上古无疫疹，亦无痘，有之自汉始何也？盖因天
地开辟于子丑，人生于寅，斯时人禀清轻无为之性，茹毛饮血之品，内少七情六欲之戕，外无饮食浓味
之嗜，浑然一小天地，是以无疫亦无疹，及汉始有者，亦由天地大运主之。自汉迄今，天地大运，正行
少阳，即如仲夏，一日十二时论之，自子而丑、而寅、而卯、而辰，虽在暑天，人犹清爽，待交巳午，炎炎
之势，如火炽热。由此推之，疫疹之有于汉后者，可悟运气之使然也。但未经岐黄断论，后人纷纷，
但仿伤寒类推其治。即仲景所谓至春变温、夏变热、秋变湿，亦略而不察，且立言附和。有云瘟疫伤寒、瘟疹
伤寒、斑疹伤寒，甚至热病伤寒，抑知既曰伤寒，何以有瘟、有斑、有疹、有热？认症既讹，故立言也谬，
是以肆行发表攻里，多至不救。至河间清热解毒之论出，有高人之见，异人之识，其旨既微，其意甚远。
后人未广其说，而反以为偏。《冯氏锦囊》亦云∶斑疹不可妄为发表，此所谓大中至正之论，惜未畅明其旨，
后人何所适从？吴又可注《瘟疫论》，辨伤寒、瘟疫甚晰，如头痛、发热、恶寒，不可认为伤
寒表症，强发其汗，徒伤表气，热不退，又不可下，徒伤胃气。斯语已得其奥妙。奈何以瘟毒从鼻口而
入，不传于胃而传于膜原，此论似有语病。至用达原、三消、诸承气，犹有附会表里之意。惟熊恁昭热疫
之验，首用败毒散去其爪牙，继用桔梗汤，同为舟楫之剂，治胸膈、手六经邪热。以手、足少阳俱下膈
络胸中，三焦之气为火，同相火游行一身之表，膈与六经，乃至高之分，此药浮载，亦至高之剂，施于
无形之中，随高下而退胸膈及六经之热，确系妙法。予今采用其法，减去硝、黄，以疫乃无形之毒，难以
当其猛烈，重用石膏，直入戊己，先捣其窝巢之害，而十二经之患自易平矣，无不屡试屡验，故于平日所
用方法治验，详述于下，以俟高明者正之。
上古时代没有疫疹，也没有天花，这些疾病是从汉代才开始出现的，为什么呢？大概是因为天地开辟于子丑年（地支的前两位），人类诞生于寅年（地支的第三位）。在那个时候，人们禀赋的是清轻无为的本性，食用生肉饮血的食品，体内少有七情六欲的伤害，体外没有对浓烈厚味食物的嗜好，浑然如同一个小天地，因此没有疫病也没有疹病。到了汉代开始出现，也是由天地的大运所主导。从汉代到现在，天地的大运正值少阳阶段。就像仲夏时节，以一天十二个时辰来推算，从子时到丑时、寅时、卯时、辰时，虽然是在暑天，人还觉得清爽；等到进入巳时、午时，炎炎之势，像火一样炽热。由此推论，疫病和疹病在汉代之后出现，可以领悟这是运气使然。
但是，这一观点未经岐伯、黄帝（代指中医经典理论）断论，后人纷纷议论，只是模仿伤寒病的逻辑来类推治疗方法。即使是张仲景所说的“到了春天变为温病，夏天变为热病，秋天变为湿病”，也粗略地不加考察，并且立言附和。有人说瘟疫是伤寒、瘟疹是伤寒、斑疹是伤寒，甚至说热病是伤寒，哪里知道既然称为伤寒，怎么会有瘟、有斑、有疹、有热呢？因为辨证既已错误，所以立论也就谬误，于是肆意使用发表攻里的方法，导致病人多至无法救治。
直到刘河间提出清热解毒的理论，才有高人异士的见识，其旨意精微，意义深远。后人没有广泛发扬其学说，反而认为它偏颇。《冯氏锦囊》也说：斑疹不可妄用发表法，这可以说是大中至正的理论，可惜没有充分阐明其宗旨，后人无所适从。吴又可注解《瘟疫论》，辨析伤寒与瘟疫非常清晰，如头痛、发热、恶寒，不能认为是伤寒表证，强行发汗，只会徒然损伤表气；热不退，又不可攻下，只会徒然损伤胃气。这些话已经抓住了奥妙。奈何他认为瘟毒从鼻口而入，不传于胃而传于膜原，这个论点似乎有语病。至于使用达原饮、三消饮、各种承气汤，仍然有附会表里之意的嫌疑。
只有熊恁昭治疗热疫的经验，首先使用败毒散去除其爪牙（邪势），继而又用桔梗汤，两者同为舟楫之剂（载药上浮），治疗胸膈及手六经的邪热。因为手、足少阳经都下行穿过膈络入胸中，三焦之气属于火，与相火一起游行于全身之表，膈与六经，属于至高之分，这些药物浮载，也是至高之剂，施用于无形之中，随着高下而消退胸膈及六经的热邪，确实是妙法。我现在采用这种方法，减去芒硝、大黄，因为疫病是无形的毒邪，难以承受猛烈药物的冲击，重用石膏，直入脾胃（戊己），先捣毁其窝巢的危害，那么十二经的病患自然容易平复了，无不屡试屡验，所以我将在平日所用的方法及验证情况，详细叙述如下，以等待高明者指正。
In ancient times, there were no epidemic rashes (Yizhen) nor smallpox; these diseases began in the Han Dynasty. Why? It is said that Heaven and Earth opened up during the Zi and Chou years, and humans were born in the Yin year. At that time, people possessed a pure, light, and non-action-oriented nature, consuming raw meat and blood. Internally, they were spared from the damage of the Seven Emotions and Six Desires; externally, they had no craving for rich and heavy flavors. They existed as a浑然 (integrated/harmonious) microcosm, thus having neither epidemics nor rashes. The emergence of these conditions starting from the Han Dynasty was also governed by the Great Movement of Heaven and Earth (Tian Di Da Yun). From the Han Dynasty to the present, the Great Movement of Heaven and Earth has been operating in the Shaoyang phase. Consider midsummer: analyzing it by the twelve two-hour periods of a day, from Zi to Chou, Yin, Mao, and Chen, although it is summer, people still feel refreshing. However, upon entering Si and Wu, the blazing intensity becomes like scorching fire. By extrapolating from this, one can comprehend that the appearance of epidemics and rashes after the Han Dynasty is due to the influence of Qi Yun (Five Movements and Six Qi).
However, this view was not established by Qibo and Huangdi (representative figures of classical TCM theory), leading to much debate among later generations who merely imitated the logic of Shanghan (Cold Damage) to deduce treatments. Even Zhang Zhongjing’s statement that "in spring it transforms into Warm Disease, in summer into Heat Disease, and in autumn into Dampness" was roughly overlooked without examination, and later scholars echoed such views. Some claimed that plague is Shanghan, warm rash is Shanghan, macules and papules are Shanghan, and even heat disease is Shanghan. How can it be called Shanghan if there are plagues, macules, papules, and heat? Since the syndrome differentiation was erroneous, the theoretical propositions were also flawed. Consequently, indiscriminate use of exterior-releasing and interior-purging methods led to many untreatable cases.
It was not until Liu Hejian proposed the theory of clearing heat and detoxifying that high-minded individuals with unique insights emerged. Their purport was subtle, and their meaning profound. Later generations did not widely propagate this theory but instead regarded it as biased. *Feng Shi Jin Nang* also stated: "Macules and papules should not be treated with reckless exterior-releasing methods." This is considered a theory of great centrality and correctness, yet unfortunately, its purport was not fully elucidated, leaving later generations unsure of how to proceed. Wu Keyi, in his commentary on *Wenyi Lun*, clearly distinguished between Shanghan and Wenyi (Plague/Epidemic). For instance, headache, fever, and aversion to cold should not be mistaken for Shanghan exterior syndromes; forcibly inducing sweat would only injure the exterior Qi. If the heat does not subside, purgation should not be used, as it would only injure the Stomach Qi. These words captured the essence. However, his assertion that the plague toxin enters through the nose and mouth and transmits to the Membrane Source (Mo Yuan) rather than the Stomach seems problematic. Furthermore, the use of Damoyin, Sanxiaoyin, and various Chengqi Decoctions still appears to force-fit concepts of exterior and interior.
Only Xiong Nenzhao’s experience in treating hot plague is noteworthy. He first employed Baidu San to remove the "claws and teeth" (the aggressive pathogenic factors), followed by Jiegeng Tang. Both act as "vessel and oar" agents (carrying drugs upward) to treat pathogenic heat in the chest/diaphragm and the Hand Six Meridians. Since the Hand and Foot Shaoyang meridians pass below the diaphragm and connect to the chest, and the Qi of the Sanjiao belongs to Fire, traveling with Ministerial Fire throughout the exterior of the body, the diaphragm and the Six Meridians represent the highest regions. These floating medications, being agents of the highest region, operate within the formless realm, dissipating heat in the chest/diaphragm and Six Meridians according to their height, which is indeed a brilliant method. I now adopt this method, removing Mangxiao (Mirabilite) and Huanglian/Rhubarb (implied by general purgatives or specifically mentioned as Xiao/Huang in context of Chengqi variants, here translated as Mirabilite and Rhubarb/Generic Purgatives based on "Xiao, Huang"), because epidemic toxins are formless and cannot withstand猛烈 (violent/intense) medicines. By heavily using Shigao (Gypsum Fibrosum), which directly enters the Wu and Ji (Earth/Spleen-Stomach) organs, we first destroy the nest of harm, making the afflictions of the Twelve Meridians easier to pacify. This has proven effective repeatedly. Therefore, I will detail the methods and verified cases used in my practice below, awaiting correction from those with superior wisdom.