房师午园张公，高年上盛下虚，案牍劳神，冬春不寐，感温呛咳，晕仆，两寸脉洪大，由平昔阳不
交阴，内风上冒，兼引温邪，表里煽动，症见眩仆，喉痛声哑，舌如煤熏。夫心为君主，义不受邪，因春温伤
肺，逆传心包，神明俱为震动，且素饵桂附，致炎阳独亢，营液内劫。此怔忡无寐根由，师言昔病足痹，
徽医用祛风药兼桂附得效，近三年矣。愚谓风药多燥，况桂附乎，以脉症参时令，宜辛凉轻剂，于熄风润
燥中，佐以滋阴安神。不过一剂，当夜自能成寐，再剂呛嗽除，悸眩止矣。初剂∶鲜生地（三钱）、沙参、
麦冬、淡竹叶、栝蒌仁、甘菊（炒）、山栀、茯神（各二钱）、贝母、甜杏仁（炒研。各钱半）、枣仁（八分）、
蔗汁（一杯，诸品清轻凉润，能除上焦弥漫之邪、兼入空窍熄风火，除悸眩，清音平嗽，若重浊便无效。）
再剂∶前方加天冬、玉竹、百合，减蒌仁、六七服诸症平，舌色复故。后用膏方∶三才膏加五味、核桃、牛膝、
茯神、枣仁、柏子仁、白芍、玉竹、杞子熬膏，白蜜收，白汤化服。（诸品能交心肾，安神志，利腰膝，兼使
金水相涵，阴阳和平，自无上盛下虚之患矣。）
韦氏 邪由鼻吸，伏于募原，发则头晕痛，口渴饮，热烦呕闷，溺痛带下，邪踞上中焦，主以葱豉汤散
邪，佐以清泄胆火。豆豉、葱白、山栀、羚羊角、嫩桑叶、薄荷、银花、花粉、滑石。（二服）汗出热解。
（此乍发，散邪得解者。）
族某 温邪内郁，头眩热渴，手心似烙，舌苔淡黄，寸脉浮大而数，是邪留上焦，宜整肃太阴气分。
用黄芩（酒炒）、川贝母、杏仁、山栀、栝蒌仁、麦冬、嫩桑叶、荷叶边，煎汤，一啜眩渴稍定。原方去芩、
栀、加鲜石斛、元参、花粉、蔗汁（冲），二服愈。（此温邪上受，治从气分得解者。）
族某 邪从口入，呕渴恶热，舌腻脘痞，温从湿化，宜与开泄中上，豆豉、蒌霜、通草、半夏、薏苡、
赤苓、竹茹、枳壳、郁金汁（冲）、芦根煎汤，一啜汗津津而愈。同时李某症同，但溺涩痛。前方加灯心、
车前穗，亦一剂愈。（此湿滞中上焦，治从透渗得解者。）
某 脉浮大，右数，有汗热炽，渴眩谵烦，温邪挟风热，将
陷营分。用薄荷、牛蒡、羚羊角、栀皮、丹皮、连翘、嫩桑叶，日再服。夜半汗透身凉。（此清少阳胆热得解者。）
吴 邪入膻中，舌缩唇裂，目瞑神迷，沉昏不醒者七昼夜。脉沉数，此邪深将成内闭矣。勉用鲜佩兰、
菖蒲、连翘、银花以解秽通闭，鲜生地、麦冬、梨蔗汁以生津，黄芩、知母、元参、石斛以彻热，兼下牛黄丸，
二服神识渐清，因尿管热痛，去佩兰、菖蒲、黄芩，加甘草梢、车前穗以利腑热而愈。（此清理心包热闭得解者。）
朱 风木司天，温邪内炽，脉数，头眩嗽血，由木火并炎，上迫窍络，舌鲜绛，邪已入营。用鲜生地、
羚羊角、元参、连翘、山栀、蒌霜、贝母、丹皮、鲜藕，三四服脉静身凉。（此清营热得解者。）
蒋 劳力伤阴，感温，呛咳不寐，鼻衄痰红，下利血沫，脉虚大不数。误用柴葛升散，劫液动风。法以甘
酸平润调之。阿胶（水化）、麦冬、炙草、潞参、茯神、白芍、枣仁、五味、生地、红枣，二服神安血止，
即饮糜粥。原方去胶加甜杏仁、山药，再剂而痊。
（此邪伤血络，用调补得愈者。）
族子 温邪郁而化热，头晕口干，舌燥唇血，右脉大，左模糊，有汗不解，胸腹闷，溺混浊。热邪蒸湿，
治宜上下分消。淡豉、蒌霜、羚羊角、丹皮、麦冬、山栀、赤苓、滑石、嫩桑叶、金银花露，二服热轻渴减，
晕止舌润。但宵分谵语，溺管涩痛，齿燥，液虚热劫，鲜石斛、芦根、黑豆皮、花粉、天冬、元参、蔗汁，
二服疹现稀红，肺卫之邪已从外泄。仍用轻清透发，连翘、牛蒡、鲜生地、丹皮、赤芍、沙参、竹叶，疹色淡。
忽又烦躁不寐，舌心灰燥而尖绛，邪入心营，恐其蒸痰蔽窍，急清营热兼豁痰。犀角尖（磨汁）、生地、
鲜藕、元参、丹皮、竹茹、贝母、菖蒲，再服汗透而解。（此湿热俱盛，兼治肺卫心营得解者。）
侄孙 温邪化热，头眩痰嗽，用辛凉清上。豆豉、杏仁、贝母（各钱半）、薄荷、山栀、花粉（各一钱）、
滑石、赤苓（各三钱），加灯心、桑叶。二服热退，用甘凉调理胃阴得安。（此清降痰热，治从肺胃得解者。）
族某 温邪逆入心包，神识忽明忽昧，舌干，津润全无，谵狂不近衣被。欲扫热痰熏灼，急用芳香解秽。
犀角尖（八分）、鲜生地（一两）、元参、麦冬（各五钱）、连翘、山栀、郁金（各二钱）、梨、蔗汁（各一杯冲），
再加至宝丹一丸，日再服。诸症立退。（此大剂救液开闭得解者。）
某 壮热目赤，烦冤不寐，痧疹遍体。急用救液养阴，舌转黑而燥，呃逆昏厥。服大剂犀角大黄汤加至
宝丹，不应，仍用大剂犀角地黄汤，日三四服，加紫雪（三分）。呃止厥回身凉而愈。（此大剂凉心泻火得
解者。）
马氏 有年，温邪夹滞，湿阻脘闷，舌缩渴饮，泻污水甚多。此热结旁流也。用大承气汤，直至所下皆
黑硬，然后湿滞乃尽，脘痞乃宽，舌干乃润。（此攻荡湿滞得解者。）
潘 伏邪内发，兼旬未解，谵聋肉脱，自利纯血，唇缩舌强，脉沉数。邪陷血分，症已濒险。急用犀角
地黄汤加阿胶、元参、山栀、鲜藕、黑豆皮、竹叶心。四剂谵聋渐清，利血止，思糜粥矣。（此伏邪治从血
分得解者。）
陈姓儿 周岁感温，邪热内闭，舌绛津干。用麦冬、连翘、栀心、菖蒲、竹茹、加紫雪二分，汗解而愈。
（此直泻心包邪热得解者。）
李 寒热微汗，口渴呛嗽，脉浮洪。乃春温犯肺。用辛凉轻剂，为手太阴治法。山栀、淡豉、桔梗、
花粉、杏仁、象贝、桑皮（蜜炙）、薄荷、蔗汁（冲）。二服嗽减。去栀、豉、桔、粉，加栝蒌、橘红、前
胡服愈。（此邪干肺，从卫分得解者。）
何 气粗目赤，舌绛疹红，神机不发，脉洪数，宵烦无寐，邪已入营。急宜清透，若再消导劫津，
必至液涸成痉。犀角汁、鲜生地、天冬、麦冬、元参、赤芍、丹皮、连翘、藕汁、菖蒲。日三服，汗澈热退，
神识亦清，但右脉长大，胃火犹燔。用石膏、白芍、黄芩、知母、甘草。大便数次，脉较平，寐中手指
微搐，乃液虚风动，欲成痉也。用阿胶（水化）、生地、钩藤、当归、白芍、石斛、枣仁。数剂症平。（此
营虚用滋液熄风得愈者。）
王 夏至前骤 ，邪从吸入踞募原，热渴引饮，中脘格拒，热蒸湿腾，呕闷午烦，舌腻白，脉数溺浑，
是湿胜也。治先渗湿于热，下则热势孤矣。用藿梗、佩兰以逐秽，通草、滑石、芦根以驱湿，栝蒌、贝母以
涤痰，羚羊角、山栀、丹皮以清胆火，鲜生地、连翘、麦冬以泻心火。日再服，汗出溺清，呕闷除，热渴
减。然脉仍疾数，两寸大，时烦不寐，是欲发疹也；明晨疹出，
舌苔转黄，是热胜也。治在透热于湿外，则湿不升矣。原方去藿、兰、通草、滑石、芦根、羚羊等，加黄芩、
梨汁以清肺，牛蒡、银花、连翘、赤芍以透疹，青蒿、石斛、知母、沙参以退热生津。二三服汗彻脉匀，
舌黄退，日用大麦仁粥热啜，阴复全瘳。（此分利湿热，清凉疹毒得解者。）
房师午园张公，年事已高，呈现上盛下虚之象。因处理公文劳神过度，冬春季节失眠，感受温邪后出现呛咳、晕厥跌倒。诊见两手寸脉洪大。这是由于平素阳气不能交入阴分，导致内风上扰头部，又兼感温邪，致使表里邪气煽动。症状表现为眩晕跌倒、咽喉疼痛、声音嘶哑，舌苔黑如煤熏。心为君主之官，原则上不受邪气侵犯，但因春温之邪损伤肺脏，逆传至心包络，致使神明受到震动。且患者平素服用桂枝、附子等温热药，导致炎阳独亢，营阴津液被内耗。这是心悸失眠的根本原因。张先生说，以前患足部痹痛，徽州医生用祛风药配合桂枝、附子取得疗效，至今已近三年。我认为祛风药多燥烈，何况桂枝、附子呢？结合脉症与时令，适宜使用辛凉轻剂，在熄风润燥的同时，佐以滋阴安神。只需一剂，当晚自然能入睡；再服一剂，呛咳消除，心悸眩晕停止。初诊方：鲜生地（三钱）、沙参、麦冬、淡竹叶、栝蒌仁、甘菊（炒）、山栀、茯神（各二钱）、贝母、甜杏仁（炒研，各钱半）、枣仁（八分）、蔗汁（一杯）。以上诸品性质清轻凉润，能清除上焦弥漫的邪气，兼入空窍以熄风火，消除心悸眩晕，清音平嗽。若用药重浊则无效。
复诊方：前方加天冬、玉竹、百合，减去栝蒌仁。服用六七剂后诸症平息，舌色恢复正常。后用膏方：三才膏加入五味子、核桃、牛膝、茯神、枣仁、柏子仁、白芍、玉竹、枸杞子熬制成膏，用白蜜收膏，用白开水化服。（诸药能交通心肾，安神定志，利腰膝，兼使金水相生，阴阳平和，自然没有上盛下虚的病患了。）
韦氏：邪气由鼻吸入，伏留于募原，发作时头晕头痛，口渴饮水，发热烦躁呕吐胸闷，小便疼痛带下。邪气占据上中二焦，主用葱豉汤疏散邪气，佐以清泄胆火。药用豆豉、葱白、山栀、羚羊角、嫩桑叶、薄荷、银花、花粉、滑石。（服用两剂后）汗出热解。（此为病势乍发，疏散邪气得解的情况。）
族中某人：温邪内郁，头眩热渴，手心似火烧，舌苔淡黄，寸脉浮大而数。这是邪气留滞上焦，宜整肃太阴肺气。药用黄芩（酒炒）、川贝母、杏仁、山栀、栝蒌仁、麦冬、嫩桑叶、荷叶边，煎汤，喝一次后眩晕口渴稍定。原方去掉黄芩、山栀，加鲜石斛、元参、花粉、蔗汁（冲服），服用两剂痊愈。（此为温邪从上受入，治疗从气分得解的情况。）
族中另一人：邪气从口而入，呕吐口渴恶热，舌腻脘腹痞闷，温邪从湿而化，宜开泄中上二焦。药用豆豉、蒌霜、通草、半夏、薏苡仁、赤茯苓、竹茹、枳壳、郁金汁（冲服）、芦根煎汤，喝一次后微微出汗而愈。同时李某症状相同，但小便涩痛。前方加灯心、车前穗，也是一剂痊愈。（此为湿滞中上焦，治疗从透渗得解的情况。）
某人：脉浮大，右脉数，有汗但热势炽盛，口渴眩晕谵语烦躁。温邪挟风热，将要陷入营分。药用薄荷、牛蒡子、羚羊角、栀皮、丹皮、连翘、嫩桑叶，每日服用两次。半夜汗透身凉。（此为清少阳胆热得解的情况。）
吴氏：邪气进入膻中，舌缩唇裂，闭目神迷，沉昏不醒已达七昼夜。脉沉数，这是邪气深入即将形成内闭。勉强使用鲜佩兰、菖蒲、连翘、银花以解秽通闭，鲜生地、麦冬、梨蔗汁以生津，黄芩、知母、元参、石斛以彻热，兼服牛黄丸。服用两剂后神识渐清，因尿管热痛，去掉佩兰、菖蒲、黄芩，加甘草梢、车前穗以利腑热而愈。（此清理心包热闭得解的情况。）
朱氏：风木司天，温邪内炽，脉数，头眩咳嗽吐血，由木火并炎，上迫窍络，舌鲜绛，邪已入营。药用鲜生地、羚羊角、元参、连翘、山栀、蒌霜、贝母、丹皮、鲜藕，服用三四剂后脉静身凉。（此清营热得解的情况。）
蒋氏：劳力伤阴，感受温邪，呛咳失眠，鼻衄痰中带血，下利血沫，脉虚大但不数。误用柴胡、葛根升散药物，劫夺津液引动肝风。治法以甘酸平润调理。药用阿胶（水化开）、麦冬、炙甘草、潞党参、茯神、白芍、枣仁、五味子、生地、红枣，服用两剂后神安血止，随即饮用糜粥。原方去掉阿胶加甜杏仁、山药，再服一剂而痊愈。（此为邪伤血络，用调补得愈的情况。）
族中侄子：温邪郁而化热，头晕口干，舌燥唇裂出血，右脉大，左脉模糊，有汗不解，胸腹闷，小便混浊。热邪蒸腾湿气，治疗宜上下分消。药用淡豆豉、蒌霜、羚羊角、丹皮、麦冬、山栀、赤茯苓、滑石、嫩桑叶、金银花露，服用两剂后热轻渴减，晕止舌润。但夜间谵语，尿道涩痛，牙齿干燥，津液亏虚热邪内劫，药用鲜石斛、芦根、黑豆皮、花粉、天冬、元参、蔗汁，服用两剂后疹现稀红，肺卫之邪已从外泄。仍用轻清透发之法，药用连翘、牛蒡子、鲜生地、丹皮、赤芍、沙参、竹叶，疹色淡。忽然又烦躁失眠，舌心灰燥而舌尖绛，邪入心营，恐其蒸痰蔽窍，急清营热兼豁痰。药用犀角尖（磨汁）、生地、鲜藕、元参、丹皮、竹茹、贝母、菖蒲，再服后汗透而解。（此湿热俱盛，兼治肺卫心营得解的情况。）
侄孙：温邪化热，头眩痰嗽，用辛凉清上之法。药用豆豉、杏仁、贝母（各钱半）、薄荷、山栀、花粉（各一钱）、滑石、赤茯苓（各三钱），加灯心、桑叶。服用两剂后热退，用甘凉调理胃阴得以安宁。（此清降痰热，治从肺胃得解的情况。）
族中某人：温邪逆入心包，神识忽明忽暗，舌干，津润全无，谵语狂躁不近衣被。欲扫热痰熏灼，急用芳香解秽。药用犀角尖（八分）、鲜生地（一两）、元参、麦冬（各五钱）、连翘、山栀、郁金（各二钱）、梨、蔗汁（各一杯冲服），再加至宝丹一丸，每日服用两次。诸症立退。（此大剂救液开闭得解的情况。）
某人：壮热目赤，烦冤失眠，痧疹遍体。急用救液养阴，舌转黑而燥，呃逆昏厥。服用大剂犀角大黄汤加至宝丹，无效，仍用大剂犀角地黄汤，每日三四次，加紫雪（三分）。呃止厥回身凉而愈。（此大剂凉心泻火得解的情况。）
马氏：年事已高，温邪夹滞，湿阻脘闷，舌缩渴饮，泻污水甚多。此为热结旁流。用大承气汤，直至所下皆黑硬，然后湿滞乃尽，脘痞乃宽，舌干乃润。（此攻荡湿滞得解的情况。）
潘氏：伏邪内发，兼旬未解，谵语耳聋肌肉消瘦，自利纯血，唇缩舌强，脉沉数。邪陷血分，症已濒险。急用犀角地黄汤加阿胶、元参、山栀、鲜藕、黑豆皮、竹叶心。四剂后谵聋渐清，利血止，思食糜粥矣。（此伏邪治从血分得解的情况。）
陈姓儿：周岁感温，邪热内闭，舌绛津干。药用麦冬、连翘、栀心、菖蒲、竹茹、加紫雪二分，汗解而愈。（此直泻心包邪热得解的情况。）
李氏：寒热微汗，口渴呛咳，脉浮洪。乃春温犯肺。用辛凉轻剂，为手太阴肺经治法。药用山栀、淡豆豉、桔梗、花粉、杏仁、象贝、桑皮（蜜炙）、薄荷、蔗汁（冲服）。服用两剂后咳嗽减少。去掉山栀、豆豉、桔梗、花粉，加栝蒌、橘红、前胡服用而愈。（此邪干肺，从卫分得解的情况。）
何氏：气粗目赤，舌绛疹红，神机不发，脉洪数，夜间烦躁无寐，邪已入营。急宜清透，若再消导劫津，必至液涸成痉。药用犀角汁、鲜生地、天冬、麦冬、元参、赤芍、丹皮、连翘、藕汁、菖蒲。每日三次，汗澈热退，神识亦清，但右脉长大，胃火犹燔。药用石膏、白芍、黄芩、知母、甘草。大便数次，脉较平，寐中手指微搐，乃液虚风动，欲成痉也。药用阿胶（水化）、生地、钩藤、当归、白芍、石斛、枣仁。数剂症平。（此营虚用滋液熄风得愈的情况。）
王氏：夏至前骤遇风寒，邪从吸入踞募原，热渴引饮，中脘格拒，热蒸湿腾，呕闷午烦，舌腻白，脉数溺浑，是湿胜也。治先渗湿于热，下则热势孤矣。药用藿梗、佩兰以逐秽，通草、滑石、芦根以驱湿，栝蒌、贝母以涤痰，羚羊角、山栀、丹皮以清胆火，鲜生地、连翘、麦冬以泻心火。每日两次，汗出溺清，呕闷除，热渴减。然脉仍疾数，两寸大，时烦不寐，是欲发疹也；明晨疹出，舌苔转黄，是热胜也。治在透热于湿外，则湿不升矣。原方去藿香、佩兰、通草、滑石、芦根、羚羊等，加黄芩、梨汁以清肺，牛蒡、银花、连翘、赤芍以透疹，青蒿、石斛、知母、沙参以退热生津。二三服后汗彻脉匀，舌黄退，日用大麦仁粥热啜，阴复全瘳。（此分利湿热，清凉疹毒得解的情况。）
Mr. Zhang Wuyuan, my former teacher's mentor, was elderly with a pattern of excess in the upper and deficiency in the lower. Due to mental exertion from handling official documents, he suffered from insomnia during winter and spring. After contracting warm pathogens, he experienced choking cough, dizziness, and fainting. His cun pulses on both sides were flooding (Hong Da). This was due to his usual condition where Yang fails to enter Yin, causing internal wind to rise and overwhelm the head, compounded by the invasion of warm pathogens, stirring up pathogenic factors in both the exterior and interior. Symptoms included dizziness and fainting, sore throat, hoarseness, and a tongue coating black as if scorched by coal. The Heart is the sovereign organ and theoretically should not be invaded by pathogens; however, because Spring-Warmth damaged the Lung, the pathogen transmitted inversely to the Pericardium, shaking the Shen (Spirit). Furthermore, his habitual use of Cinnamon Twig Decoction (Guizhi Tang) and Aconite Pill (Fuzi) led to excessive blazing of Yang fire, depleting Ying (Nutritive) fluids internally. This is the root cause of his palpitations and insomnia. Mr. Zhang mentioned that previously, when suffering from Bi syndrome (painful obstruction) in the feet, a doctor from Huizhou used wind-dispelling herbs combined with Cinnamon Twig and Aconite with good effect, nearly three years ago. I reasoned that wind-dispelling herbs are mostly drying, let alone Cinnamon Twig and Aconite. Considering the pulse, symptoms, and season, it was appropriate to use a mild acrid-cool formula, assisting in extinguishing wind and moistening dryness with yin-nourishing and spirit-calming herbs. One dose would allow him to sleep naturally that night; two doses would eliminate the choking cough and stop palpitations and dizziness.
Initial prescription: Fresh Rehmannia Root (Sheng Di Huang, 3 qian), Glehnia Root (Shashen), Ophiopogon Tuber (Maidong), Light Bamboo Leaf (Dan Zhuye), Trichosanthes Seed (Gualou Ren), Chrysanthemum Flower (Ganju, stir-fried), Gardenia Fruit (Shanzhi), Spirit of Poria (Fushen, each 2 qian), Fritillaria Bulb (Beimu), Sweet Almond Seed (Tian Xingren, stir-fried and ground, each 1.5 qian), Ziziphus Seed (Zaoren, 0.8 fen), Sugarcane Juice (1 cup). These ingredients are clear, light, cool, and moistening; they can eliminate the diffuse pathogenic factors in the Upper Jiao, enter the orifices to extinguish wind-fire, relieve palpitations and dizziness, clear the voice, and calm the cough. Heavy and turbid herbs would be ineffective.
Second prescription: Add Asparagus Tuber (Tiantong), Polygonatum Rhizome (Yuzhu), and Lily Bulb (Baihe) to the previous formula; remove Trichosanthes Seed. After taking six or seven doses, all symptoms subsided, and the tongue color returned to normal. Subsequently, a paste formula was used: Sancai Paste (Three Powers Paste) added with Schisandra Berry (Wuweizi), Walnut Kernel (Hetao), Achyranthes Root (Niuxi), Spirit of Poria (Fushen), Ziziphus Seed (Zaoren), Biota Seed (Baiziren), White Peony Root (Baishao), Polygonatum Rhizome (Yuzhu), and Goji Berry (Qiguo), boiled into a paste and preserved with white honey. It was taken dissolved in warm water. (These herbs can facilitate communication between the Heart and Kidney, calm the mind, benefit the waist and knees, promote mutual nourishment of Metal and Water, and harmonize Yin and Yang, thus preventing the condition of excess above and deficiency below.)
Ms. Wei: Pathogens entered via the nose and lay dormant in the Mu Yuan (Diaphragm Origin). Upon onset, she experienced dizziness and headache, thirst with desire to drink, fever, irritability, vomiting, chest fullness, painful urination, and leukorrhea. The pathogen occupied the Upper and Middle Jiao. The main treatment was Congchi Decoction (Scallion and Fermented Soybean Decoction) to disperse pathogens, assisted by clearing and draining Gallbladder fire. Ingredients: Fermented Soybean (Douchi), Scallion White (Congbai), Gardenia Fruit (Shanzhi), Antelope Horn (Lingyangjiao), Tender Mulberry Leaf (Nen Sangye), Mint (Bohe), Honeysuckle Flower (Jinyinhua), Trichosanthes Root (Huafen), Talc (Huashi). (After two doses, sweating occurred and heat resolved. This was an acute onset where dispersing pathogens led to resolution.)
Relative: Warm pathogens were internally constrained, causing dizziness, heat, and thirst. Palms felt like burning, tongue coating was pale yellow, and cun pulses were floating, large, and rapid. This indicated pathogen retention in the Upper Jiao; it was necessary to regulate the Qi aspect of the Taiyin (Lung). Ingredients: Scutellaria Root (Huangqin, wine-fried), Sichuan Fritillaria Bulb (Chuan Beimu), Almond (Xingren), Gardenia Fruit (Shanzhi), Trichosanthes Seed (Gualou Ren), Ophiopogon Tuber (Maidong), Tender Mulberry Leaf (Nen Sangye), Lotus Leaf Rim (Heye Bian). Decocted in water. After one intake, dizziness and thirst slightly settled. Remove Scutellaria and Gardenia from the original formula; add Fresh Dendrobium Stem (Xian Shihu), Scrophularia Root (Yuanshen), Trichosanthes Root (Huafen), and Sugarcane Juice (mixed in). After two doses, cured. (This was warm pathogen entering from above, resolving through the Qi aspect.)
Another Relative: Pathogen entered via the mouth, causing vomiting, thirst, aversion to heat, greasy tongue, and epigastric fullness. Warm pathogen transformed into dampness. Treatment involved opening and draining the Middle and Upper Jiao. Ingredients: Fermented Soybean (Douchi), Trichosanthes Peel (Lou Shuang), Thunberg Fritillary Vine Stem (Tongcao), Pinellia Tuber (Banxia), Coix Seed (Yiyi), Red Poria (Chiling), Bamboo Shavings (Zhuru), Aurantium Fruit (Zhiqiao), Curcuma Juice (Yujin Zhi, mixed in), Reed Rhizome (Lugen). Decocted in water. After one intake, slight sweating occurred and he recovered. At the same time, Mr. Li had similar symptoms but with dysuria. Added Centella Herb (Dengxin) and Plantago Spike (Cheqiansui) to the previous formula; also cured in one dose. (This was dampness stagnation in the Middle and Upper Jiao, resolving through permeation and leaching.)
Certain Person: Pulse was floating and large, right side rapid, with sweating but intense heat, thirst, dizziness, delirium, and irritability. Warm pathogen carried Wind-Heat, about to sink into the Ying (Nutritive) level. Ingredients: Mint (Bohe), Bullard Milk Vetch Seed (Niubangzi), Antelope Horn (Lingyangjiao), Gardenia Bark (Zhipi), Moutan Cortex (Danpi), Forsythia Fruit (Lianqiao), Tender Mulberry Leaf (Nen Sangye). Taken twice daily. By midnight, profuse sweating occurred, and body temperature cooled. (This resolved by clearing Shaoyang Gallbladder heat.)
Mr. Wu: Pathogen entered the Danzhong (Chest Center), with tongue retraction, cracked lips, closed eyes, unconsciousness, and deep coma lasting seven days and nights. Pulse was deep and rapid. This indicated deep pathogen threatening internal closure. Tentatively used Fresh Pogostemon Herba (Xian Peilan), Acorus Rhizome (Changpu), Forsythia Fruit (Lianqiao), and Honeysuckle Flower (Jinyinhua) to resolve turbidity and open closure; Fresh Rehmannia Root (Xian Shengdihuang), Ophiopogon Tuber (Maidong), Pear and Sugarcane Juice to generate fluids; Scutellaria Root (Huangqin), Anemarrhena Rhizome (Zhimu), Scrophularia Root (Yuanshen), and Dendrobium Stem (Shihu) to penetrate heat. Also administered Cow-bezoar Pills (Niuhuang Wan). After two doses, consciousness gradually cleared. Due to hot and painful urination, removed Pogostemon, Acorus, and Scutellaria; added Licorice Root Tip (Gancao Shao) and Plantago Spike (Cheqiansui) to drain bladder heat, leading to recovery. (This resolved by clearing Heat-Closure of the Pericardium.)
Mr. Zhu: Wind Wood governed the year, warm pathogens were internally blazing. Pulse was rapid, with dizziness, coughing blood. Due to Wood and Fire flaming together, pressing upwards on orifices and collaterals. Tongue was bright crimson; pathogen had entered the Ying level. Ingredients: Fresh Rehmannia Root (Xian Shengdihuang), Antelope Horn (Lingyangjiao), Scrophularia Root (Yuanshen), Forsythia Fruit (Lianqiao), Gardenia Fruit (Shanzhi), Trichosanthes Peel (Lou Shuang), Fritillaria Bulb (Beimu), Moutan Cortex (Danpi), Fresh Lotus Root (Xian Ou). After three or four doses, pulse became quiet and body temperature cooled. (This resolved by clearing Ying heat.)
Mr. Jiang: Labor injured Yin, contracted warm pathogen. Symptoms included choking cough, insomnia, epistaxis, blood-streaked sputum, bloody diarrhea, and a deficient, large, but not rapid pulse. Mistakenly treated with Bupleurum Root (Chaihu) and Kudzu Root (Gegen) for ascending and dispersing, which depleted fluids and stirred wind. Method: Regulate with sweet, sour, neutral, and moistening herbs. Ingredients: Donkey-hide Gelatin (Ejiao, dissolved in water), Ophiopogon Tuber (Maidong), Roasted Licorice Root (Zhigancao), Codonopsis Root (Lushen), Spirit of Poria (Fushen), White Peony Root (Baishao), Ziziphus Seed (Zaoren), Schisandra Berry (Wuweizi), Rehmannia Root (Shengdi), Red Date (Hongzao). After two doses, spirit calmed and bleeding stopped; then consumed rice gruel. Removed Donkey-hide Gelatin from original formula; added Sweet Almond Seed (Tian Xingren) and Chinese Yam (Shanyao). Cured after another dose. (This resolved by tonifying and regulating after pathogen damaged blood collaterals.)
Nephew: Warm pathogen constrained and transformed into heat. Symptoms: dizziness, dry mouth, dry tongue, bleeding lips. Right pulse large, left pulse vague. Sweating without relief, chest and abdominal fullness, turbid urine. Heat steamed dampness; treatment required dispersing heat and dampness from upper and lower. Ingredients: Light Fermented Soybean (Danshi), Trichosanthes Peel (Lou Shuang), Antelope Horn (Lingyangjiao), Moutan Cortex (Danpi), Ophiopogon Tuber (Maidong), Gardenia Fruit (Shanzhi), Red Poria (Chiling), Talc (Huashi), Tender Mulberry Leaf (Nen Sangye), Honeysuckle Dew (Jinyin Hua Lu). After two doses, heat lightened, thirst decreased, dizziness stopped, tongue moistened. However, delirium at night, painful dysuria, dry teeth indicated fluid deficiency and heat depletion. Ingredients: Fresh Dendrobium Stem (Xian Shihu), Reed Rhizome (Lugen), Black Soybean Skin (Heidou Pi), Trichosanthes Root (Huafen), Asparagus Tuber (Tiantong), Scrophularia Root (Yuanshen), Sugarcane Juice. After two doses, sparse red rash appeared; Lung-Wei pathogen had been excreted externally. Continued with light and clear dispersing: Forsythia Fruit (Lianqiao), Bullard Milk Vetch Seed (Niubangzi), Fresh Rehmannia Root (Xian Shengdihuang), Moutan Cortex (Danpi), Red Peony Root (Chishao), Glehnia Root (Shashen), Bamboo Leaf (Zhuye). Rash color faded. Suddenly became irritable and insomniac; tongue center gray-dry, tip crimson. Pathogen entered Heart-Ying. Feared phlegm steaming and blocking orifices; urgently cleared Ying heat and expelled phlegm. Ingredients: Rhinoceros Horn Tip (Xijiao Jian, ground juice - *Note: Substitute with Buffalo Horn in modern practice*), Rehmannia Root (Shengdi), Fresh Lotus Root (Xian Ou), Scrophularia Root (Yuanshen), Moutan Cortex (Danpi), Bamboo Shavings (Zhuru), Fritillaria Bulb (Beimu), Acorus Rhizome (Changpu). After another dose, sweating occurred and he resolved. (This was simultaneous damp-heat excess, resolving by treating Lung-Wei and Heart-Ying.)
Grandnephew: Warm pathogen transformed into heat, causing dizziness and phlegm-cough. Used acrid-cool clearing of the upper. Ingredients: Fermented Soybean (Douchi), Almond (Xingren), Fritillaria Bulb (Beimu, each 1.5 qian), Mint (Bohe), Gardenia Fruit (Shanzhi), Trichosanthes Root (Huafen, each 1 qian), Talc (Huashi), Red Poria (Chiling, each 3 qian), plus Centella Herb (Dengxin) and Mulberry Leaf (Sangye). After two doses, heat receded. Then regulated Stomach Yin with sweet-cool herbs. (This resolved by descending phlegm-heat, treating Lung and Stomach.)
Relative: Warm pathogen reversed into the Pericardium. Consciousness fluctuated between clarity and confusion. Tongue dry, completely lacking moisture. Delirious, manic, refusing clothes and bedding. To sweep away scorching heat-phlegm, urgently used aromatic herbs to resolve turbidity. Ingredients: Rhinoceros Horn Tip (Xijiao Jian, 0.8 fen), Fresh Rehmannia Root (Xian Shengdihuang, 1 liang), Scrophularia Root (Yuanshen), Ophiopogon Tuber (Maidong, each 5 qian), Forsythia Fruit (Lianqiao), Gardenia Fruit (Shanzhi), Curcuma Tuber (Yujin, each 2 qian), Pear and Sugarcane Juice (each 1 cup, mixed in), plus one pill of Zhibao Dan (Treasure of Life Pill). Taken twice daily. All symptoms immediately retreated. (This resolved by large-dose fluid rescue and opening closure.)
Certain Person: High fever, red eyes, irritability, insomnia, widespread maculopapular rash. Urgently used fluid-rescuing and yin-nourishing methods. Tongue turned black and dry, hiccups, syncope. Took large dose of Xijiao Dahuang Tang (Rhinoceros Horn and Rhubarb Decoction) plus Zhibao Dan, without effect. Still used large dose of Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction), 3-4 times daily, plus Zixue (Purple Snow Powder, 0.3 fen). Hiccups stopped, syncope reversed, body cooled, and he recovered. (This resolved by large-dose cooling the Heart and purging fire.)
Mrs. Ma: Elderly, warm pathogen combined with stagnation. Dampness obstructed epigastrium causing fullness, tongue retraction, thirst with desire to drink, profuse watery diarrhea. This was "heat binding with peripheral flow" (Re Jie Pang Liu). Used Dachengqi Tang (Major Order the Qi Decoction) until stools were black and hard, then damp-stagnation exhausted, epigastric fullness relieved, and tongue moistened. (This resolved by attacking and sweeping damp-stagnation.)
Mr. Pan: Latent pathogen emerged internally, unresolved for ten days. Delirium, deafness, emaciation, pure bloody diarrhea, lip retraction, stiff tongue, deep rapid pulse. Pathogen sank into Blood level; condition critical. Urgently used Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) added with Donkey-hide Gelatin (Ejiao), Scrophularia Root (Yuanshen), Gardenia Fruit (Shanzhi), Fresh Lotus Root (Xian Ou), Black Soybean Skin (Heidou Pi), and Bamboo Heart (Zhuxixin). After four doses, delirium and deafness cleared, bloody diarrhea stopped, appetite for rice gruel returned. (This resolved by treating latent pathogen from the Blood level.)
Child of Chen family: Contracted warm pathogen at one year old. Pathogenic heat internally closed, crimson tongue, dry fluids. Used Ophiopogon Tuber (Maidong), Forsythia Fruit (Lianqiao), Gardenia Heart (Zhixin), Acorus Rhizome (Changpu), Bamboo Shavings (Zhuru), plus Zixue (Purple Snow Powder, 0.2 fen). Resolved by sweating. (This directly purged Heart-Pericardium pathogenic heat.)
Mr. Li: Alternating chills and fever, slight sweating, thirst, choking cough, floating flooding pulse. This was Spring-Warmth invading the Lung. Used mild acrid-cool formula, method for Hand-Taiyin (Lung). Ingredients: Gardenia Fruit (Shanzhi), Light Fermented Soybean (Danshi), Platycodon Root (Jiegeng), Trichosanthes Root (Huafen), Almond (Xingren), Fritillaria Bulb (Xiangbei), Mulberry Root Bark (Sangpi, honey-fried), Mint (Bohe), Sugarcane Juice (mixed in). After two doses, cough reduced. Removed Gardenia, Fermented Soybean, Platycodon, and Trichosanthes Root; added Trichosanthes Fruit (Gualou), Tangerine Peel (Juhong), and Peucedanum Root (Qianhu). Cured. (This pathogen affecting the Lung resolved from the Wei level.)
Mr. He: Rough breathing, red eyes, crimson tongue, red rash, unresponsive spirit, flooding rapid pulse, nighttime irritability and insomnia. Pathogen had entered Ying level. Urgently needed clearing and penetrating. If digestive and fluid-depleting methods were used again, fluid exhaustion and spasms would result. Ingredients: Rhinoceros Horn Juice (Xijiao Zhi - *Substitute Buffalo Horn*), Fresh Rehmannia Root (Xian Shengdihuang), Asparagus Tuber (Tiantong), Ophiopogon Tuber (Maidong), Scrophularia Root (Yuanshen), Red Peony Root (Chishao), Moutan Cortex (Danpi), Forsythia Fruit (Lianqiao), Lotus Root Juice (Ou Zhi), Acorus Rhizome (Changpu). Three times daily. Profuse sweating, heat receded, consciousness cleared. However, right pulse was long and large, indicating lingering Stomach fire. Ingredients: Gypsum (Shigao), White Peony Root (Baishao), Scutellaria Root (Huangqin), Anemarrhena Rhizome (Zhimu), Licorice Root (Gancao). After several bowel movements, pulse normalized. During sleep, fingers twitched slightly, indicating fluid deficiency stirring wind, threatening spasms. Ingredients: Donkey-hide Gelatin (Ejiao, dissolved in water), Rehmannia Root (Shengdi), Uncaria Ramulus (Gouteng), Angelica Sinensis (Danggui), White Peony Root (Baishao), Dendrobium Stem (Shihu), Ziziphus Seed (Zaoren). After several doses, symptoms subsided. (This resolved by nourishing fluids and extinguishing wind for Ying deficiency.)
Mr. Wang: Before Summer Solstice, sudden cold-wind invasion. Pathogen inhaled and lodged in Mu Yuan. Heat, thirst with desire to drink, epigastric rejection, heat steaming dampness, vomiting, chest fullness, midday irritability, greasy white tongue, rapid pulse, turbid urine. Dampness prevailed. Treatment first leached dampness while clearing heat; once dampness is drained, heat becomes isolated. Ingredients: Agastache Stem (Huogeng), Pogostemon Herba (Peilan) to drive out turbidity; Thunberg Fritillary Vine Stem (Tongcao), Talc (Huashi), Reed Rhizome (Lugen) to expel dampness; Trichosanthes Fruit (Gualou), Fritillaria Bulb (Beimu) to wash away phlegm; Antelope Horn (Lingyangjiao), Gardenia Fruit (Shanzhi), Moutan Cortex (Danpi) to clear Gallbladder fire; Fresh Rehmannia Root (Xian Shengdihuang), Forsythia Fruit (Lianqiao), Ophiopogon Tuber (Maidong) to purge Heart fire. Twice daily. Sweating, clear urine, vomiting/fullness ceased, heat/thirst reduced. However, pulse remained rapid, cun pulses large, occasional irritability and insomnia, indicating impending rash. Next morning, rash appeared, tongue coating turned yellow, indicating heat prevailed. Treatment focused on penetrating heat outside dampness so dampness would not rise. Removed Agastache, Pogostemon, Thunberg Fritillary Vine Stem, Talc, Reed Rhizome, Antelope Horn, etc., from original formula. Added Scutellaria Root (Huangqin), Pear Juice (Lizhi) to clear Lung; Bullard Milk Vetch Seed (Niubangzi), Honeysuckle Flower (Jinyinhua), Forsythia Fruit (Lianqiao), Red Peony Root (Chishao) to vent rash; Artemisia Annua (Qinghao), Dendrobium Stem (Shihu), Anemarrhena Rhizome (Zhimu), Glehnia Root (Shashen) to reduce heat and generate fluids. After two or three doses, profuse sweating, uniform pulse, yellow coating disappeared. Daily consumption of hot barley porridge restored Yin and achieved complete recovery. (This resolved by separating and benefiting damp-heat, and cooling/rash-toxin.)