Inheriting the fire of Qi Huang, a public account with substance and warmth.
Ai Yu Xiang Tang
1. Wind-Cold Constraining the Exterior Type of Aversion to Cold [Etiology] Wind and cold evil bind the exterior, causing the defensive yang to be obstructed. [Symptoms] Aversion to cold, slight fever, no sweating, pain in the head and body, no thirst, thin white tongue coating, floating tight pulse. [Treatment Method] Spicy warm exterior-releasing, dispersing wind and scattering cold. [Main Formula] Ma Huang Tang (Ephedra Decoction) with modifications.
2. Cold in the Shaoyin Type of Aversion to Cold [Etiology] Congenital heart and kidney yang deficiency, cold evil invading the Shaoyin. [Symptoms] Aversion to cold without fever, fatigue, cold limbs, mental fatigue, vomiting, clear diarrhea, clear and long urination, pale tongue with white coating, deep weak pulse. [Treatment Method] Warm yang and disperse cold. [Main Formula] Si Ni Tang (Frigid Extremities Decoction). 3. Yang Deficiency with Yin Excess Type of Aversion to Cold [Etiology] Internal injury from overwork, or prolonged illness leading to weakened yang, resulting in internal cold and aversion to cold. [Symptoms] Aversion to cold, cold limbs, fatigue and weakness, shortness of breath, reluctance to speak, no thirst, loose stools, clear and long urination, pale complexion, pale tongue, deep slow weak pulse. [Treatment Method] Warm yang and dispel cold. [Main Formula] ① For kidney yang deficiency, use You Gui Yin (Restorative Kidney Decoction). ② For spleen yang deficiency, use Fu Zi Li Zhong Tang (Aconite Decoction for Regulating the Middle). ③ For heart yang deficiency, use Gui Zhi Gan Cao Tang (Cinnamon Twig and Licorice Decoction). 4. Yang Excess Constraining Yin Type of Aversion to Cold [Etiology] Pathogenic heat deeply hidden within, yang qi obstructed internally, unable to reach the exterior. [Symptoms] Aversion to cold with cold limbs, thirst with preference for cold drinks, heat in the chest, abdominal palpation reveals heat, dry throat with bad breath, constipation, short yellow urination, red tongue with yellow coating, hidden pulse. [Treatment Method] Clear and drain internal heat. [Main Formula] Bai Hu Tang (White Tiger Decoction) or Cheng Qi Tang (Purge the Qi Decoction). 5. Phlegm-Dampness Stagnation Type of Aversion to Cold [Etiology] Phlegm and dampness stagnate internally, preventing yang qi from circulating. [Symptoms] Aversion to cold, heavy limbs, fullness and oppression in the chest and abdomen, poor appetite, thirst without desire to drink, greasy tongue coating, slippery pulse. [Treatment Method] Unblock yang and transform phlegm. [Main Formula] Ling Gui Zhu Gan Tang (Poria, Cinnamon, Atractylodes, and Licorice Decoction) with modifications. 6. Periumbilical Aversion to Cold [Etiology] Caused by water retention internally, cold congealing in the small intestine, and deficiency of spleen and kidney yang, leading to inability to protect the exterior. [Symptoms] Periumbilical aversion to cold, as if blown by cold wind. Even in summer, at night and midnight, the abdomen still needs to be covered with a cotton blanket. Accompanied by dull abdominal pain, rumbling intestines, loose stools, poor appetite, fatigue, pale complexion, heavy lower back and knees, slight swelling of the feet, dry mouth without desire to drink, pale tongue, white slippery coating, deep thin and wiry pulse. [Treatment Method] Disperse internal dampness, warm yang and disperse cold. [Main Formula] Hui Yang Jiu Ji Tang (Revive Yang Emergency Decoction) with modifications. Famous Expert Experience Theory Li Yongcui
Fever with aversion to cold arises from yang. No fever with aversion to cold arises from yin. Nighttime cold indicates strong yin qi over yang. Daytime cold indicates overflowing yin qi within yang. Severe yin indicates cold both day and night. Yang deficiency leads to external cold, while yin excess leads to internal cold. Other conditions such as wind, cold, summer heat, dampness, phlegm, fire, stasis, and sores, all evils stagnate at the surface, preventing the yang qi from emerging, causing aversion to cold. Those with aversion to cold, even in a tightly enclosed room or near a blazing fire, still feel cold and constricted, to the point of hair standing on end, teeth chattering, unlike the aversion to wind, where one feels cold only in the presence of wind and is comfortable without it. Aversion to cold can be categorized into types such as yang deficiency, overwork, lung fire, phlegm-dampness, alcohol injury, food injury, sore toxins, stagnant fire, and postpartum conditions (briefly). Differentiating internal and external aversion to cold: External aversion to cold does not resolve even near a blazing fire, while internal aversion to cold stops with slight warmth. For disharmony of the defensive qi and aversion to cold, use Tiao Zhong Yi Qi Tang (Regulate the Middle and Benefit Qi Decoction). For weak spleen and stomach, use Bu Zhong Yi Qi Tang (Tonify the Middle and Benefit Qi Decoction). For yang deficiency, use Si Jun Zi Tang (Four Gentlemen Decoction) with Huang Qi (Astragalus), Pao Jiang (Dry-fried Ginger), Rou Gui (Cinnamon), and Fu Zi (Aconite). For exterior deficiency, use Huang Qi Jian Zhong Tang (Astragalus Decoction for Strengthening the Center). For turbid phlegm obstructing the diaphragm, first use ginger tea to induce vomiting, then use Tong Sheng San (Unblock the Sage Powder) with modifications. For lung fire, use Gan Ju Tang (Sweet Orange Decoction) with Jiu Qian (Wine-processed Scutellaria), Tian Mai Dong (Ophiopogon), and Shan Zhi Ren (Gardenia). If aversion to cold persists and various medicines are ineffective, it is also advisable to resolve stagnation. Generally, the symptoms of aversion to cold vary widely. However, people often associate aversion to cold with the Taiyang channel. This channel’s qi is stagnant and does not flow, or turbid phlegm obstructs the meridians, so Qiang Huo (Notopterygium) must be added to the medicine to disperse the Taiyang evil. 7. Half-Body Aversion to Cold [Etiology] Sweating is uneven, leading to partial dryness. [Symptoms] Half-body aversion to cold or aversion to wind, easy sweating, temperature lower than the healthy side. [Treatment Method] Tonify qi, invigorate blood, and unblock the meridians. [Main Formula] Bu Yang Huan Wu Tang (Tonify Yang and Restore Five Decoction) with modifications. Famous Expert Experience Theory Qin Bomei Half-side cold is relatively rare. The patient feels cold from head to toe, but one half of the body is not warm, and when sweating occurs, only one side is dry. When exposed to wind, one side feels cold first, joints move freely, with soreness and weakness, and the pulse is deep and thin. Use You Gui Yin with Dang Gui (Angelica), Xi Xin (Asarum), to warm and circulate yang qi, and unblock the blood vessels. 8. Cold Shivering Internal Treatment Differentiation Cold Evil Constraining the Exterior Type of Shivering [Etiology] External cold attacks the surface, evil obstructs the meridians, and the pores are closed, causing defensive qi to stagnate. [Symptoms] Aversion to cold with shivering, high fever without sweating, pain in the head and body, thin white tongue coating, wiry tight pulse. [Treatment Method] Spicy warm exterior-releasing. [Main Formula] Ma Huang Tang (Ephedra Decoction) with modifications. 9. Yang Deficiency with Cold Excess Type of Shivering [Etiology] Yang qi is weak, or cold evil injures yang, leading to internal cold excess. [Symptoms] Aversion to cold with shivering, cold limbs, relief from warmth, pale tongue, deep weak pulse. [Treatment Method] Warm yang and dispel cold. [Main Formula] Si Ni Tang (Frigid Extremities Decoction) with modifications. 10. Shivering with Sweating Type of Shivering [Etiology] External febrile disease, intense struggle between evil and righteous qi. [Symptoms] During the process of external febrile disease, sudden aversion to cold, even cold limbs, deep pulse, followed by profuse sweating, after sweating, heat subsides and body cools. [Treatment Method] Benefit qi and restore yang. [Main Formula] Shen Fu Tang (Ginseng and Aconite Decoction). 11. External Cold with Wind Heat Type of Shivering [Etiology] Initial internal heat, followed by external cold, causing cold evil to bind externally and heat evil to stagnate internally. [Symptoms] Aversion to cold with shivering, cold limbs, pain in the head and body, fever, thirst, restlessness, constipation, short red urination, red tongue with yellow coating, floating tight and rapid pulse. [Treatment Method] Detoxify and clear internal heat. [Main Formula] Fang Feng Tong Sheng Tang (Siler and Unblock the Sage Decoction). Famous Expert Experience Theory Qin Bomei Aversion to cold with shivering, referred to as “shivering cold,” is commonly seen in diseases like “malaria.” In the process of typhoid and warm diseases, sudden shivering occurs, the patient appears extremely fatigued, and after sweating, gradually calms down, referred to as “shivering sweat.” This indicates that the patient’s righteous qi is weak, and when there is an opportunity for recovery, the righteous qi rises to struggle with the evil qi. If the righteous qi prevails, sweating occurs, and the evil is resolved. Therefore, after shivering, if sweating occurs, it is life-giving; if sweating does not occur, it is fatal, which is a critical moment. If there is no collapse, it can be left to nature without panic; if necessary, pulse soup can be adjusted to support the original qi. “Shivering cold” is similar to shivering, but the difference is: shivering arises from within, while shivering is merely physical movement. Shivering is often caused by yang deficiency unable to protect the exterior, often accompanied by abdominal pain and diarrhea, cold limbs, and difficulty in urination, indicating a disease in the Shaoyin, treated by supporting yang with Zhen Wu Tang (True Warrior Decoction). 12. Long-term Morning and Evening Shivering [Etiology] Both Ying and Wei are deficient, and the Taiyang and Taiyin fail to perform their functions. [Symptoms] Morning and evening aversion to cold, shivering, the whole body feels like chicken skin, about 1 hour later, limbs are cold, pale complexion, thin tongue, weak pulse. [Treatment Method] Warm the middle, tonify deficiency, and harmonize Ying and Wei. [Main Formula] Xiao Jian Zhong Tang (Minor Construct the Middle Decoction) from “Shang Han Lun” 13. Midnight Shivering [Etiology] Due to the deficiency of the Jueyin channel, unable to smoothly connect with the Taiyin, blood injures qi, yin injures yang, yang deficiency leads to cold, hence the cold and shivering. [Symptoms] At midnight, shivering occurs, cold limbs, towards dawn, profuse sweating occurs, until dawn, sweating stops and shivering settles. Accompanied by shortness of breath, palpitations, abdominal distension after eating, cold pain in the lower abdomen, dark complexion, pale tongue, thin white coating, deep thin and wiry pulse. [Treatment Method] Benefit qi, assist yang, consolidate sweating and secure the exterior, harmonize yin and yang. [Main Formula] Zai Zao, Mu Li San (Recreate, Oyster Shell Powder) type. 14. Only Heat without Cold Internal Treatment Differentiation: Pathogenic Heat in the Lung Type of Only Heat without Cold [Etiology] Wind-heat evil rises, or external cold evil stagnates and transforms into heat, pathogenic heat invades the lung, heat scorches lung fluids into phlegm, phlegm-heat obstructs, lung fire clears and descends. [Symptoms] Fever without aversion to cold, cough with chest pain, thick and viscous yellow phlegm, coarse breathing, sore throat, thirst, red tongue, yellow dry or yellow greasy coating, slippery rapid pulse. [Treatment Method] Clear lung, drain heat, transform phlegm, and stop cough. [Main Formula] Ma Xing Shi Gan Tang (Ephedra, Apricot Kernel, Gypsum, and Licorice Decoction) with modifications. 15. Heat Excess in the Yangming Type of Only Heat without Cold [Etiology] Pathogenic heat invades the Yangming channel. [Symptoms] No aversion to cold, but fever, strong fever, red face, profuse sweating, great thirst, yellow scant urination, red tongue with yellow coating, large pulse. [Treatment Method] Clear and drain qi-level pathogenic heat. [Main Formula] Bai Hu Tang (White Tiger Decoction). 16. Heat Binding in the Intestines Type of Only Heat without Cold [Etiology] Pathogenic heat invades the Yangming organ. [Symptoms] Strong fever without aversion to cold, worse in the afternoon, abdominal fullness and pain, firm upon palpation, constipation or heat binding with side flow. Severe cases may lead to confusion and delirium, restlessness, red tongue with dry or black coating, deep solid pulse. [Treatment Method] Drain heat, unblock the intestines, and attack dryness and binding. [Main Formula] San Yi Cheng Qi Tang (Three One Purge Decoction). 17. Damp-Heat Stagnation Type of Only Heat without Cold [Etiology] The transition between summer and autumn and during rainy and humid seasons, damp-heat coexists. [Symptoms] Body heat fluctuates without aversion to cold, worse in the afternoon, sweating not smooth, thirst without desire to drink, chest tightness and epigastric fullness, heavy body, poor appetite, yellow greasy tongue coating, wiry slippery rapid pulse. [Treatment Method] Disperse qi, transform dampness, clear heat, and reach the evil. [Main Formula] San Ren Tang (Three Nut Decoction). 18. Summer Heat Injuring Qi Type of Only Heat without Cold [Etiology] Summer heat injures, excessive sweating injures fluids and qi, or sleeping outdoors and eating cold food, summer evil invades the body. [Symptoms] Fever without aversion to cold, headache, red face, coarse breathing, chest tightness, thirst with desire to drink, excessive sweating, red tongue, yellow dry coating, rapid pulse. [Treatment Method] Clear summer heat, drain heat, benefit qi, and generate fluids. [Main Formula] Wang’s Qing Shu Yi Qi Tang (Wang’s Clear Summer Heat and Benefit Qi Decoction). 19. Upper Heat and Lower Cold ① This is one of the manifestations of mixed cold and heat, referring to the patient exhibiting heat syndrome in the upper body and cold syndrome in the lower body at the same time. The etiology and pathology are due to mixed cold and heat, with yang excess in the upper body and yin excess in the lower body. ② It refers to kidney yang deficiency, with yin cold excess in the lower body, fire not returning to the source, and virtual yang rising, which is a manifestation of true cold below and false heat above. Internal Treatment Differentiation: Virtual Cold Type of Upper Heat and Lower Cold [Etiology] Lower source is cold and deficient, yang qi rises. [Symptoms] Slightly red complexion as if drunk, cold feet and shins, whole body feels cold and fearful of cold, loose stools, deep thin pulse. [Treatment Method] Unblock yang and rescue the reverse. [Main Formula] Bai Tong Tang (White Unblock Decoction). 20. Virtual Fire Type of Upper Heat and Lower Cold [Etiology] Kidney yin deficiency leads to virtual fire rising. [Symptoms] Hot head and cold feet, dry throat, red eyes, heat in the chest, thin rapid pulse. [Treatment Method] Nourish yin and lower fire. [Main Formula] Liu Wei Di Huang Wan (Six Flavor Rehmannia Pill) with modifications. 21. Half-Body Heat [Etiology] Emotional distress leads to liver qi stagnation, transforming into fire, darkening liver yin, thus causing half-body heat. [Symptoms] Half-body heat, feeling as if on fire from head to toe. Accompanied by dizziness, fatigue, half-body heat worse in the afternoon. Emotional distress leads to frequent occurrences. Red complexion, thin rapid pulse. [Treatment Method] Extinguish wind and drain heat. [Main Formula] Zhen Gan Xi Feng Tang (Calm the Liver and Extinguish Wind Decoction) with modifications. 22. Lower Body Heat [Etiology] Yin blood deficiency, yang has no attachment. [Symptoms] Lower body burning heat, especially in the genital area, dizziness, spontaneous sweating, dry throat, red urination, hot hands and feet, pale tongue, thin yellow coating, weak pulse. [Treatment Method] Nourish yin and clear heat. [Main Formula] Qin Jiao Bie Jia San (Gentiana and Turtle Shell Powder). 23. Morning Fever [Etiology] Due to excessive yang heat in the liver and stomach. [Symptoms] Morning restlessness, more active in the afternoon, able to sleep. Morning temperature above 40°C, drops to around 38°C in the afternoon, sweating and body heat, thirst, red tongue with yellow coating, rapid pulse. [Treatment Method] Clear heat and generate fluids. [Main Formula] Bai Hu Tang (White Tiger Decoction) with modifications. 24. Afternoon High Fever [Etiology] Shaoyang pivot is not functioning well, blood stasis obstructs, combined with Taiyang’s exterior yang deficiency and Shaoyin’s internal yin deficiency. [Symptoms] Fever occurs around 3 PM daily, first feeling cold in the back, then alternating between chills and fever, hot hands and feet, nausea, chest pain, cold extremities, self-resolving after a few hours, poor appetite, pale tongue, slightly dark, deep rapid pulse. [Treatment Method] Harmonize Shaoyang, invigorate blood and resolve stasis. [Main Formula] Xiao Chai Hu Tang (Minor Bupleurum Decoction) and Dang Gui Cheng Qi Tang (Angelica Purge Decoction). 25. Midnight Fever [Etiology] Due to yin fluid deficiency, leading to internal virtual heat. [Symptoms] Normal temperature during the day. At night, feels bone steaming and tidal heat, especially in the hands and feet, sweating during sleep, unable to sleep peacefully. Accompanied by dizziness, shortness of breath, abdominal distension after eating, cold pain in the lower abdomen, dark complexion, pale tongue, thin coating, rapid pulse. [Treatment Method] Tonify kidney and strengthen spleen. [Main Formula] Zi Sheng Tang (Nourishing Life Decoction). 26. Aversion to Cold and Fever Aversion to cold and fever is one of the main symptoms of external contracted surface syndrome. Internal Treatment Differentiation: Wind-Cold Invading the Surface Type of Aversion to Cold and Fever [Etiology] Wind and cold invade the Taiyang channel, obstructing the pores, and the defensive yang is restrained. [Symptoms] Aversion to cold with fever, heavy aversion to cold, light fever, pain in the head and body, no sweating, nasal congestion with runny nose, heavy cough, thin white tongue coating, floating tight pulse. [Treatment Method] Spicy warm sweating. [Main Formula] Jing Fang Bai Du San (Siler and Unblock the Evil Powder). 27. Wind-Heat Invading the Lung Type of Aversion to Cold and Fever [Etiology] External wind-heat, disharmony of the surface, lung loses its ability to diffuse and descend. [Symptoms] Fever with aversion to cold, heavy fever, light aversion to cold, slight sweating, headache, red throat, dry mouth, cough, thin yellow tongue coating, floating rapid pulse. [Treatment Method] Spicy cool exterior-releasing. [Main Formula] Yin Qiao San (Honeysuckle and Forsythia Powder). 28. Wind-Dampness Invading the Surface Type of Aversion to Cold and Fever [Etiology] Wind-dampness invades the muscles and obstructs the clear yang. [Symptoms] Aversion to cold with fever, heavy body, head feels wrapped, joint pain, white greasy tongue coating, slippery rapid pulse. [Treatment Method] Disperse wind and eliminate dampness. [Main Formula] Qiang Huo Sheng Shi Tang (Notopterygium and Eliminate Dampness Decoction). 29. Summer Heat and Dampness Interfering Type of Aversion to Cold and Fever [Etiology] Summer heat injures, excessive heat combined with dampness, obstructing the qi mechanism. [Symptoms] Aversion to cold with fever, light aversion to cold, heavy fever, head feels swollen, chest tightness, nausea, sweating, thirst, short red urination, yellow greasy tongue coating, slippery rapid pulse. [Treatment Method] Disperse summer heat and clear heat. [Main Formula] Xin Jia Xiang Ru Yin (Newly Added Aromatic Drink). 30. Alternating Cold and Heat Refers to sudden cold and heat, alternating aversion to cold and fever appearing multiple times a day. Internal Treatment Differentiation: Evil Entering the Shaoyang Type of Alternating Cold and Heat [Etiology] Typhoid fever in the Taiyang stage unresolved, evil transmits to the Shaoyang, evil and righteous qi struggle, if evil prevails, aversion to cold occurs, if righteous prevails, fever occurs. [Symptoms] Alternating cold and heat, irritability, preference for vomiting, bitter mouth, dry throat, dizziness, fullness in the chest and hypochondria, red tongue edges, thin yellow coating, wiry rapid pulse. [Treatment Method] Harmonize Shaoyang. [Main Formula] Xiao Chai Hu Tang (Minor Bupleurum Decoction). 31. Liver Qi Stagnation Type of Alternating Cold and Heat [Etiology] Liver qi stagnation leads to heat transformation. [Symptoms] Alternating cold and heat, resembling malaria. Accompanied by vomiting, acid reflux, chest and hypochondriac pain, abdominal distension, dizziness, pale tongue, thin coating, wiry pulse. [Treatment Method] Soothe the liver and resolve stagnation. [Main Formula] Xiao Yao San (Free and Easy Wanderer Powder). 32. Infection with Malaria Evil Type of Alternating Cold and Heat [Etiology] External injury from wind, cold, summer heat, and dampness, combined with malaria evil. [Symptoms] Alternating cold and heat, occurring every other day or every three days, with a fixed time. During the attack, first aversion to cold, followed by high fever, finally profuse sweating, heat subsides and body returns to normal, red tongue, thin white or yellow greasy coating, wiry pulse. [Treatment Method] Remove evil and intercept malaria. [Main Formula] Qi Bao San (Seven Treasure Powder). 33. Damp-Heat Obstructing the Three Jiao Type of Alternating Cold and Heat [Etiology] Damp-heat pathogenic disease, heat phlegm lingers in the three jiao, obstructing the qi transformation. [Symptoms] Alternating cold and heat, sweating not smooth, headache, irritability, chest tightness, abdominal distension, nausea and vomiting, dry mouth with little drinking, short yellow urination, red tongue edges, thick greasy coating, or white like accumulated powder, slippery pulse. [Treatment Method] Separate and disperse, promote qi mechanism. [Main Formula] Huang Lian Wen Dan Tang (Coptis and Warm Gallbladder Decoction). Famous Expert Experience Theory Qin Bomei A spell of cold and a spell of heat, occurring once a day or multiple times a day, is referred to as “alternating cold and heat.” This type of fever can sometimes resolve, but it cannot always resolve. Any fever that arises from external contraction is a Shaoyang channel syndrome, often accompanied by bitter mouth, dry throat, dizziness, fullness in the chest and hypochondria, and wiry rapid pulse, treated with Xiao Chai Hu Tang, and sweating, vomiting, or purging should not be used.
Women with menstrual irregularities often experience sudden cold and sudden heat before menstruation, with symptoms of headache and chest and hypochondriac tightness, caused by liver qi or liver fire stagnation, which can be treated with Tiao Jing Tang (Regulate Menstruation Decoction) (i.e., Xiao Chai Hu Tang combined with Si Wu Tang). Some women may experience menstrual onset or just after menstruation, with external wind-cold and fever, or during the fever period, menstruation occurs, with evil heat invading the uterus, stasis heat intermingling, also causing alternating cold and heat, as stated in the “Jin Gui Yao Lue” as “heat entering the blood chamber,” which can also be treated with Xiao Chai Hu Tang to drain heat. However, if heat has already entered the blood chamber, it is advisable to assist in clearing the camp and dispelling stasis, which can be adjusted by adding Dan Shen (Salvia), Chi Shao (Red Peony), Ze Lan (Lycopus), Jiao Shan Zhi (Burnt Gardenia), and if heat is severe, it is also advisable to remove the human and add Sheng Di (Rehmannia). The main symptom of “malaria” is also the repeated occurrence of cold and heat, which can occur once a day, every two days, or every three days, but the condition is very different from alternating cold and heat (the following is omitted). Damp-heat phlegm stagnating in the middle jiao, presenting cold and heat like malaria, with unclear sweating, chest tightness, nausea, dry mouth with little drinking, yellow-red urination, and foul-smelling stools, can be treated with Da Yuan Yin (Great Source Decoction). 34. Low Fever (Including functional low fever, chronic infectious diseases, endocrine diseases, pulmonary tuberculosis, tumors, blood diseases, connective tissue diseases, and some fever of unknown origin) Internal injury fever refers to fever caused by internal injury of the viscera, leading to deficiency of qi and blood or imbalance of yin and yang, primarily characterized by low fever (37.5°C to 38°C, lasting more than 2 weeks, even months or years). It is now commonly referred to as “low fever.” Internal Treatment Differentiation: Qi Stagnation Transforming into Fire Type of Low Fever [Etiology] Often caused by emotional distress, leading to liver qi stagnation, which cannot be released, prolonged stagnation transforms into heat, and even liver yang rises, causing fire to follow qi. [Symptoms] Characterized by low fever or afternoon tidal fever, the heat level fluctuates with emotional and mental states, with symptoms of depression, chest and hypochondriac pain, irritability, and easy anger. Accompanied by bitter mouth, frequent dreams, women may experience breast swelling before menstruation or have menstrual irregularities, dark tongue with yellow coating, wiry rapid pulse, especially prominent in the left guan pulse. [Treatment Method] Soothe the liver, resolve stagnation, clear the liver, and drain heat. [Main Formula] Dan Zhi Xiao Yao San (Dan Zhi Free and Easy Wanderer Powder) with modifications. 35. Blood Stasis and Qi Stagnation Type of Low Fever [Etiology] Often caused by qi stagnation, qi deficiency, yang deficiency, cold evil invasion, injury to fluids, or external injury, leading to poor circulation of qi and blood, qi stagnation and blood stasis, obstructing the camp and defense, resulting in low fever. [Symptoms] Characterized by fever occurring in the afternoon or at night, dry mouth and throat, little desire to drink, skin and hair dry, purple or stasis spots on the tongue, accompanied by body pain or lumps, dark complexion, dark circles around the eyes, cyanosis of the lips. Women may experience menstrual cessation or postpartum lochia not flowing, lower abdominal pain, thin and rough pulse. [Treatment Method] Invigorate blood, resolve stasis, and harmonize the camp and defense. [Main Formula] Xue Fu Zhu Yu Tang (Blood Mansion Disperse Stasis Decoction) with modifications. 36. Spleen and Stomach Damp-Heat Type of Low Fever [Etiology] Often caused by overwork, irregular diet, and improper eating habits, damaging the spleen and stomach, leading to internal dampness. If dampness stagnates for a long time, it transforms into heat, or if damp-heat is contracted, or if damp-heat is internally abundant, it can lead to low fever. [Symptoms] Characterized by low fever or worse in the afternoon, chest tightness, heavy body, and poor appetite. Accompanied by little desire to drink, nausea, loose stools, white greasy or yellow greasy tongue coating, slippery rapid pulse. [Treatment Method] Clear heat and drain dampness. [Main Formula] San Ren Tang (Three Nut Decoction) with modifications. 37. Qi Deficiency with Yang Floating Type of Low Fever [Etiology] Often caused by overwork, emotional distress, or hunger, leading to weakened middle qi, which cannot circulate, or stagnation in the middle or sinking down. Insufficient middle qi leads to internal fire, resulting in low fever. [Symptoms] Characterized by morning low fever with sweating, shortness of breath and fatigue, worsening with exertion. Accompanied by dizziness, pale yellow complexion, spontaneous sweating, easy to catch a cold, poor appetite, abdominal distension after eating, thin tongue, thin white coating, weak pulse. [Treatment Method] Benefit qi, strengthen the spleen, and sweetly warm to eliminate heat. [Main Formula] Bu Zhong Yi Qi Tang (Tonify the Middle and Benefit Qi Decoction) with modifications. 38. Blood Deficiency with Qi Floating Type of Low Fever [Etiology] Due to blood being transformed from essence and qi. If due to excessive thinking and labor, or postpartum blood deficiency, then internally there is no nourishment, and yang qi loses its attachment, leading to floating and rising, thus producing low fever. [Symptoms] Characterized by low fever, dizziness, palpitations, fatigue, insomnia with many dreams, dry yellow nails, women may experience fever after menstruation, with little menstrual flow or amenorrhea, pale tongue, little coating, weak pulse. [Treatment Method] Benefit qi and nourish blood. [Main Formula] Gui Pi Tang (Restore the Spleen Decoction) with modifications. 39. Yin Deficiency with Yang Excess Type of Low Fever [Etiology] Often caused by deficiency of yin fluids in the five organs, insufficient yin leads to no attachment for yang, water cannot control fire, yang qi is excessive, thus producing virtual heat. [Symptoms] Characterized by afternoon tidal heat, night heat with early cooling, bone steaming tidal heat, five hearts burning heat, red cheeks. Accompanied by palpitations, insomnia, night sweats, dry mouth and throat, constipation, short urination, sore lower back, early ejaculation, menstrual irregularities, red tongue with dry coating, thin rapid pulse. [Treatment Method] Nourish yin and clear heat. [Main Formula] Qing Gu San (Clear the Bone Powder) with modifications. 40. Spleen and Kidney Yang Deficiency Type of Low Fever [Etiology] Often caused by the progression of qi deficiency type low fever into a deeper stage, leading to yang deficiency. Yang qi deficiency leads to internal cold excess, fire not returning to the source, forcing yang to rise, thus resulting in low fever. [Symptoms] Characterized by feeling hot skin, often occurring in the morning, while feeling cold and fearful of cold, cold limbs, shortness of breath and fatigue, pale or tender red complexion, lower limb swelling, impotence, early ejaculation, poor appetite, loose stools, pale tongue, thin slippery coating, deep thin pulse. [Treatment Method] Warm and tonify spleen and kidney. [Main Formula] Shen Qi Wan (Kidney Qi Pill) with modifications. 41. Evil Remaining in the Lung and Wei Type of Low Fever [Etiology] Often caused by external evil, high fever subsiding, residual evil not cleared, heat remaining in the collaterals, thus leading to high fever transitioning to low fever. [Symptoms] Characterized by high fever transitioning to low fever, persisting for a long time. Accompanied by redness in the throat, slight cough, lymph node swelling, or slight swelling of the tonsils, red tongue, thin yellow coating, wiry rapid pulse. [Treatment Method] Clear heat and resolve the exterior. [Main Formula] Yin Qiao San (Honeysuckle and Forsythia Powder) with modifications. 42. Evil Occupying the Shaoyang Type of Low Fever [Etiology] Often caused by external evil development, occupying half the surface and half the interior, Shaoyang pivot is not functioning well, evil qi contends with yang, thus causing fever, while contending with yin leads to aversion to cold, hence alternating cold and heat lasting more than 2 weeks. [Symptoms] Characterized by alternating cold and heat, bitter mouth, dry throat, fullness in the chest and hypochondria. Accompanied by headache, women may experience menstrual irregularities, sudden cold and heat before menstruation, or during fever, menstruation occurs, thin yellow tongue coating, wiry rapid pulse. [Treatment Method] Harmonize Shaoyang, adjust the pivot. [Main Formula] Xiao Chai Hu Tang (Minor Bupleurum Decoction) with modifications. 43. Ying and Wei Disharmony Type of Low Fever [Etiology] Often caused by loose pores, leading to disharmony of Ying and Wei. [Symptoms] Characterized by low fever with sweating, occasionally feeling slightly cold and slightly hot. Accompanied by lack of energy, pale red tongue, thin white coating, slow pulse. [Treatment Method] Harmonize Ying and Wei. [Main Formula] Gui Zhi Tang (Cinnamon Twig Decoction) with modifications. 44. Liver Channel Damp-Heat Type of Low Fever [Etiology] Often caused by dysfunction of liver and gallbladder drainage, damp-heat accumulating in the liver and gallbladder, steaming the skin surface, thus leading to afternoon fever. [Symptoms] Characterized by afternoon low fever, pain in the hypochondrium. Accompanied by bitter mouth, constipation or loose stools, or jaundice, yellow greasy tongue coating, wiry rapid pulse. [Treatment Method] Soothe the liver, drain the gallbladder, and clear damp-heat. [Main Formula] Long Dan Cao Xie Gan Tang (Gentian Decoction for Draining the Liver) with modifications. 45. Food Stagnation and Heat Type of Low Fever [Etiology] Often caused by food stagnation in the middle jiao, leading to heat accumulation, thus causing fever during the afternoon when yangming qi is strong. [Symptoms] Characterized by low fever worse in the afternoon, sour belching, and acid reflux. Accompanied by vomiting or nausea, constipation or loose stools, children often have flushed cheeks, abdominal distension with hardness upon palpation, yellow greasy tongue coating, slippery pulse. [Treatment Method] Clear heat and resolve stagnation. [Main Formula] Bao He Wan (Preserve Harmony Pill) with modifications. 46. Phlegm-Dampness Stagnation Type of Low Fever [Etiology] Often caused by spleen dysfunction, leading to dampness accumulating into phlegm, phlegm stagnating internally, obstructing Ying and Wei, thus presenting low fever with slight aversion to cold. [Symptoms] Characterized by low fever with slight aversion to cold, night heat with early cooling, vomiting upon drinking. Accompanied by fullness in the chest, nausea, shortness of breath, rumbling in the intestines, white greasy tongue coating, slippery pulse. [Treatment Method] Warm and transform phlegm. [Main Formula] Ling Gui Zhu Gan Tang combined with Xiao Ban Xia Tang (Poria, Atractylodes, and Licorice Decoction combined with Minor Pinellia Decoction) with modifications. Famous Expert Experience Theory Pu Fuzhou
Pu Lao believes that internal injury low fever can be divided into qi deficiency and blood deficiency, with qi deficiency being more common. Use sweet warming methods to eliminate heat, lightly with Bu Zhong Yi Qi Tang, and heavily with Dang Gui Bu Xue Tang (Angelica Blood-Tonifying Decoction) combined with Gan Mai Da Zao Tang (Licorice, Wheat, and Jujube Decoction) with Dang Shen (Codonopsis). For low fever leaning towards blood deficiency, both men and women of all ages can use Sheng Yu Tang (Holy Healing Decoction) with Di Gu Pi (Lycium Bark). He also believes that patients with low fever should not use too many bitter cold medicines, as they not only harm the spleen and stomach but also excessive bitterness and cold can dry and injure yin. In cases of internal injury fever, the spleen and stomach are already weak, the dosage should also be light, preferably repeated doses rather than heavy doses, as rushing to use heavy doses can harm the middle qi. Jiang Chunhua
Professor Jiang believes that most patients develop yin deficiency due to fever, not that yin deficiency causes fever. For example, chronic consumptive diseases can lead to yin deficiency due to prolonged fever. If the cause of the fever is resolved, then yin deficiency can improve. If it cannot be resolved, then tonifying yang will also be ineffective. This is a common misunderstanding in medicine. The same applies to yin deficiency fever. 47. Tidal Fever Tidal fever refers to patients experiencing fever at regular intervals, or with specific timing. Internal Treatment Differentiation: Yangming Organ Full Type of Tidal Fever [Etiology] Surface evil unresolved, internal transformation into heat, combining with physical evil in the intestines, leading to stomach fullness. [Symptoms] Daytime tidal fever, hands and feet sweating, abdominal fullness and pain, constipation or heat binding with side flow, or confusion and delirium, restlessness, yellow thick tongue coating, deep solid pulse. [Treatment Method] Purge and drain heat. [Main Formula] San Yi Cheng Qi Tang (Three One Purge Decoction). 48. Yin Deficiency and Blood Deficiency Type of Tidal Fever [Etiology] Due to inherent yin deficiency, or loss of blood and fluids due to sweating, purging, or vomiting, leading to yin deficiency and dryness, causing virtual fire to rise. [Symptoms] Afternoon or nighttime tidal fever, hot hands and feet, irritability, insomnia, palpitations, fatigue, weight loss, red tongue with little coating, thin rapid pulse. [Treatment Method] Nourish yin, tonify blood, and clear heat. [Main Formula] Qing Gu San (Clear the Bone Powder). 49. Spleen and Stomach Qi Deficiency Type of Tidal Fever [Etiology] Due to overwork and internal injury, irregular diet, leading to insufficient middle qi and sinking, allowing yin fire to rise. [Symptoms] Morning tidal fever or afternoon fever, shortness of breath, fatigue, spontaneous sweating, pale complexion, thin tongue, weak pulse. [Treatment Method] Sweetly warm to eliminate heat. [Main Formula] Bu Zhong Yi Qi Tang (Tonify the Middle and Benefit Qi Decoction). 50. Summer Heat Injuring Qi Type of Tidal Fever [Etiology] Summer heat steaming, damaging qi and yin. [Symptoms] Often in summer, or early heat with evening coolness, or evening heat with morning coolness, thirst with desire to drink, restlessness, fatigue, poor appetite, yellow greasy tongue coating, rapid pulse. [Treatment Method] Clear summer heat and benefit qi. [Main Formula] Wang’s Qing Shu Yi Qi Tang (Wang’s Clear Summer Heat and Benefit Qi Decoction). 51. Blood Stasis and Heat Type of Tidal Fever [Etiology] Due to trauma or blood heat running rampant, leading to blood stagnation and heat. [Symptoms] Afternoon or nighttime fever, dry mouth and throat, reluctance to swallow water, abdominal masses, or pain in specific areas. Severe cases may lead to skin dryness, dark eyes, purple spots or bruises on the tongue, thin rapid pulse. [Treatment Method] Invigorate blood, resolve stasis, and clear heat. [Main Formula] Xue Fu Zhu Yu Tang (Blood Mansion Disperse Stasis Decoction). Famous Expert Experience Theory Qin Bomei No aversion to cold, only fever, with fluctuations in intensity at regular intervals, like the tides, referred to as “tidal fever.” This syndrome can be either deficiency or excess, both belonging to internal syndromes. The distinction is that deficiency syndromes are caused by qi and blood deficiency, and most of the heat can resolve; excess syndromes are caused by external evil transmitting internally, and heat does not resolve, rising at specific times.
Excess tidal fever is often initiated by external contraction, with body heat and sweating, abdominal fullness and pain, and constipation, with the heat increasing around 4 PM, thus also called “afternoon fever,” belonging to the Yangming stomach’s fullness. Severe cases can lead to confusion and delirium. The treatment should be purging, using Da Cheng Qi Tang (Major Purge Decoction). This is the treatment method from “Shang Han Lun,” and it must be based on the actual condition, ensuring that the righteous qi can support it before using. Later, “Wen Bing Tiao Bian” mentioned that evil heat is most likely to injure yin and, after purging, the righteous qi is weak, and evil qi gathers again, leading to the use of Li Hu Cheng Qi Tang (Protect the Stomach and Purge Decoction) and Zeng Ye Cheng Qi Tang (Increase Fluids and Purge Decoction), which can also be considered for use. Wu Youke said: “The righteous qi weakens day by day, and the yin fluids are consumed day by day, so one must be careful to protect the yin and not be reckless.” This is the significance of this.
Deficiency tidal fever is mostly due to blood deficiency and yin deficiency, often presenting with afternoon or nighttime fever, accompanied by palpitations, sweating, fatigue, and thin rapid pulse. This is often caused by significant blood loss, severe diarrhea, or prolonged illness, leading to thirst and fire, true yin being consumed, and the body becoming thinner, with heat rising from the muscles and bones, leading to yin being consumed and qi also becoming weak, thus also referred to as “bone steaming labor heat.” It is advisable to use nourishing blood and nourishing yin formulas, employing Qing Gu San (Clear the Bone Powder). There may also be morning tidal heat, afternoon heat subsiding, or due to hunger and fatigue, leading to damage to the middle qi and also causing blood deficiency, with body heat, irritability, fatigue, and weak pulse, which falls within the range of qi deficiency. Li Dongyuan has a sweet warming method to eliminate heat, using Bu Zhong Yi Qi Tang, as the formulas Sheng Ma (Cimicifuga) and Chai Hu (Bupleurum) have heat-reducing effects and should not be viewed as simple heat-reducing medicines. Summer heat in children can present with early heat and evening coolness, or evening heat and morning coolness, often accompanied by thirst and frequent urination, restlessness, and poor sleep, often lingering until autumn coolness naturally resolves. This is often seen in the southeastern and central southern regions, and there is no specific disease name yet, temporarily referred to as “summer heat,” which can be treated with Wang Mengying’s Qing Shu Yi Qi Tang with modifications. 52. Head Heat Refers to the sensation of heat in the head. Internal Treatment Differentiation: Liver Fire Rising Type of Head Heat [Etiology] Usually due to emotional distress, or anger, leading to liver qi stagnation transforming into fire, with fire rising. [Symptoms] Head heat, red face, irritability, restless sleep, pain in the hypochondrium, bitter mouth, red tongue with thin coating, wiry strong pulse. [Treatment Method] Clear liver and drain fire. [Main Formula] Long Dan Xie Gan Tang (Gentian Decoction for Draining the Liver). 53. Kidney Yin Insufficiency Type of Head Heat [Etiology] Usually due to inherent yin deficiency, or excessive sexual activity, injuring kidney yin. [Symptoms] Head heat, tinnitus, dizziness, weakness in the lower back and knees, five hearts burning heat. If yin damage affects yang, leading to both yin and yang deficiency, one may see red face, sweating, cold limbs, red tongue with little coating, thin rapid pulse. [Treatment Method] Nourish yin and subdue yang. [Main Formula] Qi Ju Di Huang Wan (Lycium and Chrysanthemum Rehmannia Pill) with modifications. 54. Yin Excess Constraining Yang Type of Head Heat [Etiology] Late stage of external febrile disease, evil invading the Shaoyin, yin excess constraining yang, leading to floating yang. [Symptoms] Head heat with red cheeks, sore throat and irritability, clear diarrhea, cold limbs, pale tongue with white coating, deep thin pulse. [Treatment Method] Draw yang from yin, revive yang and rescue the reverse. [Main Formula] Bai Tong Zhu Dan Fang (White Unblock Pig Gallbladder Formula). 55. Head Cold Refers to the sensation of cold in the head. Internal Treatment Differentiation: Jueyin Cold Type of Head Cold [Etiology] External cold evil invading, directly affecting the Jueyin; or cold from the exterior entering the interior, transmitting to the Jueyin. Cold evil follows the Jueyin meridian, rising to the top of the head. [Symptoms] Cold in the head, headache at the top, desire to wrap oneself in clothing, pale complexion, cold limbs, nausea, vomiting clear saliva, white tongue coating, deep tight pulse. [Treatment Method] Disperse cold, descend the reverse, and harmonize the stomach. [Main Formula] Wu Zhu Yu Tang (Evodia Decoction). 56. Deficiency Cold of the Governing Vessel Type of Head Cold [Etiology] Due to excessive labor, prolonged illness without nourishment, or cold dampness invading, leading to deficiency cold following the governing vessel to the top of the head. [Symptoms] Cold in the forehead and top of the head, may extend to the back, relieved by warmth, sometimes light and sometimes heavy, persisting for a long time, cold limbs, lower back and knee pain, pale complexion, pale tongue, thin white coating, deep thin or slow pulse. [Treatment Method] Warm yang and tonify deficiency. [Main Formula] Lu Rong Yi Jing Wan (Deer Antler Essence Pill). Famous Expert Experience Theory Qin Bomei Wind evil enters the brain from the Fengfu point, causing headache and cold sensation in the brain, with coldness in the neck and back, referred to as “brain wind,” treated with Shen Sheng San (Divine Sacred Powder). “Cold Jue Headache” arises from cold qi in the liver channel, also known as “Jueyin Headache.” During pain, there is a sensation of cold in the brain, fear of wind, often desiring to cover oneself and sleep, with a pale and gloomy complexion, slight cyanosis, vomiting clear saliva, cold limbs, and pulse is deep and wiry or deep and tight. The treatment should warm the liver and harmonize the stomach, using Dang Gui Si Ni Tang (Angelica Frigid Extremities Decoction) or Wu Zhu Yu Tang with Dang Gui and Rou Gui (Cinnamon). Headaches that extend from the top to the forehead, especially fear of cold, feeling wind as if it directly enters the brain, with pain mostly in the top and forehead, but not severe, relieved by warmth, pulse is thin and weak. This is due to deficiency cold of the governing vessel, and the Yangming pulse is also weak, using Lu Jiao Jiao, Shu Di, Shu Fu Pian, Bai Zhi, Chuan Xiong, Sheng Ma, and ginger to warm and nourish. 57. Head and Face Heat [Etiology] Due to prolonged illness, depleting qi and injuring yin, leading to excess fire. [Symptoms] Intermittent heat sensation in the head and face, red cheeks and ears. Often accompanied by sweating, red cheeks, disappearing in a few minutes or tens of minutes, pale red tongue, thin rapid pulse. [Treatment Method] Nourish yin and tonify kidney. [Main Formula] Liu Wei Di Huang Wan (Six Flavor Rehmannia Pill) with modifications. Famous Expert Experience Theory Qin Bomei Intermittent heat sensation in the head and face, red cheeks and ears, or accompanied by sweating, disappearing in a few minutes or tens of minutes, commonly referred to as “upper fire,” is one of the symptoms of yin deficiency. If there are no other symptoms, it is advisable to take Liu Wei Di Huang Wan regularly. 58. Facial Heat [Etiology] Damage to the spleen and stomach after illness, leading to insufficient middle qi, causing virtual fire to rise to the face. [Symptoms] Facial heat, worsens with movement, especially at night. Slight aversion to cold, dizziness, fatigue, poor appetite, fullness in the abdomen, shortness of breath, preference for sleep, pale complexion, thin white tongue coating, weak pulse. [Treatment Method] Regulate and tonify the spleen and stomach. [Main Formula] Bu Zhong Yi Qi Tang (Tonify the Middle and Benefit Qi Decoction) with modifications. 59. Ice Cold at Midnight [Etiology] Due to imbalance of yin and yang, not connecting smoothly. At midnight, when yang qi is at its peak, qi cannot circulate, thus manifesting as cold at the Baihui point where all yang converges. [Symptoms] Sudden cold sensation at the Baihui point at midnight, with a cool feeling from the center of the eyebrows to the tip of the nose, forming a line. Accompanied by dry nasal passages, nausea, and unproductive cough, red tongue with thin white coating, tight pulse. [Treatment Method] Connect yin and yang. [Main Formula] Wu Zhu Yu Tang (Evodia Decoction) with modifications. 60. Abdominal Cold Internal Treatment Differentiation: Spleen and Stomach Yang Deficiency Type of Abdominal Cold [Etiology] Overeating cold and cool foods, leading to stagnation of spleen yang, insufficient spleen yang, unable to warm the abdomen, thus feeling cold. [Symptoms] Cold or painful sensation in the abdomen, acid reflux or vomiting clear water, fear of cold and preference for warmth, fatigue, loose stools, pale tongue with thin white coating, deep thin pulse. [Treatment Method] Warm and tonify spleen yang. [Main Formula] Xiao Jian Zhong Tang (Minor Construct the Middle Decoction). 61. Kidney Yang Deficiency Type of Abdominal Cold [Etiology] Due to inherent yang deficiency, excessive sexual activity, or prolonged illness without proper rest, leading to lower source deficiency, kidney yang unable to rise. [Symptoms] Cold sensation in the abdomen, early morning diarrhea, weakness in the lower back and knees, frequent urination or residual urination, pale tongue, thin white coating, deep thin pulse, weak pulse. [Treatment Method] Warm the kidney and strengthen yang. [Main Formula] Shen Qi Wan combined with Si Shen Wan (Kidney Qi Pill combined with Four God Pill). 62. Chong and Ren Deficiency Type of Abdominal Cold [Etiology] Due to congenital insufficiency, poor postnatal development, excessive sexual activity, pregnancy, childbirth, or menstruation in cold and wet conditions, leading to damage to Chong and Ren, causing cold to congeal in the uterus. [Symptoms] Cold sensation in the abdomen, especially in the lower abdomen, delayed menstruation, light flow, pale color, or with blood clots, or clear thin discharge, or difficulty conceiving, or dark circles under the eyes, pale tongue with teeth marks, thin white coating, slow pulse. [Treatment Method] Regulate and tonify Chong and Ren, warm the meridians and disperse cold. [Main Formula] Wen Jing Tang (Warm the Meridians Decoction). 63. Liver Channel Cold Stagnation Type of Abdominal Cold [Etiology] External cold invading the Jueyin channel. [Symptoms] Cold sensation in the abdomen, especially in the lower abdomen, with pulling pain in the testicles, or contraction of the scrotum, worsened by cold, relieved by warmth, or cold limbs, white slippery tongue coating, deep wiry or slow pulse. [Treatment Method] Warm the liver, disperse cold, and promote qi and blood. [Main Formula] Nuan Gan Jian (Warm the Liver Decoction). 64. Chest and Abdominal Burning Heat [Etiology] Cold drinks remaining in the channels, obstructing yang qi from reaching the exterior. [Symptoms] Whole body feels cold, but the chest and abdomen feel burning hot, dry mouth, sore throat, nasal congestion, difficulty breathing, shortness of breath, cold limbs, purple lips, stiff neck and back, poor appetite, normal tongue, thick slightly greasy coating, deep slippery pulse. [Treatment Method] Expel cold and unblock yang. [Main Formula] Yang He Tang (Yang Harmony Decoction). 65. Midnight Chest Heat [Etiology] Due to blood stasis obstructing the chest, leading to heat transformation. [Symptoms] At midnight, feeling heat in the chest, waking up startled, with no other symptoms. [Treatment Method] Invigorate blood and dispel stasis. [Main Formula] Dan Shen Shu Ying Yin (Salvia Chest Soothing Decoction). 66. Back Heat Internal Treatment Differentiation: Lung Fire Type of Back Heat [Etiology] Lung fire is excessive. [Symptoms] Heat in the back, worsens in the afternoon, dry throat, cough with yellow phlegm, chest and back pain, red face, constipation, red tongue with yellow coating, rapid pulse. [Treatment Method] Clear lung and drain fire. [Main Formula] Xie Bai San (Drain White Powder). 67. Yin Deficiency Type of Back Heat [Etiology] Kidney yin deficiency. [Symptoms] Sensation of heat in the back, increasing at night, lower back pain, hot hands and feet, night sweats, red tongue with little coating, thin rapid pulse. [Treatment Method] Nourish yin and clear heat. [Main Formula] Zhi Bai Di Huang Wan (Anemarrhena and Rehmannia Pill). 68. Back Cold Internal Treatment Differentiation: External Wind-Cold Type of Back Cold [Etiology] Wind-cold invading the muscle surface. [Symptoms] Cold in the back, fever, pain in the head and body, thin white tongue coating, floating tight pulse. [Treatment Method] Release the exterior, dispel wind, and scatter cold. [Main Formula] Jiu Wei Qiang Huo Tang (Nine Flavor Notopterygium Decoction). 69. Yang Deficiency with Yin Excess Type of Back Cold [Etiology] Due to inherent yang weakness, cold arises from within. [Symptoms] Cold in the back, preference for warmth, pale complexion, cold hands and feet, loose stools, clear long urination, pale tongue, white and slippery coating, deep slow pulse. [Treatment Method] Warm the meridians, assist yang, disperse cold and transform dampness. [Main Formula] Fu Zi Tang (Aconite Decoction). 70. Phlegm-Dampness Stagnation Type of Back Cold [Etiology] Due to prolonged illness or aging, leading to weakness of spleen and kidney yang, water dampness condensing into phlegm, obstructing yang qi. [Symptoms] Cold in the back like ice, cough or wheezing, thin white phlegm, dizziness, no desire to drink, or preference for drinking but not much, abdominal fullness, poor appetite, fatigue, or slight swelling of the limbs, white slippery tongue coating, deep slippery pulse. [Treatment Method] Strengthen the spleen and eliminate dampness. [Main Formula] Yan Nian Fu Ling Yin (Longevity Poria Decoction). Famous Expert Experience Theory Qin Bomei People with weak yang qi often feel cold in the back, using Sheng Yu Tang with Gui Zhi (Cinnamon). “Ancient and Modern Medical Mirror” has a method of applying warming plaster externally. “Phlegm” patients often feel cold in the back, which is a manifestation of spleen and kidney yang deficiency. 71. Spine Heat [Etiology] Blood sea is empty, virtual heat circulating in the spine. [Symptoms] Heat in the spine, lighter in the morning and heavier in the evening, dizziness, red tongue with little moisture and no coating, thin wiry rapid pulse. [Treatment Method] Conserve yin and suppress yang. [Main Formula] Qing Gu San (Clear the Bone Powder) with modifications. 72. Five Hearts Burning Heat Five hearts burning heat refers to the sensation of heat in both hands and feet, accompanied by a feeling of heat in the chest, commonly seen in conditions of deficiency and fatigue. Often caused by yin deficiency with excess fire, or post-illness virtual heat not clearing, as well as internal heat stagnation. Internal Treatment Differentiation: Yin Deficiency with Excess Fire Type of Five Hearts Burning Heat [Etiology] Lung yin depletion, or excessive fatigue, or liver yin deficiency, leading to excess liver fire. [Symptoms] Five hearts burning heat, especially worse in the afternoon. Often desiring to hold cold objects, preferring to stretch out limbs outside the blanket while sleeping, nocturnal emissions, night sweats, red cheeks, lower back pain, dry mouth and throat, red tongue with little coating, thin rapid pulse. [Treatment Method] Nourish yin, clear heat, and eliminate restlessness. [Main Formula] Qing Gu San (Clear the Bone Powder). 73. Blood Deficiency with Liver Fire Type of Five Hearts Burning Heat [Etiology] Damage to the liver and spleen, leading to blood production and storage dysfunction, resulting in blood deficiency and excess liver fire. [Symptoms] Afternoon heat in both hands and feet, worsens with slight exertion, fatigue, shortness of breath, palpitations, poor appetite, dizziness, pale tongue, thin weak or thin rough pulse. [Treatment Method] Regulate the liver and strengthen the spleen. [Main Formula] Bu Gan Tang (Liver Tonifying Decoction). 74. Residual Evil in the Yin Division Type of Five Hearts Burning Heat [Etiology] External evil improperly treated, residual evil lingers in the Ying and Yin. [Symptoms] Heat in both hands and feet, irritability and insomnia, evening heat with morning cooling, heat subsiding without sweating, able to eat but losing weight, red tongue with little coating, thin rapid pulse. [Treatment Method] Nourish yin and dispel evil. [Main Formula] Qing Hao Bie Jia Tang (Artemisia and Turtle Shell Decoction). 75. Internal Heat Stagnation Type of Five Hearts Burning Heat [Etiology] Poor qi mechanism, yang stagnation not reaching. Or external evil unresolved, excessive use of cold, freezing the evil. Or excessive consumption of cold foods, obstructing stomach yang, preventing it from dispersing. [Symptoms] Five hearts burning heat, chest tightness, emotional distress, irritability, headache, bitter mouth, red urination, women may experience menstrual irregularities, red tongue with yellow coating, rapid pulse. [Treatment Method] Raise yang and disperse fire. [Main Formula] Sheng Yang San (Raise Yang Powder). 76. Body Heat with Cold Limbs In the process of febrile disease, both fever and cold symptoms occur simultaneously. Internal Treatment Differentiation: Heat Entering the Pericardium Type of Body Heat with Cold Limbs [Etiology] After external febrile disease, heat evil enters the interior, reversing to the pericardium, or summer heat evil obstructed internally. [Symptoms] Strong fever not subsiding, cold hands and feet, headache, red face, chest tightness, shortness of breath, irritability, delirium, followed by confusion, yellow-red urination, red tongue with dry coating, slippery rapid or strong rapid pulse. [Treatment Method] Drain heat and reach stagnation, clear the heart and open the orifices. [Main Formula] Qing Ying Tang (Clear the Camp Decoction) combined with An Gong Niu Huang Wan (Calm the Palace Pill with Cattle Gallstone). 77. Yin Excess Constraining Yang Type of Body Heat with Cold Limbs [Etiology] After external febrile disease, improper use of sweating, vomiting, or purging leads to weakened yang qi, with internal cold excess, constraining yang externally. [Symptoms] Body heat with red face, dry throat and pain, cold limbs, clear diarrhea, pale tongue with white coating, deep thin pulse. [Treatment Method] Revive yang and rescue the reverse, unblock yang and restore pulse. [Main Formula] Tong Mai Si Ni Tang (Unblock Pulse Four Reverse Decoction). 78. Cold Limbs Also known as “cold extremities” or “four reverses,” refers to the cold sensation in the hands and feet, extending upwards to the elbows and knees. Internal Treatment Differentiation: Yang Qi Deficiency Type of Cold Limbs [Etiology] Due to inherent yang deficiency, or cold evil invading the Shaoyin, leading to internal cold excess, yang qi is weak, unable to warm the limbs. [Symptoms] Cold limbs, feeling cold and curled up, pale complexion, lethargy, clear diarrhea, pale tongue, white coating, thin pulse. [Treatment Method] Revive yang and rescue the reverse. [Main Formula] Si Ni Tang (Frigid Extremities Decoction). 79. Internal Heat Stagnation Type of Cold Limbs [Etiology] Internal heat from external evil, excessive internal heat, leading to stagnation of yang qi, unable to reach the extremities. [Symptoms] Cold limbs, no sweating, high fever, red face, irritability, thirst, restlessness, delirium, constipation, short red urination, red tongue with yellow coating, rapid pulse. [Treatment Method] Clear heat, drain fire, and unblock the intestines. [Main Formula] Bai Hu Cheng Qi Tang (White Tiger and Purge Decoction). 80. Yang Qi Obstruction Type of Cold Limbs [Etiology] Emotional distress leads to liver qi stagnation, causing qi mechanism to be obstructed, leading to internal stagnation of yang. [Symptoms] Cold limbs, fullness and oppression in the chest and hypochondria, belching, vomiting, diarrhea, or abdominal pain, or difficulty urinating, thin white tongue coating, wiry pulse. [Treatment Method] Soothe stagnation and unblock yang, promote qi mechanism. [Main Formula] Si Ni San (Frigid Extremities Powder). 81. Blood Deficiency with Cold Limbs [Etiology] Due to inherent blood deficiency, exposure to cold evil, leading to stagnation of blood, causing poor circulation to the extremities. [Symptoms] Cold limbs, cold body, pale skin, or abdominal pain, pale tongue, thin white coating, deep thin pulse. [Treatment Method] Warm and nourish blood vessels, dispel cold and harmonize. [Main Formula] Dang Gui Si Ni Tang (Angelica Frigid Extremities Decoction). 82. Phlegm-Dampness Obstruction Type of Cold Limbs [Etiology] Phlegm and dampness stagnate internally, preventing the clear yang from rising. [Symptoms] Cold limbs, fullness and oppression in the chest, phlegm sounds in the throat, or vomiting phlegm, poor appetite, white greasy tongue coating, slippery pulse. [Treatment Method] Move qi, resolve stagnation, and clear phlegm. [Main Formula] Dao Tan Tang (Phlegm Dispersing Decoction). 83. Ascaris Disturbance Type of Cold Limbs (Ascaris Reversal) [Etiology] Ascaris disturbance leads to qi mechanism disorder. [Symptoms] Cold limbs, abdominal cramping pain, vomiting clear water, or vomiting ascaris, or thirst, pale tongue or dark, thin coating, thin pulse. [Treatment Method] Warm the organs and calm the ascaris. [Main Formula] Wu Mei Wan (Mume Pill). Famous Expert Experience Theory Qin Bomei
Cold limbs are referred to as “qing,” cold beyond the wrists and ankles is called “jue,” and cold beyond the elbows and knees is called “ni.” Therefore, light cases are called “jue cold,” while severe cases are called “jue reverse.” Generally, cold limbs are mostly cold syndromes, referred to as “cold jue” or “yin jue,” accompanied by cold body, pale complexion, curled up, and diarrhea, with pulse being thin and slow, treated with Si Ni Tang. At the same time, in cases of typhoid, diarrhea, and all weak syndromes in severe stages, cold limbs are seen, indicating weak yang qi and impending collapse, treated with Fu Zi Li Zhong Tang (Aconite Decoction for Regulating the Middle) or Shen Fu Tang (Ginseng and Aconite Decoction) to support yang. Internal heat stagnation leading to cold limbs is referred to as “heat jue” or “yang jue,” accompanied by body heat, red face, irritability, constipation, and short red urination, with pulse being slippery and rapid. There are also cases of cold limbs turning warm, warming and then cooling again, recurring, called “deep heat jue deep.” In all cases, deep heat leads to deep jue, while light heat leads to light jue, and should not be mistaken for yin cold, using Si Ni San or Huo Yu Tang (Fire Stagnation Decoction) for treatment. Blood deficiency patients often have cold limbs, even after sleeping, the lower limbs are difficult to warm, requiring comprehensive differentiation. Pain syndromes such as stomach pain and abdominal pain often lead to cold limbs when the pain is severe, and when the pain eases, warmth is restored, and there is no need to revive yang. 84. Double Hand Heat [Etiology] Qi and blood deficiency, qi and yin insufficiency. [Symptoms] Burning heat from the wrists to the fingertips, unbearable. Accompanied by irritability, pale and white nails, bitter mouth, dry tongue, heavy pulse. [Treatment Method] Sweetly warm to eliminate heat, benefit qi and nourish blood. [Main Formula] Bu Zhong Yi Qi Tang combined with Dang Gui Bu Xue Tang (Tonify the Middle and Benefit Qi Decoction combined with Angelica Blood-Tonifying Decoction) with modifications. 85. Fingertip Heat [Etiology] Blood deficiency and liver stagnation, leading to liver qi obstruction. [Symptoms] Burning heat in the fingertips, worsens with cold, no external redness or swelling, chest tightness, pale red tongue, thin white coating, slightly yellow coating, thin pulse. [Treatment Method] Nourish blood, soothe the liver, resolve stagnation, and clear heat. [Main Formula] Experience Formula. 86. Anal Cold [Etiology] The governing vessel governs the yang of the whole body. The governing vessel starts at the perineum. Sitting or lying on wet ground, cold dampness injures the governing vessel, leading to anal cold. [Symptoms] Cold sensation around the anus as if sitting on ice, often standing and not wanting to sit. Accompanied by strong pain in the back as if touched by electricity, pale tongue, large tongue, thin white coating, deep slow pulse. [Treatment Method] Warm the governing vessel, dispel cold, and strengthen the muscles and bones. [Main Formula] Si Ni Tang (Frigid Extremities Decoction) with modifications. 87. Leg Heat [Etiology] Phlegm-heat obstructing the meridians. [Symptoms] Nighttime leg heat, especially severe from 10 PM to 5 AM. Regardless of winter or summer, the legs must be extended outside the blanket every night. Accompanied by mental depression, abdominal fullness, dry mouth without desire to drink, short yellow urination, purple tongue, thin yellow coating, slippery rapid pulse. [Treatment Method] Clear stubborn phlegm, invigorate blood, and unblock the meridians. [Main Formula] Experience Formula. 88. Double Feet Cold in Winter and Hot in Summer [Etiology] Due to deficiency of both kidney yin and yang. [Symptoms] Every summer, the soles of the feet feel burning hot, while in winter, they feel as cold as ice. Accompanied by red cheeks, red tongue, thin rapid pulse. [Treatment Method] Nourish water and control fire. [Main Formula] Jin Gui Di Huang Wan (Golden Cabinet Rehmannia Pill).☆Source: Sohu Health ClientFor clinical reference only, non-professional doctors should not attempt acupuncture or medication.
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