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Deficient heat refers to the condition occurring after recovery from illness, when blood and qi are not yet harmonized, limbs and body are emaciated, and fever occurs frequently. The treatment should focus on regulating qi and tonifying deficiency, after which the fever will naturally subside. Formulas such as Qian's Baizhu San (Atractylodes Macrocephala Powder by Qian Yi), Yigong San (Yi Gong Powder), and Sijunzi Tang (Four Gentlemen Decoction) may be used; if the fever does not recede, Rensheng Shengxi San (Ginseng and Rhinoceros Horn Powder) can be employed. [Yang] Deficiency manifests as a bluish-white complexion, vague spirit with sluggishness, a cold sensation in the mouth, weak and soft breathing, diarrhea with frequent urination, and night sweats due to deficiency. Xingxing San (Xingxing Powder) is suitable. [Xue] There are also symptoms of preferring warmth and fearing cold, alternating coolness and warmth, irritability with fright, excess heat above and diarrhea below, curling up while lying down, sleeping with eyes partially open (exposed eyes), and cold fingers and toes. [Zeng] Deficient heat refers to fever without fixed timing after illness, occurring three to five times a day; this is external pathogenic heat taking advantage of deficiency to arise. Initially, Weiling Tang (Weiling Decoction) added with Huangbai powder (Phellodendron Bark) should be taken, mixed with warm rice water for administration. Subsequently, Qian's Baizhu San or Guzhen Tang (Guzhen Decoction) taken cool can be administered. Additionally, Heixi Dan (Black Tin Pill) can be taken with warm salt water mixed with cool water to consolidate primordial qi. Haicang stated: For wind-heat or pathogenic heat, Sijunzi Tang added with Shengjiang (Fresh Ginger) and Jingjie (Schizonepeta) can be decocted. Yunqi stated: For infantile internal pathogenic heat, Daochi San (Daochi Powder) should be used first, followed by Yihuang San (Yihuang Powder). Xue believed that deficiency and excess should be differentiated according to exterior and interior, and conditions such as heat excess repelling yin, cold excess repelling yang, and fever due to blood or qi deficiency are all subtle methods of syndrome differentiation by Zhang Zhongjing, Li Dongyuan, and other sages. These should be carefully studied and memorized, so that deficient heat resembling excess heat will not be misdiagnosed, thereby saving lives. [Qian Yi] The son of Supervisor Zhu, aged five, suddenly developed fever. A physician said it was heart heat because his cheeks were red, lips were red, he was irritable and thirsty. Thus, Niuhuang Wan (Calculus Bovis Pills) were given three doses, washed down with Yiwu Xiexin Tang (One-Ingredient Xiexin Decoction). The next day, the condition did not improve; instead, weakness increased and appetite was lost. Another purgative was given, resulting in yellow frothy stools. Qian Yi said: This is deficiency of the Heart channel with lingering heat inside, inevitably caused by injury from cold and purgative medicines, leading to consumptive disease. Qian Yi first used Baizhu San to generate fluids in the stomach, then treated it with Shengxi San. Zhu asked: Why are the stools yellow and frothy? Qian Yi replied: When stomach qi recovers, diarrhea will stop naturally; this is deficient heat. Zhu asked: Why did the physician use Xiexin Tang? Qian Yi replied: Xiexin Tang consists only of Huanglian (Coptidis Rhizoma). Huanglian is cold in nature; excessive intake causes diarrhea and damages spleen and stomach. After sitting for a while, other physicians arrived, all stating it was excess heat. Qian Yi said it was deficient heat. If it were excess heat, why would the condition worsen after purging with Xiexin Tang, accompanied by yellow face, red malar flush, five-palm heat, anorexia with thirst? The physician asked: If it is deficient heat, why are the stools yellow and frothy? Qian Yi smiled and said: Yellow frothy stools are due to excessive consumption of Xiexin Tang. Qian Yi prescribed Huhuanglian Wan (Huhuanglian Pills), which cured the disease. Qi Langzhong from Zheng, whose family liked to collect and distribute medicinal powders, had a child who suddenly developed internal organ heat. Qi took Qingjin Gao (Green Gold Ointment), three doses plus one additional dose. After finishing the medication, at midnight, the child had five diarrheal episodes and fell into a sleepy coma. Qi said the child slept with much fright and gave another dose of Qingjin Gao, resulting in three more diarrheal episodes, dry mouth, and fever. Qi said there was still residual mild heat and gave Qingjin Gao again. His wife said: After more than ten doses, there is no improvement; could it cause other diseases? So Qian Yi was summoned. Qian Yi said: It has become a state of deficiency and emaciation. First, administer Baizhu San frequently, then Xianggua Wan (Melon Pill). The child recovered in thirteen days. In the Jiayin year of Jiajing, Wang Jingchen's daughter, aged twelve, suffered from inherent spleen and stomach weakness. From summer to autumn, she had intermittent diarrhea and slight lower abdominal pain. By August and September, she developed malnutrition syndrome (ganji), with continuous fever for over twenty days. Fever subsided with sweating but returned after sweating stopped. Her abdomen from Zhongwan (CV12) to lower abdomen became distended, hard, and straight. Stools were loose, accompanied by panting, coughing, belching, all worse at night than during the day. She was restless all night and could not sleep, with nasal congestion, dim vision, and low voice. Her mother thought she would surely die. Lizhai examined her pulse and found it floating, large, and rootless, diagnosing it as a severe deficiency syndrome requiring Dushen Tang (Single Ginseng Decoction). He used Ren Shen (Ginseng Radix et Rhizoma) 1 qian, plus Shu Fuzi (Prepared Aconite Lateralis Radix) 3 fen and Wei Shengjiang (Baked Fresh Ginger) 3 slices, administered two doses daily, including the dregs. Large amounts of ganji material were expelled with a fishy odor. The abdomen gradually widened, fever decreased, and pulse became more contained. However, her hands continued to pick and grasp incessantly. Mr. Li said: This is a liver syndrome. He decocted Liuwei Wan (Six-Ingredient Pill) ingredients for her. One dose brought relief like shedding a burden. Then, Dushen Jiangfu Tang was taken by day, and Liuwei Wan ingredients by night. The pulse gradually gained root, and various symptoms receded. Previously, her hands and feet were always hot; now she began to feel cold. Mr. Li rejoiced, saying: This indicates pathogenic factors have completely retreated, and true qi has appeared. However, she still could not eat. Single Liujunzi Tang (Six Gentlemen Decoction) added with Pao Jiang (Baked Ginger) was used, enabling her to eat. Cough became severe, so Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) was given, stopping the cough. She finally slept at night. The survival of this weak girl was entirely due to Mr. Li's efforts. If not for his firm judgment and focus on treating the root, leaving the branches to heal themselves, she would certainly have become bones in the grave! I record the details of this treatment to inform others suffering from similar conditions, hoping they avoid error. This is also an attempt to extend Mr. Li's benevolence. Written by Wang Jingchen.

Danggui Buxue Tang (Angelica Sinensis Blood-Tonifying Decoction): Treats muscle heat, restlessness, red eyes, red face, thirst, unceasing day and night. The pulse is flooding and large but empty, disappearing upon heavy pressure, indicating pulse deficiency and blood deficiency. If Baihu Tang (White Tiger Decoction) is mistakenly taken, death is certain; this formula is indicated.
Huangqi (Astragali Radix) (3 qian) Danggui (Angelicae Sinensis Radix) (1 qian)
Decoct with water and take orally.

Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction): Treats middle qi deficiency, fatigue, poor appetite, or fever with thirst.
Renshen (Ginseng Radix et Rhizoma) Huangqi (Astragali Radix) (each 8 fen) Baizhu (Atractylodis Macrocephalae Rhizoma) Gancao (Glycyrrhizae Radix et Rhizoma) Chenpi (Citri Reticulatae Pericarpium) (each 5 fen) Shengma (Cimicifugae Rhizoma) Chaihu (Bupleuri Radix) (each 2 fen) Danggui (Angelicae Sinensis Radix) (3 fen)
Decoct with fresh ginger and jujube, take on an empty stomach before noon.

Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder): Removing Mudanpi (Moutan Cortex) and Zhizi (Gardeniae Fructus) yields Xiaoyao San. Treats liver and spleen blood deficiency.
Danggui (Angelicae Sinensis Radix) Gancao (Glycyrrhizae Radix et Rhizoma) (roasted) Shaoyao (Paeoniae Radix Alba) (wine-fried) Fuling (Poria) Baizhu (Atractylodis Macrocephalae Rhizoma) (stir-fried) Chaihu (Bupleuri Radix) (each 1 qian) Mudanpi (Moutan Cortex) Zhizi (Gardeniae Fructus) (stir-fried, each 7 fen)
Decoct with water and take orally.

Commentary: The aforementioned formulas are particularly suitable if the nursing mother suffers from liver and spleen blood deficiency, presenting with internal heat, alternating chills and fever, generalized pruritus, limb pain, heavy head and dizzy vision, palpitations, malar flush, dry mouth and throat. Or fever with night sweats, poor appetite, insomnia. Or mouth and tongue ulcers, earache, chest and breast distension, difficult urination, causing illness in the infant. It also treats women with yin deficiency fever, where the infant contracts sores through breastfeeding.