论曰寒热往来者,阴阳虚实更胜也。夫阴实生内寒,阳虚生外寒,皆为阴胜阳,阳实生
外热,阴虚生内热,皆为阳胜阴,阴阳相胜,故寒热互作而往来。治法宜使阴阳和平,气无
相胜,则病可愈。
治寒热往来,夜卧盗汗,四肢无力,饮食口苦,上气咳嗽。柴胡汤方
柴胡(去苗一两半) 五味子 桔梗(炒) 熟干地黄(焙) 白茯苓(去黑皮) 麦
门冬(去心焙) 紫菀(去苗) 人参 地骨皮 黄 (锉) 白术 桂(去粗皮) 牡蛎
(研粉各一两) 半夏(去滑汤洗七遍) 甘草(炙各三分)
上一十五味。粗捣筛,每服三钱匕,水一盏,生姜半分拍碎,枣三枚劈破,煎至六分,
去滓温服,不拘时候。
治寒热往来,久成痨瘵。地骨皮汤方
地骨皮 知母(焙) 柴胡(去苗) 枳壳(去瓤麸炒各半两) 鳖甲(去裙 醋炙三
分) 赤茯苓(去黑
上七味。粗捣筛,分为五帖,每帖以水三盏,煎取一盏,下地黄汁一合,更煎三五沸,
去滓分温二服,食后良久,相继服,日一帖。
治寒热似疟。桔梗汤方
桔梗(锉炒一两) 甘草(炙半两) 知母(焙半两) 柴胡(去苗一两半) 大黄(锉
炒半两) 鳖甲(去裙
上六味。锉如麻豆,分为六帖,每帖用童子小便二盏,葱白三茎,豉半合浸食顷,煎取
一盏去滓,食后分温二服,日一帖。
治寒热乍进乍退。虎骨汤方
虎骨汤(一两酒炙为末) 甘草(炙一分) 知母(焙半两) 葱白(七茎) 鳖甲(去
裙醋炙半两) 豉
上六味。细锉如麻豆,用水三盏,煎取二盏,下童子小便半盏,和煎数沸去滓,食后良
久分温三服。
治寒热不能饮食,羸瘦少力。黄 汤方
黄 (锉二两) 人参 白茯苓(去黑皮各一两) 柴胡(去苗) 当归(切焙各半两)
白术(一两) 桂(去粗皮半两) 甘草(炙半两) 枳壳(半两去瓤麸炒) 桔梗(锉炒
半两) 桃仁(半两汤浸去皮尖双仁麸
上一十一味。粗捣筛,每服三钱匕,水一盏,生姜半分拍碎,枣三枚劈破,煎至六分去
滓,不计时候温服。
论述说:寒热往来,是阴阳虚实相互偏胜的结果。阴气实盛则产生内寒,阳气虚衰则产生外寒,这都属于阴胜阳衰;阳气实盛则产生外热,阴气虚衰则产生内热,这都属于阳胜阴衰。阴阳相互偏胜,所以寒热交替发作、往来不定。治疗原则应当使阴阳恢复平衡,气机不再相互偏胜,那么疾病就可以痊愈。
治疗寒热往来,夜间睡眠时盗汗,四肢无力,饮食口苦,气逆咳嗽的方剂:柴胡汤方
柴胡(去除苗茎一两半) 五味子 桔梗(炒制) 熟干地黄(焙干) 白茯苓(去除黑皮) 麦门冬(去除心后焙干) 紫菀(去除苗茎) 人参 地骨皮 黄芩(锉碎) 白术 桂枝(去除粗皮) 牡蛎(研成粉,各一两) 半夏(用滑石汤清洗七遍) 甘草(炙制,各三分)
以上十五味药。粗捣筛碎,每次服用三钱匕,加水一盏,生姜半块拍碎,大枣三枚劈破,煎煮至六分满,滤去药渣,温服,不限定具体时间。
治疗寒热往来,日久形成痨瘵(慢性消耗性疾病)的方剂:地骨皮汤方
地骨皮 知母(焙干) 柴胡(去除苗茎) 枳壳(去除瓤麸,炒制,各半两) 鳖甲(去除裙边,醋炙,三分) 赤茯苓(去除黑皮)
以上七味药。粗捣筛碎,分为五帖,每帖用水三盏,煎取一盏,加入地黄汁一合,再煎煮三五沸,滤去药渣,分两次温服,饭后较长时间,依次服用,每日一帖。
治疗寒热症状类似疟疾的方剂:桔梗汤方
桔梗(锉碎炒制一两) 甘草(炙制半两) 知母(焙干半两) 柴胡(去除苗茎一两半) 大黄(锉碎炒制半两) 鳖甲(去除裙边)
以上六味药。锉碎如麻豆大小,分为六帖,每帖用童子小便二盏,葱白三根,淡豆豉半合浸泡片刻,煎取一盏,滤去药渣,饭后分两次温服,每日一帖。
治疗寒热忽进忽退的方剂:虎骨汤方
虎骨汤(一两酒炙后研为末) 甘草(炙制一分) 知母(焙干半两) 葱白(七根) 鳖甲(去除裙边,醋炙半两) 淡豆豉
以上六味药。细锉如麻豆大小,用水三盏,煎取二盏,加入童子小便半盏,和匀煎煮数沸,滤去药渣,饭后较长时间分三次温服。
治疗寒热导致不能饮食,身体消瘦少力的方剂:黄芪汤方
黄芪(锉碎二两) 人参 白茯苓(去除黑皮,各一两) 柴胡(去除苗茎) 当归(切后焙干,各半两) 白术(一两) 桂枝(去除粗皮半两) 甘草(炙制半两) 枳壳(半两,去除瓤麸,炒制) 桔梗(锉碎炒制半两) 桃仁(半两,汤浸去皮尖及双仁者,麸炒)
以上十一味药。粗捣筛碎,每次服用三钱匕,加水一盏,生姜半块拍碎,大枣三枚劈破,煎煮至六分满,滤去药渣,不限时间温服。
Discourse states: Alternating chills and fever (Han Re Wang Lai) is the result of Yin and Yang, deficiency and excess, mutually prevailing. When Yin is solid/excess, internal cold (Nei Han) arises; when Yang is deficient, external cold (Wai Han) arises; both are cases of Yin prevailing over Yang. When Yang is solid/excess, external heat (Wai Re) arises; when Yin is deficient, internal heat (Nei Re) arises; both are cases of Yang prevailing over Yin. Because Yin and Yang prevail against each other, chills and fever alternate and come and go. The treatment principle should aim to bring Yin and Yang into harmony, so that Qi does not prevail excessively against itself, then the disease can be cured.
Formula for treating alternating chills and fever, night sweats during sleep, weakness in the four limbs, bitter taste in the mouth during eating/drinking, and rebellious Qi with coughing: Chai Hu Tang (Bupleurum Decoction).
Chai Hu (Cimicifugae Rhizoma, Bupleuri Radix - *Note: Text says Chai Hu, usually Bupleuri*, remove seedlings, 1.5 liang) Wu Wei Zi (Schisandrae Fructus) Jie Geng (Platycodonis Radix, stir-fried) Shu Di Huang (Rehmanniae Radix Preparata, baked) Bai Fu Ling (Poria, remove black skin) Mai Men Dong (Ophiopogonis Tuber, remove heart and baked) Zi Wan (Asteris Radix, remove seedlings) Ren Shen (Ginseng Radix) Di Gu Pi (Lycii Cortex) Huang Qin (Scutellariae Radix, chopped) Bai Zhu (Atractylodis Macrocephalae Rhizoma) Gui Zhi (Cinnamomi Ramulus, remove rough bark) Mu Li (Ostreae Concha, ground to powder, each 1 liang) Ban Xia (Pinelliae Rhizoma, washed seven times in Hua Shi Tang/Gypsum Decoction) Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, each 3 qian).
The above fifteen herbs. Coarsely crush and sieve. Take three qian bi per dose, add one zhan of water, half a piece of crushed fresh ginger, three cracked jujubes. Decoct until six parts remain, filter dregs, take warm, at any time.
Formula for treating alternating chills and fever, which has long developed into Lao Zhai (consumptive disease): Di Gu Pi Tang (Lycii Cortex Decoction).
Di Gu Pi (Lycii Cortex) Zhi Mu (Anemarrhenae Rhizoma, baked) Chai Hu (Bupleuri Radix, remove seedlings) Zhi Ke (Aurantii Fructus, remove pith and bran, stir-fried, each 0.5 liang) Bie Jia (Testudinis Carapax et Plastrum, remove skirt, vinegar-fried, 3 fen) Chi Fu Ling (Poria with Red Skin, remove black skin).
The above seven herbs. Coarsely crush and sieve, divide into five doses. For each dose, use three zhan of water, decoct to obtain one zhan. Add one he of Di Huang Zhi (Juice of Rehmanniae Radix), boil for three to five boils, filter dregs, divide into two warm doses. Take after meals after a long interval, consecutively, one dose per day.
Formula for treating chills and fever resembling malaria: Jie Geng Tang (Platycodonis Radix Decoction).
Jie Geng (Platycodonis Radix, chopped and stir-fried, 1 liang) Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, 0.5 liang) Zhi Mu (Anemarrhenae Rhizoma, baked, 0.5 liang) Chai Hu (Bupleuri Radix, remove seedlings, 1.5 liang) Da Huang (Rhei Radix et Rhizoma, chopped and stir-fried, 0.5 liang) Bie Jia (Testudinis Carapax et Plastrum, remove skirt).
The above six herbs. Chop like hemp seeds, divide into six doses. For each dose, use two zhan of urine from a young boy (Tong Zi Xiao Bian), three stalks of scallion white (Cong Bai), and half a he of Dou Chi (Sojae Semen Preparatum). Soak for a moment, decoct to obtain one zhan, filter dregs. Divide into two warm doses after meals, one dose per day.
Formula for treating chills and fever that advance and retreat intermittently: Hu Gu Tang (Tiger Bone Decoction).
Hu Gu (Os Tigridis, 1 liang, wine-fried and ground to powder) Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, 1 fen) Zhi Mu (Anemarrhenae Rhizoma, baked, 0.5 liang) Cong Bai (Allii Fistulosi Bulb, seven stalks) Bie Jia (Testudinis Carapax et Plastrum, remove skirt, vinegar-fried, 0.5 liang) Dou Chi (Sojae Semen Preparatum).
The above six herbs. Finely chop like hemp seeds. Use three zhan of water, decoct to obtain two zhan. Add half a zhan of Tong Zi Xiao Bian (Urine of a Young Boy), mix and boil for several boils, filter dregs. Divide into three warm doses after meals after a long interval.
Formula for treating chills and fever leading to inability to eat, emaciation, and lack of strength: Huang Qi Tang (Astragali Radix Decoction).
Huang Qi (Astragali Radix, chopped, 2 liang) Ren Shen (Ginseng Radix) Bai Fu Ling (Poria, remove black skin, each 1 liang) Chai Hu (Bupleuri Radix, remove seedlings) Dang Gui (Angelicae Sinensis Radix, sliced and baked, each 0.5 liang) Bai Zhu (Atractylodis Macrocephalae Rhizoma, 1 liang) Gui Zhi (Cinnamomi Ramulus, remove rough bark, 0.5 liang) Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, 0.5 liang) Zhi Ke (Aurantii Fructus, 0.5 liang, remove pith and bran, stir-fried) Jie Geng (Platycodonis Radix, chopped and stir-fried, 0.5 liang) Tao Ren (Persicae Semen, 0.5 liang, soaked in water, remove skin and tips, double-kernel ones removed, bran-fried).
The above eleven herbs. Coarsely crush and sieve. Take three qian bi per dose, add one zhan of water, half a piece of crushed fresh ginger, three cracked jujubes. Decoct until six parts remain, filter dregs, take warm at any time.