一仆病与前类，而身如火烁，头痛如破，大便不泻，小水赤，口渴，鼻干，不得眠，胸
膈膨
胀，腹饥不能食，六脉弦而数。用竹叶石膏汤，加知母、枳壳、白芷、葛根，大加青蒿，一
帖而热痛减半，胸膈亦宽。惟口渴，小水短涩，睡卧不安，又与化瘟丹三钱，井水化下，渴
止，稍得睡，头晕脚软，喘急。与四物汤加青蒿、酒芩、薏苡仁、木瓜，服之全安。
一仆之病亦前相似，以服丘一斋药而大吐大泻，热益增，头痛莫能当，烦躁口渴，鼻干
，呕
吐，小水短涩，寝食废者十四日，势甚危急。询前所服药，乃藿香正气散加砂仁、浓朴、山
楂
，大耗元气之味，且五月火令当权之疫，当以甘寒之剂治之，何可以辛热香窜者，益其火而
枯其津也？其势危矣!此皆不知因时变达，惟习常胶，故以误人者。用急投人参白虎汤，加竹
茹、葛根、青蒿、升麻，一帖而热除，再帖而头痛止，诸症尽去。后连治数人，多如此类，
何也？此无行之疫，故一方见之。治多先以甘寒清解之剂投之，热退即以四物汤以补阴血，
稍加清热之剂，而青蒿之功居多，此固一时自得之愚。用录之以告同志者，使知治法当随
时俗为变，而常套不可不脱也。
马凤阳文学，五月患咳嗽，内热，额上多汗，恶风。脉左弦数，右滑数。予曰∶据弦数
为阴
虚，滑为有痰。不亟调治，恐成虚怯。以白芍药、川归、茯苓、五味子、白术、甘草、陈皮
、贝母、天花粉、酒芩、麦冬、知母、桑白皮，十帖，诸症皆瘳。七月复疟，间日一发，寒
热相半，寒热亦俱极，渴甚，上身汗多。以石膏五钱，人参、黄 、白芍药、麦冬、知母二
钱，柴胡三钱，桂枝、甘草、陈皮、贝母各一钱，竹叶三十片，一帖而愈。
有一位仆人患病，症状与前文所述类似，但身体发热如火烧灼，头痛剧烈如要破裂，大便未泻，小便色赤，口渴，鼻干，无法入睡，胸膈部胀满膨隆，腹部感觉饥饿却无法进食，六脉呈现弦而数的脉象。使用竹叶石膏汤，加入知母、枳壳、白芷、葛根，并大量增加青蒿的用量，服用一剂后，热痛减轻了一半，胸膈部的胀满感也随之缓解。只是仍有口渴、小便短少涩滞、睡眠不安的症状，又给予化瘟丹三钱，用井水送服，口渴停止，稍微能够入睡，但出现头晕、脚软、气喘急促的症状。随后给予四物汤，加入青蒿、酒炒黄芩、薏苡仁、木瓜，服用后完全康复。
另一位仆人的病情也与前文相似，但因服用了丘一斋的药物而导致剧烈呕吐和腹泻，热度更加增高，头痛难以忍受，烦躁口渴，鼻干，呕吐，小便短少涩滞，卧床休息和进食都荒废了十四天，形势非常危急。询问之前所服用的药物，原来是藿香正气散加砂仁、厚朴、山楂，这些都是大耗元气的药味。况且五月正值火令当权之时发生的疫病，应当用甘寒性质的药剂来治疗，怎么能用辛热香窜的药物，助长火势而枯竭津液呢？这形势已经很危险了！这都是因为不了解根据时令变化灵活施治，只习惯于常规僵化的做法，所以误人子弟。于是紧急投用人参白虎汤，加入竹茹、葛根、青蒿、升麻，服用一剂后热势消除，再服用一剂后头痛停止，各种症状全部去除。后来连续治疗了几个人，大多都是这种情况，为什么呢？这是因为这种无行之疫（指不按常规季节规律发作的疫病），所以一方就能见效。治疗时大多先用甘寒清解的药剂投服，热退后立即用四物汤来补益阴血，稍加清热药剂，其中青蒿的功效居多，这确实是我一时的心得体会。记录下来以告知志同道合的人，使大家知道治疗方法应当随着时俗变化而改变，不可拘泥于常套。
马凤阳是一位文人，五月时患上咳嗽，伴有内热，额头多汗，怕风。脉象左手弦数，右手滑数。我说：根据弦数脉判断为阴虚，滑脉表示有痰。如果不迅速调治，恐怕会发展成虚劳羸弱的病证。于是开具白芍药、当归、茯苓、五味子、白术、甘草、陈皮、贝母、天花粉、酒炒黄芩、麦冬、知母、桑白皮，服用十剂后，各种症状都痊愈了。七月时又患疟疾，每隔一天发作一次，寒热程度相当，且寒热都非常剧烈，极度口渴，上半身出汗多。使用石膏五钱，人参、黄芪、白芍药、麦冬各二钱，柴胡三钱，桂枝、甘草、陈皮、贝母各一钱，竹叶三十片，服用一剂后痊愈。
A servant fell ill with symptoms similar to the previous case, but his body felt as if burning like fire, his headache was severe as if his head were splitting, his stool was not loose, his urine was red, he was thirsty, his nose was dry, he could not sleep, his chest and diaphragm were distended and bloated, his abdomen felt hungry yet he could not eat, and all six pulses were wiry and rapid. He was prescribed Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) with added Zhi Mu (Anemarrhena Rhizome), Zhike (Aurantium Fructus), Baizhi (Angelicae Dahuricae Radix), and Gegen (Puerariae Lobatae Radix), along with a significantly increased dose of Qinghao (Artemisiae Annuae Herba). After one dose, the heat and pain were reduced by half, and the distension in the chest and diaphragm also eased. However, he still experienced thirst, scanty and difficult urination, and restless sleep. He was then given Sanhua Wen Dan (Three-Transforming Calming Phlegm Pill) three qian, dissolved in well water. His thirst ceased, and he slept slightly, though he subsequently developed dizziness, weak legs, and rapid breathing. Siwu Tang (Four Substances Decoction) was then administered with added Qinghao (Artemisiae Annuae Herba), Jiu Huangqin (Scutellariae Radix processed with wine), Yiyiren (Coicis Semen), and Mugua (Chaenomelis Fructus). After taking this, he fully recovered.
Another servant’s illness was also similar to the previous cases, but after taking medicine from Qiu Yizhai, he suffered severe vomiting and diarrhea, his fever increased further, his headache became unbearable, he was irritable and thirsty, his nose was dry, he vomited, his urination was scanty and difficult, and he had been unable to rest or eat for fourteen days. The situation was critical. Upon inquiry, it was found that the previously taken medicine was Huoxiang Zhengqi San (Agastache Powder to Rectify the Qi) with added Sharen (Amomi Fructus), Houpo (Magnoliae Officinalis Cortex), and Shanzha (Crataegi Fructus). These are substances that severely deplete Yuan Qi (Primal Qi). Moreover, in May, when the Fire mandate is dominant and epidemic diseases occur, treatment should employ sweet-cold agents. How could pungent-hot and aromatic-penetrating drugs be used, which would exacerbate the fire and dry up the fluids? The condition was perilous! This resulted from a failure to adapt treatment according to seasonal changes, sticking rigidly to routine practices, thus harming patients. Urgently, Renshen Baitu Tang (Ginseng and White Talcum Decoction) was administered with added Zhuru (Bambusae Caulis in Taeniam), Gegen (Puerariae Lobatae Radix), Qinghao (Artemisiae Annuae Herba), and Shengma (Cimicifugae Rhizoma). After one dose, the fever subsided; after a second dose, the headache stopped, and all symptoms disappeared. Several subsequent patients were treated similarly. Why? Because this type of "non-routine" epidemic disease responds uniformly to this formula. Generally, sweet-cold clearing and resolving agents are used first; once the fever recedes, Siwu Tang (Four Substances Decoction) is used to nourish Yin and blood, with slight additions of heat-clearing agents, among which Qinghao (Artemisiae Annuae Herba) plays the major role. This is indeed my personal insight at the time. I record it to inform colleagues, reminding them that treatment methods must vary with changing times and customs, and one must not remain bound by conventional routines.
Ma Fengyang, a scholar, suffered from cough and internal heat in May, with excessive sweating on the forehead and aversion to wind. His left pulse was wiry and rapid, and his right pulse was slippery and rapid. I stated: A wiry and rapid pulse indicates Yin deficiency, while a slippery pulse suggests the presence of Phlegm. If not treated promptly, it may develop into Xu Que (Deficiency and Emaciation Syndrome). I prescribed Shaoyao (Paeoniae Radix Alba), Chuan Gui (Angelicae Sinensis Radix), Fuling (Poria), Wuweizi (Schisandrae Chinensis Fructus), Baizhu (Atractylodis Macrocephalae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Beimu (Fritillariae Thunbergii Bulbus), Tianhuafen (Trichosanthis Radix), Jiu Huangqin (Scutellariae Radix processed with wine), Maidong (Ophiopogonis Radix), Zhi Mu (Anemarrhena Rhizoma), and Sangbaipi (Mori Cortex). After ten doses, all symptoms resolved. In July, he contracted malaria, occurring every other day, with equal intensity of chills and fever, both being extreme, accompanied by severe thirst and profuse sweating on the upper body. Shi Gao (Gypsum Fibrosum) five qian, Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Membranacei Radix), Shaoyao (Paeoniae Radix Alba), and Maidong (Ophiopogonis Radix) two qian each, Chaihu (Bupleuri Radix) three qian, Guizhi (Cinnamomi Ramulus), Gancao (Glycyrrhizae Radix et Rhizoma), Chenpi (Citri Reticulatae Pericarpium), and Beimu (Fritillariae Thunbergii Bulbus) one qian each, and thirty leaves of Zhuye (Bambusae Folium) were prescribed. He recovered after one dose.