典藏书目

[Appendix: Diphtheria Case, Post-Scarlet Fever Case]

Patient Yang (Left): The pathogenic factors of wind-warmth and epidemic pestilence stirred up the fire of the Liver and Gallbladder, accumulating and invading the Lung and Stomach meridians, manifesting as throat scarlet fever (an acute infectious disease characterized by sore throat and skin eruption). The scarlet spots are faintly visible, accompanied by fever, redness, swelling, and pain in the throat, with white putrid membranes on the inner Guan area. The tongue coating is thin and yellow, and the pulse is stagnant, slippery, and rapid. Heaven's Qi connects to the nose, and Earth's Qi connects to the mouth; inhaling impure Qi from heaven and earth through the mouth and nose interacts with the latent heat in the Lung and Stomach, steaming and affecting the Upper and Middle Jiao. The throat is the gateway of the Lung and Stomach; heat in these organs causes sore throat, swelling, and white putrid membranes on the inner Guan. The pathogenic force is currently rampant, raising concern for exacerbation. As stated in the Classics: "When wind invades internally, treat it with acrid-cool substances." This case fits this pattern.
Prescription: Cicada Slough (8 fen), Bitter Platycodon Root (1 qian), Honeysuckle Flower (3 qian), Red Peony Root from Jing (2 qian), Schizonepeta Spike (8 fen), Sweet and Bitter Licorice Root (6 fen each), Forsythia Fruit (3 qian), Fresh Bamboo Leaves (30 sheets), Fermented Soybean (3 qian), Light Mop Head Lichen (1 qian), Fritillaria Thunbergii Bulb (3 qian), White Imperata Rhizome (2 bundles), Mint Leaf (8 fen), Gardenia Fruit (1.5 qian), Processed Silkworm (3 qian).

Second Visit: Although the rash has erupted, the burning fever persists. Sore throat, swelling, and white putrid membranes remain. The pulse is surging and rapid, and the tongue is crimson. Latent warmth transforms into heat, steaming in the Yangming channel, moving from the Qi level to the Ying (Nutrient) level, consuming Yin fluids. Fire from the Jueyin and Shaoyin channels rises aggressively due to the momentum. The condition is severe; urgent treatment requires clearing both Qi and Ying levels to resolve the epidemic toxin.
Prescription: Rhinoceros Horn Tip (5 fen), Gan Zhong Huang (8 fen), Fritillaria Thunbergii Bulb (3 qian), Fresh Bamboo Leaves (30 sheets), Fresh Rehmannia Root (4 qian), Bitter Platycodon Root (1 qian), Forsythia Fruit (3 qian), Imperata and Arundo Rhizomes (heart and nodes removed, 1 liang each), Raw Gypsum (crushed, 4 qian), Light Mop Head Lichen (1 qian), Gardenia Fruit (1.5 qian), Fresh Dendrobium Stem (3 qian), Moutan Cortex (1.5 qian), Chen Jin Zhi (1 liang), Loquat Leaf Dew (taken with liquid, 4 liang).

Third Visit: The rash has receded, but fever persists. There is diffuse swelling and pain in the neck and jaw area, throat swelling, and persistent white putrid membranes on the inner Guan. The tongue coating is thin and yellow, and the pulse is deep and rapid. Warm pathogens and latent heat linger in the Lung and Stomach meridians. Blood stasis and toxic stagnation occur, with blazing fire in the Liver and Gallbladder. One wave subsides only for another to rise, making the case particularly tricky. Treatment should clear latent heat in the Lung and Stomach and resolve the accumulated toxicity of epidemic pestilence.
Prescription: Mint Leaf (8 fen), Gan Zhong Huang (8 fen), Red Peony Root from Jing (2 qian), Fresh Bamboo Leaf and Sheath (1.5 fen each), Scrophularia Root from Jing (2 qian), Bitter Platycodon Root (1 qian), Raw Cuscuta Seed/Pollen (wrapped, 3 qian), Gardenia Fruit (1.5 qian), Forsythia Fruit (3 qian), Processed Silkworm (3 qian), Fermented Soybean (3 qian), Fritillaria Thunbergii Bulb (3 qian), Motherwort Herb (3 qian), Live Arundo Root (nodes removed, 1 chi).

Patient Li (Left): The epidemic pestilence pathogen fails to reach the exterior and instead transmits inward. Fire in the Heart and Liver blazes internally, transforming into fire that enters the Ying level, damaging Yin and depleting fluids. Prescribe Xi Jiao Di Huang Tang combined with Ma Xing Shi Gan Tang to clear Qi and Ying levels and resolve the epidemic toxin.
Prescription: Rhinoceros Horn Tip (5 fen), Calcined Gypsum (crushed, 5 qian), Honeysuckle Flower (3 qian), Live Arundo Root (nodes removed, 1 chi), Fresh Rehmannia Root (4 qian), Gan Zhong Huang (8 fen), Forsythia Fruit (3 qian), Fresh Bamboo Leaves (30 sheets), Clean Ephedra Herb (4 fen), Bitter Platycodon Root (1 qian), Sichuan Fritillaria Bulb (3 qian), Chen Jin Zhi (taken with liquid, 1 liang), Apricot Seed (3 qian), Red Peony Root from Jing (2 qian), Scrophularia Root from Jing (2 qian).

Patient Chen (Left): Warm pathogens and epidemic pestilence stagnate and transform into fire, steaming the Lung and Stomach. Fire in the Heart and Liver blazes internally, causing diphtheria with rotting and painful ulcers, obstructing swallowing and drinking. Symptoms include high fever, restlessness, surging and rapid pulse, red tongue body with yellow coating. The Classics state: "When heat invades internally, treat it with salty-cold substances." Administer salty-cold detoxifying agents to clear warmth and drain heat.
Prescription: Rhinoceros Horn Tip (4 fen), Gan Zhong Huang (8 fen), Forsythia Fruit (3 qian), Scrophularia Root from Jing (1.5 qian), Fresh Rehmannia Root (3 qian), Fermented Soybean (3 qian), Red Peony Root from Jing (1.5 qian), Large Fritillaria Bulb (3 qian), Trichosanthes Root (3 qian), Charred Mint Leaf (7 fen), Honeysuckle Flower (3 qian), Raw Gypsum (crushed, 3 qian), Fresh Bamboo Leaves (30 sheets), White Imperata Rhizome (heart removed, 2 bundles).

Patient Wang (Right): Inhalation of seasonal Qi stirs up latent pathogens, accumulating and invading the Lung and Stomach meridians. The Lung governs skin and hair, and the Stomach governs muscles. Pathogens remaining between the skin/hair and muscles manifest as red scarlet fever. The red spots are faintly visible but not fully erupted. Chills and fever, chest fullness, and nausea occur because pathogens are stagnated in the Yangming channel and cannot reach the exterior. Tongue coating is thin and yellow; pulse is floating, slippery, and rapid. The pathogenic force is rampant, raising concern for exacerbation. Use acrid-cool clearing and resolving methods.
Prescription: Schizonepeta Spike (1 qian), Red Poria (3 qian), Cicada Slough (8 fen), Stir-fried Bamboo Shavings (1.5 qian), Fermented Soybean (3 qian), Amomum Fruit from Jiang (1 qian), Forsythia Fruit (3 qian), Prepared Burr Medicinal Fruit (2 qian), Mint Leaf (8 fen), Bitter Platycodon Root (1 qian), Red Peony Root from Jing (2 qian).

Child Xiang: After scarlet fever, latent pathogens remain in the Lung, causing phlegm and Qi obstruction. Damp-heat exists in the Spleen, impairing transportation. Accumulated dampness generates water, overflowing everywhere, leading to puffy face and eyes, abdominal distension, limb edema, cough, and rebellious Qi. Tongue coating is thin and greasy; pulse is soggy and slippery. The condition threatens severe edema. Temporarily use lung-salvaging and spleen-moving methods to separate and eliminate dampness, regulating Qi and resolving phlegm.
Prescription: Young Peucedanum Root (1.5 qian), Polyporus (3 qian), Raw and Processed Coix Seed (3 qian each), Processed Mulberry Root Bark (3 qian), Apricot Seed (3 qian), Areca Peel (2 qian), Radish Root (3 qian), Inula Flower (wrapped, 1.5 qian), Clear Processed Loquat Leaf (de-haired, wrapped, 3 qian), Fritillaria Thunbergii Bulb (3 qian), Broad Tangerine Peel (1 qian), Dried Bamboo Tube (1.5 qian), Fresh Winter Melon Peel (1 liang, decocted as water substitute), Poria with Skin (4 qian), Alisma Rhizome (3 qian).

Patient Li (Left): Residual pathogens, phlegm, and heat remain unclarified after scarlet fever. Both Lung and Stomach are diseased. Symptoms include fever without sweat, cough with rebellious Qi, dry mouth with desire to drink, rapid pulse, and yellow coating. This involves formless latent warmth steaming in Yangming, and有形 (formable) phlegm-heat lingering in the Lung collaterals. The condition is severe. Temporarily prescribe clearing and resolving latent warmth while resolving phlegm-heat.
Prescription: Kudzu Root (1.5 qian), Honeysuckle Flower (3 qian), Mulberry Leaf and Twig (2 qian each), Live Arundo Root (nodes removed, 1 chi), Fermented Soybean (3 qian), Forsythia Fruit (3 qian), Apricot Seed (3 qian), Red Peony Root from Jing (2 qian), Gardenia Fruit (1.5 qian), Raw Licorice Root (8 fen), Fritillaria Thunbergii Bulb (3 qian), Fresh Bamboo Shavings (2 qian), Trichosanthes Root (3 qian), Mint Leaf (8 fen).