服侄 少阴伏邪，夏至后发协热下利，口干脉数，舌绛目红，谵烦躁扰。服蔗梨西瓜等汁，转益狂躁，神
昏不寐，症由心营受烁，势必液涸成痉。先用鲜菖蒲根汤下至宝丹开窍涤痰，二服神识略清，但指臂动掣，
胫膝不温，痉厥已露，宵分齿噤口 。摇头直视。此火风入筋劫烁血液，热深厥深之象。急救营液以熄火风。
用阿胶（水化）、生地、犀角（汁）、麦冬、钩藤、木瓜、山栀、石斛、生藕汁煎，日再服，症定脉数减。
去犀角，加生龟甲、龙胆草专退肝胆风热，渐平。同时一侄孙，症同脉更沉数，饮以腊雪汤、西瓜汁，暂定。
超时辄复躁扰谵妄，服至宝丹稍静。予一见其舌干薄，齿如灰糕，决其肾水枯竭，勉用方。诸水煎生地、
犀角、生龟甲、元参、石斛等，热势辄定，然卒不救。可知温热症由伏邪内发者，多死于阴虚水涸之体也。
头为诸阳之会，烦劳伤阳，阳升风动，上扰巅顶。耳目乃清空之窍，风阳旋沸，斯眩晕作焉。良由肝胆乃
风木之脏，相火内寄，其性主动主升。或由身心过动，或由情志郁勃。或由地气上腾，或由冬藏不密。或由高
年肾液已衰，水不涵木。或由病后精神未复，阴不吸阳，以至目昏耳鸣，震眩不定，甚则心悸舌辣，肢麻筋惕，
寤不成寐，动则自汗，起则呕痰。无痰不作眩。此经所谓诸风掉眩，皆属于肝也。顾内风肆横，虚阳上升，
非发散可解，非沉寒可清，与治六气风火大异。法宜辛甘化风，或甘酸化阴。叶氏所谓缓肝之急以熄风，滋
肾之液以驱热，肝风既平，眩晕斯止。条其治法，如上焦窍络火郁，用羚羊角、山栀、连翘、
天花粉、丹皮、生地、桑叶、钩藤、天麻以泄热，从胆治也。如中虚风阳扰胃，用人参、山药、黄 、小麦、
炙草、龙眼肉以填补，从胃治也。肝风内扰，阳明正当其冲，故须补中。如下元水涸火升，用阿胶、熟地、石
斛、何首乌、杞子、天冬、黑芝麻、磁石、五味子以摄纳，从肝肾治也。其阳冒不潜，用牡蛎、淡茶、龟甲。
痰多作眩，用茯苓、川贝、橘红、竹沥、姜汁。心悸不寐，用枣仁、麦冬、茯神、龙骨。厥阳不敛，用萸肉、
白芍、牛膝炭。土被木克，呕吐不食，宜泄肝安胃，用橘白、木瓜、半夏曲、茯苓。动怒郁勃，痰火风交炽，
用二陈汤下龙荟丸。至于熄风之品，如甘菊炭、煨天麻、钩藤之属，皆可随症加入者也。
患者侄子，体内潜伏少阴经的邪气，夏至之后发作，表现为伴随发热的腹泻，口干，脉象数疾，舌质深红，眼睛发红，胡言乱语，烦躁不安。服用甘蔗、梨、西瓜等汁液后，狂躁症状反而加重，神志昏迷无法入睡。此症是由于心营（心包络及心血）被热邪灼烧，势必导致津液枯竭而引发痉病（肢体抽搐、角弓反张）。先用鲜石菖蒲根汤送服至宝丹以开窍醒神、涤除痰浊，服用两剂后神识略微清醒，但手指和手臂出现抽动，小腿和膝盖不温暖，痉厥（痉挛与昏厥）的迹象已经显露，深夜时牙齿紧闭、口噤不开，摇头直视。这是火邪和风邪侵入筋脉，劫夺并灼烧血液，热邪越深则四肢厥冷越严重的征象。急需急救营分津液以熄灭风火。使用阿胶（用水化开）、生地、犀角（取汁）、麦冬、钩藤、木瓜、山栀、石斛、生藕汁煎煮，每日服用两次，症状稳定，脉象数疾减轻。去掉犀角，加入生龟甲、龙胆草专门清除肝胆的风热，病情逐渐平复。同时有一位侄孙，症状相同但脉象更加沉数，饮用腊雪汤、西瓜汁后暂时缓解。超过一定时间后又复发躁动不安、胡言乱语，服用至宝丹后稍显安静。我一看他舌干薄，牙齿像灰糕一样，断定其肾水枯竭，勉强开具方剂。诸药煎煮生地、犀角、生龟甲、元参、石斛等，热势随即稳定，但最终未能挽救生命。由此可知，温热病症由伏邪内发的，多死于阴虚津液枯竭的体质。
头部是诸阳经汇聚之处，烦劳损伤阳气，阳气上升带动风动，向上扰乱头顶。耳目是清虚空灵的孔窍，风阳旋涡沸腾，于是眩晕发作。这主要是因为肝胆属于风木之脏，内部寄居相火，其性质主动主升。或者由于身心过度活动，或者由于情志抑郁勃发。或者由于地气上腾，或者由于冬季藏精不密。或者由于高龄者肾液已经衰退，水不能涵养肝木。或者由于病后精神未恢复，阴不能吸纳阳，以至于眼睛昏花耳鸣，震动眩晕不定，甚至心悸舌辣，肢体麻木筋脉跳动，睡觉不能成眠，活动则自汗，起身则呕吐痰涎。无痰不作眩。这就是经典所说的“诸风掉眩，皆属于肝”。然而内风肆虐横行，虚阳上升，不是发散法可以解决的，也不是沉寒药可以清泻的，这与治疗六淫风火大不相同。治法适宜用辛甘药物化生风气，或用甘酸药物化生阴液。叶天士所谓缓和肝之急迫以熄风，滋补肾之津液以驱热，肝风既已平息，眩晕自然停止。梳理其治疗方法：如上焦窍络火郁结，用羚羊角、山栀、连翘、天花粉、丹皮、生地、桑叶、钩藤、天麻以泄热，从胆经治疗。如中焦虚弱风阳扰动胃腑，用人参、山药、黄耆、小麦、炙甘草、龙眼肉以填补，从胃经治疗。肝风内扰，阳明胃经正当其冲要，所以必须补中气。如下元肾水枯竭虚火上升，用阿胶、熟地、石斛、何首乌、杞子、天冬、黑芝麻、磁石、五味子以摄纳浮阳，从肝肾治疗。其阳气冒昧不潜藏，用牡蛎、淡茶、龟甲。痰多导致眩晕，用茯苓、川贝、橘红、竹沥、姜汁。心悸失眠，用枣仁、麦冬、茯神、龙骨。厥阳不收敛，用萸肉、白芍、牛膝炭。脾土被肝木克制，呕吐不食，宜泄肝安胃，用橘白、木瓜、半夏曲、茯苓。动怒抑郁勃发，痰火风邪交炽，用二陈汤送服龙荟丸。至于熄风的药物，如甘菊炭、煨天麻、钩藤之类，都可以随症加入。
The patient's nephew had latent pathogenic factors in the Shaoyin (Lesser Yin) channel. After the Summer Solstice, he developed diarrhea accompanied by fever, dry mouth, rapid pulse, crimson tongue, red eyes, delirium, and restlessness. After consuming juices of sugarcane, pear, and watermelon, his mania worsened, leading to coma and insomnia. This condition resulted from the scorching of the Ying (Nutrient) level of the Heart, inevitably leading to fluid exhaustion and convulsions (spasms). Initially, a decoction of fresh Rhizoma Acori Tatarinowii was used to administer Zhibao Dan (Precious Treasure Pill) to open the orifices and eliminate phlegm. After two doses, his consciousness slightly cleared, but his fingers and arms twitched, and his shins and knees were cold, indicating the onset of convulsive syncope. Late at night, his teeth clenched, his mouth was locked, his head shook, and his eyes stared fixedly. This is a sign of fire and wind invading the sinews, roasting and consuming blood, where deeper heat leads to deeper extremity coldness. Urgent rescue of Ying fluids is needed to extinguish wind-fire. An infusion of Euphorbiae Humifusae Herba (Ejiao, prepared by melting), Rehmanniae Radix (Shengdi), Rhinocerotis Cornu (Xijiao, juice), Ophiopogonis Radix (Maidong), Uncariae Ramulus cum Uncis (Gouteng), Chaenomelis Fructus (Mu Gua), Gardeniae Fructus (Shanzhi), Dendrobii Caulis (Shihu), and Lotus Root Juice (Sheng Ou Zhi) was prescribed, taken twice daily. The symptoms stabilized, and the rapid pulse decreased. Xijiao was removed, and Testudinis Carapax et Plastrum (Sheng Guijia) and Gentianae Radix (Longdan Cao) were added specifically to clear wind-heat from the Liver and Gallbladder, gradually bringing the condition under control.
Meanwhile, another nephew grandson presented with similar symptoms but a more deep and rapid pulse. He drank Latue Snow Soup and watermelon juice, which provided temporary relief. However, after a certain period, he relapsed into restlessness and delirium, calming slightly only after taking Zhibao Dan. Upon seeing his dry, thin tongue and teeth resembling gray cake, I determined that his Kidney Water was exhausted. I reluctantly prescribed a formula. An infusion of Rehmanniae Radix, Rhinocerotis Cornu, Testudinis Carapax et Plastrum, Scrophulariae Radix (Yuanshen), and Dendrobii Caulis stabilized the heat, but he ultimately could not be saved. This demonstrates that warm-heat diseases originating from latent pathogens often prove fatal in patients with Yin deficiency and fluid exhaustion.
The head is the convergence point of all Yang channels. Fatigue damages Yang; when Yang rises, it generates wind, disturbing the vertex. The ears and eyes are clear and empty orifices; when wind and Yang swirl and boil, vertigo occurs. This is fundamentally because the Liver and Gallbladder are organs of Wind-Wood, harboring Ministerial Fire within, characterized by movement and ascent. Causes may include excessive physical or mental activity, emotional depression and agitation, rising earth qi, or insufficient storage during winter. It may also result from declining Kidney fluids in the elderly, where Water fails to nourish Wood, or from incomplete recovery of spirit after illness, where Yin fails to anchor Yang. This leads to blurred vision, tinnitus, shaking vertigo, palpitations, spicy tongue sensation, limb numbness, muscle twitching, sleeplessness, spontaneous sweating upon exertion, and vomiting phlegm upon rising. "No phlegm, no vertigo." As the Classics state, "All wind-induced tremors and vertigo belong to the Liver." However, internal wind running rampant and deficient Yang ascending cannot be resolved by dispersing methods nor cleared by heavy cold herbs, differing significantly from treating external six climatic factors. The method should involve using acrid-sweet combinations to transform wind, or sweet-sour combinations to generate Yin. As Ye Tianshi stated: "Soothe the Liver's urgency to extinguish wind, nourish the Kidney's fluids to drive out heat." Once Liver wind is pacified, vertigo ceases.
The treatment methods are categorized as follows: For fire stagnation in the upper jiao orifices and collaterals, use Antelopi Cornu (Lingyangjiao), Gardeniae Fructus, Forsythiae Fructus (Lianqiao), Trichosanthis Radix (Tianhuafen), Moutan Cortex (Danpi), Rehmanniae Radix, Mori Folium (Sangye), Uncariae Ramulus cum Uncis, and Gastrodiae Rhizoma (Tianma) to drain heat, treating via the Gallbladder. For middle jiao deficiency with wind-Yang disturbing the Stomach, use Ginseng Radix et Rhizoma (Renshen), Dioscoreae Rhizoma (Shanyao), Astragali Radix (Huangqi), Triticum Semen (Xiaomai), Glycyrrhizae Radix et Rhizoma Preparata (Zhigancao), and Longan Aril (Longyanrou) to tonify, treating via the Stomach. When Liver wind disturbs internally, affecting the Yangming Stomach channel, mid-jiao must be supplemented. For lower jiao fluid exhaustion with rising fire, use Euphorbiae Humifusae Herba, Rehmanniae Radix Preparata (Shudi), Dendrobii Caulis, Polygoni Multiflori Caulis (Heshouwu), Lycii Fructus (Qizi), Asparagi Radix (Tiandong), Sesami Nigris Semen (Heima Zi), Magnetitum (Cishi), and Schisandrae Fructus (Wuweizi) to grasp and anchor, treating via the Liver and Kidneys. For Yang floating without anchoring, use Ostreae Concha (Muli), light tea, and Testudinis Carapax et Plastrum. For vertigo due to excess phlegm, use Poria (Fuling), Fritillariae Thunbergii Bulbus (Chuanbei), Citri Reticulatae Pericarpium (Juhong), Bamboo Sap (Zhuli), and Ginger Juice (Jiangzhi). For palpitations and insomnia, use Ziziphi Spinosae Semen (Zaoren), Ophiopogonis Radix, Poria with Hostwood (Fushen), and Ossis Femoris Humeri (Longgu). For unrestrained Jue-Yang, use Corni Fructus (Yurou), Paeoniae Radix Alba (Baishao), and Achyranthis Bidentatae Radix Carbonized (Niuxi Tan). When Earth is overcome by Wood, causing vomiting and anorexia, soothe the Liver and harmonize the Stomach using Citri Reticulatae Pericarpium (Ju Bai), Chaenomelis Fructus, Fermented Pinelliae Rhizoma (Banxia Qu), and Poria. For anger and emotional stagnation with intense phlegm-fire and wind, administer Erchen Tang (Two-Cured Decoction) with Xiaoyao Wan (Dragon Liver Pill) below. Regarding wind-extinguishing herbs such as Chrysanthemi Flos Carbonized (Ganju Tan), calcined Gastrodiae Rhizoma, and Uncariae Ramulus cum Uncis, they can be added according to symptoms.