宁波一妓。年三十余。患黄疮。外科始用升药。疮虽愈而毒聚于咽喉。腐溃绵延。小舌烂尽。通于鼻孔。服寒冷药
数百剂。以至面色 白。同于枯骨。声哑肤寒。连唇舌俱呆白色。腹胀便溏。脉象沉细。虚软萦萦如蛛丝。延余诊之。
余曰。寒凉过度。脾胃伤败。阳气消灭。将登鬼录。先保命根。休议其病。遂用附、桂、茯苓、于术。参、 、姜、草
等温补之。服十余剂。渐有起色。饮食腹胀便溏悉愈。乃以人参养荣汤朝吞五宝丹。以化其毒。吹以珠黄散。始终用温
补药加化毒之品。至月余而诸恙皆愈。烂孔平满。但烂去小舌。不复生耳。
一柴客体本强壮。只手能举百钧。冬月得伤寒太阳症。恶寒无汗。头痛项强。毛孔痛如针刺。气急脉紧。余用麻黄
汤治之。一剂未汗。再剂又未汗。乃取彼舟中造饭缸灶。左右前后各置其一锅。内盛水纳以麻黄、羌、防等气性雄
烈发表之药烧之。令滚。去其锅盖。再烧半时许。窗门皆令密闭。使病患口鼻皆受其气。蒸之既久。始得汗出甚臭。
病遂霍然。盖其邪入既深。腠理固密。故汤药不能发汗。必用蒸法始效。此古人之巧妙。非余之杜撰也。观名医类
案及本事方释义自知。
舟子刘某。年十四。风餐露宿。日以为常。夏秋之交。食少乏力。肌黄腹胀。其母以为虚也。与食桂圆数日。人益
困惫。
胃口愈闭。腹痛泄泻。然犹勉力操舟。迨至泄泻无度。魄门不禁。肢冷脉伏。目直神昏。始延余诊。至则其母对余而
泣。以为无生理也。余谛审之。舌苔白滑。口不渴饮。人不躁动。确系太阴寒湿。即慰之曰。病虽危险。尚属可救。书
附子理中汤与之。用生附子三钱。持方至药铺撮药。而司柜者。谓附子多则不过一钱。从未见生附可用三钱。嘱其
再来问余。余曰。我曾用六七钱而应手取效者。三钱尚是中剂。何云多也。嫌多不服。我亦不能相强。且必浓煎方效。
其母以病极危笃。姑进一剂。以冀万一。于是申刻服药。至酉戌时腹中作响。渐能开言识人。
至亥子时。复大泻一次。腹觉畅甚。起居自如。知饥索食。进锅巴汤半盂。次日问以病状。嘱其原方再服一剂。竟不泻。
亦不服药。三日即能负物以行。群以为奇。不知古法转危为安者甚多。何奇之有。然是症幸在乡僻穷民。故能速愈。若
在富贵之家。延医多人。各执己见。反多阻隔。不能愈矣。
宁波有一位妓女，三十多岁。患了黄疮（一种皮肤疮疡），外科医生起初使用升药（含汞的腐蚀性药物）治疗。虽然疮口愈合了，但毒邪聚集在咽喉部位，导致腐烂溃烂持续不断，小舌（悬雍垂）完全烂掉，甚至与鼻孔相通。她服用了数百剂寒凉性质的药物，导致面色苍白如枯骨，声音嘶哑，皮肤寒冷，嘴唇和舌头都呈现呆滞的白色，腹部胀满，大便稀溏，脉象沉细，虚弱无力如同蛛丝一般。请我诊治。
我说：“寒凉药物使用过度，损伤败坏了脾胃，阳气即将消亡，不久将死。现在首要任务是保住性命根本，不要讨论其他病症。”于是使用了附子、肉桂、茯苓、白术、人参、干姜、甘草等温补药物。服用十余剂后，病情逐渐好转，饮食正常，腹胀和大便稀溏全部痊愈。接着采用早上服用人参养荣汤，吞服五宝丹以化解毒邪，并用珠黄散吹入患处。始终使用温补药物配合化解毒邪的药物，经过一个多月，所有疾病都痊愈了。烂掉的孔洞长平填满，只是小舌烂去后不再生长罢了。
另一位姓柴的客人身体原本强壮，一只手能举起百钧重物。冬天得了伤寒太阳症（外感风寒初期证候），恶寒无汗，头痛项强，毛孔疼痛如针刺，气急，脉紧。我使用麻黄汤治疗他。一剂药后没有出汗，再服一剂仍然没有出汗。于是取来他船中做饭用的缸灶，左右前后各放置一口锅，锅内盛水，放入麻黄、羌活、防风等气味雄烈、具有强烈发汗解表作用的药物煮沸。去掉锅盖，继续加热约半小时，门窗全部密闭，让患者的口鼻吸入蒸汽。蒸了很久之后，终于出了很臭的汗，病随即霍然痊愈。这是因为邪气入侵很深，腠理（皮肤毛孔及皮下组织间隙）固密，所以汤药不能发汗，必须用蒸法才有效。这是古人的巧妙之处，并非我杜撰。观看《名医类案》及《本事方释义》自然知晓。
船工刘某，十四岁。风餐露宿是日常习惯。夏秋交替之际，食欲减退，乏力，肌肤发黄，腹部胀满。他的母亲认为是虚证，给他吃了几天桂圆。结果人更加困倦疲惫，胃口更加闭塞，腹痛泄泻。但他仍然勉强划船。等到泄泻无度，肛门失禁，四肢冰冷，脉搏伏匿不见，眼睛直视，神志昏迷，这才请我诊治。到了那里，他的母亲对着我哭泣，认为没有生机了。我仔细诊察，发现舌苔白滑，口不渴饮，人不躁动，确属太阴寒湿证。于是安慰他们说：“病虽然危险，但还可以救治。”开了附子理中汤给他，使用生附子三钱。拿着方子去药店抓药，掌柜的说附子多用不超过一钱，从未见过生附子可用三钱的，让我回去再问。我说：“我曾使用六七钱而立即见效的，三钱还是中等剂量，怎么能说多呢？如果嫌多不吃，我也不能强迫。而且必须浓煎才有效。”他的母亲因为病情极其危重，姑且进服一剂，希望能有万一的希望。于是在申时服药，到酉戌时腹中作响，渐渐能开口认人。到了亥子时，又大泻一次，腹部感觉非常通畅，起居自如，知道饥饿索要食物，喝了半碗锅巴汤。第二天询问病情，嘱咐他原方再服一剂。竟然不再腹泻，也没有再吃药。三天就能负重行走，大家都觉得很奇怪，不知道古人转危为安的方法很多，有什么奇怪的。但是这个病例幸亏是在乡间穷苦人家，所以能迅速痊愈。如果在富贵人家，延请多位医生，各执己见，反而多有阻碍，就不能痊愈了。
A prostitute in Ningbo, over thirty years old, suffered from a yellow sore (a type of skin ulcer). The surgeon initially used Sheng Yao (Calx of Realgar and Orpiment, a mercury-containing corrosive drug). Although the sore healed, the toxin accumulated in the throat, causing persistent rotting and ulceration. The uvula was completely eroded, extending to the nasal cavity. She had taken hundreds of doses of cold-natured medicines, resulting in a pale complexion resembling dry bones, hoarseness, cold skin, and lips and tongue appearing stiff and white. Her abdomen was distended with loose stools. Her pulse was deep and fine, weak and soft like a spider's thread. I was summoned to consult.
I said, "Excessive use of cold medicines has damaged and ruined the Spleen and Stomach, and Yang Qi is about to perish; death is imminent. First preserve the root of life; do not discuss other diseases." Therefore, I prescribed warming and tonifying herbs including Fuzi (Radix Aconiti Lateralis Preparata), Guizhi (Ramulus Cinnamomi), Fuling (Poria), Baizhu (Rhizoma Atractylodis Macrocephalae), Renshen (Radix Ginseng), Ganjiang (Rhizoma Zingiberis Recens), and Gancao (Radix Glycyrrhizae). After taking more than ten doses, there was gradual improvement. Appetite returned, abdominal distension ceased, and loose stools stopped. Then, she took Ren Shen Yang Rong Tang (Ginseng Decoction for Nourishing Qi and Blood) in the morning and swallowed Wubao Dan (Five-Treasure Pill) to resolve the toxin. Zhuhuang San (Pearl and Calculus Bovis Powder) was blown into the affected area. Throughout the treatment, warming and tonifying herbs combined with toxin-resolving agents were used. After more than a month, all ailments were cured. The ulcerated holes filled up flat, though the uvula did not regrow after being lost.
Another patient, surnamed Chai, was originally robust, capable of lifting heavy weights with one hand. In winter, he contracted Taiyang Syndrome (Taiyang Disease) due to Cold Damage (Shanghan). He experienced aversion to cold, absence of sweating, headache, stiffness of the neck, pain in hair follicles as if pricked by needles, rapid breathing, and a tight pulse. I treated him with Mahuang Tang (Ephedra Decoction). After one dose, no sweat occurred. After a second dose, still no sweat. I then obtained cooking pots and stoves from his boat, placing them around him on all sides. Water was added to each pot along with herbs possessing strong aromatic and pungent properties for releasing the exterior, such as Mahuang (Herba Ephedrae), Qianghuo (Rhizoma et Radix Notopterygii), and Fangfeng (Radix Saposhnikoviae), and boiled vigorously. The lids were removed, and heating continued for about half an hour. Windows and doors were kept tightly closed so that the patient's nose and mouth inhaled the steam. After steaming for a long time, profuse, foul-smelling sweat finally appeared, and the illness vanished instantly. This was because the pathogen had penetrated deeply and the Cou Li (skin pores and interstitial spaces) were dense, making herbal decoctions ineffective for inducing sweat; only the steaming method could produce results. This is the ingenuity of ancient physicians, not my fabrication. One can verify this by consulting *Mingyi Leian* (Collected Cases of Famous Physicians) and *Benshi Fang Shiyi* (Explanation of Formulas from My Experience).
A boatman named Liu, aged fourteen, was accustomed to eating in the wind and sleeping in the dew. During the transition between summer and autumn, he suffered from poor appetite, fatigue, yellowish skin, and abdominal distension. His mother believed it was a deficiency syndrome and fed him Longyan (Litchi Chinensis Fruit) for several days. Consequently, he became increasingly lethargic, his appetite further decreased, and he developed abdominal pain and diarrhea. Nevertheless, he persisted in rowing the boat until the diarrhea became uncontrollable, leading to incontinence of the anus. His limbs grew cold, his pulse became hidden (Fu Pulse), his eyes stared fixedly, and he fell into coma. Only then was I called. Upon arrival, his mother wept before me, believing there was no hope. I examined him carefully: the tongue coating was white and slippery, there was no thirst or desire to drink, and he showed no restlessness. This confirmed a diagnosis of Taiyin Cold-Dampness Syndrome. I comforted them, saying, "Although the condition is critical, it is still curable." I prescribed Fuzi Lizhong Tang (Aconite Decoction to Warm the Middle) using three qian of raw Fuzi (Radix Aconiti Lateralis). Taking the prescription to the pharmacy, the pharmacist stated that Fuzi should rarely exceed one qian and that he had never seen raw Fuzi used at three qian. He advised me to return and consult again. I replied, "I have successfully used six or seven qian with immediate effect; three qian is merely a moderate dose. How can you say it is too much? If they refuse due to fear of excess, I cannot force them. Moreover, it must be decocted strongly to be effective." Because the illness was extremely critical, his mother administered one dose tentatively, hoping for a miracle. The medicine was taken at Shen hour (3-5 PM). By You-Xu hours (5-9 PM), rumbling sounds were heard in the abdomen, and he gradually regained consciousness and recognition. At Hai-Zi hours (9 PM-1 AM), he had another episode of severe diarrhea, but felt great relief in his abdomen, resumed normal activities, and expressed hunger, requesting food. He drank half a bowl of rice crust soup. The next day, upon inquiry, I instructed him to take another dose of the original prescription. He stopped having diarrhea and did not take further medication. Within three days, he could carry loads and walk. Everyone considered this miraculous, unaware that many cases of turning danger into safety exist in ancient methods. However, this case recovered quickly precisely because the patient was a poor rural inhabitant. Had he been from a wealthy family, multiple doctors would have been consulted, each adhering to their own opinions, creating obstacles that would likely prevent recovery.