医之道难矣哉。凡病伤寒最重。温热尤烈。伤寒仅在一时。温热暑疫。每发三季。为
时既久。病者益多。苟不明其源。溯流不得清也。不辨其类。疗治不得当也。则温热
暑疫。皆热证也。燎原之下。竟乏清凉一滴。人无今昔。性有异同。神酣往圣。志切琳
。俊以一隙微明。静中索照焉。夫上古圣人。首重色脉。以营之未交已交。定人生
死。片言已毕。中古圣人。专论谷气盛衰。定人生死。片言已毕。仲景叔季圣人也。既
立方论。复出不尽之脏。纬以膀胱之伤与绝。定人生死。先后合符。了无剩义矣。乃
仲景于伤寒论中。温热森森。具载黄芩、白虎等汤。是其治也。后之学人。苟能引伸
此意。便可变化不穷。神明千载。不能细察其理。反执以为治伤寒之法。盍思本汤
既无外解之功。又无内夺之力。圣人立法。果何谓乎。自晋以来。疑鬼疑蜮。陋湿无
巳。如崔文行解温。用白术、乌头、细辛、桔梗四味。更加附子。名老君神明散。更加萤
火。名务成子萤火丸。热药相投。以火济火。谁其辨诸。如仲景书。谓太阳病发热不
恶寒而渴者。为温病。朱肱活人书。谓发热恶寒。头疼身痛者。为温病。已悖圣训矣。
又云。春秋发斑咳嗽为温病。至风温治在少阴。其所立五方。如葳蕤汤、知母葛根
汤、防己汤、栝蒌根汤、葛根龙胆汤。风火相炽。燔灼无休。复改圣散子。仍用附子。表
里香燥同之。东坡先生在黄州时。颇称其效。岂知朱肱已三易其方。用败毒散而
远热药。然厥功奚减厥罪。吴氏谓伤寒坏病。更遇温热为温病。洁古老人。伤寒名
家也。其子云岐。以伤寒过经不解者为温病。指叔和之言。为仲景之文。赵嗣真谓
仲景云重感异气。变为温病。汪机谓仲景云遇温气为温病。遇温热为温毒。竟不
顾圣经之载于方策者。何曾有此一语。巢氏病源。遵崔文行解散法。一日用摩膏
火灸。二日针灸解散。三日复汗之。四日用藜芦丸、瓜蒂散吐之。五六日解未了了
者复针之。七日热已入胃。鸡子汤下之。遂使庞安常自撰微言。一以和解为主。奉
为灵宝。少移则蹶。巢庞比匪何极。李思训亦宗和解。王海藏称其当宋全盛。明哲
莫逾。拟非其伦矣。丹溪长于温热。善用凉药。温热遇之。自能解散。要非有斟酌于
其间也。东垣不善外感。长于内伤。乃从内经悟出冬温春温二义。诚暗中一大炬。
嘉言极口欢颂。真先得我心者矣。迨刘河间伤寒直格。于热病每多入理深谈。然
混在正伤寒中。在人眼光采择。不免金屑杂于泥沙者欤。至明季方中行着伤寒
条辨。可谓直登仲景之堂。独开生面。惜其论温热。亦分阴分阳。似可用热。遂为嘉
言所宗。嗟乎。病名温热。自需寒凉。乃千百年来。盈庭聚讼。先后支吾。阳春寡和于
汉庭。埙篪迭奏于晋室。良由来派不清。复无面墙体认。诚习焉而不察耳。不然。岂
诸公各自名家。乃甘悖圣矩如是耶。若夫夏月暑证。即金匮中湿 气蒸之病也。
洁古东垣。以动静分阴阳。动而得之为阳。用白虎。静而得之为阴。用大顺、冷香诸
剂。岂知夏月杲杲炎威。有阳无阴。动静不甚相远。惟多食冰果冷物。及恣意房帏。
致伤太阴少阴者。热药可以暂用。岂得视温热之味。为通行之药乎。漕宪北海林
夫子。为一代伟人。医学宗匠。俊立雪程门。三五年间。极蒙提命。因授所刻明计部
张凤逵治暑书。申明理蕴。精确不磨。虽有小疵。不掩大德。诚可振聋 于千古者
也。至叔和云四时不正之气。感则为疫。不知非时不为厉气。仅为寒疫。而大疫之
沿门阖境。传染相同者。允在兵荒之后。尸浊秽气。充斥道路。人在气交。感之而病。
气无所异。人病亦同。所以月令于孟春。掩骼理 。不敢或后者。圣王早虑及此耳。
非徒泽及枯骨也。后世治疫之法。未有定见。如嘉言上焦如雾。升逐解毒。中焦如
沤。疏逐解毒。下焦如渎。决逐解毒。俟其营卫既通。乘势追拔。勿使潜滋暗长于未
尽之时。此固不易之论。然求其反复尽义。变态直穷。老长吴又可之言。别无根据傍
也。俊幸生明备。不安苟且。日引光明之藏。志披榛莽之途。辑仲景伤寒论。三注金
匮。补注之余。先将温热暑疫四证。厘订经文。采集方论。无背圣法。有合病情。各自
成帙。蒙藩宪丁夫子。因戊午年时疫盛行。悯编户之疾苦。如恫 之乃身。遂下询
疫所自始。与所为治。恻然叹曰。嗟乎。安得明此理者数十辈。循行救治。俾在火轮
火树。梦魇心迷者。一旦提置冰山雪宝之中。奚止饮醍醐而称快哉。命急付枣。以公同志。
康熙己未辜月吴门周扬俊禹载识
医学之道，真是艰难啊！凡是患伤寒病，病情最为严重；温热病则更加猛烈。伤寒病通常只发生在特定的季节，而温热、暑病和疫病，往往在三个季节中发作。因为持续时间长久，患病的人也就越来越多。如果不明白它们的源头，就无法理清脉络；如果不辨别它们的类别，治疗就不恰当。那么温热、暑病、疫病，都属于热证。就像烈火燎原之下，竟然连一滴清凉的水都没有。人无论古今，本性有异同，精神沉浸于古代圣贤的智慧中，志向切近于美好的境界。我凭借一点点微弱的见识，在静默中寻求光照。
上古的圣人，首先重视面色和脉象，根据营气是否交会来判定人的生死，几句话就讲清楚了。中古的圣人，专门论述谷气的盛衰，以此判定人的生死，也是几句话就讲清楚了。张仲景是末世的圣人，他既制定了方论，又补充了未尽的脏腑理论，以膀胱的损伤与绝症为纬线，来判定人的生死，先后符合规律，毫无遗漏。然而张仲景在《伤寒论》中，对温热病描述得森严清晰，详细记载了黄芩汤、白虎汤等方剂，这就是他的治疗方法。后世的学者，如果能引申这个意思，就可以变化无穷，神妙千古。但他们不能仔细考察其中的道理，反而固执地认为这是治疗伤寒的方法。何不思考一下，这些方剂本来就没有解表的功效，也没有攻里的力量，圣人制定法度，究竟是什么意思呢？
自从晋代以来，人们疑神疑鬼，浅陋潮湿没有止境。比如崔文行解释温病，使用白术、乌头、细辛、桔梗四味药，再加上附子，名叫老君神明散；再加上萤火，名叫务成子萤火丸。用热药配合热病，如同火上浇油，谁能分辨其中对错？比如张仲景的书里说，太阳病发热不恶寒而且口渴的，称为温病。朱肱在《活人书》中说，发热恶寒、头疼身痛的，称为温病。这已经违背了圣人的教诲了。又说，春秋季节发斑咳嗽的是温病，至于风温治疗在少阴经。他所立的五个方子，如葳蕤汤、知母葛根汤、防己汤、栝蒌根汤、葛根龙胆汤，风火相炽，燃烧灼烧没有休止。他又修改圣散子，仍然使用附子，表里都用香燥药物。东坡先生在黄州时，很称赞它的疗效。哪里知道朱肱后来三次更改方子，使用败毒散而远离热药。然而他的功劳哪里能抵消他的罪过？吴氏认为伤寒坏病，再遇到温热就是温病。洁古老人是伤寒名家，他的儿子云岐认为伤寒经过传变未解的就是温病。他们引用叔和的话，当作仲景的文章。赵嗣真认为仲景说重感异气，变为温病。汪机认为仲景说遇温气为温病，遇温热为温毒。竟然不顾及圣经中记载在书籍上的内容，何曾有这一句话？
巢元方的《诸病源候论》，遵循崔文行的解散法。第一天用摩膏火灸，第二天针灸解散，第三天再次发汗，第四天用藜芦丸、瓜蒂散催吐，五六天如果病还没完全解除，再次针刺，七天如果热邪进入胃，用鸡蛋汤下之。于是使得庞安常自己撰写《微言》，一概以和解为主，奉为灵宝，稍微移动就会跌倒。巢元方和庞安常相比，恶劣到了极点。李思训也宗奉和解，王海藏称赞他在宋朝全盛时期，明智无人能比，但这并非同类可比。
丹溪擅长温热病，善于使用凉药，温热病遇到他，自然能解散，但这并不是因为他能在中间斟酌得当。东垣不擅长外感病，擅长内伤病，但从《内经》悟出了冬温、春温两个义理，确实是黑暗中的一把大火。嘉言极力欢颂，真是先得我心的人啊。等到刘河间的《伤寒直格》，对于热病每每多有深入的道理探讨，然而混杂在正伤寒中，在于人们眼光的选择，不免像金屑混杂在泥沙中吧。到了明代末年，方中行著《伤寒条辨》，可以说是直接登堂入室进入仲景的境界，独开生面，可惜他论述温热病，也分阴分阳，似乎可以用热药，于是被嘉言所宗奉。唉！病名温热，自然需要寒凉，但千百年来，满朝争论，前后支吾。阳春白雪在汉代很少有人唱和，埙篪合奏在晋室却接连不断。确实是因为流派不清，又没有全面体认，只是习惯而不察觉罢了。不然，为什么各位先生各自成家，却甘愿违背圣人法度到这种地步呢？
至于夏季的暑证，就是《金匮要略》中湿气蒸腾的病。洁古、东垣，用动静来分阴阳，动而得之为阳，用白虎汤；静而得之为阴，用大顺散、冷香饮子等药剂。哪里知道夏季烈日炎炎，只有阳没有阴，动静不太相近。只有多吃冰果冷物，以及肆意房事，导致损伤太阴、少阴的，热药才可以暂时使用。怎么能把温热病的药味，当作通行的药物呢？漕宪北海林夫子，是一代伟人，医学宗师。我在程门立雪求学，三五年间，极受提点教导。因此传授我所刻印的明代计部张凤逵治暑书，申明理蕴，精确不朽，虽然有小瑕疵，不掩盖大德行，确实是能唤醒千古聋聩的啊。
至于叔和说四时不正之气，感受了就成为疫。不知道非时令不为厉气，仅为寒疫。而大疫沿着门户、整个境界，传染相同的情况，确实是在兵荒马乱之后，尸体浑浊秽气，充斥道路，人在气交之中，感受它就生病。气没有什么不同，人病也一样。所以《月令》在孟春时节，掩埋骸骨整理骨头，不敢稍有落后，圣王早就考虑到这一点啊。不仅仅是恩泽惠及枯骨而已。后世治疗疫病的方法，没有定见。比如嘉言说上焦如雾，升举驱逐解毒；中焦如沤，疏泄驱逐解毒；下焦如渎，决泄驱逐解毒。等待营卫通畅后，乘势追拔，不要让它在未尽之时潜滋暗长。这固然是不易之论，然而要求它反复尽意，变态穷尽，老练的吴又可的话，并没有旁证依据。
我有幸生在明备的时代，不安于苟且，每日引导光明的宝藏，立志披开荆棘丛生的路途。辑录仲景《伤寒论》，三次注释《金匮要略》，在补注之余，先将温热暑疫四种证候，厘订经文，采集方论，不违背圣人法度，符合病情，各自成册。蒙藩宪丁夫子，因为在戊午年时疫盛行，怜悯百姓的疾苦，如同痛在自己身上。于是向下询问疫病从何开始，以及治疗的方法，悲伤叹息说：“唉！怎么能得到几十位明白这个道理的人，巡回救治，让那些在如火轮火树般痛苦、梦魇心迷的人，一下子提升到冰山雪宝般的清凉境界，何止是喝下醍醐而感到痛快呢？”命令急忙付梓刊刻，以公之于志同道合者。康熙己未年正月，吴门周扬俊禹载记。
The Way of medicine is indeed difficult. Among all diseases, Shanghan (Cold Damage) is the most severe, while Wenre (Warmth-Heat) is even more fierce. Shanghan typically occurs in a specific season, whereas Wenre, Shu (Summerheat), and Yi (Epidemic) diseases often manifest across three seasons. Because their duration is long, the number of patients increases. If one does not understand their origin, the flow cannot be clarified; if one does not distinguish their categories, treatment will not be appropriate. Thus, Wenre, Shu, and Yi are all Heat syndromes. It is like under a prairie fire, lacking even a drop of coolness. People regardless of ancient or modern times have similar natures, yet spirits immerse in the sages of old, with aspirations reaching towards perfection. With my meager insight, I seek illumination in stillness.
The sages of antiquity first valued complexion and pulse, determining life and death based on whether Ying (Nutritive Qi) had converged or not, concluding in a few words. The sages of the middle ages specifically discussed the flourishing and decline of Gu Qi (Grain Qi) to determine life and death, also concluding in a few words. Zhang Zhongjing was a sage of the later era; he established formula theories and supplemented the unfinished Zang-Fu organ theories, using the injury and extinction of the Bladder as a weft thread to determine life and death, aligning with previous methods without omission. However, in his *Treatise on Cold Damage*, Zhang Zhongjing described Wenre clearly, detailing formulas such as Huangqin Tang (Scutellaria Decoction) and Baihu Tang (White Tiger Decoction), which constituted his treatment method. Later scholars, if they could extend this meaning, could achieve infinite variations and divine wisdom over millennia. Yet, failing to carefully examine the principles, they stubbornly regarded these as methods for treating Shanghan. Why not consider that these formulas originally lack exterior-resolving efficacy and interior-purging power? What did the Sages intend by establishing these laws?
Since the Jin Dynasty, people have been suspicious and superstitious, remaining shallow and damp without end. For instance, Cui Wenxing explained Warmth-Heat by using Baizhu (Atractylodis Macrocephalae Rhizoma), Wutou (Aconiti Radix), Xixin (Asari Radix et Rhizoma), and Jiegeng (Platycodonis Radix), adding Fuzi (Aconiti Lateralis Radix Praeparata), named Laojun Shenming San (Old Lord's Divine Spirit Powder); adding Yinghuo (Lampyridis), it was named Wuchengzi Yinghuo Wan (Wuchengzi's Firefly Pill). Using hot herbs for heat conditions is like adding fuel to fire; who can discern the right from wrong? In Zhang Zhongjing's book, it states that Taiyang disease presenting with fever, aversion to cold absent, and thirst is called Wenbing (Warm Disease). Zhu Gong in *Huoren Shu* (Book of Living People) stated that fever, aversion to cold, headache, and body pain constitute Wenbing. This already contradicts the Sage's teachings. It further claims that macules and cough appearing in spring and autumn are Wenbing, and Fengwen (Wind-Warmth) is treated in the Shaoyin channel. His five formulas, such as Weirui Tang (Rehmannia Decoction), Zhimu Gegen Tang (Anemarrhenae and Puerariae Decoction), Fangji Tang (Stephaniae Decoction), Gualougen Tang (Trichosanthis Radix Decoction), and Gegen Longdan Tang (Puerariae and Gentianae Decoction), involve wind and fire blazing endlessly. He modified Shengsanzi, still using Fuzi, applying aromatic-dry herbs to both exterior and interior. Mr. Dongpo praised its efficacy when in Huangzhou. Little did he know that Zhu Gong changed the formula three times, using Baidu San (Deficiency-Toxin Powder) and avoiding hot herbs. Yet, how could his merit offset his fault? Wu Shi believed that complicated Shanghan encountering warmth becomes Wenbing. Jiegu Laoren (Old Man Jiegu) was a master of Shanghan; his son Yunqi considered Shanghan that failed to resolve after passing through meridians as Wenbing. They cited Shuhe's words as Zhongjing's text. Zhao Sizhen claimed Zhongjing said re-exposure to different pathogens changes the condition to Wenbing. Wang Ji claimed Zhongjing said encountering warm qi is Wenbing, and encountering warm heat is Wendu (Warm Toxin). They disregarded what was recorded in the Classics. Where was such a phrase?
Chao Yuanfang's *Zhubing Yuanhou Lun* followed Cui Wenxing's dispersal method: day one used massage ointment and moxibustion; day two used acupuncture and moxibustion to disperse; day three induced sweating again; day four used Licui Wan (Veratrum Pill) and Gouti San (Cucumeris Fructus Powder) to induce vomiting; days five and six used acupuncture if unresolved; day seven, if heat entered the stomach, used Egg Soup to purge. This led Pang Anchang to write *Weiyan*, prioritizing harmonization, regarding it as a spiritual treasure, where slight deviation causes collapse. Comparing Chao and Pang, the evil is extreme. Li Sixun also advocated harmonization; Wang Haicang praised him as unsurpassed in wisdom during the Song Dynasty's peak, but this comparison is inappropriate.
Danxi excelled in Warmth-Heat, skillfully using cooling herbs, allowing Warmth-Heat to naturally disperse upon encounter, though not necessarily due to precise moderation between them. Dongyuan was weak in external contractions but strong in internal injuries; he deduced the concepts of Winter-Warmth and Spring-Warmth from the *Neijing*, truly a great torch in the dark. Jiayan enthusiastically praised him, truly one who understood my heart first. When Liu Hejian's *Shanghan Zhige* discussed heat diseases with deep reasoning, it mixed them with standard Shanghan, leaving selection to the reader's eye, akin to gold dust mixed with mud. In the late Ming, Fang Zhongxing wrote *Shanghan Tiaobian*, arguably entering Zhongjing's hall directly and opening new grounds. Unfortunately, his discussion on Warmth-Heat divided Yin and Yang, suggesting heat herbs might be usable, thus becoming a model for Jiayan. Alas! Named Warmth-Heat, it naturally requires cold-cooling herbs, yet for thousands of years, debates raged, hesitating back and forth. High songs found few echoes in the Han court, while musical harmony prevailed in the Jin court. Indeed, because the lineage was unclear and comprehensive understanding was lacking, people became accustomed without noticing. Otherwise, why would masters deviate so blatantly from the Sage's rules?
Regarding Summerheat syndromes in summer, they are diseases of dampness steaming as described in *Jinkui Yaolue*. Jiegu and Dongyuan distinguished Yin and Yang by movement and stillness: dynamic acquisition is Yang, treated with Baihu Tang; static acquisition is Yin, treated with Dashun San (Great Smooth Powder) and Lengxiang Yinzi (Cool Fragrance Decoction). Who knew that in summer's blazing heat, there is Yang without Yin, and movement/stillness are not far apart? Only when excessive consumption of ice fruits/cold items or reckless sexual activity injures the Taiyin and Shaoyin channels should heat herbs be temporarily used. How can Warmth-Heat herbs be treated as universal remedies?
Lin Fuzi, the Canal Transport Commissioner of Beihai, was a great man and medical master. I stood in snow at his gate for study, receiving guidance for three to five years. He therefore provided me with his printed edition of Zhang Fengkui's *Treating Summerheat Book* from the Ming Dynasty, clarifying principles with precision. Though having minor flaws, it does not obscure its great virtue, truly awakening deafness and blindness for millennia.
Shuhe stated that abnormal Qi of the four seasons, when contracted, becomes Yi (Epidemic). He did not realize that non-seasonal Qi is not a lethal pathogen, only Cold Yi. Major epidemics spreading door-to-door and infecting entire regions occur after war and famine, where corpse filth fills roads. Humans in the Qi intersection contract illness; the Qi is no different, yet humans fall ill similarly. Hence, the *Monthly Ordinances* in early spring cover bones and arrange remains, fearing no delay, as Sage Kings foresaw this, not merely to benefit dead bones. Later methods for treating Yi lacked definitive views. For example, Jiayan stated: Upper Jiao is like mist, ascending to expel toxins; Middle Jiao is like fermentation, draining to expel toxins; Lower Jiao is like a drain, purging to expel toxins. Wait until Ying and Wei connect, then pursue extraction, preventing latent growth. This is an unchangeable theory, yet seeking thoroughness and variation, Old Wu Ke's words lack support.
Fortunately born in a bright era, unwilling to settle for mediocrity, I daily draw from the treasury of light, aiming to clear the thorny path. I compiled Zhongjing's *Shanghan Lun*, annotated *Jinkui* three times, and after supplementary notes, first sorted the scriptures for Warmth, Heat, Summerheat, and Yi syndromes, collecting formulas and theories, adhering to Sage methods and fitting clinical conditions, forming separate volumes. Thanks to Prefect Ding, who, witnessing the epidemic in the Wuwu year, pitied the people's suffering as if it were his own, inquired about the origin and treatment of the epidemic, sighing compassionately: "Alas! How can we get dozens of those who understand this principle to circulate and treat, placing those suffering in hellish heat and confusion into icy coolness, bringing relief beyond description?" He ordered urgent printing to share with colleagues.
Recorded by Zhou Yangjun Yuzai of Wumen, Zhengmonth of Jiwu Year, Kangxi Era.