吴又可治朱海畴，年四十五岁，患疫得下症，四肢不举，身卧如塑，目闭口张，舌上苔刺。问其所苦，不
能答。因问其子，两三日所服何药？云∶承气汤三剂，每剂投大黄一钱许，不效，更无他策，惟待日而已。诊
得脉尚有神，下症悉具，药浅病深也。先投大黄一两五钱，目有时而稍动。再投，舌刺无芒，口渐开，能言。
三剂，舌苔稍去，神思稍爽。四日，服柴胡清燥汤，五日，复生芒刺，烦热又加，再下之。七日，又投承气汤、
养荣汤，肢体自能稍动。计半月，共服大黄十二两而愈。又数日，始进糜粥，调理两月平复。凡治千人，所
遇此等不过三四人而已，姑存案以备参酌耳。
施幼升卖卜颇行，年四旬，秉赋肥甚。六月患时疫，口燥舌干，苔刺如锋，不时太息，咽喉肿痛，心腹胀
满，按之痛甚，渴思冰水，日晡益甚，小便赤涩，得涓滴则痛甚，此当下之症也。缘通身肌表如冰，指甲青黑，
六脉如丝，寻之则有，少按则无。医者不究里症热极，但引陶氏《全生集》以为阳症，但手足厥逆，若冷过手
肘膝，便是阴症。今已通身冰冷，比之冷过肘膝更甚，宜其谓阴症一也。且陶氏论阴阳二症，全在脉之有力无
力中分。今已脉微欲绝，按之如无，比之无力更甚，宜其为阴症二也。阴症而得至阴之脉，又何说焉？遂投附
子理中汤。末延吴至，以脉证相参，表里比较，此阳症之最重者。因内热之极，气道壅闭，下症悉具，但嫌下
之晚耳。因内热之极，至周身冰冷，此体厥也。六脉如无者，群龙无首之象，症亦危矣。急投大承气汤，嘱其
缓缓下之，脉至厥回，便得生矣。其妻以一曰阴症，一曰阳症，天地悬绝，疑而不服。更一医，指言阴毒，须
灸丹田。又三医续之，皆言阴症，妻乃惶惑。病者自言∶何不卜之神明？遂卜得从阴则吉，从阳则凶。更惑于
医之议阴症俱多，乃进附子汤，下咽如火，烦躁之极。叹曰∶吾已矣，药之误也。言未已，转剧，不超时竟殒。
吴江沈氏妇，少寡，多郁怒，而有吐血症，岁三四发，吐后即已。三月间，小发热，头疼身痛，不恶寒而
微渴，次日旧病大发，吐血逾常，更加眩晕，手振烦躁，饮食不进，且热加重。医但见吐血，以为旧病，不知
其时疫也。以发热为阴虚，头疼身痛为血虚，不知吐血前一日，已发热头痛，非吐血后所加也。众议用补，问
吴可否？吴曰∶失血补虚，权宜则可，今兼时疫，非昔比也。于是用人参二钱，茯苓、归、芍佐之。两服后，
虚症咸退，热减六七。医者、病者皆谓用参得效，欲速进，吴禁之不止。遂觉心胸烦懑，腹中不和，求哕不得，
终夜不寐。盖虚邪得补而退，实邪得补而剧也，因少与承气微利之而愈。按此病设不用利药，静养数日亦愈，
以其人大便一二日一解，则知地气自通，邪气在内，日从胃气下趋，故自愈也。
严氏妇年三十，时疫后，脉症俱平，饮食渐进，忽然肢体浮肿，别无所苦，此即气复也。盖大病后，血
未成，气暴复，血乃气之根据归，气无所根据，故为浮肿。嗣后饮食渐加，浮肿渐消。若投行气利水药则谬矣。
（据所云，则养血之剂宜投也。）
一人感疫，发热烦渴，思饮冰水，医者禁服生冷甚严，病者苦索不与，遂致两目火并，咽喉焦燥，昼夜不
寐，目中见鬼，病患困剧，自谓得冷水一滴下咽，虽死无恨。于是乘隙匍匐窃取井水一盆，置之枕旁，饮一杯，
目顿清亮。二杯，鬼物潜消。三杯，咽喉声出。四杯，筋骨舒畅，不觉熟睡，俄而大汗如雨，衣被湿透，脱然
而愈。盖其人瘦而多火，素禀阳藏，医与升散，不能作汗，则病转剧。今得冷冻饮料，表里和润，自然汗解矣。
张路玉治洪氏女，初冬发热头痛，胸满不食。已服发散消导四剂，至六日，周身痛楚，腹中疼痛，不时奔
响，屡欲圊而不行，口鼻上唇忽起黑色成片，光亮如漆，与玳瑁无异，医骇辞去。张诊之，喘汗脉促，神气昏
愦，虽症脉俱危，喜其黑色四围有红晕，鲜泽若痘疮之根脚，紧附如线，他处肉色不变，许以可治。先与葛根、
黄芩、黄连，加犀角、连翘、荆、防、紫荆、人中黄，解其肌表毒邪。俟其黑色发透，乃以凉膈散加人中黄、
紫荆、乌犀，微下二次。又与犀角地黄汤加人中黄之类，调理半月而安。此症书所不载，唯庞安常有玳瑁瘟之
名，而治法未备，人罕能识。先是一人患此濒危，口耳鼻孔皆流鲜血，亦不能救。大抵黑色枯焦不泽，四围无
红晕而灰白色黯者，皆不可救。其黑必先从口鼻至颧颊目胞两耳，及手臂足胫，甚则胸腹俱黑，从未见于额上
肩背阳位也。
陈瑞之七月间患时疫，初发独热无寒，或连热二三日，或暂可一日半日，热时烦渴无汗，热止则汗出如漉。
自言房劳后乘凉所致，服过十味香薷、九味羌活、柴胡、枳、桔等十余剂，烦渴壮热愈甚。张诊之，六脉皆洪
盛搏指，舌苔焦枯，唇口剥裂，大便五六日不通。虽云病起于阴，实则热邪亢极，胃腑剥腐之象。急与凉膈加
黄连、石膏、人中黄，得下三次，热势顿减。明晚，复发热烦渴，与白虎加人中黄、黄连，热渴俱止。两日后，
左颊发颐，一 时即平，而气急神昏。此元气下陷之故，仍与白虎加人参、犀角、连翘。颐复 发，与犀角、
连翘、升、柴、甘、桔、牛蒡、马勃。二服，右颐又发一毒，高肿赤亮，疡医调治四十日而安。同时患此者颇
多，良由时师不明此为湿土之邪，初起失于攻下，概用发散和解，引邪泛滥而发颐毒。多有肿发绵延，以及膺
胁肘臂，如流注溃腐者，纵用攻下解毒，皆不可救，不可以发颐为小症而忽之。
一北人患时疫，寒热不止，舌苔黄润，用大柴胡下之，烦闷神昏。杂进人参白虎、补中益气，热势转剧。
频与芩、连、知母不应。张诊之，左脉弦数而劲，右脉再倍于左，周身俱发红斑，惟中脘斑色皎白。诸医莫审
白斑之由，因喻之曰∶良由过服苦寒之剂，中焦阳气失职故也。法当通达其斑，兼通气化，无虑斑色不转也。
遂用犀角、连翘、山栀、人中黄，昼夜连进二服，二便齐行而斑化热退，神清食进，起坐徐行矣。其昆季同时
俱染其气，并进葱白、香豉、人中黄、连翘、薄荷之类，皆随手愈。
黄以宽风温十余日，壮热神昏，语言难出，自利溏黑，舌苔黑燥，唇焦鼻煤。先误用发散消导数剂，烦渴
弥甚，恣饮不辍。此本伏气郁发，更遇于风，遂成风温。风温脉气本浮，以热邪久伏，少阴从火化，发出太阳，
即是两感。幸年壮质强，已逾三日六日之期，症虽危殆，良由风药性升，鼓激周身元气皆化为火，伤耗真阴。
少阴之脉，不能内藏，所以反浮。古人原无治法，惟少阴例中，则有救热存阴，承气下之一症，可惜此以迅扫
久伏之邪。审其鼻息不鼾，知水之上源未绝，无虑其直视失溲也。（喻嘉言治钱仲昭，亦以其肾水未竭，故
伤寒多死下虚人，非虚语也。）酌用凉膈散加人中黄、生地，急救垂绝之阴。服后下溏黑三次，舌苔未润，
烦躁不减。更与大剂凉膈，大黄加至二两，兼黄连、犀角，三下方得热除。于是专以生津止渴大剂投之，舌苔
方去，津回渴止而愈。
按∶喻嘉言治《金鉴》类两感，其论症与此略同，第金则舌卷足冷，身蜷而便略通。此则舌黑唇焦鼻煤，
而利溏黑。故金则以麻黄附子细辛及附子泻心，此则专用凉膈，其治法不同如此。
杨乘六治一人病疫，大热大渴，唇焦目赤，两颧娇红，语言谬妄，神思昏沉，手冷过肘，足冷过膝，其舌
黑滑而胖，其脉洪大而空，曰∶此戴阳症也。外热内寒，虽身热如烙，不离覆盖，口渴引饮，不耐寒凉，面色
虽红，却娇嫩而游移不定，舌苔虽黑，却浮胖而滋润不枯。症类白虎，然白虎症未有厥冷上过肘下过膝者，遂
以大剂八味饮加人参，浓煎数碗，探冷与服，诸症乃退。继以理中、附子、六君、归、芍，调理而愈。先有用
白虎者，幸未服之。
张学海业医，以疲于临症，染时疫，微寒壮热，头痛昏沉，服发散药数剂，目直耳聋，病热增剧，口渴便
秘。改用泻火清胃解毒等剂，热尤炽，油汗如珠，谵语撮空，恶候悉具。杨诊之，其脉洪大躁疾而空，其舌干
燥，焦黄而胖。时满座皆医也，佥拟白虎承气。杨以养荣汤，用参、附各三钱，与之曰∶服此后，当得睡，睡
醒则诸脉俱静，诸病俱退，而舌变嫩红滑润矣。第无挠旁议。翌日复诊，果如所言。盖病有真假凭诸脉，脉有
真假凭诸舌。如系实症，则脉必洪大躁疾，而重按愈有力。如系实火，则舌必干燥焦黄，而敛束且坚卓，岂有
重按全无，满舌俱胖，尚得谓之实症也哉？仍用原方，减去参、附一半，守服数剂而愈。
陆养愚治费西村患时疫，头疼身热，口渴气喘，下午热潮更甚。或以藿香正气散投之，烦躁特甚，舌心焦
黑，谵语发斑。又与柴苓汤，更加呕哕，且自汗不止。脉之浮数而微，曰∶此少阳阳明合病之虚热也。用白虎
汤加人参、黄 、葛根、柴胡、灯心、竹叶，热减十分之七，汗亦稍止。后以人参、麦冬、五味、黄芩、山栀、
甘草，二剂斑亦渐退。
陈好古患两太阳痛，左胁作疼，口渴，大便泻水，小便短赤，面色如尘。陆诊之，滑大而数，右关为甚。
时春末夏初，曰∶此疫症也。陈怒瘟病之名，辞去。或以胃苓汤投之，烦渴异常，语言错乱。再求诊，脉仍前，
症似危急，然细参症候，不过热郁之极，故烦乱神昏耳。其泻者，因表气不舒，故里气不固也。用白虎合解肌
汤，二剂而定，又二剂而起。（藜按∶肺移热于大肠，故泻，非里气不固也。）
丁程川之宠，患疫而死。半月后丁自病，头痛身热，口渴烦躁。或与小柴胡汤，忽夜梦与亡宠交接，惊觉
而精已泄，汗出如雨，不能转侧，神昏谵语。亟招陆诊之，其脉微细如丝，面色如泥，四肢厥冷，幸未过肘膝，
而阳事尚自翘然。令剪其亡宠旧 裆烧灰，以附子理中汤调灌之，两剂神清，阳亦收敛。后以人参、麦冬、五
味、白芍、黄连、枣仁、知母、黄柏调理而安。（文田按∶此柴胡扰动肝邪，故摇撼肾精，以致不守。）
柴屿青治吴氏妇患疫。家人谓因怒而致，医遂用沉香、乌药、代赭等药，兼用表剂，二十余日，胸膈胀闷，
壮热不休。脉之，左手稍平，右三部洪数，此疫症邪热入腑，表散徒伤卫气，病亦不解。乃连进瓜蒂散二剂，
吐去涎痰。察其邪尚未衰，又与小承气二剂，下宿垢数行，而热渐退。调理至十余日，脉始平复。
缪仲淳治史鹤亭太史，丁亥春患瘟疫，头疼身热，口渴，吐白沫，（胃热。）昼夜不休。医误谓太史初罢官归，
妄投解郁行气药不效。又与四物汤益甚。诸医谢去，谓其必死。迎缪至，病二十余日，家人具以前方告。缪曰∶
误矣。瘟疫者，四时不正，伤寒之谓，发于春，故谓之瘟疫。不解又不下，使邪热弥留肠胃间，幸元气未尽，
故不死。亟索淡豆豉约二合许炒香，麦冬一两许，知母数钱，石膏两许，一剂大汗而解。时大便尚未通，史问
故。曰∶昨汗如雨，邪尽矣。第久病津液未回，故大便不通。肠胃燥，非有邪也。今可食甘蔗三二株，兼多饮
麦冬汤。不三日，去燥粪六十余块而愈。
张凤逵万历丁未三月间寓京师，吏部刘蒲亭病剧求治，已备后事，谵语抹衣，不寐者七八日矣。御医院吴
思泉，名医也，偕数医治之。张诊脉，只关脉洪大，其余皆伏，乃书方竹叶石膏汤。咸惊曰∶吴等已煎附子理
中汤，何冰炭如是？张诘之。吴曰∶阳症阴脉，故用附子。张曰∶两关洪大，此阳脉也。其余经为火所伏，非
阴脉也。一剂，谵语抹衣即止，熟寐片时。再诊之，洪者平而伏者起矣。又用辛凉药调理全愈。
元时江西泰和县瘟疫大作，有医者视病，中夜而归，忽遇神人骑马导从而来，医知非人，拜伏于地。神至
前，叱曰∶汝何人也？答曰∶某医人也。神曰∶汝今医病用何药？答曰∶随病冷热轻重，用药治之。神曰∶不
然，天医类用香苏散好。医如其言，试之皆效。香附炒去皮、紫苏各二两，陈皮、甘草各一钱。上为粗末，每
服三钱，水一盏，煎七分，去渣热服，不拘时，日三服。戒荤腥酒肉，无不应效。
又记云∶昔城中大疫，有白发老人，教一富家人，修合香苏散，施城中病者皆愈。其后疫鬼作人，问其富
人家，富人一实告，鬼相顾曰∶此老教三人矣，遂稽颡而退。（同上则，皆万密斋《保命歌括》。文田按∶
此亦寒疫证。）
医者乔姓，奉吕仙甚谨。一夕梦吕告之曰∶水上浮萍，甚能愈疾，多贮之。乔乃收积至十车。旦暮大疫，
乔药中每加萍一撮，无不立愈。其门如市，遂获重赀。他医效之，都不验。（《云间杂志》无名氏。）
钱国宾治管船王元暴病，头痛身热，倦卧懒动，不恶寒，只畏热，舌红肌黄，二便不利，六脉浮洪。视其
症脉，瘟病也。用清凉发散之剂，八日罔效。再四审之，心胸腹胁，俱无他症，口渴饮水，欲向外卧。令人移出，解衣
吴又可治疗朱海畴，四十五岁，患瘟疫出现可下之症，四肢不能活动，身体躺卧如雕塑般僵硬，眼睛闭合、嘴巴张开，舌苔上有芒刺。询问他的痛苦所在，他无法回答。于是问他的儿子，这两三天服用了什么药？回答说：服用了三剂承气汤，每剂投入大黄约一钱，没有效果，也没有其他办法，只能等待死亡罢了。诊察发现脉象尚有神气，可下的症状全部具备，是药力太轻而病邪深重。先投用大黄一两五钱，眼睛偶尔能稍微转动。再次投药，舌上的芒刺变得没有尖刺感，嘴巴逐渐张开，能够说话。服用三剂后，舌苔稍微消退，精神思维稍显清爽。第四天，服用柴胡清燥汤；第五天，芒刺重新生出，烦热加重，再次使用攻下法。第七天，又投用承气汤、养荣汤，肢体自然能稍微活动。共计半个月，共服用大黄十二两而痊愈。又过了几天，才开始进食稀粥，调理两个月才完全康复。凡是治疗千人，遇到这种病例不过三四个人而已，暂且保存医案以备参考斟酌。
施幼升以卖卜为生，颇为流行，四十岁左右，体质非常肥胖。六月患时行疫病，口燥舌干，舌苔芒刺如锋刃，不时叹气，咽喉肿痛，心腹胀满，按压时疼痛剧烈，渴望喝冰水，傍晚时分症状更加严重，小便赤红涩痛，得到点滴尿液则疼痛加剧，这是应当使用攻下法的症状。因为通身肌肤表面如冰一样冷，指甲青黑，六脉细如丝线，寻找时有感觉，稍微用力按压就消失不见。医生不探究里证热极的情况，只引用陶氏《全生集》认为这是阳证，但手足厥冷，如果冷过手肘膝盖，就是阴证。现在通身冰冷，比冷过肘膝更严重，应该说是阴证了。而且陶氏论述阴阳二证，完全在脉象有力无力的区分中。现在脉微欲绝，按之如无，比无力更严重，应该说是阴证了。阴证却得到至阴的脉象，还有什么可说的呢？于是投用附子理中汤。后来延请吴又可诊治，将脉象与症状相互参照，表里比较，这是阳证中最严重的情况。因为内热至极，气道壅闭，可下的症状全部具备，只是遗憾攻下得太晚罢了。因为内热至极，导致周身冰冷，这叫体厥。六脉如无，是群龙无首的景象，病情也很危险了。紧急投用大承气汤，嘱咐他们缓缓攻下，脉象恢复、厥逆回温，就能存活。病人的妻子认为一个是阴证，一个是阳证，天地悬殊，怀疑而不肯服药。又找了一位医生，指言是阴毒，必须灸丹田。接着三位医生相继诊治，都说这是阴证，妻子于是惶恐疑惑。病人自己说：为什么不占卜神明？于是占卜得到从阴则吉，从阳则凶。更加困惑于多数医生议论为阴证，于是进服附子汤，药咽下如火烧，烦躁到了极点。叹息说：我完了，是药误了我。话没说完，病情转剧，不超过时辰竟然死亡。
吴江沈氏妇女，年少守寡，多郁怒，有吐血病症，每年发作三四次，吐完血就好了。三月间，轻微发热，头疼身痛，不怕冷而微渴，第二天旧病大发，吐血超过平常，更加眩晕，手抖烦躁，饮食不进，而且热势加重。医生只见吐血，认为是旧病，不知道是时行疫病。把发热当作阴虚，头疼身痛当作血虚，不知道吐血前一天已经发热头痛，不是吐血后加重的。众人商议用补法，问吴又可是否可以？吴又说：失血补虚，权宜之计可以，现在兼有时行疫病，不同于往昔。于是用人参二钱，茯苓、当归、白芍辅助。服用两剂后，虚症全部消退，热势减少六七成。医生、病人都认为用人参有效，想要快速进补，吴又可禁止不住。于是觉得心胸烦闷，腹中不和，想打嗝打不出来，整夜不睡觉。这是因为虚邪得补而退，实邪得补而加剧，于是少量给予承气汤轻微通便而痊愈。按语：此病假如不使用通便药，静养数日也会痊愈，因为他的大便一两天解一次，就知道地气自然通畅，邪气在内，每天从胃气下趋，所以自愈。
严氏妇女三十岁，时行疫病后，脉症都平稳，饮食逐渐增加，忽然肢体浮肿，没有其他痛苦，这就是气复（正气恢复）。大概大病之后，血未生成，气突然恢复，血是气的根基归宿，气无所根据，所以发生浮肿。此后饮食逐渐增加，浮肿逐渐消退。如果投行气利水药就错了。（据所说，那么养血之剂适宜投用。）
一人感染疫病，发热烦渴，想喝冰水，医生严禁服用生冷，病人苦于索取不给，于是导致两眼如火并燃，咽喉焦燥，昼夜不睡觉，眼中见鬼，病人困顿危重，自认为得到一滴冷水咽下，即使死也无憾。于是趁隙匍匐窃取井水一盆，放在枕边，喝一杯，眼睛顿时清亮。两杯，鬼物潜消。三杯，咽喉声音发出。四杯，筋骨舒畅，不知不觉熟睡，不久大汗如雨，衣被湿透，轻松痊愈。大概这个人瘦而多火，素禀阳脏，医生用升散药，不能作汗，则病情转剧。现在得到冷冻饮料，表里和润，自然汗出而解。
张路玉治疗洪氏女，初冬发热头痛，胸满不想吃东西。已经服用发散消导药四剂，到第六天，周身痛楚，腹中疼痛，不时肠鸣奔响，屡次想上厕所却排不出，口鼻上唇忽然起黑色成片，光亮如漆，与玳瑁无异，医生惊骇离去。张路玉诊察，喘促汗出脉急促，神气昏愦，虽然症脉都危急，喜欢其黑色四周有红晕，鲜泽像痘疮的根脚，紧贴如线，其他地方肉色不变，许诺可以治疗。先给葛根、黄芩、黄连，加犀角、连翘、荆芥、防风、紫荆皮、人中黄，解除肌表毒邪。等到黑色发透，再用凉膈散加人中黄、紫荆皮、乌犀，轻微攻下两次。又给犀角地黄汤加人中黄之类，调理半月而安。此症医书所不记载，只有庞安常有玳瑁瘟的名称，而治法不完善，人很少能识别。先前有一人患此病濒危，口耳鼻孔都流鲜血，也不能救。大致黑色枯焦不润泽，四周无红晕而灰白色黯黑的，都不可救。其黑必先从口鼻至颧颊目胞两耳，及手臂足胫，甚则胸腹俱黑，从未见于额头肩背阳位。
陈瑞之七月间患时行疫病，初发独热无寒，有时连续热二三日，有时暂时好一日半日，热时烦渴无汗，热止则汗出如漉。自述房劳后乘凉所致，服过十味香薷、九味羌活、柴胡、枳壳、桔梗等十余剂，烦渴壮热更严重。张路玉诊察，六脉皆洪盛搏指，舌苔焦枯，唇口剥裂，大便五六日不通。虽说病起于阴，实则热邪亢极，胃腑剥腐之象。急给凉膈散加黄连、石膏、人中黄，得下三次，热势顿减。明晚，又发热烦渴，给白虎汤加人中黄、黄连，热渴俱止。两日后，左颊发颐（腮腺炎），一时即平，而气急神昏。这是元气下陷的缘故，仍给白虎汤加人参、犀角、连翘。颐复发，给犀角、连翘、升麻、柴胡、甘草、桔梗、牛蒡子、马勃。二剂，右颐又发一毒，高肿赤亮，疡医调治四十日而安。同时患此病的人颇多，良由当时医生不明白此为湿土之邪，初起失于攻下，概用发散和解，引邪泛滥而发颐毒。多有肿发绵延，以及膺胁肘臂，如流注溃腐者，纵用攻下解毒，都不可救，不可以发颐为小症而忽视。
一个北方人患时行疫病，寒热不止，舌苔黄润，用大柴胡汤攻下，烦闷神昏。杂进人参白虎汤、补中益气汤，热势转剧。频繁用黄芩、黄连、知母无效。张路玉诊察，左脉弦数而劲，右脉再倍于左，周身都发红斑，惟中脘斑色皎白。众医不明白斑的原因，于是告诉他说：良由过服苦寒之剂，中焦阳气失职的缘故。法当通达其斑，兼通气化，不用担心斑色不转变。于是用犀角、连翘、山栀、人中黄，昼夜连进二剂，二便齐行而斑化热退，神清食进，起坐徐行矣。他的兄弟同时都染上此气，并进葱白、香豉、人中黄、连翘、薄荷之类，都随手痊愈。
黄以宽患风温十余日，壮热神昏，语言难出，自利溏黑，舌苔黑燥，唇焦鼻煤。先误用发散消导数剂，烦渴更甚，恣饮不停。这本是伏气郁发，更遇风邪，遂成风温。风温脉气本浮，因热邪久伏，少阴从火化，发出太阳，即是两感。幸好年壮质强，已逾三日六日之期，症虽危殆，良由风药性升，鼓激周身元气皆化为火，伤耗真阴。少阴之脉，不能内藏，所以反浮。古人原无治法，只有少阴例中，则有救热存阴，承气下之一症，可惜此人以迅扫久伏之邪。审其鼻息不鼾，知水之上源未绝，不用担心其直视失溲也。（喻嘉言治疗钱仲昭，也是以其肾水未竭，所以伤寒多死于下虚之人，并非虚语。）酌用凉膈散加人中黄、生地，急救垂绝之阴。服后下溏黑三次，舌苔未润，烦躁不减。再给大剂凉膈散，大黄加至二两，兼黄连、犀角，三下方得热除。于是专以生津止渴大剂投之，舌苔方去，津回渴止而愈。
按语：喻嘉言治疗《金鉴》类两感，其论症与此略同，只是金匮要略中则是舌卷足冷，身蜷而便略通。此症则是舌黑唇焦鼻煤，而利溏黑。故金匮则以麻黄附子细辛及附子泻心汤，此症专用凉膈散，其治法不同如此。
杨乘六治疗一人患疫病，大热大渴，唇焦目赤，两颧娇红，语言谬妄，神思昏沉，手冷过肘，足冷过膝，其舌黑滑而胖，其脉洪大而空，说：这是戴阳症。外热内寒，虽然身热如烙，不离覆盖，口渴引饮，不耐寒凉，面色虽红，却娇嫩而游移不定，舌苔虽黑，却浮胖而滋润不枯。症类白虎汤证，然而白虎汤证未有厥冷上过肘下过膝者，于是以大剂八味丸加人参，浓煎数碗，探冷与服，诸症乃退。继以理中汤、附子、六君子汤、当归、白芍，调理而愈。先前有用白虎汤的，幸亏没服用。
张学海业医，因疲于临症，染时行疫病，微寒壮热，头痛昏沉，服发散药数剂，目直耳聋，病热增剧，口渴便秘。改用泻火清胃解毒等剂，热尤炽，油汗如珠，谵语撮空，恶候悉具。杨乘六诊察，其脉洪大躁疾而空，其舌干燥，焦黄而胖。当时满座都是医生，都拟用白虎承气汤。杨乘六用养荣汤，用人参、附子各三钱，给他并说：服此后，应当得睡，睡醒则诸脉俱静，诸病俱退，而舌变嫩红滑润矣。只要不被旁议干扰。翌日复诊，果然如所言。盖病有真假凭诸脉，脉有真假凭诸舌。如系实证，则脉必洪大躁疾，而重按愈有力。如系实火，则舌必干燥焦黄，而敛束且坚卓，岂有重按全无，满舌俱胖，尚得谓之实证也哉？仍用原方，减去参、附一半，守服数剂而愈。
陆养愚治疗费西村患时行疫病，头疼身热，口渴气喘，下午热潮更甚。有人用藿香正气散投之，烦躁特甚，舌心焦黑，谵语发斑。又给柴苓汤，更加呕哕，且自汗不止。诊其脉浮数而微，说：这是少阳阳明合病的虚热。用白虎汤加人参、黄芪、葛根、柴胡、灯心草、竹叶，热减十分之七，汗亦稍止。后用党参、麦冬、五味子、黄芩、山栀、甘草，二剂斑亦渐退。
陈好古患两太阳痛，左胁作疼，口渴，大便泻水，小便短赤，面色如尘。陆养愚诊察，滑大而数，右关为甚。时春末夏初，说：这是疫症。陈好古怒瘟病之名，辞去。有人用胃苓汤投之，烦渴异常，语言错乱。再求诊，脉仍前，症似危急，然细参症候，不过热郁之极，故烦乱神昏耳。其泻者，因表气不舒，故里气不固也。用白虎汤合解肌汤，二剂而定，又二剂而起。（黎按：肺移热于大肠，故泻，非里气不固也。）
丁程川的宠妾，患疫病而死。半月后丁程川自己生病，头痛身热，口渴烦躁。有人用小柴胡汤，忽然夜梦与亡宠交接，惊觉而精已泄，汗出如雨，不能转侧，神昏谵语。亟招陆养愚诊察，其脉微细如丝，面色如泥，四肢厥冷，幸未过肘膝，而阳事尚自翘然。令剪其亡宠旧裆烧灰，以附子理中汤调灌之，两剂神清，阳亦收敛。后用党参、麦冬、五味子、白芍、黄连、枣仁、知母、黄柏调理而安。（文田按：此柴胡扰动肝邪，故摇撼肾精，以致不守。）
柴屿青治疗吴氏妇患疫病。家人谓因怒而致，医遂用沉香、乌药、代赭石等药，兼用表剂，二十余日，胸膈胀闷，壮热不休。诊其脉，左手稍平，右三部洪数，这是疫症邪热入腑，表散徒伤卫气，病亦不解。于是连进瓜蒂散二剂，吐去涎痰。察其邪尚未衰，又与小承气汤二剂，下宿垢数行，而热渐退。调理至十余日，脉始平复。
缪仲淳治疗史鹤亭太史，丁亥春患瘟疫，头疼身热，口渴，吐白沫，（胃热。）昼夜不休。医生误谓太史初罢官归，妄投解郁行气药不效。又给四物汤益甚。诸医谢去，谓其必死。迎缪仲淳至，病二十余日，家人具以前方告。缪仲淳说：误矣。瘟疫者，四时不正之气，伤寒之谓，发于春，故谓之瘟疫。不解又不攻下，使邪热弥留肠胃间，幸元气未尽，故不死。急索淡豆豉约二合许炒香，麦冬一两许，知母数钱，石膏两许，一剂大汗而解。当时大便尚未通，史问原因。说：昨汗如雨，邪尽矣。只是久病津液未回，故大便不通。肠胃燥，非有邪也。今可食甘蔗三二株，兼多饮麦冬汤。不三日，去燥粪六十余块而愈。
张凤逵万历丁未三月间寓居京师，吏部刘蒲亭病重求治，已备后事，谵语抹衣，不寐者七八日矣。御医院吴思泉，名医也，偕数医治之。张凤逵诊脉，只关脉洪大，其余皆伏，乃书方竹叶石膏汤。大家都惊说：吴等人已煎附子理中汤，何冰炭如是？张凤逵诘问。吴思泉说：阳症阴脉，故用附子。张凤逵说：两关洪大，此阳脉也。其余经为火所伏，非阴脉也。一剂，谵语抹衣即止，熟寐片时。再诊之，洪者平而伏者起矣。又用辛凉药调理全愈。
元时江西泰和县瘟疫大作，有医者视病，中夜而归，忽遇神人骑马导从而来，医知非人，拜伏于地。神至前，叱曰：汝何人也？答曰：某医人也。神曰：汝今医病用何药？答曰：随病冷热轻重，用药治之。神曰：不然，天医类用香苏散好。医如其言，试之皆效。香附炒去皮、紫苏各二两，陈皮、甘草各一钱。上为粗末，每服三钱，水一盏，煎七分，去渣热服，不拘时，日三服。戒荤腥酒肉，无不应效。
又记云：昔城中大疫，有白发老人，教一富家人，修合香苏散，施城中病者皆愈。其后疫鬼作人，问其富人家，富人一实告，鬼相顾曰：此老教三人矣，遂稽颡而退。（同上则，皆万密斋《保命歌括》。文田按：此亦寒疫证。）
医者乔姓，奉吕仙甚谨。一夕梦吕告之曰：水上浮萍，甚能愈疾，多贮之。乔乃收积至十车。旦暮大疫，乔药中每加萍一撮，无不立愈。其门如市，遂获重赀。他医效之，都不验。（《云间杂志》无名氏。）
钱国宾治疗管船王元暴病，头痛身热，倦卧懒动，不恶寒，只畏热，舌红肌黄，二便不利，六脉浮洪。视其症脉，瘟病也。用清凉发散之剂，八日罔效。再四审之，心胸腹胁，俱无他症，口渴饮水，欲向外卧。令人移出，解衣
Wu Youke treated Zhu Haichou, aged forty-five, who suffered from an epidemic with symptoms indicating the need for purgation. His limbs were paralyzed, his body lay rigid as a sculpture, eyes closed and mouth open, with prickly moss on the tongue. When asked about his suffering, he could not answer. Wu then asked his son what medicines had been taken in the past two or three days. The son replied: "Three doses of Chengqi Tang (Cassia Decoction), each dose containing approximately one qian of Dahuang (Rhubarb Rhizome), but to no effect. We have no other strategy and can only wait for death." Upon examination, the pulse still showed spirit (vitality), and all symptoms requiring purgation were present; the medication was too mild for the deep-seated disease. Wu first administered five ounces of Dahuang (Rhubarb Rhizome); the patient's eyes occasionally moved slightly. After another dose, the prickle-like moss on the tongue lost its sharpness, the mouth gradually opened, and he could speak. After three doses, the tongue coating subsided slightly, and his mental clarity improved somewhat. On the fourth day, he took Chaihu Qingzao Tang (Bupleurum Decoction to Clear Dryness). On the fifth day, prickles reappeared, and irritability and heat intensified, necessitating another purgative treatment. On the seventh day, Chengqi Tang (Cassia Decoction) and Yangrong Tang (Nourishing Blood Decoction) were administered again, allowing his limbs to move slightly. Over half a month, he consumed a total of twelve taels of Dahuang (Rhubarb Rhizome) before recovering. Several days later, he began consuming congee, and after two months of conditioning, he fully recovered. Among a thousand patients treated, such cases were rare, occurring only three or four times. This case is preserved for reference.
Shi Yousheng, a fortune teller in his forties with a very obese constitution, contracted a seasonal epidemic in June. He presented with dry mouth and tongue, tongue coating with sharp prickles, frequent sighing, swollen and painful throat, abdominal distension and fullness with severe pain upon pressure, intense craving for ice water worsening at dusk, red and scanty urine causing severe pain even with drops. These were symptoms requiring purgation. However, his entire skin surface felt cold as ice, fingernails were cyanotic and black, and the six pulses were thread-thin, palpable only when sought lightly but vanishing with slight pressure. Physicians failed to investigate the extreme internal heat, instead citing Tao Shi’s *Quansheng Ji* to diagnose it as a Yang syndrome. They argued that since his extremities were cold, and colder than passing the elbows and knees, it must be a Yin syndrome. Furthermore, Tao Shi distinguished Yin and Yang syndromes by the strength of the pulse; here, the pulse was faint and nearly absent, worse than mere weakness, thus confirming Yin syndrome. Consequently, Fuzi Lizhong Tang (Aconite Decoction to Warm the Middle) was prescribed. Later, Wu Youke was consulted. Correlating pulse and symptoms, and comparing exterior and interior signs, Wu diagnosed this as the most severe form of a Yang syndrome. Extreme internal heat caused qi obstruction, presenting all purgative symptoms, but the purgation was delayed. The extreme internal heat led to whole-body coldness, termed "body jue" (extremity coldness). The absence of pulse indicated a state of "headless dragons," signaling critical danger. Wu urgently prescribed Dachengqi Tang (Major Order the Qi Decoction), advising slow administration. Once the pulse returned and coldness reversed, survival was possible. The patient's wife, confused by the conflicting diagnoses of Yin and Yang, refused the medicine. Another physician diagnosed "Yin toxicity" and recommended moxibustion at Dantian. Three more physicians agreed it was a Yin syndrome, causing the wife great anxiety. The patient himself suggested divination, which predicted auspiciousness for Yin and misfortune for Yang. Confused by the majority opinion favoring Yin diagnosis, they administered Fuzi Tang (Aconite Decoction). Upon swallowing, it felt like fire, causing extreme irritability. The patient sighed, "I am finished; the medicine has erred me." Before finishing his sentence, his condition worsened rapidly, and he died within the hour.
The wife of Mr. Shen in Wujiang, a young widow prone to depression and anger, suffered from hemoptysis recurring three or four times a year, resolving after bleeding. In March, she had mild fever, headache, and body ache without aversion to cold but with slight thirst. The next day, her old condition flared severely with excessive hemoptysis, dizziness, hand tremors, irritability, loss of appetite, and increased heat. Physicians saw only the hemoptysis, attributing it to her chronic condition, unaware it was an epidemic. They attributed fever to Yin deficiency and body ache to blood deficiency, ignoring that fever and headache preceded the bleeding. The consensus was to use tonification. When asked if this was appropriate, Wu Youke replied: "Tonifying deficiency after blood loss is acceptable as a temporary measure, but now she has an epidemic complication, unlike before." Thus, Qianren (Ginseng Radix) 2 qian, along with Fuling (Poria), Danggui (Angelica Sinensis), and Baishao (White Peony Root) were used. After two doses, deficiency symptoms receded, and heat decreased by 60-70%. Both doctors and patient believed Ginseng was effective and wanted to increase the dose, but Wu prohibited it. Subsequently, she experienced chest oppression, abdominal discomfort, inability to belch, and insomnia all night. This occurred because deficiency pathogens retreated with tonification, while excess pathogens intensified. A small amount of Chengqi Tang (Cassia Decoction) was given to mildly promote bowel movement, leading to recovery. Note: If laxatives were not used, rest would have sufficed, as her bowel movements were regular every one to two days, indicating natural qi flow and downward movement of pathogens via stomach qi.
Madam Yan, aged thirty, developed limb edema suddenly after recovering from an epidemic, with stable pulse and symptoms and increasing appetite, but no other discomfort. This was due to qi restoration. After severe illness, blood had not yet regenerated, but qi restored abruptly. Since blood is the foundation of qi, the unanchored qi caused edema. As diet improved, edema subsided. Prescribing qi-moving and diuretic herbs would have been erroneous. (Based on this, blood-nourishing formulas would be appropriate.)
A man infected with an epidemic presented with fever, irritability, and thirst, desiring ice water. Physicians strictly forbade cold foods/drinks. The patient, frustrated, developed burning eyes, scorched throat, insomnia day and night, and visual hallucinations. Desperate, he crawled to steal well water, placing it by his pillow. Drinking one cup cleared his vision; two cups dispelled hallucinations; three cups restored his voice; four cups relaxed his muscles and bones, leading to deep sleep. Soon, profuse sweating soaked his clothes, and he recovered effortlessly. Being thin and fiery-natured with a Yang-predominant constitution, previous dispersing herbs failed to induce sweat, worsening the condition. The cold drink harmonized the interior and exterior, naturally inducing sweat resolution.
Zhang Luyu treated Miss Hong in early winter with fever, headache, chest fullness, and anorexia. After four doses of dispersing and digesting herbs, by day six, she had全身 pain, abdominal pain, borborygmus, tenesmus without stool passage, and black patches appearing on the lips and nose, shiny like lacquer or hawksbill turtle shell, frightening the attending physicians. Zhang diagnosed panting, sweating, rapid pulse, and confusion. Although critical, the black patches had red halos, fresh and moist like pockmark roots, tightly attached, with normal surrounding skin, suggesting treatability. Initially, Gegen (Kudzu Root), Huangqin (Scutellaria Root), Huanglian (Coptis Rhizome), Xijiao (Rhinoceros Horn - substitute usually used today), Lianqiao (Forsythia Fruit), Jingjie (Schizonepeta), Fangfeng (Saposhnikovia Root), Zijingpi (Buddleja Bark), and Renzhonghuang (Human Excrement Charcoal) were used to resolve exterior toxic pathogens. Once the black patches emerged fully, Liangge San (Cool the Chest Powder) plus Renzhonghuang, Zijingpi, and Wuxi (Black Rhinoceros Horn) was used for mild purgation twice. Then, Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) with Renzhonghuang was used for conditioning over half a month. This condition is rarely recorded; Pang Anchang mentioned "Hawksbill Turtle Shell Plague," but treatments were incomplete. Previously, a similar case with bleeding from orifices was fatal. Generally, dry, dark, ash-colored black patches without red halos are incurable. Blackness typically starts from nose/mouth to cheeks/eyelids/ears, arms/legs, or chest/abdomen, never appearing on the forehead, shoulders, or back (Yang areas).
Chen Ruizhi contracted an epidemic in July, presenting with isolated fever without chills, lasting two to three days continuously or intermittently. During fever, he had irritability, thirst, and no sweat; during remission, profuse sweating. He attributed it to sexual exertion followed by cooling exposure. He took over ten doses of Shiwei Xiangru, Jiuwei Qianghuo, Chaihu, Zhike, and Jiegeng, worsening irritability and high fever. Zhang diagnosed surging, forceful pulses in all six positions, scorched and dry tongue coating, cracked lips and mouth, and constipation for five to six days. Although initiated by Yin factors, the pathogenic heat was extreme, showing signs of stomach fu decomposition. Urgent treatment with Liangge San plus Huanglian, Shigao (Gypsum), and Renzhonghuang resulted in three bowel movements and immediate fever reduction. The next evening, fever and thirst returned; Baihu Tang (White Tiger Decoction) with Renzhonghuang and Huanglian stopped them. Two days later, parotid swelling appeared on the left cheek, resolved quickly, but was followed by shortness of breath and confusion due to sinking yuan qi. Baihu Tang plus Renshen (Ginseng), Xijiao, and Lianqiao was given. Swelling recurred; treatment included Xijiao, Lianqiao, Shengma, Chaihu, Gancao, Jiegeng, Niubangzi, and Mabo. After two doses, a toxic swelling appeared on the right cheek. A surgeon treated it for forty days until recovery. Many others suffered similarly because contemporary physicians misunderstood the damp-earth pathogen, failing to purge early and using dispersing/harmonizing methods, causing pathogen overflow into the parotids. Extensive swelling resembling flowing abscesses was incurable even with purgation and detoxification; parotid swelling should not be neglected as minor.
A northerner with an epidemic had persistent alternating chills and fever, yellow-moist tongue coating. Dachaihu Tang (Minor Bupleurum Decoction) was used for purgation, causing irritability and confusion. Mixed administration of Renshen Baihu Tang and Buzhong Yiqi Tang worsened the heat. Frequent use of Huangqin, Huanglian, and Zhimu failed. Zhang diagnosed wiry-rapid-strong left pulse and double-right pulse, generalized erythematous macules except for a bright white patch at Zhongwan (CV12). Physicians did not understand the white patch. Zhang explained: "Overuse of bitter-cold herbs impaired middle jiao yang qi. The method should be to diffuse the macules and regulate qi transformation; do not worry about color change." Xiijiao, Lianqiao, Zhizi, and Renzhonghuang were administered day and night. After two doses, urination and defecation normalized, macules transformed, heat subsided, consciousness cleared, appetite returned, and mobility resumed. His brothers, similarly infected, were treated with Congbai, Jiangchi, Renzhonghuang, Lianqiao, and Bohe, recovering immediately.
Huang Yikuan suffered from Wind-Warmth for over ten days with high fever, confusion, difficulty speaking, loose dark stools, black-dry tongue coating, scorched lips, and sooty nose. Initial misuse of dispersing/digesting herbs worsened irritability and thirst despite excessive drinking. This was latent qi stagnation triggered by wind, becoming Wind-Warmth. Wind-Warmth pulses are typically floating; however, due to long-term heat retention, Shaoyin transformed into fire and emerged to Taiyang, constituting "Lianggan" (Dual Contraction). Fortunately, being young and strong, he passed the critical third and sixth days. Although critical, wind herbs' ascending nature stirred yuan qi into fire, damaging true yin. Shaoyin pulse failed to store internally, hence floating. Ancient texts lacked specific treatment, except for Shaoyin cases involving saving heat/storing yin or purging with Chengqi Tang. Regrettably, this case required clearing long-latent pathogens. Nasal breathing was not stertorous, indicating upper source of water was intact, ruling out fixed gaze/incontinence. Liangge San plus Renzhonghuang and Shengdi was used to save impending yin collapse. After three episodes of dark loose stools, tongue remained dry, irritability persisted. Larger doses of Liangge San with Dahuang increased to two liang, plus Huanglian and Xijiao, removed heat after three doses. Subsequently, large doses of fluids-generating and thirst-quenching herbs cleared the tongue coating, restored fluids, and cured the patient.
Note: Yu Jiayan’s treatment of "Lianggan" in *Jinjian* is similar, but presents with curled tongue/cold feet/coiled body with slight stool passage. This case had black tongue/scorched lips/sooty nose with dark loose stools. Thus, Jin Gui used Mahuang Fuzi Xixin Tang and Fuzi Xixin Tang, whereas this case used Liangge San exclusively, demonstrating different therapeutic approaches.
Yang Chengliu treated a man with epidemic featuring high fever/thirst, scorched lips/red eyes, rosy malar flush, delirious speech, mental dullness, cold hands past elbows, cold feet past knees, black-slippery-swollen tongue, and surging-empty pulse. He diagnosed "Daiyang Syndrome" (Floating Yang). Exterior heat with interior cold: though body hot as iron, he desired covering; thirsty for drinks but intolerant of cold; red face but tender/migratory; black tongue but swollen/moist/not dry. Similar to Baihu Tang syndrome, but Baihu cases do not have cold extending past elbows/knees. Large doses of Bawei Wan (Eight-Ingredient Pill) plus Renshen, decocted thick, served cool, resolved symptoms. Followed by Lizhong Tang, Fuzi, Liujun Zi Tang, Danggui, and Baishao for conditioning. Previously, Baihu Tang was considered but fortunately not administered.
Zhang Xuehai, a physician, contracted an epidemic from exhaustion: mild chills/high fever, headache/confusion. Dispersing herbs caused staring/deafness, worsening heat, thirst, and constipation. Fire-clearing/stomach-cooling/detoxifying herbs intensified heat, causing oily sweat, delirium, grasping at empty air, and ominous signs. Yang diagnosed surging-rapid-empty pulse and dry-yellow-swollen tongue. All physicians present proposed Baihu Chengqi Tang. Yang used Yangrong Tang with Renshen and Fuzi (3 qian each), predicting sleep would calm pulses/symptoms and turn tongue tender-red-smooth. Next day, prognosis held. Disease truth relies on pulse; pulse truth relies on tongue. True excess shows surging-rapid pulse strengthening on deep pressure; true fire shows dry-yellow tongue firm/constricted. How could an empty pulse and swollen tongue indicate excess? Original formula continued with half dose of Renshen/Fuzi, curing after several doses.
Lu Yangyu treated Feicun with epidemic: headache, fever, thirst, asthma, worse afternoon heat. Huoxiang Zhengqi San caused severe irritability, black-scalded tongue center, delirium, and macules. Chai Ling Tang worsened vomiting/belching and spontaneous sweating. Pulse floating-rapid-faint indicated Shaoyang-Yangming combined deficiency heat. Baihu Tang plus Renshen, Huangqi, Gegen, Chaihu, Dengxin, and Zhuye reduced heat by 70% and stopped sweating. Subsequent Ren Shen, Maidong, Wuweizi, Huangqin, Zhizi, and Gancao cleared macules in two doses.
Chen Haogu suffered bilateral Taiyang headache, left hypochondriac pain, thirst, watery diarrhea, scanty red urine, dusty complexion. Lu diagnosed slippery-large-rapid pulse, prominent at Right Guan. Late spring/early summer indicated epidemic. Chen rejected the term "plague" and left. Weiping Tang caused abnormal thirst/confusion. Re-evaluation showed critical-looking symptoms but actually extreme heat stagnation causing confusion. Diarrhea resulted from exterior qi constraint failing to secure interior qi. Baihu Tang combined with Jieji Tang resolved it in four doses. (Li notes: Lung heat transferred to Large Intestine causes diarrhea, not interior insecurity.)
Ding Chengchuan’s concubine died of plague. Half a month later, Ding fell ill with headache, fever, thirst, irritability. Xiaochaihu Tang induced a dream of intercourse with the deceased concubine, waking with seminal emission, profuse sweating, immobility, confusion, and delirium. Lu diagnosed thread-like faint pulse, muddy complexion, cold limbs (not past elbows/knees), but erect penis. Cutting the concubine’s old underwear, burning it to ash, and mixing with Fuzi Lizhong Tang cleared mind and restrained yang in two doses. Conditioning with Renshen, Maidong, Wuweizi, Baishao, Huanglian, Suanzaoren, Zhimu, and Huangbai ensured recovery. (Wentian notes: Chaihu disturbed Liver pathogen, shaking Kidney essence, causing loss of control.)
Chai Yuqing treated Madam Wu with plague. Family blamed anger; physicians used Chenxiang, Wuyao, Daizheshi, and exterior-resolving herbs for twenty days, causing chest oppression and persistent high fever. Left pulse slightly smoothed; Right three positions surging-rapid indicated epidemic heat entering Fu organs. Exterior dispersing injured Wei qi without resolving disease. Genti San (Melon Twig Powder) was administered twice to vomit phlegm. Seeing pathogen remained, Xiao Chengqi Tang was given twice to purge old feces, reducing heat. Pulse normalized after ten days of conditioning.
Miao Zhongchun treated Historian Shi Heting in spring of Dinghai year with plague: headache, fever, thirst, continuous white foam vomiting (Stomach heat). Misdiagnosed as post-retirement depression, treated with Qi-regulating herbs ineffectively. Siwu Tang worsened condition. Physicians gave up. Miao arrived after twenty days. Diagnosing epidemic (seasonal aberrant qi, akin to Cold Damage starting in Spring), he noted failure to clear or purge allowed heat to linger in intestines/stomach. Yuan qi was sufficient to prevent death. He prescribed fried Dan Dou Chi, Maidong, Zhimu, and Shigao. One dose induced profuse sweating and resolution. Constipation persisted due to fluid depletion, not pathogen. Recommended sugarcane and Maidong tea. Within three days, sixty pieces of dry stool passed, and he recovered.
Zhang Fengkui, residing in Beijing in March of Dingwei year, treated Minister Liu Puting, who was prepared for death, with delirium, picking at clothes, and insomnia for seven-eight days. Imperial Physician Wu Siquan and others prescribed Fuzi Lizhong Tang. Zhang diagnosed only surging Guan pulses, others hidden. Prescribed Zhuye Shigao Tang. Others questioned the contrast between Ice (cold) and Coal (hot). Wu claimed "Yang syndrome with Yin pulse." Zhang countered: "Surging Guan pulses are Yang. Other meridians are suppressed by fire, not Yin." One dose stopped delirium and induced sleep. Second visit showed normalization of surging and rising of hidden pulses. Xin-Liang (Acrid-Cool) herbs completed recovery.
In Yuan dynasty, Taixian County, Jiangxi, plague raged. A physician returning at midnight met a divine figure guiding him. Recognizing he was not human, the physician bowed. The deity asked what medicine he used. Physician replied: "According to cold/heat severity." Deity said: "Incorrect. Tianyi category uses Xiangsu San." The physician followed this advice with success. Formula: Chao Qu Pi Xiangfu and Zisu leaves 2 liang each; Chenpi and Gancao 1 qian each. Coarse powder, 3 qian per dose, decocted in one cup water to 70%, taken hot anytime, three times daily. Avoid meat/alcohol. All responded well.
Another record: During a city-wide plague, a white-haired old man taught a wealthy family to prepare Xiangsu San, distributing it to cure all patients. Later, plague ghosts asked the wealthy family, who confessed. Ghosts said: "This old man has taught three people," bowed, and departed. (From Wan Mizhai’s *Baoming Ge Kua*. Wentian notes: This is also Cold Plague.)
Physician Qiao, devout follower of Lü Dongbin, dreamed Lü advised storing duckweed (Ping) for curing diseases. Qiao collected ten carts. During a major epidemic, adding a pinch of Ping to prescriptions cured everyone instantly. Business boomed, making him rich. Other physicians copying this failed. (*Yunjian Zazhi*, anonymous).
Qian Guobin treated Wang Yuan, a boat manager, with sudden illness: headache, fever, lethargy, aversion to heat only, red tongue/yellow muscle, difficult urination/defecation, floating-surging pulses. Diagnosed as plague. Cooling/dispersing herbs failed for eight days. Careful review showed no chest/abdominal/flank issues, only thirst and desire to lie outward. Patient was moved outside, clothes removed...