当区别以处之。不可因释老之故，而概视缁黄为非类。盖有畸人逸士， 傺无聊，遁迹于其间者矣。
怪证奇疾，间或有之，不可谓古书尽诬也。即寻常病证之奇幻，亦有古书所未载者。少所见而多所怪，陋
矣；强不知以
为知，妄矣。不陋不妄，可为名医。
（注）病形奇怪，变幻万端，古书所有者，时或见之，古书所无者，时亦闻之。盖造物之化工莫测，病机
之酿疾无穷也。
（校）《宋史》吕夏卿得奇疾，身体渐缩，卒时才如小儿。他书亦有载此证者。揆之以理，其人必平时多
饵丹石热药，以致消缩，而窦材云此证宜服丹、附，最属不经。
（刊）梁应来云∶姑丈葛秋生病瘵，卒时身首缩小，名缩骨劳。可见近时亦有此证也。窦材乃妄人耳，自
诩越人再世，所着《扁鹊心书》专尚丹石，欺世盗名，害人不浅。嗣有陈远公，所着《石室秘录》，论证列方，
颇皆入理，奈蹈窦材故辙，假托轩、岐、仲景，诬圣愚人，贻讥后世，毛达可尝叹惜之。顷见番禺潘氏《海山
仙馆丛书》，所收女科书三卷，文理粗鄙，剿袭甚多，托名傅青主先生手着之秘本。潘氏不知医理，误信梓行，
玷辱青主矣。无知妄作，固不足论，以远公之学而托诸鬼神，诫不可解也，更有王养吾者，将郭氏《痧胀玉衡》
窃为己有，假托深山野人之秘授，编其原方为六十四卦，未免伤及事主。而沈芊绿不察，采入《尊生》，何丹
流受愚，重灾梨枣，案虽未破，君子病之。
医家临诊辨证，最要凝神定气。如曾世荣于船中治王千户子头疼额赤，诸治不效，动即大哭，细审知为船
篷小篾刺入囟上皮内，镊去即愈。苟不细心审视而率意妄治，吾恐医者道少、病者人费矣。
（注）凝神定气，惟心小胆大者能之，忍辱负重，惟智圆行方者能之。不如是，不足以为名医。如临一大
证，学识不足以当之，则宜举贤让能，不可蚊负以偾事；学识苟足以当之，而同道之识见不一，各抒议论者有
之，簧鼓惑听者有之，阴谋排
挤者有之，加以亲友之好恶，戚党之疑信，或热心关切，或乐祸幸灾，投剂果然渐效，群议自息，病或稍有波
澜，众楚交咻，斯时也若执德不宏，悻悻然委而去之，病付庸手，坐视其危，岂不轻弃人命乎？且事败之后，
亦未必竟无归咎之语。故非凝神定气之心思，不足以辨疑难险恶之大证，无含蓄坚忍之才力，不足以负扶危持
颠之重任也。其学识全无，不知轻重，乱投药石，惟利是图者，乃无耻之徒，不可与忍辱负重同语矣。
（校）龙儿偶患足指 肿胀痛，适山妻往侍外姑疾，疡科治之益剧，日夜啼泣不止。山妻闻而遗归，涤去
敷药谛视之，乃剃下短发一茎刺入甲 。时盛暑，小儿频脱袜，此必剃发落于鞋内所致也。镊而出之，遂愈。
正与曾案相类矣。
（刊）刺不镊出而误药妄治，在头者其祸稍轻，在趾者必至溃腐脱落而成残废。缘先慈耳目之聪明迥异于
人，故至老不衰，而又善体人情，事上抚下，无不欣感，烹饪汤药，靡不周至，戚族中如有大病，必延往主裁
，是以病情药性，诸练亦深。雄未冠以前，读《景岳全书》而喜之，遇证亦效其治法。先慈闻而痛戒曰∶信道
不笃，见异思迁，汝将为杀人之事乎？吾之阅历病证者多矣，无论外感不可妄投温补，即内伤证，必求其所伤
何病而先治其伤，则病去而元自复。古人不曰内虚而曰内伤，顾名思义，则纯虚之证殊罕见也。汝何懵乎？雄
聆训恍然渐有定见。三十年来，员不能起死人而生之，尚不致酿活病为死证者，先慈启迪之教也。今刊此案，
不禁思亲之感。
滋补丸药，最难消化，脾胃不健者，断勿轻服。香岩先生
云∶湖州沈赤文，年甫冠，读书明敏，父母爱之如掌珠。将毕姻，合全鹿丸一料，少年四人分服。赤文于冬令
服至春初，忽患浑身作痛，有如痛风，渐至腹中作痛，有形之块累累于肠，饮食不进，肌肉消瘦。诸医治之，
乃父畏用消导清火之药，惟以参、术补方是从。至秋初邀余诊视，问曰∶小儿晚间去黑粪如拳大者一块，目下
遍身如火，欲饮井水，不知何故？余按脉数大，身体骨立，验其所下之块，黑而坚硬，意为瘀血结成，
与酒蒸大黄丸二钱，下黑块不计，用水浸之，胖如黑豆。详询所以，乃全鹿丸未化也。始知为药所误，不数日
热极而死，同服三少年，一患喉痹而死，一患肛门毒而死，一患吐血咳嗽而死。此皆无病而喜服温补之害也，
录此以劝世人不必好补而服药。
（注）世人之爱其子也，始忧其不长，衣帛食肉以揠苗，继虑其虚羸，朝丸暮药为常馔，逢节则参，遇劳
则参，酿疾延劳，半由乎此。虽曰爱之，其实害之。愚谓富贵之家，何不将此终年无病所服参药之费，延医合
药，施诊贫病，报施不爽，则我之子孙自然康强逢吉，不必虑其虚羸而为无病之呻矣。岂不美哉！
香岩先生治痘多活法。尝于肩舆中见采桑妇，先生令舆人往搂之。妇大怒詈，其夫将扭舆人殴打。先生晓
之曰∶汝妇痘已在皮膜间，因气滞闭不能出，吾特激之使怒，今夜可遽发，否则殆矣，已而果验。又一富家子
病痘闭，诸医束手，先生命取新洁大漆桌十余张，裸儿卧于上，以手展转之，桌热即易，如是殆遍，至夜痘怒
发得生。又先生之外孙甫一龄，痘闭
不出，母乃抱归求救。先生视之甚逆，沉思良久，裸儿键置空室中，禁女弗启视。迨夜深始出之，痘已遍体粒
粒如珠。因空屋多蚊，借其 肤以发也。又汪益美布铺伙友壮年患痘闭，群医不能措手。先生令取鸡粪若干，
以醇酒热调如糊，遍涂其身面手足。越宿鸡矢燥落裂剥，而痘已出矣。此皆神而明之之治，录之亦可发人之慧
悟。然激之使发者，气闭也，展转于新漆之桌者，火闭也，假蚊口以嘬之者，血闭也；涂之以鸡矢醴者，寒闭
也。虽外治也，而有分别之妙义焉。苟欲效颦，亦当审谛。
（校）上论治案。
（刊）徐洄溪云∶痘证因时而变，不但历代不同，隔数十年亦有小变。余谓痘证每因时邪引动而发，万密
斋尝言之，王清任亦论之，故不但数十年有小变，即一、二年间亦有判然迥异者。盖痘有痘疫， 有 疫，儿
科拘守古法，但可以治常痘，此建中《琐言》之所以有救偏良法也。后人不知此义，辄訾其浪用石膏、大黄为
偏，谓止可以救惯用热药之偏，岂为知人论世之言哉！但痘挟疫邪，非用费氏之法不可。惜幼科罕读其书，不
识病因，往往阖境沿村，夭枉载道，诿诸天数，岂尽然欤！吾先慈幼时患痘，头面虽少，遍身密布，紫黑焦枯，
略无润泽，诸医束手。老医包士安曰∶此名螺疔痘，用大黄、石膏多剂，毫无起色，奄奄一息，已绝望矣。偶
亲串中遣一越人陈妪来探疾，见而 云∶尚可图也。亟以银针将遍身之痘逐粒挑出如黑豆者一颗，随以珍珠八
宝丹糁入，外用朱养心家碧玉膏封之，即能进粥，不劳余药而生。又定州杨素园大令云∶
阜平赵功甫邃于医，凡一切丸散，人所不能辨其中为何药者，赵一嗅而知之，历试不爽，殆与离娄之明、易牙
之舌，皆为天畀之独也。生平长于治痘，痘始萌，一望已知其结局，虽极危之证，治之无不收功。自云一生疗
痘，无药不用，而从未有用附子者。并识之，以质治痘名家。
开物成务之圣人，悯民疾苦，救其夭札，而垂以药治病之教，诚辅相裁成之大道也。乃秦政、汉武，穷奢
极欲，妄求不死，于是方伎进、邪说兴焉。故今世所传《神农本草经》、《黄帝内经》等书，皆有方伎之言附
会其中，如轻身不老、久服延年等语是也。即班氏《艺文志》亦承其陋，谓方伎之别有四∶曰医经，曰经方，
曰房中，曰神仙。夫医理经方，皆圣王康济苍生之术，岂可与房中、神仙之邪说并列为方伎哉！后人惑之，沦
于杂学，幸天纵长沙，集医经、经方之大成，置房中、神仙于不论，炎黄大道，赖以复明。于戏！此其所以为
医圣也。或老年血气衰弱，精力不充，藉药饵以佐谷肉果菜所未逮，亦人子竭力孝养之一端，固未可尽非焉。
但弗惑于邪说，妄求长生而服金石等药，以速其死耳。古书惟《元和纪用经》以不用桂、附、石药者为上丹，
犹为近理，故首录其方于下。
上丹 平补气血，健力加餐。
北五味（八两，夏月再加四两） 百部（酒宿浸焙） 菟丝子（酒宿浸焙） 淡肉苁蓉（酒浸各二两，四
季土旺，苁蓉再加六两） 杜仲（炒） 巴戟肉 远志肉（各二两，冬月远志再加六两） 甘枸杞（二两，秋
月再加六两） 防风（无叉枝者） 白茯苓 蛇床子（炒） 柏子仁（另研） 干薯蓣（各二两）
上十三味，用甘泉、桑柴火、砂锅，煎至味尽去滓，将
药汁慢火熬成膏，瓷器收盛。封置泥地或冷水中拔去火气。每晨淡盐汤调服数钱，春月用枣汤化服。
（注）医书有肥儿丸，无养老方，可见人情之浓于慈、薄于孝，故《韩氏医通》尝三叹焉。先府君年逾大
耋，神明不衰，虽知医而素不服药，独谆谆以养老为言。夫良医不治老，老岂能治之转少哉？然药以扶老，使
之康健而少病，未始非怡清养志之先务，虽以药扶老，实以孝治人耳。上丹本是丸方，恐老人脾气不健，运化
殊难，改丸为膏，俾易融洽。酒宿浸者，酒浸一宿也。
集灵膏 人年五十，阴气先衰，老人阴亏者多，此方滋养真阴，柔和筋骨。
西洋参（取结实壮大者，刮去皮，饭上蒸九次，日中晒九次） 甘杞子 怀牛膝（酒蒸） 天冬 麦冬
怀生地 怀熟地 仙灵脾
上八味，等分，熬成膏，白汤或温酒调服。
（注）此方始见于《广笔记》，无仙灵脾，云出内府，又载于《治法汇》，并无牛膝。方后法血虚加当归
四两，脾弱加白术四两或八两。且云治一切气血两虚，身弱咳嗽者，罔不获效。凡少年但觉气弱倦怠，津液少
，虚火上炎，急宜服之，免成劳损。后惟魏玉横先生善用此方，《续名医类案》极言其功效。愚谓即人参固本
加味也，峻补肝肾之阴，实无出此方之上者。原方用人参，近年参价甚昂，非大力者不能致，易以西洋
参，可与贫富共之矣。方名“集灵”，则以有仙灵脾者为是。《理虚元鉴》治劳嗽，于原方去参、膝，加甘、
桔、元参。
（刊）如治阴虚遗带，宜去牛膝，加黄柏。凡便滑者，亦宜
去牛膝，重加生薏苡仁。
草灵丹 老人阳气偏虚，便溺不禁者，用此温补下元，可以耐冷。
茅山苍术（泔水浸，刮去皮，饭锅上酒蒸透） 川椒红（各四两） 怀熟地 干薯蓣（各三两） 炙甘
草茯苓（各二两） 茴香（二两盐水炒） 川乌（制一两）
上八味，将六味研细末，以熟地杵膏、薯蓣煮糊，共杵丸，梧子大。每三十丸，空心淡盐汤下，以干食物
压之。
（注）脾肾两亏，内挟寒湿者，此方宜方。若阴虚火盛之人，不可服也。
十灰散 治吐血、咯血、嗽血，先用此药止之。
大蓟 小蓟 荷叶 扁柏叶 茅根 茜根 栀子 大黄 丹皮 棕榈皮
上十味，等分烧灰存性，研极细末，以纸包置泥地上一夕出火气。每服五钱，藕汁或芦菔汁或京墨汁半碗
调服。
（注）按原注云∶吐血者竞推葛氏，而先生首以此方止血，明明劫剂，毫无顾忌，细玩始知先生意之到、
理之精也，人生于阳，根于阴，阴气亏则阳自胜，上气为之喘促，咳吐痰沫，发热面红，无不相因而至，故留
得一分自家之血，即减得一分上升之火，易为收拾。何今日之医动以引火归经为谈，不可概用止血之味，甚至
有吐出亦美，壅反为害，遂令迁延时日，阴虚阳旺，煎熬不止。至于不救。果谁之咎？执引经而缓时日，冀复
元神，吾恐有形之血岂能使之速生，而无偶之阳何法使之速降？此先生所以急于止血之大旨也。
（刊）诸药烧黑，皆能止血，故以“十灰”名其方。然止涩
之品仅棕榈一味，余皆清血之热、行血之滞、破血之瘀者，合以为剂，虽主止血而无兜涩留瘀之弊，雄每用之
，并无后患，何可视为劫剂乎？
太平丸 治久嗽肺萎肺痈。
天冬 麦冬 知母 川贝母 款冬花（各三两） 杏仁 当归 熟地 生地 黄连（各一两五钱） 蒲
黄京墨 桔梗 薄荷（各一两）
上十四味，研细末和匀，以白蜜四两，于银石器中炼熟，再入黑驴皮胶一两五钱，俟烊后下诸药末搅匀，
再入麝香少许，熬二、三沸，即丸弹子大。食后细嚼一丸，薄荷汤缓缓化下。临卧噙此丸仰卧，使药流入肺窍
，则肺清嗽减。凡咳嗽服此，七日自痊。
（注）肺居膈上，汤药荡涤宜下，已过病所，宜乎难效，此噙化法之所以妙也。后庄一生治气郁痰凝，胸
膈痞塞，用人参、贝母、苦参、沉香、薄荷，为末蜜丸，噙口中听其自化，徐徐沁入。可谓善得师者。
润肺膏 治久嗽肺燥肺萎。
羊肺（一具） 杏仁（净研） 柿霜 真酥 真粉（各一两） 白蜜（二两）
上将羊肺洗净，次将五味入水搅粘，灌入肺中，白水煮熟，如常服食。
One must distinguish and treat accordingly. One should not, due to the influence of Buddhism (Shi) and Daoism (Lao), generally regard monks and priests as belonging to a different category. There are indeed eccentric and reclusive individuals who, feeling bored or unappreciated, hide themselves within these religious communities.
Strange diseases occasionally occur; one cannot claim that ancient texts are entirely false. Even the bizarre manifestations of ordinary diseases may be unrecorded in ancient books. To find strange what one has rarely seen is ignorance; to pretend to know what one does not know is presumption. Being neither ignorant nor presumptuous qualifies one to be a renowned physician.
(Note): Disease presentations are strange and changeable. What is recorded in ancient texts is sometimes seen; what is not recorded is sometimes heard of. This is because the creative power of nature is unfathomable, and the pathogenesis of disease is infinite.
(Collation): *History of Song* records that Lü Xiaqing suffered from a strange disease where his body gradually shrank, and at death he was only the size of a child. Other books also record this condition. Reasoning logically, such a person likely consumed many hot medicines like cinnabar and stone minerals regularly, causing the shrinkage. Dou Cai's claim that this condition should be treated with cinnabar and Aconite (*Fuzi*) is most absurd.
(Publication): Liang Yinglai stated: My uncle-in-law Ge Qiutian suffered from consumption (*Zhai*), and upon death, his body and head had shrunk, a condition named "Bone-Shrinking Consumption" (*Suogu Lao*). Thus, this condition exists in modern times. Dou Cai was a reckless man, boasting of being Bian Que reborn. His work *Bianque Xinshu* (*Heart Book of Bianque*) exclusively advocates mineral drugs, deceiving the world for fame and harming people significantly. Later, Chen Yuan Gong wrote *Shishi Milu* (*Secret Records of the Stone Chamber*). His discussions and prescriptions were quite reasonable, yet he followed Dou Cai's old path, falsely claiming endorsement by Xuanyuan, Qibo, and Zhang Zhongjing, insulting sages and fooling fools, thereby earning ridicule from later generations. Mao Dakai once sighed over this. Recently, I saw the *Haishan Xianguan Congshu* published by the Pan family of Panyu, which included three volumes of gynecological texts. The prose was crude and plagiarized heavily, falsely attributed to Mr. Fu Qingzhu's secret manuscripts. Mr. Pan, lacking medical knowledge, mistakenly believed and printed them, disgracing Mr. Qingzhu. Ignorant and reckless acts are hardly worth discussing, but it is incomprehensible how someone with Chen Yuan Gong's learning would resort to ghosts and gods. Furthermore, Wang Yangwu stole Guo Shi's *Shazhang Yuheng* (*Jade Balance for Sha Distension*), claiming it was secretly taught by hermits in deep mountains, and arranged its original formulas into the sixty-four hexagrams, which harmed the original author. Shen Qianlü, without investigation, included it in *Zunsheng Ji*, and He Danliu, deceived, reprinted it. Although the case is unsolved, gentlemen lament it.
When physicians examine patients and differentiate syndromes, the most crucial aspect is to concentrate their spirit and stabilize their qi. For example, Zeng Shirong treated the headache and red forehead of the son of Commander Wang on a boat. Various treatments failed, and the boy cried loudly whenever moved. Upon careful examination, Zeng discovered a small bamboo splinter from the boat canopy had pierced the skin above the anterior fontanelle. Removing it with tweezers cured him immediately. If one does not examine carefully and treats rashly, I fear the physician will lack depth in their art, and the patient will suffer unnecessary costs.
(Note): Concentrating spirit and stabilizing qi can only be achieved by those who are cautious yet bold. Bearing humiliation and heavy responsibility can only be achieved by those who are wise and upright. Without these qualities, one cannot be a renowned physician. When facing a major critical illness, if one's knowledge is insufficient, one should recommend a capable colleague rather than forcing oneself to act and failing. If one's knowledge is sufficient, but colleagues have differing views—some arguing, some confusing listeners with rhetoric, some conspiring to exclude—one must also deal with the preferences of relatives and friends, and the suspicion or trust of clansmen. Some may be warmly concerned, while others rejoice in disaster. If the prescribed medicine gradually takes effect, public criticism will cease; if the condition fluctuates slightly, everyone will criticize. At such times, if one lacks broad moral integrity and leaves resentfully, handing the patient to an incompetent doctor and watching them perish, is this not abandoning human life lightly? Moreover, after failure, there will inevitably be blame. Therefore, without a concentrated and stable mind, one cannot discern difficult and dangerous syndromes; without tolerance and endurance, one cannot bear the heavy responsibility of rescuing the critically ill. Those with no knowledge, who do not understand gravity, throw medicines around blindly, and seek only profit, are shameless scoundrels and cannot be compared to those who bear humiliation and responsibility.
(Collation): Long'er once suffered from swelling and pain in his toe. His wife was away caring for her mother-in-law, and the surgeon's treatment worsened the condition, causing the child to cry day and night. Upon returning, his wife washed off the applied medicine and examined closely, discovering a single hair from a haircut had pierced the nail bed. It was midsummer, and the child frequently took off socks; the hair must have fallen into the shoe. Removing it with tweezers cured him. This is similar to Zeng's case.
(Publication): If a foreign body is not removed and is treated with mistaken medications, the consequences in the head are slightly less severe, but in the toe, it will certainly lead to ulceration, necrosis, and amputation. My mother possessed exceptional hearing and vision, remaining sharp until old age. She was adept at understanding human feelings, treating elders and juniors with joy and gratitude. Her cooking and preparation of medicinal decoctions were meticulous. Whenever serious illnesses occurred among relatives, she was invited to preside over the treatment, so she had deep experience with disease conditions and drug properties. Before I came of age, I read *Jingyue Quanshu* (*Complete Works of Jingyue*) and admired it, often imitating its treatment methods when encountering cases. My mother sternly warned me: "If your faith in the Way is not firm and you are swayed by different ideas, will you become a killer? I have experienced many disease conditions. Regardless of external contraction, one must not recklessly use warming and tonifying herbs. Even for internal injury, one must first determine the nature of the injury and treat that first. Then the disease will leave, and the primordial qi will recover. The ancients did not say 'internal deficiency' but 'internal injury'; by name and meaning, pure deficiency is rare. Why are you so confused?" Hearing this instruction, I gradually gained clarity and resolve. For thirty years, although I cannot bring the dead back to life, I have not turned living patients into dying ones, thanks to my mother's enlightenment. Publishing this case now, I cannot help but feel longing for my parent.
Tonifying pill medicines are hardest to digest. Those with weak spleen and stomach should never take them lightly. Mr. Xiangyan said: Shen Chiwen from Huzhou, just coming of age, was bright and studious, loved by his parents like a pearl. Just before his marriage, he and three other young men shared a dose of Quanlu Wan (*Whole Deer Pill*). Chiwen took it from winter into early spring, then suddenly suffered whole-body pain resembling gout, progressing to abdominal pain with palpable lumps in the intestines, loss of appetite, and emaciation. Various doctors treated him, but his father feared using digestive and clearing-fire herbs, relying solely on Ginseng (*Renshen*) and Atractylodes (*Baizhu*) tonics. In early autumn, he invited me to consult. I asked: "Does the child pass a fist-sized black stool at night? Is his body burning hot now, desiring well water?" I felt his pulse: rapid and large. His body was skeletal. Examining the passed lump, it was black and hard, suggesting blood stasis. I gave him two qian of Jiu Zheng Dahuang Wan (*Wine-Steamed Rhubarb Pill*). He passed numerous black lumps; soaking one in water made it swell like a black soybean. Detailed inquiry revealed the cause: the Quanlu Pill had not digested. Realizing the error, he died of extreme heat within days. Of the three youths who took it together, one died of throat obstruction (*Houbi*), one of anal toxicity, and one of hemoptysis and cough. These are harms of taking warming tonics without illness. Recording this to advise people not to love tonics and take medicine unnecessarily.
(Note): People love their children, worrying initially about their growth, feeding them silk and meat to force growth (like pulling shoots to help them grow). Later, worrying about their weakness, they make pills and medicines daily meals. They take Ginseng (*Renshen*) on festivals and when tired, breeding disease and chronic fatigue, half due to this. Though called love, it is actually harm. I suggest wealthy families: why not spend the money used on Ginseng taken year-round without illness, hire a doctor to prepare medicine, and give it to the poor and sick? Retribution is sure. Then our descendants will naturally be healthy and auspicious, without needing to worry about weakness or moan without illness. How beautiful!
Mr. Xiangyan had many flexible methods for treating smallpox. Once, seeing a mulberry-picking woman from his sedan chair, he ordered the carriers to embrace her. The woman cursed angrily, and her husband tried to beat the carriers. Mr. Xiangyan explained: "Your wife's smallpox is between the skin and membrane, blocked by stagnant qi and unable to erupt. I deliberately angered her to promote eruption tonight; otherwise, it will be fatal." It proved true. Another rich family's son had closed smallpox; doctors were helpless. Mr. Xiangyan ordered ten new, clean lacquered tables. The naked child lay on them, and Mr. Xiangyan rolled him back and forth. When the table heated up, it was replaced. After many repetitions, the smallpox erupted vigorously at night, saving the child. Again, Mr. Xiangyan's grandson, aged one, had closed smallpox. The mother brought him for rescue. Mr. Xiangyan observed the adverse signs, pondered for a long time, then locked the naked child in an empty room, forbidding his daughter from entering. At nightfall, he emerged; the smallpox had covered the body like pearls. Because the empty room had many mosquitoes, their bites helped induce eruption. Also, Wang Yimei, a clerk in a cloth shop, suffered from closed smallpox in his prime. Doctors could not handle it. Mr. Xiangyan ordered chicken feces mixed with strong wine into a paste, applied all over the body, face, hands, and feet. Overnight, the chicken dung dried, cracked, and fell off, and the smallpox had erupted. These are divine and insightful treatments, recorded to inspire wisdom. However, inducing eruption by anger addresses qi closure; rolling on lacquered tables addresses fire closure; mosquito bites address blood closure; applying chicken dung addresses cold closure. Although external treatments, they have subtle distinctions. Imitators must examine carefully.
(Collation): Above discusses treatment cases.
(Publication): Xu Huixi said: Smallpox changes with the times, not only differing across dynasties but also having minor variations every few decades. I believe smallpox often erupts triggered by seasonal pathogens. Wan Mizhai mentioned this, and Wang Qingren discussed it. Thus, there are significant differences even within one or two years. Smallpox includes epidemic smallpox and regular smallpox. Pediatricians sticking to ancient methods can only treat regular smallpox. This is why Jianzhong's *Suoyan* (*Trivial Words*) offers good methods to correct biases. Later generations, not understanding this, criticize the liberal use of Gypsum (*Shigao*) and Rhubarb (*Dahuang*) as biased, saying it only corrects the bias of habitual heat-drug use. Is this truly knowing the person and their era? But when smallpox carries epidemic pathogens, Fei Yi's methods are indispensable. Regrettably, pediatricians rarely read his book, failing to recognize the etiology, leading to mass deaths across villages, blaming fate. Is it really so? My mother suffered from smallpox in childhood. Though sparse on the head and face, it was dense all over the body, purple-black, scorched, and dry. Doctors were helpless. Old Doctor Bao Shian said: "This is called Snail Carbuncle Smallpox (*Luoding Dou*). Using multiple doses of Rhubarb and Gypsum showed no improvement. She was dying, hope lost." Coincidentally, a relative sent an old woman surnamed Chen to visit. Seeing the case, she said: "It can still be treated." She quickly used silver needles to prick each smallpox pustule the size of a black bean, sprinkled Zhenzhu Babao Dan (*Pearl Eight-Treasure Powder*), and sealed it externally with Zhu Yangxin's Biyu Gao (*Jasper Ointment*). The patient could eat porridge and survived without further medicine. Director Yang Suyuan from Dingzhou said: Zhao Gongfu from Fuping was profound in medicine. For any pills or powders, others couldn't identify the ingredients, but Zhao knew by smell alone, always accurate. Like Llou's keen eyes or Yi Ya's sensitive tongue, it was a unique heavenly gift. He specialized in smallpox. From the first bud, he could foresee the outcome. Even in critical cases, treatment succeeded. He claimed to have used every medicine in his life but never Aconite (*Fuzi*). I record this to consult smallpox experts.
The sage who opens things and accomplishes affairs, pitying people's suffering and saving them from premature death, left teachings on using medicine to cure diseases. This is indeed the great way of assisting heaven and earth in nurturing creation. However, Qin Shi Huang and Han Wu Di, indulging in luxury and desire, sought immortality wildly. Thus, artisans advanced, and heretical theories arose. Therefore, transmitted texts like *Shennong Bencao Jing* (*Divine Farmer's Materia Medica*) and *Huangdi Neijing* (*Yellow Emperor's Inner Canon*) contain artisanal additions, such as "lightening the body," "not aging," and "longevity with prolonged use." Even Ban Gu's *Yiwenzhi* (*Treatise on Literature*) inherited this prejudice, classifying arts into four: Medical Classics, Classic Prescriptions, Bedroom Arts, and Immortals. Medical classics and classic prescriptions are techniques of sage kings to save the people. How can they be listed alongside the heresies of bedroom arts and immortals? Later generations were confused, falling into miscellaneous studies. Fortunately, Heaven endowed Changsha (Zhang Zhongjing) with the greatness of integrating medical classics and classic prescriptions, disregarding bedroom arts and immortals. The Great Way of Yan and Huang was thus revived. Alas! This is why he is the Sage of Medicine. Or, for elderly people with declining blood and qi and insufficient energy, using medicine to supplement grains, meats, fruits, and vegetables is one aspect of filial piety. It is not entirely wrong. But one must not be confused by heresies, seeking immortality by taking metal and stone drugs, which accelerates death. Among ancient books, only *Yuanhe Jiyong Jing* considers formulas without Cinnamon Twig (*Guizhi*), Aconite (*Fuzi*), or mineral drugs as "Upper Elixir" (*Shangdan*), which is reasonable. So, I record its formula below.
**Upper Elixir (*Shangdan*)**: Balances and tonifies qi and blood, strengthens strength, and increases appetite.
* Schisandra Berry (*Beiwuweizi*) (8 liang, add 4 liang in summer)
* Stemona Tuber (*Baibu*) (soaked in wine overnight, baked)
* Dodder Seed (*Tusizi*) (soaked in wine overnight, baked)
* Cistanche Stem (*Dan Rongcongrou*) (soaked in wine, 2 liang each; during Earth months of four seasons, add 6 liang of Cistanche)
* Eucommia Bark (*Duzhong*) (stir-fried)
* Morinda Root (*Bajirou*)
* Polygala Root (*Yuanzhi rou*) (2 liang each; in winter, add 6 liang of Polygala)
* Goji Berry (*Gan Gouqi*) (2 liang; in autumn, add 6 liang)
* Saposhnikovia Root (*Fangfeng*) (without forked branches)
* Poria (*Bai Fuling*)
* Cnidium Fruit (*Shechuangzi*) (stir-fried)
* Biota Seed (*Baizi ren*) (separately ground)
* Yam (*Gan Shuyao*) (2 liang each)
Thirteen ingredients above. Use sweet spring water and mulberry wood fire in a clay pot. Decoct until flavor is exhausted, remove dregs. Slowly boil the decoction into an extract. Store in porcelain. Seal and place in mud or cold water to remove fire qi. Take several qian mixed with light salt soup every morning. In spring, dissolve with jujube soup.
(Note): Medical books have *Fei'er Wan* (*Child-Fattening Pill*) but no geriatric formulas. This shows human affection is thicker towards mercy/love for the young and thinner towards filial piety for the old. Hence, *Han Shi Yi Tong* (*General Knowledge of Medicine by Han*) sighs three times. My late father lived past eighty, with undiminished spirit. Though knowledgeable in medicine, he never took medicine himself, only earnestly advising on geriatric care. Good doctors do not treat the old; how can the old treat themselves to regain youth? However, medicine to support the elderly, keeping them healthy and less sick, is a primary task for cultivating peace and filial intent. Although using medicine to support the old, it is essentially governing people through filial piety. *Shangdan* is originally a pill formula. Fearing the elderly spleen and stomach are weak and digestion is difficult, it is changed to an extract for easier assimilation. "Soaked in wine overnight" means soaked in wine for one night.
**Jiling Gao (*Gathering Spirit Extract*)**: At age fifty, yin qi declines first. Elderly people often have yin deficiency. This formula nourishes true yin and softens sinews and bones.
* American Ginseng (*Xiyangshen*) (choose solid and large ones, scrape skin, steam nine times over rice, sun-dry nine times)
* Goji Berry (*Gan Qizi*)
* Achyranthes Root (*Huainiuxi*) (wine-steamed)
* Asparagus Tuber (*Tiandong*)
* Ophiopogon Tuber (*Maidong*)
* Rehmannia Root (*Huai Shengdi*)
* Prepared Rehmannia Root (*Huai Shudi*)
* Epimedium Herb (*Xianlingpi*)
Eight ingredients above, equal parts. Boil into an extract. Take with plain water or warm wine.
(Note): This formula first appeared in *Guang Biji*, without Epimedium, said to come from the imperial palace. It was also recorded in *Zhifa Hui*, without Achyranthes. The post-formula notes: add Angelica Sinensis (*Danggui*) 4 liang for blood deficiency; add Atractylodes Macrocephala (*Baizhu*) 4 or 8 liang for weak spleen. It also states it treats all qi and blood dual deficiency, weak body, and cough, with universal efficacy. Whenever youths feel weak, fatigued, low in fluids, with deficient fire flaming upward, they should take it urgently to prevent consumptive disease. Later, only Mr. Wei Yuheng skillfully used this formula. *Xu Mingyi Leian* (*Continued Cases of Famous Physicians*) praises its efficacy greatly. I consider this Ren Shen Gu Ben Tang (*Ginseng Solidify the Root Decoction*) with modifications. It fiercely tonifies liver and kidney yin; nothing surpasses this formula. The original formula uses Ginseng (*Renshen*). Recently, Ginseng prices are very high, inaccessible to most. Replacing it with American Ginseng makes it accessible to both rich and poor. The name "Jiling" (*Gathering Spirit*) is because it contains Epimedium (*Xianlingpi*). *Lixu Yuanjian* (*Original Mirror for Consumptive Diseases*) treats consumptive cough by removing Ginseng and Achyranthes from the original formula, adding Licorice (*Gancao*), Platycodon (*Jiegeng*), and Scrophularia (*Yuanshen*).
(Publication): For treating yin deficiency with spermatorrhea and leukorrhea, remove Achyranthes and add Phellodendron Bark (*Huangbai*). For loose stools, also remove Achyranthes and heavily add Coix Seed (*Sheng Yiyiren*).
**Caoling Dan (*Grass Spirit Pill*)**: Elderly people often have yang deficiency, leading to urinary incontinence. Use this to warm and tonify the lower origin, enabling cold tolerance.
* Atractylodes Lancea (*Maoshan Cangzhu*) (soaked in rice water, scrape skin, steam thoroughly with wine in a rice cooker)
* Sichuan Pepper Red (*Chuanjiao hong*) (4 liang each)
* Prepared Rehmannia Root (*Huai Shudi*)
* Yam (*Gan Shuyao*) (3 liang each)
* Honey-fried Licorice Root (*Zhi Gancao*)
* Poria (*Fuling*) (2 liang each)
* Fennel Seed (*Huixiang*) (2 liang, stir-fried with salt water)
* Processed Aconite Root (*Chuanwu*) (1 liang)
Eight ingredients above. Grind six ingredients into fine powder. Mash Prepared Rehmannia into a paste, boil Yam into a paste. Mix all and form pills the size of wutong seeds. Take thirty pills on an empty stomach with light salt soup, pressing down with dry food.
(Note): Suitable for spleen and kidney dual deficiency with internal cold-dampness. Not suitable for those with yin deficiency and vigorous fire.
**Shihui San (*Ten Ashes Powder*)**: Treats hematemesis, hemoptysis, and coughing blood. Use this medicine first to stop bleeding.
* Great Thistle Root (*Daji*)
* Small Thistle Root (*Xiaoji*)
* Lotus Leaf (*Heye*)
* Biota Top (*Bai Baiye*)
* Imperata Rhizome (*Maogen*)
* Rubia Root (*Qian Gen*)
* Gardenia Fruit (*Zhizi*)
* Rhubarb Root (*Dahuang*)
* Moutan Cortex (*Danpi*)
* Palm Fiber (*Zonglupi*)
Ten ingredients above, equal parts. Charcoalize to retain nature, grind to extremely fine powder. Wrap in paper and place on mud for one night to remove fire qi. Take 5 qian mixed with half a bowl of lotus root juice, radish juice, or Beijing ink juice.
(Note): According to the original note: For hematemesis, Ge Hong's methods are preferred, but Mr. Xiangyan prioritizes this formula to stop bleeding. It is clearly a drastic agent (*jie ji*), without hesitation. Careful study reveals the precision of his intent and logic. Humans are born from yang, rooted in yin. Yin deficiency leads to yang excess. Upper qi causes panting, coughing frothy sputum, fever, and red face, all following sequentially. Thus, retaining one part of one's own blood reduces one part of rising fire, making it easier to manage. Why do today's doctors talk endlessly about "guiding fire back to its source" and refuse to use general hemostatics? Some even think vomiting is good, believing stagnation causes harm, delaying time, leading to yin deficiency and yang hyperactivity, endless frying, and untreatable conditions. Whose fault is it? Clinging to meridian-guiding herbs and delaying time, hoping to restore primordial yuan, I fear how can solid blood be generated quickly, and how can unpaired yang be lowered quickly? This is Mr. Xiangyan's main point in urgently stopping bleeding.
(Publication): All medicines charred black can stop bleeding, hence the name "Ten Ashes." However, among astringents, only Palm Fiber (*Zonglupi*) is one. The rest clear blood heat, move blood stasis, and break blood clots. Combined, although primarily stopping bleeding, they avoid the drawback of astringency leaving stasis. I use it often with no sequelae. How can it be considered merely a drastic agent?
**Taiping Wan (*Peace Pill*)**: Treats chronic cough, lung atrophy, and lung abscess.
* Asparagus Tuber (*Tiandong*)
* Ophiopogon Tuber (*Maidong*)
* Anemarrhena Rhizome (*Zhimu*)
* Fritillaria Bulb (*Chuan Beimu*)
* Coltsfoot Flower (*Kuandonghua*) (3 liang each)
* Apricot Seed (*Xingren*)
* Angelica Sinensis (*Danggui*)
* Prepared Rehmannia Root (*Shudi*)
* Raw Rehmannia Root (*Shengdi*)
* Coptis Rhizome (*Huanglian*) (1.5 liang each)
* Polygonum Knotweed Rhizome (*Puhuang*)
* Beijing Ink (*Jingmo*)
* Platycodon Root (*Jiegeng*)
* Mint (*Bohe*) (1 liang each)
Fourteen ingredients above. Grind to fine powder and mix evenly. Refine 4 liang of white honey in a silver or earthenware vessel. Add 1.5 liang of Black Donkey-hide Gelatin (*Ejiao*). After melting, add herb powder and stir. Add a little Musk (*Shexiang*). Boil two or three times. Form pills the size of弹子 (bullet seeds). After meals, chew one pill slowly, dissolving with mint soup. Before sleep, hold the pill in the mouth while lying supine, allowing medicine to flow into lung orifices, clearing lungs and reducing cough. For any cough, taking this cures in seven days.
(Note): The lung resides above the diaphragm. Decoctions wash downwards, passing the disease site, making them less effective. This is why the method of holding the pill in the mouth (*qinhua*) is wonderful. Later, Zhuang Yisheng treated qi stagnation and phlegm condensation causing chest fullness with Ginseng (*Renshen*), Fritillaria (*Beimu*), Sophora Root (*Kushen*), Aquilaria Wood (*Chenxiang*), and Mint (*Bohe*), formed into honey pills. Held in the mouth to dissolve naturally, seeping in slowly. One could say he was a good disciple.
**Runfei Gao (*Moisten Lung Extract*)**: Treats chronic cough, lung dryness, and lung atrophy.
* Sheep Lung (one piece)
* Apricot Seed (*Xingren*) (cleanly ground)
* Persimmon Frost (*Shishuang*)
* True Butter (*Zhen Su*)
* True Rice Flour (*Zhen Fen*) (1 liang each)
* White Honey (*Baimi*) (2 liang)
Clean the sheep lung. Mix the five ingredients with water to make sticky. Pour into the lung. Boil in plain water. Eat as usual.