渔庄沈 女孩邪火上郁，始喉痹，继及耳内颐部，延久不清，鼻塞气粗。宜清上焦为主
。
桔梗（钱半） 苦丁茶（钱半） 焦山栀（三钱） 淡竹叶（三钱） 连翘（三钱） 光杏仁（三
钱） 僵蚕（钱半） 人中黄（钱半） 夏枯草（三钱） 银花（二钱） 通草（钱半）
清煎三帖。
介按∶风热之邪，干于上焦气分，以致清窍不利，而喉痛颐肿，故治法以清解宣散。
安昌王 风热目涩，头疼胃馁，脉浮弦，呛咳，便结，舌微黄。宜清疏为妥。
桑叶（三钱） 蔓荆子（三钱） 天麻（八分） 生石决明（六钱） 甘菊花（二钱） 刺蒺藜（
三钱） 杏仁（三钱） 丹皮（二钱） 蕤仁（钱半） 青葙子（三钱） 谷精珠（三钱）
清煎四帖。
又 风热未净，脉弦濡，头疼已减。目涩胃馁。仍遵前法为妥（十二月十二日。）
桑叶（三钱） 钗斛（三钱） 煨天麻（八分） 蔓荆子（三钱） 甘菊（一钱） 生石决明（六
钱） 刺蒺藜（三钱） 谷芽（四钱） 蕤仁（钱半） 蝎梢（二钱） 谷精珠（三钱）
清煎四帖。
又 胃气尚馁，脉虚细，舌微黄，夜寐少安。姑宜养胃凝神。
钗斛（三钱） 炒枣仁（三钱） 谷芽（四钱） 远志（八分） 夜交藤（三钱） 茯神（四钱）
石决明（六钱） 丹皮（二钱） 蕤仁（钱半） 丹参（三钱） 刺蒺藜（三钱）
清煎四帖。
介按∶《局方》蝉花散，为治肝经郁热，风毒上攻，以致眼目涩痛之良剂。今此人头疼
咳嗽
，是属风热郁于肺经，故加杏仁以止咳，蕤仁以退赤，洵是对症发药。惟初诊之方，系从蝉
花散脱胎，则蝉衣不必减去，俾风热容易退净，次诊又加蝎梢，尤能善祛肝经蕴热，亦为佳
妙。三诊则肝热虽退，胃液未复，致肝不藏魂而夜寐少安，故以养胃柔肝，安神退热以善后
。
盛陵徐 温邪上郁，齿浮口臭，牙缝出血，脉细数，肢木。宜防牙疳。
淡竹叶（三钱） 乌元参（三钱） 细生地（三钱） 天花粉（三钱） 人中黄（三钱） 僵蚕（
钱半） 丹皮（三钱） 生石决明（六钱） 银花（三钱） 焦山栀（三钱） 知母（钱半）
清煎四帖。
介按∶胃脉络于上龈，大肠脉络于下龈，而胃又为五脏六腑之海，最善容纳，邪热入胃
，逼动肝阳，血溢而上结于龈，转成牙疳。此方清肝凉胃，为治牙疳之良剂。
Shen from Yuzhuang, a young girl: Pathogenic fire is constrained and stagnant in the upper jiao (Upper Burner), initially manifesting as throat obstruction (sore throat with swelling and difficulty swallowing), subsequently spreading to the ears and mandibular region. The condition has persisted without clearing, accompanied by nasal congestion and coarse breathing. Treatment should primarily focus on clearing the upper jiao.
Platycodonis Radix (Qianban) Luteaeviridis Folium (Qianban) Gardeniae Fructus Praeparatus (Sanqian) Lophatheri Herba (Sanqian) Forsythiae Fructum (Sanqian) Armeniacae Semen Amarum (Sanqian) Bombyx Batryticatus (Qianban) Humanis Faecis Extractum (Qianban) Prunellae Spica (Sanqian) Lonicerae Japonicae Flos (Erqian) Tectonae Caulis (Qianban)
Decoct in water, take three doses.
Commentary by Shao Jie: Wind-heat pathogen invades the qi level of the upper jiao, causing dysfunction of the clear orifices (orifices of the head and face), resulting in sore throat and mandibular swelling. Therefore, the treatment method focuses on clearing heat, resolving exterior pathogens, and diffusing stagnation.
Wang from Anchang: Dryness and irritation of the eyes due to wind-heat, headache, weak stomach qi, floating and wiry pulse, hacking cough, constipation, slightly yellow tongue coating. Treatment with clearing and dispersing methods is appropriate.
Mori Folium (Sanqian) Viticis Fructus (Sanqian) Gastrodiae Rhizoma (Bafen) Concha Arcae Preparata (Liuqian) Chrysanthemi Flos (Erqian) Tribuli Fructus (Sanqian) Armeniacae Semen (Sanqian) Moutan Cortex (Erqian) Brediae Semen (Qianban) Celosiae Semen (Sanqian) Pseudostellariae Granulum (Sanqian)
Decoct in water, take four doses.
Second visit: Wind-heat not yet fully cleared, wiry and soggy pulse, headache has decreased. Eye dryness and weak stomach qi persist. It is still appropriate to follow the previous method. (December 12th)
Mori Folium (Sanqian) Dendrobii Caulis (Sanqian) Gastrodiae Rhizoma Roasted (Bafen) Viticis Fructus (Sanqian) Chrysanthemi Flos (Yiqian) Concha Arcae Preparata (Liuqian) Tribuli Fructus (Sanqian) Hordei Fructus Germinatus (Siqian) Brediae Semen (Qianban) Scorpio Cauda (Erqian) Pseudostellariae Granulum (Sanqian)
Decoct in water, take four doses.
Third visit: Stomach qi remains weak, deficiency and fine pulse, slightly yellow tongue coating, sleep at night is slightly more peaceful. Temporarily suitable for nourishing the stomach and calming the spirit.
Dendrobii Caulis (Sanqian) Ziziphi Spinosae Semen Stir-fried (Sanqian) Hordei Fructus Germinatus (Siqian) Polygalae Radix (Bafen) Polygoni Multiflori Caulis (Sanqian) Poria (Siqian) Concha Arcae (Liuqian) Moutan Cortex (Erqian) Brediae Semen (Qianban) Salviae Miltiorrhizae Radix (Sanqian) Tribuli Fructus (Sanqian)
Decoct in water, take four doses.
Commentary by Shao Jie: *Chan Hua San* (Cicada Flower Powder) from the *Ju Fang* (Formulas of the Bureau) is an excellent remedy for liver channel constrained heat and wind-toxin attacking upward, causing eye dryness and pain. This patient’s headache and cough indicate wind-heat constrained in the lung channel; thus, adding Armeniacae Semen to stop cough and Brediae Semen to reduce redness is indeed prescribing medicine according to the syndrome. The initial prescription was derived from *Chan Hua San*, so Cicada Slough should not be removed, allowing wind-heat to be cleared easily. In the second visit, Scorpion Cauda was added, which effectively dispels latent heat in the liver channel, which is also excellent. By the third visit, although liver heat has subsided, stomach fluids have not recovered, leading to the liver failing to store the soul and disturbed sleep at night. Therefore, nourishing the stomach, softening the liver, calming the spirit, and reducing heat are used for convalescence.
Xu from Shengling: Warm pathogen constrained upward, swollen gums, bad breath, bleeding from gum spaces, fine and rapid pulse, numbness of limbs. Prevention of gingival gangrene (tooth rot/gum disease) is necessary.
Lophatheri Herba (Sanqian) Scrophulariae Radix Nigra (Sanqian) Rehmanniae Radix Tenuis (Sanqian) Trichosanthis Radix (Sanqian) Humanis Faecis Extractum (Sanqian) Bombyx Batryticatus (Qianban) Moutan Cortex (Sanqian) Concha Arcae Preparata (Liuqian) Lonicerae Japonicae Flos (Sanqian) Gardeniae Fructus Praeparatus (Sanqian) Anemarrhenae Rhizoma (Qianban)
Decoct in water, take four doses.
Commentary by Shao Jie: The collateral vessels of the Stomach connect to the upper gums, and those of the Large Intestine connect to the lower gums. The Stomach is the sea of the five zang and six fu organs, most capable of containing substances. When pathogenic heat enters the stomach, it forces liver yang to move hyperactively, causing blood to overflow and accumulate in the gums, transforming into gingival gangrene. This formula clears the liver and cools the stomach, making it an excellent remedy for treating gingival gangrene.