经云。冬伤于寒。春必病温。夏必病热。又曰。冬不藏精。春必病温。故凡肾虚多欲
之人。寒邪乘间而伏于少阴。久则寒化为热。至春阳气升发。新邪引动而发于少阳者。为温病。至夏阳
气大泄。新邪外触而发于阳明者。为热病。
邵评∶冬令闭藏。邪不外发。春夏阳气泄越。而病温热。温病发出之途由少阳。热
病发出之途由阳明。但有伏气所发。受而即发两种。极宜分辨。
然温热之症。四时俱有。有伏气内发而病者。如冬月伏寒。夏月伏暑。再感新邪而发者是也。有时
邪外触而病者。如秋应凉而反热。冬应寒而反温。感其气而即病者是也。辨症之法。凡见纯热无寒而
口渴者。即是温热。非伤寒也。但看舌苔白黄而燥者。乃阳明见象。纯红而燥者。乃少阳见象。阳明宜
存肺胃之津。少阳宜顾肝肾之液。前阳明新法。已陈温热之概。兹专以少阳温病为主。而兼以手三阴为治焉。
邵评∶纯热无寒而口渴。伏气所发温热则然也。若受而即发之病。邪遏肺气。初起必微寒。而后发热不
已。须分辨之。若苔燥。是温热病之的据。
凡人腠理疏豁。风温之邪。即能直入少阳。以少阳属木火。同气相感也。或由其人
素有伏邪。因风寒外触。其邪直从内发。而出于少阳者。亦温病也。其症初起。或见微寒。即发热不已。
口苦目赤。胁痛胸满。渴而欲呕。脉来弦滑而数。舌苔白兼边红。或淡红色。此邪初发于少阳也。宜柴、
芩、栀、丹、翘、薄清解之。至四五日。舌苔纯红起
刺。烦躁不宁。六七日。耳聋颧红。神昏。谵语。或汗出不解。或 疹透于胸前。此时木
火大炽。营分血热已极。大忌风药劫液。宜用鲜生地一二两。犀角、连翘、黄芩、薄荷、
丹皮、黑栀、钩藤、银花之属。以清胆腑之热。兼解营分之邪。热毒自解矣。（少阳兼营热）
如见目赤面红。神呆不语。舌如芒刺。或 见紫色。此包络之火亦盛也。宜犀角、鲜
地、钩丁、连翘、川连、菖蒲、丹皮、黑栀、银花等解之。芒刺一退。即当水中养木。寒凉不
可过分。宜六味甘露等汤加减。（少阳兼包络火）
邵评∶滋肾阴。清胃热。以生津液。乃少阳兼心包络正法。
如初起即见舌苔鲜红。神昏谵语。烦躁不宁者。此温邪上乘包络也。防发丹疹。切
忌升、葛、荆、防。宜犀角、连翘、钩丁、薄荷、丹皮、川斛、菖蒲、天竺黄、淡竹叶、人中黄、净银
花之类。以解包络营分之热。则毒透而神清矣。（温邪上乘包络）
如舌苔红中兼白色。症见谵语咳嗽者。此风温入于心肺两经也。宜透营分之热。
兼泄气分之邪。当用羚羊角、连翘、薄荷、黄芩、象贝、杏仁、蒌皮、丹皮、元参、栀子之类。
次用梨汁、蔗浆、金斛、麦冬、花粉、粉参之类。以养肺胃之阴。（温邪入心肺两经）
邵评∶温邪入心肺。以存阴化热为正治。
如 疹已透之后。依然神昏谵语。目睛微定。舌色鲜红者。此热痰乘于包络也。宜
犀角尖、鲜菖蒲、天竺黄、川贝母、连翘、钩丁、丹皮、淡竹叶、竹茹、辰砂之类。以开热痰。
神自清矣。火清毒解之后。如见虚烦呕恶。惊悸不寐。只用温胆汤和之。（热痰乘包络）
邵评∶包络热痰。由包络之热已化。而痰邪留伏胃中。治以涤痰和胃。
如火邪既退之后。身体不能转侧。而兼胁痛者。此必有入络之痰也。宜天虫、全蝎、钩藤、桂枝、
栝蒌、泽兰、竹沥、姜汁之类追之。（痰入络中）
如 疹已透。而热邪未退。舌绛神呆。语言颠倒。小便赤涩。点滴如稠。此热结小肠
所致。夫小肠结。则火邪逆乘心包。故神昏。急用导赤散。加川连、连翘、赤小豆、栀子
等。以清小肠之热。则便利而神清矣。（小肠热结以上诸症皆温邪为病故入少阳新法内）
邵评∶心与小肠相表里。小肠为火腑。邪热内结小肠。而逆乘心包。是腑病及脏
也。用苦味清火。先入心。且小肠火腑。非苦不通也。
《内经》说：冬季感受寒邪，春季必定发生温病；夏季必定发生热病。又说：冬季肾精不藏，春季必定发生温病。所以凡是肾气虚弱、房事过度的人，寒邪趁虚潜伏在少阴经（足少阴肾经），时间久了，寒邪转化为热邪。到了春季，阳气升发，新感之邪引动伏邪而发作于少阳经（足少阳胆经）的，称为温病；到了夏季，阳气大泄，新感之邪外触而发作于阳明经（足阳明胃经）的，称为热病。
邵评注：冬季气候闭藏，邪气不外发；春夏季节阳气宣泄浮越，从而引发温热病。温病的发病途径由少阳经发起，热病的发病途径由阳明经发起。但其中又有“伏气所发”（邪气潜伏体内随后发作）和“受而即发”（感受邪气后立即发作）两种情况，极需分辨清楚。
然而温热病症，四季都有。有的是伏邪在内自发而致病，如冬季潜伏寒邪，夏季潜伏暑邪，再感受新邪而引发的，属于此类。有的则是时邪从外部触发而致病，如秋季本该凉快却反常炎热，冬季本该寒冷却反常温暖，感受这种不正之气而立即发病的，也属于此类。辨别症状的方法：凡是见到只有发热而没有恶寒且口渴的，就是温热病，不是伤寒。只看舌苔白黄且干燥的，是阳明经的症状表现；舌苔纯红且干燥的，是少阳经的症状表现。治疗阳明经病变宜保存肺胃的津液，治疗少阳经病变宜顾护肝肾的阴液。前文关于阳明经的新法，已经阐述了温热病的概况，这里专门以少阳经温病为主，兼治手三阴经（手太阴肺经、手厥阴心包经、手少阴心经）。
邵评注：只有发热没有恶寒且口渴，这是伏气所发的温热病的特点。如果是受邪后立即发作的病，邪气遏制肺气，初起必有轻微恶寒，然后持续发热，必须分辨清楚。如果舌苔干燥，是温热病的确实依据。
凡是人体腠理（皮肤毛孔及肌肉间隙）疏松，风温之邪就能直接侵入少阳经，因为少阳经属木火，与风温之邪同气相求。或者因为患者素有伏邪，因风寒从外部触动，邪气直接从内部发出，而出现在少阳经的，也是温病。其症状初起，或见轻微恶寒，随即持续发热，口苦目赤，胁痛胸满，口渴想呕吐，脉象弦滑而数，舌苔白兼边缘红，或呈淡红色。这是邪气初发于少阳经的表现。适宜用柴胡、黄芩、栀子、牡丹皮、连翘、薄荷等药物清解。到第四五天，舌苔纯红并起刺，烦躁不安。到第六七天，出现耳聋、颧骨发红、神志昏迷、胡言乱语，或者出汗后病仍不解，或者疹子透发于胸前。此时木火炽盛，营分和血分的热毒已达极点。严禁使用风药劫耗阴液。适宜用鲜生地一两至二两，配合犀角、连翘、黄芩、薄荷、牡丹皮、黑栀子、钩藤、金银花等药物，以清泄胆腑的热邪，兼解营分的风邪，热毒自然解除。（此为少阳经兼营分热证）
如果见到眼睛红赤、面色红赤、神情呆滞不语、舌面如芒刺，或者舌色发紫，这是心包络的火邪也旺盛的表现。适宜用犀角、鲜地黄、钩藤、僵蚕、连翘、黄连、石菖蒲、牡丹皮、黑栀子、金银花等药物解毒。芒刺消退后，就应当在水中涵养肝木（滋水涵木），寒凉药物不可过分使用。适宜用六味甘露饮等汤剂加减治疗。（此为少阳经兼心包络火证）
邵评注：滋补肾阴，清泄胃热，以生津液，是治疗少阳经兼心包络火的正确方法。
如果初起就见到舌苔鲜红，伴有神志昏迷、胡言乱语、烦躁不安的，这是温邪上乘于心包络。要防止发生丹疹。切忌使用升麻、葛根、荆芥、防风等升散药物。适宜用犀角、连翘、钩藤、僵蚕、薄荷、牡丹皮、川石斛、石菖蒲、天竺黄、淡竹叶、人中黄、净金银花等药物，以解包络营分的热邪，则毒邪透出而神志清醒。（此为温邪上乘心包络）
如果舌苔红中兼有白色，症状见胡言乱语、咳嗽的，这是风温邪气侵入心和肺两经。应当透泄营分的热邪，兼清气分的邪气。当用羚羊角、连翘、薄荷、黄芩、象贝母、杏仁、瓜蒌皮、牡丹皮、玄参、栀子等药物。其次再用梨汁、蔗浆、金钗石斛、麦冬、天花粉、西洋参等药物，以滋养肺胃的阴液。（此为温邪入心肺两经）
如果疹子已经透发之后，依然神志昏迷、胡言乱语、眼睛微定、舌色鲜红的，这是热痰乘袭心包络。适宜用水牛角尖、鲜石菖蒲、天竺黄、川贝母、连翘、钩藤、僵蚕、牡丹皮、淡竹叶、竹茹、辰砂等药物，以开泄热痰，神志自然清醒。火清毒解之后，如果见到虚烦呕恶、惊悸失眠，只用温胆汤调和即可。（此为热痰乘袭心包络）
邵评注：包络的热痰，是由包络的热邪已化，而痰邪留伏在胃中所致，治疗应以涤除痰浊、调和胃气为主。
如果火邪退去之后，身体不能转动侧身，并兼有胁痛的，这必定是有入络的痰邪。适宜用白附子、全蝎、钩藤、桂枝、瓜蒌、泽兰、竹沥、姜汁等药物搜剔络中之邪。（此为痰邪入络）
如果疹子已经透发，而热邪未退，舌质深红、神情呆滞、语言颠倒错乱、小便赤涩、点滴如稠状，这是热结于小肠所致。小肠热结，则火邪逆乘心包，所以神志昏迷。急用导赤散，加黄连、连翘、赤小豆、栀子等药物，以清泄小肠的热邪，则大小便通畅而神志清醒。（以上诸症皆因温邪为病，故列入少阳新法内）
邵评注：心与小肠互为表里，小肠为火腑。邪热内结小肠，而逆乘心包，这是腑病波及脏病。使用苦味药物清火，苦味先入心，且小肠火腑，非苦味不能通泄。
The *Neijing* states: If one is injured by cold in winter, one will inevitably suffer from warm diseases in spring; and heat diseases in summer. It also says: If one fails to store essence during winter, one will inevitably suffer from warm diseases in spring. Therefore, for those with deficient kidney qi and excessive sexual activity, cold pathogenic factors may take advantage of the deficiency and lie latent in the Shaoyin channel (Foot-Shaoyin Kidney Meridian). After a long period, the cold transforms into heat. When spring arrives and yang qi ascends, new pathogenic factors trigger the latent pathogens, causing them to manifest in the Shaoyang channel (Foot-Shaoyang Gallbladder Meridian); this is called a warm disease. When summer arrives and yang qi leaks profusely, new pathogenic factors touch externally and cause manifestation in the Yangming channel (Foot-Yangming Stomach Meridian); this is called a heat disease.
Shao's Commentary: In winter, the climate is closed and stored, so pathogens do not emit outward. In spring and summer, yang qi leaks and floats outward, thereby inducing warm-heat diseases. The pathway for the emergence of warm diseases originates from the Shaoyang channel, while that for heat diseases originates from the Yangming channel. However, there are two types: "emergence due to latent qi" (pathogens lying latent within and emerging later) and "immediate emergence upon reception" (symptoms appearing immediately after receiving pathogens). These must be distinguished carefully.
However, warm-heat syndromes occur in all four seasons. Some arise from internal spontaneous emergence of latent pathogens, such as latent cold in winter or latent summer-heat in summer, triggered again by new pathogens. Others arise from external triggering by seasonal pathogens, such as abnormal heat when autumn should be cool, or abnormal warmth when winter should be cold; contracting these aberrant qi leads to immediate illness. The method for distinguishing symptoms is as follows: if one observes fever without chills accompanied by thirst, it is a warm-heat disease, not a cold damage (Shanghan). Observing the tongue coating: if white-yellow and dry, it indicates signs of the Yangming channel; if purely red and dry, it indicates signs of the Shaoyang channel. Treatment for Yangming channel disorders should preserve the fluids of the Lung and Stomach, while treatment for Shaoyang channel disorders should protect the yin fluids of the Liver and Kidneys. The previous new methods for the Yangming channel have already outlined the general principles of warm diseases. Here, we focus specifically on warm diseases of the Shaoyang channel, treating simultaneously involving the Three Yin Channels of the Hand (Hand-Taiyin Lung Meridian, Hand-Jueyin Pericardium Meridian, Hand-Shaoyin Heart Meridian).
Shao's Commentary: Fever without chills and thirst are characteristics of warm diseases arising from latent qi. For illnesses emerging immediately upon reception, the pathogen constrains Lung qi, so initially there must be slight chills, followed by persistent fever. This requires careful distinction. Dry tongue coating is definitive evidence of warm-heat disease.
When human couli (pores and interstitial spaces) are loose, Wind-Warmth pathogens can directly enter the Shaoyang channel because the Shaoyang channel belongs to Wood and Fire, resonating with similar energies. Or, if the patient has latent pathogens internally, triggered by external Cold-Wind, the pathogens emerge directly from within via the Shaoyang channel; this is also a warm disease. Initial symptoms may include slight chills, followed by persistent fever, bitter taste in the mouth, red eyes, hypochondriac pain, chest fullness, thirst with desire to vomit, and a pulse that is wiry, slippery, and rapid. The tongue coating is white with red edges, or pale red. This indicates pathogens initially manifesting in the Shaoyang channel. One should use Chai Hu (Bupleuri Radix), Huang Qin (Scutellariae Radix), Zhi Zi (Gardeniae Fructus), Mu Dan Pi (Moutan Cortex), Lian Qiao (Forsythiae Fructus), and Bo He (Menthae Haplocalycis Herba) to clear and resolve. By the fourth or fifth day, the tongue coating becomes purely red with prickles, accompanied by restlessness. By the sixth or seventh day, deafness, malar flush, coma, and delirium may occur, or sweating fails to resolve the condition, or rashes appear on the chest. At this stage, Wood and Fire are blazing, and heat in the Ying (Nutritive) and Blood levels is extreme. Wind-dispersing drugs that consume fluids are strictly contraindicated. One should use fresh Sheng Di Huang (Rehmanniae Radix) 1-2 liang, along with Xi Jiao (Rhinocerotis Cornu - note: substitute with water buffalo horn in modern practice), Lian Qiao, Huang Qin, Bo He, Mu Dan Pi, Hei Zhi Zi (Charred Gardeniae Fructus), Gou Teng (Uncariae Ramulus cum Uncis), and Yin Hua (Lonicerae Japonicae Flos) to clear heat from the Gallbladder fu organ and resolve pathogens in the Ying level. Heat toxins will naturally dissipate. (Shaoyang channel with concurrent Ying-level heat)
If one observes red eyes and face, mental dullness with muteness, tongue surface like thorns, or purple tongue color, this indicates vigorous fire in the Pericardium Luo (Pericardium Channel). One should use Xi Jiao, Xian Di Huang (Fresh Rehmanniae Radix), Gou Teng, Jiang Can (Bombyx Batryticatus), Lian Qiao, Chuan Lian Zi (note: likely Chuan Lian or Huang Lian contextually, here interpreted as Huang Lian based on standard formula components for this description, but text says 'Chuan Lian' which might be a typo for Chuan Lian Zi or implies Chuan Lian/Chuan Bei, however standard clearing formulas use Huang Lian. Given 'Chuan Lian' appears in list, I will stick to literal translation but note standard usage often involves Huang Lian for heart fire. Actually, looking at 'Jiang Ding', it likely refers to Jiang Can and Ding Xiang? No, 'Ding' usually refers to Ding Xiang or part of a name. In Qing texts, 'Gou Ding' often refers to Gou Teng and Jiang Can. Let's assume 'Jiang Ding' is Jiang Can. 'Chuan Lian' might be Chuan Lian Zi or a typo for Huang Lian. Given the context of clearing Pericardium fire, Huang Lian is key. I will translate 'Chuan Lian' as Chuan Lian Zi but acknowledge the clinical intent is clearing fire. Wait, 'Jiang Ding' is likely Jiang Can (Silkworm) and... actually 'Ding' might refer to Ding Xiang? Unlikely for heat. It is highly probable 'Jiang Ding' refers to Jiang Can and perhaps a typo for something else, or 'Ding' refers to a specific preparation. In many editions, it is 'Gou Teng, Jiang Can'. Let's look at 'Chuan Lian'. In some contexts, it might be Chuan Bei Mu. However, sticking to the text: 'Xi Jiao, Xian Di, Gou Ding, Lian Qiao, Chuan Lian, Chang Pu, Mu Dan Pi, Hei Zhi, Yin Hua'. I will translate literally. 'Gou Ding' -> Gou Teng and Jiang Can (assuming Ding is short for Jiang Can or similar insect drug, or potentially a typo for another herb. Standard interpretation of 'Gou Ding' in this era often implies Gou Teng and Jiang Can). 'Chuan Lian' -> Chuan Lian Zi.
Correction: In Wu Kun'an's texts, 'Jiang Ding' usually refers to Jiang Can (Bombyx Batryticatus) and sometimes 'Ding' is used for other things, but here likely Jiang Can. 'Chuan Lian' is likely Chuan Lian Zi. However, for clearing Pericardium fire, Huang Lian is standard. I will translate as written.
One should use Xi Jiao, Xian Di Huang, Gou Teng, Jiang Can, Lian Qiao, Chuan Lian Zi, Shi Chang Pu, Mu Dan Pi, Hei Zhi Zi, and Yin Hua to resolve. Once the prickles subside, one must nourish the Liver using Water (Kidney Yin) to support Wood. Cold-cold drugs should not be overused. One should modify formulas such as Liu Wei Gan Lu Tang. (Shaoyang channel with concurrent Pericardium fire)
Shao's Commentary: Nourishing Kidney Yin, clearing Stomach heat, and generating fluids is the correct method for Shaoyang channel with concurrent Pericardium Luo involvement.
If, from the onset, the tongue coating is bright red, accompanied by coma, delirium, and restlessness, this indicates Warm pathogens ascending to the Pericardium. One must guard against the eruption of scarlet rash. Drugs that ascend and disperse, such as Sheng Ma, Ge Gen, Jing Jie, and Fang Feng, are strictly contraindicated. One should use Xi Jiao, Lian Qiao, Gou Teng, Jiang Can, Bo He, Mu Dan Pi, Chuan Hu Shi (Chuan Shi Hu), Shi Chang Pu, Tian Zhu Huang, Dan Zhu Ye, Ren Zhong Huang, and Jing Yin Hua to resolve heat in the Pericardium Ying level. Then toxins will vent and spirit will clarify. (Warm pathogens ascending to Pericardium)
If the tongue coating is red mixed with white, and symptoms include delirium and cough, this indicates Wind-Warmth entering both the Heart and Lung channels. One should vent Ying-level heat and simultaneously drain Qi-level pathogens. Use Ling Yang Jiao (Caprae Cervi Cornu Substitutum / Antelope Horn), Lian Qiao, Bo He, Huang Qin, Xiang Bei Mu (Fritillariae Thunbergii Bulbus), Xing Ren (Armeniacae Semen Amarum), Lou Pi (Trichosanthis Pericarpium), Mu Dan Pi, Yuan Shen (Scrophulariae Radix), and Zhi Zi. Subsequently, use Li Zhi (Pear Juice), Zhe Jiang (Sugarcane Juice), Jin Hu Shi (Dendrobii Nobile Caulis), Mai Dong (Ophiopogonis Radix), Hua Fen (Trichosanthis Radix), and Fen Shen (Codonopsis/Panax Notoginseng variant, likely Codonopsis or American Ginseng depending on region, here likely Xi Yang Shen or Dang Shen. 'Fen Shen' often refers to Xi Yang Shen or high quality Dang Shen. I will use Codonopsis/American Ginseng contextually, but literally Fen Shen). These nourish Lung and Stomach yin. (Warm pathogens entering Heart and Lung channels)
Shao's Commentary: For warm pathogens entering Heart and Lung, preserving yin and resolving heat is the primary treatment.
If, after rashes have fully erupted, coma, delirium, fixed gaze, and bright red tongue persist, this indicates Phlegm-Heat assaulting the Pericardium. Use Xi Jiao Jian (Horn of Water Buffalo), Xian Chang Pu, Tian Zhu Huang, Chuan Bei Mu, Lian Qiao, Gou Teng, Jiang Can, Mu Dan Pi, Dan Zhu Ye, Zhu Ru, and Chen Sha to open and resolve phlegm-heat. Spirit will naturally clarify. After fire clears and toxins resolve, if deficiency heat, nausea, vomiting, palpitations, and insomnia remain, use Wen Dan Tang to harmonize. (Phlegm-Heat assaulting Pericardium)
Shao's Commentary: Pericardium phlegm-heat arises when Pericardium heat has transformed, leaving phlegm pathogens latent in the Stomach. Treatment should scour phlegm and harmonize the Stomach.
If, after fire pathogens recede, the body cannot turn or move, accompanied by hypochondriac pain, this indicates phlegm pathogens entering the collaterals. Use Bai Fu Zi (Typhonii Rhizoma), Quan Xie (Scorpio), Gou Teng, Gui Zhi (Cinnamomi Ramulus), Gua Lou (Trichosanthis Fructus), Ze Lan (Lycopersici Herba), Zhu Li (Bambusae Succus), and Jiang Zhi (Zingiberis Succus) to pursue and extract them. (Phlegm entering collaterals)
If rashes have erupted but heat pathogens remain, with deep red tongue, mental dullness, inverted speech, and dark, scanty, thick urine, this is caused by heat binding in the Small Intestine. Binding in the Small Intestine causes fire pathogens to counterflow and assault the Pericardium, leading to coma. Urgently use Dao Chi San, added with Chuan Lian Zi (Note: Text says 'Chuan Lian', likely Huang Lian in this context for clearing heart/small intestine heat, but I will translate as Chuan Lian Zi or note the ambiguity. Standard Dao Chi San uses Huang Lian. I will translate as Chuan Lian Zi per text but acknowledge clinical standard is Huang Lian. Actually, 'Chuan Lian' in this list might be a typo for Huang Lian or refers to Chuan Lian Zi. Given 'Dao Chi San' contains Huang Lian, adding 'Chuan Lian' might be redundant or specific. I will translate literally.), Lian Qiao, Chi Xiao Dou (Vigna Semen Rubrum), and Zhi Zi to clear Small Intestine heat. Then urination will become smooth and spirit will clarify. (Small Intestine heat binding. All above symptoms are caused by warm pathogens, thus included in the New Methods of Shaoyang.)
Shao's Commentary: The Heart and Small Intestine are interior-exterior related. The Small Intestine is the Fire Fu organ. Internal binding of pathogenic heat in the Small Intestine counterflows to assault the Pericardium; this is a Fu-organ disease affecting the Zang organ. Using bitter flavors to clear fire works because bitter enters the Heart first. Moreover, the Small Intestine Fire Fu organ cannot be unblocked without bitter flavors.