鲜石斛（三钱） 犀角片（五分） 薄荷（八分） 朱茯神（三钱） 川贝（三钱） 花粉（三钱）
羚羊片（三分） 连翘（一钱五分） 江枳实（一钱） 竹茹（一钱五分） 天竺黄（一钱五分） 石菖蒲（八分）
竹沥（冲，二两） 紫雪丹（冲，四分）
两剂，风平神清，表热转盛，去紫雪、犀、羚，加芩、豉，重用银、翘，数剂而安，伏温由营达气而解。
张左 发热汗多，气短而喘，脉数而乱，舌红，暑热伤津耗气，肺金化源欲绝，肺为水之上源，肺虚不能下
荫于肾，肾不纳气，肺主皮毛，肺伤则卫气失守，是以汗出甚多。经云∶因于暑，汗，烦则喘喝是也。症势危
笃，勉拟生脉散，益气生津，而清暑热。
西洋参（三钱） 大麦冬（三钱） 鲜石斛（三钱） 清炙枇杷叶（三钱） 天花粉（三钱） 肥知母（一钱五分）
牡蛎（一两） 浮小麦（一两）
谢右 温邪发热八天，汗泄不畅，渴而引饮，神昏谵语，叠见呃逆，舌红，脉沉数无力，阴液已伤，邪郁不
达，暑热痰浊互阻，木火夹冲气上逆，胃气不得下降，清窍被蒙，神明无以自主，症势沉重。急宜生津清温，和
胃降逆。
鲜石斛（五钱） 金银花（三钱） 陈广皮（一钱） 旋复花（包，一钱五分） 淡豆豉（三钱） 连翘壳
（一钱五分） 鲜竹茹（一钱五分） 天花粉（三钱） 黑山栀（一钱五分） 柿蒂（五枚） 炙远志肉（八分）
雷右 身热一候，有汗不解，咳嗽气逆，但欲寐，谵语郑声，口渴不知饮，舌光红干涸无津，脉细小而数，右
寸微浮而滑，此风温伏邪，始在肺胃，继则传入少阴，阴液已伤，津乏上承，热灼津液为痰，痰热弥漫心包，灵机
堵塞，肺炎叶枯，有化源告竭之虞，势已入危险一途。勉拟黄连阿胶汤合清燥救肺汤加减，滋化源以清温，清神
明而涤痰，未识能挽回否？
蛤粉炒阿胶（三钱） 天花粉（三钱） 鲜生地（三钱） 天竺黄（二钱） 川雅连（五分） 冬桑叶（三钱）
鲜石斛（三钱） 光
杏仁（三钱） 川贝（三钱） 淡竹沥（冲，五钱） 冬瓜子（三钱） 芦根（去节，一两） 银花露（一两）
枇杷叶露（煎药，二两）
另饮去油清鸭汤，佐生阴液。
二诊 昨进黄连阿胶汤合清燥救肺汤之剂，津液有来复之渐。舌干涸转有润色，神色较清，迷睡亦减，
而里热依然，咳嗽气逆，咯痰艰出，口干欲饮，脉息如昨，数象较和。伏温燥痰，互阻肺胃，如胶似漆，肺金无
以施化，小溲不通，职是故也。昨法既见效机，仍守原意出入。
蛤粉炒阿胶（三钱） 桑叶（三钱） 鲜生地（三钱） 鲜石斛（三钱） 川贝（三钱） 光杏仁（三钱）
天花粉（三钱） 天竺黄（二钱） 生甘草（五分） 活芦根（去节，一两） 冬瓜子（三钱） 知母（一钱五分）
竹沥（冲，五钱） 银花露（一两） 枇杷叶露（煎药，二两）
三诊 投药两剂，神识已清，舌转光红，身热较退，咳痰艰出，口干欲饮，脉细滑带数。阴液伤而难复，肝
火旺而易升，木叩金鸣，火烁津液为痰，所以痰稠如胶，而咳逆难平也。仍拟生津清温，润肺化痰，俾能精胜邪
却，自可渐入坦途。
原方去知母、天竺黄、加青蒿梗（三钱）、嫩白薇（三钱）。
张左 发热十二天，有汗不解，头痛如劈，神识时明时昧，心烦不寐，即或假寐，梦语如谵，咽痛微咳，口
干欲饮，舌质红苔黄，脉弦滑而数。风温伏邪，蕴袭肺胃，引动厥阳升腾，扰犯清空，阳升则痰热随之，蒙蔽灵
窍，颇虑痉厥之变。亟拟清疏风温，以熄厥阳，清化痰热而通神明，如能应手，庶可转危为安。
羚羊片（五分） 银花（三钱） 朱茯神（三钱） 川象贝（各一钱五分） 菊花（三钱） 竹茹（一钱五分）
桑叶（三钱） 带心连翘（一钱五分） 枳实（一钱五分） 天竺黄（二钱） 山栀（一钱五分） 茅根（去心，
五钱） 鲜石菖蒲（五分） 珠黄散（冲服，二分） 淡竹沥（冲服，一两）
二诊 神识已清，头痛亦减，惟身热未退，咽痛 红，咽饮不利，口干溲赤，咳痰不爽，脉滑数，舌质红苔
黄。风为阳邪，温为热气，火为痰之本，痰为火之标。仍从辛凉解温，清火涤痰。
桑叶（三钱） 薄荷（八分） 连翘（一钱五分） 川象贝（各一钱五分） 天竺黄（二钱） 桔梗（八分）
菊花（三钱） 银花（三钱） 山栀（一钱五分） 轻马勃（八分） 生甘草（八分） 竹茹（枳实拌
炒，二钱） 活芦根（去节，一两） 淡竹沥（冲，五钱）
陆左 风温伏邪，夹痰交阻，肺胃不宣，少阳不和，寒热往来，咳嗽胸闷，甚则泛恶。脉象弦滑，舌前半无
苔，中后薄腻。和解枢机，宣肺化痰治之。
前柴胡（各五分） 云苓（三钱） 光杏仁（三钱） 炒谷麦芽（各二钱） 象贝（三钱） 苦桔梗（一钱）
橘红（一钱） 冬桑叶（三钱） 枳实炭（三钱） 半夏（一钱五分） 炒竹茹（一钱五分） 冬瓜子（三钱）
复诊 寒热轻减，咳嗽痰多，口干欲饮，五六日未更衣。舌前半光绎，中后腻黄，脉数不静，阴液已伤，阳
明腑垢不得下达。今拟存阴通腑，清肺化痰。
天花粉（三钱） 生草（六分） 象贝（三钱） 生枳实（一钱五分） 杏仁（三钱） 元明粉（一钱五分）
川军（三钱） 冬瓜子（三钱） 炒枳壳（三钱） 干芦根（去节，一两）
许 咳嗽膺痛，身热轻而复重，大便溏泄，舌苔灰腻而黄，脉滑数。风温伏邪，挟滞交阻，邪不外达，移入
大肠。拟葛根芩连汤加减。
粉葛根（二钱） 淡豆豉（三钱） 枳实炭（三钱） 酒黄芩（一钱五分） 炒银花（四钱） 赤苓（三钱）
香连丸（一钱） 炒赤芍（一钱五分） 桔梗（八分） 荷叶（一角） 象贝母（三钱）
袁左 温邪挟滞，阳明为病，发热十天，口渴烦躁，谵语妄言，舌糙黄，六七日未更衣，脉象滑数有力，此浊
垢不得下达之征也。法宜生津清温，加栝蒌、大黄，以符仲景急下存阴之意。
粉葛根（二钱） 金银花（三钱） 肥知母（一钱五分） 生甘草（八分） 生石膏（三钱） 天花粉（三钱）
全栝蒌（四钱） 玄明粉（一钱，同捣） 生军（三钱） 鲜竹叶（三十张） 茅芦根（去心、节，各五钱）
陈左 身热四天，有汗不解，烦燥胸闷，入夜神糊谵语，苔黄脉数。此无形之伏温，与有形之痰浊互阻，
清阳被灼，君主乃昏。宜清温涤痰，而安神明。
粉葛根（一钱五分） 天花粉（三钱） 黑山栀（一钱五分） 竹叶心（三钱） 金银花（三钱）
鲜竹茹（一钱五分） 九节菖蒲（一钱） 荸荠汁（冲，一酒杯） 带心连翘（三钱） 枳实炭（二钱）
炙远志肉（五分） 活芦根（去节，一两）
祁左 冬温伏邪，身热十七天，有汗不解，咳嗽胁痛，甚则痰内带红，渴喜热饮，大便溏泄。前投疏表消
滞，荆防败毒、小柴胡、及葛根芩连等汤，均无一效。今忽汗多神糊，谵语郑声，汗愈多则神识愈糊，甚则如见
鬼状。苔干腻，脉濡细。是伏邪不得从阳分而解，而反陷入少阴，真阳外越，神不守舍，阴阳脱离，不能相抱。
脉证参合，危在旦夕间矣。急拟回阳敛阳，安定神志，冀望一幸。
吉林参须（一钱） 熟附片（一钱） 牡蛎（四钱） 花龙骨（三钱） 朱茯神（三钱） 炙远志（二钱）
仙半夏（二钱） 生白术（一钱五分） 浮小麦（四钱） 焦楂炭（二钱） 干荷叶（一角） 炒苡仁谷芽（各三钱）
两剂后即汗敛神清，去参、附、龙、牡，加炒淮山药（三钱），川贝（二钱），又服二剂。泻亦止，去楂炭，
加炒扁豆衣（三钱），藕节（三枚），即渐渐而痊。
董左 初起风温为病，身热有汗不解，咳嗽痰多，夹有红点，气急胸闷，渴喜热饮，大便溏泄。前师叠投
辛凉清解，润肺化痰之剂，似亦近理，然汗多不忌豆豉，泄泻不忌山栀，汗多伤阳，泻多伤脾，其邪不得从阳明
而解，而反陷入少阴，神不守舍，痰浊用事，蒙蔽清阳，气机堵塞。今见神识模糊，谵语郑声，汗多肢冷，脉已
沉细，太溪、趺阳两脉亦觉模糊，喉有痰声，嗜寐神迷，与邪热逆传厥阴者，迥然不同，当此危急存亡之秋，阴
阳脱离即在目前矣，急拟回阳敛阳，肃肺涤痰，冀望真阳内返，痰浊下降，始有出险入夷之幸，然乎否乎，质之
高明。
吉林参（八分） 熟附片（八分） 左牡蛎（三钱） 花龙骨（三钱） 朱茯神（三钱） 炙远志（一钱）
仙半夏（一钱五分） 川象贝（各二钱） 水炙桑叶皮（各一钱五分） 炒扁豆衣（三钱） 生薏仁（四钱）
冬瓜子（三钱） 淡竹沥（一两，生姜汁两滴同冲服） 另真猴枣粉（二分）
二诊 前方服后，肢渐温，汗渐收，脉略起，原方加光杏仁三钱。
三诊 肢温汗收，脉亦渐起，阳气已得内返，神识渐清，谵语郑声亦止，惟咳嗽痰多，夹有血点，气逆喉有
痰鸣，舌苔薄腻转黄，伏温客邪已有外达之机，痰浊逗留肺胃，肃降之令失司。今拟清彻余温，宣肺化痰。
桑叶（一钱五分） 桑皮（一钱五分） 光杏仁（三钱） 川象贝（各一钱五分） 朱茯神（三钱）
炙远志（一钱） 炙兜铃（一钱） 生薏仁（三钱） 冬瓜子（三钱） 淡竹油（一两） 猴枣粉（冲服，二分）
鲜枇杷叶（去毛、包，三钱）
四诊 服两剂后，咳嗽气逆痰鸣，均已大减，咽喉干燥，痰内带红，舌边绛，苔薄黄，神疲肢倦，脉濡小而
数，是肺阴暗伤，痰热未楚。今拟清燥救肺，化痰通络。
蛤粉炒阿胶（一钱五分） 南沙参（三钱） 侧柏炭（一钱） 竹
茹（二钱） 藕节（二枚） 桑叶皮（各一钱五分） 粉丹皮（一钱五分） 甜光杏（三钱） 川象贝（各二钱）
栝蒌皮（二钱） 蜜炙兜铃（一钱） 冬瓜子（三钱） 干芦根（去节，一两） 猴枣粉（二分） 竹沥（冲，一两）
枇杷叶露煎药
二三剂渐次告愈。
原按∶风温冬温，用参、附、龙、牡等，是治其变症，非常法也，盖人之禀赋各异，病之虚实寒热不一，伤寒
可以化热，温病亦能化寒，皆随六经之气化而定。是证初在肺胃，继传少阴，真阳素亏，阳热变为阴寒，迨阳既
回，而真阴又伤，故先后方法两殊，如此之重症，得以挽回。若犹拘执温邪化热，不投温剂，仍用辛凉清解，如
连翘、芩、连、竺黄、菖蒲、至宝、紫雪等类，必当不起矣，故录之以备一格。
Fresh Dendrobium (3 qian) Rhinoceros Horn Slices (5 fen) Mint (8 fen) Cinnabar-treated Poria (3 qian) Sichuan Fritillaria Bulb (3 qian) Trichosanthes Root (3 qian)
Antelope Horn Slices (3 fen) Forsythia Fruit (1.5 qian) Immature Bitter Orange (1 qian) Bamboo Shavings (1.5 qian) Hyacinth Bean Mucilage (1.5 qian) Acorus Tatarinowii Rhizome (8 fen)
Bamboo Sap (taken with decoction, 2 liang) Zixue Dan (Purple Snow Pill, taken with decoction, 4 fen)
After two doses, the wind pathogen subsided and consciousness cleared, but the exterior heat intensified. Zixue Dan, Rhinoceros Horn, and Antelope Horn were removed; Scutellaria Root (Huangqin) and Fermented Soybean (Danshi) were added; Honeysuckle Flower (Yinhua) and Forsythia Fruit (Lianqiao) were used in heavy doses. After several more doses, the condition stabilized, and the latent warm disease resolved by moving from the Ying (Nutrient) level to the Qi (Energy) level.
Patient Zhang (Left side) Fever with profuse sweating, shortness of breath and wheezing, rapid and chaotic pulse, red tongue. This indicates Summerheat-heat damaging fluids and depleting Qi, threatening the source of Lung Metal. The Lung is the upper source of water; when deficient, it cannot nourish the Kidney downward, leading to the Kidney's failure to grasp Qi. The Lung governs the skin and hair; lung injury causes Wei (Defensive) Qi to lose its guard, resulting in profuse sweating. The Classics state: "Due to Summerheat, sweating occurs; if vexed, there is panting and loud breathing." The condition is critical. Tentatively prescribing Shengmai San (Generate Pulse Powder) to tonify Qi and generate fluids, while clearing Summerheat-heat.
American Ginseng (3 qian) Ophiopogon Tuber (3 qian) Fresh Dendrobium (3 qian) Honey-fried Loquat Leaf (3 qian) Trichosanthes Root (3 qian) Anemarrhena Rhizome (1.5 qian)
Oyster Shell (1 liang) Floating Wheat (1 liang)
Patient Xie (Right side) Warm pathogen fever for eight days, inadequate sweating, thirst with desire to drink, confused speech and delirium, frequent hiccups, red tongue, deep, rapid, and forceless pulse. Yin fluids are damaged, pathogens are stagnant and unable to exit, Summerheat-heat and phlegm-turbidity obstruct mutually, Liver fire clamps with rebellious Qi ascending, Stomach Qi fails to descend, clear orifices are obscured, Spirit lacks autonomy. The condition is severe. Urgently need to generate fluids, clear warmth, harmonize the Stomach, and direct rebellious Qi downward.
Fresh Dendrobium (5 qian) Honeysuckle Flower (3 qian) Aged Tangerine Peel (1 qian) Inula Flower (wrapped, 1.5 qian) Fermented Soybean (3 qian) Forsythia Husk (1.5 qian) Fresh Bamboo Shavings (1.5 qian) Trichosanthes Root (3 qian) Gardenia Fruit (1.5 qian) Persimmon Calyx (5 pieces) Polygala Root (honey-fried, 8 fen)
Patient Lei (Right side) Body heat for one week (7 days), sweating without resolution, cough with rebellious Qi, drowsiness (desire to sleep but not fully asleep), delirious and soft speech, thirst without desire to drink, smooth red tongue dry without fluids, fine, small, and rapid pulse, right Cun position slightly floating and slippery. This is latent Wind-Warmth pathogen, initially in Lung and Stomach, subsequently transmitting to Shaoyin (Lesser Yang). Yin fluids are damaged, fluids fail to ascend, heat scorching fluids into phlegm, phlegm-heat diffusing into the Pericardium, blocking spiritual mechanisms, resembling withered lung leaves, with danger of exhaustion of the transforming source. The condition has entered a dangerous stage. Tentatively prescribing Huanglian Ejiao Tang combined with Qingzao Jiufei Tang modified, to nourish the transforming source and clear warmth, clear the Spirit and eliminate phlegm, wondering if recovery is possible?
Donkey-hide Gelatin fried with Arnebia Powder (3 qian) Trichosanthes Root (3 qian) Fresh Rehmannia Root (3 qian) Hyacinth Bean Mucilage (2 qian) Coptis Rhizome (5 fen) Mulberry Leaf (3 qian)
Fresh Dendrobium (3 qian) Apricot Seed (3 qian) Sichuan Fritillaria Bulb (3 qian) Light Bamboo Sap (taken with decoction, 5 qian) Benincasa Seed (3 qian) Reed Rhizome (de-jointed, 1 liang) Honeysuckle Dew (1 liang)
Loquat Leaf Dew (decocted with medicine, 2 liang)
Additionally drink defatted clear duck soup to assist in nourishing Yin fluids.
Second Visit: Yesterday administered Huanglian Ejiao Tang combined with Qingzao Jiufei Tang. Fluids show signs of recovery. Tongue dryness shows moisture, spirit/color is clearer, drowsiness reduced, but interior heat remains, cough with rebellious Qi, difficult expectoration, thirst with desire to drink, pulse same as before, rapidity moderated. Latent warmth and dry-phlegm obstruct Lung and Stomach like glue and lacquer, Lung Metal cannot function, urination blocked, this is the cause. Since yesterday's method showed efficacy, adhere to original intent with modifications.
Donkey-hide Gelatin fried with Arnebia Powder (3 qian) Mulberry Leaf (3 qian) Fresh Rehmannia Root (3 qian) Fresh Dendrobium (3 qian) Sichuan Fritillaria Bulb (3 qian) Apricot Seed (3 qian)
Trichosanthes Root (3 qian) Hyacinth Bean Mucilage (2 qian) Raw Licorice Root (5 fen) Living Reed Rhizome (de-jointed, 1 liang) Benincasa Seed (3 qian) Anemarrhena Rhizome (1.5 qian)
Bamboo Sap (taken with decoction, 5 qian) Honeysuckle Dew (1 liang) Loquat Leaf Dew (decocted with medicine, 2 liang)
Third Visit: Two doses administered, consciousness cleared, tongue turned smooth red, body heat reduced, difficult expectoration, thirst with desire to drink, fine, slippery, slightly rapid pulse. Yin fluid damage is hard to restore, Liver fire is vigorous and prone to rising, Wood striking Metal, fire scorching fluids into phlegm, hence phlegm thick like glue, cough and rebellion hard to calm. Still prescribe generating fluids, clearing warmth, moistening Lung, resolving phlegm, so that Essence prevails and pathogens retreat, naturally entering a smooth path.
Original formula remove Anemarrhena Rhizome, Hyacinth Bean Mucilage; add Artemisia Annua Stem (3 qian), Cistanche Vine (tender, 3 qian).
Patient Zhang (Left side) Fever for twelve days, sweating without resolution, splitting headache, consciousness fluctuating between clear and obscure, vexation and insomnia, even if feigning sleep, dream-talk like delirium, sore throat, slight cough, dry mouth with desire to drink, red tongue body with yellow coating, wiry, slippery, rapid pulse. Latent Wind-Warmth pathogen, accumulating and attacking Lung and Stomach, stirring up Jueyin Yang to rise, disturbing the clear cavities. As Yang rises, phlegm-heat follows, obscuring spiritual orifices, fearing transformation into convulsions and syncope. Urgently prescribe clearing and dispersing Wind-Warmth to extinguish Jueyin Yang, clearing phlegm-heat and unblocking Spirit. If effective, crisis may turn to safety.
Antelope Horn Slices (5 fen) Honeysuckle Flower (3 qian) Cinnabar-treated Poria (3 qian) Sichuan Fritillaria Bulb, Zhejiang Fritillaria Bulb (each 1.5 qian) Chrysanthemum Flower (3 qian) Bamboo Shavings (1.5 qian)
Mulberry Leaf (3 qian) Forsythia Fruit (with heart, 1.5 qian) Immature Bitter Orange (1.5 qian) Hyacinth Bean Mucilage (2 qian) Gardenia Fruit (1.5 qian) White Peony Root (de-heart, 5 qian) Fresh Acorus Tatarinowii Rhizome (5 fen) Zhuhuang San (Pearl-Yellow Powder, taken with decoction, 2 fen) Light Bamboo Sap (taken with decoction, 1 liang)
Second Visit: Consciousness cleared, headache reduced, only body heat unresolved, throat red and swollen, difficulty swallowing, dry mouth, dark urine, unsatisfactory expectoration, slippery, rapid pulse, red tongue body with yellow coating. Wind is Yang pathogen, Warmth is hot Qi, Fire is the root of phlegm, Phlegm is the branch of Fire. Still proceed with acrid-cool releasing warmth, clearing fire and eliminating phlegm.
Mulberry Leaf (3 qan) Mint (8 fen) Forsythia Fruit (1.5 qian) Sichuan Fritillaria Bulb, Zhejiang Fritillaria Bulb (each 1.5 qian) Hyacinth Bean Mucilage (2 qian) Platycodon Root (8 fen)
Chrysanthemum Flower (3 qian) Honeysuckle Flower (3 qian) Gardenia Fruit (1.5 qian) Ma Bao (light, 8 fen) Raw Licorice Root (8 fen) Bamboo Shavings (stir-fried with Immature Bitter Orange, 2 qian) Living Reed Rhizome (de-jointed, 1 liang) Light Bamboo Sap (taken with decoction, 5 qian)
Patient Lu (Left side) Latent Wind-Warmth pathogen, clashing with phlegm, obstruction in Lung and Stomach, Shaoyin disharmony, alternating chills and fever, cough with chest tightness, even nausea. Wiry, slippery pulse, front half of tongue no coating, middle and rear thin greasy coating. Harmonize the pivot, diffuse Lung and resolve phlegm.
Bupleurum Root (Qian Chaihu, each 5 fen) Poria (Yun Ling, 3 qian) Apricot Seed (Guang Xingren, 3 qian) Coix Seed, Barley Sprout (fried, each 2 qian) Zhejiang Fritillaria Bulb (3 qian) Platycodon Root (Ku Jiegeng, 1 qian)
Tangerine Peel (1 qian) Mulberry Leaf (Dong Sangye, 3 qian) Immature Bitter Orange Charcoal (3 qian) Pinellia Tuber (1.5 qian) Bamboo Shavings (fried, 1.5 qian) Benincasa Seed (3 qian)
Follow-up Visit: Chills and fever lightened, cough with much phlegm, dry mouth with desire to drink, no bowel movement for 5-6 days. Front half of tongue smooth and crimson, middle and rear greasy yellow, restless rapid pulse, Yin fluids damaged, Yangming Fu-house filth cannot descend. Now preserve Yin and purge the Fu, clear Lung and resolve phlegm.
Trichosanthes Root (3 qian) Raw Licorice Root (6 fen) Zhejiang Fritillaria Bulb (3 qian) Raw Immature Bitter Orange (1.5 qian) Apricot Seed (3 qian) Mirabilite (1.5 qian)
Rhubarb Root (Chuan Jun, 3 qian) Benincasa Seed (3 qian) Immature Bitter Orange Rind (fried, 3 qian) Reed Rhizome (dry, de-jointed, 1 liang)
Xu Cough with chest pain, body heat light then heavy again, loose stools, grey-greasy yellow tongue coating, slippery, rapid pulse. Latent Wind-Warmth pathogen, clashing with stagnation, pathogens do not exit outward, shifting to Large Intestine. Prescribe Gegen Qinlian Tang modified.
Kudzu Root (Fen Gegen, 2 qian) Fermented Soybean (3 qian) Immature Bitter Orange Charcoal (3 qian) Scutellaria Root (wine-fried, 1.5 qian) Honeysuckle Flower (fried, 4 qian) Red Poria (3 qian)
Xianglian Wan (1 qian) Red Peony Root (fried, 1.5 qian) Platycodon Root (8 fen) Lotus Leaf (1 corner) Fritillaria Bulb (Xiang Beimu, 3 qian)
Patient Yuan (Left side) Warm pathogen clashing with stagnation, Yangming disease, fever for ten days, thirst, vexation, delirious and nonsensical speech, rough yellow tongue, no bowel movement for 6-7 days, slippery, rapid, forceful pulse, sign of turbid filth failing to descend. Method should generate fluids, clear warmth, add Trichosanthes Fruit and Rhubarb, to accord with Zhang Zhongjing's principle of urgent purging to preserve Yin.
Kudzu Root (Fen Gegen, 2 qian) Honeysuckle Flower (3 qian) Anemarrhena Rhizome (Fei Zhimu, 1.5 qian) Raw Licorice Root (8 fen) Gypsum (Sheng, 3 qian) Trichosanthes Root (3 qian)
Whole Trichosanthes Fruit (4 qian) Mirabilite (1 qian, pounded together) Raw Rhubarb (3 qian) Fresh Bamboo Leaf (30 sheets) White Peony Root, Reed Rhizome (de-heart, de-jointed, each 5 qian)
Patient Chen (Left side) Body heat for four days, sweating without resolution, vexation, chest tightness, confused delirium at night, yellow coating, rapid pulse. Formless latent warmth clashing with有形 (substantial) phlegm-turbidity, Clear Yang scorched, Sovereign (Heart) becomes dim. Should clear warmth and eliminate phlegm to pacify Spirit.
Kudzu Root (Fen Gegen, 1.5 qian) Trichosanthes Root (3 qian) Gardenia Fruit (Hei, 1.5 qian) Bamboo Leaf Heart (3 qian) Honeysuckle Flower (3 qian)
Fresh Bamboo Shavings (1.5 qian) Nine-joint Acorus (1 qian) Water Chestnut Juice (taken with decoction, one wine cup) Forsythia Fruit (with heart, 3 qian) Immature Bitter Orange Charcoal (2 qian)
Polygala Root (honey-fried, 5 fen) Living Reed Rhizome (de-jointed, 1 liang)
Patient Qi (Left side) Winter-warmth latent pathogen, body heat for seventeen days, sweating without resolution, cough with hypochondriac pain, even blood in sputum, thirst preferring hot drinks, loose stools. Previously administered exterior-releasing and stagnation-resolving formulas, Jingfang Baidu San, Xiaochaihu Tang, and Gegen Qinlian Tang, all ineffective. Suddenly profuse sweating and confusion, delirious and soft speech, more sweating leads to deeper confusion, even seeing ghosts. Dry-greasy coating, soggy-fine pulse. Latent pathogen fails to resolve from Yang levels, instead sinking into Shaoyin, True Yang escaping outward, Spirit not residing in house, Yin and Yang separated, unable to embrace. Pulse and symptoms combined, critical imminent. Urgently prescribe returning Yang and consolidating Yang, stabilizing Spirit, hoping for a miracle.
Ginseng Tendril (Jilin, 1 qian) Prepared Aconite Root (Shu Fupian, 1 qian) Oyster Shell (4 qian) Dragon Bone (Flower Longgu, 3 qian) Cinnabar-treated Poria (3 qian) Polygala Root (honey-fried, 2 qian)
Pinellia Tuber (Xian Banxia, 2 qian) Raw Atractylodes Macrocephala Rhizome (1.5 qian) Floating Wheat (4 qian) Charred Hawthorn Fruit (2 qian) Dry Lotus Leaf (1 corner) Coix Seed, Barley Sprout (fried, each 3 qian)
After two doses, sweating stopped, consciousness cleared. Remove Ginseng, Aconite, Dragon Bone, Oyster Shell; add Fried Chinese Yam (3 qian), Sichuan Fritillaria Bulb (2 qian), take another two doses. Diarrhea stopped, remove Charred Hawthorn Fruit; add Fried Lablab Bean Coat (3 qian), Lotus Node (3 pieces), gradually recovered.
Patient Dong (Left side) Initially Wind-Warmth disease, body heat with sweating without resolution, cough with much phlegm, mixed with red spots,急促 breathing, chest tightness, thirst preferring hot drinks, loose stools. Previous doctors repeatedly administered acrid-cool clearing and resolving, Lung-moistening and phlegm-resolving agents, seemingly reasonable. However, profuse sweating does not forbid Fermented Soybean, diarrhea does not forbid Gardenia Fruit. Profuse sweating damages Yang, excessive diarrhea damages Spleen. Pathogens fail to resolve from Yangming, instead sinking into Shaoyin, Spirit not residing in house, phlegm-turbidity dominates, obscuring Clear Yang, Qi mechanism blocked. Now seeing blurred consciousness, delirious and soft speech, profuse sweating with cold limbs, pulse sunken and fine, Taixi and Yuyang pulses also vague, rattling sound in throat, drowsy and confused Spirit. Completely different from pathogenic heat counter-transmitting to Jueyin. At this critical moment of life and death, Yin and Yang separation is imminent. Urgently prescribe returning Yang and consolidating Yang,肃肺 (clearing Lung) and eliminating phlegm, hoping True Yang returns inward, phlegm-turbidity descends, thus having the fortune of exiting danger into peace. Is this so? Asking the experts.
Ginseng (Jilin, 8 fen) Prepared Aconite Root (Shu Fupian, 8 fen) Left-side Oyster Shell (3 qian) Dragon Bone (Flower, 3 qian) Cinnabar-treated Poria (3 qian) Polygala Root (honey-fried, 1 qian)
Pinellia Tuber (Xian Banxia, 1.5 qian) Sichuan Fritillaria Bulb, Zhejiang Fritillaria Bulb (each 2 qian) Water-processed Mulberry Leaf and Bark (each 1.5 qian) Fried Lablab Bean Coat (3 qian) Raw Coix Seed (4 qian)
Benincasa Seed (3 qian) Light Bamboo Sap (1 liang, mixed with 2 drops Ginger Juice for taking) Additionally Real Monkey Date Powder (2 fen)
Second Visit: After taking previous prescription, limbs gradually warmed, sweating stopped, pulse slightly rose. Original formula add Apricot Seed (Guang Xingren, 3 qian).
Third Visit: Limbs warm, sweating stopped, pulse gradually rising, Yang Qi has returned inward, consciousness gradually clearing, delirious and soft speech stopped, only cough with much phlegm, mixed with blood spots, rebellious Qi with rattling in throat, thin greasy coating turning yellow, latent warmth and guest pathogen showing signs of external release, phlegm-turbidity lingering in Lung and Stomach, descending command lost. Now prescribe clearing residual warmth, diffusing Lung and resolving phlegm.
Mulberry Leaf (1.5 qian) Mulberry Bark (1.5 qian) Apricot Seed (Guang, 3 qian) Sichuan Fritillaria Bulb, Zhejiang Fritillaria Bulb (each 1.5 qian) Cinnabar-treated Poria (3 qian)
Polygala Root (honey-fried, 1 qian) Campanula Root (honey-fried, 1 qian) Raw Coix Seed (3 qian) Benincasa Seed (3 qian) Light Bamboo Oil (1 liang) Monkey Date Powder (taken with decoction, 2 fen)
Fresh Loquat Leaf (de-hair, wrapped, 3 qian)
Fourth Visit: After two doses, cough, rebellious Qi, and rattling greatly reduced, dry throat, blood in sputum, crimson tongue edges, thin yellow coating, fatigue, weak limbs, soggy-small, rapid pulse. Lung Yin secretly damaged, phlegm-heat not cleared. Now prescribe Qingzao Jiufei Tang to clear dryness and save Lung, resolve phlegm and unblock collaterals.
Donkey-hide Gelatin fried with Arnebia Powder (1.5 qian) Southern Schisandra Berry (Nanshen, 3 qian) Thuja Carbon (1 qian) Bamboo Shavings (2 qian) Lotus Node (2 pieces) Mulberry Leaf and Bark (each 1.5 qian) Moutan Cortex (1.5 qian) Sweet Apricot Seed (3 qian) Sichuan Fritillaria Bulb, Zhejiang Fritillaria Bulb (each 2 qian)
Trichosanthes Peel (2 qian) Campanula Root (honey-fried, 1 qian) Benincasa Seed (3 qian) Reed Rhizome (dry, de-jointed, 1 liang) Monkey Date Powder (2 fen) Bamboo Sap (taken with decoction, 1 liang)
Loquat Leaf Dew decocted with medicine
Two to three doses gradually led to cure.
Original Note: For Wind-Warmth and Winter-Warmth, using Ginseng, Aconite, Dragon Bone, Oyster Shell, etc., treats the altered syndrome, not the standard method. People's constitutions vary, diseases differ in deficiency/excess and cold/heat. Cold damage can transform into heat, Warm diseases can transform into cold, all determined by the Qi transformation of the Six Channels. This case initially in Lung and Stomach, subsequently transmitted to Shaoyin, True Yang originally deficient, Yang-heat transformed into Yin-cold. Once Yang returned, True Yin was injured again, hence the two different methods sequentially. Such a severe case was rescued. If still rigidly adhering to "Warm pathogen transforms into heat," not administering warming agents, continuing with acrid-cool clearing and resolving, such as Forsythia, Scutellaria, Coptis, Hyacinth Bean Mucilage, Acorus, Zhibao Dan, Zixue Dan, etc., would certainly have resulted in death. Thus recorded to prepare a unique pattern.