Library

Wang Ximing was a respected elder in Zhushan. In his early adulthood, he had an irritable temperament and suffered from phlegm-fire (Tan Huo) internally, with a history of hemoptysis (Tu Hong). A previous physician used astringent agents too early, causing phlegm and blood stasis (Yu Xue) to stagnate in the meridians, forming the root of the disease. The patient remained unaware of this, and furthermore, moxibustion was applied to Feishu (BL13) and Gaohuang (BL43), aggravating the pre-existing condition. Simple astringency proved ineffective, and yin-nourishing herbs caused obstruction due to their cloying nature, resulting in coughing so severe that sleep was impossible. He was then mistakenly diagnosed with wind-pathogen invasion and treated with diaphoretic formulas. Unaware that fire-heat intensified by wind-dispersing herbs would flare up further, the patient experienced spurting hemoptysis from the mouth and nose, resembling a gushing spring.

I was then consulted. The pulse was surging and rapid in all six positions. The body was hot and restless. Given that it was the height of summer (Sanfu days), internal and external fire were attacking simultaneously. Even with a robust constitution, how could one withstand such consumption? I reasoned that only a method akin to "drawing firewood from under the cauldron" (Fu Di Chou Xin) could curb the upward surging of blood. Therefore, I prescribed three-times processed Rhizoma Rhei Preparata (Sanzhi Dahuang) 3 qian, Gypsum Fibrosum (Shigao) 5 qian, Radix Coptidis (Huanglian), Radix Rubiae (Qiangen), and Talcum (Huashi) each 2 qian, and Cortex Moutan (Mudanpi) 1 qian. This was decocted rapidly and administered. After two slight bowel movements, the bleeding slowed. Immediately thereafter, I prescribed Gypsum Fibrosum (Shigao), Talcum (Huashi), and Fructus Ligustri Lucidi (Dongqingzi) each 3 qian, Herba Ecliptae (Hanliancao) and Radix Rubiae (Qiangen) each 2 qian, Radix Coptidis (Huanglian), Fructus Gardeniae (Shanzhi), and Radix Bletillae (Beimu) each 1 qian, Radix Glycyrrhizae (Gancao) 0.5 fen, and Radix Imperatae (Maogen) 5 qian. Decocted and taken, the bleeding stopped completely.

Three days later, the stool became dry and hard, and the fire rose again, causing continuous coughing. The left guan pulse was wiry and forceful, while the right guan pulse was surging and slippery. I administered Danggui Longhui Wan (Angelica Sinensis and Gardenia Pill) to purge the bowels, after which the cough began to subside. The prescription was then changed to Pericarpium Trichosanthis (Gualouren) and Radix Rubiae (Qiangen) each 1.5 qian, Radix Bletillae (Beimu), Herba Ecliptae (Hanliancao), Radix Ophiopogonis (Maimendong), and Radix Anemarrhenae (Zhimu) each 1 qian, Radix Paeoniae Alba (Baishao) 2 qian, Radix Coptidis (Huanglian) and Radix Scutellariae (Huangqin) each 0.7 fen, Fructus Aurantii (Qingpi) and Radix Glycyrrhizae (Gancao) each 0.3 fen, still adding Radix Imperatae (Maogen). Thereafter, whenever constipation occurred, Longhui Wan was administered. Following this regimen for three months, the condition stabilized; after half a year, full recovery was achieved. Medical texts state: "There are six conditions where moxibustion is contraindicated; those with excess fire must not be moxed." This case resulted from erroneous moxibustion, nearly leading to death, so I recorded it specifically as a warning for those fond of moxibustion.

Zhu Hongwu, a scholar from Dexing and the great-uncle of Magistrate Zhu, was retired at home. He occasionally suffered from yin-yang imbalance, presenting with tidal fever at wu and zi hours, cough with profuse sputum, incessant sweating, chest and diaphragm discomfort, dry and hard stools, and panting, fatigue, and thirst upon exertion. I prescribed Radix Bletillae (Beimu), Radix Anemarrhenae (Zhimu), Pericarpium Trichosanthis (Gualouren), and Cortex Moriperiphyllae (Sangbaipi) each 1 qian, Fructus Aurantii (Zhike), Radix Coptidis (Huanglian), and Radix Ophiopogonis (Maimendong) each 0.8 fen, Radix Platycodi (Jiegeng), Radix Bupleuri (Chaihu), and Radix Peucedani (Qianhu) each 0.5 fen, Radix Glycyrrhizae (Gancao) 0.3 fen, and Semen Schisandrae (Wuweizi) 11 grains. Taken orally, slight sweating occurred at dawn, reducing the fever by seventy percent. Only sputum-cough, panting, and fatigue remained. Thus, I changed the formula to Pericarpium Trichosanthis (Gualouren) 2 qian, keeping other dosages as before, and added Qizhi Huatan Wan (Seven-Processed Phlegm-Resolving Pill) at night until the heat completely subsided. The patient was very pleased, believing he could cease medication henceforth. I said, "Not yet. According to the wiry and rapid pulse, malaria may develop." He did not agree. As I traveled east for half a month, a letter reported the onset of malaria, with worsened coughing and expectoration of thick, yellow, old phlegm. I stated, "Medical texts say: 'No phlegm, no malaria.'" I retained the previous formula, doubling Chaihu and Beimu as the chief herbs, adding one Fructus Mume (Wumei), and after four doses, he recovered miraculously. The patient remarked, "Your diagnosis is as responsive as a drumstick striking a drum. The ancients said: 'The wise do not treat existing diseases but prevent impending ones.' I have verified this through your words." He then recounted this to Magistrate Zhu. Magistrate Zhu joyfully said, "Dr. Sun not only possesses the orthodox lineage of Qi and Huang but also displays elegant friendship. My great-uncle had not previously heard of him. I shall compose a poem to present to him." Thus, he happily wrote several regulated verses and gave them to me, which are attached in Volume Six.