伤寒发热者。谓怫怫然发于皮肤之间。 然而散者是也。与潮热寒热若同而异。与烦
躁相
于发
所谓翕翕发热者。明其热在外也。故与桂枝汤发汗以散之。所谓蒸蒸发热者。明其热在内也
。故与调胃承气汤攻下以涤之。其发热属表者。即风邪客于皮肤。阳气怫郁所致也。其发热
属
而
而
罢。邪
外达于
其在半
阳也。无
附子细辛
热也。经
为汗衰。狂言不能食者。此名阴阳交。交者死也。此亦忌发热也。讵可与寻常发热一概而论
耶。医者
活人书云。发热而恶寒者。属太阳也。太阳病。必发热而恶寒。盖太阳主气。以温皮肤
分肉
恶寒
为温
汤微
承气
仲景云。太阳证。汗后不恶寒但恶热者实也。当和其胃气。宜调胃承气汤。太阳病。三
日。
发热。小柴胡汤主之。不可发汗。发汗则谵语。病患不渴。外有微热者。小柴胡汤加桂枝主
之。此
身热不
已。身
热相搏
下之。
也。抵
阴证有
发热
热在
不消
汤主之
伤寒烦热者。与发热同而异也。发热者。怫怫然发于肌表。有时而已者是也。烦者。为
烦而
之烦
汤。
烦疼
烦。
与脉
泄
伤寒舌上苔者。盖舌乃心之官。法应南方火。本红而泽。伤寒三日以后。舌上有膜。白
滑如
气传里
皆舌
胁
下
脏
则舌上之苔不滑而涩矣。经曰。伤寒七八日不解。热结在里。表里俱热。时时恶风。大渴。
舌上干燥而烦。欲饮水数升者。白虎加人参汤主之。是热耗津液。而胃汁已干也。若热聚于
胃。则舌为之黄。是热邪已深也。金匮要略曰。舌黄未下者。下之黄自去。若舌上色黑者。
又为热之极也。黄帝针经曰。热病舌干黑者死。以心为君主之官。开窍于舌。黑为肾色见于
心。心属火。肾属水。邪热已极。鬼贼相刑。故知必死。观其口舌。亦可见其逆顺矣。
歌括曰。饮食如常时下利。更见舌上白苔时。连脐痛引阴筋者。脏结元来死不医。无阴
证。
又曰。舌苔大热疗应难。利腹疼兮呕恶寒。懊 胁坚并中满。更兼脏结六条看。尺寸脉
紧。口中热气而干燥。足冷蜷卧。鼻中涕出。舌上苔滑。勿妄治也。或七八日以来微热。手
足温
者必欲
人懊
满。不
湿故也
伤寒发热，是指热气怫郁（郁结不畅）地发于皮肤之间，从而得以发散的情况。这与潮热、寒热往来相似但又有不同。
所谓“翕翕发热”，是明确说明热邪在体表。因此使用桂枝汤发汗以疏散表邪。
所谓“蒸蒸发热”，是明确说明热邪在体内。因此使用调胃承气汤攻下以涤荡里热。
那些发热属于表证的，是因为风邪客居于皮肤，导致阳气怫郁所致。
那些发热属于半表半里的……（原文此处有缺漏/断裂）……而罢。邪气外达于……其在半……阳也。无……附子细辛……热也。经……为汗衰。狂言不能食者，这名叫阴阳交。交者死证。这也是忌讳发热的情况。岂能与普通发热一概而论呢？医者……
《活人书》说：发热且恶寒的，属于太阳病。太阳病，必定发热且恶寒。因为太阳主气，负责温煦皮肤和分肉……恶寒……为温……汤微……承气……
仲景说：太阳证，发汗后不恶寒只恶热的，是实证。应当调和胃气，宜用调胃承气汤。太阳病，经过三天……发热，用小柴胡汤主治。不可发汗，发汗则会出现谵语。病患如果不渴，外有微热的，用小柴胡汤加桂枝主治。此……身热不……已。身……热相搏……下之……也。抵……阴证有……发热……热在……不消……汤主之。
伤寒烦热，与发热相同但又有不同。发热，是热气怫郁发于肌表，有时发作有时停止的情况。烦，是……烦而……之烦……汤。烦疼……烦。与脉……泄。
伤寒舌上生苔，大概是因为舌是心的官窍，法象对应南方的火，本应红润而有光泽。伤寒三天以后，舌上有膜，白滑如……气传里……皆舌……胁……下……脏……则舌上的苔不滑而涩了。经文说：伤寒七八天不解，热结在体内，表里都热，时时恶风，大渴，舌上干燥而烦，想要喝几升水的，用白虎加人参汤主治。这是热耗伤津液，而胃汁已经干枯了。如果热聚积在胃，那么舌就会变黄，这是热邪已经很深了。《金匮要略》说：舌苔黄而未用下法的，用下法后黄苔自去。如果舌色变黑的，又是热到了极点。《黄帝针经》说：热病舌干黑的会死。因为心是君主之官，开窍于舌，黑是肾的颜色出现在心上。心属火，肾属水，邪热已到极点，鬼贼相刑（五行相克太过），所以知道必死。观察口舌，也可以看出病情的逆顺了。
歌诀说：饮食如常时下利，更见舌上白苔时。连脐痛引阴筋者，脏结本来死不医。无阴证。又曰：舌苔大热疗应难，利腹疼兮呕恶寒。懊侬胁坚并中满，更兼脏结六条看。尺寸脉紧，口中热气而干燥，足冷蜷卧，鼻中涕出，舌上苔滑，不要妄加治疗。或七八日以来微热，手足温……者必欲……人懊……满。不……湿故也。
In cold damage (Shanghan), fever refers to heat accumulating and obstructing at the skin level, allowing it to dissipate. This is similar yet distinct from tidal fever (Chao Re) and alternating chills and fever (Han Re).
The term "Xi Xi Fever" (翕翕发热) clearly indicates that the heat is exterior. Therefore, Guizhi Tang (Cinnamon Twig Decoction) is used to induce sweating and disperse the pathogen.
The term "Zheng Zheng Fever" (蒸蒸发热) clearly indicates that the heat is interior. Therefore, Tiaowei Chengqi Tang (Regulating the Stomach and Directing Downward Decoction) is used to purge and cleanse the interior heat.
Fever belonging to the exterior syndrome results from wind pathogens lodging in the skin, causing an obstruction of Yang Qi.
[Text fragment: Fevers belonging to the half-exterior/half-interior...] ...and subsides. The pathogen reaches outward... at the half... Yang. No... Fuzi Xixin [Aconite Root and Asarum]... heat. Classic says... reduced by sweat. Delirious speech and inability to eat is named Yin-Yang Jiao (Yin-Yang Intersection). Intersection implies death. This is also a contraindication for fever. How can it be treated uniformly with ordinary fever? Physicians...
*Huoren Shu* (Book of Living People) states: Fever accompanied by aversion to cold belongs to the Taiyang (Greater Yang) channel. Taiyang disease must present with fever and aversion to cold. Because Taiyang governs Qi, warming the skin and muscle layers... aversion to cold... for warmth... Tang slightly... Chengqi [Decoction].
Jing Yue (Zhang Zhongjing) states: In Taiyang syndrome, if after sweating there is no aversion to cold but only aversion to heat, it is an excess condition. One should harmonize the Stomach Qi, preferably using Tiaowei Chengqi Tang. In Taiyang disease, after three days... fever, Xiao Chaihu Tang (Minor Bupleurum Decoction) is the primary treatment. Sweating is contraindicated; if sweating is induced, delirium will occur. If the patient has no thirst and slight exterior heat remains, Xiao Chaihu Tang plus Guizhi (Cinnamon Twig) is indicated. This... body heat not... ceased. Body... heat fighting... purging... Yes. Di... Yin syndromes have... fever... heat in... does not subside... Tang treats it.
Cold damage with vexatious heat (Fan Re) is similar to but distinct from simple fever. Fever involves heat obstructing at the muscle surface, occurring intermittently. Vexation involves... vexation and... of vexation... Tang. Vexatious pain... vexation. With pulse... purgation.
In cold damage, coating on the tongue generally occurs because the tongue is the orifice of the Heart, corresponding to the Fire element of the South, and should naturally be red and lustrous. After three days of cold damage, a membrane appears on the tongue, white and slippery like... Qi transmitting to the interior... all tongue... hypochondrium... below... Zang organs... then the coating on the tongue becomes non-slippery and rough. The Classics state: If cold damage persists for seven to eight days without resolution, heat binds in the interior, presenting with heat in both exterior and interior, occasional aversion to wind, severe thirst, dryness and vexation of the tongue, and a desire to drink several liters of water, Baihu Jia Renshen Tang (White Tiger Plus Ginseng Decoction) is indicated. This indicates that heat has consumed the body fluids, and the Stomach juices are dried up. If heat accumulates in the Stomach, the tongue turns yellow, indicating deep-seated heat pathogens. *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) states: If the tongue is yellow and purgatives have not yet been used, applying purgation will cause the yellow coating to disappear. If the tongue color turns black, it signifies extreme heat. *Huangdi Zhenjing* (Yellow Emperor's Classic of Acupuncture) states: Death ensues in heat diseases when the tongue is dry and black. Since the Heart is the sovereign organ opening into the tongue, and black is the color of the Kidney appearing on the Heart (Fire), while the Kidney is Water, the extreme heat causes mutual destruction (Water overcoming Fire excessively), thus indicating certain death. Observing the mouth and tongue reveals the favorable or unfavorable course of the disease.
Song verse states: When digestion is normal but diarrhea occurs, and a white coating appears on the tongue, pain connecting the navel and drawing to the genital tendons indicates Zang Jie (Organ Knotting), which is originally incurable and fatal. Absence of Yin syndromes. Also stated: Tongue coating in great heat is difficult to treat; diarrhea, abdominal pain, vomiting, and aversion to cold accompany it. Restlessness, hardness in the hypochondrium, and fullness in the center, along with six signs of Zang Jie, should be observed. Tight pulses at Cun and Chi positions, hot breath and dryness in the mouth, cold feet with curled posture, runny nose, and a slippery coating on the tongue indicate that one should not treat rashly. Or, after seven to eight days, slight heat, warm hands and feet... must desire... person restless... fullness. Not... wetness reason.