又次年。患血虚痰多。四肢腰背疼痛。身体难于转侧。至偶感微寒。即气急神昏。家人无不骇甚。二月间。因更衣
受寒。召余诊视。身壮热而神昏。口开气急。脉六部俱浑浑然。洪大而数。余因深知其平日体气。月黄 、当归、川芎、
苏叶、杏仁、葱白、山栀、郁金、贝母、连翘、竹茹等轻散。兼以固表之药。令其服后。助以锅巴汤。盖覆取微汗而解。
如法服之一剂果愈。此乃弃脉弃症。从平日之体气以治也。余尝见虚人患感其邪本轻。医每发散太过。即漏汗不止气
升于上。胸膈窒塞而死者。不可胜数。如前所载汪良翁之案。以体虚误汗。辄致危症蜂起。而如癫狂。亦此类也。书
之以为虚人不可发汗之戒。
鄂记绸庄内。某太太。十月间患冬温。十余日不解。医或发表。或温燥。失于清理。以致邪传阳明。大热气喘。身
发白 。与疹夹杂。诊其脉浑浑然。模糊不清。余主阳明透达清解之方。用羚羊角、人中黄、连翘、山栀、贝母、银花
等轻剂。次日早晨。追请甚急。余即往视。疹 已退。大便已解。热清而喘逆特甚。诊其脉大而空。面赤如装。余曰。
此邪去而正欲与之俱脱也。书人参、生附子各三钱。炙甘草、干姜各一钱。五味子五分。急令煎服勿迟。嘱其嗣君曰。
至申酉时大汗一出。当即亡阳矣。趁此未汗。尚可挽救。彼与一医商之。不以为然。交申时汗果大出。始信余言不谬。
急去兑参。已暴脱矣。合家懊悔复何及耶。
又过了一年。有一位患者，患有血虚且痰多，四肢、腰背部疼痛，身体难以转动侧身。每当偶然感受轻微寒气，就会出现气急和神志昏迷的症状，家人们无不感到极度惊恐。二月间，因为如厕时受寒，便请我诊治。当时患者身体高热且神志昏迷，口张气促，六部脉象都呈现浑浑噩噩、洪大且数的特征。因为我深知她平素的体质状况，所以使用了月见草（此处疑为“月季”或特定草药，依原文保留）、当归、川芎、苏叶、杏仁、葱白、山栀、郁金、贝母、连翘、竹茹等药物进行轻宣疏散，同时兼用固表止汗的药物。嘱咐服药后，饮用锅巴汤，并加盖被子以取得微汗而病解。按照这种方法服用一剂果然痊愈。这是舍弃当下的脉象和症状，而从平素体质来治疗的方法。我曾见过体虚之人患外感，邪气本来很轻，但医生发散太过，导致漏汗不止，气逆于上，胸膈堵塞窒息而死的情况，这样的例子不可胜数。如前文所载汪良翁的案例，因体虚误用发汗法，立刻导致危症蜂起，甚至出现像癫狂一样的症状，也是这一类情况。写下这些作为体虚之人不可轻易发汗的警戒。
鄂记绸庄内的一位太太，十月间患上冬温（冬季发生的温病），十多天病情未解。医生有的用发表法，有的用温燥法，失于清理调理，以致邪气传入阳明经，出现大热、气喘，身上发出白色疹点（白㾦），与红色皮疹夹杂。诊察其脉象浑浑噩噩，模糊不清。我主张使用阳明经透达清解的方剂，用了羚羊角、人中黄、连翘、山栀、贝母、银花等轻剂。第二天早晨，家属紧急追请我去诊治。此时白㾦已退，大便已通，热势已清但气喘反而特别严重。诊察其脉象大而空，面色红赤如同化妆一般。我说：“这是邪气已去，正气也随之欲脱。”于是开具人参、生附子各三钱，炙甘草、干姜各一钱，五味子五分，急忙令其煎服不要延迟。并嘱咐她的继子说：“到了申时、酉时（下午3点至7点）如果大汗一出，就会立即亡阳死亡。趁现在还未出汗，还可以挽救。”那位继子与另一位医生商量，认为不对。等到交申时，果然大汗淋漓，这才相信我的话没有错。急忙去买兑参（人参），但人已暴脱了。全家懊悔又有什么用呢。
The following year, a patient suffered from blood deficiency with excessive phlegm, pain in the four limbs and lower back, and difficulty turning or shifting her body. Whenever she was exposed to slight cold, she would experience shortness of breath and coma, causing great alarm among her family members. In February, after catching a cold while using the toilet, she summoned me for consultation. She presented with high fever and coma, open mouth with rapid breathing, and a pulse that was indistinct, surging, large, and rapid in all six positions. Knowing well her constitutive state, I prescribed light dispersing herbs such as Oenothera biennis (Yuejiancao), Angelica sinensis (Danggui), Ligusticum chuanxiong (Chuanxiong), Perilla leaf (Suye), Apricot seed (Xingren), Scallion white (Congbai), Gardenia (Shanzhi), Curcuma aromatica (Yujin), Fritillaria (Beimu), Forsythia (Lianqiao), and Bamboo shavings (Zhuru), combined with herbs to consolidate the exterior. After taking the medicine, she was instructed to drink rice crust soup and cover herself to induce a slight sweat for resolution. Following this method, one dose resulted in a cure. This case illustrates treating based on the patient's constitutive state rather than discarding the pulse and symptoms. I have often seen patients with deficiency contracting exogenous pathogens where the pathogen is mild, but physicians over-disperse, leading to uncontrollable sweating, rising qi, chest oppression, and death. Such cases are countless. As recorded in the case of Wang Liangweng mentioned earlier, improper sweating in a deficient person immediately led to critical conditions resembling mania. These writings serve as a warning against sweating in deficient individuals.
A lady from the Ebu Silk Shop contracted Winter-Warmth (Winter Warm Disease) in October, which persisted for more than ten days without resolution. Physicians either used releasing methods or warming-drying methods, failing to clear and regulate properly, allowing the pathogen to transmit to the Yangming channel. This resulted in high fever, panting, and the appearance of white miliary sweat (Bai Fei) mixed with rashes. Her pulse was indistinct and blurred. I advocated for a formula to vent and clear the Yangming channel, using light agents such as Antelope horn (Lingyangjiao), Human coprolite (Renzhonghuang), Forsythia (Lianqiao), Gardenia (Shanzhi), Fritillaria (Beimu), and Honeysuckle (Yinhua). The next morning, she was urgently summoned again. The white miliary sweat had subsided, stool had passed, heat had cleared, but panting became particularly severe. Her pulse was large and empty, and her face was red as if painted. I stated, "The pathogen has left, but the healthy qi is also about to collapse." I prescribed three qian each of Ginseng (Renshen) and Raw Aconite (Sheng Fuzi), one qian each of Honey-fried Licorice (Zhi Gancao) and Dried Ginger (Ganjiang), and half a qian of Schisandra (Wuweizi), ordering immediate decoction without delay. I warned her successor, "If profuse sweating occurs during the Shen and You hours (3 PM - 7 PM), Yang collapse will ensue immediately. While sweating has not yet occurred, rescue is still possible." He consulted another physician who disagreed. When the Shen hour arrived, profuse sweating indeed occurred, and only then did they believe my words were correct. They hurriedly sought to obtain Ginseng, but she had already suffered sudden collapse. What good would regret do for the whole family?