虚热者，因患后平复，血气未匀，四体羸弱，时多发热，治宜调气补虚，其热
自退，如钱氏白术散、异功散、四君子汤、之类，或未退，人参生犀散治之。〔杨〕
虚则面色青白，恍忽神缓，口中清冷，嘘气软弱，泄泻多尿，夜出虚汗，宜惺惺散。
〔薛〕又有喜热恶寒，乍凉乍温，怫郁惊惕，上盛下泄，屈体而卧，睡而露睛，手足
指冷等证。〔曾〕虚热，因病后发热无时，一日三五次者，此客热乘虚而作，先以
胃苓汤加黄 末，温米清汤调服，次投钱氏白术散，或固真汤带凉服，及用温盐汤
参入凉水，送下黑锡丹固守元气。海藏云∶风热邪热，四君子汤加生姜、荆芥、
煎。云岐云∶小儿客热在内，先用导赤散，次用益黄散。薛氏，以虚实分属表里，
及热盛拒阴、寒盛格阳、血虚气虚发热等证，俱仲景东垣诸圣医辨证妙法，宜详
玩而熟记之，则虚热似实热之证，庶几不至误认而全活众矣。〔钱〕朱监簿子五岁，
忽发热。医曰此心热也，腮赤而唇红，烦躁引饮，遂用牛黄丸三服，以一物泻心汤
下之。来日不愈，反加无力而不能食，又下之，便利黄沫。钱曰心经虚而有留热在
内，必被凉药下之，致此虚劳之病也，钱先用白术散生胃中津液，次以生犀散治之。
朱曰大便黄沫如何？曰胃气正，即泻自止，虚热也。朱曰医用泻心汤如何？钱曰泻
心汤者，黄连一物耳，黄连性寒，多服则利，能寒脾胃也。坐久，众医至，皆曰实
热。钱曰虚热，若实热，何以泻心汤下之不安，又加面黄颊赤，五心烦躁，不食而
引饮。医曰既虚热，何大便黄沫？钱笑曰，便黄沫者，服泻心汤多故也。钱与胡黄
连丸，治愈。郑人齐郎中者，家好收药散施，其子忽脏热，齐自取青金膏三服并一
服饵之，服毕，至三更，泻五行，其子困睡。齐言子睡多惊，又与青金膏一服，又
泻三行，加口干身热。齐言尚有微热未尽，又与青金膏。其妻曰，用药十余行未安，
莫生他病否，召钱氏至。曰已成虚羸，先用前白术散时时服之，后服香瓜丸，十三
日愈。嘉靖甲寅，敬臣之女年十二，患脾胃素弱，自夏入秋，时泻时止，小腹微
痛，至八九月间，遂成疳积之证，发热凡二十余日不止，汗泄热解，汗已复热，自
中脘至小腹膨胀坚直，大便溏，气喘咳嗽作嗳，俱昼轻夜重，彻夜烦躁不睡，鼻塞
眼暗 语。其母以为必死矣。立斋先生诊之曰，脉浮大而无根，此大虚证也，非独
参汤不可。乃用参一两，加熟附三分、煨生姜三片，日进二剂，仍并渣煎服之，大
下疳积，其气则腥，腹渐宽，热渐减，脉渐敛，然手犹寻捻不已，鼻孔出血。先生
曰，此肝证也，煎六味丸料与之，一服如脱。乃昼服独参姜附汤，夜服六味丸料，
脉渐有根，诸证渐退。先此手足恒热，至是乃始觉寒，先生喜曰，此病邪尽退，而
真气见矣。然犹饮食不进，乃单用六君子汤加炮姜，遂能食，咳嗽独甚，与补中益
气汤，嗽遂止，夜始有睡。凡弱女之得生，皆先生力也，向非先生卓有定见，专治
其本而其末自愈，则为丘中之骨，必矣！敬书施疗之颠末，以告同患此者，幸无所
误。亦推展先生一念之仁于万一云尔。王敬臣书。
惺惺散（方见痘疹） 钱氏白术散（方见渴） 异功散（方见吐泻） 人参生犀散（见后条）
固真汤（见慢惊） 黑锡丹（见杂病头痛）
当归补血汤 治肌热躁热目赤，面红烦渴，昼夜不息，其脉洪大而虚，重按全无，
此脉虚血虚也，若误服白虎汤，必死，宜此主之。
黄 （三钱） 当归（一钱）
上，水煎服。
补中益气汤 治中气虚弱，体疲食少，或发热烦渴等证。
人参 黄 （各八分） 白术 甘草 陈皮（各五分） 升麻 柴胡（各二分） 当归（三分）
上，姜枣水煎，空心午前服。
加味逍遥散 去牡丹皮山栀即逍遥散。治肝脾血虚等证。
当归 甘草（炙） 芍药（酒炒） 茯苓 白术（炒） 柴胡（各一钱） 牡丹皮 山栀（炒。各七分）
上，水煎服。
愚按∶前方，若乳母肝脾血虚，内热寒热，遍身搔痒，肢体作疼，头目昏
重，怔忡颊赤，口燥咽干。或发热盗汗，食少不寐。或口舌生疮，耳内作痛，胸
乳腹胀，小便不利，致儿为患，尤宜用之。又治妇人阴虚发热，儿饮其乳以致患
疮者。
虚热，是指病后身体刚恢复，气血尚未调和，四肢形体瘦弱，时常出现发热的症状。治疗应当以调气补虚为主，发热自然消退，可以使用钱乙的白术散、异功散、四君子汤等方剂；如果发热仍未退去，用人参生犀散治疗。〔杨〕虚证表现为面色青白，神情恍惚且反应迟钝，口中感觉清冷，呼吸气息微弱，腹泻且小便频多，夜间出虚汗，适宜使用惺惺散。〔薛〕又有喜欢温暖而厌恶寒冷，体温忽凉忽温，烦躁郁闷且易受惊惕，上部邪盛下部泄泻，蜷缩身体躺卧，睡眠时眼睛半睁（露睛），手足指头冰冷等症状。〔曾〕虚热，是指因病后发热没有固定时间，一天发作三到五次，这是外来的客热乘虚而入所致。先使用胃苓汤加黄连末，用温米汤调服；随后投予钱氏白术散，或者将固真汤放凉后服用；以及用温盐水掺入凉水，送服黑锡丹以固守元气。海藏说：风热邪热，可用四君子汤加生姜、荆芥煎服。云岐说：小儿客热在内，先用导赤散，再用益黄散。薛氏认为，应根据虚实分属表里，以及热盛拒阴、寒盛格阳、血虚气虚发热等证候，这些都是张仲景、李东垣等圣医辨证施治的妙法，应当详细研读并熟记，那么对于虚热似实热的证候，才不至于误认从而保全性命。〔钱〕朱监簿的儿子五岁，忽然发热。医生说这是心热，面颊红唇色红，烦躁引水饮用，于是服用牛黄丸三次，并用一物泻心汤送下。第二天病情未愈，反而更加无力且不能进食，又用泻下法，导致大便排出黄色泡沫状物。钱乙说：心经本虚而有留热在内，必然被凉药攻下，导致这种虚劳的病证。钱乙先用白术散滋生胃中津液，接着用生犀散治疗。朱氏问：大便为什么是黄色泡沫？回答说：胃气恢复正常，腹泻自然会停止，这是虚热。朱氏问：医生为什么用泻心汤？钱乙说：泻心汤不过是黄连一味药，黄连性寒，多服则导致腹泻，能损伤脾胃。坐了很久，众位医生到来，都说这是实热。钱乙说这是虚热，如果是实热，为什么用了泻心汤攻下后不安宁，反而加上面色黄两颊红，五心烦热，不吃东西却想喝水？医生说：既然是虚热，为什么大便是黄色泡沫？钱乙笑着说：大便呈黄色泡沫，是因为服用泻心汤过多的缘故。钱乙给予胡黄连丸，治愈了疾病。郑地人齐郎中，家里喜欢收集药散施舍给他人，他的孩子忽然内脏发热，齐某自己取青金膏三次并喂服一次，服完后，到了三更天，腹泻五次，孩子昏睡。齐某说孩子睡觉多惊悸，又给青金膏一次，又腹泻三次，加上口干身热。齐某说还有微热未尽，又给青金膏。他的妻子说：用药十余次都不安宁，难道不会生出其他病吗？于是召请钱乙前来。钱乙说：已经形成虚羸之证，先用前面的白术散时时服用，后来服用香瓜丸，十三日痊愈。嘉靖甲寅年，敬臣的女儿十二岁，患脾胃素来虚弱，从夏天进入秋天，时而腹泻时而停止，小腹微痛，到了八九月间，遂成疳积之证，发热二十多天不止，出汗后热退，汗止后又发热，从中脘到小腹膨胀坚直，大便溏薄，气喘咳嗽打嗝，都白天轻晚上重，彻夜烦躁不睡觉，鼻塞眼暗语声低微。她的母亲认为必死无疑。立斋先生诊察说：脉浮大而无根，这是大虚证，非独参汤不可。于是用人参一两，加熟附子三分、煨生姜三片，每天进两剂，连渣一起煎服，大量排出疳积之物，气味腥臭，腹部逐渐变宽，热势逐渐减退，脉象逐渐收敛，但是手还在不停地寻捻动作，鼻孔出血。先生说：这是肝证，煎六味丸料给她，一服如释重负。于是白天服独参姜附汤，晚上服六味丸料，脉象逐渐有根，各种症状逐渐消退。在此之前手足恒常发热，至此才开始觉得寒冷，先生高兴地说：这是病邪完全退去，而真气显现了。然而仍然饮食不进，于是单用六君子汤加炮姜，便能进食，咳嗽特别严重，给予补中益气汤，咳嗽随即停止，夜晚才开始有睡眠。凡是弱女能够存活，都是先生的功劳，如果不是先生卓有定见，专门治疗其根本而其末节自愈，那就成为丘中之骨（尸体）了！恭敬记录施疗的始末，以此告知同样患有此病的人，希望不要误诊。也是推广先生一念之仁于万一罢了。王敬臣书。
惺惺散（方剂见痘疹篇） 钱氏白术散（方剂见渴篇） 异功散（方剂见吐泻篇） 人参生犀散（见后条） 固真汤（见慢惊风篇） 黑锡丹（见杂病头痛篇）
当归补血汤，治疗肌热躁热目赤，面红烦渴，昼夜不息，其脉洪大而虚，重按全无，这是脉虚血虚的症状，如果误服白虎汤，必死，宜用此方主治。
黄芪（三钱） 当归（一钱）
以上药材，用水煎服。
补中益气汤，治疗中气虚弱，身体疲乏食少，或发热烦渴等症状。
人参 黄芪（各八分） 白术 甘草 陈皮（各五分） 升麻 柴胡（各二分） 当归（三分）
以上药材，用姜枣水煎，空腹午前服用。
加味逍遥散，去掉牡丹皮、山栀即为逍遥散。治疗肝脾血虚等症状。
当归 甘草（炙） 芍药（酒炒） 茯苓 白术（炒） 柴胡（各一钱） 牡丹皮 山栀（炒。各七分）
以上药材，用水煎服。
愚按：前方，如果乳母肝脾血虚，内热寒热交替，遍身搔痒，肢体作疼，头目昏重，怔忡颊赤，口燥咽干。或发热盗汗，食少不寐。或口舌生疮，耳内作痛，胸乳腹胀，小便不利，导致婴儿患病，尤其适宜使用此方。又治疗妇人阴虚发热，婴儿饮其乳汁以致患疮的情况。
Deficient heat refers to the condition occurring after recovery from illness, where qi and blood are not yet harmonized, the four limbs are emaciated and weak, and fever occurs frequently. The treatment should focus on regulating qi and tonifying deficiency, after which the fever will naturally subside. Formulas such as Qian's Baizhu San (Atractylodes Macrocephala Powder by Dr. Qian), Yigong San (Yi Gong Powder), and Sijunzi Tang (Four Gentlemen Decoction) can be used; if the fever does not subside, Rensheng Shengxi San (Ginseng and Rhinoceros Horn Powder) is indicated. [Yang] Deficiency manifests as a bluish-white complexion, absent-mindedness with sluggish spirit, a cold sensation in the mouth, weak respiration, diarrhea with frequent urination, night sweats, and is suitable for Xingxing San (Xingxing Powder). [Xue] There are also symptoms of preferring warmth and fearing cold, alternating chills and fever, irritability with fright and startle, excess above and diarrhea below, lying curled up, sleeping with eyes partially open (exposed eyes), and cold fingers and toes. [Zeng] Deficient heat refers to fever without a fixed time after illness, occurring three to five times a day; this is caused by exogenous pathogenic heat taking advantage of deficiency. Initially, Weiling Tang (Weiling Decoction) added with Coptis chinensis powder is administered, mixed with warm rice water; subsequently, Qian's Baizhu San is given, or Guzhen Tang (Guzhen Decoction) is taken when cool; additionally, black tin pill (Heixi Dan) is sent down with warm salt water mixed with cool water to consolidate primordial qi. Haicang stated: For wind-heat and pathogenic heat, Sijunzi Tang added with fresh ginger and Schizonepeta can be decocted. Yunqi stated: For pediatric exogenous heat retained inside, use Daochi San (Daochi Powder) first, then Yi Huang San (Yi Huang Powder). Dr. Xue believed that one should differentiate between deficiency and excess regarding exterior and interior, as well as conditions like heat excess rejecting yin, cold excess repelling yang, and fever due to blood or qi deficiency. These are all subtle methods of syndrome differentiation by sages such as Zhang Zhongjing and Li Dongyuan. One should study them carefully and memorize them thoroughly, so that deficient heat resembling excess heat will not be misdiagnosed, thereby saving many lives. [Qian] The son of Supervisor Zhu, aged five, suddenly developed fever. The physician said this was heart heat, characterized by red cheeks and lips, irritability, and thirst prompting drinking. Three doses of Niuhuang Wan (Calculus Bovis Pill) were administered, washed down with Yiwu Xiexin Tang (One-Ingredient Xiexin Decoction). The next day, the condition did not improve; instead, weakness increased and appetite was lost. Another purgative was given, resulting in yellow frothy stools. Qian Yi said: The heart meridian is deficient with residual heat retained inside; it must have been damaged by cold purgatives, leading to this consumptive disease. Qian Yi first used Baizhu San to generate fluids in the stomach, then treated with Shengxi San. Mr. Zhu asked: Why yellow frothy stool? The answer was: When stomach qi recovers, diarrhea stops naturally; this is deficient heat. Mr. Zhu asked: Why did the doctor use Xiexin Tang? Qian Yi said: Xiexin Tang consists only of Coptis chinensis. Coptis is cold in nature; excessive use causes diarrhea and damages the spleen and stomach. After sitting for a long time, other physicians arrived, all stating it was excess heat. Qian Yi said it was deficient heat. If it were excess heat, why would purging with Xiexin Tang cause discomfort, and why add yellow face, red cheeks, five-palm heat, anorexia, and thirst? The physician asked: Since it is deficient heat, why is the stool yellow froth? Qian Yi smiled and said: Yellow frothy stool is due to excessive consumption of Xiexin Tang. Qian Yi prescribed Huhuanglian Wan (Coptis Chinensis Pill), which cured the disease. Qi Langzhong, a person from Zheng, liked to collect herbal powders to distribute. His son suddenly had internal organ heat. Qi took Qingjin Gao (Green Gold Ointment), three doses plus one dose fed to him. After finishing, at midnight, he had five diarrheal episodes, and the son fell into deep sleep. Qi said the son slept with much fright, and gave another dose of Qingjin Gao. He had three more diarrheal episodes, adding dry mouth and body heat. Qi said there was still slight heat remaining, and gave more Qingjin Gao. His wife said: Using medicine over ten times has not brought peace; could it cause other diseases? They summoned Qian Yi. Qian Yi said: It has become emaciation and deficiency. First, use the aforementioned Baizhu San frequently, then Xianggua Wan (Melon Pill). He recovered in thirteen days. In the Jia Yin year of the Jiajing era, the daughter of Jingchen, aged twelve, suffered from inherently weak spleen and stomach. From summer to autumn, she had intermittent diarrhea, slight lower abdominal pain. By August and September, she developed rickets-like accumulation (Ganji), with continuous fever for over twenty days. Fever subsided with sweat, but returned after sweating stopped. From Zhongwan to lower abdomen, there was distension, hardness, and straightness. Stool was loose, accompanied by asthma, cough, belching, all lighter during the day and heavier at night. She was irritable all night without sleep, had nasal congestion, dim vision, and low voice. Her mother thought death was inevitable. Mr. Lizhai diagnosed: Pulse was floating, large, and rootless; this is a major deficiency syndrome, treatable only with Dushen Tang (Single Ginseng Decoction). He used one liang of Ginseng, added three fen of prepared Aconite and three slices of baked ginger, administering two doses daily, including the dregs. Large amounts of Ganji material were passed, smelling fishy. Abdomen gradually widened, heat decreased, pulse became more contained. However, hands continued to pick at things, and nosebleeds occurred. Mr. Lizhai said: This is a liver syndrome. Decoct Liuwei Wan ingredients for her. One dose felt like relief. Then, Dushen Jiangfu Tang was taken by day, and Liuwei Wan ingredients by night. Pulse gradually gained root, various symptoms receded. Previously, hands and feet were constantly hot; now they felt cold. Mr. Lizhai rejoiced: Disease pathogens have completely retreated, and true qi appears. However, food intake remained poor. Single Liujunzi Tang added with roasted ginger allowed eating. Cough became severe. Buzhong Yiqi Tang was given, cough stopped, and sleep resumed at night. The survival of this weak girl was entirely due to Mr. Lizhai. If not for his firm judgment and treating the root so the branch healed itself, she would certainly have become bones in the grave! I respectfully record the details of the treatment to inform others suffering from this disease, hoping no mistakes are made. This is also an extension of Mr. Lizhai's benevolence. Written by Wang Jingchen.
Xingxing San (Formula see Measles/Rubella section) Qian's Baizhu San (Formula see Thirst section) Yigong San (Formula see Vomiting/Diarrhea section) Rensheng Shengxi San (See following item) Guzhen Tang (Formula see Slow Convulsion section) Heixi Dan (See Miscellaneous Diseases Headache section)
Danggui Buxue Tang treats muscle heat, restlessness, red eyes, red face, vexation, and thirst, unceasing day and night. The pulse is flooding and large but empty, disappearing upon heavy pressure. This indicates pulse deficiency and blood deficiency. If mistakenly administered Baihu Tang (White Tiger Decoction), death is certain. This formula is indicated.
Huangqi (Astragali Radix) (3 qian) Danggui (Angelicae Sinensis Radix) (1 qian)
Decoct in water and take orally.
Buzhong Yiqi Tang treats middle qi deficiency, physical fatigue, poor appetite, or fever with vexation and thirst.
Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix) (each 8 fen) Baizhu (Atractylodis Macrocephalae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Chenpi (Citri Reticulatae Pericarpium) (each 5 fen) Shengma ( Cimicifugae Rhizoma), Chaihu (Bupleuri Radix) (each 2 fen) Danggui (Angelicae Sinensis Radix) (3 fen)
Decoct with fresh ginger and jujube, take on an empty stomach before noon.
Jiawei Xiaoyao San, removing Mudanpi (Moutan Cortex) and Shanzhi (Gardeniae Fructus), is Xiaoyao San. It treats liver and spleen blood deficiency.
Danggui (Angelicae Sinensis Radix), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Shaoyao (Paeoniae Radix Alba, wine-fried), Fuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma, stir-baked), Chaihu (Bupleuri Radix) (each 1 qian) Mudanpi (Moutan Cortex), Shanzhi (Gardeniae Fructus, stir-baked) (each 7 fen)
Decoct in water and take orally.
Commentary: The aforementioned formulas are particularly suitable if the nursing mother suffers from liver and spleen blood deficiency, internal heat with alternating chills and fever, generalized pruritus, limb pain, heavy head and dizzy eyes, palpitations, red cheeks, dry mouth and throat. Or fever with night sweats, poor appetite, insomnia. Or mouth and tongue ulcers, ear pain, chest and breast distension, abdominal fullness, difficult urination, causing illness in the infant. It also treats women with yin deficiency fever, where the infant contracts sores through breastfeeding.