古者于冬伤于寒不即发，至春遇温而病者，及冬中于非时之暖不即发，至春遇温而病者
，皆
胃之温。故仲景既存《素问》、《伤寒》成温之论，复于冬有非节之暖称为冬温。以温之言
蕴，所蕴不同，而为蕴则同，故通为温。《巢源》温病候、温毒候，皆两存之，固深于仲景
者也。准此以推，夏之暑亦当如是。夏伤于暑不即发，至秋遇风而病者，及夏伤于非时之寒
不即发，至秋遇风而病者，皆谓之疟。故《素问》疟论有夏伤于暑之 疟，而生气通天及金
匮真言夏暑汗不出秋风之疟，以疟之言疟，为疟不同，而所虐则同，故通为疟。惟仲景专为
“寒”字立论，故不及夏暑即发、不即发之病，而《巢源》以下亦仍之，而不复分晰也。春
主温，故温性缓，缓则性长，故为病壮热，而其脉为缓弱；秋主风，
故疟性暴，暴则性短，故为病休作，而其脉紧弦。温宜于下，则疟宜于吐。
治疟之常、蜀，犹治温之硝、黄也。惟温在冬月，故发有先后重沓，则治有汗、下兼施，与
疟之吐、下兼施，微有不同者此耳！
古称温疟有三。《素》疟论两温疟，《巢源》总叙之，意谓冬中于风，寒气藏于骨髓，
至春
遇大暑，或有所用力，邪气与汗偕出之。温疟止有先热后寒者，而无先寒后热者。何以言之
？经以先风后寒为先热后寒之因，先寒后风为先寒后热之因，大暑为时令，不必数，故止数
风寒之先后，所以止有先热后寒者也。若夏伤于大暑，腠理发泄，遇夏气非时小寒，藏于腠
理皮肤，至秋伤于风，则病成之温疟，则有先热后寒者，又有先寒后热者。何以言之？以此
暑也，小寒也，秋风也，为三感，则当置其一轻而论其两重。若伤暑重而秋风轻，则置风而
论暑、寒，而为先热后寒之疟；若暑轻而秋风重，而置暑而论寒、风，而为先寒后热之疟也
。复总而别之曰∶夫病温疟六七日，但见热者是矣。此谓壮热不兼寒者，故加“夫”字，示
与经文别出也；不析言冬夏者，明冬夏皆有此壮热者也。此与先热后寒、先寒后热为三矣。
大法由冬来者，即今春温；由夏来者，即今伏暑。古既统称温疟，则本草诸治温疟之药，皆
是治春温、伏暑明甚，《金匮》白虎加桂枝汤症正此也。此外，尚有《伤寒论》脉阴阳俱紧
者，重感于寒，变为温疟。则冬伤于寒，至春分以后，复感时行之寒者，先后皆寒，与寒多
之牡疟同理。故《金匮》蜀漆散方下云温疟加蜀漆，当即指此。越其外受之蒙，即以截其递
入之路，而俗称蜀漆截疟，亦以辞害旨哉！若白虎加桂枝汤方，自是治春温、伏暑之温疟，
与重感于寒之温疟无涉，故其方同伤寒法，不同疟法也。
古代认为，冬季感受寒邪而未立即发病，到了春季遇到温热之气而发病的，以及冬季感受非时之暖邪而未立即发病，到了春季遇到温热之气而发病的，都属于胃中的温病。所以张仲景既保留了《素问》和《伤寒论》中关于寒邪转化为温病的论述，又将冬季出现非正常温暖气候称为“冬温”。因为“温”字含义是蕴蓄，虽然所蕴蓄的邪气不同，但作为蕴蓄的状态是一样的，所以统称为温病。《诸病源候论》中的温病候、温毒候，都同时保留了这两种说法，这确实比张仲景更为深入。据此类推，夏季的暑邪也应当如此。夏季感受暑邪而未立即发病，到了秋季遇到风邪而发病的，以及夏季感受非时之寒邪而未立即发病，到了秋季遇到风邪而发病的，都称之为疟疾。所以《素问·疟论》中有因夏伤于暑而致的疟疾，以及《生气通天论》和《金匮真言论》中提到的夏季暑天汗不出、秋季遇风而致的疟疾，因为“疟”字含义是虐害，虽然所表现的疟疾类型不同，但其所造成的虐害是一样的，所以统称为疟疾。只有张仲景专门针对“寒”字立论，所以没有涉及夏季暑邪即发或不即发的病症，而《诸病源候论》以下各书也沿袭了这一做法，不再进行详细区分。春季主温，所以温邪性质缓和，缓和则病程较长，所以表现为壮热，其脉象为缓弱；秋季主风，所以疟邪性质暴烈，暴烈则病程短促，所以表现为寒热往来（发作与休止），其脉象紧弦。温病适宜用下法治疗，那么疟疾就适宜用吐法治疗。治疗疟疾常用的蜀漆，就像治疗温病常用的硝石、大黄一样。只是温病发生在冬季，所以发病有先后重叠的情况，因此治疗有汗法、下法兼施的情况，这与疟疾吐法、下法兼施的情况，仅有细微的不同罢了！
古时候称温疟有三种说法。《素问·疟论》中提到两种温疟，《诸病源候论》总括叙述，意思是冬季感受风邪，寒气藏于骨髓，到了春季遇到大暑，或者有所用力劳作，邪气随汗液一起排出。温疟只有先发热后恶寒的，而没有先恶寒后发热的。为什么这样说呢？经文以先受风后受寒为先发热后恶寒的原因，先受寒后受风为先恶寒后发热的原因，大暑是时令节气，不必列举，所以只列举风寒感受的先后顺序，因此只有先发热后恶寒的情况。如果是夏季感受大暑，腠理开泄，遇到夏季非时的小寒邪气，藏于腠理皮肤之间，到了秋季再感受风邪，则形成的温疟，既有先发热后恶寒的，又有先恶寒后发热的。为什么这样说呢？这是因为暑邪、小寒邪、秋风邪这三种外感因素，应当将其一轻者搁置不论，而着重讨论另外两重。如果伤暑较重而秋风较轻，则搁置风邪而论暑邪、寒邪，从而形成先发热后恶寒的疟疾；如果暑邪较轻而秋风较重，则搁置暑邪而论寒邪、风邪，从而形成先恶寒后发热的疟疾。又总体分辨说：患温疟六七天，只见发热的就是这种。这是指壮热不伴有恶寒的情况，所以加上“夫”字，表示与经文另作区别；不详细区分冬季和夏季，是说明冬季和夏季都有这种壮热的情况。这就与先发热后恶寒、先恶寒后发热构成了三种情况。大致法则是由冬季传来的，就是现在的春温；由夏季传来的，就是现在的伏暑。古人既然统称温疟，那么本草书中各种治疗温疟的药物，都是治疗春温、伏暑的，这一点非常明显，《金匮要略》中的白虎加桂枝汤证正是这种情况。此外，还有《伤寒论》中脉象阴阳俱紧的，是再次感受寒邪，转变为温疟。这就是冬季感受寒邪，到了春分以后，又感受时行寒邪，先后都感受寒邪，与寒邪多的牡疟原理相同。所以《金匮要略》蜀漆散方下说温疟加蜀漆，应当就是指这种情况。越过其外受的蒙蔽，即可截断其递入的路径，而俗称蜀漆截疟，也是以辞害意啊！至于白虎加桂枝汤方，自然是治疗春温、伏暑类型的温疟，与再次感受寒邪的温疟无关，所以它的方义同于伤寒治法，不同于一般疟疾治法。
The ancients believed that cases where cold pathogenic factors were contracted in winter but did not manifest immediately, and instead manifested in spring upon encountering warm qi, as well as cases where non-seasonal warmth was contracted in winter without immediate manifestation, and later manifested in spring upon encountering warm qi, all belonged to "warmth" (Wen, a type of warm disease) originating from the Stomach. Therefore, Zhang Zhongjing preserved the theories from the *Suwen* (Basic Questions) and *Shanghan Lun* (Treatise on Cold Damage) regarding the transformation of cold into warmth, and also referred to abnormal warmth occurring in winter as "Winter Warmth" (Dong Wen). Since the term "Wen" implies accumulation or entrapment, although the accumulated pathogens differ, the state of accumulation is the same; thus, they are collectively termed "Warmth." The *Chao Yuan Fang* (Source Book of Pathogenesis and Symptoms) includes both warm disease syndromes and warm toxin syndromes, preserving both views, which demonstrates a deeper understanding than Zhang Zhongjing's. By this logic, summer heat should be treated similarly. Cases where summer heat is contracted in summer but does not manifest immediately, and instead manifests in autumn upon encountering wind pathogenic factors, as well as cases where non-seasonal cold is contracted in summer without immediate manifestation, and later manifests in autumn upon encountering wind, are all termed "Malaria" (Nue). Thus, the *Suwen·Mallun* mentions malaria caused by summer heat contraction in summer, and the *Shengqi Tongtian Lun* and *Jinkui Zhenyan* mention malaria caused by failure to sweat during summer heat followed by wind exposure in autumn. Since the term "Nue" implies tyranny or oppression, although the types of malaria differ, the oppressive nature is the same; thus, they are collectively termed "Malaria." Only Zhang Zhongjing specifically established his theory based on the character "Han" (Cold); therefore, he did not cover diseases resulting from immediate or delayed onset of summer heat in summer. Subsequent texts like the *Chao Yuan Fang* followed this precedent and did not further differentiate them. Spring governs warmth, so the nature of warmth is slow/gentle; being slow, the disease course is prolonged, thus presenting with high fever and a slow/weak pulse. Autumn governs wind, so the nature of malaria is violent/sudden; being sudden, the disease course is short, thus presenting with alternating chills and fever (paroxysms and remissions) and a tight/string-like pulse. Warmth diseases are suitable for purgative treatment; therefore, malaria is suitable for emetic treatment. Shuqi (used commonly for treating malaria) is analogous to Xiaoshi and Dahuang (used commonly for treating warmth diseases). It is only because warmth diseases occur in winter that their onset may have sequential overlaps, leading to combined sweating and purging treatments. This differs slightly from the combined emetic and purging treatments used for malaria!
In ancient times, it was said that there are three types of Warm Malaria (Wen Nue). The *Suwen·Mallun* discusses two types of Warm Malaria, and the *Chao Yuan Fang* summarizes them, suggesting that wind pathogenic factors are contracted in winter, cold qi hides in the bone marrow, and in spring, upon encountering intense summer heat or physical exertion, the pathogenic factor exits with sweat. Warm Malaria presents only with fever preceding chills, and never with chills preceding fever. Why is this? The classic states that encountering wind first and then cold causes fever preceding chills, while encountering cold first and then wind causes chills preceding fever. Intense summer heat is a seasonal climate factor and need not be enumerated separately; thus, only the sequence of wind and cold is listed, explaining why there is only the case of fever preceding chills. However, if one contracts severe summer heat in summer, causing the pores to open and sweat, and then encounters non-seasonal minor cold which hides in the pores and skin, and subsequently contracts wind in autumn, the resulting Warm Malaria can present with either fever preceding chills or chills preceding fever. Why? Because there are three contracting factors: summer heat, minor cold, and autumn wind. One should set aside the lighter factor and discuss the two heavier ones. If summer heat contraction is heavy and autumn wind is light, one sets aside wind and discusses summer heat and cold, resulting in malaria with fever preceding chills. If summer heat is light and autumn wind is heavy, one sets aside summer heat and discusses cold and wind, resulting in malaria with chills preceding fever. Furthermore, it distinguishes another type: suffering from Warm Malaria for six or seven days, exhibiting only heat, is this type. This refers to high fever without accompanying chills; hence the particle "Fu" is added to indicate a distinction from the main text. It does not analyze winter versus summer because high fever occurs in both seasons. This constitutes the third type alongside fever-then-chills and chills-then-fever. Generally, those originating from winter are now called Spring Warmth (Chun Wen); those originating from summer are now called Hidden Summer Heat (Fu Shu). Since the ancients collectively termed them Warm Malaria, the herbs in materia medica used to treat Warm Malaria are clearly used for treating Spring Warmth and Hidden Summer Heat. The Baihu Jia Guizhi Tang syndrome in the *Jinkui Yaolue* precisely fits this category. Additionally, in the *Shanghan Lun*, cases where the pulse is tight at both yin and yang positions involve re-contracting cold, transforming into Warm Malaria. This means contracting cold in winter, and after the Spring Equinox, contracting epidemic cold again; since both exposures are cold, it shares the same principle as Mulie (Oyster Malaria), which involves excessive cold. Therefore, the note under the Shuqi San formula in the *Jinkui Yaolue* stating "add Shuqi for Warm Malaria" likely refers to this. By bypassing the external obstruction, one cuts off the pathway of progressive invasion; thus, the common saying that Shuqi stops malaria is perhaps misleading due to literal interpretation. As for the Baihu Jia Guizhi Tang formula, it naturally treats Warm Malaria arising from Spring Warmth or Hidden Summer Heat, unrelated to Warm Malaria caused by re-contracting cold. Hence, its therapeutic method aligns with Shanghan (Cold Damage) principles, differing from general Malaria treatment methods.