白蔻末。再诊∶前议虚不受补，皆因夏令伏邪，着于气分。夫肺主一身之气，既因气阻，清肃不行，诸经不能
流畅，三焦悉被其蒙。前言攻邪不效，盖湿热由吸而受，与风寒感冒不同，乃氤氲虚空，聚则为殃耳。故取淡
渗无味气薄之品，仅通其上，勿动中下，俾虚无伤，伏气可去，稍佐辛香，非燥也，仿辟秽之义∶经霜桑叶、
鲜枇杷叶、茯苓、蔻仁、苡仁、芦根。此湿温犯肺之轻症疗法。
又案 清王孟英先生治验
黄纯光，年七十八岁，患湿温至旬余，脉形歇代，呃忒连朝，诸医望而畏之。孟英诊曰∶脉虽歇而弦搏有
根，是得乎天者浓，虽属高年，犹为实象。参以病深声哕，原非小故，而二便窒涩，苔腻而灰，似腑气未宣，
痰湿热阻其气化流行之道也。清宣展布，尚可图焉。何新之韪其议。因以旋复花、淡竹茹、焦山栀、川楝子、
枇杷叶、光杏仁、吴茱萸、小川连、紫菀、蒌仁、陈海蜇、大地栗等为剂，片通草一两煎汤煮药。投匕即减，
数服而大吐胶痰，连次更衣，遂安粥食；惟动则嗽逆，渐露下虚之象。予西洋参、龟板、牡蛎、苁蓉、石斛、
牛膝、冬虫夏草、石英、茯苓、当归等药而各恙递安，继加砂仁熟地而起。
翁嘉顺之妇弟吴某，劳伤之后，发热身黄，自以为脱力也。
孟英察脉软数，是湿温重证，故初起即黄。亟与清解，大便渐溏，小溲甚赤，湿热已得下行，其热即减。因家
住茅家埠，吝惜舆金，遽迩辍药。七八日后复热，谵语昏聋，抽痉遗溺，再恳孟英视之，湿热之邪扰营矣。投
元参、犀角、菖蒲、连翘、竹茹、竹叶、银花、石膏，泄卫清营之法，佐牛黄丸、紫雪丹而瘳。臀皮已塌，亟
令贴羊皮金，不致成疮而愈。
又案 清周雪樵先生治验
去年七月内人患湿温，初亦不以为意，而内人素性不肯服药，仆亦听之。至五六日，病情忽重，其状恶寒
发热，热高一百零三度，头痛胸痞，渴甚而不能饮，数日不食，亦不大便，苔白腻如粉而浓，与以饮食，绝不
知味，口出秽气，数尺外即闻之，神思迷糊，语无伦次，大有垂危之势。仆乃自制化浊汤，以浓朴为君，佐以
藿香、黄芩、前胡、腹皮、佩兰、枳壳、香豉、栀仁等，而加玉枢丹以降之，一剂后，热竟全退，神思亦清。
但苔腻如故，大便不行，仍不能进食，乃以轻泻药药通其大便，兼以平胃散法调理之，至五六日后，食始知味，
又二三日乃能起。
朱雅南先生之二哲嗣达哉，去年秋，兄弟夫妇同就学于沪，其来也途次感冒，复饥饱不节，至寓而病湿温，
头晕发热，胸痞作恶，吐出痰饮甚多。初以涤饮剂治之，热益重，至一百零四度许，周身瘫痪，口出秽气，苔
腻如粉，神识迷蒙，其兄甚焦急。仆仍用化浊汤治之，而重加苏梗。一剂后，得大汗甚彻，热竟全退，神识亦清；
但大便已六七日不行，秽气苔色仍如故，用前方加减，入制大黄三钱下之，一剂不知，再加大黄二钱，又二剂乃
得大便，秽气顿已，食亦渐进。仆曰∶病已去矣，但以饮食善调之自愈，不必服药矣。
今年四月初，同乡汪太史渊若之次子廉卿，年四岁，亦病湿温，但尚不能自言其苦，屡屡惊厥，有一次厥去
一点钟许，家
人意为死而哭，幸复苏，数夕不得眠。邀仆治之，见其色惨白，其头倒，其神思倦怠，喉间咯咯有声，脉滑数，
知有痰极多，按其腹满而软，曰∶数日不食，不应有此，殆有食积。以表候其腋下，得一百零二度，曰∶口中之
度，必零三度许也。其汗则粘腻非常，泣而无泪，渴且嗜饮，然卧时复被，不知自去之也，知必有表邪。又每
以手自按其头，知头必有痛胀等事。口中亦有秽气，数武外即可嗅而知之。因知亦为化浊汤之症，亦以此方与之，
而改苏梗为苏子，用玉枢丹四分。未服药之前，尚惊厥，请推拿者推之。始已。服药数分钟后，忽呕出胶痰两大
堆，约一小钟许，粘浓成块，又数点钟后，得大便一次，极臭而多，其色黑，此夕即能安卧，明日复诊，则热
退神清，病竟全去，以搜捕余邪法治之，曰∶一剂后，可不药矣。次日竟下地行走如常。
廉按∶湿热与湿温似同实异，湿热者，先受湿，后化热，其来也渐；湿温者，先伏温，后受湿，其来也暴。
湿热轻而湿温重。初起时，最要辨明孰轻孰重，如湿重于温者，当以吴氏三仁汤、周氏化浊汤二方为主。即雪樵君
云∶湿温之病，多在胃肠，舌苔滑白浓腻者，重用川朴为君；口有秽气者，玉枢丹亦要药。其说甚是。如温重于
湿者，当以加减藿朴夏苓汤、清芳透邪汤二方为主。湿与温并重，当以新定达原饮、枳实栀豉合小陷胸汤加减，或
藿香佐金汤亦佳。此治湿温初起之方法也。其他变症甚多，论中方法毕备，对症酌用可也。今所选之案虽少，而
大致粗备，亦足为后学导夫先路矣。
又按∶验方妙用论中，添加百八十四方，以上统计五百十一方。
白蔻粉。复诊：前次讨论认为患者体质虚弱，无法承受补益，这都是因为夏季潜伏的邪气，停留在气分。肺主一身之气，既然气机阻滞，清肃功能不能正常行使，各条经脉也不能流畅运行，三焦都被其蒙蔽。之前说攻逐邪气没有效果，大概是因为湿热是通过呼吸吸入而受邪的，与风寒感冒不同，它是弥漫于虚空之中，聚集起来就造成祸害。所以选取淡渗无味、气味轻薄的药物，仅疏通上焦，不要扰动中下焦，使虚无受损，伏留的气机得以去除，稍微佐以辛香之品，并非燥烈，是仿照辟秽的意义：经霜的桑叶、鲜枇杷叶、茯苓、白蔻仁、薏苡仁、芦根。这是湿温犯肺的轻症疗法。
又一案 清代王孟英先生治疗验案
黄纯光，七十八岁，患湿温病十多天，脉搏出现歇止（代脉），呃逆连续不断，其他医生看了都畏惧不敢治。王孟英诊察后说：脉搏虽然歇止但弦急搏动有根底，这是先天禀赋浓厚，虽然属于高龄，仍表现为实证。结合病情深重且声音嘶哑呃逆，原本就不是小毛病，而且二便不通畅，舌苔腻而发灰，似乎是腑气没有宣通，痰、湿、热阻断了气化流行的道路。用清宣展布的方法，还可以图谋治愈。何新之认为他的议论很正确。于是用旋覆花、淡竹茹、焦山栀、川楝子、枇杷叶、光杏仁、吴茱萸、小川连、紫菀、瓜蒌仁、陈海蜇、大地栗等作为药方，用一两片通草煎汤来煮药。服用后立即减轻，服几剂后大吐胶状痰液，连续多次排便，于是能够喝粥进食；只是活动后就咳嗽气逆，逐渐显露出下焦虚弱的迹象。给予西洋参、龟板、牡蛎、肉苁蓉、石斛、牛膝、冬虫夏草、石英、茯苓、当归等药物，各种症状依次安定，随后加入砂仁、熟地黄而痊愈。
翁嘉顺妻子的弟弟吴某，在劳伤之后，发热身体发黄，自己认为是脱力所致。
王孟英诊察脉搏软而数，这是湿温的重证，所以初起时就发黄。紧急给予清热解表，大便逐渐变稀，小便非常红赤，湿热已经得到下行，热势随即减退。因为家住茅家埠，吝惜车费，就立刻停止服药。七八天后再次发热，胡言乱语、昏沉耳聋、抽搐痉挛、遗尿，再次恳请王孟英诊治，这是湿热之邪扰乱了营分。投用元参、犀角、石菖蒲、连翘、竹茹、竹叶、金银花、石膏，采用泄卫清营的方法，佐以牛黄丸、紫雪丹而痊愈。臀部皮肤已经塌陷，急忙令其贴上羊皮金，没有形成疮疡而愈合。
又一案 清代周雪樵先生治疗验案
去年七月，我的妻子患湿温病，起初也不在意，但我妻子平素不肯服药，我也听之任之。到了五六天，病情突然加重，症状为恶寒发热，体温高达一百零三度，头痛胸闷，口渴严重却不能饮水，几天不吃饭，也不大便，舌苔白腻如粉且厚，给饮食也完全不知味道，口中发出臭气，几尺外就能闻到，神志迷糊，说话没有条理，大有垂危之势。我自己配制化浊汤，以浓朴为君药，佐以藿香、黄芩、前胡、腹皮、佩兰、枳壳、香豉、栀仁等，并加入玉枢丹以降逆，一剂后，热势竟然全部消退，神志也清醒了。但舌苔依然腻，大便不通，仍然不能进食，于是用轻泻药通便，兼以平胃散法调理，到了五六天后，吃东西才知味道，又过了两三天才能起床。
朱雅南先生的两个儿子达哉，去年秋天，兄弟夫妇一同到上海求学，他们在途中感冒，又饥饱不节，到了住所就患了湿温病，头晕发热，胸闷恶心，吐出很多痰饮。起初用涤饮剂治疗，热势更重，达到一百零四度左右，全身瘫痪，口中发出臭气，舌苔腻如粉，神识迷蒙，他的哥哥非常焦急。我仍然用化浊汤治疗，并重加苏梗。一剂后，出了大汗且透彻，热势竟然全部消退，神识也清醒了；但大便已经六七天不通，臭气和舌苔颜色仍然如故，用前方加减，加入制大黄三钱攻下，一剂没反应，再加大黄二钱，又服两剂才得大便，臭气顿时消失，饮食也逐渐进用。我说：病已去除了，只要用饮食好好调养就会自愈，不必再服药了。
今年四月初，同乡汪太史渊若的二儿子廉卿，四岁，也患湿温病，但还不能自己诉说痛苦，屡次惊厥，有一次厥脱持续约一小时，家人以为死了而哭泣，幸好苏醒过来，几个晚上不得睡眠。邀请我诊治，见其面色惨白，头向后仰，神思倦怠，喉间咯咯有声，脉搏滑数，知道痰非常多，按压腹部胀满而软，说：几天不吃饭，不应该这样，恐怕有食积。用手表测腋下温度，得一百零二度，说：口中的温度，必定在一百零三度左右。其汗粘腻异常，哭而无泪，口渴且喜欢喝水，但睡觉时盖被子，不知道自行去掉，知道必有表邪。又见他经常用手摸自己的头，知道头部一定有疼痛肿胀等情况。口中也有臭气，几步外就可以嗅到知道。因此知道也是化浊汤的病症，也用此方给他，并将苏梗改为苏子，用玉枢丹四分。未服药之前，还有惊厥，请推拿的人推拿后才停止。服药几分钟后，忽然呕吐出两大堆胶状痰液，约一小小时左右，粘稠浓结成块，又过几个小时，排了一次大便，极臭且多，颜色黑，当晚就能安睡，第二天复诊，则热退神清，病竟全愈，用搜捕余邪的方法治疗，说：一剂后，就可以不服药了。第二天竟然下地行走如常。
廉臣按：湿热与湿温看似相同实则不同，湿热是先受湿，后化热，发病缓慢；湿温是先伏温，后受湿，发病急骤。湿热轻而湿温重。初起时，最重要的是辨明孰轻孰重，如果湿重于温，应当以吴氏三仁汤、周氏化浊汤两方为主。正如雪樵君所说：湿温的病，多在胃肠，舌苔滑白浓腻的，重用川朴为君药；口有臭气的，玉枢丹也是重要药物。这种说法很对。如果温重于湿，应当以加减藿朴夏苓汤、清芳透邪汤两方为主。湿与温并重，应当以新定达原饮、枳实栀豉合小陷胸汤加减，或者藿香佐金汤也很好。这是治疗湿温初起的方法。其他变症很多，论中的方法完备，对症酌情使用即可。现在所选的案例虽然少，但大致粗略具备，也足以为后学引导先路了。
又按：验方妙用论中，添加了一百八十四方，以上统计共五百一十一方。
White Cardamom Powder. Second consultation: The previous discussion suggested that the patient's constitution was too weak to tolerate tonification, all due to latent pathogens from summer lingering in the Qi level. The Lung governs the Qi of the whole body; since Qi is obstructed, its clear and descending function cannot operate normally, causing the meridians to fail to flow smoothly, and the Sanjiao (Triple Burner) is entirely obscured by it. The previous failure of purging methods can be attributed to the fact that Damp-Heat is received through inhalation, which differs from Wind-Cold common cold; it is misty and pervasive in the void, gathering to cause disaster. Therefore, we select bland, tasteless, and light-aroma herbs to only unblock the Upper Jiao, without disturbing the Middle and Lower Jiao, so as not to injure the emptiness, allowing the latent Qi to be expelled, slightly assisting with acrid-aromatic substances—not for dryness, but imitating the meaning of dispelling filth: Frost-treated Mulberry Leaf (Sangye), Fresh Loquat Leaf (Pipaye), Poria (Fuling), White Cardamom Seed (Kouren), Coix Seed (Yiren), Reed Rhizome (Lugen). This is the treatment method for mild cases of Damp-Warmth invading the Lung.
Another Case: Treatment Verification by Mr. Wang Mengying of the Qing Dynasty
Huang Chunguang, aged seventy-eight, suffered from Damp-Warmth for over ten days. His pulse showed intermittent pauses (Dai pulse), and hiccups persisted day after day, causing other physicians to shrink back in fear upon seeing him. Mr. Mengying diagnosed: Although the pulse has pauses, it is wiry, forceful, and rooted, indicating strong congenital endowment. Although he is of advanced age, this still presents as an Excess pattern. Considering the deep-seated disease with hoarseness and hiccups, originally not a minor issue, and given the obstruction of urination and defecation, greasy grey tongue coating, it seems the Fu organs' Qi is not unblocked, and Phlegm-Damp-Heat is blocking the pathway of Qi transformation and circulation. Clearing, dispersing, and spreading may still achieve a cure. He Xin-zhi agreed with his reasoning. Thus, he prescribed Inula Flower (Xuanfuhua), Light Bamboo Shavings (Danzhuru), Scorched Gardenia (Jiaoshanzhi), Sichuan Chinaberry Fruit (Chuanlianzi), Loquat Leaf (Pipaye), Apricot Kernel (Guangxingren), Evodia Fruit (Wuzhuyu), Small Coptis Rhizome (Xiaochuanlian), Aster Root (Ziwan), Trichosanthes Fruit (Louren), Aged Jellyfish (Chenhaidie), and Large Water Chestnut (Dadili) as the formula, decocting one tael of Common Reed Stem Pian Tong Cao to boil the herbs. After taking the first dose, symptoms immediately decreased. After several doses, he vomited large amounts of sticky phlegm, had multiple bowel movements, and was able to consume congee. However, coughing and rebellious Qi occurred upon movement, gradually revealing signs of Lower Jiao deficiency. He was given American Ginseng (Xiyangshen), Turtle Shell (Guiban), Oyster Shell (Muli), Cistanche Stem (Rongrong), Dendrobium Stem (Shihu), Achyranthes Root (Niuxi), Cordyceps (Dongchongxiacao), Quartz (Shiying), Poria (Fuling), and Angelica Sinensis Root (Danggui), after which various ailments gradually stabilized. Subsequently, adding Amomum Fruit (Sharen) and Prepared Rehmannia Root (Shudi) led to recovery.
Mr. Wu, brother-in-law of Weng Jiashun's wife, experienced fever and yellowing of the body after labor injury, believing himself to have exhausted his strength.
Mr. Mengying observed a soft and rapid pulse, identifying this as a severe case of Damp-Warmth, hence the jaundice appeared at the onset. Urgent clearing and resolving measures were taken. Stools gradually became loose, urine very red, indicating Damp-Heat was draining downward, and heat subsided. Living in Maojiabu, he was stingy with carriage fares and abruptly stopped medication. Seven or eight days later, fever recurred, accompanied by delirium, coma, deafness, convulsions, and urinary incontinence. He again requested Mr. Mengying's consultation. This indicated Damp-Heat pathogenic factors disturbing the Ying (Nutritive) level. He administered Scrophularia Root (Yuanshen), Rhinoceros Horn (Xijiao - *note: substitute with Buffalo Horn in modern practice*), Acorus Rhizome (Changpu), Forsythia Fruit (Lianqiao), Bamboo Shavings (Zhuru), Bamboo Leaves (Zhuye), Honeysuckle Flower (Yinhua), and Gypsum (Shigao), employing the method of venting the Wei level and clearing the Ying level, assisted by Calculus Bovis Pills (Niuhuang Wan) and Purple Snow Pellet (Zixue Dan), resulting in recovery. The skin on the buttocks had collapsed; urgently applying gold-beaten sheepskin prevented ulceration, leading to healing.
Another Case: Treatment Verification by Mr. Zhou Xueqiao of the Qing Dynasty
In July last year, my wife contracted Damp-Warmth. Initially, I did not pay much attention to it, but she was naturally unwilling to take medicine, and I acquiesced. By the fifth or sixth day, her condition suddenly worsened. Symptoms included aversion to cold and fever, with temperature reaching 103°F, headache, chest oppression, severe thirst unable to drink, no food intake for several days, no bowel movement, white greasy tongue coating thick like powder, complete loss of taste even when offered food, foul breath detectable from several feet away, confused mental state, incoherent speech, presenting a critical danger. I self-formulated Huazhuo Tang (Damp-Turbidity Resolving Decoction), using Magnolia Bark (Nongpu) as the sovereign herb, assisted by Patchouli Herb (Huoxiang), Scutellaria Root (Huangqin), Peucedanum Root (Qianhu), Tangerine Peel (Fupi), Eupatorium Leaf (Peilan), Bitter Orange (Zhike), Fermented Soybean (Xiangchi), and Gardenia Seed (Zhiren), and added Yushu Dan to descend rebellious Qi. After one dose, fever completely subsided, and mental clarity returned. However, the greasy tongue coating remained, bowels were still blocked, and eating was impossible. Therefore, mild laxatives were used to open the bowels, combined with Pingwei San method for regulation. After five or six days, taste returned to food, and after another two or three days, she could get up.
Mr. Zhu Yanan's second son, Da Zai, along with his brother and sister-in-law, went to Shanghai for studies last autumn. They caught a cold on the journey and suffered from irregular diet. Upon arriving at their lodging, they contracted Damp-Warmth, presenting with dizziness, fever, chest oppression, nausea, and vomiting copious phlegm-fluid. Initially treated with Phlegm-Fluid Draining agents, heat intensified to around 104°F, whole-body paralysis occurred, foul breath emitted, tongue coating greasy like powder, and consciousness was clouded. His brother was extremely anxious. I continued using Huazhuo Tang but heavily increased Perilla Stem (Sugeng). After one dose, profuse sweating occurred thoroughly, fever completely subsided, and consciousness cleared. However, bowels had been unopen for six or seven days, and foul breath/tongue coating persisted. Using the previous formula with modifications, adding Processed Rhubarb (Zhi Dahuang) 3 qian to purge. No response after one dose; increased Processed Rhubarb by 2 qian. After two more doses, bowel movement occurred, foul odor instantly disappeared, and food intake gradually resumed. I stated: The pathogen is gone; simply regulate diet for spontaneous recovery, no need for further medication.
Early April this year, Mr. Wang Yuanruo, a fellow townsman and Hanlin Academician, whose second son Lianqing was four years old, also contracted Damp-Warmth. Unable to verbalize his suffering, he suffered frequent convulsions. Once, the convulsive episode lasted about an hour; family members thought he was dead and cried, but fortunately he revived. He suffered insomnia for several nights. Inviting me to treat, I saw pale complexion, head retracted backward, mental fatigue, gurgling sound in throat, slippery-rapid pulse, knowing there was excessive phlegm. Palpating the abdomen revealed fullness yet softness. I said: Not eating for days should not present this way; likely there is Food Stagnation. Measuring axillary temperature with a watch yielded 102°F, stating oral temperature must be around 103°F. Sweat was extremely sticky, crying without tears, thirsty and desiring drink, but covering oneself during sleep without removing covers spontaneously, indicating exterior pathogen. Frequent hand-touching of head indicated headache/distension. Foul breath detectable within a few steps. Knowing this was also a Huazhuo Tang syndrome, I prescribed this formula but changed Perilla Stem to Perilla Seed (Su Zi), using Yushu Dan 4 fen. Before medication, convulsions persisted, requiring massage therapy to stop. Minutes after taking medicine, he suddenly vomited two large masses of sticky phlegm, lasting about an hour, viscous and clotted. Several hours later, one bowel movement occurred, extremely foul, abundant, black color. That night he slept peacefully. Next day's follow-up showed fever subsided, spirit clear, disease completely resolved. Treating with methods to search out residual pathogens, I said: After one dose, no more medication needed. The next day, he walked normally.
Lianchen notes: Damp-Heat and Damp-Warmth appear similar but are actually different. Damp-Heat involves receiving Dampness first, then transforming into Heat, with gradual onset; Damp-Warmth involves latent Warmth first, then receiving Dampness, with sudden onset. Damp-Heat is mild, while Damp-Warmth is severe. At the onset, it is crucial to distinguish severity. If Dampness outweighs Warmth, use Wu Shi San Ren Tang (Dr. Wu's Three Seeds Decoction) and Zhou Shi Huazhuo Tang (Mr. Zhou's Turbid-Damp Resolving Decoction) as main formulas. As Mr. Xueqiao stated: Damp-Warmth diseases often reside in the intestines and stomach; when tongue coating is slippery, white, thick, and greasy, heavily use Magnolia Bark (Chuanpu) as sovereign; if foul breath exists, Yushu Dan is also a key drug. This view is correct. If Warmth outweighs Dampness, use Modified Huopo Xialing Tang (Modified Pogostemon-Atractylodes-Pinellia-Coix Decoction) and Qingfang Touxie Tang (Clear-Aromatic Expel-Pathogen Decoction) as main formulas. If Dampness and Warmth are equal, use Xin Ding Dayin Yin (Newly Formulated Dayin Decoction), Zhishi Zhichi He Xiaoxianxiong Tang (Bitter Orange-Gardenia Combined with Small Chest-Hiding Decoction) with modifications, or Huoxiang Zuojin Tang (Patchoueli Supporting Metal Decoction) is also good. These are methods for treating early-stage Damp-Warmth. Other varied syndromes are numerous; methods in the treatise are complete; apply according to symptoms. Although selected cases are few, they broadly cover essentials, sufficient to guide future learners.
Additional Note: In "Discussion on Wonderful Uses of Verified Prescriptions," 184 new formulas were added, totaling 511 formulas above.