Library

A large dose of Dendrobii Caulis (Shihu, 石斛), Moutan Cortex (Danpi, 丹皮), Mori Folium (Sangye, 桑叶), and Phragmitis Rhizoma (Zhuye, 竹叶) was administered, resulting in recovery within three days. Yin-nourishing methods were used for convalescence, leading to gradual stabilization. Other cases, whether mild or severe, were cured uniformly by clearing heat and resolving pathogens.

It is also stated: Li Xinshu’s second son developed phlegm-cough and wheezing before the rash had fully erupted. His tongue coating was white and slippery, and his urine was not red. Some physicians prescribed Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) with Zhixue (Purple Snow), but it proved ineffective. I was then consulted. The right pulse was surging and slippery, accompanied by thirst. This indicated that due to extreme summer heat, Summerheat-Pathogen invaded the Lung, combining with pre-existing phlegm and obstructing the Lung’s regulation of Qi and water passages. Consequently, Qi mechanism stagnation prevented the rash from venting, the coating failed to resolve, and urine remained non-red. Warming and dispersing are strictly contraindicated; cooling blood is also inappropriate. I prescribed Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) combined with Weijing Tang (Reed Shoot Decoction), adding Xingren (Apricot Seed), Jiegeng (Platycodon Root), Xuanshu (Inula Flower), Pipaye (Loquat Leaf), and Haishi (Pumice). After administration, breathing stabilized, the rash emerged, the coating receded revealing a red tongue, and urine turned red. Recovery occurred within several days.

Furthermore: Mrs. Xu Gensheng, over forty years old, contracted measles during intense summer heat. Her relative, Shen Yueting, repeatedly applied heat-clearing and pathogen-resolving methods without subduing the disease severity, so he invited me to examine her. She had a robust physique with abundant phlegm, a very slippery and rapid pulse, restlessness with delirious speech, crimson tongue, flushed face, thirst with desire to drink, and constipation. I administered a large dose of Baihu Tang (White Tiger Decoction) plus Shuijiao (Rhino Horn - *Note: modern substitute usually Shengdi or Niuhuang in practice, but text says Shuijiao*), Xuanshen (Scrophularia Root), Yinhua (Honeysuckle Flower), Huafen (Trichosanthes Root), Beimu (Fritillaria Bulb), Zhuhuang (Bambusa Textilis Bamboo Moss), Zhuye (Bamboo Leaf), Zhuru (Bamboo Shavings), and Zhuli (Bamboo Juice), delivered with Guntan Wan (Rolling Phlegm Pill). After ingestion, dark, glue-like stool was passed, and pulse and symptoms gradually harmonized. Several days later, the pill was discontinued, but the condition worsened again, even reaching cold extremities (Jue). The pill was reinstated, and stability returned. This cycle repeated three times before the crisis subsided. Shen Yueting then used Baijin Wan (White Gold Pill) to clear residual phlegm from the diaphragm, followed by sweet-cool moistening methods to replenish body fluids and search out lingering heat, leading to gradual recovery.

Shen Minyuan’s "Qizheng Hui" (Collection of Strange Cases) records: When Wang Xie’an was young, excessive consumption of sour food after measles led to persistent coughing and choking. For over a year, he became emaciated, suffered from five-palm heat, and approached the state of Child Consumption (Tonglao). Someone advised him to take one whole egg (shell included) every day at dawn, beat it over a thousand times, add a little salt, brew it with boiling water, and drink it. He recovered after one hundred days.

Ye Lin’s Commentary: The selected dozens of cases cover various treatment methods. In recent times, the climate favors dryness and fire, making clearing and venting generally suitable. However, when heat transforms into phlegm, obstructing Qi mechanism and preventing rash toxin venting, contemporary physicians often fail to observe this, relying solely on exterior-dispersing methods. This vainly injures True Yin, leading to many deaths. Wang Mengying’s treatment of the cases of Li Xinshu and Xu Gensheng demonstrates great courage and insight. Nevertheless, treating heat syndromes with hot phlegm is not difficult. Observing Xu Xuanzhi’s treatment of Wang Juzhi, who had a heat syndrome but pre-existing cold phlegm, required skillful guidance and was particularly challenging. For children with inherent weakness, where excessive dispersing leads to Qi deficiency unable to expel toxins outward, Yu Chunshan’s approach of using sweet-cool methods to nourish Yin is correct. Overall, Zhang Xugu’s method of heavily adding Xuanshen to clearing-and-venting formulas to strengthen Water and nourish Yin without cloying is superior. For patients with weak Yuan Yang, adding Aconite (Fuzi) slightly to such formulas shows exceptional insight. Sun Wenyuan’s method of promoting urination to drain heat and Wu Qiao’s method of fumigation to vent toxins each contain profound principles. Students should study these carefully, adapting treatment to the specific disease rather than adhering rigidly to a single pattern.