初六日 风温,脉浮数,邪在上焦。胸痞微痛,秽浊上乾清阳。医者误认为痰饮阴邪之
乾清
阳,而用薤白汤。又有误认伤寒少阳经之胁痛,而以小柴胡治之者。逆理已甚,无怪乎谵语
烦躁,而胸痞仍不解也。议辛凉治温以退热,芳香逐秽独以止痛。
连翘(三钱) 知母(钱半) 藿香梗(二钱) 银花(三钱) 苦桔梗(二钱) 牛蒡子(二钱)
人中黄(一钱) 薄荷(八分) 石膏(五钱) 广郁金(钱半)
牛黄清心丸一丸,日三服。
初七日 风温误汗,昨用芳香逐秽,虽见小效,究未能解。今日脉沉数,乃上行极而下
也,渴甚。议气血两燔之玉女煎法,合银翘散加黄连。夜间如有谵语,仍服牛黄丸。
生石膏(八钱) 连翘(四钱) 知母(四钱) 生甘草(二钱) 丹皮(五钱) 真川连(钱半)
银花(六钱) 细生地(六钱) 连心麦冬(六钱)
煮取三碗,分三次服。
初八日 大势已解,余焰尚存,今日脉浮,邪气还表。
连翘(二钱) 麦冬(五钱) 银花(六钱) 白芍(钱半) 丹皮(二钱) 炒知母(一钱) 黄
芩炭(八分) 细生地(三钱) 生甘草(一钱)
今晚一帖,明早一帖。
初九日 脉沉数有力,邪气入里,舌老黄微黑,可下之。然非正阳明实证大满、大痞可
比,用增液足矣。
元参(两半) 麦冬(一两) 细生地(一两)
煮成三碗,分三次服完。如大便不快,再作服,快利停服。
初十日 昨服增液,黑粪已下。舌中黑边黄,口渴,面赤,脉浮,下行极而上也。自觉
饥甚,阳明热也。仍用玉女煎加知母,善攻病者,随其所在而逐之。
生石膏(八钱) 细生地(五钱) 生甘草(三钱) 生知母(六钱) 麦冬(六钱) 白粳米(
一撮)
断不可食粥,食粥则患不可言。
十一日 邪少虚多,用复脉法,二甲复脉汤。
姚 三十二岁 三月初二日 风温误认伤寒发表,致令神呆谵语,阳有汗,阴无汗,大
便稀水不爽,现下脉浮,下行极而上也。先渴今不渴者,邪归血分也。
连翘(二钱) 银花(三钱) 元参(三钱) 竹叶心(一钱) 丹皮(二钱) 犀角(二钱) 桑
叶(一钱) 甘草(一钱) 麦冬(三钱)
牛黄清心丸,三次服六丸。
初三日 昨用清膻中法,今日神识稍清,但小便短,脉无阴,大便稀水。议甘苦合化阴
气法,其牛黄丸仍服。
大生地(五钱) 真川连(一钱) 生牡蛎(一两) 黄芩(二钱) 丹皮(五钱) 犀角(三钱
)麦冬(五钱) 人中黄(一钱)
水八碗,煮取三碗,分三次服。明早再一帖。
初四日 即于前方内去犀角,加∶
生鳖甲(一两) 白芍(一两)
初五日 大热已减,余焰尚存,小便仍不快,用甘苦合化阴气法。
细生地(八钱) 炒黄柏(二钱) 丹皮(四钱) 炒知母(二钱) 连心麦冬(六钱) 生甘草
(二钱) 生白芍(四钱) 生牡蛎(五钱) 生鳖甲(八钱) 黄芩(二钱)
今晚一帖,明日二帖。
初七日 温病已解,邪少虚多,用复脉法。
真大生地(六钱) 炒白芍(六钱) 连心麦冬(六钱) 炙甘草(二钱) 麻仁(三钱) 生牡
蛎(六钱) 知母(二钱) 黄柏(二钱) 生阿胶(三钱)
三帖三日。
十一日 热淫所遏,其阴必伤,议于前方内去黄柏、知母,加鳖甲、沙参,以杜病后起
燥之路。即于前方内去知母、黄柏、加∶
生鳖甲(六钱) 沙参(三钱)
汤 甲子年四月十三日 风温自汗。
连翘(三钱) 银花(二钱) 甘草(一钱) 苦桔梗(二钱) 杏仁(二钱) 牛蒡子(三钱)
薄荷(八分) 豆豉(二钱) 芦根(三把)
今晚二帖,明早一帖,午前服完。
十四日 即于前方内加∶
连心麦冬(三钱) 细生地(三钱)
王 十岁 风温发疹,初起肢厥,脉不甚数,势非浅鲜。
连翘(五钱) 薄荷(三钱) 甘草(二钱) 牛蒡子(五钱) 桑叶(三钱) 荆芥穗(三钱)
藿梗(四钱) 郁金(三钱) 桔梗(五钱) 元参(五钱) 芦根汤煎
共为细末,六钱一包,一时许服一包,明日再服。
李 六十岁 三焦浊气不宣,自觉格拒,用通利三焦法,仍以上焦为主。
藿梗(三钱) 广皮炭(二钱) 郁金(二钱) 桔梗(三钱) 黄芩炭(钱半) 杏仁(三钱)
连翘(钱半)
服三帖病痊。
陈氏 七十岁 风温,咳嗽粘痰,脉弦数,曾吐血丝、血沫,此风温而误以治风寒之辛
温法治之也。当用辛凉甘润。
桑叶(二钱) 生甘草(一钱) 白扁豆皮(三钱) 沙参(三钱) 杏仁(二钱) 桔梗(二钱)
茶菊(二钱) 麦冬(二钱) 梨皮(五钱)
以上三人,温病日久不解,六脉全无,目闭不言,四肢不动,宛如死去。有一日一夜者
,有
二日者,有三日者,有手足不温,亦不甚凉者,有凉如冰者,有微温者,诚如吴又可所云体
厥脉厥之证。佥用紫雪丹续续灌醒,继以复脉汤收功。
赵 二十六岁 乙酉年四月初四日 六脉浮弦而数,弦则为风,浮为在表,数则为热,
证现
喉痛。卯酉终气,本有温病之明文。虽头痛身痛恶寒甚,不得误用辛温,宜辛凉芳香清上。
盖上焦主表,表即上焦也。
桔梗(五钱) 豆豉(三钱) 银花(三钱) 人中黄(二钱) 牛蒡子(四钱) 连翘(三钱)
荆芥穗(五钱) 郁金(二钱) 芦根(五钱) 薄荷(五钱)
煮三饭碗,先服一碗,即饮百沸汤一碗,覆被令微汗佳。得汗后,第二、三碗不必饮汤
。服一帖而表解,又服一帖而身热尽退。
初六日 身热虽退,喉痛未止,与代赈普济散。日三四服,三日后痊愈。
赵 四十二岁 丙戌年正月初九日 脉浮,风温,咽痛,项强,颈微肿,舌伸不长,宜
开提肺气为主。
桔梗(三钱) 连翘(三钱) 僵蚕(三钱) 人中黄(二钱) 银花(三钱) 牛蒡子(二钱)
荆芥(三钱) 薄荷(二钱)
张 六十七岁 甲申年正月十六日 本有肝郁,又受不正之时令浊气,故舌黑苔,口苦
,胸痛,头痛,脉不甚数,不渴者年老体虚,不能及时传化邪气也。法宜辛凉芳香。
连翘(三钱) 桔梗(三钱) 豆豉(三钱) 荆芥(二钱) 薄荷(钱半) 生甘草(一钱) 郁
金(二钱) 元参(三钱) 银花(三钱) 藿梗(三钱)
共为粗末,芦根汤煎。
十七日 老年肝郁挟温,昨用辛凉芳香,今日舌苔少化,身有微汗,右脉始大,邪气甫
出,但六脉沉取极弱,下虚阴不足也,议辛凉药中加护阴法。
桔梗(三钱) 麦冬(三钱) 元参(五钱) 甘草(钱半) 豆豉(二钱) 细生地(三钱) 连
翘(二钱) 银花(三钱) 芦根(三钱)
今日一帖,明日一帖,每帖煮二杯。
十八日 老年阴亏,邪退十分之七,即与填阴,耳聋脉芤,可知其阴之所存无几,与复
脉法。
炙草(三钱) 白芍(六钱) 阿胶(三钱) 麦冬(八钱) 麻仁(三钱) 大生地(八钱)
十九日 较昨日热退大半,但脉仍大,即于前方内加鳖甲六钱,以搜余邪。
二十日 脉静便溏,再于前方内加牡蛎八钱收阴,甘草三钱守中。
风温者,震方司令而化温也。温邪化热,先伤乎肺,继而变证甚繁,总之手三阴见症为
多,
治法宜辛凉,不宜辛温,宜甘润,不宜苦降。盖辛温烁肺,苦降伤胃。今观先生之治,则有
辛凉解肌,甘寒退热,芳香利窍,甘苦化阴,时时轻扬,存阴退热诸法,种种有条,方全法
备,则先生不亦神圣工巧之手乎。(舒配瑭)
初六日 患风温病,脉象浮而数,病邪位于上焦。胸部痞闷且微痛,秽浊之气上扰清阳。医生误认为是痰饮阴邪上干清阳,因而使用薤白汤。又有医生误认为是伤寒少阳经的胁痛,而用小柴胡汤治疗。这种违背医理的做法太过严重,难怪患者出现谵语、烦躁,且胸部的痞闷感仍未解除。建议采用辛凉之法治疗温病以退热,用芳香之品驱逐秽浊以止痛。
连翘(三钱) 知母(一钱半) 藿香梗(二钱) 银花(三钱) 苦桔梗(二钱) 牛蒡子(二钱)
人中黄(一钱) 薄荷(八分) 石膏(五钱) 广郁金(一钱半)
另服牛黄清心丸一丸,每日三次服用。
初七日 风温病被误用发汗法,昨日虽用了芳香逐秽之法,虽见小效,但终究未能解除病邪。今日脉象沉而数,这是病邪上行至极点转而向下的表现,口渴非常严重。建议采用气血两燔证的玉女煎法,合用银翘散并加入黄连。夜间如果出现谵语,仍服用牛黄丸。
生石膏(八钱) 连翘(四钱) 知母(四钱) 生甘草(二钱) 丹皮(五钱) 真川连(一钱半)
银花(六钱) 细生地(六钱) 连心麦冬(六钱)
煮取药液三碗,分三次服用。
初八日 大势已解,余留的热势尚存,今日脉象浮,说明邪气回归体表。
连翘(二钱) 麦冬(五钱) 银花(六钱) 白芍(一钱半) 丹皮(二钱) 炒知母(一钱) 黄芩炭(八分) 细生地(三钱) 生甘草(一钱)
今晚服一帖,明早服一帖。
初九日 脉象沉数有力,邪气入里,舌苔老黄微黑,可以使用下法。但这并非正阳明实证中的大满、大痞证可比,使用增液汤足以通便。
元参(一两半) 麦冬(一两) 细生地(一两)
煮成三碗,分三次服完。如果大便不通畅,再行服用;若大便通畅则停止服用。
初十日 昨日服用增液汤后,黑色粪便已排出。舌中黑边黄,口渴,面色红赤,脉象浮,这是下行至极点转而向上的表现。自觉非常饥饿,这是阳明热的表现。仍使用玉女煎加知母,善于治病的人,会根据病邪所在之处而驱除它。
生石膏(八钱) 细生地(五钱) 生甘草(三钱) 生知母(六钱) 麦冬(六钱) 白粳米(一撮)
绝对不可喝粥,喝粥则病情难以言喻。
十一日 邪气减少而正气虚弱,采用复脉法,方用二甲复脉汤。
姚某,三十二岁,三月初二日 风温病被误认为伤寒而使用发表法,导致神志呆滞、谵语,阳气有汗,阴液无汗,大便稀水不爽,现下脉象浮,这是下行至极点转而向上的表现。先前口渴现在不渴,是因为邪气归入血分。
连翘(二钱) 银花(三钱) 元参(三钱) 竹叶心(一钱) 丹皮(二钱) 犀角(二钱) 桑叶(一钱) 甘草(一钱) 麦冬(三钱)
牛黄清心丸,分三次服用共六丸。
初三日 昨日使用了清膻中之法,今日神识稍清,但小便短少,脉象无阴象,大便稀水。建议采用甘苦合化阴气法,牛黄丸继续服用。
大生地(五钱) 真川连(一钱) 生牡蛎(一两) 黄芩(二钱) 丹皮(五钱) 犀角(三钱) 麦冬(五钱) 人中黄(一钱)
用水八碗,煮取药液三碗,分三次服用。明早再服一帖。
初四日 即在前方中去掉犀角,加入:
生鳖甲(一两) 白芍(一两)
初五日 大热已减,余焰尚存,小便仍不畅快,使用甘苦合化阴气法。
细生地(八钱) 炒黄柏(二钱) 丹皮(四钱) 炒知母(二钱) 连心麦冬(六钱) 生甘草(二钱) 生白芍(四钱) 生牡蛎(五钱) 生鳖甲(八钱) 黄芩(二钱)
今晚服一帖,明日服两帖。
初七日 温病已解,邪少虚多,采用复脉法。
真大生地(六钱) 炒白芍(六钱) 连心麦冬(六钱) 炙甘草(二钱) 麻仁(三钱) 生牡蛎(六钱) 知母(二钱) 黄柏(二钱) 生阿胶(三钱)
三帖药服三天。
十一日 热邪淫盛遏制机体,必然损伤阴液,建议在前方中去掉黄柏、知母,加入鳖甲、沙参,以防止病后出现燥证。即在前方中去掉知母、黄柏,加入:
生鳖甲(六钱) 沙参(三钱)
汤某,甲子年四月十三日 患风温病,自汗出。
连翘(三钱) 银花(二钱) 甘草(一钱) 苦桔梗(二钱) 杏仁(二钱) 牛蒡子(三钱)
薄荷(八分) 豆豉(二钱) 芦根(三把)
今晚服两帖,明早服一帖,午前服完。
王某,十岁 患风温病并发疹,初起时四肢厥冷,脉象不甚数,病势非浅显轻微。
连翘(五钱) 薄荷(三钱) 甘草(二钱) 牛蒡子(五钱) 桑叶(三钱) 荆芥穗(三钱)
藿梗(四钱) 郁金(三钱) 桔梗(五钱) 元参(五钱) 芦根汤煎
共研为细末,每包六钱,约一小时服一包,明日再服。
李某,六十岁 三焦浊气不宣通,自觉格拒不适,采用通利三焦法,但仍以上焦为主。
藿梗(三钱) 广皮炭(二钱) 郁金(二钱) 桔梗(三钱) 黄芩炭(一钱半) 杏仁(三钱)
连翘(一钱半)
服用三帖后病愈。
陈某氏,七十岁 患风温病,咳嗽且有粘痰,脉象弦数,曾吐出血丝、血沫,这是因为风温病误用了治疗风寒的辛温法治所致。应当使用辛凉甘润之法。
桑叶(二钱) 生甘草(一钱) 白扁豆皮(三钱) 沙参(三钱) 杏仁(二钱) 桔梗(二钱)
茶菊(二钱) 麦冬(二钱) 梨皮(五钱)
以上三人,温病日久不解,六脉全无,目闭不言,四肢不动,宛如死去。有的持续一日一夜,有的两天,有的三天,有的手足不温,也不甚凉,有的凉如冰,有的微温,确实像吴又可所说的体厥和脉厥之证。大家都用紫雪丹连续灌服使其苏醒,继以复脉汤收功。
赵某,二十六岁,乙酉年四月初四日 六脉浮弦而数,弦主风,浮主在表,数主热,症状表现为喉痛。卯酉终气期间,本就有温病的明文记载。虽然头痛身痛恶寒严重,不得误用辛温药,宜用辛凉芳香清上之法。因为上焦主表,表即上焦。
桔梗(五钱) 豆豉(三钱) 银花(三钱) 人中黄(二钱) 牛蒡子(四钱) 连翘(三钱)
荆芥穗(五钱) 郁金(二钱) 芦根(五钱) 薄荷(五钱)
煮三饭碗药液,先服一碗,随即饮用百沸汤一碗,盖被令其微微出汗为佳。得汗后,第二、三碗不必再饮汤。服一帖后表证解除,又服一帖后身热尽退。
初六日 身热虽退,喉痛未止,给予代赈普济散。每日三四次服用,三日后痊愈。
赵某,四十二岁,丙戌年正月初九日 脉象浮,患风温病,咽痛,项强,颈部微肿,舌头伸不长,宜以开提肺气为主。
桔梗(三钱) 连翘(三钱) 僵蚕(三钱) 人中黄(二钱) 银花(三钱) 牛蒡子(二钱)
荆芥(三钱) 薄荷(二钱)
张某,六十七岁,甲申年正月十六日 原本就有肝郁,又受不正之时令浊气侵袭,故舌黑苔,口苦,胸痛,头痛,脉象不甚数,不渴,这是因为年老体虚,不能及时传化邪气。治法宜用辛凉芳香。
连翘(三钱) 桔梗(三钱) 豆豉(三钱) 荆芥(二钱) 薄荷(一钱半) 生甘草(一钱) 郁金(二钱) 元参(三钱) 银花(三钱) 藿梗(三钱)
共为粗末,用芦根汤煎服。
十七日 老年肝郁挟带温病,昨日用了辛凉芳香之法,今日舌苔稍化,身体有微汗,右脉始大,邪气刚刚透出,但六脉沉取极弱,这是下虚阴不足,建议在辛凉药中加入护阴之法。
桔梗(三钱) 麦冬(三钱) 元参(五钱) 甘草(一钱半) 豆豉(二钱) 细生地(三钱) 连翘(二钱) 银花(三钱) 芦根(三钱)
今日一帖,明日一帖,每帖煮两杯。
十八日 老年阴亏,邪气退了十分之七,立即予以填阴,耳聋脉芤,可知其阴所剩无几,采用复脉法。
炙草(三钱) 白芍(六钱) 阿胶(三钱) 麦冬(八钱) 麻仁(三钱) 大生地(八钱)
十九日 较昨日热退大半,但脉仍大,即在前方内加鳖甲六钱,以搜剔余邪。
二十日 脉静便溏,再于前方内加牡蛎八钱以收敛阴气,甘草三钱以守中气。
风温病,是震方(东方)当令而化为温邪。温邪化热,先伤肺脏,继而变证繁多,总之手三阴经多见症状。治法宜辛凉,不宜辛温;宜甘润,不宜苦降。因为辛温会灼伤肺阴,苦降会损伤胃气。如今看先生的治疗,则有辛凉解肌,甘寒退热,芳香利窍,甘苦化阴,时时轻扬,存阴退热等诸法,种种有条理,方全法备,先生岂不是神圣工巧之手吗?(舒配瑭评)
On the 6th day, the patient suffered from Wind-Warmth (Fengwen), with a floating and rapid pulse, indicating the pathogen was in the Upper Jiao. There was chest oppression and slight pain, as turbid pathogens disturbed the Clear Yang. The physician mistakenly identified this as Phlegm-Fluids (Tan Yin) and Yin pathogens disturbing the Clear Yang, and prescribed Xiebai Tang (Scallion Stem Decoction). Another physician mistakenly diagnosed it as hypochondriac pain of the Shaoyang channel in Cold Damage (Shanghan) and treated it with Xiao Chaihu Tang (Minor Bupleurum Decoction). This deviation from medical principles was severe; no wonder the patient experienced delirium (Chan Yu) and restlessness, while the chest oppression remained unresolved. It is proposed to treat Warmth using Acrid-Cool methods to reduce fever, and use Fragrant aromatics to dispel turbidity and relieve pain.
Qianqiao (3 qian) Zhimu (1.5 qian) Huoxiang Geng (2 qian) Yinhua (3 qian) Ku Jiegeng (2 qian) Niubangzi (2 qian)
Renzhonghuang (1 qian) Bohe (8 fen) Shigao (5 qian) Guang Yujin (1.5 qian)
Also administer Niuhuang Qingxin Wan (Calculus Bovis Heart-Calming Pill) one pill, taken three times daily.
On the 7th day, Wind-Warmth was mistakenly treated with sweating methods. Although the Fragrant aromatic method used yesterday showed slight effect, it ultimately failed to resolve the pathogen. Today the pulse is deep and rapid, indicating the pathogen has reached its peak upward movement and is now turning downward. Thirst is severe. It is proposed to adopt the formula method for Qi and Blood simultaneous blazing (Qi Xue Liang Fan), i.e., Yunu Jian (Jade Woman Decoction), combined with Yinqiao San (Honeysuckle and Forsythia Powder) plus Huanglian. If delirium occurs at night, continue administering Niuhuang Wan.
Sheng Shigao (8 qian) Lianqiao (4 qian) Zhimu (4 qian) Sheng Gancao (2 qian) Danpi (5 qian) Zhen Chuanlian (1.5 qian)
Yinhua (6 qian) Xi Shengdi (6 qian) Lianxin Maidong (6 qian)
Boil to obtain three bowls of decoction, divide into three doses.
On the 8th day, the major symptoms have resolved, but residual heat remains. Today the pulse is floating, indicating the pathogen has returned to the exterior.
Lianqiao (2 qian) Maidong (5 qian) Yinhua (6 qian) Baishao (1.5 qian) Danpi (2 qian) Chao Zhimu (1 qian) Huangqin Tan (8 fen) Xi Shengdi (3 qian) Sheng Gancao (1 qian)
Take one dose tonight, one dose tomorrow morning.
On the 9th day, the pulse is deep, rapid, and forceful, indicating the pathogen has entered the interior. The tongue coating is old yellow with slight blackness, suggesting purgation is indicated. However, this is not comparable to the fullness and stagnation of proper Yangming excess syndrome; simply using Zengye Tang (Increase Fluids Decoction) is sufficient.
Yuanshen (1.5 liang) Maidong (1 liang) Xi Shengdi (1 liang)
Boil to make three bowls, divide into three doses. If bowel movement is not smooth, take again; if smooth, stop taking.
On the 10th day, after taking Zengye Tang last night, black stool has been passed. The center of the tongue is black with yellow edges, thirst is present, face is red, and pulse is floating. This indicates the pathogen has moved from extreme descent to ascent. The patient feels extremely hungry, which is Yangming Heat. Continue using Yunu Jian plus Zhimu. A skilled healer treats according to the location of the pathogen.
Sheng Shigao (8 qian) Xi Shengdi (5 qian) Sheng Gancao (3 qian) Sheng Zhimu (6 qian) Maidong (6 qian) Bai Jingmi (a pinch)
Absolutely do not consume porridge; consuming porridge will lead to unpredictable complications.
On the 11th day, the pathogen is scanty while deficiency is predominant. Use the Fumai method, specifically Erjia Fumai Tang (Two-Shells Pulse-Recovering Decoction).
Patient Yao, 32 years old, March 2nd: Wind-Warmth was mistaken for Cold Damage and treated with exterior-releasing methods, leading to mental dullness and delirium. Yang level has sweat, Yin level has no sweat. Bowels pass watery diarrhea without relief. Current pulse is floating, indicating extreme descent turning to ascent. Previously thirsty but now not thirsty, indicating the pathogen has entered the Blood level.
Lianqiao (2 qian) Yinhua (3 qian) Yuanshen (3 qian) Zhuyexin (1 qian) Danpi (2 qian) Xijiao (2 qian) Sangye (1 qian) Gancao (1 qian) Maidong (3 qian)
Niuhuang Qingxin Wan, take six pills divided into three doses.
On the 3rd day: Yesterday, the method to clear the Pericardium (Dan Zhong) was used. Today, consciousness is slightly clearer, but urine is short, pulse lacks Yin signs, and bowels pass watery diarrhea. It is proposed to use the Sweet-Bitter method to transform Yin Qi. Continue taking Niuhuang Wan.
Da Shengdi (5 qian) Zhen Chuanlian (1 qian) Sheng Muli (1 liang) Huangqin (2 qian) Danpi (5 qian) Xijiao (3 qian) Maidong (5 qian) Renzhonghuang (1 qian)
Boil eight bowls of water to obtain three bowls of decoction, divide into three doses. Take another dose tomorrow morning.
On the 4th day: Remove Xijiao from the previous prescription and add:
Sheng Biejia (1 liang) Baishao (1 liang)
On the 5th day: High fever has subsided, but residual heat remains. Urination is still not smooth. Use the Sweet-Bitter method to transform Yin Qi.
Xi Shengdi (8 qian) Chao Huangbai (2 qian) Danpi (4 qian) Chao Zhimu (2 qian) Lianxin Maidong (6 qian) Sheng Gancao (2 qian) Sheng Baishao (4 qian) Sheng Muli (5 qian) Sheng Biejia (8 qian) Huangqin (2 qian)
One dose tonight, two doses tomorrow.
On the 7th day: The Warm disease has resolved, pathogen is scanty, deficiency is predominant. Use the Fumai method.
Zhen Da Shengdi (6 qian) Chao Baishao (6 qian) Lianxin Maidong (6 qian) Zhi Gancao (2 qian) Maren (3 qian) Sheng Muli (6 qian) Zhimu (2 qian) Huangbai (2 qian) Sheng Ejiao (3 qian)
Three doses over three days.
On the 11th day: Excessive Heat suppresses the body, inevitably injuring Yin. It is proposed to remove Huangbai and Zhimu from the previous prescription and add Biejia and Shashen to prevent dryness after the illness. Remove Zhimu and Huangbai from the previous prescription and add:
Sheng Biejia (6 qian) Shashen (3 qian)
Patient Tang, April 13th, Jiazi Year: Wind-Warmth with spontaneous sweating.
Lianqiao (3 qian) Yinhua (2 qian) Gancao (1 qian) Ku Jiegeng (2 qian) Xingren (2 qian) Niubangzi (3 qian)
Bohe (8 fen) Douchi (2 qian) Lugeng (three handfuls)
Two doses tonight, one dose tomorrow morning, finish by mid-morning.
On the 14th day: Add to the previous prescription:
Lianxin Maidong (3 qian) Xi Shengdi (3 qian)
Patient Wang, 10 years old: Wind-Warmth with rash eruption. Initially, limbs were cold, pulse was not very rapid, indicating the condition was not superficial or minor.
Lianqiao (5 qian) Bohe (3 qian) Gancao (2 qian) Niubangzi (5 qian) Sangye (3 qian) Jingjie Sui (3 qian)
Huogeng (4 qian) Yujin (3 qian) Jiegeng (5 qian) Yuanshen (5 qian) Decoct with Lugeng Tang
Grind into fine powder, pack into 6-qian packets. Take one packet every hour, continue tomorrow.
Patient Li, 60 years old: Turbid Qi of the Three Jiao is not disseminated, feeling obstruction. Use the method to unblock and benefit the Three Jiao, focusing primarily on the Upper Jiao.
Huogeng (3 qian) Guangpi Tan (2 qian) Yujin (2 qian) Jiegeng (3 qian) Huangqin Tan (1.5 qian) Xingren (3 qian)
Lianqiao (1.5 qian)
After three doses, the illness was cured.
Patient Chen, 70 years old: Wind-Warmth with cough and sticky phlegm, pulse string-like and rapid. Previously expectorated blood threads and foam. This resulted from mistaking Wind-Warmth for Wind-Cold and treating it with Acrid-Warm methods. Should use Acrid-Cool and Sweet-Moist methods.
Sangye (2 qian) Sheng Gancao (1 qian) Baibian Dou Pi (3 qian) Shashen (3 qian) Xingren (2 qian) Jiegeng (2 qian)
Chaju (2 qian) Maidong (2 qian) Lipi (5 qian)
The above three patients had prolonged Warm diseases that did not resolve. All six pulses were absent, eyes closed, unable to speak, limbs immobile, resembling death. Some lasted one to two days, others three days. Limbs were either not warm, not very cold, ice-cold, or slightly warm. This truly corresponds to Wu Youke's description of "Body Jue" and "Pulse Jue." All were revived by continuously administering Zixue Dan (Purple Snow Pill), followed by Fumai Tang to conclude treatment.
Patient Zhao, 26 years old, April 4th, Yiyu Year: Six pulses are floating, string-like, and rapid. String-like indicates Wind, floating indicates Exterior, rapid indicates Heat. Symptoms include sore throat. During the Mao-You transition period, there is explicit documentation of Warm diseases. Although headache, body ache, and severe aversion to cold are present, Acrid-Warm herbs must not be mistakenly used. Instead, Acrid-Cool and Fragrant aromatics should be used to clear the Upper Jiao. The Upper Jiao governs the Exterior; the Exterior is the Upper Jiao.
Jiegeng (5 qian) Douchi (3 qian) Yinhua (3 qian) Renzhonghuang (2 qian) Niubangzi (4 qian) Lianqiao (3 qian)
Jingjie Sui (5 qian) Yujin (2 qian) Lugeng (5 qian) Bohe (5 qian)
Boil three rice-bowls of decoction. Take one bowl first, then immediately drink one bowl of boiling water, cover with blanket to induce slight sweating. After sweating, do not drink water with the second and third bowls. One dose resolves the Exterior; a second dose clears all body heat.
On the 6th day: Body heat has subsided, but sore throat persists. Administer Daizhen Puji San (Relief Universal Relief Powder). Take three to four times daily; cured after three days.
Patient Zhao, 42 years old, January 9th, Bingxu Year: Pulse is floating. Wind-Warmth with sore throat, neck stiffness, slight neck swelling, tongue extension limited. Primary treatment should focus on lifting Lung Qi.
Jiegeng (3 qian) Lianqiao (3 qian) Jiangcan (3 qian) Renzhonghuang (2 qian) Yinhua (3 qian) Niubangzi (2 qian)
Jingjie (3 qian) Bohe (2 qian)
Patient Zhang, 67 years old, January 16th, Jiashen Year: Pre-existing Liver Stagnation, compounded by invasion of abnormal seasonal turbid Qi. Hence, black tongue coating, bitter taste in mouth, chest pain, headache. Pulse is not very rapid, no thirst, due to elderly constitution and deficiency, unable to transmit and transform pathogenic Qi promptly. Treatment should use Acrid-Cool and Fragrant aromatics.
Lianqiao (3 qian) Jiegeng (3 qian) Douchi (3 qian) Jingjie (2 qian) Bohe (1.5 qian) Sheng Gancao (1 qian) Yujin (2 qian) Yuanshen (3 qian) Yinhua (3 qian) Huogeng (3 qian)
Grind into coarse powder, decoct with Lugeng Tang.
On the 17th day: Elderly Liver Stagnation complicated by Warmth. Yesterday used Acrid-Cool and Fragrant aromatics. Today tongue coating has slightly transformed, slight sweat on body, Right pulse has become large, pathogen has just emerged. However, all six pulses are extremely weak when pressed deeply, indicating Lower Deficiency and Yin insufficiency. It is proposed to add Yin-nourishing methods to the Acrid-Cool prescription.
Jiegeng (3 qian) Maidong (3 qian) Yuanshen (5 qian) Gancao (1.5 qian) Douchi (2 qian) Xi Shengdi (3 qian) Lianqiao (2 qian) Yinhua (3 qian) Lugeng (3 qian)
One dose today, one dose tomorrow, each dose boiled to two cups.
On the 18th day: Elderly Yin deficiency. Pathogen has receded by seven-tenths. Immediately tonify Yin. Deafness and thready pulse indicate Yin reserves are nearly exhausted. Use the Fumai method.
Zhi Cao (3 qian) Baishao (6 qian) Ejiao (3 qian) Maidong (8 qian) Maren (3 qian) Da Shengdi (8 qian)
On the 19th day: Heat has receded by more than half compared to yesterday, but pulse remains large. Add Biejia (6 qian) to the previous prescription to search out residual pathogens.
On the 20th day: Pulse is calm, stools are loose. Add Muli (8 qian) to the previous prescription to consolidate Yin, and Gancao (3 qian) to maintain the Middle Jiao.
Wind-Warmth arises when the Zhen direction (East) takes command and transforms into Warmth. Warm pathogens transform into Heat, first injuring the Lung, subsequently leading to numerous changes. Generally, symptoms manifest mostly in the Hand Three Yin channels. Treatment should favor Acrid-Cool over Acrid-Warm, and Sweet-Moist over Bitter-Draining. Acrid-Warm scorches the Lung, while Bitter-Draining damages the Stomach. Observing the Master's treatment, we see methods such as Acrid-Cool releasing the muscle layer, Sweet-Cool reducing heat, Fragrant aromatics benefiting orifices, Sweet-Bitter transforming Yin, light and uplifting actions, preserving Yin and reducing heat. These methods are orderly and comprehensive, making the Master truly a divine and skillful healer. (Commentary by Shu Peitang)