Summary of case history,　The patient, a 79-year-old male, had headache and dizziness for 2 weeks, speech impairment for 1 week and fever for 1 day.On admission to hospital, The patient had many symptoms, including confusion, groping for movement, fever, headache, speech disorder, movement disorder on right limb, cough and sputum, and shortness of breath.Meanwhile, The patient had gastric and urinary tubes on her body, slept very poorly, and had constipation for ten days. His tongue is red, and the fur was thick and greasy. The pulse was like a string, smooth and strong.Admission diagnosis: Chinese medicine diagnosis: headache: The syndrome of obstruction in phlegm turbidity and dampness and temperature closing orifices.Modern medical diagnosis: Tuberculous meningoencephalitis ; acute cerebral infarction.Auxiliary examination: Cerebrospinal fluid pressure: 202 mmH2O; Appearance: Yellow and cloudy. Pandy Test: (+), WBC 1248×10^6/L↑; Cl: 115.0 mmol/L, G: 1.91 mmol/L, Pro: 4286.0 mg/L↑.T-SPOT (+), IGRAs(Interferon-Gamma Release Assay): 86.20.metagenomics next-generation sequencing (mNGS): Mycobacterium : Sequence number: 24, isotopic abundance ratio: 15.69 %; Mycobacterium tuberculosis complex: Sequence number: 22, isotopic abundance ratio: 14.38 %.MRI+DWI of Head: 1. Acute lacunar infarction in right basal ganglia and frontal lobe.This case is a joint diagnosis and treatment of traditional Chinese and western medicine.In terms of traditional Chinese medicine: In different stages of " the syndrome type of wet and warm", the use of treatments include clearing heat and detoxifying, relieving heat, invigorating spleen and drying dampness, aromatizing dampness, nourishing Yin and reducing dampness, nourishing Yin and increasing fluid, warming Yang qi.In terms of Western medicine: the patient was given notice of serious illness during hospitalization, and the patient was given quadruple anti-tuberculosis treatment, intrathecal injection of isoniazid injection, anti-platelet agglutination, lipid regulation and plaque stability, circulation improvement, stress ulcer prevention, anti-infection, dehydration and cranial pressure reduction, heart rate control and other symptomatic treatments.The patient's clinical symptoms were greatly improved, and the laboratory examination returned to normal, and then, the patient was discharged after recovery.After discharge, the patient continued to be treated with anti-tuberculosis, anti-platelet aggregation, lipid-regulating and plaque stabilization, and oral Chinese medicine. Finally, until January 9, 2022. The patient was fluent in speech, walked on his own, had no recurrence of symptoms,and had recovered.,TCM diagnosis,　headache (The syndrome of obstruction in phlegm turbidity and dampness and temperature closing orifices),Western medicine diagnosis,　tuberculous menioencephalitis;;acute stage of cerebral infarction;digestive tract hemorrhage;chronic renal insufficiency;grade 3 hypertension (very high-risk group);arrhythmia supraventricular tachycardia paroxysmal atrial fibrillation;liver cyst;left kidney cyst;left kidney stone ; brain atrophy ;dyslipidemia; cervical degenerative changes,Therapeutic methods,　In traditional Chinese medicine, the method of clearing dampness temperature and warming Yang qi is used, and TCM decoction is used for syndrome differentiation. Western medicine is based on quadruple anti-tuberculosis, anti-platelet aggregation, lipid-regulating and plaque stabilizing, improving circulation and other symptomatic treatment.,Clinical outcomes,　The patient was conscious and in good spirits. The symptoms such as slurred speech and poor physical activity were significantly improved. He had no headache or dizziness, and his stools and urination were normal. Within two years, the patient had no discomfort.