16．王女。带下频仍，少腹两侧痛，按之痛益甚，放散于两腿。多属子宫附件有炎症，古人则属诸湿热下注。川黄柏4．5克，苦参片9克，白芍9克，樗白皮9克，生侧柏叶9克，小茴香2．4克(后下)，炙乳没各9克，马鞭草9克，凤尾草9克(2剂)。二诊：药后腹痛大定，带下频仍，粘而腥。原方加丹皮9克，小蓟12克，大贝母9克，甘草梢4．5克。
[按]以上四案均是带下，但病因各有不同。杨案由湿热所致，其特点是带下色黄，或赤白相兼，粘稠臭秽，故用樗皮侧柏叶汤二服即效。王案与杨案有相似之处，即皆有湿热见证，而王案少腹两侧痛，拒按，为瘀滞，故复用行瘀止痛之药。陈、徐二案，为脾肾之虚，特点是带下无臭气，色淡而稀。陈案肾虚而脾亦虚，用药则补益脾肾，升陷固摄；徐案则专在温补收涩，调理奇经，是同中之异。
胎前
1．王女。呕吐，水谷均不得下，迄今10余日。经停将及2个月，无子宫病证候。其脉平，则此种呕吐，未必是病象。杏仁泥24克，姜半夏9克，陈皮6克，白茯苓9克，省头草9克，旋覆花9克(包)，春砂壳4．5克，佛手6克，沉香曲9克，伏龙肝30克(煎汤代水)。
[按]此为妊娠反应，古称恶阻，方药主要在于疏气、降逆、镇吐。先生认为杏仁泥、伏龙肝二药，对妊娠呕吐有一定的疗效，所以杏仁用量特大，且居于诸药之首。
2，吴女。停经将及4个月，面容无病，食后作呕，恶阻也。公丁香6克，姜半夏9克，佩兰梗9克，旋覆花9克(包)，苏子9克，陈皮6克，云苓9克。
3．王女。安胎。熟地12克，金毛脊9克，潞党参9克，杜仲9克，川断肉9克，桑寄生9克，苎麻根18克，生阿胶9克，黄芪9克，陈棕炭6克，料豆衣9克。
4．吕女。形瘦，两脉大而鼓指。此种人如见气逆，表示循环障碍；两足浮肿，此其的症。循环障碍之来源，体弱加以怀孕九月之压迫，心脏负担太重。生黄芪9克，熟地15克，山萸肉90克，五味子4．5克，巴戟天9克，潞党参9克，杭白芍9克，炙甘草3克，旋覆花9克(包)，煅牡蛎30克(先煎)。
二诊：远西脉数者之心弱用毛地黄，脉迟者之心弱用樟脑。国药毛地黄与附相等，樟脑则与参相似。参附并用，取其镇静，又取其兴奋故也。炮附块9克，全当归9克，五味子4．5克，潞党参15克，生黄芪9克，山萸肉9克，汉防己12克，生苍术9克，延胡索9克，升麻4．5克，云苓12克，炙甘草4．5克。[按]妊娠足肿，古称子肿，多从脾虚立论。先生融会新知，认为此肿是心脏负担太重，影响循环所致。方用参、附之类增强心力，颇有实际效果。
5．胡女。经停2个月，倦怠不堪，色脉皆无病态，时作呕恶，勿药有喜。乌梅肉6克，伏龙肝30克(包)煎汤代茶。
6．张女。经停60日，加以长途劳顿，水土不服，遂默默不欲饮食，时欲呕，健胃剂取其不妨碍妊娠者。党参9克，姜川连1．2克，沉香屑2．4克(后下)，旋覆花6克(包)，砂仁2．4克，佩兰梗3克，茯苓9克，伏龙肝30克(煎汤代水)。
7．张女。经两月不行。孕象。唾白沫清水，胸中闷窒，胃寒也。姜半夏9克，炮姜炭3克，荜茇6克，薤白9克，砂仁3克(后下)，陈皮6克，沉香曲9克，白蔻仁3克(研分3次吞)，佛手片6克。[按]以上三案均为恶阻，治以降气、健胃为主。胡案用乌梅，古称酸以敛肝，实有健胃之功。
8．谢女。经居3个月，其脉滑。脉滑者，孕象也。所虑不在恶阻，而在腰酸、带下，此为重身者所不应有，有之则须防其流产。春砂仁2．4克(后下)，沉香曲9克，云茯苓9克，陈皮4．5克，乌梅肉7．5克，伏龙肝24克(煎汤代水)，五味子4．5克，金毛脊9克，杜仲9克，桑寄生12克。
9．姜女。妊娠而见腹痛，已属可虑，腰脊酸楚，小溲短少，尤为可虑。急当静卧，助以药力，或可弥患于无形。杜仲9克，桑寄生12克，熟地18克，金毛脊9克，川断9克，绿升麻2．4克，仙鹤草15克。
10．朱女。经停3个多月，数日来带下较多，继以漏红，少腹及腰沉坠。急起直追，犹恐不及。熟地24克，黄芪12克，续断9克，杜仲9克，阿胶24克(烊冲)，陈棕炭12克，苎麻根15克，金毛脊12克，仙鹤草15克，升麻3克，牛角鳃炭9克。[按]此三案为妊娠期腰酸、腹痛，有流产之虑，故用补肝肾之品以保胎。朱案已见漏红，又加用止血药。
11．王女。经停3个多月，腰酸而小便频，妊娠体弱者多有之。黄芪9克，党参9克，白术9克，当归4．5克，升麻3克，柴胡2．4克，杜仲9克，桑寄生9克，清炙草4．5克。[按]此孕期尿频，属体虚，方用补中益气汤，加杜仲、桑寄生调补冲任。
12．赵女。结婚，4年，未曾生育，今经停2个月，少腹剧痛拒按。曾在某医院诊断谓宫外孕。当归18克，延胡索9克，两头尖9克，白芍15克，小茴香．2．4克，炙乳香9克，炙没药9克，炮附块6克，丹参15克。[按]宫外孕用行血逐瘀，佐以温通，法颇可取。产后
1．何女。产后1周后即有寒热，多作于午后，寒少热多，下白物如浊涕，此炎症之象。春柴胡6克，酒黄芩6克，酒淋黑大豆18克，杭白芍12克，黑荆芥6克，荜澄茄9克，甘草梢4．5克，白薇9克，生侧柏叶30克(煎汤代水)，粉萆薢9克，象贝母9克，肉桂末1．8克(分2次吞)。[按]产后1周，恶寒发热，下白物如浊涕，为感染之象。方以化浊消炎、祛瘀散结为主，并用柴、荆等清热解毒以治寒热之标。
2．张女。因滞下而早产(不足9个月)，产后滞下如故。腹中痛，其痛一因恶露未尽；二则肠粘膜刮剥而下。暮甚于昼，大致是虫痢。恶露不尽，则因子宫尚未收缩，此症主要有三点：①恶露；②滞下；③热与咳。用药必须扼守产后忌寒之说，不能因痢下而用白头翁汤。醋炒柴胡6克，薤白头9克，桃仁12克，杭白芍12克，生枳实9克，炮姜炭3克，大川芎5．4克，油当归9克，生艾叶4．5克，失笑散12克，炙紫菀9克，肉桂末0．9克(分2次吞)。另：山楂末60克，用赤砂糖调吞，3日服完。
[按]因恶露不尽，瘀血内阻，而用生化汤、失笑散；因下痢腹痛，而用四逆散加薤白；因咳嗽，而加紫菀；因产后宜温，而用艾桂。山楂既能化滞清肠，长于治滞下，又能破血散瘀，善治瘀阻腹痛。赤砂糖温中而兼逐恶血，与山楂并用，破血散瘀之功更著。
3．苏女。产后手足麻，神经失其营养，古人之概念为血不足。当归9克，熟地黄12克，，枸杞子9克，山萸肉9克，杜仲9克，金毛脊9克，黑大豆24克，酒洗嫩桑枝15克。
4．王女。产后心悸，引起一身悉肿。此不易速效，当缓图之。炮附块4．5克，益智仁9克，生苍术6克，肉桂3克，干蟾皮4．5克，巴戟天9克，五味子3克，北细辛1．5克，车前子9克。[按]产后多虚，苏女产后血虚手足麻，治用养血强筋骨；王女产后心气虚而心悸，一身悉肿，以附、桂、蟾皮等温阳强心，并用苍术、车前子等健脾利湿。
5．朱女。流产10余日，经即见，故1个月中曾数下，其色紫；无论其下与否，少腹皆痛，其痛游走无定。延胡索9克，桃仁9克，益母草15克，瞿麦9克，荆芥穗4．5克，炒丹皮9克，全当归9克，官桂皮2．4克，炮姜炭2．4克，来复丹6克(吞)。
6．何女。流产后，体力迄今未复，稍疲劳，则有热。予补中益气；呕加健胃剂。黄芪9克，潞党参9克，云苓9克，陈皮6克，白术9克，升麻3克，当归9克，柴胡3克，姜半夏6克，旋覆花12克(包)，省头草6克，炙甘草4．5克，生姜2片，大枣5枚。[按]上二案均为流产之后，一为气血阻滞，经事1个月数下，色紫，腹痛；一为体虚劳倦身热。所以前者治以通瘀止痛，后者用补中益气健脾之法。
7．汤女。产后恶露淋漓，迄今两月未净。其色鲜红，当是子宫出血，腹不胀痛，只宜温摄，不宜去瘀。生熟地各12克，萸肉9克，乌贼骨150克(煅)，阿胶24克(烊冲)，牛角（角+思）炭9克，五味子4．5克，炮姜炭2．4克，生艾叶4．5克，诃子肉9克，震灵丹9克(分2次吞)。
8．陈女。7个月早产后，迄今四旬，恶露未净，时下白带而腥臭，可知生殖器官有慢性炎症，带下频则腹痛更急。白芍12克，当归9克，荜澄茄9克，生侧柏叶15克，干地黄12克，象贝母9克，苦参片6克，黄柏6克，小茴香2．4克(后下)，台乌9克。[按]此二案均为恶露不净，前案腹不胀痛，血色鲜红，说明瘀血已去，故以养肝肾之阴而止血；后者同时兼见带下，腹痛，为湿热瘀滞，则不可止涩，而以养血、清热、燥湿为治。
9．施女。少腹右侧硬而痛，其痛时轻时剧，痛则洒然恶寒。此证见于产后，当用通瘀散寒之属。五灵脂9克，生蒲黄4．5克(包)，桃仁12克，苏木4．5克，延胡索9克，丹皮9克，艾草4．5克，吴萸3克，炮姜3克，肉桂末1．2(2次吞服)。
10．朱女。多产体力暗耗，卫气不能卫外为固，故恶寒甚而自汗，便溏，舌淡，脉弱，温补之。生黄芪9克，川桂枝4．5(后下)，白芍9克，党参9克，山萸肉9克，升麻2．4克，补骨脂9克，煨益智9克，白术9克，红枣7枚，炙甘草3克，生姜2片。
11．吴女。产后大便难，口唇燥裂，舌红，当育阴润肠。玄参9克，生地15克，麦冬9克，首乌12克，冬青子9克，桑椹子12克，知母9克，绿豆衣9克。
12．方女。产后百节空虚，风寒湿三气乘虚而入，遍体疼痛，肢端麻木。寓祛风于养血之中。当归9克，白芍9克，防己12克，羌独活各4．5克，秦艽9克，细辛3克，金毛脊9克，桑寄生9克，苍术6克，晚蚕沙12克(包)，稀莶草9克。
[按]上四案均为产后病。施案产后少腹右侧硬而痛，为寒瘀内阻，治用通瘀散寒而止腹痛。朱案产后自汗、便溏，为阳气虚不能卫外，治用桂枝汤加参、芪等味，益气固表。吴案大便难，为失血阴伤，津血不能润肠，所以选用首乌、桑椹子、生地、玄参、知母等甘寒濡润之品。方案为产后，体虚，而感受风寒湿气，以致遍体疼痛，故用药寓祛风于养血之中。
##############儿科(12个门类)####################
1．丁弟。热病延长二候以外，而神志迷蒙者，其病灶多半在肠。仲景则以为白虎证、承气证。清代则以为伏气温病，有湿重、温重之分。苔腻者湿重。病者其苔并不垢腻，而神志时明时昧，温重也。凡时症后期，凭脉而不凭舌，今两脉细数，阳症而见阴脉，危候也。连翘12克，天竺黄2．4克，黄芩9克，蚤休6克，石菖蒲12克，带心川贝6克，青蒿9克，大地龙9克，陈胆星5克。另：紫雪丹1．2克，葡萄酒送服。二诊：仍予前方加减。石菖蒲12克，黄芩9克，干地黄15克，天花粉12克，连翘12克，陈胆星6克，升麻5克，肥知母12克，紫雪丹0．9克(吞)。
三诊：紫雪丹原出《本事方》，尝用而大行于世者为叶天士，此可补仲景强心方法之不足。病者服之，谵语神蒙立止。此药兼有解毒、镇静能力。如是重症，非大量不能见效。今是轻者耳!青蒿9克，白薇9克，银花9克，连翘12，石菖蒲9克，带心川贝6克，天花粉15克，料豆衣12克，白茅根1扎。
四诊：两脉沉细不鼓指。壮年人见此脉，便难挽救；未冠者之心脏浑璞，侵害易衰弱，亦易恢复，故见此脉，未必定是绝症。病历18日，清凉苦寒，自难再进。当归9克，附子6克，潞党参9克，仙鹤草15克，大枣4枚，煨草果5克，云苓9克，白芍9克，炙甘草3克，谷麦芽各9克，酒淋黑大豆12克。
[按]患者服上方两帖后，热退至常温，而趋痊愈。紫雪丹近代方书多谓出自《局方》，其实本方原名紫雪，出于《千金翼方》，方中药味与《局方》的相同，只是少滑石一味而已。原注本方可治"曾服金石、火药，毒发猛热"等证，宋以后始逐渐应用于热病神昏、小儿惊痫。《阎氏小儿方论》中的紫雪丹，药味与《局方》相同，而剂量仅用十分之一，主治小儿惊厥，烦热涎厥，伤寒发斑，一切热毒，喉痹肿痛及疮疹毒气上攻咽喉；水浆不止等证。而《本事方》所载紫雪丹较《局方》少黄金、犀角、沉香三味。吴鞠通《温病条辨》所载紫雪丹，与局方之方相比，仅少黄金一味，主治相同，并说来自《本事方》，先生在案语中说紫雪丹出自《本事方》，即是本吴氏之说。
16．王姓女子。白带频繁，少腹两侧疼痛，按压时疼痛加剧，并放射至双腿。这多属于子宫附件有炎症，古人则将其归因于湿热下注。川黄柏4.5克，苦参片9克，白芍9克，樗白皮9克，生侧柏叶9克，小茴香2.4克（后下），炙乳香和没药各9克，马鞭草9克，凤尾草9克（共2剂）。二诊：服药后腹痛基本平息，但白带依然频繁，质地粘稠且有腥臭味。原方加入丹皮9克，小蓟12克，大贝母9克，甘草梢4.5克。
[按]以上四个医案都是关于带下病，但病因各不相同。杨先生的病例由湿热引起，其特点是白带颜色发黄，或赤白相间，粘稠且气味臭秽，因此使用樗皮侧柏叶汤，服用两剂即见效。王先生的病例与杨先生相似，都有湿热的表现，但王先生少腹两侧疼痛且拒按，这是瘀滞的表现，所以再次使用了行气活血止痛的药物。陈、徐两位患者的病例，则是脾肾虚弱所致，特点是白带无臭味，颜色淡且稀薄。陈先生的病例是肾虚兼脾虚，用药则补益脾肾，升举阳气并固摄；徐先生的病例则专注于温补收涩，调理奇经八脉，这是在相同病症中的不同之处。
胎前（妊娠期）
1．王姓女子。呕吐，水和食物都无法咽下，至今已超过10天。月经停止将近2个月，没有子宫疾病的症状。她的脉象平和，这种呕吐未必是病理现象。杏仁泥24克，姜半夏9克，陈皮6克，白茯苓9克，省头草9克，旋覆花9克（包煎），春砂壳4.5克，佛手6克，沉香曲9克，伏龙肝30克（煎汤代水）。
[按]这是妊娠反应，古称恶阻，方药主要在于疏理气机、降逆止呕。先生认为杏仁泥、伏龙肝这两味药，对妊娠呕吐有一定的疗效，所以杏仁用量特别大，且排在诸药之首。
2．吴姓女子。停经将近4个月，面容无病态，食后作呕，这是恶阻。公丁香6克，姜半夏9克，佩兰梗9克，旋覆花9克（包煎），苏子9克，陈皮6克，云苓9克。
3．王姓女子。安胎。熟地12克，金毛脊9克，潞党参9克，杜仲9克，川断肉9克，桑寄生9克，苎麻根18克，生阿胶9克，黄芪9克，陈棕炭6克，料豆衣9克。
4．吕姓女子。形体消瘦，两手脉象大而有力。这种人如果见到气逆，表示循环障碍；两足浮肿，这是确切的症状。循环障碍的来源，是因为体质虚弱加上怀孕九个月的压迫，心脏负担太重。生黄芪9克，熟地15克，山萸肉90克，五味子4.5克，巴戟天9克，潞党参9克，杭白芍9克，炙甘草3克，旋覆花9克（包煎），煅牡蛎30克（先煎）。
二诊：西医对于脉搏快的心脏衰弱用毛地黄，脉搏慢的心脏衰弱用樟脑。中药里的毛地黄与附子相当，樟脑则与人参相似。人参和附子并用，是为了取其镇静作用，同时也取其兴奋作用。炮附块9克，全当归9克，五味子4.5克，潞党参15克，生黄芪9克，山萸肉9克，汉防己12克，生苍术9克，延胡索9克，升麻4.5克，云苓12克，炙甘草4.5克。[按]妊娠足肿，古称子肿，多从脾虚立论。先生融会新知，认为此肿是心脏负担太重，影响循环所致。方用参、附之类增强心力，颇有实际效果。
5．胡姓女子。停经2个月，倦怠不堪，面色和脉象都没有病态，偶尔作呕，不用药也有喜兆（指怀孕）。乌梅肉6克，伏龙肝30克（包）煎汤代茶。
6．张姓女子。停经60天，加上长途劳顿，水土不服，于是默默不想饮食，时常想吐，选用不妨碍妊娠的健胃剂。党参9克，姜川连1.2克，沉香屑2.4克（后下），旋覆花6克（包煎），砂仁2.4克，佩兰梗3克，茯苓9克，伏龙肝30克（煎汤代水）。
7．张姓女子。月经两个月没来。怀孕迹象。唾出白沫清水，胸中闷窒，这是胃寒。姜半夏9克，炮姜炭3克，荜茇6克，薤白9克，砂仁3克（后下），陈皮6克，沉香曲9克，白蔻仁3克（研末分3次吞服），佛手片6克。[按]以上三个医案均为恶阻，治疗以降气、健胃为主。胡先生用乌梅，古称酸以敛肝，实有健胃之功。
8．谢姓女子。停经3个月，脉象滑。脉滑者，是怀孕的迹象。所担心的不在恶阻，而在腰酸、带下，这是孕妇不应有的症状，如果有，须防止流产。春砂仁2.4克（后下），沉香曲9克，云茯苓9克，陈皮4.5克，乌梅肉7.5克，伏龙肝24克（煎汤代水），五味子4.5克，金毛脊9克，杜仲9克，桑寄生12克。
9．姜姓女子。妊娠而见腹痛，已属可虑，腰脊酸楚，小便短少，尤为可虑。急当静卧，助以药力，或许可以消除隐患于无形。杜仲9克，桑寄生12克，熟地18克，金毛脊9克，川断9克，绿升麻2.4克，仙鹤草15克。
10．朱姓女子。停经3个多月，连日来白带较多，继之以漏红（少量阴道出血），少腹及腰部沉重下坠。急起直追，犹恐不及。熟地24克，黄芪12克，续断9克，杜仲9克，阿胶24克（烊化冲服），陈棕炭12克，苎麻根15克，金毛脊12克，仙鹤草15克，升麻3克，牛角鳃炭9克。[按]这三个医案为妊娠期腰酸、腹痛，有流产之虑，故用补肝肾之品以保胎。朱先生已见漏红，又加用止血药。
11．王姓女子。停经3个多月，腰酸而小便频数，妊娠体弱者多有此症。黄芪9克，党参9克，白术9克，当归4.5克，升麻3克，柴胡2.4克，杜仲9克，桑寄生9克，清炙草4.5克。[按]此孕期尿频，属体虚，方用补中益气汤，加杜仲、桑寄生调补冲任。
12．赵姓女子。结婚4年，未曾生育，今停经2个月，少腹剧痛拒按。曾在某医院诊断谓宫外孕。当归18克，延胡索9克，两头尖9克，白芍15克，小茴香2.4克，炙乳香9克，炙没药9克，炮附块6克，丹参15克。[按]宫外孕用行血逐瘀，佐以温通，法颇可取。
产后
1．何姓女子。产后1周后即有寒热（发热恶寒），多在午后发作，寒少热多，排出白色浊物如鼻涕状，这是炎症的现象。春柴胡6克，酒黄芩6克，酒淋黑大豆18克，杭白芍12克，黑荆芥6克，荜澄茄9克，甘草梢4.5克，白薇9克，生侧柏叶30克（煎汤代水），粉萆薢9克，象贝母9克，肉桂末1.8克（分2次吞服）。[按]产后1周，恶寒发热，下白物如浊涕，为感染之象。方以化浊消炎、祛瘀散结为主，并用柴、荆等清热解毒以治寒热之标。
2．张姓女子。因痢疾而早产（不足9个月），产后痢疾依旧。腹中痛，其痛一个原因是恶露未尽；第二个原因是肠粘膜刮剥而下。傍晚比白天严重，大致是虫痢。恶露不尽，是因为子宫尚未收缩，此症主要有三点：①恶露；②痢疾；③热与咳。用药必须恪守产后忌用寒凉之说，不能因为痢疾就用白头翁汤。醋炒柴胡6克，薤白头9克，桃仁12克，杭白芍12克，生枳实9克，炮姜炭3克，大川芎5.4克，油当归9克，生艾叶4.5克，失笑散12克，炙紫菀9克，肉桂末0.9克（分2次吞服）。另：山楂末60克，用赤砂糖调服，3日服完。
[按]因恶露不尽，瘀血内阻，而用生化汤、失笑散；因下痢腹痛，而用四逆散加薤白；因咳嗽，而加紫菀；因产后宜温，而用艾桂。山楂既能化滞清肠，长于治痢疾，又能破血散瘀，善治瘀阻腹痛。赤砂糖温中而兼逐恶血，与山楂并用，破血散瘀之功更著。
3．苏姓女子。产后手足麻木，神经失去营养，古人的概念认为是血不足。当归9克，熟地黄12克，枸杞子9克，山萸肉9克，杜仲9克，金毛脊9克，黑大豆24克，酒洗嫩桑枝15克。
4．王姓女子。产后心悸，引起全身浮肿。这不容易迅速见效，应当缓慢调理。炮附块4.5克，益智仁9克，生苍术6克，肉桂3克，干蟾皮4.5克，巴戟天9克，五味子3克，北细辛1.5克，车前子9克。[按]产后多虚，苏女产后血虚手足麻，治用养血强筋骨；王女产后心气虚而心悸，一身悉肿，以附、桂、蟾皮等温阳强心，并用苍术、车前子等健脾利湿。
5．朱姓女子。流产10余天后，月经又来，所以在1个月中曾数次来潮，颜色紫暗；无论是否来潮，少腹皆痛，疼痛游走不定。延胡索9克，桃仁9克，益母草15克，瞿麦9克，荆芥穗4.5克，炒丹皮9克，全当归9克，官桂皮2.4克，炮姜炭2.4克，来复丹6克（吞服）。
6．何姓女子。流产后，体力至今未恢复，稍感疲劳，则有发热。给予补中益气；呕吐加健胃剂。黄芪9克，潞党参9克，云苓9克，陈皮6克，白术9克，升麻3克，当归9克，柴胡3克，姜半夏6克，旋覆花12克（包煎），省头草6克，炙甘草4.5克，生姜2片，大枣5枚。[按]上两个医案均为流产之后，一个是气血阻滞，月经1个月数次来潮，色紫，腹痛；一个是体虚劳倦身热。所以前者治以通瘀止痛，后者用补中益气健脾之法。
7．汤姓女子。产后恶露淋漓，至今两个月未净。颜色鲜红，应当是子宫出血，腹部不胀痛，只宜温摄，不宜去瘀。生熟地各12克，萸肉9克，乌贼骨150克（煅），阿胶24克（烊化冲服），牛角思炭9克，五味子4.5克，炮姜炭2.4克，生艾叶4.5克，诃子肉9克，震灵丹9克（分2次吞服）。
8．陈姓女子。7个月早产后，至今四十天，恶露未净，时下白带且腥臭，可知生殖器官有慢性炎症，白带频繁则腹痛更急。白芍12克，当归9克，荜澄茄9克，生侧柏叶15克，干地黄12克，象贝母9克，苦参片6克，黄柏6克，小茴香2.4克（后下），台乌9克。[按]这两个医案均为恶露不净，前案腹部不胀痛，血色鲜红，说明瘀血已去，故以养肝肾之阴而止血；后者同时兼见带下，腹痛，为湿热瘀滞，则不可止涩，而以养血、清热、燥湿为治。
9．施姓女子。少腹右侧硬而痛，疼痛时轻时重，痛时洒然恶寒。此证见于产后，当用通瘀散寒之属。五灵脂9克，生蒲黄4.5克（包煎），桃仁12克，苏木4.5克，延胡索9克，丹皮9克，艾草4.5克，吴萸3克，炮姜3克，肉桂末1.2克（分2次吞服）。
10．朱姓女子。多产导致体力暗耗，卫气不能卫外固表，故恶寒甚而自汗，大便溏薄，舌淡，脉弱，温补之。生黄芪9克，川桂枝4.5克（后下），白芍9克，党参9克，山萸肉9克，升麻2.4克，补骨脂9克，煨益智9克，白术9克，红枣7枚，炙甘草3克，生姜2片。
11．吴姓女子。产后大便难，口唇燥裂，舌红，当育阴润肠。玄参9克，生地15克，麦冬9克，首乌12克，冬青子9克，桑椹子12克，知母9克，绿豆衣9克。
12．方姓女子。产后百节空虚，风寒湿三气乘虚而入，遍体疼痛，肢端麻木。寓祛风于养血之中。当归9克，白芍9克，防己12克，羌活独活各4.5克，秦艽9克，细辛3克，金毛脊9克，桑寄生9克，苍术6克，晚蚕沙12克（包煎），稀莶草9克。
[按]以上四个医案均为产后病。施先生产后少腹右侧硬而痛，为寒瘀内阻，治用通瘀散寒而止腹痛。朱先生产后自汗、便溏，为阳气虚不能卫外，治用桂枝汤加参、芪等味，益气固表。吴先生大便难，为失血阴伤，津血不能润肠，所以选用首乌、桑椹子、生地、玄参、知母等甘寒濡润之品。方先生为产后，体虚，而感受风寒湿气，以致遍体疼痛，故用药寓祛风于养血之中。
##############儿科(12个门类)####################
1．丁姓弟弟。热病延长超过两个星期（一候为五天，二候为十天）以外，而神志迷蒙的，病灶多半在肠。张仲景则认为是白虎证、承气证。清代医家则认为是伏气温病，有湿重、温重之分。苔腻者湿重。患者舌苔并不垢腻，而神志时明时昧，这是温重。凡时症后期，凭脉而不凭舌，现在两脉细数，阳症而见阴脉，是危候。连翘12克，天竺黄2.4克，黄芩9克，蚤休6克，石菖蒲12克，带心川贝6克，青蒿9克，大地龙9克，陈胆星5克。另：紫雪丹1.2克，葡萄酒送服。二诊：仍予前方加减。石菖蒲12克，黄芩9克，干地黄15克，天花粉12克，连翘12克，陈胆星6克，升麻5克，肥知母12克，紫雪丹0.9克（吞服）。
三诊：紫雪丹原出《本事方》，曾经使用而大行于世者为叶天士，此可补张仲景强心方法之不足。患者服用后，谵语神蒙立即停止。此药兼有解毒、镇静能力。如是重症，非大量不能见效。现在是轻症罢了！青蒿9克，白薇9克，银花9克，连翘12克，石菖蒲9克，带心川贝6克，天花粉15克，料豆衣12克，白茅根1扎。
四诊：两脉沉细不鼓指。壮年人见此脉，便难挽救；未成年者心脏浑璞，侵害易衰弱，亦易恢复，故见此脉，未必定是绝症。病历18日，清凉苦寒，自难再进。当归9克，附子6克，潞党参9克，仙鹤草15克，大枣4枚，煨草果5克，云苓9克，白芍9克，炙甘草3克，谷麦芽各9克，酒淋黑大豆12克。
[按]患者服用上方两帖后，热退至常温，而趋痊愈。紫雪丹近代方书多谓出自《局方》，其实本方原名紫雪，出于《千金翼方》，方中药味与《局方》的相同，只是少滑石一味而已。原注本方可治"曾服金石、火药，毒发猛热"等证，宋以后始逐渐应用于热病神昏、小儿惊痫。《阎氏小儿方论》中的紫雪丹，药味与《局方》相同，而剂量仅用十分之一，主治小儿惊厥，烦热涎厥，伤寒发斑，一切热毒，喉痹肿痛及疮疹毒气上攻咽喉；水浆不止等证。而《本事方》所载紫雪丹较《局方》少黄金、犀角、沉香三味。吴鞠通《温病条辨》所载紫雪丹，与局方之方相比，仅少黄金一味，主治相同，并说来自《本事方》，先生在案语中说紫雪丹出自《本事方》，即是本吴氏之说。
16. Ms. Wang. Frequent leukorrhea, pain in both sides of the lower abdomen, which intensifies upon pressure and radiates to both legs. This mostly belongs to inflammation of the uterus and adnexa; ancient texts attribute it to damp-heat pouring downward (Shi Re Xia Zhu). Chuan Huang Bo 4.5g, Ku Shen Pian 9g, Bai Shao 9g, Chu Bai Pi 9g, Sheng Ce Bai Ye 9g, Xiao Hui Xiang 2.4g (added later), Zhi Ru Xiang and Mo Yao 9g each, Ma Bian Cao 9g, Feng Wei Cao 9g (2 doses). Second visit: After taking the medicine, abdominal pain is largely settled, but leukorrhea remains frequent, sticky and fishy-smelling. Add Dan Pi 9g, Xiao Ji 12g, Da Bei Mu 9g, Gan Cao Shao 4.5g to the original prescription.
[Commentary] The above four cases all involve leukorrhea, but the etiologies differ. Case Yang was caused by damp-heat, characterized by yellow discharge or mixed red and white, sticky and foul-smelling; thus, Chu Pi Ce Bai Ye Tang was used with effect after two doses. Case Wang is similar to Case Yang, sharing signs of damp-heat, but Case Wang presents with pain in both sides of the lower abdomen that refuses pressure, indicating blood stasis (Yu Zhi); therefore, herbs for moving blood and relieving pain were reused. Cases Chen and Xu are due to deficiency of Spleen and Kidney, characterized by odorless, pale, and thin discharge. Case Chen involves Kidney deficiency with Spleen deficiency; treatment tonifies Spleen and Kidney, raises Yang, and secures essence. Case Xu focuses on warming, tonifying, and astringing, regulating the extraordinary vessels (Qi Jing), representing differences within similarities.
Antenatal Period
1. Ms. Wang. Vomiting, unable to keep down water or food, persisting for over 10 days. Menstruation has ceased for nearly 2 months, with no uterine pathology symptoms. Her pulse is level; this vomiting may not necessarily be pathological. Xing Ren Ni 24g, Jiang Ban Xia 9g, Chen Pi 6g, Bai Fu Ling 9g, Sheng Tou Cao 9g, Xuan Fu Hua 9g (wrapped), Chun Sha Ke 4.5g, Fo Shou 6g, Chen Xiang Qu 9g, Fu Long Gan 30g (decocted as water substitute).
[Commentary] This is a pregnancy reaction, anciently called E Zu (Morning Sickness). The formula mainly aims to soothe Qi, descend rebellious Qi, and suppress vomiting. Mr. Zhang believed that Xing Ren Ni and Fu Long Gan have certain efficacy for pregnancy vomiting; hence, the dosage of Xing Ren is particularly large and placed first among the herbs.
2. Ms. Wu. Menstruation ceased for nearly 4 months, facial appearance shows no illness, vomiting after eating, indicative of E Zu. Gong Ding Xiang 6g, Jiang Ban Xia 9g, Pei Lan Geng 9g, Xuan Fu Hua 9g (wrapped), Su Zi 9g, Chen Pi 6g, Yun Ling 9g.
3. Ms. Wang. Fetus protection. Shu Di 12g, Jin Mao Ji 9g, Lu Dang Shen 9g, Du Zhong 9g, Chuan Duan Rou 9g, Sang Ji Sheng 9g, Zhu Ma Gen 18g, Sheng E Jiao 9g, Huang Qi 9g, Chen Zong Tan 6g, Lian Dou Yi 9g.
4. Ms. Lv. Emaciated, pulses are large and forceful against the fingers. In such individuals, if Qi rebellion is seen, it indicates circulatory obstruction; bilateral foot edema is the specific symptom here. The source of circulatory obstruction is weak constitution combined with the compression of nine months' pregnancy, placing excessive burden on the heart. Sheng Huang Qi 9g, Shu Di 15g, Shan Yu Rou 90g, Wu Wei Zi 4.5g, Ba Ji Tian 9g, Lu Dang Shen 9g, Hang Bai Shao 9g, Zhi Gan Cao 3g, Xuan Fu Hua 9g (wrapped), Duan Mu Li 30g (decocted first).
Second visit: Western medicine uses Digitalis for tachycardia-induced heart weakness and Camphor for bradycardia-induced heart weakness. In Chinese medicine, Digitalis corresponds to Fu Zi, and Camphor corresponds to Ren Shen. Using Ren Shen and Fu Zi together aims at both sedation and excitation. Pao Fu Kuai 9g, Quan Dang Gui 9g, Wu Wei Zi 4.5g, Lu Dang Shen 15g, Sheng Huang Qi 9g, Shan Yu Rou 9g, Han Fang Ji 12g, Sheng Cang Zhu 9g, Yan Hu Suo 9g, Sheng Ma 4.5g, Yun Ling 12g, Zhi Gan Cao 4.5g. [Commentary] Pregnancy-related foot edema, anciently called Zi Zhong, is often discussed from the perspective of Spleen deficiency. Integrating new knowledge, Mr. Zhang believes this edema results from excessive cardiac burden affecting circulation. Using formulas like Shen-Fu to enhance cardiac power has practical effects.
5. Ms. Hu. Menstruation ceased for 2 months, extreme fatigue, complexion and pulse show no pathological signs, occasional nausea; expect pregnancy without medication. Wu Mei Rou 6g, Fu Long Gan 30g (wrapped) decocted as tea.
6. Ms. Zhang. Menstruation ceased for 60 days, compounded by long-distance travel fatigue and maladaptation to local environment, leading to taciturnity, loss of appetite, and occasional nausea. Select stomach-strengthening agents that do not interfere with pregnancy. Dang Shen 9g, Jiang Chuan Lian 1.2g, Chen Xiang She 2.4g (added later), Xuan Fu Hua 6g (wrapped), Sha Ren 2.4g, Pei Lan Geng 3g, Fu Ling 9g, Fu Long Gan 30g (decocted as water substitute).
7. Ms. Zhang. Menstruation absent for two months. Signs of pregnancy. Spitting white foam and clear fluid, chest stuffiness, indicates Stomach Cold. Jiang Ban Xia 9g, Pao Jiang Tan 3g, Bi Bo 6g, Xie Bai 9g, Sha Ren 3g (added later), Chen Pi 6g, Chen Xiang Qu 9g, Bai Kou Ren 3g (powdered, taken in 3 doses), Fo Shou Pian 6g. [Commentary] The above three cases are all E Zu, treated primarily by descending Qi and strengthening the Stomach. Case Hu uses Wu Mei; ancient theory states sour flavors astringe the Liver, but it actually strengthens the Stomach.
8. Ms. Xie. Menstruation ceased for 3 months, pulse is slippery. Slippery pulse indicates pregnancy. The concern is not E Zu, but lower back soreness and leukorrhea, which should not occur in pregnant women; if present, miscarriage must be prevented. Chun Sha Ren 2.4g (added later), Chen Xiang Qu 9g, Yun Fu Ling 9g, Chen Pi 4.5g, Wu Mei Rou 7.5g, Fu Long Gan 24g (decocted as water substitute), Wu Wei Zi 4.5g, Jin Mao Ji 9g, Du Zhong 9g, Sang Ji Sheng 12g.
9. Ms. Jiang. Abdominal pain during pregnancy is worrying; soreness of waist and spine, and scanty urination are even more concerning. Urgently rest, aided by medication, to perhaps eliminate the隐患 (hidden danger) invisibly. Du Zhong 9g, Sang Ji Sheng 12g, Shu Di 18g, Jin Mao Ji 9g, Chuan Duan 9g, Lv Sheng Ma 2.4g, Xian He Cao 15g.
10. Ms. Zhu. Menstruation ceased for over 3 months, increased leukorrhea for several days, followed by spotting, heaviness and bearing-down sensation in lower abdomen and waist. Urgent intervention is needed, lest it be too late. Shu Di 24g, Huang Qi 12g, Xu Duan 9g, Du Zhong 9g, E Jiao 24g (melted and mixed), Chen Zong Tan 12g, Zhu Ma Gen 15g, Jin Mao Ji 12g, Xian He Cao 15g, Sheng Ma 3g, Niu Jiao Sai Tan 9g. [Commentary] These three cases involve lower back soreness and abdominal pain during pregnancy with risk of miscarriage; thus, herbs tonifying Liver and Kidney are used to protect the fetus. Case Zhu shows spotting, so hemostatic herbs are added.
11. Ms. Wang. Menstruation ceased for over 3 months, lower back soreness and frequent urination, common in weak pregnant women. Huang Qi 9g, Dang Shen 9g, Bai Zhu 9g, Dang Gui 4.5g, Sheng Ma 3g, Chai Hu 2.4g, Du Zhong 9g, Sang Ji Sheng 9g, Qing Zhi Gan Cao 4.5g. [Commentary] This pregnancy-related frequency of urination is due to deficiency; the formula is Bu Zhong Yi Qi Tang, adding Du Zhong and Sang Ji Sheng to regulate Chong and Ren vessels.
12. Ms. Zhao. Married for 4 years, never conceived, now menstruation ceased for 2 months, severe lower abdominal pain refusing pressure. Diagnosed as ectopic pregnancy at a certain hospital. Dang Gui 18g, Yan Hu Suo 9g, Liang Tou Jian 9g, Bai Shao 15g, Xiao Hui Xiang 2.4g, Zhi Ru Xiang 9g, Zhi Mo Yao 9g, Pao Fu Kuai 6g, Dan Shen 15g. [Commentary] For ectopic pregnancy, promoting blood circulation and expelling stasis, assisted by warming and unblocking, is a sound method.
Postpartum Period
1. Ms. He. Chills and fever appeared one week postpartum, mostly occurring in the afternoon, with less chills and more fever, discharging white turbid matter like thick snot, indicating inflammation. Chun Chai Hu 6g, Jiu Huang Qin 6g, Jiu Lin Hei Da Dou 18g, Hang Bai Shao 12g, Hei Jing Jie 6g, Bi Cheng Qie 9g, Gan Cao Shao 4.5g, Bai Wei 9g, Sheng Ce Bai Ye 30g (decocted as water substitute), Fen Bi Xie 9g, Xiang Bei Mu 9g, Rou Gui Mo 1.8g (taken in 2 doses). [Commentary] One week postpartum, chills, fever, and discharge of white turbid matter indicate infection. The formula focuses on resolving turbidity, reducing inflammation, dispelling stasis, and dissipating nodules, using Chai Hu and Jing Jie etc. to clear heat and detoxify to treat the superficial chills and fever.
2. Ms. Zhang. Premature birth (less than 9 months) due to dysentery; dysentery persists postpartum. Abdominal pain, partly due to incomplete lochia expulsion; partly due to sloughing of intestinal mucosa. Worse at night than day, likely parasitic dysentery. Incomplete lochia expulsion is because the uterus has not yet contracted. Key issues: ① Lochia; ② Dysentery; ③ Fever and cough. Medication must adhere to the postpartum contraindication of cold herbs; cannot use Bai Tou Weng Tang just because of dysentery. Cu Chao Chai Hu 6g, Xie Bai Tou 9g, Tao Ren 12g, Hang Bai Shao 12g, Sheng Zhi Shi 9g, Pao Jiang Tan 3g, Da Chuan Xiong 5.4g, You Dang Gui 9g, Sheng Ai Ye 4.5g, Shi Xiao San 12g, Zhi Zi Wan 9g, Rou Gui Mo 0.9g (taken in 2 doses). Additionally: Shan Zha Mo 60g, taken with Chi Sha Tang, finished in 3 days.
[Commentary] Due to incomplete lochia and internal blood stasis, Sheng Hua Tang and Shi Xiao San are used; for dysentery and abdominal pain, Si Ni San plus Xie Bai is used; for cough, Zi Wan is added; for postpartum warmth, Ai Ye and Rou Gui are used. Shan Zha can resolve stagnation and clear the intestines, effective for dysentery, and also breaks blood stasis, effective for stasis-induced abdominal pain. Chi Sha Tang warms the middle and expels lochia; combined with Shan Zha, its blood-breaking and stasis-resolving power is enhanced.
3. Ms. Su. Postpartum numbness of hands and feet, nerves lacking nutrition; ancient concept attributes this to Blood deficiency. Dang Gui 9g, Shu Di Huang 12g, Gou Qi Zi 9g, Shan Yu Rou 9g, Du Zhong 9g, Jin Mao Ji 9g, Hei Da Dou 24g, Jiu Xi Nen Sang Zhi 15g.
4. Ms. Wang. Postpartum palpitations causing generalized edema. Not easily cured quickly; should be managed gradually. Pao Fu Kuai 4.5g, Yi Zhi Ren 9g, Sheng Cang Zhu 6g, Rou Gui 3g, Gan Chan Pi 4.5g, Ba Ji Tian 9g, Wu Wei Zi 3g, Bei Xi Xin 1.5g, Che Qian Zi 9g. [Commentary] Postpartum conditions are mostly deficient. Ms. Su has postpartum Blood deficiency causing limb numbness, treated by nourishing Blood and strengthening sinews/bones. Ms. Wang has postpartum Heart Qi deficiency causing palpitations and generalized edema, treated with Fu Zi, Rou Gui, Chan Pi etc. to warm Yang and strengthen the heart, plus Cang Zhu and Che Qian Zi to strengthen Spleen and promote diuresis.
5. Ms. Zhu. Miscarriage occurred over 10 days ago, menstruation returned, so she had multiple periods within a month, dark purple color; regardless of flow, lower abdominal pain is present, wandering and fixed. Yan Hu Suo 9g, Tao Ren 9g, Yi Mu Cao 15g, Qu Mai 9g, Jing Jie Sui 4.5g, Chao Dan Pi 9g, Quan Dang Gui 9g, Guan Gui Pi 2.4g, Pao Jiang Tan 2.4g, Lai Fu Dan 6g (swallowed).
6. Ms. He. Physical strength has not recovered since miscarriage; slight fatigue causes fever. Given Bu Zhong Yi Qi Tang; added stomach-strengthening agents for vomiting. Huang Qi 9g, Lu Dang Shen 9g, Yun Ling 9g, Chen Pi 6g, Bai Zhu 9g, Sheng Ma 3g, Dang Gui 9g, Chai Hu 3g, Jiang Ban Xia 6g, Xuan Fu Hua 12g (wrapped), Sheng Tou Cao 6g, Zhi Gan Cao 4.5g, Sheng Jiang 2 slices, Da Zao 5 pieces. [Commentary] The above two cases are post-miscarriage. One involves Qi and Blood stasis, multiple periods in a month, dark purple, abdominal pain; treated by moving stasis and relieving pain. The other involves body deficiency and fatigue-induced fever; treated by Bu Zhong Yi Qi Tang to strengthen Spleen.
7. Ms. Tang. Postpartum lochia dripping continuously, not cleared for two months. Bright red color, likely uterine bleeding; abdomen not distended or painful, only suitable for warming and securing, not for removing stasis. Sheng and Shu Di 12g each, Yu Rou 9g, Wu Zei Gu 150g (calcined), E Jiao 24g (melted and mixed), Niu Jiao Si Tan 9g, Wu Wei Zi 4.5g, Pao Jiang Tan 2.4g, Sheng Ai Ye 4.5g, He Zi Rou 9g, Zhen Ling Dan 9g (taken in 2 doses).
8. Ms. Chen. Four weeks after 7-month premature birth, lochia not cleared, currently discharging foul-smelling leukorrhea, indicating chronic inflammation of reproductive organs; frequent leukorrhea makes abdominal pain more urgent. Bai Shao 12g, Dang Gui 9g, Bi Cheng Qie 9g, Sheng Ce Bai Ye 15g, Gan Di Huang 12g, Xiang Bei Mu 9g, Ku Shen Pian 6g, Huang Bo 6g, Xiao Hui Xiang 2.4g (added later), Tai Wu 9g. [Commentary] Both cases involve incomplete lochia. The former case has no abdominal distension/pain and bright red blood, indicating stasis is gone; thus, nourishing Liver/Kidney Yin to stop bleeding is used. The latter case has concurrent leukorrhea and abdominal pain, indicating damp-heat and stasis; thus, astringents are avoided, and nourishing Blood, clearing Heat, and drying Dampness are used.
9. Ms. Shi. Hardness and pain in right lower abdomen, pain varying in intensity, accompanied by aversion to cold during pain. This condition appearing postpartum requires herbs for moving stasis and dispersing cold. Wu Ling Zhi 9g, Sheng Pu Huang 4.5g (wrapped), Tao Ren 12g, Su Mu 4.5g, Yan Hu Suo 9g, Dan Pi 9g, Ai Cao 4.5g, Wu Zhu Yu 3g, Pao Jiang 3g, Rou Gui Mo 1.2g (taken in 2 doses).
10. Ms. Zhu. Multiple births secretly consume physical strength, Wei Qi fails to defend the exterior, resulting in severe aversion to cold, spontaneous sweating, loose stools, pale tongue, and weak pulse; treated with warming and tonifying. Sheng Huang Qi 9g, Chuan Gui Zhi 4.5g (added later), Bai Shao 9g, Dang Shen 9g, Shan Yu Rou 9g, Sheng Ma 2.4g, Bu Gu Zhi 9g, Wei Yi Zhi 9g, Bai Zhu 9g, Hong Zao 7 pieces, Zhi Gan Cao 3g, Sheng Jiang 2 slices.
11. Ms. Wu. Postpartum difficulty defecating, dry and cracked lips, red tongue; treat by nourishing Yin and moistening intestines. Xuan Shen 9g, Sheng Di 15g, Mai Dong 9g, Shou Wu 12g, Dong Qing Zi 9g, Sang Shen Zi 12g, Zhi Mu 9g, Lv Dou Yi 9g.
12. Ms. Fang. Postpartum joints are empty, Wind-Cold-Dampness invade due to deficiency, causing generalized body pain and numbness in extremities. Embed wind-dispelling within Blood-nourishing. Dang Gui 9g, Bai Shao 9g, Fang Ji 12g, Qiang Huo and Du Huo 4.5g each, Qin Jiao 9g, Xi Xin 3g, Jin Mao Ji 9g, Sang Ji Sheng 9g, Cang Zhu 6g, Wan Can Sha 12g (wrapped), Xi Xian Cao 9g.
[Commentary] The above four cases are postpartum diseases. Case Shi has hardness and pain in right lower abdomen postpartum, due to Cold-Stasis blocking internally; treated by moving stasis and dispersing Cold to relieve pain. Case Zhu has postpartum spontaneous sweating and loose stools, due to Yang deficiency failing to defend exterior; treated with Gui Zhi Tang plus Ren Shen, Huang Qi etc. to boost Qi and secure exterior. Case Wu has difficulty defecating due to blood loss and Yin injury, fluids and Blood failing to moisten intestines; thus, Shou Wu, Sang Shen Zi, Sheng Di, Xuan Shen, Zhi Mu etc. sweet-cold and moistening herbs are selected. Case Fang is postpartum, body deficient, contracting Wind-Cold-Dampness causing generalized pain; thus, herbs embed wind-dispelling within Blood-nourishing.
Pediatrics (12 Categories)
Warm Diseases
1. Younger Brother Ding. Febrile disease prolonged beyond two weeks (one Hou is 5 days, two Hou is 10 days), with confused consciousness; the lesion is mostly in the intestines. Zhang Zhongjing would consider this Bai Hu Syndrome or Cheng Qi Syndrome. Qing dynasty physicians consider it latent Warm Disease, divided into heavy Dampness or heavy Warmth. Coated tongue indicates heavy Dampness. The patient's tongue coating is not greasy, but consciousness fluctuates between clear and confused, indicating heavy Warmth. In the late stage of seasonal diseases, rely on pulse rather than tongue. Current pulses are fine and rapid; Yang syndrome showing Yin pulse is a critical sign. Lian Qiao 12g, Tian Zhu Huang 2.4g, Huang Qin 9g, Zao Xiu 6g, Shi Chang Pu 12g, Dai Xin Chuan Bei 6g, Qing Hao 9g, Da Di Long 9g, Chen Dan Xing 5g. Additionally: Zi Xue Dan 1.2g, taken with wine. Second visit: Continue previous formula with modifications. Shi Chang Pu 12g, Huang Qin 9g, Gan Di Huang 15g, Tian Hua Fen 12g, Lian Qiao 12g, Chen Dan Xing 6g, Sheng Ma 5g, Fei Zhi Mu 12g, Zi Xue Dan 0.9g (swallowed).
Third visit: Zi Xue Dan originally comes from *Ben Shi Fang*; Ye Tianshi popularized its use. It can supplement Zhang Zhongjing's methods for strengthening the heart. After taking it, delirium and confusion stopped immediately. This herb has detoxifying and sedative properties. Severe cases require large doses for effect; this is a mild case! Qing Hao 9g, Bai Wei 9g, Yin Hua 9g, Lian Qiao 12g, Shi Chang Pu 9g, Dai Xin Chuan Bei 6g, Tian Hua Fen 15g, Lian Dou Yi 12g, Bai Mao Gen 1 bundle.
Fourth visit: Pulses are deep and fine, not forceful. In a young adult, this pulse suggests difficult rescue; in an adolescent, the heart is pure and undeveloped, susceptible to weakening but also easy to recover; thus, this pulse does not necessarily mean terminal illness. Illness duration 18 days, cooling bitter-cold herbs are hard to continue. Dang Gui 9g, Fu Zi 6g, Lu Dang Shen 9g, Xian He Cao 15g, Da Zao 4 pieces, Wei Cao Guo 5g, Yun Ling 9g, Bai Shao 9g, Zhi Gan Cao 3g, Gu Ya and Mai Ya 9g each, Jiu Lin Hei Da Dou 12g.
[Commentary] After taking the previous formula for two doses, fever subsided to normal temperature, approaching recovery. Modern formularies often attribute Zi Xue Dan to *Ju Fang*, but its original name Zi Xue comes from *Qian Jin Yi Fang*. The ingredients are the same as *Ju Fang*, except for the absence of Hua Shi. Original notes state it treats "severe fever from toxic eruption after ingesting minerals/fire drugs". Since Song dynasty, it was gradually applied to febrile diseases with coma and pediatric convulsions. *Yan Shi Xiao Er Fang Lun*'s Zi Xue Dan has same ingredients as *Ju Fang* but dose is one-tenth, treating pediatric convulsions, irritability, phlegm coma, measles rash, all heat toxins, throat swelling, and continuous drinking. *Ben Shi Fang*'s Zi Xue Dan lacks Gold, Xi Jiao, and Chen Xiang compared to *Ju Fang*. Wu Juzhong's *Wen Bing Tiao Bian* Zi Xue Dan lacks only Gold compared to *Ju Fang*, same indications, claiming origin from *Ben Shi Fang*. Mr. Zhang's comment attributing Zi Xue Dan to *Ben Shi Fang* follows Wu's assertion.