甘 二十四岁 壬戌六月二十九日 暑温邪传心包，谵语神昏，右脉洪大数实而模糊，
势甚危险。
细生地（六钱） 知母（五钱） 银花（八钱） 元参（六钱） 连翘（六钱） 生甘草（三钱）
麦冬（六钱） 竹叶（三钱） 生石膏（一两）
煮三碗，分三次服。牛黄丸（二丸），紫雪丹（三钱）。
温邪入心包络，神昏痉厥，极重之症。
连翘（三钱） 竹叶（三钱） 银花（三钱） 生石膏（六钱） 细生地（五钱） 甘草（钱半）
知母（三钱） 麦冬（五钱连心）
今晚一帖，明早一帖，再服紫雪丹（四钱）。
周 五十二岁 壬戌年七月十四日 世人悉以羌防柴葛，治四时杂感，竟谓天地有冬而
无夏
，不亦冤哉！以致暑邪不解，深入血分成厥，衄血不止，夜间烦躁，势已胶锢难解，焉得速
功。
鲜芦根（一两） 丹皮（五钱） 荷叶边（一张） 羚羊角（三钱） 元参（五钱） 杏仁（三钱）
桑叶（三钱） 滑石（三钱） 犀角（三钱） 细生地（五钱）
今晚一帖，明早一帖。
十五日 厥与热似乎稍缓，据云夜间烦躁亦减，是其佳处；但脉沉弦细数，非痉厥所宜
，急宜育阴而恋阳，复咸以止厥法。
生地（六钱） 元参（六钱） 麦冬（八钱连心） 生白芍（四钱） 桑叶（三钱） 羚羊角（三
钱） 丹皮（三钱） 犀角（三钱） 生鳖甲（六钱）
日服二帖。
十六日 脉之弦刚者，大觉和缓，沉者已起，是为起色；但热病本属伤阴，况医者误以
伤寒温燥药五六帖之多，无怪乎舌燥如草也。议启肾液法。
元参（一两） 丹皮（五钱） 桑叶（二钱） 犀角（三钱） 天冬（三钱） 麦冬（五钱） 沙参
（三钱） 银花（三钱） 生鳖甲（八钱）
日服三帖。
十七日 即于前方内加∶
连翘（钱半） 鲜荷叶边（三钱） 细生地（六钱）
再按∶暑热之邪，深入下焦血分。身半以下，地气主之。热来甚于上焦，岂非热邪深入
之明征乎？必借芳香以为搜邪之用。不然，恐日久胶固之邪一时难解也，则真阴正气日亏一
日矣
，紫雪丹之必不可少也。
紫雪丹（钱半） 分三次服。
十八日 厥已回，面赤，舌干黑苔，脉洪数有力，十余日不大便，皆下证也。人虽虚，
然亦可以调胃承气小和之。
生大黄（五钱） 元明粉（三钱，冲） 生甘草（三钱）
先用一半，煎一茶杯，缓缓服，俟夜间不便，再服下半剂。（服前方半剂，即解黑大便
多许）。便后用此方∶
生白芍（六钱） 大生地（一两） 麦冬（一两） 生鳖甲（一两）
十九日 大下宿粪如许，舌苔化而干未滋润，脉仍洪数，微有潮热，除存阴无二法。
生白芍（六钱） 沙参（六钱） 炙甘草（三钱） 麦冬（六钱） 丹皮（四钱） 牡蛎（五钱）
天冬（三钱） 大生地（一两） 鳖甲（五钱）
日服二帖。
二十一日 小便短而赤甚，微咳，面微赤，尺脉仍见数洪象，议甘润益下，以治虚热，
少复
苦味，以治不尽之实邪。且甘苦合化阴气而利小便也。按∶甘苦合化降气利小便法，举世不
知，在温热门中诚为利小便之上等法。盖热伤阴液，小便无由而生，故以甘润益水之源；小
肠火腑，非苦不通，为邪热所助，故以苦药泻小肠而退邪热。甘得苦则不呆腻，苦得甘则不
刚燥，合而成功也。
炙甘草（四钱） 生鳖甲（八钱） 生白芍（六两） 元参（五钱） 阿胶（三钱） 麦冬（六钱）
麻仁（三钱） 丹皮（三钱） 沙参（三钱） 黄连（一钱）
二十二日 已得效，仍服前方二帖。
二十三日 复脉复苦法，清下焦血分之阴热。
炙甘草（五钱） 生鳖甲（五钱） 麦冬（五钱） 生白芍（六钱） 阿胶（三钱） 丹皮（五钱）
麻仁（五钱） 天冬（二钱） 元参（三钱）
日服二帖。
王 三十八岁 癸亥六月初三日 暑温舌苔满布，色微黄，脉洪弦而刚甚，左反大于右
，不
渴，初起即现此等脉症，恐下焦精血之热，远甚于上焦气分之热也。且旧有血溢，故手心之
热又甚于手背。究竟初起，且清上焦，然不可不免知其所以然。
连翘（二钱） 豆豉（钱半） 细生地（钱半） 丹皮（二钱） 银花（二钱） 生甘草（一钱）
藿梗
（一钱） 元参（钱半） 薄荷（三分） 牛蒡子（钱半） 白茅根（二钱） 麦冬（二钱） 苦桔梗（
一钱）
初六日 热退大半，胸痞，腹中自觉不和。按∶暑必挟湿，热退湿存之故，先清气分。
连翘（二钱） 豆豉（二钱） 杏仁泥（二钱） 银花（钱半） 生苡仁（三钱） 白扁豆（二钱）
藿梗（三钱） 白通草（八分） 郁金（二钱） 滑石（钱半）
日二帖。
初七日 病退，六腑不和。
藿梗（三钱） 郁金（一钱） 半夏（二钱） 浓朴（二钱） 豆豉（二钱） 生苡仁（三钱） 广
皮炭（一钱） 滑石（三钱）
初八日 向有失血，又届暑病之后，五心发热，法当补阴以配阳；但脉双弦而细，不惟
阴不充足，即真阳亦未见其旺也。议二甲复脉汤，仍用旧有之桂、参、姜、枣。
炒白芍（四钱） 阿胶（二钱） 麦冬（三钱） 麻仁（二钱） 炙甘草（五钱） 生鳖甲（五钱）
沙参（三钱） 大生地（四钱） 生牡蛎（五钱） 桂枝（二钱） 大枣（二个） 生姜（二片）
又丸方
八仙长寿丸，加麻仁白芍蜜丸，每日三服，每服三钱。
马 三十八岁 癸丑年六月初六日 暑热本易伤阴，误用消导攻伐，重伤阴气，致令头
中、耳中，鸣无止时，此系肝风内动。若不急救肝肾之阴，螈 热厥至矣。
炒白芍（六钱） 炙甘草（三钱） 生鳖甲（五钱） 大生地（六钱） 麦冬（五钱） 生牡蛎（
五钱） 丹皮（三钱） 桑叶（三钱） 茶菊炭（二钱） 麻仁（二钱，便不实去此）
服四帖。
十二日 外邪虽退，无奈平素劳伤太过，虚不肯复，六脉无神，非参不可。
沙参（三钱） 大生地（六钱） 阿胶（三钱） 元参（六钱） 麻仁（三钱） 生鳖甲（六钱）
麦冬（六钱） 生白芍（六钱） 炙甘草（四钱）
得大便后，去元参，加
牡蛎（三钱） 人参（三钱） 桂枝 大枣（二枚） 生姜（一片）
七月初六日 病后饮食不调，又兼暑湿着里，腹中绞痛，痛极便溏，脉微数，欲作滞下
，议芩芍法，夺其滞下之源。
黄芩炭（一钱二分） 小茴香炭（八分） 广木香（一钱） 浓朴（二钱） 焦白芍（钱半） 黄
连炭（八分） 炒广皮（钱半） 枳实（一钱） 神曲炭（二钱） 山楂炭（钱半）
一二帖后腹痛除，仍服复脉汤服十余帖。
荣 十五岁 乙丑六月十一日 暑温挟痰饮怒郁，故脉芤身热而胁痛，误用足六经表药
，烦躁不宁，六日不解，至危之证。
生香附（三钱） 旋复花（三钱） 连翘（二钱） 藿梗（三钱） 生石膏（四钱） 杏仁（三钱）
薄荷（一钱） 郁金（二钱）
每帖煮两杯，分二次服。三时一帖，服二日大见效再商。
十三日 于前方内加∶
青橘叶（二钱） 鲜荷叶边（一张） 芦根（五钱）
暑伤足太阴，发为 胀，渴不欲饮，饮则呕，身微热，舌白滑，肢逆，二便闭塞，病在
中焦居多，以香开六腑浊气为主。
半夏（五钱） 藿梗（三钱） 广皮（二钱） 枳实（三钱） 浓朴（四钱） 生香附（三钱） 郁
金（二钱） 生苡仁（三钱） 白蔻仁（二钱） 杏泥（三钱） 旋复花（三钱）
煮两杯，分二次服。今日一帖，明日一帖。
孙 四十五岁 乙丑六月初六日 头痛，左关独高，责之少阳内风掀动，最有损一目之
弊。
若以为外感风寒，则远甚矣。议清少阳胆络法。再此症除左关独高，余脉皆缓，所谓通体皆
寒，一隅偏热，故先清一隅之热。《金匮》谓先治新病，旧病当后治也。
羚羊角（二钱） 苦桔梗（二钱） 生甘草（一钱） 薄荷（六分） 丹皮（钱半） 桑叶（钱半
）菊花（钱半） 刺蒺藜（一钱） 勾藤勾（一钱） 鲜荷叶（半张）
今日一帖，明日一帖。
初八日 前日左关独浮而弦，系少阳头痛，因暑而发，用清胆络法；兹关左已平其半，
但缓甚，舌苔白浓而滑，胸中痞闷，暑中之热已解，而湿尚存也。议先宣上焦气分之热。
生苡仁（五钱） 郁金（三钱） 旋复花（三钱） 藿梗（三钱） 杏仁泥（五钱） 白蔻仁（二
钱，连壳） 半夏（五钱） 广皮（三钱） 茯苓皮（三钱） 滑石（六钱） 通草（一钱）
头煎二杯，今日服，二煎一杯，明早服。
初九日 诸症俱减，舌白未除，中湿尚多，议进法于前方内加∶
加生苍术（三钱） 草果（一钱）
王 二十八岁 初三日 暑伤两太阴，手太阴之证多，一以化肺气为主。
杏仁泥（五钱） 鲜荷叶（一钱） 银花（三钱） 蔻仁（二钱，连皮） 连翘（三钱） 滑石（
八钱） 生苡仁（五钱） 浓朴（三钱） 白通草（一钱） 藿香叶（一钱） 白扁豆花（一枝）
煎二杯，分两次服。今晚明早各一帖。
初四日 两太阴之暑症，昨用冷香合辛凉，暑中之热，已退其半，但里湿与热未克即除
，故大便红水，胸中痞闷。
杏仁泥（三钱） 生苡仁（五钱） 藿梗（三钱） 泽泻（五钱） 白蔻仁（钱半） 滑石（六钱）
浓朴（三钱） 猪苓（五钱） 郁金（二钱） 白通草（二钱） 茯苓皮（三钱）
煎三杯，今晚、明早各一帖。
初五日 舌苔白浓，腹甚不和，肠鸣泄泻，聚湿尚多，急宜分泄。
生苡仁（六钱） 白蔻仁（三钱） 泽泻（五钱） 半夏（五钱） 藿梗（三钱） 茯苓皮（六钱）
椒目（五钱） 广皮（三钱） 滑石（六钱） 苍术（三钱） 浓朴（三钱）
水八碗，煎取三碗，分三次服，渣再煮一碗服。
广 二十四岁 七月二十二日 六脉洪大之极，左手更甚，目斜视，怒气可畏，两臂两
手，
卷曲而螈 ，舌斜而不语三四日，面赤身热，舌苔中黄边白，暑入心包胆络，以清心胆之邪
为要，先与紫雪丹。
桑叶（三钱） 羚羊角（三钱） 细生地（五钱） 连翘（五钱，连心） 竹茹（三钱） 银花（
五钱） 丹皮（三钱） 嫩荷叶（一张） 天冬（三钱） 麦冬（五钱） 犀角（三钱）
煮四杯，分四次服。碧雪丹（三钱） 凉开水调服。以神清热退为度，不清再服三钱，虽
三四次，均可服。
二十三日 肝热之极，加天冬凉肝，于前方加∶
天冬（三钱） 紫雪丹仍照前调服。
二十四日 暑入心胆两经，与清心络之伏热，已见小效，仍用前法而进之。
犀角（五钱） 连翘（四钱） 细生地（五钱） 羚羊角（三钱） 银花（三钱） 茶菊花（三钱）
麦冬（五钱） 桑叶（三钱） 丹皮（五钱）
煮四杯，分四次服。
二十五日 加鲜白扁豆花（一枝） 鲜荷叶边（一枚） 黄连（钱半） 黄芩（三钱）
二十六日 暑入心胆两经，屡清二经之邪，业已见效。今日饮水过多，水入微呕。盖暑
必夹湿，议于前方内去柔药，加淡渗。
犀角（二钱） 茯苓皮（五钱） 黑山栀（三钱） 茵陈（三钱） 荷叶边（一钱） 桑叶（三钱）
银花（三钱） 羚羊角（三钱） 黄连（一钱） 连翘（三钱） 黄柏炭（二钱） 生苡仁（五钱）
二十七日 暑热退后，呕水，身微黄，热退湿存。
茵陈（三钱） 杏仁泥（三钱） 白通草（一钱） 银花（三钱） 白蔻皮（二钱） 连翘（三钱）
生苡仁（五钱） 黄柏炭（二钱） 茯苓（五钱，连皮） 黑山栀（三钱）
服二帖。
二十九日 热未尽退，舌起新白苔，胸痞。暑兼湿热，不能纯治一边。
银花（三钱） 黄连（钱半） 滑石（六钱） 连翘（三钱） 藿梗（三钱） 杏仁泥（五钱） 白
通草（一钱） 生苡仁（五钱） 云苓皮（五钱） 白蔻仁（钱半）
煮三杯，分三次服，二帖。
八月初二日 暑热已退七八，惟十余日不大便，微有谵语，脉沉。可与轻通阳明，与增
液承气法。
元参（八钱） 生大黄（四钱） 麦冬（六钱，连心） 细生地（六钱）
煮成三杯，先服一杯，约二时许，如不大便，再服第二杯，明早得大便，止后服；否则
服第三杯。
初三日 温病下后宜养阴；暑温下后宜兼和胃。盖暑必挟湿，而舌苔白滑故也。脉缓，
与外台茯苓饮意。
茯苓（五钱） 浓朴（二钱） 半夏（三钱） 白蔻皮（钱半） 麦冬（五钱） 生苡仁（五钱）
藿梗（三钱） 郁金（一钱）
暑温热退湿存，故呕，腹不和而舌白苔。
杏仁泥（五钱） 浓朴（二钱） 白蔻仁（钱半） 益智仁（一钱） 半夏（五钱） 生苡仁（五
钱） 黄芩（三钱） 藿梗（三钱） 生姜（三片）
服二帖。
鞠通自医，丁巳六月十三日，时年四十岁。
Gan, aged 24. On the 29th day of the 6th lunar month in the Renxu year. The pathogenic factor of Summerheat-Warmth has transmitted to the Pericardium (Pericardium), presenting with delirium (delirious speech) and coma (loss of consciousness). The pulse on the right side is flooding, rapid, excess, and indistinct; the condition is extremely critical.
Raw Shengdi Huang (Rehmanniae Radix Preparata, 6 qian) Zhi Mu (Anemarrhenae Rhizoma, 5 qian) Yin Hua (Lonicerae Japonicae Flos, 8 qian) Yuan Shen (Scrophulariae Radix, 6 qian) Lian Qiao (Forsythiae Fructus, 6 qian) Raw Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 qian) Mai Dong (Ophiopogonis Radix, 6 qian) Zhu Ye (Bambusae Folium, 3 qian) Raw Shi Gao (Gypsum Fibrosum, 1 liang)
Decoct with water to yield three bowls, divide into three doses. Administer Niu Huang Wan (Calculus Bovis Pill, 2 pills) and Zi Xue Dan (Purple Snow Elixir, 3 qian).
When Warm pathogens enter the Pericardium Collateral, causing coma and convulsions/vertigo, it is a very severe syndrome.
Lian Qiao (Forsythiae Fructus, 3 qian) Zhu Ye (Bambusae Folium, 3 qian) Yin Hua (Lonicerae Japonicae Flos, 3 qian) Raw Shi Gao (Gypsum Fibrosum, 6 qian) Xi Sheng Di (Rehmanniae Radix Preparata, 5 qian) Gan Cao (Glycyrrhizae Radix et Rhizoma, 1.5 qian) Zhi Mu (Anemarrhenae Rhizoma, 3 qian) Mai Dong (Ophiopogonis Radix, 5 qian, retaining the heart)
Take one decoction tonight and one tomorrow morning, followed by Zi Xue Dan (Purple Snow Elixir, 4 qian).
Zhou, aged 52. On the 14th day of the 7th lunar month in the Renxu year. People generally use Qiang Huo (Notopterygii Rhizoma et Radix), Fang Feng (Saposhnikoviae Radix), Chai Hu (Bupleuri Radix), and Ge Gen (Puerariae Lobatae Radix) to treat miscellaneous colds throughout the four seasons, claiming that heaven and earth have winter but no summer. Is this not unjust? Consequently, Summerheat pathogens fail to resolve, penetrating deeply into the Blood level, leading to vertigo (cold extremities) and continuous epistaxis (nosebleed). There is nighttime irritability, and the condition has become stuck and difficult to resolve; how can one expect rapid results?
Fresh Lu Gen (Phragmitis Rhizoma, 1 liang) Dan Pi (Moutan Cortex, 5 qian) He Ye Bian (Nelumbinis Folium margin, 1 sheet) Ling Yang Jiao (Saigae Tataricae Cornu, 3 qian) Yuan Shen (Scrophulariae Radix, 5 qian) Xing Ren (Armeniacae Semen Amarum, 3 qian) Sang Ye (Mori Folium, 3 qian) Hua Shi (Talcum, 3 qian) Xi Jiao (Rhinocerotis Cornu, 3 qian) Xi Sheng Di (Rehmanniae Radix Preparata, 5 qian)
Take one decoction tonight and one tomorrow morning.
15th Day. The vertigo and fever seem slightly alleviated; reportedly, nighttime irritability has also decreased, which is a favorable sign. However, the pulse is deep, wiry, thin, and rapid, which is not suitable for convulsions/vertigo. Urgently employ the method of nourishing Yin to retain Yang, and salty-cold methods to stop vertigo.
Sheng Di (Rehmanniae Radix Preparata, 6 qian) Yuan Shen (Scrophulariae Radix, 6 qian) Mai Dong (Ophiopogonis Radix, 8 qian, retaining the heart) Raw Bai Shao (Paeoniae Radix Alba, 4 qian) Sang Ye (Mori Folium, 3 qian) Ling Yang Jiao (Saigae Tataricae Cornu, 3 qian) Dan Pi (Moutan Cortex, 3 qian) Xi Jiao (Rhinocerotis Cornu, 3 qian) Raw Bie Jia (Testudinis et Carapax Spinosa, 6 qian)
Take two decoctions per day.
16th Day. The wiry and rigid quality of the pulse feels significantly harmonized and relaxed; the deep quality has risen, indicating improvement. However, heat diseases inherently damage Yin. Moreover, the physician mistakenly used warm-drying herbs for Taiyang Cold Damage for five or six decoctions. No wonder the tongue is dry as straw. Propose the method of activating Kidney fluids.
Yuan Shen (Scrophulariae Radix, 1 liang) Dan Pi (Moutan Cortex, 5 qian) Sang Ye (Mori Folium, 2 qian) Xi Jiao (Rhinocerotis Cornu, 3 qian) Tian Dong (Asparagi Radix, 3 qian) Mai Dong (Ophiopogonis Radix, 5 qian) Sha Shen (Glehniae Radix, 3 qian) Yin Hua (Lonicerae Japonicae Flos, 3 qian) Raw Bie Jia (Testudinis et Carapax Spinosa, 8 qian)
Take three decoctions per day.
17th Day. Add to the previous formula:
Lian Qiao (Forsythiae Fructus, 1.5 qian) Fresh He Ye Bian (Nelumbinis Folium margin, 3 qian) Xi Sheng Di (Rehmanniae Radix Preparata, 6 qian)
Further analysis: The Summerheat-Heat pathogen penetrates deeply into the Lower Jiao Blood level. The lower half of the body is governed by Earth Qi. If the heat is more severe than in the Upper Jiao, is this not clear evidence of deep pathogen penetration? One must rely on aromatic substances to search out and expel the pathogen. Otherwise, the long-standing, stuck pathogen may be difficult to resolve quickly, causing True Yin and Zheng Qi to decline daily. Thus, Zi Xue Dan (Purple Snow Elixir) is indispensable.
Zi Xue Dan (Purple Snow Elixir, 1.5 qian), divided into three doses.
18th Day. Vertigo has reversed; face is red, tongue is dry with black coating, pulse is flooding, rapid, and forceful; no bowel movement for over ten days. All are indications for purgation. Although the person is deficient, one can still mildly harmonize the Stomach using Tiao Wei Cheng Qi Tang (Harmonizing the Stomach Purging Decoction).
Raw Da Huang (Rhei Radix et Rhizoma, 5 qian) Yuan Ming Fen (Natrii Sulfas, 3 qian, dissolved) Raw Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 qian)
Use half first, decoct into one teacup, take slowly. If there is still no bowel movement at night, take the remaining half. (After taking half a dose of the previous formula, a large amount of black stool was passed). After bowel movement, use this formula:
Raw Bai Shao (Paeoniae Radix Alba, 6 qian) Da Sheng Di (Rehmanniae Radix Preparata, 1 liang) Mai Dong (Ophiopogonis Radix, 1 liang) Raw Bie Jia (Testudinis et Carapax Spinosa, 1 liang)
19th Day. After forcefully purging such a large amount of accumulated feces, the tongue coating has transformed but remains dry and unmoistened; the pulse is still flooding and rapid; there is slight tidal fever. Besides preserving Yin, there is no second method.
Raw Bai Shao (Paeoniae Radix Alba, 6 qian) Sha Shen (Glehniae Radix, 6 qian) Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Honey-fried, 3 qian) Mai Dong (Ophiopogonis Radix, 6 qian) Dan Pi (Moutan Cortex, 4 qian) Mu Li (Ostreae Concha, 5 qian) Tian Dong (Asparagi Radix, 3 qian) Da Sheng Di (Rehmanniae Radix Preparata, 1 liang) Bie Jia (Testudinis et Carapax Spinosa, 5 qian)
Take two decoctions per day.
21st Day. Urine is scanty and very red; slight cough; face is slightly red; the Chi (Kidney) pulse still shows rapid and flooding qualities. Propose sweet-moistening methods to benefit the Lower Jiao to treat deficiency heat, and slightly add bitter flavors to treat residual excess pathogens. Furthermore, combining sweet and bitter transforms Yin Qi and promotes urination. Note: The method of combining sweet and bitter to descend Qi and promote urination is unknown to the world; in the category of Warm Diseases, it is indeed a superior method for promoting urination. Since heat damages Yin fluids, urine cannot be generated; thus, sweet-moistening herbs replenish the source of Water. The Small Intestine is a Fire Fu organ, which requires bitter herbs to unblock; aided by pathogenic heat, bitter herbs purge the Small Intestine to reduce pathogenic heat. Sweet herbs combined with bitter ones do not become cloying; bitter herbs combined with sweet ones do not become too drying. Together they achieve success.
Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Honey-fried, 4 qian) Raw Bie Jia (Testudinis et Carapax Spinosa, 8 qian) Raw Bai Shao (Paeoniae Radix Alba, 6 liang) Yuan Shen (Scrophulariae Radix, 5 qian) E Jiao (Colla Corii Asini, 3 qian) Mai Dong (Ophiopogonis Radix, 6 qian) Ma Ren (Cannabis Fructus, 3 qian) Dan Pi (Moutan Cortex, 3 qian) Sha Shen (Glehniae Radix, 3 qian) Huang Lian (Coptidis Rhizoma, 1 qian)
22nd Day. Effective already; continue taking two decoctions of the previous formula.
23rd Day. Restore the Fu Mai (Restoring Pulse) method and the bitter method to clear Yin-heat in the Lower Jiao Blood level.
Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Honey-fried, 5 qian) Raw Bie Jia (Testudinis et Carapax Spinosa, 5 qian) Mai Dong (Ophiopogonis Radix, 5 qian) Raw Bai Shao (Paeoniae Radix Alba, 6 qian) E Jiao (Colla Corii Asini, 3 qian) Dan Pi (Moutan Cortex, 5 qian) Ma Ren (Cannabis Fructus, 5 qian) Tian Dong (Asparagi Radix, 2 qian) Yuan Shen (Scrophulariae Radix, 3 qian)
Take two decoctions per day.
Wang, aged 38. On the 3rd day of the 6th lunar month in the Guihai year. In Summerheat-Warmth, the tongue coating is widespread and slightly yellow. The pulse is flooding, wiry, and very rigid; the Left pulse is larger than the Right. There is no thirst. Presenting with these pulse and symptom patterns from the onset suggests that the heat in the Essence and Blood of the Lower Jiao far exceeds the heat in the Qi level of the Upper Jiao. Additionally, due to a history of bleeding, the heat in the palms is even more severe than in the backs of the hands. Ultimately, at the onset, one clears the Upper Jiao, but one must understand the rationale.
Lian Qiao (Forsythiae Fructus, 2 qian) Dou Chi (Sojae Semens Praeparatum, 1.5 qian) Xi Sheng Di (Rehmanniae Radix Preparata, 1.5 qian) Dan Pi (Moutan Cortex, 2 qian) Yin Hua (Lonicerae Japonicae Flos, 2 qian) Raw Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian) Huo Geng (Agastaches Caulis, 1 qian) Yuan Shen (Scrophulariae Radix, 1.5 qian) Bo He (Menthae Haplocalycis Herba, 0.3 qian) Niu Bang Zi (Arctii Fructus, 1.5 qian) Bai Mao Gen (Imperatae Rhizoma, 2 qian) Mai Dong (Ophiopogonis Radix, 2 qian) Ku Jie Geng (Platycodonis Radix, 1 qian)
6th Day. Heat has subsided by more than half; chest feels stuffy, abdomen feels uncomfortable internally. Note: Summerheat always carries Dampness; this is due to heat subsiding while dampness remains. First clear the Qi level.
Lian Qiao (Forsythiae Fructus, 2 qian) Dou Chi (Sojae Semens Praeparatum, 2 qian) Xing Ren Ni (Armeniacae Semen Amarum Paste, 2 qian) Yin Hua (Lonicerae Japonicae Flos, 1.5 qian) Raw Yi Yi Ren (Coicis Semen, 3 qian) Bai Bian Dou (Phaseoli Multiflori Semen, 2 qian) Huo Geng (Agastaches Caulis, 3 qian) Bai Tong Cao (Tetrapanacis Medulla, 0.8 fen) Yu Jin (Curcumae Radix, 2 qian) Hua Shi (Talcum, 1.5 qian)
Two decoctions per day.
7th Day. Disease recedes, but the Six Fu organs are disharmonious.
Huo Geng (Agastaches Caulis, 3 qian) Yu Jin (Curcumae Radix, 1 qian) Ban Xia (Pinelliae Rhizoma, 2 qian) Hou Po (Magnoliae Officinalis Cortex, 2 qian) Dou Chi (Sojae Semens Praeparatum, 2 qian) Raw Yi Yi Ren (Coicis Semen, 3 qian) Guang Pi Tan (Citri Reticulatae Pericarpium Charred, 1 qian) Hua Shi (Talcum, 3 qian)
8th Day. Having a history of blood loss, and now after a Summerheat disease, there is heat in the five centers (palms, soles, and chest). The treatment should tonify Yin to harmonize with Yang. However, the pulse is double-wiry and thin; not only is Yin insufficient, but True Yang does not appear vigorous either. Propose Er Jia Fu Mai Tang (Two Shells Restoring Pulse Decoction), still using the original Gui Zhi (Cinnamomi Ramulus), Shen (Ginseng), Jiang (Zingiberis Rhizoma), and Zao (Jujubae Fructus).
Chao Bai Shao (Paeoniae Radix Alba Stir-fried, 4 qian) E Jiao (Colla Corii Asini, 2 qian) Mai Dong (Ophiopogonis Radix, 3 qian) Ma Ren (Cannabis Fructus, 2 qian) Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Honey-fried, 5 qian) Raw Bie Jia (Testudinis et Carapax Spinosa, 5 qian) Sha Shen (Glehniae Radix, 3 qian) Da Sheng Di (Rehmanniae Radix Preparata, 4 qian) Raw Mu Li (Ostreae Concha, 5 qian) Gui Zhi (Cinnamomi Ramulus, 2 qian) Da Zao (Jujubae Fructus, 2 pieces) Sheng Jiang (Zingiberis Rhizoma Recens, 2 slices)
Another Pill Formula:
Ba Xian Chang Shou Wan (Eight Immortals Longevity Pill), added with Ma Ren (Cannabis Fructus) and Bai Shao (Paeoniae Radix Alba), made into honey pills. Take three times daily, 3 qian each time.
Ma, aged 38. On the 6th day of the 6th lunar month in the Guichou year. Summerheat easily damages Yin. Mistakenly using digestive and attacking/purging herbs severely injures Yin Qi, causing constant ringing in the head and ears. This belongs to Internal stirring of Liver Wind. If one does not urgently rescue the Yin of the Liver and Kidney, convulsions and Heat-Vertigo will arrive.
Chao Bai Shao (Paeoniae Radix Alba Stir-fried, 6 qian) Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Honey-fried, 3 qian) Raw Bie Jia (Testudinis et Carapax Spinosa, 5 qian) Da Sheng Di (Rehmanniae Radix Preparata, 6 qian) Mai Dong (Ophiopogonis Radix, 5 qian) Raw Mu Li (Ostreae Concha, 5 qian) Dan Pi (Moutan Cortex, 3 qian) Sang Ye (Mori Folium, 3 qian) Cha Ju Tan (Chrysanthemi Indici Flos Charred, 2 qian) Ma Ren (Cannabis Fructus, 2 qian, remove if stool is loose)
Take four decoctions.
12th Day. Although external pathogens have retreated, due to chronic overwork and injury, deficiency refuses to recover. The six pulses lack Spirit (Shen); Ginseng is indispensable.
Sha Shen (Glehniae Radix, 3 qian) Da Sheng Di (Rehmanniae Radix Preparata, 6 qian) E Jiao (Colla Corii Asini, 3 qian) Yuan Shen (Scrophulariae Radix, 6 qian) Ma Ren (Cannabis Fructus, 3 qian) Raw Bie Jia (Testudinis et Carapax Spinosa, 6 qian) Mai Dong (Ophiopogonis Radix, 6 qian) Raw Bai Shao (Paeoniae Radix Alba, 6 qian) Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Honey-fried, 4 qian)
After obtaining bowel movement, remove Yuan Shen and add:
Mu Li (Ostreae Concha, 3 qian) Ren Shen (Panacis Ginseng Radix, 3 qian) Gui Zhi (Cinnamomi Ramulus) Da Zao (Jujubae Fructus, 2 pieces) Sheng Jiang (Zingiberis Rhizoma Recens, 1 slice)
6th Day of the 7th Lunar Month. Post-illness dietary irregularity, combined with Summerheat-Dampness adhering internally, causes colicky abdominal pain. Extreme pain leads to loose stools. The pulse is faint and rapid, suggesting impending Dysentery (Zhixia). Propose Qin Shao Fa (Huang Qin and Bai Shao Method) to cut off the source of Dysentery.
Huang Qin Tan (Scutellariae Radix Charred, 1.2 qian) Xiao Hui Xiang Tan (Foeniculi Fructus Charred, 0.8 fen) Guang Mu Xiang (Vladimiriae Radix, 1 qian) Hou Po (Magnoliae Officinalis Cortex, 2 qian) Jiao Bai Shao (Paeoniae Radix Alba Charred, 1.5 qian) Huang Lian Tan (Coptidis Rhizoma Charred, 0.8 fen) Chao Guang Pi (Citri Reticulatae Pericarpium Stir-fried, 1.5 qian) Zhi Shi (Aurantii Fructus Immaturus, 1 qian) Shen Qu Tan (Massa Medicata Fermentata Charred, 2 qian) Shan Zha Tan (Crataegi Fructus Charred, 1.5 qian)
After one or two decoctions, abdominal pain ceases; continue taking Fu Mai Tang (Restoring Pulse Decoction) for over ten decoctions.
Rong, aged 15. On the 11th day of the 6th lunar month in the Yichou year. Summerheat-Warmth carrying Phlegm-Fluids and anger/stagnation causes a Kou (hollow) pulse, body heat, and hypochondriac pain. Mistakenly using exterior-releasing herbs for the Foot Six Channels caused irritability and restlessness, unresolved for six days. This is a critical condition.
Sheng Xiang Fu (Cyperi Rhizoma, 3 qian) Xuan Fu Hua (Inulae Flos, 3 qian) Lian Qiao (Forsythiae Fructus, 2 qian) Huo Geng (Agastaches Caulis, 3 qian) Raw Shi Gao (Gypsum Fibrosum, 4 qian) Xing Ren (Armeniacae Semen Amarum, 3 qian) Bo He (Menthae Haplocalycis Herba, 1 qian) Yu Jin (Curcumae Radix, 2 qian)
Decoct each decoction into two cups, divide into two doses. One decoction every three shichen (hours); if significant improvement occurs after two days, then discuss further.
13th Day. Add to the previous formula:
Qing Ju Ye (Citri Reticulatae Folium Viride, 2 qian) Fresh He Ye Bian (Nelumbinis Folium margin, 1 sheet) Lu Gen (Phragmitis Rhizoma, 5 qian)
Summerheat damages the Foot Taiyin Spleen, manifesting as distension. Thirst without desire to drink; drinking leads to vomiting. Slight body heat, white slippery tongue coating, cold extremities, obstruction of urination and defecation. The pathology is mostly in the Middle Jiao, focusing on aromatic opening and clearing turbid Qi of the Six Fu organs.
Ban Xia (Pinelliae Rhizoma, 5 qian) Huo Geng (Agastaches Caulis, 3 qian) Guang Pi (Citri Reticulatae Pericarpium, 2 qian) Zhi Shi (Aurantii Fructus Immaturus, 3 qian) Hou Po (Magnoliae Officinalis Cortex, 4 qian) Sheng Xiang Fu (Cyperi Rhizoma, 3 qian) Yu Jin (Curcumae Radix, 2 qian) Raw Yi Yi Ren (Coicis Semen, 3 qian) Bai Kou Ren (Amomi Fructus Rotundus Seed, 2 qian) Xing Ni (Armeniacae Semen Amarum Paste, 3 qian) Xuan Fu Hua (Inulae Flos, 3 qian)
Decoct into two cups, divide into two doses. One decoction today, one tomorrow.
Sun, aged 45. On the 6th day of the 6th lunar month in the Yichou year. Headache; the Guan position on the Left is uniquely high. Blame is placed on Shaoyang Internal Wind stirring up. This poses a great risk of damaging one eye.
If considered as External contraction of Wind-Cold, it would be vastly different. Propose clearing the heat of the Shaoyang Gallbladder Collateral. Furthermore, aside from the uniquely high Left Guan pulse, all other pulses are relaxed. This is described as "the whole body is cold, one corner is hot"; thus, first clear the heat in that corner. The *Jin Gui Yao Lue* states: treat new diseases first, old diseases later.
Ling Yang Jiao (Saigae Tataricae Cornu, 2 qian) Ku Jie Geng (Platycodonis Radix, 2 qian) Raw Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian) Bo He (Menthae Haplocalycis Herba, 0.6 fen) Dan Pi (Moutan Cortex, 1.5 qian) Sang Ye (Mori Folium, 1.5 qian) Ju Hua (Chrysanthemi Flos, 1.5 qian) Ci Ji Li (Tribuli Fructus, 1 qian) Gou Teng Gou (Uncariae Ramulus Cum Uncis, 1 qian) Fresh He Ye (Nelumbinis Folium, half sheet)
One decoction today, one tomorrow.
8th Day. The day before yesterday, the Left Guan pulse was uniquely floating and wiry, belonging to Shaoyang headache triggered by Summerheat, treated with clearing Gallbladder Collateral method. Now the Left Guan pulse has flattened by half, but is very relaxed. The tongue coating is thick, white, and slippery; chest is stuffy. The heat of Summerheat has resolved, but Dampness remains. Propose first dispersing the heat of the Upper Jiao Qi level.
Raw Yi Yi Ren (Coicis Semen, 5 qian) Yu Jin (Curcumae Radix, 3 qian) Xuan Fu Hua (Inulae Flos, 3 qian) Huo Geng (Agastaches Caulis, 3 qian) Xing Ren Ni (Armeniacae Semen Amarum Paste, 5 qian) Bai Kou Ren (Amomi Fructus Rotundus Seed, 2 qian, with shell) Ban Xia (Pinelliae Rhizoma, 5 qian) Guang Pi (Citri Reticulatae Pericarpium, 3 qian) Fu Ling Pi (Poriae Cortex, 3 qian) Hua Shi (Talcum, 6 qian) Tong Cao (Tetrapanacis Medulla, 1 qian)
First decoction yields two cups, take today; second decoction yields one cup, take tomorrow morning.
9th Day. All symptoms have decreased, but the white tongue coating remains; Dampness in the Middle Jiao is still heavy. Propose advancing the method by adding to the previous formula:
Add Raw Cang Zhu (Atractylodis Rhizoma, 3 qian) Cao Guo (Tsaoko Fructus, 1 qian)
Wang, aged 28. 3rd Day. Summerheat damages both Taiyin channels (Hand and Foot). Hand Taiyin Lung symptoms are predominant; focus primarily on transforming Lung Qi.
Xing Ren Ni (Armeniacae Semen Amarum Paste, 5 qian) Fresh He Ye (Nelumbinis Folium, 1 qian) Yin Hua (Lonicerae Japonicae Flos, 3 qian) Kou Ren (Amomi Fructus Rotundus Seed, 2 qian, with skin) Lian Qiao (Forsythiae Fructus, 3 qian) Hua Shi (Talcum, 8 qian) Raw Yi Yi Ren (Coicis Semen, 5 qian) Hou Po (Magnoliae Officinalis Cortex, 3 qian) Bai Tong Cao (Tetrapanacis Medulla, 1 qian) Huo Xiang Ye (Agastaches Herba Leaf, 1 qian) Bai Bian Dou Hua (Phaseoli Multiflori Flos, 1 branch)
Decoct into two cups, divide into two doses. One decoction tonight, one tomorrow morning.
4th Day. For Summerheat affecting both Taiyin channels, yesterday using Cold Fragrant combined with Acrid-Cool methods reduced the Summerheat by half. However, interior Dampness and Heat could not be immediately cleared, resulting in bloody watery stools and chest stuffiness.
Xing Ren Ni (Armeniacae Semen Amarum Paste, 3 qian) Raw Yi Yi Ren (Coicis Semen, 5 qian) Huo Geng (Agastaches Caulis, 3 qian) Ze Xie (Alismatis Rhizoma, 5 qian) Bai Kou Ren (Amomi Fructus Rotundus Seed, 1.5 qian) Hua Shi (Talcum, 6 qian) Hou Po (Magnoliae Officinalis Cortex, 3 qian) Zhu Ling (Polyporus, 5 qian) Yu Jin (Curcumae Radix, 2 qian) Bai Tong Cao (Tetrapanacis Medulla, 2 qian) Fu Ling Pi (Poriae Cortex, 3 qian)
Decoct into three cups, one decoction tonight and one tomorrow morning.
5th Day. Tongue coating is thick and white; abdomen is very uncomfortable; borborygmus and diarrhea; accumulation of Dampness is still heavy. Urgently apply separation and drainage.
Raw Yi Yi Ren (Coicis Semen, 6 qian) Bai Kou Ren (Amomi Fructus Rotundus Seed, 3 qian) Ze Xie (Alismatis Rhizoma, 5 qian) Ban Xia (Pinelliae Rhizoma, 5 qian) Huo Geng (Agastaches Caulis, 3 qian) Fu Ling Pi (Poriae Cortex, 6 qian) Jiao Mu (Zanthoxyli Semen, 5 qian) Guang Pi (Citri Reticulatae Pericarpium, 3 qian) Hua Shi (Talcum, 6 qian) Cang Zhu (Atractylodis Rhizoma, 3 qian) Hou Po (Magnoliae Officinalis Cortex, 3 qian)
Decoct eight bowls of water to yield three bowls, divide into three doses. Decoct the dregs again with one bowl of water and take.
Guang, aged 24. July 22nd. The six pulses are extremely flooding; the Left hand is even worse. Eyes deviate sideways, rage is terrifying. Both arms and hands are curled and convulsing. The tongue deviates and cannot speak for three to four days. Face is red, body is hot. Tongue coating is yellow in the center and white on the edges. Summerheat enters the Pericardium and Gallbladder Collaterals. Clearing the pathogens of the Heart and Gallbladder is essential. First administer Zi Xue Dan (Purple Snow Elixir).
Sang Ye (Mori Folium, 3 qian) Ling Yang Jiao (Saigae Tataricae Cornu, 3 qian) Xi Sheng Di (Rehmanniae Radix Preparata, 5 qian) Lian Qiao (Forsythiae Fructus, 5 qian, retaining the heart) Zhu Ru (Bambusae Caulis in Taenia, 3 qian) Yin Hua (Lonicerae Japonicae Flos, 5 qian) Dan Pi (Moutan Cortex, 3 qian) Nen He Ye (Nelumbinis Folium Tender, 1 sheet) Tian Dong (Asparagi Radix, 3 qian) Mai Dong (Ophiopogonis Radix, 5 qian) Xi Jiao (Rhinocerotis Cornu, 3 qian)
Decoct into four cups, divide into four doses. Bi Xue Dan (Green Snow Elixir, 3 qian), taken with cool boiled water. Stop when spirit clears and heat retreats. If not clear, take another 3 qian. Even if taken three or four times, it is permissible.
23rd Day. Liver heat is extreme. Add Tian Dong (Asparagi Radix) to cool the Liver. Add to the previous formula:
Tian Dong (Asparagi Radix, 3 qian). Zi Xue Dan (Purple Snow Elixir) continues to be administered as before.
24th Day. Summerheat enters the Heart and Gallbladder channels. Clearing the latent heat of the Heart Collateral has shown minor effect. Continue with the previous method.
Xi Jiao (Rhinocerotis Cornu, 5 qian) Lian Qiao (Forsythiae Fructus, 4 qian) Xi Sheng Di (Rehmanniae Radix Preparata, 5 qian) Ling Yang Jiao (Saigae Tataricae Cornu, 3 qian) Yin Hua (Lonicerae Japonicae Flos, 3 qian) Cha Ju Hua (Chrysanthemi Indici Flos, 3 qian) Mai Dong (Ophiopogonis Radix, 5 qian) Sang Ye (Mori Folium, 3 qian) Dan Pi (Moutan Cortex, 5 qian)
Decoct into four cups, divide into four doses.
25th Day. Add Fresh Bai Bian Dou Hua (Phaseoli Multiflori Flos, 1 branch), Fresh He Ye Bian (Nelumbinis Folium margin, 1 piece), Huang Lian (Coptidis Rhizoma, 1.5 qian), Huang Qin (Scutellariae Radix, 3 qian).
26th Day. Summerheat enters the Heart and Gallbladder channels. Repeatedly clearing the pathogens of these two channels has been effective. Today, excessive water intake led to mild vomiting upon ingestion. Summerheat always carries Dampness. Propose removing soft/moistening herbs from the previous formula and adding bland-draining herbs.
Xi Jiao (Rhinocerotis Cornu, 2 qian) Fu Ling Pi (Poriae Cortex, 5 qian) Hei Shan Zhi (Gardeniae Fructus Charred, 3 qian) Yin Chen (Artemisiae Scopariae Herba, 3 qian) He Ye Bian (Nelumbinis Folium margin, 1 qian) Sang Ye (Mori Folium, 3 qian) Yin Hua (Lonicerae Japonicae Flos, 3 qian) Ling Yang Jiao (Saigae Tataricae Cornu, 3 qian) Huang Lian (Coptidis Rhizoma, 1 qian) Lian Qiao (Forsythiae Fructus, 3 qian) Huang Bo Tan (Phellodendri Cortex Charred, 2 qian) Raw Yi Yi Ren (Coicis Semen, 5 qian)
27th Day. After Summerheat retreats, vomiting water, slight yellowing of the body. Heat retreats, Dampness remains.
Yin Chen (Artemisiae Scopariae Herba, 3 qian) Xing Ren Ni (Armeniacae Semen Amarum Paste, 3 qian) Bai Tong Cao (Tetrapanacis Medulla, 1 qian) Yin Hua (Lonicerae Japonicae Flos, 3 qian) Bai Kou Pi (Amomi Fructus Rotundus Pericarpium, 2 qian) Lian Qiao (Forsythiae Fructus, 3 qian) Raw Yi Yi Ren (Coicis Semen, 5 qian) Huang Bo Tan (Phellodendri Cortex Charred, 2 qian) Fu Ling (Poria, 5 qian, with cortex) Hei Shan Zhi (Gardeniae Fructus Charred, 3 qian)
Take two decoctions.
29th Day. Heat has not fully retreated; new white coating appears on the tongue; chest is stuffy. Summerheat combines with Damp-Heat; cannot treat solely on one side.
Yin Hua (Lonicerae Japonicae Flos, 3 qian) Huang Lian (Coptidis Rhizoma, 1.5 qian) Hua Shi (Talcum, 6 qian) Lian Qiao (Forsythiae Fructus, 3 qian) Huo Geng (Agastaches Caulis, 3 qian) Xing Ren Ni (Armeniacae Semen Amarum Paste, 5 qian) Bai Tong Cao (Tetrapanacis Medulla, 1 qian) Raw Yi Yi Ren (Coicis Semen, 5 qian) Yun Ling Pi (Poriae Cortex, 5 qian) Bai Kou Ren (Amomi Fructus Rotundus Seed, 1.5 qian)
Decoct into three cups, divide into three doses. Two decoctions.
2nd Day of the 8th Lunar Month. Summerheat has retreated by seven or eight parts. Only no bowel movement for over ten days, slight delirium, pulse is deep. Can use mild purgation of Yangming, employing Zeng Ye Cheng Qi Fa (Increase Fluids Purging Decoction Method).
Yuan Shen (Scrophulariae Radix, 8 qian) Raw Da Huang (Rhei Radix et Rhizoma, 4 qian) Mai Dong (Ophiopogonis Radix, 6 qian, retaining the heart) Xi Sheng Di (Rehmanniae Radix Preparata, 6 qian)
Decoct into three cups. Take one cup first. After about two hours, if there is still no bowel movement, take the second cup. If bowel movement occurs tomorrow morning, stop subsequent doses; otherwise, take the third cup.
3rd Day. After purgation in Warm Diseases, one should nourish Yin; after purgation in Summerheat-Warmth, one should harmonize the Stomach. Summerheat always carries Dampness, evidenced by the white slippery tongue coating. The pulse is relaxed; refer to the intent of Waitai Fu Ling Yin (Fu Ling Decoction from the Imperial Library of the Tang Dynasty).
Fu Ling (Poria, 5 qian) Hou Po (Magnoliae Officinalis Cortex, 2 qian) Ban Xia (Pinelliae Rhizoma, 3 qian) Bai Kou Pi (Amomi Fructus Rotundus Pericarpium, 1.5 qian) Mai Dong (Ophiopogonis Radix, 5 qian) Raw Yi Yi Ren (Coicis Semen, 5 qian) Huo Geng (Agastaches Caulis, 3 qian) Yu Jin (Curcumae Radix, 1 qian)
Summerheat-Warmth heat retreats, Dampness remains, hence vomiting; abdominal disharmony and white tongue coating.
Xing Ren Ni (Armeniacae Semen Amarum Paste, 5 qian) Hou Po (Magnoliae Officinalis Cortex, 2 qian) Bai Kou Ren (Amomi Fructus Rotundus Seed, 1.5 qian) Yi Zhi Ren (Alpiniae Oxyphyllae Fructus, 1 qian) Ban Xia (Pinelliae Rhizoma, 5 qian) Raw Yi Yi Ren (Coicis Semen, 5 qian) Huang Qin (Scutellariae Radix, 3 qian) Huo Geng (Agastaches Caulis, 3 qian) Sheng Jiang (Zingiberis Rhizoma Recens, 3 slices)
Take two decoctions.
Jutong self-treated. June 13th, Ding Si year. Age forty.