IV. Traditional Chinese Medicine’s Clinical Data on the Diagnosis and Treatment of This Disease

(3) Dampness and Heat Combined: The main symptoms include gradually rising fever, profuse sweating that doesn’t subside, thirst but little desire to drink, irritability and abdominal discomfort, nausea and vomiting, short, red urine, loose stools that are difficult to pass, a red tongue coated with yellowish greasy substances, and a slippery, rapid pulse. Treatment focuses on clearing dampness and cooling heat, with a formula based on Wang’s Lian Pu Yin: 10g of Huang Lian, 12g each of Hou Pu and Chang Pu, 10g of Banxia, 10g of Shan Zhi, 10g of Dan Dou Chi, and 20g of Lu Gen, decocted in water and taken once daily.

(4) Heat Over Dampness: The main symptoms include intense body heat, frequent thirst, flushed face, heavy sweating, labored breathing, abdominal discomfort and body heaviness, a yellowish, slightly greasy tongue coating, and a large, rough pulse. Treatment focuses on clearing heat and drying dampness, with a formula based on Bai Hu Tang, adjusted as needed: 12g of Zhi Mu, 12g of Hou Pu and Chang Pu, 10g of Banxia, 10g of Shan Zhi, 10g of Dan Dou Chi, and 20g of Lu Gen, decocted in water and taken once daily.

(5) Heat Entering the Blood Vessels: The main symptoms include severe body heat at night, restlessness, occasional delirium or confusion, faint rashes, bloody stools, a dark red tongue with little coating—treatment focuses on clearing heat and draining heat, cooling the blood and dispersing blood, with a formula based on Qing Ying Tang, adjusted as needed: 30g of Shui Niu Jiao, 20g of Sheng Di, 15g of Chi Shu, 10g of Huang Lian, 10g of Shan Zhi, 15g of Di Yu, and 12g of Dan Pi, decocted in water and taken once daily.

(6) Qi Deficiency and Blood Loss: The main symptoms include abdominal discomfort, massive stool bleeding, sudden drops in body temperature, pale face, cold sweat, and a fine, rapid pulse—treatment focuses on replenishing qi, strengthening the body, and stopping bleeding; first take Du Shen Tang, then use Huang Tu Tang: 30g of Zao Xin Tu, 20g of Sheng Di, 12g of Bai Zhu, 10g of Zhi Mu, 10g of Lu Gen, and 10g of Gan Cao, decocted in water and taken once daily.

(7) Qi and Yin Both Damaged, Residual Heat Unremoved: The main symptoms include pale complexion, emaciation, fatigue, sluggish speech, or low-grade fever that doesn’t subside, a thin, weak pulse, a tender, red tongue coated with yellowish, dry or bare coating—treatment focuses on nourishing qi, generating fluids, and clearing residual heat, with a formula based on Zhu Ye Shi Gao Tang, adjusted as needed: 10g of Zhu Ye, 15g each of Sheng Shi Gao and Tai Zi Shen, 12g of Mai Dong, 12g of Shi Hu, 20g of Shan Yao, 15g of Yi Ren, and 20g of Bai Bian Dou, decocted in water and taken once daily.

2. Common Adjustments: For cases where dampness is severe but there is no chills or sweating, consider adding Cang Shu and Xiang Ru to promote fragrance and permeate the body; if internal dampness is heavily obstructing the abdomen and causing discomfort, remove the bitter and moist properties of Xing Ren, and add Cang Shu and Pei Lan to dry dampness and harmonize the middle burner; when internal dampness is accompanied by heat and heart discomfort, remove the warm and drying properties of Hou Pu, and add Shan Zhi and Dan Dou Chi to clear heat and drain dampness. If dampness is predominant but the heat is not severe and the tongue coating is white and greasy, consider adding Su He Xiang Wan to promote fragrance, eliminate dampness, and open up the orifices; if the heat is severe and the orifices are blocked, leading to confusion and delirium, add Zhi Bao Dan to clear the heart and open the orifices; if phlegm and heat are intertwined and phlegm is sticky and difficult to cough up, add fresh bamboo juice to clear heat and transform phlegm; if liver wind is stirring internally and causing spasms or convulsions, add Quan Ma, Di Long, Centipede, and Silkworm to calm the wind; if phlegm is congesting in the throat and threatening to block the airways, quickly add Hou Zao San to clear the turbidity; if the stool contains purple blood clots, add Cai Cao and Chi Shu to promote blood circulation and stop bleeding; if the stool is prolonged and the blood color is light, add Pao Jiang Tan to warm the middle burner and stop bleeding in the Huang Tu Tang; when the stool gradually decreases and the patient feels fatigued and lacks energy, add Dang Shen and Huang Qi to replenish the original qi; if qi is depleted and the body sweats excessively, add Long Gu and Mulberry to strengthen the body and stop sweating.

IV. Traditional Chinese Medicine’s Clinical Data on the Diagnosis and Treatment of This Disease

“Observations on the Efficacy of Feng Wei Cao Compound in Treating 28 Cases of Enteric Shanghan” – Composition: 60g of Feng Wei Cao and 60g of Yu Xing Cao, 12g of Mian Yin Chen, 9g of Huo Xiang Geng; Method: Take one dose per day, reducing the dosage by half once body temperature returns to normal, and continue taking for another week. For cases of intestinal bleeding, add 18g of Di Yu and 10g of Huai Hua Tan; for nasal bleeding, add 9g of Lian Fang and 9g of Jiao Zhi Zi, along with 30g of Mao Gen; for cases complicated by toxic hepatitis, add 10g of Jiao Zhi. All 28 cases were successfully treated. (New Chinese Medicine, 1981.8)

“Observations on the Efficacy of Cang Er Cao in Treating 15 Cases of Shanghan”

This article describes using 60g of freshly dried Cang Er Cao, decocted in water and concentrated to 200ml. Administer 100–125ml per day, four times a day. All 15 cases were successfully treated. (Shanghai Journal of Traditional Chinese Medicine, 1981.8)

“Observations on the Efficacy of Differentiated Diagnosis and Treatment of 91 Cases of Shanghan”

This article notes that when dampness is more prominent than heat, use Huo Pu Xia Ling Tang; when heat is more prominent than dampness, use Wang’s Lian Pu Yin; when dampness and heat are combined, use Mao Shu Bai Hu Tang; when dryness and heat are present, use Hao Qin Qing Dan Tang combined with Qing Hao Bie Jia Tang. A self-designed formula was used: 30g each of Sheng Di Yu, Hong Teng, and Baishang Cao, 15g of Huang Qin, 10g of Da Huang. It was concluded that using Da Huang helped to reduce fever faster than not using it. (Zhejiang Journal of Traditional Chinese Medicine, 1981.8)

“This article introduces the “通腑泻热法” treatment for Shanghan, using a basic formula containing Sheng Di Yu, Huang Qin, Da Huang, Bai Tou Weng, Dan Pi, and Hu Zang. When dampness is more prominent than heat, add Huo Pu Xia Ling Tang; when heat is more prominent than dampness, add Wang’s Lian Pu Yin. (Journal of Nanjing College of Traditional Chinese Medicine, 1989.1)”

“In the treatment of Shanghan with Yunnan Bai Yao, 36 cases of intestinal bleeding were treated. Adults received 2–3g per day, children received 0.05g/kg per day, administered in 4–6 doses via oral administration or nasogastric tube. Both the experimental group and the control group consisted of 30 cases, all of whom were treated with effective antibiotics and fluid replacement therapy; the control group used Hemostatic Sensitiv and Anluo Xue. The Yunnan Bai Yao group showed superior efficacy compared to the Western medicine group. (Chinese-Western Medicine Journal, 1989.7)”

“In the treatment of 147 cases of Shanghan with combined Chinese and Western medicine, this article introduces traditional Chinese medicine’s differentiated diagnosis and treatment: ① For the “Dampness Obstructing Defensive Qi” syndrome, treatment focuses on pungent and cool herbs to release the exterior, clear dampness, and clear heat, using Yin Qiao San or Huo Pu Xia Ling Tang, adjusted as needed. ② For the “Qi Stage Damp Heat” syndrome, when dampness is more prominent than heat, treat with clearing qi and transforming dampness using San Ren Tang; when heat is more prominent than dampness, treat with clearing heat and transforming dampness using Bai Hu Jia Cang Shu Tang; when dampness and heat are combined, treat with transforming dampness and clearing heat using Wang’s Lian Pu Yin, adjusted as needed. Western medicine primarily chose Chloramphenicol or Fluphenicol. The traditional Chinese medicine group showed better efficacy and fewer days of fever reduction compared to the control group (p<0.05, p<0.01). (Journal of Nanjing College of Traditional Chinese Medicine, 1990.1)”

“In the treatment of 94 cases of Shanghan with combined Chinese and Western medicine, this article introduces the treatment of upper-jiao damp heat: for the defensive stage, use Huo Pu Xia Ling Tang, Huo Xiang Zheng Qi San, and Xin Jia Xiang Ru; for the qi stage, use San Ren Tang; if damp heat causes phlegm to accumulate and obscure the heart membrane, administer Chang Pu Yu Jin Tang, followed by Zhi Bao Dan or An Gong Niu Huang Wan. For mid-jiao damp heat: when dampness is more prominent than heat, adjust Zheng Qi San; when dampness and heat are combined, use Lian Pu Yin; when heat is more prominent than dampness, use Bai Hu Jia Cang Shu Tang; when damp heat causes dryness and blood in the intestines, adjust Xing Jiao Di Huang Tang. For lower-jiao damp heat, use Hua Shi, Chao Zhi Zi, Dan Dou Chi, Qu Mai, and Fan Chu, each 10g; use Fu Ling, Zhu Lun, Che Qian Zi, each 30g, and Mu Tong 6g. Compared to the Western medicine group, the traditional Chinese medicine group showed better efficacy, with significantly shorter fever-reducing days and hospital stays (p<0.01, p<0.01). (Journal of Zhejiang College of Traditional Chinese Medicine, 1990.4)”

“In the clinical observation of 40 cases of Shanghan treated with combined Chinese and Western medicine, the formula Geng Gen Qin Lian Tang was used with adjustments: for those with surface symptoms, add Jin Yin Hua, Lian Qiao, and Soybean Leaves; for those with heavy dampness, add Huo Xiang, Hou Pu, and Ginger Banxia; for those with high fever and yin deficiency, thirst, constipation, add Da Huang, Hou Pu, Guang Mu Xiang, Yi Ren, and Lu Gen; for those who have lost fluids and whose tongues are red and lacking moisture, add Sheng Di, Mai Dong, and Shi Hu; for those with delirium and confusion, add Ling Yang Jiao and Chang Pu. When intestinal bleeding occurred, with a decreased body temperature and a fine, rapid pulse, use Fugui Tang with adjustments; when the body temperature did not drop significantly but the pulse was slippery and rapid, use Xing Jiao Di Huang Tang combined with Qing Ying Tang. The traditional Chinese medicine group showed better efficacy than the Western medicine group, with statistically significant differences (p<0.05). (Journal of Zhejiang College of Traditional Chinese Medicine, 1991.1)”

“In the application of Da Huang Bai Ji Powder in the treatment of intestinal bleeding caused by Shanghan”

This article describes grinding 3 parts of Da Huang and 2 parts of Bai Ji into powder; for cases with occult blood in the stool, use 1g; for cases with hidden blood + + and small amounts of tar-like stool, use 2g; for cases with occult blood +++ and large amounts of tar-like stool, use 3g—taken orally three times a day. A total of 78 cases were treated, with an overall effective rate of 94.9%. (Journal of Guiyang College of Traditional Chinese Medicine, 1991.1)

“In the analysis of the efficacy of combined Chinese and Western medicine in treating 67 cases of enteric Shanghan,” the treatment method of clearing heat, transforming dampness, and releasing the exterior was employed: herbs such as Qing Hao, Yi Yi Ren, Geng Gen, Sheng Shi Gao, Jin Yin Hua, Bai Mao Gen, Sheng Ma, Chai Hu, Ze Xie, Huang Lian, Zhi Ke, Gua Lou Pi, etc. For cases with very high fever, add Ling Yang Jiao powder; for abdominal distension, add Pin Lang, Fo Shou, and Mu

I. Calculating Heat and the Accumulation of Pathogens Add Gua Lou Ren and Sheng Da Huang. Clear heat, cool the blood, and resolve the toxin.

Use Xing Jiao, Dan Pi, Xuan Fen, and other herbs. Use Xing Jiao, Dan Pi, Zhi Pi, Huang, Qin, Zhi, Mu, Sheng, etc. to treat the illness. The power of the gun...

The country's history shows that... At the time, the state had only thirty meters of land...

At the same time, combine with Western medicine. Western medicine used Chloramphenicol, SMZ-TD,

P, Ampicillin, Cephalosporin V—both groups showed superiority over the traditional Chinese medicine group. Compared to the Western medicine group, the traditional Chinese medicine group demonstrated statistically significant advantages (p<0.05, p<0.01). (Zhejiang Journal of Traditional Chinese Medicine, 1992.7)

Yang Gui Ping observed 48 cases of Shanghan patients with fever, administering oxygen fluoroquinolone injections intravenously to replenish electrolytes and fluids. The traditional Chinese medicine formula included: Huang Qin, Huang Lian, Yu Gao, Huang Bo, Shi Chang Pu, Bai Dou Kuo, Huo Xiang, etc., taken once daily, decocted in water and consumed three times a day. The control group received Western medicine alone. Results showed that 41 cases in the treatment group showed improvement, while 28 cases in the control group improved, with a p-value of <0.05.

The treatment group was significantly superior to the control group. (Yunnan Journal of Traditional Chinese Medicine and Chinese Medicine, 2005.5)

Dong Xue Min used Shanghan herbal tea to treat 617 cases of Shanghan and Parasitic Shanghan, and conducted a comparative study with a control group of 122 cases. The treatment group used Shanghan herbal tea,

with main ingredients including Gui Zhi, Gan Jiang, Bai Kou Ren, Gan Cao, etc., weighing 30g per bag. Adults took 2 bags daily, steeping them in 600ml of water for 30 minutes, then decocting for 15–20 minutes, drinking the decoction hot after three rounds. Eight days constituted one course of treatment. The control group received Ampicillin and Cefazolin via intravenous infusion, with eight days constituting one course of treatment. The total effective rate in the treatment group was 96.11%, while the control group was 87.7%, with a statistically significant difference between the two groups. (Shanxi Journal of Traditional Chinese Medicine, 2007.4)

Zhu You Guang divided 66 Shanghan patients into two groups for observation. In addition to standard antibiotic treatment, the treatment group also brewed and drank Ma Xing Shi Gan Tang with adjustments. The prescription included: 6g of Roasted Ephedra, 9g of Apricot Kernel, 60g of Gypsum, 9g of Roasted Licorice, 6g of Tian Zhu Huang, 6g of Qiang Chong, 15g of Golden Flower, 9g of Huang Qin, 9g of Ban Lan Gen, 12g of Sang Bai, 9g of Huo Xiang, etc. One dose per day, taken once in the morning and once in the evening. The control group received only standard Western medicine treatment. Both groups paid attention to maintaining electrolyte balance; when fever was high, they used ice packs, alcohol rubs, and other methods to relieve discomfort. For those who were restless, sedatives such as Diazepam could be used. Comparing the two groups’ efficacy: the treatment group’s fever subsided on average in (7.3±4.5) days, while the control group’s fever subsided in (12.6±5.2) days. Statistical analysis showed a t-value of 4.43, p<0.01, indicating a statistically significant difference. The treatment group’s clinical symptoms of poisoning improved in (8.4±3.7) days, while the control group’s improved in (13.2±5.3) days, with a statistically significant difference. The treatment group saw 25 cases improve, 6 cases were effective, 2 cases were ineffective, with a total effective rate of 93.9%. The control group saw 14 cases improve, 11 cases were effective, 8 cases were ineffective, with a total effective rate of 75.8%. The total effective rates between the two groups were significantly different, with a p-value of <0.05. (Modern Medicine and Health, 2008.1)

V. Western Medicine Treatment

(1) Rest and Diet

Patients in the fever phase must remain in bed and rest; after the fever subsides, activities can be gradually increased according to individual circumstances, moving from light movement to a return to normal daily life. Regularly monitor body temperature, pulse, and blood pressure, paying attention to hygiene in all parts of the body to prevent pressure sores and pulmonary infections. The diet should be high-calorie, highly nutritious, and easily digestible. During fever, fluid intake and soft, residue-free foods are recommended, with small, frequent meals. In the recovery phase, patients should eat more frequently and avoid hard, fibrous foods that are difficult to digest, to prevent the occurrence of intestinal bleeding or intestinal perforation.

(2) Medicinal Treatment

1. Chloramphenicol, taken 2–4 times daily, 0.5g each time, orally. Once body temperature returns to normal, the dosage can be reduced to half, with a treatment duration of 14–21 days. Intermittent treatment can help reduce the recurrence rate; start with the same dosage as the continuous treatment, then continue for 3 days after body temperature returns to normal, stop for 5–7 days, then resume with half the dose for about a week, repeating the treatment cycle as above. Throughout the medication period, regularly check white blood cell counts every week.

2. Sulfamethoxazole-sulfonamide compound, taken 2 tablets each time, orally. The treatment duration is around 2 weeks. Patients allergic to sulfonamides, those with impaired liver or kidney function, and pregnant women should use this medication with caution; during treatment, breastfeeding should be discontinued.