大抵七情皆能动火。各经之热亦异。当分治之。东垣曰。昼则发热。夜则安静。是阳气
自旺于阳分也。
昼则安静。夜则发热烦躁。是阳气下陷入阴中也。名曰热入血室。昼则发热烦躁。夜亦
烦躁。是重阳无阴也。当急泻其阳。峻补其阴。王注曰。病热而脉数。按之不动。乃寒盛格阳
。非热也。形症是寒。按之而脉鼓。击于指下而盛者。此为热盛拒阴。非寒也。伤寒论曰。
寸口脉微。为阳不足。阴气上入阳中。则洒淅恶寒。尺脉弱为阴不足。阳气下陷入阴中。则
发热也。肺热者。轻手乃得。微按全无。日晡热甚。乃皮毛之热。其症必见喘咳。寒热轻者
泻白散。重者凉膈散。地骨皮散。心热者。微按至皮肤之下则热少。加力按之则不热。是热
在血脉也。其症烦心。心痛。掌中热而哕。以黄连泻心汤、导赤散、朱砂安神丸。脾热者。
轻按之不热。重按之亦不热。不轻不重。热在肌肉。遇夜尤甚。其症必怠惰嗜卧四肢不收。
无气以动。泻黄散。肝热者。重按之。肌肉之下。至骨之上乃热。寅卯时间尤甚。其脉弦
。四肢满闷。便难。转筋。多怒。多惊。四肢困热。筋痿不能起于床。泻青丸。柴胡引子。
肾热者。重手按至骨分。其热蒸手如火。其人骨苏苏如虫蚀。其骨困热不任。亦不能起于床
。滋肾丸主之。徐用诚云。面热者。足阳明。
口中热如胶。足少阴。口热舌干。足少阴。耳前热。手太阳。掌中热。手厥阴。少阴。
太阴。足下热而痛。足少阴。足外热。足少阳。身热肤痛。手少阴。身前热。足阳明。洒淅
寒热。手太阴。肩上热。肩似拔。手太阳。中热而喘。足少阴。肩背热。及足小指外 胫踝
后。皆属足太阳。一身尽热。狂而妄闻妄见妄言。足阳明。热而筋纵缓不收。足痿。足阳明
。厥阴。手少阴。
溪曰。恶寒者。卫气虚衰不能温。分肉实表而恶寒者。又有上焦之邪。隔绝营卫。不能
出表而恶寒者。东垣云。昼则恶寒。夜则安静。是阴气上溢于阳中也。夜则恶寒。昼则安静
。是阴血自旺于阴分也。夜则恶寒。昼亦恶寒。是重阴无阳也。当急泻其阴。峻补其阳。
Generally, the Seven Emotions (Joy, Anger, Worry, Thought, Sorrow, Fear, Fright) can all stir up internal Fire. The heat patterns in each meridian differ, and they should be treated separately. Li Dongyuan stated: Fever during the day with quietness at night indicates Yang Qi naturally flourishing in the Yang aspect (exterior/Qi level).
Quietness during the day with fever and irritability at night indicates Yang Qi sinking into the Yin aspect (Blood/Interior), termed "Heat Entering the Blood Chamber" (Re Ru Xue Shi). Fever and irritability during both day and night indicate Extreme Yang without Yin (excessive Yang heat depleting Yin fluids), requiring urgent draining of Yang heat and vigorous tonification of Yin. Wang Bing noted: Fever with a rapid pulse that does not move upon deep pressure indicates Cold excess repelling Yang to the exterior, which is not true Heat; the clinical signs are Cold. If the clinical signs suggest Cold but the pulse beats vigorously and strongly under deep pressure, this indicates Heat excess repelling Yin to the interior, which is not true Cold. The *Shanghan Lun* states: A faint pulse at the Cun position indicates insufficient Yang Qi, where Yin Qi enters the Yang center, causing shivering and aversion to cold. A weak pulse at the Chi position indicates insufficient Yin Qi, where Yang Qi sinks into the Yin center, causing fever.
Lung Heat: Heat is palpable with light touch but absent with slight pressure; heat intensifies in the late afternoon (Shen/You hours), indicating heat in the skin and hair. Symptoms necessarily include panting and coughing. For mild cases, use Xie Bai San; for severe cases, use Liang Ge San or Digupi San. Heart Heat: Heat diminishes when pressing lightly to beneath the skin but disappears with firm pressure, indicating heat in the blood vessels. Symptoms include vexation, heart pain, hot palms, and hiccups. Treat with Huanglian Xiexin Tang, Daochi San, or Zhusha Anshen Wan. Spleen Heat: No heat on light or heavy pressure; heat is felt in the muscle layer with moderate pressure, worsening at night. Symptoms include lethargy, desire to sleep, flaccidity of the four limbs, and lack of energy to move. Treat with Xie Huang San. Liver Heat: Heat is felt only with heavy pressure between the muscles and bones, worsening during Yin/Mao hours (3–7 AM). The pulse is wiry; symptoms include distension and fullness of the limbs, difficult defecation, tendon spasms, irritability, fright, heavy and hot limbs, and tendon weakness preventing getting out of bed. Treat with Xie Qing Wan or Chaihu Yinzi. Kidney Heat: Heavy pressure to the bone reveals steaming heat like touching fire; the patient feels bone marrow itching as if bitten by insects, with unbearable bone heat and inability to rise from bed. Treat primarily with Zishen Wan. Xu Yongcheng stated: Facial heat belongs to the Foot-Yangming Stomach Meridian; mouth feeling sticky and hot belongs to the Foot-Shaoyin Kidney Meridian; hot mouth and dry tongue belong to the Foot-Shaoyin Kidney Meridian; heat before the ear belongs to the Hand-Taiyang Small Intestine Meridian; heat in the palm belongs to the Hand-Jueyin Pericardium Meridian, Hand-Shaoyin Heart Meridian, and Foot-Taiyin Spleen Meridian; hot and painful soles belong to the Foot-Shaoyin Kidney Meridian; heat on the outer foot belongs to the Foot-Shaoyang Gallbladder Meridian; body heat with skin pain belongs to the Hand-Shaoyin Heart Meridian; heat in the anterior body belongs to the Foot-Yangming Stomach Meridian; shivering and aversion to cold belong to the Hand-Taiyin Lung Meridian; heat on the shoulder and shoulder blade, feeling as if being pulled, belongs to the Hand-Taiyang Small Intestine Meridian; chest heat with panting belongs to the Foot-Shaoyin Kidney Meridian; heat in the shoulder and back, and heat behind the ankle on the lateral side of the little toe, all belong to the Foot-Taiyang Bladder Meridian; whole-body heat with mania, hallucinations, and delirious speech belongs to the Foot-Yangming Stomach Meridian; heat leading to flaccid tendons and foot weakness belongs to the Foot-Yangming Stomach Meridian, Foot-Jueyin Liver Meridian, and Hand-Shaoyin Heart Meridian.
Wang Ji stated: Aversion to cold occurs due to deficiency and decline of Wei Qi failing to warm the body. Aversion to cold due to solidified flesh/muscles at the surface, or due to pathogenic factors in the Upper Jiao isolating Ying and Wei Qi preventing them from reaching the exterior, also cause aversion to cold. Li Dongyuan said: Aversion to cold during the day with quietness at night indicates Yin Qi overflowing into the Yang center. Aversion to cold at night with quietness during the day indicates Yin Blood flourishing in the Yin aspect. Aversion to cold during both day and night indicates Extreme Yin without Yang (excessive Yin cold depleting Yang Qi), requiring urgent draining of Yin cold and vigorous tonification of Yang.