（医验）薛殿宾五十岁，住山东德县大寺街，患伤寒症已经过五医，率皆谨守古医书治法，认症并无错误，经余接诊时系于前医认为不治，辞谢之后，病已一月馀，其当时症状，为潮热不解、．神识不清、脉微细、口燥唇裂、不寐自．汗、舌苔黑。病者自。诉，恒觉肠内若有粘贴之物一片（以前曾服泻药数次矣。），痛苦之状，不知所可，以病日久，周身皆痛，现无欲状态。衰弱殊甚，而热度至下午尤高，谵语、倦卧、唇裂有血痕，恶寒厥逆，症甚危殆，而自诉肠内自觉粘着一物，则反复叮咛，以相告语。余查以前论症诸医案，均无错误，时在十一月，认定为正伤寒，自初病至病危，所用之方，不出麻黄桂枝汤，症渐进行，则小柴胡汤、大青龙汤、调胃承气汤、大承气汤、四逆汤等应有尽有，均依古方为治，观其脉症，审其方药，无一不合；学医者已受古人之误，杀人之机，即在无一不合四字，可胜叹哉！病已至此，群医束手无策，诿为饮食不慎，自招病危，推辞不治。凡病至服药无效，毫无把握之时，医者总宜及早告知病家，再延他医诊治，以免贻误病机，致令后医为难，万不可存自满及嫉妒之心，尤应于此症治愈之后，再向病者细问经过，籍资经验，余本庸医，然于读书而外，自觉受益最多者，惟此一着。四十余年不敢自信，窃愿能知自爱之中西医共勉之。余检其以前所用之药，例如芍药、甘草、人参、当归、五味子、附子、干姜、大枣、白术、茯苓、桂枝等药，尤以芍药为最多，几于每方必有此品。无一不具。此等药品，虽为古方，然根本误人，即在于此；故此症大误，亦即在于此。当其初得之时，寒邪在表，此时一经发汗，本可自愈，况此君素本强壮，有何顾虑。
乃于发汗药中，遵照古方，芍药、甘草，均行列入，汗既不透，邪渐入内，又复于内热当下之时，误解厥逆便溏，此均热象遵照古方，又复加入种种收敛辛燥温补之品，泻又不透，致使肠胃之中，愈积愈热，渐至肠出血期几于无法挽回。盖此症初得之时，本当发汗，而误于成方，发汗不彻底，其后病热演进，当攻下，而又误于成方，攻下不彻底，由浅入深，遂成重症。病名极清楚，病象极显明，治法极简单，本可顺理成章，一药而愈。所可叹者，即古人误今人，今人误病人，一误再误，其唯一害人之方药，即在于桂枝、芍药、附子、人参，五味子、白术等等，与此君病变，大相反悖之各药品。此症死于此药者不知凡几，可胜叹哉！中医至此，实必束手无策矣，余适于是时自鄂回籍，接诊此症，病状如上述认为肠热已甚，此时病者已衰弱不堪，唯有哭泣。津液将枯，乃为立下方。
第一方午前八点钟服生大黄三钱枳实二钱芒硝一钱五分煎妥冲入芒硝一次服，服药后一点钟，嘱病者多饮白水。服一剂大下如黑油状物之粪便，病势大见轻减，当日服阿斯比林，（西药方）体温亦下降，因而能进稀粥一杯。
第二方午前八点服一次，午后八点服一次。
生大黄一钱枳实一钱芒硝一钱生地四钱寸冬二钱元参二钱丹皮三钱煎妥分二次早晚分服，服下后，退热最为显著，病热更减轻。
西药方此方服中药时，每日服之，约三日。
阿斯比林0.1～0.3克（一包，于发高热时服下，约在午后三点钟此药分量太轻，以病者已衰弱，恐其副作用发汗太大，致心脏有险，故用此小量。此时若用硫规，则多无效，此经验若干年始知之，谨以告知读者。（硫规虽无发汗之副作用，而不适用于此等热）服前中西药方均大效，病约五、六日，即渐向愈，此后所服药品，不过西药中之稀盐酸、橙皮酊等之清凉药，及中药内之生地露、银花露等轻清之品，而阿斯比林亦于热度微高时，给予0.1～0.2克一包服下，（约三、四日或间日服之）如此调理约二十余日；病已痊愈。
此症初起，中药有大效，西药绝无效。阿斯比林等至第二、三期，纯恃中药无特效，例如大黄、芒硝、生地、元参、丹皮等纯用西药例如甘汞、硫苦、阿比、安比、撒曹、硫规等亦无特效。余不知经过若干人之实验，而确知此症用药之时机，及适用中或西之药品，有时绝对无效，例如伤寒初得之用阿比等有时中西药相得益彰。例如二，三期，早晚服中药之泻下药，中间与以一包或二包之阿比。并能确知中西药虽系同一作用，而各有所宜，例如西药之甘汞，硫苦对于伤寒绝不如中药之大黄、芒硝。
此症中西医之治法，分之均易酿成重症。西医开首既无治法，对二、三期应用之泻下药，又缺乏滋养津液之品以佐之，故西医对于此症，亦只有听其演变。中医治此症，本有良方，惟古书立沦，似深奥而实朦胧，而又杂以不适用之各药，减其良药之效用，误人太甚，中药对二、三期之伤寒，又缺乏退热之灵验，是以不可尽信古书也。所以中医对此症，有各种不治之症矣，例如所谓坏病及种种定为不治之死证。西医对本病之预后，亦有种种不良之规定，（例如合并肠出血、脑膜炎、肺炎、肠穿孔及热度过高，脉搏反软少之类。）则中西医对于此症之治疗，均有缺点，叼想而知。余虽不敢谓中西医药，相机参用，必能使此症百治百愈。然确实知此症发生后，所以演变至于极重之时期者，强半由于中药古方巾之一部分太支离，西药中之一部分，根本对此症无大效．因而延误而成，中西医药，各有短长，则敢断言。以此症每逢冬季，最易流行，兵营中更易感染。余任第五镇军医长八年之久，成绩考试，辄冠全镇军医官长，即以此症成绩为多，曩者伴侣，仍有存者，当能证余言也。余治疗此症，何止千百，历将中西医药，反复比较试验，确知此症中医之传经说，西医之待期说，强半由于初起及经过中，治疗医药之不适合，因而酿成较重之症象，绝非本病之漫无治法，必须听其自然之谓，用特郑重记载，学者不可不注重实际，自囿于一偏之见也。佘岂敢自作聪明，反对古人，反对科学，然心所谓危，不忍不大声疾呼，以告学者。一得之愚，或有补于未来之医术，望知我者谅此苦衷也。西药巾之预防注射，最有特效，不可不知，（伤寒预防浆苗等）又甘汞——药，西医对此症甚推重之，比较有效，特并识之。
附录最近反证医验一则．张绍周前绥靖公署副官处书记官，年五十六岁。清苑县东关人，于民国二十六年七月，患温病，头痛、身热、身痛、呕逆、舌苔白、不恶寒。此不恶寒三字，系温病征象须注意。余接·诊时，先经该署西医官诊治，服药四日，未见效，热度甚高。医官认为肠热重症，窒扶斯症嘱其迷住医院，以免传染。此症并未认错，隔离更属当然，阅者不可误解。但西医谓伤寒，温病均为肠热症，不无可议，此则希望西医之有改进思想者，加之意也。嗣延余诊治，经诊断为温症，除上列症均有外，右脉洪数左脉亦大。肺胃初热，仅与以甘汞锭二片每片含量0.2克（第一日）嘱其即服。嗣即大解一次，隔八小时，再服中药，桑叶、丹皮、连翘、银花、菊花、豆豉、薄荷等药，连进二剂。第二日煎服一剂，分三次服。第三日豁然起床，病已痊愈。此症若纯以西药治之，必成肠窒扶斯重症，并无可疑，但在此季节七月病象、脉象，极易认定，即中医所称之温症。然若投以中药治伤寒之麻黄桂枝等汤，不但不能治病，且必加重。若投以西药之安基比林等则暂时解热，而呕逆更加。渐入内矣投以甘汞，以内撤其热。实可有效，但其表热不退，病变仍可演进以渐至于肠出血等等之危笃重症，此所以不得不有待期疗法之说矣。且甘汞亦不可屡服。故中医遇此症若误用一部分之伤寒药，桂枝亦在内，不可不注意必致贻误病机。此症若不在冬月，似不致误认。西医认症极确实，然其缺点，在西药之不能完全适用。设使此症用安比退热，用甘汞泻下，理想中似甚得法，然绝无大效，一试便知，勿庸辞费。中药治此症，特别有效，不必需用甘汞，余以张君呕逆太甚，用中药疏通，恐其呕吐，（汤剂缺点，故以甘汞锭以代中药。所虑者，中医谬于虚伪之古说，自作玄深沉晦之谈，以误人命耳。此症与伤寒，究其极必皆肠热，西医以其病原菌相同，故将伤寒，温病认定为一病，确实不误，不可不信，然中医对此：：症之治法，绝然不同，且均特效，则西医不知也。
以上所列张君医验，以余视之，原无列入本编之价值，然借此一症，与前列薛君之伤寒病对照，则颇有趣，以绥署医官等，皆老资格之西医，其认症断无错误，治疗用药，更属精当，然对此症治疗，所得结果，何以与余不同乎？正以见彼此认症同治法同，惟药物一项，中西各异，有适有不适耳。此余详列此条之本旨，可见中西医药，实有互相救济之场合，有合并研究之必要，中西医者，如欲增长学问，切不可分道扬镳，自居于登峰造极之列也。
温病（二）温病中医论温病与伤寒，分辨最清，中药治温病，更属奇效，可称百试百验。所虑者，误将此症认为伤寒则大左矣，西医根本即将伤寒、温病，认为一病，故其治法远不逮中医也。（除预防注射法）（原因）西医谓肠窒扶斯病菌，为本症之原因，信然。但中医气候之说，风、寒、暑、湿、燥、火，亦此症诱因之最可信者。
盖此症根本致病之由，即体内及肠内先有不清洁之微生物或气体，潜伏日久，因而致全身血液，受其影响。肺之功用在呼吸空气，变更血液，是以此脏直接先见病状，参照肺循环及皮肤呼吸各条蔓延而至胃肠，发现病变。中医所谓某种热例如暑、湿等内伏，与西医病原菌之说吻合，又云温邪由口鼻而入，则是本病诱因，亦与西医空气传染之义同。兹分一般诱因与个人诱因说明之。
1.一般诱因，诱因者，人体内早有此病隐伏，因遇某种机会，致病象得以形成是也。例如肺结核患者，早有结核菌潜伏肺脏，然其人体格尚强壮，足以抵抗病菌，因而该病菌不能发展，不见症状，一旦过劳，或偶因感冒咳嗽，失治日久，渐渐酿成肺痨，因而病重，此感冒即为诱因。温病之一般诱因，不外气候之剧烈变动，例如天气忽寒忽暖，余可类推。及不洁空气之吸入，所谓秽浊之气，自口鼻而入之类，最为的确。均可使吾入感受不适。设使感受者，体内清洁，气血顺调，则一时虽觉不适，不久即复健康，或竟完全不受外界影响，毫无病状。反之，则立时可以感觉疾患，多数感染，十之八九，不能避免，病状大略相同，再多则戍瘟疫之类，此一般共同之诱因也。
2.个人诱因，此则由于一个人之环境，或不慎而诱起本症之谓。例如冬口室内温度过高，或常在不洁空气中工作，或饮食不洁，或身体过弱之类。此种诱因，只限于某种人，始有酿成温症之可能，大多数人绝不感染。中医所谓冬不藏精，春必病温云云，即指此类而言，并无何种奥妙之处，不可混入玄说此个人之诱因也。此症在冬季最易与伤寒误认，（非冬季，伤寒症绝少，然冬季温病亦有之，医者必注意此时是否气候有大变动，是否有温症流行。再证之病象、脉象与经验，细心体认，当能分辨。
严冬之季，最宜注意，初起倘有误认，服药必见病加，（例如温病初起，认为伤寒，与以麻黄、桂枝，表证不但不解，反而内外大热．口鼻出血之类，或伤寒初起；认为温病，与以清凉解叽之品，恶寒更甚，表证加重，脉更紧细之类）必须及早反转治法，万不可偏执己见，误人性命，初学医者。戒之戒之。
（症候）温病症候亦可分为三期说明之。注意三期字样系以病之轻重言，不以深浅言也。
第一期中医所谓上焦症头痛或晕、有微恶风寒者．亦有否者。身热、午后更甚，此与伤寒初起．最易分辨之点，纵或发热，轻重不同，但多少总有发热证象，伤寒初起则否。口渴、初起或有或无自汗、或有或无咳嗽、多有脉洪大、右手尤显明，但初起亦有脉象微大者，然绝无伤寒之紧弦等咏也。胸闷不食、呕多剧烈、此症大多数头痛极甚，而不恶寒，此与伤寒不同之点，且绝无鼻塞声重者，亦与伤寒不问，若在伤寒症，头痛极甚，则未有不恶寒者，惟呕恶症，伤寒为甚，初起之时，若以种种症象辨之，此呕症亦不致与伤寒误认也。鼻干、舌苔多薄白、或无身痛或酸，此为必有之症，既不恶寒而身痛或酸，更易知其为温症矣。此温病初起之症候也。温病恶寒头痛身痛甚者，亦必酌量于清解药中稍加解表之药，例如防风、荆芥等，但不得与伤寒症相混，而误用麻、桂、羌活、细辛等药也。
（医案）薛殿宾，五十岁，居住在山东德县大寺街。他患伤寒症，已经经过五位医生诊治，这些医生都严格遵守古医书中的治法，对病症的判断并没有错误。但当我接诊时，病情已被前医判定为不治之症，他们辞谢不再治疗。此时距离发病已有一个多月。当时的症状表现为：潮热不退、神识不清、脉象微细、口燥唇裂、失眠且自汗、舌苔发黑。患者自述，常感觉肠内好像粘着一片东西（此前曾多次服用泻药）。痛苦不堪，不知所措，因为病程日久，全身疼痛，呈现出一种无欲的状态。身体极度衰弱，而体温在下午尤其高，伴有谵语、疲倦卧床、唇裂有血痕、恶寒及四肢厥逆，病情非常危重。但他反复叮咛告知我，自觉肠内有粘着之物。我查阅以前各位医生论述病情的医案，均没有错误。当时是十一月，认定为正伤寒。从初病到病危，所使用的方剂，不出麻黄桂枝汤的范围；随着病情进展，小柴胡汤、大青龙汤、调胃承气汤、大承气汤、四逆汤等应有尽有，都是依照古方进行治疗。观察其脉象和症状，审察其方药，没有一处不合古法；学医者已经受到古人的误导，杀人的机括，就在于这“无一不合”四个字，真是令人叹息啊！
病情发展到这种地步，众医束手无策，推卸说是饮食不慎，自己招致病危，便推辞不治。凡是疾病到了服药无效、毫无把握的时候，医生总应该及早告知病人家属，再聘请其他医生诊治，以免贻误病情，致使后来的医生为难。万万不可存有自满和嫉妒之心。尤其应该在治愈此症之后，再向病人详细询问经过，借此积累经验。我本是无能的医生，但在读书之外，自觉受益最多的，就是这一点。四十多年来不敢自信，私下希望懂得以自爱的中西医同仁共勉。
我检查他以前所用的药物，例如芍药、甘草、人参、当归、五味子、附子、干姜、大枣、白术、茯苓、桂枝等药，尤其是芍药用得最多，几乎每方必有此药，无一不具。这些药品虽然出自古方，但根本的错误就在这里；因此这个病例的大误，也在于此。当他刚得病时，寒邪在表，此时只要发汗，本来可以自愈，何况这位病人素来强壮，有什么顾虑呢？
然而在发汗药中，遵照古方，芍药、甘草都列入其中，导致汗出不透，邪气逐渐入里。又在内热应当攻下的时候，误解了厥逆和便溏（将其视为虚寒而非热象），遵照古方，又加入各种收敛、辛燥、温补的药物。导致泻下不透，致使肠胃之中，积热越来越重，渐渐发展到肠出血阶段，几乎无法挽回。大概这个病初起时，本当发汗，却因成方而误，发汗不彻底；其后病热演进，应当攻下，却又因成方而误，攻下不彻底。由浅入深，遂成重症。病名极清楚，病象极显明，治法极简单，本可顺理成章，一药而愈。所可叹的是，古人误导今人，今人误导病人，一误再误。唯一害人的方药，就在于桂枝、芍药、附子、人参、五味子、白术等等，这些与这位病人的病变大相悖逆的药品。死于这种药的不知有多少，真是令人叹息啊！中医到了这种地步，实在束手无策了。
我当时正好从湖北回到家乡，接诊此症。病状如上所述，认为是肠热已甚。此时病人已衰弱不堪，只有哭泣。津液将枯，于是我为他立下第一方。
第一方：午前八点钟服生大黄三钱、枳实二钱、芒硝一钱五分。煎好后冲入芒硝，一次服下。服药后一个钟头，嘱咐病人多喝白水。服一剂后，大便排出如黑油状的粪便，病势大见减轻。当天服用阿斯匹林（西药），体温也下降，因而能进稀粥一杯。
第二方：午前八点服一次，午后八点服一次。
生大黄一钱、枳实一钱、芒硝一钱、生地四钱、寸冬二钱、元参二钱、丹皮三钱。煎好后分两次早晚分服。服下后，退热最为显著，病热更减轻。
西药方：此方在服中药时每日服用，约三日。
阿斯匹林0.1～0.3克（一包，于发高热时服下，约在午后三点钟。此药分量太轻，是因为病人已衰弱，恐怕其副作用发汗太大，致使心脏有危险，故用此小量。此时若用硫酸镁，则多无效，这是若干年才知晓的经验，谨以此告知读者。（硫酸镁虽无发汗的副作用，但不适用于这种热证。）
服用前述中西药方均有大效，病约五、六日，即渐向愈。此后所服药品，不过是西药中的稀盐酸、橙皮酊等清凉药，以及中药内的生地露、银花露等轻清之品。阿斯匹林也在热度微高时，给予0.1～0.2克一包服下（约三、四日或间日服之）。如此调理约二十余日，病已痊愈。
此症初起，中药有大效，西药绝无效。阿斯匹林等至第二、三期，纯恃中药无特效。例如大黄、芒硝、生地、元参、丹皮等，纯用西药例如甘汞、硫苦、阿司匹林、安乃近、撒曹、硫酸镁等亦无特效。我不知道经过多少人的实验，而确知此症用药的时机，及适用中或西的药品。有时绝对无效，例如伤寒初得时用阿司匹林等；有时中西药相得益彰，例如二、三期，早晚服中药的泻下药，中间给予一包或两包的阿司匹林。并能确知中西药虽系同一作用，而各有所宜，例如西药的甘汞、硫苦对于伤寒绝不如中药的大黄、芒硝。
此症中西医的治法，分开来看均易酿成重症。西医开首既无治法，对二、三期应用的泻下药，又缺乏滋养津液的药品以佐之，故西医对此症，也只有听其演变。中医治此症，本有良方，惟古书立论，似深奥而实朦胧，而又杂以不适用之各药，减其良药之效用，误人太甚。中药对二、三期的伤寒，又缺乏退热的灵验，所以不可尽信古书。因此中医对此症，有各种不治之症的说法，例如所谓坏病及种种定为不治的死证。西医对本病的预后，亦有种种不良的规定（例如合并肠出血、脑膜炎、肺炎、肠穿孔及热度过高，脉搏反软少之类）。则中西医对此症的治疗，均有缺点，可想而知。我虽不敢谓中西医药相机参用，必能使此症百治百愈。然而确实知道此症发生后，所以演变至于极重之时期者，强半由于中药古方中的一部分太支离破碎，西药中的一部分，根本对此症无大效，因而延误而成。中西医药，各有短长，则敢断言。以此症每逢冬季，最易流行，兵营中更易感染。我任第五镇军医长八年之久，成绩考试，辄冠全镇军医官长，即以此症成绩为多，以前的同伴，仍有存者，当能证明我的话。我治疗此症，何止千百，历将中西医药，反复比较试验，确知此症中医的传经说，西医的待期说，强半由于初起及经过中，治疗医药的不适合，因而酿成较重之症象，绝非本病之漫无治法，必须听其自然之谓。特意郑重记载，学者不可不注重实际，自囿于一偏之见。我岂敢自作聪明，反对古人，反对科学，然心所谓危，不忍不大声疾呼，以告学者。一得之愚，或有补于未来之医术，望知我者谅此苦衷也。西药中的预防注射，最有特效，不可不知（伤寒预防疫苗等）。又甘汞——药，西医对此症甚推重之，比较有效，特并识之。
附录最近反证医验一则：张绍周，前绥靖公署副官处书记官，年五十六岁，清苑县东关人。于民国二十六年七月，患温病，头痛、身热、身痛、呕逆、舌苔白、不恶寒。此“不恶寒”三字，系温病征象须注意。我接诊时，先经该署西医官诊治，服药四日，未见效，热度甚高。医官认为肠热重症，伤寒症，嘱其迷住医院，以免传染。此症并未认错，隔离更属当然，阅者不可误解。但西医谓伤寒、温病均为肠热症，不无可议，此则希望西医之有改进思想者，加之意也。嗣延余诊治，经诊断为温症，除上列症均有外，右脉洪数，左脉亦大。肺胃初热，仅给予甘汞锭二片（每片含量0.2克，第一日），嘱其即服。嗣即大解一次，隔八小时，再服中药，桑叶、丹皮、连翘、银花、菊花、豆豉、薄荷等药，连进二剂。第二日煎服一剂，分三次服。第三日豁然起床，病已痊愈。此症若纯以西药治之，必成肠伤寒重症，并无可疑，但在此季节七月，病象、脉象，极易认定，即中医所称之温症。然若投以中药治伤寒之麻黄桂枝等汤，不但不能治病，且必加重。若投以西药之安基比林等则暂时解热，而呕逆更加，渐入内矣。投以甘汞，以内撤其热，实可有效，但其表热不退，病变仍可演进，以渐至于肠出血等等之危笃重症，此所以不得不有待期疗法之说矣。且甘汞亦不可屡服。故中医遇此症若误用一部分之伤寒药，桂枝亦在内，不可不注意，必致贻误病机。此症若不在冬月，似不致误认。西医认症极确实，然其缺点，在西药之不能完全适用。设使此症用安比退热，用甘汞泻下，理想中似甚得法，然绝无大效，一试便知，勿庸辞费。中药治此症，特别有效，不必需用甘汞，余以张君呕逆太甚，用中药疏通，恐其呕吐（汤剂缺点），故以甘汞锭以代中药。所虑者，中医谬于虚伪之古说，自作玄深沉晦之谈，以误人命耳。此症与伤寒，究其极必皆肠热，西医以其病原菌相同，故将伤寒、温病认定为一病，确实不误，不可不信，然中医对此症之治法，绝然不同，且均特效，则西医不知也。
以上所列张君医验，以余视之，原无列入本编之价值，然借此一症，与前列薛君之伤寒病对照，则颇有趣。以绥署医官等，皆老资格之西医，其认症断无错误，治疗用药，更属精当，然对此症治疗，所得结果，何以与余不同乎？正以见彼此认症同，治法同，惟药物一项，中西各异，有适有不适耳。此余详列此条之本旨，可见中西医药，实有互相救济之场合，有合并研究之必要。中西医者，如欲增长学问，切不可分道扬镳，自居于登峰造极之列也。
温病（二）温病中医论温病与伤寒，分辨最清，中药治温病，更属奇效，可称百试百验。所虑者，误将此症认为伤寒则大左矣。西医根本即将伤寒、温病，认为一病，故其治法远不逮中医也。（除预防注射法）（原因）西医谓肠窒扶斯病菌，为本症之原因，信然。但中医气候之说，风、寒、暑、湿、燥、火，亦此症诱因之最可信者。
盖此症根本致病之由，即体内及肠内先有不清洁之微生物或气体，潜伏日久，因而致全身血液，受其影响。肺之功用在呼吸空气，变更血液，是以此脏直接先见病状，参照肺循环及皮肤呼吸各条蔓延而至胃肠，发现病变。中医所谓某种热例如暑、湿等内伏，与西医病原菌之说吻合，又云温邪由口鼻而入，则是本病诱因，亦与西医空气传染之义同。兹分一般诱因与个人诱因说明之。
1. 一般诱因：诱因者，人体内早有此病隐伏，因遇某种机会，致病象得以形成是也。例如肺结核患者，早有结核菌潜伏肺脏，然其人体格尚强壮，足以抵抗病菌，因而该病菌不能发展，不见症状，一旦过劳，或偶因感冒咳嗽，失治日久，渐渐酿成肺痨，因而病重，此感冒即为诱因。温病之一般诱因，不外气候之剧烈变动，例如天气忽寒忽暖，余可类推。及不洁空气之吸入，所谓秽浊之气，自口鼻而入之类，最为的确。均可使吾人感受不适。设使感受者，体内清洁，气血顺调，则一时虽觉不适，不久即复健康，或竟完全不受外界影响，毫无病状。反之，则立时可以感觉疾患，多数感染，十之八九，不能避免，病状大略相同，再多则成瘟疫之类，此一般共同之诱因也。
2. 个人诱因：此则由于一个人之环境，或不慎而诱起本症之谓。例如冬日室内温度过高，或常在不洁空气中工作，或饮食不洁，或身体过弱之类。此种诱因，只限于某种人，始有酿成温症之可能，大多数人绝不感染。中医所谓“冬不藏精，春必病温”云云，即指此类而言，并无何种奥妙之处，不可混入玄说此个人之诱因也。此症在冬季最易与伤寒误认，（非冬季，伤寒症绝少，然冬季温病亦有之，医者必注意此时是否气候有大变动，是否有温症流行。再证之病象、脉象与经验，细心体认，当能分辨。
严冬之季，最宜注意，初起倘有误认，服药必见病加，（例如温病初起，认为伤寒，与以麻黄、桂枝，表证不但不解，反而内外大热、口鼻出血之类；或伤寒初起，认为温病，与以清凉解肌之品，恶寒更甚，表证加重，脉更紧细之类）必须及早反转治法，万不可偏执己见，误人性命，初学医者，戒之戒之。
（症候）温病症候亦可分为三期说明之。注意“三期”字样系以病之轻重言，不以深浅言也。
第一期：中医所谓上焦症。头痛或晕、有微恶风寒者，亦有否者。身热、午后更甚，此与伤寒初起最易分辨之点，纵或发热，轻重不同，但多少总有发热证象，伤寒初起则否。口渴、初起或有或无。自汗、或有或无。咳嗽、多有。脉洪大、右手尤显明，但初起亦有脉象微大者，然绝无伤寒之紧弦等脉也。胸闷不食、呕多剧烈。此症大多数头痛极甚，而不恶寒，此与伤寒不同之点，且绝无鼻塞声重者，亦与伤寒不同。若在伤寒症，头痛极甚，则未有不恶寒者。惟呕恶症，伤寒为甚，初起之时，若以种种症象辨之，此呕症亦不致与伤寒误认也。鼻干、舌苔多薄白、或无。身痛或酸，此为必有之症，既不恶寒而身痛或酸，更易知其为温症矣。此温病初起之症候也。温病恶寒头痛身痛甚者，亦必酌量于清解药中稍加解表之药，例如防风、荆芥等，但不得与伤寒症相混，而误用麻黄、桂枝、羌活、细辛等药也。
(Medical Case) Xue Dianbin, aged fifty, resided at Dasijie, De County, Shandong Province. He suffered from Shanghan (Cold Damage Disease), having been treated by five physicians previously. All these physicians strictly adhered to the treatment methods found in ancient medical texts, and their diagnosis of the symptoms was without error. However, when I took over the case, the condition had already been deemed incurable by the previous doctors, who declined further treatment. At that time, more than a month had passed since the onset of the illness. The symptoms at that moment included: tidal fever that did not resolve, confusion of consciousness, faint and fine pulse, dry mouth and cracked lips, insomnia with spontaneous sweating, and a black tongue coating. The patient reported that he constantly felt as if there were a sticky mass adhering inside his intestines (he had taken laxatives several times before). He was in great pain and did not know what to do. Due to the prolonged duration of the illness, his whole body ached, and he presented a state of apathy. His physical strength was extremely weak, and his body temperature was especially high in the afternoon. He also exhibited delirium, fatigue while lying down, blood traces on his cracked lips, aversion to cold, and cold extremities. The condition was very critical. Yet, he repeatedly emphasized and informed me that he felt an object sticking inside his intestines. I reviewed the medical records of the previous physicians discussing the case, and none contained errors. It was November, and I diagnosed it as Zheng Shanghan (True Cold Damage Disease). From the initial onset to the critical stage, the prescriptions used did not go beyond Mahuang Guizhi Tang (Ephedra and Cinnamon Twig Decoction). As the condition progressed, Xiao Chaihu Tang (Minor Bupleurum Decoction), Da Qinglong Tang (Major Blue-green Dragon Decoction), Tiaowei Chengqi Tang (Regulate the Stomach and Order the Qi Decoction), Da Chengqi Tang (Major Order the Qi Decoction), Sini Tang (Frigid Extremities Decoction), etc., were all available and used according to ancient formulas. Observing the pulse and symptoms, and examining the prescriptions, nothing was inconsistent with the classics; however, students of medicine have been misled by the ancients. The mechanism of killing lies precisely in these four characters: "nothing inconsistent." This is truly sigh-worthy!
The disease had reached such a desperate state that all physicians were at a loss for measures. They blamed dietary indiscretion, claiming the patient brought the critical condition upon himself, and thus refused to treat him. Whenever a disease reaches a point where medication is ineffective and there is no certainty, the physician should inform the family early on and invite another doctor for consultation, to avoid delaying the optimal treatment window and making it difficult for subsequent physicians. One must never harbor feelings of self-satisfaction or jealousy. Especially after curing such a case, one should ask the patient in detail about the course of the illness to gain experience. Although I am an incompetent physician, apart from reading books, I feel I have benefited most from this practice. For over forty years, I have dared not be overconfident, and privately hope that Chinese and Western practitioners who understand self-preservation will take this to heart.
I examined the medications he had previously taken, such as Shaoyao (Paeoniae Radix Alba), Gancao (Glycyrrhizae Radix et Rhizoma), Renshen (Ginseng Radix), Danggui (Angelicae Sinensis Radix), Wuweizi (Schisandrae Fructus), Fuzi (Aconiti Lateralis Radix Praeparata), Ganjiang (Zingiberis Rhizoma), Dazao (Jujubae Fructus), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), and Guizhi (Cinnamomi Ramulus). In particular, Shaoyao was used the most, appearing in almost every prescription. These drugs, although from ancient formulas, are fundamentally misleading; thus, the major error in this case lay here. When he first contracted the illness, the pathogenic cold was in the exterior. At that time, inducing sweating would have allowed for natural recovery. Moreover, this gentleman was constitutionally strong, so what was there to worry about?
However, in the diaphoretic formulas, following ancient prescriptions, both Shaoyao and Gancao were included. Consequently, sweat was not thoroughly induced, and the pathogen gradually entered the interior. Later, when internal heat required purgation, the cold extremities and loose stools were misunderstood (as deficiency-cold rather than heat). Following ancient formulas, various astringent, acrid-dry, and warming-tonifying substances were added. This resulted in incomplete purgation, causing heat to accumulate increasingly within the intestines and stomach, eventually progressing to intestinal bleeding, a stage almost beyond salvage. Generally, at the onset, sweating should have been induced, but due to reliance on fixed formulas, the sweating was incomplete. Later, as the pathological heat advanced, purgation was indicated, but again due to fixed formulas, the purgation was incomplete. The disease progressed from superficial to deep, becoming severe. The disease name was clear, the manifestations were obvious, and the treatment method was simple. It could have been cured with a single appropriate prescription following logical progression. What is lamentable is that the ancients misled moderns, and moderns misled patients, leading to repeated errors. The uniquely harmful medications were Guizhi, Shaoyao, Fuzi, Renshen, Wuweizi, Baizhu, etc.—substances completely contrary to the pathology of this patient. Countless people have died from these medicines; how can one not sigh! Traditional Chinese Medicine (TCM) has reached a point of helplessness in such cases.
At that time, I happened to return from Hubei to my hometown and took charge of this case. The symptoms were as described above, indicating intense intestinal heat. The patient was extremely debilitated, only able to weep. Body fluids were nearly exhausted. Therefore, I prescribed the First Formula.
First Formula: Take Sheng Dahuang (Raw Rheum Palmatum Radix et Rhizoma) 3 qian, Zhishi (Aurantii Fructus Immaturus) 2 qian, and Mangxiao (Natrii Sulfas) 1.5 qian. Boil until ready, dissolve Mangxiao into the decoction, and administer at once. One hour after taking the medicine, instruct the patient to drink plenty of plain water. After one dose, large bowel movements resembling black oil occurred, and the condition improved significantly. On that day, Aspirin (Western medicine) was administered, and body temperature decreased, allowing the patient to consume a cup of thin porridge.
Second Formula: Administer once at 8:00 AM and once at 8:00 PM.
Sheng Dahuang 1 qian, Zhishi 1 qian, Mangxiao 1 qian, Shengdi (Rehmanniae Radix Preparata) 4 qian, Cundong (Ophiopogonis Radix) 2 qian, Yuan Shen (Scrophulariae Radix) 2 qian, Danpi (Moutan Cortex) 3 qian. Boil and divide into two doses for morning and evening administration. After ingestion, the antipyretic effect was most significant, and the pathological heat further subsided.
Western Medicine Prescription: Take this alongside the Chinese herbal medicine daily for approximately three days.
Aspirin 0.1–0.3 g (one packet, taken during high fever, around 3:00 PM). The dosage is light because the patient was debilitated, and excessive sweating caused by side effects might endanger the heart. If Magnesium Sulfate were used at this time, it would likely be ineffective. This is an experience gained after many years, shared here for readers' reference. (Magnesium Sulfate, while lacking the side effect of inducing sweating, is not suitable for this type of heat.)
Both the aforementioned Chinese and Western prescriptions were highly effective. Within five to six days, the patient gradually recovered. Subsequent treatments involved cooling agents such as dilute hydrochloric acid and orange peel tincture from Western medicine, and light, clearing preparations like Shengdi Lu (Rehmannia Dew) and Yinhua Lu (Honeysuckle Dew) from TCM. Aspirin was given in packets of 0.1–0.2 g when the temperature was slightly elevated (taken every three to four days or on alternate days). After such management for over twenty days, the patient fully recovered.
In the initial stage of this case, Chinese medicine was highly effective, while Western medicine was absolutely ineffective. By the second and third stages, relying solely on Chinese medicine lacked specific efficacy. For example, pure use of Western medicines such as Calomel, Epsom Salt, Aspirin, Analgin, Saccharin, and Magnesium Sulfate also lacked specific efficacy. I do not know how many experiments have been conducted, but I am certain of the timing for medication and the applicability of Chinese or Western drugs. Sometimes they are absolutely ineffective, e.g., using Aspirin in the early stage of Shanghan. Sometimes Chinese and Western medicines complement each other, e.g., in the second and third stages, administering purgative Chinese medicine in the morning and evening, and giving one or two packets of Aspirin in between. It is also known that although Chinese and Western medicines may have similar actions, each has its specific indications. For instance, Western medicines like Calomel and Epsom Salt are far inferior to Chinese medicines like Dahuang and Mangxiao for treating Shanghan.
Regarding the treatment of this case, separating Chinese and Western approaches easily leads to severe complications. Initially, Western medicine lacked a treatment method, and for the purgatives used in the second and third stages, it lacked fluids-nourishing agents to support them. Thus, Western medicine could only watch the disease evolve. TCM originally had good formulas for this condition, but ancient texts present theories that seem profound yet are actually vague, mixed with inappropriate drugs that reduce the efficacy of good medicines, causing great harm. Furthermore, Chinese medicine lacks effective antipyretics for the second and third stages of Shanghan, so one cannot blindly trust ancient books. Therefore, TCM considers various conditions as incurable, such as so-called "ruined diseases" and various designated fatal syndromes. Western medicine also has various poor prognostic indicators for this disease (e.g., complications like intestinal bleeding, meningitis, pneumonia, intestinal perforation, and high fever with a paradoxically soft and weak pulse). It is evident that both Chinese and Western treatments for this condition have shortcomings. Although I dare not claim that combining Chinese and Western medicines will guarantee a hundred percent cure rate, I am certain that half of the reason this disease progresses to such a critical stage is due to the fragmented nature of some ancient Chinese formulas and the fundamental ineffectiveness of some Western drugs for this condition, leading to delays. I dare to assert that Chinese and Western medicines each have strengths and weaknesses. Since this disease is most prevalent in winter and easily spreads in military barracks, I served as the Chief Medical Officer of the Fifth Division for eight years. In performance exams, I ranked first among all military officers, largely due to my success in treating this disease. Some of my former colleagues are still alive and can testify to my words. I have treated this disease thousands of times, repeatedly comparing and experimenting with Chinese and Western medicines. I am certain that the TCM theory of meridian transmission and the Western medicine concept of waiting for the disease course are largely due to inappropriate treatment in the initial and intermediate stages, resulting in more severe symptoms. It is absolutely not that the disease itself is untreatable and must be left to nature. I record this solemnly; scholars must pay attention to practical reality and not confine themselves to biased views. How dare I act smartly to oppose the ancients or science? But feeling the danger, I cannot help but cry out loudly to warn scholars. My humble opinion may contribute to future medical arts; I hope those who understand me will forgive my earnest intentions. Preventive injections in Western medicine are highly effective and must not be ignored (e.g., Typhoid vaccine). Also, Calomel is highly regarded by Western medicine for this condition and is relatively effective; I note this together.
Appendix: A recent counter-evidence medical case. Zhang Shaozhou, former Secretary of the Adjutant General's Office of the Pacification Office, aged fifty-six, from Dongguan, Qingyuan County. In July of the 26th year of the Republic of China, he suffered from Wenbing (Warm Disease), presenting with headache, fever, body pain, vomiting, white tongue coating, and absence of aversion to cold. The phrase "absence of aversion to cold" is a sign of Warm Disease and requires attention. When I consulted, he had first been treated by the office's Western physician for four days without effect, and the fever was very high. The physician diagnosed it as a severe intestinal heat condition, Typhoid Fever, and advised hospitalization to prevent contagion. The diagnosis was not wrong, and isolation was certainly appropriate; readers should not misunderstand. However, the Western claim that both Shanghan and Wenbing are intestinal heat diseases is debatable, hoping for Western physicians with progressive thinking to consider this. Subsequently, I was invited to treat him. Diagnosed as Wenbing, besides the listed symptoms, the right pulse was surging and rapid, and the left pulse was also large. Initial heat in the Lung and Stomach. I prescribed only two Calomel tablets (each containing 0.2 g) on the first day, instructed immediate ingestion. Then, a large bowel movement occurred. Eight hours later, Chinese medicine was administered: Sangye (Mori Folium), Danpi, Lianqiao (Forsythiae Fructum), Yinhua (Lonicerae Japonicae Flos), Juhua (Chrysanthemi Flos), Douchi (Sojae Semen Preparatum), Bohe (Menthae Haplocalycis Herba), etc. Two doses were taken consecutively. On the second day, one dose was boiled and divided into three servings. On the third day, he got up abruptly, and the illness was cured. If this case were treated purely with Western medicine, it would undoubtedly become a severe intestinal typhoid case. However, in July, the symptoms and pulse are easy to identify as Wenbing as termed in TCM. If one were to prescribe Ma Huang Gui Zhi Tang (Ephedra and Cinnamon Twig Decoction) used for Shanghan, it would not only fail to cure but worsen the condition. If Anji Bilin (Analgin) were used, it would temporarily reduce fever but worsen vomiting, allowing the pathogen to enter deeper. Administering Calomel to withdraw heat internally is indeed effective, but since the exterior heat does not resolve, the lesion can still progress to critical conditions like intestinal bleeding. This is why the concept of a waiting period therapy arises. Moreover, Calomel should not be taken frequently. Therefore, if TCM practitioners mistakenly use part of the Shanghan formulas, including Guizhi, they must pay attention, or they will delay the treatment opportunity. This case, if not in winter, would likely not be misdiagnosed. Western physicians diagnose accurately, but their shortcoming is that Western drugs are not entirely applicable. If Analgin were used for fever and Calomel for purgation, it seems ideal theoretically, but in reality, it has little effect, which can be verified by trial. No need for further discussion. Chinese medicine is particularly effective for this case and does not require Calomel. I used Calomel tablets instead of Chinese herbal decoctions for Mr. Zhang because his vomiting was too severe, and I feared vomiting would prevent the intake of liquid medicine. My concern is that TCM is misled by false ancient theories, engaging in obscure discussions that harm lives. Ultimately, both this case and Shanghan involve intestinal heat. Western medicine identifies them as one disease because the pathogens are the same, which is correct and should be believed. However, TCM treatment methods are completely different yet equally effective, a fact unknown to Western medicine.
The above case of Mr. Zhang, in my view, originally had no value for inclusion in this compilation. However, comparing this case with the preceding Shanghan case of Mr. Xue is quite interesting. The medical officers of the Pacification Office were senior Western physicians whose diagnoses were undoubtedly correct, and their treatment and medication were precise. Why were the results different from mine? It shows that although both sides agreed on the diagnosis and treatment principles, the medications differed between Chinese and Western systems, with some being suitable and others not. This is the main purpose of detailing this item: it shows that there are occasions where Chinese and Western medicines can mutually supplement each other, and combined research is necessary. Physicians of both systems, if they wish to expand their knowledge, must not go separate ways and place themselves at the pinnacle of perfection.
Warm Disease (II): TCM distinguishes clearly between Warm Disease and Shanghan. Chinese herbal medicine treats Warm Disease with miraculous effects, proving reliable in every test. The concern is mistaking this condition for Shanghan, which is a major error. Western medicine fundamentally regards Shanghan and Warm Disease as one disease, so their treatment methods fall far short of TCM (except for preventive injection methods). (Reason) Western medicine states that Enterobacter typhosus is the cause of this disease, which is true. However, TCM's theory of climate—Wind, Cold, Summer-heat, Dampness, Dryness, Fire—is also the most credible inducer of this disease.
The fundamental cause of this disease lies in unclean microorganisms or gases initially present in the body and intestines, lying dormant for a long time, thereby affecting the entire blood system. The function of the Lung is to breathe air and change the blood; therefore, this organ directly manifests symptoms first. Referring to pulmonary circulation and skin respiration, the disease spreads to the gastrointestinal tract, revealing lesions. TCM's concept of internal stagnation of certain heats, such as Summer-heat or Dampness, aligns with the Western theory of pathogens. Furthermore, the saying that Warm Pathogens enter through the mouth and nose refers to the inducement of this disease, which is consistent with the Western meaning of airborne transmission. Here, general inducements and individual inducements are explained separately.
1. General Inducement: An inducement is a situation where a disease is already latent in the human body, and upon encountering certain opportunities, symptoms form. For example, a tuberculosis patient has tubercle bacilli latent in the lungs. If the person's physique is strong enough to resist the bacteria, the bacteria cannot develop, and no symptoms appear. Once overworked or suffering from a cold cough, if untreated for a long time, it gradually develops into pulmonary tuberculosis, worsening the condition. This cold is the inducement. The general inducements for Warm Disease are mainly drastic changes in climate, such as sudden shifts between cold and warm weather, which can be extrapolated similarly. Inhalation of unclean air, so-called turbid qi entering through the mouth and nose, is the most accurate. These can make us feel uncomfortable. If the infected person has a clean interior and smooth Qi and Blood flow, although feeling uncomfortable for a moment, health will soon return, or even remain completely unaffected by external influences, showing no symptoms. Conversely, one can immediately feel the disease. Most infections, nine out of ten, cannot be avoided, with roughly similar symptoms. If more people are affected, it becomes an epidemic. These are the general common inducements.
2. Individual Inducement: This refers to the induction of the disease due to an individual's environment or negligence. For example, indoor temperatures being too high in winter, working often in unclean air, eating unclean food, or having a weak physique. Such inducements only pose a possibility of developing Warm Disease for certain individuals; the majority are absolutely not infected. TCM says, "If one does not store essence in winter, one will suffer from Warm Disease in spring," referring to this category. There is nothing mysterious about it; do not mix this personal inducement into mystical theories. This disease is most easily confused with Shanghan in winter. (Although Shanghan is rare in non-winter months, Warm Disease also occurs in winter. Physicians must pay attention to whether there are major climate changes or Warm Disease outbreaks at this time. Corroborating with symptoms, pulse, and experience, careful observation can distinguish them.)
During the severe winter season, utmost attention is needed. If misdiagnosed at the onset, medication will surely aggravate the illness. (For example, if Warm Disease at the onset is mistaken for Shanghan and treated with Mahuang and Guizhi, the exterior syndrome will not only not resolve but cause severe internal and external heat, epistaxis, etc.; or if Shanghan at the onset is mistaken for Warm Disease and treated with cooling and muscle-releasing agents, aversion to cold will worsen, the exterior syndrome will intensify, and the pulse will become tighter and finer.) One must reverse the treatment method early on. Never stick to one's own views, or it will cost lives. Novice physicians, beware, beware!
(Symptoms) Symptoms of Warm Disease can also be explained in three stages. Note that the term "three stages" refers to the severity of the disease, not its depth.
Stage One: Known in TCM as Upper Jiao Syndrome. Headache or dizziness; some have slight aversion to wind and cold, others do not. Fever, worse in the afternoon. This is the easiest point to distinguish from the initial stage of Shanghan. Even if fever varies in severity, there is always some sign of fever, whereas Shanghan at the onset typically does not present this way. Thirst: present or absent at the onset. Spontaneous sweating: present or absent. Cough: common. Pulse: usually surging and large, especially obvious on the right hand. However, at the onset, the pulse may be slightly large, but absolutely not tight and string-like as in Shanghan. Chest oppression, loss of appetite, frequent and severe vomiting. Most cases of this disease feature severe headache without aversion to cold, which differs from Shanghan. Also, there is absolutely no nasal congestion or heavy voice, differing from Shanghan. In Shanghan, severe headache is invariably accompanied by aversion to cold. Although vomiting is more severe in Shanghan, if differentiated by various symptoms at the onset, this vomiting symptom will not be mistaken for Shanghan. Dry nose, tongue coating mostly thin white or absent. Body pain or soreness is a mandatory symptom. Since there is no aversion to cold but body pain or soreness exists, it is easier to identify as Warm Disease. These are the symptoms of Warm Disease at the onset. For Warm Disease with severe aversion to cold, headache, and body pain, one must酌情 (discretely) add a small amount of exterior-releasing herbs to the clearing and resolving formulas, such as Fangfeng (Saposhnikoviae Radix) and Jingjie (Perillae Folium), but must not confuse it with Shanghan and mistakenly use Mahuang, Guizhi, Qianghuo (Notopterygii Rhizoma et Radix), or Xixin (Asari Radix et Rhizoma).