李荔生封翁。素有痰火。发必召诊。试辄幸中。己丑九月前疾复作。愚按其脉。向来滑大。今忽损小。浮部奄奄至
数不明。且气来又不连续。愕然谓其世兄梅生太史曰。尊甫之脉。何以反常之至此。梅翁医道甚精。并深信愚之脉
理。乃惊疑久久。始作声曰。无大害乎。愚知其素性纯孝。不敢直告。为定清疏上焦之方。加金匮肾气丸。服之颇安。
越数日复诊。封翁问脉息如何。愚勉强慰之。不得已私谓梅翁曰。脉象已现真脏。如雀啄食。每五六至。或十余至
一止。恐是元阳暴衰之征。为之奈何。梅翁嘱为定方。用桂苓甘术汤加龙牡以镇摄之。又拟两方治上焦之痰。用
陈皮八两。苍术、半夏各二两。风化硝、青盐各五钱。生姜汁半碗。以四味煎汁合姜汁收入陈皮。令不时口内噙咽
少许。治下焦之虚。用人参五钱。生附子八钱。以附子煎汁收入人参。将参用铜刀切小块。外用茯苓细末。合炼蜜
包裹为丸。晒干。每日空心服三钱。奈封翁平日大忌参附。梅翁力劝数四。至于泣谏。终不能用。医有令服参须五
分试之。膈间作胀。益加畏慎。余曰。参须与参不同。服仅五分。是以作胀。能服五钱。即不胀矣。况愚所制参附为丸。
外用茯苓包裹入胃。使参附之性。必至下焦乃发。是下焦元气可藉温补而转旺。而中焦阴邪。又何难驱除罄尽
耶。岂复能作胀耶。赤心苦口。意终不回。但问小儿明年可入都否。余曰。病尚未愈。梅翁必不止暂离膝下。此愚之
所稔知也。梅翁泪涔涔下。愚亦不胜嗟叹。盖翁之生平。性最慈爱。乐善忘倦。远近无不颂德。与愚尤有夙缘。嗟嗟。
珠林玉树。食报靡涯。不幸至冬。轨遭大变。惜哉。
父慈子孝。一堂和气。那堪罹此闵凶。心禅写入案中。缠绵悱恻。至性流露。非深心人不能体会至此何忍卒读。
（淞樵评）
Li Lisheng, a respected official (Fengweng). He had long suffered from phlegm-fire. Whenever an episode occurred, he would summon me for consultation, and my attempts at treatment were often fortunate enough to succeed. In the ninth month of the Jichou year, his old illness recurred. I palpated his pulse; it had always been slippery and large (Hua Da), but now it had suddenly become thin and small. On superficial pressure, the pulse was faint, with an indistinct rate, and the qi flow was discontinuous. Astonished, I said to his eldest son, Meisheng Taishi: "Why has your father's pulse become so abnormal?" Master Mei was well-versed in medical principles and deeply trusted my understanding of pulse diagnosis. After a long period of shock and doubt, he finally spoke, asking, "Is there no major harm?" Knowing his inherent filial piety, I dared not tell him the truth directly. Instead, I prescribed a formula to clear and diffuse the Upper Jiao, adding Jin Kui Shen Qi Wan (Kidney Qi Pill from the Golden Cabinet). He took it and felt quite relieved.
Several days later, upon re-examination, Master Li asked how his pulse was. I comforted him reluctantly and, unable to keep silent, privately told Master Mei: "The pulse image now reveals Zang pulses (True Visceral Pulses), resembling a sparrow pecking at food—beating five or six times, or ten-plus times, before pausing. This is likely a sign of sudden collapse of Primordial Yang. What shall we do?" Master Mei instructed me to prescribe a formula. We used Gui Ling Gan Zhu Tang (Cinnamon Twig, Poria, Licorice, and Atractylodes Macrocephala Decoction) added with Long Gu (Dragon Bone) and Mu Li (Oyster Shell) to anchor and secure the qi. Additionally, two formulas were drafted to treat phlegm in the Upper Jiao: Chen Pi (Tangerine Peel) 8 liang, Cang Zhu (Atractylodes Rhizome) and Ban Xia (Pinellia Tuber) 2 liang each, Feng Hua Xiao (Weathered Nitre) and Qing Yan (Green Salt) 5 qian each, and half a bowl of fresh ginger juice. The first four ingredients were decocted, the juice mixed with ginger juice, and the Chen Pi incorporated. The patient was instructed to hold small amounts in the mouth and swallow occasionally. To treat deficiency in the Lower Jiao, Ren Shen (Ginseng Root) 5 qian and Sheng Fu Zi (Raw Aconite Lateralis Radix Preparata) 8 qian were used. The Fu Zi was decocted, and its juice was infused into the Ren Shen. The Ren Shen was cut into small pieces with a copper knife, then coated with fine powder of Fu Ling (Poria) and wrapped in refined honey to form pills, which were dried in the sun. Three qian were taken on an empty stomach daily.
However, Master Li strictly avoided Ginseng and Aconite in his daily life. Despite Master Mei’s repeated urging and even tearful persuasion, he ultimately refused. A physician suggested trying just 5 fen of Ren Xu (Ginseng Tendril). Upon taking it, he felt distension in the diaphragm region, becoming even more wary. I explained, "Ren Xu differs from Ren Shen. Taking only 5 fen causes distension. If one could take 5 qian, there would be no distension. Moreover, the Ginseng-Aconite pill I formulated is wrapped in Fu Ling externally; once ingested, the properties of Ginseng and Aconite will only manifest after reaching the Lower Jiao. Thus, the Yuan Qi (Primordial Qi) in the Lower Jiao can be revitalized through warming and tonification, and the Yin pathogenic factors in the Middle Jiao can surely be eradicated. Would distension still occur?" I spoke with utmost sincerity and earnestness, but his mind remained unswayed. He merely asked, "Can my son go to the capital next year?" I replied, "Your illness has not yet healed. Master Mei certainly will not leave your side temporarily; this is something I know well." Master Mei shed tears profusely, and I could not help but sigh.
Master Li was, throughout his life, most compassionate and diligent in charity, praised by people near and far for his virtue, and held a special karmic connection with me. Alas! Like jade trees in a pearl forest, enjoying boundless rewards, he unfortunately met a great disaster in winter. How pitying. Fatherly love and filial piety created a harmonious household; how could they bear such tragic misfortune? Xin Chan recorded this case, filled with lingering sorrow and profound emotion, revealing genuine nature. Only those with deep hearts can truly understand this. How can one bear to finish reading it? (Commentary by Song Qiao)