冒寒之病,偶因外冒寒邪,较伤寒则轻,比中寒甚缓。盖伤寒伤乎六经,中寒直中乎里,惟冒寒之病,乃寒
气罩冒于躯壳之外,而未传经入里也。是以遍体 疼,头亦微痛,畏寒发热而乏汗,脉象举之而有余,宜辛
温解表法治之。服药之后,务宜谨避风寒,覆被而卧,俾其微微汗出而解,否则传经入里,
当审何经而分治之。倘或伏而不发,来年必发为春温、风温等病,不可以不知也。
昔贤谓冬应寒而反温,非其时而有其气,人感之而即病者,名曰冬温是也。其劳力辛苦之人,动作汗出,
温气乘袭,多在于表;其冬不藏精之人,肾经不足,温气乘袭,多在于里。冬温虽发于冬时,然用药之法,与
伤寒迥别。盖温则气泄,寒则气敛,二气本属相反,误用辛温,变证迭出矣。其证头痛有汗,
咳嗽口渴,不恶寒而恶热,或面浮,或咽痛,或胸疼,阳脉浮滑有力者,乃温邪窜入肺经也,宜用辛凉解表法
加连翘、象贝治之,口渴甚者,温邪入胃腑也,再加芦根、花粉治之。如或下利,阴脉不浮而滑,温邪已陷
于里也,宜以清凉透邪法加葛根、黄芩治之。倘热势转剧,神气昏愦, 语错乱,舌苔转黑者,不
易治也,勉以祛热宣窍法治之,紫雪丹亦可用之。种种变证,不能尽述,须仿诸温门中之法可也。
或问∶冬温发热而不恶寒,倘恶寒者,为何病也?答曰∶冬温恶寒,偶亦有之,良由先感温气,即被严
寒所侵,寒在外而温在里,宜用辛温解表法先去寒邪,继用凉解里热法而清温气。又问曰∶伤寒冒寒皆恶寒,
何以别之?曰∶伤寒冒寒初起无口渴,以此别之?曰∶温邪当发为冬温,倘其微者,伏而不发,为何病也?
曰∶伏而不发,来春必变为温毒也。凡治时病者,新邪伏气,切要分明,庶不至千里毫厘之失。
又问∶先生之书,专为六气而设,风、寒、暑、湿、燥,皆已详明,何独火证不详?恐为不全之书,
而火证可补述否?答曰∶子不知君火秉权之候,有温病、温毒也;相火主政之时,有热病、暑病也。君相司
令而病者,非火证而何?何不全之有哉!况火为阳邪,其证最着,如脉数有力,舌苔黄燥,或目赤,
或口渴,或喉痛,或溺红,皆火证也,法当清凉治之。其余五志之火,龙雷之火,悉属内伤,兹不论之。
冒寒这种病,是因为偶然外感寒邪所致,其病情比伤寒轻,但比中寒发作缓慢。因为伤寒是寒邪伤害六经,中寒则是寒邪直接侵入体内脏腑,而冒寒之病,仅仅是寒气笼罩在体表之外,并没有传入经络或深入体内。因此出现全身疼痛,头部也轻微疼痛,怕冷发热且无汗,脉象轻取即感到有力,适宜用辛温解表法治疗。服药之后,务必小心避开风寒,盖好被子卧床休息,使其微微出汗而病愈,否则病邪会传入经络深入体内,届时应当审查是哪一经受邪而分别进行治疗。如果病邪潜伏不发,来年必定会发为春温、风温等疾病,这一点不可不知道。
以前的贤者说,冬天本应寒冷却反而温暖,不是时候却有温暖的气候,人感受了这种气候立即发病的,就叫做冬温。那些从事体力劳动辛苦的人,活动时出汗,温气趁机侵袭,病位多在体表;那些冬天没有藏精(肾精亏虚)的人,肾经不足,温气趁机侵袭,病位多在体内。冬温虽然发生在冬季,但是用药的方法,与伤寒截然不同。因为温热之气使腠理开泄,寒凉之气使腠理收敛,这两种气性本来相反,如果误用辛温药物,就会变证丛生。其症状表现为头痛有汗,咳嗽口渴,不怕冷只怕热,或者面部浮肿,或者咽喉疼痛,或者胸部疼痛,阳脉浮滑有力的,这是温邪窜入肺经,适宜用辛凉解表法加连翘、象贝母治疗;口渴严重的,是温邪进入胃腑,再加芦根、天花粉治疗。如果出现腹泻,阴脉不浮而滑,说明温邪已经陷入体内,适宜用清凉透邪法加葛根、黄芩治疗。如果热势更加剧烈,神志昏沉迷糊,胡言乱语,舌苔转黑,这就难以治疗了,勉强使用祛热宣窍法治之,紫雪丹也可以使用。各种各样的变证,不能全部叙述,必须仿效各类温病门中的治法即可。
有人问:冬温发热而不怕冷,如果出现怕冷的情况,是什么病呢?回答说:冬温也有偶尔怕冷的情况,这大多是由于先感受了温气,紧接着又被严寒侵袭,寒邪在表而温邪在里,适宜先用辛温解表法去除寒邪,接着再用凉解里热法来清除温气。又问:伤寒和冒寒起初都怕冷,如何区别它们呢?回答说:伤寒和冒寒初起时没有口渴,以此作为区别。又问:温邪应当发为冬温,如果轻微的,潜伏而不发作,是什么病呢?回答说:潜伏而不发作,来年春天必定变为温毒。凡是治疗时令病的医生,对于新感邪气和伏气温邪,必须分辨清楚,才不至于造成毫厘千里的大错。
又问:先生的这本书,专门针对六气而设,风、寒、暑、湿、燥都已经详细说明,为什么唯独火证不详述?恐怕是不完整的书,火证可以补充叙述吗?回答说:你不知道君火当令的时候,有温病、温毒;相火主政的时候,有热病、暑病。由君火和相火主持时令而引发的疾病,难道不是火证吗?哪里算不完整呢!况且火属于阳邪,其症状最为显著,如脉搏数而有力,舌苔黄而干燥,或者眼睛发红,或者口渴,或者喉咙痛,或者小便红赤,都是火证,治法应当用清凉法治疗。其余五志之火,龙雷之火,都属于内伤范畴,这里就不讨论了。
The disease of "Mao Han" (Exposure to Cold) occurs due to accidental external exposure to cold pathogenic factors. Its severity is lighter than that of Shang Han (Cold Damage), but its onset is more gradual compared to Zhong Han (Direct Strike by Cold). This is because Shang Han injures the Six Channels, whereas Zhong Han directly strikes the interior organs. In contrast, Mao Han involves cold qi merely enveloping the exterior of the body without transmitting into the channels or penetrating the interior. Consequently, symptoms include generalized body pain, slight headache, aversion to cold, fever, and absence of sweating. The pulse is surging and abundant upon light palpation. Treatment should employ the method of releasing the exterior with acrid-warm herbs. After taking the medicine, one must strictly avoid wind and cold, lie in bed covered with blankets, and allow a slight sweat to emerge for recovery; otherwise, the pathogen may transmit into the channels and penetrate the interior, at which point treatment must be differentiated according to the specific channel involved. If the pathogen remains latent and does not manifest immediately, it will inevitably develop into Chun Wen (Spring Warmth) or Feng Wen (Wind Warmth) in the following year; this knowledge is indispensable.
Ancient sages stated that when winter should be cold but turns warm instead, possessing the climate out of season, and illness ensues immediately upon contraction, it is named Dong Wen (Winter Warmth). For those engaged in strenuous labor who sweat during exertion, warm qi takes advantage of the open pores to invade, typically affecting the exterior. For those who failed to conserve essence during winter (leading to Kidney Jing deficiency), the Kidney Channel is insufficient, allowing warm qi to invade, typically affecting the interior. Although Dong Wen manifests in winter, the principles of medication are radically different from Shang Han. Warmth causes the dispersal of qi, while cold causes the consolidation of qi; these two natures are inherently opposite. Misapplication of acrid-warm herbs will lead to successive complications. Symptoms include headache with sweating, cough, thirst, aversion to heat rather than cold, facial edema, sore throat, or chest pain. A floating, slippery, and forceful Yang pulse indicates that warm pathogenic factors have penetrated the Lung Channel; treatment should utilize the method of releasing the exterior with acrid-cool herbs, adding Qiaqiao (Forsythiae Fructus) and Xiangbei (Fritillariae Thunbergii Bulbus). Severe thirst indicates the warm pathogen has entered the Stomach Fu organ; add Lugeng (Phragmitis Rhizoma) and Huafen (Trichosanthis Radix) to the prescription. If diarrhea occurs, and the Yin pulse is not floating but slippery, it indicates the warm pathogen has sunk into the interior; treatment should employ the method of clearing heat and venting the pathogen with cool-natured herbs, adding Gegen (Puerariae Lobatae Radix) and Huangqin (Scutellariae Radix). If the heat intensity worsens, accompanied by mental confusion, delirious speech, and black tongue coating, the condition becomes difficult to treat. One may tentatively apply the method of dispelling heat and opening the orifices; Zixue Dan (Purple Snow Pill) may also be used. Various complications cannot be exhaustively listed; one must emulate the methods found in various categories of Warm Disease literature.
A question was posed: "Dong Wen presents with fever and no aversion to cold. If aversion to cold is present, what disease is it?" The answer is: "Occasionally, Dong Wen presents with aversion to cold. This is usually due to first contracting warm qi, followed immediately by severe cold invasion. With cold on the exterior and warm qi in the interior, one should first use the method of releasing the exterior with acrid-warm herbs to expel the cold pathogen, followed by the method of cooling and resolving interior heat to clear the warm qi." Another question arose: "Both Shang Han and Mao Han present with initial aversion to cold. How are they distinguished?" The answer is: "Shang Han and Mao Han do not present with thirst in their early stages; this distinguishes them." Yet another question: "Warm pathogens should manifest as Dong Wen. If mild cases remain latent and do not manifest, what disease is it?" The answer is: "Latent pathogens that do not manifest will transform into Wendu (Warm Toxin) in the coming spring." In treating seasonal diseases, one must clearly distinguish between newly contracted pathogens and latent pathogens to avoid significant diagnostic errors.
Another inquiry: "Your book is specifically designed for the Six Qi. Wind, Cold, Summerheat, Dampness, and Dryness are detailed thoroughly. Why is Fire syndrome omitted? Is this an incomplete work? Can Fire syndrome be supplemented?" The response: "You are unaware that when Junhuo (Ministerial Fire/Emperor Fire) holds authority, there are Wenbing (Warm Diseases) and Wendu (Warm Toxins); when Xianghuo (Ministerial Fire) governs, there are Rebing (Heat Diseases) and Shubing (Summerheat Diseases). Diseases arising under the command of Junhuo and Xianghuo are, in fact, Fire syndromes. How could this be considered incomplete? Moreover, Fire is a Yang pathogen, and its manifestations are most prominent. Examples include a rapid and forceful pulse, yellow and dry tongue coating, red eyes, thirst, sore throat, or red urine. These are all Fire syndromes, treated with cooling methods. Other types of fire, such as those arising from the Five Emotions (Wuzhi) or Dragon-Lei fire, belong to internal injury categories and are not discussed here."