冬伤于寒，是感受冬时闭藏之令太过也。不藏精与按跷，是疏泄之太早，冬行春令，而
奉生
者少也。判然两义，王好古混而同之，张景岳、喻嘉言从而和之。一若冬时只有疏泄太早之
病，而无闭藏太过之病，是不通也。且《内经》冬不藏精、冬不按跷，不与四时递言。何者
?此但主阳舒阴敛之义，对夏暑汗不出而言，不合四时五行循环之气也；冬伤于寒，是与春
伤于风、夏伤于暑、秋伤于湿递言，皆各因其时令本气之太过也。夫冬伤于寒者，寒气外逼
，则卫气内陷，而荣气为所灼耗也。冬日皮肤宜温，夏日皮肤宜凉。若冬日薄衣露处，皮肤
皆寒，则腠理致密，卫气略无伸舒，而内积于荣分，津液隐为所销，内热有太盛欲焚之虑矣
。人身八万四千毛孔，皆气所出入之道也；气不出入，则必内郁。西医谓人身有炭气、有养
气之分。养气即平气也。炭气即郁浊之毒瓦斯也。冬伤于寒，束住卫气，郁而不舒，则为炭气
，其发病为温热，不亦宜乎!不藏精者，荣气外泄，与此异矣。然二者病机虽各不同，而多
出于贫苦。何者?力食则汗泄非时，而不藏精；游手则薄衣露处，而伤于寒。其病也，一由
宣泄之太早，一由闭遏之太过，虽同为温病，而治法又有不同矣。不藏精者，宜固本而养阴
；伤于寒者，宜宣郁而解表也。诿曰∶不藏精即伤于寒也，以虚为实，其治法有不误而杀人
者乎?
“冬季感受寒邪”，是指感受了冬季闭藏之气太过盛的病机。“不藏精”与“按跷”，是指疏泄之气发生得太早，在冬季行春季生发之令，导致奉养生机的气血减少。这是两种截然不同的病机，王好古将其混淆为一谈，张景岳、喻嘉言也跟着附和。这仿佛认为冬季只有疏泄太早的病证，而没有闭藏太过的病证，这是不通达的见解。况且《内经》中提到的“冬不藏精”、“冬不按跷”，并不是与四时（春、夏、秋、冬）依次递进论述的。为什么呢？因为这两者主要阐述的是阳气舒展、阴气收敛的道理，是针对夏季暑热汗不出而言的，并不符合四时五行循环往复的气机规律；而“冬伤于寒”，是与“春伤于风”、“夏伤于暑”、“秋伤于湿”依次递进论述的，都是各自因应时令本气的太过所致。
所谓“冬伤于寒”，是因为寒气从外部逼迫，导致卫气内陷，营气被灼烧消耗。冬季皮肤应当保持温暖，夏季皮肤应当保持凉爽。如果在冬季穿着单薄衣服露宿，皮肤都会受寒，那么腠理就会致密，卫气稍微无法伸展舒展，从而内积于营分，津液暗中受到销蚀，内部的热邪有过于旺盛甚至想要焚烧身体的忧虑。人身八万四千个毛孔，都是气出入的通道；气如果不能出入，就必然在内郁结。西医认为人体内有炭气（二氧化碳等浊气）和养气（氧气）的区别。养气就是平和之气。炭气就是郁滞浑浊的毒瓦斯。冬季感受寒邪，束缚住卫气，使其郁结而不能舒展，就变成了炭气，其发病表现为温热病，不也是合乎情理的吗！
至于“不藏精”，则是营气向外泄耗，这与上述情况不同。然而这两种病机虽然各不相同，但多出于贫苦之人。为什么呢？从事体力劳动的人，出汗不符合正常时节，导致不藏精；游手好闲的人，穿着单薄露宿，导致伤于寒。他们的病，一个是由于宣泄太早，一个是由于闭遏太过，虽然都表现为温病，但治疗方法又有不同。对于不藏精者，适宜固护根本并滋养阴液；对于伤于寒者，适宜宣散郁结并解除表邪。如果推脱说“不藏精就是伤于寒”，将虚证当作实证治疗，难道没有误治杀人的吗？
"Contracting cold in winter" refers to the pathogenesis of being affected by an excessive accumulation of the closing and storing energy of winter. "Not storing essence" and "acupoint massage/exercise (Anqiao)" refer to premature discharge, where the spring-like generating command is executed during winter, resulting in a deficiency of the Qi that nourishes life. These are two distinctly different meanings. Wang Haogu confused them into one, and Zhang Jingyue and Yu Jiayan followed suit in agreeing with him. This implies that there are only diseases of premature discharge in winter, but no diseases of excessive storage, which is an illogical view. Furthermore, "Winter not storing essence" and "Winter Anqiao" mentioned in the *Neijing* (Inner Canon) are not discussed in succession with the four seasons. Why? Because these primarily illustrate the principle of Yang expanding and Yin contracting, specifically contrasting with the condition of summer heat without sweating; they do not align with the cyclic Qi of the four seasons and five elements. In contrast, "Contracting cold in winter" is discussed in succession with "Contracting wind in spring," "Contracting summer-heat in summer," and "Contracting dampness in autumn." All of these result from the excess of the primary Qi of their respective seasonal commands.
Regarding "contracting cold in winter," external cold forces the Wei Qi (Defensive Qi) inward, causing Ying Qi (Nutritive Qi) to be scorched and consumed. The skin should be warm in winter and cool in summer. If one wears thin clothes and sleeps outdoors in winter, the skin becomes cold, the Cou Li (pores/skin texture) become dense, and the Wei Qi cannot extend or relax properly. It accumulates internally within the Ying division, secretly consuming body fluids. There is a concern that internal heat may become excessively strong, threatening to burn the body. The eighty-four thousand pores of the human body are pathways for Qi to enter and exit; if Qi cannot circulate, it must stagnate internally. Western medicine distinguishes between carbon gas (carbon dioxide/toxic waste gases) and oxygen (vital air). Oxygen corresponds to balanced Qi, while carbon gas corresponds to stagnant, turbid toxic gases. When winter cold binds the Wei Qi, causing it to stagnate without relaxation, it transforms into carbon gas. Is it not reasonable that its manifestation as a warm disease (Wen Bing)?
"Not storing essence," on the other hand, involves the leakage of Ying Qi outward, which differs from the above. However, although the pathogenesis of these two conditions is different, they often arise among the poor. Why? Those engaged in manual labor sweat at inappropriate times, leading to not storing essence; those who are idle wear thin clothes and sleep outdoors, leading to contracting cold. Their illnesses stem from either premature discharge or excessive obstruction. Although both manifest as warm diseases, their treatment methods differ. For those not storing essence, it is appropriate to consolidate the root and nourish Yin; for those contracting cold, it is appropriate to disperse stagnation and release the exterior. To claim that "not storing essence is the same as contracting cold" and to treat deficiency as excess—would such erroneous treatments not lead to death?