二十日 病势虽较前稍减，脉体亦小，黄苔亦彻。但寒从左升，热从入分，寒少热多，
颇似
温疟。议白虎桂枝法，加青蒿等，使陷下之邪，一齐涌出，庶不致缠绵日久，坐耗真元也。
石膏（三钱） 知母（钱半，炒黑） 甘草（一钱） 桂枝（三钱） 京米（一撮） 青蒿（八
分）
二十一日 痰饮是本病，温热是客气。客气易退，本病难除。现下客气已减六七，胁下
常痛
引痛，系痰饮为患。大温大凉，皆在难施之际。仍议以辛而微凉者，清不尽之邪，复以芳香
降气开痰止痛。如下半日渴思凉饮，仍如石膏三钱。
降香末（三钱） 苏子霜（二钱） 制香附（三钱） 连翘（二钱） 杏仁泥（三钱） 银花（三
钱） 旋复花（三钱，包） 郁金（二钱）
二十二日 脉静身凉，舌苔悉退，温热已尽。惟余痰饮胁痛，一以宣通悬饮为法。
生香附（二钱） 降香末（三钱） 广皮（钱半） 旋复花（三钱，包） 小茴香（三钱） 半夏
（四钱） 苏子霜（二钱） 郁金（二钱） 杏仁泥（三钱）
甘澜水五杯，煮取二杯，分二次服，明早一帖。
二十三日 今日大便后，面微赤，脉微大，舌微苔，胸中热思凉饮，又有余邪上泛之故
。议芳香之中，仍稍加辛凉。
旋复花（三钱，包） 杏仁泥（五钱） 连翘（二钱） 降香末（二钱） 小枳实（三个） 银花
（三钱） 生香附（二钱） 郁金（二钱） 芦根（三把）
二十四日 犹有余热，舌苔未化，仍用前法。但小便不禁，去枳实。
二十五日 脉静身凉，惟头微热，余邪已去八九，一以宣肺透饮为主。须能入胁者宜
之。
杏仁泥（三钱） 郁金（二钱） 茯苓（二钱） 旋复花（三钱） 藿梗（三钱） 降香末（二钱）
生香附（三钱）
甘澜水五杯，煮成两杯，分二次服。
三月初四日 食复，脉弦细而滑，胁痛胀，舌苔重浊，不思食。其人本有痰饮，与两和
肝胃法。
旋复花（三钱） 青皮（钱半） 郁金（二钱） 制香附（半钱） 广皮炭（钱半） 红曲（八分）
降香末（三钱） 半夏（三钱） 神曲炭（二钱）
脉虽安静，苔尚未化，未可恣意饮食。胁下刺痛，开胃兼与和络。
半夏（五钱） 新绛（三钱） 乌药（二钱） 广皮（钱半） 旋复花（三钱） 归须（二钱） 青
皮（钱半） 降香末（三钱） 郁金（二钱） 生香附（二钱） 延胡索（一钱） 小枳实（一钱）
章 丙寅年二月十一日 头痛身热，脉芤数，口渴，自汗，喉痛，舌苔重浊而尖赤甚，
温病也。势甚重，法宜辛凉，最忌发汗。
连翘（三钱） 银花（三钱） 麦冬（三钱） 桔梗（三钱） 桑叶（钱半） 细生地（三钱） 甘
草（一钱） 薄荷（八分） 射干（二钱） 元参（三钱） 牛蒡子（三钱）
今晚一帖，明早一帖。
十二日 温热咽痛之极，阴本亏也。
桔梗（八钱） 人中黄（三钱） 马勃（三钱） 牛蒡子（八钱） 元参（八钱） 连翘（六钱）
射干
（四钱） 黄连（三钱） 黄芩（三钱） 银花（三钱） 薄荷（二钱） 荆芥穗（二钱） 细生地（四
钱）
共为粗末，分八包，一时服一包。芦根汤煎，去渣服。
十三日 大便通，咽痛减，脉渐静，不可躁。
桔梗（三钱） 麦冬（五钱） 黄芩（一钱） 银花（三钱） 元参（五钱） 连翘（二钱） 射干
（二钱） 人中黄（一钱） 丹皮（二钱） 芦根（二钱） 黄连（一钱） 细生地（五钱） 白茅根（三钱
）牛蒡子（三钱）
煮两碗，分二次，今晚明早各半帖。
十四日 脉静，痛止大半，小便未畅，余焰尚存，仍不可食谷。
细生地（五钱） 连翘（二钱） 射干（二钱） 丹皮（三钱） 银花（二钱） 人中黄（钱半）
元参（三钱） 牡蛎（三钱） 桔梗（二钱） 黄芩（一钱） 麦冬（六钱） 黄连（八分）
二帖共煎四碗，分四次服。明日午前服完，计今日两碗，明日两碗，如服完后，喉仍微
痛，小便不畅，明晓再服一帖。如喉痛已止，小便亦畅，可少啜粥汤，静俟十六日换方服药。
十六日 脉静身凉，用一甲复脉汤。
炙甘草（六钱） 大生地（六钱） 阿胶（三钱） 麦冬（五钱） 白芍（六钱） 麻仁（三钱）
牡蛎（八钱）
赵 初六日 热病脉七至，烦躁无宁晷，谵语神昏，汗出辄复热，脉不为汗衰。《内经
》所
邪，获效亦不少。但黄帝岐伯所云之死症，谁敢谓必生，勉与玉女煎法。
生石膏（四两） 次生地（八钱） 知母（一两） 麦冬（八钱） 甘草（五钱） 京米（一合）
煮五杯，分五次服。外服紫雪丹。
初七日 温热未清，又加温毒，喉肿，舌肿，唇肿，项强，面色反青。伏毒不发，与痘
科之闷痘相似，可与代赈普济散。
一时许服一包，鲜荷叶边汤煎，其紫雪丹照旧服不可断，有好牛黄清心丸亦可。
初八日 热病螈 ，痉厥神昏，脉洪大而芤，与育阴潜阳，咸以止厥法。但喉舌之肿，
未能一时消尽，可与代赈普济散间服，其紫雪丹仍用。
细生地（一两） 麦冬（四钱，连心） 生白芍（五钱） 勾藤勾（三钱） 丹皮（四钱） 生鳖
甲（八钱） 生牡蛎（八钱） 犀角（三钱） 黄芩（二钱）
煮三杯，分三次服。
初十日 左脉洪而有力，右脉甚软，是温邪日久，陷入下焦血分无疑。古谓三时热病，
深入
下焦血分者，每借芳香以为搜逐之用。仍用紫雪丹五分一次，约三次，热退神清能言即止。
次生地（一两） 丹皮（三钱） 生鳖甲（六钱） 生白芍（五钱） 麦冬（五钱，连心） 生龟
板（六钱） 生牡蛎（六钱） 生甘草（五钱） 生阿胶（五钱，药化入）
十一日 汗已得而脉未静，宿粪已解而肿未消、神未清，其代赈普济散仍服一二次，紫
雪丹仍服三五分，其汤药与重收阴气。
生白芍（五钱） 细生地（一两） 生甘草（五钱） 麦冬（五钱） 黄芩（三钱） 生牡蛎（二
钱，研粉煎汤代水）
煮三杯，分三次服。渣再煎一杯，明日服。
十二日 汗出脉静身凉之后，甫过七八日，忽又身热，脉洪数有力，便涩口渴思凉。乃
余邪续出，以当日受邪之时，非一次也，并非食后劳复之比。但久病不宜反复，恐气血不支也，
与玉女煎法。紫雪丹（三分）一次，身热神昏螈 则服，否则止。
生石膏（八钱） 生甘草（三钱） 知母（五钱） 细生地（五钱） 麦冬（五钱） 黄芩（三钱）
京米（一撮）
十三日 减石膏。
十四日 今日脉浮大，下行极而上也。
生石膏（二两，另煎），有热则加。
知母（五钱） 次生地（八钱） 生鳖甲（五钱） 生甘草（四钱） 龟板（五钱） 麦冬（六钱）
生牡蛎（五钱） 京米（一撮）
头煎三杯，今夜服。二煎两杯，明早服。若能睡熟但令稳睡，不可呼之服药。
十五日 今日右脉已小，左脉仍壮，邪气又归下焦血分。先用紫雪丹以搜之，继之培阴
清热。热淫于内，治以咸寒，佐以苦甘法。
知母（五钱） 生甘草（四钱） 生牡蛎（六钱） 次生地（一两） 丹皮（四钱） 生鳖甲（六
钱） 黄柏（三钱） 麦冬（六钱） 生龟板（六钱） 生白芍（三钱）
煮五杯，今晚服三杯，明早两杯。
十六日 今日右脉复浮而大，犹思凉饮，暂与玉女煎法。其芳香搜逐邪浊之法，仍不能
止。
生石膏（一两） 知母（五钱） 生甘草（四钱） 次生地（六钱） 麦冬（六钱） 生鳖甲（六
钱） 京米（一合）
煮四杯，分四次服。
十七日 今日右脉稍沉而小，左脉仍洪大而浮。余邪续出，神识反昏，微螈 ，肢微厥
，非
吉兆也。舌上津液已回，大便甚通。自始至终，总无下法，只有护阴，一面搜逐深入之伏邪
。
大生地（一两） 生鳖甲（五钱） 生甘草（四钱） 丹皮（三钱） 勾藤勾（三钱） 生白芍（
六钱） 生牡蛎（五钱） 麦冬（六钱） 阿胶（三钱） 生龟板（五钱）
煮五杯，分五次服。
十八日 神清改方。
十九日 温毒日久，诸症渐减，惟脉未静，应照邪少虚多例，其不尽之邪，付之紫雪可
也。
生白芍（四钱） 钩藤（三钱） 生鳖甲（五钱） 大生地（八钱） 麦冬（六钱） 生龟板（五
钱） 炙甘草（三钱） 羚羊角（三钱） 生牡蛎（五钱） 丹皮（四钱） 阿胶（三钱）
煮四杯，分四次服。
二十日 病虽渐次就退，伏热犹未清楚。暂与少加清热之品。
生白芍（四钱） 钩藤（二钱） 次生地（一两） 生甘草（三钱） 羚羊角（三钱） 丹皮（三
钱） 麦冬（六钱） 生牡蛎（六钱） 黄芩（二钱） 生鳖甲（四钱）
煮三杯，分三次服。
二十一日 犹有螈 ，仍从少阳中求之，再用紫雪丹（一钱），分二次服。
刘 六十岁 癸丑年七月初九日 温病误表，津液消亡。本系酒客，热由小肠下注，溺
血每
至半盆，已三四日矣。又亡津液，面大赤，舌苔老黄而中黑，唇黑裂，大便七日不下，势如
燎原，与急下以存津液法。
大承气，减枳朴分量，加丹皮、犀角。
初十日 昨日下后，舌上津液已回，溺血顿止，与清血分之热。
焦白芍（四钱） 犀角（四钱） 麦冬（四钱） 丹皮（五钱） 银花（五钱） 细生地（五钱）
生甘草（二钱） 天冬（二钱）
十一日 照前方。
十二日 前方加麻仁（三钱）。
十三日 前方四帖。
十七日 邪去七八，已能进粥，阴虚甚于余邪。
复脉汤去参桂姜枣，二帖。
十九日 照前方加生牡蛎、生鳖甲，二帖。
二十一日 照前方又加生龟板，服二十一帖。
八月初十日 照前方又加海参（二条），鲍鱼片（五钱），服二十帖。
史氏 二十七岁 癸丑年七月初一日 温热误汗于前，又误用龙胆芦荟等极苦化燥于后
，致
七月胎动不安，舌苔正黄，烂去半边，目睛突出眼眶之外，如蚕豆大，与玉女煎加犀角。以
气血两燔，脉浮洪数极故也。
生石膏（四两） 知母（一两） 炙甘草（四钱） 犀角（六钱） 京米（一撮） 细生地（六钱）
麦冬（五钱）
初二日 烦躁稍静，胎不动，余如故。照前方再服三帖。
初五日 大便不通，小便数滴而已，溺管痛，舌苔黑，唇黑裂，非下不可。虽有胎，经
云∶有故无殒，故无殒也。
生大黄（六钱） 元明粉（四钱） 川朴（一钱） 枳实（一钱）
煮两杯，分二次服，得快便即止。
初六日 下后脉静身凉，目睛渐收，与甘寒柔润。
初十日 复脉汤去刚药。
十四日 复脉加三甲。
二十日 服专翕大生膏十二斤，至产后弥月方止。
赵 五十五岁 癸丑年六月二十六日 体瘦无子，过服桂、附，津液枯燥。于二十二日
得温
热，自服补中益气汤三帖，致邪无出路，服辛凉轻剂二帖，竹叶石膏汤三帖，至七月初二日
，烦躁不寐，并不卧床，赤身满地混抓，谵语干热，无汗舌黄，与调胃承气汤，加元参一小
剂，得大便少许，随出赤红疹数十枚，少安半日，其症如前，与沃阴之甘凉法。二三日大躁
大狂，又与调胃承气汤一小帖。又出疹数十枚，又少安，热总不退，脉总不静。如是者前后
共下十三次，出疹十三次。而后脉静身凉，服复脉汤七帖后作专翕大生膏半料，计十二斤，
半年后始撤消。此证原案已失，举其大略，以备一格。
王 三十八岁 温病狂热，大渴引饮，周十二时，饮凉水担余，癫狂谵语，大汗不止。
每日
用白虎汤合犀角地黄汤，石膏用半斤，日服二帖。外用紫雪一两有余，间服牛黄清心丸五六
丸。如是者七八日，热始渐退，药渐减，后以复脉汤收功。
温疫者，厉气流行而兼秽浊，户户皆然，如役所使也。是证也，悉从口鼻而入，先病手
太阴
，而后延布三焦。治法一以护阴、清热、逐秽为主。然法者规矩也。规矩不能使人巧，巧用
在人也。今于其证中之有证者，先生则法中之有法。病见极重之证，方施至重之方，然未尝
有一毫护此失彼之弊。如案中王、赵、史、刘数姓之 ，非先生胸有定见，法施奇绝，安望
其生耶？真乃运用之妙，存乎一心，岂庸手所能乎！至于精微妙旨，善读者细玩案中，自知其
妙，予不敢再加妄论也。（舒配瑭）
20th: Although the disease condition has slightly improved compared to before, the pulse body has become smaller, and the yellow coating has completely receded. However, cold qi rises from the left, while heat disperses from within; there is less cold and more heat, resembling warm malaria (Wen Nüe). It is proposed to use the Baihu Guizhi method (White Tiger plus Cinnamon Twig Decoction), adding Qinghao (Artemisiae Annuae Herba) etc., so that the trapped pathogenic factors will surge out together, preventing the condition from lingering for a long time and wasting the true yuan (vital energy).
Shigao (Gypsum Fibrosum, 3 qian) Zhimu (Anemarrhenae Rhizoma, 1.5 qian, stir-baked until black) Gancao (Licorice Root, 1 qian) Guizhi (Cinnamomi Ramulus, 3 qian) Jingmi (Rice, a pinch) Qinghao (Artemisiae Annuae Herba, 8 fen)
21st: Phlegm-fluid retention (Tan Yin) is the root disease, while warm-heat (Wen Re) is the guest pathogen (Ke Qi). The guest pathogen is easy to retreat, but the root disease is difficult to eradicate. Currently, the guest pathogen has decreased by six or seven tenths. Pain in the hypochondrium often radiates, caused by phlegm-fluid retention. Both strongly warming and strongly cooling agents are difficult to apply at this time. It is still proposed to use pungent and slightly cool herbs to clear the remaining pathogens, followed by aromatic herbs to descend qi, resolve phlegm, and relieve pain. If thirst for cold drinks occurs in the afternoon, continue using Shigao (Gypsum Fibrosum) 3 qian as before.
Xiangjiao Mo (Costi Rhizoma Powder, 3 qian) Suzi Shuang (Perillae Fructus Frost, 2 qian) Zhi Xiangfu (Cyperi Rhizoma, Prepared, 3 qian) Lianqiao (Forsythiae Fructum, 2 qian) Xingren Ni (Apricot Seed Paste, 3 qian) Yinhua (Lonicerae Japonicae Flos, 3 qian) Xuanfuhua (Inulae Flos, 3 qian, wrapped) Yujin (Curcumae Radix, 2 qian)
22nd: The pulse is calm, the body is cool, the tongue coating has completely receded, and the warm-heat pathogen is exhausted. Only phlegm-fluid retention causing hypochondriac pain remains. The treatment focuses entirely on promoting the circulation of suspended fluid (Xuan Yin).
Sheng Xiangfu (Cyperi Rhizoma, Raw, 2 qian) Xiangjiao Mo (Costi Rhizoma Powder, 3 qian) Guangpi (Citri Reticulatae Pericarpium, 1.5 qian) Xuanfuhua (Inulae Flos, 3 qian, wrapped) Xiaohuixiang (Foeniculi Fructum, 3 qian) Banxia (Pinelliae Rhizoma, 4 qian) Suzi Shuang (Perillae Fructus Frost, 2 qian) Yujin (Curcumae Radix, 2 qian) Xingren Ni (Apricot Seed Paste, 3 qian)
Boil five cups of Ganlan Shui (Ganlan Water - water boiled and stirred vigorously) to obtain two cups, divide into two doses, take tomorrow morning another dose.
23rd: After defecation today, the face is slightly red, the pulse is slightly large, there is a slight tongue coating, and there is heat in the chest with a desire for cold drinks, due to the resurgence of residual pathogens. It is proposed to add slightly pungent-cool herbs among the aromatic ones.
Xuanfuhua (Inulae Flos, 3 qian, wrapped) Xingren Ni (Apricot Seed Paste, 5 qian) Lianqiao (Forsythiae Fructum, 2 qian) Xiangjiao Mo (Costi Rhizoma Powder, 2 qian) Xiao Zhishi (Immature Bitter Orange Fruit, 3 pieces) Yinhua (Lonicerae Japonicae Flos, 3 qian) Sheng Xiangfu (Cyperi Rhizoma, Raw, 2 qian) Yujin (Curcumae Radix, 2 qian) Lugeng (Phragmitis Rhizoma, 3 handfuls)
24th: There is still residual heat, and the tongue coating has not transformed. Continue the previous method. However, due to urinary incontinence, remove Zhishi (Immature Bitter Orange Fruit).
25th: The pulse is calm, the body is cool, only the head is slightly hot, and eight or nine-tenths of the residual pathogens have been eliminated. Focus mainly on diffusing the lungs and venting phlegm-fluid. Herbs that can enter the hypochondrium are suitable.
Xingren Ni (Apricot Seed Paste, 3 qian) Yujin (Curcumae Radix, 2 qian) Fuling (Poria, 2 qian) Xuanfuhua (Inulae Flos, 3 qian) Huogeng (Agastachis Caulis, 3 qian) Xiangjiao Mo (Costi Rhizoma Powder, 2 qian) Sheng Xiangfu (Cyperi Rhizoma, Raw, 3 qian)
Boil five cups of Ganlan Shui (Ganlan Water) into two cups, divide into two doses.
March 4th: Relapse due to diet. The pulse is wiry, fine, and slippery. Hypochondriac pain and distension, heavy and turbid tongue coating, loss of appetite. Since the patient originally had phlegm-fluid retention, use the method of harmonizing both liver and stomach.
Xuanfuhua (Inulae Flos, 3 qian) Qingpi (Citri Reticulatae Pericarpium Viride, 1.5 qian) Yujin (Curcumae Radix, 2 qian) Zhi Xiangfu (Cyperi Rhizoma, Prepared, 0.5 qian) Guangpi Tan (Charred Citri Reticulatae Pericarpium, 1.5 qian) Hongqu (Red Yeast Rice, 8 fen) Xiangjiao Mo (Costi Rhizoma Powder, 3 qian) Banxia (Pinelliae Rhizoma, 3 qian) Shenqu Tan (Medicated Leaven, Charred, 2 qian)
Although the pulse is quiet, the coating has not yet transformed; do not indulge in food. For stabbing pain in the hypochondrium, promote appetite and harmonize the collaterals.
Banxia (Pinelliae Rhizoma, 5 qian) Xinjiang (Safflower Stamen, 3 qian) Wuyao (Linderae Radix, 2 qian) Guangpi (Citri Reticulatae Pericarpium, 1.5 qian) Xuanfuhua (Inulae Flos, 3 qian) Guixu (Angelicae Sinensis Radix Tip, 2 qian) Qingpi (Citri Reticulatae Pericarpium Viride, 1.5 qian) Xiangjiao Mo (Costi Rhizoma Powder, 3 qian) Yujin (Curcumae Radix, 2 qian) Sheng Xiangfu (Cyperi Rhizoma, Raw, 2 qian) Yanhusuo (Corydalis Rhizoma, 1 qian) Xiao Zhishi (Immature Bitter Orange Fruit, 1 qian)
Zhang: Bingyin Year, Feb 11th. Headache and body heat, Kou pulse (hollow) and rapid, thirst, spontaneous sweating, sore throat, heavy and turbid tongue coating with very red tip. This is a warm disease. The condition is severe; the method should be pungent-cool. Sweating is strictly contraindicated.
Lianqiao (Forsythiae Fructum, 3 qian) Yinhua (Lonicerae Japonicae Flos, 3 qian) Maidong (Ophiopogonis Radix, 3 qian) Jiegeng (Platycodonis Radix, 3 qian) Sangye (Mori Folium, 1.5 qian) Xi Shengdi (Rehmanniae Radix Preparata, 3 qian) Gancao (Licorice Root, 1 qian) Bohe (Menthae Haplocalycis Herba, 8 fen) Shegan (Belamcandae Rhizoma, 2 qian) Yuan Shen (Scrophulariae Radix, 3 qian) Niubangzi (Arctii Fructum, 3 qian)
One dose tonight, one dose tomorrow morning.
12th: Warm-heat causing extreme sore throat indicates original yin deficiency.
Jiegeng (Platocodonis Radix, 8 qian) Renzhonghuang (Human Manure Processed, 3 qian) Mabo (Amanita Muscaria, 3 qian) Niubangzi (Arctii Fructum, 8 qian) Yuan Shen (Scrophulariae Radix, 8 qian) Lianqiao (Forsythiae Fructum, 6 qian) Shegan (Belamcandae Rhizoma, 4 qian) Huanglian (Coptidis Rhizoma, 3 qian) Huangqin (Scutellariae Radix, 3 qian) Yinhua (Lonicerae Japonicae Flos, 3 qian) Bohe (Menthae Haplocalycis Herba, 2 qian) Jingjisui (Schizonepetae Spica, 2 qian) Xi Shengdi (Rehmanniae Radix Preparata, 4 qian)
Grind into coarse powder, divide into eight packets. Take one packet every hour. Decoct with Lugeng Tang (Reed Shoot Decoction), strain, and drink.
13th: Bowels unblocked, sore throat reduced, pulse gradually calming. Do not be impatient.
Jiegeng (Platocodonis Radix, 3 qian) Maidong (Ophiopogonis Radix, 5 qian) Huangqin (Scutellariae Radix, 1 qian) Yinhua (Lonicerae Japonicae Flos, 3 qian) Yuan Shen (Scrophulariae Radix, 5 qian) Lianqiao (Forsythiae Fructum, 2 qian) Shegan (Belamcandae Rhizoma, 2 qian) Renzhonghuang (Human Manure Processed, 1 qian) Danpi (Moutan Cortex, 2 qian) Lugeng (Phragmitis Rhizoma, 2 qian) Huanglian (Coptidis Rhizoma, 1 qian) Xi Shengdi (Rehmanniae Radix Preparata, 5 qian) Baimaogen (Imperatae Rhizoma, 3 qian) Niubangzi (Arctii Fructum, 3 qian)
Boil two bowls, divide into two doses, half a dose tonight and half tomorrow morning.
14th: Pulse calm, pain stopped mostly, urination not smooth, residual fire remains. Still cannot eat grains.
Xi Shengdi (Rehmanniae Radix Preparata, 5 qian) Lianqiao (Forsythiae Fructum, 2 qian) Shegan (Belamcandae Rhizoma, 2 qian) Danpi (Moutan Cortex, 3 qian) Yinhua (Lonicerae Japonicae Flos, 2 qian) Renzhonghuang (Human Manure Processed, 1.5 qian) Yuan Shen (Scrophulariae Radix, 3 qian) Muli (Concha Ostreae, 3 qian) Jiegeng (Platocodonis Radix, 2 qian) Huangqin (Scutellariae Radix, 1 qian) Maidong (Ophiopogonis Radix, 6 qian) Huanglian (Coptidis Rhizoma, 8 fen)
Decoct two doses together into four bowls, divide into four doses. Finish by noon tomorrow (two bowls today, two tomorrow). If after finishing, throat still slightly hurts and urination is not smooth, take another dose tomorrow morning. If throat pain stops and urination is smooth, sip some porridge soup, wait quietly for the prescription change on the 16th.
16th: Pulse calm, body cool. Use Yi Jia Fu Mai Tang (One-Shell Pulse-Recovering Decoction).
Zhi Gancao (Prepared Licorice Root, 6 qian) Da Shengdi (Rehmanniae Radix, 6 qian) E'jiao (Donkey-Hide Gelatin, 3 qian) Maidong (Ophiopogonis Radix, 5 qian) Baishao (Paeoniae Radix Alba, 6 qian) Mahren (Semen Cannabis, 3 qian) Muli (Concha Ostreae, 8 qian)
Zhao: 6th. Heat disease with pulse rate of seven beats per breath, restlessness without respite, delirium and coma, fever returns immediately after sweating, pulse does not weaken with sweat. As mentioned in *Neijing*... pathogens, effective treatments are not few. But who dares say survival is certain regarding the death syndromes spoken of by Yellow Emperor and Qibo? I reluctantly prescribe the Yuni Jian (Jade Woman Decoction) method.
Sheng Shigao (Raw Gypsum Fibrosum, 4 liang) Ci Shengdi (Rehmanniae Radix Preparata, 8 qian) Zhimu (Anemarrhenae Rhizoma, 1 liang) Maidong (Ophiopogonis Radix, 8 qian) Gancao (Licorice Root, 5 qian) Jingmi (Rice, 1 he)
Boil five cups, divide into five doses. Apply Zixue Dan externally.
7th: Warm-heat not cleared, plus warm-toxin added. Swollen throat, swollen tongue, swollen lips, stiff neck, complexion turns green. Latent toxin not erupting resembles "closed acne" in dermatology. Prescribe Daizhen Puji San.
Take one packet in about an hour, decoct with fresh lotus leaf edge water. Continue Zixue Dan without interruption. Good quality Niuhuang Qingxin Wan (Calculus Bovis Heart-Clearing Pill) is also acceptable.
8th: Heat disease with convulsions (Yong), spasm, coma, pulse surging and large yet hollow. Apply nourishing yin and subduing yang, salty flavor to stop spasms. However, swelling of throat and tongue cannot disappear instantly. Intermittently administer Daizhen Puji San. Continue Zixue Dan.
Xi Shengdi (Rehmanniae Radix Preparata, 1 liang) Maidong (Ophiopogonis Radix, 4 qian, keep heart) Sheng Baishao (Raw Paeoniae Radix Alba, 5 qian) Goutenggou (Uncariae Ramulus cum Uncis, 3 qian) Danpi (Moutan Cortex, 4 qian) Sheng Biejia (Carapax et Plastrum Testudinis, Raw, 8 qian) Sheng Muli (Concha Ostreae, Raw, 8 qian) Xijiao (Rhino CeratUs, 3 qian) Huangqin (Scutellariae Radix, 2 qian)
Boil three cups, divide into three doses.
10th: Left pulse surging and forceful, right pulse very soft. This confirms warm pathogen has lingered for a long time and sunk into the lower jiao blood level. Ancient texts state that for heat diseases in three seasons sinking into lower jiao blood level, aromatic herbs are often borrowed for searching and expelling. Continue Zixue Dan 5 fen once, approx. three times. Stop when heat subsides, spirit clears, and speech resumes.
Ci Shengdi (Rehmanniae Radix Preparata, 1 liang) Danpi (Moutan Cortex, 3 qian) Sheng Biejia (Carapax et Plastrum Testudinis, Raw, 6 qian) Sheng Baishao (Raw Paeoniae Radix Alba, 5 qian) Maidong (Ophiopogonis Radix, 5 qian, keep heart) Sheng Guiban (Plastrum Testudinis, Raw, 6 qian) Sheng Muli (Concha Ostreae, Raw, 6 qian) Sheng Gancao (Raw Licorice Root, 5 qian) Sheng E'jiao (Raw Donkey-Hide Gelatin, 5 qian, melt into medicine)
11th: Sweat obtained but pulse not calm. Old feces passed but swelling not reduced, spirit not clear. Continue Daizhen Puji San 1-2 times, Zixue Dan 3-5 fen. The herbal decoction should focus heavily on consolidating yin qi.
Sheng Baishao (Raw Paeoniae Radix Alba, 5 qian) Xi Shengdi (Rehmanniae Radix Preparata, 1 liang) Sheng Gancao (Raw Licorice Root, 5 qian) Maidong (Ophiopogonis Radix, 5 qian) Huangqin (Scutellariae Radix, 3 qian) Sheng Muli (Concha Ostreae, Raw, 2 qian, ground to powder, decoct water substitute)
Boil three cups, divide into three doses. Decoct dregs again for one cup, take tomorrow.
12th: After sweating, pulse calm, body cool, just past 7-8 days, suddenly fever returns. Pulse surging, rapid, forceful. Urination difficult, thirst for cold drinks. This is residual pathogens emerging continuously. Unlike relapse due to diet or labor, this depends on the initial pathogen entry timing. However, chronic illness should not relapse repeatedly, fearing qi and blood exhaustion. Prescribe Yuni Jian (Jade Woman Decoction) method. Zixue Dan 3 fen once. Take if fever, coma, and convulsions occur; otherwise stop.
Sheng Shigao (Raw Gypsum Fibrosum, 8 qian) Sheng Gancao (Raw Licorice Root, 3 qian) Zhimu (Anemarrhenae Rhizoma, 5 qian) Xi Shengdi (Rehmanniae Radix Preparata, 5 qian) Maidong (Ophiopogonis Radix, 5 qian) Huangqin (Scutellariae Radix, 3 qian) Jingmi (Rice, a pinch)
13th: Reduce Shigao dosage.
14th: Today's pulse is floating and large, descending to the extreme then rising.
Sheng Shigao (Raw Gypsum Fibrosum, 2 liang, decoct separately), add if heat persists.
Zhimu (Anemarrhenae Rhizoma, 5 qian) Ci Shengdi (Rehmanniae Radix Preparata, 8 qian) Sheng Biejia (Carapax et Plastrum Testudinis, Raw, 5 qian) Sheng Gancao (Raw Licorice Root, 4 qian) Guiban (Plastrum Testudinis, 5 qian) Maidong (Ophiopogonis Radix, 6 qian) Sheng Muli (Concha Ostreae, Raw, 5 qian) Jingmi (Rice, a pinch)
First decoction three cups, take tonight. Second decoction two cups, take tomorrow morning. If able to sleep soundly, let him sleep steadily; do not wake him to take medicine.
15th: Right pulse now small, left pulse still strong. Pathogen returns to lower jiao blood level. First use Zixue Dan to search it out, then nourish yin and clear heat. For heat rampant inside, treat with salty-cold, assisted by bitter-sweet method.
Zhimu (Anemarrhenae Rhizoma, 5 qian) Sheng Gancao (Raw Licorice Root, 4 qian) Sheng Muli (Concha Ostreae, Raw, 6 qian) Ci Shengdi (Rehmanniae Radix Preparata, 1 liang) Danpi (Moutan Cortex, 4 qian) Sheng Biejia (Carapax et Plastrum Testudinis, Raw, 6 qian) Huangbai (Phellodendri Cortex, 3 qian) Maidong (Ophiopogonis Radix, 6 qian) Sheng Guiban (Plastrum Testudinis, Raw, 6 qian) Sheng Baishao (Raw Paeoniae Radix Alba, 3 qian)
Boil five cups, take three cups tonight, two cups tomorrow morning.
16th: Right pulse floats and becomes large again, still desires cold drinks. Temporarily use Yuni Jian (Jade Woman Decoction) method. The aromatic method for searching and expelling turbid pathogens cannot be stopped yet.
Sheng Shigao (Raw Gypsum Fibrosum, 1 liang) Zhimu (Anemarrhenae Rhizoma, 5 qian) Sheng Gancao (Raw Licorice Root, 4 qian) Ci Shengdi (Rehmanniae Radix Preparata, 6 qian) Maidong (Ophiopogonis Radix, 6 qian) Sheng Biejia (Carapax et Plastrum Testudinis, Raw, 6 qian) Jingmi (Rice, 1 he)
Boil four cups, divide into four doses.
17th: Right pulse slightly sunken and small, left pulse still surging, large, and floating. Residual pathogens emerge continuously. Spirit becomes confused, slight convulsions, limbs slightly cold. Not a good omen. Tongue moisture has returned, bowels very open. Throughout the entire process, purgative methods were never used, only protecting yin and searching out latent pathogens deep inside.
Da Shengdi (Rehmanniae Radix, 1 liang) Sheng Biejia (Carapax et Plastrum Testudinis, Raw, 5 qian) Sheng Gancao (Raw Licorice Root, 4 qian) Danpi (Moutan Cortex, 3 qian) Goutenggou (Uncariae Ramulus cum Uncis, 3 qian) Sheng Baishao (Raw Paeoniae Radix Alba, 6 qian) Sheng Muli (Concha Ostreae, Raw, 5 qian) Maidong (Ophiopogonis Radix, 6 qian) E'jiao (Donkey-Hide Gelatin, 3 qian) Sheng Guiban (Plastrum Testudinis, Raw, 5 qian)
Boil five cups, divide into five doses.
18th: Spirit clear, change prescription.
19th: Warm-toxin has lasted long, symptoms gradually reducing, but pulse not calm. Follow the example of little pathogen and much deficiency. Leave the unresolved pathogens to Zixue Dan.
Sheng Baishao (Raw Paeoniae Radix Alba, 4 qian) Gouteng (Uncariae Ramulus cum Uncis, 3 qian) Sheng Biejia (Carapax et Plastrum Testudinis, Raw, 5 qian) Da Shengdi (Rehmanniae Radix, 8 qian) Maidong (Ophiopogonis Radix, 6 qian) Sheng Guiban (Plastrum Testudinis, Raw, 5 qian) Zhi Gancao (Prepared Licorice Root, 3 qian) Lingyangjiao (Saiga Tataricae Cornu, 3 qian) Sheng Muli (Concha Ostreae, Raw, 5 qian) Danpi (Moutan Cortex, 4 qian) E'jiao (Donkey-Hide Gelatin, 3 qian)
Boil four cups, divide into four doses.
20th: Disease gradually receding, but latent heat not yet clear. Temporarily add some clearing-heat herbs.
Sheng Baishao (Raw Paeoniae Radix Alba, 4 qian) Gouteng (Uncariae Ramulus cum Uncis, 2 qian) Ci Shengdi (Rehmanniae Radix Preparata, 1 liang) Sheng Gancao (Raw Licorice Root, 3 qian) Lingyangjiao (Saiga Tataricae Cornu, 3 qian) Danpi (Moutan Cortex, 3 qian) Maidong (Ophiopogonis Radix, 6 qian) Sheng Muli (Concha Ostreae, Raw, 6 qian) Huangqin (Scutellariae Radix, 2 qian) Sheng Biejia (Carapax et Plastrum Testudinis, Raw, 4 qian)
Boil three cups, divide into three doses.
21st: Still convulsing. Seek resolution from Shaoyang channel. Use Zixue Dan (1 qian), divide into two doses.
Liu: 60 years old. Gui Chou Year, July 9th. Warm disease treated incorrectly with exterior-releasing methods, fluids consumed. Originally a wine drinker. Heat flows downward from Small Intestine. Hematuria reaches half a basin each time, lasting 3-4 days. Fluids further depleted. Face very red, old yellow tongue coating with black center, black cracked lips. No bowel movement for 7 days. Condition raging like a prairie fire. Apply urgent purgation to preserve fluids.
Da Chengqi Tang (Major Order the Qi Decoction), reduce Zhishi (Immature Bitter Orange Fruit) and Houpo (Magnoliae Officinalis Cortex) dosages, add Danpi (Moutan Cortex) and Xijiao (Rhino CeratUs).
10th: After purgation yesterday, tongue moisture returned, hematuria stopped immediately. Clear heat from blood level.
Jiao Baishao (Charred Paeoniae Radix Alba, 4 qian) Xijiao (Rhino CeratUs, 4 qian) Maidong (Ophiopogonis Radix, 4 qian) Danpi (Moutan Cortex, 5 qian) Yinhua (Lonicerae Japonicae Flos, 5 qian) Xi Shengdi (Rehmanniae Radix Preparata, 5 qian) Sheng Gancao (Raw Licorice Root, 2 qian) Tiandong (Asparagi Radix, 2 qian)
11th: Follow previous prescription.
12th: Add Mahren (Semen Cannabis, 3 qian) to previous prescription.
13th: Four doses of previous prescription.
17th: Pathogen gone 70-80%, able to eat porridge. Yin deficiency exceeds residual pathogen.
Fu Mai Tang (Pulse-Recovering Decoction) remove Renshen (Ginseng Radix et Rhizoma), Guizhi (Cinnamomi Ramulus), Jiang (Zingiberis Rhizoma), Zao (Jujubae Fructus). Two doses.
19th: Follow previous prescription, add Sheng Muli (Concha Ostreae, Raw) and Sheng Biejia (Carapax et Plastrum Testudinis, Raw). Two doses.
21st: Follow previous prescription, add Sheng Guiban (Plastrum Testudinis, Raw). Take 21 doses.
Aug 10th: Follow previous prescription, add Haishen (Holothuria, 2 pieces) and Baoyu Pian (Abalone Sliced, 5 qian). Take 20 doses.
Shi Family: 27 years old. Gui Chou Year, July 1st. Warm-heat incorrectly sweated previously, then incorrectly used Longdan (Gentianae Radix) and Lushen (Aloe) which are extremely bitter and drying. Caused fetal movement and insecurity in the 7th month. Tongue coating yellow, half ulcerated. Eyes protruding outside eye sockets, size of broad bean. Prescribe Yuni Jian (Jade Woman Decoction) plus Xijiao (Rhino CeratUs). Due to qi and blood burning simultaneously, pulse floating, surging, rapid, and extreme.
Sheng Shigao (Raw Gypsum Fibrosum, 4 liang) Zhimu (Anemarrhenae Rhizoma, 1 liang) Zhi Gancao (Prepared Licorice Root, 4 qian) Xijiao (Rhino CeratUs, 6 qian) Jingmi (Rice, a pinch) Xi Shengdi (Rehmanniae Radix Preparata, 6 qian) Maidong (Ophiopogonis Radix, 5 qian)
2nd: Restlessness slightly calmed, fetus stable, rest same. Continue previous prescription for three doses.
5th: No bowel movement, urine only a few drops, urethral pain, black tongue coating, black cracked lips. Purging is necessary. Although pregnant, the Classic says: "If there is a cause, no injury [to the fetus]; if no injury, then no injury."
Sheng Dahuang (Raw Rheum Palmatum Radix et Rhizoma, 6 qian) Yuan Ming Fen (Natrii Sulfas, 4 qian) Chuan Po (Magnoliae Officinalis Cortex, 1 qian) Zhishi (Immature Bitter Orange Fruit, 1 qian)
Boil two cups, divide into two doses. Stop when loose stool is achieved.
6th: After purgation, pulse calm, body cool, eyes retracting. Apply sweet-cold and moistening methods.
10th: Fu Mai Tang (Pulse-Recovering Decoction) remove harsh drugs.
14th: Fu Mai Tang add Three Shells (San Jia).
20th: Take Zhuanxi Dasheng Gao (Special Gathering Great Life Paste) 12 jin. Stop after full month postpartum.
Zhao: 55 years old. Gui Chou Year, June 26th. Thin body, childless. Overused Guizhi (Cinnamomi Ramulus) and Fuzi (Aconiti Lateralis Radix Preparata), fluids dry and withered. On the 22nd, contracted warm-heat. Self-administered Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) for three doses, causing pathogen no exit. Took two doses of mild pungent-cool agents, three doses of Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction). By July 2nd, restless insomnia, pacing naked scratching everywhere, delirious dry heat, no sweat, yellow tongue. Prescribed Tiaowei Chengqi Tang (Regulate the Stomach and Order the Qi Decoction) plus a small dose of Yuan Shen (Scrophulariae Radix). Obtained small amount of stool, followed by dozens of crimson rashes. Calm for half a day, symptoms returned. Applied Wo Yin (Pouring Yin) sweet-cool method. Next 2-3 days, extreme agitation and madness. Another small dose of Tiaowei Chengqi Tang. Dozens more rashes appeared, calm again. Heat never subsided, pulse never calmed. In total, purged 13 times, erupted rashes 13 times. Afterwards, pulse calm, body cool. After taking seven doses of Fu Mai Tang (Pulse-Recovering Decoction), made half portion of Zhuanxi Dasheng Gao (Special Gathering Great Life Paste), totaling 12 jin. Took half a year to fully resolve. Original case record lost, presenting general outline for reference.
Wang: 38 years old. Warm disease with fierce fever, extreme thirst driving drinking, throughout 24 hours, drank over a dan of cold water. Manic delirium, continuous profuse sweating. Daily use of Baihu Tang (White Tiger Decoction) combined with Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction). Shigao (Gypsum Fibrosum) used half a jin, two doses daily. Externally applied over 1 liang of Zixue Dan (Purple Snow Pill), intermittently took 5-6 pills of Niuhuang Qingxin Wan (Calculus Bovis Heart-Clearing Pill). After 7-8 days, heat gradually subsided, medication reduced, finally concluded with Fu Mai Tang (Pulse-Recovering Decoction).
Warm epidemic refers to malignant qi circulating mixed with filth and turbidity, affecting every household, like forced labor. This syndrome enters entirely through mouth and nose, first affecting Hand Taiyin Lung, then spreading to the Triple Burner. Treatment focuses primarily on protecting yin, clearing heat, and expelling filth. However, methods are rules. Rules cannot make one skillful; skill lies in the person. For cases within cases, the master establishes methods within methods. When seeing extremely severe conditions, apply extremely potent prescriptions, yet never suffer from protecting one aspect at the expense of another. For patients surnamed Wang, Zhao, Shi, Liu in these cases, without the master having firm conviction and employing miraculous methods, how could survival be hoped? Truly, the subtlety of application resides in the mind, far beyond the capability of mediocre practitioners! As for the exquisite and profound principles, careful readers will understand their brilliance by studying the cases; I dare not add rash comments. (Shu Peitang)