一、《六元正纪大论》曰∶辰戌之岁，初之气，民厉温病。卯酉之岁，二之气，厉大至，民善暴死，终之气，其病
温。寅申之岁，初之气，温病乃起。丑未之岁，二之气，温厉大行，远近咸若。子午之岁，五之气，其病温。己亥之
岁，终之气，其病温厉。
叙气运，原温病之始也。每岁之温，有早暮微盛不等，司天在泉，主气客气，相加临而然也。细考《素问》注自知，
兹不多赘。按吴又可谓温
病非伤寒，温病多而伤寒少，甚通。谓非其时而有其气，未免有顾此失彼之诮。盖时和岁稔，天气以宁，民气以和，虽
当盛之岁亦微；至于凶荒兵
火之后，虽应微之岁亦盛，理数自然之道，无足怪者。
二、《阴阳应象大论》曰∶喜怒不节，寒暑过度，生乃不固。故重阴必阳，重阳必阴，故曰∶冬伤于寒，春必病温。
上节统言司天之病，此下专言人受病之故。
细考宋元以来诸名家，皆不知温病伤寒之辨。
如庞安常之《卒病论》，朱肱之《活人书》，韩HT 和之《微旨》，王氏之《证治》，刘守真之《伤
寒医鉴》、《伤寒直格》，张子和之《伤寒心镜》等书，非以治伤寒之法治温病，即将温暑认作伤寒，
而疑麻桂之法不可用，遂别立防风通圣、双解通圣、九味羌活等汤，甚至于辛温药中加苦寒，王安
道《溯洄集》中辨之最详，兹不再辩。论温病之最详者，莫过张景岳、吴又可、喻嘉言三家。时
医所宗者，三家为多，请略陈之∶按张景岳、喻嘉言皆着讲寒字，并未理会本文上有“故曰”二字，上文
有“重阴必阳、重阳必阴”二句，张氏立论出方，悉与伤寒混，谓温病即伤寒，袭前人之旧，全无实得，
固无足论。喻氏立论，虽有分析，中篇亦混入伤寒少阴、厥阴证，出方亦不能外辛温发表、辛热温里，
为害实甚。以苦心力学之士，尚不免智者千虑之失，尚何怪后人之无从取法，随手杀人哉！甚矣学
问之难也！吴又可实能识得寒温二字，所见之证，实无取乎辛温辛热甘温，又不明伏气为病之理，以
为何者为即病之伤寒，何者为不即病待春而发之温病，遂直断温热之原非风寒所中，不责己之不
明，反责经言之谬。瑭推原三子之偏，各自有说∶张氏混引经文，将论伤寒之文，引证温热，以伤寒
化热之后，经亦称热病故也，张氏不能分析，遂将温病认作伤寒。喻氏立论，开口言春温，当初春之
际，所见之病，多有寒证，遂将伤寒认作温病。吴氏当崇祯凶荒兵火之际，满眼温疫，遂直辟经文
“冬伤于寒、春必病温”之文。盖皆各执己见，不能融会贯通也。瑭按伏气为病，如春温、冬咳、温疟，
《内经》已明言之矣。亦有不因伏气，乃司天时令现行之气，如前列《六元正纪》所云是也。此二者，
皆理数之常者也。更有非其时而有其气，如又可所云戾气，间亦有之，乃其变也。惟在司命者善
查其常变而补救之。
三、《金匮真言论》曰∶夫精者身之本也，故藏于精者，春不病温。
《易》曰∶履霜坚冰至，圣人恒示戒于早，必谨
于微。记曰∶凡事豫则立。经曰∶上工不治已病治未病，圣人不治已乱治未乱。此一节当与月令参
看，与上条冬伤于寒互看，盖谓冬伤寒则春病温，惟藏精者足以避之。故《素问》首章《上古天真论》，
即言男女阴精之所以生，所以长，所以枯之理；次章紧接《四气调神大论》，示人春养生以为夏奉长
之地，夏养长以为秋奉收之地，秋养收以为冬奉藏之地，冬养藏以为春奉生之地。盖能藏精者一切
病患皆可却，岂独温病为然哉！《金匮》谓五脏元真通畅，人即安和是也。何喻氏不明此理，将冬伤
于寒作一大扇文本，将不藏精又作一大扇文本，将不藏精而伤于寒，又总作一大扇文本，勉强割裂
《伤寒论》原文以实之，未免有过虑则凿之弊。不藏精三字须活看，不专主房劳说，一切人事之能摇
动其精者皆是，即冬日天气应寒而阳不潜藏，如春日之发泄，甚至桃李反花之类亦是。
四、《热论篇》曰∶凡病伤寒而成温者，先夏至日者为病温；后夏至日者为病暑，暑当与汗出，勿止。
温者，暑之渐也。先夏至，春候也。春气温，阳气发越，阴精不足以承之，故为病温。后夏至，
温盛为热，热盛则湿动，热与湿搏而为暑也。勿者，禁止之词。勿止暑之汗，即治暑之法也。
五、《刺志论》曰∶气盛身寒，得之伤寒；气虚身热，得之伤暑。
此伤寒暑之辨也。经语分明如此，奈何世人悉以治寒法治温暑哉！
六、《生气通天论》曰∶因于暑，汗，烦则喘喝，静则多言。
暑中有火，性急而疏泄，故令人自汗。火与心同气相求，故善烦（烦从火从页，谓心气不宁，而面
若火烁也）。烦则喘喝者，火克金故喘，郁遏胸中清廓之气，故欲喝而呻之。其或邪不外张而内藏
于心，则静；心主言，暑邪在心，虽静亦欲自言不休也。
七、《论疾诊尺篇》曰∶尺肤热甚，脉盛躁者，病温也；其脉盛而滑者，病且出也。
此节以下，诊温病之法。
经之辨温病分明如是，何世人悉谓伤寒，而悉
以伤寒足三阴经温法治之哉！张景岳作《类经》，割裂经文，蒙混成章，由未细心 绎也。尺肤热
脉，火烁精也；脉盛躁，精被火煎沸也；脉盛而滑，邪机向外也。
八、《热病篇》曰∶热病三日，而气口静人迎躁者，取之诸阳
五十九刺，以泻其热而出其汗，实其阴以补其不足者。身热甚，阴阳皆静者，勿刺也；其可刺者，急取
之，不汗出则泄。所谓勿刺者，有死征也。热病七日八日动喘而弦者，急刺之，汗且自出，浅刺手大
指间。热病七日八日脉微小，病者溲血，口中干，一日半而死，脉代者一日死。热病已得汗出而脉
尚躁，喘，且复热，勿刺肤，喘甚者死。热病七日八日脉不躁，躁不散数，后三日中有汗，三日不汗四
日死；未曾汗者，勿腠刺之。
热病不知所痛，耳聋不能自收，口干，阳热甚，阴颇有寒者，热在骨髓，死不可治。
热病已得汗而脉尚躁盛，此阴脉之极也，死；
其得汗而脉静者，生。热病者，脉尚躁盛而不得汗
者，此阳脉之极也，死（阳脉之极，虽云死征，较前阴阳俱静有差，此证犹可大剂急急救阴，亦有活
者。盖已得汗而阳脉躁甚，邪强正弱，正尚能与邪争，若留得一分正气，便有一分生理，只在留之得
法耳。至阴阳俱静，邪气深入下焦阴分，正无捍邪之意，直听邪之所为，不死何待）。脉盛躁，得汗静者生。
热病不可刺者有九∶一曰汗不出，大颧发赤，
哕者死。二曰泄而腹满甚者死。三曰目不明，热不已者死。四曰老人婴儿，热而腹满者死。五
曰汗大出，呕。下血者死。六曰舌本烂，热不已者死。七曰咳而衄汗不出，出不至足者死。八曰
髓热者死。九曰热而痉者死，腰折、螈 、齿噤 也。凡此九者不可刺也。
太阳之脉色荣颧骨，热病也，与厥阴脉争见者，死期不过三日。
少阳之脉色荣颊前，热病也，与少阴脉争见者，死期不过三日。
此节历叙热病之死征，以禁人之刺，盖刺则必死也。然刺固不可，亦间有可药而愈者。盖刺法
能泄能通，开热邪之闭结最速，至于益阴以留阳，实刺法之所短，而汤药之所长也。
热病三日而气口静人迎躁者，邪机尚浅，在上
焦，故取之诸阳以泄其阳邪，阳气通则汗随之；实其阴以补其不足者，阳盛则阴衰，泻阳则阴得安其
位，故曰实其阴，泻阳之有余，即所以补阴之不足，故曰补其不足也（实其阴以补其不足，此一句，实
治温热之吃紧大纲。盖热病未有不耗阴者，其耗之未尽则生，尽则阳无留恋，必脱而死也。真能体
味此理，思过半矣。此论中治法，实从此处入手）。
身热甚而脉之阴阳皆静，脉证不应，阳证阴脉，故曰勿刺。
热病七、八日动喘而弦，喘为肺气实，弦为风
火鼓荡，故浅刺手大指间，以泄肺气，肺之热痹开则汗出。大指间，肺之少商穴也。
热证七、八日脉微小者，邪气深入下焦血分，逼血从小便出，故溲血，肾精告竭，阴液不得上潮，
故口中干；脉至微小，不惟阴精竭，阳气亦从而竭矣，死象自明。倘脉实者可治，法详于后。
热病已得汗，脉尚躁而喘，故知其复热也；热不为汗衰，火热克金故喘，金受火克，肺之化源欲
绝，故死。间有可治，法详于后。
热病不知所痛，正衰不与邪争也；耳聋，阴伤
精欲脱也；不能自收，真气惫也；口干热甚，阳邪独盛也；阴颇有寒，此寒字，作虚字讲，谓下焦阴分颇
有虚寒之证，以阴精亏损之人，真气败散之象已见，而邪热不退，未有不乘其空虚而入者，故曰热在骨髓，死不治也。
其有阴衰阳盛而真气未至溃败者，犹有治法，详见于后。
热病已得汗而脉尚躁盛，此阴虚之极，故曰死。然虽不可刺，犹可以药沃之得法，亦有生者，法详于后。
脉躁盛不得汗，此阳盛之极也。阳盛而至于极，阴无容留之地，故亦曰死。然用药开之得法，犹可生，法详于后。
汗不出而颧赤，邪盛不得解也；哕，脾阴病也。阴阳齐病，治阳碍阴，治阴碍阳，故曰死也。泄而
腹满甚，脾阴病重也，亦系阴阳皆病。目不明，精散而气脱也。经曰∶精散视岐，又曰气脱者目不
明。热犹未已，仍铄其精而伤其气，不死得乎！老人婴儿，一则孤阳已衰，一则稚阳未足，既得温热
之阳病，又加腹满之阴病，不必至于满甚，而已有死道焉。汗不出为邪阳盛，呕为正阳衰；下血者，
热邪深入不得外出，必逼迫阴络之血下注，亦为阴阳两伤也。舌本烂，肾脉胆脉心脉皆循喉咙系舌
本，阳邪深入，则一阴一阳之火结于血分，肾水不得上济，热退犹可生，热仍不止，故曰死也。咳而
衄，邪闭肺络，上行清道，汗出邪泄可生，不然则化源绝矣。髓热者，邪入至深至于肾部也。热而痉，
邪入至深至于肝部也。以上九条，虽皆不可刺，后文亦间立治法，亦有可生者。太阳之脉色荣颧骨
为热病者，按手太阳之脉，由目内 斜络于颧，而与足太阳交，是颧者两太阳交处也，太阳属水，
水受火沸，故色荣赤为热病也；与厥阴脉争见，厥阴，木也，水受火之反克，金不来生木反生火，水无
容足之地，故死速也。少阳之脉色荣颊前为热病者，按手少阳之脉，出耳前，过客主人前（足少阳
穴），交颊至目锐 而交足少阳，是颊前两少阳交处也，少阳属相火，火色现于二经交会之处，故为
热病也；与少阴脉争见，少阴属君火，二火相炽，水难为受，故亦不出三日而死也。
九、《评热病论》∶帝曰∶有病温者，汗出辄复热，而脉躁疾，不为汗衰，狂言不能食，病名为何？岐伯曰∶病名
阴阳交，交者死也。
人所以汗出者，皆生于谷，谷生于精。今邪气
交争于骨肉而得汗者，是邪却而精胜也。精胜则当能食而不复热。复热者，邪气也，汗者，精气也。
今汗出而辄复热者，邪气胜也；不能食者，精无俾也；病而留者，其寿可立而倾也。且夫《热论》曰∶
汗出而脉尚躁盛者死。今脉不与汗相应，此不胜其病也，其死明矣。狂言者，是失志，失志者死。
今见三死，不见一生，虽愈必死也。
此节语意自明，经谓必死之证，谁敢谓生，然药之得法，有可生之理，前所谓针药各异用也，详见后。
十、《刺热篇》曰∶肝热病者，小便先黄，腹痛多卧，身热。热争则狂言及惊，胁满痛，手足躁，不
得安卧，庚辛甚，甲乙大汗，气逆则庚辛日死。刺足厥阴、少阳，其逆则头痛员员脉引冲头也。
肝病小便先黄者，肝脉络阴器；又肝主疏泄。
肝病则失其疏泄之职，故小便先黄也。腹痛多卧，木病克脾土也。热争，邪热甚而与正气相争也。
狂言及惊，手厥阴心包病也，两厥阴同气，热争，则手厥阴亦病也。胁满痛，肝脉行身之两旁，胁其要
路也。手足躁不得安卧，肝主风，风淫四末，又木病克土，脾主四肢，木病热，必吸少阴肾中真阴，阴
伤，故骚扰不得安卧也。庚辛金日克木，故甚。甲乙肝木旺时，故汗出而愈。气逆谓病重而不顺其
可愈之理，故逢其不胜之日而死也。刺足厥阴、少阳，厥阴系本脏，少阳，厥阴之腑也，并刺之者，
病在脏，泻其腑也。逆则头痛以下，肝主升，病极而上升之故。
自庚辛日甚以下之理，余脏仿此。
十一、心热病者，先不乐，数日乃热。热争则
卒心痛，烦闷善呕，头痛面赤无汗；壬癸甚，丙丁大汗，气逆则壬癸死。刺手少阴、太阳。
心病先不乐者，心包名膻中，居心下代君用事，经谓膻中为臣使之官，喜乐出焉，心病故不乐
也。卒心痛，凡实痛，皆邪正相争，热争，故卒然心痛也。烦闷，心主火，故烦，膻中气不舒，故闷。
呕，肝病也，两厥阴同气，膻中代心受病，故热甚而争之后，肝病亦见也，且邪居膈上，多善呕也。头
痛，火升也。面赤，火色也。无汗，汗为心液，心病故汗不得通也。
十二、脾热病者，先头重，颊痛，烦心，颜青，欲呕，身热；热争则腰痛，不可用俯仰，腹满泄，两
一、《六元正纪大论》中说：在辰年和戌年，初之气阶段，民众容易流行温热病。在卯年和酉年，二之气阶段，瘟疫严重爆发，民众容易突然死亡；到了终之气阶段，疾病表现为温热病。在寅年和申年，初之气阶段，温热病开始兴起。在丑年和未年，二之气阶段，温热瘟疫广泛流行，无论远近地区都一样。在子年和午年，五之气阶段，疾病表现为温热病。在己年和亥年，终之气阶段，疾病表现为温热瘟疫。
叙述五运六气，是为了探究温热病的起源。每年的温热病，有发生早晚、病情轻重不同的情况，这是由司天（主管上半年气候的客气）、在泉（主管下半年气候的客气）、主气（每年固定不变的气候规律）和客气（逐年变化的气候规律）相互叠加影响所致。仔细考证《素问》的注释自然明白，这里不再多赘述。按照吴又可的观点，认为温热病不是伤寒，温热病多见而伤寒少见，这非常通达。但他认为“非其时而有其气”（不在该出现的时候却出现了相应的气候），未免有顾此失彼的指责。大概如果气候调和、年成丰收，天气安宁，民众气息平和，即使在应该盛行的年份，病情也轻微；至于在凶年饥荒、战争兵火之后，即使在应该轻微的年份，病情也会盛行，这是理数和自然的道理，不足为怪。
二、《阴阳应象大论》中说：喜怒没有节制，寒暑过度，生命就不稳固。所以重阴必转化为阳，重阳必转化为阴，所以说：冬天感受了寒邪，春天必定发生温热病。
上一节总述司天导致的疾病，这一节以下专门论述人受病的原因。
仔细考察宋元以来各位名家，都不知道温热病与伤寒的区别。
比如庞安常的《卒病论》，朱肱的《活人书》，韩祗和的《微旨》，王履的《证治》，刘完素的《伤寒医鉴》、《伤寒直格》，张从正的《伤寒心镜》等书籍，不是用治疗伤寒的方法来治疗温热病，就是将温病、暑病认作伤寒。他们怀疑麻黄汤、桂枝汤的方法不可用，于是另外创立防风通圣散、双解通圣散、九味羌活汤等方剂，甚至在辛温药物中加入苦寒药。王安道在《溯洄集》中辨析得最详细，这里不再辩论。论述温热病最详细的，莫过于张景岳、吴又可、喻嘉言三家。当时医生所尊崇的，以这三家为多，请简要陈述一下：按张景岳、喻嘉言都着重讲解“寒”字，并没有理会原文上有“故曰”二字，上文有“重阴必阳、重阳必阴”两句。张氏确立理论和处方，完全与伤寒混淆，认为温热病就是伤寒，沿袭前人的旧说，完全没有实际心得，本来不值得讨论。喻氏确立理论，虽然有分析，但中间篇章也混入伤寒少阴、厥阴证，开出的方剂也不能脱离辛温发表、辛热温里的范畴，危害实在很大。以苦心力学的人士，尚且不免智者千虑的一失，又何况后人无法取法，随手杀人呢！学问之难啊！吴又可确实能识别“寒”和“温”两个字，他所见到的病症，确实不需要使用辛温、辛热、甘温的药物，但他不明白伏气致病（邪气潜伏体内随后发病）的道理，不知道什么是不即时发病的伤寒，什么是潜伏到春天才发作的温热病，于是直接断定温热的根源并非风寒侵袭，不责怪自己不明理，反而责怪经典言论的错误。我推究这三人偏颇之处，各自都有说法：张氏混淆引用经文，将论述伤寒的文字，引用来证明温热病，因为伤寒化热之后，经典也称其为热病，张氏不能分析，于是将温热病认作伤寒。喻氏确立理论，开口就说春温，在初春之际，所见到的病症，多有寒证，于是将伤寒认作温热病。吴氏处于崇祯年间凶荒兵火的时期，满眼都是温热瘟疫，于是直接批判经文“冬伤于寒、春必病温”的说法。大概都是各执己见，不能融会贯通。我按：伏气致病，如春温、冬咳、温疟，《内经》已经明确说明了。也有不因伏气，而是司天时令现行之气，如前面所列《六元正纪》所说的那样。这两者，都是理数的常态。更有不在该出现的时候却出现相应气候的情况，如吴又可所说的戾气，偶尔也有，这是变异。只有掌管生命的医生善于查考常态与变异并加以补救。
三、《金匮真言论》中说：精是身体的根本，所以藏精的人，春天不会患温热病。
《易经》说：踩到霜就知道坚冰快要来了，圣人经常在早期示警，必须在细微处谨慎。《礼记》说：凡事预先准备就能成功。经典说：高明的医生不治疗已发生的病，而是治疗未发生的病；圣人治理已发生的混乱，而是治理未发生的混乱。这一节应当与《月令》参看，与上一条“冬伤于寒”互看，大概是说冬天感受寒邪则春天患温热病，只有藏精的人足以避免它。所以《素问》首章《上古天真论》，就讲男女阴精之所以产生、生长、枯竭的道理；第二章紧接着《四气调神大论》，教导人们春季养生以为夏季奉养生长提供基础，夏季养长以为秋季奉养收敛提供基础，秋季养收以为冬季奉养闭藏提供基础，冬季养藏以为春季奉养生发提供基础。大概能藏精的人，一切病患都可以排除，难道只有温热病是这样吗！《金匮》说五脏元真通畅，人就能安康，就是这个意思。为什么喻氏不明白这个道理，将“冬伤于寒”看作一大段文本，将“不藏精”又看作一大段文本，将“不藏精而伤于寒”又总括为一大段文本，勉强割裂《伤寒论》原文来证实它，未免有过分忧虑而导致穿凿附会的弊病。“不藏精”三个字必须灵活看待，不专指房劳，一切人事中能动摇其精的因素都是，即使冬日天气应该寒冷而阳气不潜藏，像春日一样发泄，甚至桃李反季开花之类也是。
四、《热论篇》中说：凡是患伤寒而变成温热病的，先夏至日发生的称为病温；后夏至日发生的称为病暑，暑病应当让汗出，不要止住汗。
温，是暑的渐进过程。先夏至，是春季的气候特征。春气温和，阳气发散，阴精不足以承受，所以生病温。后夏至，温热极盛变为热，热盛则湿气动，热与湿搏结就成为暑。“勿”是禁止的词。不要止住暑病的汗，就是治疗暑病的方法。
五、《刺志论》中说：气盛身寒，是得了伤寒；气虚身热，是得了伤暑。
这是区分伤寒和暑病。经典语意如此分明，为何世人全用治疗寒病的方法治疗温热暑病呢！
六、《生气通天论》中说：感受暑邪，出汗，心烦则气喘呼叫，安静则多说话。
暑中有火，性质急躁且疏泄，所以让人自汗。火与心同气相求，所以容易心烦（烦字从火从页，指心气不宁，面色如火烧）。心烦则气喘呼叫，是因为火克金所以喘，郁遏胸中清廓之气，所以想呼叫呻吟。或者邪气不外张而内藏于心，则表现为静；心主言语，暑邪在心，即使安静也想自言自语不停。
七、《论疾诊尺篇》中说：尺部皮肤很热，脉象盛大躁动的，是病温；脉象盛大而滑利的，病邪将要外出。
这一节以下是诊断温热病的方法。
经典辨别温热病如此分明，为何世人全说是伤寒，全用治疗伤寒足三阴经温热病的方法呢！张景岳作《类经》，割裂经文，蒙混成章，是因为没有细心推演。尺肤热脉，是火灼伤精液；脉盛躁，是精被火煎沸；脉盛而滑，是病邪机转向外。
八、《热病篇》中说：热病三天，寸口脉平静而人迎脉躁动的，取诸阳经的五十九穴进行针刺，以泻其热而出其汗，充实其阴以补其不足。身体热甚，阴阳脉都平静的，不要针刺；可以针刺的，急取之，不出汗则用泻法。所谓不要针刺，是有死征。热病七天八天，气喘而脉弦的，急刺之，汗将会自出，浅刺手大拇指间。热病七天八天，脉微小，病人尿血，口中干，一天半会死，脉代则一天死。热病已经出汗而脉还躁动，气喘，并且复发热，不要刺皮肤，喘严重的会死。热病七天八天，脉不躁动，躁动但不散漫数急，后三天中有汗，三天无汗第四天死；未曾出汗的，不要刺腠理。
热病不知疼痛，耳聋不能自主收摄，口干，阳热很盛，阴分颇有寒象的，热在骨髓，死不可治。
热病已经出汗而脉还躁盛，这是阴脉的极端，死；
如果出汗而脉静的，生。热病患者，脉还躁盛而不得汗的，这是阳脉的极端，死（阳脉的极端，虽然说是死征，比前文阴阳俱静稍有差别，此证还可以用大剂量急急救阴，也有活的。大概已经出汗而阳脉躁甚，邪气强正气弱，正气尚能与邪气抗争，只要留住一分正气，便有一分生机，只在留之得法而已。至于阴阳俱静，邪气深入下焦阴分，正气没有抵御邪气的意愿，任由邪气所为，不死等什么）。脉盛躁，出汗后变静的生。
热病不可针刺的有九种：一曰不出汗，两颧发赤，呃逆的会死。二曰腹泻而腹部胀满严重的会死。三曰眼睛看不清，热不退的会死。四曰老人婴儿，发热而腹部胀满的会死。五曰大汗出，呕吐，下血的会死。六曰舌根腐烂，热不退的会死。七曰咳嗽兼鼻衄，无汗，有汗不到足的会死。八曰髓热的会死。九曰发热而痉挛的会死，腰背反折、抽搐、牙关紧闭。凡这九种不可针刺。
太阳经脉色泽反映在颧骨，是热病，与厥阴脉同时出现的，死期不超过三天。
少阳经脉色泽反映在颊前，是热病，与少阴脉同时出现的，死期不超过三天。
这一节列举叙述热病的死征，以禁止人针刺，大概针刺必然致死。然而针刺固然不可，也偶尔有用药而愈的。大概刺法能泄能通，开通热邪闭结最快，至于益阴以留阳，是刺法的短处，而汤药的长处。
热病三天而寸口脉平静人迎脉躁动的，邪气机转尚浅，在上焦，所以取诸阳经以泄其阳邪，阳气通则汗随之；充实其阴以补其不足的，阳盛则阴衰，泻阳则阴得以安其位，所以叫充实其阴，泻阳之有余，就是补阴之不足，所以叫补其不足（充实其阴以补其不足，这一句，实际上是治疗温热的关键大纲。大概热病没有不耗伤阴液的，耗伤未尽则生，耗尽则阳无所留恋，必脱而死。真正能体味此理，思过半矣。此论中的治法，实际上从此处入手）。
身体热甚而脉之阴阳皆静，脉证不应，阳证阴脉，所以说不针刺。
热病七、八天动喘而脉弦，喘为肺气实，弦为风火鼓荡，所以浅刺手大拇指间，以泄肺气，肺之热痹开则汗出。大拇指间，是肺之少商穴。
热证七、八天脉微小的，邪气深入下焦血分，逼血从小便出，所以尿血，肾精告竭，阴液不得上潮，所以口中干；脉至微小，不仅阴精竭，阳气也随之竭矣，死象自然明显。如果脉实的可治，方法详见后文。
热病已经出汗，脉还躁而喘，所以知道它会复热；热不为汗衰减，火热克金所以喘，金受火克，肺之化源欲绝，所以死。间有可治，方法详见后文。
热病不知疼痛，是正气衰不与邪气抗争；耳聋，是阴伤精欲脱；不能自收，是真气疲惫；口干热甚，是阳邪独盛；阴颇有寒，这个“寒”字，作“虚”字讲，谓下焦阴分颇有虚寒之证，以阴精亏损之人，真气败散之象已见，而邪热不退，没有不乘其空虚而入的，所以说热在骨髓，死不治。如果有阴衰阳盛而真气未至溃败的，还有治法，详见后文。
热病已经出汗而脉还躁盛，这是阴虚之极，所以说死。然而虽不可针刺，犹可以用药浇灌得法，也有生的，方法详见后文。
脉躁盛不得汗，这是阳盛之极。阳盛而至于极，阴无容留之地，所以也说死。然而用药开之得法，犹可生，方法详见后文。
不出汗而颧赤，邪盛不得解；呃逆，是脾阴病。阴阳齐病，治阳碍阴，治阴碍阳，所以说死。腹泻而腹满甚，脾阴病重，也是阴阳皆病。眼睛看不清，是精散而气脱。经典说：精散视岐，又说气脱者目不明。热犹未已，仍灼伤其精而伤其气，不死得乎！老人婴儿，一则孤阳已衰，一则稚阳未足，既得温热之阳病，又加腹满之阴病，不必至于满甚，而已有死路。汗不出为邪阳盛，呕为正阳衰；下血者，热邪深入不得外出，必逼迫阴络之血下注，也是阴阳两伤。舌根烂，肾脉胆脉心脉都循喉咙系舌本，阳邪深入，则一阴一阳之火结于血分，肾水不得上济，热退犹可生，热仍不止，所以说死。咳嗽而鼻衄，邪闭肺络，上行清道，汗出邪泄可生，不然则化源绝。髓热者，邪入至深至于肾部。热而痉，邪入至深至于肝部。以上九条，虽皆不可刺，后文也间立治法，也有可生的。太阳之脉色泽反映在颧骨为热病者，按手太阳之脉，由目内眦斜络于颧，而与足太阳交，是颧者两太阳交处也，太阳属水，水受火沸，所以色泽反映赤色为热病；与厥阴脉争见，厥阴，木也，水受火之反克，金不来生木反生火，水无容足之地，所以死速。少阳之脉色泽反映在颊前为热病者，按手少阳之脉，出耳前，过客主人前（足少阳穴），交颊至目锐眦而交足少阳，是颊前两少阳交处也，少阳属相火，火色现于二经交会之处，所以为热病；与少阴脉争见，少阴属君火，二火相炽，水难为受，所以也不出三日而死。
九、《评热病论》：黄帝说：有病温热的人，出汗随即又发热，而且脉象躁疾，不因出汗而衰减，胡言乱语不能进食，病名是什么？岐伯说：病名阴阳交，交的，会死。
人之所以出汗，都源于谷气，谷气生于精气。现在邪气交争于骨肉而得到汗的，是邪气退却而精气胜。精气胜则应当能食而不复发热。复发的热，是邪气；汗，是精气。
现在出汗而随即又发热的，是邪气胜；不能食的，是精气无补给；病而停留的，他的寿命可以立刻倾覆。况且《热论》说：出汗而脉还躁盛的会死。现在脉不与汗相应，这是不胜其病，其死很明显。胡言乱语的，是失志，失志的会死。
现在见三死，不见一生，即使痊愈也必死。
这一节语意自然明白，经典说必死的证，谁敢说能生，然而用药得法，有可生的道理，前文所谓针药各异用，详见后文。
十、《刺热篇》说：肝热病的人，小便先黄，腹痛多卧，身热。热争则胡言乱语及惊骇，胁满痛，手足躁，不得安卧，庚辛日加重，甲乙日大汗，气逆则庚辛日死。刺足厥阴、少阳经，气逆则头痛头晕脉引冲头。
肝病小便先黄的，肝脉络阴器；又肝主疏泄。
肝病则失其疏泄之职，所以小便先黄。腹痛多卧，是木病克脾土。热争，是邪热甚而与正气相争。
胡言乱语及惊骇，是手厥阴心包病，两厥阴同气，热争，则手厥阴亦病。胁满痛，肝脉行身之两旁，胁是其要路。手足躁不得安卧，肝主风，风淫四末，又木病克土，脾主四肢，木病热，必吸少阴肾中真阴，阴伤，所以骚扰不得安卧。庚辛金日克木，所以加重。甲乙肝木旺时，所以汗出而愈。气逆谓病重而不顺其可愈之理，所以逢其不胜之日而死。刺足厥阴、少阳，厥阴系本脏，少阳，厥阴之腑也，并刺之者，病在脏，泻其腑。逆则头痛以下，肝主升，病极而上升之故。
自庚辛日加重以下的道理，其余脏腑仿照此例。
十一、心热病的人，先不快乐，数日后才发热。热争则猝然心痛，烦闷善呕，头痛面赤无汗；壬癸日加重，丙丁日大汗，气逆则壬癸日死。刺手少阴、太阳经。
心病先不快乐的，心包名膻中，居心下代君用事，经典谓膻中为臣使之官，喜乐出焉，心病故不乐。
猝然心痛，凡实痛，皆邪正相争，热争，所以猝然心痛。烦闷，心主火，所以烦，膻中气不舒，所以闷。
呕，是肝病，两厥阴同气，膻中代心受病，所以热甚而争之后，肝病也见，且邪居膈上，多善呕。头痛，是火升。面赤，是火色。无汗，汗为心液，心病故汗不得通。
十二、脾热病的人，先头重，颊痛，烦心，颜青，欲呕，身热；热争则腰痛，不可用俯仰，腹满泄，两
1. The *Da Lun of the Six Origins and Correct Records* (Liuyuan Zhengji Dalun) states: In years of Chen and Xu, during the first Qi phase, people are prone to epidemic warm diseases. In years of Mao and You, during the second Qi phase, severe epidemics occur, and people may die suddenly; by the final Qi phase, the disease manifests as warm disease. In years of Yin and Shen, during the first Qi phase, warm diseases begin to arise. In years of Chou and Wei, during the second Qi phase, warm febrile epidemics spread widely, affecting both distant and nearby areas equally. In years of Zi and Wu, during the fifth Qi phase, the disease manifests as warm disease. In years of Ji and Hai, during the final Qi phase, the disease manifests as warm febrile epidemics.
Discussing the Five Movements and Six Qi (Wu Yun Liu Qi) is to investigate the origin of warm diseases. The warmth of each year varies in onset time and severity, resulting from the interaction of Si Tian (Guest Qi governing the first half of the year), Zai Quan (Guest Qi governing the second half of the year), Zhu Qi (Fixed Qi representing the constant seasonal climate pattern), and Ke Qi (Variable Guest Qi changing annually). This can be understood by carefully studying the commentaries on the *Su Wen* (Basic Questions); thus, no further elaboration is needed here. According to Wu Youke, warm diseases are not cold damage (Shanghan); warm diseases are more common than cold damage, which is a very insightful view. However, his claim that "having the qi of one season at the wrong time" invites criticism for being inconsistent. Generally, when the climate is harmonious and the harvest is abundant, the heavenly qi is peaceful, and the people's qi is balanced; even in years where outbreaks should be severe, they remain mild. Conversely, after years of famine, war, or fire, even in years where outbreaks should be mild, they become severe. This follows the natural laws of reason and numbers, and there is nothing strange about it.
2. The *Da Lun of Yin and Yang Correspondence to Phenomena* (Yinyang Yingxiang Dalun) states: Unregulated joy and anger, and excessive exposure to cold and heat, make life unstable. Therefore, extreme Yin transforms into Yang, and extreme Yang transforms into Yin. Thus it is said: If one is injured by cold in winter, one will surely suffer from warm disease in spring.
The previous section generally discussed diseases caused by Si Tian Qi; this section below specifically discusses the causes of human illness.
Carefully examining the works of various masters since the Song and Yuan dynasties, none distinguished clearly between warm diseases and cold damage. For example, Pang Anchang’s *Zu Bing Lun*, Zhu Gong’s *Huo Ren Shu*, Han Zhihe’s *Wei Zhi*, Wang Lu’s *Zheng Zhi*, Liu Wansu’s *Shanghan Yijian* and *Shanghan Zhige*, and Zhang Congzheng’s *Shanghan Xinjing* either used methods for treating cold damage to treat warm diseases, or mistook warm and summer-heat diseases for cold damage. Suspecting that the methods of Mahuang Tang (Ephedra Decoction) and Guizhi Tang (Cinnamon Twig Decoction) were unusable, they established new formulas such as Fangfeng Tongsheng San (Saposhnikovia Powder for Universal Relief), Shuangjie Tongsheng San (Double-Resolution Powder for Universal Relief), and Jiuwei Qianghuo Tang (Nine-Ingredient Notopterygium Decoction), even adding bitter-cold herbs to acrid-warm ones. Wang Andao辨析ed this most thoroughly in his *Suhui Ji*; I will not debate it here. Regarding the most detailed discussions on warm diseases, none surpasses the three families: Zhang Jingyue, Wu Youke, and Yu Jiayan. Among contemporary physicians, these three are most revered. Let me briefly state their views: Zhang Jingyue and Yu Jiayan focused heavily on the character "cold," ignoring the phrase "thus it is said" and the preceding lines "extreme Yin transforms into Yang, extreme Yang transforms into Yin." Zhang’s theories and prescriptions completely conflated warm diseases with cold damage, claiming warm disease is cold damage, following old precedents without genuine insight, which is hardly worth discussing. Yu’s theory, while analytical, mixed in Shaoyin and Jueyin syndromes of cold damage in the middle sections, and his prescriptions relied on acrid-warm exterior-releasing and acrid-hot interior-warming methods, causing significant harm. Even diligent scholars are prone to occasional errors; how can we blame later generations for lacking guidance and inadvertently causing death? Learning is indeed difficult! Wu Youke truly distinguished between "cold" and "warm." His observed cases did not require acrid-warm, acrid-hot, or sweet-warm drugs. However, he did not understand the principle of latent pathogenic qi (Fuqi) causing disease. He failed to distinguish between immediate-onset cold damage and latent pathogens manifesting as warm disease in spring. Consequently, he directly asserted that the origin of warm-heat was not due to wind-cold invasion. Instead of blaming his own lack of understanding, he blamed the classics. I trace the biases of these three: Zhang confusedly cited texts on cold damage to prove warm-heat, because after cold damage transforms into heat, the classics also call it "heat disease." Unable to analyze, Zhang mistook warm disease for cold damage. Yu opened with "spring warm disease"; in early spring, many observed cases had cold symptoms, so he mistook cold damage for warm disease. Wu lived during the chaotic times of famine and war under the Chongzhen Emperor, seeing only warm epidemics, so he directly refuted the classic text "injured by cold in winter, warm disease in spring." They all held their own views without integrating them comprehensively. I note that latent pathogenic qi causing disease, such as spring warm disease, winter cough, and warm malaria, is clearly stated in the *Neijing*. There are also cases not due to latent qi but due to the prevailing Qi of the Si Tian season, as mentioned in the *Liuyuan Zhengji*. These two are normal patterns of reason and numbers. Additionally, there are cases of "wrong season having its qi," such as the Liqi (pestilential qi) described by Wu Youke, which are variations. Only physicians skilled in distinguishing normal from abnormal patterns can remedy them appropriately.
3. The *Zhenyan Lun of the Golden Casket* (Jingui Zhenyan Lun) states: Essence is the root of the body; therefore, those who preserve their essence will not suffer from warm disease in spring.
The *I Ching* (Book of Changes) says: Treading on frost, one knows solid ice is coming. Sages warn early and are cautious in details. The *Liji* (Book of Rites) says: Preparation ensures success. The classics say: The superior physician treats disease before it arises; the sage governs chaos before it occurs. This section should be read alongside the *Yueling* (Monthly Ordinances) and cross-referenced with the previous point on "winter cold injury." It implies that winter cold leads to spring warm disease, but those who preserve essence can avoid it. Thus, the first chapter of the *Su Wen*, *Shanggu Tianzhen Lun* (Discourse on Heavenly Truth in Antiquity), explains the generation, growth, and depletion of yin essence in men and women. The second chapter, *Siqi Tiaoshen Dalun* (Great Discourse on Regulating Spirit with the Four Qi), teaches spring nourishment to support summer growth, summer growth to support autumn harvesting, autumn harvesting to support winter storage, and winter storage to support spring generation. Those who preserve essence can ward off all illnesses, not just warm disease. The *Jingui* states that when the primordial true qi of the five zang organs flows freely, the person is healthy. Why did Yu fail to understand this? He treated "winter cold injury" as one large text, "not preserving essence" as another, and "not preserving essence while injured by cold" as a third, forcibly fragmenting the original text of *Shanghan Lun* to fit his theory, falling into the trap of over-anxiety leading to forced interpretations. The phrase "not preserving essence" must be interpreted flexibly; it does not refer solely to sexual excess. Any human activity that disturbs essence counts. Even if winter weather should be cold but yang qi fails to hide and instead disperses like spring, causing peach and plum trees to bloom out of season, this also constitutes failing to preserve essence.
4. The *Relun Pian* (Chapter on Heat Discussion) states: For those who contract cold damage and develop warm disease, those occurring before the Summer Solstice are called warm disease; those after are called summer-heat disease. Summer-heat should be treated by allowing sweat to flow; do not stop it.
Warm is the gradual development of summer-heat. Before the Summer Solstice corresponds to spring conditions. Spring warmth allows yang qi to disperse; if yin essence is insufficient to support it, warm disease results. After the Summer Solstice, warmth intensifies into heat; intense heat moves dampness, and the struggle between heat and dampness creates summer-heat. "Wu" (do not) is a prohibitive term. Not stopping the sweat of summer-heat disease is the treatment method for summer-heat.
5. The *Cizhi Lun* (Discourse on Acupuncture and Vital Qi) states: Abundant qi with cold body indicates cold damage; deficient qi with hot body indicates summer-heat injury.
This distinguishes cold damage from summer-heat. The classic language is clear; why do people today use cold-damage methods for warm and summer-heat diseases?
6. The *Shengqi Tongtian Lun* (Discourse on Sheng Qi Connecting to Heaven) states: Due to summer-heat, there is sweating; if vexed, there is panting and shouting; if quiet, there is excessive talking.
Summer-heat contains fire, which is urgent and dispersing, causing spontaneous sweating. Fire shares the same qi as the Heart, leading to vexation (the character 'fan' 烦 contains 'fire' and 'head', indicating heart-mind unrest and a face burning like fire). Vexation leads to panting and shouting because fire controls metal (Lung), causing panting, and stagnates the clear qi in the chest, prompting shouting and groaning. If the pathogen does not manifest outwardly but hides in the Heart, the patient appears quiet; since the Heart governs speech, summer-heat in the Heart causes incessant self-talk even when quiet.
7. The *Lun Ji Zhenchi Pian* (Chapter on Discussing Diseases and Diagnosing by Arm Skin) states: If the skin of the forearm is very hot and the pulse is rapid and restless, it is warm disease; if the pulse is rapid and slippery, the pathogen is about to exit.
This section onwards describes methods for diagnosing warm disease.
The classics distinguish warm disease so clearly; why do people today insist it is cold damage and use methods for warm disease of the three foot-yin meridians of cold damage? Zhang Jingyue’s *Leijing* fragmented the classic text and confused the chapters due to lack of careful analysis. Hot forearm skin and pulse indicate fire scorching essence; rapid and restless pulse indicates essence boiling from fire; rapid and slippery pulse indicates the pathogen turning outward.
8. The *Rebing Pian* (Chapter on Febrile Disease) states: On the third day of febrile disease, if the Cun Kou pulse is calm and the Ren Ying pulse is restless, needle the fifty-nine points of the Yang meridians to drain heat and induce sweat, tonify Yin to supplement deficiency. If body heat is high but both Yin and Yang pulses are calm, do not needle; if needling is possible, act quickly—if no sweat, use draining methods. "Do not needle" indicates signs of death. On the seventh or eighth day, if there is wheezing and a wiry pulse, needle urgently; sweat will appear spontaneously, needle shallowly at the web between the thumb and index finger. On the seventh or eighth day, if the pulse is minute and small, and the patient has hematuria and dry mouth, death occurs within a day and a half; if the pulse is intermittent, death occurs in one day. If sweat has occurred but the pulse remains restless, with panting and recurrent fever, do not needle the skin; severe panting indicates death. On the seventh or eighth day, if the pulse is not restless, or restless but not scattered and rapid, sweat within three days; if no sweat after three days, death on the fourth day; if no sweat has occurred, do not needle the cou-li (interstices).
If febrile disease involves loss of pain sensation, deafness, inability to control limbs, dry mouth, extreme yang heat, and apparent yin cold, the heat is in the marrow; this is incurable and fatal.
If sweat has occurred but the pulse remains rapid and full, this is the extreme of yin pulse; fatal. If sweat occurs and the pulse becomes calm, survival is possible. If the pulse remains rapid and full without sweat, this is the extreme of yang pulse; fatal (Although extreme yang pulse is a sign of death, it differs slightly from simultaneous yin-yang stillness. This condition can sometimes be saved by massive doses urgently tonifying yin. Since sweat has occurred but yang pulse is extremely restless, the pathogen is strong and righteous qi weak, but righteous qi still struggles. Retaining even a bit of righteous qi preserves life, provided the method is correct. However, if yin and yang are both still, the pathogen has deeply entered the lower jiao yin aspect, and righteous qi has no will to resist, leaving fate to the pathogen; death is inevitable). If the pulse is rapid and restless but becomes calm after sweating, survival is possible.
There are nine types of febrile disease unsuitable for needling: 1. No sweat, red malar flush, and hiccups indicate death. 2. Diarrhea with severe abdominal distension indicates death. 3. Blurred vision with persistent fever indicates death. 4. Elderly and infants with fever and abdominal distension indicate death. 5. Profuse sweating, vomiting, and hematochezia indicate death. 6. Ulceration of the tongue base with persistent fever indicates death. 7. Cough with epistaxis, no sweat, or sweat not reaching the feet indicate death. 8. Marrow heat indicates death. 9. Fever with spasms (opisthotonos, convulsions, trismus) indicates death. None of these nine should be needled.
If the Taiyang meridian color reflects on the cheekbones, it is febrile disease; if seen simultaneously with Jueyin meridian signs, death occurs within three days.
If the Shaoyang meridian color reflects on the cheeks, it is febrile disease; if seen simultaneously with Shaoyin meridian signs, death occurs within three days.
This section lists signs of death in febrile disease to prohibit needling, as needling would likely cause death. Although needling is contraindicated, some cases may recover with herbal medicine. Needling drains and unblocks, opening heat-pathogen closure quickly, but tonifying yin to retain yang is its weakness, whereas decoctions excel in this regard.
On the third day, if Cun Kou is calm and Ren Ying is restless, the pathogen is shallow and in the upper jiao; thus, needling Yang meridians drains yang pathogen. When yang qi flows, sweat follows. Tonifying yin supplements deficiency because yang excess leads to yin deficiency; draining yang allows yin to rest in its proper position. Thus, draining yang excess is equivalent to supplementing yin deficiency. (Tonifying yin to supplement deficiency is the crucial principle in treating warm-heat. Febrile diseases always consume yin; if consumption is incomplete, life continues; if complete, yang has no attachment and collapses, leading to death. Understanding this principle covers half the treatment logic. Treatment strategies in this discussion stem from this point.)
High body heat with calm yin and yang pulses indicates mismatch between pulse and syndrome (yang syndrome with yin pulse); hence, do not needle.
On the seventh or eighth day, wheezing with a wiry pulse indicates lung qi excess (wheezing) and wind-fire agitation (wiry). Shallow needling at the thumb web drains lung qi. Opening lung heat-bi allows sweat. The thumb web is Shaoshang (LU-11), the Jing-well point of the Lung meridian.
On the seventh or eighth day, a minute and small pulse indicates pathogen deepening into the lower jiao blood level, forcing blood into urine (hematuria). Kidney essence is exhausted, and yin fluids cannot ascend, causing dry mouth. A minute and small pulse indicates not only yin essence exhaustion but also yang qi exhaustion; death is evident. If the pulse is forceful, it is treatable; see later methods.
After sweating, if the pulse remains restless and wheezing, recurrence of fever is predicted. Heat does not subside with sweat; fire controlling metal causes wheezing. Metal受 fire control, depleting the source of Lung qi; death ensues. Rare cases may be treatable; see later methods.
Loss of pain sensation indicates righteous qi decline and inability to fight pathogen. Deafness indicates yin injury and essence depletion. Inability to control limbs indicates exhaustion of true qi. Dry mouth and extreme heat indicate sole dominance of yang pathogen. "Apparent yin cold" uses "cold" to mean "deficiency," referring to deficiency-cold in the lower jiao yin aspect. In patients with yin essence depletion and signs of true qi collapse, persistent pathogenic heat will exploit this emptiness. Thus, heat in the marrow is fatal. Cases with yin decline and yang excess but intact true qi may still be treatable; see later methods.
After sweating, if the pulse remains rapid and full, this is extreme yin deficiency; fatal. Although needling is contraindicated, appropriate herbal therapy may save the patient; see later methods.
Rapid, full pulse without sweat indicates extreme yang excess. Extreme yang leaves no room for yin; fatal. However, appropriate herbal intervention may save the patient; see later methods.
No sweat with malar flush indicates pathogen excess unresolved. Hiccups indicate spleen yin pathology. Simultaneous yin and yang pathology makes treating one hinder the other; fatal. Diarrhea with severe abdominal distension indicates severe spleen yin pathology and simultaneous yin-yang involvement. Blurred vision indicates scattering of essence and collapse of qi. Classics state: Scattered essence causes diplopia; collapsed qi causes blindness. Persistent heat scorches essence and damages qi; death is inevitable. Elderly and infants have depleted solitary yang or immature yang. Contracting warm-heat yang disease plus yin disease of abdominal distension leads to death even before severe distension. No sweat indicates excess pathogenic yang; vomiting indicates declining righteous yang. Hematochezia indicates deep pathogen unable to exit, forcing yin collateral blood downward, causing dual yin-yang injury. Ulceration of the tongue base involves Kidney, Gallbladder, and Heart meridians connecting to the tongue. Deep yang pathogen causes yin-yang fire to knot in the blood level, preventing Kidney water from ascending. If heat subsides, survival is possible; if persistent, death occurs. Cough with epistaxis indicates pathogen closing Lung collaterals, blocking clear pathways. Sweat allows pathogen exit and survival; otherwise, Lung source dies. Marrow heat indicates pathogen reaching the deepest Kidney level. Fever with spasms indicates pathogen reaching the deepest Liver level. Although these nine are unsuitable for needling, later sections provide treatments, and some may survive. Taiyang color on cheekbones indicates febrile disease; Hand Taiyang connects to cheekbones and intersects Foot Taiyang. Taiyang belongs to Water; water boiling from fire causes red color. Simultaneous Jueyin appearance (Wood) means Water is counter-controlled by Fire, Metal fails to generate Wood and instead generates Fire, leaving no place for Water; death is swift. Shaoyang color on cheeks indicates febrile disease; Hand Shaoyang exits ear, passes Guest Master point, intersects cheek, meets Eye corner, and intersects Foot Shaoyang. Shaoyang belongs to Minister Fire; fire color at intersection indicates febrile disease. Simultaneous Shaoyin appearance (Emperor Fire) means two fires blaze, Water cannot withstand; death within three days.
9. *Ping Re Bing Lun* (Discourse on Evaluating Heat Diseases): The Yellow Emperor asked: A patient with warm disease sweats but fever returns immediately, pulse is rapid and restless, does not subside with sweat, speaks deliriously, and cannot eat. What is the disease name? Qibo replied: The disease is named Yin-Yang Intersection (Yin Yang Jiao); intersection means death.
Human sweat originates from grain, which generates essence. When pathogen and essence struggle in flesh and bone and sweat occurs, the pathogen retreats and essence prevails. If essence prevails, the patient should eat and not recur with fever. Recurrent fever is pathogen; sweat is essence. Now, sweating followed immediately by fever indicates pathogen victory. Inability to eat means essence has no support. Disease lingering implies imminent death. Furthermore, *Relun* states: Sweating with persistent rapid pulse indicates death. Here, pulse does not correspond with sweat, meaning the body cannot overcome the disease; death is certain. Delirium indicates loss of Zhi (Will/Shen); loss of Will indicates death. Seeing three signs of death and no sign of life, even if recovery seems possible, death is certain.
The meaning is clear; classics declare certain death, yet with proper herbal treatment, survival is possible, illustrating the difference between acupuncture and pharmacology; see later sections.
10. *Ci Re Pian* (Chapter on Acupuncture for Heat Diseases) states: Liver heat disease presents with yellow urine first, abdominal pain, lethargy, and fever. During heat struggle, delirium and惊 (fright) occur, hypochondriac fullness and pain, restlessness of hands and feet, and inability to lie down. Symptoms worsen on Geng/Xin days, resolve with profuse sweat on Jia/Yi days. If qi rebels, death occurs on Geng/Xin days. Needle Foot Jueyin and Shaoyang meridians. Rebellion causes headache, dizziness, and pulsation rushing to the head.
Liver disease presenting with yellow urine first: Liver meridian connects to genitalia; Liver governs free flow. Liver dysfunction loses its dispersing function, causing yellow urine. Abdominal pain and lethargy result from Wood disease attacking Earth (Spleen). Heat struggle is intense pathogenic heat fighting righteous qi. Delirium and fright involve Hand Jueyin Pericardium; both Jueyin share similar qi, so Hand Jueyin is affected during struggle. Hypochondriac pain occurs because Liver meridian runs along the sides of the body. Restlessness and insomnia occur because Liver governs Wind, Wind affects extremities, and Wood disease attacks Earth (Spleen governs limbs). Liver heat draws True Yin from Shaoyin Kidney; yin injury causes agitation. Geng/Xin (Metal) days control Wood, worsening symptoms. Jia/Yi (Wood) days are prosperous for Liver, allowing sweat and recovery. Qi rebellion means severe disease defying recovery logic; death occurs on days controlled by the pathogen. Needling Foot Jueyin (Zang) and Shaoyang (Fu) treats organ disease by draining its paired fu organ. Headache and upward movement occur because Liver governs ascending; extreme disease causes upward rebellion.
The logic for worsening on Geng/Xin days applies similarly to other zang organs.
11. Heart heat disease presents initially with unhappiness, followed by fever after several days. During heat struggle, sudden heart pain, vexation, oppression, frequent vomiting, headache, flushed face, and anhidrosis occur. Symptoms worsen on Ren/Gui days, resolve with profuse sweat on Bing/Ding days. If qi rebels, death occurs on Ren/Gui days. Needle Hand Shaoyin and Taiyang meridians.
Heart disease presenting with unhappiness: Pericardium, named Danzhong, resides below the Heart and acts on behalf of the Sovereign. Classics state Danzhong is the Official of Envoy, governing joy; heart disease causes unhappiness. Sudden heart pain results from pathogen-righteous qi struggle during heat conflict. Vexation arises because Heart governs Fire; oppression occurs because Danzhong qi is stagnant. Vomiting is associated with Liver disease; both Jueyin share qi, and Danzhong suffers on behalf of the Heart, so Liver symptoms appear after intense heat struggle. Pathogen in the diaphragm often causes vomiting. Headache results from Fire rising. Flushed face is the color of Fire. Anhidrosis occurs because sweat is the fluid of the Heart; heart disease blocks sweat passage.
12. Spleen heat disease presents initially with heavy head, cheek pain, vexation, bluish complexion, desire to vomit, and fever. During heat struggle, lower back pain prevents bending or stretching, abdominal distension, diarrhea, and...