凡病多能为寒热,但发作有期者疟也,无期者诸病也。〔内因〕经云∶荣之生
病也,寒热少气,血上下行。(小柴胡与四物各半汤。)〔外因〕经云∶风气盛于皮肤之间,
内不得通,外不得泄,风者善行而数变,腠理开则洒然寒,闭则热而闷,其寒也则
衰饮食,其热也则消肌肉,故使人 栗而不能食,名曰寒热。又云∶因于露风,乃
生寒热。又云∶风盛为寒热。(解风汤、防风汤。)〔肺〕经云∶脉之至也,喘而虚,名曰肺
痹,寒热,得之醉而使内也。又曰∶肺脉微急为肺寒热。〔脾〕经云∶脾脉小甚为
寒热。〔太阳〕经云∶三阳为病发寒热。〔阳维〕经云∶阳维为病苦寒热。〔火热
攻肺〕经云∶少阴司天,热气下临,肺气上从,喘呕寒热。又云∶少阳司天,火
气下临,肺气上从,寒热 肿。又云∶少阴司天,热淫所胜,寒热,皮肤痛。又
云∶岁木不及,燥乃大行,复则病寒热,疮疡。治以寒剂。〔寒热相错〕,经云∶阳
明司天之政,天气急,地气明,民病寒热发暴。三之气,燥热交合,民病寒热。又云∶
阳明司天,燥气下临,肝气上从,民病寒热如疟。又云∶少阴司天之政,四之气,
寒热互至,民病寒热。治视寒热多少其制。皮寒热者,不可附席,毛发焦,鼻槁
腊,不得汗,取三阳之络,以补手太阴。肌寒热者,肌痛,毛发焦而唇槁腊,不
得汗,取三阳于下,以去其血者,补足太阴,以出其汗。骨寒热者,病无所安,汗
注不休。齿未槁,取其少阴于阴股之络;齿已槁,死不治。骨厥亦然。(无汗而寒热者,
属表可治。寒热汗出不休,骨寒热者,已入骨髓,故难治也。)灸寒热之法,先灸项大椎,以年
为壮数,(王注云∶如患人之年数。)次灸橛骨,以年为壮数。(尾穷谓之橛骨。)视背 陷者
灸之,(膏肓等 陷者,为筋骨之间陷中也。王注∶以背胛骨际有陷处也。)举臂肩上陷者灸之,
(肩 穴也。)两季胁之间灸之,(京门穴也。)外踝上绝骨之端灸之,(阳辅穴也。)足小指、
次指间灸之,(侠溪穴也。) 下陷脉灸之,(承筋穴也。)外踝后灸之,(昆仑穴也。)
缺盆骨上切之坚动如筋者灸之,(当随其所有而灸之。)膺中陷骨间
灸之,(天突穴也,未详是否。)掌束骨下灸之,(阳池穴也,未详是否。)脐下关元三寸灸之,
毛际动脉灸之,(气冲穴也。)膝下三寸分间灸之,(三里穴也。)足阳明跗上动脉灸之,(冲阳穴也。)巅上
一灸之。(百会穴也。)凡当灸二十九处,灸之不已者,必视其经之过于阳者,数刺其俞而
药之。(按项大椎至巅上一灸之,二十九处也。以上出骨空论。)邪在肺,则病皮肤痛,寒热,上
气喘,汗出,咳动肩背,取之膺中外 ,背三节五脏之旁,以手疾按之快然,乃刺之,
取之缺盆中以越之。小腹满大,身时寒热,小便不利,取足厥阴。络病者,善太
息,口苦,下利,寒热,取阳陵泉。病风,且寒且热,汗出,一日数过,先刺诸
分理络脉;汗出且寒且热,三日一刺,百日而已。凡刺寒热,皆多血络,必间日
而一取之,血尽乃止,乃调其虚实。寒热,五处及天柱、风池、腰 、长强、大杼、
中膂、内俞、上 、龈交、上脘、关元、天牖、天容、合谷、阳溪、关冲、中渚、
阳池、消烁、少泽、前谷、腕骨、阳谷、少海、然谷、至阴、昆仑主之。身寒热,
阴都主之。寒热,刺脑户。风寒热,液门主之。心如悬,阴厥,脚 后廉急,不
可前却,癃癖便脓血,足跗上痛,舌卷不能言,善笑,心下痞,四肢倦,溺青、
赤、白、黄、黑,青取井,赤取荧,黄取输,白取经,黑取合。血痔泄,后
重,腹痛如癃状,卧仆必有所扶持,及失气涎出,鼻孔中痛,腹中常鸣,骨寒热无
所安,汗出不休,复溜主之。骨寒热,溲难,肾 主之。肺寒热,呼吸不得卧,上
气,呕沫,喘,气相追逐,胸满胁膺急,息难,振栗,脉鼓,气鬲,胸中有热,
支满,不嗜食,汗不出,腰脊痛,肺俞主之。咳而呕,鬲寒,食不下,寒热,皮
肉肤痛,少气不得卧,胸满支两胁,鬲上兢兢,胁痛腹 ,胃脘暴痛,上气,
肩背寒痛,汗不出,喉痹,腹中痛,积聚,默默然嗜卧,怠惰不欲动,身常湿湿,
(一作温。)心痛无可摇者,鬲俞主之。咳而胁满急,不得息,不得反侧,腋胁下与
脐相引,筋急而痛,反折,目上视,眩,耳中 然,肩项痛,惊狂,衄,少腹满,目KT KT
生白翳,咳引胸痛,筋寒热,唾血,短气,鼻酸,肝俞主之。寒热食多身羸瘦,两胁引
痛,心下贲痛,心如悬,下引脐,少腹急痛,热,面急,(一作黑。)目KT KT ,久喘咳少
气,溺浊赤,肾俞主之。寒热,咳呕沫,掌中热,虚则肩背寒栗,少气不足以息,
寒厥,交两手而瞀,口沫出。实则肩背热痛,汗出,暴四肢肿,身湿摇肘寒热,饥
则烦,饱则善面色变,(一作痈。)口噤不开,恶风泣出,列缺主之。寒热,胸背急,喉
痹,咳上气喘,掌中热,数欠伸,汗出,善忘,四肢厥逆,善笑,溺白,列缺主之。
胸中膨膨然,甚则交两手而瞀,暴痹喘逆,刺经渠及天腑,此谓之大 。肺系急,
胸中痛,恶寒,胸满悒悒然,善呕胆汁,脑中热,喘,逆气,气相追逐,多浊唾,
不得息,肩背风汗出,面腹肿,鬲中食噎不下,喉痹,肩息肺胀,皮肤骨痛,寒热
烦满,中腑主之。寒热,目KT KT ,善咳,喘逆,通谷主之。烦心咳、寒热善哕,
劳宫主之。寒热,唇口干,身热喘息,目急痛,善惊,三间主之。(一本云∶寒热,心背引痛胸
中不得息,咳唾血涎,烦中善饥,食不下,咳逆,汗不出,如疟状,目泪出,悲伤,心 主之。)
寒热善呕,商丘主之。呕,厥寒,时有微热,胁下支满,喉痛嗌干,膝外廉痛,淫泺胫酸,腋下
肿,马刀 ,肩肿吻伤痛,大冲主之。寒热头痛,喘喝,目不能视,神庭主之。其
目泣出,头不痛者,听会取之。寒热,头痛如破,目痛如脱,喘逆烦满,呕吐流
汗,头维主之。寒热,胸满头痛,四肢不举,腋下肿,上气,胸中有声,喉中鸣,天
池主之。寒热头痛,水沟主之。寒热善怖,头重足寒,不欲食,脚挛,京骨主之。
下部寒,热病汗不出,体重,逆气头眩痛,飞阳主之。肩背痛,寒热,瘰 绕颈有
大气,暴聋气蒙瞀,耳目不开,头颔痛,泪出,目鼻衄,不得息,不知香臭,风眩,
喉痹,天牖主之。寒热酸痛,四肢不举,腋下肿,马刀挟瘿,髀膝胫骨淫泺,酸痹
不仁,阳辅主之。寒热,颈瘰 ,咳呼吸,灸手三里,左取右,右取左。
寒热,颈瘰 ,大迎主之。寒热瘰 ,胸中满,有大气,缺盆中满痛者死。外溃不
死。肩引项不举,缺盆中痛,汗不出,喉痹,咳嗽血,缺盆主之。寒热,颈瘰 ,
肩痛不可举臂, 主之,寒热,颈瘰 ,耳鸣无闻,痛引缺盆,肩中热痛,手臂
不举,肩真主之。寒热瘰 ,目不明,咳上气唾血,肩中 主之。寒热,颈腋下
肿,申脉主之。寒热,颈颔肿,后溪主之。胸中满,耳前痛,齿热痛,目赤痛,颈
肿,寒热,渴饮辄汗出,不饮则皮干热烦,曲池主之。振寒,小指不用,寒热汗不
出,头痛,喉痹,舌急卷,小指之间热,口中热,烦心,心痛,臂内廉痛,聋,咳,
螈,口干,头痛不可顾,少泽主之。振寒寒热,肩 肘臂痛,头不可顾,烦
满身热,恶寒,目赤痛 烂,生翳膜,暴痛,鼽衄,耳聋,臂重痛,肘挛,痂疥,
胸满引 ,泣出而惊,颈项强,身寒,头不可顾,后溪主之。振寒寒热,颈项
肿,实则肘挛,头眩痛,狂易;虚则生疣,小者痂疥,支正主之。寒热,凄厥鼓颔,
承浆主之。肩痛引项,寒热,缺盆主之。身热汗不出,胸中热满,天 主之。寒热
肩肿,引胛中肩臂酸痛, 主之。臂厥,肩膺胸满痛,目中白翳,眼青转筋,
掌中热,乍寒乍热,缺盆中相引痛,数咳喘不得息,臂内廉痛,上鬲饮已烦满,
太渊主之。寒热,腹 央央然,不得息,京门主之。善啮颊齿唇,热病汗不出,
口中热痛,冲阳主之。胃脘痛,时寒热,皆主之。寒热篡反出,承山主之。寒热篡
后出,螈 ,脚 酸重,战栗不能久立,脚急肿痛,趺筋足挛,少腹痛引喉嗌,大
便难,承筋主之。寒热胫肿,丘墟主之。寒热,痹胫不收,阳交主之。跟厥膝急,
腰脊痛引腹,篡阴股热,阴暴痛,寒热膝酸重,合阳主之。寒热解 ,(一作烂。)淫泺
胫酸,四肢重痛,少气难言,至阳主之。寒热,腰痛如折,束骨主之。寒热骨痛,
玉枕主之。黄帝曰∶人之善病寒热,何以候之?少俞答曰∶小骨弱肉者,善病寒热。
黄帝曰∶何以候骨之大小,肉之坚脆,色之不一也?少俞答曰∶颧骨者,骨之本也。
颧大则骨大,颧小则骨小。皮肤薄而其肉无 ,其臂濡濡然,其地色 然,不与
天同色,污然独异,此其候也。然臂薄者,其髓不满,故善病寒热也。问曰∶病
者有洒淅恶寒,而复发热者何也?曰阴脉不足,阳往从之,阳脉不足,阴往乘之。
何谓阳不足,假令寸口脉微,名曰阳不足,阴气上入阳中则洒淅恶寒也。何谓阴
不足,假令尺脉弱,名曰阴不足,阳气下陷入阴中则发热也。(凡治寒热用柴胡之属者,升阳
气使不下陷入阴中,则不热也。用黄芩之属者,降阴气使不得上入阳中,则不寒也。)
上俱《灵》、《素》、《难》、《甲乙》、《金匮》之文,备载之者,以世医书多不列寒热门,
仅仅《纲目》有之,又止针法,少用药之方。然知针所取之经络,则知药之所取,亦犹是矣。吾
非不能一一以药代之,但不欲印定后人眼目。仲景曰∶妇人中风七八日,续得寒热,发作
有时,经水适断,此为热入血室,其血必结,故使如疟状,发作有时,小柴胡汤主
之。小柴胡加减法∶如寒热往来,经水不调,去半夏、加秦艽、芍药、当归、知
母、地骨皮、牡丹皮、川芎、白术、茯苓。如小柴胡汤与四物汤各半,名调经汤。
无孕呕者,加半夏。无汗者,加柴胡。恶寒者,加桂。有汗者,加地骨皮。嗽者,
加紫菀。通经,加京三棱、广术。劳者,加鳖甲。完颜小将军病寒热间作,腕后有
斑三五点,鼻中微血出,两手脉沉涩,胸膈四肢按之殊无大热,此内伤寒也。问之
向者卧殿角伤风,又渴饮冰酪水,此外感者轻,内伤者重,外从内病俱为阴也。故
先斑后衄,显内阴证。寒热间作,脾亦有之,非徒少阳之寒热也。与调中汤数服而
愈。《脉经》云∶大肠有宿食,寒栗发热,有时如疟,轻则消导,重则下之。当求之
伤食门。血中风气,体虚发渴,寒热,地骨皮散。寒热体瘦,肢节疼痛,口干心烦,
柴胡散。产后往来寒热,柴胡四物汤、黄 丸。师尼寡妇,独阴无阳,欲心萌而不
遂,阴阳交争,寒热互作,全类温疟,久则成劳,其肝脉弦长而上鱼际,宜抑阴地
黄丸。结热在里,往来寒热者,大柴胡汤。武阳仇天祥之子,病发寒热,诸医作骨
蒸劳治之,半年病甚。戴人往视之,诊其手脉尺寸皆潮于关,关脉独大。戴人
曰∶肺痈也。问其乳媪,曾有痛处,乳媪曰无。戴人令儿去衣,举其两手,观其两
胁下,右胁稍高。戴人以手侧按之,儿移身避之,按其左胁则不避。戴人曰∶此肺
部有痈,已吐脓矣。
【诊】寸口脉沉而喘,曰寒热。脉沉数细散者,寒热也。(沉细为寒,数散为热。)脉
涩洪大,寒热在中。尺肤烘然,先热后寒,寒热也。(言初扪尺肤则热,久之则寒也。)尺肤先
寒,久之而热者,亦寒热也。(言初扪尺肤则寒,久之则热也。)寒热夺形,脉坚搏,是逆也。
尺肉热者,解 安卧,脱肉者寒热,不治。诊寒热,赤脉上下贯瞳子,见一脉,一
岁死;见一脉半,一岁半死;见二脉,二岁死;见二脉半,二岁半死;见三脉,
三岁死。(见赤脉,不下贯瞳子,可治也。)寒热病者,平旦死。
凡是疾病大多能出现寒热症状,但发作有固定时间规律的是疟疾(一种以间歇性寒战和高热为特征的传染病),没有固定时间规律的是其他各种疾病。
〔内因〕《内经》说:营气(运行于脉中、具有营养作用的气)生病时,会出现寒热、气短,血液在上下部位异常流动。(可用小柴胡汤与四物汤各半合方治疗。)
〔外因〕《内经》说:风气盛发于皮肤之间,内部不能通达,外部不能宣泄。风邪善于游走且变化多端,腠理(皮肤纹理及汗孔)开泄时则感到洒淅恶寒,腠理闭塞时则发热且胸闷。其寒症会导致食欲减退,其热症会消耗肌肉,因此使人战栗而不能进食,这种病名叫寒热。又说:因为暴露于风邪,从而产生寒热。又说:风邪盛极导致寒热。(可用解风汤、防风汤治疗。)
〔肺〕《内经》说:脉搏到来时,气喘而虚弱,名叫肺痹,伴有寒热,这是由于醉酒后进行房事所致。又说:肺脉微急,表现为肺寒热。
〔火热攻肺〕《内经》说:少阴君天之气主令,热气下行,肺气上从,出现气喘、呕吐、寒热。又说:少阳相火之气主令,火气下行,肺气上从,出现寒热、浮肿。又说:少阴君天之气主令,热邪淫胜,出现寒热、皮肤疼痛。又说:岁木之气不及,燥气大行,复气至则病发寒热、疮疡。治疗用寒凉药剂。
〔寒热相错〕,《内经》说:阳明司天之政,天气急迫,地气明盛,百姓患病寒热突发。三之气阶段,燥热交合,百姓患寒热。又说:阳明司天,燥气下行,肝气上从,百姓患寒热如疟状。又说:少阴司天之政,四之气阶段,寒热交替出现,百姓患寒热。治疗视寒热多少而定制方。皮寒热者,身体不能贴近席子,毛发焦枯,鼻干萎缩,无汗,取三阳经的络穴,以补手太阴肺经。肌寒热者,肌肉疼痛,毛发焦枯而唇干萎缩,无汗,取三阳经在下部的穴位,放去瘀血,补足太阴脾经,以引出汗液。骨寒热者,病人坐卧不安,汗出如雨不止。牙齿未干枯,取足少阴肾经在大腿内侧的络穴;牙齿已干枯,属死证,无法治疗。骨厥也是这种情况。(无汗而寒热的,属于表证,可治。寒热汗出不止,骨寒热的,病邪已入骨髓,故难治。)
灸治寒热的方法,先灸项部的大椎穴,壮数按患者年龄计算(王冰注解说:如患者的年龄数)。再灸尾骶骨的橛骨穴,壮数按患者年龄计算。(尾骨尽头称为橛骨。)观察背部凹陷处进行艾灸(膏肓等穴凹陷处,是筋骨之间的陷中。王冰注:以背胛骨际有凹陷处为准)。举起手臂,肩上凹陷处艾灸(肩髃穴也)。两季胁之间艾灸(京门穴也)。外踝上绝骨末端艾灸(阳辅穴也)。足小指、次指间艾灸(侠溪穴也)。腨肠下凹陷脉处艾灸(承筋穴也)。外踝后艾灸(昆仑穴也)。缺盆骨上切按坚硬跳动如筋脉处艾灸(应当随其病变所在而施灸)。胸膺中凹陷骨间艾灸(天突穴也,不详是否确切)。手掌束骨之下艾灸(阳池穴也,不详是否确切)。脐下关元穴三寸处艾灸,毛际动脉处艾灸(气冲穴也)。膝下三寸分肉间艾灸(足三里穴也)。足阳明胃经跗上动脉处艾灸(冲阳穴也)。头顶正中一处艾灸(百会穴也)。凡应当艾灸共二十九处。艾灸后病情不愈的,必须观察经脉中阳气过盛之处,多次针刺其俞穴并用药治疗。(按项大椎至头顶正中一处,共二十九处。以上出自《灵枢·骨空论》。)
邪气在肺,则病皮肤痛,寒热,上气喘促,汗出,咳嗽牵动肩背,取之膺中外俞,背第三椎旁五脏俞穴旁,用手快速按压感到舒适处,然后针刺,取缺盆穴以宣越邪气。小腹满大,身体时而寒热,小便不利,取足厥阴肝经。络脉有病者,喜欢叹气,口苦,腹泻,寒热,取阳陵泉穴。患风病,既寒又热,汗出,一天发作数次,先刺诸分理络脉;汗出且寒热,三日刺一次,百日痊愈。凡针刺治疗寒热,都要选取多血的络脉,必须隔日取一次,血尽才停止,然后调理虚实。寒热症,五处、天柱、风池、腰俞、长强、大杼、中膂、内俞、上髎、龈交、上脘、关元、天牖、天容、合谷、阳溪、关冲、中渚、阳池、消烁、少泽、前谷、腕骨、阳谷、少海、然谷、至阴、昆仑穴主治。身寒热,阴都穴主治。寒热,刺脑户穴。风寒热,液门穴主治。心如悬吊感,阴厥,脚后廉拘急,不能前进后退,癃闭、癖积、便脓血,足背疼痛,舌卷不能言语,喜笑,心下痞塞,四肢倦怠,尿青、赤、白、黄、黑五色,青色取井穴,赤色取荥穴,黄色取输穴,白色取经穴,黑色取合穴。血痔泄泻,里急后重,腹痛如癃状,卧床仆倒必有所扶持,以及失气涎出,鼻孔中痛,腹中常鸣,骨寒热坐卧不安,汗出不止,复溜穴主治。骨寒热,小便困难,肾俞穴主治。肺寒热,呼吸不能平卧,上气,呕吐泡沫,喘,气机相互追逐,胸满胁膺拘急,呼吸艰难,振栗,脉鼓动,气机阻隔,胸中有热,支满,不爱进食,无汗,腰脊痛,肺俞穴主治。咳嗽而呕,膈寒,饮食不下,寒热,皮肉肤痛,气短不能平卧,胸满支撑两胁,膈上惊惧,胁痛腹满,胃脘暴痛,上气,肩背寒痛,无汗,喉痹,腹中痛,积聚,沉默嗜卧,怠惰不欲动,身体常湿湿(一作温),心痛无可摇动者,膈俞穴主治。咳嗽而胁满急,不能呼吸,不能翻身侧卧,腋胁下与脐相牵引,筋脉拘急而痛,反折,目上视,眩晕,耳中嗡嗡作响,肩项痛,惊狂,鼻衄,少腹满,目KT KT生白翳,咳嗽牵引胸痛,筋寒热,唾血,短气,鼻酸,肝俞穴主治。寒热食多身体羸瘦,两胁引痛,心下贲痛,心如悬吊,下引脐,少腹急痛,热,面急(一作黑),目KT KT,久喘咳少气,尿浊赤,肾俞穴主治。寒热,咳呕沫,掌中热,虚则肩背寒栗,气短不足以息,寒厥,交叉双手而昏蒙,口吐沫。实则肩背热痛,汗出,突然四肢肿,身体湿摇肘寒热,饥则烦,饱则善面色变(一作痈),口噤不开,恶风泣出,列缺穴主治。寒热,胸背急,喉痹,咳上气喘,掌中热,频繁呵欠伸懒腰,汗出,健忘,四肢厥逆,喜笑,尿白,列缺穴主治。胸中膨膨然,甚则交叉双手而昏蒙,暴痹喘逆,刺经渠及天府穴,这叫做大风。肺系急,胸中痛,恶寒,胸满悒悒然,喜呕胆汁,脑中热,喘,逆气,气机相互追逐,多浊唾,不能呼吸,肩背风汗出,面腹肿,膈中食物噎不下,喉痹,肩息肺胀,皮肤骨痛,寒热烦满,中府穴主治。寒热,目KT KT,喜咳,喘逆,通谷穴主治。烦心咳、寒热善哕,劳宫穴主治。寒热,唇口干,身热喘息,目急痛,喜惊,三间穴主治。(一本云:寒热,心背引痛胸中不得息,咳唾血涎,烦中善饥,食不下,咳逆,汗不出,如疟状,目泪出,悲伤,心俞穴主治。)寒热善呕,商丘穴主治。呕,厥寒,时有微热,胁下支满,喉痛嗌干,膝外廉痛,淫泺胫酸,腋下肿,马刀瘿,肩肿吻伤痛,大冲穴主治。寒热头痛,喘喝,目不能视,神庭穴主治。其目泣出,头不痛者,听会穴取之。寒热,头痛如破,目痛如脱,喘逆烦满,呕吐流汗,头维穴主治。寒热,胸满头痛,四肢不举,腋下肿,上气,胸中有声,喉中鸣,天池穴主治。寒热头痛,水沟穴主治。寒热善怖,头重足寒,不欲食,脚挛,京骨穴主治。下部寒,热病汗不出,体重,逆气头眩痛,飞阳穴主治。肩背痛,寒热,瘰疬绕颈有大气,暴聋气蒙瞀,耳目不开,头颔痛,泪出,目鼻衄,不能呼吸,不知香臭,风眩,喉痹,天牖穴主治。寒热酸痛,四肢不举,腋下肿,马刀挟瘿,髀膝胫骨淫泺,酸痹不仁,阳辅穴主治。寒热,颈瘰疬,咳呼吸,灸手三里穴,左病右取,右病左取。寒热,颈瘰疬,大迎穴主治。寒热瘰疬,胸中满,有大气,缺盆中满痛者死。外溃不死。肩引项不举,缺盆中痛,无汗,喉痹,咳嗽血,缺盆穴主治。寒热,颈瘰疬,肩痛不可举臂,肩髎穴主治,寒热,颈瘰疬,耳鸣无闻,痛引缺盆,肩中热痛,手臂不举,肩真穴主治。寒热瘰疬,目不明,咳上气唾血,肩中俞穴主治。寒热,颈腋下肿,申脉穴主治。寒热,颈颔肿,后溪穴主治。胸中满,耳前痛,齿热痛,目赤痛,颈肿,寒热,渴饮辄汗出,不饮则皮干热烦,曲池穴主治。振寒,小指不用,寒热汗不出,头痛,喉痹,舌急卷,小指之间热,口中热,烦心,心痛,臂内廉痛,聋,咳,抽搐,口干,头痛不可顾,少泽穴主治。振寒寒热,肩肘臂痛,头不可顾,烦满身热,恶寒,目赤痛烂,生翳膜,暴痛,鼽衄,耳聋,臂重痛,肘挛,痂疥,胸满引胁,泣出而惊,颈项强,身寒,头不可顾,后溪穴主治。振寒寒热,颈项肿,实则肘挛,头眩痛,狂易;虚则生疣,小者痂疥,支正穴主治。寒热,凄厥鼓颔,承浆穴主治。肩痛引项,寒热,缺盆穴主治。身热汗不出,胸中热满,天窗穴主治。寒热肩肿,引胛中肩臂酸痛,肩井穴主治。臂厥,肩膺胸满痛,目中白翳,眼青转筋,掌中热,乍寒乍热,缺盆中相引痛,数咳喘不得息,臂内廉痛,上鬲饮已烦满,太渊穴主治。寒热,腹中晃晃然,不能呼吸,京门穴主治。善啮颊齿唇,热病汗不出,口中热痛,冲阳穴主治。胃脘痛,时寒热,皆主之。寒热篡反出,承山穴主治。寒热篡后出,抽搐,脚酸重,战栗不能久立,脚急肿痛,趺筋足挛,少腹痛引喉嗌,大便难,承筋穴主治。寒热胫肿,丘墟穴主治。寒热,痹胫不收,阳交穴主治。跟厥膝急,腰脊痛引腹,篡阴股热,阴暴痛,寒热膝酸重,合阳穴主治。寒热解 (一作烂),淫泺胫酸,四肢重痛,少气难言,至阳穴主治。寒热,腰痛如折,束骨穴主治。寒热骨痛,玉枕穴主治。黄帝曰:人容易患寒热病,如何诊察?少俞回答说:骨骼小、肌肉弱的人,容易患寒热病。黄帝曰:如何诊察骨的大小,肉的坚脆,色的不一呢?少俞回答说:颧骨是骨的根本。颧大则骨大,颧小则骨小。皮肤薄而其肉无坚实感,其臂濡濡然,其面色晦暗,不与天色同色,污然独异,这是其征候。然而臂薄的人,其髓不满,所以容易患寒热病。问曰:病人有洒淅恶寒,而又发热的是什么原因?答曰:阴脉不足,阳往从之;阳脉不足,阴往乘之。什么叫阳不足?假如寸口脉微,名叫阳不足,阴气上入阳中则洒淅恶寒也。什么叫阴不足?假如尺脉弱,名叫阴不足,阳气下陷入阴中则发热也。(凡治疗寒热使用柴胡类药的,是升举阳气使其不陷入阴中,则不发热的。使用黄芩类药的,是降泄阴气使其不得上入阳中,则不恶寒的。)
以上是《灵枢》、《素问》、《难经》、《甲乙经》、《金匮要略》中的文字,全部记载,是因为世间的医书大多不列出寒热门,仅仅《本草纲目》有之,又只限于针法,缺少用药的方剂。然而知道针灸所取的经络,就知道药物所取的途径,也是一样的。我并非不能用药物一一替代,只是不想限定后人的眼界。张仲景说:妇人中风七八日,续得寒热,发作有时,月经适断,此为热入血室,其血必结,故使如疟状,发作有时,小柴胡汤主治。小柴胡汤加减法:如寒热往来,月经不调,去半夏,加秦艽、芍药、当归、知母、地骨皮、牡丹皮、川芎、白术、茯苓。如小柴胡汤与四物汤各半,名叫调经汤。无孕呕者,加半夏。无汗者,加柴胡。恶寒者,加桂枝。有汗者,加地骨皮。嗽者,加紫菀。通经,加京三棱、广术。劳损者,加鳖甲。完颜小将军患寒热间作,腕后有斑三五点,鼻中微血出,两手脉沉涩,胸膈四肢按之殊无大热,这是内伤寒。询问他先前卧在殿角伤风,又渴饮冰酪水,这是外感轻,内伤重,外从内病俱为阴证。所以先斑后衄,显内阴证。寒热间作,脾也有此症,不仅仅是少阳的寒热。给予调中汤数服而愈。《脉经》说:大肠有宿食,寒栗发热,有时如疟,轻则消导,重则下之。应当求之于伤食门。血中风气,体虚发渴,寒热,用地骨皮散。寒热体瘦,肢节疼痛,口干心烦,用柴胡散。产后往来寒热,用柴胡四物汤、黄芪丸。师尼寡妇,独阴无阳,欲心萌而不遂,阴阳交争,寒热互作,全类温疟,久则成劳,其肝脉弦长而上鱼际,宜用抑阴地黄丸。结热在里,往来寒热者,用大柴胡汤。武阳仇天祥之子,病发寒热,诸医作骨蒸劳治之,半年病甚。戴人前往视之,诊其手脉尺寸皆潮于关,关脉独大。戴人说:这是肺痈。询问其乳媪,曾有痛处,乳媪说无。戴人令儿去衣,举其两手,观其两胁下,右胁稍高。戴人以手侧按之,儿移身避之,按其左胁则不避。戴人说:此肺部有痈,已吐脓矣。
【诊】寸口脉沉而喘,曰寒热。脉沉数细散者,寒热也。(沉细为寒,数散为热。)脉涩洪大,寒热在中。尺肤烘然,先热后寒,寒热也。(言初扪尺肤则热,久之则寒也。)尺肤先寒,久之而热者,亦寒热也。(言初扪尺肤则寒,久之则热也。)寒热夺形,脉坚搏,是逆也。尺肉热者,解 安卧,脱肉者寒热,不治。诊寒热,赤脉上下贯瞳子,见一脉,一岁死;见一脉半,一岁半死;见二脉,二岁死;见二脉半,二岁半死;见三脉,三岁死。(见赤脉,不下贯瞳子,可治也。)寒热病者,平旦死。
Any disease may present with chills and fever, but those with periodic onset are malaria (a contagious disease characterized by intermittent chills and high fever), while those without periodic onset are various other diseases.
[Internal Causes] The Classic says: When Ying Qi (nutritive qi circulating within the vessels) becomes diseased, it presents with chills and fever, shortness of breath, and blood flowing abnormally up and down. (Treat with Xiao Chai Hu Tang combined with Si Wu Tang.)
[External Causes] The Classic says: Wind pathogen prevails between the skin, unable to penetrate inward or diffuse outward. Wind is agile and changes frequently; when Cou Li (skin pores and interstices) open, one feels chilly; when they close, one feels feverish and stifled. The chills lead to decreased appetite, and the heat consumes muscle, causing shivering and inability to eat; this is named Han Re (Chills and Fever). It also says: Exposure to wind leads to chills and fever. It also says: Excess wind causes chills and fever. (Treat with Jie Feng Tang or Fang Feng Tang.)
[Lung] The Classic says: When the pulse arrives, gasping and weakness indicate Fei Bi (Lung Obstruction), accompanied by chills and fever, caused by sexual intercourse after drunkenness. It also says: A slightly urgent Lung pulse indicates Lung Han Re.
[Spleen] The Classic says: A very small Spleen pulse indicates chills and fever.
[Tai Yang] The Classic says: Disease of the Three Yang meridians manifests as chills and fever.
[Yang Wei] The Classic says: Disease of the Yang Wei vessel causes suffering from alternating chills and fever.
[Fire-Heat Attacking Lung] The Classic says: When Shao Yin governs the year, heat qi descends, Lung qi ascends in response, leading to gasping, vomiting, and chills and fever. It also says: When Shao Yang governs the year, fire qi descends, Lung qi ascends in response, leading to chills, fever, and swelling. It also says: When Shao Yin governs the year, excessive heat causes chills and fever, and skin pain. It also says: When Wood Qi is deficient, Dryness prevails greatly; upon return, disease manifests as chills and fever, sores, and ulcers. Treat with cold agents.
[Mixed Cold and Heat] The Classic says: Under Yang Ming governance, Heaven Qi is urgent, Earth Qi is bright, and people suffer from sudden onset of chills and fever. During the Third Qi phase, Dryness and Heat combine, and people suffer from chills and fever. It also says: Under Yang Ming governance, Dryness Qi descends, Liver Qi ascends in response, and people suffer from chills and fever resembling malaria. It also says: Under Shao Yin governance, during the Fourth Qi phase, Cold and Heat alternate, and people suffer from chills and fever. Treatment depends on the proportion of cold and heat. For Pi Han Re (Skin Chills and Fever), the body cannot touch the mat, hair is scorched, nose is dry and atrophic, and there is no sweat; take the Luo-connecting points of the Three Yang meridians to tonify the Hand Taiyin Lung Meridian. For Ji Han Re (Muscle Chills and Fever), muscles ache, hair is scorched, lips are dry and atrophic, and there is no sweat; take points below on the Three Yang meridians to remove blood stasis, and tonify the Foot Taiyin Spleen Meridian to induce sweating. For Gu Han Re (Bone Chills and Fever), the patient has no place to rest comfortably, and sweat pours continuously. If teeth are not yet dried out, take the Luo-connecting points of the Foot Shaoyin Kidney Meridian on the inner thigh; if teeth are already dried out, it is a death case and untreatable. Gu Jue (Bone Jue) is similar. (Chills and fever without sweat belong to the Exterior and are treatable. Chills and fever with continuous sweating, specifically Bone Chills and Fever, indicate the pathogen has entered the bone marrow and is difficult to treat.)
The method for moxibustion in treating chills and fever: First, moxa the Da Zhui point on the neck, using the number of moxa cones equal to the patient's age (Wang Bing notes: equal to the patient's years). Then moxa the Jue Gu point at the tailbone, using the number of moxa cones equal to the patient's age. (The end of the coccyx is called Jue Gu.) Moxa any depressions on the back (such as Gao Huang points, which are depressions between bones and muscles; Wang Bing notes: look for depressions along the scapular border). Moxa the depression above the shoulder when the arm is raised (Jian Yu point). Moxa between the two costal margins (Jing Men point). Moxa the end of the Jue Gu bone above the lateral malleolus (Yang Fu point). Moxa between the little toe and the second toe (Xia Xi point). Moxa the depressed pulse below the calf muscle (Cheng Jin point). Moxa behind the lateral malleolus (Kun Lun point). Moxa where hardness and pulsation like a tendon are felt above the Que Pen bone (moxa according to the lesion). Moxa the depression between the bones in the chest (Tian Tu point, uncertain). Moxa below the metacarpal bones in the palm (Yang Chi point, uncertain). Moxa three cun below the umbilicus at Guan Yuan, and at the arterial pulse at the pubic hairline (Qi Chong point). Moxa three cun below the knee in the muscle gap (Zu San Li point). Moxa the arterial pulse on the dorsum of the foot belonging to the Foot Yangming Stomach Meridian (Chong Yang point). Moxa the vertex (Bai Hui point). There are twenty-nine sites for moxibustion. If moxibustion fails, observe where the Yang meridians are excessive, prick their Shu points repeatedly, and administer medicine. (From Da Zhui to Bai Hui, there are twenty-nine sites. This comes from the "Gu Kong Lun" chapter of Ling Shu.)
When evil is in the Lung, it causes skin pain, chills and fever, upper jiao gasping, sweating, cough pulling on the shoulders and back; take the Yingzhong Wai Shu points in the chest and the five Zang Shu points beside the third thoracic vertebra on the back. Press quickly with hand until comfortable, then needle. Take Que Pen to disperse the evil. If the lower abdomen is full and large, body alternates chills and fever, urination is difficult, take the Foot Jueyin Liver Meridian. If the collaterals are diseased, there is frequent sighing, bitter taste, diarrhea, and chills and fever; take Yang Ling Quan. If wind disease occurs with both chills and fever, sweating, occurring several times a day, first prick the collateral vessels in the muscle intervals; if sweating with chills and fever persists, prick every three days, cure in one hundred days. For all acupuncture treatments of chills and fever, select blood-rich collaterals, treat every other day until blood is exhausted, then regulate deficiency and excess. For chills and fever, Wu Chu, Tian Zhu, Feng Chi, Yao Shu, Chang Qiang, Da Shu, Zhong Lv, Nei Shu, Shang Liao, Yin Jiao, Shang Wan, Guan Yuan, Tian You, Tian Rong, He Gu, Yang Xi, Guan Chong, Zhong Zhu, Yang Chi, Xiao Shuo, Shao Ze, Qian Gu, Wan Gu, Yang Gu, Shao Hai, Ran Gu, Zhi Yin, Kun Lun control it. For body chills and fever, Yin Du controls it. For chills and fever, needle Nao Hu. For wind-cold-heat, Ye Men controls it. If the heart feels suspended, Yin Jue occurs, the posterior aspect of the leg is tight, unable to move forward or backward, strangury, masses, pus and blood in stool, pain on the dorsum of the foot, tongue curled unable to speak, excessive laughter, epigastric fullness, limb fatigue, urine green/red/white/yellow/black; green takes Jing points, red takes Ying points, yellow takes Shu points, white takes Jing points, black takes He points. For bloody hemorrhoids with diarrhea, tenesmus, abdominal pain like strangury, needing support when lying down, passing gas and saliva, pain in nostrils, constant bowel sounds, bone chills and fever with no peace and continuous sweating, Fu Liu controls it. For bone chills and fever with difficult urination, Shen Shu controls it. For lung chills and fever, inability to lie flat due to breathing difficulty, upper jiao gasping, vomiting foam, asthma, chasing qi, chest and hypochondriac tightness, difficult respiration, trembling, pulsating pulse, qi obstruction, heat in chest, fullness, anorexia, no sweat, back and spine pain, Fei Shu controls it. For cough with vomiting, diaphragmatic cold, inability to eat, chills and fever, skin/muscle pain, shortness of breath, inability to lie flat, chest fullness supporting hypochondria, diaphragmatic palpitations, hypochondriac pain, abdominal distension, sudden gastric pain, upper jiao gasping, shoulder/back cold pain, no sweat, bi syndrome of throat, abdominal pain, accumulations, silent lethargy, laziness, damp body sensation, heart pain unshakeable, Ge Shu controls it. For cough with hypochondriac fullness/tightness, inability to breathe or turn over, axillary/hypochondriac pain pulling to umbilicus, tendon tightness/pain, opisthotonos, upward gaze, dizziness, tinnitus, shoulder/neck pain, mania, epistaxis, lower abdominal fullness, leukoma, cough pulling chest pain, tendon chills and fever, hemoptysis, shortness of breath, nasal sourness, Gan Shu controls it. For chills and fever with polyphagia but emaciation, hypochondriac pulling pain, epigastric pain, heart feeling suspended, pulling to umbilicus, lower abdominal acute pain, heat, facial tension (or blackening), leukoma, chronic asthma/cough with shortness of breath, turbid red urine, Shen Shu controls it. For chills and fever, cough/vomiting foam, hot palms, deficiency causing shoulder/back cold chills, shortness of breath, cold jue, crossing hands causing fainting, salivation; excess causing shoulder/back hot pain, sweating, sudden limb swelling, body damp/shaking elbows/chills, irritability when hungry, color change when full (or abscess), locked jaw, aversion to wind/tearing, Lie Que controls it. For chills and fever, chest/back tightness, throat bi, cough/upper jiao gasping, hot palms, frequent yawning/stretching, sweating, amnesia, limb jue ni, excessive laughter, white urine, Lie Que controls it. For chest fullness, severe crossing of hands causing fainting, sudden bi/suffocation, needle Jing Qu and Tian Fu, this is called Great Wind. If lung system is tight, chest pain, aversion to cold, chest oppression, frequent bile vomiting, brain heat, asthma, reverse qi, chasing qi, profuse turbid saliva, inability to breathe, shoulder/back wind-sweating, face/abdominal swelling, food sticking in diaphragm, throat bi, shoulder-breathing lung distension, skin/bone pain, chills/fever/irritation/fullness, Zhong Fu controls it. For chills and fever, leukoma, frequent cough, asthma/reverse, Tong Gu controls it. For vexatious heart/cough, chills/fever/frequent hiccups, Lao Gong controls it. For chills and fever, dry lips/mouth, body heat/gasping, eye pain, frightfulness, San Jian controls it. (Another version: chills/fever, heart/back pulling pain, chest suffocation, coughing blood/phlegm, vexation/hunger, inability to eat, reverse cough, no sweat, malaria-like, tearing eyes, sadness, Xin Shu controls it.) For chills and fever with frequent vomiting, Shang Qiu controls it. For vomiting, cold jue, occasional slight heat, hypochondriac fullness, throat pain/dryness, lateral knee pain, sore legs/armpit swelling, machete goiter, shoulder/lip pain/swelling, Da Chong controls it. For chills/fever/headache, asthmatic drinking, blindness, Shen Ting controls it. For tearing eyes without headache, Ting Hui controls it. For chills/fever, splitting headache, protruding eye pain, asthma/reversal/vexation/fullness, vomiting/sweating, Tou Wei controls it. For chills/fever, chest fullness/headache, limb paralysis, armpit swelling, upper jiao gasping, chest sounds, throat humming, Tian Chi controls it. For chills/fever/headache, Shui Gou controls it. For chills/fever/fear, heavy head/cold feet, anorexia, leg cramps, Jing Gu controls it. For lower jiao cold, heat disease with no sweat, heavy body, reverse qi/dizziness/headache, Fei Yang controls it. For shoulder/back pain, chills/fever, scrofula around neck with large qi, sudden deafness/confusion, ear/eye blockage, head/jaw pain, tearing, eye/nose bleeding, inability to breathe, anosmia, wind dizziness, throat bi, Tian You controls it. For chills/fever/soreness, limb paralysis, armpit swelling, machete/goiter, thigh/knee/leg soreness/numbness, Yang Fu controls it. For chills/fever, neck scrofula, cough/breathing, moxa Shou San Li, left for right, right for left. For chills/fever, neck scrofula, Da Ying controls it. For chills/fever/scrofula, chest fullness, large qi, fullness/pain in Que Pen is death. External ulceration is not fatal. Shoulder pulling neck inability to lift, Que Pen pain, no sweat, throat bi, coughing blood, Que Pen controls it. For chills/fever, neck scrofula, shoulder pain inability to raise arm, Jian Liao controls it. For chills/fever, neck scrofula, tinnitus/deafness, pain pulling to Que Pen, shoulder heat/pain, arm inability to lift, Jian Zhen controls it. For chills/fever/scrofula, blurred vision, cough/upper jiao gasping/hemoptysis, Jian Zhong Shu controls it. For chills/fever, neck/armpit swelling, Shen Mai controls it. For chills/fever, neck/jaw swelling, Hou Xi controls it. For chest fullness, pre-auricular pain, tooth heat/pain, eye redness/pain, neck swelling, chills/fever, sweating upon drinking thirst, dry/hot/vexation without drinking, Qu Chi controls it. For shaking chills, little finger dysfunction, chills/fever/no sweat, headache, throat bi, stiff/curled tongue, heat between little fingers, mouth heat, vexation, heart pain, medial arm pain, deafness, cough, convulsions, dry mouth, headache inability to turn head, Shao Ze controls it. For shaking chills/chills and fever, shoulder/elbow/arm pain, head inability to turn, whole body heat/vexation, aversion to cold, red/rotten eyes, leukoma, sudden pain, rhinorrhea/epistaxis, deafness, heavy arm pain, elbow contracture, crusts/scabies, chest fullness pulling ribs, tearing/fright, neck stiffness, body cold, head inability to turn, Hou Xi controls it. For shaking chills/chills and fever, neck swelling, excess causing elbow contracture/dizziness/headache/mania; deficiency causing warts/small crusts/scabies, Zhi Zheng controls it. For chills and fever, chilling/chattering jaws, Cheng Jiang controls it. For shoulder pain pulling neck, chills and fever, Que Pen controls it. For body heat/no sweat, chest heat/fullness, Tian Chuang controls it. For chills/fever/shoulder swelling, pulling scapula/shoulder/arm soreness, Jian Jing controls it. For Bi Jue, shoulder/chest fullness/pain, leukoma, blue eyes/tendon spasms, hot palms, alternating chills/fever, pulling pain in Que Pen, frequent cough/asthma/inability to breathe, medial arm pain, upper diaphragm fluid retention/vexation/fullness, Tai Yuan controls it. For chills and fever, abdominal wobbling, inability to breathe, Jing Men controls it. For biting cheeks/teeth/lips, heat disease/no sweat, mouth heat/pain, Chong Yang controls it. For gastric pain, intermittent chills/fever, both controlled by it. For chills/fever with anus prolapse, Cheng Shan controls it. For chills/fever with post-anal discharge, convulsions, leg soreness/heaviness, trembling inability to stand long, leg acute swelling/spasm, lower abdominal pain pulling to throat, difficult defecation, Cheng Jin controls it. For chills/fever/calf swelling, Qiu Xu controls it. For chills/fever, bi/calf flaccidity, Yang Jiao controls it. For heel jue/knee urgency, back/spine pain pulling abdomen, yin groin heat, sudden yin pain, chills/fever/knee soreness/heaviness, He Yang controls it. For chills/fever with rotting/soreness, leg soreness, limb heaviness/pain, shortness of speech, Zhi Yang controls it. For chills/fever, waist pain like breaking, Shu Gu controls it. For chills/fever/bone pain, Yu Zhen controls it.
Huang Di said: How to diagnose those prone to chills and fever? Shao Yu answered: Those with small bones and weak flesh are prone to chills and fever. Huang Di asked: How to diagnose bone size, flesh firmness, and complexion differences? Shao Yu answered: The zygomatic bone is the root of bone. Large zygoma means large bones; small zygoma means small bones. Thin skin and soft flesh, flaccid arms, dark complexion differing from heaven, distinctively dirty, are signs. Thin arms mean insufficient marrow, hence prone to chills and fever. Question: Why do patients have chilly aversion followed by fever? Answer: Insufficient Yin pulse, Yang follows; insufficient Yang pulse, Yin attacks. What is Yang insufficiency? If Cun Kou pulse is faint, it is Yang insufficiency; Yin qi enters Yang causing chilly aversion. What is Yin insufficiency? If Chi pulse is weak, it is Yin insufficiency; Yang qi sinks into Yin causing fever. (Treating chills/fever with Chai Hu group raises Yang to prevent sinking into Yin, preventing fever. Using Huang Qin group lowers Yin to prevent entering Yang, preventing chills.)
The above texts are from Ling Shu, Su Wen, Nan Jing, Jia Yi Jing, and Jin Gui Yao Lue. They are fully recorded because most medical books lack a Chills and Fever section, and Ben Cao Gang Mu only lists acupuncture methods, lacking herbal formulas. However, knowing the meridians for acupuncture reveals the pathways for herbs. I could replace them with herbs, but do not wish to limit future practitioners' perspectives. Zhang Zhongjing said: Women with wind-stroke for seven-eight days, developing intermittent chills/fever coinciding with menstruation cessation, is Heat Entering Blood Chamber, blood coagulation, resembling malaria with periodic onset; treat with Xiao Chai Hu Tang. Xiao Chai Hu Tang modifications: For alternating chills/fever and irregular menstruation, remove Ban Xia, add Qin Jiao, Shao Yao, Dang Gui, Zhi Mu, Di Gu Pi, Mu Dan Pi, Chuan Xiong, Bai Zhu, Fu Ling. Half Xiao Chai Hu Tang plus half Si Wu Tang is named Tiao Jing Tang. For non-pregnant vomiting, add Ban Xia. For no sweat, add Chai Hu. For aversion to cold, add Gui Zhi. For sweating, add Di Gu Pi. For cough, add Zi Wan. For promoting menstruation, add Jing San Leng, Guang Zhu. For consumption, add Bie Jia. General Wanyan suffered intermittent chills/fever, spots on wrist, slight epistaxis, deep/rough pulses, no significant heat on pressing chest/limbs; this is internal cold injury. Inquiry revealed prior wind-strike in palace corner and craving ice milk; external pathogen was light, internal injury heavy, both exterior and interior are Yin. Hence spots before epistaxis indicates internal Yin syndrome. Intermittent chills/fever can be Spleen, not just Shaoyang. Treated with Tiao Zhong Tang, cured. Mai Jing says: Retained food in Large Intestine causes chills/fever resembling malaria; mild cases use digestion-promoting methods, severe cases use purgatives. Refer to Food Injury section. Wind in blood, deficiency thirst, chills/fever, use Di Gu Pi San. Chills/fever/emaciation/joint pain/dry mouth/vexation, use Chai Hu San. Postpartum alternating chills/fever, use Chai Hu Si Wu Tang, Huang Qi Wan. Nuns/widows, solitary Yin without Yang, suppressed desire, Yin/Yang conflict, alternating chills/fever resembling warm malaria, becoming consumption, Liver pulse string-taut reaching fish abundance, use Yi Yin Di Huang Wan. Internal heat binding, alternating chills/fever, use Da Chai Hu Tang. Son of Qiu Tianxiang had chills/fever, doctors treated as bone-steaming consumption, worsened over six months. Dai Ren examined, pulse surging at Guan, Guan pulse alone large. Dai Ren said: Lung Abscess. Asked wet nurse about pain, she denied. Dai Ren undressed child, raised arms, observed hypochondria, right side slightly higher. Pressed right side, child avoided; pressed left, no avoidance. Dai Ren said: Lung abscess, already expectorating pus.
[Diagnosis] Cun Kou pulse deep and gasping indicates chills and fever. Deep, rapid, fine, scattered pulse indicates chills and fever. (Deep/fine is cold, rapid/scattered is heat.) Choppy, surging, large pulse indicates chills and fever in the middle. Chi skin burning, heat then cold, indicates chills and fever. (Touching Chi skin first hot, then cold after time.) Chi skin initially cold, then hot after time, also indicates chills and fever. (Touching Chi skin first cold, then hot after time.) Chills and fever wasting form, firm/grasping pulse is adverse. Hot Chi flesh, relaxed lying, emaciated chills and fever is untreatable. Diagnosing chills and fever: Red vessels penetrating pupil vertically. One vessel seen, death in one year; one and a half, death in one and a half years; two vessels, death in two years; two and a half, death in two and a half years; three vessels, death in three years. (If red vessels do not penetrate pupil, treatable.) Chills and fever patients die at dawn.