巢元方曰。风邪外客于皮肤。而痰饮内渍于脏腑。致令血气不和。阴阳更相乘克。阳胜则热。阴胜则寒。阴阳之气。
为邪所乘。邪正相干。阴阳交争。时发时止。则寒热更相往来也。
吴绶曰。凡寒热往来。是无定期者。其有定期。疟也。全生云。若其人翕翕如热。淅淅如寒。无有时度。支节如解。
手足酸疼。头目昏晕。此由营卫虚弱。外为风邪相乘。搏于阳则发热。搏于阴则发寒。久不治成痨。宜荆芥散。又曰。
如苦寒热如疟。不以时度。肠满膨 。起则头晕。大便不通。或时腹痛。胸膈痞闷。此由宿谷停留不化。结于肠间。气
道不舒。阴阳交乱。宜备急丸。若止见寒热。起居如常。久而不愈。乃大病后元气未复。悉属阴虚生热。阳虚生寒。宜
八珍汤。食积为病。亦令寒热。保和丸消之。兼呕吐泄泻。六君子汤。厥冷冻饮料热。人参理中丸。作渴不止。七味白术散。
食积消而寒热尚作者。肝邪乘脾也。异功散加栀、柴。然此皆非疟症也。切不可混。
庞安常曰。小儿食积。寒热如疟。渴泻气急。要合地卧。此候当先取下积。只用平胃散。次常服进食丸。
脾土色黄。病则成疸。其病缘何。先因虚损。复感湿热。风寒外犍。停郁腠理。浸淫肢脘。内热蒸蒸。外熏色变。
此其大凡。脉必濡缓。伤寒无汗。瘀热不散。身必发黄。尿涩腹满。暑邪挟湿。经络俱 。沦肤浃髓。脏气莫展。黄如
橘色。筋骨痿软。或由疳泻。肌肉消 。肚大筋青。皮黄发卷。胎疸之疾。得于初产。生下即黄。遍身栀染。原虽不同。
阴阳必辨。阳黄体热。二便硬短。脾与心搏。胸膈必懑。先利小便。下法莫远。阴黄肢冷。清便滋泫。大便清黄。腹痛
而喘。面目爪齿。黄色暗惨。脾虚失制。肾水胀衍。约此二端。疸病斯显。再详兼症。身疼体懒。强直
其膊。枯涩其眼。溺如屋漏。浮肿若茧。或渴或呕。或寒或暖。按症求之。有此款款。淡黄兼白。乃胃怯懦。或胃不和。
其病稍浅。
Nao Yuanfang stated: Wind pathogen externally invades and stays in the skin, while phlegm-fluid internally infiltrates the zang-fu organs, causing disharmony of qi and blood and mutual restraint between yin and yang. When yang is predominant, heat occurs; when yin is predominant, cold occurs. The qi of yin and yang is invaded by the pathogen, leading to interference between pathogenic factors and healthy qi, and a struggle between yin and yang. This struggle manifests intermittently, resulting in alternating chills and fever.
Wu Shou stated: Whenever there are alternating chills and fever without a regular schedule, if there is a regular schedule, it is malaria (Malaria). *Quansheng Ji* states: If a person feels hot like burning (翕翕如热) and shivers like being chilled (淅淅如寒), with no fixed time intervals, limbs and joints feeling as if dislocated, soreness and pain in hands and feet, dizziness and blurred vision, this is due to deficiency and weakness of Ying and Wei Qi, external invasion by wind pathogen. When the pathogen combats Yang, fever occurs; when it combats Yin, cold occurs. If left untreated for a long time, it may develop into consumptive disease (Lao). Jingjie San (Schizonepeta Powder) is appropriate. It also states: If suffering from chills and fever resembling malaria without fixed timing, abdominal fullness and distension, dizziness upon rising, constipation, occasional abdominal pain, and chest/epigastric stuffiness, this is due to retained food stagnation failing to digest, knotting in the intestines, obstructing the qi mechanism, and chaotic yin-yang interaction. Beiji Wan (Emergency Rescue Pill) is appropriate. If only chills and fever are present, with normal daily activities, persisting for a long time, this indicates that yuan qi has not yet recovered after a major illness, belonging to heat generated by yin deficiency and cold generated by yang deficiency. Bazhen Tang (Eight Treasures Decoction) is appropriate. Food stagnation can also cause chills and fever; Baohe Wan (Preserve Harmony Pill) is used to resolve it. With concomitant vomiting and diarrhea, Liujunzi Tang (Six Gentlemen Decoction) is used. For true cold presenting with false heat (Jue Leng Feng Han Yin Re), Renshen Lizhong Wan (Ginseng Regulate the Middle Pill) is used. For unrelenting thirst, Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder) is used. If food stagnation has resolved but chills and fever persist, it is Liver pathogen invading the Spleen; Yigong San (Extraordinary Merit Powder) added with Gardenia (Zhizi) and Bupleurum (Chaihu) is used. However, these are not malaria syndromes and must not be confused.
Pang Anchang stated: In children, food stagnation causes chills and fever resembling malaria, accompanied by thirst, diarrhea, and rapid breathing, with a desire to lie wrapped in blankets. This syndrome should first be treated by purging the stagnation using Pingwei San (Calm the Stomach Powder), followed by regular administration of Jinshi Wan (Appetite-Stimulating Pill).
The spleen earth corresponds to the color yellow; pathology results in jaundice. What is the origin of this disease? It begins with deficiency damage, followed by contraction of damp-heat, with wind-cold externally constricting, stagnating and郁结 in the couli (interstices), infiltrating the limbs. Internal heat steams upward, externally薰蒸 causing color changes. This is the general overview. The pulse must be soggy and slow. In Shanghan (Cold Damage) with no sweat, stagnant heat does not dissipate, and the body inevitably turns yellow. Urination is difficult with abdominal fullness. Summerheat pathogen combined with dampness closes the meridians, penetrating deep into skin and marrow, preventing the free flow of organ qi. The yellow resembles the color of an orange, with flaccidity of sinews and bones. It may arise from Gan diarrhea (Childhood malnutrition/diarrhea), with emaciated muscles, large abdomen, and visible blue veins, yellowish skin, and curly hair. Fetal jaundice is acquired at birth, appearing yellow immediately after delivery, dyeing the whole body. Although origins differ, yin and yang must be distinguished. Yang jaundice presents with body heat, hard and short urination/stool, binding of Spleen and Heart, and chest/epigastric oppression. First promote urination; purgative methods are not far off. Yin jaundice presents with cold limbs, clear and moist stools, pale yellow stool, abdominal pain with panting, dark and dismal yellow color of face, eyes, nails, and teeth. Spleen deficiency fails to control, Kidney water expands and overflows. Summarizing these two aspects, jaundice becomes apparent. Further detailing accompanying symptoms: body ache and lethargy, stiffness of arms, dry eyes, urine dripping like a leaking roof, edema like cocoons, thirst or vomiting, chills or warmth. Seeking according to symptoms reveals these patterns. Pale yellow mixed with white indicates weak stomach qi or stomach disharmony; the disease is slightly superficial.