钟。取汤代水煎药。清气治呃方。犀角先煎四钱。玄参片八钱。开水泡冲去渣。鲜石斛先煎
一两。连翘壳三钱。济银花一两五钱。姜竹茹三钱。酒炒知母三钱。花粉三钱。川贝母杵四
钱。鲜竹叶二钱。风阳之呃。非重用犀知银花不止。顾翰云病情阴虚血热。西洋参三钱。大
生地八钱。花麦冬四钱。川楝核杵先一钱五分。酒炒知母二钱。酒炒川黄柏一钱。花粉四钱
。济银花八钱。连翘壳三钱。生粉草三钱。热虽在血。必使达于气分而解。故方中参用清气
品。)
康康侯子患心忡自汗。气短面赤。霎时溲溺数十次。澄澈如水。医佥谓虚。补之日剧。就孟
英诊之。左寸关数。右弦滑。心下似阻。因作痰火阻气心热移肺治。用蛤壳黄连枳实楝实旋
复花粉橘红杏仁百合丝瓜络冬瓜子海 荸荠竹茹竹沥梨汁等出入为方。服之良愈。（首方用
姜炒川连八分。丝瓜络三钱。姜竹茹三钱。炒枳实一钱五分。川楝核杵先二钱。苦杏仁一钱
五分。生蛤壳杵先五钱。南花粉四钱。生冬瓜子四钱。旋复花绢包一钱五分。初更方去川连
竹茹。加
姜竹沥两酒杯冲。百合花三钱。三帖再更方。去丝瓜络冬瓜子。加连皮北梨一两打汁冲。再
更方去瓜子枳实蛤壳旋复。加整荸荠二两。淡海 二两。陈橘皮一钱半。)
许自堂孙患感。延至秋杪。证交二十八日。诸医束手。孟英诊之。左部数。右手俨若鱼翔。
痰嗽气促。自汗螈 。苔色灰浓。渴无一息一停。垂危若是。孟英曰∶据脉莫能下手。吾且
竭力勉图。于是先以竹叶石膏汤加减至五剂。气平嗽减。汗亦渐收。苔色转黑。舌尖露绛。
改投玄参生地犀角石膏知母花粉竹叶银花等药。又五剂螈 渐减。舌绛渐退。病者闻鼓乐喧
阗。即谵妄不安。神昏如醉。夜速孟英视之。予紫雪钱余。神即清爽。仍用前方。重加竹沥
。服八剂始解黑如胶漆之大便。而黑苔渐退。右脉之至数始清。惟烦渴不减。令其恣啖北梨
。舌才不燥。痰出亦多。又六剂舌色乃淡。溲出管痛。热邪得从下行矣。凡十二日之间。共
服大剂寒凉已二十四剂。计用犀角三两有奇。而险浪始平。续以前法缓制。服六剂又解胶矢
五次。手足始知为己有。又五剂筋络之振惕始定。略能侧卧。呓语乃息。渐进稀糜。继灌甘
润充其胃汁。七八剂后渴止知饥。脉皆和缓。又浃旬谷食乃复。又旬余便溺之色始正。前后
共下黑矢四十余次。苔色亦净。授滋填善后而康。（右手俨若鱼翔。据脉莫可下手。惟痰嗽
苔浓。渴无一息一停。邪旺则正亦旺。此证书不凭脉之治。鲜竹叶二钱。生石膏先煎一两六
钱。酒炒知母四钱。制半夏三钱。姜竹茹三钱。建兰叶三钱。姜枇叶刷包三钱。生冬瓜子八
钱。活水芦根二两。南花粉五钱。旋复花绢包三钱。生蛤壳海浮石各五钱。石斛一两。三味
同先煎。更方玄参一两。大生地八钱。泡煎去渣。镑犀角先煎四钱。生石膏先煎一两。酒炒
知母四钱。花粉四钱。鲜竹叶二钱。银花一两五钱。)
段春木秋杪患发热。而腰腿痛如刀割。孟英视之。略不红肿。脉至细数。苔色黑燥。溺赤便
黑。予西洋参麦冬生地犀角银花楝实石斛知母甘草竹沥蔗汁为大剂投之。热渐退。痛渐已。
惟舌绛无津。仍予甘凉濡润为方。数日后忽舌绛倍加。燥及咽膈。水饮不能下咽。孟英曰∶
真
阴涸竭。药难奏绩矣。嗣询悉病患自误于女劳复。孟英因论曰∶烧 散鼠矢汤。皆从足少
阴以
逐邪。不过热邪袭入此经。所谓阴阳易是也。今少腹无绞痛之苦。原非他人之病易于我。真
是女劳之复。以致真阴枯涸。更将何药以骤复其真阴哉。然从此而女劳复与阴阳易。一虚一
实有定论。不致混同而谈治矣。（脉至细数三句。为阴虚风动。肝阳逆冲肺胃。肺胃不能荫
庇腰肾。西洋参三钱。花麦冬四钱。大生地泡冲去渣一两。犀角先煎四钱。楝核杵先三钱。
石斛先煎一两。酒炒知母四钱。生粉草三钱。竹沥三两。蔗汁一两和服。)
顾升庵子久患多疑善恐。不出房者数年矣。食则不肯与人共案。卧则须人防护。寡言善笑。
时或遗精。多医广药。略无寸效。孟英切脉甚滑数。予玄参丹参竹黄竹茹丹皮黄连花粉栀子
海荸荠为剂。送服当归龙荟丸。四剂即能出署观剧。（多疑善恐六句。皆肝有痰热现证。
龙
荟丸泻肝痰热。遗精之因起于肝热。遗精之祸流为肾亏。玄参雪羹针治遗精。玄参片泡煎去
渣八钱。紫丹参三钱。天竹黄三钱。姜竹茹三钱。粉丹皮二钱。酒炒川连二钱。黑栀皮一钱
五分。淡海 二两。整荸荠一两。药送当归龙荟丸三钱。)
陈某偶患溏泄。某某投以温补健脾之药。数日后泻虽减。而发热昏痉。咽喉黑腐。肝肾之阴
两
竭。孟英诊曰∶迟矣。病起泄泻。何必为寒。正是伏邪自寻出路。而温补以固留之。自然内
陷厥阴。不可救药。果即殒焉。继有高小坨弟因食蟹患泻。黄某用大剂温补药。泻虽止而颈
筋酸痛。舌绛呕渴。口气甚臭。孟英持脉沉数。曰∶食蟹而后泻。会逢其适耳。脉证如斯。
理应清润。病患自畏凉药。复误吴某温补。服及旬日。昏痉舌黑而毙。（高某颈筋酸痛三句
。热邪大伤肝胃气分之阴。清润方。酒炒知母四钱。济银花一两五钱。石斛先煎一两。干桑
葚杵先一钱半。酒炒川连一钱。苦杏泥一钱五分。活水芦根二两。南花粉四钱。整荸荠一两
淡海 二两先煎。炒枳壳一钱五分。生姜自然汁箸挑六滴和服。)
金某久患脘痛。按之漉漉有声。便秘溲赤。口渴苔黄。杳不知饥。绝粒五日。诸药下咽。倾
吐无余。孟英察脉沉弱而弦。用海 荸荠各四两煎汤饮之。径不吐。痛亦大减。继以此汤煎
高丽参黄连楝实延胡栀子枳 石斛竹茹柿蒂等药。送服当归龙荟丸。旬日而安。续予春
泽汤
调补收绩。盖其人善饮而嗜瓜果以成疾也。（脘痛为肝阳侮胃。便秘溲赤三句。皆肝阳贼肺
现证。脉沉为痰热遏伏。弦为肝热。弱为脾阳伤败。雪羹先治其倾吐无余。使气降受药。丽
参针治脉弱。延胡亦因脉弱防苦寒过剂。高丽参切一钱半。酒炒川连一钱。楝核杵先三钱。
酒炒延胡索次入一钱五分。黑栀皮一钱五分。枳 子杵先四钱。石斛先煎一两。姜竹茹三钱
。干柿蒂十个。药送龙荟丸三钱。春泽汤五苓加参。孟英必加泻肝润胃之品。)
乔有南年三十九岁。患牝疟二旬。医治罔效。孟英往诊脉微无神。倦卧奄奄。便秘半月。溺
赤不饥。痰多口甘。稍呷米饮。必揉胸捶背而始下。苔色黑腻。而有蒙茸之。象乃曰∶此精
气神三者交虚之证。不可与时行伏暑晚发同年而语也。幸前手之药。法主运中。尚无大害。
予
参术桂附沉香拌炒熟地鹿角石英苁杞归茯杜仲枣仁菟丝山萸橘皮霞天曲胡桃肉等出入为大剂
。投十余剂寒后始有热。而苔色乃退。口不作渴。甘痰亦日少。粥食渐加。即裁桂附白术加
石斛。又服七剂。解黑燥大便甚多。凡不更衣者四旬二日。寒热亦断。安谷溲澄而竟愈。（
中略。)孟英曰∶温补亦治病之一法。何可废也。第用较少耳。（治热以寒。定法也。惟热邪
陷入之浅深。仍视其人本体阳气衰旺。阴阳两虚。热邪愈易陷入深处。治法参阳药运其邪外
出。如此病约二十剂始解黑燥大便。其明证也。牝疟。热病也。脉微无神。倦卧奄奄为阳虚
证。溺赤不饥。痰多口甘。热证也。稍呷米饮。必揉胸捶背而始下。则又为脾肾阳虚。苔色
黑腻似热。蒙茸则为寒。标病为热。本病为阳虚。此热邪深陷于阳虚之本体。致现此证。潞
党参三钱。炒白术一钱五分。浓附片杵五钱。肉桂心二钱。毛鹿角杵先三钱。紫石英杵三钱
。二味同先煨六句钟。蛀陈皮次入一钱五分。云茯苓三钱。炒枣仁杵三钱。甘枸杞二钱。更
方加霞天曲三钱。再更方去参苓。加山萸肉三钱。淡苁蓉三钱。炒菟丝饼二钱。再更方去霞
天曲。加棉杜仲三钱。再更方去杞子。加箱归身二钱。再更方去当归菟丝。加沉香炒熟地四
钱。连皮胡桃肉五钱。嗣裁桂附术。加石斛先煎五钱。)
陈媪患牝疟月余。腹胀便秘。嗳多不饥。口淡脉滑。孟英主连朴橘贝杏茹旋菀杷蒺为方。数
剂即瘳。（脉滑为痰热。口淡为胃阳不旺。姜炒川连二钱。制浓朴一钱。陈橘皮一钱半。川
贝母杵四钱。姜竹茹三钱。旋复花包先三钱。紫菀茸一钱半。姜枇叶刷包三钱。。生白蒺
三钱。)
王季杰外家因夜间未寐。侵晨饮酒解寒。适见人争谇。即觉心跳。欲吐不出。气即逆奔如喘。
且肢麻手握。语言难出。孟英视之。脉象弦驶。曰∶夜坐阳升。饮醇则肝阳益浮。见人争谇
。是惊则气更上逆。不可刺也。灌以苏合香丸一颗。下咽即瘥。（是案必脱漏一段。饮醇肝
阳益浮。其人平素阴虚肝旺可知。岂可专治以苏合丸之辛香。仿孟英另案用六一散一两。淡
盐开水搅之。澄去滓。研调苏合香丸一钱。)
黄履吉截疟后患浮肿。赵某闻其体素虚。切其脉弦细。遂用温补。驯致呃忒不休。气冲碍卧
。饮食不进。势濒于危。孟英曰∶脉虽弦细而有力。子必误服温补矣。肯服吾药。犹可无恐
。
因予栝蒌薤白合小陷胸橘皮竹茹汤加柿蒂旋复苏子香附赭石紫菀杷叶为方。四剂而瘳。（栝
蒌仁研三钱。鲜薤白打一钱半。姜炒川连二钱。制半夏一钱。赖橘红次入八分。姜竹茹三钱
。生粉草一钱。姜枇叶刷包三钱。干柿蒂十个。生苏子研次入二钱。生香附次入七分。紫菀
茸一钱半。生赭石杵先五钱。炭煨六句钟。旋复花包先三钱。)
吴馥斋室春间娩子不育。汛事亦未一行。偶患呕吐发热。眩晕心 。大解溏泄。口渴溲痛。
疑娠疑损。孟英诊曰∶产及一载。而经不至。腹不胀。脉弦缓。非娠非损。乃血虚痰滞而感
冬温也。以羚羊淡豉竹茹白薇栀子杷叶知母葱白花粉投之。三剂热退吐止。去葱豉羚羊。加
生地甘草橘皮调之而愈。（呕吐发热四句。皆肝风煽升。痰热阻遏气机之象。脉弦为肝热。
脉缓为肝热壅痰阻气。羚角先煎四钱。炒豆豉次入三钱。姜竹茹三钱。香白薇一钱。黑栀皮
三钱。姜枇叶刷包三钱。酒炒知母四钱。姜汁炒花粉三钱。连须葱白打次入一钱半。嗣去葱
豉羚羊。加大生地泡煎去渣八钱。生粉草三钱。陈橘皮一钱半。)
盛犀林仆患血痢。自秋徂冬罔效。孟英察脉细弱而口干。腰膝酸疼。予鹿角霜苁蓉枸杞杜仲
菟
丝续断血余石脂木瓜砂仁末炒熟地黄。十余剂而痊。（脉证为阴虚中兼挟阳虚。血余行瘀。
石脂涩肠。鹿角霜炖和服三钱。淡苁蓉一钱半。甘枸杞三钱。菟丝饼四钱。绵杜仲二钱。川
续断二钱。血余灰绢包一钱。陈木瓜一钱半。砂仁末炒熟地八钱。药汁调服赤石脂末二钱。
)
徐月岩室患周身麻木。四肢瘫痪。口苦而渴。痰冷如冰。气逆欲呕。汛愆腹胀。频饮极热姜
汤。似乎畅适。深秋延至季冬。服药不愈。孟英诊脉沉弦而数。曰∶溺热如火乎。间有发厥
乎。病者唯唯。遂以雪羹旋赭栀楝茹斛知母花粉桑枝羚羊橄榄蛤壳为方。送下当归龙荟丸。
服之递效。二十剂即能起榻。乃去羚赭加西洋参生地苁蓉藕投之。渐愈。（人知口苦而渴为
热。不知痰冷如冰。尤为热邪深锢。肺气不行现证。溺热如火。时或发厥。皆热结肝经之证
。荸荠一两。淡海 二两。旋复绢包三钱。生赭石杵一两六钱。同先煎。姜栀皮一钱半。楝
核杵先二钱。酒炒知母四钱。南花粉四钱。酒炒桑枝三钱。羚角先煎四钱。青果连核杵三个
。生蛤壳杵五钱。同先煎。药送龙荟丸三钱。)
张肖江妹暮冬患感。朱某进温散药数服。病日剧。孟英视之。目瞪不语。面赤气逆。昼夜需
人抱坐。四日不着枕矣。乃冬温挟痰。误提而气不肃降也。以旋赭杏贝花粉茅根冬瓜子紫菀
薤白蒌仁苏子石菖蒲竹沥为剂。芦菔汤煎。三剂大便行而能卧矣。自言胸中迷闷。改用小陷
胸合三子养亲加沙参知母旋贝竹茹枇杷叶数剂。热退知饥而愈。嗣有王炳华子患感。叶某用
温散药而气逆碍卧。王秉衡作肾虚不能纳气治。连服大剂温补。喘嗽益剧。面浮跗肿。抬肩
自汗。大渴胁痛。乞治孟英。已半月不交睫矣。诊其脉右部弦大而强。舌根黑苔如煤者两条
。面黎形瘦。幸而大解溏泄。得能消受许多误药。径予旋赭黄连枳实栝蒌苏子杏仁紫菀生石
膏芦菔汁。六大剂始能就枕。而大渴不止。脘腹反形痞胀。按之坚痛。乃去旋赭。少加白芥
子半夏薤白。兼令日啖北梨数十枚。服旬日胸腹皆舒。苔色尽退。惟嗽未已。改用西洋参杏
贝芦根知母冬瓜子花粉柿霜杷叶竹沥十余剂。嗽止而跗肿渴泻亦皆霍然矣。凡啖梨三百余斤
。闻者莫不诧异。（辨冬温挟痰。在面赤目瞪不语。辨误提气不肃降。在昼夜需人抱坐。四
日不着枕。旋复花包先三钱。生赭石杵先二两。苦杏泥二钱。川贝母杵四钱。鲜茅根五钱。
生冬瓜子四钱。紫菀茸一钱半。鲜薤白一钱半。姜炒蒌仁三钱。生苏子研次入二钱。石菖蒲
(Paragraph 1) Use the decoction as water to boil the medicines. For treating hiccups caused by clear qi disorder: Rhinoceros Horn (Xijiao, 犀角) is boiled first, four qian; Scrophulariae Radix (Xuanshen, 玄参) slices, eight qian; soaked in boiling water, mixed, strained, and taken. Fresh Dendrobii Caulis (Shihu, 石斛) is boiled first, one liang; Forsythiae Fructus (Lianqiao, 连翘) shell, three qian; Jizhou Lonicerae Flos (Jinyinhua, 金银花), one tael five qian; Ginger-processed Zingiberis Rhizoma Recens (Zhuru, 竹茹), three qian; Wine-fried Anemarrhenae Rhizoma (Zhimu, 知母), three qian; Pseudobulbus Pleiones (Huafen, 花粉), three qian; Fritillariae Cirrhosae Bulbus (Chuanbeimu, 川贝母) pounded, four qian; Fresh Bambusae Folium (Zhuyeh, 竹叶), two qian. Hiccups caused by wind-yang disturbance cannot be stopped without heavy doses of Rhinoceros Horn, Anemarrhena, and Lonicera. In Gu Han Yun's case, the condition involves yin deficiency and blood heat: American Ginseng (Xiyangshen, 西洋参), three qian; Large Rehmanniae Radix (Dishengdi, 大生地), eight qian; Ophiopogonis Tuber (Maidong, 麦冬), four qian; Toosendan Fructus (Chuanlianzi, 川楝子) pounded and boiled first, one qian five fen; Wine-fried Anemarrhenae Rhizoma (Zhimu, 知母), two qian; Wine-fried Phellodendri Cortex (Huangbai, 黄柏), one qian; Pseudobulbus Pleiones (Huafen, 花粉), four qian; Jizhou Lonicerae Flos (Jinyinhua, 金银花), eight qian; Forsythiae Fructus (Lianqiao, 连翘) shell, three qian; Raw Glycyrrhizae Radix et Rhizoma (Gancao, 甘草), three qian. Although the heat is in the blood level, it must be allowed to reach the qi level to resolve. Therefore, herbs that clear qi are included in the formula.)
Kang Kanghou’s son suffered from palpitations and spontaneous sweating, shortness of breath, and a red face. He urinated dozens of times in a short period, with urine clear as water. Physicians all considered it a deficiency syndrome and prescribed tonics daily, but his condition worsened. Mengying examined him and found the pulse at the left cun and guan positions rapid, while the right pulse was wiry and slippery. There was a sensation of obstruction in the epigastrium. Thus, he treated it as phlegm-fire obstructing qi flow and heart heat transferring to the lungs. The prescription consisted of Tridacnis Concha (Geqiao, 蛤壳), Coptidis Rhizoma (Huanglian, 黄连), Aurantii Fructus (Zhishi, 枳实), Toosendan Fructus (Lianshi, 楝实), Bupleuri Flos (Xuanfu, 旋覆花), Pseudobulbus Pleiones (Huafen, 花粉), Citri Reticulatae Pericarpium (Juhong, 橘红), Armeniacae Semen Amarum (Xingren, 杏仁), Lilii Bulbus (Baihe, 百合), Luffae Fructus Retusus (Sigualuo, 丝瓜络), Benincasae Fructus (Dongguazi, 冬瓜子), Metardiolus (Haizhe, 海蜇), Dioscoreae Hypoglaucae Rhizoma (Biqi, 荸荠), Zingiberis Rhizoma Recens (Zhuru, 竹茹), Bambusae Succus (Zhuli, 竹沥), and Pyri Fructus Juice (Lizhi, 梨汁), modified as needed. The patient recovered well after taking it. (The first prescription used Ginger-processed Coptidis Rhizoma (Chuanlian, 川连), eight fen; Luffae Fructus Retusus (Sigualuo, 丝瓜络), three qian; Ginger-processed Zingiberis Rhizoma Recens (Zhuru, 竹茹), three qian; Stir-fried Aurantii Fructus (Zhishi, 枳实), one qian five fen; Toosendan Fructus (Chuanlianzi, 川楝子) pounded and boiled first, two qian; Bitter Apricot Kernel (Ku Xingren, 苦杏仁), one qian five fen; Raw Tridacnis Concha (Sheng Geqiao, 生蛤壳) pounded and boiled first, five qian; Nan Pseudobulbus Pleiones (Nan Huafen, 南花粉), four qian; Raw Benincasae Fructus (Sheng Dongguazi, 生冬瓜子), four qian; Bupleuri Flos (Xuanfuhua, 旋复花) wrapped in silk, one qian five fen. After the first change of prescription, Coptidis Rhizoma and Zingiberis Rhizoma Recens were removed, and Ginger-processed Bambusae Succus (Zhuli, 竹沥) two wine cups mixed in, plus Lilii Bulbus (Baihehua, 百合花), three qian, were added. After three doses, for the second change, Luffae Fructus Retusus and Benincasae Fructus were removed, and North Pyri Fructus with skin (Beili, 北梨), one tael juiced and mixed in, was added. For the next change, seeds, Aurantii Fructus, Tridacnis Concha, and Bupleuri Flos were removed, and whole Dioscoreae Hypoglaucae Rhizoma (Biqi, 荸荠), two tael, and light-colored Metardiolus (Hai, 海蜇), two tael, along with aged Citri Reticulatae Pericarpium (Chen Jupi, 陈橘皮), one qian half, were added.)
Xu Zitang’s grandson contracted an external pathogenic factor, which dragged on until late autumn, lasting twenty-eight days. Physicians were at a loss. Mengying examined him and found the left pulse rapid, while the right pulse resembled a swimming fish (a sign of impending collapse). Symptoms included phlegmy cough, panting, spontaneous sweating, convulsions, thick grey coating on the tongue, and unceasing thirst. The condition was critical. Mengying said, "Based on the pulse, it is difficult to proceed, but I will try my best." He initially used Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) modified, administered over five doses. The breathing stabilized, cough decreased, and sweating gradually ceased. The tongue coating turned black, and the tip appeared crimson. The prescription was changed to include Scrophulariae Radix, Rehmanniae Radix Preparata, Rhinoceros Horn, Gypsum, Anemarrhenae Rhizoma, Pseudobulbus Pleiones, Bambusae Folium, and Lonicerae Flos. After another five doses, convulsions subsided, and the crimson tongue receded. Upon hearing loud drum music, the patient became delirious and restless, appearing comatose like a drunkard. Mengying was summoned urgently at night and administered Zi Xue San (Purple Snow Powder), more than one qian. The patient’s spirit cleared immediately. The previous prescription was continued with increased Bambusae Succus. After eight doses, large black stools resembling glue or lacquer were passed, the black coating faded, and the right pulse became distinct. However, irritability and thirst persisted. The patient was advised to eat North Pyri Fructus freely, which moistened the tongue and promoted expectoration. After six more doses, the tongue color lightened, and pain occurred during urination, indicating the heat pathogen was exiting downward. Within twelve days, twenty-four large doses of cold-natured medicines were consumed, including over three taels of Rhinoceros Horn. The crisis subsided. Treatment continued with a milder approach based on the same method. After six doses, five episodes of sticky stool were passed, and the limbs regained control. Five more doses stabilized the tremors of the sinews and collaterals, allowing side-lying sleep, and mumbling ceased. Thin rice gruel was gradually introduced, followed by sweet and moistening substances to replenish stomach fluids. After seven or eight doses, thirst stopped, hunger returned, and the pulse became harmonious and slow. Grain food resumed after ten days. Stool and urine colors normalized after another ten-plus days. Over forty episodes of black dry stools were passed, and the tongue coating cleared. Tonifying and nourishing prescriptions were given for recovery, leading to full health. (Right pulse resembling a swimming fish indicates difficulty in diagnosis based solely on pulse. Only phlegmy cough, thick coating, and unceasing thirst remain. When pathogens are strong, righteous qi is also strong; this case demonstrates treatment not relying solely on pulse. Fresh Bambusae Folium, two qian; Raw Gypsum, one tael six qian boiled first; Wine-fried Anemarrhenae Rhizoma, four qian; Processed Pinelliae Rhizoma, three qian; Ginger-processed Zingiberis Rhizoma Recens, three qian; Jian Orchid Leaves, three qian; Ginger-processed Eriobotryae Folium wrapped in silk, three qian; Raw Benincasae Fructus, eight qian; Living Reed Rhizome, two tael; Nan Pseudobulbus Pleiones, five qian; Bupleuri Flos wrapped in silk, three qian; Raw Tridacnis Concha and Pumice Stone, each five qian; Dendrobii Caulis, one liang. These three ingredients boiled first. Modified prescription: Scrophulariae Radix, one liang; Large Rehmanniae Radix, eight qian, soaked and strained; Sliced Rhinoceros Horn boiled first, four qian; Raw Gypsum boiled first, one liang; Wine-fried Anemarrhenae Rhizoma, four qian; Pseudobulbus Pleiones, four qian; Fresh Bambusae Folium, two qian; Lonicerae Flos, one tael five qian.)
Duan Chunmu suffered from fever in late autumn, with waist and leg pain like knife cuts. Mengying observed no redness or swelling. The pulse was fine and rapid, the tongue coating black and dry, urine red, and stool black. A large dose of American Ginseng, Ophiopogonis Tuber, Rehmanniae Radix Preparata, Rhinoceros Horn, Lonicerae Flos, Toosendan Fructus, Dendrobii Caulis, Anemarrhenae Rhizoma, Glycyrrhizae Radix et Rhizoma, Bambusae Succus, and Sacchari Sinae Juice was administered. Fever gradually subsided, and pain ceased. However, the tongue remained crimson without moisture. Sweet and cool moistening prescriptions were continued. Days later, the crimson tongue intensified, dryness spread to the throat and diaphragm, making swallowing impossible. Mengying said, "True yin is exhausted; drugs will hardly work." Later inquiry revealed the patient had engaged in sexual activity too soon after illness (female labor recurrence). Mengying commented: "Shaokun San (Burnt Underwear Powder) and Shushi Tang (Rat Dropping Decoction) expel pathogens via the Foot-Shaoyin Kidney meridian, applicable when heat pathogens invade this meridian, known as 'Yin-Yang Exchange.' Now, there is no colic in the lower abdomen, so it is not a transfer of disease from another person. It is truly female labor recurrence causing true yin depletion. What medicine can rapidly restore true yin? From this, we have a definitive distinction between female labor recurrence (deficiency) and Yin-Yang Exchange (excess), preventing confusion in treatment." (Fine and rapid pulse indicates yin deficiency with wind stirring and liver yang counterflow attacking lung and stomach, failing to nourish kidneys. American Ginseng, three qian; Ophiopogonis Tuber, four qian; Large Rehmanniae Radix soaked and strained, one liang; Rhinoceros Horn boiled first, four qian; Toosendan Fructus pounded and boiled first, three qian; Dendrobii Caulis boiled first, one liang; Wine-fried Anemarrhenae Rhizoma, four qian; Raw Glycyrrhizae Radix et Rhizoma, three qian; Bambusae Succus, three liang; Sacchari Sinae Juice, one liang mixed.)
Gu Shengan’s son suffered from suspicion and fear for years, rarely leaving his room. He refused to eat with others, required protection while sleeping, spoke little but laughed often, and experienced frequent seminal emissions. Many doctors and medicines yielded no results. Mengying felt a slippery and rapid pulse. He prescribed Scrophulariae Radix, Salviae Miltiorrhizae Radix, Calamini Pulvis, Zingiberis Rhizoma Recens, Moutan Cortex, Coptidis Rhizoma, Pseudobulbus Pleiones, Gardeniae Fructus, Metardiolus, and Dioscoreae Hypoglaucae Rhizoma, administered with Danggui Longhui Wan (Angelica and Gentian Pill). After four doses, the patient could go out to watch plays. (Suspicion and fear indicate phlegm-heat in the liver. Longhui Wan clears liver phlegm-heat. Seminal emission originates from liver heat and leads to kidney deficiency. Scrophulariae Radix and Xue Geng (Metardiolus and Dioscoreae Hypoglaucae Rhizoma) treat seminal emission. Scrophulariae Radix slices soaked and strained, eight qian; Purple Salviae Miltiorrhizae Radix, three qian; Tian Zhuhuang (Calamini Pulvis), three qian; Ginger-processed Zingiberis Rhizoma Recens, three qian; Powdered Moutan Cortex, two qian; Wine-fried Coptidis Rhizoma, two qian; Black Gardeniae Fructus peel, one qian five fen; Light Metardiolus, two tael; Whole Dioscoreae Hypoglaucae Rhizoma, one tael. Medicine taken with Danggui Longhui Wan, three qian.)
Chen Mou occasionally suffered from loose stools. Doctor XX prescribed warming and tonifying spleen-stomach medicines. After several days, diarrhea decreased, but fever, coma, convulsions, and black putrid throat appeared, indicating exhaustion of liver and kidney yin. Mengying diagnosed, "Too late. The illness started with diarrhea; why assume it was cold? This was latent pathogens seeking an exit, but warming tonics trapped them, causing internal collapse into the Jueyin level, incurable." Indeed, the patient died. Subsequently, Gao Xiaotuo’s younger brother developed diarrhea after eating crabs. Doctor Huang used large doses of warming tonics. Diarrhea stopped, but neck tendons became painful, tongue crimson, vomiting, thirst, and foul breath appeared. Mengying felt a deep, rapid pulse and said, "Diarrhea after eating crabs was coincidental. Given the pulse and symptoms, clearing and moistening is appropriate. The patient feared cold medicines and mistakenly took Wu’s warming tonics for ten days, resulting in coma, convulsions, black tongue, and death." (Neck tendon pain indicates heat pathogen severely damaging liver and stomach qi-level yin. Clearing and moistening prescription: Wine-fried Anemarrhenae Rhizoma, four qian; Jizhou Lonicerae Flos, one tael five qian; Dendrobii Caulis boiled first, one liang; Dry Mulberry Fruit pounded and boiled first, one qian half; Wine-fried Coptidis Rhizoma, one qian; Bitter Apricot Paste, one qian five fen; Living Reed Rhizome, two tael; Nan Pseudobulbus Pleiones, four qian; Whole Dioscoreae Hypoglaucae Rhizoma, one tael; Light Metardiolus boiled first, two tael; Stir-fried Aurantii Fructus, one qian five fen; Fresh Ginger Juice, six drops mixed.)
Jin Mou suffered from chronic epigastric pain with gurgling sounds upon pressure, constipation, red urine, thirst, yellow tongue coating, anorexia, and five days of fasting. All medicines were vomited up. Mengying observed a deep, weak, and wiry pulse. He prescribed Metardiolus and Dioscoreae Hypoglaucae Rhizoma, each four tael, boiled as soup. The patient drank it without vomiting, and pain significantly reduced. Then, this soup was used to decoct Korean Ginseng, Coptidis Rhizoma, Toosendan Fructus, Corydalis Rhizoma, Gardeniae Fructus, Aurantii Fructus, Dendrobii Caulis, Zingiberis Rhizoma Recens, and Diospyroi Fructus Calyx, taken with Danggui Longhui Wan. Peace returned in ten days. Chunze Tang (Spring Marsh Decoction) was subsequently used for regulation and recovery. The illness resulted from alcohol consumption and excessive fruit intake. (Epigastric pain indicates liver yang invading stomach. Constipation and red urine indicate liver yang attacking lungs. Deep pulse suggests phlegm-heat entrapment; wiry indicates liver heat; weak indicates spleen yang damage. Xue Geng treats vomiting to allow medication absorption. Korean Ginseng addresses weak pulse; Corydalis prevents excessive bitterness/cold due to weak pulse. Korean Ginseng sliced, one qian half; Wine-fried Coptidis Rhizoma, one qian; Toosendan Fructus pounded and boiled first, three qian; Wine-fried Corydalis added later, one qian five fen; Black Gardeniae Fructus peel, one qian five fen; Aurantii Fructus pounded and boiled first, four qian; Dendrobii Caulis boiled first, one liang; Ginger-processed Zingiberis Rhizoma Recens, three qian; Ten dried Diospyroi Fructus Calyxes. Medicine taken with Longhui Wan, three qian. Chunze Tang is Wuling San plus Ginseng; Mengying always adds liver-clearing and stomach-moistening herbs.)
Qiao Younan, aged thirty-nine, suffered from Pin Malaria (cold-predominant malaria) for twenty days without effect. Mengying found a faint, spiritless pulse, extreme fatigue, bedridden state, constipation for half a month, red urine, anorexia, profuse phlegm, sweet taste in mouth, and difficulty swallowing even rice water without rubbing chest and back. Tongue coating was black, greasy, and mossy. Mengying said, "This is a severe deficiency of essence, qi, and spirit, distinct from seasonal latent summerheat. Fortunately, previous treatments focused on moving middle jiao, avoiding major harm." He prescribed a large dose of Codonopsis, Atractylodes, Cinnamon Bark, Aconite Root, Agarwood stir-fried with Prepared Rehmanniae Radix, Deer Antler, Purified Hematite, Cynomorium, Lycium, Angelica, Poria, Eucommia, Ziziphus Seed, Cuscuta, Cornus, Tangerine Peel, Xiaticur (Prepared Curcuma), and Walnut Meat. After ten-plus doses, chills preceded fever, coating faded, thirst stopped, phlegm decreased, and appetite improved. Cinnamon, Aconite, and Atractylodes were removed, and Dendrobii Caulis added. After seven more doses, many black dry stools were passed. Having not defecated for forty-two days, fever/chills ceased, digestion normalized, and urine cleared, leading to recovery. (Warming tonics are a valid treatment method, just used sparingly here. Treating heat with cold is standard. Depth of heat invasion depends on original yang strength. Yin-yang deficiency allows deeper heat invasion. Treatment involves using yang-moving herbs to expel pathogens. Resolution of black dry stools after ~20 doses confirms this. Pin Malaria is a heat disease. Faint pulse and fatigue indicate yang deficiency. Red urine and phlegm indicate heat. Difficulty swallowing rice water indicates spleen-kidney yang deficiency. Black greasy coating resembles heat, but mossiness indicates cold. Branch is heat, root is yang deficiency. Heat deeply invades yang-deficient constitution. Codonopsis Pilosae Radix, three qian; Stir-fried Atractylodis Macrocephalae Rhizoma, one qian five fen; Thick Aconiti Lateralis Radix Preparata pounded, five qian; Cinnamon Bark Heart, two qian; Deer Antler pounded and boiled first, three qian; Purified Hematite pounded, three qian. Two ingredients simmered for six minutes. Aged Tangerine Peel added later, one qian five fen; Cloud Poria, three qian; Stir-fried Ziziphus Seed pounded, three qian; Sweet Lycium, two qian. Modified: Add Xiaticur, three qian. Further modified: Remove Codonopsis and Poria, add Cornus, three qian; Cynomorium, three qian; Stir-fried Cuscuta, two qian. Further modified: Remove Xiaticur, add Eucommia, three qian. Further modified: Remove Lycium, add Angelica Sinensis, two qian. Further modified: Remove Angelica and Cuscuta, add Agarwood stir-fried with Prepared Rehmanniae Radix, four qian; Walnut Meat with skin, five qian. Finally remove Cinnamon, Aconite, Atractylodes, add Dendrobii Caulis boiled first, five qian.)
Elder Chen suffered from Pin Malaria for over a month, with abdominal distension, constipation, frequent belching, anorexia, pale taste, and slippery pulse. Mengying prescribed Lianpo Ju Bei Xing Ru Xuan Wan Pa Ji (Coptis, Magnolia, Tangerine, Fritillaria, Apricot, Bamboo, Bupleuri, Aster, Loquat, Tribulus Decoction). Recovery occurred after several doses. (Slippery pulse indicates phlegm-heat; pale taste indicates weak stomach yang. Ginger-processed Coptidis Rhizoma, two qian; Processed Magnoliae Officinalis Cortex, one qian; Aged Citri Reticulatae Pericarpium, one qian half; Fritillariae Cirrhosae Bulbus pounded, four qian; Ginger-processed Zingiberis Rhizoma Recens, three qian; Bupleuri Flos wrapped and boiled first, three qian; Aster Tataricus Rootlet, one qian half; Ginger-processed Eriobotryae Folium wrapped in silk, three qian; Raw Tribulus Fructus, three qian.)
Wang Jijie’s maternal relative stayed awake at night, drank alcohol in the early morning to ward off cold, and witnessed an argument. Immediately, palpitations arose, inability to vomit, rebellious qi like asthma, limb numbness, clenched hands, and speech difficulty. Mengying observed a wiry and swift pulse, saying, "Night sitting raises yang; alcohol floats liver yang further. Witnessing conflict causes qi to rebel upward. Acupuncture is contraindicated." He administered one pill of Suhe Xiang Wan (Styrax Pill). The patient recovered immediately upon swallowing. (This case likely has missing text. Alcohol floating liver yang implies underlying yin deficiency and liver hyperactivity. Relying solely on Suhe Xiang Wan’s acrid-aromatic nature is insufficient. Mimicking another Mengying case: use Liu Yi San, one tael, stirred in light salt water, clarified, and mixed with one qian of powdered Suhe Xiang Wan.)
Huang Lüji developed edema after malaria cessation. Doctor Zhao, noting his weak constitution and wiry-thin pulse, prescribed warming tonics. This led to incessant hiccups, rebellious qi disturbing sleep, anorexia, and critical condition. Mengying said, "Though wiry-thin, the pulse is forceful; you must have taken warming tonics wrongly. If you take my medicine, there is no fear." He prescribed Gua Lou Xie Bai He Xiao Xian Xiong Ju Pi Zhu Ru Tang modified with Diospyroi Fructus Calyx, Perilla Seed, Cyperi Rhizoma, Magnetitum, Aster, and Loquat Leaf. Recovery occurred after four doses. (Trichosanthis Fructus ground, three qian; Fresh Allii Macrostemonis Bulbus beaten, one qian half; Ginger-processed Coptidis Rhizoma, two qian; Processed Pinelliae Rhizoma, one qian; Aged Citri Reticulatae Pericarpium added later, eight fen; Ginger-processed Zingiberis Rhizoma Recens, three qian; Raw Glycyrrhizae Radix et Rhizoma, one qian; Ginger-processed Eriobotryae Folium wrapped in silk, three qian; Ten dried Diospyroi Fructus Calyxes; Raw Perilla Seed ground added later, two qian; Raw Cyperi Rhizoma added later, seven fen; Aster Tataricus Rootlet, one qian half; Raw Magnetitum pounded and boiled first, five qian, calcined for six minutes; Bupleuri Flos wrapped and boiled first, three qian.)
Wu Fuzhai’s wife delivered a non-viable infant in spring and had not menstruated. She suddenly developed vomiting, fever, vertigo, palpitations, loose stools, thirst, and painful urination, raising suspicion of pregnancy or consumptive disease. Mengying diagnosed: "One year postpartum without menses, no abdominal distension, wiry-slow pulse. Not pregnancy, not consumptive disease. It is blood deficiency with phlegm stagnation contracting winter-warmth." He prescribed Antelope Horn, Fermented Soybean, Zingiberis Rhizoma Recens, Anemarrhenae Rhizoma, Eriobotryae Folium, Anemarrhenae Rhizoma, Scallion White, and Pseudobulbus Pleiones. After three doses, fever stopped, vomiting ceased. Scallion, Fermented Soybean, and Antelope Horn were removed; Rehmanniae Radix Preparata, Glycyrrhizae Radix et Rhizoma, and Citri Reticulatae Pericarpium were added for regulation. Recovery ensued. (Vomiting and fever indicate liver wind stirring and phlegm-heat obstructing qi mechanism. Wiry pulse indicates liver heat; slow pulse indicates liver heat obstructed by phlegm. Antelope Horn boiled first, four qian; Stir-fmented Fermented Soybean added later, three qian; Ginger-processed Zingiberis Rhizoma Recens, three qian; Fragrant Anemarrhenae Rhizoma, one qian; Black Gardeniae Fructus peel, three qian; Ginger-processed Eriobotryae Folium wrapped in silk, three qian; Wine-fried Anemarrhenae Rhizoma, four qian; Ginger-juice processed Pseudobulbus Pleiones, three qian; Connected Scallion White beaten added later, one qian half. Subsequently remove Scallion, Fermented Soybean, Antelope Horn; add Large Rehmanniae Radix soaked and boiled, strained, eight qian; Raw Glycyrrhizae Radix et Rhizoma, three qian; Aged Citri Reticulatae Pericarpium, one qian half.)
Sheng Xilin’s servant suffered from bloody dysentery from autumn to winter without effect. Mengying found a fine-weak pulse, dry mouth, and sore waist/knees. He prescribed Deer Antler Frost, Cynomorium, Lycium, Eucommia, Cuscuta, Dipsacus, Calcined Human Hair, Litharge, Quince, Amomum powder stir-fried with Prepared Rehmanniae Radix. Recovery occurred after ten-plus doses. (Pulse/symptoms indicate yin deficiency with concurrent yang deficiency. Calcined Human Hair moves stasis; Litharge binds intestines. Deer Antler Frost stewed and taken, three qian; Light Cynomorium, one qian half; Sweet Lycium, three qian; Cuscuta cake, four qian; Soft Eucommia, two qian; Dipsacus, two qian; Calcined Human Hair wrapped in silk, one qian; Aged Quince, one qian half; Amomum powder stir-fried with Prepared Rehmanniae Radix, eight qian. Medicine juice mixed with Litharge powder, two qian.)
Xu Yueyan’s wife suffered from generalized numbness, limb paralysis, bitter taste, thirst, ice-cold phlegm, rebellious qi with nausea, delayed menstruation, and abdominal distension. She frequently drank extremely hot ginger tea for relief. Condition persisted from late autumn to winter despite medication. Mengying felt a deep, wiry, rapid pulse and asked, "Is urine hot as fire? Do you occasionally faint?" Patient confirmed. He prescribed Xue Geng (Metardiolus and Dioscoreae Hypoglaucae Rhizoma), Bupleuri/Magnetitum, Gardenia/Toosendan, Bamboo/Zingiber/Dendrobium/Anemarrhena/Pseudobulbus/Silk Tree Twig/Antelope/Olive/Clam Shell Decoction, taken with Danggui Longhui Wan. Gradual improvement occurred. After twenty doses, she could rise from bed. Antelope Horn and Magnetitum were removed; American Ginseng, Rehmanniae Radix Preparata, Cynomorium, and Lotus Rhizome were added. Gradual recovery ensued. (Bitter taste/thirst indicates heat; ice-cold phlegm indicates heat deeply entrenched obstructing lung qi. Hot urine and occasional fainting indicate heat binding liver meridian. Dioscoreae Hypoglaucae Rhizoma, one tael; Light Metardiolus, two tael; Bupleuri Flos wrapped in silk, three qian; Raw Magnetitum pounded, one tael six qian, boiled together first; Ginger-processed Gardeniae Fructus peel, one qian half; Toosendan Fructus pounded and boiled first, two qian; Wine-fried Anemarrhenae Rhizoma, four qian; Nan Pseudobulbus Pleiones, four qian; Wine-fried Silk Tree Twig, three qian; Antelope Horn boiled first, four qian; Olive with seed pounded, three; Raw Clam Shell pounded, five qian, boiled together first. Medicine taken with Longhui Wan, three qian.)
Zhang Xiaojiang’s sister contracted an external pathogen in late winter. Doctor Zhu prescribed warming-dispersing medicines for several doses, worsening the condition. Mengying observed fixed eyes, muteness, red face, rebellious qi, requiring holding day and night, unable to lie down for four days. This was winter-warmth with phlegm, mishandled by lifting methods, preventing qi descent. He prescribed Bupleuri/Magnetitum, Apricot/Fritillaria, Pseudobulbus, Imperatae Rhizome, Benincasae Fructus, Aster, Allii Macrostemonis Bulbus, Trichosanthis Fructus, Perilla Seed, Acorus, and Bambusae Succus, decocted in Radish Soup. After three doses, bowel movement occurred, and lying down became possible. Chest stuffiness prompted changing to Xiao Xian Xiong Tang combined with San Zi Yang Qin Tang modified with Glehniae Radix, Anemarrhenae Rhizoma, Bupleuri/Fritillaria, Zingiberis Rhizoma Recens, and Loquat Leaf. Fever subsided, hunger returned, and recovery ensued. Subsequently, Wang Binghua’s son contracted an external pathogen. Doctor Ye used warming-dispersing medicines, causing rebellious qi disturbing sleep. Wang Bingheng treated it as kidney deficiency failing to grasp qi, administering large doses of warming tonics. Wheezing/cough worsened, face/ankles swelled, shoulder-lifting sweating, severe thirst, hypochondriac pain. Seeking Mengying’s help, he hadn’t slept for half a month. Right pulse was wiry-large-strong; two strips of black coal-like coating at tongue root; sallow thin face. Fortunately, loose stools allowed tolerating many erroneous medicines. Mengying directly prescribed Bupleuri/Magnetitum, Coptidis Rhizoma, Aurantii Fructus, Trichosanthis Fructus, Perilla Seed, Apricot Kernel, Aster, Raw Gypsum, and Radish Juice. After six doses, lying down was possible, but thirst persisted, and epigastric/abdominal distension/pain appeared. Bupleuri/Magnetitum were removed; small amounts of White Mustard Seed, Pinellia, and Allii Macrostemonis Bulbus were added, along with advice to eat dozens of North Pyri Fructus daily. After ten days, chest/abdomen relaxed, coating cleared, but cough persisted. Prescription changed to American Ginseng, Apricot/Fritillaria, Reed Rhizome, Anemarrhenae Rhizoma, Benincasae Fructus, Pseudobulbus, Persimmon Frost, Loquat Leaf, and Bambusae Succus. After ten-plus doses, cough stopped, ankle swelling, thirst, and diarrhea resolved. Over 300 jin of pears were consumed, astonishing listeners. (Winter-warmth with phlegm identified by red face, fixed eyes, muteness. Mishandled lifting preventing qi descent identified by needing holding day/night, four days without pillow. Bupleuri Flos wrapped and boiled first, three qian; Raw Magnetitum pounded and boiled first, two tael; Bitter Apricot Paste, two qian; Fritillariae Cirrhosae Bulbus pounded, four qian; Fresh Imperatae Rhizome, five qian; Raw Benincasae Fructus, four qian; Aster Tataricus Rootlet, one qian half; Fresh Allii Macrostemonis Bulbus, one qian half; Ginger-processed Trichosanthis Fructus, three qian; Raw Perilla Seed ground added later, two qian; Acorus Tatarinowii Rhizome)