虚烦者。因虚而烦躁发热也。但不恶寒。头身不痛。与伤寒异耳。虽有热。不可攻热。
热去则寒起。诚格言也。如劳役虚烦。身热头痛。气口脉虚大者。即劳倦内伤症也。
补中益气汤主之。盖以甘温之品。补其中气。升其阳气。其热自止。或少加黄柏。以
滋肾阴。其效如神。如劳役虚烦。身热骨疼。腿膝 软无力。或兼自汗舌润不渴
者。当以归 建中汤。加川断、杜仲主之。
若伤寒。烦躁发热。舌燥口渴。妄言日常之事。俗名劳倦。实非也。乃心包络之火。宜
清之。温胆汤。加川连、钩藤、淡竹叶。兼痰者。加天竺黄、川贝母、如心气虚而躁烦。
不宁不寐者。左寸脉必虚小。当以茯神、远志、枣仁、丹参之类以补心气。甚者。加辰
砂、金箔之类。以镇心神。虚甚。加人参。（新法）
肺风寒痰 如见憎寒发热。鼻塞头痛。胸满气急。或咳或喘。右寸浮滑。或沉伏者。
此风痰在肺也。如舌白而润。口不渴者。痰由寒邪生也。宜二陈汤加桑杏、前胡、羌
活、苏薄之类微散之。喘加焦麻黄、葶苈子以泻肺。如舌苔白燥。口渴者。肺家津
液少也。宜泻白散。加前胡、杏仁、橘红、茯苓、象贝、川斛、薄荷、枯芩之类。
肺风热痰 如微寒发热。胸闷气逆。咳嗽兼喘。舌苔黄燥。或白刺。口渴脉数者。此
风热客肺生痰也。宜羚羊角、前胡、桑杏、蒌霜、贝母、枯芩、橘红、薄荷、旋复花、淡竹叶
之类。以去风热。痰自平矣。如痰闭气逆。加竹沥、姜汁润之。
包络热痰 如伤寒神昏谵语。目睛微定。或舌蹇语涩。舌苔尖赤。中白而燥者。此
热痰乘于包络也。宜犀角尖、川郁金、石菖蒲、天竺黄、川贝母、钩藤钩、淡竹叶、栝蒌
霜之类主之。如舌绛神呆。痰潮语蹇者。内闭也。加西黄。
痰挟痧疹 凡时感伤寒。初起即胸中烦闷。气急痰喘。先用豁痰利气药。痰已行
而喘减。但烦闷身热不除。反加耳聋足冷者。此必痰挟痧疹也。急宜透之提之。如
羚羊角、连翘、牛蒡、防风、干葛、薄荷、枳壳、桔梗、蝉蜕之类。
痧疹挟痰 凡时感初起。烦闷呕恶。手足指冷。寸口脉滞。先用解表透疹之药。疹
痧虽透。而病势不减。满闷喘急仍在者。此必痧疹兼挟伏痰也。当豁痰以透疹。前
胡、杏仁、象贝、栝蒌、橘红、海石、羚羊、牛蒡、薄荷、桔梗、竹沥、姜汁之类主之。痰行结解。
痧疹外达。而诸症自平。
络中湿痰 如发热脘闷。胸胁肩背皆痛。此湿痰窃踞肺胃之络。痰气交阻。故痛。
宜六安煎去甘草。加桂枝、钩丁、蒺藜、栝蒌皮、片姜黄、白僵蚕、木香汁之类。通之行之。
痰入肝络 伤寒有解表之后。肢体不能转动者。此痰入于肝络也。当以金星礞
石、半夏、栝蒌、茯苓、陈皮、天虫、全蝎、姜汁炒蒺藜、川桂枝、旋复花之类。以搜入络之
痰。肢自遂矣。如未应。即以养血药兼之。
解后伏痰 伤寒解表之后。热势稍退。但觉目钝神呆。身重或痛。胸满不畅者。此
胃中有伏痰也。右关脉必沉伏。或沉滑。宜二陈汤加枳实、栝蒌、姜汁、竹茹之类。豁之行之。
中宫湿痰 如伤寒胸闷。寒热模糊。恶心不渴者。中宫有湿痰也。二陈汤加枳实、
浓朴、紫苏、茅术之类和之。
积痰 如发热胸闷。咳嗽气急。痰多浓浓者。中宫积痰也。宜燥润并用。如南星、半
夏、栝蒌、海石、枳实、陈皮、茯苓之类。或导痰汤亦可。
解后余痰 凡伤寒汗解后。 疹已透后。尚觉余热未除。目睛微定者。痰也。眼下
黑色者。亦痰也。其证必中脘痞闷。少纳不饥。宜二陈汤加枳实、麦芽和之。
Xu Fan (Deficiency-Induced Restlessness): Xu Fan refers to restlessness and fever caused by deficiency of healthy Qi. Its characteristics are aversion to cold being absent, and no pain in the head or body, which differs from Shanghan (Cold Damage). Although there is heat within, purgative methods should not be used to clear the heat. For if the heat is removed, cold will arise; this is a golden rule. If it is deficiency-induced restlessness due to overwork, manifesting as body heat, headache, and a deficient and large pulse at the Qikou (Radial artery), this is a syndrome of internal injury due to fatigue. It should be treated primarily with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). This is because sweet-warm substances are used to tonify middle Qi and raise Yang Qi, whereupon the heat will naturally cease. Alternatively, a small amount of Huangbai (Phellodendri Cortex) may be added to nourish Kidney Yin, yielding miraculous efficacy. If deficiency-induced restlessness due to overwork presents with body heat, bone pain, weakness and softness in the legs and knees, or accompanied by spontaneous sweating, a moist tongue without thirst, Danggui Jianzhong Tang (Angelica Decoction for Building the Middle) combined with Chuan Duan (Dipsaci Radix) and Duzhong (Eucommiae Cortex) should be used.
If it is Shanghan presenting with restlessness, fever, dry tongue with thirst, and delirious speech regarding daily matters—colloquially called "fatigue" but actually incorrect—it is due to Fire in the Pericardium Collateral. It should be cleared using Wendan Tang (Warm the Gallbladder Decoction) added with Chuan Lian (Coptidis Rhizoma), Gouteng (Uncariae Ramulus cum Uncis), and Dan Zhuyez (Lophatheri Herba). If phlegm is also present, add Tianzhuhuang (Calami Tintinnabuli Spira) and Chuan Beimu (Fritillariae Cirrhosae Bulbus). If Heart Qi is deficient leading to agitation and restlessness, with mental unrest and insomnia, the Zucun (Left Cun position on the radial artery) pulse must be deficient and small. One should use Fushen (Poria with Hostwood), Yuanzhi (Polygalae Radix), Zaoren (Ziziphi Spinosomi Semen), Danshen (Salviae Miltiorrhizae Radix et Rhizoma), etc., to tonify Heart Qi. In severe cases, add Chen Sha (Cinnabar) and Jinbo (Gold Leaf) to calm and anchor the Spirit. If deficiency is extreme, add Renshen (Ginseng Radix et Rhizoma). (New Method)
Lung Cold-Damp Phlegm: If one experiences aversion to cold and fever, nasal congestion and headache, chest fullness and rapid breathing, or cough and asthma, with a floating-slippery or deep-hidden pulse at the Youcun (Right Cun position), this indicates Wind-Phlegm in the Lung. If the tongue coating is white and moist, and there is no thirst, the phlegm is generated by Cold Evil. Erchen Tang (Two-Aged Decoction) added with Sangye (Mori Folium), Xingren (Armeniacae Semen Amarum), Qianhu (Peucedani Radix), Qianghuo (Notopterygii Rhizoma et Radix), Sugen (Perillae Caulis), and Bohe (Menthae Haplocalycis Herba) should be used for mild dispersion. If asthma is present, add Jiao Mahuang (Processed Ephedrae Herba) and Tinglizi (Descurainiae Semen seu Lepidii Semen) to drain Lung Qi. If the tongue coating is white and dry, and there is thirst, it indicates insufficient fluids in the Lung. Xiexie San (Drain the Lung Powder) added with Qianhu, Xingren, Juhong (Citri Reticulatae Pericarpium Rubrum), Fuling (Poria), Xiangbeimu (Fritillariae Thunbergii Bulbus), Chuan Shihu (Dendrobii Nobile Caulis), Bohe, and Kuqin (Scutellariae Radix) should be used.
Lung Wind-Heat Phlegm: If there is slight aversion to cold and fever, chest fullness and rebellious Qi, cough with asthma, yellow-dry tongue coating or white prickles, thirst, and a rapid pulse, this indicates Wind-Heat lodging in the Lung generating phlegm. Lingyangjiao (Saigae Tataricae Cornu), Qianhu, Sangye, Xingren, Lou Shuang (Trichosanthis Fructus Pulvis), Beimu, Kuqin, Juhong, Bohe, Xuanfuhua (Inulae Flos), and Dan Zhuyez should be used to dispel Wind-Heat, upon which the phlegm will settle naturally. If phlegm obstruction causes rebellious Qi, add Zhuli (Bambusa Textilis Catillus) and Jiangzhi (Zingiberis Recensis Juice) to moisten.
Pericardium Heat-Phlegm: If Shanghan leads to coma and delirium, fixed gaze, or stiff tongue with slurred speech, with a red tip and dry white center on the tongue coating, this indicates Heat-Phlegm assaulting the Pericardium. Shui Niujiaojian (Water Buffalo Horn Tip), Chuan Yujin (Curcumae Radix), Shichangpu (Acori Tatarinowii Rhizoma), Tianzhuhuang, Chuan Beimu, Goutenggou (Uncariae Ramulus cum Uncis), Dan Zhuyez, and Lou Shuang should be used. If the tongue is crimson with dull spirit, and phlegm tide causes slurred speech, indicating internal closure, add Xi Huang (Bovis Calculus).
Phlegm Accompanying Rash: Whenever seasonal pathogens or Shanghan begin with chest oppression, rapid breathing, and phlegm asthma, first use phlegm-resolving and Qi-regulating herbs. Once phlegm moves and asthma decreases, but restlessness and fever persist, accompanied by deafness and cold feet, this must be Phlegm accompanying Rash. Urgent dispersal and lifting are required. Lingyangjiao, Lianqiao (Forsythiae Fructus), Niubangzi (Arctii Fructus), Fangfeng (Saposhnikoviae Radix), Gange (Puerariae Lobatae Radix), Bohe, Zhike (Aurantii Fructus Immaturus), Jiegeng (Platycodonis Radix), and Chantui (Cicadae Periostracum) should be used.
Rash Accompanying Phlegm: When seasonal pathogens begin with restlessness, nausea, vomiting, cold fingertips, and sluggish pulse at the Cunkou, first use exterior-releasing and rash-expelling herbs. Even if the rash emerges, if the disease severity does not decrease and chest fullness with rapid breathing persists, this must be Rash accompanied by latent Phlegm. Phlegm must be resolved to expel the rash. Qianhu, Xingren, Xiangbeimu, Gualou (Trichosanthis Fructus), Juhong, Haishi (Calcitum), Lingyangjiao, Niubangzi, Bohe, Jiegeng, Zhuli, and Jiangzhi should be used. Once phlegm moves and stagnation resolves, and the rash reaches the exterior, all symptoms will naturally subside.
Damp-Phlegm in Collaterals: If fever and epigastric oppression occur, with pain in the chest, hypochondrium, shoulders, and back, this indicates Damp-Phlegma occupying the collaterals of the Lung and Stomach, where Phlegm and Qi obstruct each other, causing pain. Liu'an Jian (Six-Safe Decoction) with Gancao (Glycyrrhizae Radix et Rhizoma) removed, added with Guizhi (Cinnamomi Ramulus), Gouding (Uncariae Ramulus cum Uncis), Jili (Tribuli Fructus), Gualoupi (Trichosanthis Pericarpium), Pian Jianghuang (Curcumae Longae Rhizoma), Baijiangcan (Bombyx Batryticatus), and Muxiangzhi (Aucklandiae汁) should be used to unblock and promote circulation.
Phlegm Entering Liver Collaterals: After Shanghan is released via exterior methods, if the limbs cannot move, this indicates Phlegm entering the Liver collaterals. Jinxing Mengshi (Pyritum), Banxia (Pinelliae Rhizoma), Gualou, Fuling, Chenpi (Citri Reticulatae Pericarpium), Tianchong (Arisaematis Cum Bile), Quanxie (Scorpio), Jiangzhi-fried Jili, Chuan Guizhi, and Xuanfuhua should be used to search out Phlegm in the collaterals, allowing limb movement to resume. If ineffective, combine with blood-nourishing herbs.
Latent Phlegm After Resolution: After Shanghan is released via exterior methods, if heat subsides slightly but one feels dull-eyed and dull-spirited, heavy or painful body, and chest fullness with discomfort, this indicates latent Phlegm in the Stomach. The Youguan (Right Guan position) pulse must be deep-hidden or deep-slippery. Erchen Tang added with Zhishi (Aurantii Fructus Immaturus), Gualou, Jiangzhi, and Zhuru (Bambusa Textilis Catillus processed with Ginger) should be used to resolve and promote.
Middle Palace Damp-Phlegm: If Shanghan causes chest fullness, vague sensations of cold and heat, nausea without thirst, this indicates Damp-Phlegm in the Middle Palace (Spleen/Stomach). Erchen Tang added with Zhishi, Houpo (Magnoliae Officinalis Cortex), Zisu (Perillae Folium), and Maoyu (Atractylodis Macrocephalae Rhizoma) should be used to harmonize.
Accumulated Phlegm: If fever, chest fullness, cough, rapid breathing, and thick profuse sputum occur, this is Accumulated Phlegm in the Middle Palace. Dryness-resolving and moistening should be used together. Nanxing (Arisaematis Cum Bile), Banxia, Gualou, Haishi, Zhishi, Chenpi, Fuling, etc., can be used. Daotan Tang (Great Phlegm Decoction) is also acceptable.
Residual Phlegm After Resolution: After Shanghan is resolved via sweating, or after Rash has emerged, if residual heat remains, eyes are slightly fixed, or dark circles under the eyes appear, this is Phlegm. These conditions must present with epigastric oppression, poor appetite, and lack of hunger. Erchen Tang added with Zhishi and Maiya (Hordei Fructus Germinatus) should be used to harmonize.