病起旬日。犹然头胀。渐至耳聋。正如内经病能篇所云。因于湿首如裹。此
呃忒鼻衄。皆邪混气之象。况舌色带白。咽喉欲闭。邪阻上窍。空虚之所。谅非苦
寒直入胃中可以治病。病名湿温。不能自解。即有昏痉之变。医莫泛称时气而已。
连翘 牛蒡子 银花 马勃 射干 金汁
仲景云。小便不利者。为无血也。小便利者。血症谛也。此症是暑湿气蒸。三
焦弥漫。以致神昏。乃诸窍阻塞之兆。至小腹硬满。大便不下。全是湿郁气结。彼
世医犹然以滋味呆钝滞药。与气分结邪相反极矣。议用甘露饮法。
猪苓 浙茯苓 寒水石 晚蚕砂 皂荚子
厥阴为病。必错杂不一。疟痢之后。肝脏必虚。发症。左胁有痞。腹中块儡外
坚。胁下每常汨汨有声。恶虚就实。常有寒热。胃中不知饥。而又 杂吞酸。脉长
而数。显然厥阴阳明。湿热下渗。前阴阳缩。而为湿热症也。议用升发阳明胃气。
渗泄厥阴湿热。其症自愈。
苍术 半夏 茯苓 橘红 通草 当归 柏子仁 沙蒺藜 川楝子 茴香
温疟初愈。骤进浊腻食物。湿聚热蒸。蕴于经络。寒战热炽。骨骱烦疼。舌起
灰滞之色。面目痿黄色。显然湿热为痹。仲景谓湿家忌投发汗者。恐阳伤变病。
盖湿邪重着。汗之不却。是苦味辛通为安耳。
防己 杏仁 滑石 醋炒半夏 连翘 山栀 苡仁 野赤豆皮
湿温长夏最多。湿热郁蒸之气。由口鼻而入。上焦先病。渐布中下。河间所
谓三焦病也。治与风寒食积迥异。仲景云。湿家不可发汗。汗之则痉。湿本阴邪。
其中人也则伤阳。汗则阳易泄越。而邪留不解。湿蒸热郁。发现为黄。熏蒸气隧
之间。正如罨曲之比。斯时病全在气分。连翘赤小豆汤。可以奏效。今经一月。邪
弥三焦。自耳前后。左肿及右。痈疡大发。夫痈者壅也。不惟气滞。血亦阻塞。蒸而
为脓。谷食不思。陡然肉消殆尽。胃气索然矣。商治之法。补则助壅。清则垂脱。前
辈成法。一无可遵。因思湿热秽浊。结于头面清窍。议轻可去实之法。选芳香气
味。使胃无所苦。或者壅遏得宣。少进浆粥。便是进步。经云。从上病者。治其上。灵
枢云。上焦如雾。非轻扬芳香之气。何以开之。
青菊叶 荷叶边 金银花 象贝母 绿豆皮 马兜铃 连翘 射干 金汁
脉弦缓。面目肌肤皆黄。舌白滑腻。胸脘膈间胀闭。病名湿温。由濒海潮湿
气入口鼻。至募原分布三焦。此为外因。仍食水谷腥物。与外入秽浊之邪。两相
交混。湿甚热郁。三焦隧道。气血不通。遂变黄色。发汗不愈者。湿家本有汗也。清
热消导不愈者。热从湿中而起。湿不去。则热不除也。夫湿邪无形质。攻滞乃有
形治法。其不效宜矣。昔河间治湿热。必取乎苦辛气寒。盖苦降以逐湿辛香以
祛秽。寒取乎气。藉气行。不闭塞于内也。当世医者混以伤寒表里为治。殊不知
秽湿气入口鼻。游行三焦。不与伤寒同治。
绵茵 白豆蔻 浓朴 川通草 广皮白 茯苓皮 半夏曲 块滑石
雨湿地蒸潮秽经旬。人在气交之中。口鼻吸受。从上内侵。头胀脘闷。肉刺
骨痛。盖肺位最高。其气主周身贯串。既被湿阻。气不运通。湿甚生热。汗出热缓。
少间再热。凡风寒得汗解。湿邪不从汗解耳。仲景云。湿家不可发汗。汗之则痉。
谓湿本阴晦之邪。其伤必先及阳。故汗下清降消导。与湿邪不相干涉也。湿也。
热也。皆气也。能蒙蔽周身之气。原无有形质可攻。由上不为清理。漫延中下二
焦。非比伤寒六经。自表传里相同。河间畅发此义。专以三焦宣通为法。明张司
农亦以苦辛寒主治。总以气分流利为主。气通则湿解矣。今两旬不愈。入暮昏
厥。厥者逆乱之称。以邪深入至阴之中。热蒸上冒。致神明为邪所蒙蔽矣。初湿
邪下注。而大便为溏。今则气窒结闭。而大便不通。古称热深厥深。又云。厥少热
多则病退。厥多热少则病进。凡厥多隶厥阴也。
绿豆 野赤豆 马料豆 地浆 珍珠 冰片
又 暑湿客气由上受以行中道。未按经法。致三焦痞塞。逆乱为厥。厥属邪深
在阴。故取地浆重阴清热。珠潜水底咸寒。少佐冰片辛热。能开热痹。直走至阴。
以冀厥止。究竟暑湿热气乃无质之邪。弥漫胸臆。如烟雾缭绕。诸宗气营气无
以展舒。焉有知味知饥。彼攻消峻克。能涤有形之邪滞。非湿结气分之治也。昔
轩岐云。病从上者治其上。且上焦如雾。藉轻扬可以去实。半月不更衣。断勿攻
下。皆气窒使然。
川贝 米仁 兜铃 白蔻 连翘 射干 通草
中年冲气。痰升喘急。随发随止。从肝肾本病治。固是地黄饮子。用意在浊
药轻投。勿以味浓凝滞痰气。但以质能引导至下。变饮为丸。纯是浊药柔温。若
归脾汤。甘温守中。养脾之营。更与痰饮冲逆相背。自七月间反复。必有暑湿客
气。从呼吸而受。据述肌肤间发丹疹。浮肿甚速。腠膜映红。若但内症。未必有此。
思夏秋口鼻受气。上焦先伤。与肝肾本病两途。上焦失解。理必漫延中下。而三
焦皆为病薮矣。此胀在乎脉络。不在腑肠。水谷无碍者缘此。况久病大虚。温补
不受。必当推其至理。伏邪引动宿病。仲景论必先理其邪。且口渴便实。岂温热
相宜。自言怀抱郁结。相火内寄肝胆。如茎肿囊纵。湿壅水渍。勉以三焦气分宣
通方。仿古二虚一实。偏治其实。开其一面也。
飞滑石 杏仁 茯苓皮 浓朴 猪苓 通草 白蔻仁
望色。萎瘁晦黯。闻声。呼吸不利。语音若在瓮中。诊脉右缓左急。问初病忽
热忽温。头中如裹。腰痛欲拊扪。神识呆钝。昏昏欲寐。肢节螈痉。咳痰映红。溺溲
短缩。便溏带血。不饥不渴。环口微肿。唇干不红。舌白糜腐。此水谷酒腥湿热相
并郁蒸。阻挠清气之游行。致周身气机。皆令痹塞。夫热邪湿邪皆气也。由募原
分布三焦营卫。循环升降。清浊失司。邪属无形。先着气分。时师横议表邪宜汗。
里滞宜消。见热投凉。殊不知热由湿郁。气行热走。仲景于痉 从湿化忌汗忌
下。明示后人勿伤阴阳耳。但无形之邪。久延必致有形。由气入血。一定理也。据
色脉症参之。未见或可采用。
羚羊角 茵 银花 连翘 通草 大腹皮 茯苓皮 猪苓 泽泻 至宝丹
病程已持续十多天。仍然感到头部胀满。逐渐发展到耳聋。正如《内经·病能篇》所说：“因于湿，首如裹。”这种呃逆、鼻衄，都是邪气混入气分的表现。况且舌色带白，咽喉有闭塞感，这是邪气阻滞上窍。在空虚之处，想必不是用苦寒药物直入胃中就能治愈的。病名是湿温，不能自行解除，即使出现神昏、惊厥的变化，医生也不要泛泛地称为时气病而已。
张仲景说：小便不利的，是无血证；小便利的，才是血证的确凿证据。此症是暑湿气蒸腾，三焦弥漫，导致神志昏迷，这是诸窍阻塞的先兆。至于小腹硬满，大便不通，完全是湿邪郁结、气机阻滞所致。那些世俗医生仍然用滋腻呆钝的药物，这与气分结聚的邪气截然相反。建议采用甘露饮的方法。
厥阴经发病，症状必然错杂不一。疟疾或痢疾之后，肝脏必然虚弱。发作时，左胁下有痞块，腹部肿块外坚。胁下经常发出汨汨的水声，厌恶虚证而喜欢实证，常有寒热往来。胃中不知饥饿，却又夹杂吞酸。脉象长而数。显然是厥阴与阳明湿热下渗，前阴收缩，属于湿热症。建议采用升发阳明胃气，渗泄厥阴湿热的方法，病症自然痊愈。
苍术、半夏、茯苓、橘红、通草、当归、柏子仁、沙蒺藜、川楝子、茴香
温疟刚刚痊愈，突然进食油腻食物，湿聚热蒸，蕴结于经络，出现寒战高热，骨节烦痛。舌起灰滞之色，面目萎黄，显然是湿热导致的痹证。张仲景说湿家忌用发汗法，恐怕阳气受损变生他病。因为湿邪重着，发汗不能祛除，只有用苦味辛通的药物才能安宁。
湿温病在长夏季节最多见。湿热郁蒸之气，从口鼻而入，上焦先受病，逐渐波及中下焦，这就是河间所说的三焦病。治疗与风寒、食积截然不同。张仲景说：湿家不可发汗，发汗则会导致痉证。湿本是阴邪，人感受它则损伤阳气，发汗则阳气容易泄越，而邪气留滞不解。湿蒸热郁，表现为黄疸，熏蒸于气隧之间，正像发酵曲药一样。此时病全在气分，连翘赤小豆汤可以奏效。如今经过一个月，邪气弥漫三焦，从耳前后开始，左肿波及右，痈疡大发。所谓“痈”，就是壅塞，不仅气滞，血也阻塞，蒸酿而成脓。谷食不思，陡然肌肉消瘦殆尽，胃气索然了。商量治疗方法，补益则助长壅塞，清热则可能导致虚脱。前辈成法，一无可遵循。于是想到湿热秽浊，结于头面清窍，建议用轻扬之品去实的方法，选用芳香气味的药物，使胃不受苦，或许壅遏得以宣通，稍进浆粥，就是进步。《内经》说：从上部发病的，治其上。《灵枢》说：上焦如雾，不用轻扬芳香之气，怎么能开通呢？
青菊叶、荷叶边、金银花、象贝母、绿豆皮、马兜铃、连翘、射干、金汁
脉象弦缓，面目肌肤皆黄，舌苔白滑腻，胸脘膈间胀闭。病名湿温，由濒海潮湿之气入口鼻，至募原分布三焦，这是外因。仍食用水谷腥物，与外入秽浊之邪，两相交混，湿甚热郁，三焦隧道，气血不通，遂变黄色。发汗不愈的，是因为湿家本就有汗。清热消导不愈的，是因为热从湿中而起，湿不去，则热不除也。湿邪无形质，攻滞是有形治法，其不效是理所当然的。昔年河间治疗湿热，必取苦辛气寒之法。盖苦降以逐湿，辛香以祛秽，寒取乎气，藉气行，不闭塞于内也。当世医者混以伤寒表里为治，殊不知秽湿气入口鼻，游行三焦，不与伤寒同治。
绵茵陈、白豆蔻、浓朴、川通草、广皮白、茯苓皮、半夏曲、块滑石
雨天地蒸潮秽经旬，人在气交之中，口鼻吸受，从上内侵，头胀脘闷，肉刺骨痛。盖肺位最高，其气主周身贯串，既被湿阻，气不运通，湿甚生热，汗出热缓，少间再热。凡风寒得汗解，湿邪不从汗解耳。张仲景说：湿家不可发汗，发汗则痉。谓湿本阴晦之邪，其伤必先及阳。故汗下清降消导，与湿邪不相干涉也。湿也，热也，皆气也，能蒙蔽周身之气，原无有形质可攻。由上不为清理，漫延中下二焦，非比伤寒六经，自表传里相同。河间畅发此义，专以三焦宣通为法。明张司农亦以苦辛寒主治，总以气分流利为主，气通则湿解矣。今两旬不愈，入暮昏厥。厥者逆乱之称，以邪深入至阴之中，热蒸上冒，致神明为邪所蒙蔽矣。初湿邪下注，而大便为溏，今则气窒结闭，而大便不通。古称热深厥深，又云：厥少热多则病退，厥多热少则病进。凡厥多隶厥阴也。
又案：暑湿客气由上受以行中道，未按经法，致三焦痞塞，逆乱为厥。厥属邪深在阴，故取地浆重阴清热，珠潜水底咸寒，少佐冰片辛热，能开热痹，直走至阴，以冀厥止。究竟暑湿热气乃无质之邪，弥漫胸臆，如烟雾缭绕，诸宗气营气无以展舒，焉有知味知饥。彼攻消峻克，能涤有形之邪滞，非湿结气分之治也。昔轩岐云：病从上者治其上，且上焦如雾，藉轻扬可以去实。半月不更衣，断勿攻下，皆气窒使然。
中年冲气，痰升喘急，随发随止，从肝肾本病治，固是地黄饮子。用意在浊药轻投，勿以味浓凝滞痰气，但以质能引导至下，变饮为丸，纯是浊药柔温。若归脾汤，甘温守中，养脾之营，更与痰饮冲逆相背。自七月间反复，必有暑湿客气，从呼吸而受。据述肌肤间发丹疹，浮肿甚速，腠膜映红，若但内症，未必有此。思夏秋口鼻受气，上焦先伤，与肝肾本病两途。上焦失解，理必漫延中下，而三焦皆为病薮矣。此胀在乎脉络，不在腑肠，水谷无碍者缘此。况久病大虚，温补不受，必当推其至理，伏邪引动宿病，仲景论必先理其邪，且口渴便实，岂温热相宜。自言怀抱郁结，相火内寄肝胆，如茎肿囊纵，湿壅水渍，勉以三焦气分宣通方，仿古二虚一实，偏治其实，开其一面也。
望色，萎瘁晦黯。闻声，呼吸不利，语音若在瓮中。诊脉右缓左急。问初病忽热忽温，头中如裹，腰痛欲拊扪，神识呆钝，昏昏欲寐，肢节螈痉，咳痰映红，溺溲短缩，便溏带血，不饥不渴，环口微肿，唇干不红，舌白糜腐。此水谷酒腥湿热相并郁蒸，阻挠清气之游行，致周身气机，皆令痹塞。夫热邪湿邪皆气也，由募原分布三焦营卫，循环升降，清浊失司，邪属无形，先着气分。时师横议表邪宜汗，里滞宜消，见热投凉，殊不知热由湿郁，气行热走。仲景于痉从湿化忌汗忌下，明示后人勿伤阴阳耳。但无形之邪，久延必致有形，由气入血，一定理也。据色脉症参之，未见或可采用。
The disease has persisted for more than ten days. The head still feels distended, gradually progressing to deafness. As stated in the *Neijing: Bingneng Pian* (Chapter on Disease Manifestations): "Due to dampness, the head feels as if wrapped." These symptoms of hiccups and epistaxis are all signs of pathogenic factors mixing with the Qi level. Moreover, the tongue color is white, and there is a sensation of throat closure, indicating that pathogens are obstructing the upper orifices. In such empty areas, it is unlikely that bitter-cold herbs entering directly into the stomach can cure the disease. The diagnosis is Damp-Warmth (Shiwen), which cannot resolve itself; even if coma and convulsions occur, physicians should not vaguely refer to it as Seasonal Qi (Shiqi) disease.
Qiaoliao (Forsythiae Fructus), Niuxiangzi (Arctii Fructus), Yinhua (Lonicerae Japonicae Flos), Mabo (Cordyceps militaris or related fungus), Shegan (Belamcandae Rhizoma), Jinzhi (Gold Juice).
Zhang Zhongjing said: If urination is difficult, it indicates no blood pathology; if urination is free, it confirms a blood pathology. This case involves steaming of Summerheat-Dampness, overflowing through the Triple Burner (Sanjiao), leading to mental confusion, which is a sign of obstruction in various orifices. The hardness and fullness of the lower abdomen, along with constipation, are entirely due to Dampness stagnation and Qi binding. Those worldly physicians still use cloying, dull, and stagnant medications, which are extremely contrary to the Qi-level binding pathogens. It is proposed to use the method of Ganlu Yin (Sweet Dew Decoction).
Zhuling (Polyporus), Zhe Fuling (Poria prepared in Zhejiang), Hanshuishi (Calcitum), Wancansha (Bombyx Batryticatus), Zhaojiazi (Gleditsiae Spina).
Diseases of the Jueyin (Liver/Pericardium) must be mixed and varied. After malaria or dysentery, the Liver is necessarily deficient. During attacks, there is a mass in the left hypochondrium, and abdominal masses are hard externally. There is often gurgling sound under the ribs, aversion to deficiency and preference for excess, with alternating chills and fever. The stomach feels no hunger, yet there is acid regurgitation. The pulse is long and rapid. Clearly, this is Damp-Heat seeping downward involving Jueyin and Yangming, with contraction of the anterior yin, constituting a Damp-Heat syndrome. It is proposed to raise and disperse the Stomach Qi of Yangming, and drain-dampness while clearing heat from Jueyin, so that the symptoms will heal naturally.
Cangzhu (Atractylodis Rhizoma), Banxia (Pinelliae Rhizoma), Fuling (Poria), Juhong (Citri Reticulatae Pericarpium Rubrum), Tongcao (Tetrapanacis Medulla), Danggui (Angelicae Sinensis Radix), Baiziren (Biota Seed), Shajili (Tribuli Fructus), Chuanlianzi (Meliae Toosendan Fructus), Huixiang (Foeniculi Fructus).
After initial recovery from Warm Malaria (Wen Nue), sudden intake of greasy food causes Dampness accumulation and Heat steaming, accumulating in the collaterals. This leads to chills, intense fever, and bone-joint pain. The tongue shows grayish-stagnant color, and the face and eyes appear sallow and yellow, clearly indicating Bi Syndrome caused by Damp-Heat. Zhang Zhongjing stated that patients with Dampness should avoid sweating, fearing damage to Yang and transformation into other diseases. Because Dampness is heavy and turbid, sweating does not remove it; only bitter and acrid-unblocking methods ensure peace.
Fangji (Stephaniae Tetrandrae Radix), Xingren (Armeniacae Semen Amarum), Huashi (Halcionis Pulvis), Vine-processed Banxia (Pinelliae Rhizoma processed with vinegar), Qiaoliao (Forsythiae Fructus), Shanzhi (Gardeniae Fructus), Yiren (Coicis Semen), Ye Chidoupi (Vigna umbellata skin).
Damp-Warmth is most common in late summer. The qi of Damp-Heat depression and steaming enters via the mouth and nose, affecting the Upper Jiao first, then gradually spreading to the Middle and Lower Jiao. This is what He Jian referred to as Triple Burner disease. Treatment differs significantly from Wind-Cold or Food Stagnation. Zhang Zhongjing said: Patients with Dampness must not sweat; sweating leads to spasms. Dampness is originally a Yin pathogen; contracting it damages Yang. Sweating causes Yang to leak easily, leaving pathogens unresolved. Damp steaming and Heat depression manifest as jaundice, steaming between Qi tunnels, similar to fermenting qu. At this time, the disease is entirely at the Qi level; Lianqiao Chixiaodou Tang (Forsythia and Red Bean Decoction) can be effective. Now, after one month, the pathogen has spread throughout the Triple Burner, starting from around the ears, swelling from left to right, causing severe carbuncles. "Carbuncle" means blockage; not only is Qi stagnant, but Blood is also blocked, steaming into pus. Loss of appetite and sudden wasting of muscles indicate depleted Stomach Qi. Discussing treatment: tonification aids blockage, clearing heat risks collapse. Predecessors' established methods offer nothing to follow. Thinking that Damp-Heat filthiness binds in the clear orifices of the head and face, it is proposed to use light methods to remove excess, selecting aromatic fragrant substances to spare the Stomach, hoping to relieve blockage. Advancing to consuming gruel would be progress. The *Classic* says: For diseases originating from above, treat above. The *Ling Shu* says: The Upper Jiao is like mist; without light and aromatic qi, how can it be opened?
Qingju Ye (Chrysanthemi Indici Folium), Heye Bian (Nelumbinis Folium margin), Jinyinhua (Lonicerae Japonicae Flos), Xiang Beimu (Fritillariae Thunbergii Bulbus), Lv Dou Pi (Phaseoli Semen Cuticle), Madouling (Aristolochiae Manshuriensis Fructus), Qiaoliao (Forsythiae Fructus), Shegan (Belamcandae Rhizoma), Jinzhi (Gold Juice).
The pulse is wiry and slow; the face, eyes, and skin are yellow; the tongue coating is white, slippery, and greasy; there is distension and closure in the chest, epigastrium, and diaphragm. The diagnosis is Damp-Warmth. Moist air from coastal areas enters via the mouth and nose, reaching the Mu Yuan (Barrier) and distributing through the Triple Burner; this is an external cause. Combined with ingestion of fishy water and grain foods, it mixes with external filth pathogens. Excessive Dampness and depressed Heat block the Triple Burner tunnels, preventing Qi and Blood flow, turning the body yellow. Sweating fails because Dampness patients naturally sweat. Clearing heat and promoting digestion fails because Heat arises from Dampness; if Dampness is not removed, Heat is not eliminated. Dampness has no form; attacking stagnation is a method for tangible pathogens, hence its ineffectiveness is expected. In the past, He Jian treated Damp-Heat using bitter, acrid, and cold qi methods. Bitter descends to drive out Dampness; acrid and fragrant dispels filth; cold utilizes qi movement to prevent internal blockage. Contemporary physicians mistakenly treat it as Taiyang/Yangming exterior-interior Cold Damage, failing to realize that filth-dampness enters via mouth/nose, travels through the Triple Burner, and requires different treatment.
Mian Yinchen (Artemisiae Scopariae Herba), Bai Doukou (Amomi Fructus Rotundus), Houpo (Magnoliae Officinalis Cortex), Chuan Tongcao (Tetrapanacis Medulla), Guang Pi Bai (Citri Reticulatae Pericarpium), Fuling Pi (Poria Cum Ligno Cortex), Banxia Qu (Pinelliae Fermentatum), Kuai Huashi (Halcionis Pulvis).
Rainy and humid earth steams filth for ten days. Humans exist within the Qi intersection, inhaling through mouth and nose, invading from above. Head distension, epigastric stuffiness, muscle prickling, and bone pain occur. The Lung resides highest; its qi circulates the whole body. Once obstructed by Dampness, Qi cannot move. Severe Dampness generates Heat; sweating relieves heat temporarily, but it returns shortly. While Wind-Cold resolves with sweating, Dampness does not. Zhang Zhongjing said: Dampness patients must not sweat; sweating causes spasms. Dampness is a Yin-dark pathogen; injury affects Yang first. Thus, sweating, purging, clearing, descending, and digesting are irrelevant to Dampness. Both Dampness and Heat are Qi; they can obscure the body's Qi, having no tangible form to attack. Failure to clear from above allows spread to Middle and Lower Jiao, unlike Cold Damage transmitting from Exterior to Interior via Six Channels. He Jian elaborated this, focusing on unblocking the Triple Burner. Ming Dynasty physician Zhang Jingyue also used bitter, acrid, and cold as main treatments, emphasizing Qi flow and separation; when Qi flows, Dampness resolves. Now, after two weeks without improvement, evening coma occurs. "Jue" refers to reversal/disorder; pathogens have deeply entered the Extreme Yin, Heat steams upward, obscuring the Spirit. Initially, Dampness flowed downward causing loose stools; now Qi obstruction causes constipation. Ancients called this "Deep Heat, Deep Jue"; "Less Jue, More Heat means recovery; More Jue, Less Heat means progression." Most Jue cases belong to Jueyin.
Lv Dou (Phaseoli Semen), Ye Chi Dou (Vigna umbellata), Ma Liao Dou (Soybean), Di Jiang (Earth Slurry), Zhenzhu (Margarita), Bingpian (Borneolum Syntheticum).
Another case: Summerheat-Dampness external pathogen enters from above and moves through the central pathway. Not following classic methods led to Triple Burner blockage and reversal causing Jue. Jue belongs to deep pathogens in Yin. Therefore, Earth Slurry (Di Jiang) is used for its heavy Yin nature to clear heat; Pearl (Zhenzhu) sinks in water, salty and cold; a small amount of Borneol (Bingpian) is acrid and warm, opening Heat Bi, going straight to Extreme Yin, hoping to stop Jue. Ultimately, Summerheat-Dampness-Heat is a formless pathogen, filling the chest like smoke, preventing Zong Qi and Ying Qi from舒展 (expanding). How can taste and hunger be perceived? Aggressive purgatives cleanse tangible stagnation, not Dampness binding at the Qi level. Ancient Xuanqi said: Treat above for diseases from above; Upper Jiao is like mist; light and floating can remove excess. Constipation for half a month must not be treated with purgatives; it is caused by Qi obstruction.
Chuan Bei (Fritillariae Cirrhosae Bulbus), Mi Yi Ren (Coicis Semen), Dou Ling (Aristolochiae Fructus), Bai Kou (Amomi Fructus Rotundus), Lianqiao (Forsythiae Fructus), Shegan (Belamcandae Rhizoma), Tongcao (Tetrapanacis Medulla).
Middle age rushing Qi, rising phlegm causing asthma, appearing and disappearing quickly. Treating the root in Liver and Kidney would indeed use Dihuang Yinzi (Rehmannia Decoction). The intent here is to administer heavy medicines lightly, avoiding thick flavors that stagnate Phlegm-Qi, using texture to guide downward, changing decoction to pill, purely heavy and soft-warm. If Guipi Tang (Restore the Spleen Decoction) were used, sweet-warm and center-holding, nourishing Spleen Ying, it would oppose Phlegm-Dyspnea. Recurring since July, there must be Summerheat-Dampness external pathogen received via respiration. Described skin eruption (Dan Zhen), rapid edema, red pores. If merely internal symptoms, these might not occur. Considering Summer/Autumn air received via mouth/nose, Upper Jiao injured first, distinct from Liver/Kidney root disease. Failure to resolve Upper Jiao logically spreads to Middle/Lower, making Triple Burner the source of disease. This distension is in collaterals, not fu-organs/intestines; water/grain unaffected due to this. Given chronic illness and great deficiency, warm-tonification is not tolerated. Must deduce principles: latent pathogen triggers old disease. Zhang Zhongjing argues must first resolve pathogen. Thirst and solid stool contradict warm-heat suitability. Self-reported emotional depression, Ministerial Fire residing in Liver/Gallbladder, resembling penile swelling and scrotal flaccidity, Dampness blocking water infiltration. Tentatively prescribing Triple Burner Qi Unblocking Formula, imitating ancient "two deficiencies, one excess," treating the excess primarily, opening one avenue.
Fei Huashi (Halcionis Pulvis), Xingren (Armeniacae Semen Amarum), Fuling Pi (Poria Cum Ligno Cortex), Houpo (Magnoliae Officinalis Cortex), Zhuling (Polyporus), Tongcao (Tetrapanacis Medulla), Bai Kou Ren (Amomi Fructus Rotundus Semen).
Observing complexion: sallow, exhausted, dull. Hearing voice: breathing difficult, voice muffled as if in a jar. Palpating pulse: right slow, left urgent. Asking about onset: sudden alternating heat and warmth, head feeling wrapped, lower back pain wanting pressure, mental dullness, drowsiness, limb twitching/spasms, coughing red-tinged phlegm, short scanty urine, loose bloody stools, no hunger/thirst, slight perioral swelling, dry non-red lips, white fungal tongue coating. This is simultaneous depression and steaming of Grain/Wine/Fishy Damp-Heat, obstructing pure Qi circulation, causing whole-body Qi mechanism blockage. Heat and Dampness are both Qi, distributing from Mu Yuan to Triple Burner Ying/Wei, cycling up/down, losing clear/turbid regulation. Pathogens are formless, attaching to Qi level first. Contemporary doctors wrongly debate exterior pathogens need sweating, interior stagnation needs digestion, seeing heat applying cooling. They do not know Heat arises from Dampness depression; as Qi moves, Heat follows. Zhang Zhongjing forbade sweating/purging for spasms transforming from Dampness, explicitly warning later generations not to injure Yin/Yang. But formless pathogens lingering long inevitably become tangible, moving from Qi to Blood, a fixed principle. Based on complexion, pulse, and symptoms, none seem applicable for current prescription.
Lingyang Jiao (Saigae Tataricae Cornu), Yin Chen (Artemisiae Scopariae Herba), Yinhua (Lonicerae Japonicae Flos), Lianqiao (Forsythiae Fructus), Tongcao (Tetrapanacis Medulla), Dafupi (Arecae Catechu Pericarpium), Fuling Pi (Poria Cum Ligno Cortex), Zhuling (Polyporus), Zexie (Alismatis Rhizoma), Zhibao Dan (Treasure of Life Pill).