王 三十三岁 壬戌四月二十二日 证似温热，但心下两胁俱胀，舌白，渴不多饮，呕
恶嗳气，则非温热而从湿温例矣。用生姜泻心汤之苦辛通降法。
生姜（一两） 干姜（五钱） 茯苓（六钱） 生薏仁（五钱） 半夏（八钱） 黄芩（三钱，炒）
黄连（三钱） 生香附（五钱）
水八碗，煮三茶杯，分三次服。约二时服一次。二煎用水三杯，煎一茶杯，明早服。
二十三日 心下阴霾已退，湿已转阳，应清气分之湿热。
连翘（五钱） 杏泥仁（三钱） 银花（五钱） 藿梗（三钱） 芦根（五寸） 滑石（五钱） 熟
石膏（五钱） 黄芩炭（三钱） 郁金（三钱） 黄连（二钱）
水八碗，煎三碗，分三次服。渣再煮一碗服。
二十四日 斑疹已现，气血两燔，用玉女煎合犀角地黄汤法。
生石膏（两半） 牛蒡子（六钱） 知母（四钱） 元参（八钱） 银花（一两） 薄荷（三钱）
连
翘（一两） 细生地（六钱） 犀角（三钱） 桔梗（四钱） 黄芩（四钱，炒） 人中黄（一钱）
二十五日 面赤，舌黄大渴，脉沉肢厥，十日不大便，转矢气，谵语，下证也。小承气
汤。
生大黄（八钱） 枳实（五钱） 浓朴（四钱）
水八碗，煮三碗，先服一碗，约三时得大便，止后服；不便再服第二碗。
又大便后，宜护津液，议增液法。
麦冬（一两，连心） 连翘（三钱） 细生地（一两） 银花（三钱） 元参（三钱） 甘草（二
钱，炒）
煮三杯，分三次服。能寐不必服。
二十六日 陷下之余邪不清，仍思凉饮，舌黄微，以调胃承气汤小和之。
生大黄（二钱） 元明粉（八分） 生甘草（一钱）
二十七日 昨日虽大解而不爽，脉犹沉而有力，身热不退而微厥，渴甚面赤，犹宜微和
之，但恐犯数下之戒，议增液承气，合玉女煎法。
生石膏（八钱） 知母（四钱） 黄芩（三钱） 生大黄（三钱，另煎，分为三份，每次冲一
分服）
煮成三碗，分三次服。若大便稀而不结不黑，后服勿冲大黄。
二十八日 大便虽不甚爽，今日脉浮不可下，渴思凉饮，气分热也；口中味甘，脾热甚
也。议用气血两燔例之玉女煎，加苦药以清脾瘅。
生石膏（三两） 黄连（三钱） 元参（六钱） 麦冬（一两） 细生地（一两） 知母（三钱）
黄芩（六钱）
煮四碗，分四次服。得凉汗，止后服，不渴，止后服。
二十九日 大用辛凉，微合苦寒，斑疹续出如许，身热退其大半，不得再用辛凉重剂，
议甘寒合化阴气加辛凉，以清斑疹。
连翘（三钱） 元参（四钱） 细生地（五钱） 银花（三钱） 黄芩（三钱） 花粉（三钱） 黄
连（二钱） 薄荷（一钱） 麦冬（五钱） 犀角（三钱）
煮三碗，三次服。渣再煮一碗服。
大热虽减，余焰尚存，口甘弄舌，面光赤色未除，犹宜甘寒苦寒合法。
连翘（三钱） 细生地（六钱） 黄芩（三钱） 丹皮（三钱） 元参（四钱） 黄连（二钱） 麦
冬（五钱） 银花（三钱）
水八碗，煮三碗，分三次服。
初二日 于前方内加∶
犀角（二钱） 知母（钱半）
初三日 邪少虚多，宜用复脉去桂、枣，以其人本系酒客，再去甘草之重甘，加二甲、
丹皮、黄芩。
此甘润化液，复微苦化阴，又苦甘咸寒法。
初四日 尚有余邪未尽，以甘苦合化入阴搜邪法。
元参（二两） 黄芩（二钱） 麦冬（八钱） 知母（二钱） 细生地（六钱） 生鳖甲（八钱）
银花（三钱） 丹皮（五钱） 连翘（三钱） 青蒿（一钱）
头煎三茶碗，二煎一茶碗，分四次服。
陈 二十二岁 乙丑四月十七日 面赤目赤，舌苔满布如积粉，至重之温病也。最忌发
表，且用辛凉。
荆芥穗（五钱） 薄荷（四钱） 生甘草（三钱） 桔梗（六钱） 连翘（八钱） 银花（八钱）
藿香叶（五钱） 牛蒡子（五钱） 杏仁（五钱）
共为粗末，分八包，一时许服一包，芦根汤煎，去渣服。
某 初九日 面赤目赤，舌苔满布，至重之温热病，脉反缓而弦，外热反不盛，口反不
渴，肢微厥，所谓阳证阴脉，乃本身阳气，不能十分充满，不肯化解耳。兹与化邪法。
荆芥穗（二钱） 郁金（二钱） 藿梗（二钱） 豆豉（钱半） 银花（二钱） 连翘心（钱半）
青蒿（一钱） 桔梗（钱半） 薄荷（八分） 杏仁泥（二钱）
今晚一帖，明早一帖。
十一日 温病未有不渴而燥者，今舌苔布满而不渴，虽黄而滑，脉缓甚，热不壮，盖挟
湿之故也。议照湿温例，治用苦辛寒法。
生苍术（三钱） 广皮（二钱） 郁金（三钱） 黄连（一钱） 蔻仁（一钱） 连翘（三钱） 银
花（二钱） 藿香（二钱） 天花粉（三钱） 黄芩（一钱，炒）
今晚一帖，明早一帖，各两杯，两帖而安。
陈 三十三岁 初八日 六脉弦细而劲，阴寒脉也；咳嗽稀痰，阴湿咳也；舌苔刮白而
滑，
阴舌苔也；呕吐泄泻，阴湿证也。虽发热汗出而解，乃湿中兼风，病名湿温，天下有如是之
阴虚证乎？
茯苓（四钱） 泽泻（四钱） 桂枝（三钱） 于术（三钱） 炒白芍（二钱） 生苡仁（五钱）
半夏（五钱） 广皮炭（二钱） 生姜汁（三匙冲）
初十日 痰饮兼风，误治成坏证。前用温平逐湿除风，诸恶证俱成，惟寒少热多，热后
汗出
未除，现下面赤口渴，暮夜谵语，有风化热之象，但六脉尚弦，未尽转阳也。再咳嗽则胸胁
小腹俱微痛，又有金克木之象。
桂枝（三钱） 茯苓（四钱） 杏仁（三钱） 青蒿（三钱） 炙甘草（三钱） 半夏（二钱） 炒
白芍（二钱） 生姜（三片） 猪苓（五钱） 石膏（六钱） 大枣（二个）
十四日 脉弦数，午后潮热，前有白苔，复变黄苔，呕恶口渴，颇有湿疟之象；但咳嗽
便溏，又有湿温之形。伏邪内陷，所致最难清理。
桂枝（四钱） 茯苓皮（五钱） 生石膏（八钱） 青蒿（二钱） 知母（三钱） 杏仁泥（三钱）
炙甘草（二钱） 苡仁（五钱） 滑石（六钱）
某 初十日 六脉俱弦而细，左手沉取数而有力，面色淡黄，目白睛黄。自春分午后身
热，
至今不愈。曾经大泻后，身软不渴，现下虽不泄泻，大便久未成条，午前小便清，午后小便
赤浊。与湿中生热之苦辛寒法。
茵陈（四钱） 杏仁（三钱） 滑石（六钱） 茯苓皮（五钱） 通草（钱半） 黄连（一钱） 苡
仁（四钱） 蚕砂（三钱） 黄芩（二钱） 海金砂（四钱） 苍术炭（三钱）
十三日 前方内去苍术，加石膏，增芩连。
文 三十八岁 丁卯七月初二日 湿温，舌苔白滑浓浊，脉象模糊，弦细而且沉濡。用
通三
焦法，先寒热，继微热，后不热，更方三十余帖，大抵不出渗湿之苦辛淡法。四十五日以后
方解，解后以两和脾胃收功。
Wang, aged 33. On the 22nd day of the 4th month in the Renxu year, the symptoms resembled those of Warm Disease (Wenbing), but there was fullness and distension in the epigastrium and both hypochondria, a white tongue coating, thirst with little desire to drink, vomiting, nausea, and belching. This does not belong to Warm Disease but should be treated according to the pattern of Damp-Warmth (Shiwen). The method of bitter-pungent descending regulation from Shengjiang Xiexin Tang (Ginger Decoction for Rebellious Heart) was used.
Fresh Ginger (1 liang), Dried Ginger (5 qian), Poria (6 qian), Raw Coix Seed (5 qian), Pinellia (8 qian), Scutellaria (3 qian, stir-fried), Coptis (3 qian), Cyperus (5 qian).
Add 8 bowls of water, decoct until 3 tea-cupfuls remain, divide into three doses. Take one dose approximately every two hours. For the second decoction, use 3 cups of water, decoct until 1 tea-cupful remains, take tomorrow morning.
On the 23rd, the turbid dampness in the epigastrium has receded, and the dampness has transformed into Yang heat. It is appropriate to clear the damp-heat from the Qi level.
Forsythia (5 qian), Almond Paste (3 qian), Honeysuckle (5 qian), Agastache Stem (3 qian), Reed Rhizome (5 cun), Talcum (5 qian), Prepared Gypsum (5 qian), Charred Scutellaria (3 qian), Curcuma Aromatica (3 qian), Coptis (2 qian).
Add 8 bowls of water, decoct until 3 bowls remain, divide into three doses. Boil the dregs again with water to obtain 1 bowl, take it.
On the 24th, macules and papules have appeared, indicating simultaneous blazing of Qi and Blood (Qi-Blood Liangfan). The method of Yunu Jian (Jade Woman Decoction) combined with Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) was used.
Raw Gypsum (1.5 liang), Arnebia/Buddleja Seed (6 qian), Anemarrhena (4 qian), Scrophularia (8 qian), Honeysuckle (1 liang), Mint (3 qian), Forsythia (1 liang), Small Rehmannia Root (6 qian), Rhinoceros Horn (3 qian), Platycodon (4 qian), Scutellaria (4 qian, stir-fried), Human Manure Yellow (1 qian).
On the 25th, facial redness, yellow tongue coating, extreme thirst, deep pulse with cold limbs, no bowel movement for ten days, passing flatus, and delirium indicate a syndrome suitable for purgation. Xiao Chengqi Tang (Minor Order the Yin Decoction) was prescribed.
Raw Rheum (8 qian), Immature Bitter Orange (5 qian), Magnolia Bark (4 qian).
Add 8 bowls of water, decoct until 3 bowls remain. First, take 1 bowl; if bowel movement occurs after about three shichen (6 hours), stop subsequent doses; if not, take the second bowl.
Furthermore, after bowel movement, body fluids should be protected. It is proposed to use the method of increasing fluids (Zengye).
Ophiopogon (1 liang, with heart), Forsythia (3 qian), Small Rehmannia Root (1 liang), Honeysuckle (3 qian), Scrophularia (3 qian), Licorice (2 qian, stir-fried).
Decoct until 3 cups remain, divide into three doses. If sleep is achieved, no need to take.
On the 26th, residual pathogens trapped inside are not cleared; the patient still desires cold drinks, and the tongue coating is slightly yellow. Tiaowei Chengqi Tang (Regulate the Stomach Purging Decoction) is used to mildly harmonize.
Raw Rheum (2 qian), Mirabilite (0.8 fen), Raw Licorice (1 qian).
On the 27th, although there was a large stool yesterday, it was not smooth. The pulse is still deep and forceful, fever persists with slight cold limbs, extreme thirst, and facial redness. Mild harmonization is still appropriate, but care must be taken to avoid the taboo of multiple purgations. It is proposed to use Zengye Chengqi Tang (Increasing Fluids Purging Decoction) combined with the method of Yunu Jian (Jade Woman Decoction).
Raw Gypsum (8 qian), Anemarrhena (4 qian), Scutellaria (3 qian), Raw Rheum (3 qian, decocted separately, divided into three parts, mix 1 fen per dose).
Decoct until 3 bowls remain, divide into three doses. If the stool is loose, unformed, and not black, do not mix Rheum in subsequent doses.
On the 28th, although the stool is not very smooth, the pulse is floating today, so purgation is contraindicated. Thirst and desire for cold drinks indicate Heat in the Qi level; a sweet taste in the mouth indicates severe Spleen Heat. It is proposed to use Yunu Jian (Jade Woman Decoction) from the Qi-Blood Liangfan pattern, adding bitter herbs to clear Pi Dan (Spleen Damp-Heat).
Raw Gypsum (3 liang), Coptis (3 qian), Scrophularia (6 qian), Ophiopogon (1 liang), Small Rehmannia Root (1 liang), Anemarrhena (3 qian), Scutellaria (6 qian).
Decoct 4 bowls, divide into four doses. Stop subsequent doses if cool sweat is obtained or if thirst ceases.
On the 29th, heavy use of Acrid-Cool herbs, slightly combined with Bitter-Cold, resulted in continuous eruption of macules and papules. Body heat has reduced by more than half. Heavy Acrid-Cold agents should no longer be used. It is proposed to use Sweet-Cold to transform Yin Qi, added with Acrid-Cool herbs, to clear the macules and papules.
Forsythia (3 qian), Scrophularia (4 qian), Small Rehmannia Root (5 qian), Honeysuckle (3 qian), Scutellaria (3 qian), Trichosanthes Root (3 qian), Coptis (2 qian), Mint (1 qian), Ophiopogon (5 qian), Rhinoceros Horn (3 qian).
Decoct 3 bowls, divide into three doses. Boil dregs again to get 1 bowl, take it.
Although major heat has decreased, residual fire remains. Sweet taste in mouth, tongue protrusion, and shiny red face persist. Sweet-Cold and Bitter-Cold combination is still appropriate.
Forsythia (3 qian), Small Rehmannia Root (6 qian), Scutellaria (3 qian), Moutan Bark (3 qian), Scrophularia (4 qian), Coptis (2 qian), Ophiopogon (5 qian), Honeysuckle (3 qian).
Add 8 bowls of water, decoct 3 bowls, divide into three doses.
On the 2nd day of the next month, add to the previous formula:
Rhinoceros Horn (2 qian), Anemarrhena (1.5 qian).
On the 3rd day, pathogens are few and deficiency is predominant. Fumai Tang (Restore the Pulse Decoction) without Guizhi (Cinnamon Twig) and Dazao (Jujube) should be used. Since the patient is a habitual drinker, remove the heavy sweetness of Gancao (Licorice), and add Er Xia (Pangolin Scale and Turtle Shell), Moutan Bark, and Scutellaria.
This is a method of Sweet-Moisturizing to transform fluids, restoring mild Bitterness to transform Yin, and employing Bitter-Sweet-Salty-Cold properties.
On the 4th day, residual pathogens are not yet fully cleared. Use the method of Sweet-Bitter combination entering Yin to search out pathogens.
Scrophularia (2 liang), Scutellaria (2 qian), Ophiopogon (8 qian), Anemarrhena (2 qian), Small Rehmannia Root (6 qian), Raw Turtle Shell (8 qian), Honeysuckle (3 qian), Moutan Bark (5 qian), Forsythia (3 qian), Artemisia Annua (1 qian).
First decoction: 3 tea bowls; Second decoction: 1 tea bowl. Divide into four doses.
Chen, aged 22. On the 17th day of the 4th month in the Yichou year, facial redness, eye redness, and tongue coating covering the entire surface like accumulated powder indicate a severe Warm Disease. Sweating methods to release the exterior are strictly contraindicated; temporarily use Acrid-Cool methods.
Schizonepeta Spike (5 qian), Mint (4 qian), Raw Licorice (3 qian), Platycodon (6 qian), Forsythia (8 qian), Honeysuckle (8 qian), Agastache Leaf (5 qian), Arnebia/Buddleja Seed (5 qian), Apricot Seed (5 qian).
Grind into coarse powder, divide into 8 packs. Take one pack every hour, decoct with Reed Rhizome soup, strain, and take.
[Patient], on the 9th day, facial redness, eye redness, and tongue coating covering the entire surface indicate a severe Warm-Heat Disease. The pulse is surprisingly slow and wiry, external heat is not intense, mouth is not thirsty, and limbs are slightly cold. This is described as Yang Syndrome with Yin Pulse, caused by insufficient Yang Qi to fully circulate and resolve pathogens. Now apply the pathogen-resolving method.
Schizonepeta Spike (2 qian), Curcuma Aromatica (2 qian), Agastache Stem (2 qian), Fermented Soybean (1.5 qian), Honeysuckle (2 qian), Forsythia Heart (1.5 qian), Artemisia Annua (1 qian), Platycodon (1.5 qian), Mint (0.8 fen), Almond Paste (2 qian).
One dose tonight, one dose tomorrow morning.
On the 11th day, Warm Diseases invariably present with thirst and dryness. Now, the tongue coating is full but there is no thirst; although yellow, it is slippery. The pulse is very slow, and heat is not vigorous. This is likely due to accompanying Dampness. It is proposed to follow the Damp-Warmth pattern and treat with Bitter-Pungent-Cold method.
Raw Atractylodes (3 qian), Tangerine Peel (2 qian), Curcuma Aromatica (3 qian), Coptis (1 qian), Cardamom Seed (1 qian), Forsythia (3 qian), Honeysuckle (2 qian), Agastache (2 qian), Trichosanthes Root (3 qian), Scutellaria (1 qian, stir-fried).
One dose tonight, one dose tomorrow morning, each two cups. Peace will be achieved after two doses.
Chen, aged 33. On the 8th day, all six pulses are wiry, fine, and forceful, indicating a Cold-Yin pulse; coughing with thin sputum indicates Yin-Damp Cough; tongue coating scraped white and slippery indicates Yin Tongue Coating; vomiting and diarrhea indicate Yin-Damp Syndrome. Although fever and sweating led to resolution, this is Wind accompanying Dampness, named Damp-Warmth. Is there such a Yin Deficiency syndrome in the world?
Poria (4 qian), Alisma (4 qian), Cinnamon Twig (3 qian), Atractylodes Macrocephala (3 qian), Stir-fried White Peony Root (2 qian), Raw Coix Seed (5 qian), Pinellia (5 qian), Charred Tangerine Peel (2 qian), Fresh Ginger Juice (3 spoons, mixed in).
On the 10th day, Phlegm-Fluid accompanied by Wind, mistreated leading to complicated syndrome. Previous use of warm-level damp-dispersing and wind-expelling methods caused various evil syndromes. Only cold is less and heat is more; after heat, sweating has not ceased. Currently, lower body redness and thirst, night delirium, indicate Wind transforming into Heat. However, the six pulses are still wiry, not fully transformed to Yang. Further coughing causes slight pain in chest, hypochondria, and lower abdomen, indicating Metal overcoming Wood.
Cinnamon Twig (3 qian), Poria (4 qian), Apricot Seed (3 qian), Artemisia Annua (3 qian), Honey-fried Licorice (3 qian), Pinellia (2 qian), Stir-fried White Peony Root (2 qian), Fresh Ginger (3 slices), Polyporus (5 qian), Gypsum (6 qian), Jujube (2 pieces).
On the 14th day, pulse is wiry and rapid, tidal fever in the afternoon. Previously white tongue coating changed to yellow. Vomiting, nausea, thirst, resembling Damp-Malaria; but coughing and loose stools resemble Damp-Warmth. Hidden pathogens sinking inward are difficult to clear.
Cinnamon Twig (4 qian), Poria Peel (5 qian), Raw Gypsum (8 qian), Artemisia Annua (2 qian), Anemarrhena (3 qian), Almond Paste (3 qian), Honey-fried Licorice (2 qian), Coix Seed (5 qian), Talcum (6 qian).
[Patient], on the 10th day, all six pulses are wiry and fine. Deep pressure on the left hand shows rapid and forceful pulse. Complexion is pale yellow, sclera is yellow. Fever started after noon on Spring Equinox and has not resolved. After severe purgation, body felt weak and not thirsty. Now, although no diarrhea, stool has not formed strips for a long time. Morning urine is clear, afternoon urine is red and turbid. Apply Bitter-Pungent-Cold method for Heat generated within Dampness.
Coix Seed/Imperata Root (Yinchen) (4 qian), Apricot Seed (3 qian), Talcum (6 qian), Poria Peel (5 qian), Tongcao (1.5 qian), Coptis (1 qian), Coix Seed (4 qian), Mulberry Silkworm Faeces (3 qian), Scutellaria (2 qian), Gold Sand (4 qian), Charred Atractylodes (3 qian).
On the 13th day, remove Atractylodes from the previous formula, add Gypsum, increase Scutellaria and Coptis.
Wen, aged 38. On the 2nd day of the 7th month in the Dingmao year, Damp-Warmth. Tongue coating is white, slippery, thick, and turbid. Pulse is indistinct, wiry, fine, deep, and soft. Use the method of regulating the Three Jiao. Initially treating chills and fever, then slight fever, then no fever. Prescriptions changed over thirty times, generally not departing from the pungent-bitter-dry-damp method. Resolution occurred after forty-five days, concluding with harmonizing the Spleen and Stomach.