身热恶寒头痛楚。心烦躁渴如何御。（身热。恶风。头痛。心烦。躁渴热病。中暑。其证相似。但脉不同耳。语在下。）
脉洪紧盛为热病。脉虚细弱为伤暑。（热病。脉必浮大洪紧。伤暑之脉。必虚细而弱。详考诸书。暑脉多不一。仲景云。
太阳中 者。身热而脉微。又云。其脉弦细芤迟。小便已。洒洒然毛耸。朱肱云。脉虚身热。得之伤暑。又曰。热病脉
洪大。中暑脉细弱。当以意消息也。）伤暑面垢并背寒。四肢倦怠汗无度。口噤五苓白虎佳。痰逆橘皮汤可愈。（仲景云。
手足逆冷。小有劳。身即热。口开。前板齿燥。若发其汗。则恶寒甚。加温针。则发热甚。数下之则淋甚。）皮肤既缓腠
理开。洒然毛竦风寒恶。缪加热药发斑黄。可怪庸医心术误。（仲景云。小便已洒然毛竦。故其人可出而恶寒。若行热药。
便发斑发黄也。）
（温病 温疟 风温 温疫 温毒）
伤寒春月名温病。脉来浮数是其证。发热头疼亦恶寒。冬夏比之轻不甚。升麻解肌为最良。小柴竹叶宜相称。（以上
论温病也。素问云。冬伤于寒。春必病温。仲景云。冬月冒寒气。不即病者。藏于肌肤。至春变为温病。故其证如此。
宜升麻解肌汤之类。）尺寸盛兮兼弦数。重感于寒变温疟。先热后寒小柴胡。但热不寒白虎药。（以上论温疟也。仲景云。
若脉阴阳俱盛。重感于寒者。变成温疟。素问云。疟脉自弦。弦数者热多。朱肱云。先热后寒者。小柴胡汤。但热不寒
者。白虎加桂汤主之。）濡弱阴脉浮滑阳。此是风温证候当。头疼身热常自汗。四肢不收鼾睡长。当治少阴厥阴病。误汗
黄防己汤。（以上论风温也。仲景云。阳脉浮滑。阴脉濡弱。更遇于风。变为风温。其病四肢 缓。又云。风温为病。
脉。阴阳俱浮。自汗出。身重多眠睡。鼻息必鼾。语言难出。若被下者。小便不利。直视失溲。若被火者。微发黄色。
剧则如惊痫。时螈 也。少阴火也。厥阴木也。当治炎火风木。误汗之。则用黄 防己汤救之也。）阳脉濡兮阴弦紧。更
遇温气来行令。变成温疫作天行。少长皆同无异病。热温寒清顺时宜。以平为期如斯正。（此论温疫也。仲景云。阳脉濡
弱。阴脉弦紧者。更遇温气。变为温疫。一岁少长皆同病者。温疫也）最重温毒为可怪。阳脉洪数阴实大。发斑瘾疹如
锦文。咳兼心闷何由快。（此论温毒也。仲景云。阳脉洪数。阴脉实大。更遇温热。变成温毒。温毒为病。最重也。故发
斑生疹。咳嗽。心下快痞闷。宜用元参升麻汤。）宜用元参升麻汤。长沙仲景分明载。
身体发热，怕冷，头痛且疼痛不适。心中烦躁，口渴，该如何应对？（身体发热，怕风，头痛，心烦，躁动口渴，这些是热病、中暑的症状，它们的证候相似，但脉象不同而已。谵语在下文论述。）
脉象洪大紧盛的是热病；脉象虚细弱的是伤暑。（热病的脉象必定浮大洪紧；伤暑的脉象必定虚细而弱。详细考证各种书籍，暑病的脉象大多不统一。张仲景说：太阳中暍者，身体发热而脉微弱。又说：其脉弦细芤迟，小便后，感到洒洒然毛发耸立。朱肱说：脉虚身热，是由于伤暑所致。又说：热病脉洪大，中暑脉细弱。应当用心细细体会斟酌。）伤暑的人面色污垢并且背部发冷，四肢倦怠无力，出汗不止。口噤（牙关紧闭），使用五苓散或白虎汤效果佳；痰气上逆，橘皮汤可以治愈。（张仲景说：手足逆冷，稍微劳作，身体就发热，张口呼吸，前板齿干燥。如果发汗，则恶寒严重；加用温针，则发热更甚；多次攻下，则淋证严重。）皮肤松弛腠理开泄，洒然毛发耸立，厌恶风寒。误加热药导致发斑发黄，可怪那些庸医心术不正误治。（张仲景说：小便后洒然毛发耸立，所以其人容易受寒而出恶寒。如果使用热药，就会发斑发黄。）
伤寒在春季称为温病，脉象浮数是其证候。发热头痛也怕冷，与冬夏相比病情较轻且不严重。升麻解肌汤最为良效，小柴胡汤和竹叶石膏汤适宜配合使用。（以上论述温病。《素问》说：冬天感受寒邪，春天必定发生温病。张仲景说：冬天冒犯寒气，没有立即发病的，邪气藏在肌肤之间，到了春天变为温病。所以它的证候如此。适宜使用升麻解肌汤之类的方剂。）寸尺脉盛兼见弦数，再次感受寒邪变为温疟。先发热后发冷的用小柴胡汤，只发热不发热的用白虎汤药。（以上论述温疟。张仲景说：如果脉象阴阳俱盛，再次感受寒邪的，变成温疟。《素问》说：疟疾的脉象自弦，弦数的脉象表示热多。朱肱说：先热后寒的，用小柴胡汤。只发热不发热的，用白虎加桂枝汤主治。）濡弱为阴脉，浮滑为阳脉，这是风温的证候应当如此。头疼身体发热经常自汗出，四肢不收引，长时间打鼾睡觉。应当治疗少阴和厥阴的病，误用发汗法会导致黄瘅，可用防己汤救治。（以上论述风温。张仲景说：阳脉浮滑，阴脉濡弱，再遇到风邪，变为风温。它的病四肢弛缓。又说：风温为病，脉象阴阳俱浮，自汗出，身体沉重多眠睡，鼻息一定打鼾，语言难出。如果被误用下法，小便不利，直视失禁。如果被误用火疗，轻微的发黄色，严重的像惊痫，有时抽搐。少阴属火，厥阴属木。应当治疗炎火风木之病。误用发汗，则用黄芪防己汤救之。）阳脉濡弱阴脉弦紧，再遇到温气来临施行时令，变成温疫造成天行（流行性传染病），老少都一样没有不同的病。热时温热，寒时清冷顺应时节适宜，以平和为标准这样才是正确的。（此论述温疫。张仲景说：阳脉濡弱，阴脉弦紧的，再遇到温气，变为温疫。一年中老少都同样生病的，就是温疫。）最重的是温毒令人奇怪，阳脉洪数阴脉实大。发斑瘾疹像锦缎花纹，咳嗽兼带心胸闷塞如何能痛快？（此论述温毒。张仲景说：阳脉洪数，阴脉实大，再遇到温热，变成温毒。温毒为病，是最重的。所以发斑生疹，咳嗽，心下痞闷快膈难受。适宜使用玄参升麻汤。）适宜使用玄参升麻汤，长沙太守张仲景明确记载。
Body heat, aversion to cold, headache with pain and discomfort. Restlessness in the heart, thirst, how to manage? (Body heat, aversion to wind, headache, restlessness in the heart, irritability, thirst due to heat disease or heatstroke; their symptoms are similar, but the pulse differs. Delirium is discussed below.)
A pulse that is surging, tight, and full indicates a heat disease; a pulse that is deficient, fine, and weak indicates summerheat injury. (The pulse of a heat disease must be floating, large, surging, and tight; the pulse of summerheat injury must be deficient, fine, and weak. Detailed examination of various texts shows that the pulse of summerheat varies. Zhang Zhongjing said: In Taiyang heatstroke, the body is hot and the pulse is faint. He also said: The pulse is wiry, fine, knotted, and slow; after urination, there is a sensation of shivering and hair standing on end. Zhu Gong said: A deficient pulse with body heat results from summerheat injury. He also stated: The pulse of a heat disease is surging and large, while the pulse of heatstroke is fine and weak. One should ponder this carefully.) Patients with summerheat injury have a grimy complexion and coldness in the back, fatigue in the four limbs, and uncontrolled sweating. For trismus (lockjaw), Wuling San (Five-Ingredient Powder with Poria) or Baihu Tang (White Tiger Decoction) are excellent; for rebellious phlegm-qi, Jupi Tang (Tangerine Peel Decoction) can cure it. (Zhang Zhongjing said: Cold extremities; slight exertion causes body heat; open mouth; dryness of the anterior teeth. If sweating is induced, aversion to cold becomes severe; if moxibustion/needling with heat is added, fever becomes severe; if purgatives are used repeatedly, strangury becomes severe.) The skin is lax and the cou li (pores) are open; there is a sudden shivering with hair standing on end, and an aversion to wind-cold. Incorrectly administering heat-inducing drugs leads to macules and jaundice; it is strange that quack doctors cause errors due to poor medical ethics. (Zhang Zhongjing said: After urination, there is a sudden shivering with hair standing on end, so the person is prone to chills. If heat-inducing drugs are used, macules and jaundice will develop.)
(Wenbing [Warm Disease], Wen Nue [Warm Malaria], Fengwen [Wind-Warmth], Wen Yi [Warm Epidemic], Wendu [Warm Toxin])
In spring, Shanghan [Cold Damage] is called Wenbing [Warm Disease]; a floating and rapid pulse is its sign. Fever, headache, and aversion to cold occur, but compared to winter and summer, it is milder and less severe. Shengma Jiemo Decoction (Cimicifuga Muscle-Releasing Decoction) is the best choice; Xiaochaihu Tang (Minor Bupleurum Decoction) and Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) are suitable alternatives. (The above discusses Wenbing. Suwen states: Winter injury by cold leads to Warm Disease in spring. Zhang Zhongjing said: Those who catch cold qi in winter but do not fall ill immediately harbor the pathogen in the skin and muscles, which transforms into Warm Disease in spring. Thus, the symptoms are as described. Formulas like Shengma Jiemo Tang are appropriate.) If the cun and chi positions are full and accompanied by a wiry and rapid pulse, secondary exposure to cold transforms into Wen Nue [Warm Malaria]. Chills following fever are treated with Xiaochaihu Tang; fever without chills is treated with Baihu Tang (White Tiger Decoction). (The above discusses Wen Nue. Zhang Zhongjing said: If both yin and yang pulses are full and there is secondary exposure to cold, it transforms into Warm Malaria. Suwen states: The pulse of malaria is naturally wiry; a wiry and rapid pulse indicates more heat. Zhu Gong said: Fever preceding chills is treated with Xiaochaihu Tang; fever without chills is treated with Baihu Jia Guizhi Tang [White Tiger Decoction plus Cinnamon Twig].) A deficient and weak yin pulse with a floating and smooth yang pulse indicates Fengwen [Wind-Warmth]. Headache, body heat, spontaneous sweating, flaccidity of the four limbs, and prolonged snoring sleep are characteristic. Treatment should target Shaoyin and Jueyin diseases; incorrect sweating therapy may lead to jaundice, which can be rescued with Fangji Tang (Stephania Decoction). (The above discusses Fengwen. Zhang Zhongjing said: Floating and smooth yang pulse with deficient and weak yin pulse, combined with wind exposure, transforms into Wind-Warmth. The limbs become flaccid. He also said: In Wind-Warmth, the yin and yang pulses are both floating, with spontaneous sweating, heavy body, excessive sleepiness, snoring nasal breathing, and difficulty speaking. If incorrectly purged, there is difficulty urinating, staring eyes, and incontinence. If incorrectly treated with fire therapy, mild cases show yellowing, while severe cases resemble convulsions or epilepsy with occasional spasms. Shaoyin belongs to Fire, Jueyin to Wood. One should treat the inflammatory fire and wind-wood pathogens. If sweating is incorrectly induced, Huangqi Fangji Tang [Astragalus and Stephania Decoction] should be used for rescue.) A soft yang pulse with a wiry and tight yin pulse, combined with the arrival of warm qi according to the season, transforms into Wen Yi [Warm Epidemic], affecting people of all ages similarly. Heat requires warming, cold requires clearing, following the season's appropriateness; achieving balance is the correct standard. (This discusses Wen Yi. Zhang Zhongjing said: Soft and weak yang pulse with wiry and tight yin pulse, combined with warm qi, transforms into Warm Epidemic. When people of all ages in a year suffer from the same illness, it is a Warm Epidemic.) The most severe and remarkable is Wendu [Warm Toxin]; a surging and rapid yang pulse with a solid and large yin pulse. Macules and wheals appear like brocade patterns; coughing accompanied by chest oppression—how can one feel relieved? (This discusses Wendu. Zhang Zhongjing said: Surging and rapid yang pulse with solid and large yin pulse, combined with warm-heat, transforms into Warm Toxin. Warm Toxin is the most severe disease. Hence, macules and rashes appear, along with coughing and epigastric fullness/oppression. Xuanshen Shengma Tang (Scrophularia and Cimicifuga Decoction) is appropriate.) Xuanshen Shengma Tang is appropriate, clearly recorded by Zhang Zhongjing of Changsha.