第二十五章．治伤寒温病同用方

Chapter 25. herbs for both Shanghan and Wen disease

1．仙露汤

1. Xianlu Tang

 治寒温阳明证，表里俱热，心中热，嗜凉水，而不至燥渴，脉象洪滑，而不至甚实，舌苔白浓，或白而微黄，或有时背微恶寒者。
 This formula is for Yangming stage in the Shanghan and Wen disease. The body has hot both in the body surface and inside. The person feels hot in heart, craves for cold water drink, but not to the dryness and thirsty level. The pulse is waving and slippery, but not to the shenic level. The tongue covering is white and thick, or white with little yellow, or sometimes, he feels mild chilly on the back.

生石膏（三两，捣细） 玄参（一两） 连翘（三钱） 粳米（五钱）
Shigao 90 gram (grind), Xuanshen 30 gram, Lianqiao 9 gram, Genmi (polished round-grained nonglutinous rice )15 gram.

上四味，用水五盅，煎至米熟，其汤即成。约可得清汁三盅，先温服一盅。若服完一剂，病犹在者，可仍煎一剂，服之如前。使药力昼夜相继，以病愈为度。然每次临服药，必详细问询病患，若腹中微觉凉，或欲大便者，即停药勿服。候两三点钟，若仍发热未大便者，可少少与服之。若已大便，即非溏泻而热犹在者，亦可少少与服。
Cook the ingredients until the Genmi is ready to eat. Collect about three cups of supernatant. Drink the first cup. If the disease remains, drink the second cup. Drink the tea as such day and night, until the disease is cured. Before each drink, ask the patient. If he feels cold in the abdomen, or has willingness to have bowel movement, let him stop drink. Wait for two to three hours, if he did not have bowel movement, let him drink little bit more. If he indeed has bowel movement, but it is not a slippery stool and the hot remains, also let him drink little bit more.

《伤寒论》白虎汤，为阳明府病之药，而兼治阳明经病。此汤为阳明经病之药，而兼治阳明府病。为其所主者，责重于经，故于白虎汤方中，以玄参之甘寒（《神农本草经》言苦寒，细嚼之实甘而微苦，古今药或有不同），易知母之苦寒，又去甘草，少加连翘。欲其轻清之性，善走经络，以解阳明在经之热也。方中粳米，不可误用糯米（俗名浆米）。粳米清和甘缓，能逗留金石之药于胃中，使之由胃输脾，由脾达肺，药力四布，经络贯通。糯米质粘性热，大能固闭药力，留中不散，若错用之，即能误事。
The Baihu Tang in the 《Shang Han Lun》is the formula mostly for disorders in organ level of the Yangming stage disease. It is also somehow used for the meridian level disorders in the Yangming stage. This formula however, focuses on the meridian disorders in the Yangming stage, less focuses on the organ level of the Yangming stage.  For this, to the Baihu Tang, the herb Xuanshen is added, use its sweet-cold nature (in the book 《Shennong Bencao Jin》, it said the Xuanshen is bitter-cold. But if try to chew it, it is actually sweet and mild bitter. Probably the herb in ancient time and in current time is different?) to replace the bitter-cold nature of the herb Zhimu. Also, remove the Gancao, but add the Lianqiao, to take its light-floatintg nature, good at moving in the meridian, to solve the Hot in the Yangming meridian. The Genmi in the formula should not be misused as Noumi (the glutinous rice). The Genmi is clear, sweet and calm, able to keep the stone ingredients in the stomach, make these ingredients distribute from stomach to the spleen, from spleen to the lung, and then to whole of the body, to connect the meridians. The Nuomi however, is sticky and hot, which can seal the herb healing effect, stay there without distribute out. If they are mis-used, there would affect the healing.

一叟年七十有一，因感冒风寒，头疼异常，彻夜不寝。其脉洪大有力，表里俱发热，喜食凉物，大便三日未行，舌有白苔甚浓。知系伤寒之热，已入阳明之府。因头疼甚剧，且舌苔犹白，疑犹可汗解。治以拙拟寒解汤，加薄荷叶一钱。头疼如故，亦未出汗，脉益洪实。恍悟曰：此非外感表证之头疼，乃阳明经府之热，相并上逆，而冲头部也。为制此汤，分三次温饮下，头疼愈强半，夜间能安睡，大便亦通。复诊之，脉象余火犹炽，遂用仲景竹叶石膏汤，生石膏仍用三两，煎汁一大碗，分三次温饮下，尽剂而愈。
A old man, 71 years of old, had Wind-Cold attack condition. He felt very pain in the head, hard to sleep the whole night. His pulse was waving, big and strong. He had hot in both inside and outside of the body. He craved for cold eat and drink. He had no bowel movement for three days. His tongue covering was white and thick. It was diagnosed as Shanghen Hotness, in the Yangming stage. For severe headache and white tongue covering, it was thought to use sweat therapy. He was given the Hanjie Tang, with addition of Bohe (peppermint) 3 gram. The headache was the same and there was no sweat, and the pulse was much more sthenic. I suddenly realized: this is not the Taiyang headache, bu the Yangming headache, which was due to the Yangming meridian Hotness reversed up to the head. So, he was given this Xianlu Tang, and let him drink it with three separate times. The headache was reduced to half, and he could have sleep at night and the stool started. On the second time, the pulse felt as remaining Fire burning. So, the Zhongjing Zhuye Shigao Tang was used. The Shigao used was 90 gram… After drink the herbal tea, the condition was solved.

按：竹叶石膏汤，原寒温大热退后，涤余热、复真阴之方。故其方不列于六经，而附载于六经之后。其所以能退余热者，不恃能用石膏，而恃石膏与参并用。盖寒温余热，在大热铄涸之余，其中必兼有虚热。石膏得人参，能使寒温后之真阴顿复，而余热自消，此仲景制方之妙也。又麦冬甘寒粘滞，虽能为滋阴之佐使，实能留邪不散，致成劳嗽。而惟与石膏、半夏并用，则无忌，诚以石膏能散邪，半夏能化滞也。或疑炙甘草汤（亦名复脉汤）中亦有麦冬，却无石膏、半夏。然有桂枝、生姜之辛温宣通者，以驾驭之，故亦不至留邪。彼惟知以甘寒退寒温之余热者，安能援以为口实哉！
Comments: the Zhuye Shigao Tang is originally used in the Shanghan disease and the Wen disease, after the Hotness has been mostly cleared off. It works to clear the remaining Fire and to restore the True Yin. So, it was not listed in the six stages of the diseases, but attached after the chapters. The reason for its ability to clear the remaining Fire residue, is not only due to the Shigao in it, but due to the combined use of the Shigao and the Renshen. For the Fire reside, after the later stage of the Fire burning, there must be some asthenic Fire. The Shigao, when meeting the Renshen, could make the True Yin restored very soon and the Fire residue so disappered very soon. This the smart of the Master Zhang in build up his formula. In addition, the Maidong is sweet, cold and sticky in herbal nature, though it is the helper to nourish the Yin, actually it can keep the Xie Qi not to disperse so to cause exhausting cough. Only when it is used with the Shigao and Banxia, there would have no such side effect. For the Shigao, it can disperse the Xie Qi and the Banxia can solve the stagnation. It might be doubted that, in the Zhi Gancao Tang, there is also the Maidong, but no Shigao and Banxia. But in the later formula, there is Guizhi and fresh ginger, for spicy-opening property, can work to solve the side effect of Maidong, so there is no worry for its Xie-keeping effect. …

温病中，有当日得之，即宜服仙露汤者。一童子，年十六。暑日力田于烈日之中，午饭后，陡觉发热，无汗，烦渴引饮。诊其脉，洪而长，知其暑而兼温也。投以此汤，未尽剂而愈。
In the Wen disease, some persons need to drink this Xianlu Tang on the same day he had the disease. A youth was 16 years of old. In summer, he worked in very hot sunshine. After the lunch, he suddenly had hotness, no sweat, felt annoying thirsty and craving for drink. His pulse was waving and long. It was diagnosed as the summer Wen disease. He was given this Xianlu Tang. Before finish the whole herbal tea, the condition was solved. 

按：此证初得，而胃府之热已实。彼谓温病入手经，不入足经者，何梦梦也！
Comments: In this case, the disease just occurred and the Stomach organ condition has already been sthenic. If you believe that the Wen disease only goes to the hand meridian, not to the foot meridian, how obsurd your thinking is!

上焦烦热太甚者，原非轻剂所能疗。而投以重剂，又恐药过病所，而病转不愈。惟用重剂，徐徐饮下，乃为合法。曾治一人，年四十余。素吸鸦片，于仲冬得伤寒，两三日间，烦躁无汗。原是大青龙汤证，因误服桂枝汤，烦躁益甚。迎愚诊视，其脉关前洪滑，两尺无力。为开仙露汤，因其尺弱，嘱其徐徐饮下，一次只饮药一口，防其寒凉侵下焦也。病家忽愚所嘱，竟顿饮之，遂致滑泻数次，多带冷沫。上焦益觉烦躁，鼻如烟熏，面如火炙。其关前脉，大于前一倍，又数至七至。知其已成戴阳之证，急用人参一两，煎好兑童便半茶蛊，将药碗置凉水盆中，候冷顿饮之。又急用玄参、生地、知母各一两，煎汤一大碗，候用。自服参后，屡诊其脉，过半点钟，脉象渐渐收敛，至数似又加数。遂急将候用之药炖热，徐徐饮下，一次饮药一口，阅两点钟尽剂，周身微汗而愈。此因病家不听所嘱，致有如此之失，幸而救愈，然亦险矣。审是，则凡药宜作数次服者，慎勿顿服也。盖愚自临证以来，无论内伤、外感，凡遇险证，皆煎一大剂，分多次服下。此以小心行其放胆，乃万全之策，非孤注之一掷也。
If the annoying Hot is very severe in the Upper Jiao, originally light herbal formula would be unable to solve. If use heavy/strong herbal formula, there is worry that the herbs go pass the diseased location and the disease anyway is not solved either. Only to drink the strong herbal formula tea gradually and slowly, would the herbs work on the Upper Jiao. I treated a man, who was 40 years of old. He usually smoke opium. In a winter, he had Shanghan disease. On the second and the third day, he had annoying feeling without sweat. It was Da Qinglong Tang condition, but he was mis-given Guizhi Tang. So, the annoying and agitating became worse. Her pulse was waving and slippery in the Chun position, but weak in the Chi position both sides. He was given the Xianlu Tang. Since the pulse was weak in the Chi position, he was asked to drink the herbal tea slowly and gradually, one mouth one time, as to prevent the Cold herb affects his Lower Jiao. The family however neglected my requirement, and let him drink all the tea once. This made him have slippery diarrhea with cold air bubble in the stool. His Upper Jiao was much more annoying and the nose turns black in color as smoked, and the face was red as baked. The pulse on the Chun position was double stronger than before, and it was seven times per every breath circle. Clearly he had Yang-wearing condition (e.g. the Yang Qi focuses on only the top of the body). In a urgent way, it was used Renshen 30 gram, cooked as herbal tea. It was mixed with half tea cup of child urine. The cup was put stand on a cold water. He was asked to drink the tea after cooling. Also, it was cooked the Xuanshen 30 gram, Shengdi 30 gram, and Zhimu 30 gram. After drink the Renshen tea, the pulse was check again and again. After about half hour, the pulse seemed less strong, but seemed more frequent. So, the second herbal tea was warmed up and given to him to drink urgently but slowly and gradually. It was finished within two hours. The person had mild sweat whole of the body and the condition was cured. You see, the family did not pay attention to what I asked to prepare and to use the herbs, and commit such dangerous mistake. It is lucky that the person was saved, but it is really a life-risk mistake. From this case, it should be reminded that, whenever a herbal tea should be drink in several times, it should not be drunk once for all. After I started medical clinic work, whenever I meet a dangerous condition, I asked the herbal tea drink slowly and gradually, so to make sure that the herb works without cause any other additional trouble.

《伤寒论》阳明篇中，白虎汤后，继以承气汤，以攻下肠中燥结，而又详载不可攻下诸证。诚以承气力猛，倘或审证不确，即足误事。愚治寒温三十余年，得一避难就易之法。凡遇阳明应下证，亦先投以大剂白虎汤一两剂。大便往往得通，病亦即愈。即间有服白虎汤数剂，大便犹不通者，而实火既消，津液自生，肠中不致干燥，大便自易降下。用玄明粉三钱，加蜂蜜或柿霜两许，开水冲调服下，大便即通。若仍有余火未尽，而大便不通者，单用生大黄末一钱（若凉水调服生大黄末一钱，可抵煮服者一两），蜜水调服，通其大便亦可。且通大便于服白虎汤后，更无下后不解之虞。盖下证略具，而脉近虚数者，遽以承气下之，原多有下后不解者，以其真阴亏、元气虚也。惟先服白虎汤或先服白虎加人参汤，去其实火，即以复其真阴，培其元气，而后微用降药通之，下后又何至不解乎。此亦愚百用不至一失之法也

 In the chapter of Yangming in the book 《Shang Han Lun》, after the Baihu Tang, it is the Chenqi Tang, to cleanse the dryness-blokc in the intestein. It has also indicated in detail the various conditions, in which the Cleansing therapy should not be used. This is because the Chenqi Tang is very strong in healing power, if the diagnosis is not correct, it would commit big mistake and risk life. I treated the Shanghan and Wen disease for 30 years, and have a experience to avoid this problem. Whenever there is Yangming condition, which needs the Cleansing therapy, give the person a large amount of Baihu Tang one to two dose. The stool is usually going through and the disease is also cured. Even if after several doses of the Baihu Tang, the stool did not come out, but the sthenic Fire has been cleared, and the body liquid-fluid is developing, the large intestine is no longer dry, so the stool will be easy to come out. Use Yuanming (Glauber’s salt) powder 9 gram, mixed with honey or Shishuang 30 gram about, and hot water. Let the person to drink. The stool will come out. If there is still Fire reside in the intestine, the stool does not come out, use herb Dahuang powder 3 gram, mix it with honey water to drink. It also works. (3 gram of the not cooked Dahuang, when drink with cold water, is equal to 30 gram of the cooked Dahuang).

Usually, after drink of the Baihu Tang and the stool came out, there is no case, in which the later use of the Chenqi Tang would not work. If the condition suggests the use of the Cleansing therapy, but the pulse was near asthenic frequent, after the use of the Chenqi Tang, the disease might remain after the stool comes out, for the reason that the person has deficiency in the True Yin and Yuan Qi. Only with the use of the Bai Hu Tang first, or use the Baihu Jia Renshen Tang first, to more the sthenic Fire in the body, then use herbs to nourish the Yin and Yuan Qi, and finally use little bowel-cleansing therapy, there would have no worry that the disease is not cured after the stool comes out. This is my way that has been tried for hundreds of times without one failure.

间有用白虎汤润下大便，病仍不解，用大黄降之而后解者，以其肠中有匿藏之结粪也。曾治一媪，年七十余，季冬得伤寒证，七八日间，延愚诊视。其脉洪长有力，表里俱热，烦渴异常，大便自病后未行。投以白虎加人参汤二剂，大便遂通，一日降下三次，病稍见愈，而脉仍洪长。细审病情，当有结粪未下，遂单用大黄三钱，煮数沸服之，下结粪四五枚，病遂见愈，仍非脉净身凉，又用拙拟白虎加人参以山药代粳米汤，服未尽剂而愈。然此乃百中之一二也。临证者，不可因此生平仅遇之证，遂执为成法，轻视白虎，而重视承气也。
Occasionally, there is case, in which the use of Baihu Tang has moved the stool out, but the disease is not cured. Then with the use of herb Dahuang, the disease is cured. This is because there is hidden stool in the intestine. I treated a lady, 70 years of old. She had Shanghan disease. After seven to eight days, her pulse was waving, long and strong. She had hotness in inside and outside of the body, felt very much annoying thirsty. She did not have bowel movement since getting sick. She was given Baihu Jia Renshen Tang two doses, the stool came out, three times a day. The disease was slightly improved, but the pulse was still waving and long. After check the disease condition carefully again, it was considered there might be hidden stool-block in the abdomen. She was then given Dahuang 9 gram, cooked as tea to drink. She then had bowel movement with 4 to 5 blocked stool. The disease appeared much better, bu not as completely yet. She was again given Baihu Jia Renshen Tang, with the Shangyao to replace the Genmi. Before finish the drink the disease has already cured. However, there is such case one or two out of hundred cases. Doctors should not, due to such one case, fix mind to look down the Baihu Tang but up the Chenqi Tang.

重用石膏以退火之后，大便间有不通者，即可少用通利之药通之。此固愚常用之法，而随证制宜，又不可拘执成见。曾治一少年，伤寒已过旬日，阳明火实，大便燥结，投一大剂白虎汤，一日连进二剂，共享生石膏六两，至晚九点钟，火似见退，而精神恍惚，大便亦未通行，再诊其脉，变为弦象，夫弦主火衰，亦主气虚。

After clear of the Fire with large amount of Shigao, the stool may not come out sometimes. It can come out with little bit use of bowel-cleansing herbs. This is my common way. But each person is different, the exact way to use the herbs should be based on each person’s condition. I treated a youth. He had Shanghan for several days, now with Yangming sthenic Fire condition and with block of stool in intestine. I used a heavy dose of Baihua Tang, two doses a day, with totally 180 gram of Shigao used. Until 9 pm, the Fire seems cooled down but the person was cloudy in mind and the stool did not come out. I felt his pulse again, which became string. The string means the Fire is not strong, but also means the Qi deficiency.

知此证清解已过，而其大便仍不通者，因其元气亏损，不能营运白虎汤凉润之力也。遂单用人参五钱，煎汤俾服之，须臾大便即通，病亦遂愈。盖治此证的方，原是白虎加人参汤，因临证时审脉不确，但投以白虎汤，遂致病有更改。幸迷途未远，犹得急用人参，继所服白虎汤后以成功。诚以日间所服白虎汤，尽在腹中，得人参以助之，始能运化。是人参与白虎汤，前后分用之，亦无异于一时同用之也。益叹南阳制方之神妙，诚有令人不可思议者也。

It was considered that, in this case, the Fire has been cleared, but the Yuan Qi is weak, so there was no enough Qi to move the cooling power of the Baihu Tang. He was then given Renshen 15 gram to cook as tea and to drink. Very soon, he got bowel movement and the disease was cured. For this case, the herbal formula originally needed is the Baihua Jia Renshen Tang. Due to not so care in the early diagnosis, he was given the Baihu Tang alone, so the condition was changed somehow. It is lucky that I found the mistake and used the Renshen urgently and it worked after the use of the Baihu Tang too. The reason is that, the Baihu Tang that was taken during the daytime was still in the abdomen, with the addition of later Renshen, it started to move. Apparently, the Renshen and the Baihu Tang, used separately, work the same way as they are used at the same time in one formula. It is so smart the formula by Mr. Nanyang. It is unbelievable.

吴又可谓：“如人方肉食而病适来，以致停积在胃，用承气下之，惟是臭水稀粪而已，于承气汤中，单加人参一味，虽三四十日停积之物于是方下。盖承气借人参之力鼓舞胃气，宿物始动也。”又可此论，亦即愚用人参于白虎汤后，以通大便之理也。

Mr. Wu Youke said: “If the person ate meat and had disease, the meat will be left in the stomach. With the use of Chenqi Tang, the stool that come out will be only bad odor water-like stool. If add single Renshen to the Chenqi Tang, even the stools that has been stored in the intestine for 30 or 40 days, can come out. Since the Chenqi Tang is helped by the Renshen to activate the stomach, so the hidden stool is to move.” This is the same mechanism for my use of Renshen after the Baihu Tang. 

附录：
Appendix:

湖北天门县崔××来函：
Letter from Mr. Chui, Tianmen city, Huibei province:

丁卯仲夏，何某，身染温病。他医以香薷饮、藿香正气散治之，不效。迎仆诊视，遵用清解汤，一剂而愈。时因温病盛行，以书中清解汤、凉解汤、寒解汤、仙露汤、从龙汤、馏水石膏饮，有呕者，兼用代赭石。本此数方，变通而用，救愈三千余人，共享生石膏一千余斤，并未偾事。

A summer, Mr He had Wen disease. Doctor gave him Xiangwu Yin, Huoxiang Zhenqi San. No effect. When I saw him, I used Qingjie Tang. One dose solved the problem. At that time, it was the spread of Wen disease. I used Qingjie Tang, Liangjie Tang, Hanjie Tang, Xianlu Tang, Conglong Tang, Liushui Shigao Tang. If the person has nausea, I also used Daizheshi. By this way, with some modification in the formulas, I saved 3000 persons. Totally, I used 500 kg Shigao without any side effect.

2．石膏粳米汤

2. Shigao Genmi Tang

治温病初得，其脉浮而有力，身体壮热。并治一切感冒初得，身不恶寒而心中发热者。若其热已入阳明之腑，亦可用代白虎汤。

This formula is used for early stage of  Wen disease. The pulse is floating and strong. The body is with fever. It is also used for early stage fo common cold, the body does not feel cold (no chilly), but feels hot in heart. If the Hotness has come into the Yangming organ stage, it can also be used to replace the Baihu Tang.

生石膏（二两，轧细） 生粳米（二两半）

Shigao 60 gram (grind), Genmi 75 gram.

上二味，用水三大碗，煎至米烂熟，约可得清汁两大腕。乘热尽量饮之，使周身皆汗出，病无不愈者。
Cook the ingredients until the rice is eatable. Collect supernatant about two big bowls. Drink it when it is warm, to create sweat all over the body. No disease is not cured.

若阳明腑热已实，不必乘热顿饮之，徐徐温饮下，以消其热可也。
If the Yangming organ condition is sthenic, do not drink it when hot, but dirnk it gradually when it is warm. It can clear the body Hotness.

或问：外感初得，即中有蕴热，阳明胃腑，不至燥实，何至速用生石膏二两？答曰：此方妙在将石膏同粳米煎汤，乘热饮之。俾石膏寒凉之性，随热汤发散之力，化为汗液尽达于外也。西人谓，胃本无化水之能，亦无出水之路。而壮实之人，饮水满胃，须臾水气旁达，胃中即空。盖胃中原多微丝血管，能引水气以入回血管，由回血管过肝入心，以营运于周身，由肺升出为气，由皮肤渗出为汗，余透肾至膀胱为溺。石膏煎汤，毫无气味，毫无汁浆，直与清水无异，且又乘热饮之，则敷布愈速，不待其寒性发作，即被胃中微丝血管吸去，化为汗、为气，而其余为溺，则表里之热，亦随之俱化。此寒因热用，不使伤胃之法也。且与粳米同煮，其冲和之气，能助胃气之发达，则发汗自易。其稠润之汁，又能逗留石膏，不使其由胃下趋，致寒凉有碍下焦。不但此也，清水煎开后，变凉甚速，以其中无汁浆，不能留热也。此方粳米多至二两半，汤成之后，必然汁浆甚稠。饮至胃中，又善留蓄热力，以为作汗之助也。是以人之欲发汗者，饮热茶不如啜热粥也。
It might be asked: in the early stage of Xie Qi invasion, even if there is previously accumulated Hot in the chest, the Yangming stomch organ has not be in the sthenic condition, why urgently use the Shigao 60 gram? Answer: the smart of this formula is to use the Shigao and the Genmi the same time and drink it with the soup is Hot. The Shigao is cold in herbal nature, along with the dispersing nature of the hot soup, develops sweat and moves to the outside of the body. … For a strong person, after drink the water full of the stomach, very soon, the water will be distributed all over the body and the stomach will be empty, since there are lots of micro-blood vessels in the stomach, which can bring the water-fluid into the blood vessels, then through the liver to the heart, and to the whole body, through the lung as vapor, and through the skin as sweat, and through the kidney as urine. The water after cook with Shigao is no odor, no soup, but as pure water. To drink it when hot, it will be distributed sooner before its cooling nature starts to function, it has been absorbed in the body, as sweat, as breath vapor, or as urine. By this way, the body Hot, inside or outside, can be dispersed off. This is a way of using Cold to solve the Hot, so as not to hurt the stomach. When the Shigao is cooked with the Genmi, its pushing nature can help the stomach Qi distribute, so the sweat is easier. The sticky soup of the Genmi can keep the Shigao, not to let the Shigao move down from the Stomach to hurt the Lower Jiao. In addition, after cook with pure water, the sup is easy to become cold, since there is no sticky material to keep the hot. In the formula here, the Genmi used is up to 75 gram. After cook, the soup is very sticky. After drink into the stomach, it is good at keeping the hot, making the hot to help sweat. Therefore, if a person wants to have a sweat, drink hot soup is better than to drink hot tea.

初拟此方时，惟用以治温病。实验既久，知伤寒两三日后，身不恶寒而发热者，用之亦效。丙辰正月上旬，愚自广平移居德州。自邯郸上火车，自南而北，复自北而南，一昼夜绕行千余里。车窗多破，风寒彻骨。至德州，同行病者五六人，皆身热无汗。遂用生石膏、粳米各十余两，饭甑煮烂熟，俾病者尽量饮其热汤，皆周身得汗而愈，一时称快。
In the beginning when I set up this formula, it is only used for Wen disease. After tried in clinic for a long time, it is known that, for a Shanghan disease after two to three days, the body has no chilly but only hot, it also works. …. One time, I had traveled in a train. The window glass was broken and it was very cold in the cabinet. For my partners, five to six persons, all had hot in the body but no sweat. So, I used Shigao half kg and Genmi half kg. Cooked them to soup and let them to drink the soup as much as they can. All got sweat whole of the body and cured. Everyone felt happy.

沈阳朱姓妇，年五旬。于戊午季秋，得温病甚剧。时愚初至奉天，求为延医。见其以冰囊作枕，复悬冰囊，贴面之上侧。盖从前求东人调治，如此治法，东人之所为也。合目昏昏似睡，大声呼之，毫无知觉。其脉洪大无伦，按之甚实。愚谓其夫曰：此病阳明腑热，已至极点。外治以冰，热愈内陷。然此病尚可为，非重用生石膏不可。其夫韪愚言，遂用生石膏细末四两、粳米八钱，煎取清汁四茶杯，徐徐温灌下。约历十点钟，将药服尽，豁然顿醒。后又用知母、花粉、玄参、白芍诸药，少加连翘以清其余热，服两剂全愈。
 Mrs. Zhu from Shenyang city, was 50 years of old. In an autumn, she got very severe Wen disease. At that time, I just moved to the Fengtian city. I was asked to have a look. She used ice pillow under her neck and another ice bag on the side of the head. This is from the requirement of a Japanese doctor, who treated her. It is the way of Japanese way. The patient was in sleepy condition, cloudy in mind. She was no response when called her loudly. Her pulse was waving and big very much and it is strong when pressed harder. I told her husband: this is Yangming organ Hotness condition and it reached the peak level. The use of ice from outside of the body would make the Hotness sink deeper. However, there was still chance to save her. But large amount of Shigao must be used. Her husband accepted my idea. For the formula, it was used the Shigao 120 gram, Genmi 24 gram. Cooked and poured to her continuously. For about 10 hours, the herbal soup all was poured in. The lady came awake. Later, it was used the Zhimu, Tianhuafeng, Xuanshen, and Baishao, with little Lianqiao to clear the Hot residue. Two doses solved the condition.

附录：
Appendix:

江苏崇明县蔡××来函：
Letter from Mr. Chai, Chongming city, Jiangsu province:

季秋，敝处张氏之女得瘟病甚剧，服药无效，医言不治，病家以为无望。其母求人强仆往视，见其神昏如睡，高呼不觉；脉甚洪实。用先生所拟之石膏粳米汤，生石膏用三两，粳米用五钱。见者莫不惊讶诽笑。且有一老医扬言于人曰：“蔡某年仅二十，看书不过年余，竟大胆若此！石膏重用三两，纵锻透用之亦不可，况生者乎？此药下咽，人即死矣。”有人闻此言，急来相告，仆曰：“此方若用 石膏，无须三两，即一两亦断送人命而有余。若用生者，即再多数两亦无碍，况仅三两乎。”遂急催病家购药，亲自监视，煎取清汤一大碗，徐徐温灌下。病患霍然顿醒。其家人惊喜异常，直以为死后重生矣。继而热疟流行，经仆重用生石膏治愈者不胜计。

In an autumn, the daughter of Mr. Zhang, who lived with us, got severe acute infectous disease. Treatments had been tried, but failed. Doctors declaired no way to help and the family also lost hope. Her mother strongly insisted in to have me to come to have a look. Her mind was cloudy as sleep. No response when called loudly. Her pulse was very waving and sthenic in feeling. I used youg Shigao Genmi Tang. The Shigao was 90 gram, and the Genmi was 15 gram. People who saw the formula could not prevent from laughing at it. There was also a old doctor at the present and he said: “The guy was only 20 years of old. He had only several years to read medical books, How dare he is, to use the Shigao up to 90 gram! It should not be so large amount with the processed Shigao, not to speak of the original, not-processed one! Once this formula is swallowed, the one would die!”. One person who heard this, and hurried up to tell me. I said, “if use processed Shigao, no need to use 90 gram, even 30 gram could cause loss of the life. If use the non-process Shigao, even to use more would be no problem, not to speak of only 90 gram.” I pushed the family to buy the herb, I my self cooked it for her. I let her drink the herbal soup slowly and gradually. The patient suddenly waked up. The family felt very happy, believed that she returned back life after death. Later, there was Hot malaria in this area. I sued large amount of Shigao and had lots of success.

3．镇逆白虎汤

3. Zhenni Baihu Tang (Zhenni here means to suppress the reverse)

治伤寒、温病邪传胃腑，燥渴身热，白虎证俱。其人胃气上逆，心下满闷者。
This formula is used in the treatment of Shanghan and Wen disease, in which the Xie Qi has past into the Yangming stomach stage. The person feels hot in the body, annoying thirst, a typical Baihu Tang condition. The person has also the reverse up of the Stomach Qi, with fullness feeling in the upper abdomen.

生石膏（三两，捣细） 知母（两半） 清半夏（八钱） 竹茹粉（六钱）
Shigao 90 gram (grind), Zhimu 45 gram, Qing Banxia 24 gram, Zhuru powder 18 gram.

用水五盅，煎汁三盅，先温服一盅。病已愈者，停后服。若未全愈者，过两点钟，再温服一盅。

Use five cups of water to cook the herbs, to collect three cups of supernatant. First drink one cup. If the disease is solved, stop to drink it any more. If not, drink it after two hours 

《伤寒论》白虎汤，治阳明腑热之圣药也。盖外邪炽盛，势若燎原，胃中津液，立就枯涸，故用石膏之辛寒以祛外感之邪，知母之凉润以滋内耗之阴。特是石膏质重（虽煎作汤性亦下坠），知母味苦，苦降与重坠相并，下行之力速，胃腑之热或难尽消。且恐其直趋下焦而为泄泻也，故又借粳米之浓汁、甘草之甘味，缓其下趋之势。以待胃中微丝血管徐徐吸去，由肺升出为气，由皮肤渗出为汗，余入膀胱为溺，而内蕴之热邪随之俱清，此仲景制方之妙也。然病有兼证，即用药难拘成方。犹是白虎汤证也，因其人胃气上逆，心下胀满，粳米、甘草不可复用，而以半夏、竹茹代之，取二药之降逆，以参赞石膏、知母成功也。
The Baihu Tang in the 《Shang Han Lun》is the great formula for Yangming organ Hot/fever condition. With the overwhelming of the invading Xie Qi, it burns very much to exhaust the stomach Yin liquid-fluid. Therefore, the Shigao is used, for its spicy-cooling nature to expel the invading Xie Qi. The Zhimu, for its cooling-wetness nature, is to nourish the Yin. Especially, the Shigao is heavy (even if cook it as soup, its nature is still falling), the Zhimu is bitter. The bitter-falling and the heavy-falling come together, the falling power is faster, the Stomach Hotness might be hard to clear away. Also, for worry that they may fall down to cause slippery diarrhea, it is added the Genmi, for its thick soup, and the Gancao, for its sweet-buffering function, to slow down the falling power of the previous two herbs, so as to allow the Shigao and Zhimu absorbed from stomach to the the lung, to the skin, the urine bladder, to expel the Xie Qi out of the body. This is the smart of the Master to build up his formula. However, disease is complex. It may have co-exist other condition at the same time, so that the original formula is hard as it is. For example, for the Baihu Tang condition, due to the reverse of Stomach Qi, the person feels fullness in the stomach. In this case, the Genmi and Gancao can not be used, but replaced with Banxia and Zhuru, for their ability to reverse the reversed stomach Qi, so as to help the Shigao and Zhimu.

一妇人，年三十余，得温证。始则呕吐，五六日间，心下满闷，热而且渴。脉洪滑有力，舌苔黄浓。闻其未病之先，曾有郁怒未伸，因得斯证，俗名夹恼伤寒。然时当春杪，一得即不恶寒，乃温病，非伤寒也。为疏此方，有一医者在座，疑而问曰：此证因胃气上逆作胀满，始将白虎汤方，另为更定。何以方中不用开通气分之药，若承气汤之用浓朴、枳实，而惟用半夏、竹茹乎？答曰：白虎汤用意，与承气迥异。盖承气汤，乃导邪下行之药，白虎汤乃托邪外出之药。故服白虎汤后，多有得汗而解者。间有服后未即得汗，而大热既消，其饮食之时，恒得微汗，余热亦由此尽解。若因气逆胀满，恣用破气之药，伤其气分，不能托邪外出，将邪陷愈深，胀满转不能消，或更增剧。试观《伤寒论》多有因误下伤其气分，成结胸，成心下痞硬证，不可不知也。再试观诸泻心，不轻用破气之品，却有半夏泻心汤。又仲景治“伤寒解后，气逆欲呕”有竹叶石膏汤，半夏与石膏并用；治“妇人乳、中虚、烦乱、呕逆”有竹皮大丸，竹茹与石膏并用，是半夏、竹茹善降逆气可知也。今师二方之意，用之以易白虎汤中之甘草、粳米，降逆气而不伤正气，服后仍可托邪外出，由汗而解，而胀满之证，亦即消解无余。此方愚用之屡矣，未有不随手奏效者。医者闻言省悟，听愚用药，服后，病患自觉胀满之处，如以手推排下行，病亦遂愈。
A lady, 30 years of old, had Wen disease. She felt nausea and vomit. At the fifth or the sixth day, she felt fullness in the upper abdomen, felt hot and thirsty. Her pulse was waving and slippery and strong. The tonge covering was yellow and thick. It is heard that, before she got sick, she had had angry without release, then got the Wen disease. This condition was termed Angry-bearing Shanghan. It was in spring time, the patient, when got the sick, had no chilly, so it is not Shanghan, but Wen disease. She was given this formula. There is a doctor at the presence. He felt suspect and asked: in this case, the fullness and bloating feeling is due to the reverse of the Stomach Qi. The use of Baihu Tang might be reasonable somehow, but why not use Qi-breaking herbs, such as Houpo and Zhishi, but use the Banxai and Zhuru? Answer: the aim of the Baihu Tang is different from the Chenqi Tang. The Chenqi Tang is the formula to direct the Xie Qi down to move out through the stool. The Baihu Tang is however to expel the Xie Qi through the sweat. Therefore, after drinking the Baihu Tang, there is possibility that the person gets sweat and the disease is so solved. Sometimes, the person does not sweat at that time, but the Fire is solved. Upon his eating, he then gets sweat and the disease is then solved completely. If use the Qi-breaking herbs, it would damage and exhaust the Qi, make the Qi fails to push the Xie Qi out of the body, so that the Xie Qi would turn deeper and the bloating would be worse. Check the book《Shang Han Lun》, there are many examples, in which the mis-use of bowel-cleansing therapy caused the damage to the Qi portion, so as to cause the Jiexiong condition. The person feels very hard in the upper abdomen. It should not be unknown. Then, let’s have a look at the various Xiexing Tang formulas, in which the Qi-breaking herbs are not used without care, such as Banxia Xiexing Tang. In addition, in the treatment of “After dissolvement of Shanghan, but the person has Qi-reverse and has tenency and willingness to vomit”, the Master used Zhuye Shigao Tang; in which the Banxia and the Shigao are used together. To treat “woman has brest fullness, middle hollow feeling, annoyed and agitated, and nausea or vomit”, he used Zhupi Da Wan, in which the Zhuru and the Shigao are used together. Therefore, it is deduced that, the Banxia and the Zhuru can function to reduce the reversed Qi. Now, we follow the idea of these two formulas, use the Banxia and Zhuru to replace the Gancao and Genmi in the original Baihu tang, so as to reverse the reversed stomach Qi, reduce the reversed Qi but not hurt the normal body Qi, allowing it works to push the Xie Qi out. By this way, the bloating and fullness feeling disappears naturally. I have used this formula many times, never have failure. The doctor heard this, appearing understand. After drink of the herbal tea, the patient felt as there is a pushing power to push something in the upper stomach down, so the condition was solved.

4．白虎加人参以山药代粳米汤

4. Baihu Jia Renshen, with Shanyao to replace Genmi Tang.

治寒温实热已入阳明之府，燥渴嗜饮凉水，脉象细数者。
This formula is used for Shanghan and Wen disease, in which the Xie Qi has past into the Yangming stage, the person feels annoying thirsty, craves for cold water drink, and the pulse is thin and frequent.

生石膏（三两，捣细） 知母（一两） 人参（六钱） 生山药（六钱） 粉甘草（三钱）
Shigao 90 gram (grind), Zhimu 30 gram, Renshen 18 gram, Shanyao 18 gram, Gancao 9 gram.

上五味，用水五盅，煎取清汁三盅，先温服一盅。病愈者，停后服。若未全愈者，过两点钟，再服一盅。至其服法详细处，与仙露汤同。
 Cook the ingredients in five cups of water, as to collect three cups of herbal tea. Drink the first cup with warm. If the condition is solved, stop to drink more. If not, drink the second cup after two hours. For other requirement, check it for Xianlu Tang.

伤寒法，白虎汤用于汗、吐、下后当加人参。究之脉虚者，即宜加之，不必在汗、吐、下后也。愚自临证以来，遇阳明热炽，而其人素有内伤，或元气素弱，其脉或虚数，或细微者，皆投以白虎加人参汤。实验既久，知以生山药代粳米，则其方愈稳妥，见效亦愈速。盖粳米不过调和胃气，而山药兼能固摄下焦元气，使元气素虚者，不至因服石膏、知母而作滑泻。且山药多含有蛋白之汁，最善滋阴。白虎汤得此，既祛实火，又清虚热，内伤外感，须臾同愈。愚用此方救人多矣。略列数案于下，以资参考。
In the principle for the treatment of Shanghan disease, if the Baihu Tang is used after the sweat therapy, vomiting therapy or bowel-cleansing therapy, the herb Renshen should be added in the formula. In addition, if the pulse is weak, it should also be added, even if the person has not been treated with these therapies. After my coming in the clinic work, whenever I meet the Yangming Hotness condition, but the person has inside damage, or his Yuan Qi is weak, or his pulse is asthenic frequent, or it is thin and weak, I always used the Baihu Jia Renshen Tang. After a long time test, I found that, to use the Shanyao to replace the Genmi, the formula works much safe and fast. The function of the Genmi in the formula is to harmonize the stomach Qi, but the Shanyao can in addition fix and seal the Lower Jiao Yuan Qi, to prevent slippery diarrhea, due to the Shigao and Zhimu, in the person who has had weakness in the Yuan Qi before this sickness. More over, the Shanyao is rich in protein juice, mostly good at nourishing the Yin portion. Add it in the Baihu Tang, it works to clear the sthenic Fire, as well as the asthenic Fire. The inside damage and the invading Xie Qi both can be solved soon. I have used this formula to many patients so far. Here are some examples, which are cited here for a reference.

一叟，年近六旬。素羸弱，劳嗽，得伤寒证，三日，昏愦不知人。诊其脉甚虚数，而肌肤烙手，确有实热。知其脉虚证实，邪火横恣，元气又不能支持，故传经犹未深入，而即昏愦若斯也。踌躇再四，乃放胆投以此汤。将药煎成，乘热徐徐灌之，一次只灌下两茶匙。阅三点钟，灌药两盅，豁然顿醒。再尽其余，而病愈矣。
A man, close to 60 years of old, was weak in body condition usually. He had Shanghan disease. On the third day, he lost his consciousness. His pulse was very weak and frequent, and the body skin was very burning hot. It was known that he in deed had sthenic Fire; the pulse was asthenic but the condition was sthenic. The Xie Fire is overwhelming, and the body Yuan Qi could not stand, or the Xie Qi invaded in the meridian but not deeper yet, only losing consciousness. I considered again and again, then dared to use this formula. The herbal tea was poured into his mouth gradually, two teaspoons each time. After about three hours, two cups of herbal tea was finished, and the person waked up suddenly. After finish the remaining herbs, the disease was cured.

一叟，年六旬。素亦羸弱多病，得伤寒证，绵延十余日。舌苔黄浓而干，心中热渴，时觉烦躁。其不烦躁之时，即昏昏似睡，呼之，眼微开，精神之衰惫可知。脉象细数，按之无力。投以凉润之剂，因其脉虚，又加野台参佐之。大便忽滑泻，日下数次。因思此证，略用清火之药，即滑泻者，必其下焦之气化不固。先用药固其下焦，再清其上焦、中焦未晚也。遂用熟地黄二两，酸石榴一个，连皮捣烂，同煎汤一大碗。分三次温饮下，大便遂固。间日投以此方，将山药改用一两，以生地黄代知母，煎汤成，徐徐温饮下，一次只饮药一大口。阅八点钟，始尽剂，病愈强半。翌日，又按原方，如法煎服，病又愈强半。第三日，又按其方服之，尽剂而愈。
A old man, also 60 years of old and his body condition was slim and thin for a long time sickness. He had Shanghan disease, which had last for ten days. His tongue covering was yellow, thick and dry. He felt hot and thirsty, felt annoyed and agitated sometimes. If he was not agitated, his mind would be cloudy as sleep. If called, his eyes would open little bit, appearing that his mind was very exhausted. His pulse was thin and frequent, weak when pressed harder. He was given the cooling-wetness herbs. For his weak pulse, wild Taishen was added in the formula. One day, he got sudden slippery diarrhea, several times a day. Upon considering that, to use cooling-wet herbs, he got slippery diarrhea, he must be weak in the Lower Jiao. To use herbs to fix his Lower Jiao Yuan Qi, then to clear the Upper and Middle Jiao is not too late. In the following formula, used were the Shoudi 60 gram, sour Shiliu one, which was chop in pieces. The ingredients were cooked to get one big bowl of herbal tea. The tea were separated into three parts and drunk in three separate times. The stool became formed. On the other day, the formula was changed to Shangyao 30 gram, Shengdi is used to replace the Zhimu. After ready of the tea, the patient was asked to drink it slowly and gradually, one mouth each time. Upon 8 pm, the tea was finished. The condition was much better. The next day, the original formula was followed again, the condition was additionally improved. The third day, the same formula was followed and the disease was cured.  

按：熟地黄原非治寒温之药，而病至极危时，不妨用之，以救一时之急。故仲景治脉结代，有炙甘草汤，亦用干地黄（即今生地），结代亦险脉也。如无酸石榴时，可用龙骨（ 捣）、牡蛎（ 捣）各五钱代之。
Comments: Shoudi is originally not used for the Shanghan and Wen disease. But if the condition is very severe, it might be used somehow to save the dangerous condition. So, the Master Zhang Zhngjing used the Shengdi to solve the rough (Jie pulse and Dai pulse) pulse in formula Zhi Gancao Tang. The Jie pulse and Dai pulse are also dangerous pulse. If no sour Shiliu, use the Longgu (grind) 15 gram and Muli (grind) 15 gram to replace it.

一叟，年六旬余。素吸鸦片，羸弱多病，于孟冬感冒风寒，其脉微弱而浮。愚用生黄 数钱，同表散之药治之，得汗而愈。间日，因有紧务事，冒寒出门，汗后重感，比前较剧。病卧旅邸，不能旋里。因延彼处医者延医，时身热饮水，病在阳明之府。医者因其脉微弱，转进温补，病益进。更延他医，以为上有浮热，下有实寒，用附子、吴茱萸，加黄连治之。服后，齿龈尽肿，且甚疼痛，时觉烦躁，频频饮水，不能解渴。不得已复来迎。愚至，诊其脉细而数，按之略实。遂投以此汤，加玄参六钱，以散其浮游之热。一剂牙疼即愈，烦躁与渴亦见轻。翌日，用原方去玄参，将药煎成，调入生鸡子黄三枚，作三次温饮下，大便得通而愈。
A man, 60 years of old, used Opium for a long time. He was thin and was sick. In a winter, he had Wind-Cold attack. His pulse was weak and floating. I used Shengdi several grams, together with surface-expelling herbs for the treatment. His condition was improved after getting the sweat. On the other day, he, for urgent thing to do, went out against the cold weather. His condition became worse after sweat. He was sick in hotel and hard to turn home. The local doctor saw him, seeing that he was hot and drink water, though that his condition was in the Yangming. The doctor used warming-nourishing herbs, for his very weak pulse, his condition was worse. After change to another doctor, the doctor thought that he had upper floating fire and lower sthenic Cold, so used Fuzi, Wuzhuyu, and Huanglian to treat. After the treatment, the gum was all swelling and very much pain. He felt agitated, drank water from time to time but still hard to solve the thirsty. For no way any more, asked me come to help. When I saw him, his pulse was thin and frequent. It is slight sthenic when pressed harder. He was given this formula, with addition of Xuanshen 18 gram, with the aim to remove floating Fire. After one dose, the teethache stopped, the annoyed, agitate and thirsty were improved to some level. The next day, the same formula are used but with removal of Xuanshen. The herbal tea was mixed with egg yolk three. The herbal tea was separated into three parts and he was asked to drink three separate times. After his stool came out, the disease were cured.

一人，年二十，资禀素弱。偶觉气分不舒，医者用三棱、延胡等药破之。自觉短气，遂停药不敢服。隔两日，忽发喘逆，筋惕肉动，精神恍惚。脉数至六至，浮分摇摇，按之若无。肌肤甚热，上半身时出热汗，自言心为热迫，甚觉怔忡。其舌上微有白苔，中心似黄。统观此病情状，虽陡发于一日，其受外感，已非一日。盖其气分不舒时，即受外感之时，特其初不自觉耳。为其怔忡太甚，不暇取药，急用生鸡子黄四枚，温开水调和，再将其碗置开水盆中，候温服之，喘遂止，怔忡亦见愈。继投以此汤，煎汁一大碗，仍调入生鸡子黄三枚，徐徐温饮下。自晚十点钟至早七点钟，尽剂而病若失。因其从前服药伤气，俾用玄参一两、潞参五钱，连服数剂以善其后。
A man, 20 years of old, was slim from birth. He felt Qi stagnation occasionally. Doctor used Sanlen and Yuanhu to break it. He felt short of breath, so stopped the tea drinking for fear. On the other day, he suddenly felt asthma and Qi reverse up, felt muscle tingling and his mind was cloudy and smear. His pulse was up to six times per breath circle. The pulse felt floating and shacking, but as no puse when pressed harder. His body skin was very hot when touch. The upper half body had also sweat. He said he felt his heart was pushed and pressed by Hot, felt very palpitation. His tongue covering was with slight white covering, in the middle of which it seemed yellow. For an overall consideration, his condition though happened suddenly in one day, had been in the body for a long time. When he felt stagnation in the Qi portion, it was the time he was attacked by the invading Xie Qi, only because he did not realized it yet. For his palpitation was very severe, there was no time to buy herbs, four egg yolks were mixed with hot water. The bowl was put in boiling water to warm it and to drink it. After drink, the asthma stopped and the palpitation was also reduced. Then the herbal formula here was used with addition of the egg yolk three into the final herbal tea. The final herbal tea was given to him to drink slowly and gradually. Upon 10 pm at night to the 7 am next morning, the tea was all finished and his condition was almost gone. Since the herbs he drunk before damaged the Qi portion, he was given Xuanshen 30 gram, and Dangshen 15 gram to drink for several doses for a maintenance.  

一童子，年十七。于孟夏得温证，八九日间，呼吸迫促，频频咳吐，痰血相杂。其咳吐之时，疼连胸胁，上焦微嫌发闷。诊其脉，确有实热，而数至七至，摇摇无根。盖其资禀素弱，又兼读书劳心，其受外感又甚剧，故脉象若是之危险也。为其胸胁疼闷兼吐血，遂减方中人参之半，加竹茹、三七（捣细冲服）各二钱。用三七者，不但治吐血，实又兼治胸胁之疼也。一剂血即不吐，诸病亦见愈。又服一剂全愈。
A youth, 17 years of old, had Wen disease in a summer. On the eighth to ninth day, he felt press in breath, had frequent cough and had phlegm mixed with blood. When he cough, he felt pain in the chest and side of abdomen. He felt slight chock and bloating feeling in the Upper Jiao. His pulse was sthenic, which was seven times per breath circle, felt shacking without root. For his weakness condition from birth, hard study to exhaust mind, and with the common cold attack, his pulse was very dangerous. For his pain in the chest with blood vomit, the Renshen in the formula was reduced half, and with addition of Zhuru 6 gram and Sanqi (grind and drink with herbal tea) 6 gram. The herb Sanqi is not only to solve the bleeding, but also works to release the pain in the chest. After one dose, he had no blood vomit and other conditions were also improved. Additional dose solved the problem completely.

一农家孺子，年十一。因麦秋农家忙甚，虽幼童亦作劳田间，力薄不堪重劳，遂得温病。手足扰动，不能安卧，谵语不休，所言者皆劳力之事，昼夜目不能瞑。脉象虽实，却非洪滑。拟投以此汤，又虑小儿少阳之体，外邪方炽，不宜遽用人参，遂用生石膏两半、蝉蜕一钱，煎服后，诸病如故。复来询方，且言其苦于服药，昨所服者，呕吐将半。愚曰，单用生石膏二两，煎取清汁，徐徐温饮之，即可不吐。乃如言服之，病仍不愈。再为诊视，脉微热退，谵语益甚，精神昏昏，不省人事。急用野台参两半、生石膏二两，煎汁一大碗，分数次温饮下。身热脉起，目遂得瞑，手足稍安，仍作谵语。又于原渣加生石膏、麦冬各一两，煎汁二盅，分两次温饮下。降大便一次，其色甚黑，病遂愈。
A farmer’s son was 11 years of old. Due to busy field labor work, the child also worked in the farm. For the young body that could not bear the heavy stress, he had Wen disease. His hands and feet jumped, hard to lie in calm, and had endlyss random chattering. What he talked all were about the labor work. The eyes could not close the day and night. The pulse was sthenic but not waving or slippery. He was given this formula. For the consideration that the child is a Shaoyang body, and the invading Xie Qi was just to burn, so did not use the Renshen. In the herb, it was Shigao 45 gram, Chantui 3 gram. After drink of the herbal tea, the condition remained the same. The family came to ask for formula again and told me that the child felt very hard to drink the herbal tea. The herbal tea he drank yesterday was vomited out half. I said, use Shigao 60 gram, cook and collect the supernatant, let him to drink it slowly and gradually. He would no vomit. The family followed. The vomit indeed stopped, but the disease remained. On the second visit, his pulse was weak and the hot stopped, but the chattering worse and he lost consciousness. In a hurry, wild Taishen 45 gram, and Shigao 60 gram was cooked. The herbal tea was poured to the child for several times. The body became warm and the pulse was stronger. The eye could close and the feet and hands were calm, but still had chattering. To the previous herb residue, added Shigao 30 gram, and Maidong 30 gram. The collected herbal tea was drunk for two times. The child had bowel movement once, the color of which was black and the disease was cured.

按：此证若早用人参，何至病势几至莫救。幸即能省悟，犹能竭力挽回，然亦危而后安矣。愚愿世之用白虎汤者，宜常存一加人参之想也。又按：此案与前案观之，凡用白虎汤而宜加人参者，不必其脉现虚弱之象也。凡谂知其人劳心过度，或劳力过度，或在老年，或有宿疾，或热已入阳明之府，脉象虽实，而无洪滑之象，或脉有实热，而至数甚数者，用白虎汤时，皆宜酌加人参。
Comments: if Renshen was used in the beginning, how could the condition become so severe. It is lucky that the mistake has been realized and there is chance to solve the problem. But the condition is anyway very dangerous firs and then become saved. I hope that, doctors, when is to use the Baihu Tang, keep in mind the use of Renshen. Referring this case and the previous case, Whenever to use the Baihu Jia Renshen Tang, the pulse is not needed to be asthenic weak. If it is known that, the person had a history of hard mind work, labor work, or if the person is in old age, or he has long time disease history, or if his condition is in the Yangming stage, the pulse is sthenic but no waving and slippery feeling, or if the pulse is sthenic Fire, and is frequent, in the use of Baihu Tang, the herb Renshen should always be added into the formula.

寒温证表里皆虚，汗出淋漓，阳明胃腑，仍有实热者，用此汤时，宜加龙骨、牡蛎。

In the Shanghan and Wen disease, if the body surface and inside both are weak, the person has continuous sweating and if the Yangming stomach has sthenic Fire, in consideration of using the Baihu Jia Rensehn Tang, always add Longgu and Muli to the formula.

一童子，年十六，于季冬得伤寒证。因医者用发表药太过，周身时时出汗，仍表里大热，心中怔忡，精神恍惚。脉象洪数，按之无力。遂用此汤，加龙骨、牡蛎（皆不 ）各一两，煎汁一大碗，分数次温饮下，尽剂而愈。
A youth was 16 years of old. He had Shanghan disease in a winter. For over use of surface-expelling herbs, he had sweat all over the body from time to time, but still had Hot in the body surface and inside too. He felt palpitation and his mind was cloudy. His pulse was waving and frequent, but weak when pressed hard. He was given this formula, with the addition of Longgu 30 gram, and Muli 30 gram. After drink of the herbal tea for several times, the condition was solved.

仲景治伤寒脉结代者，用炙甘草汤，诚佳方也。愚治寒温，若其外感之热不盛，遇此等脉，即遵仲景之法。若其脉虽结代，而外感之火甚实者，亦用白虎加人参以山药代粳米汤。曾治一叟，年六旬余。于孟冬得伤寒证，五六日间，延愚诊视。其脉洪滑，按之亦似有力。表里俱觉发热，间作呻吟，又兼喘逆，然不甚剧。投以白虎汤，一剂大热稍减。再诊其脉，或七八动一止，或十余动一止，两手皆然，而重按无力。遂于原方中加人参八钱，兼师炙甘草汤中用干地黄之意，以生地代知母。煎汁两盅，分二次温饮下。脉即调匀，且较前有力，而热仍如故。从前方中生石膏二两遂加倍为四两，煎汁一大碗，俾徐徐温饮下，尽剂而愈。
When the Master Zhang Zhongjing treated the Shanghan disease with Jie pulse and Dai pulse, he used Zhi Gancao Tang. It is really great formula. When I treat the Shanghan and Wen disease, if the invading Hot is not so severe, and the person has such pulse, I followed the Master’s way. If the pulse is Jie and Dai, but the invading Fire is very sthenic, I still use the Baihu Jia Renshen Tang, with the Shanyao to replace the Genmi. I treated a old man. He was 60 years of old. He had Shanghan disease in a winter. On the fifth and sixth day, I was invited to come for a help. His pulse was waving and sliperry, which felt as strong when pressed harder. His body surface and inside both were hot. He had moaning and groaning from time to time. He also had asthma and reverse of Qi, though not so severe. He was given the Baihu Tang. After one dose, his hot reduced slightly. His pulse became one stop for every seven to eight beats, or one stop every ten beats on both sides, which was weak when pressed harder. So, to the formula, added Renshen 24 gram, and also following Master’s idea in the Zhi Gancao Tang, added Shengdi, which was to replace the Zhimu. The herbs were cooked, and the person was asked to drink it and finish it for two times of drink. Then, the pulse felt calm and stronger than before, but the hotness remained the same. So the Shigao was added to 120 gram, and the herbal tea was drunk slowly and gradually. After finish it, the condition was cured.

按：治此证时，愚习用白虎汤，而犹未习用白虎汤加参也。自此以后，凡年过六旬之人，即脉甚洪实，用白虎汤时，亦必少加人参二三钱。
Comments: in the treatment of this case, I used Baihu Tang, not get used to use the Baihu Jia Renshen Tang. After this case, whenever the patient was over 60, even if the pulse was waving and sthenic, in the use of Baihu Tang, I will always add Renshen 6 to 9 gram to the formula.

结代之脉虽并论，究之结脉轻于代脉，故结脉间有宜开通者。曾治一叟，年六十余，大便下血，医治三十余日，病益进。日下血十余次，且多血块，精神昏愦。延为诊视，脉洪实异常，至数不数，惟右部有止时，其止无定数，乃结脉也。其舌苔纯黑，知系温病大实之证。从前医者，但知治其便血，不知治其温病可异也。投以白虎加人参以山药代粳米汤，将石膏改用四两，煎汤三盅，分三次温饮下。每次送服旱三七细末一钱。如此日服一剂，两日血止，大便仍滑泻，脉象之洪实减半，而其结益甚，且腹中觉胀。询其病因，知得诸恼怒之后。遂改用莱菔子六钱，而佐以白芍、滑石、花粉、茅根、甘草诸药，一剂胀消。脉之至数调匀，仍稍有洪实之象，滑泻亦减。再投以滋阴清燥汤，一剂泻止，脉亦平和。
The Jie pulse and the Dai pulse are usually mentioned the same time, but the Jie pulse is less severe than the Dai pulse. For the Jie pulse, sometimes, it might need opening therapy. There has been a man, 60 years of old. He had bleeding in stool. Previous doctor had treated him for 30 days, the condition became worse. He had bleeding stool tens of times a day, which was with with lots fo blood clots. His mind was cloudy. I was then invited to have a look. His pulse was very waving, sthenic, but not frequent. Only on the right side, there was stop of the pulse from time to time. It was a Jie pulse. His tongue covering was pure black in color. His condition was considered to be the Wen disease, a heavy sthenic condition. The previous doctor only knew to treat the bleeding, but not knew that to treat the Wen disease per se could create a change. I used the Baihu Jia Renshen Tang, with the Shanyao to replace the Genmi, and with the change of the Shigao to 120 gram. The herbal tea was separated and let the person drink. Each time, 3 gram of herb Sanqi was also drunk with the herbal tea. By this way for two days, the bleeding stopped, but the stool was still slippery, and the pulse waving and sthenic reduced half, but the Jie pulse was much more. The person also felt bloating in the abdomen. After asking, it was known that he got this disease after angry. So, in the following formula, it was used the Laifuzi 18 gram, with help of Baishao, Huashi, Tianhuafeng, Baimaogen and Gancao. One dose solved the bloating feeling and the pulse was calm down and became regular, with only slight waving and sthenic feeling. The slippery diarrhea was also reduced. Finally, he was given Ziyin Qingzao Tang. One dose solved the remaining problems.

寒温之证，最忌舌干。至舌苔薄而干，或干而且缩者，尤为险证。而究其原因，却非一致。有因真阴亏损者，有因气虚不上潮者，有因气虚更下陷者，皆可治以白虎加人参以山药代粳米汤。盖人参之性，大能补气，元气旺而上升，自无下陷之虞。而与石膏同用，又大能治外感中之真阴亏损，况又有山药、知母，以濡润之乎。
For the Shanghan and Wen disease, the dry tongue is the most to be worried. Upon to the tongue covering thin and dry, or dry and shrink, the condition was much more dangerous. The reasons contribute to this condition are largely variable. For some, the reason is due to True Yin deficiency; some to the Qi deficiency so that the Qi could not bring the water vapor up; some to the Qi deficiency and the Qi sinks. But all these condition can be treated with the Baihu Jia Renshen Tang, with Shanyao to replace the Genmi. The nature of the Renshen is to nourish the Qi. When the Yuan Qi is sufficient and raise up, there would have no worry it will sink down. Use it with the Shigao, it can solve the True Yin deficiency in the common cold-related disorders. Not to speak that there are also the Shanyao and Zhimu in the formula that work to humidify the body.

若脉象虚数者，又宜多用人参，减石膏一两，再加玄参、生地滋阴之品。煎汁三四茶盅，徐徐温饮下，一次只饮一大口，防其寒凉下侵致大便滑泻。又欲其药力息息上达，助元气以生津液，饮完一剂，再煎一剂，使药力昼夜相继，数日舌润火退，其病自愈。

If the pulse is asthenic frequent, the amount of Renshen should be used more, but the Shigao is reduced by 30 gram, and add Xuanshen and Shengdi, such Yin-nourishing herbs. The herbal tea is drunk slowly and gradually, one big mouth one time, to prevent its cold attacking the Lower Jiao so to cause slippery diarrhea. Also to keep its healing effect gradually comes up, to help the Yuan Qi to develop liquid-fluid, after finish one dose, cook another, so no break between the herbal drinks, day and night. After several days, the tongue is wet and the Fire reduces, and the disease cures.

一人年二十余，素劳力太过，即觉气分下陷。一岁之间，为治愈三次。至秋杪感冒时气，胸中烦热满闷，燥渴引饮，滑泻不止，微兼喘促。舌上无苔，其色鲜红，兼有砂粒。延医调治，投以半补半破之剂。意欲止其滑泻兼治其满闷也。服药二剂，滑泻不止。后愚为诊视，其脉似有实热，重按无力。遂先用拙拟加味天水散止其滑泻。方中生山药用两半、滑石用一两，一剂泻止。继服滋阴清火之剂，数剂喘促亦愈，火亦见退。唯舌干连喉，几不能言，频频饮水，不少濡润，胸中仍觉满闷。愚恍悟曰：此乃外感时气，挟旧病复发，故其脉象虽热，按之不实。其舌干如斯者，津液因气分下陷而不上潮也。其胸中满闷者，气分下陷，胸中必觉短气，病患不善言病情，故漫言满闷也。此时大便不行已五日。遂投以白虎加人参以山药代粳米汤，一剂病愈十之七八，而舌之干亦减半。又服一剂，大便得通，病觉全愈。舌上仍无津液，又用潞参一两、玄参两半，日服一剂，三日后舌上津液滋润矣。
A man was 20 years of old. Due to too heavy labor work, he felt sink of Qi. Within one year, he was cured three times. Upon the autumn, he felt annoying hot and bloating in the chest, dryness and thirsty and craved for drink, had endless slippery diarrhea, and had slight asthma. He had no tongue covering, the tongue was fresh red in color, with sand particles. He visited doctor. He was given half-nourishing and half –breaking herbal formula, with the aim to stop the bloating feeling and solve the slippery diarrhea. After drink of the herbal tea two doses, the slippery diarrhea remained. When I saw him, his pulse was as sthenic Fire, but weak when pressed harder. He was first given the Jiawei Tianshui San to stop the diarrhea. The formula contained Shanyao 45 gram, Huashi 30 gram. One dose solved the diarrhea. Followed were the Yin-nourishing and Fire-clearing herbs. Several doses also solved the asthma and the Fire. Only remaining problem was the dry throat, which even prevent speak. He drunk water again and again, but still felt dryness. His chest felt bloating. I suddenly realized that this was the invading Xie Qi that mixed and triggered the old disease. Therefore, his pulse is Hotness, but it was weak when pressed harder. The reason for his continuous dryness in the tongue was the Qi sink, that prevent the liquid-fluid evaporate up to the tongue. Due to the Qi sink, he of course felt short of breath in the chest. The patient was not good at telling the feeling, so he broadly told the chest bloating. At that time, he did not have bowel movement for five to six days. He was then given the Baihu Jia Renshen, with the Shanyao to replace the Genmi. One dose solve the condition 70% to 80%. The dryness in the tongue was also reduced. Additional drink solved the bowel movement. He felt cured. For the tongue was still dry, he was given to use Lushen 30 gram, and Xuanshen 45 gram. One dose was for one day. After three days, the condition was completely cured.

一童子，年十三，于孟冬得伤寒证。七八日间，喘息鼻煽动，精神昏愦，时作谵语，所言者皆劳力之事。其脉微细而数，按之无力。欲视其舌，干缩不能外伸，启齿探视，舌皮有瘢点作黑色，似苔非苔，频饮凉水，毫无濡润之意。愚曰：此病必得之劳力之余，胸中大气下陷，故津液不能上潮，气陷不能托火外出，故脉道瘀塞。不然，何以脉象若是，恣饮凉水而不滑泻乎？遂治以白虎加人参以山药代粳米汤，煎汁一大碗，徐徐温饮下，一昼夜间连进二剂，其病遂愈。
A child, 13 years of old, got Shanghan disease in a winter. On the seventh or eighth day, he had asthma, moving of nose wing, cloudy mind, and had random chattering from time to time. The talking in the delibirum are all about the labor work. His pulse was slight thin, and frequent. It also felt weak when pressed harder. When I wanted to see his tongue, the tongue was dry and shrink and hard to move out of the mouth. After open the mouth, it was seen that there are black dots on the tongue, which looked as tongue covering but not. He drank water very frequently but no wetness results. I said: this disease must be due to heavy labor work, that damaged the Big Qi in the chest, to make the Big Qi sink, the liquid-fluid hard to evaporate up. The sink Qi could not hold the Xie Fire out of the body, so that the Xie Fire blocked the blood vessels. Other wise, how the pulse felt as this, and he drank so much water and no slippery diarrhea? He was then given the Baihu Jia Renshen Tang, with Shanyao to replace the Genmi. The herbal tea was given to drink gradually and slowly. It was used two doses for one day. The disease was cured. 

按：脉虚数而舌干者，大便虽多日不行，断无可下之理，即舌苔黄而且黑亦不可下。惟按上所载治法，使其大便徐徐自通，方为稳善。若大便通后，而火犹炽，舌仍干者，可用潞参一两、玄参二两煮汁，徐徐饮之，以舌润火退为度。若或因服药失宜，大便通后，遂滑泻，其虚火上逆，舌仍干者，可用拙拟滋阴固下汤去滑石，加沙参数钱。若其为日既久，外感之火全消，而舌干神昏，或呼吸之间，常若气不舒，而时作太息者，此大气因服药下陷，病虽愈而不能自复也。宜单用人参两许煎汤服之，或少加柴胡亦可（此证有案在升陷汤下宜参观）。若微有余热，可加玄参佐之。
Comments; if the pulse is asthenic frequent and the tongue is dry, though there was not bowel movement for several days, there is no reason to use the bowel-cleansing therapy. Even if the tongue covering is yellow and black, it should not be used either. Only to following the above way, to make the stool come out naturally by it self, it would be safe. If, after the bowel movement, the Fire is still overwhelming, and the tongue is still dry, use Dangshen 30 gram, Xuanshen 60 gram to cook herbal tea and to drink gradually, until the tongue become humidity and the Fire is reduced. If due to the wrong use of the herbal therapy, after the stool comes out, but it also turns to a slippery diarrhea, the astheneic Fire is still moving reversely up and the tongue is still dry, use my Ziyin Guixia Tang, with the removal of Huashi, but addition of Shashen several grams. If the disease has been last for a long time, the invading Fire has been cleared, but the tongue is dry, and the mind is still cloudy, or sometimes, there is a sign of short of breath, or a yawn, it is due to the Qi sink, indicating that the disease is solved but the body could not restore health by itself. In this case, use single Renshen 30 grams more to cook the herbal tea to drink. Or, it is ok to add herb Chaihu some amount (check my Shenxian Tang). If there is mild hotness residue, add Xuanshen. 

寒温下后不解，医者至此，恒多束手。不知《伤寒论》原有治此证的方，即白虎加人参汤也。其一百六十八节云：“伤寒病，若吐、若下后，七、八日不解，热结在里，表里俱热，时时恶风，大渴、舌上干燥而烦，欲饮水数升者，白虎加人参汤主之。”愚生平治寒温，未有下后不解者，于仙露汤后曾详论之。然恒有经他医下后不解，更延愚为延医者，其在下后多日，大便未行，脉象不虚弱者，即按《伤寒论》原方。若在甫下之后，或脉更兼虚弱，即以山药代粳米，或更以生地代知母，莫不随手奏效。盖甫下之后，大便不实，骤用寒凉，易至滑泻。而山药收涩，地黄粘润，以之代粳米、知母，实有固下之力，而于脉之兼虚弱者，则尤宜也。况二药皆能滋真阴，下后不解，多系阴分素虚之人，阴分充足，自能胜外感之余热也。
For the Shanghan and the Wen disease, after the use of the bowel-cleansing therapy, and the stool has already come out, but the disease remains, doctors usually have no idea whatever can do. They do not know that, in the 《Shan Han Lun》, there is formula for this condition. It is the Baihu Jia Renshen Tang. In the paragraph 168, it is said: “Shanghan disease, after vomiting therapy, or bowel-cleansing therapy, the disease condition remains for seven to eight days without release; the hot block is in the inside; the body surface and inside both are hot; the person feels dislike wind from time to time, and feels strong thirsty; the tongue is dry, which makes the person feel annoying or agitate; and the person wishes to drink liters of water. In this case, use Baihu Jia Renshen Tang.” In my life long history to treat the Shanghan and Wen disease, never have a case, in which the condition was not solved after the bowel-cleansing therapy. Readers can check the discussion and case introduction in the chapter for Xianlu Tang. But, there are many cases that had been treated by other doctors using the bowel-cleansing therapy, the condition was not solved after the stool came out. The patients did not have any stool out after that therapy. For such case, if the pulse is not weak, I would use the original Baihu Jia Renshen Tang in the book. If the pulse is weak, the formula is modified by using Shanyao to replace Genmi, and the Shengdi to replace the Zhimu. It always worked. The reason is that, after the bowel-cleansing therapy with the stool out, the stool is not solid yet. If the Cold herbs are used suddenly, it would be easy to cause slippery diarrhea. The herb Shanyao is restraining and Shengdi is sticky and wetting in herbal nature, their replacement to the Gengmi and Zhimu, could fix the Lower Jiao to stop the slippery diarrhea. They are especially good for person with weak pulse. In addition, the two herbs can nourish the Yin. The person with continuous disease condition after the bowel-cleansing therapy is usually with Yin deficiency. When the Yin becomes sufficient, it can of course be able to solve the remaining Fire residue.

寒温之证，过十余日大热已退，或转现出种种危象。有宜单治以人参，不必加人参于白虎汤中者。王宇泰曰：余每治伤寒温热等证，为庸医妄汗、误下已成坏证，危在旦夕者，以人参二两，童子小便煎之，水浸冰冷，饮之立效。又张致和曾治一伤寒坏证，势近垂危，手足俱冷，气息将断。用人参一两、附子一钱，于石罀内煎至一碗，新汲水浸之冰冷，一服而尽。少顷病患汗出，鼻梁尖上涓涓如水。盖鼻梁应脾，若鼻端有汗者可救，以土在人身之中周遍故也。
For the Shanghan and the Wen diease, after about ten days, the big fever has been cleared but the person may start to have various dangerous conditions. Some patients may need only the Renshen for the treatment, not to add it into the Baihua Tang. Dr. Wang Yutai said: “When I met patient with Shanghan or the Wen disease, previous doctor had used sweat therapy or bowel-cleansing therapy in a wrong way, so the person was in a very dangerous condition, I used only the Renshen 60 gram, mixed with child urine to cook the herbal tea. The herbal tea was cooled down in cold water, then give patient to drink. It worked right away.” Dr. Zhang Zhihe also treated a patient, who has been treated in a wrong way by previous doctor. His condition was in dangerous, the hands and feet were very cold, and the breath was to stop. He used Renshen 30 gram, Fuzi 3 gram, cooked to collect one bowl, which was cooled down in newly got well water. It was given to the patient all in once. Very soon, the body had sweat, with water drops on the nose, since the nose stem corresponding to the Spleen. If there is sweat on the nose end, the person can be saved, since the Soil (the spleen) is distributed all over the body.

又：愚曾治一温证，已过两旬，周身皆凉，气息奄奄。确知其因误治，胸中大气下陷。遂用人参一两、柴胡二钱，作汤灌之，两剂全愈。此证详案，在拙拟升陷汤下可参观。
In addition: I have treated a patient with the Wen disease. The disease has last for twenty days. The body was cold all over, and the breath was very weak. It was sure that this was a condition after a wrong treatment by previous doctors, in which the Big Qi in the chest sink. I used Renshen 30 gram, and Chaihu 6 gram for the treatment. Two doses solved the problem. This case has been discussed and introduced in the port for Shenxian Tang. Please check it.

白虎汤加人参，又以山药代粳米，既能补助气分托邪外出，更能生津止渴，滋阴退热，洵为完善之方。间有真阴太虚，又必重用滋阴之药以辅翼之，始能成功者。
That in the Baihu Tang, with addition of Renshen, and with Shanyao to replace the Genmi, the formula can nourish the Qi, so as to push the Xie Qi out, as well as to develop liguid-fluid in the body, to nourish the Yin and to clear the Fire. It is a perfect formula. Occasionally, there is case with the True Yin deficiency, so the large amount of Yin-nourishing herbs should be used as help to ensure success.

一媪，年过七旬，于孟夏得温证，五六日间，身热燥渴，精神昏愦，舌似无苔，而舌皮数处作黑色，干而且缩。脉细数，按之无力。当此高年，审证论脉，似在不治。而愚生平临证，明明见不可治之证，亦必苦心研究而设法治之，此诚热肠所迫，不能自已，然亦往往多有能救者。踌躇再四，为疏两方。一方即白虎加人参以山药代粳米汤，一方用熟地黄二两，生山药、枸杞各一两，真阿胶（不炒）五钱，煎汤后，调入生鸡子黄四枚。二方各煎汁一大碗，徐徐轮流温服，阅十点钟，尽剂而愈。自言从前服药，皆不知觉，此时则犹如梦醒。视其舌上犹干黑，然不缩矣。其脉至数仍数，似有余热。又用玄参二两、潞参一两煎汤一大碗，徐徐温服，一日一剂，两日大便得通。再视其舌，津液满布，黑皮有脱去者矣。

A lady, 70 years of old, got the Wen disease in a summer. On the fifth to sixth day of the disease, she felt hot, dry and thirsty. Her mind was cloudy. Her tongue covering  was without covering and there were several black spots on the tongue, which was dry and shrink. Her pulse was thin and frequent, but weak when pressed harder. The person was in old age, together with the condition and the pulse, it seemed hard to solve. In my life, for any case, even if it is known it very hard to save the life, I still tried to study the way to solve the problem. I actually cannot prevent myself but there indeed have some cases that are saved. For this case, after a long time consideration, I prescribed two formulas. One was the Baihu Jia Renshen Tang, with Shanyao to replace the Genmi. Another one is the Shoudi 60 gram, Shanyao 30 gram, Shanyurou 30 gram, Goujizi 30 gram, Ajiao (not fry) 15 gram. After cook, add four egg yolks. The two formulas were prepared separately for big bowl each, which were given to drink in turn. After ten hours, the herbal tea were finished for drink. The person said, when she drank the herbal tea before, she felt nothing. Now she felt as waked up from a dream. Her tongue was still dry and black, but not shrank. The pulse was still frequent, appearing to have Hot residue. The following herbal formula included Xuanshen 60 gram, Dangshen 30 gram. The herbal tea was given for drink slowly and gradually, one dose for one day. It has been used for two days. The tongue was wetness and the black skin disappeared.

隔数日，其夫年与相等，亦受温病。四五日间，烦热燥渴。遣人于八十里外致冰一担，日夜食之，烦渴如故。复迎愚延医，其脉洪滑而长，重按有力，舌苔白浓，中心微黄。知其年虽高而火甚实也。遂投以白虎加人参以山药代粳米汤，将方中石膏改用四两，连进两剂，而热渴俱愈。其家人疑而问曰：此证从前日食冰若干，热渴分毫不退，今方中用生石膏数两，连进两剂而热渴俱愈，是石膏之性凉于冰远矣。愚曰：非也。石膏原不甚凉，然尽量食冰不愈而重用生石膏即愈者，因石膏生用能使寒温之热有出路也。西人不善治寒温，故遇寒温实热证最喜用冰，然多有不愈者。至石膏生用，性能发汗，其热可由汗解。即使服后无汗，亦可宣通内蕴之热，由腠理毛孔息息达出，人自不觉耳。
 Several days later, her husband, the similar age as her, also had Wen disease. On the fourth and fifth day, he felt annoying hot, dry and thirsty. He asked someone to pick up ice 80 mile away and eat the ice day and night but the annoying thirsty remained the same. I was then invited to have a look. His pulse was waving, slippery and long. It was strong when pressed harder. His tongue covering was white and thick, with yllow color in the middle portion. It was considered that, though he was old in age, but had sthenic Fire. He was given the Baihu Jia Renshen Tang, with Shanyao to replace the Genmi. The Shigao was changed to 120 gram. After two doses, the hot became worse. The family doubted and asked: for him, he ate ice every day, the hotness and thirsty did not change any. Now, use Shigao only tens of grams, and two doses were drunk but the hot and thirsty was worse. It indicated that, the cooling effect of the Shigao is less than the ice blocks. I said: no really. The Shigao originally is not very cold. That the ice-eating does not solve the problem but large amount of Shigao could solve it is due to the reason that the Shigao can create opening to the Cold and the Wen disease to leave out of the body. The western people is not good to treat the Shanghan and the Wen disease. They like to use the ice in the sthenic Fire condition. However, there are much cases that they failed. The Shigao, when used without any process on it, has ability to create sweat. The hotness can be solved through the sweat. Even if the person has no sweat after drinking the herbal tea, it can disperse the inside Hotness, removing it through the skin hole that the person could no feel. 

按：此证与前证，年岁同，受病之时亦同。而一则辅以熟地、枸杞之类，以滋真阴；一则重加生石膏，以清大热。此乃随病、脉之虚实，活泼加减，所以投之辄效也。
Comments: for this case and the previous case, the patients were similar age and the time to get the illness was also almost the same. In one case, it was used the Shoudi and Goujizi, to nourish the Yin; in another, the used was the Shigao, to clear the hotness. This is the modification of the herbal formula, according to the patient, for their body condition, the disease condition, and so on, so that the result was good.

忆五年前，族家姊，年七旬有三，忽得瘫痪证，迎愚诊视。既至见有医者在座。用药一剂，其方系散风补气理痰之品，甚为稳善，愚亦未另立方。翌日，脉变洪长，知其已成伤寒证。先时，愚外祖家近族有病者，订于斯日迎愚，其车适至，愚将行，谓医者曰：此证乃瘫痪基础预伏于内，今因伤寒而发，乃两病偕来之证。然瘫痪病缓，伤寒病急。此证阳明实热，已现于脉，非投以白虎加人参汤不可，君须放胆用之，断无差谬。后医者终畏石膏寒凉，又疑瘫痪证不可轻用凉药。迟延二日，病势垂危，复急迎愚。及至，则已夜半矣。诊其脉，洪而且数，力能搏指，喘息甚促，舌强直，几不能言。幸喜药坊即在本村，急取白虎加人参汤一剂，方中生石膏用三两，煎汤两盅，分二次温饮下，病稍愈。又单取生石膏四两，煮汁一大碗，亦徐徐饮下，至正午尽剂而愈。后瘫痪证调治不愈，他医竟归咎于愚。谓从前用过若干石膏，所以不能调治。吁！年过七旬而瘫痪者，愈者几人？独不思愚用石膏之时，乃挽回已尽之人命也。且《金匮》治热瘫痫，有风引汤，原石膏与寒水石并用。彼谤愚者，生平盖未见《金匮》也。
I remembered that, five years ago, my sister-in-law, who was 73 years of old, suddenly had paralysis. I was asked to come to have a look. When I came there, there was another doctor there. His formula was the Wind-dispersing, Qi-nourishing and Phlegm-removing herbs. It was calm and safe formula. I did not give any prescription. The next day, the pulse became waving and long, suggesting that her condition was developed into a Shanghan disease. At that time, I had something else needed to leave. Before I left, I told that doctor that her condition is due to the fact that, the reason for the paralysis had been in the body, now it was triggered by the Shanghan disease, so that the current condition was the combination of the two problems. However, the paralysis was not so urgent, but the Shanghan disease was realy urgent. At this movement, the disease had been in the Yangming sthenic Fire stage, as shown on the pulse. The Baihu Jia Renshen Tang must be used. You could use it without more worry. No need to worry about this formula. Later, the doctor feared that the Shigao is Cold, and worried that the paralysis condition should not use Cold herbs. Two days later, the lady’s condition became wosse and in a very dangerous condition that risked the life. I was urgently invited back to see her again. When came, it was middle night. Her pulse was waving and frequent, very strong so as to beat my finger. She had very urgent breath, and the tongue was straight, hard to bend, and hardly to talk. It was lucky that the herbal shop was in the same village, so the family was asked to go and buy the Baihu Jia Renshen Tang, in which the Shigao was used up to 90 gram. The herbal tea was asked to drink in two times. The condition was little improved. Then the Shigao 120 gram was cooked as herbal tea, and it was asked to drink by the lady gradually. It was finished up to the noon next day. Later, the paralysis was not cured, and that doctor blamed me as my fault. He said that, it was due to my use of Shigao in the course. Yu, For person over 70 and with paralysis, how many of them can be cured for the paralysis? You do not mention that it was the Shigao that I used and saved the lady’s life!  In addition, in the book 《Jin Kui》in the treatment of Hot epilepsy and paralysis, there is formula Fengyin Tang, in which the Hanshishi and the Shigao are used the same time. The person who blamed me actually did not read the 《Jin Kui》!

尝治一少年，素羸弱多病。于初夏得温证，表里俱热，延医调治不愈。适愚自他处治病归，经过其处，因与其父素稔，入视之。其脉数近六至，虽非洪滑鼓指，而确有实热。舌苔微黄，虽不甚干，毫无津液。有煎就药一剂未服，仍系发表之剂，乃当日延医所疏方，其医则已去矣。愚因谓其父曰：此病外感实热，已入阳明之府。其脉象不洪滑者，元气素虚故也。阳明府热之证，断无发表之理。况其脉数液短，兼有真阴虚损之象尤忌发汗乎。其父似有会悟，求愚另为疏方。本拟用白虎加人参汤，又思用人参，即须多用石膏，其父素小心过度，又恐其生疑不敢服，遂但为开白虎汤，方中生石膏用二两。嘱其煎汁两茶盅，分二次温饮下，服后若余火不净，仍宜再服清火之药。言毕，愚即旋里。后闻其服药后，病亦遂愈。迟十余日，大便又燥结，两腿微肿，将再迎愚延医。而其父友人有自谓知医者，言其腿肿，系多服生石膏之过。而孰知系服石膏犹少之过哉！病家竟误听其言，改延他医，投以大剂承气汤，服后其人即不语矣，迁延数日而亡。夫自谓知医者，不过欲炫己之长，而妄指他人之短。岂知其言之一出，即足误人性命哉！
I treated a youth. He was slim and thin and had disease for a long time. He had the Wen disease in the early summer. He felt hot inside and outside of the body. He had been treated by other doctors but no improvement. At the time, I returned back from other city and past the city where he lived. Since I knew of his father, I walked in to visit him. His pulse was up to six times per breath circle. It was though not as waving or slippery to beat the finger, indeed a sthenic Fire pulse. His tongue covering was slight yellow. It was not very dry, but neither wetness. There was a herbal tea there he did not drink it yet. It was a surface-dispersing herbal formula, which was prescribed by doctor the same day, but the doctor had left. I told his father: this was a Xie Qi invasion condition, which had come into the Yangming stage. That the pulse was not waving or slippery, is due the weakness in the body Qi portion. For the Yangming Hotness stage, there is no reason to use surface-dispersing herbs. In addition, the pulse was frequent and there was evidence of dryness condition, the body was in Yin deficiency condition, in which the sweating therapy should not be used. His father seemed understand what I meant, so asked me to give a formula. From beginning, I had had decided to use the Baihu Jia Renshen Tang, I also thought that, to use Renshen, the Shigao should be used more. For his father was too careful, I worried that he might have suspect for the use of the Renshen, so I only prescribed the Baihu Tang, in which the Shigao was 60 gram. The herbal tea was drunk twice to finish. I told him, after drink, if there was still remaining Fire residue, the Fire-cleansing herbs should be drunk again. Then I left and went my home town. Later, I heard that, after the herbal tea drink, the condition was cured. However, ten days later, he had constipation, and there was slight swelling on both legs. His father planned to invite me to come again. One of the father’s friends, who claimed that he knew medicine, said that the swelling might be cause by the wrong drink of Shigao. He did not know that it was due to too less drink of the herb Shigao! The family believed what he blamed and changed to other doctors for treatment. The later doctor used large amount of Chenqi Tang. After drink of the herbal tea, the boy was unable to talk. After several days, he died. My God, to claim knowing the medicine is as to bloat himself, so to point out other’s error. He did not know that, due to his several words, a life lost!

至产后之证，忌用寒凉。而果系产后温证，心中燥热，舌苔黄浓，脉象洪实，亦宜投以白虎加人参以山药代粳米汤，而更以玄参代知母则尤妥善。盖愚于产后温证之轻者，其热虽入阳明之府，脉象不甚洪实，恒重用玄参一两或至二两，辄能应手奏效；若系剧者，必白虎加人参以山药代粳米汤，而更以玄参代知母方能有效。
For disease after childbirth, it was forbidden to use Cold and Cooling herbs. However, if the condition belongs to the Wen disease, the lady feels dry and annoying hot in heart, with yellow and thick tongue covering, and with waving ans sthenic pulse. She should also be given the Baihu Jia Renshen Tang, with Shangyao to replace Genmi. It is even better to use the Xuanshen to replace the Zhimu. In my experience, with the less severe Wen disease after childbirth, the Fire was in the Yangming stage, but the pulse is not so waving asthenic, I always use Xuanshen up to 30 to 60 gram. It always works. If the condition is severe, I use the Baihu Jia Renshen Tang, with the Shanyao to replace the Genmi, and with the Xuanshen to replace the Zhimu.

诚以石膏、玄参，《神农本草经》皆明载其治产乳。故于产后温病之轻者，可单用玄参。至温病之剧者，不妨石膏、玄参并用也。然用石膏必须佐以人参，因其时当产后，其热虽实，而体则虚也。不用知母者，《神农本草经》未载其治产乳，不敢师心自用，漫以凉药治产后也。
In the book《Shennong Bencao Jing》, it is indicated that, the herb Shigao and Xuanshen, both can treat the breast milk problem. So, for the not severe Wen disease after childbirth, the Xuanshen can be used alone. If the condition is severe, the Shigao and the Xuanshen can be used the same time. However, the Shigao should be used with the Renshen, since after the childbirth, the Hotness is sthenic, but the body is asthenic. The reason for not using the Zhimu, is that it was not cited in the book if it can be used in the breast disorder or not. I dared not to try myself to use every kind of Cold herbs in the after childbirth conditions.

友人吴××，深通医学，其侄××亦知医，有戚家延之治产后病。临行，吴××嘱之曰：果系产后温热，阳明胃府大实，非用《衷中参西录》中白虎加人参以山药代粳米汤，更以玄参代知母不可。及至诊之，果系产后温证，病脉皆甚实。××遵所嘱，开方取药。而药坊皆不肯与，谓产后断无用生石膏之理，病家因此生疑，××辞归。病家又延医治数日，病势垂危，复求为延医。携药而往，如法服之，一剂而愈。
My friend Mr. Wu knew medicine well. His nephew also knew medicine. He was invited to a relatives for the after childbirth condition. Before leaving, Mr. Wu reminded him: if the condition belongs to the Wen disease, in a Yangming Hot and sthenic stage, the herbal formula must be used, the Baihu Jia Renshen Tang, with Shanyao to replace the Genmi, and more with the Xuanshen to replace the Zhimu, as indicated in the book《Zhongzhong Canxi Lu》. Upon the nephew reached there, the condition in deed belonged to the Yangming Wen disease. The pulse and the condition both were sthenic. The nephew followed Mr. Wu’s remind, used the formula. The herbal shop refused to give the herbs. They said that, there is no reason to use the Shigao in the after childbirth condition. The family so had suspect. The nephew so had to turn back. The family asked other doctors to have a look, but the disease became worse. They have to come to ask the nephew again. The nephew came with the herbs with him. The herbal tea was prepared and drunk. One dose solved the problem.

附录：
Appendix: 

沧县董××来函：
Letter from Mr. Dong, Cang city.

赵××，患温病。医者投以桂枝汤，觉热渴气促。又与柴胡汤，热尤甚，且增喘嗽，频吐痰涎，不得卧者六七日。医者谓病甚重，不能为矣。举家闻之，惶恐无措。伊芳弟××延为延医。既至，见病患喘促肩息，头汗自出，表里皆热，舌苔深灰，缩不能言。急诊其脉，浮数有力，重按甚空。因思此证阳明热极，阴分将竭，实为误服桂枝、柴胡之坏证。急投以白虎加人参以山药代粳米汤，更以玄参代知母。连服两剂，渴愈喘止，脉不浮数，仍然有力，舌伸能言，而痰嗽不甚见轻。继投以从龙汤，去苏子，加人参四钱，天冬八钱，服七剂全愈。
Mr. Zhao had Wen disease. Doctor gave him Guizhi Tang. He felt hot, thirsty and short of breath. He was given the Chaihu Tang, the hot became worse, with additional asthma and cough, and with spitting phlegm. He could not have a sleep for six to seven days. Doctor said that his condition was very severe and hard to save. The family heard this, felt worry and no idea what to do. The my wife’s brother was invited to have a look. When he came, he saw the patient had asthma, short of breath, sweat on head, hot on body surface and inside, deep gray tongue covering, and hard to speak. It was considered that this was a Yangming condition with severe and extreme Fire, the Yin portin was to exhaust. It was the result of wrong intake of Guizhi Tang and Chaihu Tang. It was so urgent to give the patient Baihu Jia Renshen Tang, with Shanyao to replace the Genmi, and with the Xuanshen to replace the Zhimu. After continuous two doses, the thirsty and asthma stopped; the pulse was no longer floating or frequent, but still strong; the tongue can move to speak; only the cough and phlegm were not changed. Followed was given the Conglong Tang, with removal of Souzi, but addition of Renshen 12 gram, and Tianmendong 24 gram. After seven doses, the condition was cured.

又：一赵姓妇，年二十余，产后八九日，忽得温病。因误用热药发汗，致热渴喘促，舌苔干黑，循衣摸床，呼索凉水，病家不敢与。脉弦数有力，一息七至。急投以白虎加人参以山药代粳米汤，为系产后，更以玄参代知母。方中生石膏，重用至四两。又加生地、白芍各数钱。煎汤一大碗，分四次温饮下，尽剂而愈。当时有知医者在座，疑而问曰：“产后忌用寒凉，何以如此放胆，重用生石膏？且知母、玄参皆系寒凉之品，何以必用玄参易知母？”答曰：“此理俱在《衷中参西录》中”，遂于行箧中出书示知，医者细观移时，始喟然叹服。
Another case: a lady with family name of Zhao, was 20 years of old. Eigtht to nine days after childbirth, she suddenly had Wen disease. For misuse of Hot herbs to create sweat, she felt very hot, thirsty and asthma. Her tongue covering was dry and black. She randomly touch and massage the clothes and bed, crying for cold water to drink, but the family dared not to give to her. Her pulse was sting, frequent and strong, which was seven times per breath circle. It was urgent to give the herb Baihu Jia Renshen Tang, with Shangyao to replace the Genmi. For the condition was after the childbirth, used also the Xuanshen to replace the Zhimu. In the formula, the amount of Shigao was up to 120 gram, the herb Shengdi and Baishao several grams were added. The herbal tea was given to drink for four times. After finish the herbal tea, the condition was solved completely. At that time, there was another doctor at the presence. He felt suspect and asked: “It is forbidden to use Cold herbs after childbirth, how the Xuanshen was used to replace the Zhimu?” He was answered: “The reason to do so has been well explained in the book  《Zhongzhong Canxi Lu》. So he brought out the book to show to the doctor. The doctor red the book and felt completely convinced. 

又：外祖家表妹，因产后病温，服补药二十余剂，致大热、大渴、大汗，屡索凉水。医者禁勿与饮，急欲投井。及生视之，舌黑唇焦，目睛直视，谵语发狂。诊其脉，细数有力。问其小便赤涩，大便紫黑粘滞，不甚通利。盖以产后血虚，又得温病，兼为补药所误，以致外邪无由而出，内热如焚，阴血转瞬告罄。急投以白虎加人参汤，仍用山药、玄参代粳米、知母。服后，一夜安稳。黎明，旋又反复，热渴又如从前。细思产后血室空虚，邪热乘虚而入，故大便紫黑，宜调以桃仁承气汤，以下其瘀血，邪热当随之俱下。因小便赤涩，膀胱蓄热，又加滑石四钱，甘草钱半。乃开药局者系其本族，谓此药断不可服。病家疑甚，复延前医相质。前医谓，此病余连治三次，投以温补药转剧，昨服白虎加人参汤，既稍见轻，想服承气汤亦无妨也。病家闻之，始敢煎服。因方中大黄重用六钱，俾煎汤一盅半，分三次温饮下。逾三点钟，降下大便如胶漆者二次，鲜红色者一次，小便亦清利，脉净身凉而愈。
Another case: my sister-in-law was in after childbirth, she was given the nourishing herbs for twenty doses to drink, though she had also Wen disease. She felt severe hot, strong thirsty and had heavy sweat. She craved for cold water, but doctor asked not to give it to her. She tried to suicide by pushing into a well. Upon my coming to see her, her tongue was black and the mouth lips were dry as charcoal. The eyes stared straight forwards; had random chattering. Her pulse was thin, frequent and strong. Her urine was told to be red and rough; the stool was purple, black in color and sticky, not so smooth. This was a condition, after childbirth, getting Wen disease, but misused nourishing herbs, so that the Xie Qi had no way to be expelled out. The inside Fire was as burning, and the Yin blood was to exhaust. It was urgent to give Baihu Jia Renshen Tang, with the Shangyao and Xuanshen to replace the Genmi and Zhimu. After drink of the herbal tea, the patient had a calm night. The next morning, the condition returned. The hot and the thirsty were the same as before. It was carefully considered again that, the person was after the childbirth, the blood space (uterus) was empty, the Xie Fire invaded in the blood space by taking this chance, so the stool was black and purple in color. She was given the Taoren Chenqi Tang to cleanse the dead blood, so that the Xie Fire would also move out of the body. For the urine was red and rough, there was accumulated Fire also in the urine bladder, added Huashi 12 gram, and Gancao 4.5 gram. Since the owner of the herbal shop was the relatives, he said that, this formula should not be drunk. The family got suspect very much and asked the previous doctor for consultation. That doctor said, I treated her for three times, the use of warming herbs made the condition worse. Yesterday, the use of Baihu Jia Renshen Tang reduced the condition somehow, so the Chenqi Tang should also be ok to take. Heard this, the family started dare to use it. In the formula, the Dahuang used was 18 gram. The herbal tea was drunk in warm, for three times. After three hours, the patient had a purple color bowel movement twice, and a red color one once. The urine became clear, the pulse was calm down and the body was no longer hot.

又：赵××之子，年十九岁，偶得温病，医者下之太早，大便转不通者十八日，热渴喘满，舌苔干黑，牙龈出血，目盲谵语，腹胀如鼓，脐突出二寸，屡治不效。忽大便自利，完谷不化，随食随即泻出。诊其脉，尽伏。身冷厥逆，气息将无。乍临茫然不知所措，细询从前病状及所服之药，始悟为阳极似阴，热深厥亦深也。然须用药将其滑泻止住，不复热邪旁流，而后能治其热厥。遂急用野台参三钱，大熟地、生山药、滑石各六钱。煎服后，泻止脉出，洪长滑数，右部尤甚。继拟以大剂白虎加人参汤，生石膏重用至八两。竟身热厥回，一夜甚安。至明晨，病又如故。试按其腹中，有坚块，重按眉皱似疼，且其腹胀脐突若此，知其内有燥粪甚多。遂改用大黄一两，芒硝六钱，赭石、蒌仁各八钱，煎汤一大盅，分两次温饮下。下燥粪二十七枚而愈。
Another case: the son of Mr. Zhao was 19 years of old. He had Wen diease, and the doctor used the bowel-cleansing therapy too early. He had not bowel movement for 18 days. He felt hot, thirsty, asthma and bloating. The tongue covering was dry and black in color; the gum was bleeding; he had random delirious speech and the eyes could not see; the abdomen was bloating, with the naval raising up for two inches. The condition was treated many times and days without improvement. One day, the stool came out by itself; the stool contained no-digest food; and it came out soon after eating. His pulse was hidden deep. The body was cold and the breath near stopped. From beginning, I loss the idea what condition it was. I asked the disease and its treatment history again, and I started to realize that it was the “when the Yang is extreme, it looks as a Yin and when the Hotness is extreme, the Coldness is also extreme”. However, it was urgent to stop the slippery diarrhea first, not to let the Xie flow aside, then to solve the Hotness extreme. It was urgent to use wild Taishen 9 gram, Shoudi 18 gram, Shanyao 18 gram, and Huashi 18 gram. After the drink of the herbal tea, the diarrhea stopped; the pulse showed up; the pulse was waving and slippery, especially on the right side. The followed herbal formula was the Baihu Jia Renshen Tang, in which the Shigao was used to 240 gram. The body turned warm and the Coldness stopped. The night was calm and peace. The next morning, the condition recurred the same. When pressed the abdomen, it appeared having a hard mass. When pressed hard, the person appeared pain with shrink of his eyebrow. Together with the protrusion of the naval and bloating of the abdomen, it was considered that there was dead and hidden stools inside the intestine. The herbal formula was changed to Dahuan 30 gram, Manxiao 18 gram, Daizheshi 24 gram, and Gualuren 24 gram. The herbal tea was drunk in warm twice. He had 27 dried stool pieces out and the condition was solved.   

奉天铁岭杨××来函：
Letter from Mr. Yang, Tieling city, Fengtian province:

本村张氏妇，得温病，继而小产，犹不以为意。越四五日，其病大发。遍请医生，均谓瘟病小产，又兼邪热太甚，无方可治。其夫造门求为延医。生至其家，见病患目不识人；神气恍惚；渴嗜饮水，大便滑泻；脉数近八至，且微细无力；舌苔边黄中黑，缩不能伸。为其燥热，又兼滑泻，先投以滋阴清燥汤，一剂泻止，热稍见愈。继投以大剂白虎加人参以山药代粳米汤，为其产后，以玄参代知母，为其舌缩脉数，阴分大亏，又加枸杞、生地。煎汤一大碗，调入生鸡子黄三枚，分数次徐徐温饮下。精神清爽，舌能伸出，连服三剂全愈。

Mrs. Zhang, lived in the same village, had Wen disease and also abortion. She did not pay much attention to it. Four to five days later, the disease became worse. She had various doctors come to help, but the doctors thought that her condition belonged to the abortion with Wen disease, with additional severe Xie Fire, no way to help. Her husband came to me for help. When I came to her home, she could not recognise people; her mind was cloudy; craving fro water to drink; had slippery diarrhea; the pulse was up to eight times per breath circle, mild, thin and weak; the tongue covering was yellow on the side but black on the middle; the tongue was unable to move. For the dryness, Hotness and slippery diarrhea, she was given the Ziyin Qingzao Tang. One dose stopped the diarrhea and the hot was reduced somehow. It was then followed the Baihu Jia Renshen Tang, with Shanyao to replace Genmi. For her after childbirth, used Xuanshen to replace the Zhimu. For her tongue shrink, frequent pulse and Yin deficiency, used Goujizi and Shengdi. To the herbal tea, added three egg yolk. The herbal tea was given to her drink slowly and gradually. After the drink, she felt clear in mind and can speak again. The herbal formula was repeated three doses and the condition was finally cured.

5．宁嗽定喘饮

5. Ningsou Dingchuan Yin (Ningsou means to stop cough; Dingchuan means to stop asthma. The yin here means herbal tea).

治伤寒温病，阳明大热已退，其人或素虚或在老年，至此益形怯弱，或喘，或嗽，或痰涎壅盛，气息似甚不足者。
This formula is used for Shanghan and Wen disease, in which the Yangming Hotness has gone. The person is weak in body condition usually, or he is on old age. At this time, he is weaker, with asthma, or with cough, or with lots of phlegm, and with short of breath.

生怀山药（两半） 甘蔗自然汁（一两） 酸石榴自然汁（六钱） 生鸡子黄（四个）
Shanyao 45 gram, Ganzhe (sugarcane) juice 30 grma, sour Shiliu (pomegranate) juice 18 gram, egg yolk four.

先将山药煎取清汤一大碗，再将余三味调入碗中，分三次温饮下，约两点钟服一次。若药已凉，再服时须将药碗置开水中温之。然不可过热，恐鸡子黄熟，服之即无效。
Cook the Shangyao first to collect the herbal tea. Mix the other three ingredients in. Drink it for three times in warm, and once every two hours in between. If the tea is cold, warm it again, but not too hot. If too hot, it is, the egg yolk might be ready to eat and loss healing effect.

一周姓叟，年近七旬，素有劳疾，且又有鸦片嗜好，于季秋患温病，阳明府热炽盛，脉象数而不实，喘而兼嗽，吐痰稠粘。投以白虎加人参汤，以生山药代粳米，一剂，大热已退，而喘嗽仍不愈，且气息微弱，似不接续。其家属惶恐，以为难愈。且言如此光景，似难再进药。愚曰：勿须用药，寻常服食之物即可治愈矣。为开此方，病家视之，果系寻常食物，知虽不对证，亦无妨碍。遂如法服之，二剂全愈。

A man was 70 years of old, He had a long history of disease and had crave for opium. In an autumn, he had Wen disease. The Yangming stage Hotness burned very much. The pulse was frequent and asthenic. He had asthma and cough sticky phlegm. He was given the Baihu Jia Renshen Tang, with the Shanyao to replace the Genmi. After one dose, the hotness was reduced, but the asthma and cough remained, and the breath was very weak, appearing hard to connect each breath. The family was scared, thought it was hard to solve. They said for condition as such, it seemed hard to take more herbs. I said: no need to use herbs, but the ordinary food. He was given this formula. The family saw the formula, it was indeed the ordinary food. Though they thought it was not exact matching the disease condition, but should have no big problem. Therefore, they followed the requirement to prepare the herbal tea. After two days, the condition was solved.  

6．荡胸汤

6. Dangxiong Tang

治寒温结胸，其证胸膈痰饮，与外感之邪互相凝结，上塞咽喉，下滞胃口，呼吸不利，满闷短气，饮水不能下行，或转吐出。兼治疫证结胸。
This formula is used to solve the Jiexiong condition in the Shanghan or Wen disease. The person, the phlegm in the chest and diagram is combined and stick with the invading Xie Qi, so as to block the throat and the opening of the stomach, to affect the breath, causing fullness and bloating in the chest, short of breath, and the water hard to fall down to the stomach and intestine but vomiting out. It is also used in the Jiexiong condition in the infectious disease. 

蒌仁（二两，新炒者捣） 生赭石（二两，研细） 苏子（六钱，炒捣） 芒硝（四钱，冲服）
Gualuren 60 gram (newly fry and grind), Daizheshi 60 gram (grind), Souzi 18 gram (fry and grind), Mangxiao 12 gram (drink with help of herbal tea from other ingredient).

用水四盅，煎取清汁两盅，先温服一盅。结开，大便通行，停后服。若其胸中结犹未开，过两点钟，再温服一盅。若胸中之结已开，而大便犹未通下，且不觉转矢气者，仍可温服半盅。
Cook the herbs to collect two cups of herbal tea. Drink one cup first with warm. If the chest block is opened, and the stool comes out, stop to drink the remaining te. If not, drink the second cup after two hours. If the chest block is opened, but the stool not comes out yet, drink half more cup again.

伤寒下早成结胸，至温病未经下者，亦可成结胸。至疫病自口鼻传入，遇素有痰饮者，其疹疠之气，与上焦痰饮，互相胶漆，亦成结胸。《伤寒论》陷胸汤、丸三方，皆可随证之轻重高下借用。特是大陷胸汤、丸中皆有甘遂，世俗医者，恒望而生畏。至小陷胸汤，性虽平和，又有吴又可瘟疫忌用黄连之说存于胸中，遂亦不肯轻用。及遇此等证，而漫用开痰、破气、利湿之品，若橘红、莱菔、苍术、白芥、茯苓、浓朴诸药，汇集成方，以为较陷胸诸汤、丸稳，而且病家服之，以为药性和平，坦然无疑。不知破其气而气愈下陷，利其湿而痰愈稠粘。如此用药，真令人长太息者也。愚不得已，将治结胸诸成方变通汇萃之，于大陷胸汤中取用芒硝，于小陷胸汤中取用蒌实，又于治心下痞硬之旋复代赭石汤中取用赭石，而复加苏子以为下行之向导，可以代大陷胸汤、丸。少服之，亦可代小陷胸汤。非欲与《伤寒论》诸方争胜也，亦略以便流俗之用云尔。
For the Shanghan disease, if the bowel-cleansing is used earlier, there could form the Jiexiong condition. In the Wen disease, the Jiexiong condition can also be formed even if the bowel-cleansing therapy has not been used yet. For the infectious disease, the Xie Qi comes into the body through the nose and mouth. If the person has phlegm-fluid before, the infectious Qi can combine with the phlegm-fluid in the Upper Jiao, sticks each other for form the Jiexiong condition. The Xianxiong Tang and Xianxiong Wan, the three formulas in the book《Shan Han Lun》can be used according to the severity of the disease and the position of the Jiexiong. Especially in the Da Jiexiong Tang and Da Jiexiong Wan, they contain the herb Gansui, which the most doctors feel scare to use.The Xiao Xianxiong Tang, though calm in nature, is also dared not to use, for Dr. Wu Youke said that, the Huanglian should be forbidden in the treatment of infectious, epidemic plague disease. When they meet such condition, they would usually use Phlegm-breaking, Qi-breaking, Wetness-clearing herbs, such as Juhong, Laifuzi, Cangzhu, Baijiezi, Fuling and Houpo, etc. They collect these herbs as a formula, with the idea that it is more safe and peace in use than the Da Xianxiong Tang, or Da Xiangxiong Wan. The patient or the family, when use it, also thought that it is safe to take, without any doubt. They do not know that, to break the Qi will make the Qi sink more; and to dry the Wetness will make the phlegm more stick. To use the herbs as such really makes us to have a long sign. I, for no way to really change this social mistake, have to mix the herbs together, from these Da Xianxiong Tang and the Da Xianxiong Wan, by choose of the herb Manxiao from the Da Xianxiong Tang, the Gualushi from the Xiao Xianxiong Tang, the Daizheshi from the herbal formula Xuanfu Daizheshi Tang that is used to solve the hard bloating condition, and the Souzi, to be used as director to fall down. This formula can replace the Da Xianxiong Tang and Da Xianxiong Wan. If use in small dose, it can also replace the Xiao Xianxiong Tang. I do not mean that I am cleaver than the Master, but try to harmonize the use of herbs for such condition by ordinary people in current times.

一媪，年六十余。当孟夏晨饭之际，忽闻乡邻有斗者，出视之，见强者凌弱太甚，心甚不平；又兼饭后有汗受风，遂得温证。表里俱热，胃口杜塞，腹中疼痛，饮水须臾仍吐出。七八日间，大便不通。其脉细数，按之略实。自言心中燥渴，饮水又不能受，从前服药止吐，其药亦皆吐出。若果能令饮水不吐，病犹可望愈。愚曰：易耳。为开此汤，加生石膏二两、野台参五钱，煎汤一大碗，分三次温饮下。晚间服药，翌晨大便得通而愈。当大便未通时，曾俾用山萸肉（去净核）二两煎汤，以备下后心中怔忡及虚脱，及大便通后，微觉怔忡，服之即安。
A lady was 60 years of old. In a summer morning, after breakfast, she heard a combating in the village. She went out to have a look and saw someone who was strong but who beat very rudely the others who apparently weak. She felt unhappy in heart. Later, she had sweat after eat and attacked by Wind, so she had Wen disease. She felt hot in and out of the body; felt bloating in the stomach, pain in abdomen; and vomited out the water drank. For seven to eight days, she did not have any bowel movement. Her pulse was thin and frequent, which was slight sthenic when pressed harder. She told that she felt dry and thirsty in heart but could not hold the drunk water. The herbs she took before for stopping vomit now was also vomited off. She said, if there was a way to stop the vomit, there would be hope to solve the disease. I said: It was easy. She was given this herbal formula, with addition of Shigao 60 gram, wild Taishen 15 gram. The herbal tea was drunk for three times with warm. The herbal tea was drunk at night and in the next morning, the stool came out and the condition was solved. Before the stool came out, the family had been asked to cook Shanyurou (remove the kernel) 60 gram for ready to use in case the lady feels palpitation and too weak after possible bowel movement. After the stool came out, she actually only felt slight palpitation. The Shanyurou tea was given for drink and she felt calm afterwards.

一室女得温病。两三日间，痰涎郁塞，胸膈满闷异常，频频咳吐，粘若胶漆，且有喘促之意，饮水停滞胃口，间或吐出，其脉浮滑。问之微觉头疼，知其表证犹未罢也。遂师河间双解散之意，于荡胸汤中加连翘、蝉蜕各三钱。服后微汗，大便得通而愈。

A girl had Wen disease. On the second and the third day, she felt lots of phlegm blocking in the chest; she spitted lots, which was sticky very much; she also had kind of asthma; felt the water drunk stopped in the upper stomach, which was spitted out sometimes. Her pulse was floating and slippery. When asked, she said she felt mild headache. It was so known that her surface condition did not finished yet. So, following the idea of your Hejian Shuangjie San, the herb Lianqiao 9 gram and Chantui 9 gram were added to the Tangxiong Tang. After drink of the herbal tea, the girl had mild sweat; the stool came out; and the condition was cured.

7．一味莱菔子汤

7. Single Laifuzi Tang (Laifuzi: the seed of radish)

 治同前证。
 This formula is used for the same condition as above.

莱菔子（生者一两，熟者一两） 共捣碎，煎汤一大茶杯，顿服之。
Processed Laifuzi, 30 gram, the original Laifuzi 30 gram. Grind the seeds, cook and collect one big cup of herbal tea. Drink all once.

奉天许××，年二十余。得温病。三四日觉中脘郁结，饮食至其处不下行，仍上逆吐出。来院求为延医。其脉沉滑而实，舌苔白而微黄。表里俱觉发热，然不甚剧。自言素多痰饮，受外感益甚。因知其中脘之郁结，确系外感之邪与痰饮相凝滞也。先投以荡胸汤，两点钟后，仍复吐出。为拟此方，一剂结开，可受饮食。继投以清火理痰之品，两剂全愈。
Mr. Xu, in Fengtian city, was 20 years of old, and had Wen disease. On the third and fourth day, he felt bloating in the middle abdomen. He felt that food came there and would not go down further, but reverse up to vomit out. He came for help. His pulse was deep, slippery and sthenic. The tongue covering was white wih slight yellow. He felt hot both inside and on the surface of the body, but not very severe. He said that he usually had phlegm-fluid. It would be worse upon a common cold attack. It was known that, he had bloating block in the middle abdomen, and now, it was the combination of the invading Xie Qi with the inside phlegm-fluid. He was given the Tangxiong Tang first. After two hours, the herbal tea was spit out. Then he was given this single Laifuzi Tang. One dose opened the abdomen block and he could start to eat. Later, he was given Fire-clearing and Phlegm-clearing herbs. Two doses solved the problem.

按：此证若服荡胸汤，将方中赭石细末留出数钱，开水送下，再服汤药亦可不吐，其结亦必能开。非莱菔子汤之力胜于荡胸汤也，而试之偶效，尤必载此方者，为药性较荡胸汤尤平易，临证者与病家，皆可放胆用之而无疑也。若此方不效者，亦可改用荡胸汤，先将赭石细末送下数钱之法。

Comments: for the case, if the patient was given the Dangxiong Tang, first, leave the Daizheshi powder little bit, drink it with hot water, then drink the herbal tea. In this way, the herbal tea would not be vomited out, and the block would be broken off. It does not mean that the Laifuzi is more powerful than the Dangxiong Tang, but it has been tested work, so cited here. The reason is that, its healing effect is calm than the Dangxiong Tang, both doctor and the patient family could feel easy and ready to use it. If this formula does not work, change to the Dangxiong Tang, with the drink of the Daizheshi powder several grams first.

8．镇逆承气汤

8. Zhenni Chenqi Tang

治寒温阳明府实，大便燥结，当用承气下之，而呕吐不能受药者。
This formula is used to solve Yangming sthenic condition in the Shanghan and Wen disease. The person’s stool is very dry and hard to pass. To him, the Chenqi Tang should be given, but he has vomit and hard to drink herbal tea.

芒硝（六钱） 赭石（二两，研细） 生石膏（二两，捣细） 潞党参（五钱）
Mangxiao (mirabilite)18 gram, Daizheshi 60 gram, Shigao 60 gram (grind), Dangshen 15 gram.

上药四味，用水四盅，先煎后三味，汤将成，再加芒硝，煎一两沸。取清汁二盅，先温服一盅。过三点钟，若腹中不觉转动，(不)欲大便者，再温服余一盅。
Cook the herbs, except the Mangxiao, into herbal tea. Add the Mangxiao into the tea and continue to cook for one to two boiling. Collect the supernatant for two cups. Drink the first one with warm. If, after three hours, the abdomen does not feel movement, and no willing to have bowel movement, drink the second cup.

一邻妇，年二十余。得温病已过十日，上焦燥热，呕吐，大便燥结，自病后未行。延医数次服药皆吐出。适愚自他处归，诊其脉，关前甚洪实，一息五至余，其脉上盛于下一倍，所以作呕吐。其至数数者，吐久伤津液也。为拟此汤，一剂热退呕止，大便得通而愈。
A lady, my neighbor, was 20 years of old. She had Wen disease for ten days. She felt dry and hot in the Upper Jiao; had vomiting and dry stool. She did not have bowel movement after sick. She drunk herbal tea several times but all were spit out. At that time, I just came back from other cities. When I saw her, her pulse was waving and sthenic in the Chun position. It was up to five times per breath circle. The pulse in the upper Chun position was double stronger than the lower Chi position, so she had vomit. The pulse was frequent, since the vomit exhausted the Liquid-fluid of the body. She was given this herbal tea. One dose made the hot and vomit stopped. The stool came out and the disease was cured. 

或问：此证胃腑热实大肠燥结，方中何以复用党参？答曰：此证多有呕吐甚剧，并水浆不能存者，又有初病即呕吐，十数日不止者，其胃气与胃中津液，必因呕吐而大有伤损，故用党参补助胃中元气，且与凉润之石膏并用，大能滋胃中津液，俾胃中气足液生，自能运转药力下至魄门以通大便也。愚用此方救人多矣，果遇此等证，放胆投之，无不效者。
It might be asked: this case belongs to Stomach sthenic Fire with dry-block in the large intestine. Why use Dangshen in the formula? Answer: such case usually has heavy vomit; the water could not stay in the stomach; again with vomit from beginning of the disease, ten days without stop, so that the Stomach Qi and Stomach liquid-fluid was exhausted due to the vomit. The Dangshen used is to nourish and to supply the Stomach Qi. For its cooling-wetness, its use with Shigao, can supply the liquid-fluid to the stomach. When the Stomach has sufficient liquid-fluid, the body would have ability to transport the herbal healing effect to the anus to conduct the stool. I has used this formula and saved many people. Upon meet such case, use it with dare. No failure. 

一人，年四十许。二便不通，呕吐甚剧，不受饮食。倩人询方。疑系外感之热所致，问其心中发热否？言来时未尝言及。遂为约略疏方，以赭石二两以止其呕吐，生杭芍一两以通小便，芒硝三钱以通大便。隔日，其人复来，言服后呕吐即止，二便亦通，此时心中发热且渴如故。既曰如故，是其从前原有热渴之病，阳明之腑证已实，特其初次遣人未尝详言也。投以大剂白虎加人参汤，一剂而愈。
A man was 40 years of old. He had urine and stool movement stopped, and had heavy vomit, and hard to eat anything. He send someone asking for herbal formula. I suspected his condition was due to invading Hotness, so asked if he felt hot. The person came said he did not ask for no time before come. I gave him a brief formula, which contained Daizheshi more than 60 gram to stop vomit; Baishao 30 gram to promote urination; and Mangxiao 9 gram to promote stool movement. On the other day, the person came again and said that the vomit stopped and the urine and the stool moved out, but still felt hot in heart and felt thirsty. I knew that, if the hot and the thirst were not solved, it suggested that he had Hotness and thirsty disease before. Now the Yangming stage was sthenic. The problem was that, the person who came the first time did not describe the condition in detail. Now, I gave him the Baihu Jia Renshen Tang. One dose solved the condition.

按：此证亦镇逆承气汤证，因其证两次始述明，遂致将方中药品前后两次分用之，其病亦即前后两次而愈矣。

Comments: This case is the Zhenni Chenqi Tang condition. Scine in the first visit, the condition was not asked completely, so the herbal ingredients were given in two separate formulas, so the disease was improved in two separate steps.