Differentiation of True and False Heat and Cold
Source: “Fu Qingzhu’s Recompiled Exegesis on Male Diseases”
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1. True Heat Syndrome: True heat syndrome is characterized by extreme thirst and a desire for water, a dry and cracked tongue, persistent throat pain day and night, and a feeling of intense heat without sweating.
Prescription:
Ma Huang (Ephedra) (9g), Dang Gui (Angelica Sinensis) (15g), Huang Lian (Coptis) (9g), Huang Qin (Scutellaria) (9g), Sheng Shi Gao (Gypsum) (9g), Zhi Mu (Anemarrhena) (9g), Ban Xia (Pinellia) (9g), Zhi Ke (Bitter Orange) (6g), Gan Cao (Licorice) (3g). Decoction for oral administration; one dose is light, two doses can cure.
2. True Cold Syndrome: True cold syndrome is characterized by cold hands and feet that do not warm up for a long time, a bluish-purple complexion, persistent shivering, and an inability to speak.
Prescription:
Fu Zi (Aconite) (9g), Rou Gui (Cinnamon) (3g), Gan Jiang (Dried Ginger) (3g), Bai Zhu (White Atractylodes) (15g), Ren Shen (Ginseng) (30g).
Decoction for urgent rescue. This is true cold evil, with kidney fire escaping the body, while the yin evil energy directly invades the heart palace, causing the heart to be unguarded and liver qi to be unanchored, resulting in shivering and inability to speak, with hands and feet turning blue. Therefore, using Gui (Cinnamon), Fu (Aconite), and Gan Jiang (Dried Ginger) to expel the cold evil is sufficient; why add Ren Shen (Ginseng) and Bai Zhu (White Atractylodes)? The original yang is fleeting, and only a thread of qi remains; using only Gui, Fu, and Gan Jiang, which are all pungent and hot medicines, will expel the evil, but if the righteous qi is exhausted, how can we restore the righteous qi when it is on the verge of extinction?
3. False Heat Syndrome: Although the mouth is thirsty, it is not severe; the tongue is dry but not cracked, and there are no thorn-like cracks.
Prescription:
Huang Lian (Coptis) (9g), Dang Gui (Angelica Sinensis) (9g), Bai Shao (White Peony) (9g), Ban Xia (Pinellia) (9g), Fu Ling (Poria) (9g), Chai Hu (Bupleurum) (6g), Zhi Zi (Gardenia) (6g), Zhi Ke (Bitter Orange) (3g), Chang Pu (Acorus) (1g).
Decoction for oral administration. This formula is excellent for using Huang Lian to enter the heart palace, assisted by Zhi Zi, directly penetrating without dispersing the evil; Chai Hu and Bai Shao block the enemy’s supply route; Ban Xia and Zhi Ke eliminate the remaining party. Once the central plains are secured, the four corners will return without battle. However, if the fire is strong in the center, improper use will allow the evil to spread, and it will re-enter. Moreover, the pungent heat of Chang Pu, when taken hot, will not cause a counter-reaction but will instead assist.
4. False Cold Syndrome: Cold hands and feet, but sometimes warm; shivering and body shaking, but not too severe; sometimes calm, sometimes twitching.
Prescription:
Fu Zi (Aconite) (3g), Rou Gui (Cinnamon) (3g), Ren Shen (Ginseng) (9g), Bai Zhu (White Atractylodes) (15g), Pig Gallbladder Juice (half), Bitter Herb Juice (3 tablespoons).
First, boil two bowls of water with the herbs, after cooking, place the herbs and container in cold water to cool, then add the gallbladder juice and vegetable juice, mix well, and take it all at once. The formula consists entirely of hot medicines; if not taken properly, it will surely cause false fire to surge upward, resulting in vomiting the medicine. Hot medicines must be taken cool to follow their nature, especially since the downward action is accompanied by the bitterness of the two juices to deceive the false path.
6. True Heat with False Cold: The body feels cold externally but has internal heat, alternating chills and fever, and persistent shivering; this is the manifestation of true heat presenting as false cold to deceive.
Method: Use San Huang Decoction with Shi Gao (Gypsum) and Sheng Jiang (Fresh Ginger), drink it hot. Then use well water to splash on the heart area, repeating twenty to thirty times, until the internal heat stops, and the external shivering also ceases. Afterward, use Yuan Shen (Ophiopogon), Mai Dong (Ophiopogon), and Bai Shao (White Peony) each two taels, decoct and take, allowing free drinking, and it will not be severe afterward.
7. True Cold with False Heat: The lower body is cold while the upper body is very hot, with a desire to drink water, but vomiting upon swallowing; this is true cold presenting as false heat to deceive.
Method: Use Ba Wei Decoction in large doses, cool and take. Then have a strong person rub the soles of the feet, as hot as fire, until the heat ceases. Afterward, use Wu Zhu Yu (Evodia) (30g), Fu Zi (Aconite) (3g), grind into powder, add a little musk and white flour to make a paste, and apply it to the soles of the feet. Soon, there will be deep sleep, and upon waking, the lower body will be warm while the upper body’s heat will subside.
8. Upper Heat and Lower Cold: This syndrome is characterized by excessive fire in the upper jiao, with phlegm vomiting like a gushing spring, a red face, throat pain, and an unwillingness to cover the upper body while the lower body is cold; this is upper false heat and lower true cold.
Prescription:
Shu Di Huang (Rehmannia) (250g), Shan Yao (Chinese Yam) (200g), Dan Pi (Moutan) (150g), Fu Ling (Poria) (150g), Ze Xie (Alisma) (150g), Fu Zi (Aconite) (1), Rou Gui (Cinnamon) (30g), Mai Dong (Ophiopogon) (30g), Wu Wei Zi (Schisandra) (30g).
Use ten bowls of water, decoct to three bowls, cool and take. The dregs can be boiled again with three bowls of water to yield one bowl, taken all at once, and it will immediately calm down; this is the method of treating upper diseases from below.
9. Alternating Heat and Cold: The illness presents with chills followed by fever, indicating insufficient yin meridian, with yang following; insufficient yang meridian, with yin overpowering. What is meant by insufficient yang? The pulse at the cun position is weak, known as insufficient yang. Yin energy enters the yang, causing chills. What is meant by insufficient yin? The pulse at the chi position is weak, known as insufficient yin. Yang energy sinks into yin, causing fever. In treating heat and cold, use Chai Hu (Bupleurum) to raise yang energy, preventing it from sinking into yin, thus avoiding heat; use Huang Qin (Scutellaria) to lower yin energy, preventing it from rising into yang, thus avoiding cold.
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