（温热冬温温毒温疫同治）
温病面目俱赤。语声重浊。呼吸俱粗。（若来粗去不粗去粗来不粗。或竟不粗者。即非此证。）大渴引饮。大便闭。
小便涩。舌苔老黄。甚则黑色有芒刺。但恶热不恶寒。下午益甚。脉浮洪躁甚者。邪由上焦肺经。传入中焦阳明胃经尚
未结实也。白虎汤主之。脉浮而促者。热邪尚可透表也。减味竹叶石膏汤主之。
白虎汤（见前）
减味竹叶石膏汤
竹叶（二钱五分） 石膏（四钱） 麦冬（三钱） 甘草（一钱五分）
水煎服。
阳明温病。诸证悉具。（如第一条所云） 数日不大便。脉沉数者。中焦邪渐结实也。增液汤主之。
增液汤（凡温病大便不通。皆宜先服此方。万不可遽用承气。盖此方通便生津而不伤气也。）
元参（一两） 麦冬（八钱连心） 细生地（八钱）
水八杯煎三杯。口干则与饮之。饮尽便不下。再作服。以通为度。
阳明温病。服增液后。过十二时。大便不下者。增液合调胃承气汤主之。（即照增液汤原方。与调胃承气汤方合为
一
剂。）
调胃承气汤
大黄（一钱五分） 芒硝（二钱五分） 生甘草（一钱）
水煎服。
阳明温病。诸证皆有。（如第一条所云）数日不大便。脉沉数有力。甚则脉体反小。服增液调胃承气后。大便仍不
通
者。中焦邪已结实也。大承气汤主之。（大承气乃攻里峻剂。必脉象。证象。与书中一一相符。已服增液调胃。便仍不
通
者。方可用之。如脉浮。脉迟。或恶寒。或小便清长。或舌虽黄黑。苔薄而润。或病者平素阴亏。及胃弱食少。均不可
轻用也。慎之慎之。）
温病面目俱赤。四肢厥冷。甚则通体皆厥。不螈 。但神昏。七八日以外。大便闭。小便赤。脉沉伏。或并脉亦厥。
胸腹满坚。甚则拒按。喜凉饮者。热结中焦火极似水也。大承气汤主之。
大承气汤
大黄（三钱） 芒硝（一钱五分） 浓朴（一钱五分） 枳实（一钱五分）
水三杯。先煮枳朴。后纳大黄芒硝。煮取一杯服阳明温病。（如首条所载）诸证悉有而。脉不浮者。小承气汤微和
之。
阳明温病。汗多谵语舌苔老黄而干者。有结粪也。宜小承气汤。
小承气汤
大黄（二钱五分） 浓朴（一钱） 枳实（五分）
水煎服。
阳明温病。无汗。小便不利谵语者。恐因邪犯心包。未可定为结粪也。先服牛黄丸。如不大便。再与调胃承气汤。
阳明温病。纯泻稀水无粪者。热结旁流也。调胃承气汤主之。
牛黄丸（见前） 调胃承气汤（见前）
阳明温病。下利谵语。若阳明脉实或滑疾者。肠虚胃实也。小承气汤主之。若脉不实者。热犯心包也。牛黄丸主之。
紫雪丹亦主之。
小承气汤（见前） 牛黄丸
紫雪丹（见前）
温病大热大渴。舌燥。脉不浮而躁甚。舌色金黄。痰涎壅甚者。上焦未清。而又阳土燥烈。煎熬肾水。三焦俱急也。
承气合小陷胸汤主之。
承气合小陷胸汤
生大黄（二钱五分） 浓朴（一钱） 枳实（一钱） 半夏（一钱五分） 栝蒌（一钱五分）
黄连（一钱）
水煎服。
温热本伤阴之病。若下后汗出。则胃阴受伤。急复其阴。益胃汤主之。
益胃汤
沙参（二钱） 麦冬（三钱） 冰糖（六分） 细生地（三钱） 玉竹（一钱炒香）
水煎服。
下后无汗脉浮者。邪气还表也。银翘汤主之。脉浮洪者。热甚伤津也。白虎汤主之。脉洪而芤者。金受火克元气不
支也。白虎加人参汤主之。
银翘汤
银花（二钱五分） 连翘（一钱五分） 竹叶（一钱） 甘草（五分） 麦冬（二钱） 细生地（二
钱）
水煎服。
白虎汤（见前） 白虎加人参汤（见前）
下后无汗脉不浮而数者。里热未解也。清燥汤主之。
清燥汤
麦冬（二钱五分） 知母（一钱） 人中黄（八分） 细生地（二钱五分） 元参（一钱五分）
水煎服。咳嗽胶痰加沙参（一钱五分） 桑叶（一钱） 梨汁（半酒杯） 牡蛎（一钱五分） 牛蒡子（一钱五分）
下后数日热不退。或退不尽。口燥咽干。舌苔干黑。或金黄色。脉沉而有力者。邪气复聚于胃也。然津液日耗。须
加意防护其阴。护胃承气汤微和之。脉沉而弱者。增液汤主之。
护胃承气汤
生大黄（一钱五分） 元参（一钱五分） 细生地（一钱五分） 丹皮（一钱） 知母（一钱）
麦冬（一钱五分连心）
水煎服。
增液汤（见前）
阳明温病。下后二三日。下证复见。脉不甚沉。或沉而无力。止可与增液。不可与承气。
阳明温病。下之不通者。险证有五。应下失下正虚不能运药者。正气既虚邪气复实也。新加黄龙汤主之。喘促不宁。
痰涎壅滞。右寸实大者。肺气不降里证又实也。宣白承气汤主之。左尺坚牢。小便赤痛。时烦渴甚者。火腑不通。小肠
热盛。下注膀胱也。导赤承气汤主之。神昏舌短。饮不解渴者。邪闭心包。内窍不通也。牛黄承气汤主之。阳明太热。
津液不足。间服增液。仍不下者。脏燥太甚无水舟停也。增液承气汤主之。
新加黄龙汤
细生地（五钱） 生甘草（二钱） 人参（一钱五分另煎） 生大黄（三钱） 芒硝（一钱） 元
参（五钱） 麦冬（五钱连心） 当归（一钱五分） 海参（二条洗） 姜汁（六匙）
水八杯煎三杯。先用一杯。冲参汁五分。姜汁二匙。顿服之。如腹中有响声或有转矢气。则为欲便。候一二时不便。
再如前法服一杯。候二十四刻不便。再服第三杯。如服一杯即得便。止后服。酌服益胃汤一剂。
宣白承气汤
生石膏（二钱五分） 生大黄（一钱五分） 杏仁粉（一钱） 栝蒌皮（八分）
水煎服。
导赤承气汤
赤芍（一钱五分） 细生地（二钱五分） 生大黄（一钱五分） 黄连（一钱） 黄柏（一钱）
芒硝（五分）
水煎服。
牛黄承气汤
用牛黄丸一丸化开。调生大黄末一钱五分服之。不下。再服。
增液承气汤
即于增液汤内加大黄（三钱） 芒硝（一钱五分） 下后虚烦不眠。心中懊 。甚至反复颠倒者。膈间之邪未清也。
栀子豉汤主之。
栀子豉汤（见前）
若少气加甘草（一钱） 呕者加姜汁（三匙）
阳明温病。干呕口苦而渴者邪热夹秽扰乱中宫也。如无下证。用黄连黄芩汤。（不渴而舌滑者当照湿温法治之。）
黄连黄芩汤
黄连（一钱） 黄芩（一钱） 郁金（八分） 香豆豉（一钱）
水煎服。
阳明温病。舌色绛不渴者。邪气深入血分也。清营汤主之。（若舌苔滑者。当照湿温法治之。）
清营汤（见前）
阳明发斑者。化斑汤主之。
化斑汤（见前）
阳明温病。下后疹出者。加减银翘散主之。（此因下后疹出。阴液已伤不可再用葛根升发。故仍从加减银翘法。而
稍
变其药味。）
加减银翘散
即照银翘散方 去银花连翘豆豉加蝉蜕（三钱） 赤芍（一钱） 丹皮（一钱） 杏仁（一钱五分）
斑疹用升提则衄血。或厥逆。或呛咳。或昏痉。用壅补则骛乱。若阳明证悉具。外出不快。内壅特甚者。调胃承气
汤微和之。得通则已。不可令大泄。大泄则气陷也。
调胃承气汤（见前）
阳明温毒发痘者。（形如小儿痘疮。或多或少。紫黑色。）秽浊太甚也。脉浮则用银翘散加生地元参。渴者加花粉。
毒重者加金汁人中黄。小便短者。加芩连之类。脉沉内壅者。酌量轻重下之。（如发疮形似杨梅者。轻则红紫。重则紫
黑。
多现于面部背部亦照此法。重用败毒之品。兼与利湿。如土茯苓萆 之类。）
阳明温病。无汗。实证未剧者。不可下。小便不利者。小肠热结。金受火刑也不可利水。宜用甘苦合化法。冬地三
黄汤主之。
冬地三黄汤
元参（二钱） 黄连（五分） 苇根汁（五茶匙冲） 细生地（二钱） 黄柏（五分） 银花露（五茶匙冲） 麦
冬
（四钱） 黄芩（五分） 生甘草（一钱五分）
水煎服。
温病小便不利者。不可以淡渗利水。（如五苓八正散之类）恐伤阴也。温病燥热者。不可纯用苦寒。（如三黄汤之类）
恐苦能化燥也温病。下后热退不可即食。食则病必复发。须周十二时后。缓与清淡之食。不可令饱。饱则病亦复发。发
必重也。
阳明温病下后脉静身不热。舌上津回。十数日不大便者。肠胃津液受伤也。可与益胃增液之属。下后舌苔未退尽。
身微热。面微赤。口微渴。脉微数。日浅者。亦与增液益胃之属。日深舌微干者。用下焦复脉法。均不可再用承气汤。
用之证必增剧。甚则燥咳泄泻而死。
益胃汤（见前） 增液汤（见前）
阳明温病。渴甚者悉尼浆沃之。
悉尼浆（见前）
阳明温病。斑疹温痘温疮温毒发黄。凡神昏谵语者。安宫牛黄丸主之。
牛黄丸（见前）
温病表现为面部和眼睛都发红，声音沉重浑浊，呼吸粗重。（如果吸气粗而呼气不粗，或呼气粗而吸气不粗，或者完全不粗的，就不是这种证候。）极度口渴想喝水，大便闭塞不通，小便涩滞不畅，舌苔老黄，严重时呈黑色且有芒刺。只怕热不怕冷，下午症状加重。脉象浮洪且躁动剧烈的，是邪气从上焦肺经传入中焦阳明胃经，但尚未形成结实之证。用白虎汤主治。脉象浮而急促的，说明热邪还可以透达体表。用减味竹叶石膏汤主治。
白虎汤（见前文）
减味竹叶石膏汤
竹叶（二钱五分） 石膏（四钱） 麦冬（三钱） 甘草（一钱五分）
用水煎服。
阳明温病，各种症状都具备。（如第一条所述）几天不大便，脉象沉数，是中焦邪气逐渐结实。用增液汤主治。
增液汤（凡是温病大便不通，都适宜先服用此方，千万不要急于使用承气汤。因为此方能通便生津而不伤正气。）
玄参（一两） 麦冬（八钱，保留心部） 细生地（八钱）
用水八杯煎至三杯。口干时就给病人饮用，喝完若大便仍不下，再按原法煎服，以大便通畅为度。
阳明温病，服用增液汤后，过了十二个时辰，大便仍不下的，用增液汤合调胃承气汤主治。（即按照增液汤的原方，与调胃承气汤的方子合并为一剂。）
调胃承气汤
大黄（一钱五分） 芒硝（二钱五分） 生甘草（一钱）
用水煎服。
阳明温病，各种症状都有。（如第一条所述）几天不大便，脉象沉数有力，甚至脉体反而变小，服用增液汤和调胃承气汤后，大便仍然不通的，是中焦邪气已经结实。用大承气汤主治。（大承气汤是攻下里实的峻猛药剂，必须脉象、证状与书中描述完全相符，且在服用过增液汤和调胃承气汤后大便仍不通者，方可使用。如脉浮、脉迟，或有恶寒，或小便清长，或舌虽黄黑但苔薄而润，或患者平素阴亏，以及胃弱食少等情况，均不可轻易使用。务必谨慎，务必谨慎！）
温病面部和眼睛都发红，四肢厥冷，严重时全身皆厥，没有抽搐，只是神志昏迷，七八天以后，大便闭塞，小便赤红，脉象沉伏，或者连脉搏也微弱欲绝，胸腹部胀满坚硬，严重时拒绝按压，喜欢喝凉饮的，这是热结在中焦，火极似水的表现。用大承气汤主治。
大承气汤
大黄（三钱） 芒硝（一钱五分） 厚朴（一钱五分） 枳实（一钱五分）
用水三杯，先煮枳实和厚朴，后加入大黄和芒硝，煮取一杯服用。
阳明温病。（如首条所载）各种症状都具备，但脉象不浮的，用小承气汤轻微调和。
阳明温病，汗多、说胡话、舌苔老黄而干燥的，是有燥屎内结。宜用小承气汤。
小承气汤
大黄（二钱五分） 厚朴（一钱） 枳实（五分）
用水煎服。
阳明温病，无汗，小便不利，说胡话的，恐怕是因为邪气侵犯心包，不能确定为燥屎内结。先服用牛黄丸，如果仍不大便，再给予调胃承气汤。
阳明温病，纯泻稀水而无粪便的，是热结旁流。用调胃承气汤主治。
阳明温病，腹泻伴说胡话，如果阳明脉象实或滑疾，是肠虚胃实。用小承气汤主治。如果脉象不实，是热邪侵犯心包。用牛黄丸主治。紫雪丹也可主治。
温病高热大渴，舌燥，脉象不浮而躁动剧烈，舌色金黄，痰涎壅盛的，是上焦邪气未清，同时阳土（胃）燥烈，煎熬肾水，导致三焦都紧急。用承气汤合小陷胸汤主治。
承气合小陷胸汤
生大黄（二钱五分） 厚朴（一钱） 枳实（一钱） 半夏（一钱五分） 瓜蒌（一钱五分） 黄连（一钱）
用水煎服。
温热病本是损伤阴液的病，如果攻下后出汗，则胃阴受伤，急需恢复阴液，用益胃汤主治。
益胃汤
沙参（二钱） 麦冬（三钱） 冰糖（六分） 细生地（三钱） 玉竹（一钱，炒香）
用水煎服。
攻下后无汗，脉象浮的，是邪气回归体表。用银翘汤主治。脉象浮洪的，是热盛伤津。用白虎汤主治。脉象洪大而芤的，是金（肺）受火克，元气不支。用白虎加人参汤主治。
银翘汤
金银花（二钱五分） 连翘（一钱五分） 竹叶（一钱） 甘草（五分） 麦冬（二钱） 细生地（二钱）
用水煎服。
清燥汤
麦冬（二钱五分） 知母（一钱） 人中黄（八分） 细生地（二钱五分） 玄参（一钱五分）
用水煎服。咳嗽伴有胶稠痰的，加沙参（一钱五分）、桑叶（一钱）、梨汁（半酒杯）、牡蛎（一钱五分）、牛蒡子（一钱五分）。
攻下后数日热不退，或退而不尽，口燥咽干，舌苔干黑，或呈金黄色，脉象沉而有力的，是邪气重新聚集于胃。然而津液日渐消耗，必须注意保护阴液，用护胃承气汤轻微调和。脉象沉而弱的，用增液汤主治。
护胃承气汤
生大黄（一钱五分） 玄参（一钱五分） 细生地（一钱五分） 牡丹皮（一钱） 知母（一钱） 麦冬（一钱五分，保留心部）
用水煎服。
增液汤（见前文）
阳明温病，攻下后两三天，下证的征象再次出现，脉象不甚沉，或沉而无力，只可与增液汤，不可与承气汤。
阳明温病，攻下后大便仍不通的，有五种险证：应当攻下却失于攻下，正气虚弱不能运化药力的，是正气已虚邪气复实，用新加黄龙汤主治；喘促不安，痰涎壅滞，右寸脉实大的，是肺气不降且里证实，用宣白承气汤主治；左尺脉坚牢，小便赤痛，时常烦躁口渴严重的，是火腑不通，小肠热盛下注膀胱，用导赤承气汤主治；神志昏迷，舌体短缩，饮水不能解渴的，是邪闭心包，内窍不通，用牛黄承气汤主治；阳明太热，津液不足，间歇服用增液汤，仍不大便的，是脏燥太甚，无水舟停，用增液承气汤主治。
新加黄龙汤
细生地（五钱） 生甘草（二钱） 人参（一钱五分，另煎） 生大黄（三钱） 芒硝（一钱） 玄参（五钱） 麦冬（五钱，保留心部） 当归（一钱五分） 海参（两条，洗净） 姜汁（六匙）
用水八杯煎至三杯。先用一杯，冲入参汁五分、姜汁二匙，一次性顿服。如果腹中有响声或放屁，则是将要排便的迹象，等候一两个时辰若不排便，再按前法服用一杯。等候二十四刻若不排便，再服第三杯。如果服一杯后即得大便，停止后续服药。酌情服用益胃汤一剂。
宣白承气汤
生石膏（二钱五分） 生大黄（一钱五分） 杏仁粉（一钱） 瓜蒌皮（八分）
用水煎服。
导赤承气汤
赤芍（一钱五分） 细生地（二钱五分） 生大黄（一钱五分） 黄连（一钱） 黄柏（一钱） 芒硝（五分）
用水煎服。
牛黄承气汤
用牛黄丸一丸化开，调生大黄末一钱五分服用。若不通，再服。
攻下后虚烦不眠，心中懊恼，甚至反复颠倒的，是膈间邪气未清。用栀子豉汤主治。
栀子豉汤（见前文）
若少气加甘草（一钱），呕吐者加姜汁（三匙）。
阳明温病，干呕、口苦而渴的，是邪热夹带秽浊之气扰乱中宫。如果没有下证，用黄连黄芩汤。（如果不渴而舌苔滑的，应当照湿温法治之。）
黄连黄芩汤
黄连（一钱） 黄芩（一钱） 郁金（八分） 香豆豉（一钱）
用水煎服。
阳明温病，舌色绛红但不渴的，是邪气深入血分。用清营汤主治。（如果舌苔滑的，应当照湿温法治之。）
清营汤（见前文）
化斑汤（见前文）
阳明温病，攻下后出疹的，用加减银翘散主治。（这是因为攻下后出疹，阴液已伤，不可再用葛根升提发散，所以仍从加减银翘法，而稍微改变其药味。）
加减银翘散
即按照银翘散方，去掉金银花、连翘、豆豉，加入蝉蜕（三钱）、赤芍（一钱）、牡丹皮（一钱）、杏仁（一钱五分）。
斑疹如果用升提药，则会导致鼻出血，或四肢厥逆，或呛咳，或昏厥抽搐。如果用壅补药，则会导致泄泻混乱。如果阳明证全部具备，外出不快，内部壅滞特别严重的，用调胃承气汤轻微调和。得到通畅即可，不可令其大泄。大泄则会导致气陷。
调胃承气汤（见前文）
阳明温毒发痘的。（形状像小儿痘疮，或多或少，呈紫黑色。）是秽浊之气太重。脉浮的，用银翘散加生地、玄参；口渴的加花粉；毒重的加金汁、人中黄；小便短的，加黄芩、黄连之类；脉沉内部壅滞的，酌情轻重攻下。（如果发的疮形似杨梅疮的，轻则红紫，重则紫黑，多出现在面部背部，也照此法治疗，重用败毒之品，兼以利湿，如土茯苓、萆薢之类。）
阳明温病，无汗，实证不剧烈的，不可攻下。小便不利的，是小肠热结，金（肺）受火刑，也不可利水。宜用甘苦合化法，用冬地三黄汤主治。
冬地三黄汤
玄参（二钱） 黄连（五分） 苇根汁（五茶匙冲服） 细生地（二钱） 黄柏（五分） 银花露（五茶匙冲服） 麦冬（四钱） 黄芩（五分） 生甘草（一钱五分）
用水煎服。
温病小便不利的，不可以用淡渗利水药。（如五苓散、八正散之类），恐怕会损伤阴液。温病燥热的，不可纯用苦寒药。（如三黄汤之类），恐怕苦能化燥。温病攻下后热退，不可立即进食，进食则病必复发。须过十二个时辰后，缓慢给予清淡食物，不可令其吃饱。吃饱则病亦复发，复发必定严重。
阳明温病攻下后脉静身不热，舌上津液回复，十几天不大便的，是肠胃津液受伤。可与益胃汤、增液汤之类的药物。攻下后舌苔未退尽，身体微热，面色微红，口微渴，脉微数，病程短的，也与增液汤、益胃汤之类的药物。病程长舌微干的，用下焦复脉法。均不可再用承气汤。使用承气汤则证候必定加剧，甚至导致燥咳、泄泻而死。
悉尼浆（见前文）
阳明温病，斑疹、温痘、温疮、温毒发黄，凡是神志昏迷、说胡话的，用安宫牛黄丸主治。
牛黄丸（见前文）
[The treatments for Warm-Heat Disease, Winter-Warm Disease, Warm-Toxic Disease, and Warm-Epidemic Disease are the same.]
In Warm-Heat Disease (Wen Bing), the face and eyes are both red, the voice is heavy and turbid, and respiration is coarse. (If inhalation is coarse but exhalation is not, or exhalation is coarse but inhalation is not, or neither is coarse, it is not this syndrome.) There is extreme thirst with a desire to drink, constipation, dysuria (scanty and difficult urination), an old yellow tongue coating, and in severe cases, a black coating with prickles. The patient fears heat but not cold, with symptoms worsening in the afternoon. If the pulse is floating, surging, and severely restless, the pathogen has transmitted from the Upper Jiao Lung Meridian to the Middle Jiao Yangming Stomach Meridian, but solidification has not yet occurred. Treat with Baihu Tang (White Tiger Decoction). If the pulse is floating and rapid (cu), the heat pathogen can still be vented through the exterior. Treat with Jianwei Zhuye Shigao Tang (Modified Bamboo Leaf and Gypsum Decoction).
Baihu Tang (See previous section)
Jianwei Zhuye Shigao Tang (Modified Bamboo Leaf and Gypsum Decoction)
Zhuye (Bamboo Leaf, 2.5 qian) Shigao (Gypsum, 4 qian) Maidong (Ophiopogon Root, 3 qian) Gancao (Licorice Root, 1.5 qian)
Decoct in water and take orally.
Yangming Warm-Heat Disease presents with all symptoms described above. After several days of no bowel movement, if the pulse is deep and rapid, it indicates that the pathogen in the Middle Jiao is gradually solidifying. Treat with Zengye Tang (Fluid-Replenishing Decoction).
Zengye Tang (For any Warm-Heat Disease with constipation, this formula should be taken first; do not hastily use Chengqi formulas, as this formula promotes bowel movement and generates fluids without damaging Qi.)
Xuanshen (Scrophularia Root, 1 liang) Maidong (Ophiopogon Root, 8 qian, retaining the heart) Xishengdi (Rehmannia Root, prepared fresh, 8 qian)
Decoct 8 cups of water to obtain 3 cups. Drink when thirsty. If stool does not pass after finishing one dose, prepare another. Continue until bowel movement is achieved.
After taking Zengye Tang for Yangming Warm-Heat Disease, if there is no bowel movement after 12 hours (shi chen), treat with Zengye Tang combined with Tiaowei Chengqi Tang (Regulating the Stomach and Directing Downward Decoction). (Combine the original Zengye Tang formula with the Tiaowei Chengqi Tang formula into one dose.)
Tiaowei Chengqi Tang (Regulating the Stomach and Directing Downward Decoction)
Dahuang (Rhubarb Root, 1.5 qian) Mangxiao (Mirabilite, 2.5 qian) Sheng Gancao (Raw Licorice Root, 1 qian)
Decoct in water and take orally.
In Yangming Warm-Heat Disease, if all symptoms are present, the pulse is deep, rapid, and forceful, or even small, and after taking Zengye Tang and Tiaowei Chengqi Tang there is still no bowel movement, the pathogen in the Middle Jiao has fully solidified. Treat with Dachengqi Tang (Major Directing Downward Decoction). (Dachengqi Tang is a harsh purgative for interior excess. It must only be used when the pulse and symptoms strictly match the description, and only after Zengye Tang and Tiaowei Chengqi Tang have failed to produce stool. Do not use lightly if the pulse is floating or slow, if there is aversion to cold, if urine is clear and profuse, if the tongue is yellow/black but the coating is thin and moist, if the patient has chronic Yin deficiency, or if the stomach is weak with poor appetite. Be extremely cautious.)
In Warm-Heat Disease, if the face and eyes are red, limbs are cold (Jue), or even the whole body is cold, without convulsions but with coma, and after 7-8 days there is constipation, dark urine, a deep and hidden pulse, or even a pulse that feels like cold limbs, with fullness and hardness in the chest and abdomen, severe tenderness upon pressure, and a preference for cold drinks, this is Heat binding in the Middle Jiao, where extreme Fire resembles Water. Treat with Dachengqi Tang.
Dachengqi Tang (Major Directing Downward Decoction)
Dahuang (Rhubarb Root, 3 qian) Mangxiao (Mirabilite, 1.5 qian) Houpo (Magnolia Bark, 1.5 qian) Zhishi (Immature Bitter Orange, 1.5 qian)
Decoct 3 cups of water. First boil Zhishi and Houpo, then add Dahuang and Mangxiao. Boil down to 1 cup and take.
In Yangming Warm-Heat Disease, if all symptoms are present but the pulse is not floating, treat mildly with Xiaochengqi Tang (Minor Directing Downward Decoction).
In Yangming Warm-Heat Disease, if there is profuse sweating, delirium, and an old yellow dry tongue coating, indicating dried feces, use Xiaochengqi Tang.
Xiaochengqi Tang (Minor Directing Downward Decoction)
Dahuang (Rhubarb Root, 2.5 qian) Houpo (Magnolia Bark, 1 qian) Zhishi (Immature Bitter Orange, 0.5 qian)
Decoct in water and take orally.
In Yangming Warm-Heat Disease, if there is no sweat, dysuria, and delirium, suspect that the pathogen has invaded the Pericardium (Xin Bao); do not assume it is dried feces yet. First give Niuhuang Wan (Calculus Bovis Pill). If there is still no bowel movement, then administer Tiaowei Chengqi Tang.
In Yangming Warm-Heat Disease, if there is pure discharge of watery stool without feces, this is "Heat Binding with Side Flow" (Re Jie Pang Liu). Treat with Tiaowei Chengqi Tang.
Niuhuang Wan (Calculus Bovis Pill) (See previous section) Tiaowei Chengqi Tang (See previous section)
In Yangming Warm-Heat Disease, if there is diarrhea with delirium, and the Yangming pulse is Excess (Shi) or Slippery/Fast (Hua Ji), it indicates Empty Intestine and Excess Stomach. Treat with Xiaochengqi Tang. If the pulse is not Excess, it indicates Heat invading the Pericardium. Treat with Niuhuang Wan. Zixue Dan (Purple Snow Elixir) may also be used.
Xiaochengqi Tang (See previous section) Niuhuang Wan (Calculus Bovis Pill)
Zixue Dan (Purple Snow Elixir) (See previous section)
In Warm-Heat Disease, if there is high fever, extreme thirst, dry tongue, a non-floating but severely restless pulse, golden-yellow tongue color, and copious phlegm-saliva, it means the Upper Jiao is not cleared, while the Yang Earth (Stomach) is dry and fierce, scorching Kidney Water, causing urgency in all three Jiaos. Treat with Chengqi Tang combined with Xiao Xianxiong Tang (Minor Chest-Harmonizing Decoction).
Chengqi Tang combined with Xiao Xianxiong Tang
Sheng Dahuang (Raw Rhubarb Root, 2.5 qian) Houpo (Magnolia Bark, 1 qian) Zhishi (Immature Bitter Orange, 1 qian) Banxia (Pinellia Tuber, 1.5 qian) Gualou (Trichosanthes Fruit, 1.5 qian) Huanglian (Coptis Rhizome, 1 qian)
Decoct in water and take orally.
Warm-Heat diseases inherently damage Yin. If sweating occurs after purgation, Stomach Yin is injured. Urgently restore Yin using Yiewei Tang (Benefit the Stomach Decoction).
Yiewei Tang (Benefit the Stomach Decoction)
Shashen (Glehnia Root, 2 qian) Maidong (Ophiopogon Root, 3 qian) Bingtang (Rock Sugar, 0.6 qian) Xishengdi (Rehmannia Root, prepared fresh, 3 qian) Yuzhu (Polygonatum Odoratum Rhizome, 1 qian, fried until fragrant)
Decoct in water and take orally.
If there is no sweat and a floating pulse after purgation, the pathogen has returned to the exterior. Treat with Yinqiao Tang (Honeysuckle and Forsythia Decoction). If the pulse is floating and surging, Heat is severe and injuring Jin-Ye (Body Fluids). Treat with Baihu Tang. If the pulse is surging and Kou (Hollow), Metal (Lung) is overcome by Fire and Yuan Qi (Original Qi) is unsupported. Treat with Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng).
Yinqiao Tang (Honeysuckle and Forsythia Decoction)
Yinhua (Honeysuckle Flower, 2.5 qian) Lianqiao (Forsythia Fruit, 1.5 qian) Zhuye (Bamboo Leaf, 1 qian) Gancao (Licorice Root, 0.5 qian) Maidong (Ophiopogon Root, 2 qian) Xishengdi (Rehmannia Root, prepared fresh, 2 qian)
Decoct in water and take orally.
Baihu Tang (White Tiger Decoction) (See previous section) Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng) (See previous section)
If there is no sweat and a non-floating but rapid pulse after purgation, Interior Heat is unresolved. Treat with Qingzao Tang (Clear Dryness Decoction).
Qingzao Tang (Clear Dryness Decoction)
Maidong (Ophiopogon Root, 2.5 qian) Zhimu (Anemarrhena Rhizome, 1 qian) Renzhonghuang (Human Midden Yellow, 0.8 qian) Xishengdi (Rehmannia Root, prepared fresh, 2.5 qian) Xuanshen (Scrophularia Root, 1.5 qian)
Decoct in water and take orally. For cough with sticky phlegm, add Shashen (Glehnia Root, 1.5 qian), Sangye (Mulberry Leaf, 1 qian), Lizhi (Pear Juice, half wine glass), Muli (Oyster Shell, 1.5 qian), Niubangzi (Arctium Seed, 1.5 qian).
If fever persists or does not fully resolve several days after purgation, accompanied by dry mouth and throat, dry black or golden-yellow tongue coating, and a deep, forceful pulse, the pathogen has re-accumulated in the Stomach. However, since Body Fluids are daily depleted, care must be taken to protect Yin. Treat mildly with Huwei Chengqi Tang (Protect the Stomach and Direct Downward Decoction). If the pulse is deep and weak, treat with Zengye Tang.
Huwei Chengqi Tang (Protect the Stomach and Direct Downward Decoction)
Sheng Dahuang (Raw Rhubarb Root, 1.5 qian) Xuanshen (Scrophularia Root, 1.5 qian) Xishengdi (Rehmannia Root, prepared fresh, 1.5 qian) Danpi (Moutan Cortex, 1 qian) Zhimu (Anemarrhena Rhizome, 1 qian) Maidong (Ophiopogon Root, 1.5 qian, retaining the heart)
Decoct in water and take orally.
Zengye Tang (Fluid-Replenishing Decoction) (See previous section)
In Yangming Warm-Heat Disease, if two to three days after purgation, signs of downward expulsion reappear, but the pulse is not deeply sunken or is deep and weak, only provide Zengye Tang; do not provide Chengqi Tang.
In Yangming Warm-Heat Disease, if purgation fails to produce stool, there are five dangerous syndromes:
1. Failure to purge when indicated, leading to deficiency preventing the movement of medicine: Righteous Qi is deficient, Pathogenic Qi is excessive. Treat with Xinjia Huanglong Tang (Newly Added Yellow Dragon Decoction).
2. Panting and restlessness, copious phlegm-saliva, solid-large right Cun pulse: Lung Qi fails to descend and Interior Excess exists. Treat with Xuanbai Chengqi Tang (Vent White and Direct Downward Decoction).
3. Firm-hard left Chi pulse, red painful urination, frequent severe thirst: Fire Fu organs are blocked, Small Intestine Heat is excessive and flows downward to the Bladder. Treat with Daochi Chengqi Tang (Guide Red and Direct Downward Decoction).
4. Coma, short tongue, drinking does not quench thirst: Pathogen blocks the Pericardium, internal orifices are blocked. Treat with Niuhuang Chengqi Tang (Calculus Bovis and Direct Downward Decoction).
5. Extreme Yangming Heat, insufficient Jin-Ye, intermittent Zengye Tang still fails to produce stool: Visceral dryness is too severe, "no water, boat stops." Treat with Zengye Chengqi Tang (Fluid-Replenishing and Direct Downward Decoction).
Xinjia Huanglong Tang (Newly Added Yellow Dragon Decoction)
Xishengdi (Rehmannia Root, prepared fresh, 5 qian) Sheng Gancao (Raw Licorice Root, 2 qian) Renshen (Ginseng Root, 1.5 qian, decocted separately) Sheng Dahuang (Raw Rhubarb Root, 3 qian) Mangxiao (Mirabilite, 1 qian) Xuanshen (Scrophularia Root, 5 qian) Maidong (Ophiopogon Root, 5 qian, retaining the heart) Danggui (Angelica Sinensis Root, 1.5 qian) Haishen (Sea Cucumber, 2 pieces, washed) Jiangzhi (Ginger Juice, 6 spoons)
Decoct 8 cups of water to obtain 3 cups. Take 1 cup first, mixed with 0.5 qian Ginseng juice and 2 spoons Ginger Juice, in one dose. If abdominal sounds or flatus occur, stool is imminent. Wait 1-2 hours; if no stool, take another cup as before. Wait 24 ke (approx. 6 hours); if still no stool, take the third cup. If stool passes after one cup, stop subsequent doses. Optionally take one dose of Yiewei Tang.
Xuanbai Chengqi Tang (Vent White and Direct Downward Decoction)
Sheng Shigao (Raw Gypsum, 2.5 qian) Sheng Dahuang (Raw Rhubarb Root, 1.5 qian) Xingren Fen (Apricot Seed Powder, 1 qian) Gualou Pi (Trichosanthes Peel, 0.8 qian)
Decoct in water and take orally.
Daochi Chengqi Tang (Guide Red and Direct Downward Decoction)
Chishao (Red Peony Root, 1.5 qian) Xishengdi (Rehmannia Root, prepared fresh, 2.5 qian) Sheng Dahuang (Raw Rhubarb Root, 1.5 qian) Huanglian (Coptis Rhizome, 1 qian) Huangbo (Phellodendron Bark, 1 qian) Mangxiao (Mirabilite, 0.5 qian)
Decoct in water and take orally.
Niuhuang Chengqi Tang (Calculus Bovis and Direct Downward Decoction)
Dissolve one pill of Niuhuang Wan (Calculus Bovis Pill) and mix with 1.5 qian of powdered Dahuang (Rhubarb Root). Take orally. If ineffective, repeat.
Zengye Chengqi Tang (Fluid-Replenishing and Direct Downward Decoction)
Add Dahuang (Rhubarb Root, 3 qian) and Mangxiao (Mirabilite, 1.5 qian) to Zengye Tang (Fluid-Replenishing Decoction).
After purgation, if there is empty irritability, insomnia, mental restlessness (Ao Nu), or tossing and turning, the pathogen in the Diaphragm is not cleared. Treat with Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction).
Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) (See previous section)
If there is shortness of breath, add Gancao (Licorice Root, 1 qian). If vomiting, add Jiangzhi (Ginger Juice, 3 spoons).
In Yangming Warm-Heat Disease, if there is dry retching, bitter taste, and thirst, it is Pathogenic Heat mixing with turbidity disturbing the Middle Palace. If there are no downward expulsion signs, use Huanglian Huangqin Tang (Coptis and Scutellaria Decoction). (If not thirsty but tongue coating is slippery, treat according to Damp-Warmth methods.)
Huanglian Huangqin Tang (Coptis and Scutellaria Decoction)
Huanglian (Coptis Rhizome, 1 qian) Huangqin (Scutellaria Root, 1 qian) Yujin (Curcuma Tuber, 0.8 qian) Xiang Douchi (Fragrant Fermented Soybean, 1 qian)
Decoct in water and take orally.
In Yangming Warm-Heat Disease, if the tongue is crimson and there is no thirst, the pathogen has entered the Blood Level. Treat with Qingying Tang (Clear the Nutritive Level Decoction). (If the tongue coating is slippery, treat according to Damp-Warmth methods.)
Qingying Tang (Clear the Nutritive Level Decoction) (See previous section)
In Yangming Warm-Heat Disease with macules (Ban), treat with Huaban Tang (Resolve Macules Decoction).
Huaban Tang (Resolve Macules Decoction) (See previous section)
In Yangming Warm-Heat Disease, if rash appears after purgation, treat with Jiayin Yinqiao San (Modified Honeysuckle and Forsythia Powder). (Since Yin fluids are injured after purgation, Ge Gen (Kudzu Root) lifting and dispersing agents should not be used. Thus, follow the Modified Yinqiao method with slight changes in ingredients.)
Jiayin Yinqiao San (Modified Honeysuckle and Forsythia Powder)
Based on Yinqiao San (Honeysuckle and Forsythia Powder), remove Yinhua (Honeysuckle Flower), Lianqiao (Forsythia Fruit), and Douchi (Fermented Soybean). Add Chan Tui (Cicada Slough, 3 qian), Chishao (Red Peony Root, 1 qian), Danpi (Moutan Cortex, 1 qian), Xingren (Apricot Seed, 1.5 qian).
Using lifting agents for macules/rash causes epistaxis, Jue (cold limbs), choking cough, or coma/convulsions. Using cloying tonics causes loose stools/confusion. If Yangming signs are complete, eruption is slow, and internal obstruction is severe, treat mildly with Tiaowei Chengqi Tang. Stop once unobstructed; do not cause severe purgation, as this leads to Qi sinking.
Tiaowei Chengqi Tang (Regulating the Stomach and Directing Downward Decoction) (See previous section)
In Yangming Warm-Toxic Disease with pustules (resembling smallpox, varying amounts, purple-black), the turbidity is extreme. If the pulse is floating, use Yinqiao San (Honeysuckle and Forsythia Powder) plus Shengdi (Rehmannia Root) and Xuanshen (Scrophularia Root). If thirsty, add Huafen (Trichosanthes Root). If toxicity is heavy, add Jinzhi (Golden Juice) and Renzhonghuang (Human Midden Yellow). If urine is scanty, add Huangqin (Scutellaria Root) and Huanglian (Coptis Rhizome). If the pulse is deep with internal obstruction, purge according to severity. (If sores resemble syphilis/kaposi-like lesions, light cases are red-purple, severe are purple-black, mostly on face/back. Treat similarly with heavy detoxifying herbs and damp-draining herbs like Tubaling (Smilax Glabra Rhizome) and Bi Xie (Dioscorea Hypoglauca Rhizome).)
In Yangming Warm-Heat Disease, if there is no sweat and the Excess syndrome is not severe, do not purge. If there is dysuria, it is Small Intestine Heat binding, and Metal (Lung) is punished by Fire; do not use diuretics. Use the Sweet-Bitter Harmonizing Method with Dongdi Sanhuan Tang (Winter Ground Three Yellows Decoction).
Dongdi Sanhuan Tang (Winter Ground Three Yellows Decoction)
Xuanshen (Scrophularia Root, 2 qian) Huanglian (Coptis Rhizome, 0.5 qian) Weigen Zhi (Reed Rhizome Juice, 5 tea spoons, added to decoction) Xishengdi (Rehmannia Root, prepared fresh, 2 qian) Huangbo (Phellodendron Bark, 0.5 qian) Yinhua Lu (Honeysuckle Dew, 5 tea spoons, added to decoction) Maidong (Ophiopogon Root, 4 qian) Huangqin (Scutellaria Root, 0.5 qian) Sheng Gancao (Raw Licorice Root, 1.5 qian)
Decoct in water and take orally.
For Warm-Heat Disease with dysuria, do not use bland-leaching diuretics (such as Wuling San or Bazheng San), as they may injure Yin. For Warm-Heat Disease with dryness-heat, do not use purely bitter-cold herbs (such as Sanhuang Tang), as bitterness may transform into dryness. After purgation in Warm-Heat Disease, when heat subsides, do not eat immediately; eating will cause relapse. Wait 12 hours (shi chen), then slowly give light food, avoiding fullness. Fullness causes relapse, which will be severe.
In Yangming Warm-Heat Disease, if after purgation the pulse is calm, body temperature is normal, tongue moisture returns, but there is no bowel movement for 10+ days, it is due to injury of Gastrointestinal Jin-Ye. Provide Yiewei Tang (Benefit the Stomach Decoction) or Zengye Tang (Fluid-Replenishing Decoction). If after purgation the tongue coating has not fully receded, body is slightly hot, face slightly red, mouth slightly thirsty, pulse slightly rapid, and time elapsed is short, also provide Zengye Tang or Yiewei Tang. If time elapsed is long and tongue is slightly dry, use Lower Jiao Fumai Fa (Restore Pulse Method of Lower Jiao). Do not use Chengqi Tang again; doing so will worsen symptoms, potentially leading to death from dry cough and diarrhea.
Yiewei Tang (Benefit the Stomach Decoction) (See previous section) Zengye Tang (Fluid-Replenishing Decoction) (See previous section)
In Yangming Warm-Heat Disease, if thirst is extreme, moisten with Xini Jiang (Sidney Syrup/Juice).
Xini Jiang (Sidney Syrup/Juice) (See previous section)
In Yangming Warm-Heat Disease, for macules, rashes, warm-smallpox, warm-sores, warm-toxic jaundice, if there is coma or delirium, treat with Angong Niuhuang Wan (Calculus Bovis Pill for Opening the Orifices).
Niuhuang Wan (Calculus Bovis Pill) (See previous section)