[按]此证属暑湿内伏，化火动血。前二诊以白头翁汤加清暑利湿之品;三诊虽见虚象，既为暑湿，末可遽补。冀邪去而正安。孰知一波末平，一波又起，继见咯血，是热邪迫肺，亦暑瘵一类。所幸几经清暑利湿，热减湿去，故四诊清大肠、滋肺阴双管齐下，五诊更放手养阴，开始步入坦途。
2.男。病热一候，其热弛张无定，语言低沉。此与外感风寒者有别，乃温邪也。渴喜热饮，内有伏湿;手臂红点隐约，有入营之象。病之缠绵，为意中事。鸡苏散9克(包)，带叶佩兰9克，连翘12克，黄芩9克，青蒿9克，白薇12克，紫花地Tg克，甘露消毒丹9克(分3次吞)。
[按]温邪夹湿，多缠绵难解。方用蒿、芩、连翘、鸡苏散等清热利湿，湿遇芳香则化;以其手臂红点隐约，有入营发疹之势，故再加白薇、紫花地丁凉血解毒。甘露消毒丹，是叶天士用治温热夹湿、湿温、时疫在气分氤氲难解之方。据王孟英经验:"但看病人舌苔淡白，或厚腻或千黄者，是暑湿热疫之邪，尚在气分，悉以此丹治之立效。"
3.女。壮热一候，苔白腻满布，胸中窒闷异常，呻吟之声，不绝于耳。此温邪夹湿，交阻肠胃，非短时间所能取效，予达原饮加味。粉葛9克，柴胡4.克，黄芩9克，知母9克，枳实9克，槟榔9克，煨草果4.克，白芍9克，粉草1.克，佛手9克。
[按]胸中窒闷为湿温必有之证。盖湿热蒸腾，阻滞气机，胸中清阳之地，遂为云雾之乡。治当急急开泄，宣透募原，方用湿热并治的达原饮加减:草果燥脾去湿，芳香辟秽;槟榔、佛手、枳实疏利壅滞;知母、黄芩、白芍清热泻火;柴、葛透邪外达。
先生尝说:"余遇有湿温证，外有表邪，苔腻胸满，好以柴、葛并用。盖柴胡虽不能发汗，然而疏导少阳，使上焦得通，津液得下，其人澉然汗出;若表证末罢，里热已结，柴胡更属妙品。用其通便祛浊，稳当无比。"录之以供参考。
4.男。病湿温匝月，苔灰腻，脉濡数，扪其肌肤，不甚润泽而热。与人问答，有意识者半，不知所云者半，合目则谵语频作，不更衣10日许。邪气尚未肃清而正气虚，已是吃紧之极。软柴胡4.克，制川朴4，5克，生苍术4.克，黄芩9克，全瓜蒌12克，杭白芍9克，生枳实9克，连皮槟榔9克，山楂肉12克，莱菔英9克，六神丸30粒(分3次吞)。另:参须15克，浓煎代茶。原注:此人午后服药，至翌晨3时许，得垢腻之大便甚畅，热减神清。从此方加减，凡10日许而病瘥。
[按]邪盛正虚，用参以固正气;身热，大便旬日末解，用柴、芩、枳、朴、瓜蒌、槟榔清热导滞通腑;莱菔英既可清肠，又可行滞。六神丸习惯用治咽喉病，可是先生认为:"六神丸并可兴奋心肌与脑神经"。先生曾说:"热病心力衰竭用附桂则人畏惧，用六神丸既能强心，又不遭谤。"热病心衰或中毒性休克用之，多奏良效。
5.男。神气肃索，高热1周，第2天即耳聋，谵语，两手痉动。假使外邪，决无如此严重，假使温邪，初期而呈此象，预后不良，无待言矣。大豆卷12克，黑山栀9克，陈胆星6克，石菖蒲12克，黄芩9克，银柴胡4.克，带心川贝6克，广玉金4.克，连翘9克，白茅根1扎，青蒿子9克，紫雪丹0.克(吞)。
二诊:肠伤寒初起一二日耳聋神糊者甚少，苔厚腻而尖淡红，续予下方:石菖蒲9克，连翘9克，白薇9克，苫参片6克，赤苓9克，陈胆星4.克，黄芩9克，青蒿子9克，银花9克，紫雪丹0.克(吞)。三诊:得衄仍不解，便当预防各部出血，而以肠部为甚。其证候以仲景分类，为阳明证。便通，则是阳明经证。天花粉12克，银花12克，黄芩6克，石菖蒲9克，肥知母9克，连翘9克，山栀9克，广地龙9克，白茅根1扎，绿豆衣18克，青蒿子9克。[按]服昨药，神志大清，惟懊侬不已。
四诊:温邪夹湿，今第11日，神志从迷蒙中转清朗，腹部隐约有玫瑰疹，佳象也。舌见淡红，后半白腻，可以证明其病灶在肠。在此数日之内，处方总是阳明范围。天花粉12克，黄芩6克，紫花地丁g克，白薇9克，粉甘草3克，银柴胡6克，净连翘9克，苦丁茶9克，银花15克，茅芦根各30克。五诊:得黑色便，吾人不能遽下肠出血之断语。假使肠出血其人多脉伏、肢冷，呈虚脱状态。今泻下，病势反挫。川黄柏6克，银花炭12克，飞滑石9克(包)，带心川贝6克，苦参片9克，嫩白薇9克，连翘9克，石菖蒲9克，淡竹叶30片，粉甘草3克，炒荠菜花12克。
六诊:病历二候，舌质淡，根黄腻，湿与温已成相持之局，清温渗湿并进。川雅连1.克，苦参片6克，赤苓9克，萆藓9克，连翘9克，黄柏6克，黄芩6克，通草3克，泽泻9克，石菖蒲9克，生熟苡仁各12克，甘露消毒丹30克(分2次泡茶)。
七诊:湿温证之白痦，半因于多汗，皮肤不清洁;半因于毒素由肌腠外泄。医者要在任其自汗，强之使出不可也。故时医从疏散法透痦，等于揠苗助长。清水豆卷12克，连翘9克，苦参片4.克，泽泻9克，炒米仁12克，牛蒡子9克，白薇12克，川黄柏4.克，葛根24克，车前子9克(包)。[按]此诊时病人发热早轻暮重，但最高不超出38.C。
八诊:湿温证第16日，神志清晰，在极期中见之，最是佳象。大便溏，日约三四行，则为此时所最忌。古人苦以坚之，此类药多能收敛肠粘膜。川黄柏4.克，川雅连1.克，荠菜花9克，白槿花12克，苦参片9克，银花炭12克，通草3克，生地榆12克，赤苓9克，嫩白薇9克，荷叶1角。九诊:病虽已呈尾声，热退净，而便溏犹未尽除。前方加艾叶6克，藕节5只，杭白芍9克，乌梅6克，去赤苓，通草，荠菜花。
[按]此案高热1周即见耳聋、谵语、两手痉动等病情严重之象，是伤寒之重者。初予清热开窍之方，加紫"雪丹镇痉熄风，药证相投，应手而效，神转清朗。因其病灶在肠。继则直清阳明，苦寒坚肠抑菌，避免了肠出血的并发症，大大缩短了疗程。七诊时，葛根用至24克之多，一则取其长于解热，二则取其能松肌，有促迸毒素排泄之功效。
6.女。吞厚朴末，闷已瘥减。湿温证之闷大别有二:热度高时，心脏不强之闷，其脉多虚弱;热不高亦闷者，营养缺乏居多，仲景称为虚痞。此二者，党参皆能治。厚朴、郁金之治闷，纯是健胃作用，因其芳香挥发，多少有催动血行之故，对于心脏不强，稍有助益;用于虚痞则无效。病者汗多，面色不华，虚象居多，芳香类药不宜常服。世人只解芳香化浊(栀子厚朴汤)，不解甘温健脾并用之法(如泻心汤)，仲景之说，衰佚久矣。川连1.克，姜半夏9克，干姜4.克，党参9克，黄芩6克，粉草3克，生姜1小块，厚朴末2.克(分2次吞)。
[按]痞者，满而不实之谓。本案虽有邪热壅聚。然汗多，面色不华，心脾两虚之象显露，故为虚痞无疑，予仲景泻心汤，确系对症方药。
7.男。热9日不退，舌边尖红绛，呈三角形，此唯湿温证之阴伤者有之。夫阴液为抵御温邪之根本，初起阴液即耗，将来之变化殊难逆料。清水豆卷9克，鲜生地18克，北沙参9克，知母12克，花粉18克，连翘12克，黄芩9克，卷心竹叶30片，碧玉散12克(包)，粉葛根30克(煎汤代水)。
[按]此例病甫九日，即见阴伤，欲滋阴则碍于湿热，便湿得阴柔。在此三难之中，乃甘寒、苦寒、淡渗并用。粉葛甘平微辛，本经谓"主消渴"，自张凤逵、叶天士倡"葛根耗胃汁"之说.津伤者毋敢用之。今取其"内升胃津以滋肺，外散肌表之热"，且用量较大。可见先生毫不因循守旧。
8吴男。热己旬余不退，其热早暮起伏，夜来谵语手痉，多半是肠伤寒。泄泻、腹中雷鸣，予葛根芩连汤加味。粉葛根9克，黄芩9克，川连1.克，银花炭9克，连翘9克，苦参6克，赤苓12克，六一散12克(包)。二诊:泻减，昨夜依旧谵语手痉，苔不厚腻，此温重于湿者。清水豆卷12克，黄芩9克，银花9克，连翘12克，青蒿子9克，白薇12克，地龙9克，赤苓9克，天花粉9克，神犀丹1粒(化服)。
三诊:据实验室检查报告，可确诊为肠伤寒。耳聋，谵语，手痉，舌红，加养阴药。银花9克，连翘12克，白薇12克，玄参9克，细生地15克，石斛9克，川连1.5克，知母9克，赤苓12克，神犀丹1粒(化服)。
四诊:谵语、手痉大定，数日之内，别无变化，便有出险之望。银花12克，连翘12克，黄芩9克，生石膏30克(打)，青蒿子9克，白茅根1扎，赤苓9克，石菖蒲9克，神犀丹1粒(化服)。
[按]湿热蕴结，身热泄泻，腹中雷鸣，故有取于葛根芩连。热重于湿，内扰心营，夜则谵语，故于二诊开始，侧重清热。神犀丹由犀角、银花、黄芩、生地、连翘、板蓝根、豆豉、玄参、花粉、紫草、甘中黄、鲜石菖蒲汁组成，有清热、凉血、解毒及宣透作用。
9.女。热13日，舌边尖红，苔中白腻，此湿温证。病者神志有迷蒙状，胸前后呈现不明显之红点，此毒邪欲由毛窍外泄，当因其势而利导之。银花9克，连翘9克，黄芩9克，升麻3克，竹叶30片，黑山栀9克，紫花地Tg克，赤芍9克，丹皮9克，紫草9克。
二诊:精神症状特别显著，血中热毒炽盛也。银花9克，连翘12克，紫草6克，紫花地T12克，丹皮9克，赤芍9克，焦山栀9克，赤苓9克，碧玉散12克(包)。[按]湿温虽由热与湿搏结而成，而湿与热往往有侧重，此即热重于湿者。病延13日，大部分湿邪已从燥化;舌边尖红，神昏，斑疹隐隐，有人营之趋势。故用药重于清热、凉血、解毒。
10.男。病伤寒12日，其热在弛张不定中。热之退，不足喜;热之高，不足虑。所虑在神志迷蒙，脉来糊数。扶正实为当务之急，医者当权衡其轻重缓急，不可墨守成规。生黄芪9克，潞党参9克，小生地18克，麦冬9克，连翘12克，石斛9克，陈胆星2.克，粉草3克，鲜石菖蒲9克。
二诊:病13日，已入严重阶段，人夜神识昏糊，谵语不休，热型升降无定。升者邪盛正虚之势，降者正复邪减之候。在此惊涛骇浪之中，只有扶持正气，最关紧要。大生地24克，带心麦冬9克，带心连翘15克，玄参9克，北沙参9克，知母9克，鲜石斛9克，碧玉散12克(包)，黄芪9克，广郁金3克，鲜石菖蒲9克，生米仁30克。
三诊:伤寒两候，正在严重时期。虽夜间神昏、谵语，幸无重大变化。能再坚持一候，则化险为夷，或有希望。今其热不退，津液、体力俱已亏耗，故扶正养阴，两属重要。大生地24克，连心麦冬12克，带心连翘12克，北沙参9克，鲜石斛9克，知母12克，鲜石菖蒲9克，青蒿9克，生米仁30克。
四诊:伤寒半月，病在迸行中。所幸体力、津液，由于将护得当，加之药物补益，形势尚见良好。可见扶正实为治伤寒之要法。生黄芪24克，党参9克，大生地15克，知母12克，连翘12克，石斛9克，生米仁18克，远志肉4.克，五味子4.克，鲜石菖蒲9克。
五诊:病已16日，迭迸培元扶正之剂，病势渐向光明之途迈进。多言与不静皆能引起气急，培元扶正，乃不移之法。嘱多静卧。党参24克，麦冬12克，五味子4.克，炮附片4.克(先煎)，大生地24克，山萸肉9克，象贝9克，生米仁30克，浮小麦9克。六诊:伤寒在此期间，最为吃紧关头，扶正之外，滋养饮料尤不可少。若数日内能安然度过，则大海航舟，岸影近矣。高丽参须4.克，炮附块4.克(先煎)，党参12克，炙别甲30克(先煎)，麦冬9克，细生地18克，象贝12克，生米仁24克。
七诊:伤寒19日，其热仍在高峰，病者自觉胸次烦热，口渴引饮，此壮热内炽，在扶正药中，当复人清润之属。高丽参须6克，鲜石斛9克，炙别甲24克，炮附片4.克(先煎)，鲜生地30克，大贝母9克，连翘9克，广郁金2.克，鲜石菖蒲9克，生米仁18克，鲜荷梗30厘米。入诊:病势稳定，危险期大致度过，舌边尖红，数日内不可大意。高丽参须6克，鲜生地30克，石斛9克，连翘12克，炮附块6克，麦冬9克，黑大豆15克，大贝母9克，鲜荷梗30厘米。:九诊:病势渐趋坦途，津液将复，舌润，新苔已布，可以无虑。银柴胡4.克，青蒿9克，细生地24克，炙别甲30克(先煎)，浙贝9克，生米仁30克，黑大豆15克，鲜荷叶1角，谷麦芽各9克，高丽参须6克。
[按]此虚人而病湿温者，湿热日久，化燥化火，而气阴不足.脉来糊数，神识昏蒙，故治疗颇难。毅然主以扶正养阴，俾正气得复，始可与病邪抗争。尤其是五诊以后，屡用附子振奋阳气，与大队养阴药同用，取阳生阴长之意，而无灼阴伤津之弊。
[按语] 此证属于暑湿内伏，化火动血。前两诊使用白头翁汤加清暑利湿的药物；第三诊虽然见到虚象，但因为是暑湿之邪，不可急于进补。希望邪气去除后正气得以安宁。谁知一波未平一波又起，接着出现咯血，这是热邪迫肺，也属于暑瘵一类。所幸经过几次清暑利湿的治疗，热减湿去，所以第四诊清大肠、滋肺阴双管齐下，第五诊更放手养阴，开始步入坦途。
2. 男。发热一周，热势弛张不定，语言低沉。这与外感风寒者不同，是温邪所致。口渴喜欢喝热水，说明内有伏湿；手臂红点隐约可见，有入营分的迹象。病情缠绵是意料之中的事。鸡苏散9克（包煎），带叶佩兰9克，连翘12克，黄芩9克，青蒿9克，白薇12克，紫花地丁15克，甘露消毒丹9克（分3次吞服）。
[按语] 温邪夹湿，多缠绵难解。方用青蒿、黄芩、连翘、鸡苏散等清热利湿，湿遇芳香则化；因其手臂红点隐约，有入营发疹之势，故再加白薇、紫花地丁凉血解毒。甘露消毒丹，是叶天士用来治疗温热夹湿、湿温、时疫在气分氤氲难解的方剂。据王孟英的经验：“只要看病人舌苔淡白，或厚腻或干黄的，是暑湿热疫之邪，尚在气分，都用这个方子治疗立效。”
3. 女。高热一周，舌苔白腻满布，胸中窒闷异常，呻吟之声，不绝于耳。这是温邪夹湿，交阻肠胃，不是短时间能取效的，予达原饮加味。粉葛9克，柴胡4克，黄芩9克，知母9克，枳实9克，槟榔9克，煨草果4克，白芍9克，粉草1克，佛手9克。
[按语] 胸中窒闷是湿温病必有的症状。因为湿热蒸腾，阻滞气机，胸中清阳之地，遂为云雾之乡。治疗应当急急开泄，宣透募原，方用湿热并治的达原饮加减：草果燥脾去湿，芳香辟秽；槟榔、佛手、枳实疏利壅滞；知母、黄芩、白芍清热泻火；柴胡、葛根透邪外达。
先生曾说：“我遇到湿温证，外有表邪，苔腻胸满，喜欢柴胡、葛根并用。因为柴胡虽然不能发汗，然而疏导少阳，使上焦得通，津液得下，其人澉然汗出；如果表证未罢，里热已结，柴胡更是妙品。用它通便祛浊，稳当无比。”记录下来供参考。
4. 男。患湿温病一个月，舌苔灰腻，脉濡数，摸其肌肤，不甚润泽而发热。与人问答，意识清醒的有一半，不知所云的有一半，闭目则谵语频作，不大便约10天。邪气尚未肃清而正气虚，已是极其危急的情况。软柴胡4克，制川朴4.5克，生苍术4克，黄芩9克，全瓜蒌12克，杭白芍9克，生枳实9克，连皮槟榔9克，山楂肉12克，莱菔子9克，六神丸30粒（分3次吞服）。另：参须15克，浓煎代茶。原注：此人午后服药，至翌晨3时许，得垢腻之大便甚畅，热减神清。从此方加减，凡10日许而病瘥。
[按语] 邪盛正虚，用人参以固护正气；身热，大便旬日未解，用柴胡、黄芩、枳实、厚朴、瓜蒌、槟榔清热导滞通腑；莱菔子既可清肠，又可行滞。六神丸习惯用治咽喉病，可是先生认为：“六神丸并可兴奋心肌与脑神经”。先生曾说：“热病心力衰竭用附子、肉桂则人畏惧，用六神丸既能强心，又不遭谤。”热病心衰或中毒性休克用之，多奏良效。
5. 男。神气肃索，高热1周，第2天即耳聋，谵语，两手痉动。假使是外邪，决无如此严重，假使是温邪，初期而呈此象，预后不良，无待言矣。大豆卷12克，黑山栀9克，陈胆星6克，石菖蒲12克，黄芩9克，银柴胡4克，带心川贝6克，广玉金4克，连翘9克，白茅根1扎，青蒿子9克，紫雪丹0.5克（吞服）。
二诊：肠伤寒初起一二日耳聋神糊者甚少，苔厚腻而尖淡红，续予下方：石菖蒲9克，连翘9克，白薇9克，苦参片6克，赤苓9克，陈胆星4克，黄芩9克，青蒿子9克，银花9克，紫雪丹0.5克（吞服）。三诊：得衄仍不解，便当预防各部出血，而以肠部为甚。其证候以仲景分类，为阳明证。便通，则是阳明经证。天花粉12克，银花12克，黄芩6克，石菖蒲9克，肥知母9克，连翘9克，山栀9克，广地龙9克，白茅根1扎，绿豆衣18克，青蒿子9克。[按语] 服昨药，神志大清，惟懊侬不已。
四诊：温邪夹湿，今第11日，神志从迷蒙中转清朗，腹部隐约有玫瑰疹，佳象也。舌见淡红，后半白腻，可以证明其病灶在肠。在此数日之内，处方总是阳明范围。天花粉12克，黄芩6克，紫花地丁15克，白薇9克，粉甘草3克，银柴胡6克，净连翘9克，苦丁茶9克，银花15克，茅芦根各30克。五诊：得黑色便，吾人不能遽下肠出血之断语。假使肠出血其人多脉伏、肢冷，呈虚脱状态。今泻下，病势反挫。川黄柏6克，银花炭12克，飞滑石9克（包煎），带心川贝6克，苦参片9克，嫩白薇9克，连翘9克，石菖蒲9克，淡竹叶30片，粉甘草3克，炒荠菜花12克。
六诊：病历二候，舌质淡，根黄腻，湿与温已成相持之局，清温渗湿并进。川雅连1克，苦参片6克，赤苓9克，萆薢9克，连翘9克，黄柏6克，黄芩6克，通草3克，泽泻9克，石菖蒲9克，生熟苡仁各12克，甘露消毒丹30克（分2次泡茶）。
七诊：湿温证之白痦，半因于多汗，皮肤不清洁；半因于毒素由肌腠外泄。医者要在任其自汗，强之使出不可也。故时医从疏散法透痦，等于揠苗助长。清水豆卷12克，连翘9克，苦参片4克，泽泻9克，炒米仁12克，牛蒡子9克，白薇12克，川黄柏4克，葛根24克，车前子9克（包煎）。[按语] 此诊时病人发热早轻暮重，但最高不超出38.0℃。
八诊：湿温证第16日，神志清晰，在极期中见之，最是佳象。大便溏，日约三四行，则为此时所最忌。古人苦以坚之，此类药多能收敛肠粘膜。川黄柏4克，川雅连1克，荠菜花9克，白槿花12克，苦参片9克，银花炭12克，通草3克，生地榆12克，赤苓9克，嫩白薇9克，荷叶1角。九诊：病虽已呈尾声，热退净，而便溏犹未尽除。前方加艾叶6克，藕节5只，杭白芍9克，乌梅6克，去赤苓，通草，荠菜花。
[按语] 此案高热1周即见耳聋、谵语、两手痉动等病情严重之象，是伤寒之重者。初予清热开窍之方，加紫雪丹镇痉熄风，药证相投，应手而效，神转清朗。因其病灶在肠。继则直清阳明，苦寒坚肠抑菌，避免了肠出血的并发症，大大缩短了疗程。七诊时，葛根用至24克之多，一则取其长于解热，二则取其能松肌，有促进毒素排泄之功效。
6. 女。吞厚朴末，闷已瘥减。湿温证之闷大别有二：热度高时，心脏不强之闷，其脉多虚弱；热不高亦闷者，营养缺乏居多，仲景称为虚痞。此二者，党参皆能治。厚朴、郁金之治闷，纯是健胃作用，因其芳香挥发，多少有催动血行之故，对于心脏不强，稍有助益；用于虚痞则无效。病者汗多，面色不华，虚象居多，芳香类药不宜常服。世人只解芳香化浊（栀子厚朴汤），不解甘温健脾并用之法（如泻心汤），仲景之说，衰佚久矣。川连1克，姜半夏9克，干姜4克，党参9克，黄芩6克，粉草3克，生姜1小块，厚朴末2克（分2次吞服）。
[按语] 痞者，满而不实之谓。本案虽有邪热壅聚。然汗多，面色不华，心脾两虚之象显露，故为虚痞无疑，予仲景泻心汤，确系对症方药。
7. 男。热9日不退，舌边尖红绛，呈三角形，此唯湿温证之阴伤者有之。夫阴液为抵御温邪之根本，初起阴液即耗，将来之变化殊难逆料。清水豆卷9克，鲜生地18克，北沙参9克，知母12克，花粉18克，连翘12克，黄芩9克，卷心竹叶30片，碧玉散12克（包煎），粉葛根30克（煎汤代水）。
[按语] 此例病甫九日，即见阴伤，欲滋阴则碍于湿热，便湿得阴柔。在此三难之中，乃甘寒、苦寒、淡渗并用。粉葛甘平微辛，本经谓“主消渴”，自张凤逵、叶天士倡“葛根耗胃汁”之说，津伤者毋敢用之。今取其“内升胃津以滋肺，外散肌表之热”，且用量较大。可见先生毫不因循守旧。
8. 吴男。热已旬余不退，其热早暮起伏，夜来谵语手痉，多半是肠伤寒。泄泻、腹中雷鸣，予葛根芩连汤加味。粉葛根9克，黄芩9克，川连1克，银花炭9克，连翘9克，苦参6克，赤苓12克，六一散12克（包煎）。二诊：泻减，昨夜依旧谵语手痉，苔不厚腻，此温重于湿者。清水豆卷12克，黄芩9克，银花9克，连翘12克，青蒿子9克，白薇12克，地龙9克，赤苓9克，天花粉9克，神犀丹1粒（化服）。
三诊：据实验室检查报告，可确诊为肠伤寒。耳聋，谵语，手痉，舌红，加养阴药。银花9克，连翘12克，白薇12克，玄参9克，细生地15克，石斛9克，川连1.5克，知母9克，赤苓12克，神犀丹1粒（化服）。
四诊：谵语、手痉大定，数日之内，别无变化，便有出险之望。银花12克，连翘12克，黄芩9克，生石膏30克（打碎），青蒿子9克，白茅根1扎，赤苓9克，石菖蒲9克，神犀丹1粒（化服）。
[按语] 湿热蕴结，身热泄泻，腹中雷鸣，故有取于葛根芩连。热重于湿，内扰心营，夜则谵语，故于二诊开始，侧重清热。神犀丹由犀角、银花、黄芩、生地、连翘、板蓝根、豆豉、玄参、花粉、紫草、甘中黄、鲜石菖蒲汁组成，有清热、凉血、解毒及宣透作用。
9. 女。热13日，舌边尖红，苔中白腻，此湿温证。病者神志有迷蒙状，胸前后呈现不明显之红点，此毒邪欲由毛窍外泄，当因其势而利导之。银花9克，连翘9克，黄芩9克，升麻3克，竹叶30片，黑山栀9克，紫花地丁15克，赤芍9克，丹皮9克，紫草9克。
二诊：精神症状特别显著，血中热毒炽盛也。银花9克，连翘12克，紫草6克，紫花地丁12克，丹皮9克，赤芍9克，焦山栀9克，赤苓9克，碧玉散12克（包煎）。[按语] 湿温虽由热与湿搏结而成，而湿与热往往有侧重，此即热重于湿者。病延13日，大部分湿邪已从燥化；舌边尖红，神昏，斑疹隐隐，有人营之趋势。故用药重于清热、凉血、解毒。
10. 男。病伤寒12日，其热在弛张不定中。热之退，不足喜；热之高，不足虑。所虑在神志迷蒙，脉来糊数。扶正实为当务之急，医者当权衡其轻重缓急，不可墨守成规。生黄芪9克，潞党参9克，小生地18克，麦冬9克，连翘12克，石斛9克，陈胆星2克，粉草3克，鲜石菖蒲9克。
二诊：病13日，已入严重阶段，人夜神识昏糊，谵语不休，热型升降无定。升者邪盛正虚之势，降者正复邪减之候。在此惊涛骇浪之中，只有扶持正气，最关紧要。大生地24克，带心麦冬9克，带心连翘15克，玄参9克，北沙参9克，知母9克，鲜石斛9克，碧玉散12克（包煎），黄芪9克，广郁金3克，鲜石菖蒲9克，生米仁30克。
三诊：伤寒两候，正在严重时期。虽夜间神昏、谵语，幸无重大变化。能再坚持一候，则化险为夷，或有希望。今其热不退，津液、体力俱已亏耗，故扶正养阴，两属重要。大生地24克，连心麦冬12克，带心连翘12克，北沙参9克，鲜石斛9克，知母12克，鲜石菖蒲9克，青蒿9克，生米仁30克。
四诊：伤寒半月，病在进行中。所幸体力、津液，由于将护得当，加之药物补益，形势尚见良好。可见扶正实为治伤寒之要法。生黄芪24克，党参9克，大生地15克，知母12克，连翘12克，石斛9克，生米仁18克，远志肉4克，五味子4克，鲜石菖蒲9克。
五诊：病已16日，迭进培元扶正之剂，病势渐向光明之途迈进。多言与不静皆能引起气急，培元扶正，乃不移之法。嘱多静卧。党参24克，麦冬12克，五味子4克，炮附片4克（先煎），大生地24克，山萸肉9克，象贝9克，生米仁30克，浮小麦9克。六诊：伤寒在此期间，最为吃紧关头，扶正之外，滋养饮料尤不可少。若数日内能安然度过，则大海航舟，岸影近矣。高丽参须4克，炮附块4克（先煎），党参12克，炙别甲30克（先煎），麦冬9克，细生地18克，象贝12克，生米仁24克。
七诊：伤寒19日，其热仍在高峰，病者自觉胸次烦热，口渴引饮，此壮热内炽，在扶正药中，当复人清润之属。高丽参须6克，鲜石斛9克，炙别甲24克，炮附片4克（先煎），鲜生地30克，大贝母9克，连翘9克，广郁金2克，鲜石菖蒲9克，生米仁18克，鲜荷梗30厘米。入诊：病势稳定，危险期大致度过，舌边尖红，数日内不可大意。高丽参须6克，鲜生地30克，石斛9克，连翘12克，炮附块6克，麦冬9克，黑大豆15克，大贝母9克，鲜荷梗30厘米。:九诊：病势渐趋坦途，津液将复，舌润，新苔已布，可以无虑。银柴胡4克，青蒿9克，细生地24克，炙别甲30克（先煎），浙贝9克，生米仁30克，黑大豆15克，鲜荷叶1角，谷麦芽各9克，高丽参须6克。
[按语] 此虚人而病湿温者，湿热日久，化燥化火，而气阴不足，脉来糊数，神识昏蒙，故治疗颇难。毅然主以扶正养阴，俾正气得复，始可与病邪抗争。尤其是五诊以后，屡用附子振奋阳气，与大队养阴药同用，取阳生阴长之意，而无灼阴伤津之弊。
[Commentary] This syndrome belongs to summerheat-dampness lying latent internally, transforming into fire and disturbing blood. The first two consultations used Baitouweng Decoction (Bupleurum Root Decoction) with added herbs for clearing summerheat and promoting diuresis; although the third consultation showed signs of deficiency, since it is summerheat-dampness, tonification should not be rushed. The hope is that once the pathogen is eliminated, the healthy qi will be at peace. Who would have thought that before one wave subsided, another arose, followed by hemoptysis; this is heat pathogen forcing its way into the lung, also belonging to the category of summerheat consumption (Shu Zhai). Fortunately, after several treatments of clearing summerheat and promoting diuresis, the heat decreased and dampness was removed. Therefore, in the fourth consultation, clearing the large intestine and nourishing lung yin were pursued simultaneously; in the fifth consultation, more emphasis was placed on nourishing yin, and the patient began to enter a smooth recovery phase.
2. Male. Fever has lasted for one week (hou), with fluctuating fever patterns and low speech. This differs from exterior cold-wind invasion; it is caused by warm pathogen. Thirst with preference for hot drinks indicates latent dampness internally; faint red spots on the arms suggest entry into the Ying (Nutritive) level. A lingering course of illness is expected. Jisu San (Chicken Su Powder) 9g (wrapped), Peilan with leaves 9g, Lianqiao (Forsythia Fruit) 12g, Huangqin (Scutellaria Root) 9g, Qinghao (Artemisia Annua Herb) 9g, Baiwei (Cynanchum Atratum Root) 12g, Zihuadi Ding (Viola Yedoensis Herb) 15g, Ganlu Xiaodu Dan (Sweet Dew Detoxifying Pill) 9g (swallowed in 3 doses).
[Commentary] Warm pathogen combined with dampness tends to be lingering and difficult to resolve. The formula uses Qinghao, Huangqin, Lianqiao, Jisu San, etc., to clear heat and promote dampness resolution; dampness transforms when encountering aromatic herbs. Because of the faint red spots on the arms indicating a trend towards entering the Ying level and erupting rashes, Baiwei and Zihuadi Ding are added to cool blood and detoxify. Ganlu Xiaodu Dan is a formula used by Ye Tianshi to treat warm-heat combined with dampness, damp-warmth, and epidemic diseases where pathogens are muddled and difficult to resolve in the Qi level. According to Wang Mengying's experience: "Just look at the patient's tongue coating; if it is pale white, or thick and greasy, or dry and yellow, it indicates that summerheat, damp-heat, or epidemic pathogens are still in the Qi level. All can be treated effectively with this pill."
3. Female. High fever for one week, tongue coating white and greasy covering the entire surface, extreme chest oppression, groaning sounds non-stop. This is warm pathogen combined with dampness, obstructing the stomach and intestines; it cannot be resolved in a short time. Daduan Yin (Reach the Original Decoction) with modifications is prescribed. Fenge (Kudzu Root) 9g, Chaihu (Bupleurum Root) 4g, Huangqin (Scutellaria Root) 9g, Zhimu (Anemarrhena Rhizome) 9g, Zhishi (Immature Bitter Orange) 9g, Binglang (Areca Seed) 9g, Weicaoguo (Calculus Arecae prepared) 4g, Baishao (White Peony Root) 9g, Fengan (Licorice Root) 1g, Foshou (Citrus Sarcodactylis Fruit) 9g.
[Commentary] Chest oppression is a necessary symptom of damp-warmth. Because damp-heat steams and boils, obstructing Qi mechanism, the clear Yang area of the chest becomes like a land of clouds and mist. Treatment should urgently open and drain, venting the Mu Yuan (Original Source). The formula uses Daduan Yin which treats both dampness and heat: Caoguo dries the spleen and removes dampness, aromatic to dispel filth; Binglang, Foshou, Zhishi regulate stagnation; Zhimu, Huangqin, Baishao clear heat and purge fire; Chaihu and Gegen guide pathogens outward.
Mr. Zhang once said: "When I encounter damp-warmth cases with exterior pathogens, greasy tongue coating, and chest fullness, I prefer using Chaihu and Gegen together. Although Chaihu cannot induce sweating, it regulates Shaoyang, allowing the Upper Jiao to unblock and fluids to descend, resulting in profuse sweating; if exterior symptoms persist but interior heat has consolidated, Chaihu is even more excellent. Using it to unblock bowels and expel turbidity is extremely steady." Recorded for reference.
4. Male. Damp-warmth disease for one month, gray greasy tongue coating, soggy rapid pulse, skin feels not moist but hot. In conversation, consciousness is half clear, half confused; eyes closed leads to frequent delirium. No bowel movement for about 10 days. Pathogens not yet cleared while healthy qi is deficient; this is extremely critical. Ruan Chaihu (Soft Bupleurum Root) 4g, Zhi Chuanpu (Prepared Magnolia Bark) 4.5g, Sheng Cangzhu (Atractylodes Rhizome raw) 4g, Huangqin (Scutellaria Root) 9g, Quangualou (Whole Trichosanthes Fruit) 12g, Hang Baishao (White Peony Root) 9g, Sheng Zhishi (Immature Bitter Orange raw) 9g, Lianpi Binglang (Areca Seed with peel) 9g, Shanzha Rou (Hawthorn Flesh) 12g, Laifuzi (Radish Seed) 9g, Liushen Wan (Six Gods Pill) 30 pills (swallowed in 3 doses). Additionally: Renshen Xu (Ginseng Tendril) 15g, decocted strongly as tea. Original note: After taking medicine in the afternoon, by 3 AM the next day, foul greasy stool passed smoothly, heat reduced, spirit cleared. Adjusting this formula over about 10 days led to recovery.
[Commentary] Excess pathogens and deficient healthy qi require Ginseng to consolidate healthy qi; body heat and ten-day constipation require Chaihu, Huangqin, Zhishi, Chuanpu, Gualou, Binglang to clear heat, guide stagnation, and unblock bowels; Laifuzi clears intestines and moves stagnation. Liushen Wan is habitually used for throat diseases, but Mr. Zhang believed: "Liushen Wan can also excite myocardium and brain nerves." Mr. Zhang once said: "For heart failure in febrile diseases, people fear using Fuzi (Aconite) and Rougui (Cinnamon Bark); using Liushen Wan strengthens the heart without causing criticism." It often yields good results for febrile disease heart failure or toxic shock.
5. Male. Spirit appears solemn, high fever for 1 week, deafness on the second day, delirium, spasms of both hands. If it were exterior pathogens, severity would not be so great; if warm pathogen, presenting thus early implies poor prognosis, which goes without saying. Dayoujuan (Soybean Sprout) 12g, Heishanzhi (Black Gardenia Fruit) 9g, Chendanxing (Arisaema with Pinellia prepared) 6g, Shichangpu (Acorus Rhizome) 12g, Huangqin (Scutellaria Root) 9g, Yin Chaihu (Stellaria Root) 4g, Daixin Chuanbei (Fritillaria Bulb with heart) 6g, Guang Yujin (Curcuma Longa Rhizome) 4g, Lianqiao (Forsythia Fruit) 9g, Baimaogen (Imperata Rhizome bundle) 1 bunch, Qinghaozi (Artemisia Annua Seed) 9g, Zixue Dan (Purple Snow Pill) 0.5g (swallowed).
Second consultation: Few cases of deafness and confusion in the first 1-2 days of Enteric Typhoid; thick greasy coating with pale red tip. Continue with the following formula: Shichangpu 9g, Lianqiao 9g, Baiwei 9g, Kushen Pian (Sophora Root slices) 6g, Chiling (Red Poria) 9g, Chendanxing 4g, Huangqin 9g, Qinghaozi 9g, Yinhua (Honeysuckle Flower) 9g, Zixue Dan 0.5g (swallowed). Third consultation: Epistaxis occurred but fever persists; must prevent bleeding in various parts, especially intestines. Classified by Zhang Zhongjing, this is Yangming syndrome. Bowel movement通畅 indicates Yangming Channel syndrome. Tianhuafen (Trichosanthes Root) 12g, Yinhua 12g, Huangqin 6g, Shichangpu 9g, Fei Zhimu (Anemarrhena Rhizome) 9g, Lianqiao 9g, Shanzhi (Gardenia Fruit) 9g, Guang Dilong (Pheretima Earthworm) 9g, Baimaogen 1 bunch, Lvdouyi (Mung Bean Coat) 18g, Qinghaozi 9g. [Commentary] After taking yesterday's medicine, spirit became very clear, only feeling stifled.
Fourth consultation: Warm pathogen combined with dampness, now day 11. Spirit cleared from confusion. Faint rose rash on abdomen, a good sign. Tongue pale red, posterior half white greasy, proving lesion in intestines. Prescriptions within these days always fall within Yangming scope. Tianhuafen 12g, Huangqin 6g, Zihuadi Ding 15g, Baiwei 9g, Fen Gancao (Powdered Licorice) 3g, Yin Chaihu 6g, Jing Lianqiao (Clean Forsythia) 9g, Kudingcha (Ilex Kudingcha Leaf) 9g, Yinhua 15g, Maolugen (Imperata Rhizome) and Lugendong (Phragmites Rhizome) each 30g. Fifth consultation: Black stool obtained; we cannot hastily diagnose intestinal hemorrhage. If intestinal bleeding, pulse would be hidden, limbs cold, showing collapse state. Now diarrhea occurs, but disease momentum is checked. Chuan Huangbai (Phellodendron Bark) 6g, Yinhua Tan (Charred Honeysuckle) 12g, Fei Huashi (Calcined Talc) 9g (wrapped), Daixin Chuanbei 6g, Kushen Pian 9g, Nen Baiwei (Tender Cynanchum) 9g, Lianqiao 9g, Shichangpu 9g, Danzhuye (Bamboo Leaf) 30 pieces, Fen Gancao 3g, Chao Qicaihua (Stir-fried Shepherd's Purse Flower) 12g.
Sixth consultation: Disease duration two weeks. Tongue body pale, root yellow greasy. Dampness and warmth have reached a stalemate; clearing warmth and promoting dampness proceed together. Chuan Yalian (Acrid Coptis) 1g, Kushen Pian 6g, Chiling 9g, Bibi (Dioscorea Hypoglauca Rhizome) 9g, Lianqiao 9g, Huangbai 6g, Huangqin 6g, Tongcao (Tetrapanax Pith) 3g, Zexie (Alisma Rhizome) 9g, Shichangpu 9g, Sheng Shu Yiren (Raw and Prepared Coix Seed) each 12g, Ganlu Xiaodu Dan 30g (brewed as tea in 2 doses).
Seventh consultation: White millet-like papules (Bai Ping) in damp-warmth are partly due to excessive sweating and unclean skin; partly due to toxins excreting through muscle pores. Physicians should allow natural sweating; forcing it out is inadvisable. Thus, contemporary physicians using dispersing methods to vent papules is like pulling shoots to help them grow. Qingshui Doujuan 12g, Lianqiao 9g, Kushen Pian 4g, Zexie 9g, Chao Miren (Stir-fried Coix Seed) 12g, Niubangzi (Arctium Fruit) 9g, Baiwei 12g, Chuan Huangbai 4g, Gegen (Kudzu Root) 24g, Cheqianzi (Plantago Seed) 9g (wrapped). [Commentary] During this consultation, patient had fever lighter in morning, heavier in evening, max not exceeding 38.0°C.
Eighth consultation: Damp-warmth day 16. Spirit clear, seen during peak period, most auspicious. Loose stools, 3-4 times daily, is most taboo at this time. Ancients used bitter drugs to firm bowels; such drugs often contract intestinal mucosa. Chuan Huangbai 4g, Chuan Yalian 1g, Qicaihua 9g, Bai Jin Hua (Hibiscus Mutabilis Flower) 12g, Kushen Pian 9g, Yinhua Tan 12g, Tongcao 3g, Sheng Diyu (Sanguisorba Root) 12g, Chiling 9g, Nen Baiwei 9g, Heye (Lotus Leaf) 1 corner. Ninth consultation: Disease nearing end, heat gone, but loose stools not fully resolved. Add Aiye (Mugwort Leaf) 6g, Ou Jie (Lotus Node) 5 pieces, Hang Baishao 9g, Wumei (Chinese Plum) 6g to previous formula; remove Chiling, Tongcao, Qicaihua.
[Commentary] This case showed severe symptoms like deafness, delirium, and hand spasms after 1 week of high fever, indicating severe typhoid. Initially prescribed clearing heat and opening orifices, adding Zixue Dan to calm spasms and extinguish wind; medicine matched syndrome, effective immediately, spirit cleared. Since lesion was in intestines, subsequently directly cleared Yangming, using bitter-cold to firm intestines and inhibit bacteria, avoiding intestinal hemorrhage complications, greatly shortening treatment course. In seventh consultation, Gegendosage reached 24g, primarily for its heat-clearing ability and muscle-relaxing effect, promoting toxin excretion.
6. Female. Swallowed Houpo (Magnolia Bark) powder, oppression relieved. Oppression in damp-warmth generally falls into two categories: when temperature is high, oppression due to weak heart function, pulse usually weak; when temperature is not high but oppression exists, mostly due to nutritional deficiency, called Deficiency Fullness (Xu Pi) by Zhang Zhongjing. Dangshen (Codonopsis Root) can treat both. Houpo and Yujin (Curcuma Aromatica Rhizome) treat oppression purely via stomach-strengthening action; due to aromatic volatility, they slightly promote blood circulation, offering slight benefit for weak heart; ineffective for deficiency fullness. Patient sweats much, complexion dull, mostly deficiency signs; aromatic drugs should not be taken long-term. People only understand aromatic transformation of turbidity (Zhizi Houpo Tang), not the method of combining sweet-warm spleen-tonifying drugs (like Xiexin Tang). Zhang Zhongjing's theories have long declined. Chuanlian (Coptis Rhizome) 1g, Jiang Banxia (Pinellia with Ginger prepared) 9g, Ganjiang (Dried Ginger) 4g, Dangshen 9g, Huangqin 6g, Fen Gancao 3g, Shengjiang (Fresh Ginger) 1 small piece, Houpo Mo (Magnolia Bark Powder) 2g (swallowed in 2 doses).
[Commentary] Pi refers to fullness without solidity. Although this case has pathogenic heat congestion, excessive sweating and dull complexion reveal Heart-Spleen dual deficiency, undoubtedly Deficiency Fullness. Prescribing Zhang Zhongjing's Xiexin Tang (Drain the Epigastrium Decoction) is indeed symptomatic.
7. Male. Fever not receding for 9 days, tongue edges and tip crimson red, triangular shape; only seen in Yin-deficient damp-warmth cases. Yin fluid is the foundation for resisting warm pathogens; depletion at onset makes future changes hard to predict. Qingshui Doujuan 9g, Xian Shengdi (Fresh Rehmannia Root) 18g, Beishashen (Glehnia Root) 9g, Zhimu 12g, Huafen (Trichosanthes Root) 18g, Lianqiao 12g, Huangqin 9g, Juanxin Zhuye (Heart-shaped Bamboo Leaf) 30 pieces, Biyu San (Jade Green Powder) 12g (wrapped), Fen Gegen (Kudzu Root) 30g (decocted water substitute).
[Commentary] This example shows Yin damage just nine days into illness. Nourishing Yin hinders damp-heat, making dampness sticky. Among these three difficulties, sweet-cold, bitter-cold, and bland-leaching methods are used together. Gegen is sweet, flat, slightly acrid; Ben Cao Jing states it "mainly treats thirst." Since Zhang Fengkui and Ye Tianshi advocated "Gegen consumes Stomach Juice," those with fluid injury dare not use it. Now utilizing its ability to "raise Stomach juice internally to nourish Lung, dissipate surface heat externally," with larger dosage. Shows Mr. Zhang does not stick to old conventions.
8. Wu Male. Fever unremitting for over ten days, fluctuating morning and evening, night delirium and hand spasms, likely Enteric Typhoid. Diarrhea, borborygmus. Ge Gen Qin Lian Tang (Kudzu, Scutellaria, and Coptis Decoction) with modifications. Fen Gegen 9g, Huangqin 9g, Chuanlian 1g, Yinhua Tan 9g, Lianqiao 9g, Kushen 6g, Chiling 12g, Liuyi San (Six-to-One Powder) 12g (wrapped). Second consultation: Diarrhea reduced, last night still delirium and spasms, coating not thick greasy, this is warmth heavier than dampness. Qingshui Doujuan 12g, Huangqin 9g, Yinhua 9g, Lianqiao 12g, Qinghaozi 9g, Baiwei 12g, Dilong (Earthworm) 9g, Chiling 9g, Tianhuafen 9g, Shenxi Dan (Divine Marker Pill) 1 pill (dissolved).
Third consultation: Lab report confirms Enteric Typhoid. Deafness, delirium, spasms, red tongue, add Yin-nourishing drugs. Yinhua 9g, Lianqiao 12g, Baiwei 12g, Xuanshen (Scrophularia Root) 9g, Xi Shengdi (Fine Fresh Rehmannia) 15g, Shihu (Dendrobium Stem) 9g, Chuanlian 1.5g, Zhimu 9g, Chiling 12g, Shenxi Dan 1 pill (dissolved).
Fourth consultation: Delirium and spasms largely settled, no other changes in days, hope for survival emerges. Yinhua 12g, Lianqiao 12g, Huangqin 9g, Sheng Shigao (Raw Gypsum) 30g (crushed), Qinghaozi 9g, Baimaogen 1 bunch, Chiling 9g, Shichangpu 9g, Shenxi Dan 1 pill (dissolved).
[Commentary] Damp-heat accumulation causes fever, diarrhea, borborygmus, hence Ge Gen Qin Lian is chosen. Heat heavier than dampness, disturbing Heart Ying internally, causing night delirium, so from second consultation focus shifts to clearing heat. Shenxi Dan consists of Rhinoceros Horn, Honeysuckle, Scutellaria, Rehmannia, Forsythia, Isatis Root, Fermented Soybean, Scrophularia, Trichosanthes Root, Arnebia, Urine Sediment, Fresh Acorus Juice; it clears heat, cools blood, detoxifies, and vents.
9. Female. Fever 13 days, tongue edges/tip red, center coating white greasy, damp-warmth syndrome. Patient spirit confused, faint red spots on chest/back, toxins attempting to exit via hair follicles; follow momentum to guide them out. Yinhua 9g, Lianqiao 9g, Huangqin 9g, Shengma (Cimicifuga Rhizome) 3g, Zhuye 30 pieces, Heishanzhi 9g, Zihuadi Ding 15g, Chishao (Red Peony Root) 9g, Danpi (Moutan Bark) 9g, Zicao (Arnebia Root) 9g.
Second consultation: Mental symptoms particularly significant, blood heat-toxin blazing. Yinhua 9g, Lianqiao 12g, Zicao 6g, Zihuadi Ding 12g, Danpi 9g, Chishao 9g, Jiao Shanzhi (Charred Gardenia) 9g, Chiling 9g, Biyu San 12g (wrapped). [Commentary] Damp-warmth forms from heat-damp binding, often with one side heavier; here heat heavier than dampness. Disease prolonged 13 days, most dampness transformed to dryness; tongue edges/tip red, coma, faint macules indicate trend into Ying level. Medication focuses heavily on clearing heat, cooling blood, detoxifying.
10. Male. Typhoid 12 days, fever fluctuating. Fever reduction not overly joyful; high fever not overly worrying. Concern lies in confused spirit, soggy rapid pulse. Supporting healthy qi is urgent priority; physicians must weigh severity and urgency, not stick rigidly to rules. Sheng Huangqi (Raw Astragalus Root) 9g, Lu Dangshen (Codonopsis) 9g, Xiao Shengdi (Small Fresh Rehmannia) 18g, Maidong (Ophiopogon Tuber) 9g, Lianqiao 12g, Shihu 9g, Chendanxing 2g, Fen Gancao 3g, Xian Shichangpu 9g.
Second consultation: Disease day 13, entered serious stage. Nighttime spirit confused, continuous delirium, fever pattern unstable. Rising indicates excess pathogens/deficient qi; falling indicates recovering qi/reducing pathogens. Amidst stormy seas, supporting healthy qi is most crucial. Da Shengdi (Large Fresh Rehmannia) 24g, Daixin Maidong (Ophiopogon with heart) 9g, Daixin Lianqiao (Forsythia with heart) 15g, Xuanshen 9g, Beishashen 9g, Zhimu 9g, Xian Shihu 9g, Biyu San 12g (wrapped), Huangqi 9g, Guang Yujin 3g, Xian Shichangpu 9g, Sheng Miren (Raw Coix Seed) 30g.
Third consultation: Typhoid two weeks, serious period. Though night coma/delirium, fortunately no major changes. Persist one more week, danger turns to safety, perhaps hope. Fever persists, fluids and strength depleted, so supporting qi and nourishing Yin both important. Da Shengdi 24g, Lianxin Maidong 12g, Daixin Lianqiao 12g, Beishashen 9g, Xian Shihu 9g, Zhimu 12g, Xian Shichangpu 9g, Qinghao 9g, Sheng Miren 30g.
Fourth consultation: Typhoid half month, progressing. Fortunately strength and fluids, due to proper care and drug tonification, situation remains good. Supporting qi is key method for treating typhoid. Sheng Huangqi 24g, Dangshen 9g, Da Shengdi 15g, Zhimu 12g, Lianqiao 12g, Shihu 9g, Sheng Miren 18g, Yuanzhi Rou (Polygala Flesh) 4g, Wuweizi (Schisandra Berry) 4g, Xian Shichangpu 9g.
Fifth consultation: Disease day 16, repeatedly administered Yuan-supporting formulas, disease momentum moving toward light. Talking too much and restlessness cause breathlessness; Yuan-supporting is unchanging method. Advise rest. Dangshen 24g, Maidong 12g, Wuweizi 4g, Pao Fupian (Prepared Aconite Slice) 4g (decoct first), Da Shengdi 24g, Shanyurou (Cornus Fruit) 9g, Xiangbei (Fritillaria Thunbergii) 9g, Sheng Miren 30g, Xiaomai (Floating Wheat) 9g. Sixth consultation: Typhoid at critical juncture, besides supporting qi, nourishing drinks essential. If passing safely in few days, shore is near. Gaolian Renshen Xu (Korean Ginseng Tendril) 4g, Pao Fu Kuai (Prepared Aconite Chunk) 4g (decoct first), Dangshen 12g, Zhi Biejia (Burnt Turtle Shell) 30g (decoct first), Maidong 9g, Xi Shengdi 18g, Xiangbei 12g, Sheng Miren 24g.
Seventh consultation: Typhoid day 19, fever still peak. Patient feels chest vexation-heat, thirsty desiring drink, vigorous heat burning internally. In supporting drugs, add clearing-moistening types. Gaolian Renshen Xu 6g, Xian Shihu 9g, Zhi Biejia 24g, Pao Fupian 4g (decoct first), Xian Shengdi 30g, Da Beimu (Fritillaria Cirrhosa) 9g, Lianqiao 9g, Guang Yujin 2g, Xian Shichangpu 9g, Sheng Miren 18g, Xin Hegeng (Fresh Lotus Stem) 30cm. Eighth consultation: Disease stable, danger period roughly passed, tongue edges/tip red, do not be careless in coming days. Gaolian Renshen Xu 6g, Xian Shengdi 30g, Shihu 9g, Lianqiao 12g, Pao Fu Kuai 6g, Maidong 9g, Heidadou (Black Soybean) 15g, Da Beimu 9g, Xin Hegeng 30cm. Ninth consultation: Disease trending smoothly, fluids recovering, tongue moist, new coating spread, no worries. Yin Chaihu 4g, Qinghao 9g, Xi Shengdi 24g, Zhi Biejia 30g (decoct first), Zhe Bei (Zhejiang Fritillaria) 9g, Sheng Miren 30g, Heidadou 15g, Xin Heye (Fresh Lotus Leaf) 1 corner, Guya Maiya (Barley and Malt) each 9g, Gaolian Renshen Xu 6g.
[Commentary] For deficient persons with damp-warmth, damp-heat prolonged transforms to dryness-fire, Qi-Yin insufficient, pulse soggy rapid, spirit confused, treatment difficult. Resolutely main treatment is supporting Qi and nourishing Yin, so healthy qi recovers, then can fight pathogens. Especially after fifth consultation, repeatedly using Fuzi (Aconite) to振奋 Yang Qi, combined with large group of Yin-nourishing drugs, taking meaning of Yang generating Yin, without damaging Yin fluids.