(《素问·热论》连前篇)
凡病伤寒而成温者,先夏至日者为病温,后夏至日者为病暑。(寒邪中人而成温病暑病者,其在时则以夏至前后言,
在病则以热之微甚言,故凡温病暑病,皆伤寒也。)暑当与汗皆出,勿止。(暑气侵入,当令有汗,则暑随汗出,故曰勿
止。《阴阳应象》等论曰∶冬伤于寒,春为温病;夏伤于暑,秋为 疟。仲景曰∶冬时严寒,触冒之者,乃名伤寒。其伤
于四时之气,皆能为病,以伤寒为毒,最成杀厉之气也。中而即病者,名曰伤寒。不即病者,寒毒藏于肌肤,至春变为
温病,至夏变为暑病。暑病者,热极,重于温也。是以辛苦之人,春夏多温热病,皆由冬时触寒所致,非时行之气也。
凡时行者,春时应暖而复大寒,夏时应热而反大凉,秋时应凉而反大热,冬时应寒而反大温,此非其时而有其气,是以
一岁之中,长幼之病多相似者,此则时行之气也。)
(《素问·热论》连前篇)
帝曰∶热病已愈,时有所遗者何也?岐伯曰∶诸遗者,热甚而强食之,故有所遗也。若此者,皆病已衰而热有所藏,
因其谷气相搏,两热相合,故有所遗也。(病虽衰而余热未除,尚有所藏,因而强食,则病气与食气相并,两热合邪,以
致留连不解,故名曰遗。)帝曰∶善。治遗奈何?岐伯曰∶视其虚实,调其逆从,可使必已矣。(食滞于中者病之实,脾
弱不能运者病之虚,实则泻之,虚则补之,虚实弗失,则逆从可调,病必已矣。)帝曰∶病热当何禁之?岐伯曰∶病热少
愈,食肉则复,多食则遗,此其禁也。(复者病复作,遗则延久也。凡病后脾胃气虚,未能消化饮食,故于肉食之类皆当
从缓,若犯食复,为害非浅。其有挟虚内馁者,又不可过于禁制,所以贵得宜也。)
(《素问·热论》承接前一篇的内容)
凡是患伤寒病而转化为温病(由寒邪郁久化热所致的温热性疾病)的,发病在夏至日之前的称为温病,发病在夏至日之后的称为暑病。(寒邪侵入人体导致温病和暑病的,从时间上讲是以夏至日前后来区分,从病情上讲是以热势的轻重来区分,所以凡是温病和暑病,都属于伤寒的范畴。)暑邪致病时应当让汗液排出,不要强行止汗。(暑气侵入人体,应当使身体出汗,这样暑邪就会随着汗液排出体外,所以说不要强行止汗。《阴阳应象大论》等篇章论述说:冬季感受寒邪,春季会发为温病;夏季感受暑邪,秋季会发为疟疾。张仲景说:冬季严寒,人们触犯冒犯它,这就叫做伤寒。人们受到四季气候之气的伤害,都能导致疾病,其中以伤寒最为毒烈,是最具杀伤力的邪气。中邪后立即发病的,叫做伤寒。没有立即发病的,寒毒潜伏在肌肤之间,到了春天就转变为温病,到了夏天就转变为暑病。暑病的特点是热势极盛,比温病更严重。因此,辛勤劳作的人,在春夏季节多患温热病,这都是因为冬季触犯了寒邪所致,并非属于时行疫气。凡是时行疫气,是指春季本该温暖却突然大寒,夏季本该炎热却突然大凉,秋季本该凉爽却突然大热,冬季本该寒冷却突然大温,这种非其时而有其气的情况,导致一年之中,无论老少患病症状大多相似,这就是所谓的时行疫气。)
(《素问·热论》承接前一篇的内容)
黄帝问道:热病已经痊愈,但时常还有余热遗留的情况,这是为什么呢?岐伯回答说:各种遗留不愈的情况,是因为热势尚盛时勉强进食,所以导致余热遗留。像这种情况,都是疾病虽然衰退但体内仍有热邪潜伏,因为食物之气与残留的热邪相互搏结,两股热邪相合,所以导致余热遗留。(疾病虽然衰退但余热未除,仍然有所潜伏,如果此时勉强进食,则病气与食气相结合,两热合邪,导致病情缠绵难愈,所以名叫遗证。)黄帝说:好。治疗遗证该怎么办?岐伯回答说:观察病证的虚实,调理气机的逆顺,就可以使疾病必定痊愈。(饮食停滞在中焦是病证的实证,脾虚不能运化是病证的虚证,实证用泻法,虚证用补法,不失误于虚实辨证,那么气机的逆顺就可以调理,疾病必定痊愈。)黄帝说:患热病时应当禁忌什么?岐伯回答说:患热病稍有好转时,吃肉会导致疾病复发,多吃食物会导致余热遗留,这就是需要禁忌的。(复指疾病再次发作,遗指病程延长。凡是病后脾胃气虚,不能消化饮食,所以对于肉食之类的食物都应当谨慎缓进,如果违反这一禁忌导致食复,危害非常深重。那些兼有虚弱、内部饥饿的人,又不可以过于严格禁止,所以贵在掌握适度的原则。)
(Continuing from the previous chapter of *Suwen: Re Lun*)
For those who contract Cold Damage (Shanghan) and subsequently develop Warm Disease (Wenbing, a warm-heat disease caused by long-standing cold pathogen transforming into heat), if the onset occurs before the Summer Solstice, it is termed Warm Disease; if it occurs after the Summer Solstice, it is termed Summerheat Disease (Shubing). (Regarding Cold Damage leading to Warm Disease or Summerheat Disease, the distinction in time is based on the period before and after the Summer Solstice, while the distinction in pathology is based on the severity of heat. Therefore, all Warm Diseases and Summerheat Diseases are categorized under Cold Damage.) When afflicted by Summerheat, sweating should be allowed to occur naturally and should not be forcibly stopped. (When Summerheat pathogen invades the body, sweating should be permitted so that the Summerheat can exit with the sweat; hence, it is said not to stop it. As discussed in chapters such as *Yinyang Yingxiang Dalun*: Injury by cold in winter leads to Warm Disease in spring; injury by summerheat in summer leads to Malaria (Nue) in autumn. Zhang Zhongjing stated: Severe cold in winter, if encountered and exposed to, is called Cold Damage. Exposure to the qi of the four seasons can cause disease, but Cold Damage is the most toxic and lethal. If illness occurs immediately upon exposure, it is called Cold Damage. If illness does not occur immediately, the cold toxin hides within the skin and muscles, transforming into Warm Disease in spring and Summerheat Disease in summer. Summerheat Disease is characterized by extreme heat, being more severe than Warm Disease. Therefore, hardworking individuals often suffer from warm-heat diseases in spring and summer, which are caused by encountering cold in winter, not by epidemic qi. Epidemic qi refers to situations where spring should be warm but is severely cold, summer should be hot but is severely cool, autumn should be cool but is severely hot, and winter should be cold but is severely warm. This occurrence of qi out of season causes many people of all ages to fall ill with similar symptoms throughout the year, which is known as epidemic qi.)
(Continuing from the previous chapter of *Suwen: Re Lun*)
The Yellow Emperor asked: After a Heat Disease has healed, why does residual heat sometimes persist? Qibo replied: In cases of persistence, it is because food was consumed forcefully while the heat was still intense, thus causing residual heat to remain. In such instances, although the disease has declined, some heat remains hidden. The qi of the ingested food clashes with this residual heat, and the two heats combine, resulting in persistent residual heat. (Although the disease has subsided, residual heat has not been eliminated and remains latent. If one forces eating at this time, the pathogenic qi combines with the food qi, merging two sources of heat, leading to lingering and unresolved conditions, hence named "residual syndrome" or Yi Zheng.) The Yellow Emperor said: Excellent. How should residual syndrome be treated? Qibo replied: Observe the deficiency and excess, regulate the adverse and normal states, and the disease will surely be cured. (Food stagnation in the middle jiao represents an excess condition; spleen weakness failing to transport represents a deficiency condition. Excess is treated by purging, deficiency by tonifying. If deficiency and excess are not mistaken, then the adverse and normal states can be regulated, and the disease will surely be cured.) The Yellow Emperor asked: What dietary prohibitions apply during Heat Disease? Qibo replied: When Heat Disease is slightly improving, consuming meat may cause recurrence (Fu), and overeating may lead to residual heat (Yi); these are the prohibitions. (Recurrence refers to the return of the disease; residual heat refers to prolonged duration. After illness, the stomach and spleen qi are deficient and unable to digest food properly; therefore, meat and similar foods should be introduced cautiously. Violating this prohibition leads to "food recurrence," causing significant harm. However, for those with concurrent deficiency and internal hunger, restrictions should not be overly strict; thus, moderation is prized.)