《脉经》曰∶脉大无力为阳虚,脉数无力为阴虚。无力曰虚,有力曰实。
夫发热者,谓怫怫然发于皮肤之间,则成热也,与潮热、
寒热若同而异。潮热者,有时而热,不失其时;寒热者,寒已而热,相继而发;至于发热,则无时而发也。
血虚有汗潮热者。
人参养荣汤 治积劳虚损,四肢倦怠,肌肉消瘦而少颜色,吸呼气短,饮食无味也。
人参(去芦) 当归 陈皮 黄 (蜜炙) 桂心 白术(去芦) 甘草(炙,一钱) 白芍(酒炒,
二钱) 熟地黄(酒浸) 茯苓(去皮) 五味子(各七分半) 远志(去心,炒五分)
上锉一剂,生姜三片、枣二枚、水二钟,煎至一钟,食远服。
气虚有汗潮热者,补中益气汤。(方见内伤。)
乌鸡丸 治童男室女身发潮热、吐血痰、出盗汗、饮食少进、四肢无力。
黄 (蜜炙) 人参(去芦) 白术(去芦当 当归(酒洗) 白芍(酒炒) 生地 陈皮 秦艽 柴胡
银柴胡 前胡 黄芩 胡黄连 黄柏(去粗皮) 知母(去毛) 贝母(去心) 桑白发 地骨皮 麦门冬
(去心) 五味子(各一两。)
上锉细片,用乌骨白鸡一只,耳有绿色、脑有金色者佳,重一斤者,以麻子喂七日,缢死,去毛并内肠杂,
纳药于内,用绿豆一斗五升浸润,放入小甑内三寸浓,又将青蒿四两衬之放鸡在上,仍以绿豆盖之,蒸极熟,
将鸡折碎,同药晒干为末,汤浸,蒸饼为丸,如梧桐子大。每服七十丸,空心清米汤下。
血虚无汗潮热者,茯苓补心汤。(方见妇人虚劳门。)
气虚无汗潮热者。
人参清肌散 治男妇气虚无汗潮热。
人参 白术 茯苓 当归 赤芍 柴胡 半夏 葛粉 甘草
上锉一剂,姜枣煎服。
女子血虚有汗潮热者,茯苓补心汤。(方见妇人虚劳门。)
气血两虚,无汗潮热者,逍遥散。(方见妇人虚劳门。)
男妇四肢发热,筋骨间如火烙手者,郁遏阳气于脾胃之中也。
升阳散火汤 治男妇四肢发热,肌表热如火烙,扪之烙手。此病多因血气而得之,或胃虚过食冷物,
郁遏阳气于脾土之中,即火郁则发之,即火郁汤。
升麻 葛根 白芍 羌活 独活 人参(各五钱) 柴胡(八钱) 防风(三钱半) 生甘草(二钱)
炙甘草(三钱) 上锉一剂,生姜煎服。忌寒凉生冷之物,月余。
伤寒发热者,是外之寒邪伤卫也。九味羌活汤(方见伤寒。)
伤暑发热者,是外之热邪伤荣也。清暑益气汤(方见中暑。)
内伤发热者,是阳气自伤,属脾肺也。(其脉大而无力。)补中益气汤(方见内伤。)
阴虚发热者,是阴血自伤,属心肾也。(其脉数而无力。)滋阴降火汤(方见虚劳。)
夜则静,昼则发热者,此热在气分也。小柴胡汤加栀子、黄连、知母、地骨皮。
昼则静,夜则发热者,此热在血分也。四物汤加知母、黄柏、黄连、栀子、牡丹皮、柴胡。
昼夜俱发热者,此热在血气之分也。四物汤合小柴胡汤加黄连、栀子。
子午潮热者,加减逍遥散加黄芩、胡黄连、麦门冬、地骨皮、秦艽、木通、车前子、灯芯,水煎服。
一切发热憎寒者,邪在半表半里也。柴苓汤,即小柴胡汤合五苓散。
当归饮 治劳心生热,鼻少见血,五心烦热。
当归(一钱二分) 芍药(一钱) 川芎(五分) 生地黄(一钱) 牡丹皮(一钱) 黄连(酒炒,
七分) 麦门冬(去心,二钱) 地骨皮(七分) 酒黄芩(七分) 炒栀子(六分) 柴胡(六分) 生甘
草(三分)
上锉一剂,水煎,食远热服。
一 仆人,五月间病热口渴、唇干谵语。诊其脉细而迟,用四君子加黄 、当归、芍药、熟附子,进一服,
热愈甚,狂言狂走。或曰附子差矣。诊其脉如旧,仍增附子进一大服,遂汗出而热退,脉还四至矣。
一 妇人,夏间病热,初用平调气血兼清热和解之剂。服二三剂不应,热愈甚,舌上焦黑,膈间有火,漱
水不咽。诊其脉,两手皆虚微而右手微甚,六七日内谵语撮空、循衣摸床,恶症俱见。后用四物汤加黄芩、人
参、白术、陈皮、麦门冬、知母、熟附子。服之一二时,汗出而热退。次日复热,再服仍退。又次日复发,知
其虚汗也,遂连进十服,皆加附子而安。
一 男子发热烦渴头痛,误行发汗,喘急腹痛,自汗谵语。用十全大补汤加附子治之,熟睡唤而不醒,及
觉诸症顿退,再剂而痊。
The *Mai Jing* (Pulse Classic) states: A pulse that is large but forceless upon pressure indicates Yang deficiency; a pulse that is rapid but forceless indicates Yin deficiency. A forceless pulse is termed "deficiency" (Xu), while a forceful pulse is termed "excess" (Shi).
"Fever" (Fa Re) refers to heat accumulating between the skin and muscles, forming a sensation of heat. It appears similar to but differs from tidal fever (Chao Re) and alternating chills and fever (Han Re). Tidal fever occurs at specific times without missing its schedule; alternating chills and fever involves chills followed by fever in succession. In contrast, general fever occurs without a fixed time.
For cases of blood deficiency with sweating and tidal fever:
**Renshen Yangrong Tang** (Ginseng Decoction for Nourishing Qi and Blood) treats chronic fatigue and deficiency, manifesting as lassitude of the four limbs, emaciation with sallow complexion, shortness of breath, and loss of taste.
Ingredients: Renshen (Radix Ginseng, remove rhizome), Danggui (Radix Angelicae Sinensis), Chenpi (Pericarpium Citri Reticulatae), Huangqi (Radix Astragali, honey-fried), Guixin (Cortex Cinnamomi), Baizhu (Rhizoma Atractylodis Macrocephalae, remove rhizome), Gancao (Radix Glycyrrhizae, roasted, 1 qian), Baishao (Radix Paeoniae Alba, wine-fried, 2 qian), Shudihuang (Radix Rehmanniae Preparata, soaked in wine), Fuling (Sclerotium Poriae, remove bark), Wuweizi (Fructus Schisandrae, each 0.75 fen), Yuanzhi (Radix Polygalae, remove heart, fried, 0.5 fen).
Process these herbs into coarse powder for one dose. Add three slices of Shengjiang (Rhizoma Zingiberis Recens), two dates (Dazao), and two zhong of water. Decoct until one zhong remains. Take after meals.
For cases of qi deficiency with sweating and tidal fever, use **Buzhong Yiqi Tang** (Decoction for Supplementing the Middle and Augmenting Qi). (Formula see Internal Injury chapter.)
**Wuji Wan** (Black-Bone Chicken Pill) treats tidal fever, hemoptysis or blood-stained sputum, night sweats, poor appetite, and weakness in the four limbs in unmarried men and women.
Ingredients: Huangqi (Radix Astragali, honey-fried), Renshen (Radix Ginseng, remove rhizome), Baizhu (Rhizoma Atractylodis Macrocephalae, remove rhizome), Danggui (Radix Angelicae Sinensis, washed in wine), Baishao (Radix Paeoniae Alba, wine-fried), Shengdihuang (Radix Rehmanniae Recens), Chenpi (Pericarpium Citri Reticulatae), Qinjiao (Radix Gentianae Macrophyllae), Chaihu (Radix Bupleuri), Yin Chaihu (Radix Stemonae), Qianhu (Radix Peucedani), Huangqin (Radix Scutellariae), Huhuanglian (Rhizoma Coptidis Chinensis), Huangbai (Cortex Phellodendri, remove rough bark), Zhimu (Rhizoma Anemarrhenae, remove hairs), Beimu (Bulbus Fritillariae Cirrhosae, remove heart), Sangbaixian (Cortex Mori Radicis), Digupi (Cortex Lycii Radicis), Maimendong (Radix Ophiopogonis, remove heart), Wuweizi (Fructus Schisandrae, each 1 liang).
Cut these herbs into fine slices. Take one white chicken with black bones (preferably with green feathers on ears and golden feathers on the head, weighing about 1 jin). Feed it hemp seeds for seven days, then strangle it. Remove feathers and internal organs. Stuff the herbs inside the chicken. Soak with 1.5 dou of mung beans. Place in a small steamer (zeng) with a depth of 3 cun, line the bottom with 4 liang of Qinghao (Herba Artemisiae Annuae), place the chicken on top, and cover with mung beans. Steam until thoroughly cooked. Crush the chicken meat, dry it together with the herbs, and grind into powder. Mix with water and steamed wheat cake dough to form pills the size of paulownia seeds. Take 70 pills per dose, swallowed with clear rice soup on an empty stomach.
For cases of blood deficiency without sweating and tidal fever, use **Fuling Buxin Tang** (Poria Decoction for Nourishing the Heart). (Formula see Women's Deficiency Labor section.)
For cases of qi deficiency without sweating and tidal fever:
**Renshen Qingji San** (Ginseng Powder for Clearing the Skin) treats qi deficiency causing lack of sweating and tidal fever in both men and women.
Ingredients: Renshen (Radix Ginseng), Baizhu (Rhizoma Atractylodis Macrocephalae), Fuling (Sclerotium Poriae), Danggui (Radix Angelicae Sinensis), Chishao (Radix Paeoniae Rubra), Chaihu (Radix Bupleuri), Banxia (Rhizoma Pinelliae), Gefen (Radix Puerariae Lobatae starch), Gancao (Radix Glycyrrhizae).
Process into coarse powder for one dose. Decoct with Shengjiang (Rhizoma Zingiberis Recens) and Dazao (Fructus Jujubae) and take orally.
For women with blood deficiency, sweating, and tidal fever, use **Fuling Buxin Tang** (Poria Decoction for Nourishing the Heart). (Formula see Women's Deficiency Labor section.)
For cases of dual qi and blood deficiency without sweating and tidal fever, use **Xiaoyao San** (Powder for Free Wanderer). (Formula see Women's Deficiency Labor section.)
When the four limbs of men and women feel hot, and the bones and sinews feel as if scorched by fire, this is due to Yang qi being constrained within the Spleen and Stomach.
**Shengyang Sanhuo Tang** (Decoction for Ascending Yang and Dispersing Fire) treats heat in the four limbs and skin surface feeling like burning to the touch. This condition often arises from blood and qi disharmony, or from Stomach deficiency combined with excessive consumption of cold foods, leading to Yang qi constraint in the Spleen earth. Following the principle "when fire is constrained, disperse it," this is also known as Huoyu Tang (Fire Constraint Decoction).
Ingredients: Shengma (Rhizoma Cimicifugae), Gegen (Radix Puerariae Lobatae), Baishao (Radix Paeoniae Alba), Qianghuo (Rhizoma et Radix Notopterygii), Duhuo (Radix et Rhizoma Angelicae Pubescentis), Renshen (Radix Ginseng, each 5 qian), Chaihu (Radix Bupleuri, 8 qian), Fangfeng (Radix Saposhnikoviae, 3.5 qian), Sheng Gancao (Radix Glycyrrhizae, raw, 2 qian), Zhi Gancao (Radix Glycyrrhizae, roasted, 3 qian).
Process into coarse powder for one dose. Decoct with Shengjiang (Rhizoma Zingiberis Recens) and take orally. Avoid cold and raw foods for over a month.
Fever caused by Shanghan (Cold Damage) results from external Cold pathogen injuring the Wei qi. Use **Jiuwei Qianghuo Tang** (Nine-Ingredient Decoction for Dispelling Wind-Damp-Cold). (Formula see Shanghan chapter.)
Fever caused by Shangshu (Summerheat Injury) results from external Heat pathogen injuring the Ying blood. Use **Qingshu Yiqi Tang** (Decoction for Clearing Summerheat and Augmenting Qi). (Formula see Zhongshu chapter.)
Fever caused by Neishang (Internal Injury) results from self-injury of Yang qi, involving the Spleen and Lung. (Pulse is large and forceless.) Use **Buzhong Yiqi Tang** (Decoction for Supplementing the Middle and Augmenting Qi). (Formula see Internal Injury chapter.)
Fever caused by Yin deficiency results from self-injury of Yin blood, involving the Heart and Kidney. (Pulse is rapid and forceless.) Use **Ziyin Jianghuo Tang** (Decoction for Nourishing Yin and Descending Fire). (Formula see Xulao chapter.)
If quiet at night but feverish during the day, the heat is in the Qi level. Use **Xiaochaihu Tang** (Minor Arcus Decoction) plus Zhizi (Fructus Gardeniae), Huanglian (Rhizoma Coptidis), Zhimu (Rhizoma Anemarrhenae), and Digupi (Cortex Lycii Radicis).
If quiet during the day but feverish at night, the heat is in the Blood level. Use **Siwu Tang** (Four-Substance Decoction) plus Zhimu (Rhizoma Anemarrhenae), Huangbai (Cortex Phellodendri), Huanglian (Rhizoma Coptidis), Zhizi (Fructus Gardeniae), Mudanpi (Cortex Moutan), and Chaihu (Radix Bupleuri).
If feverish both day and night, the heat is in both Blood and Qi levels. Combine **Siwu Tang** (Four-Substance Decoction) and **Xiaochaihu Tang** (Minor Arcus Decoction), adding Huanglian (Rhizoma Coptidis) and Zhizi (Fructus Gardeniae).
For tidal fever occurring at Zi and Wu hours (midnight and noon), use Modified Xiaoyao San plus Huangqin (Radix Scutellariae), Huhuanglian (Rhizoma Coptidis Chinensis), Maimendong (Radix Ophiopogonis), Digupi (Cortex Lycii Radicis), Qinjiao (Radix Gentianae Macrophyllae), Mutong (Caulis Akebiae), Cheqianzi (Semen Plantaginis), and Dengxincai (Medulla Junci). Decoct in water and take orally.
For all fevers accompanied by aversion to cold, the pathogen is in the Half-Exterior and Half-Interior. Use **Chai Ling Tang** (Bupleurum and Poria Decoction), which combines Xiaochaihu Tang (Minor Arcus Decoction) and Wuling San (Five-Ingredient Powder with Poria).
**Danggui Yin** (Angelica Drink) treats heat generated by mental labor, occasional epistaxis, and five-palm heat.
Ingredients: Danggui (Radix Angelicae Sinensis, 1.2 qian), Shaoyao (Radix Paeoniae Alba, 1 qian), Chuanxiong (Rhizoma Chuanxiong, 0.5 fen), Shengdihuang (Radix Rehmanniae Recens, 1 qian), Mudanpi (Cortex Moutan, 1 qian), Huanglian (Rhizoma Coptidis, wine-fried, 0.7 fen), Maimendong (Radix Ophiopogonis, remove heart, 2 qian), Digupi (Cortex Lycii Radicis, 0.7 fen), Jiu Huangqin (Radix Scutellariae, wine-fried, 0.7 fen), Chao Zhizi (Fructus Gardeniae, fried, 0.6 fen), Chaihu (Radix Bupleuri, 0.6 fen), Sheng Gancao (Radix Glycyrrhizae, raw, 0.3 fen).
Process into coarse powder for one dose. Decoct in water and take warm after meals.
A servant fell ill in May with fever, thirst, dry lips, and delirious speech. His pulse was thin and slow. I prescribed **Sijunzi Tang** (Four-Gentlemen Decoction) plus Huangqi (Radix Astragali), Danggui (Radix Angelicae Sinensis), Baishao (Radix Paeoniae Alba), and Shufuzi (Radix Aconiti Lateralis Preparata). After one dose, the fever worsened, and he exhibited wild speech and running behavior. Someone suggested Fuzi was incorrect. Upon re-examination, the pulse remained unchanged. I increased the dose of Fuzi and administered another large dose. He subsequently sweated, the fever subsided, and his pulse returned to four beats per breath.
A woman fell ill with fever in summer. Initially treated with formulas to harmonize Qi and Blood while clearing heat and resolving exterior symptoms. After two or three doses, there was no improvement, and the fever intensified. Her tongue coating became scorched black, she felt fire in the diaphragm, and desired to rinse her mouth but not swallow. Her pulse was weak and minute in both hands, more so on the right. Within six to seven days, she exhibited delirium, grasping at empty air, and picking at clothes—signs of severe illness. Later, I prescribed **Siwu Tang** (Four-Substance Decoction) plus Huangqin (Radix Scutellariae), Renshen (Radix Ginseng), Baizhu (Rhizoma Atractylodis Macrocephalae), Chenpi (Pericarpium Citri Reticulatae), Maimendong (Radix Ophiopogonis), Zhimu (Rhizoma Anemarrhenae), and Shufuzi (Radix Aconiti Lateralis Preparata). After one to two hours, she sweated and the fever subsided. The fever returned the next day, but subsided again after medication. On the third day, it recurred. Recognizing this as sweat due to deficiency, I continued administering ten doses, all containing Fuzi, which resolved the condition.
A man suffered from fever, irritability, thirst, and headache. Mistakenly treated with diaphoretic methods, he developed wheezing, abdominal pain, spontaneous sweating, and delirium. I treated him with **Shiquan Dabu Tang** (Ten-Ingredient Great Tonifying Decoction) plus Fuzi (Radix Aconiti Lateralis Preparata). He fell into a deep sleep and did not wake when called. Upon waking, all symptoms vanished instantly. After two more doses, he recovered completely.