坐食四月，不能工作，盖手足提不起，头晕目眩，夜不成寐，想睡不想动，脉沉涩，舌黄，面如橘黄，目珠全黄，断其湿热相搏，致成胆黄也。
茵陈四钱，秦艽二钱，败酱草二钱，连翘二钱，龙胆草二钱，栀子五个，大豆卷二钱，正西庄二钱
服四剂，诸恙大减，精神见佳，黄亦渐退。于前方去龙胆草、西庄，加当归二钱，赤小豆三钱，五倍子二钱，夜明砂二钱，八剂全愈。后来诊所打证明要求恢复工作。
（53）厥证
女，年未详
据述昨天四肢厥冷，不省人事。余诊察之，手足不温，尚能转身，亦能答话。脉散漫无伦次，把反关，呼吸颇对皮人，算不到度数。舌边红，中心灰白。摸其胸膛，喜按，以为阳气未离，投以四逆汤（附子、干姜、甘草、芍药），嘱其冷服，到傍晚安然。
次日复诊，其夫云曾作干呕。察其舌，满布蓝色，未几吐蓝水，余不知何故。证诸脉，六部尚有动止，不似初复时无伦次，人事稍清，只是索饮。问其曾食何物？云昨夜吃过香蕉及乌梅糖，乃知吃香蕉有舌蓝现象。至于吐蓝，不无犯胃表现，嘱其急用萝卜子煎水服，解其毒，除胀满欲吐。服下泻水一盆，由是患者稍觉舒适，但仍欲吐不吐。余因其系水灾区灾民，初来异地，水土不服，遂投正气散，方内去苏叶、白芷，加扁豆、吴茱萸，服下即安。
此妇有孕八月，娇养成性，不愿服药。后又发生胸胀胃满，令购香砂六君子丸，迄九个月，产一男孩。余处理此证，乃理想治法，临急之时，方用四逆汤，盖当时并未辨明阴阳离合也。
女，年未详
突患干呕，手足冷，经拿痧、扎针、吃药者三日，未得疗效。第四日，乃夫雇工由南昌抬往乡下，预备后事，抵家时，患者奄奄一息，我因情急，乃先用烧针丸五粒（磁石、赭石、雄黄合成，为一道人所售者，用于止呕）针刺定，置清油灯上烧红，淬入盛新汲井水之杯中，俟其冷却至微热，撬牙灌入。甫入口，由喉间呛出。静待片刻，即撬开猛灌，下咽后，有作膈声，复如雷响，但患者仍动澹不得。
诊其脉，浮大欲散，关部按至骨，不甚应指，两尺则全无。察其舌，边微红，中心满布灰白色，舌本尚有胃气。唇色淡红，知其阳气未离。额上光滑带亮，扪之是冷汗，不粘指。腹部亦有汗，胁下，足弯、腿夹等处无汗。我认为皮毛之汗，不从阳化，逗留于皮肤，宜助气作汗，同水气突出。乃嘱取葱一束，豆豉一升，煎汤以盆盛之，盆口横架一棍，将患者去衣扶坐熏之。顷刻，患者寒噤数次，透大气，叫唤一声。即扶至床，拭干湿气。约过一小时，满身大汗淋漓，头部微汗，身热，透出亦是热气。神智渐清，双目欲合，其自抱小腹，云时有跳痛，并觉头欲下坠。余以“振振欲擗地”；以手抱小腹为“悸”理解之，投以真武汤：
附子四钱，白术二钱，桂枝木二钱，茯苓四钱，杭芍二钱，服一剂，是夜安然。
次日复诊，脉浮不大，但无力，两关稍应指，两尺似有似无，拟方：
服一剂，腹鸣如雷，欲大便，上桶又不解。知其阳通水去，改用调胃和中法。
茯苓三钱，金钗石斛二钱，东波叩二钱，砂仁二钱，扁豆二钱，杭芍二钱，佩兰叶二钱，毕澄茄二钱，姜枣各二
再服一剂，渐思食，嘱其勿食粥，以防停饮。连日食藕粉，日三次。若求食甚切，须于干饭同食肉汤。后五日去南昌，该妇不愿吃药，停药后发生皮寒。
男，55岁
素来耳聋，喜食炙■物，烟酒成癖。某年夏秋间，发生拖沓病。某医以虚弱论治，服十全大补丸，无甚感觉。改用大剂参附，服完八剂，面红，夜睡竖起索饮。乃更医投归脾汤，令多服。悉遵医嘱，但觉耳更聋，日见消瘦。一日我登其门，见其与前大异，耳聋且不省人事，懒与人言，我以手牵他，竟有反缩现象。
脉沉紧，不明度数，两足如鹤膝，舌有裂纹，目光扩张。知为肾津枯涸，已成煎厥矣。其子促余开方，余告曰：“肾津枯涸，所以聋上加聋；两足鹤膝，肾水告竭，脉现沉紧，变幻不定，目光扩张，肝肾不同源；夜睡竖起，已成心烦；两颧通红，必有躁病发现，烦躁兼之，有何生理？”坚不拟方，仅建议吃燕窝。
自是经常发烦，夜间更甚。一日跑出门外，欲入水，家人促归。将睡时，见旁边一壶酒，遂提壶咽下。旋即大呕不止，汗出如注。从此肾气上泛，呃声大作，中焦气上，一呃全身冲动，是晚呃止声绝而卒。
男，10岁
暑天烧热后四肢厥冷，某儿科用羚羊角及诸风药，病势加剧。六脉有度数，第无浮沉迟数胎息，四肢冰冷，不索饮，亦不求食。要睡房中，且须其母伴身旁，舌全白，唇淡白，能说话，但不愿说。断为阴寒内伏，已成厥证。
附子二钱，干姜二钱，甘草一钱，葱白二个。嘱速服。服后三小时，此孩叫娘盖被，娘摸其手足，不若服药前冰人，但欲转侧靠人睡一起，并索饮，讨糖吃。
翌日，其父云手足不冰冷，但完全回阳，要靠其母同睡，畏扇风。知厥虽有而阳未复。
附子四钱，炮黑干姜三钱，炙草二钱，杭芍钱半，上桂一钱，红枣三个
服一剂后，能吃粥半碗，作呕，欲便而便不出，额上有汗。知厥已消失。欲呕者，胃有寒也，和胃为主。
党参（炙）二钱，叩仁二钱，杭芍二钱，炙草一钱，良姜一钱，扁豆衣二钱，川椒八分，乌梅二个，姜枣各二。服后病势较退。
七八日后，其父复来，云此孩病去三分之二，但要穿夹衣，畏风，吃饭不多，有时打饱膈，贪睡。我以为多服风药，复吃羚羊角，未免大肆寒凉，所以仍畏风寒。令服黑锡丹，每日二十粒，五日为度，果效。
男，31岁
潮热不退，神昏气弱，不愿劳动，不想吃饭，夜不入睡，二便极少，自料必无生理。余见其面如黑色，倦怠不堪，奄奄一息。诊脉六部皆无，惟关部一息一至，尚有胎息，断其胃气尚存。正面六部无脉，必有原因。询及曾否呕吐？答以来诊所途中曾呕过两次。乃知途中颇受颠簸，即令以热开水送饮，患者一饮而尽。再诊脉，六部皆有消息，满现沉细，度其病虽危笃，而元阳未损，察舌干燥边湿，唇色焦枯。此病湿极化热，胃为热灼，变为煎厥，疏方：
犀角钱半，元参二钱，南沙参、鲜生地、东波叩各二钱，冬瓜仁、薏苡仁、生石膏各三钱，甘蔗汁一杯嘱连服五剂。
服第一剂后，小便于床上，举家惶惶，咸以遗尿为不祥之兆。患者即于床上喊叫是尿急不及起床所致，告家人勿事慌张。五剂毕，神事安宁，二便渐趋正常，表情渐转愉快，但仍未进食。改方：
鲜生地、橘络、沙参、犀角、玉竹、芦根、赤芍、连翘、牛子各二钱，生石膏、金钗石斛各三钱，甘蔗汁一杯
再服五剂，精神较有进步，能食粥，口内破皮，想食肉，一夜未闭眼。知为阴不入阳，于前方加：
鸡子黄一个，阿胶二钱，泽泻二钱，川连一钱，细生地二钱，薏苡仁二钱，莲子心钱半，云苓二钱
服两剂，能吃粥，夜间成眠。嘱服善后方：
男，37岁
口渴不止，人皆以为是消渴症，自述曾服花粉十多斤，洋参数两，效果杳然。诊脉数极，唇舌均绛，两颧赤亮。乃消渴变症，而为薄厥也。嘱找土瓜（打子瓜）吃，以吃饱为度。时当九月，往各处搜寻，买到四只。比即吃下两只，犹感不足，再吃第三只，登时打一饱呃，似觉一溜烟下去，随即打一尿噤，霎时屙尿半桶。从此许久未叫喝茶，问以故，曰：“不渴了”。待吃第四只，旋即大便，下一大堆溏而带酱色之物，顿时病去大半。
越日着人换方，令寻水缸下之涎鱼虫十只，水煎温服，自是病情若失。
男，24岁
四月（阴历）来就诊，见其手挽棉袍，身着棉袄，疑其疯癫。其会吾意，告以伏天亦须棉衣。曾服附子、力参、蒙桂不少，畏寒依旧。其脉寸伏而尺浮数，各不相维系，料必阴阳阻隔。舌无厚滞，唇色淡红，形色沉暗，四肢冰冷，食不正常，溲短，夜睡不安，白天不出外，畏风甚，总不离棉衣。断其热深厥亦深，不是寒症，乃邪并于内，而阴遏于外也。内经云：“热深厥亦深”，又云“热极生寒”，当散其热，使达于外，宜清凉疏散，以解其热，然专用凉药，亦非所宜也。鲜芦根五钱，煅石膏、薏苡仁各三钱，苏梗、佩兰叶、橘络、甜杏仁、瓜蒌仁、冬瓜仁、叩仁、前胡各二钱，豆豉四十粒
服十剂后，患者可不穿棉衣，在外散步，不觉寒冷。寸脉不伏，两尺不浮，一息四至，皆能应指。知阴无外遏，改方：
菖蒲、郁金、佩兰叶、杏仁、瓜蒌仁、橘络、知母各二钱，芦根四钱，煅石膏三钱，川柏钱半，金银花四钱，连翘二钱，豆豉四十粒
再服十剂，身有微汗，饮食见增，皮肤作痒，六脉不匀调，令暂停药，一俟胃气恢复，再行斟酌。可吃猪肝、猪肚，谨防发生疖毒。果如余言。盖其多服温补，内热郁甚，必成毒也。
（54）腹胀
男，40岁
性情拖沓，有病不愿吃药，专食燕窝、银耳。某年初秋，偶感腹胀，修行路腰挺，只能仰睡，饮食减少，面容肌瘦。至来年二月，病势大作，走路横行，眼胞浮肿，欲食不能食，张口透气。本地一棺材商，曾亲至其家访视，说能治此病并且包好。其家不信，着人邀我。
其人腹大如箕，青筋未现，脉中空，关部若有若无，说话气粗。我有束手之感，权以金匮肾气丸一两，嘱其作两日服。其妻云此地有治此病者，我促其请来谈谈。及至，问用何药？答以“凡肚子大都有水，医书云“排脏腑而廓心胸”，水在外，而不在里，腹中寒，气虚，无热气蒸水，致水聚一处。如服似尖瓮形，可治；腹见平满者，则水滥满布矣，不治。”又云，“此证当属气虚，水蓄脐下理当大补元气”。遂用鲤鱼、大雄鸡各一只与黄芪四两同炖，烂极为度，然后食之。我闻其言，信为有理，乃鼓励患者大胆依其法。果然，一次吃后，服消过半，再次吃，竟获全愈矣。
男，53岁
服膨胀而坚硬，青筋满布，便溏，食入则胀满难受，脉沉缓，面色暗垢，舌滑润，知为中焦有寒，不是单腹胀，亦不是水分与气分，乃肾无关键力，非温肾不可。
益智仁（盐水炒）二钱，巴戟天二钱，自附二钱，川椒一钱，党参二钱，白术二钱，固脂二钱，胡芦巴二钱，上桂末一钱（吞服），川姜一钱
服两剂，腹胀见减，腹壁见收，便不溏泄，食欲见增。
附子三钱，益智仁二钱，上桂末一钱，复盆子二钱，菟丝子二钱，固脂二钱，吴茱萸二钱，川椒一钱
我以为必须开鬼门而洁净府，单用温肾法，可祛寒，寒去而肾气自充，府亦洁矣。
女，16岁
腹大如瓠，脚小，且见浮肿，不寒不热，能食能走，面无血色者三、四年，百药罔效。六脉无度数，舌色淡红，颇难诊断。又观指纹，青赤两色。沉思良久，乃忆及二十年前，某小儿科认此为“白火丹”，后查书，是何白，又名瓠白。某小儿科曾嘱寻无根草，水酒捣汁服。因不识是何草药，农医某云是破铜钱中有“十”者，此草生长田缺水沟，无根，能治白火丹。我仿此用：
破铜钱一握滤干水，置石臼捣烂，再以水酒捣汁，乘冷服下。外用灰面、鸡子白、生地共捣贴腰上。再服四草汤：
此外，用多量破铜钱煎水沐浴，于最热时坐盆上熏之。悉按上法服用，后七日，其一人来复诊，其面色虽白，而两颐现宕纹，有笑容，腹消去大半，当以利湿、利小便、除黄为主。
怀牛膝二钱，茵陈四钱，前仁二钱，冬瓜仁三钱，滑石三钱，生姜二片
服八剂，全愈，现在学堂读书。
农医治病有特效者，我亲见数人，实不可忽视。
女，58岁
水泻后腹膨如鼓，其脉浮数互见，舌上满布白苔，边微红，摸其腹，有小块，但膨胀而不坚硬，且哇哇作响。知为水蓄三焦，以分利为主：
云苓三钱，猪苓二钱，泽泻二钱，前仁二钱，白术二钱，川通钱半，桂枝钱半，京半夏二钱，丝瓜络三钱
复诊面无血色，白如竹纸，脉象如前，据云节日曾食鸡，知三焦挟痰，遂于前方去桂枝，加上桂末一钱，东波叩二钱，焦山楂二钱，两剂而愈。
男，40岁
四肢无力，食减贪睡，懒于劳动。未几，腹大如箕，不能起床，食则饱胀不堪。诊脉沉弱，面目俱黄。其腹大如箕，不似抱瓮状，虽膨胀，但不若鼓之硬。乃三焦失司，肾水不得运化。
甘遂五钱，广木香五钱共研末。外购猪肾一对，竹刀劈作四片，去内筋膜，将上药末置其内，再合拢，外以粗纸裹定煨熟，取猪腰子，去药末，细嚼之，随随吞下，勿暴食之，可多吃几次。吃过三次，尿量顿增，腹胀见软，能打屁，便无异常。经察之，腹消二分之一。再服两次，下黄水一盆，腹胀已去十分之八。然后以蚕豆半斤，大蒜瓣四两同煮食，共三次，续有效，且能劳动。但面目尚未脱黄，给黄病丸药二两得全收全功，身体逐渐恢复强壮 。此以肾治肾，从肾引水，各从其类也。
男，16岁
Sitting idle for four months, unable to work, because the hands and feet could not be lifted, accompanied by dizziness and vertigo, insomnia at night, wanting to sleep but lacking the desire to move. The pulse was deep and choppy (Chen Se), the tongue coating was yellow, the complexion was orange-yellow like an orange peel, and the eyeballs were entirely yellow. It was diagnosed as damp-heat clashing with each other, resulting in Dan Huang (a type of jaundice).
Yinchen 4 qian, Qinjiao 2 qian, Baijiangcao 2 qian, Lianqiao 2 qian, Longdancao 2 qian, Zhizi 5 pieces, Dadoujuan 2 qian, Zhengxizhuang 2 qian.
After taking four doses, all symptoms significantly decreased, spirit improved, and the yellow color gradually receded. In the previous formula, Longdancao and Xizhuang were removed, and Danggui 2 qian, Chixiaodou 3 qian, Wubeizi 2 qian, and Yemingcha 2 qian were added. After eight more doses, full recovery was achieved. Later, the clinic issued a certificate requesting his restoration to work.
(53) Jue Syndrome
Female, age unspecified.
According to her account, yesterday her four limbs were cold, and she lost consciousness. Upon my examination, her hands and feet were not warm, yet she could turn over and answer questions. The pulse was scattered and chaotic, located on the reverse side (Fan Guan Mai - radial artery pulse appearing on the dorsal aspect of the wrist), breathing was perceptible against the skin but difficult to count accurately. The sides of the tongue were red, and the center was grayish-white. Palpating her chest, she preferred pressure, indicating that Yang Qi had not yet dispersed. I administered Sini Tang (Aconite Decoction: Fuzi, Ganjiang, Gancao, Shaoyao), instructed her to take it cold, and by evening, she was peaceful.
On the next day's follow-up, her husband stated she had experienced dry retching. Observing her tongue, it was covered in blue, and shortly after, she vomited blue fluid. I did not know the cause. Referencing the pulse, all six positions still had rhythmic beats, unlike the chaos upon initial recovery; consciousness was slightly clearer, though she only requested water. Asking what she had eaten the previous night, she replied she had eaten bananas and dark plum candy. Thus, it was known that eating bananas caused the blueness of the tongue. As for vomiting blue fluid, it could not be excluded as a stomach-violating manifestation. I instructed immediate administration of Radish Seed decoction to detoxify and relieve bloating and nausea. After taking it, she passed a basin of watery stool, feeling somewhat comfortable thereafter, though still desiring to vomit without success. Considering she was a refugee from a flood zone, newly arrived in an unfamiliar place, suffering from maladaptation to the local environment, I administered Zhengqi San. In the formula, Suye and Baizhi were removed, and Bidou and Wuzhuyu were added. She became peaceful after taking it.
This woman was eight months pregnant, accustomed to being pampered, and unwilling to take medicine. Later, she developed chest distension and gastric fullness. Her family purchased Xiangsha Liujunzi Wan. At nine months, she delivered a boy. My management of this case was considered an ideal treatment method; using Sini Tang in an emergency was appropriate because Yin-Yang separation had not been clearly differentiated at that time.
Female, age unspecified.
Suddenly suffered from dry retching and cold hands and feet. After three days of scraping (Gua Sha), acupuncture, and medication, there was no effect. On the fourth day, her husband hired porters to carry her from Nanchang to the countryside to prepare for funeral arrangements. Upon arriving home, she was near death. Due to the urgency, I first used five Burned Needle Pills (composed of Cishi, Zhe Shi, Xionghuang, sold by a Daoist priest for stopping vomiting). I needled acupoints to stabilize, heated the pills red over a clear oil lamp, quenched them in a cup of fresh well water, waited until they cooled to lukewarm, pried open her teeth, and poured it in. Upon entering the mouth, it was coughed up from the throat. After waiting quietly for a moment, I pried her teeth open again and forced it down. After swallowing, there was a diaphragmatic spasm sound, followed by a thunderous noise, but the patient remained motionless.
Palpating her pulse, it was floating, large, and about to scatter. Pressing the Guan position to the bone, the response was not strong; the two Chi positions were completely imperceptible. Observing her tongue, the edges were slightly red, the center was fully covered in grayish-white, but the root still showed Stomach Qi. The lips were pale red, indicating Yang Qi had not dispersed. The forehead was smooth and shiny; touching it revealed cold sweat that did not stick to the fingers. There was also sweat on the abdomen, but none under the hypochondrium, popliteal fossae, or inner thighs. I believed the sweat on the skin was not generated by Yang transformation but stagnated in the skin. It was necessary to assist Qi to generate sweat and expel the pathogenic water. I instructed taking a bundle of Congbai (Green Onion White) and one sheng of Douchi, decocting them in a basin. A stick was placed across the basin opening, the patient was undressed and seated to fumigate. In an instant, the patient shivered several times, exhaled a deep breath, and cried out. She was then helped to bed, and the moisture was wiped dry. About an hour later, she sweated profusely all over, with slight sweating on the head, and her body heat radiated warmth. Consciousness gradually cleared, eyes closing. She held her lower abdomen, saying there was occasional throbbing pain and a sensation of her head falling. Interpreting "Zhenzhen Yu Pi Di" (trembling desire to fall prone) and holding the lower abdomen as "Ji" (palpitation/throbbing), I administered Zhenwu Tang:
Fuzi 4 qian, Baizhu 2 qian, Guizhimu 2 qian, Fuling 4 qian, Hangshao 2 qian. One dose taken, peaceful that night.
Next day's follow-up, pulse was floating but not large, weak; Guan positions responded slightly; Chi positions seemed present yet absent. Prescribed:
Fuzi 4 qian, Baizhu 3 qian, Fuling 5 qian, Hangshao 2 qian, Shanggui 1 qian, Zhigancao 1 qian.
One dose taken, borborygmus like thunder, desire to defecate, but unable to pass stool on the toilet. Knowing Yang was unblocking and water was leaving, changed to a method of harmonizing the Stomach and regulating the Middle Jiao.
Fuling 3 qian, Jinchai Shihu 2 qian, Dongbokou 2 qian, Sharen 2 qian, Bidou 2 qian, Hangshao 2 qian, Peilan Ye 2 qian, Bichengqie 2 qian, Jiang and Zao 2 pieces each.
Another dose taken, gradually desired food. Instructed not to eat congee to prevent fluid retention. For several days, ate lotus root powder three times daily. If craving food intensely, must eat meat soup with solid rice. Five days later, went to Nanchang. The woman refused medication; after stopping, she experienced skin chills.
Male, 55 years old.
Chronically deaf, fond of roasted foods, addicted to tobacco and alcohol. In a certain summer-autumn period, a lingering illness occurred. A doctor treated it as deficiency, administering Shiquan Dabu Wan, with little effect. Switched to large doses of Renshen and Fuzi. After eight doses, face turned red, slept upright demanding water. Changed doctors, prescribed Guipi Tang, advised taking more. Followed all advice, but ears became more deaf, and he wasted away daily. One day I visited, finding him vastly different: deaf, unconscious, reluctant to speak. When I pulled his hand, he reflexively withdrew it.
Pulse was deep and tight, indeterminate rate. Legs resembled crane knees (osteophytes/deformity). Tongue had cracks, gaze was dilated. Known as depletion of Kidney fluids, having become Jian Jue (scorching Jue due to heat damaging Yin). His son urged me to prescribe. I said: "Depletion of Kidney fluids causes deafness upon deafness; crane knees indicate exhaustion of Kidney Water; pulse is deep and tight, changing unpredictably; dilated gaze shows Liver and Kidney do not share the same source; sleeping upright indicates mental restlessness; malar flush indicates impending agitation. With irritability and restlessness combined, what physiology remains?" Firmly refused to prescribe, only suggested eating bird's nest.
Since then, frequent irritability, worse at night. One day ran outside, wanting to enter water, family urged return. Just before sleep, saw a pot of wine nearby, picked it up and drank. Immediately severe continuous vomiting, sweating like rain. From then on, Kidney Qi rebelled upward, loud hiccups, Middle Jiao Qi rose. Each hiccup caused whole-body convulsion. That night, hiccups stopped, voice ceased, and he died.
Male, 10 years old.
After heating up in summer, four limbs became cold. A pediatrician used Lingyangjiao and wind-dispersing herbs, worsening the condition. Six pulses had rhythm but lacked Fu-Chen-Chi-Shu Tai Xi (fundamental pulse qualities). Limbs ice-cold, no desire for water or food. Wanted to sleep in the room, requiring mother's company. Tongue entirely white, lips pale white. Could speak but unwilling. Diagnosed as internal latent Yin-Cold, having become Jue Syndrome.
Fuzi 2 qian, Ganjiang 2 qian, Gancao 1 qian, Congbai 2 pieces. Instructed to take quickly. Three hours after taking, the child called for mother to cover with quilt. Mother touched limbs, not as icy as before, but wanted to turn and sleep together with mother, asking for water and candy.
Next day, father said limbs were no longer cold, but Yang had fully returned, needing mother to sleep with him, fearing fan wind. Knew Jue was resolved but Yang had not fully recovered.
Fuzi 4 qian, Paomei Ganjiang 3 qian, Zhigancao 2 qian, Hangshao 1.5 qian, Shanggui 1 qian, Hongzao 3 pieces.
One dose taken, could eat half bowl of congee, retching, desire to defecate but unable, sweat on forehead. Knew Jue had disappeared. Retching indicates Cold in Stomach; focus on harmonizing Stomach.
Dangshen (Roasted) 2 qian, Kouren 2 qian, Hangshao 2 qian, Zhigancao 1 qian, Liangjiang 1 qian, Biandouyi 2 qian, Chuanjiao 0.8 fen, Wumei 2 pieces, Jiang and Zao 2 pieces each. Condition retreated after taking.
Seven to eight days later, father returned, saying illness gone by two-thirds, but needed padded jacket, feared wind, ate little, sometimes belched, sleepy. I thought excessive wind herbs and Lingyangjiao were too cooling, hence fear of wind-cold. Ordered Heixi Dan, 20 pills daily for five days. Indeed effective.
Male, 31 years old.
Tidal fever unrelenting, confusion, weak Qi, unwilling to labor, anorexia, insomnia, scant urination and defecation, believing life was hopeless. I saw his face black, extreme fatigue, near death. Pulse in all six positions was absent, except Guan position one beat per respiration, retaining Tai Xi (root). Judged Stomach Qi still existed. No pulse in frontal six positions must have a reason. Asked if he vomited? Answered he vomited twice on the way to the clinic. Realized significant jolting during transit. Instructed to drink hot boiled water, which he finished in one gulp. Re-palpating pulse, all six positions showed movement, fully deep and fine. Speculated disease critical but Yuan Yang undamaged. Tongue dry with wet edges, lips scorched and withered. Disease: Dampness transformed into Heat, Stomach scorched by Heat, becoming Jian Jue. Prescribed:
Xijiao 1.5 qian, Xuanshen 2 qian, NanShashen, Xianshengdi, Dongbokou each 2 qian, Dongguaren, Yiyiren, Sheng Shigao each 3 qian, Sugarcane juice 1 cup. Instructed to take continuously for five doses.
After first dose, urinated on bed. Family panicked, considering enuresis an ill omen. Patient shouted on bed that it was urgent need to urinate, unable to get up in time, told family not to panic. After five doses, spirit calm, urination and defecation normalized, expression happier, but still not eating. Changed formula:
Xianshengdi, Juluo, Shashen, Xijiao, Yuzhu, Lugen, Chishao, Lianqiao, Niuzi each 2 qian, Sheng Shigao, Jinchai Shihu each 3 qian, Sugarcane juice 1 cup.
Another five doses, spirit improved, could eat congee, oral mucosa peeled, craved meat, slept with eyes open all night. Known as Yin failing to enter Yang. Added to previous formula:
Jizihuang 1 piece, Ejiao 2 qian, Zexie 2 qian, Chuanlian 1 qian, Xi Shengdi 2 qian, Yiyiren 2 qian, Lianzixin 1.5 qian, Yunling 2 qian.
Two doses taken, could eat congee, slept at night. Instructed to take convalescent formula:
Yangshen 1 qian, Maidong 2 qian, Wuweizi 1.5 qian. Decoct and take. Recovered completely since.
Male, 37 years old.
Unremitting thirst. Others thought it was Xiao Ke (Wasting-Thirst). Self-reported taking over ten jin of Huafen and several liang of Yangshen with no effect. Pulse rapid and extreme, lips and tongue crimson, malar eminences bright red. This is a variant of Xiao Ke, becoming Bo Jue. Instructed to find Tugua (Da Zi Gua) to eat until full. It was September, searched everywhere, bought four. Ate two immediately, still felt insufficient, ate third. Instantly let out a full burp, felt like smoke going down, then a urinary spasm, immediately urinated half a bucket. Since then, long time no request for tea. Asked why, said: "Not thirsty anymore." Eating the fourth, immediately defecated a large amount of loose, sauce-colored stool. Illness largely cured instantly.
Next day sent someone to change prescription, ordered finding ten Salminaria larvae (Xianyu Chong) under water jars, decocted in water, taken warm. Condition vanished thereafter.
Male, 24 years old.
Visited in April (Lunar Calendar). Saw him wearing cotton robe and jacket, suspected madness. He understood my meaning, stating even in dog days he needs cotton clothes. Had taken much Fuzi, Lishen, Mengui, but fear of cold persisted. Pulse Cun submerged, Chi floating and rapid, not connected, likely Yin-Yang obstruction. Tongue coating not thick/stagnant, lips pale red, appearance dull/dark, limbs ice-cold, irregular diet, short urine, restless sleep, stays indoors, fears wind heavily, always wears cotton. Diagnosed: Deep Heat leads to Deep Jue, not a Cold syndrome, but Pathogen merging internally while Yin is obstructed externally. Neijing says: "Deep Heat, Deep Jue"; also "Extreme Heat generates Cold". Should dissipate Heat, allowing it to reach exterior. Suitable for cool, dispersing methods to resolve Heat, but pure cold herbs are not suitable. Xian Lugen 5 qian, Duanshipao, Yiyiren each 3 qian, Sugeng, Peilan Ye, Juluo, Tian Xingren, Gualou Ren, Dongguaren, Kouren, Qianhu each 2 qian, Douchi 40 grains.
After ten doses, patient could walk outside without cotton, feeling no cold. Cun pulse no longer submerged, Chi pulses no longer floating, four beats per respiration, all responsive. Knew Yin no longer externally obstructed. Changed formula:
Changpu, Yujin, Peilan Ye, Xingren, Gualou Ren, Juluo, Zhimu each 2 qian, Lugen 4 qian, Duanshipao 3 qian, Chuanbai 1.5 qian, Jinyinhua 4 qian, Lianqiao 2 qian, Douchi 40 grains.
Another ten doses, slight sweating, increased appetite, skin itching, six pulses uneven. Instructed to pause medication, wait for Stomach Qi recovery to reconsider. Can eat pig liver, pig stomach, beware of boils/toxins. As predicted. Because excessive warm tonics caused severe internal Heat stagnation, inevitably forming toxin.
(54) Abdominal Distension
Male, 40 years old.
Procrastinating nature, unwilling to take medicine when sick, specifically eats bird's nest and silver ear fungus. Early autumn of a certain year,偶然ly felt abdominal distension. Walking straightened waist, could only sleep supine, reduced diet, emaciated face. By February next year, condition worsened, walked sideways, eyelids swollen, desired to eat but couldn't, breathed through open mouth. Local coffin merchant visited, claimed he could cure and guarantee recovery. Family didn't believe, invited me.
Abdomen large as a basket, green veins not visible, pulse hollow, Guan position faint, speaking with coarse Qi. I felt helpless, temporarily gave Jinkui Shenqi Wan 1 liang, instructed to take over two days. Wife said there was a healer here for this disease, urged me to invite him. Arrived, asked what medicine? Answered: "All big bellies have water. Medical books say 'expel organs and clear heart/chest'. Water is outside, not inside. Abdominal cold, Qi deficiency, no hot Qi steaming water, causing water accumulation. If shaped like a pointed urn, can be treated; if abdomen flat and full, water floods everywhere, untreatable." Also said, "This case belongs to Qi deficiency, water accumulating below navel, should greatly tonify Yuan Qi." Then used one carp, one large rooster stewed with 4 liang Huangqi until very soft, then eaten. Hearing this, I believed it reasonable, encouraged patient to boldly follow method. Indeed, after one meal, half absorbed; second meal, fully cured.
Male, 53 years old.
Abdomen distended and hard, green veins fully distributed, loose stools, bloating after eating, pulse deep and slow, complexion dark and dirty, tongue slippery and moist. Known as Cold in Middle Jiao, not isolated abdominal distension, nor Water or Qi differentiation, but Kidney lacks key power, must Warm Kidney.
Yizhiren (Salt-fried) 2 qian, Bajitian 2 qian, Zifu 2 qian, Chuanjiao 1 qian, Dangshen 2 qian, Baizhu 2 qian, Guzhi 2 qian, Hulusiba 2 qian, Shanggui end 1 qian (swallow), Chuanjiang 1 qian.
Two doses taken, abdominal distension reduced, abdominal wall tightened, stools no longer loose, appetite increased.
Fuzi 3 qian, Yizhiren 2 qian, Shanggui end 1 qian, Fupenzi 2 qian, Tusizi 2 qian, Guzhi 2 qian, Wuzhuyu 2 qian, Chuanjiao 1 qian.
I believed must open Ghost Gate (sweat pores) and purify the House (bladder/intestines). Using only Kidney-warming method can dispel Cold; Cold gone, Kidney Qi naturally fills, House becomes clean.
Female, 16 years old.
Abdomen large as gourd, small feet, edematous, neither cold nor hot, able to eat and walk, bloodless face for 3-4 years, hundred medicines ineffective. Six pulses indeterminate, tongue pale red, difficult to diagnose. Observed fingerprint, green and red colors. Pondered long, recalled 20 years ago, a pediatrician recognized this as "Bai Huo Dan", later checked book, what is Bai, also named Hu Bai. Pediatrician once instructed finding Wugen Cao, crush with water/wine for juice. Not knowing herb, farmer-doctor said it is the one with "Ten" in broken copper coin. This herb grows in field-ditch lacking water, rootless, cures Bai Huo Dan. I imitated this use:
A handful of broken copper coins, filter dry water, pound in stone mortar, crush with water/wine, take cold. Externally: Ash flour, egg white, Shengdi pounded together, applied to waist. Take Four Grass Soup again:
Dengxincao 1 liang, Yinchencao 2 qian, Tongcao 2 qian, Gancaoshao 2 qian, decoct and take.
Additionally, bathe in large amount of broken copper coin decoction, sit on basin fumigating at hottest time. All followed above methods. Seven days later, one person came for follow-up. Face white, but cheeks showed wrinkles, smiling, abdomen reduced by more than half. Should focus on draining Dampness, promoting urination, removing Jaundice.
Huainiuxi 2 qian, Yinchen 4 qian, Qianren 2 qian, Dongguaren 3 qian, Huashi 3 qian, Shengjiang 2 slices.
Eight doses taken, fully cured, now studying in school.
Farmer-doctors treating diseases with special effects, I personally saw several, truly cannot be ignored.
Female, 58 years old.
After watery diarrhea, abdomen distended like drum. Pulse floating and rapid alternating, tongue fully coated white, edges slightly red. Palpating abdomen, small lumps, but distended not hard, rumbling loudly. Known as Water accumulating in San Jiao, focus on separating and draining:
Yunling 3 qian, Zhuling 2 qian, Zexie 2 qian, Qianren 2 qian, Baizhu 2 qian, Chuantong 1.5 qian, Guizhi 1.5 qian, Jing Banxia 2 qian, Sigualuo 3 qian.
Two doses taken, abdominal distension slightly reduced, still rumbling.
Follow-up: Face bloodless, white as bamboo paper, pulse as before. Claimed ate chicken during festival, known San Jiao carries Phlegm. Removed Guizhi from previous formula, added Shanggui end 1 qian, Dongbokou 2 qian, Jiaoshanzha 2 qian. Two doses cured.
Male, 40 years old.
Four limbs weak, reduced appetite, sleepy, lazy to labor. Soon, abdomen large as basket, unable to rise from bed, bloating unbearable after eating. Pulse deep and weak, face and eyes yellow. Abdomen large as basket, not like holding urn, though distended, not as hard as drum. San Jiao lost control, Kidney Water unable to transform.
Gansui 5 qian, Guangmuxiang 5 qian, ground to powder. Buy one pair of pig kidneys externally, split into four pieces with bamboo knife, remove internal fascia, put powder inside, close again, wrap in coarse paper, roast熟. Take pig kidney, remove powder, chew finely, swallow gradually, do not overeat, can eat multiple times. After three times, urine volume suddenly increased, abdominal distension softened, able to pass gas, stool normal. Examined, abdomen reduced by half. Two more times, passed one basin of yellow water, abdominal distension gone 80%. Then cooked half jin broad beans with 4 liang garlic cloves, ate together, three times total, continued effective, able to labor. But face/eyes still yellow. Given Huangbing Wan 2 liang, completed full success, body gradually recovered strength. This treats Kidney with Kidney, draws water from Kidney, each follows its kind.
Male, 16 years old