钱乙曰。面上左腮为肝。右腮为肺。额上为心。鼻为脾。颏为肾。赤色者热也。随症治之。身热不饮水者。热在外。
身热饮水者。热在内也。小儿热病。六一散妙药也。寒水石散亦佳。凡热症疏利后。或和解后。无虚症。勿温补。热必
随生也。诸热通用小儿清心丸。
李 曰。肝热手寻衣领。乱捻物。泻青丸。壮热饮水喘闷。泻白散。心热视其睡。口中气温。或合面睡。及上窜咬
牙。导赤散。脾热目黄肚大。怠惰嗜卧。身热饮水。四肢不收。泻黄散。肺热手掐眉目鼻面。甘桔汤。肾热两足不喜衣
覆。地黄丸。
薛己曰。肝热者。左颊先赤。便难筋急。多怒多惊。四肢困倦。寅卯时益甚。泻青丸、柴胡饮子。心热者额上先赤。
心烦心痛。掌中热而哕。或壮热饮水。巳午时益甚。导赤散、泻心汤。脾热者。鼻上先赤。其热在肌肉。遇夜益甚。泻
黄散。肺热者。右颊先赤。日西热甚。轻则泻白散。重则地骨皮散。肾热者。颏下先赤。两足热甚。骨酥酥如虫蚀。热
盛不能起于床。夜间益盛。滋肾丸。
谭殊圣曰。虚热者。因病后发热无时。一日三五次者。此客热乘虚而作。其必气血未匀。四体羸弱。治宜调气补虚。
其热自退。宜白术散。或未退。人参犀角散。
薛己曰。虚则喜热恶寒。乍凉乍温。怫郁惊惕。上盛下泄。屈体而卧。睡而露睛。面色青白。恍惚神缓。嘘气软弱。
手足指冷。宜惺惺散。实则仰体而卧。睡不露睛。面赤气粗。口热燥渴。二便难。烦啼暴叫。手足指热。宜四顺清凉饮
加柴胡。壮热恶风寒。为元气不充。表之虚热也。壮热不恶风寒。为外邪所客。表之实热也。壮热欲饮汤。为津液短少。
里之虚热也。壮热饮水。为内火燔烁。里之实热也。热而二便调和。风邪蕴结于里而发者。此表热。惺惺散加麻黄汗之。
热而颊赤作渴。睡眠不安。四肢惊掣者。此里热。四顺清凉饮。
Qian Yi said: The left cheek of the face corresponds to the Liver, the right cheek to the Lungs, the forehead to the Heart, the nose to the Spleen, and the chin to the Kidneys. Redness indicates Heat (Re). Treatment should be based on specific symptoms. If the body is feverish but there is no desire to drink water, it is Exterior Heat (Re zai wai); if the body is feverish with a desire to drink water, it is Interior Heat (Re zai nei). For pediatric febrile diseases, Liu Yi San (Six-to-One Powder) is an excellent remedy, and Hanshuishi San (Cold Water Stone Powder) is also good. After any syndrome has been treated with draining and purging or harmonizing methods, if there are no signs of deficiency, do not use warming and tonifying therapies, as Heat will inevitably arise. Xiao'er Qingxin Wan (Children's Heart-Clearing Pill) can be used for various types of Heat syndromes.
Li said: Liver Heat manifests as the hands seeking the collar and randomly twisting objects; treat with Xieqing Wan (Drain the Green Pill). Severe fever with thirst, asthma, and chest oppression; treat with Xiebai San (Drain the White Powder). Heart Heat is observed by checking sleep patterns, warm breath from the mouth, sleeping face down, upward rolling of the eyes, and teeth grinding; treat with Daochi San (Direct Redness Away Powder). Spleen Heat manifests as yellow eyes, distended abdomen, lethargy and drowsiness, fever with thirst, and flaccidity of the four limbs; treat with Xiehuang San (Drain the Yellow Powder). Lung Heat manifests as picking at the eyebrows, eyes, nose, and face; treat with Ganjie Tang (Licorice and Magnolia Bud Decoction). Kidney Heat manifests as the two feet disliking being covered by bedding; treat with Dihuang Wan (Rehmannia Pill).
Xue Ji said: In Liver Heat, the left cheek reddens first, accompanied by difficult defecation, tendon stiffness, irritability, and fright, with fatigue in the four limbs, worsening during Yin-Mao hours (3-7 AM); treat with Xieqing Wan or Chaihu Yinzi (Bupleurum Drink). In Heart Heat, the forehead reddens first, accompanied by mental restlessness, heart pain, heat in the palms, hiccups, or severe fever with thirst, worsening during Si-Wu hours (9 AM-1 PM); treat with Daochi San or Xiexin Tang (Drain the Heart Decoction). In Spleen Heat, the nose reddens first, the heat resides in the muscles, worsening at night; treat with Xiehuang San. In Lung Heat, the right cheek reddens first, with heat worsening in the late afternoon; for mild cases, use Xiebai San; for severe cases, use Digupi San (Lycium Bark Powder). In Kidney Heat, the chin reddens first, with intense heat in the two feet, bones feeling soft and sore as if eaten by insects, inability to rise from bed due to excessive heat, worsening at night; treat with Zishen Wan (Nourish the Kidney Pill).
Tan Shusheng said: Deficiency Heat refers to fever occurring without fixed timing after an illness, happening three to five times a day. This is pathogenic Heat taking advantage of deficiency, resulting in uneven Qi and Blood and emaciation of the four limbs. Treatment should focus on regulating Qi and tonifying deficiency, after which the heat will subside naturally. Use Baizhu San (Atractylodes Macrocephala Powder); if the heat does not recede, use Renshen Xijiao San (Ginseng and Rhinoceros Horn Powder).
Xue Ji said: Deficiency syndromes favor warmth and dislike cold, presenting with alternating chills and fever, irritability and fright, excess above and leakage below, curling up while sleeping, eyes open during sleep, greenish-white complexion, absent-mindedness and sluggish spirit, weak sighing, and cold finger tips. Treat with Xingxing San. Excess syndromes present with lying flat while sleeping, eyes closed during sleep, red face, coarse breathing, oral heat and dryness with thirst, difficulty in urination and defecation, irritable crying and screaming, and hot finger tips. Treat with Sishun Qingliang Yin (Four-Obedient Cooling Decoction) added with Chaihu (Bupleurum). Severe fever with aversion to wind and cold indicates insufficient Yuan Qi (Original Qi), representing Exterior Deficiency Heat. Severe fever without aversion to wind and cold indicates invasion by external pathogens, representing Exterior Excess Heat. Severe fever with desire to drink hot liquids indicates shortness of Jin Ye (Body Fluids), representing Interior Deficiency Heat. Severe fever with drinking water indicates blazing Internal Fire, representing Interior Excess Heat. Fever with normal urination and defecation, caused by Wind Pathogen accumulation internally, is classified as Exterior Heat; treat with Xingxing San added with Mahuang (Ephedra) to induce sweating. Fever with red cheeks, thirst, restless sleep, and convulsions/tremors of the four limbs is classified as Interior Heat; treat with Sishun Qingliang Yin.