夫阴寒者。肾中之真火衰也。阴虚者。胃中之真水亏也。真火衰。则有寒而
无热。真水亏。则有热而无寒。经曰。阴虚则发热是也。世或不察。见其发热。
动曰伤寒。舛误悖谬。莫可言状。殊不知与伤寒二字。绝不相干。试诊其脉。
则不紧而数。不实而虚。验其症。或头目眩晕。或引衣倦卧。或腰腿酸疼。或
渴喜热饮。身虽热而未尝恶寒。不喜食而未尝胀满。询其因。非酒色过纵。
必大劳大病后。不能谨欲。乃致此。急与六味地黄汤大剂饮之。则热退而
病却矣。或畏寒口渴。则用七味汤。足冷脉弱。则与八味汤。或有畏其泥膈
而不敢轻尝者。盖不知六味八味等汤。皆是肾经本药。直达下焦。使果阴
虚。急借以益水补火。必不可缺。必不可缓之剂。更何疑之有。
治验
一人年五旬。得发热症。已曾服药七八日矣。比予诊之。脉来虚数。目赤唇
焦。舌肿大无津。余曰。此肾阴水衰之候也。宜进地黄汤。彼家犹豫。复延
医者曰。脉虚甚矣。乃所用药。则芩连栀粉清火之剂。余曰。若服此而津
生。所不待言。服此而更甚。则非此药所能疗也。及服之愈甚。始信予言。
遂进地黄汤一剂。觉少寐而舌和。二剂而津果生。后与生脉散相间服之得痊。
一人年五旬余。素不谨欲。冒寒发热。他医曾与解散。及余视之。则脉微细。
面色通红。目赤唇焦。舌黑而枯。予曰。此真阴衰竭。水火两亏。宜以八味
汤加五味子峻补方可。其家虽信。未肯轻投。余曰。不用此药。则无救矣。
急延吾友唐子松声验之何如。比至诊之。谓余曰。此八味汤加五味子
候也。其言若合符节。遂取而进服之。果舌有微津。连剂焦枯顿释。又加
人参。调理而安。后不守禁。半载后。犯房戒。用他药以殒。
一徽商年二十八。病后不谨发热。彼家以过啖浓味故复。医者投小柴胡
汤三剂。体倦。腰胯痛。不能转侧。余诊之。脉微弱。曰此女劳复也。以七味
汤加五味杜仲。连进二剂。即能转侧。又数剂。兼人参而痊。
六味地黄汤
怀熟地（三钱） 山茱萸（一钱五分去核） 茯苓（一钱） 淮山药（一钱五分炒）
牡丹皮（一钱） 泽泻（一钱）
水煎。
八味地黄汤（即前方） 加熟附肉桂（各五分） 去附子名七味汤
阴寒证，是由于肾中真火（命门之火）衰弱所致。阴虚证，是由于胃中真水（津液/阴精）亏损所致。真火衰弱，则表现为有寒象而无热象；真水亏损，则表现为有热象而无寒象。《内经》说：“阴虚则发热”，正是此理。世间有人不能明察，见到患者发热，就动辄说是伤寒，这种错误悖谬之处，简直无法用言语形容。殊不知这与“伤寒”二字毫无关系。试着诊察其脉象，脉搏不紧而数，不实而虚。验证其症状，或是头目眩晕，或是喜欢拉着衣物疲倦地躺卧，或是腰腿酸痛，或是口渴但喜欢喝热水。身体虽然发热却并不怕冷，不想吃东西但并不感到腹胀满。询问病因，如果不是因为酒色过度放纵，一定是大病或大劳之后，不能谨慎节制欲望，才导致这种情况。应立即给予大剂量的六味地黄汤服用，那么热退病愈了。或者如果伴有畏寒和口渴，则使用七味汤。如果脚冷、脉弱，则给予八味汤。如果有的人担心这些药滋腻碍胃而不敢轻易尝试，那是不知道六味、八味等汤剂，都是肾经的本药，能直达下焦。如果确实是阴虚，急需借用它们来益水补火，这是必不可缺、必不可缓的方剂，还有什么可怀疑的呢？
治验案例：
有一位五十岁的人，得了发热的病症，已经服药七八天了。等到我诊治他时，脉象虚而数，眼睛红赤，嘴唇焦裂，舌头肿大且无津液。我说：“这是肾阴水衰弱的征候。”适宜进服地黄汤。那家人犹豫不决，又请其他医生来看，说：“脉象非常虚弱。”然而所开的药，却是黄芩、黄连、栀子、石膏等清火的药物。我说：“如果服用这些药后津液生出，那自然不用说；如果服用后病情反而加重，那就不是这些药所能治疗的了。”等到服用后病情更加严重，才开始相信我的话。于是进服一剂地黄汤，感觉睡眠稍安且舌苔调和。两剂后津液果然生出。后来与生脉散交替服用，得以痊愈。
另一位五十多岁的人，平时不谨慎节制欲望，受寒后发热。其他医生曾给予解表发散的药物。等到我诊治时，脉象微细，面色通红，眼睛红赤，嘴唇焦裂，舌头黑而干枯。我说：“这是真阴衰竭，水火两亏。”应当用八味汤加入五味子进行峻补才可以。那家人虽然相信，但不肯轻易投药。我说：“如果不使用这个药，就没有办法救治了。”急忙请我的朋友唐松声来验证一下如何。等到他到来诊治后，对我说：“这是八味汤加五味子的证候。”他的话如同符节相合一样准确。于是取药服用，果然舌头上有了微量津液，连续服用几剂后，焦枯之象顿时消除。后来又加入人参，调理后安定下来。后来没有遵守禁忌，半年后，因违反房事戒律，用其他药物致死。
一位徽州商人，二十八岁，病后不谨慎节制而发热。那家人认为是因为吃了浓味食物所以复发，医生投予小柴胡汤三剂。导致身体疲倦，腰胯疼痛，不能转身侧卧。我诊治他，脉象微弱，说：“这是女劳复（因房事劳累导致的疾病复发）。”用七味汤加入五味子、杜仲，连续服用两剂，就能转身侧卧。又服用几剂，兼用人参，得以痊愈。
六味地黄汤
怀熟地（三钱） 山茱萸（一钱五分，去核） 茯苓（一钱） 淮山药（一钱五分，炒） 牡丹皮（一钱） 泽泻（一钱）
用水煎煮。
The syndrome of Yin-cold is caused by the decline of the True Fire (Mingmen Fire) in the Kidney. The syndrome of Yin-deficiency is caused by the depletion of the True Water (Body Fluids/Yin Essence) in the Stomach. When the True Fire declines, there are cold manifestations without heat; when the True Water depletes, there are heat manifestations without cold. The Classics state: "Yin-deficiency leads to fever," which is exactly this principle. In the world, some people fail to observe carefully. Upon seeing a patient with fever, they casually say it is Shanghan (Cold Damage). Such errors and absurdities are indescribable. They do not realize that it has absolutely nothing to do with the term "Shanghan." Try to palpate their pulse; it will be neither tight but rapid, nor full but empty. Verify their symptoms: perhaps dizziness and vertigo of the head and eyes, or a preference for pulling clothes while lying down in fatigue, or soreness and pain in the waist and legs, or thirst but a preference for hot drinks. Although the body is hot, there is no aversion to cold; although there is no desire to eat, there is no feeling of abdominal distension and fullness. Inquire about the cause: if it is not due to excessive indulgence in alcohol and sexual activity, it must be after a major illness or severe labor, where one failed to exercise caution and restraint in desires, thereby causing this condition. Immediately administer a large dose of Liuwei Dihuang Tang (Six-Ingredient Rehmannia Decoction), and the fever will recede and the illness will resolve. If accompanied by aversion to cold and thirst, then use Qiwei Tang (Seven-Ingredient Decoction). If the feet are cold and the pulse is weak, then administer Bawei Tang (Eight-Ingredient Decoction). Some may fear that these medicines are cloying and obstructive, thus daring not to try them lightly. This is because they do not know that Liuwei and Bawei decoctions are the primary medicines for the Kidney meridian, reaching directly to the Lower Jiao. If it is indeed Yin-deficiency, urgently borrowing them to benefit Water and supplement Fire is an indispensable and urgent remedy. What else is there to doubt?
Case Records:
A person aged fifty suffered from fever and had already taken medicine for seven or eight days. When I examined him, his pulse was deficient and rapid, his eyes were red, his lips were cracked, and his tongue was swollen and devoid of fluids. I said, "This is a sign of declining Kidney Yin-Water. It is suitable to administer Dihuang Tang (Rehmannia Decoction)." His family hesitated and invited another doctor, saying, "The pulse is extremely deficient." However, the prescribed medication consisted of Qinghuo (Clearing Heat) agents such as Huangqin (Scutellariae Radix), Lianzi (Coptidis Rhizoma), Zhizi (Gardeniae Fructus), and Fen (likely Shigao/Gypsum Fibrosum). I said, "If taking this generates fluids, so be it; but if taking it worsens the condition, then these medicines cannot treat it." After taking it, the condition worsened, and only then did they believe my words. Subsequently, one dose of Dihuang Tang was administered. He felt slightly better sleep and his tongue harmonized. After two doses, fluids indeed generated. Later, he alternated taking Shengmai San (Generate Pulse Powder) and recovered.
Another person, over fifty years old, who usually did not exercise caution in desires, contracted cold and developed fever. Other doctors had previously given dispersing and resolving agents. When I examined him, his pulse was faint and fine, his facial complexion was bright red, his eyes were red, his lips were cracked, and his tongue was black and dry. I said, "This is exhaustion of True Yin, with deficiency of both Water and Fire. It is appropriate to use Bawei Tang (Eight-Ingredient Decoction) added with Wuweizi (Schisandrae Fructus) for vigorous tonification." Although his family believed me, they were unwilling to administer it lightly. I said, "Without using this medicine, there is no hope of rescue." I urgently invited my friend Tang Songsheng to verify how it would go. Upon arrival and examination, he told me, "This is the indication for Bawei Tang added with Wuweizi." His words matched perfectly like tally sticks. So we took the medicine and administered it. Indeed, a slight amount of fluid appeared on the tongue. After continuous doses, the dry and scorched state instantly resolved. Later, Renshen (Ginseng Radix et Rhizoma) was added, and he settled down after regulation. Later, failing to observe dietary/lifestyle restrictions, half a year later, he violated sexual abstinence rules and died using other medications.
A merchant from Huizhou, aged twenty-eight, developed fever after an illness due to lack of caution. His family thought it was a recurrence due to consuming rich flavors, so the doctor administered Xiaochaihu Tang (Minor Bupleurum Decoction) for three doses. This resulted in body fatigue, pain in the waist and hips, and inability to turn sideways. I examined him; his pulse was faint and weak. I said, "This is Nulaofu (recurrence due to sexual exertion after illness)." Using Qiwei Tang (Seven-Ingredient Decoction) added with Wuweizi (Schisandrae Fructus) and Duzhong (Eucommiae Cortex), administered continuously for two doses, he could immediately turn sideways. After several more doses, combined with Renshen (Ginseng Radix et Rhizoma), he recovered.
Liuwei Dihuang Tang (Six-Ingredient Rehmannia Decoction)
Huai Shudi (Prepared Rehmanniae Radix, 3 qian)
Shanzhuyu (Corni Fructus, 1.5 qian, pitted)
Fuling (Poria, 1 qian)
Huai Shanyao (Dioscoreae Rhizoma, 1.5 qian, stir-fried)
Mudanpi (Moutan Cortex, 1 qian)
Zexie (Alismatis Rhizoma, 1 qian)
Decoct in water.
Bawei Dihuang Tang (Eight-Ingredient Rehmannia Decoction) (i.e., the above formula)
Add Shu Fuzi (Prepared Aconiti Lateralis Radix) and Rougui (Cinnamomi Cortex), each 0.5 qian.
Removing Fuzi yields Qiwei Tang (Seven-Ingredient Decoction).