（师尼寡妇附）
〔大〕经曰∶阳不足则先寒后热，阴不足则先热后寒，皆由劳伤气血，阴阳不调，寒
热如疟也。当分气血虚实而治之。
〔薛〕前症若寸口脉微，名曰阳不足，则阴气上入于阳中，用补中益气汤。若尺部
脉弱，名曰阴不足，则阳气下陷入阴中，用益阴肾气丸。若因气血俱虚，用八珍汤。若
困怒动肝火，用小柴胡汤。若阴阳俱不足，则气血不归其本部，以致寒热交争也。一妇
人年六十有四，久郁怒，头痛寒热。春间乳内时痛，服流气饮之类益甚，时有血如经行。
又大惊恐，饮食不进，夜寐不宁，两乳肿胀，两胁 痛，午后色赤。余以为肝脾郁怒火燥，
先以逍遥散加酒炒黑龙胆一钱、山栀一钱五分，服二剂，肿痛顿愈，又二剂全愈。再用
归脾汤加炒栀、贝母，诸症悉愈。
〔大〕地骨皮散 治血风气虚，时作寒热，或晡热内热。
柴胡 地骨皮（各一两） 桑白皮（炒） 枳壳（麸炒） 前胡 黄 （炒，各七钱五分）
白茯苓 五加皮 人参 甘草 桂心 白芍药（各半两）
上 咀，每服三五钱，水一盏半，生姜三片，煎至七分，温服。
生地黄散 治妇人血气不调，或时寒热，体痛，不思饮食。
生干地黄 北柴胡（各一两） 羌活 木香 桂心 防风（各半两） 酸枣仁（炒研）
羚羊角屑 白芍药 白术 黄 川牛膝 白茯苓 当归 枳壳（各七钱五分）
上 咀，每服三五钱，水一盏，姜三片，煎至七分，去滓，空心温服。
异功散 治妇人血气虚冷，时发刺痛，头目昏闷，四肢无力，寒热往来，状似劳倦，并
宜服之。
乌药 川芎 苦梗 玄胡索 当归 陈皮（各一钱半） 官桂 牡丹皮 芍药
白芷 干姜（各一钱）
上作一服，用水二盅，生姜三片，煎至一盅，入酒半盏，再煎一二沸，不拘时。
上三方内有桂，唯寒多者宜之。第三方无滞气、污血，尤不宜服。
七宝汤 治寒热往来。
防风（去芦） 知母 生地黄（各半两） 柴胡（去芦） 秦艽 甘草（炙）
前胡（去芦，各二钱半）
上 咀，每服五钱，水一盏半，加人参三寸，煎至七分，热服。
柴胡散 治妇人寒热体瘦，肢节疼痛，口干心烦，不欲饮食。
北柴胡 赤茯苓 黄 白术（各一钱） 麦门冬（三钱） 鳖甲（醋炙，二钱） 人参
地骨皮 枳壳（麸炒） 生地黄 桑白皮 赤芍药 桔梗 甘草（各半钱）
上作一服，水二盅，生姜三片，煎至一盅，不拘时服。
桃仁丸 治妇人头目昏重，心神烦闷，或时寒热，肢节疼痛，不欲饮食。
桃仁（汤浸，去皮、尖、双仁，麸炒微黄） 芎 白术 柴胡（去苗）
人参（去芦） 生地黄 酸枣仁（微炒，各一两） 赤茯苓 诃黎勒皮（各七钱半）
枳壳（麸炒微黄，去幅） 赤芍药（各半两）
上为末，炼蜜和捣三二百杵，丸如梧桐子大。每以生姜、荆芥、薄荷汤下三十丸。
青蒿散 治男子妇人肢体倦疼，虚劳寒热。
用青蒿八九月间将成实时采，去枝梗，以蒿用童子小便浸三日，晒干为末。每服二钱，
乌梅一个，煎至七分服。
上三方，热多者宜之。
〔师尼寡妇异乎妻外家之治〕
〔罗〕刘宋褚澄疗师尼寡妇，别制方者，盖有谓也。此二种寡居，独阴无阳，欲心萌
而多不遂，是以阴阳交争，乍寒乍热，全类温疟，久则为劳。尝读《史记·仓公传》载∶
济北王侍人韩女，病腰背痛寒热，众医皆以为寒热病，治之不瘥。仓公曰∶此病得之欲
男子不可得也。众曰∶何以知欲男子不可得？仓公曰∶诊其脉，肝脉弦出寸口，是以知之。
盖男子以精为主，妇人以血为主，男子精盛以思室，妇人血盛以怀胎，夫肝摄血者也，是
厥阴肝脉弦出寸口上鱼际，则阴盛可知。故知褚氏之言，信有谓矣。
〔大〕师尼寡妇与室女出嫁愆期者，多因欲心萌而不遂，恹恹成病，乍寒乍热，久
则为劳。又有经闭白淫，痰逆头风，膈气痞闷，面 瘦瘠等证，皆寡妇之病也。
〔薛〕前证若肝脉弦出鱼际，用小柴胡加生地黄送下生地黄丸。久而血虚，佐以四
物汤。若兼怒动肝火而寒热者，佐以加味逍遥散。若兼亏损肝经而寒热者，佐以八珍汤。
若兼亏损元气而寒热者，佐以补中益气汤。若兼郁伤脾气而寒热者，佐以《济生》归脾汤。
一妇人因夫经商久不归，发寒热，月经旬日方止，服降火凉血药，反潮热内热，自汗
盗汗、月经频数。余曰∶热汗，气血虚也。经频，肝脾虚也。用归脾汤、六味丸而愈。尝
治兼证既愈而寒热不衰，当仍用本证药。一妇人年三十有七，早孀居，两腿骨作痛，晡
热体倦，月经不调，或发寒热，数年矣。一日颈项两侧结核，两胁胀痛，此系肝经郁火
而成也。先用小柴胡汤合四物数剂，肝症顿愈。又用加味逍遥散加泽兰、乳香、没药，三
十剂，血症渐痊。再用加味归脾汤，年余而安。一孀妇两腿作痛，或用除湿化痰等药，
遍身作痛而无定处，此血症也。不信，乃服流气饮之类而殁。一放出宫人年四十余，臀
腿内股作痛，晡热口干，月经不调，此系肝经血少不能养经络而然也。宜加味逍遥散加
泽兰叶五十帖，诸症稍缓，又以归脾汤二百余剂而痊。一放出宫人，臀腿肿痛，内热
晡热，恶寒体倦，咳嗽胸痞，月经过期而少，彼以为气毒流注，服清热理气之剂益甚，此
肝经瘀血停留所致。盖肝经上贯鬲，布胁肋，循喉咙，下循 内 ，绕阴器，抵少腹。主
治之法，但当补其所不胜，而制其所胜。补者脾也，制者肝也。经曰∶虚即补之，实则
泻之。此定法也。彼不信，仍服前药，遂致不起。
〔本〕生地黄丸 许学士治一尼患恶风体倦，乍寒乍热，面赤心悸，或时自汗。是
时疫气大行，医见其寒热，作伤寒治之，用大小柴胡汤杂进，数日病急，召予诊之，三
部无寒邪脉，但厥阴弦长而上鱼际，宜服抑阴等药，故制此方。
生地黄（二两） 柴胡 秦艽 黄芩（各半两） 芍药（一两）
上为细末，炼蜜丸如桐子大。每服三十
丸，用乌梅汤吞下，日三服，不拘时。
(Attached: Nuns, Widows, and Female Servants)
[Da] The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: When Yang Qi is insufficient, there is first chills followed by fever; when Yin Qi is insufficient, there is first fever followed by chills. All these are caused by fatigue damaging Qi and Blood, leading to disharmony of Yin and Yang, resulting in alternating chills and fever resembling malaria. Treatment should be differentiated based on the deficiency or excess of Qi and Blood.
[Xue] In the aforementioned symptoms, if the Cun Kou pulse at the wrist is faint, it is named Yang insufficiency, meaning Yin Qi ascends into the Yang aspect; use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). If the Chi pulse at the wrist is weak, it is named Yin insufficiency, meaning Yang Qi sinks into the Yin aspect; use Yiyin Shenqi Wan (Nourish Yin and Kidney Qi Pill). If both Qi and Blood are deficient, use Bazhen Tang (Eight Treasures Decoction). If provoked by anger stirring Liver Fire, use Xiaochaihu Tang (Minor Bupleurum Decoction). If both Yin and Yang are insufficient, Qi and Blood fail to return to their proper origins, causing a struggle between cold and heat. A woman aged sixty-four, suffering from long-term depression and anger, experienced headache with alternating chills and fever. In spring, her breasts were intermittently painful; after taking Liuyang Yin (Flowing Qi Drink), the condition worsened, and she occasionally bled as if menstruating. Subsequently, due to great fright and fear, she lost her appetite, had restless sleep, bilateral breast swelling, hypochondriac pain, and flushed complexion in the afternoon. I considered this to be Liver and Spleen depression transforming into fire and dryness. I initially prescribed Xiaoyao San (Free and Easy Wanderer Powder) with Jiu Chao Hei Longdan Cao (Wine-fried Black Gentian Root) one qian and Shanzhi (Gardeniae Fructus) one qian five fen. After two doses, the swelling and pain subsided instantly; after another two doses, she was completely cured. Then, using Guipi Tang (Restore the Spleen Decoction) with fried Shanzhi and Beimu (Fritillariae Bulbus), all symptoms resolved.
[Da] Digupi San (Lycium Bark Powder) treats blood deficiency and Qi deficiency causing intermittent chills and fever, or evening fever and internal heat.
Chai Hu (Bupleuri Radix), Digupi (Lycii Cortex) (each 1 liang); Sangbaipi (Mori Cortex, stir-fried), Zhike (Aurantii Fructus, bran-fried), Qian Hu (Peucedani Radix), Huang Qin (Scutellariae Radix, stir-fried) (each 7.5 qian); Baifuling (Poria), Wujia Pi (Acanthopanacis Cortex), Renshen (Ginseng Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Guixin (Cinnamomi Ramulus), Shaoyao (Paeoniae Radix Alba) (each 0.5 liang).
Decoct the herbs. Take 3-5 qian per dose with 1.5 cups of water and 3 slices of fresh ginger, decoct until 0.7 cup remains, and take warm.
Shengdihuang San (Rehmannia Root Powder) treats women with irregular Qi and Blood, intermittent chills and fever, body pain, and loss of appetite.
Sheng Gan Dihuang (Dry Rehmanniae Radix), Bei Chai Hu (Bupleuri Radix) (each 1 liang); Qianghuo (Notopterygii Rhizoma et Radix), Muxiang (Aucklandiae Radix), Guixin (Cinnamomi Ramulus), Fangfeng (Saposhnikoviae Radix) (each 0.5 liang); Suanzaoren (Ziziphi Spinosae Semen, stir-fried and crushed), Lingyangjiaoxie (Saigae Tataricae Cornu), Shaoyao (Paeoniae Radix Alba), Baizhu (Atractylodis Macrocephalae Rhizoma), Huang Qin (Scutellariae Radix), Chuanniuxi (Cyathulae Radix), Baifuling (Poria), Danggui (Angelicae Sinensis Radix), Zhike (Aurantii Fructus) (each 7.5 qian).
Decoct the herbs. Take 3-5 qian per dose with 1 cup of water and 3 slices of fresh ginger, decoct until 0.7 cup remains, remove dregs, and take warm on an empty stomach.
Yigong San (Extraordinary Merit Powder) treats women with cold Qi and Blood deficiency, frequent stabbing pain, dizziness and heavy head, limb weakness, alternating chills and fever, resembling fatigue. It is suitable for all such cases.
Wuyao (Linderae Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Kujie Geng (Platycodonis Radix), Yuanhusuo (Corydalis Rhizoma), Danggui (Angelicae Sinensis Radix), Chenpi (Citri Reticulatae Pericarpium) (each 1.5 qian); Guangui (Cinnamomi Cortex), Mudanpi (Moutan Cortex), Shaoyao (Paeoniae Radix), Baizhi (Angelicae Dahuricae Radix), Jiangjiang (Zingiberis Rhizoma Recens) (each 1 qian).
Combine as one dose. Use 2 bowls of water and 3 slices of fresh ginger, decoct until 1 bowl remains. Add 0.5 bowl of wine, boil briefly, and take at any time.
Among the above three formulas containing Cinnamon, only those with predominant cold symptoms should use them. The third formula lacks Qi-moving and blood-resolving properties and is particularly unsuitable for use.
Qibao Tang (Seven Treasures Decoction) treats alternating chills and fever.
Fangfeng (Saposhnikoviae Radix, remove radicle), Zhimu (Anemarrhenae Rhizoma), Shengdihuang (Rehmanniae Radix) (each 0.5 liang); Chai Hu (Bupleuri Radix, remove radicle), Qin Jiao (Gentianae Macrophyllae Radix), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Qian Hu (Peucedani Radix, remove radicle) (each 2.5 qian).
Decoct the herbs. Take 5 qian per dose with 1.5 cups of water and a 3-cun piece of Renshen (Ginseng Radix), decoct until 0.7 cup remains, and take hot.
Chaihu San (Bupleurum Powder) treats women with alternating chills and fever, emaciation, joint pain, dry mouth, irritability, and loss of appetite.
Bei Chai Hu (Bupleuri Radix), Chifuling (Poria cum Risus), Huang Qin (Scutellariae Radix), Baizhu (Atractylodis Macrocephalae Rhizoma) (each 1 qian); Maidong (Ophiopogonis Radix) (3 qian); Biejia (Testudinis Carapax et Plastrum, vinegar-fried) (2 qian); Renshen (Ginseng Radix), Digupi (Lycii Cortex), Zhike (Aurantii Fructus, bran-fried), Shengdihuang (Rehmanniae Radix), Sangbaipi (Mori Cortex), Chishaoyao (Paeoniae Radix Rubra), Jiegeng (Platycodonis Radix), Gancao (Glycyrrhizae Radix et Rhizoma) (each 0.5 qian).
Combine as one dose. Use 2 bowls of water and 3 slices of fresh ginger, decoct until 1 bowl remains, and take at any time.
Taoren Wan (Peach Kernel Pill) treats women with heavy and dizzy head, mental restlessness, intermittent chills and fever, joint pain, and loss of appetite.
Taoren (Persicae Semen, soaked in water, peel removed, germ removed, double-kernel avoided, bran-fried until slightly yellow), Xiong (Ligustici Chuanxiong Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Chai Hu (Bupleuri Radix, remove sprouts), Renshen (Ginseng Radix, remove radicle), Shengdihuang (Rehmanniae Radix), Suanzaoren (Ziziphi Spinosae Semen, lightly stir-fried) (each 1 liang); Chifuling (Poria cum Risus), Helilepi (Terminaliae Chebulae Pericarpium) (each 7.5 qian); Zhike (Aurantii Fructus, bran-fried until slightly yellow, pith removed), Chishaoyao (Paeoniae Radix Rubra) (each 0.5 liang).
Grind into fine powder. Mix with refined honey and pound 200-300 times. Form pills the size of Sophora seeds. Take 30 pills with decoction of fresh ginger, Jingjie (Schizonepetae Spica), and Bohe (Menthae Haplocalycis Herba).
Qinghao San (Artemisia Annua Powder) treats men and women with limb fatigue and pain, consumptive disease with alternating chills and fever.
Harvest Qinghao (Artemisiae Annuae Herba) in August or September when it is about to fruit. Remove stems and leaves. Soak the herb in urine of a healthy boy for three days, dry, and grind into powder. Take 2 qian per dose with one Wumei (Chebulae Fructus), decoct until 0.7 cup remains, and take.
Among the above three formulas, those with predominant heat symptoms should use them.
[Different Treatment for Nuns, Widows compared to Wives and Daughters-in-law]
[Luo] Chu Cheng of the Liu Song dynasty formulated specific prescriptions for nuns and widows because there is a reason. These two groups live in widowhood/seclusion, possessing only Yin without Yang. Their desires arise but are often unfulfilled, causing a struggle between Yin and Yang, manifesting as alternating chills and fever, resembling Warm Malaria. Prolonged, this becomes Consumption Disease. I once read in the *Records of the Grand Historian: Biography of Cang Gong*: Han Nu, a maid of the King of Jibei, suffered from lower back pain, alternating chills and fever. Many physicians treated it as a cold-heat disease, but it did not improve. Cang Gong said: This disease arises from desiring a man but being unable to obtain one. The crowd asked: How do you know she desires a man? Cang Gong said: Upon palpating her pulse, the Liver pulse was wiry and extended beyond the Cun Kou position. Thus, I knew. Generally, men are governed by Essence, and women by Blood. Men with abundant Essence desire sexual intercourse; women with abundant Blood conceive. The Liver governs the storage of Blood. Therefore, when the Jueyin Liver pulse is wiry and extends beyond the Cun Kou to the Yuji area, it indicates excessive Yin. Thus, I believe Chu's words have merit.
[Da] Nuns, widows, and unmarried women who marry late often suffer from unfulfilled desires, becoming depressed and ill, with alternating chills and fever. Prolonged, this becomes Consumption Disease. Other symptoms include amenorrhea, leukorrhea, phlegm rising causing headaches, chest qi stagnation and fullness, and sallow emaciation. These are diseases of widows.
[Xue] In the aforementioned syndromes, if the Liver pulse is wiry and extends beyond the Yuji area, use Xiaochaihu Tang (Minor Bupleurum Decoction) with Shengdihuang (Rehmanniae Radix) to swallow Shengdihuang Wan (Rehmannia Pill). If prolonged blood deficiency occurs, assist with Siwu Tang (Four Substances Decoction). If accompanied by anger stirring Liver fire with chills and fever, assist with Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). If accompanied by Liver meridian deficiency with chills and fever, assist with Bazhen Tang (Eight Treasures Decoction). If accompanied by Yuan Qi (Original Qi) deficiency with chills and fever, assist with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). If accompanied by Spleen Qi injury from depression with chills and fever, assist with *Jisheng* Guipi Tang (*Essential Prescriptions of Worth* Restore the Spleen Decoction).
A woman whose husband traveled for business and did not return for a long time developed chills and fever. Her menstruation lasted ten days before stopping. After taking cooling and blood-cooling herbs, she instead developed tidal fever, internal heat, spontaneous sweating, night sweats, and frequent menstruation. I said: Hot sweat indicates Qi and Blood deficiency. Frequent menstruation indicates Liver and Spleen deficiency. She recovered using Guipi Tang (Restore the Spleen Decoction) and Liuwei Wan (Six-Ingredient Pill with Rehmannia). I once treated a case where accessory symptoms resolved but chills and fever persisted; one must continue using the medicine for the primary syndrome. A thirty-seven-year-old woman, widowed early, suffered from bone pain in both legs, evening fever, fatigue, irregular menstruation, and intermittent chills and fever for several years. One day, nodules appeared on both sides of her neck, and her hypochondrium became distended and painful. This was formed by Liver meridian depression-fire. Initially, she took Xiaochaihu Tang (Minor Bupleurum Decoction) combined with Siwu Tang (Four Substances Decoction) for several doses, and the Liver symptoms resolved instantly. Then, she took Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) with Zelán (Leonuri Herba), Ruxiang (Boswelliae Resina), and Moyao (Commiphorae Resina) for thirty doses, and the blood stasis gradually healed. Finally, she took Jiawei Guipi Tang (Modified Restore the Spleen Decoction), and she stabilized after more than a year. Another widow suffered leg pain. Someone used dampness-draining and phlegm-resolving herbs, causing generalized wandering pain. This was a blood disorder. She did not believe this and took Liuyang Yin (Flowing Qi Drink), resulting in death. A released palace maid, over forty, suffered pain in the buttocks and inner thighs, evening fever, dry mouth, and irregular menstruation. This was due to Liver Blood deficiency failing to nourish the meridians. She should have taken Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) with Zelán Ye (Leonuri Folium) for fifty doses to alleviate symptoms, and then Guipi Tang (Restore the Spleen Decoction) for over two hundred doses to recover. Another released palace maid suffered swelling and pain in the buttocks and legs, internal heat, evening fever, aversion to cold, fatigue, cough, chest stuffiness, and delayed scanty menstruation. She believed it was Qi toxicity flowing through collaterals and took heat-clearing and Qi-regulating agents, which worsened the condition. This was caused by blood stasis lingering in the Liver meridian. The Liver meridian passes through the diaphragm, spreads in the hypochondrium, follows the throat, descends along the medial thigh, circles the genitalia, and reaches the lower abdomen. The treatment principle is to tonify what it cannot overcome (Spleen) and control what it overcomes (Liver). Tonification targets the Spleen; control targets the Liver. The Classics state: Deficiency requires tonification; Excess requires purging. This is a fixed rule. She did not believe this and continued taking previous medicines, ultimately dying.
[Ben] Shengdihuang Wan (Rehmannia Pill) was prescribed by Xu Xueshi for a nun suffering from aversion to wind, fatigue, alternating chills and fever, red face, palpitations, and occasional spontaneous sweating. At that time, an epidemic was rampant. Physicians saw her chills and fever and treated her as Cold Damage, administering various combinations of Daxiaochaihu Tang (Major Bupleurum Decoction) and Xiaochaihu Tang (Minor Bupleurum Decoction). After several days, her condition worsened. I was summoned to diagnose her. There were no cold-pathogen pulses in the three positions, only a Jueyin wiry-long pulse extending to the Yuji area. It was appropriate to use Yin-suppressing medicines, so I formulated this prescription.
Shengdihuang (Rehmanniae Radix) (2 liang); Chai Hu (Bupleuri Radix), Qin Jiao (Gentianae Macrophyllae Radix), Huang Qin (Scutellariae Radix) (each 0.5 liang); Shaoyao (Paeoniae Radix) (1 liang).
Grind into fine powder. Mix with refined honey and form pills the size of Sophora seeds. Take 30 pills per dose, swallowed with Wumei Tang (Chebulae Fruit Decoction), three times daily, at any time.