bubble_chart Concept

Feverish feeling in palms and soles refers to fever in the palms and soles. This fever is often detected by touch in infants and young children, while older children may also report it themselves.

This condition is referred to as "heat in the palms" and "heat in the soles" in Neijing and Nan Jing; in the "Cold-Damage Disease Treatise," it is called "heat in the soles"; Zhubing Yuanhou Lun refers to it as "heat in the palms," while later generations of physicians have termed it "feverish feeling in palms and soles."

Although this condition shares the meaning of "heat in the hands and feet" with symptoms such as "slight warmth in the hands and feet," "vexing heat in the hands and feet," and "vexing heat in the limbs," the affected areas and the degree of fever differ. This article focuses solely on localized fever in the palms and soles.

This condition also shares similarities with "vexing heat in the chest, palms, and soles," but "vexing heat in the chest, palms, and soles" additionally includes fever in the chest area, often a self-reported symptom in adult patients, and thus will not be discussed in this article.

bubble_chart Pattern Analysis

1. Malnutrition Due to Spleen Deficiency︰Feverish feeling in palms and soles, emaciated physique, complexion shallow yellow, skin and hair withered, fatigued and prefers lying down, reluctance to take milk or food, epigastric abdominal distension and fullness, flushed cheeks with dysphoria, late afternoon tidal fever, steaming bone fever with night sweat, restless sleep at night, loose stool thin or dry and knotted, urine yellow and turbid like rice water, tongue texture red with scant coating, pulse thin and rapid, finger veins pale and sluggish. The causes of its formation are: first, dietary irregularities, indulgence in rich and sweet foods, injury to the spleen and stomach, leading to impaired transportation and transformation, resulting in retention of food. Prolonged retention of food prevents the absorption of essential nutrients, leading to infantile malnutrition with accumulation and fever; second, transformation from other diseases into malnutrition. Conditions such as vomiting and diarrhea, dysentery, or parasitic infections (e.g., Chinese Taxillus Herb) injure qi and blood, deplete body fluids, and disrupt the middle energizer's functions of reception and transportation, eventually resulting in infantile malnutrition over time. This is a pattern of deficiency complicated by excess. In the initial stage (first stage), the disease lies in retention of food, with a focus on dispersing accumulation. Options include Xiaogan Li Pi Tang (Malnutrition-Dispersing Spleen-Regulating Decoction), Chubby Child Pill, etc. Subsequently, Ginseng, Poria and White Atractylodes Powder can be selected to tonify the spleen and replenish qi. If the constitution is deficient but retention of food remains unresolved, presenting a complex deficiency-excess pattern, the method should combine attack and supplementation. Options include Qingre Sweet Dew Decoction (Heat-Clearing Sweet Dew Decoction), Suppressing the Liver and Reinforcing the Spleen Decoction, etc. If a pure deficiency pattern manifests, methods to tonify qi and nourish yin should be employed, with formulas such as Bufeisan (Lung-Tonifying Powder), Turtle Carapace Powder, Ginseng Nutrient-Nourishing Decoction, etc.
2. Yin Deficiency︰feverish feeling in palms and soles, listlessness, emaciation, cough with scanty sputum, dizzy vision and tinnitus, dry mouth and throat, afternoon tidal fever, flushed cheeks, night sweat, restlessness and insomnia, frequent urination, severe constipation, red tongue with scant fluid, smooth and less-coated tongue surface, thin and rapid weak pulse. The cause of the disease is mostly due to innate weakness, or after a major illness or Rebing, failure to recuperate properly, depletion of yin-blood, healthy qi not yet restored, leading to the failure of various organs to receive nourishment from yin-blood, resulting in a yin deficiency with internal heat deficiency pattern. Treatment can be tailored based on accompanying symptoms of feverish feeling in palms and soles. If dry cough, poor appetite, and dry stools are prominent, it indicates lung and stomach yin deficiency, and Adenophora and Ophiopogon Decoction can be selected to enrich and tonify the yin of the lung and stomach; if restlessness and insomnia are prominent, it indicates insufficiency of heart yin, and Sour Jujube Decoction can be used to enrich yin and tranquilize the spirit; if tinnitus, dizzy vision, or even muscle spasms are present, it indicates liver-kidney yin deficiency, and treatment should focus on nourishing the liver and kidney, using formulas such as Anemarrhena and Phellodendron Rehmannia Decoction.

The differentiation between infantile malnutrition with accumulation due to spleen deficiency and blood deficiency with yin depletion involves two main aspects: First, inquire about the medical history. The former initially presents with an excess pattern, gradually revealing a deficiency pattern. The latter develops from injuries to yin fluids caused by other illnesses. Second, distinguish the symptoms. The former exhibits obvious symptoms of food retention in the spleen and stomach, such as abdominal distension and fullness, undigested food in the stool, milky urine, or the consumption of non-food items like soil or coal cinders. The latter shows signs of yin and blood deficiency with internal heat, such as tidal fever, flushed cheeks, dry throat, dry cough, and a thin, rapid pulse.

For children with feverish sensations in the palms and soles, while using medication, attention should also be paid to dietary care. Even for children with infantile malnutrition due to spleen deficiency, it is necessary to supplement with a certain amount of nutritious food. The ancient saying, "Nourishing the right will naturally eliminate the accumulation," is indeed a valuable insight. Additionally, it is important to let the child get more sunlight and breathe fresh air to promote recovery of their constitution.

bubble_chart Documentation

1. Nan Jing．The Sixteenth Difficulty: "Suppose one obtains the heart pulse, its external symptoms are: a red face, dry mouth, and a tendency to laugh; its internal symptoms are: moving qi above the navel, which feels firm and painful when pressed; the illness: vexation, heart pain, heat in the palms, and retching. If these symptoms are present, it is the heart; if not, it is not."
2. 《Bao Ying Jin Jing Lu》: "Children with distended chest and abdomen. Fever and sudden oppression, pulse patterns like stringed pearls, crying when the abdomen is pressed, this belongs to spleen and stomach deficiency, and food stagnation."