从霜降以后至春分以前,凡有触冒霜露,体中寒即病者,谓之伤寒也。(治法除湿、暑、疟疾外,皆伤寒
法也。)
从立春节后,其中无暴寒,又不冰雪,而人有壮热为病者,此属春时阳气发于外,冬时伏寒变为温病。
(春温应常纪者有四∶岁少阳司天之政,初之气;太阳司天之政,初之气;阳明司天之政,终之气;太阴司
天之政,二之气,皆病温。其不应常纪而反常者,不可候之,而随时变易也。)
冬伤于寒,春必温病。(全文见五脏。)太阳病发热而渴,不恶寒者,为温病。(治见冬温。)
阳脉洪数,阴脉实大者,遇温热变为温毒。(论见大法。治见发 。《活人》云∶初春发 、咳嗽,
为温毒。)
发汗不解,身灼热,为风温。其证脉浮汗出,身重多眠。盖其病不独见于春间,故另立风温门。
尺肤热甚,脉盛躁者,病温也。(全文见诊。)夫精者,身之本也,故藏于精者,春不病温。
凡治温病,可刺五十九穴。成注云∶所谓五十九穴者,刺两手内外侧各三,凡十二 ,五指间各一,
凡八 ,足亦如之。头入发际一寸傍三分各三,凡六 ,巅上一,囟会一,发际一,廉泉一,风池二,天柱二。
(《内经》云∶气口静,人迎躁者取之,若气口人迎皆静者,勿刺也。人迎,谓结喉动脉也。)王太仆注《素
问》五十九刺云∶刺头上五行。五行者,以越诸阳之热逆也。(谓头中行上星、囟会、前顶、百会、后顶五穴,
头第二行两傍五处、承光、通天、络 、玉枕十穴,第三行两傍临泣、目窗、正营、承灵、脑空十穴也。)
大杼、膺俞、缺盆、背俞,此八者以泻胸中之热也。气街、三里、巨虚上下廉,此八者,以泻胃中之热也。
云门、 骨、委中、髓空,此八者,以泻四肢之热也。五脏俞傍五,此十者,以泻五脏之热也。(谓背第五
行两傍魄户、神堂、魂门、意舍、志室十穴也。)
从霜降节气之后到春分节气之前,凡是因接触冒犯霜露,体内受寒立即发病的,称为伤寒。(除了湿病、暑病、疟疾的治疗方法外,其余都采用治疗伤寒的方法。)
从立春节气之后,期间没有突然的严寒,也没有冰雪,而人出现高热症状的,这属于春季阳气发散于体表,冬季潜伏的寒邪转化为温病。
(符合常规气候规律的春温病有四种情况:少阳司天之年,初之气阶段;太阳司天之年,初之气阶段;阳明司天之年,终之气阶段;太阴司天之年,二之气阶段,这些时候都会发生温病。那些不符合常规气候规律而是反常的情况,无法预测,会随时间变化而改变。)
冬季感受寒邪,春季必定发生温病。(全文详见五脏章节。)太阳病表现为发热且口渴,不恶寒的,称为温病。(治疗方法详见冬温章节。)
脉象阳部洪大数急,阴部实大而有力的,遇到温热气候就会转化为温毒。(理论论述详见大法章节。治疗方法详见发斑章节。《活人书》说:初春出现发斑、咳嗽,是温毒的表现。)
发汗后病邪未解,身体灼热,称为风温。其症状表现为脉浮、汗出、身体沉重、嗜睡多眠。因为这种病不仅仅见于春季,所以单独设立风温门类。
尺肤(前臂内侧皮肤)非常热,脉象盛大躁动的,是温病。(全文详见诊法章节。)精气是人体的根本,所以能固藏精气的,春季就不会得温病。
凡治疗温病,可以针刺五十九个穴位。成无己注解说:所谓的五十九穴,是指刺双手内外侧各三个穴位,共十二个穴位,五指间各刺一个,共八个穴位,足部也类似如此。头部入发际一寸处,旁开三分各三个穴位,共六个穴位,头顶正中一个,囟会穴一个,发际处一个,廉泉穴一个,风池穴两个,天柱穴两个。
(《内经》说:气口脉静,人迎脉躁动的取穴治疗,如果气口和人迎脉都静止不动的,不要针刺。人迎穴,指的是结喉旁的动脉处。)王冰注《素问》五十九刺时说:刺头部的五行穴位。五行,是用来宣泄诸阳经逆上的热邪。(指头部中行上星、囟会、前顶、百会、后顶五个穴位,头部第二行两旁五处、承光、通天、络却、玉枕十个穴位,第三行两旁临泣、目窗、正营、承灵、脑空十个穴位。)
大杼穴、膺俞穴、缺盆穴、背俞穴,这八个穴位用来泻除胸中的热邪。气街穴、三里穴、巨虚上廉穴、巨虚下廉穴,这八个穴位用来泻除胃中的热邪。云门穴、髀骨穴(此处疑为“髀关”或泛指大腿部位穴位,原文作“ 骨”,结合上下文及《素问·水热穴论》,通常指“髀关”或“伏兔”等,但依原文直译)、委中穴、髓空穴(即悬钟),这八个穴位用来泻除四肢的热邪。五脏俞穴旁边各五个穴位,这十个穴位用来泻除五脏的热邪。(指背部第五行两旁魄户、神堂、魂门、意舍、志室十个穴位。)
From after the Frost Descent solar term to before the Spring Equinox solar term, anyone who contracts cold immediately upon exposure to frost and dew is said to have Cold Damage (Shanghan). (Except for the treatment methods of Dampness (Shi), Summerheat (Shu), and Malaria (Nue), all other cases follow the treatment principles of Cold Damage.)
After the Beginning of Spring solar term, if there is no sudden severe cold or ice/snow, yet a person suffers from high fever, this belongs to Warm Disease (Wenbing) caused by the dispersal of Spring Yang Qi on the exterior and the transformation of latent Winter Cold into Warmth.
(Four regular climatic patterns correspond to Spring Warmth: in years governed by Shaoyang as the Heavenly Ruler during the First Qi; Taiyang as the Heavenly Ruler during the First Qi; Yangming as the Heavenly Ruler during the Last Qi; and Taiyin as the Heavenly Ruler during the Second Qi, Warm diseases occur. Abnormal patterns that deviate from these regularities cannot be predicted and change with time.)
If one is injured by Cold in Winter, Warm Disease will inevitably occur in Spring. (See full text under Five Zang Organs.) In Taiyang disease, if there is fever and thirst without aversion to cold, it is called Warm Disease. (Treatment see Winter Warmth.) If the Yang pulse is surging and rapid, and the Yin pulse is solid and large, encountering warm and hot weather transforms it into Warm Toxin (Wendu). (Theory see General Principles. Treatment see Eruption/Spots. The *Liuren* book states: In early spring, eruption and cough indicate Warm Toxin.)
If sweating fails to resolve the condition and the body feels burning hot, it is called Wind-Warmth (Fengwen). Its symptoms include floating pulse, sweating, heavy body, and excessive sleepiness. Since this disease is not limited to spring, a separate category for Wind-Warmth is established.
If the skin of the chi position (inner forearm) is very hot and the pulse is vigorous and restless, it indicates Warm Disease. (See full text under Diagnosis.) Essence (Jing) is the root of the body; therefore, those who preserve their essence will not suffer from Warm Disease in Spring.
For treating Warm Disease, fifty-nine acupoints may be needled. Cheng Wuji's commentary states: The so-called fifty-nine points include three points on each side of both hands' inner and outer aspects, totaling twelve points; one point between each of the five fingers, totaling eight points; similarly for the feet. On the head, three points one cun inside the hairline and three fen lateral, totaling six points; one point at the vertex (Baihui); one at Xinhui; one at the hairline (Yintang area/Lianquan context dependent, here likely referring to specific scalp points); one at Lianquan; two at Fengchi; two at Tianzhu.
(The *Neijing* states: If the Qi Kou pulse is quiet and the Ren Ying pulse is agitated, needle them. If both are quiet, do not needle. Ren Ying refers to the artery at the carotid region near the Adam's apple.) Wang Bing's commentary on the *Suwen* regarding the fifty-nine needles states: Needle the five rows on the head. These five rows are used to vent the rebellious heat of the Yang meridians. (This refers to the midline row: Shangxing, Xinhui, Qiangding, Baihui, Houding; the second lateral row: Wuchu, Chengguang, Tongtian, Luoque, Yuzhen; and the third lateral row: Linqi, Muchuang, Zhengying, Chengling, Naokong.)
Dazhu, Ying Shu, Quepen, and Bei Shu—these eight points are used to drain heat from the chest. Qijie, Sanli, Shangjuxu, and Xiajuxu—these eight points are used to drain heat from the Stomach. Yunmen, Biguan (interpreted from " 骨" based on standard lists, though literal translation is Hip Bone), Weizhong, and Xuankong (Xuangu)—these eight points are used to drain heat from the four limbs. The five points adjacent to each of the Five Zang Back-Shu points—these ten points are used to drain heat from the Five Zang Organs. (Referring to the fifth lateral row on the back: Pohu, Shentang, Hunmen, Yishe, Zhishi.)