晚发者。夏受暑湿之邪。留伏于里。至秋新邪引动而发也。其症与疟疾相似。但寒
热模糊。脉象沉滞。舌苔粘腻。脘痞烦闷。午后更热。天明汗解。或无汗。清晨稍解。此
暑湿之邪。留着于里。最难骤愈。治法不外三焦主治。在上焦。则舌苔白腻。头胀
身痛。肢疼胸闷。咽干溺涩等症。当泄气分之热。宜连翘、杏仁、滑石、薄荷、橘红、通草、
半夏、桔梗。热邪重。加黄芩、芦根。湿邪重。加白蔻、浓朴。在中焦。则舌苔微黄粘腻。
痞闷胸满。或目黄舌白。口渴溺赤。宜湿热兼治。用泻心法。半夏、陈皮、赤苓、枳实、川
连、通草之类。若湿邪重。则脾阳受伤。目黄腹胀。小溲不利。或大便不实。又宜温中
去湿。如茅术、浓朴、二苓、泽泻、木香、木瓜之类。湿甚。加干姜。湿热结于下焦气分。
必兼小腹胀满。小便不利。宜茯苓、猪苓、滑石、寒水石、晚蚕砂、茵陈、泽泻之类。桂苓
甘露饮亦可。若暑湿之邪。入于营分。则口渴。心烦。舌赤。宜清营分之邪。犀角、鲜
地、菖蒲、元参、连翘、银花之类。若舌苔中黄边绛。齿燥唇焦。脉左数右大。此暑邪
内燔。气血两伤也。玉女煎。
初起发寒热。殊类伤寒。第脚膝痛。或肿。与伤寒异。属湿热。虽由坐卧湿地。与湿水
而得。久之必湿化为热。初宜发散。后兼分利。与湿症同法。
主治大法 用茅术、紫苏、二活、秦艽、米仁等。以去风湿。兼利关节。黄柏、黄芩、以清
热。防己、木瓜、萆 以达下。消肿利湿。槟榔、陈皮以行气。后佐以血分药调之。川断、芎归、丹参之类。
攻胃。呕逆。二陈、平胃加木瓜。小水不利。五苓散。
攻心。则恍惚谬妄。呕吐不食。眠卧不安。左寸乍大乍小。乍有乍无。不治。
邪客三阳。属表。见寒热拘急。宜汗。邪客三阴。属里。见二便阻涩。宜渗利。
鸡鸣散 治香港脚肿痛。寒湿流注。筋脉浮肿。最验。
槟榔（为君重用） 陈皮（盐水炒） 吴茱萸（少许盐水炒） 木瓜 紫苏 桔梗 生姜
鸡鸣时服。天明。大便见黑色粪。是湿毒已下也。
Late-onset fever refers to the condition where summerheat-dampness pathogenic factors are contracted in summer, lie latent within the interior, and are triggered by new pathogenic factors in autumn. Its symptoms resemble malaria (Malaria), but the alternating chills and fever are indistinct, the pulse is deep and sluggish, the tongue coating is sticky, there is epigastric fullness and stifling sensation, heat worsens in the afternoon, and relief occurs with sweating at dawn or slightly improves in the early morning without sweating. This indicates that summerheat-dampness pathogenic factors are lingering in the interior, making it difficult to cure rapidly. The treatment method essentially follows the management of the Three Burners (San Jiao).
When the disease is in the Upper Burner, symptoms include a white and greasy tongue coating, head distension and body pain, limb pain and chest tightness, dry throat, and scanty or difficult urination. One should vent the heat from the Qi level (Qi Fen). Suitable herbs include Qingkailing (Forsythiae Fructus), Xingren (Armeniacae Semen Amarum), Huashi (Talcum), Bohe (Menthae Haplocalycis Herba), Juhong (Citri Reticulatae Pericarpium Rubrum), Tongcao (Tetrapanacis Medulla), Banxia (Pinelliae Rhizoma), and Jiegeng (Platycodonis Radix). If heat pathogenic factors are heavy, add Huangqin (Scutellariae Radix) and Lugen (Phragmitis Rhizoma); if dampness pathogenic factors are heavy, add Baokouren (Amomi Fructus Rotundus) and Houpo (Magnoliae Officinalis Cortex).
When the disease is in the Middle Burner, symptoms include a slightly yellow and greasy tongue coating, epigastric and chest fullness, or yellow eyes with a white tongue coating, thirst, and red urine. One should treat both dampness and heat simultaneously using the Xiexin Method (Draining the Heart Method), employing herbs such as Banxia (Pinelliae Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Chifuling (Poria Cocos with Red Branch), Zhishi (Aurantii Fructus Immaturus), Chuanlian (Coptidis Rhizoma), and Tongcao (Tetrapanacis Medulla). If dampness is heavy, damaging Spleen Yang (Spleen Qi-Yang), leading to yellow eyes, abdominal distension, difficult urination, or loose stools, one should warm the middle and dispel dampness, using herbs such as Maoyu (Atractylodis Rhizoma), Houpo (Magnoliae Officinalis Cortex), Erling (Poria Cocos and Polyporus Umbellatus), Zexie (Alismatis Rhizoma), Muxiang (Aucklandiae Radix), and Mugua (Chaenomelis Fructus). If dampness is severe, add Ganjiang (Zingiberis Rhizoma).
If damp-heat knots in the Qi level of the Lower Burner, it must be accompanied by lower abdominal fullness and difficult urination. Suitable herbs include Fuling (Poria Cocos), Zhuling (Polyporus Umbellatus), Huashi (Talcum), Hanshuishi (Calcitum), Wancansha (Bombyx Batryticatus), Yinchen (Artemisiae Scopariae Herba), and Zexie (Alismatis Rhizoma). Guiling Ganlu Yin (Guiling Sweet Dew Decoction) can also be used.
If summerheat-dampness pathogenic factors enter the Ying (Nutritive) Level, symptoms include thirst, mental restlessness, and a crimson tongue. One should clear the Ying level pathogenic factors, using Shuixi (Rhinocerotis Cornu, now substituted with Shuangshui Niujiao or Water Buffalo Horn), Xian Di (Rehmanniae Radix Recens), Changpu (Acori Tatarinowii Rhizoma), Yuan Shen (Scrophulariae Radix), Linqiao (Forsythiae Fructus), and Yinhua (Lonicerae Japonicae Flos). If the tongue coating is yellow in the center and crimson on the edges, with dry teeth and scorched lips, and the pulse is rapid on the left and large on the right, this indicates internal blazing of summerheat pathogenic factors and injury to both Qi and Blood. Use Yunnv Jian (Jade Woman Decoction).
In the initial stage, chills and fever appear, resembling Taiyang Disease (Taiyang Bing). However, pain or swelling in the legs and knees distinguishes it from Taiyang Disease; it belongs to damp-heat. Although caused by sitting or lying on wet ground or contact with water, over time dampness transforms into heat. Initially, dispersing methods are suitable; later, draining and separating methods are added. This follows the same principles as treating dampness syndromes.
General Treatment Principles: Use Maoyu (Atractylodis Rhizoma), Zisu (Perillae Folium), Erhuo (Qianghuo and Duhuo), Qinjiao (Gentianae Macrophyllae Radix), and Yiren (Coicis Semen) to dispel wind-dampness and benefit joints; Huangbai (Phellodendri Cortex) and Huangqin (Scutellariae Radix) to clear heat; Fangji (Stephaniae Tetrandrae Radix), Mugua (Chaenomelis Fructus), and Bixie (Dioscoreae Hypoglaucae Rhizoma) to reach the lower part, reduce swelling, and promote diuresis; Binglang (Arecae Semen) and Chenpi (Citri Reticulatae Pericarpium) to move Qi. Later, supplement with blood-invigorating herbs for regulation, such as Chuanduan (Dipsaci Radix), Xionggui (Chuanxiong Rhizoma and Angelicae Sinensis Radix), and Danshen (Salviae Miltiorrhizae Radix et Rhizoma).
If the pathogen attacks the Stomach, causing vomiting and hiccups, use Erchen Tang (Two-Cured Decoction) and Pingwei San (Stomach-Pacifying Powder) with added Mugua (Chaenomelis Fructus). If urination is difficult, use Wuling San (Five-Ingredient Powder with Poria).
If the pathogen attacks the Heart, resulting in mental confusion, delirium, vomiting, anorexia, insomnia, and a Left Cun pulse that fluctuates between large and small, present and absent, this is incurable.
If pathogens lodge in the Three Yang meridians, it is a Exterior Syndrome, presenting with chills, fever, and stiffness; sweating is indicated. If pathogens lodge in the Three Yin meridians, it is an Interior Syndrome, presenting with obstruction and difficulty in defecation and urination; diaphoresis/drainage is indicated.
Jiming San (Crowing Rooster Decoction) treats Hongxiangjiao (Beriberi/Lower Limb Edema) with swelling and pain, cold-dampness flowing into collaterals, and edema of tendons and vessels. It is highly effective.
Ingredients: Binglang (Arecae Semen) - used heavily as Sovereign herb; Chenpi (Citri Reticulatae Pericarpium) - stir-fried with salt water; Wuzhuyu (Evodiae Fructus) - a small amount, stir-fried with salt water; Mugua (Chaenomelis Fructus); Zisu (Perillae Folium); Jiegeng (Platycodonis Radix); Shengjiang (Zingiberis Rhizoma Recens). Take at the time of the crowing rooster (early morning). By dawn, black stool appears, indicating that damp-toxin has been discharged downwards.