视其前后心间，有黑点数十，如疙蚤斑，知为羊毛瘟也。用小针于黑处一挖即出毛一茎，凡取数百茎，乃少安。日食西
瓜十一个，数日乃愈。（用药不误，而不能取效，则必反更审视，以求其不效之故，始克有济。若不效，即遽易方，数易
之后，必致迷误。此案可为审病之法。文田按∶热在胃腑，而求之肌表之间，安得见效？此白虎证也。凡善治温病者，
以汗解，其次以疹解，其次以斑解。至于斑点发黑，此阴伤于辛散之故也。而随俗指为羊毛瘟，岂非庸医乎？）
吴桥治朝有濡，壮年，偶以讼系士师，归家数日而发热。医以为痰火，治之旬日，而病益危。桥诊之，六
脉隐见不常，且举身紫斑发矣。耳聋口噤，目上视，循衣摸床，昏瞀绝食者五日。语所亲曰∶疫也。即以寒水
下辰砂六一散，稍饮辄少安。寻授柴胡石膏犀角汤，一再服而病去其大半，七日愈。（《太函集》。）
杨玉衡曰∶乙亥、丙子、丁丑之间，吾邑连歉，瘟气盛行，用赔赈散治愈无算。方用白僵蚕酒炒二钱，蝉
蜕一钱，广姜黄去皮三分，生大黄四钱，共为末，每服一钱八分二厘五毫，用黄酒一杯，蜂蜜五钱，调匀冷
服，中病即止，因易其名曰升降散。盖取僵蚕、蝉蜕升阳中之清阳，姜黄、大黄降阴中之浊阴，一升一降，内
外通和，而杂气之流毒顿息矣。炼蜜为丸，名太极丸，服法同。
刘兆平年八旬，患瘟病，表里大热，气喷如火，舌黄口燥，谵语发狂，脉洪长滑数。杨用河间双解散治之，
大汗不止，举家惊惶，复饮一服汗止。但本证未退，改制增损双解散∶白僵蚕酒炒三钱，全蝉蜕十二枚，广姜
黄七分，防风、薄荷叶、荆芥穗、当归、白芍、黄连、连翘、栀子各一钱，黄芩、桔梗各二钱，石膏六钱，滑
石三钱，甘草一钱，酒浸大黄二钱，芒硝二钱。水煎去渣，冲芒硝，入蜜三匙，黄酒半杯，和匀冷服，两剂而
痊。因悟麻黄春夏时，不可轻用也。（杨玉衡名璇，着有《寒温条辨》。）
孙文垣治何明吾，时疫食复，大便不通，呕恶，内热昏愦，或作梦语，循衣摸床，此热在心包络。以竹茹、
麦冬、知母、山栀各一钱，陈皮、半夏曲、酸枣仁、枳实各八分，甘草三分，服之，夜半人事稍清。余热未散，
用石膏三钱，知母二钱，竹茹、麦冬、生枣仁各一钱，天花粉、陈皮各七分，枳实、麦芽、半夏曲各六分，大
便行而热退。
鲍五保患时疫，耳聋，身热口渴，大便五日不行，人事不清。竹叶、黄芩、柴胡、半夏曲、甘草、枳壳、
天花粉、知母，煎服，而热渴更甚，大便行而泻，手挛缩不能伸，且发呃咳嗽。改用柴胡、石膏、竹茹、人参、
甘草、麦冬、半夏曲、橘红、黄芩、黄连，一服而呃止泻除，诸症悉愈。
朱氏子头痛身热，口渴气促，申酉时潮热更甚，舌心焦黑，遍身紫斑，语言不清，发呃耳聋。误进藿香正
气散，加呕逆水泻。又服柴苓汤，呕益甚，热转剧，六脉洪数。此少阳阳明合病之疫，用石膏五钱，知母、柴
胡各三钱，黄芩一钱五分，半夏曲、麦冬、竹茹、橘红、葛根各一钱，粉草、枳实各五分。服下热退其七，舌
不燥，再以柴胡、半夏曲、白芍、竹茹各一钱，石膏三钱，麦冬、知母各一钱五分，黄连、甘草、人参各五
分，饮之而斑退，诸症悉平。
江右熊二官疫后食复，额痛口渴，谵语神昏，面青舌黑，鼻中停灰，不省人事，小水短少。势已危急，以
小柴胡汤去半夏，加石膏、知母、当归、山栀、豆豉、枳实与之，一帖得微汗，热退大半。次日，以柴胡、滑
石、甘草、知母、石膏、人参、桔梗、黄芩、花粉与之，舌黑退，人事清，饮食进而愈。
程竹坡室，年过六十，染疫，头疼口渴，舌苔前黄燥，后紫黑，身热沉重，人事昏愦，语言错乱，小水短
涩，呕逆烦躁，耳聋，胸胁痛，时五月初旬也。脉左浮而弦数，右洪长而数，邪在少阳、阳明二经。即以柴胡、
石膏为君，知母、麦冬、天花粉、竹茹为臣，黄连为佐，甘草、枳壳、桔梗为使，二帖得微汗，热退神清。因
骤进荤粥，又大热，谵语昏沉，此食复也。以小柴胡加山栀子、枳实、淡豆豉、鳖甲，四帖复得汗，热退神清。
仍口渴躁烦，以生脉汤加黄连、香薷、竹茹、竹叶而安。
程元祖春瘟食复，人事昏沉，内热口渴，舌如焦煤，胁痛耳聋，身热如火，僵硬不能转，脉数，左数右洪
大而数。以柴胡、石膏各五钱，黄芩、知母、葛根各二钱，山栀子、枳实各三钱，甘草五分，进三帖，额上微
汗，腹中雷鸣，大便行三次，皆清水，热仍不退，右寸稍软。前方加人参七分，又二帖，汗出热退。身仍僵，
口仍渴，耳仍聋，泻亦不止，汗亦不收，勺粒不进者，已十三日。以人参、麦冬、白芍、石斛各一钱，五味子
十一粒，当归八分，桂枝三分，黄柏、甘草各五分投之，左脉已弱，咳嗽，人事渐爽，粥饮稍进，泻止，稍
可转身，大有生气。以四物汤加苡仁、甘草、陈皮、白术、石斛、百合、贝母，调理一月而瘳。
金溪令臧太夫人，劳倦后多食鱼虾，偶发寒热，三日不退。第四日，左耳前后及颊车皆红肿。第五日，右
边赤肿。第六日，肿及满头，红大如斗，眼合无缝，昏愦谵语。粒米不进者八日，六部脉洪长而数，此大头疫
也，乃阳明少阳二经壅热所致。高年不敢用硝、黄，惟宜轻清解散之剂，使因微汗而解。以贯众、石膏各六钱，
柴胡、葛根各三钱，赤芍、天花粉各二钱，甘草一钱，黑豆四十九粒，日进二帖，脉始减半。第九日方进粥饮，
前药除石膏，又四帖而安。
一仆发热头疼，口渴腹痛，小便赤，大便泻，日夜不睡者六日。孙诊之曰∶据脉汗后浮数，热不减，乃疫
症也。以滑石三钱，青蒿、葛根、白芷、片芩各一钱半，炙甘草、升麻各五分，一帖即得睡，热减半，头疼除。
惟小水赤，头晕，脚膝无力，此病后血虚之故。以四物汤加青蒿、酒芩、苡仁，服之而安。
雍正癸丑，疫气流行，抚吴使者嘱叶天士制方救之。叶曰∶时毒疠气，必应司天，癸丑湿土气化营运，后
天太阳寒水，湿寒合德，挟中运之火，流行气交，阳光不治，疫气大行。故凡人之脾胃虚者，乃应其疠气，邪
从口鼻皮毛而入。病从湿化者，发热目黄，胸满，丹疹泄泻，当察其舌色，或淡白，或舌心干焦者，湿邪犹在
气分，甘露消毒丹治之。若壮热，旬日不解，神昏谵语，斑疹，当察其舌，绛干光圆硬，津涸液枯，是寒从火
化，邪已入营矣，用神犀丹治之。甘露消毒丹方∶飞滑石十五两，淡黄芩十两，茵陈十一两，藿香四两，连
翘四两，石菖蒲六两，白蔻仁四两，薄荷四两，木通五两，射干四两，川贝母五两，生晒研末，每服三钱，开水
调下。或神面糊丸如弹子大，开水化服亦可。神犀丹方∶犀角尖六两，生地一斤熬膏，香豆豉八两熬膏，连翘
十两，黄芩六两，板蓝根九两，银花一斤，金汁十两，元参七两，花粉四两，石菖蒲六两，紫草四两，即
用生地、香豉、金汁捣丸，每丸三钱重，开水磨服。二方活人甚众，时比之普济消毒饮云。
雄按∶普济解毒饮乃湿温时疫之主方，神犀丹乃温热暑疫之主方也。若初病即觉神情躁乱，而舌赤口干
者，是温暑直入营分。酷热之时，阴虚之体，及新产妇人，最易患此，急用神犀丹，多可挽回，切勿拘泥
日数，误投别药，以致偾事。兼治痘麻毒重，挟带紫斑，及麻痘后余毒内炽，口糜咽腐，目赤神烦，
等症。方中银花，有鲜者捣汁用尤良。如无金汁，可用人中黄四两研入。无板蓝根，以飞净青黛代之。
观察患者前后心间，有数十个黑点，像跳蚤咬的斑痕一样，知道这是羊毛瘟。用小针在黑处一挑，立刻能挑出一根毛，总共取出了几百根毛，病情才稍微安定下来。每天吃十一个西瓜，过了几天才痊愈。（用药没有错误，但不能见效，就必须重新审视，寻找无效的原因，这样才能得到救治。如果无效，就立即更换方剂，多次更换之后，必然导致误诊误治。这个案例可以作为审察病情的方法。文田按语：热邪在胃腑，却从肌表去求治，怎么能见效呢？这是白虎汤证。凡是善于治疗温病的人，首选发汗解表，其次是出疹而解，再次是出斑而解。至于斑点发黑，这是因为阴液被辛散药物耗伤的缘故。却随俗称为羊毛瘟，这难道不是庸医吗？）
吴桥治疗朝有濡，脉象濡软，正值壮年，偶然因为诉讼被关押在官府，回家几天后发热。医生认为是痰火，治疗十天，病情更加危急。吴桥诊察他，六脉隐现无常，而且全身出现紫斑。耳聋口噤，眼睛上翻，循衣摸床（无意识地抓摸衣物和床沿），昏迷不食五天。他对亲近的人说：这是疫病。立即用寒水送服辰砂六一散，稍加饮用后病情稍安。随后给予柴胡石膏犀角汤，服用一两次后，病去大半，七天痊愈。（出自《太函集》。）
杨玉衡说：乙亥、丙子、丁丑年间，我们县连续歉收，瘟疫之气盛行，用赔赈散治愈了无数人。方子用白僵蚕酒炒二钱，蝉蜕一钱，广姜黄去皮三分，生大黄四钱，共研为末，每次服用一钱八分二厘五毫，用黄酒一杯，蜂蜜五钱，调匀冷服，中病即止，因此改名为升降散。大概是取僵蚕、蝉蜕升发阳中之清阳，姜黄、大黄降泄阴中之浊阴，一升一降，内外通和，于是杂气的流毒顿时平息。炼蜜为丸，名叫太极丸，服用方法相同。
刘兆平八十岁，患瘟疫病，表里大热，气息喷吐如火，舌苔黄口干燥，谵语发狂，脉象洪长滑数。杨医生用河间双解散治疗，大汗不止，全家惊慌，再服用一服后汗止。但本证未退，改制增损双解散：白僵蚕酒炒三钱，全蝉蜕十二枚，广姜黄七分，防风、薄荷叶、荆芥穗、当归、白芍、黄连、连翘、栀子各一钱，黄芩、桔梗各二钱，石膏六钱，滑石三钱，甘草一钱，酒浸大黄二钱，芒硝二钱。水煎去渣，冲入芒硝，加入蜂蜜三匙，黄酒半杯，和匀冷服，两剂后痊愈。由此领悟到麻黄在春夏时节不可轻易使用。（杨玉衡名璇，著有《寒温条辨》。）
孙文垣治疗何明吾，时疫后因饮食复发，大便不通，呕吐恶心，内热昏愦，有时说梦话，循衣摸床，这是热邪在心包络。用竹茹、麦冬、知母、山栀各一钱，陈皮、半夏曲、酸枣仁、枳实各八分，甘草三分，服用后，半夜人事稍清。余热未散，用石膏三钱，知母二钱，竹茹、麦冬、生枣仁各一钱，天花粉、陈皮各七分，枳实、麦芽、半夏曲各六分，大便通畅后热退。
鲍五保患时疫，耳聋，身热口渴，大便五日不行，人事不清。用竹叶、黄芩、柴胡、半夏曲、甘草、枳壳、天花粉、知母，煎服，结果热渴更甚，大便行而腹泻，手挛缩不能伸展，且发生呃逆咳嗽。改用柴胡、石膏、竹茹、人参、甘草、麦冬、半夏曲、橘红、黄芩、黄连，服用一剂后呃止泻除，诸症悉愈。
朱氏之子头痛身热，口渴气促，申酉时潮热更甚，舌心焦黑，遍身紫斑，语言不清，发呃耳聋。误进藿香正气散，加重呕吐逆乱和水泻。又服柴苓汤，呕吐更甚，热势转剧，六脉洪数。这是少阳阳明合病的疫病，用石膏五钱，知母、柴胡各三钱，黄芩一钱五分，半夏曲、麦冬、竹茹、橘红、葛根各一钱，粉草、枳实各五分。服用后热退七成，舌不燥，再用柴胡、半夏曲、白芍、竹茹各一钱，石膏三钱，麦冬、知母各一钱五分，黄连、甘草、人参各五分，饮之而斑退，诸症悉平。
江右熊二官疫后食复，额痛口渴，谵语神昏，面青舌黑，鼻中停灰，不省人事，小水短少。病情已危急，用小柴胡汤去半夏，加石膏、知母、当归、山栀、豆豉、枳实与之，一帖得微汗，热退大半。次日，以柴胡、滑石、甘草、知母、石膏、人参、桔梗、黄芩、花粉与之，舌黑退，人事清，饮食进而愈。
程竹坡的妻子，年过六十，染疫，头疼口渴，舌苔前黄燥，后紫黑，身热沉重，人事昏愦，语言错乱，小水短涩，呕逆烦躁，耳聋，胸胁痛，当时是五月初旬。脉左浮而弦数，右洪长而数，邪在少阳、阳明二经。即以柴胡、石膏为君药，知母、麦冬、天花粉、竹茹为臣药，黄连为佐药，甘草、枳壳、桔梗为使药，二帖得微汗，热退神清。因突然进食荤粥，又大热，谵语昏沉，这是食复。用小柴胡加山栀子、枳实、淡豆豉、鳖甲，四帖复得汗，热退神清。仍口渴躁烦，以生脉汤加黄连、香薷、竹茹、竹叶而安。
程元祖春瘟食复，人事昏沉，内热口渴，舌如焦煤，胁痛耳聋，身热如火，僵硬不能转动，脉数，左数右洪大而数。用柴胡、石膏各五钱，黄芩、知母、葛根各二钱，山栀子、枳实各三钱，甘草五分，进三帖，额上微汗，腹中雷鸣，大便行三次，皆清水，热仍不退，右寸稍软。前方加人参七分，又二帖，汗出热退。身仍僵，口仍渴，耳仍聋，泻亦不止，汗亦不收，勺粒不进者，已十三日。用人参、麦冬、白芍、石斛各一钱，五味子十一粒，当归八分，桂枝三分，黄柏、甘草各五分投之，左脉已弱，咳嗽，人事渐爽，粥饮稍进，泻止，稍可转身，大有生气。以四物汤加苡仁、甘草、陈皮、白术、石斛、百合、贝母，调理一月而瘳。
金溪令臧太夫人，劳倦后多食鱼虾，偶发寒热，三日不退。第四日，左耳前后及颊车皆红肿。第五日，右边赤肿。第六日，肿及满头，红大如斗，眼合无缝，昏愦谵语。粒米不进者八日，六部脉洪长而数，这是大头疫，乃阳明少阳二经壅热所致。高年不敢用硝、黄，惟宜轻清解散之剂，使因微汗而解。用贯众、石膏各六钱，柴胡、葛根各三钱，赤芍、天花粉各二钱，甘草一钱，黑豆四十九粒，日进二帖，脉始减半。第九日方进粥饮，前药除石膏，又四帖而安。
一仆发热头疼，口渴腹痛，小便赤，大便泻，日夜不睡者六日。孙文垣诊之曰：据脉汗后浮数，热不减，乃是疫症也。用滑石三钱，青蒿、葛根、白芷、片芩各一钱半，炙甘草、升麻各五分，一帖即得睡，热减半，头疼除。惟小水赤，头晕，脚膝无力，这是病后血虚的缘故。用四物汤加青蒿、酒芩、苡仁，服之而安。
雍正癸丑年，疫气流行，抚吴使者嘱叶天士制方救之。叶天士说：时毒疠气，必应司天，癸丑湿土气化营运，后天太阳寒水，湿寒合德，挟中运之火，流行气交，阳光不治，疫气大行。所以凡人之脾胃虚者，乃应其疠气，邪从口鼻皮毛而入。病从湿化者，发热目黄，胸满，丹疹泄泻，当察其舌色，或淡白，或舌心干焦者，湿邪犹在气分，甘露消毒丹治之。若壮热，旬日不解，神昏谵语，斑疹，当察其舌，绛干光圆硬，津涸液枯，是寒从火化，邪已入营矣，用神犀丹治之。甘露消毒丹方：飞滑石十五两，淡黄芩十两，茵陈十一两，藿香四两，连翘四两，石菖蒲六两，白蔻仁四两，薄荷四两，木通五两，射干四两，川贝母五两，生晒研末，每服三钱，开水调下。或神面糊丸如弹子大，开水化服亦可。神犀丹方：犀角尖六两，生地一斤熬膏，香豆豉八两熬膏，连翘十两，黄芩六两，板蓝根九两，银花一斤，金汁十两，元参七两，花粉四两，石菖蒲六两，紫草四两，即用生地、香豉、金汁捣丸，每丸三钱重，开水磨服。二方活人甚众，时比之普济消毒饮云。
雄按：普济解毒饮乃湿温时疫之主方，神犀丹乃温热暑疫之主方也。若初病即觉神情躁乱，而舌赤口干者，是温暑直入营分。酷热之时，阴虚之体，及新产妇人，最易患此，急用神犀丹，多可挽回，切勿拘泥日数，误投别药，以致偾事。兼治痘麻毒重，挟带紫斑，及麻痘后余毒内炽，口糜咽腐，目赤神烦，等症。方中银花，有鲜者捣汁用尤良。如无金汁，可用人中黄四两研入。无板蓝根，以飞净青黛代之。
Observing the front and back of the heart region, there are dozens of black spots, resembling flea bites or macules, indicating this is *Yangmao Wen* (Wool Plague). Using a small needle to pick at the black spots immediately extracts one hair strand; hundreds of strands were extracted in total, after which the condition slightly stabilized. Eating eleven watermelons daily, recovery occurred after several days. (If the medication is correct but ineffective, one must re-examine to find the cause of ineffectiveness before treatment can succeed. If ineffective, changing prescriptions hastily and repeatedly will inevitably lead to confusion and error. This case serves as a method for scrutinizing diseases. Annotation by Wentian: The heat is in the Stomach Fu organ, yet treatment was sought from the muscle and skin surface; how could it be effective? This is a *Baihu Tang* (White Tiger Decoction) pattern. Those skilled in treating Warm Diseases prioritize resolution through sweating,其次 through rash eruption, and thirdly through macule/petechiae eruption. When macules turn black, it is due to Yin injury caused by acrid-dispersing herbs. To follow popular custom and call it *Yangmao Wen* is indeed the work of a mediocre physician.)
Wu Qiao treated Chao Youru, whose pulse was soft and soggy (*Ru*). In his prime, he had been imprisoned due to a lawsuit. After returning home for a few days, he developed fever. Physicians attributed it to Phlegm-Fire and treated him for ten days, during which his condition worsened critically. Wu Qiao diagnosed him: the six pulses were intermittent and irregular, and purple macules appeared all over his body. He suffered from deafness, locked jaw, upward staring of the eyes, picking at clothes and bed sheets (*Xun Yi Mo Chuang*), coma, and refusal to eat for five days. He told his relatives, "This is an epidemic." Wu immediately administered *Chensha Liuyi San* (Cinnabar Six-One Powder) with cold water; slight relief followed minimal intake. Subsequently, *Chaihu Shigao Xijiao Tang* (Bupleurum, Gypsum, and Rhinoceros Horn Decoction) was given. After one or two doses, more than half the illness disappeared, and he recovered in seven days. (From *Taihan Ji*.)
Yang Yuheng stated: Between the years Yihai, Bingzi, and Dingchou, our county suffered consecutive poor harvests, and epidemic qi prevailed. Countless cases were cured using *Peizhen San* (Compensation Relief Powder). The formula consists of *Bai Jiangcan* (Bombyx Batryticatus), wine-fried, 2 qian; *Chantui* (Cicada Slough), 1 qian; *Guang Jianghuang* (Curcuma Longa Rhizome), peeled, 3 fen; *Sheng Dahuang* (Rhei Radix et Rhizoma), raw, 4 qian. These are ground into powder. Each dose is 1 qian 8 fen 2 li 5 hao, mixed with one cup of yellow wine and 5 qian of honey, taken cold. Stop when the disease is conquered. It was renamed *Shengjiang San* (Ascending-Descending Powder). The rationale is that *Jiangcan* and *Chantui* ascend the clear Yang within Yin, while *Jianghuang* and *Dahuang* descend the turbid Yin within Yang. One ascends, one descends, harmonizing the interior and exterior, thereby instantly halting the toxic flow of miscellaneous qi. Honey pills, named *Taiji Wan* (Supreme Ultimate Pill), have the same administration method.
Liu Zhaoping, aged eighty, suffered from a plague with severe heat in both exterior and interior. His breath felt like fire, tongue coating was yellow, mouth dry, with delirium and mania. The pulse was surging, long, slippery, and rapid. Physician Yang used *Shuangjie San* (Double Resolution Powder) from Liu Wansu's school. Profuse sweating ensued without stopping, causing family panic. A second dose stopped the sweating. However, the primary syndrome remained unresolved. Modified *Zengsun Shuangjie San* (Modified Double Resolution Powder) was prescribed: *Bai Jiangcan* (Bombyx Batryticatus), wine-fried, 3 qian; *Quan Chantui* (Cicada Slough), 12 pieces; *Guang Jianghuang* (Curcuma Longa Rhizome), 7 fen; *Fangfeng* (Saposhnikoviae Radix), *Bohe Ye* (Menthae Haplocalycis Folium), *Jingjie Sui* (Schizonepetae Spica), *Danggui* (Angelicae Sinensis Radix), *Baishao* (Paeoniae Radix Alba), *Huanglian* (Coptidis Rhizoma), *Lianqiao* (Forsythiae Fructus), *Zhizi* (Gardeniae Fructus), each 1 qian; *Huangqin* (Scutellariae Radix), *Jiegeng* (Platycodonis Radix), each 2 qian; *Shigao* (Gypsum Fibrosum), 6 qian; *Huashi* (Talcum), 3 qian; *Gancao* (Glycyrrhizae Radix et Rhizoma), 1 qian; *Jiu Jin Dahuang* (Rhei Radix et Rhizoma soaked in wine), 2 qian; *Mangxiao* (Natrii Sulfas), 2 qian. Decocted in water, strained, Mangxiao added, along with three spoons of honey and half a cup of yellow wine, mixed and taken cold. Two doses resulted in recovery. From this, he realized that *Mahuang* (Ephedrae Herba) should not be used lightly in spring and summer. (Yang Yuheng, name Xuan, authored *Hanwen Tiaobian*.)
Sun Wen Yuan treated He Mingwu, who suffered from a post-epidemic relapse due to dietary indiscretion. Symptoms included constipation, nausea/vomiting, internal heat with confusion, occasional sleep-talking, and picking at clothes/bed sheets. This indicated Heat in the Pericardium Collateral. Prescription: *Zhuru* (Bambusae Caulis in Taeniam), *Maidong* (Ophiopogonis Radix), *Zhimu* (Anemarrhenae Rhizoma), *Shanzhi* (Gardeniae Fructus), each 1 qian; *Chenpi* (Citri Reticulatae Pericarpium), *Banxia Qu* (Pinelliae Fermentatum), *Suanzaoren* (Ziziphi Spinosae Semen), *Zhishi* (Aurantii Fructus Immaturus), each 8 fen; *Gancao* (Glycyrrhizae Radix et Rhizoma), 3 fen. Taken, consciousness slightly cleared by midnight. Residual heat remained. Prescription: *Shigao* (Gypsum Fibrosum), 3 qian; *Zhimu* (Anemarrhenae Rhizoma), 2 qian; *Zhuru* (Bambusae Caulis in Taeniam), *Maidong* (Ophiopogonis Radix), *Sheng Zaoren* (Ziziphi Spinosae Semen), each 1 qian; *Tianhuafen* (Trichosanthis Radix), *Chenpi* (Citri Reticulatae Pericarpium), each 7 fen; *Zhishi* (Aurantii Fructus Immaturus), *Maiya* (Hordei Fructus Germinatus), *Banxia Qu* (Pinelliae Fermentatum), each 6 fen. Bowel movement occurred, and heat subsided.
Bao Wubao suffered from a seasonal epidemic with deafness, fever, thirst, constipation for five days, and unclear consciousness. Prescribed: *Zhuye* (Phyllostachys Viridis Folium), *Huangqin* (Scutellariae Radix), *Chaihu* (Bupleuri Radix), *Banxia Qu* (Pinelliae Fermentatum), *Gancao* (Glycyrrhizae Radix et Rhizoma), *Zhiqiao* (Aurantii Fructus), *Tianhuafen* (Trichosanthis Radix), *Zhimu* (Anemarrhenae Rhizoma), decocted and taken. Result: heat and thirst worsened, bowel movement led to diarrhea, hand spasms preventing extension, hiccups, and coughing. Changed prescription to: *Chaihu* (Bupleuri Radix), *Shigao* (Gypsum Fibrosum), *Zhuru* (Bambusae Caulis in Taeniam), *Renshen* (Ginseng Radix et Rhizoma), *Gancao* (Glycyrrhizae Radix et Rhizoma), *Maidong* (Ophiopogonis Radix), *Banxia Qu* (Pinelliae Fermentatum), *Juhong* (Citri Reticulatae Pericarpium Rubrum), *Huangqin* (Scutellariae Radix), *Huanglian* (Coptidis Rhizoma). One dose stopped hiccups and diarrhea, resolving all symptoms.
The son of the Zhu family had headache, fever, thirst, shortness of breath, tidal fever worsening at Shen/You hours (3-7 PM), scorched-black center of the tongue, purple macules all over the body, unclear speech, hiccups, and deafness. Mistakenly given *Huoxiang Zhengqi San* (Agastache Powder for Regulating the Qi), vomiting and watery diarrhea worsened. Then given *Chai Ling Tang* (Bupleurum and Poria Decoction), vomiting increased, heat intensified, and the six pulses became surging and rapid. This was an epidemic of Shaoyang-Yangming combined disease. Prescription: *Shigao* (Gypsum Fibrosum), 5 qian; *Zhimu* (Anemarrhenae Rhizoma), *Chaihu* (Bupleuri Radix), each 3 qian; *Huangqin* (Scutellariae Radix), 1.5 qian; *Banxia Qu* (Pinelliae Fermentatum), *Maidong* (Ophiopogonis Radix), *Zhuru* (Bambusae Caulis in Taeniam), *Juhong* (Citri Reticulatae Pericarpium Rubrum), *Gegen* (Puerariae Lobatae Radix), each 1 qian; *Fencao* (Glycyrrhizae Radix et Rhizoma), *Zhishi* (Aurantii Fructus Immaturus), each 5 fen. Heat reduced by 70%, tongue no longer dry. Second phase: *Chaihu* (Bupleuri Radix), *Banxia Qu* (Pinelliae Fermentatum), *Baishao* (Paeoniae Radix Alba), *Zhuru* (Bambusae Caulis in Taeniam), each 1 qian; *Shigao* (Gypsum Fibrosum), 3 qian; *Maidong* (Ophiopogonis Radix), *Zhimu* (Anemarrhenae Rhizoma), each 1.5 qian; *Huanglian* (Coptidis Rhizoma), *Gancao* (Glycyrrhizae Radix et Rhizoma), *Renshen* (Ginseng Radix et Rhizoma), each 5 fen. Macules faded, all symptoms resolved.
Xiong Erguan from Jiangyou suffered a post-epidemic dietary relapse. Symptoms: forehead pain, thirst, delirium, coma, blue face, black tongue, gray residue in nose, unconsciousness, scanty urination. Condition critical. Prescribed *Xiao Chaihu Tang* (Minor Bupleurum Decoction) minus *Banxia*, plus *Shigao* (Gypsum Fibrosum), *Zhimu* (Anemarrhenae Rhizoma), *Danggui* (Angelicae Sinensis Radix), *Shanzhi* (Gardeniae Fructus), *Douchi* (Sojae Semens Praeparatum), *Zhishi* (Aurantii Fructus Immaturus). One dose produced slight sweat, heat reduced by more than half. Next day: *Chaihu* (Bupleuri Radix), *Huashi* (Talcum), *Gancao* (Glycyrrhizae Radix et Rhizoma), *Zhimu* (Anemarrhenae Rhizoma), *Shigao* (Gypsum Fibrosum), *Renshen* (Ginseng Radix et Rhizoma), *Jiegeng* (Platycodonis Radix), *Huangqin* (Scutellariae Radix), *Huafen* (Trichosanthis Radix). Black tongue receded, consciousness cleared, appetite returned, recovery achieved.
The wife of Cheng Zhupo, over sixty, contracted an epidemic. Symptoms: headache, thirst, anterior tongue coating yellow and dry, posterior coating purple-black, heavy fever, coma, confused speech, scanty/astringent urination, vomiting/reflux, irritability, deafness, chest/hypochondriac pain. Time: early May. Pulse: left floating, wiry, rapid; right surging, long, rapid. Pathogen in Shaoyang and Yangming meridians. Formula: *Chaihu* (Bupleuri Radix), *Shigao* (Gypsum Fibrosum) as Sovereign; *Zhimu* (Anemarrhenae Rhizoma), *Maidong* (Ophiopogonis Radix), *Tianhuafen* (Trichosanthis Radix), *Zhuru* (Bambusae Caulis in Taeniam) as Ministers; *Huanglian* (Coptidis Rhizoma) as Assistant; *Gancao* (Glycyrrhizae Radix et Rhizoma), *Zhiqiao* (Aurantii Fructus), *Jiegeng* (Platycodonis Radix) as Envoys. Two doses produced slight sweat, heat receded, consciousness cleared. Due to sudden intake of meat/gruel, high fever returned, delirium/coma recurred—this was a dietary relapse. Prescribed *Xiao Chaihu Tang* plus *Shanzhi* (Gardeniae Fructus), *Zhishi* (Aurantii Fructus Immaturus), *Dan Douchi* (Sojae Semens Praeparatum), *Biejia* (Testudinis Carapax et Plastrum). Four doses produced sweat, heat receded, consciousness cleared. Still thirsty and irritable. Prescribed *Shengmai San* (Generate the Pulse Powder) plus *Huanglian* (Coptidis Rhizoma), *Xiangru* (Elsholtziae Herba), *Zhuru* (Bambusae Caulis in Taeniam), *Zhuye* (Phyllostachys Viridis Folium). Condition stabilized.
Cheng Yuanzu suffered a spring plague with dietary relapse. Symptoms: coma, internal heat/thirst, tongue like burnt coal, hypochondriac pain/deafness, fever like fire, stiffness preventing turning, rapid pulse, left rapid, right surging-large-rapid. Prescription: *Chaihu* (Bupleuri Radix), *Shigao* (Gypsum Fibrosum), each 5 qian; *Huangqin* (Scutellariae Radix), *Zhimu* (Anemarrhenae Rhizoma), *Gegen* (Puerariae Lobatae Radix), each 2 qian; *Shanzhi* (Gardeniae Fructus), *Zhishi* (Aurantii Fructus Immaturus), each 3 qian; *Gancao* (Glycyrrhizae Radix et Rhizoma), 5 fen. Three doses: slight sweat on forehead, borborygmus, three bowel movements of clear water, heat persisted, right Cun pulse slightly soft. Added *Renshen* (Ginseng Radix et Rhizoma), 7 fen to previous formula. Two more doses: sweat and heat receded. Body still stiff, mouth still thirsty, ears still deaf, diarrhea uncontrolled, sweat uncontrollable, no food intake for 13 days. Prescription: *Renshen* (Ginseng Radix et Rhizoma), *Maidong* (Ophiopogonis Radix), *Baishao* (Paeoniae Radix Alba), *Shihu* (Dendrobii Caulis), each 1 qian; *Wuweizi* (Schisandrae Chinensis Fructus), 11 grains; *Danggui* (Angelicae Sinensis Radix), 8 fen; *Guizhi* (Cinnamomi Ramulus), 3 fen; *Huangbai* (Phellodendri Cortex), *Gancao* (Glycyrrhizae Radix et Rhizoma), each 5 fen. Left pulse weakened, coughing, consciousness gradually improved, gruel/drink intake resumed, diarrhea stopped, able to turn slightly, signs of life revived. Prescribed *Siwu Tang* (Four Substance Decoction) plus *Yiren* (Coicis Semen), *Gancao* (Glycyrrhizae Radix et Rhizoma), *Chenpi* (Citri Reticulatae Pericarpium), *Baizhu* (Atractylodis Macrocephalae Rhizoma), *Shihu* (Dendrobii Caulis), *Baihe* (Lilii Bulbus), *Beimu* (Fritillariae Cirrhosae Bulbus). Regulated for one month until recovery.
Lady Zang, wife of the Magistrate of Jinxian, after fatigue and excessive consumption of fish/shrimp, developed alternating chills and fever for three days. Day 4: redness/swelling around left ear and masseter. Day 5: right side red/swollen. Day 6: swelling spread to entire head, red as large as a bucket, eyes closed tight, coma/delirium. No food for eight days. Six pulses surging, long, rapid. Diagnosis: *Datou Yi* (Great Head Epidemic), caused by stagnant heat in Yangming and Shaoyang meridians. Due to advanced age, avoided *Xiaoshi* (Natrii Sulfas) and *Dahuang* (Rhei Radix et Rhizoma). Used light/clear resolving agents to induce slight sweat. Prescription: *Guanzhong* (Cyathulae Officinalis Rhizoma), *Shigao* (Gypsum Fibrosum), each 6 qian; *Chaihu* (Bupleuri Radix), *Gegen* (Puerariae Lobatae Radix), each 3 qian; *Chishao* (Paeoniae Radix Rubra), *Tianhuafen* (Trichosanthis Radix), each 2 qian; *Gancao* (Glycyrrhizae Radix et Rhizoma), 1 qian; *Heidou* (Phaseoli Radiati Semen), 49 grains. Two doses daily. Pulses halved. Day 9: resumed gruel/drink. Previous formula minus *Shigao*, four more doses until stable.
A servant had fever, headache, thirst, abdominal pain, red urine, diarrhea, insomnia for six days. Sun [Wen Yuan] diagnosed: Pulse floating-rapid after sweating, heat unchanged, indicates epidemic syndrome. Prescription: *Huashi* (Talcum), 3 qian; *Qinghao* (Artemisiae Annuae Herba), *Gegen* (Puerariae Lobatae Radix), *Baizhi* (Angelicae Dahuricae Radix), *Pian Qin* (Scutellariae Radix slice), each 1.5 qian; *Zhi Gancao* (Prepared Glycyrrhizae Radix et Rhizoma), *Shengma* (Cimicifugae Rhizoma), each 5 fen. One dose: slept, heat halved, headache removed. Remaining symptoms: red urine, dizziness, weak legs/knees—due to blood deficiency post-illness. Prescription: *Siwu Tang* (Four Substance Decoction) plus *Qinghao* (Artemisiae Annuae Herba), *Jiu Qin* (Scutellariae Radix soaked in wine), *Yiren* (Coicis Semen). Condition stabilized.
In the Guiyou year of Yongzheng, epidemic qi prevailed. The Governor of Wu instructed Ye Tianshi to formulate a remedy. Ye said: Seasonal toxic pestilence corresponds to the ruling Qi. Guiyou is Wet Earth operation. Post-heaven Taiyang Cold Water combines with Wet-Cold, carrying Middle-Transport Fire, circulating in Qi-Jiao. Solar Yang fails to govern, epidemic qi spreads widely. Thus, those with deficient Spleen/Stomach respond to this pestilence; pathogen enters via mouth/nose/skin-hair. If disease transforms via Dampness: fever, yellow eyes, chest fullness, erysipelas/rash, diarrhea. Observe tongue: if pale white or dry/scorched center, Dampness remains in Qi Level. Treat with *Ganlu Xiaodu Dan* (Sweet Dew Detoxifying Decoction). If high fever persists ten days, coma/delirium, macules/rash: observe tongue—if crimson, dry, smooth, round, hard, fluids exhausted, Cold has transformed into Fire, pathogen entered Ying Level. Treat with *Shenxi Dan* (Divine Rhinoceros Horn Pill).
*Ganlu Xiaodu Dan*: *Fei Huashi* (Talcum), 15 liang; *Dan Huangqin* (Scutellariae Radix), 10 liang; *Yinchen* (Artemisiae Scopariae Herba), 11 liang; *Huoxiang* (Agastaches Rugosae Herba), 4 liang; *Lianqiao* (Forsythiae Fructus), 4 liang; *Shichangpu* (Acori Tatarinowii Rhizoma), 6 liang; *Baokouren* (Amomi Fructus Rotundus), 4 liang; *Bohe* (Menthae Haplocalycis Folium), 4 liang; *Mutong* (Akebiae Caulis), 5 liang; *Shegan* (Belamcandae Rhizoma), 4 liang; *Chuan Beimu* (Fritillariae Cirrhosae Bulbus), 5 liang. Sun-dried, ground to powder. Take 3 qian, mix with boiled water. Or make pills size of bullets with divine wheat paste, dissolve in boiled water.
*Shenxi Dan*: *Xijiao Jian* (Rhinocerotis Cornu), 6 liang; *Shengdi* (Rehmanniae Radix), 1 jin (boiled to paste); *Xiang Douchi* (Sojae Semens Praeparatum), 8 liang (boiled to paste); *Lianqiao* (Forsythiae Fructus), 10 liang; *Huangqin* (Scutellariae Radix), 6 liang; *Banlangen* (Isatidis Radix), 9 liang; *Yinhua* (Lonicerae Japonicae Flos), 1 jin; *Jinzhi* (Human Excrement Juice), 10 liang; *Yuannan* (Scrophulariae Radix), 7 liang; *Huafen* (Trichosanthis Radix), 4 liang; *Shichangpu* (Acori Tatarinowii Rhizoma), 6 liang; *Zicao* (Leonuri Herba), 4 liang. Use Shengdi, Xiangshi, Jinzhi to pound into pills. Each pill 3 qian, grind in boiled water. Both formulas saved many, compared to *Puji Xiaodu Yin*.
Annotation by Xiong: *Puji Jiedu Yin* is the main formula for Damp-Warmth seasonal epidemics; *Shenxi Dan* is the main formula for Warm-Heat Summer-Epidemics. If initial illness presents with agitation/confusion, red tongue, dry mouth, Warm-Heat directly enters Ying Level. During extreme heat, Yin-deficient constitutions and postpartum women are most susceptible. Urgently use *Shenxi Dan*; often reversible. Do not rigidly adhere to day counts or misprescribe other drugs, causing failure. Also treats severe vaccine/measles toxicity with purple macules, and residual toxicity after measles/vaccine causing oral ulcers/pharyngeal rot, red eyes, mental irritability. Fresh *Yinhua* (Lonicerae Japonicae Flos) pounded for juice is best. If *Jinzhi* unavailable, use *Ren Zhonghuang* (Human Excrement Stone) 4 liang ground in. If *Banlangen* unavailable, substitute with purified *Qingdai* (Indigo Naturalis).