案一（载伤寒论广要） 元罗太无先生治验
劳役受热，饮食失节，损伤脾胃，时发烦躁而渴，又食冷物过度，遂病身体困倦，头痛四肢逆冷，呕吐而心
下痞。医者不审，见其四肢逆冷，呕吐心下痞，乃用桂末三钱匕，热酒调服，仍以绵衣裹之，作阴毒伤寒治之，
汗遂大出，汗后，即添口干舌涩，眼白睛红，项强硬，肢体不柔和，小便淋赤，大便秘涩，循衣
摸床，如发狂状，问之则言语错乱，视其舌则赤而欲裂，朝轻暮剧，凡七八日，家人辈视为危殆，不望生全。予
诊其脉六七至，知其热症明矣，遂用大承气汤苦辛大寒之剂，服之利下三行，折其锐势；翌日以黄连解毒汤大
苦寒之剂，使徐徐服之，以去余热；三日后，病十分中减之五六，更与白虎加人参汤泻热补气，前症皆退；戒以
慎起居，节饮食，月余平复。
又案（载三世医验） 明陆养愚先生治验
史洞庭尊正，四月间患头痛发热，予诊其脉，洪数见于气口，用清解药二剂，大约柴葛栀芩之类，未服，
而病者之兄唐承尊延一医来，用大青龙汤二剂，病家止服一剂，夜间遍身如烧，口渴咽干，已有谵语矣。明日
唐复延其诊，又谓非伤寒，乃痛风也，用羌、独活，何首乌、牛膝等二剂，乃登高而歌，弃衣而走，骂詈不避
亲疏。史家复延予。予至，闻欲裸而出，令数妇人持之。予谓洞庭曰∶此阳症也，扰动之益剧，宜婉言谕之。
果如予言而止。因先用糖水法灌之，其势便缓，随以白虎加元明粉、芩、连、蒌仁、犀角，数帖而骂詈始止；
然犹或妄言，知大便久不去也；以润字丸三钱投之，夜出燥屎一二十枚，而谵语犹未全止；复进前汤，又以丸
药二钱投之，出燥屎数枚，溏便少许；又三日，方思粥饮，以清气养荣汤（归身、白芍、川芎、茯苓、木香、
豆蔻、陈皮、川连）调理之。
吴煦野公子，年二十三岁，精神极旺，三月清明节馆中归家，夜大醉遂有房事，五更小解，忽脐下作痛，
肠中雷鸣，小便不利，明日遂发寒热头痛。延医诊脉，自告以酒后犯远归之戒。医者疑是阴症伤寒，以理中汤两
剂令一日夜尽服之。第二日呕逆大作，烦躁口渴，饮食不进，昼夜不卧。延予延医，已第三日矣，其脉左弦右
洪，寸关有力，尺部尚和，面赤戴阳。予不知其服理中之故，出撮柴葛解肌汤（柴胡、葛根、赤芍、甘草、
黄芩、知母、川贝、生地、丹皮、石膏、淡竹叶）二剂。煦野及亲友见之大骇，因备述远归阴虚，投理中不减，
正拟倍加参附。予曰∶脉症俱阳，纵有房事，阴未尝虚，若再用参附，恐仙人亦难拯救。予令今夜必服此二剂，
庶不传里。病者自抱心虚，止服一剂。明早诊视，症尚不剧，脉仍洪大，并两尺亦大。予曰∶热邪已入腑矣，
日晡必剧。以白虎汤二剂投之，病者尚犹豫未决。予曰∶今日怕石膏，明日大黄也。延挨煎就未服，而烦渴躁
热大作，且有谵语。煦野公骇之。予曰∶此势所必然。连进二服，热略不减，于是群然议用大黄。予曰∶今日
大黄又用不得。仍以前方二剂与之，至五更始得少睡，早间诊视，两尺沉实，舌苔已浓，改用小陷胸汤送润字
丸一钱，至晚又进一钱，夜半出燥屎数十枚，热减泄止，大势始定；此后枳实黄连服至数十剂，少用滋补，即
痞膈饮食不能进，调治将二月，方得全愈。
又案（载张氏医通） 清张路玉先生治验
徐君育，素禀阴虚多火，且有脾约便血证，十月间患冬温，发热咽痛。里医用麻黄杏仁半夏枳橘之属，遂喘
逆倚息不得卧，声飒如哑，头面赤热，手足逆冷，右手寸关虚大微数，此热伤手太阴气分也。与葳蕤、甘草等药
不应，为制猪肤汤一瓯，令隔汤顿热，不时挑服，三日声清，终剂而痛如失。
又治郑墨林室，素有便红，怀妊七月，正肺气养胎时而患冬温，咳嗽咽痛如刺，下血如崩，脉较平时反觉
小弱而数，此热伤手太阴血分也。与黄连阿胶汤二剂，血止后，去黄连加葳蕤、桔梗、人中黄四剂而安。
又案 清吴鞠通先生治验
脉不浮而细数，大渴引饮大汗，里不足之热病也。用玉女煎法∶知母四钱，生石膏一两，桑叶三钱，麦冬、
细生地各五
钱，粳米一撮，甘草三钱。复诊∶昨用玉女煎法，诸症俱减，平素有消渴病，用玉女煎，大便稀溏加牡蛎，一
面护阴，一面收下∶牡蛎一两，生石膏五钱，炒知母二钱，麦冬、大生地各五钱，炙甘草三钱，粳米一撮；
终与益胃汤调理而愈。
又案 清王孟英先生治验
姚某，年未三旬，烟瘾甚大，适伊芳母病温而殁，劳瘁悲哀之际，复病温邪，胁痛筋掣，气逆痰多，热壮神
昏，茎缩自汗，医皆束手。所亲徐丽生瞩其速孟英诊之，脉见芤数，舌绛无津，有阴虚阳越，热炽液枯之险；
况初发即尔，其根蒂之不坚可知。与犀、羚、元参、知母，壮水熄风；苁蓉、楝实、鼠矢、石英，潜阳镇逆；
沙参、麦冬、石斛、葳蕤，益气充津；花粉、栀子、银花、丝瓜络，蠲痰清热。一剂知，四剂安，随以大剂养
阴而愈。
朱敦书令爱病温，医投温散，服二剂，遍身麻 ，月事适来，医进小柴胡汤，遂狂妄莫制，乞援于孟英。
脉至洪滑弦数，目赤苔黄，大渴不寐，是 因温邪而发，所以起病至今，时时大汗，何必再攻其表，汛行为热
迫于营，胡反以姜枣温之，参柴升之，宜其燎原而不可遏也。与大剂犀角、元参、生地、石膏、知母、花粉、
银花、竹叶、贝母、白薇，以清卫凉营，服后即眠，久而未醒。或疑为昏沉也，屡为呼唤。病者惊寤，即令家
人启箧易服，穿鞋梳头，告别父母，云欲往花神庙归位。人莫能拦，举家痛哭，急迓孟英复视脉象。嘱其家静
守勿哭，仍以前方加重，和以竹沥童便，灌下即安，继用养阴清热而愈。
毕方来室，患痰嗽碍眠，医与补摄，而至涕泪全无，耳闭不饥，二便涩滞，干嗽无痰，气逆自汗。孟英切
脉，右寸沉滑，左手细数而弦，乃高年阴亏，温邪在肺，未经清化，率为补药所锢，宜开其痹而通其胃，与蒌、薤、
紫菀、兜铃、杏、贝、冬瓜子、甘、桔、旋、茹之剂而安。
许少卿室，故医陈启东先生之从女也。夏初病温，何新之十进清解，病不略减，因邀诊于孟英。脉至弦洪
豁大，左手为尤，大渴大汗，能食妄言，面赤足冷，彻夜不瞑。孟英曰∶证虽属温，而真阴素亏，久伤思虑，
心阳外越，内风鸱张；幸遇明手，未投温散，尚可无恐。与龙、牡、犀、珠、龟板、鳖甲、贝母、竹沥、竹叶、
辰砂、小麦、元参、丹参、生地、麦冬为大剂投之，外以烧铁淬醋令吸其气，蛎粉扑止其汗，捣生附子贴于涌
泉穴。甫服一剂，所亲荐胡某往视，大斥王议为非，而主透疹之法。病家惑之，即煎胡药进焉。病者神气昏瞀，
又易服王药，渐以向愈，而阴不易复，频灌甘柔滋镇，月余始能起榻，季夏汛行，惟情志不怡，易生惊恐，与
麦、参、熟地、石英、茯神、龙眼、甘、麦、大枣、三甲等药善其后。
姚令舆室，素患喘嗽，复病春温，医知其本元久亏，投以温补，痉厥神昏，耳聋谵语，面赤舌绛，痰喘不
眠，医皆束手矣。延孟英诊之，脉犹弦滑，曰∶证虽危险，生机未绝，遽尔轻弃，毋乃太忍。与犀角、羚羊、
元参、沙参、知母、花粉、石膏，以清热熄风，救阴生液，佐苁蓉、石英、鳖甲、金铃、旋复、贝母、竹沥，
以潜阳镇逆，通络蠲痰，三剂而平。继去犀羚石膏，加生地黄，服旬日而愈。
余侄森伯，患发热面赤，渴而微汗。孟英视之曰∶春温也，乘其初犯，邪尚在肺，是以右寸之脉洪大，宜
令其下行由腑而出，则即可霍然。投知母、花粉、冬瓜子、桑叶、枇杷叶、黄芩、苇茎、栀子等药，果大便连
泻极热之水二次，而脉静身凉，知饥啜粥，遂痊。
王皱石广文令弟，患春温，始则谵语发狂，连服清解大剂，遂昏沉不语，肢冷如冰，目闭不开，遗溺不饮。
孟英诊其脉，弦大而缓滑，黄腻之苔满布，秽气直喷。投承气汤加银花、石斛、
黄芩、竹茹、元参、石菖蒲，下胶黑矢甚多，而神稍清，略进汤饮。次日去硝黄，加海蜇、莱菔、黄连、石膏，
服二剂而战解肢和，苔退进粥，不劳余力而愈。
褚芹香女校书，患月愆寒热，医以为损，辄投温补，驯至腹胀不饥，带淋便闭，溲涩而痛。孟英诊脉弦劲
而数。乃热伏厥阴，误治而肺亦壅塞也。与清肃开上之剂，吞当归龙荟丸，两服，寒热不作而知饥，旬日诸
恙悉安。
张养之，己亥九月间，患恶寒头痛，自饵温散，不效，邀孟英诊之。脉极沉重，按至骨则弦滑隐然，卧曲
房密帐之中，炉火重裘，尚觉不足以御寒，且涎沫仍吐，毫不作渴，胸腹无胀闷之苦，咳嗽无暂辍之时，惟大
解坚燥，小溲不多，口气极重耳。乃谓曰∶此积热深锢，气机郁而不达，非大苦寒以泻之不可也；重用硝黄犀
角，冀顽邪蕴毒得以通泄下行，则周身之气机自然流布矣。养之伏枕恭听，大为感悟，如法服之。越二日，大便
下如胶漆，秽恶之气达于户外，而畏寒即以降序，糜粥日以加增，旬日后粪色始正，百日后康健胜常。
段春木之室烂喉，内外科治之束手。姚雪蕉孝廉荐孟英视之，骨瘦如柴，肌热如烙，韧痰阻于咽喉，不能
咯吐，须以纸帛搅而曳之，患处红肿白腐，龈舌皆糜，米饮不沾，月事非期而至，按其脉，左细数，右弦滑。
曰∶此阴亏之体，伏火之病，失于清降，扰及于营。先以犀角地黄汤，清营分而调妄行之血；续与白虎汤加
西洋参等，肃气道而泻燎原之火；外用锡类散，扫痰腐而消恶毒；继投甘润药，蠲余热而充津液。日以向安，
月余而起。
廉按∶温热病，最怕发热不退及痉厥昏蒙，更有无端而发晕及神清而忽间以狂言者，往往变生不测，遇
此等证最能惑人，不比阳证阴脉阳缩舌卷撮空见鬼者，易烛其危也。要诀在辨明虚实，辨得真方可下手。
以余临证实验，温热实症，阳明胃肠病居多；温热虚症，少阴心肾病居多。前哲俞东扶颇有发明，试节述其说
曰∶今之所谓伤寒者，大概皆温热病耳。惟伤寒则足经为主，温热则手经病多。如风温之咳嗽鼻鼾，热病之神
昏谵语，或溏泻粘垢，皆手太阴肺、手厥阴心包络、手阳明大肠现证。甚者喉肿肢掣，昏蒙如醉，躁扰不宁，
齿焦舌燥，发 发颐等证，其邪分布充斥，无复六经可考，故不以六经法治耳。就予生平所验，初时兼挟表邪
者最多，仍宜发散，如防、葛、豉、薄、牛蒡、杏仁、滑石、连翘等，以得汗为病轻，无汗为病重。如有 ，
则参入蝉蜕、桔梗、芦根、西河柳之类；如有痰，则参入土贝、天虫、栝蒌、橘红之类，如现阳明证，则白虎承
气；少阳证则小柴胡去参半，加花粉、知母；少阴证，则黄连阿胶汤、猪苓汤、猪肤汤；俱宗仲景六经成法
有效。但温热病之三阴证多死，不比伤寒；盖冬不藏精者，东垣所谓肾水内竭，孰为滋养也。惟大剂养阴，佐以
清热，或可救之。养阴如二地、二冬、阿胶、丹皮、元参、人乳、蔗浆梨汁，清热如三黄、石膏、犀角、大青、知母、
芦根、茅根、金汁、雪水、西瓜、银花露、丝瓜汁，随其对症者选用。
[Case 1] (Recorded in *Guang Yao Lun Shang Han*) Treatment experience of Mr. Luo Taiwu from the Yuan Dynasty
Due to excessive labor and heat exposure, coupled with irregular diet, the spleen and stomach were damaged, leading to frequent irritability and thirst. Additionally, excessive consumption of cold foods resulted in body fatigue, headache, cold limbs, vomiting, and epigastric fullness (Xin Xia Pi). The physician failed to carefully examine the condition; seeing the cold limbs, vomiting, and epigastric fullness, he used three qian bi of Cinnamon Twig Powder (Guizhi), mixed with hot wine, wrapped the patient in cotton clothes, and treated it as Yin Toxin Cold Damage (Yin Du Shang Han). This led to profuse sweating. After sweating, the patient developed dry mouth and tongue, red sclera, stiff neck, non-flexible limbs, painful and reddish urination, constipation, symptoms of touching the bedclothes, resembling mania, confused speech when questioned, and a red, cracked tongue. Symptoms were lighter in the morning and worse in the evening, persisting for seven or eight days. The family considered the condition critical and hopeless. I palpated the pulse at six or seven beats per breath and determined it was clearly a heat syndrome. I then administered Da Cheng Qi Tang (Major Order the Qi Decoction), a bitter, pungent, and greatly cold formula. After three bowel movements, the acute pathogenic force was subdued. The next day, I prescribed Huang Lian Jie Du Tang (Coptis Decoction for Resolving Toxicity), a greatly bitter and cold formula, to be taken slowly to clear residual heat. Three days later, the illness improved by five or six parts out of ten. I then administered Bai Hu Jia Ren Shen Tang (White Tiger Decoction plus Ginseng) to purge heat and tonify qi, causing all previous symptoms to recede. I advised careful daily routine and dietary moderation, and the patient recovered completely after more than a month.
[Another Case] (Recorded in *San Shi Yi Yan*) Treatment experience of Mr. Lu Yangyu from the Ming Dynasty
The principal wife of Mr. Shi Dongting suffered from headache and fever in April. Upon palpation, her pulse was surging and rapid at the Qi Kou position. I prescribed two doses of clearing and resolving herbs, roughly consisting of Bupleurum Root (Chaihu), Kudzu Root (Gegen), Gardenia Fruit (Zhizi), and Scutellaria Root (Huangqin). Before they could be taken, the patient's brother, Tang Chengzun, invited another physician who prescribed Da Qing Long Tang (Major Green Dragon Decoction) for two doses. The family administered only one dose. That night, the patient's whole body felt like burning, with thirst and dry throat, accompanied by delirious speech. The next day, Tang invited me again. He claimed this was not Cold Damage but Gout (Tong Feng), and prescribed two doses of Notopterygium Root (Qianghuo), Saposhnikovia Root (Duhuo), Polygonum Multiflorum Root (Heshouwu), and Achyranthes Root (Niuxi). Consequently, the patient climbed high and sang, threw off her clothes and ran, cursing without distinguishing relatives from strangers. The Shi family invited me again. Upon arrival, hearing that the patient wanted to go out naked, I ordered several women to restrain her. I told Dongting: "This is a Yang syndrome; agitating it will worsen the condition. You should speak to him gently." As predicted, the agitation stopped. Therefore, I first administered sugar water, which eased the condition. Subsequently, I used Bai Hu Tang (White Tiger Decoction) added with Yuan Ming Fen (Mirabilite), Scutellaria Root (Huangqin), Coptis Rhizome (Huanglian), Trichosanthes Seed (Gualouren), and Rhinoceros Horn (Xijiao - note: modern substitutes often used). After several doses, the cursing ceased. However, she still occasionally spoke nonsense, indicating long-standing constipation. I administered Run Zi Wan (Moistening Pill) three qian. At night, she passed ten to twenty pieces of dry stool, but delirium did not fully cease. I re-administered the previous decoction and gave two qian of pills. She passed several pieces of dry stool and a small amount of loose stool. Three days later, she desired porridge. I regulated her condition with Qing Qi Yang Rong Tang (Clear Qi and Nourish Ying Decoction) containing Dang Gui Shen, White Peony Root (Baishao), Szechuan Lovage Root (Chuanxiong), Poria (Fuling), Aucklandia Root (Muxiang), Cardamom (Doukou), Tangerine Peel (Chenpi), and Coptis Rhizome (Chuanlian).
Mr. Wu Xuye, aged twenty-three, had vigorous spirit. On the Qingming Festival in March, after returning home from his school, he got heavily drunk and engaged in sexual intercourse. At the fifth watch during urination, he suddenly experienced pain below the umbilicus, borborygmus, and difficulty urinating. The next day, he developed chills, fever, and headache. When the physician palpated his pulse, he admitted to violating the taboo of sexual activity after drinking and traveling far. The physician suspected Yin Syndrome Cold Damage and prescribed Li Zhong Tang (Regulate the Middle Decoction) for two doses, to be consumed within a day and night. On the second day, severe vomiting and reflux occurred, along with irritability, thirst, inability to eat, and insomnia day and night. I was consulted on the third day. His pulse was wiry on the left and surging on the right, strong at Cun and Guan positions, while Chi position was relatively harmonious. His face was red, resembling floating yang (Dai Yang). Unaware of the Li Zhong Tang usage, I prescribed Chai Ge Jie Ji Tang (Bupleurum and Kudzu Decoction to Release the Muscle Layer) for two doses. Mr. Xuye and his relatives were shocked and explained his yin deficiency after returning from afar, noting that Li Zhong Tang had not helped and they intended to double the dosage of Ginseng and Aconite. I said: "The pulse and symptoms are all Yang. Even with sexual activity, Yin is not deficient. If you use Ginseng and Aconite again, even immortals might fail to save him." I ordered that both doses must be taken tonight to prevent transmission to the interior. The patient, feeling heart emptiness, took only one dose. The next morning, symptoms were not severe, but the pulse remained surging and large, including both Chi positions. I said: "Heat pathogen has entered the Fu organs; it will worsen at dusk." I prescribed Bai Hu Tang (White Tiger Decoction) for two doses. The patient hesitated. I said: "If you fear gypsum today, you will fear rhubarb tomorrow." Delaying administration, the烦渴 (restlessness, thirst) and heat intensified, with delirium. Mr. Xuye was terrified. I said: "This is inevitable." After continuous intake of two doses, heat slightly decreased. Everyone discussed using Rhubarb (Dahuang). I said: "Rhubarb cannot be used today." I still gave the previous formula for two doses. He slept slightly at the fifth watch. Morning palpation showed deep and solid Chi pulses, and thick tongue coating. I changed to Xiao Xian Xiong Tang (Minor Chest-Harmonizing Decoction) to deliver Run Zi Wan (Moistening Pill) one qian. By evening, another qian was given. At midnight, dozens of dry stools were passed, heat subsided, diarrhea stopped, and the major condition stabilized. Thereafter, Zhi Shi and Coptis Rhizome (Huanglian) were taken for dozens of doses. With slight tonification, epigastric fullness and inability to eat occurred. Regulation lasted nearly two months before full recovery.
[Another Case] (Recorded in *Zhang Shi Yi Tong*) Treatment experience of Mr. Zhang Luyu from the Qing Dynasty
Mr. Xu Yu, constitutionally yin-deficient with abundant fire, and suffering from Pi Yue (Splee Constriction) with blood in stool, contracted Winter Warmth (Dong Wen) in October, presenting with fever and sore throat. Local physicians used Ephedra Stem (Mahuang), Apricot Kernel (Xingren), Pinellia Tuber (Banxia), Aurantium Fruit (Zhike), and Citrus Peel (Jupi), leading to wheezing, orthopnea, hoarseness, red and hot head and face, and cold hands and feet. The pulse at the right Cun and Guan was deficient, large, and slightly rapid, indicating heat damaging the Qi aspect of the Hand-Taiyin Lung Meridian. Prescriptions of Polygonatum Rhizome (Weiyu) and Licorice Root (Gancao) were ineffective. I prepared Zhu Fu Tang (Pig Skin Decoction), instructing him to warm it over boiling water and take small amounts frequently. After three days, his voice cleared, and upon finishing the dose, the pain vanished.
I also treated the wife of Mr. Zheng Mulin, who had chronic blood in stool. Pregnant for seven months, during the period when Lung Qi nourishes the fetus, she contracted Winter Warmth, presenting with cough, stabbing sore throat, and heavy bleeding. Her pulse was smaller, weaker, and faster than usual, indicating heat damaging the Blood aspect of the Hand-Taiyin Lung Meridian. I prescribed Huang Lian E Jiao Tang (Coptis and Donkey-Hide Gelatin Decoction) for two doses. After bleeding stopped, I removed Coptis Rhizome (Huanglian) and added Polygonatum Rhizome (Weiyu), Platycodon Root (Jiegeng), and Human-Placed Yellow (Ren Zhong Huang) for four doses, resulting in stability.
[Another Case] Treatment experience of Mr. Wu Jutong from the Qing Dynasty
Pulse is not floating but fine and rapid, with extreme thirst prompting drinking and profuse sweating, indicating a heat disease with interior insufficiency. Use the method of Yu Nu Jian (Jade Woman Decoction): Anemarrhena Rhizome (Zhimu) 4 qian, Raw Gypsum (Sheng Shigao) 1 liang, Mulberry Leaf (Sangye) 3 qian, Ophiopogon Tuber (Maidong) and Fine Rehmannia Root (Xi Shengdi) each 5 qian, Rice (Jingmi) a pinch, Licorice Root (Gancao) 3 qian. Follow-up visit: Yesterday, Yu Nu Jian reduced all symptoms. Since he chronically suffers from Xiao Ke (Wasting-Thirst), using Yu Nu Jian caused loose stools; add Oyster Shell (Muli) to protect Yin and consolidate. Formula: Oyster Shell (Muli) 1 liang, Raw Gypsum (Sheng Shigao) 5 qian, Stir-fried Anemarrhena Rhizome (Chao Zhimu) 2 qian, Ophiopogon Tuber (Maidong) and Large Rehmannia Root (Da Shengdi) each 5 qian, Roasted Licorice Root (Zhi Gancao) 3 qian, Rice (Jingmi) a pinch. Finally, Yi Wei Tang (Benefit Stomach Decoction) was used for regulation and cure.
[Another Case] Treatment experience of Mr. Wang Mengying from the Qing Dynasty
Mr. Yao, under thirty years old, had a heavy smoking habit. Coinciding with his mother's death from Warmth, amidst exhaustion and grief, he contracted Warmth Pathogen. Symptoms included hypochondriac pain, muscle spasms, rebellious Qi, profuse phlegm, high fever, coma, penile retraction, and spontaneous sweating. Physicians were helpless. Relative Xu Lisheng urged immediate consultation with Mengying. Pulse was hollow and rapid; tongue was crimson without fluid, indicating danger of Yin deficiency with Yang hyperactivity, intense heat, and fluid exhaustion. Given its onset severity, root instability was evident. I prescribed Rhinoceros Horn (Xijiao), Antelope Horn (Lingyangjiao), Scrophularia Root (Yuanshen), and Anemarrhena Rhizome (Zhimu) to nourish Water and extinguish Wind; Cistanche Stem (Rongrong), Melia Fruit (Lianshi), Rat Dropping (Shuzhi), and Hematite (Shiying) to subdue Yang and suppress rebellion; Glehnia Root (Shashen), Ophiopogon Tuber (Maidong), Dendrobium Stem (Shihu), and Polygonatum Rhizome (Weiyu) to tonify Qi and replenish fluids; Trichosanthes Root (Huafen), Gardenia Fruit (Zhizi), Honeysuckle Flower (Yinhua), and Loofah Network (Sigualuo) to resolve phlegm and clear heat. One dose brought improvement, four doses brought peace, followed by large doses of Yin-nourishing herbs for cure.
Ms. Zhu Dunshu, daughter of Lord Zhu, contracted Warmth. Physicians administered warming dispersants. After two doses, numbness spread over the body. Menstruation arrived. Physician administered Xiao Chai Hu Tang (Minor Bupleurum Decoction), leading to uncontrollable madness. She sought help from Mengying. Pulse was surging, slippery, wiry, and rapid; eyes red, coating yellow, extreme thirst, insomnia. This arose from Warmth Pathogen. Why attack the exterior when there is constant profuse sweating? Menstruation occurs due to heat forcing into Ying level. Why use Ginger and Jujube to warm, and Ginseng and Bupleurum to ascend? This explains the uncontainable spreading fire. I prescribed large doses of Rhinoceros Horn (Xijiao), Scrophularia Root (Yuanshen), Rehmannia Root (Shengdi), Gypsum (Shigao), Anemarrhena Rhizome (Zhimu), Trichosanthes Root (Huafen), Honeysuckle Flower (Yinhua), Bamboo Leaf (Zhuye), Fritillaria Bulb (Beimu), and Anemarrhena Root (Baiwei) to clear Wei and cool Ying. She slept immediately after ingestion, remaining asleep for a long time. Suspected coma, she was called repeatedly. Upon waking, she instructed family to change clothes, put on shoes, comb hair, bid farewell to parents, stating she wished to return to her position at the Flower Goddess Temple. Family wept, urgently summoned Mengying. He instructed family to remain quiet and not cry, increased the previous formula, mixed with Bamboo Juice (Zhuli) and Child Urine (Tongbian), and administered. She calmed down, subsequently cured with Yin-nourishing and heat-clearing herbs.
Mrs. Bi Fanglai suffered from phlegm-cough disturbing sleep. Physicians administered tonifying and astringent herbs, leading to absence of tears and saliva, ear blockage, loss of appetite, difficult urination and defecation, dry cough without phlegm, rebellious Qi, and spontaneous sweating. Mengying palpated the pulse: right Cun was deep and slippery; left hand was fine, rapid, and wiry. This indicated Yin deficiency in an elderly person, Warmth Pathogen in the Lung, un-resolved by clearing and transforming, instead trapped by tonics. I opened obstruction and regulated Stomach with Trichosanthes Fruit (Gualou), Macrostemon Stem (Xiebai), Aster Root (Ziwan), Starflower Fruit (Doulou), Apricot Kernel (Xingren), Fritillaria Bulb (Beimu), Winter Melon Seed (Dongguazi), Licorice Root (Gancao), Platycodon Root (Jiegeng), Inula Flower (Xuanfu), and Pinellia Tuber (Ruju). She stabilized.
Mrs. Xu Shaoqing, niece of late physician Chen Qidong. Early summer, she contracted Warmth. He Xinzhi used clearing and resolving methods ten times without relief. Mengying was consulted. Pulse was wiry, surging, open, and large, especially on the left. Extreme thirst, profuse sweating, ability to eat, delirious speech, red face, cold feet, insomnia all night. Mengying said: "Although it is Warmth, true Yin is chronically deficient, mental strain has caused Heart Yang to float outward, and internal Wind rises. Fortunately, a skilled physician avoided warming dispersants, so there is no fear." I prescribed large doses of Dragon Bone (Longgu), Oyster Shell (Muli), Rhinoceros Horn (Xijiao), Pearl (Zhuzhen), Tortoise Plastron (Guiban), Turtle Carapace (Biejia), Fritillaria Bulb (Beimu), Bamboo Juice (Zhuli), Bamboo Leaf (Zhuye), Cinnabar (Chensha), Wheat (Xiaomai), Scrophularia Root (Yuanshen), Salvia Root (Danshen), Rehmannia Root (Shengdi), and Ophiopogon Tuber (Maidong). Externally, heated iron quenched in vinegar was inhaled, oyster powder applied to stop sweating, and raw Aconite paste applied to Yongquan Acupoint (Yongquan). After one dose, relative Hu visited, criticized Wang's prescription, and advocated rash-expelling method. Family was confused, administered Hu's medicine. Patient became mentally confused, switched back to Wang's medicine, and gradually improved. However, Yin was hard to restore. Frequent administration of sweet, soft, nourishing, and sedating herbs allowed her to rise from bed after a month. In mid-summer, menstruation occurred, but mood was unstable, prone to fright. I concluded treatment with Wheat, Ginseng, Prepared Rehmannia Root (Shudi), Hematite (Shiying), Poria (Fushen), Longan Aril (Longyan), Licorice Root (Gancao), Wheat (Xiaomai), Jujube (Dazao), and Three Shells (Sanjia).
Mrs. Yao Lingyu, chronically suffering from asthma and cough, contracted Spring Warmth. Physicians knew her original Qi was depleted and administered warming tonics, leading to convulsions, syncope, coma, deafness, delirium, red face, crimson tongue, phlegm-wheezing, and insomnia. Physicians were helpless. Mengying was consulted. Pulse was still wiry and slippery. He said: "Although dangerous, vital energy remains. Abandoning it hastily is too cruel." I prescribed Rhinoceros Horn (Xijiao), Antelope Horn (Lingyangjiao), Scrophularia Root (Yuanshen), Glehnia Root (Shashen), Anemarrhena Rhizome (Zhimu), Trichosanthes Root (Huafen), and Gypsum (Shigao) to clear heat, extinguish wind, save Yin, and generate fluids. Assisted by Cistanche Stem (Rongrong), Hematite (Shiying), Turtle Carapace (Biejia), Golden Bell Fruit (Jinlingzi), Inula Flower (Xuanfu), Fritillaria Bulb (Beimu), and Bamboo Juice (Zhuli) to subdue Yang, suppress rebellion, unblock collaterals, and resolve phlegm. Stabilized after three doses. Then removed Rhinoceros Horn, Antelope Horn, and Gypsum, added Raw Rehmannia Root (Shengdi). Cured after ten days.
My nephew Senbo suffered from fever, red face, thirst, and slight sweating. Mengying observed: "This is Spring Warmth. Taking advantage of initial invasion, pathogen is still in the Lung, hence right Cun pulse is surging and large. It should descend through the Fu organs to exit, leading to quick recovery." I prescribed Anemarrhena Rhizome (Zhimu), Trichosanthes Root (Huafen), Winter Melon Seed (Dongguazi), Mulberry Leaf (Sangye), Loquat Leaf (Pipaye), Scutellaria Root (Huangqin), Reed Rhizome (Weijing), and Gardenia Fruit (Zhizi). Indeed, he passed extremely hot water twice via stool, pulse calmed, body cooled, hunger returned, ate porridge, and recovered.
Younger brother of Scholar Wang Zoushi contracted Spring Warmth. Initially delirious and manic. Continuous large doses of clearing and resolving led to coma, mutism, ice-cold limbs, closed eyes, enuresis, and refusal to drink. Mengying palpated pulse: wiry, large, slow, and slippery; thick yellow greasy coating covering the tongue; foul odor. I prescribed Cheng Qi Tang (Order the Qi Decoction) added with Honeysuckle Flower (Yinhua), Dendrobium Stem (Shihu), Scutellaria Root (Huangqin), Bamboo Sheath (Zhuru), Scrophularia Root (Yuanshen), and Acorus Rhizome (Shichangpu). Passed much black, tarry stool, mind slightly cleared, accepted some soup. Next day, removed Mirabilite and Rhubarb, added Jellyfish (Hai zhe), Radish Seed (Laifu), Coptis Rhizome (Huanglian), and Gypsum (Shigao). After two doses, shaking resolved, limbs relaxed, coating retreated, ate porridge, cured without further effort.
Ms. Chu Qinxiang, female scholar, suffered from delayed menstruation and chills/fever. Physicians assumed deficiency and administered warming tonics, leading to abdominal distension, loss of appetite, leukorrhea, stranguria, constipation, and painful urination. Mengying palpated pulse: wiry, firm, and rapid. Heat was hidden in Jueyin, and Lung was obstructed due to mis-treatment. I prescribed clearing and descending upper-jiao formula, swallowing Dang Gui Long Hui Wan (Angelica and Calotropis Pill). After two doses, chills/fever ceased, hunger returned, all ailments resolved within ten days.
Zhang Yangzhi, in September of Ji Hai year, suffered from aversion to cold and headache. Self-medicated with warming dispersants without effect. Consulted Mengying. Pulse was extremely heavy; pressing to bone revealed wiry and slippery qualities. Lying in a dark, enclosed room with heavy furs and fire, he still felt cold, expectorated saliva, had no thirst, no chest/abdominal fullness, constant cough, only hard dry stool, scant urine, and heavy breath. I said: "Accumulated heat is deeply entrenched, Qi mechanism is depressed and blocked. Only greatly bitter and cold herbs can purge it. Heavy use of Mirabilite, Rhubarb, and Rhinoceros Horn is hoped to allow stubborn pathogen and accumulated toxin to drain downward, naturally circulating Qi throughout the body." Yangzhi listened respectfully, was greatly enlightened, and took the medicine as directed. Two days later, stool passed like glue and lacquer, foul odor reached outside. Aversion to cold decreased, porridge intake increased daily. Stool color normalized after ten days, health exceeded normal after one hundred days.
Mrs. Duan Chunmu suffered from rotten throat. Internal and external medicine physicians were helpless. Recommended to Mengying by Yao Xuejiao. Emaciated, skin hot as branding, tough phlegm obstructing throat, unable to expectorate, requiring paper wiping to remove. Lesion red, swollen, white and rotting, gums and tongue ulcerated, unable to swallow rice or water, menstruation came unexpectedly. Pulse: left fine and rapid, right wiry and slippery. I said: "This is Yin deficiency constitution with latent fire disease, failure to clear and descend, disturbing Ying level. First, Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction) to clear Ying level and regulate reckless bleeding; then Bai Hu Tang (White Tiger Decoction) added with American Ginseng to purify airway and purge spreading fire; externally, Xi Lei San to sweep phlegm-rot and eliminate toxicity; subsequently, sweet and moistening herbs to clear residual heat and replenish fluids. Daily improvement, rose after one month."
Lian's Note: Warmth diseases most fear persistent fever, convulsions/syncope, and confusion. Also, sudden dizziness without cause or intermittent manic speech despite clear consciousness often leads to unpredictable changes, confusing physicians. Unlike Yang syndrome with Yin pulse, retracted Yang, curled tongue, grasping at empty air, or seeing ghosts, which easily reveal danger. The key lies in distinguishing deficiency and excess; only with true differentiation can treatment begin. Based on my clinical experience, warmth excess syndromes mostly involve Yangming Stomach and Intestines; warmth deficiency syndromes mostly involve Shaoyin Kidney and Heart. Predecessor Yu Dongfu made significant contributions. Briefly quoting his theory: "What is now called Cold Damage is generally Warmth disease. Cold Damage mainly involves Foot meridians; Warmth mainly involves Hand meridians. For example, Wind-Warmth cough and snoring, Heat disease coma and delirium, or sticky diarrhea, are manifestations of Hand-Taiyin Lung, Hand-Jueyin Pericardium, and Hand-Yangming Large Intestine. Severe cases include throat swelling, limb spasms, drunken-like confusion, restlessness, scorched teeth, dry tongue, mumps, and parotitis. Pathogens distribute extensively, no longer fitting Six Meridian patterns, hence Six Meridian treatment is not used. In my experience, initial cases often have exterior pathogen involvement, suitable for dispersing with防风 (Fangfeng), Kudzu Root (Gegen), Fermented Soybean (Chidou), Mint (Bohe), Buttercup Seed (Niubangzi), Apricot Kernel (Xingren), Talc (Huashi), Forsythia Fruit (Lianqiao), etc. Sweating indicates mild disease; no sweat indicates severe disease. If macules appear, add Cicada Slough (Chantui), Platycodon Root (Jiegeng), Reed Rhizome (Lugen), Western River Willow (Xi Heliu); if phlegm, add Earth Fritillaria (Tu Bei), Silkworm (Tianchong), Trichosanthes Fruit (Gualou), Tangerine Peel (Juhong); if Yangming syndrome appears, Bai Hu or Cheng Qi; if Shaoyang syndrome appears, Xiao Chai Hu Tang removing Ginseng and Pinellia, adding Trichosanthes Root and Anemarrhena Rhizome; if Shaoyin syndrome appears, Huang Lian E Jiao Tang, Zhu Ling Tang, or Zhu Fu Tang. All follow Zhang Zhongjing's Six Meridian established methods effectively. However, Warmth disease Three Yin syndromes often result in death, unlike Cold Damage; because those who do not store essence in winter, as Dongyuan said, kidney water is internally exhausted, who nourishes it? Only large doses of Yin-nourishing herbs assisted by heat-clearing may save them. Yin-nourishing includes Two Di (Rehmannia), Two Dong (Ophiopogon), Donkey-Hide Gelatin (Ejiao), Moutan Bark (Danpi), Scrophularia Root (Yuanshen), Human Milk, Sugarcane Syrup, Pear Juice; heat-clearing includes Three Huangs, Gypsum, Rhinoceros Horn, Isatis Root (Daqing), Anemarrhena Rhizome (Zhimu), Reed Rhizome (Lugen), Imperata Rhizome (Maogen), Gold Juice (Jin Zhi), Snow Water, Watermelon, Honeysuckle Dew, Loofah Juice. Select according to symptoms."