夫发热者。非止一端。杂病中俱有发热。医者宜照各门治法治之。盖病有虚实寒热之不
同。岂可一律而治耶。
一论伤寒发热。是寒邪入卫。与阳气交争。而为外热。阳气主外。为寒所薄。而失其职。
故为热。其脉紧而有力。是外之寒邪伤卫也。治主外。宜服九味羌活汤。（方见伤寒）
一论伤暑发热。是火邪伤心。元气耗散。而热邪入客于中。故发为热。汗大泄。无气
以动。其脉虚迟而无力。是外之热邪伤荣也。治主内。宜服清暑益气汤。（方见中暑）
一论内伤发热。是阳气自伤。不能升达。降下阴分。而为内伤。乃阴虚也。故其脉大而
无力。属肺脾。宜服补中益气汤。（方见内伤）
一论阴虚发热。是阴血自伤。不能制火。阳气升腾内热。乃阳旺也。故其脉数而无力。
属心肾。经曰。脉大无力为阳虚。脉数无力是阴虚。宜服清离滋坎汤。（方见劳瘵）
一论大病后。气血两虚。遂成劳怯。潮热往来。盗汗自汗。或无汗燥热。世俗更以柴胡
、地骨皮。往往不效。其病愈甚。
一论男子血虚。有汗潮热者。以人参养荣汤。（方见后）
一论男子气虚。有汗潮热者。以补中益气汤。（方见内伤）
一论血虚。无汗潮热者。以茯苓补心汤。（方见妇人虚劳）
一论气虚。无汗潮热者。以人参清肌散。（方见后）
一论女子血虚。有汗潮热者。以茯苓补心汤。
一论气血两虚。无汗潮热者。以逍遥散。（方见妇人虚劳）
一论发热咳嗽咯血。以人参五味子散。骨蒸者五蒸汤。清骨散。以上皆治劳热之圣药也
（方俱见后）
一论男妇四肢肌表。发热如火烙。此病多因血虚而得之。或胃虚遇食冷物。抑遏阳气于
脾土之中。火即上越。宜用
升阳散火汤
升麻 葛根 白芍 羌活 独活 人参（各五分） 柴胡（八分） 生甘草 防风
炙甘草（各三分）
上锉一剂。生姜煎服。忌寒凉生冷之物。
一论夜则静。昼则发热者。此热在气分也。宜小柴胡汤。（方见伤寒）根据本方加栀子、黄
连、地骨皮。
一论昼则静。夜则发热者。此热在血分也。宜四物汤。（方见补益）根据本方加栀子、黄柏
、知母、黄连、牡丹皮、柴胡。
一论昼夜俱发热者。此热在气血之分也。宜四物汤（方见补益）合小柴胡汤。（方见伤寒）
根据本方加五味。再加黄连、山栀仁。一剂而安。
一论子午潮热者。
加减逍遥散
当归（二钱） 白芍（二钱） 白术（一钱五分） 茯苓（三钱） 柴胡（八分） 甘草（八分）
胡黄
连（六分） 麦门冬（二钱） 黄芩（二钱） 地骨皮（三钱） 秦艽（三钱） 木通（二钱）
车前子（三钱） 灯草（十根）
上锉。水煎服。
一论一应发热憎寒。非杂病发热者。此邪在半表半里也。宜用
柴苓汤 小柴胡汤（方见伤寒） 五苓散（方见中暑）二方相合是也。
一论积劳虚损。四肢倦怠。肌肉消瘦。颜色枯槁。汲汲短气。饮食无味也。
人参养荣汤
人参（三钱） 当归（二钱） 陈皮（一钱五分） 蜜炙黄 （二钱） 桂心（五分） 白术（去
芦一
钱五分） 白芍（二钱酒炒） 熟地黄（三钱） 白茯苓（三钱去皮） 五味子（四分） 远志
（八分去心） 甘草（炙八分）
上锉。姜、枣煎服。
一论男妇气虚。无汗潮热者。宜用
人参清肌散
人参（二钱） 白术（一钱五分） 白茯苓（三钱去皮） 当归（二钱） 赤芍（二钱） 柴胡（
八分） 半夏（二钱） 葛粉（二钱） 甘草（八分）
上锉。姜、枣煎服。其药服之自愈。
一论虚劳潮热咳嗽。红痰盗汗。宜
人参五味散
黄 （二钱） 人参（三钱） 白术（一钱五分） 白茯苓（三钱） 当归（二钱） 熟地黄（三
钱）
桔梗（八分） 地骨皮（三钱） 陈皮（二钱） 前胡（二钱） 柴胡（八分） 五味子（四分）
枳壳（一钱） 桑白皮（三钱） 甘草（八分）
上锉。生姜、乌梅半个。水煎。加知母二钱。
一论男妇五心烦热。骨蒸劳热。宜
清骨散
人参（一钱） 赤茯苓（五钱） 柴胡（二钱） 蓁艽（五钱） 生地黄（二钱） 熟地黄（二钱
）薄荷（七分） 胡黄连（五分）
上锉一剂。水煎温服。
一论发热口干。小便赤涩。夜则安静。昼则发热。此症在气分也。清心莲子饮。（方见
赤白浊）
一论男妇肌肉燥热。目赤面红。烦渴引饮。日夜不息。其脉洪大而虚。重按全无。内经
曰。
脉虚血虚。脉实血实。又名血虚发热。症象白虎。若误服白虎。必死。此病因饥饿劳役而起
宜服
当归补血汤
嫩黄 （蜜水炒一两） 当归（酒洗二钱）
上锉一剂。水煎。温服。
一人虚劳发热自汗。诸药不能退其热者。服当归补血汤。一剂如神。
一沈大尹不时发热。日饮冰水数碗。寒药两剂。热渴益甚。形体日瘦。尺脉洪大而数。
时或
无力。王太仆曰。热之不热。责其无火。寒之不寒。责其无水。又云。倏往倏来。是无火也
时作时止。是无水也。法宜补肾。用加减八味丸。不月而愈。
一男子七十九。头痛发热。眩晕喘急。痰涎壅塞。小便频数。口干引饮。遍舌生刺。缩
敛如荔枝然。下唇黑裂。面目俱赤。烦躁不寐。或时喉间如烟火上冲。急饮凉水少解。已
濒于死。脉洪大而无伦。且有力。扪其身烙手。此肾经虚火游行于外。投以十全大补。
茱萸、泽泻、丹皮、山药、麦门冬、五味、附子一钟。熟睡良久。脉症各减三四。再与八味
丸服之。诸症悉退。后畏冷物而痊。
一儒者发热口干。小便频浊。大便秘结。盗汗遗精。遂致废寝。用当归六黄汤二剂。盗
汗顿止。用六味地黄丸。二便调和。用十全大补汤。及前丸兼服。月余诸症悉愈。
一人年近四旬。忽发潮热。口干。喜饮冷水。求医治。以凉药投之。数服罔效。四五日
浑
身沉重。不能举止。四肢强直。耳聋谵语妄言。眼闭不省人事。六脉浮大无力。此气血脾胃
虚损至极。余将十全大补汤。去地黄、白芍。加熟附子一服。须臾病者睡。口鼻痰响。人咸
以为服桂、附、参、 之误。余曰。此病药交攻。不必忧疑也。又强进一服。过一二时许。
即能转身动止。次日连进数剂。则诸病次第而潜瘳矣。此病从脉不从症而治之也。
一人发热烦渴。或头痛。因服发散药。反增喘急腹痛。自汗如雨。日夜呓语。余意此劳
伤元
气。误汗所致。其腹必喜手按。询之果然。与十全大补汤。加熟附子一钱服之。熟睡久而不
醒。举家惊惶。及觉。诸症顿进。再剂而痊。凡人饮食劳役。起居失宜。见一切火症。悉系
内真寒而外假热。故肚腹喜暖。口畏冷物。此乃形气病。气血既虚。属不足。法当纯补元
气。为善治者矣。
六味丸 十全大补汤（俱见补益） 八味丸（亦见补益）
发热这一症状，并非只有一种成因。在杂病中也都可能出现发热。医生应当根据各门疾病的治法来治疗。因为疾病有虚、实、寒、热的不同，怎么能用同一种方法治疗呢？
第一论伤寒发热：这是寒邪侵入卫分（护卫体表的阳气），与阳气相互抗争，从而产生体表发热。阳气主司体表防御，被寒邪所迫，导致其职能丧失，所以出现发热。其脉象紧而有力，说明是外部的寒邪损伤了卫气。治疗重点在表，适宜服用九味羌活汤。（方剂见伤寒篇）
第二论伤暑发热：这是火邪伤害心脏，元气耗散，热邪侵入体内客居其中，所以发为发热。表现为大汗淋漓，没有力气活动。其脉象虚迟而无力，说明是外部的热邪损伤了营血。治疗重点在里，适宜服用清暑益气汤。（方剂见中暑篇）
第三论内伤发热：这是阳气自我受损，不能升发通达，反而降入阴分，从而形成内伤，这属于阴虚。所以其脉象大而无力，病位属肺和脾。适宜服用补中益气汤。（方剂见内伤篇）
第四论阴虚发热：这是阴血自我受损，不能制约火气，导致阳气升腾产生内热，这属于阳旺。所以其脉象数而无力，病位属心和肾。经书说：脉大无力为阳虚，脉数无力为阴虚。适宜服用清离滋坎汤。（方剂见劳瘵篇）
第五论大病之后：气血两虚，遂成劳怯（慢性虚弱性疾病），出现潮热往来（定时发热或忽冷忽热）、盗汗（夜间睡着出汗）自汗（白天不活动也出汗），或者无汗且燥热。世俗医生往往使用柴胡、地骨皮，常常无效，反而使病情加重。
第七论男子气虚：有汗且潮热的，用补中益气汤。（方剂见内伤篇）
第八论血虚：无汗且潮热的，用茯苓补心汤。（方剂见妇人虚劳篇）
第十一论气血两虚：无汗且潮热的，用逍遥散。（方剂见妇人虚劳篇）
第十二论发热伴有咳嗽咯血：用人参五味子散。骨蒸潮热（感觉热从骨头里透出来）的用五蒸汤、清骨散。以上都是治疗劳热（虚劳发热）的圣药。（方剂俱见后文）
第十三论男女四肢及肌肤表面发热，如火烧烙烫。这种病多因血虚所致。或者是胃气虚弱，遇到吃生冷食物，遏制了阳气在脾土之中，火气向上越出。适宜用升阳散火汤。
处方：升麻、葛根、白芍、羌活、独活、人参（各五分）、柴胡（八分）、生甘草、防风、炙甘草（各三分）。
上药切碎为一剂，加生姜煎服。忌食寒凉生冷之物。
第十四论夜间安静，白天发热的，这是热在气分。适宜用小柴胡汤。（方剂见伤寒篇）在此方基础上加栀子、黄连、地骨皮。
第十五论白天安静，夜间发热的，这是热在血分。适宜用四物汤。（方剂见补益篇）在此方基础上加栀子、黄柏、知母、黄连、牡丹皮、柴胡。
第十六论昼夜都发热的，这是热在气血之间。适宜用四物汤（方剂见补益篇）合小柴胡汤（方剂见伤寒篇）。在此方基础上加五味子等五味药，再加黄连、山栀仁。一剂即可安愈。
第十七论子午时（中午11点至下午1点）潮热者：
加减逍遥散
处方：当归（二钱）、白芍（二钱）、白术（一钱五分）、茯苓（三钱）、柴胡（八分）、甘草（八分）、胡黄连（六分）、麦门冬（二钱）、黄芩（二钱）、地骨皮（三钱）、秦艽（三钱）、木通（二钱）、车前子（三钱）、灯草（十根）。
上药切碎，水煎服。
第十八论一切发热伴憎寒（怕冷），非杂病发热者。这是邪气在半表半里之间。适宜用柴苓汤，即小柴胡汤（方剂见伤寒篇）与五苓散（方剂见中暑篇）两方相合而成。
第十九论积劳虚损：四肢倦怠，肌肉消瘦，面色枯槁，气息短促急促，饮食无味。
人参养荣汤
处方：人参（三钱）、当归（二钱）、陈皮（一钱五分）、蜜炙黄芪（二钱）、桂心（五分）、白术（去芦头一钱五分）、白芍（二钱，酒炒）、熟地黄（三钱）、白茯苓（三钱，去皮）、五味子（四分）、远志（八分，去心）、甘草（炙八分）。
上药切碎，加姜、枣煎服。
第二十论男女气虚，无汗且潮热的，适宜用：
人参清肌散
处方：人参（二钱）、白术（一钱五分）、白茯苓（三钱，去皮）、当归（二钱）、赤芍（二钱）、柴胡（八分）、半夏（二钱）、葛粉（二钱）、甘草（八分）。
上药切碎，加姜、枣煎服。服药后自愈。
第二十一论虚劳引起的潮热咳嗽，红痰（带血的痰），盗汗。适宜用：
人参五味散
处方：黄芪（二钱）、人参（三钱）、白术（一钱五分）、白茯苓（三钱）、当归（二钱）、熟地黄（三钱）、桔梗（八分）、地骨皮（三钱）、陈皮（二钱）、前胡（二钱）、柴胡（八分）、五味子（四分）、枳壳（一钱）、桑白皮（三钱）、甘草（八分）。
上药切碎，加生姜、半个乌梅，水煎。另加知母二钱。
第二十二论男女五心烦热（两手心、两脚心及心胸烦热），骨蒸劳热。适宜用：
清骨散
处方：人参（一钱）、赤茯苓（五钱）、柴胡（二钱）、秦艽（五钱）、生地黄（二钱）、熟地黄（二钱）、薄荷（七分）、胡黄连（五分）。
上药切碎为一剂，水煎温服。
第二十三论发热口干，小便赤涩，夜间安静，白天发热。此症在气分。用清心莲子饮。（方剂见赤白浊篇）
第二十四论男女肌肉燥热，眼睛红，面部红，烦躁口渴想喝水，日夜不停。其脉象洪大而虚，重按完全无力。《内经》说：脉虚则血虚，脉实则血实。这也叫血虚发热，症状表现像白虎汤证（阳明经热盛）。如果误服白虎汤，必死无疑。此病因饥饿和过度劳累引起。适宜服用：
当归补血汤
处方：嫩黄芪（蜜水炒一两）、当归（酒洗二钱）。
上药切碎为一剂，水煎，温服。
有一人患虚劳发热自汗，各种药物都不能退热，服用当归补血汤，一剂如神效。
第二十五沈大尹不时发热，每天喝几碗冰水，服用两剂寒凉药，但热渴更加严重，身体日渐消瘦。尺脉洪大而数，有时无力。王太仆说：用热药治不好寒证，责任在于无火；用寒药治不好热证，责任在于无水。又说：热势忽来忽去，是无火；热势时作时止，是无水。治法宜补肾，用加减八味丸，不到一个月痊愈。
第二十六一男子七十九岁，头痛发热，眩晕气喘急促，痰涎壅塞，小便频数，口干想喝水，满舌生刺，收缩收敛像荔枝核一样，下唇黑裂，面目都红，烦躁失眠，有时喉咙间像烟火上冲，急饮凉水稍解，已濒临死亡。脉象洪大无序，且有力。摸其身烫手。这是肾经虚火游行于体表。投以十全大补汤，加上茱萸、泽泻、丹皮、山药、麦门冬、五味子、附子一钟（量词，约一杯的量）。熟睡良久后，脉象和症状各减轻三四成。再服用八味丸，诸症全部消退。后来畏惧冷物而痊愈。
第二十七一儒生发热口干，小便频数浑浊，大便秘结，盗汗遗精，遂致废寝忘食。用当归六黄汤两剂，盗汗立刻停止。用六味地黄丸，二便调和。用十全大补汤，以及前面的丸药兼服，月余诸症全部痊愈。
第二十八一人年近四十，忽然发潮热，口干，喜欢喝冷水。求医治疗，医生用凉药投之，服了几次毫无效果。四五天后浑身沉重，不能举动，四肢强直，耳聋谵语妄言，眼闭不省人事。六脉浮大无力。这是气血脾胃虚损到了极点。我将十全大补汤，去掉地黄、白芍，加熟附子一服。片刻后病人睡觉，口鼻有痰响，大家都以为是用桂枝、附子、人参的错误。我说：这是病与药交攻，不必担忧怀疑。又强行进服一剂。过了一两个时辰，就能转身活动。第二天连续进服数剂，则诸病次第逐渐痊愈。这是从脉象而不从症状来治疗的案例。
第二十九一人发热烦渴，有时头痛，因为服用发散药，反而增加气喘腹痛，自汗如雨，日夜说胡话。我心想这是劳伤元气，误用发汗所致。他的腹部一定喜欢用手按压，询问果然如此。给予十全大补汤，加熟附子一钱服用。熟睡很久不醒，全家惊慌。等到醒来，诸症顿减。再服两剂而痊愈。凡是饮食失调、劳役过度、起居不当，见到一切火症，都属于内真寒而外假热。所以肚子喜欢暖，口畏冷物。这是形气病，气血既虚，属于不足证，治法应当纯补元气，这才是善于治疗的人。
六味丸、十全大补汤（俱见补益篇）、八味丸（亦见补益篇）。
Fever is not a single condition. Fever can occur in various miscellaneous diseases. Physicians should treat according to the methods specified for each category of disease. Since diseases differ in deficiency (Xu), excess (Shi), cold (Han), and heat (Re), how can they all be treated with one uniform method?
First, regarding fever from Cold Damage (Shanghan): This occurs when cold pathogenic factors invade the Wei level (the defensive Qi that protects the exterior) and contend with Yang Qi, resulting in external heat. Yang Qi governs the exterior; when constrained by cold, it loses its function, thus generating heat. The pulse is tight and forceful, indicating that external cold has injured the Wei Qi. Treatment focuses on the exterior; Jiwei Qianghuo Tang (Nine-Ingredient Notopterygia Decoction) is appropriate. (Formula see Shanghan section)
Second, regarding fever from Summerheat Injury: This occurs when fire pathogenic factors injure the Heart, causing dispersion of Yuan Qi (Original Qi), while heat pathogens enter and lodge internally, resulting in fever. Symptoms include profuse sweating and lethargy due to lack of Qi. The pulse is deficient, slow, and weak, indicating that external heat has injured the Ying level (Nutritive Blood). Treatment focuses on the interior; Qingshu Yiqi Tang (Clear Summerheat and Boost Qi Decoction) is appropriate. (Formula see Zhongshu section)
Third, regarding fever from Internal Injury: This occurs when Yang Qi is self-injured and fails to ascend and diffuse, instead descending into the Yin levels, forming internal injury, which belongs to Yin Deficiency. Thus, the pulse is large but weak. The pathology involves the Lung and Spleen. Buchong Yiqi Tang (Tonify the Middle and Boost Qi Decoction) is appropriate. (Formula see Neishang section)
Fourth, regarding fever from Yin Deficiency: This occurs when Yin Blood is self-injured and fails to control Fire, causing Yang Qi to ascend and generate internal heat, representing Yang Hyperactivity. Thus, the pulse is rapid but weak. The pathology involves the Heart and Kidney. The Classics state: A large but weak pulse indicates Yang Deficiency; a rapid but weak pulse indicates Yin Deficiency. Qingli Zikan Tang (Clear Li [Heart] and Nourish Kan [Kidney] Decoction) is appropriate. (Formula see Laozhai section)
Fifth, following severe illness: Both Qi and Blood are deficient, leading to chronic weakness (Laoqie). Symptoms include tidal fever (fever at specific times) or alternating chills and fever, night sweats (Dao Han), spontaneous sweating (Zihan), or anhidrosis with dry heat. Lay practitioners often use Chai Hu (Bupleuri Radix) and Digupi (Lycii Cortex), which are often ineffective and may worsen the condition.
Sixth, for men with Blood Deficiency presenting with sweating and tidal fever: Renshen Yangrong Tang (Ginseng and Nutritive-Qi Tonifying Decoction) is used. (Formula see later)
Seventh, for men with Qi Deficiency presenting with sweating and tidal fever: Buchong Yiqi Tang (Tonify the Middle and Boost Qi Decoction) is used. (Formula see Neishang section)
Eighth, for Blood Deficiency presenting with anhidrosis and tidal fever: Fuling Buxin Tang (Poria and Heart-Nourishing Decoction) is used. (Formula see Funren Xulao section)
Ninth, for Qi Deficiency presenting with anhidrosis and tidal fever: Renshen Qingji San (Ginseng and Muscle-Clearing Powder) is used. (Formula see later)
Tenth, for women with Blood Deficiency presenting with sweating and tidal fever: Fuling Buxin Tang (Poria and Heart-Nourishing Decoction) is used.
Eleventh, for Qi and Blood Dual Deficiency presenting with anhidrosis and tidal fever: Xiaoyao San (Free and Easy Wanderer Powder) is used. (Formula see Funren Xulao section)
Twelfth, for fever accompanied by cough and hemoptysis: Renshen Wuweizi San (Ginseng and Schisandra Powder) is used. For bone-steaming fever (Guzheng), Wuzheng Tang (Five Steaming Decoction) or Qinggu San (Bone-Clearing Powder) are used. All these are supreme remedies for treating febrile diseases arising from deficiency (Laore). (Formulas see later)
Thirteenth, for men and women with fever in the limbs and skin surface, feeling as if scorched by fire: This condition often arises from Blood Deficiency. Alternatively, it may result from Stomach Qi Deficiency where consumption of cold foods suppresses Yang Qi within the Spleen Earth, causing Fire to flare upward. Shengyang Sanhuo Tang (Raise Yang and Disperse Fire Decoction) is appropriate.
Prescription: Shengma (Cimicifugae Rhizoma), Gegen (Puerariae Lobatae Radix), Baishao (Paeoniae Radix Alba), Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Renshen (Ginseng Radix et Rhizoma) (each 5 fen); Chaihu (Bupleuri Radix) (8 fen); Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), Fangfeng (Saposhnikoviae Radix), Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma) (each 3 fen).
Decoct one dose with fresh ginger. Avoid cold and raw foods.
Fourteenth, for those who are quiet at night but have fever during the day: The heat resides in the Qi level. Xiao Chaihu Tang (Minor Bupleurum Decoction) is appropriate. (Formula see Shanghan section). Add Zhizi (Gardeniae Fructus), Huanglian (Coptidis Rhizoma), and Digupi (Lycii Cortex) to this formula.
Fifteenth, for those who are quiet during the day but have fever at night: The heat resides in the Blood level. Siwu Tang (Four Substances Decoction) is appropriate. (Formula see Buyi section). Add Zhizi (Gardeniae Fructus), Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma), Huanglian (Coptidis Rhizoma), Mudanpi (Moutan Cortex), and Chaihu (Bupleuri Radix) to this formula.
Sixteenth, for those with fever both day and night: The heat resides between the Qi and Blood levels. Combine Siwu Tang (Four Substances Decoction) (Formula see Buyi section) with Xiao Chaihu Tang (Minor Bupleurum Decoction) (Formula see Shanghan section). Add five flavors (Wuweizi, Schisandrae Chinensis Fructus) and add Huanglian (Coptidis Rhizoma) and Shanzhiren (Gardeniae Fructus). One dose brings relief.
Seventeenth, for tidal fever occurring at Zi and Wu hours (midnight and noon):
Jiajian Xiaoyao San (Modified Free and Easy Wanderer Powder)
Prescription: Danggui (Angelicae Sinensis Radix) (2 qian), Baishao (Paeoniae Radix Alba) (2 qian), Baizhu (Atractylodis Macrocephalae Rhizoma) (1.5 qian), Fuling (Poria) (3 qian), Chaihu (Bupleuri Radix) (8 fen), Gancao (Glycyrrhizae Radix et Rhizoma) (8 fen), Huhuanglian (Coptidis Rhizoma / Coptis chinensis var. microphylla) (6 fen), Maimendong (Ophiopogonis Radix) (2 qian), Huangqin (Scutellariae Radix) (2 qian), Digupi (Lycii Cortex) (3 qian), Qinjiao (Gentianae Macrophyllae Radix) (3 qian), Mutong (Akebiae Caulis) (2 qian), Cheqianzi (Plantaginis Semen) (3 qian), Dengcao (Junci Medulla) (10 strands).
Decoct with water.
Eighteenth, for all cases of fever with aversion to cold that are not due to miscellaneous diseases: The pathogen is in the Half-Exterior and Half-Interior. Chailing Tang (Chaihu and Wuling Decoction), which combines Xiao Chaihu Tang (Minor Bupleurum Decoction) (Formula see Shanghan section) and Wuling San (Five-Ingredient Poria Powder) (Formula see Zhongshu section), is appropriate.
Nineteenth, for chronic exhaustion and deficiency: Limbs are fatigued, muscles are emaciated, complexion is sallow and dull, breath is short and hurried, and there is no taste for food.
Renshen Yangrong Tang (Ginseng and Nutritive-Qi Tonifying Decoction)
Prescription: Renshen (Ginseng Radix et Rhizoma) (3 qian), Danggui (Angelicae Sinensis Radix) (2 qian), Chenpi (Citri Reticulatae Pericarpium) (1.5 qian), Honey-fried Huangqi (Astragali Radix) (2 qian), Guixin (Cinnamomi Cortex) (5 fen), Baizhu (Atractylodis Macrocephalae Rhizoma, de-rooted) (1.5 qian), Baishao (Paeoniae Radix Alba, wine-fried) (2 qian), Shudihuang (Rehmanniae Radix Praeparata) (3 qian), Bai Fuling (Poria, peeled) (3 qian), Wuweizi (Schisandrae Chinensis Fructus) (4 fen), Yuanzhi (Polygalae Radix, heart removed) (8 fen), Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma) (8 fen).
Decoct with fresh ginger and jujubes.
Twentieth, for men and women with Qi Deficiency, anhidrosis, and tidal fever:
Renshen Qingji San (Ginseng and Muscle-Clearing Powder)
Prescription: Renshen (Ginseng Radix et Rhizoma) (2 qian), Baizhu (Atractylodis Macrocephalae Rhizoma) (1.5 qian), Bai Fuling (Poria, peeled) (3 qian), Danggui (Angelicae Sinensis Radix) (2 qian), Chishao (Paeoniae Radix Rubra) (2 qian), Chaihu (Bupleuri Radix) (8 fen), Banxia (Pinelliae Rhizoma) (2 qian), Gefen (Puerariae Flos / Pueraria starch) (2 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (8 fen).
Decoct with fresh ginger and jujubes. Self-healing will occur after taking the medicine.
Twenty-first, for chronic deficiency with tidal fever, cough, bloody sputum, and night sweats:
Renshen Wuweisan (Ginseng and Schisandra Powder)
Prescription: Huangqi (Astragali Radix) (2 qian), Renshen (Ginseng Radix et Rhizoma) (3 qian), Baizhu (Atractylodis Macrocephalae Rhizoma) (1.5 qian), Bai Fuling (Poria) (3 qian), Danggui (Angelicae Sinensis Radix) (2 qian), Shudihuang (Rehmanniae Radix Praeparata) (3 qian), Jiegeng (Platycodonis Radix) (8 fen), Digupi (Lycii Cortex) (3 qian), Chenpi (Citri Reticulatae Pericarpium) (2 qian), Qianhu (Peucedani Radix) (2 qian), Chaihu (Bupleuri Radix) (8 fen), Wuweizi (Schisandrae Chinensis Fructus) (4 fen), Zhiqiao (Aurantii Fructus Immaturus) (1 qian), Sangbaipi (Mori Cortex) (3 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (8 fen).
Decoct with fresh ginger and half a dried plum (Wumei). Add Zhimu (Anemarrhenae Rhizoma) 2 qian.
Twenty-second, for men and women with "five-center" heat (palms, soles, and chest), and bone-steaming deficiency fever:
Qinggu San (Bone-Clearing Powder)
Prescription: Renshen (Ginseng Radix et Rhizoma) (1 qian), Chi Fuling (Poria with red bran) (5 qian), Chaihu (Bupleuri Radix) (2 qian), Qinjiao (Gentianae Macrophyllae Radix) (5 qian), Shengdihuang (Rehmanniae Radix) (2 qian), Shudihuang (Rehmanniae Radix Praeparata) (2 qian), Bohe (Menthae Haplocalycis Herba) (7 fen), Huhuanglian (Coptidis Rhizoma / Coptis chinensis var. microphylla) (5 fen).
Decoct one dose with water and take warm.
Twenty-third, for fever with dry mouth, dark and scanty urination, quietness at night, and fever during the day: The pathology is in the Qi level. Qingxin Lianzi Yin (Clear Heart and Lotus Seed Drink) is used. (Formula see Chibai Zhuo section)
Twenty-fourth, for men and women with dry hot muscles, red eyes and face, irritability, thirst with desire to drink, persisting day and night. The pulse is surging (Hong) yet deficient (Xu), and completely empty upon heavy pressure. The *Neijing* states: "Deficient pulse indicates Blood Deficiency; Excess pulse indicates Blood Excess." This is also called Blood Deficiency Fever. The symptoms resemble the Baihu Tang syndrome (Yangming Channel Heat). If Baihu Tang is mistakenly administered, death is certain. This condition arises from hunger and overwork. Danggui Buxue Tang (Danggui and Astragalus Decoction) is appropriate.
Prescription: Tender Huangqi (Astragali Radix, honey-water fried) (1 liang), Danggui (Angelicae Sinensis Radix, wine-washed) (2 qian).
Decoct one dose with water and take warm.
Case: A patient with chronic deficiency fever and spontaneous sweating failed to respond to various drugs. After taking Danggui Buxue Tang, the fever subsided miraculously with one dose.
Twenty-fifth: Shen Dayin experienced intermittent fever. He drank several bowls of ice water daily and took two doses of cold-natured medicines, yet his heat and thirst worsened, and his body grew thinner daily. His Chi (Cun Cun) pulse was surging, rapid, yet sometimes weak. Wang Taipu said: "If heat cannot be warmed, blame the lack of Fire; if cold cannot be cooled, blame the lack of Water." He also said: "Heat coming and going suddenly indicates lack of Fire; heat appearing and disappearing intermittently indicates lack of Water." The treatment should tonify the Kidney using Jiabian Bawei Wan (Modified Eight-Ingredient Pill). He recovered within a month.
Twenty-sixth: A seventy-nine-year-old man suffered from headache, fever, vertigo, urgent asthma, phlegm obstruction, frequent urination, dry mouth with desire to drink, prickles covering the tongue that contracted like a lychee pit, black cracked lower lip, red face and eyes, irritability, insomnia, and occasional sensation of smoke/fire rising in the throat, relieved slightly by drinking cold water. He was near death. The pulse was surging, chaotic, yet forceful. His body felt burning to the touch. This was Empty Fire from the Kidney Meridian wandering externally. He was administered Shiquan Dabu Tang (Ten Substance Great Tonifying Decoction) plus Zhuyu (Corni Fructus), Zexie (Alismatis Rhizoma), Danpi (Moutan Cortex), Shanyao (Dioscoreae Rhizoma), Maimendong (Ophiopogonis Radix), Wuweizi (Schisandrae Chinensis Fructus), and Fuzi (Aconiti Lateralis Radix Praeparata) in one cup. After a long sleep, the pulse and symptoms decreased by three or four parts. He then took Bawei Wan (Eight-Ingredient Pill), and all symptoms receded. He eventually recovered by avoiding cold substances.
Twenty-seventh: A scholar suffered from fever, dry mouth, frequent turbid urination, constipation, night sweats, and seminal emission, leading to neglect of sleep and food. He took Danggui Liu Huang Tang (Danggui and Six-Huang Decoction) for two doses, stopping night sweats immediately. He took Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill), regulating bowel and bladder movements. He then took Shiquan Dabu Tang (Ten Substance Great Tonifying Decoction) combined with the previous pill, recovering fully within a month.
Twenty-eighth: A man nearing forty suddenly developed tidal fever, dry mouth, and preference for cold water. A physician prescribed cooling medicines, which were ineffective after several doses. Four or five days later, he became heavy-bodied, immobile, with stiff limbs, deafness, delirious speech, closed eyes, and unconsciousness. The six pulses were floating, large, and weak. This indicated extreme deficiency of Qi, Blood, and the Spleen/Stomach. I modified Shiquan Dabu Tang (Ten Substance Great Tonifying Decoction) by removing Dihuang (Rehmanniae Radix) and Baishao (Paeoniae Radix Alba), adding Shufuzi (Prepared Aconite Lateralis Radix). After one dose, the patient slept, with rattling phlegm in mouth and nose. Others thought this was a mistake to use Guizhi (Cinnamomi Ramulus), Fuzi (Aconiti Lateralis Radix Praeparata), and Renshen (Ginseng). I said: "This is the disease fighting the medicine; do not worry." I forced another dose. After one or two hours, he could move and turn. Over the next few days, continuous doses led to gradual recovery. This case demonstrates treating based on the pulse rather than symptoms.
Twenty-ninth: A patient with fever, irritability, thirst, and occasional headache took dispersing medicines, which aggravated asthma, abdominal pain, profuse sweating like rain, and nocturnal muttering. I reasoned this was damage to Original Qi from labor, caused by mistaken sweating. The abdomen must prefer pressure. Upon inquiry, this was confirmed. I gave Shiquan Dabu Tang (Ten Substance Great Tonifying Decoction) with 1 qian of Shufuzi (Prepared Aconite Lateralis Radix). He slept deeply for a long time, alarming his family. Upon waking, symptoms improved drastically. Two more doses cured him. Generally, for irregular diet, overwork, and improper living habits, any apparent "Fire" symptoms belong to True Cold inside and False Heat outside. Thus, the abdomen prefers warmth, and the mouth fears cold. This is a Form-Qi disease where Qi and Blood are deficient, belonging to Insufficiency. The method should be purely tonifying Original Qi. This is the skillful approach.
Liuwei Wan (Six-Ingredient Pill), Shiquan Dabu Tang (Ten Substance Great Tonifying Decoction) (both see Buyi section), Bawei Wan (Eight-Ingredient Pill) (also see Buyi section).