《难经》湿温，言脉不言症；《脉经》湿温，言症不言脉。何也？盖在《难经》者既属
伤寒
，则必有头痛、发热等症。又以其脉阳濡弱也。
推得先受温而尺热、口渴在其中；阴小急也，
推得后受湿而身疼、拘急在其中∶不言症而
症可知已。其与《脉经》所言先受湿后受热者迥别。后受湿者，其湿浮于表，与寒同法而减
等。小急者紧之减象也。许叔微苍术白虎汤，苍术散湿、白虎治温最合，缘此湿温重在温也
。先受湿者，其湿沉于里，与凡湿病同法，故胫冷、胸腹满，其脉当沉，可以白虎概治之乎
？头目痛、妄言，是湿甚于里，将与后受之热合化，故禁汗之，虚表以甚里，苍术其可用乎？
缘此湿温，虽属中 ，重在湿也。观其所重，两者悬殊，朱奉议见其名同而合之，则奉议
之不足与言伤寒也明矣。（三风温准此。）
《内经》以先热后寒为温疟，与先寒后热之寒疟反对，而以但热不寒为瘅疟，《金匮》
瘅、
温二疟皆但温不寒，注家不能分别。泉谓疟之命名，本对温而立。冬感于寒及非时之温，至
春发者，其状和顺谓之温；夏感于暑及非时之寒，至秋发者，其状酷虐谓之疟。疟有寒、温
、无寒，先温而感春寒，则内热为外寒所抑，表实故无寒。曰温疟者，合二病以名之。仲景
书言温、言疟，则必言温疟，立言之体宜然。其与《内经》不同者，《内经》主疟，仲景主
温也，宜所言之同温矣。若瘅则《内经》、仲景皆主疟，宜所言之不同矣。但此温疟者，“
者”字当作“也”，与上文连读，谓瘅、温二疟，并宜白虎加桂方也。不然，自鳖甲煎丸条
以下，皆方论并列，何独瘅疟条有论无方乎？徐灵胎批《金匮》本亦云白虎加桂枝汤，此温
疟、瘅疟之主方。
《难经》中关于湿温的论述，只谈脉象而不谈症状；《脉经》中关于湿温的论述，只谈症状而不谈脉象。为什么呢？因为在《难经》中，湿温既归属于伤寒（外感热病的一类），那么必然会有头痛、发热等症状。又因为它的脉象是阳部濡弱，由此推断出先感受温热之邪而尺部热、口渴的情况包含在其中；阴部脉小急，由此推断出后感受湿邪而身体疼痛、拘挛紧急的情况包含在其中：虽然没有直接陈述症状，但症状已经可以推知了。这与《脉经》中所说的先受湿邪后受热邪的情况截然不同。后受湿邪的，湿邪浮越在体表，治疗方法与寒证相同但要减等处理。“小急”是“紧”脉的减弱表现。许叔微使用的苍术白虎汤，用苍术散湿、白虎汤治疗温邪最为合适，因为这个湿温证重在温邪上。先受湿邪的，湿邪沉伏在体内，与一般的湿病治疗方法相同，所以会出现小腿冷、胸腹胀满，其脉象应当沉，怎么可以用白虎汤一概治疗呢？头目痛、胡言乱语，这是湿邪重于里部，将要与后感受的热邪合化，所以禁止发汗，因为发汗会使表虚而加重里证，苍术还能使用吗？因为这个湿温证，虽然属于中焦病变，但重在湿邪。观察它们侧重点的不同，两者相差悬殊，朱奉议看到名字相同就将二者合并讨论，那么朱奉议就不值得与他谈论伤寒学了。（三风温的判断也依据此理。）
《内经》将先发热后恶寒称为温疟，与先恶寒后发热的寒疟相对立，而将只发热不恶寒称为瘅疟，《金匮要略》中瘅疟、温疟都表现为只发热不恶寒，注释家们不能加以区分。我认为疟疾的命名，本来是相对于温病而言的。冬天感受寒邪以及非时之温邪，到春天发作的，病情和顺称为温；夏天感受暑邪以及非时之寒邪，到秋天发作的，病情酷虐称为疟。疟疾有寒疟、温疟、无寒疟之分，先出现温病症状又感受春寒，则内热被外寒所抑制，表实故而无恶寒。称为温疟，是将两种病症合并来命名。张仲景的书里提到温病或疟疾，就一定会提到温疟，这是立文的体例使然。它与《内经》不同的地方在于，《内经》以疟疾为主，张仲景以温病为主，所以所说的内容都涉及温邪。如果是瘅疟，则《内经》和张仲景都以疟疾为主，所以所说的内容不同。但是这里的温疟，“者”字应当作“也”解，与上文连读，意思是瘅疟、温疟两种疟疾，都适宜使用白虎加桂枝汤。不然的话，从鳖甲煎丸条以下，都是方剂与论述并列，为什么唯独瘅疟条只有论述没有方剂呢？徐灵胎批注的《金匮要略》版本中也说是白虎加桂枝汤，这是温疟、瘅疟的主方。
The *Nan Jing* (Classic of Difficult Issues) discusses Shi Wen (Damp-Heat) by mentioning pulse conditions but not symptoms; the *Mai Jing* (Pulse Classic) discusses Shi Wen by mentioning symptoms but not pulse conditions. Why is this? Since in the *Nan Jing*, Shi Wen belongs to Shang Han (Cold Damage, a category of exogenous febrile diseases), there must necessarily be symptoms such as headache and fever. Furthermore, because its pulse at the Yang position is Ru (Soft) and Ruo (Weak), one can deduce that the condition of feeling warm pathogenic factors first, resulting in heat in the Chi (Cun Cun) position and thirst, is included therein; because the pulse at the Yin position is Xiao Ji (Small and Urgent), one can deduce that the condition of feeling damp pathogenic factors later, resulting in body pain and stiffness/tethering, is included therein: although symptoms are not explicitly stated, they can be inferred. This is completely different from what the *Mai Jing* describes as feeling damp pathogenic factors first and then heat pathogenic factors. When dampness is felt later, it floats on the exterior, and the treatment method is similar to that for cold patterns but with reduced intensity. "Xiao Ji" is a diminished manifestation of Jin (Tight). Xu Shuwei's Cang Zhu Bai Hu Tang (Atractylodis Rhizoma and White Tiger Decoction) uses Cang Zhu (Rhizoma Atractylodis) to dissipate dampness and Bai Hu Tang (White Tiger Decoction) to treat warmth, which fits perfectly, because this type of Shi Wen emphasizes the warmth pathogen. When dampness is felt first, it sinks into the interior, and the treatment method is the same as for general dampness diseases; therefore, there will be cold calves and fullness in the chest and abdomen, and the pulse should be Chen (Deep). How can it be treated generally with Bai Hu Tang? Head and eye pain and delirious speech indicate that dampness is severe in the interior and is about to combine and transform with the subsequently felt heat; therefore, sweating (diaphoresis) is contraindicated, as it would cause exterior deficiency and exacerbate interior pathology, so how could Cang Zhu be used? Because this type of Shi Wen, although belonging to the Middle Jiao (Middle Burner), emphasizes dampness. Observing their respective emphases, the difference between the two is significant. Zhu Fengyi merged them simply because their names were the same; thus, it is clear that Zhu Fengyi is not worthy of discussing Shang Han with him. (The judgment for San Feng Wen [Three Wind Warmth] follows this principle.)
The *Nei Jing* (Inner Canon) defines Wen Nue (Warm Malaria) as fever preceding chills, opposing Han Nue (Cold Malaria) where chills precede fever, and defines Dan Nue (Suffocating Malaria) as fever without chills. In the *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet), both Dan Nue and Wen Nue present with only warmth/fever and no chills, yet commentators fail to distinguish between them. I argue that the naming of Nue (Malaria) was originally established in contrast to Wen (Warmth/Warm Disease). If one contracts cold pathogens in winter or non-seasonal warmth, and it manifests in spring, and the presentation is harmonious, it is called Wen; if one contracts summerheat pathogens in summer or non-seasonal cold, and it manifests in autumn, and the presentation is harsh/cruel, it is called Nue. Nue includes Han Nue, Wen Nue, and Wu Han Nue (Non-chill Nue). If one first experiences Wen symptoms and then contracts spring cold, the internal heat is suppressed by the external cold, and due to exterior excess, there is no chills. It is called Wen Nue because it combines two disease entities into one name. In Zhang Zhongjing's writings, when mentioning Wen or Nue, he must mention Wen Nue; this is the standard style of his writing. The difference from the *Nei Jing* is that the *Nei Jing* focuses on Nue, whereas Zhang Zhongjing focuses on Wen; thus, what they discuss involves warmth. However, regarding Dan Nue, both the *Nei Jing* and Zhang Zhongjing focus on Nue; thus, what they discuss differs. But here, regarding this Wen Nue, the character "Zhe" (者) should be read as "Ye" (也), connecting with the preceding text, meaning that both Dan Nue and Wen Nue are suitable for treatment with Bai Hu Jia Gui Zhi Fang (White Tiger plus Cinnamon Twig Formula). Otherwise, from the section on Bie Jia Jian Wan (Turtle Shell Decoction to Reduce Accumulations) onwards, formulas and discussions are listed together side-by-side; why does the Dan Nue section have discussion but no formula? The version of *Jin Gui* annotated by Xu Lingtai also states Bai Hu Jia Gui Zhi Tang (White Tiger plus Cinnamon Twig Decoction); this is the principal formula for Wen Nue and Dan Nue.