说文疫，民皆病也。从 。役、省声。内经素问遗篇论司天在泉，升降不时，五运暴郁，刚柔失守，三年化疫。故
曰五疫之至，皆相染易，无问大小，病状相似，即仲景所谓一岁之中，长幼之病，多相似者是也。至宋元时则不名为疫，
而名曰瘟。近贤喻嘉言曰、四时不正之气，伤人致病，初不为疫也，因病致死，病气尸气，混合成疫，以故鸡瘟
死鸡，猪瘟死猪，牛马瘟死牛马。推之于人，何独不然。如世俗所称大头瘟者，头面腮颊，肿如瓜瓠者是也。所称
捻颈瘟者，喉痹失音，颈大腹胀，如虾蟆者是也。所称瓜瓤瘟者，胸高胁起，呕汁如血者是也。所称杨梅瘟者，遍
身紫块，忽发如霉疮者是也。所称疙瘩瘟者，发块如瘤，遍身流走，旦发夕死者是也。所称绞肠瘟者，肠鸣干呕，
水泄不通者是也。小儿痧痘，传染犹多。此外刘松峰有葡萄瘟鸬 瘟等种种名目，无足深究。陈素中谓凶暴
大病，死人在数日间。戴天章谓中人人病，中物物伤。张石顽云时疫之邪，皆从湿土郁蒸而发，不异障雾之毒，
或发于山川原陆，或发于河井沟渠。杨栗山云毒雾之来也无端，烟瘴之出也无时。凡疵疠旱潦之气，禽兽草
木，往往不免，或数年而一见，或数十年而一见。不明证治，咸委劫运，良可伤悼。前人论疫，至精至详。今人但闻
西人有黑死病之说，又有鼠疫之新论，一若中国之医，并疫症而不知者。夫中医未尝不言疫也，中医言瘟疫，
有大头瘟捻颈瘟种种之区别，所述情状，如腮颊肿硬结核，以及喉痹失音呕汁如血等，颇与鼠疫情形，仿佛
相同，近时中医之研究西说者，亦出有鼠疫专书，互相发明。鼠疫之类，又有一种名肺炎疫。夫炎者热也，肺炎
者肺热之谓也。香岩叶氏云、温邪上受，首先犯肺其症身热咳嗽，甚则气喘神昏或斑疹吐衄等候，与肺热之
症吻合，谓之风温，俗谓冬温春发是也。拙于东西学说，茫无头绪，故就中医界限言之，悖谬与否，不能知也。夫
温之与瘟，音同义别瘟即是疫，陆九芝既详论之，喻氏又云盛夏湿温之症，即藏疫疠在内，一人受之则为湿
温，一方受之则为疫疠，伤寒温热感四时之正邪，疫病由于天地不正之疠气。伤寒温热邪由外廓而入，疫邪
从口鼻膜原而入，直行中道，流布三焦，议论最为扼要，治法具详本书中，然温热湿寒之气，皆能为疫。吴又可
温疫论主达原饮，治湿疫也。余师愚疫论主清瘟败毒饮，治热疫也。东坡圣散子，治寒疫也。近时通用者，如普
济消毒饮、玉枢丹、紫雪丹、甘露消毒丹、炼雄丹、神犀丹、古方今方，皆可取用。余师愚疫症条辨，既属精详王孟
英温热经纬，尤为可采。甘露消毒丹治暑湿热疫之邪尚在气分，神犀丹治温暑直入营分，清瘟败毒饮为十
二经泄火之药。犹忆清光绪二十八年岁在壬寅，沪上疫症大作。吾师谓少阳司天，运值风木，风火交煽，合用
辛凉镇重之剂，以三石汤为主方，治效大着。当时门下按法用之，皆奇验。惜其案散佚，无从搜辑。民国七年，方
将抄存之案，次第排印。而南京鼠疫之恐慌特甚，既以前说登之日报，贡社会之采择。又因同学何永清君述
师门之事，惜疫案之阙，爰拟此以补之。续貂之诮，所不免尔。（文涵志）
《说文解字》解释“疫”字，意为百姓都患病。字形从“疒”，役声（省声）。《内经·素问》遗篇论述司天在泉之气，升降失常，五运之气暴然郁结，刚柔失守，三年后化为疫病。所以说五种疫病到来时，都会相互传染，不论年龄大小，病症表现相似，这就是张仲景所说的“一年之中，无论老少，生病症状多相似”的情况。到了宋元时期，不再称为“疫”，而称为“瘟”。近代贤者喻嘉言说：四季中不正的气候，伤害人体导致疾病，起初并不叫作疫；因为病人致死，病气与尸气混合才形成疫，所以鸡瘟让鸡死亡，猪瘟让猪死亡，牛马瘟让牛马死亡。推及到人类，难道会例外吗？比如世俗所称的“大头瘟”，就是头面腮颊肿胀，像瓜瓠一样的情况。所称的“捻颈瘟”，就是喉痹失音，颈部肿大腹部胀大，像蛤蟆一样的情况。所称的“瓜瓤瘟”，就是胸部高耸胁肋突起，呕吐出如血样的汁液的情况。所称的“杨梅瘟”，就是全身出现紫色斑块，突然发作如同霉疮的情况。所称的“疙瘩瘟”，就是身上发出肿块像瘤子一样，遍布全身游走不定，早晨发作晚上就死亡的情况。所称的“绞肠瘟”，就是肠鸣干呕，水泻不通的情况。小儿的痧痘，传染性也很多。此外刘松峰有葡萄瘟、鸬鹚瘟等种种名目，不值得深究。陈素中说凶险暴烈的大病，死人在数日之内。戴天章说瘟疫中人则人病，中物则物伤。张石顽说时疫之邪，都是从湿土郁蒸而发，不异于障雾之毒，有的发于山川原陆，有的发于河井沟渠。杨栗山说毒雾的到来没有缘由，烟瘴的出没没有定时。凡是疵疠旱涝之气，禽兽草木，往往也不能避免，有的几年出现一次，有的几十年出现一次。如果不明白证候和治疗，全都归结为劫数命运，实在令人悲伤哀悼。前人论述疫病，非常精详。今人只听说西方人有黑死病的说法，又有鼠疫的新理论，好像中国的医生连疫病都不知道似的。其实中医并非不言疫病，中医所说的瘟疫，有大头瘟、捻颈瘟等各种区别，所描述的病情，如腮颊肿硬结核，以及喉痹失音、呕吐如血等，与鼠疫的情形颇为相似。近时研究西方学说的中医，也出版了关于鼠疫的专著，互相印证发明。鼠疫这一类中，还有一种名为肺炎疫。所谓“炎”就是热，肺炎就是肺热的意思。叶天士（香岩）说：温邪从上受入，首先侵犯肺脏，其症状是身体发热咳嗽，甚至气喘神昏或出现斑疹吐衄等情况，这与肺热的病症相吻合，称之为风温，俗称为冬温春发。我对于东西方学说感到茫然无头绪，所以仅从中医的理论界限来谈论，是否正确，无法知晓。至于“温”与“瘟”，读音相同但意义不同，“瘟”即是“疫”，陆九芝已经详细论述过。喻氏又说盛夏湿温的病证，即体内蕴藏疫疠之气，一个人受到它则为湿温，一方众人受到它则为疫疠。伤寒和温热病感受的是四时的正常邪气，疫病则是由于天地间不正的疠气所致。伤寒和温热的邪气由体表而入，疫邪从口鼻膜原而入，直行中道，流布三焦，这种议论最为扼要，治疗方法在本书中有详细说明。然而温热湿寒之气，都能成为疫病。吴又可《温疫论》主张用达原饮，治疗湿疫。余师愚《疫论》主张用清瘟败毒饮，治疗热疫。苏东坡的圣散子，治疗寒疫。近时通用的方剂，如普济消毒饮、玉枢丹、紫雪丹、甘露消毒丹、炼雄丹、神犀丹等古方今方，都可以取用。余师愚的《疫症条辨》，既属精详；王孟英的《温热经纬》，尤为可采。甘露消毒丹治疗暑湿热疫之邪尚在气分的情况；神犀丹治疗温暑直入营分的情况；清瘟败毒饮是十二经泄火的药物。我还记得清光绪二十八年，岁次壬寅，上海地区疫病大作。我的老师认为当时少阳司天，运气值风木，风火交煽，合用辛凉镇重的药剂，以三石汤为主方，治疗效果显著。当时门生弟子按照方法使用，都有奇效。可惜那些医案散佚，无从搜集整理。民国七年，正准备将抄存的医案次第排印。而此时南京鼠疫恐慌特别严重，既然前文已刊登在日报上，供社会参考选择。又因同学何永清君讲述老师门下的事情，惋惜疫病医案的缺失，于是拟定此文以作补充。难免遭到续貂的讥笑。（文涵志）
The *Shuowen Jiezi* explains the character "Yi" (Epidemic), meaning that all people are sick. The structure involves the radical "Disease" (illness), with a phonetic component derived from "Yi" (service/役) in abbreviated form. The lost chapters of *Suwen* in the *Neijing* discuss the Si Tian and Zai Quan energies, where irregular ascending and descending movements, sudden stagnation of the Five Movements (Wu Yun), and loss of balance between rigid and soft forces lead to the transformation into epidemics after three years. Therefore, it is said that when the five plagues arrive, they are all contagious, regardless of age, with similar symptoms. This corresponds to what Zhang Zhongjing described as: "In one year, the illnesses of both young and old are often similar." By the Song and Yuan dynasties, this was no longer called "Yi" but "Wen" (Plague).
The modern sage Yu Jiayan stated: The abnormal qi of the four seasons harms humans and causes disease; initially, it is not called an epidemic. It becomes an epidemic only when patients die, and the pathogenic qi mixes with corpse qi. Thus, chicken plague kills chickens, swine plague kills pigs, and cattle/horse plague kills cattle and horses. Applying this to humans, why would it be different? For example, the so-called "Big Head Plague" refers to swelling of the head, face, cheeks, and jaw, resembling a gourd. The "Twisted Neck Plague" refers to throat obstruction with loss of voice, swollen neck, and distended abdomen, resembling a toad. The "Melon Rind Plague" refers to high chest and rising flanks, vomiting fluid like blood. The "Yangmei Plague" refers to purple patches all over the body, suddenly appearing like syphilitic sores. The "Lump Plague" refers to lumps emerging like tumors, moving throughout the body, causing death from morning to evening. The "Intestine Twisting Plague" refers to borborygmus, dry retching, and inability to pass water or stool. Childhood diseases such as sand pox and smallpox are also highly contagious. Additionally, Liu Songfeng mentioned various names such as Grape Plague and Cormorant Plague, which do not warrant deep investigation. Chen Suzhong stated that fierce and violent major illnesses result in death within a few days. Dai Tianzhang said that if the plague affects humans, humans get sick; if it affects objects, objects are harmed. Zhang Shiwang claimed that the pathogen of seasonal epidemics arises from the stagnation and steaming of damp earth, akin to the toxicity of fog and haze, originating either from mountains, plains, and lands, or from rivers, wells, and ditches. Yang Lishan stated that the arrival of toxic fog has no cause, and the emergence of smoke and miasma has no fixed time. Any abnormal qi of pestilence, drought, or flood often affects birds, beasts, grass, and trees, occurring once every few years or once every few decades. If one does not understand the syndromes and treatments, attributing everything to fate is truly lamentable.
Predecessors' discussions on epidemics were extremely precise and detailed. Today's people only hear of Western theories regarding the Black Death and new theories on bubonic plague, as if Chinese medicine practitioners know nothing about epidemics. In fact, Chinese medicine does discuss epidemics. Chinese medicine distinguishes between Big Head Plague, Twisted Neck Plague, etc., describing conditions such as swollen and hard lymph nodes in the cheeks and jaw, throat obstruction with loss of voice, and vomiting blood-like fluid, which closely resemble the manifestations of bubonic plague. Recently, Chinese physicians studying Western theories have published specialized books on bubonic plague, mutually illuminating each other. Among types of bubonic plague, there is another named Pneumonic Plague. "Yan" means heat; thus, Pneumonic Plague refers to lung heat. Ye Tianshi (Xiangyan) stated: Warm pathogens enter from above and first attack the Lung. Symptoms include fever, cough, and in severe cases, panting, confusion, macules, rashes, hematemesis, or epistaxis. These align with lung heat syndromes and are termed Wind-Warmth, commonly known as Winter-Warmth or Spring-Onset. Being unfamiliar with Eastern and Western theories and lacking clarity, I speak only within the boundaries of Chinese medicine; whether this is erroneous or not, I cannot say.
"Wen" and "Wen" sound the same but differ in meaning; "Wen" (Plague) is equivalent to "Yi". Lu Jiuzhi discussed this in detail. Yu Shi also stated that in midsummer, Damp-Warmth syndromes contain hidden epidemic pathogens; if one person contracts it, it is Damp-Warmth; if a region contracts it, it is an epidemic. Cold Damage and Warm-Heat diseases arise from the normal pathogens of the four seasons, whereas epidemics arise from abnormal pestilential qi of heaven and earth. The pathogens of Cold Damage and Warm-Heat enter from the exterior, while epidemic pathogens enter through the mouth, nose, and membrane source, proceeding directly along the central pathway and spreading through the Triple Burner. This discussion is most concise, and treatment methods are detailed in this book. However, warm, hot, damp, and cold qi can all become epidemics. Wu Keyou's *Treatise on Warm Epidemics* advocates Da Yuan Yin for treating Damp Epidemics. Yu Shiyu's *Treatise on Epidemics* advocates Qing Wen Bai Du Yin for treating Heat Epidemics. Su Dongpo's Sheng San Zi treats Cold Epidemics. Commonly used formulas today include Pu Ji Xiao Du Yin, Yu Shu Dan, Zi Xue Dan, Gan Lu Xiao Du Dan, Lian Xiong Dan, and Shen Xi Dan; both ancient and modern formulas can be utilized. Yu Shiyu's *Differentiation of Epidemic Syndromes* is precise and detailed; Wang Mengying's *Latitude and Longitude of Warm-Heat* is particularly valuable. Gan Lu Xiao Du Dan treats epidemic pathogens of summer-heat, dampness, and heat still in the Qi level; Shen Xi Dan treats warm-heat entering the Ying level directly; Qing Wen Bai Du Yin is a formula for draining fire from the twelve meridians.
I still remember that in the 28th year of Guangxu (1902, Ren Yin year), a major epidemic broke out in Shanghai. My teacher reasoned that Shaoyang governed the Heaven Qi, and the movement corresponded to Wind-Wood. With wind and fire stirring together, he combined acrid-cool and heavy-settling agents, using San Shi Tang as the main formula, achieving significant efficacy. Students at the time applied this method and observed miraculous results. Unfortunately, these case records were lost and could not be collected. In the 7th year of the Republic of China (1918), I intended to collate and print the copied cases. However, panic over the bubonic plague in Nanjing was particularly intense. Since previous texts had been published in daily newspapers for social reference, and due to my classmate He Yongqing recounting matters from my teacher's school, lamenting the absence of epidemic cases, I drafted this text to supplement them. I inevitably invite criticism for adding inferior appendages to a fine work. (Wen Hanzhi)