(出丹溪)
昼则增剧 夜则安静,是阳病有余,气病而血不病也。
夜则增剧,昼则安静,是阴病有余,血病而气不病也。
昼则发热,夜则安静,是阳气自盛于阳分也。昼则安静,夜则发热烦躁,是阳气下陷入阴中也。(热入
血室。)昼则发热烦躁,夜亦发热烦躁,是重阳无阴也。(补阴泻阳。)
夜则恶寒,昼则安静,是阴气自盛于阴分也。夜则安静,
昼则恶寒,是阴气上冒于阳中也。夜则恶寒,昼亦恶寒,是重阴无阳也。(补阳泻阴。)
昼则恶寒,夜则烦躁,饮食不入,名曰阴阳交错者死。
按∶昼夜静剧,仍须辩证之寒热有余不足。即如昼静夜剧,其证见阳热之有余者,是阳陷入阴也。其
证见阴寒之不足者,是阴气自盛也。其证见虚热而不甚者,则为阴虚,而非阳盛矣。其证见微寒而不甚者,又
为阳虚,而非阴盛矣。余根据此例推之。更有寒热日夜数过,寒已即热,热已复寒,无已时者,在初病为风气
太盛,所谓风胜则动也。在汗后为里邪外争,在下后为外邪内争,皆为阴阳不和,而有病进病
退之别也。在久病为阴阳败乱,元气无主也。
(出丹溪)
昼则增剧 夜则安静,是阳病有余,气病而血不病也。
夜则增剧,昼则安静,是阴病有余,血病而气不病也。
昼则发热,夜则安静,是阳气自盛于阳分也。昼则安静,夜则发热烦躁,是阳气下陷入阴中也。(热入
血室。)昼则发热烦躁,夜亦发热烦躁,是重阳无阴也。(补阴泻阳。)
夜则恶寒,昼则安静,是阴气自盛于阴分也。夜则安静,
昼则恶寒,是阴气上冒于阳中也。夜则恶寒,昼亦恶寒,是重阴无阳也。(补阳泻阴。)
昼则恶寒,夜则烦躁,饮食不入,名曰阴阳交错者死。
按∶昼夜静剧,仍须辩证之寒热有余不足。即如昼静夜剧,其证见阳热之有余者,是阳陷入阴也。其
证见阴寒之不足者,是阴气自盛也。其证见虚热而不甚者,则为阴虚,而非阳盛矣。其证见微寒而不甚者,又
为阳虚,而非阴盛矣。余根据此例推之。更有寒热日夜数过,寒已即热,热已复寒,无已时者,在初病为风气
太盛,所谓风胜则动也。在汗后为里邪外争,在下后为外邪内争,皆为阴阳不和,而有病进病
退之别也。在久病为阴阳败乱,元气无主也。
(出自朱丹溪)
白天病情加重,夜间安静,这是阳病有余,气分有病而血分无病。
夜间病情加重,白天安静,这是阴病有余,血分有病而气分无病。
白天发热,夜间安静,这是阳气在阳分自然偏盛。白天安静,夜间发热烦躁,这是阳气下陷进入阴分中。(热入血室证)白天发热烦躁,夜间也发热烦躁,这是重阳而无阴。(治宜补阴泻阳)
夜间恶寒,白天安静,这是阴气在阴分自然偏盛。白天安静,夜间恶寒,这是阴气上犯于阳分中。夜间恶寒,白天也恶寒,这是重阴而无阳。(治宜补阳泻阴)
白天恶寒,夜间烦躁,饮食不能进,名叫阴阳交错,这种病症预后不良,主死。
按语:判断昼夜病情的轻重变化,仍然需要辨证分析寒热有余不足的情况。就像白天安静夜间加重,如果症状表现为阳热有余,这是阳气陷入阴分。如果症状表现为阴寒不足,这是阴气自然偏盛。如果症状表现为虚热但不严重,则是阴虚,而不是阳盛。如果症状表现为微寒但不严重,则是阳虚,而不是阴盛。我根据这个例子类推。更有寒热一天内多次交替,寒退即热,热退复寒,没有休止的时候,这在初病时是风气太盛,所谓风胜则动。在发汗后出现,是里邪与正气外争;在攻下后出现,是外邪与正气内争,这都是阴阳不和,而有病情进展或退却的区别。在久病中出现,则是阴阳败乱,元气失去主宰。
(From Zhu Danxi)
Aggravation during the day and quietness at night indicate excess in Yang diseases, where Qi is diseased but Blood is not.
Aggravation at night and quietness during the day indicate excess in Yin diseases, where Blood is diseased but Qi is not.
Fever during the day and quietness at night indicate that Yang Qi naturally prevails in the Yang aspect. Quietness during the day and fever with irritability at night indicate that Yang Qi has sunk into the Yin aspect. (Heat entering the Blood Chamber.) Fever and irritability both during the day and at night indicate excessive Yang without Yin. (Treatment: Tonify Yin and drain Yang.)
Chills at night and quietness during the day indicate that Yin Qi naturally prevails in the Yin aspect. Quietness at night and chills during the day indicate that Yin Qi has risen to invade the Yang aspect. Chills both at night and during the day indicate excessive Yin without Yang. (Treatment: Tonify Yang and drain Yin.)
Chills during the day, irritability at night, and inability to take food are named "intermingling of Yin and Yang," a condition indicating death.
Note: Assessing the severity changes between day and night still requires differentiation of excess or deficiency in cold and heat. For instance, if symptoms are quiet by day and severe by night, and present with signs of excess Yang-heat, this indicates Yang sinking into Yin. If they present with signs of deficiency in Yin-cold, this indicates natural prevalence of Yin Qi. If they present with deficient heat that is not severe, it is Yin deficiency, not Yang excess. If they present with slight cold that is not severe, it is Yang deficiency, not Yin excess. I deduce other cases based on this example. Furthermore, there are cases where chills and fever alternate multiple times throughout the day and night, with heat following chills and chills following heat without cessation. In early-stage disease, this is due to excessive Wind pathogen, as stated, "When Wind prevails, movement occurs." After sweating therapy, it represents interior pathogens contending with exterior; after purgative therapy, it represents exterior pathogens contending with interior. These all indicate disharmony of Yin and Yang, distinguishing between progression and regression of the disease. In chronic disease, it indicates disarray of Yin and Yang, with Yuan Qi losing its mastery.