痫症种类虽多。然其源总属手厥阴心包络火病也。大概宜以清心散主之。但要久服则有效耳。
（此症丹溪断为痰火。的是千古灼见。）
清心散
青黛 僵蚕 生地 木通 黄连 辰砂 琥珀（另研）
白芍 赤芍
四明治验方（予每用此及后东庄方治痫。辄验。故附存之。）
当归 生地 丹皮 青黛 黄连 羚羊角 陈皮
半夏 南星
上为末。作丸。辰砂为衣。空心白滚汤下。曾治二人甚效。
东庄治验方
桃仁（一两去油研如霜） 朱砂（五钱） 川连（一两） 礞石（稍 金色为度钱半）
芦荟（五钱） 沉香（钱半） 寒水石 生黄芩 大黄（以上二两）
上用姜汁一茶杯。将大黄切片浸透。于炭火上焙干。再浸再焙。以收尽姜汁为度。各研成末。
水法为丸。淡姜汤临卧时每服二钱。
庚子六月。同晦木过语溪访吕用晦。适用晦病热症。造榻前与之语。察其神气。内伤症也。
予因询其致病之由。曰。偶夜半。从卧室中出庭外与人语。移时就寝。次日便不爽快。渐次发热。
饮食俱废。不更衣者数日矣。服药以来。百无一效。将何以处之。予曰。粗工皆以为风露所逼。故
重用辛散。不进饮食。便曰停食。妄用消导。孰知邪之所凑。其气必虚。若投以补中益气汤。则
汗至而便通。热自退矣。用晦欣然。辄命取药。立煎饮之。旁观者。皆以热甚。又兼饱闷。遽投
补药必致祸。予慰之曰。无容惊扰。即便矣。顷之索器。下燥矢数十块。觉胸膈通泰。旁观者始
贺。是晚熟寐至五鼓。热退进粥。用晦曰。不谓君学问如此之深也。不然几败矣。连服补中益气
数剂。神情如旧。逾日而别。景岳云。医家不贵于能愈病。而贵于能愈难病。病家不贵于能延医
。而贵于能延真医。如此症若非东庄笃信不疑。一为旁观所阻。则必误于粗工矣。无如病家之能
延真医者。不易多得。遂使医家之能愈
难病者。亦不易多觏。则且奈之何哉。为之一慨。
七月初一日。用晦以室人病相邀。同黄晦木至语溪。用晦言室人病可缓治。业师徐五宜先生
之长君。伤寒危甚。须即往。子为我救之。我已致之业师矣。顷之有人来言。病者晚来狂叫。晕
去五六次。早起一晕竟绝。医不必往也。用晦为之痛惜。予问病来几日。云九日矣。予又问胸尚
热否。曰胸但不冷耳。予语用晦曰。可救也。急趋用晦同晦木往视之。至则僵尸在床。口鼻无气
。面色青黯。口噤。目闭。手撒。独唇色紫黑。予笑谓晦木曰。此人不死。阴虚症。误服白虎所
致耳。切其脉。两尺尚在。时旁观者皆笑予妄。遂取人参一两。熟地二两。炮姜五钱。浓煎汤。
挖而灌之。尽剂。口开面色转红。不及一时。大叫冷甚。连以热汤饮之。即发壮热。通身淋漓汗
下而苏矣。此晚腹胀不便。予曰。无忧也。大汗之后。虚不能出耳。再饮药一钟即得解。次曰。
其尊人五宜先生来曰，诸病悉除。但多妄言怒骂。如有鬼神驱之者。先生将何以教之。予为之调
治数日不得间。因就宿其家。至夜半诊其脉曰。虚至此乎。复以大剂附子理中建中投之。数日而
愈。病热至九日。则其舌必黑。而脉之洪数无伦可知。斯时即以大剂参地养其阴。何至阳无所附
。而狂叫晕绝哉。犹幸胸尚不冷。则知阳分未尽。尚得起死回生耳。彼始焉。杂用风燥以亡其阴
。继焉。纵加霜雪以亡其阳。遂使虽有明哲。亦只袖手以视。而莫可施其回挽者。盖不知其几也
。有活人之心者。尚其于
此等案中。细加参究。将自不致有操刀之患矣。
（谦按。阴虚之阴字。当作寒字看。乃阴中之阳虚。实元气不足也。非丹溪谓阳常有余阴
常不足阴道常虚之阴虚。用知柏龟板鳖甲之症也。今之人解阴中之阳虚症。往往混入阴中之阴虚
者。祸如反掌耳。胃液告匮。久病神魂离散。即见此。状。与阳明实狂燥矢谵妄者。天渊之判。
不可不知。）用晦室人。患产后惊悸。初起时。见筐中绵絮。念将所生儿入绵絮中。不几闷死。
即作惊恐忧患之状。后凡有所触。意中以为不耐。即忧患不止。或一端执想。数日才已。饮食不
进。面少精采。服诸补心养血药无一效。至是用晦招予治之。予诊其脉曰。孩时得毋因齿病致大
惊否。用晦向室人问之。曰。十岁时果曾病齿。治齿者用刀钳之。几受惊而死。子何以能识之也
。解曰。脉法当如是耳。不精于象数钤法之学人不能也。少时以惊受损。伤其君火。心包气散。
痰得留之。今产后大虚。痰因虚动。病端见矣。夫心为君主。主明则下安。国乃大昌。故凡七情
皆由心起。今心气虚甚。痰邪侵扰。思虑亦因之多变。况喜乐气之阳也。忧患惊恐。气之阴也。
阳虚则阴得乘之。又儿为其所爱。气虚痰入。则爱不得其正。因爱而过为防护之。惟恐不至。遂
因而生忧耳。今先用归脾养荣八味等类五十大剂。待其气血完备。然后攻之。痰可得而去。而病
不再发矣。用晦如予言治之。果愈。惊则气散。受惊而曰因齿者。肾主骨。齿乃骨余。其尺脉必
沉而散。以是欢四明脉法之精者。犹浅于窥
四明者也。难其于因齿受惊因惊致损痰因虚动心由痰扰处。溯流穷源。晰辨无不精尽。先补后攻
。治验更极神奇。医道中乃让此公出一头地耳。
新安程结先子病疟。每日至辰时大寒。午时大热。热即厥。两目直视。不能出声。颏脱。涎水从
口角涌出不止。日流数升。至丑时始汗解。饮食不进。昏冒几绝。予往视之。皆诛伐太过所致也
。投以补脾之药。不即效。延他医调治。用柴胡防风南星半夏等药。病势转剧。其家复延予治之
。值医者在。予请曰。此何证也。而用前药。曰。子不识乎。此肝疟也。肝疟令人色苍苍然太息
。其状若死。予笑曰。据子述经言。当得通脉四逆矣。何用前药。予诚不识此何病。但知虚甚耳
。请先救人后治病。何如。曰。子用何药。予曰。大剂参附。庶可挽回。医力争参附不便。予漫
应曰。谨奉教。医始洋洋色喜而别。是夜用人参一两。黄 二两。炮姜三钱。比晓。熟地桂附并
进。次日辰时。病不复发矣。此缘劳役过度。寒热往来。医认为疟。且时当秋令。一味发散寒
凉。重虚其虚。展转相因。肝脾大败。非峻补气血。何由得生。夫病由人生。人将死矣。而乃妄
牵经义。强合病患。及至处方。又乖成法。自误误人。至死不觉。悲夫。先救人后治病。以病由
人生也。然病固由人而生。而人实由病而死。则欲救人。不又当先治病乎。不知补正乃所以去邪
。救人即所以治病。原无彼此之分。四明见得此症只要峻补气血。速救肝脾。其病自
除。故云云。以见彼所治病之药之谬。而不可服耳。读者当会其意。勿泥其词可也。
（留人治病之法。非平时笃学。临症行权。不能起也。如见寒热烦躁。仍以寒热烦躁治之。
速之死耳。何以生为。正所谓拨乱反正。安危从此一举耳。余往往见此等症。皆前医见而却走
者。不得已用大剂参 附保元生脉理中。一昼夜尽一二斤药。挽回者不少矣。然胆大心小。
不在当时。而在平日也。故云附子三五枚。人参少半斤。参力若不济。前功必尽弃。平时无学力
。至此滋疑惧是也。）
吕坦人子。生甫数月。忽急惊风。抽搐直视。发热不乳。医以抱龙丸及羌活防风薄荷僵蚕等
作煎调服。坦人商于予。予曰。误矣。此脾士虚而肝木盛也。急用五味异功散。加煨姜进之。少
顷。熟睡微汗。热退而乳。用异功以实脾土之虚。加煨姜以制肝木之盛。其处方之严密。直与长
洲并驾。杭友沈侨如甥病伤寒。诊其脉浮数有力。舌黑。胸脯痛胀。此得之劳倦后复伤饮食。医
以寒凉消导攻之。火受遏抑。无所归也。急以大剂参术归 炮姜救之。戒其家人曰。夜半当发战
。战则汗而解矣。如战时。频频以粥与之。时予与黄晦木黄复仲吕用晦同卧天长寺。四鼓时。病
家急叩门曰。服后果寒甚索被。顷之大热昏沉而死矣。先生尚有法救之否。予曰。不足计也。汗
来矣。但战时曾进粥否。曰。实未也。予笑曰。吾语汝战时须与粥。正所以助胃气。使汗来速而
不至困乏耳。今亦不妨。子第归。此时当得汗矣。诸子皆为予疑。促予往视。至则汗解而 睡矣
。归语数子。为发一笑。心细如发。胆大于身。由其胸有灼见也。彼胸无灼见者。心小只见其畏
葸。胆大适成其孟浪。因循以致
祸。妄投而杀人。二者均失耳。以是知胆能大于用药之时者。必其心能小于临症之际。而心能小
于临症之际者。尤必其识能超于群医之上者也。
吴餐霞室人。患妊娠胃口 胀。不思饮食。口渴。下利。面少精采。医以消导寒凉与之。病
转甚而胎不安。予曰。此得于饮食后服凉水所致耳。投以大剂理中汤。数剂而愈。水能灭火。饮
食后服凉水。则伤胃中之阳可知。自宜救之理中。以养胃气。顾见病治病之医家。岂能窥寻及此
哉。见其胃口 胀不思饮食也。则有消导而已矣。见其口渴下利也。则有寒凉而已矣。岂知胃气
转伤。则病势转甚。而彼犹不知其故也。方且谓药本对症。而无如其病犯条款耳。呜呼。古今来
弄假成真。而求生得死者。十中宁有八九也。冤哉。
桐乡曹献 室人。十一月病疟。发则头重腰痛。寒从背起。顷之壮热烙手。汗出不止。予曰
。此太阳经疟也。用大青龙汤。献 曰。病来五六日。委顿甚矣。而病者禀素怯弱。又他医言有汗
要无汗。带补为主。今汗如此。而子复用此药。恐不能当。予笑曰。第服此。其病自除。当晚汗
犹未止。进一大剂即熟睡。次日不发。逾日以补中益气调理而痊。
既为太阳经疟。乃不用麻黄汤而用大青龙者。以症见壮热烙手。汗出不止也。即此见前辈用
方之谛。
一妇人产后恶露不尽。至六七日。鲜血奔注。发热口渴胁痛狂叫。饮食不进。或用四物汤调理。
或用山楂青皮延胡索黄芩等行血药。卒无一效。予至。见诸医议论纷纭。无一确实。细切其脉洪
大而数。予曰。此恶露未尽。留泊血海。凡新化之血。皆迷失故道。不去蓄利瘀。则以妄为常。
曷以御之。遂以醋制大黄一两。生地黄一两。桃仁泥五钱。干漆三钱。浓煎饮之。或曰。产后大
虚。药毋过峻否。予曰。生者自生。去者自去。何虚之有。第急饮之。果熟寐竟夜。次早下黑血
块数升。诸病如失矣。复用补中益气调理而安。前案以麻黄桂枝等止汗。此案以大黄桃仁等止血。
变化莫测。谁不惊奇。而不知其所辨亦止在症。所窥亦止在脉也。
石门吴弁玉。发热多汗便秘。数日不止。医曰。此停食伤寒也。不宜与食。待热退始可以稀
粥汤饮之。病势转甚。延予视之。予问曰。肚中饥否。曰饥。索其日所用药。则芩连枳壳花粉浓
朴之属。予笑曰。子但吃饭。病即除矣。无庸此等药也。病者喜甚。曰。吾本无食。医言有食。
故耐此数日饿耳。然便秘云何。予曰。致新即推陈矣。胃中久无谷气。故前物积而不下。且子之
发热多汗。一味虚症。遂用参术调补而痊。发热而且便秘。似非虚症。不宜遽投参术矣。然多汗不
止。则阳中之阳。其亏无疑。故以参术调补而痊也。伤寒心法云。不能便而能食者。仓廪盈溢。
自能通利。不便无忧。可见致新即推陈。实出至理。而所谓
吃饭病即除者。本非趣话也。
沈启廷孙甫三岁。脾虚发肿。两足更甚。乳食不思。午后发热。头面羸瘦。俗医云。此病如
用官料药。便成发黄鼓胀而死。但当服草头药。并以针挑其指。出黄水自愈。浙西人言出自医家
药笼中者。谓之官料药。俗传单方一二味。谓之草头药。妇女酷信此说。不读书者从而和之。往
往以此误事。决不为戒。启廷力排此说。延予调治。予曰。此脾虚也。非参术不能收功。病已发
黄鼓胀将死矣。草头药何以治之。且官料药。皆草根树皮也。何出自医家。便为官料。启廷信而
服之。渐有回色。未几又发泻。又头上生毒。烂至见骨。又出 。皆极重。病缠绵不休。予一味
补正。他病见则随症稍加减之。如是者自夏迄冬尽。用参几斤余。才得脱体。次年始长肌肉。设惑
于众论。能有救否发肿而两足尤甚者，脾虚下陷也。乳食不思者。属阳明胃土受病。盖脾运则阳
明之气上达而胃开。今中州失运。则阳明之气亦不能上达也。补正者补中益气。盖虚者实之。下
者举之也。夫重症蜂起。冬夏迁延。而能徐收全效。固非有定见者不能。而知人善任。如彼其专
且久。而不为庸俗所迷。则沈启廷也者。亦岂易得耶。至于官料草头之说。直捷爽快。尤足破迷
正讹。石门镇朱殿臣。病痢。日逾百余次。身发热。饮食不进。殿臣以平日所用药示予。率皆槟
榔大黄之属。予曰。
此破气利血药也。治滞下当调气。不当破气。当和血。不当利血。以生地当归白芍黄芩木香等数
大剂饮之。三日而愈。
当调气不当破气。当和血不当利血二语。是治痢家千古不易之则。临是症者。当援以为鹄也。
Epilepsy (Xian Zheng) encompasses various types, but its root source generally belongs to Fire Disease of the Pericardium Meridian of Hand-Jueyin (Shou Jueyin Xinbaoluo Huo Bing). Generally, it is suitable to use Qingxin San (Clear Heart Powder) as the principal formula. However, long-term administration is required for effectiveness.
(This condition was diagnosed by Zhu Danxi as Phlegm-Fire, which is indeed a profound insight spanning millennia.)
Qingxin San (Clear Heart Powder)
Qingdai (Indigo Naturalis), Jiangcan (Bombyx Batryticatus), Shengdi (Rehmanniae Radix Preparata), Mutong (Akebiae Caulis), Huanglian (Coptidis Rhizoma), Chensha (Cinnabar), Hupo (Amber - separately ground)
Baishao (Paeoniae Radix Alba), Chishao (Paeoniae Radix Rubra)
Siming Verified Formula (I often use this formula and the subsequent Dongzhuang Formula to treat epilepsy, with frequent success, so I record them here for reference.)
Danggui (Angelicae Sinensis Radix), Shengdi (Rehmanniae Radix Preparata), Danpi (Moutan Cortex), Qingdai (Indigo Naturalis), Huanglian (Coptidis Rhizoma), Lingyangjiao (Saigae Tataricae Cornu), Chenpi (Citri Reticulatae Pericarpium)
Banxia (Pinelliae Rhizoma), Nanxing (Arisaematis Cum Bile)
Grind the above herbs into powder, form pills, coat with Chensha (Cinnabar). Take on an empty stomach with warm boiled water. It was effective in treating two cases.
Dongzhuang Verified Formula
Taoren (Persicae Semen - one liang, remove oil and grind like frost), Zhusha (Cinnabar - five qian), Chuanlian (Coptidis Rhizoma - one liang), Mengshi (Calamina - calcined until slightly golden, 1.5 qian)
Luhui (Aloe - five qian), Chenxiang (Aquilaria Lignum - 1.5 qian), Hanshuishi (Calcitum), Sheng Huangqin (Scutellariae Radix raw), Dahuang (Rhei Radix et Rhizoma - both two liang)
Take one teacup of Ginger Juice (Jiangzhi). Slice Dahuang, soak thoroughly, then dry over charcoal fire. Repeat soaking and drying until all ginger juice is absorbed. Grind each herb into powder separately.
Form pills using water method. Take two qian before bed with light ginger soup.
In the sixth month of Gengzi year, together with Huimu, I visited Lü Yonghui at Yu Xi. At that time, Yonghui was suffering from a Heat Syndrome. I went to his bedside to converse with him and observed his spirit and qi, diagnosing it as an Internal Injury Syndrome.
I asked about the cause of his illness. He said, "Accidentally, in the middle of the night, I walked out of the bedroom to the courtyard to talk with someone, and went to bed shortly after. The next day, I felt unwell, and gradually developed fever."
He had lost his appetite and had not had a bowel movement for several days. Since taking medicine, none of it had been effective. What should be done? I said, "Mediocre physicians usually attribute this to invasion by wind and dew, thus heavily using acrid-dispersing herbs; when food intake stops, they assume food stagnation and recklessly use digestion-promoting herbs. Who knows that where evil gathers, qi must be deficient. If administered Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction), sweat will occur, bowels will move, and heat will subside naturally." Yonghui agreed happily and immediately ordered the medicine to be taken. It was decocted and drunk instantly. Onlookers thought that given the severe heat and fullness, suddenly administering tonifying medicine would surely bring disaster. I comforted them, saying, "Do not be alarmed." Soon, he requested a chamber pot and passed dozens of hard stool pieces, feeling a sense of openness and comfort in the chest and diaphragm. The onlookers then congratulated him. That night, he slept soundly until wu geng (3-5 AM), the heat subsided, and he took porridge. Yonghui said, "I did not expect your scholarship to be so profound. Otherwise, we would have nearly failed." After taking several doses of Buzhong Yiqi Tang, his spirit and demeanor returned to normal, and we parted the next day. Zhang Jingyue said: A physician's value lies not in curing ordinary diseases but in curing difficult ones; a patient's value lies not in merely seeking a doctor but in seeking a true physician. For such a case, if Dongzhuang had not trusted without doubt, and had been hindered by onlookers, he would certainly have been misled by mediocre physicians. Unfortunately, patients who can seek true physicians are rare, making it difficult to find physicians who can cure difficult diseases. What can be done? I sigh at this.
On the first day of the seventh month, Lü Yonghui invited me because his wife was ill. Together with Huang Huimu, I went to Yu Xi. Yonghui said his wife's illness could wait, but his former teacher Mr. Xu Wuyi's eldest son had critical Shanghan (Cold Damage) and needed immediate help. Please go save him; I have already informed my former teacher. Shortly after, someone came to say the patient screamed wildly at night, fainted five or six times, and upon waking, fainted again and seemed to have died. The physician need not go. Yonghui lamented this deeply. I asked how many days the illness had lasted, and he replied nine days. I asked again if the chest was still hot, and he said the chest was merely not cold. I told Yonghui, "It can be saved." Urgently, Yonghui and Huimu went to examine. Upon arrival, the patient lay like a corpse, with no breath at mouth and nose, cyanotic-dark complexion, locked jaw, closed eyes, and relaxed hands (note: text says 'hand scatter', implying flaccidity, though context suggests critical state), only the lips were purple-black. I smiled and said to Huimu, "This person will not die. This is a Yin Deficiency syndrome caused by misusing Baihu Tang (White Tiger Decoction)." Palpating the pulse, the two Chi (Kidney) pulses were still present. Onlookers laughed at my absurdity. So, I took one liang of Renshen (Ginseng Radix et Rhizoma), two liang of Shudi (Rehmanniae Radix Preparata), and five qian of Paojiang (Zingiberis Rhizoma Preparata), decocted thickly, pried open the mouth, and灌 (administered) it. After finishing the dose, the mouth opened, complexion turned red. In less than an hour, he screamed loudly, feeling extremely cold. We continuously gave hot soup. Immediately, he developed high fever, sweated profusely all over, and regained consciousness. That night, he had abdominal distension and constipation. I said, "Do not worry. After heavy sweating, deficiency prevents expulsion." Drink another cup of medicine, and he will pass stool. The next day, his father Mr. Wuyi came and said all illnesses were gone, but he spoke nonsense and cursed angrily, as if possessed by ghosts. How should we treat him? I treated him for several days without respite, so I stayed at his home. At midnight, palpating the pulse, I said, "Deficient to this extent?" Again, I administered a large dose of Fuzi Lizhong Jianzhong Tang (Aconite Regulate Middle and Establish Middle Decoction). He recovered in several days. By the ninth day of fever, the tongue must be black, and the pulse洪数 (surging and rapid) beyond measure is evident. At this time, even with large doses of Shen-Di (Ginseng-Rehmannia) to nourish Yin, how could Yang have no attachment, leading to wild screaming and fainting? Fortunately, the chest was not cold, indicating Yang was not exhausted, allowing revival from death. Initially, miscellaneous wind-drying drugs consumed Yin; subsequently, frost-and-snow-like cold drugs consumed Yang. Thus, even wise physicians could only stand by helpless. Those with a heart to save people should carefully study such cases to avoid the danger of wielding the knife improperly.
(Qian notes: The character 'Yin' in Yin Deficiency should be read as 'Cold'. It is Yang Deficiency within Yin, actually Yuanqi (Primal Qi) insufficiency. It is not the Yin Deficiency described by Danxi as 'Yang often surplus, Yin often deficient', nor the syndrome treated with Zhibai Guiban Biejia (Anemarrhenae-Rhizoma, Anemarrhenae-Cortex, Tortoise Plastron, Softshell Turtle Carapace). People today often confuse Yin Deficiency of Yang within Yin with Yin Deficiency of Yin within Yin, causing disaster instantly. When Stomach fluids are depleted and soul/spirit scatter due to chronic illness, this state appears. It is worlds apart from Yangming Excess mania, dry stool, and delirium. One must know this.)
Lü Yonghui's wife suffered from postpartum fright palpitations. Initially, seeing cotton wadding in a basket, she imagined putting her newborn into it, fearing it would suffocate, and displayed signs of fright and anxiety. Later, any trigger made her feel intolerable, leading to continuous anxiety. She would fixate on one thought for days. She ate nothing, lacked luster in her face, and all heart-nourishing and blood-tonifying medicines failed. Yonghui summoned me. I palpated her pulse and asked, "Did you suffer a great fright due to dental disease in childhood?" Yonghui asked his wife, who replied, "At ten years old, I indeed had a toothache. The dentist used pliers, nearly killing me with fright. How did you know?" I explained, "The pulse method dictates this. Only those proficient in Xiangshu Qianfa (Image-Number Divination Methods) can discern this." Childhood fright damaged Junhuo (Monarch Fire), dispersing Xinbao (Pericardium) qi, allowing phlegm to remain. Now, postpartum severe deficiency causes phlegm to move due to deficiency, revealing the disease onset. The Heart is the Monarch; if clear, the lower parts are peaceful, and the nation prospers. Thus, all Seven Emotions arise from the Heart. Now, Heart qi is severely deficient, phlegm-evil invades, and thoughts become variable. Joy and happiness are Yang of qi; worry and fright are Yin of qi. Yang deficiency allows Yin to invade. Because the child is loved, qi deficiency and phlegm intrusion distort proper love, leading to excessive protection and worry. First, administer fifty doses of Guipi Yangrong Bawei (Restore the Spleen Nourish Ying Eight Substances) type formulas. Wait for qi and blood to complete, then attack. Phlegm can be removed, and the disease will not recur. Yonghui followed my advice, and she recovered. Fright scatters qi. The connection to teeth is because Kidneys govern bones, and teeth are the surplus of bones; Chi pulse must be deep and scattered. This praises the precision of Siming's pulse methods. Tracing the source from tooth-fright to damage, phlegm-movement, and Heart-disturbance, his analysis was precise. Tonifying first, then attacking, the treatment was miraculous. This gentleman stands head and shoulders above others in medicine.
Cheng Jiexian's son from Xin'an suffered from Malaria. Every day at Chen hour (7-9 AM), severe chills; at Wu hour (11 AM-1 PM), severe heat. Heat led to syncope, eyes staring straight, inability to speak, chin dropping, saliva flowing endlessly from the mouth corner, liters per day. Relief with sweat at Chou hour (1-3 AM). No food intake, coma nearly fatal. I examined and attributed it to excessive purgation/attack. Prescribed spleen-tonifying medicine, no immediate effect. Other doctors used Chaihu (Bupleuri Radix), Fangfeng (Saposhnikoviae Radix), Nanxing, Banxia. Condition worsened. Family summoned me again. The other doctor was present. I asked, "What syndrome is this, yet you use previous medicines?" He said, "Don't you know? This is Liver Malaria. Liver malaria makes one look pale and sigh, appearing dead." I laughed, "According to your citation of classics, Tongmai Sini Tang (Unblock Pulse Four Reversals Decoction) should be used. Why previous medicines? I don't recognize this disease, only knowing extreme deficiency. Let's save life first, treat disease later, okay?" He asked, "What medicine?" I said, "Large dose Renshen and Fuzi (Aconiti Lateralis Radix Preparata), perhaps salvageable." The doctor argued against Renshen/Fuzi. I casually agreed and left. That night, I used one liang Renshen, two liang Huangqi (Astragali Radix), three qian Paojiang. By dawn, added Shudi, Guizhi (Cinnamomi Ramulus), and Fuzi. Next day at Chen hour, no recurrence. This was due to overwork, alternating chills and fever. Doctors mistook it for malaria. In autumn, using only dispersing/cold herbs further depleted deficiency, damaging Liver and Spleen. Without severe tonification of qi and blood, survival was impossible. Disease arises from human error. People die, yet doctors force classical theories onto patients and violate standard prescriptions. Self-deception and deceiving others, unaware until death. Sad! Saving life first treats disease because disease arises from human error. But since disease kills, saving life requires treating disease. Tonifying upright qi removes evil; saving life is treating disease. There is no distinction. Siming saw that severe tonification of qi and blood, rapidly saving Liver and Spleen, would cure the disease. Thus, he criticized the previous wrong medicines. Readers should grasp the intent, not stick to words.
(Method of preserving life to treat disease requires daily study and flexibility in practice. Treating chills/fever/agitation with chills/fever drugs accelerates death. This is correcting chaos. I often see such cases rejected by previous doctors. Using large doses of Renshen, Fuzi, Baoyuan, Shengmai, Lizhong, consuming one or two jin in a day, has saved many. But courage must be paired with caution, rooted in daily learning. As stated: 3-5 Fuzi, half a jin Renshen. If Renshen power fails, all effort is wasted. Lack of daily study breeds fear at critical moments.)
Lü Tanren's son, months old, suddenly had acute convulsive wind (Jing Feng), convulsions, staring, fever, refusing milk. Doctor used Baolong Wan and Qianghuo, Fangfeng, Bohe, Jiangcan decoction. Tanren consulted me. I said, "Wrong. This is Spleen Earth deficiency and Liver Wood excess. Urgently use Wuwei Yigong San (Five Agents Benefit Society Powder) with roasted ginger. Soon, he slept, sweated slightly, heat subsided, and nursed. Yigong San strengthens Spleen Earth; roasted ginger controls Liver Wood. His prescription precision rivals Changzhou (Ye Tianshi)."
Hangzhou friend Shen Qiaoru's nephew had Shanghan. Pulse floating, rapid, forceful; black tongue; chest pain/distension. Caused by fatigue and dietary injury. Doctors used cold/digestive attacks, suppressing fire, leaving it无处 (nowhere) to go. Urgently used large dose Renshen, Baizhu (Atractylodis Macrocephalae Rhizoma), Danggui, Huangqi, Paojiang. Warned family: "Midnight shivering will occur; sweating will resolve it. Feed porridge frequently during shivering." I was staying at Tianchang Temple with Huang Huimu, Huang Fuzhong, Lü Yonghui. At fourth watch, family knocked urgently: "After medicine, severe cold, wanted blankets. Then high fever, coma, died. Any method?" I said, "Not worth calculating. Sweat is coming. Did he eat porridge during shivering?" "No." I laughed, "I said feed porridge to boost Stomach qi for swift sweat without exhaustion. It's fine now. Go back, he will sweat." Everyone doubted me, urged visit. Arrived, he was sweating and sleeping. Returned, told friends, a joke. Mind detailed as hair, courage larger than body, due to clear insight. Those without insight are timid yet reckless, delaying leads to disaster, random prescribing kills. Both fail. Knowing one who dares in prescribing must be cautious in diagnosis, and cautious diagnosis requires superior insight.
Wu Canxia's wife, pregnant, epigastric distension, anorexia, thirst, diarrhea, lackluster face. Doctors used digestive/cold herbs, worsening condition and endangering fetus. I said, "Caused by drinking cold water after meals." Prescribed large dose Lizhong Tang (Regulate Middle Decoction). Recovered in several doses. Water extinguishes fire; cold water after meals damages Stomach Yang. Lizhong restores Stomach qi. Doctors treating symptoms miss this. Distension/anorexia -> digestives; thirst/diarrhea -> colds. They don't realize Stomach qi damage worsens disease, thinking medicine matches symptoms while disease violates rules. Alas, many seek life but get death. Unjust.
Tongxiang Cao Xianzhai's wife, November malaria. Head heaviness, waist pain, cold starting from back, then high heat burning hands, endless sweating. I said, "Taiyang Meridian Malaria." Used Daqinglong Tang (Major Green Dragon Decoction). Xianzhai said, "Ill for 5-6 days, very weak, constitution frail. Others said induce sweat with tonics. Now sweating much, dare not use this." I laughed, "Just take it, disease will leave." That night sweat continued, took large dose, slept soundly. Next day no recurrence, recovered with Buzhong Yiqi Tang.
Since Taiyang Malaria, why Daqinglong instead of Mahuang Tang? Because of high heat and endless sweat. Shows predecessors' precise formula use.
A woman, postpartum lochia incomplete. Day 6-7, fresh blood gushing, fever, thirst, hypochondriac pain, screaming, anorexia. Siwu Tang or Shan Zha, Qingpi, Yanhusuo, Huangqin failed. I found doctors arguing. Pulse洪大 (surging-large) and rapid. I said, "Lochia incomplete, pooling in Blood Sea. New blood loses its path. Must remove stasis, otherwise abnormal becomes normal. How to defend?" Used Vine-processed Dahuang one liang, Shengdi one liang, Taoren paste five qian, Ganqi (Drynariae Rhizoma / or possibly Kansui root depending on interpretation, but likely Ganqi as in *Fufang* contexts often implies specific processing, here likely *Ganqi* resin or similar strong breaker, text says 'Ganqi' which can mean Drynaria or Resin. Given 'strong breaker', likely Resin/Ganqi 干漆). Decocted thick. Someone said, "Postpartum deficiency, too harsh?" I said, "Living stays, dead goes. What deficiency? Drink quickly." Slept all night. Next morning passed liters of black blood clots, symptoms vanished. Recovered with Buzhong Yiqi Tang. Previous case stopped sweat with Mahuang/Guizhi; this case stopped bleeding with Dahuang/Taoren. Unpredictable changes. Differentiation based on symptoms and pulse.
Shimen Wu Bianyu, fever, heavy sweat, constipation for days. Doctor said, "Food stagnation Shanghan. No food, wait for heat to subside for porridge." Condition worsened. I asked, "Hungry?" "Yes." Checked meds: Huangqin, Huanglian, Zhike, Huafen, Houpo. I laughed, "Eat rice, disease cures. No need for these drugs." Patient happy, "I had no food, doctor said yes, so starved. Constipation?" I said, "New generates, old eliminates. Stomach lacks grain qi, so accumulation doesn't move. Fever/sweat is pure deficiency." Used Renshen/Baizhu tonification. Recovered. Fever/constipation seems excess, but heavy sweat indicates Yang deficiency. *Shanghan Xinfa*: "Can't stool but can eat, granary full, self-regulates. No worry." Eating cures disease is not a joke.
Shen Qiting's grandson, 3 years old, Spleen deficiency edema, worse in legs, anorexia, afternoon fever, emaciated head/face. Folk doctors said: "Official medicine causes jaundice/tympanites death. Use herbal grass remedies, needle prick fingers for yellow water." Zhejiang calls pharmacy drugs 'official', folk single herbs 'grass'. Women believe, non-readers agree, causing errors. Qiting rejected this, summoned me. I said, "Spleen deficiency. Only Renshen/Baizhu works. Jaundice/tympanites imminent, how can grass work? Official medicine is just roots/bark, why bad?" Qiting believed, recovered color. Then diarrhea, head abscesses, pus, severe, lingering. I solely tonified upright qi, adjusted slightly for other symptoms. From summer to winter, used several jin of Renshen, finally recovered. Flesh grew next year. Confusion would have killed him. Edema/legs = Spleen sinking. Anorexia = Yangming Stomach affected. Spleen transport moves Yangming qi up. Central loss of transport blocks Yangming. Tonification uses Buzhong Yiqi (tonify middle, raise sagging). Severe cases, long duration, slow recovery requires firm view. Qiting's trust was rare. Official vs Grass debate breaks confusion.
Shimen Town Zhu Dianchen, dysentery, >100 times/day, fever, anorexia. Showed previous meds: Binglang, Dahuang. I said, "Qi-breaking blood-draining drugs. Treat stagnation by regulating qi, not breaking; harmonizing blood, not draining." Used Shengdi, Danggui, Baishao, Huangqin, Muxiang. Recovered in 3 days.
"Regulate qi, don't break; harmonize blood, don't drain" is the eternal rule for dysentery. Use as target.