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Any occurrence of chills and fever (Hanre), tidal fever (Chaore), vexing heat (Fanre), or alternating hot and cold sensations (Wanglai Re) should be comprehensively analyzed in conjunction with Shanghan disease (Cold Damage). For instance, fever caused by overwork (Laoyi Re), epidemic febrile diseases (Wenyi Re), phlegm-heat (Tanre), food stagnation (Shangshi), and heat induced by gout (Jiaoqi) must not be treated initially as one would treat the onset of Shanghan. Misdiagnosis may prove fatal. Conditions such as macule eruption (Shengban), corpse infection (Shizhu), consumptive disease (Laozhai), and ghost infection (Guizhu) also manifest as chills, fever, or heat. This is because although their root causes differ, their superficial manifestations are often similar. Therefore, various examples are listed below for reference.

**Clearing Fire (Xiehuo):** When Qi is excessive and the pulse is vigorous, accompanied by body heat and restlessness, it is appropriate to use purgatives such as Sanyichengqi Tang (Three-Yi Cinnamon Twig Decoction) or Liangge San (Cool the Diaphragm Powder). If the heat is in the Middle Jiao (Middle Burner), use Sishun Qingliang Yin; if in the Lower Jiao (Lower Burner), use Bazheng San (Eight-Positive Powder) and similar formulas.

**Cooling Blood (Liangxue):** Nighttime fever is predominant, possibly accompanied by sweating, epistaxis (nosebleed), body heat, and difficult defecation. Use Siwu Tang (Four Substances Decoction) removing Chuanxiong, adding Huanglian (Coptis Rhizome), Shengdihuang (Rehmannia Root), and Digupi (Dogwood Bark); Bupleurum (Chaihu), raw licorice (Shengcao), and Anemarrhena (Zhimu) may also be added. For consumption fever with bone-steaming sensation and hemoptysis, use Qinghao (Artemisia Annua), Gejie (Gecko), Biejia (Turtle Shell), and Xiaomai (Wheat).

**Clearing Qi (Qingqi):** Daytime fever is predominant, indicating heat in the Qi level. Use Chaihu Yinzi (Bupleurum Drink) or Baihu Tang (White Tiger Decoction). In cases of summerheat, refer to previous examples. For steaming heat, use Wumei (Mume Fruit), Qinjiao (Gentiana Macrophylla), and Chaihu (Bupleurum).

**Clearing the Muscle Layer (Qingji):** Light palpation reveals significant heat, while heavy pressure does not, indicating heat in the muscle layer (Jibiao). It is suitable to clear this heat using Zhuru (Bamboo Shavings), Zhuye (Bamboo Leaves), Digupi (Dogwood Bark), and Maidong (Ophiopogon Tuber).

**Clearing the Spirit (Qingshen):** Heat caused by depression of Shen (Spirit/Qi) is treated with Qingshen San (Clear Spirit Powder).

**Suppressing Fire and Ascending Water:** When heat is in the upper part and Yin water fails to ascend, causing deficiency fire to boil, the method of raising Yang and clearing fire is used; deficiency conditions require tonification.

**Nourishing Yin and Retreating Yang:** Initial Yang syndromes that were mistakenly purged may transform into apparent Yin syndromes where purging is contraindicated. Use Baihu Tang (White Tiger Decoction) and similar formulas.

**Clearing Spleen Heat (Xiehuang):** Caused by Spleen heat. Excess patterns are treated with Tiaowei Chengqi Tang (Regulate the Stomach Cinnabar Decoction) or Xiehuang San (Drain Yellow Powder); deficiency patterns are treated with Renshen Huangqi San (Ginseng and Astragalus Powder).

**Guiding Out Heart Fire (Daochi):** Heart heat. Excess patterns are treated with Xiexin Tang (Drain Heart Decoction); deficiency patterns with Zhusha Anshen Wan (Cinnabar Calming the Spirit Pill).

**Clearing Lung Heat (Xiebai):** Lung heat. Excess patterns are treated with Liangge San (Cool the Diaphragm Powder); deficiency patterns with Renshen Baihu Tang (Ginseng White Tiger Decoction).

**Clearing Liver Heat (Xieqing):** Liver heat excess pattern is treated with Chaihu Yinzi (Bupleurum Drink).

**Nourishing Yin (Ziyin):** Kidney heat excess pattern is treated with Zishen Wan (Nourish Kidney Pill), which follows the principle of nourishing Yin. Non-excess patterns should not be purged.

**Purgative for Food (Xiashi):** Heat caused by food injury to the Taiyin meridian, or heat due to retained food requiring purgation.

**Guiding Phlegm (Daotan):** Undissipated phlegm fluid condenses and generates heat; it should be guided out and resolved.

**Eliminating Accumulation (Xiaoji):** Heat accumulated due to stagnation should first be addressed by eliminating the accumulation, after which the heat will subside naturally.

**Detoxifying (Jiedu):** Erysipelas (Dandu) with redness and swelling, or Qi stagnation and blockage, can be dispersed according to symptoms. If sores and toxins are about to erupt, treat according to the Six Evils (Liuyin).

**Sedating/Descending (Zhenzhui):** Use herbs such as Chaihu (note: original text says "Chai Xue", likely a variant or error, interpreted here contextually), Zhusha (Cinnabar), Hupo (Amber), and Xijiao (Rhinoceros Horn - *Note: Modern practice substitutes with Buffalo Horn*) to suppress floating and wandering fire.

**Benefiting Essence (Yijing):** For Yin deficiency with essence depletion and collapse of Yuan Qi, use Yin-nourishing medicines.

**Moistening Dryness (Runzao):** Refer to the previously mentioned methods for moistening dryness.

**Expelling Blood Stasis (Zhuxue):** Blood stasis syndrome requires purgation.

**Separating and Promoting Urination (Fenli):** Urination rapidly reduces fire; sometimes diuretics alone are sufficient. Additionally, in the "Release Muscle and Generate Fluids" example and the "Tonify Middle for Deficiency" example, add Mutong (Akebia Stem).

**Water Application (Shuiwo):** Pour water on the exterior or have the patient sit in water, but only after carefully assessing the pulse and symptoms.

**Raising and Dispersing (Jieyue):** After sweating or purging, if Yuan Qi is deficient and sinks, causing Yin and Yang Qi to become thin and unable to rise, resulting in deficiency heat, use Fuyuan Dan (Restore Vitality Pill) or Lingsha (Calamine/Cinnabar mixture) to uplift them.

**Earth Slurry (Yu Dijiang):** After sweating or purging, if the pulse is rapid, body heat persists, thirst is extreme, and drinking water does not quench it, drink fresh well water from a newly dug well.

**Dispersing Wind (Xiaofeng):** Heat generated from wind pathogens causing dizziness and oppression is treated with Fangfeng Tongsheng San (Wind-Protecting Universal Rescue Powder), Chuanxiong (Szechwan Lovage Rhizome), and Shigao (Gypsum Fibrosum).

**Clearing Metal (Qingjin):** Lung dryness with stagnant heat or fire invasion is cleared using Baihu Tang (White Tiger Decoction) plus Digupi (Dogwood Bark).

**Tonification (Bu):** Insufficiency of Yuan Qi or sinking of Stomach Qi causing heat is treated with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). Add blood-tonifying herbs for blood deficiency.

**Soaking the Form (Zixing):** For blood deficiency and Qi weakness where pathogens cannot be dispersed.

**Acupuncture (Zhen):** To guide Qi. For febrile diseases with inability to sweat, bleed at Shangyang (LI1), Hegu (LI4), Yanggu (SI7), Xiaxi (GB43), Lidui (ST45), Laogong (PC8), and Wanggu (SI4). For uncontrolled high fever, bleed at Xian Gu (ST43).

**Following Treatment (Congzhi):** Decoct herbs with wine, or use warm/hot herbs as assistants.

**Contrary Treatment (Fanzhi):** Use honey-fried Aconite (Wutou) and similar preparations.

**Raising and Dispersing (Shengsan):** When the condition is about to manifest macules or rashes with body heat, use Shengma Tang (Cimicifuga Decoction) to disperse.

**Cooling Bone and Flesh Layer for Consumptive Fever:** Principles regarding Qi and Blood are stated above.

Liver (Danggui, Chaihu) | Heart (Shengdi, Huanglian) | Spleen (Shaoyao, Mugua) | Lung (Shigao, Sangbaipi) | Kidney (Zhimu, Shengdi)
Bladder (Huashi, Zexie).

**Formula: Chaihu Meilian San:** Treats bone-steaming consumption fever; three doses can eradicate the root cause.
*Ingredients:*
Huhuanglian (Picrorhiza Rhizome), Chaihu (Bupleurum), Qianhu (Peucedanum), Wumei (Mume Fruit) — each 3 qian.
*Preparation:*
Cut into slices. Take 3 qian per dose. Decoct with 1 cup of child's urine, 1 pig gallbladder, 1 pig spinal cord, and half a cup of Chinese leek root white. Boil until reduced to 70%. Take warm at any time. After the heat subsides, proceed with further regulation.