尝读《内经》有“冬伤于寒，春必病温”之语，此中原有深义，非浅学人所易窥测也。乃笃信西说者，
据病菌潜伏各有定期之说，谓病菌传于人身，未有至一月而始发动者，况数月乎？因此一倡百和，遂谓《内
经》皆荒渺之谈，分毫不足凭信。不知毒瓦斯之传染有菌，而冬令严寒之气，为寒水司天之正气，特其气严寒
过甚，或人之居处衣服欠暖，或冒霜雪而出外营生，即不能御此气耳。是以寒气之中人也，其重者实时成病，
即冬令之伤寒也。其轻者，微受寒侵，不能即病，由皮肤内侵，潜伏于三焦脂膜之中，阻塞气化之升降流通，
即能暗生内热。迨至内热积而益深，又兼春回阳生触发其热，或更薄受外感以激发其热，是以其热自
内暴发而成温病，即后世方书所谓伏气成温也。
至于治之之法，有清一代名医多有谓此证不宜发汗者。然仍宜即脉证之现象而详为区别。若其脉象虽
有实热，而仍在浮分，且头疼、舌苔犹白者，仍当投以汗解之剂。然宜以辛凉发汗，若薄荷叶、连翘、蝉蜕诸
药，且更以清热之药佐之。若拙拟之清解汤。凉解汤、寒解汤三方，斟酌病之轻重，皆可选用也。此乃先
有伏气又薄受外感之温病也。
若其病初得即表里壮热，脉象洪实，其舌苔或白而欲黄者，宜
投以白虎汤，再加宣散之品若连翘、茅根诸药。如此治法，非取汗解，然恒服药后竟自汗而解。即或服药后不
见汗，其病亦解。因大队寒凉之品与清轻宣散之品相并，自能排逐内蕴之热，息息自腠理达于皮毛以透出也（
此乃伏气暴发自内达外之温病春夏之交多有之）。盖此等证皆以先有伏气，至春深萌动欲发，而又或因暴怒，
或因劳心劳力过度，或因作苦于烈日之中，或因酣眠于暖室内，是以一发表里即壮热。治之者，只可宣散清
解，而不宜发汗也。此冬伤于寒春必病温之大略治法也。
《内经》又谓∶“冬不藏精，春必病温。”此二语不但为西医所指摘，即中医对此节经文亦恒有疑意。
谓冬不藏精之人，若因肾虚而寒入肾中，当即成少阴伤寒，为直中真阴之剧证，何能迟至春令而始成温病？
不知此二句经文原有两解，其所成之温病亦有两种，至其治法又皆与寻常治法不同。今试析言之，并详其治法。
冬不藏精之人，其所患之温病，有因猝然感冒而成者。大凡病温之人，多系内有蕴热，至春阳萌动之时，
又薄受外感拘束，其热即陡发而成温。冬不藏精之人，必有阴虚，所生之热积于脏腑，而其为外感所拘束而发
动，与内蕴实热者同也。其发动之后，脉象多数，息多微喘，舌上微有白苔，津液短少，后或干黄，或
舌苔渐黑，状如斑点（为舌苔甚薄若有若无故见舌皮变黑），或频饮水不能解渴，或时入阴分益加潮热。此
证初得其舌苔白时，亦可汗解，然须以大滋真阴之药辅之。愚治此证，恒用连翘、薄荷叶各三钱，玄参、
生地黄各一两，煎汤服之，得汗即愈。若服药后汗欲出仍不能出，可用白糖水送服西药阿斯匹林二分许，
其汗即出。或单将玄参、生地黄煎汤，送服阿斯匹林一瓦，亦能得汗。若至热已传里，舌苔欲黄，或至黄而兼
黑，脉象数而有力，然按之弦硬，非若阳明有实热者之洪滑，此阴虚热实之象，宜治以白虎加人参汤，更以生
地黄代知母，生山药代粳米，煎一大剂，取汤一大碗，分多次温饮下（拙着伤寒温病同用方后载有此方，
附载治愈之案若干。可参观也 ）。
又有因伏气所化之热先伏藏于三焦脂膜之中，迨至感春阳萌动而触发，其发动之后，恒因冬不藏精者
其肾脏虚损，伏气乘虚而窜入少阴。其为病状∶精神短少，喜偃卧，昏昏似睡，舌皮干，毫无苔，小便短赤，其
热郁于中而肌肤却无甚热。其在冬令，为少阴伤寒，即少阴证，初得宜治以黄连阿胶汤者也。在春令，即为少
阴温病。而愚治此证，恒用白虎加人参汤，以生地黄代知母，生怀山药代粳米，更先用鲜白茅根三两煎汤以
之代水煎药，将药煎一大剂，取汤一大碗，分三次温饮下，每饮一次调人生鸡子黄一枚。初饮一次后，其脉
当见大，或变为洪大，饮至三次后，其脉又复和平，而病即愈矣。此即冬不藏精春必病温者之大略治法也。
上所论各种温病治法，原非凭空拟议也，实临证屡用有效，而后敢公诸医界同人也。
有温病初得即表里大热，宜治以白虎汤或白虎加人参汤者。其证发现恒在长夏，或在秋夏之交。而愚
生平所遇此等证，大抵在烈日之中，或田间作苦，或长途劳役，此《伤寒论》所谓 病也，亦可谓之暑温也。
其脉洪滑有力者，宜用白虎汤。若脉虽洪大而按之不实者，宜用白虎加人参汤。又皆宜煎一大剂，分数次
温饮下，皆可随手奏效。
伏气化热成温病者，大抵因复略有感冒，而后其所化之热可陡然成温，表里俱觉壮热。不然者，虽伏
气所化之热深入阳明之府，而无外感束其表，究不能激发其肌肉之热。是以治之者恒不
知其为伏气化热，放胆投以治温病之重剂，是以其热遂永留胃府致生他病。今试举一案以明之∶
天津刘××，于壬申正月上旬，觉心中时时发热，而周身又甚畏冷。时愚回籍，因延他医延医，服药
二十余剂，病转增剧，二便皆闭。再服他药，亦皆吐出。少进饮食，亦恒吐出。此际愚
适来津，诊其脉，弦长有力，然在沉分。知其有伏气化热，其热
不能外达于表，是以心中热而外畏冷，此亦热深厥深之象也。俾先用鲜茅根半斤切碎，水煮三四沸，视茅根
皆沉水底，其汤即成。取清汤三杯，分三次服，每服一次，将土狗三个捣为末，生赭石三钱亦为细末，以茅
根汤送下。若服过两次未吐，至三次赭石可以不用。及将药服后，呕吐即止，小便继亦通下。再诊其
脉，变为洪长有力，其心中仍觉发热，外表则不畏冷矣。其大便到此已半月未通下。遂俾用大潞参五钱煎汤，
送服生石膏细末一两。翌晨大便下燥粪数枚，黑而且硬。再诊其脉，力稍缓，知心中犹觉发热。又俾用潞党
参四钱煎汤，送服生石膏细末八钱。翌晨又下燥粪二十余枚，仍未见溏粪。其心中不甚觉热，脉象仍似
有力，又俾用潞党参三钱煎汤，送服生石膏细末六钱。又下燥粪十余枚，后则继为溏粪，病亦从此全愈矣。
盖凡伏气化热窜入胃府，非重用石膏不解，《伤寒论》白虎汤原为治此证之的方也。然用白虎汤之例，汗
吐下后皆加人参，以其虚也。而此证病已数旬，且频呕吐，其元气之虚可知，故以人参煎汤送石膏，此亦仿
白虎加人参汤之义也。至石膏必为末送服者，以其凉而重坠之性善通大便，且较水煮但饮其清汤者，其退热
之力又增数倍也。是以凡伏气化热，其积久所生之病，有成肺病者，有成喉病者，有生眼疾者，有患齿疼者，
有病下痢者，有病腹疼者（即盲肠炎），其种种病因若皆由于伏气化热，恒有用一切凉药其病皆不能愈，而
投以白虎汤或投以白虎加人参汤，再因证加减，辅以各病当用之药，未有不随手奏效者。此治伏气化热之大
略也。至于拙着全书中，所载伏气化热之病甚多，其治法亦各稍有不同，皆可参观。
我曾阅读《内经》，其中有“冬伤于寒，春必病温”的说法，这其中的深意并非浅薄学识的人所能轻易窥探。然而那些笃信西医理论的人，依据病菌潜伏各有固定周期的说法，认为病菌传染给人身，没有经过一个月才开始发作的，何况是几个月呢？因此一呼百应，于是认为《内经》都是荒谬渺茫的言论，丝毫不足凭信。他们不知道毒气的传染确实有细菌，但冬季严寒之气，是寒水司天的正气，只是其气严寒过度，或者人的居处衣服不够暖和，或者冒着霜雪出去谋生，就不能抵御这种寒气罢了。所以寒气侵入人体，严重的当时就发病，这就是冬季的伤寒。轻微的，只是微受寒邪侵袭，不能立即发病，由皮肤内侵，潜伏在三焦脂膜之中，阻塞气化的升降流通，就能暗中产生内热。等到内热积聚而更深，又加上春天阳气回升触发其热，或者再轻微感受外感以激发其热，因此热从内部暴发而成温病，就是后世方书所说的伏气成温。
至于治疗的方法，清朝一代的名医多有认为此证不宜发汗的。然而仍然应当根据脉象和症状的表现详细加以区别。如果脉象虽然有实热，但仍然在浮分（轻取即得），且头疼、舌苔还是白色的，仍然应当投用汗解的药剂。但是应当用辛凉发汗，如薄荷叶、连翘、蝉蜕等药，并且再用清热的药物辅助。比如我拟定的清解汤、凉解汤、寒解汤三方，斟酌病情的轻重，都可以选用。这是先有伏气又轻微感受外感的温病。
如果病初起即表里壮热，脉象洪大坚实，舌苔或者白而欲黄，应当投用白虎汤，再加宣散的药物如连翘、茅根等药。这样的治法，不是取汗解，然而常常服药后竟自汗而解。即使服药后不见汗，病也解了。因为大队寒凉之品与清轻宣散之品相并，自然能排逐内蕴的热，息息从腠理达于皮毛透出（这是伏气暴发自内达外的温病，春夏之交多有发生）。大概这些证候都是因为先有伏气，到春深萌动欲发，而又或因暴怒，或因劳心劳力过度，或因在烈日中劳作，或因在暖室内酣睡，因此一发表里即壮热。治疗者，只可宣散清解，而不宜发汗。这是冬伤于寒春必病温的大略治法。
《内经》又说：“冬不藏精，春必病温。”这两句话不但被西医所指责，即中医对此节经文也常有疑问。认为冬不藏精的人，若因肾虚而寒入肾中，当即成为少阴伤寒，为直中真阴的剧烈证候，怎么能延迟到春季才成为温病？不知道这两句经文原本有两种解释，其所成的温病也有两种，至于治疗方法又都与寻常治法不同。现在试着分析说明，并详细说明其治法。
冬不藏精的人，其所患的温病，有因突然感冒而成的。大凡患温病的人，多系内有蕴热，到春阳萌动之时，又轻微感受外感拘束，其热就陡然发作而成温。冬不藏精的人，必有阴虚，所生的热积于脏腑，而其被外感所拘束而发动，与内蕴实热者相同。其发动之后，脉象多数，呼吸多微喘，舌上微有白苔，津液短少，后来或干黄，或舌苔渐黑，状如斑点（为舌苔很薄若有若无故见舌皮变黑），或频繁饮水不能解渴，或有时进入阴分更加潮热。此证初得其舌苔白时，也可以汗解，但是必须以大滋真阴的药物辅助。我治疗此证，常用连翘、薄荷叶各三钱，玄参、生地黄各一两，煎汤服用，得汗即愈。如果服药后汗欲出仍不能出，可用白糖水送服西药阿斯匹林二分许，其汗即出。或者单将玄参、生地黄煎汤，送服阿斯匹林一瓦，也能得汗。如果至热已传里，舌苔欲黄，或至黄而兼黑，脉象数而有力，然而按之弦硬，不像阳明有实热者的洪滑，这是阴虚热实的象，应当用白虎加人参汤治疗，更以生地黄代替知母，生山药代替粳米，煎一大剂，取汤一大碗，分多次温饮下（拙著伤寒温病同用方后载有此方，附载治愈的案例若干。可以参考）。
又有因伏气所化的热先伏藏于三焦脂膜之中，等到感受春阳萌动而触发，其发动之后，常因冬不藏精者肾脏虚损，伏气乘虚而窜入少阴。其病症表现：精神短少，喜欢仰卧，昏昏似睡，舌皮干，毫无苔，小便短赤，其热郁于中而肌肤却没有甚么热。其在冬季，为少阴伤寒，即少阴证，初得适宜用黄连阿胶汤治疗。在春季，即为少阴温病。而我治疗此证，常用白虎加人参汤，以生地黄代替知母，生怀山药代替粳米，更先用鲜白茅根三两煎汤以此代水煎药，将药煎一大剂，取汤一大碗，分三次温饮下，每次饮用一次调人生鸡子黄一枚。初次饮用一次后，其脉应当见大，或变为洪大，饮用至三次后，其脉又复和平，而病即愈了。这就是冬不藏精春必病温者的大略治法。
上面所论述的各种温病治法，原本不是凭空拟议的，确实是临证屡用有效，而后才敢公诸医界同人。
有温病初得即表里大热，适宜用白虎汤或白虎加人参汤治疗的。其证发现常在长夏，或在秋夏之交。而我生平所遇此类证候，大多在烈日之中，或田间劳作，或长途劳役，这是《伤寒论》所谓的中暍病，也可以称之为暑温。其脉洪滑有力的，适宜用白虎汤。若脉虽洪大而按之不实，适宜用白虎加人参汤。也都适宜煎一大剂，分数次温饮下，都可随手奏效。
伏气化热成温病的，大多因再次略有感冒，然后其所化的热可陡然成温，表里都觉壮热。否则的话，虽然伏气所化的热深入阳明之腑，而无外感束缚其表，终究不能激发其肌肉之热。所以治疗者常不知道其为伏气化热，放胆投用治温病的重剂，因此其热遂永留胃腑导致生其他病。现在试举一案来说明：
天津刘××，在壬申年正月初旬，觉得心中时时发热，而周身又非常畏冷。当时我回籍，便请其他医生诊治，服药二十余剂，病情转增剧烈，二便皆闭。再服其他药，也都吐出。稍微进食，也常吐出。此时我恰好来到天津，诊其脉，弦长有力，然而在沉分。知道他有伏气化热，其热不能外达于表，所以心中热而外畏冷，这也是热深厥深的象。让他先用鲜茅根半斤切碎，水煮三四沸，看茅根都沉水底，其汤即成。取清汤三杯，分三次服，每服一次，将土狗三个捣为末，生赭石三钱也为细末，以茅根汤送下。如果服过两次未吐，至第三次赭石可以不用。及将药服后，呕吐即止，小便继亦通下。再诊其脉，变为洪长有力，其心中仍觉发热，外表则不畏冷了。其大便到此已半月未通下。于是让他用大潞参五钱煎汤，送服生石膏细末一两。翌晨大便下燥粪数枚，黑而且硬。再诊其脉，力稍缓，知心中犹觉发热。又让他用潞党参四钱煎汤，送服生石膏细末八钱。翌晨又下燥粪二十余枚，仍未见溏粪。其心中不甚觉热，脉象仍似有力，又让他用潞党参三钱煎汤，送服生石膏细末六钱。又下燥粪十余枚，后来则继为溏粪，病也从此全愈了。
大概凡是伏气化热窜入胃腑，非重用石膏不解，《伤寒论》白虎汤原为治此证的对症之方。然而用白虎汤的例法，汗吐下后皆加人参，因为其虚。而此证病已数旬，且频呕吐，其元气之虚可知，所以用人参煎汤送石膏，这也仿照白虎加人参汤的意义。至于石膏必为末送服，是因为其凉而重坠之性善通大便，且较水煮但饮其清汤者，其退热之力又增数倍。所以凡是伏气化热，其积久所生的病，有成肺病的，有成喉病的，有生眼疾的，有患齿疼的，有病下痢的，有病腹疼的（即盲肠炎），其种种病因若皆由于伏气化热，常用一切凉药其病皆不能愈，而投以白虎汤或投以白虎加人参汤，再因证加减，辅以各病当用之药，没有不随手奏效的。这是治伏气化热的大略。至于拙著全书中，所载伏气化热之病甚多，其治法也各稍有不同，皆可参考。
I once read in the *Neijing* (Inner Canon) the phrase "Winter injury by cold leads to warm disease in spring" (Dong shang yu han, chun bi bing wen). The profound meaning within this statement is not easily fathomed by those with superficial knowledge. However, those who firmly believe in Western theories, citing the notion that pathogens have specific incubation periods, argue that pathogens transmitted to the human body do not take a month to manifest, let alone several months. Consequently, one voice is echoed by hundreds, leading them to dismiss the *Neijing* as absurd and unreliable. They fail to realize that while toxic transmission involves bacteria, the severe cold of winter is the righteous qi governed by Cold Water (Han Shui Si Tian). It is only when the cold is excessively severe, or when one's dwelling or clothing is insufficiently warm, or when one ventures out into frost and snow for livelihood, that they cannot resist this qi. Thus, when cold qi invades the human body, if severe, illness occurs immediately; this is Winter Cold Damage (Dong Ling Shang Han). If mild, slight cold invasion does not cause immediate illness; instead, it penetrates from the skin inward, lying dormant within the Sanjiao (Triple Burner) fatty membranes, obstructing the ascending, descending, flowing, and circulating mechanisms of Qi transformation, thereby secretly generating internal heat. When this internal heat accumulates and deepens, and is further triggered by the rising Yang of spring, or stimulated by a slight external contraction, the heat erupts from within, resulting in Warm Disease (Wen Bing). This is what later medical texts refer to as "latent qi transforming into warmth" (Fu Qi Cheng Wen).
Regarding treatment methods, many renowned physicians of the Qing Dynasty believed this syndrome should not be treated with sweating methods. Nevertheless, one must still carefully distinguish based on pulse and symptom manifestations. If the pulse indicates excess heat but remains at the floating level (superficial), and headache and white tongue coating persist, sweating agents should still be administered. However, acrid-cool sweating methods should be used, employing herbs such as Mint Leaf (Bohe Ye), Forsythia Fruit (Lian Qiao), and Cicada Slough (Chan Tui), assisted by heat-clearing herbs. For instance, my formulated formulas—Qingjie Tang (Clearing and Resolving Decoction), Liangjie Tang (Cooling and Resolving Decoction), and Hanjie Tang (Cold-Resolving Decoction)—can be selected according to the severity of the condition. This applies to Warm Disease caused by latent qi combined with slight external contraction.
If the disease begins with intense heat in both the exterior and interior, with a surging and solid pulse, and the tongue coating is white turning yellow, Baihu Tang (White Tiger Decoction) should be administered, supplemented with dispersing herbs like Forsythia Fruit (Lian Qiao) and Imperata Rhizome (Mao Gen). This treatment method does not aim to induce sweating, yet patients often recover through spontaneous sweating after taking the medicine. Even if no sweating occurs, the disease resolves. This is because the large dose of cooling herbs combined with light, clear, and dispersing agents naturally expels the internally accumulated heat, allowing it to exit gradually through the interstices (Cou Li) to the skin surface (this type of Warm Disease, where latent heat erupts from within to the exterior, is common during the transition between spring and summer). Generally, these syndromes arise because latent qi has been present, awakening in late spring, and is further triggered by sudden anger, excessive mental or physical labor, working under the scorching sun, or sleeping deeply in a warm room, causing immediate intense heat in both interior and exterior upon manifestation. Treatment should focus on dispersing and clearing heat, avoiding sweating methods. This outlines the general treatment for "Winter injury by cold leads to warm disease in spring."
The *Neijing* also states: "Winter failure to store essence leads to warm disease in spring." These two sentences are criticized not only by Western medicine but also questioned by some Traditional Chinese Medicine (TCM) practitioners regarding this scripture. They argue that individuals who fail to store essence in winter, if kidney deficiency allows cold to enter the Kidney, should immediately develop Shaoyin Cold Damage (Shao Yin Shang Han), a severe syndrome directly attacking True Yin, rather than delaying until spring to develop Warm Disease. They do not realize that these two sentences have two interpretations, resulting in two types of Warm Disease, each requiring treatments different from standard ones. I will now analyze them and detail their treatments.
For individuals who failed to store essence in winter, the Warm Disease they contract may result from sudden external contraction. Generally, those suffering from Warm Disease have internal accumulated heat. When spring Yang awakens, slight external contraction constrains this heat, causing it to erupt suddenly. Individuals who failed to store essence inevitably have Yin deficiency, with generated heat accumulating in the Zang-Fu organs. Their heat erupting due to external constraint is similar to that of excess internal heat. After eruption, the pulse is frequent, breathing is slightly panting, the tongue has a slight white coating, fluids are scant, later becoming dry and yellow, or the coating turns black with spot-like patterns (due to very thin coating making the tongue skin appear black), drinking frequently fails to quench thirst, or tidal fever worsens when entering the Yin aspect. When the tongue coating is initially white, sweating can resolve the condition, but it must be assisted by herbs that greatly nourish True Yin. In treating this, I commonly use three qian of Forsythia Fruit (Lian Qiao) and Mint Leaf (Bohe Ye), along with one liang of Scrophularia Root (Xuan Shen) and Raw Rehmannia Root (Sheng Di Huang), decocted in water. Recovery follows sweating. If sweat is desired but does not occur after medication, half a fen of Aspirin can be taken with sweet water to induce sweating. Alternatively, decocting Scrophularia Root (Xuan Shen) and Raw Rehmannia Root (Sheng Di Huang) alone and taking one grain of Aspirin with the decoction also induces sweating. If the heat has transmitted to the interior, with the coating turning yellow or yellow-black, and the pulse rapid and forceful but wiry and hard upon pressure (unlike the surging and slippery pulse of Yangming excess heat), this indicates Yin deficiency with heat excess. Baizhu Jia Renshen Tang (White Tiger Decoction plus Ginseng) should be used, substituting Raw Rehmannia Root (Sheng Di Huang) for Anemarrhena Rhizome (Zhi Mu) and Raw Chinese Yam (Sheng Huai Shan Yao) for Coix Seed (Jing Mi). Decoct a large dose to obtain one bowl of liquid, taken in multiple warm doses. (This formula is recorded in my work *Shanghan Wenbing Tong Yong Fang*, accompanied by case records for reference.)
Another type arises from heat generated by latent qi, which lies dormant in the Sanjiao fatty membranes. Upon triggering by spring Yang, the eruption often finds the Kidneys of those who failed to store essence damaged, allowing latent qi to invade the Shaoyin channel due to deficiency. Symptoms include shortness of spirit, preference for lying supine, drowsiness, dry tongue skin without coating, scanty dark urine, heat郁 (congested) internally while the skin feels relatively cool. In winter, this is Shaoyin Cold Damage (Shaoyin Syndrome), initially treated with Huanglian Ejiao Tang (Coptis and Donkey-Hide Gelatin Decoction). In spring, it becomes Shaoyin Warm Disease. I treat this using Baizhu Jia Renshen Tang (White Tiger Decoction plus Ginseng), substituting Raw Rehmannia Root (Sheng Di Huang) for Anemarrhena Rhizome (Zhi Mu) and Raw Chinese Yam (Sheng Huai Shan Yao) for Coix Seed (Jing Mi). First, decoct three liang of fresh Imperata Rhizome (Bai Mao Gen) in water to replace normal water for decocting the medicine. Prepare a large dose to yield one bowl, taken in three warm doses. After each dose, mix in one raw chicken egg yolk. After the first dose, the pulse should become large or surging-large; after three doses, the pulse returns to harmony, and the disease resolves. This outlines the general treatment for "Winter failure to store essence leads to warm disease in spring."
The various Warm Disease treatments discussed above are not theoretical speculations but are based on repeated clinical efficacy, hence shared with colleagues in the medical field.
There are cases of Warm Disease beginning with intense heat in both exterior and interior, suitable for treatment with Baihu Tang (White Tiger Decoction) or Baizhu Jia Renshen Tang (White Tiger Decoction plus Ginseng). These syndromes typically appear in late summer or the transition between autumn and summer. In my experience, such cases usually occur after exposure to scorching sun, field labor, or long-distance exertion. This corresponds to the "Zhong Re" (Heat Stroke/Summerheat) mentioned in the *Shanghan Lun* (Treatise on Cold Damage), also known as Summerheat-Warmth (Shu Wen). If the pulse is surging, slippery, and forceful, Baihu Tang (White Tiger Decoction) is appropriate. If the pulse is surging-large but empty upon pressure, Baizhu Jia Renshen Tang (White Tiger Decoction plus Ginseng) is indicated. Both should be decocted in large doses and taken in divided warm portions, yielding prompt results.
Warm Disease resulting from latent qi transforming into heat usually follows a slight recurrence of external contraction, causing the transformed heat to erupt suddenly, resulting in intense heat in both interior and exterior. Otherwise, even if the heat from latent qi penetrates deeply into the Yangming Fu organs, without external constraint, it cannot stimulate muscle heat. Therefore, physicians often fail to recognize latent qi transformation and boldly administer heavy Warm Disease remedies, causing the heat to remain permanently in the Stomach Fu, leading to other diseases. Consider this case:
Mr. Liu XX from Tianjin, in early January of the Ren-Shen year, felt constant internal heat but extreme aversion to cold all over his body. As I was then in my hometown, he consulted other physicians. After more than twenty doses of medicine, his condition worsened significantly, with complete retention of urine and feces. Subsequent medications were vomited up. Even small amounts of food were vomited. At this time, I happened to arrive in Tianjin. His pulse was wiry, long, and forceful, but deep. I identified latent qi transforming into heat, unable to reach the exterior, causing internal heat and external aversion to cold—a sign of "deep heat leading to deep cold limbs" (Re Shen Jue Shen). I prescribed him to first boil half a jin of fresh Imperata Rhizome (Mao Gen), chopped, for three to four boils until the rhizomes sink. He was to drink three cups of the clear liquid in three doses. With each dose, he took three powdered ground beetles (Tu Gou) and three qian of raw Oyster Shell (Shi Jue Ming - *Note: Text says Shi Jie, likely Hematite/Shi Gany or similar heavy sedative, context implies heavy settling herb, usually Shi Gany/Hematitum in such contexts for vomiting, but text says 'Shi Jie', I will translate as Hematite/Ochre based on 'heavy' property description later, though strictly 'Shi Jie' might be a typo for Shi Gany or similar. Given 'heavy and sinking' description, Hematitum is standard. However, sticking to text 'Shi Jie' -> Ochre/Hematite*). Actually, 'Shi Jie' is likely a typo for 'Shi Gany' (Hematitum) or 'Da Shi' (Magnetitum). Given the context of stopping vomiting and heavy nature, I will use Hematitum (Shi Gany) as the standard interpretation for 'Shi' heavy herbs in Zhang Xichun's practice, but strictly the text says 'Shi Jie'. I will translate as Ochre/Hematite. Let's stick to the literal 'Shi Jie' translated as Ochre or assume Hematite. Zhang Xichun often uses Shi Gany. I will use Hematitum (Shi Gany) for accuracy of intent, noting the text says Shi Jie. Wait, 'Shi Jie' might be 'Shi Jie' (Stone Knot)? No. It is likely 'Shi Gany'. I will use Hematitum (Shi Gany) [Hematitum].] ... *Correction*: The text says "Shi Jie". In Zhang Xichun's works, he often uses "Shi Gany" (Hematitum). "Shi Jie" is likely a typo for "Shi Gany" or "Da Shi". Given the description "cool and heavy/sinking", Hematitum fits best. I will translate as Hematitum (Shi Gany).
...With each dose, he took three powdered ground beetles (Tu Gou) and three qian of Hematitum (Shi Gany) [assuming typo for Shi Jie], washed down with the Imperata Rhizome decoction. If no vomiting occurred after two doses, the third dose could omit the Hematitum. After taking the medicine, vomiting ceased, and urination resumed. Re-palpation showed a surging, long, and forceful pulse. Internal heat persisted, but external aversion to cold disappeared. Bowel movement had been absent for half a month. I then prescribed five qian of Radix Codonopsis (Lu Shen) decocted in water, taken with one liang of fine Powdered Gypsum (Shi Gao). The next morning, several hard, black feces were passed. Pulse strength decreased slightly, indicating persistent internal heat. I prescribed four qian of Radix Codonopsis (Lu Dang Shen) decocted in water, taken with eight qian of Powdered Gypsum (Shi Gao). The next morning, over twenty hard feces were passed, still no loose stool. Internal heat diminished, pulse remained somewhat forceful. I prescribed three qian of Radix Codonopsis (Lu Dang Shen) decocted in water, taken with six qian of Powdered Gypsum (Shi Gao). Over ten more hard feces were passed, followed by loose stools, and the disease was completely cured.
Generally, when latent qi transforms into heat and invades the Stomach Fu, only a heavy dose of Gypsum (Shi Gao) can resolve it. Baihu Tang (White Tiger Decoction) from the *Shanghan Lun* is the precise formula for this. However, in the usage of Baihu Tang, Ginseng is added after sweating, vomiting, or purging due to deficiency. Here, the disease has lasted weeks with frequent vomiting, indicating significant Yuan Qi deficiency. Thus, decocting Ginseng to take with Gypsum mimics the principle of Baizhu Jia Renshen Tang (White Tiger Decoction plus Ginseng). Gypsum must be taken as powder because its cool and heavy/sinking nature effectively promotes bowel movement, and its heat-clearing power is several times greater than drinking the decoction liquid alone. Therefore, for diseases resulting from long-term accumulation of latent qi transforming into heat—whether lung disease, throat disease, eye disease, toothache, dysentery, or abdominal pain (appendicitis)—if caused by latent qi heat, cooling herbs often fail. However, administering Baihu Tang (White Tiger Decoction) or Baizhu Jia Renshen Tang (White Tiger Decoction plus Ginseng), modified according to symptoms and assisted by specific herbs for each condition, invariably yields prompt results. This outlines the general treatment for latent qi transforming into heat. My complete works contain many such cases with varying treatments, all worth referencing.