安昌陈 湿热郁遏，脐下胀闷，睾丸偏坠，脉涩滞，舌黄腻。宜疏利为主。（二月二十四
日。）
川楝子（三道） 橘核（三钱） 鸡内金（二钱） 川萆 （三钱） 延胡（三钱） 赤苓（四钱）
香
附（三钱） 玫瑰花（五朵） 炒青皮（八分） 泽泻（三钱） 通草（钱半） （引）两头尖（七十粒）
四帖。
介按∶此系七疝中之气疝，其脉涩滞，而舌黄腻，是夹湿热之候。方从《济生》橘核丸
加减
，确治睾丸偏大，痛引脐腹之专剂。兹又加以萆 、赤苓、泽泻等味以利湿，用两头尖以浊
导浊，治法极是。若再参用荔枝核、山楂核等味，尤为灵效，此鄙人所历验不爽者。
某 小便流浊涩痛，右脉弦细，睾丸偏坠。宜金铃子散为主。（四月初四日。）
川楝子（三钱） 川萆 （三钱） 木通（钱半） 海金沙（四钱） 延胡（三钱） 泽泻（三钱）
赤
苓（四钱） 车前子（三钱） 橘核（三钱） 生香附（二钱） 炒枳壳（钱半） （引）两头尖（七十
粒）
四帖。
介按∶此与前案大同小异，方从金铃子散合橘核丸加减，而参用利湿导浊之品，治法极
为稳妥。
清水闸陈 湿热下注为痔，始起下疳，脉滑数，九月身发疹痘，系是结毒。宜清解，仰
希外科政之。
苦参（一钱） 藏连丸（一钱） 桑寄生（三钱） 草（三钱） 银花（三钱） 炒知母（钱
半） 茯苓（四钱） 天花粉（三钱） 炒条芩（钱半） 焦山栀（三钱） 生白芍（钱半）
清煎四帖。
介按∶此症虽是湿热下注，恰系脾肾阴亏，以脾司统血之职，肾主摄纳之权，兹以阴络
被伤，其血内溢。故治法以清热滋阴为主。
渔庄沈（湘记） 结喉旁及右手臂肿，溃而不敛，左脉细数，右寸关弦，不时汗出，形体
怯弱。宜防疮劳。（五月初十日。）
北沙参（三钱） 霍斛（三钱） 豆皮（三钱） 忍冬藤（三钱） 茯神（四钱） 炒白芍（钱
半）
枣仁（三钱） 地骨皮（三钱） 炙黄 皮（八分） 生牡蛎（四钱） 新会皮（钱半） （引）陈南枣
（三枚）
三帖。
又 疮毒未敛，脉弦细数，阴火上升，齿痛，舌白少津。宜养阴清降，防疮劳。（五月
十三日。）
西洋参（钱半） 骨碎补（三钱） 生地（四钱） 天花粉（钱半） 粉丹皮（三钱） 怀药（三
钱） 广皮（钱半） 蜜银花（钱半） 钗斛（三钱） 生牡蛎（四钱） 冬桑叶（三钱）
清煎三帖。
又 疮劳胃钝，脉虚濡，舌滑白，迩由湿热伤气，清窍不利。宜清利为妥。（又月初四
日。）
骨碎补（三钱） 生米仁（三钱） 蔻壳（一钱） 冬瓜子（四钱） 炒远志（八分） 抱木茯神
（四钱） 新会皮（钱半） 川贝（钱半） 苦丁茶（钱半） 谷芽（四钱） 石莲子（三钱）
清煎四帖。
又 疮劳形怯，胃气稍振，脉虚细，舌滑白，湿热犹存，仍遵前法损益。（又月初七日
。）
骨碎补（三钱） 生米仁（四钱） 丹参（三钱） 省头草（钱半） 远志（八分） 怀药（三钱）
新会皮（钱半） 通草（钱半） 茯神（四钱） 炒谷芽（四钱） 冬瓜子（四钱）
清煎四帖。
又 诸款悉减，脉虚细，疮口未敛。宜补虚扶元为妥。（六月初九日。）
太子参（一钱） 归身（钱半） 霍石斛（三钱） 金樱子（三钱） 茯神（四钱） 炒白芍（钱
半） 新会皮（钱半） 怀山药（三钱） 夜交藤（三钱） 生牡蛎（四钱） 炒杜仲（三钱）
清煎五帖。
介按∶此症溃而未敛，脓血去多，营液大耗，以致形体怯弱，次以胃热上冲而齿痛，三
因湿热重
伤，故其处方，初以养胃敛阴，次则参以滋阴潜阳。三四两方，又佐渗湿。终则悉属扶脾益
肾以安神，俾脾能统血，肝能藏血，心能生血，血液充足，则形体亦得恢如常矣。
Patient Chen from Anchang: Damp-heat pathogenic factors are constrained and obstructed, causing distension and fullness below the umbilicus, and unilateral pendulous swelling of the testis. The pulse is choppy and stagnant, and the tongue coating is yellow and greasy. Treatment should primarily focus on dispersing and draining. (February 24th.)
*Chuanlianzi* (Sanqian) *Juhe* (Sanqian) *Jineijin* (Erqian) *Chuanbixie* (Sanqian) *Yanhusuo* (Sanqian) *Chi Ling* (Siqian)
*Xiangfu* (Sanqian) *Meiguihua* (Wuduo) *Chao Qingpi* (Bafen) *Zexie* (Sanqian) *Tongcao* (Qianban) [Guiding herb] *Liangtoujian* (Qishili)
Four doses.
Commentary by Shao Jie: This case belongs to Qi Hernia among the Seven Hernias. The choppy pulse and yellow-greasy tongue coating indicate a condition complicated by damp-heat. The prescription is modified from *Juhe Wan* (Orange Seed Pill) in *Jisheng Fang*, which is indeed a specific formula for treating enlarged testes and pain radiating to the umbilical and abdominal regions. Here, herbs such as *Chuanbixie*, *Chi Ling*, and *Zexie* are added to promote diuresis and drain dampness, while *Liangtoujian* is used to treat turbidity with turbidity. The treatment method is highly appropriate. If *Lizhihe* (Lychee Seed) and *Shanzhahé* (Hawthorn Seed) were also incorporated, the efficacy would be even more remarkable; this is an experience I have verified without failure.
Certain Patient: Turbid urine with dysuria, right pulse is wiry and thin, and unilateral pendulous swelling of the testis. Treatment should primarily use *Jinlingzi San* (Cuckoo Flower Powder). (April 4th.)
*Chuanlianzi* (Sanqian) *Chuanbixie* (Sanqian) *Mutong* (Qianban) *Haijinsha* (Siqian) *Yanhusuo* (Sanqian) *Zexie* (Sanqian)
*Chi Ling* (Siqian) *Cheqianzi* (Sanqian) *Juhe* (Sanqian) *Sheng Xiangfu* (Erqian) *Chao Zhike* (Qianban) [Guiding herb] *Liangtoujian* (Qishili)
Four doses.
Commentary by Shao Jie: This case is largely similar to the previous one. The prescription is a modification of *Jinlingzi San* combined with *Juhe Wan*, incorporating herbs that drain dampness and guide out turbidity. The treatment method is extremely prudent.
Patient Chen from Qingshuizha: Damp-heat sinking downward causes hemorrhoids. Initially, chancre appeared. The pulse is slippery and rapid. In September, rashes and pustules erupted on the body, indicating syphilitic condensation toxin (*Jiedu*). Treatment should clear and resolve heat toxins; it is recommended to consult a surgeon for management.
*Kushen* (Yiqian) *Zanglian Wan* (Yiqian) *Sangjisheng* (Sanqian) *Caoheche* (Sanqian) *Yinhua* (Sanqian) *Chao Zhimu* (Qianban) *Fuling* (Siqian) *Tianhuafen* (Sanqian) *Chao Huangqin* (Qianban) *Jiao Shanzhi* (Sanqian) *Sheng Baishao* (Qianban)
Decocted in water, four doses.
Commentary by Shao Jie: Although this condition manifests as damp-heat sinking downward, it coincides with deficiency of Spleen and Kidney Yin. Since the Spleen governs the function of controlling blood, and the Kidney governs the power of grasping and receiving, damage to the Yin collaterals now causes internal bleeding. Therefore, the treatment method focuses on clearing heat and nourishing Yin.
Patient Shen (Xiangji) from Yuzhuang: Swelling beside the Adam's apple and the right arm, which has ulcerated but fails to heal. The left pulse is fine and rapid, the right Cun and Guan positions are wiry, sweating occurs intermittently, and the physique is frail and weak. Prevention of Chancre Consumption (*Chuang Lao*) is advised. (May 10th.)
*Beishashen* (Sanqian) *Huoxu* (Sanqian) *Doupi* (Sanqian) *Rendongteng* (Sanqian) *Fushen* (Siqian) *Chao Baishao* (Qianban)
*Zaoren* (Sanqian) *Digupi* (Sanqian) *Zhi Huangpi* (Bafen) *Sheng Muli* (Siqian) *Xinhui Pi* (Qianban) [Guiding herb] *Chen Nanzao* (Sanmei)
Three doses.
Revisit: The sore toxin has not healed, the pulse is wiry, fine, and rapid, Yin fire ascends, causing toothache, and the tongue is white with little fluid. Treatment should nourish Yin and clear descending fire, preventing Chancre Consumption. (May 13th.)
*Xiyangshen* (Qianban) *Gusuibu* (Sanqian) *Shengdi* (Siqian) *Tianhuafen* (Qianban) *Fen Danpi* (Sanqian) *Huai Yao* (Sanqian) *Guang Pi* (Qianban) *Mi Yinhua* (Qianban) *Chai Hu* (Sanqian) *Sheng Muli* (Siqian) *Dongsangye* (Sanqian)
Decocted in water, three doses.
Revisit: Chancre Consumption leads to dull stomach Qi, the pulse is deficient and soggy, the tongue coating is slippery and white. Recently, damp-heat has injured Qi, causing obstruction of the clear orifices. Treatment should prioritize clearing and draining. (Early May, 4th day.)
*Gusuibu* (Sanqian) *Sheng Yiren* (Sanqian) *Kouke* (Yiqian) *Dongguazi* (Siqian) *Chao Yuanzhi* (Bafen) *Baomu Fushen* (Siqian) *Xinhui Pi* (Qianban) *Chuanbei* (Qianban) *Kudingcha* (Qianban) *Guya* (Siqian) *Shilianzi* (Sanqian)
Decocted in water, four doses.
Revisit: Chancre Consumption results in physical frailty, Stomach Qi shows slight recovery, the pulse is deficient and fine, the tongue coating is slippery and white, damp-heat remains. Continue the previous method with modifications. (Early May, 7th day.)
*Gusuibu* (Sanqian) *Sheng Yiren* (Siqian) *Danshen* (Sanqian) *Shentoucao* (Qianban) *Yuanzhi* (Bafen) *Huai Yao* (Sanqian)
*Xinhui Pi* (Qianban) *Tongcao* (Qianban) *Fushen* (Siqian) *Chao Guya* (Siqian) *Dongguazi* (Siqian)
Decocted in water, four doses.
Revisit: All symptoms have decreased significantly, the pulse is deficient and fine, the sore has not yet healed. Treatment should focus on tonifying deficiency and supporting Yuan Qi. (June 9th.)
*Taizishen* (Yiqian) *Guishen* (Qianban) *Huoshihu* (Sanqian) *Jinyingzi* (Sanqian) *Fushen* (Siqian) *Chao Baishao* (Qianban)
*Xinhui Pi* (Qianban) *Huai Shanyao* (Sanqian) *Yejaoteng* (Sanqian) *Sheng Muli* (Siqian) *Chao Duzhong* (Sanqian)
Decocted in water, five doses.
Commentary by Shao Jie: This condition ulcerated but failed to heal due to excessive loss of pus and blood, leading to significant depletion of Ying fluids and Yin, resulting in physical frailty. Subsequently, Stomach heat rushed upward causing toothache. Thirdly, severe injury by damp-heat occurred. Thus, the initial prescriptions focused on nourishing Stomach Yin and astringing Yin, followed by incorporating methods to nourish Yin and subdue Yang. The third and fourth formulas additionally assisted in leaching out dampness. Finally, the approach entirely supported the Spleen and benefited the Kidney to calm the Spirit, ensuring the Spleen can control blood, the Liver can store blood, and the Heart can generate blood. With sufficient blood, the physical form will recover to normal.