天津胡××，年四十二岁，于孟秋得泄泻兼灼热病。
病因 其兄因痢病故，铺中之事及为其兄殡葬之事，皆其一人经
理，哀痛之余，又兼心力俱瘁，遂致大便泄泻周身发热。
证候 一日夜泻十四五次，将泻时先腹疼，泻后疼益甚，移时始
愈，每过午一点钟，即觉周身发热，然不甚剧，夜间三点钟后，又渐愈，其脉六部皆弱，两尺尤甚。
诊断 按此证系下焦虚寒及胸中大气虚损也。盖下焦寒甚者，能迫下焦之元阳上浮，胸中大
气虚甚者，恒不能收摄，致卫气外浮，则元阳之上浮与卫气之外浮相并，即可使周身发热。
其发在过午者，因过午则下焦之阴寒益盛，而胸中大气益虚也（胸中大气乃上焦之阳气，过午阴
盛，是以大气益虚）。此本虚寒泄泻之证，原不难治，而医者因其过午身热，皆不敢投以温补，是以屡治不愈。拟
治以大剂温补之药，并收敛其元阳归其本源，则泄泻止而灼热亦愈矣。
处方 白术（五钱炒） 熟怀地黄（一两） 生怀山药（一两） 净萸肉（五钱）
干姜（三钱） 乌附子（三钱） 生杭芍（三钱） 云苓片（二钱） 炙甘草（三钱）
共煎汤一大盅，温服。
复诊 服药一剂，身热即愈，服至三剂，泄泻已愈强半，脉象亦
较前有力，遂即原方略为加减俾再服之。
处方 白术（六钱炒） 熟怀地黄（一两） 生怀山药（一两） 净萸肉（五钱）
龙眼肉（五钱） 干姜（四钱） 乌附子（四钱） 云苓片（二钱） 炙甘草（三钱）
效果 将药连服十余剂，病遂全愈。
帮助 大队温补药中复用芍药者，取其与附子并用，能收敛元阳归根于阴，且能分利小便则泄
泻易愈也。至后方去芍药者，因身已不热元阳已归其宅，且泄泻已就愈，仍有茯苓以利其
小便，无须再用芍药也。
天津的胡××，四十二岁，在初秋时节患上了泄泻并伴有身体灼热的疾病。
病因：他的哥哥因痢疾去世，店铺的事务以及为哥哥办理丧事，都由他一人操持，在极度哀痛之余，又加上心力交瘁，从而导致大便泄泻且周身发热。
证候：一天一夜腹泻十四五次，每次排便前先是腹痛，排便后疼痛更加剧烈，过了一段时间才缓解。每天午后一点钟左右，便觉得周身发热，但热度并不剧烈；夜间三点钟以后，发热又逐渐消退。其六部脉象皆弱，两尺脉尤为明显。
诊断：根据此证，属于下焦虚寒及胸中大气虚损。大概是因为下焦寒气极盛，逼迫下焦的元阳上浮；而胸中大气虚损严重时，往往不能固摄，导致卫气外浮。这样，元阳的上浮与卫气的外浮相结合，就会导致周身发热。发热出现在午后，是因为午后下焦的阴寒更盛，而胸中的大气更虚（胸中大气即是上焦的阳气，午后阴气旺盛，所以大气更显虚弱）。这本来是虚寒性质的泄泻证，原本不难治疗，但医生们因为他在午后身热，都不敢使用温补药物，因此多次治疗都不见痊愈。现拟定用大剂量的温补药物进行治疗，并收敛元阳使其回归本源，那么泄泻停止，灼热也会痊愈。
处方：炒白术五钱，熟怀地黄一两，生怀山药一两，净山茱萸五钱，干姜三钱，乌附子三钱，生杭芍三钱，云苓片二钱，炙甘草三钱。
共煎成一大盅汤药，温服。
复诊：服用一剂药后，身热即愈；服用至三剂，泄泻已好转大半，脉象也比之前有力，于是就在原方基础上稍作加减，让他继续服用。
处方：炒白术六钱，熟怀地黄一两，生怀山药一两，净山茱萸五钱，龙眼肉五钱，干姜四钱，乌附子四钱，云苓片二钱，炙甘草三钱。
效果：将药物连续服用十余剂，病便完全痊愈。
按语：在大队温补药中再次使用芍药，是取它与附子配合使用，能够收敛元阳，使其归根于阴，并且能分利小便，从而使泄泻容易痊愈。至于后方去掉芍药，是因为身体已经不热，元阳已经回归本位，且泄泻已经接近痊愈，仍有茯苓来通利小便，不需要再使用芍药了。
Mr. Hu XX from Tianjin, aged forty-two, contracted diarrhea accompanied by burning heat in early autumn.
Etiology: His elder brother died of dysentery. Mr. Hu managed all matters regarding the shop and his brother's funeral alone. Following intense grief and mental exhaustion, he developed diarrhea and generalized feverish sensation.
Symptoms: He experienced fourteen to fifteen episodes of diarrhea per day and night. Abdominal pain preceded each bowel movement, intensifying after defecation, subsiding only after some time. Around 1:00 PM daily, he felt a generalized burning heat, though not severe; this sensation gradually subsided after 3:00 AM. The pulse was weak in all six positions, particularly pronounced at the Chi (Cun-Kou) position on both wrists.
Diagnosis: This syndrome is attributed to deficiency-cold in the Lower Jiao (Lower Burner) and deficiency of the Great Qi in the Chest. Severe cold in the Lower Jiao can force the Yuan Yang (Original Fire) to float upward. When the Great Qi in the chest is severely deficient, it often fails to retain and secure, causing Wei Qi (Defensive Qi) to float outward. The combination of floating Yuan Yang and floating Wei Qi results in generalized burning heat. The occurrence of heat in the afternoon is because Yin-cold in the Lower Jiao becomes more abundant after noon, while the Great Qi in the chest becomes more deficient (The Great Qi in the chest refers to the Yang Qi of the Upper Jiao; as Yin dominates in the afternoon, the Great Qi appears even more deficient). This is fundamentally a deficiency-cold diarrhea syndrome, which should not be difficult to treat. However, physicians, noting the afternoon fever, dared not administer warming and tonifying prescriptions, leading to repeated treatment failures. I propose treating with a large dose of warming and tonifying herbs, while simultaneously consolidating the Yuan Yang to return it to its source. Thus, the diarrhea will cease, and the burning heat will resolve.
Prescription:
Bai Zhu (Atractylodis Rhizoma, stir-fried), 5 qian;
Shu Di Huang (Rehmanniae Radix Praeparata), 1 liang;
Sheng Shan Yao (Dioscoreae Rhizoma, raw), 1 liang;
Jing Yu Rou (Corni Fructus), 5 qian;
Gan Jiang (Zingiberis Rhizoma), 3 qian;
Wu Fu Zi (Aconiti Lateralis Radix Praeparata), 3 qian;
Sheng Hang Shao (Paeoniae Radix Alba, raw), 3 qian;
Yun Ling Pian (Poria Sclerotium slices), 2 qian;
Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried), 3 qian.
Decoct together in a large cup of water, take warm.
Follow-up Visit: After one dose, the fever resolved. After three doses, the diarrhea improved significantly, and the pulse became stronger than before. Therefore, slight modifications were made to the original prescription for continued administration.
Prescription:
Bai Zhu (Atractylodis Rhizoma, stir-fried), 6 qian;
Shu Di Huang (Rehmanniae Radix Praeparata), 1 liang;
Sheng Shan Yao (Dioscoreae Rhizoma, raw), 1 liang;
Jing Yu Rou (Corni Fructus), 5 qian;
Long Yan Rou (Longans Arillus), 5 qian;
Gan Jiang (Zingiberis Rhizoma), 4 qian;
Wu Fu Zi (Aconiti Lateralis Radix Praeparata), 4 qian;
Yun Ling Pian (Poria Sclerotium slices), 2 qian;
Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried), 3 qian.
Outcome: After continuous administration of over ten doses, the illness was completely cured.
Commentary: The inclusion of Shao Yao (Paeoniae Radix) among the major warming and tonifying herbs is intended to utilize its synergy with Fu Zi (Aconiti Lateralis Radix Praeparata) to consolidate the Yuan Yang and guide it back to the Yin, while also promoting diuresis to facilitate the resolution of diarrhea. In the subsequent prescription, Shao Yao was removed because the body was no longer hot, the Yuan Yang had returned to its residence, and the diarrhea was nearly resolved. With Yun Ling Pian (Poria Sclerotium) still present to promote diuresis, there was no further need for Shao Yao.