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In diseases of cold and heat, those with Yin deficiency are difficult to treat. For chronic illness accompanied by aversion to cold, one should use methods to resolve stagnation. Aversion to cold indicates Yang deficiency; use Ren Shen (Ginseng Radix) and Huang Qi (Astragali Radix). In severe cases, add a small amount of Fu Zi (Aconiti Lateralis Radix Praeparata) to promote the action of Ren Shen and Huang Qi. Severe aversion to cold in the back, with a pulse that is floating, large, and forceless, indicates Yang deficiency. In consumptive disorders, severe aversion to cold in winter: if Qi is excess, purgatives may be used; alternatively, exterior-resolving methods are suitable, using Chai Hu (Bupleuri Radix) and Ge Gen (Puerariae Lobatae Radix). Cang Zhu (Atractylodis Rhizoma) is feared for being too drying. For fever due to Yin deficiency, use Si Wu Tang (Four Substances Decoction) plus fried Bai Hu (Phellodendri Cortex); if Qi deficiency is also present, add Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), and Huang Qi (Astragali Radix). For fever due to Yang deficiency, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). For night fever due to damp-phlegm, use San Bu Wan (Three Tonics Pill) plus Bai Shao (Paeoniae Radix Alba). For fever due to Qi deficiency, use Shen Su Yin (Ginseng and Perilla Drink). For chronic Yin deficiency with Qi stagnation causing night fever: Jiu Shao Yao (Wine-processed Paeoniae Radix) 1 liang 2 qian, Xiang Fu (Cyperi Rhizoma) 1 liang, Cang Zhu (Atractylodis Rhizoma) 5 qian, Pian Qin (Scutellariae Baicalensis Radix) 3 qian, Gan Cao (Glycyrrhizae Radix et Rhizoma) 1.5 qian; make pills with steamed wheat cake dough and take.

Fever with paroxysms: occurring at night and stopping during the day, or vice versa; occurring between Si-Wu hours (9 AM - 1 PM) or Shen-Wei hours (3 PM - 7 PM): use Xiao Chai Hu Tang (Minor Bupleurum Decoction) plus Ren Shen (Ginseng Radix) and Bai Zhu (Atractylodis Macrocephalae Rhizoma); if thirsty, add Gua Lou Gen (Trichosanthis Radix). If the pulse is weak and previous medicines do not reduce symptoms, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with increased amounts of Ren Shen (Ginseng Radix), Huang Qi (Astragali Radix), Dang Gui (Angelicae Sinensis Radix), and Bai Zhu (Atractylodis Macrocephalae Rhizoma); taking it for a long time will lead to self-healing.

For fever with aversion to cold, exterior resolution is appropriate: use Chai Hu (Bupleuri Radix) for fever, and Cang Zhu (Atractylodis Rhizoma) for aversion to cold. If Qi is slightly deficient, with bone-steaming fever or chills, dry stool, excess pulse, ability to eat, and fever resolving after free bowel movements, use Chai Hu Yin Zi (Bupleurum Drink). If Qi is excess, with exterior heat, ability to eat, wiry pulse, no sweat, and ability to sleep, or for cold-heat alternating due to phlegm accumulation, use Xiao Chai Hu Tang (Minor Bupleurum Decoction).

Case 1: A man contracted aversion to cold in June, with dry constipation, fear of wind, robust physique, and normal daily routine. Use Da Cheng Qi Tang (Major Order the Yellow Decoction).
Case 2: A woman with aversion to cold: use Ku Shen (Sophorae Flavescentis Radix) and Chi Xiao Dou (Vigna umbellata Seed), each 1 qian, powdered; induce vomiting with vinegar water, then use Chuan Xiong (Ligustici Chuanxiong Rhizoma), Cang Zhu (Atractylodis Rhizoma), Nan Xing (Arisaematis Rhizoma Preparatum), and Huang Qin (Scutellariae Baicalensis Radix wine-processed); make pills with yeast paste.
Case 3: A 23-year-old man developed fever from drinking alcohol. Use Qing Dai (Indigo Naturalis) and Gua Lou Ren (Trichosanthis Semen), ground and mixed with ginger juice; drink several spoonfuls daily; cured in three days.
Case 4: A person had slight chills at dawn followed by fever until evening, sweating in both axillae, extreme heat in hands and feet, then chest fullness and stiffness, solid stool, ability to eat, resembling consumptive disease. Pulse was not rapid, but wiry, thin, and deep. Inquiry revealed onset due to anger. Use Da Chai Hu Tang (Major Bupleurum Decoction). Chest and back stiffness remained unresolved; later treated with Er Chen Tang (Two Cured Things Decoction) plus Qiang Huo (Notopterygii Rhizoma et Radix), Fang Feng (Saposhnikoviae Radix), Huang Qin (Scutellariae Baicalensis Radix), and Hong Hua (Carthami Flos).

Official Zhou Bendao, over 30 years old, suffered from aversion to cold. He took hundreds of Fu Zi (Aconiti Lateralis Radix Praeparata) pills, worsening his condition. Seeking treatment, his pulse was wiry and seemingly slow. I gave him Jiang Cha (River Tea) with a little ginger juice and sesame oil to induce vomiting of about one sheng of phlegm. His cotton clothes were reduced by half. Then I prescribed Fang Feng Tong Sheng San (Wind-Barrier Universal Release Powder) without Da Huang (Rhei Radix et Rhizoma) and Mang Xiao (Natrii Sulfas), adding Di Huang (Rehmanniae Radix). After more than 100 doses, he stabilized. Zhou was very pleased. I said, "Not yet. Dry-heat remains, and blood yin has been damaged. You must eat bland foods to nourish the stomach and practice introspection to nourish the spirit, so that Kidney Water can generate and Heart Fire can descend." He was ambitious in his career, focused on external affairs, and ignored taboos. I said, "If given more blood-nourishing and cooling medicines, he might stabilize slightly. But with internal and external unrest, Kidney Water will not generate, and Fu Zi toxicity will inevitably manifest." Later, he served as a night patrol officer in Wucheng. His stomach cold required Fu Zi for treatment, but he feared Sheng Jiang (Zingiberis Rhizoma Recens). Thus, he sliced pork kidneys, boiled them with Fu Zi for three doses, and was cured. I said, "Return home immediately; your Fu Zi toxicity is prone to flare up." He thought me pedantic. Half a year later, he died from a carbuncle on the back.

Case 5: A man in his twenties had fever, headache, delirium, and hallucinations in September. The physician gave Xiao Chai Hu Tang (Minor Bupleurum Decoction) for over ten doses, but fever worsened. He was fat, with a wiry, large, and rapid pulse, especially on the left. Treated as deficiency: Ren Shen (Ginseng Radix) and Bai Zhu (Atractylodis Macrocephalae Rhizoma) as sovereign, Fu Ling (Poria), Shao Yao (Paeoniae Radix) as minister, Huang Qi (Astragali Radix) as assistant, and one piece of Fu Zi (Aconiti Lateralis Radix Praeparata) as envoy. Two doses showed no improvement. Some argued that with a rapid/large pulse, high fever, and intense thirst, Fu Zi was dangerous. I said, "Deficiency is severe. Mistakenly using cold/cool medicines, combined with obesity and left pulse larger than right, is critical. Without one piece of Fu Zi to move Ren Shen and Bai Zhu, how can there be emergency rescue?" Gave one more dose, then removed Fu Zi and made a large formula. Over 50 doses led to profuse sweating and cure. Self-nourishment continued for two months, constitution still unstable.

Case 6: A 19-year-old man, unafraid of labor in farming, suddenly had high fever and thirst, drank several bowls of water freely. Next morning fever subsided, blindness, delirious speech, inability to turn abdomen, anorexia, tremors. Urgent call on second day. Pulses both sides were choppy and large, right worse. Moxibustion 30 cones on Qi Hai (CV6). Use Bai Zhu (Atractylodis Macrocephalae Rhizoma) 2 qian, Huang Qi (Astragali Radix) 2 qian, Shu Fu Zi (Prepared Aconiti Lateralis Radix) 1 piece, Chen Pi (Citri Reticulatae Pericarpium) 0.5 qian. Ten doses ineffective, slight thirst increased, other symptoms persisted. Consumed little rice gruel. This indicates Qi harmonized but Blood not responding. Remove Fu Zi from previous formula, add Jiu Dang Gui (Wine-processed Angelicae Sinensis Radix) to harmonize Blood. Add Ren Shen (Ginseng Radix) 1.5 qian due to heat. Thirty doses led to stability.

Brother Zheng, over 20, had fever and thirst with delirium in early autumn, resembling possession. After eight days, pulses were surging, rapid, and forceful. Fat, white complexion, visible bones/tendons, pulse felt under fingers. Likely caused by cooling medicines. This is fatigue-labor disease; warm tonification brings peace. Already took 7-8 doses of Chai Hu (Bupleuri Radix) without effect. Prescribed Huang Qi (Astragali Radix) and Fu Zi (Aconiti Lateralis Radix Praeparata) Tang, served cold. After three doses, slight sweat, slept well, pulse softened. Continued treatment. Used Huang Qi Bai Zhu Tang (Astragalus and Atractylodes Decoction) for ten days to stabilize, added Chen Pi (Citri Reticulatae Pericarpium), recovered fully in half a month.

Relative Lu, indulged in alcohol and lust, nearly 50 years old. One day severe aversion to cold, shaking, thirst but little desire to drink. Pulse large and weak, Right Guan slightly excess and rapid, heavy pressure choppy. Caused by internal stagnation of alcohol-heat, exterior excess with interior deficiency. Prescribed Huang Qi (Astragali Radix) with double amount of Gan Ge (Puerariae Lobatae Radix) decoction. Finished 5-6 doses, profuse sweat, stabilized.

A woman with emaciation, night sweats, and aversion to cold: Use Wu Zhu Yu (Evodiae Fructus) size of a chicken egg, soaked in 3 sheng of wine for half a day, boiled and taken.

Facial cold and heat: Facial cold is Stomach heat, cold stagnating heat. Facial heat is Fire arising, constrained and generating heat. If a patient suddenly shows red spots on the face, death is likely.