小儿气禀纯阳血气壅实，故脏腑稍乖，阴阳气变，即壅盛于内，熏蒸于外，乃发热
矣。盖阴不能以配阳，血不能以配气，故凡疾作，属火俱多，肝热则颊赤目直，手寻衣
领，拘挛善惊，两眼赤痛。心热则烦叫唇鲜，上窜切牙，虚痛志乱，口内生疮，小便
赤肿，肺热则喘急不息，大便秘结，手捏眉口，鼻塞毛焦。脾热则口流涎沫，目黄肚
大，HT 齿好嗔。心脾合热，则重舌木舌。胃热则口气作臭。肾热则停耳多脓，流臭不
已，下窜畏明，五脏蕴蓄风热毒瓦斯，则面赤如绯，五心烦热，四肢温壮，目涩多渴。若
上冲咽喉，则与血气相搏，结聚壅盛，而成喉闭腮肿。若壅热不散，留滞胸膈，热则生
风生悸矣。然发热者，轻重不同，有所谓翕翕发热者。若合羽所覆，明其热在外而属
表，乃风寒客于皮肤，阳气怫郁所致，宜汗而散之。所谓蒸蒸发热者，似熏蒸之蒸，明
其热在内，而属里，乃阳气下陷而入阴中也，当下以清之。是经汗下而热不除者，此
是表里俱虚，气不归元，阳浮于外也。不可再用凉药，及再汗下，当和胃气，使阳气收
敛于内，其热自止。若表症未罢，而邪复得聚，是谓两感，则举按脉实，面黄颊赤，唇
燥口干，口鼻气热，小便赤涩，大便坚硬，是表里俱热也。故发热恶寒者，是发于阳
也。无热恶寒者，是发于阴也。有表而热者，谓之表热。非表而热者，谓之里热。然
诸热属心，火之象也。小热之气，凉以和之∶大热之气，寒以折之；甚热之气则汗发
之，发之不去，则逆制之，制之不尽，求其属以衰之。苦者，以治五脏，五腑属阴而居
于内；辛者，以治六腑，六腑属阳，而在于外。内者下之，外者发之，次宜养血益阴，
其热自愈。然古有八十种之分，不可具载。总之，诸病无不热者，其热总是本身之火发
现，必求其所因以调之，切勿徒事寒冷，益令伤此身中阳气也。有发早晚两度者，诸之
惊热，世呼为潮热，此是荣卫壅实，五脏生热，熏发于外，故曰日晡朝热者，阳明实热
也。实者，邪气实，当利大便。然久则为虚，非补土以藏阳，即滋阴而退火。有成于
伤寒之后，余热不解者，有因痞气有块，阴伤不均者，有因 瘕，并食冷成滞，脾胃
不和者；有因脏腑虚怯，阴阳不和，或胃暑湿脾疳者∶有因疮疹未出，及余毒不解者。
然因积食等症而热者，则必肚热如火而脚冷，宜急下之。若形瘦多渴，骨蒸盗汗，头
疮发穗，飧泥食炭，五心长热，吃食不长肌肉者，谓之疳热。若因心脯有热，当风解
脱，是以风邪伤于皮毛，入于脏腑，而目涩头昏，胸膈烦闷，恶风壮热有汗者，谓之风
热。若面赤头痛，唇焦咽疼，舌肿目赤，颊下结硬，口内生疮，痰实不利，涕唾稠粘，
睡卧不安，谵语狂妄，谓之膈热。若在胎母服热药，及糟酒爆炙，热毒入胞，儿生之
后，身体黄赤，眼闭呻吟，面赤身热，口热如汤，或生疮疥，谓之胎热。夜热则夕发旦
止；客热则来去不定，寒热则发和疟状；血
热则辰己发热，惊热则癫叫恍惚，食热则肚背先热；积热则颊赤口疮而频渴烦热，则焦
躁不安而善啼，虚热则困倦无力，癖热则涎嗽饮水。热而实者，必面赤气粗，口热烦
渴，唇肿便难，掀揭衣被，烦啼躁叫。热而虚者，必面色青白，身则微热，口中气冷，
两便皆利，手足心皆冷，恍惚神慢，嘘气软弱，虚汗自出。然虚热不可峻攻，盖热去则
寒易起。又不可太补，盖余热得补，则热复作，必求其属以衰之，所谓不求其属投之不
入。更有因邪热在心，心本属火，又为其热所乘，故乃炎上而焦，哭啼时有汗，面红便
赤，口气亦热，仰身烦啼，畏见灯火，如见麻痘之状者。然凡欲出麻痘而热者，必中指
鼻尖及耳皆冷，乳食不贪，目涩眼赤，常如睡状，或时寒热，困乱心烦，耳后红丝缠绕
是也。其候最似伤寒，但伤寒是从表入里，疮疹是从里出表耳，更有惊风热者，必咬乳
流涎，仰视惊啼而入候症见，更有疫毒热者，因感冒四时不正之气，头痛壮热，与伤
寒相似，但一时所行之症人人相类是也。夜热有三，有因血热，有因宿食，有因疳劳
者。更有温壮热者，是由脏腑不调，或内有伏热，或内挟宿寒，搏于胃气，故令不和。
血气壅塞，蕴积体热，名曰温壮。若大便黄而臭者，伏热也。若大便白而酸臭者，挟宿
寒也。又曰∶修灶缺唇，食姜余指。有因小儿在胎，其母好食姜竦，姜性至热，攻入血
脉，传入经络，轻则令儿遍体生丹发疥，或头额生核，重则令儿发大痈疖，溃烂肌肉，
十死一生，此谓之荣热。有小儿在胎母伤和气，或饥饱劳役，或忧愁思虑，是以动之真
气，乘袭虚邪，干乱神魂，流入胎脏，儿乃受之。既生之后，儿常昏困，腹急气粗，重
则喘急，睡思不稳，狂啼烦哭，肌肉不滋，亦生疮疾，热发早晚，此谓之卫热。爰有病
久则皿气虚，气虚则发厥，血虚则发热，气血俱虚，是以手足厥而身发热者，然凡病热
而左脸先赤，是肝受热也。右脸先赤，是肺受热也。额上先赤，是心受热也。颐间先
赤，是肾受热也。鼻上先赤，是脾受热也。有发热而吐酸口秽，头仰不卧，上热下冷额
汗胸胀，气逆多啼，掌心倍热，人迎脉实，头痛脉数者，此伤食也。若发热身重体疼而
黄者，是湿也。若增寒发热，恶风自汗，脉浮胸痞者，是痰也。若寸口脉微，则阳不
足，故阴气上入阳中，而恶寒。若尺部脉弱，则阴不足，故阳气下入阴中而发热，若
失治焉，则阴阳不归其分，以致寒热交争而不已。盖阳盛则热，虚则寒，阴盛则寒，虚
则热，总之阴阳相胜也。然寒为阴，热为阳，表为阳，里为阴。若邪客于表，则与阳
争而为寒，邪入于里，则与阴争而为热，邪在半表半里，则外与阳争为寒，内与阴争为
热也。若昼静夜热，是阳气下陷入阴，昼热夜静，是阳气旺于阳分，昼夜俱热者，是重
阳无阴也。宜亟泻其阳，而峻补其阴，故昼病则在气，夜病则在血也。若身热而脉弦
数，战栗而不恶寒者，是瘅疟也。若发热恶寒，而脉浮数者，是温病也。若四肢发热，
口苦咽干，烦躁闷乱者，是火乘土位，湿热相合，故烦躁闷乱也。身体沉重，走注疼
痛，乃湿热相搏，风热郁而不得伸也。若发热恶寒，大渴不止，烦躁肌热，不欲近衣，
厥脉洪大，按之无力，或兼鼻干目痛者，是阴血虚发燥热也，治当补血。若不能食，身
热自汗者，是气虚也，治宜补气。若滑泄频频，唇干咽燥者，是虚阳上浮也。尺寸脉俱
满者，为重实，尺寸脉俱弱者，为重虚，脉洪大，或缓而滑，或数而鼓，此热甚拒阴，
虽形症似寒，实非寒也。热而脉数按之不鼓，此寒盛格阳，虽形症似热，实非热也。
如大热而以手久按，重按之不甚热者，此皮毛之热，而热在表也。若重按久按之而愈
热，轻安之而不甚热者，此筋骨之热，而热在里也。若不轻不重，按之而热者，此肌肉
之热，而热在半表半里也。更凡壮热而恶风寒者，乃元气不足，是表之虚热也。若壮热
而不恶风寒者，乃外邪所客，是表之实热也。若壮热而好饮汤者，是津液短少里之虚
热也。若壮热而好饮水者，是内火消烁里之实热也。更凡掌中热者，腹中热∶掌中寒
者，腹中寒；时所独热者，腰以上热；手所独热者，腰以下热；肘前独热者，胸前热；
肘后独热者，肩背热；臂中独热者，腰腹热；肘后以下三四寸热者，肠中有虫。又胃
居脐上，胃热则脐以上热；肠居脐下，肠热则脐以下热；肝胆居胁，肝胆热则胁亦热；
脯居胸背，脯热则胸背亦热；肾居腰，肾热则腰亦热，可类推也。然凡重阳必阴，重阴
必阳，阳主热，阴主寒，寒甚则热，热甚则寒，故曰∶寒生热，热生寒。此阴阳之变，
是以治寒者，须防热，治热者，尤须防寒也。凡诸热症，皆忌饮酒，否则抱薪救火，
终于无功。若脉阴阳俱虚而热不止，及下痢发热，或热不为汗衰，或汗后复热，而脉躁
及狂言不能食者，皆为凶候也。
小儿先天禀赋纯阳，血气充盈壅实，因此脏腑稍有失调，阴阳之气发生变动，就会在体内壅盛，熏蒸于体表，从而出现发热。这是因为阴不能配合阳，血不能配合气，所以凡是疾病发作，多属于火证。肝热则两颊发红、眼睛直视，手抓衣领，肢体拘挛且容易受惊，两眼红痛；心热则烦躁呼叫、嘴唇鲜红，向上窜动、咬紧牙齿，虚性疼痛导致神志混乱，口腔内生疮，小便赤红肿胀；肺热则呼吸急促不止，大便秘结，手揉眉口部位，鼻塞、毛发枯焦；脾热则口流涎沫，目黄腹胀，牙齿好动且易怒；心脾合热，则出现重舌（舌头肿大重叠）或木舌（舌体僵硬）。胃热则口气臭秽。肾热则耳内停积多脓，流出恶臭不止，向下窜动、畏光。五脏蕴蓄风热毒邪，则面色红如绯色，五心烦热，四肢温热壮热，眼睛干涩多渴。如果热邪上冲咽喉，则与血气相搏结，聚集成壅盛之势，形成喉闭（咽喉闭塞不通）和腮肿。如果壅滞的热邪不散，留滞在胸膈，热极则会生风、生悸动。
然而发热有轻重不同，有所谓“翕翕发热”的，像被羽毛覆盖一样，说明热在体表而属于表证，这是风寒客居于皮肤，阳气郁遏所致，应当用发汗法来解散它。所谓“蒸蒸发热”的，像蒸汽熏蒸一样，说明热在体内而属于里证，这是阳气下陷进入阴分中，应当用泻下法来清泄它。经过发汗和泻下治疗后热仍不退的，这是表里俱虚，气不归元，阳气浮越于外。此时不可再用凉药，也不能再次发汗或泻下，应当调和胃气，使阳气收敛于内，其热自然停止。如果表证未罢，而邪气又聚集，这叫作“两感”，则脉象举按皆实，面黄颊赤，嘴唇干燥口干，口鼻出气热，小便赤涩，大便坚硬，这是表里俱热。所以发热伴恶寒的，是发于阳经；无热但恶寒的，是发于阴经。有表证而热的，叫作表热；非表证而热的，叫作里热。
然而各种热证都归属于心，是火的征象。小热之气，用凉药来调和；大热之气，用寒药来折服；甚热之气则用发汗法发散，发之不去，则用逆治法制约，制约不尽，则求其本源以削弱它。苦味药，用来治疗五脏，五腑属阴而居于内；辛味药，用来治疗六腑，六腑属阳而位于外。病在内者用泻下法，病在外者用发汗法，其次宜养血益阴，其热自愈。古代虽有八十种分类，不可能全部记载。总之，各种疾病没有不伴有热的，这种热总是本身之火的表现，必须探究其原因来调理，切勿单纯使用寒凉药物，以免进一步损伤体内的阳气。
有早晚各发作一次的，诸种惊热，世人称为潮热，这是营卫壅实，五脏生热，熏蒸发于体表，所以说日晡时（下午3-5点）发热，是阳明实热。实者，是邪气实，应当通利大便。然而久病则为虚，不是补土（健脾）以藏阳，就是滋阴以退火。有的成于伤寒之后，余热未解；有的因痞气有块，阴伤不均；有的因瘕积，并食冷物造成停滞，脾胃不和；有的因脏腑虚怯，阴阳不和，或胃暑湿、脾疳疾；有的因疮疹未出，及余毒未解。然而因积食等症而发热的，则必定肚子热如火而脚冷，应当急用泻下法。如果形体消瘦多渴，骨蒸盗汗，头疮发穗，完谷不化或嗜食异物，五心长期发热，吃东西不长肌肉的，叫作疳热。如果因心脯有热，当风解脱衣物，是以风邪伤于皮毛，入于脏腑，而眼睛干涩头晕，胸膈烦闷，恶风壮热有汗的，叫作风热。如果面赤头痛，嘴唇焦裂咽疼，舌肿目赤，脸颊下方结硬，口腔内生疮，痰实不利，鼻涕唾沫稠粘，睡卧不安，胡言乱语狂妄的，叫作膈热。如果在胎时母亲服用热药，及食用糟酒爆炙食物，热毒进入胞宫，婴儿出生后，身体黄赤，眼闭呻吟，面赤身热，口热如汤，或生疮疥的，叫作胎热。夜热则是傍晚发作早晨停止；客热则是来去不定；寒热则是发作类似疟疾的样子；血热则是辰巳时（上午7-11点）发热；惊热则是癫狂呼叫、神情恍惚；食热则是肚背先热；积热则是两颊红、口疮且频繁口渴烦热，则焦躁不安且爱啼哭；虚热则是困倦无力；癖热则是流涎咳嗽饮水。
热而实的，必定面赤气粗，口热烦渴，嘴唇肿胀大便难，掀开衣被，烦躁啼哭大叫。热而虚的，必定面色青白，身体微热，口中气冷，大小便皆通利，手足心皆冷，神情恍惚精神萎靡，嘘气软弱，虚汗自出。然而虚热不可峻猛攻伐，因为热去则寒邪容易兴起。又不可过于进补，因为余热得到补益，则热会复发，必须求其本源以削弱它，所谓不求其本源，投药就不见效。更有因邪热在心，心本属火，又被热邪所乘，所以乃炎上而焦，哭啼时有汗，面红便赤，口气亦热，仰身烦躁啼哭，畏见灯火的，如见麻疹痘疮状的。然而凡欲出麻疹痘疮而发热的，必定中指、鼻尖及耳朵皆冷，乳食不贪，眼睛干涩眼红，常如睡状，或时而寒热，困乱心烦，耳后红丝缠绕是也。其症状最像伤寒，但伤寒是从表入里，疮疹是从里出表罢了。更有惊风热的，必定咬乳头流涎，仰视惊啼而入候症见；更有疫毒热的，因感冒四时不正之气，头痛壮热，与伤寒相似，但一时流行的病症人人相似是也。
夜热有三种，有因血热的，有因宿食的，有因疳劳的。更有温壮热的，是由脏腑不调，或内有伏热，或内挟宿寒，搏结于胃气，所以令其不和。血气壅塞，蕴积体热，名叫温壮。如果大便黄而臭的，是伏热。如果大便白而酸臭的，是挟宿寒。又说：修灶缺唇，食姜余指。有因小儿在胎时，其母喜好食用生姜，姜性至热，攻入血脉，传入经络，轻则令婴儿遍体生丹毒发疥疮，或头额生核，重则令婴儿发大痈疖，溃烂肌肉，十死一生，这叫做荣热。有小儿在胎时母亲伤和气，或饥饱劳役，或忧愁思虑，以此动摇了真气，乘袭虚邪，干扰神魂，流入胎脏，婴儿乃受之。既出生之后，婴儿常昏困，腹急气粗，重则喘急，睡思不稳，狂啼烦哭，肌肉不滋长，亦生疮疾，热发早晚，这叫做卫热。
又有病久则血气虚，气虚则发厥，血虚则发热，气血俱虚，所以手足厥冷而身体发热的。然而凡病热而左脸先红的，是肝受热也。右脸先红的，是肺受热也。额头先红的，是心受热也。下巴间先红的，是肾受热也。鼻上先红的，是脾受热也。有发热而吐酸口臭，头仰不卧，上热下冷，额头出汗，胸胀，气逆多啼，掌心倍热，人迎脉实，头痛脉数的，此是伤食也。如果发热身重体疼而黄的，是湿也。如果增寒发热，恶风自汗，脉浮胸痞的，是痰也。如果寸口脉微，则阳不足，故阴气上入阳中，而恶寒。如果尺部脉弱，则阴不足，故阳气下入阴中而发热，如果失治，则阴阳不归其分，以致寒热交争而不已。盖阳盛则热，虚则寒，阴盛则寒，虚则热，总之是阴阳相胜也。然而寒为阴，热为阳，表为阳，里为阴。如果邪客于表，则与阳争而为寒，邪入于里，则与阴争而为热，邪在半表半里，则外与阳争为寒，内与阴争为热也。
如果昼静夜热，是阳气下陷入阴，昼热夜静，是阳气旺于阳分，昼夜俱热的，是重阳无阴也。应当急泻其阳，而峻补其阴，所以昼病则在气，夜病则在血也。如果身热而脉弦数，战栗而不恶寒的，是瘅疟也。如果发热恶寒，而脉浮数的，是温病也。如果四肢发热，口苦咽干，烦躁闷乱的，是火乘土位，湿热相合，所以烦躁闷乱也。身体沉重，走注疼痛，乃湿热相搏，风热郁而不得伸也。如果发热恶寒，大渴不止，烦躁肌热，不欲近衣，厥脉洪大，按之无力，或兼鼻干目痛的，是阴血虚发燥热也，治当补血。如果不能食，身热自汗的，是气虚也，治宜补气。如果滑泄频频，唇干咽燥的，是虚阳上浮也。尺寸脉俱满的，为重实，尺寸脉俱弱的，为重虚，脉洪大，或缓而滑，或数而鼓，此热甚拒阴，虽形症似寒，实非寒也。热而脉数按之不鼓，此寒盛格阳，虽形症似热，实非热也。如大热而以手久按，重按之不甚热的，此皮毛之热，而热在表也。若重按久按之而愈热，轻按之而不甚热的，此筋骨之热，而热在里也。若不轻不重，按之而热的，此肌肉之热，而热在半表半里也。更凡壮热而恶风寒的，乃元气不足，是表之虚热也。若壮热而不恶风寒的，乃外邪所客，是表之实热也。若壮热而好饮汤的，是津液短少里之虚热也。若壮热而好饮水的，是内火消烁里之实热也。更凡掌中热的，腹中热；掌中寒的，腹中寒；时所独热的，腰以上热；手所独热的，腰以下热；肘前独热的，胸前热；肘后独热的，肩背热；臂中独热的，腰腹热；肘后以下三四寸热的，肠中有虫。又胃居脐上，胃热则脐以上热；肠居脐下，肠热则脐以下热；肝胆居胁，肝胆热则胁亦热；脯居胸背，脯热则胸背亦热；肾居腰，肾热则腰亦热，可类推也。
然而凡重阳必阴，重阴必阳，阳主热，阴主寒，寒甚则热，热甚则寒，所以说：寒生热，热生寒。这是阴阳的变化，所以治寒者，须防热，治热者，尤须防寒也。凡诸热症，皆忌饮酒，否则抱薪救火，终于无功。如果脉阴阳俱虚而热不止，及下痢发热，或热不为汗衰，或汗后复热，而脉躁及狂言不能食者，皆为凶候也。
Infants and young children are endowed with pure Yang constitution and abundant, stagnant Qi and Blood. Therefore, when the Zang-Fu organs experience slight disharmony or changes in Yin-Yang Qi, it leads to internal stagnation and external steaming, resulting in fever. This is because Yin cannot coordinate with Yang, and Blood cannot coordinate with Qi. Consequently, most disease manifestations belong to Fire syndromes. Liver Heat manifests as red cheeks, staring eyes, hands grasping at clothing collars, limb stiffness, susceptibility to fright, and red, painful eyes. Heart Heat manifests as irritability, crying, bright red lips, upward rushing movements, teeth grinding, confusion due to deficiency pain, oral ulcers, and red, swollen urine. Lung Heat manifests as incessant rapid breathing, constipation, hands rubbing the eyebrows and mouth, nasal congestion, and dry, brittle hair. Spleen Heat manifests as drooling, yellow eyes, abdominal distension, restless teeth, and irritability. Combined Heart-Spleen Heat manifests as double tongue (Chong She) or wooden tongue (Mu She). Stomach Heat manifests as foul breath. Kidney Heat manifests as excessive pus in the ears, continuous foul discharge, downward rushing movements, and photophobia. When the five Zang organs accumulate Wind-Heat and toxic factors, the face becomes red like cinnabar, there is heat in the five centers (palms, soles, and chest), limbs feel warm and hot, eyes are dry, and there is excessive thirst. If the heat rushes upward to the throat, it contends with Qi and Blood, forming stagnation and swelling, leading to throat closure (Hou Bi) and mumps-like swelling of the cheeks. If stagnant heat does not dissipate and remains in the chest and diaphragm, extreme heat generates Wind and palpitations.
However, fevers vary in severity. There is "Xi Xi Fever" (fever felt like being covered by feathers), indicating heat on the exterior and belonging to Exterior Syndromes, caused by Wind-Cold lodging in the skin and obstructing Yang Qi; this should be treated with sweating methods to disperse it. There is "Zheng Zheng Fever" (feeling like steaming), indicating heat in the interior and belonging to Interior Syndromes, caused by Yang Qi sinking into the Yin; this should be treated with purgative methods to clear it. If fever persists after sweating and purging, it indicates deficiency in both exterior and interior, Qi failing to return to its source, and Yang floating externally. Cool medicines should not be used, nor further sweating or purging; instead, harmonize the Stomach Qi to allow Yang Qi to converge internally, and the fever will cease. If exterior symptoms persist and pathogens re-aggregate, it is called "Liang Gan" (Double Contraction), presenting with full pulse upon lifting and pressing, yellowish complexion with red cheeks, dry lips and mouth, hot breath from nose and mouth, dark scanty urine, and hard stool, indicating heat in both exterior and interior. Thus, fever with aversion to cold indicates onset in Yang channels; absence of fever but with aversion to cold indicates onset in Yin channels. Fever with exterior signs is called Exterior Heat; fever without exterior signs is called Interior Heat.
Generally, all heat syndromes belong to the Heart, representing the image of Fire. For mild heat, use cool herbs to harmonize; for severe heat, use cold herbs to subdue; for extreme heat, use sweating methods. If sweating fails, use counter-treatment methods; if that fails, seek the root cause to weaken it. Bitter herbs treat the five Zang organs; pungent herbs treat the six Fu organs. Treatments for internal conditions involve purging, while those for external conditions involve sweating. Subsequently, nourishing Blood and benefiting Yin can resolve the heat. Although ancient texts classify eighty types, they cannot all be listed here. In summary, almost all diseases involve heat, which is essentially the manifestation of one's own internal fire. One must investigate the cause to regulate it, avoiding mere use of cold/cool substances that might damage the body's Yang Qi.
Fever occurring twice daily (morning and evening) is often called Tidal Fever (Chao Re) in cases of fright-heat, caused by stagnation of Ying and Wei Qi and heat generation in the five Zang organs steaming outward. Fever appearing at dusk (Shen hour) indicates Yangming Excess Heat. Excess requires promoting bowel movements. However, chronic cases become deficient, requiring tonification of Earth (Spleen) to store Yang or nourishing Yin to retreat fire. Causes include residual heat after Shang Han (Cold Damage), masses from Pi Qi (stagnation), irregular Yin injury, Jia masses (abdominal lumps) combined with cold food stagnation causing Spleen-Stomach disharmony, deficiency of Zang-Fu with Yin-Yang imbalance, stomach summer-heat dampness, or spleen malnutrition syndrome. It may also result from un erupted rash/toxins. Fever due to food accumulation presents with a belly hot as fire and cold feet, requiring urgent purging. Emaciation with excessive thirst, bone-stealing night sweats, scalp eruptions, eating non-food items, persistent heat in five centers, and failure to gain muscle mass defines Malnutrition Heat (Gan Re). Fever due to heart-heat exposed to wind results in wind-pathogen invading skin and organs, causing dry eyes, dizziness, chest oppression, aversion to wind, high fever with sweat, defined as Wind-Heat. Face redness, headache, cracked lips, sore throat, swollen tongue, red eyes, hardness below cheeks, oral ulcers, difficult phlegm, thick sputum, restlessness, delirium, and madness define Diaphragm Heat. Fetal Heat (Tai Re) occurs if the mother consumed hot drugs, alcohol, or fried foods during pregnancy, transmitting heat-toxin to the fetus, resulting in yellow-red skin, closed eyes with groaning, facial redness, body heat, scalding mouth temperature, or skin sores after birth. Night fever starts in evening and stops in morning; Guest Fever comes and goes unpredictably; Cold-Heat alternates resembling Malaria; Blood Heat occurs during Chen-Si hours (7-11 AM); Fright Heat involves convulsions and trance; Food Heat starts in abdomen/back; Accumulation Heat involves red cheeks, oral ulcers, frequent thirst, irritability, and crying; Deficiency Heat involves fatigue and weakness; Pi Heat involves drooling, coughing, and drinking water.
Excess Heat presents with red face, coarse breathing, mouth heat, irritability, swollen lips, difficulty defecating, kicking off covers, and frantic crying. Deficiency Heat presents with blue-white complexion, slight body heat, cold breath, normal urination/defecation, cold palms/soles, trance, lethargy, weak sighing, and spontaneous cold sweat. Deficiency heat should not be aggressively attacked, as removing heat may invite cold; nor overly tonified, as tonics may retain residual heat. One must address the root. Pathogenic heat in the Heart (Fire element) causes inflammation, crying with sweat, red face/stool, hot breath, arching back, irritability, and fear of light, resembling measles/varicella. Pre-rash fever features cold middle finger, nose tip, and ears, poor feeding, dry/red eyes, sleepiness, alternating chills/fever, restlessness, and red threads behind ears. Unlike Shang Han which moves from exterior to interior, rashes emerge from interior to exterior. Fright-Wind Heat involves biting nipples, drooling, upward gaze, and frightful crying. Epidemic Toxic Heat resembles Shang Han but affects everyone similarly during outbreaks.
Night fever has three types: Blood Heat, retained food, and Gan-Lao (malnutrition consumption). Warm-Zhuang Fever arises from organ disharmony, latent heat, or retained cold clashing with Stomach Qi, causing Qi-Blood stagnation and body heat retention. Yellow smelly stool indicates latent heat; white sour-smelly stool indicates retained cold. Maternal consumption of ginger during pregnancy (highly heating) can transmit heat through meridians to the fetus, causing generalized erysipelas, sores, or head nodules; severe cases cause large abscesses and tissue necrosis, termed Ying Heat. Maternal emotional disturbance or labor can move True Qi, allowing empty pathogens to disturb Shen and enter the womb, causing postnatal lethargy, abdominal urgency, coarse breathing, restlessness, crying, poor growth, and sores, termed Wei Heat.
Prolonged illness depletes Qi and Blood. Qi deficiency leads to syncope; Blood deficiency leads to fever. Combined deficiency causes cold extremities with body fever. Redness location indicates affected organ: Left cheek = Liver; Right cheek = Lung; Forehead = Heart; Chin = Kidney; Nose = Spleen. Fever with sour regurgitation, bad breath, head tilt, upper heat/lower cold, forehead sweat, chest distension, air reflux, crying, hot palms, full Renying pulse, headache, and rapid pulse indicates Food Injury. Fever with heaviness, pain, and jaundice indicates Dampness. Fever with increased chills, aversion to wind, spontaneous sweat, floating pulse, and chest stuffiness indicates Phlegm. Microcun Kou pulse indicates Yang deficiency with Yin rising causing chills. Weak Chi pulse indicates Yin deficiency with Yang sinking causing fever. Untreated, Yin-Yang fail to separate, causing alternating chills/fever. Yang excess causes heat, deficiency causes cold; Yin excess causes cold, deficiency causes heat. This is mutual overcoming of Yin-Yang. Cold/Yin/Interior vs Heat/Yang/Exterior. Exterior pathogens contend with Yang causing chills; Interior pathogens contend with Yin causing heat; Half-exterior/half-interior pathogens contend with both. Quiet day/fever night indicates Yang sinking into Yin; Hot day/quiet night indicates Yang flourishing in Yang divisions; Constant day/night heat indicates Double Yang without Yin, requiring draining Yang and tonifying Yin. Day illness relates to Qi; Night illness relates to Blood.
Hot body with wiry-rapid pulse, tremors without chills indicates Dan Malaria. Fever with chills and floating-rapid pulse indicates Warm Disease. Hot limbs, bitter taste, dry throat, irritability indicates Fire attacking Earth position with Damp-Heat combination. Heavy body, migrating pain indicates Damp-Heat clashing with constrained Wind-Heat. Fever with chills, extreme thirst, irritability, desire to discard clothes, surging-but-empty pulse, dry nose, painful eyes indicates Yin-Blood deficiency causing dry heat; treat by nourishing Blood. Inability to eat, fever, spontaneous sweat indicates Qi deficiency; treat by tonifying Qi. Frequent loose stools, dry lips/throat indicate Floating Empty Yang. Full Cun-Chi pulses indicate Severe Excess; Weak Cun-Chi pulses indicate Severe Deficiency. Surging, slow-slippery, or rapid-beating pulses indicate Heat rejecting Yin (appearing cold but is heat). Rapid pulse not beating strongly under pressure indicates Cold rejecting Yang (appearing hot but is cold). Deep pressure revealing less heat indicates superficial/exterior heat; deep pressure revealing more heat indicates deep/interior heat; moderate pressure revealing heat indicates half-exterior/half-interior heat. High fever with aversion to wind/cold indicates Yuan Qi deficiency (Exterior Deficiency Heat). High fever without aversion indicates external pathogen invasion (Exterior Excess Heat). High fever desiring hot drinks indicates short fluids (Interior Deficiency Heat). High fever desiring cold water indicates internal fire consuming fluids (Interior Excess Heat).
Palmar heat indicates abdominal heat; palmar cold indicates abdominal cold. Upper body heat corresponds to waist-up; lower body heat to waist-down. Elbow front heat corresponds to chest; elbow back heat to shoulders/back. Arm heat corresponds to waist/abdomen. Heat 3-4 cun below elbow back indicates intestinal worms. Stomach heat (above navel) causes above-navel heat; Intestine heat (below navel) causes below-navel heat. Liver/Gallbladder heat (flanks) causes flank heat. Chest/Back heat (chest area) causes chest/back heat. Kidney heat (waist) causes waist heat. These can be inferred analogously.
Extreme Yang transforms to Yin; Extreme Yin transforms to Yang. Yang governs heat; Yin governs cold. Extreme cold generates heat; extreme heat generates cold. Thus, treating cold requires guarding against heat, and treating heat requires guarding against cold. Alcohol is contraindicated in all heat syndromes, as it is like adding fuel to fire. Fatal signs include persistent fever despite Yin-Yang deficiency, dysentery with fever, fever unrelieved by sweating, recurrence after sweating, rapid pulse, delirium, and inability to eat.