安徽富藩台堂夫人病疫，初起但寒不热，头晕眼花，腰体疼痛。医者误认虚寒，用六味加杜仲、续断、
牛膝、木瓜，两服后，昏沉如迷，呼吸将绝，并不知其为病所苦。令叔五公，现任兵部郎中，邀予往看。
诊其脉，沉细而数；稽其症，面颜红赤，头汗如淋，身热肢冷，舌燥唇焦。予曰∶非虚也，乃疫耳。五曰∶种
种形状是虚，何以言疫？予曰∶若是虚症，面颜不至红赤，舌不焦，唇不燥，通身大汗，乃元阳将脱之象，
岂独头汗如淋、身热肢冷哉？大剂决不敢服，暂用凉膈散，清其内热，明日斑疹微露，症自明矣。次日斑点隐隐，含于
皮内。五见骇然曰∶几误矣。即投败毒中剂，加大青叶钱半，升麻五分。次日周身斑见，紫赤松浮，身忽大热，肢亦不
冷，烦躁大渴，即换大剂，石膏八两，犀角六钱，黄连五钱，加生地一两，紫草三钱，大青叶三钱，连投二服，斑转艳
红，惟咳嗽不止，痰中带血粉红。此金被火灼，即按本方加羚羊角三钱，桑皮三钱，棕炭三钱，丹皮二钱，又二服，嗽
宁血止，色转深红，热亦大减。照本方去紫草、羚羊、桑皮、棕炭；减生地五钱，石膏二两，犀角二钱；加木通钱
半，滑石五钱，以小水不利也。又二服，诸症已减十分之六，犹用石膏二两四钱，犀角二钱，黄连钱半，
生地四钱，去木通、滑石。又二服后，用犀角钱半，黄连八分，石膏八钱，加人参一钱，当归一钱，麦冬
三钱，五味子五分。连服二帖，饮食倍增，精神渐旺矣。
安徽富藩台（官职名）的堂夫人患了疫病，起初只是怕冷而不发热，头晕眼花，腰部和身体疼痛。医生误认为是虚寒证，使用了六味地黄丸加杜仲、续断、牛膝、木瓜，服用两剂后，病人昏迷不醒如同醉酒，呼吸微弱几乎停止，完全不知道是疾病带来的痛苦。她的叔叔五公，现任兵部郎中，邀请我去诊治。
我诊察她的脉象，沉细而数；考察她的症状，面色红赤，头部出汗如淋雨般，身体发热但四肢冰冷，舌面干燥嘴唇焦裂。我说：“这不是虚证，而是疫病。”五公说：“种种表现像是虚证，为什么说它是疫病？”我说：“如果是虚证，面色不会红赤，舌头不会焦裂，嘴唇不会干燥，全身大汗淋漓，那是元阳即将脱失的迹象，难道仅仅是头部出汗如淋、身体发热四肢冰冷吗？大剂量的药我不敢服用，暂时使用凉膈散，清除体内的热邪，明天如果斑疹微微显露，病症自然就会明朗了。”第二天斑点隐隐约约地出现在皮肤内部。五公见了惊恐地说：“差点就误诊了。”随即投用败毒散的中剂量，加大青叶一钱半，升麻五分。第二天周身出现斑点，颜色紫赤且松浮，身体突然高热，四肢也不再冰冷，烦躁且极度口渴，于是更换为大剂量处方：石膏八两，犀角六钱，黄连五钱，加生地一两，紫草三钱，大青叶三钱，连续服用两剂，斑点转为艳红色，只有咳嗽不止，痰中带粉红血。这是因为肺金被火邪灼伤，于是按照原方加入羚羊角三钱，桑白皮三钱，棕榈炭三钱，丹皮二钱，又服用两剂，咳嗽平息出血停止，血色转为深红，热势也大幅减退。依照原方去掉紫草、羚羊角、桑白皮、棕榈炭；减少生地五钱，石膏二两，犀角二钱；加入木通一钱半，滑石五钱，因为小便不利。又服用两剂，各种症状已经减轻了十分之六，仍然使用石膏二两四钱，犀角二钱，黄连一钱半，生地四钱，去掉木通、滑石。再服用两剂后，使用犀角一钱半，黄连八分，石膏八钱，加入人参一钱，当归一钱，麦冬三钱，五味子五分。连续服用两帖，饮食量倍增，精神逐渐旺盛起来。
Madam, the wife of the Vice Governor of Anhui Province, contracted an epidemic plague. Initially, she experienced only chills without fever, dizziness, blurred vision, and pain in her waist and body. The physician mistakenly diagnosed it as a deficiency-cold syndrome and prescribed Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) augmented with Duzhong (Eucommia Bark), Xuduan (Dipsacus Root), Niuxi (Achyranthes Root), and Mugua (Chaenomeles Fruit). After two doses, she fell into a coma resembling drunkenness, her breathing became faint and nearly ceased, and she was unaware of the suffering caused by the illness. Her uncle, Mr. Wu, currently serving as a Director in the Ministry of War, invited me to examine her.
I palpated her pulse, which was deep, fine, and rapid; I observed her symptoms: her face was red, sweat poured from her head like rain, her body was hot while her limbs were cold, and her tongue was dry with cracked lips. I said, "This is not a deficiency syndrome, but an epidemic plague." Mr. Wu asked, "All these manifestations appear to be deficiency; why do you say it is an epidemic?" I replied, "If this were a deficiency syndrome, her face would not be red, her tongue would not be scorched, nor her lips dry. Profuse sweating over the entire body would indicate the impending collapse of Primordial Yang. How could it be merely head sweating like rain, with body heat and cold limbs? I dare not administer large doses [of warming tonics]. For now, I will use Liangge San (Cooling the Chest Powder) to clear internal heat. Tomorrow, if macules and papules emerge slightly, the nature of the disease will become clear."
The next day, spots appeared faintly beneath the skin. Mr. Wu was horrified, saying, "We almost made a mistake." He immediately administered a medium dose of Baidu San (Defeat Poison Powder), adding Dayeqingye (Isatis Leaf) 1.5 qian and Shengma (Cimicifuga Rhizome) 5 fen. On the second day, macules appeared all over the body, purple-red and loose-floating. Her body suddenly became extremely hot, and her limbs were no longer cold. She suffered from irritability and extreme thirst. Therefore, I switched to a large-dose prescription: Shigao (Gypsum Fibrosum) 8 liang, Xijiao (Rhinoceros Horn - *Note: Use substitutes in modern practice*) 6 qian, Huanglian (Coptis Rhizome) 5 qian, plus Shengdi (Rehmannia Root) 1 liang, Zicao (Arnebiae Radix seu Lithospermi Radix) 3 qian, and Dayeqingye 3 qian. After two doses, the macules turned bright red. However, coughing persisted, and pink blood appeared in the sputum. This indicated that Metal (Lung) was being scorched by Fire. Following the original formula, I added Lingyangjiao (Antelope Horn - *Note: Use substitutes in modern practice*) 3 qian, Sangbaipi (Morus Cortex) 3 qian, Zongtan (Pinus Carbonized) 3 qian, and Danpi (Moutan Cortex) 2 qian. After another two doses, the cough subsided, bleeding stopped, the color of the blood turned dark red, and the heat significantly decreased.
According to the base formula, I removed Zicao, Lingyangjiao, Sangbaipi, and Zongtan; reduced Shengdi by 5 qian, Shigao by 2 liang, and Xijiao by 2 qian; and added Mutong (Akebia Caulis) 1.5 qian and Huashi (Talcum) 5 qian, due to difficult urination. After two more doses, all symptoms had diminished by six-tenths. I continued using Shigao 2.4 liang, Xijiao 2 qian, Huanglian 1.5 qian, and Shengdi 4 qian, removing Mutong and Huashi. After another two doses, I used Xijiao 1.5 qian, Huanglian 0.8 fen, Shigao 8 qian, and added Renshen (Ginseng Radix et Rhizoma) 1 qian, Danggui (Angelica Sinensis Radix) 1 qian, Maidong (Ophiopogon Tuber) 3 qian, and Wuweizi (Schisandra Fruit) 0.5 fen. After taking two prescriptions continuously, her food intake doubled, and her spirit gradually recovered strength.