凡治伤寒、温疫宜温补者，为其寒邪凝滞，阳不胜阴，非温不能行，非温不能复也。如
寒气在经者，以邪在表也，宜用温散，法具如前；寒气在脏者，以阳气虚也，或宜温补，或
止温中。然用温之法，但察其外虽热而内无热者，便是假热，宜温不宜凉也；病虽热而元气虚
者，亦是假热，宜温不宜凉也。真热者，谁不得而知之。惟假热为难辨耳。病假热者，非用
甘温，热必不退，矧真寒者，又在不言可知。大都实证多真热，虚证多假热，故治实者多宜
用凉。治虚者多宜用温。真假不识，误人不浅矣。又真寒假热之辨，则实亦有寒，实亦有热
。虚亦有寒，虚亦有热，若谓实者皆热，虚者皆寒，则凿而谬矣。但实而寒者，只宜温散，
不必滋补。虚而热者，只宜调补，最畏寒凉。盖寒凉无生意，而善败元气。若以寒凉治虚证
，则热未必退，且暂用则或可。久则无不败脾而危者。既已病热，又不宜寒，则总云假热，
本非过也。
一、伤寒发热，而命门阳虚，或恶寒，或身痛，或呕，或痢，脉弱气虚，而表不能解者
，必用大温中饮。或理阴煎。若伤寒身热，心肺有寒，或呕哕而咳，或腹满而喘，止有寒邪
而无虚者，宜小青龙汤。若阴证伤寒，自利脉沉，身痛发热，腹痛厥逆，但有寒邪而元气无
虚者，当用温药，宜四逆汤。若寒在太阴，腹痛吐痢，或胀满厥逆，脾胃虚寒，而邪有不解
者，宜温胃饮，或理中汤。若伤寒一二日，邪在太阳，或在少阴，背恶寒而表不解者，宜附
子理阴煎。在仲景则用附子汤。若风寒在表，阴寒在里，外为身热，而内则泻痢不能止，或
见呕恶，或腹因痢痛者，此其中气下泄，则外邪益陷，必不能解，宜速用胃关煎，或大温中
饮。凡患伤寒，有阴阳大虚，元气将败，而邪不能解者，非六味回阳饮不可。然但有大虚大
寒之意，即当用此。若待其败，恐无及矣。凡阴盛隔阳，内真寒而外假热者，其证必头红面
赤，或干渴舌焦，或口疮喉痛，或烦喘狂躁，或身热如火，或见虚斑而蚊迹遍身，或发阴黄
而溺如金汁。虽其外有此证，而脉则微弱不鼓，且或为呕恶，或为泄泻，或背腹畏寒，或气
短似喘，或昏睡无知，或惊惶惧怯，或虽热不渴，或言虽谵妄而气促声微，或身虽躁狂而举
动无力，禁之则止，是皆内虚外实，真寒假热之证。须用理阴煎，或六味回阳饮、大温中饮
、八味地黄汤之类，大剂与之，庶可保全。若虚火上浮，喉痛热躁，不能热饮者，用井水浸
药冷与饮之，此用假寒之味，以解上焦之假热，真热之性，以救下焦之真寒，回阳起死，真
神妙之法也。其有血气本虚，用补相便。然温补既多，而病日昏愦，且见烦热难愈者。此其
阳邪独亢，阴气不至，而虚中有热也。但改滋阴，以犀角地黄汤加黄芩、麦冬，或一柴胡饮
加知母之类。此十补一清之法。一剂即效，其妙如神。医中圆活，最宜知此。
凡是治疗伤寒、温疫需要采用温补法的，是因为寒邪凝滞，阳气不能胜过阴气，不用温法就不能推动气血运行，不用温法就不能恢复阳气。如果寒气在经络，是因为邪气在体表，适宜用温散法，方法如前所述；如果寒气在脏腑，是因为阳气虚弱，或者适宜温补，或者仅温中焦。然而使用温法的原则，只要观察患者虽然外表发热但内部没有热象的，这就是假热，适宜温法而不适宜凉法；病情虽然表现为热象但元气虚弱的，也是假热，适宜温法而不适宜凉法。真正的热证，是谁都能知道的。只有假热才难以辨别罢了。如果是假热，不用甘温的药物，热势必然不退，何况是真寒证，更是不言自明的大致上实证多表现为真热，虚证多表现为假热，所以治疗实证多适宜用凉药。治疗虚证多适宜用温药。真假分不清，误人是很深的。另外关于真寒假热的辨别，其实实证也有寒，实证也有热。虚证也有寒，虚证也有热，如果说实证都是热，虚证都是寒，那就固执而谬误了。但是实证而有寒的，只适宜温散，不必滋补。虚证而有热的，只适宜调补，最忌讳寒凉。因为寒凉药物没有生机，而且容易败坏元气。如果用寒凉药物治疗虚证，那么热未必能退，况且暂时使用或许还可以。时间久了没有不损伤脾胃而导致危重的。既然已经患病发热，又不适宜用寒凉，所以总称为假热，本来也不算过分。
一、伤寒发热，而命门阳气虚弱，或者恶寒，或者身体疼痛，或者呕吐，或者痢疾，脉弱气虚，而表证不能解除的，必须用大温中饮。或者理阴煎。如果伤寒身热，心肺有寒，或者呕吐呃逆而咳嗽，或者腹部胀满而气喘，只有寒邪而没有虚证的，适宜用小青龙汤。如果是阴证伤寒，自下利脉沉，身体疼痛发热，腹痛四肢厥冷，只有寒邪而元气不虚的，应当用温药，适宜用四逆汤。如果寒邪在太阴经，腹痛吐痢，或者胀满四肢厥冷，脾胃虚寒，而邪气不能解除的，适宜用温胃饮，或者理中汤。如果伤寒一二天，邪气在太阳经，或者在少阴经，背部恶寒而表证不解的，适宜用附子理阴煎。在张仲景的书中则用附子汤。如果风寒在体表，阴寒在体内，外部表现为身热，而内部则是泻痢不止，或者出现呕吐恶心，或者腹部因痢疾疼痛的，这是中气下陷，那么外邪更加陷入，一定不能解除，应当迅速用胃关煎，或者大温中饮。凡是患伤寒，有阴阳极度虚弱，元气将要败绝，而邪气不能解除的，非六味回阳饮不可。然而只要有极度虚弱和极度寒冷的意思，就应当使用此方。如果等到元气败绝，恐怕就来不及了。凡是阴盛格阳，内部真寒而外部假热的，其症状一定是头红面赤，或者口干舌燥，或者口疮喉痛，或者烦躁气喘狂躁，或者身体热如火烧，或者出现虚斑且身上像蚊子咬的痕迹遍布，或者发阴黄且小便像金汁一样。虽然外部有这些症状，但脉象微弱无力，并且或者为呕吐恶心，或者为泄泻，或者背腹畏寒，或者气短似喘，或者昏睡无知，或者惊惶恐惧，或者虽然发热但不口渴，或者言语虽然谵妄但气促声微，或者身体虽然躁狂但举动无力，制止就能停止，这些都是内虚外实，真寒假热的证候。必须用理阴煎，或者六味回阳饮、大温中饮、八味地黄汤之类，大剂量给予，才可以保全性命。如果是虚火上浮，喉痛热躁，不能喝热药的，用井水浸泡药物后冷服，这是用假寒的药性，来解除上焦的假热，利用药物真热的本性，来救治下焦的真寒，这是回阳起死，真正神妙的治疗方法。那些血气原本虚弱，适合用补法的。然而温补过多，而病情日益昏沉，并且出现烦热难愈的。这是阳邪独亢，阴气不到，而虚中有热。只需改为滋阴，用犀角地黄汤加黄芩、麦冬，或者一柴胡饮加知母之类。这是十补一清的方法。一剂就见效，其妙处如神。医家灵活变通，最应该知晓这一点。
In general, when treating Shanghan (Cold Damage) or Wenyi (Warm Epidemics) with warming and tonifying methods, it is because cold pathogens are stagnant, and Yang Qi fails to overcome Yin. Without warming, movement cannot occur; without warming, recovery of Yang Qi is impossible. If cold qi resides in the meridians, it is because the pathogen is at the exterior level, and warming dispersal is appropriate, as detailed previously. If cold qi resides in the Zang organs, it is due to deficiency of Yang Qi; either warming and tonification or merely warming the Middle Jiao is indicated. However, the principle for using warming methods is to observe: if there is heat on the outside but no heat inside, this is false heat, and warming is indicated rather than cooling. If the disease presents with heat signs but the Yuan Qi (Original Qi) is deficient, this is also false heat, and warming is indicated rather than cooling. True heat is easily known by everyone. It is only false heat that is difficult to distinguish. For false heat, unless sweet-warming herbs are used, the heat will not subside; how much more so for true cold, which needs no further explanation. Generally, excess patterns often present true heat, while deficiency patterns often present false heat. Therefore, treating excess patterns often requires cooling agents, while treating deficiency patterns often requires warming agents. Failure to distinguish between true and false can cause significant harm. Furthermore, regarding the differentiation of true cold with false heat, excess patterns can have both cold and heat. Deficiency patterns can also have both cold and heat. To claim that all excess patterns are hot and all deficiency patterns are cold is rigid and erroneous. However, for excess patterns with cold, only warming dispersal is suitable, without need for tonification. For deficiency patterns with heat, only regulating and tonifying is suitable, and one must fear cold-cooling agents. Cold-cooling agents lack life-generating properties and tend to damage Yuan Qi. If cold-cooling agents are used to treat deficiency patterns, the heat may not subside, and although temporary use might be acceptable, prolonged use will inevitably damage the Spleen and Stomach and lead to critical conditions. Since fever is present but cold agents are unsuitable, labeling it generally as false heat is not excessive.
1. In cases of Shanghan with fever, where the Mingmen (Gate of Life) Yang is deficient, accompanied by aversion to cold, body pain, vomiting, or dysentery, with weak pulse and deficient Qi, such that the exterior syndrome cannot resolve, Da Wen Zhong Yin (Great Warming the Middle Decoction) or Li Yin Jian (Regulating Yin Decoction) must be used. If Shanghan presents with body heat, and there is cold in the Heart and Lungs, accompanied by vomiting, hiccups, and coughing, or abdominal fullness and wheezing, with only cold pathogen and no deficiency, Xiao Qing Long Tang (Minor Blue Dragon Decoction) is appropriate. If Yin-pattern Shanghan presents with spontaneous diarrhea, deep pulse, body pain, fever, abdominal pain, and cold extremities, with only cold pathogen and no Yuan Qi deficiency, warming medicines should be used, specifically Si Ni Tang (Frigid Extremities Decoction). If cold is in the Taiyin channel, presenting with abdominal pain, vomiting, and dysentery, or distension and cold extremities, due to Spleen and Stomach deficiency-cold with unresolved pathogen, Wen Wei Yin (Warming the Stomach Infusion) or Li Zhong Tang (Regulate the Middle Decoction) is appropriate. If Shanghan occurs within one or two days, with pathogen in the Taiyang channel or Shaoyin channel, presenting with aversion to cold in the back and unresolved exterior syndrome, Fu Zi Li Yin Jian (Aconite Regulating Yin Decoction) is appropriate. In Zhang Zhongjing’s texts, Fu Zi Tang (Aconite Decoction) is used. If Wind-Cold is at the exterior and Yin-Cold is in the interior, presenting externally with body heat but internally with unceasing diarrhea and dysentery, or with vomiting/nausea or abdominal pain due to dysentery, this indicates sinking of Middle Qi, causing the exterior pathogen to sink deeper, making resolution impossible. One must quickly use Wei Guan Jian (Stomach Gate Decoction) or Da Wen Zhong Yin. In any case of Shanghan where there is severe deficiency of Yin and Yang, impending failure of Yuan Qi, and inability to resolve the pathogen, Liu Wei Hui Yang Yin (Six-Ingredient Return Yang Infusion) is indispensable. However, if there is a sense of severe deficiency and severe cold, this formula should be used immediately. Waiting until failure occurs may be too late. In cases of Yin Excess repelling Yang, with true cold inside and false heat outside, symptoms must include red head and face, dry mouth with scorched tongue, mouth ulcers and sore throat, irritability, wheezing, mania, or body heat like fire, or appearance of deficiency spots and mosquito-bite-like marks all over the body, or Yin Jaundice with urine resembling golden juice. Although these external signs exist, the pulse is weak and powerless, and there may be vomiting/nausea, diarrhea, aversion to cold in the back and abdomen, shortness of breath resembling asthma, lethargy with loss of consciousness, panic and fear, or fever without thirst. Even if speech is delirious, the Qi is rapid and voice is faint; even if the body is restless and manic, movements are weak, and stopping them halts the behavior. These are all signs of internal deficiency and external excess, true cold with false heat. One must use Li Yin Jian, or Liu Wei Hui Yang Yin, Da Wen Zhong Yin, Ba Wei Di Huang Wan (Eight-Ingredient Rehmannia Pill), etc., in large doses to preserve life. If floating deficiency fire causes sore throat, heat, and restlessness, preventing the intake of hot drinks, soak the medicine well water and administer cold. This uses the property of false cold to resolve the false heat of the Upper Jiao, while utilizing the true heat nature of the herbs to save the true cold of the Lower Jiao. This is a truly miraculous method for returning Yang and reviving the dead. For those whose Blood and Qi are originally deficient and suitable for tonification, however, if excessive warming and tonification leads to increasing confusion and persistent difficult-to-resolve irritant heat, this indicates solitary hyperactivity of Yang pathogens and absence of Yin Qi, resulting in heat within deficiency. One should switch to nourishing Yin, using Xi Jiao Di Huang Tang (Rhino Horn and Rehmannia Decoction) added with Huang Qin (Scutellaria Root) and Mai Dong (Ophiopogon Tuber), or Yi Chai Hu Yin (One Bupleurum Infusion) added with Zhi Mu (Anemarrhena Rhizome). This is the method of ten parts tonifying and one part clearing. Effect is seen after one dose, its efficacy is miraculous. Practitioners must be flexible and understand this principle best.