《内经》以冬月天寒，人伤而即病者，名伤寒。若伤而不即病，寒邪郁而成热，至春而病者，
名温病。《伤寒论》。太阳病发热而渴，不恶寒者。为温病。同言太阳病，以不渴恶寒名伤
寒，以渴而不恶寒者，名温病。然则《内经》所云，明温病之原，仲景所云，别温病之症。知
病原，识症状，知伤寒温病之所以别矣。第《内经》所谓温病者，冬受寒邪，至春始发之温病
也。仲景所谓温病者，人感湿热，当时即发之温病也。进而求之，即春之温病亦有三种，有
冬伤于寒，至春而成温病者；有冬感温气，至春更感温热，而病温热、温毒者；有非冬感
寒，非重感温热，但遇时行温热之邪。而即发温病者。是此而知伤寒不独于冬，四时有暴
寒，皆能伤寒者。温病不独发于春，四时有暴热，皆有温热病者，但要明其病原主治耳。桢
又悟得伤寒之邪，伤于太阳从表而起；温热之病，感于阳明而入肠胃，自内而发。故温病发
热而渴不恶寒者。若先感温热，又冒风寒，而发身痛头痛，恶寒发热而渴者，此太阳有表邪
之寒热病。不得名之温热病也，当发表清热和解主治者。故太阳伤寒，用羌活败毒散发表。
若太阳寒热病，则用羌活冲和汤和解。阳明伤寒，用葛根汤发表。若阳明寒热病，则用干葛
石膏汤和解。若少阳伤寒，用羌活柴胡汤。少阳寒热病，用小柴胡汤和解。若身痛头痛，恶
寒发热，口不渴者，乃三时暴感之伤寒症，非温热之症。总之，伤寒外感风寒，里无积热。
故初起以辛温散表，不可早用清凉，直待表散里热，方用清里。今温病先感热而病者，故宜
清凉和解。惟恶寒身痛，无汗脉浮，表有寒邪者，方用辛凉散表。《活人》云∶伤寒者，冬伤
于寒即发之寒热病也。冬温者，冬有温气，感而即发之热病也。春温者。冬伤于寒，至春阳
气发升，寒邪郁而发热之温病也。风温者，不因冬感寒邪，即于春令，感当时温热之气而病
者。然此皆一人自感而独病者。若暴寒暴热，天地之邪气流行，沿门长幼皆病者，此名时疫之病。
羌活冲和汤 见发热。
温热之病，阳明经多，然亦有兼太阳者，故立此方和解，以温症用不得麻桂辛温耳。
干葛石膏汤
升麻 干葛 知母 石膏 甘草
此方和解阳明表里症，带太阳仍加羌活。
小柴胡汤 见寒热。
此方和解少阳表里者，若带太阳表症，加羌活；带阳明表症，加干葛。
凉膈散 见发狂。
温病表解里热者，以此方清热；若带表症，仍加表药。
三黄巨胜汤 见发狂。
此方专治阳毒，故温热重者用之也。若带表症，仍加散表之药。
三乙承气汤 见大便结。
温病里热，止须清里。然有热结大肠大便不通者，以此方下之。
《黄帝内经》认为，冬季天气寒冷，人受寒邪侵袭随即发病的，称为伤寒。如果受了寒邪但没有立即发病，寒邪在体内郁结而化热，等到春季才发病的，称为温病（由伏寒化热引起的温热性疾病）。《伤寒论》中提到：“太阳病（太阳经受邪所致的病证）出现发热且口渴，不恶寒的，是温病。”同样提及太阳病，以“不渴、恶寒”为特征的叫伤寒，以“口渴、不恶寒”为特征的叫温病。既然如此，《黄帝内经》所说的是阐明温病的病因起源，张仲景所说的是区分温病的症状表现。知晓病因，识别症状，就明白伤寒与温病区别所在了。只是《黄帝内经》所说的温病，是指冬季感受寒邪，到春季才发作的温病；张仲景所说的温病，是指人感受湿热之邪，当时就发作的温病。进一步探究，即使是春季的温病也有三种情况：有冬季感受寒邪，到春季演变为温病的；有冬季感受温气，到春季又感受温热之气，从而患温热病或温毒病的；有并非冬季感寒，也非再次感受强烈的温热，只是遇到时行温热邪气，随即发作温病的。由此可知，伤寒不仅仅发生在冬季，四季都有突发寒冷，都能导致伤寒；温病也不仅仅发作于春季，四季都有突发炎热，都会有温热病发生，关键在于要明了其病因和主治方法。
我又领悟到，伤寒的病邪，伤害太阳经，从体表发起；温热性质的疾病，感受阳明经，侵入肠胃，从体内发起。所以温病表现为发热、口渴、不恶寒。如果先感受温热邪气，又冒犯风寒，从而引发身体疼痛、头痛、恶寒、发热且口渴的，这是太阳经受表邪侵袭的寒热病，不能称之为温热病，应当采用发表、清热、和解的方法为主进行治疗。因此，太阳伤寒，使用羌活败毒散来发散表邪。如果是太阳经的寒热病，则使用羌活冲和汤来和解。阳明伤寒，使用葛根汤发散表邪。如果是阳明经的寒热病，则使用干葛石膏汤来和解。少阳伤寒，使用羌活柴胡汤。少阳经的寒热病，使用小柴胡汤来和解。如果出现身体疼痛、头痛、恶寒、发热但口不渴的，这是三个季节突发感受的伤寒症，不是温热性质的病症。总之，伤寒是外感风寒，体内没有积热。所以在初起阶段用辛温药物发散表邪，不可过早使用清凉药物，直到表邪解散、里热显现后，才使用清里热的药物。现在的温病是先感受热邪而发病的，所以适宜用清凉和解的方法。只有当出现恶寒、身体疼痛、无汗、脉浮等表有寒邪的表现时，才使用辛凉药物发散表邪。《活人书》说：伤寒，是冬季感受寒邪随即发作的寒热病。冬温，是冬季有温气，感受后随即发作的热病。春温，是冬季感受寒邪，到春季阳气升发，寒邪郁结而发热的温病。风温，不是因为冬季感受寒邪，而是在春季时令，感受当时的温热之气而发病的。然而这些都是一人独自感受邪气而单独患病的情况。如果是暴寒或暴热，天地间的邪气流行，导致全家老少都生病的，这名叫时疫（季节性流行病）。
【方剂】羌活冲和汤 见发热章节。
温热性质的疾病，多涉及阳明经，但也有兼涉太阳经的，所以设立此方进行和解治疗，因为治疗温症不能使用麻黄、桂枝等辛温药物。
【方剂】干葛石膏汤
组成：升麻、干葛、知母、石膏、甘草。
此方用于和解阳明经表里病症，若兼有太阳经症状仍加羌活。
【方剂】小柴胡汤 见寒热章节。
此方用于和解少阳经表里病症，若兼有太阳经表症，加羌活；若兼有阳明经表症，加干葛。
【方剂】凉膈散 见发狂章节。
温病表邪已解而里热盛的，用此方清热；若兼有表症，仍加解表药。
According to the *Huangdi Neijing* (Yellow Emperor's Inner Canon), when people are affected by cold pathogens in winter due to severe weather and fall ill immediately, it is named Shanghan (Cold Damage). If the cold pathogen affects the body but does not cause immediate illness, instead stagnating within and transforming into heat, manifesting as illness in spring, it is named Wenbing (Warm Disease). The *Shanghan Lun* (Treatise on Cold Pathogenic Diseases) states: "In Taiyang disease (disease of the Taiyang channel manifested by headache, stiff neck, aversion to cold, fever, and floating pulse), if there is fever and thirst without aversion to cold, it is a Warm Disease." Although both mention Taiyang disease, those characterized by "no thirst and aversion to cold" are called Shanghan, while those characterized by "thirst and no aversion to cold" are called Wenbing. Thus, what the *Neijing* describes clarifies the etiology of Warm Disease, while what Zhang Zhongjing describes distinguishes the symptoms of Warm Disease. Knowing the etiology and recognizing the symptoms allows one to understand the distinction between Shanghan and Wenbing. However, the Warm Disease mentioned in the *Neijing* refers to that which originates from cold pathogen contracted in winter and manifests in spring. The Warm Disease mentioned by Zhang Zhongjing refers to that which results from contracting damp-heat pathogens and manifests immediately. Further investigation reveals that even Spring Warm Diseases have three types: one type contracts cold in winter and transforms into Warm Disease in spring; another type contracts warm qi in winter and is further affected by warm-hot qi in spring, resulting in Warm-Hot Disease or Warm-Toxic Disease; the third type is not caused by winter cold nor repeated strong warm-hot exposure, but simply occurs upon encountering epidemic warm-hot pathogens, leading to immediate onset of Warm Disease. From this, we know that Shanghan is not limited to winter; sudden cold in any season can cause Shanghan. Similarly, Warm Disease is not limited to spring; sudden heat in any season can cause Warm-Hot diseases. The key lies in clearly understanding their etiology and treatment principles.
I have also realized that the pathogen of Shanghan injures the Taiyang channel and arises from the exterior; whereas Warm-Hot diseases affect the Yangming channel and enter the stomach and intestines, arising from the interior. Therefore, Warm Disease presents with fever, thirst, and no aversion to cold. If one first contracts warm-hot pathogens and then is exposed to wind-cold, resulting in body pain, headache, aversion to cold, fever, and thirst, this is a Cold-Heat Disease of the Taiyang channel with exterior pathogens, and cannot be named a Warm-Hot Disease. It should be treated primarily by releasing the exterior, clearing heat, and harmonizing. Thus, for Taiyang Shanghan, Qianghuo Baidu San (Notopterygium Decoction to Overcome Toxicity) is used to release the exterior. For Taiyang Cold-Heat Disease, Qianghuo Chonghe Tang (Notopterygium Decoction for Harmony) is used to harmonize. For Yangming Shanghan, Gegen Tang (Kudzu Root Decoction) is used to release the exterior. For Yangming Cold-Heat Disease, Gange Shigao Tang (Pueraria and Gypsum Decoction) is used to harmonize. For Shaoyang Shanghan, Qianghuo Chaihu Tang (Notopterygium and Bupleurum Decoction) is used. For Shaoyang Cold-Heat Disease, Xiaochaihu Tang (Minor Bupleurum Decoction) is used to harmonize. If symptoms include body pain, headache, aversion to cold, fever, but no thirst, these are Shanghan symptoms contracted suddenly during other seasons, not Warm-Hot symptoms. In summary, Shanghan involves external contraction of wind-cold with no accumulated heat in the interior. Therefore, at the initial stage, acrid-warm herbs are used to disperse the exterior; cooling herbs should not be used early. Only after the exterior is dispersed and interior heat becomes apparent should interior-clearing methods be employed. Since current Warm Diseases arise from prior heat contraction, cooling and harmonizing methods are appropriate. Only when there is aversion to cold, body pain, absence of sweating, and a floating pulse indicating exterior cold pathogens should acrid-cool herbs be used to disperse the exterior. The *Heren Shu* (Book of Living People) states: Shanghan is the cold-heat disease that develops immediately after winter cold contraction. Dongwen (Winter Warmth) is the heat disease that develops immediately after contracting warm qi in winter. Chunwen (Spring Warmth) is the Warm Disease where winter cold stagnates and generates heat due to rising yang qi in spring. Fengwen (Wind Warmth) is the disease contracted from seasonal warm-hot qi in spring, independent of winter cold. However, these refer to individuals contracting pathogens independently. If sudden cold or heat causes epidemic pathogens to circulate, affecting all ages in a household, this is named Shi Yi (Seasonal Epidemic).
[Formula] Qianghuo Chonghe Tang (Notopterygium Decoction for Harmony) - See Fever section.
Warm-Hot diseases mostly involve the Yangming channel, but may also involve the Taiyang channel. This formula is established for harmonization because Mahuang (Ephedrae Herba) and Guizhi (Cinnamon Twig) acrid-warm herbs are contraindicated in treating Warm Diseases.
[Formula] Gange Shigao Tang (Pueraria and Gypsum Decoction)
Ingredients: Shengma (Cimicifugae Rhizoma), Gange (Puerariae Radix), Zhimu (Anemarrhenae Rhizoma), Shigao (Gypsum Fibrosum), Gancao (Glycyrrhizae Radix et Rhizoma).
This formula harmonizes Yangming channel interior-exterior syndromes. If accompanied by Taiyang symptoms, add Qianghuo (Notopterygii Rhizoma et Radix).
[Formula] Xiaochaihu Tang (Minor Bupleurum Decoction) - See Cold-Heat section.
This formula harmonizes Shaoyang channel interior-exterior syndromes. If accompanied by Taiyang exterior symptoms, add Qianghuo; if accompanied by Yangming exterior symptoms, add Gange.
[Formula] Liangge San (Cooling the Diaphragm Powder) - See Mania section.
For Warm Disease where the exterior is resolved but interior heat remains, use this formula to clear heat. If exterior symptoms persist, add exterior-releasing herbs.
[Formula] Sanhuang Jusheng Tang (Three-Yellow and Sesame Decoction) - See Mania section.
This formula specifically treats Yang Du (Yang Toxin), so it is used for severe Warm-Hot cases. If exterior symptoms persist, add exterior-dispersing herbs.
[Formula] San Yi Chengqi Tang (Modified Three-Efficiency Bowel-Unblocking Decoction) - See Constipation section.
For Warm Disease with interior heat, only interior clearing is needed. However, if there is heat accumulation in the large intestine causing constipation, use this formula to purge.