（师尼寡妇附）
〔大〕经曰∶阳不足则先寒后热，阴不足则先热后寒，皆由劳伤气血，阴阳不调，寒
热如疟也。当分气血虚实而治之。
〔薛〕前症若寸口脉微，名曰阳不足，则阴气上入于阳中，用补中益气汤。若尺部
脉弱，名曰阴不足，则阳气下陷入阴中，用益阴肾气丸。若因气血俱虚，用八珍汤。若
困怒动肝火，用小柴胡汤。若阴阳俱不足，则气血不归其本部，以致寒热交争也。一妇
人年六十有四，久郁怒，头痛寒热。春间乳内时痛，服流气饮之类益甚，时有血如经行。
又大惊恐，饮食不进，夜寐不宁，两乳肿胀，两胁 痛，午后色赤。余以为肝脾郁怒火燥，
先以逍遥散加酒炒黑龙胆一钱、山栀一钱五分，服二剂，肿痛顿愈，又二剂全愈。再用
归脾汤加炒栀、贝母，诸症悉愈。
〔大〕地骨皮散 治血风气虚，时作寒热，或晡热内热。
柴胡 地骨皮（各一两） 桑白皮（炒） 枳壳（麸炒） 前胡 黄 （炒，各七钱五分）
白茯苓 五加皮 人参 甘草 桂心 白芍药（各半两）
上 咀，每服三五钱，水一盏半，生姜三片，煎至七分，温服。
生地黄散 治妇人血气不调，或时寒热，体痛，不思饮食。
生干地黄 北柴胡（各一两） 羌活 木香 桂心 防风（各半两） 酸枣仁（炒研）
羚羊角屑 白芍药 白术 黄 川牛膝 白茯苓 当归 枳壳（各七钱五分）
上 咀，每服三五钱，水一盏，姜三片，煎至七分，去滓，空心温服。
异功散 治妇人血气虚冷，时发刺痛，头目昏闷，四肢无力，寒热往来，状似劳倦，并
宜服之。
乌药 川芎 苦梗 玄胡索 当归 陈皮（各一钱半） 官桂 牡丹皮 芍药
白芷 干姜（各一钱）
上作一服，用水二盅，生姜三片，煎至一盅，入酒半盏，再煎一二沸，不拘时。
上三方内有桂，唯寒多者宜之。第三方无滞气、污血，尤不宜服。
七宝汤 治寒热往来。
防风（去芦） 知母 生地黄（各半两） 柴胡（去芦） 秦艽 甘草（炙）
前胡（去芦，各二钱半）
上 咀，每服五钱，水一盏半，加人参三寸，煎至七分，热服。
柴胡散 治妇人寒热体瘦，肢节疼痛，口干心烦，不欲饮食。
北柴胡 赤茯苓 黄 白术（各一钱） 麦门冬（三钱） 鳖甲（醋炙，二钱） 人参
地骨皮 枳壳（麸炒） 生地黄 桑白皮 赤芍药 桔梗 甘草（各半钱）
上作一服，水二盅，生姜三片，煎至一盅，不拘时服。
桃仁丸 治妇人头目昏重，心神烦闷，或时寒热，肢节疼痛，不欲饮食。
桃仁（汤浸，去皮、尖、双仁，麸炒微黄） 芎 白术 柴胡（去苗）
人参（去芦） 生地黄 酸枣仁（微炒，各一两） 赤茯苓 诃黎勒皮（各七钱半）
枳壳（麸炒微黄，去幅） 赤芍药（各半两）
上为末，炼蜜和捣三二百杵，丸如梧桐子大。每以生姜、荆芥、薄荷汤下三十丸。
青蒿散 治男子妇人肢体倦疼，虚劳寒热。
用青蒿八九月间将成实时采，去枝梗，以蒿用童子小便浸三日，晒干为末。每服二钱，
乌梅一个，煎至七分服。
上三方，热多者宜之。
〔师尼寡妇异乎妻外家之治〕
〔罗〕刘宋褚澄疗师尼寡妇，别制方者，盖有谓也。此二种寡居，独阴无阳，欲心萌
而多不遂，是以阴阳交争，乍寒乍热，全类温疟，久则为劳。尝读《史记·仓公传》载∶
济北王侍人韩女，病腰背痛寒热，众医皆以为寒热病，治之不瘥。仓公曰∶此病得之欲
男子不可得也。众曰∶何以知欲男子不可得？仓公曰∶诊其脉，肝脉弦出寸口，是以知之。
盖男子以精为主，妇人以血为主，男子精盛以思室，妇人血盛以怀胎，夫肝摄血者也，是
厥阴肝脉弦出寸口上鱼际，则阴盛可知。故知褚氏之言，信有谓矣。
〔大〕师尼寡妇与室女出嫁愆期者，多因欲心萌而不遂，恹恹成病，乍寒乍热，久
则为劳。又有经闭白淫，痰逆头风，膈气痞闷，面 瘦瘠等证，皆寡妇之病也。
〔薛〕前证若肝脉弦出鱼际，用小柴胡加生地黄送下生地黄丸。久而血虚，佐以四
物汤。若兼怒动肝火而寒热者，佐以加味逍遥散。若兼亏损肝经而寒热者，佐以八珍汤。
若兼亏损元气而寒热者，佐以补中益气汤。若兼郁伤脾气而寒热者，佐以《济生》归脾汤。
一妇人因夫经商久不归，发寒热，月经旬日方止，服降火凉血药，反潮热内热，自汗
盗汗、月经频数。余曰∶热汗，气血虚也。经频，肝脾虚也。用归脾汤、六味丸而愈。尝
治兼证既愈而寒热不衰，当仍用本证药。一妇人年三十有七，早孀居，两腿骨作痛，晡
热体倦，月经不调，或发寒热，数年矣。一日颈项两侧结核，两胁胀痛，此系肝经郁火
而成也。先用小柴胡汤合四物数剂，肝症顿愈。又用加味逍遥散加泽兰、乳香、没药，三
十剂，血症渐痊。再用加味归脾汤，年余而安。一孀妇两腿作痛，或用除湿化痰等药，
遍身作痛而无定处，此血症也。不信，乃服流气饮之类而殁。一放出宫人年四十余，臀
腿内股作痛，晡热口干，月经不调，此系肝经血少不能养经络而然也。宜加味逍遥散加
泽兰叶五十帖，诸症稍缓，又以归脾汤二百余剂而痊。一放出宫人，臀腿肿痛，内热
晡热，恶寒体倦，咳嗽胸痞，月经过期而少，彼以为气毒流注，服清热理气之剂益甚，此
肝经瘀血停留所致。盖肝经上贯鬲，布胁肋，循喉咙，下循 内 ，绕阴器，抵少腹。主
治之法，但当补其所不胜，而制其所胜。补者脾也，制者肝也。经曰∶虚即补之，实则
泻之。此定法也。彼不信，仍服前药，遂致不起。
〔本〕生地黄丸 许学士治一尼患恶风体倦，乍寒乍热，面赤心悸，或时自汗。是
时疫气大行，医见其寒热，作伤寒治之，用大小柴胡汤杂进，数日病急，召予诊之，三
部无寒邪脉，但厥阴弦长而上鱼际，宜服抑阴等药，故制此方。
生地黄（二两） 柴胡 秦艽 黄芩（各半两） 芍药（一两）
上为细末，炼蜜丸如桐子大。每服三十
丸，用乌梅汤吞下，日三服，不拘时。
(Attached: Nuns, Widows)
[Da Lun] The *Neijing* states: When Yang qi is insufficient, coldness precedes heat; when Yin qi is insufficient, heat precedes cold. All these arise from labor and fatigue damaging Qi and Blood, leading to disharmony of Yin and Yang, presenting with chills and fever resembling malaria. Treatment should be differentiated based on the deficiency or excess of Qi and Blood.
[Xue Ji] In the aforementioned symptoms, if the Cun Kou (inch position) pulse is faint, it is named Yang insufficiency, causing Yin Qi to ascend into the Yang aspect; use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). If the Chi (cubit position) pulse is weak, it is named Yin insufficiency, causing Yang Qi to sink into the Yin aspect; use Yi Yin Shen Qi Wan (Yin-Nourishing Kidney Qi Pill). If both Qi and Blood are deficient, use Ba Zhen Tang (Eight-Treasure Decoction). If caused by anger stirring Liver Fire, use Xiao Chai Hu Tang (Minor Bupleurum Decoction). If both Yin and Yang are insufficient, Qi and Blood fail to return to their proper origins, resulting in alternating chills and fever. A woman aged sixty-four suffered from long-term depression and anger, experiencing headache and alternating chills and fever. In spring, she had intermittent pain inside the breasts; taking Liu Qi Yin (Flowing Qi Drink) aggravated the condition, accompanied by occasional bleeding resembling menstruation. Subsequently, due to severe fright, she lost her appetite, slept restlessly at night, experienced swelling in both breasts, pain in both hypochondria, and redness of the face in the afternoon. I diagnosed this as Liver and Spleen depression transforming into fire and dryness. Initially, I prescribed Xiao Yao San (Free Wanderer Powder) with Jiu Chao Hei Long Dan Cao (Wine-fried Black Gentian Root) one qian and Shan Zhi (Gardenia Fruit) one qian five fen. After two doses, the swelling and pain subsided immediately; after another two doses, she was fully recovered. Then, using Gui Pi Tang (Restore the Spleen Decoction) with fried Shan Zhi and Bei Mu (Fritillaria Bulb), all symptoms resolved.
[Da Lun] Di Gu Pi San (Lycium Bark Powder) treats blood deficiency and Qi deficiency causing intermittent chills and fever, or evening internal heat.
Chai Hu (Bupleuri Radix), Di Gu Pi (Lycii Cortex) (each 1 liang); Sang Bai Pi (Mori Cortex, stir-fried), Zhi Qiao (Aurantii Fructus, bran-fried), Qian Hu (Peucedani Radix), Huang Qin (Scutellariae Radix, stir-fried) (each 7 qian 5 fen); Bai Fu Ling (Poria), Wu Jia Pi (Acanthopanacis Cortex), Ren Shen (Ginseng Radix et Rhizoma), Gan Cao (Licorice Root), Gui Xin (Cinnamomi Ramulus), Bai Shao Yao (Paeoniae Radix Alba) (each 0.5 liang).
Crush the herbs. For each dose, take 3-5 qian, add 1.5 sheng of water and 3 slices of fresh ginger, decoct until 0.7 sheng remains, and take warm.
Sheng Di Huang San (Rehmannia Root Powder) treats women with irregular Qi and Blood, intermittent chills and fever, body pain, and anorexia.
Sheng Gan Di Huang (Dried Rehmanniae Radix), Bei Chai Hu (Bupleuri Radix) (each 1 liang); Qiang Huo (Notopterygii Rhizoma et Radix), Mu Xiang (Aucklandiae Radix), Gui Xin (Cinnamomi Ramulus), Fang Feng (Saposhnikoviae Radix) (each 0.5 liang); Suan Zao Ren (Ziziphi Spinosae Semen, stir-fried and crushed), Ling Yang Jiao Jie (Saiga Antelope Horn), Bai Shao Yao (Paeoniae Radix Alba), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Huang Qin (Scutellariae Radix), Chuan Niu Xi (Cyathulae Radix), Bai Fu Ling (Poria), Dang Gui (Angelicae Sinensis Radix), Zhi Qiao (Aurantii Fructus) (each 7 qian 5 fen).
Crush the herbs. For each dose, take 3-5 qian, add 1 sheng of water and 3 slices of ginger, decoct until 0.7 sheng remains, strain, and take warm on an empty stomach.
Yi Gong San (Benefit the Work Powder) treats women with cold Qi and Blood deficiency, frequent stabbing pain, dizziness and heavy head, limb weakness, alternating chills and fever, resembling fatigue; it is suitable for all such cases.
Wu Yao (Linderae Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Ku Geng (Platycodonis Radix), Yuan Hu Suo (Corydalis Rhizoma), Dang Gui (Angelicae Sinensis Radix), Chen Pi (Citri Reticulatae Pericarpium) (each 1 qian 5 fen); Guan Gui (Cinnamomi Ramulus), Mu Dan Pi (Moutan Cortex), Shao Yao (Paeoniae Radix), Bai Zhi (Angelicae Dahuricae Radix), Gan Jiang (Zingiberis Rhizoma) (each 1 qian).
Combine as one dose. Add 2 zhong of water and 3 slices of ginger, decoct until 1 zhong remains, add 0.5 zhong of wine, boil briefly, and take at any time.
Among the above three formulas containing Cinnamon Twig, only those with predominant cold symptoms should use them. The third formula lacks Qi-moving and blood-stasis-resolving properties and is particularly unsuitable for use.
Qi Bao Tang (Seven-Treasures Decoction) treats alternating chills and fever.
Fang Feng (Saposhnikoviae Radix, remove radicle), Zhi Mu (Anemarrhenae Rhizoma), Sheng Di Huang (Rehmanniae Radix) (each 0.5 liang); Chai Hu (Bupleuri Radix, remove radicle), Qin Jiao (Gentianae Macrophyllae Radix), Gan Cao (Licorice Root, honey-fried), Qian Hu (Peucedani Radix, remove radicle) (each 2 qian 5 fen).
Crush the herbs. For each dose, take 5 qian, add 1.5 sheng of water and a 3-cun piece of Ren Shen (Ginseng Radix et Rhizoma), decoct until 0.7 sheng remains, and take hot.
Chai Hu San (Bupleurum Powder) treats women with chills and fever, emaciation, joint pain, dry mouth, irritability, and anorexia.
Bei Chai Hu (Bupleuri Radix), Chi Fu Ling (Poria with Red Hosta Root), Huang Qin (Scutellariae Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma) (each 1 qian); Mai Men Dong (Ophiopogonis Tuber) (3 qian); Bie Jia (Testudinis Carapax et Plastrum, vinegar-fried) (2 qian); Ren Shen (Ginseng Radix et Rhizoma), Di Gu Pi (Lycii Cortex), Zhi Qiao (Aurantii Fructus, bran-fried), Sheng Di Huang (Rehmanniae Radix), Sang Bai Pi (Mori Cortex), Chi Shao Yao (Paeoniae Radix Rubra), Jie Geng (Platycodonis Radix), Gan Cao (Licorice Root) (each 0.5 qian).
Combine as one dose. Add 2 zhong of water and 3 slices of ginger, decoct until 1 zhong remains, and take at any time.
Tao Ren Wan (Peach Kernel Pill) treats women with heavy and dizzy head, mental restlessness, intermittent chills and fever, joint pain, and anorexia.
Tao Ren (Persicae Semen, soaked in water, peel and tip removed, double-kernel removed, bran-fried until slightly yellow), Xiong (Ligustici Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Chai Hu (Bupleuri Radix, remove sprouts), Ren Shen (Ginseng Radix et Rhizoma, remove radicle), Sheng Di Huang (Rehmanniae Radix), Suan Zao Ren (Ziziphi Spinosae Semen, lightly stir-fried) (each 1 liang); Chi Fu Ling (Poria with Red Hosta Root), He Li Le Pi (Terminaliae Chebulae Pericarpium) (each 7 qian 5 fen); Zhi Qiao (Aurantii Fructus, bran-fried until slightly yellow, pith removed), Chi Shao Yao (Paeoniae Radix Rubra) (each 0.5 liang).
Grind into fine powder, mix with refined honey, pound 300-200 times, and form pills the size of Sophora seeds. Take 30 pills per dose with decoction of ginger, Schizonepeta, and mint.
Qing Hao San (Artemisia Annua Powder) treats men and women with limb fatigue and pain, consumptive chills and fever.
Harvest Qing Hao (Artemisiae Annuae Herba) in August or September when it is about to fruit but not yet ripe. Remove stems and leaves. Soak the herb in urine of a young boy for three days, dry, and grind into powder. Take 2 qian per dose with one Wumei (Chebulae Fructus), decoct until 0.7 sheng remains, and take.
Among the above three formulas, those with predominant heat symptoms should use them.
[Different Treatment for Nuns, Widows compared to Wives and Relatives]
[Luo Shi] Chu Cheng of the Liu Song dynasty formulated special prescriptions for nuns and widows because there is a reason. These two groups live in widowhood/seclusion, possessing only Yin without Yang. Their desires arise but are often unfulfilled, causing Yin and Yang to contend, resulting in alternating chills and fever, completely resembling Warm Malaria. Prolonged, this becomes consumption. I once read in the *Records of the Grand Historian: Biography of Cang Gong*: Han Nu, a concubine of the King of Jibei, suffered from lower back pain, chills, and fever. Many physicians treated it as a chills-and-fever disease, but it did not improve. Cang Gong said: This disease arises from desiring a man but being unable to obtain one. They asked: How do you know she desires a man? Cang Gong said: Palpating her pulse, the Liver pulse is wiry and extends beyond the Cun Kou to the Yu Ji area; thus I know. Generally, men prioritize Essence, while women prioritize Blood. When men's Essence is abundant, they desire sexual intercourse; when women's Blood is abundant, they can conceive. The Liver governs Blood storage. Therefore, if the Jueyin Liver pulse is wiry and extends beyond the Cun Kou to the Yu Ji, it indicates excessive Yin. Thus, Chu's words are indeed well-founded.
[Da Lun] Nuns, widows, and unmarried women who marry late often suffer from unfulfilled desires, becoming depressed and ill, with alternating chills and fever. Prolonged, this becomes consumption. Other symptoms include amenorrhea, leukorrhea, phlegm-induced headaches, chest qi stagnation and fullness, and sallow, emaciated complexion; these are diseases of widows.
[Xue Ji] In the aforementioned symptoms, if the Liver pulse is wiry and extends beyond the Yu Ji, use Xiao Chai Hu Tang (Minor Bupleurum Decoction) with Sheng Di Huang (Rehmanniae Radix) to deliver Sheng Di Huang Wan (Rehmannia Pill). If prolonged blood deficiency occurs, assist with Si Wu Tang (Four-Substance Decoction). If accompanied by anger stirring Liver fire with chills and fever, assist with Jia Wei Xiao Yao San (Modified Free Wanderer Powder). If accompanied by Liver meridian deficiency with chills and fever, assist with Ba Zhen Tang (Eight-Treasure Decoction). If accompanied by Yuan Qi (Original Qi) deficiency with chills and fever, assist with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). If accompanied by Spleen Qi injury from depression with chills and fever, assist with *Jisheng* Gui Pi Tang (*Essential Prescriptions of Benefit to Living* Restore the Spleen Decoction).
A woman whose husband traveled for business and did not return for a long time developed chills and fever, with menstruation lasting ten days. Taking cooling and blood-cooling herbs instead caused tidal fever, internal heat, spontaneous sweating, night sweats, and frequent menstruation. I said: Hot sweat indicates Qi and Blood deficiency. Frequent menstruation indicates Liver and Spleen deficiency. She recovered using Gui Pi Tang (Restore the Spleen Decoction) and Liu Wei Wan (Six-Ingredient Pill with Rehmannia). I once treated a case where mixed symptoms resolved but chills and fever persisted; the original syndrome medication should still be used. A thirty-seven-year-old woman, widowed early, suffered bone pain in both legs, evening fever, fatigue, irregular menstruation, and intermittent chills and fever for years. One day, nodules appeared on both sides of the neck, and the hypochondria became distended and painful, caused by Liver meridian depression-fire. Initially, Xiao Chai Hu Tang (Minor Bupleurum Decoction) combined with Si Wu Tang (Four-Substance Decoction) for several doses quickly cured the Liver symptoms. Then, Jia Wei Xiao Yao San (Modified Free Wanderer Powder) with Ze Lan (Lycopus Herba), Ru Xiang (Olibanum), and Mo Yao (Myrrha) for thirty doses gradually cured the blood stasis. Finally, Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction) brought stability after more than a year. Another widow suffered leg pain; using damp-draining and phlegm-resolving herbs caused generalized, migrating pain, which was actually a blood stasis syndrome. Disbelieving this, she took Liu Qi Yin (Flowing Qi Drink) and died. A released palace maid, over forty, suffered pain in the buttocks and inner thighs, evening fever, dry mouth, and irregular menstruation, caused by Liver Blood deficiency failing to nourish the collaterals. She should have taken Jia Wei Xiao Yao San (Modified Free Wanderer Powder) with Ze Lan Ye (Lycopus Leaf) for fifty doses to alleviate symptoms, then Gui Pi Tang (Restore the Spleen Decoction) for over two hundred doses to recover. Another released palace maid suffered buttock and thigh swelling/pain, internal heat, evening fever, aversion to cold, fatigue, cough, chest fullness, and delayed, scant menstruation. She believed it was Qi toxicity flowing through collaterals and took clearing-heat and Qi-regulating herbs, worsening the condition. This was caused by blood stasis lingering in the Liver meridian. The Liver meridian passes through the diaphragm, spreads in the hypochondria, follows the throat, descends along the medial thigh, circles the genitalia, and reaches the lower abdomen. The treatment method is to tonify what it cannot overcome (Spleen) and control what it overcomes (Liver). Tonifying the Spleen controls the Liver. The Classics state: Deficiency requires tonification, excess requires purging. This is a fixed rule. Disbelieving this, she continued taking previous medications and ultimately died.
[Ben] Sheng Di Huang Wan (Rehmannia Pill): Xu Xueshi treated a nun suffering from aversion to wind, fatigue, alternating chills and fever, red face, palpitations, and occasional spontaneous sweating. At that time, epidemic Qi was prevalent. Physicians saw her chills and fever and treated her as Taiyang Cold Damage, administering Da Xiao Chai Hu Tang (Major and Minor Bupleurum Decoctions) indiscriminately. After several days, her condition worsened critically. I was summoned to diagnose her. The three positions showed no Cold Damage pulses, only a Jueyin wiry-long pulse extending to the Yu Ji. It was appropriate to use Yin-suppressing herbs, so I formulated this prescription.
Sheng Di Huang (Rehmanniae Radix) (2 liang), Chai Hu (Bupleuri Radix), Qin Jiao (Gentianae Macrophyllae Radix), Huang Qin (Scutellariae Radix) (each 0.5 liang), Shao Yao (Paeoniae Radix) (1 liang).
Grind into fine powder, mix with refined honey, and form pills the size of Sophora seeds. Take 30 pills per dose with Wumei Tang (Chebulae Fruit Decoction), three times daily, at any time.