王子与，病革，始延孟英视之，曰∶阴虚之质，暑热胶锢，殆误投补药矣。乃叔少洪云∶侄素孱弱，医
投熟地等药十余剂耳。孟英曰∶暑热证，必看邪到血分，始可议用生地，何初病即进熟地？岂仅知禀赋之虚，而
未睹外来之疾耶？昔贤治暑，但申表散温补之戒，讵料今人于律外更犯滋腻之辜，而一误致此，略无悔悟，不
啻如油入面，如漆投胶，将何法以挽回哉？越日果卒。夫小米舍人，仅此一脉，完姻未久，遽尔珠沉，殊为惨然。
潘红茶方伯之孙翼廷，馆于许双南家，酷热之时，啜冷石花（汤）一碗，遂至心下痞闷，四肢渐冷，上
过肘膝，脉伏自汗。方某谓∶“阳虚阴暑”，脱陷在即，疏大剂姜、附、丁、桂以回阳。（而）双南在苏，
其三郎李书，骇难主药，
邀族人许芷卿诊而决之。芷卿云∶此药断不可投。第证极危急，须逆孟英商之。时已夜半，孟英往视，曰∶既
受暑热，复为冷冻饮料冰伏胸中，大气不能转旋，是以肢冷脉伏，二便不行。速取六一散一两，以淡盐汤搅之，澄
去滓，调下紫雪丹一钱。
翌日再诊∶脉见，胸舒，溺行，肢热，口干，舌绛，暑象毕呈，化而为疟。予多剂白虎汤而愈。丙午（岁），举于乡。
康康侯司马之夫人，久伤谋虑，心火外浮，面赤齿痛，因啖西瓜，遂脘闷不舒，喜得热按，泄泻不饥，自
觉舌浓数寸，苔色灰腻。孟英与∶浓朴 滑石 葱白 薤白 枇杷叶 橘皮 薄荷 旋复 省头草，一剂霍然。
许少卿室，故医陈启东先生之从女也。夏初患感，何新之十进清解，病不略减，因邀诊于孟英。脉至弦
洪豁大，右手为尤，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（骨） 牡（蛎） 犀（角） （珍）
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；（牡）蛎粉扑止其汗；捣生附子贴涌泉穴。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，忽见世父启东扼其喉，使药不能下
咽。且嘱云∶宜服王先生药。少卿闻之大骇，专服王药，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（冬） 参（须） 熟地 石英 茯神 龙眼 甘（草） （
小）麦 大枣 三甲等药，善其后。
秋杪，归宁，微吸客邪，寒热如疟。孟英投以清解，已得向安。胡某闻之，复于所亲处云∶此证实由夏间
治法不善，以致邪气留恋，再服清凉，必死无疑。汤某复从而和之。许氏即招汤某延医，谓其阳气伤残，沉寒
久伏，以理中汤加威灵仙、桂枝、半夏、浓朴、姜、枣等药。病者颇疑药太燥烈，汤复膏吞拭舌，说得天花乱
坠，病家惑之，初服胃气倍加，继而痰嗽不饥，黄苔满布，肌消汛断，内热汗多，心悸不眠，卧榻不起。病者
坚却其药，然已进二十剂矣。再邀何新之商之，亦难措手。仍嘱其求诊于孟英，
按脉弦细软数，篡（窜）患悬痈，纵有神丹，不可救药矣。
何缙阶令正，素患肝厥，仲夏患感，沈樾亭按温证法治之，内风不致陡动，而大便泄泻，脉细而弦，渴饮
痰多，不饥不寐。因邀孟英商之，投∶白头翁汤加三甲、石斛、茯苓、竹茹而安。随以峻补善后而痊。
胡孟绅乃弟季权，患黑 ，苔秽，脉浑，气粗，面垢。孟英即以凉膈散投之，大解得行，脘亦不闷，
皆透绽，脉显滑数而洪，遂与大剂凉润清肃之药，直俟其旬日外，大解不泻，药始缓
授。复又沉卧不醒，人皆疑之。孟英曰∶痰热尚炽也，仍授大剂数帖，果频吐胶痰累日，而眠食渐安。
是役也，当两病披猖之际，举家皇皇，他医或以前证为神不守舍，议投温补。后证则以为必败。闻者无
不危之。赖季权之夫人，独具卓识，任贤不二，孟英始无掣肘之虑，而咸得收功也。
濮东明令孙女，素禀阴虚，时发夜热，少餐不寐。仲夏患感，发疹，汛不当期而至。孟英用犀（角） 羚（羊角）
知（母） 贝（母） 石膏 生地 栀（子） （连）翘 花粉 甘草 竹叶 芦根等药，疹透神清，唯鼻燥
异常，吸气入喉，辣痛难忍，甚至肢冷。复于方中加元参、竹茹、菊叶、荷杆，各患始减，而心忡吐沫，彻夜
不瞑，渴、汗、便黑，改投∶西洋参 生地 麦冬 小麦 竹叶 黄连 珍珠 百合 贝母 石斛 牡蛎 龟
版蔗汁诸药而愈。季秋适姚益斋为室。
仲夏，淫雨匝月，泛滥为灾。季夏，酷暑如焚，人多
热病。沈小园者，患病于越，医者但知湿甚，而不知化热，投以平胃散数帖，壮热昏狂，证极危殆。返杭
日，渠居停吴仲庄浼孟英视之，脉滑实而数，大渴溲赤，稀水旁流，与∶石膏 大黄，数下之而愈。仲庄欲施
药济人，托孟英定一善法。孟英曰∶余不敢（以）师心自用，考古惟叶天士甘露消毒丹、神犀丹二方，为湿温
暑疫最妥之药。一治气分，一治营分，规模已具。即有兼证，尚可通融，司天在泉，不必拘泥。今岁奇荒，明
年恐有奇疫。但“甘露”二字，人必疑为大寒之药，“消毒”二字，世人或作外证之方。
因易其名曰∶普济解疫丹，吴君与诸好善之家，根据方合送，救活不知若干人也。
普济解疫丹∶孟英自注云∶此治湿温时疫之主方也。按六元正纪，五运分步，每年春分后十三日交二运
征，火旺，天乃渐温。芒种后十日交二运宫，土旺，地乃渐湿，温湿蒸腾，更加烈日之暑，烁石流金，人在气
交之中，口鼻吸受其气，留而不去，乃成温热暑疫之病，则为发热倦怠，胸闷腹胀，肢酸咽肿， 疹身黄，颐
肿口渴，溺赤便秘，吐泻疟痢，淋浊疮疡等证。但看病患舌苔淡白，或浓苔，或干黄者，是暑湿热疫之邪，尚
在气分，悉以此丹治之立效。而薄滋味，（孟英自批∶家慈每于夏季茹素，且云∶汝辈为医者，当
知之，余见瘟疫流行之岁，无论贫富，无可避之，总由不知坚壁清野之故耳，试看茹素者，独可不染，岂非
胃中清虚，邪不能留乎！旨哉斯言，特谨识之。）远酒色，尤为辟疫之仙方，智者识之。医家临证，能准此
化裁，自可十全为上。（上参喻嘉言、张石顽、叶天士、沈尧封诸家。）
神犀丹∶孟英自注云∶温热暑疫诸病，邪不即解，耗液伤营，逆传内陷，痉厥昏狂，谵语发 等证，但看
病患舌色干光，或紫绛、或圆硬、或黑胎，皆以此丹救之。若初病即觉神情烦躁，而舌赤口干者，是温暑直入
营分。酷热之时，阴虚之体，及新产妇人，患此最多，急须用此，多可挽回。切勿拘泥日数，误投别药以偾事
也。兼治痘 毒重，夹带紫 危证，暨痘 之后余毒内炽，口糜咽腐，目赤神烦诸证。（上本叶氏，参治验。）
陈蕴泉，陡患昏谵，夤夜乞诊于孟英，脉甚滑数，苔色腻黄，乃平素多痰，兼吸暑热。与清解药一剂，
化而为疟，脉亦较平。或谓其体弱不宜凉药，须用人参，渠家惶惑，孟英坚持以为不可。盖暑脉颇类乎虚，
而痰阻于肺，呼吸不调，又与气虚短促者相似。平昔先虚，有病必先去病。况热能伤气，清暑热即所以顾
元气也。何新之亦赞是议，遂连投白虎加减而愈。
次年春，因丧外家悲悼，复感温邪，失于整肃，病日以甚，迨孟英自豫章归诊，已不可救药矣。
李德昌之母，仲夏患感，医诊为湿，辄与燥剂，大便反泻，遂疑高年气陷，改用补土，驯至气逆神昏，
汗多舌缩，已办后事，始乞诊于孟英，脉洪数无伦，右尺更甚。与大剂∶犀角 石膏 黄芩 黄连 黄柏
知母 花粉 栀子 石斛 竹叶 莲心 元参 生地之药，另以冷雪水调
紫雪丹。一昼夜，舌即出齿，而喉舌赤腐，咽水甚痛。乃去三黄（黄连、黄柏、黄芩），加银花、射干、豆
根，并吹以锡类散，三日后，脉证渐和，稀糜渐受。改授甘凉缓剂，旬日后，得解坚黑矢而愈。
胡纫秋，于酷热时偶有不适，医用柴、葛、香薷药散之，反恶寒胸痞。更医用枳、朴、槟榔以泻之，
势日剧。延孟英视之∶自汗不收，肢背极冷，奄奄一息，脉微无神。曰∶禀赋素亏，阳气欲脱，此必误认表证
使然。予∶救逆汤加（人）参、（黄） 服之渐安，继以补气生津，调理匝月而痊。
壬寅夏，（某）感受暑湿，误投温散，以致谵语神昏，势濒于危。而肛前囊后之间，溃出腥脓，疮口深
大。疡科以为悬痈也。敷治罔效。孟英诊曰∶悬痈乃损怯症，成之以渐，今病来迅速，腥秽异常，是身中久
蕴浓味湿热之毒，挟外受之暑邪，无所宣泄，下注而为此症，切勿敷药，以遏其外走之势。但舌强而紫赤，脉
细而滑数，客邪炽盛，伏热蕴隆，阴分甚亏，深虞津涸。先予清营之剂，三投而神气渐清，次以凉润阳明，便
畅而热蠲脓净，改用甘柔滋养，月余溃处肌平。善后参入参、 ，竟得康强如昔。
金晓耕，发热两旬，医予表散，竟无汗泄。嗣投温补，而大解泄泻，小水不行，口干肌削，势濒于危。
胡纫秋荐孟英诊之。右寸独见沉数。曰∶暑热锢于肺经耳。予∶白虎（汤）、苇茎（汤）、天水（散）加（
茯）苓、桔（梗）、杏（仁）、贝（母）为方，服后，头面 疹遍发，密无针缝，明如水晶光，人皆
危之。孟英曰∶此肺邪得泄也。果肌润热退，泻止知饥。又服甘凉濡润二十余剂， 疹始愈。亦仅见之证也。
王子与病情危重，才请王孟英诊治。王孟英说：“患者是阴虚体质，暑热之邪胶结固滞，大概是之前误用了补药。”其叔父王少洪说：“侄子向来孱弱，医生投了熟地黄等药十余剂罢了。”王孟英说：“暑热证，必须等到病邪深入血分，才可以考虑使用生地黄，为什么刚发病就进用熟地黄？难道只知道禀赋虚弱，却没看到外来的疾病吗？”以前的贤人治疗暑病，只是强调要警惕表散法和温补法，哪里料到现代人不仅在法规之外犯错，更犯了滋腻药物的罪过，一错再错导致这种地步，还不知悔改，这就像油入面、漆投胶一样难以分离，还有什么办法可以挽回呢？第二天果然去世了。小米舍人（指王子与），只有这一根独脉（无子嗣），完婚不久，突然去世，实在令人悲惨。
潘红茶方伯的孙子潘翼廷，在许双南家做馆师。酷热之时，喝了一碗冷石花汤，随即感到心下痞闷，四肢逐渐变冷，冷感超过肘膝，脉搏伏匿，自汗出。姓方的医生认为这是“阳虚阴暑”，阳气脱陷在即，于是开出了大剂量的干姜、附子、丁香、肉桂来回阳救逆。（当时）许双南在苏州，他的三儿子李书，对主药感到惊骇为难，邀请族人许芷卿诊断并决断。许芷卿说：“这些药绝对不可以服用。只是病情极其危急，必须违背常规去咨询王孟英。”当时已是半夜，王孟英前往诊视，说：“既然受了暑热，又因冷冻饮料使胸中气机被冰伏，大气不能转旋，所以肢体冰冷、脉搏伏匿、大小便不通。迅速取六一散一两，用淡盐汤搅拌，澄清去掉渣滓，调服紫雪丹一钱。”
第二天复诊：脉搏出现，胸部舒畅，小便通利，肢体回暖，口干，舌质红绛，暑热症状完全呈现，转化为疟疾。给予多剂白虎汤而痊愈。丙午年，考中举人。
康康侯司马的夫人，长期思虑过度，导致心火外浮，面部发红，牙齿疼痛，因为吃了西瓜，随即胃脘部闷胀不适，喜欢热敷按压，腹泻且没有饥饿感，自觉舌头肿胀浓厚数寸，舌苔灰腻。王孟英给予厚朴、滑石、葱白、薤白、枇杷叶、橘皮、薄荷、旋覆花、省头草，一剂药后霍然痊愈。
许少卿的妻子，是已故医生陈启东先生的侄孙女。夏初患感冒，何新之连续十次使用清热解表药，病情没有减轻，于是邀请王孟英诊治。脉象弦、洪、豁大，右手更为明显，极度口渴，大汗出，能进食但胡言乱语，面部发红，脚部发冷，整夜不睡觉。王孟英说：“证候虽然属于温病，但真阴素来亏损，长期思虑伤神，心阳外越，内风鸱张。幸好遇到明眼医生，没有投用温散药，还可以不用担心。”给予龙骨、牡蛎、犀角、珍珠、龟板、鳖甲、贝母、竹沥、竹叶、辰砂、小麦、元参、丹参、生地、麦冬，为大剂量投服。外用烧红的铁块淬醋，让病人吸入其气味；用牡蛎粉扑洒以止汗；捣碎生附子贴敷涌泉穴。刚服下一剂药，亲戚推荐的胡某前往诊视，大力斥责王孟英的意见是错误的，主张透疹的方法。病家被迷惑，立即煎煮胡某的药给病人服用！病人神志昏乱恍惚，忽然看见叔父陈启东扼住她的喉咙，使药无法咽下。并且嘱咐说：“应该服用王先生开的药。”许少卿听说后大惊，专门服用王孟英的药，病情逐渐好转。但是阴液不易恢复，频繁灌服甘柔滋润镇潜的药物，一个多月后才能够起床。季夏时节，月经来潮。只是情志不愉快，容易受到惊恐。给予麦冬、人参须、熟地、石英、茯神、龙眼、甘草、小麦、大枣、三甲等药，善后调理。
秋末，回娘家探亲，轻微感受客邪，寒热往来如疟疾。王孟英投用清热解表药，已经得到安宁。胡某听说后，又在亲戚处说：“这个证候确实是因为夏天治疗方法不当，导致邪气留恋，再服用清凉药，必定死亡无疑。”汤某也跟着附和。许氏于是聘请汤某延医，称其阳气伤残，沉寒久伏，使用理中汤加威灵仙、桂枝、半夏、厚朴、生姜、大枣等药。病人很怀疑药太燥烈，汤某又用蜜糖吞服并擦拭舌头，说得天花乱坠，病家被迷惑，初服时胃气加倍增加，继而痰嗽、不思饮食，黄苔满布，肌肉消瘦、月经中断，内热汗多，心悸失眠，卧床不起。病人坚决拒绝服药，然而已经服用了二十剂。再次邀请何新之商量，也难以着手处理。仍然嘱咐其求诊于王孟英。按脉弦细软数，并发悬痈，纵有神医丹药，也不可救药了。
何缙阶的正室夫人，素来患有肝厥，仲夏患感冒，沈樾亭按照温证法治之，内风没有陡然发作，但是大便泄泻，脉细而弦，口渴饮水，痰多，不思饮食，不能入睡。于是邀请王孟英商量，投用白头翁汤加三甲、石斛、茯苓、竹茹而安定。随后用峻补之法善后而痊愈。
胡孟绅的弟弟季权，患黑斑（痘疹类重症），舌苔秽浊，脉象浑乱，呼吸气粗，面色污垢。王孟英立即投用凉膈散，大便得以通畅，胃脘也不闷胀，斑疹全部透出绽开，脉象显现滑数而洪大，于是给予大剂量的凉润清肃药物，一直等到十几天后，大便不再泄泻，药物才减缓给药。后来又沉睡不醒，大家都对此表示怀疑。王孟英说：“痰热依然炽盛。”仍然给予大剂量药物几帖，果然频繁吐出胶状痰液好几天，然后睡眠和饮食逐渐安稳。
这次疫情，当两种病症猖獗之际，全家惊慌失措，其他医生有的认为前证是神不守舍，建议投用温补。后证则认为必定败坏。听到的人无不感到危险。幸亏季权的夫人独具卓识，任用贤才坚定不移，王孟英才没有掣肘的顾虑，最终都取得了疗效。
濮东明的孙女，素禀阴虚，时常夜间发热，少吃则不眠。仲夏患感冒，发疹，月经不按周期而至。王孟英用犀角、羚羊角、知母、贝母、石膏、生地、栀子、连翘、花粉、甘草、竹叶、芦根等药，疹透后神志清醒，只是鼻燥异常，吸气入喉，辣痛难忍，甚至肢体发冷。后来在方中加入元参、竹茹、菊叶、荷杆，各症状才减轻，但是心慌吐沫，整夜不睡，口渴、出汗、大便色黑，改投西洋参、生地、麦冬、小麦、竹叶、黄连、珍珠、百合、贝母、石斛、牡蛎、龟版、蔗汁诸药而痊愈。季秋适嫁姚益斋为妻。
仲夏，连绵阴雨一个月，泛滥成灾。季夏，酷暑如火，许多人患热病。沈小园在越地患病，医生只知道湿气重，却不知道化热，投用平胃散数帖，导致壮热昏狂，证候极其危殆。返回杭州那天，房东吴仲庄恳请王孟英诊视，脉象滑实而数，极度口渴，小便赤涩，稀水旁流，给予石膏、大黄，数次攻下而痊愈。仲庄想施药救济世人，委托王孟英定一个妥善的法子。王孟英说：“我不敢主观自用，考古以来只有叶天士的甘露消毒丹、神犀丹两方，是治疗湿温暑疫最妥当的药物。一方治气分，一方治营分，规模已具。即使有兼证，尚可通融，司天在泉的变化，不必拘泥。今年奇荒，明年恐怕有奇疫。但是‘甘露’二字，人们必疑为大寒之药，‘消毒’二字，世人或许当作外科证候的方子。因此改名曰：普济解疫丹，吴君与各乐善之家，根据方子合送，救活的人不知有多少。”
普济解疫丹：王孟英自注说：“这是治疗湿温时疫的主方。按《六元正纪大论》，五运分步，每年春分后十三日交二运征，火旺，天气渐渐变暖。芒种后十日交二运宫，土旺，地气渐渐湿润，温湿蒸腾，再加上烈日的暑气，烁石流金，人在气交之中，口鼻吸受其气，留而不去，乃成温热暑疫之病，表现为发热倦怠，胸闷腹胀，肢酸咽肿，斑疹身黄，腮肿口渴，小便赤涩便秘，吐泻疟痢，淋浊疮疡等证。只要看病患舌苔淡白，或浓苔，或干黄的，是暑湿热疫之邪，尚在气分，全部以此丹治疗立效。而且清淡饮食，（王孟英自批：家慈每于夏季吃素，并且说：你们作为医生，应当知道，我见瘟疫流行之年，无论贫富，无可躲避，总由不知道坚壁清野的缘故罢了，试看吃素的人，唯独不被感染，岂不是因为胃中清虚，邪气不能停留吗！这话真妙，特谨记录。）远离酒色，更是辟邪防疫的仙方，智者应知晓。医生临证，能准确据此化裁，自然可十全为上。（以上参考喻嘉言、张石顽、叶天士、沈尧封诸家。）”
神犀丹：王孟英自注说：“温热暑疫诸病，邪气不解，耗液伤营，逆传内陷，出现痉厥昏狂，谵语发斑等证，只要看病患舌色干光，或紫绛、或圆硬、或黑胎，都用此丹救治。如果初病即觉神情烦躁，而舌赤口干者，是温暑直入营分。酷热之时，阴虚之体，及新产妇人，患此最多，急须用此，大多可以挽回。切勿拘泥日数，误投别药以致坏事。兼治痘毒重，夹带紫斑危证，以及痘疹之后余毒内炽，口糜咽腐，目赤神烦诸证。（以上本于叶氏，参考治验。）”
陈蕴泉，突然患昏谵，深夜乞求王孟英诊治，脉象甚滑数，舌苔色腻黄，是平时多痰，兼吸暑热。给予清热解表药一剂，转化为疟疾，脉象也较平稳。有人说他体弱不宜凉药，须用人参，他家惶恐疑惑，王孟英坚持认为不可。因为暑脉颇类似虚脉，而痰阻于肺，呼吸不调，又与气虚短促者相似。平时先虚，有病必先祛病。况且热能伤气，清暑热即所以顾护元气也。何新之也赞同这个意见，于是连续投用白虎汤加减而痊愈。
次年春天，因为丧外家悲悼，又感温邪，失于整理肃杀，病情日益加重，等到王孟英从豫章回来诊视，已经不可救药了。
李德昌的母亲，仲夏患感冒，医生诊断为湿，辄给予燥剂，大便反而泄泻，于是怀疑高龄气陷，改用补土法，逐渐导致气逆神昏，汗多舌缩，已经办理后事，才乞求王孟英诊治，脉象洪数无比，右尺脉更甚。给予大剂量犀角、石膏、黄芩、黄连、黄柏、知母、花粉、栀子、石斛、竹叶、莲心、元参、生地的药，另以冷雪水调服紫雪丹。一昼夜，舌头伸出齿外，而喉舌赤腐，咽水甚痛。于是去掉三黄（黄连、黄柏、黄芩），加银花、射干、豆根，并吹以锡类散，三日后，脉证渐和，稀糜渐受。改授甘凉缓剂，旬日后，排出坚硬黑屎而痊愈。
胡纫秋，在酷热时偶有不适，医生用柴胡、葛根、香薷药发散，反而恶寒胸痞。换医生用枳壳、厚朴、槟榔以泻之，病情日益加剧。延请王孟英诊视：自汗不收，肢背极冷，奄奄一息，脉微无神。说：“禀赋素亏，阳气欲脱，这一定是误认表证所致。”给予救逆汤加人参、黄芪，服之渐安，继以补气生津，调理一个月而痊愈。
壬寅年夏天，某人感受暑湿，误投温散，以致谵语神昏，势濒于危。而在肛前囊后之间，溃出腥脓，疮口深大。疡科认为是悬痈。敷治无效。王孟英诊察说：“悬痈是损怯症，慢慢形成，现在病来迅速，腥秽异常，是身中久蕴浓味湿热之毒，挟外受之暑邪，无所宣泄，下注而为此症，切勿敷药，以遏其外走之势。但舌强而紫赤，脉细而滑数，客邪炽盛，伏热蕴隆，阴分甚亏，深虞津涸。先予清营之剂，三次投药而神气渐清，其次以凉润阳明，大便通畅而热退脓净，改用甘柔滋养，月余溃处肌平。善后参入人参、黄芪，竟得康强如昔。”
金晓耕，发热两周，医生给予表散，竟然无汗泄。随后投用温补，而大便泄泻，小便不通，口干肌肉消瘦，势濒于危。胡纫秋推荐王孟英诊视。右寸脉独见沉数。说：“暑热锢于肺经耳。”给予白虎汤、苇茎汤、天水散加茯苓、桔梗、杏仁、贝母为方，服后，头面斑疹遍发，密无针缝，明如水晶光，人都对此感到危险。王孟英说：“这是肺邪得泄也。”果然肌肤润泽热退，泻止知饥。又服甘凉濡润二十余剂，斑疹始愈。也是罕见的证候。
Wang Ziyu's condition was critical when Wang Mengying was finally summoned. Wang Mengying said, "The patient has a Yin-deficient constitution with Summerheat-Heat pathogens firmly entrenched; this is likely due to the prior mistaken administration of tonic medicines." His uncle, Wang Shaohong, replied, "My nephew has always been frail; the physician administered Shudi (Rehmanniae Radix Preparata) and similar herbs for over ten doses." Wang Mengying stated, "In Summerheat-Heat syndromes, one should only consider using Shengdi (Rehmanniae Radix) once the pathogen has entered the Blood level. Why use Shudi at the onset of illness? Do you only recognize constitutional deficiency while ignoring exogenous diseases?" Ancient sages treating Summerheat merely warned against inappropriate exterior-releasing and warming-tonifying methods. Who would have predicted that modern physicians would commit the sin of using cloying and greasy herbs beyond established protocols? One error led to this state, yet there is no repentance. This is like oil mixing with flour or lacquer adding to glue—how can it be reversed? The next day, he indeed passed away. Xiaomi Sheyin (a courtesy title referring to Wang Ziyu), having no male heir, died suddenly shortly after marriage, which is truly tragic.
Pan Hongcha Fangbo's grandson, Pan Yiting, was employed as a tutor in the Xu Shuangnan household. During intense heat, he drank a bowl of cold Shihua (Tongue Fern) soup, subsequently developing epigastric fullness and oppression, with his limbs gradually becoming cold up past the elbows and knees. His pulse was hidden (Fu), accompanied by spontaneous sweating. Physician Fang diagnosed this as "Yang deficiency with Cold Summerheat," predicting imminent collapse of Yang Qi. He prescribed a large dose of Jiang (Zingiberis Rhizoma), Fuzi (Aconiti Lateralis Radix Preparata), Ding (Caryophylli Flos), and Rougui (Cinnamomi Cortex) to restore Yang. (At that time, Xu Shuangnan was in Suzhou.) His third son, Li Shu, was alarmed by the prescription and invited clan member Xu Zhijing to diagnose and decide. Xu Zhijing said, "These medicines must absolutely not be taken. Given the critical urgency, we must consult Wang Mengying contrary to convention." It was already midnight when Wang Mengying arrived. He said, "Having contracted Summerheat-Heat, and then having the chest cavity frozen by cold beverages, the Great Qi cannot rotate. Hence, cold limbs, hidden pulse, and obstruction of urination and defecation. Quickly take Liu Yi San (Six-to-One Powder) one liang, stir with light salt water, clarify and remove dregs, then mix with Zi Xue Dan (Purple Snow Pill) one qian."
On the following day, during the second consultation: the pulse emerged, the chest felt relieved, urination resumed, limbs warmed, mouth became dry, tongue was crimson, and Summerheat symptoms fully manifested, transforming into Malaria. Multiple doses of Baihu Tang (White Tiger Decoction) were given, resulting in recovery. In the Bingwu year, he passed the provincial examination.
Madam Sima of Kang Kanghou suffered from long-term mental overstrain, causing Heart Fire to float outward, presenting with facial redness and toothache. After eating watermelon, she developed epigastric oppression and discomfort, preferring hot compressions, diarrhea, and lack of appetite. She felt her tongue was swollen and thick by several inches, with a grayish, greasy coating. Wang Mengying prescribed Houpo (Magnoliae Officinalis Cortex), Huashi (Talcum), Congbai (Allii Fistulosi Bulbus), Xiebai (Allii Macrostemonis Bulbus), Pipaye (Loquat Leaf), Jupi (Citri Reticulatae Pericarpium), Bohe (Menthae Haplocalycis Herba), Xuanfu (Inulae Flos), and Shentoucao (Artemisiae Scopariae Herba). One dose resulted in rapid recovery.
Ms., wife of Xu Shaoqing, was the niece of the late physician Mr. Chen Qidong. At the beginning of summer, she contracted a common cold. He Xinzhi administered Qingjie (Clearing and Resolving) formulas ten times consecutively, but the illness did not subside slightly. Wang Mengying was invited to diagnose. The pulse was Xian (Wiry), Hong (Surging), Huo (Hollow), and Da (Large), especially on the right side. Symptoms included extreme thirst, profuse sweating, ability to eat but delirious speech, facial redness, cold feet, and insomnia throughout the night. Wang Mengying said, "Although the syndrome belongs to Warmth, her True Yin has been deficient since youth, and long-term mental strain caused Heart Yang to escape outward, stirring internal Wind. Fortunately, a discerning doctor treated her without using warming and releasing agents, so there is still hope." He prescribed Longgu (Fossilia Ossis Mastodi), Muli (Concha Ostreae), Xijiao (Rhinocerotis Cornu), Zhenzhu (Margarita), Guiban (Carapax et Plastrum Testudinis), Biejia (Carapax et Plastrum Trionycis), Beimu (Fritillariae Cirrhosae Bulbus), Zhuli (Bambusae Sap), Zhuye (Bambusae Folium), Chencha (Stibnatum Rubrum), Xiaomai (Tritici Fructus), Yuan Shen (Scrophulariae Radix), Danshen (Salviae Miltiorrhizae Radix), Shengdi (Rehmanniae Radix), and Maidong (Ophiopogonis Tuber) in a large dose. Externally, red-hot iron was quenched in vinegar for inhalation; Muli powder was applied to stop sweating; raw Fuzi paste was applied to Yongquan (KI 1). After just one dose, a relative recommended Dr. Hu to examine her. Dr. Hu strongly criticized Wang's approach, advocating for a method to vent rashes. The family, confused, administered Dr. Hu's decoction. The patient became mentally confused and hallucinated seeing her uncle Chen Qidong strangling her throat, preventing swallowing. She instructed, "You should take Mr. Wang's medicine." Xu Shaoqing was greatly alarmed upon hearing this and exclusively continued Wang's medication. The condition gradually improved. However, Yin fluids were difficult to restore; frequent administration of sweet, moistening, and sedating herbs was required for over a month before she could get out of bed. In the late summer, menstruation occurred. She remained emotionally distressed and prone to fright. Wang Mengying prescribed Maidong, Renshen Xu (Ginseng Fibers), Shudi, Shiyin (Quartz), Fushen (Poria with Hostwood), Longyan (Longan Aril), Gancao (Glycyrrhizae Radix et Rhizoma), Xiaomai, Dazao (Jujubae Fructus), and Sanjia (Three Turtle Shells) for convalescence.
At the end of autumn, upon returning to her natal home, she lightly contracted external pathogens, presenting with alternating chills and fever resembling malaria. Wang Mengying administered clearing and resolving herbs, bringing relief. Dr. Hu remarked to relatives, "This case resulted from improper treatment in summer, allowing pathogens to linger. Further cooling will surely cause death." Dr. Tang concurred. The Xu family engaged Dr. Tang, who claimed their Yang Qi was damaged and deep cold had lain dormant. He prescribed Lizhong Tang (Regulate the Middle Decoction) plus Weilingxian (Akebiae Caulis), Guizhi (Cinnamomi Ramulus), Banxia (Pinelliae Rhizoma), Houpo, Shengjiang (Zingiberis Rhizoma Recens), and Dazao. The patient suspected the herbs were too drying and pungent. Dr. Tang used honey to swallow and wipe the tongue, speaking persuasively. The family was convinced. Initially, stomach Qi seemed strengthened, but soon phlegm-cough, anorexia, a yellow coating covering the tongue, muscle wasting, amenorrhea, internal heat, profuse sweating, palpitations, and insomnia ensued, confining her to bed. The patient firmly refused further medication, though twenty doses had already been taken. He Xinzhi was consulted again but found the situation difficult to manage. They were advised to seek Wang Mengying. The pulse was wiry, fine, soft, and rapid. She also developed a perineal abscess (Xuanyong). Wang declared that even divine medicine could not save her.
Madam Zhengshi of He Jinjie, who suffered from Liver Jue (Liver Convulsion) habitually, contracted a cold in mid-summer. Shen Yueting treated it as a Warmth syndrome. Internal wind did not flare up abruptly, but she experienced diarrhea, a fine and wiry pulse, thirst with excessive drinking, phlegm, anorexia, and insomnia. Wang Mengying was consulted and prescribed Baitouweng Tang (Pulsatillae Decoction) plus Sanjia, Shihu (Dendrobii Caulis), Fuling (Poria), and Zhuru (Bambusae Caulis in Taenia). The condition stabilized. Subsequently, strong tonification ensured full recovery.
Ji Quan, younger brother of Hu Mengshen, presented with black spots (severe rash/variola-like disease), turbid coating, chaotic pulse, coarse breathing, and a dirty complexion. Wang Mengying immediately administered Liangge San (Cool the Chest Powder). Defecation became smooth, and epigastric oppression resolved. All rashes erupted and spread. The pulse became slippery, rapid, and surging. Large doses of cooling, moistening, and purgative-clearing herbs were given. Dosage was reduced only after ten days when diarrhea ceased. Later, he fell into a deep coma. Everyone doubted the treatment. Wang Mengying explained, "Phlegm-heat remains vigorous." He continued large doses. Indeed, copious sticky phlegm was expectorated for days, after which sleep and appetite gradually normalized.
During this epidemic, when both illnesses raged, the family was panicked. Other physicians suggested warming tonics for the first symptom (attributed to Spirit not residing in its house) and deemed the second symptom hopeless. Listeners were alarmed. Fortunately, Ji Quan's wife possessed unique insight and trusted Wang Mengying unreservedly, allowing him to work without hindrance, leading to successful outcomes for all.
Miss Granddaughter of Pu Dongming, constitutionally Yin-deficient, often had night fevers and insomnia if eating little. In mid-summer, she contracted a cold, developed rashes, and menstruated irregularly. Wang Mengying used Xijiao, Lingyangjiao (Saigae Tataricae Cornu), Zhimu (Anemarrhenae Rhizoma), Beimu, Shigao (Gypsum Fibrosum), Shengdi, Zhizi (Gardeniae Fructus), Lianqiao (Forsythiae Fructus), Huafen (Trichosanthis Radix), Gancao, Zhuye, and Lugeng (Phragmitis Rhizoma). After rashes cleared and spirit settled, she suffered extreme nasal dryness, burning pain upon inhalation, and even cold limbs. Yuanshen (Scrophulariae Radix), Zhuru, Juye (Chrysanthemi Folium), and Hegan (Nelumbinis Petiolus) were added, alleviating symptoms. However, palpitations, salivation, insomnia, thirst, sweating, and black stools ensued. The prescription was changed to Xiyangshen (American Ginseng), Shengdi, Maidong, Xiaomai, Zhuye, Huanglian (Coptidis Rhizoma), Zhenzhu, Baihe (Lilii Bulbus), Beimu, Shihu, Muli, Guiban, and Zhezhijue (Sugarcane Juice). She recovered and married Yao Yizhai in late autumn.
In mid-summer, continuous rain lasted a month, causing floods. In late summer, scorching heat prevailed, and many suffered from heat diseases. Shen Xiaoyuan fell ill in Yue. Physicians recognized dampness but missed the transformation into heat, prescribing Pingwei San (Peace the Stomach Powder) for several doses. This resulted in high fever, delirium, and critical danger. Upon returning to Hangzhou, landlord Wu Zhongzhuang requested Wang Mengying's diagnosis. Pulse was slippery, solid, and rapid; extreme thirst, red urine, and overflow diarrhea were present. Shi Gao and Dahuang (Rhei Radix et Rhizoma) were given, and multiple purgations led to recovery. Wu wished to distribute medicine to help others and asked Wang to formulate a reliable method. Wang said, "I dare not act subjectively. Historically, Ye Tianshi's Ganlu Xiaodu Dan (Sweet Dew Detoxifying Powder) and Shenxi Dan (Divine Calamity Pill) are the most appropriate for Damp-Warmth and Summer-Epidemic. One treats the Qi level, the other the Ying level. Their frameworks are complete. Even with combined syndromes, flexibility exists; one need not rigidly adhere to Si Tian Zai Quan theories. With this year's famine, next year may bring a strange epidemic. However, 'Ganlu' sounds too cold, and 'Xiaodu' might be mistaken for external treatments. Therefore, I renamed it Puji Jieyi Dan (Universal Relief Epidemic-Detoxifying Pill). Mr. Wu and other charitable families distributed it according to the formula, saving countless lives."
Puji Jieyi Dan: Wang Mengying annotated: "This is the main formula for Damp-Warmth and Time Epidemics. According to the *Suwen*, Five Movements divide steps. Thirteen days after Spring Equinox, the second movement (Fire) begins, warming the sky. Ten days after Grain in Ear, the second palace (Earth) begins, humidifying the earth. Warmth and humidity vaporize together with intense solar heat, melting stone and flowing metal. Humans within this Qi intersection inhale these energies; if retained, they form Warmth, Heat, Summerheat, and Epidemic diseases. Symptoms include fever, fatigue, chest tightness, abdominal distension, limb soreness, pharyngeal swelling, rashes, jaundice, parotid swelling, thirst, red urine, constipation, vomiting, diarrhea, malaria, dysentery, strangury, turbidity, and sores. If the tongue coating is pale white, thick, or dry yellow, the Summerheat-Damp-Heat-Epidemic pathogen is still in the Qi level. This pill acts effectively. Furthermore, bland diet (My mother ate vegetarian food in summer, saying: You doctors should know, in plague years, rich and poor alike cannot avoid infection unless they practice 'clearing the fields and fortifying walls.' Vegetarians alone remain uninfected because their stomachs are clear and empty, preventing pathogen retention. Profound words! I record them carefully.) and abstinence from alcohol and sex are immortal prescriptions for prevention. Wise ones should note this. Physicians adapting this accurately can achieve perfect results. (Referencing Yu Jiayan, Zhang Shiweng, Ye Tianshi, Shen Yaofeng.)"
Shenxi Dan: Wang Mengying annotated: "For Warmth, Summerheat, and Epidemic diseases where pathogens do not resolve quickly, consuming fluids and injuring the Ying level, leading to reverse transmission and internal entrapment, manifesting as spasms, convulsions, coma, delirium, and rashes: if the tongue is dry and glossy, purple-crimson, round and stiff, or has a black coating, use this pill. If early symptoms show irritability, red tongue, and dry mouth, Warmth/Summerheat has directly entered the Ying level. During extreme heat, Yin-deficient individuals and postpartum women suffer this most. Urgent use of this pill can often save them. Do not rigidly count days or mistakenly use other drugs. It also treats severe variola toxins with purple spots, critical conditions, and residual toxicity after smallpox/chickenpox causing oral ulcers, throat rot, red eyes, and restlessness. (Based on Ye's methods, referencing clinical cases.)"
Chen Yunquan suddenly suffered from coma and delirium. Wang Mengying was summoned late at night. Pulse was slippery and rapid; coating was greasy and yellow. This indicated habitual phlegm combined with Summerheat inhalation. One dose of clearing/resolving herbs transformed the condition into malaria, and the pulse stabilized. Some argued his weak constitution precluded cooling herbs and insisted on Renshen. The family was confused, but Wang insisted against it. Summerheat pulses mimic deficiency, and lung obstruction mimics Qi deficiency shortness of breath. When constitution is initially deficient, disease must be removed first. Heat injures Qi; clearing Summerheat protects Original Qi. He Xinzhi agreed. Continuous administration of modified Baihu Tang cured him.
The following spring, grieving his maternal family's death, he contracted Warmth pathogens again. Neglecting proper management, the condition worsened. By the time Wang returned from Yuzhang to diagnose, it was incurable.
Mrs. Li Dechang contracted a cold in mid-summer. Diagnosed as dampness, she received drying agents, causing diarrhea. Suspecting sinking Qi due to age, she switched to Spleen-tonifying methods. This led to rebellious Qi, coma, profuse sweating, and retracted tongue. Funeral arrangements were made before Wang was consulted. Pulse was surging, rapid, and boundless, worse on the right Chi position. Large doses of Xijiao, Shigao, Huangqin (Scutellariae Radix), Huanglian, Huangbai (Phellodendri Cortex), Zhimu, Huafen, Zhizi, Shihu, Zhuye, Lianxin (Nelumbinis Plumula), Yuan Shen, and Shengdi were given. Zi Xue Dan was mixed with cold snow water. Within a day, her tongue protruded, throat and tongue became red and ulcerated, and swallowing water was painful. The three yellows (Huanglian, Huangbai, Huangqin) were removed; Jinyinhua (Lonicerae Japonicae Flos), Shegan (Belamcandae Rhizoma), and Dougen (Phaseoli Semen) were added, and Xilei San was insufflated. After three days, pulse and symptoms harmonized, and thin gruel was tolerated. Sweet-cool mild agents were given. Ten days later, hard black stool was passed, and she recovered.
Hu Renqiu felt slight discomfort during intense heat. A physician used Chaihu (Bupleuri Radix), Gegen (Puerariae Radix), and Xiangru (Moslae Herba) to release the exterior, causing aversion to cold and chest oppression. Another physician used Zhike (Aurantii Fructus), Houpo, and Binglang (Arecae Semen) to purge, worsening the condition. Wang Mengying diagnosed: spontaneous sweating, extremely cold limbs and back, faint breath, and minute, spiritless pulse. He said, "Constitutional deficiency with impending Yang collapse, caused by misdiagnosing an exterior syndrome." He prescribed Niujin Tang (Rescue the Reversed Decoction) plus Renshen and Huangqi (Astragali Radix). Gradual improvement followed. Qi-tonifying and fluid-generating herbs regulated her for a month until recovery.
In the summer of the Renyin year, someone contracted Summerheat-Dampness, mistreated with warming/releasing herbs, leading to delirium, coma, and critical danger. An abscess with foul pus erupted between the anus and scrotum, deep and large. Surgeons diagnosed Xuanyong (Perineal Abscess). External applications failed. Wang diagnosed: "Xuanyong is a chronic wasting condition formed gradually. This acute onset with foul odor indicates internal accumulation of damp-heat toxin from rich foods, combined with external Summerheat, draining downward. Do not apply external meds to block outward expulsion. However, stiff purple-red tongue, fine slippery-rapid pulse indicate excess external pathogen, latent heat, and severe Yin deficiency fearing fluid exhaustion." First, Ying-level clearing agents were given. After three doses, spirit clarified. Then, Yangming-level cooling/moistening agents smoothed bowels, cleared heat, and purified pus. Sweet-moistening nourishing herbs flattened the wound over a month. Convalescence with Renshen and Huangqi restored health.
Jin Xiaogeng had fever for two weeks. Exterior-releasing herbs failed to induce sweat. Warming tonics caused diarrhea and urinary retention, dry mouth, emaciation, and critical danger. Recommended by Hu Renqiu, Wang diagnosed: Right Cun pulse was uniquely deep, rapid, and numbing. "Summerheat-Heat trapped in the Lung Meridian." He prescribed Baihu Tang, Weijing Tang (Euphrasiae Decoction), and Tianshui San (Heavenly Water Powder) plus Fuling, Jiegeng (Platycodonis Radix), Xingren (Armeniacae Semen Amarum), and Beimu. After ingestion, rashes covered the head and face densely, crystal-clear. Everyone feared this. Wang said, "This is Lung pathogen venting." Indeed, skin became moist, fever subsided, diarrhea stopped, and appetite returned. Twenty-plus doses of sweet-cool moistening herbs healed the rashes. A rare case.