小便难；发其汗者，必谵语；加烧针者，则耳聋难言；但吐下之，则遗矢便利，如此疾者，宜服葳蕤汤。又治
温热病方十∶
（一）治肝腑脏温病，阴阳毒，颈背双筋牵，先寒后热，腰强急缩，目中生花方。（栀子、豆豉、柴胡、
鲜生地、大青、芒硝、
白术、桂心、生姜、石膏。）
（二）治肝腑脏温病，阴阳毒，先寒后热，颈筋挛牵，面目赤黄，身中强直方。（元参、细辛、栀子、黄芩、
升麻、芒硝、石膏、竹叶、车前草。）
（三）治心腑脏温病，阴阳毒，战掉不安，惊动方，（大青、黄芩、栀子、知母、芒硝、麻黄、元参、石膏、
生葛根、生地黄。）
（四）治脾腑脏温病，阴阳毒，头重颈直，皮肉痹，结核隐起方。（大青、羚羊角、升麻、射干、芒硝、
栀子、寒水石、元参。）
（五）治肺腑脏温病，阴阳毒，咳嗽连续，声不绝，呕逆方。（麻黄、栀子、紫菀、大青、元参、葛根、桂
心、甘草、杏仁、前胡、石膏。）
（六）治肾腑脏温病，身面如刺，腰中欲折，热毒内伤方。（茵陈、栀子、芒硝、苦参、生葛、鲜生地、石
膏、葱白、豆豉。）
（七）治温毒攻胃，下黄赤汁，及烂肉汁，赤滞下，伏气腹痛，诸热毒方。（栀子、豆豉、薤白。）
（八）治温病后劳复，或食或饮，或动作方。（栀子、豆豉、石膏、鼠屎。）
（九）治温病后，食太饱不消，劳复脉实者方。（栀子、豆豉、鼠屎、大黄。）
（十）治温病后，劳复，气欲绝方。（麦冬、甘草、大枣、竹叶、粳米。）
又曰∶凡热病新瘥后，食坚实难消之物，胃气尚虚弱，不能消化，必更结热，适以药下之，则胃气虚冷，
大利难禁，不下之必死，下之复危，皆难救也。热病及大病之后，多坐此死，不可不慎也。故凡温热病新瘥后，
但得食糜粥，宁少食令饥，慎勿饱，不得他有所食，虽思之勿与之也。引日转久，可渐食羊肉白糜若羹汁，雉
兔鹿肉不可食，猪狗肉亦然。又当静卧，慎
勿早起梳头洗面，非但体劳。亦不可多言语，用心使意劳烦。凡此皆令人劳复。余劳尚可，女劳则死，当吐舌
数寸，或吐涎而死。故温病新瘥，未满百日，气力不平复，而犯房室，名为阴阳易之病，皆难治多死。此思邈之
论温热也。
王氏外台秘要曰∶……温热病，头痛，骨肉烦疼，口燥心闷者……外寒内热者，或已下之，余热未尽者，
或热病自得利，有虚热烦渴者，宜服古今录验知母解肌汤。或已下及自得下，虚热未歇者，除麻黄，加知母葛
根。病热未除，因而梦泄者，除麻黄，加白薇、人参各二钱，则止。冬温未即病，至春被积寒所折，不得发，
至夏热，其春寒解，冬温毒始发出。肌中斑烂隐疹如锦纹，而咳心闷，呕吐清汁，眼赤口疮，下部亦生疮，宜
服古今录验漏芦橘皮汤，得下为佳。下后余症未除，更服葛根橘皮汤。温毒发斑，赤斑者五死一生，黑斑者十
死一生，宜服备急黑奴丸。若渴，但与水，须臾当寒，寒讫便汗，则解。日移五丈不觉，更服一丸。此疗六日
胸中当大热，口噤，名坏病，医所不疗，服此丸多瘥。若但温毒发斑，宜服肘后黑膏，使毒从皮中出，则愈。
温病有热，饮水暴冷而呃者，宜服短剧茅根汤，枇杷叶饮子亦效，茅根橘皮汤尤佳。肺腑脏热，暴气斑点，宜
服删繁香豉汤。温毒病吐下后，有余热而渴，宜服深师芍药汤。此 孙之论温热也。
朱氏类证活人书云∶夏至以前，发热恶寒，头疼身痛，其脉浮紧者，此名温病也。病由冬伤于寒，伏至
夏至以前，发为温病，盖因春温暖之气而发也。治法解肌汤最良。热多者，烦渴发热，不恶寒，或虚烦，并竹
叶石膏汤次第服之。脉尺寸俱浮，头疼身热，常自汗出，体重，其息必喘，四肢不收，默默但欲眠，此名风温
也。其人素伤于风，因复伤于热，风热相薄，即发风温。主四肢不收，头疼身热，当自汗出不解，治在少阴厥
阴，不可发汗。发汗即谵言独语，内烦躁扰，不得卧，若惊痫，目乱无精。疗之者复发其汗，如此死者，医杀
之也。治法宜葳蕤汤。若身灼热者，知母干葛汤；渴甚者，栝蒌根汤；脉浮身重汗出者，汉防己汤。两胫逆冷，
满腹满，多汗，头目痛苦，妄言，此名湿温也。病由湿热相薄，则发湿温。其脉阳濡而弱，阴小而急，治在太
阴，不可发汗。汗出必不出言，耳聋，不知痛所在，身青面色变，名曰重 。如此死者，医杀之也。白虎加苍
术汤主之。初春病患肌肉发斑瘾疹如锦纹，而咳心闷，但呕清汁，此名温毒也。温毒发斑者，冬时触冒疹毒，
至春始发。病初在表，或已发汗吐下，而表证未罢，毒瓦斯不散，故发斑，黑膏主之。又有冬月温暖，人感乖戾
之气，冬未即病，至春或被积寒所折，毒瓦斯不得泄，至天气暄热，温毒始发，则肌肉斑烂瘾疹如锦纹，而咳心
闷，但呕清汁，葛根橘皮汤主之，黄连橘皮汤尤佳。病患先热后寒，尺寸脉俱盛，此名温疟也，白虎加桂枝汤
主之。久不愈者，服疟母煎丸，当自愈。夏月发热恶寒，头疼，身体肢节痛重，其脉洪盛者，此名热病也。病由
冬伤于寒，因暑气而发为热病。治法桂枝石膏汤主之，栀子升麻汤亦可选用。此奉议之论温热也。
刘河间伤寒六书云∶有表而热者，谓之表热；无表而热者，谓之里热。凡表里俱热之症，或半在表，或半
在里，汗之不可，吐之又不可，法当和解；用凉膈、天水二散合服，水煎解之。或表热多、里热少，天水一，凉
膈半；或里热多、表热少，凉膈一，天水半，合和解之。若仍不能退其热者，用黄连解毒汤，直清里热。热势
更甚者，大柴胡合大承气汤下之，双除表里之热，大柴胡合三一承气汤亦佳。下症未全，不可下者，用白虎汤，
或知母石膏汤。其症初起，有暴发而为热者，病在心肺，宜用局方雄黄解毒丸。有里病积热者，病在肾肝，宜用局方妙
香
丸。如上焦热而烦者，宜用牛黄散。但上焦热，无他症者，宜用桔梗汤。中焦有湿热，不能食而热者，脾虚也，
宜以藿、朴、白术、陈皮之类治之。中焦有实热，能食而热者，胃实也，宜以栀子黄芩汤或三黄丸之类治之。
脏腑热极，大便闭结者，宜用大黄牵牛散。若病久憔悴，寝汗发热，五脏齐损，瘦弱虚烦，肠 下血，骨蒸痿
弱，四肢无力，不能运动者，此久热骨蒸也，病在下焦肝肾，宜养血益阴，热能自退，当归、生地合钱氏地黄
丸之类。如热入血室，发狂不认人者，宜用牛黄膏以宣解之。如阳狂奔走骂詈，不避亲疏，此阳有余，阴不足，
宜用当归承气汤下之。若两胁肋热，或一身夜热，或日晡肌热者，皆为血热也，四顺饮子主之，若小便闭而不
通，脐下状如复碗，痛闷不可忍者，乃肠胃干涸，膻中气不下，三焦气不化也，宜用八正散加沉香、木香，令
气通达，小便自通。此守真之论温热也。
李氏此事难知云∶冬伤于寒，春必温病，盖因房室劳伤与辛苦之人，腠理开泄，少阴不藏，肾水涸竭而
得之。无水则春木无以发生，故为温病。至长夏之时，时强木长，因绝水之源，无以滋化，故为大热病也。……邪
之所感，浅者其病轻而易治，深者其病重而难治，尤深者其病死而不治。此东垣之论温热也。
朱氏脉因证治云∶因房劳辛苦之过，腠理开泄，少阴不藏，触冒冬时杀厉之气，严寒之毒，中而即病，
曰伤寒。不即病，寒毒藏于肌肤之间，至春变为温病，至夏变为热病，皆热不得发泄，郁蒸于内，遇感而发，
虽曰伤寒，实为热病，死症甚多。
（一）温病二三日，体热腹满头痛，饮食如故，脉直而疾者，八日死。
（二）温病四五日，头痛腹满而吐，脉来细劲，十二日死。
（三）温病八九日，头身不痛，目不赤，身不变而反利，脉来牒牒，按之不弹手，时大，心下坚，十七日
死。
（四）温病汗不出，出不至足者死。
（五）温病厥汗出，肾脉强急者生，虚缓者死。
（六）温病下痢，腹中痛甚者死。
（七）热病七八日，不汗躁狂，口舌暴燥焦黑，脉反细弱、或代者死。
（八）热病得汗，脉躁者死，脉转大者死。
（九）热病七八日，脉不躁，喘不数，后三日中有汗，不汗者四日死。
（十）热病脉涩小疾，腹满膨胀，身热不得大小便死。
（十一）热病脉浮大绝，喘而短气，大衄不止，腹中疼死。
（十二）热病脉浮洪，肠鸣腹满，四肢清，注泄死。
（十三）热病脉绝动疾，便血，夺形肉，身热甚死。
（十四）热病脉小疾，咳喘眩悸，夺形肉，身热死。
（十五）热病腹胀，便血，脉大，时时小绝，汗出而喘，口干，视不见者死。
（十六）热病脉转小，身热甚死。
（十七）热病脉转小，身热甚，咳而便血，目陷妄言，循衣缝，躁扰不卧死。
（十八）热病呕血，咳而烦满，身黄腹胀，泄不止，脉绝死。
（十九）热病螈 ，狂走不能食，腹满，胸痛引腰脊，呕血死。
（二十）热病不知所痛，不能自收，口干阳热甚，阴颇有寒者死。
（二十一）热病在肾，口干渴，舌燥黄赤，日夜饮水不知，腹大胀尚饮，目无精光者死。
（二十二）热病喘咳唾血，手足腹肿，面黄，振栗不言，名肺绝死，丁日死（后仿此）。
（二十三）热病头痛，呕宿汗，呕逆吐血，水浆不入口，狂妄，腹大满，名脾绝死。
（二十四）热病烦满骨痛，嗌肿不可咽，欲咳不能咳，歌笑而哭，名心绝死。
（二十五）热病僵卧，足不安地，呕血，血妄行，遗屎溺，名肝绝死。
（二十六）热病喘悸吐逆，骨痛短气，目视不明，汗如珠，名肾绝死，此丹溪之论温热也。
王氏溯洄集云∶伤寒，以病因而为病名∶温病、热病，以天时与病形而为病名。伤寒即发于天令寒冷之
时，而寒邪在表，闭其腠理∶故非辛甘温之剂，不足以散之，此仲景桂枝、麻黄等汤之所以必用也。温病、热
病，后发于天令暄热之时，伏热自内而达于外，郁其腠理，无寒在表，故非辛凉或苦寒或酸苦之剂，不足以解
之。此仲景桂枝、麻黄等汤独治外者之所以不可用，而后人所处水解散、大黄汤、千金汤、防风通圣散之类兼
治内外者之所以可用也。夫即病之伤寒，有恶风恶寒之证者，风寒在表，而表气受伤故也；后发之温病、热病，
有恶风恶寒之证者，重在风寒新中，而表气亦受伤故也。若无新中之风寒，则无恶风恶寒之证，故仲景曰∶太
阳病发热而渴，不恶寒者，为温病。温病如此，则知热病亦如此。……且温病、热病，亦有先见表证而后传里
者。盖伏热自内达外，热郁腠理，不得外泄，遂复还里而成可攻之证，非如伤寒从表而始也。或者不悟此理，
乃于春夏温病、热病而求浮紧之脉，不亦疏乎！殊不知紧为寒脉，有寒邪则见之，无寒邪则不见也。其温病、
热病或见紧脉者，乃重感不正之暴寒，与内伤过度之冷食也。岂其本
然哉！夫温病、热病之脉，多在肌肉之分而不甚浮，且右手反盛于左手者，诚由郁热在内故也。其或左手盛或
浮者，必有重感之风寒，否则非温病、热病，自是暴感风寒之病耳！凡温病、热病，若无重感，表证虽间见，
而里病为多，故少有不渴者。斯时也，法当治里热为主，而解表兼之，亦有治里而表自解者。余每见世人治温热
病，虽误攻其里，亦无大害；误发其表，变不可言。此足以明其热之自内达外矣。其间有误攻里而致大害者，
乃春夏暴寒所中之新感症，邪纯在表，未入于里故也，不可与温病、热病同论。……虽然，伤寒与温病、热病，
其攻里之法，若果是以寒除热，固不必求异，其发表之法，断不可不异也。若温病、热病被时行不正之气所发，
及重感异气而变者，则又当观其何时何气，参酌而治，尤不可例以仲景即病伤寒药通治也。此安道之论温热也。
汪氏证治要诀云∶温与热有轻重之分，故仲景云∶若遇温气，则为温病，更遇温热，则为温毒。热比温为
尤重故也。苟但冬伤于寒，至春而发，不感异气，名曰温病，病稍轻。温病未已，更遇温气，变为温毒；亦可
名曰温病，病较重。此伏气之温病也。又有不因冬月伤寒，至春而病温者，此特春温之气，可名曰春温，如冬
之伤寒，秋之伤湿，夏之中暑相同。此新感之温病也。以此观之，是春之病温，有三种不同∶有冬伤于寒，至春
发为温病者；有温病未已，更遇温气，则为温病，与重感温气相杂而为温病者；有不因冬伤于寒，不因更遇温
气，只于春时感春温之气而病者。若此三者，皆可名为温病，不必各立名色，只要辨其病源之不同而已。此石
山之论温热也。
王氏伤寒准绳云∶从立春节后，其中无暴大寒，又不冰雪，而有人壮热为病者，此属春时阳气发于外，
冬时伏寒，变为温病。按活人所云∶温病有二∶其用升麻解肌汤者，乃正伤
寒太阳证，恶寒而不渴者，特以其发于温暖之时，故谓之温病尔；其用竹叶石膏汤者，乃仲景所谓渴不恶寒之
小便困难；如果误用发汗法治疗，必然出现胡言乱语的症状；如果加用烧针疗法，则会导致耳聋、言语困难；如果仅仅使用催吐或泻下的方法，则会出现大小便失禁。对于这类疾病，适宜服用葳蕤汤（Jade Bamboo Decoction）。另外记载治疗温热病的十个方剂：
（一）治疗肝脏温热病、阴阳毒，表现为颈背两侧筋脉牵引拘急，先恶寒后发热，腰部僵硬紧缩，眼前视物如花乱舞的方剂。（药材包括：栀子、豆豉、柴胡、鲜生地、大青叶、芒硝、白术、桂心、生姜、石膏。）
（二）治疗肝脏温热病、阴阳毒，先恶寒后发热，颈部筋脉挛缩牵引，面目呈现赤黄色，身体僵硬直立的方剂。（药材包括：玄参、细辛、栀子、黄芩、升麻、芒硝、石膏、竹叶、车前草。）
（三）治疗心脏温热病、阴阳毒，表现为战栗动摇、心神不安、惊悸扰动的方剂。（药材包括：大青叶、黄芩、栀子、知母、芒硝、麻黄、玄参、石膏、生葛根、生地黄。）
（四）治疗脾脏温热病、阴阳毒，表现为头重颈项强直，皮肤肌肉麻木不仁，皮下有结核隐起的方剂。（药材包括：大青叶、羚羊角、升麻、射干、芒硝、栀子、寒水石、玄参。）
（五）治疗肺脏温热病、阴阳毒，表现为连续咳嗽，声音不断，伴有呕吐逆气的方剂。（药材包括：麻黄、栀子、紫菀、大青叶、玄参、葛根、桂心、甘草、杏仁、前胡、石膏。）
（六）治疗肾脏温热病，表现为身面如针刺感，腰部感觉要折断，热毒内伤的方剂。（药材包括：茵陈、栀子、芒硝、苦参、生葛根、鲜生地、石膏、葱白、豆豉。）
（七）治疗温毒攻冲胃部，排出黄红色汁液，以及腐烂肉样的汁液，赤色黏滞的痢疾，伏气温病引起的腹痛，以及各种热毒病症的方剂。（药材包括：栀子、豆豉、薤白。）
（八）治疗温热病痊愈后因劳累复发，或因饮食、饮水、动作不当导致复发的方剂。（药材包括：栀子、豆豉、石膏、鼠屎。）
（九）治疗温热病痊愈后，因吃得过饱不消化，劳累复发且脉象实有力的方剂。（药材包括：栀子、豆豉、鼠屎、大黄。）
（十）治疗温热病痊愈后因劳累复发，气息微弱欲绝的方剂。（药材包括：麦冬、甘草、大枣、竹叶、粳米。）
又说：凡是热病刚刚痊愈后，食用坚硬难消化的食物，由于胃气依然虚弱，不能消化，必然再次结聚热邪。此时如果用药物攻下，会导致胃气虚冷，造成严重腹泻难以控制；如果不攻下则必死无疑，攻下后又处于危险境地，都很难救治。热病及大病之后，很多人因此死亡，不可不谨慎。所以凡是温热病刚刚痊愈后，只能吃稀粥，宁可少吃保持轻微饥饿感，千万不要吃撑，不得食用其他食物，即使想吃也不要给。经过一段时间后，可以逐渐食用羊肉、白米粥或羹汁，雉鸡、兔子、鹿肉不可食用，猪肉、狗肉也是如此。还应当静卧休息，切勿早起梳头洗脸，这不仅会劳累身体。也不可以说太多话，用心思使意念劳烦。所有这些都会导致劳累复发。一般的劳累还可以忍受，如果是房事劳累则会致死，表现为舌头吐出数寸长，或者吐出涎沫而死。所以温热病刚痊愈，未满一百天，体力尚未完全恢复，而犯房事，这叫做“阴阳易”病，都很难治疗，死亡率很高。这是孙思邈关于温热病的论述。
王焘《外台秘要》说：……温热病，头痛，骨肉烦痛，口燥心闷的……外有寒象内有热邪的，或者已经用过泻下法，余热未尽的，或者热病自然得利，有虚热烦渴的，适宜服用古今录验知母解肌汤。或者已经泻下及自然泻下，虚热未歇的，去掉麻黄，加入知母、葛根。病热未除，因而发生梦遗的，去掉麻黄，加入白薇、人参各二钱，则可以止住。冬温病当时未发病，到春天被积寒所遏制，未能发散，到了夏天天气炎热，春天的寒气解除，冬天的温毒才发出。肌肤中出现斑烂隐疹像锦纹一样，并且咳嗽心闷，呕吐清汁，眼睛发红，口腔生疮，下部也生疮，适宜服用古今录验漏芦橘皮汤，能泻下为佳。泻下后余症未除，再服用葛根橘皮汤。温毒发斑，红色斑点的五死一生，黑色斑点的十死一生，适宜服用备急黑奴丸。如果口渴，只给水喝，片刻后会感到寒冷，寒冷过后就会出汗，病就好了。太阳移动五丈的距离还没感觉到变化，再服一丸。此药治疗六日胸中应当大热，口噤不开，称为坏病，医生无法治疗的，服用此丸大多痊愈。如果只是温毒发斑，适宜服用肘后备急方黑膏，使毒邪从皮肤中排出，则痊愈。温热病有热，因突然饮用冷水而打嗝的，适宜服用短剧茅根汤，枇杷叶饮子也有效，茅根橘皮汤尤其好。肺脏温热，突发气斑点，适宜服用删繁香豉汤。温毒病在吐下后，有余热而口渴的，适宜服用深师芍药汤。这是孙思邈关于温热病的论述。
朱肱《类证活人书》说：夏至以前，发热恶寒，头疼身痛，脉象浮紧的，这名叫温病。病因是冬天受寒，潜伏到夏至以前，因为春天温暖之气而发作。治疗方法以解肌汤最好。热多的，烦渴发热，不恶寒，或者虚烦，依次服用竹叶石膏汤。脉象尺寸部都浮，头疼身热，经常自汗出，身体沉重，呼吸必定气喘，四肢无力下垂，沉默只想睡觉，这名叫风温。其人平时伤于风，又再次伤于热，风热相搏，就发作风温。主治四肢无力下垂，头疼身热，应当自汗出不解，病位在少阴、厥阴，不可发汗。发汗就会导致胡言独语，内心烦躁扰乱，不能躺卧，像惊痫一样，眼睛昏乱无神。治疗者如果再发其汗，这样死亡的，是医生杀死的。治疗方法适宜用葳蕤汤。如果身体灼热的，用知母干葛汤；口渴严重的，用栝蒌根汤；脉浮身体重汗出的，用汉防己汤。两小腿逆冷，腹部胀满，多汗，头目痛苦，胡言乱语，这名叫湿温。病因是湿热相搏，就发作湿温。其脉象阳部濡弱，阴部小急，病位在太阴，不可发汗。发汗后一定不出声，耳聋，不知道疼痛所在，身体发青面色改变，名叫重暍。这样死亡的，是医生杀死的。主治用白虎加苍术汤。初春病患肌肉发斑瘾疹像锦纹一样，并且咳嗽心闷，只是呕吐清汁，这名叫温毒。温毒发斑的，冬天触犯疹毒，到春天才发作。病初在表，或者已经发汗吐下，而表证未罢，毒瓦斯不散，所以发斑，用黑膏主治。又有冬天月温暖，人感受乖戾之气，冬天未即发病，到春天或被积寒所遏制，毒瓦斯不得泄，到天气暖和，温毒才发作，则肌肉斑烂瘾疹像锦纹一样，并且咳嗽心闷，只是呕吐清汁，用葛根橘皮汤主治，黄连橘皮汤尤其好。病患先热后寒，尺寸脉都盛，这名叫温疟，主治用白虎加桂枝汤。久不愈的，服用疟母煎丸，应当自愈。夏天月发热恶寒，头疼，身体肢节痛重，脉象洪盛的，这名叫热病。病因是冬天受寒，因为暑气而发作热病。治疗方法用桂枝石膏汤主治，栀子升麻汤也可选用。这是奉议（朱肱）关于温热病的论述。
刘完素《伤寒六书》说：有表证而热的，叫表热；无表证而热的，叫里热。凡是表里俱热的症状，或者一半在表，或者一半在里，发汗不可以，催吐又不可以，法当和解；用凉膈散、天水散两个方子合服，用水煎煮解开热邪。或者表热多、里热少，天水散一份，凉膈散半份；或者里热多、表热少，凉膈散一份，天水散半份，合起来和解。如果仍然不能退热，用黄连解毒汤，直接清泄里热。热势更严重的，用大柴胡汤合大承气汤泻下，双除表里之热，大柴胡汤合三一承气汤也很好。下症未全，不可泻下的，用白虎汤，或者知母石膏汤。其症状初起，有暴发而为热的，病在心肺，适宜用局方雄黄解毒丸。有里病积热的，病在肾肝，适宜用局方妙香丸。如上焦热而烦的，适宜用牛黄散。只是上焦热，没有其他症状的，适宜用桔梗汤。中焦有湿热，不能进食而热的，是脾虚，适宜用藿香、厚朴、白术、陈皮之类治疗。中焦有实热，能进食而热的，是胃实，适宜用栀子黄芩汤或三黄丸之类治疗。脏腑热极，大便闭结的，适宜用大黄牵牛散。如果病久憔悴，睡时出汗发热，五脏齐损，瘦弱虚烦，肠下血，骨蒸痿弱，四肢无力，不能运动的，这是久热骨蒸，病在下焦肝肾，适宜养血益阴，热能自退，用当归、生地合钱氏地黄丸之类。如果热入血室，发狂不认识人的，适宜用牛黄膏宣散解郁。如果阳狂奔走骂詈，不避亲疏，这是阳有余，阴不足，适宜用当归承气汤泻下。如果两胁肋热，或者一身夜间热，或者日晡时肌热，都是血热，主治用四顺饮子。如果小便闭而不通，脐下状如倒扣的碗，痛闷不可忍受，乃是肠胃干涸，膻中气不下，三焦气不化，适宜用八正散加沉香、木香，令气通达，小便自通。这是守真（刘完素）关于温热病的论述。
李东垣《此事难知》说：冬天受寒，春天必发温病，大概是因为房事劳伤与辛苦之人，腠理开泄，少阴不藏，肾水枯竭而得的。没有水则春天的木气无以发生，所以为温病。到长夏之时，时令强木生长，因为断绝了水的源头，无以滋化，所以为大热病。……邪气所感，浅的病轻而易治，深的病重而难治，尤其深的病死而不治。这是东垣（李杲）关于温热病的论述。
朱震亨《脉因证治》说：因为房劳辛苦的过错，腠理开泄，少阴不藏，触冒冬天杀厉之气，严寒之毒，中而即病，叫伤寒。不即病，寒毒藏在肌肤之间，到春天变为温病，到夏天变为热病，都是热不得发泄，郁蒸于内，遇感而发，虽然叫伤寒，实为热病，死症很多。
（一）温病二三日，体热腹满头痛，饮食如故，脉直而疾的，八日死。
（二）温病四五日，头痛腹满而吐，脉来细劲的，十二日死。
（三）温病八九日，头身不痛，目不赤，身不变而反利，脉来牒牒，按之不弹手，时而大，心下坚的，十七日死。
（四）温病汗不出，出汗不到足的死。
（五）温病厥逆汗出，肾脉强急的生，虚缓的死。
（六）温病下痢，腹中痛甚的死。
（七）热病七八日，不汗躁狂，口舌暴燥焦黑，脉反细弱、或代脉的死。
（八）热病得汗，脉躁的死，脉转大的死。
（九）热病七八日，脉不躁，喘不数，后三日中有汗，不汗的四日死。
（十）热病脉涩小疾，腹满膨胀，身热不得大小便的死。
（十一）热病脉浮大绝，喘而短气，大衄不止，腹中疼的死。
（十二）热病脉浮洪，肠鸣腹满，四肢清冷，注泄的死。
（十三）热病脉绝动疾，便血，夺形肉，身热甚的死。
（十四）热病脉小疾，咳喘眩悸，夺形肉，身热的死。
（十五）热病腹胀，便血，脉大，时时小绝，汗出而喘，口干，视不见的死。
（十六）热病脉转小，身热甚的死。
（十七）热病脉转小，身热甚，咳而便血，目陷妄言，循衣缝，躁扰不卧的死。
（十八）热病呕血，咳而烦满，身黄腹胀，泄不止，脉绝的死。
（十九）热病抽搐，狂走不能食，腹满，胸痛引腰脊，呕血的死。
（二十）热病不知所痛，不能自收，口干阳热甚，阴颇有寒的死。
（二十一）热病在肾，口干渴，舌燥黄赤，日夜饮水不知，腹大胀尚饮，目无精光的死。
（二十二）热病喘咳唾血，手足腹肿，面黄，振栗不言，名肺绝死，丁日死（后仿此）。
（二十三）热病头痛，呕宿汗，呕逆吐血，水浆不入口，狂妄，腹大满，名脾绝死。
（二十四）热病烦满骨痛，咽肿不可咽，欲咳不能咳，歌笑而哭，名心绝死。
（二十五）热病僵卧，足不安地，呕血，血妄行，遗屎溺，名肝绝死。
（二十六）热病喘悸吐逆，骨痛短气，目视不明，汗如珠，名肾绝死，这是丹溪（朱震亨）关于温热病的论述。
王履《溯洄集》说：伤寒，以病因而为病名；温病、热病，以天时与病形而为病名。伤寒即发于天令寒冷之时，而寒邪在表，闭其腠理；所以非辛甘温之剂，不足以散之，这是仲景桂枝、麻黄等汤之所以必用的原因。温病、热病，后发于天令暄热之时，伏热自内而达于外，郁其腠理，无寒在表，所以非辛凉或苦寒或酸苦之剂，不足以解之。这是仲景桂枝、麻黄等汤独治外者之所以不可用，而后人所处水解散、大黄汤、千金汤、防风通圣散之类兼治内外者之所以可用的原因。夫即病之伤寒，有恶风恶寒之证的，是风寒在表，而表气受伤的缘故；后发之温病、热病，有恶风恶寒之证的，重在风寒新中，而表气亦受伤的缘故。如果没有新中的风寒，则无恶风恶寒之证，所以仲景说：太阳病发热而渴，不恶寒者，为温病。温病如此，则知热病亦如此。……而且温病、热病，也有先见表证而后传里的。盖伏热自内达外，热郁腠理，不得外泄，遂复还里而成可攻之证，不像伤寒从表而始。有人不明白这个道理，乃于春夏温病、热病而求浮紧之脉，不也太疏忽了吗！殊不知紧为寒脉，有寒邪则见之，无寒邪则不见也。其温病、热病或见紧脉的，乃是重感不正之暴寒，与内伤过度之冷食也。难道是其本然吗！夫温病、热病的脉，多在肌肉之分而不甚浮，且右手反盛于左手者，诚由郁热在内缘故。其或左手盛或浮的，必有重感之风寒，否则非温病、热病，自是暴感风寒之病耳！凡温病、热病，若无重感，表证虽间见，而里病为多，所以少有不渴的。这时候，法当治里热为主，而解表兼之，亦有治里而表自解的。我常见世人治温热病，虽误攻其里，亦无大害；误发其表，变不可言。这足以明其热之自内达外矣。其中有误攻里而致大害的，乃是春夏暴寒所中之新感症，邪纯在表，未入于里缘故，不可与温病、热病同论。……虽然，伤寒与温病、热病，其攻里之法，若果是以寒除热，固不必求异，其发表之法，断不可不异也。若温病、热病被时行不正之气所发，及重感异气而变的，则又当观其何时何气，参酌而治，尤不可例以仲景即病伤寒药通治也。这是安道（王履）关于温热病的论述。
汪机《证治要诀》说：温与热有轻重之分，所以仲景说：若遇温气，则为温病，更遇温热，则为温毒。热比温为尤重缘故。苟但冬伤于寒，至春而发，不感异气，名叫温病，病稍轻。温病未已，更遇温气，变为温毒；亦可名叫温病，病较重。这是伏气之温病。又有不因冬月伤寒，至春而病温的，此特春温之气，可名叫春温，如冬之伤寒，秋之伤湿，夏之中暑相同。这是新感之温病。以此观之，是春之病温，有三种不同：有冬伤于寒，至春发为温病的；有温病未已，更遇温气，则为温病，与重感温气相杂而为温病的；有不因冬伤于寒，不因更遇温气，只于春时感春温之气而病的。若此三者，皆可名为温病，不必各立名色，只要辨其病源之不同而已。这是石山（汪机）关于温热病的论述。
王肯堂《伤寒准绳》说：从立春节后，其中无暴大寒，又不冰雪，而有人壮热为病的，此属春时阳气发于外，冬时伏寒，变为温病。按活人所云：温病有二：其用升麻解肌汤的，乃正伤寒太阳证，恶寒而不渴的，特以其发于温暖之时，故谓之温病尔；其用竹叶石膏汤的，乃仲景所谓渴不恶寒之
Difficulty in urination; if diaphoresis (sweating therapy) is applied, delirium will inevitably occur; if burning needle therapy is added, deafness and difficulty in speech will result; if only emesis or purgation is used, fecal and urinary incontinence will ensue. For such conditions, Yu Zhi Tang (Jade Bamboo Decoction) is appropriate. Additionally, ten formulas for treating Warm-Heat diseases are recorded:
(1) Formula for treating Liver Warm-Heat disease, Yin-Yang Toxicity, with牵引 (pulling/tightening) of the tendons on both sides of the neck and back, initial chills followed by fever, stiffness and contraction of the waist, and visual disturbances described as seeing flowers before the eyes. (Ingredients: Gardenia, Fermented Soybean, Bupleurum, Fresh Rehmannia Root, Isatis Leaf, Mirabilite, Atractylodes Macrocephala, Cinnamon Twig Heart, Fresh Ginger, Gypsum.)
(2) Formula for treating Liver Warm-Heat disease, Yin-Yang Toxicity, with initial chills followed by fever, spasm and pulling of the neck tendons, red-yellow complexion, and rigidity of the body. (Ingredients: Scrophularia Root, Asarum, Gardenia, Scutellaria Root, Cimicifuga Rhizome, Mirabilite, Gypsum, Bamboo Leaf, Plantago Seed/Herb.)
(3) Formula for treating Heart Warm-Heat disease, Yin-Yang Toxicity, with tremors, restlessness,惊动 (startle/agitation). (Ingredients: Isatis Leaf, Scutellaria Root, Gardenia, Anemarrhena Rhizome, Mirabilite, Ephedra Stem, Scrophularia Root, Gypsum, Raw Kudzu Root, Raw Rehmannia Root.)
(4) Formula for treating Spleen Warm-Heat disease, Yin-Yang Toxicity, with heavy head and stiff neck, numbness of skin and flesh, and subcutaneous nodules. (Ingredients: Isatis Leaf, Antelope Horn, Cimicifuga Rhizome, Belamcanda Rhizome, Mirabilite, Gardenia, Aragonite, Scrophularia Root.)
(5) Formula for treating Lung Warm-Heat disease, Yin-Yang Toxicity, with continuous coughing, unceasing voice, and vomiting with reflux. (Ingredients: Ephedra Stem, Gardenia, Aster Tataricus Root, Isatis Leaf, Scrophularia Root, Kudzu Root, Cinnamon Twig Heart, Licorice Root, Apricot Seed, Peucedanum Root, Gypsum.)
(6) Formula for treating Kidney Warm-Heat disease, with sensations like pricks on the body and face, feeling that the waist is about to break, caused by internal injury from Heat-Toxin. (Ingredients: Artemisia Capillaris, Gardenia, Mirabilite, Sophora Root, Raw Kudzu Root, Fresh Rehmannia Root, Gypsum, Green Onion White, Fermented Soybean.)
(7) Formula for treating Warm-Toxin attacking the Stomach, discharging yellow-red fluid, rotting flesh-like fluid, bloody dysentery, abdominal pain due to latent Qi, and various Heat-Toxin conditions. (Ingredients: Gardenia, Fermented Soybean, Allium Macrostemon Bulb.)
(8) Formula for treating relapse due to overexertion after Warm-Heat disease, or relapse due to improper diet, drinking, or physical activity. (Ingredients: Gardenia, Fermented Soybean, Gypsum, Rat Feces.)
(9) Formula for treating relapse due to overexertion after Warm-Heat disease, where food was consumed excessively and not digested, and the pulse is excess/solid. (Ingredients: Gardenia, Fermented Soybean, Rat Feces, Rhubarb.)
(10) Formula for treating relapse due to overexertion after Warm-Heat disease, where Qi is nearly exhausted. (Ingredients: Ophiopogon Tuber, Licorice Root, Jujube, Bamboo Leaf, Rice Grain.)
It is further stated: After a heat disease has just healed, if one consumes solid, hard-to-digest foods, and the Stomach Qi remains weak and unable to digest them, heat will inevitably re-accumulate. If purgatives are then administered, it will cause Stomach Qi deficiency and cold, leading to severe diarrhea that cannot be controlled; if not purged, death is certain; if purged, the condition becomes critical again, making rescue difficult. Many die after heat or major illnesses due to this negligence; caution is essential. Therefore, after a Warm-Heat disease has just healed, one should only consume rice gruel, preferring to eat little and remain slightly hungry, avoiding fullness, and refraining from other foods, even if desired. After some time, mutton, white rice gruel, or soup can be gradually introduced. Pheasant, rabbit, and deer meat should not be eaten, nor pork or dog meat. One should lie quietly and avoid getting up early to comb hair or wash the face, as this causes physical fatigue. One should also avoid excessive talking and mental exertion. All these lead to relapse due to overexertion. General overexertion may be bearable, but sexual overexertion leads to death, characterized by the tongue protruding several inches or vomiting saliva until death. Thus, if sexual intercourse occurs within 100 days of recovering from a Warm-Heat disease, while strength has not fully recovered, it is called "Yin-Yang Exchange" disease, which is difficult to treat and often fatal. This is Sun Simiao’s discussion on Warm-Heat diseases.
Wang Tao’s *Waitai Miyao* states: ...For Warm-Heat disease presenting with headache, irritability and pain in bones and flesh, dry mouth, and chest oppression... for those with external cold and internal heat, or where residual heat remains after purgation, or where natural bowel movement has occurred leaving deficient heat with irritability and thirst, Gu Jin Lu Yan Zhi Mu Jie Ji Tang (Ancient and Modern Recorded Mother Root Muscle-Releasing Decoction) is suitable. If purgation or natural purgation has occurred and deficient heat persists, remove Ephedra Stem and add Anemarrhena Rhizome and Kudzu Root. If fever persists and nocturnal emission occurs, remove Ephedra Stem and add Glehnia Root and Ginseng Root, each 2 qian, to stop it. Winter-Warmth disease may not manifest immediately; if suppressed by accumulated cold in spring, it waits until summer heat resolves the spring cold, at which point winter warmth toxin emerges. Rashes and hidden rashes appear like brocade patterns on the skin, accompanied by cough, chest oppression, vomiting clear fluid, red eyes, oral ulcers, and sores in the lower body. Gu Jin Lu Yan Lou Lu Ju Pi Tang (Ancient and Modern Recorded Agrimony and Tangerine Peel Decoction) is suitable, with purgation being ideal. If residual symptoms persist after purgation, Ge Gen Ju Pi Tang (Kudzu Root and Tangerine Peel Decoction) should be taken. For Warm-Toxin causing macules, red macules indicate five deaths to one survival, black macules ten deaths to one survival; Bei Ji Hei Nu Wan (Emergency Black Slave Pill) is suitable. If thirsty, give water; shortly thereafter, chills will occur, followed by sweating, resolving the disease. If five zhang of sun movement passes without change, administer another pill. This treats "Huai Bing" (Ruined Disease) characterized by intense chest heat and locked jaw after six days, which doctors usually cannot treat; this pill often cures it. For simple Warm-Toxin macules, Zhou Hou Hei Gao (Elbow Emergency Black Plaster) is suitable to expel toxin through the skin. For Warm-Heat disease with sudden hiccups after drinking cold water, Duan Ju Mao Gen Tang (Short Drama Imperata Root Decoction) is suitable; Bi Pa Ye Yin Zi (Loquat Leaf Drink) is also effective, and Mao Gen Ju Pi Tang (Imperata Root and Tangerine Peel Decoction) is especially good. For Lung organ heat with sudden qi spots, Shan Fan Xiang Chi Tang (Eliminate Complexity Fragrant Fermented Bean Decoction) is suitable. For Warm-Toxin disease with residual heat and thirst after emesis/purgation, Shen Shi Shao Yao Tang (Deep Master Peony Decoction) is suitable. This is Sun Simiao’s discussion on Warm-Heat diseases.
Zhu Gong’s *Lei Zheng Huo Ren Shu* states: Before Summer Solstice, fever with chills, headache, body pain, and floating-tight pulse is named Warm-Heat disease. The cause is winter cold invasion, lying latent until before Summer Solstice, triggered by spring warmth. The best treatment is Jie Ji Tang (Muscle-Releasing Decoction). For high heat, irritability, thirst, fever, no chills, or deficient irritability, Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) should be taken sequentially. If pulses at Cun and Chi positions are both floating, with headache, fever, spontaneous sweating, heaviness, panting, flaccid limbs, silence, and desire to sleep, it is named Feng Wen (Wind-Warmth). This occurs when the person is constitutionally injured by wind and re-injured by heat; wind and heat interact, triggering Wind-Warmth. Main symptoms include flaccid limbs, headache, fever, spontaneous sweating that does not resolve. Treatment focuses on Shaoyin and Jueyin meridians; diaphoresis is contraindicated. Diaphoresis leads to delirious speech, internal irritability, inability to lie down, resembling epilepsy, with chaotic vision and lack of spirit. If treated by inducing sweat again, death results; this is physician-induced homicide. The appropriate treatment is Yu Zhi Tang. If the body is scorching hot, Zhi Mu Gan Ge Tang (Anemarrhena and Raw Kudzu Decoction) is used; for severe thirst, Gua Lou Gen Tang (Trichosanthes Root Decoction); for floating pulse, heaviness, and sweating, Han Fang Ji Tang (Han Fangji Decoction). If calves are cold, abdomen is full, sweating is profuse, head/eyes are painful, and there is delirium, it is named Shi Wen (Damp-Warmth). Caused by damp-heat interaction. Pulse is superficially soggy/weak and deep/small/urgent; treatment focuses on Taiyin; diaphoresis is contraindicated. Diaphoresis leads to muteness, deafness, unawareness of pain, cyanosis, and color changes, named Zhong Yue (Severe Heat Stroke). Death results; this is physician-induced homicide. Bai Hu Jia Cang Zhu Tang (White Tiger plus Atractylodes Decoction) is primary. In early spring, patients with macules/rashes like brocade, cough, chest oppression, and vomiting clear fluid have Wen Du (Warm-Toxin). Wen Du macules arise from winter toxin exposure, manifesting in spring. Initially in the exterior; if emesis/purgation fails to resolve exterior signs and toxin remains, macules appear; Hei Gao (Black Plaster) is primary. Alternatively, winter warmth allows abnormal qi invasion; if suppressed by spring cold, toxin remains until summer heat releases it, causing similar symptoms; Ge Gen Ju Pi Tang (Kudzu Root and Tangerine Peel Decoction) is primary, Huang Lian Ju Pi Tang (Coptis and Tangerine Peel Decoction) is better. Patients with initial heat followed by chills, strong Cun-Chi pulses have Wen Nue (Warm-Malaria); Bai Hu Jia Gui Zhi Tang (White Tiger plus Cinnamon Twig Decoction) is primary. Chronic cases use Nue Mu Jian Wan (Malaria Mass Decoction Pill). In summer, fever/chills, headache, limb pain/heaviness, and surging pulse indicate Re Bing (Heat Disease), caused by winter cold triggered by summer heat. Gui Zhi Shi Gao Tang (Cinnamon Twig and Gypsum Decoction) is primary; Zhi Zi Sheng Ma Tang (Gardenia and Cimicifuga Decoction) is optional. This is Feng Yi (Zhu Gong)’s discussion on Warm-Heat diseases.
Liu Hejian’s *Shang Han Liu Shu* states: Exterior heat is called Biao Re (Exterior Heat); interior heat without exterior signs is called Li Re (Interior Heat). For simultaneous exterior-interior heat, or half-exterior/half-interior, neither diaphoresis nor emesis is suitable; harmonization is required. Use Liang Ge San (Cooling the Diaphragm Powder) and Tian Shui San (Heavenly Water Powder) combined. Ratio depends on heat distribution: more exterior heat uses 1 part Tian Shui to 0.5 part Liang Ge; more interior heat uses 1 part Liang Ge to 0.5 part Tian Shui. If heat persists, Huang Lian Jie Du Tang (Coptis Detoxification Decoction) clears interior heat directly. For severe heat, Da Chai Hu Tang (Major Bupleurum Decoction) combined with Da Cheng Qi Tang (Major Order the Qi Decoction) purges both exterior and interior heat; Da Chai Hu Tang combined with San Yi Cheng Qi Tang is also good. If purge indications are incomplete, do not purge; use Bai Hu Tang (White Tiger Decoction) or Zhi Mu Shi Gao Tang (Anemarrhena and Gypsum Decoction). For acute onset heat affecting Heart/Lung, Ju Fang Xiong Huang Jie Du Wan (Official Bureau Realgar Detoxification Pill) is suitable. For chronic interior heat accumulation affecting Kidney/Liver, Ju Fang Miao Xiang Wan (Official Bureau Wonderful Incense Pill) is suitable. For upper jiao heat with irritability, Niu Huang San (Buffalo Horn Powder) is suitable. For isolated upper jiao heat, Jie Geng Tang (Platycodon Decoction) is suitable. For middle jiao damp-heat with anorexia and heat (Spleen deficiency), use Huo Xiang, Hou Po, Bai Zhu, Chen Pi. For middle jiao excess heat with appetite (Stomach excess), use Zhi Zi Huang Qin Tang (Gardenia and Scutellaria Decoction) or San Huang Wan (Three Yellows Pill). For extreme organ heat with constipation, Da Huang Qian Niu San (Rhubarb and Morning Glory Seed Powder) is suitable. For chronic wasting, night sweats, heat, five-organ damage, emaciation, deficient irritability, intestinal bleeding, bone-steaming, weakness, and immobility, this is chronic bone-steaming heat affecting Lower Jiao Kidney/Liver; nourish blood and yin using Dang Gui, Sheng Di combined with Qian Shi Di Huang Wan (Qian’s Rehmannia Pill). For heat entering Blood Chamber with madness and misidentification, Niu Huang Gao (Buffalo Horn Paste) is suitable. For wild running and cursing (excess Yang, deficient Yin), Dang Gui Cheng Qi Tang (Angelica Order the Qi Decoction) purges. For hypochondriac heat, nightly body heat, or afternoon muscle heat, this is Blood Heat; Si Shun Yin Zi (Four Smooth Infusion) is primary. For urinary retention with suprapubic distension like an inverted bowl and unbearable pain, due to dry intestines/colon and stagnant Qi in Danzhong/Sanjiao, Ba Zheng San (Eight Uprights Powder) plus Chen Xiang, Mu Xiang promotes Qi flow and urination. This is Shou Zhen (Liu Wansu)’s discussion on Warm-Heat diseases.
Li Shi’s *Ci Shi Nan Zhi* states: Winter cold invasion leads to Spring Warm-Heat disease, often due to sexual exhaustion or hard labor opening pores, failing to store Shaoyin, depleting Kidney Water. Without water, Spring Wood cannot generate, causing Warm-Heat. By Late Summer, Wood grows strongly but lacks Water source, causing Great Heat Disease. ...Superficial pathogens cause mild/easy-to-treat disease; deep pathogens cause severe/difficult disease; extremely deep pathogens are fatal/incurable. This is Dong Yuan (Li Gao)’s discussion on Warm-Heat diseases.
Zhu Shi’s *Mai Yin Zheng Zhi* states: Due to sexual/labor exhaustion opening pores and failing to store Shaoyin, exposure to winter killing cold/toxin causes immediate Shang Han (Cold Damage). If not immediate, cold toxin hides in skin/flesh, transforming into Warm-Heat in Spring and Heat Disease in Summer. Heat cannot vent, stagnates internally, and erupts upon trigger. Though called Shang Han, it is actually Heat Disease with many fatalities.
(1) Warm-Heat day 2-3: body heat, abdominal fullness, headache, normal diet, straight/fast pulse → death on day 8.
(2) Warm-Heat day 4-5: headache, abdominal fullness, vomiting, thin/tough pulse → death on day 12.
(3) Warm-Heat day 8-9: no head/body pain, eyes not red, body unchanged but loose stools, pulsating pulse non-elastic on pressure, occasionally large, epigastric hardness → death on day 17.
(4) Warm-Heat: no sweat, or sweat not reaching feet → death.
(5) Warm-Heat with cold extremities and sweat: strong/tense Kidney pulse → survival; weak/slow pulse → death.
(6) Warm-Heat with dysentery and severe abdominal pain → death.
(7) Heat Disease day 7-8: no sweat, agitation/manic, sudden dry/black tongue, fine/weak or intermittent pulse → death.
(8) Heat Disease with sweat: rapid pulse → death; pulse becomes large → death.
(9) Heat Disease day 7-8: pulse not rapid, panting not frequent, sweat within next 3 days → survival; no sweat → death on day 4.
(10) Heat Disease: choppy/small/fast pulse, abdominal fullness/bloating, fever, inability to pass stool/urine → death.
(11) Heat Disease: floating/extreme pulse, panting/shortness of breath, massive epistaxis, abdominal pain → death.
(12) Heat Disease: floating/surging pulse, borborygmus, abdominal fullness, cold limbs, profuse diarrhea → death.
(13) Heat Disease: absent/rapid pulse, hematochezia, emaciation, severe fever → death.
(14) Heat Disease: small/fast pulse, cough/wheeze/dizziness/palpitations, emaciation, fever → death.
(15) Heat Disease: abdominal distension, hematochezia, large pulse, intermittent small pulse, sweating/panting, dry mouth, blindness → death.
(16) Heat Disease: pulse becomes small, severe fever → death.
(17) Heat Disease: pulse becomes small, severe fever, cough/hematochezia, sunken eyes, delirium, picking at clothes, restlessness/insomnia → death.
(18) Heat Disease: hematemesis, cough/irritability/fullness, jaundice, abdominal distension, intractable diarrhea, absent pulse → death.
(19) Heat Disease: convulsions, manic running, anorexia, abdominal fullness, chest pain radiating to back, hematemesis → death.
(20) Heat Disease: unaware of pain, inability to control body, dry mouth/excessive Yang heat, significant Yin cold → death.
(21) Heat Disease in Kidney: dry mouth/thirst, dry/yellow-red tongue, drinking day/night without relief, abdominal distension despite drinking, lifeless eyes → death.
(22) Heat Disease: panting/cough/spitting blood, edema of hands/feet/abdomen, yellow face, trembling/muteness → Lung Exhaustion death, dies on Ding day.
(23) Heat Disease: headache, vomiting old sweat/reflux/vomit blood, inability to drink, mania, abdominal fullness → Spleen Exhaustion death.
(24) Heat Disease: irritability/fullness, bone pain, throat swelling/swallowing difficulty, urge to cough but cannot, singing/laughing/crying → Heart Exhaustion death.
(25) Heat Disease: rigid lying, feet unable to touch ground, hematemesis, erratic bleeding, fecal/urinary incontinence → Liver Exhaustion death.
(26) Heat Disease: panting/palpitations/reflux, bone pain/shortness of breath, blurred vision, pearl-like sweat → Kidney Exhaustion death. This is Dan Xi (Zhu Zhenheng)’s discussion on Warm-Heat diseases.
Wang Shi’s *Su Hui Ji* states: Shang Han is named by etiology; Wen Bing/Re Bing are named by season and manifestation. Shang Han occurs in cold weather, cold pathogen in exterior closing pores; requires Acrid-Sweet-Warm agents (e.g., Zhongjing’s Gui Zhi/Ma Huang Tangs) to disperse. Wen Bing/Re Bing occur in warm weather, latent heat reaches exterior from inside, blocking pores without exterior cold; requires Acrid-Cool, Bitter-Cold, or Sour-Bitter agents to resolve. Thus, Zhongjing’s exterior-only formulas are unsuitable, while later formulas like Shui Jie San, Da Huang Tang, Qian Jin Tang, Fang Feng Tong Sheng San (treating interior/exterior) are suitable. Immediate Shang Han with aversion to wind/cold indicates exterior Cold-Wind damaging Wei Qi. Delayed Wen Bing/Re Bing with aversion to wind/cold indicates new Cold-Wind invasion damaging Wei Qi. Without new invasion, no aversion exists; hence Zhongjing says: Taiyang disease with fever/thirst and no aversion is Wen Bing. Heat Disease follows similarly. ...Wen Bing/Re Bing may show exterior signs first then transmit inward. Latent heat reaches exterior, blocks pores, fails to vent, returns inward forming attackable syndrome, unlike Shang Han starting from exterior. Seeking floating-tight pulse in Spring/Summer Wen Bing/Re Bing is erroneous; tight pulse indicates cold. Tight pulse in Wen Bing/Re Bing implies secondary acute cold or cold food injury, not inherent. Wen Bing/Re Bing pulses are typically in muscle layer, not very floating, and Right hand stronger than Left due to internal heat. Left dominance/float indicates secondary Cold-Wind; otherwise, it is acute Cold-Wind, not true Wen Bing/Re Bing. Generally, Wen Bing/Re Bing without secondary invasion has more interior than exterior signs, so thirst is common. Treatment prioritizes clearing interior heat, assisting exterior release; sometimes clearing interior resolves exterior. I observe physicians harming patients by wrongly purging interior (less harmful) vs. wrongly inducing sweat (catastrophic), proving heat originates internally. Harm from purging interior occurs only in new Cold-Wind cases (pure exterior, not entered interior), distinct from Wen Bing/Re Bing. ...Although interior purging for heat removal is similar between Shang Han and Wen Bing/Re Bing, exterior release methods must differ. If Wen Bing/Re Bing is triggered by epidemic qi or secondary pathogenic factors, treatment must consider timing and qi nature, not universally applying Zhongjing’s immediate Shang Han formulas. This is An Dao (Wang Lv)’s discussion on Warm-Heat diseases.
Wang Shi’s *Zheng Zhi Yao Jue* states: Wen and Re differ in severity; Zhongjing says: encountering Wen Qi causes Wen Bing; encountering additional Warmth causes Wen Du. Re is heavier than Wen. If winter cold invades and manifests in Spring without other pathogens, it is Wen Bing (milder). If Wen Bing continues and encounters Wen Qi, it becomes Wen Du (heavier). This is Latent Qi Wen Bing. If not caused by winter cold but manifests in Spring due to Spring Warmth Qi, it is Chun Wen (Spring Warmth), analogous to Winter Cold, Autumn Damp, Summer Heat. This is New Invasion Wen Bing. Thus, Spring Wen Bing has three types: 1) Winter cold manifesting in Spring; 2) Persistent Wen Bing exacerbated by Wen Qi; 3) Direct Spring Warmth invasion without winter cold. All are termed Wen Bing; differentiation lies in etiology. This is Shi Shan (Wang Ji)’s discussion on Warm-Heat diseases.
Wang Ken-tang’s *Shang Han Zhun Sheng* states: After Start of Spring, without extreme cold or ice, if someone has high fever, it belongs to Spring Yang emerging externally, transforming winter latent cold into Wen Bing. According to *Huo Ren*, Wen Bing has two types: 1) Using Sheng Ma Jie Ji Tang: correct Shang Han Taiyang syndrome, aversion to cold without thirst, named Wen Bing because it occurs in warm season; 2) Using Zhu Ye Shi Gao Tang: corresponds to Zhongjing’s “thirst without aversion to cold,”