水肿肚大，不能多食，亦不能劳动，腹壁如水晶色。验其足心，尚不平满。按脉至骨，不分度数，独两寸搏指，知肺气尚存，令用猪肚一个，茶汤盐水洗净后，活捉青蛤蟆放入猪肚内，扎口，置砂锅内炖熬一日一夜取出。去蛤蟆皮、头、肠杂，与猪肚同撕碎缓缓吃下，不用盐酱，吃完为度。
照法服三个，肚消大半，但四、五日大便一次，再用乌鱼（十两上下）一条，不用水洗，以布揩净，竹刀剖腹，去肠杂，内放皮硝五钱，以线缝口，外用黄泥裹之，放火上烘燥（烘两面），以闻到鱼香为度，取出去泥，用竹筷取食鱼肉，不用盐酱，耐心吃下两三斤，大便量增加，腹胀顿减，获大效。
（55）骨节疼痛
男，18岁
肆业中学，素不爱运动，某日因玩单双杠而致骨节疼痛，服中西药，未见起色。
脉见沉涩，关部沉细无力，舌苔灰黄，唇色惨白，断为思虑伤脾，脾运不济，则胃气不充，湿郁不化，致水气相混，阻碍升降，因而面黄、肢软、身痛。
茵陈三钱，苍术二钱，秦艽二钱，丝瓜络、橘络、天仙藤、九节菖蒲、当归各二钱，栀仁四个，薏苡仁三钱，赤小豆钱半，煨姜一钱，枣二枚
服两剂，身觉如虫行，满身疼痛，不仅骨节痛，其因服药有效，迳自加服二剂，觉精神痛快，不若以前之郁闷。
越日再诊，六脉均匀无偏。改方：
茵陈三钱，白术、苍术、郁金、九节菖蒲、连翘、赤芍、金钗石斛、当归、大豆卷、省头草、川牛膝、木瓜各二钱，栀子五个，赤小豆钱半，姜枣各二
服四剂，骨节疼痛大减，其要求证明回校。
（56）吐血
女，45岁
孀居。某年隆冬，因其子在岭里看戏赌钱，乃乘风赶至岭里寻子归来，途中边走边哭，已吐血不止，到家睡到床上，血涌出，成盆成堆，临夜请其胞弟诊治，投以犀角地黄汤，未见甚效。及天明，吐淡红色血，量稍减少。患者头晕目眩，起坐不稳。
余诊其脉，浮数难数，关部寂然，断其受寒激怒，致血妄动，将有气虚血脱之虑，处方独参汤：
高丽参五钱煎汤频频咽下。约过一小时，病者云头晕好，坐得住，喉间无响声。直至薄暮，仍不断吐血，但只半碗许。余嘱将血扫去，铲出血上之土，置瓦上焙干，与高丽参水兑服，是夜二时血止，索粥食，乃与热食。旋即突然大吐，知其被上呛，遂于方内加：
服一剂稍安，但仍畏寒，于方中加
男，年未详
吐血甚多，色分鲜、紫，发热畏寒，胸郁咳嗽。寸口脉浮搏指，断为寒湿伤肺。
桂枝钱半，杭芍二钱，杏仁二钱，郁金二钱，藕节八个，大小蓟炭各钱半，戈半夏一钱，黑姜一钱，桔梗二钱，仙鹤草二钱，童便磨墨一盅兑付
两剂后热减，不畏寒，仅咳时痰中带血，胸膈仍郁闷。此热瘀膈上，肝木未遂，以去瘀调肝为治。
桃仁二钱，郁金二钱，仙鹤草二钱，桔梗二钱，百部二钱，田三七一钱，藕节五个，橘络,二钱，瓜蒌二钱，炒栀子五个，蛇胆尖贝末一支，冲服
连前服药四剂，痰中带血减少，热退清，胸郁解。但食后饱胀，消化不良，肢软，头晕，怔忡，此湿热未透，法当渗湿解热。
栀子四钱，西茵陈二钱，赤茯苓三钱，川木通钱半，猪苓二钱，莲子心二钱酸枣仁二钱，龙胆草二钱，橘络二钱，尖贝二钱，茅根二钱，另 用仙鹤草片一瓶分作三日服，全愈。
男，36岁
突患吐血，邻人告其买水参顿鸭，吃了一只，吐血见减。另日再吃一只血止。自以为病愈，乃乘舆往南昌清真馆食清炖鸭一只。当日傍晚归家，其见室内灯光，顿时眼花头晕，往后一摔，仰卧地下，随即血出，大呕大吐，量达盈盆，举家号叫，次日延三医会诊。梅、黄二医先我而至，颇受殷勤招待，我至其家，似无人过问，乃自往塾师处闲坐，旋即不辞而回。是日服梅、黄医方不效，但血不甚汹涌。其再延我诊，我推辞之，经再三请求，乃随往之。时见患者满面红光，唇满尚有血迹，六脉俱浮，关部不及四至，似此无根之脉，不便施治。适塾师云，此病是因食水参炖鸭，恐过于寒凉，要我从此考虑用药。余细察患者叫关窗户，并叫加背心，知有畏风表现。令其卧下，更觉肚内作响，血又大出，当时忆及王医曾用桂枝汤治疗吐血之经验，遂考虑其畏风是肺部有寒，确与食水参炖鸭有关。桂枝可宣发肺气，杭芍则调和营卫，姜枣以调和胃气，肺气一通，自然不畏风而寒自解矣。乃见症治症，拟方：
服一剂，当晚十二时，身上热蒸蒸 ，吐血时肚内不再作响，且觉爽快，亦不似昨日躲缩畏风。次日复诊脉象仍浮，但能应指，无紊乱脉象，前方之效已明。表寒既解，亟宜引血归经。
自附二钱，力参二钱，蒙桂末（冲服）一钱，炙草一钱，黑姜二钱，当归二钱，熟地炭三钱
服两剂，血止，目已不花，但稍有紫色血块出，知有瘀积。遂于前方加
服两剂，血告终止。其眷属虑其吐血甚多，大伤元气，每日以冰糖炖燕窝当早餐，以清炖莲子当午餐，一星期后，患者胸脘板塞，喉间发痒，脉平。断因过食寒凉，停积上脘，致令胸口板塞。其喉痒者，是肺气被遏，急用萝卜子（炒香）五钱，水煎童便兑服。燕窝、莲子，一概停食，日进餐粥餐饭，忌油腻，粥内可加红豆一合，同炖。至于服药，则以生脉散常服。刻下暂服回龙汤（清早用自己尿服下）。
当日我将书上所谓“吐血不死，咳嗽必死”告其家属，并云其家尚有遗传性咳嗽，宜注意。以后若有梦遗，则肺病难免。后果如余言。
男，15岁
八月来咳嗽不止，间或痰带血丝。据述经Ｘ光透视为肺结核病。乡人云系童子劳，吃八角乌炖肉两次，从此病势日增。
察脉浮滑，关部尚能搏指，初咳时摇头掷之，认为伤风咳嗽，未得宣通肺气，肺气一通，咳嗽自愈。一钱被肺、泻肺、止咳、醒痰之品，均未采用。
前胡二钱，苏梗二钱，台党钱半，桔梗二钱，法夏二钱，，杏仁二钱，橘络二钱
桑叶三钱，枇杷叶二钱，橘络二钱，前胡、桔梗、京半夏、瓜蒌仁、甜杏仁、冬瓜仁、佩兰叶、白前各二钱，薏苡仁三钱，藕节三个，藓茅根一握。令服四剂。
又嘱用猪油四两，先煎去渣，入糯米糖半斤，溶化，再入白蜜四两，同煎成丝，取出以磁罐盛之，每日用开水调服一匙，吃完为度。
服毕，云病好大半，白天不咳，仅夜间稍咳，面部稍见浮肿。我令购猪肺一叶，煮熟，外用五味子研末煎食，遂获全愈。
男，40岁
自知医。常患吐血，服药甚多。其吐血，四季不离棉衣，咳嗽痰少，汗出不止，一日访余，欲得良方。诊脉细数，断其肾虚卫弱，肺金不润。遂仿洄溪以琼玉膏治吐血法，于原方略事加减。
鲜生地一斤，人参须一两，藕一斤，云苓一斤，鲜茅根一握。同入铜锅煎至水剩半锅为度，捞起去渣，再煎剩八碗水后，入白蜜收膏以瓷罐装好，每日用一小盅，开水化服，以不畏风，不吐血为有效。
依法制服一月余，即不穿棉衣，吐血亦止，但咳得气急，遂令再服一料，全愈。
（57）呕血
男，年未详
某年端午节日，饮酒一碗半，食鱼肉甚多，酒后手舞足蹈，欲去划船，不意一跳而跌仆地下，即呕血甚多。余见其满口喷血，头向两侧转，面红亮，舌红甚，脉洪大无伦，骇甚。剥开眼皮视之，白珠如猪血，显系酒醉而血液妄行。令速购葛花五钱，如无葛花，则买葛根一两，温水浸软，同芦根一束捣烂敷胸口。外以新汲井水漂发（此人幸有长发六寸），持碗盛水，令其发垂入碗内（切勿以水淋头），至其不摇头为止。同时，以花蕊石末，五钱，水煎童便兑服。敷药后约十分钟，患者手摸敷药处，两目即开。随即腹内大鸣，患者又手摸腹。口内所哺，有血水夹内，间或叹气。余令用竹床放睡，勿惊动，暂勿乱进食。是夜三点钟大汗。另日清晨能说话，换方犀角地黄汤，加入灶心土一块。两剂后大效。余嘱停药，可连服绿豆炖粥，日三次，切勿乱进食。患者若感饥饿，可用精肉炖汤，食汤勿食肉，此养胃法也。必俟胃热解除，胃津充沛，方可进食。依此法，获全愈。
（58）衄血
男，30岁
家人每以酒代茶，甚或当饭。一日，其醉饱后，在竹子阴凉处睡整天，旋患鼻血长流，至昏厥不闻声，身不转侧。抬至我家，时方日下，检药不及，急以韭菜一斤煎水，再以鸡蛋一个，去壳打百下，取出韭菜不要，将此汁煮蛋，蛋入汤内，化动后即捞起，不要太熟，即撬开其口，将蛋和汤灌下，约过二十分钟，出血减少。其父欲再吃一个，余以为乘热吃下之物，于止血不宜，急灶心土一块，，以新汲水搅浑澄清，乘冷服下，前后一小时，鼻血全止，人渐苏醒。
次日，以其脉洪数，舌上有泡，知有热迫现象，拟方：
犀角二钱，生地三钱，丹皮二钱。童便作引
其父坚持服洋参，我以为不合病情。他以其子体弱，认为非吃不可，竟用洋参二钱，麦冬二钱，五味子一钱同煎。此药乃其家常备药，以为能避暑热。当时我无可如何，嘱其非加童便、灶心土不可。服后病势似减非减，患者总觉胸口板塞，知有瘀血未出，洋参定然误事矣。
越日其父来，云患者遍身痿黄，眼花，其人如狂。余令速将患者抬来诊断。其面色痿黄，不能起坐，目花，狂笑，脉洪大，双目全黄，断定有瘀血，投以桃核承气汤。
服两剂，狂笑止，但黄色未退，目转老黄色，怒目视人，遂改用龙胆泻肝汤。连服两剂，病势顿减，然半月不思食，口苦，到晚发烦。认为血分有燥，乃以猪膏发煎，每日以无灰酒调服一匙，至服完一料为度，自此告愈，
我以为治血症须注意血后停瘀，不宜过份服寒凉。犀角地黄汤，洋参未免失之过早，当引为教训。盖血症后去瘀解热，泻有余而补不足也，庶为治血症一大理解。
男，25岁
素有黄症。一日鼻血长流，昏倒在地，不省人事，举家惶惶，啼哭一夜，天亮即延我往诊。其脉数而有力，独关部沉伏，知必有感触，致血出不止。然何故昏昏不省人事？疑之。其头部冷汗溢出，舌边红而中心黄，唇色焦，两目瞳人不明，必为血热妄行，引动肾气，所以额汗而瞳人不见。我急则治其标，用四生饮止血。
生艾叶、生柏叶、生荷叶、鲜生地，不拘多少（当时药肆无鲜生地，以干生地代之），同捣成汁，乘冷服下。不到二十分钟，患者目开，头不旋转，鼻血不暴出，但见胸口急跳。至下午，病者能坐起，鼻孔仅少量血水流出，且有黄色鼻涕。断其肺热渐退，是夜令取灶心土一块，入新汲水内搅浑澄清去渣，和童便出吃下，鼻血全止。再投犀角地黄汤两剂全愈。
（59）声音不出
男，27岁
终日陪妻伴妾，房中作乐。其身体肥胖，平时无咳嗽。一日，忽然声嗄，遂至失音。面不华色，舌无甚白滞，稍见干燥。脉沉至骨，难分度数。证诸上情，当非咳嗽失音及鸭公痨，实乃房劳过度，肾经失职，致不能上蒸肺气，所以声闭。处方：
诃子三钱，熟地炭四钱，益智仁二钱，女贞子二钱，远志二钱，灵磁石二钱，杉木节七个水煎。另用陈杉木一小根，烧成火熄，置水内炖十分钟，倾入碗内，不用火熄，乘热与前药同服。可服四剂。余用诃子、熟地炭者，取其泻火、去凝、除腻，专解肾热之义。并嘱分房独宿，直至全愈。其服四剂，有时喉头发痒，大咳一声，吐出血块，顿感舒适。换方：
诃子四钱、益智仁三钱，熟地炭八钱，远志三钱，九节菖蒲三钱，女贞子三钱，板蓝根二钱，当归二钱，莲子心二钱，柏子仁二钱，杉木节七个
前后服药十剂，病情若失。最后说明不可妄投补品。
男，42岁
声音不出者年余。问其原委，乃笔之于纸云，起病于秋后，稍咳嗽、夜不成寐，减至失音，别无他症。
诃子二钱，苏子二钱，杏仁二十粒，通草二钱，水煎，加热酒兑服，令服十剂。又拟方：
猪油四两，炼去渣，加入米糖四两，烊化后，再加血蜜四两，同煎至牵成丝为度，磁碗装之，日服一匙，开水兑下。服毕全愈。
二、外科
（1）漆疮
男，20岁
即将迎亲，而身上突然红肿发亮，皮肤现点。某医认作天痘，用药升发，未得效果。又某外科认作疮毒，服荆防败毒散，亦未应手。
余见其面色红亮，仅上身红肿，发痒发胀，但又抓不得痒处。脉浮数而关沉数，界限不明，疑之。时已薄暮，待之明日处方。是夜患者将其原住之房间（即将作新房者）让我居住。余至此室，见满房家具，油漆鲜艳，一股浓厚油漆气味逼人，令人难受。因此，遂考虑患者原居此室，按其病情，对照浓厚之油漆气息，再结合前医之治法，乃疑其患漆疮也。
次日清晨，令采新鲜家苏叶一束，煎水沐浴，且以韭汁涂鼻。洗澡后，患者叫好过得多矣，鼻孔流血水，但无热。至午后，红肿全消。
（2）颈上大庖
Edema causing abdominal distension, inability to eat much, and inability to engage in physical labor; the abdominal wall skin appears transparent like crystal. Examination of the soles of the feet shows they are not yet completely flat (indicating persistent swelling or indentation upon pressure). Palpation of the pulse down to the bone reveals no distinction in floating or sunken degrees, except that the two Cun positions beat forcefully against the fingers, indicating that Lung Qi is still present. Prescription: Take one pig stomach, wash it thoroughly with tea water and salt water, place a live green toad inside, tie the mouth tightly, and stew it in a clay pot for one day and one night before removing it. Remove the toad's skin, head, and internal organs, shred them together with the pig stomach, and eat slowly without adding salt or sauce, finishing the entire portion.
Following this method for three courses, the abdominal swelling subsided by more than half, but bowel movements occurred only once every four to five days. A subsequent prescription was made: Take one black carp (approximately 10 liang), do not wash with water, wipe clean with a cloth, cut open the abdomen with a bamboo knife, remove the internal organs, place 5 qian of mirabilite (Glauber's salt) inside, sew the mouth with thread, wrap externally with yellow mud, and bake on fire until dry (both sides), stopping when a fishy aroma is detected. Remove the mud after cooling, use bamboo chopsticks to eat the fish meat without salt or sauce, patiently consuming two to three jin. The volume of stool increased, and abdominal distension was instantly reduced, achieving significant efficacy.
I diagnosed this condition as water retention in the San Jiao (Triple Burner). Therefore, I imitated the principle of "cleansing the Fu organs" (promoting urination) and followed the rule of "each following its kind" (using animal drugs to expel water) to drive away the source of water.
(55) Pain in Bone Joints
Male, 18 years old.
A middle school student who did not love exercise. One day, playing on horizontal and parallel bars caused pain in the bone joints. He took Chinese and Western medicines with no improvement.
The pulse was deep and choppy; the Guan position was deep, thin, and weak. The tongue coating was grayish-yellow, and the lips were pale white. The diagnosis was excessive worry injuring the Spleen; insufficient Spleen transportation led to deficient Stomach Qi, causing dampness to stagnate and fail to transform. This resulted in water qi mixing and obstructing the ascending and descending mechanisms, leading to sallow complexion, soft limbs, and body pain.
Prescription: Yin Chen (Artemisiae Scopariae Herba) 3 qian, Cang Zhu (Atractylodis Rhizoma) 2 qian, Qin Jiao (Gentianae Macrophyllae Radix) 2 qian, Si Gua Luo (Luffae Fructus Retinervia), Ju Luo (Citri Reticulatae Pericarpium Viride), Tian Xian Teng (Akebiae Caulis), Jiu Jie Chang Pu (Acori Tatarinowii Rhizoma), Dang Gui (Angelicae Sinensis Radix) each 2 qian, Zhi Ren (Gardeniae Semen) 4 pieces, Yi Yi Ren (Coicis Semen) 3 qian, Chi Xiao Dou (Phaseoli Hongsei Semen) 1.5 qian, Wei Jiang (Prepared Ginger) 1 qian, Zao (Jujubae Fructus) 2 pieces.
After taking two doses, he felt as if insects were crawling on his body, with whole-body pain, not limited to the joints. Because the medication was effective, he voluntarily took two more doses. He felt spiritually refreshed and no longer depressed as before.
On the next day, the six pulses were uniform without bias. The formula was changed:
Yin Chen (Artemisiae Scopariae Herba) 3 qian, Bai Zhu (Atractylodis Macrocephalae Rhizoma), Cang Zhu (Atractylodis Rhizoma), Yu Jin (Curcumae Longae Radix), Jiu Jie Chang Pu (Acori Tatarinowii Rhizoma), Lian Qiao (Forsythiae Fructus), Chi Shao (Paeoniae Radix Rubra), Jin Cha Shi Hu (Dendrobii Nobile Caulis), Dang Gui (Angelicae Sinensis Radix), Da Dou Juan (Sojae Germinatus), Sheng Tou Cao (Menthae Haplocalycis Herba), Chuan Niu Xi (Cyathulae Radix), Mu Gua (Chaenomelis Fructus) each 2 qian, Zhi Zi (Gardeniae Fructus) 5 pieces, Chi Xiao Dou (Phaseoli Hongsei Semen) 1.5 qian, Sheng Jiang (Zingiberis Rhizoma Recens) and Zao (Jujubae Fructus) each 2 pieces.
After taking four doses, bone joint pain decreased significantly, and the patient requested a certificate to return to school.
(56) Hematemesis
Female, 45 years old.
A widow. In the dead of winter one year, her son went to Lingli to watch plays and gamble. She braved the wind to go find him and return. While walking and crying on the way, she began vomiting blood incessantly. Upon arriving home and lying in bed, blood gushed out in basins and piles. At night, her brother treated her with Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction), but there was little effect. By dawn, she vomited pale red blood, and the amount decreased slightly. The patient suffered from dizziness and vertigo, unable to sit or stand steadily.
I palpated her pulse: floating and rapid, difficult to count; the Guan position was silent. I diagnosed cold exposure and anger causing reckless movement of blood, with a risk of Qi deficiency and Blood collapse. I prescribed Du Shen Tang (Single Ginseng Decoction):
Gao Li Shen (Korean Ginseng Root) 5 qian decocted in water, swallowed frequently. After about an hour, the patient said her dizziness had improved, she could sit steadily, and there was no sound in her throat. Until dusk, she continued to vomit blood, but only about half a bowl. I instructed to sweep away the blood, scoop up the solidified blood clots (referred to as 'earth' in the text, likely meaning the coagulated mass), dry them on tiles, and mix with Korean Ginseng water to drink. At 2 AM that night, the bleeding stopped. She asked for porridge, which was given warm. Suddenly, she vomited heavily again; knowing it was due to upward reflux of heat, I added to the formula:
Shao Yao (Paeoniae Radix) 2 qian, Fu Zi (Aconiti Lateralis Radix Praeparata) 3 qian, Pao Jiang (Prepared Ginger) 2 qian, Li Shen (Potent Ginseng) 4 qian.
After one dose, she stabilized slightly but remained afraid of cold. I added to the formula:
Shang Gui (Cinnamon Twig) 1 qian, Dang Gui Tan (Charred Angelicae Sinensis Radix) 3 qian, Shu Di (Prepared Rehmanniae Radix) 5 qian, Tong Bian (Child's Urine) ground like ink and mixed in. Three doses resulted in a cure.
Male, age unspecified.
Vomiting large amounts of blood, color varying between bright red and purple, fever, aversion to cold, chest oppression, and cough. The Cun Kou (Radial artery at the wrist) pulse was floating and beating against the finger. Diagnosed as Cold-Dampness injuring the Lung.
Prescription: Gui Zhi (Cinnamomi Ramulus) 1.5 qian, Hang Shao (White Peony Root) 2 qian, Xing Ren (Armeniacae Semen Amarum) 2 qian, Yu Jin (Curcumae Longae Radix) 2 qian, Ou Jie (Nelumbinis Nelumbo Stem Node) 8 pieces, Da Xiao Ji Tan (Charred Cirsii Japonici Herba and Cirsii setosae Herba) each 1.5 qian, Ge Ban Xia (Pinelliae Rhizoma Preparatum) 1 qian, Hei Jiang (Blackened Ginger) 1 qian, Jie Geng (Platycodonis Radix) 2 qian, Xian He Cao (Agrimoniae Herba) 2 qian, Tong Bian (Child's Urine) ground like ink, 1 zhong mixed in.
After two doses, fever decreased, aversion to cold ceased, but blood appeared in sputum during coughing, and chest diaphragm remained oppressed. This indicated Heat and Stasis blocking the upper Diaphragm, with Liver Wood Qi unfulfilled. Treatment should focus on removing stasis and regulating the Liver.
Prescription: Tao Ren (Persicae Semen) 2 qian, Yu Jin (Curcumae Longae Radix) 2 qian, Xian He Cao (Agrimoniae Herba) 2 qian, Jie Geng (Platycodonis Radix) 2 qian, Bai Bu (Stemonae Radix) 2 qian, Tian San Qi (Notoginseng Radix et Rhizoma) 1 qian, Ou Jie (Nelumbinis Nelumbo Stem Node) 5 pieces, Ju Luo (Citri Reticulatae Pericarpium Viride) 2 qian, Gua Lou (Trichosanthis Fructus) 2 qian, Chao Zhi Zi (Fried Gardeniae Fructus) 5 pieces, She Dan Jian Bei Mo (Snake Gallbladder and Fritillaria Thunbergii Powder) 1 stick, taken by washing down.
Including previous medications, four doses were taken. Blood in sputum decreased, fever cleared, and chest oppression resolved. However, postprandial fullness, indigestion, soft limbs, dizziness, and palpitations occurred. This indicated unresolved Damp-Heat; the method should be to leach out dampness and clear heat.
Prescription: Zhi Zi (Gardeniae Fructus) 4 qian, Xi Yin Chen (Artemisiae Scopariae Herba) 2 qian, Chi Fu Ling (Poria with Red Heart) 3 qian, Chuan Mu Tong (Akebiae Caulis) 1.5 qian, Zhu Ling (Polyporus) 2 qian, Lian Zi Xin (Nelumbinis Plumula) 2 qian, Suan Zao Ren (Ziziphi Spinosae Semen) 2 qian, Long Dan Cao (Gentianae Radix) 2 qian, Ju Luo (Citri Reticulatae Pericarpium Viride) 2 qian, Jian Bei (Fritillariae Thunbergii Bulbus) 2 qian, Mao Gen (Imperatae Rhizoma) 2 qian. Additionally, Xian He Pian (Agrimonia Tablets) one bottle divided into three days. Full recovery.
Male, 36 years old.
Sudden hematemesis. Neighbors advised buying Water Ginseng stewed duck. After eating one duck, bleeding decreased. Eating another one stopped the bleeding. Believing himself cured, he rode to a Halal restaurant in Nanchang and ate a stewed duck. That evening, upon seeing indoor lighting, he became dizzy and fell backward, lying supine on the ground. Immediately, blood erupted, vomiting large amounts filling a basin. The family cried out. Three doctors were consulted the next day. Doctors Mei and Huang arrived first and were treated hospitably. I arrived and seemed ignored, so I sat idly with the tutor and left without saying goodbye. The prescriptions from Mei and Huang were ineffective that day, though the bleeding was not surging. He invited me again; I declined, but after repeated requests, I accompanied him. The patient had a ruddy face, blood traces around the lips, all six pulses floating, and the Guan position less than four beats per breath. Such a rootless pulse made treatment difficult. The tutor mentioned the illness stemmed from eating Water Ginseng stewed duck, fearing it was too cold, and suggested considering this in medication. Observing the patient asking to close windows and add a vest, I noted signs of wind aversion. Lying down, he reported rumbling in the abdomen, and bleeding increased again. Recalling Doctor Wang's experience using Gui Zhi Tang (Cinnamon Twig Decoction) for hematemesis, I considered his wind aversion indicated Cold in the Lung, related to the cold-natured duck and ginseng. Gui Zhi can disseminate Lung Qi, Hang Shao harmonizes Ying and Wei, and Jiang Zao harmonizes Stomach Qi. Once Lung Qi flows, wind aversion ceases and Cold resolves. Treating the symptoms, I prescribed:
Gui Zhi (Cinnamomi Ramulus) 2 qian, Hang Shao (White Peony Root) 1.5 qian, Fa Xia (Prepared Pinelliae Rhizoma) 1 qian, Jiang (Ginger) and Zao (Jujube) each 2 pieces.
After one dose, at midnight, the body felt hot, the abdomen no longer rumbled during vomiting, he felt refreshed, and no longer shrank back in fear of wind. Next day, the pulse was still floating but responsive, without disorder, confirming the efficacy of the previous formula. Since exterior Cold was resolved, priority was to guide blood back to its vessels.
Prescription: Zi Fu (Prepared Aconitum Carmerichaelii Lateralis Radix) 2 qian, Li Shen (Potent Ginseng) 2 qian, Meng Gui End (Cinnamon Bark Powder) 1 qian (washed down), Zhi Cao (Honey-fried Licorice Root) 1 qian, Hei Jiang (Blackened Ginger) 2 qian, Dang Gui (Angelicae Sinensis Radix) 2 qian, Shu Di Tan (Charred Prepared Rehmanniae Radix) 3 qian.
After two doses, bleeding stopped, eyesight cleared, but some purple blood clots were discharged, indicating residual stasis. Added to the previous formula:
Tian San Qi (Notoginseng Radix et Rhizoma) 1 qian, E Jiao Zhu (Gelatin Pill) 2 qian.
After two doses, bleeding ceased. Relatives worried that massive blood loss damaged Yuan Qi greatly. They fed him Bird's Nest stewed with rock sugar for breakfast and stewed lotus seeds for lunch daily. After a week, he experienced chest and epigastric stiffness and throat itching, with a normal pulse. Diagnosed as overconsumption of cold foods causing stagnation in the Upper Jiao, leading to chest stiffness. Throat itching indicated suppressed Lung Qi. Urgently prescribed Luobo Zi (Radish Seed, fried fragrant) 5 qian, decocted in water with Tong Bian (Child's Urine) to drink. Bird's nest and lotus seeds were stopped. Diet consisted of porridge and rice, avoiding greasy food; adzuki beans could be added to porridge. Medication included regular Sheng Mai San (Generate the Pulse Powder). Temporarily take Hui Long Tang (Return Dragon Decoction, drinking own urine early in the morning).
That day, I told the family what the book says: "Hematemesis does not kill, but coughing will." I also warned of a hereditary tendency for cough in the family and advised caution. If nocturnal emissions occur, lung disease is inevitable. This proved true.
Male, 15 years old.
Coughing incessantly since August, occasionally with blood-streaked sputum. According to X-ray fluoroscopy, it was pulmonary tuberculosis. Villagers called it "Virginity Labor" (a folk term for consumption in young men) and said eating Star Anise and Black Chicken stewed meat twice worsened the condition.
Pulse was floating and slippery; the Guan position could still be felt beating. Initially shaking the head while coughing, it was diagnosed as Wind-Cold cough. Without dispersing Lung Qi, cough would not heal. No astringent, purging, antitussive, or phlegm-resolving herbs were used.
Prescription: Qian Hu (Peucedani Radix) 2 qian, Su Geng (Perillae Caulis) 2 qian, Tai Dang (Codonopsis Radix) 1.5 qian, Jie Geng (Platycodonis Radix) 2 qian, Fa Xia (Prepared Pinelliae Rhizoma) 2 qian, Xing Ren (Armeniacae Semen Amarum) 2 qian, Ju Luo (Citri Reticulatae Pericarpium Viride) 2 qian.
After two doses, the body felt comfortable, wanting to undress. Formula changed:
Sang Ye (Mori Folium) 3 qian, Pi Pa Ye (Eriobotryae Folium) 2 qian, Ju Luo (Citri Reticulatae Pericarpium Viride) 2 qian, Qian Hu (Peucedani Radix), Jie Geng (Platycodonis Radix), Jing Ban Xia (Pinelliae Rhizoma), Gua Lou Ren (Trichosanthis Semen), Tian Xing Ren (Sweet Apricot Seed), Dong Gua Ren (Benincasae Semen), Pei Lan (Eupatorii Herba), Bai Qian (Cynanchi Stauntonii Rhizoma et Radix) each 2 qian, Yi Yi Ren (Coicis Semen) 3 qian, Ou Jie (Nelumbinis Nelumbo Stem Node) 3 pieces, Xian Mao Gen (Imperatae Rhizoma) one handful. Four doses.
Also instructed: Melt 4 liang of lard, strain, add 0.5 jin of glutinous rice sugar, dissolve, then add 4 liang of white honey, boil until it forms threads. Store in a porcelain jar. Take one spoon daily dissolved in boiling water until finished.
After finishing, he said the illness was mostly better, no daytime cough, slight nighttime cough, and slight facial edema. I instructed buying one pig lung, boiled, and eaten with Wu Wei Zi (Schisandrae Chinensis Fructus) powder decocted. Full recovery.
Male, 40 years old.
Self-taught in medicine. Often suffered from hematemesis, taking many medicines. For his hematemesis, he wore cotton clothes in all seasons, had little sputum with cough, and profuse sweating. One day he visited seeking a good prescription. Pulse was fine and rapid. Diagnosed as Kidney deficiency with weak Wei Qi, and Lung Metal lacking moisture. I imitated the method of Hui Xi (Dan Xi) using Qiong Yu Gao (Jade Jade Paste) for hematemesis, making slight modifications to the original formula.
Prescription: Xian Sheng Di (Fresh Rehmanniae Radix) 1 jin, Ren Shen Xu (Ginseng Rootlets) 1 liang, Ou (Lotus Rhizome) 1 jin, Yun Ling (Poria) 1 jin, Xian Mao Gen (Fresh Imperatae Rhizoma) one handful. Decoct in a copper pot until half the water remains, strain, then decoct again until 8 bowls remain. Add white honey to form a paste, store in a porcelain jar. Take one small cup daily dissolved in boiling water. Effective if wind aversion and hematemesis cease.
Following this for over a month, he no longer needed cotton clothes, and bleeding stopped. However, coughing caused shortness of breath. He took another dose and fully recovered.
(57) Hematemesis (Vomiting Blood)
Male, age unspecified.
On Dragon Boat Festival, drank 1.5 bowls of wine and ate much fish and meat. After drinking, he danced wildly, intending to row a boat, but jumped and fell, vomiting large amounts of blood. I saw blood spraying from his mouth, head turning side to side, face bright red, tongue very red, and pulse extremely flooding. Shocked. Opening eyelids, the whites looked like pig blood, clearly indicating drunkenness causing reckless blood movement. Ordered to buy 5 qian of Ge Hua (Puerariae Flos); if unavailable, buy 1 liang of Ge Gen (Puerariae Radix), soak in warm water until soft, crush with a bundle of Lu Gen (Reed Rhizome), and apply to the chest. Externally, use fresh well water to rinse hair (the person fortunately had long hair of 6 cun), hold a bowl of water, let hair drip into the bowl (do not pour water on head), until he stops shaking his head. Simultaneously, take 5 qian of Hua Rui Shi (Spinel Powder), decoct in water with Tong Bian (Child's Urine) to drink. About ten minutes after application, the patient touched the applied area, and eyes opened. Soon, loud sounds in the abdomen, patient touched abdomen. Mouth contained blood-water mixture, occasional sighing. Instructed to sleep on a bamboo bed, avoid disturbance, and temporarily refrain from random eating. At 3 AM that night, profuse sweating. Next morning, able to speak. Changed to Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction) with one piece of Zao Xin Tu (Kitchen Hearth Earth). Two doses showed great effect. Instructed to stop medication, continue feeding mung bean porridge three times daily, avoid random eating. If hungry, use lean meat soup, drink soup only, not meat, to nourish the Stomach. Only after Stomach Heat clears and Stomach Fluids replenish can solid food be eaten. Following this method, full recovery.
(58) Epistaxis (Nosebleed)
Male, 30 years old.
Family often used wine instead of tea, or even as a meal. One day, after getting drunk and full, he slept all day in the shade of bamboo. Subsequently, he suffered from prolonged nosebleeds until fainting, unconscious, unable to turn. Brought to my house, it was afternoon, time ran out for checking medicines. Urgently decocted 1 jin of Jiu Cai (Garlic Chives) in water. Took one egg, cracked shell, beaten 100 times, removed chives, boiled the egg in this juice. When the egg moved in the soup, removed it (not too cooked), pried open his mouth, and forced the egg and soup down. After about 20 minutes, bleeding decreased. His father wanted another one. I thought hot food was unsuitable for stopping bleeding. Urgently took a piece of Zao Xin Tu (Kitchen Hearth Earth), stirred in fresh well water until cloudy then clarified, and drank cold. Within an hour, nosebleed stopped completely, and consciousness gradually returned.
Next day, pulse was flooding and rapid, blisters on tongue, indicating Heat forcing blood. Prescribed:
Xi Jiao (Rhinocerotis Cornu) 2 qian, Sheng Di (Rehmanniae Radix) 3 qian, Dan Pi (Moutan Cortex) 2 qian. Tong Bian (Child's Urine) as guide.
His father insisted on giving Yang Shen (American Ginseng). I thought it unsuitable. He believed his son was weak and must take it. Used 2 qian Yang Shen, 2 qian Mai Dong (Ophiopogonis Radix), 1 qian Wu Wei Zi (Schisandrae Chinensis Fructus) decocted together. This was a household remedy for summer heat. I had no choice but to insist on adding Tong Bian and Zao Xin Tu. After taking, symptoms seemed neither reduced nor unchanged. Patient always felt chest stiffness, indicating unexpelled blood stasis; American Ginseng must have caused error.
Next day, father came, saying the patient was sallow all over, dizzy, and acting like a madman. I ordered him brought for diagnosis. Sallow complexion, unable to sit, dizzy, laughing wildly, pulse flooding, eyes completely yellow. Diagnosed blood stasis, administered Tao He Cheng Qi Tang (Peach Kernel and Saltpeter Decoction).
After two doses, wild laughter stopped, but yellow color did not recede; eyes turned dark yellow, glaring at people. Changed to Long Dan Xie Gan Tang (Gentian Liver-Draining Decoction). Two doses, condition suddenly reduced. However, no appetite for half a month, bitter taste in mouth, irritability at night. Considered Dryness in the Blood level. Prescribed Pig Fat and Hair Decoction (Zhi Gao Fa Jian), one spoon daily mixed with ash-free wine, until one dose finished. Then cured.
I believe treating blood disorders requires attention to post-hemorrhagic stasis and avoiding excessive cold-cooling herbs. Xi Jiao Di Huang Tang and American Ginseng were perhaps introduced too early; this should be a lesson. After blood disorders, removing stasis and clearing heat, draining excess rather than tonifying deficiency, is a major understanding in treating blood diseases.
Male, 25 years old.
Suffered from Jaundice. One day, prolonged nosebleed, fainted, unconscious. Family panicked, cried all night. Summoned me at dawn. Pulse rapid and forceful, Guan position deep and hidden. Knew there must be a trigger causing continuous bleeding. But why unconscious? Suspected. Cold sweat on forehead, red tongue edges with yellow center, scorched lips, unclear pupils. Must be Blood Heat causing reckless movement, stirring Kidney Qi, hence forehead sweat and unclear pupils. Treating the acute symptom first, used Si Sheng Yin (Four Raw Drinks) to stop bleeding.
Sheng Ai Ye (Fresh Mugwort Leaf), Sheng Bai Ye (Fresh Biota Leaf), Sheng He Ye (Fresh Lotus Leaf), Xian Sheng Di (Fresh Rehmanniae Radix), any amount (no fresh Rehmannia available, used dried instead). Crushed into juice, taken cold. Within 20 minutes, eyes opened, head stopped spinning, nosebleed slowed, but chest palpitation observed. By afternoon, patient could sit up, only small amount of bloody water and yellow nasal discharge. Diagnosed Lung Heat gradually subsiding. That night, took Zao Xin Tu (Kitchen Hearth Earth), stirred in fresh well water, clarified, strained, mixed with Tong Bian (Child's Urine) and drank. Nosebleed stopped completely. Another two doses of Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction) resulted in full recovery.
(59) Aphonia (Loss of Voice)
Male, 27 years old.
Accompanied wife and concubines daily, engaging in sexual activity. Body obese, usually no cough. One day, sudden hoarseness leading to aphonia. Face lacked luster, tongue had little white turbidity, slightly dry. Pulse deep to the bone, hard to distinguish degrees. Based on these, it was not cough-induced aphonia or Duck Public Tuberculosis, but excessive sexual fatigue, Kidney Meridian dysfunction, failing to steam Lung Qi upward, causing voice closure. Prescribed:
He Zi (Terminalia Chebulae Fructus) 3 qian, Shu Di Tan (Charred Prepared Rehmanniae Radix) 4 qian, Yi Zhi Ren (Alpiniae Oxyphyllae Fructus) 2 qian, Nv Zhen Zi (Ligustri Lucidi Fructus) 2 qian, Yuan Zhi (Polygalae Radix) 2 qian, Ling Ci Shi (Magnetite) 2 qian, Shan Mu Jie (Chinese Fir Branch Node) 7 pieces, decocted in water. Additionally, a small piece of aged Shan Mu (Chinese Fir), burned until embers extinguished, stewed in water for 10 minutes, poured into a bowl. Do not extinguish the ember, take hot with the previous medicine. Four doses. I used He Zi and Shu Di Tan to clear Fire, remove coagulation, eliminate grease, specifically resolving Kidney Heat. Instructed separate sleeping quarters until cure. After four doses, sometimes throat itched, one big cough expelled a blood clot, feeling comfortable. Changed formula:
He Zi (Terminalia Chebulae Fructus) 4 qian, Yi Zhi Ren (Alpiniae Oxyphyllae Fructus) 3 qian, Shu Di Tan (Charred Prepared Rehmanniae Radix) 8 qian, Yuan Zhi (Polygalae Radix) 3 qian, Jiu Jie Chang Pu (Acori Tatarinowii Rhizoma) 3 qian, Nv Zhen Zi (Ligustri Lucidi Fructus) 3 qian, Ban Lan Gen (Isatidis Radix) 2 qian, Dang Gui (Angelicae Sinensis Radix) 2 qian, Lian Zi Xin (Nelumbinis Plumula) 2 qian, Bai Zi Ren (Biota Seed) 2 qian, Shan Mu Jie (Chinese Fir Branch Node) 7 pieces.
Ten doses in total, condition disappeared. Finally explained not to recklessly administer tonics.
Male, 42 years old.
Aphonia for over a year. Asked for history, wrote: Onset after autumn, slight cough, insomnia at night, progressing to aphonia, no other symptoms.
Six positions of pulse floating, rapid, and uncertain. Knew exterior pathogen not penetrated, internal latent pathogen causing harm. Prescribed:
He Zi (Terminalia Chebulae Fructus) 2 qian, Su Zi (Perillae Fructus) 2 qian, Xing Ren (Armeniacae Semen Amarum) 20 grains, Tong Cao (Tetrapanacis Medulla) 2 qian, decocted in water, mixed with heated wine, ten doses. Also planned:
Lard 4 liang, refined and strained, add 4 liang rice sugar, melt, then add 4 liang blood honey (dark honey), boil until threads form. Store in porcelain bowl. One spoon daily with boiling water. Cure after finishing.
II. Surgery
(1) Lacquer Dermatitis
Male, 20 years old.
About to get married, suddenly developed red, swollen, shiny skin with spots. One doctor diagnosed as Smallpox, used ascending/dispersing drugs, no effect. Another surgeon diagnosed as Carbuncle Toxin, took Jing Fang Bai Du San (Schizonepeta and Saposhnikovia Decoction to Overcome Toxicity), also ineffective.
I saw his face bright red, only upper body red and swollen, itchy and distended, but scratching aggravated the itch. Pulse floating and rapid, Guan deep and rapid, boundaries unclear. Suspected. It was dusk, decided to prescribe next day. That night, the patient let me stay in his original room (to be the new bridal chamber). Entering, I saw furniture covered in bright lacquer, strong pungent lacquer odor unbearable. Considering he lived here, matching symptoms with strong lacquer odor, and previous treatments, I suspected Lacquer Dermatitis.
Next morning, ordered fresh domestic Perilla leaves, decocted for bathing, and applied Garlic Chive juice to nostrils. After bathing, patient said much better, nose bled watery blood but no fever. By afternoon, redness and swelling completely subsided.
(2) Large Abscess on Neck