本 疫邪传胃，舌黄，脉洪数，汗渴。白虎汤，一服热退。明午复烦，恐散漫之邪虽去，已成里结也。
用苦辛寒方∶人中黄、元明粉、黄芩、知母、枳壳、槟榔。三服脉症俱平。用蜜煎导粪下而解。
冷 高年染疫，脉右大于左，由邪从口鼻吸受，客于夹脊，溢自募原，见症头痛，胸中怫郁，务彻其邪，
使速离募原。仿达原饮，用黄芩、知母、花粉、浓朴、枳壳、赤芍、豆豉，汗出热退，间日前症仍作，恶热，
更加谵妄。诊时扬手掷足，揭去衣被，卧不安席，此欲战汗也。顷之，臂胫冷，身振战，逾一炊时，肢温汗
透，脉静身凉。
白 甲戌春大疫，初病渴烦，五日后液复神苏。毗陵医按伤寒论治，拘定日数，谓邪入阳明之腑。予言
疫邪始伏募原，继乃表里分传，不比风寒自表传里，治法必分彻表里之热，方不逆入心包，变现痉厥。今邪有
转机，再与透解营热，则不虞内陷矣。乃用鲜生地、石斛、丹皮、知母、麦冬、竹茹、甘蔗、参须。一剂神识
清，洪脉退，加青蒿、地骨皮。汗津津而热退。
冷 时邪伤肺，逆传膻中，由卫入营，酿毒发疹，密入云片，竟至神昏遗溺，是邪方张，而阴气已亏也。
用沙参、麦冬以保肺阴，牛蒡、连翘以泄疹毒，生地、五味以固肾气，丹皮、鲜藕引入血分，菖蒲、郁金开心
窍，降热痰。二服疹消，加减症平。
张氏 疫症投补，壮热烦冤，齿焦唇血，舌芒刺，昏谵，循衣撮空，颔颤手战，脉小数，此热邪深陷，
液涸风生，已显痉象。速用生地（六钱）、鲜斛、天冬（各四钱）、赤芍、元参（各三钱）、连翘、栀子、
知母（各一钱）、鲜藕（二两），石菖蒲（汁）冲服。唇舌稍润，躁扰渐平。三服
神识清爽，调理得痊。
赵氏 疫疠用五积散，烦渴，昏谵不寐，舌缩唇黑。又误进麻黄汤，肢搐鼻衄，脉数无度。窃谓五积散
治伤寒恶寒，方中姜、桂、苍、朴皆热燥，疫症本不恶寒，服此营液愈涸，邪焰益炽，是抱薪救焚，再服麻桂，
强汗劫津，更伤表气，与内陷热邪风马不及，势必痉厥衄红矣。勉用鲜生地、石斛（各五钱）、天冬、麦冬（各
二钱）、山栀、知母、赤芍、连翘（各钱半）、犀角（磨汁七分）、蔗汁（一杯）冲服，即安睡，醒而神苏。
王氏 初春感疫，寒热不时，头胀面肿，此鼻吸疠邪，袭入窍络，目闭项痛，失治则结核溃脓，急须解散。
仿普济消毒饮，升麻、柴胡、桔梗、薄荷、陈皮、连翘、甘草，加山栀、荆芥、冬桑叶。三服而消。
韦妪 病疫兼旬，烦渴脉数，舌黑神迷，症成内闭，用犀角（尖）、元参、牛黄、鲜生地、连翘、麦冬、
石菖蒲、银花露。二服热减神清。
曹氏 病起头晕欲呕，是秽邪从口鼻吸入，壮热肢冷，昏谵多寐，邪已熏灼心包，神明蒙蔽，急宜开解，
勿令窍闭。羚羊角（八分）、人中黄（一钱）、豆豉（二钱）、栀心、连翘心（各钱半）、薄荷（一钱）、
竹叶心（五钱）、菖蒲（根汁五匙）。一服神苏，汗出而解。
何氏 暑疫汗烦，疹出目瞑，舌焦脉洪长，症已传胃。仿石顽以秽攻秽，人中黄、豆豉、石膏、犀角（汁）、
银花露、知母、山栀。症退。
贡氏妹 时疫秋发，传染必深，初起寒热，耳后结核，头眩胫冷，疹出便泻，宜从少阳透热泄湿，表里
分解。医虑其体素阴虚，早投阿胶、熟地、鸡子黄滋腻，致壅气分之邪，脉来沉数，热势深陷，必难汗解，
姑用清里彻热法∶黄芩、羚羊角、人中黄、栀皮、连翘、滑石、通草、灯心。日再服，头汗剂颈，热犹蒸湿，
思欲清扫弥漫，虽核消疹退，泻止胫温，而舌心已干，邪劫胃液，随用鲜地黄、石斛、麦冬、沙参、花粉、白
芦根。舌已强，光燥无津，脉更促数，用透营滋液，犀角尖（磨汁）、鲜地黄、藕汁、
天冬、西瓜翠衣、芦根、淡竹叶、栀心、知母。舌犹干黑而缩，目瞑多睡，三焦受邪，幸前药沁透心包，
膻中不为热痰蒸蔽，然机窍不灵，仍用昨犀角方，加水甜梨肉二服，即以梨片安舌上，咀其凉润，越宿，
舌津黑蜕，汗出热解。
张氏（据述） 病经旬余，仍头晕脘闷，热烦汗潮，今夏延境 疫，皆湿土郁蒸致病，节交处暑，炎
未除，必是时气晚发，胆火上冒，湿热交搏，灼及心营，神呆液涸，撮空齿噤，热极生风，遂成痉厥。速宜透
邪救液，遥拟一方∶生地、犀角、羚羊角、元参、赤芍、鲜梨、麦冬、蒌仁、连翘、芦根。三服症平。
肖 体微热而虚烦，不渴不寐，是疫症已退，脉虚大按之如无，此禁谷而胃虚也。经云∶胃不和则卧不
安，得胃阴一复，烦热自除。用潞参、玉竹、白芍、归身、麦冬、茯神、枣仁、石斛、半夏曲、甘草、香稻叶。
数服全瘳。
眭女 口鼻吸入疠邪，头晕脘痞，烦热面红，适值经行，连小腹亦胀闷，脉右小数，左模糊，乃湿热与
气血混并，治宜上下分解。栀皮、嫩桑叶、枳壳、栝蒌霜、郁金、杏仁、薄荷、人参、丹皮、赤芍、桃仁。
日二服。头晕腹胀已减，但热烦，中脘微痛，犹是热蒸湿痰阻气，且烦出于肺，防其变现斑疹。用宣通法∶枳
壳、栝蒌霜、白蔻壳、大贝母、杏仁、丹皮、赤芍、牛蒡子，连翘、灯心。二服汗出未彻，红疹稀疏，邪已外
透，渴不多饮，而溺赤便溏，胸仍不宽，脉仍小数，湿热尚炽。法用辛凉透热于表，甘淡渗湿于里。薄荷、豆
豉、通草、牛蒡子、杏仁、贝母、栝蒌、枳壳、赤苓、滑石、车前子、灯心。数服诸症渐平，但口燥饥不思食，
乃病后胃津未复，法宜凉润调养胃阴。麦冬、石斛、玉竹、白芍、沙参、薏仁、茯神、蔗汁。数服而瘳。
眭女 热渴脘闷，舌苔里黄尖赤，头痛未解，手心如烙，湿邪搏热，僭踞上中焦，速速透解，毋俾
出入募原，酿成陷里重症。枯芩（酒炒）、豆豉、枳壳、蒌霜、栀皮、薄荷、杏仁、荷叶边，二服汗出热减，
去豆豉、荷叶边，加连翘、牛蒡子、丹皮。预防入营发疹，忽咳而衄，此蕴热迫血，直犯清道，为疫毒将解
之兆，用黑山栀、鲜生地、杏仁、大贝母、花粉、沙参、芦根、蔗汁。数服愈。
族某 疫后感暑，舌光薄而干，渴饮肢厥，脉右缓左微，便溏语谵，仍理三焦在里湿热。元参、麦冬、
花粉、石斛、赤苓、车前、薏米、知母。二服肢和舌润，去元参、车前、知母，加沙参、玉竹、大麦仁。数服
而安。
侄 热渴呕眩而烦，舌苔黄腻，牙垢唇燥，疫邪作热，由募原分布上中焦，阅所服方，未能透邪，势必
表里分传，宜急急宣解为要。淡豆豉、人中黄、黄芩、枳壳、栀皮、连翘、半夏、牛蒡子、嫩桑叶。二服烦眩呕
渴俱止，舌苔黄腻亦消，脉来虚大，数象较退，邪留气分，不难透解。原方去人中黄、枳壳、连翘、半夏、
桑叶，加薄荷、青蒿、麦冬、赤苓、蔗汁。一服微汗，未彻，两寸脉仍大，舌心灰尖绛，火邪劫营。用透热
救阴，鲜生地、花粉、石斛、麦冬、知母、元参、丹皮、赤芍、蔗汁。一服汗至胸项而还，邪犹未彻，舌心黑
燥边绛干，心胃火燔，清营热以透表。犀角尖（汁）、鲜生地、丹皮、花粉、元参、滑石、麦冬、苏梗、灯
心、蔗汁、甘草。一服汗周热解。
贡 （据述）时疫脉数，热渴晕闷，误用苍芷劫液，柴葛升阳，遂至躁烦谵妄，舌黑齿焦，循衣撮空，
此邪热入营，将变昏痉，为棘手重症。遥拟透营宣窍救液法，用犀角（磨汁五分）、鲜生地（五钱）、干生
地（三钱）、山栀、连翘、赤芍（各二钱）、鲜石菖蒲（四钱）、鲜藕、西瓜翠衣（各二两）。二服神清舌润，
去犀角、鲜生地、菖蒲、西瓜翠衣，加茯苓（二钱）、灯心（八分）、六一散（六分），冲服。彻热渗湿而平。
潘 疫热挟胆火上升，头痛如裂，旬日外出热减，渴烦震眩不解，脉虚面垢，此疫邪兼暑也。用羚羊角、
天麻、嫩桑叶、薄荷、香薷、山栀、麦冬、花粉、石斛、灯心。日二服，诸症悉平。惟液涸口燥，不思纳食，
宜调肺胃之阴。麦冬、沙参、玉竹、白芍、生地、扁豆。一服而思食米味，得服平，为过二三日可以全愈。
【案例一：冷案】疫邪传入胃腑，舌苔发黄，脉象洪大且数，伴有出汗和口渴。服用白虎汤后，一次服药热势即退。次日中午再次出现烦躁，担心散漫的邪气虽然已去，但体内已形成里实结滞。
使用苦辛寒方剂：人中黄、元明粉（芒硝）、黄芩、知母、枳壳、槟榔。服用三剂后，脉象和症状均平复。再用蜜煎导法通便，病愈。
【案例二：冷案】高龄患者感染疫病，右脉大于左脉，这是因为邪气从口鼻吸入，客居于夹脊部位，溢出至募原，出现的症状有头痛，胸中烦闷郁结。务必彻底清除邪气，使其迅速离开募原。
仿照达原饮方意，使用黄芩、知母、天花粉、厚朴、枳壳、赤芍、豆豉。服药后出汗热退，隔日之前的症状再次发作，恶热，并加重出现胡言乱语。诊察时患者扬手掷足，掀开衣被，卧不安席，这是将要发生战汗的表现。不久，手臂和小腿发冷，身体颤抖，经过一顿饭的时间，四肢温暖，汗透全身，脉象平静，身体凉爽。
【案例三：白案】甲戌年春季发生大瘟疫，初起表现为口渴烦躁，五日后津液恢复，神志清醒。毗陵的医生按照《伤寒论》治疗，拘泥于发病天数，认为邪气已进入阳明腑证。我指出，疫邪起初潜伏在募原，随后表里分传，不同于风寒之邪自表入里的传变规律，治疗方法必须分别彻解表里之热，才不会逆传心包，出现痉厥等变证。如今邪气已有转机，再给予透解营分热邪的药物，就不必担忧邪气内陷了。于是使用鲜生地、石斛、丹皮、知母、麦冬、竹茹、甘蔗、参须。服用一剂后神志清醒，洪脉消退，加入青蒿、地骨皮。微微出汗后热退。
【案例四：冷案】时邪伤肺，逆传膻中，由卫分进入营分，酿毒发疹，皮疹密集如云片，甚至导致神昏遗尿，这是邪气正盛，而阴气已经亏损的表现。
使用沙参、麦冬以保护肺阴，牛蒡子、连翘以泄除疹毒，生地、五味子以固护肾气，丹皮、鲜藕引入血分，石菖蒲、郁金开通心窍，降泄热痰。服用两剂后疹消，加减治疗后症状平复。
【案例五：张氏案】疫病误用补药，出现高热烦冤，牙齿焦枯，嘴唇出血，舌生芒刺，神志昏迷胡言乱语，循衣摸空，下颌颤动手部抖动，脉象细小数，这是热邪深陷，津液枯竭而生风，已经显现出痉病的征象。迅速使用生地（六钱）、鲜石斛、天冬（各四钱）、赤芍、玄参（各三钱）、连翘、栀子、知母（各一钱）、鲜藕（二两），石菖蒲汁冲服。唇舌稍润，躁扰逐渐平息。服用三剂后神识清爽，调理后痊愈。
【案例六：赵氏案】疫病使用五积散，出现烦渴，神昏胡言不眠，舌头缩短嘴唇发黑。又误服麻黄汤，导致肢体抽搐鼻出血，脉象数乱无度。我认为五积散是治疗伤寒恶寒的方剂，方中干姜、肉桂、苍术、厚朴皆属热燥之品，疫病本来不恶寒，服用此药使营阴津液更加枯竭，邪火更加炽盛，这是抱薪救火；再服用麻黄、桂枝，强行发汗劫夺津液，更伤表气，这与内陷的热邪风马牛不相及，势必导致痉厥鼻衄。勉强使用鲜生地、石斛（各五钱）、天冬、麦冬（各二钱）、山栀、知母、赤芍、连翘（各钱半）、犀角（磨汁七分）、蔗汁（一杯）冲服，随即安睡，醒来神志清醒。
【案例七：王氏案】初春感受疫病，寒热不时，头胀面肿，这是鼻吸疠邪，侵袭窍络，若失治则会导致结核溃脓，急需解散邪气。
仿照普济消毒饮，使用升麻、柴胡、桔梗、薄荷、陈皮、连翘、甘草，加入山栀、荆芥、冬桑叶。服用三剂后消散。
【案例八：韦妪案】患疫病兼旬（二十天），烦渴脉数，舌黑神志迷蒙，症成内闭，使用犀角尖、玄参、牛黄、鲜生地、连翘、麦冬、石菖蒲、银花露。服用两剂后热减神清。
【案例九：曹氏案】病起头晕欲呕，这是秽邪从口鼻吸入，壮热肢冷，神昏胡言多寐，邪气已熏灼心包，神明被蒙蔽，急需开解，勿令窍闭。使用羚羊角（八分）、人中黄（一钱）、豆豉（二钱）、栀子心、连翘心（各钱半）、薄荷（一钱）、竹叶心（五钱）、石菖蒲根汁（五匙）。服用一剂后神志清醒，出汗而解。
【案例十：何氏案】暑疫出汗烦躁，疹出目瞑，舌焦脉洪长，症已传胃。仿照石顽先生“以秽攻秽”之法，使用人中黄、豆豉、石膏、犀角汁、银花露、知母、山栀。症状退去。
【案例十一：贡氏妹案】时疫秋季发作，传染必深，初起寒热，耳后结核，头眩小腿冷，出疹便泻，宜从少阳透热泄湿，表里分解。医生顾虑其体质素来阴虚，过早投用阿胶、熟地、鸡子黄等滋腻药物，导致气分之邪壅滞，脉来沉数，热势深陷，必然难以通过汗法解除，暂用清里彻热法：黄芩、羚羊角、人中黄、栀子皮、连翘、滑石、通草、灯心。每日服用两次，头部出汗仅到颈部，热势仍如蒸湿，思欲清扫弥漫之邪，虽然核消疹退，泻止胫温，但舌心已干，邪气劫夺胃液，随即使用鲜地黄、石斛、麦冬、沙参、花粉、白芦根。舌头僵硬，光亮干燥无津，脉象更促数，使用透营滋液法：犀角尖（磨汁）、鲜地黄、藕汁、天冬、西瓜翠衣、芦根、淡竹叶、栀子心、知母。舌头仍然干黑而缩，眼睛闭合多睡，三焦受邪，幸好前药沁透心包，膻中未被热痰蒸蔽，然而机窍不灵，仍用昨日犀角方，加水甜梨肉，服用两剂，即将梨片置于舌上，咀嚼其凉润之气，过夜后，舌苔黑蜕去，生出津液，出汗热解。
【案例十二：张氏案（据述）】病经旬余，仍头晕脘闷，热烦汗潮，今夏境内流行疫病，皆因湿土郁蒸致病，节气交至处暑，炎热未除，必定是时气晚发，胆火上冒，湿热交搏，灼伤心营，神呆液涸，撮空齿噤，热极生风，遂成痉厥。速宜透邪救液，遥拟一方：生地、犀角、羚羊角、玄参、赤芍、鲜梨、麦冬、瓜蒌仁、连翘、芦根。服用三剂后症状平复。
【案例十三：肖案】身体微热而虚烦，不渴不眠，这是疫病已退，脉象虚大按之如无，这是禁食导致胃虚。经云：胃不和则卧不安，待胃阴恢复，烦热自然消除。使用潞党参、玉竹、白芍、当归身、麦冬、茯神、枣仁、石斛、半夏曲、甘草、香稻叶。服用数剂后全愈。
【案例十四：眭女案】口鼻吸入疠邪，头晕脘痞，烦热面红，正值经期，连小腹也胀闷，脉右小数，左模糊，乃湿热与气血混并，治疗宜上下分解。使用栀子皮、嫩桑叶、枳壳、瓜蒌霜、郁金、杏仁、薄荷、人参、丹皮、赤芍、桃仁。每日两次。头晕腹胀已减，但仍有热烦，中脘微痛，仍是热蒸湿痰阻气，且烦出于肺，防其出现斑疹。使用宣通法：枳壳、瓜蒌霜、白蔻壳、大贝母、杏仁、丹皮、赤芍、牛蒡子、连翘、灯心。服用两剂后出汗未彻，红疹稀疏，邪气已外透，口渴不多饮，小便赤大便溏，胸仍不宽，脉仍小数，湿热尚炽。法用辛凉透热于表，甘淡渗湿于里。使用薄荷、豆豉、通草、牛蒡子、杏仁、贝母、栝楼、枳壳、赤茯苓、滑石、车前子、灯心。服用数剂后诸症渐平，但口燥饥不思食，这是病后胃津未复，法宜凉润调养胃阴。使用麦冬、石斛、玉竹、白芍、沙参、薏仁、茯神、蔗汁。服用数剂后痊愈。
【案例十五：眭女案】热渴脘闷，舌苔里黄尖赤，头痛未解，手心如烙，湿邪搏热，僭踞上中焦，速速透解，勿使出入募原，酿成陷里重症。使用枯芩（酒炒）、豆豉、枳壳、瓜蒌霜、栀子皮、薄荷、杏仁、荷叶边，服用两剂后出汗热减，去掉豆豉、荷叶边，加入连翘、牛蒡子、丹皮。预防入营发疹，忽然咳嗽且鼻衄，这是蕴热迫血，直犯清道，为疫毒将解之兆，使用黑山栀、鲜生地、杏仁、大贝母、花粉、沙参、芦根、蔗汁。服用数剂后痊愈。
【案例十六：族某案】疫病后感暑，舌光薄而干，渴饮肢厥，脉右缓左微，便溏语谵，仍理三焦在里湿热。使用玄参、麦冬、花粉、石斛、赤茯苓、车前、薏米、知母。服用两剂后四肢调和舌润，去掉玄参、车前、知母，加入沙参、玉竹、大麦仁。服用数剂后安宁。
【案例十七：侄案】热渴呕眩而烦，舌苔黄腻，牙垢唇燥，疫邪作热，由募原分布上中焦，看所服方剂，未能透邪，势必表里分传，宜急急宣解为要。使用淡豆豉、人中黄、黄芩、枳壳、栀子皮、连翘、半夏、牛蒡子、嫩桑叶。服用两剂后烦眩呕渴俱止，舌苔黄腻亦消，脉来虚大，数象较退，邪留气分，不难透解。原方去掉人中黄、枳壳、连翘、半夏、桑叶，加入薄荷、青蒿、麦冬、赤茯苓、蔗汁。服用一剂后微汗，未彻，两寸脉仍大，舌心灰尖绛，火邪劫营。使用透热救阴法：鲜生地、花粉、石斛、麦冬、知母、玄参、丹皮、赤芍、蔗汁。服用一剂后汗至胸项而还，邪犹未彻，舌心黑燥边绛干，心胃火燔，清营热以透表。使用犀角尖（汁）、鲜生地、丹皮、花粉、玄参、滑石、麦冬、苏梗、灯心、蔗汁、甘草。服用一剂后汗周热解。
【案例十八：贡氏案（据述）】时疫脉数，热渴晕闷，误用苍术、白芷劫液，柴胡、葛根升阳，遂至躁烦谵妄，舌黑齿焦，循衣撮空，这是邪热入营，将变昏痉，为棘手重症。遥拟透营宣窍救液法，使用犀角（磨汁五分）、鲜生地（五钱）、干生地（三钱）、山栀、连翘、赤芍（各二钱）、鲜石菖蒲（四钱）、鲜藕、西瓜翠衣（各二两）。服用两剂后神清舌润，去掉犀角、鲜生地、菖蒲、西瓜翠衣，加入茯苓（二钱）、灯心（八分）、六一散（六分），冲服。彻热渗湿而平。
【案例十九：潘案】疫热挟胆火上升，头痛如裂，旬日外出热减，渴烦震眩不解，脉虚面垢，这是疫邪兼暑也。使用羚羊角、天麻、嫩桑叶、薄荷、香薷、山栀、麦冬、花粉、石斛、灯心。每日两次，诸症悉平。惟液涸口燥，不思纳食，宜调肺胃之阴。使用麦冬、沙参、玉竹、白芍、生地、扁豆。服用一剂后思食米味，得服平，过二三日可以全愈。
[Case 1: Cold's Case] The epidemic pathogen transmits to the Stomach, presenting with a yellow tongue coating, surging and rapid pulse, sweating, and thirst. After one dose of Baihu Tang (White Tiger Decoction), the fever subsides. By noon the next day, restlessness recurs; it is feared that although the scattered pathogen has left, interior stagnation has formed.
A bitter-pungent-cold formula is used: Renzhonghuang (Human Waste Yellow), Yuanmingfen (Magnsii Sulfas), Huangqin (Scutellariae Radix), Zhimu (Anemarrhenae Rhizoma), Zhike (Aurantii Fructus), and Binglang (Arecae Semen). After three doses, both pulse and symptoms normalize. Honey suppository is used to guide out feces, leading to recovery.
[Case 2: Cold's Case] An elderly patient contracts an epidemic. The right pulse is larger than the left, indicating the pathogen entered via the mouth and nose, lodged in the夾脊 (Jiaji area between the spine and shoulder blades), and overflowed from the Mu Yuan (Moyuan/Root of Diaphragm). Symptoms include headache and chest oppression/stuffiness. It is crucial to thoroughly eliminate the pathogen so it quickly leaves the Mu Yuan.
Imitating the Dacanyin (Reach the Original Decoction), Huangqin (Scutellariae Radix), Zhimu (Anemarrhenae Rhizoma), Huafen (Trichosanthis Radix), Houpo (Magnoliae Officinalis Cortex), Zhike (Aurantii Fructus), Chishao (Paeoniae Radix Rubra), and Douchi (Sojae Semen Praeparatum) are used. Sweating occurs, and heat subsides. Two days later, previous symptoms recur with aversion to heat, worsening into delirium. During examination, the patient throws hands and feet about, removes clothes and blankets, and cannot lie still on the bed; this indicates impending "Zhan Han" (Battle Sweat). Soon, arms and shins become cold, body trembles violently. After the time it takes to cook a meal, limbs warm, sweat penetrates fully, pulse becomes calm, and body cools.
[Case 3: Bai's Case] In the spring of the Ji Xu year, a major epidemic occurred. Initially, there was thirst and irritability. Five days later, fluids recovered, and consciousness cleared. A doctor in Biling treated according to Shanghan Lun (Treatise on Cold Damage), rigidly adhering to disease days, claiming the pathogen entered the Yangming Fu organs. I stated that epidemic pathogens initially hide in the Mu Yuan, then transmit simultaneously to exterior and interior, unlike wind-cold which transmits from exterior to interior. Treatment must separately clear exterior and interior heat to prevent counter-flow into the Pericardium, manifesting as spasm and convulsion. Now that the pathogen shows signs of turning, providing herbs to penetrate and resolve Ying-level heat will prevent internal sinking. Thus, Xian Shengdi (Fresh Rehmanniae Radix), Shihu (Dendrobii Caulis), Danpi (Moutan Cortex), Zhimu (Anemarrhenae Rhizoma), Maidong (Ophiopogonis Radix), Zhuru (Bambusae Caulis in Taeniam), Sugarcane juice, and Renshenxu (Ginseng Rootlet) were used. After one dose, consciousness cleared, surging pulse receded. Qinghao (Artemisiae Annuae Herba) and Digupi (Lycii Cortex) were added. Slight sweating led to heat resolution.
[Case 4: Cold's Case] Seasonal pathogen injures the Lung, counter-transmitting to the Danzhong (Chest/Pericardium region), moving from Wei to Ying levels, brewing toxicity and causing rash. Rash is dense like cloud patterns, progressing to coma and urinary incontinence. This indicates the pathogen is flourishing while Yin qi is already deficient.
Shashen (Glehniae Radix) and Maidong (Ophiopogonis Radix) are used to protect Lung Yin; Niubangzi (Arctii Fructus) and Lianqiao (Forsythiae Fructus) to vent rash toxin; Shengdi (Rehmanniae Radix) and Wuweizi (Schisandrae Fructus) to secure Kidney Qi; Danpi (Moutan Cortex) and fresh lotus root to enter Blood level; Shichangpu (Acori Tatarinowii Rhizoma) and Yujin (Curcumae Radix) to open Heart orifices and descend hot phlegm. After two doses, rash dissipates; symptoms normalize after modification.
[Case 5: Zhang's Case] Epidemic treated with tonics resulted in high fever, vexation, burnt teeth, bleeding lips, prickly tongue, coma, delirium, grasping at empty air, jaw trembling, hand shaking, and fine-rapid pulse. This is deep-seated heat, depleted fluids generating wind, showing signs of spasm. Quickly use Shengdi (6 qian), fresh Shihu, Tiandong (Asparagi Radix) (each 4 qian), Chishao (Paeoniae Radix Rubra), Xuanshen (Scrophulariae Radix) (each 3 qian), Lianqiao (Forsythiae Fructus), Zhizi (Gardeniae Fructus), Zhimu (Anemarrhenae Rhizoma) (each 1 qian), fresh lotus root (2 liang), and Shichangpu juice taken with decoction. Lips and tongue slightly moisten, restlessness calms. After three doses, consciousness is clear; recovery follows regulation.
[Case 6: Zhao's Case] Wujisan (Five Accumulations Decoction) used for epidemic caused vexation, thirst, coma, delirium, insomnia, retracted tongue, and black lips. Then Mahuang Tang (Ephedra Decoction) was mistakenly given, causing limb twitching and epistaxis, with chaotic rapid pulse. I reasoned that Wujisan treats Taiyang cold damage with aversion to cold; its ingredients Jiang (Zingiberis Rhizoma), Gui (Cinnamomi Ramulus), Cangzhu (Atractylodis Rhizoma), and Houpo (Magnoliae Officinalis Cortex) are hot and drying. Epidemics do not present with aversion to cold; taking this depletes Ying fluids further, intensifying fire—like adding wood to a fire. Taking Mahuang and Guizhi again forces sweating,劫津 (robbing fluids), damaging exterior Qi. This is unrelated to internalized heat-pathogen; spasm, convulsion, and bleeding are inevitable. Reluctantly using Xian Shengdi (5 qian), Shihu (5 qian), Tiandong (2 qian), Maidong (2 qian), Shanzhi (Gardeniae Fructus), Zhimu (Anemarrhenae Rhizoma), Chishao (Paeoniae Radix Rubra), Lianqiao (Forsythiae Fructus) (each 1.5 qian), Xijiao (Rhinocerotis Cornu - note: substitute with water buffalo horn in practice) (7 fen ground juice), and sugarcane juice taken with decoction. Patient slept peacefully, woke with clear consciousness.
[Case 7: Wang's Case] Early spring epidemic contraction caused irregular chills and fever, head distension, and facial swelling. This is inhaling pestilential pathogen invading orifices and collaterals. If untreated, tubercles may ulcerate and suppurate; urgent dispersal is needed.
Imitating Puji Xiaodu Yin (Universal Benefit Decoction to Eliminate Toxins), Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix), Jiegeng (Platycodonis Radix), Bohe (Menthae Haplocalycis Herba), Chenpi (Citri Reticulatae Pericarpium), Lianqiao (Forsythiae Fructus), Gancao (Glycyrrhizae Radix et Rhizoma) are used, plus Shanzhi (Gardeniae Fructus), Jingjie (Schizonepetae Herba), and Dong Sangye (Mori Folium). Three doses lead to resolution.
[Case 8: Widow Wei's Case] Epidemic lasting twenty days presented with vexation, thirst, rapid pulse, black tongue, and confused spirit, forming interior closure. Xijiao (Rhinocerotis Cornu tip), Xuanshen (Scrophulariae Radix), Niuhuang (Bovis Calculus), Xian Shengdi (Fresh Rehmanniae Radix), Lianqiao (Forsythiae Fructus), Maidong (Ophiopogonis Radix), Shichangpu (Acori Tatarinowii Rhizoma), and Yinhualu (Honeysuckle Inflorescence Dew) were used. After two doses, heat reduced, spirit cleared.
[Case 9: Cao's Case] Onset with dizziness and nausea indicates foul pathogen inhaled via mouth/nose. High fever, cold limbs, coma, delirium, and hypersomnia indicate pathogen scorching Pericardium, obscuring Ming (Spirit). Urgent opening and resolving is required to prevent orifice closure. Lingyangjiao (Capris Cornu), Renzhonghuang (Human Waste Yellow), Douchi (Sojae Semen Praeparatum), Zhixin (Gardeniae Fructus Core), Lianqiaoxin (Forsythiae Fructus Core) (each 1.5 qian), Bohe (Menthae Haplocalycis Herba) (1 qian), Zhuyexin (Phyllostachidis Folium Core) (5 qian), and Changpugenju (Acori Tatarinowii Rhizoma Juice) (5 spoons) are used. One dose clears spirit, sweating resolves illness.
[Case 10: He's Case] Summer epidemic with sweating, vexation, rash emergence, eye closing, scorched tongue, and surging-long pulse indicates transmission to Stomach. Imiting Shiwan's method of "using filth to attack filth," Renzhonghuang (Human Waste Yellow), Douchi (Sojae Semen Praeparatum), Shigao (Gypsum Fibrosum), Xijiao juice (Rhinocerotis Cornu), Yinhualu (Honeysuckle Inflorescence Dew), Zhimu (Anemarrhenae Rhizoma), and Shanzhi (Gardeniae Fructus) are used. Symptoms subside.
[Case 11: Sister Gong's Case] Autumn epidemic, deep contagion. Initial chills/fever, post-auricular tubercles, dizziness, cold shins, rash with diarrhea. Should resolve Shaoyang heat and drain dampness, separating exterior and interior. Doctor worried about inherent Yin deficiency, early administration of Ejiao (Donkey-hide Gelatin), Shudi (Rehmanniae Radix Preparata), and Jizihuang (Galli Ovipartum) caused Qi-level pathogen stagnation. Pulse deep-rapid, heat deeply sunk, difficult to resolve by sweating. Temporarily use clearing interior and penetrating heat method: Huangqin (Scutellariae Radix), Lingyangjiao (Capris Cornu), Renzhonghuang (Human Waste Yellow), Zhipi (Gardeniae Fructus Pericarpium), Lianqiao (Forsythiae Fructus), Huashi (Talcum), Tongcao (Tetrapanacis Medulla), Dengxincao (Junci Medulla). Twice daily. Head sweat only reaches neck, heat steams dampness. Although tubercles/rash resolve, diarrhea stops, shins warm, tongue center dries, pathogen robs Stomach fluids. Immediately use Xian Dihuang (Fresh Rehmanniae Radix), Shihu (Dendrobii Caulis), Maidong (Ophiopogonis Radix), Shashen (Glehniae Radix), Huafen (Trichosanthis Radix), Bai Lugeng (White Phragmitis Rhizoma). Tongue stiff, smooth/dry without fluid, pulse more rapid/agitated. Use penetrating Ying and nourishing fluids method: Xijiao tip (ground juice), Xian Dihuang (Fresh Rehmanniae Radix), Ouji (Lotus Root Juice), Tiandong (Asparagi Radix), Xiguacuiyi (Watermelon Rind), Lugeng (Phragmitis Rhizoma), Dan Zhuye (Bambusae Folium), Zhixin (Gardeniae Fructus Core), Zhimu (Anemarrhenae Rhizoma). Tongue still dry/black/retracted, eyes closed/hypersomnia, Sanjiao affected. Fortunately, previous medicine penetrated Pericardium, Danzhong not blocked by hot phlegm, but orifices dull. Still use yesterday's Xijiao formula, add sweet pear flesh, two doses. Place pear slice on tongue, chew for cool/moistening effect. Overnight, black coating sheds, saliva returns, sweating resolves heat.
[Case 12: Zhang's Case (Reported)] Ill for over ten days, still dizzy, epigastric stuffiness, hot vexation, tidal sweating. This summer's local epidemic is due to damp-earth stagnation steaming. At Chushu (End of Heat), heat remains; likely late-onset seasonal qi, Gallbladder fire rising, damp-heat intermingling, scorching Xin Ying (Heart-Blood level), causing dull spirit, depleted fluids, grasping at air, clenched teeth, extreme heat generating wind, resulting in spasm/convulsion. Urgently penetrate pathogen and save fluids. Prescribed remotely: Shengdi (Rehmanniae Radix), Xijiao (Rhinocerotis Cornu), Lingyangjiao (Capris Cornu), Xuanshen (Scrophulariae Radix), Chishao (Paeoniae Radix Rubra), fresh pear, Maidong (Ophiopogonis Radix), Louren (Trichosanthis Semen), Lianqiao (Forsythiae Fructus), Lugeng (Phragmitis Rhizoma). Three doses normalize symptoms.
[Case 13: Xiao's Case] Slight body heat, empty vexation, no thirst, insomnia. Epidemic has retreated, pulse void-large, empty upon pressure. This is stomach deficiency from fasting/grain restriction. Classic says: "Stomach disharmony leads to restless sleep." Once Stomach Yin recovers, vexation/heat self-resolves. Use Lushen (Codonopsis Radix), Yuzhu (Polygonati Odorati Rhizoma), Baishao (Paeoniae Radix Alba), Guishen (Angelicae Sinensis Radix), Maidong (Ophiopogonis Radix), Fushen (Poria Cum Radix), Zaoren (Ziziphi Spinosae Semen), Shihu (Dendrobii Caulis), Banxiaqu (Pinelliae Fermentum), Gancao (Glycyrrhizae Radix et Rhizoma), Xiangdaoye (Oryzae Sativa Folium Fragrans). Several doses lead to full recovery.
[Case 14: Girl Sui's Case] Inhaling pestilential pathogen causes dizziness, epigastric fullness, vexation/heat, red face. Menstruation coincides, lower abdomen distended. Right pulse small-rapid, left blurred. Damp-heat mixed with Qi/Blood. Treatment: separate upper/lower. Zhipi (Gardeniae Fructus Pericarpium), Neng Sangye (Young Mori Folium), Zhike (Aurantii Fructus), Gualoushuang (Trichosanthis Fructus Pulvis), Yujin (Curcumae Radix), Xingren (Armeniacae Semen Amarum), Bohe (Menthae Haplocalycis Herba), Renshen (Ginseng Radix), Danpi (Moutan Cortex), Chishao (Paeoniae Radix Rubra), Tao Ren (Persicae Semen). Twice daily. Dizziness/distension reduce, but heat/vexation remain, slight epigastric pain. Heat steams damp-phlegm blocking Qi; vexation originates from Lung, preventing rash/spots. Use unblocking method: Zhike (Aurantii Fructus), Gualoushuang (Trichosanthis Fructus Pulvis), Baikouke (Amomi Fructus Pericarpium), Da Beimu (Fritillariae Thunbergii Bulbus), Xingren (Armeniacae Semen Amarum), Danpi (Moutan Cortex), Chishao (Paeoniae Radix Rubra), Niubangzi (Arctii Fructus), Lianqiao (Forsythiae Fructus), Dengxincao (Junci Medulla). Two doses, sweat incomplete, sparse red rash, pathogen externalized. Thirsty but drinks little, urine red, stool loose, chest not wide, pulse small-rapid, damp-heat vigorous. Method: pungent-cool to penetrate heat externally, sweet-bland to leach dampness internally. Bohe (Menthae Haplocalycis Herba), Douchi (Sojae Semen Praeparatum), Tongcao (Tetrapanacis Medulla), Niubangzi (Arctii Fructus), Xingren (Armeniacae Semen Amarum), Beimu (Fritillariae Bulbus), Gualou (Trichosanthis Fructus), Zhike (Aurantii Fructus), Chiling (Poria cum Ligno Rubrum), Huashi (Talcum), Cheqianzi (Plantaginis Semen), Dengxincao (Junci Medulla). Several doses symptoms flatten. Dry mouth, hunger but no appetite indicates post-illness Stomach fluid deficiency. Method: cool-moisturize to nourish Stomach Yin. Maidong (Ophiopogonis Radix), Shihu (Dendrobii Caulis), Yuzhu (Polygonati Odorati Rhizoma), Baishao (Paeoniae Radix Alba), Shashen (Glehniae Radix), Yiren (Coicis Semen), Fushen (Poria Cum Radix), Zheshui (Sugarcane Juice). Several doses cure.
[Case 15: Girl Sui's Case (Second Visit)] Heat/thirst, epigastric stuffiness, yellow tongue coating inside/red tip, unresolved headache, palms hot as iron. Damp-heat combats, occupying Upper/Middle Jiao. Quickly penetrate/resolve, do not let it exit/enter Mu Yuan, brewing severe interior sinking. Kuqin (Scutellariae Radix, wine-fried), Douchi (Sojae Semen Praeparatum), Zhike (Aurantii Fructus), Lou Shuang (Trichosanthis Fructus Pulvis), Zhipi (Gardeniae Fructus Pericarpium), Bohe (Menthae Haplocalycis Herba), Xingren (Armeniacae Semen Amarum), Heyebian (Nelumbinis Folium Margin), two doses sweat/heat reduce. Remove Douchi, Heyebian, add Lianqiao (Forsythiae Fructus), Niubangzi (Arctii Fructus), Danpi (Moutan Cortex). Prevent Ying entry/rash. Suddenly coughs and epistaxis; accumulated heat forces blood, attacking clear pathways, sign of epidemic toxin resolving. Use Hei Shanzhi (Blackened Gardeniae Fructus), Xian Shengdi (Fresh Rehmanniae Radix), Xingren (Armeniacae Semen Amarum), Da Beimu (Fritillariae Thunbergii Bulbus), Huafen (Trichosanthis Radix), Shashen (Glehniae Radix), Lugeng (Phragmitis Rhizoma), Zheshui (Sugarcane Juice). Several doses cure.
[Case 16: Clan Member's Case] Post-epidemic summerheat. Tongue smooth/thin/dry, thirsty/drinking, cold limbs, right pulse slow/left faint, loose stool, delirious speech. Regulate Sanjiao interior damp-heat. Xuanshen (Scrophulariae Radix), Maidong (Ophiopogonis Radix), Huafen (Trichosanthis Radix), Shihu (Dendrobii Caulis), Chiling (Poria cum Ligno Rubrum), Cheqian (Plantaginis Semen), Yimi (Coicis Semen), Zhimu (Anemarrhenae Rhizoma). Two doses limbs harmonize, tongue moist. Remove Xuanshen, Cheqian, Zhimu, add Shashen (Glehniae Radix), Yuzhu (Polygonati Odorati Rhizoma), Damairen (Hordei Fructus Germinatus). Several doses bring peace.
[Case 17: Nephew's Case] Heat/thirst, vomiting, dizziness, vexation. Yellow greasy tongue coating, dental plaque, dry lips. Epidemic heat distributes from Mu Yuan to Upper/Middle Jiao. Previous formulas failed to penetrate pathogen; likely simultaneous exterior-interior transmission. Urgent dispersal/resolution essential. Danshidouchi (Light Sojae Semen Praeparatum), Renzhonghuang (Human Waste Yellow), Huangqin (Scutellariae Radix), Zhike (Aurantii Fructus), Zhipi (Gardeniae Fructus Pericarpium), Lianqiao (Forsythiae Fructus), Banxia (Pinelliae Rhizoma), Niubangzi (Arctii Fructus), Neng Sangye (Young Mori Folium). Two doses vexation/dizziness/vomit/thirst stop, yellow greasy coating disappears. Pulse void-large, rapidness decreases, pathogen stays in Qi level, easy to penetrate. Remove Renzhonghuang, Zhike, Lianqiao, Banxia, Sangye from original, add Bohe (Menthae Haplocalycis Herba), Qinghao (Artemisiae Annuae Herba), Maidong (Ophiopogonis Radix), Chiling (Poria cum Ligno Rubrum), Zheshui (Sugarcane Juice). One dose slight sweat, incomplete, Cun pulses still large, tongue center gray/tip crimson, fire rob Ying. Use penetrating heat/save Yin: Xian Shengdi (Fresh Rehmanniae Radix), Huafen (Trichosanthis Radix), Shihu (Dendrobii Caulis), Maidong (Ophiopogonis Radix), Zhimu (Anemarrhenae Rhizoma), Xuanshen (Scrophulariae Radix), Danpi (Moutan Cortex), Chishao (Paeoniae Radix Rubra), Zheshui (Sugarcane Juice). One dose sweat reaches chest/neck then stops, pathogen not fully cleared, tongue center black/dry/edges crimson, Heart/Stomach fire blazing. Clear Ying heat to penetrate exterior. Xijiao tip (juice), Xian Shengdi (Fresh Rehmanniae Radix), Danpi (Moutan Cortex), Huafen (Trichosanthis Radix), Xuanshen (Scrophulariae Radix), Huashi (Talcum), Maidong (Ophiopogonis Radix), Sugeng (Perillae Caulis), Dengxincao (Junci Medulla), Zheshui (Sugarcane Juice), Gancao (Glycyrrhizae Radix et Rhizoma). One dose sweat circulates, heat resolves.
[Case 18: Gong's Case (Reported)] Epidemic rapid pulse, heat/thirst/dizziness/stuffiness. Mistakenly used Cangzhu (Atractylodis Rhizoma) and Zhi (Saussureae Radix) to rob fluids, Chaihu (Bupleuri Radix) and Gegen (Puerariae Lobatae Radix) to raise Yang. Resulted in restlessness/delirium, black tongue, burnt teeth, grasping at air. Pathogen heat enters Ying, impending coma/spasm, difficult case. Remotely prescribe penetrating Ying, opening orifices, saving fluids: Xijiao (ground juice 5 fen), Xian Shengdi (5 qian), Gan Shengdi (Dried Rehmanniae Radix) (3 qian), Shanzhi (Gardeniae Fructus), Lianqiao (Forsythiae Fructus), Chishao (Paeoniae Radix Rubra) (each 2 qian), Xian Shichangpu (Fresh Acori Tatarinowii Rhizoma) (4 qian), Xian Ou (Fresh Lotus Root), Xiguacuiyi (Watermelon Rind) (each 2 liang). Two doses spirit clear, tongue moist. Remove Xijiao, Xian Shengdi, Changpu, Xigua Cuiyi, add Fuling (Poria) (2 qian), Dengxin (Junci Medulla) (8 fen), Liuyisan (Six-to-One Powder) (6 fen), taken with decoction. Penetrates heat, leaches dampness, normalizes.
[Case 19: Pan's Case] Epidemic heat carries Gallbladder fire upward, splitting headache. Ten days later, external heat reduces, but thirst/vexation/shaking/dizziness persist. Void pulse, dirty face. Epidemic pathogen combined with summerheat. Lingyangjiao (Capris Cornu), Tianma (Gastrodiae Rhizoma), Neng Sangye (Young Mori Folium), Bohe (Menthae Haplocalycis Herba), Xiangru (Elsholtziae Herba), Shanzhi (Gardeniae Fructus), Maidong (Ophiopogonis Radix), Huafen (Trichosanthis Radix), Shihu (Dendrobii Caulis), Dengxincao (Junci Medulla). Twice daily, all symptoms flat. Only fluid depletion/dry mouth, no appetite. Regulate Lung/Stomach Yin. Maidong (Ophiopogonis Radix), Shashen (Glehniae Radix), Yuzhu (Polygonati Odorati Rhizoma), Baishao (Paeoniae Radix Alba), Shengdi (Rehmanniae Radix), Bian Dou (Vigna Radiatae Semen Album). One dose desires rice taste, comfort achieved. Over two-three days, full recovery expected.