The patient is an 18-year-old male, hospitalization number 65427, admitted to the hospital on December 12, 2013 for “cough with chest tightness and shortness of breath for more than 2 months, aggravated for half a month”. The patient was diagnosed with “pulmonary tuberculosis” in the local hospital in early 2009, and was given standardized anti-tuberculosis treatment, and the medication was stopped according to the doctor’s instructions. 2013, coughing appeared in the beginning of October without any obvious triggers, and the symptoms were still mild at first, so the patient did not pay attention to it, and the cough was aggravated in the beginning of December, 2013, accompanied by chest tightness and shortness of breath, and then he went to Guangzhou Chest Hospital for consultation. On December 6th, ultrasound showed weight pericardial effusion, and on December 10th, chest CT of Guangzhou Chest Hospital showed 1. left upper anterior mediastinum mass shadow, considering the possibility of malignant thymoma with pericardial and pleural metastasis; 2. left lower lung infection, tuberculosis to be drained. In order to alleviate the symptoms, pericardiocentesis was performed to drain the pericardial fluid, and a total of 800 ml of yellowish pericardial fluid was drained out, which slightly relieved the patient’s symptoms after treatment. on December 12, 2013, the patient was admitted to the hospital for further treatment. Admission symptoms: the patient’s spirit is poor, shortness of breath is obvious, especially at every turn, can’t lie down, sleep is poor, the amount of stool is small, no fever, no dizziness, no headache, no abdominal distension and abdominal pain, the tongue is pale and fat, the moss is greasy, and the pulse is rapid, dull, and fine. Due to the mediastinal mass compressing the trachea and neck blood vessels, the patient’s neck was swollen, seriously affecting the cardiopulmonary function, with obvious shortness of breath and chest tightness. The patient’s condition was critical, and he was admitted to the hospital with a critical illness notification. After communicating with the patient’s father, he was given active treatment, and was first given diuretic and asthma medication, which was not effective. On the same day, the patient was given a heavy dose of “Typhoid Fever” four reverse soup + Xiaoqinglong Tang + Wu Ling San plus and minus decoction, many times a small amount of frequent oral intake, the next morning checkup, the patient’s father informed that the patient can lie down and fall asleep in the middle of the night. Immediately, he made an appointment with the Department of Thoracic Surgery for ultrasound-guided mediastinal mass biopsy, and was diagnosed with mediastinal germ cell tumor. After that, the patient underwent chemotherapy and mediastinal radiotherapy in our department for several times, and at the same time with Chinese medicine treatment, the efficacy evaluation was obvious. Experience of Chinese medicine treatment: In this case, the patient was firstly given diuretic and asthmatic western medicine, but the effect was not good, and the patient complained that there was no obvious effect. The patient complained that there was no obvious effect, but after the heavy dose of traditional Chinese medicine soup was frequently administered, the patient showed obvious clinical effect on the same day, which provided valuable time for the clear pathologic diagnosis. One of the main medicines of Si-Yi Tang is appendicitis, and Zhang Zhongjing is the first one who is good at heavy dose, and the later generations of doctors have Fan Zhonglin and Li Ke, one of the main medicines of Xiaoqinglong Tang is Xin Xin, which is used by the general practitioners with no more than 3 grams, and it is basically impossible to be sure of whether there is any curative effect or not. Ancient medical practitioners who used Hsu Hsin are mainly Zhang Zhongjing, modern medical practitioners are mainly Hebei famous doctor Liu Peiran, clinical doctor Li Ke, in the former theory and practice of the guidance of the small, I personally tasted cooked epiphyllum and Hsu Hsin, and followed the decoction method, starting from 10 grams to 100 grams, and did not feel any toxic side effects, especially Hsu Hsin, decoction, no numbness in the throat and gas closed the sensation of fainting, which is the main medicines of the patient’s admission to the hospital, that is, the use of cooked epiphyllum and Hsu Hsin, which are used to treat the patient. Therefore, in this case, the patient was admitted to the hospital and was treated with the main medicines of Radix Rehmanniae Praeparata and Rhizoma Polygonati Odorati, which achieved unexpected curative effects. (The prescription dosage is based on personal experience. (The prescribed dosage is based on personal experience, please do not copy and use without authorization.)