When Kidney Qi is abundant, cold sensations arise. When Kidney Qi is deficient, cold moves within the interior. When Heart Qi is deficient, heat is retained inside. I propose that for this syndrome, if it arises from Liver and Spleen Blood deficiency, Siwu Tang (Four Substances Decoction) combined with Renshen (Ginseng Root) and Baizhu (Atractylodes Rhizome) should be used. If it results from Liver and Spleen depression and anger, Xiaochaihu Tang (Minor Bupleurum Decoction) combined with Siwu Tang (Four Substances Decoction) is indicated.
For Spleen and Stomach Qi deficiency, Buzhong Yiqi Tang (Decoction to Tonify the Middle and Augment the Qi) is used. For Liver and Spleen Blood deficiency, Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) is applied. For Wind-Heat in the Liver Channel, Jiawei Xiaochaihu Tang (Modified Minor Bupleurum Decoction) is prescribed. For Blood deficiency in the Heart Channel, Tianwang Buxin Dan (Emperor of Heaven’s Pill to Nourish the Heart) is given. For Qi deficiency in the Lung Channel, Renshen Bufei Tang (Ginseng Decoction to Tonify the Lungs) is used. For Blood deficiency in the Liver Channel, Jiawei Siwu Tang (Modified Four Substances Decoction) is administered.
Generally speaking, fever occurring before noon belongs to the Qi level; Qingxin Lianzi Yin (Decoction to Clear the Heart and Nourish the Lotus Seed) is used. Fever occurring after noon belongs to the Blood level; Siwu Tang (Four Substances Decoction) is modified by adding Renshen (Ginseng Root), Baizhu (Atractylodes Rhizome), and Mudanpi (Moutan Cortex). Heat originating from the left side indicates Liver Fire. In excess patterns, Longdancao (Gentian Root) and Shanzhi (Gardeniae Fructus) are added to Siwu Tang (Four Substances Decoction); in deficiency patterns, Renshen (Ginseng Root), Baizhu (Atractylodes Rhizome), and Huangqi (Astragali Radix) are added. Heat originating from below the umbilicus indicates Deficient Fire (Yin Fire); Siwu Tang (Four Substances Decoction) is modified by adding Renshen (Ginseng Root), Baizhu (Atractylodes Rhizome), Zhimu (Anemarrhenae Rhizoma), and Huangbai (Phellodendri Cortex), stir-fried with wine.