附片100克 干姜36克 甘草12克 上肉桂10克(研末，泡水兑
入)
服上方后，身热退去四、五，脉稍有神，小便赤而长，略进稀粥。再剂则热退七、八，大便始通，色黑而硬，惟咳嗽痰多，痰中兼带有血。病家另延数医诊视，皆云热症，出方总不离苦寒凉下之法。由于前医所误之鉴，又未敢轻试。后因病人吃梨一个，当晚忽发狂打人，身热大作，有如前状，又急邀余诊治，始言吃梨之事。余视之，舌白而滑，仍喜滚饮，此阳神尚虚，阴寒未净，急欲扶阳犹不及，反与滋阴清 凉之水果，又增里寒，病遂加重。即告以禁服生酸水果冷物及清凉苦寒之药为幸，余仍主以大剂回阳祛寒之剂治之。照第二方加倍分量，并加茯苓30克、半夏16克、北细辛4克，早晚各服一剂，共连服六剂。三日后再诊，身热已不作，咳痰渐愈，饮食增加，小便淡黄而长，大便转黄而溏。又照方去半夏、细辛，加砂仁、白术、口芪，每日一剂，连进十余剂，诸病俱愈。后体健胜于前。
按：凡病有真热证与真寒证之分，又有真热假寒证与真寒假热证之别。然真者易识，而假者难辨。《内经》曰： “治病必求于本。”即凡病当须辨明阴阳之意也。
伤寒病少阴阴极似阳证(二)
原云南省某医院院长秦××，住昆明市小南门内绣衣街，有独子名念祖，年十三岁，患伤寒重证，发热二十余日 不退。秦精于西医，对其子曾以多种针药施治，未效。又邀约徐、应等数位西医同道会诊，均断言无法挽救。后由秦之门生李××君推荐，邀余于1948年1月7日前往诊视。患儿已发热不退二十余日，晨轻夜重，面色青黯，两颧微发红，口唇焦燥而起血壳，日夜不寐，人事不省。呼吸喘促，时而发迷无神，时又见烦乱谵语，两手乱抓有如撮空理线。食物不进，小便短赤，大便已数日不通，舌苔黑燥，不渴饮，喂水仅下咽二、三日，多则不吮。脉象浮而空，重按无力。此系伤寒转入少阴，阴寒太盛，阴盛格阳，心肾不交，致成外假热而内真寒之阴极似阳证。外虽现一派燥热之象，内则阴寒已极，逼阳外浮，将有脱亡之势。法当大剂扶阳抑阴，回阳收纳，交通心肾，方可挽回，若误认热证，苦寒下咽，必危殆莫救。拟方白通汤加上内佳主之。
附片250克干姜50克 葱白4茎上肉桂15克(研末，泡水兑入)
处方之后，秦对中医药怀有疑虑，见此温热大剂，更不敢用，且对余说，他还有一特效办法，即抽取一伤寒病刚愈患者之血液输给病儿，可望有效。殊料是日输血后，身热尤甚，腹痛呻吟不止，更加烦乱谵语。至此，秦已感到束手无策，始将余所拟方药煎汤与其子试服。当晚服后，稍见安静，得寐片刻，面部青黯色稍退而略润，脉象不似昨日之空浮，烦躁谵语稍宁。但见欲寐愈甚，现出少阴虚寒本象，又照原方煎服一次。
1月8日复诊，热度稍降，唇舌已较润，烦乱止。但有时仍说昏话，曾呕吐涎痰一次，仍以白通汤加味扶阳抑阴，交通心肾兼化气行水主之。
附片300克 干姜30克 茯苓30克 上肉桂15克(研末，泡水兑
入) 葱白4茎
上方服后，当晚整夜烦躁不宁，不能入寐，秦君为此又生疑似，次日促余急往诊视，见到正用硼酸水给患儿洗口。
详查病情，脉稍有力，热度较前稍降，神情淡漠，不渴饮。
断定此系阴寒太盛，阳气太虚，虽得阳药以助，然病重药轻，药力与病邪相攻，力不胜病，犹兵不胜敌。虽见烦躁不宁，乃药病相争之兆，不必惊疑，尚须加重分量始能克之，拟用大剂四逆汤加味治之。
附片400克 干姜150克 上肉桂20克(研末，泡水兑入) 朱衣
茯神50克 炙远志20克 公丁香5克 生甘草20克
此方药力较重，为救危急，嘱煎透后一小时服药一次。当天下午五时又诊视之，病势已大松，烦躁平定，人已安静，小便转较长。病有转机，是夜叉照原方连进，大便始通，泻出酱黑稀粪三次，发热已退去大半，烦乱谵语已不再作，且得熟寐四、五小时。
10日清晨，脉浮绥，唇舌回润，黑苔退去十之六、七，身热退去十之八、九，大有转危为安之象。照第三方加西砂仁10克苍术10克吴萸8克治之。
11日复诊。大便又畅泻数次，其色仍酱黑。身热已退净，唇上焦黑血壳已脱去，黑苔更见减少，津液满口。日夜一个对时大便共泄泻十余次，秦君夫妇为此耽心害怕，认为有肠出血或肠穿孔的危险，每见其子排泻大便，即流泪惊惶不已。余当即详加解释，良由寒湿邪阴内盛，腹中有如冰霜凝聚，今得阳药温化运行，邪阴溃退，真阳返回而使冰霜化行。所拟方药，皆非泻下之剂，其排泻者为内停寒湿污秽之物，系病除佳兆，邪去则正自能安，方保无虞。于是，病家疑虑始减，继续接受治疗。仍以大剂温化日夜连进。
附片400克 干姜80克 上肉桂20克(研末，泡水兑入) 西砂
仁10克 茯苓50克 苡仁20克 蔻仁8克 甘草30克
12日诊。服药后大便又泻十余次，色逐渐转黄，小便已 较清长，黑苔全退，尚有白滑苔，食思恢复，随时感到腹中饥饿而索求饮食。因伤寒后期，阳神未复，脾胃亦虚，须当注意调摄，以防食复、劳复等证发生，只宜少量多餐，继拟下方调治。
附片400克 千姜80克 上肉桂20克(研末，泡水兑入) 西砂
仁10克 口芪30克 炙甘草20克 元肉30克
13日诊。大便仅泻二次，色黄而溏，唇色红润，白滑苔已退净，神识清明，食量较增，夜已能熟寐，脉静身凉，大病悉退，但阳神尚虚，形体瘦弱，起动则有虚汗而出，遂拟黄芪建中汤加桂附调理之。
附片300克 黄芪80克 桂尖2O克 , 杭芍30克 炙甘草20克
上肉桂20克(研末，泡水兑入) 生姜30克 大枣4枚 饴糖30克
(烊化兑入)
14日诊。脉沉缓而有神，唇舌红润，大便泻利已止，小便清长，有轻微咳嗽，腹中时或作痛，拟四逆汤加味治之。
附片300克 干姜100克 北细辛8克 上肉桂11克(研末，泡
水兑入) 广陈皮10克 法夏10克 甘草10克
15日诊。咳嗽、腹痛已止，唯正气尚虚，起卧乏力，继以四逆汤加参、芪作善后调理，服五、六剂而愈，其后体质健康如常。
伤寒病少阴阴盛格阳证马××之子，十三岁，住昆明市。1945年11月22日，患 伤寒病已廿余日，医者诊治未愈，寒邪引入阴分，格拒真阳浮越于外，致身热夜重，体温摄氏四十余度，反不恶寒，两颧发赤，唇焦而起血壳，头昏不食，欲寐无冲，饮水不多，心烦胸闷，冒逆欲呕，小便短赤，大便数日不通，白（疒咅）遍体如 麻，脉沉而紧，舌苔白腻。此阳虚阴盛之象，法当挟阳温化，破阴回阳主之。
附片26克 干姜1 0克上肉桂3克(研束，泡水兑入) 茯苓10克
葱白4茎
23日复诊。服昨方后呕吐涎水数碗，属温药运行，病除之兆。仍身热头昏无神，不渴饮，此伤寒寒极之证，阴寒内盛，阳不胜阴，决无热证，治法不变，
附片50克 干姜13克上肉桂3克(研末，泡水兑入) 茯苓10克
麦芽6克 葱白4茎
24日三诊。舌苔白腻而润，脉较和缓，昨夜曾大便一 次，色黑，初硬而后溏，此里寒内重，阳气尚虚，阳不潜藏，仍潮热，晨轻夜重，头昏欲寐无神，以大剂扶阳抑阴主之。
附片60克 干姜13克 上肉硅5克(研末，泡水兑入) 茯苓10克
西砂仁3克 公丁1．3克 甘草3克
25日四诊。今晨诊脉，一息五至，状若平脉，舌苔白滑尚厚腻，体温稍降至39.5℃，昨夜又解大便一次，心烦胸闷稍减，已得熟寐。惟病久里寒尚重，隔拒真阳，浮游于外而潮热，颧赤，多虚汗，头昏无神。此乃中阳不运，阴寒阻遏，胸腹胀闷仍不能食，热饮仅三、四日而已，势必驱尽里 寒邪阴，真阳始得返归其舍，潮热诸疰，焉有不退之理乎！
附片100克干姜16克上肉桂5克(研末，泡水兑入) 茯神10克
甘草10克
26日五诊。服昨方二次，于夜晚服药后，反见心中烦躁不安，此乃重剂温药，逐动阴寒，药力与病邪相攻之象。待至清晨，得天阳以助，遂见宁静得寐。刻诊，体温降至38．7℃，呼吸平和，脉搏一息五至，舌苔仍白腻而滑润。胃寒日久，仍不思饮食，痰多而夫黑血，属寒痰瘀血化行溃退，非热甚灼阴可比。所喜者，两颧赤色减退，白（疒咅）渐靥，体温已有下降，为病退佳兆。此病虚寒已极，决无热象足征，余乃抱定宗旨，仍以扶阳温化辅正主之。
附片180克 干姜16克上肉桂5克(研末，泡水兑入) 甘草1 0克
30日六诊。昨前三日，病家曾请西医诊治，医者以病情危重又无特效药而告退，又复延余以求尽力挽救之。刻诊脉缓弱无力，舌苔白润，小便已较清长，夜间仍有潮热，病者虚弱已极。此三阴虚寒之证，病情日久，阳神极虚，缓迨延误，恐有虚脱亡阳之虞，仍以扶阳抑阴，强心辅正主之。
附片130克 干姜16克 上肉桂6克(研末，泡水兑入) 西砂
仁5克 公丁3克 甘草10克
12月1 H七诊。体温已降至37℃，脉象缓弱，一息四至，面颧赤色全退，现出虚寒病容，晦暗无华，昨夜得汗，身热退后，反畏寒，属阴退阳回，阳气虽已来复，尚虚弱而无力以卫外所致。昨夜大便一次，色酱黑而溏，虽唇焦有黑血壳，然始终不见渴饮，此三阴寒极之证，阳神太亏，仍以扶阳扶正主之。
附片130克 干姜2 o克 上肉桂5克(研末，泡水兑入) 西砂
仁10克 茯神10克 苡仁20克 甘草10克
2日八诊。今晨诊视，体温37．2℃，脉象缓弱，一息四至，舌白润，各节病情均见好转，口淡无味，不思饮食。此乃病久中宫太寒，脾胃阳虚，司运失权，俟邪阴逐尽，中阳来复，则浙可思食矣。仍以扶阳扶正主之。
附片130克 干姜25V 上肉桂6克(研末，泡水兑入) 西砂
仁10克老扣仁3克炙甘草10克
3 H九诊，体温摄氏37．8℃，脉和缓，唇上黑血壳已脱去，舌苔较退，唇舌均转红润，不渴饮，胃气渐复，刻有思饮之意，入夜微有咳声。乃里寒尚未肃清，元阳仍虚，仍以扶阳辅正主之，稍佐治咳，切忌过早施用滋补之剂。
附片100克干姜25克上肉桂6克(研末，泡水兑入)西砂仁5克
法夏1 D克 炙冬花5克 吴萸6克 炙甘草10克
4日十诊。体温降至36．7℃，咳已止，阳神尚虚，照昨方再进一剂。
5日十一诊。脉缓弱，苔已退，唇舌红润，不渴饮，小便清长，晨间体温36．5℃，惟睡眠少，胃口不开，头上时有冷汗，阳神太亏，继以扶阳健胃，养心安神主之。
附片160克 干姜65克 西砂仁6克(捣) 上肉桂5克(研
末，泡水兑入) 老扣仁3克(捣) 炙远志6克 朱衣茯神
10克 炒枣仁10克 琥珀3克(研末，兑服) 甘草6克
6日十二诊。脉象、体温已正常，唇舌红润，昨日已进饮食，睡眠转佳，阳神尚虚，仍以扶阳辅正主之。
附片130克 干姜205 上肉桂5克(研末，泡水兑入) 西砂
仁6克明党参2 0克甘草6克
7日13诊。脉、舌，体温均如常，二便通畅，饮食、精神转佳，大病已退，渐加调补，可期痊愈。遂拟扶阳建中调理善后，数剂而后恢复健康。
附片100克 干姜16克 西砂仁6克(捣) 老扣仁3克(捣)
上肉桂10克(研末，泡水兑入) 口芪20克 明党参20克炙甘
草6克小儿伤寒病并肠出血危证
张××之子，年八岁，云南省宾川县人。1945年4月，患伤寒病已十余日，住原昆华医院治疗，病势日趋严重，遂将病儿移回家中。4月23日，改延余诊视。面青唇白而焦，舌质红而润，无苔，脉象弦紧，按之则空虚无力，体温潮热，日轻夜重，神识昏愦，言语昏乱，腹胀如蛊，曾大便下血二次，小便短少而赤，形体瘦赢。此系患伤寒病，寒入阴分，致腹中阴霾四布，元阳大虚，已成危证，恐有生阳将脱之虞。当以扶阳抑阴治之。然温热之药服后，触动阴寒，必有吐泻之状，由于正气太虚，一线残阳将脱，唯恐吐泻之时，又易痰鸣气喘虚脱，思维再三，只有背城一战，方有挽 回之机，犹豫迟疑，错过病机，则追之莫及矣。急以通脉四逆汤加上肉桂主之。
黑附片100克 干姜26克 生草10克 上肉桂10克(研末，泡水
兑入) 葱白2茎
是晚七时．张君复来寓告知，服药二次，旋即呕吐涎水，继则泄泻黑粪，腹胀已消去其半，幸未气喘痰鸣，唯精神太弱。当即告之，已有转机，宜原方再进一剂。
24日晨复诊。昨日服药后吐泻，腹胀若失，弦紧脉象已平，潮热亦退。缘伤寒大病月久，元阳太耗，鼓胀虽消，而邪阴未净，阳神未充，散乱无主，尚见沉迷无神，时有烦乱说昏话。然病情已有转机，毋须置疑，仍以扶阳抑阴主之。
附片130克 干姜26克 上肉桂13克(研末，泡水兑入) 西砂
仁4克茯神16克炙远志3克生草4克
附片100克，干姜36克，甘草12克，上肉桂10克（研成粉末，用开水冲泡后兑入药汤中）。
服用上述方剂后，身热退去四五成，脉搏稍有起色，小便颜色红赤且尿量增多，开始少量进食稀粥。再服一剂后，热势退去七八成，大便开始通畅，排出黑色硬便，仅余咳嗽痰多，痰中带血。病家另外邀请了几位医生诊治，都认为是热证，开出的方子总不离苦寒攻下的治法。鉴于前医误治的教训，不敢轻易尝试。后来病人吃了一个梨，当晚突然发狂打人，身热大作，症状如前。又急忙邀请我诊治，这才告知吃了梨的事。我看他舌苔白而滑润，仍喜欢喝热水，这是阳气神气尚虚，阴寒未净，急欲扶助阳气还来不及，反而给予滋阴清凉的水果，又增加了里寒，病情因此加重。我便告知若能禁止食用生冷酸水果及清凉苦寒的药物，便是万幸，我仍以大剂量回阳祛寒的方剂治疗。按照第二方的剂量加倍，并加入茯苓30克、半夏16克、北细辛4克，早晚各服一剂，连续服用六剂。三天后再诊，身热已不再发作，咳痰逐渐痊愈，饮食增加，小便淡黄且尿量长，大便转黄而溏。又照原方去掉半夏、细辛，加入砂仁、白术、黄芪，每日一剂，连续进服十余剂，各种病症全部痊愈。后来身体比患病前更健康。
按语：凡是疾病都有真热证与真寒证的区别，又有真热假寒证与真寒假热证的不同。然而真证容易识别，而假证难以辨别。《内经》说：“治病必求于本。”即凡病都必须辨明阴阳的意思。
原云南省某医院院长秦××，住在昆明市小南门内绣衣街，有一个独生子名叫念祖，十三岁，患伤寒重症，发热二十多天不退。秦先生精通西医，对其子曾用多种针药治疗，无效。又邀请徐、应等数位西医同道会诊，均断言无法挽救。后经秦先生的门生李××君推荐，邀我于1948年1月7日前往诊视。患儿已发热不退二十多天，早晨轻晚上重，面色青暗，两颧微发红，口唇焦燥而起血痂，日夜不能入睡，人事不省。呼吸喘促，时而发呆无神，时而又见烦躁混乱、胡言乱语，两手乱抓，如同撮空理线。食物不进，小便短赤，大便已数日不通，舌苔黑燥，不渴饮，喂水仅能咽下两三口，多了就不吸吮。脉象浮而空，重按无力。这是伤寒转入少阴，阴寒太盛，阴盛格拒阳气，心肾不交，导致外现假热而内里真寒的阴极似阳证。外虽现一派燥热之象，内则阴寒已极，逼迫阳气外浮，将有脱亡之势。治法应当大剂量扶阳抑阴，回阳收纳，交通心肾，方可挽回，若误认为热证，使用苦寒药物，必然危殆无法救治。拟方白通汤加味主治。
附片250克，干姜50克，葱白4茎，上肉桂15克（研成粉末，用开水冲泡后兑入药汤中）。
处方之后，秦先生对中医药怀有疑虑，见此温热大剂，更不敢用，且对我说，他还有一特效办法，即抽取一个刚愈的伤寒病人的血液输给病儿，可望有效。不料是日输血后，身热更加严重，腹痛呻吟不止，更加烦躁混乱、胡言乱语。至此，秦先生已感到束手无策，才将我拟定的方药煎汤给其子试服。当晚服后，稍见安静，得睡片刻，面部青黯色稍退而略润，脉象不似昨日之空浮，烦躁谵语稍宁。但见想睡觉的症状更甚，现出少阴虚寒的本象，又照原方煎服一次。
1月8日复诊，热度稍降，唇舌已较润，烦躁停止。但有时仍说昏话，曾呕吐涎痰一次，仍以白通汤加味扶阳抑阴，交通心肾兼化气行水主治。
附片300克，干姜30克，茯苓30克，上肉桂15克（研成粉末，用开水冲泡后兑入药汤中），葱白4茎。
上方服后，当晚整夜烦躁不宁，不能入睡，秦先生为此又产生怀疑，次日催促我急忙前往诊视，见到正用硼酸水给患儿洗口。
详细检查病情，脉稍有力，热度较前稍降，神情淡漠，不渴饮。
断定此系阴寒太盛，阳气太虚，虽然得到阳药以助，然病重药轻，药力与病邪相攻，力不胜病，犹如兵不胜敌。虽见烦躁不宁，乃是药病相争的征兆，不必惊疑，尚须加重分量始能克制，拟用大剂量四逆汤加味治疗。
附片400克，干姜150克，上肉桂20克（研成粉末，用开水冲泡后兑入药汤中），朱衣茯神50克，炙远志20克，公丁香5克，生甘草20克。
此方药力较重，为救危急，嘱咐煎透后一小时服药一次。当天下午五时又诊视之，病势已大松，烦躁平定，人已安静，小便转较长。病有转机，是夜又照原方连进，大便始通，泻出酱黑稀粪三次，发热已退去大半，烦乱谵语已不再作，且得熟睡四五个小时。
10日清晨，脉浮缓，唇舌回润，黑苔退去十分之六七，身热退去十分之八九，大有转危为安之象。照第三方加西砂仁10克、苍术10克、吴茱萸8克治疗。
11日复诊。大便又畅泻数次，其色仍酱黑。身热已退净，唇上焦黑血痂已脱去，黑苔更见减少，津液满口。日夜一个时辰大便共泄泻十余次，秦君夫妇为此担心害怕，认为有肠出血或肠穿孔的危险，每见其子排泻大便，即流泪惊惶不已。我当即详加解释，良由寒湿邪阴内盛，腹中有如冰霜凝聚，今得阳药温化运行，邪阴溃退，真阳返回而使冰霜化行。所拟方药，皆非泻下之剂，其排泻者为内停寒湿污秽之物，系病除佳兆，邪去则正自能安，方保无虞。于是，病家疑虑始减，继续接受治疗。仍以大剂量温化日夜连进。
附片400克，干姜80克，上肉桂20克（研成粉末，用开水冲泡后兑入药汤中），西砂仁10克，茯苓50克，薏苡仁20克，蔻仁8克，甘草30克。
12日诊。服药后大便又泻十余次，色逐渐转黄，小便已较清长，黑苔全退，尚有白滑苔，食欲恢复，随时感到腹中饥饿而索求饮食。因伤寒后期，阳气神气未复，脾胃亦虚，须当注意调摄，以防食复、劳复等证发生，只宜少量多餐，继拟下方调治。
附片400克，干姜80克，上肉桂20克（研成粉末，用开水冲泡后兑入药汤中），西砂仁10克，黄芪30克，炙甘草20克，龙眼肉30克。
13日诊。大便仅泻二次，色黄而溏，唇色红润，白滑苔已退净，神识清明，食量较增，夜已能熟睡，脉静身凉，大病悉退，但阳气神气尚虚，形体瘦弱，起动则有虚汗而出，遂拟黄芪建中汤加桂附调理之。
附片300克，黄芪80克，桂尖20克，杭芍30克，炙甘草20克，上肉桂20克（研成粉末，用开水冲泡后兑入药汤中），生姜30克，大枣4枚，饴糖30克（烊化兑入）。
14日诊。脉沉缓而有神，唇舌红润，大便泻利已止，小便清长，有轻微咳嗽，腹中时或作痛，拟四逆汤加味治疗。
附片300克，干姜100克，北细辛8克，上肉桂11克（研成粉末，用开水冲泡后兑入药汤中），广陈皮10克，法夏10克，甘草10克。
15日诊。咳嗽、腹痛已止，唯正气尚虚，起卧乏力，继以四逆汤加人参、黄芪作善后调理，服五六剂而愈，其后体质健康如常。
伤寒病少阴阴盛格阳证 马××之子，十三岁，住昆明市。1945年11月22日，患伤寒病已二十多天，医者诊治未愈，寒邪引入阴分，格拒真阳浮越于外，致身热夜重，体温摄氏四十余度，反不恶寒，两颧发赤，唇焦而起血痂，头昏不食，欲寐无神，饮水不多，心烦胸闷，冒逆欲呕，小便短赤，大便数日不通，全身发出白㾦如麻，脉沉而紧，舌苔白腻。此阳虚阴盛之象，治法当挟阳温化，破阴回阳主治。
附片26克，干姜10克，上肉桂3克（研成粉末，用开水冲泡后兑入药汤中），茯苓10克，葱白4茎。
23日复诊。服昨方后呕吐涎水数碗，属温药运行，病除之兆。仍身热头昏无神，不渴饮，此伤寒寒极之证，阴寒内盛，阳不胜阴，决无热证，治法不变。
附片50克，干姜13克，上肉桂3克（研成粉末，用开水冲泡后兑入药汤中），茯苓10克，麦芽6克，葱白4茎。
24日三诊。舌苔白腻而润，脉较和缓，昨夜曾大便一次，色黑，初硬而后溏，此里寒内重，阳气尚虚，阳不潜藏，仍潮热，晨轻夜重，头昏欲寐无神，以大剂量扶阳抑阴主治。
附片60克，干姜13克，上肉桂5克（研成粉末，用开水冲泡后兑入药汤中），茯苓10克，西砂仁3克，公丁香1.3克，甘草3克。
25日四诊。今晨诊脉，一息五至，状若平脉，舌苔白滑尚厚腻，体温稍降至39.5℃，昨夜又解大便一次，心烦胸闷稍减，已得熟睡。惟病久里寒尚重，隔拒真阳，浮游于外而潮热，颧赤，多虚汗，头昏无神。此乃中阳不运，阴寒阻遏，胸腹胀闷仍不能食，热饮仅两三勺而已，势必驱尽里寒邪阴，真阳始得返归其舍，潮热诸症，焉有不退之理乎！
附片100克，干姜16克，上肉桂5克（研成粉末，用开水冲泡后兑入药汤中），茯神10克，甘草10克。
26日五诊。服昨方二次，于夜晚服药后，反见心中烦躁不安，此乃重剂温药，逐动阴寒，药力与病邪相攻之象。待至清晨，得天阳以助，遂见宁静得睡。刻诊，体温降至38.7℃，呼吸平和，脉搏一息五至，舌苔仍白腻而滑润。胃寒日久，仍不思饮食，痰多而无黑血，属寒痰瘀血化行溃退，非热甚灼阴可比。所喜者，两颧赤色减退，白㾦渐收，体温已有下降，为病退佳兆。此病虚寒已极，决无热象足征，我乃抱定宗旨，仍以扶阳温化辅正主治。
附片180克，干姜16克，上肉桂5克（研成粉末，用开水冲泡后兑入药汤中），甘草10克。
30日六诊。昨前三日，病家曾请西医诊治，医者以病情危重又无特效药而告退，又复延我以求尽力挽救之。刻诊脉缓弱无力，舌苔白润，小便已较清长，夜间仍有潮热，病者虚弱已极。此三阴虚寒之证，病情日久，阳气神气极虚，延误恐有虚脱亡阳之虞，仍以扶阳抑阴，强心辅正主治。
附片130克，干姜16克，上肉桂6克（研成粉末，用开水冲泡后兑入药汤中），西砂仁5克，公丁香3克，甘草10克。
12月1日七诊。体温已降至37℃，脉象缓弱，一息四至，面颧赤色全退，现出虚寒病容，晦暗无华，昨夜得汗，身热退后，反畏寒，属阴退阳回，阳气虽已来复，尚虚弱而无力以卫外所致。昨夜大便一次，色酱黑而溏，虽唇焦有黑血痂，然始终不见渴饮，此三阴寒极之证，阳气神气太亏，仍以扶阳扶正主治。
附片130克，干姜20克，上肉桂5克（研成粉末，用开水冲泡后兑入药汤中），西砂仁10克，茯神10克，薏苡仁20克，甘草10克。
2日八诊。今晨诊视，体温37.2℃，脉象缓弱，一息四至，舌白润，各节病情均见好转，口淡无味，不思饮食。此乃病久中宫太寒，脾胃阳虚，司运失权，俟邪阴逐尽，中阳来复，则可思食矣。仍以扶阳扶正主治。
附片130克，干姜25克，上肉桂6克（研成粉末，用开水冲泡后兑入药汤中），西砂仁10克，老扣仁3克，炙甘草10克。
3日九诊，体温摄氏37.8℃，脉和缓，唇上黑血痂已脱去，舌苔较退，唇舌均转红润，不渴饮，胃气渐复，刻有思饮之意，入夜微有咳声。乃里寒尚未肃清，元阳仍虚，仍以扶阳辅正主治，稍佐治咳，切忌过早施用滋补之剂。
附片100克，干姜25克，上肉桂6克（研成粉末，用开水冲泡后兑入药汤中），西砂仁5克，法夏10克，炙冬花5克，吴茱萸6克，炙甘草10克。
4日十诊。体温降至36.7℃，咳已止，阳气神气尚虚，照昨方再进一剂。
5日十一诊。脉缓弱，苔已退，唇舌红润，不渴饮，小便清长，晨间体温36.5℃，惟睡眠少，胃口不开，头上时有冷汗，阳气神气太亏，继以扶阳健胃，养心安神主治。
附片160克，干姜65克，西砂仁6克（捣碎），上肉桂5克（研成粉末，用开水冲泡后兑入药汤中），老扣仁3克（捣碎），炙远志6克，朱衣茯神10克，炒枣仁10克，琥珀3克（研成粉末，兑服），甘草6克。
6日十二诊。脉象、体温已正常，唇舌红润，昨日已进饮食，睡眠转佳，阳气神气尚虚，仍以扶阳辅正主治。
附片130克，干姜20克，上肉桂5克（研成粉末，用开水冲泡后兑入药汤中），西砂仁6克，明党参20克，甘草6克。
7日十三诊。脉、舌，体温均如常，二便通畅，饮食、精神转佳，大病已退，渐加调补，可期痊愈。遂拟扶阳建中调理善后，数剂而后恢复健康。
附片100克，干姜16克，西砂仁6克（捣碎），老扣仁3克（捣碎），上肉桂10克（研成粉末，用开水冲泡后兑入药汤中），黄芪20克，明党参20克，炙甘草6克。
张××之子，年八岁，云南省宾川县人。1945年4月，患伤寒病已十余日，住原昆华医院治疗，病势日趋严重，遂将病儿移回家中。4月23日，改延我诊视。面青唇白而焦，舌质红而润，无苔，脉象弦紧，按之则空虚无力，体温潮热，日轻夜重，神识昏愦，言语昏乱，腹胀如蛊，曾大便下血二次，小便短少而赤，形体瘦赢。此系患伤寒病，寒入阴分，致腹中阴霾四布，元阳大虚，已成危证，恐有生阳将脱之虞。当以扶阳抑阴治之。然温热之药服后，触动阴寒，必有吐泻之状，由于正气太虚，一线残阳将脱，唯恐吐泻之时，又易痰鸣气喘虚脱，思维再三，只有背城一战，方有挽回之机，犹豫迟疑，错过病机，则追之莫及矣。急以通脉四逆汤加上肉桂主治。
黑附片100克，干姜26克，生草10克，上肉桂10克（研成粉末，用开水冲泡后兑入药汤中），葱白2茎。
是晚七时，张君复来寓告知，服药二次，旋即呕吐涎水，继则泄泻黑粪，腹胀已消去其半，幸未气喘痰鸣，唯精神太弱。当即告之，已有转机，宜原方再进一剂。
24日晨复诊。昨日服药后吐泻，腹胀若失，弦紧脉象已平，潮热亦退。缘伤寒大病月久，元阳太耗，鼓胀虽消，而邪阴未净，阳气神气未充，散乱无主，尚见沉迷无神，时有烦乱说昏话。然病情已有转机，毋须置疑，仍以扶阳抑阴主治。
附片130克，干姜26克，上肉桂13克（研成粉末，用开水冲泡后兑入药汤中），西砂仁4克，茯神16克，炙远志3克，生草4克。
Aconiti Lateralis Radix Praeparata (Fupian) 100g, Zingiberis Rhizoma (Ganjiang) 36g, Glycyrrhizae Radix et Rhizoma (Gancao) 12g, Cinnamomi Cortex (Shang Rougui) 10g (ground into powder, soaked in water and added to the decoction).
After taking the above prescription, the body heat subsided by four or five tenths, the pulse showed slight vitality, urine became red and copious, and a small amount of thin porridge was consumed. After another dose, the fever subsided by seven or eight tenths, defecation began to be smooth, passing black and hard stools; only cough with profuse sputum, mixed with blood, remained. The family invited several other physicians for consultation, all of whom diagnosed it as a heat syndrome, prescribing formulas invariably based on bitter-cold purgative methods. Due to the cautionary lesson of previous misdiagnosis, they dared not try lightly. Later, after the patient ate one pear, he suddenly went mad and beat people that night, with severe recurrence of high fever, similar to the initial state. He was urgently invited to treat again, at which point the matter of eating the pear was disclosed. I observed his tongue was white and slippery, and he still preferred hot drinks. This indicated that Yang Qi was still deficient and Yin-Cold had not been cleared. Urgent support of Yang was needed, yet giving yin-nourishing and cooling fruits increased interior cold, worsening the condition. I advised that it would be fortunate if raw, sour, cold foods and cooling bitter-cold medicines were strictly avoided. I continued to prescribe large doses of formulas to restore Yang and dispel cold. Doubling the dosage of the second formula, and adding Poria (Fuling) 30g, Pinelliae Tuber (Banxia) 16g, and Asari Radix (Beixixin) 4g, one dose each morning and evening, taken continuously for six doses. Upon re-examination three days later, the fever had ceased, cough and sputum gradually improved, food intake increased, urine became pale yellow and copious, and stool turned yellow and loose. The prescription was modified by removing Banxia and Beixixin, adding Amomum Fruit (Sharen), Atractylodis Macrocephalae Rhizoma (Baizhu), and Astragali Radix (Huangqi), one dose daily, taken continuously for more than ten doses, resulting in the complete resolution of all symptoms. His health subsequently exceeded its pre-illness state.
Note: Diseases are categorized into true heat and true cold syndromes, as well as true heat with false cold and true cold with false heat patterns. However, true patterns are easy to identify, while false ones are difficult to distinguish. The *Neijing* states: "In treating diseases, one must seek the root." This implies that all diseases require differentiation of Yin and Yang.
Shanghan Disease: Shaoyin Extreme Yin Resembling Yang Syndrome (II)
Mr. Qin XX, former president of a certain hospital in Yunnan Province, resided at Xiuyi Street inside the Small South Gate of Kunming City. His only son, Nianzu, aged thirteen, suffered from severe Shanghan disease with persistent fever for over twenty days. Mr. Qin was proficient in Western medicine and had treated his son with various injections and medications without effect. He invited several Western medical colleagues, including Xu and Ying, for consultation, who all declared the case incurable. Subsequently, recommended by Mr. Qin's student, Mr. Li XX, I was invited to examine the patient on January 7, 1948. The child had had unrelenting fever for over twenty days, milder in the morning and heavier at night. His complexion was dark blue-black, with slight redness on both cheeks. Lips were scorched and dry with scabs, sleepless day and night, unconscious. Breathing was panting; occasionally dazed and spiritless, alternatively restless and delirious, with hands grasping aimlessly as if picking threads from empty air. No food intake, scanty red urine, no bowel movement for several days. Tongue coating was black and dry, no thirst, swallowing only two or three mouthfuls of water when fed, refusing more. Pulse was floating and empty, powerless upon deep pressure. This indicated Shanghan transitioning to Shaoyin, excessive Yin-Cold causing Yin to repel Yang, failure of Heart and Kidney communication, resulting in an exterior false heat and interior true cold pattern of extreme Yin resembling Yang. Although exterior signs suggested dryness and heat, interior Yin-Cold was extreme, forcing Yang to float outward, indicating imminent collapse. The treatment method should be large doses to support Yang and suppress Yin, restore Yang and gather it, and communicate Heart and Kidney, to save the situation. Misidentifying this as a heat syndrome and administering bitter-cold drugs would inevitably lead to fatal danger. The prescribed formula was Baitong Tang modified.
Aconiti Lateralis Radix Praeparata (Fupian) 250g, Zingiberis Rhizoma (Ganjiang) 50g, Scallion White (Congbai) 4 stalks, Cinnamomi Cortex (Shang Rougui) 15g (ground into powder, soaked in water and added to the decoction).
After the prescription, Mr. Qin harbored doubts about Traditional Chinese Medicine. Seeing this large dose of warm-hot herbs, he dared not use them further. He told me he had another special method: transfusing blood from a patient recently recovered from Shanghan into his son, hoping for efficacy. Unexpectedly, after the blood transfusion that day, the fever intensified, abdominal pain and groaning continued incessantly, and restlessness and delirium worsened. At this point, Mr. Qin felt helpless and finally had the prescribed herbal decoction administered to his son. After taking it that night, there was slight calmness, brief sleep, fading of the dark blue-black facial color with slight moistening, pulse no longer empty and floating as yesterday, and reduced restlessness and delirium. However, the desire to sleep increased, revealing the fundamental pattern of Shaoyin deficiency-cold. Another dose of the original formula was prepared and administered.
Re-examination on January 8: Temperature slightly decreased, lips and tongue moister, restlessness stopped. Occasionally spoke confused words, vomited saliva and phlegm once. Continued using Baitong Tang modified to support Yang, suppress Yin, communicate Heart and Kidney, and transform Qi to promote water metabolism.
Aconiti Lateralis Radix Praeparata (Fupian) 300g, Zingiberis Rhizoma (Ganjiang) 30g, Poria (Fuling) 30g, Cinnamomi Cortex (Shang Rougui) 15g (ground into powder, soaked in water and added to the decoction), Scallion White (Congbai) 4 stalks.
After taking the above prescription, the patient was restless and unable to sleep all night. Mr. Qin became suspicious again and urged my urgent visit the next day. I found him washing the child's mouth with boric acid solution.
Detailed examination: Pulse slightly stronger, temperature slightly lower than before, expression indifferent, no thirst.
Diagnosed as excessive Yin-Cold and too deficient Yang. Although aided by Yang-tonifying herbs, the disease was severe and the medication light; the medicinal force clashed with the pathogen but was insufficient, like soldiers failing against enemies. The restlessness was a sign of the clash between medicine and disease, not requiring alarm. Dosage must be increased to overcome it. Prescribed large-dose Sini Tang modified.
Aconiti Lateralis Radix Praeparata (Fupian) 400g, Zingiberis Rhizoma (Ganjiang) 150g, Cinnamomi Cortex (Shang Rougui) 20g (ground into powder, soaked in water and added to the decoction), Poria with Cinnabar Coating (Zhuyi Fushen) 50g, Prepared Polygalae Radix (Zhianyuanzhi) 20g, Clove (Gongdingxiang) 5g, Raw Licorice Root (Sheng Gancao) 20g.
This prescription had strong medicinal power. To address the emergency, instructed to boil thoroughly and take one dose one hour after boiling. Re-examined at 5 PM that afternoon: condition greatly relaxed, restlessness settled, patient calm, urine longer. The disease showed signs of turning. That night, another dose of the original formula was taken. Bowel movement occurred, passing three times of dark brown watery stool. Fever subsided by more than half, restlessness and delirium ceased, and sound sleep lasted four to five hours.
Morning of the 10th: Pulse floating and moderate, lips and tongue regained moisture, black coating reduced by six or seven-tenths, fever subsided by eight or nine-tenths, showing great potential for turning danger into safety. Modified the third prescription with Cardamom Fructus (Xisha Ren) 10g, Atractylodis Rhizoma (Cangzhu) 10g, and Evodiae Fructus (Wuyu) 8g.
Re-examination on the 11th: Defecated freely several times, color still dark brown. Fever completely subsided, black scabs on lips shed, black coating further reduced, mouth full of fluids. Over twelve hours, defecated more than ten times. Mr. and Mrs. Qin were worried, fearing intestinal bleeding or perforation. Every time their son defecated, they cried in panic. I explained in detail: It is due to internal excess of cold-damp evil Yin, accumulation in the abdomen like ice and frost. Now, warmed by Yang herbs, the evil Yin retreats, True Yang returns, melting the ice and frost. The prescribed formulas are not purgatives; the expelled material is internally retained cold-damp filth, a good omen of disease removal. When pathogens leave, Zheng Qi naturally settles, ensuring safety. Thus, the family's doubts lessened, continuing treatment. Large doses of warming-transforming formulas continued day and night.
Aconiti Lateralis Radix Praeparata (Fupian) 400g, Zingiberis Rhizoma (Ganjiang) 80g, Cinnamomi Cortex (Shang Rougui) 20g (ground into powder, soaked in water and added to the decoction), Cardamom Fructus (Xisha Ren) 10g, Poria (Fuling) 50g, Coicis Semen (Yiren) 20g, Arecae Seed (Kouren) 8g, Licorice Root (Gancao) 30g.
Examination on the 12th: After taking medicine, defecated more than ten times, color gradually turning yellow, urine clearer and longer, black coating fully gone, remaining white-slippery coating. Appetite restored, feeling hungry anytime seeking food. In the late stage of Shanghan, Yang Qi has not recovered, Spleen and Stomach are also deficient. Careful regulation is needed to prevent relapse due to diet or labor. Only small frequent meals are suitable. Next prescription for regulation:
Aconiti Lateralis Radix Praeparata (Fupian) 400g, Zingiberis Rhizoma (Ganjiang) 80g, Cinnamomi Cortex (Shang Rougui) 20g (ground into powder, soaked in water and added to the decoction), Cardamom Fructus (Xisha Ren) 10g, Astragali Radix (Huangqi) 30g, Prepared Licorice Root (Zhigancao) 20g, Longan Aril (Yuanrou) 30g.
Examination on the 13th: Defecated only twice, yellow and loose, lips ruddy, white-slippery coating completely gone, mind clear, food intake increased, sound sleep at night, pulse calm, body cool, major illness receded. But Yang Qi still deficient, body emaciated, sweating upon movement. Prescribed Huangqi Jianzhong Tang modified with Guizhi and Fuzi for regulation.
Aconiti Lateralis Radix Praeparata (Fupian) 300g, Astragali Radix (Huangqi) 80g, Cinnamon Twig (Guizhi) 20g, Paeoniae Radix Alba (Hangshao) 30g, Prepared Licorice Root (Zhigancao) 20g, Cinnamomi Cortex (Shang Rougui) 20g (ground into powder, soaked in water and added to the decoction), Fresh Ginger (Shengjiang) 30g, Jujube (Dazao) 4 pieces, Maltose (Yitang) 30g (dissolved and added).
Examination on the 14th: Pulse deep, moderate, and spirited, lips and tongue ruddy, diarrhea stopped, urine clear and long, slight cough, occasional abdominal pain. Prescribed Sini Tang modified.
Aconiti Lateralis Radix Praeparata (Fupian) 300g, Zingiberis Rhizoma (Ganjiang) 100g, Asari Radix (Beixixin) 8g, Cinnamomi Cortex (Shang Rougui) 11g (ground into powder, soaked in water and added to the decoction), Tangerine Peel (Guangchenpi) 10g, Processed Pinellia (Faxia) 10g, Licorice Root (Gancao) 10g.
Examination on the 15th: Cough and abdominal pain stopped, only Zheng Qi still deficient, fatigue rising and lying down. Continued with Sini Tang plus Ginseng and Astragalus for convalescence. Took five or six doses and recovered, thereafter constitution normal.
Shanghan Disease: Shaoyin Excessive Yin Repelling Yang Syndrome. Son of Ma XX, thirteen years old, residing in Kunming City. On November 22, 1945, suffering from Shanghan for over twenty days, untreated by doctors. Cold pathogen entered Yin level, repelling True Yang to float outward, causing body heat heavier at night, body temperature over 40°C, contrary lack of aversion to cold, red cheeks, scorched lips with scabs, dizziness, anorexia, desire to sleep but spiritless, little drinking, vexation, chest tightness, nausea, scanty red urine, no bowel movement for days, whole body covered in white miliary rash (Bai Bao), pulse deep and tight, tongue coating white and greasy. This is a manifestation of Yang deficiency and Yin excess. Treatment method: Support Yang and warm transformation, break Yin and restore Yang.
Aconiti Lateralis Radix Praeparata (Fupian) 26g, Zingiberis Rhizoma (Ganjiang) 10g, Cinnamomi Cortex (Shang Rougui) 3g (ground into powder, soaked in water and added to the decoction), Poria (Fuling) 10g, Scallion White (Congbai) 4 stalks.
Re-examination on the 23rd: After taking yesterday's prescription, vomited several bowls of saliva/phlegm, indicating warm herbs moving, a sign of disease removal. Still feverish, dizzy, spiritless, no thirst. This is extreme cold of Shanghan, internal excess of Yin-Cold, Yang unable to overcome Yin, definitely no heat syndrome. Treatment method unchanged.
Aconiti Lateralis Radix Praeparata (Fupian) 50g, Zingiberis Rhizoma (Ganjiang) 13g, Cinnamomi Cortex (Shang Rougui) 3g (ground into powder, soaked in water and added to the decoction), Poria (Fuling) 10g, Hordeum Vulgare Sprout (Maiya) 6g, Scallion White (Congbai) 4 stalks.
Third examination on the 24th: Tongue coating white, greasy and moist, pulse relatively moderate. Had one bowel movement last night, black color, initially hard then loose. This indicates heavy interior cold, Yang still deficient, Yang not storing, still tidal fever, milder in morning, heavier at night, dizziness, desire to sleep but spiritless. Prescribed large dose to support Yang and suppress Yin.
Aconiti Lateralis Radix Praeparata (Fupian) 60g, Zingiberis Rhizoma (Ganjiang) 13g, Cinnamomi Cortex (Shang Rougui) 5g (ground into powder, soaked in water and added to the decoction), Poria (Fuling) 10g, Cardamom Fructus (Xisha Ren) 3g, Clove (Gongding) 1.3g, Licorice Root (Gancao) 3g.
Fourth examination on the 25th: Morning pulse, five beats per breath, resembling normal pulse. Tongue coating white, slippery, thick and greasy. Body temperature slightly dropped to 39.5°C. Had one bowel movement last night, vexation and chest tightness slightly reduced, achieved sound sleep. Only prolonged interior cold remains heavy, repelling True Yang, floating outward causing tidal fever, red cheeks, much spontaneous sweat, dizziness, spiritless. This is Middle Yang failing to transport, Yin-Cold obstructing, chest and abdominal distension still preventing eating, hot drinks only two or three spoonfuls. Must drive out all interior cold and evil Yin before True Yang can return to its residence. How could tidal fever and other symptoms not subside!
Aconiti Lateralis Radix Praeparata (Fupian) 100g, Zingiberis Rhizoma (Ganjiang) 16g, Cinnamomi Cortex (Shang Rougui) 5g (ground into powder, soaked in water and added to the decoction), Poria with Cinnabar Coating (Fushen) 10g, Licorice Root (Gancao) 10g.
Fifth examination on the 26th: After taking yesterday's prescription twice, felt inner restlessness after night dose. This is heavy warm herbs stirring Yin-Cold, medicinal force clashing with pathogen. By morning, aided by Heavenly Yang, saw calmness and sleep. Current examination: Temperature dropped to 38.7°C, breathing peaceful, pulse five beats per breath, tongue coating still white, greasy and slippery. Long-standing stomach cold, still no appetite, profuse sputum without black blood. Belongs to cold-phlegm and blood stasis transforming and retreating, not comparable to heat severely burning Yin. Fortunately, cheek redness faded, white miliary rash healing, temperature dropping, good omen of disease receding. This disease is extremely deficient-cold, definitely no heat evidence. I stick to my principle, still supporting Yang, warming transformation, and assisting Zheng.
Aconiti Lateralis Radix Praeparata (Fupian) 180g, Zingiberis Rhizoma (Ganjiang) 16g, Cinnamomi Cortex (Shang Rougui) 5g (ground into powder, soaked in water and added to the decoction), Licorice Root (Gancao) 10g.
Sixth examination on the 30th: Previous three days, family consulted Western doctors, who withdrew citing critical condition and lack of specific drugs, then returned to me for rescue. Current examination: Pulse slow, weak, powerless, tongue coating white and moist, urine clearer and longer, still tidal fever at night, patient extremely weak. This is Three Yin deficiency-cold syndrome. Disease prolonged, Yang Qi extremely deficient, delay risks collapse and Yang loss. Still supporting Yang, suppressing Yin, strengthening Heart and assisting Zheng.
Aconiti Lateralis Radix Praeparata (Fupian) 130g, Zingiberis Rhizoma (Ganjiang) 16g, Cinnamomi Cortex (Shang Rougui) 6g (ground into powder, soaked in water and added to the decoction), Cardamom Fructus (Xisha Ren) 5g, Clove (Gongding) 3g, Licorice Root (Gancao) 10g.
Seventh examination on December 1st: Temperature dropped to 37°C, pulse slow and weak, four beats per breath, cheek redness completely gone, revealing deficient-cold appearance, dull and lusterless. Sweated last night, after fever subsided, now aversion to cold. Indicates Yin retreating, Yang returning. Yang has recovered but is weak and powerless to defend exterior. Had one bowel movement last night, dark brown and loose. Although lips scorched with black scabs, never thirsty. This is Three Yin extreme cold syndrome, Yang Qi too deficient. Still supporting Yang and Zheng.
Aconiti Lateralis Radix Praeparata (Fupian) 130g, Zingiberis Rhizoma (Ganjiang) 20g, Cinnamomi Cortex (Shang Rougui) 5g (ground into powder, soaked in water and added to the decoction), Cardamom Fructus (Xisha Ren) 10g, Poria with Cinnabar Coating (Fushen) 10g, Coicis Semen (Yiren) 20g, Licorice Root (Gancao) 10g.
Eighth examination on the 2nd: Morning examination, temperature 37.2°C, pulse slow and weak, four beats per breath, tongue white and moist, all conditions improving, bland taste, no appetite. This is prolonged disease causing central palace too cold, Spleen-Stomach Yang deficiency, loss of transport authority. Wait until evil Yin is driven out, Middle Yang recovers, then appetite will return. Still supporting Yang and Zheng.
Aconiti Lateralis Radix Praeparata (Fupian) 130g, Zingiberis Rhizoma (Ganjiang) 25g, Cinnamomi Cortex (Shang Rougui) 6g (ground into powder, soaked in water and added to the decoction), Cardamom Fructus (Xisha Ren) 10g, Black Cardamom (Lao Kou Ren) 3g, Prepared Licorice Root (Zhigancao) 10g.
Ninth examination on the 3rd: Temperature 37.8°C, pulse moderate, black scabs on lips shed, tongue coating receded, lips and tongue ruddy, no thirst, Stomach Qi recovering, desiring drink, slight cough at night. Interior cold not yet cleared, Yuan Yang still deficient. Still supporting Yang and assisting Zheng, slightly aiding cough. Avoid early tonification.
Aconiti Lateralis Radix Praeparata (Fupian) 100g, Zingiberis Rhizoma (Ganjiang) 25g, Cinnamomi Cortex (Shang Rougui) 6g (ground into powder, soaked in water and added to the decoction), Cardamom Fructus (Xisha Ren) 5g, Processed Pinellia (Faxia) 10g, Prepared Adenophorae Radix (Zhidonghua) 5g, Evodiae Fructus (Wuyu) 6g, Prepared Licorice Root (Zhigancao) 10g.
Tenth examination on the 4th: Temperature dropped to 36.7°C, cough stopped, Yang Qi still deficient, continue yesterday's prescription for one dose.
Eleventh examination on the 5th: Pulse slow and weak, coating gone, lips and tongue ruddy, no thirst, urine clear and long, morning temperature 36.5°C, only little sleep, poor appetite, occasional cold sweat on head. Yang Qi too deficient. Continue supporting Yang, strengthening Stomach, nourishing Heart and calming Spirit.
Aconiti Lateralis Radix Praeparata (Fupian) 160g, Zingiberis Rhizoma (Ganjiang) 65g, Cardamom Fructus (Xisha Ren) 6g (crushed), Cinnamomi Cortex (Shang Rougui) 5g (ground into powder, soaked in water and added to the decoction), Black Cardamom (Lao Kou Ren) 3g (crushed), Prepared Polygalae Radix (Zhianyuanzhi) 6g, Poria with Cinnabar Coating (Zhuyi Fushen) 10g, Fried Ziziphus Seed (Chao Zaoren) 10g, Amber (Hupo) 3g (ground into powder, taken with decoction), Licorice Root (Gancao) 6g.
Twelfth examination on the 6th: Pulse and temperature normal, lips and tongue ruddy, ate food yesterday, sleep improved, Yang Qi still deficient. Still supporting Yang and assisting Zheng.
Aconiti Lateralis Radix Praeparata (Fupian) 130g, Zingiberis Rhizoma (Ganjiang) 20g, Cinnamomi Cortex (Shang Rougui) 5g (ground into powder, soaked in water and added to the decoction), Cardamom Fructus (Xisha Ren) 6g, Codonopsis Radix (Ming Dangshen) 20g, Licorice Root (Gancao) 6g.
Thirteenth examination on the 7th: Pulse, tongue, and temperature normal, urination and defecation smooth, diet and spirit improved, major illness receded, gradually adding regulation and tonification, recovery expected. Prescribed Fu Yang Jian Zhong for convalescence. Health restored after several doses.
Aconiti Lateralis Radix Praeparata (Fupian) 100g, Zingiberis Rhizoma (Ganjiang) 16g, Cardamom Fructus (Xisha Ren) 6g (crushed), Black Cardamom (Lao Kou Ren) 3g (crushed), Cinnamomi Cortex (Shang Rougui) 10g (ground into powder, soaked in water and added to the decoction), Astragali Radix (Huangqi) 20g, Codonopsis Radix (Ming Dangshen) 20g, Prepared Licorice Root (Zhigancao) 6g.
Pediatric Shanghan Disease with Critical Intestinal Hemorrhage
Son of Zhang XX, eight years old, from Binchuan County, Yunnan Province. In April 1945, suffering from Shanghan for over ten days, treated at former Kunhua Hospital, condition worsening, moved home. On April 23, consulted me. Face blue, lips white and scorched, tongue red and moist, no coating, pulse string-tight, empty and powerless upon pressure, tidal fever, milder in day, heavier at night, confused consciousness, disordered speech, abdominal distension like drum, had passed bloody stool twice, scanty red urine, emaciated. This is Shanghan, cold entering Yin level, Yin-Evil spreading in abdomen, Yuan Yang greatly deficient, critical condition, fear of Yang collapse. Must treat by supporting Yang and suppressing Yin. However, after warm herbs, stirring Yin-Cold will cause vomiting and diarrhea. Due to too deficient Zheng Qi, a thread of residual Yang about to collapse, fear of phlegm-rattle and asthma collapse during vomiting/diarrhea. Thinking carefully, only fighting a desperate battle offers hope of rescue. Hesitation misses the opportunity, regretting too late. Urgently prescribed Tongmai Sini Tang plus Cinnamomi Cortex.
Black Aconiti Lateralis Radix Praeparata (Hei Fupian) 100g, Zingiberis Rhizoma (Ganjiang) 26g, Raw Licorice Root (Sheng Cao) 10g, Cinnamomi Cortex (Shang Rougui) 10g (ground into powder, soaked in water and added to the decoction), Scallion White (Congbai) 2 stalks.
At 7 PM that evening, Mr. Zhang came to inform that after two doses, immediately vomited saliva, then passed black stool, abdominal distension reduced by half, fortunately no asthma or phlegm-rattle, only spirit too weak. Immediately informed him that condition is turning, should continue original prescription for one dose.
Morning re-examination on the 24th: Vomiting and diarrhea after yesterday's dose, abdominal distension gone, string-tight pulse flattened, tidal fever subsided. Due to prolonged severe Shanghan, Yuan Yang exhausted. Although distension resolved, evil Yin not cleared, Yang Qi not filled, scattered and masterless, still dazed and spiritless, occasionally restless speaking confused words. However, condition has turned, no doubt, still supporting Yang and suppressing Yin.
Aconiti Lateralis Radix Praeparata (Fupian) 130g, Zingiberis Rhizoma (Ganjiang) 26g, Cinnamomi Cortex (Shang Rougui) 13g (ground into powder, soaked in water and added to the decoction), Cardamom Fructus (Xisha Ren) 4g, Poria (Fuling) 16g, Prepared Polygalae Radix (Zhianyuanzhi) 3g, Raw Licorice Root (Sheng Cao) 4g.