丸煎。加黄 、赤石脂、麦冬、玉竹。接服两剂。而泻利已减去十之六七。头晕心悸亦平矣
。再服数日全愈。夫参、 、熟地。为泻痢病最忌之药。盖补滞之品能闭塞肠胃中之病毒致
人于危。而此独以补药奏功者。虚实异宜也。然亦惟纯虚无滞者。始可纯补。否则又当别论
矣。
路某病痢年余。日夜数次。手指清冷。脉息小弱。饮食起居如常。与理中汤加黄 、
木香、浓朴、白芍。服两剂。痢即止。接服数剂全愈。
完某子三岁。病后泄泻汗多。口干不欲饮茶。体瘦神疲。咳嗽有痰。小便清。舌色淡。纯属
虚象。用四君子汤合生脉散。加黄 、花粉。服后汗止泻减。但咳嗽多痰。原方以花粉易贝
母。接服两剂而安。
王姓妇年五十余。夏间陡患泄泻。暴注下迫。一日夜二十余次。发热
口渴。胸闷腹痛。舌苔黄腻。脉数溲热。盖暑湿蕴伏。肠胃中兼有宿滞。火性急速。故暴注
下迫也。病者闻之叹曰。真名医也。今年家中因财政困难。故将楼下房屋。赁租与人。自居
楼上。讵知亢热非常。自知受暑云云。遂用黄芩汤加连翘、苡仁、六一散、佩兰、枳壳。一
剂热退利减。二剂全愈。
壬子四月。张兆魁君患温病。头痛发热胸闷。舌苔淡黄腻。与小
茈胡合小陷胸汤。去人参。加浓朴。服后热退闷松。至夜间觉烦懑不适。鼻衄如注。次日清
晨。速予往诊。血仍未止。诊其脉缓滑不数。扪其身凉如平人。问其苦则但觉心中烧热而已
。遂易方用干生地五钱。阿胶五钱。麦冬、牛膝、贝母各三钱。茅根五钱。黄芩二钱。梨汁
一小钟和服。覆杯而愈。此四月十三日事也。至五月初二日。张君又病。咳嗽呕吐。潮热胸
闷，胁痛。舌苔薄腻。脉滑不数。盖天气骤热。湿秽逼人。而又兼有恼怒郁闷之事。遂酿成
湿温而兼胃病也。初用小陷胸汤加茈胡、橙皮、佛手。接服两剂。不见功效。而呕吐益甚。
遂改用旋复代赭汤去人参。加茈胡、黄芩、黄连、青蒿、六一散、苡仁。服后呕吐少平。遂
仍用原
方。明日午后复诊。则病患方战栗恶寒。浓被覆之。犹觉畏冷。旋即发热。予谓恐将作战汗
。否则病将转疟而退也。因仍以原方减轻其剂。至晚间八时。其仆复来延诊。述现下出汗不
止
。两手俱冷。举家惶恐。诊之。脉息虚缓有根。惟神气疲惫。懒于言动。问其苦。则曰。心
内慌慌不宁。盖战汗后元气大虚。能放而不能收也。当以药力助之。用潞党参四钱。生黄
四钱。枸杞子四钱。炒枣仁四钱。朱拌茯神四钱。甘草一钱。红枣五枚。立遣其仆购药。急
煎与服。并力戒其家。不可慌乱偾事。服后汗止神安。酣睡一夜。明日复往诊视。则病患方
坐而食粥。言语几如平人。仍以原方减轻其剂。数日后。张君偕其弟小芬君来予寓诊病。则
全愈矣。
张华亭子十五岁。癸丑夏间卧病。服药五剂弗效。延予诊之。病患常觉心内烦杂
不安。数日未能眠。大便泄泻咳嗽。咳则右胁作痛。身热。舌边红。苔薄白。舌动则现裂
痕
。小便黄浊。精神疲倦。脉息 数。阅前服方。则槟榔、枳实、黄连、栝蒌、薤白、生地、
薄
荷、桑叶等。盖克削过甚。胃津耗竭。湿热未清。而脑力复受损也。拟方用北沙参二钱。百
合四钱。枣仁、朱拌茯神各四钱。苡仁三钱。青蒿三钱。佩兰一钱五分。杏仁二钱。枇杷叶
一片。朱染灯草二尺。作煎剂。服后安睡两小时。心烦定。自觉爽快多矣。大便亦不泄泻。
食锅巴糕数片。身热亦轻。脉转缓滑。原方去佩兰、杏仁。加鲜石斛三钱。贝母一钱。枸杞
子二钱。茅根三钱。接服两剂而痊。
戴姓子甫周岁。壬子夏间。泄泻发热。延幼科治之。服药三四日。病益剧。延予诊之。则已
喘促不安。目上视。手足抽搐。作舞蹈状。舌光红无苔。面色惨淡。头微热。手足微冷。身
不热。胸博觉饱满。倏喘倏搐。搐则目上视。无片刻安宁。口渴。与以茶则少安。顷刻又喘
又搐上视矣。病甚危险。予见其母衣孝服而哭甚哀。盖其父殁才一月也。为之恻然。遂勉力
治
之。用四君子汤。党参二钱。白术一钱五分。茯苓一钱。甘草五分。加干地黄三钱。朱拌茯
神三钱。扁豆三钱。木香八分。作煎剂。盖以泄泻多日。胃气已虚。而舌光无苔。气喘手冷
。又为阴阳两虚之证。其手足抽搐而目上视者。则筋无液养。而现脑筋症状。昔人所谓痉病
是也。姑以此方救其元气。养其阴液。非能必其活也。讵次日清晨。病家遣人来告。谓此药
服后。即能安眠。喘痉俱止。至夜间两句钟时。解大便一次。胸满遂平。惟神气疲弱。仍以
原方加枸杞子二钱。麦冬一钱。山药三钱。并令以乳与饮。及以米粥与食。如此调养数日后
始痊。
潘锦文子两岁。泻利数日。经幼科医治之无效。遂延予治。手冷汗多。精神疲惫。时作嗳气
。舌苔薄腻。脉息 滑。此暑湿痰滞之病。治不得法。而胃气受伤也。宜先固正气。用理中
汤。党参、白术各二钱。干姜五分。加黄 八分。木香五分。服后汗渐少。手转温。接服一
剂。汗全止。但泄泻发热。口渴欲饮。入暮热甚。舌苔转为黄腻。遂易方用青蒿二钱。黄芩
、佩兰、桔梗各一钱。枳壳一钱五分。苡仁三钱。滑石二钱。花粉一钱。接服两剂。渴稍平
。泄泻止。惟夜仍发热。舌苔浓腻而黄。舌尖红。目睛黄。小便清。盖湿热痰滞蕴结上焦。
病在上而不在下也。仍宜清轻开化。遂易方用旋复花五分。石菖蒲三分。苡仁三钱。桔梗八
分。枳壳一钱五分。茵陈一钱五分。连翘二钱。茯苓、六一散各二钱。茅根四钱。服后热较
轻。舌苔亦退。二便通利。乃于方中去菖蒲、旋复、茯苓、六一散。加山栀、贝母、青蒿露
、丝瓜络、沙参、枇杷叶。接服两剂。热全退。遂改用沙参、麦冬、百合、花粉、茅根、扁
豆、苡仁、茵陈、石斛等药。三日而安。凡小儿之病。易虚易实。此病本由暑湿乳滞蕴结上
中二焦。致泄泻发热。徒以幼科医家。不知此理。犯叶天士之戒。妄以山楂、神曲、黄芩、
防风、葛根、枳实等消导升散之剂。致胃气受伤。故现汗多手冷。得理中汤而胃气回冷汗止
。然病究未去。故复转热渴而舌上现黄浓苔。得清轻开化之药。则病去而热退。步骤井然。
不可稍差铢黍。其舌苔转黄浓。与热渴大作者。实理中汤有以促成之。然非舌苔黄浓。既
热且渴。则清化之品亦胡可浪投。相违适相成也。又小儿之病。幼科多严禁乳食。不知乳食
过饱固足增病。而过饥亦能伤胃。此病当热渴苔浓之时。则暂禁乳食。热轻苔退。及出冷汗
之时。则渐与乳饮。但勿使其过饱耳。饮食起居为看护病患之紧要关键。小儿为尤要焉。盖
襁褓之儿。饥饱皆不能自言。医家病家。尤宜体贴周至也。
丸剂或煎剂。加入黄芪、赤石脂、麦冬、玉竹。接续服用两剂后，腹泻痢疾症状已减轻十分之六七。头晕和心悸也平复了。再服用数日便完全痊愈。人参、黄芪、熟地黄，本是治疗泻痢病最忌讳的药物。因为补益且滋腻的药物能够闭塞肠胃中的病邪病毒，导致人陷入危险境地。而此例却依靠补药取得功效，这是因为虚实证候适宜不同所致。然而也只有纯粹是虚证而没有积滞的患者，才可以单纯使用补法；否则又应当另外讨论。
路某患痢疾一年多，日夜发作数次，手指清冷，脉象细小虚弱，但饮食起居如常。给予理中汤加黄芪、木香、厚朴、白芍。服用两剂后，痢疾即止。接续服用数剂后完全痊愈。
完某的儿子三岁，病后泄泻且出汗多，口干但不想喝茶，身体消瘦精神疲倦，咳嗽有痰，小便清长，舌色淡，纯属虚象。使用四君子汤合生脉散，加黄芪、天花粉。服用后汗止泻减，但咳嗽多痰，原方用天花粉替换贝母，接续服用两剂后病情安定。
王某的妻子五十多岁，夏天突然患泄泻，急骤如水注下迫，一天一夜二十多次，发热口渴，胸闷腹痛，舌苔黄腻，脉数且小便热。这是暑湿蕴伏，肠胃中兼有宿食积滞，火性急速，所以出现暴注下迫的症状。病人听后感叹说：“真是名医啊！今年家中因财政困难，将楼下房屋租给别人住，自己住在楼上。哪知酷热非常，自知受了暑气。”于是用黄芩汤加连翘、薏苡仁、六一散、佩兰、枳壳。一剂后热退利减，二剂后完全痊愈。
壬子年四月，张兆魁先生患温病，头痛发热胸闷，舌苔淡黄腻，给予小柴胡汤合小陷胸汤，去人参，加厚朴。服用后热退闷松，到夜间觉得烦闷不适，鼻出血如注。次日清晨，急忙请我去诊治，血仍未止。诊其脉缓滑不数，摸其身凉如常人，问其痛苦则只觉心中烧热而已。于是换方用干生地五钱，阿胶五钱，麦冬、牛膝、贝母各三钱，白茅根五钱，黄芩二钱，梨汁一小钟调和服用，喝完一杯就痊愈了。这是四月十三日的事。到了五月初二日，张先生又病了，咳嗽呕吐，潮热胸闷，胁痛，舌苔薄腻，脉滑不数。盖因天气骤热，湿秽逼人，而又兼有恼怒郁闷之事，遂酿成湿温兼胃病。初用小陷胸汤加柴胡、陈皮、佛手，接续服用两剂，不见功效，而呕吐更严重。于是改用旋覆代赭汤去人参，加柴胡、黄芩、黄连、青蒿、六一散、薏苡仁。服用后呕吐稍平，于是仍用原方。第二天午后复诊，病患正战栗恶寒，用厚被子覆盖，仍觉得畏冷，随即发热。我说是将要发生战汗，否则病将转为疟疾而退。因此仍以原方减轻剂量。到晚间八时，他的仆人又来请诊，述说现在出汗不止，两手都冷，全家惶恐。诊之，脉息虚缓有根，只是神气疲惫，懒于言语动作，问其痛苦，则说心里慌慌不宁。这是战汗后元气大虚，能发散而不能收敛。应当以药力帮助它，用潞党参四钱，生黄芪四钱，枸杞子四钱，炒枣仁四钱，朱砂拌茯神四钱，甘草一钱，红枣五枚。立即派遣仆人购药，急煎服用，并极力告诫其家人，不可慌乱误事。服用后汗止神安，酣睡一夜。第二天再去诊视，则病患正坐着喝粥，言语几乎如常人。仍以原方减轻剂量。数日后，张先生偕同他弟弟小芬先生来我的寓所诊病，则完全痊愈了。
张华亭的儿子十五岁，癸丑年夏天卧病，服药五剂无效，延请我诊治。病患常觉心内烦杂不安，数日未能睡眠，大便泄泻咳嗽，咳则右胁作痛，身热，舌边红，苔薄白，舌头动则现裂痕，小便黄浊，精神疲倦，脉象数。看前服用的方子，则是槟榔、枳实、黄连、瓜蒌、薤白、生地、薄荷、桑叶等。这是因为攻伐削损太过，胃津耗竭，湿热未清，而脑力又受损。拟定方子用北沙参二钱，百合四钱，枣仁、朱拌茯神各四钱，薏苡仁三钱，青蒿三钱，佩兰一钱五分，杏仁二钱，枇杷叶一片，朱染灯草二尺，作煎剂。服用后安睡两小时，心烦定，自觉爽快多了。大便也不泄泻，吃了几片锅巴糕，身热也轻，脉转缓滑。原方去佩兰、杏仁，加鲜石斛三钱，贝母一钱，枸杞子二钱，茅根三钱。接续服用两剂而痊愈。
戴姓之子刚满周岁，壬子年夏天，泄泻发热，延请儿科医生治疗，服药三四天，病情加重，延请我诊治，则已经喘促不安，眼睛上视，手足抽搐，呈舞蹈状，舌光红无苔，面色惨淡，头微热，手足微冷，身不热，胸部觉得饱满，忽而喘促忽而抽搐，抽搐时眼睛上视，没有片刻安宁，口渴，给茶则稍安，顷刻又喘又搐上视。病情很危险，我看见他母亲穿着孝服哭得很哀伤，原来他父亲去世才一个月。为此感到悲伤，于是尽力治疗。用四君子汤，党参二钱，白术一钱五分，茯苓一钱，甘草五分，加干地黄三钱，朱拌茯神三钱，扁豆三钱，木香八分，作煎剂。因为泄泻多天，胃气已虚，而舌光无苔，气喘手冷，又是阴阳两虚的证候。其手足抽搐而眼睛上视的，则是筋脉无津液滋养，而出现脑神经症状，古人所说的痉病就是这种情况。姑且以此方挽救其元气，滋养其阴液，不能保证一定活下来。没想到次日清晨，病家派人来告知，说这药服用后，就能安眠，喘痉都停止。到夜间两点钟时，解大便一次，胸满遂平，只是神气疲弱，仍以原方加枸杞子二钱，麦冬一钱，山药三钱，并令以乳汁喂饮，以及米粥喂食。如此调养数日后才痊愈。
潘锦文的儿子两岁，泄泻数天，经儿科医生医治无效，于是延请我治疗，手冷汗多，精神疲惫，时常打嗝，舌苔薄腻，脉象滑。这是暑湿痰滞的病，治不得法，而胃气受伤。应当先固护正气，用理中汤，党参、白术各二钱，干姜五分，加黄芪八分，木香五分。服用后汗渐少，手转温，接续服用一剂，汗全止，但泄泻发热，口渴欲饮，入夜热甚，舌苔转为黄腻。于是换方用青蒿二钱，黄芩、佩兰、桔梗各一钱，枳壳一钱五分，薏苡仁三钱，滑石二钱，天花粉一钱。接续服用两剂，渴稍平，泄泻止，惟夜晚仍发热，舌苔浓腻而黄，舌尖红，目睛黄，小便清。这是湿热痰滞蕴结上焦，病在上而不在下。仍宜清轻开化，于是换方用旋覆花五分，石菖蒲三分，薏苡仁三钱，桔梗八分，枳壳一钱五分，茵陈一钱五分，连翘二钱，茯苓、六一散各二钱，茅根四钱。服用后热较轻，舌苔亦退，二便通利，乃于方中去菖蒲、旋复、茯苓、六一散，加山栀、贝母、青蒿露、丝瓜络、沙参、枇杷叶。接续服用两剂，热全退，遂改用沙参、麦冬、百合、花粉、茅根、扁豆、薏苡仁、茵陈、石斛等药，三日而安。凡是小儿的疾病，易虚易实，此病本由暑湿乳滞蕴结上中二焦，致泄泻发热，徒然因为儿科医生不知此理，犯了叶天士的戒律，妄用山楂、神曲、黄芩、防风、葛根、枳实等消导升散之剂，致胃气受伤，故现汗多手冷，得理中汤而胃气回冷汗止。然而病终究未去，故复转热渴而舌上现黄浓苔，得清轻开化之药，则病去而热退，步骤井然，不可稍有差错。其舌苔转黄浓，与热渴大作的，实在是理中汤有促成作用。然而若非舌苔黄浓，既热且渴，则清化之品也不可乱投，相违适相成也。又小儿的疾病，儿科医生多严禁乳食，不知乳食过饱固然足以增加疾病，而过饥也能伤胃。此病当热渴苔浓之时，则暂禁乳食，热轻苔退，及出冷汗之时，则渐给乳饮，只要不使其过饱即可。饮食起居为看护病患的重要关键，小儿尤其重要。因为襁褓中的婴儿，饥饱都不能自己说，医家和病家，尤其应该体贴周到。
Pills or decoctions. Added Huangqi (Astragali Radix), Chishizhi (Halloysit Rubrum), Maidong (Ophiopogonis Radix), and Yuzhu (Polygonati Odorati Rhizoma). Continued administration for two doses. Diarrhea and dysentery reduced by six or seven tenths. Dizziness and palpitations also subsided. After several more days of administration, complete recovery was achieved. Ginseng, Huangqi (Astragali Radix), and Shudihuang (Rehmanniae Radix Preparata) are the most contraindicated medicines for treating diarrhea and dysentery. This is because tonifying and cloying substances can obstruct viral pathogens in the intestines and stomach, leading to critical danger. However, in this case, tonifying medicine alone achieved success due to the difference in deficiency and excess patterns. Nevertheless, only when there is pure deficiency without stagnation can pure tonification be used; otherwise, a different approach must be considered.
Mr. Lu suffered from dysentery for over a year, occurring several times day and night. His fingers were cold and clammy, and his pulse was fine and weak. His diet and daily activities remained normal. He was prescribed Lizhong Tang (Regulate the Middle Decoction) with added Huangqi (Astragali Radix), Muxiang (Aucklandiae Radix), Houpo (Magnoliae Officinalis Cortex), and Baishao (Paeoniae Radix Alba). After two doses, the dysentery stopped immediately. Continuing for several more doses led to full recovery.
The three-year-old son of Mr. Wan suffered from post-illness diarrhea with excessive sweating. He had a dry mouth but no desire to drink tea. He was emaciated and fatigued, with cough and phlegm. His urination was clear, and his tongue was pale, indicating a purely deficient pattern. Si Jun Zi Tang (Four Gentlemen Decoction) combined with Sheng Mai San (Generate the Pulse Powder) was used, with added Huangqi (Astragali Radix) and Huafen (Trichosanthis Radix). After administration, sweating ceased and diarrhea decreased. However, he still had much cough and phlegm. In the original formula, Huafen (Trichosanthis Radix) replaced Beimu (Fritillariae Bulbus). After two more doses, he stabilized.
Mrs. Wang, over fifty years old, suddenly developed diarrhea in summer. It presented as sudden, urgent, and profuse watery stools, occurring more than twenty times in a day and night. She had fever, thirst, chest oppression, and abdominal pain. Her tongue coating was yellow and greasy, her pulse rapid, and her urination hot. This indicated summerheat-dampness lying latent, with old food stagnation in the intestines and stomach. The nature of fire is swift and urgent, hence the sudden, urgent, and profuse stools. The patient sighed upon hearing this, saying, "Truly a famous doctor." She explained that due to financial difficulties this year, she rented out the ground floor and lived upstairs. Unaware of the extreme heat, she realized she had contracted summerheat. Thus, Huangqin Tang (Scutellaria Decoction) was prescribed with added Lianqiao (Forsythiae Fructus), Yiyiren (Coicis Semen), Liuyi San (Six-to-One Powder), Peilan (Eupatorii Herba), and Zhike (Aurantii Fructus Immaturus). After one dose, fever subsided and diarrhea decreased. After two doses, complete recovery occurred.
In the fourth month of the Renzi year, Mr. Zhang Zhaokui suffered from warm disease. Symptoms included headache, fever, and chest oppression. The tongue coating was pale yellow and greasy. Xiao Chaihu Tang (Minor Bupleurum Decoction) combined with Xiao Xianxiong Tang (Minor Sinking Chest Decoction) was given, removing Renshen (Ginseng Radix et Rhizoma) and adding Houpo (Magnoliae Officinalis Cortex). After administration, fever subsided and oppression relieved. At night, he felt irritable and uncomfortable, followed by severe epistaxis. Early the next morning, I was summoned urgently. Bleeding had not stopped. His pulse was slow, slippery, and not rapid. His body felt cool, like a healthy person. When asked about discomfort, he reported only a burning sensation in the heart. The prescription was changed to Gan Shengdi (Prepared Rehmanniae Radix) 5 qian, Ejiao (Donkey-hide Glue) 5 qian, Maidong (Ophiopogonis Radix), Niuxi (Achyranthis Bidentatae Radix), and Beimu (Fritillariae Bulbus) each 3 qian, Baigen (Imperatae Rhizoma) 5 qian, Huangqin (Scutellariae Radix) 2 qian, mixed with a small cup of Pear Juice. Recovery occurred after finishing one cup. This event took place on April 13th. On May 2nd, Mr. Zhang fell ill again with cough, vomiting, tidal fever, chest oppression, and hypochondriac pain. The tongue coating was thin and greasy, and the pulse was slippery but not rapid. This was caused by sudden weather heating up, oppressive dampness, and emotional anger/depression, resulting in damp-warmth complicated by stomach disease. Initially, Xiao Xianxiong Tang (Minor Sinking Chest Decoction) with added Chaihu (Bupleuri Radix), Chenpi (Citri Reticulatae Pericarpium), and Foshou (Citri Sarcodactylis Fructus) was used. After two doses, there was no effect, and vomiting worsened. Therefore, Xuanshen Daizhe Tang (Inula and Hematite Decoction) was substituted, removing Renshen (Ginseng Radix et Rhizoma) and adding Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Qinghao (Artemisiae Annuae Herba), Liuyi San (Six-to-One Powder), and Yiyiren (Coicis Semen). Vomiting slightly subsided after administration, so the original formula was continued. During the afternoon follow-up, the patient was shivering and aversive to cold, feeling cold even under thick blankets, followed by fever. I suspected impending "battle sweat" (Zhan Han); otherwise, the disease might transform into malaria and recede. Thus, the original formula was administered at a reduced dose. At 8 PM, the servant returned, reporting continuous sweating and cold hands. The family was panicked. His pulse was deficient, slow, and rooted. He appeared spiritually exhausted and reluctant to speak or move. He complained of inner restlessness. This indicated massive deficiency of primal qi after battle sweat, where dispersion occurred but consolidation failed. Medicinal support was needed: Ludangshen (Codonopsis Radix) 4 qian, Sheng Huangqi (Raw Astragali Radix) 4 qian, Gouqizi (Lycii Fructus) 4 qian, Chao Zaoren (Stir-fried Ziziphi Spinosae Semen) 4 qian, Zhusha Ban Fushen (Vermilion-coated Poria with Stimulating Effect) 4 qian, Gancao (Glycyrrhizae Radix et Rhizoma) 1 qian, and Hongzao (Jujubae Fructus) 5 pieces. The servant was sent immediately to buy and decoct the herbs. I strictly warned the family against panic and mishandling. After administration, sweating stopped, spirit calmed, and he slept soundly. The next day, he was sitting eating porridge, speaking almost normally. The original formula was continued at a reduced dose. Several days later, Mr. Zhang and his brother Mr. Xiaofen visited my residence for further consultation, fully recovered.
The fifteen-year-old son of Zhang Huating lay ill in summer during the Guichou year. Five doses of medication had been ineffective. Upon my examination, the patient often felt inner irritability and unrest, unable to sleep for several days. He had diarrhea and cough, with right hypochondriac pain upon coughing. He had fever, red tongue edges, thin white coating, and cracks appearing when the tongue moved. Urine was yellow and turbid. Spirit was fatigued, and the pulse was rapid. Reviewing previous prescriptions revealed Binglang (Arecae Semen), Zhishi (Aurantii Fructus Immaturus), Huanglian (Coptidis Rhizoma), Gualou (Trichosanthis Fructus), Xiebai (Allii Macrostemonis Bulbus), Shengdi (Rehmanniae Radix), Bohe (Menthae Haplocalycis Herba), Sangye (Mori Folium), etc. This indicated excessive attacking and damaging, exhausting stomach fluids, clearing insufficient damp-heat, and damaging mental energy. The proposed formula used Beishashen (Glehniae Radix) 2 qian, Baihe (Lilii Bulbus) 4 qian, Zaoren (Ziziphi Spinosae Semen) and Zhusha Ban Fushen (Vermilion-coated Poria with Stimulating Effect) each 4 qian, Yiyiren (Coicis Semen) 3 qian, Qinghao (Artemisiae Annuae Herba) 3 qian, Peilan (Eupatorii Herba) 1.5 qian, Xingren (Pruni Semen) 2 qian, Pipaye (Eriobotryae Folium) one piece, and Zhuran Dengcao (Vermilion-stained Juncus Effusus) 2 chi, prepared as a decoction. After administration, he slept peacefully for two hours, irritability settled, and he felt much refreshed. Diarrhea stopped, he ate a few pieces of scorched rice cake, fever lightened, and the pulse became slow and slippery. Peilan (Eupatorii Herba) and Xingren (Pruni Semen) were removed from the original formula, adding Xian Shihu (Fresh Dendrobii Caulis) 3 qian, Beimu (Fritillariae Bulbus) 1 qian, Gouqizi (Lycii Fructus) 2 qian, and Maogen (Imperatae Rhizoma) 3 qian. After two more doses, he recovered.
The son of the Dai family, just one year old, suffered from diarrhea and fever in summer during the Renzi year. Pediatric treatment for three to four days worsened the condition. Upon my examination, he was panting uneasily, eyes rolling upward, and limbs convulsing in a dancing manner. The tongue was bare and red, complexion pale, head slightly hot, hands and feet slightly cold, body temperature normal, and chest felt full. He alternated between panting and convulsing, with eyes rolling upward during convulsions, having no peace. He was thirsty; tea provided slight relief, but soon panting and convulsions resumed. The condition was critical. Seeing his mother wearing mourning clothes and crying bitterly (her husband had died only a month prior), I felt compassion and attempted treatment. Si Jun Zi Tang (Four Gentlemen Decoction) was used: Dangshen (Codonopsis Radix) 2 qian, Baizhu (Atractylodis Macrocephalae Rhizoma) 1.5 qian, Fuling (Poria) 1 qian, Gancao (Glycyrrhizae Radix et Rhizoma) 0.5 qian, plus Gan Dihuang (Prepared Rehmanniae Radix) 3 qian, Zhusha Ban Fushen (Vermilion-coated Poria with Stimulating Effect) 3 qian, Bidou (Dolichoris Semen) 3 qian, and Muxiang (Aucklandiae Radix) 0.8 fen, prepared as a decoction. Since diarrhea had persisted for many days, stomach qi was deficient. The bare red tongue, panting, and cold hands indicated dual deficiency of yin and yang. The limb convulsions and upward eye gaze indicated tendons lacking fluid nourishment, presenting neurological symptoms known as Jing Bing (Spasm Disease). This formula aimed to save primal qi and nourish yin fluids, though survival was not guaranteed. Unexpectedly, the next morning, the family reported that after taking the medicine, he slept peacefully, and panting/spasms stopped. At 2 AM, he passed stool once, relieving chest fullness. He remained spiritually weak. The original formula was continued with added Gouqizi (Lycii Fructus) 2 qian, Maidong (Ophiopogonis Radix) 1 qian, and Shanyao (Dioscoreae Rhizoma) 3 qian. Milk and rice porridge were administered. After several days of such care, he recovered.
The two-year-old son of Pan Jinwen suffered from diarrhea for several days. Pediatric treatment was ineffective. Upon my examination, he had cold clammy hands, excessive sweating, spiritual fatigue, and occasional belching. The tongue coating was thin and greasy, and the pulse was slippery. This was summerheat-dampness-phlegm stagnation, treated improperly, injuring stomach qi. First, righteous qi should be consolidated using Lizhong Tang (Regulate the Middle Decoction): Dangshen (Codonopsis Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma) each 2 qian, Ganjiang (Zingiberis Rhizoma) 0.5 fen, plus Huangqi (Astragali Radix) 0.8 fen, and Muxiang (Aucklandiae Radix) 0.5 fen. After administration, sweating gradually decreased, and hands warmed. After one more dose, sweating stopped completely. However, diarrhea, fever, and thirst persisted, worsening at night. The tongue coating turned yellow and greasy. The prescription was changed to Qinghao (Artemisiae Annuae Herba) 2 qian, Huangqin (Scutellariae Radix), Peilan (Eupatorii Herba), and Jiegeng (Platycodonis Radix) each 1 qian, Zhike (Aurantii Fructus Immaturus) 1.5 qian, Yiyiren (Coicis Semen) 3 qian, Huashi (Talcum) 2 qian, and Huafen (Trichosanthis Radix) 1 qian. After two doses, thirst slightly subsided, and diarrhea stopped. Night fever persisted. Tongue coating was thick, greasy, and yellow; tongue tip red; sclera yellow; urine clear. This indicated damp-heat-phlegm stagnation accumulating in the upper jiao, with pathology located above rather than below. Clearing and transforming methods using light substances were appropriate. The prescription was changed to Xuanfuhua (Inulae Flos) 0.5 fen, Shichangpu (Acori Tatarinowii Rhizoma) 0.3 fen, Yiyiren (Coicis Semen) 3 qian, Jiegeng (Platycodonis Radix) 0.8 fen, Zhike (Aurantii Fructus Immaturus) 1.5 qian, Yinchen (Artemisiae Scopariae Herba) 1.5 qian, Lianqiao (Forsythiae Fructus) 2 qian, Fuling (Poria) and Liuyi San (Six-to-One Powder) each 2 qian, and Maogen (Imperatae Rhizoma) 4 qian. Fever lightened, tongue coating retreated, and bowel/bladder movements normalized. Shichangpu (Acori Tatarinowii Rhizoma), Xuanfuhua (Inulae Flos), Fuling (Poria), and Liuyi San (Six-to-One Powder) were removed. Shanzi (Gardeniae Fructus), Beimu (Fritillariae Bulbus), Qinghao Lu (Qinghao Distillate), Sigualuo (Luffae Fructus Retinervus), Shashen (Glehniae Radix or Adenophorae Radix), and Pipaye (Eriobotryae Folium) were added. After two doses, fever completely subsided. Subsequently, Shashen (Glehniae Radix or Adenophorae Radix), Maidong (Ophiopogonis Radix), Baihe (Lilii Bulbus), Huafen (Trichosanthis Radix), Maogen (Imperatae Rhizoma), Bian Dou (Dolichoris Semen), Yiyiren (Coicis Semen), Yinchen (Artemisiae Scopariae Herba), and Shihu (Dendrobii Caulis) were used. Recovery occurred in three days. Pediatric diseases are prone to deficiency and excess. This illness originated from summerheat-dampness and milk stagnation accumulating in the upper and middle jiao, causing diarrhea and fever. Due to pediatricians' ignorance of this principle, violating Ye Tianshi's warnings, they recklessly used digestive and ascending-dispersing agents like Shanzha (Crataegi Fructus), Shenqu (Massa Medicata Fermentata), Huangqin (Scutellariae Radix), Fangfeng (Saposhnikoviae Radix), Gegen (Puerariae Lobatae Radix), and Zhishi (Aurantii Fructus Immaturus), injuring stomach qi. Hence, excessive sweating and cold hands appeared. Lizhong Tang (Regulate the Middle Decoction) restored stomach qi, stopping cold sweating. However, the pathogen remained, leading to recurrent fever/thirst and thick yellow tongue coating. Clearing and transforming agents removed the pathogen and fever. The steps were orderly, allowing no error. The thick yellow coating and intense fever/thirst were actually facilitated by Lizhong Tang (Regulate the Middle Decoction). However, without thick yellow coating, fever, and thirst, clearing agents should not be thrown around indiscriminately. Opposition and complementarity work together. Furthermore, pediatricians often strictly forbid milk and food for children. They do not know that while overeating increases disease, hunger also damages the stomach. During the phase of fever, thirst, and thick coating, milk and food should be temporarily forbidden. As fever lightens and coating retreats, and especially during cold sweating, milk and drinks should be gradually introduced, avoiding overfeeding. Diet and起居 (daily routine) are crucial keys in nursing patients, especially for children who cannot express hunger or satiety. Doctors and families must be considerate and thorough.