一、辨气 风寒之气，从外收敛入内，病无蒸气触人，间有作蒸气者，必待数日后，转入阳明府症之时。温热
及湿
温症，其气从中蒸达于外，病即有蒸气触人，轻则盈于床帐，重则蒸然一室，以人身脏腑、气血、津液，得寒
气则内敛，得火气则上炎。温热，火气也，人受之，自脏腑蒸出于肌表。气血津液，逢蒸而败，因败而溢，溢
出有盛衰，充达有远近，非鼻观精者，不能辨之；辨之既明，治之毋惑，知为温热，而非伤寒。则凡于头痛、
发热诸表症，不得误用辛温发散；于诸里症当清当下者，亦不得迟回瞻顾矣。
二、辨色 风寒主收敛，敛则结，面色多绷结光而洁，温热主蒸散，散则缓，面色多松缓而垢晦。人受蒸
气，则津液上溢于面，头目之间多垢滞，或如油腻，或如烟熏，望之可憎者，皆温热之色也。一见此色，虽头
痛发热，即不得用辛热发散；一见舌黄烦渴诸里症，即宜攻下，不可拘于下不厌迟之说。
三、辨舌 风寒在表，舌多无苔，即有白苔，亦薄而滑；渐传入里，方由白而黄，转燥而黑。温热一见
头痛发热，舌上便有白苔，且浓而不滑，或色兼淡黄，或粗如积粉，或兼二三色，或白苔即燥。又有至黑不燥，则
以兼湿挟痰之故∶然必按之粗涩，或兼有朱点，有罅纹，不可误认为里寒阴结也。治温热者，能先于表症辨之，
不能辛温发散；一见里症，即用清凉攻下，斯得之矣。
四、辨神 风寒之中人，令人心知所苦而神自清，如头痛寒热之类，皆自知之；至传里入胃，如或有神
昏、谵语之时。缘风寒为病，其气不昏而神清。温热初起，便令人神情异常而不知所苦，大概烦躁者居多，甚
或如痴如醉，搅乱惊悸。及问其何所苦，则不自知。即问有神清而能自知者，亦多梦寐不安，闭目若有所见，
此即谵语之根也。或亦以始初不急从凉散，迁延时日，故使然耳。
五、辨脉 温热之脉，传变后与风寒颇同，初起时与风
寒迥别；风寒从皮毛而入，一二日脉多浮，或兼紧、兼缓、兼洪，无不浮者，传里始不见浮脉，然其至数，亦
清楚而不模糊。温热从中道而出，一二日脉多沉，迨自里出表，脉始不沉而数，或兼弦，或兼大，然总不浮，
其至数则模糊而不清楚。凡初起脉沉迟，勿认作阴症；沉者邪在里，迟者邪在脏也，脉象同于阴寒，而气色、
舌苔、神情，根据前诸法辨之，自有不同者。或数而无力，亦勿作虚视，因其热蒸气散，脉自不能鼓指，但当解
热，不当补气，受病之因各殊，故同脉而异断。
一、辨别气味 风寒之邪，从体表向内收敛侵入，病证通常没有蒸腾之气触人，偶尔有蒸腾之气的情况，也一定要等到数日后，病邪转入阳明腑证的时候才会出现。温热病及湿温病，其气机从中焦蒸腾达于体表，病证即刻就有蒸腾之气触人，轻则充满床帐周围，重则使整个房间热气蒸腾，这是因为人身脏腑、气血、津液，遇到寒气则向内收敛，遇到火气则向上炎升。温热病属于火气范畴，人体感受了它，自然从脏腑蒸腾出于肌表。气血津液，被热邪蒸灼而败坏，因败坏而溢出，溢出的多少有盛衰之分，充达的范围有远近之别，不是鼻子灵敏的人，不能辨别；既然辨别得清楚，治疗时就不会迷惑，知道这是温热病，而不是伤寒。那么对于头痛、发热等表证，就不能误用辛温发散的方法；对于各种里证应当清解或攻下的，也不应迟疑观望。
二、辨别面色 风寒主收敛，收敛则导致气血凝结，面色多紧绷光亮而洁净；温热主蒸散，蒸散则导致气血松弛，面色多松软迟缓且污垢晦暗。人受到热邪蒸灼，津液就会上溢于面部，头目之间多有垢滞，或者像油腻，或者像烟熏，看起来令人厌恶的，都是温热病的面色。一旦见到这种面色，即使有头痛发热，也不能使用辛热发散的方法；一旦见到舌苔黄、烦躁口渴等各种里证，就应当攻下，不可拘泥于“下法不宜过早”的说法。
三、辨别舌象 风寒在表，舌头上大多没有苔，即使有白苔，也是薄而滑润的；逐渐传入里证，才由白变黄，转燥变黑。温热病一见头痛发热，舌上便有白苔，而且浓厚而不滑润，或者颜色兼带淡黄，或者粗糙如积粉，或者兼有二三种颜色，或者白苔即干燥。又有至黑但不干燥的情况，这是由于兼夹湿邪和痰浊的缘故：但是必须触摸感觉粗糙涩手，或者兼有朱砂点，有裂纹，不可误认为是里寒阴结。治疗温热病的人，能在表证阶段先辨别出来，不使用辛温发散；一见里证，立即使用清凉攻下的方法，这就对了。
四、辨别神志 风寒侵犯人体，让人心里清楚自己哪里痛苦而神志自然清醒，比如头痛、恶寒发热之类，都是自己知道的；到了传入里入胃的阶段，如出现神昏、谵语的时候。因为风寒致病，其气机不昏乱而神志清醒。温热病初起，就让人神情异常而不知道哪里痛苦，大抵烦躁的人居多，甚至像痴呆或醉酒一样，搅动混乱、惊恐心悸。等到问他哪里痛苦，他却自己也不知道。即使问到有神志清醒并能自知的人，也多梦寐不安，闭眼好像看到了什么，这就是谵语的根源。或许也是因为起初不及时从凉散治疗，拖延时日，所以才导致这样。
五、辨别脉象 温热病的脉象，传变之后与风寒颇为相同，初起时与风寒截然不同；风寒从皮毛而入，一二天脉象多浮，或者兼紧、兼缓、兼洪，没有不浮的，传入里证后才不见浮脉，然而其脉率，也清晰而不模糊。温热病从中道而出，一二天脉象多沉，等到从里出表，脉象才不沉而数，或者兼弦，或者兼大，但总体不浮，其脉率则模糊而不清楚。凡是初起脉象沉迟，不要认作阴证；沉表示邪气在里，迟表示邪气在脏，脉象虽然同于阴寒，但气色、舌苔、神志，根据前面诸法辨别，自然有不同之处。或者脉数而无力，也不要当作虚证看待，因为热邪蒸腾散泄，脉自然不能鼓指，只应当解热，不应当补气，受病的起因各不相同，所以脉象相同而诊断不同。
1. Differentiating by Odor: The pathogenic factor of Wind-Cold enters inward from the exterior with a contracting nature. Typically, there is no steaming vapor emanating from the patient that can be sensed by others; if such vapor exists, it usually appears only after several days when the disease has transferred to the Yangming Fu-organ syndrome (a stage characterized by heat accumulation in the intestines/stomach). In contrast, for Warm-Heat diseases and Damp-Warmth diseases, the pathogenic qi steams outward from the interior. Consequently, a steaming vapor is immediately perceptible. Mild cases may fill the bed curtains, while severe cases may make the entire room steamy. This occurs because the Zang-Fu organs, Qi, Blood, and Body Fluids of the human body contract inward when exposed to Cold, but flare upward when exposed to Fire. Warm-Heat belongs to the category of Fire; upon infection, it naturally steams from the Zang-Fu organs out to the muscle surface. When Qi, Blood, and Body Fluids are scorched by heat, they deteriorate and overflow. The degree of overflow varies, as does the extent of its reach. Only those with a keen sense of smell can distinguish this; once clearly differentiated, treatment will not be confused. Knowing it is Warm-Heat rather than Cold Damage (Shanghan), one must not mistakenly use Acrid-Warm dispersing methods for exterior symptoms like headache and fever; nor should one hesitate to apply Clearing or Purging methods for interior symptoms requiring them.
2. Differentiating by Complexion: Wind-Cold has a contracting nature, leading to condensation; thus, the complexion tends to be tight, shiny, and clean. Warm-Heat has a steaming and dissipating nature, leading to laxity; thus, the complexion tends to be loose, slow, and dull or dirty. When affected by steaming heat, Body Fluids overflow upward to the face, causing turbidity around the head and eyes. It may appear oily or soot-like, looking repulsive; these are all complexions indicative of Warm-Heat. Upon seeing such a complexion, even if accompanied by headache and fever, Acrid-Warm dispersing methods must not be used. Upon seeing interior symptoms such as yellow tongue coating, irritability, and thirst, purgation should be employed immediately, without being bound by the saying that "purgation should not be applied too early."
3. Differentiating by Tongue Appearance: When Wind-Cold is at the exterior level, the tongue typically lacks coating; if a white coating is present, it is thin and slippery. As it gradually transfers to the interior, the coating changes from white to yellow, then becomes dry and eventually black. In Warm-Heat diseases, upon the appearance of headache and fever, a white coating appears on the tongue immediately. This coating is thick and not slippery; it may have a pale yellow tint, be coarse like accumulated powder, display two or three colors simultaneously, or be dry despite being white. There are also cases where the coating turns black but remains non-dry; this is due to the concurrent presence of Dampness and Phlegm. However, upon palpation, the coating feels coarse and rough, or may have red papillae (cinnabar dots) or fissures. One must not mistake this for Interior Cold Yin-Condensation. A practitioner treating Warm-Heat should differentiate during the exterior phase, avoiding Acrid-Warm dispersing methods; upon identifying interior symptoms, they should immediately apply Cooling and Purgative methods. This approach is correct.
4. Differentiating by Spirit/Mental State: When invaded by Wind-Cold, the patient remains mentally clear about their suffering, such as knowing they have a headache or chills/fever. Even when the disease transfers to the interior and stomach, manifesting as mental confusion or delirious speech, the fundamental nature of Wind-Cold pathology maintains clear spirit amidst potential clouding. In contrast, Warm-Heat disease causes abnormal mental state and lack of awareness of specific discomfort right from the onset. Irritability is common, and in severe cases, the patient may appear dazed or intoxicated, exhibiting agitation, panic, and palpitations. When asked about their discomfort, they often do not know. Even if some patients retain clarity and self-awareness, they frequently suffer from restless sleep and visual hallucinations with closed eyes, which are the roots of delirious speech. This may result from failing to apply Cooling and dispersing methods promptly at the beginning, allowing the condition to drag on.
5. Differentiating by Pulse: The pulse of Warm-Heat disease resembles that of Wind-Cold after transmission, but differs significantly at the onset. Wind-Cold enters via the skin and hair; within one to two days, the pulse is mostly Floating, possibly combined with Tight, Slow, or Surging qualities, invariably Floating. It ceases to be Floating only after transferring to the interior, yet its rate remains distinct and clear. Warm-Heat emerges from the Middle Jiao; within one to two days, the pulse is mostly Deep. Only when moving from interior to exterior does the pulse cease to be Deep and become Rapid, possibly combined with Wiry or Large qualities, but generally not Floating. Its rate is vague and indistinct. If the pulse is Deep and Slow at the onset, do not mistake it for a Yin Syndrome. Deep indicates pathogen in the interior; Slow indicates pathogen in the Zang organs. Although the pulse quality mimics Yin-Cold, the complexion, tongue coating, and mental state will differ according to the previous differentiation methods. If the pulse is Rapid but forceless, do not treat it as Deficiency. Because the Heat steams and dissipates, the pulse naturally fails to press forcefully against the fingers. One should resolve the Heat rather than tonify Qi. Since the etiology differs, identical pulses may yield different diagnoses.