一北平黄教廉女,甫周岁,病久不愈。余视之,瘦弱已极,热仍不退,顷之群医毕集,
俱商用山楂、神曲、荆芥、防风等味,皆消导药也。余窃谓不然,因忆《内经》有云∶实者
泻之,虚者补之。此女瘦弱已极,岂实症乎?然众论哗然,未可与辨。越三日,余又往看视
,黄曰∶我女昨大泻下黄沫,且角弓反张,不知其故?余曰∶此凉药毒也。黄曰∶然。前服
山楂等药不效,复加黄连二分遂剧。前医在侧甚惭,强余立方,余辞之归。次日,黄以众方
请正,余阅之乃五苓散,仍加消导发散之味。彼时,本欲另立一方,又恐医家挠阻,黄亦未
必深信,因就原方加注,剖明某药可用、某药难投,总本张景岳直救真阴之说,黄亦心折,
因谓众医曰∶我女病久,必须滋阴为上,乃大加熟地二钱,连进二剂,其热陡退,病亦渐愈
。缘前此刻削太甚,复元较迟。
一邻友方元兴,有子岁余,常见其持单买药,询之?方曰∶儿病已久,更数医矣,今又
延某医包治,此其药单也。逾数日,泣谓余曰∶某医悔口,子不生矣。君其有术乎?细叩其
故,方曰∶我子体热已久,近日气弱神昏,腹中膨胀,吐泻发喘、两目上视,命在须臾。邀
余往视,见其子囟门下陷,面色青黄,取向日医方阅之。悉是去积、发散、凉血之药,与症
相反。余曰∶得之矣,用理中地黄汤去附子、泽泻、加枸杞、故纸、一剂而安,十余剂而健
壮矣。
一余胞侄,乳名文豹,素甚壮实,周岁疹后,发热兼旬不退,咳嗽时以手扪口,喉痛可
知,后数日昼夜昏睡不醒,因延本地时医,投以清热解表凉药,一剂而热立止,超时体冷彻
骨,热复大作,再投前剂则无效矣。又延他医,投以芩、连、石斛等药,非惟热不能解,且
面色青黄,三阳黑暗,大喘大泻,愈增危笃,医亦束手。余查痘疹诸书,皆云疹系热症,宜
用寒凉,其说亦与症不符,姑用救阴固本平补之药一剂,灌之,悉皆吐出。余顾儿谓余曰∶
腹中作响,风已动矣;喉如鸡声,痰已塞矣;且吃乳即吐,头摇睛泛,气促神昏,两目无光
,面无人色,败症现矣。急请前医,皆裹足不至,遍查各书,俱载疹后发热不退,而头摇睛
泛,吐泻神昏,乃慢脾风不治之症。然亦不忍坐视不救。细思喉中作响必系寒痰。盖缘真阳
外越,寒生于中,如系实火,则前此芩、连之药何至反剧,外虽极热,内实真寒,非用大辛
大热之品,不能冲开寒痰,故前诸药皆吐而不受。因取附子、姜、桂煎汤欲灌,余母曰∶此
儿现下发热,且唇已开裂出血,何可再用附子?余思《内经》云∶假者反之。此症非辛热之
品,终不能引火归源以消寒滞也。虽易去附子,仍改用胡椒一钱,肉桂一钱,炮姜四片,似
觉平淡,以期老母不疑,煎汤灌下,痰声立止。又取伏龙肝冲水灌之,吐亦渐止。少顷儿忽
眼动,呵欠咳嗽时即不以手扪口。又顷,连溺小便,稠浊紫黑,疹后邪毒节次尽下,似有起
色。因用附子理中汤合用六味地黄汤去泽泻、丹皮,加故纸、枸杞,一剂而败症全除。惟大
热未退,乃于前汤内复加枣仁、五味、白芍等敛阴之药,一剂而安。此正《内经》所云∶治
风先治血,及甘温退大热之义也。其后细审,此症咳嗽喉痛,心火烁肺金也,呕吐泄泻,脾
胃虚寒也。用胡椒、姜、桂,所以开涌喉之寒痰也。用灶心土者,补土所以敌木也。木平则
风息,土旺则金生,金既得生,火不能克,则向者克肺之邪火仍反归于心。心为君主之官,
邪不能犯,心与小肠相表里致疹毒传入膀胱,下溺为紫黑色也。余弟云∶此儿疹后发热,误
服凉药,命已不测,得吾兄方药,真不啻起白骨而肉之,实如再生,爰更其名药生,将来即
取字曰佩伯,志不忘也。
一余胞侄钧,守南阳时生一女,偶尔伤食,中州医者必以酒制大黄推荡之,每月一二次
,屡经克伐,至二岁,此女脾胃大伤,瘦弱至极,阴虚夜热,昏睡露睛,忽成慢惊。庸医尚
不知其为不足症,乃以五苓散加黄连四分,下咽即结胸不语,次日毙命。中虚生寒,再进黄
连,未有不毙者。
一余姻亲家人之子,甫二岁,其母已逝,乳母哺之,饮食不调,发黄气短,发热腹胀,
虚弱之形已现。奈医者坚称内热,进以寒凉,吐泻不止,遂成慢惊。有邻人授以《福幼编》
一本,其父与医商,医曰∶小儿纯阳之体,何可用此热药?乃向药包中取出抱龙丸一粒,研
而灌之,尚未灌完,而已毙矣。
一余外甥阎霖家使女,十岁出疹,稠密成片,隐隐不出,三日后绝口不食;卧于西廊,
面无人色,将成慢惊。余二女往彼问及,霖曰∶使女患疹,汤水不入,置之此间,已经二日
,只待气绝,送出埋之。二女曰∶何不于《遂生编》内求方治之!因照大补元煎本方,用附
子一钱,肉桂二钱,浓煎,节次灌之,一剂能食粥一酒杯,二剂脾胃渐健,于是弟减附子,
数剂全愈。倘以疹为热症,进以寒凉,岂能生乎!
一六安广文程公之子,九岁,久病不愈,泄泻抽搐,奄奄一息。医曰∶已成慢惊,虽神
医来此,亦难为力。广文呼号求救,几不欲生。同学宋孝廉,以余向赠之《福幼编》授程,
程阅而疑之。宋曰∶此子已无生理,舍此更无他术,服此温补之剂,或可挽回。仓卒间无肉
桂,遂以桂子四钱,研碎加味理中地黄汤内,如法浓煎,频频与服,二剂惊止,又三剂全愈
。乾隆壬子年,余回六安,宋孝廉亲口言之也。
一裕州刺史徐公独子,十岁,气体本虚,病后大热不退,屡服凉药,泄泻呕吐,角弓反
张,诸症作矣。群医毕至,仍系清热解表,病热更加,万无生理。少府史某者,诣署求见。
司阍曰∶本官有少爷染患慢惊,命悬旦夕,不暇会晤。史曰∶我之来,因慢惊,非公事也。
即延之入。徐曰∶小儿慢惊坏症,医技已穷,君能救之乎?史袖出《福幼编》曰∶此前庄本
府之胞叔所着,专治慢惊,但其方与古书不同,应否与服,堂翁其自主之。徐曰∶着书人断
无孟浪之理,即遵照《编》内之方,不减分毫,用逐寒荡惊汤一剂,喉间寒痰已开,接服理
中地黄汤四剂,惊止热退全愈。余胞弟一鹏,彼时在南阳,已知大略,后史尉至湖北,亲口
言之又详。自丁酉至今二十余年,此《编》愈人愈多,聊记数条,以祛众惑,阅者益可坚信
,无致贻误也。以上见《福幼编》。
A daughter of Huang Jiaolian from Beiping, just one year old, had been ill for a long time without recovery. Upon examination, I found her extremely emaciated, with fever persisting. Soon, many physicians gathered, all prescribing herbs such as Hawthorn Fruit (Shanzha), Medicated Leaven (Shenqu), Schizonepeta (Jingjie), and Saposhnikovia Root (Fangfeng), which are all digestive-promoting agents. I privately disagreed, recalling the statement in *Huangdi Neijing* (Yellow Emperor's Inner Canon): "Excess conditions are treated by purging; deficiency conditions are treated by tonifying." This girl was extremely emaciated; could this be an excess condition? However, the crowd argued loudly, making debate impossible. Three days later, I visited again. Mr. Huang said: "My daughter had severe diarrhea with yellow froth yesterday, and developed opisthotonos (backward arching of the body due to muscle spasm). I do not know why?" I replied: "This is toxicity caused by cold-natured medicines." Mr. Huang said: "Indeed. The previous prescription of Hawthorn and others was ineffective, and adding two fen of Coptis Rhizome (Huanglian) worsened the condition." The preceding physician present felt ashamed and insisted I prescribe a formula. I declined and returned home. The next day, Mr. Huang presented formulas from various doctors for my review. I saw it was Wuling San (Five-Ingredient Powder with Poria), still containing digestive and dispersing herbs. At that time, I wished to prescribe a new formula but feared obstruction by other physicians, and Mr. Huang might not fully trust me. Therefore, I annotated the original formula, clarifying which herbs were suitable and which were not, generally following Zhang Jingyue’s theory of directly saving and tonifying True Yin. Mr. Huang was convinced and told the other physicians: "My daughter has been ill for a long time; nourishing Yin must be the priority." He significantly increased Rehmannia Root (Shudi) to two qian. After two doses, the fever subsided suddenly, and the illness gradually improved. Because previous treatments had been too harsh, recovery was slow.
A neighbor and friend, Fang Yuanxing, had a son over one year old. I often saw him buying medicine with a single prescription. When asked, he said: "The child has been ill for a long time, seeing several doctors. Now another doctor has agreed to treat him exclusively. This is his prescription." Several days later, he wept and told me: "That doctor regretted his promise; my son will not survive. Do you have any method?" Upon detailed inquiry, he said: "My son has had internal heat for a long time. Recently, his qi is weak, spirit is confused, abdomen is distended, vomiting and diarrhea occur with wheezing, eyes roll upward, and life hangs by a thread." I invited myself to examine the child. The fontanelle was sunken, complexion greenish-yellow. Reviewing previous prescriptions, they consisted entirely of accumulation-resolving, dispersing, and blood-cooling herbs, contrary to the symptoms. I said: "I understand the cause." I used Lizhong Dihuang Tang (Regulate the Middle and Nourish Yin Decoction), removing Aconite Root (Fuzi) and Alisma Rhizome (Zexie), adding Goji Berry (Gouqi) and Psoralea Fruit (Guzhi). One dose brought stability; after more than ten doses, the child became robust.
My paternal nephew, nickname Wenbao, was usually robust. After measles at age one, fever persisted for half a month. He coughed frequently, touching his mouth, indicating throat pain. Days later, he slept day and night without waking. A local physician prescribed cooling and exterior-releasing herbs. After one dose, fever stopped, but the body became ice-cold. Fever then surged back; repeating the dose was ineffective. Another physician prescribed Scutellaria Root (Huangqin), Coptis Rhizome (Huanglian), and Dendrobium Stem (Shihu). Not only did the fever not resolve, but the complexion turned greenish-yellow, the three Yang channels appeared dull, severe wheezing and diarrhea occurred, and the condition became critical. Physicians were helpless. Consulting texts on rashes, all stated measles is a heat condition treated with cold herbs, which contradicted the symptoms. I tentatively used a formula to save Yin, secure the root, and gently tonify. It was vomited out immediately. Observing the child, I noted: "Abdominal rumbling indicates wind stirring; chicken-like sound in throat indicates phlegm obstruction; vomiting upon feeding, head shaking, eye rolling, shortness of breath, confusion, dull eyes, and pale face indicate terminal syndrome." I urgently summoned previous physicians, but they refused to come. Consulting books, post-measles fever with head shaking, eye rolling, vomiting, diarrhea, and confusion is identified as Slow Spleen Wind (Man Pi Feng), an untreatable condition. Yet I could not sit idle. Carefully considering, the throat noise indicated cold-phlegm. True Yang had floated outward, generating cold internally. If it were excess fire, why did Huangqin and Huanglian worsen it? Externally hot, internally truly cold. Only large acrid-hot substances could break through the cold-phlegm, explaining why previous medicines were rejected. I prepared a decoction of Aconite Root (Fuzi), Ginger (Shengjiang), and Cinnamon Twig (Rougui) to administer. My mother objected: "The child is febrile, lips are cracked and bleeding; how can Fuzi be used?" Recalling *Neijing*: "Treat false conditions oppositely." This case required acrid-hot substances to guide fire back to its source and eliminate cold stagnation. Although I removed Fuzi, I used Pepper (Hujiao) 1 qian, Cinnamon Bark (Rougui) 1 qian, and Roasted Ginger (Paojiang) 4 slices. Though seemingly mild, this appeased my mother. After administration, phlegm sounds ceased. Dragon Liver Earth (Fulonggan) water was administered, stopping vomiting. Soon, the child moved his eyes, yawned, and coughed without touching his mouth. Urination followed, with thick, turbid, purple-black urine, indicating expulsion of measles toxins. There were signs of recovery. I used Fuzi Lizhong Tang combined with Liuwei Dihuang Tang (Six-Ingredient Pill with Rehmannia), removing Alisma (Zexie) and Moutan Cortex (Danpi), adding Psoralea (Guzhi) and Goji (Gouqi). One dose eliminated the terminal syndrome. Persistent high fever remained, so I added Sour Jujube Seed (Suanzaoren), Schisandra Berry (Wuweizi), and White Peony Root (Baishao) to astringe Yin. One dose brought peace. This aligns with *Neijing*: "To treat wind, first treat blood," and the principle of using sweet-warm herbs to reduce great heat. Later analysis showed: cough and sore throat resulted from Heart Fire scorching Lung Metal; vomiting and diarrhea resulted from Spleen-Stomach deficiency-cold. Pepper, Ginger, and Cinnamon opened cold-phlegm in the throat. Dragon Liver Earth supplemented Earth to control Wood (Liver). When Wood is peaceful, wind ceases; when Earth is prosperous, Lung Metal is generated. With Lung Metal supported, Heart Fire cannot attack it, returning to the Heart. As the Monarch organ, the Heart repels pathogens. Heart and Small Intestine are interior-exteriorly related, allowing measles toxin to enter the Bladder, exiting via urine as purple-black. My brother said: "This child, after measles fever, took cooling herbs mistakenly, nearly dying. Your prescription revived him from bones, like being reborn. We renamed him Yaosheng (Medicine Born), courtesy name Peibo, to never forget."
My nephew Jun, while serving in Nanyang, had a daughter. She suffered food stagnation. Central Plains physicians invariably used Wine-processed Rhubarb Stalk (Dahuang) to purge bowels, once or twice monthly. Repeated purgation damaged her Spleen and Stomach by age two. She became extremely emaciated, with Yin deficiency night fever, sleeping with eyes open, suddenly developing Slow Convulsion (Man Jing). Quack physicians failed to recognize this deficiency syndrome, prescribing Wuling San plus 4 fen of Coptis (Huanglian). Upon swallowing, she developed Jie Xiong (Chest Binding) and muteness, dying the next day. Middle Jiao deficiency-cold aggravated by Coptis is fatal.
The son of a relative’s servant, aged two, lost his mother, fed by a wet nurse. Irregular diet caused jaundice, shortness of breath, fever, abdominal distension, and visible weakness. Physicians insisted on internal heat, administering cold herbs. Unstopping vomiting and diarrhea led to Slow Convulsion. A neighbor provided *Fu You Bian*. The father consulted a physician, who said: "Children are pure Yang bodies; how can hot herbs be used?" He took one Bao Long Wan (Dragon-Holding Pill), crushed and administered it. Before finishing, the child died.
My niece Yan Lin’s maid, aged ten, had dense measles that failed to erupt fully. After three days, she refused food. Lying in the west corridor, pale, approaching Slow Convulsion. My daughters asked Yan Lin, who said: "The maid has measles, cannot drink, has been here two days, waiting for death to bury her." Daughters suggested seeking a prescription from *Sui Sheng Bian*. Following Dabu Yuansheng Tang (Great Tonify Origin Decoction) with Aconite Root (Fuzi) 1 qian and Cinnamon Bark (Rougui) 2 qian, concentrated and administered in portions, she ate a cup of porridge after one dose. After two doses, Spleen-Stomach strengthened. Reducing Fuzi, she recovered after several doses. If measles were treated as heat with cold herbs, survival would be impossible!
Son of Cheng Gong, a scholar in Lu’an, aged nine, had chronic illness with diarrhea and convulsions, barely breathing. Physician said: "Slow Convulsion formed; even a divine physician could not help." Cheng cried for help. Classmate Song Xiaolian gave him my previously gifted *Fu You Bian*. Cheng doubted it. Song said: "No hope remains except this warm-tonic approach." Lacking Cinnamon, Song used Cassia Seeds (Guizi) 4 qian, ground and added to modified Lizhong Dihuang Tang. Administered frequently, convulsions stopped after two doses; full recovery after three. In Renzi year of Qianlong era, Song confirmed this to me in Lu’an.
Only son of Xu Gong, Prefect of Yuzhou, aged ten, constitutionally weak. Post-illness persistent high fever, repeated cooling herbs caused diarrhea, vomiting, and opisthotonos. Physicians applied cooling and exterior-releasing methods, worsening the condition. Shi Mou, Vice Prefect, requested audience. Gatekeeper said: "Young master has Slow Convulsion, dying soon, no time for visitors." Shi said: "I come for Slow Convulsion, not official business." Entered, Xu Gong asked: "Medical skill exhausted; can you save him?" Shi presented *Fu You Bian*, authored by his uncle, specifically for Slow Convulsion, differing from ancient texts. Xu Gong agreed to follow it exactly. Using Zhuhan Dangjing Tang (Expel Cold and Shake Off Convulsion Decoction) one dose, throat cold-phlegm cleared. Followed by Lizhong Dihuang Tang four doses, convulsions stopped, fever retreated, full recovery. My brother Yi Peng, then in Nanyang, knew the outline. Later, Shi Wei went to Hubei, detailing this to me. Over twenty years since Dingyou, this book has saved many. Recording these cases dispels doubts. Readers should trust it firmly to avoid errors. Above from *Fu You Bian*.