姜左 外寒束于表分，湿痰内蕴中焦，太阳阳明为病。寒热无汗，头疼，胸闷泛恶，纳谷减少，脉浮滑，
苔白腻。拟汗解化滞，重用表药。经云∶体若燔炭，汗出而散。
淡豆豉（三钱） 赤茯苓（三钱） 炒枳壳（一钱五分） 净麻黄（四分） 生姜（二片） 姜半夏（二钱）
六神曲（三钱） 青防风（一钱） 广陈皮（一钱） 炒谷芽（三钱） 炒赤芍（一钱五分）
孔左 外邪袭于太阳，湿滞内阻中焦，有汗恶风不解，遍体酸疼，胸闷泛恶，腹内作胀。宜疏邪解肌，化
滞畅中。
川桂枝（八分） 仙半夏（二钱） 炒枳壳（一钱） 白蔻仁（八分） 炒赤芍（一钱五分） 陈广皮（一钱）
大腹皮（二钱） 六神曲（三钱） 紫苏梗（一钱五分） 苦桔梗（一钱） 赤苓（三钱） 制
川朴（一钱） 生姜（二片）
张左 寒邪外束，痰饮内搏，支塞肺络，清肃之令不行，气机窒塞不宣，寒热无汗，咳嗽气喘，难于平卧，
胃有蕴热，热郁而烦躁，脉浮紧而滑，舌苔薄腻而黄。宜疏外邪以宣肺气，化痰饮而清胃热，大青龙加减。
蜜炙麻黄（四分） 云苓（三钱） 橘红（八分） 炙款冬（一钱五分） 川桂枝（六分） 象贝母（三钱）
半夏（二钱） 石膏（三钱） 旋复花（包，一钱五分） 杏仁（三钱） 生甘草（六分）
王左 脉郁数，苔薄腻尖红，身热不扬，烦躁不寐，时欲呕，此无形之邪，与有形之痰滞互阻阳明，阳明经
邪，不能外达也。宜疏达伏邪，而化痰滞。
淡豆豉（三钱） 薄荷叶（一钱） 鲜竹茹（枳实同炒，三钱） 炒谷麦芽（各三钱） 黑山栀（一钱五分）
朱茯神（三钱） 荆芥穗（一钱五分） 象贝母（三钱） 净蝉衣（一钱） 苦桔梗（一钱） 地枯萝（三钱）
清炙枇杷叶（去毛、包，三张）
吴左 发热不退，胸闷呕吐，舌中有一条白苔，脉弦滑而数，太阳阳明未解，痰滞逗留，中焦气滞，宣化失
司。当拟栀豉汤疏解表邪，温胆汤蠲除痰饮，俾得邪从外解，饮从内化，则热可退，而呕吐自止。
淡豆豉（三钱） 黄芩（一钱五分） 半夏（二钱） 炒谷麦芽（各三钱） 赤芍（二钱） 生姜（一片）
川桂枝（四分） 竹茹（一钱
五分） 陈皮（一钱） 鸡金炭（一钱五分） 泽泻（一钱五分）
袁右 伤寒两候，太阳之邪未罢，阳明之热已炽，热熏心包，神明无以自主，发热谵语，口渴欲饮，脊背
微寒，脉浮滑而数，苔黄。宜桂枝白虎，一解太阳之邪，一清阳明之热。
川桂枝（五分） 仙半夏（二钱） 生甘草（四分） 连翘（三钱） 熟石膏（打，三钱） 炙远志（一钱）
朱茯神（三钱） 知母（一钱五分） 生姜（一片） 红枣（二枚）
李左 伤寒挟滞，太阳阳明为病，身热十余日不解，脊背微寒，脉浮滑而数，口干不多饮，唇焦，苔薄腻
而黄，五六日不更衣，太阳之邪未罢，阳明之热熏蒸，肠中浊垢，不得下达。拟桂枝白虎汤加减，疏太阳之邪，
清阳明之热，助以通腑，盖阳明有胃实当下之条也。
川桂枝（五分） 生甘草（五分） 元明粉（一钱五分） 竹茹（一钱五分） 石膏（三钱） 栝蒌（三钱）
川军（三钱） 半夏（一钱五分） 生姜（二片） 大枣（三枚）
狄右 伤寒两候，壮热无汗，谵语烦躁，舌焦无津，脉象沉数，肢反逆冷，五六日不更衣，此邪已化热，由阳
明而传厥阴，阴液已伤，燥矢不下，有热深厥深之见象，风动痉厥，恐在目前。急拟生津清热，下则存阴，以望转机。
生石膏（四钱） 生甘草（五分） 肥知母（一钱五分） 鲜生地（六钱） 玄参（三钱） 鲜石斛（三钱）
郁李仁（研，三钱） 大麻仁（研，四钱） 天花粉（三钱） 茅芦根（各一两） 清宁丸（包煎，三钱）
二诊 昨进生津清热，下则存阴之剂，得便甚畅，壮热渐减，微汗蒸蒸，四肢转温，书所谓里气通而表自
和之意。惟口干欲饮，尚有谵语，舌上干糙未润，少阴津液已伤，阳明伏热尚炽，脉数未静。仍宜滋少阴之
阴，清阳明之热，冀其津生邪却，始得入于坦途。
生石膏（四钱） 肥知母（一钱五分） 生甘草（五分） 天花粉（三钱） 鲜生地（六钱） 鲜石斛（三钱）
玄参（三钱） 川贝（二钱） 冬桑叶（二钱） 粉丹皮（二钱） 北秫米（包，三钱） 茅芦根（各一两）
三诊 两进生津清热之剂，壮热大减，谵语亦止，舌糙黑未润，口干欲饮，脉数溲赤，阴液被热销铄，津
无上承。再拟甘凉生津，以清邪热。
羚羊片（五分） 鲜生地（八钱） 鲜石斛（五钱） 生石膏（打，四钱） 冬桑叶（二钱） 玄参（三钱）
生甘草（五分） 肥知母（一钱五分） 粉丹皮（二钱） 大麦冬（三钱） 茅芦根（各一两）
四诊 表里之邪，均已大减，舌焦黑转为红绛，津液有来复之渐，邪热有退化之机，脉数较和。仍守甘凉
生津，以清余焰。
西洋参（一钱） 鲜生地（八钱） 鲜石斛（五钱） 肥知母（一钱五分） 玄参（三钱） 大麦冬（三钱）
天花粉（三钱） 生甘草（五分） 桑叶（二钱） 粉丹皮（三钱） 川贝母（二钱） 北秫米（包，三钱）
茅芦根（各一两）
诸右 伤寒一候，经水适来，邪热陷入血室，瘀热交结，其邪外无向表之机，内无下行之势，发热恶寒，
早轻暮重，神糊谵语，如见鬼状，胁痛胸闷，口苦苔黄，少腹痛拒按，腑气不行，脉象弦数，症势重险，恐再进一步
则入厥阴矣。姑拟小柴胡汤，加清热通瘀之品，一以和解枢机之邪，一以引瘀热而下行，冀其应手为幸。
柴胡（一钱） 炒黄芩（一钱） 羚羊片（八分） 藏红花（八分） 桃仁泥（包，一钱） 青皮（一钱）
绛通草（八分） 赤芍（三钱） 清宁丸（包，三钱） 生蒲黄（包，二钱）
王左 肾阴本亏，寒邪外受，太阳少阴同病，发热微寒，遍体酸楚，腰痛如折，苔薄腻微黄，脉象尺弱，
寸关浮紧而数。太阳主一身之表，腰为少阴之府，风寒乘隙而入，营卫不能流通，两感重症。姑拟阳旦疏达表
邪，以冀速解为幸。
川桂枝（五分） 苏梗叶（各一钱五分） 北细辛（三分） 浓杜仲（一钱五分） 丝瓜络（一钱五分）
葱头（三枚） 酒炒黄芩（一钱） 淡豆豉（三钱） 炙甘草（五分） 晚蚕沙（三钱） 生姜（两片）
封左 诊脉浮紧而弦，舌苔干白而腻，身热不扬，微有恶寒，咳嗽气逆，十四昼夜不能平卧，咽痛淡红不
肿，两颧赤色，据述病起于夺精之后，寒邪由皮毛而入于肺，乘虚直入少阴之经，逼其水中之火飞越于上，书
曰戴阳重症也。阅前方，始而疏解，前胡、薄荷、牛蒡、杏、贝之品，继则滋养，沙参、石斛、毛燕、川贝，
不啻隔靴搔痒，扬汤止沸。夫用药如用兵，匪势凶猛，非勇悍之将，安能应敌也。拙拟小青龙合二加龙骨汤，
一以温解寒邪，一以收摄浮阳，未识能挽回否？尚希明哲指教。
蜜炙麻黄（五分） 川桂枝（八分） 大白芍（三钱） 生甘草（八分） 熟附片（一钱五分） 牡蛎
（，四钱） 花龙骨（四钱） 五味子（干姜三分拌捣，一钱） 光杏仁（三钱） 仙半夏（三钱）
水炙桑皮（二钱） 远志（八分）
服二剂后，气喘渐平，去麻黄又服两剂，颧红退，即更方，改用平淡之剂调理，如杏、贝、甘、桔、茯神、
桑皮、苡仁、冬瓜子、北秫米等，接服五六剂而痊。
姚左 伤寒两感，太阳少阴为病。太阳为寒水之经，本阴标阳，标阳郁遏，阳不通行，故发热恶寒而无
汗；少阴为水火之脏，本热标寒，寒入少阴，阴盛火衰，完谷不化，故腹痛而洞泄。胸闷呕吐，舌苔白腻，食滞中
宫，浊气上逆，脉象沉迟而细，仲圣云∶脉沉细，反发热，为少阴病。与此吻合，挟阴挟食，显然无疑，症势
非轻。姑宜温经达邪，和中消滞。
净麻黄（四分） 熟附子（一钱） 藿苏梗（各一钱五分） 制川朴（一钱） 枳实炭（一钱） 仙半夏（二钱）
赤苓（三钱） 白蔻仁（研，八分） 六神曲（三钱） 生姜（一片） 干荷叶（一角）
二诊 服温经达邪，和中消滞之剂，得微汗，恶寒发热较轻，而胸闷呕吐，腹痛泄泻，依然不止，苔腻不
化，脉沉略起，太阳之经邪，虽有外解之势，少阴之伏邪未达，中焦之食滞互阻，太阴清气不升，阳明浊气不降
也，恙势尚在重途，还虑增剧。仍守原法出入，击鼓而进取之。
荆芥（一钱） 防风（一钱） 淡豆豉（三钱） 熟附子（一钱） 藿苏梗（各一钱五分） 仙半夏（二钱）
生姜（二片） 枳实炭（一钱） 制川朴（一钱） 六神曲（三钱） 大腹皮（二钱） 酒炒 黄芩（一钱）
干荷叶（一角）
三诊 脉沉已起，恶寒已而身热未退，泄泻止而呕恶胸闷。渴喜热饮，心烦少寐，舌转灰腻，少阴之邪，已
转阳明之经，中焦之食滞，与素蕴之湿浊，互阻不化也，脉证参合，渐有转机。今拟透解阳明之经邪，宣化中焦
之湿滞。
粉葛根（二钱） 淡豆豉（三钱） 嫩前胡（一钱五分） 藿香梗（一钱五分） 炒黄芩（一钱五分）
仙半夏（二钱） 枳实炭（一钱） 炒竹茹（一钱五分） 六神曲（三钱） 大腹皮（二钱） 赤茯苓（朱砂拌，三钱）
干荷叶（一角）
四诊 得汗，表热大减，而里热尚炽，呕恶止而胸脘不舒，渴喜冷冻饮料，心烦少寐，小溲短赤，舌边尖红绛
碎痛，苔转薄黄，脉象濡数，良由寒已化热，热又伤阴，津少上承，心肝之火内炽，还虑劫液之变。今拟生津清解
而降浮火，邪却津生，始得坦然。
天花粉（三钱） 生甘草（五分） 炒黄芩（一钱五分） 川雅连（四分） 连翘壳（三钱） 朱茯神（三钱）
江枳壳（一钱） 炒竹茹（一钱五分） 川贝母（二钱） 活芦根（一尺）
五诊 表里之热均减，渴喜冷冻饮料，心烦少寐，小溲短赤，舌红绛碎痛，糜点已起，脉左弦数，右濡数。此阴
液已伤，津乏上承，心肝之火内炽，伏热蕴湿交蒸，病情
变化，正难预料。仍以滋液生津，引火下行。
西洋参（一钱五分） 生甘草（五分） 鲜生地（四钱） 川连（五分） 川通草（八分） 天花粉（三钱）
川贝（二钱） 连翘（三钱） 白薇（一钱五分） 北秫米（包，三钱） 鲜竹叶（三十张） 活芦根（去节，一尺）
六诊 热势渐退，舌糜亦化，佳兆也。而心烦少寐，渴喜冷冻饮料，脉数不靖，阴液伤而难复，虚火旺而易
升，邪热已解，余焰未清，仍守增液生津，引火下行，药既获效，毋庸更张。
原方加琥珀安寐丸（一钱五分），野蔷薇花露（半斤），入煎。
贺右 伤寒两感，挟滞交阻，太阳少阴同病。恶寒发热，头痛无汗，胸闷腹痛拒按，泛恶不能饮食，腰酸
骨楚，苔白腻，脉象沉细而迟。病因经后房劳而得，下焦有蓄瘀也。虑其传经增剧。拟麻黄附子细辛汤加味，
温经达邪，去瘀导滞。
净麻黄（四分） 熟附片（一钱五分） 细辛（三分） 赤苓（三钱） 仙半夏（三钱） 枳实炭（一钱）
制川朴（一钱） 大砂仁（八分） 楂炭（三钱） 延胡索（一钱） 两头尖（酒浸、包，一钱五分） 生姜（三片）
二诊 昨投麻黄附子细辛汤，去瘀导滞之剂，得畅汗，寒邪已得外达，发热渐退，腹痛亦减，惟头胀且痛，
胸闷不思纳食，脉象沉迟，舌苔薄腻，余邪瘀滞未楚，阳气不通，脾胃健运失司。今制小其剂而转化之。
川桂枝（五分） 炒赤芍（三钱） 紫苏梗（一钱五分） 云苓（三钱） 仙半夏（三钱） 枳实炭（一钱）
金铃子（二钱） 延胡索（一钱） 大砂仁（八分） 炒谷麦芽（各三钱） 生姜（三片）
杨右 脉象浮弦，汗多如雨，恶风发热不解，遍体骨楚，少腹痛拒按，舌苔薄而腻，病从房劳经后而得。
风入太阳，皮毛开而经 闭，蓄瘀积而气滞阻，即两感之重症也。亟宜温经达邪，去瘀消滞，以冀应手乃吉。
川桂枝（八分） 白芍（二钱） 清炙草（八分） 熟附子（二钱） 云茯苓（三钱） 砂仁（八分）
焦楂炭（三钱） 五灵脂（一钱） 两头尖（酒浸、包，一钱五分） 生姜（三片）
此症一剂而愈，故录之。明日以桂枝汤加和胃之品调之。
陈左 气阴已伤，伏邪留恋，渐欲传入少阴，虚阳易于外越，痰湿弥漫中宫，清阳不能宣布，颇虑正虚邪
实。姑拟扶正达邪，宣化痰湿，俾太阴之邪，从阳枢外泄乃顺。
潞党参（三钱） 生甘草（八分） 广陈皮（一钱五分） 熟附块（二钱） 仙半夏（三钱） 熟谷芽（三钱）
软柴胡（八分） 云茯
苓（三钱） 生姜（三片） 红枣（五枚）
卫左 始由发热恶寒起见，继则表不热而里热，口干不欲饮，四肢逆冷，脉沉苔腻，加之呕恶呃逆，大便
不实。外邪由太阳而陷于太阴，不得泄越，阳气被遏，胃阳不宣也。脉沉非表，为邪陷于里之证。四肢逆冷，经
Jiang, Left: External cold binds the exterior, damp-phlegm accumulates in the middle jiao, resulting in concurrent Taiyang and Yangming diseases. Manifestations include alternating chills and fever, anhidrosis, headache, chest oppression with nausea, reduced appetite, floating-slippery pulse, and white-greasy tongue coating. The treatment strategy is to induce sweating to resolve the exterior and transform stagnation, heavily utilizing exterior-resolving herbs. As stated in the *Classic*: "When the body is hot as if burning charcoal, sweating disperses the heat."
Prescription: Fermented Soybean (Sanqian), Red Poria (Sanqian), Stir-fried Bitter Orange (Yiqianwufen), Purified Ephedra (Sifen), Fresh Ginger (Pian), Pinellia Prepared with Ginger (Erqian), Medicated Leaven (Sanqian), Blue Windproof (Yiqian), Broad-leaved Tangerine Peel (Yiqian), Stir-fried Rice Sprout (Sanqian), Stir-fried Red Peony Root (Yiqianwufen).
Kong, Left: External pathogens attack the Taiyang channel, damp-stagnation obstructs the interior of the middle jiao. Sweating occurs but aversion to wind persists without relief, accompanied by generalized body aches, chest oppression with nausea, and abdominal distension. The approach should be to disperse pathogens and release the muscle layer, transforming stagnation to unblock the middle.
Prescription: Cinnamon Twig (Bafen), Pinellia Prepared with Ginger (Erqian), Stir-fried Bitter Orange (Yiqian), White Cardamom Seed (Bafen), Stir-fried Red Peony Root (Yiqianwufen), Aged Tangerine Peel (Yiqian), Greater Citron Fruit (Erqian), Medicated Leaven (Sanqian), Perilla Stem (Yiqianwufen), Bupleurum Root (Yiqian), Red Poria (Sanqian), Magnolia Bark Prepared (Yiqian), Fresh Ginger (Pian).
Zhang, Left: Cold pathogens bind externally, phlegm-fluids collide internally, obstructing lung collaterals. The descending function of the lungs fails, causing qi mechanism obstruction. Symptoms include chills, fever, anhidrosis, cough, asthma, difficulty lying flat. Stomach harbors latent heat, leading to irritability due to heat constraint. Pulse is floating-tight and slippery; tongue coating is thin-greasy and yellow. Treatment should dispel external pathogens to diffuse lung qi, transform phlegm-fluids, and clear stomach heat. Modified Da Qing Long Tang.
Prescription: Honey-fried Ephedra (Sifen), Cloud Poria (Sanqian), Orange Peel (Bafen), Flower of Winter Jasmine Prepared (Yiqianwufen), Cinnamon Twig (Lifen), Fritillaria Bulb (Sanqian), Pinellia (Erqian), Gypsum (Sanqian), Inula Flower wrapped (Yiqianwufen), Apricot Seed (Sanqian), Raw Licorice (Lifen).
Wang, Left: Pulse is constrained and rapid; tongue coating is thin-greasy with a red tip. Body heat is not prominent, irritability and insomnia are present, frequent urge to vomit. This indicates formless pathogens interacting with有形 (form) phlegm-stagnation obstructing the Yangming channel, preventing external release. Strategy: Disperse latent pathogens and transform phlegm-stagnation.
Prescription: Fermented Soybean (Sanqian), Mint Leaf (Yiqian), Fresh Bamboo Shavings stir-fried with Immature Bitter Orange (Sanqian), Stir-fried Grain Sprouts (Sanqian each), Black Gardenia (Yiqianwufen), Poria with Salvia Root dyed red (Sanqian), Schizonepeta Spike (Yiqianwufen), Fritillaria Bulb (Sanqian), Cicada Slough (Yiqian), Bupleurum Root (Yiqian), Radish Root dried (Sanqian), Loquat Leaf prepared with honey, de-haired, wrapped (Sanzhang).
Wu, Left: Fever persists, chest oppression and vomiting occur. A strip of white coating appears on the center of the tongue. Pulse is wiry-slippery and rapid. Taiyang-Yangming exterior syndrome remains unresolved; phlegm-stagnation lingers, causing middle jiao qi stagnation and failure of diffusion/transformation. Prescribe Zhi Chi Tang to disperse exterior pathogens, and Wen Dan Tang to eliminate phlegm-fluids, allowing pathogens to exit externally and fluids to transform internally, thus reducing fever and stopping vomiting.
Prescription: Fermented Soybean (Sanqian), Scutellaria (Yiqianwufen), Pinellia (Erqian), Stir-fried Grain Sprouts (Sanqian each), Red Peony Root (Erqian), Fresh Ginger (Pian), Cinnamon Twig (Sifen), Bamboo Shavings (Yiqianwufen), Tangerine Peel (Yiqian), Charred Chicken Gizzard Lining (Yiqianwufen), Alisma (Yiqianwufen).
Yuan, Right: Two periods have passed since onset of cold damage. Taiyang pathogen has not subsided, while Yangming heat is blazing. Heat steams the Pericardium, disturbing the mind, causing fever, delirious speech, thirst with desire to drink, slight chills on the spine. Pulse is floating-slippery-rapid; tongue coating is yellow. Use Guizhi Baihu Tang to simultaneously resolve Taiyang pathogen and clear Yangming heat.
Prescription: Cinnamon Twig (Wufen), Pinellia Prepared with Ginger (Erqian), Raw Licorice (Sifen), Forsythia (Sanqian), Calcined Gypsum crushed (Sanqian), Polygala Root prepared (Yiqian), Poria with Salvia Root dyed red (Sanqian), Anemarrhena (Yiqianwufen), Fresh Ginger (Pian), Jujube (Ermei).
Li, Left: Cold damage complicated by food stagnation, affecting both Taiyang and Yangming. Fever for over ten days without resolution, slight chills on the spine, floating-slippery-rapid pulse, dry mouth with little desire to drink, cracked lips, thin-greasy yellow tongue coating. No bowel movement for five to six days. Taiyang pathogen remains, Yangming heat steams intestines, turbid filth cannot descend. Modify Guizhi Baihu Tang to disperse Taiyang pathogen, clear Yangming heat, and assist in purging the bowels, following the principle that Yangming excess requires purgation.
Prescription: Cinnamon Twig (Wufen), Raw Licorice (Wufen), Mirabilite (Yiqianwufen), Bamboo Shavings (Yiqianwufen), Gypsum (Sanqian), Trichosanthes Fruit (Sanqian), Rhubarb (Sanqian), Pinellia (Yiqianwufen), Fresh Ginger (Pian), Jujube (Sanmei).
Di, Right: Two periods have passed since onset of cold damage. High fever with anhidrosis, delirious speech and irritability, scorched tongue without fluid, sinking-rapid pulse, cold extremities reversed, no bowel movement for five to six days. Pathogen has transformed into heat, transmitting from Yangming to Jueyin. Yin fluids are damaged, dry stool cannot pass. Signs of "deep heat causes deep cold" appear; risk of wind stirring and convulsions is imminent. Urgently nourish yin and clear heat; purging preserves yin, hoping for a turning point.
Prescription: Raw Gypsum (Siquan), Raw Licorice (Wufen), Large Anemarrhena (Yiqianwufen), Fresh Rehmannia (Liucun), Scrophularia (Sanqian), Fresh Dendrobium (Sanqian), Prunus Seed crushed (Sanqian), Hemp Seed crushed (Siquan), Trichosanthes Root (Sanqian), Imperata Rhizome and Phragmites Rhizome (Liangge Yiliang), Qingning Pills wrapped (Siquan).
Second Visit: After taking the previous prescription for nourishing yin, clearing heat, and purging to preserve yin, bowel movement was smooth, high fever gradually decreased, slight sweating occurred, limbs warmed. This aligns with the saying: "When interior qi flows freely, exterior harmonizes spontaneously." However, dry mouth with desire to drink persists, delirium remains, tongue is dry and rough, indicating injury to Shaoyin yin fluids and lingering Yangming latent heat. Pulse remains rapid. Continue nourishing Shaoyin yin and clearing Yangming heat, hoping for fluid generation and pathogen elimination to proceed smoothly.
Prescription: Raw Gypsum (Siquan), Large Anemarrhena (Yiqianwufen), Raw Licorice (Wufen), Trichosanthes Root (Sanqian), Fresh Rehmannia (Liucun), Fresh Dendrobium (Sanqian), Scrophularia (Sanqian), Sichuan Fritillaria (Erqian), Mulberry Leaf (Erqian), Moutan Cortex (Erqian), Sorghum wrapped (Sanqian), Imperata Rhizome and Phragmites Rhizome (Liangge Yiliang).
Third Visit: After two doses of yin-nourishing and heat-clearing agents, high fever greatly reduced, delirium stopped. Tongue coating is rough-black and unmoistened, dry mouth with desire to drink, rapid pulse, dark urine. Yin fluids were scorched by heat, unable to ascend. Further prescribe sweet-cool fluids to generate yin and clear pathogenic heat.
Prescription: Antelope Horn slices (Wufen), Fresh Rehmannia (Baqian), Fresh Dendrobium (Wuqian), Raw Gypsum crushed (Siquan), Mulberry Leaf (Erqian), Scrophularia (Sanqian), Raw Licorice (Wufen), Large Anemarrhena (Yiqianwufen), Moutan Cortex (Erqian), Ophiopogon (Sanqian), Imperata Rhizome and Phragmites Rhizome (Liangge Yiliang).
Fourth Visit: Exterior and interior pathogens largely reduced. Tongue color changed from scorched-black to crimson-red, signs of yin recovery appearing, pathogenic heat retreating, pulse number becoming milder. Continue sweet-cool yin-generation to clear residual heat.
Prescription: American Ginseng (Yiqian), Fresh Rehmannia (Baqian), Fresh Dendrobium (Wuqian), Large Anemarrhena (Yiqianwufen), Scrophularia (Sanqian), Ophiopogon (Sanqian), Trichosanthes Root (Sanqian), Raw Licorice (Wufen), Mulberry Leaf (Erqian), Moutan Cortex (Sanchian), Sichuan Fritillaria (Erqian), Sorghum wrapped (Sanqian), Imperata Rhizome and Phragmites Rhizome (Liangge Yiliang).
Zhu, Right: One period has passed since onset of cold damage. Menstruation just started; pathogenic heat sank into the Blood Chamber. Stasis and heat interlocked. Pathogen has no outward direction nor downward momentum. Chills and fever, lighter in morning, heavier in evening, confused spirit with delirium, seeing hallucinations, hypochondriac pain and chest oppression, bitter taste, yellow tongue coating, lower abdominal pain with refusal to press, fu-organ qi blocked. Pulse wiry-rapid. Condition is severe and dangerous; fear of transmission to Jueyin. Tentatively prescribe Xiao Chai Hu Tang plus heat-clearing and blood-invigorating herbs to harmonize the pivot and guide stasis-heat downward.
Prescription: Bupleurum (Yiqian), Stir-fried Scutellaria (Yiqian), Antelope Horn slices (Bafen), Saffron (Bafen), Peach Kernel paste wrapped (Yiqian), Green Mandarin Peel (Yiqian), Red Reed Joint (Bafen), Red Peony Root (Sanqian), Qingning Pills wrapped (Siquan), Raw Polygonatum wrapped (Erqian).
Wang, Left: Kidney yin originally deficient, external cold acquired. Concurrent Taiyang and Shaoyin disease. Fever with slight chills, generalized soreness, waist pain like breaking, thin-greasy slightly yellow tongue coating, weak chi pulse, floating-tight-rapid cunkou and guankou pulses. Taiyang governs the exterior; waist is the mansion of Shaoyin. Wind-cold entered through gaps, Ying and Wei circulation blocked. Severe Lianggan (dual infection). Tentatively use Yang Dan Tang to disperse exterior pathogens.
Prescription: Cinnamon Twig (Wufen), Perilla Stem and Leaf (Yiqianwufen each), Northern Asarum (Sfen), Eucommia Bark concentrated (Yiqianwufen), Luffa Network (Yiqianwufen), Scallion Head (Sanmei), Wine-fried Scutellaria (Yiqian), Fermented Soybean (Sanqian), Honey-fried Licorice (Wufen), Silkworm Sand (Sanqian), Fresh Ginger (Pian).
Feng, Left: Pulse floating-tight and wiry; tongue coating dry-white and greasy. Body heat not prominent, slight aversion to cold, cough with rebellious qi, unable to lie flat for 14 days. Throat painful, pale red, non-swollen, malar flush. History of onset after essence depletion. Cold entered via skin/hair into Lung, then directly into Shaoyin channel due to deficiency, forcing fire from water to fly upward. Book calls this severe Dai Yang (floating yang) syndrome. Previous prescriptions used dispersion (Peucedanum, Mint, Arctium, Apricot, Fritillaria) then nourishment (Glehnia, Dendrobium, Bird's Nest, Fritillaria), ineffective like scratching an itch through boots or boiling water to stop fire. Medication is like warfare; only brave generals can fight fierce enemies. I tentatively prescribe Xiao Qing Long Tang combined with Er Jia Long Gu Tang to warm-disperse cold and secure floating yang.
Prescription: Honey-fried Ephedra (Wufen), Cinnamon Twig (Bafen), Large White Peony Root (Sanqian), Raw Licorice (Bafen), Prepared Aconite Slice (Yiqianwufen), Oyster Shell (Siquan), Dragon Bone flower (Siquan), Schisandra Berry (mixed with 3 fen dried ginger, pounded, Yiqian), Almond (Sanqian), Pinellia Prepared with Ginger (Sanqian), Mulberry Bark water-prepared (Erqian), Polygala (Bafen).
After two doses, wheezing gradually calmed. Ephedra removed, took two more doses, malar flush receded. Formula changed to mild regulators: Apricot, Fritillaria, Licorice, Platycodon, Poria, Mulberry Bark, Coix Seed, Winter Melon Seed, Sorghum, etc. Continued for 5-6 doses until cured.
Yao, Left: Cold damage Lianggan, Taiyang-Shaoyin disease. Taiyang is Water channel, root yin marked yang. Marked yang constrained, yang not circulating, hence fever, chills, anhidrosis. Shaoyin is Water-Fire organ, root heat marked cold. Cold enters Shaoyin, yin excess fire decline, undigested food passes, hence abdominal pain and watery diarrhea. Chest oppression, vomiting, white-greasy tongue coating, food stagnation in middle jiao, turbid qi rebelling upward. Pulse sinking-slow-thin. Zhang Zhongjing says: "Pulse sinking-thin, yet feverish, is Shaoyin disease." Matches perfectly. Cold and food stagnation evident. Condition serious. Tentatively warm channels to reach pathogen, harmonize middle to digest stagnation.
Prescription: Purified Ephedra (Sifen), Prepared Aconite (Yiqian), Agastache and Perilla Stems (Yiqianwufen each), Prepared Magnolia Bark (Yiqian), Charred Immature Bitter Orange (Yiqian), Pinellia Prepared with Ginger (Erqian), Red Poria (Sanqian), White Cardamom crushed (Bafen), Medicated Leaven (Sanqian), Fresh Ginger (Pian), Dry Lotus Leaf (Yijiao).
Second Visit: After warming channels and digesting stagnation, slight sweat obtained, chills/fever lighter. But chest oppression, vomiting, abdominal pain/diarrhea persist, greasy coating unchanged, pulse slightly risen. Taiyang exterior pathogen showing signs of release, but Shaoyin latent pathogen not reached, middle jiao food stagnation obstructs. Taiyang clear qi not ascending, Yangming turbid qi not descending. Condition still serious, fear worsening. Stick to original method with modifications, advance like drumming.
Prescription: Schizonepeta (Yiqian), Saposhnikovia (Yiqian), Fermented Soybean (Sanqian), Prepared Aconite (Yiqian), Agastache and Perilla Stems (Yiqianwufen each), Pinellia Prepared with Ginger (Erqian), Fresh Ginger (Pian), Charred Immature Bitter Orange (Yiqian), Prepared Magnolia Bark (Yiqian), Medicated Leaven (Sanqian), Greater Citron Fruit (Erqian), Wine-fried Scutellaria (Yiqian), Dry Lotus Leaf (Yijiao).
Third Visit: Pulse sunk has risen, chills stopped but fever remains, diarrhea stopped but vomiting/chest oppression persist. Thirst for hot drinks, irritability, poor sleep, tongue turned gray-greasy. Shaoyin pathogen transferred to Yangming channel. Middle jiao food stagnation interacts with inherent damp-turbidity, obstructing transformation. Pulse/symptoms show gradual improvement. Now plan to penetrate-release Yangming channel pathogen, diffuse-transform middle jiao damp-stagnation.
Prescription: Kudzu Root (Erqian), Fermented Soybean (Sanqian), Young Peucedanum (Yiqianwufen), Agastache Stem (Yiqianwufen), Stir-fried Scutellaria (Yiqianwufen), Pinellia Prepared with Ginger (Erqian), Charred Immature Bitter Orange (Yiqian), Stir-fried Bamboo Shavings (Yiqianwufen), Medicated Leaven (Sanqian), Greater Citron Fruit (Erqian), Red Poria mixed with Cinnabar (Sanqian), Dry Lotus Leaf (Yijiao).
Fourth Visit: Obtained sweat, exterior heat greatly reduced, interior heat still blazing. Vomiting stopped but chest/epigastric discomfort remains, thirst for cold drinks, irritability, poor sleep, scanty dark urine, red-cracked painful tongue edges/tips, thin-yellow coating, soggy-rapid pulse. Cold transformed to heat, heat injured yin, insufficient fluids to ascend, Heart-Liver fire blazing internally. Fear fluid exhaustion. Now plan to generate fluids, clear and release, descend floating fire. Once pathogen leaves and fluids return, peace ensues.
Prescription: Trichosanthes Root (Sanqian), Raw Licorice (Wufen), Stir-fried Scutellaria (Yiqianwufen), Coptis (Sifen), Forsythia Husk (Sanqian), Poria with Salvia Root dyed red (Sanqian), Jiang Bitter Orange (Yiqian), Stir-fried Bamboo Shavings (Yiqianwufen), Sichuan Fritillaria (Erqian), Living Reed Root (Yichi).
Fifth Visit: Exterior-interior heat both reduced, thirst for cold drinks, irritability, poor sleep, scanty dark urine, red-cracked painful tongue with ulceration, left wiry-rapid pulse, right soggy-rapid. Yin fluids damaged, lack of fluids to ascend, Heart-Liver fire blazing internally, latent heat and damp steaming together. Condition changes hard to predict. Still nourish fluids, generate yin, guide fire downward.
Prescription: American Ginseng (Yiqianwufen), Raw Licorice (Wufen), Fresh Rehmannia (Siquan), Coptis (Wufen), Sichuan Reed Joint (Bafen), Trichosanthes Root (Sanqian), Sichuan Fritillaria (Erqian), Forsythia (Sanqian), Anemarrhena (Yiqianwufen), Sorghum wrapped (Sanqian), Fresh Bamboo Leaf (Sanshizhang), Living Reed Root de-jointed (Yichi).
Sixth Visit: Heat trend gradually receding, tongue ulcers healing, good omen. Irritability, poor sleep, thirst for cold drinks, restless rapid pulse remain. Yin damaged hard to recover, deficient fire easy to rise. Pathogenic heat resolved, residual flames uncleaned. Continue increasing fluids, generating yin, guiding fire downward. Prescription effective, no need to change.
Original formula plus Amber Calming Pill (Yiqianwufen), Wild Rose Dew (Banjin), added to decoction.
He, Right: Cold damage Lianggan, complicated by stagnation, Taiyang-Shaoyin concurrent disease. Chills fever, headache anhidrosis, chest oppression abdominal pain refusing pressure, nausea unable to eat, sore waist bones, white-greasy tongue coating, sinking-slow-thin pulse. Cause: intercourse after menstruation, stasis accumulation in lower jiao. Fear transmission worsening. Prescribe Ma Huang Fu Zi Xi Xin Tang modified to warm channels, reach pathogen, remove stasis, guide stagnation.
Prescription: Purified Ephedra (Sifen), Prepared Aconite Slice (Yiqianwufen), Asarum (Sfen), Red Poria (Sanqian), Pinellia Prepared with Ginger (Sanqian), Charred Immature Bitter Orange (Yiqian), Prepared Magnolia Bark (Yiqian), Amomum (Bafen), Hawthorn Char (Sanqian), Corydalis (Yiqian), Both Ends Sharp (wine soaked wrapped, Yiqianwufen), Fresh Ginger (Sanpian).
Second Visit: Yesterday administered Ma Huang Fu Zi Xi Xin Tang to remove stasis/guide stagnation. Profuse sweat obtained, cold pathogen reached exterior, fever receding, abdominal pain reduced. Only head distension/pain, chest oppression no appetite, sinking-slow pulse, thin-greasy tongue coating. Residual pathogen/stagnation not cleared, yang qi not flowing, spleen-stomach transport failed. Reduce dose to transform.
Prescription: Cinnamon Twig (Wufen), Stir-fried Red Peony Root (Sanqian), Perilla Stem (Yiqianwufen), Cloud Poria (Sanqian), Pinellia Prepared with Ginger (Sanqian), Charred Immature Bitter Orange (Yiqian), Golden Bell Fruit (Erqian), Corydalis (Yiqian), Amomum (Bafen), Stir-fried Grain Sprouts (Sanqian each), Fresh Ginger (Sanpian).
Yang, Right: Pulse floating-wiry, sweating profuse like rain, aversion to wind fever unresolved, generalized bone ache, lower abdominal pain refusing pressure, thin-greasy tongue coating. Cause: intercourse after menstruation. Wind enters Taiyang, pores open but menses closed, stasis accumulates qi blocked. Severe Lianggan. Urgently warm channels to reach pathogen, remove stasis digest stagnation.
Prescription: Cinnamon Twig (Bafen), White Peony (Erqian), Honey-fried Licorice (Bafen), Prepared Aconite (Erqian), Cloud Poria (Sanqian), Amomum (Bafen), Charred Hawthorn (Sanqian), Trogopterus Dung (Yiqian), Both Ends Sharp (wine soaked wrapped, Yiqianwufen), Fresh Ginger (Sanpian).
This case cured in one dose, recorded here. Next day regulate with Guizhi Tang plus stomach-harmonizing herbs.
Chen, Left: Qi and yin damaged, latent pathogen lingers, gradually entering Shaoyin. Deficient yang easily escapes outward. Damp-turbidity fills middle jiao, clear yang cannot announce. Fear deficiency real/pathogen strong. Tentatively support righteous to reach pathogen, diffuse transform damp-turbidity, so Taiyin pathogen exits via yang pivot smoothly.
Prescription: Dang Shen (Sanqian), Raw Licorice (Bafen), Broad Tangerine Peel (Yiqianwufen), Prepared Aconite Block (Erqian), Pinellia Prepared with Ginger (Sanqian), Cooked Grain Sprout (Sanqian), Soft Bupleurum (Bafen), Cloud Poria (Sanqian), Fresh Ginger (Sanpian), Jujube (Wumei).
Wei, Left: Initially fever chills, later exterior not hot but interior hot, dry mouth no desire to drink, cold extremities, sinking pulse greasy coating, plus vomiting hiccup loose stool. Exterior pathogen sank from Taiyang to Taiyin, unable to vent, yang qi constrained, stomach yang not announced. Sinking pulse not exterior, indicates pathogen sinking interior. Cold extremities, channel...