汪石山治汪世昌，形肥色紫，年逾三十。秋间病恶寒发热，头痛自汗，恶心，咯痰恶食。医以疟治。诊之，
脉浮濡而缓，右寸略弦，曰∶非疟也，此必过劳伤酒所致。饮以清暑益气汤，四五服而愈。
易思兰治一春元下第归，得寒热病，每日申酉二时，初微寒，继作大热，而烦躁甚如狂，过此二时，平复
无恙，惟小便赤黄而涩。往时一有心事，夜即梦遗，每日空心用盐饮烧酒数杯。医者以为病疟，用清脾饮、柴
苓汤，并截药俱不效。六脉惟左尺浮，中沉取之皆洪数有力，余部皆平，曰∶此潮热病也。以加减补中益气治
之，日进一服，三日病渐退。复用六味地黄丸兼前药，调理一月而安。或问寒热而不以疟治，何也？曰∶此非
疟，乃潮热也。潮者，如水之潮，根据期而至。《八法流注》云∶申酉二时属膀胱与肾，此病专属二经，水衰火
旺，当申酉时火动于中，故发热而躁，躁属肾。若疟疾肝部必弦，今不然，惟左尺独现火象。此因平日斫丧太
过，肾水亏损，阴火旺炽，加之盐饮烧酒，引入肾经，故小便赤黄而涩也。又曰∶此非阴虚火动乎？曰∶阴虚
之热，自午至亥，发热不间。今惟申酉时热，热止便凉，与阴虚不同。又曰∶或亦尝用补中益气而不效，何也？
曰∶加减之法，或未同耳。予之去升、柴，加丹皮、泽泻、黄柏者，丹皮泻膀胱，泽泻泻肾火，黄柏为君，以
生肾水，水旺则火衰，而寒热退矣。用六味丸者，亦取有丹皮、泽泻耳。如不知此，仍用升、柴，乃以肝脾之
药治肾，所以不效也。
孙文垣治李坦渠子妇，十月寒热起，一日一发，咳嗽心痛，腰亦痛。次年正月望后，始间日一发，肌肉大
减，喉疼，汗出如雨，白带如注，饮食减少，百治汗不止。脉之，右手软弱，左手散乱，此汗多而脉不敛，病
至此危矣。经云火热似疟，此之谓欤。以黄 二钱，白芍一钱五分，甘草、阿胶各一钱，鳖甲三钱，桂枝五分，
乌梅一个，水煎服，其汗止。再诊，脉已敛，神气亦回，前方加何首乌、石斛、牡蛎，寒热亦不发，饮食少加，
然有幽谷回春之象。
喻嘉言治吴吉长内，新秋病洒淅恶寒，寒已发热，渐生咳嗽。然病未甚也，服表散药不愈，体日 羸。延
至初冬，饮以参、术补剂，转觉厌厌欲绝，食饮不思，有咳无声，泻痢不止，危甚。医议以人参五钱，附子三
钱，加入姜、桂、白术等，作一剂服，以止泻补虚，而收背水之捷。病家无措，延喻诊毕，未及交语，前医至，
即令疏方，喻飘然而出。盖以渠见既讹，难与言耳。前医既去，乃曰∶是症总由误药所致，始先皮毛间洒淅恶
寒发热，肺金为时令之燥所伤也。用表散已为非法，至用参、术补之，则肺气闭锢，而咳嗽之声不扬，胸腹胀
饱，不思饮食，肺中之热，无处可宣，急奔大肠，食入不待运化而即出。食不入，则肠中之垢污亦随气奔而出，
是以泻痢无休也。今以润肺之药，兼润其肠，则源流俱清，寒热、咳嗽、泄泻一齐俱止矣。服四剂必安，不足
虑也。方用黄芩、地骨皮、甘草、杏仁、阿胶，一剂泻即少止，四剂寒热俱除，再数剂咳嗽亦愈。设与若辈商
之，彼方执参、附为是，能相从乎？又乡中王氏妇，秋月亦病寒热，服参、术后厌厌一息，但无咳嗽，十余
日不进粒米，亦无大便，时时晕去，不省人事。其夫来寓，详述其证，求发补剂。乃以大黄、芒硝、石膏、甘
草四味，为粗末与之。彼不能辨，归而煎服。其妇云∶此药甚咸。夫喜曰∶咸果补药，遂将二剂连服。顷之，
腹中弩痛，下结粪数块，绝而复苏，进粥二盏，前病已如失矣，凡此，素有定见于中，始无炫惑。书之为临症
者广其识焉。
高鼓峰治程氏子，每日至辰时大寒，午时大热，热即厥，两目直视，不能出声，颏脱，涎水从口角涌出，
日流数升，至丑时始汗解，饮食不进，昏冒欲绝。诊之，皆诛伐太过所至也。投以补脾之药，不即效。延他医，
用柴胡、南星、半夏等，势转剧。复延诊，值医者在座，询之曰∶此何症也，而用前药？曰∶子不识乎？此肝
疟也。肝疟令人色苍苍然太息，其状若死。高笑曰∶据子述经言，当得通脉四逆矣，何用前药？某诚不识此为
何病，但知虚甚耳。请先救人，然后治病何如？曰∶子用何药？曰∶大剂参、附，庶可挽回。彼力争参、附不
便。乃漫应曰∶谨奉教。始洋洋色喜而别。是夜用人参一两，黄 二两，炮姜三钱。比晓，熟地、桂、附并进，
次日辰时，病不复发矣，此缘劳役过度，寒热往来，医认为疟，且时当秋令，一味发散寒凉，重虚其虚，展转
相因，肝脾大败，非峻补气血，何由得生？夫病由人生，人将死矣，而乃妄牵经义，强合病情。及至处方，又
乖成法，自误误人，至死不觉，悲夫。
吕仲嘉内人，在室十四岁时，寒热往来，迨后适仲嘉，又十余年，寒热如故。或作疟治，或作虚治， 羸
枯削，几于骨立。高诊之曰∶此非疟非虚，乃血风症耳。以五加皮散加熟地二两，每剂共药五六两许，水二升，
浓煎一升，每日进一剂。如是者二十剂，寒热顿除。
冯楚瞻治徐山公，患似疟非疟。医以柴胡汤连进数剂，渐至不省人事，口噤僵卧，咸谓无生理。曰∶此阳
虚作寒，阴虚作热，误当疟治，必死也。以重剂熟地、白术、五味、牛膝、麦冬、制附子，另煎人参一两冲服，
三日而苏，后用温补而愈。
吴孚先治小姨，病寒热如疟，语言谵妄，如见鬼状。有指为热入血室者，然证与长沙所论三条，了不相合。
诊得右寸浮滑，知为风痰胶固肺脏，故洒淅寒热。痰迷心窍，故语言谵妄。宜发表利气自愈，用二陈汤加苏、
防、前、葛、枳、桔、桑、杏，数剂微汗而痊。
有一师尼，乍寒乍热，面赤心烦，或时自汗，恶风体倦，大小柴胡杂进，其病益剧。诊视脉无寒邪，但厥
阴脉弦长而出鱼际，治以抑阴地黄丸而愈。
薛立斋治一妇人，因夫久出经商，发寒热，月经旬日方止，服降火凉血药，内热益甚，自汗盈盈，月经频
数。曰∶内热自汗，乃脾气虚热也，非血不归脾也。用归脾汤、六味丸而愈。
一室女久患寒热，月经失期，以小柴胡汤加生地治之少愈，更以生地黄丸而痊。柴胡、秦艽各半两，生地
二两，酒湿杵膏，赤芍一两为末，蜜丸。每三十丸，乌梅汤下，日三服。
易思兰治一男子病寒热，众作疟治，年余不愈。又以为劳疟、虚疟，用鳖甲散、补中益气汤，俱不效。脉
左右三部俱浮大无力，形瘦色黑，饮食不美。知为阴虚发热病也。早进六味丸，晚服补阴丸。七日后，饮食渐
美，寒热减半。又服一斤，未一月全愈。盖此似疟非疟，乃阴虚之候也。凡正疟则寒热虽参差而有准。今寒热
往来，或一日一次二次，且寒而不厥，身热如火，热退又无汗，兼之形瘦色黑，怔忡不寐，口渴便秘，岂可谓
疟乎？且疟脉当弦，（诸虚损脉亦多弦。）发则弦而大，退则弦而小。今浮大无力，早晚相同，诚阴血不足，阳火有余。
火发于外则为热，火郁于中则为寒。形瘦者，火之消烁也。色黑者，火极似水也。怔忡不睡者，心血亏损也。（
肝火浮入胞络者多。）饮食不美、口渴便秘者，火炽于上下也。但生肾水，养血滋阴，阴血充则火自降，寒热退而
病瘳矣。
立斋治一妇人，久患寒热，服清脾饮之类，胸膈饱胀，饮食减少。用调中益气加茯苓、半夏、炮姜各一钱，
二剂而痊。
朱丹溪治赵孺人，夜间发寒后便热，丑寅时退，起来口渴，食少无味，谷不化，腹痛而泄，倦怠，或遇事
烦躁，赤眼气壅。又不耐风寒，亦恶热。白术、归身各二钱，白芍、陈皮各一钱，人参、黄 各五分，
炒柏、炙草、炒芩、丹皮、木通、缩砂各三分，煎下保和丸、实肠丸，各三十丸。
吕十四孺人，怒气后寒热咳嗽，食少淋泄，缩砂、甘草各三分，人参五分，白术钱半，连翘、陈皮、茯苓各
一钱，姜二片同煎。
一妇人年五十余，形实喜作劳，性急味浓，喜火食，夏却患热，恶寒发热，更无休时，衣被虽浓，常凛然，
两脉皆涩。朱作杂合邪治之。遂以四物汤加陈皮，以人参、白术为君，生甘草、黄柏为佐，多入姜汁，吞通神
丸三十丸，回金、抑青各二十丸，阿魏十丸。煎三帖而得睡，第五帖而身和，第七帖通身微汗，诸症皆除。
华佗传，有妇人长病多年，世谓寒热注病者。冬十一月中，佗令坐石槽中，平旦用寒水汲灌，云当满百。
始七八灌，寒战欲死。灌者惧欲止，佗令满数，将至八十灌，热气如蒸出，嚣嚣高二三尺。满百灌，佗乃使燃
火，温床浓覆，良久汗始出，着粉汗燥便愈。（《三国志》）
马元仪治张某，寒热数日，痛，呕逆，胸满身疼，左脉弦涩，关尺虚微。此中气虚寒，胸中之气不化而为
满，胃中之阳不布而为呕，卫外之阳不固而为痛。以四君子补脾胃之虚，炮姜、附子、肉桂补阳气而除邪，少
加黄连以为引导，一剂脉起，再剂痛止得睡，不数剂而霍然。
顾允谐寒热日作，胸满不舒，自汗不止已数日。或用柴胡、黄芩两解之法不愈。诊其脉，右三部虚微，左
三部弦涩。望其色，枯白不泽。脉微为阳微，弦为虚风，由正气不足，虚邪外袭而成寒热，治宜补中益气。即
有胸满，亦是阳虚不布，非气实而然也。况自汗者，阳虚不能卫外故也。面色不华者，气血亏损，无以上荣于
面也。遂与理中汤理其中气，加桂枝以祛虚邪。后倍加参、附，不数剂而愈。
唐氏子患寒热，弥月不瘥，胸中有块高突，按之则痛，时见厥逆，兼多自汗。诊其脉，右三部虚微，按之
如丝，此症实脉虚，邪实正衰之候也。攻之则碍虚，补之则助邪。然用补则正气旺而邪自去，若任攻则邪气去
而正独全者鲜矣。用人参二钱，扶正养正为主，佐以炙甘草和平益气以却虚邪，炮姜、黄连、半夏以开痞而散
结，肉桂以固其本，桂枝以越其邪。制方井井有条，可以为法。二剂寒热减，两脉起，加人参以助中焦运化，
而痛渐平。再用桂附理中汤调理而愈。
一妇人患寒热半月，两脉浮虚，按之则豁然空，两寸倍甚。曰∶脉见空豁，寒热不时，面色不华者，气血
不荣也。语言错乱者，神明失养也。与归脾汤加黄连、肉桂各七分，令其心肾内交。服后脉渐有神，改用人参
三两，黄 三两，归身一两，炙草二钱，生地五钱，远志二钱，枣仁三钱，杞子五钱，大剂补气养荣。数剂寒
热止，神气清。令早服七味丸，下午进归脾大造膏，百日而愈。
李东垣治中书左丞姚公茂，上热下寒，用既济解毒汤良愈。（未选入。）
来天培治马振昌室，年约五旬，夏间忽患寒热头痛，每未申时起，至寅卯时退，头晕，胸胃嘈杂。或作暑
风治，益甚，不能饮食，无汗，气急懒言。诊之，六脉沉细，两关微弦。此劳倦伤脾，中气不足，外感寒邪，
内伤生冷，清阳不升，气虚不能达也。与补中益气汤加炮姜、半夏，一剂汗出热短，嘈杂渐已。继以归脾汤加
半夏、桂枝、白豆仁，寒热除，饮食进，调理而愈也。
马氏妪年七旬，八月忽病寒热，恶心头疼，身痛，心跳不眠，呕吐不食，展转呻吟。诊之，两关弦而紧，
余脉细小。以为脾气虚寒，肝气上逆。与姜附理中汤，加白芍和肝，二剂渐瘳。
朱丹溪治一人，天明时发微寒，便热至晚，（病盛于阳。）两腋汗出，手足热甚，（四肢为诸阳之本。）
则胸满拘急，大便实而能食，（邪热可知。）似劳怯病者，（虚损之甚亦作寒热。）脉不数，但弦细而沉。（
此张子和谓为有积之脉。）询之，因怒气而得。但用大柴胡汤，惟胸背拘急不除。后用二陈汤加羌活、防风、
红花、黄芩治之。
汪石山治一人，形短苍白，平素喜饮，五月间忽发寒热。医作寒治，燥渴益甚，时常啖梨，呕吐痰多，每
次或至碗许，饮食少进，头痛晕闷，大便不通，小便如常，或一夜不安，或一日连发二次，或二日三日一发，
或连发数日，平素两关脉亦浮洪。先令服独参汤二三帖，呕吐少止，寒热暂住三日。他医曰∶渴甚脉洪，热之
极矣，乃用独参以助其热，非杀之而何？及往视脉，皆浮洪近数，曰∶此非疟而亦非热也。脉洪者，阴虚阳无
所附，孤阳将欲飞越，故脉见此。其病属虚，非属热也。渴甚者，胃虚精少，不上朝于口，亦非热也。盖年逾
六十，血气已衰，加以疟药性皆燥烈，又当壮火食气之时，老人何以堪此？然则邪重剂轻，非参所能独治。遂
以参、 各七钱，归身、麦冬各一钱，陈皮七分，甘草五分，水煎，每次温服一酒杯。服至六七帖，痰止病除
而食进，大便旬余不通，增之以蜜，仍令服三十余帖，以断病根。续后脉亦收敛而缓，非复向之鼓击而驶矣。
汪石山诊治汪世昌，患者体型肥胖、面色紫暗，年龄超过三十岁。秋季患恶寒发热、头痛、自汗、恶心、咯痰及食欲不振之症。医生按疟疾治疗。诊察发现其脉象浮而濡缓，右寸脉略呈弦象，汪石山说：“这不是疟疾，这必定是由于过度劳累和饮酒损伤所致。”给予清暑益气汤服用，四五剂后痊愈。
易思兰诊治一位落第归来的秀才，患上寒热病，每天申时（下午3-5点）和酉时（下午5-7点），起初轻微恶寒，随后出现高热，烦躁异常如同发狂，过了这两个时辰后，身体恢复平静无恙，只有小便赤黄且排尿涩痛。以往只要心中有所牵挂，夜间就会梦遗，每日空腹饮用盐水烧酒数杯。医生认为是疟疾，使用清脾饮、柴苓汤以及截疟药物，均无效。六脉中仅左尺脉浮，中取沉取皆洪数有力，其余部位脉象平和。易思兰说：“这是潮热病。”用加减补中益气汤治疗，每日一剂，三天后病情逐渐消退。再用六味地黄丸配合之前的药物，调理一个月后康复。有人问：为何有寒热症状却不按疟疾治疗？回答说：“这不是疟疾，而是潮热。‘潮’就像海水潮汐，按时到来。《八法流注》说：申酉两个时辰属于膀胱与肾经，此病专门归属于这两条经络，肾水亏虚而火旺，到了申酉时体内火动，所以发热且烦躁，烦躁属于肾的病变。如果是疟疾，肝部脉象必然弦，现在并非如此，只有左尺脉单独显现火象。这是因为平日纵欲过度，肾水亏损，阴火旺盛炽烈，再加上饮用盐水烧酒，引邪入肾经，所以小便赤黄且涩痛。”又问：“这难道不是阴虚火动吗？”回答说：“阴虚产生的热，从午时到亥时持续发热，没有间断。现在仅在申酉时发热，热退即凉，与阴虚不同。”又问：“或许也曾使用过补中益气汤却无效，为什么？”回答说：“加减的方法，可能有所不同。我去掉升麻、柴胡，加入牡丹皮、泽泻、黄柏，其中牡丹皮清泻膀胱之火，泽泻清泻肾火，黄柏作为君药以滋生肾水，水旺则火衰，寒热自然消退。”使用六味地黄丸，也是取其含有牡丹皮、泽泻的缘故。如果不懂这个道理，仍然使用升麻、柴胡，那就是用治肝脾的药物来治肾，所以无效。
孙文垣诊治李坦渠的妻子，十月间出现寒热，一日一发，伴有咳嗽、心痛、腰痛。次年正月十五之后，改为隔日一发，肌肉大幅消瘦，喉咙疼痛，出汗如雨，白带如注，饮食减少，多种方法治疗但汗止不住。诊脉，右手脉软弱，左手脉散乱，这是汗出过多导致脉气不收敛，病势至此非常危险。《内经》说火热之证类似疟疾，说的就是这种情况吧。处方用黄芪二钱，白芍一钱五分，甘草、阿胶各一钱，鳖甲三钱，桂枝五分，乌梅一个，水煎服，汗随即停止。再诊时，脉象已收敛，神气也恢复，前方加入何首乌、石斛、牡蛎，寒热也不再发作，饮食略有增加，呈现出幽谷回春的景象。
喻嘉言诊治吴吉长的妻子，初秋患病，洒淅恶寒，寒罢发热，渐渐产生咳嗽。虽然病势尚不严重，但服用解表发散药后未愈，身体日益虚弱。拖延至初冬，饮用参、术等补益药剂，反而觉得气息奄奄欲绝，不思饮食，有咳无声，腹泻痢疾不止，情况危急。医生商议用人参五钱、附子三钱，加入姜、桂、白术等，制成一剂服用，以止泻补虚，寻求背水一战的捷效。病人家属不知所措，请喻嘉言诊治完毕，还没来得及交谈，前医赶到，立即让他开方，喻嘉言飘然离去。大概是因为那医生的见解已经错误，难以与他沟通。前医离开后，喻嘉言说：“这个病症总由误药所致。起初皮毛间洒淅恶寒发热，是肺金被时令之燥所伤。用解表发散药已经是非法之举，再用参、术补益，则肺气闭锢，咳嗽声音不扬，胸腹胀满饱胀，不思饮食，肺中的热气无处宣发，急奔大肠，食物进入后来不及运化就排出。食物不进，则肠中的污垢也随气奔涌而出，所以腹泻痢疾无休无止。现在用润肺的药物，兼润其肠，则源流俱清，寒热、咳嗽、泄泻一齐停止。”服用四剂必安，不必担忧。方用黄芩、地骨皮、甘草、杏仁、阿胶，一剂后腹泻稍止，四剂后寒热全除，再服几剂咳嗽也痊愈了。假如与那些医生商量，他们正坚持人参、附子是对的，能听从吗？另外乡中王氏妇人，秋天也患寒热，服用参、术后气息奄奄，仅有一息尚存，但没有咳嗽，十余日不进米粒，也没有大便，时常晕倒，不省人事。她的丈夫来到寓所，详细陈述病情，请求开具补剂。喻嘉言却用大黄、芒硝、石膏、甘草四味药，研成粗末给她。她丈夫不能辨别，回去煎服。那妇人说：“这药很咸。”丈夫高兴地说：“咸果然是补药”，于是将两剂连服。不久，腹中绞痛，排出结块粪便数块，昏厥后复苏，喝了二碗粥，前面的病已像丢失了一样消失。凡此种种，都是因为有坚定的见解在心中，才不会被迷惑。写下来是为了让临症者广增见识。
高鼓峰诊治程氏之子，每天辰时（上午7-9点）大寒，午时（上午11-1点）大热，热极则四肢厥冷，两眼直视，不能出声，下巴脱臼，涎水从口角涌出，每天流出数升，到丑时（凌晨1-3点）才汗出缓解，饮食不进，昏沉冒昧欲绝。诊察认为，这都是之前过度攻伐所致。投以补脾药物，没有立即见效。延请其他医生，使用柴胡、南星、半夏等，病情反而加剧。再次延请诊治，正值医者在座，询问说：“这是什么病，却用前面的药？”医生说：“您没读过书吗？这是肝疟。肝疟使人面色苍苍然太息，状若死尸。”高鼓峰笑着说：“根据你引用的经文，应当得到通脉四逆汤，为什么用前面的药？我确实不认识这是什么病，只知道虚损非常严重。请先救人，然后再治病如何？”医生说：“你用的是什么药？”回答说：“大剂量的人参、附子，才可以挽回。”那人极力争辩说人参、附子不便使用。高鼓峰便敷衍说：“谨遵教诲。”那人洋洋得意地笑着告别。当晚使用人参一两，黄芪二两，炮姜三钱。等到天亮，熟地、桂枝、附子并进，第二天辰时，病不再复发。这是由于劳役过度，寒热往来，医生误认为是疟疾，且当时正值秋季，一味使用发散寒凉药物，使虚者更虚，辗转相因，导致肝脾大败，如果不峻补气血，怎么能生存？病由人造成，人将要死了，却还妄牵经义，强行符合病情。等到处方时，又违背成法，自误误人，直到死也不觉悟，可悲啊。
吕仲嘉的妻子，在娘家十四岁时，寒热往来，后来嫁给吕仲嘉，又过了十多年，寒热依旧。有的按疟疾治，有的按虚证治，身体瘦弱枯削，几乎骨立。高鼓峰诊察说：“这不是疟疾也不是虚证，乃是血风症。”用五加皮散加熟地二两，每剂药共五六两左右，水二升，浓煎成一升，每日进一剂。像这样服用二十剂，寒热顿时消除。
冯楚瞻诊治徐山公，患似疟非疟之症。医生用柴胡汤连续进服数剂，逐渐发展到不省人事，口噤僵卧，大家都认为没有生机。冯楚瞻说：“这是阳虚作寒，阴虚作热，误当疟疾治疗，必死无疑。”用重剂量的熟地、白术、五味子、牛膝、麦冬、制附子，另煎人参一两冲服，三天后苏醒，后用温补法治愈。
吴孚先诊治小姨，患寒热如疟，语言谵妄，如同见鬼状。有人指出为热入血室，但症状与长沙（张仲景）所论述的三条完全不相合。诊得右寸脉浮滑，知道是风痰胶固于肺脏，所以洒淅寒热。痰迷心窍，所以语言谵妄。宜发表利气自愈，用二陈汤加紫苏、防风、前胡、葛根、枳壳、桔梗、桑白皮、杏仁，数剂微汗而痊愈。
有一位师尼，乍寒乍热，面赤心烦，有时自汗，恶风体倦，大小柴胡汤杂进，病情更加严重。诊视脉象无寒邪，但厥阴脉弦长而出鱼际，用抑阴地黄丸治愈。
薛立斋诊治一妇人，因丈夫久出经商，发寒热，月经十天方止，服用降火凉血药，内热更甚，自汗淋漓，月经频数。薛立斋说：“内热自汗，乃脾气虚热，并非血不归脾。”用归脾汤、六味丸治愈。
一室女久患寒热，月经失期，用小柴胡汤加生地治疗稍好，再用生地黄丸痊愈。处方：柴胡、秦艽各半两，生地二两，酒湿杵膏，赤芍一两为末，蜜丸。每三十丸，乌梅汤送下，日服三次。
易思兰诊治一男子患寒热，众人按疟疾治，一年多不愈。又以为是劳疟、虚疟，用鳖甲散、补中益气汤，均无效。脉左右三部俱浮大无力，形体消瘦面色黑，饮食不佳。知为阴虚发热病。早晨进服六味丸，晚上服补阴丸。七日后，饮食渐佳，寒热减半。又服一斤，不到一个月全愈。盖此似疟非疟，乃是阴虚之候。凡是正疟，则寒热虽参差不齐但有规律。现在寒热往来，或一日一次二次，且寒而不厥，身热如火，热退又无汗，兼之形瘦色黑，怔忡不寐，口渴便秘，岂能说是疟疾？且疟脉当弦，（诸虚损脉亦多弦。）发作时弦而大，退去时弦而小。现在浮大无力，早晚相同，诚然是阴血不足，阳火有余。火发于外则为热，火郁于中则为寒。形瘦者，是火之消烁。色黑者，是火极似水。怔忡不睡者，是心血亏损。（肝火浮入胞络者多。）饮食不佳、口渴便秘者，是火炽于上下。只须生肾水，养血滋阴，阴血充则火自降，寒热退而病愈。
立斋诊治一妇人，久患寒热，服用清脾饮之类，胸膈饱胀，饮食减少。用调中益气汤加茯苓、半夏、炮姜各一钱，二剂而痊愈。
朱丹溪诊治赵孺人，夜间发寒后便热，丑寅时退，起来口渴，食少无味，谷不化，腹痛而泄，倦怠，或遇事烦躁，赤眼气壅。又不耐风寒，亦恶热。处方：白术、当归身各二钱，白芍、陈皮各一钱，人参、黄芪各五分，炒黄柏、炙甘草、炒黄芩、牡丹皮、木通、缩砂仁各三分，煎好后送服保和丸、实肠丸，各三十丸。
吕十四孺人，怒气后寒热咳嗽，食少淋泄，处方：缩砂仁、甘草各三分，人参五分，白术钱半，连翘、陈皮、茯苓各一钱，姜二片同煎。
一妇人年五十余，形体壮实喜劳作，性情急躁口味浓重，喜吃火食，夏天却患热病，恶寒发热，更无休止，衣被虽厚，常觉凛然，两脉皆涩。朱丹溪作杂合邪治之。遂以四物汤加陈皮，以人参、白术为君药，生甘草、黄柏为佐药，多入姜汁，吞服通神丸三十丸，回金丸、抑青丸各二十丸，阿魏十丸。煎服三帖而得睡，第五帖而身和，第七帖通身微汗，诸症皆除。
华佗传记载，有妇人长病多年，世人称为寒热注病。冬十一月，华佗令其坐石槽中，平旦用寒水汲灌，说应当满一百次。开始七八次灌注，寒战欲死。灌注者害怕想停止，华佗令满次数，将至八十次灌注，热气如蒸出，嚣嚣高二三尺。满百次灌注，华佗才让人燃火，温床厚覆，良久汗始出，着粉汗干便愈。（《三国志》）
马元仪诊治张某，寒热数日，痛，呕逆，胸满身疼，左脉弦涩，关尺虚微。此为中气虚寒，胸中之气不化而为满，胃中之阳不布而为呕，卫外之阳不固而为痛。用四君子汤补脾胃之虚，炮姜、附子、肉桂补阳气而除邪，少加黄连以为引导，一剂脉起，再剂痛止得睡，不数剂而霍然痊愈。
顾允谐患寒热日作，胸满不舒，自汗不止已数日。或用柴胡、黄芩两解之法不愈。诊其脉，右三部虚微，左三部弦涩。望其色，枯白不泽。脉微为阳微，弦为虚风，由正气不足，虚邪外袭而成寒热，治宜补中益气。即使有胸满，亦是阳虚不布，非气实而然也。况且自汗者，阳虚不能卫外故也。面色不华者，气血亏损，无以上荣于面也。遂与理中汤理其中气，加桂枝以祛虚邪。后倍加参、附，不数剂而愈。
唐氏之子患寒热，满月不愈，胸中有块高突，按之则痛，时见厥逆，兼多自汗。诊其脉，右三部虚微，按之如丝，此症实脉虚，邪实正衰之候也。攻之则碍虚，补之则助邪。然而用补则正气旺而邪自去，若任攻则邪气去而正独全者鲜矣。用人参二钱，扶正养正为主，佐以炙甘草和平益气以却虚邪，炮姜、黄连、半夏以开痞而散结，肉桂以固其本，桂枝以越其邪。制方井井有条，可以为法。二剂寒热减，两脉起，加人参以助中焦运化，而痛渐平。再用桂附理中汤调理而愈。
一妇人患寒热半月，两脉浮虚，按之则豁然空，两寸倍甚。说：“脉见空豁，寒热不时，面色不华者，气血不荣也。语言错乱者，神明失养也。”给予归脾汤加黄连、肉桂各七分，令其心肾内交。服后脉渐有神，改用人参三两，黄芪三两，当归身一两，炙草二钱，生地五钱，远志二钱，枣仁三钱，杞子五钱，大剂补气养荣。数剂寒热止，神气清。令早服七味丸，下午进归脾大造膏，百日而愈。
李东垣诊治中书左丞姚公茂，上热下寒，用既济解毒汤良愈。（未选入。）
来天培诊治马振昌之妻，年约五旬，夏间忽患寒热头痛，每未申时起，至寅卯时退，头晕，胸胃嘈杂。或作暑风治，益甚，不能饮食，无汗，气急懒言。诊之，六脉沉细，两关微弦。此为劳倦伤脾，中气不足，外感寒邪，内伤生冷，清阳不升，气虚不能达也。给予补中益气汤加炮姜、半夏，一剂汗出热短，嘈杂渐已。继以归脾汤加半夏、桂枝、白豆蔻仁，寒热除，饮食进，调理而愈。
马氏老妇年七旬，八月忽病寒热，恶心头疼，身痛，心跳不眠，呕吐不食，展转呻吟。诊之，两关弦而紧，余脉细小。以为脾气虚寒，肝气上逆。给予姜附理中汤，加白芍和肝，二剂渐瘳。
朱丹溪诊治一人，天明时发微寒，便热至晚，（病盛于阳。）两腋汗出，手足热甚，（四肢为诸阳之本。）则胸满拘急，大便实而能食，（邪热可知。）似劳怯病者，（虚损之甚亦作寒热。）脉不数，但弦细而沉。（此张子和谓为有积之脉。）询之，因怒气而得。但用大柴胡汤，惟胸背拘急不除。后用二陈汤加羌活、防风、红花、黄芩治之。
汪石山诊治一人，形体短小苍白，平素喜饮酒，五月间忽发寒热。医生作寒证治，燥渴更甚，时常吃梨，呕吐痰多，每次或至碗许，饮食少进，头痛晕闷，大便不通，小便如常，或一夜不安，或一日连发二次，或二日三日一发，或连发数日，平素两关脉亦浮洪。先令服独参汤二三帖，呕吐稍止，寒热暂住三日。其他医生说：“渴甚脉洪，热之极矣，乃用独参以助其热，非杀之而何？”及往视脉，皆浮洪近数，说：“这不是疟疾也不是热证。脉洪者，阴虚阳无所附，孤阳将欲飞越，故脉见此。其病属虚，非属热也。渴甚者，胃虚精少，不上朝于口，亦非热也。盖年逾六十，血气已衰，加以疟药性皆燥烈，又当壮火食气之时，老人何以堪此？然则邪重剂轻，非参所能独治。”遂以人参、黄芪各七钱，当归身、麦冬各一钱，陈皮七分，甘草五分，水煎，每次温服一酒杯。服至六七帖，痰止病除而食进，大便旬余不通，增之以蜜，仍令服三十余帖，以断病根。续后脉亦收敛而缓，非复向之鼓击而驶矣。
Wang Shishan treated Wang Shichang, who was obese with a purplish complexion and over thirty years old. In autumn, he suffered from aversion to cold and fever, headache, spontaneous sweating, nausea, expectoration of phlegm, and anorexia. The physician treated him for malaria. Upon examination, the pulse was floating, soggy, and slow, with the right Cun position slightly wiry. Wang Shishan said: "This is not malaria; it must be caused by overexertion and alcohol injury." He prescribed Qingshu Yiqi Tang (Clear Summerheat and Boost Qi Decoction), which cured him after four or five doses.
Yi Silan treated a scholar who had failed the imperial examinations and returned home, suffering from alternating chills and fever. Every day during the Shen (3-5 PM) and You (5-7 PM) hours, he initially felt slight chills, followed by high fever and severe irritability resembling madness. After these two hours, he would return to normal, except for dark yellow and difficult urination. Previously, whenever he had mental concerns, he would have nocturnal emissions. He drank several cups of salted liquor on an empty stomach daily. Physicians thought it was malaria and used Qingpi Yin (Clear Spleen Drink), Chai Ling Tang (Bupleurum and Poria Decoction), and antimalarial drugs, all without effect. Among the six pulses, only the left Chi position was floating; middle and deep pressure revealed surging, rapid, and forceful qualities, while other positions were peaceful. Yi Silan said: "This is tidal fever." He treated him with Jiabian Buzhong Yiqi Tang (Modified Decoction to Supplement the Middle and Augment the Qi), one dose daily. After three days, the illness gradually receded. He then used Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) combined with the previous medicine, and after one month of regulation, he recovered. Someone asked: "Why treat chills and fever as non-malaria?" He replied: "This is not malaria, but tidal fever. 'Tidal' refers to water tides arriving on schedule. The *Bafa Liuzhu* states: 'Shen and You hours belong to the Bladder and Kidney meridians.' This disease specifically belongs to these two meridians. With kidney water deficiency and fire hyperactivity, fire moves internally during Shen and You hours, causing fever and irritability; irritability belongs to the Kidney. If it were malaria, the Liver pulse would necessarily be wiry, but now it is not; only the left Chi shows fire signs. This is due to excessive sexual indulgence in the past, leading to kidney water depletion and vigorous yin fire, compounded by salted liquor drawing pathogenic factors into the Kidney meridian, causing dark yellow and difficult urination." Another asked: "Is this not yin deficiency with fire movement?" He replied: "Heat from yin deficiency persists continuously from Wu (11 AM-1 PM) to Hai (9-11 PM). Now heat occurs only during Shen and You hours, cooling down when heat subsides, which differs from yin deficiency." Another asked: "Perhaps Bu Zhong Yi Qi Tang was used before without effect? Why?" He replied: "The method of modification may differ. I removed Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix), adding Mudanpi (Moutan Cortex), Zexie (Alismatis Rhizoma), and Huangbai (Phellodendri Cortex). Mudanpi clears bladder fire, Zexie clears kidney fire, and Huangbai serves as the sovereign herb to generate kidney water. When water is abundant, fire declines, and chills/fever subside." Using Liuwei Dihuang Wan also utilizes its content of Mudanpi and Zexie. If one does not understand this and continues using Shengma and Chaihu, it is treating the Kidney with herbs for the Liver and Spleen, hence ineffective.
Sun Wenyuan treated the wife of Li Tanqu. In October, alternating chills and fever began, occurring once daily, accompanied by cough, heart pain, and lower back pain. After the 15th of January the following year, it became every other day, with significant muscle wasting, sore throat, profuse sweating like rain, leukorrhea like a flow, reduced diet, and refractory sweating despite various treatments. Pulse diagnosis showed a weak right hand and scattered left hand; this indicated that excessive sweating led to uncollected pulse qi, a critical condition. As the *Classic* states, "Fire-heat resembles malaria," referring to this case. He prescribed Huangqi (Astragali Radix) 2 qian, Baishao (Paeoniae Radix Alba) 1.5 qian, Gancao (Glycyrrhizae Radix) and Ejiao (Asini Corii Colla) each 1 qian, Biejia (Testudinis Carapax et Plastrum) 3 qian, Guizhi (Cinnamomi Ramulus) 0.5 qian, and one Wumei (Mume Fructus), decocted in water. Sweating stopped. On re-examination, the pulse had collected, and spirit returned. He added Heshouwu (Polygoni Multiflori Radix), Shihu (Dendrobii Caulis), and Muli (Ostreae Concha) to the previous formula. Chills and fever ceased, diet improved slightly, showing signs of recovery from a critical state.
Yu Jiayan treated the wife of Wu Jizhang. In early autumn, she suffered from shivering chills, followed by fever, gradually developing a cough. Though the illness was not severe, taking exterior-releasing drugs did not cure her, and her body grew increasingly emaciated. By early winter, after drinking tonics containing Renshen (Ginseng Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma), she felt breathless and near death, with no appetite, silent cough, and continuous diarrhea/dysentery, critically ill. Physicians proposed using 5 qian of Renshen and 3 qian of Fuzi (Aconiti Lateralis Radix Praeparata), added with Ginger, Cinnamon, and Atractylodes, in one dose to stop diarrhea and tonify deficiency, seeking a desperate victory. The family was at a loss and invited Yu Jiayan. Before Yu could speak, the previous physician arrived and asked for a prescription. Yu left calmly, knowing the previous doctor's views were erroneous and communication was futile. After the previous doctor left, Yu said: "This syndrome is entirely caused by mismedication. Initially, shivering chills and fever at the skin level indicated Lung Metal injured by seasonal dryness. Using exterior-releasing drugs was already illegal; using Renshen and Baizhu to tonify further closed the Lung qi, silencing the cough, causing chest/abdominal fullness, and anorexia. Heat in the Lung had no outlet and rushed to the Large Intestine. Food entered but was not transformed, exiting immediately. Without food intake, intestinal filth also rushed out with qi, causing endless diarrhea/dysentery. Now, using moistening Lung herbs, along with moistening Intestine herbs, will clear both source and stream, stopping chills/fever, cough, and diarrhea simultaneously." Four doses would ensure safety. The formula used Huangqin (Scutellariae Radix), Digupi (Lycii Cortex), Gancao, Xingren (Armeniacae Semen Amarum), and Ejiao. Diarrhea stopped after one dose; chills/fever cleared after four; cough resolved after a few more. If consulted with those doctors, they would insist on Renshen and Fuzi and never agree. Additionally, a woman surnamed Wang in the village also had autumn chills/fever. After taking Renshen and Baizhu, she became breathless, without cough, unable to eat rice for ten days, constipated, fainting frequently and losing consciousness. Her husband detailed the symptoms and requested tonics. Yu prescribed Dahuang (Rhei Radix et Rhizoma), Mangxiao (Natrii Sulfas), Shigao (Gypsum Fibrosum), and Gancao, ground coarsely. The husband could not distinguish them and decocted them. The woman said: "This medicine is very salty." The husband rejoiced: "Salty is indeed tonic," and gave two doses. Soon, abdominal cramping occurred, passing several hard feces, fainting then reviving, drinking two bowls of porridge, and the illness vanished. These cases show that having firm insights prevents confusion. Written to broaden physicians' knowledge.
Gao Gufeng treated the son of the Cheng family. Every Chen hour (7-9 AM), severe chills; every Wu hour (11 AM-1 PM), severe heat, leading to cold limbs, staring eyes, inability to speak, jaw dislocation, and copious salivation (liters per day), resolving with sweating at Chou hour (1-3 AM). No food intake, coma-like state. Diagnosis: caused by excessive attacking/draining therapies. Tonifying Spleen herbs had no immediate effect. Other doctors used Chaihu, Nanxing (Arisaematis Rhizoma), Banxia (Pinelliae Rhizoma), worsening the condition. Upon re-examination, Gao asked the attending doctor: "What disease is this, using such drugs?" The doctor said: "Don't you know? This is Liver Malaria. Liver Malaria causes pale complexion, sighing, and a death-like state." Gao laughed: "Based on your citation, Tongmai Sini Tang (Decoction to Revive the Pulse and Restore Yang) should be used, why those drugs? I don't recognize this disease, only that deficiency is extreme. Let's save the patient first, then treat the disease, how about that?" The doctor asked: "What drugs do you use?" Gao replied: "Large doses of Renshen and Fuzi can reverse this." The doctor argued against Renshen and Fuzi. Gao敷衍ly agreed and left. That night, he used 1 liang of Renshen, 2 liang of Huangqi, and 3 qian of Paojiang (Zingiberis Rhizoma Preparatum). At dawn, Shudi (Rehmanniae Radix Preparata), Guizhi, and Fuzi were given together. By the next Chen hour, the illness did not recur. This was due to overwork causing alternating chills/fever, misdiagnosed as malaria. In autumn, using dispersing/cold drugs exacerbated deficiency, damaging Liver and Spleen. Without strong tonification of Qi and Blood, survival was impossible. The illness was caused by human error; the patient was dying, yet the doctor clung to classics and forced fit to pathology. Prescriptions violated standard methods, self-deceiving and harming others until death. Tragic.
The wife of Lv Zhongjia had alternating chills/fever at age 14. After marrying Lv, for over ten years, chills/fever persisted. Treated as malaria or deficiency, she became emaciated and skeletal. Gao diagnosed: "Not malaria, not deficiency, but Blood-Wind Syndrome." He used Wujia Pi San (Acanthopanacis Cortex Powder) plus 2 liang of Shudi. Each dose totaled 5-6 liang of herbs, decocted in 2 sheng of water to 1 sheng, taken daily. After twenty doses, chills/fever disappeared instantly.
Feng Chuzhan treated Xu Shangong, suffering from malaria-like symptoms. Doctors used Chaihu Tang repeatedly, leading to unconsciousness, locked jaws, and rigid lying posture, deemed hopeless. Feng said: "Yang deficiency causes cold, Yin deficiency causes heat. Misdiagnosing as malaria leads to death." He used heavy doses of Shudi, Baizhu, Wuweizi (Schisandrae Fructus), Niuxi (Achyranthis Bidentatae Radix), Maidong (Ophiopogonis Radix), and Zhi Fuzi, separately decocting 1 liang of Renshen to mix in. After three days, consciousness returned; subsequent warm tonification cured him.
Wu Fuxian treated his sister-in-law with malaria-like chills/fever, delirious speech, seeing ghosts. Some suggested Heat entering the Blood Chamber, but symptoms did not match Zhang Zhongjing's three descriptions. Right Cun pulse was floating and slippery, indicating Wind-Phlegm congealing in the Lung, causing shivering chills/fever. Phlegm confusing the Heart orifice caused delirium. Exterior-releasing and Qi-promoting treatment would cure naturally. He used Erchen Tang (Two-Aged Phlegm Decoction) plus Zisu (Perillae Folium), Fangfeng (Saposhnikoviae Radix), Qianhu (Peucedani Radix), Gegen (Puerariae Lobatae Radix), Zhike (Aurantii Fructus Immaturus), Jiegeng (Platycodonis Radix), Sangbaipi (Mori Cortex), and Xingren. After several doses, mild sweating cured her.
A nun had intermittent chills/fever, red face, vexation, spontaneous sweating, aversion to wind, fatigue. Da Xiao Chaihu Tangs mixed made it worse. Pulse showed no cold pathogen, but Jueyin pulse was wiry, long, and extending to the Thenar eminence. Yiyin Dihuang Wan (Yin-Suppressing Rehmannia Pill) cured her.
Xue Lizhai treated a woman whose husband traveled for business. She developed chills/fever, menstruation lasting ten days. Taking Fire-descending and Blood-cooling drugs worsened internal heat, profuse sweating, and frequent menstruation. Xue said: "Internal heat and sweating are Spleen Qi deficiency heat, not Blood failing to return to Spleen." GuiPi Tang (Restore the Spleen Decoction) and Liuwei Dihuang Wan cured her.
A virgin girl had chronic chills/fever and irregular menstruation. Xiaochaihu Tang (Minor Bupleurum Decoction) plus Shengdi (Rehmanniae Radix) improved her slightly; then Shengdi Huang Wan (Rehmannia Pill) cured her. Formula: Chaihu and Qinjiao (Radix Gentianae Macrophyllae) each 0.5 liang, Shengdi 2 liang, pounded into paste with wine; Chishao (Paeoniae Radix Rubra) 1 liang powdered, honey pills. Thirty pills with Wumei soup, three times daily.
Yi Silan treated a man with chills/fever, treated as malaria for over a year without success. Later considered Labor Malaria or Deficiency Malaria, using Biejia San (Turtle Shell Powder) and Buzhong Yiqi Tang, all ineffective. Pulses were floating, large, and powerless in all three positions bilaterally. Emaciated, dark complexion, poor diet. Diagnosed as Yin Deficiency Fever. Morning: Liuwei Dihuang Wan; Evening: Buyin Wan (Tonify Yin Pill). After seven days, diet improved, chills/fever halved. After another jin (approx. 500g), cured within a month. This resembles malaria but is Yin Deficiency. True malaria has regular chills/fever intervals. Here, chills/fever come and go, sometimes once or twice daily, chills without cold limbs, burning heat, no sweat after heat, emaciation, dark complexion, palpitations, insomnia, thirst, constipation. How can this be malaria? Malaria pulse is wiry (deficiency pulses also often wiry); wiry-large upon onset, wiry-small upon remission. Here, floating-large-powerless, constant day and night, indicates Yin-Blood deficiency and Yang-Fire excess. Fire outward is heat; Fire trapped inward is cold. Emaciation is Fire consuming flesh. Dark complexion is Extreme Fire resembling Water. Palpitations/insomnia are Heart Blood deficiency. Poor diet/thirst/constipation is Fire blazing above and below. Generating Kidney Water and nourishing Yin-Blood allows Fire to descend, curing chills/fever.
Lizhai treated a woman with chronic chills/fever. Qingpi Yin caused chest fullness and anorexia. Tiaozhong Yiqi Tang (Regulate Middle and Augment Qi Decoction) plus Fuling (Poria), Banxia, and Paojiang (each 1 qian) cured her in two doses.
Zhu Danxi treated Lady Zhao. Night chills followed by heat, resolving at Chou/Yin hours (1-5 AM). Thirst upon waking, poor appetite, indigestion, abdominal pain/diarrhea, fatigue, irritability, red eyes, Qi stagnation. Averse to wind/cold and heat. Formula: Baizhu, Dangshen (Codonopsis Radix - note: text says Renshen/Huangqi amounts small, likely implying mild tonification or specific context, but text lists Renshen/Huangqi 5 fen), Danggui (Angelicae Sinensis Radix) each 2 qian; Baishao, Chenpi (Citri Reticulatae Pericarpium) each 1 qian; Renshen, Huangqi (Astragali Radix) each 5 fen; Chao Baipiao (Phellodendri Cortex), Zhi Gancao (Prepared Licorice), Chao Huangqin (Scutellariae Radix), Mudanpi, Mutong (Akebiae Caulis), Suosha (Amomi Fructus Rotundus) each 3 fen. Decocted, taken with Baohe Wan (Preserve Harmony Pill) and Shichang Wan (Solidify Intestine Pill), 30 pills each.
Lady Lu Shisi had chills/fever/cough after anger, poor diet, dysuria/diarrhea. Formula: Suosha, Gancao each 3 fen; Renshen 5 fen; Baizhu 1.5 qian; Lianqiao (Forsythiae Fructus), Chenpi, Fuling each 1 qian; 2 slices of Ginger. Decocted together.
A woman over fifty, robust, hardworking, irritable, rich diet, liked hot food. In summer, suffered heat, chills/fever without respite, feeling cold despite thick clothing. Both pulses choppy. Zhu treated as mixed pathogens. Formula: Siwu Tang (Four Substances Decoction) plus Chenpi; Renshen and Baizhu as sovereign; Sheng Gancao, Huangbai as assistants; lots of Jiangzhi (Ginger Juice); swallow Tongshen Wan (Divine Spirit Pill) 30 pills, Huijin Wan (Return Metal Pill), Yiqing Wan (Suppress Green Pill) 20 pills each, Awei (Asafetida) 10 pills. Three doses brought sleep; fifth dose body harmonized; seventh dose mild whole-body sweating, all symptoms resolved.
Hua Tuo biography: A woman suffered chronic illness for years, called "Cold-Heat Transmission Disease" in winter, eleventh month. Hua Tuo had her sit in a stone trough, pouring cold water at dawn, aiming for 100 pours. First 7-8 pours caused severe chills nearing death. Attendants feared stopping, but Hua Tuo insisted. Near 80 pours, steam rose like vapor, two-three chi high. After 100 pours, Hua Tuo ordered fire lit, bed warmed, covered thickly. After a long time, sweat appeared, powder applied, sweat dried, cured. (*Records of the Three Kingdoms*)
Ma Yuanyi treated Zhang Mou. Chills/fever for days, pain, vomiting/reversal, chest fullness, body ache. Left pulse wiry-choppy, Guan/Chi deficient/faint. Middle Qi deficiency-cold, Chest Qi not transforming causing fullness, Stomach Yang not distributing causing vomiting, Wei Yang not securing causing pain. Sijunzi Tang (Four Gentlemen Decoction) tonified Spleen/Stomach deficiency; Paojiang, Fuzi, Rougui (Cinnamomi Cortex) tonified Yang and expelled evil; slight Huanglian (Coptidis Rhizoma) as guide. One dose pulse rose; two doses pain stopped, sleep gained; few doses cured completely.
Gu Yunxie had daily chills/fever, chest fullness, continuous sweating for days. Chaihu/Huangqin dual-resolution failed. Right pulses deficient/faint, Left wiry-choppy. Complexion withered white. Faint pulse = Yang deficiency; Wiry = Deficient Wind. Caused by insufficient Zheng Qi, external Xu Evil invading. Treatment: Buzhong Yiqi Tang. Even with chest fullness, it is Yang deficiency failing to distribute, not Qi excess. Sweating is Yang deficiency failing to secure exterior. Pale complexion is Qi/Blood deficiency failing to nourish face. Given Lizhong Tang (Regulate Middle Decoction) to regulate Middle Qi, plus Guizhi to dispel deficient evil. Later doubled Renshen/Fuzi, cured in few doses.
Son of Tang family had chills/fever for a month, unresolved. Mass protruding in chest, painful on pressure, occasional cold limbs, profuse sweating. Right pulses deficient/faint, thread-like. Real pulse, deficient pattern; Pathogen excess, Zheng Qi decline. Attacking harms deficiency; Tonifying aids pathogen. However, tonifying strengthens Zheng Qi so Pathogen leaves; attacking removes Pathogen but rarely saves Zheng Qi alone. Used 2 qian Renshen to support/nourish Zheng Qi; Zhi Gancao to harmonize/Qi to repel deficient evil; Paojiang, Huanglian, Banxia to open obstruction/dissolve nodules; Rougui to root; Guizhi to vent evil. Prescription orderly, exemplary. Two doses chills/fever reduced, pulses rose; added Renshen to aid Middle Jiao transformation, pain eased. Guifu Lizhong Tang regulated to cure.
A woman had chills/fever for half a month. Pulses floating-deficient, hollow on pressure, Cun positions especially prominent. "Hollow pulse, irregular chills/fever, pale complexion: Qi/Blood failing to nourish. Confused speech: Spirit/Mind lacking nourishment." Given GuiPi Tang plus Huanglian/Rougui (each 7 fen) to connect Heart/Kidney. Pulse gained spirit; switched to 3 liang Renshen, 3 liang Huangqi, 1 liang Danggui, 2 qian Zhi Gancao, 5 qian Shengdi, 2 qian Yuanzhi (Polygalae Radix), 3 qian Zaoren (Ziziphi Spinosae Semen), 5 qian Qizi (Lycii Fructus). Large dose tonifying Qi/Nourishing Ying. Few doses chills/fever stopped, spirit clear. Morning: Qiwei Wan (Seven-Ingredient Pill); Afternoon: GuiPi Dazao Gao (Restore Spleen Great Creation Paste). Cured in 100 days.
Li Dongyuan treated Yao Gongmao, Upper Heat/Lower Cold. Jiji Jiedu Tang (Ji-Ji Detoxifying Decoction) cured well. (Not selected.)
Lai Tianpei treated Ma Zhenchang's wife, approx. 50 years old. Summer sudden chills/fever/headache, starting Wei/Shen hours, ending Yin/Mao hours. Dizziness, gastric discomfort. Treated as Summerwind, worsened. Anorexia, no sweat, shortness of breath, reluctance to speak. Six pulses deep-fine, Guan positions slightly wiry. Fatigue injuring Spleen, Middle Qi insufficient, External Cold pathogen, Internal raw/cold injury, Clear Yang not ascending, Qi deficiency failing to reach. Buzhong Yiqi Tang plus Paojiang, Banxia. One dose sweat, heat shortened, discomfort resolved. Followed by GuiPi Tang plus Banxia, Guizhi, Baixiangdou (Cardamomi Fructus Albus). Chills/fever removed, diet advanced, cured with regulation.
Old woman Ma, 70 years old. August sudden chills/fever, nausea/headache, body ache, palpitations/insomnia, vomiting/anorexia, groaning. Guan pulses wiry-tight, others fine-small. Spleen Qi deficiency-cold, Liver Qi reversing upward. Jiangfu Lizhong Tang plus Baishao to harmonize Liver. Two doses improved.
Zhu Danxi treated a man. Dawn slight chills, heat until evening (Pathogen盛 in Yang). Axillary sweating, hot hands/feet (Limbs root of Yang). Chest fullness/tension, solid stool, able to eat (Pathogen heat known). Resembles Consumption disease (Severe deficiency also causes chills/fever). Pulse not rapid, but wiry-fine-deep (Zhang Zihe calls this accumulation pulse). Caused by anger. Dachaihu Tang only relieved chest/back tension. Later Erchen Tang plus Qianghuo (Notopterygii Rhizoma), Fangfeng, Honghua (Carthami Flos), Huangqin cured him.
Wang Shishan treated a man, short/pale, habitually drinks alcohol. May sudden chills/fever. Doctor treated as Cold, dry-thirst worsened, ate pears often, copious phlegm vomiting (bowlfuls), poor diet, headache/dizziness, constipation, normal urine. Irregular fever patterns. Ping usual Guan pulses floating-hong. First Du Shen Tang (Single Ginseng Decoction) 2-3 doses, vomiting stopped, chills/fever paused 3 days. Other doctor said: "Thirst severe, pulse hong, extreme heat. Using Single Ginseng aids heat, isn't this killing him?" Visiting pulse, floating-hong-near-rapid. Said: "Not malaria, not heat. Pulse hong: Yin deficiency, Yang has no attachment, Lone Yang about to fly away. Disease is deficiency, not heat. Severe thirst: Stomach deficiency, essence scarce, not reaching mouth, not heat. Over 60, Qi/Blood declining. Malaria drugs are drying/hot. Elderly cannot bear this. But pathogen heavy, dose light, Ginseng alone cannot treat." Formula: Renshen, Huangqi each 7 qian; Danggui, Maidong each 1 qian; Chenpi 7 fen; Gancao 5 fen. Decocted, warm sip. 6-7 doses, phlegm stopped, illness removed, diet advanced. Constipation >10 days, added honey, continued 30+ doses to cut root. Pulse converged/slowed, no longer beating fast.