岐伯曰∶今时之人，以酒为浆，以妄为常，醉以入房。此叹世风之不古，而不能如古人之虚邪贼风、避之有时，精
神内守，病安从来也。自岐伯迄今，又四五千年矣，加以中外交通，人烟繁萃，兵革时起，饥馑荐臻，温病瘟疫，有不
从而日增者乎？痘疮发现于后汉，至唐宋而盛行。痧症亦名干霍乱，宋时虽盛行，而至有清以来为尤烈。烂喉丹痧、白
喉、鼠疫等，虽为往昔异名之病，然皆自有清而后盛行。所以然者，盖上古之时，天清地宁，民淳俗朴，虚邪苛毒无由
而生，即或有之，发现亦鲜，故人不觉；世愈降，民俗愈浇，而恶疾险症亦遂愈多也。
吴又可生于多疫之秋，故其言曰∶业医者，所记所诵，连篇累牍，俱是伤寒，及其临证，悉见瘟疫，求其真伤寒，
百无一二云云，诚非虚语。其立说虽为后世温病瘟疫混淆之滥觞，而其发明疫邪自口鼻而入，伏于膜原，与夫九传之变，
则为治疫之金针，而不容埋没。
喻嘉言之温症三大例，可谓深知伏气变病之理。惟治金鉴一案，标其名为伤寒死症奇验，而强词夺理，竟作冬伤于
寒，又兼冬不藏精之春温两感症，用麻黄附子细辛汤及附子泻心汤，以炫其奇；且云不藏精之人，肾中阳气不鼓，精液
不得上升，故枯燥外见，用附子助阳，则阴气上交于阳位，如釜底加火，则釜中之气水上腾，而润泽有立至者。此种言
论，荒谬已极，既标名伤寒，何得又作温病？夫不藏精者，精液枯竭，所以化火，惟恐清凉之不急，何得反用辛温？火
上加油，焉有不燎原者乎？其证状壮热、谵语、皮肤枯涩、舌卷、唇焦、足冷，即王海藏《阴症略例》所谓阴极似阳之
阴症，实非温病也。
《临证指南》、《温证论治》，《景岳发挥》诸书，伪托叶天士之所作也。（天士生平未尝着述，其所流传于世者，泰
半由于伪托，即《温证论治》及《临证指南》，乃叶派崇奉之灵符，一为顾景文之手笔，一出于华岫云之采辑。他如《景
岳发挥》，为梁溪姚球所撰，坊贾因书不售，剜补桂名，遂致洛阳纸贵。曹畸庵《医学读书志》言之甚详。又如陈修园
之《医学三字经》，修园自称亦曾托名叶天士。其作伪情形可概见矣）《临证指南》及《景岳发挥》，并详伏气，不独新
感。吴鞠通徒取《温热论》之温邪上受，首先犯肺，逆传心包十二字，撇开伏气，以新感立论，更固执《临证指南》所
云仲景伤寒先分六经，河间温热须究三焦之语，划分三焦界限，愈失愈远；既非叶派之全豹，复开后学之盲从，此温病
家之罪人也。陆九芝谓河间治法，亦惟六经是言，而三焦而字，始终不见于《六书》，初不解《指南》之何以有是语，
久之而悟《指南》于西昌之论瘟，认作河间之论温，约略记得河间之书，人皆说是异于仲景者，故即不妨托之河间耳。
此论固属确凿，而天士之意或又不然。夫河间主火，是其专长，人所共知，且作《三消论》，以三焦论治。三消之为病，
乃燥热怫郁，精血枯竭，亦须清凉，无异温病，此天士或由此而悟也。然《三消论》所谓之三焦，乃指上中下所病之部
位而言，此与天士以温病必始于上焦而终于下焦，又似是而非，实风马牛不相及也。但天士论温，虽知伏气，而论新感
则混同于瘟疫，故援又可之说，以温邪上受，首先犯肺，逆传心包为纲领。其邪之首先犯肺者，药用辛凉，是为新感之
温热，即陆氏所谓不过小小感冒，如小风热、小风温也；其逆传心包者，药用犀角、金汁、人中黄之属，是为瘟疫之重
症，即陆氏所谓不出数日遽入心包，为一场大病以至于死也。
陆氏之治温病，执定阳明，以阳明为成温之薮，凡属内外之邪，必通行此要津，如导江河而至于海，固属提纲挈领。
然只发明在阳明之温病，而于温病之伏气新感不分，轻重缓急同治，虽可为治法之常，犹未能通权达变。其意在扫除荆
棘，新辟康庄，实则未免矫枉过正。
王孟英温病家之卓卓者也，其指摘鞠通曰∶鞠通之排定三焦路径，必欲温热病遵其道而行，有是理乎？夫温热究三
焦者，非谓病自上焦始而渐及于中下也。伏气自内而发，则病起于下者有之；胃乃藏垢纳污之所，湿温疫毒，病起于中
者有之；暑邪挟湿者亦犯中焦。又暑属火，而心为火脏，同气相求，邪极易犯，虽始上焦，亦不能必其在手太阴一经也。
其辨别伏气新感曰∶伏气温病自里出表，乃先从血分而后达于气分。更有邪伏深沉，不能一齐外出者，正如抽蕉剥茧，
层出不穷，不比外感温邪由卫及气、自营而血也。此等议论，皆至理名言，可为师法。且其验案甚伙，更堪玩味。
章虚谷与吴鞠通为同时人，皆崇拜叶天士者也。章氏于温热虽无发明处，然亦纠正吴氏《温病条辨》之谬，较之吴
氏尚胜一筹。
伏邪之病，《内经》论之甚详，而不见其名。《伤寒论》虽有伏气之病，而无新感之称，所以世之论温病者，恒混淆
不分。清·蒋宝素所着《医略稿》之伏邪篇，阐扬伏温一病，昭然大白。惜其乃援吴氏《瘟疫论》行邪伏邪之说，仍属
瘟温不分，未可为法。柳宝诒继之，辨别瘟温之相异，新感伏气之不同，既正诸家之谬，复发前人所未言，实论伏气温
之最详备者也。
他如周禹载、尤在泾、舒驰远、陈平伯，于温病均有所发明。周禹载之《温热暑疫全书》，乃发明温病发于少阳者
也。其说曰∶温病所伤者，寒也；所病者，温也；所伏者，少阴也；所发者，少阳也。其所以然者，少阴本虚而伤寒，
春则木旺而水亏，火气燔灼，病必有阳而无阴，药必用寒而远热，黄芩汤其主治也。尤在泾之《伤寒贯珠集》，乃发明
少阴清法与厥阴清法者也。其说曰∶少阴之热有从阳经传入者，亦有自受寒邪，久而变热者。阳经之寒，变则热归于气，
或入于血；阴经之寒，变则热入于血，而不归于气。厥阴之病，本自消渴，其里有热，乃传经之邪，厥阴受之也。舒驰
远之《伤寒六经定法》，乃发明太阴经之火者也。其说曰∶太阴经之着痹、行痹二症，为火旺阴亏，热结经隧，赤热肿
痛，手不可近，法宜清热润燥。陈平伯之《温热病指南》，乃发明肺胃为温邪必犯之地者也。其说曰∶风温为燥热之邪，
燥令从金化，燥热归阳明，故肺胃为温邪必犯之地。且风温为燥热之病，燥则伤阴，热则伤津，泄热和阴，又为风温病
一定之治法也。
以上诸家立言，皆有至理，然皆各举一端，学人博取而会通之，以为温病之治法则可，苟拘泥一家之言，则大不可。
《伤寒论》之六经见证，乃百病之提纲，非独为伤寒病而设。刘松峰有瘟疫六经治法，朱兰台之《疫证治例》亦分
六经。治瘟疫尚以六经见证，何况温病乎！所谓见证者，乃以证候见于何经，即从何经而治之也。若作伤寒之六经传经，
由太阳而阳明，终于厥阴解之，则谬矣。《难经》曰∶温病之脉行在诸经，不知何经之动也。然则凡论温病者，岂可胶
柱鼓瑟哉？
至于治病之法，则《内经》云∶治寒以热，治热以寒。又曰∶从内之外者，调其内；从外之内者，治其外。从内之
外而盛于外者，先调其内，而后治其外；从外之内而盛于内者，先治其外，而后调其内。中外不相及，则治主病。又曰∶
治热以寒，温而行之；治寒以热，凉而行之；治温以清，冷而行之；治清以温，热而行之。故消之削之，吐之下之，补
之泻之，久新同法。此皆治病之通法，治温热者亦不能外也。
陆九芝曰∶天士于《临证指南》，既以小风寒抵作伤寒一大法门，于《温证论治》，又以小风热抵作温热一大法门，
所以伤寒一证，至天士而失传，温热一证，亦至天士而失传。此叹景文、岫云之作伪也。孰知不有当日天士之误，则无
后世温病之争，而伤寒温病均无人阐发矣。夫《难经》伤寒有五之伤寒，外感之总称也，《伤寒论》则六淫之全书也。
然五种伤寒之中，又有伤寒之目，故伤寒虽有广义，亦有狭义。既有狭义，则伤寒与温病，又未可混而不分也。今日之
所谓温病学人，亦非专言温病，乃概暑湿燥火而言，既不悖乎经旨，又能发扬光大，何尝不可与《伤寒论》后先辉映，
相得益彰乎？此书虽为正温病之名而作，亦未始非为《伤寒论》进一解也。
岐伯说：现在的人，把酒当作饮料随意饮用，把妄作妄为当作常态，醉酒后行房事。这是在感叹世风不如古代淳朴，人们不能像古人那样及时躲避虚邪贼风，使精神内守，这样疾病又从何而来呢？从岐伯到现在，已经四五千年了，加上中外交通往来频繁，人口密集，战乱不断，饥荒接连发生，温病和瘟疫，能不因此日益增多吗？痘疮在后汉时期出现，到了唐宋时期盛行。痧症也叫干霍乱，宋代虽然盛行，但到了清朝更为猛烈。烂喉丹痧、白喉、鼠疫等，虽然是过去名称不同的疾病，但都自有清朝以后才盛行。之所以如此，大概是因为上古时代，天空清澈大地安宁，民风淳朴习俗质朴，虚邪苛毒没有产生的条件，即使有，显现的也很少，所以人们不觉得；社会越发展，民俗越浮薄，而恶疾险症也就越来越多了。
吴又可生于多疫病的时代，所以说：从事医学的人，所记诵的内容，连篇累牍，都是关于伤寒的，等到临证时，见到的全是瘟疫，想找真正的伤寒病人，一百个里面也没有一两个等等，这确实不是空话。他的学说虽然成为后世温病与瘟疫混淆的开端，但他阐明疫邪从口鼻而入，潜伏在膜原，以及九传的变化，则是治疗疫病的金针（关键方法），不容埋没。
喻嘉言提出的温症三大例，可以说是深知伏气变病的道理。只是他诊治《医宗金鉴》中的一例病例，标榜其名为伤寒死症的奇验，却强词夺理，竟将其解释为冬天受寒，又兼冬天肾精不藏导致的春温两感症，使用麻黄附子细辛汤及附子泻心汤，来炫耀其奇特；并且说肾精不藏的人，肾中阳气不能鼓动，精液不得上升，所以外表呈现枯燥之象，用附子助阳，则阴气上交于阳位，就像锅底加火，锅中的水汽就会上腾，润泽的效果立刻就能见到。这种言论，荒谬至极，既然标榜是伤寒，怎么又说是温病呢？那些肾精不藏的人，精液枯竭，所以化火，唯恐清凉药不够急迫，怎么能反而用辛温的药呢？火上浇油，哪有不着成燎原之势的呢？他的症状表现为壮热、谵语、皮肤枯涩、舌卷、唇焦、足冷，这正是王海藏《阴症略例》中所说的阴极似阳的阴症，实际上并不是温病。
《临证指南》、《温证论治》、《景岳发挥》等书，都是伪托叶天士所作的。（叶天士生平从未著述，他所流传于世的作品，大半是伪托的，其中《温证论治》和《临证指南》，分别是叶派推崇的灵符，前者是顾景文的笔迹，后者出于华岫云的采辑。其他的如《景岳发挥》，是梁溪姚球所撰，书商因为书卖不出去，挖补替换书名，于是导致洛阳纸贵。曹畸庵的《医学读书志》对此说得非常详细。又如陈修园的《医学三字经》，修园自己也承认曾假托叶天士之名。其作伪的情况可以概见一斑）《临证指南》及《景岳发挥》，都详细论述了伏气，不仅仅局限于新感。吴鞠通只取《温热论》中“温邪上受，首先犯肺，逆传心包”十二个字，撇开伏气，以新感立论，更固执地引用《临证指南》中说的“仲景伤寒先分六经，河间温热须究三焦”的话，划分三焦界限，离真理越来越远；既不是叶派的完整面貌，又开启了后学盲目跟从的风气，这是温病学家的罪人。陆九芝说河间的治法，也只谈六经，而“三焦”二字，始终不见于《六书》（指刘河间的著作），起初不明白《指南》为什么会有这样的话，久而久之才明白，《指南》将西昌关于瘟的论述，认作是河间关于温的论述，大致记得河间的书中，人们都说其异于仲景，所以就不妨假托给河间罢了。这个论点固然确凿，但叶天士的本意或许并非如此。河间主火，是他的专长，人所共知，而且他作《三消论》，以三焦论治。三消之为病，乃是燥热怫郁，精血枯竭，也需要清凉药，与温病无异，这可能是叶天士由此悟出的道理。然而《三消论》所说的三焦，是指上中下所患病的部位而言，这与叶天士认为温病必始于上焦而终于下焦，似是而非，实际上是风马牛不相及。但是叶天士论温，虽然知道伏气，但在论新感时却混同于瘟疫，所以援引吴又可的说法，以“温邪上受，首先犯肺，逆传心包”为纲领。其邪首先犯肺的，药用辛凉，这是新感的温热，即陆氏所谓不过是小小的感冒，如小风热、小风温；其逆传心包的，药用犀角、金汁、人中黄之类，这是瘟疫的重症，即陆氏所谓不出数日就进入心包，是一场大病以至于死亡。
陆九芝治疗温病，执着于阳明，以阳明为形成温病的渊薮，凡是内外之邪，必定通行这个要津，如同引导江河流入大海，固然是提纲挈领。然而只阐明了在阳明的温病，而对于温病的伏气与新感不分，轻重缓急同治，虽然可以作为治法的常规，还不能做到通权达变。他的意图在于扫除荆棘，新辟康庄大道，实则未免矫枉过正。
王孟英是温病家中卓越的人物，他指责吴鞠通说：吴鞠通排定三焦路径，一定要让温热病遵循其道而行，有这样的道理吗？探究温热病的三焦，不是说病从上焦开始逐渐波及中下。伏气自内而发，那么病起于下的情况是有的；胃是藏垢纳污的地方，湿温疫毒，病起于中的情况是有的；暑邪挟湿的也会侵犯中焦。另外暑属火，而心为火脏，同气相求，邪气极易侵犯，虽然始自上焦，也不能一定说是在手太阴一经。他辨别伏气与新感说：伏气温病自里出表，乃先从血分而后达于气分。更有邪气潜伏深沉，不能一齐外出的，正如抽蕉剥茧，层出不穷，不像外感温邪由卫分及气分、由营分而血分。这些议论，都是至理名言，值得效法。而且他的验案很多，更值得玩味。
章虚谷与吴鞠通是同时代人，都崇拜叶天士。章氏对于温热病虽然没有新的发明，但也纠正了吴氏《温病条辨》的错误，比吴氏尚胜一筹。
伏邪的病，《内经》论述得很详细，但没有出现它的名字。《伤寒论》虽然有伏气病，但没有新感的称呼，所以世上讨论温病的人，常常混淆不分。清代的蒋宝素所著的《医略稿》中的伏邪篇，阐扬了伏温这一疾病，使其昭然大白。可惜他援引了吴氏《瘟疫论》中行邪伏邪的说法，仍然属于瘟温不分，不足为法。柳宝诒继承了他的观点，辨别瘟温的差异，新感伏气的不同，既纠正了诸家的错误，又发挥了前人所未言说的内容，确实是论述伏气温病最详备的了。
其他如周禹载、尤在泾、舒驰远、陈平伯，对于温病都有发明。周禹载的《温热暑疫全书》，是阐发温病发于少阳的。他的说法是：温病所伤的是寒，所病的是温，所伏的是少阴，所发的是少阳。之所以如此，是因为少阴本虚而受伤寒，春天木旺而水亏，火气燔灼，病必有阳而无阴，药必用寒而远离热药，黄芩汤是其主治方。尤在泾的《伤寒贯珠集》，是阐发少阴清法与厥阴清法的。他的说法是：少阴的热有从阳经传入的，也有自受寒邪，久而变热的。阳经的寒，变则热归于气，或入于血；阴经的寒，变则热入于血，而不归于气。厥阴的病，本自消渴，其里有热，是传经之邪，厥阴受之。舒驰远的《伤寒六经定法》，是阐发太阴经的火证的。他的说法是：太阴经的着痹、行痹二症，为火旺阴亏，热结经隧，赤热肿痛，手不可近，治法宜清热润燥。陈平伯的《温热病指南》，是阐发肺胃为温邪必犯的地方的。他的说法是：风温为燥热之邪，燥令从金化，燥热归阳明，所以肺胃为温邪必犯之地。而且风温为燥热之病，燥则伤阴，热则伤津，泄热和阴，又是风温病一定的治法。
以上诸家立言，都有至理，但都各举一端，学习者广泛吸取并融会贯通，作为温病的治疗法则是可以的，如果拘泥于一家之言，那就大错特错了。《伤寒论》的六经见证，是百病的提纲，不仅仅是为伤寒病设立的。刘松峰有瘟疫六经治法，朱兰台的《疫证治例》也分六经。治疗瘟疫还用六经见证，何况温病呢！所谓见证，是以证候见于何经，就从何经而治之。如果按照伤寒的六经传经，由太阳而阳明，终于厥阴来解释，那就错了。《难经》说：温病的脉行在诸经，不知道是哪一经动的。既然如此，那么凡论温病的人，岂可胶柱鼓瑟（不知变通）呢？
至于治病的方法，《内经》说：治寒以热，治热以寒。又说：从内之外者，调其内；从外之内者，治其外。从内之外而盛于外的，先调其内，而后治其外；从外之内而盛于内的，先治其外，而后调其内。中外不相及，则治主病。又说：治热以寒，温而行之；治寒以热，凉而行之；治温以清，冷而行之；治清以温，热而行之。所以消之削之，吐之下之，补之泻之，久病新病同法。这些都是治病的通法，治疗温热病也不能例外。
陆九芝说：叶天士在《临证指南》中，既以小风寒抵作伤寒的一大法门，在《温证论治》中，又以小风热抵作温热的一大法门，所以伤寒一证，到叶天士那里失传了，温热一证，也到叶天士那里失传了。这是在感叹顾景文、华岫云等人的作伪。谁知道如果不是当时叶天士的错误，就没有后世温病的争论，而伤寒和温病都没有人阐发了。《难经》中说伤寒有五的伤寒，是外感的总称，《伤寒论》则是六淫的全书。然而五种伤寒之中，又有狭义的伤寒，所以伤寒虽有广义，也有狭义。既有狭义，那么伤寒与温病，又不可以混而不分。今天的所谓温病学人，也不是专言温病，而是概括暑湿燥火而言，既不违背经旨，又能发扬光大，何尝不可以与《伤寒论》前后辉映，相得益彰呢？这本书虽然是正温病之名而作，也未尝不是为《伤寒论》进一解。
Qibo said: People nowadays treat wine as a beverage, regard reckless behavior as normal, and engage in sexual intercourse while intoxicated. This laments the decline of social morals compared to ancient times; people fail to avoid empty evils and thieving winds (pathogenic factors) in a timely manner like the ancients, nor do they keep their spirits inwardly guarded. How could diseases arise? From Qibo to the present, four or five thousand years have passed. Added to this are frequent interactions between China and foreign countries, dense populations, frequent wars, and successive famines. Would warm diseases (Wenbing) and epidemics not increase daily under these circumstances? Smallpox appeared in the Later Han Dynasty and became prevalent during the Tang and Song Dynasties. Sha syndrome (also known as dry Huoluan) was prevalent in the Song Dynasty but became even more severe after the Qing Dynasty. Diseases such as rotting throat dan sha (scarlet fever-like illness), diphtheria, and plague, although having different names in the past, only became prevalent after the Qing Dynasty. The reason for this is that in ancient times, the sky was clear and the earth peaceful, the people were simple and customs unadulterated, so empty evils and harsh toxins had no way to arise. Even if they did, they rarely manifested, so people did not notice them. As society declined, customs became more frivolous, and thus malignant diseases and dangerous syndromes increased.
Wu Youke lived in an era plagued by epidemics, so he stated: "Practitioners memorize and recite volumes upon volumes of texts on Shanghan (Cold Damage). Yet when treating patients clinically, they encounter nothing but epidemics. True Shanghan cases account for less than one or two out of a hundred." This is indeed not an empty statement. Although his theories served as the origin for the later confusion between warm diseases and epidemics, his elucidation that epidemic pathogens enter through the mouth and nose, lie latent in the membrane source (Moyuan), and undergo nine types of transmission, constitutes the golden needle (key method) for treating epidemics and should not be overlooked.
Yu Jiayan's three major examples of warm syndromes demonstrate a profound understanding of the pathology of latent qi transforming into disease. However, regarding a case in the *Yizong Jinjian* (Golden Mirror of Medicine), he labeled it as a miraculous verification of a fatal Shanghan syndrome but used forced reasoning, interpreting it as a spring warmth (Chunwen) dual-infection syndrome caused by winter cold injury combined with failure to store essence during winter. He prescribed Mahuang Fuzi Xixin Tang (Ephedra, Aconite, and Asarum Decoction) and Fuzi Xiexin Tang (Aconite and Rhubarb Decoction) to showcase its novelty. He claimed that in individuals who fail to store essence, kidney yang fails to stir, preventing essence fluids from ascending, resulting in external dryness. By using Fuzi to assist yang, yin qi ascends to the yang position, akin to adding fire to a pot, causing steam to rise and providing immediate moistening. Such arguments are extremely absurd. If it is labeled as Shanghan, how can it also be considered a warm disease? In those whose essence is depleted, essence fluids are exhausted and transform into fire. One should fear the lack of urgent cooling measures; how can acrid-warm herbs be used instead? Adding oil to fire, how could it not spread uncontrollably? His symptoms—high fever, delirium, dry and rough skin, curled tongue, scorched lips, and cold feet—correspond exactly to the "yin syndrome resembling yang" described in Wang Haizang's *Yinzheng Lueli*. It is actually a yin syndrome, not a warm disease.
Books such as *Linzheng Zhinan* (Clinical Guide), *Wenzheng Lunzhi* (Discussion on Treatment of Warm Syndromes), and *Jingyue Fahui* (Elucidation of Jingyue) are falsely attributed to Ye Tianshi. (Ye Tianshi never wrote any books himself. Most works circulating under his name are forgeries. *Wenzheng Lunzhi* and *Linzheng Zhinan*, revered as sacred talismans by the Ye school, were written by Gu Jingwen and compiled by Hua Xiuyun, respectively. Similarly, *Jingyue Fahui* was authored by Yao Qiu of Liangxi; booksellers altered the title to include Gui's name because sales were poor, leading to high demand. Cao Jian's *Yixue Dushu Zhi* details this extensively. Chen Xiuyuan also admitted in his *Yixue Sanzijing* to having used Ye Tianshi's name. These instances reveal the extent of forgery.) Both *Linzheng Zhinan* and *Jingyue Fahui* discuss latent qi extensively, not just new sensations (Xingan). Wu Jutong solely adopted the twelve characters from *Wenre Lun*: "Warm pathogens ascend from above, first attacking the Lung, and may reverse-transmit to the Pericardium." He discarded the concept of latent qi, basing his theory on new sensations. Furthermore, he rigidly adhered to the statement in *Linzheng Zhinan*: "Zhongjing's Shanghan is first divided into six channels; Hejian's warm diseases must be investigated through the Triple Burner." He delineated boundaries of the Triple Burner, drifting further from the truth. He represented neither the complete picture of the Ye school nor opened the door for blind following by later students; he is a sinner among warm disease practitioners. Lu Jiuzhi pointed out that Hejian's treatment methods were discussed exclusively in terms of the Six Channels, yet the term "Triple Burner" never appears in Hejian's *Six Books*. Initially puzzled by why *Zhinan* contained such remarks, Lu eventually realized that *Zhinan* mistook Xichang's discussion on plague for Hejian's discussion on warm diseases. Knowing that people generally regarded Hejian's work as differing from Zhongjing's, they felt free to attribute it to him. While this argument is solid, Ye Tianshi's intent might have been different. Hejian's specialization in Fire was well-known, and he wrote *Sanxiao Lun* (Treatise on Three Consumptions), treating Sanxiao via the Triple Burner. Sanxiao diseases involve dry-heat stagnation and exhaustion of essence and blood, requiring cooling treatments similar to warm diseases; perhaps Ye Tianshi deduced this from there. However, the "Triple Burner" in *Sanxiao Lun* refers to the anatomical locations of upper, middle, and lower pathologies, which is semantically similar but practically unrelated to Ye Tianshi's view that warm diseases necessarily start in the Upper Burner and end in the Lower Burner. Nevertheless, although Ye Tianshi knew of latent qi, he conflated new sensations with epidemics in his discussion of warm diseases. Thus, he adopted Youke's theory, taking "warm pathogens ascend from above, first attacking the Lung, and may reverse-transmit to the Pericardium" as the guideline. When the pathogen first attacks the Lung, acrid-cool herbs are used, representing new-sensation warm-heat, which Lu referred to as minor colds like minor wind-heat or minor wind-warmth. When it reverse-transmits to the Pericardium, herbs like Rhinoceros Horn, Gold Juice, and Human Midden Yellow are used, representing severe epidemic cases, which Lu described as entering the Pericardium within days, leading to a major illness and death.
Lu Jiuzhi treated warm diseases by focusing strictly on the Yangming channel, viewing Yangming as the reservoir where warm diseases form. He believed all internal and external pathogens must pass through this vital gateway, much like rivers flowing into the sea, which serves as a comprehensive outline. However, he only elucidated warm diseases located in the Yangming, failing to distinguish between latent qi and new sensations, and treating light/heavy and slow/urgent cases uniformly. While this may serve as a standard method, it lacks flexibility. His intention was to clear obstacles and open new paths, but he arguably went too far in correcting errors.
Wang Mengying was an outstanding figure among warm disease practitioners. He criticized Jutong: "Does Jutong's fixed pathway of the Triple Burner imply that warm-heat diseases must follow this route? Is there any logic in this?" Investigating the Triple Burner in warm-heat diseases does not mean the disease always starts in the Upper Burner and gradually spreads to the Middle and Lower. Latent qi emerging from within can cause diseases starting in the Lower Burner. The stomach, being a place of accumulation, can be the site of wet-warmth and epidemic toxins starting in the Middle Burner. Summer-heat pathogens carrying dampness also invade the Middle Burner. Moreover, summer-heat belongs to Fire, and the Heart is the Fire organ; due to sympathetic resonance, pathogens easily invade. Even if starting in the Upper Burner, it cannot be assumed to be confined to the Hand-Taiyin Lung channel. Regarding the distinction between latent qi and new sensations, he stated: "Latent qi warm diseases emerge from the interior to the exterior, moving from the Blood level to the Qi level first. Some pathogens lie deep and cannot exit simultaneously, like peeling a banana or cocoon, endlessly emerging, unlike external warm pathogens that move from Wei (Defensive) to Qi, and from Ying (Nutritive) to Blood." These discussions contain profound truths and are worthy of emulation. His clinical cases are numerous and worth studying.
Zhang Xugu and Wu Jutong were contemporaries who both worshipped Ye Tianshi. Although Zhang made no new discoveries regarding warm-heat diseases, he corrected errors in Jutong's *Wenbing Tiaobian* (Systematic Differentiation of Warm Diseases), performing slightly better than Jutong.
The disease of latent evil is discussed in detail in the *Neijing* (*Inner Canon*), though the specific name is absent. Although *Shanghan Lun* (*Treatise on Cold Damage*) mentions latent qi, it does not use the term "new sensation," leading to constant confusion among those discussing warm diseases. Jiang Baosu's *Fuxie Pian* (Chapter on Latent Evil) in his *Yilue Gao* (*Draft of Medical Notes*) elucidated latent warm diseases clearly. Unfortunately, he borrowed the concepts of traveling and latent pathogens from Wu's *Wenyi Lun* (*Treatise on Epidemic Pestilence*), still failing to distinguish between plague and warm diseases, making it unsuitable as a model. Liu Baoyi followed up, distinguishing the differences between plague and warm diseases, and between new sensations and latent qi. He corrected previous errors and expounded on points previously unmentioned, making his work the most comprehensive discussion on latent qi warm diseases.
Others such as Zhou Yucai, You Zaijing, Shu Chiyuan, and Chen Pingbo also made contributions to warm disease theory. Zhou Yucai's *Wenre Shuyi Quan shu* (*Complete Book on Warm, Heat, Summer-heat, and Epidemic Diseases*) elucidates warm diseases originating in the Shaoyang channel. He stated: "What warm diseases injure is Cold; what they manifest as is Warmth; what lies latent is Shaoyin; what erupts is Shaoyang." The reason is that Shaoyin is inherently deficient and injured by Cold. In spring, Wood flourishes while Water is depleted, causing Fire to blaze. The disease will have Yang without Yin, requiring cold herbs and avoiding warm ones. Huangqin Tang (Scutellaria Decoction) is the primary treatment. You Zaijing's *Shanghan Guan Zhu Ji* (*Pearl String Collection on Cold Damage*) elucidates clearing methods for Shaoyin and Jueyin. He stated: "Heat in Shaoyin may transmit from Yang channels or arise from Cold pathogens lingering and transforming into heat over time. When Cold in Yang channels transforms, heat returns to the Qi level or enters the Blood level. When Cold in Yin channels transforms, heat enters the Blood level without returning to the Qi level." Jueyin disease involves polydipsia and internal heat, resulting from transmitted pathogens affecting Jueyin. Shu Chiyuan's *Shanghan Liujing Dingfa* (*Fixed Methods for the Six Channels of Cold Damage*) elucidates fire syndromes in the Taiyin channel. He stated: "The two syndromes of Bi obstruction (fixed and migrating) in the Taiyin channel result from excessive fire and yin deficiency, with heat binding in the meridians, causing redness, heat, swelling, and pain that cannot be touched. The treatment should clear heat and moisten dryness." Chen Pingbo's *Wenre Bing Zhinan* (*Guide to Warm Disease Treatment*) elucidates that the Lung and Stomach are the sites inevitably attacked by warm pathogens. He stated: "Wind-warmth is a dry-heat pathogen. Dryness follows Metal transformation, and dry-heat returns to Yangming. Thus, the Lung and Stomach are the inevitable targets. Since wind-warmth is a dry-heat disease, dryness injures Yin and heat injures fluids. Clearing heat and harmonizing Yin is the definitive treatment for wind-warmth."
The statements of these masters all contain profound truths, but each highlights only one aspect. Students should absorb broadly and integrate them to form a comprehensive treatment principle for warm diseases. Adhering rigidly to one school's views is highly inadvisable. The Six Channel manifestations in *Shanghan Lun* are the outline for all diseases, not just for Shanghan. Liu Songfeng proposed Six Channel treatments for epidemics, and Zhu Lantai's *Yizheng Zhili* (*Examples of Treating Epidemics*) also divides them into Six Channels. If even epidemics are treated based on Six Channel manifestations, how much more so for warm diseases! "Manifestations" means treating based on which channel the symptoms appear in. Interpreting this as the sequential transmission of Shanghan—from Taiyang to Yangming, ending in Jueyin—is erroneous. The *Nanjing* states: "The pulse of warm diseases travels through the various channels; it is unknown which channel is active." Therefore, those discussing warm diseases cannot be dogmatic.
Regarding treatment methods, the *Neijing* says: "Treat cold with heat, treat heat with cold." It also states: "For conditions originating internally and manifesting externally, regulate the interior; for conditions originating externally and penetrating internally, treat the exterior. If internal-originating conditions become severe externally, regulate the interior first, then treat the exterior; if external-originating conditions become severe internally, treat the exterior first, then regulate the interior. If interior and exterior are unrelated, treat the primary disease." It further states: "Treat heat with cold, administer warmly; treat cold with heat, administer coolly; treat warmth with clarity, administer coldly; treat clarity with warmth, administer hotly." Thus, reducing, cutting, vomiting, purging, tonifying, and draining are applied similarly regardless of whether the disease is chronic or acute. These are general principles of treatment, applicable to warm-heat diseases as well.
Lu Jiuzhi said: "In *Linzheng Zhinan*, Ye Tianshi treated minor wind-cold as a major category of Shanghan; in *Wenzheng Lunzhi*, he treated minor wind-heat as a major category of warm diseases. Consequently, the knowledge of Shanghan was lost at Ye Tianshi's time, and the knowledge of warm diseases was also lost at his time." This laments the forgeries by Jingwen and Xiuyun. Who would have thought that without Ye Tianshi's errors, there would be no later disputes between Shanghan and warm diseases, and neither would have been elucidated? The "Shanghan has five types" mentioned in the *Nanjing* refers to the general term for external contraction. *Shanghan Lun* is the comprehensive book on the Six Excesses. However, among the five types of Shanghan, there is a specific type called "Shanghan." Thus, Shanghan has both broad and narrow meanings. With a narrow meaning, Shanghan and warm diseases cannot be conflated. Today's warm disease practitioners do not speak solely of warm diseases but encompass summer-heat, dampness, dryness, and fire. This does not contradict canonical principles and further develops them. Why cannot they shine alongside *Shanghan Lun*, complementing each other? Although this book was written to clarify the name of warm diseases, it also serves to provide further interpretation for *Shanghan Lun*.