四川闻藩台二令媛。癸丑冬月一病即斑，其色深红而松浮，症原不重，但脉细数有力，此内有伏热。
即用中剂，加大青叶，连投五服，斑退而神安，再二服，可以无事。因年轻畏药，不肯多服，又不忌饮食，
越七日，身忽大热，大渴，嘴唇 肿，牙缝流血，口秽喷人。予用大剂，加生地一两，次日热渴稍杀，而颈
亦红肿，即于本方加牛子、夏枯草、银花各三钱，连投三服，颈虽消，右腮又肿，又于本方去牛子、夏枯草，
加板蓝根、马勃。又三服而腮肿全消，唇亦稍散，周身泛砂，红白相间，又于本方去板蓝根、马勃，加大
青叶。又三服，嘴唇全消，通身脱皮成片。彼按本方调理十余日方痊。此症计用石膏八斤有另，犀角八两，
黄连七两。闻公任部曹时，与予契交，夫人信任无疑，是以得痊。
正红旗护军活隆武者，乃太仆寺员外郎华公胞侄也，系予世好。丙午夏，出疹本轻，尊人畏予用药过
峻，惧不敢邀，及至舌卷囊缩，方邀予治。诊其脉，细数有力；观其色，气壮神昂，非死候也；及验其
舌，其黑如煤，其坚如铁，敲之戛戛有声。因问曰∶前医何以不药？尊人曰∶彼云满舌皆黑，前人列于不
治。予曰∶水来克火，焉有苔浓如甲哉？按此起病之初，舌苔必白而浓，此火极水化之象，误以为挟寒，
妄肆温表，燔灼火焰，以致热毒阻于中焦，离不能下降，坎不能上升，热气熏蒸。由白而黄，由黄而
黑矣。治宜重清胃热，兼凉心肾，非大苦大寒，不能挽回。即用大剂，重用犀、连，更加生地、知、柏、抑阳扶
阴，连投四服，其苔整脱亦如舌大，后用三小剂而痊。
四川按察使司副使（闻藩台）的二女儿，在癸丑年冬天刚发病就出现了斑疹。斑疹颜色深红且松浮，症状原本不重，但脉象细数而有力，这是体内有伏热所致。
随即使用中等剂量的方药，加入大青叶，连续服用五剂后，斑疹消退，神志安宁，再服两剂就可以痊愈了。因为患者年轻害怕吃药，不肯多服，又不忌口饮食，过了七天，身体突然高热，极度口渴，嘴唇肿胀，牙缝流血，口中秽气喷人。我使用大剂量方药，加入一两生地，第二天热势和口渴稍减，但颈部也出现红肿。于是就在原方中加入牛蒡子、夏枯草、金银花各三钱，连续服用三剂，颈部肿胀虽然消退，但右侧腮部又肿起来。又在原方中去掉牛蒡子、夏枯草，加入板蓝根、马勃。再服三剂后，腮部肿胀完全消退，嘴唇也稍微消散，周身泛起砂粒状皮疹，红白相间。又在原方中去掉板蓝根、马勃，加大青叶。再服三剂，嘴唇完全消肿，全身成片脱皮。她按照这个方子调理十多天才痊愈。此症共计使用了石膏八斤多，犀角八两，黄连七两。听说这位公任部曹时，与我交情深厚，夫人对我信任无疑，所以得以痊愈。
正红旗护军活隆武，是太仆寺员外郎华公的亲侄子，也是我家世代友好的关系。丙午年夏天，他出疹病情本来较轻，他的父亲担心我用药过于峻猛，害怕不敢来邀请诊治，等到出现舌头卷缩、阴囊收缩的症状时，才来请我治疗。诊察他的脉象，细数而有力；观察他的神色，气壮神旺，不是死证；等到检查他的舌头，舌苔黑得像煤炭，坚硬得像铁，敲击时发出嘎嘎的声音。于是问道：“之前的医生为什么不给药？”他的父亲说：“他们说满舌都是黑色，前人列为不治之症。”我说：“水来克火，怎么会有苔厚如铠甲的呢？回想这一起病之初，舌苔必定是白而浓厚的，这是火极似水的假象，误以为是挟寒，妄用温散解表药，导致火热燔灼，致使热毒阻滞在中焦，心火不能下降，肾水不能上升，热气熏蒸。由白色转为黄色，由黄色转为黑色了。治疗应当重在清泻胃热，兼以凉补心肾，非用大苦大寒之药，不能挽回局面。”随即使用大剂量方药，重用犀角、黄连，再加上生地、知母、黄柏，以抑制阳亢、扶持阴液，连续服用四剂，舌苔整片脱落，如同舌头变大一样（指舌面恢复光滑），后来再用三个小剂量方剂而痊愈。
The second daughter of the Vice Commissioner of Surveillance (Wen Fantai) in Sichuan developed macules (rash spots) immediately upon falling ill in the winter month of the Gui-Chou year. The color was deep red and loose-floating; the symptoms were originally not severe, but the pulse was fine, rapid, and forceful, indicating latent heat within.
An intermediate dosage prescription was used initially, with *Da Qing Ye* (Isatidis Folium) added. After five consecutive doses, the macules receded and the spirit calmed; two more doses would have sufficed for recovery. However, due to her youth and fear of medication, she refused to take more, and failed to observe dietary restrictions. Seven days later, she suddenly suffered from high fever, extreme thirst, swollen lips, bleeding from the gum spaces, and foul breath. I prescribed a large-dose formula, adding one liang of *Sheng Di Huang* (Rehmanniae Radix). The next day, the fever and thirst subsided slightly, but swelling and redness appeared on the neck. Therefore, I added three qian each of *Niu Bang Zi* (Arctii Fructus), *Xia Ku Cao* (Prunellae Spica), and *Yin Hua* (Flos Lonicerae Japonicae) to the original formula. After three consecutive doses, the neck swelling subsided, but the right cheek swelled again. I then removed *Niu Bang Zi* and *Xia Ku Cao* from the formula and added *Ban Lan Gen* (Radix Isatidis) and *Ma Bo* (Pilulae Fomes). After another three doses, the cheek swelling completely disappeared, and the lip swelling partially resolved. Sand-like eruptions appeared all over the body, alternating between red and white. I then removed *Ban Lan Gen* and *Ma Bo* and increased the amount of *Da Qing Ye*. After three more doses, the lip swelling completely subsided, and the entire body shed skin in sheets. She continued to regulate her condition using this formula for over ten days before fully recovering. In total, this case required more than eight jin of *Shi Gao* (Gypsum Fibrosum), eight liang of *Xi Jiao* (Rhino-Cornu, now substituted with Buffalo Horn), and seven liang of *Huang Lian* (Coptidis Rhizoma). When this gentleman served as a Ministry Official, he had a close friendship with me, and his wife trusted me implicitly, which contributed to his daughter's recovery.
Huolongwu, a Guard of the Plain Red Banner, was the nephew of Huagong, Vice Director of the Court of Imperial Entertainments, and also a family friend of long standing. In the summer of the Bing-Wu year, he contracted measles (exanthematous disease), which was initially mild. His father, fearing my prescriptions were too harsh, hesitated to invite me. It was only when he developed tongue retraction (she juan) and scrotal retraction (nang suo) that he sought my treatment. Upon examination, his pulse was fine, rapid, and forceful; his complexion showed robust qi and spirited demeanor, indicating it was not a terminal sign. Upon inspecting his tongue, the coating was black as coal and hard as iron, producing a clattering sound when tapped. I asked, "Why did previous physicians withhold medication?" His father replied, "They said the entire tongue was black, which earlier authorities listed as untreatable." I said, "Water overcoming Fire—how could there be a coating thick like armor? Recalling the onset, the tongue coating must have been white and thick; this is the phenomenon of extreme Fire transforming into Water [false cold signs]. Misdiagnosed as Cold-encumbrance, warm-releasing exterior-dispersing methods were recklessly applied, causing blazing fire to scorch, leading to heat-toxin obstruction in the Middle Jiao. Heart Fire could not descend, and Kidney Water could not ascend, resulting in steaming heat. Thus, it changed from white to yellow, and from yellow to black." The treatment should focus heavily on clearing Stomach Heat while cooling the Heart and Kidneys; only great bitter-cold herbs can reverse this situation. I immediately prescribed a large-dose formula, heavily utilizing *Xi Jiao* and *Huang Lian*, plus *Sheng Di Huang*, *Zhi Mu* (Anemarrhenae Rhizoma), and *Mu Dan Pi* (Moutan Cortex - note: text says Zhi, Bai, likely Zhi Mu and Huang Bai), to suppress Yang and support Yin. After four consecutive doses, the tongue coating shed entirely, revealing a smooth surface resembling an enlarged tongue. Three subsequent small-dose prescriptions completed the cure.