热病衡正
——对温病派理论实践的再认识
柴中元·著
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姜春华教授序
柴君中元近以其所著《热病衡正》一书，问序于余，余乃序曰：柴君学术思想主张百家争鸣，反对一家独霸，有感于医坛为叶天士学派所独占垂二百年，近且弥漫全国，医学院校悉尊叶氏为宗。一若医学之发展至叶氏为极，又若叶氏唯一正确无误，苟不破除此种思想，学术难期进步。余极韪其言。叶天士《温热论》起首曰“温邪上受，首先犯肺，逆传心包"，系误解明人袁体安之论所致，袁氏本谓四时之邪，各有所犯，春曰风温首先犯肺，夏秋冬之邪即各有所犯，不必上受犯肺，袁氏立辛凉轻剂，亦以其在上之温邪，非泛指四时之病，叶氏误为泛治一切温热之法，此所以流毒甚广，今柴君广泛搜罗温热伤寒之论为《热病衡正》，使叶氏之学与各家之学并列，衡而正之，俾从事于此者得正确之途径，有助于人民健康，喜而为之序，如上。
上海第一医学院姜春华
时在一九八四年六月
熊寥笙研究员序
柴君中元，医中英俊，敏而好学，不耻下问。连年以来，所著《景岳新方辨》、《治肾研究》两书，曾各方徵求意见，已先后问世，颇得读者好评。今岁又辑近代各家论温学说成集，参以己意，颜曰《热病衡正》。予读之而喜曰：寒温学说之争，晦塞二千余年，群言淆乱，而能衡之以正，言人所未言，非具真知灼见，曷克臻此，岐黄仲景之学，而今而后，可大白于天下矣！新著书出，必将促进百家争鸣，振兴中医，有厚望焉，故乐为之序以告读者。
重庆市中医研究所
八旬老朽熊寥笙
一九八四年六月十日于渝州寂庐
王绪鳌副厅长序
科学的进步，在于学术的繁荣；学术的繁荣，决于学术的民主。只要存在不同的学术观点，就必产生不同的学术流派。面不同流派之间的学术争鸣，活跃了学术气氛，推动了医学科学的发展。春秋战国时代的诸子蠡起，百家争鸣，曾促进了我国科学、文化的迅猛发展。金元时代，刘河间、李东垣，张子和、朱丹溪四大家的学术争鸣，对明清医学的发展，也起了巨大的影响。百家争鸣的延续，对更新更完整的医学理论和医学流派的产生，起着推动作用，它是科学发展的动力，也是促使医学向前迈进的一个重要条件。
任何学科的每一个成就，都受着时代的局限，不可能完美无缺，即便象盛极一时的明清温病学派，我们在看到其学术上重要成就的同时，也不能忽视了所存在的某些缺点与不足之处。运用辩证唯物主义一分为二的观点，取其精华，去其糟粕，批判地继承，这是我们对待祖国医学遗产所应树立的正确立场。在学术上，必须提倡百家争鸣，以理服人，以实践检验真理，要通过讨论、评议、分析、探索，来辨清是非，以达到提高中医学术水平之目的。一切漫骂式的贬斥诟议，出奴入主的门户之见，党同伐异的宗派思想，割断历史，否定一切的错误观点，决不能代替真正的学术争鸣，也不能促进中医学术勺向前发展。
今夏，有幸得览柴中元同志新著《热病衡正》，深感柴君深精医理，富有实学，特别对感证，独具卓识，颇有新意。是书远绍旁搜，采撷前人之说，钩元提要，畅抒作者之见，针对清代叶天士等温病学派进行了广泛的抨击，文笔犀利，见解新颖，这对促进学术争鸣，活跃学术空气，无疑是有所帮助的。
近百余年来，我国医坛上，确实是叶派的温热学说，占据了重要地位，附和通论的多，随人喧喝者众，针砭时弊的少，要求变革者鲜，对叶派持不同意见的学术观点，已渐罕为人知。作者抱着“促进百家争鸣有小补，活跃学术空气起作用。的目的，采撷陆九芝、恽铁樵等诸家学说，或介绍，或评议，或引发，或探索，实能启发后学，广开思路，足发前人之窗奥。余自愧学识谫陋，于伤寒、温病学说一知半解，得读是书，耳目为之一新，获益非浅。是书对进一步研究外感热病，研究伤寒、温病的源流、发生，发展及其相互关系，都有一定参考价值。作者这种整理祖国医学的方法，对促进中医学出发展，无疑是有积极作用的。读后有见如上，遂书之以为序。
古越王绪鳌
一九八四年七月于杭州
自序
诚如谢诵穆氏所说：“温病学说之派别极多，不仅叶吴等数家而已。古代发挥温病之学说，多有在叶吴之外者，叶吴之温病，不过温病学说之一部分，尚不足为全体温病学说之代表。”但近人在谈及清后中医之于外感热病时，开口叶、薛，闭口吴，王，竟好象只存在叶吴一派！
历史证明，要推动科学事业的发展，宜“百家争鸣”，忌“独尊儒术”。无论何时何地何一领域，凡由一家一派之学长期在学术上占统治地位，弊病极多。中医学自不例外，“百家争鸣"，则医道中兴；“独尊儒术"，则思想僵化，这是必然的规律。然叶派学说之几乎主宰中医对外感热病的研究，迄今已垂二百年！曾有人指出：由于叶派长期宰据医坛，时医习用轻清而不问治疗成绩之流弊，百余年前，就已无形中蔚为风气，睹九芝正因目击其祸，才奋笔著《世补斋医书》，文词虽不免偏激，实为救时之良药。也有人认为，时医误治屡屡，覆辙相寻滔滔，学术空气沉闷，学术思想僵化，叶派末流之弊，早已遗祸无穷。当然，这类说法，在叶派中人，则坚决否认，且视为攻讦，故激烈反对。但这至少已说明，围绕叶派的温热之学，评价不同，有争论，这是客观存在。
近三十年中，“双百”方针，一直提倡，但抨击叶派学说的医著，绝少重梓。抨击叶派学说之医文，难得一见。加上现在统一作为全国高等医药院校教材的《温病学》又一以叶吴之学为尊等原因。抨击叶派医家的学术观点，已日渐为后来者所罕知。中医界对此熟视无睹，竞让“口头上倡‘百家争鸣’，实际上则‘独尊儒术’”，成为一种既成事实，这实在是很不应该的。
或许有人会说：1978年，《新医药学杂志》上明明就发表过姜春华教授评批叶氏之文，进行过讨论。但静水投石，不比激流奔腾。姜老之作，在全国各地医刊登载着大量叶派观点文章的历史条件下，实在只能说是风毛麟角，空谷足音，难以为百家争鸣，百花齐放之盛况征。何妨姜老文出，医界哗然，并不曾见谅于时医。故与其说此事体现了中医界贯彻“双百”方针的认真，到不如说此事反映出现在以叶派学说为医家正宗，以抨叶观点为左道旁门，这种思想，已是何等的牢固！
恽铁樵说；“温病伤寒之辨别，可谓是中医之症结，明清两朝之医学，只在此间题上磨旋，门户之见，谬说之兴，均由此起，著作汗牛充栋，而医学晦盲否塞。”余谓近代医史之状况，并不完全如此，恽氏之言，出于愤慨。但从中可以肯定一点：在恽氏之时，就已有不少医家不满现状，要求变革，希望在外感热病学方面，荡除错误理论，发掘前人经验，去其糟粕，取其精华，吸收新知，融汇贯通，开创新路子，取得新进展。恽氏学派猛烈地反击废止派，痛斥时弊，推崇经学，主张中西汇通，其目的就是为了振岐黄之坠绪以发扬光大之。
叶派学说，是一定时代的产物，不可能完美无缺，以今日之眼光视之，事实上缺憾不少，加之末流之弊，自然会招致要求变革医家的不满，所以继陆九芝之后，站在叶派学说对立面来研究外感热病的名家，曾一度风起云涌，大不乏人，他们著书立说，树帜坛坫，与叶吴诸家，各立门户，争相斗妍，从而掀起了著名的寒温之争。陆九芝、恽铁樵，祝味菊等这一批被今人统隶于伤寒派的医家，和柳宝怡等温热派医家，在“医以叶说为宗，而举世同风”的历史条件下，不附和通论，不因循流俗，针对叶派学说，各抒己见，进行驳辩，提出了不少独到的新见解，大大丰富了中医对外感热病之研究，也推动了百家争鸣的开展，这在中国近代医学史上，无疑起了积极的作用。惜近三十年中，由于上述原因，该派学者，常詖人诋为复古卫道、影响中医学发展的守旧派，他们的学术思想，由于受到不同程度的歪曲，已不复为后来者真正所了解。中医界现在“后继乏人，后继乏术”的严重局面，与这一问题有否关系，实很值得我们的深思。前人有诗云：“九州生气恃风雷，万马齐喑尤可哀；我劝天公重抖擞，不拘一格降人材。”余谓我中医界欲发奋自强，振兴崛起，为大发展开创祈局面，就必先“诸子蠡起，百家争鸣”，打破一家一派之学长期在学术上宰据医坛统治地位所造成的沉闷空气而后可。
过去伤寒学派中人，鉴于叶氏被人作为偶象来崇拜已久，又恶该派中人之推崇仲景，阳奉而阴违，故大都利用仲景之威望，通过阐明其学，来予之驳辩，来予以抨击。而叶派中人，对该派之抨击，则相当的反感，他们一方面加倍热烈地崇扬叶氏学说，一方面抓住该派中有些人崇尚经学，主张太过之小辫，责其“复古”，加以排斥。近则或谓叶派医著，亦为中医之经典，指谪其书，便是数典忘祖。余谓若必随俗浮沉，讳莫如深，避这“复古卫道”，“数典忘祖”的瓜田李下之嫌，则举世长此同调，禾稗概不予辨，则不独大不利于中医事业之兴旺，且遗误病人亦无穷。仲景、天士，于中国医学，固贡献卓著，其创新精神，尤足可贵，但我们只应以历史唯物主义观点，给予其一定的历史地位，决不能因此就拜倒于古人之脚下。须知迷信权威，因循守旧，固执偏见，狂妄自大，此为我中医事业发展之巨大隋性力，它一直妨碍着人们去探索真理、获得真知灼见。伟人不是圣人，经典并非天书，明见其学有瑕疵，为何缄口不许言！余深不满于此，且有见如上，故不揣学识谫陋，采撷前人之说，或介绍，或评议，或引发，或探索，畅述己见，纂辑成集，名曰《热病衡正》，冀醒来者之耳目，若此能于促进百家争鸣有小补，于活跃学术空气起作用，余即因此而不能见谅于时医，亦何辞焉！稿甫成，送呈国家科委中医组姜春华教授及重庆市中医研究所熊寥笙研究员审阅，其时，二老适均健康不佳，荷承二老分别在病中挥毫为小书写序，又承浙江省卫生厅王绪鳌副厅长拨冗写序，遂使小书添辉增色，并蒙县科协、县卫生局领导支持付梓，使此书得以较快与较多的读者见面，值此杀青之际，附志数言，一以记前辈领导之支持，一以示作者衷心之感谢！
上虞柴中元书于百官龙山之寓所
时在甲子年夏月
卷一医家医著介评抨击叶派学说医家之源流初探
中医对外感热病之研究，至逊清而大炽，彼时流派众多，其中以叶吴影响最大。该派在外感热病学方面，其刻意罗织，欲与仲景学说分庭抗礼之事实，无用讳言。正因为此，招致了不少治伤寒之学者的不满，他们认为叶派学说在理论上颇多疵谬，而治效亦并不可观，凭此欲与仲景学说相对抗，是狂妄。他们目击时弊，又因当时废止派大肆攻击《伤寒论》这一特定的历史条件，故针锋相对地提出了批评，进行了抨击，于是，就掀起了寒温之争。对学术发展来说，开展百家争鸣，各抒己见，这无疑是好事。本文拟对叶派学说有过异议的医家，寻源析流，略作探讨。但其中有些重要医家，如陆九芝等人，因另拟有专文介评，故本文述及时从略。读者可以参阅下文。
探源
一、抨击叶派之肇始发凡期
最早对叶氏学说进行评批者，为吴江徐大椿(1693-1771)。徐氏宇灵胎，又名大业，晚年隐居洄溪，故又号洄溪老人，与叶桂齐名，为清代著名医家。经验丰富，博学多才。著有《医学源流论》、《难经经释》、《神农本草经百种录》、《慎疾刍言》，《伤寒类方》、《兰台轨范》等多种。其治学具有批判精神。他除了著《医贯砭》，专门抨击赵氏之学外，对《外科正宗》及《临证指南》亦作了认真评点。其于指南一书，有褒有贬，虽贬多于褒，但议论持平，大致恰当，尚易为叶派中人所接受。此所以徐评之《临证指南》，在叶派医者主宰医坛之历史条件下，一直畅行，而转求无徐评者，反不易得也。
叶、徐二人同时，而徐氏年齿较晚。叶派中尝有人论徐氏之评指南，云其“虽有失理微词，不能掩其大醇。”这只是嫌其有些措词，未免对前辈有失礼敬，对评批则基本上持肯定态度。唯王孟英为维护叶氏学说尊严，曾反驳徐氏，将其评点之认为失当处，列条指出，但为数甚少，足见徐氏之评批，可挑剔处不多。
热病衡正
——对温病派理论实践的再认识
柴中元·著
--------------------------------------------------------------------------------
姜春华教授序
柴中元君最近将他所著的《热病衡正》一书，请我为其作序。我于是写道：柴君的学术思想主张百家争鸣，反对一家独霸。他感慨于医学界被叶天士学派独占近二百年，且目前弥漫全国，医学院校都尊奉叶氏为宗师。这仿佛意味着医学的发展在叶氏那里达到了极致，又似乎只有叶氏是唯一正确无误的。如果不破除这种思想，学术很难期望进步。我非常赞同他的观点。叶天士《温热论》开篇说“温邪上受，首先犯肺，逆传心包”，这是误解了明代袁体安的理论所致。袁氏原本说的是四季的邪气，各有侵犯的部位，春季的风温首先侵犯肺脏，夏、秋、冬的邪气则各自有不同的侵犯部位，不一定都是从上受而犯肺。袁氏创立辛凉轻剂（辛凉性质的轻清方剂），也是针对在上部的温邪，并非泛指治疗所有四时的疾病。叶氏误将其作为泛治一切温热病的方法，这就是流毒甚广的原因。如今柴君广泛搜集温热与伤寒的论述编成《热病衡正》，使叶氏之学与各家之学并列，加以衡量并纠正，让从事这方面工作的人得到正确的途径，有助于人民健康，我高兴地为此作序，如上所述。
上海第一医学院 姜春华
时在一九八四年六月
熊寥笙研究员序
柴中元君，是医学界的英俊人才，聪敏且好学，不以向地位低的人请教为耻。连年以来，他所著的《景岳新方辨》、《治肾研究》两本书，曾向各方征求过意见，已经先后出版，颇得读者好评。今年他又辑录近代各家关于温病的学说成集，参入自己的见解，命名为《热病衡正》。我读后高兴地说：寒温学说之争，晦暗阻塞了两千多年，群言淆乱，而能加以衡量并纠正，说出别人没说的话，如果不是具备真知灼见，怎么能达到这个境界？岐伯、黄帝和仲景的学问，从今以后，可以大白于天下了！新书问世，必将促进百家争鸣，振兴中医，对此寄予厚望，所以乐意为之作序以告知读者。
重庆市中医研究所
八旬老朽 熊寥笙
一九八四年六月十日于渝州寂庐
王绪鳌副厅长序
科学的进步，在于学术的繁荣；学术的繁荣，取决于学术的民主。只要存在不同的学术观点，就必然产生不同的学术流派。不同流派之间的学术争鸣，活跃了学术气氛，推动了医学科学的发展。春秋战国时代的诸子蜂起，百家争鸣，曾促进了我国科学、文化的迅猛发展。金元时代，刘河间、李东垣、张子和、朱丹溪四大家的学术争鸣，对明清医学的发展，也起了巨大的影响。百家争鸣的延续，对更新更完整的医学理论和医学流派的产生，起着推动作用，它是科学发展的动力，也是促使医学向前迈进的一个重要条件。
任何学科的每一个成就，都受着时代的局限，不可能完美无缺，即便像盛极一时的明清温病学派，我们在看到其学术上重要成就的同时，也不能忽视所存在的某些缺点与不足之处。运用辩证唯物主义一分为二的观点，取其精华，去其糟粕，批判地继承，这是我们对待祖国医学遗产所应树立的正确立场。在学术上，必须提倡百家争鸣，以理服人，以实践检验真理，要通过讨论、评议、分析、探索，来辨清是非，以达到提高中医学术水平之目的。一切漫骂式的贬斥诟议，出奴入主的门户之见，党同伐异的宗派思想，割断历史，否定一切的错误观点，决不能代替真正的学术争鸣，也不能促进中医学术的前进发展。
今夏，有幸读到柴中元同志的新著《热病衡正》，深感柴君深精医理，富有实学，特别对感证（外感热病的证候），独具卓识，颇有新意。是书远绍旁搜，采撷前人之说，钩元提要，畅抒作者之见，针对清代叶天士等温病学派进行了广泛的抨击，文笔犀利，见解新颖，这对促进学术争鸣，活跃学术空气，无疑是有所帮助的。
近百余年来，我国医坛上，确实是叶派的温热学说，占据了重要地位，附和通论的多，随人喧喝者众，针砭时弊的少，要求变革者鲜，对叶派持不同意见的学术观点，已渐罕为人知。作者抱着“促进百家争鸣有小补，活跃学术空气起作用”的目的，采撷陆九芝、恽铁樵等诸家学说，或介绍，或评议，或引发，或探索，实能启发后学，广开思路，足发前人之窗奥。我自愧学识浅陋，于伤寒、温病学说一知半解，得读是书，耳目为之一新，获益非浅。是书对进一步研究外感热病，研究伤寒、温病的源流、发生，发展及其相互关系，都有一定参考价值。作者这种整理祖国医学的方法，对促进中医学出发展，无疑是有积极作用的。读后有见如上，遂书之以为序。
古越 王绪鳌
一九八四年七月于杭州
自序
诚如谢诵穆氏所说：“温病学说之派别极多，不仅叶吴等数家而已。古代发挥温病之学说，多有在叶吴之外者，叶吴之温病，不过温病学说之一部分，尚不足为全体温病学说之代表。”但近人在谈及清后中医之于外感热病时，开口叶、薛，闭口吴，王，竟好象只存在叶吴一派！
历史证明，要推动科学事业的发展，宜“百家争鸣”，忌“独尊儒术”。无论何时何地何一领域，凡由一家一派之学长期在学术上占统治地位，弊病极多。中医学自不例外，“百家争鸣"，则医道中兴；“独尊儒术"，则思想僵化，这是必然的规律。然叶派学说之几乎主宰中医对外感热病的研究，迄今已垂二百年！曾有人指出：由于叶派长期宰据医坛，时医习用轻清而不问治疗成绩之流弊，百余年前，就已无形中蔚为风气，睹九芝正因目击其祸，才奋笔著《世补斋医书》，文词虽不免偏激，实为救时之良药。也有人认为，时医误治屡屡，覆辙相寻滔滔，学术空气沉闷，学术思想僵化，叶派末流之弊，早已遗祸无穷。当然，这类说法，在叶派中人，则坚决否认，且视为攻讦，故激烈反对。但这至少已说明，围绕叶派的温热之学，评价不同，有争论，这是客观存在。
近三十年中，“双百”方针，一直提倡，但抨击叶派学说的医著，绝少重梓。抨击叶派学说之医文，难得一见。加上现在统一作为全国高等医药院校教材的《温病学》又一以叶吴之学为尊等原因。抨击叶派医家的学术观点，已日渐为后来者所罕知。中医界对此熟视无睹，竞让“口头上倡‘百家争鸣’，实际上则‘独尊儒术’”，成为一种既成事实，这实在是很不应该的。
或许有人会说：1978年，《新医药学杂志》上明明就发表过姜春华教授评批叶氏之文，进行过讨论。但静水投石，不比激流奔腾。姜老之作，在全国各地医刊登载着大量叶派观点文章的历史条件下，实在只能说是风毛麟角，空谷足音，难以为百家争鸣，百花齐放之盛况征。何妨姜老文出，医界哗然，并不曾见谅于时医。故与其说此事体现了中医界贯彻“双百”方针的认真，到不如说此事反映出现在以叶派学说为医家正宗，以抨叶观点为左道旁门，这种思想，已是何等的牢固！
恽铁樵说；“温病伤寒之辨别，可谓是中医之症结，明清两朝之医学，只在此间题上磨旋，门户之见，谬说之兴，均由此起，著作汗牛充栋，而医学晦盲否塞。”余谓近代医史之状况，并不完全如此，恽氏之言，出于愤慨。但从中可以肯定一点：在恽氏之时，就已有不少医家不满现状，要求变革，希望在外感热病学方面，荡除错误理论，发掘前人经验，去其糟粕，取其精华，吸收新知，融汇贯通，开创新路子，取得新进展。恽氏学派猛烈地反击废止派，痛斥时弊，推崇经学，主张中西汇通，其目的就是为了振岐黄之坠绪以发扬光大之。
叶派学说，是一定时代的产物，不可能完美无缺，以今日之眼光视之，事实上缺憾不少，加之末流之弊，自然会招致要求变革医家的不满，所以继陆九芝之后，站在叶派学说对立面来研究外感热病的名家，曾一度风起云涌，大不乏人，他们著书立说，树帜坛坫，与叶吴诸家，各立门户，争相斗妍，从而掀起了著名的寒温之争。陆九芝、恽铁樵，祝味菊等这一批被今人统隶于伤寒派的医家，和柳宝怡等温热派医家，在“医以叶说为宗，而举世同风”的历史条件下，不附和通论，不因循流俗，针对叶派学说，各抒己见，进行驳辩，提出了不少独到的新见解，大大丰富了中医对外感热病之研究，也推动了百家争鸣的开展，这在中国近代医学史上，无疑起了积极的作用。惜近三十年中，由于上述原因，该派学者，常詖人诋为复古卫道、影响中医学发展的守旧派，他们的学术思想，由于受到不同程度的歪曲，已不复为后来者真正所了解。中医界现在“后继乏人，后继乏术”的严重局面，与这一问题有否关系，实很值得我们的深思。前人有诗云：“九州生气恃风雷，万马齐喑尤可哀；我劝天公重抖擞，不拘一格降人材。”余谓我中医界欲发奋自强，振兴崛起，为大发展开创祈局面，就必先“诸子蠡起，百家争鸣”，打破一家一派之学长期在学术上宰据医坛统治地位所造成的沉闷空气而后可。
过去伤寒学派中人，鉴于叶氏被人作为偶象来崇拜已久，又恶该派中人之推崇仲景，阳奉而阴违，故大都利用仲景之威望，通过阐明其学，来予之驳辩，来予以抨击。而叶派中人，对该派之抨击，则相当的反感，他们一方面加倍热烈地崇扬叶氏学说，一方面抓住该派中有些人崇尚经学，主张太过之小辫，责其“复古”，加以排斥。近则或谓叶派医著，亦为中医之经典，指谪其书，便是数典忘祖。余谓若必随俗浮沉，讳莫如深，避这“复古卫道”，“数典忘祖”的瓜田李下之嫌，则举世长此同调，禾稗概不予辨，则不独大不利于中医事业之兴旺，且遗误病人亦无穷。仲景、天士，于中国医学，固贡献卓著，其创新精神，尤足可贵，但我们只应以历史唯物主义观点，给予其一定的历史地位，决不能因此就拜倒于古人之脚下。须知迷信权威，因循守旧，固执偏见，狂妄自大，此为我中医事业发展之巨大隋性力，它一直妨碍着人们去探索真理、获得真知灼见。伟人不是圣人，经典并非天书，明见其学有瑕疵，为何缄口不许言！余深不满于此，且有见如上，故不揣学识谫陋，采撷前人之说，或介绍，或评议，或引发，或探索，畅述己见，纂辑成集，名曰《热病衡正》，冀醒来者之耳目，若此能于促进百家争鸣有小补，于活跃学术空气起作用，余即因此而不能见谅于时医，亦何辞焉！稿甫成，送呈国家科委中医组姜春华教授及重庆市中医研究所熊寥笙研究员审阅，其时，二老适均健康不佳，荷承二老分别在病中挥毫为小书写序，又承浙江省卫生厅王绪鳌副厅长拨冗写序，遂使小书添辉增色，并蒙县科协、县卫生局领导支持付梓，使此书得以较快与较多的读者见面，值此杀青之际，附志数言，一以记前辈领导之支持，一以示作者衷心之感谢！
上虞柴中元书于百官龙山之寓所
时在甲子年夏月
卷一医家医著介评抨击叶派学说医家之源流初探
中医对外感热病之研究，至逊清而大炽，彼时流派众多，其中以叶吴影响最大。该派在外感热病学方面，其刻意罗织，欲与仲景学说分庭抗礼之事实，无用讳言。正因为此，招致了不少治伤寒之学者的不满，他们认为叶派学说在理论上颇多疵谬，而治效亦并不可观，凭此欲与仲景学说相对抗，是狂妄。他们目击时弊，又因当时废止派大肆攻击《伤寒论》这一特定的历史条件，故针锋相对地提出了批评，进行了抨击，于是，就掀起了寒温之争。对学术发展来说，开展百家争鸣，各抒己见，这无疑是好事。本文拟对叶派学说有过异议的医家，寻源析流，略作探讨。但其中有些重要医家，如陆九芝等人，因另拟有专文介评，故本文述及时从略。读者可以参阅下文。
探源
一、抨击叶派之肇始发凡期
最早对叶氏学说进行评批者，为吴江徐大椿(1693-1771)。徐氏宇灵胎，又名大业，晚年隐居洄溪，故又号洄溪老人，与叶桂齐名，为清代著名医家。经验丰富，博学多才。著有《医学源流论》、《难经经释》、《神农本草经百种录》、《慎疾刍言》，《伤寒类方》、《兰台轨范》等多种。其治学具有批判精神。他除了著《医贯砭》，专门抨击赵氏之学外，对《外科正宗》及《临证指南》亦作了认真评点。其于指南一书，有褒有贬，虽贬多于褒，但议论持平，大致恰当，尚易为叶派中人所接受。此所以徐评之《临证指南》，在叶派医者主宰医坛之历史条件下，一直畅行，而转求无徐评者，反不易得也。
叶、徐二人同时，而徐氏年齿较晚。叶派中尝有人论徐氏之评指南，云其“虽有失理微词，不能掩其大醇。”这只是嫌其有些措词，未免对前辈有失礼敬，对评批则基本上持肯定态度。唯王孟英为维护叶氏学说尊严，曾反驳徐氏，将其评点之认为失当处，列条指出，但为数甚少，足见徐氏之评批，可挑剔处不多。
Thermal Disease Balanced and Corrected
— A Re-examination of the Theory and Practice of the Warm Disease School
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Preface by Professor Jiang Chunhua
Mr. Chai Zhongyuan recently asked me to write a preface for his book *Thermal Disease Balanced and Corrected*. I therefore wrote: Mr. Chai's academic thought advocates "a hundred schools of thought contending," opposing the hegemony of a single school. He is concerned that the medical field has been dominated by the Ye Tianshi (Ye Gui) school for nearly two centuries, and currently permeates the whole country, with medical colleges and universities revering Ye as their ancestor. It seems as if the development of medicine reached its peak with Ye, and that only Ye is uniquely correct and error-free. If this mindset is not broken through, academic progress is unlikely. I highly agree with his words. The opening of Ye Tianshi's *Treatise on Warm Pathogens* states, "Warm pathogens enter from above, first attacking the Lung; in severe cases, they reverse-transmit to the Pericardium." This resulted from a misunderstanding of the theory of Yuan Ti'an from the Ming Dynasty. Yuan originally stated that pathogens of the four seasons attack specific areas: Wind-Warmth in spring first attacks the Lung, while pathogens in summer, autumn, and winter have their respective targets and do not necessarily enter from above to attack the Lung. Yuan established mild acrid-cool formulas (light and clear formulas with acrid-cool properties) specifically for warm pathogens located in the upper body, not as a general method for treating all seasonal diseases. Ye mistakenly treated it as a universal method for all warm diseases, which is why its harmful influence spread widely. Today, Mr. Chai has extensively collected discussions on both Warm Diseases and Cold Damage (*Shanghan*) to compile *Thermal Disease Balanced and Corrected*, placing Ye's learning alongside other schools' learning, measuring and correcting them. This provides those engaged in this field with the correct path, contributing to people's health. I am pleased to write this preface as follows.
First Medical College of Shanghai, Jiang Chunhua
June 1984
Preface by Researcher Xiong Liaosheng
Mr. Chai Zhongyuan is a distinguished talent in the medical field, intelligent and eager to learn, unashamed to ask questions of those with lower status. Over recent years, his books *Analysis of Jingyue's New Formulas* and *Research on Kidney Treatment* sought opinions from various parties and have been published successively, receiving high praise from readers. This year, he compiled a collection of modern scholars' theories on warm diseases, adding his own insights, titled *Thermal Disease Balanced and Corrected*. I read it with joy and said: The dispute between Cold Damage and Warm Disease theories has been obscure and blocked for over two thousand years, with confused voices everywhere. To balance and correct it, and to say what others have not said, requires true knowledge and penetrating insight. Otherwise, how could one achieve this? The teachings of Qibo, Huangdi, and Zhang Zhongjing can now be made clear to the world! The publication of this new book will surely promote the contention of a hundred schools and revitalize Traditional Chinese Medicine (TCM). I have high hopes for it, so I happily write this preface to inform readers.
Chongqing Institute of Traditional Chinese Medicine
The eighty-year-old Xiong Liaosheng
June 10, 1984, at Jilu, Yuzhou
Preface by Deputy Director Wang Xu'ao
Scientific progress lies in academic prosperity; academic prosperity depends on academic democracy. As long as different academic viewpoints exist, different academic schools must arise. Academic contention among different schools enlivens the academic atmosphere and promotes the development of medical science. The rise of philosophers during the Spring and Autumn and Warring States periods, and the contention of a hundred schools, promoted the rapid development of China's science and culture. In the Jin and Yuan dynasties, the academic contention among Liu Hejian, Li Dongyuan, Zhang Zihe, and Zhu Danxi had a huge impact on the development of medicine in the Ming and Qing dynasties. The continuation of the contention of a hundred schools promotes the emergence of updated and more complete medical theories and schools; it is the driving force of scientific development and an important condition for medicine to move forward.
Every achievement in any discipline is limited by its era and cannot be perfect. Even for the Warm Disease school of the Ming and Qing dynasties, which was once extremely prosperous, while we see its important academic achievements, we must not ignore certain shortcomings and deficiencies. Applying the dialectical materialist viewpoint of dividing things into two aspects, taking the essence and discarding the dross, and inheriting critically, is the correct stance we should adopt towards our motherland's medical heritage. Academically, we must advocate the contention of a hundred schools, convince people with reason, and test truth with practice. Through discussion, evaluation, analysis, and exploration, we can distinguish right from wrong to achieve the goal of improving the academic level of TCM. All abusive criticism, sectarian views of "masters and slaves," factional thoughts of supporting one's own side and attacking others, historical nihilism, and erroneous viewpoints denying everything absolutely cannot replace true academic contention nor promote the forward development of TCM academia.
This summer, I was fortunate to read Comrade Chai Zhongyuan's new book *Thermal Disease Balanced and Corrected*. I deeply feel that Mr. Chai has profound medical knowledge and substantial practical experience. Particularly regarding exogenous febrile syndromes (Zheng), he has unique insights and novel ideas. The book traces back and searches broadly, collecting previous scholars' theories, extracting key points, and freely expressing the author's views. It extensively criticizes the Warm Disease school, such as Ye Tianshi in the Qing Dynasty. The writing is sharp, and the insights are novel, which undoubtedly helps promote academic contention and enliven the academic atmosphere.
For nearly a century, the Warm Disease theory of the Ye school indeed occupied an important position in China's medical field. There were many who echoed common theories and many who followed others' clamor, but few who criticized current evils or demanded change. Academic viewpoints holding different opinions from the Ye school have gradually become unknown to later generations. The author, aiming to "make a small contribution to promoting the contention of a hundred schools and playing a role in enlivening the academic atmosphere," collected the theories of Lu Jiuzhi, Yun Tieqiao, and others. Through introduction, evaluation, inspiration, and exploration, it truly inspires students, broadens horizons, and reveals the secrets of predecessors. I shamefully admit my shallow knowledge and half-understanding of Cold Damage and Warm Disease theories. Reading this book refreshed my mind and ears, and I benefited greatly. This book has certain reference value for further studying exogenous febrile diseases, the origins, occurrence, development, and interrelationships of Cold Damage and Warm Diseases. The author's method of organizing the motherland's medical heritage undoubtedly plays a positive role in promoting the development of TCM. Having these views after reading, I wrote this preface.
Guyue Wang Xu'ao
July 1984, Hangzhou
Self-Preface
As Xie Songmu said: "There are many sects in Warm Disease theory, not just a few families like Ye and Wu. Ancient theories expounding on Warm Diseases often existed outside Ye and Wu. The Warm Diseases of Ye and Wu are merely a part of Warm Disease theory and are insufficient to represent the entirety of Warm Disease theory." Yet, when modern people discuss post-Qing dynasty TCM regarding exogenous febrile diseases, they open with Ye and Xue, and close with Wu and Wang, as if only the Ye-Wu school exists!
History proves that to promote the development of scientific undertakings, one should advocate "the contention of a hundred schools" and avoid "revering only Confucianism." Whenever and wherever, in any field, if the study of one family or school occupies a ruling position academically for a long time, there are many drawbacks. TCM is no exception. "Contention of a hundred schools" leads to the revival of medical arts; "revering only Confucianism" leads to ideological rigidity. This is an inevitable law. However, the Ye school's theory has almost dominated TCM research on exogenous febrile diseases for nearly two centuries! Some have pointed out: Due to the Ye school's long-term dominance of the medical field, contemporary physicians habitually used light and clear methods without regard for treatment results. This drawback became an invisible trend over a hundred years ago. Lu Jiuzhi, witnessing this disaster, vigorously wrote *Shibu Zhai Yi Shu*. Although his language may be somewhat extreme, it is truly a good medicine for saving the times. Others believe that contemporary physicians' frequent misdiagnoses and repeated mistakes, along with a stagnant academic atmosphere and rigid academic thought, show that the drawbacks of the late Ye school have already caused infinite harm. Of course, people within the Ye school firmly deny such statements, viewing them as attacks, and thus oppose them fiercely. But this at least shows that evaluations of the Ye school's warm disease theory differ, and disputes exist, which is an objective reality.
In the past thirty years, the "Two Hundred Flowers" policy has always been advocated, but medical works criticizing the Ye school are rarely reprinted. Medical articles criticizing the Ye school are hard to come by. Coupled with the fact that the unified textbook *Warm Diseases* for national higher medical institutions reveres Ye and Wu's learning, academic viewpoints criticizing Ye school physicians have gradually become unknown to later generations. The TCM community turns a blind eye to this, allowing "advocating 'contention of a hundred schools' verbally, but 'revering only Confucianism' in practice" to become an accomplished fact. This is truly undesirable.
Perhaps someone might say: In 1978, Professor Jiang Chunhua clearly published an article criticizing Ye's theory in the *New Medicine and Pharmacy Journal* and conducted discussions. But dropping a stone in still water is not like a raging torrent. Under the historical conditions where medical journals across the country published a large number of articles containing Ye school viewpoints, Professor Jiang's work can only be described as rare feathers and horns, footsteps in an empty valley. It is difficult to serve as evidence for the grand occasion of "contention of a hundred schools and blooming of a hundred flowers." When Professor Jiang's article came out, the medical world was abuzz, yet contemporary physicians did not forgive him. Therefore, rather than saying this event reflects the TCM community's seriousness in implementing the "Two Hundred Flowers" policy, it is better to say it reflects how solid the current ideology is that regards the Ye school theory as the orthodox lineage of physicians and views criticisms of Ye as heterodox paths!
Yun Tieqiao said: "The distinction between Warm Diseases and Cold Damage can be called the crux of TCM. The medicine of the Ming and Qing dynasties only spun around this issue. Sectarian views and the rise of erroneous theories all started here. Works filled libraries, yet medicine remained obscure and blocked." I believe the situation of modern medical history is not entirely so; Yun's words stem from indignation. But one thing can be confirmed from this: At Yun's time, many physicians were dissatisfied with the status quo and demanded change. They hoped to eradicate erroneous theories, excavate predecessors' experiences, discard the dross, take the essence, absorb new knowledge, integrate thoroughly, open new paths, and achieve new progress in the field of exogenous febrile diseases. Yun's school fiercely countered the abolitionists, severely criticized current evils, revered classical studies, and advocated the integration of Chinese and Western medicine. Their purpose was to revive the declining lineage of Qibo and Huangdi and carry it forward.
The Ye school theory is a product of a specific era and cannot be perfect. Viewed through today's eyes, in fact, there are many flaws. Plus the drawbacks of its late followers, it naturally attracts dissatisfaction from physicians demanding change. Thus, following Lu Jiuzhi, famous experts standing on the opposite side of the Ye school theory to study exogenous febrile diseases once surged like wind and clouds, with no lack of people. They wrote books and established theories, raised banners in academic circles, set up separate gates against Ye, Wu, and others, competing to show off their beauty, thereby igniting the famous Cold-Warm controversy. Physicians like Lu Jiuzhi, Yun Tieqiao, and Zhu Weiju, a batch of physicians collectively classified by modern people as belonging to the Cold Damage school, and Warm Disease physicians like Liu Baoyi, under the historical condition of "medicine takes Ye's theory as its ancestor, and the whole world follows the same style," did not echo common theories nor follow vulgar trends. Targeting the Ye school theory, each expressed their own views and refuted them, proposing many unique new insights. This greatly enriched TCM research on exogenous febrile diseases and also promoted the development of the contention of a hundred schools, which undoubtedly played a positive role in modern Chinese medical history. Unfortunately, in the past thirty years, due to the aforementioned reasons, scholars of this school were often slandered by others as conservative factions who defend old ways and hinder the development of TCM. Their academic thoughts, distorted to varying degrees, are no longer truly understood by later generations. Whether the serious situation of "lack of successors and skills" in the TCM community now is related to this problem is well worth our deep reflection. An ancient poet wrote: "The vitality of the nine provinces relies on wind and thunder; it is sad that ten thousand horses stand mute. I advise the Lord of Heaven to shake himself again and send down talents without sticking to one pattern." I believe that if our TCM community wants to strive for self-improvement, revitalize and rise, and create a new situation for great development, it must first "have philosophers rise and a hundred schools contend," breaking the stagnant air caused by one family or school occupying the ruling position in the medical field for a long time.
Physicians of the past Cold Damage school, seeing that Ye had been worshipped as an idol for a long time, and disliking that members of that school revered Zhongjing while outwardly complying but inwardly violating, mostly utilized Zhongjing's prestige. By elucidating his learning, they refuted and attacked them. Members of the Ye school, however, were quite sensitive to such attacks. On one hand, they enthusiastically praised Ye's theory even more; on the other hand, they seized upon the weak point of some members of the opposing school advocating classical studies and advocating excessive treatments, accusing them of "restoring the past" and excluding them. Recently, some have claimed that Ye school medical works are also classics of TCM, and criticizing their books is forgetting one's ancestors. I say that if one must float with the tide, keep silent, and avoid the suspicion of "defending old ways" and "forgetting ancestors," then the whole world will continue to sing in tune, unable to distinguish wheat from weeds. This would not only be greatly detrimental to the prosperity of TCM but also cause infinite harm to patients. Zhongjing and Tianshi certainly made outstanding contributions to Chinese medicine, and their innovative spirit is particularly valuable. However, we should only give them a certain historical status using a historical materialist viewpoint. We must not bow down to the feet of ancients because of this. We must know that worshipping authority, following old routines, adhering to prejudices, and being arrogant are huge inertial forces hindering the development of TCM. They have always prevented people from exploring truth and obtaining true insights. Great men are not saints, and classics are not heavenly books. If one clearly sees flaws in their learning, why remain silent and forbid speaking! I am deeply dissatisfied with this and have the views mentioned above. Therefore, not presuming my shallow knowledge, I collected previous scholars' theories, introduced, evaluated, inspired, and explored them, freely stating my own views, compiling them into a collection named *Thermal Disease Balanced and Corrected*. I hope to refresh the minds of future readers. If this can make a small contribution to promoting the contention of a hundred schools and play a role in enlivening the academic atmosphere, even if contemporary physicians do not forgive me for this, what excuse do I need! As soon as the manuscript was completed, it was sent to Professor Jiang Chunhua of the TCM Group of the State Science and Technology Commission and Researcher Xiong Liaosheng of the Chongqing Institute of TCM for review. At that time, both elders were in poor health. I am indebted to them for writing prefaces for this small book while ill. I am also grateful to Deputy Director Wang Xu'ao of the Zhejiang Provincial Health Department for taking time to write a preface. This added brilliance to the small book. With the support of the County Association for Science and Technology and the County Health Bureau leadership for printing, this book could meet more readers sooner. At this moment of completion, I attach a few words to record the support of senior leaders and to express the author's sincere gratitude!
Written by Chai Zhongyuan of Shangyu at his residence on Longshan, Baiguan
Summer of the Jiazi Year
Volume One: Introduction and Evaluation of Physicians and Medical Works; Initial Exploration of the Origins of Physicians Criticizing the Ye School Theory
TCM research on exogenous febrile diseases flourished greatly in the late Qing Dynasty. At that time, there were many schools, among which the Ye-Wu school had the greatest influence. It is unnecessary to hide the fact that this school deliberately constructed theories in the field of exogenous febrile diseases, desiring to stand shoulder-to-shoulder with Zhongjing's theory. Precisely because of this, it attracted the dissatisfaction of many scholars studying Cold Damage. They believed that the Ye school theory had many theoretical flaws and its therapeutic effects were not impressive. Relying on this to confront Zhongjing's theory was arrogant. Witnessing current evils, and given the specific historical condition at that time when abolitionists fiercely attacked *Treatise on Cold Damage*, they proposed counter-criticisms and launched attacks, thus igniting the Cold-Warm controversy. For academic development, carrying out the contention of a hundred schools and expressing views freely is undoubtedly a good thing. This article intends to trace the sources and analyze the flow of physicians who had objections to the Ye school theory, making a brief exploration. However, some important physicians, such as Lu Jiuzhi, have special articles dedicated to their introduction and evaluation, so this article briefly mentions them. Readers can refer to the following text.
Exploring the Sources
I. The Initial Period of Criticizing the Ye School
The earliest person to criticize Ye's theory was Xu Dachun (1693-1771) from Wujiang. Xu's courtesy name was Lingtai, also known as Daye. In his later years, he lived in seclusion at Huixi, hence his pseudonym Old Man of Huixi. He was famous alongside Ye Gui and was a renowned physician of the Qing Dynasty. He had rich experience and was knowledgeable and talented. He authored *Discussions on the Origins of Medicine*, *Commentary on the Classic of Difficult Issues*, *Record of Hundred Kinds of Shen Nong's Divine Farmer's Materia Medica*, *Cautious Words on Illness*, *Classification of Cold Damage Formulas*, and *Lantai Guideline*, among others. His scholarship possessed a critical spirit. Besides writing *Critique of Medical Continuity* to specifically attack Zhao's learning, he also carefully commented on *Orthodox Manual of External Diseases* and *Clinical Guide*. His commentary on the *Guide* contained both praise and criticism. Although criticism outweighed praise, his arguments were balanced and generally appropriate, making them acceptable to those within the Ye school. This is why Xu's commented *Clinical Guide* circulated widely under the historical condition where Ye school physicians dominated the medical field, while it was actually difficult to find copies without Xu's comments.
Ye and Xu were contemporaries, though Xu was younger. Someone within the Ye school discussed Xu's commentary on the *Guide*, saying it "although has minor irrational remarks, cannot cover its overall excellence." This merely complained about some wording, implying a lack of respect for seniors, but basically held a positive attitude towards the criticism. Only Wang Mengying, in order to maintain the dignity of Ye's theory, refuted Xu, listing items he considered inappropriate in the commentary. However, the number was very small, showing that there were few points in Xu's criticism that could be nitpicked.