刘 甲子五月十三日 面赤肿，喉痛，身热，自汗，舌黄。
马勃（三钱） 银花（六钱） 牛蒡子（六钱） 荆芥穗（二钱） 元参（六钱） 薄荷（钱半）
人中黄（二钱） 桔梗（五钱） 连翘（六钱） 射干（二钱） 板蓝根（三钱） 桑叶（六钱）
共为粗末，分七包，一时许服一包，芦根汤煎。
十四日 用前法。
十五日 于前方内加∶
黄连（二钱） 黄芩（三钱）
某 甲子五月十一日 温毒喉痛发疹，腿酸痛甚重症也，须用急急轻扬，恐其聚而为灾
也。
马勃（五钱） 射干（五钱） 薄荷（五钱） 元参（一两） 连翘（一两二钱） 荆芥穗（六钱）
桔梗（两半） 僵蚕（五钱） 板蓝根（三钱） 银花（一两） 牛蒡子（八钱） 人中黄（四钱）
共为粗末，七钱一包，一时服一包，通十二时服十包，服完再作服，芦根汤煎，二帖愈
。
王氏 二十三岁 甲子五月十一日 温毒颊肿，脉伏而象模糊，此谓阳证阴脉耳，面目
前后俱肿，其人本有瘰 ，头痛身痛，谵语肢厥，势甚凶危，议普济消毒饮法。
连翘（一两二钱） 牛蒡子（八钱） 银花（两半） 荆芥穗（四钱） 桔梗（八钱） 薄荷（三
钱） 人中黄（四钱） 马勃（五钱） 元参（八钱） 板蓝根（三钱）
共为粗末，分十二包，一时许服一包，芦根汤煎服，肿处敷水仙膏，用水仙花根去芦，
捣烂敷之，中留一小口，干则随换，出毒后，敷三黄二香散。
三黄二香散
黄连（一两） 黄柏（一两） 生大黄（一两） 乳香（五钱） 没药（五钱）
上为极细末，初用细茶汁调敷，干则易之，继用香油调敷。
十二日 脉促，即于前方内加∶
生石膏（三两） 知母（八钱）
十三日 即于前方内加∶
犀角（八钱） 黄连（三钱） 黄芩（六钱）
十四日 于前方内加∶
大黄（五钱）
十五日 于前方内去大黄，再加∶
生石膏（一两）
十六日 于前方内加∶
金汁（半茶杯） 分次冲入药内服。
十八日 脉出，身壮热，邪机向外也。然其势必凶，当静以镇之，勿事荒张，稍有谵语
，即服∶
牛黄清心丸一二丸。其汤药仍用前方。
二十日 肿消热退，脉亦静，用复脉汤七帖，全愈。
王 二十三岁 乙丑八月十一日 温毒发斑，时在初秋，盛暑未消，何妄用大汗大下之
伤寒六经法，悖谬已极。右脉洪大芤甚，渴甚，汗太甚。急急重用化斑汤。
生石膏（四两） 细生地（一两） 知母（二两） 京米（一两） 炙甘草（一两） 犀角（五钱）
水八碗，煮三碗，分三次服，渣再以水五碗煮两碗，夜间明早，服至已前完。
史 二十二岁 温毒三日，喉痛胀，滴水不下，身热脉洪数，先以代赈普济散五钱煎汤
，去
渣嗽口与喉，噙化少时，俟口内有涎，即控吐之。再嗽再化再吐，如是者三五时，喉即开，
可服药矣。计用代赈普济散二两后，又用五钱一次与服，每日十数次，三日而喉痛止，继以
玉女煎五帖，热全退，后用复脉汤七帖收功。
代赈普济散方
主治温毒、喉痹、项肿、发疹、发斑、温痘、牙痛、杨梅疮毒、上焦一切风热、皮毛痱
痤等
证。如病极重者，昼夜服十二包，至轻者服四包，量病增减。如喉痹滴水不下咽者，噙一大
口，仰面浸患处，少时有稀痰吐出，再噙再吐，四五次，喉即开。服药后如大便频数，甚至
十数次者，勿畏也，毒尽前愈。如服三五次，大便尚坚结不通者，每包可加酒炒大黄五六分
，或一钱。
桔梗（十两） 牛蒡子（八两） 黄芩（六两，炒） 人中黄（四两） 荆芥穗（八两） 银花（
一两）
蝉蜕（六两） 马勃（四两） 板蓝根（四两） 薄荷（四两） 元参（十两） 大青叶（六两） 生
大黄（四两，炒黑） 连翘（十两，连心） 僵蚕（六两） 射干（四两）
上为粗末，每包五钱，小儿减半，瓷瓶收好，勿出香气。
按∶此方用东垣普济消毒饮，去直升少阳、阳明之升麻、柴胡，直走下焦之黄连，合化
清气
之培赈散，改名曰代赈普济散，大意化清气，降浊气，秽毒自开也。方名代赈者，
凶荒之后，必有温疫，凶荒者赈之以谷，温
疫者赈之以药，使贫者病者皆得食赈，故方名代赈也。
李 四十岁 周身斑疹，夹紫黑痘数百枚，与代赈普济散，日五两，服至七日后愈。
戴氏 感受秽浊，满面满脊杨梅密布，与代赈普济散，每日六两，九日消尽。
徐 五十一岁 己酉五月二十日 因湿毒而发天行杨梅疮，脉弦兼有外风。
代赈普济散，每日服三包，每包五钱。加∶
土茯苓（五钱）煎三杯，分二次服，日共六次。
陈 三十二岁 温热面赤，口渴烦躁，六七日壮热大汗，鼻衄，六脉洪数而促，左先生
用五
苓散双解表里。余曰∶此温病阳明经证也，其脉促，有燎原之势，岂缓药所能挽回非白虎不
可。
生石膏（八两） 知母（一两） 生甘草（五钱） 粳米（二合） 白茅根（一两） 侧柏叶炭（
八钱）
煮四碗，分四次服，尽剂而脉静身凉。
《脉经》谓数而时一止曰促，缓而时一止曰结。按∶古方书从无治促、结之明文，余一
生治
病，凡促脉主以石膏，结脉主以杏仁。盖促为阳，属火，故以石膏得肺胃之阳；结脉属阴，
乃肺之细管中块痰，堵截隧道而然，故以杏仁利肺气而消块痰之阴，无不如意。然照世人用
药，石膏用七八钱，杏仁用三五钱，必无效也。吾尝谓未能学问思辨，而骤然笃行，岂非孟
浪之极，既已学问思辨，而不能笃行，岂非见义不为，无勇乎。
[Case 1]
Patient Liu, presented on the 13th day of the 5th month in the Jiazi year. Symptoms included facial redness and swelling, sore throat, body fever, spontaneous sweating, and a yellow tongue coating.
Prescription: Ma Bo (Fritillariae Thunbergii Bulbus, 3 qian), Yin Hua (Jin Yin Hua/Flos Lonicerae Japonicae, 6 qian), Niu Bang Zi (Fructus Arctii, 6 qian), Jing Jie Sui (Herba Schizonepetae Spike, 2 qian), Yuan Shen (Scrophulariae Radix, 6 qian), Bo He (Menthae Haplocalycis Herba, 1.5 qian), Ren Zhong Huang (Human Middle Yellow, 2 qian), Jie Geng (Platycodonis Radix, 5 qian), Lian Qiao (Forsythiae Fructum, 6 qian), She Gan (Belamcandae Rhizoma, 2 qian), Ban Lan Gen (Isatidis Radix, 3 qian), Sang Ye (Mori Folium, 6 qian).
Grind all ingredients into coarse powder, divide into seven packets. Take one packet every hour or so, decocted with Lu Gen Tang (Reed Rhizome Decoction).
On the 14th day, continue with the previous method.
On the 15th day, add to the previous prescription: Huang Lian (Coptidis Rhizoma, 2 qian), Huang Qin (Scutellariae Radix, 3 qian).
[Case 2]
Patient [Name Omitted], presented on the 11th day of the 5th month in the Jiazi year. Warm toxin caused sore throat with rash eruption; severe soreness and pain in the legs indicate a critical condition. Urgent use of light, dispersing methods is required to prevent pathogenic factors from gathering and causing disaster.
Prescription: Ma Bo (Fritillariae Thunbergii Bulbus, 5 qian), She Gan (Belamcandae Rhizoma, 5 qian), Bo He (Menthae Haplocalycis Herba, 5 qian), Yuan Shen (Scrophulariae Radix, 1 liang), Lian Qiao (Forsythiae Fructum, 1.2 liang), Jing Jie Sui (Herba Schizonepetae Spike, 6 qian), Jie Geng (Platycodonis Radix, 1.5 liang), Jiang Can (Bombyx Batryticatus, 5 qian), Ban Lan Gen (Isatidis Radix, 3 qian), Yin Hua (Jin Yin Hua/Flos Lonicerae Japonicae, 1 liang), Niu Bang Zi (Fructus Arctii, 8 qian), Ren Zhong Huang (Human Middle Yellow, 4 qian).
Grind all ingredients into coarse powder, each packet weighing 7 qian. Take one packet every hour, ten packets over twelve hours. If necessary, prepare more after finishing. Decoct with Lu Gen Tang (Reed Rhizome Decoction). Cured after two doses.
[Case 3]
Ms. Wang, 23 years old, presented on the 11th day of the 5th month in the Jiazi year. Warm toxin caused cheek swelling. The pulse was hidden (Fu) and indistinct, termed "Yang syndrome with Yin pulse." Swelling covered the front and back of the face and head. The patient had pre-existing scrofula (Luo Li), accompanied by headache, body ache, delirium, and cold limbs. The condition was extremely critical. Proposed treatment based on Pu Ji Xiao Du Yin (Universal Relief Detoxification Decoction).
Prescription: Lian Qiao (Forsythiae Fructum, 1.2 liang), Niu Bang Zi (Fructus Arctii, 8 qian), Yin Hua (Jin Yin Hua/Flos Lonicerae Japonicae, 1.5 liang), Jing Jie Sui (Herba Schizonepetae Spike, 4 qian), Jie Geng (Platycodonis Radix, 8 qian), Bo He (Menthae Haplocalycis Herba, 3 qian), Ren Zhong Huang (Human Middle Yellow, 4 qian), Ma Bo (Fritillariae Thunbergii Bulbus, 5 qian), Yuan Shen (Scrophulariae Radix, 8 qian), Ban Lan Gen (Isatidis Radix, 3 qian).
Grind all ingredients into coarse powder, divide into twelve packets. Take one packet every hour or so, decocted and taken with Lu Gen Tang (Reed Rhizome Decoction). Apply Shui Xian Gao (Narcissus Paste) externally to the swollen area (using Narcissus bulb root, removing the rhizome, mashing it, applying to the site leaving a small opening, changing when dry; after toxin discharge, apply San Huang Er Xiang San).
San Huang Er Xiang San (Three Yellows and Two Aromatics Powder): Huang Lian (Coptidis Rhizoma, 1 liang), Huang Bai (Phellodendri Cortex, 1 liang), Sheng Da Huang (Rhei Radix et Rhizoma, raw, 1 liang), Ru Xiang (Olibanum, 5 qian), Mo Yao (Myrrha, 5 qian).
Grind into very fine powder. Initially mix with strong tea juice for application, change when dry; subsequently mix with sesame oil for application.
On the 12th day, the pulse became rapid (Cu). Added to the previous prescription: Sheng Shi Gao (Gypsum Fibrosum, raw, 3 liang), Zhi Mu (Anemarrhenae Rhizoma, 8 qian).
On the 13th day, added to the previous prescription: Xi Jiao (Rhino Horn, 8 qian), Huang Lian (Coptidis Rhizoma, 3 qian), Huang Qin (Scutellariae Radix, 6 qian).
On the 14th day, added to the previous prescription: Da Huang (Rhei Radix et Rhizoma, 5 qian).
On the 15th day, removed Da Huang from the previous prescription and added: Sheng Shi Gao (Gypsum Fibrosum, raw, 1 liang).
On the 16th day, added to the previous prescription: Jin Zhi (Golden Juice, half teacup), mixed into the medicine and taken in divided doses.
On the 18th day, the pulse emerged, and high fever persisted, indicating pathogenic factors moving outward. However, the situation remained critical. Calmness should be used to suppress the pathogen; do not panic. If slight delirium occurs, take Niu Huang Qing Xin Wan (Calculus Bovis Clear Heart Pills), 1-2 pills. Continue with the previous decoction.
On the 20th day, swelling subsided, fever receded, and the pulse calmed. Used Fu Mai Tang (Restore the Pulse Decoction) for seven doses, resulting in complete recovery.
[Case 4]
Mr. Wang, 23 years old, presented on the 11th day of the 8th month in the Yichou year. Warm toxin caused macules/patches. It was early autumn, and summer heat had not dissipated. Why did he recklessly use the Taiyang/Six Channels methods involving heavy sweating and purgation? This was extremely contrary to principles. The right pulse was surging (Hong), large, and hollow (Kou); severe thirst; excessive sweating. Urgently use Hua Ban Tang (Resolve Macules Decoction) in heavy dosage.
Prescription: Sheng Shi Gao (Gypsum Fibrosum, raw, 4 liang), Xi Sheng Di (Rehmanniae Radix Preparata, fine, 1 liang), Zhi Mu (Anemarrhenae Rhizoma, 2 liang), Jing Mi (Pollen Oryzae Sativae, 1 liang), Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Preparata, 1 liang), Xi Jiao (Rhino Horn, 5 qian).
Decoct with eight bowls of water until three bowls remain. Divide into three doses. Decoct the dregs again with five bowls of water until two bowls remain. Take between night and next morning before Si hour (9-11 AM).
[Case 5]
Mr. Shi, 22 years old. Warm toxin for three days, sore throat with distension, unable to swallow even a drop of water, body fever, pulse surging and rapid. First, decoct Dai Zhen Pu Ji San (Emergency Relief Universal Relief Powder), 5 qian, remove dregs, use for gargling and washing the throat. Hold in mouth for a while, then spit out once saliva is produced. Repeat gargling, holding, and spitting for 3-5 hours until the throat opens and medication can be taken. After using a total of 2 liang of Dai Zhen Pu Ji San, administer 5 qian orally at a time, more than ten times daily. After three days, throat pain ceased. Subsequently, use Yu Nu Jian (Jade Woman Decoction) for five doses to completely clear heat, followed by Fu Mai Tang (Restore the Pulse Decoction) for seven doses to conclude treatment.
Dai Zhen Pu Ji San Formula:
Indications: Warm toxin, throat obstruction (Hou Bi), neck swelling, rash eruption, macules/patches, warm measles, toothache, lues venereum toxin, all wind-heat in the Upper Jiao, skin prickly heat, acne, etc. For severe cases, take 12 packets day and night; for mild cases, 4 packets, adjusting according to severity. If throat obstruction prevents swallowing, hold a large mouthful, tilt head back to soak the affected area, expectorate thin phlegm after a short time, repeat 4-5 times until throat opens. If frequent stools occur after taking medicine, even ten-plus times, do not fear; this indicates toxin exhaustion and healing. If after 3-5 doses stool remains hard and unpassable, add Jiu Chao Da Huang (Wine-fried Rhei Radix et Rhizoma), 5-6 fen or 1 qian per packet.
Prescription: Jie Geng (Platycodonis Radix, 10 liang), Niu Bang Zi (Fructus Arctii, 8 liang), Huang Qin (Scutellariae Radix, stir-fried, 6 liang), Ren Zhong Huang (Human Middle Yellow, 4 liang), Jing Jie Sui (Herba Schizonepetae Spike, 8 liang), Yin Hua (Jin Yin Hua/Flos Lonicerae Japonicae, 1 liang), Chan Tui (Cicada Slough, 6 liang), Ma Bo (Fritillariae Thunbergii Bulbus, 4 liang), Ban Lan Gen (Isatidis Radix, 4 liang), Bo He (Menthae Haplocalycis Herba, 4 liang), Yuan Shen (Scrophulariae Radix, 10 liang), Da Qing Ye (Isatidis Folium, 6 liang), Sheng Da Huang (Rhei Radix et Rhizoma, raw, stir-fried black, 4 liang), Lian Qiao (Forsythiae Fructum, with heart, 10 liang), Jiang Can (Bombyx Batryticatus, 6 liang), She Gan (Belamcandae Rhizoma, 4 liang).
Grind into coarse powder, 5 qian per packet, half dose for children. Store in porcelain bottle, keep sealed to preserve aroma.
Commentary: This formula adapts Dongyuan's Pu Ji Xiao Du Yin (Universal Relief Detoxification Decoction), removing Sheng Ma (Cimicifugae Rhizoma) and Chai Hu (Bupleuri Radix) which ascend Shaoyang/Yangming, and Huang Lian (Coptidis Rhizoma) which descends to Lower Jiao, combining it with Pei Zhen San (Relief Supply Powder) which transforms clear Qi. Named Dai Zhen Pu Ji San. The main idea is to transform clear Qi, descend turbid Qi, and open up foul toxins. The name "Dai Zhen" (Substitute Relief) implies that after famine, epidemics arise; famine is relieved with grain, epidemics are relieved with medicine, ensuring the poor and sick receive sustenance/treatment.
[Case 6]
Mr. Li, 40 years old. Generalized macules/rash, interspersed with hundreds of purple-black pustules. Given Dai Zhen Pu Ji San, 5 liang daily. Cured after seven days.
[Case 7]
Mrs. Dai. Contracted turbid pathogens, presenting with dense lues venereum lesions covering face and back. Given Dai Zhen Pu Ji San, 6 liang daily. Resolved completely after nine days.
[Case 8]
Mr. Xu, 51 years old, presented on the 20th day of the 5th month in the Jiyu year. Developed epidemic lues venereum due to damp-toxin. Pulse wiry (Xian) with external wind.
Given Dai Zhen Pu Ji San, 3 packets daily, 5 qian per packet. Add: Tu Fu Ling (Smilacis Glabrae Rhizoma, 5 qian), decoct in three cups, divide into two doses, six times daily in total.
[Case 9]
Mr. Chen, 32 years old. Warm-heat disease causing facial redness, thirst, irritability. High fever and profuse sweating for 6-7 days, epistaxis. Six pulses were surging, rapid, and hurried (Cu). Mr. Left initially used Wu Ling San (Five-Ingredient Powder with Poria) to resolve both exterior and interior. I stated: This is Yangming Channel syndrome of warm disease. The hurried pulse indicates a prairie-fire momentum; slow-acting medicines cannot reverse it. Only Bai Hu Tang (White Tiger Decoction) will suffice.
Prescription: Sheng Shi Gao (Gypsum Fibrosum, raw, 8 liang), Zhi Mu (Anemarrhenae Rhizoma, 1 liang), Sheng Gan Cao (Glycyrrhizae Radix et Rhizoma, raw, 5 qian), Jing Mi (Pollen Oryzae Sativae, 2 he), Bai Mao Gen (Imperatae Rhizoma, 1 liang), Ce Bai Ye Tan (Cacumen Platycladi Carbonized, 8 qian).
Decoct to four bowls, divide into four doses. After completing the dose, pulse calmed and body cooled.
The *Mai Jing* (Pulse Classic) states: Rapid pulse with occasional pause is called Cu (Hurried) pulse; slow pulse with occasional pause is called Jie (Knotted) pulse. Commentary: Ancient medical texts have no explicit prescriptions for treating Cu or Jie pulses. In my life treating patients, I primarily use Shi Gao (Gypsum) for Cu pulse and Xing Ren (Armeniacae Semen Amarum) for Jie pulse. Cu pulse belongs to Yang/Fire, so Shi Gao obtains Lung/Stomach Yang energy. Jie pulse belongs to Yin, caused by phlegm nodules blocking fine vessels in the Lung, so Xing Ren benefits Lung Qi and eliminates Yin phlegm nodules, achieving desired results. However, using standard dosages (Shi Gao 7-8 qian, Xing Ren 3-5 qian) as done by others yields no effect. I have said: Without learning, questioning, reflecting, and discriminating, acting rashly is extreme imprudence. Having learned and reflected but failing to act decisively is lacking courage in the face of righteousness.