（一名时行伤寒。通称寒疫。）
【因】春应温而反寒。夏应热而反凉。感而为病。长幼率皆相似。互相传染。其所
以传染者。由寒气中或挟厉风。或挟秽湿。病虽与伤寒相类。而因则同中有异。
【证】初起头疼身痛。憎寒壮热。无汗不渴。胸痞恶心。或气逆作呕。或肢懈腹痛
。舌苔白薄。甚或淡灰薄腻。若传里后。亦有口渴便闭。耳聋神昏者。舌苔由白而黄。
由黄而黑。
【脉】左略紧。右弦缓。
【治】春分后挟厉风而发。头疼形寒独甚者。苏羌达表汤。加鲜葱曰（三钱）、淡
香豉（四钱）、辛温发表。秋分前挟秽湿而发。身痛肢懈独甚者。藿香正气汤加葱豉。
辛淡芳透。均加紫金片以解毒。如有变证。可仿正
伤寒传变例治之。
【秀按】时行寒疫。俞君区别挟厉风挟秽湿两因。按时求原。对症立方。确有见地
。若其人素体阳虚。外寒直中阴经。陡然吐利腹痛。肢冷筋吊者。则为时行中寒。应仿
阴症伤寒例治之。以予所验。寒疫多发于四五六七四个月。若天时晴少雨多。湿令大行
。每多伤寒兼湿之证。藿香正气汤。加葱豉紫金片。汗利兼行。避秽解毒。确是对病真
方。若寒挟厉风。邪气独盛于表。而里无伏热者。则活人败毒散。每用三四钱。葱豉汤
泡服。亦奏肤功。即圣散子治寒疫。其功亦着。
【廉勘】春应温而反寒。夏应热而反凉。感此非时之寒为寒疫。秋应凉而反热。冬
应寒而反温。感此非时之暖为温疫。此皆四时之常疫也。通称时疫。近世寒疫少。温疫
多。医者尤宜注意。前哲吴坤安曰。治时疫。当分天时寒暄燥湿。病者虚实劳逸。因症
制宜。不可执泥。如久旱天时多燥。温疫流行。宜清火解毒。忌用燥剂。久雨天时多湿
。民多寒疫。或兼吐泻。宜燥湿散寒。忌用润剂。此治时疫之正法也。
【病因】春季本该温暖却反而寒冷，夏季本该炎热却反而凉爽，人体感受这些异常气候而发病。无论老少，症状大多相似，且容易互相传染。之所以会传染，是因为寒气中夹杂了厉风（一种强烈的风邪）或秽湿（污浊的湿气）。虽然病症表现与伤寒相似，但病因则在相同中有不同之处。
【症状】初起时头痛、身体疼痛，怕冷且高热，无汗且不口渴，胸脘部痞闷、恶心，或者气逆作呕，或者四肢懈怠、腹痛。舌苔白而薄，严重时呈淡灰色且薄腻。如果病邪传入体内，也会出现口渴、大便闭塞、耳聋、神志昏蒙等症状。舌苔由白色转为黄色，再由黄色转为黑色。
【脉象】左手脉略紧，右手脉弦缓。
【治法】春分后若因夹杂厉风而发病，头痛和形寒特别严重的，用苏羌达表汤，加鲜葱白（三钱）、淡豆豉（四钱），以辛温之法发散表邪。秋分前若因夹杂秽湿而发病，身体疼痛和四肢懈怠特别严重的，用藿香正气汤加葱白、豆豉，以辛淡芳香透达之法治疗。以上两种情况均加紫金片以解毒。如果出现变证，可以参考正伤寒传变的规律进行治疗。
【秀按语】对于时行寒疫，俞君区分了夹杂厉风和夹杂秽湿两种病因，按时令探求本源，针对症状开具方剂，确有独到见解。如果患者素体阳虚，外寒直接侵入阴经，突然发生呕吐、腹泻、腹痛，四肢冰冷、筋脉拘挛者，则属于时行中寒，应仿照阴症伤寒的例法治疗。根据我的经验，寒疫多发于农历四月、五月、六月、七月这四个月。如果天气晴朗少、雨水多，湿气盛行，往往多见伤寒兼湿的证候。此时用藿香正气汤，加葱白、豆豉、紫金片，发汗与利湿并行，避秽解毒，确实是对症的真方。如果是寒邪夹杂厉风，邪气独盛于体表，而体内没有伏热者，则可用活人败毒散，每次服用三四钱，用葱豉汤泡服，也能取得显著疗效。即使用圣散子治疗寒疫，其功效也很显著。
【廉勘语】春季本该温暖却反而寒冷，夏季本该炎热却反而凉爽，感受这种非时之寒称为寒疫。秋季本该凉爽却反而炎热，冬季本该寒冷却反而温暖，感受这种非时之暖称为温疫。这些都是四季常见的疫病，通称为时疫。近代以来，寒疫较少，温疫较多，医生尤其应当注意。前贤吴坤安说：治疗时疫，应当分辨天时是寒是暄（温暖）、是燥是湿，以及患者的虚实劳逸状况，因病制宜，不可固执拘泥。例如久旱之时多燥，温疫流行，宜清火解毒，忌用燥烈之剂；久雨之时多湿，民众多患寒疫，或兼有吐泻，宜燥湿散寒，忌用滋润之剂。这是治疗时疫的正法。
(This condition is also known as *Shixing Shanghan* [Seasonal Epidemic Cold Damage], and is commonly referred to as *Hanyi* [Cold Epidemic].)
[Etiology] In spring, warmth should prevail but cold prevails instead; in summer, heat should prevail but coolness prevails instead. Contracting these abnormal climatic conditions leads to disease. The symptoms are similar among people of all ages, and the disease is contagious. The reason for its contagion lies in the cold pathogen being accompanied by *Lifeng* [Violent Wind, a strong wind evil] or *Hui Shi* [Filthy Dampness, turbid dampness]. Although the clinical presentation resembles *Shanghan* [Cold Damage], the etiology shares similarities yet has distinct differences.
[Symptoms] At onset, there is headache, body pain, aversion to cold with high fever, absence of sweating, and no thirst. There may be chest fullness and nausea, or rebellious qi causing vomiting, or limb flaccidity and abdominal pain. The tongue coating is white and thin; in severe cases, it may appear pale gray and thinly greasy. If the pathogen transmits inward, symptoms such as thirst, constipation, deafness, and mental confusion may occur. The tongue coating changes from white to yellow, and then from yellow to black.
[Pulse] The left pulse is slightly tight (*Jin*), and the right pulse is wiry and slow (*Xuan Huan*).
[Treatment] After the Spring Equinox, if the disease arises due to accompanying *Lifeng*, and headache and aversion to cold are particularly severe, use *Suqiang Dabiao Tang* (Perilla and Notopterygium Decoction to Release the Exterior), adding fresh scallion white (3 qian) and light fermented soybean (4 qian), employing acrid-warm methods to release the exterior. Before the Autumn Equinox, if the disease arises due to accompanying *Hui Shi*, and body pain and limb flaccidity are particularly severe, use *Huoxiang Zhengqi Tang* (Patchouli Qi-Regulating Decoction) added with scallion and fermented soybean, employing acrid-light aromatic methods to diffuse. In both cases, add *Zijin Pian* (Purple Gold Tablet) to resolve toxicity. If complicated syndromes arise, treatment can follow the transmission patterns of standard *Shanghan*.
[Commentary by Xiu] Regarding *Shixing Hanyi* [Seasonal Cold Epidemic], Master Yu distinguishes between two etiologies: accompanying *Lifeng* and accompanying *Hui Shi*. By seeking the root according to the season and prescribing formulas based on symptoms, he demonstrates profound insight. If a patient has a constitution of innate Yang deficiency, and external cold directly invades the Yin meridians, suddenly causing vomiting, diarrhea, abdominal pain, cold limbs, and tendon spasm, this constitutes *Shixing Zhonghan* [Seasonal Mid-Cold]. It should be treated according to the principles of Yin-pattern *Shanghan*. Based on my experience, *Hanyi* occurs frequently in the fourth, fifth, sixth, and seventh lunar months. If the weather is sunny less often and rainy more often, with dampness prevailing, syndromes of *Shanghan* combined with dampness are common. Using *Huoxiang Zhengqi Tang* added with scallion, fermented soybean, and *Zijin Pian*, simultaneously inducing sweating and promoting urination to avoid filth and resolve toxicity, is indeed an accurate formula for this condition. If cold accompanies *Lifeng*, with pathogenic factors dominating the exterior and no latent heat in the interior, *Huo Ren Baidu San* (Person-Rescuing Detoxification Powder) can be used, 3–4 qian per dose, taken with soaked scallion and fermented soybean decoction, which also yields excellent results. Even using *Sheng San Zi* (Holy Mixture) to treat *Hanyi* shows significant efficacy.
[Annotation by Lian] When spring should be warm but is cold, and summer should be hot but is cool, contracting this non-seasonal cold is called *Hanyi* [Cold Epidemic]. When autumn should be cool but is hot, and winter should be cold but is warm, contracting this non-seasonal warmth is called *Wenyi* [Warm Epidemic]. These are the regular epidemics of the four seasons, collectively termed *Shiyi* [Time Epidemic]. In recent times, *Hanyi* is rare, while *Wenyi* is common; physicians should pay particular attention. The former scholar Wu Kun'an stated: "When treating *Shiyi*, one must distinguish whether the heavenly climate is cold or warm, dry or damp, and assess the patient's deficiency/excess and labor/rest. Treatment must be tailored to the syndrome and cannot be rigidly applied." For instance, during prolonged droughts, the climate is dry, and *Wenyi* spreads; clearing fire and resolving toxicity is appropriate, while avoiding drying agents. During prolonged rains, the climate is damp, and people often suffer from *Hanyi*, possibly with vomiting and diarrhea; drying dampness and dispersing cold is appropriate, while avoiding moistening agents. This is the orthodox method for treating *Shiyi*.