（附冬温 温热 秋燥）
陈（右） 风温八日，身热咳嗽，左胁作痛，日来神昏不宁，甚则迷昧，气升痰嘶，痰色稠黄，齿垢颧红，自汗
渴饮。脉数浮弦，舌红苔黄。日前痰中屡屡见红。此由风邪化热，灼烁肺胃，所有津液，尽为火热熬炼，皆
化为痰肺为热炎所熏，肺叶煽动，有喘厥之虞。用竹叶石膏汤加味。
麦冬（去心三钱） 石膏（五钱煨） 桑白皮（二钱炙） 天花粉（二钱） 梨肉（二两） 制半夏（
一钱五分） 北沙参（四钱） 马兜铃（一钱五分） 淡竹叶（十六片）
二诊 情神之迷昧较清。舌苔亦化，气升较轻，然痰仍黄浓，痰声如潮。脉数弦滑。肺胃为热所灼，津液
尽化为痰，痰随气升，气随痰逆。前意参上病下取法。
马兜铃（一钱五分） 光杏仁（去尖打四钱） 炙桑皮（三钱） 冬瓜子（五钱打） 栝蒌皮（四钱） 川贝（
去心三钱） 海浮石（三钱） 薏仁（五钱） 枇杷叶（去毛一两） 风化霜（七分） 苇茎（一两五钱）
竹沥达痰丸（三钱竹茹汤先送下）
三诊 上升之气，大为平定， 语亦退，烦懊亦减。虽已出于望外。但脉象滑数而软，舌苔浮糙，上 糜
腐星布。痰热化火灼阴，一波未定，一波又起矣。再化痰热，参入甘凉。
马兜铃（一钱五分） 冬瓜子（五钱打） 风化硝（八分） 栝蒌仁（五钱研） 杏仁泥（三钱） 海浮石（
三钱） 茯苓（四钱） 苇茎（一两五钱） 鲜竹茹（水炒二钱） 梨汁（一酒杯温另服） 荸荠汁（半酒杯同
冲） 上濂珠（三分） 真川贝母（去心五分二味研极细末先送下）
四诊 痰喘渐平，热亦大减而白腐渐多，却不甚作渴。脉形软滑。阴分亏损，浊随气火上浮，虚多而实
少矣。急和其阴，而参清化气热。
南北沙参（各二钱） 川贝母（去心二钱） 冬瓜子（四钱） 川石斛（三钱） 滑石块（四钱） 淡天冬（一
钱） 猪茯苓（各二钱） 二泉胶（蛤粉拌炒一钱五分） 香豆豉（二钱炒） 竹茹（水炒一钱五分） 泽泻
（一钱五分） 苇茎（七钱） 上濂珠（三分） 川贝母（四分二味研为极细末先调服）
五诊 痰喘全平，腐糜忽少忽多。舌质呆紫苔，淡黄而 ，望之干毛，却不燥渴。胸次如哽如阻。脉形软
滑。此的属阴分伤损，浊蒸不化。治多棘手。勉再以清化并行法，以图万幸。
南沙参（四钱） 青盐半夏（一钱五分） 竹茹（姜汁炒二钱） 枇杷叶（去毛一两） 栝蒌霜（三钱
）滑石块（五钱）
杏仁泥（三钱） 金石斛（四钱） 川贝母（三钱） 香豆豉（三钱） 芦根（去节一两） 陈关蛰
（洗淡一两） 大荸荠（拍碎四枚二味煎汤代水）
六诊 糜腐大化，胸中痞满。阴多渐复，而胃浊仍阻。犹恐治浊伤阴，动多窒碍。
法半夏（一钱五分） 金沸草（一钱） 杜苏子（炒研三钱） 茯苓（四钱） 豆豉（三钱） 橘
红（盐水炒一钱） 杏仁泥（三钱） 竹茹（姜汁炒二钱） 玫瑰花（去蒂三朵）
七诊 一险于喘呼神昧，再险于阴伤糜腐，又险于浊阻膈痞，证象错综，治多窒碍。何幸清凉润燥，补
泻纷更，应如桴鼓。履夷出险，殆天授非人力欤。
法半夏（一钱五分） 云苓（四钱） 猪苓（一钱五分） 薤白头（二钱） 玫瑰花（去蒂三朵） 上
广皮（盐水炒一钱） 枳壳（一钱） 甜广皮（炒香三钱） 栝蒌仁（姜汁炒研三钱） 生熟谷芽（各一钱）
祝（十五岁） 饮食内伤，时邪外感。从泄泻而至发热，热势甚炽，纤毫无汗，神情懊烦，频渴不多饮。
脉象郁数，舌红苔黄罩灰。此由邪湿相合，三焦均受。恐邪湿交蒸，邪化为火，而湿化为燥。用薛氏升泄法。
煨葛根（一钱五分） 生甘草（三分） 淡芩（一钱五分） 滑石（三钱） 米仁（三钱） 大豆卷（二钱）
上广皮（一钱） 苦桔梗（一钱） 通草（一钱） 泽泻（三钱）
二诊 用薛氏升泄之法，便泄稍减，咳嗽增多，热势渐减，苔灰大化。虽属转轻之象，而未得汗邪无出
路，所以热仍不解，心中时觉 烦。病起之际，即耳窍闭塞。良由脾土素弱，所以感受风邪，上阻清窍，下
趋大肠。但风脉必浮，今脉不以浮应，似非风象。殊不知风在表则浮，今风入肠胃，病既入里，则脉不以
浮应矣。仿喻嘉言先生逆流挽舟法。
前胡（一钱） 川羌活（一钱） 白桔梗（一钱） 郁金（一钱五分） 云茯苓（三钱） 柴胡（四分）
青防风（一钱） 炒枳壳（七分） 米仁（三钱） 蔻仁（四分） 淡芩（七分）
三诊 引邪外达，正气虚微，不能托送，未能得汗，便泄有粘腻，色白带赤，热势得见退轻，而迷沉欲寐，
有时夹杂谵语。脉象糊滑，重按少力，苔黄，近根仍带灰润。此由中气不足，外感之风，氤氲之湿，熏蒸之
热，炼液成痰，弥漫神机。里虚内陷之象，恐神昏发痉。拟扶助中阳，兼清湿热而化浊痰。
台参须（七分） 川连（五分） 制半夏（一钱五分） 陈胆星（一钱） 竹茹（一钱五分） 竺黄
（二钱） 茯苓（三钱） 干姜（四分） 橘红（一钱） 生薏仁（三钱） 蚕沙（三钱）
四诊 昨进扶助中阳，兼清热而化浊痰，热势发扬于外，表热稍甚，迷蒙较退，时觉懊烦。自病起至今，
耳窍闭塞，今则时兼谵语，口渴欲饮。舌红，后半灰霉，脉象稍起，而软数微弦。风燥之气，上阻清窍，而风
与湿合，遂成熏蒸之局，神机为之弥漫。恐邪不外越，复从内窜。拟清化法。必得邪从外越，方是退步，然
不易也。
黑豆衣（三钱） 连翘（三钱） 郁金（一钱五分） 鲜石菖（二钱） 鲜竹叶（二十片） 绿豆衣（三钱）
桔梗（一钱） 薄荷（一钱） 南沙参（三钱） 荷叶边（三钱） 甘草（四分）
五诊 便泄已止，咳嗽增多，邪势欲从肺，经外泄。而每至正午阳旺之时，转烦懊不宁，言语错乱，颧红
面赤，下午仍多眠睡。皆风邪化火，劫烁阴津。昨投泄热和阴，舌苔深黄稍化，而边仍红前半红点满布，
后半灰霉。津伤热炽。拟泄热救阴，稍为扩充。
羚羊片（二钱） 鲜铁斛（七钱） 大麦冬（三钱） 花粉（二钱） 竹叶心（二十片） 赤茯苓（三钱）
黑山栀皮（三钱） 西洋参（一钱五分） 连翘壳（三钱） 真川贝母（去心二钱） 光杏仁（三钱）
六诊 疏泄风邪，清化气热，便泄渐定，解出溏粪带黑，热之象也。风为阳邪，不从外越，从中化热，热灼
肺胃，咳嗽不爽，懊烦不宁。热扰神明，言语妄乱。热劫津液，神机不运，所以不为烦懊，即为迷睡。阳明热
胜则目赤颧红，口渴欲饮脉数微弦，舌红苔色深黄，根带霉黑。种种见端，皆风邪化火劫烁阴津之象。
症方一候，邪势鸱张，恐阴津日干，而神昏发痉。拟救阴泄热。
羚羊片（二钱） 大麦冬（三钱） 广玉金（一钱五分） 连翘壳（三钱） 甘草（五分） 鲜铁斛（七钱）
真川贝（二钱） 石菖蒲（二钱） 黑山栀皮（三钱） 北沙参（四钱） 竹叶心（二十片）
七诊 脉象沉细软弱，较昨稍起。神志较清，懊烦略定，迷睡略退，咳嗽增多，痰出粘腻。舌红稍淡，灰霉
略化阴津渐回，而喉有痰声。良由津液为热邪所炼，即化为痰，前贤谓痰，即有形之火，火即无形之痰，
非虚语也。拟凉肝泄热，兼清肺胃，以保阴液。
羚羊片（一钱五分） 西洋参（一钱五分） 鲜铁皮斛（六钱） 肥知母（一钱五分） 川贝母（二钱） 连
翘（三钱） 玉泉散（三钱） 大麦冬（三钱） 桑叶（一钱炙） 冬瓜子（三钱） 竹叶心（二十片）
八诊 脉渐起，咳嗽较爽。内陷之邪，还于肺胃，所以神志渐清，热势降序，口渴稍定，舌苔灰霉较化。惟
仍眠多醒少，还是神机欠运，胸中之热弥漫。再泄热和阴，兼宣肺气，以引邪外出。
玉泉散 连翘 铁皮斛 光杏仁 薄荷 象贝 牛蒡子 霜桑叶 黑栀皮 天冬 前胡
九诊 口渴渐定，热势渐轻，舌红渐淡，苔黄转白，灰霉渐退，右脉稍起，皆热化津回之象。理应神清气
爽。而眠多醒少，仍复如前，耳聋不爽，大便不解。病之初起，原属风温夹湿，邪既化热，劫烁阴津，虽有湿
邪，亦成燥火。今津回热化，燥仍为湿，余热与湿，弥漫胸中，如雾氤氲，所以眠多醒少。拟清泄火风，参以化痰。
连翘（三钱） 黑栀皮（三钱） 天竺黄（二钱） 桔梗（二钱） 广郁金（一钱五分） 前胡（一钱五分）
晚蚕砂（三钱） 薄荷（一钱） 陈胆星（七分） 象贝母（二钱） 桑叶（二钱） 白金丸（五分入煎）
十诊 昨进化痰泄热，咳嗽稍甚痰不甚多，而痰中带红，左颊红赤。苔霉近根全化，而舌心黄又带霉
黑，大便不行。脉数右大。还是肺胃热胜。痰既得出，仍守清胃养津。即请商裁。
玉泉散（五钱） 鲜生地（五钱） 黑栀皮（三钱） 川贝母（二钱） 肥知母（二钱） 铁皮斛（八钱）
连翘（三钱） 天花粉（三钱） 生甘草（六分） 粉丹皮（二钱） 悉尼汁（一两） 白茅根肉（一两）
十一诊 迷睡稍退。胸中弥漫之热。略得扩清大便欲解不出。脉象右大。再参增液以望便行。
鲜生地（八钱） 大麦冬（三钱） 玉泉散（四钱） 象贝母（三钱） 黑栀皮（三钱） 淡芩（一钱五分）
冬瓜子（三钱） 大玄参（三钱） 连翘（三钱） 粉丹皮（二钱） 悉尼汁（一两） 白茅根肉（一两）
十二诊 大便畅行。然津液为热所耗，木火升动懊烦口渴，左颊红赤。耳鸣窍闭，咳嗽咽痒。脉数，重按
微弦。风温之邪化火劫津，幸数日以来，舌未焦燥，神未昏糊。泄热存阴，似难更动。
羚羊片（一钱五分） 鲜生地（六钱） 川贝母（二钱） 杏仁（三钱） 炙桑皮（二钱） 玉泉散（五钱）
鲜铁皮斛（六钱） 天花粉（二钱） 连翘（三钱） 荷叶边（三钱）
十三诊 多眠渐退，两次得汗，咳嗽渐轻，痰亦渐少内陷之邪，仍还于表，是为正色。但热仍未解，耳聋
不聪。脉数舌质淡红，苔淡黄，灰霉未尽。肺胃余热，未能遽澈。存阴泄热，并不表汗而汗自出。良以津液。
来复，所以液能化汗。拟乘此疏风泄热，以望邪有出路。
冬桑叶（一钱五分） 杏仁（三钱） 连翘壳（三钱） 前胡（一钱） 川贝母（二钱） 池菊花（二钱）
薄荷（一钱） 黑山栀（三钱） 桔梗（一钱） 荷叶边（三钱）
十四诊 内陷之邪，还于肺胃。咳嗽身热，耳聋，音声雌腻。脉数右大，舌质淡红，淡黄灰霉之苔逐步化
轻。病既由深而浅，宜再辛凉散风微苦泄热。
桑叶（二钱） 菊花（二钱） 薄荷（一钱） 黑栀皮（二钱） 赤茯苓（一钱五分） 桔梗（一钱）
云茯苓（一钱五分） 粉前胡（一钱） 大力子（三钱） 连翘壳（三钱） 郁金（一钱五分） 荷叶边（三钱）
改方加杏仁三钱，豆豉三钱，枳壳一钱五分。
十五诊 身热渐轻。舌苔灰霉已化，烦懊亦定。阴津既回内陷之邪，还于肺胃，其多眠应当立退，乃神
情安静，仍复多眠。皆由风邪入于上焦，上焦之气，闭而不行，卫气行于阴而不得出于阳。开泄上焦，使
上焦气宣，为目前要务。
杏仁（三钱） 桑叶（二钱） 淡豉（二钱） 枳壳（八分） 桔梗（一钱） 薄荷（一钱）
橘红（一钱） 郁金（一钱五分） 青防风（一钱） 干荷叶边（三钱）
十六诊 胸背皆经得汗，风邪稍得开泄，耳窍略聪，卫气渐开，且能知味，然仍时多眠睡。舌黄灰霉既
化，而反觉白腻。上焦之气不行，谷气过多，恐其酿湿生热，不可不防。
光杏仁（三钱） 淡豆豉（二钱） 广橘红（一钱） 丝通草（八分） 生薏仁（三钱） 炒枳壳（一钱）
桔梗（一钱） 防风（一钱） 云茯苓（三钱） 广郁金（一钱五分） 干荷叶边（三钱）
十七诊 内陷之邪，还于肺胃，而从汗出。耳窍闭塞已开，身热亦退。脉静苔化，大局已定。宜和中醒胃。
青盐半夏（一钱五分） 茯苓（三钱） 桔梗（一钱） 郁金（一钱五分） 防风（一钱） 薄橘红（一钱）
米仁（三钱） 枳壳（一钱五分） 范志曲（一钱五分） 谷芽（二钱）
十八诊 脉静苔化，胃开思食。久热之下，阴津不能遽复。宜和阴益肾。
炙生地（三钱） 炙甘草（四分） 白芍（一钱） 橘白（盐水炒一钱） 麦冬（炒一钱五分） 阿胶珠（
一钱五分）
甜杏仁（炒香三钱） 生熟谷芽（各一钱）
十九诊 滋水和阴，胃气渐复，多眠亦退。风为阳邪，温乃热气，其所伤者，无非阴液。但柔腻之药，不能
久进。宜甘凉和养。
西洋参（一钱五分） 生玉竹（三钱） 广橘白（一钱） 生熟谷芽（各一钱） 川石斛（四钱） 生甘
草（三分） 生山药（三钱） 甜杏仁（三钱） 范志曲（一钱）
陆（左） 咳嗽不爽，发热汗出不解，气从上逆，大便溏泄。脉数右大，苔浓心黄。风温袭于肺胃，症方七日，
(Attached: Winter-Warmth, Warm-Thermal, Autumn-Dryness)
Patient Chen (Female). Suffering from Wind-Warmth (Fengwen, a warm-heat disease caused by wind-heat pathogen) for eight days. Symptoms include fever, cough, and pain in the left hypochondrium. Recently, there is mental confusion and restlessness; at times, consciousness is severely impaired. Qi rebels upward accompanied by phlegm rattle. The sputum is thick, yellow, and sticky. Dental plaque is present, and the malar region is red. There is spontaneous sweating and thirst with desire to drink. The pulse is rapid, floating, and wiry. The tongue is red with a yellow coating. Previously, blood was frequently seen in the sputum. This condition arises because the wind pathogen transforms into heat, scorching the Lung and Stomach. All body fluids are refined by the fire-heat into phlegm. The Lungs are fumigated by heat, causing the lung lobes to flutter, creating a risk of panting and syncope. Treatment uses Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) with modifications.
Ophiopogon Radix (Qu Xin San Qian) - Ophiopogonis Radix (3 qian, heart removed)
Gypsum Fibrosum (Wu Qian Wei) - Gypsum Fibrosum (5 qian, calcined)
Morus Alba Root Bark (Er Qian Zhi) - Morus Albae Radicis Cortex (2 qian, stir-baked)
Trichosanthes Root (Er Qian) - Trichosanthis Radix (2 qian)
Pear Flesh (Liang Liang) - Pyri Fructus (2 liang)
Prepared Pinellia Tuber (Yi Qian Wu Fen) - Pinelliae Rhizoma Preparatum (1.5 qian)
Glehnia Root (Si Qian) - Glehniae Radix (4 qian)
Aristolochia Fruit (Yi Qian Wu Fen) - Aristolochiae Fructus (1.5 qian)
Light Bamboo Leaves (Shi Liu Pian) - Bambusae Folium (16 slices)
Second Visit: The patient's mental confusion has cleared somewhat compared to before. The tongue coating is also receding, and the upward rebellion of Qi is lighter. However, the sputum remains yellow and thick, with a sound like roaring tides. The pulse is rapid, wiry, and slippery. Heat scorches the Lung and Stomach, refining all fluids into phlegm. Phlegm rises with Qi, and Qi rebels with Phlegm. The previous treatment strategy referenced the method of "treating upper diseases from below."
Aristolochia Fruit (Yi Qian Wu Fen) - Aristolochiae Fructus (1.5 qian)
Apricot Seed (Qu Jian Da Si Qian) - Armeniacae Semen (4 qian, tip removed, crushed)
Stir-baked Mulberry Root Bark (San Qian) - Mori Radicis Cortex (3 qian, stir-baked)
Winter Melon Seed (Wu Qian Da) - Benincasae Semen (5 qian, crushed)
Trichosanthes Peel (Si Qian) - Trichosanthis Pericarpium (4 qian)
Fritillaria Bulb (Qu Xin San Qian) - Fritillariae Cirrhosae Bulbus (3 qian, heart removed)
Floating Stone (San Qian) - Lapide Talcum (3 qian)
Coix Seed (Wu Qian) - Coicis Semen (5 qian)
Loquat Leaf (Qu Mao Yi Liang) - Eriobotryae Folium (1 liang, hairs removed)
Weathered Soda (Qi Fen) - Natrii Sulfas Exsiccatus (0.7 qian)
Reed Rhizome (Liang Wu Qian) - Imperatae Rhizoma (1.5 liang)
Zhuli Datan Wan (Zhu Ru Tang Xian Song Xia) - Bamboo Sap Phlegm-Expelling Pill (3 qian, taken first with Bamboo Sheath Decoction)
Third Visit: The upward-rebellious Qi is largely pacified. Delirium has subsided, and restlessness has decreased. Although this improvement exceeds expectations, the pulse is slippery, rapid, and soft. The tongue coating is floating and rough. There are scattered ulcerations on the upper palate. Phlegm-heat transforming into fire scorches Yin. As one wave settles, another rises. We again resolve phlegm-heat, incorporating sweet-cool moistening herbs.
Aristolochia Fruit (Yi Qian Wu Fen) - Aristolochiae Fructus (1.5 qian)
Winter Melon Seed (Wu Qian Da) - Benincasae Semen (5 qian, crushed)
Weathered Soda (Ba Fen) - Natrii Sulfatis Crystallohydricus (0.8 qian)
Trichosanthes Seed (Wu Qian Yan) - Trichosanthis Semen (5 qian, ground)
Apricot Paste (San Qian) - Armeniacae Semen Pastum (3 qian)
Floating Stone (San Qian) - Lapide Talcum (3 qian)
Poria (Si Qian) - Polyporus (4 qian)
Reed Rhizome (Liang Wu Qian) - Imperatae Rhizoma (1.5 liang)
Fresh Bamboo Sheath (Shui Chao Er Qian) - Bambusae Caulis Internodium (2 qian, water-stir-fried)
Pear Juice (Yi Jiu Bei Wen Ling Fu) - Pyri Sucus (1 wine cup, warmed, taken separately)
Water Chestnut Juice (Ban Jiu Bei Tong Chong) - Eleocharis Fructus Sucus (0.5 wine cup, mixed together)
Shang Lian Zhu (San Fen) - Pearl Concha (0.3 qian)
Zhen Chuan Bei Mu (Qu Xin Wu Fen) - Fritillariae Cirrhosae Bulbus (0.5 qian, heart removed; these two are ground into fine powder and taken first)
Fourth Visit: Phlegm-panting gradually calms, and heat significantly decreases, but oral white ulcers increase, though there is little thirst. The pulse form is soft and slippery. Yin deficiency prevails; turbid qi floats up with Qi-fire. Deficiency is predominant, excess is minor. Urgently harmonize Yin and combine with clearing-transforming Qi-heat.
Northern and Southern Glehnia Roots (Ge Er Qian) - Glehniae Radix et Adenophorae Radix (2 qian each)
Fritillaria Bulb (Qu Xin Er Qian) - Fritillariae Cirrhosae Bulbus (2 qian, heart removed)
Winter Melon Seed (Si Qian) - Benincasae Semen (4 qian)
Sichuan Dendrobium (San Qian) - Dendrobii Caulis (3 qian)
Talc Block (Si Qian) - Talcum (4 qian)
Light Asparagus Root (Yi Qian) - Asparagi Radix (1 qian)
Polyporus and Poria (Ge Er Qian) - Polyporus et Poria (2 qian each)
Er Quan Jiao (Ha Fen Ban Chao Yi Qian Wu Fen) - Gelatinum Corii Asini (1.5 qian, stir-fried with Arceuthi Pulvis)
Fragrant Fermented Soybean (Er Qian Chao) - Sojae Semen Praeparatum (2 qian, stir-fried)
Bamboo Sheath (Shui Chao Yi Qian Wu Fen) - Bambusae Caulis Internodium (1.5 qian, water-stir-fried)
Alisma (Yi Qian Wu Fen) - Alismatis Rhizoma (1.5 qian)
Reed Rhizome (Qi Qian) - Imperatae Rhizoma (7 qian)
Shang Lian Zhu (San Fen) - Pearl Concha (0.3 qian)
Chuan Bei Mu (Si Fen) - Fritillariae Cirrhosae Bulbus (0.4 qian; these two are ground into fine powder and taken first)
Fifth Visit: Phlegm-panting is completely resolved. Oral ulcers fluctuate in quantity. The tongue body appears dull purple; the coating is pale yellow and dry-looking, appearing parched without moisture, yet there is no sensation of dryness or thirst. The chest feels obstructed, as if choked. The pulse is soft and slippery. This definitely belongs to Yin injury, with turbid steaming failing to transform. Treatment is difficult. Tentatively using a combined method of clearing-transforming and harmonizing, hoping for a fortunate outcome.
Southern Glehnia Root (Si Qian) - Adenophorae Radix (4 qian)
Green Salt Pinellia (Yi Qian Wu Fen) - Pinelliae Rhizoma (1.5 qian)
Bamboo Sheath (Jiang Zhi Chao Er Qian) - Bambusae Caulis Internodium (2 qian, stir-fried with Ginger Juice)
Loquat Leaf (Qu Mao Yi Liang) - Eriobotryae Folium (1 liang, hairs removed)
Trichosanthes Frost (San Qian) - Trichosanthis Pericarpium (3 qian)
Talc Block (Wu Qian) - Talcum (5 qian)
Apricot Paste (San Qian) - Armeniacae Semen Pastum (3 qian)
Jin Shi Hu (Si Qian) - Dendrobii Caulis (4 qian)
Chuan Bei Mu (San Qian) - Fritillariae Cirrhosae Bulbus (3 qian)
Fragrant Fermented Soybean (San Qian) - Sojae Semen Praeparatum (3 qian)
Reed Shoot (Qu Jie Yi Liang) - Phragmitis Rhizoma (1 liang, nodes removed)
Chen Guan Zhe (Xi Dan Yi Liang) - Neritinae Concha (1 liang, washed and desalted; these two are decocted to replace water)
Sixth Visit: Ulcers have largely healed. Chest fullness and oppression persist. Yin is gradually recovering, but Stomach turbidity remains obstructed. We fear that treating turbidity may damage Yin, causing further obstruction.
Processed Pinellia (Yi Qian Wu Fen) - Pinelliae Rhizoma Preparatum (1.5 qian)
Golden Boiling Grass (Yi Qian) - Antennariae Herba (1 qian)
Du Su Zi (Chao Yan San Qian) - Perillae Fructus (3 qian, stir-fried and ground)
Poria (Si Qian) - Polyporus (4 qian)
Fermented Soybean (San Qian) - Sojae Semen Praeparatum (3 qian)
Orange Peel (Yan Shui Chao Yi Qian) - Citri Reticulatae Pericarpium (1 qian, stir-fried with salt water)
Apricot Paste (San Qian) - Armeniacae Semen Pastum (3 qian)
Bamboo Sheath (Jiang Zhi Chao Er Qian) - Bambusae Caulis Internodium (2 qian, stir-fried with Ginger Juice)
Rose Flower (Qu Di San Duo) - Rosae Rugosae Flos (3 flowers, sepals removed)
Seventh Visit: The first danger was panting and mental obscurity; the second, Yin injury with ulcers; the third, turbid obstruction causing chest fullness. The syndrome is complex, and treatment faces many obstacles. Fortunately, cooling and moistening methods, alternating tonification and purgation, yielded results as swiftly as drumbeats. Escaping danger safely seems heaven-sent rather than human effort.
Processed Pinellia (Yi Qian Wu Fen) - Pinelliae Rhizoma Preparatum (1.5 qian)
Cloud Poria (Si Qian) - Polyporus (4 qian)
Polyporus (Yi Qian Wu Fen) - Polyporus (1.5 qian)
Allium Macrostemon Bulb (Er Qian) - Allii Macrostemonis Bulbus (2 qian)
Rose Flower (Qu Di San Duo) - Rosae Rugosae Flos (3 flowers, sepals removed)
Upper Guangpi (Yan Shui Chao Yi Qian) - Citri Reticulatae Pericarpium (1 qian, stir-fried with salt water)
Magnolia Bud (Yi Qian) - Magnoliae Flos (1 qian)
Sweet Guangpi (Chao Xiang San Qian) - Citri Reticulatae Pericarpium (3 qian, stir-fried until fragrant)
Trichosanthes Seed (Jiang Zhi Chao Yan San Qian) - Trichosanthis Semen (3 qian, stir-fried with Ginger Juice and ground)
Raw and Cooked Barley Sprouts (Ge Yi Qian) - Hordei Fructus Germinatus (1 qian each)
Patient Zhu, 15 years old. Internal injury from diet, external contraction of seasonal pathogens. Progressed from diarrhea to fever. The heat intensity is very high, with absolutely no sweat. Mental state is vexed and restless. Frequent thirst with little desire to drink. The pulse is constrained and rapid. The tongue is red with a yellow coating overlaid with gray. This is due to evil-dampness combining, affecting the Triple Burner. We fear evil-dampness steaming together, transforming into fire and dryness. Use Xue Shi Shengxie Fa (Xue’s Ascending and Draining Method).
Calcined Kudzu Root (Yi Qian Wu Fen) - Puerariae Radix (1.5 qian, calcined)
Raw Licorice Root (San Fen) - Glycyrrhizae Radix et Rhizoma (0.3 qian)
Light Scutellaria (Yi Qian Wu Fen) - Scutellariae Radix (1.5 qian)
Talc (San Qian) - Talcum (3 qian)
Coix Seed (San Qian) - Coicis Semen (3 qian)
Soybean Hull (Er Qian) - Sojae Helvolus (2 qian)
Upper Guangpi (Yi Qian) - Citri Reticulatae Pericarpium (1 qian)
Bitter Platycodon (Yi Qian) - Platycodonis Radix (1 qian)
Akebia Stem (Yi Qian) - Akebiae Caulis (1 qian)
Alisma (San Qian) - Alismatis Rhizoma (3 qian)
Second Visit: After using Xue’s Ascending and Draining Method, diarrhea slightly decreased, cough increased, heat gradually subsided, and gray coating largely resolved. Although this indicates improvement, lack of sweat means the pathogen has no exit, so heat persists, and the mind feels occasionally vexed. At onset, ear orifices were blocked. Likely due to inherent weak Spleen Earth, wind pathogen invaded, obstructing clear orifices above and descending to Large Intestine below. Wind pulses should be floating; current pulse is not floating, seemingly not wind-like. However, wind in the exterior causes floating pulse; now wind enters intestines/stomach, disease is interior, so pulse does not respond with floating. Imitate Yu Jiayan’s “Retrieving the Boat Against the Current” method.
Peucedanum Root (Yi Qian) - Peucedani Radix (1 qian)
Sichuan Notopterygium (Yi Qian) - Notopterygii Rhizoma et Radix (1 qian)
White Platycodon (Yi Qian) - Platycodonis Radix (1 qian)
Curcuma Tuber (Yi Qian Wu Fen) - Curcumae Radix (1.5 qian)
Cloud Poria (San Qian) - Polyporus (3 qian)
Bupleurum Root (Si Fen) - Bupleuri Radix (0.4 qian)
Blue Windproof (Yi Qian) - Saposhnikoviae Radix (1 qian)
Stir-fried Magnolia Bud (Qi Fen) - Magnoliae Flos (0.7 qian, stir-fried)
Coix Seed (San Qian) - Coicis Semen (3 qian)
Cardamom Seed (Si Fen) - Amomi Fructus (0.4 qian)
Light Scutellaria (Qi Fen) - Scutellariae Radix (0.7 qian)
Third Visit: Guiding evil outward, Zhengqi is deficient and weak, unable to push it out. No sweat achieved. Diarrhea is sticky, white with red streaks. Heat slightly reduced, but mental heaviness and drowsiness persist, sometimes with delirium. Pulse is muddy-slippery, weak upon heavy pressure. Tongue coating yellow, root still gray-moist. Due to Middle Qi deficiency, external wind, enveloping dampness, and steaming heat refine fluids into phlegm, obscuring Shen-Ji (Spirit Mechanism). Signs of interior deficiency and internal sinking. Fear of mental confusion and convulsions. Plan to support Middle Yang, simultaneously clear damp-heat and transform turbid phlegm.
Tai Shen Xu (Qi Fen) - Ginseng Radix et Rhizoma (0.7 qian, rootlets)
Sichuan Coptis (Wu Fen) - Coptidis Rhizoma (0.5 qian)
Processed Pinellia (Yi Qian Wu Fen) - Pinelliae Rhizoma Preparatum (1.5 qian)
Chen Dan Xing (Yi Qian) - Arisaematis Cum Bile Preparatum (1 qian)
Bamboo Sheath (Yi Qian Wu Fen) - Bambusae Caulis Internodium (1.5 qian)
Zhu Huang (Er Qian) - Bambusae Spica (2 qian)
Poria (San Qian) - Polyporus (3 qian)
Dried Ginger (Si Fen) - Zingiberis Rhizoma (0.4 qian)
Orange Peel (Yi Qian) - Citri Reticulatae Pericarpium (1 qian)
Raw Coix Seed (San Qian) - Coicis Semen (3 qian)
Silkworm Sand (San Qian) - Bombyx Batryticatus (3 qian)
Fourth Visit: Yesterday’s formula supported Middle Yang, cleared heat, and transformed turbid phlegm. Heat flared outward, superficial heat slightly worse, mental clouding retreated, occasional vexation. Since onset, ear orifices blocked; now intermittent delirium and thirst with desire to drink. Tongue red, posterior half gray-moldy. Pulse slightly rising, but soft, rapid, and slightly wiry. Wind-dryness obstructs clear orifices; wind combines with dampness, creating a steaming pattern, obscuring Shen-Ji. Fear pathogen will not vent outward but will窜 (pierce) internally. Plan clearing-transforming method. Must achieve pathogen venting outward to retreat, though difficult.
Black Bean Coat (San Qian) - Phaseoli Vulgaris Testa (3 qian)
Forsythia Fruit (San Qian) - Forsythiae Fructus (3 qian)
Curcuma Tuber (Yi Qian Wu Fen) - Curcumae Radix (1.5 qian)
Fresh Acorus Rhizome (Er Qian) - Acori Tatarinowii Rhizoma (2 qian, fresh)
Fresh Bamboo Leaves (Er Shi Pian) - Bambusae Folium (20 slices)
Mung Bean Coat (San Qian) - Phaseoli Radiati Testa (3 qian)
Platycodon Root (Yi Qian) - Platycodonis Radix (1 qian)
Mint Herb (Yi Qian) - Menthae Haplocalycis Herba (1 qian)
Southern Glehnia Root (San Qian) - Adenophorae Radix (3 qian)
Lotus Leaf Rim (San Qian) - Nelumbinis Folium (3 qian)
Licorice Root (Si Fen) - Glycyrrhizae Radix et Rhizoma (0.4 qian)
Fifth Visit: Diarrhea stopped, cough increased. Pathogen trend wants to vent via Lung channel. But every noon when Yang is peak, turns to vexation and restlessness, disordered speech, red cheeks and face. Afternoon sleepiness predominates. All due to wind transforming into fire, seizing Yin fluids. Yesterday’s heat-draining and Yin-harmonizing formula: deep yellow coating slightly resolved, edges still red, anterior half covered in red spots, posterior half gray-moldy. Fluid injury, intense heat. Plan heat-draining and Yin-saving, slightly expanding.
Antelope Horn Slice (Er Qian) - Saigae Tataricae Cornu (2 qian)
Fresh Tie Pi Shi Hu (Qi Qian) - Dendrobii Caulis (7 qian, fresh)
Large Maidong (San Qian) - Ophiopogonis Radix (3 qian)
Huafen (Er Qian) - Trichosanthis Radix (2 qian)
Bamboo Heart (Er Shi Pian) - Bambusae Folium (20 slices)
Red Poria (San Qian) - Polyporus (3 qian)
Black Gardenia Skin (San Qian) - Gardeniae Fructus (3 qian)
American Ginseng (Yi Qian Wu Fen) - Panacis Quinquefolii Radix (1.5 qian)
Forsythia Shell (San Qian) - Forsythiae Fructus (3 qian)
Real Chuan Bei Mu (Qu Xin Er Qian) - Fritillariae Cirrhosae Bulbus (2 qian, heart removed)
Guang Xing Ren (San Qian) - Armeniacae Semen (3 qian)
Sixth Visit: Dispersing wind, clearing Qi-heat. Diarrhea stabilizes, passing loose black stool, indicating heat. Wind is Yang pathogen; not venting outward, transforms to heat internally. Heat scorches Lung/Stomach, cough unsmooth, vexation/restlessness. Heat disturbs Shen-Ming, causing delirium. Heat seizes fluids, Shen-Ji fails to operate, leading to either vexation or stupor. Yangming heat excess causes red eyes/cheeks, thirst, rapid/slightly wiry pulse, red tongue/deep yellow coating/black moldy root. All signs indicate wind transforming to fire, seizing Yin. Disease duration one week, pathogen rampant. Fear Yin drying, leading to confusion/convulsions. Plan saving Yin and draining heat.
Antelope Horn Slice (Er Qian) - Saigae Tataricae Cornu (2 qian)
Large Maidong (San Qian) - Ophiopogonis Radix (3 qian)
Guang Yu Jin (Yi Qian Wu Fen) - Curcumae Radix (1.5 qian)
Forsythia Shell (San Qian) - Forsythiae Fructus (3 qian)
Licorice Root (Wu Fen) - Glycyrrhizae Radix et Rhizoma (0.5 qian)
Fresh Tie Pi Shi Hu (Qi Qian) - Dendrobii Caulis (7 qian, fresh)
Real Chuan Bei (Er Qian) - Fritillariae Cirrhosae Bulbus (2 qian)
Acorus Rhizome (Er Qian) - Acori Tatarinowii Rhizoma (2 qian)
Black Gardenia Skin (San Qian) - Gardeniae Fructus (3 qian)
Northern Glehnia Root (Si Qian) - Glehniae Radix (4 qian)
Bamboo Heart (Er Shi Pian) - Bambusae Folium (20 slices)
Seventh Visit: Pulse sunken, thin, weak, slightly better than yesterday. Shen clearer, vexation settled, stupor lessened, cough increased, sticky sputum. Tongue red slightly pale, gray-moldy resolving, Yin returning, but phlegm sound in throat. Fluids refined by heat into phlegm. Ancients said: Phlegm is solidified fire; Fire is formless phlegm. Not empty words. Plan cooling Liver, draining heat, clearing Lung/Stomach to protect Yin fluids.
Antelope Horn Slice (Yi Qian Wu Fen) - Saigae Tataricae Cornu (1.5 qian)
American Ginseng (Yi Qian Wu Fen) - Panacis Quinquefolii Radix (1.5 qian)
Fresh Tie Pi Shi Hu (Liu Qian) - Dendrobii Caulis (6 qian, fresh)
Fei Zhi Mu (Yi Qian Wu Fen) - Anemarrhenae Rhizoma (1.5 qian)
Chuan Bei Mu (Er Qian) - Fritillariae Cirrhosae Bulbus (2 qian)
Forsythia (San Qian) - Forsythiae Fructus (3 qian)
Yu Quan San (San Qian) - Yu Quan Powder (3 qian)
Large Maidong (San Qian) - Ophiopogonis Radix (3 qian)
Mulberry Leaf (Yi Qian Zhi) - Mori Folium (1 qian, stir-baked)
Winter Melon Seed (San Qian) - Benincasae Semen (3 qian)
Bamboo Heart (Er Shi Pian) - Bambusae Folium (20 slices)
Eighth Visit: Pulse rising, cough smoother. Internalized pathogen returns to Lung/Stomach. Shen clears, heat descends, thirst stabilizes, gray-moldy coating resolves. Still sleeps much, wakes little; Shen-Ji sluggish, chest heat diffuse. Again drain heat, harmonize Yin, diffuse Lung Qi to guide pathogen out.
Yu Quan San, Forsythia, Tie Pi Shi Hu, Guang Xing Ren, Mint, Xiang Bei Mu, Bullace Seed, Frost Mulberry Leaf, Black Gardenia Skin, Tian Dong, Peucedanum Root.
Ninth Visit: Thirst stabilizes, heat lightens, tongue red fades, yellow coating turns white, gray-moldy recedes, right pulse rises. Signs of heat resolving and fluids returning. Should feel refreshed. Yet sleeps much, wakes little. Deafness persists, constipation. Onset was Wind-Warmth with dampness. Pathogen turned to heat, seizing Yin. Even dampness becomes dry-fire. Now fluids return, heat resolves, but dryness reverts to dampness. Residual heat and dampness diffuse in chest like mist, causing sleepiness. Plan clearing/draining fire-wind, incorporating phlegm-resolving.
Forsythia (San Qian) - Forsythiae Fructus (3 qian)
Black Gardenia Skin (San Qian) - Gardeniae Fructus (3 qian)
Heavenly Bamboo Slurry (Er Qian) - Bambusae Spica (2 qian)
Platycodon (Er Qian) - Platycodonis Radix (2 qian)
Guang Yu Jin (Yi Qian Wu Fen) - Curcumae Radix (1.5 qian)
Peucedanum Root (Yi Qian Wu Fen) - Peucedani Radix (1.5 qian)
Late Silkworm Sand (San Qian) - Bombyx Batryticatus (3 qian)
Mint (Yi Qian) - Menthae Haplocalycis Herba (1 qian)
Chen Dan Xing (Qi Fen) - Arisaematis Cum Bile Preparatum (0.7 qian)
Xiang Bei Mu (Er Qian) - Fritillariae Thunbergii Bulbus (2 qian)
Mulberry Leaf (Er Qian) - Mori Folium (2 qian)
Bai Jin Wan (Wu Fen Ru Jian) - White Gold Pill (0.5 qian, added to decoction)
Tenth Visit: Yesterday’s phlegm-draining/heat-clearing made cough slightly worse, sputum not excessive, but blood-streaked. Left cheek red. Moldy coating near root resolved, but tongue center yellow/moldy-black. Constipation. Pulse rapid, right large. Lung/Stomach heat excess. Sputum expelled, maintain clearing Stomach/nourishing fluids. Consult.
Yu Quan San (Wu Qian) - Yu Quan Powder (5 qian)
Fresh Sheng Di (Wu Qian) - Rehmanniae Radix (5 qian, fresh)
Black Gardenia Skin (San Qian) - Gardeniae Fructus (3 qian)
Chuan Bei Mu (Er Qian) - Fritillariae Cirrhosae Bulbus (2 qian)
Fei Zhi Mu (Er Qian) - Anemarrhenae Rhizoma (2 qian)
Tie Pi Shi Hu (Ba Qian) - Dendrobii Caulis (8 qian)
Forsythia (San Qian) - Forsythiae Fructus (3 qian)
Tian Hua Fen (San Qian) - Trichosanthis Radix (3 qian)
Raw Licorice (Liu Fen) - Glycyrrhizae Radix et Rhizoma (0.6 qian)
Fen Dan Pi (Er Qian) - Moutan Cortex (2 qian)
Xi Ni Zhi (Yi Liang) - Dioscoreae Hypoglaucae Rhizoma Sucus (1 liang)
Bai Mao Gen Rou (Yi Liang) - Imperatae Rhizoma (1 liang)
Eleventh Visit: Stupor slightly receded. Diffuse chest heat slightly cleared. Bowels want to move but cannot. Right pulse large. Add fluid-increasing herbs to hope for bowel movement.
Fresh Sheng Di (Ba Qian) - Rehmanniae Radix (8 qian, fresh)
Large Maidong (San Qian) - Ophiopogonis Radix (3 qian)
Yu Quan San (Si Qian) - Yu Quan Powder (4 qian)
Xiang Bei Mu (San Qian) - Fritillariae Thunbergii Bulbus (3 qian)
Black Gardenia Skin (San Qian) - Gardeniae Fructus (3 qian)
Light Scutellaria (Yi Qian Wu Fen) - Scutellariae Radix (1.5 qian)
Winter Melon Seed (San Qian) - Benincasae Semen (3 qian)
Da Xuan Shen (San Qian) - Scrophulariae Radix (3 qian)
Forsythia (San Qian) - Forsythiae Fructus (3 qian)
Fen Dan Pi (Er Qian) - Moutan Cortex (2 qian)
Xi Ni Zhi (Yi Liang) - Dioscoreae Hypoglaucae Rhizoma Sucus (1 liang)
Bai Mao Gen Rou (Yi Liang) - Imperatae Rhizoma (1 liang)
Twelfth Visit: Bowels moved freely. But fluids consumed by heat. Wood/Fire rising, vexation/thirst, left cheek red. Tinnitus/blockage, cough/throat itch. Pulse rapid, deep slight wiry. Wind-Warmth turning to fire/seizing Yin. Fortunately, tongue not scorched, Shen not confused over past days. Drain heat, preserve Yin, hard to change.
Antelope Horn Slice (Yi Qian Wu Fen) - Saigae Tataricae Cornu (1.5 qian)
Fresh Sheng Di (Liu Qian) - Rehmanniae Radix (6 qian, fresh)
Chuan Bei Mu (Er Qian) - Fritillariae Cirrhosae Bulbus (2 qian)
Xing Ren (San Qian) - Armeniacae Semen (3 qian)
Zhi Sang Pi (Er Qian) - Mori Radicis Cortex (2 qian, stir-baked)
Yu Quan San (Wu Qian) - Yu Quan Powder (5 qian)
Fresh Tie Pi Shi Hu (Liu Qian) - Dendrobii Caulis (6 qian, fresh)
Tian Hua Fen (Er Qian) - Trichosanthis Radix (2 qian)
Forsythia (San Qian) - Forsythiae Fructus (3 qian)
Lotus Leaf Rim (San Qian) - Nelumbinis Folium (3 qian)
Thirteenth Visit: Sleepiness receding. Sweated twice. Cough/lighter, sputum/fewer. Internalized pathogen returns to exterior, correct sign. Heat unresolved, deafness persists. Pulse rapid, tongue pale-red, coating pale-yellow, gray-moldy incomplete. Lung/Stomach residual heat not fully cleared. Preserve Yin, drain heat. Sweat occurs without diaphoresis because fluids return, converting to sweat. Seize opportunity to disperse wind/drain heat, seeking pathogen exit.
Winter Mulberry Leaf (Yi Qian Wu Fen) - Mori Folium (1.5 qian)
Xing Ren (San Qian) - Armeniacae Semen (3 qian)
Forsythia Shell (San Qian) - Forsythiae Fructus (3 qian)
Peucedanum Root (Yi Qian) - Peucedani Radix (1 qian)
Chuan Bei Mu (Er Qian) - Fritillariae Cirrhosae Bulbus (2 qian)
Chi Ju Hua (Er Qian) - Chrysanthemi Flos (2 qian)
Mint (Yi Qian) - Menthae Haplocalycis Herba (1 qian)
Black Gardenia (San Qian) - Gardeniae Fructus (3 qian)
Platycodon (Yi Qian) - Platycodonis Radix (1 qian)
Lotus Leaf Rim (San Qian) - Nelumbinis Folium (3 qian)
Fourteenth Visit: Internalized pathogen returns to Lung/Stomach. Cough/fever, deafness, hoarse voice. Pulse rapid, right large. Tongue pale-red, pale-yellow/gray-moldy coating lightening. Disease moving deep to shallow. Again use acrid-cool dispersing wind, slightly bitter draining heat.
Mulberry Leaf (Er Qian) - Mori Folium (2 qian)
Chrysanthemum (Er Qian) - Chrysanthemi Flos (2 qian)
Mint (Yi Qian) - Menthae Haplocalycis Herba (1 qian)
Black Gardenia Skin (Er Qian) - Gardeniae Fructus (2 qian)
Red Poria (Yi Qian Wu Fen) - Polyporus (1.5 qian)
Platycodon (Yi Qian) - Platycodonis Radix (1 qian)
Cloud Poria (Yi Qian Wu Fen) - Polyporus (1.5 qian)
Fen Qian Hu (Yi Qian) - Peucedani Radix (1 qian)
Da Li Zi (San Qian) - Armeniacae Semen Amarum (3 qian)
Forsythia Shell (San Qian) - Forsythiae Fructus (3 qian)
Yu Jin (Yi Qian Wu Fen) - Curcumae Radix (1.5 qian)
Lotus Leaf Rim (San Qian) - Nelumbinis Folium (3 qian)
Modified prescription adds: Xing Ren 3 qian, Dou Chi 3 qian, Zhi Ke 1.5 qian.
Fifteenth Visit: Fever lightening. Gray-moldy coating resolved, vexation settled. Yin returned, pathogen returned to Lung/Stomach. Sleepiness should cease, yet quiet but sleepy. Wind entering Upper Jiao, Qi closed, Wei Qi circulates in Yin, cannot emerge to Yang. Opening Upper Jiao to diffuse Qi is urgent.
Xing Ren (San Qian) - Armeniacae Semen (3 qian)
Mulberry Leaf (Er Qian) - Mori Folium (2 qian)
Dan Chi (Er Qian) - Sojae Semen Praeparatum (2 qian)
Zhi Ke (Ba Fen) - Aurantii Fructus (0.8 qian)
Platycodon (Yi Qian) - Platycodonis Radix (1 qian)
Mint (Yi Qian) - Menthae Haplocalycis Herba (1 qian)
Orange Peel (Yi Qian) - Citri Reticulatae Pericarpium (1 qian)
Yu Jin (Yi Qian Wu Fen) - Curcumae Radix (1.5 qian)
Qing Fang Feng (Yi Qian) - Saposhnikoviae Radix (1 qian)
Dry Lotus Leaf Rim (San Qian) - Nelumbinis Folium (3 qian)
Sixteenth Visit: Chest/back sweated. Wind slightly dispersed. Ear orifices clearer. Wei Qi opening, taste returning. Still sleepy. Yellow/gray-moldy coating resolved, but white-greasy appeared. Upper Jiao Qi stagnant, grain Qi excessive, fearing damp-heat fermentation. Preventive measure needed.
Guang Xing Ren (San Qian) - Armeniacae Semen (3 qian)
Dan Dou Chi (Er Qian) - Sojae Semen Praeparatum (2 qian)
Guang Ju Hong (Yi Qian) - Citri Reticulatae Pericarpium (1 qian)
Si Tong Cao (Ba Fen) - Tetrapanacis Medulla (0.8 qian)
Raw Coix Seed (San Qian) - Coicis Semen (3 qian)
Stir-fried Zhi Ke (Yi Qian) - Aurantii Fructus (1 qian, stir-fried)
Platycodon (Yi Qian) - Platycodonis Radix (1 qian)
Fang Feng (Yi Qian) - Saposhnikoviae Radix (1 qian)
Cloud Poria (San Qian) - Polyporus (3 qian)
Guang Yu Jin (Yi Qian Wu Fen) - Curcumae Radix (1.5 qian)
Dry Lotus Leaf Rim (San Qian) - Nelumbinis Folium (3 qian)
Seventeenth Visit: Internalized pathogen returns to Lung/Stomach, exits via sweat. Ear blockage opened, fever retreated. Pulse calm, coating resolved, situation stabilized. Harmonize Middle, awaken Stomach.
Green Salt Pinellia (Yi Qian Wu Fen) - Pinelliae Rhizoma (1.5 qian)
Poria (San Qian) - Polyporus (3 qian)
Platycodon (Yi Qian) - Platycodonis Radix (1 qian)
Yu Jin (Yi Qian Wu Fen) - Curcumae Radix (1.5 qian)
Fang Feng (Yi Qian) - Saposhnikoviae Radix (1 qian)
Bo Ju Hong (Yi Qian) - Citri Reticulatae Pericarpium (1 qian)
Mi Ren (San Qian) - Coicis Semen (3 qian)
Zhi Ke (Yi Qian Wu Fen) - Aurantii Fructus (1.5 qian)
Fan Zhi Qu (Yi Qian Wu Fen) - Massai Medicamentum (1.5 qian)
Gu Ya (Er Qian) - Hordei Fructus Germinatus (2 qian)
Eighteenth Visit: Pulse calm, coating resolved, Stomach opens, appetite returns. After prolonged heat, Yin cannot quickly recover. Harmonize Yin, benefit Kidney.
Zhi Sheng Di (San Qian) - Rehmanniae Radix (3 qian, stir-baked)
Zhi Gan Cao (Si Fen) - Glycyrrhizae Radix et Rhizoma (0.4 qian, stir-baked)
Bai Shao (Yi Qian) - Paeoniae Radix Alba (1 qian)
Ju Bai (Yan Shui Chao Yi Qian) - Citri Reticulatae Pericarpium Album (1 qian, stir-fried with salt water)
Mai Dong (Chao Yi Qian Wu Fen) - Ophiopogonis Radix (1.5 qian, stir-fried)
E Jiao Zhu (Yi Qian Wu Fen) - Gelatinum Corii Asini (1.5 qian)
Tian Xing Ren (Chao Xiang San Qian) - Armeniacae Semen (3 qian, stir-fried until fragrant)
Raw/Cooked Gu Ya (Ge Yi Qian) - Hordei Fructus Germinatus (1 qian each)
Nineteenth Visit: Nourishing Water/Yin, Stomach Qi recovering, sleepiness receding. Wind is Yang pathogen, Warm is heat qi. Injury is solely Yin fluids. But soft/greasy herbs cannot be used long. Use sweet-cool harmonizing/nourishing.
American Ginseng (Yi Qian Wu Fen) - Panacis Quinquefolii Radix (1.5 qian)
Raw Yu Zhu (San Qian) - Polygonati Odorati Rhizoma (3 qian)
Guang Ju Bai (Yi Qian) - Citri Reticulatae Pericarpium Album (1 qian)
Raw/Cooked Gu Ya (Ge Yi Qian) - Hordei Fructus Germinatus (1 qian each)
Chuan Shi Hu (Si Qian) - Dendrobii Caulis (4 qian)
Raw Licorice (San Fen) - Glycyrrhizae Radix et Rhizoma (0.3 qian)
Raw Shan Yao (San Qian) - Dioscoreae Rhizoma (3 qian)
Tian Xing Ren (San Qian) - Armeniacae Semen (3 qian)
Fan Zhi Qu (Yi Qian) - Massai Medicamentum (1 qian)
Patient Lu (Female). Cough unsmooth, fever with sweat not resolving. Qi rebelling upward. Loose stools. Pulse rapid, right large. Coating thick, center yellow. Wind-Warmth attacking Lung/Stomach. Disease just seven days,