治男女上热下寒之病。凡饮食过度。致伤脾胃。色欲过节。耗损真元。脾胃不和。遂致气不升降。
上热则头痛目眩。或痰涎呕逆。胸膈不快。咽喉干燥。饮食无味。下虚则腰膝无力。大便泄涩。
里急后重。脐肚冷痛。治以凉。则脾气怯弱。肠鸣下利。治以温。则上焦壅热。口舌生疮。及香港脚上攻。
与浮肿心烦。宜先服此药。然后
以所主之药治之。无不效者。
五加皮（五钱酒炒） 枳壳（二两炒） 甘草（一两炒） 草果（五钱）
柴胡（一两） 陈皮（五钱） 地骨皮（两炒） 诃子（五两去核） 半夏（五钱） 桑白皮（二两炒）
桔梗（五钱） 骨碎补（五钱去毛炒）
上 散。加苏叶生姜。水煎食后服。嗽倍半夏。上隔热甚加黄芩。
下部虚弱甚熟附子。如用附子。更加生姜。女人血虚加当归。
瘴疾多上热而下寒。此正张给事所谓阳浮而阴闭也。愚尝谓寓于广者。平居无疾。亦须服降气镇坠之药。
及养正丹。黑锡丹。然养正丹。四药皆有利性。南方阳气恒泄。稍失制度。宁免误人。怕服不若黑锡丹。
降气药。及苏子降气汤。秘传降汤二药。均治上盛下虚。然秘传降气汤。若胃寒气虚者。亦不宜多服。得病而
上热下寒者。李待制干姜附子汤法。最妙易简方。亦类在降气汤。后更云煎临时以药汁磨沉香。再煎滚
此法最良。病退而余热在上者。正宜服之。
治疗男女上热下寒的病证。凡是饮食过量，导致损伤脾胃；房事过度，耗损真元（人体根本元气）。脾胃功能不和，于是导致气机升降失常。
上部有热则出现头痛、目眩，或者痰涎上涌、恶心呕吐，胸膈部感觉不舒畅，咽喉干燥，饮食没有味道。下部虚弱则腰膝无力，大便泄泻或涩滞不通，伴有里急后重（腹痛窘迫，时时欲便，肛门重坠，便出不爽），肚脐周围冷痛。如果用寒凉药治疗，会导致脾气怯弱，肠鸣腹泻；如果用温热药治疗，则会导致上焦壅塞郁热，口舌生疮，以及脚气病邪气上攻，伴随浮肿和心烦。应当先服用此药，然后再根据具体病情使用主治药物，没有不有效的。
五加皮（五钱，酒炒） 枳壳（二两，炒） 甘草（一两，炒） 草果（五钱）
柴胡（一两） 陈皮（五钱） 地骨皮（一两，炒） 诃子（五两，去核） 半夏（五钱） 桑白皮（二两，炒）
桔梗（五钱） 骨碎补（五钱，去毛，炒）
以上药材制成散剂。服用时加入紫苏叶、生姜，用水煎煮，饭后服用。咳嗽者加倍使用半夏。上部隔热严重加黄芩。
下部虚弱严重者加熟附子。如果使用附子，再加生姜。女性血虚加当归。
瘴疟多表现为上热下寒，这正是张给事所说的“阳浮而阴闭”。我曾经对居住在岭南地区的人说，平时即使没有疾病，也应该服用降气镇坠的药物，如养正丹、黑锡丹等。然而养正丹及上述四种药物都有通利之性，南方阳气容易外泄，稍微失去节制，怎能避免误人子弟？恐怕服用这些不如服用黑锡丹、降气药，以及苏子降气汤、秘传降气汤这两种药物。它们都治疗上盛下虚的证候。但是秘传降气汤，如果是胃寒气虚的患者，也不宜多服。患病而出现上热下寒的情况，李待制采用的干姜附子汤方法，是最为精妙简易的方子，也类似于降气汤。后来又说煎药时临时用药物汁液磨沉香，再煮沸。这种方法最好。病势减退而余热留在上部的，正好适宜服用。
Treats the condition of upper heat and lower cold in both men and women. Whenever excessive food intake damages the Spleen and Stomach, or excessive sexual activity depletes the Zhenyuan (True Yuan/Original Qi), the harmony between the Spleen and Stomach is disrupted, leading to the failure of Qi mechanism to ascend and descend properly.
Upper heat manifests as headache and dizziness, or with phlegm-saliva rising and vomiting, discomfort in the chest and diaphragm, dry throat, and loss of taste for food. Lower deficiency presents as weakness in the waist and knees, diarrhea or difficult defecation, tenesmus (urgent need to defecate with heavy sensation in the anus), and cold pain around the umbilicus. If treated with cooling methods, it leads to weak Spleen Qi, borborygmus, and diarrhea; if treated with warming methods, it results in stagnation and heat in the Upper Jiao, sores on the mouth and tongue, and the upward attack of Hongxiangjiao (Gouty Arthritis/Foot Rot), accompanied by edema and vexation. One should first take this medicine, and then treat according to the specific indications, achieving invariably effective results.
Wujia Pi (Acanthopanacis Cortex, five qian, stir-fried with wine) | Zhike (Aurantii Fructus Immaturus, two liang, stir-fried) | Gancao (Glycyrrhizae Radix et Rhizoma, one liang, stir-fried) | Caoguo (Tsao-ko Fruit, five qian)
Chaihu (Bupleuri Radix, one liang) | Chenpi (Citri Reticulatae Pericarpium, five qian) | Digupi (Lycii Cortex, one liang, stir-fried) | Hezi (Chebulae Fructus, five liang, pitted) | Banxia (Pinelliae Tuber, five qian) | Sangbaipi (Mori Cortex, two liang, stir-fried)
Jiegeng (Platycodonis Radix, five qian) | Gusuibu (Drynariae Rhizoma, five qian, depilated and stir-fried)
Process the above into a powder. Add Ziye (Perilla Leaf) and Shengjiang (Fresh Ginger), decoct in water, and take after meals. For cough, double the dosage of Banxia. For severe upper heat, add Huangqin (Scutellariae Radix).
For severe lower deficiency, add Shu Fuzi (Prepared Aconiti Lateralis Radix). When using Fuzi, add additional Shengjiang. For women with Blood deficiency, add Danggui (Angelicae Sinensis Radix).
Zhangji (Malarial Disease in Miasma Regions) often presents with upper heat and lower cold, which is precisely what Zhang Jishi described as "Yang floating and Yin closing." I have previously stated that those residing in Guangnan should take Qi-descending and sedating medicines, such as Yangzheng Dan (Nourishing Righteousness Pill) and Heixi Dan (Black Tin Pill), even when free from disease. However, Yangzheng Dan and these four medicines all possess purgative properties. In the South, Yang Qi tends to leak out; slight loss of regulation may easily lead to harm. It is feared that taking these is inferior to taking Heixi Dan, Qi-descending medicines, Su Zi Jiang Qi Tang (Perillaseed Decoction to Direct Qi Downward), and Michuan Jiangqi Tang (Secretly Transmitted Decoction to Direct Qi Downward). These two medicines both treat excess in the upper and deficiency in the lower. However, Michuan Jiangqi Tang is not suitable for frequent use by those with Cold-Qi and Qi-deficiency in the Stomach. For illness presenting with upper heat and lower cold, the method of Ganjiang Fuzi Tang (Ginger and Aconite Decoction) advocated by Li Daizhi is the most exquisite and simple prescription, also resembling Jiangqi Tang. It further states: decoct the medicine, and temporarily grind Chenxiang (Aquilariae Lignum Resinatum) using the medicinal juice, then boil again. This method is excellent. When the pathogen recedes but residual heat remains in the upper part, this is precisely suitable for consumption.