袁姓妇，年三十六岁，得温病兼下痢证。
病因 仲秋乘火车赴保定归母家省视，往来辛苦，路间又兼受风，遂得温病兼患下痢。
证候 周身壮热，心中热而且渴，下痢赤多白少，后重腹疼，一昼夜十余次，舌苔白浓，中心
微黄，其脉左部弦硬，右部洪实，一息五至。
诊断 此风温之热已入阳明之腑，是以右脉洪实，其炽盛之肝火下迫肠中作痢，是以左脉弦硬。
夫阳明脉实而渴者，宜用白虎加入参汤，因其肝热甚盛，证兼下痢，又宜以生山药代粳米
以固下焦气化，更辅以凉肝调气之品，则温与痢庶可并愈。
处方 生石膏（三两捣细） 野党参（四钱） 生怀山药（一两） 生杭芍（一两） 知母（
六钱） 白头翁（五钱） 生麦芽（四钱） 甘草（四钱）
将药煎汤三盅，分三次温饮下。
复诊 将药分三次服完，温热已退强半，痢疾已愈十之七八，腹已不疼，脉象亦较前和平，遂即原方
略为加减俾再服之。
处方 生石膏（二两捣细） 野台参（三钱） 生怀山药（八钱） 生杭芍（六钱）
知母（五钱） 白头翁（五钱） 秦皮（三钱） 甘草（三钱）
共煎汤两盅，分两次温服下。
效果 将药煎服两剂，诸病皆愈，惟脉象似仍有余热，胃中似不开通懒于饮食。俾用鲜梨、鲜藕、
莱菔三者等分，切片煮汁，送服益元散三钱许，日服两次，至三次则喜进饮食，脉亦和平如常矣。
帮助 凡温而兼痢之证，最为难治。盖温随下痢深陷而永无出路，即痢为温热所灼而益加疼坠，
惟石膏与人参并用，能升举下陷之温邪，使之徐徐上升外散。而方中生山药一味，在
白虎汤中能代粳米以和胃，在治痢药中又能固摄下焦气化，协同芍药、白头翁诸药以润肝滋肾，
从容以奏肤功也。至于麦芽炒用之为消食之品，生用之不但消食实能舒发肝气，宣散
肝火，而痢病之后重可除也。至后方加秦皮者，取其性本苦寒，力善收涩，借之以清热补虚，原
为痢病将愈最宜之品。是以《伤寒论》白头翁汤中亦借之以清厥阴热痢也。
病因：仲秋时节乘坐火车前往保定回娘家探望，旅途劳顿，途中又感受风邪，因而患上温病并伴有下痢。
证候：全身高热，心中烦热且口渴，下痢赤多白少，里急后重、腹部疼痛，一昼夜发作十余次，舌苔白厚，中心微黄，脉象左侧弦硬，右侧洪实，一息五至（脉搏频率正常偏快）。
诊断：这是风温之热邪已传入阳明腑证，所以右脉洪实；炽盛的肝火下迫肠道导致下痢，所以左脉弦硬。阳明脉实且口渴者，适宜使用白虎加入参汤；但因其肝热极盛，且病症兼有下痢，适宜用生山药代替粳米以固摄下焦气化，再辅以凉肝调气的药物，则温病与痢疾或许可以一并痊愈。
处方：生石膏（三两，捣碎） 野党参（四钱） 生怀山药（一两） 生杭芍（一两） 知母（六钱） 白头翁（五钱） 生麦芽（四钱） 甘草（四钱）
将药物煎煮成三盅药汤，分三次温服。
复诊：将药物分三次服完后，温热症状已退去大半，痢疾已痊愈十之七八，腹部不再疼痛，脉象也较之前平和，于是就在原方基础上略作加减，让患者继续服用。
处方：生石膏（二两，捣碎） 野台参（三钱） 生怀山药（八钱） 生杭芍（六钱） 知母（五钱） 白头翁（五钱） 秦皮（三钱） 甘草（三钱）
共同煎煮成两盅药汤，分两次温服。
效果：将药物煎服两剂后，各种病症皆愈，只是脉象似乎仍有余热，胃中似乎不通畅，懒得进食。嘱咐用鲜梨、鲜藕、莱菔（萝卜）三者等量，切片煮汁，送服益元散约三钱，每日服用两次，到第三次时便喜欢进食，脉象也恢复平和如常。
按语：凡是温病兼有痢疾的证候，最为难治。因为温邪随着下痢深陷体内而永远没有出路，同时痢疾被温热灼烧而更加疼痛坠胀。只有石膏与人参并用，能够升举下陷的温邪，使其徐徐上升外散。方中的生山药一味，在白虎汤中能代替粳米以调和胃气，在治疗痢疾的药物中又能固摄下焦气化，协同芍药、白头翁等药物以滋润肝脏、滋养肾脏，从容不迫地发挥疗效。至于麦芽炒制后作为消食药物，生用不仅消食，确实能舒展肝气、宣散肝火，从而消除痢病后的里急后重。至于后方加入秦皮，是取其本性苦寒，善于收涩，借此清热补虚，原本就是痢疾将愈时最适宜的药材。因此，《伤寒论》中的白头翁汤中也借用它来清除厥阴经的热痢。
A woman surnamed Yuan, aged thirty-six, suffered from Warm Disease complicated with dysentery.
Etiology: In mid-autumn, she took a train to Baoding to visit her natal home. The journey was arduous, and during the trip, she was exposed to wind pathogens, resulting in Warm Disease accompanied by dysentery.
Symptoms: High fever throughout the body, heat and thirst in the heart region, dysentery with more red (blood) than white (mucus), tenesmus and abdominal pain, occurring more than ten times a day. The tongue coating was thick white with a slightly yellow center. The pulse was wiry and hard on the left side, and flooding and solid on the right side, with five beats per breath (normal to slightly rapid rate).
Diagnosis: The heat of Wind-Warmth has entered the Yangming Fu organs, hence the right pulse is flooding and solid. The blazing Liver Fire presses downward into the intestines causing dysentery, hence the left pulse is wiry and hard. For Yangming pulse excess with thirst, Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng) is appropriate. However, due to the extreme severity of Liver Heat and the complication of dysentery, it is advisable to replace rice grain with raw Chinese Yam to consolidate Qi transformation in the Lower Jiao, supplemented by herbs that cool the Liver and regulate Qi, so that both the Warm Disease and dysentery may be cured simultaneously.
Prescription: Raw Gypsum (3 liang, crushed) Wild Codonopsis (4 qian) Raw Huai Chinese Yam (1 liang) Raw Hang Peony Root (1 liang) Anemarrhena Rhizome (6 qian) Pulsatilla Root (5 qian) Raw Malt (4 qian) Licorice Root (4 qian)
Decoct the herbs in water to yield three bowls of decoction, take warm, divided into three doses.
Follow-up Visit: After completing the three doses, the fever had subsided by more than half, the dysentery had improved by seventy to eighty percent, abdominal pain had ceased, and the pulse had become more harmonious compared to before. Therefore, slight modifications were made to the original prescription for continued administration.
Prescription: Raw Gypsum (2 liang, crushed) Wild Taishan Codonopsis (3 qian) Raw Huai Chinese Yam (8 qian) Raw Hang Peony Root (6 qian) Anemarrhena Rhizome (5 qian) Pulsatilla Root (5 qian) Bark of the Tree Peony Root (3 qian) Licorice Root (3 qian)
Decoct together to yield two bowls of decoction, take warm, divided into two doses.
Outcome: After taking two doses of the modified prescription, all symptoms resolved. However, the pulse still seemed to indicate residual heat, and the stomach felt obstructed with loss of appetite. She was advised to slice equal parts of fresh pear, fresh lotus root, and radish, boil them to make juice, and take this juice to administer about 3 qian of Yi Yuan San (Benefit Prime Powder), twice daily. By the third dose, her appetite returned, and her pulse became harmonious and normal.
Commentary: Cases of Warm Disease complicated with dysentery are particularly difficult to treat. This is because the Warm pathogen sinks deeply with the dysentery, having no outlet, while the dysentery is scorched by the warmth, exacerbating pain and tenesmus. Only the combination of Gypsum and Ginseng can lift the sunken Warm pathogen, allowing it to rise slowly and disperse outward. In this formula, the single herb of Raw Chinese Yam serves to harmonize the Stomach by replacing rice grain in Baihu Tang, and in treating dysentery, it consolidates Qi transformation in the Lower Jiao. It cooperates with Peony Root and Pulsatilla Root to nourish the Liver and Kidney, achieving results gracefully. As for Malt, when stir-fried, it acts as a digestive aid; when used raw, it not only aids digestion but also soothes Liver Qi and disperses Liver Fire, thereby relieving tenesmus associated with dysentery. Regarding the addition of Tree Peony Root Bark in the later prescription, its bitter-cold nature and astringent properties are utilized to clear heat and tonify deficiency, making it an ideal herb for resolving dysentery. Thus, in the Pulsatilla Decoction (Baitouweng Tang) from *Shanghan Lun* (Treatise on Cold Damage), it is also employed to clear Jueyin Heat Dysentery.