又次年。患血虚痰多。四肢腰背疼痛。身体难于转侧。至偶感微寒。即气急神昏。家人无不骇甚。二月间。因更衣
受寒。召余诊视。身壮热而神昏。口开气急。脉六部俱浑浑然。洪大而数。余因深知其平日体气。月黄 、当归、川芎、
苏叶、杏仁、葱白、山栀、郁金、贝母、连翘、竹茹等轻散。兼以固表之药。令其服后。助以锅巴汤。盖覆取微汗而解。
如法服之一剂果愈。此乃弃脉弃症。从平日之体气以治也。余尝见虚人患感其邪本轻。医每发散太过。即漏汗不止气
升于上。胸膈窒塞而死者。不可胜数。如前所载汪良翁之案。以体虚误汗。辄致危症蜂起。而如癫狂。亦此类也。书
之以为虚人不可发汗之戒。
鄂记绸庄内。某太太。十月间患冬温。十余日不解。医或发表。或温燥。失于清理。以致邪传阳明。大热气喘。身
发白 。与疹夹杂。诊其脉浑浑然。模糊不清。余主阳明透达清解之方。用羚羊角、人中黄、连翘、山栀、贝母、银花
等轻剂。次日早晨。追请甚急。余即往视。疹 已退。大便已解。热清而喘逆特甚。诊其脉大而空。面赤如装。余曰。
此邪去而正欲与之俱脱也。书人参、生附子各三钱。炙甘草、干姜各一钱。五味子五分。急令煎服勿迟。嘱其嗣君曰。
至申酉时大汗一出。当即亡阳矣。趁此未汗。尚可挽救。彼与一医商之。不以为然。交申时汗果大出。始信余言不谬。
急去兑参。已暴脱矣。合家懊悔复何及耶。
The following year, a patient suffered from blood deficiency with excessive phlegm, pain in the four limbs and lower back, and difficulty turning or shifting her body. Whenever she was exposed to slight cold, she would experience shortness of breath and coma, causing great alarm among her family members. In February, after catching a cold while using the toilet, she summoned me for consultation. She presented with high fever and coma, open mouth with rapid breathing, and a pulse that was indistinct, surging, large, and rapid in all six positions. Knowing well her constitutive state, I prescribed light dispersing herbs such as Oenothera biennis (Yuejiancao), Angelica sinensis (Danggui), Ligusticum chuanxiong (Chuanxiong), Perilla leaf (Suye), Apricot seed (Xingren), Scallion white (Congbai), Gardenia (Shanzhi), Curcuma aromatica (Yujin), Fritillaria (Beimu), Forsythia (Lianqiao), and Bamboo shavings (Zhuru), combined with herbs to consolidate the exterior. After taking the medicine, she was instructed to drink rice crust soup and cover herself to induce a slight sweat for resolution. Following this method, one dose resulted in a cure. This case illustrates treating based on the patient's constitutive state rather than discarding the pulse and symptoms. I have often seen patients with deficiency contracting exogenous pathogens where the pathogen is mild, but physicians over-disperse, leading to uncontrollable sweating, rising qi, chest oppression, and death. Such cases are countless. As recorded in the case of Wang Liangweng mentioned earlier, improper sweating in a deficient person immediately led to critical conditions resembling mania. These writings serve as a warning against sweating in deficient individuals.
A lady from the Ebu Silk Shop contracted Winter-Warmth (Winter Warm Disease) in October, which persisted for more than ten days without resolution. Physicians either used releasing methods or warming-drying methods, failing to clear and regulate properly, allowing the pathogen to transmit to the Yangming channel. This resulted in high fever, panting, and the appearance of white miliary sweat (Bai Fei) mixed with rashes. Her pulse was indistinct and blurred. I advocated for a formula to vent and clear the Yangming channel, using light agents such as Antelope horn (Lingyangjiao), Human coprolite (Renzhonghuang), Forsythia (Lianqiao), Gardenia (Shanzhi), Fritillaria (Beimu), and Honeysuckle (Yinhua). The next morning, she was urgently summoned again. The white miliary sweat had subsided, stool had passed, heat had cleared, but panting became particularly severe. Her pulse was large and empty, and her face was red as if painted. I stated, "The pathogen has left, but the healthy qi is also about to collapse." I prescribed three qian each of Ginseng (Renshen) and Raw Aconite (Sheng Fuzi), one qian each of Honey-fried Licorice (Zhi Gancao) and Dried Ginger (Ganjiang), and half a qian of Schisandra (Wuweizi), ordering immediate decoction without delay. I warned her successor, "If profuse sweating occurs during the Shen and You hours (3 PM - 7 PM), Yang collapse will ensue immediately. While sweating has not yet occurred, rescue is still possible." He consulted another physician who disagreed. When the Shen hour arrived, profuse sweating indeed occurred, and only then did they believe my words were correct. They hurriedly sought to obtain Ginseng, but she had already suffered sudden collapse. What good would regret do for the whole family?