癸卯春，邵秋子令堂，年近六旬，患寒热如疟者久矣。诸医杂治罔效。孟英视之，曰∶此湿邪久蕴，已从
热化，误投提补，动其肝阳，痰饮因而上逆。与通降之法，寒热即减。而包某谓疟久阴虚，理宜滋养，病家闻之
近是，遂进首乌、鳖甲等药，渐至脉伏胸痞，呃忒自汗，渴饮不食，颧赤便泄。包某束手，疏生脉散以塞责。
举家彷徨，再求孟英诊之，曰∶此滋腻阻滞气机，清阳不司旋运，痰饮闭滞隧络，非脱象也。补药不可再进。
以∶栝蒌薤白（半夏汤）合小陷胸（汤）加竹茹、旋复、贝母、杏仁、紫菀、枇杷叶投之，呃止脉出，大有转
机。而郑某谓病固属痰，须温热以宣通，勿寒凉而凝遏，病家又惑焉。姜、桂频投，既而唇肿咽痛，不能进
饮，舌干短硬，难出语言，复请孟英救疗。予犀角地黄汤加元参、知母、银花、竺黄、花粉、胆星、石菖蒲、
竹沥之类，此第三次生机也。奈狂澜莫障，
邪说横行，辄以凉药不宜擅服，久病必定元虚。甘言悦耳，遂至升散温补，各逞所能。符咒乩方，罔不遍试。
延至仲夏， 腐龈糜，唇高数寸，竟成燎原莫救。仍恳孟英设法，乃坚辞不能措手。付局医黄某敷治肿烂，
日甚而终。
季秋，顾听泉邀孟英视康康候副转之恙。切其脉∶滑数，而右歇左促。且肝部（左关）间有雀啄，气口（
右寸）又兼解索。望其面，宛如熏黄，头汗自出，呼吸粗促，似不紧续，坐卧无须臾之宁，便溺涩滞，浑赤极
臭，心下坚硬拒按，形若覆碗。观其舌色，边紫苔黄，殊不甚干燥。问其所苦，曰∶口渴甜腻、不欲饮食。
苟一合眼，即气升欲喘，烦躁不能自持、胸中懊 、莫可言状。孟英曰∶此由湿热误补，漫无出路，充斥三焦，
气机为其阻塞而不流行。蔓延日久，津液为之凝滞而成痰饮。不啻人禽杂处，苗莠同畴，邪正混为一家。医见
肢冷自汗，不知病由壅闭而然，欲以培正。而邪气方张，得补反为树帜，岂非资寇兵而 盗粮哉？非其类者，
锄而去之，乃为吃紧之治。听泉曰∶良是也。夏间起病，闻自心悸少寐，杨某以为虚而补之，时尚出差办事。
暑湿外侵，受而不觉。迨闱差未竣，其病斯发，而诸医之药，总不外乎温补一途，以致愈补愈剧。今
拟温胆法，待君可否？孟英曰∶脉证多怪，皆属于痰，今胸痞如斯，略无痰吐，盖由痰能阻气，气不能运痰耳。宜
于温胆（汤）中，加薤白、蒌仁通其胸中之阳；又合以小陷胸（汤），此为治饮痞之圣法。参以栀、豉泄其久
郁之热以除懊 ；佐以兰草，涤其陈腐之气而醒脾胃。听泉深然之。连投二剂，各恙皆减，脉亦略和。而病者
以为既系实证，何妨一泻而去之，连服大黄丸二次，承气汤半帖。孟英急止之，曰∶畏虚进补固非，欲速妄攻
亦谬。盖湿蒸为热，灼液成痰，病非一朝一夕而成，治以上下分消为是，不比热邪传腑，可一泻而愈也。越
日，下部果渐肿。孟英曰∶攻痞太速之戒，古人不我欺也。与听泉商，以前法加黄芩，合泻心（汤）意，再配
雪羹投之，痰果渐吐，痞亦日消。而自腹至足，以及茎囊肿势日加。孟英谓∶势已如此，难以遽消，但从三消
设法，则自上而下，病必无虞。与听泉商，用河间桂芩甘露饮意。而姚平泉孝廉，力主崇土胜湿之法，深以寒
凉为不可用。众议仍投前日之药。孟英曰∶前药原可服也，嫌力不足耳。次日痰中带血甚多。孟英曰∶湿热熏
蒸不已，自气及营矣。与听泉及王子能参军商，以∶知（母） （黄）柏 犀角 鳖甲 白芍 苡仁 贝母 石
斛茅根 麦冬 滑石 栀子 藕汁 童便，投之而止。越数日又吐，且肢冷自汗、心馁畏脱。姚平泉谓
“气不摄血”，当举归脾汤以统之。举家皇皇，连请诊脉者三次。孟英曰∶脉来屡变，陈芝江所以不能指实其
病，而杨、阮诸人皆疑为大虚之候也。然望、闻、问、切，不可独凭于指下。今溲如赭石汤，浑赤有脚，其为
湿热之病，昭昭若揭。初伤于气分，则津液受灼以为痰。渐及于营，则
阴血不安而妄溢。邪气内盛，岂非病实？而真实类虚，吾不受病之欺也。坚守前议，镇静不摇，服二剂果止。
孟英曰∶血之复吐也，由于气分之邪以扰及之。欲清气道之邪，必先去其邪所根据附之痰。盖津液既为邪热灼烁
以成痰，而痰反即为邪热之山险也。不妨峻攻其实，而缓行其势。初进滚痰丸三钱，得下泄气一次，副转云∶
四十日来，未有之通畅也。连投数日，始解胶痰黑矢多遍，而小溲亦渐清长。苔色亦退，寝食遂安，惟下部之
肿犹尔也。马香崖、陆虚舟皆主实脾行水之法。孟英曰∶谛参脉证，并不在脾，况善饥便燥，口渴溺多，吾方
虑转“消证”，亟投甘润之不遑。恶可渗利伤阴，补土劫液耶？且脾
虚下陷之肿，与湿盛而肿之肿，其膝之上下，内外情势，必然相贯。今膝之上下，内外凹凸迥判，毫不毗连。
盖由湿热所酿之痰饮，既误补而痞塞中焦，复妄攻以流窜隧络，所谓不能一荡而蠲，势必旁趋四射。
吾当以法取之。会又咳痰带血，而精神食欲如常。孟英曰∶无恐也，此乃前次嚼三七太多，兜涩留瘀，最不宜
用，吐而去之极妙。但须金水同治，冀咳止而血络不震动为要耳。与甘露饮加藕汁、童溺服之，四剂而止。咳
嗽亦宁。于是专治其下部之肿，以固本（丸）加知（母）、（黄）柏、贝母、花粉。旋复、橘络、丝瓜络、羚
羊角、楝实、葱须、豆卷、薏苡、竹沥，出入为剂，二、三帖间，其高突肿硬之处，即觉甚痒，搔之水出如
汗，而作葱气。六、七日后，两脚反觉干瘦燥痛，茎囊亦随之而消矣。孟英曰∶此用润药
消肿，尚且干痛咽燥，设从他议而投燥脾利水之法，更当何如哉？盖寒湿则伤阳，热湿则伤阴，血液皆阴也。
善后之法，还宜滋养血液，稍佐竹沥以搜络中未尽之痰，使愈后不为他日之患，更属法中之法。服之饮食中
节，便溺有权，幸无消渴之虞，而竟愈焉。
顾宗武，偶患微寒发热，医进温散法，热虽退而不饥不大便。复用平胃散数帖，腹渐胀而偏于右。尚疑其
中气之虚寒也，遂与温运燥补诸药，胀乃日增，杳不进谷。或谓∶恐属痈疡，因招外科连某诊之，作胁疽治，
病如故。严某谓“胁疽”部位不对，肠痈证据不符，作内疝治，仿子和活人之法，及当归龙荟丸”相间投，亦
无效。乃延孟英视之，脉极弦细而促，舌绛小渴，小溲赤少，饮而不食者月余矣。证实脉虚，坚持不治。其家
问曰∶此证究是何病？乞为指示。孟英曰∶据述病患素慎起居而薄滋味，显非停滞与痈疽之患，良由暑湿内
蕴，势欲外泄，是以初起有微寒发热之候，误与风寒药，热虽暂退于表，邪仍伏处乎中，不饥不便，肺胃失其
下行，再加辛燥温补，气机更形窒滞，邪伏永无出路，津液潜消，
胀日甚，以
气血流行之脏腑。为暑湿割踞之窠巢，补之不可，攻之不能，病虽不在膏肓，卢扁
望而惊走，逾旬径殁。
顾竹如孝廉令嫒，患感十余日，耳聋不语，昏不识人，客未入室，而彼反先知，医以为祟。凡犀角、地黄、
牛黄清心（丸）、复脉等汤，遍服无效，已摒挡后事矣。所亲濮根崖嘱延诊于孟英，脉至滑数，舌不能伸，苔
色黄腻，遗溺便闭，目不交睫者已四昼夜。胸腹按之不柔，予白虎汤去（粳）米、甘草，加石菖蒲、元参、犀
角、鳖甲、花粉、杏仁、竹叶、竺黄、竹沥，投一剂即谵语滔滔。渠父母疑药不对病。孟英曰∶不语者欲其能
语，是转机也。再投之，大渴而喜极热之饮。渠父母又疑凉药非宜。孟英姑应之曰∶再服一剂，更方可也。三
投之，痰果渐吐，四剂后，舌伸便下，神识渐清。乃去菖蒲、石膏、犀角、鳖甲，加生地、石斛、麦冬、贝
母，数帖。热尽退，而痰味甚咸。又去杏（仁）、贝（母）、竺黄，加西洋参、牡蛎。龟板、苁蓉，服之痊愈。
逾年失怙，继遭祝融（火灾），郁损情怀，误投温补。至戊申年殒。
邵鱼竹给谏患感，杨某作疟治不应，始迓孟英诊之，脉软汗多，热不甚壮，苔色浓腻，呕恶烦躁，痰多
腿酸，显是湿温。因谓其令郎子 曰∶湿温者，湿蕴久而从时令之感以化热也。不可从表治，更勿畏虚率补。
与宣解一剂，各恙颇减。奈众楚交咻，谓病由心力劳瘁而来，况汗多防脱，岂可罔顾本原？群医附和，遂服
参、归、熟地之药，病日以剧。最后，吴古年诊之云∶此湿温也，何妄投补剂？
然已末从挽救，交十四日而殒，始悔不从王议。
翁嘉顺之妇弟吴某，劳伤之后，发热身黄，自以为脱力也。孟英诊脉，软数。是湿温重症，故初起即黄。
亟与清解，大便渐溏，小便甚赤。湿热已得下行，其热即减。因家住毛家埠，吝惜舆金，遽尔辍药，七八日
后，复热，谵语。耳聋，抽痉，遗溺。再恳孟英视之，湿热之邪扰营矣。投∶元参 犀角 菖蒲 连翘 竹茹 竹
叶银花 石膏，以泄卫清营之法，佐牛黄丸、紫雪丹而瘳。臀皮已塌，亟令贴羊皮金，不致成疮而愈。
吴宪章，年逾花甲，患感，医知其为湿温也，投药不应，而仍能起榻理事。石北涯拉孟英视之，冀其勿至
加剧。及诊脉，左寸数疾，余皆软大，谷食略减，便溏溲少，苔色腻黄，舌尖独黑。孟英不肯与方，人咸诧
之。因曰∶证原不重，吾以脉象舌色察之，是平昔曲运心机，离火内亢，坎水不制，势必自焚，况兼湿温之感
乎？果数日而殒。
黄纯光，年七十八岁，患湿温，至旬余，脉形歇代，呃忒连朝，诸医望而畏之。孟英诊曰∶脉虽歇而弦
搏有根，是得乎天者浓，虽属高年，犹为实象，参以病深声哕，原非小故，而二便窒涩，苔腻而灰，似属腑气
未宣，痰、湿、热阻其气化流行之道也。清宣展布，尚可图焉。何新之韪其议，因与∶旋
（复） （竹）茹 栀（子） 楝（实） 枇（杷叶） 杏（仁） （吴）萸 （黄）连 （紫）菀 （栝）
蒌雪羹为剂，片通草一两，煎汤煮药，投匕即减。数服而大吐胶痰，连次更衣，遂安粥食。唯动则嗽逆，
渐露下虚之象，与∶西洋参 龟板 牡蛎 苁蓉 石斛 牛膝 冬虫夏草 紫石英 茯苓 当归等药，各恙降序，
继加砂仁炒熟地而起。
汤西塍，年逾花甲，感证初起，周身肤赤，满口苔黄，头痛、腰痛、便溏、溲痛，伊芳亲家何新之诊为险
候，嘱延孟英诊之，脉见弦细而软，乃阴虚劳倦，湿温毒重之证。清解之中，须寓存阴。以∶犀角 羚（羊
角） （茯）苓 （竹）茹 银（花） （连）翘 桑（枝） 苇茎 通草 兰叶为方，煎以冬瓜汤服之，遍身赤
疹，而左眼胞忽肿，右臂酸疼不举，耳聋，神不清爽。亟以∶元参 丹皮 菊花 栀子 桑枝 丝瓜络 石斛
竹叶，煎调神犀丹为剂，偶邀疡科视外患，亦知病因湿热，连进木通等药，脉更细弱，神益昏惫，饮食不进，
溲涩愈痛，新之以为难挽矣，孟英曰∶急救阴液，尚可转机，援以复脉汤去姜、桂、麻仁，易西洋参，加知
母、花粉、竹叶、蔗浆灌之，一剂神苏脉起，再服苔退知饥，三啜身凉溺畅，六帖后，肤蜕安眠，目开
舌润。或疑甘柔滑腻之药，何以能清湿热？孟英曰∶阴虚内
热之人，蕴湿易于化火，火能烁液，濡布无权，频溉甘凉，津回气达。徒知利湿，阴气先亡。须脉症参详，法
难执一也。又服数剂后，忽然肢肿，遍发风块，瘙痒异常，或又疑证之有变也。孟英曰∶此阴津充而余邪自寻
出路也耳，与轻清药数帖，果瘥。
金禄卿室，沈裕昆之少女也。患温，顾听泉连进轻清凉解而病不减。气逆无寐，咳吐粘痰，舌绛咽干，耳聋
谵语，旬日外，始延孟英诊焉。曰∶体瘦脉细数，尺中更乱，竟是阴气先伤，阳气独发，所谓“伤寒偏死下虚
人”。譬之火患将临，既无池井，缸贮又空，纵竭心力，曷能有济？再四研诘，乃知发病前一日，徒然带下如
崩，是真液早经漏泄矣。否则药治未讹，胡忽燎原益炽？痉厥之变，不须旋踵。禄卿坚垦勉图。孟英以∶西洋
参生地 “二冬” 二至 元参 犀角 黄连 鸡子黄 知母为方，另用石斛 龟板 鳖甲各四两，左牡蛎
一斤，煮汤代水煎药，顾听泉又加阿胶，且云∶我侪用此育阴镇阳，充液熄风大剂，焉能津枯风动，痉厥陡生
乎？服二剂，果不能减。后惑旁言，而祷签药，附、桂、干姜，罔知顾忌，径至四肢拘挛而逝。是误药速增其
毙而增其惨也。继而裕昆患湿温，亦犯重 而亡（重 谓热性病的热气极盛）。
翁嘉顺之妹，亦染病，病势极危，因役于冥曹，自以为不起。孟英曰∶年壮阴充、药治不谬，焉能死乎？
昔人云∶“见理明者，阳阴五行不能拘”。吾当以理胜数，遂按法治之，病乃日减。且慎寒暄，节饮食，守
禁忌，调治二旬，果然康健。
又其姑吴翁氏，病温，初不服药，七日外，始迓孟英诊之。曰∶此病邪虽不盛，第频吐涎沫，不能退场门，
In the spring of the Gui-Mao year, the mother of Shao Qiuzi, aged nearly sixty, had suffered from alternating chills and fever resembling malaria for a long time. Various physicians treated her with mixed methods without effect. Wang Mengying examined her and said: "This is dampness pathogen lingering in the body for a long time, which has transformed into heat due to mistaken use of tonifying and ascending drugs, disturbing the Liver Yang, causing phlegm-fluids to rebel upward." He prescribed a method of unblocking and descending; the chills and fever decreased immediately. However, Physician Bao believed that prolonged malaria leads to Yin deficiency and should be nourished. The patient's family found this plausible and administered herbs such as Polygonum multiflorum (He Shou Wu) and Turtle Shell (Bie Jia). Gradually, the pulse became hidden, chest oppression occurred, hiccups and spontaneous sweating appeared, thirst with desire to drink but inability to eat developed, malar flush emerged, and diarrhea ensued. Physician Bao was at a loss and prescribed Shengmai San (Generate the Pulse Decoction) to shirk responsibility. The whole family was anxious and sought Wang Mengying again. He said: "This is caused by cloying and greasy drugs obstructing the Qi mechanism, preventing the Clear Yang from rotating and transforming normally, while phlegm-fluids block the collaterals. This is not a collapse syndrome. Tonics must not be taken further." He prescribed Gua Lou Xie Bai Ban Xia Tang (Trichosanthes Fruit, Macrostemon Rhizome, and Pinellia Decoction) combined with Xiao Xian Xiong Tang (Small Chest-Hammer Decoction), adding Bamboo Shavings (Zhu Ru), Inula Flower (Xuan Fu Hua), Fritillaria Bulb (Bei Mu), Apricot Seed (Xing Ren), Aster Root (Zi Wan), and Loquat Leaf (Pi Pa Ye). After administration, hiccups stopped, the pulse reappeared, and there was significant improvement. Physician Zheng, however, argued that although the disease belongs to phlegm, it requires warm and acrid herbs to diffuse and unblock, warning against cold and bitter herbs that might congeal and inhibit. The family was confused again and frequently administered Ginger (Jiang) and Cinnamon Twig (Gui Zhi). Subsequently, lip swelling, sore throat, inability to swallow liquids, dry and stiff tongue, and difficulty speaking occurred. They requested Wang Mengying's rescue treatment again. He prescribed Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction) plus Scrophularia Root (Yuan Shen), Anemarrhena Rhizome (Zhi Mu), Honeysuckle Flower (Yin Hua), Arisaema Rhizome processed with bile (Dan Xing), Atractylodes Rhizome (Shi Chang Pu), and Bamboo Juice (Zhu Li). This was the third chance for survival. Alas, the raging waves could not be blocked, and false theories prevailed, claiming that cold herbs should not be used arbitrarily and that chronic illness implies Yuan Qi deficiency. Sweet words were pleasing, leading to the use of dispersing and warming tonics, each physician displaying their skills. Talismans and divination prescriptions were tried indiscriminately. By mid-summer, the gums rotted, lips swelled several inches high, becoming an uncontrollable fire. They still begged Wang Mengying for help, but he firmly declined, stating he could not intervene. Treatment was handed over to a local physician, Mr. Huang, who applied external dressings to the swollen and ulcerated areas. The condition worsened daily until death.
In late autumn, Gu Tingquan invited Wang Mengying to treat Kang Kanghou, a Vice Commissioner. Palpating his pulse: slippery and rapid, with intermittent beats on the right and hurried beats on the left. Furthermore, between the Liver position (Left Guan), there were Sparrow-pecking pulses, and at the Qi Gate (Right Cun), there were Untying-Rope pulses. Observing his face, it resembled smoked yellow; head sweat flowed spontaneously; respiration was coarse and hurried, seemingly discontinuous; sitting or lying down offered no moment of peace; urination and defecation were difficult, turbid, dark red, and extremely foul; the epigastrium was hard and refused pressure, shaped like an inverted bowl. Observing his tongue: purple edges, yellow coating, not very dry. Asked about his suffering, he said: "Thirsty with a sweet and sticky sensation, no desire to eat. As soon as I close my eyes, Qi rises and I feel like panting; I am irritable and cannot control myself; there is indescribable restlessness in the chest." Wang Mengying said: "This is due to mistaking tonification for damp-heat, leaving no outlet, filling the Triple Burner, blocking the Qi mechanism so it cannot circulate. Prolonged spread causes body fluids to stagnate and form phlegm-fluids. It is like humans and birds mixing, weeds and crops growing together, pathogens and healthy Qi merging into one faction. Physicians see cold limbs and spontaneous sweating, not knowing the disease stems from obstruction, and attempt to cultivate righteousness. However, when pathogenic Qi is flourishing, tonification only strengthens its banner, effectively supplying weapons and grain to bandits! One must weed out the non-belonging elements; this is the urgent treatment." Tingquan agreed. The disease started in summer, initially presenting as palpitations and insomnia. Physician Yang considered it deficiency and tonified it, while the patient was still handling official duties. Summer-dampness invaded externally, unnoticed. Only after the examination duty ended did the disease manifest. All previous physicians' prescriptions focused solely on warming and tonifying, making the condition worse with each dose. Now, proposing the Wen Dan method, he asked for approval. Wang Mengying said: "Strange pulses and symptoms all belong to phlegm. With such chest oppression and no expectoration, it is because phlegm obstructs Qi, and Qi cannot move phlegm. It is appropriate to add Macrostemon Rhizome (Xie Bai) and Trichosanthes Seed (Gua Lou Ren) to Wen Dan Tang (Warm the Gallbladder Decoction) to unblock the Yang of the chest; combine it with Xiao Xian Xiong Tang. This is the sage method for treating fluid-type oppression. Add Gardenia (Zhi Zi) and Fermented Soybean (Chi Dou) to drain long-stagnant heat and remove restlessness; assist with Eupatorium (Lan Cao) to cleanse stale Qi and awaken the Spleen and Stomach." Tingquan deeply agreed. Two doses reduced all symptoms, and the pulse harmonized slightly. The patient, believing it was an excess syndrome, suggested purging to eliminate it, taking Da Huang Wan (Rhubarb Pill) twice and half a dose of Cheng Qi Tang (Order the Qi Decoction). Wang Mengying urgently stopped him, saying: "Fearing deficiency and tonifying is wrong, but rushing to purge is also erroneous. Dampness steaming into heat burns fluids into phlegm; this disease did not happen overnight. Treatment should focus on draining from above and below, unlike heat pathogens transmitting to the fu organs which can be cured by a single purge." The next day, the lower body indeed began to swell. Wang Mengying said: "The ancient warning against purging oppression too quickly has not deceived me." He consulted with Tingquan, added Scutellaria Root (Huang Qin) to the previous method, incorporated the intent of Xie Xin Tang (Drain the Epigastrium Decoction), and paired it with Xue Geng (Snow Soup). Phlegm was gradually expectorated, and oppression subsided daily. However, swelling increased from the abdomen to the feet and the scrotum. Wang Mengying said: "The situation is already severe, difficult to resolve quickly. We must plan from the perspective of 'Three Excesses' (San Xiao), moving from top to bottom, ensuring safety." Consulting Tingquan, he used the intent of He Jian's Gui Ling Gan Lu Yin (Cassia, Poria, and Sweet Dew Drink). Yao Pingquan Xiaolian strongly advocated strengthening Earth to overcome dampness, deeply believing cold herbs were unusable. The consensus remained to continue the previous medication. Wang Mengying said: "The previous medicine was acceptable, merely lacking strength." The next day, sputum contained much blood. Wang Mengying said: "Continuous damp-heat steaming has moved from the Qi level to the Ying level." Consulting Tingquan and Canjun Wangzineng, he prescribed Anemarrhena Rhizome (Zhi Mu), Phellodendron Bark (Huang Bo), Rhinoceros Horn (Xi Jiao), Turtle Shell (Bie Jia), White Peony Root (Bai Shao), Coix Seed (Yi Yi Ren), Fritillaria Bulb (Bei Mu), Dendrobium Stem (Shi Hu), Imperata Rhizome (Mao Gen), Ophiopogon Tuber (Mai Dong), Talcum (Hua Shi), Gardenia (Zhi Zi), Lotus Root Juice (Ou Zhi), and Child's Urine (Tong Bian). Administration stopped the bleeding. Days later, vomiting blood recurred, accompanied by cold limbs, spontaneous sweating, and heart weakness fearing collapse. Yao Pingquan stated "Qi fails to control blood" and recommended Gui Pi Tang (Restore the Spleen Decoction) to govern it. The family panicked, inviting pulse-takers three times. Wang Mengying said: "The pulse changes repeatedly; Chen Zhijiang could not identify the disease accurately, and Yang, Ruan, and others suspected extreme deficiency. However, inspection, auscultation/olfaction, inquiry, and palpation cannot rely solely on the pulse. Now urine resembles ochre soup, turbid and dark with sediment, clearly indicating a damp-heat disease. Initially injuring the Qi level, body fluids are burned into phlegm. Gradually affecting the Ying level, Yin blood becomes unsettled and bleeds recklessly. Pathogenic Qi is internally abundant; is this not an excess disease? True excess mimicking deficiency—I will not be deceived by the disease." Adhering firmly to the previous strategy, calm and unshaken, two doses stopped the bleeding. Wang Mengying said: "The recurrence of hemoptysis is due to Qi-level pathogens disturbing the Ying. To clear pathogens from the Qi pathway, one must first remove the phlegm they attach to. Since body fluids are burned by pathogenic heat into phlegm, phlegm becomes a fortress for the heat. It is permissible to aggressively attack the excess while moderating the momentum." Initially administering Gun Tan Wan (Rolling Phlegm Pill) 3 qian, he passed flatus once. The Vice Commissioner said: "Never had such smooth passage in forty days." Continuing for several days, he passed multiple stools of black, glue-like phlegm, and urination became clear and long. Tongue coating receded, sleep and appetite returned, except for the persistent lower body swelling. Ma Xiangya and Lu Xuzhou advocated solidifying the Spleen and promoting water metabolism. Wang Mengying said: "Carefully analyzing pulse and symptoms, the issue is not in the Spleen. Moreover, with hunger, dry stool, thirst, and polyuria, I worry about transformation into 'Xiao Ke' (Wasting-Thirst). I am too busy prescribing moistening agents to consider diuretics that injure Yin and deplete fluids. Also, edema from Spleen Qi sinking differs from edema from dampness abundance; the contours around the knees would naturally connect. Here, the凹凸 (concavities and convexities) above and below, inside and outside the knees are distinct and disconnected. This is because phlegm-fluids brewed by damp-heat, after mistaken tonification blocked the Middle Jiao, and mistaken purging scattered them into collaterals, cannot be cleared in one sweep, inevitably spreading sideways. I will treat it according to the method." Coincidentally, coughing up bloody sputum occurred again, but spirit and appetite were normal. Wang Mengying said: "Do not fear. This is due to excessive chewing of Panax notoginseng (San Qi) previously, causing stasis retention, which is highly inappropriate. Vomiting it out is excellent. However, we must treat Metal and Water simultaneously, hoping to stop cough and prevent vibration of blood vessels." Prescribing Gan Lu Yin (Sweet Dew Decoction) with Lotus Root Juice and Child's Urine, four doses stopped it. Cough also settled. Then focusing on lower body swelling, he used Gu Ben Wan (Solidify the Root Pill) plus Anemarrhena Rhizome (Zhi Mu), Phellodendron Bark (Huang Bo), Fritillaria Bulb (Bei Mu), Trichosanthes Root (Hua Fen), Inula Flower (Xuan Fu Hua), Tangerine Reticulated Peel (Ju Luo), Luffa Vine (Si Gua Luo), Antelope Horn (Ling Yang Jiao), Melia Fruit (Lian Shi), Green Onion Root (Cong Xu), Soybean Sprouts (Dou Juan), Coix Seed (Yi Yi Yi), and Bamboo Juice (Zhu Li), varying the formula. Within two or three doses, the raised, hard swelling felt very itchy; scratching released fluid like sweat with a green onion odor. Six or seven days later, both legs felt dry, thin, and painful, and the scrotum subsided. Wang Mengying said: "Using moistening drugs to reduce swelling still causes dry pain and throat dryness; imagine what would happen if we followed other advice and used drying Spleen and diuretic methods? Cold-damp injures Yang, hot-damp injures Yin; blood is Yin. For convalescence, nourishing blood is suitable, slightly assisting with Bamboo Juice to search out remaining phlegm in collaterals, preventing future complications, which is a method within a method." With regulated diet and proper urination/defecation, fortunately avoiding Wasting-Thirst, he recovered completely.
Gu Zongwu occasionally suffered mild chills and fever. Physicians used warming and dispersing methods; fever subsided but appetite failed and constipation persisted. Repeated use of Ping Wei San (Calm the Stomach Powder) for several doses led to abdominal distension,偏于右 (biased to the right). Suspecting deficiency-cold of Middle Qi, they administered warming, moving, drying, and tonifying drugs, increasing distension daily until complete anorexia. Someone suggested abscess, summoning Surgeon Lian, who treated it as Hypochondriac Carbuncle, with no change. Yan Mou said the location didn't match Hypochondriac Carbuncle, and evidence didn't fit Intestinal Abscess, treating it as Internal Hernia, imitating Zhang Zihe's methods, alternating Dang Gui Long Hui Wan (Angelica Dragon Bile Pill), also ineffective. Wang Mengying was summoned. Pulse: extremely wiry, fine, and hurried. Tongue: crimson, slight thirst. Urine: dark red, scanty. Drinking without eating for over a month. Excess syndrome with deficient pulse; insisted on refusing treatment. Family asked: "What disease is this? Please indicate." Wang Mengying said: "According to the patient's careful lifestyle and bland diet, it is clearly not food stagnation or carbuncle. It is likely Summer-Dampness internal accumulation, attempting to vent externally, hence initial mild chills and fever. Mistakenly given Wind-Cold drugs, fever temporarily subsided superficially, but pathogens remained潜伏 (latent) in the center. No hunger, no bowel movement, Lung and Stomach lost their descending function. Adding acrid, drying, warming, and tonifying drugs further obstructed the Qi mechanism. Pathogens latent with no exit, body fluids secretly consumed, distension worsening. The organs where Qi and Blood circulate have become nests occupied by Summer-Dampness. Tonification is impossible, purging is inadvisable. Although not in the critical stage, even Lu and Bian would flee in shock. He died after ten days."
Gu Zhuru Xiaolian's daughter suffered from a febrile disease for over ten days: deafness, muteness, unconsciousness, recognizing guests before entering, doctors attributed to spirits. Xi Jiao Di Huang Tang, Niu Huang Qing Xin Wan (Calming Heart Pill), Mai Men Dong Tang (Ophiopogon Decoction), etc., were all ineffective. Funeral arrangements were made. Relative Pu Genya invited Wang Mengying. Pulse: slippery and rapid. Tongue: unable to extend, yellow greasy coating. Enuresis and fecal impaction. Eyes open for four days and nights. Chest and abdomen firm upon pressure. Prescribed Bai Hu Tang (White Tiger Decoction) minus Rice and Licorice, adding Atractylodes Rhizome (Shi Chang Pu), Scrophularia Root (Yuan Shen), Rhinoceros Horn (Xi Jiao), Turtle Shell (Bie Jia), Trichosanthes Root (Hua Fen), Apricot Seed (Xing Ren), Bamboo Leaf (Zhu Ye), Arisaema Rhizome (Zhu Huang), and Bamboo Juice (Zhu Li). One dose resulted in continuous delirious speech. Parents doubted the prescription. Wang Mengying said: "Muteness turning to speech is a turning point." Another dose: intense thirst preferring extremely hot drinks. Parents doubted cold herbs. Wang Mengying said: "Take one more dose, then adjust." Third dose: phlegm gradually expectorated. After four doses, tongue extended, bowels moved, consciousness cleared. Removed Atractylodes Rhizome, Gypsum, Rhinoceros Horn, Turtle Shell; added Rehmannia Root (Sheng Di), Dendrobium Stem (Shi Hu), Ophiopogon Tuber (Mai Dong), Fritillaria Bulb (Bei Mu). Several doses: fever completely subsided, phlegm tasted salty. Removed Apricot Seed, Fritillaria Bulb, Arisaema Rhizome; added American Ginseng (Xi Yang Shen), Oyster Shell (Mu Li), Tortoise Shell (Gui Ban), Cistanche Stem (Rong Rong). Recovery achieved. Over a year later, father died; subsequently suffered fire disaster, emotional depression, mistaken warming tonification. Died in the Wu-Shen year.
Shao Yuzhu Jijian suffered from a febrile disease. Yang Mou treated it as Malaria without success, then invited Wang Mengying. Pulse: soft, profuse sweating, fever not severe, thick greasy coating, nausea, irritability, profuse phlegm, leg soreness. Clearly Wet-Warm Disease. Told his son: "Wet-Warm Disease is dampness accumulating long-term, transforming into heat due to seasonal influences. Do not treat from the exterior, nor fear deficiency and blindly tonify." Prescribed Xuan Jie (Vent and Resolve) one dose; symptoms reduced significantly. However, amidst conflicting opinions claiming the disease came from mental exhaustion and fearing collapse due to sweating, ignoring the root, physicians concurred, administering Ginseng, Angelica, and Prepared Rehmannia. Condition worsened daily. Finally, Wu Gonian diagnosed: "This is Wet-Warm Disease, why blindly administer tonics?" Too late to save, died on the fourteenth day, regretting not following Wang's advice.
Weng Jiashun's brother-in-law, Mr. Wu, after labor injury, had fever and jaundice, attributing it to fatigue. Wang Mengying palpated: soft and rapid. Severe Wet-Warm Disease, hence immediate jaundice. Urgently prescribed clearing and resolving; stool gradually loose, urine very dark. Damp-heat descended, fever reduced. Living in Maojiabu, stingy with carriage fare, stopped medication abruptly. Seven to eight days later, fever returned, delirium, deafness, spasms, enuresis. Requested Wang Mengying again. Damp-heat pathogens disturbed the Ying level. Prescribed Scrophularia Root (Yuan Shen), Rhinoceros Horn (Xi Jiao), Atractylodes Rhizome (Shi Chang Pu), Forsythia Fruit (Lian Qiao), Bamboo Shavings (Zhu Ru), Bamboo Leaf (Zhu Ye), Honeysuckle Flower (Yin Hua), Gypsum (Shi Gao), using the method of venting Wei and clearing Ying, assisted by Niu Huang Wan (Cow Bezoar Pill) and Zi Xue Dan (Purple Snow Pellet). Recovered. Buttock skin collapsed; urgently applied sheepskin gold dressing to prevent ulceration.
Wu Xianzhang, over sixty, suffered from a febrile disease. Physicians knew it was Wet-Warm Disease, but medication failed, yet he could still rise and manage affairs. Shi Beiya invited Wang Mengying, hoping to prevent aggravation. Pulse: Left Cun rapid and hurried, others soft and large. Food intake slightly reduced, loose stool, scanty urine, yellow greasy coating, tip of tongue uniquely black. Wang Mengying refused to prescribe. People were surprised. He said: "The syndrome is originally not heavy. Observing pulse and tongue, this person usually exerts mental effort excessively, Fire (Heart) hyperacts internally, Water (Kidney) fails to control it, inevitably self-immolation, especially with Wet-Warm infection." Indeed, he died after a few days.
Huang Chunguang, seventy-eight years old, suffered from Wet-Warm Disease. After ten days, pulse showed intermittent beats, continuous hiccups. Physicians feared it. Wang Mengying diagnosed: "Pulse intermittent but wiry and forceful with root; Heaven-endowed Qi is strong. Although elderly, it is an excess image. Combined with deep disease and hoarse voice, it is serious. Bowel and bladder obstruction, gray greasy coating, suggests Fu organ Qi not disseminated, phlegm, dampness, and heat blocking Qi transformation. Clearing and disseminating may still work." He Xin zhi agreed. Prescribed Inula Flower (Xuan Fu Hua), Bamboo Shavings (Zhu Ru), Gardenia (Zhi Zi), Melia Fruit (Lian Shi), Loquat Leaf (Pi Pa Ye), Apricot Seed (Xing Ren), Evodia Fruit (Wu Zhu Yu), Coptis Rhizome (Huang Lian), Aster Root (Zi Wan), Trichosanthes Fruit (Gua Lou), Xue Geng (Snow Soup), and one liang of Tong Cao (Akebia Caulis), decocted in water to cook herbs. Immediate relief. Several doses produced massive expectoration of glue-like phlegm, frequent bowel movements, returning to porridge diet. Movement induced cough and rebellion, revealing lower deficiency. Prescribed American Ginseng (Xi Yang Shen), Tortoise Shell (Gui Ban), Oyster Shell (Mu Li), Cistanche Stem (Rong Rong), Dendrobium Stem (Shi Hu), Achyranthes Root (Niu Xi), Cordyceps (Dong Chong Xia Cao), Purple Quartz (Zi Shi Ying), Poria (Fu Ling), Angelica Root (Dang Gui). Symptoms subsided sequentially; added Sand Ginger (Sha Ren) stir-fried with Prepared Rehmannia (Shu Di) for recovery.
Tang Xicheng, over sixty, initial febrile syndrome: whole body red rash, full mouth yellow coating, headache, lower back pain, loose stool, painful urination. His relative He Xin zhi diagnosed as dangerous, invited Wang Mengying. Pulse: wiry, fine, and soft. Deficient Yin and labor-induced fatigue, severe Wet-Warm toxin. Clearing and resolving must preserve Yin. Prescribed Rhinoceros Horn (Xi Jiao), Antelope Horn (Ling Yang Jiao), Poria (Fu Ling), Bamboo Shavings (Zhu Ru), Honeysuckle Flower (Yin Hua), Forsythia Fruit (Lian Qiao), Mulberry Branch (Sang Zhi), Reed Rhizome (Wei Jing), Akebia Caulis (Tong Cao), Eupatorium Leaf (Lan Ye), decocted in Winter Melon Soup. Whole body red rashes appeared; suddenly left eyelid swollen, right arm sore and immobile, deafness, unclear spirit. Urgently prescribed Scrophularia Root (Yuan Shen), Moutan Cortex (Dan Pi), Chrysanthemum Flower (Ju Hua), Gardenia (Zhi Zi), Mulberry Branch (Sang Zhi), Luffa Vine (Si Gua Luo), Dendrobium Stem (Shi Hu), Bamboo Leaf (Zhu Ye), decocted with Shen Xi Dan (Divine Rhinoceros Pellet). Occasionally consulted surgeon for external lesions, who also identified damp-heat cause, continuously administered Wood Tong (Mu Tong) etc., pulse finer and weaker, spirit more drowsy, no food intake, painful urination worsened. Xin zhi thought it incurable. Wang Mengying said: "Urgently rescue Yin fluids, still a turning point." Used Mai Men Dong Tang minus Ginger, Cinnamon, Hemp Seed, replaced with American Ginseng, added Anemarrhena Rhizome (Zhi Mu), Trichosanthes Root (Hua Fen), Bamboo Leaf (Zhu Ye), Sugarcane Juice (Zhe Jiang). One dose: spirit revived, pulse rose. Second dose: coating receded, hunger returned. Third dose: body cooled, urination smooth. Six doses: skin shed, peaceful sleep, eyes open, tongue moist. Some questioned how sweet, soft, and greasy drugs could clear damp-heat. Wang Mengying said: "Those with Yin deficiency and internal heat easily transform dampness into fire. Fire burns fluids, impairing distribution. Frequently irrigating with sweet-cool herbs restores fluids and reaches Qi. Merely knowing to promote dampness eliminates Yin first. Must analyze pulse and symptoms; methods cannot be rigid." After several doses, sudden limb swelling, widespread wheals, abnormal itching. Others suspected change. Wang Mengying said: "This is Yin fluids replenishing, residual pathogens seeking exit." Prescribed light and clear herbs for several doses; indeed recovered.
Jin Luqing's wife, young daughter of Shen Yukun. Suffered from Warm Disease. Gu Tingquan continuously administered light, cool, clearing, and resolving drugs without improvement. Qi rebellion, insomnia, coughing sticky phlegm, crimson tongue, dry throat, deafness, delirium. After ten days, Wang Mengying was consulted. Said: "Thin body, fine and rapid pulse, chaotic Chi position. Yin Qi injured first, Yang Qi alone flaring, as said in Shang Han: 'Preferentially kills those with lower deficiency.' Like impending fire, no ponds or wells, empty jars; exhausting efforts is useless." Investigated thoroughly, learned that one day before onset, she had severe leukorrhea, true fluids leaked early. Otherwise, treatment was correct, why did it flare like fire? Spasm and collapse imminent. Luqing insisted on trying. Wang Mengying prescribed American Ginseng (Xi Yang Shen), Rehmannia Root (Sheng Di), "Two Winters" (Dong Hua, Dong Mi), "Two Reaches" (Er Zhi Wan), Scrophularia Root (Yuan Shen), Rhinoceros Horn (Xi Jiao), Coptis Rhizome (Huang Lian), Egg Yolk (Ji Zi Huang). Separately decocted Dendrobium Stem (Shi Hu), Tortoise Shell (Gui Ban), Turtle Shell (Bie Jia) 4 liang each, Left Oyster Shell (Zuo Mu Li) 1 jin, using this liquid to decoct herbs. Gu Tingquan added Donkey-hide Gelatin (E Jiao), saying: "We use this large dose to nourish Yin, suppress Yang, fill fluids, extinguish wind; how can fluid depletion and wind stirring cause sudden spasm?" Two doses: indeed no reduction. Later confused by side remarks, prayed for talismanic medicine, administered Aconite (Fu), Cinnamon (Gui), Dried Ginger (Gan Jiang), without caution, died of limb rigidity. Mistaken medicine accelerated death and increased tragedy. Subsequently, Yukun suffered Wet-Warm Disease, also died from severe heat.
Weng Jiashun's sister also contracted disease, critical condition, believing herself doomed due to underworld service. Wang Mengying said: "Young age, abundant Yin, correct treatment, how can she die? Ancients said: 'One who understands principles is not bound by Yin-Yang and Five Elements.' I will let principle defeat fate." Treated accordingly, condition improved daily. Cautious of weather, regulated diet, observed taboos, treated for twenty days, truly recovered.
His aunt, Mrs. Wu, suffered from Warm Disease. Initially refused medication. After seven days, Wang Mengying was consulted. Said: "Pathogen not strong, but frequent vomiting of saliva, inability to pass stool,"