论曰。有表而热者。谓之表热也。无表而热者。谓之里热也。有暴发而为热者。乃久不宣通而致也。有服
温药过剂而为
热者。有恶寒战栗而热者。盖诸热之属者。心火之象他。王注曰。百端之起。皆自心生。是以上善若水。下愚
若火。治法曰。少热之气。凉以和之。大热之气。寒以取之。甚热之气。则汗发之。发之不尽。则逆治之。制
之不尽。求其属以衰之。故曰苦者以治五脏。五脏属阴而居于内。辛者以治六腑。六腑属阳而在于外。故内者
下之。外者发之。又宜养血益阴。其热自愈。此所谓不治而治也。故不治谓之常治。治之不治。谓之暴治。
经所谓诸寒而热者取之阴。诸热而寒者取之阳。此所谓求其属也。王注曰。益火之源。以消阴翳。用水之主。
以制阳光。此之谓也。
病有暴热者。病在心肺。有积热者。病在肾肝。暴热者宜局方中雄黄解毒丸。积热者局方中妙香丸。暴热
上喘者。病在心肺。谓之高喘。木香金铃子散。上焦热而烦者。牛黄散。脏腑秘者。大黄牵牛散。上焦热无他
证者。桔梗汤。有虚热不能食而热者。脾虚也。宜以浓朴白术陈皮之类治之。有实热能食而热者。胃实也。
宜以栀子黄芩汤。或三黄丸之类治之。郁金柴胡之类亦是也。有病久憔悴发热盗汗。谓五脏齐损。此热劳骨蒸
病也。瘦弱虚烦。肠 下血。皆蒸劳也。宜养血益阴。热能自退。当归生地黄或钱氏地黄丸是也。
木香金铃子散 治暴热。心肺上喘不已。
大黄（半两） 金铃子 木香（各三钱） 轻粉（少许） 朴硝（二钱）
上为细末。柳白皮汤调下三钱或四钱。食后服。以利为度。喘止即止。
牛黄散 治上焦热而烦。不能睡卧。
栀子（半两） 大黄（半两） 郁金（半两） 甘草（二钱半）
上为细末。每服五钱。水煎温服食后。微利则已。
大黄牵牛散 治相火之气。游走脏腑。大便秘结。
大黄（一两） 牵牛（头末五钱）
上为细末。每服三钱。有厥冷。用酒调三钱。无厥冷而手足烦热者。蜜汤调下食后。微利为度。此谓不时
而热者。湿热也。
地黄丸 治久新憔悴。寝汗发热。五脏齐损。瘦虚弱烦。肠 下血。骨蒸痿弱无力。不能运动。
熟地黄（一两） 山茱萸（四钱） 干山药（四钱） 牡丹皮 白茯苓 泽泻（各三钱）
上为细末。炼蜜为丸。如桐子大。每服五十丸。空心温酒送下。如烦渴皮肤索泽。食后煎服防风饮子。空
心服地黄丸。
防风当归饮子
柴胡 人参 黄芩 甘草（各一两） 大黄 当归 芍药（各半两） 滑石（三两）
上为粗末。每服五钱。水一盏半。生姜三片。同煎至七分。去滓温服。如痰实咳嗽。加半夏。如大便黄。
米谷完出。惊惧溺血淋闭咳血衄血。自汗头痛积热肺痿。后服大金花丸。
大金花丸
黄连 黄柏 黄芩 山栀子（各一两）
上为细末。滴水为丸。如小豆大。每服一百丸。温水下。日二三服。或大便实。加大黄。自利不用大黄。
如中外有热者。此药 作散服名解毒汤。或腹满呕吐。欲作利者。每服半两解毒汤中加半夏茯苓浓朴各三钱。
生姜三片。如白脓下痢后重者。加大黄三钱。
凉膈散 加减附于后
连翘 山栀子 大黄 薄荷叶 黄芩（各半两） 甘草（一两半） 朴硝（二钱半）
上件为粗末。每服半两。水一盏半。煎至一盏。去滓入蜜一匙。微煎温服。食后。
咽嗌不利。肿痛并涎嗽者。加桔梗一两。荆芥穗半两。咳而呕者。加半夏二钱半。生姜一钱。
如鼻衄呕血者。加当归芍药生地黄各半两。一料内服。如淋闭者。加滑石四两。茯苓一两。
或闭而不通。脐下状如复碗。痛闷不可忍者。乃肠胃干涸。膻中气不下故。经所谓膀胱者。州都之官。津
液藏焉。气化则能出矣。故膻中者。臣使之官名。三焦相火。下合右肾。为气海也。王注曰。膀胱位当孤府。
故谓都官。居下内空。故藏津液。若得气海之气施化。则溲便注泄。气海之气不及。则 隐不通。故不得便利
也。先用沉香木香各三钱。酒调下。或八正散。甚则宜上涌之。令气通达。小便自通。经所谓病在下。上取之。
王注曰。热攻于上。不利于下。气盛于上。则温辛散之。苦以利之可也。
当归承气汤
当归 大黄（各一两） 甘草（半两） 芒硝（九钱）
上 如麻豆大。每服二两。水一大碗。入生姜五片。枣十枚。同煎至半碗。去滓热服。若阳狂奔走骂詈不
避亲疏。此阳有余阴不足。大黄芒硝去胃中实热。当归补血益阴。甘草缓中。加生姜枣。胃属土。此引至于胃中
也。经所谓微者逆之。甚者从之。此之谓也。以大利为度。微缓以瓜蒂散加防风藜芦。吐其病自愈。后调洗心
散凉膈散解毒汤等药调治之。
牛黄膏 治热入血室。发狂不认人者。
牛黄（二钱半） 朱砂 郁金 牡丹皮（各三钱） 脑子 甘草（各一钱）
上为细末。炼蜜为丸。如皂子大。新水化下。
治暴热者。局方中解毒雄黄丸 雄黄（碎飞） 郁金（各一分） 巴豆（去皮出油十四个）。
治久热者。局方中妙香丸。
辰砂（飞研九两） 牛黄 龙脑 腻
粉（研） 麝香（研各三两） 金箔（九十片研） 巴豆（三百一十粒去心腹炒研细）
治虚劳骨蒸。烦热下血者。钱氏地黄丸。
治虚热不能食者。脾虚也。宜以浓朴白术陈皮之类治之。
治实热能食者。胃实也。宜以栀子黄芩或三黄丸之类治之。郁金柴胡亦可。
治表热恶寒而渴。白虎汤也。
肤如火燎而热。以手取之不甚热。为肺热也。目白睛赤。烦燥或引饮。独黄芩一味主之。水煎。
两胁下肌热。脉浮弦者。柴胡饮子主之。
两胁肋热。或一身尽热者。或日晡肌热者。皆为血热也。四顺饮子主之。
夜发热。主行阴。乃血热也。四顺桃仁承气选用。当视其腹痛血刺痛。与有表入里。腹中转失气燥结之异。
昼则明了。夜则谵语。四顺饮子证。与桃仁承气相似。不可不辨也。发热虽无胁热亦为柴胡证。昼则行阳二十
五度。气也。大抵柴胡。夜则行阴二十五度。血也。大抵四顺饮子。
It is stated: When heat is present on the exterior, it is called Exterior Heat (Biao Re). When heat is present in the interior without exterior symptoms, it is called Interior Heat (Li Re). Sudden onset of heat is caused by long-standing stagnation and lack of free flow. Heat resulting from excessive dosage of warm medicines, as well as heat accompanied by aversion to cold and shivering, belongs to the manifestation of Heart Fire (Xin Huo). Wang Bing's commentary states: "The rise of myriad diseases all originates from the Heart." Therefore, the superior wisdom resembles water, while the inferior foolishness resembles fire. The treatment principles are: For mild heat, use cool properties to harmonize; for severe heat, use cold properties to eliminate; for extreme heat, induce sweating to release it. If sweating does not fully resolve it, employ reverse treatment (treating heat with cold when heat manifests as cold, etc.). If suppression fails, seek its root affiliation to diminish the pathogenic factor. Thus, bitter substances treat the Zang organs, as the Zang organs belong to Yin and reside within; pungent substances treat the Fu organs, as the Fu organs belong to Yang and reside externally. Therefore, internal conditions are treated with purgation, and external conditions with diaphoresis. Additionally, nourishing blood and benefiting Yin allows the heat to subside spontaneously, which is termed "treating without treating" (Zhi Bu Zhi). This so-called "non-treatment" refers to following natural laws, known as standard treatment (Chang Zhi); forced intervention that fails is termed violent treatment (Bao Zhi). As the Classics state: "For heat treated with cold remedies but remaining unrelieved, take from the Yin"; "For cold treated with hot remedies but remaining unremoved, take from the Yang." This is what is meant by "seeking its affiliation." Wang Bing's commentary says: "Enrich the source of Fire to dissipate the shadows of Yin; utilize the master of Water to control the brilliance of Yang." This refers to this principle.
Diseases presenting with sudden high fever involve the Heart and Lung. Diseases with accumulated internal heat involve the Kidney and Liver. For sudden high fever, the Xionghuang Jiedu Wan (Realgar Detoxification Pill) from the Ju Fang (Official Formulary) is suitable. For accumulated heat, the Miaoxiang Wan (Wonderful Fragrance Pill) from the Ju Fang is suitable. Sudden high fever with upper body panting involves the Heart and Lung, termed High Panting (Gao Chuan), treatable with Muxiang Jinlingzi San (Costus and Golden Bell Fruit Powder). Upper Jiao heat with vexation is treated with Niuhuang San (Calculus Bovis Powder). Constipation of the Fu organs is treated with Dahuang Qianniu San (Rhubarb and Morning Glory Seed Powder). Upper Jiao heat without other symptoms is treated with Jiegeng Tang (Platycodon Decoction). Deficiency heat causing inability to eat and fever indicates Spleen Deficiency (Pi Xu), treatable with Houpo, Baizhu, Chenpi, etc. Excess heat allowing eating and fever indicates Stomach Excess (Wei Shi), treatable with Zhizi Huangqin Tang or Sanhuang Wan (Three Yellows Pill); Yujin and Chaihu may also be used. Chronic illness leading to emaciation, fever, and night sweats indicates damage to all five Zang organs, known as Heat Consumption Bone Steaming Disease (Re Lao Gu Zheng). Emaciation, deficiency vexation, and hematochezia are manifestations of steaming consumption. Nourishing blood and benefiting Yin allows heat to recede spontaneously; Danggui and Shengdihuang, or Qian Shi Dihuang Wan (Qian's Rehmannia Pill), are suitable.
Muxiang Jinlingzi San: Treats sudden heat and incessant panting due to heat in the Heart and Lung.
Ingredients: Dahuang (Ban Liang), Jinlingzi, Muxiang (each San Qian), Qingfen (a little), Puxiao (Er Qian).
Preparation and Administration: Grind into fine powder. Mix with decoction of Willow White Bark, take San or Si Qian after meals. Stop when bowel movement occurs; stop medication when panting ceases.
Niuhuang San: Treats upper Jiao heat with vexation and insomnia.
Ingredients: Zhizi (Ban Liang), Dahuang (Ban Liang), Yujin (Ban Liang), Gancao (Er Qian Ban).
Preparation and Administration: Grind into fine powder. Take Wu Qian each time, decoct in water, take warm after meals. Mild diarrhea indicates efficacy.
Dahuang Qianniu San: Treats Ministerial Fire wandering through the Fu organs and constipation.
Ingredients: Dahuang (Yi Liang), Qianniu (Tou Mo Wu Qian).
Preparation and Administration: Grind into fine powder. Take San Qian each time. If limbs are cold, mix with wine. If no limb coldness but hands/feet are hot, mix with honey water, take after meals. Mild diarrhea is the limit. This intermittent heat is damp-heat.
Dihuang Wan: Treats chronic or acute emaciation, night sweats with fever, damage to all five Zang organs, weakness, vexation, hematochezia, bone-steaming fever, flaccidity, and immobility.
Ingredients: Shudihuang (Yi Liang), Shanzhuyu (Si Qian), Gansanyao (Si Qian), Mudanpi, Bai Fuling, Zexie (each San Qian).
Preparation and Administration: Grind into fine powder, make pills with refined honey, size of Sophora seeds. Take fifty pills each time, swallow with warm wine on an empty stomach. If vexation/thirst and dry skin occur, take Fangfeng Yinzi after meals; take Dihuang Wan on an empty stomach.
Fangfeng Danggui Yinzi:
Ingredients: Chaihu, Renshen, Huangqin, Gancao (each Yi Liang), Dahuang, Danggui, Shaoyao (each Ban Liang), Huashi (San Liang).
Preparation and Administration: Coarsely crush. Take Wu Qian each time, add one and a half cups of water, three slices of fresh ginger, decoct to seven parts, strain, take warm. Add Banxia for phlegm-stasis cough. If stool is yellow with undigested food, fearfulness, hematuria, stranguria, hemoptysis, epistaxis, spontaneous sweating, headache, accumulated heat, or lung abscess, subsequently take Dajinhua Wan.
Dajinhua Wan:
Ingredients: Huanglian, Huangbai, Huangqin, Shanzhizi (each Yi Liang).
Preparation and Administration: Grind into fine powder, make pills with drops of water, size of soybeans. Take one hundred pills each time with warm water, two to three times daily. If stool is hard, add Dahuang. If diarrhea, do not use Dahuang. If heat exists inside and out, take as powder named Jiedu Tang. If abdominal fullness/vomiting suggests impending diarrhea, add Banxia, Fuling, Houpo (each San Qian) and three slices of ginger to Ban Liang of Jiedu Tang. For dysentery with white pus and tenesmus, add Dahuang (San Qian).
Liangge San: Modifications follow.
Ingredients: Lianqiao, Shanzhizi, Dahuang, Bohe Ye, Huangqin (each Ban Liang), Gancao (Yi Liang Ban), Puxiao (Er Qian Ban).
Preparation and Administration: Coarsely crush. Take Ban Liang each time, add one and a half cups of water, decoct to one cup, strain, add one spoon of honey, simmer slightly, take warm after meals.
Modifications: For throat obstruction, swelling/pain with salivary cough, add Jiegeng (Yi Liang), Jingjie Sui (Ban Liang). For cough with vomiting, add Banxia (Er Qian Ban), Shengjiang (Yi Qian).
For epistaxis or hematemesis, add Danggui, Shaoyao, Shengdihuang (each Ban Liang), consume within one dose. For stranguria, add Huashi (Si Liang), Fuling (Yi Liang).
If urinary retention with umbical sensation like an inverted bowl and unbearable pain/distress, this is intestinal dryness and failure of Danzhong Qi to descend. The Classics state: "The Bladder is the Officer of the Prefecture, storing fluids; only through Qi transformation can they exit." Thus, Danzhong is the name of the Envoy Official. The Sanjiao Ministerial Fire descends to merge with the Right Kidney, forming the Sea of Qi. Wang Bing notes: "The Bladder resides in the solitary Fu, hence 'Prefecture Officer.' Located lower, hollow inside, it stores fluids. With Qi Sea transformation, urination flows freely. Insufficient Qi Sea Qi leads to obstruction." Initially take Chenxiang and Muxiang (each San Qian) mixed with wine, or Bazheng San. In severe cases, induce vomiting to unblock Qi, allowing urination to resume naturally. The Classics state: "Disease below, treat above." Wang Bing notes: "Heat attacking above hinders below. Qi excess above requires warm/pungent dispersal and bitter draining."
Danggui Chengqi Tang:
Ingredients: Danggui, Dahuang (each Yi Liang), Gancao (Ban Liang), Mangxiao (Jiu Qian).
Preparation and Administration: Cut into hemp/mustard seed sizes. Take Liang each time, add one large bowl of water, five slices of ginger, ten dates, decoct to half bowl, strain, take hot. For manic running/cursing ignoring kinship, indicating Yang excess/Yin deficiency: Dahuang/Mangxiao clear Stomach excess heat; Danggui nourishes blood/Yin; Gancao moderates; Ginger/Dates guide to Stomach (Earth). The Classics state: "Minor cases oppose the disease; major cases follow the disease." This is the meaning. Aim for profuse diarrhea. If milder, use Gaidi San with Fangfeng/Lilv to induce vomiting. Subsequently regulate with Xixin San, Liangge San, Jiedu Tang, etc.
Niuhuang Gao: Treats heat entering the Blood Chamber, mania, and loss of recognition.
Ingredients: Niuhuang (Er Qian Ban), Zhusha, Yujin, Mudanpi (each San Qian), Naozhi, Gancao (each Yi Qian).
Preparation and Administration: Grind into fine powder, make pills with refined honey, size of soap pods. Dissolve in new spring water and take.
For sudden heat: Jiefang Xionghuang Wan from Ju Fang.
Ingredients: Xionghuang (crushed/flying), Yujin (each Yi Fen), Badou (peeled/oil removed, fourteen kernels).
For chronic heat: Miaoxiang Wan from Ju Fang.
Ingredients: Chensha (flying/grinded nine Liang), Niuhuang, Longnao, Nifen (ground), Shexiang (ground, each San Liang), Jinbo (ninety leaves, ground), Badou (three hundred ten kernels, heart/belly removed, stir-fried, ground fine).
For deficiency consumption bone-steaming, vexation, and lower bleeding: Qian Shi Dihuang Wan.
For deficiency heat with inability to eat: Spleen Deficiency, treat with Houpo, Baizhu, Chenpi, etc.
For excess heat with ability to eat: Stomach Excess, treat with Zhizi Huangqin Tang or Sanhuang Wan; Yujin and Chaihu are also applicable.
For exterior heat with aversion to cold and thirst: Baihu Tang.
Skin feels like burning fire but is not hot to touch: Lung Heat. Red sclera, vexation, or desire to drink: Treat solely with Huangqin, decocted in water.
Heat in both hypochondriac muscles with floating/wiry pulse: Chaihu Yinzi.
Heat in both hypochondriac ribs, whole body heat, or afternoon muscle heat: All indicate Blood Heat. Treat with Sishun Yinzi.
Night fever indicates Yin/Blood heat. Select Sishun Yinzi or Taoren Chengqi Tang. Observe for abdominal pain, stabbing blood pain, differentiation from exterior-to-interior transition, abdominal gas movement, and dryness/constipation.
Clear during day, delirious at night: Sishun Yinzi pattern, similar to Taoren Chengqi Tang, must be distinguished. Fever without hypochondriac heat is still a Chaihu pattern. Daytime Yang circulation (25 cycles) relates to Qi; Nighttime Yin circulation (25 cycles) relates to Blood. Generally, Chaihu treats Qi patterns; Sishun Yinzi treats Blood patterns.