病候 表里俱壮热。舌苔边黄、中黑，甚干。精神昏愦，时作谵语。小便短涩，大便一日夜四五次，带
有粘滞。其臭异常，且含有灼热之气，其脉左右皆洪长。重诊欠实，至数略数，两呼吸间可九至。
诊断 此纯系温病之热，阳明与少阳合病也。为其病在阳明，故脉象洪长；为其兼入少阳，故小便
短少，致水归大便而滑泻。为其身形素弱，故脉中虽挟有外感之实热，而仍重按不实也。
疗法 当泻热兼补其正，又大剂徐徐服之，方与滑泻无碍也。
处方 生石膏（三两细末） 生山药（一两） 大生地（两半） 生杭芍（八钱） 甘草（三钱） 野台参（五
钱）
煎汤三大盅，徐徐温饮下。一次只饮一大口，时为早六点钟，限至晚八点时服完。此方即白虎加人参汤，
以生山药代粳米，以生地代知母，而又加白芍也。以白虎汤清阳明之热，为其脉不实故加人参；为其滑泻
故以生山药代粳米；生地代知母，为其少阳之府有热；致小便不利而滑泻，所以又加白芍以清少阳之
热，即以利小便也。
效果 所备之药，如法服完。翌晨精神顿爽，大热已退，滑泻亦见愈，脉象已近平和。因泻仍不止，又
为疏方，用生山药一两、滑石一两、生杭芍五钱、玄参五钱、甘草三钱（此即拙拟之滋阴清燥汤加玄参也）
一剂泻止，脉静身凉，脱然全愈。
病者 胡××之幼子，年三岁。
病名 间歇热。
病因 先因失乳，饮食失调，泄泻月余，甫愈，身体虚弱，后又薄受外感，遂成间歇热。
病候 或昼或夜发灼无定时，热近两点钟，微似有汗，其热始解。如此循环不已，体益虚弱。
诊断 此乃内伤、外感相并而为间歇热。盖外感之症，在少阳可生间歇热；内伤之病，在厥阴亦生
间歇热（肝虚者，恒寒热往来）。
疗法 证虽兼内伤外感，原宜内伤外感并治，为治外感用
西药，取孺子易服；治内伤用中药，先后分途施治，方为稳妥。
处方 （安知歇貌林一瓦） 为一日之量，分作三次，开水化服。将此药服完后，其灼必减轻，继
用生地八钱，煎汤一茶杯，分多次徐徐温饮下，灼热当全愈。但用生地者，取其味甘易服也。
效果 先将安知歇貌林服下，每服一次，周身皆微有凉汗，其灼热果见轻减。翌日，又将生地煎汤，
如法服完，病即霍然愈矣。盖生地虽非补肝虚正药，而能滋肾水以生肝，更能凉润肝血，则肝得其养，其肝
之虚者，自然转虚为强矣。
病者 卢姓，盐山人。
病因 孟秋天气犹热，开窗夜寝受风，初似觉凉，翌日即大热成温病。
病候 初次延医服药，竟投以麻、桂、干姜、细辛大热之剂。服后心如火焚，知误服药，以箸探喉，
不能吐。热极在床上乱滚，症甚危急。急来迎愚，及至，言才饮凉水若干，病热稍愈。然犹呻吟连声，不
能安卧。诊其脉近七至，洪大无伦，右部尤甚。舌苔黄浓，大便三日未行。
诊断 此乃阳明胃府之热已实，又误服大热之剂，何异火上添油，若不急用药解救，有危在目前之
虞。幸所携药囊中有自制离中丹（系用生石膏一两、朱砂二分制成），先与以五钱，俾用温开水送下，过半点
钟，心中之热少解，可以安卧。俾再用五钱送服，须臾呻吟亦止。再诊其脉，较前和平。此时可容取药，
宜再治以汤剂以期全愈。
处方 生石膏（三两） 知母（一两） 生山药（六钱） 玄参（一两）
甘草（三钱） 煎汤三盅，分三次温饮下。
效果 当日将药服完，翌日则脉静身凉，大便亦通下矣。
奉天宫某，年三十余，胸中满闷，常作呃逆，连连不止，调治数年，病转加剧。其脉洪滑有力，关前
尤甚，知其心火炽盛，热痰凝郁上焦也。遂用朴硝四两、白矾一两，掺炒熟麦面四两，炼蜜为丸，三钱重，每
服一丸，日两次，服尽一料全愈。盖朴硝味原咸寒，禀寒水之气，水能胜火，寒能治热，为治心有实热者
之要品。《内经》所谓“热淫于内，治以咸寒”也。用白矾者，助朴硝以消热痰也。调以炒熟麦面者，诚
以麦为心谷，以防朴硝白矾之过泻伤心，且炒之则气香归脾，又能防硝矾之不宜于脾胃也。
【病案一】
症状表现：体表和体内都有高热。舌苔边缘发黄、中间发黑，非常干燥。精神昏沉迷糊，时常说胡话。小便短少且排尿不畅，大便一天一夜排便四五次，粪便带有黏滞感。气味异常臭秽，且含有灼热的气息，左右手的脉象都呈现洪大长直之象。重按脉搏感觉不够充实有力，脉率稍快，两次呼吸之间脉搏跳动可达九次。
诊断：这纯粹是温病的邪热，属于阳明经与少阳经合病。因为病位在阳明经，所以脉象表现为洪大长直；因为邪气兼入少阳经，导致小便短少，致使水液流向大肠而引起滑泄腹泻。因为患者身体素来虚弱，所以虽然脉中夹杂有外感实热，但重按时仍感觉不实。
治疗方法：应当泻除邪热的同时补益正气，并且要大剂量药汤慢慢服用，这样才无碍于已经存在的滑泄腹泻。
处方：生石膏（三两，研成细末） 生山药（一两） 大生地（一两半） 生杭芍（八钱） 甘草（三钱） 野台参（五钱）
煎煮三大碗汤剂，慢慢温热饮用。一次只喝一大口，时间从早上六点钟开始，限定在晚上八点前服完。这个方子就是白虎加人参汤，用生山药代替粳米，用地黄代替知母，并且加入了白芍。用白虎汤清解阳明经的热邪，因为脉象不实所以加入人参；因为有滑泄腹泻所以用生山药代替粳米；用地黄代替知母，是因为少阳腑中有热；导致小便不利而滑泄，所以又加入白芍以清解少阳经的热邪，同时也起到利小便的作用。
疗效：准备好的药物，按照方法全部服完。第二天早晨精神顿时清爽，大热已退，滑泄腹泻也开始好转，脉象接近平和。因为腹泻仍未停止，又为其开具方子，使用生山药一两、滑石一两、生杭芍五钱、玄参五钱、甘草三钱（这是我拟定的滋阴清燥汤加入玄参），服用一剂后腹泻停止，脉象平静身体凉爽，彻底痊愈。
患者：胡某某的幼子，年龄三岁。
病名：间歇热。
病因：先前因为断奶，饮食失调，腹泻持续一个多月，刚刚痊愈，身体虚弱，之后又轻微感受外邪，于是形成间歇热。
症状表现：有时白天有时夜晚发作灼热感，没有固定时间，发热接近两个小时，微微出汗后，热势才开始解除。如此循环往复不停，身体更加虚弱。
诊断：这是内伤和外感相结合而形成的间歇热。大概外感的病症，在少阳经可以产生间歇热；内伤的疾病，在厥阴经也会产生间歇热（肝虚的人，常常出现忽冷忽热的往来症状）。
治疗方法：证候虽然兼有内伤和外感，原本应该内外同治，但因为治疗外感使用西药，便于儿童服用；治疗内伤使用中药，先后分头施治，这样才稳妥。
处方：（阿司匹林一瓦[0.6克]）作为一天的量，分成三次，用开水化开服用。将此药服完后，发热必然减轻，接着使用生地八钱，煎成一茶杯汤，分多次慢慢温热饮用下，发热应当完全痊愈。但使用地黄的缘故，是取其味甘容易服用的原因。
疗效：先将阿司匹林服下，每次服用后，周身都有微微的凉汗，发热果然见轻减轻。第二天，又将生地煎汤，按照方法服完，病立刻霍然痊愈了。大概地黄虽然不是补肝虚的正宗药物，但能滋补肾水以滋生肝木，更能凉润肝血，那么肝脏得到滋养，其肝虚的情况，自然由虚转强了。
患者：姓卢，盐山人。
病因：初秋天气仍然炎热，开窗夜间睡觉受风，起初似乎觉得凉快，第二天就大热形成温病。
症状表现：初次请医生服药，竟然投以麻黄、桂枝、干姜、细辛等大热性质的药剂。服用后心中像火烧一样，知道误服了药物，用筷子探喉催吐，不能吐出。热极时在床上乱滚，症状非常危急。急忙来迎接我诊治，等到时，说才喝了一些凉水，病情热度稍微缓解。但仍然呻吟不断，不能安卧。诊察他的脉象接近七至，洪大无比，右部尤其严重。舌苔黄厚浓浊，大便三天未行。
诊断：这是阳明胃腑的热邪已经结实，又误服了大热的药剂，何异于火上浇油，如果不紧急用药解救，有危及生命的危险。幸好所带的药囊中有自制的离中丹（是用生石膏一两、朱砂二分制成），先给予五钱，让用温开水送服，过了半个小时，心中的热度稍微缓解，可以安卧。再让用五钱送服，一会儿呻吟也停止了。再次诊察脉象，比之前平和。此时可以容许去取药，适宜再用汤剂治疗以期完全痊愈。
处方：生石膏（三两） 知母（一两） 生山药（六钱） 玄参（一两） 甘草（三钱） 煎煮三碗汤，分三次温热饮用。
疗效：当天将药服完，第二天则脉象平静身体凉爽，大便也通畅排出了。
【病案二】
奉天宫某人，年龄三十多岁，胸中满闷，经常打呃逆，连续不止，调理治疗数年，病情反而加剧。他的脉象洪滑有力，关前部位尤其明显，知道他是心火炽盛，热痰凝郁在上焦。于是使用朴硝四两、白矾一两，掺入炒熟的麦面四两，炼蜜做成丸药，每丸三钱重，每次服用一丸，每天两次，服完一料药后完全痊愈。大概朴硝味道原为咸寒，禀受寒水之气，水能胜火，寒能治热，是治疗心脏有实热的重要药物。《内经》所说的“热淫于内，治以咸寒”就是这个道理。使用白矾的原因，是帮助朴硝消除热痰。调和以炒熟麦面的原因，实在是因为麦是心的谷类食物，以防朴硝和白矾过度泻下损伤心脏，而且炒过后香气归脾，又能防止硝石和白矾不利于脾胃。
[Case 1]
Symptoms: High fever in both the exterior and interior. The tongue coating is yellow on the edges and black in the center, extremely dry. Mental state is confused and drowsy, with occasional delirium. Urine is scanty and difficult to pass; stool occurs four to five times a day and night, sticky and tenacious. The odor is exceptionally foul and emits a burning sensation. The pulse is surging, long, and straight on both left and right sides. Deep pressure reveals a lack of solidity, with a slightly rapid rate, reaching nine beats per two breaths.
Diagnosis: This is purely the heat of warm disease (Wen Bing), involving a combined syndrome of the Yangming and Shaoyang channels. Because the pathology is in the Yangming channel, the pulse appears surging and long; because the pathogen has also entered the Shaoyang channel, urine becomes scanty, causing water to flow into the large intestine resulting in slippery diarrhea. Because the patient's constitution is inherently weak, although the pulse contains excess heat from external contraction, it feels empty upon deep pressure.
Therapeutic Method: One should purge heat while tonifying healthy Qi, administering the prescription in large doses slowly taken over time, so as not to hinder the existing slippery diarrhea.
Prescription: Sheng Shi Gao (Raw Gypsum Fibrosum, 3 liang, finely powdered); Sheng Shan Yao (Raw Dioscoreae Rhizoma, 1 liang); Da Sheng Di (Raw Rehmanniae Radix, 1.5 liang); Sheng Hang Shao (Raw Paeoniae Radix Alba, 8 qian); Gan Cao (Licorice Root, 3 qian); Ye Tai Shen (Wild Codonopsis Pilosula, 5 qian).
Decoct in three large bowls of water, drink slowly while warm. Take only one large mouthful at a time, starting at 6:00 AM and finishing by 8:00 PM. This formula is Bai Hu Jia Ren Shen Tang (White Tiger Decoction plus Ginseng), using Raw Dioscoreae Rhizoma instead of Rice, Raw Rehmanniae Radix instead of Anemarrhenae Rhizoma, and adding White Peony Root. Bai Hu Tang clears heat from the Yangming channel; Ren Shen (Ginseng) is added because the pulse lacks solidity; Raw Dioscoreae Rhizoma replaces Rice because of the slippery diarrhea; Raw Rehmanniae Radix replaces Anemarrhenae Rhizoma because there is heat in the Shaoyang fu-organ; this causes urinary difficulty and slippery diarrhea, so Bai Shao (White Peony Root) is added to clear Shaoyang heat and promote urination.
Outcome: The prepared medicine was administered according to the method. By the next morning, mental clarity returned instantly, high fever subsided, slippery diarrhea improved, and the pulse became nearly normal. Since diarrhea persisted, another prescription was given: Sheng Shan Yao (1 liang), Hua Shi (Talcum, 1 liang), Sheng Hang Shao (5 qian), Xuan Shen (Scrophulariae Radix, 5 qian), Gan Cao (3 qian) (this is my proposed Zi Yin Qing Zao Tang [Nourish Yin and Clear Dryness Decoction] plus Xuan Shen). After one dose, diarrhea stopped, pulse calmed, body cooled, and full recovery was achieved.
Patient: Young son of Mr. Hu, aged three years.
Disease Name: Intermittent Fever.
Etiology: Previously due to weaning and dietary irregularity, leading to diarrhea for over a month. Just after recovery, the body was weak, and subsequently, mild external contraction occurred, resulting in intermittent fever.
Symptoms: Burning sensations occur either during the day or night without fixed timing. Fever lasts nearly two hours; slight sweating occurs, after which the heat resolves. This cycle repeats endlessly, further weakening the body.
Diagnosis: This is an intermittent fever caused by the combination of internal injury and external contraction. External contraction syndromes can produce intermittent fever when located in the Shaoyang channel; internal injury diseases can also produce intermittent fever when located in the Jueyin channel (liver deficiency often presents with alternating chills and fever).
Therapeutic Method: Although the syndrome involves both internal injury and external contraction, treating them simultaneously is appropriate. However, Western medicine is used for the external contraction for easier administration to the child, while Chinese medicine is used for the internal injury, treating them sequentially for safety.
Prescription: Aspirin (1 grain [0.6g]) as the daily dose, divided into three times, dissolved in boiling water. After taking this medicine, the fever will surely decrease. Then, use Sheng Di Huang (Rehmanniae Radix, 8 qian), decocted in one teacup of water, drunk slowly in multiple portions while warm; the fever should completely resolve. Sheng Di Huang is used because its sweet taste makes it easy to take.
Outcome: After taking Aspirin initially, each dose produced slight cool sweat throughout the body, and the fever indeed decreased. The next day, Sheng Di Huang decoction was taken as directed, and the illness was suddenly cured. Although Sheng Di Huang is not the primary herb for tonifying liver deficiency, it nourishes Kidney Water to generate Liver Wood and cools/moistens Liver Blood. Thus, the Liver receives nourishment, and liver deficiency naturally transforms from weak to strong.
Patient: Surname Lu, from Yanshan.
Etiology: In early autumn, the weather remained hot. Sleeping with windows open led to wind exposure. Initially feeling cool, the next day high fever developed into warm disease.
Symptoms: The first physician prescribed herbs such as Ma Huang (Ephedrae Herba), Gui Zhi (Cinnamomi Ramulus), Gan Jiang (Zingiberis Rhizoma), and Xi Xin (Asari Radix et Rhizoma)—all large heat-natured agents. After ingestion, the heart felt like it was burning. Realizing the error, the patient attempted to induce vomiting with chopsticks but failed. Agitated by extreme heat, the patient rolled around on the bed; the condition was critical. I was urgently summoned. Upon arrival, the patient reported drinking some cold water, which slightly relieved the heat. However, groaning continuously, unable to lie still. Pulse was near seven beats per breath, surging and excessively large, especially on the right side. Tongue coating was thick and heavy yellow. No bowel movement for three days.
Diagnosis: Heat in the Yangming Stomach fu-organ is solid/excess, compounded by the mistaken administration of large heat agents. This is akin to adding oil to fire. Without urgent medication, danger looms. Fortunately, my medical kit contained self-made Li Zhong Dan (made from 1 liang Raw Gypsum Fibrosum and 2 fen Cinnabar). I first gave 5 qian, to be taken with warm water. Half an hour later, chest heat lessened, allowing rest. Another 5 qian was given, stopping groaning shortly after. Re-palpation showed a more peaceful pulse. It was now safe to retrieve further medicine, suitable for decoction treatment to ensure complete recovery.
Prescription: Sheng Shi Gao (Raw Gypsum Fibrosum, 3 liang); Zhi Mu (Anemarrhenae Rhizoma, 1 liang); Sheng Shan Yao (Raw Dioscoreae Rhizoma, 6 qian); Xuan Shen (Scrophulariae Radix, 1 liang); Gan Cao (Licorice Root, 3 qian). Decoct in three bowls, divide into three warm doses.
Outcome: Medicine finished on the same day. By the next day, pulse calmed, body cooled, and bowels moved.
[Case 2]
A person from Fengtian Palace, over thirty years old, suffered from chest fullness and continuous hiccups for several years despite treatment, with worsening symptoms. Pulse was surging, slippery, and forceful, especially at the Guan position. This indicated blazing Heart Fire and congealed phlegm-heat in the Upper Jiao. Prescription: Pu Xiao (Mirabilite, 4 liang), Bai Fan (Alumen, 1 liang), mixed with 4 liang of stir-fried wheat flour, formed into pills with refined honey, each weighing 3 qian. Take one pill twice daily. Complete course resulted in full recovery. Pu Xiao is salty and cold, inheriting the energy of Cold Water; Water conquers Fire, and Cold treats Heat, making it a key herb for excess heat in the Heart. As stated in *Nei Jing*: "When heat prevails internally, treat with salty-cold." Bai Fan is used to assist Pu Xiao in eliminating phlegm-heat. Stir-fried wheat flour is used because wheat is the grain corresponding to the Heart, preventing Pu Xiao and Bai Fan from overly purging and damaging the Heart; stir-frying imparts fragrance that enters the Spleen, protecting the Spleen and Stomach from the harsh nature of Mirabilite and Alumen.