千金方云咳者灸两乳下黑白际各数十壮即瘥 又以蒲当乳头周匝围身令前后正中当脊骨
灸十壮
上气咳嗽短气气满食不下灸肺募五十壮 上气咳逆短气风劳百病灸肩井二百壮 上气咳
逆短气胸满多唾唾恶冷痰灸肺俞五十壮
诸病喘呕吐酸暴注下迫转筋小便混浊腹胀大鼓之有声如鼓痈疽疡疹瘤气结核吐下霍乱瞀
郁肿胀鼻塞鼽衄血溢血泄淋 身热恶寒战栗惊惑悲笑谵妄衄 血污皆属于热
按此病机皆内经气交变论五常政论至真要论等文河间刘守真撮而为六气为病今但以身热
发热分例如以下经言有诸病本之不同故兹病机不复参附一一见各类云余证仿此
经曰夫热病者皆伤寒之类也 阳胜则热 阴虚则内热 阳盛则外热内外皆热则喘而渴故
欲
冷冻饮料也 阳盛则身热腠理闭喘粗为之俯仰汗不出而热齿干以烦冤腹满死能冬不能夏有四肢热
逢风寒如炙于火者是人阴气虚阳气盛也 人身非常热也为之热而烦满者阴气少而阳气胜故热
而烦满也 三阳之病发寒热 病热而有所痛者是三阳之动也
内经曰大热病气热脉满是谓重实尺寸脉俱虚是谓重虚
粗大者阴不足阳有余为热中也王注云粗大谓脉洪大也脉洪为热脉缓而滑脉尺粗常热者皆
热中也
阳气有余为身热无汗脉反涩者为太过血少阴虚也
谨按经曰脉至而从按之不鼓诸阳皆然王注云病热而脉数按之不鼓动乃寒盛格阳而致
之非热也形证是寒按之而脉气鼓击于指下盛者此为热盛拒阴而生病
非寒也
又曰推而内之外而不内身有热也伤寒论曰寸口脉微为阳不足阴气上入阳中则洒淅恶寒尺
脉弱
为阴不足阳气下陷入阴中则发热也与难经言覆溢相乘及六难浮损沉实义皆诊法之至要于热证
大宜谙识
难经曰热病之脉阴阳俱浮浮之而滑沉之散涩 脉经曰弦数多热 数为热极数脉为虚为热
数
洪热烦 脉来如悬钩而浮为热 滑数心下结热盛 紧而数寒热俱发 沉细滑疾者热 脉盛滑
紧者病 在外热 脉沉而紧上焦有热下寒脉浮紧且滑直者外热内冷内不通 寸口脉浮大而疾
者名曰阳中之阳病若烦满身热头痛腹中热 寸口脉实热在脾肺数为吐为热在胃口 关脉滑数
胃中有客热 缓而滑为热中 牢脉为脾胃盛热 尺脉实为身热心痛数为脐下热痛浮为下热风
凡脉洪大伤寒热病也
谨按经曰脉浮紧发热为伤寒卒病 脉浮而大者风脉浮数无热者为风 脉浮如数而有热者
气也皆与热证脉相类
脉经曰热病脉小或细喘逆不得大小便腹大而胀汗出而厥逆泄注脉大小不调皆难治 热病
已得
汗而脉尚躁盛此阴脉之极也死 热病不得汗而脉躁盛者此阳脉之极也死 脉浮而涩涩而身有
热者死
The *Qianjin Fang* (Prescriptions Worth a Thousand Gold) records: For cough, moxa-heat each of dozens of moxa cones at the boundary between black and white skin below both breasts, and the condition will heal. Additionally, use cattail leaves to encircle the body around the nipples, aligning the anterior and posterior midpoints with the spine, and apply ten moxa cones.
For qi rebellion, cough, shortness of breath, chest fullness, and inability to eat, apply fifty moxa cones to the Front-Mu point of the Lung (Fei Mu). For qi rebellion, coughing and wheezing, shortness of breath, wind-lao (wind-related chronic debility), and various diseases, apply two hundred moxa cones to Jianjing (GB21). For qi rebellion, coughing and wheezing, shortness of breath, chest fullness, excessive saliva, and cold phlegm, apply fifty moxa cones to Feishu (BL13).
Various conditions such as panting, vomiting, acid regurgitation, sudden diarrhea with tenesmus, muscle cramps, turbid urine, abdominal distension with a drum-like sound upon percussion, carbuncles and sores, rashes, tumor-qi, tubercles, vomiting and diarrhea with cholera-like symptoms, mental confusion and depression, swelling, nasal congestion, rhinorrhea, epistaxis, blood extravasation or hemorrhage, strangury, fever with aversion to cold, shivering, fright and confusion, inappropriate laughing or crying, delirium, epistaxis, and foul discharges are all attributed to Heat.
According to this pathogenesis, these principles originate from chapters such as *Qi Jiao Bian Lun*, *Wu Chang Zheng Da Lun*, and *Zhi Yao Yao Lun* in the *Neijing*. Liu Wansu (Liu Shouzhen) of Hejian summarized them into the theory of disease caused by the Six Qi (Six Pathogenic Factors). Here, we only take fever and elevated body temperature as examples, citing relevant classic texts. Since the root causes of various diseases differ, the "Twelve Pathogenesis Principles" are not annotated one by one here; see respective categories for details, and other syndromes follow this pattern.
The classics state: Heat diseases belong to the category of Cold Damage (Shanghan). Excess Yang leads to heat; Yin deficiency leads to internal heat. If both interior and exterior are hot, there will be panting and thirst, leading to a desire for frozen beverages. Excess Yang causes body heat, closed pores, coarse breathing, and difficulty in bending or stretching, with no sweat but continued heat, dry teeth, and vexatious distress. Abdominal fullness indicates death; such patients can tolerate winter but not summer. Heat in the four limbs, feeling like being roasted by fire when encountering wind or cold, indicates deficiency of Yin Qi and excess of Yang Qi. The human body does not constantly have high temperature; if one feels hot and vexed/full, it is because Yin is scant and Yang prevails, causing heat and vexation. Diseases of the Three Yang channels manifest with alternating chills and fever; pain accompanying heat indicates the movement of Yang Qi.
The *Neijing* states: In severe heat diseases, with hot breath and full pulse, it is called "Chong Shi" (Double Excess); if the pulses at Cun, Guan, and Chi are all deficient, it is called "Chong Xu" (Double Deficiency). A coarse pulse indicates insufficient Yin and excess Yang, known as "Re Zhong" (Heat in the Middle). Wang Bing’s commentary notes that "coarse" refers to a洪大 (Hongda, surging and large) pulse. A surging pulse indicates heat; a slow and slippery pulse, or a coarse Chi pulse with constant heat sensation, all indicate Re Zhong. Excess Yang Qi causes body heat without sweat; if the pulse is instead choppy, it indicates blood deficiency and Yin deficiency.
Respectfully following the classics: When the pulse seems to accord with the disease but does not throb under pressure, this applies to all Yang channels. Wang Bing comments: In heat diseases, if the rapid pulse does not throb under pressure, it is due to extreme Cold repelling Yang, not true Heat; the signs and symptoms are Cold. Conversely, if the pulse throbs vigorously under pressure, it indicates Heat repelling Yin, not Cold.
Furthermore, pushing the pulse inward reveals heat on the exterior but not the interior, indicating body heat. The *Shanghan Lun* states: A faint Cun pulse indicates insufficient Yang, allowing Yin Qi to enter the Yang level, causing shivering and aversion to cold. A weak Chi pulse indicates insufficient Yin, allowing Yang Qi to sink into the Yin level, causing fever. This aligns with the concepts of Fu-Yi interaction and the meanings of floating-damaged and sunken-solid in the Sixth Difficulty of the *Nan Jing*. These are essential diagnostic methods, particularly important for recognizing heat syndromes.
The *Nan Jing* states: In heat diseases, the Yin and Yang pulses are both floating; floating makes them slippery, while sinking makes them scattered and choppy. The *Mai Jing* states: String-taut and rapid pulses often indicate heat; rapid pulses indicate extreme heat, or deficiency/heat; surging pulses indicate heat and vexation; a pulse coming like a hanging hook and floating indicates heat; slippery and rapid pulses indicate abundant heat binding in the epigastrium; tight and rapid pulses indicate simultaneous cold and heat; deep, fine, slippery, and rapid pulses indicate heat; strong, slippery, and tight pulses indicate disease in the exterior with heat; deep and tight pulses indicate upper jiao heat and lower jiao cold; floating, tight, slippery, and straight pulses indicate exterior heat and interior cold with internal blockage; large, rapid, and floating Cun pulses are named Yang-Zhong-Zhi-Yang disease; if accompanied by vexation, body heat, headache, and abdominal heat, it confirms this; solid Cun pulses indicate heat in Spleen and Lung; rapid pulses indicate vomiting or heat in the stomach opening; slippery and rapid Guan pulses indicate guest-heat in the Stomach; slow and slippery pulses indicate heat in the middle; firm pulses indicate abundant heat in Spleen and Stomach; solid Chi pulses indicate body heat and heart pain; rapid Chi pulses indicate heat and pain below the navel; floating Chi pulses indicate lower jiao wind. Generally, surging and large pulses are seen in Cold Damage and heat diseases.
Respectfully following the classics: Floating-tight pulse with fever indicates acute Cold Damage; floating and large pulses indicate Wind; floating and rapid pulses without fever indicate Wind pathogen; floating pulses resembling rapidity with fever indicate Qi disorders. All these resemble heat syndrome pulses.
The *Mai Jing* states: Small or fine pulses in heat diseases, with panting and reversal, inability to pass stool or urine, abdominal distension, sweating, cold extremities, and diarrhea, along with irregular pulse sizes, are difficult to treat. If heat disease has sweated but the pulse remains restless and vigorous, this is the extreme of Yin pulses, indicating death. If heat disease does not sweat and the pulse is restless and vigorous, this is the extreme of Yang pulses, indicating death. Floating and choppy pulses with body heat indicate death.