华元化曰∶人之寒热往来者,其病何也?此乃阴阳相胜也。阳不足则先寒后热,阴不足
则先热后寒。又上盛则发热,下盛则发寒。皮寒而躁者阳不足,皮热而躁者阴不足,皮寒而
寒者,阴盛也,皮热而热者,阳盛也。热发于下,则阴中之阳邪也,热发于上,则阳中之阳
邪也。寒起于上,则阳中之阴邪也。寒起于下,则阴中之阴邪也。颊赤多言而寒者,阳中之
阴邪也;面青多言而热者,阴中之阳邪也;面青多言而寒者,阴中之阴邪也。若不言者,不
可治也。阴中之阴中者,一生九死;阳中之阳中者,九生一死。阴病难治,阳病易医。诊其
脉候,滑实在上,则阳中之阳也;滑实在下,则阴中之阳也。微弱在上,则阳中之阴也;微
弱在下,则阴中之阴也。滑实在中则中热,微弱在中则中寒。寒用热取,热以寒攻。逆顺之
法,从乎天地,本乎阴阳也。从之者生,逆之者死。《金匮大要论》曰∶夜发寒者从,夜发
热者逆。昼发热者从,昼发寒者逆。逆从之道,亦在乎审明。
四逆汤(热十四) 理中汤(热一) 四味回阳饮(新热一) 温胃饮(新热五) 暖肝煎(新
热十五) 六味回阳饮(新热二) 寿脾煎(新热十六) 化肝煎(新寒十) 补中益气汤(补三十
)六气煎(新因二一) 归气饮(新热十四) 补阴益气煎(新补十六) 理阴煎(新热三) 五
福饮(新补六) 韩氏温中汤(热八九) 归脾汤(补三二) 五积散(散三九) 五味沉附汤(热
百十六) 右归饮(新补三) 右归丸(新补五) 海藏八味丸(补一二一) 一气丹(新热二二)
九气丹(新热二三) 滋阴八味丸(新寒十七) 一阴煎(新补八) 二阴煎(新补十) 加减一
阴煎(新补九) 玉女煎(新寒十二) 化阴煎(新寒七) 当归六黄汤(寒六五) 白虎汤(寒二)
泻白散(寒四二) 加味逍遥散(补九三) 清化饮(新因十三) 泻黄散(寒五七) 天王补心
丹(补百八) 玉泉散(新寒十五) 太清饮(新寒十三) 三才封髓丹(寒一六六) 保阴煎(新
寒一) 泻心汤(寒二七) 华佗阳脱方(热四六) 抽薪饮(新寒三) 徙薪饮(新寒四) 黄连
解毒汤(寒一) 七正散(寒百十六) 八正散(寒百十五) 黄芩芍药汤(寒百九) 五淋散(寒
百十七) 导赤散(寒一二二) 芍药清肝散(寒六一) 正气汤(寒六六) 凉膈散(攻十九)
黄芩知母汤(寒五一) 三补丸(寒一六二) 安神丸(寒一四二) 黄芩清肺饮(寒三八) 排气
饮(新和六) 地黄膏(寒九一) 《直指》黄芩汤(寒百七) 大温中饮(新散八) 大补元煎(
新补一) 丹溪大补阴丸(寒一五七) 五君子煎(新热六) 大厘清饮(新寒五) 《正传》麦
门冬汤(寒四四) 大连翘饮(寒七八) 大金花丸(攻五五) 犀角地黄汤(寒八十、八一、八
二) 一柴胡饮(新散一) 三柴胡饮(新散三) 四柴胡饮(新散四) 五柴胡饮(新散五) 加
味龙胆泻肝汤(寒六四)
华佗(字元化)说:人出现寒热交替往来的症状,这是什么病呢?这是由于阴阳相互偏胜所致。阳气不足,就会先感到寒冷随后发热;阴气不足,就会先感到发热随后发冷。又比如上部邪气盛则发热,下部邪气盛则发冷。皮肤寒冷且烦躁的,是阳气不足;皮肤发热且烦躁的,是阴气不足;皮肤寒冷且畏寒的,是阴气过盛;皮肤发热且身热的,是阳气过盛。热象从下部发起,属于阴分中的阳邪;热象从上部发起,属于阳分中的阳邪。寒象从上部发起,属于阳分中的阴邪;寒象从下部发起,属于阴分中的阴邪。脸颊发红、多言妄语却伴有恶寒的,属于阳分中的阴邪;面色青紫、多言妄语却伴有发热的,属于阴分中的阳邪;面色青紫、多言妄语却伴有恶寒的,属于阴分中的阴邪。如果患者沉默不语,则是不可治愈的病症。属于阴中之阴证的,一生中九死一生;属于阳中之阳证的,九生一死。阴证难以治疗,阳证容易医治。诊察其脉象,滑而有力且位于上部,属于阳中之阳;滑而有力且位于下部,属于阴中之阳;微弱无力且位于上部,属于阳中之阴;微弱无力且位于下部,属于阴中之阴。滑而有力位于中部,说明中部有热;微弱无力位于中部,说明中部有寒。寒证用热法来取效,热证用寒法来攻治。顺逆的治疗法则,顺应天地规律,根本在于阴阳。顺应者生,违背者死。《金匮大要论》说:夜间发作寒症的为顺证,夜间发作热症的为逆证。白天发作热症的为顺证,白天发作寒症的为逆证。顺逆的道理,也在于仔细审察明确。
四逆汤(热十四) 理中汤(热一) 四味回阳饮(新热一) 温胃饮(新热五) 暖肝煎(新热十五) 六味回阳饮(新热二) 寿脾煎(新热十六) 化肝煎(新寒十) 补中益气汤(补三十) 六气煎(新因二一) 归气饮(新热十四) 补阴益气煎(新补十六) 理阴煎(新热三) 五福饮(新补六) 韩氏温中汤(热八九) 归脾汤(补三二) 五积散(散三九) 五味沉附汤(热百十六) 右归饮(新补三) 右归丸(新补五) 海藏八味丸(补一二一) 一气丹(新热二二) 九气丹(新热二三) 滋阴八味丸(新寒十七) 一阴煎(新补八) 二阴煎(新补十) 加减一阴煎(新补九) 玉女煎(新寒十二) 化阴煎(新寒七) 当归六黄汤(寒六五) 白虎汤(寒二) 泻白散(寒四二) 加味逍遥散(补九三) 清化饮(新因十三) 泻黄散(寒五七) 天王补心丹(补百八) 玉泉散(新寒十五) 太清饮(新寒十三) 三才封髓丹(寒一六六) 保阴煎(新寒一) 泻心汤(寒二七) 华佗阳脱方(热四六) 抽薪饮(新寒三) 徙薪饮(新寒四) 黄连解毒汤(寒一) 七正散(寒百十六) 八正散(寒百十五) 黄芩芍药汤(寒百九) 五淋散(寒百十七) 导赤散(寒一二二) 芍药清肝散(寒六一) 正气汤(寒六六) 凉膈散(攻十九) 黄芩知母汤(寒五一) 三补丸(寒一六二) 安神丸(寒一四二) 黄芩清肺饮(寒三八) 排气饮(新和六) 地黄膏(寒九一) 《直指》黄芩汤(寒百七) 大温中饮(新散八) 大补元煎(新补一) 丹溪大补阴丸(寒一五七) 五君子煎(新热六) 大厘清饮(新寒五) 《正传》麦门冬汤(寒四四) 大连翘饮(寒七八) 大金花丸(攻五五) 犀角地黄汤(寒八十、八一、八二) 一柴胡饮(新散一) 三柴胡饮(新散三) 四柴胡饮(新散四) 五柴胡饮(新散五) 加味龙胆泻肝汤(寒六四)
Hua Yuanhua (Zhen) stated: What is the pathology behind alternating chills and fever in humans? This condition arises from the mutual excess of Yin and Yang. When Yang Qi is insufficient, chills precede fever; when Yin is insufficient, fever precedes chills. Furthermore, excess in the upper body manifests as fever, while excess in the lower body manifests as chills. If the skin is cold yet the patient is restless, it indicates insufficient Yang; if the skin is hot yet the patient is restless, it indicates insufficient Yin. If the skin is cold and the patient feels chilly, it signifies an excess of Yin; if the skin is hot and the patient feels hot, it signifies an excess of Yang. Heat originating from the lower part belongs to the Yang pathogen within Yin; heat originating from the upper part belongs to the Yang pathogen within Yang. Cold originating from the upper part belongs to the Yin pathogen within Yang; cold originating from the lower part belongs to the Yin pathogen within Yin. Red cheeks, excessive talking, accompanied by chills, indicate a Yin pathogen within Yang; a blueish complexion, excessive talking, accompanied by fever, indicate a Yang pathogen within Yin; a blueish complexion, excessive talking, accompanied by chills, indicate a Yin pathogen within Yin. If the patient remains silent, the condition is incurable. A condition classified as "Yin within Yin" has a mortality rate of nine deaths for every one survival; a condition classified as "Yang within Yang" has a survival rate of nine for every one death. Yin syndromes are difficult to treat, whereas Yang syndromes are easier to cure. Upon examining the pulse: if it is slippery and forceful in the upper position, it indicates Yang within Yang; if slippery and forceful in the lower position, it indicates Yang within Yin. If weak and thin in the upper position, it indicates Yin within Yang; if weak and thin in the lower position, it indicates Yin within Yin. If slippery and forceful in the middle position, it indicates internal heat; if weak and thin in the middle position, it indicates internal cold. Cold syndromes are treated with heat methods, and heat syndromes are attacked with cold methods. The principles of following or opposing these patterns align with Heaven and Earth, rooted in Yin and Yang. Following them leads to life; opposing them leads to death. The *Jingui Dayao Lun* states: Chills occurring at night are a favorable sign (Shun); fever occurring at night is an unfavorable sign (Ni). Fever occurring during the day is a favorable sign; chills occurring during the day are an unfavorable sign. The distinction between favorable and unfavorable signs depends on careful and clear examination.
Si Ni Tang (Four Reversal Decoction) Li Zhong Tang (Regulate the Middle Decoction) Si Wei Hui Yang Yin (Four-Ingredient Return-to-Yang Decoction) Wen Wei Yin (Warm the Stomach Decoction) Nuan Gan Jian (Warm the Liver Infusion) Liu Wei Hui Yang Yin (Six-Ingredient Return-to-Yang Decoction) Shou Pi Jian (Longevity Spleen Infusion) Hua Gan Jian (Transform the Liver Infusion) Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) Liu Qi Jian (Six-Qi Infusion) Gui Qi Yin (Return-to-Qi Decoction) Bu Yin Yi Qi Jian (Tonify Yin and Augment Qi Infusion) Li Yin Jian (Regulate Yin Infusion) Wu Fu Yin (Five Blessings Decoction) Han Shi Wen Zhong Tang (Han’s Warm the Middle Decoction) Gui Pi Tang (Restore the Spleen Decoction) Wu Ji San (Five Accumulations Powder) Wu Wei Chen Fu Tang (Five-Ingredient Sunken Aconite Decoction) You Gui Yin (Right Restoration Decoction) You Gui Wan (Right Restoration Pill) Hai Zang Ba Wei Wan (Hai Zang Eight-Ingredient Pill) Yi Qi Dan (One-Qi Elixir) Jiu Qi Dan (Nine-Qi Elixir) Zi Yin Ba Wei Wan (Nourish Yin Eight-Ingredient Pill) Yi Yin Jian (Single Yin Infusion) Er Yin Jian (Double Yin Infusion) Jia Jian Yi Yin Jian (Modified Single Yin Infusion) Yu Nu Jian (Jade Maiden Infusion) Hua Yin Jian (Transform Yin Infusion) Dang Gui Liu Huang Tang (Angelica Hexa-Coptis Decoction) Bai Hu Tang (White Tiger Decoction) Xie Bai San (Drain White Powder) Jia Xiao Yao San (Modified Free and Easy Wanderer Powder) Qing Hua Yin (Clear Transformation Decoction) Xie Huang San (Drain Spleen Powder) Tian Wang Bu Xin Dan (Emperor of Heaven Tonify Heart Pill) Yu Quan San (Jade Spring Powder) Tai Qing Yin (Great Purity Decoction) San Cai Feng Sui Dan (Three Talents Seal Marrow Pill) Bao Yin Jian (Protect Yin Infusion) Xie Xin Tang (Drain Heart Decoction) Hua Tuo Yang Tuo Fang (Hua Tuo’s Yang Collapse Formula) Chou Xin Yin (Draw Out the Firewood Decoction) Xi Xin Yin (Remove the Firewood Decoction) Huang Lian Jie Du Tang (Coptis Detoxification Decoction) Qi Zheng San (Seven Upright Powders) Ba Zheng San (Eight Upright Powders) Huang Qin Shao Yao Tang (Scutellaria Peony Decoction) Wu Lin San (Five Dampnesses Powder) Dao Chi San (Guide out Redness Powder) Shao Yao Qing Gan San (Peony Clear Liver Powder) Zheng Qi Tang (Upright Qi Decoction) Liang Ge San (Cool the Diaphragm Powder) Huang Qin Zhi Mu Tang (Scutellaria Anemarrhena Decoction) San Bu Wan (Three Tonics Pill) An Shen Wan (Calm Spirit Pill) Huang Qin Qing Fei Yin (Scutellaria Clear Lung Decoction) Pai Qi Yin (Expel Qi Infusion) Di Huang Gao (Rehmannia Ointment) *Zhizhi* Huang Qin Tang (*Direct Guide* Scutellaria Decoction) Da Wen Zhong Yin (Great Warm the Middle Infusion) Da Bu Yuan Jian (Great Tonify Origin Infusion) Dan Xi Da Bu Yin Wan (Danxi Great Tonify Yin Pill) Wu Jun Zi Jian (Five Gentlemen Infusion) Da Li Qing Yin (Great Clarify Purity Infusion) *Zhengzhuan* Mai Men Dong Tang (*Transmission* Ophiopogon Decoction) Da Liao Qiao Yin (Great Clear Liao Qiao Infusion) Da Jin Hua Wan (Great Golden Flower Pill) Xi Jiao Di Huang Tang (Rhinoceros Horn Rehmannia Decoction) Yi Chai Hu Yin (Single Bupleurum Infusion) San Chai Hu Yin (Triple Bupleurum Infusion) Si Chai Hu Yin (Quadruple Bupleurum Infusion) Wu Chai Hu Yin (Quintuple Bupleurum Infusion) Jia Long Dan Xie Gan Tang (Modified Gentian Drain Liver Decoction)