为势甚炽。
牛蒡子（三钱） 川贝母（二钱） 甜广皮（一钱） 杏仁（三钱） 竹茹（水炒二钱） 生甘草（四分）
炙桑皮（二钱） 大连翘（三钱） 茯苓（三钱）
二诊 苔黄稍化。仍然腻浊，大便不利，每至日晡，辄仍凛热。外风引动湿热，郁阻营卫。再为宣化。
杏仁（三钱） 蔻仁（五分） 淡芩（一钱） 滑石（三钱） 鲜竹茹（水炒一钱） 米仁（三钱）
广郁金（一钱五分） 通草（一钱） 赤茯苓（三钱） 鲜佛手（一钱）
三诊 轻宣肺气而化湿邪，每晨汗出，上焦之湿，理当从汗而解，乃日晡仍然似疟，便不畅行，腹膨脘
痞欲呕，频转矢气。脉形滑数。此必有形之积，阻而不化。拟导滞兼清湿热。
南楂炭（三钱） 缩砂仁（五分） 云茯苓（三钱） 青陈皮（各一钱） 泽泻（二钱） 范志曲（二钱）
莱菔子（炒研三钱） 木香槟榔丸（三钱先服）
恩（左） 温邪将及两候，发热有汗不解，夜甚无寐，胸闷不舒，烦渴而不欲饮。脉数，右部沉郁，左部弦大，
舌红苔黄，根带灰霉。无形之邪，有形之湿，熏蒸不化，遂致清津不能上供，阴液由此渐亏。恐化燥而神
机不运，渐成昏蔽。拟退热泄湿。即请商裁。
羚羊片（一钱五分） 淡芩（一钱五分） 光杏仁（三钱） 赤苓（三钱） 生米仁（三钱） 连翘壳（三钱）
广郁金（一钱五分） 滑石块（三钱） 通草（一钱） 生梨汁（一两） 芦根（打汁调一两） 白蔻仁（三分先服）
二诊 流湿润燥，参以退热，热势外扬，能得微汗，口渴大减。然大便不行，大腹满痛，频转矢气。脉象滑
数。正合阳明病频转矢气之条，以丸药缓下。即请商裁。
豆豉（三钱） 郁金（一钱五分） 滑石（二钱） 赤苓（三钱） 杏仁（三钱） 楂炭（三钱）
淡芩（酒炒一钱五分） 通草（一钱） 枳实导滞丸（三钱先服）
三诊 热势降序，仍然起伏，大腹满痛，频转矢气，大便不行。脉数左弦，舌尖红绛。阴伤热恋，宿滞不达。
再泄热利湿，参以磨滞。
连翘壳（三钱） 细生地（五钱） 滑石块（三钱） 黄芩（一钱五分） 栝蒌仁（五钱） 黑山栀（三钱）
光杏仁（三钱） 通草（一钱） 枳实（一钱五分） 芦根（一两） 青竹叶（二十片）
改方停药，饮白残花露佛手露各二两。
四诊 大便畅行，热痰悉化。然频渴欲饮。舌红苔白，根带灰黑。阴伤不复。再泄热和阴。
生地 川连 花粉 青蒿 竹叶 阿胶 连翘 滑石 杏仁 芦根
谢（右） 辛凉疏泄，汗未畅达，热仍不解，头胀耳鸣。脉数右大。风温袭于肺胃，不能外达，三日正炽。
淡豆豉（三钱） 薄荷（一钱） 连翘（二钱） 池菊花（二钱） 枳壳（一钱炒） 牛蒡子（三钱）
桔梗（一钱） 桑叶（一钱五分） 光杏仁（三钱） 广郁金（一钱五分） 宋半夏（一钱五分）
二诊 疏泄肺胃，得汗甚畅，邪从汗解，热势大减，胀痛渐松。苔黄较化，脉亦略缓。然炉烟虽熄，余烬未
消，身热尚未尽退。还宜疏泄余邪。
桑叶（一钱五分） 杏仁（三钱） 郁金（一钱五分） 山栀（二钱） 池菊花（一钱五分） 粉前胡（一钱）
苦桔梗（一钱） 连翘壳（三钱） 枳壳（一钱） 悉尼（切片入煎一两） 象贝母（二钱）
包（左） 温邪将及二候，上焦之热，移入大肠，发热便泄，懊烦不寐，频渴欲饮，耳窍失听。舌光无苔，干燥
无津，脉左大，重按无力。邪热不从外达，灼烁于内，阴津损伤，往往有液劫而神昏者，不可不知。拟养津泄热。
鲜石斛（六钱） 连翘（三钱） 黑栀皮（三钱） 香豉（三钱） 淡黄芩（一钱五分） 鲜生地（六钱）
滑石（三钱） 桔梗（一钱） 桑叶（一钱五分） 芦根（一两）
二诊 便泄已止，热势虽不甚盛，而仍神烦少寐，口渴欲饮，舌燥无津，既干且腻，右目红赤作痛。脉数
左大。风温夹湿化热，由大肠还于肺胃，气燥津伤。拟流湿润燥，开泄风热。
桑叶 薄荷 荆芥 连翘壳 朱茯神 桔梗
甘菊花 鲜石斛 晚蚕砂 辰灯心 蔻仁末（三分另用鲜芦根二两打汁调服）
左 时病八日，始则发热便泄，继而呃逆频频，便泄虽止，而表热入里，遂致里热神烦，频渴欲饮，面色
浮红。舌苔焦黑无津，脉象细数。此由邪热不从外达，转从内陷，劫烁阴津，所以满舌焦干，气火上冲，吸
气不得入，所以频频呃逆，将有神昏发痉之变。勉拟存阴救津，兼清龙相，以平其冲逆之威。能否应手，
非敢所知也。
大生地（四钱） 阿胶珠（二钱） 赤茯苓（三钱） 大麦冬（三钱） 生草（五分） 鲜竹茹（一钱五分）
柿蒂（五枚） 枇杷叶（去毛一两） 大补阴丸（三钱先服）
方（左） 风温两候，风化为火，火风内旋，由壮热懊烦而致螈 。叠经泄热和阴，火风渐平，烙热亦定，乃
大便通行之后，频见溏泄，咽痛鼻红，咳嗽痰多稠黄，耳窍闭塞。脉象数大，重按带弦，舌红苔黄。沸腾之
风火虽熄，而气分之热，何能遽化。风痰为热所灼，自然色变黄稠。气燥则清窍不利，自然两耳失聪。咽
通于胃，喉通于肺，今肺胃两经，为风热渊薮，自然咽中作痛。大肠与胃相联续，与肺相表里，热盛之下，
府气失通，肺胃之热，乘热下移，再以牛乳横助其虐，所以大便为之频泄。为今之计，惟有清化肺胃，以
清肠热。与式训仁兄大人同议方。
射干（六分） 桔梗（一钱） 川斛（五钱） 黑山栀（三钱） 细木通（五分） 前胡（一钱）
淡芩（一钱五分） 连翘（三钱） 六一散（三钱） 茅根（一两） 竹叶（十二片）
浦（左） 咳嗽头胀发热，寤难成寐，知饥欲食。脉数而弦。风温袭于外，肝火炽于内。姑疏风泄热。
桑叶（一钱五分） 薄荷（一钱） 前胡（一钱） 黄芩（酒炒一钱五分） 竹茹（水炒一钱五分） 菊花（一钱）
象贝（二钱） 黑山栀（三钱） 粉丹皮（二钱） 枳实（一钱炒）
二诊 辛凉散风，微苦泄热，邪势不达，未能得汗，咳嗽头痛，恶风。邪尚在表，再进辛凉。
桑叶（二钱） 炒枳壳（二钱） 前胡（一钱五分） 牛蒡子（三钱） 光杏仁（三钱） 菊花（二钱）
白桔梗（一钱） 象贝（二钱） 薄荷（一钱） 竹茹（水炒一钱五分）
秦（左） 发热烦渴，胸闷气逆，频咳痰多，神烦少寐。脉数糊滑。此风温挟湿，郁蒸肺胃。症逾两候，恐致昏喘。
桑叶 制半夏 桔梗 冬瓜子 水炒竹茹 青芦管 前胡 橘红 生薏仁 光杏仁 通草
二诊 气逆稍定，热亦渐减，而脉仍滑数。还是肺胃之湿未楚也。再为降化。
光杏仁 生薏仁 制半夏 赤茯苓 云茯苓 炒苏子
橘红 冬瓜子 生香附 丝通草 旋复花 炒枳壳 水炒竹茹
顾（左） 发热咳嗽多痰，喉间霍霍有声，胸闷神烦。脉数而滑。此温邪挟湿，蒸于肺胃。七日正炽。
甜葶苈 光杏仁 制半夏 炒枳壳 炒苏子 金沸草 薄橘红 赤茯苓 云茯苓
居（童） 先是口碎作痛，四日前忽然热起，势甚炽张，胸闷懊烦，鼻衄便泄，兹则咽中作
痛。舌红苔白，脉数滑大。此风邪先袭于上，复以时令之邪与湿相合，致一阴一阳之火，俱结于上。病
属风温，方在五日，邪势炽甚之际，当是易进难退之时也。
泡射干（六分） 广郁金（六分冲） 马勃（一钱五分） 荆芥（一钱） 牛蒡子（三钱） 炒银花（
一钱五分） 连翘壳（三钱半） 玄参（三钱） 桔梗（一钱） 杏仁泥（三钱） 竹叶心（十六片）
竹叶心 桔梗（二味代茶）
改方加黄芩酒炒秦艽。
二诊 前进辛以散风，苦以泄热，汗出邪势从外而泄。而肺胃之热蕴结，痧疹并发而不少衰，痛不少
减。脉数滑大，舌红边绛。喉关以内，白腐满布，喉肿关小微咳。此炉烟甫熄，余烬复燃，肺胃之热，冲斥于
中，喉疳重症，出入极为迅速。恐火烁肺金，而致气喘。商请专门名家酌夺。
郁金（一钱五分） 山豆根（三钱） 京玄参（三钱） 羚羊片（先煎二钱） 连翘（三钱） 大贝母（三钱）
桔梗（一钱五分） 生石膏（七钱打） 牛蒡子（三钱） 射干（七分） 茅根（去心一两） 芦根（
去节一两） 鲜荷叶（七钱）
三诊 昨进大剂泄热，热势大为轻减，喉肿较退，痛势大轻。涎水之自涌者，至此渐能下咽。脉洪大略
收火风之灼铄肺胃者，已退三舍，当乘胜而助鼓再进。
羚羊片（二钱） 玄参肉（三钱） 牛蒡子（三钱） 鲜石斛（六钱） 连翘（三钱） 生石膏（七钱）
泡射干（六分） 荆芥（一钱） 黑山栀（三钱） 苦桔梗（二分） 鲜荷叶络（七钱） 茅根（去心一两）
芦根（去节一两）
某 气喘不定，痰多稠浓。苔白转黄，舌边尖红绛，唇朱颧赤，脉数至六至以外。夫风为阳邪，阳邪易于
化火，所有痰浊，尽从阳化，华盖之脏，独当其炎，所以清肃之令不行，右降之权尽失。痰鸣气喘， 如梦
语，将有耗气伤阴等变矣。
磨犀尖（四分） 杏仁泥（三钱） 桑白皮（二钱） 冬瓜子（四钱） 生石膏（五钱） 肥知母（二钱炒）
马兜铃（一钱五分） 川贝母（二钱炒） 生薏仁（四钱） 栝蒌霜（三钱） 茯苓（三钱） 连翘（三钱）
青芦管（一两） 枇杷叶（去毛一两）
某 风温大势已解，而痰热未清，咳恋痰稠黄浓，火升少寐。右寸脉独大。良以邪热灼肺，手太阴清肃
无权，则足太阴转输失职，致热蒸而炼液成痰，痰火因而内炽。鼻准清冷，乃气机之闭郁，以兼症之中，
别无元阳衰脱之见端也。拟清化痰热而肃肺气。
茯苓（三钱） 黑山栀（一钱五分） 海浮石（三钱） 炒蒌皮（三钱） 川贝母（二钱） 杏仁泥（三钱）
冬瓜子（五钱） 风化硝（五分） 新绛（五分） 枇杷叶（去毛四片） 竹茹（一钱五分盐水炒）
灯心（盐水拌三尺）
贾（左） 症起四日，壮热无汗，肢体烦疼，头胀作痛，痰多口腻。脉数右部浮大。夫热重而至炙手，自必懊
烦闷，此时尚无烦懊情形，其热之尚在肌表，显然可见。考太阳为六经之首，主皮肤而统卫气。今风
邪在表，阳气屈曲不伸，故发热头疼。其所以不能作汗者，良由湿痰素盛，内壅不宣，则表邪难达，吴又
可先生所谓水注闭其后窍，则前窍涓滴，此正发汗之义也。肢体之痛，左胁为甚，肝藏居左，风气通于
肝也。拟于疏解之中，参入化痰，必得汗泄方能推散，然不易也。
荆芥穗（一钱五分） 霜桑叶（一钱五分） 羌活（一钱） 广郁金（磨冲六分） 旋复花（绢包二钱） 制半
夏（一钱五分） 橘红（一钱） 赤白苓（各二钱） 光杏仁（三钱） 真猩绛（六分） 枳实（一钱五分
）竹茹（一钱） 桔梗（一钱）
改方去羌活猩绛，加香附橘络秦艽。
二诊 汗出，肌表之邪，由此外达，热势大退，遍体烦疼亦止，神情亦觉爽适。但脉仍带数，热退未楚，偏
左瘕积阻滞，气道失宣，气短腋痛。脉数微滑，邪势渐去，湿热未清。再舍其标而治其本。
杏仁（三钱） 蔻仁（三粒） 橘红（一钱） 豆卷（三钱） 制半夏（一钱五分） 云茯苓（四钱）
广郁金（一钱五分） 薏仁（四钱） 炒枳壳（一钱） 炒蒌皮（三钱） 炒苏子（三钱）
某 风温之后，恣食甜腻，酿湿生痰，肺降痹阻，以致热退不清，痰鸣气急，不能安眠。苔白不渴，脉左大，
右部软滑。心胸不舒，气弱生寒，阳不旋转。恐喘甚汗脱。
葶苈子（五分） 杏仁泥（三钱） 茯苓（三钱） 制半夏（一钱五分） 方通草（一钱） 炒苏子（三钱）
橘红（一钱） 白前（一钱五分） 旋复花（一钱五分） 生米仁（三钱）
邹（右） 天燥太过，肺胃风热内烁，更兼肝火凌金，咳痰带血，沉迷多睡。脉数而滑。盖阴虚则火炽，其热
势内蕴胸中，如姻雾弥漫，所以沉迷而多睡也。恐昏痉等变。从云瞻兄方中，参入扩清胸中之热。
黑山栀（三钱） 栝蒌霜（三钱） 海浮石（三钱） 篾竹叶（一把） 真川贝（五分） 上濂珠（三分二味研
极细末调服）
左 风温袭于肺胃，咳嗽壮热神烦，更兼天气亢燥，温燥之邪，化气为湿，以致肺热脾湿相蒸，痰黄而
稠。日来热恋不解，咳亦不止，形色瘦削。脉数小软。营气日亏，邪势留恋，若再缠绵，必生变局。治法惟有
泄化邪湿，庶可保全元气耳。
大豆卷 杏仁泥 生薏仁 前胡 川贝母 桔梗
通草 滑石 炒栝蒌皮 枇杷叶（去毛）
徐 （右）咳剧身热，痰稠头目昏晕，胁痛神烦不寐。脉数弦滑此风温袭肺，化热内灼。适值经来，有暴喘之虞。
连翘（三钱） 天花粉（二钱） 桑叶（一钱） 光杏仁（打三钱） 广郁金（一钱五分） 山栀（三钱）
川贝母（二钱） 甘菊花（一钱五分） 丝瓜子（打三钱） 丹皮炭（二钱） 枇杷叶（去毛炙四片）
The pathogenic heat is extremely fierce.
Babaozi (Folium Arctii, 3 qian) Chuanbeimu (Bulbus Fritillariae Cirrhosae, 2 qian) Tianguangpi (Pericarpium Citri Reticulatae, 1 qian) Xingren (Semen Armeniacae Amarum, 3 qian) Zhuru (Caulis Bambusae in Taeniam, stir-fried with water, 2 qian) Shenggancao (Radix Glycyrrhizae Preparata, 4 fen)
Zhisangpi (Cortex Mori Radicis, 2 qian) Dalianqiao (Fructus Forsythiae, 3 qian) Fuling (Poria, 3 qian)
Second visit: The yellow tongue coating has slightly receded but remains greasy and turbid. Bowel movements are unsmooth. Every day at dusk, chills and fever recur. External wind stirs up damp-heat, causing stagnation and obstruction of Ying and Wei. Treatment again focuses on dispersing and resolving.
Xingren (Semen Armeniacae Amarum, 3 qian) Kourén (Semen Amomi Rotundum, 5 fen) Danqin (Radix Scutellariae, 1 qian) Huashi (Talcum, 3 qian) Xianzhuru (Fresh Caulis Bambusae in Taeniam, stir-fried with water, 1 qian) Miren (Semen Coicis, 3 qian)
Guangyujin (Radix Curcumae Longae, 1.5 qian) Tongcao (Medulla Tetrapanacis, 1 qian) Chifuling (Poria cum Rubro, 3 qian) Xianfoshou (Fructus Aurantii, fresh, 1 qian)
Third visit: After lightly dispersing Lung Qi to resolve dampness, sweating occurs every morning. Dampness in the Upper Jiao should theoretically be resolved through sweating. However, chills and fever resembling malaria persist at dusk. Bowel movements are unsmooth, abdomen is distended, epigastrium feels stifled with nausea, and there is frequent passage of flatus. The pulse is slippery and rapid. This indicates the presence of tangible accumulation obstructing and failing to transform. The proposed method is to guide out stagnation while clearing damp-heat.
Nanzhatan (Carbonized Fructus Crataegi, 3 qian) Suosharen (Semen Amomi Rotundum, 5 fen) Yunfuling (Poria, 3 qian) Qingchenpi (Pericarpium Citri Reticulatae Viride et Pericarpium Citri Reticulatae, 1 qian each) Zexie (Rhizoma Alismatis, 2 qian) Fanzhiqu (Massa Medicata Fermentata Chinensis, 2 qian)
Laifuzi (Stir-fried and ground Semen Raphani, 3 qian) Muxiangbinglang Wan (Pilula Magnolioliae et Arecae, 3 qian taken first)
En (Left): Warm pathogen has persisted for nearly two periods. Fever with sweating does not resolve; symptoms worsen at night with insomnia. Chest oppression and discomfort, irritability, thirst without desire to drink. Pulse is rapid; right side is deep and stagnant, left side is wiry and large. Tongue is red with yellow coating, root showing grayish mold-like appearance. Intangible pathogen combined with tangible dampness steams and fails to transform, preventing clear fluids from ascending, leading to gradual depletion of Yin fluids. There is fear of transformation into dryness causing dysfunction of Shen mechanism, potentially progressing to confusion and obscuration. Proposed treatment: reduce heat and drain dampness. Please advise.
Lingyangpian (Cornu Saigae Tataricae, 1.5 qian) Danqin (Radix Scutellariae, 1.5 qian) Guangxingren (Semen Armeniacae Amarum, 3 qian) Chiling (Poria cum Rubro, 3 qian) Shengmiren (Semen Coicis, 3 qian) Lianqiaoqiao (Fructus Forsythiae, 3 qian)
Guangyujin (Radix Curcumae Longae, 1.5 qian) Huashikuai (Talcum, 3 qian) Tongcao (Medulla Tetrapanacis, 1 qian) Shenglizhi (Succus Pyri Sinensis, 1 liang) Lugeng (Rhizoma Phragmitis, juice prepared, 1 liang) Baikourén (Semen Amomi Rotundum, 3 fen taken first)
Second visit: Flowing moisture moistens dryness, combined with heat-reducing measures. Heat expands outward, allowing slight sweating. Thirst is significantly reduced. However, bowel movements remain blocked, lower abdomen is full and painful, with frequent passage of flatus. Pulse is slippery and rapid. This aligns with the syndrome of Frequent Flatus in Yangming Disease. Use pills for mild purgation. Please advise.
Douchi (Semen Sojae Preparatum, 3 qian) Yujin (Radix Curcumae Longae, 1.5 qian) Huashi (Talcum, 2 qian) Chiling (Poria cum Rubro, 3 qian) Xingren (Semen Armeniacae Amarum, 3 qian) Zhatan (Carbonized Fructus Crataegi, 3 qian)
Danqin (Stir-fried with wine Radix Scutellariae, 1.5 qian) Tongcao (Medulla Tetrapanacis, 1 qian) Zhishi Daozhi Wan (Pilula Akebiae et Immaturae Trilobae, 3 qian taken first)
Third visit: Heat intensity decreases sequentially but fluctuates. Lower abdomen is full and painful, frequent passage of flatus, bowel movements blocked. Pulse is rapid and wiry on the left; tongue tip is red and crimson. Yin injury with lingering heat, old stagnation not discharged. Re-treatment: drain heat, promote urination to remove dampness, and assist in grinding down stagnation.
Lianqiaoqiao (Fructus Forsythiae, 3 qian) Xi Shengdi (Radix Rehmanniae Preparata, 5 qian) Huashikuai (Talcum, 3 qian) Huangqin (Radix Scutellariae, 1.5 qian) Gualouren (Semen Benincasae, 5 qian) Heishanzhi (Fructus Gardeniae, 3 qian)
Guangxingren (Semen Armeniacae Amarum, 3 qian) Tongcao (Medulla Tetrapanacis, 1 qian) Zhishi (Fructus Aurantii Immaturus, 1.5 qian) Lugeng (Rhizoma Phragmitis, 1 liang) Qingzhuye (Folium Nelumbinis, 20 leaves)
Prescription changed, medication stopped. Drink Bicanhua Lu (White Remnant Flower Dew) and Foshou Lu (Finger Citron Dew), 2 liang each.
Fourth visit: Bowel movements flow freely, hot phlegm is completely resolved. However, frequent thirst and desire to drink persist. Tongue is red with white coating, root showing gray-black. Yin injury has not recovered. Re-treatment: drain heat and harmonize Yin.
Shengdi (Radix Rehmanniae Preparata) Chuanlian (Rhizoma Coptidis) Huafen (Radix Angelicae Dahuricae) Qinghao (Herba Artemisiae Annuae) Zhuye (Folium Nelumbinis) Ejiao (Colla Corii Asini) Lianqiao (Fructus Forsythiae) Huashi (Talcum) Xingren (Semen Armeniacae Amarum) Lugeng (Rhizoma Phragmitis)
Xie (Right): Acrid-cool dispersing and draining failed to produce adequate sweating; heat persists unresolved. Head distension and tinnitus. Pulse is rapid and large on the right. Wind-warmth attacks Lung and Stomach, unable to reach exterior. On the third day, pathogenic force is intense.
Danshouchi (Prepared Semen Sojae, 3 qian) Bohe (Herba Menthae, 1 qian) Lianqiao (Fructus Forsythiae, 2 qian) Chiju hua (Flos Chrysanthemi Indici, 2 qian) Zhike (Fructus Aurantii, stir-fried, 1 qian) Niubangzi (Fructus Arctii, 3 qian)
Jiegeng (Radix Platycodonis, 1 qian) Sangye (Folium Mori, 1.5 qian) Guangxingren (Semen Armeniacae Amarum, 3 qian) Guangyujin (Radix Curcumae Longae, 1.5 qian) Songbanxia (Rhizoma Pinelliae Preparatum, 1.5 qian)
Second visit: Dispersing and draining Lung and Stomach resulted in profuse sweating, pathogen released via sweat, heat significantly reduced, distension and pain gradually relieved. Yellow tongue coating has largely resolved, pulse slightly slower. Although the furnace smoke has extinguished, embers remain; body heat is not fully subsided. Still suitable to disperse residual pathogen.
Sangye (Folium Mori, 1.5 qian) Xingren (Semen Armeniacae Amarum, 3 qian) Yujin (Radix Curcumae Longae, 1.5 qian) Shanzhi (Fructus Gardeniae, 2 qian) Chujuhua (Flos Chrysanthemi Indici, 1.5 qian) Fen Qianhu (Radix Peucedani, 1 qian)
Ku Jiegeng (Radix Platycodonis, 1 qian) Lianqiaoqiao (Fructus Forsythiae, 3 qian) Zhike (Fructus Aurantii, 1 qian) Xini (Slice for decoction, 1 liang) Xiangbeimu (Bulbus Fritillariae Thunbergii, 2 qian)
Bao (Left): Warm pathogen has persisted for nearly two periods. Heat from Upper Jiao transfers to Large Intestine. Fever with diarrhea, restlessness and irritability, insomnia, frequent thirst and desire to drink. Ear orifices lose hearing. Tongue is bare without coating, dry without fluid. Pulse is large on the left, powerless upon heavy pressure. Pathogenic heat does not reach exterior, scorches internally, damaging Yin fluids. Often leads to fluid exhaustion and Shen confusion, which must be known. Proposed treatment: nourish fluids and drain heat.
Xianshihu (Herba Dendrobii, 6 qian) Lianqiao (Fructus Forsythiae, 3 qian) Heizhipi (Pericarpium Gardeniae, 3 qian) Xiangchi (Prepared Semen Sojae, 3 qian) Dan Huangqin (Radix Scutellariae, 1.5 qian) Xian Shengdi (Fresh Radix Rehmanniae, 6 qian)
Huashi (Talcum, 3 qian) Jiegeng (Radix Platycodonis, 1 qian) Sangye (Folium Mori, 1.5 qian) Lugeng (Rhizoma Phragmitis, 1 liang)
Second visit: Diarrhea has stopped. Although heat is not severe, there is still mental restlessness and little sleep. Thirst with desire to drink. Tongue is dry without fluid, both dry and greasy. Right eye is red, swollen, and painful. Pulse is rapid and large on the left. Wind-warmth combined with dampness transforms into heat, returning from Large Intestine to Lung and Stomach. Qi is dry, fluids injured. Proposed treatment: flow moisture to moisten dryness, open and drain wind-heat.
Sangye (Folium Mori) Bohe (Herba Menthae) Jingjie (Herba Schizonepetae) Lianqiaoqiao (Fructus Forsythiae) Zhu Fushen (Poria cum Parati et Rhizoma Polygalae) Jiegeng (Radix Platycodonis)
Gan Juhua (Flos Chrysanthemi Morifolii) Xianshihu (Herba Dendrobii) Wancansha (Spina Gossypii) Chen Dengxin (Medulla Junci) Kouren Mo (Powdered Semen Amomi Rotundum, 3 fen, separately mixed with juice of fresh Lugeng 2 liang)
Left: Time disease for eight days. Initially fever and diarrhea, subsequently frequent hiccup. Diarrhea stopped, but exterior heat entered interior, causing interior heat, mental restlessness, frequent thirst and desire to drink, flushed face. Tongue coating is scorched black without fluid, pulse is fine and rapid. This is due to pathogenic heat not reaching exterior, turning inward, seizing and scorching Yin fluids, resulting in a scorched dry tongue. Qi and fire rush upward, inhalation is difficult, hence frequent hiccups. Danger of Shen confusion and convulsions looms. Tentatively prescribe preserving Yin and saving fluids, clearing Dragon and Minister Fire to calm the upward rushing force. Whether effective is uncertain.
Da Shengdi (Radix Rehmanniae Preparata, 4 qian) Ejiaozhu (Colla Corii Asini bead, 2 qian) Chifuling (Poria cum Rubro, 3 qian) Da Maidong (Radix Ophiopogonis, 3 qian) Shengcao (Radix Glycyrrhizae Preparata, 5 fen) Xianzhuru (Fresh Caulis Bambusae in Taeniam, 1.5 qian)
Shidi (Calyx Persicae, 5 pieces) Pipaye (Folium Eriobotryae, de-haired, 1 liang) Dabu Yin Wan (Pilula Anemarrhenae et Asparagi, 3 qian taken first)
Fang (Left): Wind-warmth for two periods. Wind transforms into fire, fire and wind rotate internally. From high fever and irritability to convulsions. Repeated treatments of draining heat and harmonizing Yin have calmed fire and wind, fixed burning heat. After bowel movement became smooth, frequent loose stools appeared. Sore throat, nosebleed, cough with much thick yellow phlegm, ear blockage. Pulse is rapid and large, wiry upon heavy pressure. Tongue red with yellow coating. Although boiling wind-fire has extinguished, how can Qi-level heat resolve immediately? Wind-phlegm scorched by heat naturally turns yellow and thick. Dryness of Qi obstructs clear orifices, naturally causing deafness. Throat connects to Stomach, larynx to Lung. Now Lung and Stomach meridians are the source of wind-heat, naturally causing sore throat. Large Intestine connects to Stomach, is exterior-interior with Lung. Under excessive heat, Fu organ Qi loses regulation. Lung-Stomach heat moves downward with heat. Cow milk exacerbates this, hence frequent loose stools. Current plan: only clear and transform Lung and Stomach to clear intestinal heat. Discuss prescription with Brother Shixun.
Shegan (Radix Belamcandae, 6 fen) Jiegeng (Radix Platycodonis, 1 qian) Chuanhu (Rhizoma Dendrobii, 5 qian) Heishanzhi (Fructus Gardeniae, 3 qian) Xi Mutong (Caulis Akebiae, 5 fen) Qianhu (Radix Peucedani, 1 qian)
Danqin (Radix Scutellariae, 1.5 qian) Lianqiao (Fructus Forsythiae, 3 qian) Liuyisan (Six-to-One Powder, 3 qian) Maogen (Rhizoma Imperatae, 1 liang) Zhuye (Folium Nelumbinis, 12 leaves)
Pu (Left): Cough, head distension, fever, difficulty sleeping after waking, hunger with desire to eat. Pulse is rapid and wiry. Wind-warmth attacks externally, Liver fire blazes internally. Temporarily disperse wind and drain heat.
Sangye (Folium Mori, 1.5 qian) Bohe (Herba Menthae, 1 qian) Qianhu (Radix Peucedani, 1 qian) Huangqin (Stir-fried with wine Radix Scutellariae, 1.5 qian) Zhuru (Stir-fried with water Caulis Bambusae in Taeniam, 1.5 qian) Juhua (Flos Chrysanthemi Morifolii, 1 qian)
Xiangbei (Bulbus Fritillariae Thunbergii, 2 qian) Heishanzhi (Fructus Gardeniae, 3 qian) Fen Danpi (Cortex Moutan, 2 qian) Zhishi (Fructus Aurantii Immaturus, stir-fried, 1 qian)
Second visit: Acrid-cool disperses wind, slightly bitter drains heat. Pathogenic force does not reach exterior, no sweating achieved. Cough, headache, aversion to wind. Pathogen still in exterior. Advance acrid-cool again.
Sangye (Folium Mori, 2 qian) Chao Zhike (Fructus Aurantii, stir-fried, 2 qian) Qianhu (Radix Peucedani, 1.5 qian) Niubangzi (Fructus Arctii, 3 qian) Guangxingren (Semen Armeniacae Amarum, 3 qian) Juhua (Flos Chrysanthemi Morifolii, 2 qian)
Bai Jiegeng (Radix Platycodonis, 1 qian) Xiangbei (Bulbus Fritillariae Thunbergii, 2 qian) Bohe (Herba Menthae, 1 qian) Zhuru (Stir-fried with water Caulis Bambusae in Taeniam, 1.5 qian)
Qin (Left): Fever, irritability, thirst, chest oppression, rebellious Qi, frequent cough with much phlegm, mental restlessness, little sleep. Pulse is rapid, muddy, and slippery. This is Wind-warmth carrying dampness, stagnating and steaming Lung and Stomach. Symptoms exceed two periods, fear of confusion and panting.
Sangye (Folium Mori) Zhi Banxia (Rhizoma Pinelliae Preparatum) Jiegeng (Radix Platycodonis) Dongguazi (Semen Benincasae) Shui Chao Zhuru (Stir-fried with water Caulis Bambusae in Taeniam) Qing Luguan (Green Rhizoma Phragmitis) Qianhu (Radix Peucedani) Juhong (Exocarpium Citri Reticulatae) Sheng Yiren (Semen Coicis) Guangxingren (Semen Armeniacae Amarum) Tongcao (Medulla Tetrapanacis)
Second visit: Rebellious Qi slightly settled, heat gradually reduced, but pulse remains slippery and rapid. Dampness in Lung and Stomach is still not cleared. Again, descend and transform.
Guangxingren (Semen Armeniacae Amarum) Sheng Yiren (Semen Coicis) Zhi Banxia (Rhizoma Pinelliae Preparatum) Chifuling (Poria cum Rubro) Yunfuling (Poria) Chao Suzi (Fructus Perillae, stir-fried)
Juhong (Exocarpium Citri Reticulatae) Dongguazi (Semen Benincasae) Sheng Xiangfu (Rhizoma Cyperi, raw) Si Tongcao (Silk-threaded Medulla Tetrapanacis) Xuanfuhua (Capitulum Inulae, stir-fried) Chao Zhike (Fructus Aurantii, stir-fried) Shui Chao Zhuru (Stir-fried with water Caulis Bambusae in Taeniam)
Gu (Left): Fever, cough with much phlegm, rattling sound in throat, chest oppression, mental restlessness. Pulse is rapid and slippery. This is Warm pathogen carrying dampness, steaming Lung and Stomach. On the seventh day, pathogenic force is intense.
Tian Tingli (Semen Lepidii et Descurainiae) Guangxingren (Semen Armeniacae Amarum) Zhi Banxia (Rhizoma Pinelliae Preparatum) Chao Zhike (Fructus Aurantii, stir-fried) Chao Suzi (Fructus Perillae, stir-fried) Jin Feicao (Herba Oldenlandiae) Bo Juhong (Thin Exocarpium Citri Reticulatae) Chifuling (Poria cum Rubro) Yunfuling (Poria)
Ju (Child): Initially mouth ulcers and pain. Four days ago, sudden onset of fever, very fierce. Chest oppression, irritability, nosebleed, diarrhea. Now sore throat. Tongue red with white coating, pulse rapid, slippery, and large. Wind pathogen first attacked upper part, then seasonal pathogen combined with dampness, causing Yin and Yang fires to knot in the upper part. Disease belongs to Wind-warmth, only five days into illness. At the peak of fierce pathogenic force, it is a time when easy to enter but hard to retreat.
Pao Shegan (Steeped Radix Belamcandae, 6 fen) Guang Yujin (Radix Curcumae Longae, 6 fen mixed) Mabo (Pulvis Malaci, 1.5 qian) Jingjie (Herba Schizonepetae, 1 qian) Niubangzi (Fructus Arctii, 3 qian) Chao Yinhua (Flos Lonicerae Japonicae, stir-fried, 1.5 qian) Lianqiaoqiao (Fructus Forsythiae, 3.5 qian) Xuanshen (Radix Scrophulariae, 3 qian) Jiegeng (Radix Platycodonis, 1 qian) Xingren Ni (Paste of Semen Armeniacae Amarum, 3 qian) Zhuye Xin (Heart of Folium Nelumbinis, 16 leaves)
Zhuye Xin (Heart of Folium Nelumbinis) Jiegeng (Radix Platycodonis) (These two replace tea)
Change prescription, add Huangqin (Radix Scutellariae) stir-fried with wine and Qinjiao (Radix Gentianae Macrophyllae).
Second visit: Previous acrid to disperse wind, bitter to drain heat. Sweating occurred, pathogenic force drained outward. But heat in Lung and Stomach accumulated, rash erupted simultaneously without abatement, pain not reduced. Pulse rapid, slippery, large. Tongue red, edges crimson. Inside throat gate, white rot covers completely. Throat swollen, slight cough. Furnace smoke just extinguished, embers reignite. Heat in Lung and Stomach rushes and repels in the middle. Severe Hou Gan (throat ulcer), changes are extremely rapid. Fear of fire scorching Lung Metal, leading to panting. Consult specialized experts for decision.
Yujin (Radix Curcumae Longae, 1.5 qian) Shandougen (Radix Sophorae Tonkinensis, 3 qian) Jing Xuanshen (Radix Scrophulariae, 3 qian) Lingyang Pian (Cornu Saigae Tataricae, pre-decocted 2 qian) Lianqiao (Fructus Forsythiae, 3 qian) Da Beimu (Bulbus Fritillariae Thunbergii, 3 qian)
Jiegeng (Radix Platycodonis, 1.5 qian) Sheng Shigao (Mineral Gypsum, crushed, 7 qian) Niubangzi (Fructus Arctii, 3 qian) Shegan (Radix Belamcandae, 7 fen) Maogen (Rhizoma Imperatae, de-heart, 1 liang) Lugeng (Rhizoma Phragmitis, de-knot, 1 liang) Xian Heye (Folium Nelumbinis, fresh, 7 qian)
Third visit: Yesterday administered large dose to drain heat. Heat significantly reduced, throat swelling retreated, pain greatly lightened. Saliva gushing now gradually able to swallow. Pulse large and surging slightly restrained. Fire and wind scorching Lung and Stomach have retreated three stages. Should take advantage of victory and drum up courage to advance again.
Lingyang Pian (Cornu Saigae Tataricae, 2 qian) Xuanshen Rou (Cortex Scrophulariae, 3 qian) Niubangzi (Fructus Arctii, 3 qian) Xian Shihu (Herba Dendrobii, 6 qian) Lianqiao (Fructus Forsythiae, 3 qian) Sheng Shigao (Mineral Gypsum, 7 qian)
Pao Shegan (Steeped Radix Belamcandae, 6 fen) Jingjie (Herba Schizonepetae, 1 qian) Heishanzhi (Fructus Gardeniae, 3 qian) Ku Jiegeng (Radix Platycodonis, 2 fen) Xian Heye Luo (Net of Folium Nelumbinis, fresh, 7 qian) Maogen (Rhizoma Imperatae, de-heart, 1 liang) Lugeng (Rhizoma Phragmitis, de-knot, 1 liang)
Certain Patient: Irregular panting, much thick and dense phlegm. Tongue coating turns from white to yellow. Tongue edges and tip red and crimson. Lips vermilion, malar region red. Pulse rapid, exceeding six beats per breath. Wind is Yang pathogen, Yang pathogen easily transforms into fire. All turbid phlegm transforms from Yang. The organ covered by Hua Gai (Lung) alone bears the inflammation, so clear and descending command does not function, right-descending authority is completely lost. Phlegm rattling and panting, like dream speech. Danger of Qi consumption and Yin injury looms.
Mo Xijian (Ground Rhinoceros Horn, 4 fen) Xingren Ni (Paste of Semen Armeniacae Amarum, 3 qian) Sangbaipi (Cortex Mori Radicis, 2 qian) Dongguazi (Semen Benincasae, 4 qian) Sheng Shigao (Mineral Gypsum, 5 qian) Fei Zhimu (Rhizoma Anemarrhenae, stir-fried, 2 qian)
Madouling (Fructus Aristolochiae, 1.5 qian) Chuan Beimu (Bulbus Fritillariae Cirrhosae, stir-fried, 2 qian) Sheng Yiren (Semen Coicis, 4 qian) Gualou Shuang (Powdered Semen Benincasae, 3 qian) Fuling (Poria, 3 qian) Lianqiao (Fructus Forsythiae, 3 qian)
Qing Luguan (Green Rhizoma Phragmitis, 1 liang) Pipaye (Folium Eriobotryae, de-haired, 1 liang)
Certain Patient: Major trend of Wind-warmth has resolved, but Phlegm-Heat not cleared. Cough lingers with thick yellow dense phlegm. Fire rises, little sleep. Right Cun pulse uniquely large. Indeed, pathogenic heat scorches Lung. Hand-Taiyin lacks clear and descending authority, thus Foot-Taiyin fails in transportation duty. Heat steams and refines fluids into phlegm, Phlegm-Fire blazes internally. Nose tip is cold, indicating closure and depression of Qi mechanism. Among accompanying symptoms, no sign of Yuan Yang collapse. Proposed treatment: clear and transform Phlegm-Heat,肃 (purify/descend) Lung Qi.
Fuling (Poria, 3 qian) Heishanzhi (Fructus Gardeniae, 1.5 qian) Haifushi (Lapis Calcitae, 3 qian) Chao Loupi (Pericarpium Benincasae, stir-fried, 3 qian) Chuan Beimu (Bulbus Fritillariae Cirrhosae, 2 qian) Xingren Ni (Paste of Semen Armeniacae Amarum, 3 qian)
Dongguazi (Semen Benincasae, 5 qian) Fenghua Xiao (Sal Nitri, weathered, 5 fen) Xinjiang (New Crimson Silk, 5 fen) Pipaye (Folium Eriobotryae, de-haired, 4 slices) Zhuru (Caulis Bambusae in Taeniam, 1.5 qian stir-fried with salt water)
Dengxin (Medulla Junci, 3 chi soaked in salt water)
Jia (Left): Symptoms started four days ago. High fever without sweat, limb restlessness and pain, head distension and pain, much phlegm, sticky mouth. Pulse rapid, right side floating and large. When heat is heavy enough to scorch hands, one must feel irritable and stifled. Currently no such irritability, clearly indicating heat is still in muscle-surface. Sun Taiyang is the head of Six Meridians, governs skin and controls Wei Qi. Now Wind pathogen is in exterior, Yang Qi is bent and cannot extend, hence fever and headache. The reason for inability to sweat is due to abundant Damp-Phlegm internally obstructing and not venting, making exterior pathogen hard to reach. As Mr. Wu Youke said: if water blocks the rear orifice, the front orifice drops nothing. This is the true meaning of inducing sweating. Limb pain is worse on left hypochondrium. Liver stores reside on left, Wind Qi connects to Liver. Plan to include phlegm-resolving in dispersing. Must achieve sweating to push out pathogen, yet not easy.
Jingjisui (Achene Schizonepetae, 1.5 qian) Shuang Sangye (Frost-covered Folium Mori, 1.5 qian) Qianghuo (Rhizoma et Radix Notopterygii, 1 qian) Guang Yujin (Radix Curcumae Longae, ground and mixed, 6 fen) Xuanfuhua (Capitulum Inulae, wrapped in silk, 2 qian) Zhi Banxia (Rhizoma Pinelliae Preparatum, 1.5 qian) Juhong (Exocarpium Citri Reticulatae, 1 qian) Chi Bai Ling (Poria cum Rubro and Poria Alba, 2 qian each) Guang Xingren (Semen Armeniacae Amarum, 3 qian) Zhen Xingjiang (True Star Crimson, 6 fen) Zhishi (Fructus Aurantii Immaturus, 1.5 qian) Zhuru (Caulis Bambusae in Taeniam, 1 qian) Jiegeng (Radix Platycodonis, 1 qian)
Change prescription, remove Qianghuo and Xingjiang, add Xiangfu (Rhizoma Cyperi), Juluo (Reticulum Citri Reticulatae), Qinjiao (Radix Gentianae Macrophyllae).
Second visit: Sweating occurred, exterior pathogen reached outward, heat significantly retreated, whole-body restlessness and pain stopped, spirit feels refreshed. But pulse still carries rapidity, heat not fully cleared. Left-sided mass obstructs, Airway loses ventilation, shortness of breath, axillary pain. Pulse rapid, slightly slippery. Pathogenic force gradually leaving, damp-heat not cleared. Abandon branch to treat root.
Xingren (Semen Armeniacae Amarum, 3 qian) Kourén (Semen Amomi Rotundum, 3 grains) Juhong (Exocarpium Citri Reticulatae, 1 qian) Doujuan (Semen Sojae Germinatum, 3 qian) Zhi Banxia (Rhizoma Pinelliae Preparatum, 1.5 qian) Yunfuling (Poria, 4 qian)
Guang Yujin (Radix Curcumae Longae, 1.5 qian) Yiren (Semen Coicis, 4 qian) Chao Zhike (Fructus Aurantii, stir-fried, 1 qian) Chao Loupi (Pericarpium Benincasae, stir-fried, 3 qian) Chao Suzi (Fructus Perillae, stir-fried, 3 qian)
Certain Patient: After Wind-warmth, indulged in sweet and greasy food, brewing dampness and generating phlegm. Lung descending blocked, hence heat did not clear completely, phlegm rattling,急促 (rapid) breathing, unable to sleep peacefully. Tongue white, no thirst. Pulse large on left, soft and slippery on right. Chest and heart uncomfortable, Qi weak generating cold, Yang not rotating. Fear of severe panting and sweat collapse.
Tinglizi (Semen Lepidii et Descurainiae, 5 fen) Xingren Ni (Paste of Semen Armeniacae Amarum, 3 qian) Fuling (Poria, 3 qian) Zhi Banxia (Rhizoma Pinelliae Preparatum, 1.5 qian) Fang Tongcao (Square Medulla Tetrapanacis, 1 qian) Chao Suzi (Fructus Perillae, stir-fried, 3 qian)
Juhong (Exocarpium Citri Reticulatae, 1 qian) Baiqian (Rhizoma Cynanchi Stauntonii, 1.5 qian) Xuanfuhua (Capitulum Inulae, 1.5 qian) Sheng Miren (Semen Coicis, 3 qian)
Zou (Right): Heaven's dryness is excessive. Lung-Stomach Wind-Heat scorches internally, compounded by Liver Fire insulting Metal. Cough with blood-streaked phlegm, lethargy and excessive sleep. Pulse rapid and slippery. Indeed, Yin deficiency leads to blazing fire. Heat accumulates internally in chest, like fog spreading, hence lethargy and excessive sleep. Fear of confusion and convulsions. From Brother Yunzhan's prescription, add expansion and clearing of chest heat.
Heishanzhi (Fructus Gardeniae, 3 qian) Gualou Shuang (Powdered Semen Benincasae, 3 qian) Haifushi (Lapis Calcitae, 3 qian) Mie Zhuye (Stripped Folium Nelumbinis, a handful) Zhen Chuanbei (True Bulbus Fritillariae Cirrhosae, 5 fen) Shang Lianzhu (Top Pearl, 3 fen, these two ground to fine powder and mixed for administration)
Left: Wind-warmth attacks Lung and Stomach. Cough, high fever, mental restlessness. Coupled with weather being excessively dry, Warm-Dry pathogen transforms Qi into dampness. Thus Lung Heat and Spleen Dampness steam each other, phlegm becomes yellow and thick. Days pass with lingering heat unresolved, cough continues. Appearance is thin and emaciated. Pulse is rapid, small, and soft. Ying Qi declines daily, pathogenic force lingers. If prolonged, changes will occur. Treatment method: only drain and transform pathogenic dampness, thereby preserving Yuan Qi.
Da Doujuan (Semen Sojae Germinatum) Xingren Ni (Paste of Semen Armeniacae Amarum) Sheng Yiren (Semen Coicis) Qianhu (Radix Peucedani) Chuan Beimu (Bulbus Fritillariae Cirrhosae) Jiegeng (Radix Platycodonis)
Tongcao (Medulla Tetrapanacis) Huashi (Talcum) Chao Gualoupi (Pericarpium Benincasae, stir-fried) Pipaye (Folium Eriobotryae, de-haired)
Xu (Right): Severe cough, body heat, thick phlegm, dizziness of head and eyes, hypochondriac pain, mental restlessness, insomnia. Pulse rapid, wiry, slippery. This is Wind-warmth attacking Lung, transforming into heat and scorching internally. Coinciding with menstruation, danger of sudden panting exists.
Lianqiao (Fructus Forsythiae, 3 qian) Tianhuafen (Radix Angelicae Dahuricae, 2 qian) Sangye (Folium Mori, 1 qian) Guang Xingren (Semen Armeniacae Amarum, crushed 3 qian) Guang Yujin (Radix Curcumae Longae, 1.5 qian) Shanzhi (Fructus Gardeniae, 3 qian)
Chuan Beimu (Bulbus Fritillariae Cirrhosae, 2 qian) Gan Juhua (Flos Chrysanthemi Morifolii, 1.5 qian) Sigua Zi (Semen Trichosanthis, crushed 3 qian) Danpi Tan (Cortex Moutan carbonized, 2 qian) Pipaye (Folium Eriobotryae, de-haired and roasted, 4 slices)