李姓媪，年八旬有三，于孟夏得温病，兼项后作疼。
病因 饭后头面有汗，忽隔窗纱透入凉风，其汗遂闭，因得斯证。
证候 项疼不能转侧，并不能俯仰，周身发灼热，心中亦热，思凉物，脉象左部弦而长，右部则弦
硬有力，大便干燥，小便
短少。
诊断 此因汗出腠理不闭，风袭风池、风府，是以项疼，因而成风温也。高年之脉，大抵弦细，
因其气虚所以无甚起伏，因其血液短少，是以细而不濡，至于弦硬而长有力，是显有温热
之现象也。此当清其实热而辅以补正兼解表之品。
处方 生石膏（一两轧细） 野台参（三钱） 生怀地黄（一两） 生怀山药（五钱）
玄参（三钱） 沙参（三钱） 连翘（二钱）
西药阿斯匹林一瓦，先将阿斯匹林用白糖水送下，继将中药煎汤一大盅，至甫出汗时，即将汤药乘热服下。
效果 如法将药服下后，周身得汗，表里之热皆退，项之疼大减，而仍未脱然。俾每日用阿斯
匹林一瓦强（约三分），分三次用白糖水送下，隔四点钟服一次。若初次服后微见汗者，后
两次宜少服，如此两日，项疼全愈。盖阿斯匹林不但能发汗去热，且能为热性关节疼痛之最妙药也。
天津李××，年三十八岁，于孟冬上旬得温病。
病因 其妻于秋间病故，子女皆幼，处处须自经管，伤心又兼劳心，遂致暗生内热，薄受外感，遽成温病。
证候 初得时，即表里俱热，医者治以薄荷、连翘、菊花诸药，服后微见汗，病稍见轻。至再
诊时，病患自觉呼吸短气，此气郁不舒也，医者误以为气虚，遂于清热药中加党参以补其
气，服后右胁下陡然作疼，彻夜不能卧，亦不能眠，心中发热，舌苔白浓，大便四日未行，其左
右脉皆弦，右部尤弦而有力，一分钟八十二至。
诊断 凡脉象弦者主疼，又主血液短少，此证之右胁非常疼痛，
原为证脉相符，而其伤心劳心以致暗生内热者，其血液必然
伤损，此亦证脉相符也。其右脉弦而有力者，外感之热已入阳明之府也。拟治以白虎汤而辅以开郁滋阴之品。
处方 生石膏（二两轧细） 知母（八钱） 玄参（八钱） 天冬（八钱）
川楝子（五钱捣碎） 生莱菔子（五钱捣碎） 连翘（三钱） 甘草（二钱） 粳米（三钱）
共煎汤两大盅，分两次温服下。
复诊 将药服完，热退强半，胁疼已愈三分之二，脉象变为浮弦，惟胸膈似觉郁闷，大便犹未
通下。再治以宽胸清热润燥之剂，为其脉浮有还表之象，宜再少加透表之药以引之外
出，其病当由汗而解。
处方 糖栝蒌（二两切碎） 生石膏（一两捣细） 知母（五钱） 玄参（五钱）
连翘（三钱） 川楝子（四钱捣碎） 甘草（二钱）
共煎汤两盅，分二次温服下。其服完两次之后，迟一点钟再服西药阿斯匹林一瓦。温复以取微汗。
效果 如法将药服完，果周身皆得微汗，病若失，其大便亦通下矣。
An elderly woman surnamed Li, aged eighty-three, contracted warm disease (Wen Bing) in early summer, accompanied by pain at the back of the neck.
Etiology: After a meal, sweat appeared on her head and face. Suddenly, cool wind blew through the window screen, causing the sweat to close up abruptly, leading to this condition.
Symptoms: Neck pain prevented turning or tilting the head, as well as bending forward or backward. The whole body felt burning hot, and there was heat in the chest. She craved cold foods. The pulse was wiry and long on the left side, and wiry, hard, and forceful on the right side. Stool was dry, and urine was scanty.
Diagnosis: This occurred because when sweating, the couli (pores) were not closed, allowing wind pathogens to attack Fengchi (GB20) and Fengfu (GV16), resulting in neck pain and subsequently Wind-Warmth disease. In the elderly, pulses are generally wiry and fine; due to Qi deficiency, there is little fluctuation; due to blood insufficiency, the pulse is fine but not moist. A wiry, hard, long, and forceful pulse clearly indicates the presence of warm-heat pathogens. Treatment should focus on clearing excess heat, assisted by herbs that tonify the healthy Qi and resolve the exterior.
Prescription: Raw Gypsum Fibrosum (Shi Gao, 30g, finely ground) [Gypsumis Fibrosum]; Wild Taishan Ginseng (Yetaishen, 9g) [Codonopsis Radix]; Raw Huai Rehmanniae Root (Sheng Dihuang, 30g) [Rehmanniae Radix]; Raw Huai Dioscoreae Rhizome (Sheng Shanyao, 15g) [Dioscoreae Rhizoma]; Scrophulariae Radix (Xuanshen, 9g) [Scrophulariae Radix]; Glehniae Radix (Shashen, 9g) [Glehniae Radix]; Forsythiae Fructus (Lianqiao, 6g) [Forsythiae Fructus]. Western medicine: Aspirin 1 grain. First, take Aspirin with sugar water. Then, decoct the Chinese herbal medicine into one large cup of soup. When slight sweating begins, drink the herbal soup while it is still hot.
Outcome: Following this method, the patient sweated profusely, and both interior and exterior heat subsided. Neck pain decreased significantly but did not completely disappear. Prescribed Aspirin slightly stronger than 1 grain (approx. 3 fen) daily, divided into three doses taken with sugar water, every four hours. If slight sweating occurred after the first dose, subsequent doses should be reduced. After two days, neck pain was completely cured. Aspirin not only induces sweating and reduces fever but is also an excellent remedy for painful joints caused by heat.
Li XX from Tianjin, aged thirty-eight, contracted warm disease in early winter.
Etiology: His wife died of illness in autumn. With young children and all matters requiring his personal management, he suffered grief and mental exertion. This led to latent internal heat generation. Combined with a mild external contraction, it rapidly developed into warm disease.
Symptoms: From the onset, both exterior and interior were hot. The physician treated him with Bohe (Menthae Haplocalycis Herba), Lianqiao (Forsythiae Fructus), and Juhua (Chrysanthemi Flos). After taking the medicine, slight sweating occurred, and symptoms improved slightly. At the second consultation, the patient complained of shortness of breath, indicating Qi stagnation and lack of free flow. The physician mistakenly diagnosed Qi deficiency and added Dangshen (Codonopsis Radix) to tonify Qi among the heat-clearing herbs. After ingestion, severe pain suddenly erupted in the right hypochondrium, preventing lying down or sleeping throughout the night. There was heat in the chest, a thick white tongue coating, and no bowel movement for four days. Both left and right pulses were wiry, with the right side particularly wiry and forceful, beating 82 times per minute.
Diagnosis: A wiry pulse primarily indicates pain and blood insufficiency. The severe pain in the right hypochondrium matches the pulse presentation. Furthermore, grief and mental exertion causing latent internal heat inevitably damage blood, which also aligns with the pulse findings. The wiry and forceful right pulse indicates that the external heat has entered the Yangming Fu organs. The proposed treatment is Baihu Tang (White Tiger Decoction), assisted by herbs that open stagnation and nourish Yin.
Prescription: Raw Gypsum Fibrosum (Shi Gao, 60g, finely ground) [Gypsumis Fibrosum]; Anemarrhenae Rhizoma (Zhimu, 24g) [Anemarrhenae Rhizoma]; Scrophulariae Radix (Xuanshen, 24g) [Scrophulariae Radix]; Asparagi Radix (Tian Dong, 24g) [Asparagi Radix]; Toosendan Fructus (Chuan Lianzi, 15g, crushed); Raw Raphani Semen (Sheng Laifuzi, 15g, crushed); Forsythiae Fructus (Lianqiao, 9g) [Forsythiae Fructus]; Glycyrrhizae Radix et Rhizoma (Gancao, 6g) [Glycyrrhizae Radix et Rhizoma]; Oryza Sativa (Jingmi, 9g). Decoct together into two large cups, divide into two doses, and take warm.
Second Consultation: After finishing the medicine, heat subsided by more than half, and hypochondriac pain improved by two-thirds. The pulse became floating and wiry. However, the chest and diaphragm felt stifled, and stool remained unpassed. Treat with a formula to broaden the chest, clear heat, and moisten dryness. Since the floating pulse suggests the pathogen is returning to the exterior, slightly add herbs that vent the exterior to guide the pathogen out. The disease should resolve through sweating.
Prescription: Sugar-coated Trichosanthis Fructus (Tang Gualou, 60g, chopped); Raw Gypsum Fibrosum (Shi Gao, 30g, crushed); Anemarrhenae Rhizoma (Zhimu, 15g) [Anemarrhenae Rhizoma]; Scrophulariae Radix (Xuanshen, 15g) [Scrophulariae Radix]; Forsythiae Fructus (Lianqiao, 9g) [Forsythiae Fructus]; Toosendan Fructus (Chuan Lianzi, 12g, crushed); Glycyrrhizae Radix et Rhizoma (Gancao, 6g) [Glycyrrhizae Radix et Rhizoma]. Decoct together into two cups, divide into two doses, and take warm. One hour after finishing the two doses, take Aspirin 1 grain. Cover warmly to induce slight sweating.
Outcome: Following this method, slight sweating occurred over the whole body, the illness seemed to vanish, and stool was passed.