（四时伤寒不同 传变 汗下大法 可汗 不可汗 可下 不可下 可吐 不可吐 愈解 死证 阴阳 表里
伤寒杂病 类证 杂论 察色要略）
阴阳大论云春气温和夏气暑热秋气清凉冬气冷冽此则四时正气之序也冬时严寒万类深藏君子固密则不伤于寒触冒
之者乃名伤寒耳其伤于四时之气皆能为病（即下文时行之气）以伤寒为毒者以其最成杀厉之气也中而即病者名曰伤寒不
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（内经曰先夏至日为温病后夏至日为暑病温暑之病
本伤于寒而得之故太医均谓之伤寒也）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（活人云夏月发热
恶寒头疼身重肢节疼痛其脉洪盛者是也冬伤于寒因暑气而发为热病）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（此辨伤寒时气之
异）夫欲候知四时正气为病及时行疫气之法皆当按斗历占之
四时八节二十四气七十二候决病法
立春正月节斗指艮 雨水正月中指寅
惊蛰二月节指甲 春分二月中指卯
清明三月节指乙 谷雨三月中指辰
立夏四月节指巽 小满四月中指巳
芒种五月节指丙 夏至五月中指午
小暑六月节指丁 大暑六月中指未
立秋七月节指坤 处暑七月中指申
白露八月节指庚 秋分八月中指酉
寒露九月节指辛 霜降九月中指戌
立冬十月节指干 小雪十月中指亥
大雪十一月节指壬 冬至十一月中指子
小寒十二月节指癸 大寒十二月中指丑
（二十四气节有十二中气有十二五日为一候气亦同合有七十二候决病生死此须洞解之也）
九月霜降后宜渐寒向冬大寒至正月雨水节后宜解也所以谓之雨水者以冰雪解而为雨水故也至二月惊蛰节后气渐和
暖向夏大热至秋便凉（此为四时正气）从霜降以后至春分以前凡有触冒冰雪体中寒即病者谓之伤寒也九月十月寒气尚微
为病则轻十一月十二月寒冽已严为病则重正月二月寒渐将解为病亦轻此以冬时不调适有伤寒之人即为病也（此为四时正
气中而即病者也）其冬有非节之暖者名曰冬温冬温之毒与伤寒大异冬温复有先后更相重沓亦有轻重为治不同证如后章
（此为时行之气前云冬时应寒而反大温者是也冬温应常纪者有三岁少阴司天之政五之气阳明司天之政终之气厥阴司天
之政终之气皆病冬温其不应常纪而反常者则不可候之而随时变易也）从立春节后其中无暴大寒又不冰雪而有人壮热为病
此属春时阳气发于外冬时伏寒变为温病（此为温病也内经曰冬伤于寒春必病温外邪唤出内邪也春温应常纪者有四岁少阴
司天之政初之气太阳司天之政初之气阳明司天之政初之气太阴司天之政二之气皆病温其不应常纪而反常者不可候之而
随时变易也）从春分以后至秋分节前天有暴寒者皆为时行寒疫也三月四月或有暴寒其时阳气尚弱为寒所折病热犹轻五月
六月阳气已盛为寒所折病热则重七月八月阳气已衰为寒所折病热亦微其病与温及暑病相似但治有殊耳（此辨时行与伤寒
相似治法不同要在辨其病原寒热温三者之异则用药冷热之品味判然矣）十五日得一气于四时之中一时有六气四六名为二
十四气也然气候亦有应至而不至或有未应至而至者或有至而太过者皆成病气也（素问六微旨大论帝曰其有至而至有至而
不至有至而太过何也岐伯曰至而至者和至而不至来气不及也未至而至来气有余也帝曰至而不至未至而至何如岐伯曰应
则顺否则逆逆则变生变生则病金匮要略曰有未至而至有至而不至有至而不去有至而太过何故也师曰冬至之后甲子夜半
少阳起少阳之时阳始生天得温和以未得甲子天因温和此为未至而至也以得甲子而天未温和此为至而不至也以得甲子天
大寒不解此为至而不去也以得甲子而天温如盛夏五六月时此为至而太过也）但天地动静阴阳鼓击者各正一气耳是以彼春
之暖为夏之暑彼秋之忿为冬之怒是故冬至之后一阳爻升一阴爻降也夏至之后一阳气下一阴气上也斯则冬夏二至阴阳合
也春秋二分阴阳离也阴阳交易人变病焉此君子春夏养阳秋冬养阴顺天地之刚柔也小人触冒必婴暴疹须知毒烈之气留在
何经而发何病详而取之是以春伤于风夏必飧泄夏伤于暑秋必病疟秋伤于湿冬必咳嗽冬伤于寒春必病温此必然之道可不
审明之与伤寒之病逐日浅深以施方治（经曰未满三日者可汗而已其满三日者可泄而已）今世人伤寒或始不早治或治不对
病或日数久淹困乃告医医人又不根据次第而治之则不中病皆宜临时消息制方无不效也今采仲景旧论录其证候诊脉声色对
病真方有神验者拟防世急也（仲景之书逮今千年而显用于世者王叔和之力也）又土地温凉高下不同物性刚柔飧居亦异是
故黄帝兴四方之问岐伯举四治之能以训后贤开其未悟者临病之工宜须两审也（庞 叔和非医方圆机孰能臻此也如桂枝汤
自
西北二方居人四时行之无不应验自江淮间地偏暖处惟冬及春可行之自春末及夏至以前桂枝麻黄青龙内宜加黄芩也自夏
至以后桂枝内又须随证增知母大青升麻石膏辈取汗也若时行寒疫及病久虚寒者正方古方不待加减矣夏至以后虽宜白虎
汤自非新中 而变暑病乃汗后解表药耳一白虎未能驱逐表邪故也或有冬及始春寒甚之时人患斯病因汗下后偶变狂躁不
解须当作内热治之不拘于时令也南方无霜雪之地不因寒气中人地气不藏虫类泄毒岚瘴间作不用此治法别有方也又一州
之内有山居者为居积阴之所盛夏冰雪其气寒腠理闭难伤于邪其人寿其有病者多中风中寒之疾也有平泽居者为居积阳之
所严冬生草其气温腠理疏易伤于邪其人夭其有病者多中温中暑之疾也）
王 夫伤于寒有即病者焉有不即病者焉即病者发于所感之时不即病者过时而发于春夏也即病谓之伤寒不即病谓
之温与
暑夫伤寒温暑其类虽殊其所受之原则不殊也由其原之不殊故一以伤寒而为称由其类之殊故施治不得以相混以所称而混
其治宜乎贻祸后人以归咎于仲景之法而委废其大半也吁可谓溺井怨伯益失火怨燧人矣夫法也方也仲景专为即病之伤寒
设不兼为不即病之温暑设也后人能知仲景之书本为即病者设不为不即病者设则尚恨其法散落所存不多而莫能御夫粗工
妄治之万变果可惮烦而或废之乎今人虽以治伤寒法治温暑亦不过借用耳非仲景立法之本意也虽然岂特可借以治温暑而
已凡杂病之治莫不可借也今人因伤寒治法可借以治温暑遂谓其法通为伤寒温暑设吁此非识流而昧源者与请以证之夫仲
景之书三阴经寒证居热证什之七八彼不即病之温暑但一于热耳何由而为寒哉夫惟后人以仲景书通为伤寒温暑设遂致诸
温剂皆疑焉而不敢用韩祗和虽觉桂枝汤之难用但谓今昔之世不同然未悟仲景书本为即病之伤寒设也且其所着微旨一书
又纯以温暑作伤寒立论而即病之伤寒反不言及又以夏至前胸膈满闷呕逆气塞肠鸣腹痛身体拘急手足逆冷等证视为温暑
谓与仲景三阴寒证脉理同而证不同遂别立温中法以治夫仲景所叙三阴寒证乃是冬时即病之伤寒故有此证今欲以仲景所
叙三阴寒证求对于春夏温暑之病不亦 乎以余观之其胸膈满闷呕逆气塞等证若非内伤冷物则不正暴寒所中或过服寒药
所变或内外俱伤于寒之病也且祗和但曰寒而当温然未尝求其所以为寒之故能求其故则知温暑本无寒证矣朱奉议作活人
书累数万言于仲景伤寒论多有发明其伤寒即入阴经为寒证者诸家不识而奉议识之但惜其亦不知仲景专为即病者立法故
其书中每每以伤寒温暑混杂议论竟无所别况又视伤寒论为全书遂将次传阴经热证与即入阴经寒证牵合为一立说且谓大
抵伤寒阳明证宜下少阴证宜温而于所识即入阴经之见又未免自相悖矣夫阳明证之宜下者固为邪热入胃其少阴证果是伤
寒传经热邪亦可温乎况温病暑病之少阴尤不可温也自奉议此说行而天下后世蒙害者多矣迨夫成无己作伤寒论注又作明
理论其表章名义纤悉不遗可谓善羽翼仲景者然即入阴经之寒证又不及朱奉议能识况即病立法之本旨乎宜其莫能知也惟
其莫知故于三阴诸寒证止随文解义而已未尝明其何由不为热而为寒也至于刘守真出亦以温暑作伤寒立论而遗即病之伤
寒其所处辛凉解散之剂固为昧者有中风伤寒错治之失而立盖亦不无桂枝麻黄难用之惑也既惑于此则无由悟夫仲景立桂
枝麻黄汤之有所主用桂枝麻黄汤之有其时矣故其原病式有曰夏热用麻黄桂枝之类热药发表须加寒药不然则热甚发黄或
斑出矣（此说出于庞安常而朱奉议亦从而和之）殊不知仲景立麻黄汤桂枝汤本不欲用于夏热之时也苟悟夫桂枝麻黄汤本
非治温暑之剂则群疑冰泮矣何也夫寒之初客于表也闭腠理郁阳气而为热故非辛温之药不能开腠理以泄其热此麻黄汤之
所由立也至于风邪伤表虽反疏腠理而不能闭然邪既客表则表之正气受伤而不能流通故亦发热也必以辛甘温之药发其邪
则邪去而腠理自密矣此桂枝汤之所由立也其所以不加寒药者盖由风寒在表又当天令寒冷之时而无所避故也后人不知仲
景立法之意故有惑于麻黄桂枝之热有犯于春夏之司气而不敢用于是有须加寒药之论夫欲加寒药于麻黄桂枝汤之中此乃
不悟其所以然故如此耳若仲景为温暑立方必不如此必别有法但惜其遗佚不传致使后人有多歧之患若知仲景伤寒论专为
即病伤寒作则知麻黄桂枝所以宜用之故除传经热证之外其直伤阴经与太阳不郁热即传阴经诸寒证皆有所归着而不复疑
为寒药误下而生矣若乃春夏有恶风恶寒纯类伤寒之证盖春夏暴中风寒之新病非冬时受伤过时而发者不然则或者温暑将
发而复感于风寒或因感风寒而动乎久郁之热遂发为温暑也仲景曰太阳病发热而渴不恶寒者为温病观此则知温病不当恶
寒而当渴其恶寒而不渴者非温病矣仲景虽不言暑病然暑病与温病同但复过一时而加重与温病耳其不恶寒而渴则无异也
春夏虽有恶风恶寒表证其桂枝麻黄二汤终难轻用勿泥于发表不远热之语也于是用辛凉解散庶为得宜苟不慎而轻用之诚
不能免夫狂躁斑黄衄血之变而亦无功也虽或者行桂枝麻黄于春夏而效乃是因其辛甘发散之力偶中于万一断不可视为常
道而守之今人以败毒散参苏饮通解散百解散之类不问四时中风伤寒一例施之虽非至正之道较之不慎而轻用麻黄桂枝于
春夏以致变者较必近理然败毒散等若用于春夏亦止可治暴中风寒之证而已其冬时受伤过时而发之温病暑病则不宜用也
用则非徒无益亦反害之矣若夫仲景于三阴经每用温药正由病之所必须与用之有其时耳若概以三阴寒证视为杂病而外之
得无负于仲景济人利物之至仁而误后世乎自近代先觉不示伤寒温暑异治之端绪但一以寒凉为主而诸温热之剂悉在所略
致使后之学人视仲景书欲仗焉而不敢以终决欲弃焉则犹以为立法之祖而莫能外甚则视为文具又甚则束之高阁而谓其法
宜于昔而不宜于今由治乱动静之殊治静属水乱动属火故其温热之药不可用于今属火之时也噫斯言也其果然耶否耶但能
明乎仲景本为即病者设法则桂枝麻黄自有所用诸温热之剂皆不可略矣若谓仲景法不独为即病者设则凡时行及寒疫温疟
风温等病亦通以伤寒六经病诸方治之乎伤寒例曰冬温之毒与伤寒大异为治不同又曰寒疫与温及暑病相似但治有殊耳是
则温暑及时行寒疫温疟风温等仲景必别有治法今不见者亡之也观其所谓为治不同所谓温疟风温温毒温疫脉之变证方治
如说岂非亡其法乎决不可以伤寒六经病诸方通治也叔和搜采仲景旧论之散落者以成书功莫大矣但惜其既以自己之说混
于仲景所言之中又以杂脉杂病纷纭并载于卷首故使玉石不分主客相乱若先备仲景之言而次附己帮助书其名则不致惑于
后人而累仲景矣余尝欲编类其书以伤寒例居前而六经病次之相类病又次之瘥后病又次之诊察治法治禁治误病解未解等
又次之其杂脉杂病与伤寒有所关者采以附焉其与伤寒无相关者皆删去如此庶几法度纯一而玉石有分主客不乱矣然有志
未暇姑叙此以俟他日
伤寒温病热病说
有病因有病名有病形辨其因正其名察其形三者俱当始可以言治矣且如伤寒此以病因而为病名者也温病热病此以天
时与病形而为病名者也由三者皆起于感寒或者通以伤寒称之夫通称伤寒者原其因之同耳至于用药则不可一例而施也何
也夫伤寒盖感于霜降后春分前然不即发郁热而发于春夏者也伤寒即发于天令寒冷之时而寒邪在表闭其腠理故非辛甘温
之剂不足以散之此仲景桂枝麻黄等汤之所以必用也温病热病后发于天令暄热之时怫热自内而达于外郁其腠理无寒在表
故非辛凉或苦寒或酸苦之剂不足以解之此仲景桂枝麻黄等汤独治外者之所以不可用而后人所处水解散大黄汤千金汤防
风通圣散之类兼治内外者之所以可用也夫即病之伤寒有恶风恶寒之证者风寒在表而表气受伤故也后发之温病热病有恶
风恶寒之证者重有风寒新中而表气亦受伤故也若无新中之风寒则无恶风恶寒之证故仲景曰太阳病发热而渴不恶寒者为
（四时伤寒不同、传变、汗下大法、可汗、不可汗、可下、不可下、可吐、不可吐、愈解、死证、阴阳、表里、伤寒杂病、类证、杂论、察色要略）
《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，冬天的气候冷冽。这是四季正常气候的顺序。冬季严寒，万物深藏，君子若能固密腠理则不伤于寒；若触犯冒犯寒气，才称为伤寒。然而，人受四时之气侵害都能致病（即下文所说的时行之气）。之所以称伤寒为毒，是因为它形成了最具有杀伤厉烈性质的邪气。感受寒邪随即发病的，称为伤寒；若不立即发病，寒毒潜伏在肌肤之中，到春天变为温病，到夏天变为暑病。暑病的火热程度比温病更重。（《内经》说：夏至之前得的病称为温病，夏至之后得的病称为暑病。温病和暑病原本都是因伤于寒而得之，所以太医都统称为伤寒。）因此，辛勤劳作的人，在春夏季节多患温热病，这都是因为冬季触犯了寒气所致，并非所谓的“时行之气”。（《活人书》说：夏季发热、恶寒、头痛、身体沉重、肢节疼痛，脉象洪盛的，就是这种情况。冬季伤于寒，因暑气激发而发为热病。）凡是时行疫气，是指春季应当温暖却反而大寒，夏季应当炎热却反而大凉，秋季应当凉爽却反而大热，冬季应当寒冷却反而大温。这种非其时而出现的气候，导致一年中老少病人的症状大多相似，这就是时行之气。（此处辨析伤寒与时气的区别。）想要掌握四时正气致病及时行疫气致病的规律，都应当依据斗历（古代观测天象定节气的仪器/历法）来占测。
四时八节二十四气七十二候决病法：
立春正月节，斗指艮位；雨水正月中，斗指寅位。
惊蛰二月节，斗指甲位；春分二月中，斗指卯位。
清明三月节，斗指乙位；谷雨三月中，斗指辰位。
立夏四月节，斗指巽位；小满四月中，斗指巳位。
芒种五月节，斗指丙位；夏至五月中，斗指午位。
小暑六月节，斗指丁位；大暑六月中，斗指未位。
立秋七月节，斗指坤位；处暑七月中，斗指申位。
白露八月节，斗指庚位；秋分八月中，斗指酉位。
寒露九月节，斗指辛位；霜降九月中，斗指戌位。
立冬十月节，斗指干位；小雪十月中，斗指亥位。
大雪十一月节，斗指壬位；冬至十一月中，斗指子位。
小寒十二月节，斗指癸位；大寒十二月中，斗指丑位。
（二十四节气中有十二个节气是“节”，十二个是“中气”。每五日为一“候”，气与候相同，合起来共有七十二候。判断疾病的生死，必须透彻理解这些内容。）
九月霜降后，天气逐渐变寒，直到冬季大寒，到了正月雨水节后，冰雪消融成为雨水，寒气才解除。所以叫作“雨水”，是因为冰雪融化而成雨水。到了二月惊蛰节后，气候逐渐和暖，趋向夏季的大热；到了秋天便转凉。（这是四时的正常正气。）从霜降以后到春分以前，凡是有触犯冰雪，体内受寒随即发病的，称为伤寒。九月、十月寒气尚微弱，致病则较轻；十一月、十二月寒冽已严酷，致病则较重；正月、二月寒气逐渐将解，致病也轻。这是因为冬季调摄不当，有伤寒之人随即发病。（这是四时正气中感受寒邪随即发病的情况。）如果冬季出现非节令的暖和天气，称为冬温。冬温的毒性与普通伤寒大不相同。冬温又有先发和后发的区别，病情有轻重，治疗方法也不同，详见后章。（这是时行之气。前文说“冬季应当寒冷却反而大温”就是指此。冬温符合常纪规律的有三种情况：少阴司天之政的五之气、阳明司天之政的终之气、厥阴司天之政的终之气，都会发生冬温。不符合常纪而反常的，则无法预测，需随时间变化而调整。）从立春节后，其中没有突然的大寒，也没有冰雪，但有人壮热生病，这属于春季阳气发散于外，冬季潜伏的寒邪变为温病。（这是温病。《内经》说：冬季伤于寒，春天必生温病。外邪唤醒内伏之邪。春温符合常纪规律的有四岁少阴司天之政初之气、太阳司天之政初之气、阳明司天之政初之气、太阴司天之政二之气，都会发生温病。不符合常纪而反常的，则无法预测，需随时间变化而调整。）从春分以后到秋分节前，天空出现突然的寒冷，都属于时行寒疫。三月、四月或有突然寒冷，此时阳气尚弱，被寒气遏制，发病热势较轻；五月、六月阳气已盛，被寒气遏制，发病热势则重；七月、八月阳气已衰，被寒气遏制，发病热势也微。其病症与温病及暑病相似，但治疗方法不同。（此处辨析时行寒疫与伤寒相似但治法不同，关键在于辨别病原是寒、是热还是温，三者不同，用药的冷热属性也就截然不同。）十五日得一气，在四季中，一季有六气，四六相乘名为二十四节气。然而气候也有应至而未至，或未应至而至，或虽至而太过者，都会形成病气。（《素问·六微旨大论》黄帝问：有的气既按时到达又按时到来，有的按时到达但未按时到来，有的按时到达却太过，为什么呢？岐伯回答：按时到达且按时到来，是和缓正常的；按时到达但未按时到来，是来气不足；未到之时却提前到来，是来气有余。黄帝问：按时到达但未按时到来，未到之时却提前到来，情况如何？岐伯回答：应至而至为顺，不应至而至为逆。逆则变异产生，变异产生则生病。《金匮要略》说：有未到之时却提前到来，有按时到达但未按时到来，有按时到达却不去，有按时到达却太过，为什么呢？老师说：冬至之后的甲子日夜半，少阳之气始起。少阳之时，阳气始生，天气变得温和。如果未到甲子日，天气已经温和，这叫“未至而至”。如果已到甲子日，天气仍未温和，这叫“至而不至”。如果已到甲子日，天气依然大寒不解，这叫“至而不去”。如果已到甲子日，天气温暖如盛夏五六月时，这叫“至而太过”。）天地动静，阴阳鼓击，各自端正一气罢了。所以那春天的温暖造就了夏天的暑热，那秋天的肃杀造就了冬天的愤怒。因此，冬至之后，一阳爻上升，一阴爻下降；夏至之后，一阳气下降，一阴气上升。这是冬至和夏至时阴阳交合，春分和秋分时阴阳分离。阴阳交互交易，人就发生变化而生病。所以君子春夏养阳，秋冬养阴，顺应天地的刚柔。小人触犯冒犯，必定遭受暴烈的疹疾。需要知道毒烈之气留在哪条经络，引发什么疾病，详细诊察以取效。因此，春伤于风，夏天必患飧泄；夏伤于暑，秋天必患疟疾；秋伤于湿，冬天必患咳嗽；冬伤于寒，春天必患温病。这是必然的道理，不可不审明。对于伤寒之病，要根据每日病情的深浅来施用方治。（经书说：未满三天的，可以通过发汗治愈；已满三天的，可以通过泻下治愈。）现在世人患伤寒，有的开始不早点治疗，有的治疗不对症，有的拖延日久困顿后才告诉医生，医生又不按次第治疗，这样就不中病。都应当临时斟酌制方，没有不有效的。如今采集张仲景的旧论，记录其证候、诊脉声色，针对病症的真实方剂，其中有神验的，以防世人之急需。（张仲景的书流传至今千年而在世上显扬，靠的是王叔和的力量。）另外，土地温凉高下不同，物性刚柔饮食居住也各异，所以黄帝兴起四方之问，岐伯列举四治之法，以教导后贤，开启他们未悟之处。临病诊治的工匠，必须双重审察。（庞安常说：如果不是王叔和这样的医家方圆之才，谁能达到这种境界呢？比如桂枝汤，在西北两方的居民，四季使用无不灵验；在江淮之间地偏暖的地方，只有冬季和春季可以使用；从春末到夏至以前，桂枝汤、麻黄汤、青龙汤内部适宜加入黄芩。从夏至以后，桂枝汤内又须随证增加知母、大青、升麻、石膏之类以取汗。如果是时行寒疫及病久虚寒者，用正方古方，不需要加减。夏至以后虽然适宜用白虎汤，但除非是新近感受寒邪而转变为暑病，否则只是汗后解表的药物而已。单用白虎汤未能驱逐表邪的缘故。有的人在冬季及初春严寒之时患病，因汗下后偶然变成狂躁不解，应当当作内热治疗，不拘泥于时令。南方无霜雪之地，不因寒气中人，地气不藏，虫类泄毒，岚瘴间作，不用此治法，另有方子。又如一州之内，有山居者，居住在积聚阴气的地方，盛夏仍有冰雪，气候寒冷，腠理闭塞，难伤于邪，其人长寿。有病者多患中风、中寒之疾。有平泽居者，居住在积聚阳气的地方，严冬仍生草，气候温暖，腠理疏松，易伤于邪，其人短命。有病者多患中温、中暑之疾。）
王履说：伤于寒，有随即发病的，有不随即发病的。随即发病的，发生在感受之时；不随即发病的，过时发作于春夏。随即发病的称为伤寒，不随即发病的称为温与暑。伤寒、温病、暑病，类别虽然不同，但所受的原则（病因）并无不同。正因为病因无不同，所以一律以“伤寒”称呼；正因为类别不同，施治不得混淆。如果因名称相同而混淆治法，恐怕会贻祸后人，归咎于张仲景的方法而废弃大半。唉，这就像掉进井里怨恨伯益（发明水井的人），失火怨恨燧人氏（发明钻木取火的人）一样。法度和方剂，张仲景专为随即发病的伤寒设立，并不兼为不随即发病的温暑设立。后人能知道张仲景的书本是为随即发病者设立，不为不随即发病者设立，还遗憾其法散落所存不多，不能抵御粗工妄治的各种变化，难道可以因为怕麻烦而废弃吗？今人虽然用治伤寒的方法治温暑，也不过是借用罢了，并非张仲景立法之本意。虽然如此，岂止可以借用来治温暑而已？凡杂病的治疗，没有不可以借用的。今人因为伤寒治法可借用来治温暑，就说其法是通用于伤寒、温暑设立的。唉，这不是识流而昧源的人吗？请让我证明这一点。张仲景的书，三阴经的寒证占热证的十分之七八，那些不随即发病的温暑只是一于热罢了，怎么会变成寒证呢？正因为后人把张仲景的书通盘视为适用于伤寒、温暑，导致诸温剂都被怀疑而不敢用。韩祗和虽然觉得桂枝汤难用，但认为今昔时代不同，然而并未领悟张仲景的书本是为随即发病的伤寒设立的。而且他所著的《伤寒微旨论》一书，又纯以温暑当作伤寒立论，反而不提随即发病的伤寒。他又把夏至前胸膈满闷、呕逆、气塞、肠鸣、腹痛、身体拘急、手足逆冷等证视为温暑，认为与张仲景所述三阴寒证脉理相同而证候不同，于是另立温中法来治疗。张仲景所述三阴寒证，乃是冬季随即发病的伤寒，所以有此证。今欲用张仲景所述三阴寒证去对应春夏温暑之病，不也是荒谬吗？依我看来，他所说的胸膈满闷、呕逆、气塞等证，如果不是内伤冷物，就是不正暴寒所中，或是过服寒药所变，或者是内外俱伤于寒的病。况且韩祗和只说当用温药，却未曾探究其为寒的原因。如果能探究其原因，就知道温暑本来没有寒证。朱奉议撰写《活人书》，累数万言，对张仲景《伤寒论》多有发明。对于伤寒即入阴经成为寒证这一点，诸家不识而朱奉议识之。可惜他也不知道张仲景专为随即发病者立法，所以书中每每将伤寒、温暑混杂议论，竟无所分别。何况他又视《伤寒论》为全书，遂将次传阴经的热证与即入阴经的寒证牵强合为一说，并认为大抵伤寒阳明证宜下，少阴证宜温，而对于他所认识的即入阴经的见地，又未免自相矛盾。夫阳明证宜下的，固然是邪热入胃；其少阴证果若是伤寒传经的热邪，也可以温吗？况且温病、暑病的少阴证尤其不可温。自从朱奉议此说流行，天下后世蒙受危害者很多。等到成无己作《伤寒论注》，又作《明理论》，其表彰名义，纤悉无遗，可以说是善于辅翼张仲景的人了。然而对于即入阴经的寒证，又不如朱奉议能识别，何况即病立法之本旨呢？应该是不了解吧。正因为不了解，所以对于三阴诸寒证只是随文解义，未曾阐明为何不为热而为寒。至于刘守真出来，也以温暑当作伤寒立论，而遗漏了随即发病的伤寒。他所处方剂中的辛凉解散之剂，固然是为了纠正愚者将中风、伤寒错治的失误而立，但也并非没有桂枝、麻黄难用的困惑。既然对此困惑，就无法领悟张仲景设立桂枝汤、麻黄汤有所主用，以及桂枝汤、麻黄汤有其适用之时。所以他在《原病式》中说：“夏季炎热，用麻黄、桂枝之类热药发表，必须加寒药，不然则会热甚发黄或出斑。”（此说出于庞安常，朱奉议也附和此说。）殊不知张仲景设立麻黄汤、桂枝汤，本就不打算用于夏季炎热之时。如果领悟到桂枝汤、麻黄汤本就不是治疗温暑的方剂，那么群疑就会像冰融化一样消散。为什么呢？寒之初客于体表，闭塞腠理，郁遏阳气而发热，所以非辛温之药不能开腠理以泄其热，这是麻黄汤之所以设立的原因。至于风邪伤表，虽然使腠理疏松而不能闭塞，但邪气既客于表，则表之正气受伤而不能流通，所以也发热。必须以辛甘温之药发散其邪，则邪去而腠理自然密闭，这是桂枝汤之所以设立的原因。之所以不加寒药，是因为风寒在表，又正值天气寒冷之时，无处躲避的缘故。后人不知张仲景立法之意，所以对麻黄、桂枝的热性感到困惑，触犯春夏的司天之气而不敢使用，于是有了须加寒药的论点。想在麻黄、桂枝汤中加入寒药，这是不悟其所以然才如此做的。如果张仲景为温暑立方，绝不会如此，必定另有方法。可惜其法遗失不传，致使后人有多歧之患。如果知道张仲景《伤寒论》专为随即发病的伤寒而作，就知道麻黄、桂枝所以宜用的原因。除了传经热证之外，其直伤阴经与太阳不郁热即传阴经的诸寒证，皆有所归着，不再怀疑为寒药误下而生。至于春夏有恶风、恶寒，纯类伤寒的证候，大概是春夏暴受中风寒的新病，不是冬季受伤过时发作的。否则，或许是温暑将要发作而又复感于风寒，或因感风寒而动乎久郁之热，遂发为温暑。张仲景说：“太阳病，发热而渴，不恶寒者，为温病。”观此可知，温病不应当恶寒而应当口渴；其恶寒而不渴的，就不是温病了。张仲景虽不言暑病，但暑病与温病相同，只是又过一时而加重于温病罢了。其不恶寒而口渴则无异。春夏虽有恶风、恶寒的表证，但桂枝、麻黄二汤终究难以轻用，不要拘泥于“发表不远热”的话。于是用辛凉解散，庶几得当。如果不慎重而轻用，确实不能避免狂躁、发斑、发黄、鼻衄血等变证，而且也无功效。或许有人在春夏行用桂枝、麻黄而有效，那是因其辛甘发散之力偶然中于万一，断不可视为常道而坚守。今人用败毒散、参苏饮、通解散、百解散之类，不问四时中风、伤寒一例施用，虽非至正之道，但与不慎而轻用麻黄、桂枝于春夏以致变者相比，必较合理。然而败毒散等若用于春夏，也只可治暴受中风寒的证候而已。对于冬季受伤过时发作的温病、暑病则不宜用。用了不仅无益，反而有害。至于张仲景在三阴经每用温药，正是由病之所必须，且用之有其时耳。如果一概将三阴寒证视为杂病而排斥在外，岂不是辜负了张仲景济人利物的至仁之心，而误导后世吗？自近代先觉不示伤寒、温暑异治的端绪，但以寒凉为主，而诸温热之剂悉在所略，致使后之学人视张仲景之书，想依靠它而不敢最终决断，想抛弃它，则犹以为立法之祖而不能外。甚者视为文具，又甚者束之高阁，谓其法宜于昔而不宜于今。由治乱动静之殊，治静属水，乱动属火，所以其温热之药不可用于今属火之时。唉，这话果真如此吗？否？只要能明白张仲景本为随即发病者设法，则桂枝、麻黄自有其用，诸温热之剂皆不可略。如果说张仲景的法不只为了随即发病者设立，则凡时行及寒疫、温疟、风温等病，也通以伤寒六经病诸方治之吗？《伤寒例》说：“冬温之毒与伤寒大异，为治不同。”又说：“寒疫与温及暑病相似，但治有殊耳。”则是温暑及时行寒疫、温疟、风温等，张仲景必定别有治法。如今不见者，亡佚了。观其所谓“为治不同”，所谓温疟、风温、温毒、温疫脉之变证方治如说，岂非亡其法乎？决不可以伤寒六经病诸方通治也。王叔和搜采张仲景旧论之散落者以成书，功莫大矣。可惜其既以自己之说混于张仲景所言中，又以杂脉杂病纷纭并载于卷首，故使玉石不分，主客相乱。若先备张仲景之言，而次附己帮助书其名，则不致惑于后人而累及张仲景。我曾想编类其书，以《伤寒例》居前，而六经病次之，相类病又次之，瘥后病又次之，诊察治法、治禁、治误、病解未解等又次之，其杂脉杂病与伤寒有所关者，采以附焉。其与伤寒无相关者，皆删去。如此庶几法度纯一，而玉石有分，主客不乱。然有志未暇，姑叙此以俟他日。
《伤寒温病热病说》：
有病因、有病名、有病形。辨其因，正其名，察其形，三者俱当，始可以言治矣。且如伤寒，此以病因而为病名者也；温病、热病，此以天时与病形而为病名者也。由三者皆起于感寒，或者通以伤寒称之。夫通称伤寒者，原其因之同耳。至于用药，则不可一例而施也。何也？夫伤寒盖感于霜降后、春分前，然不即发，郁热而发于春夏者也。伤寒即发于天令寒冷之时，而寒邪在表，闭其腠理，故非辛甘温之剂不足以散之。此仲景桂枝、麻黄等汤之所以必用也。温病、热病，后发于天令暄热之时，怫热自内而达于外，郁其腠理，无寒在表，故非辛凉或苦寒或酸苦之剂不足以解之。此仲景桂枝、麻黄等汤独治外者之所以不可用，而后人所处水解散、大黄汤、千金汤、防风通圣散之类兼治内外者之所以可用也。夫即病之伤寒有恶风、恶寒之证者，风寒在表而表气受伤故也；后发之温病、热病有恶风、恶寒之证者，重有风寒新中而表气亦受伤故也。若无新中之风寒，则无恶风、恶寒之证。故仲景曰：“太阳病，发热而渴，不恶寒者，为温病。”
(The differences of Cold Damage in the four seasons, transmission and transformation, general principles of sweating and purging, indications for sweating, contraindications for sweating, indications for purging, contraindications for purging, indications for emesis, contraindications for emesis, resolution of disease, death syndromes, Yin and Yang, exterior and interior, Cold Damage and miscellaneous diseases, differentiation of similar syndromes, miscellaneous discussions, brief overview of observing complexion)
The *Treatise on Yin and Yang* states: The climate of spring is mild, the climate of summer is hot and humid, the climate of autumn is cool, and the climate of winter is cold and biting. This is the sequence of the normal Qi (vital energy) of the four seasons. In winter, when it is severely cold, all things hide deeply. If a gentleman can keep his body secure and closed (solidify the defensive Qi), he will not be injured by cold; however, if one exposes oneself to or violates the cold, it is then called Cold Damage (Shanghan). Nevertheless, injury by the Qi of the four seasons can all cause disease (i.e., the epidemic Qi mentioned below). Cold Damage is termed "poison" because it forms the most lethal and destructive pathogenic factor. Those who contract it and fall ill immediately are said to have Cold Damage. Those who do not fall ill immediately harbor the cold toxin in their skin and muscles; when spring arrives, it transforms into Warm Disease (Wenbing); when summer arrives, it transforms into Summerheat Disease (Shubing). Summerheat disease is more severe in heat than Warm Disease. (*Neijing* states: Diseases acquired before the Summer Solstice are called Warm Disease; those acquired after the Summer Solstice are called Summerheat Disease. Both Warm Disease and Summerheat Disease originate from injury by cold, hence the Imperial Physicians generally refer to them as Cold Damage.) Therefore, hardworking people often suffer from warm-heat diseases in spring and summer, all caused by violating cold in winter, not by the "epidemic Qi." (*Huoren Shu* states: Fever, aversion to cold, headache, heavy body, and painful joints with a surging pulse in summer indicate this condition. Injury by cold in winter, triggered by summerheat Qi, develops into heat disease.) Whenever there is epidemic Qi, it refers to situations where spring should be warm but is excessively cold, summer should be hot but is excessively cool, autumn should be cool but is excessively hot, and winter should be cold but is excessively warm. Because the climate does not match the season, illnesses among people of all ages in that year tend to be similar; this is what is called epidemic Qi. (This section distinguishes between Cold Damage and seasonal epidemic Qi.) To understand the methods for diseases caused by normal seasonal Qi and epidemic Qi, one must consult the astronomical calendar (Doulì).
**Method for Determining Disease Based on Four Seasons, Eight Festivals, Twenty-Four Solar Terms, and Seventy-Two Pentads:**
Li Chun (Start of Spring), first month festival, Dipper points Gen; Yu Shui (Rain Water), first month middle, Dipper points Yin.
Jing Zhe (Awakening of Insects), second month festival, Dipper points Jia; Chun Fen (Spring Equinox), second month middle, Dipper points Mao.
Qing Ming (Clear and Bright), third month festival, Dipper points Yi; Gu Yu (Grain Rain), third month middle, Dipper points Chen.
Li Xia (Start of Summer), fourth month festival, Dipper points Xun; Xiao Man (Grain Buds), fourth month middle, Dipper points Si.
Mang Zhong (Grain in Ear), fifth month festival, Dipper points Bing; Xia Zhi (Summer Solstice), fifth month middle, Dipper points Wu.
Xiao Shu (Minor Heat), sixth month festival, Dipper points Ding; Da Shu (Major Heat), sixth month middle, Dipper points Wei.
Li Qiu (Start of Autumn), seventh month festival, Dipper points Kun; Chu Shu (End of Heat), seventh month middle, Dipper points Shen.
Bai Lu (White Dew), eighth month festival, Dipper points Geng; Qiu Fen (Autumn Equinox), eighth month middle, Dipper points You.
Han Lu (Cold Dew), ninth month festival, Dipper points Xin; Shuang Jiang (Frost Descent), ninth month middle, Dipper points Xu.
Li Dong (Start of Winter), tenth month festival, Dipper points Qian; Xiao Xue (Minor Snow), tenth month middle, Dipper points Hai.
Da Xue (Major Snow), eleventh month festival, Dipper points Ren; Dong Zhi (Winter Solstice), eleventh month middle, Dipper points Zi.
Xiao Han (Minor Cold), twelfth month festival, Dipper points Gui; Da Han (Major Cold), twelfth month middle, Dipper points Chou.
(Twenty-four solar terms include twelve "Jie" (terms) and twelve "Zhong Qi" (middle Qi). Every five days constitute one "Hou" (pentad). The logic applies equally to Qi and Hou. Understanding these seventy-two pentads is essential for determining life and death in disease.)
After Frost Descent in September, the weather gradually becomes cold until Major Cold in winter. After the Rain Water term in January, ice and snow melt into rain, and the cold dissipates. Hence it is called "Rain Water." By the Awakening of Insects term in February, the climate becomes gradually warm, trending toward the great heat of summer; by autumn, it turns cool. (These are the normal Qi of the four seasons.) From Frost Descent until before the Spring Equinox, anyone who exposes themselves to ice and snow and falls ill due to internal cold is diagnosed with Cold Damage. In September and October, the cold air is still slight, so the illness is mild. In November and December, the cold is severe, so the illness is heavy. In January and February, the cold is gradually resolving, so the illness is light. This occurs when one fails to regulate properly during winter, leading to immediate onset of Cold Damage. (This refers to immediate onset of Cold Damage due to normal seasonal Qi.) If there is unseasonable warmth in winter, it is called Winter Warmth (Dongwen). The toxicity of Winter Warmth is vastly different from Cold Damage. Winter Warmth has early and late occurrences, with varying severity and treatment, detailed in subsequent chapters. (This is epidemic Qi. As stated earlier, "winter should be cold but is warm.") There are three regular patterns for Winter Warmth: the fifth Qi of Shaoyin ruling heaven, the final Qi of Yangming ruling heaven, and the final Qi of Jueyin ruling heaven. Irregular patterns cannot be predicted and must be adjusted according to time. After the Start of Spring term, if there is no sudden severe cold or ice/snow, yet someone suffers from high fever, it belongs to Warm Disease transforming from latent winter cold due to the outward expansion of spring Yang Qi. (*Neijing*: "Injury by cold in winter leads to Warm Disease in spring.") There are four regular patterns for Spring Warmth: the first Qi of Shaoyin, Taiyang, and Yangming ruling heaven, and the second Qi of Taiyin ruling heaven. Irregular patterns require adjustment based on time. From the Spring Equinox until before the End of Autumn term, sudden cold spells constitute an epidemic cold plague (Shixing Hanyi). In March and April, when Yang Qi is weak, cold suppression results in milder heat. In May and June, when Yang Qi is strong, cold suppression results in heavier heat. In July and August, when Yang Qi is declining, cold suppression results in milder heat. These symptoms resemble Warm Disease and Summerheat Disease, but treatments differ. (This distinguishes epidemic cold from Cold Damage; the key is distinguishing the pathogen as cold, heat, or warm, which dictates the temperature nature of the herbs.) Every fifteen days yields one Qi. In each season, there are six Qi, totaling twenty-four Qi. However, climates may arrive early, late, or excessively, creating pathogenic factors. (*Suwen*: Huangdi asks about Qi arriving on time, late, or excessively. Qibo explains that timely arrival is harmony; late arrival is deficiency; early arrival is excess. *Jingui Yaolue*: Mentions early arrival, late arrival, lingering Qi, and excessive Qi. The Master says: After Winter Solstice, on the Jiazi day at midnight, Shaoyang Qi rises. If the weather warms before Jiazi, it is "early arrival." If it remains cold after Jiazi, it is "late arrival." If cold persists long after Jiazi, it is "lingering Qi." If it becomes as hot as midsummer after Jiazi, it is "excessive Qi.") Heaven and earth move and rest, Yin and Yang interact, each maintaining its own Qi. Thus, spring's warmth becomes summer's heat, and autumn's severity becomes winter's anger. After Winter Solstice, one Yang line rises and one Yin line descends; after Summer Solstice, one Yang line descends and one Yin line rises. This is the convergence of Yin and Yang at the solstices and their separation at the equinoxes. Through the interaction of Yin and Yang, humans change and become ill. Therefore, gentlemen nourish Yang in spring and summer, and Yin in autumn and winter, following the heaven-earth rigidity and flexibility. Commoners who violate these rules suffer from violent rashes. One must determine which meridian holds the toxic Qi and what disease it causes, examining carefully to treat effectively. Thus: Wind injury in spring leads to undigested diarrhea in summer; Summerheat injury in summer leads to malaria in autumn; Dampness injury in autumn leads to cough in winter; Cold injury in winter leads to Warm Disease in spring. This is the inevitable way; it must be clearly understood. For Cold Damage, prescriptions must be applied according to the daily progression of the disease. (Scripture states: If less than three days, cure by sweating; if more than three days, cure by purging.) Nowadays, people with Cold Damage either delay treatment, receive incorrect treatment, or wait until they are critically ill before seeking help. Doctors then fail to treat according to the stages, missing the mark. One must adjust prescriptions dynamically to ensure efficacy. Here, we collect Zhang Zhongjing's old theories, recording syndromes, pulse diagnosis, voice, and complexion, along with authentic prescriptions for specific diseases that have proven miraculous, to meet urgent needs. (Zhang Zhongjing's works have been prominent for a millennium largely due to Wang Shuhe.) Furthermore, land varies in warmth, coolness, altitude, and texture; materials vary in rigidity and flexibility; diet and residence differ. Thus, the Yellow Emperor asked questions about the four directions, and Qibo presented healing methods for the four regions to instruct later generations. Practitioners must double-check these factors. (Pang Anchang said: Only a master like Wang Shuhe could achieve this. For example, Guizhi Tang is effective year-round in the northwest. In the warmer Jianghuai region, it is only suitable for winter and spring. From late spring to pre-summer solstice, Huangqin should be added to Guizhi Tang, Mahuang Tang, and Qinglong Tang. From summer solstice onwards, Zhimu, Daqingye, Shengma, and Shigao should be added to Guizhi Tang for sweating. For epidemic cold or chronic deficiency-cold, use standard ancient formulas without modification. Although Baihu Tang is suitable post-summer solstice, it is mainly for post-sweating exterior release if summerheat transforms from recent cold exposure; Baihu Tang alone cannot expel exterior pathogens. Some patients in deep winter or early spring develop mania after sweating/purging; this should be treated as internal heat, ignoring seasonal constraints. Southern regions without frost/snow do not suffer from external cold invading; earth Qi does not store, insects release toxins, and miasmas arise; different treatments apply. Also, mountain dwellers live in yin-accumulating areas with ice/snow even in midsummer; their pores close, protecting them from pathogens, leading to longevity. Illnesses are mostly wind-stroke or cold-strike. Plain/delta dwellers live in yang-accumulating areas with grass in winter; their pores open, making them susceptible to pathogens, leading to shorter lifespans. Illnesses are mostly warm-strike or summerheat-strike.)
Wang Lu stated: Cold injury has immediate onset and delayed onset. Immediate onset occurs at the time of infection; delayed onset occurs later in spring or summer. Immediate onset is called Cold Damage; delayed onset is called Warm or Summerheat diseases. Although Cold Damage, Warm Disease, and Summerheat Disease differ in category, their origin (etiology) is the same. Hence, they are collectively called Cold Damage. However, because their categories differ, treatments must not be confused. Confusing treatment based on nomenclature would harm future generations and lead to the abandonment of Zhang Zhongjing's methods. This is like blaming Boyi for falling into a well or Suiren for a fire. Zhang Zhongjing's laws and formulas were specifically designed for immediate Cold Damage, not for delayed Warm/Summerheat diseases. If later generations understood that Zhang's book was for immediate cases, they would regret the loss of his methods rather than abandon them due to fear of incompetent doctors' errors. Modern practitioners borrowing Cold Damage methods for Warm/Summerheat diseases are merely using them incidentally, not following Zhang's original intent. However, these methods can be borrowed for any miscellaneous disease. Moderns believe Zhang's methods cover both Cold Damage and Warm/Summerheat diseases. This confuses the stream with the source. Let me prove this: In Zhang's book, 70-80% of Shaoyin, Shaoyang, and Taiyin syndromes are cold, whereas delayed Warm/Summerheat diseases are purely heat. How can they become cold? Later generations treating Zhang's book as universal led to suspicion of warming agents. Han Zhihe found Guizhi Tang difficult to use, attributing it to changing times, but failed to realize Zhang's focus on immediate Cold Damage. His *Wei Zhi Lun* treats Warm/Summerheat as Cold Damage, ignoring immediate Cold Damage. He misinterpreted pre-summer solstice symptoms (chest fullness, vomiting, cold limbs) as Warm/Summerheat, similar to Zhang's Shaoyin cold syndromes, and created "Warming Middle" methods. Zhang's Shaoyin cold syndromes were for immediate winter Cold Damage. Applying these to spring/summer Warm/Summerheat is erroneous. I believe chest fullness/vomiting result from internal cold food, sudden cold exposure, or overuse of cold medicines, or dual cold injury. Han Zhihe prescribed warming without investigating the cause of cold; understanding the cause reveals Warm/Summerheat lacks cold syndromes. Zhu Fengyi's *Huoren Shu* clarified many aspects of Zhang's work, recognizing that Cold Damage entering Yin meridians causes cold syndromes. However, he also failed to recognize Zhang's focus on immediate cases, mixing Cold Damage and Warm/Summerheat discussions. He combined transmitted heat syndromes with immediate cold syndromes, suggesting Yangming requires purging and Shaoyin requires warming. This is contradictory: if Shaoyin involves transmitted heat, can it be warmed? Especially for Warm/Summerheat Shaoyin, warming is contraindicated. Zhu's theory caused widespread harm. Cheng Wuji's commentary praised Zhang's terminology but missed the nuance of immediate cold syndromes and the original legislative intent, leading to superficial interpretation. Liu Wansu also treated Warm/Summerheat as Cold Damage, omitting immediate Cold Damage. His辛凉 (pungent-cool) dispersal formulas corrected errors in treating wind-stroke/Cold Damage but retained confusion regarding Guizhi/Mahuang. He argued that pungent-hot herbs like Mahuang/Guizhi must be cooled in summer to prevent jaundice/rashes. This view, shared by Pang Anchang and Zhu Fengyi, misunderstands Zhang. Zhang did not intend these formulas for summer heat. Recognizing that Guizhi/Mahuang are not for Warm/Summerheat resolves doubts. Cold initially attacks the exterior, closing pores and trapping Yang Qi, causing heat; thus, pungent-warm herbs are needed to open pores and release heat (Mahuang Tang). Wind injury loosens pores but traps pathogen, damaging Zheng Qi and causing heat; pungent-sweet-warm herbs disperse the pathogen and restore pore closure (Guizhi Tang). No cooling herbs were added because the pathogen was in the exterior during cold weather. Later generations, confused by the heat of these herbs in spring/summer, suggested adding cooling herbs. This stems from misunderstanding the rationale. If Zhang formulated for Warm/Summerheat, he would not have done this. His methods were lost, causing confusion. Knowing Zhang's book targets immediate Cold Damage clarifies why Mahuang/Guizhi are used. Except for transmitted heat, direct Yin meridian injuries and non-heat-trapped Taiyang injuries transforming into Yin cold syndromes fit these formulas. In spring/summer, wind/cold symptoms resembling Cold Damage are usually new acute infections, not delayed winter injuries. Or, Wind/Cold triggers latent heat, causing Warm/Summerheat. Zhang states: "Taiyang disease with fever, thirst, and no aversion to cold is Warm Disease." Thus, Warm Disease should feature thirst, not aversion to cold. Summerheat disease is similar to Warm Disease but more severe. While some spring/summer cases have exterior signs, Guizhi/Mahuang should be used cautiously. Do not rigidly follow "releasing exterior ignores heat." Use pungent-cool dispersal instead. Misuse leads to mania, rashes, jaundice, and epistaxis. Occasional success in spring/summer is accidental; do not make it a rule. Moderns use Baidu San, Susu Yin, etc., indiscriminately. While not ideal, it is safer than misusing Mahuang/Guizhi in summer. However, these formulas only treat acute wind/cold in spring/summer, not delayed Warm/Summerheat diseases. Using them for the latter is harmful. Zhang uses warming herbs in Yin meridians because the pathology demands it and timing is appropriate. Excluding Yin cold syndromes from Zhang's scope betrays his benevolence. Recent scholars prioritize cooling, neglecting warming herbs, claiming modern "fire" eras don't suit ancient "water" methods. This is questionable. Understanding Zhang's focus on immediate cases validates the use of Guizhi/Mahuang and warming herbs. If Zhang's methods covered all epidemics, would Six Meridian formulas treat Wind-Warmth and Malaria? *Shanghan Li* states Winter Warmth differs from Cold Damage. Epidemic cold differs from Warm/Summerheat. Thus, Zhang had specific methods for these, now lost. Wang Shuhe compiled Zhang's scattered works, a great merit, but mixed his own views and miscellaneous pulses/diseases at the beginning, confusing jade with stone. If he had placed Zhang's words first and appended his own, confusion would be avoided. I intended to reorganize the book: *Shanghan Li* first, then Six Meridians, similar diseases, post-recovery, diagnostics, methods, contraindications, errors, etc., attaching relevant miscellaneous items and deleting irrelevant ones. This would clarify the law and distinguish truth from falsehood. Lacking time, I record this for the future.
**On Cold Damage, Warm Disease, and Heat Disease:**
There are etiology, disease name, and disease manifestation. Identifying the cause, naming correctly, and observing form are prerequisites for treatment. Cold Damage is named by etiology; Warm/Heat diseases are named by season and manifestation. All originate from cold injury, leading some to call them all Cold Damage. While the cause is the same, treatment cannot be uniform. Cold Damage occurs between Frost Descent and Spring Equinox, often delaying onset until spring/summer due to trapped heat. Immediate Cold Damage occurs in cold weather, with cold pathogen in the exterior closing pores; pungent-sweet-warm herbs are necessary (Guizhi/Mahuang Tangs). Warm/Heat diseases occur in warm weather, with internal heat reaching the exterior and blocking pores, without exterior cold; pungent-cool, bitter-cold, or sour-bitter herbs are required. Thus, Guizhi/Mahuang Tangs (treating exterior only) are unsuitable, while formulas like Shuijie San, Dahuang Tang, Qianjin Tang, and Fangfeng Tongsheng San (treating interior and exterior) are applicable. Immediate Cold Damage has aversion to wind/cold due to exterior pathogen damaging surface Qi. Delayed Warm/Heat diseases have aversion to wind/cold only if newly superimposed with wind/cold damaging surface Qi. Without new wind/cold, there is no aversion to wind/cold. Hence Zhang states: "Taiyang disease with fever, thirst, and no aversion to cold is Warm Disease."