许氏医案
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重校许氏医案
伤寒论坛贴：吾自中医瑰宝苑下载许氏医案一观，见其错漏极多，甚者有误其本意者，乃重校一过。句读文字多有重订者，然吾未见原本，不免想当然耳。存疑处均留括号说明，然亦恐有错改乱猜之处，难免贻笑方家，博雅君子当为指出，待吾再次修订云尔。（gqdxk）
juzhuo按：中医瑰宝苑内容大多转自各资源网站。少部分为本人所录入者，如《医林琐语》、《柳洲医话》《洄溪医案》、《慎疾刍言》、《脉诀阐微》、《辨症玉函》等，本人所录内容基本全校，转录者几乎未校，错乱之处，实有蹙不忍读者，本人亦心有余而力不足，慨也。承蒙“gqdxk”校对《许氏医案》，本人深表谢意，同时本人在此一并致谢所有关心本小站的前辈和同仁。
《许氏医案》提要
方书所载之症治，与人以规矩；医案所记之验案，示人以活法。吾人习医固宜以《内》、《难》《甲乙》筑其基，仲景及后贤治疗各书致其用，尤宜广阅名家医案，以明变化。不然，墨守成法，执方临病，岂能收覆怀之效哉!《许氏医案》一卷，许恩普先贤逐年之验案也。断证如折狱，处方若用兵，且言简意赅，一目了然，洵为医林之羽翼，后学之楷模。爰刊行世，想同道诸公亦必先睹为快乎。
己丑年，京畿道胡贷青病剧，延余诊视。舌黑，谵语，不省人事，诸医均以为实热实结，拟用大承气汤。余诊脉，洪而无力，不渴，复以姜片擦舌即淡，症若伤寒，化为虚热，拟用人参竹叶石膏汤。一服便行见效，加减数剂而愈。后月余，舌退一壳如枳壳，即书中所谓六十样舌中之銕甲舌，阴亏也。设症不辨虚实，则死生反掌矣。
己丑，工部员外杨味春夫人吴勤惠公小姐产时搐搦，不省人事，集医治以肝风不效。适夫人嫡堂兄吴纯甫太守进京引见，与余父子世交，延余诊视。脉虚，知为血晕，非肝风也。先用韭菜根置两壶中加醋煮开，以壶两嘴对两鼻孔热气熏之，立时生男苏醒，拟以当归参芪千金汤服之安。然继而胞衣不下者一日，合家惊惶，余着寻鸡头菱（即芡实也，原本有误）叶撕破，加炒皂刺三钱，同煎服之。时许，胞衣随恶血分碎而下，安然无恙矣。
己丑，候选通判缪仲勉少君伤寒。他医误为瘟疫，重用凉药，以致病剧。卧床两月，痰喘欲绝，延余诊视。脉沉濡而滑相等，尚可挽回。拟以生脉散加半夏杭芍，服之见效，数服即能饮食。治理数月，两腿不能伸屈站立。其母祗此一子，不胜情急，询余曰：废否？余曰：以脉缓和无力，不至残疾。即用十全大补汤加杜、牛膝（盖土牛膝乎，抑或杜仲&牛膝也，杜字定有误。三字相合为“怀牛膝”亦未可知），下注三阴，并令捶打以舒筋血，又两月全愈矣。
庚寅年，户部员外宝源局监督胡吕瑞少君泊生鹾尹壶相小产，胎不下者十余日。诸医均以攻伐之药，胎更不下，而疼如绞，命在旦夕，延余诊视。脉濡，以体素弱，加以小产误服攻伐，重伤气血，以致血竭而胎不下。以十全大补汤加重以助气血，加朴硝一钱以化死胎。即下，去硝，用生化汤加参芪以扶气血，数服而愈。
壬辰，胡吕瑞部郎痢疾，昼夜百余次，汗出如流。年逾五旬，诸医均以年老，气血就衰将脱之象，重用参芪等药，而痢反剧，延余诊视。脉急有力，寒化为邪（邪字不可解，其盖热乎），照《内经》初痢用清，久痢用固之法，拟以黄芩汤加减以扶正清热。胡不敢服，强而后可。一服见效，数服减轻。满月后，用真人养脏汤加减滋阴固摄之剂，数服遂愈。
辛卯，刘仲良太史夫人比部段少沦之胞妹，因观剧，夜深衣单，卒中痰迷。齿脉均闭，便溺俱遗，心窝微存一息，针不出血，诸医束手，延余诊视。曰：症有七不论脉，此其痰闭之一也。系受风寒痰闭，便溺俱遗，亦非五脏绝也。手未撒，发未指，面未如妆，汗未如珠，尚可挽回。幸假至契，深信不疑，拟以小续命汤，三生饮，再造丸合参加全蝎等药，以扶正气，逐风化痰，行气和血。以口闭药不下咽，用乌梅擦牙，竹箸启齿，小壶呷药，时许即呼妈矣。医治三日方苏，月余遂愈。
胡公度待御之仆某，年弱冠，在京出痘，色紫周身无缝，登屋狂叫，延余诊视。脉洪实有力，舌苔黑，知为热邪。拟归宗汤加减以去热邪燥粪，遂安。复拟犀角地黄加减，清热透发，数贯脓结痂而愈，变为麻脸，非旧日面目矣。又有厨夫某，中风不语，他医误以瘟治病剧，延余诊视。脉细，知系卒中。拟以小续命加参芪一服，即大呼曰：何不早服此药也？又大同居东沈智泉中风，亦用此药加减而愈。又水部正郎杨紫沧中风，亦用此药加减而愈。又内务府科房王寿龄母中风，亦用此方加减而愈。又给谏洪良品中风亦用此方加减，寿延二年。故后哲嗣鸿卿明府向云，误信人言，以年老气衰，将余初拟方内羌活、独活、防风未用，以致病未除根也。其余贫民无名之人，不可胜道也。
唐春卿阁部堂于壬辰秋患背寒如冰，难以转动，月余矣，延余诊视。少阳弦紧，太阴紧急，知系两经外感，汗未解澈之伏邪，拟以柴平散加减以和解之。唐公以为体素虚弱，他医用参芪姜附重剂，尚不能愈，而以此和解，可乎？余曰：譬如盗贼伏于家中，不开门驱逐，害焉能除？请姑试之。一服见效。唐曰：十日后天坛当差，能否?余曰：可。复拟滋养之剂，数服大愈，果应差矣。
刘次方于庚寅年为巡街御史时，相召宴饮。余赴道谢，言未曾面，何见爱之深也?刘云：见余脉案，拟方真有道理，愿为疾病扶持之交，余以小道偶中逊谢。无何，刘患牙疼面肿，太阳筋跳如锥痛，诸药罔效，寝食俱废，延余诊视。脉数无力，知为虚热，气血相搏，邪火上蒸。内服玉女煎加减，外以开水熏洗痛处，以和气血，又以热手巾燠之，再用烧酒以小指蘸滴耳内，如火外发，倾刻痛止，气血和矣。再用唾膏贴之消肿，再用硼砂、冰片、细辛、蒲黄、黄柏、青盐共研细末，频擦牙龈，消肿止疼。内服滋阴以退虚热即愈。又水部张蔚如夫人，牙疼异常，饮食俱废，亦如法加减，治之遂愈。此虚火疼十之八九，若实火疼，宜用连翘、银花、绿豆皮、芦根等清凉之药。若虫牙疼用明雄黄，松香等药擦之即死。以上诸疼，七十方中，无此妙也。萨嘉乐太史夫人患牙疳，肿疼异常，已落一齿，几于穿鼻透腮，延余诊视。脉洪有力，知为热毒。内服金银花散加减，外用硼砂、冰片、红枣烧灰、儿茶、人中白、陀僧、青盐、枯矾研细末敷，继用犀黄散加轻粉麝（此处恐亦有误）敷之，旬日遂愈。庚寅张季端殿撰夫人体虚难眠，延余诊视。脉沉细，用温补药数服而愈。嗣后感冒风寒，渠以为旧症，用参芪等药服之以致沉重，复延诊视。脉紧无力，知为虚人外感，治以再造散加减，解邪和中之剂，服之寒战，似药不合。渠言奈何？余复诊之脉动，言时发汗，以姜白糖水饮之助气。夫人胞叔杨子琛明府，知医信余，力言不错，药邪相争，故寒战耳。张留余俟之，至十点钟时，果汗而愈矣。又张次子二岁时，素患腿疼，不能行走，教人捶打，以重物压之方眠。余诊视脉弱极，两尺几无，知为先后天不足之故，拟用十全大补汤加杜仲、牛膝，下注三阴，数服遂愈。
甲午秋，戎部（工部可称水部，莫非兵部可称戎部乎）李星若夫人腹疼如绞，日久欲死，延余诊视。脉沉细，知系虚寒气结，他医误用凉药，以致病剧。余始拟以附于理中汤加减，一服而愈。旋因食抄，绞痛如故，九日不便。诊脉虚细，系九结中之秘结，不可攻下，拟以前方加润导之品便（恐漏一通字）而愈。旋又风抄，九月初一日痛绝，齿脉俱闭，仅存一息。其胞兄内阁中书虹若言女初三日吉期，设无救奈何？余为情急，恐药饵不及，嘱星若亲灸章门、虎口、三里等穴，并将前方加山甲、牛膝、桂枝、木香、乌药等擦牙，以箸启齿呷药，一时而苏，脉复。余出曰：包辨喜事无虞。数服而愈。丙申年来请，言夫人血崩晕绝。往诊脉扰急，知系小产，非血崩也。治以生化汤，加参芪去旧生新之品遂愈。马积生太史夫人亦患腹痛如绞，数月病剧，延余诊视。脉息腹痛相同，因体因症加减。拟方不敢服，以为与他医用寒药相反也。适曾任广州府冯端本太守寿日，与马姻亲李星若亦姻娅，同往称礼。即（莫非漏一席字）马遍询同乡可否服余之药，佥云可归即试服。次早请余，言病减半矣。深信不疑，连服数剂而愈。农部张馨庵屠逊庵亦河南人，两夫人亦患此症欲死，均为如法治愈。
徐颂阁侍郎三公子，于甲午岁淋症，他医误以血淋苦寒之药，数月病剧。卧床不起，身不能动，将一年矣，延余诊视。仅存一息，脉沉细，知为阴亏变色，非血淋也。诘其故，言无外务，以妻归宁浙省，病年不归，思想而得。余曰：欲心一动，精却离舍成淋，久则阴亏变色，误为热淋，治以寒药，至于此极。拟以人参菟丝丸加减，大补之剂，以固心肾。一服见效，复诊加减，数服能食，月余全愈。
李实之太史放甘肃主考时，夫人住京，系朱相国之孙女，湖北廉访之女，内阁章京伯平之妹。产后病剧，延余诊视。脉沉细，四肢拘挛，瘫痿溺黑，知受风寒化热为痹，拟以独活寄生汤加减见效，继为加减，数服而愈。朱即请以夫人小产数胎为忧，余诊视，脉沉无力，气血两虚，拟以泰山磐石散、千金保胎丸合参，令有孕时服三十剂。果胎安矣，连举二子。甲午农部李有荣之夫人，临产三日未落草，咸谓胎死腹中。夫人自期亦死，情急许稔婆百金，下死胎以保夫人之命。稔婆无策，延余诊视。脉缓，舌苔面色均无青赤，知胎无恙。询之稔婆，向言尚未顺胎知经人早，浆破血竭（此句如何断句当存疑），犹鱼在盆，无水不行，数日不生者多也。安慰夫人不要慌乱，静心安卧，包管无恙。即重用达生散加重参芪归芎各一两，外加葱头七个，黄杨脑（盖即黄杨木叶）七个。熊亦奇太史知医，斟酌意药太重，余言非此重剂不能壮气生血，毋疑。幸李素信余医，留坐茶点少待，服药时许，家人报喜生一少爷，母子均安然矣。
癸巳孙来山尚书小姐，因寒癃闭二日，腹胀如鼓。李山农方伯知医，曾治尚书湿病而愈，兹治小姐不效，素信余医，代为荐诊。少阳脉弦，知为虚痞，拟以柴胡半夏茯苓汤加减，汗解溺畅，遂愈。
京畿道徐叔鸿夫人，胸胀大痛，世医误以经闭三月癥瘕，治之几危，延余诊视。六脉相等，阳搏阴别，孕兆也。徐公曰：生过三胎，知无孕。余曰：十样胎十样生。年近四旬，气血渐衰，正气不敌，胎气引动，素有肝气，故胀痛。拟以安胎养血调和肝气之品，请姑服之。以手试腹如伏杂状（伏杂意不可解），即知是胎非病。徐公如约，次早来请，言真医也，果胎跳矣。再拟数服全愈。至秋举一子，即六少爷也。
乙未夏，京师霍乱转筋急症，倾刻无救，一月之间，死有十数万人。如前明崇祯六年之瘟疫相似也。余因刊有《辩瘟论霍乱论》，以行气活血针刮各法，施散数十万张，救活无算。适小妾亦得此症，如法救活。其他如法救活更无算。惟龚鲁卿观察，仆救活后戒食米食，不听，食粥两碗，症发不治而亡。
乙未，比部正郎欧阳伯春病伤寒，世医误以为瘟，治以苦寒之药，不眠者三日，谵语揭被，狂叫大热，舌苔黑刺，延余诊视。脉洪无力，知为虚热。以姜擦舌即白，的为伤寒，非瘟疫也。虚火上炎，内无实热，拟以人参竹叶汤加减引火归原之品。伊诸亲多不敢主，幸伊姑丈比部郭斡臣力主服之遂安。四服全愈。
甲午，王子捷太史令媛感冒风寒，理宜解表和中，汗澈即愈，而世医误以犀角羚羊角等药，引邪入内，不能言语，病剧。延余诊视，脉沉紧，用羌活汤加附子、肉桂去黄芩、生地，一服能言，发出疹子而愈。
甲午冬，黄慎之殿撰伤寒，时医以为冬瘟，治以元参论两等寒药二十余日，烦躁不省人事，三日不能合眼，延余诊视。脉数不及，知为胃气欲绝之象。拟以人参汤加减引火归原之剂，一服遂眠，至次午方醒。倩余道谢复诊脉，复依方加减月余，全愈。
甲午，刘伯崇殿撰弟归，感寒谵语，暴病惊人，延余诊视。脉浮数，知为风寒化热无汗，拟以羌活汤加减，一服汗解而愈。
甲午冬，程从周军门少君绍周太守患喉痹，时医误以温补治之，遂致喉肿水不下咽三日矣，延余诊视。脉沉细，余曰：此症肺胃肾虚，火上冲喉咙成痹。单者重而双者轻。最忌刀针刺破喉咙，引毒入内不治。并忌温药助邪，散药发邪，凉药伏邪。误服温补助邪，项肿以致于此。余为先刺少商、商阳二穴出黑血，以浅毒贴金刚匙（此句不可解）以拔毒，吹吴氏丹药以消毒，拟以滋阴清肺汤加减以和解之。服药时许饮水，晚间食粥，次日加托里透脓之品数服，外溃内消而愈。
Xu's Medical Cases
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Revised Xu's Medical Cases
Shanghan Forum Post: I downloaded "Xu's Medical Cases" from the Chinese Medicine Treasure Garden to read, and found that there were extremely many errors and omissions, some of which even misunderstood the original meaning. Therefore, I revised it once again. The punctuation and text have been largely re-edited, but as I have not seen the original version, my revisions may be somewhat subjective. Places with doubts are kept with bracketed explanations, but I fear there may be incorrect modifications or random guesses, which might be laughed at by experts. Learned gentlemen should point them out so that I can revise them again. (gqdxk)
juzhuo Note: Most content in the Chinese Medicine Treasure Garden is reposted from various resource websites. A small portion was entered by myself, such as "Yi Lin Suo Yu," "Liu Zhou Yi Hua," "Hui Xi Yi An," "Shen Ji Chu Yan," "Mai Jue Chan Wei," "Bian Zheng Yu Han," etc. The content I entered has been basically fully proofread, while the transcribed content was hardly proofread at all. The errors and confusion are truly unbearable to read, and I feel powerless despite my willingness to help, which is sigh-worthy. I am deeply grateful to "gqdxk" for proofreading "Xu's Medical Cases." At the same time, I would like to express my gratitude to all seniors and colleagues who have cared about this small website.
Summary of "Xu's Medical Cases"
Formulary books (books recording prescriptions and treatments) provide rules and standards for treating diseases; medical cases demonstrate flexible methods through verified records. We must certainly build our foundation on the "Huangdi Neijing" (Yellow Emperor's Inner Canon), "Nanjing" (Classic of Difficult Issues), and "Jiayi Jing" (A-B Classic) when studying medicine, apply the treatments of Zhang Zhongjing and later sages, and especially widely read the medical cases of famous doctors to understand changes. Otherwise, sticking rigidly to established methods and applying fixed prescriptions to diseases cannot yield infallible results! "Xu's Medical Cases," one volume, consists of the verified cases accumulated year by year by the late scholar Xu Enpu. Diagnosing is like judging a case, prescribing is like using troops; the language is concise and meaningful, clear at a glance. It is indeed an aid to the medical field and a model for learners. Thus, it is published for the world, and I suppose fellow practitioners will surely want to see it first.
In the Ji Chou year, Hu Daiqing from the Capital Circuit fell seriously ill, and I was invited to treat him. His tongue coating was black, he spoke deliriously, and was unconscious. All physicians believed it was excess heat and excess accumulation, intending to use Da Cheng Qi Tang (Major Order of the Yellow Earth Decoction). I palpated his pulse; it was surging yet forceless, and he had no thirst. After wiping his tongue with ginger slices, the coating lightened. Although the symptoms resembled Shanghan (Cold Damage), they had transformed into deficiency heat. I intended to use Renshen Zhuye Shigao Tang (Ginseng, Bamboo Leaf, and Gypsum Decoction). One dose produced immediate effects, and after several doses with modifications, he recovered. Over a month later, a layer of tongue coating peeled off like an aril, resembling the "Iron Armor Tongue" mentioned in books among the sixty types of tongues, indicating Yin fluid deficiency. If the nature of the disease (excess vs. deficiency) is not distinguished, life and death can change in an instant.
In the Ji Chou year, the wife of Yang Weichun, Yuanwailang (Vice Director) of the Ministry of Works, Miss Wu Qinhui (daughter of Wu Qin Hui Gong), suffered convulsions and loss of consciousness during childbirth. Treatments for Liver Wind were ineffective. Coincidentally, her paternal cousin, Prefect Wu Chunfu, came to Beijing for an audience. As our families were old friends, he invited me to treat her. Her pulse was deficient, indicating Blood Syncope (Xue Yun), not Liver Wind. First, I placed leek roots in two pots with vinegar, boiled them, and used the steam from the spouts to fumigate both nostrils. Immediately, a male infant was born, and she regained consciousness. I prescribed Danggui Shenqi Qianjin Tang (Angelica, Ginseng, Astragalus, and Thousand Gold Decoction) to stabilize her condition. However, the placenta remained undelivered for a day, causing family panic. I instructed someone to find leaves of Jitouling (Euryale Seed, originally erroneous in the text), tear them, add three qian of fried Spina Gleditsiae (Zaoci), decoct together, and administer. Soon, the placenta broke apart and passed with lochia, and she was safe.
In the Ji Chou year, Shaojun (young master) Miao Zhongmian, a candidate for Tongpan (Assistant Magistrate), contracted Shanghan (Cold Damage). Other physicians mistakenly diagnosed it as Wenyi (Plague/Contagious Disease) and heavily used cooling medicines, worsening the condition. He lay in bed for two months, suffering from phlegm and wheezing nearing suffocation. I was invited to treat him. His pulse was deep, soft, and slippery, indicating recovery was possible. I prescribed Shengmai San (Generate the Pulse Powder) with Banxia (Pinellia) and Hangshao (Hangzhou Peony Root). Effects were seen immediately, and after several doses, he could eat. After months of regulation, his legs could not bend or straighten for standing. His mother, having only this son, was extremely anxious and asked, "Is he disabled?" I said, "The pulse is harmonious and weak, not leading to disability." I immediately used Shiquan Dabu Tang (Complete Great Tonifying Decoction) plus Duzhong (Eucommia Bark) and Niuxi (Achyranthes Root) [Note: Text suggests uncertainty whether it was Tu Niuxi, Duzhong & Niuxi, or Huai Niuxi]. I directed the treatment to sink into the Three Yin meridians and ordered him to be beaten/massaged to relax sinews and blood vessels. After another two months, he fully recovered.
In the Geng Yin year, Shaoyun Baoyuan Ju Jian Du (Supervisor of Bao Yuan Bureau) Hu Lv Rui's concubine, Hu Xiang, had a miscarriage, and the fetus did not pass for over ten days. Physicians used attacking/draining medicines, making the fetus harder to expel, causing cramping pain, with life hanging in the balance. I was invited to treat her. Her pulse was weak. Due to her naturally weak constitution and the heavy damage to Qi and Blood from mistaken attacking drugs after miscarriage, Blood exhaustion prevented fetal expulsion. I used Shiquan Dapu Tang with increased dosage to boost Qi and Blood, adding one qian of Poxiao (Mirabilite) to dissolve the dead fetus. It expelled immediately. I removed Poxiao and used Shenghua Tang (Generation and Transformation Decoction) with Renshen (Ginseng) and Huangqi (Astragalus) to support Qi and Blood. After several doses, she recovered.
In the Ren Chen year, Bulang (Departmental Vice Director) Hu Lv Rui suffered from Dysentery (Liji), going over a hundred times a day and night, sweating profusely. Over fifty years old, physicians thought his Qi and Blood were declining towards collapse and heavily used Renshen and Huangqi, but the dysentery worsened. I was invited to treat him. His pulse was urgent and forceful. Cold transformed into pathogenic heat (the character "Xie" is unclear, likely referring to Heat). Following the "Neijing" principle of clearing early dysentery and consolidating chronic dysentery, I prescribed Huangqin Tang (Scutellaria Decoction) with modifications to support righteousness and clear heat. Mr. Hu dared not take it; only after persuasion did he drink it. One dose showed effect, several doses reduced severity. After a full month, I used Zhenren Yangzang Tang (True Person's Nourishing Viscera Decoction) with modifications for nourishing Yin and consolidating/astringing. Several doses led to recovery.
In the Xin Mao year, Mrs. Liu Zhongliang (Taishi title), younger sister of Pianbu Duan Shaolun, watched a play late at night with thin clothing, suddenly contracting Phlegm Confusion (Tan Mi). Teeth and pulse were closed, urination and defecation were incontinent, only a faint breath remained in the heart pit, acupuncture drew no blood, physicians were helpless. I was invited to treat. I said: There are seven conditions where pulse diagnosis is secondary; this is one of Phlegm Obstruction. It is caused by Wind-Cold leading to Phlegm obstruction; incontinence does not mean Five Zang organ failure. Hands not flung open, hair not standing up, face not painted white, sweat not like pearls—recovery is possible. Fortunately, relying on close relations, trust was absolute. I prescribed Xiao Xuming Tang (Minor Continue Life Decoction), Sansheng Yin (Three Lives Infusion), Zaizao Wan (Create Again Pill) combined with Renshen and Quanxie (Scorpion) to support righteous Qi, expel Wind, transform Phlegm, move Qi, and harmonize Blood. Since mouth was closed and medicine couldn't be swallowed, I used Wumei (Mume Fruit) to rub teeth, bamboo chopsticks to pry mouth open, and a small pot to sip medicine. Soon, she called for her mother. Treated for three days before waking, fully recovered after a month.
A servant of Hu Gongdu, a Daiyu (Attendant Gentleman), aged just over twenty, developed smallpox in Beijing. Lesions were purple, seamless across the body, climbing roofs and screaming. I was invited to treat. Pulse was surging, solid, and forceful; tongue coating was black, indicating Heat Pathogen. I prescribed Guizong Tang (Return to Ancestral Lineage Decoction) with modifications to remove Heat Pathogen and dry feces, bringing stability. Then I prescribed Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) with modifications to clear heat and vent eruption. After several courses of pus formation and scabbing, he recovered, left with pockmarks, no longer his former appearance. Another cook suffered stroke aphasia; other doctors mistook it for plague, worsening condition. I was invited to treat. Pulse was fine, indicating Stroke (Zhongfeng). I prescribed Xiao Xuming Tang plus Renshen and Huangqi. One dose, he shouted loudly: "Why didn't you give this medicine earlier?" Similarly, Shen Zhiquan from Datong, Yang Zicang, Water Department Principal Lang, Wang Shouling's mother (Internal Affairs Department), and Hong Liangpin, Censor, all suffered stroke and recovered with modifications of this formula. Hong Liangpin lived two more years. His successor, Hong Qing Mingfu, told me later that trusting rumors about old age and Qi decline, he omitted Qianghuo, Duhuo, and Fangfeng from my initial prescription, leaving the root cause untreated. Countless poor unnamed people also recovered.
Tang Chunqing, Gebutang (Grand Secretary), suffered back coldness like ice and inability to turn for over a month in autumn of Ren Chen year. I was invited to treat. Shaoyang pulse was wiry and tight, Taiyin pulse was urgent. This indicated external contraction affecting two meridians, latent pathogens not fully resolved by sweating. I prescribed Chaiping San (Bupleurum and Pinellia Powder) with modifications to harmonize. Mr. Tang argued his constitution was weak; previous heavy doses of Renshen, Huangqi, Ganjiang, Fuzi failed. Is harmonizing appropriate? I said: Like thieves hiding at home, if you don't open the door to drive them out, how can harm be removed? Please try. One dose effective. Tang asked if he could attend duties at Temple of Heaven in ten days. I said yes. I then prescribed nourishing agents. After several doses, great improvement, and he attended duties as predicted.
In Geng Yin year, Liu Cifang, then Patrol Censor, invited me to dinner. I went to thank him, asking why he valued me so much without meeting. Liu said he saw my pulse cases and prescriptions were logical, wishing for a friendship supporting each other in illness. I modestly declined. Soon, Liu suffered toothache and facial swelling, Taiyang meridian tendons throbbing like awl pain, unresponsive to drugs, unable to sleep or eat. I was invited to treat. Pulse was rapid and forceless, indicating Deficiency Heat, Qi and Blood struggling, Evil Fire steaming upward. Internally, Yunnv Jian (Jade Woman Decoction) with modifications; externally, hot water fumigation/washing to harmonize Qi and Blood, hot towel compress, and burning wine dropped into ear with little finger to vent fire outward. Pain stopped instantly, Qi and Blood harmonized. Saliva paste applied to reduce swelling. Borax, Borneol, Asarum, Polygonum, Scutellaria, and Rock Salt ground fine, frequently rubbed on gums to reduce swelling and stop pain. Internally, nourishing Yin to retreat deficiency heat cured him. Mrs. Zhang Weilru (Water Department) had severe toothache, unable to eat/drink, treated similarly and cured. 80-90% of toothaches are Deficient Fire; Excess Fire should use Lianqiao, Yinhua, Moutong, Luzhu Gen. Worm toothache uses Xionghuang, Xiangxi. Among seventy formulas, none are as miraculous. Saji Le Taishi's wife had Gum Gangrene, severe swelling/pain, lost a tooth, nearly piercing nose/cheek. Pulse surging and forceful, Heat Toxin. Internally, Jinyinhua San (Honeysuckle Powder) modified; externally, Borax, Borneol, Red Date ash, Child Tea, Renzhongbai, Tuoseng, Rock Salt, Ku Fan ground fine and applied. Then Xihuang San plus Qingfen and She Xiang applied. Recovered in ten days. In Geng Yin year, Dianzhuan Zhang Jiduan's wife had deficiency insomnia. Pulse deep/fine, warm tonics cured. Later caught Wind-Cold, thought it was old issue, took Renshen/Huangqi, became heavy. Pulse tight/forceless, Deficient person with External Contraction. Treated with Zaizao San modified to release evil and harmonize middle. Chills occurred, seemed incompatible. I re-palpated, advised sweating, drinking Ginger-Sugar water to assist Qi. Husband's uncle Yang Zichen, knowing medicine and trusting me, insisted it was drug-pathogen struggle causing chills. Waited until 10 AM, sweated and recovered. Zhang's second son, age two, had leg pain, couldn't walk, needed beating/heavy pressure to sleep. Pulse extremely weak, Chi pulses nearly absent, Congenital/Postnatal insufficiency. Shiquan Dabu Tang plus Duzhong, Niuxi, sinking to Three Yin meridians. Several doses cured.
Autumn of Jia Wu year, Li Xingruo's wife (Rongbu - possibly Bingbu/Military Department) had abdominal pain like wringing, long duration, near death. Pulse deep/fine, Deficiency Cold Qi Knot. Mistaken cooling drugs worsened it. I prescribed Fuzi Lizhong Tang modified. One dose cured. Later, eating fried food caused recurrence, pain like wringing, constipation for nine days. Pulse deficient/fine, Nine Knots type Constellation (Biejie), cannot purge. Prescribed previous formula plus moistening/lubricating agents to unblock bowels. Recovered. Later, wind attack, Sept 1st pain extreme, teeth/pulse closed, one breath left. Brother Hongruo said daughter's wedding is Sept 3rd, what if no rescue? Desperate, fearing medicine too slow, instructed Li Xingruo to moxa Zhangmen, Hukou, Zusanli points. Applied modified formula (Shanjia, Niuxi, Guizhi, Muxiang, Wuyao) to teeth, pried mouth, fed medicine. Revived instantly, pulse returned. I said: Wedding proceeds safely. Several doses cured. In Bing Shen year, visited for postpartum hemorrhage syncope. Pulse chaotic/rapid, diagnosed miscarriage, not hemorrhage. Treated with Shenghua Tang plus Renshen/Huangqi to remove old/generate new. Recovered. Ma Jisheng Taishi's wife had similar abdominal pain, severe for months. Pulse matched symptoms. Formula feared due to contrast with previous cold drugs. Attended Feng Duanben's birthday party, relative of Li Xingruo. Asked fellow provincials if they dared take my medicine; all agreed. Tried next morning, pain halved. Continued doses, cured. Zhang Xinnan and Tu Xunan (Ministry of Agriculture) wives, also Henan natives, had same symptom, cured similarly.
Xu Songge Shilang's third son had Lin Syndrome (Strangury) in Jia Wu year. Mistakenly treated as Blood Lin with bitter-cold drugs, condition worsened over months. Bedridden, immobile for nearly a year. Pulse deep/fine, one breath left. Yin deficiency color change, not Blood Lin. Cause: Wife returned to Zhejiang, longing caused essence to leave residence, forming Lin. Long-term Yin deficiency. Mistakenly treated as Heat Lin with cold drugs. Prescribed Renshen Tusizi Wan (Ginseng and Dodder Pill) modified, major tonic to secure Heart/Kidney. One dose effective. Modified upon return visit, several doses allowed eating, fully recovered in a month.
Li Shizhi Taishi served as Chief Examiner in Gansu; wife in Beijing, granddaughter of Prime Minister Zhu, daughter of Hubei Lianfang, sister of Cabinet Clerk Bo Ping. Postpartum severe illness. Pulse deep/fine, limb spasms, paralysis, dark urine. Wind-Cold transforming to Heat causing Bi Syndrome. Duohuo Jisheng Tang modified effective. Continued modifications, cured. Zhu worried about wife's multiple miscarriages. Pulse deep/forceless, Qi/Blood dual deficiency. Taishan Panshi San (Mount Tai Rock Stability Powder) combined with Qianjin Baotai Wan (Thousand Gold Fetus Protection Pill) plus Renshen. Take thirty doses when pregnant. Fetus stabilized, gave birth to two sons. In Jia Wu year, Li Yourong (Ministry of Agriculture) wife, three days past due date, assumed fetal death. Wife accepted death, promised midwife 100 taels to save herself. Midwife sought my help. Pulse slow, tongue/color normal, fetus alive. Midwife explained delayed labor often due to ruptured membranes/blood depletion ("like fish in basin without water"). Comforted wife to rest calmly. Heavy dose of Dasheng San with extra Renshen, Huangqi, Danggui, Chuanxiong (1 liang each), 7 green onion heads, 7 Huangyangnao (likely Huangyang wood leaves). Xiong Yiqi Taishi, knowledgeable in medicine, thought dose too heavy. I insisted heavy dose needed to strengthen Qi/Blood. Li trusted me, waited. Shortly after medicine, baby boy born, mother and child safe.
Gui Si year, Sun Laishan Shangshu's daughter had Cold-induced urinary retention for two days, abdomen distended like drum. Li Shannong Fangbo, knowledgeable, cured Shangshu's dampness but failed here. Recommended me. Shaoyang pulse wiry, Deficiency Distension. Chaihu Banxia Fuling Tang modified. Sweating resolved, urination smooth, cured.
Xu Shuhong's wife (Capital Circuit) had chest swelling/severe pain. Physicians mistook for Amenorrhea/Distension-Mass (Zhixia) for three months, treatment nearly fatal. Six pulses equal, Yang surging Yin distinct, pregnancy sign. Xu said: Had three births, knows not pregnant. I said: Ten pregnancies, ten deliveries. Near forty, Qi/Blood declining, righteous Qi insufficient, fetal Qi moving, pre-existing Liver Qi causing distension/pain. Prescribed Fetus-Calming, Blood-Nourishing, Liver-Harmonizing agents. Palpated abdomen like "Fuza" (unclear term), confirmed fetus not disease. Xu complied. Next morning reported true doctor, fetal movement felt. More doses cured. Autumn, gave birth to sixth son.
Summer of Yi Wei year, Beijing Cholera with tendon cramps, sudden death within moments. Over one month, hundreds of thousands died, similar to Chongzhen Year 6 plague. I published "Discourse on Plague and Cholera," distributed hundreds of thousands of sheets detailing Qi-moving, Blood-invigorating, acupuncture, scraping methods, saving countless lives. My concubine also got it, saved by same method. Others saved similarly. Only Guan Luqing's servant survived but ignored dietary advice (no rice), ate porridge, relapsed and died.
Yi Wei year, Ouyang Bochun, Principal Lang of Bianbu, contracted Shanghan. Physicians mistook for plague, used bitter-cold drugs. Insomnia three days, delirium, kicking covers, screaming, high fever, black prickly tongue coating. Pulse surging/forceless, Deficiency Heat. Ginger wiped tongue white, confirming Shanghan, not plague. Deficient Fire flaming upward, no internal excess heat. Renshen Zhuye Tang modified to guide fire back to source. Relatives hesitant, but father-in-law Guo Wanchen insisted. Four doses cured.
Jia Wu year, Wang Zijie Taishi's daughter caught Wind-Cold. Should resolve exterior/harmonize middle, sweat resolves. Physicians used Xijiao/Lingyangjiao, drawing evil inward, aphasia, worsening. Pulse deep/tight. Qianghuo Tang plus Fuzi, Rougui, removing Huangqin, Dihuang. One dose speech returned, rash erupted, cured.
Winter Jia Wu year, Huang Shenzhi Dianzhuan had Shanghan. Physicians thought Winter Plague, used Xuan Shen etc. cold drugs for 20+ days. Restlessness, unconscious, insomnia three days. Pulse rapid/deficient, Stomach Qi near exhaustion. Renshen Tang modified to guide fire back. One dose slept, woke noon next day. Thanked me, re-palpated, continued modified formula for month, cured.
Jia Wu year, Liu Bocdong Dianzhuan's brother returned, caught cold, delirious, acute shock. Pulse floating/rapid, Wind-Cold transforming to Heat, no sweat. Qianghuo Tang modified. One dose sweat resolved, cured.
Winter Jia Wu year, Cheng Congzhou Junmen's young master Shaozhou Taoshi had Houibi (Sore Throat). Physicians wrongly used warming/tonifying, throat swelled, unable to swallow water for three days. Pulse deep/fine. Lung/Stomach/Kidney deficiency, Fire rushing up throat. Unilateral heavier than bilateral. Avoid knife/needle puncture (draws poison in). Avoid warming (helps evil), dispersing (vents evil), cooling (traps evil). Mistaken warming caused neck swelling. Acupunctured Shaoshang, Shangyang to drain black blood. Applied shallow poison to Jin Gang Chi (unclear) to draw poison. Blown Wu Shi Dan Yao to disinfect. Ziyin Qingfei Tang modified to harmonize. Drank water after medicine, ate porridge evening. Next day added interior-supporting/pus-expelling agents. External ulceration/internal resolution, cured.