、木香、甘草各八分。天仙藤三钱。橘皮一钱。生姜三片。红枣三枚。煎服。两剂后。痛大
退。能举动矣。惟腿膝觉痛。盖余病未清也。以原方去半夏、川芎。减轻其剂。加牛膝、苡
仁、党参等。接服两剂而瘥。
丁姓妇年逾六旬。病延多日。由其婿金峙生君延予治。胸次闷塞不舒。饮食不进。身不发热
。惟胸博一片热。溲热口干。舌苔薄腻。脉弦小滑。此暑湿痰滞郁结上焦不通。先宜宣开上
焦。然后再议调补。方用石菖蒲三分。香橼皮、佛手、佩兰、枳壳、桔梗各一钱。麦冬、杏
仁各一钱五分。连翘二钱。接服两剂。胸闷松。稍能进粥汤。惟心悸怔忡。头晕汗多。盖病
退而气血虚也。遂易方用北沙参、白芍、干地黄各二钱。黄 一钱。枣仁、柏子仁各三钱。
香橼皮八分。麦冬一钱五分。甘草五分。接服四剂。诸恙悉除矣。
王姓妇年六十一岁。夏间陡患头晕心悸。胸闷嘈杂。时发寒热。予诊其脉细小。口干溲热。
身体素瘦。盖阴液素亏。兼有郁抑。而复受暑也。乃以轻剂调之。二剂而愈。方用北沙参一
钱五分。麦冬二钱。枣仁、茯神各三钱。佩兰、香橼皮各一钱。青蒿、连翘各三钱。六一散
二钱。天花粉一钱五分。煎服。
赵姓妇年近四旬。禀质素弱。春间患怔仲不寐。自服人乳
二十日始愈。夏间复病。每日午后发热。身困胸闷作恶。不思饮食。泄泻。自用元参、麦冬
、山栀、桔梗、薄荷、甘草等药。热愈甚。延予延医。右脉弦数。舌苔白腻。小便热。予谓
此湿温病。最忌滋腻之药。虽体质素衰。亦不宜用补药。当先治病。特方法宜和平。而不可
用重剂耳。遂拟方用黄芩一钱五分。苡仁、滑石、青蒿各三钱。佩兰一钱。蔻仁、通草各六
分。橘皮五分。接服两剂。热退泻减。但胸次作痛。怔忡复作。手麻不寐。脉转缓小。咳嗽
。舌尖红。中苔薄腻。遂改用蔻仁六分。木香、佛手各八分。枣仁、柏子仁、茯神、茯苓各
三钱。佩兰一钱。枇杷叶一片。两剂诸恙全退。能进饮食矣。
安雷川君令嫒。两岁。冬月间因佣妇不慎。将沸水泼于其腿。溃烂如手掌大。啼哭不休。
初延西医治之。不能定痛。乃邀予诊。予用藤黄膏涂之。旋即止痛。未及两星期。而长肉收口矣。
附藤黄膏方
藤黄（一两） 黄蜡（一两） 麻油（八两）
先将藤黄敲碎。置入麻油内。慢火煎之。俟藤黄枯焦。其汁尽出。即离火。滤去渣。将黄蜡
置油中熔化。和匀成膏。置冷地出火毒。专治汤火伤。止痛生肌。效验无匹。用时将膏涂患
处。以油纸盖之。外加布包扎。每日换一二次。
史姓妇年约三旬。患目疾。服药不效。延予治。视其两目。并不红肿。又无 膜。问之。但
觉昏花作痛。畏见日光灯光。头晕神疲。此劳神太过血液衰耗。脑力不充血不足以养目也。
经云。目得血而能视。治宜养血为主。初用集灵膏合二至丸作煎剂。接服五剂大效。嗣以原
方作膏剂。服至半月。目力如常矣。
龚姓女七岁。夏间头顶生疖如贯珠。出脓后久不生肌。每三日必出脓一次。否则肿胀疼痛。
乃以绿云膏贴之。每日洗换。不十日瘥。
家嫂于今年九月。陡患喉症。初起时仅咽喉两旁红肿起白点。发热恶寒。头疼。舌苔淡黄而
腻。脉滑。盖湿热痰滞酝酿为患。初用薄荷四分。桑叶一钱。连翘四钱。栝蒌、金银花、贝
母各三钱。金果榄二钱。鲜生地六钱。煎服。外吹蓬莱雪。次日寒热退。而咽喉两旁则破烂
。汤水难下。舌苔淡黄浓腻。右脉滑数。乃痰伏上焦也。前方去薄荷、桑叶。加杏仁三钱。
冬瓜仁、丝瓜络各四钱。黄芩二钱。木通一钱。石菖蒲四分。梨汁一酒钟和服。第三日复诊
。喉部溃烂未至蔓延。咽内常觉痰阻。舌苔黄腻。痰浊甚重。轻剂不能治也。乃易方用旋复
花二钱。贝母四钱。海浮石、蒌仁、半夏曲、麦冬、生地各三钱。川连五分。橘皮一钱五分
。梨汁、莱菔汁和服。并另用梨汁、莱菔汁与饮。痰渐活动。能稍稍咯出矣。然舌苔则满布
粘腻。口粘而干。大便数日未通。右脉滑数。乃以原方去海浮石。加滚痰丸三钱同煎。盖欲
通其大便。使痰浊下降也。此药服后。夜间能睡一二时。知饥欲食。而病势遂大退矣。然并
未大便。惟吐痰则甚多。舌苔尚腻。仍以前方去滚痰丸。服后诸恙俱退。家嫂以药太苦。遂不
服药。但以薄粥调养。越日大便始通。而起居如常矣。
张姓女年十七岁。体素羸瘦。自去年秋间。经水止而不来。时发寒热。延医治已小愈。今年
四月。偶因邻舍失火。突受惊恐。病势转剧。医药罔效。乃延予治。咳嗽发热。胸闷腹胀。
胁痛不寐。肌肉瘦削。满舌光赤无苔。脉息弦细。饮食不进。夫肌肉既消于外。阴液又亡于
内。而饮食复不能进。将何恃以生存乎。乃婉言谢之。讵病家必欲服药。乃用增液汤。加青
蒿、地骨皮、西洋参、柏子仁、茯神、香橼皮、蒌仁等药以养阴退热。兼消积滞。接服三剂
。得大汗而热退。大便解出臭秽粘硬之粪甚多。知饥欲食。二三日后。居然能进粥饭碗许。
素馄饨能食二十枚。亦能行走如常。其家狂喜。诧为神奇。予观其肢体太瘦。丰姿太薄。虑
其终难收功。因告之曰。今虽小效。后事尚难预料。其时初交小暑。不数日天气骤然酷热。
无病之人。尚觉难受。而此女果复发热睡倒。不能起床。饮食不进。予乃决其死期在立秋前
后。病家仅此一女。必欲其生。遂复延他医及针科延医。至七月杪而死耗至矣。又友人张挹
山君内弟。自今年春间卧病。缠延床蓐。延医服药。病虽退而肛门之旁生一漏孔。日流脓水。
每大便则粪从孔出。至八月间挹山君之夫人。由安庆归。见其弟病危若此。乃荐予诊。予入
其室。见病患卧于床。瘦削不堪。几同枯骨。视其舌则光而不红。脉息细如蛛丝。每夜出汗
甚多。予出其室。私嘱其家曰。速备后事。病不可为矣。其家谓现下尚能饮食。言语亦甚清
晰。何不能治。予曰。大肉脱者死。此人仅剩皮骨。如何能生。果于是日夜间二句钟死矣。
夫决生死之法。为诊病之重要关键。而其学理则莫精于素问难经两书。故欲请求医学。不可
不于此二书加之意也。若近人好摘内经之小疵。而辄肆诋毁者。非无识少年。即别怀私
意。又何足与之深论耶。
Mu Xiang (Aucklandiae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma) each 8 fen. Tian Xian Teng (Stauntoniae Caulis), 3 qian. Ju Pi (Citri Reticulatae Pericarpium), 1 qian. Sheng Jiang (Zingiberis Rhizoma Recens), 3 slices. Hong Zao (Jujubae Fructus), 3 pieces. Decoct and take orally. After two doses, the pain subsided significantly, and movement became possible. However, pain remained in the legs and knees, indicating that residual pathogenic factors had not yet cleared. Remove Ban Xia (Pinelliae Rhizoma) and Chuan Xiong (Ligustici Chuanxiong Rhizoma) from the original formula, reduce the dosage, and add Niu Xi (Achyranthis Bidentatae Radix), Yi Ren (Coicis Semen), Dang Shen (Codonopsis Radix), etc. Continue taking for two doses until recovery.
A woman surnamed Ding, over sixty years old, had been ill for many days. Her son-in-law, Mr. Jin Zhisheng, invited me to treat her. She complained of chest stuffiness and discomfort, inability to eat, no fever, but a sensation of heat in the chest, hot urination, and dry mouth. The tongue coating was thin and greasy, and the pulse was wiry, small, and slippery. This was due to summerheat-dampness and phlegm-stasis stagnating and knotting in the Upper Jiao (Upper Burner), obstructing Qi mechanism. Initially, it is appropriate to ventilate and open the Upper Jiao, and then discuss tonification. The formula used Shi Chang Pu (Acori Tatarinowii Rhizoma), 3 fen; Xiang Yuan Pi (Citri Grandis Pericarpium), Fo Shou (Citri Sarcodactylis Fructus), Pei Lan (Eupatorii Herba), Zhi Ke (Aurantii Fructus Immaturus), Jie Geng (Platycodonis Radix) each 1 qian; Mai Dong (Ophiopogonis Radix), Xing Ren (Armeniacae Semen Amarum) each 1.5 qian; Lian Qiao (Forsythiae Fructum), 2 qian. After taking this consecutively for two doses, chest stuffiness relaxed, and she could slightly consume porridge and soup. However, she experienced Xin Ji Zheng Chong (palpitations and anxiety), dizziness, and excessive sweating, indicating that as the disease receded, Qi and Blood became deficient. Thus, the formula was changed to Bei Sha Shen (Glehniae Radix), Bai Shao (Paeoniae Radix Alba), Di Huang (Rehmanniae Radix Preparata) each 2 qian; Huang Qi (Astragali Radix), 1 qian; Zao Ren (Ziziphi Spinosae Semen), Bai Zi Ren (Platycladi Semen) each 3 qian; Xiang Yuan Pi, 8 fen; Mai Dong, 1.5 qian; Gan Cao, 5 fen. After taking this consecutively for four doses, all ailments were eliminated.
A woman surnamed Wang, aged sixty-one, suddenly suffered from dizziness and palpitations in summer, with chest stuffiness and a sour/bitter sensation, alternating chills and fever. I diagnosed her pulse as fine and small, with dry mouth and hot urination. Her body was constitutionally thin, suggesting chronic Yin fluid deficiency combined with Qi stagnation, compounded by summerheat invasion. Therefore, a light formula was used to regulate her condition. After two doses, she recovered. The formula used Bei Sha Shen, 1.5 qian; Mai Dong, 2 qian; Zao Ren, Fu Shen (Poria with Hostwood) each 3 qian; Pei Lan, Xiang Yuan Pi each 1 qian; Qing Hao (Artemisiae Annuae Herba), Lian Qiao each 3 qian; Liu Yi San (Six-to-One Powder), 2 qian; Tian Hua Fen (Trichosanthis Radix), 1.5 qian. Decoct and take orally.
A woman surnamed Zhao, nearly forty years old, had a constitutionally weak physique. In spring, she suffered from Zheng Tong (palpitations) and insomnia, which healed after self-administering human milk for twenty days. In summer, the illness relapsed: daily afternoon fever, body fatigue, chest stuffiness, nausea, anorexia, and diarrhea. Self-medication with Yuan Shen (Scrophulariae Radix), Mai Dong, Shan Zhi (Gardeniae Fructus), Jie Geng, Bo He (Menthae Haplocalycis Herba), Gan Cao exacerbated the heat. I was consulted. The right pulse was wiry and rapid, tongue coating white and greasy, urination hot. I determined this was Shi Wen Bing (Damp-Warmth Disease), where greasy/nourishing herbs are strictly contraindicated. Although constitutionally weak, tonics should also be avoided initially. The treatment should focus on resolving the disease using mild methods rather than heavy doses. The prescribed formula contained Huang Qin (Scutellariae Radix), 1.5 qian; Yi Ren, Shi Gao (Talcum), Qing Hao each 3 qian; Pei Lan, 1 qian; Kou Ren (Amomi Fructus Rotundus), Tong Cao (Tetrapanacis Medulla) each 6 fen; Ju Pi, 5 fen. After two doses, fever subsided and diarrhea decreased. However, chest pain occurred, Zheng Tong recurred, hand numbness and insomnia appeared, pulse became slow and small, cough developed, tip of tongue red, middle coating thin and greasy. The formula was modified to Kou Ren 6 fen; Mu Xiang (Aucklandiae Radix), Fo Shou each 8 fen; Zao Ren, Bai Zi Ren, Fu Shen, Fu Ling (Poria) each 3 qian; Pei Lan, 1 qian; Pi Pa Ye (Loquat Leaf), one piece. After two doses, all symptoms disappeared, and appetite returned.
An Leichuan's daughter, aged two, suffered scalds on her leg in winter due to a nanny's negligence. The wound was palm-sized and ulcerated, causing incessant crying. Western medicine failed to relieve pain. I applied Teng Huang Gao (Arsenic Oxyde Ointment). Pain ceased immediately. Within two weeks, granulation tissue formed and the wound closed.
Formula for Teng Huang Gao:
Teng Huang (Realgar), 1 liang; Huang La (Yellow Beeswax), 1 liang; Ma You (Sesame Oil), 8 liang.
Crush Teng Huang, place in sesame oil, and simmer slowly. When Teng Huang chars and juice is extracted, remove from fire. Filter out residue. Melt Huang La into the oil, mix uniformly to form ointment. Place in a cool area to eliminate "fire toxicity." This ointment specifically treats scalds and burns, stops pain, promotes flesh regeneration, and has unparalleled efficacy. Apply to the affected area, cover with oil paper, wrap with cloth externally. Change dressing once or twice daily.
A woman surnamed Shi, about thirty years old, suffered from eye disease unresponsive to medication. Examination showed no redness, swelling, or pterygium (Yi Mem). She reported blurred vision, pain, photophobia (aversion to sunlight/lamp light), dizziness, and mental fatigue. This resulted from excessive mental labor depleting Blood, leading to insufficient cerebral blood supply to nourish the eyes. As stated in the *Classic of Internal Medicine*: "The eyes see when they receive Blood." Treatment should prioritize nourishing Blood. Initially, Ji Ling Gao (Collection Spirit Paste) combined with Er Zhi Wan (Two Solstice Pill) was decocted. After five doses, significant improvement was seen. Subsequently, the same formula was made into a paste. After half a month of consumption, vision normalized.
A girl surnamed Gong, seven years old, developed boils on the vertex of her head resembling beads in summer. After pus discharge, healing was delayed. Pus exuded every three days; otherwise, swelling and pain occurred. Lv Yun Gao (Green Cloud Ointment) was applied, washed and changed daily. Recovery occurred within ten days.
My sister-in-law suddenly suffered from a throat disorder in September this year. Initially, only bilateral throat redness/swelling with white spots, fever, aversion to cold, headache, pale yellow greasy tongue coating, and slippery pulse were present. This was caused by damp-heat and phlegm-stasis fermenting. Initial treatment used Bo He, 4 fen; Sang Ye (Mori Folium), 1 qian; Lian Qiao, 4 qian; Gua Lou (Trichosanthis Fructus), Jin Yin Hua (Lonicerae Japonicae Flos), Bei Mu (Fritillariae Cirrhosae Bulbus) each 3 qian; Jin Guo Lan (Stephaniae Tetrandrae Radix), 2 qian; Xian Sheng Di (Rehmanniae Radix Recens), 6 qian. Decoct and take. Externally, Peng Lai Xue powder was blown into the throat. The next day, chills and fever subsided, but the throat mucosa became ulcerated, making swallowing difficult. Tongue coating became thick pale yellow greasy, right pulse slippery and rapid. Phlegm was lodged in the Upper Jiao. Bo He and Sang Ye were removed from the previous formula; Xing Ren, 3 qian; Dong Gua Ren (Benincasae Semen), Si Gua Luo (Luffae Fructus Retinervus) each 4 qian; Huang Qin, 2 qian; Mu Tong (Akebiae Caulis), 1 qian; Shi Chang Pu, 4 fen; Pear Juice, one cup mixed and taken. On the third day, throat ulceration did not spread, but phlegm obstruction persisted in the pharynx. Tongue coating yellow greasy, heavy turbid phlegm. Light formulas were ineffective. The formula was changed to Xuan Fu Hua (Inulae Flos), 2 qian; Bei Mu, 4 qian; Hai Fu Shi (Pumex), Lou Ren (Trichosanthis Semen), Ban Xia Qu (Pinelliae Fermented Rhizoma), Mai Dong, Sheng Di (Rehmanniae Radix) each 3 qian; Chuan Lian (Coptidis Rhizoma), 5 fen; Ju Pi, 1.5 qian. Pear juice and Daikon Radish juice mixed and taken. Additionally, these juices were drunk separately. Phlegm loosened and could be expectorated slightly. However, tongue coating was sticky and greasy throughout, mouth sticky and dry, constipation for several days, right pulse slippery and rapid. Hai Fu Shi was removed from the original formula, and Gun Tan Wan (Rolling Phlegm Pill), 3 qian, was added to the decoction. The intention was to unblock the bowels to descend turbid phlegm. After taking this medicine, she slept for one to two hours at night, felt hungry and desired food, and the disease greatly receded. However, bowel movement still had not occurred, though expectoration increased. Tongue coating remained greasy. The formula without Gun Tan Wan was continued. All symptoms subsided after taking it. Due to the bitter taste, my sister-in-law refused further medication and relied on thin porridge for diet. The next day, bowel movement occurred, and daily activities resumed normally.
A girl surnamed Zhang, seventeen years old, was constitutionally emaciated. Since last autumn, menstruation had stopped. Alternating chills and fever occurred. Medical treatment provided slight relief. In April this year, due to a neighbor's fire, she suffered sudden fright, worsening the condition despite medical efforts. Cough, fever, chest stuffiness, abdominal distension, hypochondriac pain, insomnia, muscle wasting, smooth red tongue without coating, wiry-fine pulse, and anorexia were present. With external muscle wasting and internal Yin depletion, plus inability to ingest food, survival seemed impossible. I politely declined treatment. However, the family insisted on medication. I prescribed Zeng Ye Tang (Increase Fluids Decoction) added with Qing Hao, Di Gu Pi (Lycii Cortex), Xi Yang Shen (American Ginseng), Bai Zi Ren, Fu Shen, Xiang Yuan Pi, Lou Ren to nourish Yin, clear heat, and resolve stagnation. After three doses, profuse sweating occurred, fever subsided, and foul, sticky-hard stool was passed. Hunger and desire for food returned. Within two to three days, she could consume a bowl of porridge, twenty plain wontons, and walk normally. Her family was ecstatic, calling it miraculous. Observing her extreme emaciation and frailty, I feared ultimate failure and warned them: "Although there is current improvement, the outcome remains unpredictable." It was just after Minor Heat, and weather turned extremely hot shortly after. Even healthy people found it unbearable. This girl indeed relapsed with fever, bedridden, unable to rise or eat. I predicted death around Start of Autumn. Having only this daughter, the family sought other doctors, including acupuncture specialists. Death occurred at the end of July.
Another case: Friend Zhang Yishan's brother-in-law lay ill since spring, bedridden. Medication reduced symptoms but caused a fistula near the anus leaking pus daily. Stool exited through the fistula during defecation. In August, Mrs. Zhang returned from Anqing, seeing her brother's critical state, and recommended me. Entering the room, the patient lay emaciated, almost like a skeleton. Tongue was smooth but not red; pulse was thread-like. Night sweats were severe. Leaving the room, I privately advised the family: "Prepare funeral arrangements; the case is incurable." They argued he could eat and speak clearly. I replied: "When large muscles waste away, death ensues. This person is skin and bones; how can he survive?" Indeed, he died at 2:00 AM that night.
Determining life and death is a crucial key in diagnosis, with its theoretical basis most refined in the *Su Wen* (Basic Questions) and *Nan Jing* (Classic of Difficult Issues). Therefore, those seeking medical knowledge must pay attention to these two books. Those who nitpick minor flaws in the *Nei Jing* (Inner Canon) and slander it are either ignorant youths or harbor ulterior motives, unworthy of serious discussion.