今人见发热数日不凉，即混名之曰伤寒。而不辨其为风、为寒、为湿、为热、为温，一
例以
豆豉、豆卷、牛蒡、沙参、生地、洋参、石斛投之，此大谬也。不知此数病者，虽隶于伤寒
门类，皆由伤寒传变，不得混名之曰伤寒，而以冬至以前所发之真伤寒治之。况其所用者，
并非伤寒方，且其所视者，亦并非伤寒症，特欲以伤寒两字愚病家耳。《素问》曰∶热病者
，皆伤寒之类也。又曰∶人之伤于寒也，则为热病。人伤于寒，而传为热，何也？寒甚则生
热也。又曰∶凡病伤寒而成温者，先夏至日为病温；后夏至日为病暑。《难经》五十八难曰
∶伤寒有五，有中风；有伤寒；有湿温；有热病；有温病，伤寒为病之总名。五者乃病之分
证。仲景《伤寒》论其始曰∶太阳之为病，脉浮，头项强痛而恶寒。其后乃一一分别治之。
有所谓中风者，太阳病，发热汗出，恶风脉缓者是也；有所谓伤寒者，太阳病，或已发热，
或未发热，必恶寒体痛呕逆，脉阴阳俱紧者是也，病自伤寒来，故用桂枝、麻黄之辛温，以
祛风而散寒。有所谓湿痹者，太阳病，关节疼痛而烦，脉沉而细者是也。有所谓 病者，太
阳中热，其人汗出，恶寒身热者是也；有所谓温病者，太阳病，发热而渴，不恶寒者是也。
其病亦自伤寒来。其方如葛根之辛凉，石膏之辛甘寒，黄芩、黄连、大黄之诸苦寒者皆治之
。今人既不辨伤寒症中之为风、为寒、为湿、为热，为温，又不问《伤寒论》中，以何者为
主方。
炳按∶伤寒正名，剿撮《伤寒论》开场白。引用《难经》伤寒有五语，做一篇文本，实
要骂
用豆卷、豆豉、牛蒡、沙参、生地、洋参、石斛之医耳。余无自己一言半语，表张医理，
迹
近谤书。总之，药之酸甘咸辛苦之味，寒热温凉补散消夺等等之性，有是病，即用是药。古
来名手，不越规矩，如偏爱偏憎，早用寒凉，抑遏病邪，固属误人；而偏喜补燥，使邪亦
不外达，助热化火劫津，亦所不免矣。且着书，此等言语不宜说，因自遇有痧疹未透，可不
用牛蒡，温热无汗，不用豆豉，热病化火，不用生地、石斛救液乎？转觉写方时自有抵触。
而惟以豆豉、豆卷、洋参、石斛等味，为治伤寒之良剂，并治百病之妙药，岂不可笑哉
？孔子
曰∶名不正则言不顺。余愿治病者，必先正其病之名，然后定其方所主。勿混言之曰伤寒，
而以无关于伤寒之药误人也。陆九芝先生有伤寒有五论，其说甚详且精，略举其凡，以破夫
伤寒愚人之术焉。
炳按∶伤寒一症，何人不知，伤寒一书，何医不看。汉后王叔和集勒成书，以后注述阐
扬张
氏之书，有其名而无其书者，不知凡几，即书尚存，专攻一世，不能尽读，一书莫说多，以
四十卷为则，请读三顾，能否上口背出乎？要之既为医，伤寒病理，不可不知耳。
江浙少真正伤寒，故不必泥定伤寒看病，再者，世运日变，两间气化亦变迁，前贤未尽
之理
，亦须后人纠正。如王安道、刘河间、朱丹溪治四时发热之病，已遍用辛凉苦寒，救济前人
辛温香燥之弊。至清代古吴叶先生香岩，阐发治温，又以甘濡立法化邪，其实杭嘉湖亦从此
法。王士雄驳吴鞠通《条辨》，病名题旨未清，乃言曰冬伤于寒，至春发者曰温病；夏至后
发者曰热病。冬春感风热之邪，而病者首先犯肺，名曰风温。其病于冬者曰冬温，病于春者
曰春温，即叶氏所论者，是亦名时气温病。夏至后所发热病，在《内经》亦曰暑，以其发于
暑令也。故仲景以夏月感暑成病者名曰 。盖暑 者，皆热之类也。然尚有湿温一条未言，
但湿温即湿热也。须分两条，一者其人常伤于湿，因而感 热为之湿温，病苦妄言，治在足
太阴，不可发汗。汗出必不能言、耳聋。前贤主以苍术石膏汤之用苍术、石膏、知母、甘草
，但此病不易治。其时令湿热，亦曰湿温，叶氏有论，薛生白有暑湿者，条分缕晰，亦曰湿
热病论三十八条。余是附入。伤寒有五，《难经》有中风，有伤寒，有湿温，有热病，有温
病，而不知内伤寒症有五，一停饮、二伤食、三香港脚、四虚烦、五内痈也。同伤寒十二证，
一冬温，二寒疫，三瘟疫，四温病，五热病，六风温，七温疟，八湿温，九中 ，十温毒，
十一风湿，十二痉病。见清代《医宗金鉴》伤寒心法要诀欲正名，亦当知此。
现在的人见到发热几天不退，就胡乱称之为“伤寒”。而不分辨它是风邪、寒邪、湿邪、热邪还是温邪，一律用豆豉、豆卷、牛蒡子、沙参、生地、西洋参、石斛等药物来治疗，这是极大的谬误。不知道这些病证，虽然归属于伤寒门类，但都是由伤寒传变而来，不能混同称为“伤寒”，更不能用冬至前所发的真伤寒的方法来治疗。况且他们所用的方药，并非治疗伤寒的方剂，而且他们所看的症状，也并非真正的伤寒症，只是想要用“伤寒”这两个字来愚弄病人罢了。《素问》说：“热病，都属于伤寒的范畴。”又说：“人受寒邪侵袭，就会发生热病。”人受了寒邪，却传变为热病，为什么呢？因为寒邪极盛则生热。《素问》还说：“凡是患伤寒而转化为温病的，在夏至之前发病的叫‘温病’；在夏至之后发病的叫‘暑病’。”《难经·五十八难》说：“伤寒有五种类型：有中风、有伤寒、有湿温、有热病、有温病，其中‘伤寒’是疾病的总称。这五种则是疾病的具体分证。”张仲景在《伤寒论》开篇时说：“太阳病（太阳经受邪所致的病证）的特征是：脉浮，头项强痛而恶寒。”随后才一一分别论述治疗方法。所谓“中风”，是指太阳病，表现为发热、汗出、恶风、脉缓；所谓“伤寒”，是指太阳病，无论是否已经发热，必定恶寒、身体疼痛、呕吐逆气，脉象寸关尺三部俱紧，这种病源自伤寒，所以使用桂枝、麻黄等辛温药物，以祛风散寒。所谓“湿痹”，是指太阳病，关节疼痛且烦扰不安，脉象沉细；所谓“暍病”（中暑），是指太阳中热，患者汗出、恶寒、身热；所谓“温病”，是指太阳病，发热且口渴，不恶寒。这些病也都源自伤寒。其治疗方药如葛根的辛凉、石膏的辛甘寒、黄芩黄连大黄等的苦寒，都用于治疗此类病症。现在的人既不分辨伤寒症中属于风、寒、湿、热、温中的哪一种，又不询问《伤寒论》中以何者为主方。
炳按：纠正伤寒的名称，不过是摘录《伤寒论》的开场白，引用《难经》中“伤寒有五”的话，写成这篇文章，实际上是要痛斥那些使用豆卷、豆豉、牛蒡、沙参、生地、西洋参、石斛等药物的医生。文中没有一句半句表达作者自己的医理观点，痕迹上近乎诽谤之书。总之，药物有酸甘咸辛苦的味道，药性有寒热温凉补散消夺等不同，有什么样的病，就用什么样的药。古代名医，都不越规矩，如果偏爱或憎恶某类药，过早使用寒凉药，遏制病邪，固然会误人；而如果偏喜补燥药，使病邪不能外达，助热化火劫伤津液，也难免发生。况且著书立说，这类言语不宜多说，因为如果遇到痧疹未透发，难道就不能不用牛蒡子吗？温热无汗，难道就不能不用豆豉吗？热病化火，难道就不能用地黄、石斛来救阴液吗？反而觉得写处方时自有抵触。然而却认为豆豉、豆卷、西洋参、石斛等味是治疗伤寒的良剂，并治百病的妙药，岂不可笑吗？孔子说：“名分不正，言语就不顺当。”我希望治病的人，必须先端正疾病的名称，然后确定主治的方剂。不要混而言之说是“伤寒”，从而用与伤寒无关的药物误人。陆九芝先生有《伤寒有五论》，说法非常详细精辟，这里略举其概要，以破除那些对伤寒一知半解者的错误方法。
炳按：“伤寒”这一病症，谁不知道？《伤寒论》这一本书，哪个医生不看？汉代以后，王叔和搜集整理成书，此后注释阐述弘扬张仲景著作的人，有名无实的不知有多少，即使书籍尚存，专门攻研一生，也不能全部读完，一本书尚且难以说完，以四十卷为标准，请读三遍，能否背诵出来呢？总之，既然作为医生，伤寒的病理是不可不知道的。江浙地区很少有真正的伤寒，所以不必拘泥于“伤寒”来看病。再者，世运日益变化，天地间的气化也随之变迁，前贤未尽的道理，也需要后人纠正。如王安道、刘河间、朱丹溪治疗四时发热之病，已普遍使用辛凉苦寒之法，救济前人辛温香燥的弊端。到了清代古吴叶天士（叶香岩），阐发治疗温病的方法，又以甘润濡养立法以化解病邪，其实杭嘉湖地区也是从此法入手。王士雄驳斥吴鞠通的《温病条辨》，认为病名题旨不清，于是说道：冬季感受寒邪，到春季发作的叫“温病”；夏至后发作的叫“热病”。冬春季节感受风热之邪，而病者首先侵犯肺脏，名叫“风温”。在冬季发生的叫“冬温”，在春季发生的叫“春温”，也就是叶氏所论述的，这也称为时令气温病。夏至后所发的热病，在《内经》中也称为“暑”，因为它发生在暑令期间。所以张仲景将夏季感受暑邪而成病的命名为“暑病”。盖“暑”、“暍”者，都属于热病的范畴。然而还有一条“湿温”未曾言及，但湿温即是湿热。须分为两条：一是其人常伤于湿，因而感受热邪成为湿温，病症表现为胡言乱语，治疗在足太阴脾经，不可发汗。若发汗则必然不能说话、耳聋。前贤主张使用苍术石膏汤，用苍术、石膏、知母、甘草，但这种病不易治疗。当时的时令湿热，也称为湿温，叶天士有论述，薛生白有《暑湿论》，条理清晰，也称为湿热病论三十八条。我将其附入此处。《难经》说伤寒有五：中风、伤寒、湿温、热病、温病，却不知道内伤寒症也有五种：一是停饮、二是伤食、三是脚气、四是虚烦、五是内痈。加上伤寒十二证：一是冬温，二是寒疫，三是瘟疫，四是温病，五是热病，六是风温，七是温疟，八是湿温，九是中暍，十是温毒，十一是风湿，十二是痉病。见载于清代《医宗金鉴·伤寒心法要诀》。想要正名，也应该知道这些内容。
Nowadays, when people see fever lasting for several days without subsiding, they indiscriminately name it "Shanghan" (Cold Damage). They fail to distinguish whether it is caused by Wind (Feng), Cold (Han), Dampness (Shi), Heat (Re), or Warmth (Wen), and instead uniformly prescribe fermented soybean (Douchi), soaked soybean sprouts (Doujuan), burdock fruit (Niubang), Glehnia root (Shashen), Rehmannia root (Shengdi), American ginseng (Yangshen), and Dendrobium (Shihu) for treatment. This is a grave error. They do not realize that although these diseases fall under the category of Shanghan, they all result from the transmission and transformation of Shanghan. They cannot be indiscriminately called Shanghan, nor can they be treated with the methods used for true Shanghan occurring before the Winter Solstice. Moreover, the formulas they use are not those for treating Shanghan, and the symptoms they observe are not true Shanghan symptoms; they merely wish to confuse patients with the term "Shanghan." The *Suwen* states: "All heat diseases belong to the category of Shanghan." It also says: "When humans are injured by cold, they develop heat diseases." Why does injury by cold transform into heat? Because extreme cold generates heat. The *Suwen* further states: "For those who contract Shanghan and develop into Wen disease, if it occurs before the Summer Solstice, it is called 'Wen disease'; if it occurs after the Summer Solstice, it is called 'Shu disease' (Heat Disease)." The *Nanjing* (Classic of Difficult Issues), Chapter 58, states: "There are five types of Shanghan: Zhongfeng (Wind Strike), Shanghan (Cold Damage), Shiwen (Damp-Warmth), Rebing (Heat Disease), and Wenbing (Warm Disease). 'Shanghan' is the general name for these diseases. These five are specific syndromes within this category." Zhang Zhongjing begins his *Treatise on Cold Damage* (*Shanghan Lun*) by stating: "The characteristic of Taiyang disease (disease of the Taiyang channel) is floating pulse, stiffness and pain in the head and nape, and aversion to cold." Subsequently, he distinguishes and treats each one individually. What is called "Zhongfeng" refers to Taiyang disease, characterized by fever, sweating, aversion to wind, and a slow pulse. What is called "Shanghan" refers to Taiyang disease, where regardless of whether fever has already appeared or not, there is invariably aversion to cold, body pain, vomiting, and reversal, with tight pulses at both yin and yang positions. Since this illness originates from cold damage, Xin-wen (acrid-warm) herbs like Guizhi (Cinnamon Twig) and Mahuang (Ephedra) are used to dispel wind and scatter cold. What is called "Shibi" (Damp Bi) refers to Taiyang disease, characterized by painful and irritable joints, with deep and fine pulses. What is called "Yebing" (Heatstroke/Miasma) refers to Taiyang heat strike, where the patient sweats, feels aversion to cold, and has body heat. What is called "Wenbing" refers to Taiyang disease, characterized by fever and thirst, without aversion to cold. These illnesses also originate from Shanghan. Their treatments involve formulas such as Gegen (Kudzu Root) which is acrid-cool, Shigao (Gypsum) which is acrid-sweet-cold, and Huangqin (Scutellaria), Huanglian (Coptis), and Dahuang (Rhubarb) which are bitter-cold, all used to treat these conditions. Nowadays, people neither distinguish whether the Shanghan syndrome belongs to Wind, Cold, Dampness, Heat, or Warmth, nor do they inquire which formula serves as the main prescription in the *Shanghan Lun*.
Bing notes: Correcting the name of Shanghan merely involves copying the opening remarks of the *Shanghan Lun* and citing the phrase "Shanghan has five types" from the *Nanjing* to compose this text. In reality, it aims to criticize doctors who use Doujuan, Douchi, Niubang, Shashen, Shengdi, Yangshen, and Shihu. There is not a single word expressing the author's own medical theory; it resembles a defamatory pamphlet. In short, medicines have flavors of sour, sweet, salty, bitter, and acrid, and properties of cold, hot, warm, cool, tonifying, dispersing, reducing, and purging. For every disease, the corresponding medicine should be used. Ancient masters did not deviate from principles. If one favors or dislikes certain drugs, using cold-natured drugs too early to suppress pathogens is indeed misleading; yet favoring drying-tonic drugs, preventing pathogens from exiting outward, assisting heat to transform into fire and depleting fluids, is also unavoidable. Furthermore, such statements are inappropriate in medical texts. For instance, if mumps-rash (Shazhen) is not fully erupted, why not avoid Niubang? If there is no sweat due to warm-heat, why not avoid Douchi? If heat disease transforms into fire, why not use Shengdi and Shihu to rescue fluids? It seems contradictory to write prescriptions while holding these views. Yet, regarding Douchi, Doujuan, Yangshen, and Shihu as excellent remedies for Shanghan and miraculous cures for hundred diseases, is it not laughable? Confucius said: "If names are not correct, language is not in accordance with truth." I hope healers first correct the name of the disease, then determine the governing formula. Do not indiscriminately call it Shanghan and misuse drugs unrelated to Shanghan. Mr. Lu Jiuzhi has an essay "On the Five Types of Shanghan," which is detailed and precise. Here, I briefly outline its essence to debunk the ignorance surrounding Shanghan.
Bing notes: Who does not know the syndrome of Shanghan? Which doctor has not read the book *Shanghan Lun*? After the Han Dynasty, Wang Shuhe compiled it into a book. Since then, countless commentators have elaborated on Zhang’s work, some having only the name but not the actual text. Even if the book exists, studying it exclusively for a lifetime may not allow one to finish reading it. One book alone is hard to exhaust; taking forty volumes as a standard, please read it three times. Can you recite it from memory? In summary, as long as one is a physician, understanding Shanghan pathology is indispensable. True Shanghan is rare in Jiangsu and Zhejiang, so one need not rigidly adhere to "Shanghan" when diagnosing. Moreover, as times change, the Qi transformation of heaven and earth also shifts. Principles left unexplored by sages must be corrected by later generations. For example, Wang Andao, Liu Hejian, and Zhu Danxi, in treating febrile diseases of the four seasons, widely used acrid-cool and bitter-cold methods to remedy the deficiencies of previous acrid-warm and aromatic-dry approaches. In the Qing Dynasty, Ye Tianshi (Ye Xiangyan) from Gusu elucidated the treatment of Warm Diseases, establishing laws based on sweet-moistening to resolve pathogens. Indeed, the Hang-Jia-Hu region adopted this method. Wang Shizhong refuted Wu Jutong’s *Treatise on Warm Diseases*, arguing that the disease names were unclear. He stated: Injury by cold in winter, manifesting in spring, is called "Wenbing"; manifesting after the Summer Solstice is called "Rebing." Contracting wind-heat in winter or spring, affecting the lungs first, is named "Fengwen." Occurring in winter is "Dongwen"; occurring in spring is "Chunwen," which corresponds to what Ye discussed, also known as seasonal temperature diseases. Febrile diseases occurring after the Summer Solstice are called "Shu" in the *Neijing* because they occur during the heat season. Thus, Zhang Zhongjing named diseases contracted from summer heat as "Shubing." Both "Shu" and "Ye" belong to the category of heat. However, "Shiwen" was not mentioned. Shiwen is essentially damp-heat. It must be divided into two categories: First, individuals often injured by dampness who subsequently contract heat, resulting in Shiwen. Symptoms include delirium. Treatment focuses on the Foot-Taiyin Spleen channel; sweating is contraindicated. If sweated, the patient will lose speech ability and become deaf. Ancients advocated Cangzhu Shigao Tang, using Cangzhu (Atractylodes), Shigao (Gypsum), Zhimu (Anemarrhena), and Gancao (Licorice), but this disease is difficult to treat. Seasonal damp-heat is also called Shiwen. Ye Tianshi has discussions on this, and Xue Shengbai has *Shushi Lun* (Treatise on Summer-Dampness), which is clear and detailed, also referred to as the Thirty-Eight Articles on Damp-Heat Theory. I append this here. The *Nanjing* states Shanghan has five types: Zhongfeng, Shanghan, Shiwen, Rebing, Wenbing. But it does not know that internal Shanghan syndromes also have five types: 1. Fluid retention (Tingyin), 2. Food stagnation (Shangshi), 3. Beriberi (Xiangjiao), 4. Empty irritability (Xufan), 5. Internal abscess (Neiyong). Combined with the Twelve Shanghan Syndromes: 1. Dongwen, 2. Hanyi, 3. Wenyi, 4. Wenbing, 5. Rebing, 6. Fengwen, 7. Wenmie, 8. Shiwen, 9. Zhongye, 10. Wendu, 11. Fengshi, 12. Jingbing. See *Yizong Jinjian* (Golden Mirror of Medicine) *Essentials of Shanghan Heart Method*. To correct names, one must know these contents.