Also divided into low fever and high fever.
(high fever)
Example 1 Wang XX, male, 1 1 year old. The high fever lasted for more than a month, and the highest body temperature reached 42℃. After treatment with various antibiotics and antipyretics, no effect was found. The symptoms are as follows: the heat potential rises twice every day after 15: 00 noon, and then drops slightly the next morning. Although the body temperature is above 40℃, the patient does not feel feverish consciously, and his pulse is astringent, his tongue is dark, his face is not hot, his right hypochondriac pain persists, his mouth is not thirsty, his stool is self-regulated, and urination is beneficial. Although the body temperature is high and consciously anti-hot, there is no exterior heat to know; If the mouth is not thirsty, it will not knot, so there is no internal heat and it is known. The astringent pulse, persistent hypochondriac pain and dull tongue are blood stasis and fever, which can be used for credit reporting. It is suggested to use the method of promoting blood circulation and removing blood stasis to modify Xuefu Zhuyu Decoction. Angelica tail, Radix Paeoniae Rubra, Rhizoma Ligustici Chuanxiong, Stigma Croci Sativi, Fructus Aurantii preparata, Radix Bupleuri and Myrrha each 4.5g, Radix Cyathulae and dried earthworm each 6g, Radix Platycodonis and Radix Glycyrrhizae each 3g, taken continuously for one week, during which raw turtle shell, raw oyster, or Rhizoma Corydalis and Sanguis Draxonis were added, and the fever decreased slightly in the afternoon. Take one pill in the morning and one pill in the evening. After two weeks, the fever decreased and the pain decreased; After three weeks of afternoon, the fever has decreased, the hypochondriac pain has disappeared, black feces have been seen in the stool, the tongue is slightly dull and the pulse is thin, so it is changed to one dose every two days, and the medicine is delayed and continued, so that the blood stasis is gone without injury. Twenty days later, I came back for a visit. The fever has gone down for more than two weeks, and I stopped taking the medicine for one week. The patient increased from 29.5 kg to 3 1 kg, the tongue color was bright red but not dark, the pulse was relieved but not astringent, and the mental and physical strength returned to normal. Pu Fuzhou Medical Case ")
Case 2 is a male patient with chronic granulocytic autohemosis. Every evening, the fever began to reach 40℃, and I sweated and felt cold in the middle of the night, which has been ups and downs for half a year. Usually, the palms are slightly hot, the feet are not warm, the waist is particularly sore, and the stool is once every few days. Thick and greasy tongue coating, heavy and thin pulse and weakness. It was diagnosed as deficiency of yin and yang in the lower energizer, and the middle energizer was weak. Radix Astragali, Radix Rehmanniae, Radix Angelicae Sinensis, Cistanches, Cimicifuga Rhizoma, Atractylodis Macrocephalae and Alismatis Rhizoma were used to remove the heat, and the heat calmed down the next night.
(Qin Bowei's "Qian Zhai Medical Lecture Notes")
Case 3: Liu Xx, male, 17 years old, outpatient number: 565375. Date of initial diagnosis: 196512/0/day. After working in the middle of the month, the patient felt cold in the shower and caused fever (39℃). After two weeks of western medicine treatment, the fever still persisted. During hospitalization, the body temperature fluctuated around 38℃ every afternoon. The diagnosis was not confirmed by various examinations of western medicine. Fever has been transported for more than three months. When you come to the clinic, you have a fever (38.5℃) from 4 pm to 2 pm every day. Before you have a fever, you have aversion to cold, followed by body heat, no sweat, dizziness, dry throat, dull pain in your chest, followed by sweating and fever, and your diet is acceptable and your stool is average. The tongue coating is thick and red. The pulse is slightly thinner and slightly floating. Syndrome differentiation; Fever due to yin deficiency, disharmony between camp and health. Treatment: nourishing yin and clearing heat, and harmonizing camp and health. Prescription: Artemisia annua 1 0g turtle shell10g qinchong 6g cortex lycii radicis12g radix scrophulariae12g Flos lonicerae15g radix trichosanthis15g fresh radix rehmanniae12g cortex moutan/. .5g of Ramulus Cinnamomi 3g of Glycyrrhiza uralensis Fisch 6g of fresh Rhizoma Imperatae 3g1October 25th: After taking the above 4 doses, the fever decreased slightly. In the afternoon, the body temperature was 38.9℃, and the chest felt painful and the pulse was slightly slippery. After removing Ramulus Cinnamomi from the top, 3.5g of Rhizoma Typhonii was added, and 3.5g of Radix Bupleuri was changed, followed by 6 doses. 1 1 month 1 day: the body temperature was normal for two days after taking the medicine, and it reached 38℃ yesterday, with thick white fur and rapid pulse. The patient has fever after daily feeding, which belongs to Yangming qi stagnation and unclear heat accumulation. He was given burnt areca nut10g and cicada slough 3.5g, followed by 6 doses. 1 1 8th of the month. The fever is not serious. Yesterday, the temperature was 37. st, the right ear ached, yellow water flowed (known as otitis media), and there was no discomfort. The pulse was thin and slightly counted, and the tongue coating was white. Four doses were added above. Moon 12: I haven't had a fever recently, and the general condition is good. Guan Youbo's Clinical Experience Selection) [Comment] Fever caused by internal injury refers to fever caused by deficiency or disorder of qi and blood of viscera. Deficiency heat is caused by deficiency of yin and yang, qi and blood; Excess heat is caused by qi stagnation, blood stasis and food stagnation. This group of diseases
All the cases are persistent high fever, and together with the "low fever" in the lower segment, all of them belong to the category of internal injury and fever.
Example 1: fever in the afternoon, unsmooth pulse, dull tongue, persistent hypochondriac pain, no exterior heat witness, and no interior heat to follow. The syndrome is blood stasis and fever. When promoting blood circulation and removing blood stasis, we can use Xuefu Zhuyu decoction to make remarkable achievements.
Case 2: Deficiency of both yin and yang, lack of qi in the middle, and immediate treatment with warmth to remove heat.
Case 3 has been suffering from fever for more than three months. Because it is hot at night and cold early, with dry throat, red tongue and rapid pulse, the syndrome belongs to yin deficiency and fever. Therefore, Artemisia annua Turtle Decoction and Qinggu Powder are added and subtracted to clear yin and disperse heat. Because it is late autumn, and there is aversion to cold and fever and sweating, Guizhi Decoction is combined to reconcile camp and health. The whole prescription is still based on resolving muscles, clearing away pathogenic factors, nourishing yin and removing heat. Later, Changshan, Jiaolang and Cicada are added to eliminate phlegm and guide stagnation, and the qi is promoted, and the internal and external harmony is achieved.
(low fever)
Example 1 Huang xX, female, 39 years old. Date of initial diagnosis: 1976 1 1 6th. After the May Day holiday this year, I got sick with cold, and the fever was above 38oC. After that, the fever dropped, but it never returned, and it was low every day for half a year.
(37.2℃ ~ 37.3℃), dry and stuffy nose, dry mouth and fear of cold, restless from heat in the latter half of the night, red face, sweating on the head, hands and feet and no sweat all over the body, thirst for drink, cough with excessive phlegm, constipation, slow and thin pulse, right tongue color, yellow fur in the center, and follicles on the edge of the tongue. Syndrome Differentiation: Cold pathogen is lost in sweat solution, cold stagnation turns into heat, and pathogen is lingering in qi. Exogenous diseases are not bone steaming and hot flashes. Treatment. Exterior-interior double solution, imitation of Fangfeng Tongsheng San method. Prescription: Bupleurum 4.5g, Scutellariae Radix 9g, Anemarrhena rhizome 9g, Gypsum Fibrosum12g, Jiao Shan Gardenia 9g, Semen Sojae Preparata 9g, Semen Armeniacae Amarum 9g, Radix Glycyrrhizae 4.5g, Herba Houttuyniae 30g, Radix Paeoniae Alba 9g, parched Fructus Aurantii 9g, restrained Radix et Rhizoma Rhei 9g, Jiang Banxia12g, Agent A. A 58 a 1 1 month 1 day
(M-diagnosis): After taking the medicine, I feel sweaty, my stool is smooth, I am no longer afraid of cold, my dry mouth is reduced, my sputum is reduced, my nose is still dry, and my right neck feels swollen. To eliminate evil, the original method is still used, and the prescription is as follows: Bupleurum root 4.5g, Radix Puerariae 9g, Scutellariae Radix 9g, Jiao Shan Gardenia 9g, Semen Sojae Preparata 9g, Radix Paeoniae Rubra 9g, Fructus Aurantii preparata 9g, Jiang Banxia 9g, Herba Houttuyniae 30g, Almond 9g, Prunella vulgaris 9g, Radix Glycyrrhizae 3g1month 14 days.
(Three Diagnoses): Exogenous pathogen has been solved, and low fever has been stopped. ..... Follow-up patients no longer have low fever, and gradually recover to health, and go to work.
(Jin Shoushan attending, Wu Jie et al. finishing: high fever and low fever, new traditional chinese medicine)) 227, 1979)
Example = Guo xx, female, 40 years old. Date of initial diagnosis:1June, 973 17. In the past three years, the patient had a low-grade fever in the afternoon, often reaching 37.7℃ ~ 37.8℃. Every night, his legs were numb and his spirit was listless. After examination, the reason was unknown and long-term treatment was ineffective. The pulse is thin and slightly counted, the left side is slightly chordal, and the tongue is slightly red without coating. Syndrome Differentiation: Yin deficiency and liver hyperactivity. Treatment: nourishing yin and regulating liver. Prescription: Radix Rehmanniae 24g Cornus officinalis12g Dioscorea opposita12g Cortex Moutan12g Rhizoma Alismatis 9g Poria 9g Radix Bupleuri 9g Radix Schisandrae Chinensis 6g Radix Paeoniae Alba 9g Cortex Cinnamomi 6g. Follow-up visit on June 26th: The low fever has dropped to 37C, and I was asked to take more than one dose of Qianfang10g to consolidate the curative effect. Yue Meizhong Medical Records ")
Example 3 Gong Sa X, male, 58 years old. Date of initial diagnosis:1March 5, 965. Low-grade fever for more than two years, hot hands and feet, very hot in the afternoon, high body temperature, frequent spontaneous sweating-59-out, dizziness, general acid drowsiness, cough, normal defecation, delayed pulse, pale tongue and thin white fur. Syndrome differentiation; Insufficient gas and liquid. Treatment: benefiting qi and nourishing yin. Prescription: Flour Wheat12g, Radix Glycyrrhizae Preparata 6g, Fructus Jujubae (cut) 5g, Radix Astragali12g, Radix Asparagi 3g, Cortex Lycii 6g, March 9th.
(Second diagnosis): After taking the medicine, the low-grade fever has subsided, sweating has decreased, dizziness and cough have also decreased, but at night, hands and feet still have fever, defecation is normal, pulse and tongue are normal, so stop taking the medicine and observe. March 12
(Third diagnosis): A low-grade fever occurred two days after the drug was stopped, and Zongyuanfang took another 5 doses. March 20
(Four Diagnosis): After taking the medicine, I occasionally have a low-grade fever. In recent days, my stomach is poor, sometimes I have abdominal pain in the middle of the night, and my stool is thin. After meals, I have a slight breath, a faint bowel sound, a deep and thin pulse, and a tongue without fur, which is a weakness of temper. Treatment should benefit qi and slow down the liver. Prescription: 6 grams of Codonopsis pilosula fried atractylodes 4 grams of poria cocos 3 grams of roasted licorice1.5 grams of dried tangerine peel 2.4 grams of papaya 3 grams of fried wheat 9 grams of Schisandra chinensis (beaten) 3 grams of jujube (cut) 3 pieces on April 2.
(5 diagnosis): the low fever has gone, and the appetite has improved. The original prescription has taken 5 doses, and all the symptoms are flat. (Medical Experience in Pu Fuzhou)
According to low fever, it is one of the common syndromes, which can be seen as a variety of diseases. UI is difficult to diagnose by examination, so western medicine is often labeled as "low fever to be investigated" Traditional Chinese medicine believes that some patients are caused by exogenous pathogenic heat lost in sweating, resulting in residual heat entanglement. Exogenous fever, if the evil is on the muscle surface, can be solved in a sweat. The key to the effectiveness of the contact method lies in whether the syndrome differentiation of stem is accurate and whether the prescription is appropriate. If you have a fever, you should use a heat-clearing and detoxicating agent, which is not in line with the pathogenesis and will lead to mistreatment.
For example 1, Jin believes that "the fever of sweating is beyond the treatment of common antiperspirant drugs, and Bupleurum and Radix Puerariae must be used to relieve muscle and penetrate the exterior, and it can still be perspired". This example shows that the nose is dry and blocked, and the dry mouth is knotted, indicating that the heat is more serious. Exogenous cold pathogen loses to sweating, turns heat into internal heat, and is treated with the method of clearing away heat and eliminating pathogenic factors, which can relieve both exterior and interior. After taking the medicine, the sweat will be relaxed, the stool will pass, the exterior will be relieved, and the stagnation of heat will subside.
The second syndrome belongs to yin deficiency and liver hyperactivity, mainly nourishing yin and regulating liver, and the chronic deficiency and low fever can be subsided by using cinnamon skillfully to cause fire to return to the original. Pu believes that there are many reasons for low-grade fever. "Improper treatment of exogenous fever, loss of appetite, or deficiency of constitution often leads to low-grade fever." Others, such as deficiency of middle qi, disharmony between liver and spleen, yin deficiency, qi deficiency and blood deficiency, can all cause internal injuries and low fever. In terms of treatment, he believes that bitter cold drugs should not be used more. Excessive use of bitter cold not only hurts the spleen and stomach, but also easily turns dryness into yin. The internal injury has low fever, the spleen and stomach are weak, and the dosage should be light. It is better to take another dose than to take a heavy dose. Otherwise, it is easy to hurt the qi, which will aggravate the symptoms.
Case 3: Deficiency of Qi and Yin. The prescription of Ganmai Jujube Decoction plus Astragalus membranaceus is also a method of warming and removing heat; In addition, the product of promoting fluid production and increasing fluid is added to replenish qi, nourish yin and remove heat. It is a rigorous prescription and proper medicine delivery.