Symptoms: Sudden drop in body temperature, cold sweat on forehead, pale complexion, rapid breathing, flared nostrils,

Symptoms: Sudden drop in body temperature, cold sweat on forehead, pale complexion, rapid breathing, flared nostrils, phlegm sounds in the throat, blue lips and cold limbs, even coma and convulsions, tongue is dark blue, pulse is extremely weak. Treatment principle: Restore yang and reverse the situation, benefit qi and nourish yin. Formula: Shengmai San combined with Shenfu Longmu Tang with modifications. Ren Shen 10g, Mai Dong 12g, Wu Wei Zi 3g, Pao Fu Zi 6g, Long Gu 15g, Mu Li 15g. If the patient is unconscious, add Shi Chang Pu to awaken the spirit and open the orifices; if the complexion is bluish-purple, add Dan Shen and Chuan Xiong to activate blood circulation and remove blood stasis. If sweating is obvious, add Shan Yu Rou, calcined Long Gu, and calcined Mu Li; for those with cold limbs and weak pulse, add Pao Fu Zi 15g, brewed frequently. Injection: Shenmai Injection 40–60 ml, mixed with 100 ml of 10% glucose solution, administered intravenously every 10–15 minutes, repeated 3–5 times consecutively. V. Analysis of Formulas Used by Professor Pei Zhengxue Professor Pei Zhengxue integrates the diagnostic and treatment methods of the School of Cold Damage and the School of Warm Diseases, combining the six-channel differentiation of cold damage, the Wei-Qi-Ying-Xue and three-jiao differentiation of warm disease, according to the etiology, location, nature of the disease, the ebb and flow of righteous and evil forces, and the different stages of disease development. He summarizes ancient prescriptions and creates the Mahuang-Guizhi class of formulas. The Mahuang formula consists of Mahuang, Guizhi, Xingren, Gan Cao, Sheng Jiang, Da Zao, and other ingredients, treating wind-cold exterior real syndrome characterized by headache, fever, aversion to cold, body pain, no sweat, and floating, tight pulse. Recent experiments have proven that this formula has a certain inhibitory effect on influenza viruses, thus confirming that what ancient people referred to as wind-cold exterior real syndrome is mostly today’s viral upper respiratory infection. Adding Sheng Shigao results in the Da Qinglong formula, mainly treating headache, body pain, fever, aversion to cold, no sweat, thirst, irritability, and floating, tight pulse—this is wind-cold exterior real plus interior heat, i.e., the main formula for wind-cold exterior real turning into heat inside. This formula has consistently been effective in treating upper respiratory infections; adding Yin Hua, Lianqiao, Gong Ying, Bai Jiang, and other heat-clearing, detoxifying herbs further enhances its effectiveness. The Da Qinglong formula without Guizhi, Sheng Jiang, and Da Zao is called Ma ( Huang) Xing (Ren) Shi (Gao) Gan (Cao) Tang, which traditional Chinese medicine says is suitable for four symptoms: annoyance, wheezing, thirst, and cough. From a modern medical perspective, this formula is suitable for all bronchial and pulmonary infections, including acute and chronic bronchitis, bronchopneumonia, as well as pulmonary infections associated with emphysema and pulmonary heart disease. The Guizhi formula is known as the “crown of all formulas,” composed of Guizhi, Bai Shao, Gan Cao, Sheng Jiang, Da Zao, and other ingredients, mainly treating headache, fever, aversion to cold, sweating, and floating, slow pulse—this is wind-cold exterior虚 syndrome, equivalent to today’s common cold. The main significance of this formula is not to treat the common cold, but rather, through modifications and adaptations, to treat a series of internal medicine conditions related to autonomic nervous dysfunction, especially during the recovery phase of pneumonia. The Baihu formula class: The Baihu formula consists of Sheng Shigao, Zhi Mu, Jing Mi, and Gan Cao—four ingredients—and is a famous formula in “Treatise on Cold Damage,” mainly treating Yangming meridian syndrome (extreme heat, extreme thirst, extreme sweating, extreme pulse). From a modern medical perspective, modifications and adaptations of this formula can treat many high-fever conditions, suitable for fevers caused by various infectious diseases as well as those caused by physicochemical factors. Some call this formula the first choice for heat-related diseases in traditional Chinese medicine, which is not an exaggeration. Adding Ren Shen to this formula results in the Ren Shen Baihu formula (“Treatise on Cold Damage”), mainly treating extreme heat and simultaneous deficiency of qi and yin. Adding Lingyang Jiao and Xi Jiao results in the Lingxi Baihu formula (“Warm Heat Latitude and Longitude”), mainly treating exogenous warm diseases, simultaneous deficiency of qi and blood, extreme heat and thirst, confusion and muttering. Adding Xuan Shen and Xi Jiao results in the Hua Ban formula (“Differential Diagnosis of Warm Diseases”), mainly treating heat invading Ying and Blood, speech, rash, and purple-yellow tongue coating. Removing Zhi Mu and adding Ban Xia, Mai Dong, Ren Shen, and Zhuye results in the Zhu Ye Shigao formula (“Treatise on Cold Damage”), mainly treating residual heat that hasn’t cleared, simultaneous damage to qi and yin, manifested as high body temperature, excessive sweating, dry mouth and thirst, weakness and lack of qi, and qi reversal leading to nausea. From a modern medical perspective, it is suitable for all post-heat disease conditions involving autonomic nervous dysfunction and sympathetic overactivity. The Sang Ju Yin Qiao class: Sang Ju Yin and Yinqiao San both originate from “Differential Diagnosis of Warm Diseases.” Sang Ju Yin consists of Sang Ye, Ju Hua, Lian Qiao, Xing Ren, Jiegeng, Lu Gen, Bohe, Gan Cao, and other eight ingredients, mainly treating wind-heat exterior syndrome, manifested as headache, fever and aversion to cold (more heat than cold), thirst, sore throat, and cough. Modern medicine believes this formula is suitable for acute tonsillitis caused by Gram-positive cocci or various non-viral upper respiratory infections, including lobar pneumonia, bronchopneumonia, acute and chronic bronchitis, especially effective for children’s high fever from upper respiratory infections. Yinqiao San consists of Jingjie Sui, Jiegeng, Er Hua, Lian Qiao, Bohe, Zhuye, Dan Douzhi, Niubangzi, Gan Cao, Lu Gen, and other ingredients, mainly treating wind-heat exterior syndrome combined with sore throat, manifested as headache, fever and aversion to cold (more heat than cold), thirst, and sore throat. This formula’s indications are slightly heavier than Sang Ju, with stronger heat-clearing and detoxifying power. From a Western medical perspective, besides treating acute tonsillitis, it is also highly effective against systemic suppurative cocci infections. The Wuwei Disinfection Drink (“Golden Mirror of Medical Classics”): The formula consists of Jin Yin Hua, Ye Ju Hua, Pu Gong Ying, Zi Hua Di Ding, Zi Bei Tian Kui, and other five ingredients, mainly treating toxic sores and various suppurative infections. Although the formula has only five ingredients, its efficacy is very good. The Qingwen Baidu Drink (“First-hand Experience in Epidemic Diagnosis”): The formula consists of Huang Lian, Huang Qin, Zhi Zi, Mu Dan, which are all excellent medicinal herbs.

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Composed of herbs such as Poria, Scrophularia, Forsythia, Rehmannia, Rhinoceros Horn, Gypsum, and Bamboo Leaves, this formula primarily treats the internal invasion of pathogenic heat and the simultaneous spread of pathogenic factors to both qi and blood. Clinical manifestations include high fever with intense thirst, profuse sweating accompanied by confusion, dryness and restlessness, erythematous skin lesions due to yang toxicity, hematemesis, hematochezia, and other symptoms. From a modern medical perspective, this prescription is suitable for sepsis caused by various infections; in traditional Chinese medicine, the so-called "internal invasion of pathogenic heat" often refers to sepsis in Western medicine. When warm diseases progress from the qi level to the ying and xue levels, only formulas that nourish yin and cool blood can effectively address the underlying condition. Representative formulas of this type include Qingying Decoction, Yuniu Jian, Huaban Decoction, and Xijiao Dihuang Decoction.

Qingying Decoction (from "Wenbing Tiaobian") consists of bamboo leaves, Salvia miltiorrhiza, rhinoceros horn, forsythia, Coptis chinensis, honeysuckle, Rehmannia, scrophularia, and Ophiopogon japonicus, among others. It mainly treats the condition of heat entering the ying and xue levels, with clinical manifestations including tidal fever with intense thirst, confusion and speech disturbances, irritability and insomnia, and faint rashes. From a modern medical standpoint, this formula is appropriate for electrolyte imbalances and dehydration caused by high fever in acute infectious diseases.

Yuniu Jian (from "Jingyue Quanshu") is composed of Anemarrhena asphodeloides, Achyranthes bidentata, Gypsum, Rehmannia glutinosa preparata, and Ophiopogon japonicus, among others. It primarily treats symptoms such as vexing heat and thirst, headache and toothache, red tongue with little coating, and a fine, rapid pulse. In traditional Chinese medicine, this pattern is considered excess yang in the Yangming meridian and deficiency in the Shaoyin meridian, essentially indicating severe heat damaging yin. Huaban Decoction (from "Wenbing Tiaobian") comprises Gypsum, Anemarrhena asphodeloides, Japonica rice, licorice, scrophularia, and rhinoceros horn, and is used to treat conditions where heat has entered the ying and xue levels, presenting with speech disturbances, rash development, and a dark red tongue.

Xijiao Dihuang Decoction (from "Qianjin Fang") is made up of rhinoceros horn, Rehmannia, Paeonia lactiflora, and Moutan cortex. This formula serves as the primary treatment for cases where heat has invaded the blood level, with symptoms including tidal fever with intense thirst, confusion and speech disturbances, erythematous skin lesions due to yang toxicity, hematemesis, hematochezia, hematuria, a dark red tongue without coating, and a fine, rapid pulse. In recent years, this formula has been widely applied to bleeding associated with real heat syndromes in various internal medicine disorders.

Wind-calming and orifice-opening formulas: Most of these prescriptions have the functions of clearing heat, calming wind, and opening orifices, making them suitable for conditions involving yin injury, wind agitation, and heat invading the pericardium during the peak or later stages of febrile illnesses. Commonly used clinical formulas include Lingjiao Gouteng Decoction, Dading Fengzhu, Niuhuang Qingxin Pill, Zixue Dan, and Zhibao Dan. Lingjiao Gouteng Decoction (from "Tongshu Shanghan Lun") consists of antelope horn, hook vine, mulberry leaves, Fritillaria cirrhosa, bamboo shavings, Rehmannia glutinosa, chrysanthemum, white peony, Poria cocos, and licorice, and is primarily used to treat persistent high fever, confusion and speech disturbances, and convulsions. Dading Fengzhu (from "Wenbing Tiaobian") is composed of raw turtle shell, raw oyster shell, raw soft-shelled turtle shell, donkey-hide gelatin, Ophiopogon japonicus, dried Rehmannia, sesame seeds, raw white peony, schisandra berries, honey-fried licorice, and egg yolk, and is mainly used to treat symptoms such as extreme fatigue, limb weakness, tremors, and numbness. This formula is particularly effective for treating convulsive symptoms in the late stage of febrile diseases. Niuhuang Qingxin Pill (from "Wanmizhai Fang") is made up of Coptis chinensis, Scutellaria baicalensis, Gardenia jasminoides, buffalo horn, Curcuma wenyujin, cinnabar, and other herbs, and is primarily used to treat symptoms such as confusion and speech disturbances, locked jaw, stiff neck, limb twitching, and high fever with flushed face. Zixue Dan (from "Heji Ju Fang") consists of cold water stone, raw gypsum, magnetite, talc, saltpeter, agarwood, sandalwood, musk, cloves, antelope horn, lespedeza, licorice, mirabilite, and cinnabar, among others (this formula originally contained a small amount of buffalo horn, but it is no longer used today). It is mainly used to treat symptoms such as confusion and speech disturbances, high fever with intense thirst, convulsions and seizures, stiff neck, and locked jaw. Zhibao Dan (from "Heji Ju Fang") is composed of rhinoceros horn, tortoiseshell, cinnabar, realgar, borneol, musk, buffalo horn, and benzoin, among others (it originally contained gold and silver foil, but these are no longer used today), and is primarily used to treat symptoms such as mutism, excessive phlegm and coarse breathing, body heat with a red tongue, yellow and greasy coating, and a slippery, rapid pulse. Meanwhile, Professor Pei Zhengxue has created his own proprietary compound formula, Canggong Sutong Mixture (10 g of Atractylodes, 15 g of dandelion, 10 g of Perilla frutescens, 6 g of Aristolochia manshuriensis, 30 g of Hui Ren, 15 g of Achyranthes bidentata, 10 g of earthworm, 15 g of honeysuckle, and 15 g of forsythia), which is used to reduce fever; Huangyu Erma Zao Tang (10 g of Coptis chinensis, 15 g of Houttuynia cordata, 15 g of honeysuckle, and 10 g of Tripterygium wilfordii) is used to eliminate pulmonary infections. The Chuanshan Menghai Decoction (15 g of Gardenia jasminoides, 15 g of green stone, 15 g of sea foam stone, and 10 g of soybean powder) was also created by Professor Pei Zhengxue to treat patients with excessive phlegm that is difficult to cough up. Additionally, the Xiehuo Dan was formulated to treat all inflammatory diseases, such as upper respiratory tract infections, acute pharyngitis, tracheitis, pneumonia, systemic infections, and sepsis. The formula includes 100 g of Gypsum, 10 g of rhubarb, 6 g of Coptis chinensis, 10 g of Scutellaria baicalensis, 40 g of honeysuckle, 40 g of forsythia, 40 g of wild chrysanthemum, 40 g of seven-leaf one-stem flower, 40 g of mountain bean root, and 40 g of Houttuynia cordata. The Gypsum is decocted five times, while the other ingredients are decocted twice, and the resulting juices are mixed and concentrated into a paste. Twenty milligrams of metoclopramide are added to make a granular preparation, with each dose being 0.5 g, taken twice daily after meals.

Sixth, examples of clinical cases treated by Professor Pei Zhengxue:

Case 1: Mr. Jin, male, 56 years old, presented on November 1, 2005. The patient had developed chills and fever one week earlier after exposure to wind-cold, with a body temperature of 38.5°C, cough, yellow and copious sputum, chest pain, sweating, temporary reduction in fever after sweating, followed by a subsequent rise, nausea, vomiting, abdominal pain, and constipation. A chest X-ray at a tertiary hospital showed bilateral lung infection, normal blood analysis, and detection of Streptococcus pneumoniae in the sputum. He had previously been given cephalosporin antibiotics, but his fever did not significantly decrease after three days. His tongue was red with a yellow and greasy coating, and his pulse was large, full, and slippery. Western medical diagnosis: Streptococcus pneumoniae pneumonia. Traditional Chinese medicine differentiation: Warm heat invading the lungs, heat stagnating in the large intestine. Treatment principle: Disperse the lungs and clear the bowels, clear heat stagnation. Prescription: Modified Baihu Tang combined with Xiaoxianxiong Tang.

The prescription included 60 g of Gypsum, 10 g of Trichosanthes kirilowii, 5 g of rhubarb, 10 g of apricot kernel, 20 g of Anemarrhena asphodeloides, 20 g of Japonica rice, 10 g of Atractylodes, 15 g of red peony, 10 g of Bupleurum, and 10 g of Platycodon grandiflorus. At the same time, antibiotics were discontinued.

After seven doses, the patient's fever returned to normal, and his cough, sputum production, and chest pain improved. A follow-up chest X-ray showed near-complete recovery.

Analysis: The warm heat pathogen invaded the lungs and then spread to the large intestine, affecting both the exterior and interior simultaneously. Therefore, the treatment focused on dispersing the lungs and clearing the bowels, as well as clearing heat stagnation. The formula used Platycodon grandiflorus and apricot kernel to open the lung qi, while heavily relying on Gypsum, Anemarrhena asphodeloides, Trichosanthes kirilowii, and Platycodon grandiflorus to clear internal heat. Rhubarb was also used to promote bowel movement, addressing the root cause of the problem and relieving the heat congestion in the upper burner, while Atractylodes was employed to strengthen the spleen and remove dampness, Japonica rice to harmonize the stomach, Bupleurum to soothe the liver and clear heat, thereby balancing the middle burner, and red peony to invigorate the blood and prevent excessive cooling from hindering blood circulation and making it harder to eliminate the pathogen.