（论文已见首篇总例）
（冬为伤寒 春为温病 夏为暑病 秋为疟 一岁长幼病相似为疫 多眠多汗脉浮为风温 一身尽痛为湿 身反张
为痉）
吴 夫伤寒之病自霜降之后天令大寒而感之者乃伤寒也若天令温暖而感之者为冬温也如至春天令温暖有人壮热
为
病者乃温病也若天令尚寒冰雪未解而感寒者亦曰伤寒也若三月至七八月之间天道忽有暴寒而感之者此名时行寒疫也若
夏至后壮热脉洪者谓之热病也如四时天令不正感而为病长幼相似互相传染者谓之时行之气也夫时气者一曰时疫盖受天
地疫疠之气而为病乃非寒也又有温疟风温温毒温疫中风伤风中湿风湿中暑中 湿温等证一皆发热状似伤寒故医家通以
伤寒称之者为发热传变皆相类也至于用药则不同矣但发表解肌有差别尔盖冬月伤寒者人之着寒而即病也若不即病至春
变为温病至夏变为热病温病热病乃因伏寒为变既变不得复言其寒矣其寒疫乃天时之暴寒与冬时之严寒又有轻重之不同
时气自是天行疫疠之气又非寒比也温病乃山泽蒸气暑病乃炎日之火风乃天之贼邪伤于人者也有中者为重伤者为轻温疟
风温等病又是伤寒坏证更感异气所变各有其因不同岂可通以伤寒称而治之如不识其名妄行治疗本中暑作热病治之湿温
作风温治之虚实混淆是非紊乱夭人天年可不慎哉
凡四时伤寒通宜补散故丹溪治伤寒多用补中益气汤气虚者四君子汤加发散剂血虚者四物汤加发散剂东垣 治风湿用
补中益气加羌活防风升麻 本苍术海藏治风湿无汗者用神术汤有汗者用白术汤治刚痉用神术汤加羌活麻黄治柔痉用白
术汤加桂心 术治风湿用白术汤随证加药治中 脉弦细芤迟者用黄 汤此皆与仲景所谓辛苦之人触冒之病伤寒同意也
丹 仲景论伤寒而未及乎中寒先哲治冒大寒昏中者用附子理中汤其议药则得之矣曰伤曰中未有议其异同者夫伤
寒
有即病有不即病因其旧有郁热风寒外束肌腠自密郁发为热病邪循经而入由渐而深初用麻黄桂枝等微表而安以病体不甚
虚也若中寒则仓卒感受其病即发而暴因其腠理疏豁一身受邪难分经终无热可发温补自解此气大虚不急治则死矣伤风伤
暑伤湿亦如伤寒之渐入也中风中暑中湿亦如中寒之暴受也除伤寒外杂病之治可一隅反之矣
（相关论述已在首篇总例中见到）
冬季感受寒邪称为伤寒，春季感受温邪称为温病，夏季感受暑邪称为暑病，秋季感受疟邪称为疟疾，一年内无论老少患病症状相似者称为疫病。多眠、多汗、脉浮的称为风温；全身疼痛的称为湿病；身体反张的称为痉病。
吴氏说：伤寒之病，是在霜降之后，天气大寒时感受寒邪而发病的，这才是真正的伤寒。如果天气温暖时感受邪气而发病的，称为冬温。到了春天，天气温暖，有人出现高热而发病的，称为温病。如果天气仍然寒冷，冰雪未消融时感受寒邪的，也称为伤寒。如果在三月至七八月之间，天道突然有暴寒而感受邪气的，这种称为时行寒疫。如果在夏至后出现高热、脉象洪大的，称为热病。如果四时气候不正常，人感受邪气而发病，且老少症状相似、互相传染的，称为时行之气。所谓时气，也叫时疫，是因为接受了天地间的疫疠之气而发病，这并非寒邪所致。此外还有温疟、风温、温毒、温疫、中风、伤风、中湿、风湿、中暑、中湿温等证候，都表现为发热，症状类似伤寒，所以医家通称这些为“伤寒”，是因为它们的发热和传变过程都相似。但是用药则不同，只是在发表解肌的方法上有差别罢了。
大概冬季的伤寒，是人受寒后立即发病的。如果不立即发病，到春天就变为温病，到夏天就变为热病。温病和热病是由于伏藏的寒邪发生变化所致，既然已经变化，就不能再说它是寒邪了。至于寒疫，是天时的暴寒与冬季的严寒相比又有轻重的不同。时气则是天行疫疠之气，又不同于寒邪。温病是由于山泽蒸发的湿气，暑病是由于烈日下的火气，风邪是天的贼邪伤害于人。有中风的，有重伤的，有轻伤的。温疟、风温等疾病又是伤寒误治后的坏证，再次感受异气所变，各有其病因不同，怎么能一概用伤寒来称呼并治疗呢？如果不认识这些病名，妄自行事治疗，把中暑当作热病治，把湿温作风温治，虚实混淆，是非紊乱，使人夭折寿命，能不谨慎吗？
凡是四时伤寒，通常适宜采用补益兼发散的方法。所以朱丹溪治疗伤寒多用补中益气汤；气虚的人用四君子汤加发散药；血虚的人用四物汤加发散药。李东垣治疗风湿用补中益气汤加羌活、防风、升麻、本苍术。海藏治疗风湿无汗的用神术汤，有汗的用白术汤。治疗刚痉用神术汤加羌活、麻黄；治疗柔痉用白术汤加桂心、白术。治疗风湿用白术汤随证加减药物。治疗中暑脉弦细芤迟的用黄芪汤。这些都与张仲景所说的辛苦之人触冒邪气所患的伤寒意思相同。
张仲景论述伤寒，但没有涉及中寒。先哲治疗因冒犯大寒而昏厥的中寒患者，使用附子理中汤，他们在议药方面是正确的。但是关于“伤”和“中”是否有区别，前人没有议论过。伤寒有即发和不即发的区别，因为体内原有郁热，风寒外束，肌腠闭塞，郁积而发为热病，邪气循经而入，由浅入深，初起用麻黄、桂枝等轻微发汗即可安愈，因为此时病体不是很虚弱。如果是中寒，则是仓促感受寒邪，病立即发作而且猛烈，因为腠理疏豁，一身受邪，难以分经，最终没有热可发，必须用温补法才能解除。这是因为正气大虚，不紧急治疗就会死亡。伤风、伤暑、伤湿也像伤寒一样逐渐深入。中风、中暑、中湿也像中寒一样突然感受。除了伤寒之外，其他杂病的治疗也可以由此举一反三了。
(The discussion has been seen in the general examples of the first chapter.)
Winter cold invasion is called Shanghan (Cold Damage); spring warmth disease is called Wenbing (Warm Disease); summer heat disease is called Shubing (Summer Heat Disease); autumn malaria is called Nue (Malaria); when people of all ages in a year have similar illnesses, it is called Yi (Epidemic). Excessive sleep, excessive sweating, and floating pulse indicate Fengwen (Wind-Warmth). Whole-body pain indicates Shi (Dampness). Body rigidity with opisthotonos indicates Jing (Spasm).
Wu stated: The disease of Shanghan occurs when one contracts cold after the Frost's Descent solar term, when the weather is severely cold; this is true Shanghan. If one contracts pathogenic factors during warm weather, it is called Dongwen (Winter Warmth). When spring arrives and the weather is warm, if someone develops high fever, it is called Wenbing. If the weather remains cold with ice and snow unmelting, and one contracts cold, it is also called Shanghan. If between the third month and the seventh or eighth month, sudden severe cold occurs due to celestial changes and one contracts it, this is named Shixing Hanyi (Seasonal Cold Epidemic). If after the Summer Solstice, high fever and a flooding pulse occur, it is called Rebing (Heat Disease). If the climate of the four seasons is abnormal, causing illness upon contraction, where symptoms are similar among young and old and spread contagiously, it is called Shixing Zhiqi (Seasonal Pathogenic Qi). This "Shiqi" is also known as Shi Yi (Seasonal Epidemic), caused by contracting epidemic pestilential qi from heaven and earth, which is not cold. Furthermore, there are conditions such as Wen Nue (Warm Malaria), Fengwen, Wendu (Warm Toxin), Wenyi (Warm Epidemic), Zhongfeng (Stroke/Attack by Wind), Shangfeng (Injury by Wind), Zhongshi (Attack by Dampness), Fengshi (Wind-Dampness), Zhongshu (Attack by Summer Heat), and Zhong Wenwen (Attack by Warm-Dampness). All these present with fever and resemble Shanghan; thus, physicians generally refer to them as Shanghan because their fever and progression are similar. However, the medication differs, specifically in the methods of releasing the exterior and resolving the muscle layer.
Generally, winter Shanghan is an immediate onset following cold exposure. If not immediately ill, it transforms into Wenbing in spring and Rebing in summer. Wenbing and Rebing result from latent cold transforming; once transformed, it can no longer be described as cold. Shixing Hanyi involves sudden cold of the season, differing in severity from the severe cold of winter. Shiqi refers to epidemic qi circulating through nature, distinct from cold. Wenbing arises from vapor rising from mountains and marshes; Shubing arises from the fire of scorching suns; Feng is the thief-evil of heaven harming humans. There are attacks, heavy injuries, and light injuries. Wen Nue and Fengwen are complications of Shanghan that have deteriorated and transformed due to subsequent contraction of different pathogens; each has its own cause. How can they all be labeled as Shanghan and treated uniformly? If one does not recognize their names and treats blindly, treating Summer Heat attack as Heat Disease, or Warm-Dampness as Wind-Warmth, confusing deficiency and excess, creating chaos between right and wrong, leading to premature death, how can one not be cautious?
For Shanghan across the four seasons, supplementation combined with dispersal is generally appropriate. Therefore, Zhu Danxi often used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) for Shanghan. For those with Qi deficiency, Sijunzi Tang (Four Gentlemen Decoction) plus dispersing agents was used; for Blood deficiency, Siwu Tang (Four Substance Decoction) plus dispersing agents was used. Li Dongyuan treated Wind-Dampness using Buzhong Yiqi Tang added with Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), and Shengma (Cimicifugae Rhizoma). Haicang treated Wind-Dampness without sweat using Shenzhu Tang (Divine Skill Decoction) and with sweat using Baizhu Tang (Atractylodis Macrocephalae Decoction). For Gangjing (Rigid Spasm), Shenzhu Tang added with Qianghuo and Mahuang (Ephedrae Herba) was used; for Roujing (Soft Spasm), Baizhu Tang added with Guixin (Cinnamomi Cortex) and Baizhu (Atractylodis Macrocephalae Rhizoma) was used. For Wind-Dampness, Baizhu Tang was used with modifications according to symptoms. For Summer Heat attack presenting with string-taut, fine, hollow, or slow pulses, Huangqi Tang (Astragali Decoction) was used. All these align with Zhang Zhongjing's description of Shanghan contracted by hardworking individuals exposed to pathogenic factors.
Zhang Zhongjing discussed Shanghan but did not address Zhonghan (Severe Cold Attack). Ancient sages treated Zhonghan characterized by fainting due to exposure to extreme cold using Fuzi Lizhong Tang (Aconite Decoction to Regulate the Middle). Their prescription of medicine was correct, but they did not discuss the differences between "Shang" (Injury) and "Zhong" (Attack). Shanghan may manifest immediately or be delayed. Because internal stagnant heat exists, external wind-cold constricts the skin and pores, causing heat to erupt from stagnation. The pathogen enters via the meridians, deepening gradually. Initially, mild diaphoresis with Mahuang and Guizhi (Cinnamomi Ramulus) suffices because the body is not significantly deficient. In contrast, Zhonghan results from sudden exposure; the disease manifests immediately and violently. Because the pores are open and the whole body is affected, meridian differentiation is difficult, and there is typically no fever to release; warming and tonification are required for resolution. This occurs due to severe deficiency of vital energy; without urgent treatment, death ensues. Shangfeng (Wind Injury), Shangshu (Summer Heat Injury), and Shangshi (Dampness Injury) enter gradually like Shanghan. Zhongfeng (Wind Attack), Zhongshu (Summer Heat Attack), and Zhongshi (Dampness Attack) occur suddenly like Zhonghan. Beyond Shanghan, the treatment of miscellaneous diseases can be inferred by analogy from these principles.