Library

Wei Yuhuang of Qiantang compiled the *Xu Mingyi Leian* (Continued Cases of Famous Physicians), consisting of sixty volumes. At that time, there was no printed edition in the world. I borrowed a copy from the Siku Quanshu collection at the Wenlan Pavilion and transcribed it. The work contains over 668,000 characters, with extensive citations and occasional critical discussions, all of which are precise and appropriate. Wei Yuhuang recorded dozens of his own medical cases. He was particularly skilled in treating hypochondriac pain (hypochondriac pain due to Liver dryness), epigastric pain (epigastric pain due to Liver Wood overacting on Stomach Earth), and hernia masses (hernia and abdominal masses). He stated that physicians often use aromatic-dry herbs to treat these conditions, which depletes Liver Yin. Initially, there might be a slight effect, but long-term use can lead to death. Therefore, he created a formula named *Yiguan Jian* (One-Glance Decoction) to treat hypochondriac pain, acid regurgitation, hernia masses, and all Liver diseases, except those caused by Phlegm-Fluid retention. The formula consists of *Shashen* (Adenophorae Radix), *Maidong* (Ophiopogonis Tuber), *Dihuang* (Rehmanniae Radix), *Guishen* (Angelicae Sinensis Radix), *Gouqizi* (Lycii Fructus), and *Chuanlianzi* (Meliae Toosendan Fructus). These six herbs are modified according to the condition. The therapeutic effect is immediate, like striking a drum. If accompanied by bitter taste and dry mouth, adding *Jiu Lian* (Coptidis Rhizoma processed with wine) is especially effective. I imitated his method to treat these conditions and achieved miraculous results. I hereby highlight its efficacy to warn physicians against the misuse of aromatic-dry herbs.

(Bingzhang) Commentary: For hypochondriac pain caused by Phlegm-Stasis obstructing collaterals, Liver Qi stagnation with Blood stasis, and hernia masses formed by Phlegm coagulation, Ye Tianshi’s method of acrid-moistening unblocking collaterals combined with *Jinlingzi San* (Golden Bell Powder) is most effective, emphasizing unblocking and transforming. *Yiguan Jian* is sticky and tonifying, which is likely unsuitable for such cases.

The *Cheng Yanxuan Yi'an* (Medical Cases of Cheng Yanxuan) details his clinical experiences, showing considerable insight. However, when treating the daughter of Zhang Rugong who suffered from Summerheat-Wind (Summerheat pathogen causing wind-stroke symptoms), he used *Gegen* (Puerariae Lobatae Radix) and *Fangfeng* (Saposhnikoviae Radix). This caused the pathogen to sink into the Pericardium, resulting in coma and cold limbs. Although he subsequently used formulas to clear collateral heat and open the orifices, the condition worsened, leading to convulsions and death. He concluded that Summerheat entering the Pericardium is extremely critical and incurable. However, he failed to realize that Summerheat-Wind strictly contraindicates acrid-warm ascending and dispersing herbs. The initial use of *Gegen* and *Fangfeng* depleted Yin fluids, allowing Heat pathogens to enter the interior. This illustrates the difficulty of learning medicine. Recalling the mid-autumn of the Gui-Si year of the Daoguang era, my third brother, Yihao, aged fifteen, suffered from latent Summerheat syndrome. Initial symptoms included fever, aversion to cold, and headache. A local physician, renowned for his reputation, examined him hastily and misdiagnosed it as Cold invasion. He prescribed two doses of *Guizhi* (Cinnamomi Ramulus), *Gegen*, and *Fangfeng*. Consequently, the patient developed coma and cold limbs. I had just returned from the prefectural city and invited Mao Pingzhai to treat him. Mao diagnosed Heat pathogens entering the interior and prescribed *Dihuang* (Rehmanniae Radix), *Yuanshen* (Scrophulariae Radix), *Yinhua* (Lonicerae Japonicae Flos), *Lianqiao* (Forsythiae Fructus), and *Zhuye* (Bambusae Folium). The patient did not recover. People blamed Mao Pingzhai, unaware that the error originated with the first physician. I record this to emphasize the necessity of caution in studying medicine.

(Bingzhang) Commentary: Both Summerheat-Warmth and Summerheat-Wind involve latent Heat within, and both strictly contraindicate acrid-warm ascending and dispersing herbs to avoid depleting Yin fluids. Misuse causes the pathogen to sink deeply into the interior, which is incomparable to Exterior-Cold Shaoyang disease where there is no internal Heat.