发热有阳陷入阴者，有阳浮于外者。阳陷入阴者，其热自阴分达于阳分，与疟热相似，
而实
不同疟，为阴阳交争，此为阳陷于阴，故但热不寒，若独用表散药，则药力从阳分而泄，何
由入阴分引阳邪而出？用宜孙真人柴胡梅连散，盖以梅连摄柴胡入阴分而出之阳，其邪乃得
去也。（说见《小儿诸热辨》。）阳浮于外者，乃表里俱虚，阳气不归元而浮于外也，宜以六
神散入粳米煎。和其胃气，阳气归内，身体自凉。（说见《慈幼筏》。）此二证一系外感，一
系内伤，临证宜详察之。柴胡梅连散∶柴胡、前胡各三钱，胡黄连、乌梅各一钱。上 咀，
每一钱，童便一盏，猪肚一枚，猪脊髓一条，韭根白半钱，同煎，不拘时温服。六神散∶四
君子加山药、扁豆（姜水浸，去壳炒）、煨生姜、大枣。王孟英读书精细，最有卓识，如论虞
花溪治夜热症，独能辨前人之误，详见《古今医案按选》，备录于此。
虞花溪治一妇，年四十余，夜间发热晨退，五心烦热无休止时，半年后，虞诊其脉，六
部皆
数伏而牢，浮取全不应，与东垣升阳散火汤，（妙！切记此法，今人则竟滋阴降火矣。）四服
热减大半，胸中觉清快胜前，再与二帖，热悉退，后以四物加知柏，少佐炒干姜，服二十余
帖愈。
余按∶夜热脉数，的系阴虚，因其脉伏且牢，浮取不应，故用升阳散火得效，仍以阴药
收功
，然阴药用六味及二地、二冬必不效，妙在芎归合知柏，及从治之炒干姜也。王孟英云∶此
热在血分，而误治半年，其热愈伏愈深，故脉症如是，补用升阳散火，所谓“火郁发之”也
，后以炒干姜佐四物知柏收功，乃血分受病之专剂，与阴虚生热当用阴药者治法有别，误用
皆为戈戟。
江氏之注，俞氏之论，皆欠明晰，无怪庸庸者之议药不议病也。
冯楚瞻曰∶潮热之证，有阴阳之分。平旦潮热，自寅至申，行阳二十五度，诸阳用事，
热在
行阳之分，肺气主之。日晡潮热，自申至寅，行阴二十五度，诸阴用事，热在行阴之分，肾
气主之。一以清肺，一以滋肾。若气虚潮热，参、 、熟附，所谓温能除大热也。血行潮热
，归、芍、骨皮，所谓养阴退阳也。其论潮热颇详，如《伤寒论》所云∶日晡潮热，以阳明
主于申酉戌之故。则所谓行阳主肺气，行阴主肾气，乃浑举之辞，不可执一。
发热这一症状，有的是阳气陷入阴分所致，有的是阳气浮越于体表所致。阳气陷入阴分的，其热势从阴分透达至阳分，与疟疾的发热相似，但实质上不同于疟疾。这是因为阴阳相互交争，属于阳气陷于阴分，所以表现为只发热而不恶寒。如果单独使用解表发散的药物，药力会从阳分泄出，怎能进入阴分引导阳邪外出呢？此时适宜使用孙思邈的柴胡梅连散，大概是用乌梅、黄连来制约柴胡，使其进入阴分并将邪气引出到阳分，这样邪气才能被去除。（此观点详见《小儿诸热辨》。）阳气浮越于体表的，乃是表里两虚，阳气不能回归本源而浮越于外，适宜用六神散加入粳米煎服。以此调和胃气，使阳气回归体内，身体自然凉爽。（此观点详见《慈幼筏》。）这两种证候，一种属于外感病，一种属于内伤病，临证时应当仔细辨别。
柴胡梅连散的组成：柴胡、前胡各三钱，胡黄连、乌梅各一钱。将药材切碎，取一钱药量，配合童便一盏、猪肚一枚、猪脊髓一条、韭根白半钱，一同煎煮，不拘时间温服。
六神散的组成：四君子汤加上山药、扁豆（用姜水浸泡，去壳炒制）、煨生姜、大枣。
王孟英读书细致，最有卓越见识，例如他评论虞花溪治疗夜热症时，唯独能辨别前人的错误，详见《古今医案按选》，此处完整记录于此。
虞花溪治疗一位四十多岁的妇女，夜间发热，早晨退热，五心烦热没有停止的时候。半年后，虞花溪诊察她的脉象，六部脉皆数伏且牢，轻取完全不应指。给予东垣的升阳散火汤（妙！切记此法，如今的人却只知道滋阴降火了）。服用四剂后，热势减去大半，胸中感觉清爽舒适胜过从前；再服用两帖，热势完全消退。后来用四物汤加知母、黄柏，稍加佐使炒干姜，服用二十多帖痊愈。
我按语：夜间发热且脉数，确属阴虚。但因为脉象伏且牢，轻取不应，所以使用升阳散火汤得以见效，最后仍以滋阴药物收功。然而，若滋阴药用六味地黄丸及生地、熟地、天冬、麦冬等，必定无效。妙在川芎、当归合用知母、黄柏，以及采用反治法的炒干姜。王孟英说：这热邪在血分，却被误治半年，导致热邪愈伏愈深，所以脉症如此。补益之法用升阳散火，这就是所谓的“火郁发之”。后来用炒干姜佐助四物汤和知柏以收功，这是治疗血分受病的专方，与阴虚生热当用滋阴药的治法不同，误用都会变成伤害身体的武器。
江氏的注释，俞氏的论述，都不够明晰，难怪平庸者只会议论药物而不去辨析病机。
冯楚瞻说：潮热这一证候，有阴证和阳证的区别。平旦时分出现潮热，从寅时到申时，阳气运行二十五度，诸阳经主事，热邪位于行阳之分，由肺气主管。日晡时分出现潮热，从申时到寅时，阴气运行二十五度，诸阴经主事，热邪位于行阴之分，由肾气主管。前者用清肺法，后者用滋肾法。如果是气虚引起的潮热，用人参、黄芪、熟附子，这就是所谓“温能除大热”。如果是血行不畅引起的潮热，用当归、白芍、地骨皮，这就是所谓“养阴退阳”。他的关于潮热的论述颇为详细，如《伤寒论》所说：日晡潮热，是因为阳明经主令于申、酉、戌时的缘故。那么所谓行阳主肺气、行阴主肾气，不过是笼统的说法，不可拘泥执一。
Fever may arise from Yang Qi sinking into the Yin aspect, or from Yang Qi floating on the exterior. When Yang sinks into Yin, the heat manifests from the Yin aspect reaching the Yang aspect; it resembles the fever of malaria (Malaria), but is essentially different. This is due to the contention between Yin and Yang, where Yang is trapped in Yin, resulting in fever without chills. If one solely uses diaphoretic drugs (Diaphoretics) to release the exterior, the medicinal force will dissipate through the Yang aspect, making it impossible to enter the Yin aspect to guide the Yang pathogen out. In such cases, Sun Simiao's Chaihu Meilian San (Bupleurum and Picrorhiza Decoction) is appropriate. The logic is that Wumei (Chinese Plum Fruit) and Huanglian (Coptis Rhizome) restrain Chaihu (Bupleuri Radix), guiding it into the Yin aspect to expel the pathogen to the Yang side, thereby eliminating the pathogen. (See "Differentiation of Various Fevers in Children".)
When Yang floats on the exterior, it indicates deficiency in both the interior and exterior, with Yang Qi failing to return to its root and floating outward. In this case, Liushen San (Six-God Powder) decocted with Oryza Sativa Germ (Jingmi, Rice Kernel) should be used. This harmonizes Stomach Qi, allowing Yang Qi to return inward, and the body temperature naturally cools. (See "The Raft for Nurturing Infants".) These two conditions differ: one is related to external contraction (External Contraction), and the other to internal injury (Internal Injury). Clinicians must examine them carefully.
Chaihu Meilian San consists of: Chaihu (Bupleuri Radix) and Qianhu (Peucedani Radix), each 3 qian; Huhuanglian (Picrorhizae Rhizoma) and Wumei (Chinese Plum Fruit), each 1 qian. The herbs are chopped. Take 1 qian of the mixture, along with one cup of children's urine (Tongbian), one pig stomach (Zhudu), one pig spinal cord (Zhujisuin), and half a qian of leek root white (Jiu Gen Bai). Decoct together and take warm at any time.
Liushen San consists of: Sijunzi Tang (Four Gentlemen Decoction) plus Shanyao (Dioscoreae Rhizoma), Biandou (Lablab Album Seed) soaked in ginger water, shelled and stir-fried; Wei Jiangsheng (Prepared Ginger); and Dazao (Zizyphi Fructus).
Wang Mengying was meticulous in his reading and possessed unique insight. For instance, in discussing Yu Huaxi's treatment of night fever, he alone identified errors made by predecessors. This is detailed in "Selected Cases of Ancient and Modern Medicine" and is recorded here in full.
Yu Huaxi treated a woman in her forties who suffered from fever at night which subsided in the morning, accompanied by constant five-palm heat (Five-palm Heat). After six months, Yu palpated her pulse: all six positions were rapid, deep, hidden, and firm; superficial pressure elicited no response. He prescribed Dongyuan's Shengyang Sanhuo Tang (Ascending Yang and Dispersing Fire Decoction). After four doses, the fever reduced by more than half, and she felt significantly clearer and more comfortable in the chest. Two additional doses cleared the fever completely. Subsequently, using Siwu Tang (Four Substances Decoction) added with Zhimu (Anemarrhenae Rhizoma) and Huangbai (Phellodendri Cortex), with a small amount of stir-fried Ganjiang (Zingiberis Rhizoma Recens) as an assistant, she took over twenty doses and recovered.
My commentary: Night fever with a rapid pulse indeed indicates Yin deficiency. However, because the pulse was deep, hidden, and firm, with no response to superficial pressure, Shengyang Sanhuo Tang was effective, and the treatment concluded with Yin-nourishing drugs. Nevertheless, if Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) or Shengdi (Rehmanniae Radix), Shudi (Rehmanniae Radix Preparata), Tiandong (Asparagi Radix), and Maidong (Ophiopogonis Radix) were used, they would certainly fail. The brilliance lies in combining Xiong (Chuanxiong Rhizoma) and Gui (Angelicae Sinensis Radix) with Zhimu and Huangbai, and employing the counter-treatment method of stir-fried Ganjiang. Wang Mengying stated: The heat resides in the Blood aspect. Mismanaged for half a year, the heat became deeper and more concealed, hence the pulse and symptoms appeared thus. Using Shengyang Sanhuo represents the principle of "dispersing fire stagnation" (Fire Stagnation). Later, using stir-fried Ganjiang to assist Siwu Tang and Zhimu/Huangbai served as a specific formula for diseases in the Blood aspect. This differs from the treatment of heat generated by Yin deficiency, which requires Yin-nourishing methods; misapplying either leads to harm.
Jiang's annotations and Yu's discussions lack clarity, which explains why mediocre practitioners discuss herbs rather than disease patterns.
Feng Chuzhan said: Tidal fever (Tidal Fever) has Yin and Yang distinctions. Tidal fever occurring at dawn, from Yin hour to Shen hour, corresponds to the circulation of Yang Qi for twenty-five degrees, when all Yang meridians are active. The heat is in the Yang-circulating aspect, governed by Lung Qi. Tidal fever occurring at dusk (Ribu), from Shen hour to Yin hour, corresponds to the circulation of Yin Qi for twenty-five degrees, when all Yin meridians are active. The heat is in the Yin-circulating aspect, governed by Kidney Qi. The former is treated by clearing the Lung, the latter by nourishing the Kidney. If tidal fever is caused by Qi deficiency, Renshen (Ginseng Radix), Huangqi (Astragali Radix), and Shufu (Aconiti Lateralis Radix Preparata) are used, illustrating that "warmth can eliminate great heat." If tidal fever is caused by blood dynamics issues, Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix Alba), and Gupi (Lycii Cortex) are used, illustrating that "nourishing Yin retreats Yang." His discussion on tidal fever is quite detailed. As stated in Shanghan Lun (Treatise on Cold Damage Disorders): "Ribu tidal fever" occurs because the Yangming channel governs the Shen, You, and Xu hours. Therefore, stating that Yang circulation is governed by Lung Qi and Yin circulation by Kidney Qi is a generalized statement and should not be taken rigidly.