镇江蒋鹤龄中医师，寓于贵州路镛寿里，夫妇年近五旬，只庶出一子，爱逾拱璧。时年8岁，在小学二年级读书，身体素壮，活泼而顽皮，课外活动，更不逮言，故素平不易致病也。在端阳佳节之次日晨，以包车送至学校，尚无丝毫病象，至十一时，校方以电话通知蒋医师云，其子发热头痛，速来包车接回。蒋即自乘车往，抱之而归。自己诊察后，即投解表退热之剂，不效。再服二煎，仍不效。延至下午四时许，热度更高，头痛神糊，而又时或烦躁。至此时期，忽发急惊之状，如上文所述。
一家惊惶失色，延余诊之。蒋即问余曰：“此时脑膜炎颇有流行，吾子得非是证耶。”时余年才三十，见其身体颇壮，知为健啖之儿童，且为独子，平时杂食必多。因按其脘腹，则儿知拒按，膨满而硬实。询其日来所食何物，据蒋师母告余，谓“因节在端阳，三日前已食角黍(即棕子)。早晨及下午，皆以角黍为点心，中午及晚餐，皆有鱼肉鸡鸭及火腿等等。因其素来健啖，故未之禁。即今晨上学时，尚食角黍两大枚，一小枚，其他枇杷、荔枝，更无论矣。中午前车接归来，下午即病变如此，先生其救我爱儿。”余闻其言，知为食积胃脘，腑气不通。不通则闭，闭则酿生内热，循经反射于脑，因而致痉。若不急攻其胃家实，则痉必不止而殆矣。因思《金匮》痉病篇，有以大承气汤治阳明痉病之法，今可师仲景之法以治之。因拟硝黄蒌葛汤，令其速服无疑。
蒋从余言，立令配方灌之。讵初灌之时，吐出痰涎颇多，夹以少量不消化之食物。稍停再灌，缓缓灌至二十分钟，始将头煎灌下。后不二小时，大便即解，如胶如酱，此时痉象已减。再隔半小时，又解一次，于是神识清醒，痉象全无矣。次日再延复诊，全家称谢至再至三。又将前方减量，加和胃及清热之品，两帖而安。
硝黄蒌葛汤方生大黄三钱元明粉四钱(分冲)炒枳壳三钱全瓜蒌四钱粉葛根三钱生黄芩三钱焦楂肉四钱莱菔子三钱鲜竹叶三十片妇人惊恐痉病妇人气郁，中心窒闷，神思别有所注。忽惊喇叭震耳之声，大惊走避，热汗满身，心悸肉明。迨惊定汗收，即觉头昏脑胀，渐至恶寒发热。次日即热甚谵语，烦躁不安，反复颠倒，口干欲饮，齿垢唇焦，舌色紫绛，两目均红。再次日则忽发痉象。与以白虎合泻心汤加葛根、瓜萎、远志、石菖蒲，一剂而得汗得下，谵祛痉除。再剂而热退神清，烦停渴止。终以凉膈散合增液法，两剂而痊。
有刘守书者，充电车公司查票员，生活小康，时而深夜迟归。其妻王氏，疑其别有金屋也，每（目间）良人之所之，然终无所获。而刘已知之，亦不向其道破。一日，其妻知下班时间，刘必随车归公司，乃往公司前门较远之道旁候之。但候之颇久，心急意烦。当此心思别有专注之时，一切声息，均不入其耳鼓矣。于途旁踱来踱去，低首而思。有另一汽车飞来，胎轮声响，而彼不之觉也。迨车将飞至，司机者见途旁不让，诚恐招祸，立按起喇叭。王氏忽惊此声，仓惶逃避至路旁。道上之汽车，已一掠而过，犹闻汽车司机工友之詈骂声也。
王氏无奈，只得返家。沿途犹心跳不已，抵家后饮涕啜泣。无何，即恶寒发热，头重脑胀。至次日，即转烦躁不安，反复颠倒，神糊谵语，如见鬼神，不得一刻宁。口干齿垢，而唇焦脱皮，大渴欲饮，而舌色紫绛，两目红如中酒，目睛转动呆滞。如此情形，似应延医治之矣。然妻则恨不延医，夫亦忿而不理。再至第三日，则热极上冲于脑，忽发痉象，头项强直，手足拘挛，牙关亦紧，两目上耸。症至此时，其夫始延余治。
余既得其病之前情，迨诊察之后，断为由惊惧而皮毛开，由皮毛开而风邪入，由风邪入而寒热起，而迅至化热，由风邪所化之热，与肝郁之内热，合而上攻，于是痉象作矣。再参合其口干欲饮，烦躁热甚等种种症状，乃决为之处方。以白虎汤合泻心汤，以清之泻之而除其热，加葛根、瓜蒌根，以清其经腧之热，加远志、石菖蒲，以镇其心中之悸，必得之矣。
服药之后，大便连下三次。在大便第一次下后，皮肤即继续有汗。三次下后，发热即大减，而痉象亦逐渐减退。翌晨刘君视之，痉已全止，而病者熟睡矣。迨一觉醒来，神识已清。无何，索饮粥汤少许，更觉安静，惟热仍未清。第二诊时，即将大黄稍减，又服一帖。大便复下三次，黄黑色已大减，热全退清，而心烦、口渴全止矣。至第三诊，既恐其余邪未清，再行复发，又虑其热痉伤津，须养阴液，乃改以凉膈散合增液法以为加减，而两面顾及之。连服两帖，神恬气静，津液已回，向之口干舌绛，齿垢唇焦者，均一一复旧，而病愈矣。
复思痉病之治，《金匮》已示汗下之大法，用泻心汤而不用承气者，因其热极而腹不满也，应避厚朴之燥。用蒌葛而不用桂枝者，因其但热而不恶寒，应避桂枝之温也。然此方之剪裁，仍以《金匮》之大法所启悟。至后用增液法者，因王氏生儿已多，气血向感不足，加之肝郁之久，阴分早伤，今不得已，而用清凉泻下，病去养阴，又在所必须矣。
至《金匮》奔豚篇中，有该病自惊恐得之之明文，余初尚疑之，今观王氏之痉病，亦由惊恐而得，更信仲景先师之不我欺也。
白虎汤合泻心汤加昧方生石膏三两肥知母四钱炙甘草二钱锦纹军三钱生黄芩三钱上川连一钱粉葛根四钱瓜蒌根四钱远志肉三钱石菖蒲二钱凉膈散合增液法方川大黄二钱(酒洗)元明粉二钱净连翘三钱淡黄芩三钱(酒炒)炙甘草一钱生山栀三钱润元参三钱大麦冬三钱鲜生地四钱恶寒(阳虚恶寒证)病者日日恶寒，他无所苦。居平之时，人衣单而彼衣夹，人衣棉而彼衣裘。即盛夏之时，亦终日啬啬恶寒，必行走于烈日之下，上晒下蒸，皮肤有汗，乃不恶寒。入室片时，又复恶寒矣。夏夜必覆薄棉之被，冬令之重衾叠裘，更可知矣。询之病近四年，脉微沉迟。投之以崔氏八味丸，不效。投之以甘草干姜汤，又不效；投之以桂枝附子汤加肉桂、干姜方，仍然无效。后过一年余，忽以气中而亡。
近四年之久而不愈，由同业王杰夫介就余诊。据病者自述，其恶寒之疾，并无任何诱因，系由渐而来。初觉身有微寒，以为受凉冒风，以姜汤服之数次，若愈若不愈。即有时不恶寒，有时复又微寒。因他无所若，遂亦置之。如此约月余，渐觉寒甚，始就医求诊。一医无效，再医亦无效，三医仍然无效。于是中医不效，改就西医，内服注射，久之亦无效果。其间有间药一二月者，盖诸药不效，恨不服药耳。如此者药近四年，依然恶寒也。再后则恶寒更甚，虽至盛夏之时，亦复如此。必奔走于烈日之下，体力劳动，上为日光之直射，下为地热之反射，乃可稍稍有汗，而恶寒得解。如一至室中，稍静片时，则又啬啬恶寒矣。炎酷之夏夜。必覆以小棉被或毛毯，冬令寒冷之时，必重衾叠被，羊裘大衣，然犹恶寒不已也。余因为之诊脉，觉微沉迟，尺部觉较更沉，其他毫无病象。询其家庭状况，乃知固如齐人焉，而有一妻一妾者。然妻妾均无出，告余之时，犹深伯道之感，余乃慰之。断为肾亏无疑，并戒其年过五旬，节欲为要。盖纵欲则精气衰，节欲则精气盛，俗所谓寡欲宜男也。因令至胡庆余堂，购崔氏八味丸服之。少服恐难生效，必加量服之；短期恐亦不效，必长期服之。病者如余言，每次服五六十丸(梧桐子大)，每日早晚各一次。服至两月，依然无效，复就余诊。余令一日三次，再服一月。然终服如未服，毫未减轻。
三次复诊时，余以其未见寸效，因思脾胃阳虚，或亦致此，遂以甘草干姜汤试之。依仲景方法，炙草用六钱，干姜用三钱，速服十剂，亦不效。再将甘草加至一两，干姜加至六钱，续服五剂，仍不效。而患者心仍不死，必求我再为设法。
当此之时，余颇觉技穷。沉思至再，因想及恶寒之证，其病在表，表阳之虚，再因里阳之虚，或合而致此。乃为之勉处一方，以桂枝加附子汤再加姜、桂，且其量亦重。令服五帖，不效。令续服五帖，以瞻其进退，过旬日后再来，仍然丝毫无效也。余以迭治不痊，乃坚谢不敏。盖最可怪者，即服药改用三汤，始终服如未服。若谓不对证耶，则必致引起其他反应，而此则反应无之。谓为药对证耶，则又何以大量不效，久服亦不效。故此病未愈，为余终身一大憾事。此一大疑团，中心蕴结，近三十年而不解。然此后廿余年中，如张某之病，亦未见过第二例。复思一般医者，每有治验记录，而治不验者不与焉。余今特破向来之例，纪我之治不验者，以告医界同人，深恨学识浅薄，经验未丰，尚希知者有以教之。
崔氏八昧地黄丸方熟地黄八两(九蒸、捣烂)干山药四两山茱萸肉四两白茯苓三两牡丹皮三两泽泻三两上肉桂一两附子一两(泡去皮脐)研为细末，炼蜜为丸，如梧桐子大，每次服三十丸，每日早晚各一次，温酒下。
按：此方曾服至60～80丸。
桂枝附子汤加肉桂干姜方川桂枝五钱京芍药五钱炙甘草三钱生熟附子各四钱上肉桂一钱炮姜炭三钱生姜三钱大枣十五枚按：此方生熟附子并用者，冀其温里兼达表也。
善饥(急性善饥证)青年学生，体质中等，忽患善饥之证。一日六餐，每餐均属多量，通常饭碗，约有十八碗之多。询之他无所苦，惟饱食二三小时，即觉饥肠辘辘，不能忍也，而大便仍然如常，举家骇极。余询知，曾踢足球，而跌仆一次，然不能肯定为病原。姑以十全大补汤，去肉桂、加黄精试之，二剂而减，四剂而安。
在抗战之前二年，沪南陆家浜有戴君如者，其长子求学于民立中学。每日晨八时到校，中午归来午餐。一日，十时余，即快步回家，向其母素食。曰：不知何故，腹中饥饿异常，任何食物，其速与我。其母诧曰：汝今晨曾食粥三碗，大饼油条各一，何以两小时后，即饥饿若此耶?戴生曰：我亦不自知。今趁第二课后，休息之时来家，快上第三课矣，其速与我。其母以昨日剩余之饭，用大碗盛之，加以开水，即与之食。此一大碗，约有寻常之两碗。食毕匆促而去，盖学校距家颇近也。至中午归来，仍呼饿极。适其父亦归，闻状亦大惊异。立命取来饭菜，一家同桌而餐。戴君目睹其子之食饭，迥异常时。饭送入口，亦若不甚咀嚼，唇舌略动，即下咽矣。计其平常饭碗，连食满满四碗。食毕已将近一时，又匆匆上学而去。讵至三时三十分，忽又返家，索食如前。中午饭多余剩，又急与之。立食三碗，掷箸起去。及至五时返家，仍然索食。食至两碗，其母因止之曰：儿今一日间食量非常，姑自行克制之。稍待至六时，又晚餐矣，届时再食可也，其子乃勉从之。即至六时晚餐，又食饭两碗，啜粥三碗。
戴君固为惊异，经再四思之，他无病状，此或偶然之事。即至次日，仍然饥饿如初，与昨日之情形，丝毫无异。
至下午五时，挈其子来就余诊，告余以昨今两日之事实。诊其脉无异象，不过微大微数，不足以为病脉耳。询其昨晨到校，曾与同学赛踢足球片时，因抢球曾被推踢一跤，但毫无损伤。视此情形，亦不足为暴食如此之多之诱因。征之中西书中，虽有善饥症之状，不过时时觉饥，量稍增多耳，亦不如此之特甚。若以全日计，约有十八九碗之多也。询其两日来大便如何，则又不见增多，亦如寻常。其食之渣滓，从何道而去耶?余沉思至再，不能得其病情，且亦从未见过，戴君则促余设法。余思暴食至如此之多，其有需要，必有所不足。不足即是虚，虚即当补。补之之方，气血兼顾，则十全大补汤尚矣。然内有肉桂之温，在大病后之需温补者，必须用之。
今戴生非病后之可比，决为去之，另加黄精以实之。盖本草载黄精一品，有久服不饥之效，此真所谓“医者意也。”余今以意为之，亦自觉可笑。遂以意立方如次以与之，令服两帖，以瞻其效否。讵意服药一帖后，即觉小效。续服二帖，即觉大效。连服三帖，其饥饿之感，则戛然而止矣。后戴君偕子来谢，笑谓余曰：“虽云我之爱儿，若朝朝吃饭如此之多，则吾月薪所得，只供伊一人吃饭矣。”相与大笑。
十全大补汤去肉桂加黄精方西党参四钱焦白术四钱云茯苓四钱炙甘草三钱大熟地四钱川芎三钱全当归四钱炒白芍三钱炙黄芪四钱蒸黄精五钱红枣十枚生姜二钱麻疹麻疹夹食重证三齿幼女，先之以长途啼哭，风邪袭肺，继之以荤腻杂食，脾胃大伤。四五日后，忽然发热，而患麻疹。次日热高如灼，肌肤干燥无汗，疹忽隐伏，气息喘促，目赤面绯，面带紫暗，舌胎厚腻燥黄，大便不通，小便赤色，渐至牙龈腐烂，口出恶臭，烦躁不安，已呈绝象。投以泻心承气合增液法加味方，大泻而转安。嗣以药未续服，终成败证而殇。
镇江中医师蒋鹤龄，居住在贵州路镛寿里。他和妻子年近五十，只有一个庶出的儿子，视若珍宝。当时孩子八岁，读小学二年级，身体原本强壮，活泼顽皮，课外活动非常活跃，所以平时不容易生病。在端午节次日清晨，由包车送到学校时，还没有任何病状。到上午十一时，学校打电话通知蒋医师说，他儿子发热头痛，请速来包车接回。蒋医师随即乘车前往，将孩子抱回家。经过诊察后，立即给予解表退热的药剂，但无效。再服用第二煎，仍然无效。拖延到下午四时许，热度更高，头痛且神志模糊，并且时而烦躁。到了这个时期，突然发作急惊风的症状，如上文所述。
全家惊慌失色，延请我诊治。蒋医师问我：“此时脑膜炎颇有流行，我的孩子莫非是这种病症吗？”当时我年仅三十岁，见其身体颇为壮实，知道这是饮食旺盛的儿童，而且是独子，平时杂食必然很多。因此按压他的脘腹部，孩子知道抗拒按压，腹部膨满而硬实。询问他这几天吃了什么食物，据蒋师母告诉我，说：“因为正值端午佳节，三天前已经吃了粽子（即角黍）。早晨和下午，都以粽子为点心，中午和晚餐，都有鱼肉鸡鸭及火腿等。因为他素来食欲好，所以没有禁止。就连今早上学时，还吃了两大枚一小枚粽子，其他的枇杷、荔枝更不用说了。中午坐前车接回家后，下午病情就变成这样了，先生请救救我的爱儿。”我听了她的话，知道这是食积停滞在胃脘，腑气不通畅。不通则闭塞，闭塞则酿生内热，循经反射于脑部，因而导致痉挛。如果不紧急攻下胃中的实邪，那么痉挛必定不止，会有危险。于是想到《金匮要略》痉病篇中，有用大承气汤治疗阳明痉病的方法，现在可以效法张仲景的方法来治疗。因此拟定硝黄蒌葛汤，命令他们迅速服用，不要犹豫。
蒋医师听从我的话，立刻配药灌服。没想到初灌的时候，吐出了很多痰涎，夹杂着少量未消化的食物。稍停片刻再灌，缓缓灌入二十分钟，才将头煎药灌下去。之后不到两小时，大便即排出，像胶像酱一样，此时痉挛现象已经减轻。再过半小时，又解了一次大便，于是神志清醒，痉挛现象完全消失了。第二天再次延请复诊，全家再三致谢。又将前方减量，加入和胃及清热的药物，两帖后病情安定。
硝黄蒌葛汤方：生大黄三钱，元明粉四钱（分冲），炒枳壳三钱，全瓜蒌四钱，粉葛根三钱，生黄芩三钱，焦山楂肉四钱，莱菔子三钱，鲜竹叶三十片。
妇人惊恐致痉病：妇人气机郁结，心中窒闷，神思专注于别处。忽然听到喇叭震耳的声音，大惊逃跑躲避，全身热汗淋漓，心悸肉跳。等到惊吓平定、汗水收敛后，即觉得头昏脑胀，逐渐出现恶寒发热。次日即高热谵语，烦躁不安，反复颠倒，口干想喝水，牙齿有垢，嘴唇焦裂，舌色紫绛，两眼均红。再次日则突然发作痉挛症状。给予白虎汤合泻心汤加葛根、瓜蒌、远志、石菖蒲，一剂后得汗得下，谵语去除，痉挛消除。再服一剂后热退神清，烦躁停止，口渴止住。最终用凉膈散合增液法，两剂后痊愈。
有一位叫刘守书的人，是电车公司的查票员，生活小康，有时深夜晚归。他的妻子王氏怀疑他有外遇，经常暗中跟踪丈夫的去向，但最终一无所获。而刘守书也知道这件事，也没有向她揭穿。一天，他的妻子知道下班时间刘守书必随车回公司，便去公司前门较远的道路旁等候。但等了很久，心里焦急烦闷。当心思专注在某处时，所有的声音都听不进去了。他在路边踱来踱去，低头思考。有一辆汽车飞驰而来，轮胎声响，但他没有察觉。等到车即将飞至，司机看到路边不让行，诚恐招致祸患，立即按响喇叭。王氏忽然被这声音惊吓，仓皇逃避到路边。路上的汽车已一掠而过，还能听到汽车司机工友的骂声。
王氏无奈，只得回家。沿途心跳不已，到家后饮泣流泪。不久，即出现恶寒发热，头重脑胀。到了次日，转为烦躁不安，反复颠倒，神志模糊谵语，如见鬼神，不得片刻安宁。口干齿垢，嘴唇焦裂脱皮，大渴想喝水，舌色紫绛，两眼红得像喝醉了一样，眼球转动呆滞。如此情形，似乎应该延请医生治疗了。然而妻子恨不延医，丈夫也愤怒不理。再到第三天，则热极上冲于脑，突然发作痉挛症状，头项强直，手足拘挛，牙关紧闭，两眼上翻。症候到了这个时候，他的丈夫才开始延请我诊治。
我既了解了病情的前因，诊察之后，判断是由惊恐导致皮毛开泄，由皮毛开泄导致风邪入侵，由风邪入侵导致寒热起，并迅速化热，由风邪所化的热，与肝郁的内热，合而上攻，于是痉挛发作。再参合其口干欲饮、烦躁热甚等各种症状，于是决定为他处方。用白虎汤合泻心汤，以清泻之除去热邪，加葛根、瓜蒌根，以清经络腧穴的热，加远志、石菖蒲，以镇定心中的悸动，一定能治愈。
服药之后，大便连续下了三次。在大便第一次排出后，皮肤即继续出汗。三次大便排出后，发热即大幅减少，而痉挛现象也逐渐减退。第二天早上刘君来看望，痉挛已经完全停止，病人熟睡了。等到一觉醒来，神志已经清醒。不久，索要少许粥汤饮用，更加安静，只是热仍未清。第二诊时，即将大黄稍微减量，又服一帖。大便又排了三次，黄黑色已大幅减少，热全部退清，而心烦、口渴全部停止了。到了第三诊，既担心余邪未清，再次复发，又担心热痉伤津，需要滋养阴液，于是改为凉膈散合增液法进行加减，两方面兼顾。连服两帖，神志恬静气息平和，津液已恢复，之前的口干舌绛、齿垢唇焦者，均一一恢复正常，病愈了。
回想痉病的治疗，《金匮要略》已经示出汗法和下法的大法，用泻心汤而不用承气汤的，是因为热极而腹部不满，应避开厚朴的燥性。用瓜蒌、葛根而不用桂枝的，是因为只有热而没有恶寒，应避开桂枝的温性。然而此方的剪裁，仍以《金匮要略》的大法所启悟。至于后用增液法的，是因为王氏生育子女多，气血向来不足，加之肝郁日久，阴分早已受伤，如今不得已使用清凉泻下，病去之后养阴，又是必须的了。
至于《金匮要略》奔豚篇中，有该病自惊恐得之的明文，我起初还怀疑它，现在看王氏的痉病，也是由惊恐而得，更相信张仲景先师没有欺骗我。
白虎汤合泻心汤加味方：生石膏三两，肥知母四钱，炙甘草二钱，锦纹军（大黄）三钱，生黄芩三钱，上川连（黄连）一钱，粉葛根四钱，瓜蒌根四钱，远志肉三钱，石菖蒲二钱。
凉膈散合增液法方：川大黄二钱（酒洗），元明粉二钱，净连翘三钱，淡黄芩三钱（酒炒），炙甘草一钱，生山栀三钱，润元参三钱，大麦冬三钱，鲜生地四钱。
恶寒（阳虚恶寒证）：病人日日恶寒，没有其他痛苦。平时别人穿单衣而他穿夹衣，别人穿棉衣而他穿裘皮衣。即使是盛夏之时，也终日瑟瑟发抖地恶寒，必须行走于烈日之下，上晒下蒸，皮肤有汗，才不恶寒。进入室内片刻，又恢复恶寒了。夏夜一定覆盖薄棉被子，冬季的重衾叠裘，更可知晓了。询问病情接近四年，脉象微沉迟。投以崔氏八味丸，无效。投以甘草干姜汤，又无效；投以桂枝附子汤加肉桂、干姜方，仍然无效。后来过了一年多，忽然因气中（中风）而死。
患者张廷干，住在闸北鸿兴路，经营老虎灶（烧开水铺），有恶寒的疾病。
将近四年久而不愈，由同业王杰夫介绍来找我诊治。据病人自述，他的恶寒疾病，没有任何诱因，是逐渐而来的。起初觉得身体微寒，以为是受凉冒风，喝姜汤服了几次，似愈非愈。即使有时不恶寒，有时又微寒。因为其他没有不适，也就置之不理。这样大约一个月，渐渐觉得寒冷严重，才开始就医求诊。一位医生无效，第二位医生也无效，第三位医生仍然无效。于是中医无效，改看西医，内服注射，久了也没有效果。其间有间隔一两个月吃药的，大概是诸药无效，恨不得不吃药罢了。这样吃药将近四年，依然恶寒。再后来则恶寒更甚，即使到了盛夏之时，也是如此。必须奔走于烈日之下，体力劳动，上为日光直射，下为地热反射，才可以稍稍出汗，而恶寒得以解除。如果一到室内，稍静片刻，就又瑟瑟恶寒了。炎热酷夏的夜晚，一定覆盖小棉被或毛毯，冬季寒冷之时，一定重衾叠被，羊裘大衣，然而仍然恶寒不止。我为他诊脉，感觉微沉迟，尺部感觉更沉，其他毫无病象。询问他的家庭状况，才知道他确实像齐国人那样，有一个妻和一个妾。然而妻妾均无子女，告诉我的时候，仍深感伯道无儿（无后）的痛苦，我便安慰他。判断为肾亏无疑，并告诫他年过五十，节制欲望是关键。因为纵欲则精气衰败，节欲则精气旺盛，俗所谓寡欲宜男（容易生子）。因此命令他去胡庆余堂购买崔氏八味丸服用。少服恐怕难以生效，必须加量服用；短期恐怕也不见效，必须长期服用。病人照我的话，每次服五六十丸（梧桐子大小），每日早晚各一次。服至两个月，依然无效，又来找我诊治。我命令一日三次，再服一个月。然而终究服用如同没服用，丝毫未减轻。
第三次复诊时，我见他未见寸效，于是想到脾胃阳虚，或许也会导致这种情况，遂用甘草干姜汤尝试。依张仲景的方法，炙甘草用六钱，干姜用三钱，速服十剂，也无效。再将甘草加至一两，干姜加至六钱，续服五剂，仍无效。而病人心里仍不死心，必要求我再想办法。
在这个时候，我颇觉技穷。沉思再三，想到恶寒之证，病在表，表阳之虚，再加上里阳之虚，或许合而致此。于是勉强为他开一方，用桂枝加附子汤再加姜、桂，而且剂量也重。令服五帖，无效。令续服五帖，以观察进退，过旬日后再来，仍然丝毫无效。我因多次治疗不愈，于是坚决推辞不再诊治。最奇怪的是，即使用了三种汤药，始终服用如同没服用。如果说不对证，则必然会引起其他反应，而这里却没有反应。如果说药对证，那么为何大量久服也无效。因此这个病未愈，是我终身的一大憾事。这一大疑团，心中蕴结，近三十年而不解。然而此后二十多年中，像张某这样的病，也未见过第二例。回想一般医者，每有治验记录，而治不验的不予记载。我今天特意打破以往的惯例，记录我治不验的案例，告知医界同人，深恨学识浅薄，经验未丰，尚希望知情者有所指教。
崔氏八味地黄丸方：熟地黄八两（九蒸、捣烂），干山药四两，山茱萸肉四两，白茯苓三两，牡丹皮三两，泽泻三两，上肉桂一两，附子一两（泡去皮脐）。研为细末，炼蜜为丸，如梧桐子大，每次服三十丸，每日早晚各一次，温酒送下。
按：此方曾服至60～80丸。
甘草干姜汤方：炙甘草一两，炮姜炭六钱。
按：此方为第二次加重之量。
桂枝附子汤加肉桂干姜方：川桂枝五钱，京芍药五钱，炙甘草三钱，生熟附子各四钱，上肉桂一钱，炮姜炭三钱，生姜三钱，大枣十五枚。
按：此方生熟附子并用者，冀其温里兼达表也。
善饥（急性善饥证）：青年学生，体质中等，忽然患上善饥之证。一天六餐，每餐均属多量，通常饭碗，约有十八碗之多。询问其他没有痛苦，只是饱食二三小时后，即觉得饥肠辘辘，不能忍受，而大便仍然如常，全家骇怕至极。我询问得知，他曾踢足球，跌仆过一次，但不能肯定为病原。姑且以十全大补汤，去掉肉桂、加黄精试之，两剂而减轻，四剂而安定。
在抗战之前二年，沪南陆家浜有位戴君如，他的长子求学于民立中学。每天早晨八时到校，中午归来午餐。一天，十时左右，即快步回家，向其母亲索要素食。说：不知何故，腹中饥饿异常，任何食物，赶快给我。他母亲惊讶地说：你今天早晨曾吃粥三碗，大饼油条各一，何以两小时后，即饥饿到这种地步呢？戴生说：我也不自知。现在趁第二课后，休息之时回家，快上第三课了，赶快给我。他母亲用昨日剩余的饭，用大碗盛之，加以开水，即给他吃。这一大碗，约有寻常的两碗。吃完匆匆而去，因为学校距家颇近。到中午归来，仍喊饿极了。适逢他父亲也回来，闻讯亦大惊异。立刻命取来饭菜，一家同桌而餐。戴君目睹其子吃饭，迥异常时。饭送入口，也似乎不甚咀嚼，唇舌略动，即下咽了。计算他平常的饭碗，连食满满四碗。吃完已将近一时，又匆匆上学而去。岂料至三时三十分，忽然又返家，索食如前。中午饭多余剩，又急忙给他。立刻吃三碗，扔下筷子起身离去。等到五时回家，仍然索食。吃到两碗，他母亲因此制止他说：儿子今天一天食量非常，暂且自行克制一下。稍待至六时，又有晚餐了，到时候再吃也可以，他儿子乃勉强听从。即至六时晚餐，又吃饭两碗，喝粥三碗。
戴君固然惊异，经过再三思考，其他无病状，这或许是偶然之事。即至次日，仍然饥饿如初，与昨日的情形，丝毫无异。
至下午五时，带着他来找我诊治，告诉我昨今两天的事实。诊其脉无异象，不过微大微数，不足以作为病脉罢了。询问他昨天早晨到校，曾与同学赛踢足球片刻，因抢球曾被推踢一跤，但毫无损伤。看此情形，也不足以成为暴食如此之多的诱因。征之中西书中，虽有善饥症之状，不过是时时觉饥，食量稍增多耳，也不至于如此特别严重。若以全日计，约有十八九碗之多也。询问他这两日大便如何，则又不见增多，也如寻常。他吃的渣滓，从何道而去呢？我沉思再三，不能得其病情，且也从未见过，戴君则催促我设法。我想暴食至如此之多，其有需要，必有所不足。不足即是虚，虚即当补。补之的方子，气血兼顾，则十全大补汤尚佳。然而内有肉桂之温，在大病后之需温补者，必须用之。
现在戴生不可与大病后相比，决然去掉肉桂，另加黄精以充实之。盖本草载黄精一品，有久服不饥之效，这真所谓“医者意也”。我现在以意为之，也自觉可笑。遂以意立方如下与之，令服两帖，以观察其效否。岂料服药一帖后，即觉小效。续服二帖，即觉大效。连服三帖，其饥饿之感，则戛然而止矣。后来戴君偕同儿子来谢，笑着说：“虽然说是我的爱儿，如果天天吃饭如此之多，则我的月薪所得，只够供他一人吃饭了。”相与大笑。
十全大补汤去肉桂加黄精方：西党参四钱，焦白术四钱，云茯苓四钱，炙甘草三钱，大熟地四钱，川芎三钱，全当归四钱，炒白芍三钱，炙黄芪四钱，蒸黄精五钱，红枣十枚，生姜二钱。
麻疹麻疹夹食重证：三岁幼女，先之以长途啼哭，风邪袭肺，继之以荤腻杂食，脾胃大伤。四五日后，忽然发热，而患麻疹。次日热高如灼，肌肤干燥无汗，疹忽隐伏，气息喘促，目赤面绯，面带紫暗，舌苔厚腻燥黄，大便不通，小便赤色，渐至牙龈腐烂，口出恶臭，烦躁不安，已呈绝象。投以泻心承气合增液法加味方，大泻而转安。嗣以药未续服，终成败证而殇。
Jiang Heling, a Traditional Chinese Medicine (TCM) physician from Zhenjiang, resided at Yongsou Li, Guizhou Road. He and his wife were nearly fifty years old and had only one son born to a concubine, whom they cherished more than a precious jade pendant. At that time, the boy was eight years old and in the second grade of primary school. His constitution was originally robust; he was lively, playful, and engaged vigorously in extracurricular activities, making him generally resistant to illness. On the morning following the Dragon Boat Festival, he was taken to school by hired car with no signs of illness. However, at 11:00 AM, the school telephoned Physician Jiang to report that his son had developed fever and headache, requesting an immediate pick-up. Physician Jiang drove to the school and brought the child home. After examination, he administered a formula for releasing the exterior and reducing fever, but it was ineffective. A second dose also failed. By around 4:00 PM, the fever intensified, accompanied by severe headache, clouded consciousness, and intermittent irritability. At this stage, the child suddenly exhibited symptoms of acute convulsive disease (Ji Jing), as described above.
The family was panicked and discolored, inviting me for consultation. Physician Jiang asked, "Meningitis is prevalent at this time; could my son be suffering from this condition?" I was then only thirty years old. Observing his robust physique, I knew he was a child with a hearty appetite and, being an only son, likely consumed a varied diet. Upon palpating his epigastrium and abdomen, the child resisted pressure; the abdomen was distended, full, and hard. Inquiring about his recent diet, his mother informed me, "Due to the Dragon Boat Festival, we ate zongzi (sticky rice dumplings wrapped in bamboo leaves) three days ago. Both morning and afternoon snacks consisted of zongzi. Lunch and dinner included fish, meat, chicken, duck, and ham. Since he has always had a good appetite, we did not restrict him. Even this morning before school, he ate two large and one small zongzi, along with loquats and lychees. After returning home by car at noon, the condition deteriorated this afternoon. Please save my beloved son." Hearing this, I determined that food stagnation in the stomach and intestines (Wei Wan) caused obstruction of Fu organ Qi. Obstruction leads to closure, and closure generates internal heat, which reflects along the meridians to the brain, causing spasms. If the excess in the Stomach (Wei Jia Shi) is not urgently purged, the spasms will not cease, leading to danger. Recalling the chapter on Spasm Disease in the *Jin Gui Yao Lue*, there is a method using Da Cheng Qi Tang to treat Yangming spasm disease. I decided to follow Zhang Zhongjing's method. Thus, I prescribed Xiao Huang Lou Ge Tang, instructing them to administer it immediately without hesitation.
Physician Jiang followed my advice and prepared the medicine for administration. Initially, upon pouring it in, the child vomited much phlegm-saliva mixed with undigested food. After a brief pause, we slowly administered the medicine over twenty minutes until the first decoction was fully given. Within two hours, the child passed stool resembling glue or paste. At this point, the spasmodic symptoms subsided. Half an hour later, another bowel movement occurred, after which the child's consciousness cleared completely, and all spasmodic signs vanished. The next day, during the follow-up visit, the family expressed their gratitude repeatedly. I reduced the dosage of the previous formula and added herbs to harmonize the Stomach and clear heat. After two doses, the condition stabilized.
**Xiao Huang Lou Ge Tang Formula**: Sheng Da Huang (Rhei Radix et Rhizoma) 3 qian, Yuan Ming Fen (Natrii Sulfas) 4 qian (dissolved separately), Chao Zhi Qiao (Aurantii Fructus Immaturus) 3 qian, Quan Gua Lou (Trichosanthis Fructus) 4 qian, Fen Ge Gen (Puerariae Lobatae Radix) 3 qian, Sheng Huang Qin (Scutellariae Radix) 3 qian, Jiao Zha Rou (Crataegi Fructus) 4 qian, Lai Fu Zi (Raphani Semen) 3 qian, Xian Zhu Ye (Bambusae Folium) 30 pieces.
**Case of Convulsion due to Fright in Women**: A woman suffered from Qi stagnation, feeling stifled in her heart, with her mind focused elsewhere. Suddenly startled by the deafening sound of a horn, she fled in terror, sweating profusely with palpitations and muscle twitching. After the fright subsided and sweat stopped, she felt dizzy and head-distended, gradually developing aversion to cold and fever. The next day, she experienced high fever, delirious speech, irritability, restlessness, dry mouth with desire to drink, dental plaque, cracked lips, purple-crimson tongue coating, and red eyes. The following day, she suddenly developed convulsions. I prescribed Bai Hu Tang combined with Xie Xin Tang, adding Ge Gen (Puerariae Lobatae Radix), Gua Lou (Trichosanthis Fructus), Yuan Zhi (Polygalae Radix), and Shi Chang Pu (Acori Tatarinowii Rhizoma). After one dose, she sweated and had bowel movements; delirium ceased, and convulsions stopped. After a second dose, fever receded, consciousness cleared, irritability stopped, and thirst ceased. Finally, using Liang Ge San combined with Zeng Ye Fa (Method of Increasing Fluids), she recovered after two doses.
Liu Shoushu was a ticket inspector for the tram company, living comfortably but often returning late at night. His wife, Wang Shi, suspected he had another home and secretly tracked him but found nothing. Liu knew of this but never confronted her. One day, knowing Liu would return with the tram after work, she waited far from the company gate. Waiting for a long time made her anxious and irritable. When her mind was focused, she became deaf to surrounding sounds. Pacing back and forth with her head down in thought, she did not notice an approaching car and its tire noise. As the car sped towards her, the driver, fearing an accident due to her not moving aside, honked loudly. Startled by the sound, Wang Shi fled in panic to the roadside. The car swept past, and she heard the driver cursing.
Helpless, Wang Shi returned home, her heart pounding, weeping upon arrival. Soon, she developed aversion to cold and fever, heavy head, and dizziness. The next day, she became irritable, restless, delirious, seeing ghosts, unable to find peace. Her mouth was dry with dental plaque, lips cracked and peeling, extremely thirsty, tongue purple-crimson, eyes red as if drunk, and eye movements sluggish. This situation seemed to require medical attention. However, the wife resented seeking a doctor, and the husband was angry and ignored her. By the third day, extreme heat rushed to the brain, causing sudden convulsions: stiff neck and limbs, clenched jaw, and upward rolling of eyes. Only then did the husband invite me.
Having learned the history, and after examination, I diagnosed that fright caused the pores to open, allowing Wind pathogen to enter, leading to cold-heat disturbance, which rapidly transformed into heat. This Wind-transformed heat combined with Liver Qi stagnation internal heat, attacking upwards, causing convulsions. Considering her dry mouth, desire to drink, irritability, and high fever, I prescribed Bai Hu Tang combined with Xie Xin Tang to clear and purge heat, adding Ge Gen (Puerariae Lobatae Radix) and Gua Lou Gen (Trichosanthis Radix) to clear heat in the channels and collaterals, and Yuan Zhi (Polygalae Radix) and Shi Chang Pu (Acori Tatarinowii Rhizoma) to calm the Heart palpitations. Cure was certain.
After taking the medicine, she had three bowel movements consecutively. After the first movement, skin continued to sweat. After the third, fever decreased significantly, and convulsions gradually subsided. The next morning, Mr. Liu reported that convulsions had completely stopped, and the patient was sleeping soundly. Upon waking, her consciousness was clear. She requested a little porridge, felt calmer, though heat remained. In the second consultation, I slightly reduced Da Huang (Rhei Radix et Rhizoma) and gave one more dose. Three more bowel movements occurred; yellow-black stool decreased greatly, fever completely resolved, and irritability and thirst ceased. In the third consultation, fearing residual pathogens and recurrence, and considering Yin fluid injury from heat-spasm, I switched to Liang Ge San combined with Zeng Ye Fa (Method of Increasing Fluids) to address both aspects. After two doses, her spirit was tranquil, Qi peaceful, and fluids restored. Dry mouth, purple tongue, dental plaque, and cracked lips all returned to normal, and she recovered.
Reflecting on the treatment of spasm disease, the *Jin Gui Yao Lue* outlines the major methods of sweating and purging. Using Xie Xin Tang instead of Cheng Qi Tang is because the heat is extreme but the abdomen is not full, avoiding the drying nature of Hou Po (Magnoliae Officinalis Cortex). Using Lou (Trichosanthis Fructus/Radix) and Ge Gen (Puerariae Lobatae Radix) instead of Gui Zhi (Cinnamomi Ramulus) is because there is heat without aversion to cold, avoiding the warmth of Gui Zhi. However, the modification of this formula is still inspired by the major principles of the *Jin Gui Yao Lue*. The subsequent use of Zeng Ye Fa (Method of Increasing Fluids) was necessary because Mrs. Wang had borne many children, her Qi and Blood were inherently deficient, and long-term Liver stagnation had injured her Yin. Given the necessity of using cooling purgatives, nourishing Yin after the disease resolves was essential.
Regarding the Ben Tun (Running Piglet) chapter in the *Jin Gui Yao Lue*, there is explicit text stating this disease arises from fright. I initially doubted it, but observing Mrs. Wang's spasm disease arising from fright, I now believe Zhang Zhongjing did not deceive us.
**Bai Hu Tang Combined with Xie Xin Tang Modified Formula**: Sheng Shi Gao (Gypsum Fibrosum) 3 liang, Fei Zhi Mu (Anemarrhenae Rhizoma) 4 qian, Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Preparata) 2 qian, Jin Wen Jun (Da Huang/Rhei Radix et Rhizoma) 3 qian, Sheng Huang Qin (Scutellariae Radix) 3 qian, Shang Chuan Lian (Coptidis Rhizoma) 1 qian, Fen Ge Gen (Puerariae Lobatae Radix) 4 qian, Gua Lou Gen (Trichosanthis Radix) 4 qian, Yuan Zhi Rou (Polygalae Radix) 3 qian, Shi Chang Pu (Acori Tatarinowii Rhizoma) 2 qian.
**Liang Ge San Combined with Zeng Ye Fa Formula**: Chuan Da Huang (Rhei Radix et Rhizoma) 2 qian (wine-washed), Yuan Ming Fen (Natrii Sulfas) 2 qian, Jing Lian Qiao (Forsythiae Fructum) 3 qian, Dan Huang Qin (Scutellariae Radix) 3 qian (wine-fried), Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Preparata) 1 qian, Sheng Shan Zhi (Gardeniae Fructus) 3 qian, Run Yuan Shen (Scrophulariae Radix) 3 qian, Da Mai Dong (Ophiopogonis Radix) 3 qian, Xian Sheng Di (Rehmanniae Radix) 4 qian.
**Aversion to Cold (Yang Deficiency Aversion to Cold Syndrome)**: The patient suffered from daily aversion to cold without other discomforts. Normally, when others wore single clothes, he wore lined clothes; when others wore cotton, he wore fur. Even in midsummer, he shivered constantly in the cold, needing to walk under the scorching sun, steaming from below and baking from above, with sweating on the skin, to feel warm. Entering a room for a moment brought back the cold. In summer nights, he covered himself with thin cotton quilts; in winter, heavy quilts and layered furs were used. The illness lasted nearly four years, with a pulse that was faint, deep, and slow. Treatment with Cui Shi Ba Wei Wan (Dr. Cui's Eight-Ingredient Pill) was ineffective. Gan Cao Gan Jiang Tang (Licorice and Dried Ginger Decoction) was also ineffective. Gui Zhi Fu Zi Tang plus Rou Gui (Cinnamomi Cortex) and Gan Jiang (Zingiberis Rhizoma) was equally ineffective. Over a year later, he suddenly died from Qi strike (stroke).
Patient Zhang Tinggan lived on Hongxing Road, Zhabei, operating a water-boiling stall. He suffered from aversion to cold for nearly four years without cure. Introduced by colleague Wang Jiefu, he consulted me. He stated the aversion to cold had no specific trigger and developed gradually. Initially, he felt slight chill, thinking it was exposure to wind, and drank ginger soup several times with partial relief. Sometimes he was not cold, sometimes slightly cold. With no other complaints, he ignored it. After about a month, the cold sensation intensified, prompting him to seek medical help. One doctor failed, the second failed, and the third failed. Switching to Western medicine with oral medications and injections yielded no results over time. There were intervals of one or two months without medication, likely due to frustration with ineffectiveness. After nearly four years of medication, the aversion to cold persisted. Later, it worsened; even in midsummer, it remained. He had to engage in physical labor under the hot sun, with direct solar radiation above and geothermal reflection below, to induce slight sweating and relieve the cold. Returning indoors and resting briefly brought back the shivering cold. In hot summer nights, he used small cotton blankets or wool throws; in winter, heavy quilts, sheepskin coats, yet the cold persisted. My pulse diagnosis revealed a faint, deep, and slow pulse, deeper at the Chi position, with no other abnormalities. Learning his family situation, I found he had one wife and one concubine, both childless. He expressed sorrow over having no heirs (like Bo Dao). I comforted him and diagnosed Kidney deficiency beyond doubt, advising him to restrain desires as he was over fifty. Indulgence depletes Essence and Qi; restraint preserves them. I instructed him to buy Cui Shi Ba Wei Wan (Dr. Cui's Eight-Ingredient Pill) from Hu Qing Yu Tang. Small doses might not work, so increased dosage was needed. Short-term use might fail, so long-term use was required. He took 50-60 pills (walnut-sized) twice daily. After two months, there was no effect, and he returned. I advised taking it three times daily for another month. Yet, it seemed as if he hadn't taken it at all, with no alleviation.
At the third follow-up, seeing no improvement, I considered Spleen and Stomach Yang deficiency might be the cause, so I tried Gan Cao Gan Jiang Tang (Licorice and Dried Ginger Decoction). Following Zhang Zhongjing's method, I used 6 qian of Zhi Gan Cao (Prepared Licorice Root) and 3 qian of Gan Jiang (Dried Ginger), administering ten doses quickly, but it was ineffective. I then increased Gan Cao to 1 liang and Gan Jiang to 6 qian, continuing for five doses, still ineffective. The patient remained hopeful and begged for further attempts.
I felt at a loss. Reflecting deeply, I considered that while the disease manifested in the Exterior, Exterior Yang deficiency combined with Interior Yang deficiency might be the cause. I reluctantly prescribed Gui Zhi Jia Fu Zi Tang (Cinnamon Twig Decoction plus Aconite) with added Ginger and Cinnamon, in heavy doses. Five doses were ineffective. Another five doses were taken to observe progress, but after ten days, there was still no effect. Due to repeated failures, I firmly declined further treatment. The most bizarre aspect was that despite trying three different formulas, the patient reacted as if he had taken nothing. If the prescription were incorrect, other reactions should have occurred, but none appeared. If correct, why did large doses and long-term use fail? This unresolved case remains a lifelong regret and a mystery for nearly thirty years. In the subsequent twenty-plus years, I never encountered a similar case. Generally, physicians record successful treatments but omit failures. I break this tradition here to record my failure, informing my colleagues, lamenting my shallow knowledge and lack of experience, and hoping for guidance from experts.
**Cui Shi Ba Wei Di Huang Wan Formula**: Shu Di Huang (Rehmanniae Radix Preparata) 8 liang (steamed nine times, mashed), Gan Shan Yao (Dioscoreae Rhizoma) 4 liang, Shan Zhu Yu (Corni Fructus) 4 liang, Bai Fu Ling (Poria) 3 liang, Mu Dan Pi (Moutan Cortex) 3 liang, Ze Xie (Alismatis Rhizoma) 3 liang, Shang Rou Gui (Cinnamomi Cortex) 1 liang, Fu Zi (Aconiti Lateralis Radix Preparata) 1 liang (soaked, skin and umbilicus removed). Grind into fine powder, mix with refined honey to make pills the size of walnut seeds. Take 30 pills twice daily (morning and evening) with warm wine.
Note: This formula was taken in doses of 60-80 pills.
**Gan Cao Gan Jiang Tang Formula**: Zhi Gan Cao (Prepared Licorice Root) 1 liang, Pao Jiang Tan (Charred Ginger) 6 qian.
Note: This represents the increased dosage used in the second attempt.
**Gui Zhi Fu Zi Tang Plus Rou Gui and Gan Jiang Formula**: Chuan Gui Zhi (Cinnamomi Ramulus) 5 qian, Jing Shao Yao (Paeoniae Radix Alba) 5 qian, Zhi Gan Cao (Prepared Licorice Root) 3 qian, Sheng/Shu Fu Zi (Raw/Cooked Aconite Lateralis Radix) 4 qian each, Shang Rou Gui (Cinnamon Bark) 1 qian, Pao Jiang Tan (Charred Ginger) 3 qian, Sheng Jiang (Fresh Ginger) 3 qian, Da Zao (Jujubae Fructus) 15 pieces.
Note: Using both raw and cooked Aconite aims to warm the interior and reach the exterior simultaneously.
**Excessive Hunger (Acute Excessive Hunger Syndrome)**: A young student of average constitution suddenly developed excessive hunger. He ate six meals a day, each in large quantities, totaling about eighteen bowls of rice. He reported no other discomforts, only feeling intense hunger two to three hours after eating, unbearable, while bowel movements remained normal. The family was terrified. I learned he had fallen once while playing football, but this was not confirmed as the cause. I tentatively prescribed Shi Quan Da Bu Tang (Ten Significant Tonifying Decoction) minus Rou Gui (Cinnamon Bark) plus Huang Jing (Polygonati Rhizoma). After two doses, symptoms decreased; after four doses, he stabilized.
Two years before the Anti-Japanese War, in Jiabang, South Shanghai, Mr. Dai Ruru's eldest son studied at Minli Middle School. He went to school at 8:00 AM and returned for lunch at noon. One day, around 10:00 AM, he hurried home demanding vegetarian food from his mother, saying he didn't know why but felt extremely hungry. His mother was surprised, asking how he could be so hungry after eating three bowls of porridge and one big pancake with fried dough sticks that morning. The son replied he didn't know either. During the break after the second class, he came home again, urging his mother to feed him quickly before the third class. His mother served him a large bowl of leftover rice mixed with hot water, equivalent to two normal bowls. He ate hastily and left, as the school was nearby. Upon returning at noon, he cried out that he was starving. His father returned, heard this, and was shocked. He ordered food to be brought, and the family ate together. Mr. Dai observed his son eating differently than usual, swallowing without much chewing. He finished four full bowls of rice. It was nearly 1:00 PM, and he hurried off to school. Surprisingly, at 3:30 PM, he returned home demanding food again. His mother gave him the remaining lunch. He ate three bowls, threw down his chopsticks, and left. Returning at 5:00 PM, he demanded food again. Eating two bowls, his mother stopped him, suggesting he control his appetite until dinner at 6:00 PM. He reluctantly agreed. At dinner, he ate two bowls of rice and three bowls of porridge.
Mr. Dai was astonished. Thinking it might be accidental since there were no other symptoms, the next day, the hunger was exactly the same as the previous day.
At 5:00 PM, he brought his son to me. I examined the pulse, which was slightly large and rapid, but not indicative of a serious disease. He mentioned playing football earlier and falling, but with no injury, this seemed insufficient to explain such excessive eating. Medical literature describes excessive hunger, but usually involves frequent hunger with slightly increased intake, not this extreme amount of nearly nineteen bowls a day. Bowel movements were normal. I pondered deeply, unable to determine the cause, having never seen such a case. Mr. Dai urged me to find a solution. I reasoned that such excessive eating implies a need due to deficiency. Deficiency requires tonification. For tonifying both Qi and Blood, Shi Quan Da Bu Tang (Ten Significant Tonifying Decoction) is excellent. However, it contains Rou Gui (Cinnamon Bark), which is warming, suitable for post-illness deficiency but not necessarily for this case. Since the student was not recovering from a major illness, I decided to remove Rou Gui and add Huang Jing (Polygonati Rhizoma) to solidify and nourish. The Materia Medica states that long-term use of Huang Jing prevents hunger. This truly exemplifies "medicine relies on intuition." I formulated the prescription based on this intuition, finding it somewhat amusing. I prescribed the following for two doses to observe efficacy. After one dose, he felt slight improvement. After two more doses, significant improvement. After three doses, the sensation of hunger ceased abruptly. Later, Mr. Dai and his son thanked me. Laughing, Mr. Dai said, "If my beloved son eats like this every day, my monthly salary would only suffice for his meals." We laughed together.
**Shi Quan Da Bu Tang Minus Rou Gui Plus Huang Jing Formula**: Xi Dang Shen (Codonopsis Radix) 4 qian, Jiao Bai Zhu (Atractylodis Macrocephalae Rhizoma) 4 qian, Yun Fu Ling (Poria) 4 qian, Zhi Gan Cao (Prepared Licorice Root) 3 qian, Da Shu Di (Prepared Rehmannia Root) 4 qian, Chuan Xiong (Chuanxiong Rhizoma) 3 qian, Quan Dang Gui (Angelicae Sinensis Radix) 4 qian, Chao Bai Shao (Paeoniae Radix Alba Preparata) 3 qian, Zhi Huang Qi (Astragali Radix) 4 qian, Zheng Huang Jing (Polygonati Rhizoma) 5 qian, Hong Zao (Jujubae Fructus) 10 pieces, Sheng Jiang (Fresh Ginger) 2 qian.
**Measles Complicated by Food Stagnation (Severe Case)**: A three-year-old girl first cried for a long distance, allowing Wind pathogen to attack the Lung, followed by consumption of rich and greasy foods, severely injuring the Spleen and Stomach. Four to five days later, she suddenly developed fever and contracted measles. The next day, fever was burning high, skin dry and anhidrotic, rash suddenly disappeared, breathing was panting, eyes red, face crimson with purplish-dark hue, tongue coating thick, greasy, dry, and yellow, bowel obstruction, urine dark red, gums rotting, foul breath, irritability, presenting a critical state. I administered a modified formula combining Xie Xin Cheng Qi (Purging Heart and Bowels) with Zeng Ye Fa (Method of Increasing Fluids). Profuse purging led to stabilization. However, due to discontinuation of medication, the condition ultimately deteriorated, resulting in death.