十九日 黄亦少退，脉之软者亦鼓指；惟舌赤、小便赤浊，余湿余热未尽，尚须清之。
茯苓皮（五钱） 茵陈（四钱） 生苡仁（三钱） 黑栀子（三钱） 杏仁（三钱） 黄柏炭（二
钱） 半夏（三钱） 黄连（八分） 广皮炭（二钱） 萆 （三钱） 滑石（五钱）
二十日 黄退，小便赤浊，舌赤脉洪，湿热未净。
滑石（五钱） 栀皮（二钱，炒） 萆 （三钱） 黄连（一钱） 海金砂（三钱） 半夏（三钱）
王 二十八岁 乙酉三月二十日 上年初秋伏暑，午后身热汗出，医者误以为阴虚劳损
，不
食，胸痞，咳嗽，舌苔白滑，四肢倦怠，不能起床。至今三月不解，已经八月之久，深痼难
拔，勉与宣化三焦，兼从少阳提邪外出法。
桂枝（三钱） 蔻仁（二钱） 黄芩（二钱，炒） 青蒿（三钱） 茯苓皮（五钱） 滑石（六钱）
苡仁（五钱） 半夏（五钱） 杏仁（四钱） 广皮（三钱） 通草（一钱）
此药服二帖，能进饮食；服四帖，饮食大进，即能起行立。后八日复诊，以调理脾胃而
愈。
李 十八岁 十一月初九日 伏暑如疟状，脉弦数，寒热往来，热多于寒，解后有汗，
与青蒿鳖甲汤，五帖而愈。
金氏 三十岁 乙酉四月二十二日 上年伏暑，寒热时发如疟状，以通宣三焦立法，补
水补火皆妄也。
杏仁（三钱） 藿梗（三钱） 蔻仁（五钱） 茯苓皮（五钱） 苡仁（五钱） 半夏（四钱） 青
蒿（八分） 炒黄芩（二钱） 生姜（二钱） 大枣（二个）
服四帖。
初二日 伏暑愈后，以平补中焦为要，仍须宣通，勿得粘滞。
半夏（三钱） 莲子（五钱，去心皮） 广皮（二钱） 益智仁（一钱） 茯苓（五钱） 生姜（
三片） 生苡仁（五钱）
某 九月二十四日 初因肝郁，继因内饮招外风为病，现下寒热如疟状。又有伏暑内发
，新
凉外加之象，六脉弦细而紧，两关独大而浮，厥阴克阳明，医者全然不究病从何来，亦不究
脉象之是阴是阳，一概以地黄等柔药补阴，以阴药助阴病，人命其何堪哉。势已沉重，欲成
噎食反胃，勉与两和肝胃，兼提少阳之邪外出法。
桂枝（三钱） 蔻仁（二钱） 川椒炭（二钱） 青蒿（一钱） 苡仁（三钱） 杏仁（三钱） 半
夏（六钱） 香附（三钱） 生姜（四钱） 广皮（三钱） 旋复花（三钱）
二十八日 寒热减半，呕止，舌苔满黄，但仍滑耳，于前方内加∶
黄芩（二钱，炒）
再服四帖，如一二帖内寒热止，去青蒿。若舌苔干燥，腹痛止，去川椒，加
茯苓（五钱）
十月初六日 伏暑已解七八，痰饮肝郁未除，下焦且有湿热。
杏仁（四钱） 旋复花（三钱） 通草（一钱） 蔻仁（三钱） 香附（三钱） 萆 （五钱） 苡
仁（五钱） 半夏（五钱） 蚕砂（三钱） 茯苓皮（五钱） 广皮（二钱）
煮三杯，分三次服，数帖痊愈。
陶 五十八岁 乙酉九月十八日 伏暑遇新凉而发，舌苔HT 白，上灰黑，六脉不浮不沉
而数
，误与发表，胸痞不食，此危证也。何以云危？盖四气杂感，又加一层肾虚，又加一层肝郁
，又加一层误治，又加一层酒客中虚，何以克当！勉与河间之苦辛寒法，一以宣通三焦，而
以肺气为主，望其气化而湿热俱化也。
杏仁（四钱） 郁金（三钱） 藿香叶（三钱） 蔻仁（三钱） 黄芩（三钱） 黄连（一钱） 苡
仁（五钱） 滑石（五钱） 半夏（五钱） 茯苓皮（五钱） 通草（一钱） 广皮（三钱）
二十三日 舌之灰化为黄，滑而不燥，唇赤颧赤，脉之弦者，化而为滑数，是湿与热俱
重也。
杏仁泥（五钱） 茯苓（六钱） 木通（五钱） 蔻仁（三钱） 茵陈（五钱） 苡仁（五钱） 黄
连（二钱） 滑石（一两） 黄柏炭（四钱）
半夏（五钱）
二十六日 伏暑舌之灰者化黄，兹黄虽退，而白滑未除，当退苦药，加辛药，脉滑甚，
重加化痰，小心复感要紧。
杏仁（五钱） 郁金（三钱） 滑石（一两） 蔻仁（三钱） 藿梗（三钱） 苡仁（五钱） 枳实
（三钱） 半夏（一两） 黄柏炭（三钱） 广皮（三钱） 茯苓皮（六钱）
煮三杯，分三次服。
十月初二日 伏暑虽退，舌之白滑未化，是暑中之伏湿尚存也，小心饮食要紧。脉之滑
大者
已减，是暑中之热去也。无奈太小而不甚流利，是阳气未充，不能化湿，重与辛温，助阳气
，化湿气。
杏仁泥（五钱） 广皮（五钱） 半夏（六钱） 蔻仁（三钱） 益智仁（三钱） 川椒炭（三钱）
苡仁（五钱） 干姜（三钱） 木通（三钱）
煮三杯，分三次服，以舌苔黄为度。
初六日 伏暑之外感者，因大汗而退，舌白滑苔，究未能化黄，前方大用刚燥未除也，
务要小心饮食，毋使脾困。
杏仁泥（四钱） 煨草果（八分） 益智仁（三钱） 蔻仁（三钱） 茅术炭（三钱） 半夏（五
钱） 苡仁（五钱） 广皮炭（五钱） 浓朴（二钱） 茯苓皮（五钱） 神曲炭（三钱）
王氏 二十二岁 二月二十六日 伏暑咳嗽寒热，将近一年不解，难望回生，既咳且呕
而泄
泻，勉与通宣三焦，俾邪有出路，或者得有生机。何以知其为伏暑而非劳？瘵劳之咳，重在
丑寅卯木旺之时，或午前，或终日，湿家之咳，旺在戌亥子。劳之寒热后无汗，伏暑寒热如
疟状，丑寅卯阳升，乃有汗而止。劳之阴虚身热，脉必芤大，伏暑之脉，弦细而弱。故知其
为伏暑而非劳瘵也。再左边久不着席，此水在肝也。
生苡仁（五钱） 广皮（三钱） 蔻仁（二钱） 半夏（五钱） 茯苓皮（五钱） 郁金（一钱）
青蒿（八分） 香附（三钱） 桂枝（三钱） 旋复花（三钱） 生姜（三片） 大枣（二个）
煮三杯，分三次服。
此方服四帖，寒热减，去青蒿，又服十帖，后健脾胃收功。
裘 四十岁 乙酉八月初五日 酒客中虚湿重，面色滞暗，业已有日，现下又感伏暑新
凉，
头胀便溏，舌白滑，脉弦细，中虚寒湿可知，不能戒酒，断乎病不除根。盖客症易除，久病
伏湿虚寒难退也。
杏仁（三钱） 广皮（五钱） 藿梗（三钱） 苡仁（一两） 半夏（六钱） 黄芩炭（六钱） 蔻
仁（三钱） 茯苓（一两） 青蒿（二钱）
煮三杯，分三次服，头胀除去青蒿，服七帖愈。
周 五岁 本系伏暑，误以为风寒挟食，发表消导难进，致邪气深入下焦血分，夜热早
凉，与煎厥瘅疟相似。食减脉大，汗多便结，先与救阳明之阴。
梨汁（一酒杯） 藕汁（一酒杯） 鲜芦根汁（半酒杯） 荸荠汁（一酒杯） 元参（五钱） 连
心麦冬（五钱）
三帖。
On the 19th day, the jaundice has faded, and the previously soft pulse now beats against the fingers; however, the tongue is red and crimson, and the urine is red and turbid. The residual dampness and heat have not yet been cleared, so clearing measures are still required.
Poria Peel (Wulingpi) (5 qian), Yinchen (4 qian), Raw Coix Seed (Sheng Yiren) (3 qian), Black Gardenia (Heizhizi) (3 qian), Apricot Kernel (Xingren) (3 qian), Charred Phellodendron Bark (Huangbo Tan) (2 qian), Pinellia (Banxia) (3 qian), Coptis Rhizome (Huanglian) (8 fen), Tangerine Peel Char (Guangpi Tan) (2 qian), Dioscorea Hypoglauca Rhizome (Bixie) (3 qian), Talcum (Huashi) (5 qian).
On the 20th day, the jaundice has receded, but the urine remains red and turbid, the tongue is red, and the pulse is surging (Hong). The damp-heat pathogen has not yet been completely cleared.
Talcum (Huashi) (5 qian), Fried Gardenia Skin (Zhi Pi) (2 qian), Dioscorea Hypoglauca Rhizome (Bixie) (3 qian), Coptis Rhizome (Huanglian) (1 qian), Goldthread Root (Haijinsha) (3 qian), Pinellia (Banxia) (3 qian).
Patient Wang, male, 28 years old. Consulted on March 20 of the Yiyou year. Last early autumn, he suffered from latent summerheat (Fushu), presenting with afternoon fever and sweating. The physician mistakenly diagnosed this as yin deficiency and consumptive disease (Laosun), leading to anorexia, chest oppression, cough, white slippery tongue coating, fatigue in the four limbs, and inability to get out of bed. It has been three months without resolution, lasting eight months in total. The pathogen is deeply entrenched and difficult to eradicate. I tentatively employed a method to diffuse and transform the Sanjiao (Triple Burner), combined with extracting the pathogen outward via the Shaoyang (Lesser Yang) channel.
Cinnamon Twig (Guizhi) (3 qian), Cardamom Seed (Kouren) (2 qian), Scutellaria Root (Huangqin) (2 qian, fried), Artemisia Annua (Qinghao) (3 qian), Poria Peel (Wulingpi) (5 qian), Talcum (Huashi) (6 qian), Coix Seed (Yiren) (5 qian), Pinellia (Banxia) (5 qian), Apricot Kernel (Xingren) (4 qian), Tangerine Peel (Guangpi) (3 qian), Akebia Stem (Tongcao) (1 qian).
After taking two doses, the patient could eat; after four doses, appetite greatly improved, and he was able to stand and walk. Upon follow-up on the eighth day, recovery was achieved by regulating the Spleen and Stomach.
Patient Li, male, 18 years old. Consulted on November 9. Latent summerheat presented like malaria, with a wiry and rapid pulse, alternating chills and fever, with fever exceeding chills, and sweating after paroxysms. Prescribed Qinghao Biejia Tang (Qinghao and Turtle Shell Decoction); cured after five doses.
Patient Jin, female, 30 years old. Consulted on April 22 of the Yiyou year. Last year, she suffered from latent summerheat, with intermittent chills and fever resembling malaria. The treatment principle was to unblock and diffuse the Sanjiao (Triple Burner); tonifying water or fire would be erroneous.
Apricot Kernel (Xingren) (3 qian), Agastache Stem (Huogeng) (3 qian), Cardamom Seed (Kouren) (5 qian), Poria Peel (Wulingpi) (5 qian), Coix Seed (Yiren) (5 qian), Pinellia (Banxia) (4 qian), Artemisia Annua (Qinghao) (8 fen), Fried Scutellaria Root (Chao Huangqin) (2 qian), Fresh Ginger (Shengjiang) (2 qian), Jujube (Dazao) (2 pieces).
Four doses taken.
On the 2nd day, after latent summerheat resolved, the priority is to gently tonify the Middle Jiao (Middle Burner), while maintaining diffusion and unblocking; avoid sticky or cloying herbs.
Pinellia (Banxia) (3 qian), Lotus Seed (Lianzi) (5 qian, heart and skin removed), Tangerine Peel (Guangpi) (2 qian), Alpinia Oxyphylla Fruit (Yizhiren) (1 qian), Poria (Fuling) (5 qian), Fresh Ginger (Shengjiang) (3 slices), Raw Coix Seed (Sheng Yiren) (5 qian).
Patient [Name Unknown], consulted on September 24. Initially due to Liver Qi stagnation, subsequently complicated by internal fluid retention attracting external wind. Currently presenting with chills and fever resembling malaria. There are signs of latent summerheat activating internally and new coolness attacking externally. The six pulses are wiry, fine, and tight; the Guan positions are particularly large and floating. This indicates Jueyin (Liver) overacting on Yangming (Stomach). The physician entirely failed to investigate the origin of the disease or whether the pulse pattern indicated yin or yang, indiscriminately using soft, moistening herbs like Rehmannia to tonify yin, thereby aiding a yin pathology with yin herbs. How can human life bear this? The condition is already severe, threatening to develop into dysphagia and regurgitation. I tentatively employed a method to harmonize both the Liver and Stomach, combined with extracting Shaoyang pathogen outward.
Cinnamon Twig (Guizhi) (3 qian), Cardamom Seed (Kouren) (2 qian), Charred Sichuan Pepper (Chuanjiao Tan) (2 qian), Artemisia Annua (Qinghao) (1 qian), Coix Seed (Yiren) (3 qian), Apricot Kernel (Xingren) (3 qian), Pinellia (Banxia) (6 qian), Cyperus Rhizome (Xiangfu) (3 qian), Fresh Ginger (Shengjiang) (4 qian), Tangerine Peel (Guangpi) (3 qian), Inula Flower (Xuanfuhua) (3 qian).
On the 28th day, chills and fever reduced by half, vomiting stopped, tongue coating is fully yellow but still slippery. Add to the previous formula:
Scutellaria Root (Huangqin) (2 qian, fried).
Take another four doses. If chills and fever cease within one or two doses, remove Artemisia Annua (Qinghao). If tongue coating becomes dry and abdominal pain stops, remove Charred Sichuan Pepper and add Poria (Fuling) (5 qian).
On October 6, latent summerheat has resolved by 70-80%, but phlegm-fluid retention and Liver Qi stagnation remain, and there is damp-heat in the Lower Jiao (Lower Burner).
Apricot Kernel (Xingren) (4 qian), Inula Flower (Xuanfuhua) (3 qian), Akebia Stem (Tongcao) (1 qian), Cardamom Seed (Kouren) (3 qian), Cyperus Rhizome (Xiangfu) (3 qian), Dioscorea Hypoglauca Rhizome (Bixie) (5 qian), Coix Seed (Yiren) (5 qian), Pinellia (Banxia) (5 qian), Mulberry Silkworm Excrement (Can Sha) (3 qian), Poria Peel (Wulingpi) (5 qian), Tangerine Peel (Guangpi) (2 qian).
Boil to yield three cups, divide into three doses; cured after several doses.
Patient Tao, male, 58 years old. Consulted on September 18 of the Yiyou year. Latent summerheat triggered by new coolness. Tongue coating is white in the center, turning gray-black at the apex. Six pulses are neither floating nor sunken but rapid. Mistakenly treated with exterior-releasing herbs, resulting in chest oppression and anorexia. This is a critical syndrome. Why critical? Because it involves mixed pathogens from four climatic factors, compounded by Kidney deficiency, Liver stagnation, iatrogenic error, and middle jiao deficiency in a chronic alcohol user. How can such a constitution withstand these burdens? I tentatively employed Liu Hejian’s bitter-pungent-cold method, focusing on diffusing and unblocking the Sanjiao (Triple Burner) with Lung Qi as the primary focus, hoping that qi transformation will resolve both dampness and heat.
Apricot Kernel (Xingren) (4 qian), Turmeric Tuber (Yujin) (3 qian), Perilla Leaf (Huoxiangye) (3 qian), Cardamom Seed (Kouren) (3 qian), Scutellaria Root (Huangqin) (3 qian), Coptis Rhizome (Huanglian) (1 qian), Coix Seed (Yiren) (5 qian), Talcum (Huashi) (5 qian), Pinellia (Banxia) (5 qian), Poria Peel (Wulingpi) (5 qian), Akebia Stem (Tongcao) (1 qian), Tangerine Peel (Guangpi) (3 qian).
On the 23rd day, the gray color on the tongue has turned yellow, slippery but not dry. Lips and malar regions are red. The wiry pulse has transformed into a slippery-rapid pulse, indicating severe dampness and heat.
Apricot Kernel Paste (Xingren Ni) (5 qian), Poria (Fuling) (6 qian), Akebia Stem (Mutong) (5 qian), Cardamom Seed (Kouren) (3 qian), Yinchen (5 qian), Coix Seed (Yiren) (5 qian), Coptis Rhizome (Huanglian) (2 qian), Talcum (Huashi) (1 liang), Charred Phellodendron Bark (Huangbo Tan) (4 qian), Pinellia (Banxia) (5 qian).
On the 26th day, the gray tongue coating from latent summerheat has turned yellow. Although the yellow has receded, the white slippery coating persists. Bitter herbs should be withdrawn, and pungent herbs added. The pulse is very slippery, requiring intensified phlegm-resolving measures. Caution is needed to prevent re-infection.
Apricot Kernel (Xingren) (5 qian), Turmeric Tuber (Yujin) (3 qian), Talcum (Huashi) (1 liang), Cardamom Seed (Kouren) (3 qian), Agastache Stem (Huogeng) (3 qian), Coix Seed (Yiren) (5 qian), Immature Bitter Orange (Zhishi) (3 qian), Pinellia (Banxia) (1 liang), Charred Phellodendron Bark (Huangbo Tan) (3 qian), Tangerine Peel (Guangpi) (3 qian), Poria Peel (Wulingpi) (6 qian).
Boil to yield three cups, divide into three doses.
On October 2, although latent summerheat has receded, the white slippery tongue coating has not transformed, indicating residual latent dampness within the summerheat. Dietary caution is essential. The previously large-slippery pulse has diminished, indicating the heat of summerheat has gone. However, the pulse is now small and not very fluent, indicating insufficient yang qi unable to transform dampness. Heavy use of pungent-warm herbs is required to assist yang qi and transform dampness.
Apricot Kernel Paste (Xingren Ni) (5 qian), Tangerine Peel (Guangpi) (5 qian), Pinellia (Banxia) (6 qian), Cardamom Seed (Kouren) (3 qian), Alpinia Oxyphylla Fruit (Yizhiren) (3 qian), Charred Sichuan Pepper (Chuanjiao Tan) (3 qian), Coix Seed (Yiren) (5 qian), Dried Ginger (Ganjiang) (3 qian), Akebia Stem (Mutong) (3 qian).
Boil to yield three cups, divide into three doses; stop when tongue coating turns yellow.
On the 6th day, the exterior component of latent summerheat receded due to profuse sweating, but the white slippery tongue coating ultimately failed to turn yellow, indicating that the strong drying herbs in the previous formula did not fully eliminate the pathogen. Strict dietary caution is necessary to prevent Spleen dysfunction.
Apricot Kernel Paste (Xingren Ni) (4 qian), Roasted Tsaoko Cardamom (Wei Caoguo) (8 fen), Alpinia Oxyphylla Fruit (Yizhiren) (3 qian), Cardamom Seed (Kouren) (3 qian), Charred Atractylodes Macrocephala Rhizome (Maozhu Tan) (3 qian), Pinellia (Banxia) (5 qian), Coix Seed (Yiren) (5 qian), Charred Tangerine Peel (Guangpi Tan) (5 qian), Magnolia Bark (Noupo) (2 qian), Poria Peel (Wulingpi) (5 qian), Charred Medicated Leaven (Shenqu Tan) (3 qian).
Patient Wang, female, 22 years old. Consulted on February 26. Latent summerheat-induced cough and chills/fever have persisted for nearly a year, making recovery unlikely. She presents with cough, vomiting, and diarrhea. I tentatively employed a method to unblock and diffuse the Sanjiao (Triple Burner), allowing the pathogen an exit route, perhaps offering a chance of survival. How do I know it is latent summerheat rather than consumptive disease (Chai Lao)? Cough from Chai Lao peaks during the Wood hours (Chou, Yin, Mao, 1 am - 7 am), either before noon or all day. Cough from dampness patients peaks during the Water hours (Xu, Hai, Zi, 7 pm - 3 am). Consumptive disease chills/fever are followed by no sweat; latent summerheat chills/fever resemble malaria, with sweating stopping during the Yang rising hours (Chou, Yin, Mao). Consumptive disease yin deficiency fever presents with a large-empty (Kou) pulse; latent summerheat presents with a wiry-fine-weak pulse. Thus, it is latent summerheat, not Chai Lao. Furthermore, the left side of her body cannot touch the pillow, indicating water accumulation in the Liver.
Raw Coix Seed (Sheng Yiren) (5 qian), Tangerine Peel (Guangpi) (3 qian), Cardamom Seed (Kouren) (2 qian), Pinellia (Banxia) (5 qian), Poria Peel (Wulingpi) (5 qian), Turmeric Tuber (Yujin) (1 qian), Artemisia Annua (Qinghao) (8 fen), Cyperus Rhizome (Xiangfu) (3 qian), Cinnamon Twig (Guizhi) (3 qian), Inula Flower (Xuanfuhua) (3 qian), Fresh Ginger (Shengjiang) (3 slices), Jujube (Dazao) (2 pieces).
Boil to yield three cups, divide into three doses.
After four doses of this formula, chills and fever decreased; Qinghao was removed. After ten more doses, recovery was finalized by strengthening the Spleen and Stomach.
Patient Qiu, male, 40 years old. Consulted on August 5 of the Yiyou year. Chronic alcohol users have deficient middle jiao and heavy dampness. Complexion is dull and dark. Illness has existed for days. Now complicated by latent summerheat and new coolness. Symptoms include head distension, loose stools, white slippery tongue coating, and wiry-fine pulse. This indicates middle jiao deficiency with cold-damp. Without quitting alcohol, the root cause cannot be eradicated. Acute pathogens are easy to remove, but latent dampness and deficiency-cold from chronic illness are difficult to retreat.
Apricot Kernel (Xingren) (3 qian), Tangerine Peel (Guangpi) (5 qian), Agastache Stem (Huogeng) (3 qian), Coix Seed (Yiren) (1 liang), Pinellia (Banxia) (6 qian), Charred Scutellaria Root (Huangqin Tan) (6 qian), Cardamom Seed (Kouren) (3 qian), Poria (Fuling) (1 liang), Artemisia Annua (Qinghao) (2 qian).
Boil to yield three cups, divide into three doses. Remove Artemisia Annua if head distension resolves; cured after seven doses.
Patient Zhou, male, 5 years old. Originally latent summerheat, mistakenly diagnosed as wind-cold with food retention. Exterior-releasing and digestion-promoting methods were ineffective, causing the pathogen to penetrate deeply into the Blood level of the Lower Jiao. Night fever and morning coolness appeared, resembling Jian Jue (Jian Jue Syndrome) or Dan Nue (Dan Malaria). Reduced appetite, large pulse, profuse sweating, and constipation. First, administer a method to rescue the Yin of the Yangming (Stomach/Large Intestine).
Pear Juice (1 wine cup), Lotus Root Juice (1 wine cup), Fresh Reed Rhizome Juice (Half wine cup), Water Chestnut Juice (1 wine cup), Scrophularia Root (Yuanshen) (5 qian), Ophiopogon Tuber with Heart (Lianxin Maidong) (5 qian).
Three doses.