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The high fever caused by internal injuries is due to yin yang disorder of Zang-fu. It is characterized by long disease course, acute outbreak and chronic consumption, followed with complicated symptoms such as coldness mixed with heat, deficiency mixed with excess, and exterior mixed with interior syndromes. It is difficult in clinical differentiations and treatments.
(1) Clearing away heat with the drugs of sweet taste and warm nature: clearing away heat with the drugs of sweet taste and warm nature is benefiting qi and raising yang to disperse heat syndromes and relieve qi deficiency with sweet taste drugs. Fever due to qi deficiency is commonly seen in chronic deficiency and injured diseases, such as chronic myocarditis, gastroptosis, and chronic hepatitis. Symptoms: long term low or high fever, low voice, short breath, fatigue, less taking, abdominal distension, loose stools, deep, thready and rapid pulse, pale tongue with thin coating. The formula is modification of Bu Zhong Yi Qi Tang. This method can treat fever due to blood deficiency, that is tonifying qi to produce blood. Therefore, some high fevers due to blood deficiency are treated by tonifying qi and producing blood. For instance, postpartum hemorrhage, menorrhagia, hemorrhage due to stomach disease and anemia due to nephropathy. Symptoms: afternoon fever, skin fever, palm fever, yellow complexion, pale and white lip, mouth and tongue, dizziness, dim-sighted, dry mouth, deep and thready pulse. The modification of Dang Gui Bu Xue Tang, Gui Pi Tang and Huang Qi Jian Zhong Tang are applied to supply qi and blood, regulate ying and wei, so as to relieve heat.
(2) Dispersing stasis and relieving heat: fever due to blood stasis is commonly seen in acute pelvic inflammation, appendicitis, fever after injury and acute cerebrovascular disease. Pathogenesis: qi turns into heat due to stagnation of qi and blood; and the stagnation of heat and blood lead to high fever. Symptoms: fever in the afternoon,  alternate chills and fever, local pain, followed with upset, irritability, palpitation, insomnia, dark of lip and eyes, dark red tongue with petechia, hesitant, or wiry and tense pulse. The modification of Tao Hong Si Wu Tang is commonly applied.

Key words: internal injury, high fever, differentiation and treatment

Author: Wuyi (ST15) Chen
The first Traditional Chinese medicine hospital of Kaifeng, Henan (475001)


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