理藩院侍郎奎公四令弟病疫，昏闷无声，身不大热，四肢如冰，六脉沉细而数。延一不谙者，已
用回阳救急汤，中表兄富公，力争其不可。及予至，诊其脉，沉细而数；察其形，唇焦而裂，因向富公
曰∶此阳极似阴，非阴也。若是真阴，脉必沉迟，唇必淡而白，焉有脉数、唇焦认为阴症哉？此热毒伏于
脾经，故四肢厥逆，乘于心肺，故昏闷无声，况一身斑疹紫赤，非大剂不能挽回。遂用石膏八两，犀角六
钱，黄连五钱、余佐以大青叶、羚羊角。连服二帖，至夜半身大热，手足温，次日脉转洪大。又一服热减而
神清矣。以后因症逐日减用，八日而愈，举家狂喜，以为异传。
癸丑冬月，国子监司业五公名格者，二令媳病疫，恶寒发热，头痛呕吐。请一医者，用表散药，加
藿香、半夏、苍术，其症反极。又延一人，用清凉之剂稍安，次日加石膏三钱，犀角八分，黄连五分，脉转
沉伏，四肢逆冷，昏迷若昧，医者认为转阴。谢以不治。五公满服愁怀，徘徊庭院。夫人曰∶数年前活
我者谁乎？五公恍然大悟曰∶非此人断乎不可，邀余述其所以。予诊其脉，验其症色，曰∶此易事耳。五
曰∶明系热症，投凉药反剧，更有何术？予曰∶治病犹用兵也，小固不可以敌大，弱固不可以敌强，病大
药小，反增其势，予按法治之，管教十四日而愈。未几二令郎亦病，诊其脉，观其色，曰∶令郎之症，受
毒已深，较令媳更重。即按法治之，七、八日，种种变症难以枚举，好在二十一日。两服后，周身斑点紫
赤相间，有紧有束，有松有浮。五公骇然曰∶君言较前更重，何其验也。即用大剂，石膏八两，犀角六钱，黄连五钱，
更加生地一两，紫草三钱，归尾二钱，大青叶三钱。一服三煎，更以四煎熬水，次日煎药。一方服至六帖，紧者松，束
者浮，但鼻血泉涌，谵妄无伦。五惧去血过多。予曰∶此热血妄行，毒犹因此而得发越，止之甚易。即照本方加棕炭三
钱，桑皮三钱，羚羊角三钱，两服血止，去桑皮、棕炭、羚羊。又二服，胃气渐开，色转淡红，渐有退者，用石膏四两，
犀角四钱，黄连三钱，去紫草、归尾，减生地五钱，大青叶钱半。又二服，斑全消，用生地三钱，犀角三
钱，黄连二钱，石膏二两八钱。又二服，饮食大进，自颈至胸。复泛红砂，此余毒尽透也，用生地三钱，
犀角二钱，黄连钱半，石膏一两六钱。又二帖，精神渐长，仍用生地三钱，犀角钱半，黄连八分，洋参一
钱，麦冬三钱，归身钱半，石膏八钱，酸梅二个。又三服而安。五公喜而言曰∶小儿之生，先生再造矣。
予曰，前治令媳，乃救令郎耳！此症若初服生姜、半夏、苍术、藿香，断不能救。斑乃胃热之症，诸药大能
燥胃，火上添油，尚望生乎？嗣后一家连治七人，俱是大险，在我治之无难，五亦服之若素。
【附一：昏闷无声治验】
理藩院侍郎奎公的四位弟弟患瘟疫，出现神志昏沉、胸闷且不能发声的症状，身体发热不明显，四肢冰冷，六脉（寸关尺左右手）沉细而数。请了一位不懂医理的人诊治，已经使用了回阳救急汤，中表兄富公极力反对这种做法。等到我到达时，诊察其脉象，仍是沉细而数；观察其形体，嘴唇焦枯开裂，于是我对富公说：“这是阳极似阴证，并非真正的阴证。如果是真正的阴寒证，脉象必定沉迟，嘴唇必定淡白，哪有脉象数疾、嘴唇焦枯却认为是阴证的道理呢？”这是热毒潜伏在脾经，所以导致四肢厥冷；热邪上犯心肺，所以导致神志昏闷无声。况且全身斑疹呈现紫红色，非用大剂量药物不能挽回生机。于是使用石膏八两，犀角六钱，黄连五钱，其余佐以大青叶、羚羊角。连续服用两剂后，到了半夜身体大发高热，手足转温，第二天脉象转为洪大。再服一剂后热势减退，神志清醒。此后根据症状每日逐渐减少药量，八天后痊愈，全家狂喜，认为这是神奇的医术。
癸丑年冬天，国子监司业五公名叫格的人，他的二弟媳患瘟疫，出现恶寒发热、头痛呕吐的症状。请了一位医生，使用了发散解表的药物，加入藿香、半夏、苍术，结果病情反而极度加重。又请了另一位医生，使用了清凉的药剂稍见安宁，第二天加入石膏三钱，犀角八分，黄连五分，脉象转为沉伏，四肢逆冷，昏迷不醒像失去知觉一样，医生认为是转化为阴证。推辞说不治了。五公满腹愁怀，在庭院中徘徊。夫人说：“几年前救活我的人是谁啊？”五公恍然大悟地说：“如果不是这个人断定不行。”邀请我说明其中的道理。我诊察其脉象，验证其症状面色，说：“这是容易处理的事。”五公说：“明明是热症，投用凉药反而加剧，还有什么办法？”我说：“治病就像用兵打仗，小的固然是不能对抗大的，弱的固然是不能对抗强的，病重药轻，反而助长病势。我按照法则治疗，保证十四天痊愈。”不久，二弟的儿子也病了，诊察其脉象，观察其面色，说：“令郎的病，受毒已深，比令嫂更严重。”随即按照法则治疗，七八天内，各种变症难以一一列举，好在二十一天内。两服药后，周身斑点紫赤相间，有的紧束，有的松散，有的浮起。五公害怕地说：“您说比以前更重，为何如此灵验。”立即使用大剂量药物，石膏八两，犀角六钱，黄连五钱，更加生地一两，紫草三钱，归尾二钱，大青叶三钱。一剂药煎三次，再用第四次煎的水来煎第二天的药。一方连服六剂，紧束的变得松散，紧束的变得浮起，只是鼻血如泉水涌出，胡言乱语没有条理。五公害怕失血过多。我说：“这是热血妄行，毒邪正因为此得以发越，止住它很容易。”即照原方加入棕炭三钱，桑皮三钱，羚羊角三钱，服用两剂后血止，去掉桑皮、棕炭、羚羊角。又服两剂，胃气逐渐开通，颜色转为淡红，渐渐有消退的迹象，使用石膏四两，犀角四钱，黄连三钱，去掉紫草、归尾，减去生地五钱，大青叶一两半。又服两剂，斑疹完全消退，使用生地三钱，犀角三钱，黄连二钱，石膏二两八钱。又服两剂，饮食大增，从颈部到胸部再次泛起红砂，这是余毒全部透发的表现，使用生地三钱，犀角二钱，黄连一两半，石膏一两六钱。又服两帖，精神逐渐恢复，仍用生地三钱，犀角一两半，黄连八分，洋参一钱，麦冬三钱，当归身一两半，石膏八钱，酸梅两个。又服三剂而安定。五公高兴地说：“小儿能活下来，是先生再造之恩。”我说：“之前治疗令嫂，其实是救了令郎！这个病症如果起初服用生姜、半夏、苍术、藿香，绝对不能救活。斑疹是胃热的病症，那些药物大能燥伤胃气，如同火上浇油，还指望能活吗？此后一家接连治疗七人，都是极大的险症，在我治疗起来不难，五公也习以为常地服用。”
[Appendix 1: Treatment Case of Coma, Chest Stifling, and Inability to Speak]
The fourth younger brother of Kui Gong, Vice Minister of the Lifan Yuan (Court of Colonial Affairs), contracted epidemic plague. He presented with coma, chest stifling, and inability to speak; his body was not significantly hot, his four limbs were ice-cold, and his six pulses (cun, guan, chi on both hands) were deep, fine, and rapid. A physician unfamiliar with proper diagnosis had already administered Huayang Jiuji Tang (Decoction for Restoring Yang and Saving from Emergency). His cousin-in-law, Gong Fu, strongly argued against this treatment. Upon my arrival, I palpated his pulse—deep, fine, and rapid—and observed his physical condition: his lips were scorched and cracked. I said to Gong Fu, "This is 'Extreme Heat resembling Yin' syndrome, not true Yin syndrome. If it were true Yin cold, the pulse would necessarily be deep and slow, and the lips pale and white. How can one consider it a Yin syndrome when the pulse is rapid and the lips are scorched?" This is heat-toxin latent in the Spleen meridian, causing cold extremities (Jue Ni); the pathogen attacks the Heart and Lungs, causing coma and chest stifling with inability to speak. Moreover, the macules and rashes all over the body are purple-red; only a large dose of medicine can reverse this critical condition. Therefore, I prescribed Shi Gao (Gypsum Fibrosum) 8 liang, Xi Jiao (Rhinoceros Horn - *Note: Substitute with Buffalo Horn in modern practice*) 6 qian, Huang Lian (Coptidis Rhizoma) 5 qian, assisted by Da Qing Ye (Isatidis Folium) and Ling Yang Jiao (Saiga Tataricae Cornu). After taking two doses, by midnight, his body became highly feverish, and his hands and feet turned warm. The next day, his pulse transformed into a surging (Hong) and large (Da) quality. After one more dose, the fever subsided, and his spirit cleared. Thereafter, the dosage was gradually reduced daily according to the symptoms, and he recovered in eight days. The whole family was ecstatic, regarding it as miraculous medical art.
In the winter of the Gui Chou year, Wu Ge, the Simye (Vice Director) of the Guozijian (Imperial Academy), reported that his second brother's daughter-in-law suffered from epidemic plague with aversion to cold, fever, headache, and vomiting. A physician was consulted who used exterior-releasing herbs, adding Huo Xiang (Agastaches Herba), Ban Xia (Pinelliae Rhizoma Praeparatum), and Cang Zhu (Atractylodis Rhizoma). Consequently, the symptoms worsened severely. Another physician was invited who used cooling agents, providing slight relief. The next day, Shi Gao (Gypsum Fibrosum) 3 qian, Xi Jiao (Rhinoceros Horn) 8 fen, and Huang Lian (Coptidis Rhizoma) 5 fen were added. However, her pulse became deep and hidden (Fu), her four limbs turned cold, and she fell into a comatose state resembling unconsciousness. The physician diagnosed this as a transformation into Yin syndrome and declined further treatment due to hopelessness. Wu Gong was filled with sorrow and paced the courtyard. His wife asked, "Who saved me years ago?" Wu Gong suddenly realized and said, "It must be this person." He invited me to explain the rationale. I palpated her pulse and examined her symptoms and complexion, stating, "This is an easy matter." Wu Gong asked, "Clearly a Heat syndrome, yet administering cooling medicines made it worse. What other method is there?" I replied, "Treating disease is like using troops; the small cannot fight the large, and the weak cannot fight the strong. When the disease is severe but the medication is light, it inadvertently boosts the pathogenic force. Following my protocol, I guarantee recovery within fourteen days." Soon after, Wu Gong's second son also fell ill. I palpated his pulse and observed his complexion, saying, "Your son's condition involves deep toxin penetration, which is heavier than your sister-in-law's." I treated him according to the same protocol. Within seven to eight days, various complicated changes occurred, too numerous to enumerate. Fortunately, after two doses, purple-red macules appeared all over his body, some tight and bound, others loose and floating. Wu Gong exclaimed in fear, "You said it was heavier than before; how accurate you are!" I immediately prescribed a large dose: Shi Gao (Gypsum Fibrosum) 8 liang, Xi Jiao (Rhinoceros Horn) 6 qian, Huang Lian (Coptidis Rhizoma) 5 qian, plus Sheng Di Huang (Rehmanniae Radix Praeparata) 1 liang, Zi Cao (Arnebiae Radix seu Lithospermi Radix) 3 qian, Gui Wei (Angelicae Sinensis Radix Caulis) 2 qian, and Da Qing Ye (Isatidis Folium) 3 qian. One dose was decocted three times, and the residue was used to decoct the next day's medicine. After taking six doses of this formula, the tight macules loosened, and the bound ones floated. However, nosebleeds gushed like a spring, accompanied by delirious speech. Wu Gong feared excessive blood loss. I said, "This is reckless movement of hot blood; the toxin is being expelled through this hemorrhage. Stopping it is very easy." I modified the original formula by adding Zong Tan (Carbonized Palm Fiber) 3 qian, Sang Bai Pi (Mori Cortex) 3 qian, and Ling Yang Jiao (Saiga Tataricae Cornu) 3 qian. After two doses, the bleeding stopped, and Sang Bai Pi, Zong Tan, and Ling Yang Jiao were removed. After another two doses, stomach qi gradually opened, the color turned pale red, and the rash began to recede. I then prescribed Shi Gao (Gypsum Fibrosum) 4 liang, Xi Jiao (Rhinoceros Horn) 4 qian, Huang Lian (Coptidis Rhizoma) 3 qian, removing Zi Cao and Gui Wei, reducing Sheng Di Huang by 5 qian, and using Da Qing Ye (Isatidis Folium) 1.5 liang. After two more doses, the macules completely disappeared. I prescribed Sheng Di Huang (Rehmanniae Radix Praeparata) 3 qian, Xi Jiao (Rhinoceros Horn) 3 qian, Huang Lian (Coptidis Rhizoma) 2 qian, and Shi Gao (Gypsum Fibrosum) 2.8 liang. After two additional doses, his appetite increased significantly, and red sand-like spots reappeared from the neck to the chest, indicating the complete emergence of residual toxins. I prescribed Sheng Di Huang (Rehmanniae Radix Praeparata) 3 qian, Xi Jiao (Rhinoceros Horn) 2 qian, Huang Lian (Coptidis Rhizoma) 1.5 qian, and Shi Gao (Gypsum Fibrosum) 1.6 liang. After two more doses, his spirit gradually strengthened. I continued with Sheng Di Huang (Rehmanniae Radix Praeparata) 3 qian, Xi Jiao (Rhinoceros Horn) 1.5 qian, Huang Lian (Coptidis Rhizoma) 0.8 qian, Yang Shen (Codonopsis Pilosula or Panax Ginseng depending on context, here likely Codonopsis) 1 qian, Mai Dong (Ophiopogonis Tuber) 3 qian, Dang Gui Shen (Angelicae Sinensis Radix Caulis) 1.5 qian, Shi Gao (Gypsum Fibrosum) 8 qian, and two sour plums. After three more doses, he stabilized. Wu Gong joyfully said, "My son's survival is thanks to your regeneration." I replied, "By treating your sister-in-law earlier, I was essentially saving your son! If ginger, banxia, cangzhu, and huoxiang had been used initially, he certainly could not have been saved. Macules are a symptom of Stomach Heat; those previous herbs are highly drying and damage Stomach Qi, adding oil to fire. How could life be expected? Subsequently, our family treated seven members consecutively, all presenting with critical danger. For me, treatment was not difficult, and Wu Gong took the medicines as a matter of course."