小序 医之有案，如奕者，之谱，可按而覆也。然使失之晦与冗，则胡取乎？家先生之医案等身矣，
语简而意明，洵足以尽脉之变。谨取数十则殿之，由此以窥轩岐之诊法焉，千百世犹旦暮也。
新安吴文邃，眩晕者三载战栗恶寒居帏帐之内，数外家拥之，当五月而向火。姜、桂屡投，病势
日剧。千里延余。为诊其脉，浮之细小，沉之搏坚。是郁火内伏，不得宣越也。以山栀三钱，黄连
二钱，黄柏一钱五分，柴胡一钱，甘草五分，生姜五片，乘热亟饮之。移时而恶寒少减，再剂而
辍去火炉，逾月而起。更以六味丸加知、 。人参汤送，两月全安。所以知文邃病者，虽恶寒而
喜饮热汤，虽脉细而按之搏指，灼然为内真热而外假寒，热极反兼胜己之化。以凉药热饮
者，内真寒而外假热之剂也。
制台张石林，胫膝肿痛，赤如涂丹。用槟榔、木通、牛膝、苡仁等药，继用苍术、黄柏，毫末无功。余
诊之曰，尺大而软，责在少阴。遂用人参、地黄各三钱，麦冬二钱，丹皮、牛膝、枸杞各三钱，沉香
一钱。连服四剂瘥减，二月而康复。
苏松道尊高玄圃，神气不充，两足酸软。或与安神壮骨，或与补肾养阴，或与清热去湿，卒不
效也。召余诊之。六脉波和，独有中州涩而无力。是土虚不能制水，湿气注于下焦。以补中益
气汤加苍术，旬日即愈。夫脉虚下陷之证，误服牛膝、苡仁、黄柏等下行之剂则愈陷，此前药
所以无功也。
车驾郎赵讳昌期，两臂痛甚，两手灼热。诸医皆谓脾主四肢，与之清胃健脾，至三日而溺色
如泔。余曰，六脉俱涩，喉有喘呼。《内经》云∶“肺所生病者，上气喘满，臂痛，掌中热，溺色变。”今
诸证咸显，若合符节。遂与枳壳、桔梗各三钱，茯苓、知母各二钱，甘草一钱。一剂而痛减。再剂
而溺清，三剂且霍然矣。
太常卿胡慕东，形神俱劳，十昼夜目不得瞑，自服归脾汤数剂；中夜见鬼，更服苏合丸无功。
余曰，脉大而滑，痰气胶固也。二陈汤加枳实、苏子，两日进四剂，未获痊可。更以人参汤送滚
痰丸，下痰积甚多，因而瞑眩，大剂六君子汤，服一月乃安。
内臣赵荣庵，忽然昏仆，胸腹硬满，气口独强，此食厥也。以枳实、橘红二两，煎汤四碗，加食盐
少许，探吐颇多。更用香砂平胃散，数剂始安。
沔阳州学宪钱长玉夫人，腹痛肠鸣，或以怒伤肝气治，或以虫积血积治。余往视之身伛偻
而气喘呼，脉弦而细，此女子之疝也。青木香、广木香各一钱五分，川楝子、木通、肉桂、茴香各
一钱，当归、甘草各八分。一剂知，四剂已。
新安吴声宏，荒于酒色，起立辄眩仆。余诊之，两尺如烂绵，左关弦且急。病得之立而使内，筋
与骨并伤也。声宏鼓掌曰，先生胸中有镜，指下有神，古之扁仓勿是过也。幸善以救吾。与萆
蠲痹汤加龟版、虎骨、鹿茸，服两旬而痛若失。
维扬孝廉王伟然，喜读书，不以寒暑废。忽呕血碗，许不药而愈。偶坐谈次乞，余诊视。余曰，尊
恙虽愈，元本日亏，须兢兢保任，过长夏乃安耳。伟然不以余言为意。余谓其弟张甫曰，今长
公神门欲脱，水不胜火，炎赫之令，将不禄矣。张甫曰，尚可图否？余曰，阳躁而不鼓，阴衰而欲
绝，虽有智者，靡所适从。果至六月十九日呕血而绝。
丹阳邑尊王维凝，染患伤寒，汗下后邪已解矣，时时灼热。或曰，汗后不为汗衰，邪气深重。禁
其饮食，且与清剂。困倦已极，求治于余。诊其脉小，按其腹濡。此邪气已尽，正气未复，谷气不
加，阳明失养，非病也，饥也。病者不能言，但首肯不已。以糜粥徐徐进之，日进五六次。居五日，
弗药而愈。
吴门佥宪郭履台，春秋已高，少外家入房，昏倦不食。医者咸知其虚，投补中汤加姜、桂，不效。遣
使迎余。兼夜而往视之，目不能瞬，口不能言，肌体如烙。或谓此人参、姜、桂之毒也。余捧腹曰，
脉大而鼓，按之如无，真气欲绝，正嫌病重而药轻耳。遂以人参三两，熟附三钱，煎液，半日饮
尽，目乃大开。再作剂如前，至旦日饮尽，口能言矣。数日而神气渐复，更以大剂补中，兼服八
味丸计五十日而起。
相国方禹修，足疮浸淫，绵延三载。若解毒。若燥湿，若清热祛风，靡不遍尝，而势不少衰。余曰，
脉大无力，气虚之候也。气虚则下陷，日与疏利，有愈趋而愈下矣。以补中益气加萆 、苍术
服，外以当归白术膏和二妙散涂之，脓水渐干，更以六味丸加苍术、黄柏，间服一载而愈。
新安吴修予令侄，烦躁发热，肌体骨立，沉困着床，目不得瞑者已三年矣。大江以南，迎医几
遍，求一刻安卧，竟不可得也。余诊其肝脉沉而坚，此怒火久伏，木郁宜达也。以柴胡五钱，白
芍药、丹皮、栀子各三钱，甘草、桂枝各五分。日晡方进剂，未抵暮而熟寐，至旦日午后未寤。伊芳
兄衷伯大为忧惧。余曰，卧则魂归于肝。三岁不归，疲劳已极，譬如久热得凉，乐而忘返，无庸
虑也。至夜分方醒，喜不自禁。遗书致谢曰，积患沉深，揣无生理。三年之疾，一剂而起之，人非
木石，刻骨感衷，当与江河俱永耳。
相国方禹修夫人，触于惊恐身霭霭如在车船，开目则眩，起立欲仆。众议补虚化痰，屡投弗
效。余为察脉，左独沉牢。是惊气入心，蓄血为祟。用大黄、穿山甲、归尾、桃仁、降真、苏木、郁金，一
剂而血下，再剂而复下数升，寻愈。
邵武邑宰何金阳令郎，久耽书癖，昕夕穷神，而不自节。气暴阴伤，形瘁于劳，精摇于梦，汗出
乎寐，而柴闸极其中。饵药历岁，毫末无功。不远数千里，以乞刀圭，余比至而病益进矣。诊其脉，
大而数，按之极软。此中气积虚，反为凉剂所苦。乃以归脾汤入桂一钱，人参五钱。当晚得熟
寐。居二十日而汗敛精藏。更以还少丹与补中益气间服，数月而康。
南都许轮所孙女，十八岁，患痰喘羸弱。四月初诊之，手太阴脉搏指，足少阴脉如烂绵，水衰
而火乘金也。余曰，金以火为雠，今不浮涩而反洪大，贼脉见矣。肾水不能救，秋令可忧。至八
月初五日诊之，肺之洪者变而为细，肾之软者变而为大。岁在戊午，君火司天，法当两尺不
应。今尺当不应而反大，寸当浮大而反细。经曰∶“尺寸反者死。”况肺脉如丝，悬悬欲绝。经云∶
“脉至悬绝，十二日死。”予之短期，当在十六日。然安谷者逾期，不安谷者不及期，以食不断，
故当逾期。况十六、十七二日皆金。助其一线之气，安得遽绝！十八日交寒露节，又值火日。经
曰∶“手太阴气绝，丙日笃，丁日死。”寅时乃气血注肺之时，不能注则绝，必死于十八日寅时
矣。轮所闻之，潸然泪下。以为能食，犹不肯信。果至十八日未晓而终。
闽中周东志，形羸善饭，忽胀满。众皆泥其食太多，不能运化治以槟、枳、楂、芽、神曲、浓朴，胀势
转增。余以其右手洪滑，知为胃火，用石膏、黄连、山栀、木香、陈皮、酒蒸大黄，二剂而胀止。
闽中太学张仲辉，纵饮无度，兼嗜瓜果，忽患泄泻，自中夜至黎明，洞下二十余次。先与分利，
不应；继与燥剂，转见沉剧。余以其六脉俱浮，因思经云∶“春伤于风，夏生飧泄。”非大汗之，不
能解也。麻黄、升麻、干葛、甘草、生姜煎服。原医者笑云，书生好奇妄行险峻。麻黄为重剂，虽在
伤寒，且勿轻用，斯何证也，而以杀之耶！仲辉惑之。已而困甚，叹曰，吾命将尽，姑服此剂，以冀
万一。遂服而取汗，泄泻顿止。
白下姚越甫，乙卯秋二子俱以痨瘵毙，悲痛不已。蒸热咳嗽，两目不明，腰肢无力，口吐清涎，
唇有白点。或与滋阴，或与开郁，或与补中，或与清火，药无遗用，病日益深。夜梦亡父语之曰，
汝病已深，时医束手，非士材先生不能疗也。醒时漏下四鼓，张灯扣门乞治。余诊视之，左脉
数大无伦，右脉沉缓无力。此为传尸，有恶虫蚀藏，若不取去，决无生理。为治加味芎归血余
散加甘遂、天灵盖，共为末，以东引桃枝煎汤。于八月初二天未明时，空心调服。至辰巳时，下
虫如小鼠者三枚，两头尖者数枚。以病者困顿，亟与人参一两煎服。薄暮又服参一两。明日
四鼓，更以末药减半服，又下两头尖虫数枚。所下之虫，烈火 过，雄黄末研匀，入瓶封固，埋
于僻地绝人行处。另用峻补半载渐瘥。
江右给谏晏怀泉如夫人，盛暑腹痛，自汗淋漓。治之以清火行气，俱无当也。余诊其左脉涩，
右脉濡。此气弱不能营运，血因以阻耳。与参、 、姜、桂、桃仁、归尾、苏木、玄胡索、郁金，二剂而痊。
当盛暑而行姜、桂，舍时从证也。
吏部少宰蒋恬庵，目中岐视，手足麻痹。或滋阴，或补土，或化痰，汤液屡更，迄无功验。余诊其
寸口独大，两尺独清，是心肾不交也。以六味地黄丸料配补心丹作煎液，计进六剂而岐视
收，一月而麻痹释然。更以十全大补丸服数斤，遂不复发。
给谏章鲁斋，肌体痒且麻，逾三日乃发黑块如博棋子，大便痛楚，呕恶。一岁之中，必四五发。
医者以热毒治之，绝不取效。余诊其脉，举之则大，按之则缓，湿与风俱也。荆芥、防风、羌活、独
活、苍术、白术、茯苓、木通、川芎、当归、黄 、桔梗、甘草，十剂旋效。更以酒糊为丸，人参汤送，以杜
其根蒂。
襄阳郡侯于鉴如，酒后腹痛，久而痛处渐坚。余曰，脉大而长，且搏指矣，必有坚积。然两尺濡
软，不敢峻攻。先以四君子汤补完胃气，然后与攻积丸，下十数行，皆黑而韧者，腹中之痛犹
未尽也。经曰∶“大积大聚，其可犯也，衰其半而止。”但以补中益气加蓬术为丸，服两月而霍
然。
休邑吴文哉，伤寒发躁，面赤足冷时时索水，却不能饮。伊芳弟日休问余决短期。手扬足掷，难
以候脉。五六人制之，方得就诊。脉大而无伦，按之如无余曰，浮大沉小，阴证似阳，谓之阴躁
与附子理中汤，当有生理。日休骇曰，医者十辈至，不曰柴胡、承气，则曰三黄、石膏，今反用热
剂，乌乎敢哉！余曰，内真寒而外假热，服温补犹救十中之七；若用寒凉，立见败坏矣。日休卜
之吉。遂用人参四钱，熟附一钱，白术二钱，干姜一钱，甘草八分，煎成，冰冷与饮。甫一时许，而
狂躁稍定。数剂而神清气爽。
京卿须日华，暴怒伤阴，吐血甚多。余思《内经》云∶“大怒则血菀于上，令人薄厥。”今血厥而
呕数升，金气大虚，而木寡于畏也。以人参一两，培养金宫。且木欲实，金当平之。又况血脱益
气，治其母也。以沉香三钱制肝木，更以炮姜少许为向导之兵。再进而血始定。然脉法则已
违度矣。经云∶“至如颓土，按之不得，是肌气予不足，白 发而死。”言木克土也。及期果验。
江右袁启莘，居恒劳心，遇事沉滞。时当仲夏，溲便不通。五苓、六一，累进无功。诊其两寸洪大，
知为心火刑金，故气化不及州都也。黄连、知、 、麦冬、牛膝、茯苓、人参，两剂而小便如泉。
金陵朱修之，八年痿废，更医殆遍，卒无中病者。千里招余。诊其六脉有力，按之搏指。犹是强
饭。此心阳独亢，壮火炎蒸，古称脉痿者是也。以承气下数行，右足展舒。再下之，手中可以持
物。更以芩、连、山栀、酒蒸大黄蜜丸，以参汤送。一月之内，积滞尽去，四肢皆能屈伸。余曰，今积
滞既祛，真元虚惫。与三才膏十斤，尽剂而康复，如是元气之实，如是治法之峻，如是相信之
专，皆得未曾有，不可以为训也。
文学顾六吉，胸中有奇痛，不吐则不安者，已历两载。偶为怒触，四十日不进浆粥，三十日不
下溲便，面赤如绯，神昏如醉。终事毕备，以为旦夕死矣。余视其脉，举之则濡，接之则滑，是胃
中有火，膈上有痰，浸淫不已，侵犯膻中，壅遏心窍，故迷昧乃尔。以沉香、海石、胆星、瓦楞子、牛
黄、雄黄、天竺黄、朱砂、冰、麝为细末，姜汁、竹沥和沸汤调送。初进犹吐其半，继进乃全纳矣。随
服六君子加星、香、姜、沥，两日而溲便通，三日而糜饮进。调摄百余日，遂复其常。
征君陈眉公，患三日疟，浃气未瘥。素畏药饵，尤不喜人参。余诊其脉，浮之则濡，沉之则弱，营
卫俱穷，故绵延不已。因固请曰，素不服参者，天畀之丰也。今不可缺者，病魔之久也。正气虚
惫，脉如悬丝，而可拘以常乎？变通趋时，不得失也。先服钱许，口有津生，腹无烦满。乃色喜云，
素所胶而不化者，今日发吾覆矣。敢以性命委重，惟兄所命耳。遂以人参一两，何首乌一两，
煎成，入生姜汁一钟。甫一剂而势减七八，再进而疟遂截。
给谏许霞城，悲郁之余，陡发寒热，腹中满闷。医者谓为外感风而内挟食也。余独以为不然。
举之无浮盛之象，按之无坚搏之形，安在其内伤外感乎？不过郁伤中气耳。以补中益气加
木香、白蔻，十剂而复其居处之常。
别驾施笠泽，两足肿重，痛若虎啮，叫号彻于户外。自用四物汤加槟榔、木通、牛膝、苡仁，数饮
Preface A physician's medical records are like a chess player's score sheets, allowing for review and analysis. However, if they are obscure and verbose, what value do they hold? My father's medical records are piled high, yet the language is concise and the meaning clear, truly sufficient to exhaust the variations of pulse diagnosis. I have carefully selected dozens of cases to append here, through which one may glimpse the diagnostic methods of Huangdi (Yellow Emperor) and Qibo, making them as clear as day or night even after thousands of centuries.
Wu Wensui from Xin'an suffered from vertigo for three years, accompanied by trembling and aversion to cold. He hid within curtains, surrounded by many family members, and sought warmth from fire even in May. Repeated administration of ginger and cinnamon twig failed, and the condition worsened daily. He invited me from a thousand li away. Upon palpating his pulse, it was fine and small upon superficial pressure (floating), but firm and bounding upon deep pressure (sinking). This indicated latent郁 fire (depressed heat) within, unable to be dispersed. I prescribed Gardenia (Gardeniae Fructus) 3 qian, Coptis (Coptidis Rhizoma) 2 qian, Phellodendron (Phellodendri Cortex) 1.5 qian, Bupleurum (Bupleuri Radix) 1 qian, Licorice (Glycyrrhizae Radix) 0.5 qian, and five slices of fresh ginger, administered hot. After a while, his aversion to cold decreased slightly; after two doses, he no longer needed the fire stove, and after a month, he could rise. Subsequently, Liuwei Wan (Six-Ingredient Pill with Rehmannia) plus Anemarrhena (Anemarrhenae Rhizoma) and Phellodendron were taken with Ginseng Decoction, resulting in full recovery after two months. The reason I diagnosed Wu Wenshui's illness was that although he had aversion to cold, he preferred drinking hot soup; although his pulse was fine, it felt bounding under pressure. This was clearly internal true heat with external false cold, where extreme heat mimics the transformation of its controlling element (water). Using cold medicine taken hot is the method for internal true cold with external false heat.
Zhang Shilin, a regional commander, suffered from swelling and pain in his shins and knees, with skin red as cinnabar. Previous treatments with Areca Seed (Arecae Semen), Tetrapanax (Tetrapanacis Medulla), Achyranthes (Achyranthis Bidentatae Radix), and Coix Seed (Coicis Semen), followed by Atractylodes (Atractylodis Macrocephalae Rhizoma) and Phellodendron, yielded no result. I diagnosed: "The chi (kidney) pulse is large and soft, indicating pathology in Shaoyin (Kidney)." I prescribed Ginseng (Ginseng Radix) and Rehmannia (Rehmanniae Radix) each 3 qian, Ophiopogon (Ophiopogonis Radix) 2 qian, Moutan (Moutan Cortex), Achyranthes, and Goji (Lycii Fructus) each 3 qian, and Agarwood (Aquilariae Lignum) 1 qian. After four doses, symptoms decreased, and he recovered in two months.
Gao Xuanpu, Dao Governor of Suzhou and Songjiang, lacked spiritual energy and had sore, weak legs. Treatments included calming spirit and strengthening bones, tonifying kidney and nourishing yin, and clearing heat and draining dampness, all without effect. Upon my examination, the six pulses were harmonious, except for the middle jiao (spleen/stomach area) which was choppy and powerless. This indicated spleen earth deficiency failing to control water, with dampness sinking to the lower jiao. I prescribed Buzhong Yiqi Tang (Decoction for Boosting the Middle and Augmenting Qi) plus Atractylodes, resulting in cure within ten days. For conditions of pulse deficiency and sinking, misusing descending agents like Achyranthes, Coix Seed, and Phellodendron causes further sinking, explaining the previous failure.
Zhao Changqi, a carriage official, suffered severe arm pain and burning hands. Physicians attributed this to the spleen governing the four limbs and treated with stomach-clearing and spleen-strengthening herbs. By the third day, his urine was turbid like rice wash. I said: "All six pulses are choppy, and there is wheezing in the throat." The *Neijing* states: "Diseases of the lung include upper body asthma and fullness, arm pain, heat in the palms, and changes in urine color." All symptoms matched perfectly. I prescribed Magnolia Bark (Magnoliae Officinalis Cortex) and Platycodon (Platycodonis Radix) each 3 qian, Poria (Poria), and Anemarrhena each 2 qian, and Licorice 1 qian. Pain decreased after one dose, urine cleared after two, and he was cured after three.
Hu Mudong, Minister of Ceremonies, was physically and mentally exhausted, unable to sleep for ten days and nights. Self-administered Guipi Tang (Restore the Spleen Decoction) for several doses without success; seeing ghosts at midnight, he took Suhé Wan (Styrax Pill) without effect. I diagnosed: "The pulse is large and slippery, indicating stubborn phlegm-qi adhesion." Erchen Tang (Two-Aged Decoction) plus Pinellia (Pinelliae Rhizoma Preparatum) and Perilla Fruit (Perillae Fructus) were given, four doses over two days, without cure. Then, Guntan Wan (Rolling Phlegm Pill) was taken with Ginseng Decoction, expelling much phlegm accumulation, causing a healing crisis (mingxuan). Finally, a large dose of Liujunzi Tang (Six-Gentlemen Decoction) was taken for a month until stable.
Zhao Rong'an, an inner court official, suddenly fainted with hardness and fullness in the chest and abdomen, and a distinct strength in the qi-kou (cun) pulse. This was food syncope (Shijue). I used Zhi Shi (Immature Bitter Orange) and Chenpi (Citrus Reticulatae Pericarpium) 2 liang each, decocted in four bowls of water with a little salt, inducing vomiting of much food. Later, Xiangsha Pingwei San (Aromatic Amomum Powder for Calming the Stomach) was used, and he stabilized after several doses.
Madam Qian Changyu, wife of the Education Commissioner of Mianyang Prefecture, suffered abdominal pain and borborygmus. Treated for liver qi injury from anger and for parasite/blood stasis accumulation without success. I observed her stooped posture and wheezing; her pulse was wiry and fine. This was a woman's hernia (Shan). Qingmuxiang (Indigo Naturalis/Indigofera Root), Guangmuxiang (Costus Root) each 1.5 qian, Toosendan (Evodiae Fructus), Tetrapanax, Cinnamon Twig (Cinnamomi Ramulus), and Fennel (Foeniculi Fructus) each 1 qian, Angelica Sinensis (Angelicae Sinensis Radix) and Licorice each 0.8 qian. Effective after one dose, cured after four.
Wu Shenghong from Xin'an indulged in alcohol and sex, often fainting when standing. I palpated his chi pulses as soft as rotten cotton, and the left guan pulse as wiry and rapid. The disease resulted from intercourse while standing, injuring both sinews and bones. Shenghong praised me, saying ancient Bian Que and Cang Gong could not surpass me. I prescribed Bixie Juanbi Tang (Decoction for Draining Dampness and Relieving Bi) plus Turtle Shell (Testudinis Carapax et Plastrum), Tiger Bone (Pantheris Ossis - *Note: Modern substitutes used*), and Deer Antler (Cervi Cornu Pantotrichum). After twenty days, pain disappeared.
Wang Weiran, a successful candidate from Yangzhou, loved reading regardless of weather. Suddenly vomited a bowl of blood; Physician Xu predicted recovery without medication. Upon request, I examined him and said: "Though recovered, your primal qi is daily depleted. You must guard it carefully until after the long summer." He ignored me. I told his brother Zhang Fu: "His Shenmen pulse is about to escape; water cannot control fire. In the blazing season, he will likely die." Zhang Fu asked if it could be saved. I said: "Yang is restless but fails to pulse; yin is declining towards extinction. Even a wise man has no course. It will indeed end on June 19th with hematemesis." He died as predicted.
Wang Weining, Magistrate of Danyang, contracted Cold Damage (Shanghan). After sweating and purging, pathogens were resolved, but he felt intermittent burning heat. Others said pathogens were deep because sweat didn't reduce fever, so they restricted diet and gave cooling agents. Exhausted, he sought my help. His pulse was small, and his abdomen was soft upon palpation. Pathogens were gone, righteous qi un-recovered, grain qi lacking, causing Yangming malnutrition. It was hunger, not disease. He nodded affirmatively but couldn't speak. I fed him millet gruel slowly, five or six times a day. He recovered in five days without medicine.
Guo Lutai, Vice Commissioner from Wu Gate, was elderly. Having indulged in sex in youth, he became drowsy and anorexic. Doctors knew he was deficient and gave Buzhong Tang plus ginger and cinnamon without effect. I visited overnight. His eyes wouldn't blink, mouth wouldn't speak, and body felt like a branding iron. Some blamed toxicity from ginseng, ginger, and cinnamon. I laughed: "The pulse is large and bounding, but empty upon pressure; true qi is about to perish. The disease is heavy, but the medicine is too light." I prescribed Ginseng 3 liang and Prepared Aconite (Aconiti Lateralis Radix Praeparata) 3 qian, decocted and consumed in half a day. His eyes opened. A second dose allowed speech by morning. Spirit recovered in days; large doses of Buzhong Yiqi Tang and Bawei Wan (Eight-Ingredient Pill) over fifty days led to recovery.
Fang Yuxiu, Grand Secretary, had a spreading foot ulcer for three years. Tried detoxification, drying dampness, clearing heat, dispelling wind—all ineffective. I said: "Large but powerless pulse indicates qi deficiency. Qi sinks; daily purgatives make it sink further." I prescribed Buzhong Yiqi Tang plus Bixie and Atractylodes internally, and applied Danggui Baizhu Gao (Angelica and Atractylodes Paste) mixed with Ermiao San externally. Pus dried up. Later, Liuwei Wan plus Atractylodes and Phellodendron taken intermittently for a year cured it.
Nephew of Wu Xiuyu from Xin'an suffered irritability, fever, emaciation, bedridden state, and insomnia for three years. Physicians everywhere failed. I palpated his liver pulse as deep and firm—long-standing fire anger causing wood depression needing dispersion. I prescribed Chaihu (Bupleuri Radix) 5 qian, White Peony (Paeoniae Radix Alba), Moutan, and Gardenia each 3 qian, Licorice and Cinnamon Twig each 0.5 qian. Taken at dusk, he slept deeply until afternoon next day. His brother Zhongbo worried. I explained: "When sleeping, the soul returns to the liver. Three years absent, exhaustion is extreme, like finding cool relief after long heat. No need to worry." He woke at midnight, overjoyed, writing thanks: "Three-year illness cured in one dose. Gratitude eternal."
Madam Fang Yuxiu, shocked by fear, felt floating/unstable as if in a boat/carriage, dizzy with open eyes, wanting to fall when standing. Treated for deficiency and phlegm without effect. Her left pulse alone was deep and firm. Shock qi entered the heart, blood stasis was the culprit. I used Rhubarb (Rhei Radix et Rhizoma), Pangolin Scales (Manis Squama), Angelica Tail (Angelicae Sinensis Radix), Peach Kernel (Persicae Semen), Liquidambar (Liquidambaris Resina), Sappan Wood (Sappan Lignum), and Curcuma (Curcumae Longae Rhizoma). One dose moved blood, two doses moved several sheng more, and she recovered.
Son of He Jinyang, Magistrate of Shaowu, addicted to study, exhausting spirit without rest. Violent qi injured yin, form wasted by labor, essence shaken by dreams, sweating during sleep, blocking middle jiao. Medicines for a year failed. Invited from far away, condition worsened. Pulse large and rapid, soft upon pressure. Middle qi severely deficient, harmed by cooling agents. I prescribed Guipi Tang plus Cinnamon Twig 1 qian and Ginseng 5 qian. Slept well that night. In twenty days, sweat stopped, essence stored. Huan Shao Dan (Return to Youth Pill) and Buzhong Yiqi Tang alternated for months restored health.
Granddaughter of Xu Lun suo from Nan Du, 18 years old, suffered phlegm-wheezing and weakness. April exam: Hand Taiyin pulse bounding, Foot Shaoyin pulse soft as rotten cotton. Water deficiency, fire attacking metal. "Metal fears fire; now instead of floating/choppy, it is large/surging—a thief pulse appears. Kidney water cannot save; autumn will be worrying." August 5 exam: Lung pulse changed from large to fine; kidney pulse changed from soft to large. Year Wuwu, Sovereign Fire governs heaven; chi pulses should be absent. Now chi is large, cun is fine. Classic says: "Reverse cun-chi means death." Lung pulse like a thread, hanging and about to sever. Classic says: "Pulse hanging and severing, death in twelve days." I predicted death on the 16th. But eating extends life. Days 16-17 are Metal days, supporting her qi. Day 18 is Cold Dew solar term, Fire day. Classic: "Hand Taiyin qi perishes, Bing day severe, Ding day death." Yin hour is when qi enters lungs; failure to enter means death. She died at Yin hour on the 18th as predicted.
Zhou Dongzhi from Minzhong, thin but good appetite, suddenly bloated. Treated for indigestion with Areca, Immature Bitter Orange, Hawthorn, Barley Sprout, Medicated Leaven, and Magnolia Bark, worsening bloating. Right hand pulse large and slippery indicated stomach fire. I used Gypsum (Gypsi Fibrosum), Coptis, Gardenia, Aucklandia (Aucklandiae Radix), Tangerine Peel, and Wine-processed Rhubarb. Two doses stopped bloating.
Zhang Zhonghui, Student from Minzhong, drank excessively, ate fruits, sudden diarrhea 20+ times from midnight to dawn. Diuretics failed; drying agents worsened it. Six pulses floating. Classic: "Spring wind injury leads to summer undigested stool." Needs heavy sweating. Ma Huang (Ephedrae Herba), Cimicifuga (Cimicifugae Rhizoma), Kudzu (Puerariae Lobatae Radix), Licorice, Ginger. Original doctor mocked using such a strong herb. Patient hesitated, then tried it due to desperation. Sweating stopped diarrhea immediately.
Yao Yuefu from Baixia, lost two sons to consumption in autumn, grief-stricken. Fever, cough, blurred vision, weak waist, salivating, white spots on lips. Tried yin-nourishing, depression-relieving, middle-tonifying, fire-clearing—no effect. Dreamt of father saying only Mr. Shicai could cure him. Left pulse rapid and large, right pulse deep, slow, powerless. Diagnosis: Transmitted Corpse (Chuan Shi) with evil worms eating viscera. Prescribed Jiawei Xiong Gui Xue Yu San plus Kansui (Kansui Radix) and Tianlinggai (Human Skull Cap), powdered, taken with East-facing Peach Branch decoction on empty stomach. Passed mouse-like and pointed worms. Given massive Ginseng support. Worms processed with Realgar. Strong tonification for half a year cured him.
Madam Yan Huai quan, Wife of Censor from Jiangyou, abdominal pain and sweating in midsummer. Cooling and qi-moving failed. Left pulse choppy, right pulse soggy. Qi weak failing to move blood, causing stasis. Ginseng, Astragalus (Astragali Radix), Ginger, Cinnamon Twig, Peach Kernel, Angelica Tail, Sappan Wood, Corydalis (Corydzalis Rhizoma), Curcuma. Two doses cured. Using warming herbs in summer follows syndrome over season.
Jiang Tian'an, Vice Minister of Personnel, double vision, limb numbness/paralysis. Yin-nourishing, earth-tonifying, phlegm-resolving failed. Cun pulse large, chi pulses clear/cold. Heart-Kidney non-interaction. Liuwei Dihuang Wan formula combined with Buxin Dan (Heart-Nourishing Pill) decocted. Six doses improved vision, one month relieved paralysis. Shiquan Dabu Wan (Ten Complete Tonifying Pills) for months prevented recurrence.
Zhang Luzhai, Censor, itchy/numb skin turning into black blocks like chess pieces after three days, painful defecation, nausea/vomiting. Occurs 4-5 times/year. Heat-toxin treatment failed. Pulse large on surface, slow on pressure—wind-damp combination. Schizonepeta (Schizonepetae Spica), Saposhnikovia (Saposhnikoviae Radix), Notopterygium (Notopterygii Rhizoma et Radix), Angelica Dahurica (Angelicae Dahuricae Radix), Atractylodes, White Atractylodes, Poria, Tetrapanax, Ligusticum (Ligustici Chuanxiong Rhizoma), Angelica, Astragalus, Platycodon, Licorice. Ten doses effective. Pills made with wine paste, taken with Ginseng tea to prevent recurrence.
Yu Jianru, Marquis of Xiangyang, abdominal pain after drinking, hardening over time. Pulse large, long, bounding—solid accumulation. Chi pulses soft—avoid harsh attack. First Si Jun Zi Tang (Four Gentlemen Decoction) to strengthen stomach qi, then Gongji Wan (Accumulation-Attacking Pill). Passed dark, tough stools. Pain remained. Classic: "Attack large accumulations only until half reduced." Buzhong Yiqi Tang plus Curcuma (Curcumae Rhizoma) pills for two months cured.
Wu Wen zai from Xiuyi, Cold Damage with agitation, red face, cold feet, seeking water but unable to drink. Brother Ri Xiu asked for prognosis. Restless, hard to pulse. Held down by five people. Pulse large, chaotic, empty on pressure. Floating large, sinking small—Yin syndrome resembling Yang, called Yin Agitation. Prescribed Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction). Brother horrified: "Doctors suggested Chaihu, Chengqi, Sanhuang, Gypsum. Why hot herbs?" I said: "Internal true cold, external false heat. Warm tonics save 7/10; cold herbs cause immediate collapse." Brother divined auspicious. Ginseng 4 qian, Prepared Aconite 1 qian, Atractylodes 2 qian, Dried Ginger 1 qian, Licorice 0.8 qian. Cooled before drinking. Agitation settled in an hour. Clarity returned after several doses.
Xu Rijhua, Capital Minister, violent anger injured yin, massive hematemesis. *Neijing*: "Great anger causes blood stagnation above, leading to Bo Jue (thin syncope)." Blood syncope with vomiting. Metal qi (Lung) greatly deficient, Wood (Liver) unrestrained. Ginseng 1 liang to nourish Metal. Wood needs Metal to control. Blood loss requires Qi tonification (treating the mother). Costus (Aucklandiae Radix) 3 qian to restrain Liver; roasted Ginger as guide. Bleeding stopped. Pulse law violated. Classic: "Like collapsing earth, unpalpable... death in white hair." Wood conquers Earth. Prediction came true.
Yuan Qixin from Jiangyou, mental labor, sluggish. Midsummer, urinary retention. Wuling San and Liuyi San failed. Cun pulses large—Heart Fire punishing Metal, Qi transformation failing to reach Bladder (Zhoudou). Coptis, Anemarrhena, Phellodendron, Ophiopogon, Achyranthes, Poria, Ginseng. Two doses restored urination.
Zhu Xiuzhi from Jinling, eight years paraplegic, many doctors failed. Pulses strong, bounding. Overeating. Heart Yang hyperactive, vigorous fire steaming. Ancient "Mai Wei" (Pulse Paralysis). Chengqi Tang purged several times. Right leg extended. Hands could hold objects. Qinlian Zhizi Da Huang Wan (Honeysuckle, Coptis, Gardenia, Rhubarb Honey Pills) taken with Ginseng tea. One month, stagnation gone, limbs flexible. Then, Zhen Yuan (True Primal) deficient. Santai Gao (Three Powers Paste) 10 jin cured. Such strong qi, harsh treatment, and trust were unprecedented.
Gu Liuji, Scholar, chest pain for two years, relief only after vomiting. Anger triggered 40 days no food, 30 days no urine/stool, red face, confused. Pulse soft on surface, slippery underneath. Stomach fire, diaphragm phlegm invading Pericardium, blocking Heart orifices. Agarwood, Sea Glass (Hai Piao Xiao), Aster (Tan Shi), Argo Shell (Wa Leng Zi), Calculus Bovis (Niuhuang), Realgar (Xionghuang), Heavenly Bamboo (Tian Zhu Huang), Cinnabar (Zhusha), Borneol (Bingpian), Musk (Shexiang) powdered. Mixed with Ginger Juice and Bamboo Sap (Zhulv) in boiling water. Initially vomited half, then retained. Followed by Liujunzi Tang plus herbs. Urine/stool passed in two days, gruel in three. 100 days care restored normalcy.
Chen Meigong, Gentleman, tertian malaria, lingering qi. Feared medicine, especially Ginseng. Pulse: superficial soft, deep weak. Ying and Wei exhausted. Persuaded him: "Normally you don't take Ginseng due to abundance. Now, long illness requires it. Deficient qi, pulse like hanging thread—can we stick to routine? Adapt to time." Took a coin's worth first, saliva generated, no fullness. Joyful: "My stubbornness broken today. I entrust my life to you." Ginseng 1 liang, Polygonum Multiflorum (He Shou Wu) 1 liang, Ginger juice. One dose reduced severity 70-80%, two doses stopped malaria.
Xu Xiacheng, Censor, sadness/depression triggered sudden chills/fever, abdominal fullness. Doctors thought exterior wind + interior food stagnation. I disagreed. No floating excess, no deep firmness. Not exterior/interior. Just depressed Middle Qi. Buzhong Yiqi Tang plus Aucklandia and White Cardamom. Ten doses restored normalcy.
Shi Lizze, Vice Administrator, swollen/heavy legs, tiger-bite pain, screaming. Self-treated with Siwu Tang plus Areca, Tetrapanax, Achyranthes, Coix Seed. Multiple doses... [Text cuts off]