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Fang Yuyi Cao (Imitation of Yuji Cao)

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Abstract

"Fang Yuyi Cao" consists of two volumes, authored by Li Wenrong (courtesy name Guanxian) of Dantu during the Qing Dynasty. Mr. Li, also known as the Old Man Rumei, wrote "Zhiyi Bibian" (Must-Distinguish Knowledge in Medicine), which our society has already published in the first collection of woodblock printed medical series. Readers of this book all admire his detailed and accurate discussions; only an experienced veteran could write such words. This book records his clinical treatment cases, mostly involving difficult or tricky conditions, using unexceptional prescriptions. His profound analysis of diseases is comparable to that of Xichang (Yu Jia Yan). Compared to "Xue Shi Yi An" (Medical Cases of the Xue Family) which is vague, and "Linzheng Zhinan" (Guide to Clinical Practice) whose efficacy is unknown, this work is worlds apart, truly being a top-tier medical case record. Therefore, it is urgently published for the appreciation of fellow enthusiasts.

Preface to Fang Yuyi Cao

Scholars study to understand principles. Besides classics and history, they also study the "minor arts" of *Ling Shu* (Spiritual Pivot) and *Su Wen* (Basic Questions), where profound truths reside. Solid learning is insufficient for verification without careful study; an open mind is insufficient to elucidate subtleties. Those who have experienced the joys and hardships know them; those who have benefited from the effects know them. I recall that in the autumn of the Yiyi year, I suffered from malaria and was misdiagnosed/treated by physicians, nearly beyond saving. Observer Qian specially recommended Mr. Li Guanxian, a scholar from Runzhou, to come. After one examination, the condition turned from adverse to favorable, and after regulation, he recovered completely, like being reborn. Thus, we became close friends. Later, Guanxian associated with me, and wherever he went, things went smoothly. Whenever discussing diagnosis and treatment, it was always effective. Some feared at first visit that Guanxian would say the disease was incurable, because once he said so, even seeking distant doctors would not save them. It is known that Guanxian is truly experienced in this regard (having broken his arm three times, implying great experience). Moreover, he is open and upright. Knowing him for a long time, in his spare time from official duties, he often discussed literature with me, exploring the arts of Qi Bo and Yu Fu, never hearing him speak of private matters. Knowing his character is upright and his heart is correct, his studies are particularly refined. I privately sigh that when Mr. Qian first recommended him, saying he is rare in recent times, he indeed did not deceive me. Now seeing his written work "Fang Yuyi Cao", it is credible and authentic, with simple words but far-reaching meaning, serving as an aid for those interested to extend and relate. Thus, I narrate its outline, allowing later generations to see a glimpse. The 15th day of the 8th month in the Yiwu year of Daoguang 15, Friend Yun Ting Tao Shu wrote at Jiangjie Office.

Preface to Fang Yuyi Cao

One cannot be a physician without reading while practicing clinically. Su Dongpo said, "Medicine may come from the hands of physicians, but prescriptions are mostly passed down from ancients." Therefore, only by reading much can one differentiate syndromes; only by reading much can one use prescriptions. Those who do not use ancient prescriptions do not abandon them; they simply have not seen them properly. Those skilled in using prescriptions even read books without fixed prescriptions, not adhering rigidly to formulas to treat diseases, yet the formulas naturally align with the ancients. I have held this view for treating people for a long time. I read Mr. Li Guanxian of Jingjiang's book and sighed that he could practice clinically through reading. Yu Jiayan's "Yuyi Cao" advocates discussing the disease before the medicine. Mr. Li based his work on this, recording several of his life's successful treatments. People admire and imitate it; it is trustworthy and calms impatience, never arrogant. This surpasses Xichang (Yu Jiayan). Scholar Wang Yaojie came from Jingjiang, brought it to show me, and asked for a preface. After proofreading several times, I corrected errors. Mr. Li has a son; why not publish it to spread it? Let the world know that clinicians must read more to differentiate syndromes and use prescriptions to save lives. I also have insights into clinical practice, but regret not being able to seek correction from Mr. Li. When I was in Beijing previously, I heard of someone called "Li Half-Immortal," guessing it was Mr. Li. So I happily wrote this preface and returned it. Spring, February, Guangxu 7, Yuanhe Lu Moxiu wrote in his Beijing residence.

Narrative to Fang Yuyi Cao

Enshou knows nothing of medicine. Since my ancestors, Mr. Jiefu and Mr. Genxian, successively gained fame in medicine, our family collected *Ling Su* and pulse classics, but alas, they are all lost. However, dozens of volumes of Li Shizhen's *Bencao Gangmu* (Compendium of Materia Medica) remain. Every time I cite its allusions in writing, I always see prescriptions by Mr. Xishen of Tie Weng City attached. Strange that his name is not transmitted. I guess he is a recluse type, surely proficient in medicine, perhaps one of us. The Old Man Rumei excels in literature. In his leisure, he reads prescription books and occasionally uses his residual skills to help people, achieving immediate cures. Later, he became a guest of Tao Wenyi, receiving special appreciation, becoming famous near and far. Remembering when Enshou was young, I saw my uncle, Teacher Zhiyin, borrow a manuscript of "Fang Yuyi Cao" placed on the desk, rubbing it incessantly. He also taught me the Old Man's "Hanyitang Wen". Reading it felt like aphorisms curing fatal diseases. My writing improved slightly, but I suffered from not daring to inquire about "Fang Yuyi Cao". Last year, staying in Jinling, Wenchun sent me this book to read. After one read, I knew medical principles connect to literary ones. The Old Man creates prescriptions based on disease, never taking it lightly. His pulse diagnosis is meticulous, like explaining topics from *Da Xue* and *Zhong Yong*; his syndrome identification is precise, like grasping the main point of a major essay. He does not stick to ancient prescriptions nor cling to preconceptions, just as writing varies flexibly. No wonder his efficacy is so divine. Each case in the book narrates the origin and process in detail, dissecting key points, resolving knots immediately, spanning thousands of words, with pen strength sufficient to match. The rhetoric is rich, worthy of praise. Indeed, the medicine of scholars surpasses market quacks and yamen clerks immeasurably, exceeding Yu's original compilation. Now Master Wenchun is eighty years old, dedicating himself to transmitting his ancestors' works, practicing benevolence and filial piety, most commendable. Both generations enjoyed long lives, knowing the merit of preservation must be passed down. Mr. Shen is distant! I wish those who obtain this book love learning and think deeply, understanding its meaning mentally. Not only will the people of Tie Weng City avoid premature death, but soon it will spread worldwide, everyone joyfully roaming in the realm of benevolence and longevity. Time: Guangwu Dinghai, Leap 4th Month, lower half, 4th day. Nephew Enshou respectfully narrated at Xintianweng Studio, South of Xuanwu Fang, Capital.

Autobiographical Preface to Fang Yuyi Cao

Prescription books fill warehouses, rarely claiming no miraculous effect, yet often ineffective when used. Did the ancients deceive us? Or is disease change infinite, and medicine should not adhere to fixed prescriptions? If medical case books show visible results, they should inspire later generations. But like "Xue Shi Yi An", thick as two feet, selection not refined, language vague, whether a man or woman, real or fake, readers are confused. As for Ye's "Linzheng Zhinan", few copies seen, text shallow, prescriptions merely safe, no efficacy mentioned, such a book need not exist. Only Mr. Yu Jiayan's "Yuyi Cao" has great power and deep thought, incisive discussion, obvious efficacy, verifiable. Though only two fascicles, sufficient for concise study and contemplation, entering divine wisdom. My heart mimics and pursues it. Thinking myself, over twenty years, I have had unique insights, obtaining methods beyond the ancients'. In the 2nd month of Xinmao year, Governor Yunting stayed at the office. With nothing to do in the rainy window, I recorded casually. Although much forgotten, what went through hard effort is still vividly recorded. Already obtained several pieces. What year, what month, what disease, what effect, mostly the people are still there, credible and authentic. If I gain insights later, I will still excerpt them. Though lacking the merit of investigating things, I have a spiritual nature; though lacking the learning of breaking arms three times, I truly have the heart of cutting flesh for parents. If Mr. Yu knows, perhaps he won't drive me away from his door! Hence titled "Fang Yuyi Cao".

Volume 1 of Fang Yuyi Cao

Treatment Effect of Tian Zhan Chu's Wife

Tian Zhan Chu's fifth brother is my best friend. In the 14th year of Jiaqing, he was stationed far away in Wumen. His wife contracted a seasonal pathogen. Physicians all used Shaoyang/Salvia dispersing medicines for cold damage, lifting too much, heat did not decrease; then all used cold-cooling medicines, such as Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Shanzhi (Gardeniae Fructus), Shigao (Gypsum Fibrosum), etc., taken continuously for many doses, heat still did not decrease. Face turned red, scalp painful, hand could not touch, touching caused severe pain. Condition heavy, doctors said evil entered interior, no way to treat. Changed to another contemporary doctor, added Xijiao (Rhinocerotis Cornu) and Lingyangjiao (Saiga Tataricae Cornu) to previous medicines, saying this is the only turning dose, if not responding again, it is untreatable. Coincidentally, his wife's brother Li Jinzhi was also my best friend, knowing I understood Traditional Chinese Medicine, invited me for one diagnosis to decide life or death. I diagnosed his pulse: upper part floating, large, and empty; both Chixi (Kidney pulses) deep, thin, almost absent. Although breath weak, unwilling to speak, mind still clear, not comatose. Asked if he wanted to drink? Said no. Asked about urination and defecation: stool small amount and loose, urine clear and white, lower abdomen had pain sensation. I hurriedly said: This is Dai Yang Syndrome (Floating Yang Syndrome). This is constitutionally Yin deficiency unable to anchor Yang. Now seasonal pathogen mistakenly treated as Cold Damage, warm dispersing too much, deficient Yang floats upward. Treatment should guide fire back to source. Doctors saw his irritability, did not know it was Dragon/Thunder fire rising invading clear void organs, instead thought heat evil entered interior, recklessly used cold medicines, Yang's return path blocked; using cold medicine again, not only abdominal pain and diarrhea will worsen, but rootless Yang will perish with sweat, what to do? Thus, actually used Zhenwu Tang (True Warrior Decoction) advising quick intake. Patient knowing Fuzi (Aconiti Lateralis Radix Praeparata) was used, absolutely refused to take it, thinking I am so irritable and hot, how can I take such hot medicine? His brother advised: You took many cooling medicines, yet fire flares upward. Now this formula is called guiding fire back to source, maybe effective. Now critical, why not try? Persuaded repeatedly, reluctantly took half a dose. Originally had not slept for ten days. After taking medicine, fell asleep peacefully for about two hours. Sleep began, scalp no longer painful, facial redness fully retreated, abdominal pain stopped, heart no longer irritable. Then requested medicine again to finish the dose. Next day invited me for follow-up. Illness seemed gone. Carefully asked: Normally suffers from upper body redness/inflammation, gave birth many times, Yin originally deficient, thus Yang within Yin easily moves. Changed to Fuzi Liyin Jian (Aconite Regulating Yin Decoction) taken for one dose, then specifically used Liyin Jian for three doses. Later regulated with Bazhen Tang (Eight Treasures Decoction) modified until complete recovery. Half a month later, Zhan Chu returned from Wumen, thanked me, and said fortunately he was not home, his wife survived, otherwise would surely die. I asked why? Zhan Chu said: Such heat signs, all doctors used cold-cooling, but you alone used great heat. And you do not practice medicine publicly, how could I believe you! I said: Then you need not thank me either. This is fate, cannot be forced.

Treatment Effect of Yan Fengyao

Tian Zhan Chu lived in Hehuachi Alley. His neighbor, Mr. Yan Fengyao, was a famous doctor in Danyang, practicing here, always effective, truly a veteran. For Tian's illness, he also examined, but was ridiculed by other doctors, unable to show unique insight. Later heard my treatment method, deeply admired. Coincidentally, his respected lady also contracted seasonal illness. Mr. was nearly seventy, originally had hemiplegia, fearing pulse diagnosis inaccurate, delayed inviting doctor. Doctor did not recognize disease, Mr. also did not understand, so invited me to diagnose. Time was midsummer, disease was seasonal pathogen. Consciousness dull, high fever, thirst, desire for hot drinks. Although hot, disliked cold. Family boiled water on charcoal stove for her to drink, she alone said not hot. Pulse came Hong (Surging), rapid, and slippery. Only Right Cun (Inch position) appeared deep. Excess heat syndrome, yet showing cold signs. Not extreme heat resembling cold. Doctor's confusion lies here. I also hesitated undecided. Suddenly inspiration came. Asked master: Does your lady have any old ailments? Master said: No. I said: Not necessarily major ailment, or elderly with much phlegm? Master said: This is true. About three bowls per day, feels refreshed. Asked how many days sick? Said: Five days. Coughed up phlegm during illness? Said: No. I said: Understood. Master asked how? I said: Seasonal pathogen is heat syndrome. Diagnosis is heat syndrome. Why only Cun position deep? Lung Qi obstructed by phlegm. Three bowls phlegm per day, five days no cough, accumulated phlegm must be substantial? Blocking Lung Qi, upper and lower不通 (blocked). Inside very hot, Qi cannot reach up. Mouth/nose inhale only cold air, stops at throat, cannot go down. Lung connects to throat. Now obstructed by phlegm. Below lung very hot, above throat very cold. Must first use vomiting method to extract phlegm. Although not easy to say. Boiling water down throat not hot, phlegm adhesion extraordinary. Lung closure severe. Although using Gouti San (Melon Seed Powder) or Zhichi Tang (Gardenia and Soybean Decoction) methods, likely rejected, insufficient to search lung orifices, lift Lung Qi, and stir phlegm. Must use Zhang Zhongjing's Mahuang Xinggan Shigan Tang (Ephedra, Apricot Kernel, Gypsum, and Licorice Decoction). Master said: Mahuang (Ephedrae Herba) is taboo in summer months. Now June midsummer, suffering seasonal pathogen not Cold Damage. Can Mahuang be taken? I smiled: Medicine does not adhere to fixed prescriptions, use according to suitability, ancient teaching. Now phlegm blocks Lung Bi (Obstruction), only Mahuang's great acrid-hot can search lung and activate phlegm. Also this formula has Shigao's cold to control Mahuang's heat, Xingren's descending to assist Mahuang's ascending, Gancao's sweet to slow Mahuang's urgency. Different from Zheng Shanghan (True Cold Damage) using Mahuang Tang (Ephedra Decoction) solely for acrid-hot dispersing. Master said: Lady over sixty. If taking causes continuous heavy sweating, fear Yang collapse? I said: Medicine has supervision/control. Already stated. Also Mahuang is Lung herb. Down throat reaches Lung first. Lung Qi opens/lifts, phlegm-saliva activates. Activated then vomits. Medicine exits with phlegm. Mahuang nature light/floating, how can enter abdomen cause heavy sweat? Besides seasonal pathogen also requires sweat resolution. Vomiting contains dispersing intent. Shigao is main drug of Baihu Tang (White Tiger Decoction), *Jingui Yaolue* prescription for Heatstroke. Color white enters Lung, clears Yangming heat simultaneously. Dispersing and clearing, evil heat thereby resolved, possible. Master said: Will this definitely cause vomiting? I said: Mahuang powerful force, enters Lung searches phlegm. Phlegm knot opened, inevitably surges up causing vomiting. Master said: Understanding clear and thorough, no other doubt. Please prescribe. I prescribed Mahuang 0.8 qian, Xingren 3 qian, Shigao 5 qian, Gancao 1 qian. Urged must take and left. Next day woke before dawn. Recalled yesterday's discussion, laughed at own excessive loyalty, but carefully considered no error. Early morning, without invitation, called me. Went to find clinic open, rushed in. Master came out to welcome. I didn't exchange pleasantries, urgently asked: How? Master smiled replied: Efficacy like spirit. My heart settled. Carefully asked: After taking medicine briefly, immediately vomited over a sheng of phlegm. Only slight sweat. External heat retreated. Consciousness completely clear. I entered for follow-up. Pulse not Surging, pressing still rapid. No longer desires hot drink, desires cold drink. Tongue red, no coating. Knows great heat injured Yin. Changed to Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction). One dose heat reduced, two doses fully recovered. This case, if not careful questioning, how could enter the door? Seeing and knowing is called Divine. Hearing and knowing is called Sage. Asking and knowing is called Skilled. Cutting and knowing is called Clever. Divine, Sage, Skilled, Clever called Four Diagnoses. None can be missing. I see today's rough practitioners pretending fashionable style. Arriving at homes to diagnose, only one pulse touch, then immediately prescribe. Master wants to detail condition, says: I have dozens of families inviting today, how can delay for one family? Alas! Three Positions and Nine Contours completely unclear, unwilling to ask. Treat human life as worthless grass, none worse than this. Although quack doctors killing people not hear compensation, in the dark, how can sin escape? Confucius said: Reverently awe. Hope colleagues in this profession also revere.

Treatment Effect of Da Yuchuan

Friend Da Dongzhou, one day suddenly visited me saying: You claim good at diagnosis. Now there is a disease you can treat, I will then bow in submission. I asked what disease. Da said: Go with me, know when arriving. Halfway, suddenly told me: Just joking with you! Patient is my cousin Yuchuan. Disease untreatable. Only hope brother diagnoses death date, handles funeral affairs. Arriving home, asked disease. Suffered from Dan Nue (Hot Malaria). Single heat no chills. Already two months. Never sweated. Daily high fever about six hours. Emaciated bones standing. Truly critical. Diagnosed Six Mai (Six Pulses) Xuan (Wiry) and Shuo (Rapid). Completely lacking softness/gentleness. Pressing still has root. I know he originally indulged in internal practices (sexual activity). Liver and Kidney both deficient. Added to great heat injuring Yin. Yin cannot transform sweat. Evil has no exit. Doctors did not know. Used only Dayuan Yin (Reach Original Drink), Qingspi Yin (Clear Spleen Drink), Xiao Chaihu Tang (Minor Bupleurum Decoction) etc. How to get sweat? I said: Disease heavy but did not take matching medicine. Still can be done. Then used Jingyue Guichai Yin (Guizhi and Bupleurum Drink from Jingyue). Chaihu 1.5 qian, Danggui 1 liang, Gancao 1 qian. Add Shengdigu 2 liang. Order strong decoction to take. After taking, drink one bowl of hot rice water. Not even one dose, heavy sweat and resolved.