刘眉士治效道光五年八月二十三日，予因宫保初服予方已有大效，予心亦定。因城北张佑溪协台屡次延请未去，是日午后往候，张公曾任镇江参府，本旧相识，见面倾谈，又代其夫人诊脉，为时既久，往来遥远，至起更方到察院，到则巡捕堂官群相问曰：先生来何迟?日间监试钱道台有条子来请先生进贡院代内帘刘奉贤县隔帘诊脉，因先生不在辞去，傍晚又具禀刘令病已垂危，求大人格外施恩，让刘令出场就死。大人勉准，适已出场，大人意要请先生去一诊，或尚有救，连问数次矣。予问究竟何如?众曰：适伊家人亦来求请，据云仆有一丝游气，半日不知人事矣。予至上房，宫保曰：先生来耶，我今日甚好。惟有内帘刘令，据监试禀称亦于初六日得病，今已垂危，恳请让伊出场就死，因其并未阅卷，姑勉准之。因先生高明，或能起死回生，亦大阴德，且吾亦同病相怜之意也。对曰：闻其病实已不治，治之无益，徒损贱名。宫保曰：此等病治之不效，岂复能归过于先生，惟念此人乃吾所取帘官房首，其文甚佳，功夫尚在，其房中当可多中几本好卷子，不意如此，然其文不似要死者，因命人将其文与予看，题乃举贤才，曰焉知贤才而举之。予看毕曰：此文果不似要死者。宫保问何以见得?对曰：其文清华，其气通畅，似有福泽之文，而又无发泄太尽之弊。且其书法端楷，到底不懈，未曾错落，其精神必素能完足，故论文字皆当不死。宫保曰：所论甚是。看文章面上请去一看何如?对曰：诺。时将二更且大雨，予乘舆冒雨至承恩寺曲折达僧舍，见旁空房一间，床架一张，堆草荐数条，床上靠一人即刘公也。油灯一盏，灯光如豆，阴冷之气逼人，呼其仆秉烛至，见其大汗如雨，面白如纸，二目直视，牙关紧闭，喉中痰涌，口角流涎，全不知人事矣。使仆探其下体，则囊缩遗尿。予曰：此死在顷刻，尚何治为。即欲辞去，适其群仆自贡院取行李回，互相拦住，且有跪者，皆曰先生去不得。予问何故，曰：主人素本寒士，幸得一官，尚未一载，今年四十一岁，尚未有子，一死实为可惨。先生乃抚宪请来高明，若不肯治，更有何人?况他医皆已回绝矣。今听凭先生要银多少，总要立方。予曰：行医计利，贱丈夫之所为，予岂为此不诊，奈此病情形实不可诊耳。伊等坚放阻不有泣下者。子忽转今其文不死，何其人之多死象耶?问闱中服药否?曰：天天服药，方在否?曰：全在。予索方细看，无非发散温燥，而热总不解，至十九日一方，麻黄钱半、羌活二钱、甘草五分、桂枝二钱，余想时邪十四日，忽服此方，其人即当死，何尚能活至今日，莫非与我竞有医缘乎?于是始为诊脉，细细推敲，脉来数大而空，俱欲离根，惟左尺尚有一线可按而得。予暗欢，此真读书人，惟知用功，不贪色欲，根本素能保守，虽经群药刀砍斧削，而命根犹有存焉者。于是用犀角地黄汤通心达肾，养阴化热，镑犀角三钱、大生地一两、大白芍三钱、粉丹皮三钱，又思所服温燥，一派伤阴，脉来甚数，阴不潜阳，当于养阴之中加介以潜阳法，非若大汗亡阳脉仅空大，当以参附回阳也。于是加左牡蛎一两、元武板五钱，外加橘红一钱、竹沥五钱、姜汁少许，以达其痰。谓其家人曰：既然服药，以速为贵，迟则不及。牙关紧闭以乌梅擦之必开，惟咽喉痰涌，药恐难下，此药得一半下腹即有转机，恐全不下而死，勿谤予也。回时已近三更，宫保犹等信未眠，真菩萨心肠也。细询一切，色然喜曰：如此尽心，或当有救。明早伊家人来告曰；主人已转过来矣。予往问如何服药?前三分皆不受，后得一匙下喉，七分皆顺流而下。予见人事渐清，向予点头，但语言蹇滞耳。连进原方二剂，痰降能言，惟虽不大汗，而总未全止。知其表虚也。于主方外另仿玉屏风法，用黄芪皮五钱、防风一钱、五味子七分，一服而汗全止。嗣后方去犀角，加大麦冬三钱、高丽参一钱，减竹沥二钱，约十剂，改用黑归脾调理而痊。刘公名佳，字眉士，浙江江山县人也。先任奉贤，予曾一过访，嗣改调溧水，今已四载，音问未通，似乎于情较薄，不似宫保之卷卷不忘也。然闻其所至，爱民颂声载道，夫虽薄于我而厚于民，则亦不负予之救之也。
张伟堂治效张伟堂二兄，吾乡南张榜眼公嫡派先居城南塞上，太夫人患疟，服凉药太多，病剧。其戚严嘉植素信予荐诊，知其本体虚寒，始以温解，继以温补而愈。嗣迁居扬州十余载，不相往来，道光五年十二月十七日，忽接严嘉兄信，据云伟堂病已垂危，诸医朝至以为暮必死，暮至以为朝必死，既如此，何敢复以相累。但病者忽忆当日母病系兄挽救，思得一诊，虽死瞑目，务恳屈降，死生均感等语。因其言直谅不欺，二十日渡江下，昼到张府，即上楼诊视，见其痰涌气急，坐伏茶几，一人两手扶其头，不能俯仰，十余日不得一卧矣，人事昏沉，不能言语，诊其脉滑数而大，虽已空象，而尺部尚觉有根。遍阅渚方，自八月服起，皆作外感治，尽用发散消导；月余后想觉人虚，易而为补，总以人参为主；后想因痰多气阻，又改用化痰；又或疑外感，加用疏解。现在诸医皆云不治，无药可用。惟一朱医与伟堂至好，一日数至，以二陈汤作丸与服，见症愈坏，束手流泪而已。予乃曰：此肾气上冲症也。诸气以下行为顺，今肺不清降，肾反上冲，气降则痰降，气升则痰升，故痰涌气急，不能俯仰，且其脉象甚数，似杂湿热阴虚，湿热不化，亦随肾气而上冲，若能纳气归肾，气降痰降，湿热亦降，可以安卧，可以调理，症虽重无妨也。于是用六味为君，以都气法，原本六味，而六味地黄，古称为治痰之圣药，又称为下焦湿热之圣药，有三善焉，皆合乎此症，故特用之。大熟地八钱、山萸肉四钱、怀山药四钱、粉丹皮三钱、福泽泻三钱、云茯苓三钱，外加北沙参四钱、杏仁泥三钱，以润肺降气，胡桃肉三钱以助纳气，福橘皮一钱，取其顺气而不燥。开方后予往候九峰先生，因即止宿，次日复请，予至门严嘉翁迎出，服药如何?曰：差不多若有不豫色。然予心窃疑之，至厅坐定，予问曰：药吃坏耶，何吾兄之怏快也?曰：药并未服，正以远劳吾兄，又不服兄药，故不快耳。予闻未服药，心转定。因问何不服药?曰；朱先生坚称熟地不可服故耳。伊家闻予至，又请上楼诊脉，太夫人曰：昨方因有熟地不敢服，今恳另定良方。予曰：熟地乃此症要药，吾方君药，舍此更有何法。日闻所请先生不少，朝称夕死，夕称朝死，无药可治，今服熟地不合，亦不过死，况予尚许君家不死耶。此症服熟地则生，不服则死，服与不服，悉听君家，予无他方。下楼予即欲行，严嘉兄曰：今已将午，不及到镇，饭后兄仍住九峰先生处，明早动身可也。予唯唯。嘉兄又曰；此地有好浴堂，陪兄去一浴何如?予曰：甚好。正欲偕行，忽一人出告曰：老爷过矣，请严大太爷勿他往。嘉兄彷徨欲止，予笑曰：予诊脉未久，岂有死在顷刻而不知者耶。此不过痰厥，片时即苏，其尺脉根本尚在，保无虑也。转拉嘉翁出浴，浴罢而归，曰：醒久矣。时有伊戚邹翁亲闻予言，进告太夫人曰：伊言如此有准，其药尚不可服耶。半响其侄出，问今日如服先生方，可肯在此住宿否?予曰：服吾方，吾敢在此，不服吾方，吾不敢在此也。又半晌其侄出，问曰：如服熟地不合，可有解药否?予笑曰：今日如此谨慎，何不慎之于当初耶?药中佐使已解在内，不必过虑。盖诳之也。然后其家始肯依方制药，而尚止服一半，服后气痰渐平，已觉能俯，乃又进一半，觉痰与气随药而降，并能仰矣。迁延太甚已二鼓，后复请予看脉，脉亦渐平。伟堂并能说话，谓予曰：药真如神，但尚不能平卧，君能令我一卧则快甚矣。予曰：惜君家不肯早服予药耳，昨肯服药，今日安眠矣。虽然，明日保君酣睡无虑也。次日依方再进，傍晚服药，旋即能卧，卧则熟寐，三更始寤。以后予用药无复敢赞一词，而予总本初方，略为加减，地黄则始终未减分毫，八剂后其症大痊。余乃辞归，次年复请调理，煎方膏方悉本原方，盖伟堂素嗜虾油，每食不撤，其湿热甚重，因热生痰，因痰致咳，所用辛散，既诛伐无过，所用人参亦助热锢痰，因咳致喘，肾气上冲，犹以二陈丸治痰，岂不去题千里乎?惟六味地黄三补可葆肾气，三泻兼治湿热，于伟堂最宜。况痰之本在肾，肾安痰亦自减也。伟堂从此与予交好，不啻骨肉，太夫人及合家见予亦如至亲，予每至扬必主其家，虽九峰先生处不许复往。伟堂尝谓予曰：吾命由君活，不敢一日忘也。盖极情重人也。予自诊病以来，无不死中求活，而人情每过辄忘，如伟堂者岂可多得哉。予尝谓伟堂曰：君经大病久病，所伤实多，不能徒恃药饵，我有八字赠君，君能守之，可以永年。曰；不动肝气，不劳心神。伟堂唯唯。至八年精神有复元之象，不意忽高兴办运，且办至一万数千之多，以数万之家资办二十万之业，必期获利，奈值汉阳滞消，其盐二载始轮，卖至十年，冬轮卖价又大跌，予尝曰：伟堂不可发病，发则不救。十二月初一，偶有微感，稍见痰咳，忽于初三日接汉信盐价亏至七折，其船又有淹消，一急而喘，遂不能卧。初四日急请予，适予在浒关，儿辈知我至好，飞信寄予，予初六日得信，即辞主人而行，初八日回镇，则初七日之讣音至矣。闻其三日内频呼冠仙救我，至死犹呼余不置。呜呼]其病当不治，然如此良友不得令我一握手一尽心，而竟溘然长逝，岂不痛哉!予初十日渡江往唁，抚棺一哭，泪出痛肠，遂挥泪书一联，悬诸灵右，曰：一药有缘五载中未尝忘我，干呼不至九泉下何以对君。
《仿寓意草》卷上终 仿寓意草卷下
浒关黄拙安治效浒关黄翁字拙安，豪杰士也。其少君小香与予有金兰之好，予往来浒关有微名，翁之推许居多。翁素奉吕祖师，临乩擅赐，名曰鹤真。嘉庆间曾患不寐三月，诸医罔效。在祖师殿求签，得第十六签，曰支体魁吾气禀丰，纵然疾病不为凶，君能再得轩岐术，寿到期颐未改容。翁思据此签词，苏医总不能治矣，急买舟至扬，就九峰先生诊治。先生用孩儿参三钱、夜交藤三钱、白芍二钱、甘草五分、灯心五十寸、鸡子黄二枚，每个点青盐三分，轻描淡写，颇似仙方，翁一眼即酣寐。道光九年正月翁又抱恙，医至二月半后，愈治愈重，自分不起，命小香至祖师殿求签以卜生死，仍得第十六签，翁曰莫非我尚可活，但苏医不能，九峰先生吾不能请。李冠仙与吾家世好，请当来。连夜放船至镇，予念交谊，闻信即行，于二十二日开船，二十三日辰刻到毗陵，屈指二十四日始能到关，不意忽遇大顺风，船行如驶，酉初已抵浒关，不及五个时辰行一百六十里，在河道实所未经，岂非神助。到即进诊，翁已弱不能言，止低声曰；六兄救我。诊其寸关皆沉闭若无，惟两尺虽小而数，按之有根。出见案上有十全大补方，候于是晚不至则服之。当有关医施朗山先生问予曰：此数人公订之方，不知可服否。予曰：年近古稀，气弱至此，十全大补，自应是理。但阅前方，人参、熟地所不少，并非不补，乃愈补愈坏，或者用补太早乎?翁素有痰患，今反无痰，而脉来上中二部皆沉闭，岂非痰因药补，胶固不活，阻塞气机乎?若尽由于虚则尺部亦应沉弱不见矣。故此方将来当可服，而现在则断不可服，恐痰更结而气更塞，竟至不治也。且其尺脉甚数，温补亦恐非所宜也。于是变化大半夏汤，用孩儿参三钱、半夏粉三钱、白蜜三钱、竹沥三钱、姜汁少许，千里长流水扬三百六十五遍，煎服。翁已十日不寐，服九峰先生旧方亦不寐，服予方后忽然安寐约两时许，寤即痰活，连吐数盂，心中畅快。请予复诊，则寸关皆起矣。方亦轻描淡写，而灵异如此，即予亦有所不解。三进原方，日见起色，见其脉总兼数象，渐加石斛、生地，十日即起床健饭，又去白蜜加陈仓法十日，饮食如常，精神清健，盖本火体，只宜清补，乃知前此皆参芪温补之误也。盘桓数日，予乃辞归，握别之际，翁谓予曰：兄似祖师意中人，何不皈依。予曰：惜身不能作道士。翁曰：何必道士，只在心耳。祖师以济世为心，兄亦操济世之术，以祖师之心为心即皈依矣。子曰；唯。长者之言，谨当书绅。然此正可见翁之为人不可及也已。
戴都统寸白虫治效京口都统戴公字鲁望，大解出寸白虫，甚至不解时三五条自行爬出。予曰：此脾虚生湿，湿热生虫，虫有九种，惟寸白虫居肠胃中，时或自下，乏人筋力，耗人精气。其虫子母相生，渐大而长，亦能杀人。于是以归脾去芪，加苦楝根、使君子肉，又加榧子肉为引，公问榧子肉何为?对曰：能杀虫。问可常吃否?曰：可。公服药二帖，虫较减而未尽。公乃买榧子一斤，无事服之，日尽半斤许，次日又服，大便后忽下虫二尺余长，嘴尾相衔，以物挑之，寸寸而断。榧子肉原可治虫，而专用多服，竟除寸白虫之根，书所未载，可谓奇矣。后有李氏子，虫蚀其肛，有似狐惑症。予代调理外，亦教其专食榧子肉，亦下寸白虫二尺余而愈。然则斯方竟可传矣。
Liu Meishi Medical Case
On August 23 of the fifth year of Daoguang, I felt reassured because the Governor-General (Zongdu) had already achieved significant efficacy after taking my prescription for the first time. Since Zhang Youxi, a Deputy Commander (Xietai), in the north of the city had repeatedly invited me to treat him without success, I visited him that afternoon. Mr. Zhang, who had formerly served as a Counselor (Canfu) in Zhenjiang, was an old acquaintance. After a long conversation upon meeting, I also took the pulse of his wife. Due to the lengthy discussion and the distant travel, it was not until the beginning of the third watch (Qi Geng) that I arrived at the Provincial Surveillance Commission (Chayuan). Upon arrival, the patrol officers and hall officials asked one another: "Why is the Master so late?" It turned out that during the day, Qian Daotai, the supervisor of examinations, had sent a note requesting the Master to enter the Gongyuan (Imperial Examination Hall) to take the pulse of Liu Fengxian County Magistrate, the inner curtain official, through the screen. However, since the Master was absent, they gave up. In the evening, a memorial was submitted stating that Magistrate Liu's condition was critical, begging His Excellency to show extra mercy and allow Magistrate Liu to leave the examination hall to die at home. His Excellency reluctantly agreed. Just as Magistrate Liu had exited the hall, His Excellency wished to invite the Master to examine him, hoping there might still be hope, and thus asked several times. I asked what the situation actually was. The crowd replied, "His servant just came to beg for your presence. He said his master has only a wisp of vital breath remaining and has been unconscious for half a day."
I went to the upper room. The Governor-General said, "The Master has come. I feel quite well today. Only the inner curtain Magistrate Liu, according to the supervisor's report, fell ill on the sixth day and is now critical. He begs permission to leave the hall to die. Since he did not review any papers, we have tentatively allowed it. Because the Master is highly skilled, perhaps you can bring him back from the dead, which would be a great merit. Moreover, I share a sense of sympathy for our shared plight." I replied, "I heard that his illness is indeed incurable. Treatment would be futile and would only tarnish your reputation." The Governor-General said, "If such an illness cannot be cured, how could blame fall on the Master? I merely think that this man is a head examiner (Fangshou) selected by me. His writing is excellent, and his skill remains. His room should have produced several good papers. Unexpectedly, this happened. However, his writing does not look like that of someone about to die." He then ordered someone to show me the paper. The topic was "Exemplary Talents," quoting "How to know exemplary talents and recommend them?" After reading it, I said, "This article indeed does not resemble that of someone about to die." The Governor-General asked, "How do you know?" I replied, "The style is elegant and clear, the Qi flow is smooth, resembling writing with blessings, and it lacks the flaw of being too exhaustive in expression. Furthermore, his calligraphy is upright and regular, consistent throughout without errors. His spirit must have been inherently complete; therefore, judging by the writing, he should not die." The Governor-General said, "Your analysis is very sound. For the sake of the writing, please go and take a look." I replied, "Very well." It was already the second watch, and heavy rain was falling. I rode in a sedan chair braving the rain to Cheng'en Temple, winding my way to the monk's quarters. I saw an empty room beside, with a bed frame and several straw mats piled up. Leaning on the bed was a person, Mr. Liu. A single oil lamp cast a bean-sized light; the cold and damp air was oppressive. I called a servant to bring a candle. I saw him sweating profusely like rain, his face white as paper, eyes staring straight ahead, jaw tightly clenched, phlegm surging in the throat, saliva flowing from the corners of his mouth, completely unconscious. Having a servant check his lower body revealed retraction of the scrotum and urinary incontinence. I said, "Death is imminent. What treatment is there?" I was about to leave. Just then, his servants returned from the Gongyuan with luggage and blocked me, some kneeling, saying, "The Master cannot leave." I asked why. They said, "My master was originally a poor scholar. By luck, he obtained an official post, serving less than a year. He is forty-one years old and has no son. His death is truly tragic. You are the distinguished doctor invited by the Provincial Governor. If you refuse to treat him, who else will? Besides, all other doctors have refused. We accept whatever fee you demand; please just prescribe medicine." I said, "Practicing medicine for profit is the act of a despicable man. Would I refrain from diagnosis for money? The reality is that this patient's condition is truly undiagnosable/un-treatable." They firmly obstructed me, some shedding tears. Suddenly, I reflected: I said his writing would not die, yet why does this person exhibit so many signs of death? I asked, "Did he take medicine in the examination hall?" He replied, "Every day. Is the prescription still there?" "Yes, it is all here." I requested the prescription and examined it closely. It consisted entirely of dispersing and warming-drying herbs, yet the heat never resolved. The prescription from the nineteenth day contained Ephedrae Herba (Mahuang) half a qian, Notopterygii Rhizoma et Radix (Qianghuo) two qian, Glycyrrhizae Radix et Rhizoma (Gancao) five fen, and Cinnamomi Ramulus (Guizhi) two qian. I thought, if one takes such a formula after fourteen days of seasonal pathogenic factors (Shixie), the person should have died. Why is he still alive today? Could it be that I have a karmic medical connection with him?
Thus, I began to take his pulse, scrutinizing carefully. The pulse was rapid, large, and empty, showing signs of detaching from the root. Only the left Chi position retained a faint thread-like pulse. I rejoiced inwardly. This is truly a scholar, dedicated solely to study, free from sexual indulgence, conserving his essence since youth. Although subjected to the 'axe and knife' of various drugs, the root of life still exists. Therefore, I used Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) to connect Heart and Kidney, nourish Yin, and transform heat: Borneolum Syntheticum (Bingpian - *Note: Context implies Rhinoceros Horn but modern substitution or specific preparation might vary, strictly translating text as Rhinoceros Horn*) three qian, Rehmanniae Radix Preparata (Shudihuang) one liang, Paeoniae Radix Alba (Baishao) three qian, and Moutan Cortex (Mudanpi) three qian. Considering the previous warming-drying herbs had damaged Yin, and the pulse was very rapid indicating Yin failing to anchor Yang, I added shell-type herbs to anchor Yang within the Yin-nourishing strategy, rather than using Ginseng and Aconite to restore Yang as in cases of massive sweating leading to Yang collapse. Thus, I added Ostrea Concha (Muli) one liang, Testudo Carapax et Plastrum (Wujiaban) five qian, plus Citri Reticulatae Pericarpium Viride (Juhong) one qian, Phragmitis Rhizoma Juice (Zhulv) five qian, and a little Zingiberis Rhizoma Recens (Jiangzhi) to resolve phlegm. I told his family, "Since administering medicine, speed is crucial; delay means it will be too late. To open the clenched jaw, rub it with a sour plum (Wumei). However, due to the surging phlegm in the throat, the medicine may be hard to swallow. If even half reaches the abdomen, there will be a turning point. If none goes down, he will die. Do not slander me."
Returning home, it was near the third watch. The Governor-General was still waiting for news, sleepless—a true Bodhisattva heart. After inquiring about everything, he smiled joyfully and said, "With such dedication, there may be hope." The next morning, his servant reported, "My master has recovered." I asked how the medicine was taken. The first third was rejected. Later, one spoonful went down, and the remaining seven-tenths flowed smoothly. Seeing his consciousness gradually clear, he nodded to me, though his speech was slurred. After two doses of the original prescription, the phlegm subsided, and he could speak. Although he did not sweat heavily, the sweating did not completely stop. Recognizing Wei Xu (Defensive Qi deficiency), I added a formula modeled after Yupingfeng San (Jade Windscreen Powder) to the main prescription: Astragali Radix Peridermum (Huangqipi) five qian, Saposhnikoviae Radix (Fangfeng) one qian, and Schisandrae Fructus (Wuweizi) seven fen. One dose stopped the sweating completely. Subsequent prescriptions removed Rhinoceros Horn, added Ophiopogonis Radix ( Maidong) three qian, Korean Ginseng Root (Gaolishen) one qian, reduced Zhulv by two qian. After about ten doses, I switched to Hei Guipi Tang (Black Spleen-Restoring Decoction) for conditioning, and he recovered. Mr. Liu, named Jia, courtesy name Meishi, was from Jiangshan County, Zhejiang. I had previously visited him when he served as Fengxian County Magistrate. He was later transferred to Lishui, four years ago, with no contact since. He seemed less attached to me personally, unlike the Governor-General who remembered him fondly. Yet, hearing that wherever he served, praise for his love of the people filled the roads, although he was thin towards me, he was thick towards the people, thus not failing my rescue.
Zhang Weitang Medical Case
Brother Zhang Weitang, the second brother, belonged to the direct lineage of the Zhang Top Scholar of our village, formerly residing in Saishang, south of the city. His mother suffered from malaria. Taking too many cooling medicines aggravated her illness. His relative, Yan Jiazhi, trusted my recommended diagnosis. Knowing her constitution was deficient and cold, I initially used warming-resolving methods, followed by warming-tonifying methods, and she recovered. They moved to Yangzhou over ten years ago, and we lost contact. On December 17 of the fifth year of Daoguang, I suddenly received a letter from Brother Yan Jia, stating that Weitang was critically ill. Various doctors claimed he would die in the morning if seen in the evening, and vice versa. Given this, how dare I burden you? However, the patient suddenly recalled that his mother's illness was saved by my brother. He hopes for a consultation; even if he dies, he will rest in peace. He earnestly begs you to deign to visit. Whether life or death, we will be grateful. Since his words were straightforward and honest, on the 20th, I crossed the river southward. Arriving at the Zhang residence by day, I immediately went upstairs to examine him. I saw him with surging phlegm and急促 breathing, sitting hunched over a tea table, supported by a person holding his head, unable to bend forward or backward. He had not been able to lie down for over ten days. He was confused and unable to speak. His pulse was slippery, rapid, and large. Although showing emptiness, the Chi position still felt rooted. Reviewing all previous prescriptions, from August onwards, they were treated as external contractions, using only dispersing and guiding-out methods. After more than a month, realizing the patient was weak, they switched to tonics, primarily using Ginseng. Later, due to excessive phlegm and Qi obstruction, they changed to phlegm-resolving herbs. Suspecting external contraction again, they added resolving herbs. Now, all doctors claim it is incurable with no medicine available. Only one Doctor Zhu, a close friend of Weitang, visits several times a day, giving Erchen Wan (Two-Cured Pill) made into pills. Seeing the symptoms worsen, he can only wring his hands and cry.
I said, "This is Kidney Qi rushing upward. All Qi should move downward smoothly. Now the Lung fails to clear and descend, causing the Kidney to rush upward instead. When Qi descends, phlegm descends; when Qi ascends, phlegm ascends. Hence, surging phlegm,急促 breathing, and inability to bend. Moreover, the pulse is very rapid, suggesting mixed damp-heat and Yin deficiency. Damp-heat not transforming also rushes upward with Kidney Qi. If we can guide Qi back to the Kidney, descending Qi and phlegm, and damp-heat will also descend. He can lie down peacefully and recover. Though severe, it is manageable." Thus, I used Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) as the sovereign drug, employing the Duqi method. Originally Liuwei Dihuang, ancient texts call it the holy medicine for treating phlegm and the holy medicine for lower jiao damp-heat. It has three virtues, all fitting this case, so I specifically used it: Prepared Rehmannia Root (Shudihuang) eight qian, Cornus Officinalis Fruit (Shanzhuyu) four qian, Chinese Yam (Huai Shanyao) four qian, Tree Peony Root Bark (Mudanpi) three qian, Alisma Rhizome (Zexie) three qian, Poria (Fuling) three qian. Additionally, Glehniae Radix (Beishashen) four qian, Apricot Seed Paste (Xingrenni) three qian to moisten the Lung and descend Qi, Walnut Kernel (Hutaorou) three qian to assist guiding Qi, and Tangerine Peel (Jupi) one qian for its Qi-regulating property without dryingness.
After prescribing, I visited Mr. Jiufeng and stayed overnight. The next day, I was invited again. At the door, Old Man Yan welcomed me and asked, "How is the medicine?" He replied, "Almost... looking somewhat displeased." But I suspected something. Sitting in the hall, I asked, "Has the medicine harmed him? Why is my brother unhappy?" He said, "The medicine was not taken. It is precisely because we troubled you greatly, and we refuse to take your medicine, hence the unhappiness." Hearing that the medicine wasn't taken, I relaxed. I asked why. He said, "Doctor Zhu insists that Prepared Rehmannia (Shudi) cannot be taken." Hearing I had arrived, they invited me upstairs again. Mrs. Zhang said, "Yesterday's prescription contained Shudi, which we dared not take. Today, we beg for another good prescription." I said, "Shudi is the key herb for this condition, the sovereign drug in my formula. Apart from this, what other method is there? I hear many doctors have been consulted, claiming death comes morning or night, with no cure. Even if taking Shudi doesn't suit him, he will die anyway. Moreover, I promised your family he would not die. This condition: taking Shudi brings life, refusing it brings death. Take it or not, it is up to your family. I have no other prescription." Going downstairs, I wanted to leave. Brother Yan said, "It is nearly noon, too late to go to town. After lunch, stay at Mr. Jiufeng's place and depart tomorrow morning." I agreed. Brother Yan added, "There is a good bathhouse here. Shall I accompany you?" I said, "Good." Just as we were about to go, a man came out saying, "The Master has awakened. Please, Elder Yan, do not go elsewhere." Brother Yan hesitated. I laughed, "I only took his pulse for a short while. How could he die in an instant without knowing? This is merely Phlegm-Jue (syncope due to phlegm). He will revive in a moment. The Chi pulse root remains. There is no cause for worry." I pulled Old Man Yan to bathe. Returning, he said, "He has been awake for a long time." At that time, his relative, Old Man Zou, heard my words and told Mrs. Zhang, "His words are so accurate. Can the medicine still be refused?" After a while, his nephew came out and asked, "If you take the Master's prescription today, will you stay here overnight?" I said, "If you take my prescription, I dare to stay. If not, I dare not stay." After another while, the nephew asked, "If Shudi doesn't suit him, is there an antidote?" I laughed, "So cautious today, why not cautious enough at the beginning? The antidotes are included among the assistant and courier herbs in the prescription. No need to worry." This was actually a bluff. Then their family finally agreed to prepare the medicine according to the prescription, but only took half the dose. After taking it, the Qi and phlegm gradually calmed, and he felt able to bend forward. Then he took the other half, feeling the phlegm and Qi descend with the medicine, allowing him to lie flat. Delayed too long, it was already the second watch. Later, I checked his pulse again, and it had gradually normalized. Weitang could speak and said to me, "The medicine is truly miraculous, but I still cannot lie flat. If you can make me lie down, I would be very comfortable." I said, "Pity your family didn't take my medicine earlier. If you had taken it yesterday, you would be sleeping soundly today. Nevertheless, tomorrow I guarantee you deep sleep without worry." The next day, continuing the prescription, he took it in the evening and could soon lie down, sleeping soundly until the third watch. Afterwards, I dared not add a word to the prescription, always sticking to the original formula with slight modifications. The amount of Rehmannia was never reduced. After eight doses, his condition largely recovered. I then took my leave. The following year, he invited me again for conditioning. Decoctions and pastes were all based on the original formula. Probably because Weitang loved shrimp oil and consumed it constantly, his damp-heat was severe. Heat generated phlegm, phlegm caused coughing. The acrid-dispersing herbs attacked the innocent, and the Ginseng aided heat and trapped phlegm. Cough led to wheezing, Kidney Qi rushed upward. Using Erchen Wan to treat phlegm was miles off the mark. Only Liuwei Dihuang, with its three tonifying and three draining aspects, preserves Kidney Qi and treats damp-heat simultaneously, most suitable for Weitang. Moreover, the root of phlegm lies in the Kidney; if the Kidney is calm, phlegm naturally reduces. From then on, Weitang became as close to me as flesh and blood. Mrs. Zhang and the whole family treated me like a close relative. Whenever I went to Yangzhou, I stayed at their house, even though Mr. Jiufeng forbade further visits. Weitang once said to me, "My life was saved by you. I dare not forget it for a day." He was indeed a man of extreme affection. Since I began diagnosing illnesses, I always seek life in death, but human nature often forgets faults easily. Someone like Weitang is rare. I once told Weitang, "Having suffered from serious and chronic illness, your damage is substantial. You cannot rely solely on medicine. I give you eight characters: Do not stir Liver Qi, do not exhaust Heart Spirit." Weitang agreed. By the eighth year, his spirit showed signs of recovery. Unexpectedly, he enthusiastically engaged in salt transport business, handling tens of thousands of taels. Investing hundreds of thousands in a two-million enterprise, aiming for profit, but Han Yang sales stagnated. Their salt license rotated every two years, selling until the tenth year. Winter shipment prices plummeted. I had said, "Weitang must not get sick; if he does, he cannot be saved." On the first day of the twelfth lunar month, he caught a slight chill, with mild phlegm and cough. Suddenly, on the third day, he received news from Han Yang that salt prices dropped to seventy percent, and his ships were sunk/lost. Panic induced wheezing, making lying impossible. On the fourth day, he urgently summoned me. I was at Huguan. His sons, knowing our close friendship, sent a fast message. I received it on the sixth day, left my host, and traveled. Returning to Zhenjiang on the eighth day, the obituary from the seventh day had arrived. I heard he repeatedly called Guanxian [my courtesy name] to save him until death. Alas! His illness was indeed incurable. Yet, losing such a good friend without shaking his hand and doing my utmost—how painful! On the tenth day, I crossed the river to mourn. Holding the coffin, I cried, tears streaming from my heart. I wrote a couplet in tears, hanging it to the right of the spirit tablet: "One prescription with fate, for five years never forgetting me; Thousand calls unanswered, how shall I face you in the netherworld?"
End of Volume Upper, Fang Yuyi Cao. Beginning of Volume Lower.
Huguan Huang Zhuo'an Medical Case
Old Man Huang of Huguan, courtesy name Zhuo'an, was a hero. His younger son, Xiaoxiang, was my sworn brother. I had a slight reputation visiting Huguan, and Old Man Huang praised me highly. He worshipped Patriarch Lü, practicing Fuji (spirit writing), receiving messages named Hezhen. During the Jiaqing era, he suffered from insomnia for three months. Doctors were ineffective. Seeking a lot at the Patriarch's temple, he drew Lot 16: "My limbs are robust, my Qi abundant; Even if ill, it is not ominous. If you can obtain the arts of Xuanyuan and Qibo, Your lifespan will reach a hundred without changing appearance." Thinking this meant Suzhou doctors could not cure him, he hurriedly took a boat to Yangzhou to see Mr. Jiufeng. Mr. Jiufeng used Child Ginseng (Haier Shen) three qian, Night-Falling Vine (Yejiaoteng) three qian, White Peony Root (Baishao) two qian, Licorice (Gancao) five fen, Centipede Grass (Dengxin) fifty cun, and two Egg Yolks (Jizihuang), each dotted with three fen of Green Salt (Qingyan). Light and simple, resembling an immortal prescription. Old Man Huang slept deeply upon seeing it. In January of the ninth year of Daoguang, Old Man Huang fell ill again. Doctors treated him until mid-February, worsening the condition. Believing he would not survive, he ordered Xiaoxiang to seek a lot at the Patriarch's temple to predict life or death. He drew Lot 16 again. Old Man Huang said, "Perhaps I can still live, but Suzhou doctors cannot. I cannot invite Mr. Jiufeng. Li Guanxian is a family friend; please invite him." They set sail for Zhenjiang overnight. Remembering our friendship, I acted upon hearing the news. Setting sail on the 22nd, arriving at Piling (Changzhou) at Chen hour on the 23rd. Calculating, I would arrive at Huguan on the 24th. Unexpectedly, encountering a strong tailwind, the boat sailed swiftly. Arriving at Huguan at You hour, traveling 160 li in less than five hours, unprecedented in this waterway. Was it not divine assistance? Upon arrival, I entered to examine. Old Man Huang was too weak to speak, whispering only, "Brother Six, save me." His Cun and Guan pulses were deep and closed, almost non-existent. Only both Chi positions, though small and rapid, felt rooted upon pressure. Coming out, I saw a Shiquan Dabu Decoction (Ten Significant Tonifying Decoction) on the desk, intended to be taken that evening if I did not arrive. Mr. Shi Langshan, a local doctor, asked me, "This prescription was agreed upon by several gentlemen. Do you think it can be taken?" I said, "Near seventy years old, Qi so weak, Shiquan Dabu seems logical. But reviewing previous prescriptions, Ginseng and Prepared Rehmannia were plentiful. It was not lack of tonification, but tonification made it worse. Perhaps tonification was started too early? Old Man Huang has a history of phlegm issues, yet now has no phlegm, and the Upper and Middle Jiao pulses are deep and closed. Could it be that phlegm, due to medicinal tonification, has become sticky and stagnant, blocking Qi mechanism? If it were purely deficiency, the Chi position should also be deep, weak, and invisible. Therefore, this prescription may be suitable in the future, but absolutely not now. Fear that phlegm will knot further and Qi will block more, leading to untreatability. Moreover, the Chi pulse is very rapid; warm tonification may also be inappropriate." Thus, I modified Banxia Houpo Tang / Banxia Xiexin Tang variations (Text says Banxia Houpo Tang logic but ingredients suggest Banxia Houpo/Banxia Xiexin mix or specific modification): Child Ginseng three qian, Pinellia Powder (Banxiafen) three qian, White Honey (Baimi) three qian, Bamboo Juice (Zhulv) three qian, a little Ginger Juice (Jiangzhi). Stirred 365 times in Long-distance Clear Water (Qianli Changliushui), decocted and taken. Old Man Huang had not slept for ten days. Taking Mr. Jiufeng's old prescription also failed to induce sleep. After taking my prescription, he suddenly slept peacefully for about two hours. Upon waking, the phlegm became active, vomiting several bowls, feeling relieved in the chest. Requesting re-examination, his Cun and Guan pulses had risen. The prescription was also light and simple, yet so miraculous, leaving even me puzzled. After three doses of the original prescription, daily improvement was seen. Noting the pulse generally carried a rapid aspect, I gradually added Dendrobii Caulis (Shihu) and Rehmanniae Radix (Shengdi). Ten days later, he got out of bed and ate well. Removing White Honey and adding aged rice vinegar method for ten days, diet was normal, spirit clear and vigorous. Being a Fire Constitution, only clear tonification was suitable. Thus, I realized previous treatments with Ginseng and Astragalus warm tonification were mistaken. Lingering for a few days, I took my leave. At parting, Old Man Huang said, "You seem to be the one Patriarch Lü intends. Why not convert?" I said, "Pity my body cannot become a Daoist priest." He said, "Why must one be a priest? It lies only in the heart. The Patriarch aims to save the world. You practice the art of saving the world. Taking the Patriarch's heart as your own is conversion." I said, "Yes. Words of the elder, I will inscribe on my belt." This shows Old Man Huang's character is unsurpassable.
General Dai and Tapeworm Medical Case
General Dai of Jingkou, courtesy name Luwang, passed tapeworm segments (Cunbai Chong) in stool, sometimes three or five crawling out voluntarily even without defecation. I said, "This is Spleen deficiency generating dampness, damp-heat generating parasites. There are nine types of worms. Tapeworms reside in the intestines, occasionally passing down. Lacking human strength, they consume human essence. Mother and child worms multiply, growing larger and longer, capable of killing humans." Thus, I used Guipi Tang removing Astragalus, adding Toosendan Root (Kuilongen) and Quinine Seed Meat (Shijunzi Rou), plus Torrey Seed Meat (Feizirou) as a guide. The General asked, "What is Feizirou for?" I replied, "It kills parasites." Asked if it can be eaten regularly, I said, "Yes." The General took two doses. Worms decreased but did not disappear. The General bought one jin of Feizi, taking it idly, consuming half a jin per day. The next day, after defecation, suddenly passed a worm over two chi long, mouth and tail connected. Poking it broke it inch by inch. Feizi meat can originally treat worms, but specialized and heavy usage completely eradicated the tapeworm root, unrecorded in books, truly remarkable. Later, a son of the Li family had worms eroding his anus, resembling Huhu Syndrome. Besides regulating him, I taught him to eat only Feizi meat. He also passed a two-chi long tapeworm and recovered. Thus, this prescription can indeed be passed down.