天津范姓媪，年过五旬，得温病兼下痢证。
病因 家务劳心，恒动肝火，时当夏初，肝阳正旺，其热下迫，遂患痢证。因夜间屡次入厕，
又受感冒兼发生温病。
证候 表里皆觉发热，时或作渴，心中烦躁，腹中疼甚剧，恒作
呻吟。昼夜下痢十余次，旬日之后系纯白痢，其舌苔浓欲
黄，屡次延医服药，但知治痢且用开降之品，致身体虚弱卧
不能起，其脉左右皆弦而有力，重按不实，搏近五至。
诊断 此病因肝火甚盛，兼有外感之热已入阳明，所以脉象弦而有力。其按之不实者，因从
前服开降之药过多也。其腹疼甚剧者，因弦原主疼，兹则弦而且有力，致腹中气化不和故疼
甚剧也。其烦躁者，因下久阴虚，肾气不能上达与心相济，遂不耐肝火温热之灼耗，故觉烦躁也。
宜治以清温凉肝之品，而以滋阴补正之药辅之。
处方 生杭芍（一两） 滑石（一两） 生怀山药（一两） 天花粉（五钱）
山楂片（四钱） 连翘（三钱） 甘草（三钱）
共煎汤一大盅，温服。
复诊 将药煎服一剂，温热已愈强半，下痢腹疼皆愈，脉象亦见和缓，拟再用凉润滋阴之剂，以清其余热。
处方 生怀山药（一两） 生杭芍（六钱） 天花粉（五钱） 生怀地黄（五钱）
玄参（五钱） 山楂片（三钱） 连翘（二钱） 甘草（二钱）
共煎汤一大盅，温服。
效果 将药连服两剂，病遂全愈。惟口中津液短少，恒作渴，运动乏力，俾用生怀山药细末煮作
茶汤，兑以鲜梨自然汁，当点心服之，日两次，浃辰之间当即可撤消矣。盖山药原善滋阴，而其补
益之力又能培养气化之虚耗。惟其性微温，恐与病后有余热者稍有不宜，借鲜梨自然汁之凉润
以相济为用，则为益多矣。
病因 因家务劳心，经常引发肝火，当时正值夏初，肝阳正旺盛，其热邪向下逼迫，于是患了下痢证。因为夜间多次上厕所，又受到感冒侵袭，从而并发温病。
证候 感觉表里都发热，有时感到口渴，心中烦躁，腹部疼痛非常剧烈，经常发出呻吟声。昼夜下痢十多次，十天之后变成纯白痢，舌苔厚腻欲转黄，屡次请医生服药，但只知道治疗痢疾且使用开降性质的药物，导致身体虚弱到卧床不能起身，脉象左右两侧都弦而有力，重按不实，脉搏频率接近五至（每分钟约50-60次）。
诊断 此病因肝火非常旺盛，兼有外感的热邪已经传入阳明经，所以脉象弦而有力。重按时感觉不实，是因为之前服用开降类药物过多的缘故。腹部疼痛非常剧烈，是因为弦脉原本主痛，现在弦而且有力，导致腹部气化功能不和，所以疼痛剧烈。烦躁不安，是因为下痢日久导致阴虚，肾气不能上达与心相交济，于是无法耐受肝火和温热之邪的灼烧消耗，所以感到烦躁。
处方 生杭芍（一两） 滑石（一两） 生怀山药（一两） 天花粉（五钱）
山楂片（四钱） 连翘（三钱） 甘草（三钱）
共同煎煮成一大盅汤剂，温服。
复诊 将药煎服一剂后，温热症状已减轻大半，下痢和腹痛都痊愈了，脉象也见和缓，打算再用凉润滋阴的方剂，以清除残余的热邪。
处方 生怀山药（一两） 生杭芍（六钱） 天花粉（五钱） 生怀地黄（五钱）
玄参（五钱） 山楂片（三钱） 连翘（二钱） 甘草（二钱）
共同煎煮成一大盅汤剂，温服。
效果 将药连续服用两剂，疾病便完全痊愈。只是口中津液短少，经常感到口渴，运动乏力，建议用生怀山药细末煮成茶汤，兑入鲜梨自然汁，当作点心服用，每天两次，不久之后即可消除。因为山药原本善于滋阴，而其补益之力又能培养气化的虚耗。只是其性微温，恐怕对病后有余热者稍有不宜，借助鲜梨自然汁的凉润来相互济助，则益处就多了。
Tianjin, a surnamed Fan elderly woman, over fifty years old, suffered from warm disease complicated with dysentery.
Etiology Due to mental exertion in household affairs, liver fire was frequently stirred up. At that time, it was early summer, and liver yang was vigorous; its heat forced downward, leading to the onset of dysentery. Because she entered the toilet repeatedly at night, she contracted a cold, which subsequently triggered warm disease.
Symptoms She felt feverish both on the exterior and interior, occasionally felt thirsty, experienced mental restlessness and irritability, and suffered from severe abdominal pain, often groaning. She had dysentery more than ten times a day and night. After ten days, the stool became pure white mucus. The tongue coating was thick and turning yellow. Repeatedly consulting physicians and taking medicine, only treatments for dysentery using descending and opening agents were used, resulting in physical weakness so severe that she could not get out of bed. The pulse was wiry and forceful on both left and right sides, but empty upon heavy pressure, with a rate close to five beats per breath (approximately 50-60 beats per minute).
Diagnosis This condition is caused by excessive liver fire, combined with external pathogenic heat that has entered the Yangming channel, hence the wiry and forceful pulse. The emptiness upon heavy pressure is due to the excessive use of descending and opening medicines previously. The severe abdominal pain occurs because the wiry pulse indicates pain, and here it is wiry and forceful, causing disharmony of qi transformation in the abdomen, thus leading to severe pain. The restlessness is due to yin deficiency from prolonged diarrhea, preventing kidney qi from ascending to interact with the heart, thereby failing to withstand the scorching consumption of liver fire and warm heat, resulting in feelings of irritability.
Treatment should employ herbs that clear warmth and cool the liver, assisted by herbs that nourish yin and tonify healthy qi.
Prescription Raw Hang Shaoyao (Paeoniae Radix Alba) (1 liang), Huashi (Talcum) (1 liang), Raw Huai Shanyao (Dioscoreae Rhizoma) (1 liang), Tianhuafen (Trichosanthis Radix) (5 qian), Shanzha Pian (Crataegi Fructus Sliced) (4 qian), Lianqiao (Forsythiae Fructus) (3 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (3 qian).
Decoct together in a large cup of water, take warm.
Second Visit After one dose, the warm symptoms subsided by more than half, dysentery and abdominal pain resolved, and the pulse became harmonious and slow. It is proposed to use another prescription of cooling, moistening, and yin-nourishing agents to clear residual heat.
Prescription Raw Huai Shanyao (Dioscoreae Rhizoma) (1 liang), Raw Hang Shaoyao (Paeoniae Radix Alba) (6 qian), Tianhuafen (Trichosanthis Radix) (5 qian), Raw Huai Dihuang (Rehmanniae Radix) (5 qian), Xuanshen (Scrophulariae Radix) (5 qian), Shanzha Pian (Crataegi Fructus Sliced) (3 qian), Lianqiao (Forsythiae Fructus) (2 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (2 qian).
Decoct together in a large cup of water, take warm.
Outcome After two consecutive doses, the illness was completely cured. However, there was a shortage of saliva in the mouth, frequent thirst, and fatigue upon movement. It was advised to consume fine powder of Raw Huai Shanyao (Dioscoreae Rhizoma) boiled as tea, mixed with natural juice of fresh pear, taken as a snack twice daily. Within a short period, these symptoms would resolve. Shanyao naturally nourishes yin, and its tonifying power can cultivate the depletion of qi transformation. Although its nature is slightly warm, which might be slightly unsuitable for residual heat after illness, combining it with the cooling and moistening properties of fresh pear juice creates a beneficial synergy.