温者，温其中也。脏受寒侵，必须温剂。经云∶寒者热之，是已。然有当温不温误人者
即有不当温而温以误人者，有当温而温之不得其法以误人者，有当温而温之不量其人、不
量其证与其时以误人者，是不可不审也。
天地杀厉之气，莫甚于伤寒，其自表而入者，初时即行温散，则病自除。若不由表入，
而直中阴经者，名曰中寒。其症恶寒厥逆，口鼻气冷，或冷汗自出，呕吐泻利，或腹中急痛
厥逆无脉，下利清谷，种种寒证并见，法当温之。又或寒湿侵淫，四肢拘急，发为痛痹，
亦宜温散。此当温而温者也。
然又有不当温而温者何也？如伤寒邪热传里，口燥、咽干，便闭、谵语，以及斑、黄、
狂乱、衄、吐、便血诸症，其不可温，固无论矣。若乃病热已深，厥逆渐进，舌则干枯，反
不知渴，又或挟热下利，神昏气弱，或脉来涩滞，反不应指，色似烟熏，形如槁木，近之无
声，望之似脱，甚至血液衰耗，筋脉拘挛，但唇、口、齿、舌，干燥而不可解者，此为真热假
寒之候，世俗未明亢害承制之理，误投热剂，下咽即败矣。更有郁热内蓄，身反恶寒；湿热
胀满，皮肤反冷；中暑烦心，脉虚自汗；燥气焚金，痿软无力者，皆不可温。又有阴虚脉细
数，阳乘阴而吐血者，亦不可温，温之则为逆候，此所谓不当温而温者也。
然又有当温而温之不得其法者何也？假如冬令伤寒，则温而散之。冬令伤风，则温而解
之。寒痰壅闭，则温而开之。冷食所伤，则温而消之。至若中寒暴痛，大便反硬，温药不止
者，则以热剂下之。时当暑月，而纳凉饮冷，暴受寒侵者，亦当温之。体虚挟寒者，温而补
之。寒客中焦，理中汤温之。寒客下焦，四逆汤温之。又有阴盛格阳于外，温药不效者，则
以白通汤加人尿、猪胆汁反佐以取之，经云∶热因寒用是已。复有真虚挟寒，命门火衰者，
必须补其真阳，太仆有言∶大寒而盛，热之不热，是无火也，当补其心。此心字，指命门而
言，《内经》所谓七节之旁中有小心是也。书曰∶益心之阳，寒亦通行，滋肾之阴，热
之犹可是也。然而医家有温热之温，有温存之温，参、 、归、术，和平之性，温存之温也
春日煦煦是也。附子、姜、桂，辛辣之性，温热之温也，夏日烈烈是也。和煦之日，人人
可近，燥烈之日，非积雪凝寒，开冰解冻不可近也。更有表里皆寒之证，始用温药，里寒顿
除，表邪未散，复传经络，以致始为寒中，而其后转变为热中者，容或有之。借非斟酌时宜
对证投剂，是先以温药救之者，继以温药贼之矣。亦有三阴直中，初无表邪，而温剂太过
遂令寒退热生，初终异辙，是不可以不谨。所谓温之贵得其法者此也。
然又有温之不量其人者何也？夫以气虚无火之人，阳气素微，一旦客寒乘之，则温剂宜
重，且多服亦可无伤。若其人平素火旺，不喜辛温，或曾有阴虚失血之症，不能用温者，即
中新寒，温药不宜太过，病退则止，不必尽剂，斯为克当其人矣。若论其证，寒之重者，微
热不除，寒之轻者，过热则亢，且温之与补，有相兼者，有不必相兼者。虚而且寒，则兼用
之。若寒而不虚，即专以温药主之。丹溪云∶客寒暴痛，兼有积食者，可用桂、附，不可遽
用人参。盖温即是补，予遵其法，先用姜、桂温之，审其果虚，然后以参、术辅之，是以屡
用屡验，无有差忒，此温之贵量其证也。
若论其时，盛夏之月，温剂宜轻，时值隆冬，温剂宜重。然亦有时当盛暑，而得虚寒极
重之证，曾用参、附煎膏而治愈者，此舍时从证法也。譬如霜降以后，禁用白虎，然亦有阳
明证，蒸热自汗，谵语烦躁，口渴饮冷者，虽当雨雪飘摇之际，亦曾用白虎治之而痊安，但
不宜太过耳。此温之贵量其时，而清剂可类推已。
迩时医者，群尚温补，痛戒寒凉，且曰∶阳为君子，阴为小人。又曰∶阳明君子，苟有
过，人必知之，诚以知之而即为补救，犹可言也。不思药以疗病，及转而疗药，则病必增剧
而成危险之候，又况桂枝下咽，阳盛则殆；承气入胃，阴盛以败。安危之机，祸如反掌，每
多救援弗及之处，仁者鉴此，顾不痛欤！吾愿医者，精思审处，晰理不差于毫厘，用药悉归
于中正，俾偏阴偏阳之药，无往不底于中和，斯为善治。噫！可不勉哉！
温法，就是温补中焦。脏腑受到寒邪侵袭，必须使用温性药物。《内经》说：“寒者热之”，就是这个道理。然而，有应当用温法却不用而误人的；有不应当用温法却用了而误人的；有应当用温法但使用方法不当而误人的；有应当用温法但不考虑患者体质、证候和时令而误人的。这些情况，不可不仔细审察。
天地间致病的厉气，没有比伤寒更严重的了。如果病邪从体表侵入，初期就采用温散的方法，病自然能除。如果不是由表入里，而是直接侵犯阴经的，名叫“中寒”。其症状表现为怕冷、四肢厥冷、口鼻气息寒冷，或者冷汗自出、呕吐腹泻，或者腹部急痛、四肢厥冷且无脉象、下利清谷（泻下未消化的食物），各种寒证同时出现，治法都应当用温法。或者是寒湿浸淫，导致四肢拘挛紧急，发作成痛痹，也适宜用温散法。这就是“当温而温”的情况。
然而又有不应当用温法却用了的情况，为什么呢？比如伤寒的热邪传入体内，出现口干、咽干、便秘、胡言乱语，以及发斑、黄疸、狂乱、流鼻血、吐血、便血等症状，这些都不可以用温法，这当然是不言而喻的。如果是热病已经深入，四肢厥逆逐渐加重，舌头干枯，反而不知道口渴，或者夹杂热邪而下利，神志昏迷、气息微弱，或者脉来涩滞，反而摸不到脉搏，面色像烟熏一样，形体枯槁如木柴，靠近听没有声音，远看好像要脱形，甚至血液衰耗，筋脉拘挛，只有嘴唇、口腔、牙齿、舌头干燥而无法缓解的，这是真热假寒的征候。世俗之人不明白亢盛之害受承制制约的道理，误投热性药物，药一下咽就会导致败亡。更有内蓄郁热，身体反而怕冷；湿热胀满，皮肤反而发冷；中暑心烦，脉虚自汗；燥气伤肺，肢体痿软无力的，都不可用温法。还有阴虚脉细数，阳气乘虚侵犯阴分而吐血的，也不可用温法，用温法就会变成逆证，这就是所谓“不当温而温”的情况。
然而又有应当用温法但使用方法不当的情况，为什么呢？假如是冬季感受伤寒，就用温法发散它。冬季感受风邪，就用温法解表它。寒痰壅塞闭阻，就用温法开泄它。被冷食所伤，就用温法消导它。至于中寒突发剧痛，大便反而坚硬，单用温药无效的，就用热性药攻下它。正值暑月，因为贪凉饮冷，突然遭受寒邪侵袭的，也应当用温法。体质虚弱兼有寒邪的，用温法兼以补益。寒邪客于中焦，用理中汤温中散寒。寒邪客于下焦，用四逆汤温肾回阳。又有阴寒太盛格拒阳气于外，用温药无效的，就用白通汤加入人尿、猪胆汁反佐来取效，《内经》说：“热因寒用”就是这个意思。再有真正虚损兼有寒邪，命门火衰的，必须补益真阳。太仆（张景岳）说：“大寒而盛，用热药却不发热，这是无火，应当补心。”这个“心”字，指的是命门，《内经》所说的“七节之旁中有小心”就是指这个。书上说：“益心之阳，即使是寒证也能通行；滋肾之阴，即使是热证也可以治疗。”然而医家有温热性质的温，有温存性质的温。人参、白术、当归、白术，性质平和，属于温存之温，就像春日暖阳煦煦的样子。附子、干姜、肉桂，性质辛辣，属于温热之温，就像夏日烈日烈烈的样子。和煦的日子，人人都可以亲近；燥烈的时候，除非积雪凝寒、开冰解冻，否则不可亲近。更有表里皆寒的证候，开始用温药，里寒顿时消除，但表邪未散，又传变到经络，导致起初是寒中，后来转变为热中的，这种情况或许会有。如果不是斟酌时令、对证投药，先是用温药救治，继而又用温药伤害正气，那就错了。也有三阴经直中寒邪，起初没有表邪，但温药太过，导致寒退热生，初终病情不同，这也是不可忽视的。这就是所谓温法贵在得法的意思。
然而又有温法不考虑患者体质的情况，为什么呢？对于气虚无火的人，阳气素来微弱，一旦客寒侵袭，温剂应该重用，而且多服也不会受伤。如果其人平时火旺，不喜欢辛温，或者曾有阴虚失血的病症，不能用温药的，即使新近感受寒邪，温药也不宜太过，病退了就停止，不必服完全部药剂，这才是适合该患者的用法。若论证候，寒重的，微温即可去除；寒轻的，过热就会亢盛。而且温法和补法，有相兼使用的，有不必相兼的。既虚又寒，就兼用温补。如果只寒不虚，就专门用温药主治。丹溪说：“客寒突发疼痛，兼有积食的，可以用桂枝、附子，不可以立刻用人参。”大概温即是补，我遵循他的方法，先用姜、桂温散，审察确实虚损后，再用参、术辅助，因此屡用屡验，没有差错，这就是温法贵在衡量证候的意思。
若论时令，盛夏月份，温剂宜轻；正值隆冬，温剂宜重。但也有时值盛夏，却得了极重的虚寒证，曾用人参、附子煎膏治愈的，这是舍时从证的治法。譬如霜降以后，禁用白虎汤，但也有阳明证，蒸蒸发热、自汗、胡言乱语烦躁、口渴想喝冷饮的，虽然正值雨雪飘摇之际，也曾有用白虎汤治疗而痊愈的，只是不宜太过罢了。这就是温法贵在衡量时令，而清法的运用可以类推了。
近来医者，群起崇尚温补，严厉禁忌寒凉，并且说：“阳是君子，阴是小人。”又说：“阳明是君子，如果有过错，人们一定知道。”诚然，知道了就能补救，还说得过去。没想到药是用来治病的，结果转而治病变成了治药（拘泥于用药禁忌），那么病一定会加重而成危险之候。更何况桂枝汤咽下，如果阳盛就会危险；承气汤入胃，如果阴盛就会败坏。安危的关键，祸福如反掌之间，往往多有救援不及的地方。仁爱的人看到这些，难道不痛心吗！我希望医者，精心思考审慎处理，辨析道理不差毫厘，用药完全归于中正，使偏阴偏阳的药物，无处不达中和之境，这才是善于治疗。唉！怎能不努力呢！
Warming method refers to warming the middle jiao (Middle Burner). When the zang organs are invaded by cold, warming agents must be used. The Classics state: "For cold, use heat," which is correct. However, there are cases where failure to use warming when indicated causes harm; there are cases where using warming when not indicated causes harm; there are cases where warming is indicated but applied incorrectly causing harm; and there are cases where warming is indicated but applied without considering the patient's constitution, syndrome, or season, causing harm. These situations require careful examination.
Among pathogenic factors in heaven and earth, none is more severe than Cold Damage (Shanghan). If the pathogen enters from the exterior, employing a warming and dispersing method initially will naturally eliminate the disease. If it does not enter from the exterior but directly invades the Yin meridians, it is called "Direct Invasion of Cold" (Zhong Han). Symptoms include aversion to cold, cold extremities, cold breath from mouth and nose, spontaneous cold sweating, vomiting and diarrhea, acute abdominal pain, cold extremities with absent pulse, and passage of undigested food in stool. When various cold syndromes appear together, the treatment principle is to warm. Alternatively, if cold-dampness infiltrates, causing stiffness and cramping of the four limbs leading to painful Bi syndrome, warming and dispersing is also appropriate. This constitutes "warming when indicated."
However, there are cases where warming is not indicated yet employed. Why? For instance, when Heat pathogens from Cold Damage transmit inward, presenting with dry mouth and throat, constipation, delirium, as well as macules, jaundice, mania, epistaxis, hematemesis, and hematochezia, warming is contraindicated, which goes without saying. If heat has penetrated deeply, with progressive cold extremities, dry tongue, yet no thirst, or accompanied by heat-induced diarrhea, coma, and weak qi, or with a choppy pulse that is imperceptible, complexion like smoke-stained, body emaciated like dead wood, silent upon approach, and appearing as if spirit is departing, even with depletion of blood and fluids causing tendon vessel cramping, where only the lips, mouth, teeth, and tongue remain dry and unrelieved, this is a sign of True Heat and False Cold. Laypeople do not understand the principle of excessive damage being controlled by counteracting forces; mistakenly administering hot agents leads to collapse upon ingestion. Furthermore, internal accumulation of stagnant heat causing apparent aversion to cold; damp-heat distension with cold skin; summerheat causing vexation with deficient pulse and spontaneous sweating; dryness damaging Lung Metal causing flaccidity and weakness—all these are unsuitable for warming. Also, yin deficiency with fine and rapid pulse, where yang invades yin causing hematemesis, should not be warmed; warming leads to adverse conditions. This is what is meant by "warming when not indicated."
However, there are cases where warming is indicated but applied improperly. Why? If one contracts Cold Damage in winter, one warms and disperses it. If one contracts Wind in winter, one warms and resolves it. If cold-phlegm obstructs, one warms and opens it. If injured by cold food, one warms and eliminates it. In cases of sudden severe pain from direct cold invasion with hard stool, if warming medicines fail, one uses hot purgatives. During summer months, if one seeks coolness and drinks cold beverages, suddenly contracting cold, warming is still required. For those with deficiency and cold, one warms and tonifies. If cold lodges in the Middle Jiao, Lizhong Tang (Regulate the Middle Decoction) is used to warm. If cold lodges in the Lower Jiao, Sini Tang (Frigid Extremities Decoction) is used to warm. In cases where extreme yin repels yang to the exterior and warming fails, Baitong Tang (White Tongue Decoction) added with human urine and pig gallbladder bile is used for counter-assistance, as stated in the Classics: "Use heat due to cold application." For true deficiency with cold and decline of Mingmen Fire (Gate of Vitality), one must tonify true yang. Taipu (Zhang Jingyue) said: "In severe cold, if heating does not produce warmth, it is lack of fire; one must tonify the Heart." Here, "Heart" refers to the Mingmen, as mentioned in the Neijing: "Beside the seventh vertebra lies the Small Heart." Books state: "Benefiting Heart Yang allows circulation even in cold; nourishing Kidney Yin allows treatment even in heat." However, physicians distinguish between Warming-Nature (Re Wen) and Gentle-Warmth (Wen Cun). Ginseng, Atractylodes, Angelica, and Atractylodes macrocephala have mild nature, representing Gentle-Warmth, like the gentle sun in spring. Aconite, Ginger, and Cinnamon Twig have pungent-hot nature, representing Warming-Nature, like the fierce sun in summer. One can approach the gentle sun anytime; one should only approach the fierce sun when ice is melting and snow is thawing. There are also cases of exterior and interior cold. Initially using warming medicine removes interior cold instantly, but if exterior pathogen remains, it may transmit to meridians, transforming from initial cold-interior to later heat-interior. If one does not weigh the season and syndrome, first saving with warming then harming with further warming, error occurs. Also, direct invasion of Three Yin without exterior pathogen, where excessive warming generates heat after cold retreats, changes the course entirely. Thus, precision in warming is crucial.
However, there is warming without considering the patient. For those with qi deficiency and lack of fire, whose yang is inherently weak, if attacked by exogenous cold, heavy doses of warming agents are suitable and multiple doses cause no harm. But for those with inherent excess fire who dislike pungent-warm herbs, or those with history of yin deficiency and bleeding, warming is contraindicated. Even with new cold invasion, warming should not be excessive; stop when symptoms resolve, without finishing the dose. This suits the patient. Regarding syndrome: for severe cold, slight warming suffices; for mild cold, excessive heat causes hyperactivity. Warming and tonifying may be combined or separate. For both deficiency and cold, combine them. For cold without deficiency, use only warming. Danxi said: "For sudden cold pain with food stagnation, Guizhi Tang (Cinnamon Twig Decoction) and Fuzi (Aconite Root) may be used, but Ren Shen (Ginseng Root) should not be used immediately." Generally, warming is tonifying. I follow this: first warm with Ginger and Cinnamon Twig; if deficiency is confirmed, then assist with Ginseng and Atractylodes. This yields consistent results. This illustrates weighing the syndrome in warming.
Regarding season: in midsummer, warming agents should be light; in deep winter, they should be heavy. Yet, sometimes in midsummer, severe deficiency-cold occurs, cured by decocted paste of Ginseng and Aconite. This is "abandoning season for syndrome." For example, after Frost Descent, Baihu Tang (White Tiger Decoction) is forbidden. Yet, in Yangming syndrome with steaming fever, spontaneous sweating, delirium, irritability, and thirst for cold drinks, even during snowstorms, Baihu Tang has been used successfully, provided it is not overused. This shows weighing the season in warming, and cooling methods can be inferred similarly.
Recently, physicians favor warming-tonification and strictly prohibit cooling. They say: "Yang is the gentleman, Yin is the petty person." And: "Yangming is the gentleman; faults are known." Knowing allows remedy, which is acceptable. But medicine treats disease; turning to treat the medicine itself aggravates disease into danger. As stated: "Guizhi Tang swallowed, if yang is excess, danger ensues; Chengqi Tang entering stomach, if yin is excess, collapse follows." Life and death hinge like flipping a hand; rescue often fails. Benevolent doctors should grieve at this. I hope physicians think carefully, discern principles accurately, and prescribe moderately, ensuring drugs balancing yin and yang achieve harmony. This is good treatment. Alas! How can one not strive?