张子和治束茂之病，虚劳寝汗，面有青黄色，自膝以下冷痛无汗，腹中燥热。医以姜附补之，五晦朔不令
饮也，又禁梳头，作寒治之。张曰∶子之病不难愈，难于将护，恐愈后阴道转茂，子必不慎。束曰∶不敢。乃
先以舟车丸、浚川散，下五七行，心火下降。觉渴，与冰水饮之，又令澡浴。数日间，面红而泽。后以河水煮
粥，温养脾胃，又以治血当归丸、人参柴胡散、五苓散、木香白术散调之，病即瘥，汗止足暖食进。张曰∶此
本肺脾之病，当以凉剂。盖水一物，在目为泪，在皮为汗，在下为小溲。若禁饮水，则渴而燥热生。人若不渴，
与水亦不饮之矣。束既愈，果忘其戒，病复作，张已去，乃殂。
窦材治一妇人，伤寒疡后，转成虚劳，乃前医下凉药，损其元气故也。病患发热咳嗽，吐血少食，为灸关
元百壮，服金液、保命、四神、钟乳粉，一月全愈。
弘治乙丑岁，姑苏儒学闻教谕恭，遘羸疾，吴医治之，率用三白汤，无奇效。一日谒张养正求治，亦用三
白汤。家人曰∶前医用之多矣。养正正色曰∶子勿哓哓，吾用汤便不同。遂投熟附二三片煎，俾服即瘥。（《续
医说》。）
王时勉治常熟徐氏，中气不足。脉曰∶此脉宜补剂，当参、 ，譬如筑室造基，不可时日计其成绪，须药
百裹乃可望愈。一至于十，病不少减。更谋一医，病势增剧。复请于王。王脉之，曰∶尔信道不笃，又更别药；
以致增剧。徐莫讳，乃曰∶曾服利气之剂。王曰∶必如吾言则生，否则非吾所能也。从之，果及期而愈。肯堂
尝见《格致余论》，载浦江郑君仲夏患痢，丹溪煎人参膏与服，至五斤而剂止，十斤而病安。今人轻身重财，
罔顾体之强弱，病之浅深，亟于求效。况谋利嗜贿之徒，动辄便施刚峻劫剂，至于轻病变重，重病至危，往往
有之。古人有言曰∶不死于病，而死于医。
窦材治一人，身长五尺，因酒色伤，渐觉肌肉消瘦，令灸关元三百壮，服保元丹一斤，自后大便滑，小便
长，饮食渐加，肌肉渐生，半年如故。（此案附骨缩病后，故念庵谓有缺文。）
孙文垣治吴肖峰室，董浔阳次女，而龙山之妹也。患咳嗽体倦，多汗腹痛，呻吟不绝口者半月，诸治愈加，
脉之，左手三五不调，而右手沉弦，面色青，息甚微，腹中漉漉有声。问上年夏日曾病否？曰∶曾头痛体倦多
汗，但不咳嗽，不腹痛，今五月初，病如上年。医谓伤风，用参苏饮发之，始咳嗽，与治嗽则加腹痛。又谓通
则不痛，以沉香滚痰丸下之，遂惫不可支。曰∶此乃注夏病，仲景谓春夏剧，秋冬瘥者是也。问注夏何为咳嗽？
曰∶原不咳嗽，由参苏饮重发其汗，肺金受伤，故燥而咳。何以腹痛？曰∶因治咳，寒其中气故也。况又服滚
痰丸之剂，以重伤之。盖五月六阳之气，布散于外，汗而又汗，汗多则亡阳。夏至一阴将萌，腹中尚虚，虚而
复下，下多则亡阴。阴阳俱亡，不惫何待？乃用酒炒白芍五钱，甘草、黄 各三钱，桂枝二钱，大枣二枚，水
煎临卧服，加饴糖一合，饮讫而睡，自巳至申不醒。咸谓夏不用桂，伐天和也，诸痛不补，助邪气也，不可为矣。
龙山以其言告。曰∶既已得睡，则阴气生，汗可敛，痛可止也。问所投剂何名？曰∶此仲景小建中汤也。夫腹
痛如缚，带脉急缩也；面青脉弦，肝木盛而脾土受克也。故以白芍和之，桂枝伐之，甘草缓之，黄 、大枣、
饴糖以补之，自虚回汗敛而痛止矣。语未竟，病者醒而索粥，粥后又睡至天明，腹全不痛。惟稍咳嗽，加五味
子、麦冬、兼治注夏而全愈矣。临别语龙山曰∶令妹之病，克伐太过，今虽愈，而脉弦不退，（不用滋水生木，
弦安得遂退？所谓知其一，未知其二。）犹为可虑。宜戒恼怒，节饮食，谢去人事，恬淡颐养，（安可责之妇
人。）庶可永年。否则有害，至阴极阳生，恐不能保无患也。后至期，与良人龃龉，怒而绝药，果以凶闻。
薛立斋治沈察，年二十六，所禀虚弱，兼之劳心，癸巳春，发热吐痰，甲午冬为甚，其热时起于小腹，吐
痰无定时。或谓脾经湿痰郁火，用芩、连、枳实、二陈。或专主心火，用三黄丸之类。至乙未冬，其热多起足
心，亦无定时，吐痰不绝，或遍身如芒刺，或又以为阴火生痰，用四物、二陈、知、柏之类，俱无验。丙申夏，
热痰甚，盗汗，作渴。曰∶此乃肾经虚损，火不归经，当壮水之主，以镇阳光。其脉尺洪大，余却虚浮，遂用
补中益气及六味地黄而愈。后不守禁，其脉复作，谓火令可忧，当慎调摄。会试且缓，但彼忽略，至伐戊戌夏，
果殁于京。（雄按∶洪大虚浮之脉，火不归经之证，岂补中益气之可试乎？虽与六味同用，亦非治法。）
龚子才治周侍御，患虚损，目不敢闭，闭则神飞飘散，无所知觉，且不敢言，言即气不接，昏沉懒食。诊
视之，六脉虚微，此元气衰弱，心神虚惫也。先与朱砂安神丸，一服少安。后以补中益气汤，倍参、 ，加远
志、茯神、枣仁、白芍、生地、麦冬，连进数剂，渐瘳。（雄按∶据脉证，宜补而兼以镇摄为治，升麻、
柴胡未可轻试。）
刘氏子年十八，患虚劳，热咳痰喘，面赤自汗，旬余不能就枕，势危剧。诊之，六脉微数，乃阴虚火动也。
令五更时以壮盛妇人乳一钟，重汤煮温，作三四十口呷之。天明煎河东地黄丸一服。少顷，将大小米入山药、
莲肉、红枣、胡桃仁数个，煮稀粥食。半晌，又煎清离滋坎汤二剂、加竹沥、童便、姜汁少许，频频服之。至
午又进粥少许，加白雪糕食之。过半晌，又进前药二剂。夜间睡则药止，醒则即服。如此三昼夜，药不住口，
火乃渐息，能枕席。后减药之半，半月病减六七，服汤剂调理而愈。此症若以寻常之法施治，日进一二剂，则
是一杯水，岂能救车薪之火哉？
孙文垣治张文学子心，二尹可泉长君也，弱冠病，医作劳瘵治，久不效。自分必死，督家人治含敛。脉之，
左寸短弱，右关略弦，余皆洪大。咳嗽，下午热从足心起，渐至头面，夜半乃退，面色青，形羸气促，多梦遗，
卧床奄奄，已绝粒断药二日。谓可治。可泉曰∶医佥谓火起九泉者死，大肉尽削者死，咳嗽加汗者死，脉不为
汗衰者死。（此感症则然。）又当火令之时，恐肺金将绝，乃谓可治何也？曰∶症虽危，两颧不赤，心火未焚也；
声音不哑，肺金未痿也；耳叶不焦，肾水未涸也。面赤者，忧疑不决；左寸短者，心神不足；关略弦者，谋为不
遂。症与色脉，皆非瘵也。良由志愿不遂，殆心病，非肾病也，故谓可治。盖病患因星士许发解，因而落第，
故挹怏寝疾也。为立方，名调肝益神汤，以人参、枣仁、龙骨为君，丹参、石斛、贝母、麦冬、五味为臣，山
栀、香附为佐，服二十剂而病起。丸方，则熟地、龟板、枸杞、人参、麦冬、五味、茯苓，蜜丸，服三月全安。
陆祖愚治金伯远妇，年未四旬，生育已多，且数小产，致病怯弱，不时眩晕恶心，胸膈痞满，饮食不进，
四肢浮肿，晡时潮热，大便时泻时燥，此及夜间，恍惚不眠。诊得左寸浮涩，两关俱弦细，两尺初取觉洪大，
重按则少神，知其心脾肾三经受病。而前医纯以清凉治之，非也。以陈皮、贝母、前胡、苏子、木通、苡仁、
当归、白芍、天麻为煎剂，巳午未三时服。黎明用熟地、人参、制附子、杜仲、麦冬、山药、知母、白术同为
丸，淡盐汤送下。黄昏服安神丸。如此分为三治，初服便觉有头绪，调理两月，诸症如失。
殷岐山于春末患伤寒，医与汗下，症已愈矣。然精神时常觉恍惚，肌肉未能充实。至秋时，发热微咳嗽，
食减肌削，且精滑便溏，医谓阴虚，服六味加减几百剂，至冬，甚恶寒，不能出户。诊其脉，浮之损小，其色
白不泽，曰∶阳虚症也，非参不可。凡阴虚之热，蒸蒸内出，骨甚于肉，肉甚于皮，阴分必剧，重扪则热不
甚，明乎外热内不热也，且热发无常，是阳气有时亏盈也。（语未妥。）阴虚火旺之嗽，口口相续，口渴咽干，
痰涎稠浊。（此近伤风症矣。）今微咳无痰，明乎阳气之不能上升也。（亦未妥。）即精滑者，亦因阳气不足，
故阴精不固也。至大便不实与畏寒，其为阳虚显然矣。总由伤寒汗下之后，元气未复，而强力作劳，以致损
惫。用加减八味丸，五更淡盐汤下，日中用四君、四物，加枣仁、远志作煎剂，间用补中益气汤，两月而愈。
黄履素曰∶予少患下元虚，不能多言，稍不戒，所得病不可状，丹田若无物者，甚则夜半阴极之时，阳气
欲脱，手足厥冷，汗大泄，一交子丑，气分乃渐复，此系肾阳衰弱之候。常服温肾之药，于滋阴料中，多用菟
丝子、枸杞子、肉苁蓉、五味子、鹿茸、紫河车之属，遂得渐愈。前症因目病，误服黄连丸，顿剧。要知阳衰
之症，寒药在所最忌。知母、黄柏之属，最伤胃中生发之气，即平人亦不宜多服。又本草云∶升麻、川芎，下
虚人忌服。予服四物汤，川芎稍多，服补中益气汤，失加人参，皆顿觉下虚，前症陡发，药之附应如此。
李士材治何邑宰之子，虚损遗精盗汗，瘦骨柴立，已濒于危。简其所服，以四物、知、柏为主，芩、连、
二冬为加减。诊其脉，大而数，按重极软，（犹有胃气，故可治。）曰∶中气大寒，反为药苦矣。乃以归
脾汤入肉桂一钱，人参五钱，当晚熟睡，居十日而汗止精藏，更以还少丹，兼进补中益气，服一月而愈。
顾宗伯患发热困倦，目昏耳鸣，脚软不能行，大便燥结，手足麻痹，腰胯疼痛。李诊之曰∶肾虚不能上交，
心虚不能下济。用八味丸、十全大补汤，加龙眼肉三十枚。五十余日，精神渐旺，肌肉渐充。一日，多饮虎骨
酒，大便乃结。医者皆云∶八味丸非久服之药，十全大补宜去肉桂，反用知母、元参佐之。服之数月，遂至不起。
按∶是症八味、十全、元参、知母，其失正均，惟集灵膏一方，真的剂也。
李翰林劳而无度，醉而御内，汗出多痰，服宽膈化痰之药，转觉滞闷。诊其脉，沉而涩，两尺尤甚，曰∶
痰得涩脉难愈，况尺中涩甚，精伤之象也，在法不治。乞投剂，勉用补中益气加半夏、茯苓，两帖有小效，众
医皆喜。李曰∶涩象不减，脉至无根，死期近矣。果十余日而殁。（据脉症，药亦大左。）
卢不远治吴叔显，三月间生疮，服药疮已合，而喘急殊甚，十日不能就枕。往诊之，先用发疮开肺，次用
降气补肾，断其次日当疮发，五日当足肿，六日当出水，十日可喘定就睡。嗣后足生二毒，三月始完复。次年
七月，偶以伤风微热，左三部脉惟隐隐见。以大剂人参、归、地、甘草，十帖脉方起，二十帖如常。十月再感，
左脉更不如秋，但微热，起居如故，三日就枕，七日头痛如破。因告其兄，以秋病之危，今若昏死，决无生理。
彼尚疑其言，九日果微昏错语，十二日不识人，再七日死。或问曰∶某昨岁垂危，君言变症，历历如响，幸全
生焉。今冬微恙，君言不起，果应其言，其症为一为两？曰∶其人气骨夭弱，肾精不全，其疮亦从肾发也。不
知而用发散，元气转耗，疮毒内逆于肺而喘。予用四逆散，使太阴气开，疮遂外出；用六味料，使少阴纳气，
息遂内均。清升浊降，足肿生痈，病俱外去，是以生也。今秋左脉不起，是元气内索，不堪左旋矣。比起而再
戕贼之，病发于骨髓，所以脑痛，因之遂昏，是内关之症，气独内绝，是以死也。其病皆根本于肾，是一非两，
不在症之轻重为异同也。
冯楚瞻治余侍读，数年参药久服，或时气逆上攻，或时气坠下迫，二阴皆重，失气甚频，大便溏而不畅，
脉则细数无力。向服补中益气，殊不知愈升则气愈降，况兼陈皮辛散，反泄元气，岂未闻塞因塞用之说乎！乃
以八味加鹿茸、补骨脂、五味子为丸，参汤吞服于空心。以嫩防风三两，酒煮取汁，拌炒黄 一斤，炒黄白术
半斤，熟附子四两，三味煎汁，去滓熬膏，以人参六两为末，收成细丸，日中食远白汤吞服四钱。 能升托，
术能固中，参能补里，附能回阳，四味共剂收功，何虑虚陷者不为振作发生也？遂愈。
胡春坊年将六旬，抱病九月余，寒热攻补杂进，症随药变，虚虚实实之间，几莫能辨。诊之，六脉洪大有
力，似非阳虚也。乃时当暑月，汗出恶风，痰嗽鼻塞，饮食如故，却精神实疲，此阴亏不能敛阳，以致阳浮阴
散，清浊不分，邪火消谷，生痰不生血也。但为养阴，则阳有所根据，投以六味，加盐水煮橘红、麦冬、五味子，
不三剂而愈。
赵宦病赤如妆，不省人事，口多谵语，手足躁动，六脉洪大搏指。所服乃柴、广、半之类，以其剂小，不
能为害，不知真阴失守，虚阳上浮，神气欲脱，补救尚虞不及，敢以清利速其死耶。以人参八钱，熟地、麦冬、
丹参、白芍、茯神、远志、牛膝、姜炭，每日二剂，不数日而愈。
高鼓峰治吴升玉，发热多汗，便秘数日不行。医曰∶此停食伤寒也，不宜与食，待热退始可以稀粥饮之。
Zi Hezi treated Shu Maozhi, who suffered from deficiency consumption with night sweats, a bluish-yellow complexion, cold and painful legs below the knees without sweat, and dry heat in the abdomen. Physicians had treated him with warming tonics such as Ginger (Shengjiang) and Aconite (Fuzi), forbade him to drink water for five days and nights, and prohibited him from combing his hair, treating it as a cold syndrome. Zi Hezi said, "Your illness is not difficult to cure, but difficult to manage afterwards. I fear that after recovery, your sexual desire will increase, and you will surely fail to restrain yourself." Shu replied, "I dare not be careless." Therefore, Zi first administered Zhouche Wan (Boat and Cart Pill) and Xunchuan San (River Clearing Powder) to induce bowel movements five or six times, causing Heart Fire to descend. The patient felt thirsty, so he was given ice water to drink and allowed to bathe. Within a few days, his face became ruddy and lustrous. Afterwards, he was fed congee cooked with river water to warm and nourish the Spleen and Stomach, and regulated with Zhixue Danggui Wan (Blood-Regulating Angelica Pill), Renshen Chaihu San (Ginseng and Bupleurum Powder), Wuling San (Five-Ling Powder), and Muxiang Baizhu San (Aucklandia and Atractylodes Powder). The illness resolved, sweating stopped, feet became warm, and appetite improved. Zi Hezi said, "This was originally a Lung and Spleen disease, which should have been treated with cooling agents. Water manifests as tears in the eyes, sweat on the skin, and urine in the lower jiao. If water intake is forbidden, thirst and dry heat arise. If one does not feel thirsty, even if water is offered, they will not drink." After Shu recovered, he indeed forgot the doctor's warning, the illness relapsed, and since Zi Hezi had already left, he eventually died.
Dou Cai treated a woman whose condition transformed into deficiency consumption after recovering from typhoid fever and sores. This was caused by previous physicians using cold-cooling medicines that damaged her Yuan Qi (Original Qi). The patient had fever, cough, hemoptysis, and poor appetite. Dou Cai moxibusted the Guanyuan (CV4) point 100 cone-sized moxa cones and administered Jin Ye Dan (Golden Fluid Pill), Baoming Dan (Life-Preservation Pill), Sishen Dan (Four-Spirit Pill), and Zhongru Fen (Cloud Milk Powder). She fully recovered within one month.
In the Yichou year of the Hongzhi era, Wen Gong, the Instructor of the Confucian School in Gusu, suffered from a wasting disease. Doctors in Wu typically used Sanbai Tang (Three Whites Decoction) without remarkable effect. One day, he sought treatment from Zhang Yangzheng, who also prescribed Sanbai Tang. The family said, "Previous doctors have used this many times." Zhang Yanzheng sternly said, "Do not chatter; my decoction will be different." He added two or three slices of Prepared Aconite (Shu Fuzi) to the decoction, and the patient recovered immediately upon taking it. (From *Xu Yi Shuo*.)
Wang Shimian treated Xu Shi of Changshu, who had insufficient Middle Qi. Wang said, "This pulse indicates the need for tonifying agents, specifically Ginseng (Renshen) and [Atractylodes] (Baizhu). It is like building a house foundation; one cannot calculate its completion by days. One must take over a hundred doses to expect recovery." After ten doses, the illness did not significantly improve. Another physician was consulted, and the condition worsened. Wang was asked again. Upon palpating the pulse, Wang said, "Your faith in my method is not firm, and you changed medications; this led to worsening. Do not hide it, Xu: 'Have you taken qi-regulating agents?' Wang said, 'If you follow my advice, you will live; otherwise, it is beyond my ability.' Xu complied, and indeed recovered at the expected time. Kentang once read *Gezhi Yulun*, which recorded that Zheng Jun of Pujiang suffered from dysentery in midsummer. Danxi administered Ginseng Paste, stopping at five jin, and the illness resolved at ten jin. Nowadays, people value wealth over their bodies, disregarding constitution and disease depth, seeking quick results. Moreover, profit-seeking practitioners often use harsh, purgative drugs, turning mild illnesses severe and severe ones critical. As the ancients said, 'One does not die of the illness, but of the physician.'"
Dou Cai treated a man, five chi tall, who suffered muscle emaciation due to excessive alcohol and sexual activity. He ordered moxibustion on Guanyuan (CV4) for 300 cones and administration of Baoyuan Dan (Protect Origin Pill) totaling one jin. Thereafter, his stool became loose, urination increased, diet improved, and muscles regenerated. He returned to normal after half a year. (This case is appended to bone shrinking disease, hence Nian'an noted missing text.)
Sun Wenyuan treated the wife of Wu Xiaofeng, the second daughter of Dong Xunyang and sister of Longshan. She suffered from cough, fatigue, hyperhidrosis, abdominal pain, and constant groaning for half a month. Various treatments aggravated her condition. Pulse diagnosis revealed irregularity in the left hand and deep-chordiness in the right hand; her complexion was blue, respiration faint, and borborygmus audible in the abdomen. Asked about summer illness last year, she replied she had headache, fatigue, and sweating but no cough or abdominal pain. In early May, symptoms recurred. Previous physicians diagnosed wind injury and used Shen Su Yin (Ginseng and Perilla Decoction) to induce sweating, which initiated coughing; treating the cough exacerbated abdominal pain. Then, applying the principle "patency prevents pain," Chenxiang Guntan Wan (Agarwood and Phlegm-Rolling Pill) was used to purge, leading to extreme exhaustion. Sun Wenyuan said, "This is Summer-Sickness (Zhuxia Bing), described by Zhang Zhongjing as worsening in spring/summer and improving in autumn/winter." Asked why Summer-Sickness causes cough, he explained, "Originally there was no cough; Shen Su Yin induced heavy sweating, damaging Lung Metal, causing dryness and cough. Why abdominal pain? Because treating the cough introduced cold into the Middle Jiao. Furthermore, Guntan Wan further injured the body. In the sixth lunar month, Yang Qi spreads outward. Sweating repeatedly leads to loss of Yang. At the Summer Solstice, Yin begins to sprout; the abdomen is still deficient. Purging when deficient leads to loss of Yin. With both Yin and Yang depleted, exhaustion is inevitable." He prescribed Wine-fried White Peony Root (Bai Shao) 5 qian, Licorice (Gancao) and Scutellaria (Huangqin) 3 qian each, Cinnamon Twig (Guizhi) 2 qian, and Jujube (Dazao) 2 pieces, decocted in water and taken before bed, adding Maltose (Yitang) 1 he. After drinking, the patient slept soundly from Si hour to Shen hour. Many criticized using Cinnamon Twig in summer, fearing it disrupts natural harmony, and argued against tonification in pain cases, fearing it aids pathogenic factors. Longshan reported this to Sun Wenyuan, who said, "Since she slept, Yin Qi has generated, sweating can be consolidated, and pain can cease." Asked for the formula name, he replied, "This is Zhang Zhongjing's Xiao Jianzhong Tang (Minor Construct the Middle Decoction). Abdominal pain like binding indicates tension in the Dai Mai (Girdle Vessel); blue face and chordy pulse indicate Liver Wood excess suppressing Spleen Earth. Thus, Bai Shao harmonizes, Guizhi disperses, Gancao moderates, and Huangqin, Dazao, and Yitang tonify. Deficiency returns, sweating stops, and pain ceases." Before finishing speaking, the patient woke up asking for porridge. After eating, she slept until dawn, with no abdominal pain. Only slight cough remained, treated with Schisandra (Wuweizi) and Ophiopogon (Maidong), alongside management of Summer-Sickness, leading to full recovery. Before parting, Sun told Longshan, "Your sister's illness involved excessive purging. Although recovered, the chordy pulse remains. (Without nourishing Water to generate Wood, how can the chordy pulse subside? Knowing one aspect but not the other.) Caution is still needed. Avoid anger, regulate diet, withdraw from social affairs, and cultivate tranquility. (How can this be demanded of a woman?) Perhaps longevity can be achieved. Otherwise, harm may occur. When Yin reaches extremity and Yang generates, disaster may ensue." Later, during that period, conflict with her husband led to anger and cessation of medicine, resulting in death.
Xue Lizhai treated Shen Cha, aged 26, who had a weak constitution and mental overwork. In spring of Gui Si year, he had fever and phlegm expectoration, worsening in winter of Jia Wu year. Heat originated from the lower abdomen, and expectoration was irregular. Some attributed it to Spleen damp-phlegm and stagnant fire, prescribing Scutellaria (Huangqin), Coptis (Huanglian), Aurantium (Zhishi), and Erchen Tang. Others focused on Heart Fire, using Sanhuang Wan (Three Yellows Pill). By winter of Yi Wei year, heat often rose from the sole of the foot, expectoration continued, and sometimes the whole body felt like prickling. Others attributed it to Yin fire generating phlegm, prescribing Siwu Tang, Erchen Tang, Anemarrhena (Zhimu), and Phellodendron (Huangbai), all without effect. In summer of Bing Shen year, heat and phlegm were severe, with night sweats and thirst. Xue said, "This is Kidney deficiency with Fire not returning to its source. We must strengthen the Master of Water to suppress Solar Flare." The pulse was large and forceful at the Chi position but empty and floating elsewhere. He used Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction) and Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia), leading to recovery. However, failing to observe restrictions caused the pulse to recur. He warned that the Fire season was worrying and advised careful regulation, delaying the metropolitan examination. Ignoring this, by summer of Wu Xu year, he died in Beijing. (Xiong notes: Large-empty-floating pulse and Fire not returning to source are not suitable for trial with Buzhong Yiqi Tang. Even combined with Liuwei Dihuang Wan, it is not the correct method.)
Gong Zicai treated Zhou Shiyu, who suffered from deficiency consumption. He dared not close his eyes, as doing so caused his spirit to scatter and lose awareness. He dared not speak, as speech caused breathlessness, lethargy, and anorexia. Pulse diagnosis showed all six positions were empty and minute, indicating衰竭 of Yuan Qi and exhaustion of Heart Spirit. First, Zhusha Anshen Wan (Cinnabar Calming Spirit Pill) was given, providing slight relief. Then, Buzhong Yiqi Tang was used with doubled Ginseng and [Atractylodes], plus Polygala (Yuanzhi), Poria (Fushen), Ziziphus Seed (Suanzaoren), White Peony (Baishao), Rehmannia (Shengdi), and Ophiopogon (Maidong). After several doses, he gradually improved. (Xiong notes: Based on pulse and symptoms, treatment should combine tonification with calming/subduing. Cimicifuga (Shengma) and Bupleurum (Chaihu) should not be lightly tried.)
The son of Mr. Liu, aged 18, suffered from deficiency consumption with hot cough, wheezing, red face, and spontaneous sweating. For over ten days, he could not lie down, and the condition was critical. Pulse was slightly rapid in all six positions, indicating Yin deficiency with stirring Fire. He was instructed to drink one cup of milk from a robust woman at the fifth watch, warmed in hot water, sipped slowly. At dawn, Hedong Dihuang Wan was administered. Shortly after, a thin congee was made with millet, rice, Chinese Yam (Shanyao), Lotus Seed (Lianrou), Jujube (Dazao), and Walnut Kernel (Hetaoren). After some time, Qingli Zikan Tang (Clear Li and Nourish Kan Decoction) was prepared in two doses, with added Bamboo Sap (Zhuli), Child's Urine (Tongbian), and Ginger Juice (Jiangzhi), taken frequently. By noon, more congee and Baixue Gao (White Snow Cake) were given. After another while, two more doses of the previous medicine were given. Medicine was withheld during sleep and resumed upon waking. For three days and nights, medicine was continuously administered, Fire gradually subsided, and he could rest on pillows. Dosage was halved later. Within half a month, the illness reduced by 60-70%, and he recovered with herbal regulation. Treating this with ordinary methods (one or two doses daily) would be like pouring a cup of water on a burning cartload of firewood—utterly ineffective.
Sun Wenyuan treated the eldest son of Zhang Wenxue, courtesy name Kequan. Ill since adolescence, treated as tuberculosis (Laozai) by physicians without effect, he despaired of life and prepared for burial. Pulse diagnosis showed short and weak Left Cun, slightly chordy Right Guan, and large elsewhere. Symptoms included cough, afternoon heat rising from soles to head, resolving at midnight, blue complexion, emaciation, shortness of breath, frequent nocturnal emissions, and prostration. He had fasted and stopped medicine for two days. Sun said it was curable. Kequan objected, citing prognostic signs of death (fire from nine springs, flesh wasting, cough with sweating, pulse unaltered by sweating). He questioned how Sun could claim cure during the Fire season when Lung Metal seemed doomed. Sun replied, "Although critical, malar flush is absent (Heart Fire not burning); voice is clear (Lung Metal not flaccid); earlobes are not scorched (Kidney Water not dried). Red face indicates indecision; short Left Cun indicates insufficient Heart Spirit; slightly chordy Guan indicates unfulfilled ambitions. Symptoms and pulse do not match tuberculosis. Likely due to unfulfilled ambitions, it is a Heart disease, not Kidney, hence curable." The patient had failed exams despite astrological promises, leading to depression. Sun prescribed Tiaogan Yishen Tang (Regulate Liver and Benefit Spirit Decoction) with Ginseng, Ziziphus Seed, Dragon Bone as Sovereign; Salvia (Danshen), Dendrobium (Shihu), Fritillaria (Beimu), Ophiopogon, and Schisandra as Ministers; Gardenia (Shanzhi) and Cyperus (Xiangfu) as Assistants. After 20 doses, he recovered. A pill formula with Prepared Rehmannia (Shudi), Turtle Shell (Guiban), Goji (Gouqi), Ginseng, Ophiopogon, Schisandra, and Poria, honey-pilled, was taken for three months for complete health.
Lu Zuyu treated the wife of Jin Boyuan, under 40, with multiple births and miscarriages, leading to weakness, dizziness, nausea, chest oppression, anorexia, limb edema, evening tidal fever, alternating diarrhea and constipation, and nighttime insomnia. Pulse was floating-choppy at Left Cun, string-thin at both Guans, initially large at Chi but lacking spirit upon pressure. Disease affected Heart, Spleen, and Kidney. Previous pure cooling treatment was incorrect. Decoction of Tangerine Peel (Chenpi), Fritillaria, Peucedanum (Qianhu), Perilla Seed (Suzi), Akebia (Mutong), Coix Seed (Yiren), Angelica (Danggui), White Peony, and Gastrodia (Tianma) was taken during Si, Wu, and Wei hours. At dawn, pills of Prepared Rehmannia, Ginseng, Processed Aconite, Eucommia (Duzhong), Ophiopogon, Chinese Yam, Anemarrhena, and Atractylodes were taken with light salt water. At dusk, Anshen Wan was taken. Divided into three treatments, improvement was immediate. After two months of regulation, symptoms vanished.
Yin Qishan contracted typhoid in late spring, treated with sweating and purging, symptoms resolved but spirit remained vague and muscles unfilled. In autumn, fever, mild cough, anorexia, emaciation, seminal emission, and loose stool appeared. Diagnosed as Yin deficiency, hundreds of doses of modified Liuwei Dihuang Wan were taken. By winter, severe aversion to cold prevented leaving home. Pulse was small and damaged on superficial palpation; complexion was pale and dull. Yin said, "This is Yang deficiency; Ginseng is essential. Yin deficiency heat rises internally, bone > muscle > skin; deep pressure reveals less heat, indicating external heat but internal coolness. Irregular fever suggests fluctuating Yang. (This statement is imprecise.) Yin deficiency with Fire flourishing cough involves continuous coughing, thirst, dry throat, and thick phlegm. (This resembles wind-cold.) Now, mild cough without phlegm indicates failure of Yang to ascend. (Also imprecise.) Seminal emission is due to insufficient Yang failing to secure Yin Essence. Loose stool and cold aversion clearly indicate Yang deficiency. Overall, post-typhoid sweating/purging failed to restore Yuan Qi, and overexertion caused depletion. Modified Bawei Wan was taken at dawn with salt water. During the day, Sijunzi Tang and Siwu Tang with Ziziphus Seed and Polygala were decocted. Intermittently, Buzhong Yiqi Tang was used. Recovery occurred in two months."
Huang Lvsu stated: "In my youth, I suffered from lower origin deficiency, unable to speak much. Without caution, the illness became indescribable, feeling empty in the Dantian. At midnight, when Yin is extreme and Yang wants to escape, hands and feet became cold, sweating profusely. After Zi-Chou hours, Qi gradually recovered. This is Kidney Yang衰弱. I commonly took Kidney-warming herbs in Yin-nourishing formulas, using Dodder Seed (Tusizi), Goji (Gouqi), Cistanche (Rongcong), Schisandra, Deer Antler (Lurong), and Placenta (Ziheche), gradually recovering. Previously, eye disease was mismanaged with Coptis Pills, worsening instantly. One must know that cold herbs are strictly contraindicated in Yang deficiency. Anemarrhena and Phellodendron damage Stomach generating Qi and should not be taken excessively even by healthy people. Materia Medica states Cimicifuga and Ligusticum (Chuanxiong) are contraindicated in lower deficiency. Taking Siwu Tang with too much Chuanxiong, or Buzhong Yiqi Tang without Ginseng, instantly triggered lower deficiency and recurrence. Drug responses are thus precise."
Li Shicai treated the son of Magistrate He, suffering from deficiency consumption, seminal emission, night sweats, emaciation, and near-death state. His medications consisted mainly of Siwu Tang, Anemarrhena, Phellodendron, Scutellaria, Coptis, and Winter Melon/Ophiopogon. Pulse was large and rapid but extremely soft upon heavy pressure (indicating remaining Stomach Qi, hence curable). Li said, "Middle Qi is severely cold, harmed by medication." He prescribed Guipi Tang with 1 qian Cinnamon Bark (Rougui) and 5 qian Ginseng. The patient slept well that night. After ten days, sweating stopped and essence was retained. Huan Shao Dan was added, along with Buzhong Yiqi Tang. Recovery occurred in one month.
Grand Secretary Gu suffered from fever, fatigue, blurred vision, tinnitus, weak legs, constipation, limb numbness, and hip pain. Li diagnosed Kidney deficiency failing to communicate upward and Heart deficiency failing to descend. Eight-Ingredient Pill (Bawei Wan) and Shiquan Dabu Tang were prescribed with 30 Longan Arils. Over 50 days, spirit strengthened and muscles filled. One day, excessive Tiger Bone Wine caused constipation. Physicians claimed Bawei Wan should not be taken long-term, suggested removing Cinnamon from Shiquan Dabu, and adding Anemarrhena and Scrophularia (Yuanshen). After months of this, he died. Note: Errors in using Bawei, Shiquan, Yuanshen, and Anemarrhena were equal. Only Jiling Gao (Collecting Spirit Paste) was the truly appropriate formula.
Hanlin Li worked excessively and engaged in sex while drunk, resulting in sweating and copious phlegm. Broad-chest phlegm-resolving drugs caused stagnation. Pulse was deep and choppy, especially at Chi positions. Li said, "Phlegm with choppy pulse is hard to cure; severe choppy Chi indicates Essence injury, untreatable by law." Begging for prescription, Li reluctantly used Buzhong Yiqi Tang with Pinellia (Banxia) and Poria. Two doses showed slight effect, pleasing other doctors. Li said, "Choppy image persists, pulse lacks root; death is near." Indeed, he died in ten days. (Based on pulse/symptoms, the prescription was also largely incorrect.)
Lu Bu Yuan treated Wu Shuxian. Sores appeared in March, healed with medicine, but severe asthma persisted, preventing lying down for ten days. Diagnosis: First, promote sore eruption and open Lungs; then, direct Qi downward and tonify Kidneys. Prediction: Sores would reappear next day, foot swelling on day five, oozing on day six, asthma settling and sleep possible by day ten. Subsequently, two sores appeared on the foot, fully healing in three months. Next July, mild fever from wind-cold showed only faint pulses in left three positions. Large dose of Ginseng, Angelica, Rehmannia, and Licorice for ten doses raised the pulse; twenty doses normalized it. October relapse: left pulse worse than autumn, mild fever, normal routine, sleeping in three days, severe headache on day seven. Warned brother of autumn danger, predicting coma and death if unconscious. Brother doubted. On day nine, mild confusion and slurred speech occurred; day twelve, inability to recognize people; seven days later, death. Questioned: "Last year, you predicted changes accurately, saving me. This winter, minor illness, you predict death. Are these same or different?" Answer: "His constitution is weak, Kidney Essence incomplete, sores originated from Kidney. Unknowingly using diaphoretics consumed Yuan Qi, pushing toxin inward to Lungs causing asthma. I used Sini San to open Taiyin, allowing sore eruption; Liuwei material to guide Shaoyin, regulating respiration. Clear ascending, turbid descending, foot swelling and abscess expelled disease externally, hence survival. This autumn, left pulse failed to rise, indicating internal exhaustion of Yuan Qi, unable to rotate. Rising again and injuring further, disease entered marrow, causing brain pain and coma. This is Neiguan syndrome, Qi cut off internally, hence death. Both illnesses rooted in Kidney; one nature, not differing by severity."
Feng Chuzhan treated Reader Yu, who had taken Ginseng for years. Sometimes Qi rushed upward, sometimes sank downward, heaviness in both yin openings, frequent flatulence, loose unsmooth stool, fine-rapid-weak pulse. Previously used Buzhong Yiqi Tang, unaware that raising Qi further lowers it. Plus Citrus Peel's acrid dispersion leaks Yuan Qi. Did he not hear 'treat obstruction with obstruction'? Prescribed Bawei Wan with Deer Antler, Psoralea (Buguzhi), and Schisandra, swallowed with Ginseng decoction on empty stomach. Young Fangfeng 3 liang boiled in wine, mixed with stir-fried Astragalus (Huangqi) 1 jin, stir-fried Atractylodes (Baizhu) 0.5 jin, Prepared Aconite (Shu Fuzi) 4 liang. Decocted, strained, concentrated to paste, mixed with Ginseng powder 6 liang, formed into fine pills. Taken at noon with plain water, 4 qian. Huangqi lifts and supports, Baizhu stabilizes middle, Ginseng tonifies interior, Fuzi restores Yang. These four together achieve success; why worry about deficiency collapse not revitalizing? Recovered.
Hub Chunfang, nearly 60, ill for over nine months, received mixed cold/hot and tonifying/purging treatments, symptoms changing with drugs, indistinguishable between deficiency/excess. Pulse was large-forceful, seemingly not Yang deficiency. But in summer month, sweating, wind-aversion, phlegm-cough, nasal congestion, normal diet, yet exhausted spirit. This is Yin deficiency failing to contain Yang, causing Yang float and Yin scatter, confusion of clear/turbid, evil fire consuming grain, generating phlegm instead of blood. Merely nourishing Yin gives Yang a basis. Prescribed Liuwei Dihuang Wan with Salt-water boiled Chenpi, Maidong, and Wuweizi. Recovered in less than three doses.
Zhao Huan suffered from redness like makeup, unconsciousness, delirium, restless limbs, and large-forceful pulse hitting fingers. Previously taken Chaihu, Guangchen, Banxia, etc., harmless due to small dose. Unknown was True Yin loss, Floating Yang, Spirit about to escape. Remedying might be insufficient; daring to use clearing/draining accelerates death. Prescribed Ginseng 8 qian, Prepared Rehmannia, Ophiopogon, Salvia, White Peony, Poria, Polygala, Achyranthes (Niuxi), Charred Ginger (Jiangtan). Two doses daily. Recovered in a few days.
Gao Gufeng treated Wu Shengyu, fever, sweating, constipation for days. Doctor said: "Food stagnation typhoid. No food, wait for heat to subside before thin congee."