前人有阴虚注夏之说，余又创阳虚注秋之说，近察人间之病，似有可名注冬者。常见有
人每
交冬令，即气急痰多，咳嗽喘促，不能见风，不能正眠，五更以后，即须危坐，面色苍黄，
颧颊浮肿，腿酸背胀，举动不便，饮食、二便如常，亦可赤涩溏泄，春分渐暖，始渐平愈。
此乃脾、肾之阳两虚，肾中水邪上溢于肺，脾中湿邪下溜于肾，上下湿热浊阴弥漫，肝阳疏
泄宣发之性抑郁而不得舒。其人目胞浮而似肿者，脾气滞也，目光露努而少神者，肝气滞也
。故必待木气得令许久，肝气始能升举，始能泄肾邪而醒脾阳，与《内经》秋伤于湿，冬生
咳嗽之证相似。然伤湿为新病，此乃逐年如此，至时即发，形同痼疾，得不谓之注冬乎?朱
丹溪谓∶逐年入冬即患咳喘者，时令之寒，束其内热也；先于秋月，泄去内热，使寒至无热
可包，则不发喘九。即此证也。第泄热之说，犹有可议者。此证虽因内有湿热，实因阳气虚
弱，寒湿在表，三焦不得宣通，始蕴蓄而成痰热也，虽无表证，实由表邪。治法当以苦淡清
其里，辛温疏其表。苦淡如二妙散、胃苓汤之属；辛温如荆防败毒散、冲和汤之属。古用越
婢半夏汤，麻黄、石膏并用，最为有义。若年深岁久，痰涎胶固，寒湿深刺筋骨者，更非海
浮石、海蛤粉、瓦愣子、 牡蛎、焦楂、桃仁、赭石、礞石，不能涤其痰；非细辛、羌活、
白芷、葛根诸品，不能攻其表；非黄柏、侧柏、胆草、柴胡、苦参大苦大寒，不能泄其浊而
坚基。且宜先于夏月，乘阳气宣发之令，预为加减多服，使筋骨腠理无有留邪，肠胃三焦无
有伏湿，则阴邪下泄，真阳外充，膻中泰然，百体俱适矣。其补药止宜菟丝、杜仲、牡蛎、
海
螵蛸，苦坚咸温，镇固肾气，不宜姜、桂辛烈灼阴也；更不宜承气、陷胸重泄脾肾真气也。
若以苏、杏降气，则伐气而上虚； 、术补脾，则助邪而中满。
前人有关于“阴虚注夏”的说法，我又创立了“阳虚注秋”的理论，近期观察人间疾病，似乎有一种可以命名为“注冬”的病证。常见有人每当进入冬季时令，就出现气急痰多、咳嗽喘促的症状，不能受风，无法平卧安睡，五更以后就必须危坐，面色苍黄，颧骨和脸颊浮肿，腿部酸软背部胀满，行动不便，饮食和二便情况正常，但也可能出现小便赤涩或大便溏泄的情况，直到春分时节天气渐暖，症状才逐渐平息痊愈。这是由于脾脏和肾脏的阳气双重虚弱，肾中的水邪向上溢入肺脏，脾中的湿邪向下流注于肾脏，导致上下焦湿热浊阴之气弥漫，肝阳疏泄宣发的本性受到抑制而不能舒展。此人眼睑浮肿似肿者，是脾气阻滞所致；目光外露努张且缺乏神采者，是肝气阻滞所致。因此必须等到木气（肝气）当令许久之后，肝气才能升举，才能宣泄肾中邪气并唤醒脾阳，这与《黄帝内经》中“秋季感受湿邪，冬季发生咳嗽”的病证相似。然而，《内经》所言伤湿属于新感之病，而此病则是每年如此，到特定时节即发作，形态如同顽固性疾病，怎能不称之为“注冬”呢？朱丹溪曾说：“每年入冬即患咳喘的人，是因为时令的寒邪束缚了体内的热邪；如果在先前的秋月季节，泄去体内热邪，使得寒邪到来时没有热邪可包裹，那么就不会发作喘证。”指的就是这种病证。只是关于“泄热”的说法，还有值得商榷的地方。此病虽然因体内有湿热，但实质是因为阳气虚弱，寒湿停留在体表，导致三焦不得宣通，从而蕴蓄形成痰热。虽然表面没有明显的表证，实则由表邪引起。治疗方法应当用苦味淡味药物清利里热，用辛温药物疏散表邪。苦淡类药物如二妙散、胃苓汤之类；辛温类药物如荆防败毒散、冲和汤之类。古人使用越婢半夏汤，麻黄与石膏并用，最为合乎义理。如果病程年深日久，痰涎胶结固着，寒湿深入刺入筋骨，就更非海浮石、海蛤粉、瓦楞子、牡蛎、焦山楂、桃仁、代赭石、礞石不能涤荡其痰；非细辛、羌活、白芷、葛根等品不能攻逐在表之邪；非黄柏、侧柏叶、龙胆草、柴胡、苦参等大苦大寒之药，不能泄除浊邪并坚固根基。而且适宜先在夏季，趁着阳气宣发之时令，预先进行加减并多服用，使筋骨腠理中没有留存的邪气，肠胃三焦中没有潜伏的湿邪，这样阴邪就能向下排泄，真阳就能向外充盛，膻中部位安然舒适，全身各部都感到适意。其补益药物只适宜选用菟丝子、杜仲、牡蛎、海螵蛸，利用苦坚咸温的特性，镇固肾气，不宜使用生姜、肉桂等辛烈之品灼伤阴液；更不宜使用承气汤、陷胸汤等重剂泻下以损伤脾肾的真气。如果使用苏叶、杏仁降气，则会耗伐正气而导致上虚；如果使用苍术、白术补脾，则会助长邪气而导致中满。
Predecessors had the concept of "Yin-Deficiency Summer-Lethargy" (Yin Xu Zhu Xia), and I have further created the theory of "Yang-Deficiency Autumn-Lethargy" (Yang Xu Zhu Qiu). Upon recent observation of illnesses in the world, there seems to be a condition that can be named "Winter-Lethargy" (Zhu Dong). It is common to see individuals who, upon entering the winter season, immediately experience rapid breathing with excessive phlegm, coughing and wheezing, inability to tolerate wind, and inability to sleep flat. After the fifth watch (around 1-3 AM), they must sit upright; their complexion is sallow and yellow, with edema on the cheekbones and cheeks, soreness in the legs, distension in the back, and inconvenience in movement. Their diet and bowel/bladder functions are generally normal, though they may also present with dark, scanty urination or loose stools. The condition gradually subsides only when the weather warms up after the Spring Equinox. This arises from a dual deficiency of Spleen and Kidney Yang, where Water Pathogens from the Kidney overflow upward into the Lung, and Damp Pathogens from the Spleen flow downward into the Kidney. Upper and lower Jiao are filled with turbid Yin of damp-heat, depressing the Liver Yang's nature of dispersal and promotion, preventing it from unfolding smoothly. When the eyelids are swollen, it indicates stagnation of Spleen Qi; when the eyes appear protruding and lack spirit, it indicates stagnation of Liver Qi. Therefore, one must wait until the Wood Qi (Liver Qi) has been in command for a long time before the Liver Qi can ascend, thereby venting Kidney pathogens and awakening Spleen Yang. This resembles the syndrome described in the *Nei Jing* (Inner Canon): "Injury by dampness in autumn leads to cough in winter." However, injury by dampness refers to a new-onset disease, whereas this condition recurs annually, manifesting at specific times, resembling a chronic stubborn disease. How can it not be called "Winter-Lethargy"? Zhu Danxi stated: "Those who suffer from cough and asthma every winter are affected by seasonal cold binding internal heat; if internal heat is drained in the preceding autumn, so that when cold arrives there is no heat to bind, then asthma will not occur." This refers to this very syndrome. Yet, the theory of "draining heat" remains debatable. Although this condition involves internal damp-heat, its root cause is actually weak Yang Qi, with cold-damp lingering on the exterior, causing the Triple Burner (San Jiao) to fail in diffusion, thereby accumulating into phlegm-heat. Although there are no obvious exterior signs, it is truly caused by exterior pathogens. The treatment method should employ bitter and bland herbs to clear the interior, and acrid-warm herbs to disperse the exterior. Bitter-bland formulas include Er Miao San (Two Marvels Powder) and Wei Ling Tang (Stomach Cinnamon Decoction); acrid-warm formulas include Jing Fang Bai Du San (Schizonepeta and Saposhnikovia Decoction to Overcome Toxins) and Chong He Tang (Harmonizing Decoction). Ancient practitioners used Yue Bi Ban Xia Tang (Yuebi Pinellia Decoction), combining Ephedrae Herba (Mahuang, 麻黄) and Gypsum Fibrosum (Shigao, 石膏), which is highly appropriate. If the disease has persisted for years, with phlegm-saliva becoming tenacious and fixed, and cold-damp penetrating deeply into sinews and bones, then only Hai Fu Shi (Pumice), Hai Ge Fen (Clam Shell Powder), Wa Leng Zi (Arca Shell), Ostreae Concha (Muli, 牡蛎), Zao Sha Zha (Fried Hawthorn Fruit), Persicariae Semen (Taoren, 桃仁), Haematitum (Zheshi, 赭石), and Qing Shi (Calamine) can purge the phlegm; only Xi Xin (Asarum), Qiang Huo (Notopterygii Rhizoma et Radix), Bai Zhi (Angelicae Dahuricae Radix), and Ge Gen (Puerariae Lobatae Radix) can attack the exterior pathogens; only Huang Bo (Phellodendri Cortex), Ce Bai Ye (Biota Top Leaf), Long Dan Cao (Gentianae Radix), Chai Hu (Bupleuri Radix), and Ku Shen (Sophorae Flavescentis Radix)—all extremely bitter and cold—can drain turbidity and strengthen the foundation. Furthermore, it is advisable to take modified prescriptions extensively during summer, taking advantage of the season when Yang Qi is diffusing, so that no pathogenic factors remain in the sinews, bones, and interstices, and no latent dampness lingers in the intestines, stomach, and Triple Burner. Thus, Yin pathogens will drain downward, True Yang will充盈 (fill) outward, the Chest Center (Dan Zhong, 膻中) will be peaceful, and all parts of the body will feel comfortable. For tonifying medicines, only Tu Si Zi (Cuscutae Semen), Du Zhong (Eucommiae Cortex), Muli (Ostreae Concha, 牡蛎), and Hai Piao Xiao (Sepiae Endoconcha) are suitable; their bitter-astringent and salty-warm properties stabilize and secure Kidney Qi. One should avoid using Sheng Jiang (Zingiberis Rhizoma Recens, 生姜) and Rou Gui (Cinnamomi Cortex, 肉桂) as their acrid-hot nature burns Yin. One must also avoid using Cheng Qi Tang (Order the Qi Decoction) or Xiong Xiong Tang (Chest-Crushing Decoction) to heavily purge and damage the True Qi of the Spleen and Kidney. If Su Ye (Perillae Folium) and Xing Ren (Prunus Armeniacae Semen) are used to direct Qi downward, it will deplete Qi and cause upper deficiency; if Cang Zhu (Atractylodis Rhizoma) and Bai Zhu (Atractylodis Macrocephalae Rhizoma) are used to tonify the Spleen, they will aid the pathogen and cause central fullness.