戊子夏，征郡蛟水暴涨，横流泛滥，田庐人畜，到处被湮，歙休尤甚。公奉委往勘，暑
湿烦
蒸，感伏膜原，交秋疾作，始而寒热似疟，继则单热不寒。吾宗思敏翁为治两旬，大热已退
，日晡微潮，拟属邪去正亏，转为养阴和胃。越日寒热又作，以为感复，辅正驱邪，病状如
故，神形益疲。度其恙久，阴阳两虚，连投补剂，寒热总不能止，嘱邀予商。予进署时，公
寒热正发，卧榻呻吟，诊毕思翁适至，谓予曰∶燕公祖之恙，吾看多次，愈而反复，烦子酌
之。予曰∶顷诊脉象数犹带弦，热时口犹作渴，是属秋时晚发，感证似疟之候。大局无妨，
但恙久正气固虚，余波似仍未净。过补恐其腻邪，过清虑其伤正，酌以辅正剂中，微寓和解
之意，邪退而正不伤，斯为美也。思翁称善，遂令疏方。药用首乌、人参、当归、茯苓、甘
草、料豆衣、扁豆壳、陈皮、半夏、糯稻根须，引加鲜姜红枣，另以井河水各半煎。露一宿
，明早温服。后旦再议，届期复召，询其家人云∶昨服药后，寒热未来，夜眠安稳。入室公
起坐就诊。笑曰∶疟魔已被君驱去矣。复与思翁斟酌加减，不旬日而痊。公善画山水，有倪
迂风，惜墨如金，求之不得，病痊后，亲绘一HT 赠予，并序其事。
道光戊子冬，郡城饶君扬翁公郎浓卿兄病，初起寒热头痛咳嗽，服辛散药一剂，次日单
热不
寒，口渴烦躁，嗽痰带血，下午突作昏晕。当晚折简逆予，黎明至郡，见其面目俱赤，舌黄
耳聋，呛咳胁痛，汗出而热不衰，诊脉洪大数疾。谓君翁曰∶公郎之恙，乃风温犯肺，邪在
上焦，速为清解，免致蔓延中下。辛散之品，不宜用也。方用料豆、甘草、桑叶、蒌皮、杏
仁、桔梗、牛蒡子、贝母、梨皮之属。诘朝复召，问知夜来热甚烦谵，咳血甚多，望其面目
仍赤，诊毕昏晕又作，额汗淋漓。翁甚彷徨，适黄就唐表兄至，予告之曰∶此证确属风温为
病，但质亏病重，虑难支撑。昨方力薄，故不应效。就兄曰∶鄙见亦然，不识当如何用药。
予曰∶噫，难言。考风温名载仲景《伤寒论》中，但只言脉证及误治之变，并未出方。叔和
以下，亦皆无治法，惟朱奉议创立六方，可谓登坛树帜。然既言不可发汗，何葳蕤汤中又用
麻黄、羌活等药耶?宋元迄今，名贤代出，所论风温证治，未有一言折衷，可为法守者。惟
近时休邑汪广朝先生，所立风温汤一方，只葳蕤、料豆、甘草三味，药简功专，颇有深意。
予治此证，每宗此方范围而扩充之，往往获验。就兄以为然，于是照方加入沙参、生地、丹
皮、地骨皮、知母、贝母、黄芩，引用芦根梨汁白蜜，服之大效。诊视数次，热势渐退，苦
寒渐减，转手养阴润肺，调理两月，幸得保全。是役也，使非君翁信而不疑，就兄推诚赞助
，未见其有成功也。予常语人曰∶凡起一大证，务须病家能笃信，医者有主持，旁人不妄议
，三者失一，不可为矣。
戊子年夏天，徽州郡城蛟水暴涨，洪水横流泛滥，农田房屋和人畜到处被淹没，歙县和休宁两地尤为严重。饶公奉命前往勘察，因暑湿闷热蒸腾，感受伏邪于膜原（半表半里之隙），到了秋天疾病发作，起初寒热往来像疟疾一样，后来只有发热没有恶寒。我的同族思敏翁为他治疗了二十天，大热虽然退了，但每天傍晚有轻微的低热，判断属于邪气已去、正气亏损，于是转为滋养阴液、调和胃气的方法。第二天寒热又发作，认为是感冒复发，采用扶助正气、驱除邪气的方法，病情症状依旧，精神和形体更加疲惫。考虑到病程已久，阴阳两虚，连续投用补剂，寒热始终不能停止，便邀请我商量诊治。
我进入官署时，饶公的寒热正在发作，躺在病榻上呻吟，诊脉结束后，思敏翁恰好来到，对我说：“燕公祖的病，我看治过多次，好了又反复，烦请你斟酌决定。”我说：“刚才诊察脉象数而带弦，发热时口仍作渴，这属于秋季晚发的感证，症状类似疟疾。大局无妨，只是病程久正气确实虚弱，余邪似乎仍未净尽。过度进补恐怕会腻滞留邪，过度清热又担心损伤正气，建议在扶正的药物中，微微寓含和解的意思，使邪气退去而正气不伤，这才是最好的方法。”思敏翁称好，于是让我开方。药用首乌、人参、当归、茯苓、甘草、料豆衣、扁豆壳、陈皮、半夏、糯稻根须，引药加鲜姜、红枣，另外以井水和河水各一半煎煮。露天放置一夜，明早温服。第二天早上再商议，到期再次召请，询问他的家人说：“昨天服药后，寒热没有再发，夜间睡眠安稳。”进屋见饶公起身坐定就诊，笑着说：“疟魔已经被您驱除了。”又与思敏翁斟酌加减药物，不到十天就痊愈了。饶公擅长画山水，有倪瓒的风格，惜墨如金，想求他的画都得不到，病愈后，亲自绘制一幅画赠送给我，并写下序言叙述此事。
道光戊子年冬天，郡城中饶君扬翁的公子浓卿兄生病，初起时寒热、头痛、咳嗽，服用辛散药物一剂，第二天变成只有发热没有恶寒，口渴烦躁，咳嗽痰中带血，下午突然昏晕。当晚写信急邀我去，黎明时分到达郡城，见其面目都红赤，舌苔黄，耳聋，呛咳胁痛，出汗但热势不退，诊脉洪大、数且疾速。我对饶君翁说：“令公子的病，是风温犯肺，邪气在上焦，必须迅速清解，以免蔓延到中焦和下焦。辛散的药物，不宜使用。”方药用料豆、甘草、桑叶、瓜蒌皮、杏仁、桔梗、牛蒡子、贝母、梨皮之类的药物。第二天早晨再次召请，问知夜间发热很甚，出现烦躁谵语，咳血很多，望其面目仍然红赤，诊脉结束后昏晕又发作，额头汗出淋漓。饶君翁非常彷徨无助，恰好黄就唐表兄到来，我告诉他说：“这个证确实属于风温为病，但是患者体质亏虚而病情重，担心难以支撑。昨天的方子力量薄弱，所以没有见效。”就唐兄说：“我的见解也是这样，不知道应当如何用药。”我说：“唉，很难说。考察‘风温’之名记载在张仲景《伤寒论》中，但只说了脉证及误治后的变证，并没有给出方剂。王叔和以下的人，也都缺乏治疗方法，只有朱肱创立了六个方子，可以说是登坛树帜。然而既然说不可发汗，为什么葳蕤汤中又用麻黄、羌活等药呢？从宋元到现在，名医代代出现，所论述的风温证治，没有一句话能折衷一致、可以作为法则遵守的。只有近时休宁县汪广朝先生，所立的风温汤一方，只用葳蕤、料豆、甘草三味药，药简功专，颇有深意。我治疗这个证，每遵循此方的范围而扩充它，往往获得验证。”就唐兄认为对，于是照方加入沙参、生地、丹皮、地骨皮、知母、贝母、黄芩，引用芦根、梨汁、白蜜，服用后大效。诊视数次，热势渐渐退去，苦寒药物渐渐减少，转而用手滋养阴液、润肺，调理两个月，幸得保全性命。这次诊疗，如果不是饶君翁深信不疑，就唐兄推诚赞助，不见得有成功啊。我常常对人说：“凡是大病发生，务必让病人家属笃信，医生有主持主见，旁人不当妄议，三者缺其一，就不能治好病。”
In the summer of the Wuzi year, the Jiao River in Huizhou Prefecture swelled violently, flooding and inundating fields, houses, humans, and livestock everywhere, with She County and Xiuning being particularly severe. Mr. Rao was commissioned to inspect the disaster area. Affected by the steaming heat and dampness, he contracted latent pathogens in the Mo Yuan (the space between the exterior and interior). As autumn arrived, the illness manifested, initially presenting with alternating chills and fever resembling malaria, followed by fever without chills. My clansman, Mr. Simin, treated him for twenty days. The high fever subsided, but a slight tidal fever occurred every afternoon. It was judged that the pathogen had departed while the healthy qi was deficient, so the treatment shifted to nourishing yin and harmonizing the stomach. The next day, chills and fever recurred. It was considered a relapse of the common cold, and methods to support healthy qi and expel pathogens were used, but the symptoms remained unchanged, and his spirit and physique grew increasingly fatigued. Considering the prolonged nature of the illness and the deficiency of both yin and yang, continuous administration of tonics failed to stop the chills and fever. He then invited me to consult on the case.
Upon entering the office, Mr. Rao was experiencing an episode of chills and fever, groaning on his sickbed. After completing the pulse diagnosis, Mr. Simin happened to arrive and said to me, "I have treated Ancestor Yan's illness many times; it improves but recurs. I leave it to you to decide." I replied, "The current pulse is rapid and slightly wiry, and thirst persists during fever. This belongs to late-onset seasonal pathogens in autumn, with symptoms resembling malaria. The overall situation is not dangerous. However, due to the prolonged illness, the healthy qi is indeed deficient, and residual pathogens may not be fully cleared. Over-tonification risks stagnating the pathogens, while over-clearing heat may damage the healthy qi. Therefore, within the formula supporting healthy qi, we should subtly incorporate the principle of harmonization, allowing the pathogen to retreat without injuring the healthy qi. This would be ideal." Mr. Simin agreed, and I prescribed the following: Polygonum multiflorum (He Shou Wu), Ginseng (Ren Shen), Angelica sinensis (Dang Gui), Poria (Fu Ling), Licorice (Gan Cao), Vigna angularis seed coat (Liao Dou Yi), Dolichos lablab shell (Bian Dou Qiao), Tangerine peel (Chen Pi), Pinellia (Ban Xia), and Glutinous rice root hairs (Nuo Dao Gen Xu). The decoction included fresh ginger and red dates as guides, prepared with half well water and half river water. It was left exposed overnight and taken warm the next morning. We agreed to discuss further the following morning. Upon my return, his family reported that after taking the medicine the previous day, there were no more chills or fever, and he slept peacefully at night. Entering the room, Mr. Rao sat up for consultation and smiled, saying, "The malaria demon has been driven away by you." Further adjustments were made in consultation with Mr. Simin, and he recovered in less than ten days. Mr. Rao was skilled in landscape painting, emulating Ni Zan's style, valuing ink like gold, making his works hard to obtain. After recovering, he personally painted a picture to gift me, accompanied by a preface narrating the event.
In the winter of the Wuzi year of the Daoguang era, Mr. Nongqing, son of Mr. Rao Yangweng in the prefecture city, fell ill. Initially, he presented with chills, fever, headache, and cough. After one dose of acrid-dispersing medicine, the next day he exhibited only fever without chills, accompanied by thirst, irritability, cough with blood-streaked sputum, and sudden syncope in the afternoon. A letter was sent urgently inviting me at night. Arriving in the city at dawn, I observed his face and eyes were red, tongue coating yellow, deafness, hacking cough with hypochondriac pain, sweating without reduction in fever, and the pulse was surging, rapid, and hurried. I told Mr. Rao, "Your son's illness is Wind-Warmth invading the Lung, with pathogens in the Upper Jiao. Immediate clearing and resolving are necessary to prevent spread to the Middle and Lower Jiao. Acrid-dispersing agents should not be used." The prescription included Vigna angularis (Liao Dou), Licorice (Gan Cao), Mulberry leaf (Sang Ye), Trichosanthes peel (Lou Pi), Apricot kernel (Xing Ren), Platycodon (Jie Geng), Burdock fruit (Niu Bang Zi), Fritillaria (Bei Mu), and Pear peel (Li Pi).
Summoned again the next morning, I learned that during the night, the fever was severe with irritability and delirium, and hemoptysis was heavy. His face and eyes remained red. After the pulse diagnosis, syncope recurred, with profuse sweating on the forehead. Mr. Rao was anxious and hesitant. His cousin, Huang Jiutang, happened to visit. I told him, "This case is indeed Wind-Warmth disease, but given the patient's constitutional deficiency and severe illness, prognosis is guarded. The previous formula was too weak, hence ineffective." Cousin Huang said, "My view is the same; how should we medicate?" I replied, "It is difficult to say. The term 'Wind-Warmth' appears in Zhang Zhongjing's *Treatise on Cold Damage*, but only describes pulse/symptoms and complications from misdiagnosis, without providing formulas. From Wang Shuhe onwards, there were also no established treatments. Only Zhu Fengyi created six formulas, establishing a school. However, since it states diaphoresis is contraindicated, why does Wei Rui Tang contain Ephedra (Ma Huang) and Notopterygium (Qiang Huo)? Since the Song and Yuan dynasties until now, numerous experts have emerged, yet their discussions on Wind-Warmth lack a consensus that can serve as a standard. Only recently, Mr. Wang Guangchao from Xiuning County established the Wind-Warmth Decoction, using only three herbs: Allii tuberosi bulb (Wei Rui), Vigna angularis (Liao Dou), and Licorice (Gan Cao). The formula is simple and potent, showing profound insight. In treating this condition, I usually expand upon this formula's scope and often achieve success." Cousin Huang agreed. Thus, the prescription was modified to include Glehnia (Sha Shen), Rehmannia (Sheng Di), Moutan bark (Dan Pi), Lycium bark (Di Gu Pi), Anemarrhena (Zhi Mu), Fritillaria (Bei Mu), and Scutellaria (Huang Qin), guided by Reed rhizome (Lu Gen), Pear juice, and White honey. The effect was significant. After several consultations, the fever gradually subsided, and bitter-cold medicines were reduced. The treatment then shifted to nourishing yin and moistening the lungs. After two months of regulation, he fortunately survived. This case succeeded because Mr. Rao trusted completely and Cousin Huang supported sincerely. If either were missing, success would not have been achieved. I often tell people: "When a major illness arises, it is essential that the family trusts firmly, the doctor maintains authority, and bystanders do not interfere rashly. If any one of these three is missing, cure is impossible."