大少爷之病，伏暑晚发之病也。暑邪者何？天之热气下，地之湿气上，人在气交之中，
无隙可避，感而受者。假使发于当时，其邪易达，其气未深耳。惟深伏三焦，直至秋晚而发，
道远气深自内达外，焉得见轻。所以病经十有三日，日重一日矣。然伏邪仅在三焦，不逢寒
热分争之下，所见者无非胸前痞闷，口中甜腻，二便失调而已。兹乃肢麻不已，更见厥逆，
显系所患之邪不从三焦而出，反入于肺肝。肝者将军之宫，其性横逆，上犯肺气则见为厥，
傍流中土则见为麻，麻厥并至，不惟热盛，亦且肝伤逆矣。然肝阳之逆，暑气之侵，原非无
故而作，良以风喜伤肝，未平之前先招风气，引动伏邪。加以阴气素虚，肝失所养，所谓最
虚之处便是客邪之处。三焦久病累及乎肝，最
为恶候，能不虑其虚不化邪、厥逆频频乎？所幸者，胆受暑。胆属少阳，其机不枢，有出入之
意焉。是以寒热之势变为寒热往来，间日而作，俾得从此渐轻，不独肝脏之邪可以外传于
腑，即溜在三焦者，亦可望其归并也。但少阴本虚，脉弦而芤，最怕欲化不能，亦恐半途而
废，邪实正虚，用药最难入手。然就寤言不寐，多梦纷纭，邪在胆经为甚，惟有十味温胆汤加
减，似属左右咸宜。未知是否？候政。
十味温胆汤加羚羊角、龙齿、省头草。
大少爷所患的，是伏暑晚发之病。什么是暑邪呢？就是天上的热气下降，地上的湿气上升，人处在天地气交之中，没有缝隙可以躲避，感受了这种邪气而发病。假如在受邪当时就发作，那么邪气容易透达，病位尚浅。只有当邪气深伏于三焦，直到秋末才发作，因为路途遥远、病位深重，自然要从内向外透达，怎么能轻易好转呢？所以病情经过十三天，一天比一天加重。然而，如果伏邪仅仅停留在三焦，没有遇到寒热交争的情况，所表现的症状无非是胸前痞闷、口中甜腻、大小便失调罢了。现在却出现肢体麻木不止，更见到四肢厥冷，这明显显示所受的邪气不从三焦外出，反而内陷入肺肝二脏。肝被称为将军之官，其性刚强横逆，向上侵犯肺气则表现为厥逆，旁流影响中焦脾胃则表现为麻木，麻木与厥逆同时出现，不仅说明热势亢盛，也表明肝脏受损且气机逆乱。然而，肝阳上逆和暑气侵袭，原本不是无缘无故发生的，大概是因为风邪容易伤肝，在病情未平之前先招致风气，引动了潜伏的邪气。加上患者素来阴气虚弱，肝失濡养，所谓最虚弱的地方就是邪气客居的地方。三焦久病累及肝脏，属于极为凶险的证候，怎能不担心正气虚弱无法化除邪气、导致厥逆频繁发作呢？所幸的是，胆经受到暑邪侵袭。胆属少阳经，其枢机功能失常，具有出入开阖的特性。因此寒热的症状变为寒热往来，每隔一日发作一次，使得病情能够从此逐渐减轻，这不仅肝脏的邪气可以外传至腑，就连滞留在于三焦的邪气，也可以期望它们归并消散。但是少阴本已虚弱，脉象弦而芤，最怕的是邪气欲化而不能化，也恐怕半途而废，邪气实盛而正气虚弱，用药最难着手。然而从睡眠方面看，入睡困难，多梦纷纭，这是邪气在胆经为甚的表现，唯有使用十味温胆汤加减，似乎比较适宜。不知是否妥当？请指正。
The young master's illness is a case of latent summerheat manifesting late. What is summerheat pathogen? It refers to the hot qi from heaven descending and the damp qi from earth ascending; humans exist within this intersection of qi, with no gap to avoid it, thus contracting the pathogen upon exposure. If it were to manifest at the time of contraction, the pathogen would be easily expelled, and its depth would be shallow. However, since it has deeply lodged in the Sanjiao (Triple Burner) and only manifests in late autumn, the distance is long and the pathology is deep, naturally attempting to reach the exterior from the interior; how can it be expected to improve easily? Therefore, after thirteen days of illness, the condition worsens day by day. Nevertheless, if the latent pathogen remains solely within the Sanjiao, without encountering a struggle between cold and heat, the observed symptoms would merely be chest stuffiness, a sweet and sticky taste in the mouth, and irregular bowel and bladder movements. Currently, however, there is incessant numbness of the limbs, accompanied by cold extremities (Jue Ni). This clearly indicates that the pathogen does not exit via the Sanjiao but instead penetrates into the Lung and Liver organs. The Liver is the palace of the general; its nature is horizontal and rebellious. When it invades the Lung qi upwards, it manifests as Jue Ni (cold extremities/reversal); when it flows laterally affecting the Middle Jiao (Spleen/Stomach), it manifests as numbness. With both numbness and Jue Ni present, it indicates not only excessive heat but also liver injury and rebellious qi. However, the rebellion of Liver Yang and the invasion of summerheat do not occur without cause. Likely, wind pathogen tends to injure the Liver; before the condition stabilizes, it first attracts wind qi, stirring up the latent pathogen. Furthermore, given the patient's inherent deficiency of Yin qi, the Liver lacks nourishment. As the saying goes, "the most deficient area is where the pathogen resides." Prolonged illness of the Sanjiao affecting the Liver is an ominous sign; one must worry about the deficiency failing to transform the pathogen and frequent episodes of Jue Ni. Fortunately, the Gallbladder has been affected by summerheat. The Gallbladder belongs to the Shaoyang (Lesser Yang) channel; its pivot mechanism is obstructed, possessing the intent of entry and exit. Thus, the pattern of cold and heat has transformed into alternating chills and fever, occurring every other day, allowing the condition to gradually lighten. Not only can the pathogen in the Liver organ transmit outward to the Fu organs, but even that lingering in the Sanjiao may be expected to converge and dissipate. However, the Shao Yin (Lesser Yin) is inherently deficient, with a wiry (Xuan) and hollow (Kou) pulse. There is great fear that the pathogen cannot be transformed, or that progress will stall halfway. With excess pathogen and deficient healthy qi, prescribing medication is extremely difficult. Regarding sleep, the inability to fall asleep and numerous dreams indicate that the pathogen is prominent in the Gallbladder channel. Only the modification of Shi Wei Wen Dan Tang (Ten-Ingredient Warming the Gallbladder Decoction) seems appropriate. Whether this is correct awaits your judgment.
Shi Wei Wen Dan Tang (Ten-Ingredient Warming the Gallbladder Decoction) added with Lingyang Jiao (Antelope Horn), Long Chi (Dragon Teeth), and Sheng Tou Cao (Herba Menthae Haplocalycis).