（一）《阴阳大论》云∶春气温和，夏气暑热，秋气清凉，冬气冰冽，此则四时正气之序也。（《伤寒例》）
成无己曰∶春夏为阳，春温夏热者，阳之动始于温，盛于暑故也；秋冬为阴，秋凉而冬寒者，以阴之动始于凉，盛
于寒故也。
（二）冬时严寒，万类深藏，君子固密，则不伤于寒。触冒之者，乃名伤寒耳。（《伤寒例》）
成无己曰∶冬三月纯阴用事，阳乃伏藏，水冰地坼，寒气严凝，当是之时，善摄生者，出处固密，去寒就温，则不
伤于寒。其涉寒冷，触冒霜雪为病者，谓之伤寒也。
（三）其伤于四时之气，皆能为病。（《伤寒例》）
成无己曰∶春风、夏暑、秋湿、冬寒，谓之四时之气。
陆九芝曰∶仲景原文，首着“四时之气”四字，则《伤寒论》之不独言冬月伤寒，而并春夏秋三时之温热湿燥论之，
岂不显然，乃必曰仲景独知有寒者何哉？仲景本知有温热。既谓仲景但论寒，反谓叔和将温热搀入论中，以为仲景之论
乱于叔和，真不知其是何肺腑。他人不足责，黄坤载自称古今无双，则更可笑矣。
（四）以伤寒为毒者，以其最成杀厉之气也。（《伤寒例》）
成无己曰∶热为阳，阳主生；寒为阴，阴主杀。阴寒为病，最为肃杀毒厉之气。
王朴庄曰∶寒本正气，而有杀厉之毒，不特使人病于冬，且能使人病于春夏，故治之不可不急也。
刘仲迈曰∶毒之为言害也。《博雅》一曰恶也。《周礼·天官》∶医师掌医之政令，聚毒药以供医事。论云以伤寒为
毒者，喻为害之意云尔。又《易·师卦》以此毒天下而民从之，与《老子》“亭之、毒之”之毒，在《易》义当训治，
在《老子》则为“优育”之意。后贤有以本论毒字为语病者，真所见未广耳。
（五）中而即病者，名曰伤寒。（《伤寒例》）
王朴庄曰∶此桂枝、麻黄二汤证也。
（六）不即病者，寒毒藏于肌肤，至春变为温病，至夏变为暑病。暑病者，热极重于温也。（《伤寒例》）
王朴庄曰∶庞安常云∶严寒时，奔走荷重劳力之人，皆辛苦之徒也，当阳气闭藏，反扰动之，令郁发腠理，津液强
渍，为寒所搏，腠理反密，寒毒与营卫相浑，则病成矣。其不实时成病者，寒毒藏肌肤间，至春夏阳气发生，与毒相搏，
因春温气而变者名温病，因夏暑而变者名热病，因暑湿而变者名湿温。以病本由冬时中寒，故通谓之伤寒焉。
陆九芝曰∶庞说如此，足以为《难经》伤寒共有五种之证。
（七）是以辛苦之人，春夏多温热病者，皆由冬时触寒所致，非时行之气也。（《伤寒例》）
陆九芝曰∶此言温病热病皆非疫病，而皆由触寒所致，故皆名伤寒。读此两语，则仲景明明告人以温热之病，即在
《伤寒论》中矣。后人既不知此本仲景语，而又疑叔和自为此语，转若仲景所未道，因而削之。又因而驳之。若彼一见
《外台秘要》，（按《外台秘要》诸论伤寒篇，以《阴阳大论》、王叔和、华佗、陈廪丘、范汪论、短剧论、千金论、经
心录论为八家。《阴阳大论》语，即《伤寒例》中文。又《病源》、《千金》，所引《伤寒例》文，俱称经言，则《伤寒例》
在隋唐时，本作仲景原文）亦当哑然自笑矣。
王秉衡曰∶伤寒，外感之总名也；《伤寒论》，统论外感之书也。
王永嘉曰∶《难经》云伤寒有五，则五种外感，昔人皆谓之伤寒矣。《伤寒论》有治风、治温、治 、治湿诸法。则
非专论一伤寒矣。
王孟英曰∶吴鞠通谓宋元以来，不明仲景一书专为伤寒而设。吴氏直未读《伤寒论》也。注《伤寒》者无虑数十家，
皆以为专论伤寒之书，故恒觉支离附会。考论中风、寒、温、 、湿五气为病，古人皆曰伤寒，故《难经》云伤寒有五，
而仲圣以《伤寒》名其书也。此等大纲不清，岂可率尔着书？
杨照藜曰∶注《伤寒》者无虑数十家，皆以为专论伤寒之书，故恒支离附会不适于用。惟《重庆堂随笔》指出为统
论外感之书，觉《伤寒论》之全体俱现，此与尧封之见相同者。
（八）凡时行者，春时应暖而反大寒；夏时应热而反大凉；秋时应凉而反大热；冬时应寒而反大温。此非其时而有
其气。是以一岁之中，长幼之病多相似者，此则时行之气也。（《伤寒例》）
张路玉曰∶伤寒是感天时肃杀之气，以寒犯寒，必先寒水。时行是感湿土郁蒸之气，以湿犯湿，必先湿土。阳明为
营卫之原，始病则营卫俱病，经络无分，三焦相溷，内外不通，所以其病即发而暴，非比伤寒以次传经而入也。盖地为
污秽浊恶之总归，平时无所不受，适当天时不正之极，则平时所受浊恶之气，亦必乘时迅发。或冬时过暖，肃杀之令不
行，至春反大寒冷；或盛夏湿热污秽之气交蒸，忽然热极生风，而人汗孔闭拒，毒邪不得发泄而为病。病则老幼无分，
此实时行之气也。
王朴庄曰∶四时失其正气，必实时发病，而长幼多相似，故曰时行。
陆九芝曰∶此言疫病，不独温病、热病。至首言应温而反大寒，则有寒疫在内，仲景亦何尝不知疫乎？
（九）其冬有非节之暖者，名曰冬温。冬温之毒，与伤寒大异。（《伤寒例》）
张路玉曰∶冬温者，时当大寒，而反大温，东风时至，则肌腠疏豁，忽然大寒，而衣袂单薄，寒郁其邪，其病即发
者为冬温。以其所感非时温气，故言与伤寒大异。若不即发，藏于皮肤，则入伤血脉，至春发为温病；藏于经络，则入
伤骨髓，至夏发为热病矣。
（十）从立春节后，其中无暴大寒，又不冰雪，而有人壮热为病者，此属春时阳气，发于冬时伏寒，变为温病。（《伤
寒例》）
成无己曰∶此为温病也。《内经》云∶冬伤于寒，春必病温。
（十一）是以春伤于风，夏必飧泄；夏伤于暑，秋必 疟；秋伤于湿，冬必咳嗽；冬伤于寒，春必病温。此必然之
道，可不审明之？（《伤寒例》）
王朴庄曰∶此引《素问》以明四时正气皆能留连致病，而语意专为春温发也。风即春令生升之气。飧泄，溏粪也。
，二日一发疟，岐伯谓由人汗空疏，腠理开，因得秋气，邪内薄于五脏，横连膜原，故蓄作有时，而间日一发。湿即
初秋凉气，时有微雨，日凡数阵，谚云远秋十日，作秋天者是也。盖风、暑、湿、寒，原为正气，故当时有不即病者。
其夏之飧泄，升极必降也；秋之 疟，散极必蓄也；冬之咳嗽，降极必升也；春之温病，蓄极必散也。故曰必然之道也。
（十二）若脉阴阳俱盛，重感于寒者，变成温疟。（《伤寒例》）
成无己曰∶脉阴阳俱盛者，伤寒之脉也。《难经》云∶伤寒之脉，阴阳俱盛而紧涩。经云∶脉盛身寒，得之伤寒。
则为前病。热未已，再感于寒，寒热相搏，变为温疟。
王三阳曰∶阴阳俱盛者，伤寒脉也。十三日以上，寒已传里，变为热病矣，脉当沉数，今复见伤寒脉，岂非重感于
外寒乎？寒热相搏，故曰变为温疟。
（十三）阳脉浮滑，阴脉濡弱者，更遇于风，变为风温。（《伤寒例》）
成无己曰∶此前热未歇，又感于风者也。《难经》云∶中风之脉，阳浮而滑，阴濡而弱。风来乘热，故变风温。
（十四）阳脉洪数，阴脉实大者，更遇温热，变为温毒，温毒为病最重也。（《伤寒例》）
成无己曰∶此前热未已，又感温热者也。阳主表，阴主里，洪数实大皆热也。两热相合变为温毒。以其表里俱热，
故为病最重。
王朴庄曰∶此温毒与《金匮》阳毒阴毒同。洪数者，气之热；实大者，血之热。温热之气挟毒戾而入阳明变为温毒，
凡一切斑疹皆其类也。毒之陷伏者即不治，故云为病最重也。
（十五）阳脉濡弱，阴脉弦紧者，更遇温气，变为温疫。（《伤寒例》）
王朴庄曰∶温疫，即湿温。（按湿温，即湿温时疫，非《难经》所谓伤寒有五之湿温也）时行之气，不外寒、热、
燥、湿四者。寒变温疟，热变温毒，燥变风温，湿变温疫，故《总病论》叙四种温病，直以温疫为湿温。濡弱者，天
气之湿客于上，故阳脉见之；弦紧者，地气之湿客于下，故阴脉见之。温气者，春夏间先时太过之热，蒸动地湿之气，
伤寒病后受之，蕴而成身热多汗不解之证。此气易于传染，能使长幼受多相似，故名为疫。言温疫者，以别于寒疫也。
寒疫必兼寒湿，温疫必兼湿热，此其大略也。
（十六）太阳病，发热而渴，不恶寒者，为温病。（《辨太阳病脉证并治》）
成无己曰∶发热而渴，不恶寒者，阳明也。此太阳受邪，知为温病，非伤寒也。积温成热，所以发热而渴，不恶寒
也。
庞安常曰∶温与热有轻重之分，故仲景云∶若遇温气，则为温病；更遇温热，则为温毒。热比温为尤重也。若但冬
伤于寒，至春而发，不感异气，名曰温病，此病之稍轻者也；温病未已，更遇温气，变为温病，亦可名曰温病，此病之
稍重者也。伤寒例以再遇温气名曰温疫。又有不因冬月伤寒，至春为温病者，此特感春温之气，可名曰春温。如冬之伤
寒，秋之伤湿，夏之伤暑相同也。以此观之，是春之病温有三种∶有冬伤于寒，至春发为温病者；有温病未已，更遇温
气而为温病，与重感温气相杂而为温病者；有不因冬伤于寒，不因更遇温气，只于春时感春温之气而病者。若此三者，
皆可名为温病，不必各立名色，只要知其病源之所以不同也。
张云岐曰∶伤寒汗下不愈而过经，其证尚在而不除者，亦温病也。经云∶温病之脉，行在诸经，不知何经之动，随
其经之所在而取之。如太阳病汗下后过经不愈，诊得尺寸俱浮者，太阳温病也；如身热目疼，汗下后过经不愈，诊得尺
寸俱长者，阳明温病也；如胸胁痛，汗下后过经不愈，诊得尺寸俱弦者，少阳温病也；如腹满嗌干，过经不愈，诊得尺
寸俱沉细者，太阴温病也；如口燥舌干而渴，过经不愈，诊得尺寸俱沉者，少阴温病也；如烦满囊缩，过经不愈，诊得
尺寸俱微缓者，厥阴温病也。随其经取之，随其症治之。如发斑，乃温毒也。
柯韵伯曰∶温病内外皆热，所以别于中风、伤寒之恶寒发热也。此条不是发明《内经》“冬伤于寒，春必病温”之
义，乃概言太阳温病之症如此，若以春温释之，失仲景之旨矣。夫太阳一经，四时俱能受病，不必于冬；人之温病，不
必因于伤寒；且四时俱能病温，不必于春。推而广之，则六经俱有温病，非独太阳一经也。
（十七）若发汗已，身灼热者，名风温。风温为病，脉阴阳俱浮，自汗出，身重，多眠睡，鼻息必鼾，语言难出。
若被下者，小便不利，直视失溲；若被火者，微发黄色，剧则如惊痫，时螈 ；若火熏之，一逆尚引日，再逆促命期。
（《辨太阳病脉证并治》）
黄宝臣曰∶发热恶寒者，太阳证也；发热而渴，不恶寒者，阳明证也。今太阳病始得之，不俟寒邪变热，即现阳明
之发热而渴不恶寒者，知非太阳伤寒，乃太阳温病也。《内经》云冬不藏精之人，春必病温；又云冬伤于寒，春必病温。
原内阴已亏，外阳被郁，伏邪酝酿，早从热化，至春一遇外邪，热从内应，故证现发热而渴不恶寒也。宜用寒凉之品于
太阳表药中，微似汗以和之。若用辛温之剂，以大发其汗，内蕴之热，得辛温而益盛。故发汗已，不但身不凉静，而反
灼热，则轻病变重，而成风温矣。盖风温之为病，脉阴尺阳寸俱浮，自汗出，犹为太阳中风之本象；至于身重、多眠睡，
则标本合热，而显出少阴之危象也。肾热上壅于肺，而鼻息必鼾；肾热上凌于心，而语言难出。热甚则脏腑之津液必伤。
若被误下，则水泉竭，而小便不利，甚至少阴之气将绝，不能荣太阳之脉而直视，不能约膀胱之气而失溲。若被火灸烧
针，是以火益火，微则热郁蒸土而发黄色；剧则热亢攻心而如惊痫，热甚生风而时螈 ，黄色渐深，中带黑色，若火熏
之状。夫被下已为一逆矣，被火是再逆也。一逆尚可延引时日，再逆则促其命期矣，医者可不慎哉？
王孟英曰∶彼冬温、春温之先犯手太阴者，皆曰风温，乃吸受之风温也；此伏邪内发，误汗致逆者，亦曰风温，乃
内动之虚风也。然风温在肺，只宜清解，若误以辛热之药汗之，亦有自汗多眠，鼻鼾难语之变。余治梁宜人一案可质也。
案见《王氏医案续篇》。
陆九芝曰∶按当时之所谓误下者，乃巴豆小丸子，故阴愈伤，以巴豆亦温热药也。
（十八）太阳中热者， 是也，其人汗出恶寒，身热而渴也。（《金匮》以白虎加人参汤主之）（《辨太阳病脉证并治》）
周禹载曰∶冬月寒能伤人，则名中寒；夏月热亦能伤人，则名中热。此是外表之热，故曰中，与伏寒发为热病之热
不同。而同用白虎者，则以所伤在气，则所主在金，所病在热，金病则母子俱病，故与伏气之在少阴，发出而由阳明者
无异，要皆并主一汤。不因冬月之伏与夏月之中为二义也。亦不因伏气之渴与今病之渴为稍异也。方主人参白虎者，石
（一）《阴阳大论》说：春天的气候温和，夏天的气候暑热，秋天的气候清凉，冬天的气候冰寒，这就是四季正常气候的次序。（出自《伤寒例》）
成无己说：春夏属于阳，春天温暖、夏天炎热，是因为阳气发动始于温和，极盛于暑热；秋冬属于阴，秋天凉爽而冬天寒冷，是因为阴气发动始于凉爽，极盛于寒冷。
（二）冬季严寒，万物深藏，君子（指善于养生的人）固护肌表，就不受寒邪伤害。如果触犯冒犯寒邪，这才叫作伤寒。（出自《伤寒例》）
成无己说：冬季三个月纯阴当令，阳气伏藏，水结冰地裂开，寒气严酷凝结。在这个时候，善于养生的人，无论居家还是外出都固密防护，远离寒冷靠近温暖，就不受寒邪伤害。那些涉足寒冷，触犯霜雪而生病的人，称为伤寒。
（三）人受到四时气候的影响，都能导致疾病。（出自《伤寒例》）
成无己说：春风、夏暑、秋湿、冬寒，称为四时之气。
陆九芝说：张仲景原文，首先强调“四时之气”这四个字，那么《伤寒论》不仅仅论述冬季的伤寒，同时也论述春夏秋三季的温热湿燥病，这难道不明显吗？为什么一定要说张仲景只知道有寒邪呢？张仲景本来就知道有温热病。既然说张仲景只论寒邪，反而说王叔和将温热病掺入其中，认为张仲景的论述被王叔和搞乱了，真是不知道他是什么心思。别人不足为怪，黄坤载自称古今无双，那就更可笑了。
（四）把伤寒看作是有毒害的，是因为它形成了最具有杀伤厉烈性质的邪气。（出自《伤寒例》）
成无己说：热属于阳，阳主生长；寒属于阴，阴主肃杀。阴寒致病，是最具肃杀毒厉性质的邪气。
王朴庄说：寒本是正气，但具有杀厉之毒，不仅使人冬季生病，也能使人春夏生病，所以治疗不可不紧急。
刘仲迈说：毒的意思就是害。《博雅》说毒是恶的意思。《周礼·天官》记载：医师掌管医疗政令，收集毒药以供医疗使用。《伤寒论》说以伤寒为毒，只是比喻其有害的意思罢了。另外《易经·师卦》说用此毒治理天下而百姓顺从，与《老子》中“亭之、毒之”的毒，在《易经》中义当解释为治理，在《老子》中则是“优育”的意思。后辈中有认为本书中的“毒”字是语病的，真是见识不广罢了。
（五）感受寒邪后立即发病的，名叫伤寒。（出自《伤寒例》）
王朴庄说：这是桂枝汤、麻黄汤的证候。
（六）感受寒邪后没有立即发病的，寒毒潜伏在肌肤之间，到春天变为温病，到夏天变为暑病。暑病，比温病的热势更重。（出自《伤寒例》）
王朴庄说：庞安常说：在严寒时节，奔走负重劳力的人，都是辛苦劳作之人，正当阳气闭藏之时，反而扰动他们，使阳气郁结发散于腠理，津液强行浸渍，被寒邪搏结，腠理反而密闭，寒毒与营卫相混，于是疾病形成。那些当时没有立即发病的，寒毒潜伏在肌肤间，到了春夏阳气生发时，与毒邪相搏，因为春季温热之气而变化的叫温病，因为夏季暑气而变化的叫热病，因为暑湿而变化的叫湿温。因为病本源于冬季感受寒邪，所以通称为伤寒。
陆九芝说：庞氏的说法如此，足以证明《难经》中伤寒共有五种的说法。
（七）因此，辛苦劳作的人，在春夏季节多患温热病，都是由冬季触冒寒邪所致，不是时行疫气。（出自《伤寒例》）
陆九芝说：这里说温病热病都不是疫病，而是都由触冒寒邪所致，所以都名为伤寒。读这两句话，那么张仲景明明告诉人们温热病就在《伤寒论》中了。后人既然不知道这是张仲景的话，又怀疑王叔和自己写的这句话，转而又像张仲景没说过一样，因而删削它。又进而驳斥它。如果他们一看到《外台秘要》，（按《外台秘要》诸论伤寒篇，以《阴阳大论》、王叔和、华佗、陈廪丘、范汪论、短剧论、千金论、经心录论为八家。《阴阳大论》的话，即《伤寒例》中的文字。又《诸病源候论》、《千金方》，所引用的《伤寒例》文字，都称为经言，则《伤寒例》在隋唐时期，原本就是张仲景的原文）也应该哑然自笑了。
王秉衡说：伤寒，是外感病的总称；《伤寒论》，是统论外感病的书。
王永嘉说：《难经》说伤寒有五，那么五种外感病，古人全都称为伤寒了。《伤寒论》有治风、治温、治湿等法。那么就不是专门论述一种伤寒了。
王孟英说：吴鞠通说宋元以来，不明白张仲景的书是专为伤寒而设的。吴氏根本没有读过《伤寒论》。注释《伤寒论》的不超过几十家，都认为它是专门论述伤寒的书，所以常常觉得支离破碎、牵强附会。考察论述中风、寒、温、燥、湿五气致病，古人都称为伤寒，所以《难经》说伤寒有五，而张仲圣以《伤寒》命名他的书。这些大纲不清，怎么能轻易著书？
杨照藜说：注释《伤寒论》的不超过几十家，都认为它是专门论述伤寒的书，所以常常支离附会不适于实用。只有《重庆堂随笔》指出它是统论外感病的书，觉得《伤寒论》的全貌都显现出来了，这与尧封的见解相同。
（八）凡是时行病，春天应该暖而反大寒；夏天应该热而反大凉；秋天应该凉而反大热；冬天应该寒而反大温。这不是其时却有这种气候。因此一年之中，老少病人的症状大多相似，这就是时行之气。（出自《伤寒例》）
张路玉说：伤寒是感受天时肃杀之气，以寒犯寒，必先伤肾水。时行是感受湿土郁蒸之气，以湿犯湿，必先伤脾土。阳明胃是营卫的源头，初病则营卫俱病，经络不分，三焦混杂，内外不通，所以其病发作急暴，不像伤寒依次传经而入。大地是污秽浊恶的总归处，平时无所不受，正当天时不正的极端时刻，那么平时所受的浊恶之气，也必然乘时而迅速发作。或者冬季过暖，肃杀之令不行，到春天反而大寒冷；或者盛夏湿热污秽之气交蒸，忽然热极生风，而人的汗孔闭拒，毒邪不得发泄而致病。患病则老幼不分，这就是时行之气。
王朴庄说：四时失去正常气候，必然实时发病，而且老少大多相似，所以叫时行。
陆九芝说：这里说的是疫病，不只是温病、热病。至于开头说应温而反大寒，那么其中有寒疫在内，张仲景又何尝不知道疫病呢？
（九）如果冬季有非节令的暖和天气，名叫冬温。冬温的毒邪，与伤寒大不相同。（出自《伤寒例》）
张路玉说：冬温，是时令应当大寒，却反而大温，东风时至，则肌肤腠理疏豁，忽然大寒，而衣服单薄，寒邪郁闭其邪气，其病立即发作的叫冬温。因为它所感受的不是时令的温气，所以说与伤寒大不相同。如果不立即发作，潜伏在皮肤，则入内损伤血脉，到春天发为温病；潜伏在经络，则入内损伤骨髓，到夏天发为热病了。
（十）从立春节后，其中没有暴大的寒冷，也没有冰雪，而有人壮热患病的，这属于春时阳气，发于冬季潜伏的寒邪，变为温病。（出自《伤寒例》）
成无己说：这是温病。《内经》说：冬季伤于寒，春天必定得温病。
（十一）因此春天伤于风，夏天必定飧泄；夏天伤于暑，秋天必定疟疾；秋天伤于湿，冬天必定咳嗽；冬天伤于寒，春天必定得温病。这是必然的道理，可以不审明吗？（出自《伤寒例》）
王朴庄说：这是引用《素问》来阐明四时正气都能留连致病，而语意专为春季温病发端。风就是春令生升之气。飧泄，是溏粪。疟，是隔日一发疟疾，岐伯说是由于人汗孔疏阔，腠理开，因得到秋气，邪气内迫于五脏，横连膜原，所以蓄积发作有定时，而隔日一发。湿就是初秋凉气，时有微雨，每天几阵，谚语说远秋十日，作秋天者是也。大概风、暑、湿、寒，原本是正气，所以在当时有不立即发病的。那夏天的飧泄，是升极必降；秋天的疟疾，是散极必蓄；冬天的咳嗽，是降极必升；春天的温病，是蓄极必散。所以说是必然的道理。
（十二）如果脉象寸关尺三部都盛大，再次感受寒邪的，变成温疟。（出自《伤寒例》）
成无己说：脉象阴阳俱盛，是伤寒的脉象。《难经》说：伤寒的脉象，阴阳俱盛而紧涩。经文说：脉盛身寒，得之伤寒。则为前病。热未已，再感于寒，寒热相搏，变为温疟。
王三阳说：阴阳俱盛，是伤寒脉。十三日以上，寒已传里，变为热病了，脉应当沉数，现在又见伤寒脉，岂不是再次感受外寒吗？寒热相搏，所以叫变为温疟。
（十三）阳脉浮滑，阴脉濡弱的，再次遇风的，变为风温。（出自《伤寒例》）
成无己说：这是前热未歇，又感受风邪。《难经》说：中风的脉象，阳浮而滑，阴濡而弱。风来乘热，故变风温。
（十四）阳脉洪数，阴脉实大的，再次遇温热的，变为温毒，温毒为病最重。（出自《伤寒例》）
成无己说：这是前热未已，又感受温热邪气。阳主表，阴主里，洪数实大都属热。两热相合变为温毒。因为其表里俱热，所以为病最重。
王朴庄说：此温毒与《金匮要略》中的阳毒阴毒相同。洪数是气的热；实大是血的热。温热之气挟毒戾而入阳明变为温毒，凡一切斑疹皆其类也。毒之陷伏者即不治，故云为病最重也。
（十五）阳脉濡弱，阴脉弦紧的，再次遇温气的，变为温疫。（出自《伤寒例》）
王朴庄说：温疫，就是湿温。（按湿温，即湿温时疫，非《难经》所谓伤寒有五之湿温也）时行之气，不外寒、热、燥、湿四者。寒变温疟，热变温毒，燥变风温，湿变温疫，故《总病论》叙四种温病，直以温疫为湿温。濡弱者，天气之湿客于上，故阳脉见之；弦紧者，地气之湿客于下，故阴脉见之。温气者，春夏间先时太过之热，蒸动地湿之气，伤寒病后受之，蕴而成身热多汗不解之证。此气易于传染，能使长幼受多相似，故名为疫。言温疫者，以别于寒疫也。寒疫必兼寒湿，温疫必兼湿热，此其大略也。
（十六）太阳病，发热而渴，不恶寒的，是温病。（出自《辨太阳病脉证并治》）
成无己说：发热而渴，不恶寒的，是阳明证。这是太阳受邪，知为温病，非伤寒也。积温成热，所以发热而渴，不恶寒也。
庞安常说：温与热有轻重之分，所以张仲景说：若遇温气，则为温病；更遇温热，则为温毒。热比温为尤重也。若但冬伤于寒，至春而发，不感异气，名曰温病，此病之稍轻者也；温病未已，更遇温气，变为温病，亦可名曰温病，此病之稍重者也。伤寒例以再遇温气名曰温疫。又有不因冬月伤寒，至春为温病者，此特感春温之气，可名曰春温。如冬之伤寒，秋之伤湿，夏之伤暑相同也。以此观之，是春之病温有三种：有冬伤于寒，至春发为温病者；有温病未已，更遇温气而为温病，与重感温气相杂而为温病者；有不因冬伤于寒，不因更遇温气，只于春时感春温之气而病者。若此三者，皆可名为温病，不必各立名色，只要知其病源之所以不同也。
张云岐说：伤寒汗下不愈而过经，其证尚在而不除者，亦温病也。经云：温病之脉，行在诸经，不知何经之动，随其经之所在而取之。如太阳病汗下后过经不愈，诊得尺寸俱浮者，太阳温病也；如身热目疼，汗下后过经不愈，诊得尺寸俱长者，阳明温病也；如胸胁痛，汗下后过经不愈，诊得尺寸俱弦者，少阳温病也；如腹满嗌干，过经不愈，诊得尺寸俱沉细者，太阴温病也；如口燥舌干而渴，过经不愈，诊得尺寸俱沉者，少阴温病也；如烦满囊缩，过经不愈，诊得尺寸俱微缓者，厥阴温病也。随其经取之，随其症治之。如发斑，乃温毒也。
柯韵伯说：温病内外皆热，所以别于中风、伤寒之恶寒发热也。此条不是发明《内经》“冬伤于寒，春必病温”之义，乃概言太阳温病之症如此，若以春温释之，失仲景之旨矣。夫太阳一经，四时俱能受病，不必于冬；人之温病，不必因于伤寒；且四时俱能病温，不必于春。推而广之，则六经俱有温病，非独太阳一经也。
（十七）如果发汗后，身体灼热的，名叫风温。风温为病，脉象寸关尺俱浮，自汗出，身体沉重，多眠睡，鼻息必鼾，语言难出。如果被误用下法的，小便不利，直视失禁；如果被误用火疗的，轻微发黄，严重则像惊痫，时时抽搐。如果用火熏法，一次逆治尚且拖延时日，两次逆治则加速死亡。（出自《辨太阳病脉证并治》）
黄宝臣说：发热恶寒的，是太阳证；发热而渴，不恶寒的，是阳明证。现在太阳病始得之，不俟寒邪变热，即现阳明之发热而渴不恶寒者，知非太阳伤寒，乃太阳温病也。《内经》云冬不藏精之人，春必病温；又云冬伤于寒，春必病温。原内阴已亏，外阳被郁，伏邪酝酿，早从热化，至春一遇外邪，热从内应，故证现发热而渴不恶寒也。宜用寒凉之品于太阳表药中，微似汗以和之。若用辛温之剂，以大发其汗，内蕴之热，得辛温而益盛。故发汗已，不但身不凉静，而反灼热，则轻病变重，而成风温矣。盖风温之为病，脉阴尺阳寸俱浮，自汗出，犹为太阳中风之本象；至于身重、多眠睡，则标本合热，而显出少阴之危象也。肾热上壅于肺，而鼻息必鼾；肾热上凌于心，而语言难出。热甚则脏腑之津液必伤。若被误下，则水泉竭，而小便不利，甚至少阴之气将绝，不能荣太阳之脉而直视，不能约膀胱之气而失溲。若被火灸烧针，是以火益火，微则热郁蒸土而发黄色；剧则热亢攻心而如惊痫，热甚生风而时抽搐，黄色渐深，中带黑色，若火熏之状。夫被下已为一逆矣，被火是再逆也。一逆尚可延引时日，再逆则促其命期矣，医者可不慎哉？
王孟英说：彼冬温、春温之先犯手太阴者，皆曰风温，乃吸受之风温也；此伏邪内发，误汗致逆者，亦曰风温，乃内动之虚风也。然风温在肺，只宜清解，若误以辛热之药汗之，亦有自汗多眠，鼻鼾难语之变。余治梁宜人一案可质也。案见《王氏医案续篇》。
陆九芝说：按当时之所谓误下者，乃巴豆小丸子，故阴愈伤，以巴豆亦温热药也。
（十八）太阳中热者，即是喝病，其人汗出恶寒，身热而渴也。（《金匮要略》以白虎加人参汤主之）（出自《辨太阳病脉证并治》）
周禹载说：冬月寒能伤人，则名中寒；夏月热亦能伤人，则名中热。此是外表之热，故曰中，与伏寒发为热病之热不同。而同用白虎者，则以所伤在气，则所主在金，所病在热，金病则母子俱病，故与伏气之在少阴，发出而由阳明者无异，要皆并主一汤。不因冬月之伏与夏月之中为二义也。亦不因伏气之渴与今病之渴为稍异也。方主人参白虎者，石
(1) The *Yin-Yang Da Lun* (Great Treatise on Yin and Yang) states: "The Qi of spring is mild, the Qi of summer is hot and sultry, the Qi of autumn is cool and clear, and the Qi of winter is icy cold. This is the order of the correct Qi of the four seasons." (*Shanghan Li*, Preface to Shanghan)
Cheng Wuji stated: "Spring and summer belong to Yang; the warmth of spring and heat of summer occur because the movement of Yang begins with mildness and reaches its peak in heat. Autumn and winter belong to Yin; the coolness of autumn and cold of winter occur because the movement of Yin begins with coolness and reaches its peak in cold."
(2) "In winter, when severe cold prevails, all things are deeply hidden. If a gentleman (one who knows how to preserve health) keeps his exterior secure, he will not be injured by cold. Those who are exposed to it are said to have contracted Cold Damage (Shanghan)." (*Shanghan Li*, Preface to Shanghan)
Cheng Wuji stated: "During the three months of winter, pure Yin governs, and Yang is hidden and stored. Water freezes and the earth cracks; the cold Qi is severe and condensed. At this time, those who are good at preserving their health keep themselves secure whether at home or abroad, avoiding cold and seeking warmth, so they are not injured by cold. Those who venture into the cold, exposing themselves to frost and snow and falling ill, are called suffering from Cold Damage (Shanghan)."
(3) "Being affected by the Qi of the four seasons can all cause disease." (*Shanghan Li*, Preface to Shanghan)
Cheng Wuji stated: "Spring wind, summer heat, autumn dampness, and winter cold are called the Qi of the four seasons."
Lu Jiuzhi stated: "Zhang Zhongjing's original text first emphasizes the four characters 'Qi of the four seasons.' Thus, it is obvious that the *Treatise on Cold Damage* does not only discuss winter Cold Damage but also discusses warm, hot, damp, and dry diseases of spring, summer, and autumn. Why must one say that Zhang Zhongjing only knew of cold? Zhang Zhongjing originally knew of warm and hot diseases. To claim that Zhang Zhongjing only discussed cold, and then to argue that Wang Shuhe mixed warm diseases into the text, claiming Zhang Zhongjing's treatise was confused by Wang Shuhe, truly reveals what kind of mind he has. Others are not worth mentioning, but Huang Kunzai, who claims to be unparalleled since ancient times, is even more laughable."
(4) "Considering Cold Damage as toxic is because it forms the most lethal and destructive Qi." (*Shanghan Li*, Preface to Shanghan)
Cheng Wuji stated: "Heat belongs to Yang, and Yang governs generation; cold belongs to Yin, and Yin governs destruction. Illness caused by Yin-cold is the most severe toxic and destructive Qi."
Wang Puzhuang stated: "Cold is originally correct Qi, yet it possesses lethal toxicity. It not only causes illness in winter but also in spring and summer, so treatment cannot be delayed."
Liu Zhongmai stated: "The word 'toxic' means harmful. *Bo Ya* says toxic means evil. *Rites of Zhou · Heavenly Officials* records: 'Physicians manage medical decrees, gathering toxic substances for medical use.' The *Treatise* says considering Cold Damage as toxic, merely implying its harmful nature. Furthermore, in the *I Ching · Shi Hexagram*, it says 'using this toxin to govern the world, and the people follow,' and in *Laozi*, 'ting zhi, du zhi' (governing/nourishing), the meaning of 'du' in *I Ching* should be interpreted as governing, while in *Laozi* it means 'nurturing.' Later scholars who considered the word 'toxic' in this treatise as a linguistic error truly had limited insight."
(5) "Those who are struck by cold and immediately fall ill are named Cold Damage (Shanghan)." (*Shanghan Li*, Preface to Shanghan)
Wang Puzhuang stated: "This refers to the patterns treated by Guizhi Tang (Cinnamon Twig Decoction) and Mahuang Tang (Ephedra Decoction)."
(6) "Those who do not immediately fall ill harbor the cold toxin in the skin and muscles. By spring, it transforms into Warm Disease (Wenbing); by summer, it transforms into Summerheat Disease (Shubing). Summerheat disease is hotter and more severe than Warm Disease." (*Shanghan Li*, Preface to Shanghan)
Wang Puzhuang stated: "Pang Anchang said: 'During severe cold, those who run, carry heavy loads, or labor are hardworking people. When Yang Qi is closed and stored, disturbing them causes Yang to stagnate and erupt in the interstices, forcing fluids to soak out. Bound by cold, the interstices become tight. The cold toxin mixes with Ying and Wei, and the disease forms. For those who do not fall ill immediately, the cold toxin hides in the skin and muscles. When Yang Qi arises in spring and summer, it fights with the toxin. Transforming due to spring warmth is called Warm Disease (Wenbing); transforming due to summer heat is called Heat Disease (Rebing); transforming due to summer damp-heat is called Damp-Warmth (Shiwen). Since the root of the disease comes from contracting cold in winter, it is collectively called Cold Damage (Shanghan).'
Lu Jiuzhi stated: "Pang's explanation suffices to prove the evidence of the five types of Cold Damage mentioned in *Nan Jing*."
(7) "Therefore, hardworking people often suffer from warm and hot diseases in spring and summer, all caused by contracting cold in winter, not by the epidemic Qi of the season." (*Shanghan Li*, Preface to Shanghan)
Lu Jiuzhi stated: "This states that Warm Disease and Heat Disease are not epidemics, but are all caused by contracting cold, hence all are named Cold Damage (Shanghan). Reading these two sentences, Zhang Zhongjing clearly informs people that warm diseases are included in the *Treatise on Cold Damage*. Later generations, not knowing this was Zhang Zhongjing's words, suspected Wang Shuhe wrote them himself, acting as if Zhang Zhongjing had never said them, thus deleting them. Then refuting them. If they had seen *Waitai Miyao*... [Note: *Waitai Miyao* lists eight sources for Shanghan discussions, including *Yin-Yang Da Lun*, Wang Shuhe, Hua Tuo, etc. The words of *Yin-Yang Da Lun* are the text of *Shanghan Li*. Also, *Zhoubing Yuanhou Lun* and *Qianjin Fang* cite *Shanghan Li* text as 'Jingyan' (Scriptural words), meaning *Shanghan Li* in Sui and Tang dynasties was originally Zhang Zhongjing's text] ...they would have laughed silently at themselves.
Wang Bingheng stated: "Cold Damage (Shanghan) is the general name for external contractions; the *Treatise on Cold Damage* is a book comprehensively discussing external contractions."
Wang Yongjia stated: "*Nan Jing* says Cold Damage includes five types, so ancients called all five external contractions Cold Damage. The *Treatise on Cold Damage* contains methods for treating wind, warmth, dampness, etc. Thus, it is not solely about one type of Cold Damage."
Wang Mengying stated: "Wu Jutong claimed that since Song and Yuan dynasties, people did not understand that Zhang Zhongjing's book was specifically designed for Cold Damage. Mr. Wu simply hadn't read the *Treatise on Cold Damage*. Dozens of commentators on *Shanghan* considered it a book solely on Cold Damage, hence always feeling it was fragmented and forced. Examining the discussion of wind, cold, warmth, dryness, and dampness causing disease, ancients all called it Cold Damage, hence *Nan Jing* says 'Cold Damage has five,' and Zhang Zhongsheng named his book *Shanghan*. With such main outlines unclear, how could one casually write a book?"
Yang Zhaoli stated: "Dozens of commentators on *Shanghan* considered it a book solely on Cold Damage, hence often fragmented and impractical. Only *Chongqing Tang Suibi* pointed out it is a book comprehensively discussing external contractions, making the whole picture of the *Treatise on Cold Damage* appear, which aligns with Yaofeng's view."
(8) "Whenever there is an epidemic movement, spring should be warm but is unexpectedly very cold; summer should be hot but is unexpectedly very cool; autumn should be cool but is unexpectedly very hot; winter should be cold but is unexpectedly very warm. This is having the Qi of another season at the wrong time. Therefore, throughout the year, the illnesses of young and old are mostly similar. This is the Qi of seasonal epidemic movement." (*Shanghan Li*, Preface to Shanghan)
Zhang Luyu stated: "Cold Damage is contracting the肃杀 (severe/drying) Qi of heaven and time; attacking cold with cold first injures Kidney Water. Seasonal epidemic movement is contracting the stagnant steaming Qi of wet earth; attacking dampness with dampness first injairs Spleen Earth. Yangming Stomach is the source of Ying and Wei. Initially, both Ying and Wei are diseased, meridians are indistinguishable, Sanjiao is mixed, interior and exterior are blocked, so the disease erupts suddenly, unlike Cold Damage which transmits step-by-step through meridians. The earth is the total return of filth and turbidity, accepting everything normally. When extreme abnormal weather occurs, the accumulated filth necessarily erupts swiftly. Or winter is too warm, the drying command fails, leading to extreme cold in spring; or midsummer humid heat and filth steam together, suddenly extreme heat generates wind, pores close, toxins cannot vent, causing disease. Old and young are equally affected; this is the seasonal epidemic Qi."
Wang Puzhuang stated: "When the four seasons lose their correct Qi, disease inevitably occurs immediately, and young and old are mostly similar, hence called 'seasonal movement' (Shixing)."
Lu Jiuzhi stated: "This refers to epidemics, not just warm or hot diseases. Regarding the opening statement 'should be warm but is extremely cold,' there is cold epidemic within it. Did Zhang Zhongjing not know about epidemics?"
(9) "If there is unseasonable warmth in winter, it is named Winter Warmth (Dongwen). The toxin of Winter Warmth is greatly different from Cold Damage." (*Shanghan Li*, Preface to Shanghan)
Zhang Luyu stated: "Winter Warmth occurs when the season demands severe cold but is instead very warm. East winds arrive, skin and interstices become open. Suddenly severe cold arrives, but clothes are thin. Cold traps the pathogen, and the disease erupts immediately; this is Winter Warmth. Because it contracts non-seasonal warm Qi, it is said to be greatly different from Cold Damage. If it does not erupt immediately, hiding in the skin, it enters and damages blood vessels, erupting as Warm Disease in spring; hiding in meridians, it enters and damages bone marrow, erupting as Heat Disease in summer."
(10) "After the Beginning of Spring solar term, if there is no sudden severe cold, nor ice or snow, yet someone suffers from high fever, this belongs to Spring Yang Qi erupting from latent winter cold, transforming into Warm Disease." (*Shanghan Li*, Preface to Shanghan)
Cheng Wuji stated: "This is Warm Disease. *Neijing* says: 'If injured by cold in winter, one will surely get Warm Disease in spring.'"
(11) "Therefore, injuring oneself to wind in spring leads to undigested stool diarrhea in summer; injuring oneself to summerheat in summer leads to malaria in autumn; injuring oneself to dampness in autumn leads to cough in winter; injuring oneself to cold in winter leads to Warm Disease in spring. This is the inevitable way, can it not be carefully examined?" (*Shanghan Li*, Preface to Shanghan)
Wang Puzhuang stated: "This cites *Suwen* to clarify that the correct Qi of the four seasons can linger and cause disease, with the intent specifically focusing on spring warmth. Wind is the rising Qi of spring. Undigested stool diarrhea (Sunxie) is loose stool. Malaria (Nuè) is intermittent fever occurring every two days; Qibo attributed it to open pores and interstices allowing autumn Qi to invade internally, connecting horizontally to the membrane source, causing periodic accumulation and eruption. Dampness is early autumn cool air with occasional light rain. Wind, summerheat, dampness, and cold were originally correct Qi, so some did not fall ill immediately. Summer diarrhea represents descent after peak ascent; autumn malaria represents accumulation after peak dispersion; winter cough represents ascent after peak descent; spring warm disease represents dispersion after peak accumulation. Hence, it is called the inevitable way."
(12) "If pulse Yin and Yang are both full, and one is re-injured by cold, it transforms into Warm Malaria (Wen Nue)." (*Shanghan Li*, Preface to Shanghan)
Cheng Wuji stated: "Pulse Yin and Yang both full is the pulse of Cold Damage. *Nan Jing* says: 'The pulse of Cold Damage is full and tense/choppy at both Yin and Yang positions.' The classic says: 'Full pulse with cold body, contracted from Cold Damage.' This is the previous illness. Before the heat subsides, being re-injured by cold, cold and heat struggle, transforming into Warm Malaria."
Wang Sanyang stated: "Yin and Yang both full is the Cold Damage pulse. After thirteen days, cold has transmitted to the interior, transforming into Heat Disease, pulse should be deep and rapid. Seeing the Cold Damage pulse again implies re-injury by external cold. Cold and heat struggle, hence called transforming into Warm Malaria."
(13) "If Yang pulse is floating and slippery, and Yin pulse is soggy and weak, and one is further encountered by wind, it transforms into Wind-Warmth (Fengwen)." (*Shanghan Li*, Preface to Shanghan)
Cheng Wuji stated: "This is previous heat not yet resolved, encountering wind. *Nan Jing* says: 'The pulse of Wind Strike is floating and slippery at Yang, soggy and weak at Yin.' Wind riding on heat causes transformation into Wind-Warmth."
(14) "If Yang pulse is surging and rapid, and Yin pulse is solid and large, and one is further encountered by warm heat, it transforms into Warm Toxicity (Wendu). Warm Toxicity is the most severe among diseases." (*Shanghan Li*, Preface to Shanghan)
Cheng Wuji stated: "This is previous heat not yet resolved, encountering warm heat. Yang governs exterior, Yin governs interior. Surging, rapid, solid, and large are all heat. Two heats combine to transform into Warm Toxicity. Because interior and exterior are both hot, it is the most severe disease."
Wang Puzhuang stated: "This Warm Toxicity is the same as Yang Toxicity and Yin Toxicity in *Jingui Yaolue*. Surging and rapid indicate Qi heat; solid and large indicate Blood heat. Warm heat Qi carrying toxicity enters Yangming, transforming into Warm Toxicity; all rashes and macules belong to this category. If the toxin sinks and lies hidden, it is untreatable, hence called the most severe disease."
(15) "If Yang pulse is soggy and weak, and Yin pulse is string-taut and tight, and one is further encountered by warm Qi, it transforms into Warm Epidemic (Wenyi)." (*Shanghan Li*, Preface to Shanghan)
Wang Puzhuang stated: "Warm Epidemic is Damp-Warmth. (Note: Damp-Warmth here refers to Damp-Warmth Epidemic, not the Damp-Warmth among the five types of Cold Damage in *Nan Jing*). The Qi of seasonal movement is not outside cold, heat, dryness, and dampness. Cold transforms into Warm Malaria, heat into Warm Toxicity, dryness into Wind-Warmth, dampness into Warm Epidemic. Thus *Zong Bing Lun* lists four types of warm diseases, directly equating Warm Epidemic with Damp-Warmth. Soggy and weak indicate heavenly dampness affecting the upper, hence seen in Yang pulse; string-taut and tight indicate earthly dampness affecting the lower, hence seen in Yin pulse. Warm Qi is excessive heat earlier than season in spring/summer, steaming earthly dampness. Contracted after Cold Damage, it accumulates into symptoms of body heat, profuse sweating, and unresolved condition. This Qi is easily contagious, causing similar illnesses in young and old, hence named Epidemic. Named Warm Epidemic to distinguish from Cold Epidemic. Cold Epidemic must include cold-damp; Warm Epidemic must include damp-heat. This is the general outline."
(16) "Taiyang disease, with fever, thirst, and no aversion to cold, is Warm Disease." (*Bian Taiyang Bing Mai Zheng Bing Zhi*)
Cheng Wuji stated: "Fever, thirst, and no aversion to cold indicate Yangming. This is Taiyang receiving pathogen, known as Warm Disease, not Cold Damage. Accumulated warmth becomes heat, hence fever, thirst, and no aversion to cold."
Pang Anchang stated: "Warmth and heat have degrees of severity. Thus Zhang Zhongjing said: 'Encountering warm Qi leads to Warm Disease; encountering warm heat leads to Warm Toxicity.' Heat is heavier than warmth. If only injured by cold in winter, erupting in spring without other pathogens, it is named Warm Disease (slightly lighter); if Warm Disease is ongoing and encounters warm Qi again, transforming into Warm Disease (heavier); *Shanghan Li* names re-encountering warm Qi as Warm Epidemic. Also, those not injured by winter cold but getting Warm Disease in spring, specifically contracting spring warm Qi, can be named Spring Warmth (Chunwen), similar to winter cold, autumn damp, or summer heat. Thus, spring warm disease has three types: 1. Winter cold erupting in spring as Warm Disease; 2. Ongoing Warm Disease encountering warm Qi again or mixing with re-contracted warm Qi; 3. Not injured by winter cold nor re-encountering warm Qi, but contracting spring warm Qi directly. All three can be named Warm Disease; no need for separate names, just know the different origins."
Zhang Yunqi stated: "Cold Damage not cured by sweating/purging, passing the meridian stage, with symptoms persisting, is also Warm Disease. Classic says: 'Pulse of Warm Disease travels through various meridians; unknown which moves, treat according to location.' E.g., Taiyang disease after sweating/purging, pulse floating at cun/guan/chchi is Taiyang Warm Disease; body heat/eye pain, pulse long is Yangming Warm Disease; chest/hypochondriac pain, pulse string-taut is Shaoyang Warm Disease; abdominal fullness/throat dryness, pulse deep/fine is Taiyin Warm Disease; mouth dry/thirst, pulse deep is Shaoyin Warm Disease; irritability/fullness/genital retraction, pulse faint/slow is Jueyin Warm Disease. Treat according to meridian and symptom. E.g., rash emergence is Warm Toxicity."
Ke Yunbo stated: "Warm Disease has heat inside and out, distinguishing it from Wind Strike and Cold Damage's aversion to cold and fever. This clause does not expound *Neijing*'s 'winter cold, spring warmth' principle, but generally describes Taiyang Warm Disease symptoms. Interpreting it only as Spring Warmth loses Zhang Zhongjing's intent. Taiyang meridian can be diseased in all four seasons, not just winter; human Warm Disease need not stem from Cold Damage; warm disease can occur in all seasons, not just spring. Extending this, all six meridians have Warm Disease, not just Taiyang."
(17) "If after sweating, the body is burning hot, it is named Wind-Warmth. In Wind-Warmth disease, pulse Yin and Yang are both floating, spontaneous sweating, body heaviness, excessive sleepiness, snoring breath, difficulty speaking. If purged incorrectly: urine difficult, staring gaze, incontinence. If fire therapy applied: slight yellowing, severe like convulsions/epilepsy with twitching. If smoke-fired: one reversal delays death, two reversals hastens death." (*Bian Taiyang Bing Mai Zheng Bing Zhi*)
Huang Baochen stated: "Fever/aversion to cold is Taiyang pattern; fever/thirst/no aversion to cold is Yangming pattern. Now Taiyang disease shows Yangming symptoms immediately without cold turning to heat, indicating Taiyang Warm Disease, not Cold Damage. *Neijing*: 'Those who do not store essence in winter get Warm Disease in spring'; 'Injured by cold in winter, get Warm Disease in spring.' Originally internal Yin deficient, external Yang constrained, latent pathogen ferments, transforms to heat early. In spring, meeting external pathogen, heat responds internally, causing fever/thirst/no aversion to cold. Should use cold/cool herbs with Taiyang exterior drugs for slight sweat. Using acrid-warm drugs for heavy sweating makes internal heat flourish. Thus, after sweating, body burns hot, light disease becomes heavy, forming Wind-Warmth. Wind-Warmth pulse floating indicates Taiyang Wind Strike aspect; body heaviness/excessive sleepiness indicates Shaoyin danger from combined heat. Kidney heat congesting Lung causes snoring; Kidney heat harassing Heart causes speech difficulty. Severe heat damages fluid. Incorrect purging exhausts water source, urine difficult, Shaoyin Qi failing, unable to nourish Taiyang pulse (staring gaze), unable to control Bladder Qi (incontinence). Fire therapy adds fire to fire: slight yellowing from heat steaming earth; severe convulsions/twitching from heat attacking heart/wind generation. Yellow darkening with black center resembles smoke-fire. Purging is one reversal; fire is second. One reversal delays; two reversals hastens death. Physicians must be cautious!"
Wang Mengying stated: "Winter/Spring Warmth attacking Hand-Taiyin Lung is called Wind-Warmth (inhaled); this latent pathogen erupting from incorrect sweating is also called Wind-Warmth (internal virtual wind). Wind-Warmth in Lung should only be cleared/resolved. Incorrectly using acrid-hot drugs for sweating causes spontaneous sweating, sleepiness, snoring, speech difficulty. See my case of Lady Liang in *Wangshi Yi'an Xupian*."
Lu Jiuzhi stated: "The 'incorrect purging' of that time referred to Croton seed pills (Badou Xiaowan), thus damaging Yin further, as Croton seed is also a warm-hot drug."
(18) "Taiyang Zhongre (Summerheat Stroke) is also called Re (Heatstroke). The person sweats, is averse to cold, has body heat and thirst." (*Jingui Yaolue* treats with Baihu Jia Renshen Tang) (*Bian Taiyang Bing Mai Zheng Bing Zhi*)
Zhou Yuzai stated: "Winter cold injuring people is named Zhonghan (Mid-Cold); summer heat injuring people is named Zhongre (Mid-Heat). This is external heat, hence 'Zhong', different from latent cold erupting as Heat Disease. Both use Baihu Tang because injury is in Qi, governed by Metal, disease is Heat. Metal disease affects mother/son (Kidney/Lung), similar to latent Qi in Shaoyin erupting via Yangming. Both use the same decoction. Not distinguished by winter latent vs. summer direct injury, nor by thirst difference. Formula uses Ginseng Baihu Tang because..."