An elderly woman experienced persistent high fever (body temperature 39-40°C) for four days. She was initially treated with antipyretic and analgesic injections, which slightly reduced the fever before it rose again. Subsequently, she was given penicillin for two days, but the fever persisted. She also presented with headache, mild aversion to cold, cough with white sticky phlegm, nausea, vomiting, dry mouth, constipation, scanty dark urine, a floating, thin, and wiry pulse, and a slightly yellow, thick tongue coating. The diagnosis was external cold pathogen transforming into internal heat, with qi stagnation and triple energizer obstruction, leading to a lack of harmony between the exterior and interior. A combined prescription of Gardenia and Fermented Soybean Decoction, Minor Chest Bind Decoction, and Minor Bupleurum Decoction (excluding ginger and jujube) was administered. After taking just one dose, the fever subsided, and all accompanying symptoms were resolved.