天津侯姓学徒，年十三岁，得暑温兼泄泻。
病因 季夏天气暑热，出门送药受暑，表里俱觉发热，兼头目眩晕。服药失宜，又兼患泄泻。
证候 每日泄泻十余次，已逾两旬，而心中仍觉发热懒食，周身酸软无力，时或怔忡，小
便赤涩发热，其脉左部微弱，右部重按颇实，搏近六至。
诊断 此暑热郁于阳明之腑，是以发热懒食，而肝肾气化不舒，
是以小便不利致大便泄泻也。当清泻胃腑，调补肝肾，病当自愈。
处方 生怀山药（两半） 滑石（一两） 生杭芍（六钱） 净萸肉（四钱）
生麦芽（三钱） 甘草（三钱）
共煎汤一大盅，温服。
复诊 服药一剂泻即止，小便通畅，惟心中犹觉发热，又间有怔忡之时，遂即原方略为加减俾再服之。
处方 生怀山药（一两） 生怀地黄（一两） 净萸肉（八钱） 生杭芍（六钱）
生麦芽（二钱） 甘草（二钱）
共煎汤一大盅，温服。
效果 将药连服两剂，其病霍然全愈。
帮助 初次所用之方，即拙拟之滋阴清燥汤加山萸肉、生麦芽也。
从来寒温之热传入阳明，其上焦燥热下焦滑泻者，最为难治，
因欲治其上焦之燥热，则有碍下焦之滑泻；欲补其下焦之滑泻，则有碍上焦之燥热，是以医者对之恒至束手。
然此等证若不急为治愈，则下焦滑泻愈久，上焦燥热必愈甚，是以本属可治之证，因稍为迟延竟至不可救
者多矣。惟拙拟之滋阴清燥汤，山药与滑石并用，一补大便，一利小便。而山药多液，滑石性凉，又善清上焦之
燥热，更辅以甘草、芍药以复其阴（仲景谓作甘草芍药汤以复其阴），阴复自能胜燥热，而芍药又善利小便，
甘草亦善调大便，汇集四味为方，凡遇证之上焦燥热下焦滑泻者，莫不随手奏效也。间有阳明热实，服药后
滑泻虽止而燥热未尽清者，不妨继服白虎汤。其热物理虚者，或服白虎加人参汤，若虑其复作滑泻，可于
方中仍加滑石三钱，或更以生山药代粳米煎取清汤，一次只饮一大口，徐徐将药服完，其热全消，亦不至复
作滑泻。愚用此法救人多矣，滋阴清燥汤后，附有治愈多案可参观也。至此案方中加萸肉、生麦芽
者，因其肝脉弱而不舒，故以萸肉补之，以生麦芽调之，所以遂其条达之性也。至于第二方中为泻止小便已
利，故去滑石。为心中犹怔忡，故将萸肉加重。为犹有余热未清，故又加生地黄。因其余热无多，如此治法已
可消除净尽，无须服白虎汤及白虎加人参汤也。
A thirteen-year-old apprentice surnamed Hou in Tianjin suffered from Summerheat-Warmth complicated by diarrhea.
Etiology: In late summer, the weather was hot and sultry. He contracted summerheat while going out to deliver medicine, resulting in a sensation of heat in both the exterior and interior, accompanied by dizziness of the head and eyes. Improper medication administration further led to diarrhea.
Symptoms: He experienced diarrhea more than ten times daily for over twenty days. Despite this, he still felt internal heat, had a poor appetite, and suffered from generalized soreness, weakness, and occasional palpitations (Zhenchong). His urine was dark red, scanty, painful, and felt hot. The pulse was weak on the left side, but firm and substantial upon heavy pressure on the right side, with a frequency approaching six beats per respiration cycle (approximately 100–120 beats per minute).
Diagnosis: This condition is caused by summerheat-heat stagnating in the Yangming Fu organs, leading to fever and anorexia. The Qi transformation of the Liver and Kidney is obstructed, causing difficulty in urination, which subsequently leads to diarrhea. Treatment should focus on clearing and purging the stomach and intestines of heat, while regulating and tonifying the Liver and Kidneys. The disease will resolve spontaneously.
Prescription: Raw Huai Yam (Sheng Huai Shanyao) 1.5 liang, Talcum (Huashi) 1 liang, Raw Hang Peony Root (Sheng Hangshaoyao) 6 qian, Clean Cornus Fruit (Jing Yurou) 4 qian, Raw Malt (Sheng Maiya) 3 qian, Licorice Root (Gancao) 3 qian.
Decoct together in a large cup of water and take warm.
Second Visit: After one dose, the diarrhea ceased immediately, and urination became smooth. However, he still felt internal heat and occasionally experienced palpitations. Therefore, the original prescription was slightly modified for continued use.
Prescription: Raw Huai Yam (Sheng Huai Shanyao) 1 liang, Raw Rehmannia Root (Sheng Dihuang) 1 liang, Clean Cornus Fruit (Jing Yurou) 8 qian, Raw Hang Peony Root (Sheng Hangshaoyao) 6 qian, Raw Malt (Sheng Maiya) 2 qian, Licorice Root (Gancao) 2 qian.
Decoct together in a large cup of water and take warm.
Outcome: After taking two doses consecutively, the illness was completely cured.
Commentary: The initial prescription used was my formulated Yin-Nourishing and Dryness-Clearing Decoction (Ziyin Qingzao Tang) supplemented with Cornus Fruit (Yurou) and Raw Malt (Sheng Maiya).
Historically, when pathogenic heat from Cold or Warm diseases transmits to the Yangming stage, presenting with upper Jiao dryness-heat and lower Jiao slippery diarrhea, it is extremely difficult to treat. Treating the upper Jiao dryness-heat may aggravate the lower Jiao diarrhea, while tonifying the lower Jiao diarrhea may hinder the clearance of upper Jiao dryness-heat. Consequently, physicians often find themselves at a loss.
However, if such conditions are not treated promptly, prolonged lower Jiao diarrhea will inevitably exacerbate upper Jiao dryness-heat. Thus, what should be a treatable condition often becomes incurable due to slight delays. My formulated Yin-Nourishing and Dryness-Clearing Decoction uses Huai Yam and Talcum together; one tonifies the stool, and the other promotes urination. Huai Yam is rich in fluids, and Talcum is cool in nature, effectively clearing upper Jiao dryness-heat. Assisted by Licorice and Peony to restore Yin (as Zhang Zhongjing stated, using Licorice and Peony Decoction to restore Yin), the restored Yin can overcome dryness-heat. Peony also promotes urination, and Licorice harmonizes the bowels. Combining these four herbs creates a formula that is effective for any case involving upper Jiao dryness-heat and lower Jiao slippery diarrhea. In cases of Yangming excess heat where diarrhea stops after medication but dryness-heat remains, Baihu Tang (White Tiger Decoction) may be continued. If there is deficiency accompanying the heat, Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng) may be used. To prevent recurrence of diarrhea, add 3 qian of Talcum to the formula, or substitute Rice (Jingmi) with Raw Huai Yam, decocting only the clear soup, drinking one large mouthful at a time slowly. This eliminates heat without recurring diarrhea. I have saved many people using this method; refer to the cases recorded after Yin-Nourishing and Dryness-Clearing Decoction. In this case, Cornus and Raw Malt were added because the Liver pulse was weak and stagnant; thus, Cornus tonifies it, and Raw Malt regulates it, facilitating the Liver’s natural course of free flow. In the second prescription, Talcum was removed because diarrhea stopped and urination improved. Cornus dosage was increased because of persistent palpitations. Raw Rehmannia was added because residual heat remained. Since the residual heat was minimal, this treatment sufficed to eliminate it completely, making Baihu Tang and Baihu Jia Renshen Tang unnecessary.