Cold and Heat

Cold and Heat

Fever and chills are often due to external pathogenic factors damaging the Ying and Wei (1). Damage to the Ying results in chills, while damage to the Wei leads to fever. For healthy individuals, treatment should focus on dispersing with Ma Huang and Gui Zhi. In cases of blood loss, where there is severe deficiency of Yin blood, sweating should be avoided as it would further deplete the body's fluids; instead, Xiao Chai Hu Tang combined with Jing Jie, Fang Feng, Zi Su, Xing Ren, Bo He, Qian Hu, and Ge Gen can be used to harmonize and disperse, thus avoiding the prohibition against sweating in Zhang Zhongjing’s “Shang Han Lun” for patients with blood disorders. If the condition is not caused by external pathogens but rather by internal disharmony of the Ying and Wei, presenting as alternating chills and fever—resembling malaria but not quite—it should not be treated as malaria. Instead, Xiao Chai Hu Tang or Xiao Yao San should be used to harmonize the Ying and Wei, leading to recovery. Additionally, when cold and heat are caused by blood stasis, there will invariably be areas of stabbing pain; in such cases, Xue Fu Zhu Yu Tang is indicated. This differs from cold and heat associated with other diseases, a distinction that physicians must recognize.

[Note]

(1) Ying and Wei: Refers to the defensive functions of the body’s skin and tissues. According to the “Ling Shu · Ying Wei Sheng Hui Pian,” “The Ying resides within the vessels, while the Wei resides outside.” The Ying provides nourishment internally, whereas the Wei offers protection externally.

[Commentary] The treatment principles for cold and heat in blood-related conditions largely follow the “Shang Han Lun.” For cases caused by external pathogens, Xiao Chai Hu Tang combined with Jing Jie, Fang Feng, and other herbs is used to harmonize and disperse; for those caused by internal injury, Xiao Chai Hu Tang or Xiao Yao San is employed to resolve the disharmony; and for cases stemming from blood stasis, Xue Fu Zhu Yu Tang is recommended for clearing and transforming the stagnant blood.