经云∶阳虚生外寒。未尝言发热。夫外寒与阴虚生内热对峙而言，其发热也，阳不潜藏
，亦
非借薪而燃，实无根之焰，龙雷之火也。其为症身热舌苔淡黄，口燥齿浮，而不消水，脉浮
大满指，按之索然，面色惨淡，午后微红，（是为戴阳）言语无力，纳少胸闷，大便亦有燥结
者。若误投凉剂，初亦如无损，旋必加重，治此症必须从其类以求之，用八味汤凉服。盖阴
无阳无以生，阳无阴无以附，以六味纳气归肾，以桂、附引火归原，凉服者，热因寒用也。
曾见一妇，小产后身作大热，舌黄脉大，口干大便多日不解。医者皮相其症，不辨真假，而
用白虎汤大服，便通热缓，病家甚为喜悦。时予尚无医名，其家人所述如此，予欲一诊，偕
往视之，曰∶以我之见，是格阳于上，昨方不可再服，必当温补，庶可奏功。问∶既系虚症
，何昨日服药，大便通，热势减耶？予曰∶此大便之结，如寒月水泽腹坚，其通者几微，亢
阳为寒凉所逼而出焉。其热势减者，亦因寒凉灌濯，暂为退舍，脉象浮大，软如绵絮，急服
八味汤，尚恐无及。其家不信，医来复诊，见有应效，仍用前方，加麦冬、五味，又一服，
两目真视，循衣摸床，一昼夜而终，悔已无及矣！
凡暑气流行，自小暑至三伏，炎威赫奕烁石流金。若中秋前，骄阳炽盛，尚有残暑，人
当其
境，自汗泄肌，精神脱落，邪从口鼻吸受，伏于膜原，即发者为伤暑中暑，前已略论之矣。
遇时不发，直至初冬，或交冬至一阳来复，始欲泄者，名曰伏暑。其见症也，身热或肢热，
或咳嗽痰血；又感新寒或鼻衄牙宣，暑邪已入血分，心烦少寐，自汗淋漓，气短无力，脉细
如丝，重按不散，渴思冷冻饮料，小便秽赤等症，虽当寒月，重裘被体，总用凉剂，加补肺之品
，如生脉白虎汤；又如滑石、连翘、白金汁、银花露、西瓜翠、白通草、北沙参、麦冬之类
，亦可采用。若伏邪已入血分，非黄连不治，佐宜丹皮、白芍、鲜生地之类，可随症配入。
一人周姓，年逾三旬，孟冬患身热，自汗如雨，不饥不纳，形软不能起坐，一医用龙牡、归
、地，养血摄敛，病日加重。延予诊视，面色惨淡无神，脉细欲绝，乃问思冷冻饮料否？答曰∶
欲而家人不许。又令人倾其溺器，气秽而赤，病者又述不得安寐，已十昼夜矣。予曰∶此伏
暑症也。方中须用人参，病家业断以无力为辞。予曰∶不用亦可，但非经一月，则不能行立
奈何？曰∶得保无虞为幸，迟起亦所愿耳。方用白虎汤，加∶
北沙参（四钱） 麦冬（二钱）
一服汗收，酣寝一夜，半日，诸患霍然，后果调匝月始愈。
此症昧者多有误认阳虚阴症，用温补者，祸不旋踵。观此篇亦可了了。
《黄帝内经》中说：阳气虚弱会产生外寒。并没有说过（阳虚）会发热。外寒与阴虚生内热是相对的概念，这里的发热，是因为阳气不能潜藏，也不是借助柴薪燃烧那样有根的火，而是没有根基的火焰，即龙雷之火。
这种病症的表现是：身体发热，舌苔淡黄，口燥齿浮，但不想喝水，脉象浮大满指，重按却空虚无力，面色惨淡，午后两颧微红（这称为戴阳证），说话无力，食欲少且胸闷，大便也有干燥结滞的情况。如果误用寒凉药物，起初似乎没什么损害，随后病情必定加重。治疗此症必须顺从其病性来求治，使用八味丸（金匮肾气丸）但需冷服。因为阴无阳则无法生成，阳无阴则无法依附，用六味地黄丸纳气归肾，用肉桂、附子引火归原，冷服则是运用“热因寒用”的反佐法。
我曾见过一位妇人，小产后身体出现高热，舌苔黄，脉象大，口干，多日大便不通。医生只从表面看症状，不辨别真假，而用了白虎汤大量服用，结果大便通了，热势稍缓，病家非常高兴。当时我还没有医名，听家属如此描述，我想亲自诊察，便一同前往查看。我说：“依我看，这是格阳于上（真寒假热），昨天的方子不可再服，必须温补，才能见效。”问：“既然是虚证，为什么昨天服药后，大便通了，热势也减了呢？”我说：“这大便的结滞，就像寒冬腊月水泽结冰一样坚硬，能通只是极细微的缝隙；亢盛的阳气被寒凉药逼迫而外出。热势减退，也是因为寒凉药浇灌冲刷，暂时退避而已。脉象虽然浮大，但软如棉絮，急服八味汤，还恐怕来不及。他们不信，医生再来复诊，见有应效，仍用前方，加了麦冬、五味子，又服了一剂，病人两眼直视，手循摸衣床，一昼夜就去世了，后悔已经来不及了！
凡是暑气流行，从小暑到三伏，炎热威力极大，能使石头熔化、金属流金。如果在中秋之前，骄阳炽盛，还有残存的暑气，人处于这种环境中，自然汗出泄肌，精神耗损，邪气从口鼻吸入，潜伏在膜原，立即发作的叫伤暑或中暑，前面已经简略论述过了。遇到当时不发作，直到初冬，或者冬至一阳来复时才欲发泄的，名叫伏暑。
它的症状表现是：身体发热或四肢发热，或咳嗽痰血；又感受新寒或鼻出血、牙龈出血，暑邪已经进入血分，心烦失眠，大汗淋漓，气短无力，脉细如丝，重按不散，口渴想喝冷冻饮料，小便秽浊发红等症状。虽然是在寒冷的月份，穿着厚重的皮衣，总要用凉剂，加上补肺的药物，如生脉散合白虎汤；又如滑石、连翘、白金汁、银花露、西瓜翠衣、白通草、北沙参、麦冬之类，也可以采用。如果伏邪已经进入血分，非黄连不能治愈，辅助用药适宜丹皮、白芍、鲜生地之类，可根据症状配合加入。
有一个姓周的人，三十多岁，孟冬时节患身体发热，出汗如雨，不想吃东西也不进食，形体软弱不能起坐。一个医生用龙骨、牡蛎、当归、地黄，养血摄敛，病情日益加重。请我诊治，面色惨淡无神，脉细欲绝，于是问他是否想喝冷冻饮料？回答说：想喝，但家人不允许。又让人倒掉他的尿壶，尿液气味秽浊且发红，病人又说无法安睡，已经十昼夜了。我说：“这是伏暑症。方中必须用人参，病家已经以无力承担为由拒绝了。我说：不用也可以，但如果不是经过一个月，就不能行走站立吗？”他说：能保全性命就是幸运，晚点起来也是愿意的。方子用白虎汤，加：北沙参（四钱）、麦冬（二钱）。一服后汗止，酣睡一夜，半天时间，各种病痛霍然消失，后来调养一个月才痊愈。
The *Classic of Internal Medicine* states: "Yang deficiency generates external cold." It never mentions fever. External cold is contrasted with "Yin deficiency generating internal heat." In this context, the fever arises because Yang Qi fails to hide and store itself; it is not like fire burning with fuel (which has a root), but rather a flame without a root, known as the "Fire of Dragon and Thunder" (Longlei Huo).
The manifestations of this syndrome include: body heat, pale yellow tongue coating, dry mouth, floating teeth, yet no desire to drink water; the pulse is floating, large, and fills the finger pads, but feels empty and forceless upon deep pressure; the facial complexion is dull and bleak, with slight redness on the cheeks in the afternoon (this is called *Daiyang* or "Floating Yang"); speech is weak; appetite is poor with chest fullness; and stool may also be dry and constipated. If cool/cold-natured formulas are mistakenly administered, there may initially seem to be no harm, but soon the condition will definitely worsen. To treat this syndrome, one must follow its nature to seek treatment, using **Bawei Wan** (Eight-Ingredient Pill / Jin Gui Shen Qi Wan) taken cold. This is because Yin cannot generate without Yang, and Yang cannot attach without Yin. Using **Liujunzi Tang** (Six-Ingredient Rehmannia Decoction) to guide Qi back to the Kidney, and using Cinnamon Twig (*Guizhi*) and Aconite Root (*Fuzi*) to guide Fire back to its source, while taking it cold applies the principle of "treating heat with cold" (using cold administration for hot-natured drugs, i.e., *Re Yin Han Yong*).
I once saw a woman who developed high fever after a miscarriage, with a yellow tongue coating and a large pulse, dry mouth, and no bowel movement for many days. The physician looked only at the superficial symptoms, failing to distinguish between true and false conditions, and prescribed **Baihutang** (White Tiger Decoction) in large doses. Consequently, her bowels moved and the fever subsided slightly, causing great joy among her family. At that time, I had no medical reputation. Hearing their account, I wished to examine her personally and went with them. I said, "In my opinion, this is 'Ge Yang Yu Shang' (Gridlock of Yang in the Upper Jiao/True Cold False Heat). The prescription from yesterday must not be taken again; warm tonification is necessary to achieve efficacy." They asked, "If it is indeed a deficiency syndrome, why did the bowels move and the fever subside after taking medicine yesterday?" I replied, "This constipation is like water freezing solid in winter ponds; the passage was merely a tiny crack. The hyperactive Yang was forced out by the cold-natured herbs. The reduction in fever was also due to the cooling effect temporarily retreating the pathogen. Although the pulse appears floating and large, it is soft like cotton wadding. Urgently administering Bawei Wan might still be too late." They did not believe me. When the physician returned for a follow-up, seeing some initial relief, he continued with the previous formula, adding Ophiopogon Tuber (*Maidong*) and Schisandra Fruit (*Wuweizi*). After another dose, the patient's eyes stared fixedly, she picked at the bedclothes, and she died within a day and night. The regret was irreparable!
Whenever Summerheat Qi prevails, from Minor Heat (*Xiaoshu*) to the Sanfu period, the heat is intense enough to melt stones and flow metal. If before Mid-Autumn Festival, the scorching sun remains strong, residual Summerheat persists. People exposed to this environment sweat profusely, depleting their spirit and essence. Pathogenic factors enter through the mouth and nose, lying latent in the *Moyuan* (Membrane Source). Immediate onset is termed Injury by Summerheat (*Shangshu*) or Collapse by Summerheat (*Zhongshu*), which has been briefly discussed previously. If it does not manifest during the season but lies dormant until early winter, or until the Winter Solstice when Yang begins to recover, it is named Latent Summerheat (*Fushu*).
Its manifestations include: body heat or limb heat, or cough with blood-stained sputum; contracting new cold or suffering from epistaxis and bleeding gums; the Summerheat pathogen has entered the Blood level; mental restlessness and insomnia; profuse sweating; shortness of breath and weakness; a pulse fine as a silk thread, unyielding under heavy pressure; thirst craving frozen beverages; and turbid, reddish urine. Even in cold months, when wearing heavy fur coats, cool/cold-natured formulas should generally be used, combined with Lung-tonifying herbs such as **Shengmaibaihutang** (Lifegiving Pulse and White Tiger Decoction); or herbs like Calcined Gypsum (*Shihui* - note: text says Shihui usually implies Shi Gao, but here likely refers to Talcum *Huashi* given context, however WHO term for 滑石 is Talcum), Forsythia Fruit (*Lianqiao*), Platinum Juice (*Baijin Zhi*), Honeysuckle Dew (*Yinhua Lu*), Watermelon Rind (*Xigua Cui*), White Akebia Stem (*Baitongcao*), Glehnia Root (*Beishashen*), and Ophiopogon Tuber (*Maidong*), etc., can also be adopted. If the latent pathogen has entered the Blood level, only Coptis Rhizome (*Huanglian*) can cure it; auxiliary herbs suitable for addition include Moutan Bark (*Danpi*), White Peony Root (*Baishao*), and Fresh Rehmannia Root (*Xianshengdi*), mixed according to symptoms.
A man surnamed Zhou, over thirty years old, suffered from body heat in early winter, sweating like rain, with no hunger or intake of food, his body so weak he could not sit up. One physician used Dragon Bone (*Longgu*), Oyster Shell (*Muli*), Angelica Sinensis (*Danggui*), and Rehmannia Root (*Dihuang*) to nourish blood and secure/astringe, but the condition worsened daily. I was invited to examine him. His facial complexion was dull and lacked spirit, and his pulse was fine and nearly imperceptible. I asked if he desired frozen drinks. He answered, "I want to, but my family forbids it." I then had someone pour out his urinal; the urine was odorous and red. The patient also stated he had been unable to sleep peacefully for ten days and nights. I said, "This is a case of Latent Summerheat. Ginseng Root (*Renshen*) must be included in the formula." The family declined, citing financial inability. I said, "It can be omitted, but unless you wait a month, he will not be able to walk or stand." They replied, "To ensure safety is our hope; rising late is acceptable." The formula used was **Baihutang** (White Tiger Decoction), added with: Glehnia Root (*Beishashen*, 4 qian) and Ophiopogon Tuber (*Maidong*, 2 qian). After one dose, sweating ceased, and he slept soundly through the night. By midday, all ailments vanished miraculously. He subsequently recovered after a month of recuperation.
Ignorant practitioners often mistake this syndrome for Yang-deficiency Yin-cold patterns and use warm tonics, leading to immediate disaster. Reading this section makes the distinction clear.