圣翁夫人，夏间病患热盛无汗，烦渴昏谵，医治旬余不解，圣翁外贸，伊芳郎荫千兄，廷
予诊
视。脉数舌黄，谓曰∶此热病也，非清不可。疏竹叶石膏汤与之。时夜将半，闻叩扉声甚急
，启视，荫兄慌入而言曰∶病危矣。询其故。曰妙剂，当服头渣，至暮未见动静，再服复渣
，更静后，忽寒战肢抖，少顷汗出如浆，肤冷息微，闭目不语。众以为殆，归咎药性太凉，
欲投参附以救其脱，亟求复诊以决之。予即随往，扪其肌肤果冷，细按脉虽虚 ，然至数和
缓，并不急疾。曰无妨，此战汗也。因本气不足，邪气鸱张，予重用清剂驱之，邪不能留，
逐与正争，是以战而汗出。邪虽从此而解，正亦由此而亏，且任其养息，切勿惊扰，元气来
复，自然肤暖神苏，若骤进参附，诚恐余烬复炎，反为害矣。叶氏论温热病战汗解后，胃气
空虚，有肤冷一昼夜之说。取书与阅，群疑始释。另立一方，用生脉散加茯神、玉竹、白芍
、甘草，嘱市药煎好，俟其苏醒与服，并啜稀粥，以养胃气。次早荫兄来谢云∶昨夕非子有
定见，几为旁言所误，遵嘱静守，超时汗敛神苏，忙将煎好之药服讫，复睡至晓，肌肤已温
，唯形倦气怠耳。更为辅正养阴和胃，渐次而康。
安波按∶斯证若脉急数，自汗如雨，躁烦不安，神志不宁，是自气脱阳越之候，速宜
大剂回阳，与此大相悬绝。
圣翁夫人，在夏季患热病，体内热势亢盛且无汗，伴有烦躁、口渴、神志昏沉及胡言乱语等症状，经过十余天的治疗病情未缓解。当时圣翁外出经商，其女婿荫千兄（即廷予）请我为其诊治。
我诊察发现其脉象数疾，舌苔黄腻，便对他说：“这是热病，非用清热法不可。”于是开具了竹叶石膏汤给她服用。
当时夜已过半，听到急促的敲门声，开门查看，荫千兄惊慌地跑进来说：“病情危急了。”询问原因，他说：“服用了您开的妙药，先服第一遍煎煮的药渣，到了傍晚还没有什么动静；再服第二遍煎煮的药渣后，病人更加安静，随后突然发生寒战和肢体颤抖，过了一会儿大汗淋漓如浆，皮肤冰冷，气息微弱，闭着眼睛不说话。大家都认为情况危险，归咎于药性太凉，想要投用参附汤来挽救阳气外脱，急忙请求再次复诊以做决定。”
我随即前往诊视，触摸她的肌肤确实冰冷，但仔细切按脉搏虽然虚弱，然而节律和缓，并不急迫快速。我说：“不要紧，这是‘战汗’现象。因为患者本身体质不足，邪气猖獗，我重用清热剂驱除邪气，邪气无法停留，于是与正气相争，所以出现寒战并出汗。邪气虽然由此解除，正气也由此亏损，应当任其静养休息，千万不要惊扰，元气恢复后，自然会皮肤回暖、神志清醒。如果骤然进用参附等温补药，恐怕余留的热邪重新燃起，反而造成危害。”
叶天士在论述温热病通过战汗解除后，提到胃气空虚，有皮肤冰冷持续一昼夜的说法。我拿出书籍给他们看，众人的疑虑才消除。另外开了一方，使用生脉散加入茯神、玉竹、白芍、甘草，嘱咐去药店煎好，等她苏醒后服用，并让她喝些稀粥，以养护胃气。
第二天早上，荫千兄前来道谢说：“昨晚如果不是您有定见，差点被旁人的言论误导。遵照您的嘱咐静静守候，过了那个时段后汗止神清，忙将煎好的药服完，又睡到早晨，肌肤已经温暖，只是身体疲倦、精神懈怠罢了。”后来再用扶正、养阴、和胃的方法调理，逐渐康复。
安波按：此证如果脉象急数，自汗如雨，躁动烦闷不安，神志不宁，那就是气脱阳越的征候，必须迅速使用大剂量回阳救逆的药物，这与上述情况截然不同。
Madam Sheng, in the summer, suffered from a heat disease characterized by intense internal heat, absence of sweating, irritability, thirst, mental confusion, and delirium. After more than ten days of treatment without relief, while her husband was away on business, her son-in-law, Mr. Yin Qian (Tingyu), requested my consultation.
Upon examination, I found her pulse rapid and tongue coating yellow, and stated to him: "This is a heat disease; it must be treated with clearing methods." I prescribed Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) for her.
Around midnight, urgent knocking was heard at the door. Upon opening it, Mr. Yin entered in panic, saying, "The condition is critical." When asked why, he explained: "After taking your excellent prescription, she took the first decoction, but showed no reaction by evening. After taking the second decoction, she became even quieter, then suddenly experienced chills and limb tremors. Shortly after, she sweated profusely like syrup, her skin became cold, breathing weak, eyes closed, and unresponsive. Everyone thought she was dying and blamed the medicine for being too cooling. They wanted to administer Shenfu Tang (Ginseng and Aconite Decoction) to rescue the collapsing Yang, and urgently sought a re-examination to decide."
I went immediately. Touching her skin, it was indeed cold, but upon careful palpation, although the pulse was deficient, its rhythm was harmonious and moderate, not rapid or frantic. I said, "No need to worry. This is 'Zhan Han' (Battle Sweat). Due to insufficient constitutional Qi and rampant pathogenic factors, I used heavy clearing agents to drive out the pathogens. The pathogens could not remain, so they contended with the healthy Qi, resulting in shivering followed by sweating. Although the pathogens are resolving, the healthy Qi is also depleted. Let her rest quietly; do not disturb her. Once Yuan Qi (Original Qi) recovers, her skin will naturally warm up, and consciousness will return. If we suddenly administer Shenfu (Ginseng and Aconite), there is a fear that residual heat may flare up again, causing harm."
Ye Tianshi, in his discussion on warm diseases resolving through battle sweat, mentioned that after resolution, stomach Qi is empty, citing cases where skin remains cold for twenty-four hours. I showed them the book, and their doubts were dispelled. I prescribed another formula: Shengmai San (Generate the Pulse Powder) added with Fushen (Poria with Hostwood), Yuzhu (Polygonatum Odoratum Rhizome), Baishao (White Peony Root), and Gancao (Licorice Root). I instructed them to have it decocted and administered once she regained consciousness, along with some thin rice gruel to nourish Stomach Qi.
The next morning, Mr. Yin came to thank me, saying: "If not for your firm judgment last night, we would almost have been misled by others' remarks. Following your advice to keep quiet, after that period passed, the sweat stopped and spirit returned. We hurriedly gave the decocted medicine, and she slept until dawn. Her skin is now warm, only feeling physically tired and mentally sluggish." Subsequently, using methods to support Zheng Qi (Upright Qi), nourish Yin, and harmonize the Stomach, she gradually recovered.
An Bo notes: If this syndrome presented with a rapid and forceful pulse, spontaneous sweating like rain, restlessness and irritability, and unsettled spirit, it would indicate collapse of Qi and floating of Yang. In such a case, large doses of Yang-restoring formulas should be administered immediately. This is vastly different from the case described above.