谢氏治学的基本方法是：不以后人之说证前人。他认为历代之所谓温病，本义不同，“欲知温病学说思想变迁之痕迹，自必从内难仲景等叙起，然着笔之时，当从内难之本义，作一朴质之叙述，凡清医对于内难仲景之注解，当一律屏去。”如果阑入清医之注解，就是用清医的思想来证前人之说了，这样，“无形中已失去内难仲景之本义。”故他在叙述《温病学说思想之变迁》时，将“内经仲景之温病，还之内经仲景。以叶吴孟英之温病，还之叶吴孟英。”这样抽茧剥焦，逐层揭去，先弄清历代各家温病学说之真面目，则有关争论的是非问题，就可判定了。其次，他认为凡是批判一种学说，目光必笼罩此学说之全体，抓住其关键，解决其根本，如支支节节，攻其局部，则此剿彼窜，将永无宁日，他认为陆九芝抨击叶派，具有这种缺点，所以不能彻底荡平其壁垒。故他考古论今，详评捆析，从大处落墨，对有关温病的几个关键性问题，逐一解答批评，认为这样便可彻底解决问题，荡平叶吴学说之壁垒。
二、《温病论衡》的概况
此书先刊于《中医新生命》杂志。后于1936年出单行本，由知行医学出版社出版，书面由陆渊雷题签，后附有《湿温论治》。全书共分六章，书首有引言。第一章《温病学说思想之变迁》先叙述了内经、难经，到戴北山、陆九芝为止的二十八家温病之本义。然后在结论中发表了自己的见解，这是全书抨击叶派学说很显力量的重要片断。第二章《温病病名名实之歧异》，讨论了湿温，风温，温毒，温疟，冬温，这五个古今名实淆乱的温病；第三章《伏气与外感》，为研究温病病因之专篇，内中对伏气学说提出了批评。第四章《伤寒温病与时行》，先列述前代医家的各种意见，然后发表作者自己的看法。第五章《清代温病书中所包含之疾病》，“专取叶派学说，作单独之剖析”，认为只少是包括了肺炎，肠伤寒，斑疹伤寒，猩红热，脑膜炎，丹毒，霍乱，痢疾，疟疾，中暑，耳下腺炎，黄疽，胁膜炎等这几种病在内。第六章《叶派温病治术之批评》，主要指摘叶派治术中的不足之处，认为：辛凉轻剂及滋阴疗法，用于“治犯肺之温病，寻常感冒，或足以了之。”如治疗肺炎等较重之温病，就已药轻而不及彀，不及麻杏石汤等方显得有力量，如竟用以治胃系之温病，就尤属治术之下驷。全书采撷陆九芝，章太炎、陆渊雷等人的论说较多，总的认为叶吴学说从理论到治疗，缺憾很多，陆九芝虽作了大举之驳击，但仅成对抗之势。他为了彻底解决近百年来在温病问题上的种种争执，批倒叶吴学说中的错误理论，纠正时医泛用轻清之流弊，故有《温病论衡》一书之撰作。
三、争鸣意见举隅
1·对《温热论》评价过高不恰当：叶桂的《温热论》被某些治温热之学者，奉为圭臬。谢氏认为将这部书捧的太高是不恰当的。他说；“所谓《温热论》者，吴医汇讲刻之，贮春仙馆刻之，拜石山房刻之，种福堂又刻之，王孟英等所视为金科玉律者也，然循其字里行间而核之，则有自相矛盾者，有混杂不清者，凌乱支离，不可卒读，不意歌讴赞美珍同瓖宝之《温热论》，乃如此不堪，彼终身由之而不疑，信之而不违者，亦事理之不可解也。”他指出；“《温热论》曰：‘伤寒多有变证，温热虽久，在一经不移，以此为辨。’然其后则曰：‘三焦不得从外解，必致成里结，里结于何，在阳明胃与肠也。’所谓胃者，在手阳明乎？抑足阳明乎？使为足阳明，其说固无以自存，而既能传胃，则久在一经之说，亦自相矛盾矣。”观叶吴学派之著作，不可否认，该派中人为了与仲景学说分庭抗礼，确实发了一些刻意罗织，不合事理的议论，如《临证指南》中，谓伤寒先伤阳经，温病先伤肺经。又谓仲景伤寒，先分六经，河间温热，须究三焦。《温病条辨》硬说《伤寒论》只为狭义伤寒而设，只论六气中一气，其余五气概未之及。这一类为妄立门户而不顾事实，歪曲仲景学说的说法，其错误是十分明显的，如曲为之释，实在也毫无意义。《温热论》虽然是一部有功于外感热病研究的重要文献，但毕竟是一家之言，且也沾有这种弊病，所以，我们应当客观地来研究它，不应该先存有“《温热论》是正统，其他不同观点的争鸣著作都是左道旁门”这种想法。谢氏敢于直率地指谪《温热论》多疵，这对破除迷信，正确评价古籍，是使人很受启发的。
2·温邪并不都先犯肺；谢氏明确将温病划成肺胃二系，认为；“论温病者，必当定肺胃二字为关键。”而“温邪上受，首先犯肺，逆传心包。此十二字者，仅为犯肺温病之纲领，决不能包括湿温等胃系温病。”但叶派中人竟以此“十二字，为温病纲领，于是胃系温病之起病，不由于犯肺者，亦一律以此十二字兼统之，于是胃系温病初起之病因病理治疗诸学说，一律平空割去，另冠以肺系之证治，此真俗语之所谓张冠李戴，最后则胃系温病中期末期，亦皆以治肺之药治之，而治疗之成绩，遂不可问。此种流弊，无形中蔚为风气，流行于时医之腕底。”他认为陆九芝抨击叶吴之学，正是为此。叶派学说之论温病，谓初起在上焦手太阴，确有肺胃不分之弊，是错误的理论。现在一般认为“流脑”属“春温”、“风温”范畴，“乙脑”属“暑温”范畴。流行性出血热、钩端螺旋体病等也属温热病范畴：但我们知道：象“乙脑”、流行性出血热，钩端螺旋体病、肠伤寒等这一类温热病，根本就不是首先犯肺的。而且，属于呼吸道传染病的“流脑”，“首先犯肺"说也不及张景岳“鼻通于脑，毒入脑中，则流布诸经，令人相染。”之说为合理。叶派所说之温病、连疟疾、痄腮、黄疸，中暑，痢疾等都包括在内，这些病都是极少首先犯肺的，所以，将“首先犯肺”等12字，视作肺系温病之纲领还可，说成是温病之纲领，是无论如何也说不通的。对此，作者拟将再作专文驳之，读者可参阅下文。
3·叶氏混淆温病之名实：谢氏细考叶氏医案，认为“叶氏所说之肺系温病，其轻者为流行性感冒，为支气管炎，其重者为肺炎。流行性感冒与支气管炎，古称伤风，肺炎即《金匮》之肺胀。”这二种病本不属于温病范畴，但叶氏竞杜撰称为温病，这正如章太炎先生所说，是悬牛头，卖马脯，名不符实。所以，谢氏认为；将伤风、肺胀等几种本来是与温病并列的一些病，混称为温病，“人谓叶天士所发明，吾谓叶天士所杜撰。人谓叶天士所特创，吾谓叶天士所混称，”将这一类漠不相关的病凭空阑入温病范畴，他认为根本就无此必要，所以他说：“温病名实之淆乱，叶天士为祸首。”
4·滋阴法为治温病之下驷：对叶派治术之批评，谢氏基本上是通过采录前人之说，经过熔裁，来表明自己观点的。其中一个方面，认为温病本质是热，要抓住撤热这一关，截断病势，才能保住阴津，使阴不伤。他录陆氏之说云：“总之，使病速去，阴始不伤，欲保其阴，必速去病。”谢氏认为；以生地养阴，石斛养胃这一类治法，不是说不可用，耍在分清主次，不能颠倒本末，对《临证指南，温热门》席姓一案的治法，他认为药法极不可取，以生地滋阴，本是取其甘寒多液，改为熟地，再烧之戍炭，就尤为育阴之下乘了。他认为叶氏这种滋阴法，顶多也只能说是学到了丹溪滋阴法的一半(因为丹溪的滋阴法，比较重视清君相之火以撤热)，象这样的去“移治不可滋阴之病机，则其悖谬而偾事也固宜。”
5·轻清疗法作用轻微：谢氏认为辛凉轻清之法只能治治小风温小风热，实际上就是说只能治治辨证属热的伤风感冒、喉炎等一类的小病。不用说治胃系温病及脑膜炎等病，就是治疗肺胀，也不能有效地逆转抑止病势，否则，“何以不出数日，遽入心包，为一场大病，以至于死。若不数日而病即入心，即可死者，则必非如其所说只须轻剂之辛凉，且何以如其所言，不即敌于辛凉之轻剂耶。”他认为章太炎论肺炎治法一文殊精绝，故不嫌引文冗长，大段节录，大旨谓麻杏石甘汤，越婢汤等都是治肺炎之良方，但“《临证指南》治肺胀，大抵用辛凉轻剂，相习成风，莫或之改，今骤以麻黄等之辛温，必相顾骇异。”其实以麻黄治肺胀，平淡无奇，无所用骇怪。总之，谢氏认为：辛凉轻剂，仅“可以治轻微之感冒，不可以应付危险之肺炎，以辛凉应付一切，药轻而不及彀，此所以有逆传心包之变也。”
结语：《温病论衡》之学术见解，与叶派不同，但对研究外感热病来说，我们不能轻易否定其学术价值。前人说得好：“为医不当有家派”，为了为外感热病学的研究开创新局面，我们应当摒弃门户之见，来认真研究与叶派观点不同的一些学术见解，现在尊叶派著编《温病学》教材，目的不是“独尊儒术”。《温病论衡》的撰作动机，诚如谢氏自云：“吾非讥谈叶派者也，求事理之真相而已。”有志于振兴中医事业的各个学派，目标一致，都是为了求事理之真相，故不赞成《温病论衡》之学术观点者，可以诘难，可以反驳，但却不宜反感，如因学术观点之不同而攻讦异己，在现在新的历史条件下倘或这样做，就大错而特错了。
从《温热逢源》看柳宝怡
对温病学说的独特见解
柳宝怡(1842一1901)号冠群，字谷孙，江阴人，为晚清著名温热派医家，著有医学书藉十二种，其中《温热逢源》三卷，通过注释经文，商兑诸家，以伏气发温为重点，探微抉隐，质疑问难，发表了自己独特的学术见解，对后世影响不小。现条述其主要观点如下；
一、伏气温病的发病
1·发病常见：柳氏之于外感，论伤寒，则谓“正伤寒病，南方不多见。即间有之，亦鲜重征”；论疫病，则谓：即吴又可之所论，实劝；“仍属伏气居多”，由于吴氏“将伏气化温之病，概行抹煞”，“遂将当时所见之病，无论其为伏温，为温疫，一概谓之疫邪。不责己之分辨不清，反疑内经冬伤于寒之语力不确，其才识粗疏，横肆武断，亦未免不自量矣。”故他有《辨正吴又可温疫论各条》一篇之撰作。柳氏认为：此不独吴氏如此，诸家之论温，多有“疫邪伏邪牵合为一”，误伏邪为疫邪之失，这甚至在著《医略》十三篇，煌煌然著伏邪之名，使伏温一病，昭然大白于天下的蒋问斋，亦未免此弊；论温病，则谓；“就温病言，亦有两证：有随时感受之温邪，如叶香岩，吴鞠通所论是也；有伏气内发之温邪，即内经所论者是也。”但“近人专宗叶氏，将伏气发温之病，置而不讲。每遇温邪，无论暴感伏气，概用叶氏辛凉轻浅之法，银翘、桑菊，随手立方；医家病家，取其简便，无不乐从。没有以伏气之说进者，彼且视为异说，茫然不知伏气为何病。嗟乎！伏温是外感中常有之病，南方尤多，非怪证也。其病载在内经、难经、伤寒论著书，非异说也。临证者，竟至茫然莫辨，门径全无，医事尚堪问哉！”综观上述，其以伏气温病为外感中之常见病的观点，已可概见。
2·证多重险：柳氏说：“凡外感病之重且险者，皆温热病也。”这种证发重险的温热病，柳氏非指“随时感受之温邪，如叶香岩，吴鞠通所论者”，而是指伏气温病。柳氏根据暴感温病从表入里，证发常轻浅，伏气温病从内出外，证发常重险的认识，不但说：“伏气由内而发，治之者以清泄里热为主，其见证至繁且杂，须兼视六经形证，乃可随机立法。暴感风温，其邪专责在肺，以辛凉轻敌为主，热重者，兼以甘寒清化，其病与伏温病之表里出入，路径各殊，其冶法之轻重深浅，分属迥异。”而且还认为常疫之从口鼻吸入戾气，邪机仅在募原者，一般亦多不重，故他在《辨正吴又可温疫论各条》中说：“所列九传证情，变幻殊甚。然唯伏气化温，从少阴外达者，每每有之。邪机仅在募原者，未必如是也。”正因为伏气为病深重，暴感为病轻浅，而寸医不知别此，对伏温从少阴初发之证，亦宗法叶香岩，以辛凉轻解为治，故柳氏责其“失之肤浅”。观上论，即可见其谓伏气温病重险而重要之观点。
据柳氏云：“近日医家，不囿于吴又可募原之说，即泥于吴鞠通三焦之论，而绝不知有少阴伏邪随经发病之理。故遇此等证，便觉毫无把握，轻者迁延致重，重者无法挽救，近年所见不少矣，哀哉！”因目击这种时弊，有鉴前人治温病法，各失之偏，柳氏基于以上认识，认为只要掌握伏气温病的证治规律，其他温热病，就不难触类旁通，举一返三，这样，临证自可左右逢源，得心应手，其书名之所以曰逢源，其论温之所以重伏气，即是为此。
二，伏气温病的病理
谢氏治学的基本方法是：不以后人的说法来证明前人的观点。他认为历代所谓的温病，其本义各不相同，“想要了解温病学说思想变迁的痕迹，自然必须从《内经》《难经》及张仲景等人的论述开始追溯，但在落笔时，应当依据《内经》《难经》的本义，作一朴实的叙述，凡是清代医家对于《内经》《难经》及张仲景的注解，都应当一律摒弃。”如果夹带清代医家的注解，就是用清代医家的思想来印证前人的说法，这样，“无形中已经失去了《内经》《难经》及张仲景的本义。”因此他在叙述《温病学说思想之变迁》时，将“《内经》《伤寒论》中的温病，还原给《内经》《伤寒论》；叶天士、吴鞠通、孟英的温病，还原给叶天士、吴鞠通、孟英。”这样抽茧剥丝，逐层揭开，先弄清历代各家温病学说的真面目，那么有关争论的是非问题，就可以判定。其次，他认为凡是批判一种学说，目光必须笼罩此学说的全体，抓住其关键，解决其根本，如果只是支支节节地攻击其局部，则此处剿灭彼处窜逃，将永无宁日，他认为陆九芝抨击叶派，具有这种缺点，所以不能彻底荡平其壁垒。故他考古论今，详细评析，从大处落墨，对有关温病的几个关键性问题，逐一解答批评，认为这样便可彻底解决问题，荡平叶吴学说之壁垒。
二、《温病论衡》的概况
此书先刊于《中医新生命》杂志。后于1936年出单行本，由知行医学出版社出版，书面由陆渊雷题签，后附有《湿温论治》。全书共分六章，书首有引言。第一章《温病学说思想之变迁》先叙述了《内经》《难经》，到戴北山、陆九芝为止的二十八家温病之本义。然后在结论中发表了自己的见解，这是全书抨击叶派学说很有力量的重要片段。第二章《温病病名名实之歧异》，讨论了湿温、风温、温毒、温疟、冬温，这五个古今名实淆乱的温病；第三章《伏气与外感》，为研究温病病因之专篇，内中对伏气学说提出了批评。第四章《伤寒温病与时行》，先列述前代医家的各种意见，然后发表作者自己的看法。第五章《清代温病书中所包含之疾病》，“专取叶派学说，作单独之剖析”，认为至少是包括了肺炎、肠伤寒、斑疹伤寒、猩红热、脑膜炎、丹毒、霍乱、痢疾、疟疾、中暑、耳下腺炎、黄疸、胁膜炎等这几种病在内。第六章《叶派温病治术之批评》，主要指摘叶派治术中的不足之处，认为：辛凉轻剂及滋阴疗法，用于“治疗犯肺之温病，寻常感冒，或足以了结。”如治疗肺炎等较重之温病，就已药轻而不够力，不及麻杏石甘汤等方显得有力量，如竟用以治疗胃系之温病，就尤属治术之下乘。全书采撷陆九芝、章太炎、陆渊雷等人的论说较多，总的认为叶吴学说从理论到治疗，缺憾很多，陆九芝虽作了大举之驳击，但仅成对抗之势。他为了彻底解决近百年来在温病问题上的种种争执，批倒叶吴学说中的错误理论，纠正时医泛用轻清之流弊，故有《温病论衡》一书之撰作。
三、争鸣意见举隅
1·对《温热论》评价过高不恰当：叶桂的《温热论》被某些治温热之学者，奉为圭臬。谢氏认为将这部书捧得太高是不恰当的。他说：“所谓《温热论》者，吴医汇讲刻之，贮春仙馆刻之，拜石山房刻之，种福堂又刻之，王孟英等所视为金科玉律者也，然循其字里行间而核之，则有自相矛盾者，有混杂不清者，凌乱支离，不可卒读，不意歌讴赞美珍同瑰宝之《温热论》，乃如此不堪，彼终身由之而不疑，信之而不违者，亦事理之不可解也。”他指出：“《温热论》曰：‘伤寒多有变证，温热虽久，在一经不移，以此为辨。’然其后则曰：‘三焦不得从外解，必致成里结，里结于何，在阳明胃与肠也。’所谓胃者，在手阳明乎？抑足阳明乎？使为足阳明，其说固无以自存，而既能传胃，则久在一经之说，亦自相矛盾矣。”观叶吴学派之著作，不可否认，该派中人为了与仲景学说分庭抗礼，确实发了一些刻意罗织，不合事理的议论，如《临证指南》中，谓伤寒先伤阳经，温病先伤肺经。又谓仲景伤寒，先分六经，河间温热，须究三焦。《温病条辨》硬说《伤寒论》只为狭义伤寒而设，只论六气中一气，其余五气概未之及。这一类为妄立门户而不顾事实，歪曲仲景学说的说法，其错误是十分明显的，如曲为之释，实在也毫无意义。《温热论》虽然是一部有功于外感热病研究的重要文献，但毕竟是一家之言，且也沾有这种弊病，所以，我们应当客观地来研究它，不应该先存有“《温热论》是正统，其他不同观点的争鸣著作都是左道旁门”这种想法。谢氏敢于直率地指谪《温热论》多疵，这对破除迷信，正确评价古籍，是使人很受启发的。
2·温邪并不都先犯肺；谢氏明确将温病划成肺胃二系，认为：“论温病者，必当定肺胃二字为关键。”而“温邪上受，首先犯肺，逆传心包。此十二字者，仅为犯肺温病之纲领，决不能包括湿温等胃系温病。”但叶派中人竟以此“十二字，为温病纲领，于是胃系温病之起病，不由于犯肺者，亦一律以此十二字兼统之，于是胃系温病初起之病因病理治疗诸学说，一律平空割去，另冠以肺系之证治，此真俗语之所谓张冠李戴，最后则胃系温病中期末期，亦皆以治肺之药治之，而治疗之成绩，遂不可问。此种流弊，无形中蔚为风气，流行于时医之腕底。”他认为陆九芝抨击叶吴之学，正是为此。叶派学说之论温病，谓初起在上焦手太阴，确有肺胃不分之弊，是错误的理论。现在一般认为“流脑”属“春温”、“风温”范畴，“乙脑”属“暑温”范畴。流行性出血热、钩端螺旋体病等也属温热病范畴：但我们知道：象“乙脑”、流行性出血热，钩端螺旋体病、肠伤寒等这一类温热病，根本就不是首先犯肺的。而且，属于呼吸道传染病的“流脑”，“首先犯肺"说也不及张景岳“鼻通于脑，毒入脑中，则流布诸经，令人相染。”之说为合理。叶派所说之温病、连疟疾、痄腮、黄疸，中暑，痢疾等都包括在内，这些病都是极少首先犯肺的，所以，将“首先犯肺”等12字，视作肺系温病之纲领还可，说成是温病之纲领，是无论如何也说不通的。对此，作者拟将再作专文驳之，读者可参阅下文。
3·叶氏混淆温病之名实：谢氏细考叶氏医案，认为“叶氏所说之肺系温病，其轻者为流行性感冒，为支气管炎，其重者为肺炎。流行性感冒与支气管炎，古称伤风，肺炎即《金匮》之肺胀。”这二种病本不属于温病范畴，但叶氏竞杜撰称为温病，这正如章太炎先生所说，是悬牛头，卖马脯，名不符实。所以，谢氏认为；将伤风、肺胀等几种本来是与温病并列的一些病，混称为温病，“人谓叶天士所发明，吾谓叶天士所杜撰。人谓叶天士所特创，吾谓叶天士所混称，”将这一类漠不相关的病凭空阑入温病范畴，他认为根本就无此必要，所以他说：“温病名实之淆乱，叶天士为祸首。”
4·滋阴法为治温病之下驷：对叶派治术之批评，谢氏基本上是通过采录前人之说，经过熔裁，来表明自己观点的。其中一个方面，认为温病本质是热，要抓住撤热这一关，截断病势，才能保住阴津，使阴不伤。他录陆氏之说云：“总之，使病速去，阴始不伤，欲保其阴，必速去病。”谢氏认为；以生地养阴，石斛养胃这一类治法，不是说不可用，耍在分清主次，不能颠倒本末，对《临证指南，温热门》席姓一案的治法，他认为药法极不可取，以生地滋阴，本是取其甘寒多液，改为熟地，再烧之戍炭，就尤为育阴之下乘了。他认为叶氏这种滋阴法，顶多也只能说是学到了丹溪滋阴法的一半(因为丹溪的滋阴法，比较重视清君相之火以撤热)，象这样的去“移治不可滋阴之病机，则其悖谬而偾事也固宜。”
5·轻清疗法作用轻微：谢氏认为辛凉轻清之法只能治治小风温小风热，实际上就是说只能治治辨证属热的伤风感冒、喉炎等一类的小病。不用说治胃系温病及脑膜炎等病，就是治疗肺胀，也不能有效地逆转抑止病势，否则，“何以不出数日，遽入心包，为一场大病，以至于死。若不数日而病即入心，即可死者，则必非如其所说只须轻剂之辛凉，且何以如其所言，不即敌于辛凉之轻剂耶。”他认为章太炎论肺炎治法一文殊精绝，故不嫌引文冗长，大段节录，大旨谓麻杏石甘汤，越婢汤等都是治肺炎之良方，但“《临证指南》治肺胀，大抵用辛凉轻剂，相习成风，莫或之改，今骤以麻黄等之辛温，必相顾骇异。”其实以麻黄治肺胀，平淡无奇，无所用骇怪。总之，谢氏认为：辛凉轻剂，仅“可以治轻微之感冒，不可以应付危险之肺炎，以辛凉应付一切，药轻而不及彀，此所以有逆传心包之变也。”
结语：《温病论衡》之学术见解，与叶派不同，但对研究外感热病来说，我们不能轻易否定其学术价值。前人说得好：“为医不当有家派”，为了为外感热病学的研究开创新局面，我们应当摒弃门户之见，来认真研究与叶派观点不同的一些学术见解，现在尊叶派著编《温病学》教材，目的不是“独尊儒术”。《温病论衡》的撰作动机，诚如谢氏自云：“吾非讥谈叶派者也，求事理之真相而已。”有志于振兴中医事业的各个学派，目标一致，都是为了求事理之真相，故不赞成《温病论衡》之学术观点者，可以诘难，可以反驳，但却不宜反感，如因学术观点之不同而攻讦异己，在现在新的历史条件下倘或这样做，就大错而特错了。
从《温热逢源》看柳宝怡
对温病学说的独特见解
柳宝怡(1842一1901)号冠群，字谷孙，江阴人，为晚清著名温热派医家，著有医学书藉十二种，其中《温热逢源》三卷，通过注释经文，商兑诸家，以伏气发温为重点，探微抉隐，质疑问难，发表了自己独特的学术见解，对后世影响不小。现条述其主要观点如下；
一、伏气温病的发病
1·发病常见：柳氏之于外感，论伤寒，则谓“正伤寒病，南方不多见。即间有之，亦鲜重征”；论疫病，则谓：即吴又可之所论，实劝；“仍属伏气居多”，由于吴氏“将伏气化温之病，概行抹煞”，“遂将当时所见之病，无论其为伏温，为温疫，一概谓之疫邪。不责己之分辨不清，反疑内经冬伤于寒之语力不确，其才识粗疏，横肆武断，亦未免不自量矣。”故他有《辨正吴又可温疫论各条》一篇之撰作。柳氏认为：此不独吴氏如此，诸家之论温，多有“疫邪伏邪牵合为一”，误伏邪为疫邪之失，这甚至在著《医略》十三篇，煌煌然著伏邪之名，使伏温一病，昭然大白于天下的蒋问斋，亦未免此弊；论温病，则谓；“就温病言，亦有两证：有随时感受之温邪，如叶香岩，吴鞠通所论是也；有伏气内发之温邪，即内经所论者是也。”但“近人专宗叶氏，将伏气发温之病，置而不讲。每遇温邪，无论暴感伏气，概用叶氏辛凉轻浅之法，银翘、桑菊，随手立方；医家病家，取其简便，无不乐从。没有以伏气之说进者，彼且视为异说，茫然不知伏气为何病。嗟乎！伏温是外感中常有之病，南方尤多，非怪证也。其病载在内经、难经、伤寒论著书，非异说也。临证者，竟至茫然莫辨，门径全无，医事尚堪问哉！”综观上述，其以伏气温病为外感中之常见病的观点，已可概见。
2·证多重险：柳氏说：“凡外感病之重且险者，皆温热病也。”这种证发重险的温热病，柳氏非指“随时感受之温邪，如叶香岩，吴鞠通所论者”，而是指伏气温病。柳氏根据暴感温病从表入里，证发常轻浅，伏气温病从内出外，证发常重险的认识，不但说：“伏气由内而发，治之者以清泄里热为主，其见证至繁且杂，须兼视六经形证，乃可随机立法。暴感风温，其邪专责在肺，以辛凉轻敌为主，热重者，兼以甘寒清化，其病与伏温病之表里出入，路径各殊，其冶法之轻重深浅，分属迥异。”而且还认为常疫之从口鼻吸入戾气，邪机仅在募原者，一般亦多不重，故他在《辨正吴又可温疫论各条》中说：“所列九传证情，变幻殊甚。然唯伏气化温，从少阴外达者，每每有之。邪机仅在募原者，未必如是也。”正因为伏气为病深重，暴感为病轻浅，而寸医不知别此，对伏温从少阴初发之证，亦宗法叶香岩，以辛凉轻解为治，故柳氏责其“失之肤浅”。观上论，即可见其谓伏气温病重险而重要之观点。
据柳氏云：“近日医家，不囿于吴又可募原之说，即泥于吴鞠通三焦之论，而绝不知有少阴伏邪随经发病之理。故遇此等证，便觉毫无把握，轻者迁延致重，重者无法挽救，近年所见不少矣，哀哉！”因目击这种时弊，有鉴前人治温病法，各失之偏，柳氏基于以上认识，认为只要掌握伏气温病的证治规律，其他温热病，就不难触类旁通，举一返三，这样，临证自可左右逢源，得心应手，其书名之所以曰逢源，其论温之所以重伏气，即是为此。
二，伏气温病的病理
The basic method of Xie's scholarship is: not to use later scholars' theories to validate earlier ones. He believed that the so-called "warm diseases" (Wenbing, warm-heat diseases) throughout history had different original meanings. "To understand the traces of the evolution of warm disease theory and thought, one must naturally start from the *Neijing* (Inner Canon), *Nanjing* (Classic of Difficult Issues), and Zhang Zhongjing, but when writing, one should base the narrative on the original meaning of the *Neijing* and *Nanjing*, providing a plain description, and generally discard all annotations by Qing dynasty physicians regarding the *Neijing*, *Nanjing*, and Zhang Zhongjing." If annotations by Qing physicians are interjected, it means using the thoughts of Qing physicians to validate the words of predecessors, thereby "inadvertently losing the original meaning of the *Neijing*, *Nanjing*, and Zhang Zhongjing." Therefore, when narrating the "Evolution of Warm Disease Theory and Thought," he stated that "the warm diseases in the *Neijing* and *Shanghan Lun* (Treatise on Cold Damage) should be returned to the *Neijing* and *Shanghan Lun*; the warm diseases of Ye Tianshi, Wu Jutong, and Mengying should be returned to Ye, Wu, and Mengying." By peeling back layers like extracting silk from cocoons, first clarifying the true face of various schools of warm disease theory across generations, the issues of right and wrong in related debates can then be judged. Secondly, he believed that whenever criticizing a theory, one's perspective must encompass the entirety of that theory, grasping its key points and resolving its fundamentals; if one only attacks fragments locally, where one part is suppressed another escapes, leading to endless turmoil. He believed that Lu Jiuzhi's criticism of the Ye school suffered from this flaw, thus failing to completely dismantle its defenses. Hence, by examining ancient texts and discussing contemporary issues, providing detailed analysis, and focusing on the big picture, he answered and criticized several key issues related to warm diseases one by one, believing this approach could thoroughly resolve problems and dismantle the barriers of the Ye-Wu theory.
II. Overview of *Lunheng Wenbing* (Critical Review of Warm Diseases)
This book was first published in the magazine *Zhongyi Xin Shengming* (New Life of Traditional Chinese Medicine). A standalone edition was released in 1936 by Zhixing Medical Publishing House, with the title signed by Lu Yuanlei, followed by an appendix *Shiwen Lunzhi* (Discussion on the Treatment of Damp-Warmth). The whole book consists of six chapters, preceded by an introduction. Chapter One, "Evolution of Warm Disease Theory and Thought," first narrates the original meanings of warm diseases according to twenty-eight schools from the *Neijing* and *Nanjing* up to Dai Beishan and Lu Jiuzhi. Then, in the conclusion, he expresses his own views, which constitute a powerful and important fragment of the book attacking the Ye school's theory. Chapter Two, "Discrepancies in Names and Realities of Warm Disease Terminology," discusses five warm diseases with confused names and realities in ancient and modern times: Shiwen (Damp-Warmth), Fengwen (Wind-Warmth), Wendu (Warm-Toxin), Wenmie (Warm-Malaria), and Dongwen (Winter-Warmth); Chapter Three, "Fuqi (Hidden Pathogenic Factors) and Waigan (External Contraction)," is a specialized article on studying the etiology of warm diseases, in which he criticizes the Fuqi theory. Chapter Four, "Shanghan, Wenbing, and Shixing (Epidemic/Seasonal Diseases)," first lists various opinions of previous physicians and then presents the author's own views. Chapter Five, "Diseases Included in Qing Dynasty Warm Disease Books," "specifically takes the Ye school's theory for separate analysis," believing it includes at least pneumonia, typhoid fever, epidemic hemorrhagic fever, scarlet fever, meningitis, erysipelas, cholera, dysentery, malaria, heatstroke, parotitis, jaundice, pleurisy, and other such diseases. Chapter Six, "Critique of the Ye School's Therapeutic Techniques for Warm Diseases," mainly points out the shortcomings in the Ye school's therapeutic methods, stating that: Light and cool agents (Xinliang Qingji) and yin-nourishing therapies are sufficient "to treat warm diseases affecting the lung or common colds." However, for treating heavier warm diseases like pneumonia, these light medicines are insufficient and less effective than formulas such as Mahuang Xingren Shigao Tang (Ephedra, Apricot Seed, and Gypsum Decoction). Using them to treat stomach-system warm diseases would especially be considered inferior therapy. The book cites extensively from Lu Jiuzhi, Zhang Taiyan, Lu Yuanlei, etc., generally concluding that the Ye-Wu theory has many flaws from theory to treatment. Although Lu Jiuzhi made a major refutation, it only created a confrontational stance. To thoroughly resolve the disputes over warm diseases in the past century, refute the erroneous theories in the Ye-Wu school, and correct the malpractice of contemporary physicians overusing light and clear remedies, Xie wrote *Lunheng Wenbing*.
III. Examples of Controversial Opinions
1. Overestimating the *Wenre Lun* (Treatise on Warm Heat) is Inappropriate: Ye Gui's *Wenre Lun* is regarded as the standard by some scholars of warm-heat diseases. Xie believes holding this book in too high esteem is inappropriate. He said: "The so-called *Wenre Lun* was printed by Wu Yi Huijiang, Zhu Chunxian Guan, Baishi Shanfang, and Zhongfu Tang, and was considered the golden rule by Wang Mengying and others. However, examining it line by line, there are self-contradictions and unclear mixtures, chaotic and fragmented, making it unreadable. Unexpectedly, the *Wenre Lun*, praised and cherished like a treasure, is so unbearable. It is incomprehensible how they followed it all their lives without doubt and believed in it without violation." He pointed out: "*Wenre Lun* states: 'Cold damage often has transformed symptoms; although warm diseases last long, they remain in one meridian, using this as a distinction.' But later it says: 'If the Sanjiao cannot resolve externally, it inevitably leads to interior knotting. Where is this interior knotting? In the Yangming Stomach and Intestines.' Does 'stomach' refer to the Hand Yangming or Foot Yangming? If it refers to the Foot Yangming, the theory cannot stand; yet if it can transmit to the stomach, the statement that it stays in one meridian for a long time is also self-contradictory." Observing the works of the Ye-Wu school, it is undeniable that its members, in order to rival Zhang Zhongjing's theory, indeed made some deliberately fabricated and unreasonable arguments. For example, in *Linzheng Zhinan* (Guide to Clinical Practice), it claims cold damage first injures the Yang meridians, while warm diseases first injure the Lung meridian. It also claims Zhang Zhongjing's cold damage divides into six meridians, while He Jian's warm heat requires investigating the Sanjiao. *Wenbing Tiaobian* (Systematic Differentiation of Warm Diseases) insists that *Shanghan Lun* was set only for narrow-sense cold damage, discussing only one of the six Qi, ignoring the other five. Such statements, establishing sects regardless of facts and distorting Zhang Zhongjing's theory, are obviously erroneous; interpreting them forcibly is meaningless. Although *Wenre Lun* is an important document contributing to the study of exogenous febrile diseases, it is ultimately just one school's view and suffers from these flaws. Therefore, we should study it objectively and should not pre-conceive that "'*Wenre Lun* is orthodox, and other controversial works with different viewpoints are heterodox.'" Xie's willingness to frankly criticize the flaws in *Wenre Lun* is inspiring for breaking superstition and correctly evaluating ancient texts.
2. Warm Pathogens Do Not All Initially Attack the Lung: Xie clearly divided warm diseases into Lung and Stomach systems, believing: "Those discussing warm diseases must take 'Lung' and 'Stomach' as the key." And "Warm pathogens enter from above, initially attacking the Lung, and reversely transmitting to the Pericardium. These twelve characters are merely the guideline for warm diseases attacking the Lung, and certainly cannot include stomach-system warm diseases like Damp-Warmth." Yet members of the Ye school used these "twelve characters as the guideline for all warm diseases. Thus, stomach-system warm diseases whose onset did not originate from attacking the Lung were also uniformly governed by these twelve characters. Consequently, the etiology, pathology, and treatment theories for the initial stage of stomach-system warm diseases were arbitrarily cut off and replaced with lung-system syndrome differentiation and treatment. This is truly what the vernacular calls 'putting a bull's head on a horse carcass.' Finally, even the middle and late stages of stomach-system warm diseases were treated with lung-targeting medicines, making treatment results unpredictable. This malpractice inadvertently became a trend, prevalent among contemporary physicians." He believed Lu Jiuzhi's criticism of the Ye-Wu school was precisely for this reason. The Ye school's theory on warm diseases, stating they begin in the Upper Jiao Hand Taiyin, indeed suffers from the flaw of not distinguishing between Lung and Stomach, which is an erroneous theory. Currently, it is generally believed that "epidemic cerebrospinal meningitis" belongs to the categories of "Spring Warmth" and "Wind Warmth," and "Japanese encephalitis" belongs to "Summer Warmth." Epidemic hemorrhagic fever, leptospirosis, etc., also belong to the category of warm-heat diseases. But we know that warm diseases like "Japanese encephalitis," epidemic hemorrhagic fever, leptospirosis, and typhoid fever do not initially attack the Lung at all. Moreover, for respiratory infectious diseases like "epidemic cerebrospinal meningitis," the "initially attacks the Lung" theory is less reasonable than Zhang Jingyue's saying: "The nose connects to the brain; toxins entering the brain then spread through all meridians, causing infection in others." The warm diseases mentioned by the Ye school include malaria, mumps, jaundice, heatstroke, dysentery, etc., all of which rarely initially attack the Lung. Therefore, viewing "initially attacks the Lung" and the other 12 characters as the guideline for lung-system warm diseases is acceptable, but calling it the guideline for all warm diseases is untenable. Regarding this, the author intends to write a special paper to refute it; readers may refer to the following text.
3. Ye Confused the Names and Realities of Warm Diseases: Xie carefully examined Ye's medical cases and believed: "The lung-system warm diseases mentioned by Ye, the mild forms are influenza and bronchitis, and the severe form is pneumonia. Influenza and bronchitis were anciently called Shangfeng (Wind Injury), and pneumonia is Feizhang (Lung Distension) in the *Jinkui Yaolue*." These two types of diseases originally did not belong to the category of warm diseases, yet Ye fabricated the term "warm disease" for them. As Mr. Zhang Taiyan said, this is "hanging a bull's head but selling horse meat," where the name does not match the reality. Therefore, Xie believed: mixing diseases like Shangfeng and Feizhang, which were originally parallel to warm diseases, under the term "warm disease"—"People say Ye Tianshi invented it, I say Ye Tianshi fabricated it. People say Ye Tianshi specially created it, I say Ye Tianshi mixed the terms." Inserting these unrelated diseases into the category of warm diseases arbitrarily, he believed there was no necessity for this. Hence he said: "The confusion of names and realities in warm diseases, Ye Tianshi is the chief culprit."
4. Yin-Nourishing Method is Inferior for Treating Warm Diseases: Critiquing the Ye school's therapeutic techniques, Xie basically expressed his own views by collecting and synthesizing previous scholars' opinions. One aspect is that since the essence of warm diseases is heat, one must grasp the point of reducing heat to intercept the disease progression, thereby preserving Yin fluids and preventing Yin injury. He quoted Lu's saying: "In short, if the disease is removed quickly, Yin will not be injured; to protect Yin, one must remove the disease quickly." Xie believed that methods like using Shengdi (Rehmanniae Radix) to nourish Yin and Shihu (Dendrobii Caulis) to nourish the Stomach are not unusable, but one must distinguish primary from secondary and not reverse cause and effect. Regarding the treatment method for Case Xi in *Linzheng Zhinan, Wenre Men* (Warm Heat Section), he believed the medicinal method was extremely inadvisable. Using Shengdi to nourish Yin relies on its sweet-cold and juicy nature; changing it to Shudi (Prepared Rehmanniae Radix) and burning it to charcoal makes it even more inferior for nurturing Yin. He believed Ye's Yin-nourishing method could at best be said to have learned half of Danxi's Yin-nourishing method (because Danxi's method attaches more importance to clearing the Ministerial Fire to reduce heat). Like this, applying it to pathogenesis where Yin should not be nourished leads to absurdity and failure, which is inevitable.
5. Light and Clear Therapy Has Minor Effects: Xie believed that light and cool-clearing methods can only treat minor Wind-Warmth and minor Wind-Heat, essentially meaning they can only treat minor illnesses like wind-cold/cold-heat common colds and laryngitis differentiated as heat. Without mentioning treating stomach-system warm diseases and meningitis, even treating Feizhang (Lung Distension) cannot effectively reverse or suppress the disease progression. Otherwise, "why would the disease suddenly enter the Pericardium within a few days, becoming a major illness leading to death? If the disease enters the Heart and causes death within a few days, it certainly is not as described requiring only light cool agents. Furthermore, why, as he claimed, does it not immediately succumb to light cool agents?" He believed Zhang Taiyan's article on pneumonia treatment was exceptionally profound, so he did not mind quoting lengthy excerpts. The main idea was that Mahuang Xinggan Tang and Yebibo Tang are good prescriptions for pneumonia, but "*Linzheng Zhizan* treats Feizhang mostly with light cool agents, a habit formed by custom, with no one correcting it. Now suddenly using pungent-warm herbs like Mahuang, people look at each other in horror." Actually, using Mahuang to treat Feizhang is plain and ordinary, nothing to be horrified about. In summary, Xie believed: Light cool agents "can only treat minor colds and cannot handle dangerous pneumonia. Using light cool agents to deal with everything, the medicine is too light and insufficient, which is why there are transformations like reverse transmission to the Pericardium."
Conclusion: The academic views in *Lunheng Wenbing* differ from the Ye school, but for studying exogenous febrile diseases, we cannot easily deny its academic value. As predecessors said well: "Physicians should not have sectarian affiliations." To open a new situation in the research of exogenous febrile diseases, we should abandon sectarian prejudices and seriously study academic views different from the Ye school. Current textbooks compiling *Wenbing* (Warm Diseases) respecting the Ye school are not for "solely尊崇 Confucianism" (establishing exclusive orthodoxy). The motive for writing *Lunheng Wenbing*, as Xie himself said: "I am not mocking the Ye school; I seek the truth of matters." Various schools dedicated to revitalizing Traditional Chinese Medicine share the same goal: seeking the truth of matters. Therefore, those who do not agree with the academic views of *Lunheng Wenbing* may question and refute, but should not feel resentful. Attacking others due to differences in academic views would be a great mistake under new historical conditions.
Viewing Liu Baoyi from *Wenre Fengyuan*
Unique Views on Warm Disease Theory
Liu Baoyi (1842–1901), courtesy name Guqun, style Gusun, from Jiangyin, was a famous warm-heat school physician in the late Qing Dynasty. He authored twelve medical books, including *Wenre Fengyuan* (Tracing the Source of Warm Heat) in three volumes. By annotating classics and consulting various schools, focusing on warm diseases arising from hidden pathogens, exploring subtleties, raising questions, and expressing unique academic views, he had a significant impact on later generations. His main viewpoints are listed below:
I. Onset of Warm Diseases with Hidden Pathogens
1. Common Onset: Regarding exogenous diseases, Liu stated regarding cold damage: "True cold damage is not common in the South. Even if it occurs, severe signs are rare." Regarding epidemics, he stated: Referring to Wu Youke's discussion, "it still belongs mostly to hidden pathogens." Because Wu "completely erased diseases transforming from hidden pathogens to warmth," "thus whatever diseases he saw at the time, whether hidden warmth or warm epidemics, he uniformly called epidemic pathogens. Blaming others for unclear differentiation instead of reflecting on his own lack of clarity, he doubted the accuracy of the *Neijing*'s phrase 'winter injury by cold,' showing coarse talent and rash arbitrariness, which was somewhat presumptuous." Hence he wrote a piece titled "Correcting Each Item of Wu Youke's Treatise on Epidemic Diseases." Liu believed: This was not just Wu's case; many discussions on warmth by various schools had the error of "linking epidemic pathogens and hidden pathogens together," mistaking hidden pathogens for epidemic pathogens. Even Jiang Wenzhai, who wrote thirteen articles in *Yilüe*, prominently naming hidden pathogens and making hidden warmth widely known, unfortunately suffered from this flaw. Discussing warm diseases, he stated: "Regarding warm diseases, there are two syndromes: there are warm pathogens contracted at any time, as discussed by Ye Xiangyan and Wu Jutong; and there are warm pathogens originating internally from hidden pathogens, as discussed in the *Neijing*." But "recent people exclusively follow Ye, ignoring diseases of warmth arising from hidden pathogens. Whenever encountering warm pathogens, whether sudden contraction or hidden pathogens, they uniformly use Ye's light and shallow pungent-cool methods, prescribing Yinqing (Honeysuckle and Forsythia Decoction) or Sangju (Mulberry Leaf and Chrysanthemum Decoction) at will; physicians and patients, finding it convenient, all gladly accept. None advance the theory of hidden pathogens; they regard it as a heterodox view, ignorant of what hidden pathogens are. Alas! Hidden warmth is a common disease among exogenous diseases, especially in the South, not a strange syndrome. Its diseases are recorded in the *Neijing*, *Nanjing*, and *Shanghan Lun*, not a heterodox view. Clinicians are utterly confused, having no entry point; how can medical practice be questioned!" Summarizing the above, his view that warm diseases with hidden pathogens are common among exogenous diseases is evident.
2. Syndromes Are Often Severe and Dangerous: Liu said: "All severe and dangerous exogenous diseases are warm-heat diseases." This type of severe and dangerous warm-heat disease referred to by Liu does not mean "warm pathogens contracted at any time, as discussed by Ye Xiangyan and Wu Jutong," but rather warm diseases with hidden pathogens. Based on the understanding that sudden contraction warm diseases enter from exterior to interior and often present lightly, while warm diseases with hidden pathogens emerge from interior to exterior and often present severely, Liu not only said: "Hidden pathogens originate from within; treatment focuses on clearing and draining interior heat. The manifestations are numerous and complex, requiring simultaneous observation of Six Meridian syndromes to legislate treatments flexibly. Sudden contraction Wind-Warmth, the pathogen specifically targets the Lung, primarily using light pungent-cool agents; for severe heat, sweet-cold clearing transformation is added. The movement of interior/exterior of these diseases differs from that of hidden warmth diseases, their paths are distinct, and the depth and weight of their treatments are vastly different." He also believed that common epidemics entering via mouth and nose with pathogenic qi located only in the Mu Yuan (Sea of Origin) are generally not severe. Thus, in "Correcting Each Item of Wu Youke's Treatise on Epidemic Diseases," he said: "The nine transmitted syndromes listed show great variation. However, only when hidden pathogens transform into warmth and reach outward from Shaoyin does this frequently occur. When pathogenic mechanisms are only in the Mu Yuan, it is unlikely to be so." Precisely because hidden pathogens cause deep and severe diseases, while sudden contractions cause light and shallow diseases, and contemporary physicians fail to distinguish this, treating early-stage hidden warmth emerging from Shaoyin by following Ye Xiangyan's method of light pungent-cool resolution, Liu criticized this as "superficial." From the above discussion, his view that warm diseases with hidden pathogens are severe, dangerous, and important is visible.
According to Liu: "Recent physicians, not confined by Wu Youke's theory of Mu Yuan, nor stuck to Wu Jutong's theory of Sanjiao, absolutely do not know the principle of hidden pathogens in Shaoyin developing along meridians. Thus, encountering such syndromes, they feel completely uncertain; mild cases drag on becoming severe, severe cases have no rescue method. Many such cases have been seen in recent years, alas!" Witnessing this contemporary malpractice and seeing that previous methods for treating warm diseases were each biased, based on the above understanding, Liu believed that as long as one masters the syndrome differentiation and treatment laws of warm diseases with hidden pathogens, other warm-heat diseases can be understood by analogy,举一反三 (inferring three from one). Thus, clinical practice can be versatile and proficient. The reason for the book's title *Fengyuan* (Meeting the Source) and the emphasis on hidden pathogens in his discussion of warmth is for this purpose.
II. Pathology of Warm Diseases with Hidden Pathogens