陈幼 两目上窜，时剧时轻，今晚角弓反张，脐腹疼胀，舌强不利吮乳，舌尖边淡红，中后薄腻，脉
濡弱，哭声不扬。气阴暗伤，虚风内动，痰热逗留，肺胃气机室塞，窍道不通。与熄风安神，化痰宣肺法。
石决（三钱） 朱茯神（三钱） 川象贝（各二钱） 嫩钩钩（后下，三钱） 青龙齿（三钱） 炙远志
（一钱） 陈木瓜（二钱） 山茨菇片（五分） 净蝉衣（八分） 炙僵蚕（三钱） 珍珠粉（冲服，一分）
金器（入煎，一具）
二诊 角弓反张之势已和，舌强不利吮乳，手足心热，哭泣声哑，脉象弦细，风阳挟痰热上阻廉泉，横窜络
道。肺胃气机窒塞不宣。再拟熄风涤痰，清热宣肺。
霜桑叶（二钱） 朱茯神（三钱） 川象贝（各二钱） 嫩白薇（一钱五分） 甘菊花（三钱） 远志肉（一钱）
炙僵蚕（三钱） 青龙齿（三钱） 净蝉衣（八分） 石决（三钱） 山茨菇片（四分）
嫩钩钩（后入，三钱） 淡竹沥（冲服，一两） 真猴枣珍 珠粉（冲服，各一分） 金器（入煎，一具）
朱幼 初病伏邪化热，销烁阴液，发热口渴，唇皮焦燥，过服清凉，以致脾阳受伤，清气下陷，小溲清长，
而大便溏泄也，势成慢惊重症。急拟温肾运脾。
煨葛根（二钱） 炒于术（一钱五分） 陈广皮（一钱） 扁豆衣（三钱） 熟附片（八分） 炙甘草（五分）
焦谷芽（三钱） 炮姜炭（四分） 炒淮药（三钱） 干荷叶（一角）
冯幼 先天不足，后天又弱，吐泻已久，神疲内热，口干不多饮，舌质红，指纹红紫带青，已过气关。呕
吐伤胃，泄泻伤脾，脾阳胃阴两伤，肝木来乘，所谓阴虚生内热，阳陷则飧泄也，渐入慢惊一途，恐鞭长莫及
矣。勉拟连理汤加味，温养脾胃，抑木和中，以望转机。
炒潞党参（一钱五分） 炙甘草（五分） 炮姜炭（三分） 焦谷芽（三钱） 陈木瓜（二钱） 陈广皮（一钱）
云茯苓（二钱） 川雅连（三分） 炒于术（一钱五分） 灶心黄土（一两）
马左 形寒畏冷，遍身骨楚，头项强痛，泛泛作恶，小溲短少，脉紧急，苔薄腻。太阳阳明两经同病，急与
葛根汤散其寒邪，不致缠绵是幸。
粉葛根（一钱五分） 云苓（三钱） 炒谷芽（三钱） 川桂枝（五分） 姜半夏（三钱） 陈佩兰（一钱
五分） 净麻黄（五分） 陈广皮（一钱五分） 炒香豉（三钱） 煨姜（两片）
二诊 昨进葛根汤，得汗甚多，头项痛骨楚均舒，泛泛作恶已止。身热头眩，口干欲饮，脉象弦数，苔薄腻
黄，舌质红。太阳之邪已解，阳明之热内炽，幸喜素体强盛，不致迁延。今与桂枝白虎，一以清阳明之热，一
以肃太阳之邪。
川桂枝（三分） 赤苓（三钱） 炒谷芽（三钱） 生石膏（三钱） 江枳壳（一钱五分） 省头草（一钱
五分） 天花粉（三钱） 苦桔梗（八分） 炒竹茹（一钱五分） 干芦根（去节，五钱）
费左 身热不退，头项强痛，角弓反张，神昏谵语，渴喜冷冻饮料，脉象弦数，苔薄腻，舌红。前医叠投
表散之剂，汗出太多，高年气阴本亏，重汗乏阴，以致阴虚不能敛阳，二元不入于阳，若见风动呃逆，则无望
矣！急与桂枝羚羊，未识能转危为安否。
粉葛根（一钱五分） 朱茯神（三钱） 生石决（四钱） 川桂枝（三分） 羚羊片（五分） 鲜石菖蒲（一钱）
嫩钩尖（三钱） 天花粉（三钱） 天竺黄（一钱五分） 鲜竹叶（三十张） 活芦根
（去节，一尺）
二诊 头项强痛轻减，身热亦略退，神志平静，渴喜多饮，脉细数，苔腻舌红。阴亏于下，阳浮于
上。前方既见效机，仍守原意出入。
粉葛根（一钱五分） 朱茯神（三钱） 生石决（五钱） 羚羊角（五分） 石菖蒲（八分） 嫩钩尖（三钱）
天花粉（三钱） 天竺黄（一钱五分） 川贝母（三钱） 鲜竹叶（三十张） 朱灯心（二扎）
三诊 神志已清，头项强痛亦止，神疲欲卧，纳谷不香，脉濡细，苔薄腻，险岭已逾，可告无虞。再
与清养之品，善后可矣。
冬桑叶（三钱） 朱茯神（三钱） 生谷芽（三钱） 甘菊花（三钱） 川贝母（三钱） 香佩兰（一钱五分）
生石决（三钱） 天花粉（三钱） 生竹茹（一钱五分） 嫩钩尖（后入，三钱） 鲜竹叶（三十张）
【陈姓患儿】双眼向上凝视，症状时重时轻。今晚出现角弓反张（背部肌肉强直，身体向后弯曲如弓状），脐腹部疼痛胀满，舌体僵硬导致吮乳困难，舌尖及边缘淡红，舌中后部苔薄腻，脉象濡弱，哭声低微不扬。此为气阴暗中受损，虚风内动，痰热滞留，肺胃气机闭塞不通，窍道受阻。治宜熄风安神，化痰宣肺。
处方：石决明三钱，朱砂拌茯神三钱，川贝母与象贝母各二钱，嫩钩藤后下三钱，青龙齿三钱，炙远志一钱，陈皮木瓜二钱，山慈菇片五分，净蝉蜕八分，炙僵蚕三钱，珍珠粉冲服一分，金器入煎一具。
【二诊】角弓反张之势已缓和，但舌体僵硬仍致吮乳不利，手足心发热，哭泣声音嘶哑，脉象弦细。此乃风阳挟带痰热上阻廉泉穴，横窜经络通道。肺胃气机窒塞不得宣通。再拟熄风涤痰，清热宣肺之法。
处方：霜桑叶二钱，朱砂拌茯神三钱，川贝母与象贝母各二钱，嫩白薇一钱五分，甘菊花三钱，远志肉一钱，炙僵蚕三钱，青龙齿三钱，净蝉蜕八分，石决明三钱，山慈菇片四分，嫩钩藤后下三钱，淡竹沥冲服一两，真猴枣与珍珠粉各一分冲服，金器入煎一具。
【朱姓患儿】初病时伏邪化热，耗伤阴液，表现为发热口渴，嘴唇皮肤焦燥。因过服清凉药物，致使脾阳受伤，清气下陷，小便清长，大便溏泄，病情发展为慢惊风重症。急拟温肾运脾之法。
处方：煨葛根二钱，炒白术一钱五分，陈皮一钱，扁豆衣三钱，熟附片八分，炙甘草五分，焦谷芽三钱，炮姜炭四分，炒山药三钱，干荷叶一角。
【冯姓患儿】先天禀赋不足，后天脾胃又虚弱，呕吐腹泻日久，精神疲倦伴内热，口干但不多饮，舌质红，指纹红紫带青且已过气关。呕吐损伤胃气，泄泻损伤脾气，导致脾阳与胃阴两伤，肝木乘侮脾土，即所谓阴虚生内热，阳气下陷则致完谷不化的飧泄。病情渐入慢惊风范畴，恐药力难及。勉强拟定连理汤加味，以温养脾胃，抑木和中，期望病情转机。
处方：炒党参一钱五分，炙甘草五分，炮姜炭三分，焦谷芽三钱，陈皮木瓜二钱，陈皮一钱，云茯苓二钱，川黄连三分，炒白术一钱五分，灶心黄土一两。
【马左患者】形体怕冷畏寒，全身骨节酸痛，头项强痛，恶心欲吐，小便短少，脉象紧急，苔薄腻。此为太阳经与阳明经同病，急用葛根汤发散寒邪，以免病情缠绵。
处方：粉葛根一钱五分，云茯苓三钱，炒谷芽三钱，川桂枝五分，姜半夏三钱，陈皮佩兰一钱五分，净麻黄五分，陈皮一钱五分，炒香豉三钱，煨姜两片。
【二诊】昨日服用葛根汤后，出汗甚多，头项痛及骨节酸痛均缓解，恶心感已止。现身热头晕，口干想喝水，脉象弦数，苔薄腻黄，舌质红。太阳经之邪已解，阳明经之热内炽。幸好患者素体强健，不至于迁延不愈。今用桂枝白虎汤加减，一方面清阳明之热，一方面肃清太阳之余邪。
处方：川桂枝三分，赤茯苓三钱，炒谷芽三钱，生石膏三钱，江枳壳一钱五分，省头草一钱五分，天花粉三钱，苦桔梗八分，炒竹茹一钱五分，干芦根去节五钱。
【费左患者】身热不退，头项强痛，角弓反张，神志昏迷胡言乱语，渴喜冷饮，脉象弦数，苔薄腻，舌红。前医多次投用解表发汗之剂，汗出过多。患者年高，气阴本已亏损，再次大汗更乏阴液，以致阴虚不能敛阳，阴阳之气不相顺接。若出现肝风内动、呃逆等症状，则无望治愈！急用桂枝羚羊角汤加减，不知能否转危为安。
处方：粉葛根一钱五分，朱砂拌茯神三钱，生石决明四钱，川桂枝三分，羚羊片五分，鲜石菖蒲一钱，嫩钩尖三钱，天花粉三钱，天竺黄一钱五分，鲜竹叶三十张，活芦根去节一尺。
【二诊】头项强痛减轻，身热亦略退，神志平静，渴喜多饮，脉细数，苔腻舌红。此为阴亏于下，阳浮于上。前方既已见效，仍守原意进行加减。
处方：粉葛根一钱五分，朱砂拌茯神三钱，生石决明五钱，羚羊角五分，石菖蒲八分，嫩钩尖三钱，天花粉三钱，天竺黄一钱五分，川贝母三钱，鲜竹叶三十张，朱灯心二扎。
【三诊】神志已清醒，头项强痛亦停止，精神疲倦想睡觉，食欲不佳，脉象濡细，苔薄腻。险境已过，可告知无虞。再予清养之品善后。
处方：冬桑叶三钱，朱砂拌茯神三钱，生谷芽三钱，甘菊花三钱，川贝母三钱，香佩兰一钱五分，生石决明三钱，天花粉三钱，生竹茹一钱五分，嫩钩尖后下三钱，鲜竹叶三十张。
[Case of Infant Chen] The eyes roll upward, with symptoms fluctuating in severity. Tonight, opisthotonos (severe muscle spasms causing the body to arch backward) occurred, accompanied by pain and distension in the umbilical and abdominal regions. The tongue is stiff, making breastfeeding difficult; the tip and edges are pale red, while the middle and posterior parts have a thin greasy coating. The pulse is soggy and weak, and the cry is low and indistinct. This indicates latent injury to Qi and Yin, internal movement of deficient wind, lingering phlegm-heat, obstruction of Lung and Stomach Qi mechanism, and blockage of orifices. Treatment should focus on extinguishing wind and calming the spirit, resolving phlegm and diffusing the Lung.
Prescription: Shi Jue Ming (Haliotidis Concha) 3 qian, Zhu Fu Shen (Poria with Cinnabar) 3 qian, Chuan Xiang Bei (Fritillariae Cirrhosae Bulbus and Fritillariae Thunbergii Bulbus) 2 qian each, Nen Gou Tou (Uncariae Ramulus cum Uncis) added later 3 qian, Qing Long Chi (Dragonis Massa Ossis et Dens) 3 qian, Zhi Yuan Zhi (Polygalae Radix) 1 qian, Chen Mu Gua (Chaenomelis Fructus) 2 qian, Shan Ci Gu Pian (Cremastrae Pseudobulbus) 0.5 fen, Jing Chan Yi (Bombyx Batryticatus) 0.8 fen, Zhi Jiang Can (Bombyx Batryticatus) 3 qian, Zhen Zhen Zhu Fen (Margarita Pulvis) taken with decoction 1 fen, Jin Qi (Gold Artifact) boiled in water one piece.
[Second Visit] The tendency of opisthotonos has eased, but the stiff tongue still hinders breastfeeding. There is heat in the palms and soles, hoarseness in crying, and the pulse is wiry and fine. This suggests Wind-Yang carrying Phlegm-Heat obstructing Lianquan (Ren-23) upwards and invading collateral channels. The Qi mechanism of the Lung and Stomach is blocked and not diffusing. Further treatment aims to extinguish wind and wash away phlegm, clear heat and diffuse the Lung.
Prescription: Shuang Sang Ye (Mori Folium) 2 qian, Zhu Fu Shen (Poria with Cinnabar) 3 qian, Chuan Xiang Bei (Fritillariae Cirrhosae Bulbus and Fritillariae Thunbergii Bulbus) 2 qian each, Nen Bai Wei (Cynanchi Atrati Radix) 1.5 qian, Gan Ju Hua (Chrysanthemi Flos) 3 qian, Yuan Zhi Rou (Polygalae Radix) 1 qian, Zhi Jiang Can (Bombyx Batryticatus) 3 qian, Qing Long Chi (Dragonis Massa Ossis et Dens) 3 qian, Jing Chan Yi (Bombyx Batryticatus) 0.8 fen, Shi Jue Ming (Haliotidis Concha) 3 qian, Shan Ci Gu Pian (Cremastrae Pseudobulbus) 0.4 fen, Nen Gou Tou (Uncariae Ramulus cum Uncis) added later 3 qian, Dan Zhu Li (Bambusae Succus) taken with decoction 1 liang, Zhen Hou Zao (Calculus Martis) and Zhen Zhu Fen (Margarita Pulvis) each 1 fen taken with decoction, Jin Qi (Gold Artifact) boiled in water one piece.
[Case of Infant Zhu] Initially, latent pathogenic factors transformed into heat, consuming Yin fluids, presenting as fever, thirst, and dry, cracked lips. Overuse of cooling medicines injured Spleen Yang, causing clear Qi to sink, resulting in copious clear urination and loose stools. The condition developed into severe slow convulsion (Man Jing). Urgent treatment should warm the Kidney and promote Spleen function.
Prescription: Wei Ge Gen (Puerariae Lobatae Radix prepared with bran) 2 qian, Chao Yu Zhu (Atractylodis Macrocephalae Rhizoma stir-fried) 1.5 qian, Chen Guang Pi (Citri Reticulatae Pericarpium) 1 qian, Bian Dou Yi (Dolichoris Semen Tegumentum) 3 qian, Shu Fu Pian (Aconiti Lateralis Radix Praeparata) 0.8 fen, Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma) 0.5 fen, Jiao Gu Ya (Setariae Fructus Germinatus Carbonized) 3 qian, Pao Jiang Tan (Zingiberis Rhizoma Carbonized) 0.4 fen, Chao Huai Yao (Dioscoreae Rhizoma stir-fried) 3 qian, Gan He Ye (Nelumbinis Folium) one corner.
[Case of Infant Feng] Congenital deficiency combined with acquired weakness; prolonged vomiting and diarrhea led to mental fatigue and internal heat. Dry mouth with little desire to drink, red tongue body, red-purple finger vein with green tint extending past the Qi gate. Vomiting injures the Stomach, diarrhea injures the Spleen, damaging both Spleen Yang and Stomach Yin. Liver Wood overacts on Spleen Earth, described as Yin deficiency generating internal heat and Yang sinking causing undigested stool evacuation (Sun Xie). Gradually entering the realm of slow convulsion, prognosis is poor. Tentatively prescribing Lian Li Tang modified to warm and nourish Spleen and Stomach, suppress Liver and harmonize Middle Jiao, hoping for a turning point.
Prescription: Chao Lu Dang Shen (Codonopsis Radix stir-fried) 1.5 qian, Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma) 0.5 fen, Pao Jiang Tan (Zingiberis Rhizoma Carbonized) 0.3 fen, Jiao Gu Ya (Setariae Fructus Germinatus Carbonized) 3 qian, Chen Mu Gua (Chaenomelis Fructus) 2 qian, Chen Guang Pi (Citri Reticulatae Pericarpium) 1 qian, Yun Fu Ling (Poria) 2 qian, Chuan Ya Lian (Coptidis Rhizoma) 0.3 fen, Chao Yu Zhu (Atractylodis Macrocephalae Rhizoma stir-fried) 1.5 qian, Zao Xin Huang Tu (Caulis Arundinis Centum) 1 liang.
[Case of Ma Zuo] Fear of cold, aversion to chill, generalized bone soreness, stiffness and pain in head and neck, nausea, scanty urine, urgent pulse, thin greasy coating. Simultaneous disease of Taiyang and Yangming meridians. Urgently use Ge Gen Tang to disperse cold pathogens, avoiding lingering illness.
Prescription: Fen Ge Gen (Puerariae Lobatae Radix) 1.5 qian, Yun Ling (Poria) 3 qian, Chao Gu Ya (Setariae Fructus Germinatus stir-fried) 3 qian, Chuan Gui Zhi (Cinnamomi Ramulus) 0.5 fen, Jiang Ban Xia (Pinelliae Rhizoma Preparatum) 3 qian, Chen Pei Lan (Eupatorii Herba) 1.5 qian, Jing Ma Huang (Ephedrae Herba) 0.5 fen, Chen Guang Pi (Citri Reticulatae Pericarpium) 1.5 qian, Chao Xiang Chi (Sojae Semnis Praeparatum stir-fried) 3 qian, Wei Jiang (Zingiberis Rhizoma Recens prepared) two slices.
[Second Visit] After taking Ge Gen Tang yesterday, profuse sweating occurred. Head/neck pain and bone soreness relieved, nausea stopped. Now experiencing body heat, dizziness, dry mouth with desire to drink, wiry-numerous pulse, thin greasy yellow coating, red tongue body. Taiyang pathogen resolved, Yangming heat blazing internally. Fortunately, constitution is strong, preventing prolongation. Now using Gui Zhi Bai Hu Tang to clear Yangming heat and settle residual Taiyang pathogen.
Prescription: Chuan Gui Zhi (Cinnamomi Ramulus) 0.3 fen, Chi Ling (Poria with pink mycelium) 3 qian, Chao Gu Ya (Setariae Fructus Germinatus stir-fried) 3 qian, Sheng Shi Gao (Gypsum Fibrosum) 3 qian, Jiang Zhi Ke (Aurantii Fructus Immaturus) 1.5 qian, Sheng Tou Cao (Agastaches Herba) 1.5 qian, Tian Hua Fen (Trichosanthis Radix) 3 qian, Ku Jie Geng (Platycodonis Radix) 0.8 fen, Chao Zhu Ru (Bambusae Caulis in Taenia stir-fried) 1.5 qian, Gan Lu Gen (Phragmitis Rhizoma) de-jointed 5 qian.
[Case of Fei Zuo] Persistent fever, stiffness and pain in head and neck, opisthotonos, delirium, craving cold drinks, wiry-numerous pulse, thin greasy coating, red tongue. Previous doctors repeatedly used diaphoretic agents, causing excessive sweating. In an elderly patient with pre-existing Qi and Yin deficiency, further sweating depletes Yin. Yin deficiency fails to anchor Yang, leading to disharmony between Yin and Yang. If liver wind stirring and hiccups appear, prognosis is hopeless. Urgently use Gui Zhi Ling Yang Fang, uncertain if it can turn danger to safety.
Prescription: Fen Ge Gen (Puerariae Lobatae Radix) 1.5 qian, Zhu Fu Shen (Poria with Cinnabar) 3 qian, Sheng Shi Jue Ming (Haliotidis Concha) 4 qian, Chuan Gui Zhi (Cinnamomi Ramulus) 0.3 fen, Ling Yang Pian (Capricornis Cornu Slice) 0.5 fen, Xian Shi Chang Pu (Acori Tatarinowii Rhizoma Fresh) 1 qian, Nen Gou Jian (Uncariae Ramulus cum Uncis Tip) 3 qian, Tian Hua Fen (Trichosanthis Radix) 3 qian, Tian Zhu Huang (Bambusae Calamus) 1.5 qian, Xian Zhu Ye (Bambusae Folium Fresh) 30 leaves, Huo Lu Gen (Phragmitis Rhizoma Live) de-jointed one chi.
[Second Visit] Head/neck stiffness and pain reduced, fever slightly subsided, consciousness calm, craving large amounts of water, fine-numerous pulse, greasy coating, red tongue. Yin deficiency below, Yang floating above. Since previous prescription showed efficacy, maintain original intent with modifications.
Prescription: Fen Ge Gen (Puerariae Lobatae Radix) 1.5 qian, Zhu Fu Shen (Poria with Cinnabar) 3 qian, Sheng Shi Jue Ming (Haliotidis Concha) 5 qian, Ling Yang Jiao (Capricornis Cornu) 0.5 fen, Shi Chang Pu (Acori Tatarinowii Rhizoma) 0.8 fen, Nen Gou Jian (Uncariae Ramulus cum Uncis Tip) 3 qian, Tian Hua Fen (Trichosanthis Radix) 3 qian, Tian Zhu Huang (Bambusae Calamus) 1.5 qian, Chuan Bei Mu (Fritillariae Cirrhosae Bulbus) 3 qian, Xian Zhu Ye (Bambusae Folium Fresh) 30 leaves, Zhu Deng Xin (Junci Medulla with Cinnabar) two bundles.
[Third Visit] Consciousness cleared, head/neck stiffness and pain ceased, mental fatigue with desire to sleep, poor appetite, soggy-fine pulse, thin greasy coating. Danger passed, safe from worry. Continue with clearing and nourishing agents for recovery.
Prescription: Dong Sang Ye (Mori Folium) 3 qian, Zhu Fu Shen (Poria with Cinnabar) 3 qian, Sheng Gu Ya (Setariae Fructus Germinatus) 3 qian, Gan Ju Hua (Chrysanthemi Flos) 3 qian, Chuan Bei Mu (Fritillariae Cirrhosae Bulbus) 3 qian, Xiang Pei Lan (Eupatorii Herba) 1.5 qian, Sheng Shi Jue Ming (Haliotidis Concha) 3 qian, Tian Hua Fen (Trichosanthis Radix) 3 qian, Sheng Zhu Ru (Bambusae Caulis in Taenia) 1.5 qian, Nen Gou Jian (Uncariae Ramulus cum Uncis Tip) added later 3 qian, Xian Zhu Ye (Bambusae Folium Fresh) 30 leaves.