From after Frost's Descent until before Spring Equinox, anyone who falls ill immediately upon exposure to frost and dew and contracting wind-cold in the body is termed Shanghan (Cold Damage) [Shanghan (Disease caused by cold pathogen)]. The treatment methods, except for summerheat-dampness and malaria, all follow the principles of treating Shanghan.

After the Beginning of Spring, if there is no sudden severe cold or ice/snow, yet someone suffers from high fever and illness, this belongs to Wenbing (Warm Disease) [Wenbing (Warm disease)], where spring yang qi expands outward and latent winter cold transforms into warm disease. (Spring warmth following regular climatic patterns occurs in four scenarios: when Shaoyang governs the year with Taiyang governing the first Qi; Yangming governing the first Qi; Taiyin governing the final Qi and second Qi; these times are prone to warm diseases. Abnormal cases deviating from regular patterns cannot be predicted by standard rules but must adapt to seasonal changes.)

The *Neijing* states: "Injury by cold in winter leads to warm disease in spring." Li Dongyuan explains that "injury by cold in winter" refers to autumn-like weather occurring in winter (warmth instead of cold), causing excessive fire and deficient kidney water. With kidney water depleted, earth (which water controls) becomes excessive; metal (which produces water) becomes insufficient; wood (which controls fire) rebels due to excessive fire. Fire and earth combine with damp-heat assisting each other, resulting in warm disease. It does not manifest in winter but in spring because the cold-water qi occupies the Mao position (East/Spring), holding authority, and severe cold commands reappear in spring. Pores open, Shaoyin (Kidney) fails to store, and those who engage in sexual activity or labor exhaust their yang qi externally and deplete kidney water internally. In spring, when yang should generate and vent outward, who encourages it? With internal kidney water exhausted and no nourishment, both sources of generation are cut off. Without sources, how can Wood grow? What remains in the body is heat. As time strengthens and Wood grows, it becomes warm disease.

The *Nan Jing* discusses: Sunyang disease presenting with fever, thirst, and aversion to coldlessness is termed Wenbing. Explanation: Sunyang disease features a floating pulse, headache, stiff neck, and back pain. Cold injury typically causes aversion to cold. If there is no aversion to cold but thirst exists, it has transferred to Yangming, meaning the exterior syndrome has resolved and evil has entered the interior. Since there is no aversion to cold, it is not a Shanghan syndrome. Although it resembles Yangming combined with Sunyang symptoms, it is not the Yangming aspect of Shanghan. Thus, it is determined to be Wenbing.

The *Huoren Shu* states: Fever, aversion to cold, headache, body ache, and a floating-tight pulse before Summer Solstice indicate Wenbing. Shanghan in spring is called Wenbing. Mild winter cold injuries manifesting as Wenbing before Summer Solstice are triggered by spring's warm qi (this is not Wenyi/Warm Pestilence). Treating Wenbing differs from winter Shanghan and summer Rebing (Heat Disease) because the heat is milder. (In early spring and late autumn, yang qi resides in the interior; the condition is slightly lighter. Even without medication, it may resolve spontaneously in five to six days.) Shengma Tang (Cimicifugae Decoction), Jiexi Tang (Muscle-Releasing Decoction), and Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction) are most effective. For greater heat, Xiaochaihu Tang (Minor Bupleurum Decoction) is primary. For no thirst and slight exterior heat, add Guizhi (Cinnamon Twig) to Xiaochaihu Tang. For cough, add Wuweizi (Schisandra Fruit) to Xiaochaihu Tang. For irritability, thirst, fever, and no aversion to cold, administer Zhuye Shigao Tang (Phyllostachys Bamboo Leaf and Gypsum Decoction) sequentially. Mahuang Tang (Ephedra Decoction), Guizhi Tang (Cinnamon Twig Decoction), and Da Qinglong Tang (Major Green Dragon Decoction) are only reliably used in Northwest regions year-round. In warmer areas like Jianghuai, they are only suitable for winter and early spring. From late spring to before Summer Solstice, modifications are needed for Guizhi Tang, Mahuang Tang, and Da Qinglong Tang. According to the *Huoren Shu*, there are two types of Wenbing: those treated with Shengma Tang or Jiexi Tang correspond to typical Shanghan Sunyang syndrome (aversion to cold, no thirst), named Wenbing due to onset in warm weather. Those treated with Zhuye Shigao Tang correspond to Zhang Zhongjing's description of Wenbing (thirst, no aversion to cold). Careful distinction is required to avoid error. However, "no aversion to cold with thirst" Wenbing occurs in all seasons, not just spring.

Wendu (Warm Toxin)
A yang pulse that is Hongshu (Surging and Rapid) and a yin pulse that is Shida (Solid and Large), encountering warm-heat qi transforms into Wendu. (Cheng Wuji notes: Previous heat has not subsided, and warm-heat qi is contracted again. Yang governs the exterior, Yin the interior; Hongshu and Shida all indicate heat. Two heats combining become Wendu.)

The *Huoren Shu* states: Macules appearing with cough in early spring are termed Wendu.

Wu Youke states: Non-seasonal warmth in winter is called Dongwen (Winter Warmth), which is a Shi Xing Zhi Qi (Seasonal Epidemic Qi). If macules appear, it is also called Wendu, representing seasonal epidemic macules. Furthermore, complicated Shanghan with Yang pulse Hongshu and Yin pulse Shida, upon encountering warm-heat qi, transforms into Wendu, which is the most severe. This is because prolonged unresolved heat combines with newly contracted warm-heat qi. For those without sweat, Sanhuang Shigao Tang (Three Yellows and Gypsum Decoction) induces sweating. For those with spontaneous sweating, Renshen Baizhu Tang (Ginseng and White Tiger Decoction - *Note: Text says Baizhu but context implies Baihu/Gypsum* -> Renshen Baitou Tang/Gypsum Decoction) is primary. For irritability, fever, delirium, and insomnia, combine Baitou Tang (White Tiger Decoction) with Huanglian Jiedu Tang (Coptis Detoxification Decoction). For intense exterior heat, add Chaihu (Bupleurum). For internal excess with constipation, use Sanhuang Xiexin Tang (Three Yellows Heart-Draining Decoction) to purge, or Daxiehu Tang (Major Bupleurum Decoction) with Mangxiao (Mirabilite). If macules resemble brocade patterns, prognosis is poor; treat with Renshen Huaban Tang (Ginseng Macule-Resolving Decoction), Xuanshen (Scrophularia), Shengma (Cimicifuga), Heigao (Black Paste), and Daqing Siwu Tang (Great Cyan Four Substances Decoction) (See Macule section for formulas).

If sweating fails to resolve the condition and the body burns hot, it is Fengwen (Wind Warmth). Symptoms include floating pulse, spontaneous sweating, heavy body, and somnolence. (Lou Quanshan notes: This disease is not limited to spring, hence a separate Wind Warmth category.)

Diagnosis: Heat in the Chi skin (inner forearm) and a surging, restless pulse indicate Wenbing. Essence (Jing) is the root of the body; those who conserve essence will not contract Wenbing in spring.

Acupuncture: For treating Wenbing, fifty-nine acupoints may be needled. Cheng Wuji notes: These include three points on each side of the hands' inner/outer aspects (12 total); one point between each of the five fingers (8 total); similarly for the feet; six points one cun below the hairline on both sides (3 per side); one at the vertex (Baihui), one at Lianquan, two Fengchi, and one Tianzhu. (*Neijing*: If Qikou is still and Renying is restless, needle; if both are still, do not needle. Renying is the artery at the larynx.) Wang Bing annotates the *Suwen* fifty-nine needles: Needling five rows on the head disperses rebellious heat from Yang meridians (Midline: Shangxing, Zonghui, Qian Ding, Baihui, Houding; Second row lateral: Chengguang, Tongtian, Luoque, Yuzhen; Third row lateral: Linqi, Mucuang, Zhengying, Chengling, Naokong). Dazhu, Ying Shu, Quepen, and Back-Shu points (8 points) drain chest heat. Qichuan, Zusanli, Shangjuxu, and Xiajuxu (8 points) drain stomach heat. Yunmen, Guyuan, Weizhong, and Suikong (8 points) drain limb heat. Five points beside the Back-Shu of the Five Zang organs (10 points: Pohu, Shen Tang, Hun Men, Yi She, Zhi Shi) drain Zang heat.

Appendix:
Yun Qizi states: If Shanghan persists after sweating and purging, exceeding meridian transmission stages without resolution, it is also Wenbing. The classic states: Wenbing pulses travel through various meridians; identify the affected meridian and treat accordingly. For Sunyang syndrome persisting post-sweat/purge with floating Chi/Cun pulses, it is Sunyang Wenbing. For fever and eye pain with long Chi/Cun pulses, it is Yangming Wenbing. For hypochondriac pain with wiry Chi/Cun pulses, it is Shaoyang Wenbing. For abdominal fullness and dry throat with deep-thin Chi/Cun pulses, it is Taiyin Wenbing. For dry mouth/tongue/thirst with deep Chi/Cun pulses, it is Shaoyin Wenbing. For irritability/fullness and testicular retraction with faint-slow Chi/Cun pulses, it is Jueyin Wenbing. Treat according to the meridian and syndrome. Macules indicate Wendu.

Wang Ji states: There is a difference in severity between Wen and Re. Zhang Zhongjing said: Encountering Wen qi causes Wenbing; encountering Re (heat) qi causes Wendu, making Re more severe than Wen. If winter cold manifests in spring without other pathogens, it is Wenbing (mild). If Wenbing recurs with Wen qi, it becomes Wendu (severe). The *Shanghan Li* calls recurrent Wen qi Wenyi (Warm Pestilence). Some contract Wenbing in spring directly from spring Wen qi without prior winter cold, termed Chunwen (Spring Warmth), analogous to winter Shanghan, autumn dampness, or summer heatstroke. Thus, spring Wenbing has three origins: winter cold manifesting in spring; lingering Wenbing combining with new Wen qi; or direct contraction of spring Wen qi. All are named Wenbing; distinguish only by etiology.

Shengma Jiexi Tang Formula: Treats Shanghan, Wenbing, epidemic headache, and high fever.
Ge Gen (Kudzu Root, 1 liang), Mahuang (Ephedra, 7.5 qian, processed), Huang Qin (Scutellaria), Shao Yao (Peony), Gui Xin (Cinnamon Bark), Gan Cao (Licorice, roasted, 2.5 qian each). Chop herbs. Take 4 qian, add 1.5 cups water and one jujube, boil to 0.8 cup. Take three times daily. If unresolved after three days and pulse is floating, repeat dose to induce sweat. If pulse is deep-solid, purge.

Shengma Gegen Tang: Treats adults and children with seasonal epidemic, headache, fever, and macules (emerged or unemerged).
Shengma (Cimicifuga), Shao Yao (Peony), Gan Cao (Licorice, 2.5 qian each), Gan Ge (Kudzu Root, 3 qian). One dose, 2 cups water, 3 slices ginger, boil to 1 cup. Take anytime.

Chaihu Shengma Tang: Treats epidemic plague, high fever, aversion to wind, headache, body ache, nasal congestion, dry throat, cough, thick sputum.
Chaihu (Bupleurum), Gan Ge (Kudzu), Jing Jie (Schizonepeta), Chi Shao Yao (Red Peony), Shi Gao (Gypsum, 1.5 qian each), Qian Hu (Peucedanum), Shengma (Cimicifuga), Sang Bai Pi (Mulberry Root Bark), Huang Qin (Scutellaria, 1 qian each). One dose, 2 cups water, 3 slices ginger, 20 fermented soybeans, boil to 1 cup. Take anytime.

Sanhuang Shigao Tang
Shi Gao (Gypsum, 4 qian), Huang Qin (Scutellaria), Huang Lian (Coptis, 2 qian each), Huang Bo (Phellodendron), Shan Zhi Ren (Gardenia Seed, 1.5 qian each), Xiang Chi (Fermented Soybean, 100 grains), Mahuang (Ephedra, 2 qian; use 3 qian if cold), Gan Cao (Licorice, 1 qian). One dose, 2 cups water, boil to 1 cup. Strain and drink. Cover with blankets to induce sweat and cure.