Taiyang disease, fever with thirst, and absence of aversion to cold is known as warm disease. After sweating, if the body feels scorching hot, it is called wind-warmth. Wind-warmth as a disease is characterized by floating pulses in both yin and yang, spontaneous sweating, heaviness of the body, excessive sleepiness, snoring during nasal breathing, and difficulty in speaking. If treated with purgatives, there will be difficulty in urination, staring straight ahead, and loss of bladder control; if treated with fire, there will be a slight yellowing of the skin, and in severe cases, symptoms resembling fright epilepsy with intermittent convulsions; if treated with fire fumigation, one mistake may prolong the illness, but a second mistake will hasten the end of life.

bubble_chart Note

• Fever without thirst and with aversion to cold is a Taiyang pattern.
• Fever with thirst and without aversion to cold is a Yangming pattern.
• Now, when Taiyang disease is first contracted, without waiting for the cold pathogen to transform into heat and transfer to Yangming, but immediately presenting with heat, thirst, and no aversion to cold, it is known not as taiyang cold-damage disease, but as taiyang warm disease.
• Due to the rich and indulgent people not storing essence in winter, and the hardworking people being injured by cold in winter, the internal yin is already deficient, and the external yang is depressed, causing the meridians and collaterals throughout the body to transform into warmth early, so that upon encountering an external pathogen in spring, it immediately responds internally: (1) Those who feel a cold pathogen will have no sweat, known as warm disease, and should be treated with Water Resolving Powder, assessing the exterior and interior to resolve it. Water Resolving Powder is the combination of Six-to-One Powder and Saposhnikovia Root Tong Sheng. (2) Those who feel a wind pathogen will have sweat, known as wind-warmth, and should be treated with Water Resolving Powder minus Ephedra, plus Cinnamon Twig, and double Gypsum, to induce slight sweating and harmonize. If sweating is greatly induced, it will further assist the accumulation of heat, causing the body to feel as if it is scorching.
• Wind-warmth as a disease is characterized by wind pathogens flourishing in the exterior, so the yin and yang pulses are both floating; pathogenic heat congesting in the chest, causing excessive sleepiness and snoring during nasal breathing. Wind pathogens injure the defensive qi, causing insecurity of exterior qi, hence spontaneous sweating; intense heat injures qi, causing heaviness of the body, fatigue, and difficulty in speaking.
• If treated with purgatives, it will further deplete yin fluids, causing the water source to dry up and difficulty in urination. The qi of the taiyang fu is about to be exhausted, hence staring straight ahead. The qi of the shaoyin zang is not firm, hence loss of bladder control.
• If treated with fire, it will add fire to fire and scorch yang qi, leading to slight yellowing of the skin; in severe cases, extreme heat produces wind, hence symptoms resembling fright epilepsy with intermittent convulsions. Slight yellowing, with the disease deepening and the color gradually turning black, hence resembling fire fumigation.
• Warm disease, Rebing without aversion to cold is exterior heat. Thirst with desire to drink is interior heat. Exterior heat without cold should not be treated with sweating; interior heat without excess should not be treated with purgatives. Dual exterior and interior heat especially should not be treated with fire. One mistake refers to sweating, purging, or fire; a second mistake refers to sweating followed by purging, or purging followed by fire.
• One mistake may deplete yin and prolong the illness; a second mistake will cause yin to perish immediately, hence hastening the end of life.
• Cold-damage disease is injury from the proper cold of winter.
• Warm disease is injury from the sudden cold of the three seasons.
• Sudden cold out of season is an abnormal qi, which causes disease by combining with seasonal qi, hence in spring combined with wind-warmth, it is named wind-warmth; in summer combined with summerheat, it is named summerheat.
• People commonly call it cold-damage disease, also known as seasonal epidemic. Physicians see its transmission and change through the six meridians, with the exterior and interior conditions the same, hence treating it the same.
• Warm disease, Rebing without sweat should be treated with Dyers Woad Dragon Decoction; intermittent sweating should be treated with Cinnamon Twig Two Spleen-Qi Effusing One Decoction; with sweat should be treated with Cinnamon Twig combined with White Tiger Decoction.
• For internal heat, Saposhnikovia Sage-Inspired Powder.
• For exterior excess, double Ephedra; for interior excess, double Rhubarb Rhizoma.
• Assess the severity of the disease and the amount of medicine to resolve it. Within three days, there is no case that will not recover.
• For those with heavy external contraction of pathogens and early internal damage to yin, who have already been treated with sweating and purging without recovery, assess the exterior and interior, and treat according to the symptoms seen in transmission and change.
• This method can be used in the west and north throughout the four seasons, with no case not responding immediately.
• In the warmer regions between the Yangtze and Huai rivers, it can be used from the beginning of winter to early spring.
• If it is the end of spring or before autumn, and the pulse and symptoms are in agreement, when using Ma, Gui, Qinglong, and other decoctions, they must be used lightly and reduced, adjusting according to the symptoms, stopping when appropriate, and being cautious not to overdo it, as excess can lead to adverse reactions.
• This is what the classics refer to as treating the same disease differently.

bubble_chart Collected Annotations

• Cheng Zhi said: "Warm disease heat arises from within, hence fever and thirst without aversion to cold. Wind-warmth involves heat both internally and externally, accompanied by spontaneous sweating, hence symptoms like body heaviness and excessive sleepiness, with distinctions of severity and life-threatening conditions. Physicians should distinguish primarily based on the presence or absence of sweating, and also consider whether to induce sweating or not as a subtle strategy for treatment."
• He also said: "Zhang Zhongjing's Qinglong and Baihu are divine! Extending this idea, it can be applied endlessly. Warm disease should be treated with increased cooling within dispersing methods, while wind-warmth should not be treated with increased dispersing within cooling methods."
• Cheng Yingmiao said: "On the first day of contracting taiyang, fever and thirst without aversion to cold occur because pathogenic qi has long been stored internally, and its external contraction to taiyang is just the beginning. The internally stored heat is not a matter of a single day or night. Since winter, not storing essence and being injured by cold, kidney yin has already been deficient. As soon as spring yang fever arrives, even if the disease has not yet manifested, the entire body's meridians are already permeated with the qi of yang exuberance and yin deficiency. What is referred to as developing into warm disease in spring is inherited from its embryonic stage."