迨遍阅诸方，只桑菊、银翘、豆豉、豆卷而已。然当危急之时，决将产后两字，置之度外。为书一方，以白虎承气增液法加减与之。并嘱另以好西瓜汁与之多饮。此方服后，大便得下二次，恶臭粘腻，莫可名状。然硝、黄不敢多用者，以正气虚也。大便既解，呃逆顿除，皮肤有汗，热势渐减，神情亦转安静，且能略进米饮。次日为之略为加减，续服一剂。大便又下二次，并解赤头蛔虫一条。于是神情完全清明。后又续进清理余邪、扶持正气之剂，旬日而告痊矣。
白虎承气增液法加减方生石膏三两肥知母鲜石斛各四钱鲜生地一两天花粉六钱生黄芩三钱生山栀四钱大麦冬三钱锦纹军元明粉各二钱炒粳米一两鲜芦根三两生梨汁一杯(冲服)妇人产后热病(二)妇人产后三日，患生热病。住所炎热，因之身热更高，而日晡尤甚，自汗昼多而夜少，口渴欲得冷饮，脘口拒按作痛，舌苔黄腻，询之曾食荤腻，滞于中脘。以自虎承气泻心法加减主之，并嘱迁一清凉之地，病家忽略余言，终至成败血症而亡。
顾雨芝妻何氏，年32岁，亦于六月间分娩。第三日即发热恶风，他医治之无效。延至第八日，始延余诊。病者家中为一老虎灶，煤灶之气，薰蒸满室。屋既狭小，病者又卧於一阁楼之上，举头即是屋顶，闷热异常。病者则周身有汗，昼甚多而夜较少，因自昼上为日晒，下为炉蒸也。其一切症状，并不如前者之甚。惟有时昏睡，有时烦躁，热势日晡尤甚，口于作渴，亦欲冷饮，脘口则拒按作痛，舌苔黄腻。问之则产后二三日，曾食荤腻、桂圆等品，浊腻滞於中焦故也。
余乃为之处方，又白虎承气泻心法加减与之。并令另以生梨汁或荸荠汁，少少与之。如服药见效，明日复诊，若或不效，最好送至医院。盖余恐病者住所太热，服药难见功也。次日未见进退，复将前方加减与服，依然如初。余乃决定送人医院，得一空气清凉之地，或可早愈也。不意病家忽略余言，未人医院，又延他医治之。迁延旬日，愈治愈危。
复延余诊，此时在产后已二十余日矣。余见其昏糊更甚，顽热不退，自汗不止，眼珠上耸，脉细数之极，决为之注射葡萄糖，以增其液。待针头刺入静脉，观其回血，已如酱油水矣。知毒已人血，乃告以不治。后未三日而亡。
白虎承气泻心法加减方粉葛根三钱生石膏二两肥知母天花粉各四钱石菖蒲生黄芩生山栀连翘各三钱生大黄二钱鲜竹叶一把综上两证观之，得一结论焉。此两人之病，前者重而后者轻。然重者生，而轻者死者，住所有关系也。前者住于一甚高之空屋内，空气较佳，无溽暑炉灶以益其邪热，故用药得以应手奏功。后者居于一炉灶之上，屋顶之下阁楼之上，上下交蒸，自汗太多，故虽用凉药，而不易见效，此其致死之一端。且产后二三日，即进荤腥、桂圆等品，病已发见，犹以为产后体虚而补之，此亦其致死之一端也。
温病秋温恶候叠见证秋温重候，医投桑菊银翘，渐至神昏谵语。终之旬日以降，十恶之候，已见其五：撮空也，捻指也，循衣也，摸床也，直视也。他如谵语渐变郑声，舌燥终至断津，更无论矣。饮之以西瓜汁，注之以葡萄糖，灌之以白虎承气增液汤。一剂大泻而热减，再剂续泻而神清，终以竹叶石膏汤合凉膈散完全收功。
在抗战后之第三年，有陈姓者，忘其名，以苏北沦陷，来沪求生。依其戚张士隐君，住于现建国中路之天成里内。
日作小工，夜晚归来，只能糊口而已。于秋八月间，忽患温病。初以为小病无碍，且又经济困难，未延医治。四五日后，即见化燥。口干齿垢，舌腻唇焦，神昏谵语，阳明实热之证也。此时始延医治之，医以银、翘、桑、菊，合栀、豉之类以治疗之。再剂不效，盖证重药轻，车薪杯水，其何能济。如此延及旬日，而险象环生。如撮空、捻指、循衣、摸床、直视等十恶之症，已见其五，其险恶可知。
其戚张士隐君，固如齐人焉，而有一妻一妾；又如汾阳焉，而更儿女众多。故经济亦难顾及。迨证危至此，医辞不治，乃不得不为之设法，另求他医，以尽人事而已，乃延余往诊。余既入室，由张君导至一小阁楼上，抬头颇低，光线暗黑，即开电灯诊视。见其一切症状，如上所述，亦即辞以不治。张君固强之，且谓余曰：“即用药无效，不幸死亡，不怪医生也。且其妻在苏北原籍，若不幸而亡，其妻亦必怪余不为穷亲戚尽力治疗，先生幸为我图之。”余亦无奈，即再为之细加诊察。见其烦躁与昏沉互见，尚未完全昏沉也。
询其小便赤涩而短，尚未完全津渴也。重按其胸腹，亦知皱眉，尚未完全失知觉也。询其有无呃逆，据云偶则有之，时‘问不长，测知胃气尚未全绝也。至于舌上断津，燥裂口臭，更无论矣。
当即对张君曰：“此阳明实热之证。延至此时，下亦死，而不下亦死。君既如此要求，余为医者，亦当尽最后之力。
此王孟英先生所谓与其坐以待毙，莫如含药而亡。陈君之证，若非恶证十有其五，犹较有把握，故不敢作豪语日必可脱险也。”乃先令购一大西瓜，取汁以汤匙饮之，再为之处方。以白虎承气合增液法，酌用大量，令配药速回。随又以葡萄糖之溶液1000毫升。为之施行静脉注射，以增其血液，以强其心脏。约40分钟，注射完毕。盖一小阁楼上，施行注射，亦必须席阁板而为之。迨注射以后，药亦配来。立令煎与服之，余即辞去。
服药之后，不三小时，即觉病者腹内雷鸣，无何即大泻于卧席之上。初为燥硬之干球，继为粘稠之黑粪，如酱如胶，挑之成带状，其粘如是。续服二煎，一夜间连解大便四次。翌晨视之，而人之神识渐清矣。张君喜极，于上午十时，复延余诊。余见病者神清，气息亦较静，目睛已转白，胸腹部亦较和软，惟重按之，仍有疼痛。舌上津液已回，但未十分润泽。口中热臭已减，小便已较多，然黄赤如故。呃逆已除，完全不作。再饮以西瓜汁，已觉清凉适口，而知其味甘美也。乃令将原方稍减分量，再服一帖。病更好转，已思食粥汤。三诊之时，以竹叶石膏合凉膈散清解余邪而安。
白虎承气汤合增液法方生石膏六两肥知母五钱炙甘草三钱锦纹军元明粉各六钱炒枳实四钱鲜石斛五钱鲜生地炒粳米各一两鲜芦根一大枝(去节)竹叶石膏汤合凉膈散方鲜竹叶一两生石膏三两麦门冬(去心)四线潞党参三钱炙甘草二钱川大黄三钱(酒洗)净连翘四钱淡黄芩三钱(酒炒)栀子仁三钱炒粳米一两秋温昏谵腹满证秋温旬日，口干齿燥，舌苔焦黄，大便旬日不解，腹大满而喘，按之如石，时或谵语，时或昏沉。以重剂大承气汤加青皮、莱菔子主之。
长寿路英华里，有李姓者，年46岁。患秋温病旬日，他医治之无效，嗣延余诊。病者仰卧床上，腹部满如覆釜，平面视之，腹部高．于胸部，约二三寸。气息微喘，按之如石，满腹皆痛，脉实而有力，口干齿燥，舌苔焦黄，而热度反不高。询其致病之由，据其家人告余：“在十日之前，某夕其友人家有喜事，伊去应酬，既醉且饱，远道乘车归来。
当夜发热恶寒，次日寒退，而热则更高。诸医罔效，延至今日，热反不高矣。”询其大便，不解已旬日，病后即未解过，且谵语、昏沉，间代而作。问其撮空、摸床等恶候有否，答曰：“尚未有此。”余察其体质壮实，且腹部高于胸部，可以大下，更不可迟缓。乃书大承气汤加青皮、莱菔子两味。大黄、元明粉各用一两，川朴、枳壳各用五钱，青皮三钱，莱菔子四钱。次日未延续诊，余颇怀疑。抑病家不敢服耶，抑服之而愈耶，或服之而毙耶。又恐药量过重，为他医所攻击，心中不能释然。四五日后，有其邻人来就诊者，欣然告余曰：“前日李姓之病，服先生药一帖，大泻而愈。如此重病，方未再剂，先生真神医也。我即李姓介绍来此就诊者也。”余闻之，心始帖然而安。
大承气汤加青皮莱菔子方锦纹大黄一两元明粉一两(分冲)川厚朴三钱炒枳壳五钱细青皮三钱莱菔子四钱秋温外热中寒证妇人七月病热，延已旬余。自汗口渴，高热谵语，周身酸楚，舌苔黄腻带焦，小溲短赤，大便干燥，心烦不安，胸中痞闷。以白虎合泻心汤法，加滑石、木通主之。服药得下后，诸症悉退，独热势不减。续与银、翘、芩、连、花粉、滑石等品，不效。察其欲得热饮，改以附子泻心汤加葛根、干姜，一剂而热清矣。
船主王同庆之妻，年35岁，于七月初旬，患生热病。
以船泊于上海叉袋角之苏州河岸，即延附近之医师，治之无效。后延旬余，病势渐进，如上文所述，改延余诊。时天气颇热，俗所谓秋老虎也。余见此状，索阅前方，知为二豆派所误(时医每以豆豉、豆卷为首药)，乃以白虎合泻心法，加滑石、木通与之。
一剂而诸症大减，再剂而诸症悉除，惟有热势不减。乃续予以连翘、银花、黄芩、黄连、花粉、滑石等品。依然无效。续延余诊，病者忽问其夫索饮开水。夫告之曰：“汝枕边有一杯开水，其忘之耶。”病者以手扪杯曰：“此水已不热，改取极开之水方佳。”余扪其怀，则颇有七分之热度。
王即为之改换开水，而病者饮之，似不觉其烫口者，此时余心知其故矣。盖自汗病久，已早伤津，而对证用药，又不得不用白虎合泻心汤加味法。待清之下之以后，其里热虽去，而里寒生矣。急为之处方，以附子泻心汤加葛根、干姜主之。加葛根者，以表尚有真热也；加干姜者，以里实为真寒也。待此药服后，一剂而痊，表热退，热饮亦止矣。接后调理之剂，以善其后。
白虎合泻心汤加滑石木通方生石膏三两肥知母四钱炙甘草二钱粳米一两锦纹军三钱川黄连一钱(另炖冲)黄芩三钱块滑石三钱木通二钱五分附子泻心汤加葛根干姜方熟附片四线锦纹军二钱上川连八分生黄芩三钱粉葛粉三钱炮姜炭三钱春温痰火发狂证春温不解，邪热入于营血，身有癍疹，色紫黑，肌肤炙手，内热如焚，唇焦齿垢，舌苔燥黄。初则谵语神糊，继则发狂乱走，如见鬼神，甚或攀窗登屋。以大承气汤去厚朴、易瓜蒌，加石膏、葛根、黄连、连翘、胆南星、石菖蒲主之。名日豁痰承气汤。
患者胡永年，年45岁，于三月间患温病。经医治之无效，于第五日即发癍疹。上述症状，次第而见。此乃大实大热之证。延至旬日，渐见发狂，四出奔走，如见鬼神，作叩拜顶礼之状，甚或殴人詈骂。其妻请强有力者两人，挟之登车，来余诊所求治。余知为狂者，温言以熨之。病者神情稍安，忽跪于地，对余作礼拜状，余更笑容和声以拽之坐。诊其脉沉数而有力，肌肤炙手，胸部尤其，周身癍疹烂然，色带紫黑，唇焦齿垢，舌苔干燥而焦黄。询其大便，已六日未解，小溲短赤。余即告慰病者，令两人先送之回家，其妻留取方笺，盖恐其有发狂之意外也。
因为之处方。以承气汤去厚朴，易全栝楼，加生石膏、葛根、黄连、连翘、胆南星、石菖蒲。以芦根为引。其所以去厚朴者，嫌温燥也。易瓜萎者，能陷胸膈之痰也。加石膏为癍疹所必需，葛根为脑脊及阳明热邪所必用，黄连、连翘之清心凉膈，南星、菖蒲之豁痰开穷。盖证情如此，不得不用此重剂也。服药之后，大便连下两次，如胶如漆，肤有微汗，神情较静，狂态大减。
次日延余出诊。其妻恐其外出也，乘其睡时，将房门上锁，来余诊所。待余至时，开锁推门，则室内无人，病者不知所往。于床下觅之，亦不见。正惊讶之间，忽闻屋上瓦作声，其妻取高凳，立于其上，推天窗视之，则病者固坐于屋上也。其妻唤之，余亦温言以唤之，始含笑人窗而下。余再为之诊察一过，见身上癍疹，紫黑色已减，而较红润，舌苔亦退去大半，肌热亦大减，表如此，里可知矣。因为之各药减量少许，再加鲜生地、鲜石斛以凉血增液。再剂之后，大便续解三次，其狂状若失，而神识清明矣。后再处以清理余邪兼扶正之品，而病遂痊。
豁痰承气汤方锦纹军五钱元明粉五钱炒枳实四钱生石膏三两全瓜蒌六钱粉葛根四钱川黄连一钱五分净连翘四钱胆南星四钱石菖蒲三钱鲜芦根一支按：此方次日减量少许，加鲜生地一两，鲜石斛四钱。
妇人春温狐惑病证妇人冬令进补，春节时，寒热喉痛，经医注射白喉血清，喉痛减而腹痛又作。医谓伤寒兼腹膜炎，治之久而不效。渐至手足发冷，时静时躁，唇青齿燥，口有恶臭，阴道有恶液流出，医辞不治。余承其乏，姑拟泻心合增液承气汤法，冀作万一之望，一剂大效。终以气忿，而绝食伤生，殊可惜也。
有顾盛氏者，于冬季常进补品。以桂圆肉及大枣肉，共蒸成膏服之，所服甚多。至次年正月初四日，忽发寒热，喉痛大作，求治于西医。医谓白喉也，注射白喉血清，而喉痛顿减。一二日后，又变为腹痛，寒热颇甚，大便多日未解。
乃进前同孚路某医院求治，医断为伤寒而兼腹膜炎。盖此时腹痛之甚，手不可近，硬固如板，小溲黄赤，思食冷物，但热不寒，热度颇高，以腹痛之故，呼号烦乱，不可终日。病家又拒绝开刀，医除用退热剂外，兼以冰囊罨敷于腹部(按此法不可用)，以冀消炎止痛，别无他法。
By the time I had reviewed all the medical prescriptions, I found that only Sangju Yin (Mulberry Leaf and Chrysanthemum Decoction), Yinqiao San (Honeysuckle and Forsythia Powder), fermented soybean (Douchi), and soybean sprouts (Doujuan) were used. However, in a critical situation, I decided to temporarily set aside the specific condition of "postpartum." I prescribed a formula based on Baihu Chengqi Zengye Fa (White Tiger, Da Huang, and Fluid-Generating Method) with modifications, and instructed to give high-quality watermelon juice for her to drink in large amounts. After taking this prescription, the patient had two bowel movements; the excrement was foul-smelling and sticky, indescribable. I dared not use too much Mangxiao (Mirabilite/Natrii Sulfas) and Dahuang (Rhubarb Root) because the patient's healthy Qi was deficient. Once the bowels were unblocked, the hiccups were instantly relieved, sweat appeared on the skin, the fever gradually subsided, her mental state became calm, and she could consume a small amount of rice water. The next day, I made slight modifications to the prescription and administered another dose. She had two more bowel movements and passed a single roundworm with a reddish head. Consequently, her mental state became completely clear. Subsequently, she continued to take formulas that cleared residual pathogens and supported healthy Qi, and she recovered after ten days.
Modified Baihu Chengqi Zengye Fa: Shigao (Gypsum Fibrosum) 3 liang, Zhimu (Anemarrhenae Rhizoma) and Xiandiezhi (Dendrobii Caulis) each 4 qian, Xianshengdi (Rehmanniae Radix) 1 liang 2 qian, Tianhuafen (Trichosanthis Radix) 6 qian, Shenghuangqin (Scutellariae Radix) 3 qian, Shengzhizi (Gardeniae Fructus) 4 qian, Damaidong (Ophiopogonis Radix) 3 qian, Jinwenjun (Rhei Radix et Rhizoma) and Yuanmingfen (Natrii Sulfas) each 2 qian, fried Jingsmi (Oryza Sativa) 1 liang, Xinlugen (Phragmitis Rhizoma) 3 liang, and fresh pear juice 1 cup (mixed in).
Postpartum Febrile Disease (II): A woman suffered from a febrile disease three days after childbirth. Due to the heat of her residence, her body temperature rose higher, especially severe during the Shen hour (3-5 PM). She had spontaneous sweating, more abundant during the day and less at night, thirst craving cold drinks, and abdominal pain that resisted pressure. Her tongue coating was yellow and greasy. Inquiry revealed she had consumed rich and greasy foods, which stagnated in the Middle Jiao. I treated her primarily with a modified Baixu Chengqi Xiexin Fa (White Tiger, Da Huang, and Heart-Clearing Method) and advised moving to a cool place. However, the family ignored my advice, and she ultimately died of sepsis.
He Shi, wife of Gu Yuzhi, aged 32, also gave birth in June. On the third day, she developed fever and aversion to wind, which other doctors failed to treat. It was not until the eighth day that I was called to consult. Her home contained a coal stove, and the smoke filled the room. The house was narrow, and she slept in an attic where the roof was directly overhead, creating extreme mugginess. She sweated profusely, much more during the day than at night, due to sun exposure above and stove heat below. Her symptoms were not as severe as the previous case. Sometimes she was comatose, sometimes irritable, with fever peaking in the Shen hour. She had dry mouth and thirst, desiring cold drinks, and abdominal pain resisting pressure. Her tongue coating was yellow and greasy. Inquiry revealed that two or three days postpartum, she had eaten rich, greasy foods and longan fruit, causing turbid dampness to stagnate in the Middle Jiao.
I therefore prescribed a modified Baixu Chengqi Xiexin Fa and instructed her to drink small amounts of fresh pear juice or water chestnut juice. If effective, she would return for consultation the next day; if not, it was best to send her to a hospital. I feared that the hot environment would hinder the efficacy of the medicine. The next day, there was no improvement, and even with modified medication, the condition remained unchanged. I then decided to send her to a hospital to find a cooler environment, hoping for an earlier recovery. Unexpectedly, the family ignored my advice, did not admit her to the hospital, and sought treatment from other doctors. Ten days passed, and her condition worsened with each treatment.
When I consulted again, it had been over twenty days postpartum. She appeared more delirious, with persistent high fever, continuous spontaneous sweating, upward deviation of the eyes, and a fine, rapid pulse. I decided to inject glucose to replenish fluids. When the needle entered the vein and blood returned, it looked like soy sauce water. I realized the toxins had entered the bloodstream and informed them that the case was incurable. She died less than three days later.
Modified Baixu Chengqi Xiexin Fa: Ge Gen (Puerariae Lobatae Radix) 3 qian, Shigao (Gypsum Fibrosum) 2 liang, Zhimu (Anemarrhenae Rhizoma) and Tianhuafen (Trichosanthis Radix) each 4 qian, Shichangpu (Acori Tatarinowii Rhizoma), Huangqin (Scutellariae Radix), Zhizi (Gardeniae Fructus), and Lianqiao (Forsythiae Fructus) each 3 qian, Dahuang (Rhei Radix et Rhizoma) 2 qian, and fresh Zhuye (Bambusae Folium) one handful.
Observing these two cases, I drew a conclusion: the first case was severe but the patient survived, while the second was mild but the patient died. This difference was related to the living environment. The first patient lived in a tall, airy room with better air quality, without the exacerbating effects of summer heat and stoves, allowing the medication to work effectively. The second patient lived under a stove and in an attic, suffering from steaming heat from above and below, leading to excessive sweating. Thus, despite using cooling medications, they were ineffective, which was one cause of death. Additionally, consuming rich foods and tonics like longan just two or three days postpartum, when the illness was already manifesting, thinking it was deficiency requiring tonification, was another cause of death.
Severe Autumn-Warmth Complications: In a severe case of autumn-warmth, the physician initially prescribed Sangju Yin and Yinqiao San. The condition gradually progressed to delirium and confusion. After about ten days, five of the ten ominous signs appeared: grasping at empty air, picking at imaginary threads, rubbing clothes, touching the bed, and fixed staring. Other signs included delirium changing to monosyllabic speech, and tongue dryness progressing to cracked surface. Treatment involved drinking watermelon juice, intravenous glucose injection, and administering Baihu Chengqi Zengye Tang (White Tiger, Da Huang, and Fluid-Generating Decoction). After one dose, heavy diarrhea occurred and fever decreased; after the second dose, continued diarrhea led to clarity of mind. Finally, Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) combined with Liangge San (Cooling the Diaphragm Powder) achieved complete recovery.
In the third year after the Anti-Japanese War, a Mr. Chen (name forgotten) came to Shanghai to survive due to the fall of Northern Jiangsu. He relied on his relative, Mr. Zhang Shiyin, living in Tiancheng Li on present-day Jianguo Middle Road. He worked manual labor during the day and earned barely enough to live at night. In August, he suddenly contracted warmth-pathogen. Initially thinking it was a minor illness and facing financial difficulties, he did not seek medical help. Four or five days later, the condition transformed into dryness. He had dry mouth, dental plaque, greasy tongue, scorched lips, delirium, and confusion, indicating Yangming excess-heat syndrome. Only then did he seek treatment. The doctor prescribed Yinhua (Lonicerae Japonicae Flos), Lianqiao (Forsythiae Fructus), Sangye (Mori Folium), and Juhua (Chrysanthemi Flos), combined with Zhizi (Gardeniae Fructus) and Douchi (Fermented Soybean). Two doses were ineffective because the pathology was severe while the medication was light, like pouring a cup of water on a burning cartload of firewood. This delay lasted ten days, with life-threatening situations arising. Five of the ten ominous signs—grasping at empty air, twisting fingers, rubbing clothes, touching the bed, and fixed staring—had appeared, indicating extreme danger.
His relative, Mr. Zhang Shiyin, had a complex family structure similar to the story of the Qi man with one wife and one concubine, and many children like Guo Ziyi. Financial resources were strained. When the condition became critical and doctors refused treatment, he had to seek other options to do his utmost, so he invited me to consult. Entering the room, Mr. Zhang led me to a small attic with low ceilings and dark lighting. I turned on the electric light to examine him. His symptoms matched those described above, so I initially declared it incurable. Mr. Zhang insisted, saying, "Even if the medication fails and he dies unfortunately, do not blame the doctor. Moreover, his wife is in their hometown in Northern Jiangsu; if he dies, she will surely blame me for not trying hard enough to save our poor relative. Please try your best." Having no choice, I examined him carefully again. I saw alternating irritability and drowsiness, though not fully comatose.
I asked about his urination; it was red, scanty, and difficult, indicating that fluid depletion was not yet total. Deep palpation of his chest and abdomen caused him to frown, showing he still had sensation. Asking about hiccups, he reported occasional occurrences of short duration, suggesting the Stomach Qi was not entirely exhausted. As for the cracked tongue lacking fluids, dryness, cracking, and foul breath, these were evident.
I said to Mr. Zhang, "This is a Yangming excess-heat syndrome. Delayed to this point, purging may kill him, but not purging will also kill him. Since you insist, as a doctor, I must exert my final effort. This is what Master Wang Mengying meant by 'rather die from medicine than sit and wait for death.' If Mr. Chen's condition did not have five out of ten ominous signs, I would be more confident, so I dare not boast that he can definitely escape danger." I first instructed buying a large watermelon, extracting the juice, and feeding it with a spoon. Then I prescribed a formula using Baihu Chengqi combined with Zengye Fa in large doses, instructing quick preparation. Simultaneously, I prepared 1000 ml of glucose solution for intravenous injection to increase blood volume and strengthen the heart. The injection took about 40 minutes, conducted while sitting on the attic floorboards. After the injection, the herbs arrived. I ordered them to be decocted and administered immediately, then left.
Within three hours of taking the medicine, the patient felt rumbling in his abdomen, followed by massive diarrhea on his bedding. Initially, it consisted of dry, hard pellets, followed by sticky black stool resembling paste or glue, forming strips when picked up due to its stickiness. After taking the second decoction, he had four bowel movements overnight. The next morning, his consciousness had gradually cleared. Mr. Zhang was overjoyed and invited me back at 10 AM. I observed that his spirit was clear, breathing was calmer, his eyes had returned to normal white sclera, and his chest and abdomen were softer, though painful upon deep pressure. Tongue fluids had returned but were not fully moist. Oral odor and heat had decreased, urine volume increased but remained yellow-red. Hiccups had ceased completely. Drinking watermelon juice now tasted cool and sweet. I instructed reducing the dosage slightly and taking another dose. His condition improved further, and he desired porridge. At the third visit, I used Zhu Ye Shi Gao Tang combined with Liangge San to clear residual pathogens and stabilize him.
Baihu Chengqi Tang combined with Zengye Fa: Shigao (Gypsum Fibrosum) 6 liang, Zhimu (Anemarrhenae Rhizoma) 5 qian, Zhi Gancao (Prepared Licorice Root) 3 qian, Jinwenjun (Rhei Radix et Rhizoma) and Yuanmingfen (Natrii Sulfas) each 6 qian, Chao Zhishi (Immature Bitter Orange) 4 qian, Xian Shihu (Dendrobii Caulis) 5 qian, Xian Shengdi (Rehmanniae Radix) and Chao Jingsmi (Fried Rice) each 1 liang, and a large branch of Xian Lugen (Phragmitis Rhizoma, nodes removed).
Zhu Ye Shi Gao Tang combined with Liangge San: Xian Zhuye (Fresh Bamboo Leaf) 1 liang, Shigao (Gypsum Fibrosum) 3 liang, Maidong (Ophiopogonis Radix, core removed) 4 qian, Ludangshen (Codonopsis Radix) 3 qian, Zhi Gancao (Prepared Licorice Root) 2 qian, Chuan Dahuang (Rhei Radix et Rhizoma) 3 qian (wine-washed), Jing Lianqiao (Forsythiae Fructus) 4 qian, Dan Huangqin (Scutellariae Radix) 3 qian (wine-fried), Zhiren (Gardeniae Fructus) 3 qian, and Chao Jingsmi (Fried Rice) 1 liang.
Autumn-Warmth with Delirium, Abdominal Fullness: After ten days of autumn-warmth, the patient had dry mouth and scorched teeth, scorched-yellow tongue coating, and no bowel movement for ten days. The abdomen was severely distended with panting, hard as stone upon palpation, accompanied by intermittent delirium and drowsiness. Treated with a heavy dose of Dachengqi Tang (Major Order the Qi Decoction) added with Qingpi (Citri Reticulatae Pericarpium) and Laifuzi (Radish Seed).
In Yinghua Li, Changshou Road, a Mr. Li, aged 46, suffered from autumn-warmth for ten days without effect from other doctors, so I was consulted. He lay supine, his abdomen distended like an inverted pot, protruding 2-3 cun above his chest when viewed horizontally. He breathed slightly rapidly, his abdomen was hard as stone and painful throughout, his pulse was full and forceful, his mouth was dry with scorched teeth, and his tongue coating was scorched yellow, yet his fever was not particularly high. His family explained that ten days prior, he attended a wedding feast, got drunk and full, and traveled home by carriage. That night he had fever and aversion to cold. The next day the cold resolved, but the fever intensified. Doctors failed to treat him, and now the fever was lower. He had not had a bowel movement since the onset of illness, and experienced alternating delirium and drowsiness. Asked about ominous signs like grasping at air or touching the bed, he denied them. Observing his robust constitution and the abdominal distension exceeding the chest, I determined that strong purgation was necessary and should not be delayed. I prescribed Dachengqi Tang (Major Order the Qi Decoction) added with Qingpi (Citri Reticulatae Pericarpium) and Laifuzi (Radish Seed). Dahuang (Rhei Radix et Rhizoma) and Yuanmingfen (Natrii Sulfas) each 1 liang, Chuan Houpo (Magnoliae Officinalis Cortex) and Zhike (Aurantii Fructus) each 5 qian, Qingpi (Citri Reticulatae Pericarpium) 3 qian, and Laifuzi (Radish Seed) 4 qian. I did not follow up the next day, feeling suspicious. Did the family dare not administer it? Did it cure him? Or did it kill him? I worried about criticism from other physicians regarding the heavy dosage. Four or five days later, a neighbor visiting me happily reported, "Mr. Li's illness yesterday, after one dose of your prescription, resulted in heavy diarrhea and recovery. For such a severe illness, without even a second dose, you are truly a divine physician. I am here recommended by Mr. Li." Hearing this, I finally felt at ease.
Dachengqi Tang added with Qingpi and Laifuzi: Jinwen Dahuang (Rhei Radix et Rhizoma) 1 liang, Yuanmingfen (Natrii Sulfas) 1 liang (divided for administration), Chuan Houpo (Magnoliae Officinalis Cortex) 3 qian, Chao Zhike (Fried Aurantii Fructus) 5 qian, Xi Qingpi (Fine Citri Reticulatae Pericarpium) 3 qian, and Laifuzi (Radish Seed) 4 qian.
Autumn-Warmth with Exterior Heat and Interior Cold: A woman fell ill with heat in July, lasting over ten days. She had spontaneous sweating, thirst, high fever, delirium, body aches, yellow-greasy scorched tongue coating, scanty red urine, dry stool, restlessness, and chest oppression. Treated with Baihu combined with Xiexin Fa (White Tiger and Heart-Clearing Method) added with Huashi (Talcum) and Mutong (Akebiae Caulis). After medication induced evacuation, most symptoms subsided, but the fever persisted. Continued treatment with Yinhua (Lonicerae Japonicae Flos), Lianqiao (Forsythiae Fructus), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Tianhuafen (Trichosanthis Radix), and Huashi (Talcum) was ineffective. Observing her desire for hot drinks, I changed the prescription to Fuzi Xiexin Tang (Aconite and Heart-Clearing Decoction) added with Ge Gen (Puerariae Lobatae Radix) and Ganjiang (Zingiberis Rhizoma). One dose cleared the fever.
Wang Tongqing, a boat captain's wife, aged 35, fell ill with heat in early July. Her boat was moored at Suzhou Creek near Chadaijiao, Shanghai. Nearby doctors treated her without success. After ten days, her condition worsened as described previously, so I was consulted. The weather was hot, known as "Autumn Tiger." Seeing this, I reviewed previous prescriptions and realized they had been misled by the "Two Beans School" (contemporary physicians often prioritizing Douchi and Doujuan). I prescribed Baihu combined with Xiexin Fa, adding Huashi (Talcum) and Mutong (Akebiae Caulis). One dose greatly reduced symptoms; two doses eliminated them, except for persistent fever. I continued with Lianqiao (Forsythiae Fructus), Yinhua (Lonicerae Japonicae Flos), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Tianhuafen (Trichosanthis Radix), and Huashi (Talcum), but to no avail. Upon re-consultation, the patient suddenly asked her husband for boiled water. He replied, "There is a cup of water by your pillow; have you forgotten?" She touched the cup and said, "This water is no longer hot; please get very hot water." I felt her armpit and detected significant heat. Mr. Wang replaced the water, and she drank it without finding it scalding. I then understood the reason. Prolonged sweating had damaged fluids, and although I used Baihu combined with Xiexin Fa to clear heat, once the interior heat was cleared and purged, interior cold emerged. I urgently prescribed Fuzi Xiexin Tang (Aconite and Heart-Clearing Decoction) added with Ge Gen (Puerariae Lobatae Radix) and Ganjiang (Zingiberis Rhizoma). Ge Gen was added because exterior true heat remained; Ganjiang was added because interior true cold existed. After one dose, she recovered, exterior heat subsided, and her craving for hot drinks ceased. Subsequent conditioning agents completed the treatment.
Baihu combined with Xiexin Fa added with Huashi and Mutong: Shigao (Gypsum Fibrosum) 3 liang, Zhimu (Anemarrhenae Rhizoma) 4 qian, Zhi Gancao (Prepared Licorice Root) 2 qian, Jingsmi (Oryza Sativa) 1 liang, Jinwen Jun (Rhei Radix et Rhizoma) 3 qian, Chuan Huanglian (Coptidis Rhizoma) 1 qian (decocted separately and mixed in), Huangqin (Scutellariae Radix) 3 qian, Kuai Huashi (Talcum) 3 qian, and Mutong (Akebiae Caulis) 2.5 qian.
Fuzi Xiexin Tang added with Ge Gen and Ganjiang: Shu Fupian (Prepared Aconiti Lateralis Radix) 4 qian, Jinwen Jun (Rhei Radix et Rhizoma) 2 qian, Shang Chuanlian (Coptidis Rhizoma) 0.8 qian, Sheng Huangqin (Scutellariae Radix) 3 qian, Fen Ge Gen (Puerariae Lobatae Radix powder) 3 qian, and Pao Jiangtan (Charred Zingiberis Rhizoma) 3 qian.
Spring-Warmth with Phlegm-Fire Madness: Spring-warmth unresolved, pathogenic heat enters Ying and Blood levels. The body presents with macules and rashes, purple-black in color, skin hot to touch, internal heat burning, scorched lips, dental plaque, and dry scorched-yellow tongue coating. Initially delirious and confused, subsequently running wildly mad, seeing ghosts and spirits, or climbing windows and roofs. Treated with Dachengqi Tang (Major Order the Qi Decoction) removing Houpo (Magnoliae Officinalis Cortex), replacing with Gualou (Trichosanthis Fructus), and adding Shigao (Gypsum Fibrosum), Ge Gen (Puerariae Lobatae Radix), Huanglian (Coptidis Rhizoma), Lianqiao (Forsythiae Fructus), Dannanxing (Arisaema cum Bile), and Shichangpu (Acori Tatarinowii Rhizoma). Named Huotan Chengqi Tang (Phlegm-Expelling Order the Qi Decoction).
Patient Hu Yongnian, aged 45, contracted warmth in March. Treatment failed, and on the fifth day, macules and rashes appeared. Symptoms unfolded sequentially. This was a syndrome of extreme excess and heat. By the tenth day, madness developed. He ran around wildly, acting as if seeing ghosts, performing bowing and prostrating gestures, and even beating and cursing people. His wife hired two strong men to carry him to my clinic. Knowing he was mad, I spoke gently to soothe him. His spirit calmed slightly, and he suddenly knelt to bow to me. I smiled and spoke softly to guide him to sit. His pulse was deep, rapid, and forceful. Skin was hot to touch, especially the chest. Macules and rashes were widespread, purple-black. Lips were scorched, teeth had plaque, and tongue coating was dry and scorched yellow. Bowel movements had ceased for six days; urine was scanty and red. I reassured him and sent him home with the two men, while his wife took the prescription, fearing a recurrence of madness.
I prescribed Chengqi Tang removing Houpo (Magnoliae Officinalis Cortex), substituting Quan Gualou (Whole Trichosanthis Fructus), and adding Shigao (Gypsum Fibrosum), Ge Gen (Puerariae Lobatae Radix), Huanglian (Coptidis Rhizoma), Lianqiao (Forsythiae Fructus), Dannanxing (Arisaema cum Bile), and Shichangpu (Acori Tatarinowii Rhizoma), using Lugen (Phragmitis Rhizoma) as a guide. Houpo was removed due to its warm and drying nature. Gualou was substituted to descend phlegm in the chest and diaphragm. Shigao was essential for macules/rashes; Ge Gen for brain/spinal cord and Yangming heat; Huanglian and Lianqiao to clear Heart and cool Diaphragm; Nanxing and Shichangpu to expel phlegm and open orifices. Given the severity, this heavy prescription was necessary. After taking the medicine, he had two bowel movements, sticky like glue or lacquer, with slight sweating, calmer spirit, and significantly reduced madness.
The next day, I was called for a house call. His wife, fearing he would go out, locked the door while he slept and came to my clinic. Upon arrival, I unlocked the door, but the room was empty. Searching under the bed yielded nothing. Just as we were surprised, we heard noise on the roof. His wife fetched a ladder, stood on it, opened the skylight, and saw him sitting on the roof. Calling him, and speaking gently myself, he finally smiled and climbed down through the window. Re-examining him, the purple-black macules had faded to a rosier hue, tongue coating had largely receded, and muscle heat had significantly decreased. Extraneous conditions being thus, interior conditions could be inferred. I reduced the dosages slightly and added Xian Shengdi (Rehmanniae Radix) and Xian Shihu (Dendrobii Caulis) to cool blood and generate fluids. After two more doses, he had three more bowel movements, madness disappeared, and consciousness was clear. Subsequent treatment focused on clearing residual pathogens and supporting healthy Qi, leading to full recovery.
Huotan Chengqi Tang (Phlegm-Expelling Order the Qi Decoction): Jinwen Jun (Rhei Radix et Rhizoma) 5 qian, Yuanmingfen (Natrii Sulfas) 5 qian, Chao Zhishi (Fried Immature Bitter Orange) 4 qian, Shigao (Gypsum Fibrosum) 3 liang, Quan Gualou (Whole Trichosanthis Fructus) 6 qian, Fen Ge Gen (Puerariae Lobatae Radix powder) 4 qian, Chuan Huanglian (Coptidis Rhizoma) 1.5 qian, Jing Lianqiao (Forsythiae Fructus) 4 qian, Dannanxing (Arisaema cum Bile) 4 qian, Shichangpu (Acori Tatarinowii Rhizoma) 3 qian, and Xian Lugen (Fresh Phragmitis Rhizoma) 1 branch. Note: The next day, the dosage was slightly reduced, and Xian Shengdi (Rehmanniae Radix) 1 liang and Xian Shihu (Dendrobii Caulis) 4 qian were added.
Spring-Warmth with Huoxu Syndrome in Women: A woman took tonics in winter. During Spring Festival, she suffered from alternating chills and fever with sore throat. After injection of diphtheria antiserum, the sore throat subsided, but abdominal pain began. Doctors diagnosed typhoid fever complicated by peritonitis. Treatment was prolonged and ineffective. Gradually, her hands and feet became cold, alternating between quiet and agitated states, blue lips, dry teeth, foul breath, and foul vaginal discharge. Doctors refused treatment. Taking over the case, I tentatively prescribed Xiexin combined with Zengye Chengqi Fa (Heart-Clearing and Fluid-Generating Order the Qi Method), hoping for a miracle. One dose showed great effect. Ultimately, however, she died from anger-induced starvation, which was regrettable.
Mrs. Gu Sheng frequently took tonics in winter, consuming large amounts of steamed paste made from longan flesh and jujube flesh. On the fourth day of the first lunar month of the following year, she suddenly developed chills, fever, and severe sore throat, seeking Western medical treatment. The doctor diagnosed diphtheria and injected antiserum, relieving the sore throat. One or two days later, abdominal pain developed with significant chills and fever, and no bowel movement for many days. She went to a hospital on Qiantong Road. The doctor diagnosed typhoid fever complicated by peritonitis. The abdominal pain was severe, intolerable to touch, hard as a board, with scanty yellow-red urine, craving for cold food, pure heat without chills, and high fever. Due to the pain, she cried out in distress all day. The family refused surgery. Besides antipyretics, the doctor applied ice bags to the abdomen (note: this method is inadvisable) to reduce inflammation and pain, having no other options.