论真热真寒
天师曰∶真病原难分晰，然有假即有真也。即以前症言之，如人喉痛口干，舌燥身热，与假热无
异，然而此曰真热者，何以辨之。假热之症，口虽渴而不甚，舌虽干而不燥，即燥而无芒刺，无裂纹，
喉虽痛而日间轻，身虽热而有汗；不若真热之症，口干极而呼水，舌燥极而开裂生刺，喉日夜痛而不已，
身大热烙手而无汗也。方用麻黄三钱，黄连三钱，黄芩三钱，石膏三钱，知母三钱，半夏二钱，枳壳二
钱，甘草一钱，当归五钱，水煎服。一剂轻，二剂愈。此方纯用寒凉之药，以祛逐其火，火一去而上
焦宽快矣。更有人手足冰冷。或数厥逆，身战畏寒，与假寒无异，然而谓之真寒者，何以辨之？假寒之
症，手足冰冷，或有时温和，厥逆身战，亦不太甚，有时而安，然有时而发搐；不若真寒之症，手足寒
久不回，色变青紫，身战不已，口噤出声而不可禁也。方用附子三钱，肉桂一钱，干姜一钱，白术五
钱，人参一两，急救之。此乃直中寒邪，肾火避出躯壳之外，而阴寒之气直犯心宫，心君不守，肝气无根据，
乃发战发噤，手足尽现青色也。然则止宜用附、桂、干姜祛逐其寒邪足矣，何以又用白术、人参？且少用
亦足济用，何以多加如许也？盖元阳飞越，止一线之气未绝，若不急用人参，返气于若存若亡之际，
而徒用桂、附、干姜，一派辛辣火热之药，邪虽外逐，而正气亦
就垂绝。故不若多加于危急之际，则败军残卒，见有孤军未亡，而又骁勇之将，号召散失，有不再整旗
枪，共奔毒□下者乎，此真治之妙也。
张公曰∶奇论天开。真治即直治，真治其本病，而不必以假药骗之，对症用药可也，余不再论。
华君曰∶亦同。
天师说：真正的病因确实难以分辨清楚，然而有假象就必然有真相。就拿前面的症状来说，比如有人喉咙痛、口干、舌燥、身体发热，这与假热的症状没有两样，但是这种被称为真热的情况，该如何辨别呢？假热的症状是：口虽然渴但并不严重，舌虽然干但不干燥，即使干燥也没有芒刺和裂纹；喉咙虽然痛但白天较轻，身体虽然发热但有汗出；不像真热的症状那样：口干至极而呼叫要水喝，舌燥至极而开裂并生出芒刺，喉咙日夜疼痛不止，身体极度发热且烫手而无汗。方剂用麻黄三钱，黄连三钱，黄芩三钱，石膏三钱，知母三钱，半夏二钱，枳壳二钱，甘草一钱，当归五钱，加水煎服。服用一剂后症状减轻，两剂后痊愈。这个方子纯用寒凉药物，用来祛除体内的火邪，火邪一去，上焦（胸膈以上部位）就会感到宽舒畅快。
又有人手足冰冷，或者多次出现四肢厥逆（手脚冰凉过肘膝），身体颤抖怕冷，这与假寒的症状无异，但是这种被称为真寒的情况，该如何辨别呢？假寒的症状是：手足冰冷，或者有时温度温和，四肢厥逆和身体颤抖也不太严重，有时安静，有时却发生抽搐；不像真寒的症状那样：手足寒冷久久不能回暖，颜色变为青紫色，身体颤抖不止，牙关紧闭发出声音且无法控制。方剂用附子三钱，肉桂一钱，干姜一钱，白术五钱，人参一两，用于急救。这是寒邪直中脏腑，肾阳（命门之火）被逼迫逃离躯壳之外，阴寒之气直接侵犯心宫，导致心神不守，肝气失去依托，从而引发战栗和牙关紧闭，手足全部呈现青色。既然这样，只应当用附子、肉桂、干姜来祛除寒邪就足够了，为什么又要用白术、人参呢？而且少量使用也足以见效，为什么要大量增加这么多呢？这是因为元阳（人体根本之阳气）飞越散失，仅存一线气息未断，如果不紧急用人参，在气息若存若亡之际挽回元气，而仅仅使用桂枝、附子、干姜这一派辛辣火热的药物，虽然邪气被驱逐在外，但正气也会随之濒临绝灭。所以不如在危急时刻多加人参，这就好比败军残兵，看到还有孤军未亡，又有骁勇的将领号召溃散的士兵，难道还会不整顿旗鼓，共同奔向战场吗？这就是真正治疗方法的奥妙所在。
张公说：这是奇论，如天开一般新颖。所谓真治就是直治，真正治疗其本病，而不必用虚假的药物欺骗它，对症用药即可，我不再多说。
华君说：我也同意。
The Heavenly Master said: The true nature of the disease is indeed difficult to distinguish clearly; however, where there is a false appearance, there must be a true reality. Speaking of the previous symptoms, such as when a person suffers from sore throat, dry mouth, dry tongue, and fever, it is indistinguishable from false heat. Yet, how can one differentiate this condition identified as true heat? In cases of false heat, although the mouth feels thirsty, the thirst is not severe; although the tongue is dry, it is not parched; even if dry, there are no prickles or cracks. Although the throat hurts, the pain is lighter during the day; although the body is hot, there is sweating. This contrasts with true heat, where the mouth is extremely dry causing calls for water, the tongue is extremely dry leading to cracking and the formation of prickles, the throat hurts continuously day and night, and the body is intensely hot to the touch without sweating. The prescription consists of Ephedrae Herba (Mahuang) 3 qian, Coptidis Rhizoma (Huanglian) 3 qian, Scutellariae Radix (Huangqin) 3 qian, Gypsum Fibrosum (Shigao) 3 qian, Anemarrhenae Rhizoma (Zhimu) 3 qian, Pinelliae Tuber (Banxia) 2 qian, Aurantii Fructus (Zhike) 2 qian, Glycyrrhizae Radix et Rhizoma (Gancao) 1 qian, and Angelicae Sinensis Radix (Danggui) 5 qian. Decoct in water and take orally. Symptoms alleviate after one dose and resolve after two doses. This formula uses purely cold-natured herbs to expel fire. Once the fire is expelled, the upper jiao (the area above the diaphragm) will feel relaxed and comfortable.
Furthermore, some people have cold hands and feet, or experience multiple episodes of limb jue-ni (cold limbs extending beyond elbows and knees), trembling body, and aversion to cold, which appears identical to false cold. However, how can one identify this as true cold? In cases of false cold, although hands and feet are cold, they may sometimes become warm; the jue-ni and trembling are not too severe, with periods of calm alternating with spasms. This differs from true cold, where hands and feet remain cold for a long time without warming, turning blue-purple in color, the body trembles incessantly, and the jaw is clenched emitting sounds uncontrollably. The prescription for emergency rescue consists of Aconiti Lateralis Radix Praeparata (Fuzi) 3 qian, Cinnamomi Cortex (Rougui) 1 qian, Zingiberis Rhizoma (Ganjiang) 1 qian, Atractylodis Macrocephalae Rhizoma (Baizhu) 5 qian, and Ginseng Radix (Renshen) 1 liang. This represents direct invasion by cold pathogenic factors, where Kidney Fire (Mingmen Fire) is forced out of the body shell, and Yin-cold qi directly attacks the Heart Palace. Consequently, the Heart Spirit loses its residence, and Liver Qi lacks support, resulting in tremors, jaw clenching, and hands and feet appearing entirely cyan. One might ask, since using Fuzi, Rougui, and Ganjiang to expel cold pathogens should suffice, why add Baizhu and Renshen? Moreover, small doses should be sufficient; why increase them so significantly? It is because the Yuan Yang (fundamental Yang Qi) has fled and scattered, leaving only a thread of breath unextinguished. If Ren Shen is not urgently used to restore vital energy at this precarious moment between life and death, and one relies solely on the pungent and hot herbs like Rougui, Fuzi, and Ganjiang, although the pathogen may be expelled outward, the righteous Qi will also approach extinction. Therefore, it is better to administer larger doses of Ren Shen in critical moments. This is akin to defeated soldiers seeing that an isolated army remains intact and a brave general rallying the scattered troops; would they not then reorganize their banners and spears and rush together to the battlefield? This is the subtlety of true treatment.
Master Zhang said: This is a remarkable theory, opening up new horizons. True treatment is direct treatment; it addresses the root disease directly without deceiving with false remedies. Symptomatic medication is sufficient; I have nothing more to add.
Master Hua said: I agree.