乙卯冬初，余挈眷回籍，卜居 溪。秀水吕君慎庵邀余游新塍，视屠舜传之女适张氏者。据云病起产后，延
已五年，久卧于床，势成瘫痪，广服补剂，迄不见功。及入室视之，病者尚着单衣，贴身仅铺草席，而窗户尽扃。
因询畏热而喜暗乎？曰然。按脉弦而滑，执烛照之，面有赤色，苔甚黄腻。复询其胸闷气升乎？溲热易汗乎？亦
曰然。且汛事仍行，饥不能食，耳鸣头晕，腿软痰多。病不在于血分，虽起自产后，而根株实不在是。细诘之，
始云未嫁之前，宿有气升眩晕之疾，于今已十载矣。余曰是也，此固风阳内炽，搏液成痰之证，因娩而血大去，
故发之较剧，医者不揣其本而齐其末，遂以为产后之虚，温补率投，升逆愈甚，下虚上实，致不能行。与清火降
痰之剂而别。曰气得下趋，病可渐愈。后闻其西席钟君子安向慎庵云∶服王药五帖，即能扶杖以出矣。
舜传之舅嫂，因用力拔针而患指痛，内外杂治，渐至痛遍一身，卧榻不起，食少形消。余诊之，脉细而数，
口干舌绛。乃营阴大亏，无以营养筋骨。岂可因拔针起病，遂以为外伤而妄投燥烈之药乎？宜其病日以甚也。以
集灵膏加减为方而愈。
谢君再华之室，偶患齿痛，日以加甚，至第五日，知余游武林，拉往视之，已呻吟欲绝，浑身肉颤，按脉不
能准，问病不能答，苔色不能察，惟欲以冷器贴痛处。余谛思良久，令以
淡盐汤下滋肾丸三钱；外以坎宫锭涂痛外、吴茱萸末醋调贴涌泉穴。次日复诊，已谈笑自若，如常作针黹矣。向
余致谢曰∶昨药一饮即寐，而病如失，真仙丹也。余谓昨日大窘，若非素知为肝阳内炽之体，几无措手。今火虽
降，脉尚弦数，宜用滋潜善后。以一贯煎方，嘱其熬膏服之，遂不复发。
仁和邵位西枢部令嫒字许子双司马为媳者，在都患心悸头晕，渐不起榻，驯致不能出语。旋杭，多医治之，
佥以为虚，广服补剂，遂减餐少寐，频吐痰涎，畏风怕烦，溲短便闭，汛愆带盛，以为不能过冬至矣。适余游武
林，赵君菊斋嘱其邀诊。脉之弦数而滑，面白唇红，目光炯炯而眉蹙羞明，苔黄乳裂，既非喑证，又非失音，强
使出一、二字，则艰涩异常，摇手点头，或以笔代口，且无妄见，亦非祟病。余谛审之，谓其必起于惊恐，而痰
涎阻于窍隧。病者颔之。以起病时为一大瓶堕地，乍闻其声而一吓也。遂与清心肝胆胃之法，加舒络涤痰开郁之
品。服后各恙渐减，眠食渐安。丙辰春，余复视之。仍卧于床，仍不出语。按钮氏《续觚剩》鼠魂一条，与此相
似，彼特神其说耳。然余竟不能治之使语，殊深抱愧，录之以质高明。戊午季秋，复游武林往诊，尚如故。闻其
仍服补剂，因力劝阻，而赠以清肺通络涤痰之品，制丸噙化。服至次年春仲，遍身发疹，频吐秽痰，语能渐出，
乃蕴结外解，从此整肃，可期奏绩，初论尚不甚爽。
丙辰春初，余游梅泾，曹霭山茂才拉视其令郎之证。云起于往夏疟后，暮热鼻衄，善欠羞明，额颊时 ，溲
混有脚。先禀素弱，佥虑成劳，频服滋填，毫无寸效，久不起榻。及余诊之，脉软滑而微长，苔淡黄而不渴，仅
能仰卧，反侧不能。曰
此非虚劳也，乃热伏阳明，是以机关不利，筋骨不束，而见以上诸证。幸衄血频流，小溲混浊，热气尚有宣泄，
而人不甚枯削，以阳明为多气多血之经也。与生槐蕊、知、柏、芩、栀、白薇、花粉、茅根、茹、斛、丝瓜络等
药，久服果渐愈。
里中张君雪沂令正，三十七岁。于乙巳年患经行腹痛，医进胶艾汤多剂，痛乃日盛，而加以呕吐，迄今十载，
诸药备尝。迩年经至益频，痛势益剧，满床乱滚，声彻比邻。乞余诊之，脉弦滑而数。曰∶巅痛、口渴乎？带多、
腰痛乎？汛色紫黑乎？病者惊以为神，惨容为之一展。余谓雪沂曰∶此证不但温燥腻补不可用，即四物汤亦在禁
例。宜乎遍访女科，而竟无一效也。与芩、连、栀、胆、茹、柏、蒿、薇、乌 、茅根、藕为剂，服至下月经行，
即不吐，痛亦大减。此等药服逾半载，各恙悉蠲。
钱塘张君篪伯令郎韵梅茂才之室，自去年夏间娩后，虽不自乳，经亦未行。方疑其劳也，四月间患感，医进
升散药，遂腹膨气逆，肢痉欲厥，或又疑其娠也。延余诊之，脉弦巅痛，乃营虚肝郁，微挟客邪，误投提表耳。
以清解轻宣之品数剂而愈，继参养荣，月事亦至，人皆诧为神治，其实非大病也。
仁和胡次瑶孝廉，北上未归，其令正于仲夏陡患肢麻昏晕，速余往视。面微红，音低神惫，睛微赤，舌苔微
黄，足微冷，身微汗，胸微闷，脉微弦。乃本元素薄，谋虑萦思，心火上炎，内风随以上僭也。不可误以为痧闭，
而妄投香燥辛散之品。以人参、龙、蛎、菖、连、石英、麦冬、小麦、竹叶、莲子心为方，两啜而愈，寻与平补
善其后。
仁和戴君文叔令嫒，年十二。患风斑睛赤，服升散药数帖，
忽觉胸次不舒，饮食下咽即吐，时作时止，医皆莫措。六、七日后，其作愈频，而有欲厥之势。所亲徐君乐亭，
嘱延余诊。脉弦而数，夜不成眠，目赤未蠲，苔黄口苦。是发斑不由外感，乃稚质阴亏，风阳上越，助以温散，
厥少陡升，肃降无权，因而吐逆。以连、柏、橘、半、栀、苑、茹、旋、海 ，少加苏叶煎送当归龙荟丸。一剂
知，二剂已。
桐乡冯诒斋广文，年二十七岁。自上年患 ，至今已十余枚，皆破而不敛，肌肉渐削，迨季夏渐形发热，而
纳食阻膈，溲短便溏，气逆嗽痰，咽喉疼肿。诸医束手，秀水庄丈芝阶荐余诊之。脉数而左寸关兼弦大，是病由
过扰心阳，兼伤谋虑，从前但从呆补，已成不治之证，近则吸受暑邪，犹日服滋填之剂，是以药造病也。而诒斋
一见倾心，坚留数日。因谓其令兄静岩赞府曰∶余仅许愈其新病也。以沙参、苡、斛、橘、半、蒿、薇、蛤壳、
浮石、茯苓，煎吞香连丸。二剂而痛泻渐止，去香连加鳖甲。又二剂而热退，改用参、苓、橘、半、苡、蛎、石
英、首乌、象牙屑、冬虫草等出入为方，卧时另制噙化丸，以肃上焦痰滞。服四帖已能起榻，眠食皆安，余遂归。
秋杪闻其没于鱼江外科家，少年博学，惜哉！余邮挽一联云∶“倾盖相知，讵成永诀；着书未竟，遽赴修文。”
知渠方注顾亭林先生《肇域志》而即病也。其夫人即于秋杪起患赤痢，延至次年春杪，证已濒危。适余游鸳湖，
往视之。昼夜三、四十行，汛断肌消，少腹素有聚瘕，跃跃而动，气冲胸下，绞痛难堪，卧不能眠，饥不能食，
口干舌绛，五热溺无，头项汗频，音低色夺，脉来细数，右软尺空。是久积忧劳，兼伤哀恸。真阴
素弱，岂可与常痢同观。以沙参、熟地、黄连、黄柏、白头翁、秦皮、冬虫夏草、枸杞、橘核、白薇，用藕、苡、
燕窝煮汤煎药，服二十剂。余游瀛洲转禾复诊，脉和痢减，安谷能眠，痛止溺行，面有华色。改用人参、熟地、
龟版、归身、黄连、黄柏、枸杞、白薇、薏苡、砂仁，以藕汤煎成，入阿胶烊服而愈。
项君香圃患赤痢濒危，所亲庄眉仙少府拉余往视。脉细不饥，口干舌绛，形消色瘁，不寐溺无。禾中医者以
其素耽曲 ，辄进苦燥渗利之药，而不闻景岳云∶酒之为害，阴虚者饮之，则伤阴也。况病因暑热，不夹湿邪，
温燥过投，阴液有立涸之虞。余将旋里，为定西洋参、生地、甘草、银花、石斛、麦冬、生白芍、扁豆花、枳
子、藕汁一方，冬瓜汤煎，令其恣服。次年春，余往禾候庄芝阶先生之疾，有一人来拜谢，面如重枣，素昧生平，
甚讶之。眉仙曰∶即香圃也，面向赤，上年因病危而色脱，故先生不识耳。承惠之方，服十余剂而愈。今又善饮
如昔矣。
角里街怡昌烛铺苏妪，年已六旬。偶患腹痛，医谓寒也，进以热剂，痛渐剧而腹胀便闭，按之甚坚，又以为
肠痈，攻之而愈痛，遂绝粒不眠，呼吸将绝。挽余诊之，脉滑而数，舌绛苔黄，口臭溺无，热阻气也。以雪羹煎
汤调益元散五钱徐灌之，即痛减气平；次日以雪羹汤送当归龙荟丸三钱，便行溺畅；随以轻清药数帖而痊。
七月中旬，余游 李归，道出梅泾，吕君慎庵拉视沈则甫令正之恙。两年前曾患滞下，嗣后便泻不已，今夏
更剧，每
晨尤甚，后重肠鸣，不饥不渴，畏热无汗，胸闷时呕，夜不成眠，形消色瘁，小溲通畅，脉软微弦，经事渐稀。
乃中虚木侮，生化无权，气久虚而血将涸矣。若刚燥则助风阳，滋腻更增滑溜，议砥柱中流，回狂澜而镇风轮。
以潞党参、山药、石脂、余粮各三钱，茯苓、白芍各一钱五分，煨诃子、橘皮各一钱，牡蛎八钱，乌梅肉炭八分，
酒炒黄柏六分，熟附子、炙甘草各五分，甘澜水煎陈米汤煮药使浓浓，徐徐细呷，俾留恋中宫，不致直下为法。
迨八月下旬，在曹霭山茂才处晤则甫云∶前方服至四剂，病即愈，今已色华能食矣。因以诗什、芽茶为赠。次年
冬，闻患寒热亡。
山妻怀孕四月，患间疟，腹痛便溏，汗多呕闷，乃痰气内滞，风暑外侵，脉滑而弦。与枳、桔、苏、连、柴、
芩、菖、夏，三剂而瘳。大女馥宜患微寒热炽，每发于夜，汛不当期而至，口渴便闭，目眩多汗，米饮不沾，暑
热为疟也，脉洪数。以知、芩、橘、半、蒿、薇、鲜斛、元参、栀子、花粉，服六剂而热减大半；去蒿、半，加
西洋参、麦冬、竹茹、枇杷叶，又六剂而便行疟止；随去元参、鲜斛，加归身调之而愈。季杰弟 室之疟，日轻
夜重，少腹觉有块，上冲则呕嗽并作，杳不进谷。余游禾归，已交八日矣。脉软以涩，是肝郁于内，暑侵其外也。
用芩、夏、翘、滑、菖、蛤、苏、连、旋、橘、丝瓜络，服六帖，诸恙霍然，随与清养善后。仲秋二十八日，余
游濮院归。是夜又陡患霍乱，腹痛异常。余起诊其脉，细数而弦，肢冷畏寒，盖覆甚浓，询其口不渴，而泻亦不
热，惟小溲全无，吐者极苦，舌色甚赤，乃新凉束暑也。玉枢丹、绛雪灌之皆不受，泻至四、五次，始觉渐热而
口大渴，仍不受饮，语言微
謇。余令捣生藕汁徐灌之，渐能受，随以芩、连、苡、楝、栀、斛、桑叶煎服，痛即减，吐泻亦止，次日知饥，
略受食，神惫已极，筋络 疼，与清养法而痊。
硖石镇蒋寅 大理令正，久患少腹聚气，时或上冲于胸而为脘痛，时或下坠而为腿肿，带多汛速，腹胀胸闷，
口腻不渴，便虽溏而欲解不行，必啖盐而始畅。皆以为脾虚，率进补剂，病日以甚。迎余诊之，脉弦滑。以栀、
芩、菖、枳、连、夏、茹、旋、雪羹清肝热以豁痰，滞气果下行至足，而胸腹渐舒。
管君幼斋令正，汛停七月，至仲秋经行不多，腹乃微胀，继则胸闷不饥，身有寒热。吕某以桂枝、黄连等药
进，而痞闷转加，二便不行，口糜而渴，得饮即吐，夜不能寐，五内如焚。余诊之，脉弦而细，面赤足冷，神惫
不支。是营阴素亏，气机多郁，郁久生热，辛燥忌投。授沙参、蒌、薤、栀、茹、旋、苑、冬瓜子、枇杷叶，二
剂而燥矢行，胸腹舒，知饥，吐止，继以宣养而瘥。其汛停良由血不足，非有血不行而阻也。
前月中旬，余过濮院，有香海寺前一妇患三疟求诊。面白唇红，舌绛而渴，寒微热盛，溲短便艰，汛事先期，
不眠，脉数，乃暑邪侵营也。与元参、丹皮、知、薇、蒿、栀、花粉、鲜斛、竹叶之方。至八月下旬，再游其地，
渠复求视，云前方服即病减，至二十剂而痊，乃子以为病后须服补药，才四帖，疟复作，遂不敢再进。余谓此必
温补方也，阅之果然。仍授清化之剂，五服而瘳。
仲秋偶觉左乳微疼，按之更甚，始知有坚核如小豆大，外微肿，即取外科药围涂，而以纸盖之，迨药干，揭
之甚痛，余不能忍。且佥云必破而不易收功，以其在乳盘之内也。余不畏死，而惧不能受此楚毒，因往求吕君慎
庵视之。曰无虑也，扫
榻款留。日以葱白寸许，嵌入梅花点舌丹一粒，旋复花三钱煎汤下；外用洄溪束毒围围之，亦以纸盖之，而药干
则自然脱落，略无粘肉伐毛之苦，此玉精炭之妙用也。凡十二日，核渐消尽。深佩吕君之德，谨录之以识其手眼
之不可及，而方药之效验，俾后人亦有所征信也。
一铁匠妇患感，杂治经旬，身热不退，不眠妄语，口渴耳聋，求治于余。脉来细数，唇红面白，肌瘦汗频。
虽是贫家，却为娇质，神虚液夺，余暑未清。以西洋参、甘草、小麦、黄连、麦冬、石斛、丹参、莲心、竹叶为
剂服之，神气遂安；自云心悸，因加红枣与紫石英，服之浃旬，竟以告愈。
九月初旬，蒋君寅 招余治其令兄仲卿孝廉夫人之病。年五十九岁。平素操持，腹有聚气，脘痛时作，大便
易溏。半月以来，身热耳聋，病泻不食，胸中痞塞，痰韧如胶，口腻欲呕，神情惫甚，脉来虚弦而细，舌苔黄腻
无津。乃营津久耗，气郁不舒，既挟客邪，过投清散，以致本实欲拨也。与参、苓、橘、半、蒌、薤、茹、连、
In the early winter of the Yimao year, I returned to my hometown with my family and settled by the stream. Mr. Lv Shen'an from Xiushui invited me to Xincheng to examine the daughter of Tu Shunchuan (who had married into the Zhang family). According to her family, the illness began postpartum and had persisted for five years. She had been bedridden for a long time, developing paralysis, and had widely taken tonic preparations without effect. Upon entering the room to examine her, the patient was still wearing thin clothing, with only a straw mat beneath her, and all windows were tightly shut. I asked if she feared heat and preferred darkness; she replied in the affirmative. Her pulse was wiry and slippery. Illuminating with a candle, her face appeared red, and her tongue coating was yellow and greasy. I further asked if she experienced chest fullness and rising qi, hot urination, and easy sweating; she confirmed these as well. Additionally, her menstruation continued normally, yet she felt hungry but could not eat, suffered from tinnitus and dizziness, weak legs, and excessive phlegm. The disease did not reside in the Blood aspect; although it originated postpartum, its root lay elsewhere. After careful inquiry, she revealed that before marriage, she had suffered from chronic qi rebellion and vertigo for ten years. I said: "Indeed, this is a pattern of internal blazing Wind-Yang, scorching fluids to form Phlegm. Because of the massive blood loss during childbirth, the condition manifested severely. Physicians failed to investigate the root and treated only the branches, assuming postpartum deficiency, and indiscriminately administered warming tonics. This exacerbated the rebellious Qi, leading to deficiency below and excess above, resulting in immobility." I prescribed decoctions to clear Fire and descend Phlegm, then departed, saying: "If the Qi can descend, the illness will gradually improve." Later, I heard Zhong Zi'an, a tutor, tell Lv Shen'an: "After taking Dr. Wang's medicine for five doses, she could walk out leaning on a cane."
Tu Shunchuan's brother-in-law's wife suffered finger pain due to forceful needle removal. Despite various internal and external treatments, the pain spread throughout her body, confining her to bed, with reduced appetite and emaciation. My examination revealed a fine and rapid pulse, dry mouth, and a crimson tongue. This indicated severe depletion of Ying-Yin, unable to nourish the sinews and bones. How could one attribute this solely to external trauma from needle removal and recklessly administer drying and acrid-hot medicines? No wonder the condition worsened daily. I cured her using modified Jiling Gao (Cistanche Pill).
Mrs. Xie Zaihua occasionally suffered from toothache, which intensified daily. By the fifth day, knowing I was in Wulin, she summoned me. She was groaning near death, trembling all over, with an unmeasurable pulse, inability to answer questions, and unclear tongue coating. She desired to apply cold objects to the painful area. After deep contemplation, I instructed her to swallow San Qian of Zishen Wan (Kidney Nourishing Pill) with light salt water; externally, I applied Kangong Ding (Kangong Ointment) to the painful area and pasted Wu Zhu Yu powder mixed with vinegar onto Yongquan (KI-1). On the second day's follow-up, she was chatting calmly, resuming needlework as usual. She thanked me, saying: "Yesterday, after one drink of medicine, I slept, and the illness vanished like magic; truly a fairy pill." I replied: "Yesterday was extremely difficult. Had I not known your constitution of internal blazing Liver-Yang, I would have been at a loss. Although the Fire has subsided, the pulse remains wiry and rapid. You should use Yin-nourishing and Yang-subduing methods for recovery." I prescribed Yi Guan Jian (One Decoction), advising her to take it as a paste, preventing recurrence.
The daughter of Shao Weixi, a Privy Councilor from Renhe, married to Sima Xu Zishuang, suffered palpitations and dizziness in the capital, gradually becoming bedridden and mute. Upon returning to Hangzhou, multiple physicians treated her, all diagnosing deficiency and administering widespread tonics. This led to reduced intake and sleep, frequent vomiting of saliva/phlegm, aversion to wind and annoyance, short urine, constipation, irregular menstruation, and heavy leukorrhea. They believed she would not survive until Winter Solstice. Coinciding with my visit to Wulin, Zhao Juzhai requested my consultation. Her pulse was wiry, rapid, and slippery; her face was pale with red lips, eyes bright but frowning against light, and tongue coating yellow with fissures. It was neither aphasia nor mutism. Forcing one or two words resulted in extreme difficulty; she shook her head, nodded, or used a pen to communicate, with no hallucinations, ruling out demonic influence. Careful examination suggested onset due to fright, with Phlegm-saliva blocking the orifices. The patient agreed. Tracing back, a large bottle had fallen suddenly, causing a startle. I prescribed methods to clear Heart, Liver, Gallbladder, and Stomach, adding herbs to soothe collaterals, wash away Phlegm, and relieve depression. Symptoms gradually subsided, and sleep/appetite improved. In spring of Bingchen year, upon re-examination, she remained bedridden and mute. Referencing Niu Xiu's *Xu Gu Sheng* ("Rat Soul" entry), which resembled this case but was mystified, I admitted my inability to restore her speech, feeling ashamed, and recorded it for expert advice. In late autumn of Wuwu year, visiting again, her condition remained unchanged. Hearing she still took tonics, I strongly advised against it and gifted pills for clearing Lung, unblocking collaterals, and washing Phlegm. By mid-spring of the following year, she broke out in rashes and vomited turbid phlegm frequently, gradually regaining speech. This indicated trapped pathogens resolving outwardly. From then on, recovery was expected, though my initial diagnosis was not entirely precise.
In early spring of Bingchen year, while in Meijing, Scholar Cao Aishan invited me to see his son. The illness started after summer malaria last year: evening fever, epistaxis, yawning, photophobia, numbness of forehead/cheeks, turbid urine, and swollen feet. Given his weak constitution, everyone feared consumptive disease and frequently administered yin-nourishing tonics with no effect, leaving him bedridden. My examination showed a soft, slippery, slightly long pulse; pale yellow tongue coating without thirst; able only to lie supine, unable to turn. I said: "This is not consumptive disease, but Heat latent in the Yangming channel, causing joint dysfunction and lack of sinew/bone binding, presenting as above. Fortunately, frequent epistaxis and turbid urine indicate heat expulsion, and he is not severely emaciated because Yangming is a channel abundant in Qi and Blood." I prescribed Sheng Huairui, Zhimu, Huangbai, Huangqin, Zhizi, Baiwei, Huafen, Maogen, Zhuru, Shihu, and Sigualuo. Long-term use led to gradual recovery.
Mrs. Zhang Xueyi, aged 37, suffered dysmenorrhea starting in Yisi year. Multiple doses of Jiao'ai Tang increased pain and induced vomiting. Over ten years, she tried all medicines. Recently, menstruation became more frequent, pain more severe, rolling on the bed, screaming audible to neighbors. Pulse was wiry, slippery, and rapid. I asked: Cephalalgia? Thirst? Heavy leukorrhea? Lumbago? Dark purple/black menstrual blood? She was amazed, thinking me divine, and her grimace softened. I told Xueyi: "For this pattern, warming-drying and cloying tonics are contraindicated; even Siwu Tang is forbidden. No wonder gynecologists failed." I prescribed Huangqin, Lian, Zhizi, Danni, Zhuru, Huangbai, Qinghao, Baiwei, Wumei, Maogen, and Ou. By next menstruation, vomiting ceased, and pain greatly reduced. Taking these herbs for over half a year eliminated all symptoms.
Mrs. Yunmei, wife of Liangcai Rongmei, son of Zhang Chibo from Qiantang, had not menstruated since summer delivery last year, despite not breastfeeding. Suspected deficiency, she contracted a cold in April. Physicians administered lifting/dispersing drugs, causing abdominal distension, rebellious Qi, limb spasms, and syncope. Others suspected pregnancy. My examination showed wiry pulse and vertex headache. This was Ying-blood deficiency with Liver depression, slight exterior pathogen, mismanaged by surface-lifting drugs. Several doses of clearing/resolving and light-dispersing herbs cured her. Subsequent Yangrong supplementation restored menstruation. People marveled at the miraculous cure, but it was not a major disease.
Hu Ciyao, a Jinshi from Renhe, was away in the north. His wife suddenly suffered limb numbness and vertigo in mid-summer. Examination: slightly red face, low voice, fatigue, slightly red eyes, pale yellow tongue coating, cold feet, slight sweat, mild chest stuffiness, wiry pulse. Constitution was originally weak, burdened by worry/thoughts, causing Heart-Fire flaming upward and internal Wind rising. Do not mistake for Sha-closure or recklessly use aromatic-drying/acrid-dispersing drugs. Prescription: Renshen, Longgu, Muli, Shichangpu, Lian, Shiying, Maidong, Xiaomai, Zhuye, Lianzixin. Two doses cured her; followed by mild tonification.
Dai Wenshu's daughter, aged 12, suffered wind-rash and red eyes. After several doses of lifting/dispersing drugs, she suddenly felt chest discomfort, immediate vomiting after swallowing food, intermittent. Doctors were helpless. After six-seven days, frequency increased, approaching syncope. Relative Xu Leting requested my consultation. Pulse wiry and rapid, insomnia, persistent red eyes, yellow coating, bitter taste. Rash was not from exterior contraction but from childhood Yin deficiency with Wind-Yang floating up. Warming dispersants aggravated Jue-Shaoyang, impairing descending function, causing vomiting. Prescription: Lian, Bai, Ju, Ban, Zhi, Yuan, Ru, Xuan, Haifushi, with少许 Suye decocted to deliver Danggui Longhui Wan. One dose effective, two doses cured.
Feng Yizhai, a scholar from Tongxiang, aged 27. Since last year, suffered from sores, now over ten, ulcerated and non-healing, with muscle wasting. By late summer, fever developed, dysphagia, short urine, loose stool, rebellious Qi, cough with phlegm, sore throat/swelling. Doctors were helpless. Zhuang Zhijie recommended me. Pulse rapid, left Cun/Guan wiry and large. Illness caused by excessive disturbance of Heart-Yang and mental strain. Previous treatment relied on static tonification, rendering it incurable. Recent summer-heat invasion combined with continued yin-tonics created iatrogenic disease. Feng insisted I stay. I told his brother Jingyan: "I only promise to cure the new illness." Prescription: Shashen, Yiyiren, Shihu, Ju, Ban, Qinghao, Baiwei, Geqiao, Fusshi, Fuling, decocted to swallow Xianglian Wan. Two doses stopped pain/diarrhea; removed Xianglian, added Biejia. Two more doses reduced fever; switched to Renshen, Fuling, Ju, Ban, Yiyiren, Muli, Shiying, Shouwu, Xiangyasui, Dongchongxiacao. Bedtime pills cleared upper Jiao Phlegm-stasis. Four doses allowed getting up, normal sleep/appetite, then I returned. Late autumn, heard he died at a surgeon's home. Regrettable! Sent couplet: "Acquaintance turned to eternal parting; unfinished books, sudden call to literary service." He was annotating Gu Tinglin's *Zhaoyuzhi* when ill. His wife also got bloody dysentery in late autumn, worsening to spring. Visiting Yuanhu, she had 30-40 stools/day, amenorrhea, emaciation, active abdominal mass, Qi rushing to chest, unbearable colic, insomnia, anorexia, dry mouth/crimson tongue, five-palm heat, anuria, head/neck sweating, low voice/pale color, fine/rapid pulse, right soft/kidney empty. Chronic worry/labor plus grief. True Yin weak, unlike common dysentery. Prescription: Shashen, Shudi, Huanglian, Huangbai, Baitouweng, Qinpi, Dongchongxiacao, Gouqi, Juhe, Baiwei, decocted in Ou/Yiyiren/Yanwo soup. Twenty doses. Follow-up in He: pulse harmonized, dysentery reduced, eating/sleeping restored, pain/anuria resolved, complexion glowing. Changed to Renshen, Shudi, Guiban, Danggui, Huanglian, Huangbai, Gouqi, Baiwei, Yiyiren, Sharen, decocted in Ou soup, dissolved Ejiao. Cured.
Xiang Xiangpu, critically ill with bloody dysentery. Relative Zhuang Mixian requested consultation. Fine pulse, anorexia, dry mouth/crimson tongue, emaciation/fatigue, insomnia/anuria. Jiaxing doctors, noting alcohol indulgence, used bitter-drying/diuretic drugs, ignoring Jingyue's warning: "Alcohol harms Yin; drinking damages Yin in Yin-deficient persons." Etiology was summer-heat without dampness; excessive drying threatened total Yin collapse. Before leaving, I prescribed Xiyangshen, Shengdi, Gancao, Yinhua, Shihu, Maidong, Sheng Baishao, Biandouhua, Zhizi, Ouji, decocted in winter melon soup, to be taken freely. Next spring, waiting for Zhuang Zhijie in Jiaxing, a man greeted me with a red face, unknown to me. Mixian said: "It's Xiangpu. He was always red-faced; last year illness caused pallor, hence unrecognized. Your prescription cured him in ten doses. Now he drinks as before."
Su, elderly woman from Yichang Candle Shop, aged 60. Occasional abdominal pain. Doctor diagnosed Cold, gave hot drugs. Pain worsened, abdominal distension/constipation, hard on palpation. Diagnosed as intestinal abscess, attacked with purgatives, pain increased. Starvation/inspiration, breathing nearly ceased. Consultation: Slippery/rapid pulse, crimson tongue/yellow coating, bad breath/anuria. Heat obstructing Qi. Snow Broth decocted to mix with YiYuan San (5 qian), slowly灌ed. Pain/Qi normalized next day. Snow Broth delivered Danggui Longhui Wan (3 qian); bowel/bladder unblocked. Light-clearing herbs completed cure.
Mid-July, traveling Li Gui via Meijing, Lv Shen'an invited me to see Shen Zefu's wife. Two years ago, dysentery; thereafter chronic diarrhea, worse this summer, mornings especially. Tenesmus, borborygmus, anorexia, no thirst, fear of heat/no sweat, chest fullness/vomiting, insomnia, emaciation/pallor, free urination, soft/wiry pulse, sparse menstruation. Middle-Jiao deficiency with Wood insulting Earth, failure of transformation/transportation. Qi deficiency leading to Blood exhaustion. Acrid-hot aids Wind-Yang; cloying increases slipping. Strategy: Stabilize center, calm Wind-wheel. Prescription: Ludangshen, Shanyao, Shizhi, Yuliang each 3 qian; Fuling, Baishao 1.5 qian; Wei Hezi, Jupi 1 qian; Muli 8 qian; Wumei carbon 0.8 fen; Jiuhuangbai 0.6 fen; Shufuzi, Zhigancao 0.5 fen. Decocted in Ganlan water with thick Chenmi soup, sipped slowly to retain in Middle Jiao. Late August, met Zefu: four doses cured, healthy/eating. Gifted poetry/tea. Next winter, heard he died of chills/fever.
My wife, pregnant four months, suffered tertian malaria, abdominal pain, loose stool, profuse sweat, nausea/chest oppression. Phlegm-Qi stagnation internally, Wind-Heat externally. Slippery/wiry pulse. Prescription: Zhike, Jiegeng, Sue, Lian, Chai, Qin, Changpu, Ban. Three doses cured. Eldest daughter Fuyi: mild chills/high fever, nocturnal onset, premature menstruation, thirst, constipation, vertigo, sweating, anorexia. Summer-heat malaria.洪数 pulse. Prescription: Zhimu, Qin, Ju, Ban, Qinghao, Baiwei, Xian Shihu, Xuanshen, Zhizi, Huafen. Six doses halved fever; removed Qinghao/Ban, added Xiyangshen, Maidong, Zhuru, Pipaye. Six more doses bowel movement/malaria cessation; removed Xuanshen/Xian Shihu, added Danggui. Cured. Brother Jijie's wife: Malaria, lighter by day/heavier by night, lower abdominal mass, rising Qi causing vomiting/cough, anorexia. Returned from Jiaxing after eight days. Soft/rough pulse. Liver depression internally, summer-heat externally. Prescription: Qin, Ban, Qiaohua, Huashi, Changpu, Geqiao, Su, Lian, Xuan, Ju, Sigualuo. Six doses complete resolution; followed by clearing/nourishing.
Late Zhongqiu (Aug 28), returning from Puyuan, sudden cholera-like disorder, severe abdominal pain. Pulse fine/rapid/wiry, cold limbs/aversion to cold, heavy quilts, no thirst, non-hot diarrhea, anuria, bitter vomiting, crimson tongue. New coolness binding summer-heat. Yushu Dan/Jiangxue refused. After 4-5 diarrheas, felt warm, extreme thirst, refused drink, slurred speech. Crushed fresh Ou juice slowly灌ed; accepted. Then Qin, Lian, Yiyiren, Chuanlianzhong, Zhizi, Shihu, Sangye. Pain reduced, vomiting/diarrhea stopped. Next day hunger returned, slight intake, extreme fatigue, meridian pain. Clearing/nourishing method cured.
Jiang Yin, Dalishi's wife from Xiashi town: Chronic lower abdominal Qi accumulation, rising to chest causing epigastric pain, falling to legs causing edema, heavy leukorrhea, rapid menstruation, abdominal/chest fullness, sticky mouth/no thirst, loose stool but difficult defecation, relieved only by salt. Diagnosed Spleen deficiency, given tonics, worsened. Pulse wiry/slippery. Prescription: Zhizi, Qin, Changpu, Zhike, Lian, Ban, Ru, Xuan, Xue Geng. Clear Liver Heat, resolve Phlegm. Stagnant Qi descended to feet, chest/abdomen relaxed.
Guan Youzhai's wife: Amenorrhea seven months. Mid-autumn, light menstruation, mild abdominal distension, chest fullness/anorexia, alternating chills/fever. Lv used Guizhi, Huanglian, etc., worsening obstruction, constipation/urinary retention, oral ulcers/thirst, vomiting after drinking, insomnia, burning internal organs. Pulse wiry/fine, red face/cold feet, fatigue. Ying-Yin deficiency, Qi stagnation, prolonged stagnation generating Heat. Avoid acrid-hot. Prescription: Shashen, Lou, Xie, Zhizi, Ru, Xuan, Yuan, Dongguazi, Pipaye. Two doses: dry stool passed, chest/abdomen relaxed, hunger returned, vomiting stopped; followed by dispersing/nourishing. Amenorrhea due to Blood insufficiency, not blockage.
Mid-month, passing Puyuan, woman from Xianghai Temple suffered tertian malaria. Pale face/red lips, crimson tongue/thirst, mild chills/high fever, short urine/hard stool, early menstruation, insomnia, rapid pulse. Summer-heat invading Ying. Prescription: Xuanshen, Danpi, Zhimu, Baiwei, Qinghao, Zhizi, Huafen, Xian Shihu, Zhuye. Late August, revisited. Patient said previous formula worked, cured in 20 doses. Son insisted on post-illness tonics; took four doses, malaria recurred, refused further. I suspected warming tonics; confirmed. Prescribed clearing/transformation agents. Five doses cured.
Zhongqiu: Left breast slight pain, worse on pressure. Hard nodule, bean-sized, slight swelling. Applied surgical paste, covered with paper. When dry, peeling was painful. Everyone said rupture inevitable, hard to heal due to location. Feared torture, sought Lv Shen'an. Advice: No worry. Daily: Scallion white (1 cun) embedded with Meihua Dianshe Dan pill, delivered with Xuanfuhua decoction. External: Huixi Shudu Wei. Covered with paper, fell off naturally when dry, no flesh-hair damage. Jade Essence Charcoal efficacy. Twelve days, nodule disappeared. Deeply admire Lv's virtue/skill, record for posterity.
Blacksmith's wife: Cold, miscured for ten days. Persistent fever, insomnia/confabulation, thirst/deafness. Fine/rapid pulse, red lips/pale face, emaciation/sweating. Poor but delicate constitution, Spirit/Qi deficiency, fluid depletion, lingering summer-heat. Prescription: Xiyangshen, Gancao, Xiaomai, Huanglian, Maidong, Shihu, Danshen, Lianxin, Zhuye. Spirit/Qi stabilized; added Hongzao, Zi Shiyin for palpitations. Ten days, cured.
Early September, Jiang Yin invited me to treat brother Zhongqing's wife, Jinshi, aged 59. Habitual labor, abdominal Qi mass, episodic epigastric pain, loose stool. Half month: fever/deafness, diarrhea/anorexia, chest oppression, tough phlegm, sticky mouth/nausea, extreme fatigue, deficient/wiry/fine pulse, yellow/greasy dry tongue coating. Ying-fluid depleted, Qi stagnation, exterior pathogen, excessive clearing/dispersing damaging root. Prescription: Renshen, Fuling, Ju, Ban, Lou, Xie, Ru, Lian...