(附胸中烦热、虚热、虚烦不眠)
阴虚发热症难治。戴云∶凡脉数而无力者,便是阴虚也,四物汤加炒黄柏、黄芩、
兼气虚,加人参、黄 、黄芩、白术。四物汤加炒柏,是降火补阴之妙剂,甚者必加龟板
吃酒人发热,难治;不饮酒人因酒发热者,亦难治。一男子年二十三岁,因酒发热,用青黛、
栝蒌仁,入姜汁,每日数匙入口中,三日而愈。阳虚发热,补中益气汤。手足心热,属热郁,用
火郁汤。伤寒寒热,当用表散。发热,柴胡;恶寒,苍术;虚人,用苍术,恐燥。发热恶风
,人壮气实者,宜先解表。发热恶寒,亦宜解表。
入方
苍术(半两) 片芩(三钱) 甘草(一钱半)
上为末。汤浸炊饼丸服。
治手心发热。
山栀 香附 或加苍术 白芷 半夏(生用) 川芎
上为末,神曲糊丸服。
治烦不得眠。
六一散加牛黄。
治大病后阴虚,气郁夜热。
酒芍药(一两二钱半) 香附(一两) 苍术(半两) 炒片芩(三钱) 甘草(一钱半)
上为末,炊饼丸服。
湿痰发热。
炒片芩 炒黄连(半两) 香附(二两半) 苍术(二两)
上为末,用栝蒌穣丸。
湿痰,夜发热。
以三补丸加白芍药为末,见补损。
退劳热食积痰。
上甲 下甲 侧柏 栝蒌子 半夏 黄连 黄芩 炒柏
上为末,炊饼为丸。
胸中烦热,须用栀子仁。有实热而烦躁者,亦用栀子仁;有虚热而烦躁者,宜参、 、
麦门冬、白茯苓、竹茹、白芍药。若脉实数有实热者,神芎丸。
虚热,用黄 ,止虚汗亦然。又云∶肌热及去痰者,须用黄芩。肌热亦用黄 。如肥白
热,宜人参、黄 、当归、芍药、浮小麦炒,止虚汗同。补中益气汤,治虚中有热,或肌表之热。
附方
火郁汤
升麻 葛根 柴胡 白芍(各一两) 防风 甘草(各五钱)
上 咀。每五钱,入连须葱白三寸煎,稍热,不拘时
补中益气汤 见内伤。
神芎丸
大黄 黄芩 滑石 牵牛
上为末,滴水为丸。
阴虚发热症难以治疗。戴元礼说:凡是脉象数而无力,就是阴虚。使用四物汤(由当归、川芎、白芍、熟地黄组成的补血基础方)加入炒黄柏、黄芩;如果兼有气虚,加入人参、黄芪、黄芩、白术。四物汤加炒黄柏,是降火补阴的妙方,病情严重的必须加入龟板。
饮酒之人出现发热,难以治疗;不饮酒的人因饮酒而发热,也难以治疗。有一个二十三岁的男子,因饮酒发热,用青黛、栝蒌仁,调入姜汁,每天数次送入口中,三天痊愈。阳虚发热,使用补中益气汤。手足心发热,属于热郁证,用火郁汤。伤寒引起的寒热往来,应当使用解表发散法。发热者用柴胡;恶寒者用苍术;体质虚弱的人,也用苍术,但担心其燥性。发热伴恶风,且人体质壮实者,宜先解表。发热伴恶寒,也宜解表。
【入方】
苍术(半两) 片芩(三钱) 甘草(一钱半)
以上药物研为细末。用米汤浸湿炊饼(一种面食)制成丸剂服用。
治疗手心发热。
山栀 香附 或加苍术 白芷 半夏(生用) 川芎
以上药物研为细末,用神曲糊制成丸剂服用。
治疗大病后阴虚,气机郁滞导致的夜间发热。
酒白芍药(一两二钱半) 香附(一两) 苍术(半两) 炒片芩(三钱) 甘草(一钱半)
以上药物研为细末,用炊饼制成丸剂服用。
湿痰发热。
炒片芩 炒黄连(半两) 香附(二两半) 苍术(二两)
以上药物研为细末,用栝蒌瓤(栝蒌果实除去种子后的皮和纤维部分)制成丸剂。
湿痰,夜间发热。
以三补丸(通常指由黄芩、黄连、黄柏组成的清热燥湿方,此处语境可能指代特定配伍或笔误,依原文提取)加入白芍药研为细末,参考“补损”类方剂(见补损章节)。
退除劳热、食积、痰热。
上甲(鳖甲) 下甲(龟甲) 侧柏 栝蒌子 半夏 黄连 黄芩 炒黄柏
以上药物研为细末,用炊饼制成丸剂。
胸中烦热,必须用栀子仁。有实热而烦躁的,也用栀子仁;有虚热而烦躁的,宜用人参、黄芪、麦门冬、白茯苓、竹茹、白芍药。如果脉象实数且有实热的,使用神芎丸。
虚热,使用黄芪,止虚汗也是如此。又说:肌肉发热及去除痰浊的,必须用黄芩。肌肉发热也用黄芪。如形体肥白者发热,宜用人参、黄芪、当归、芍药、浮小麦炒制,止虚汗的方法相同。补中益气汤,治疗虚中有热,或肌表之热。
【附方】
火郁汤
升麻 葛根 柴胡 白芍(各一两) 防风 甘草(各五钱)
以上药物切碎。每次取五钱,加入带须葱白三寸煎煮,稍热时服用,不拘时间。
补中益气汤 见内伤章节。
(Note: Chest distress with heat, deficiency heat, vexation and insomnia due to deficiency)
Deficiency heat is difficult to treat. Dai Yuanli stated: Whenever the pulse is rapid and forceless, it indicates Yin deficiency. Use Siwu Tang (Four Substances Decoction) added with stir-fried Huangbai (Phellodendri Cortex) and Huangqin (Scutellariae Radix); if Qi deficiency is also present, add Renshen (Ginseng Radix), Huangqi (Astragali Radix), Huangqin (Scutellariae Radix), and Baizhu (Atractylodis Macrocephalae Rhizoma). Siwu Tang added with stir-fried Huangbai is an excellent formula for descending fire and nourishing Yin; in severe cases, Guiban (Testudinis Carapax et Plastrum) must be added.
Fever in individuals who consume alcohol is difficult to treat; fever caused by alcohol consumption in those who do not usually drink is also difficult to treat. A twenty-three-year-old male developed fever due to alcohol consumption. He was treated with Qingdai (Indigo Naturalis) and Gualouren (Trichosanthis Semen), mixed with Jiangzhi (Zingiberis Recens Juice), administered orally several times a day, and he recovered in three days. Yang deficiency fever is treated with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). Heat in the palms and soles belongs to Heat Stagnation, treated with Huoyu Tang (Fire-Stagnation Decoction). Chills and fever caused by Shanghan (Cold Damage) should be treated with exterior-releasing methods. For fever, use Chaihu (Bupleuri Radix); for chills, use Cangzhu (Atractylodis Rhizoma); for deficient persons, Cangzhu (Atractylodis Rhizoma) is used, but its drying nature is a concern. Fever with aversion to wind in robust individuals with strong Qi should first be treated with exterior release. Fever with chills should also be treated with exterior release.
[Prescriptions]
Cangzhu (Atractylodis Rhizoma) (half tael) Pianqin (Scutellariae Radix) (three qian) Gancao (Glycyrrhizae Radix et Rhizoma) (one and a half qian)
Grind into powder. Form pills using rice soup-soaked cooked dough and take orally.
Treats heat in the palms.
Shanzhi (Gardeniae Fructus) Xiangfu (Cyperi Rhizoma) or add Cangzhu (Atractylodis Rhizoma), Baizhi (Angelicae Dahuricae Radix), Banxia (Pinelliae Rhizoma, raw), Chuanxiong (Ligustici Chuanxiong Rhizoma).
Grind into powder, form pills using Shenqu (Mass Medicamentosa) paste and take orally.
Treats vexation and inability to sleep.
Liuyisan (Six-to-One Powder) added with Niuhuang (Bovis Calculus).
Treats night fever due to Yin deficiency and Qi stagnation after a serious illness.
Jiu Shaoyao (Paeoniae Radix Alba processed with wine) (one tael two qian and a half) Xiangfu (Cyperi Rhizoma) (one tael) Cangzhu (Atractylodis Rhizoma) (half tael) Stir-fried Pianqin (Scutellariae Radix) (three qian) Gancao (Glycyrrhizae Radix et Rhizoma) (one and a half qian)
Grind into powder, form pills using cooked dough and take orally.
Damp-phlegm fever.
Stir-fried Pianqin (Scutellariae Radix) Stir-fried Huanglian (Coptidis Rhizoma) (half tael) Xiangfu (Cyperi Rhizoma) (two tael and a half) Cangzhu (Atractylodis Rhizoma) (two tael)
Grind into powder, form pills using Gualou Rang (Trichosanthis Pericarpium fiber).
Damp-phlegm, night fever.
Use Sanbu Wan (Three-Tonics Pill) added with Baishaoyao (Paeoniae Radix Alba), ground into powder; refer to tonifying deficiency formulas.
Resolves consumptive fever, food retention, and phlegm-heat.
Shangjia (Biejiar / Turtle Shell) Xiajia (Guiban / Tortoise Shell) Cebai (Platycladi Cacumen) Gualouzi (Trichosanthis Semen) Banxia (Pinelliae Rhizoma) Huanglian (Coptidis Rhizoma) Huangqin (Scutellariae Radix) Stir-fried Huangbai (Phellodendri Cortex)
Grind into powder, form pills using cooked dough.
Chest distress with heat requires Zhizi Ren (Gardeniae Fructus seed). For excess heat with vexation, Zhizi Ren (Gardeniae Fructus seed) is also used; for deficiency heat with vexation, use Renshen (Ginseng Radix), Huangqi (Astragali Radix), Maidong (Ophiopogonis Radix), Baifuling (Poria), Zhuru (Bambusae Caulis in Taeniam), and Baishaoyao (Paeoniae Radix Alba). If the pulse is full and rapid indicating excess heat, use Shenxiong Wan (Shenxiong Pill).
Deficiency heat is treated with Huangqi (Astragali Radix); stopping spontaneous sweating due to deficiency is also done with Huangqi (Astragali Radix). It is further stated: For muscle heat and removing phlegm, Huangqin (Scutellariae Radix) is required. Muscle heat also uses Huangqi (Astragali Radix). For obese, white-complexioned individuals with heat, use Renshen (Ginseng Radix), Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix), and fried Fuxiaomai (Tritici Levis Fructus); the method for stopping spontaneous sweating is the same. Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) treats heat within deficiency or heat at the muscle surface.
[Attached Prescriptions]
Huoyu Tang (Fire-Stagnation Decoction)
Shengma (Cimicifugae Rhizoma) Gegen (Puerariae Lobatae Radix) Chaihu (Bupleuri Radix) Baishao (Paeoniae Radix Alba) (each one tael) Fangfeng (Saposhnikoviae Radix) Gancao (Glycyrrhizae Radix et Rhizoma) (each five qian)
Chop the herbs. Take five qian per dose, add three cun of scallion whites with roots, decoct in water, drink when slightly warm, at any time.
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) See Internal Injury section.
Shenxiong Wan (Shenxiong Pill)
Dahuang (Rhei Radix et Rhizoma) Huangqin (Scutellariae Radix) Huashi (Talcum) Qianniu (Pharbitidis Semen)
Grind into powder, form pills by adding drops of water.