典史宋晓岚，同乡也。丙辰春，与余同携眷入秦。将至临潼，其孙女甫周岁，坐车为雨泥所滑，女失手坠车下，轮辗其腹，顷刻而毙，亦气数也。其媳以恸女故，日切悲哀，兼介入，安土重迁，乡思颇切，晓岚尤吝于财，虽宦游而饮食衣服，不遂妇愿。至夏忽患胸胁大痛，喘嗽不宁，饮食俱减。晓岚来求治余，诊其左脉弦而牢，右寸坚而滑，知为气郁，乃以左金丸合颠倒木金散进。二服后，吐痰涎数碗，再视之，则左少软，而右亦渐乎矣。因以逍遥散加木香青皮等叠进之，半月后始就平复。因劝晓岚曰，儿女情怀，须少宽假。前日之病，久则成癫，若不去其痰，遥遥千里，携带而来，竞成废人，不悔之甚乎。晓岚遵之，辞色稍温，三月后，如居故土矣。
劳倦失眠脉坏难治
商州牧赵笏山同乡，崞县人。以进士宰秦中，所至有政声，丙辰夏，以天旱祈雨，夜作早兴，又商地皆山，每祷出入崎岖甚苦。秋末忽病，商僻地少医，遣干仆入省，求余往治。余以需次人，不敢私出省，同乡武芝田观察，言于抚军吴仲容先生，乃治任随之，越秦岭而视焉。至其署，笏山尚危坐，议论风生。问何病？曰，夜不瞑目者廿日矣。问何所苦？则曰，胸满气急，饮食不思。茶后诊之，六脉俱形沉数，而右关毫无神气，乍沉乍浮，乍缓乍急，且二至而一息。余以脉非吉象，不便明言，乃曰，君所患为心火上炎，心肾不交故也。急滋阴以壮水，则得寐、笏山急索一方，乃以地黄汤加生地、桔梗进之。药下二刻，倦而就枕，沉沉酣睡，晨钟动方起。请余入曰，真仙丹也。前屡服天王补心丹，以为睡觉良药，而竟不寐。今服君药，彻夜常眠，披衣而起，如释重负，弟病虽危，有阁下神手当无恐也。再诊之，脉似稍起，而右关依然。乃进七味都气汤，又开香砂六君汤敷衍之。亟欲归省，而笏山再三款留，不得已为延三日。临行笏山食亦少进，起坐颇自如，嘱余笔论其病，余乃书曰；金水不生，脾胃枯竭，室欲惜精，少思淡食，一阳始生，病将自绝。笏山铭之。余归途无事，戏作挽联云："越秦岭而视君，愧余寡术。牧商山而怀古，想尔同仙。"入省后，芝田问笏山之病何如？余曰：必不起！曰；何故？曰：脉已败坏，焉得不死。因告以已作挽联，同人皆笑，芝田阴为料理身后，至十一月二十四日殁于署。其弟来省交代，余即书前联挽之，并道及论病数语。其弟憬然曰：阁下何神哉！叩头而去，扶柩归焉。
气郁吐逆
同乡张文泉司马，于余为同谱弟，丙辰春，先后入秦需次，公余则酒宴过从，其戚乔其亦介人，为楚郧阳府经，以提饷来秦，馆于文泉之室，文泉厚遇之。而乔鄙甚，饮食之外索洋烟，洋烟之外索衣服。又索小费。文泉稍拂之，则裂眦负气。久而不堪其扰，拟遣之去，又以军饷未齐，迟迟两月，临行诟谇百端，几乎握拳相向。文泉素讷于言，不能发泄，心甚恚之。一日由咸宁过余，余留晚餐，言次文泉含泪欲滴，余劝以不仁之人无可计较，既去矣，置之可也。文泉归馆，则气急腹痛，呕吐大作。急遣车邀余，至则痰涎溢地，犹张口作吐状，汗出如流，面带青色。诊之，则六脉俱伏。乃日，此气郁而逆也，甚则发厥，急命捣生姜汁半碗灌之，刻许而吐定，然胸腹闷乱，转侧难安。乃以越鞠丸合顺气汤进之，至天明而腹舒，仍命服顺气汤，三日而愈。
阴虚血弱胃绝难医
邻人刘锡庆，商于楚，年三十余无子，父母共忧之。娶妻数年，百方调补终莫效。一日刘忽患腹痛，邀余往视。众以为霍乱，服霍香正气散不效。诊其六脉沉弱，知为阴虚。因曰，君腹痛必喜按，且时作时止，非常病也，且痛发必在脐下。刘曰，然。乃投以七味都气汤(方：熟地山芋山药丹皮泽泻茯苓五味子)加肉桂二钱，两服而痛止。归后家人问其病，余曰，此阴虚血弱，腹痛易治，惟两尺细仅如丝，毫无胃气，恐命之不久也。越年许，余白京师归，已于数月前，以瘵终矣。刘本孤子，家极贫，以刘贾少裕，刘殁后双亲衰独，抚养无人，兼两餐不继。见者皆恻恻云。
寒湿下注关节疼痛
介之罗王庄张冠英，家称小有，继娶吾里中李姓女。得腿病，骨节痛楚，不可屈伸，且时作肿，卧床已半年矣延医视之，或以为下痿，用虎潜丸（方：炒黄柏炒知母熟地龟板陈皮白芍锁阳虎骨干姜牛膝当归羊肉）补之；或以为瘫痪，用续命汤散之。皆不效。其内弟请余往治。余诊六脉缓大。告之曰，既非下痿，亦非瘫痪。所患乃寒湿下注，关节不灵，肿痛必在关节。病虽久，可治也。乃先进羌活胜湿汤加牛膝防己以疏利之。三服后，杖而能起。又往视之，投以五苓理中汤（五苓散与理中汤合剂），四服后，肿痛全消。意不愿服药。余曰：湿气未清，恐将复作，不如多服，以免后患。张听之，服药二十余剂，乃以酒肉来谢。余告以谨避风寒湿气。相隔十余年，余见于其戚家席上，称健步焉。
肝郁气结土败难愈
里中田大授，家少裕，而年老无子，妻悍不敢置妾，后以失业窘于财，郁而为病。城中有老医名荣同者，田素信之，请其诊视。荣曰：风寒外感也，散之不效。又视之曰年老气虚也，补之益甚。荣穷于术，乃邀余治。诊其肝脉滑数，脾部见弦急，且三至一息。乃曰，君所患为肝气郁结，木来侮土，土已败矣。病可小愈，命不可保也。田似嫌其唐突，请示一方，余以逍遥散合左金丸进之。数服而病减，进饮食矣。又请视之，诊其肝脉稍长，而脾脉如故。知不能愈，乃以逍遥散敷衍之。半月，精神爽健，出入游行。值村中演优戏，相见于庙庑，告余曰，病已全除，当无恐。余曰，脉至不息方可，后半年，余赴都，及来春归，询之，已欹殁数月矣。
产后气虚升降失常
邻人郝某之次女，产后经数月，饮食不思。精神减少，时兼胸满，面黄肌瘦．延医视之，以为痨瘵。投以八珍汤，获小效，而病复如故。或又以为产后血虚，用大剂四物汤合生化汤，转增腹痛。继有庸手，作伤寒阴症冶，去益远而病增剧。法无可施，来求余治。诊其六脉浮弱，右关尤甚。乃曰，此气虚，非血虚也。当补气以生血。他人多用血药，品多清降，不转馁其气乎．因处以补中益气汤。其父素明针灸，颇知医，难之曰，病苦胸满，益以补中，不增甚乎。余曰，令嫒胃气下陷，清阳不升，故浊阴不降，以致饮食留滞，故胸苦满。若清阳既升则浊阴下降，胸中自当痛快。命如方服之。三剂而精神作，饮食进。更命易汤以丸，一斤而全愈矣。
湿痹似瘫
介之田村乔某，忘其名，年老得痹疾，或手或足，痛发左右无定。医药数辈皆以瘫痪治之，药不啻千百剂，竟罔效。委顿经年，已为治丧具矣，而痛则饮食二便尚无大害。其里中有商于都者，知余名，因嘱请治。余至其家，未见病人，先问其子曰：遵大人是何病？其子以瘫痪告。余曰：老年人得此病十无二三愈者，恐治之亦无益也。然既来不得不一视之。入其室，则病者拱手称谢，问答数语，口舌便利，视其口眼无歪斜状，神气亦清。乃问手足麻木乎？曰，并不麻木，惟有时作痛，不可忍耳。因诊其脉，六部俱缓而沉，兼带弱象。告之曰，君所患乃湿痹，既非瘫痪，又非痿症。盖寒湿着于皮肤，四肢重滞，每转侧则重不可举，如移山挪石，非人不行。病者曰，不错，不错，先生所认既真，急请施方必可愈也。余曰，愈则可愈，然无速效，须服药数十付，起居调摄，乃杖而起，早亦在三月外，迟则半年。病者曰，但求病愈，何必急急。乃先以五苓理中汤加附子苍术进之。五服而痛少止，肚腹宽，饮食进。又易羌活胜湿汤加牛膝，肉桂等类，命多服之，半月痛全止。惟举动艰滞，步履尚难。更以白木附子汤，加松节、萆薢等。命十服后，丸服之。更命每早晚遣入扶掖，往返数十步不必再视也。病者遵之，越三月，趋车备物衣冠而来，见其行走如常，而履阶遇限，尚多不利，急遣还而养之。冬十一月遇于城中酒市，则指挥如意，毫无痛苦矣。此事相隔十余年，辛酉其子来求治眼，谈次具陈本末，乃始忆而录之。
阴虚肝郁双目痛楚
乔某之子名夏清，忽踵门，先以函入，拆视之，词极文雅谦抑，延之入。问之，已入县庠。据云一别十余年，家道零落，又以嫂氏妒悍，避其虐，舌耕于祁县。春来乍得眼疾，两珠痛楚，夜则尤甚。易数医，无少效。因忆前治家君之病，甚有确见，故特来请治。余拨其眶视之，则黑珠周围起白膜，带二三红血点。诊其脉，则左关弦滑，尺微细。乃曰，此阴亏肝郁也。幸未久，尚无害。若再迟数月，则生外障，翳膜遮睛，则揭去匪易。乃先开一疏肝散，又继以杞菊地黄汤，二方并付之。告之曰：先服疏肝散三四剂，痛当止；继服地黄汤不十剂，当无事矣。每晚临卧，以火酒洗之，避风寒辛热，遥遥数十里可勿再来省往返也。夏清揖而去。半月后，忽自称谢，渭目疾痊愈，专申感悃，并偕邻村郭某来云，亦有病求治，余适在城中宴会，未及见，后不果来。
年老血崩阴阳两虚
邻人刘锡庆之姊，三醮而仍寡，年近五旬，忽患血崩，村医以为蹉跌，用发灰地榆类涩之而不效。经月余，来邀余治，见其面白如灰，气息仅属，甚不堪。视其脉则沉细迟弱，凡虚象无所不有。乃曰，此病危如朝露，过半月，恐不救也。又贫寒难事药饵，急欲辞归，其婿忽止之曰：岳母病如可愈，药钱我任之，万一不救，则不必矣。余感其义，乃告之曰：君热肠如是，余当竭力，虽无旦夕效，然性命或无碍也。投以大剂六味回阳饮（方：附子炮姜甘草当归党参肉桂），二日而精神起，然崩则如故。其婿来曰，命似可救，而血崩不止。余曰，君无虑，止血崩实易事，但岳母阳阴两虚，不固其气，血崩难止。今有回阳饮以作其气，再用提补，靡不效矣。又投人参养荣丸，加柴胡，升麻以提之，又加芡实、龙骨以涩之，凡五进而血止，因命专服人参养荣丸，两月后，偕其婿来敛衽拜谢。就内人取针线数事而去。越数日精心密缕，封而呈焉。并云贫无可酬，聊以手指答救命之恩云耳。
霍乱转筋
业师庞芸圃夫子，秋间抱丧弟之戚，忽患水泻，自辰至申酉如厕者三十余次，如桶泻水。继之以吐，困顿不堪。且时时作转筋，急遣人呼余至，问其形证，按其脉俱弦直，知为霍乱。以藿香正气散进，泻少止，而二刻许，复吐，所服药点滴无存，前病发作。至天明，转筋将近腹，两腿不可曲伸污便床褥。及余视之，神气仅属，濒于危矣，举家惶恐，余急命刺尺泽，委中二穴，出紫黑血半盏，刻许而吐定，可服药矣，仍煎前方与之，逾时安卧，至午后则腿舒而泻少止。至晚又进一剂，三日而安。而先生知无害，便不服药。余视之见其皮粘于骨，面色青黯，乃以老亲在堂之说，竭力劝之方许焉，告以香砂六君子汤。半月始得如常，而出入动作矣。
热疟
先生之母，余太师女也，年过八旬，颇壮健。夏秋，忽得疟疾，发则如火烧身，狂叫反侧，他医用药截之不效。招余治之，见其目如赤珠，口干唇破，时时呼冷水。问二便，则小便如血，大便闭数日矣。按其脉，则六部弦数尤甚。乃告日，此热疟也。单热不寒，须内清其热则火退而疟自止。若徒用截法，万无效理。因投以大剂白虎汤，重用石膏至两许，二服而热退，四服而疟已．
脾虚肝郁
先生之弟妇，患头痛发呕，饮食不思．时瘟疫盛行，疑为时症，余偶到塾，其侄兰芬兄言其状，并邀之治。问身觉憎寒壮热乎？曰，否。问身痛鼻塞乎？曰，否。然则非时症。诊其脉，则左关弦滑，余俱细弱。告兰芬曰：此脾虚肝郁也，作时证治，必散之，虚而散，则大误矣。兰芬请一方，因以逍遥散进。余过而忘之，越数日，见兰芬，告余曰，药才二服，病全除矣。
寒疟
丁未岁，余读于乡之僧寺。是年太阴司天，五月后阴雨经旬，里中地极下湿，而农家露宿于野，外感风寒，必病疟利。因先配常山酒一坛施之。六月半疟果大作，凡十人而五六，取酒者接踵至，保全颇多。至七月中，疟少息而酒亦罄矣，寺僧名昌裕，素无赖，以佘在寺稍敛迹。旋亦病疟，向余求酒，余以酒已完，欲再制之非浸渍十数日不可，仓卒不能办。昌裕似嫌余吝，乃招而来曰：子怒我错矣，疟虽一病，而人之虚实禀赋不同，余所施之酒，未必人人尽效。我为若治之何如?僧始转怒为喜，乃诊其脉，则弦而迟。告曰：弦是疟正脉，而迟则寒象。子患寒疟，发必多寒少热，且先寒后热，身痛无汗。僧曰：良是。乃以越婢汤发之，二日疟少止，令五服则全愈矣。
食积腹痛
黑六，里中人，遗其名。一日腹痛欲绝，强步至门，跪求余治。余曰：何忽得此疾?泣诉曰，昨日吃莜面条半大碗，饭罢入瓜田渴甚，饮凉水二碗，归家则腹痛作矣。胸中如碗鼓甚，按之如刺。余曰，此食积也。但汝胸中如石塞窦无隙可通，用药治之，恐药弱而病强，攻之不破也。痛者曰：然则听之乎。余曰，尔欲病愈，须遣人扶掖，在田野中，往返疾行数百步乃可，病者辞以不能。余曰，不能则难治也。再三苦求，乃以大剂承气汤加麦芽，槟榔疏之。告曰，三服乃可。病者归，初服而胸中如坠，二服后下气暴作，急如厕，则如桶脱底，胸腹空虚，负耒而耕矣。
胃热血结
Song Xiaolan, a Dian Shi (Registrar), was a fellow townsman. In the spring of Bingchen year, he traveled to Shaanxi with his family together with me. As they approached Lintong, his granddaughter, who had just turned one year old, slipped from her carriage due to rain and mud. She fell off the carriage, and her abdomen was run over by the wheel, resulting in instantaneous death; this was also attributed to fate. His daughter-in-law, grieving intensely for her daughter, was immersed in sorrow daily. Additionally, she was stubborn, attached to her homeland, and suffered from strong homesickness. Xiaolan was particularly stingy with money; although he held an official post, his wife's desires for food and clothing were not met. By summer, she suddenly suffered from severe pain in the chest and hypochondrium, restless wheezing and coughing, and reduced appetite. Xiaolan sought my treatment. I palpated her left pulse as wiry and firm, and the right cun position as hard and slippery. I determined it was Qi stagnation and prescribed Zuojin Wan (Golden Left Pill) combined with Diandao Mujin San (Inverted Wood-Gold Powder). After two doses, she vomited several bowls of phlegm and saliva. Upon re-examination, the left pulse had softened slightly, and the right pulse had gradually relaxed. Therefore, I administered Xiaoyao San (Free and Easy Wanderer Powder) with added Muxiang (Aucklandiae Radix) and Qingpi (Tangerine Peel) continuously. It took half a month for her condition to stabilize. I advised Xiaolan, "You must be more lenient regarding familial emotions. The illness from before, if prolonged, could develop into insanity. If the phlegm is not eliminated, carrying it along on a journey of thousands of miles will eventually render her a useless person, which would be a great regret." Xiaolan complied, and his demeanor and speech softened. After three months, she felt as comfortable as if living in her hometown.
**Insomnia due to Fatigue: Ruined Pulse Difficult to Treat**
Zhao Hushan, Prefect of Shangzhou, was a fellow townsman from Guoxian. He served in Shaanxi as a Jinshi graduate, gaining a reputation for good governance wherever he went. In the summer of Bingchen year, due to drought, he prayed for rain, working late at night and rising early. Furthermore, Shangzhou is mountainous, making every prayer outing arduous and difficult. At the end of autumn, he suddenly fell ill. Being a remote area with few doctors, he sent a capable servant to the provincial capital to request my presence. As a waiting official, I dared not leave the province privately. Wu Zhitian, an Inspector and fellow townsman, reported this to Governor Wu Zhongrong, who authorized my travel. I packed my bags and followed, crossing the Qinling Mountains to examine him. Upon arriving at his office, Zhao Hushan was still sitting upright, speaking with vigor. When asked about his illness, he said, "I have not been able to sleep for twenty days." Asked about his suffering, he replied, "Chest fullness, shortness of breath, and no desire to eat." After tea, I palpated his pulses; all six positions were deep and rapid. However, the right guan position lacked spirit entirely, fluctuating between deep and floating, slow and rapid, with only two beats per respiration. Believing the pulse was inauspicious, I did not speak plainly but said, "Your condition is caused by Heart Fire flaring upward and a lack of communication between the Heart and Kidney. You urgently need to nourish Yin and strengthen Water to achieve sleep." Zhao Hushan urgently requested a prescription, so I prescribed Dihuang Tang (Rehmannia Decoction) with added Shengdi (Raw Rehmannia Root) and Jiegeng (Platycodon Root). Within two quarters of an hour after taking the medicine, he felt tired, lay down, and slept deeply until the morning bell rang. He invited me in, saying, "This is truly an immortal elixir! I had previously taken Tianwang Buxin Dan (Emperor of Heaven's Heart-Nourishing Pill) many times, believing it to be a good remedy for sleep, yet I could not sleep. Now, after taking your medicine, I slept through the night. Rising with my clothes on, I feel relieved. Although my illness is critical, with your divine skill, there is nothing to fear." Upon re-examination, the pulse seemed slightly improved, but the right guan remained weak. I then prescribed Qiwei Duqi Tang (Seven-Ingredient Duqi Decoction) and additionally opened Xiangsha Liujun Tang (Costus and Amomum Six-Gentlemen Decoction) to manage the condition. Eager to return to the province, Zhao Hushan repeatedly urged me to stay. Reluctantly, I extended my visit by three days. Before leaving, Zhao Hushan's intake of food had increased slightly, and he moved and sat quite freely. He asked me to write down my analysis of his illness. I wrote: "Metal and Water do not generate each other; Spleen and Stomach are depleted. Practice continence and cherish Jing (Essence); reduce thinking and eat blandly. When Yang begins to generate, the illness will naturally cease." Zhao Hushan memorized this. On my way back, having nothing to do, I jokingly composed a couplet for mourning: "Crossing the Qinling Mountains to see you, I am ashamed of my limited skills; Governing Shangshan while cherishing the past, I imagine you like an immortal." After entering the provincial capital, Zhitian asked about Zhao Hushan's condition. I said, "He certainly will not recover!" He asked why. I replied, "The pulse is ruined; how can he not die?" I told them I had written a mourning couplet. The colleagues laughed, and Zhitian secretly arranged for his funeral affairs. Zhao Hushan died in his office on the 24th day of the eleventh month. His brother came to the provincial capital to handle the handover. I wrote the aforementioned couplet to mourn him and recounted my diagnosis. His brother realized and said, "How divine you are!" He kowtowed and left, escorting the coffin home.
**Qi Stagnation with Vomiting and Regurgitation**
Zhang Wenquan, a Sima (Director) and fellow townsman, was a younger member of my clan. In the spring of Bingchen year, he arrived in Shaanxi to await a post. During his spare time, we socialized over wine and banquets. His relative Qiao Qi was also a rigid man, serving as a Jing (Manager) in Yunyang Prefecture, Hubei, coming to Shaanxi to transport tax grain, and staying in Wenquan's residence. Wenquan treated him generously. However, Qiao was extremely base; beyond demanding food and drink, he demanded opium, and beyond opium, clothing. He also demanded petty fees. Whenever Wenquan slightly opposed him, Qiao would glare and hold a grudge. After enduring the disturbance for a long time, Wenquan planned to send him away. However, due to incomplete military pay, he delayed for two months. Upon departure, Qiao cursed endlessly, almost coming to blows. Wenquan, usually taciturn, could not vent his anger and harbored deep resentment. One day, passing through Xianning, he visited me. I invited him to dinner. During our conversation, Wenquan was on the verge of tears. I advised him that there is no point calculating against unrighteous people; since he has left, let it go. Upon returning to his inn, Wenquan experienced sudden shortness of breath, abdominal pain, and severe vomiting. I was urgently summoned by carriage. Upon arrival, I found phlegm and saliva overflowing on the floor, his mouth open as if still vomiting, sweating profusely, and his face showing a bluish hue. Palpating his pulses, all six positions were hidden (Fu). I said, "This is Qi stagnation leading to rebellion. If severe, it may lead to syncope." I urgently ordered half a bowl of fresh ginger juice to be crushed and administered. After a moment, the vomiting stopped, but his chest and abdomen remained distended and chaotic, making turning difficult. I prescribed Yueju Wan (Pill to Resolve Five Stagnations) combined with Shunqi Tang (Regulating Qi Decoction). By dawn, his abdomen relaxed. I continued prescribing Shunqi Tang. He recovered in three days.
**Yin Deficiency and Blood Weakness: Stomach Qi Exhausted, Difficult to Cure**
My neighbor, Liu Xiqing, traded in Hubei. In his thirties, he had no sons, causing his parents great worry. After marrying for several years, various tonics and supplements failed to produce offspring. One day, Liu suddenly suffered from abdominal pain and invited me to examine him. Others thought it was cholera and prescribed Huoxiang Zhengqi San (Agastache Powder to Rectify the Qi), but it was ineffective. Palpating his six pulses, they were deep and weak, indicating Yin deficiency. I said, "Your abdominal pain must be relieved by pressure, comes and goes intermittently, and is not a common illness. The pain likely originates below the umbilicus." Liu agreed. I prescribed Qiwei Duqi Tang (Seven-Ingredient Duqi Decoction: Prepared Rehmannia Root, Cornus Fruit, Chinese Yam, Moutan Bark, Alisma Rhizome, Poria, Schisandra Berry) with two qian of Rougui (Cinnamon Bark). After two doses, the pain ceased. Later, when his family asked about the illness, I said, "This is Yin deficiency and blood weakness. Abdominal pain is easy to treat, but the two chi positions are thin as threads, lacking Stomach Qi entirely. I fear his life will be short." Over a year later, upon my return from Beijing, I learned he had died of tuberculosis several months prior. Liu was an orphan from a very poor family. Since his cousin Liu Jia was somewhat wealthy, after Liu's death, his elderly parents were left alone without support or consistent meals. Those who saw them felt deep compassion.
**Cold-Dampness Descending: Joint Pain**
Zhang Guanying from Luowangzhuang, Jiexiu, had a modest income. He remarried a woman surnamed Li from our locality. He developed a leg disease with painful joints, inability to flex or extend, and intermittent swelling. He had been bedridden for half a year. Doctors consulted either diagnosed lower limb flaccidity and prescribed Huyian Wan (Tiger-Hiding Pill: Fried Phellodendron Bark, Fried Anemarrhenae Rhizome, Prepared Rehmannia Root, Tortoise Shell, Tangerine Peel, White Peony Root, Cynomorium, Dried Ginger, Achyranthes Root, Angelica Sinensis, Lamb Meat) to tonify; or diagnosed paralysis and prescribed Xuming Tang/San (Reviving Life Decoction/Powder) to disperse. Neither was effective. His brother-in-law invited me to treat him. Palpating his six pulses, they were slow and large. I told him, "It is neither lower limb flaccidity nor paralysis. Your condition is Cold-Dampness descending, causing joint stiffness. Swelling and pain are localized in the joints. Although chronic, it is treatable." I first prescribed Qianghuo Shengshi Tang (Notopterygium Decoction to Overcome Dampness) with added Niuxi (Achyranthes Root) and Fangji (Stephania Root) to promote drainage. After three doses, he could rise using a cane. Upon re-examination, I prescribed Wuling Lizhong Tang (Wuling San combined with Lizhong Tang). After four doses, the swelling and pain completely subsided. He expressed reluctance to continue medication. I said, "Dampness is not yet cleared; relapse is possible. It is better to take more to prevent future issues." Zhang listened, taking over twenty doses, and subsequently thanked me with wine and meat. I advised him to strictly avoid wind, cold, and dampness. More than ten years later, I saw him at a banquet hosted by his relatives, noting his vigorous gait.
**Liver Qi Stagnation and Knotting: Earth Failure, Difficult to Heal**
Tian Dashou, a local resident, had some wealth but was old and childless. His wife was domineering, preventing him from taking concubines. Later, unemployment led to financial distress, causing Qi depression and illness. An old doctor in the city named Rong Tong was trusted by Tian. Rong diagnosed "Wind-Cold external contraction" and prescribed dispersants, which failed. Re-examining, he diagnosed "Old age Qi deficiency" and prescribed tonics, which worsened the condition. With his methods exhausted, Rong invited me to treat. Palpating his Liver pulse, it was slippery and rapid; the Spleen position showed wiry and urgent qualities, with three beats per respiration. I said, "Your condition is Liver Qi stagnation. Wood insults Earth, and Earth is already failing. The illness may improve slightly, but your life cannot be guaranteed." Tian seemed offended by my bluntness and asked for a prescription. I prescribed Xiaoyao San (Free and Easy Wanderer Powder) combined with Zuojin Wan (Golden Left Pill). After several doses, his illness decreased, and he began eating. Upon re-examination, his Liver pulse was slightly longer, but the Spleen pulse remained unchanged. Knowing he could not be cured, I prescribed Xiaoyao San merely to appease him. Half a month later, his spirit was bright, and he went out and walked around. Coinciding with a village opera performance, we met in a temple corridor. He told me, "My illness is completely gone; there is no need to worry." I said, "Only if the pulse becomes continuous and uninterrupted is there safety." Six months later, when I went to the capital and returned the following spring, I inquired and found he had been dead for several months.
**Postpartum Qi Deficiency: Ascending and Descending Dysfunction**
The second daughter of my neighbor, Mr. Hao, several months postpartum, had no appetite. Her spirit diminished, accompanied by occasional chest fullness, yellowish complexion, and emaciation. Doctors diagnosed it as consumption (Lao Zhai) and prescribed Bazhen Tang (Eight-Treasure Decoction), yielding slight improvement, but the illness recurred. Others diagnosed postpartum Blood deficiency and prescribed large doses of Siwu Tang (Four-Substance Decoction) combined with Shenghua Tang (Generating Transformation Decoction), which aggravated abdominal pain. Subsequently, incompetent physicians treated it as a Cold Syndrome of Shaoyin in Cold Damage, moving further from the correct path and worsening the illness. With no other options, she sought my treatment. Palpating her six pulses, they were floating and weak, especially at the right guan position. I said, "This is Qi deficiency, not Blood deficiency. We must tonify Qi to generate Blood." Others mostly used Blood tonics, which are often cooling and descending, potentially starving the Qi. Therefore, I prescribed Buzhong Yiqi Tang (Center-Supplementing Qi-Boosting Decoction). Her father, familiar with acupuncture and knowledgeable in medicine, questioned, "The patient suffers from chest fullness; supplementing the Center will not make it worse?" I said, "Your daughter's Stomach Qi has sunk, Clear Yang fails to ascend, thus Turbid Yin fails to descend, causing food retention and chest fullness. Once Clear Yang ascends, Turbid Yin will descend, and the chest will feel clear and comfortable." She followed the prescription. After three doses, her spirit revived, and she ate. I then changed the decoction to pills. After consuming one jin, she fully recovered.
**Damp Bi Mimicking Paralysis**
Mr. Qiao from Tiancun, Jiexiu (name forgotten), suffered from Bi syndrome in old age, with pain occurring randomly in hands or feet. Multiple generations of doctors treated it as paralysis, administering hundreds of doses of medicine without effect. He was debilitated for a year, and funeral preparations were even made, though his pain did not significantly affect his diet or excretion. A merchant named Yuandu from the village knew my reputation and requested my treatment. Upon arriving at his home, before seeing the patient, I asked his son, "What illness does your father have?" The son replied, "Paralysis." I said, "Less than two or three out of ten elderly patients with this condition recover. I fear treatment will be of little benefit. However, since I am here, I must examine him." Entering the room, the patient bowed and thanked me. Our conversation revealed fluent speech. His mouth and eyes were not deviated, and his spirit was clear. I asked, "Are your hands and feet numb?" He replied, "Not numb at all, only occasionally painful, unbearable." Palpating his pulse, all six positions were slow, deep, and weak. I told him, "Your condition is Damp Bi, neither paralysis nor flaccidity syndrome. Cold-Dampness adheres to the skin, causing heaviness in the limbs. Turning over makes it feel as heavy as lifting mountains or moving stones, requiring assistance. It is not impossible to move, but requires help." The patient said, "Correct, correct. Since your diagnosis is accurate, please prescribe immediately; it must be curable." I said, "It can be cured, but there is no quick fix. You must take dozens of doses, regulate daily life, and use a cane to walk. Early recovery is three months; late is half a year." The patient said, "I only seek cure; why rush?" I first prescribed Wuling Lizhong Tang (Wuling San combined with Lizhong Tang) with added Fuzi (Prepared Aconite Root) and Cangzhu (Atractylodes Rhizome). After five doses, pain lessened, abdomen expanded, and appetite improved. I switched to Qianghuo Shengshi Tang (Notopterygium Decoction to Overcome Dampness) with added Niuxi (Achyranthes Root) and Rougui (Cinnamon Bark), advising frequent use. After half a month, pain ceased completely. Movement remained sluggish, and walking was difficult. I then prescribed Baomu Fuzi Tang (Baomu Aconite Decoction) with added Songjie (Pine Joint) and Bixie (Dioscorea Hypoglauca Rhizome). After ten doses, he took pills. I instructed that morning and evening attendants assist him to walk tens of steps, eliminating the need for further visits. The patient complied. Three months later, he arrived dressed properly, claiming normal walking, though stairs and obstacles remained difficult. I advised him to return home and rest. In November of winter, I met him at a city tavern; he was directing things smoothly, free of pain. This event occurred over ten years ago. In the Xin You year, his son came seeking treatment for eyes. During our talk, he recounted the details, prompting me to recall and record this case.
**Yin Deficiency and Liver Stagnation: Eye Pain**
Mr. Qiao's son, named Xia Qing, suddenly visited, sending a letter first. The letter was elegant and humble. Inviting him in, I learned he had entered the county school. He mentioned that after over ten years apart, his family had declined. Avoiding the abuse of his jealous sister-in-law, he taught students in Qi County. In spring, he suddenly developed eye disease; both eyeballs were painful, worse at night. Several doctors failed to provide any relief. Remembering my accurate diagnosis of his father's illness, he specifically came to seek treatment. I lifted his eyelids to examine; white membranes surrounded the black pupils, with two or three red blood spots. Palpating his pulse, the left guan was wiry and slippery, and the chi was faint and fine. I said, "This is Yin deficiency and Liver stagnation. Fortunately, it is recent and harmless. If delayed by several months, external obstructions will form, and nebulae will cover the pupils, making removal difficult." I first prescribed Shugan San (Liver-Regulating Powder), followed by Qiju Dihuang Tang (Chrysanthemum and Lycium Rehmannia Decoction), providing both prescriptions. I advised, "Take Shugan San for three to four doses; pain should stop. Then take Dihuang Tang for less than ten doses; you will be fine. Every night before bed, wash the eyes with rice wine. Avoid wind, cold, and pungent-hot foods. There is no need to travel dozens of miles back and forth to the province." Xia Qing bowed and left. Half a month later, he suddenly appeared to express gratitude, stating his eye disease was cured. He also brought a neighbor, Mr. Guo, who also sought treatment. I happened to be attending a banquet in the city and did not see them; he never came back.
**Elderly Woman with Metrorrhagia: Yin and Yang Both Deficient**
The sister of my neighbor Liu Xiqing, widowed after three marriages, nearly fifty years old, suddenly suffered from metrorrhagia (profuse uterine bleeding). Village doctors attributed it to trauma and used astringents like hair ash and Diyü (Sanguisorba Root), but these were ineffective. After more than a month, she invited me to treat. Her face was ashen gray, her breath faint, and her condition dire. Palpating her pulse, it was deep, fine, slow, and weak, presenting all signs of deficiency. I said, "This illness is critical as morning dew; if it passes half a month, it may be incurable." Due to poverty, medication was difficult. I was eager to leave. Her son-in-law stopped me, saying, "If my mother-in-law can be cured, I will pay for the medicine. If she cannot be saved, then no payment is needed." Moved by his righteousness, I said, "With such a warm heart, I will do my utmost. Although there may be no immediate effect, her life might be saved." I prescribed a large dose of Liuwei Huiyang Yin (Six-Ingredient Decoction to Return Yang: Prepared Aconite Root, Roasted Ginger, Licorice, Angelica Sinensis, Codonopsis, Cinnamon Bark). After two days, her spirit improved, but bleeding continued. Her son-in-law reported, "Life seems salvageable, but bleeding persists." I said, "Do not worry. Stopping metrorrhagia is actually easy, but your mother-in-law has both Yin and Yang deficiency. Without securing Qi, bleeding is hard to stop. Now, Huiyang Yin boosts Qi. Using lifting and tonifying agents will surely work." I prescribed Ren Shen Yang Rong Wan (Ginseng Nourishing Youngevity Pills) with Chaihu (Bupleurum Root) and Shengma (Cimicifuga Rhizome) to lift, and Qianshi (Euryale Seed) and Longgu (Fossilized Bones) to astringe. After five administrations, bleeding stopped. I instructed her to take Ren Shen Yang Rong Wan exclusively. Two months later, she and her son-in-law came to bow in gratitude. She borrowed needles and thread from my wife and left. Days later, she presented carefully sewn items, saying, "We are too poor to repay you; this small gesture acknowledges the debt of life."
**Cholera with Tendon Twitching**
My master, Master Pang Yunpu, mourned his brother's death in autumn. He suddenly suffered from watery diarrhea, visiting the toilet over thirty times from Chen to Shen hours, flowing like water from a bucket. This was followed by vomiting, leaving him exhausted. He frequently experienced tendon twitching (charley horse). I was urgently summoned. Asking about symptoms and palpating his pulses, they were wiry and straight, indicating Cholera. I prescribed Huoxiang Zhengqi San (Agastache Powder to Rectify the Qi). Diarrhea slightly stopped, but after two quarters of an hour, vomiting resumed, and the ingested medicine was expelled. The previous illness recurred. By dawn, tendon twitching reached near the abdomen; legs could not flex or extend, soiling the bed. Upon examination, his spirit was faint, nearing danger. The family was panicked. I urgently ordered acupuncture at Chize (LU5) and Weizhong (BL40), drawing half a cup of dark purple-black blood. After a moment, vomiting stopped, and medication could be taken. I decocted the previous formula and administered it. After an hour, he rested peacefully. By afternoon, his legs relaxed, and diarrhea slowed. Another dose was given in the evening. He stabilized in three days. Knowing he was safe, Master Pang refused further medication. Examining him, I saw his skin adhering to bones and his face dark blue-green. Using the argument of his elderly parents, I persuaded him to accept treatment, prescribing Xiangsha Liujun Zi Tang (Costus and Amomum Six-Gentlemen Decoction). It took half a month for him to return to normal and resume activities.
**Heat Malaria**
My master's mother, a daughter of my Grandmaster, was over eighty years old and quite robust. In summer and autumn, she suddenly contracted malaria. Attacks felt like fire burning the body, with wild shouting and tossing. Other doctors' attempts to arrest the malaria were ineffective. Summoning me, I observed her eyes like red pearls, dry mouth, cracked lips, and constant calls for cold water. Regarding excretion, urine was bloody, and constipation lasted several days. Palpating her pulse, all six positions were wiry and rapid, especially prominent. I told her, "This is Heat Malaria. Single heat without chills requires internal clearing of heat. Once fire retreats, malaria stops. Merely using arrest methods will definitely fail." I prescribed a large dose of Baihu Tang (White Tiger Decoction), heavily using Shigao (Gypsum Fibrosum) up to one liang. After two doses, fever subsided; after four doses, malaria ceased.
**Spleen Deficiency and Liver Stagnation**
My master's sister-in-law suffered from headache, vomiting, and loss of appetite. During a plague epidemic, others suspected an exterior syndrome. I happened to visit the schoolhouse; her nephew Lanfen described her condition and invited me to treat. I asked, "Do you feel aversion to cold and high fever?" She said, "No." "Body pain and nasal congestion?" She said, "No." Thus, it was not an exterior syndrome. Palpating her pulse, the left guan was wiry and slippery, while others were fine and weak. I told Lanfen, "This is Spleen Deficiency and Liver Stagnation. Treating it as an exterior syndrome requires dispersing. Dispersing in deficiency is a major error." Lanfen requested a prescription. I prescribed Xiaoyao San (Free and Easy Wanderer Powder). I forgot about it afterward. Several days later, seeing Lanfen, he told me, "After only two doses, the illness was completely resolved."
**Cold Malaria**
In Ding Wei year, I studied in a temple in my hometown. That year, Taiyin governed the year. After May, continuous rain lasted for days. The local land was extremely damp, and farmers slept outdoors. External contraction of Wind-Cold inevitably led to malaria and dysentery. I prepared a jar of Changshan Wine (Dichroa Root Wine) to distribute. By mid-June, malaria indeed erupted; five or six out of ten people were affected. Those seeking wine came in succession, saving many. By mid-July, malaria subsided, and the wine ran out. Monk Changyu, known for being unruly, kept a low profile because I was in the temple. He soon contracted malaria and asked for wine. I said the wine was finished, and brewing new batches required soaking for ten-plus days, impossible to prepare hastily. Changyu seemed to think I was stingy and invited me, saying, "You blame me for being wrong? Malaria is one disease, but people's deficiency/excess constitutions differ. My wine may not work for everyone. Shall I treat you?" The monk turned from anger to joy. Palpating his pulse, it was wiry and slow. I said, "Wiry is the standard pulse for malaria; slow indicates Cold. You suffer from Cold Malaria. Attacks will feature more cold than heat, starting with cold followed by heat, body pain, and no sweat." The monk agreed. I prescribed Yebipi Tang (Yebipi Decoction) to induce sweating. After two days, malaria slightly stopped; after five doses, he fully recovered.
**Food Accumulation Abdominal Pain**
Hei Liu, a local (name forgotten), suffered from excruciating abdominal pain one day. He forced himself to walk to my door and knelt begging for treatment. I asked, "Why did you suddenly get this illness?" He cried, "Yesterday I ate half a large bowl of oat noodles. After eating, I entered a melon field, very thirsty, and drank two bowls of cold water. Upon returning home, abdominal pain started. My chest feels like a drum, pressing it feels like stabbing." I said, "This is Food Accumulation. But your chest is blocked like stone with no gap. Medication may be too weak to break the accumulation." He asked, "Should I just let it be?" I said, "If you want to recover, someone must support you to walk briskly hundreds of steps in the fields." He claimed he couldn't. I said, "Then it is difficult to treat." After persistent begging, I prescribed a large dose of Chengqi Tang (Chengqi Decoction) with Maiya (Barley Sprout) and Binglang (Betel Nut) to drain. I said, "Three doses are sufficient." Upon returning home, after the first dose, his chest felt like falling. After the second dose, gas surged violently. Rushing to the toilet, it was like a bucket bottom falling out; his chest and abdomen felt empty. He returned to plowing.
**Stomach Heat and Blood Stasis**