张 二十七岁 甲子三月十三日 脐右有积气，以故右脉沉细弦沉伏，阳微之极，浊阴
太甚
克之也。溯其初原从左胁注痛而起，其为肝着之咳无疑。此症不必治咳，但宣通肝之阴络，
久病在络故也。使浊阴得有出路，病可自已，所谓治病必求其本者也。如不识纲领而妄冀速
愈，必致剥削阳气殆尽而亡。
桂枝尖（三钱） 小茴香（三钱） 降香末（二钱） 桃仁（三钱） 川楝子（二钱） 青皮络（
二钱
）炒广皮（一钱） 归须（三钱） 乌药（三钱） 苏子霜（三钱） 旋复花（三钱，新绛纱包）
十九日 服通络药，已见小效，脉气大为回转，但右胁着席则咳甚，胁下支饮故也，议
于前方内去桃仁、川楝、小茴，加∶
生香附（三钱） 半夏（六钱） 杏仁（三钱） 肉桂（八分）
再服四帖。
二十三日 先痛后便而见血，议通阴络法。
苏子霜（三钱） 归须（二钱） 降香末（三钱） 桃仁（二钱） 两头尖（三钱） 丹皮（三钱）
藏红花（一钱） 半夏（五钱） 小茴香（三钱） 香附（二钱） 广木香（一钱） 广陈皮（一钱）
张 二十八岁 脐左 瘕，面黄，肢倦，食少，不能作文，看书亦不能久，宛如虚损
，与∶
化 回生丹。
缓通阴络法，每日空心服一丸，亦有早晚服一丸，时服之二年有余，计服化 回生丹六
百丸之多， 始化净，气体撤消，看书作文，始举进士。
吴 三十一岁 脐右结 ，径广五寸，睾如鹅卵大，以受重凉，又加暴怒而得，痛不可
忍，
不能立，不能坐，并不能卧，服辛香流气饮，三日服五帖，重加附子、肉桂，至五七钱之多
，丝毫无效，因服天台乌药散，初服二钱，满腹如火烧，
明知药至脐右患处，如搏物然，痛加十倍，少时腹中起蓓蕾无数，凡一蓓蕾，
下浊气一次，如是者二三十次，腹中痛楚松快。少时痛又大作，服药如前，腹中热痛，起蓓
蕾，下浊气亦如前，但少轻耳。自巳初服药起，至亥正共服五次，每次轻一等。次一日腹微
痛，再服乌药散，则腹中不知热矣。以后每日服二三次，七日后肿痛全消。后以习射助阳而
体壮。
叶 四十五岁 乙酉四月二十八月 无论 瘕，虽有气血之分，然皆系阴病结于阴部，
岂有用阴药之理，维日已久沉寒痼冷疾，非巴豆不能除根。用∶
天台乌药散
六月初九日 业已见效，未能除根，照常服前药，早晚各五分， 瘕痛发时服二钱，舌
苔浓白，面色淡黄而暗，左脉沉细阳微，再与汤药行湿通阳。
云茯苓块（五钱） 益智仁（钱半） 萆 （四钱） 白蔻仁（一钱，连皮） 生苡仁（五钱）
半夏（五钱） 广陈皮（二钱） 桂枝（二钱） 白通草（一钱）
服至舌苔退为度。
甘 二十九岁 乙酉年五月初一日 十年瘕气，六脉弦细而紧。
淡吴萸（三钱） 乌药（三钱） 川椒炭（五钱） 归须（二钱） 良姜（二钱） 小茴香（五钱，炒
黑）
煮三杯，分三次服。已服五帖。
初九日 病减者减其制，每日服半帖。
王氏 四十岁 乙酉五月二十一日 六脉弦紧，心下伏梁，非易化之症。一生忧泣，肝
之郁也，又当燥金太乙天符之年，金来克木，痛愈甚矣。与温络法，其吐血亦络中寒也。
降香末（三钱） 川椒炭（二钱） 香附（三钱） 半夏（三钱） 枳实（三钱） 归须（三钱）
公丁香（八分） 广皮
服四帖。
二十五日 诸症皆效，自觉气上阻咽。加∶
旋复花（五钱）
二十九日 效不更方，再服。
六月初二日 加吴萸（三钱）
余氏 三十岁 乙酉五月二十四日 瘕结脐左，经来必痛，六脉沉细，阳微。
吴茱萸（三钱） 川楝子（三钱） 公丁香（一钱） 良姜（二钱） 全当归（三钱） 降香末（
三钱） 小茴香（三钱） 艾炭（三钱）
煮三杯，分三次服，服七帖后，接服丸药。
六月初二日 业已见效，每日服半帖，再服十天。
二十日 每行经前三日，腹微痛时，空心服化 回生丹一丸，服至经尽后，腹中丝毫不
痛为止。下月经行，腹痛发时，再如此服法。 瘕痛亦服回生，空心服一丸，化净为度。
车 五十五岁 须发已白大半，脐左坚大如盘，隐隐微痛，不大便十数日。先延外科治
之，
外科谓肠痈，以大承气下之，三四次终不通。延余诊视，按之坚冷如石，面色青黄，脉短涩
而迟，先尚能食，屡下之后，糜粥不进，不大便已四十九日。余曰∶此 也，金气之所结也
，以肝木抑郁，又感秋金燥气，邪中入里，久而结成，愈久愈坚，非下不可。然寒下非其治
也，以天台乌药散二钱，加巴豆一分，姜汤和服。设三服以待之，如不通，第二次加巴豆霜
分半，再不通，第三次加巴豆霜二分，服至三次后，始下黑亮球四十九枚，坚莫能破，继以
苦温甘辛之法调理，渐次能食。又十五日不大便，余如前法，下至第二次而通，下黑亮球十
五枚，虽亦坚结，然破之能碎，但燥极耳，外以香油熬川椒熨其坚处，内服芳香透络，月余
化净。于此证方知燥金之气伤人如此，而温下之法，断不容紊也。
乙酉年 治通廷尉久疝不愈，时六十八岁，先是通廷外任时，每发疝，医者必用人参，
故留
邪在久不得愈。至乙丑季夏，受凉复发，坚结肛门，坐卧不得，胀痛不可忍，汗如雨下，七
日不大便。余曰∶疝本寒邪，凡坚结牢固，皆属金象，况现下势甚危急，非温下不可。亦用
天台乌药散一钱，巴豆霜分许，下至三次始通，通后痛渐定，调以倭硫黄丸，兼用金匮蜘蛛
散，渐次化净。
[Case 1]
Patient Zhang, aged 27. On the 13th day of the 3rd month in the Jiazi year, there was an accumulation of Qi on the right side of the umbilicus. Consequently, the right pulse was deep (Chen), fine (Xi), wiry (Xian), and hidden (Fu). This indicates extreme deficiency of Yang Qi and excessive Yin turbidity overcoming Yang. Tracing back to the origin, it began with shooting pain from the left hypochondrium, which undoubtedly belongs to "Gan Zhuo" (Liver Fixation) causing cough. This condition does not require treating the cough directly; instead, one should ventilate and unblock the Yin collaterals of the Liver, as chronic diseases often reside in the collaterals. If the Yin turbidity is given a way out, the disease will resolve itself. This is what is meant by "treating the disease requires seeking its root." If one fails to recognize this principle and recklessly hopes for a quick cure, it will inevitably lead to the depletion of Yang Qi and death.
Prescription: Guizhi Jian (Cinnamon Twig Tip, 3 qian), Xiaohui Xiang (Fennel, 3 qian), Jiangxiang Mo (Dalbergia Odorifera Powder, 2 qian), Taoren (Peach Kernel, 3 qian), Chuanlianzi (Sichuan Chinaberry, 2 qian), Qingpi Luo (Green Tangerina Peel Collateral, 2 qian), Chao Guangpi (Stir-fried Citrus Reticulata Peel, 1 qian), Guixu (Angelica Sinensis Root Tip, 3 qian), Wuyao (Lindera Root, 3 qian), Suzi Shuang (Perilla Fruit Frost, 3 qian), Xuanfuhua (Inula Flower, 3 qian, wrapped in Xinjiang Sha/New Crimson Gauze).
On the 19th day: After taking the collateral-unblocking medicine, slight efficacy was seen, and the pulse Qi significantly recovered. However, coughing worsened when lying on the right hypochondrium due to "Zhi Yin" (Fluid retention under the ribs). It is proposed to remove Taoren, Chuanlianzi, and Xiaohui Xiang from the previous formula and add: Sheng Xiangfu (Cyperi Rhizome, 3 qian), Banxia (Pinellia Tuber, 6 qian), Xingren (Apricot Seed, 3 qian), Rougui (Cinnamon Bark, 8 fen). Take four more doses.
On the 23rd day: Pain preceded by blood in stool. Propose the method of unblocking the Yin collaterals.
Prescription: Suzi Shuang (Perilla Fruit Frost, 3 qian), Guixu (Angelica Sinensis Root Tip, 2 qian), Jiangxiang Mo (Dalbergia Odorifera Powder, 3 qian), Taoren (Peach Kernel, 2 qian), Liangtoujian (Aconitum Lateralis Preparatum, 3 qian), Danpi (Moutan Cortex, 3 qian), Zanghonghua (Saffron, 1 qian), Banxia (Pinellia Tuber, 5 qian), Xiaohui Xiang (Fennel, 3 qian), Xiangfu (Cyperi Rhizome, 2 qian), Guangmuxiang (Costus Root, 1 qian), Guang Chenpi (Citrus Reticulata Peel, 1 qian).
[Case 2]
Patient Zhang, aged 28. A "Jia" mass (mobile abdominal mass) on the left side of the umbilicus. Yellow complexion, limb fatigue, poor appetite, inability to engage in mental work or read for long periods, resembling consumptive disease. Prescribed Huasheng Dan (Revitalizing Pill).
Adopted the method of slowly unblocking the Yin collaterals. Taken one pill daily on an empty stomach, or sometimes morning and evening. Continued for over two years, consuming a total of 600 pills of Huasheng Dan. Only then was the pathogen completely resolved, the body restored, allowing him to study and write, eventually passing the imperial examination.
[Case 3]
Patient Wu, aged 31. A hard knot formed on the right side of the umbilicus, five cun in diameter. The testicle swelled like a goose egg. Caused by severe cold exposure compounded by sudden rage. Pain was unbearable; unable to stand, sit, or lie down. Took Xinxiang Liuqi Yin (Acrid-Aromatic Qi-Flowing Decoction), five doses over three days, with added Fuzi (Prepared Aconite Root) and Rougui (Cinnamon Bark) up to 5-7 qian, but with no effect. Then took Tiantai Wuyao San (Tiantai Lindera Powder). Upon taking the first 2 qian, felt heat like fire burning throughout the abdomen. Knew the medicine reached the affected area at the right umbilicus, feeling like striking an object, pain increased tenfold. Soon, numerous bud-like swellings appeared in the abdomen. Each swelling corresponded to the discharge of one batch of turbid gas. This happened 20-30 times, bringing relief from abdominal pain. Later, pain flared up again. Took medicine as before; abdominal heat and pain returned, buds appeared, turbid gas discharged similarly, but slightly milder. From Si Chu (9-11 AM) to Hai Zheng (9-11 PM), took medicine five times, each time reducing pain severity. Next day, mild abdominal pain remained. Took Wuyao San again; abdominal heat disappeared. Thereafter, took it 2-3 times daily. After seven days, swelling and pain completely subsided. Later, practiced archery to boost Yang Qi, resulting in robust health.
[Case 4]
Patient Ye, aged 45. On the 28th day of the 4th month in the Yiyu year. Whether "Jia" (mass) or "Ju" (accumulation), although distinguished by Qi and Blood, both are Yin pathogens binding in Yin regions. How could Yin-nourishing herbs be appropriate? Moreover, it has been a chronic cold-deep-seated disease for a long time; only Radix Crotonis Fructus (Badou, Castor Bean) can eradicate the root. Used Tiantai Wuyao San (Tiantai Lindera Powder).
On the 9th day of the 6th lunar month: Efficacy seen, but root not eradicated. Continue previous medicine, 5 fen morning and evening; take 2 qian when Jia pain occurs. Thick white tongue coating, pale yellow and dark complexion, left pulse deep, fine, and Yang deficient. Further prescribe decoction to move dampness and unblock Yang.
Prescription: Yun Fuling Kuai (Poria Block, 5 qian), Yizhiren (Bitter Apricot Seed, 1.5 qian), Bi Xie (Dioscorea Hypoglauca Rhizome, 4 qian), Baiko Ren (White Cardamom Seed, 1 qian, with skin), Sheng Yiren (Coix Seed, 5 qian), Banxia (Pinellia Tuber, 5 qian), Guang Chenpi (Citrus Reticulata Peel, 2 qian), Guizhi (Cinnamon Twig, 2 qian), Bai Tongcao (Tetrapanax Pith, 1 qian).
Take until tongue coating recedes.
[Case 5]
Patient Gan, aged 29. On the 1st day of the 5th month in the Yiyu year. Ten-year history of Jia Qi. Six pulses are wiry, fine, and tight.
Prescription: Dan Wuyu (Light Evodia Fruit, 3 qian), Wuyao (Lindera Root, 3 qian), Chuanjiao Tan (Charred Sichuan Pepper, 5 qian), Guixu (Angelica Sinensis Root Tip, 2 qian), Liangjiang (Galangal Rhizome, 2 qian), Xiaohui Xiang (Fennel, 5 qian, stir-fried black).
Boil to yield three cups, divide into three doses. Already taken five doses.
On the 9th day: Disease reduced, so reduce dosage. Take half a dose daily.
[Case 6]
Patient Wang, aged 40. On the 21st day of the 5th month in the Yiyu year. Six pulses are wiry and tight. "Fuliang" (fixed subcardiac mass) below the heart. Not an easy-to-resolve condition. A life of sorrow and weeping causes Liver Qi stagnation. Furthermore, it is a year of Taiyi Tianfu with strong Metal energy, where Metal overcomes Wood, exacerbating pain. Apply warming collateral method. Hematemesis is also due to cold in the collaterals.
Prescription: Jiangxiang Mo (Dalbergia Odorifera Powder, 3 qian), Chuanjiao Tan (Charred Sichuan Pepper, 2 qian), Xiangfu (Cyperi Rhizome, 3 qian), Banxia (Pinellia Tuber, 3 qian), Zhishi (Immature Bitter Orange, 3 qian), Guixu (Angelica Sinensis Root Tip, 3 qian), Gong Dingxiang (Clove, 8 fen), Guangpi (Citrus Reticulata Peel).
Take four doses.
On the 25th day: All symptoms responded well. Patient feels Qi obstructing the throat. Add: Xuanfuhua (Inula Flower, 5 qian).
On the 29th day: Efficacy maintained, do not change prescription. Take again.
On the 2nd day of the 6th lunar month: Add Wuyu (Evodia Fruit, 3 qian).
[Case 7]
Patient Yu, aged 30. On the 24th day of the 5th month in the Yiyu year. Jia knot on the left side of the umbilicus. Menstrual pain is inevitable. Six pulses are deep, fine, and Yang deficient.
Prescription: Wuyu (Evodia Fruit, 3 qian), Chuanlianzi (Sichuan Chinaberry, 3 qian), Gong Dingxiang (Clove, 1 qian), Liangjiang (Galangal Rhizome, 2 qian), Quandanggui (Whole Angelica Sinensis, 3 qian), Jiangxiang Mo (Dalbergia Odorifera Powder, 3 qian), Xiaohui Xiang (Fennel, 3 qian), Aitan (Mugwort Charcoal, 3 qian).
Boil to yield three cups, divide into three doses. After taking seven doses, follow with pill medicine.
On the 2nd day of the 6th lunar month: Efficacy seen. Take half a dose daily for another ten days.
On the 20th day: Three days before menstruation, when mild abdominal pain occurs, take one pill of Huasheng Dan on an empty stomach. Continue until after menstruation ends and abdominal pain ceases completely. For the next menstrual cycle, if abdominal pain occurs, repeat this method. For Jia pain, also take Huasheng Dan, one pill on an empty stomach, until the pathogen is resolved.
[Case 8]
Patient Che, aged 55. Hair and beard mostly white. Hard, large mass on the left side of the umbilicus, like a plate, with dull mild pain. No bowel movement for over ten days. Initially treated by surgeons, who diagnosed Intestinal Abscess (Chang Yong) and used Dachengqi Tang (Major Order the Qi Decoction) for purgation. Three to four times failed to induce passage. Consulted me. Palpation revealed hardness and coldness like stone. Complexion greenish-yellow. Pulse short, choppy, and slow. Initially able to eat, but after repeated purgation, even gruel was refused. No bowel movement for 49 days. I said: This is accumulation,結由 Metal Qi. Due to Liver Wood depression and autumn Dry-Metal Qi invasion, pathogens entered the interior and formed knots over time. The longer it persists, the harder it becomes. Purging is necessary. However, cold purging is incorrect. Therefore, use Tiantai Wuyao San (2 qian) plus Badou (Castor Bean, 1 fen), mixed with Ginger Decoction. Set three dosing stages: if no result, second dose adds Badou Frost (Ban fen); if still no result, third dose adds Badou Frost (2 fen). After the third dose, passed 49 black, shiny, ball-shaped stools, extremely hard. Subsequently regulated with Bitter-Warm-Sweet-Acrid method, gradually able to eat. Fifteen days later, no bowel movement again. Used previous method; passed on second attempt, 15 black, shiny balls. Also hard but breakable, merely dry. Externally applied hot pepper fried in sesame oil to the hard area. Internally took aromatic collateral-penetrating herbs. Resolved within a month. From this case, one realizes how severely Dry-Metal Qi harms the body, and that Warm-Purgative methods must not be confused.
[Case 9]
In the Yiyu year, treated Tong Tingwei for chronic hernia lasting long, aged 68. Previously, during his provincial posting, every hernia attack was treated with Ginseng by other doctors, thus retaining pathogens and preventing cure. In the late summer of the Yichou year, relapse occurred due to cold exposure. Hard knot formed in the anus, unable to sit or lie down, unbearable distending pain, sweating profusely, no bowel movement for seven days. I said: Hernia is originally Cold Pathogen. Any hard, firm knot belongs to the Metal image. Given the critical situation, warm purging is essential. Used Tiantai Wuyao San (1 qian) plus Badou Frost (approx. 1 fen). Passed stool after three doses. Pain settled afterwards. Regulated with Wowuhuang Wan (Malay Sulfur Pill), combined with Jingui Zhizhu San (Golden Cabinet Spider Powder). Gradually resolved.