总括 发热无过先有余，次传不足始成虚；身中有热先除热，热里逢虚先补虚。
脉法 脉沉而数者骨间有热，欲以腹按清冷也，小儿八九至为发热，浮大数风热，有力为实，无力为虚。
《内经》曰∶阳胜则外热，阳虚则外寒，阴胜则内寒，阴虚则内热，阴阳相胜则寒热往来。
又曰∶阳不足则先寒后热，阴不足则先热后寒，阴阳不归其分，则寒热交争也。
又曰∶肝热病者左颊先赤，心热病者额先赤，脾热病者鼻先赤，肺热病者右颊先赤，肾热病者颐先赤，病虽未发，
其症已先见于面矣。（自批∶治六经热方∶治心热用泻心汤，治肝热用泻青丸，治脾热用泻黄丸，治肺热用泻白散，治
肾热用滋肾地黄丸，治小肠热用导赤散。）夫热有轻重不同，有所谓翕翕发热者，若合羽取覆，其热在外属表，乃风寒
客于皮肤，阳气拂郁所致，宜发汗而散之。有所谓蒸蒸发热者，若熏蒸之气，其热在内，属里，乃阳气下陷而入阴中也，
法当攻下以涤之。表症未罢邪气传里，里未作实是为半表半里之间，则表里俱发热而又轻于里，纯在表也。发热恶寒发
于阳也，无热恶寒发于阴也。夫小儿生禀纯阳，血气壮实，五脏易生热也，热各有不同故治亦不同焉。
潮热者或午时发热，或日晡发热，发时如潮水之应不差也。
《伤寒论》云∶潮热实热也，当利大便。若虚症亦能潮热，必须进以温补之剂。脉实者宜大柴胡下之，脉虚浮数者
百解散汗之，若发热而呕者小柴胡汤主之。
惊热者遍身发热，面青自汗，心悸不宁，脉数烦躁，颠叫恍惚，以钱氏惊风丸、安神丸主之。
夜热者但夜间发热，是阴中有阳邪也，宜进元戎四物二连汤。但夜间发热症候多端，先要辨其虚实，明其表里，方
可投药，若概用元戎汤不妥。
余热者谓寒邪未尽之遗热也。仁斋曰∶伤寒汗下后而热又来乃表里俱虚，气不归元，阳浮于外，不可再用凉药，盖
热去则寒起，叔和解之详矣。宜和胃气，使阳气收敛归内，其热自止，宜参苓白术散主之。
食热者手心热，肚腹先热，嗳气吐乳，大便酸臭，宜下积丸。
疳症者形瘦多渴，骨蒸盗汗，泻泄无常，肚大脚弱是也，宜胡黄连之类，当参看疳积门调治之。
壮热者一向不止，表里俱热，烦渴躁喘气粗，甚则发惊痫也，宜火府丹、通圣散。
烦热者心烦不安，五心烦热，小便赤涩，宜一粒金丹主之。
积热者眼胞浮肿，面黄足冷，发热从头至肚为甚，治法详伤积论中。
风热者呵欠面赤，风邪客于皮毛，入于脏腑，则恶风发热，目涩多睡。阳气有余，身热无汗；阴气有余，身寒有汗；
阴阳有余，无汗而寒。《素问》曰∶汗出而身热者，风热也，宜清解散、犀角丸主之。
虚热者因病后发热无时，面色青白，困倦少力，泻泄多尿，虚汗自出，恍恍神慢者是也。
凡病久则血气虚，气虚则发厥，血虚则发热，气血皆虚则手足厥而身热也。宜服钱氏白术散或四君子汤，甚者宜行
从治之法，以姜附之类佐之，经所谓甘温除大热是也。
变蒸热者，温温微热，气粗，惊，少吮乳，泻黄，上唇尖有水珠状是也，不必服药。如兼他症者当以所感之候略为
和解。
癖热者，涎嗽饮水，由乳食不消，伏结于中致成癖块也，详在积聚门中矣。
寒热者，症如疟状，阴阳相胜也，详疟症篇。
血热者，《全婴方》云∶已午间热，遇夜则凉是也，服六合汤。
麻痘热者，面赤足冷，身发壮热，呵欠烦闷，咳嗽腰疼，呕吐作惊，腹痛自痢，中指鼻尖耳冷是也。
〔附方〕
泻心汤 黄连一两为末，清水调服五分。
泻青丸 见惊风症内。
泻黄丸 藿香 山栀 石膏 防风 甘草
泻白散 见咳嗽症内。
滋肾地黄丸 黄柏 知母 桂枝
导赤散 见惊风症内。
大柴胡汤 见疟疾症内。
小柴胡汤 见诸吐症内。
百解散 干葛 麻黄 黄芩 桂枝 赤芍药 甘草
凉惊丸 黄连 防风 川芎 薄荷 大黄 胆草 蜜丸，青黛为衣。
安神丸 见疳积症内。
元戎四物二连汤 当归 芍药 川芎 黄连 生地 胡黄连
参苓白术散 见诸泻症内。
下积丸 丁香 砂仁 川巴豆 使君子
火府丹 生地 木通 黄芩 甘草
通圣散 防风 荆芥 当归 芍药 薄荷 黄芩 连翘 石膏 滑石 川芎 麻黄 桔梗 朴硝 山栀 大
黄白术 甘草
一粒金丹 人参 犀角 琥珀 玳瑁 防风 茯苓 冰片 朱砂 寒水石 甘草 米糊为丸，金箔为衣，麦冬
汤下。
清解散 防风 天麻 前胡 茯苓 桔梗 枳壳 细辛 柴胡 川芎 甘草
犀角丸 犀角 珍珠 防风 羌活 茯神 大黄 天竺黄 朱砂 甘草 立夏前宜服。
钱氏白术散 人参 白术 茯苓 藿香 干葛 木香 甘草
四君子汤 见惊风症内。
六合汤 当归 川芎 大黄 熟地
总括：发热病症，没有不是先由邪气有余（实证）开始，随后传变为正气不足（虚证），最终形成虚证的；身体中有热邪时，应先清除热邪，如果在清热的过程中遇到虚象，则应先补益正气。
脉法：脉象沉而数的，说明骨髓间有热，用手按压腹部感觉清凉；小儿脉搏一息八九至为发热，脉浮大数主风热，脉有力为实证，脉无力为虚证。
《黄帝内经》说：阳气偏胜则体表发热，阳气虚弱则体表发冷，阴气偏胜则体内发冷，阴气虚弱则体内发热，阴阳相互偏胜则出现寒热往来交替的症状。
又说：阳气不足则先感到寒冷后发热，阴气不足则先感到发热后发冷，阴阳之气不能各守其位，则会出现寒热交争的现象。
又说：肝经有热病的，左脸颊先发红；心经有热病的，额头先发红；脾经有热病的，鼻子先发红；肺经有热病的，右脸颊先发红；肾经有热病的，下巴先发红，病虽然还没有完全发作，但其症状已经先在面部显现了。（自批注：治疗六经热证的方剂：治疗心热用泻心汤，治疗肝热用泻青丸，治疗脾热用泻黄丸，治疗肺热用泻白散，治疗肾热用滋肾地黄丸，治疗小肠热用导赤散。）
发热有轻重不同，有一种叫“翕翕发热”的，像合上羽毛覆盖在身上那样，热感在体表，属于表证，这是风寒邪气客居皮肤，导致阳气拂郁所致，适宜用发汗的方法疏散它。有一种叫“蒸蒸发热”的，像熏蒸的热气一样，热感在体内，属于里证，这是阳气下陷进入阴分中，治法应当用攻下的方法来涤荡它。如果表证未解，邪气传入里部，但里部尚未形成实邪，这处于半表半里之间，此时表里都发热但比纯里证轻，属于纯在表的情况。发热且恶寒是发于阳经，无热但恶寒是发于阴经。
小儿先天禀赋纯阳，血气壮实，五脏容易生热，但热证各有不同，所以治疗方法也各不相同。
潮热，有的在中午发热，有的在傍晚发热，发作时间像潮水一样准时不差。
《伤寒论》说：潮热属于实热，应当通利大便。如果是虚证也能出现潮热，必须使用温补的药剂。脉象实的适宜用大柴胡汤攻下，脉象虚浮数的适宜用百解散发汗，如果发热且伴有呕吐的，以小柴胡汤为主治。
惊热，表现为全身发热，面色青，自汗，心悸不安，脉数烦躁，尖叫恍惚，以钱乙的惊风丸、安神丸为主治。
夜热，只是夜间发热，这是阴分中有阳邪，适宜服用元戎四物二连汤。但是夜间发热的症候多种多样，必须先辨别虚实，明确表里，然后才可以投药，如果一概使用元戎汤是不妥当的。
余热，是指寒邪未尽留下的残余热邪。仁斋说：伤寒经过发汗或攻下后，热邪又回来，这是因为表里俱虚，气不归元，阳气浮越于外，不可再用凉药，因为热去则寒起，叔和对此解释得很详细。适宜调和胃气，使阳气收敛回归内部，热自然停止，宜用参苓白术散主治。
食热，表现为手心热，肚子腹部先热，嗳气吐乳，大便酸臭，适宜用下积丸。
疳症，表现为形体消瘦多口渴，骨蒸盗汗，腹泻无常，肚子大脚弱，这是疳症的表现，适宜用胡黄连之类的药物，应当参考疳积门的调治方法。
壮热，一直不止，表里俱热，烦渴躁动气喘气粗，甚至引发惊痫，适宜用火府丹、通圣散。
烦热，表现为心烦不安，五心烦热，小便赤涩，宜用一粒金丹主治。
积热，表现为眼睑浮肿，面色黄足冷，发热从头到肚子最为严重，治法详见伤积论中。
风热，表现为打哈欠面赤，风邪客居皮毛，侵入脏腑，则恶风发热，眼睛干涩多睡。阳气有余，身热无汗；阴气有余，身寒有汗；阴阳都有余，无汗且寒。《素问》说：出汗且身热的，是风热，宜用清解散、犀角丸主治。
虚热，表现为病后发热无定时，面色青白，困倦少力，腹泻多尿，虚汗自出，精神恍惚怠慢，这是虚热的表现。
凡是病久则血气虚弱，气虚则发生厥逆，血虚则发热，气血都虚则手足厥冷且身热。适宜服用钱氏白术散或四君子汤，严重的适宜采用从治之法，用姜、附子之类辅助，这就是经文所说的“甘温除大热”。
变蒸热，表现为微微发热，气粗，受惊，少吃奶，腹泻，上唇尖有水珠状，这是变蒸热，不必服药。如果兼有其他症状，应当根据所感受的症候稍微进行和解。
癖热，表现为流涎咳嗽饮水，由于乳食不消化，伏结在中焦导致形成癖块，详情在积聚门中。
血热，《全婴方》说：午间发热，遇夜晚则凉爽，这是血热，服用六合汤。
麻痘热，表现为面赤足冷，身体发出壮热，打哈欠烦闷，咳嗽腰疼，呕吐作惊，腹痛自痢，中指鼻尖耳朵冷，这是麻痘热。
〔附方〕
泻心汤：黄连一两研为末，清水调服五分。
泻青丸：见惊风症内。
泻黄丸：藿香、山栀、石膏、防风、甘草。
泻白散：见咳嗽症内。
滋肾地黄丸：黄柏、知母、桂枝。
导赤散：见惊风症内。
大柴胡汤：见疟疾症内。
小柴胡汤：见诸吐症内。
百解散：干葛、麻黄、黄芩、桂枝、赤芍药、甘草。
凉惊丸：黄连、防风、川芎、薄荷、大黄、胆草，蜜丸，青黛为衣。
安神丸：见疳积症内。
元戎四物二连汤：当归、芍药、川芎、黄连、生地、胡黄连。
参苓白术散：见诸泻症内。
下积丸：丁香、砂仁、川巴豆、使君子。
火府丹：生地、木通、黄芩、甘草。
通圣散：防风、荆芥、当归、芍药、薄荷、黄芩、连翘、石膏、滑石、川芎、麻黄、桔梗、朴硝、山栀、大黄、白术、甘草。
一粒金丹：人参、犀角、琥珀、玳瑁、防风、茯苓、冰片、朱砂、寒水石、甘草，米糊为丸，金箔为衣，麦冬汤送下。
清解散：防风、天麻、前胡、茯苓、桔梗、枳壳、细辛、柴胡、川芎、甘草。
犀角丸：犀角、珍珠、防风、羌活、茯神、大黄、天竺黄、朱砂、甘草，立夏前宜服。
钱氏白术散：人参、白术、茯苓、藿香、干葛、木香、甘草。
四君子汤：见惊风症内。
六合汤：当归、川芎、大黄、熟地。
General Principles: Fever syndromes invariably begin with excess (Shi syndrome) of pathogenic factors, subsequently transmitting to deficiency (Xu syndrome) of healthy Qi, ultimately forming a deficiency pattern. When heat is present in the body, one should first eliminate the heat; if deficiency is encountered amidst the heat, one should first tonify the deficiency.
Pulse Diagnosis: A pulse that is deep and rapid indicates heat within the bone marrow, where pressing the abdomen feels cool. In children, a pulse rate of eight or nine beats per respiration indicates fever. A floating, large, and rapid pulse indicates wind-heat. A forceful pulse indicates excess, while a feeble pulse indicates deficiency.
The *Huangdi Neijing* states: "When Yang prevails, there is external heat; when Yang is deficient, there is external cold; when Yin prevails, there is internal cold; when Yin is deficient, there is internal heat. When Yin and Yang prevail against each other, there is alternating chills and fever."
It also states: "When Yang is insufficient, there is first cold then heat; when Yin is insufficient, there is first heat then cold. If Yin and Yang do not remain in their proper divisions, there is a struggle between cold and heat."
Furthermore: "In Liver Heat Disease, the left cheek becomes red first; in Heart Heat Disease, the forehead becomes red first; in Spleen Heat Disease, the nose becomes red first; in Lung Heat Disease, the right cheek becomes red first; in Kidney Heat Disease, the chin becomes red first. Although the disease has not yet fully manifested, its symptoms are already visible on the face." (Self-commentary: Formulas for treating heat in the Six Channels: For Heart heat, use Xie Xin Tang; for Liver heat, use Xie Qing Wan; for Spleen heat, use Xie Huang Wan; for Lung heat, use Xie Bai San; for Kidney heat, use Zi Shen Di Huang Wan; for Small Intestine heat, use Dao Chi San.)
Fever varies in severity. There is what is called "Xi Xi Fa Re" (fever like feathers covering), where the heat feels superficial and belongs to the Exterior syndrome. This is caused by Wind-Cold pathogens lodging in the skin, leading to the stagnation of Yang Qi, and should be treated with diaphoresis to disperse it. There is also "Zheng Zheng Fa Re" (steaming fever), resembling steaming vapors, where the heat is internal and belongs to the Interior syndrome. This is caused by Yang Qi sinking into the Yin aspect, and the method should involve purgation to cleanse it. If the Exterior syndrome has not resolved but the pathogen has transmitted to the Interior, yet the Interior has not formed excess, this lies between the Exterior and Interior. Here, both Exterior and Interior exhibit fever, but it is lighter than pure Interior fever, indicating the pathogen is purely at the Exterior. Fever accompanied by aversion to cold originates from the Yang channels; absence of fever but presence of aversion to cold originates from the Yin channels.
Children are born with Pure Yang constitution, possessing robust blood and Qi, making their Five Zang organs prone to generating heat. Since heat syndromes vary, treatments differ accordingly.
Tidal fever occurs either at noon or in the late afternoon, arriving as punctually as the tide.
The *Shanghan Lun* states: "Tidal fever is excessive heat, and one should promote bowel movements. However, deficiency patterns can also cause tidal fever, requiring warm tonifying agents." If the pulse is excess, Da Chai Hu Tang should be used for purgation; if the pulse is deficient, floating, and rapid, Bai Jie San should be used for diaphoresis. If fever is accompanied by vomiting, Xiao Chai Hu Tang is the primary treatment.
Jing Re (Startling Heat) presents with generalized fever, cyanotic complexion, spontaneous sweating, palpitations, restlessness, rapid pulse, screaming, and mental confusion. It is primarily treated with Qian's Jing Feng Wan and An Shen Wan.
Ye Re (Night Fever) involves fever only at night, indicating Yang pathogens within the Yin aspect. Yuan Rong Si Wu Er Lian Tang is appropriate. However, night fever has diverse manifestations; one must distinguish between excess and deficiency, and clarify the Exterior and Interior, before administering medication. Blindly using Yuan Rong Tang is inappropriate.
Yu Re (Residual Heat) refers to residual heat left after incomplete elimination of Cold pathogens. Ren Zhai stated: "After sweating or purging in Shanghan, if fever returns, it is due to emptiness in both Exterior and Interior, Qi failing to return to its origin, and Yang floating externally. Cool herbs should not be used again, as eliminating heat may induce cold. Shu He explained this in detail." One should harmonize Stomach Qi to allow Yang Qi to converge internally, stopping the fever naturally. Shen Ling Bai Zhu San is suitable.
Shi Re (Food Heat) presents with hot palms, abdominal heat, belching, regurgitation of milk, and sour-smelling stool. Xia Ji Wan is indicated.
Gan Syndrome (Malnutrition Syndrome) presents with emaciation, polydipsia, bone-stealing night sweats, irregular diarrhea, distended abdomen, and weak legs. Herbs such as Hu Huang Lian are suitable; refer to the Gan Ji chapter for detailed regulation.
Zhuang Re (Violent Fever) persists continuously, involving heat in both Exterior and Interior, with irritability, thirst, restlessness, panting, and coarse breathing, potentially leading to convulsions. Huo Fu Dan and Tong Sheng San are indicated.
Fan Re (Irritable Heat) presents with mental irritability, five-palm heat, and dark, scanty urine. Yi Li Jin Dan is indicated.
Ji Re (Accumulation Heat) presents with swollen eyelids, sallow complexion, cold feet, and fever most severe from head to abdomen. Treatment details are found in the discussion on Injury Accumulation.
Feng Re (Wind-Heat) presents with yawning, facial redness, aversion to wind, fever, dry eyes, and somnolence due to Wind pathogens lodging in the skin/hair and invading the Zang-Fu. Excess Yang leads to body heat without sweat; excess Yin leads to body cold with sweat; excess of both Yin and Yang leads to no sweat and cold. The *Suwen* states: "Sweating with body heat is Wind-Heat," treated with Qing Jie San and Xi Jiao Wan.
Xu Re (Deficiency Heat) presents with irregular fever after illness, cyanotic-pale complexion, fatigue, weakness, diarrhea, frequent urination, spontaneous sweating, and lethargic spirit.
Prolonged illness depletes Blood and Qi. Qi deficiency leads to Jue (syncope/cold extremities); Blood deficiency leads to fever. Deficiency of both Blood and Qi leads to cold extremities and body heat. Qian Shi Bai Zhu San or Si Jun Zi Tang are suitable. Severe cases require the "Following Method" (Cong Zhi), assisted by Ginger and Fu Zi, exemplifying the principle of "Sweet-Warm herbs removing great heat."
Bian Zheng Re (Developmental Fever) presents with mild warmth, coarse breathing, startle, poor sucking, diarrhea, and water-bubble-like appearance on the upper lip tip. Medication is unnecessary. If accompanied by other symptoms, slight harmonization based on the specific condition is advised.
Pi Re (Mass Heat) involves salivation, coughing, and drinking water, caused by undigested milk/food stagnating in the Middle Jiao, forming masses. See the Ji Ju chapter.
Han Re (Chills and Fever) resembles malaria, caused by Yin-Yang mutual prevalence. See the Malaria chapter.
Xue Re (Blood Heat): The *Quan Ying Fang* states: "Heat during midday, cooling at night." Liu He Tang is administered.
Ma Dou Re (Smallpox/Measles Fever) presents with facial redness, cold feet, violent fever, yawning, irritability, cough, back pain, vomiting, convulsions, abdominal pain, dysentery, and cold middle fingers, nose tip, and ears.
[Attached Formulas]
Xie Xin Tang: Coptis Rhizome (Huanglian), 1 liang, powdered, taken with clear water, 5 fen.
Xie Qing Wan: See Jing Feng Syndrome section.
Xie Huang Wan: Patchouli Leaf (Huoxiang), Gardenia Fruit (Shanzhi), Gypsum (Shigao), Saposhnikovia Root (Fangfeng), Licorice Root (Gancao).
Xie Bai San: See Cough Syndrome section.
Zi Shen Di Huang Wan: Phellodendron Bark (Huangbai), Anemarrhena Rhizome (Zhimu), Cinnamon Twig (Guizhi).
Dao Chi San: See Jing Feng Syndrome section.
Da Chai Hu Tang: See Malaria Syndrome section.
Xiao Chai Hu Tang: See Vomiting Syndromes section.
Bai Jie San: Kudzu Root (Gegen), Ephedra Stem (Mahuang), Scutellaria Root (Huangqin), Cinnamon Twig (Guizhi), Red Peony Root (Chishaoyao), Licorice Root (Gancao).
Liang Jing Wan: Coptis Rhizome (Huanglian), Saposhnikovia Root (Fangfeng), Ligusticum Rhizome (Chuanxiong), Mint Herb (Bohe), Rhubarb Root (Dahuang), Gentian Root (Dancao), honey pills, coated with Indigo Naturalis (Qingdai).
An Shen Wan: See Gan Ji Syndrome section.
Yuan Rong Si Wu Er Lian Tang: Angelica Sinensis Root (Danggui), Peony Root (Shaoyao), Ligusticum Rhizome (Chuanxiong), Coptis Rhizome (Huanglian), Rehmannia Root (Shengdi), Picrorhiza Rhizome (Huhuanglian).
Shen Ling Bai Zhu San: See Diarrhea Syndromes section.
Xia Ji Wan: Clove Bud (Dingxiang), Amomum Fruit (Sharen), Croton Seed (Chuan Badou), Quisqualis Fruit (Shijunzi).
Huo Fu Dan: Rehmannia Root (Shengdi), Akebia Stem (Mutong), Scutellaria Root (Huangqin), Licorice Root (Gancao).
Tong Sheng San: Saposhnikovia Root (Fangfeng), Schizonepeta Spike (Jingjie), Angelica Sinensis Root (Danggui), Peony Root (Shaoyao), Mint Herb (Bohe), Scutellaria Root (Huangqin), Forsythia Fruit (Lianqiao), Gypsum (Shigao), Talcum (Huashi), Ligusticum Rhizome (Chuanxiong), Ephedra Stem (Mahuang), Platycodon Root (Jiegeng), Mirabilite (Puxiao), Gardenia Fruit (Shanzhi), Rhubarb Root (Dahuang), Atractylodes Macrocephala Rhizome (Baizhu), Licorice Root (Gancao).
Yi Li Jin Dan: Ginseng Root (Renshen), Rhino Horn (Xijiao), Amber (Hupo), Trichosaurus Squama (Daimao), Saposhnikovia Root (Fangfeng), Poria (Fuling), Borneol (Bingpian), Cinnabar (Zhusha), Aragonite (Hanshuishi), Licorice Root (Gancao), rice paste pills, coated with Gold Foil, taken with Ophiopogon Decoction (Maidong Tang).
Qing Jie San: Saposhnikovia Root (Fangfeng), Gastrodia Rhizome (Tianma), Peucedanum Root (Qianhu), Poria (Fuling), Platycodon Root (Jiegeng), Aurantium Fruit (Zhike), Asarum Root (Xixin), Bupleurum Root (Chaihu), Ligusticum Rhizome (Chuanxiong), Licorice Root (Gancao).
Xi Jiao Wan: Rhino Horn (Xijiao), Pearl (Zhenzhu), Saposhnikovia Root (Fangfeng), Notopterygium Rhizome (Qianghuo), Poria (Fushen), Rhubarb Root (Dahuang), Hyacinth Bean Meal (Tianzhuhuang), Cinnabar (Zhusha), Licorice Root (Gancao). Suitable for consumption before Start of Summer.
Qian Shi Bai Zhu San: Ginseng Root (Renshen), Atractylodes Macrocephala Rhizome (Baizhu), Poria (Fuling), Patchouli Leaf (Huoxiang), Kudzu Root (Gegen), Aucklandia Root (Muxiang), Licorice Root (Gancao).
Si Jun Zi Tang: See Jing Feng Syndrome section.
Liu He Tang: Angelica Sinensis Root (Danggui), Ligusticum Rhizome (Chuanxiong), Rhubarb Root (Dahuang), Prepared Rehmannia Root (Shudi).