Classica Sinica Medica

往來寒熱 简体 往来寒热

wǎng lái hán rè

Alternating chill and fever · wang lai han re

Also rendered: Alternating chill and fever (This site) · Coming-and-going cold and heat (Literal) · Intermittent fever (Clinical)

Pathology

Reviewed · 2026-10-31

At a glance

Pinyin
wǎng lái hán rè
Simplified
往来寒热
Literal
往 wǎng is to go, 來 lái to come; together they make the coming and going of a thing that will not stay. 寒 is cold and 熱 heat. The four graphs describe a fever that arrives as chill and departs as heat, or the reverse, and returns on its own schedule: not a steady heat, not a single shiver, but an alternation that the patient can time.
Shuowen
**《說文》：「往，之也。」「寒，凍也。」「熱，溫也。」** 往來者，去而復還之謂；寒熱者，一病而兩象。**六至十篇四見**：第六篇一（行216）、第七篇二（行324、351）、第九篇一（行637）。**與「潮熱」之别**：潮熱如潮有信，屬陽明裏實，僅熱而無寒；往來寒熱則寒熱迭作、休作有時，屬少陽半表半裏。**與「瘧」之别**：瘧亦寒熱往來，而其發有定日，此則逐日而作，不必間日。

In brief

The signature of shaoyang: chill and fever succeeding one another, coming and going with a rhythm the patient learns to expect. The chapter explains it as the upright qi and the pathogen contending below the flank — the two do not overcome each other, so one moment the body is cold and the next burning, and neither state holds. It is distinguished from the tide-like fever of yang brightness, which is heat alone, rises at a fixed hour and belongs to repletion within, and from malaria, whose alternation keeps to set days. Where it appears the treatment is to harmonise rather than to purge or to sweat, and the chapter’s answer is minor bupleurum; where heat is already bound within and the alternation persists, major bupleurum.

Senses in the classical corpus

1
少陽主證 往來寒熱，休作有時
血弱氣盡、腠理開，邪入與正氣相搏結於脅下，正邪分爭，故寒熱迭作而休作有時，主以小柴胡湯
Blood and qi both spent, the interstices open, the pathogen enters and wrestles with the upright qi below the flank; the two contend and neither prevails, so chill and fever alternate and stop of their own accord. Minor bupleurum governs.
血弱氣盡，腠理開，邪氣因入，與正氣相搏，結於脅下，正邪分爭，往來寒熱，休作有時，默默不欲飲食，藏府相連，其痛必下，邪高痛下，故使嘔也，小柴胡湯主之。 — 辨太陽病脉證并治中第六
2
熱結在裏而往來 復往來寒熱者
傷寒十餘日，熱結在裏，而仍往來寒熱，是裏結未全離少陽，故與大柴胡湯，兼下兼和
More than ten days in, heat is bound within and yet the alternation continues: the binding has not wholly left shaoyang. Major bupleurum both harmonises and purges.
傷寒十餘日，熱結在裏，復往來寒熱者，與大柴胡湯。 — 辨太陽病脉證并治下第七
3
轉入少陽 往來寒熱，尚未吐下
本太陽病不解而轉入少陽，脅下鞕滿、乾嘔不能食、往來寒熱，脉沉緊而未曾吐下，仍與小柴胡
A taiyang disease unresolved has turned into shaoyang: hardness and fullness below the flank, dry retching, inability to eat, alternating chill and fever, a deep tight pulse, and no vomiting or purging yet given. Minor bupleurum still applies.
本太陽病不解，轉入少陽者，脅下鞕滿，乾嘔不能食，往來寒熱，尚未吐下，脉沉緊者，與小柴胡湯。 — 辨少陽病脉證并治第九

Occurrences in the classics

Passages where the term does real work, with the original, pinyin and English on the same line.

Display
3 passages
辨太陽病脉證并治中第六·辨太陽病脉證并治中第六 Read in context →
血弱氣盡，腠理開，邪氣因入，與正氣相搏，結於脅下，正邪分爭，往來寒熱，休作有時，默默不欲飲食，藏府相連，其痛必下，邪高痛下，故使嘔也，小柴胡湯主之。 血弱气尽，腠理开，邪气因入，与正气相搏，结于胁下，正邪分争，往来寒热，休作有时，默默不欲饮食，藏府相连，其痛必下，邪高痛下，故使呕也，小柴胡汤主之。
xuè ruò qì jǐn còu lǐ kāi xié qì yīn rù yǔ zhèng qì xiāng bó jié yú xié xià zhèng xié fēn zhēng wǎng lái hán rè xiū zuò yǒu shí mò mò bù yù yǐn shí zàng fǔ xiāng lián qí tòng bì xià xié gāo tòng xià gù shǐ ǒu yě xiǎo chái hú tāng zhǔ zhī
When the blood is weak and the qi exhausted, the interstices open and the pathogenic qi enters. It wrestles with the upright qi and binds below the flank; upright and evil contend, so chills and fever alternate and the attacks come and go at fixed times. The patient is silent and does not wish for food. Viscera and bowels are linked together, so the pain must move downward: the evil is above and the pain below, which is why vomiting occurs. Minor Bupleurum Decoction governs it.
「正邪分爭」四字，是往來寒熱之根；「休作有時」四字，是其候。
辨太陽病脉證并治下第七·辨太陽病脉證并治下第七 Read in context →
傷寒十餘日，熱結在裏，復往來寒熱者，與大柴胡湯。 伤寒十余日，热结在里，复往来寒热者，与大柴胡汤。
shāng hán shí yú rì rè jié zài lǐ fù wǎng lái hán rè zhě yǔ dà chái hú tāng
After more than ten days of cold damage, with heat bound inside and alternating cold and heat returning, give Major Bupleurum Decoction.
熱結在裏而仍往來，故大柴胡兼下；若純裏實，則不復有寒。
辨少陽病脉證并治第九·辨少陽病脉證并治第九 Read in context →
本太陽病不解，轉入少陽者，脅下鞕滿，乾嘔不能食，往來寒熱，尚未吐下，脉沉緊者，與小柴胡湯。 本太阳病不解，转入少阳者，胁下硬满，干呕不能食，往来寒热，尚未吐下，脉沉紧者，与小柴胡汤。
běn tài yáng bìng bù jiě zhuǎn rù shào yáng zhě xié xià yìng mǎn gān ǒu bù néng shí wǎng lái hán rè shàng wèi tǔ xià mài chén jǐn zhě yǔ xiǎo chái hú tāng
When Taiyang disease is unresolved and turns into shaoyang, with hardness and fullness below the ribs, dry vomiting, inability to eat, alternating cold and heat, and no vomiting or purging yet given, if the pulse is deep and tense, give Minor Bupleurum Decoction.
太陽轉少陽之明文：脅下鞕滿、乾嘔不能食、往來寒熱三證並見。

Compounds built on this term

往來寒熱
wǎng lái hán rè
alternating chill and fever
辨少陽病脉證并治第九
休作有時
xiū zuò yǒu shí
remitting and returning on schedule
辨太陽病脉證并治中第六
正邪分爭
zhèng xié fēn zhēng
upright qi and pathogen contending
辨太陽病脉證并治中第六
潮熱
cháo rè
tide-like fever
辨陽明病脉證并治第八

How it has been translated

Every rendering below is a decision about which reader is being addressed. There is no neutral option.

This sitealternating chill and feverkeeps the coming and going
Literalgoing-and-coming cold and heatexact, but reads as weather
Clinicalintermittent fever with chillsclear, loses the alternation's rhythm

Entry status

Review pending — who reviews this?

2026-10-31

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Reading path

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