凌（六八）温疫自口鼻吸入。由肺叶干于心包络。神识不清。左脉洪大。烦渴。鼾声。胸背间赤疹隐约。温邪郁遏。
意有溃烂之形。是水谷之湿热交蒸。蕴于皮膜。蕴湿酿热而成毒。非清非散。热邪无发泄之机。三焦交炽喉哑继起。舌
色如赭。此温疫为化火化燥之因。势防热邪内陷。原属可虑。拟以滋清营分。兼佐泄邪。俾得络热稍清。庶几转机为
幸。未识高明以为然否。
犀角（一钱） 鲜生地（八钱） 郁金（一钱） 牛蒡子（三钱） 银花（一钱）
黑元参（一钱五分） 连翘心（二钱） 石菖蒲根（六分） 紫雪丹（三分）
谢（三九）两脉洪数。夜躁不寐。热盛烦渴。 疹未透。拟清胃腑热邪。兼以疏 。
犀角 鲜生地 花粉 羚羊角 连翘心 银花 牛蒡子 嫩元参
钱（八岁）感冒时邪。身热脉数。已经见 。
犀角（一钱） 郁金（一钱） 嫩元参（一钱五分） 牛蒡子（一钱五分） 花粉（一钱五分） 黑山栀（一钱五
分） 连翘（一钱五分） 银花（一钱） 加芦根（一两）
戴（四八）时疫未经宣透。邪已蕴结阳明。见症烦渴。昏谵不寐。两脉洪数。分明发 。阅方发散伤阳。苦寒损胃。
总非腑病所宜。拟凉膈疏 。请备参末议。
犀角 郁金 嫩元参 牛蒡子 花粉 银花 连翘心 石菖蒲根 紫雪丹（一分）
雷（十三）温邪发疹。烦渴少寐。两脉独大。
牛蒡子（炒研，三钱） 杏仁（去尖研，三钱） 连翘壳（一钱五分） 羚羊角（一钱） 桔梗（一钱）
黑山栀（一钱五分） 薄荷梗（一钱） 加芦根（一两） 茅根（五钱）
杨（二八）疹邪胸背已齐。脉右软短。烦渴热频。少寐。舌白。蛔厥。大便不解。仍议清疏营络透疹。
香犀角 鲜生地 桔梗 牛蒡子 草郁金 嫩元参 薄荷叶 连翘心 黑山栀 小川连 加芦根
又 烦渴昏谵。便秘。疹隐太早。冒风所致。
牛蒡子（二钱） 蝉衣（二钱） 桔梗（一钱） 荆芥（一钱五分） 赤芍（一钱五分） 连翘（一钱五分） 生
石膏（四钱） 黑山栀（一钱五分） 杏霜（三钱） 加芦根（一两）
又 热胜渴烦。辛寒清彻。
牛蒡子（二钱） 生石膏（四钱） 蝉衣（五分） 荆芥穗（一钱） 杏霜（三钱） 知母（一钱五分） 薄荷叶
（八分） 连翘（一钱五分） 黑山栀（一钱五分） 加芦根（一两）
吴
葛根（八分） 牛蒡子（二钱） 粉丹皮（一钱） 连翘（一钱五分） 荆芥（一钱） 甜杏仁（二钱） 犀尖
（八分） 加芦根（五钱） 西河柳（二钱）
凌某（六十八岁）：温疫之邪从口鼻吸入，由肺叶传入心包络。出现神识不清、左脉洪大、烦躁口渴、打鼾声、胸背部隐约可见赤色皮疹等症状。这是温邪郁结遏阻所致，似乎有溃烂的形态趋势。这是由于水谷中的湿热交蒸，蕴结于皮膜之间，湿蕴化热而成毒。此时若不用清法也不用散法，热邪便没有发泄的途径，导致三焦火热炽盛，喉哑症状继起，舌色如赭石般红暗。这是温疫转化为火、转化为燥的原因，形势上需防止热邪内陷，原本就值得忧虑。拟用滋阴凉营的方法，兼佐以泄邪之法，使得络脉中的热邪稍得清除，或许能有转机，侥幸痊愈。不知高明之士以为如何？
犀角（一钱）、鲜生地（八钱）、郁金（一钱）、牛蒡子（三钱）、银花（一钱）、黑元参（一钱五分）、连翘心（二钱）、石菖蒲根（六分）、紫雪丹（三分）。
谢某（三十九岁）：两脉洪数，夜间躁动不寐，热盛烦躁口渴，疹子尚未透发。拟清胃腑热邪，兼以疏风透疹。
犀角（一钱）、郁金（一钱）、嫩元参（一钱五分）、牛蒡子（一钱五分）、花粉（一钱五分）、黑山栀（一钱五分）、连翘（一钱五分）、银花（一钱），加芦根（一两）。
戴某（四十八岁）：时疫未经宣透，邪气已蕴结于阳明经。见症为烦躁口渴、昏谵不寐，两脉洪数，分明是发疹之证。查看之前的方剂，发散药损伤阳气，苦寒药损伤胃气，总不是治疗腑病所适宜的。拟用凉膈散疏风清热。请备参末议。
犀角、郁金、嫩元参、牛蒡子、花粉、银花、连翘心、石菖蒲根、紫雪丹（一分）。
牛蒡子（炒研，三钱）、杏仁（去尖研，三钱）、连翘壳（一钱五分）、羚羊角（一钱）、桔梗（一钱）、黑山栀（一钱五分）、薄荷梗（一钱），加芦根（一两）、茅根（五钱）。
杨某（二十八岁）：疹邪在胸背已出齐，右脉软短，烦躁口渴，热势频繁，睡眠少，舌苔白，蛔厥，大便不解。仍议清疏营络、透发疹邪。
香犀角、鲜生地、桔梗、牛蒡子、草郁金、嫩元参、薄荷叶、连翘心、黑山栀、小川连，加芦根。
牛蒡子（二钱）、蝉衣（二钱）、桔梗（一钱）、荆芥（一钱五分）、赤芍（一钱五分）、连翘（一钱五分）、生石膏（四钱）、黑山栀（一钱五分）、杏霜（三钱），加芦根（一两）。
再诊：热胜渴烦，辛寒清热透彻。
牛蒡子（二钱）、生石膏（四钱）、蝉衣（五分）、荆芥穗（一钱）、杏霜（三钱）、知母（一钱五分）、薄荷叶（八分）、连翘（一钱五分）、黑山栀（一钱五分），加芦根（一两）。
吴某：
葛根（八分）、牛蒡子（二钱）、粉丹皮（一钱）、连翘（一钱五分）、荆芥（一钱）、甜杏仁（二钱）、犀尖（八分），加芦根（五钱）、西河柳（二钱）。
**Patient Ling (68 years old):** The pathogen of warm epidemic enters through the mouth and nose, transmitting from the lung lobes to the pericardium collateral. Symptoms include unclear consciousness, a surging and large left pulse, irritability with thirst, snoring sounds, and faintly visible red rashes on the chest and back. This is caused by the stagnation and suppression of warm pathogens, seemingly showing signs of ulceration. It results from the steaming and intermingling of damp-heat from food and fluids, accumulating in the skin and fascia; dampness accumulates to generate heat, which transforms into toxicity. If neither clearing nor dispersing methods are used, the heat pathogen lacks an outlet for release, leading to blazing fire in the Triple Burner and subsequent hoarseness, with the tongue appearing dark red like jasper. This indicates that the warm epidemic is transforming into fire and dryness, posing a risk of heat pathogen sinking inward, which is indeed concerning. The proposed treatment involves nourishing yin and cooling the nutritive level, assisted by methods to vent the pathogen, hoping to slightly clear the heat in the collaterals and bring about a turning point for recovery. I wonder if experts agree?
Rhinoceros Horn (1 qian), Fresh Rehmannia Root (8 qian), Curcuma Aromatica Rhizome (1 qian), Arctii Fructus (3 qian), Lonicerae Japonicae Flos (1 qian), Black Scrophulariae Radix (1.5 qian), Forsythiae Flower Heart (2 qian), Acori Tatarinowii Rhizoma (0.6 fen), Zi Xue Dan (Purple Snow Pill) (0.3 fen).
**Patient Xie (39 years old):** Both pulses are surging and rapid. Restlessness at night with insomnia, intense heat with irritability and thirst, and the rash has not yet erupted. The plan is to clear heat from the stomach fu organ and assist in dispersing wind to promote eruption.
Rhinoceros Horn, Fresh Rehmannia Root, Pseudostellariae Radix, Antelope Horn, Forsythiae Flower Heart, Lonicerae Japonicae Flos, Arctii Fructus, Young Scrophulariae Radix.
**Patient Qian (8 years old):** Contracted seasonal pathogenic factors due to cold, presenting with fever and rapid pulse, with rashes already appearing.
Rhinoceros Horn (1 qian), Curcuma Aromatica Rhizome (1 qian), Young Scrophulariae Radix (1.5 qian), Arctii Fructus (1.5 qian), Pseudostellariae Radix (1.5 qian), Gardeniae Fructus (1.5 qian), Forsythiae Fructus (1.5 qian), Lonicerae Japonicae Flos (1 qian), plus Reed Rhizome (1 liang).
**Patient Dai (48 years old):** The seasonal epidemic was not properly dispersed and vented; the pathogen has accumulated and bound in the Yangming channel. Symptoms include irritability, thirst, delirium, insomnia, and surging, rapid pulses, clearly indicating the eruption of rashes. Previous prescriptions using dispersing agents damaged yang qi, and bitter-cold agents damaged the stomach qi; neither is suitable for treating fu organ diseases. The proposal is to use Liang Ge San (Cool the Diaphragm Decoction) to disperse wind and clear heat. Please consider this suggestion.
Rhinoceros Horn, Curcuma Aromatica Rhizome, Young Scrophulariae Radix, Arctii Fructus, Pseudostellariae Radix, Lonicerae Japonicae Flos, Forsythiae Flower Heart, Acori Tatarinowii Rhizoma, Zi Xue Dan (Purple Snow Pill) (0.1 fen).
**Patient Lei (13 years old):** Warm pathogen causing rash, with irritability, thirst, scant sleep, and both pulses notably large.
Arctii Fructus (stir-fried and ground, 3 qian), Apricot Seed (tips removed, ground, 3 qian), Forsythiae Shell (1.5 qian), Antelope Horn (1 qian), Platycodonis Radix (1 qian), Gardeniae Fructus (1.5 qian), Mint Stem (1 qian), plus Reed Rhizome (1 liang), Imperatae Rhizoma (5 qian).
**Patient Yang (28 years old):** The rash pathogen has fully erupted on the chest and back. The right pulse is soft and short. Symptoms include irritability, thirst, frequent heat sensations, scant sleep, white tongue coating, ascariasis-induced convulsions (Hui Jue), and constipation. The strategy remains to clear and disperse the nutritive collaterals and promote rash eruption.
Fragrant Rhinoceros Horn, Fresh Rehmannia Root, Platycodonis Radix, Arctii Fructus, Grass Curcuma Aromatica Rhizome, Young Scrophulariae Radix, Mint Leaf, Forsythiae Flower Heart, Gardeniae Fructus, Small Coptis Rhizome, plus Reed Rhizome.
Second consultation: Irritability, thirst, delirium, constipation, rash hidden too early due to exposure to wind.
Arctii Fructus (2 qian), Cicada Slough (2 qian), Platycodonis Radix (1 qian), Schizonepeta Spike (1.5 qian), Red Peony Root (1.5 qian), Forsythiae Fructus (1.5 qian), Raw Gypsum (4 qian), Gardeniae Fructus (1.5 qian), Apricot Frost (3 qian), plus Reed Rhizome (1 liang).
Third consultation: Heat prevails with thirst and irritability, treated with pungent-cold clearing to thoroughly resolve heat.
Arctii Fructus (2 qian), Raw Gypsum (4 qian), Cicada Slough (0.5 fen), Schizonepeta Spike Tip (1 qian), Apricot Frost (3 qian), Anemarrhenae Rhizoma (1.5 qian), Mint Leaf (0.8 fen), Forsythiae Fructus (1.5 qian), Gardeniae Fructus (1.5 qian), plus Reed Rhizome (1 liang).
**Patient Wu:**
Puerariae Lobatae Radix (0.8 fen), Arctii Fructus (2 qian), Moutan Cortex (1 qian), Forsythiae Fructus (1.5 qian), Schizonepeta Spike (1 qian), Sweet Apricot Seed (2 qian), Rhinoceros Tip (0.8 fen), plus Reed Rhizome (0.5 liang), Tamarici Ramulus (2 qian).