disease first, followed by Heart, Spleen, Lung, and Kidney. As Zhang Zhongjing discussed, the transmission of pathogens also lacks a fixed pattern, which can be cross-referenced with this classic to clarify the principles. For instance, if pathogenic heat emerges from the Heart Meridian, the patient first feels unhappy for several days (manifesting as internal restlessness); heat struggle causing qi rebellion leads to sudden heart pain and increased irritability; invasion of the Stomach causes vomiting; since the Heart and Small Intestine are exterior-interiorly related, and the Small Intestine meridian ascends to the head and face, heat exiting from interior to exterior results in headache and flushed face; closed cou-li (pores) result in anhidrosis. Ren-Gui corresponds to Water; Small Intestine corresponds to Bing Fire, and Heart to Ding Fire. Since Water overcomes Fire, the condition worsens on Ren-Gui days. Bing-Ding correspond to Fire and are prosperous; profuse sweating leads to resolution. If qi rebels, prosperous Water extinguishes Fire, leading to death. Needling the Hand-Shaoyin Heart and Hand-Taiyang Small Intestine meridians aims to drain the pathogen. One might ask: This chapter divides heat diseases of the five zang organs; does this not include pathogens transmitted from exterior to interior? Can you explain them all as latent pathogens emerging from within? I reply: Exterior pathogens transmitting to interior were clearly described in the previous chapter, starting with Taiyang on day one up to Jueyin on day six. This chapter mentions yellow urine appearing first, unhappiness preceding fever, etc., indicating interior symptoms manifest before disease onset, proving these are latent pathogens emerging from within. Furthermore, the previous chapter concluded that meat should be avoided after residual heat, exhausting that logic. The statement "any cold damage becoming warm disease" serves as the outline for this chapter. The discussion following Liver Heat Disease clarifies warm diseases occurring before the Summer Solstice; severe warmth becomes heat disease. Later scholars, unaware of this, due to the chapter title "Needling Heat," separated the outline into the previous chapter. Careful reading shows this separation is redundant. Since the beginning already states that cold injury leads to heat disease, explaining the logic fully, repeating "cold damage becoming warm" is indeed redundant. The core meaning lies in "before Summer Solstice" and "after Summer Solstice," specifically discussing the principle of latent pathogens changing disease nature with climate. Thus, this was likely the original outline, corrupted by later fragmentation. Moreover, the summary at the end states: "For Liver Heat Disease, redness appears on the left cheek first..." teaching practitioners to needle upon seeing color changes before latent pathogens emerge, termed "treating disease before it arises." This further proves the point. Additionally, diseases of the five zang organs require prosperous qi times for pathogens to move from interior to exterior and resolve via sweating. This contrasts with the progression from Taiyang to Jueyin, representing an exit vs. entry distinction. Thus, highlighting Liver and Heart Heat Diseases clarifies pathogens moving from interior to exterior, contrasting with those moving from exterior to interior. Why do readers and commentators remain oblivious and negligent? Some ignorant individuals deny the existence of latent pathogen emergence; for such people, discussing these scriptural meanings is futile.