Library

Quan Ying Fang records: When infants and young children experience fever after eating in the morning every day, but their body temperature returns to normal (cool) at night, worldly physicians mostly diagnose it as deficiency consumption (Xu Lao), or consider it to be malnutrition fever (Gan Re). They do not realize that this is actually a pattern of Blood Heat. It is appropriate to use Long Dan Wan (Gentian Pill) and Di Huang Gao (Rehmannia Paste) and similar formulas, administering them frequently until the condition gradually resolves.

Commentary: The "Blood Heat" mentioned in Quan Ying Fang refers to fever during the Si and Wu hours (9:00 AM – 3:00 PM), with cooling occurring at night. This differs from Li Dongyuan's description of "fever at night and clarity during the day." However, Li Dongyuan's concept of "Blood Heat" refers to internal heat generated by Yin deficiency, characterized by fever at night and clarity during the day, based on the theory that day belongs to Yang and night belongs to Yin. Zheng's concept of "Blood Heat" refers to the condition where an infant's blood and Qi are abundant and excess pathogens are present internally. Specifically, the "Si and Wu hours" are when Heart Fire is dominant. Since the Heart governs Blood, when Qi and Blood circulate to the Si and Wu periods, Yang Qi becomes vigorous. The struggle between Yang Qi and Healthy Qi causes fever during these specific times; if fever occurs outside these times, it does not constitute Blood Heat.

[Xue Ji] A child experienced fever during the Yin and Mao hours (3:00 AM – 7:00 AM), sometimes accompanied by convulsions and phlegm. The condition resolved after taking Bao Long Wan (Protect Dragon Pill) and Xie Qing Wan (Drain Green Pill). Later, the illness recurred. While taking the previous two pills, the child developed coughing and wheezing, frequent convulsions, a red complexion, or complexions of green/yellow, facial edema, or salivation. I reasoned that coughing and wheezing were due to Spleen and Lung Qi deficiency; frequent convulsions were due to Liver Wood overacting on the Spleen; the green-yellow complexion indicated Liver Qi affecting the Heart and Spleen; edema and salivation indicated Spleen Qi deficiency. Therefore, I used Yi Zhi Wan (Yi Zhi Pill) to nourish Heart Blood, and Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) to tonify Spleen Qi, resulting in recovery. Another child experienced fever and palpitations during the Si and Wu hours. During episodes, the child appeared physically and mentally fatigued, had a sallow complexion, poor appetite, salivation, and a desire to drink hot water. I attributed this to insufficient Heart Qi. The family disagreed and instead administered Heart-cooling medicines, which worsened the condition with vomiting and diarrhea, sleeping with eyes partially open (exposed pupils), and cold extremities, nearly developing into Slow Spasm Wind (Man Pi Feng). I first treated with Liu Jun Jiang Gui Tang (Six Gentlemen Decoction with Ginger and Cinnamon) assisted by Di Huang Wan (Rehmannia Pill), leading to recovery. Another child experienced fever and a red face during the Shen and You hours (3:00 PM – 7:00 PM), accompanied by abdominal pain. Someone used harsh purgatives to drain the bowels, causing convulsions, phlegm expectoration, thirst, and abdominal pain that ceased upon pressure. This was a complication arising from damage to the Spleen and Stomach. Administration of Qi Wei Bai Zhu San (Seven-Ingredient Atractylodes Macrocephala Powder) and Bu Zhong Yi Qi Tang quickly stabilized the condition.

Long Dan Wan: Treats infants and young children who easily develop fever after eating, or feel cool at night, indicating a Blood Heat pattern. It can also treat Malnutrition Fever (Gan Re).
Ingredients: Xuan Huang Lian (Scutellariae Radix, de-haired), Chi Shao Yao (Paeoniae Radix Rubra) (each 1.5 liang); Cao Long Dan (Gentianae Radix, de-rooted), Qing Pi (Citri Reticulatae Pericarpium Viride, de-pith) (each 0.83 liang); Bing Lang (Arecae Semen, one large fruit); She Xiang (Moschus) (a small amount).
Preparation and Administration: Grind the above ingredients into fine powder. Add a small amount of Pig Bile and rice paste to form pills, sized like radish seeds. Administer 3–20 pills per dose, taken with rice drink on an empty stomach.

Liu He Tang: Treats Blood Heat in infants and young children, characterized by fever daily during the Si and Wu hours, with cooling at night.
Ingredients: Dang Gui (Angelicae Sinensis Radix), Da Huang (Rhei Radix et Rhizoma), Chuan Xiong (Chuanxiong Rhizoma), Shu Di Huang (Rehmanniae Radix Praeparata).
Preparation and Administration: Grind the above ingredients into fine powder. For a three-year-old child, administer 1 qian, decoct with half a zhan of water until one-third remains. Take at any time.

Zhu Dan Wan: Treats infants and young children who develop fever after breakfast daily and feel cool at night, indicating Blood Heat.
Ingredients: Hu Huang Lian (Coptidis Rhizoma / Scutellariae Radix variant, 0.83 liang), Xuan Huang Lian, Chi Shao Yao (each 1.5 liang).
Preparation and Administration: Grind the above ingredients into fine powder. Mix with Pig Bile to form a paste, place inside a pig gallbladder, suspend it, and cook thoroughly using Jiang Shui (fermented rice liquid). Remove, mix with rice flour to form pills, sized like beans. For a three-year-old child, administer 30 pills with rice soup, three times daily, at any time.