详观病案，知系因吐血过多，下焦真阴亏损，以致肾气不敛，冲气上冲。五更乃三阳升发之时，冲气
上冲者必益甚，所以脑筋跳动，喘嗽加剧也。欲治此症，当滋阴纳气，敛冲镇肝，方
能有效。爰拟方于下以备酌用∶
生山药（一两） 大熟地（一两） 净萸肉（六钱） 怀牛膝（六钱） 柏子仁（六钱） 生
龙骨（四钱） 生牡蛎（四钱） 生赭石（四钱） 生鸡内金（二钱） 玄参（二钱） 炙甘草（二钱）
日服一剂，煎渣重服。
小儿少阳之体，不堪暑热，恒喜食凉饮冷以解暑，饮食失宜，遂多泄泻，泻多亡阴，益至燥渴多饮，而
阴分虚损者，其小溲恒不利，所饮之水亦遂尽归大肠，因之泄泻愈甚，此小儿暑天水泻所以难治也。而所拟
之方，若能与证吻合，则治之亦非难事。方用生怀山药一两，滑石八钱，生杭芍六钱，甘草三钱，煎
汤一大盅，分三次温饮下。一剂病减，再剂全愈矣。方中之意∶山药滋真阴，兼固其气；滑石泻暑热，
兼利其水，甘草能和胃，兼能缓大便，芍药能调肝，又善利小便；肝胃调和其泄泻尤易愈也。此方即拙拟滋
阴清燥汤。原治寒温之证，深入阳明之府，上焦燥热，下焦滑泻。而小儿暑天水泻，其上焦亦必燥热，是以宜
之。至于由泻变痢，由疟转痢者，治以此方，亦能随手奏效。何者？暑天热痢，最宜用天水散；方中滑石，
甘草同用，固河间之天水散也。又可治以芍药甘草汤；方中白芍、甘草同用，即仲景之芍药甘草汤也。且由
泻变痢，由疟转痢者，其真阴必然亏损，气化必不固摄，而又重用生山药为之滋阴固气化，是以无论由泄
变痢，由疟转痢者皆宜。若服此药间有不效者，可加白头翁三钱，因白头翁原为治热痢之要药也。
仔细查看病案，得知这是由于吐血过多，导致下焦真阴亏损，进而使肾气不能收敛，冲脉之气上逆。五更时分是三阳经气升发的时候，此时上逆的冲气必然更加严重，所以出现脑部神经跳动、气喘咳嗽加剧的症状。想要治疗这个病症，应当采用滋阴纳气、收敛冲气并镇压肝气的治法，方能见效。因此拟定以下方剂供斟酌使用：
生山药（一两） 大熟地（一两） 净萸肉（六钱） 怀牛膝（六钱） 柏子仁（六钱） 生龙骨（四钱） 生牡蛎（四钱） 生赭石（四钱） 生鸡内金（二钱） 玄参（二钱） 炙甘草（二钱）
每日服用一剂，煎煮药渣后再次服用。
小儿属于少阳之体，难以承受暑热，常常喜欢食用冷饮来解暑，因饮食不当，往往导致泄泻。泄泻过多会耗伤阴液，进而引起口干舌燥、大量饮水；而阴分虚损的小儿，其小便通常不利，喝进去的水便全部流入大肠，因此泄泻更加严重，这就是小儿夏季水样腹泻难以治疗的原因。如果所拟定的方剂能与证候相符，那么治疗起来也并非难事。方用生怀山药一两，滑石八钱，生杭芍六钱，甘草三钱，煎成一大盅汤剂，分三次温服。服用一剂病情减轻，服用两剂即可痊愈。方中的用意是：山药滋养真阴，兼能固摄元气；滑石清泻暑热，兼能通利水道；甘草能调和胃气，兼能缓解大便急迫；芍药能调理肝脏，又善于通利小便；肝胃调和，其泄泻就更容易治愈了。这个方子就是我先前拟定的滋阴清燥汤。原本用于治疗寒温类疾病深入阳明腑证，表现为上焦燥热、下焦滑脱泄泻的情况。而小儿夏季水样腹泻，其上焦也必定存在燥热，因此适用此方。至于由泄泻转变为痢疾，或由疟疾转变为痢疾的情况，使用此方治疗，也能随手取得疗效。为什么呢？夏季的热性痢疾，最适合使用天水散；方中滑石与甘草同用，正是刘河间的天水散。还可以使用芍药甘草汤进行治疗；方中白芍与甘草同用，即是张仲景的芍药甘草汤。而且，由泄泻转为痢疾、由疟疾转为痢疾的患者，其真阴必然亏损，气化功能必然不能固摄，再加上重用生山药来滋阴并固摄气化，因此无论是由泄泻转为痢疾，还是由疟疾转为痢疾，都适宜使用此方。如果服用此药后偶尔无效，可以加入白头翁三钱，因为白头翁原本是治疗热性痢疾的重要药物。
A careful examination of the medical case reveals that it stems from excessive hematemesis (vomiting blood), which has depleted the True Yin in the Lower Jiao, leading to the failure of Kidney Qi to consolidate and the rebellious ascent of Chong Qi. The fifth watch (approximately 3-5 AM) is the time when the Qi of the Three Yang meridians ascends and develops; at this time, the rebellious Chong Qi will inevitably become more severe, resulting in throbbing sensations in the brain/nerves and exacerbated asthma and coughing. To treat this condition, one should employ methods to nourish Yin and grasp Qi, restrain Chong Qi, and suppress the Liver. Only then can efficacy be achieved. Therefore, the following prescription is proposed for consideration:
Raw Dioscoreae Rhizoma (Shanyao) 1 liang, Prepared Rehmanniae Radix (Dishudi) 1 liang, Clean Corni Fructus (Yurou) 6 qian, Huai Achyranthis Bidentatae Radix (Huainiuxi) 6 qian, Biota Seed (Baiziren) 6 qian, Raw Longgu (Dragon Bone) 4 qian, Raw Muli (Oyster Shell) 4 qian, Raw Hematitum (Zheishi) 4 qian, Raw Galli Gigerii Endothelium Corneum (Jineijin) 2 qian, Scrophulariae Radix (Xuanshen) 2 qian, Roasted Glycyrrhizae Radix et Rhizoma (Zhigancao) 2 qian.
Take one dose daily; decoct the dregs and take again.
Children possess a Shaoyang constitution and cannot easily withstand summer heat. They often prefer cold drinks to relieve the heat. Improper diet frequently leads to diarrhea. Excessive diarrhea consumes Yin fluids, leading to dryness, thirst, and increased water intake. In children with deficiency of Yin, urination is often obstructed; consequently, the ingested water flows entirely into the Large Intestine, exacerbating the diarrhea. This is why summer water diarrhea in children is difficult to treat. However, if the prescribed formula matches the syndrome, treatment is not difficult. The prescription uses Raw Huai Dioscoreae Rhizoma (Shanyao) 1 liang, Talcum (Huashi) 8 qian, Raw Hang Paeoniae Radix Alba (Hangshaoyao) 6 qian, and Glycyrrhizae Radix et Rhizoma (Gancao) 3 qian. Decoct in a large cup of water and take warm in three divided doses. Symptoms will alleviate after one dose and resolve completely after two doses. The rationale of the formula is as follows: Shanyao nourishes True Yin and consolidates Qi; Huashi clears summerheat and promotes diuresis; Gancao harmonizes the Stomach and relieves urgency of the bowels; Shaoyao regulates the Liver and effectively promotes diuresis. When the Liver and Stomach are harmonized, diarrhea becomes easier to cure. This formula is my previously formulated Ziyin Qingzao Tang (Nourishing Yin and Clearing Dryness Decoction). It was originally designed for Cold-Warm diseases penetrating the Fu organs of the Yangming, presenting with upper Jiao dryness-heat and lower Jiao slippery diarrhea. Since children with summer water diarrhea also necessarily have upper Jiao dryness-heat, this formula is suitable. As for cases where diarrhea transforms into dysentery, or malaria transforms into dysentery, treating them with this formula can also yield immediate results. Why? Summer heat-dysentery is most appropriately treated with Tianshui San (Sky Water Powder); the combination of Huashi and Gancao in the formula constitutes Hejian's Tianshui San. It can also be treated with Shaoyao Gancao Tang (Peony and Licorice Decoction); the combination of Baishao and Gancao in the formula constitutes Zhongjing's Shaoyao Gancao Tang. Furthermore, patients whose diarrhea transforms into dysentery or whose malaria transforms into dysentery inevitably suffer from depletion of True Yin and failure of Qi transformation to consolidate. By heavily using Raw Shanyao to nourish Yin and consolidate Qi transformation, this formula is suitable regardless of whether the condition originated from diarrhea transforming into dysentery or malaria transforming into dysentery. If occasional ineffectiveness occurs after taking this medicine, add 3 qian of Pulsatillae Radix (Baitouweng), as Baitouweng is an essential herb for treating heat-dysentery.