温疫论
1.自敘
九，此治疫緊要關節。奈何自古迄今，從未有發明者。仲景雖有《傷寒論》，然其法始自太陽，或傳陽明，或傳少陽，或三陽竟自傳胃。蓋為外感風寒而設，故其傳法與溫疫自是迥別。嗣後論之者紛紛，不止數十家，皆以傷寒為辭。其於溫疫證則甚略之。是以業醫者所記所而無所施，未免指鹿為馬矣。餘初按諸家鹹謂∶春、夏、秋皆是溫病，而傷寒必在冬時。然歷年較之，溫疫四時皆有。及究傷寒，每至嚴寒，雖有頭疼、身痛、惡寒、無汗、發熱，總似太陽證，至六七日失治，未嘗傳經。每用發散之劑，一汗即解。間有不藥亦自解者，並未嘗因失汗以致發黃、譫語、狂亂、苔刺等證。此皆感冒膚淺之病，非真傷寒也。傷寒，感冒，均系風寒，不無輕重之殊。究竟感冒居多，傷寒希有。況溫疫與傷寒，感受有霄壤之隔。今鹿馬攸分，益見傷寒世所絕少。仲景以傷寒為急病，倉卒失治，多致傷生，因立論以濟天下後世，用心可謂仁矣。然傷寒與溫疫，均急病也。以病之少者，尚諄諄告世。至於溫疫多於傷寒百倍，安忍反置勿論？或謂溫疫之證，仲景原別有方論，歷年既久，兵火湮沒，即《傷寒論》乃稱散亡之餘，王叔和立方造論，謬稱全書。溫疫之論，未必不由散亡也明矣。崇禎辛巳，疫氣流行，山東、浙省、南北兩直，感者尤多，至五六月益甚，或至闔門傳染。始發之際，時師誤以傷寒法治之，未嘗見其不殆也。或病家誤聽七日當自愈，不爾，十四日必瘳，因而失治，有不及期而死者；或有妄用峻劑，攻補失敘而死者；或遇醫家見解不到，心疑膽怯，以急病用緩藥，雖不即受其害，然遷延而致死者，比比皆是。所感輕者，尚獲僥倖；感之重者，更加失治，枉死不可勝記。嗟乎！守古法不合今病，以今病簡古書，原無明論，是以投劑不效，醫者彷徨無措，病者日近危篤，病癒急，投藥愈亂，不死於病，乃死於醫，不死於醫，乃死於聖經之遺亡也。籲！千載以來，何生民不幸如此。餘雖固陋，靜心窮理，格其所感之氣，所入之門，所受之處，及其傳變之體，平日所用歷驗方法，詳述於下，以俟高明者正之。\x時崇禎壬午仲秋姑蘇洞庭吳有性書於淡淡齋\x
Ninth: this is the crucial juncture in treating epidemic disease. Why is it that from antiquity to the present there has never been anyone to elucidate it? Although Zhongjing had the Shanghan Lun, its method begins with taiyang, or transmits to yangming, or transmits to shaoyang, or the three yang directly transmit to the stomach. It was established for externally contracted wind-cold, and so its transmission differs utterly from that of warm epidemic. Thereafter those who discussed it were numerous, no fewer than several dozen schools, all speaking in terms of cold damage. As for warm epidemic patterns, they treated them very briefly. Thus what physicians have recorded and memorized has no application, and they cannot avoid calling a deer a horse. I at first followed the various schools, which all said: in spring, summer, and autumn there is only warm disease, and cold damage must occur in winter. Yet comparing over the years, warm epidemic occurs in all four seasons. And when I investigated cold damage, it always came in severe cold; though there were headache, generalized pain, aversion to cold, absence of sweating, and fever, all resembling taiyang patterns, when after six or seven days treatment was neglected, the channels were never transmitted. Each time dispersing agents were used, one sweat resolved it. Sometimes without medicine it also resolved of itself, and there was never a case in which failure to sweat led to jaundice, delirious speech, mania, or prickly moss-like coating. These are all superficial common cold illnesses, not true cold damage. Cold damage and common cold both belong to wind-cold, and there is no lack of difference in severity. In the end, common cold is the majority and cold damage rare. Moreover, warm epidemic and cold damage differ as heaven from earth in their contraction. Now that deer and horse are distinguished, it is all the more evident that cold damage is extremely rare in the world. Zhongjing took cold damage as an urgent disease, in which hasty neglect of treatment often leads to loss of life, and so he established his discourse to succor the world and later ages; his intent may be called benevolent. Yet cold damage and warm epidemic are both urgent diseases. For the rarer disease he earnestly warned the world; as for warm epidemic, which is a hundred times more common than cold damage, how could he bear to set it aside and not discuss it? Some say that for warm epidemic patterns Zhongjing originally had separate formulas and discourses, but as years passed and wars and fires destroyed them; even the Shanghan Lun is said to be the remnant of scattered loss, and Wang Shuhe established formulas and made discourses, erroneously calling it a complete book. That the discourse on warm epidemic likewise must have been scattered and lost is clear. In the xinsi year of Chongzhen, epidemic qi prevailed, and in Shandong, Zhejiang, and the two Zhili regions north and south those affected were especially many; by the fifth and sixth months it grew worse, and in some cases whole households were infected. At the first onset, physicians of the time mistakenly treated it by the cold damage method, and never did they see it not prove fatal. Some families, mistakenly hearing that by the seventh day it should heal of itself, or else that by the fourteenth day it must recover, thereby neglected treatment, and some died before the term; some recklessly used drastic agents, attacking and supplementing out of order, and died; some encountered physicians whose insight was insufficient and whose hearts were doubtful and timid, who for an urgent disease used slow medicines, and though they did not immediately suffer harm, yet through delay deaths occurred—such cases were everywhere. Those with light affection still escaped by luck; those with heavy affection, with treatment further neglected, died unjustly beyond all counting. Alas! To hold to ancient methods that do not fit present diseases, and to measure present diseases against ancient books, since there was originally no clear discourse, the remedies administered had no effect; the physician wandered about at a loss, the patient drew daily nearer to danger, and the more urgent the disease, the more chaotic the medicines—so that they did not die of the disease but died of the physician, and did not die of the physician but died of the loss of the sacred canon. Oh! For a thousand years, how unfortunate have the people been. Though I am crude and ignorant, I have calmed my mind and exhausted the principles, investigating the qi that is contracted, the gate by which it enters, the place it receives, and the body of its transmission and transformation, and I have set forth in detail below the methods I have daily used and repeatedly verified, awaiting correction by the enlightened. Written by Wu Youxing of Dongting, Gusu, in mid-autumn of the renwu year of Chongzhen, at the Dandan Studio.