论夜发寒热
天师曰∶夜治者，病重于夜间而发热者也。或寒少而热多，或热少而寒多，一到天明，便觉清
爽，一到黄昏，便觉沉困，此阴气甚虚，故行阳分则病减，行阴分则病重也。方用熟地一两，山茱萸四钱，
当归三钱，白芍三钱，鳖甲五钱，柴胡三钱，白芥子三钱，陈皮一钱，生何首乌三钱，茯苓五钱，北五味
一钱，麦冬三钱，水煎服。（〔批〕补阴辟邪丹。）此方妙在鳖甲同柴胡并用，又以诸补阴之药，合而攻
之也。盖鳖甲乃至阴之物，逢阴则入，逢阳则转。即此二味原是治阴经之邪热，况又用于纯阴同队之中，
有不去阴邪而迅散哉。生何首乌直入阴经，亦能攻邪，加以白芥子去脏膈之滞痰，又不耗其真阴之气，有不
奏功如响者乎。譬如人家主妇，一旦被贼人所执，刀火相逼，倘箱柜空虚，则贼人失望，势必因羞变怒，
愈将主妇施刑。今用熟地、山茱、当归、芍药，纯是补正之品，同群共投，犹贼在房中，尽将金玉散倾，
则贼喜出望外，必且弃主妇而取资财，饱则扬去。又有鳖甲、首乌、芥子之类，力能战邪，则堂外声扬，夺
门攻击，邪自张皇，更思早遁。倘止用鳖甲、首乌，则又势单力薄，无物饵贼，岂肯甘心反走，必致相
争相战，彼此败衄而后去。更有妙论，
人多未知。如此等症，必须在黄昏之前，以此药先与之，则阴气固而邪不敢入。又譬如人家门户谨
防，锁钥严整，司更值宿之仆俱各精健绝伦，则贼必望风退却，又何争越墙上壁，而主妇知觉，呼召家
人，捆缚而献哉。此皆日间不治，而以夜间先治之法也。
张公曰∶真绝奇之论。予何从而赞助高深，惟有阴经之邪盛，而又带阳经之邪，天师尚未发明也，
余一论之。阴邪之盛，必发夜间无疑矣。然亦有阴邪而兼带阳邪，亦发于夜间，其病亦发寒发热，无异纯
阴邪气之症，但少少烦躁耳，不比阴症之常静也。法当于补阴之中。少杂阳药一二味，使阴长阳消，自然
奏功如响。方用熟地一两，山茱萸四钱，当归三钱，鳖甲五钱，柴胡三钱，白芥子三钱，陈皮一钱，生何
首乌三钱，茯苓五钱，北五味一钱，麦冬三钱。此天师方也。予再加人参二钱，白术三钱而已，即可治阴
邪而兼治阳邪之症。
论夜间发作的寒热证
天师说：所谓“夜治”，是指病情在夜间加重并伴有发热的病症。有的患者恶寒轻而发热重，有的发热轻而恶寒重，一到天亮，就觉得清爽舒适；一到黄昏，就觉得沉重困倦。这是因为阴气极度虚弱，所以当阳气运行于阳分时，病势减轻；当阳气运行于阴分时，病势加重。方剂用熟地黄一两、山茱萸四钱、当归三钱、白芍三钱、鳖甲五钱、柴胡三钱、白芥子三钱、陈皮一钱、生何首乌三钱、茯苓五钱、北五味子一钱、麦冬三钱，水煎服。（批注：补阴辟邪丹。）这个方子的妙处在于鳖甲与柴胡并用，再加上各种滋阴的药物，合力攻逐病邪。因为鳖甲是至阴之物，遇到阴分则进入，遇到阳分则转向。仅凭这两味药原本就是治疗阴经邪热的，何况又用在纯滋阴的药队之中，哪有不能迅速驱散阴邪的道理呢？生何首乌直接入阴经，也能攻逐邪气，加上白芥子去除脏腑膈膜的停滞之痰，又不耗损真阴之气，难道不能像回声一样迅速见效吗？
这就好比家里的主妇，一旦被贼人抓住，刀火相逼，如果箱柜空空如也，贼人就会失望，必定会因为羞愧而转为愤怒，更加对主妇施刑。现在用熟地、山茱萸、当归、芍药，全是补益正气的药物，一同投下，就像贼人在房中，将金玉财宝全部倾倒出来，贼人喜出望外，必定会抛弃主妇去取钱财，吃饱喝足后就会扬长而去。又有鳖甲、何首乌、白芥子这类药物，力量足以战胜邪气，则在堂外大声喧哗，夺门攻击，邪气自然惊慌失措，更想早早逃跑。如果只用鳖甲、何首乌，那么势力单薄，没有东西引诱贼人，贼人岂肯甘心反身逃走，必定会导致双方争斗，彼此受损后才离开。还有更精妙的论述，人们大多不知道。像这样的病症，必须在黄昏之前，先用此药给予患者，那么阴气就能固守，邪气不敢侵入。这又好比人家门户严防，锁钥严整，巡夜值宿的仆人个个精明强健，贼人必定望风退却，哪里还会争着翻墙越壁，惊动主妇察觉，呼叫家人捆绑献俘呢？这些都是白天不治疗，而在夜间预先治疗的法则。
张公说：真是绝妙奇特的理论。我怎么能赞助您的高深见解呢？只有阴经邪气盛，同时又夹杂阳经邪气的情况，天师尚未阐明，我再来论述一番。阴邪旺盛，必定在夜间发作，这是毫无疑问的。然而也有阴邪兼带阳邪的，也是在夜间发作，病症也是忽冷忽热，与纯阴邪气的症状无异，只是稍微有些烦躁罢了，不像阴症通常那样安静。治疗方法应当在补阴之中，少量混杂一二味阳药，使阴气增长、阳气消退，自然能像回声一样迅速见效。方剂用熟地黄一两、山茱萸四钱、当归三钱、鳖甲五钱、柴胡三钱、白芥子三钱、陈皮一钱、生何首乌三钱、茯苓五钱、北五味子一钱、麦冬三钱。这是天师的方子。我再加入人参二钱、白术三钱而已，就可以治疗既含阴邪又含阳邪的病症了。
Discussion on the Onset of Chills and Fever at Night
The Heavenly Master said: "Night treatment" refers to conditions where the illness worsens at night accompanied by fever. In some cases, chills are mild while fever is severe; in others, fever is mild while chills are severe. Upon dawn, one feels refreshed and clear; upon dusk, one feels heavy and lethargic. This is due to extreme deficiency of Yin Qi. Thus, when Yang Qi moves through the Yang aspects, the disease alleviates; when it moves through the Yin aspects, the disease intensifies. The prescription consists of Shu Di Huang (Prepared Rehmannia Root) 1 liang, Shan Zhu Yu (Cornus Officinalis Fruit) 4 qian, Dang Gui (Angelica Sinensis Root) 3 qian, Bai Shao (White Peony Root) 3 qian, Bie Jia (Tartar Testudinis Shell) 5 qian, Chai Hu (Bupleurum Root) 3 qian, Bai Jie Zi (Sinapis Semen) 3 qian, Chen Pi (Citrus Reticulata Pericarpium) 1 qian, Sheng He Shou Wu (Polygoni Multiflori Radix Preparata - raw) 3 qian, Fu Ling (Poria) 5 qian, Bei Wu Wei Zi (Schisandrae Chinensis Fructus) 1 qian, and Mai Dong (Ophiopogonis Tuber) 3 qian. Decoct in water and take orally. (Annotation: Bu Yin Bi Xie Dan [Supplement Yin and Repel Evil Pill].) The brilliance of this formula lies in the combined use of Bie Jia and Chai Hu, along with various Yin-nourishing herbs working together to attack the pathogen. Since Bie Jia is a substance of extreme Yin nature, it enters when encountering Yin and turns when encountering Yang. These two ingredients alone are originally used to treat heat pathogens in the Yin meridians; moreover, they are used within a team of purely Yin-nourishing herbs. How could they fail to rapidly disperse Yin pathogens? Sheng He Shou Wu directly enters the Yin meridians and can also attack pathogens. Added with Bai Jie Zi to remove stagnant phlegm from the viscera and diaphragm, without consuming true Yin Qi, how could it not produce effects as swiftly as an echo?
Consider this analogy: If the mistress of a house is seized by thieves, threatened with knives and fire, but the chests and cabinets are empty, the thieves will be disappointed. They will likely turn anger out of shame and torture the mistress further. Now, using Shu Di Huang, Shan Zhu Yu, Dang Gui, and Bai Shao—all substances that tonify righteousness (Zheng Qi)—administered together is like the thieves being in the room while all gold and jade are scattered about. The thieves, overjoyed, will abandon the mistress to take the wealth. Sated, they will leave. Furthermore, herbs like Bie Jia, He Shou Wu, and Bai Jie Zi have the power to battle pathogens. Their presence creates noise outside the hall, attacking through doors, causing the pathogens to panic and seek early escape. If only Bie Jia and He Shou Wu were used, their strength would be insufficient, lacking bait for the thieves. Would they willingly retreat? No, they would fight, resulting in mutual defeat before leaving. There is an even more profound point that few know. For such conditions, one must administer this medicine before dusk. Then, Yin Qi becomes solid, and pathogens dare not enter. It is like securing doors and windows tightly, ensuring locks are intact, and having vigilant night-watch servants who are exceptionally capable. Thieves will surely retreat at the sight. Why would they attempt to climb walls, alerting the mistress, who then calls family members to bind and capture them? These are methods of treating at night rather than during the day.
Lord Zhang said: "This is truly a unique and extraordinary theory. How can I support your profound insights? However, there is a case where Yin meridian pathogens are excessive yet accompanied by Yang meridian pathogens, which the Heavenly Master has not yet elucidated. Let me discuss this. Excessive Yin pathogens undoubtedly manifest at night. Yet, there are cases where Yin pathogens are accompanied by Yang pathogens, also manifesting at night. The symptoms involve alternating chills and fever, similar to pure Yin pathogen conditions, but with slight irritability, unlike the usual quietness of Yin syndromes. The method should involve adding one or two Yang-tonifying herbs among the Yin-nourishing ones, allowing Yin to grow and Yang to diminish, naturally producing swift effects. The prescription uses Shu Di Huang 1 liang, Shan Zhu Yu 4 qian, Dang Gui 3 qian, Bie Jia 5 qian, Chai Hu 3 qian, Bai Jie Zi 3 qian, Chen Pi 1 qian, Sheng He Shou Wu 3 qian, Fu Ling 5 qian, Bei Wu Wei Zi 1 qian, and Mai Dong 3 qian. This is the Heavenly Master's formula. I add Ren Shen (Ginseng Radix et Rhizoma) 2 qian and Bai Zhu (Atractylodis Macrocephalae Rhizoma) 3 qian. This suffices to treat conditions containing both Yin and Yang pathogens."