癸丑冬月。裕大昌木行伊芳君夫人。年二十六岁。怀孕三月。骤然腹痛下血。既痛且胀。痛
甚则头出冷汗。手冷鼻冷。胸闷呕吐。前后阴皆阻胀不堪。左手脉伏不现。右脉弱小。面色淡黄
白而无光采。舌色淡无苔。此气血虚寒之象。殆由劳力受寒使然。盖中下焦阳气不足腹部
受寒。则血脉流行阻滞而为痛胀。胃脏受寒则消化停阻而呕吐。子宫之血管破裂则下血。左
手脉伏者。血为寒凝。营卫之功用失常度也。右脉弱小者。气血虚寒之本相也。前后阴与腹
部阻胀拒按者。血为寒凝。阳气不能营运也。额冷鼻冷手冷面色无神者。亦皆虚寒之本色也
。其病殆与伤寒直中阴经无异。特孕妇之病。又兼漏下。与常人异耳。问之。果因送其伯父
之殡。夜间操麻雀牌未眠。黎明乘舆登山。饱受风寒。归家即病。拟方以胶艾汤合建中汤法
。当归、地黄各四钱。川芎二钱。阿胶三钱。以止血安胎。肉桂八分。制附子一钱五分。桂
枝二钱。炒白芍三钱。以回阳止痛。而散寒邪。砂仁一钱。木香一钱五分。以温胃消滞。而
通阻胀。党参三钱。红枣三枚。生姜三片。以扶元气而和营卫。作煎剂服。明日复诊。痛胀
均大退。呕吐亦止。能对予发言。亦能进粥。左脉亦现。面色亦较有生气。但下血未止。心
内常觉空虚。乃以原方去木香、砂仁、桂枝、川芎。并稍减桂、附。改地黄为熟地。而当归
亦减用二钱。加枸杞子三钱。茴香二钱。接服三剂。饮食起居。略如平人矣。一月后。始强
健。而胎则杳然。盖下血时已随波而堕矣。
金平卿君哲嗣。年八岁。体质素瘦。今年三月
出痧。痧后又生泡疮。至六月初旬。又病喉痧。发热咽痛。初由西医蒋某治之。用冷水浸毛
巾罨颈项。又用水浴法。及服安知必林。与盐剥水嗽喉等法。均无效。病势益剧。其岳家童
姓荐予治。时
液大亏。热邪燔灼于上焦也。热不难解。惟咽喉全部腐烂而阴液亏耗。断非实症可比。危险
已极。幸神不昏。呼吸不促。不烦躁。尚可挽救。拟方以增液汤为主。鲜生地一两。麦门冬
、元参各三钱。加鲜石斛、金银花、连翘各三钱。黄芩一钱。天花粉二钱。知母一钱。甘草
六分。作煎剂服。外吹锡类散。先用淡盐汤漱喉。漱后吹药。金君自以体温计置病患口中
验热度。已有一百零五度之高。予谓体温计虽能验热度之高下。然不能分虚实。万不可泥以
论病。若只准体温计所验之热度以定治法。则当用三黄白虎。然就脉象舌色而论。则不独三
黄白虎不可误投。即西药中之退热剂。亦非所宜。否则危亡立见，噬脐无及矣。金君韪之。
遂以予方煎服焉。
十六日复诊。四肢不热。身热亦轻。舌色红艳而光。毫无苔垢。大便通
利。溲色黄浊。言语多。口不渴。彻夜不寐。喉烂如故。脉息虚数。原方去黄芩、花粉、知
母、鲜生地。加西洋参一钱五分。枣仁、朱拌茯神各三钱。干地黄五钱。用百合一枚煎汤代
水煎药。
十七日复诊。舌上红色转淡。夜间能睡一二时。谵语亦减。咽喉上部腐烂较退。
惟下部及隔帘等处。仍然腐烂。精神疲惫。脉息虚细无神。是气血大虚六候也。急宜培补。
拟方以大补元煎合增液汤法。西洋参二钱。炒熟地炭三钱。干地黄四钱。怀山药三钱。朱染
茯神四钱。麦门冬、元参、石斛各二钱。人中黄四分。吹药仍用锡类散。日吹数次。
十八日复诊。夜寐甚安。谵语亦止。稍能进粥汤。喉烂减退大半。脉息仍细弱无神。仍用
原方。熟地加至四钱。又加莲子三钱。女贞子三钱。
十九日复诊。喉烂全退。用毛笔蘸水
拭之。腐物随笔而出。全部皆现好肉。不比前数日之粘韧难拭矣。脉息亦较有神。而现滑象
。舌色仍淡无苔。小便清。能进薄粥。仍用原方。熟地减用三钱。去石斛。加扁豆三钱。
二十日复诊。饮食较多。乃以原方减轻其剂。接服两日。眠食俱安。但忽又发热。或轻或重
。而热之时间又不一致。金君复以体温计验之。仍在一百零五度。及零三四度之间。甚以为
忧。予曰。无恐也。此气血未能撤消。营卫未能调和。而邪热之内伏者。仍不免有余蕴耳。
且现下喉烂全愈。眠食俱安。种种生机。与七日以前之危险现状。相去不啻天渊。乃以前方
去熟地。酌加青蒿、佩兰、苡仁、地骨皮等药。接服两剂。遍身发出白 。如水晶。如粟米
。而热遂退。饮食亦渐多。但仍不能起床行立。嘱以饮食培养。如鸡鸭汤、粥饭之类。尽量
食之。自是遂不服药。越数日。为其祖母诊病。此儿犹未能起床。但饮食甚多。每日夜须食
六七餐。至半月后。始稍能行动。一月后始能出卧室。可以想见其病之危。体之虚矣。当其未能出卧室之时。亦间
有发热便秘。面目浮肿诸现状。皆未以药治之。盖此为病后应有之现象。一俟气血精神恢
撤消状。则自痊矣。此病得瘥。固由病家始终坚信。旁无掣肘之人。而夏君子雨赞助之力。
亦足多焉。予用熟地时。病家不敢服。虑其补也。赖夏君为之解说。盖夏与金固旧交。而亦
精于医者也。
金平卿君令堂。年逾五旬。体素胖。今年六月。疽发背。先由西医刘某医治
多日。溃烂甚深。而不能生长肌肉。遍身发生小疖。形如豆大。其痛异常。手臂动摇。腿
亦颤动。不能起坐。彻夜不寐。西医见之却走。称为不治之症。并断其死期不能出一星期之
外。金君闻之大恐。适予为其公子治喉症。乃邀以延医。并云。聊尽人子之职分而已。其意
盖深以病势之危。恐终不能起耳。予诊其脉洪大不柔。左手寸部尤觉大硬。舌光赤无苔。亦
无津液。盖高年阴液大亏。孤阳独炽。外症出脓后。津血益伤。加以西医治法。只知消毒防
腐。而不知培养气血为根本之图。宜乎愈治愈坏。变症百出也。其时亦有夏君子雨同诊。遂
共商治法。用复脉汤去桂枝、姜、酒。加枣仁、茯神、黄 、熟地、枸杞子、鸡子黄等药。
加重其剂。黄 、熟地、干地黄、党参、枣仁、茯神等均用五钱。余药亦均用三四钱。鸡子
黄一枚。生冲和服。接服三剂。夜间稍稍能睡。背部患处亦稍见新肉。而脉息亦较敛矣。接
服至十剂。患处新肉日见增高。遍身小疖亦均出脓而消。舌色亦淡。饮食亦稍能进。手臂两
腿亦均不动摇矣。惟精神疲弱。时欲睡眠。脉息转虚滑。仍以原方减轻其剂。又服十剂。患
处肌肉渐平。而腰以下又发一痈。出脓碗许。仍以前方培养气血。越数日。病患忽不能安寐
。自欲奔走。几类发狂。舌仍光赤。盖脓出后阴液复亏。虚火复炽也。乃以原方去参、 。
重用干地黄、柏子仁、枣仁、麦冬。加莲子心。两剂而安。复以培补气血之药。服至一月始
瘥。
牛瑞堂先生令媳。筱川兄夫人。今年二月患喉痧症。服药不效。筱川邀予诊。痧出鲜
红。咽喉右边破烂。色红而兼有白腐。并不大肿。舌前半红赤无苔。颧红唇红。作恶。汤水
不能下咽。脉数身热。此阴液素亏。感受温热为病。先宜养阴清热解毒。拟方用细生地、
麦冬、金银花、紫花地丁、连翘各三钱。贝母、知母各二钱。甘草五分。橄榄三枚。作煎剂
。
仍用原方。下午十时复诊。诸恙无大进退。惟舌光红无津。片刻不饮茶。则燥硬不柔。身微
热。不能寐。盖日间亲戚问病者多。言语劳神。以阴亏之病。骤然劳神。则津液益亏脑力益
衰。而虚火亦益炽。此所以舌本燥硬。而光赤无津不能寐也。非大剂养液安神之法。断难有济。
幸筱川父子见信。乃以大剂增液汤为主。干地黄五钱。麦冬、元参各三钱。加鲜石斛三钱。
朱拌茯神、枣仁各四钱。百合三钱。甘草五分。莲子心四分。予坐俟煎药。且监视其煎药之
法。第三日。复诊。诸恙悉减。喉烂亦退。惟精神疲弱。夜间不能多寐。仍以原方。减轻其
剂。并加茅根、沙参、地骨皮等药。接服两剂。喉烂全平。身热亦退。痧亦脱皮。但不思饮
食。舌淡无苔。脉息 小。而兼有滑象。盖津液虽复。胃气尚虚。乃以四君子汤。加干地黄
、炒熟地炭、生谷芽、炒扁豆、莲肉等药。调补数日而痊。
刘子衡君令堂。年六十三岁。今年夏间。因孙儿病逝。悲哭太过。遂患喉症。延予治之。予
视其发白如霜。舌红如朱。中间略有薄苔。咽喉两旁满布白腐。以毛笔蘸水拭之。则依然
鲜红之好肉。并不溃烂。烦躁不宁。彻夜不寐。脉息虚 。盖劳神太过。虚火上升。心肾不能
相交。水火不能既济之病也。而况守节四十年。持斋二十载。其精血之衰脑力之耗。为何如耶
。乃与增液汤。干地黄五钱。麦冬、元参各三钱。加西洋参二钱。鲜石斛、枣仁、朱拌茯神
、百合各三钱。一服烦躁定。能安睡。接服四剂全愈。
张文卿君夫人。年三十岁。今年五月初十日来诊。咽喉两旁肿塞。汤水不能下咽。虽口津亦
不能咽。胀塞非常。口有秽气。两旁既肿塞。而其下复溃烂。身热口渴。舌苔白腻。脉息滑
数有力。盖温毒痰热。蓄积上焦。污血壅阻。而成喉痈。治不得法。致肿势日盛。将成喉闭
而死矣。救急之法。当先放血以开其闭。否则牙关拘急。口不能张。呼吸闭塞。神丹莫救矣
。乃以刀刺喉内肿处。出紫黑血块甚多。盖皆毒血也。随以蓬莱雪吹之。并以金银花、紫花
地丁、黄芩、贝母、栝蒌、金果榄各三钱。鲜生地八钱。干生地四钱。川连八分。橘皮一钱
。作煎剂。加梨汁一酒钟和服。下午复诊。喉内见粘。有稠脓。乃以毛笔蘸水洗涤。洗出稠
脓甚多。喉肿觉松。复于两臂曲池穴。针刺出血。以分毒血上行之势。仍以原方。再进一剂
。明日大雨倾盆。未及来诊。第三日来复诊。则热全退。喉肿大消。能进薄粥两碗。舌苔亦退
。又得大便。脉息亦转 滑矣。易方以金银花、贝母、花粉、苡仁、茯苓各三钱。佩兰一钱
。元参、麦冬各二钱。干生地三钱。接服两剂全愈。凡喉痈肿势过甚者。皆由污血为患。急
宜刀刺放血。万万不可姑息也。
朱姓妇年五十一岁。素有脑病。发则卒然昏倒。口噤不语。惟心内尚觉了然。移时始苏。其
家本住盐城。因其子在此经商。遂常往来。壬子九月。其媳分娩。三朝日。贺客盈庭。稍形
劳碌。始觉头晕口燥。旋即昏倒口噤。不能言语。两手指痉挛。口眼歪斜。至次日清晨。仍
未苏醒。其戚李某延予治之。已全不省人事。面色晦惨。几类死人。身不发热。手指微凉。
脉息小数。因其手指痉搐不柔。诊脉殊多困难。以箸启齿视舌。则光而微现白色薄苔。盖血
液亏耗。脑力素衰。复因劳役动火。因而发为痉厥也。乃以增液汤加羚羊角、贝母、石菖蒲
、西洋参、白芍、花粉、橘皮为煎剂。并以至宝丹一粒。研碎和入。徐徐灌之。午后七时复
诊。则药已灌下多时。而病患亦稍能言语。口亦能张。视其舌色。则红赤而光。微有白苔数
点。面色亦转活润。但手指尚痉挛如故。大便溏泻。脉息与前无异。口干欲饮茶。是药已大
见功效。乃于前方去至宝丹、石菖蒲、羚羊角。加枸杞子、竹茹、枣仁、柏子仁。接服三日
。痉挛全止。能饮食起坐矣。今年六月。来予医院诊病。则貌颇丰润。精力亦佳。予几不相
识矣。
城内磨刀巷李善门君。年四十余。呃逆不止。呃声震床帐。先是李君病。经某医屡
用汗药。微有呃逆。嗣又改延某医延医。断为湿温病。用大承气汤。云非下则呃不能止。病
家信之。讵知承气汤服后。不惟呃逆加甚。且不能坐。不能言矣。予视其舌质焦燥无津。按
其脉尚有胃气。扪其身则不发热。遂勉强担任。用北沙参、麦冬、玉竹、石斛、干地黄各
三钱。贝母一钱五分。甘草一钱。莲肉十粒。作煎剂。非专为治呃也。不过以其津枯气弱。命在
垂危。姑以此药救其津液耳。不料此药服后。安睡两小时。呃声顿止。特醒后则呃又作。予
因戒其家人。今日之药。服后宜任其熟睡。不可频频呼唤。扰其元神。俟其自醒。则自然不
呃矣。第三日复诊。果如予言。呃全止。且能进粥矣。惟神气呆滞。状若痴愚。其家甚以为
忧。且恐予药之误。予曰。无恐也。再过半月。即不痴矣。因以六君子汤养胃汤出入。培养
胃气。接服数日而起。据近世生理学家。谓呃逆由于横膈膜之痉挛。麦冬、地黄。为补液制
痉之圣药。故能止呃。特未见前人发明及此。而西医之治呃。又仅有吗啡麻醉之一法。然则
李君之病。于医学界乃有绝大之关系也。此病治愈。次年六月。有王某者。亦病呃。先是
王在南京与人涉讼。被拘多日。遂病回镇江。予见其呃逆连声。言语阻碍。询其病状。则胸闷
不舒。不饥不食。舌苔白腻。脉息沉小。盖郁抑过甚。痰水停结于胸膈间而不能消化也。乃与
浓朴半夏汤加茈胡、黄芩、香橼皮、佛手、沉香。接服两剂，胸闷松。能饮食。惟呃逆如故
。其苦异常。因思李善门之事。用麦冬三钱。干地黄四钱。少佐木香、香橼、半夏、生姜、
癸丑年冬天，裕大昌木行的伊芳君夫人，二十六岁，怀孕三个月。突然腹痛并阴道出血，既疼痛又腹胀。疼痛剧烈时头部出冷汗，手脚冰凉，鼻子发冷，胸闷呕吐，前后阴部都阻塞胀满难忍。左手脉象伏而不显，右手脉象弱小，面色淡黄白而无光泽，舌色淡且无苔。这是气血虚寒的征象，大概是因为劳累受寒所致。因为中下焦阳气不足，腹部受寒，导致血脉流行阻滞而引发疼痛和胀满；胃脏受寒则消化停阻而呕吐；子宫血管破裂则导致下血。左手脉伏，是血液被寒气凝结，营卫功能失常的表现。右手脉弱小，是气血虚寒的根本表现。前后阴与腹部阻塞胀满、拒按，是血液被寒气凝结，阳气不能营运的表现。额头、鼻子、手脚冰冷，面色无神，也都是虚寒的本色。这个病大概与伤寒直中阴经没有区别，只是孕妇患病，又兼有漏下（非经期阴道出血），与常人不同罢了。询问病情，果然是因为送伯父的殡仪，夜间打麻将未眠，黎明乘轿登山，饱受风寒，回家后随即发病。拟定方剂以胶艾汤合建中汤法。当归、地黄各四钱，川芎二钱，阿胶三钱，用以止血安胎；肉桂八分，制附子一钱五分，桂枝二钱，炒白芍三钱，用以回阳止痛，散除寒邪；砂仁一钱，木香一钱五分，用以温胃消滞，通利阻塞胀满；党参三钱，红枣三枚，生姜三片，用以扶助元气，调和营卫。煎服。第二天复诊，疼痛胀满均大幅减退，呕吐也停止，能与我交谈，也能喝粥，左脉也出现了，面色也较有生气。但下血未止，心里常觉空虚。于是用原方去掉木香、砂仁、桂枝、川芎，并稍微减少肉桂、附子的用量，将地黄改为熟地黄，当归也减量至二钱，加入枸杞子三钱，茴香二钱，接续服用三剂。饮食起居，大致如同常人。一个月后，身体才强健起来，而胎儿已经没有了。因为在大量出血时，胎儿已经随之流产了。
金平卿先生的儿子，八岁，体质向来瘦弱。今年三月出痧疹，痧疹后又生泡疮。到六月初旬，又患喉痧症，发热咽痛。起初由西医蒋某治疗，用冷水浸湿毛巾敷颈项，又用水浴法，以及服用安知必林（阿司匹林）和盐水漱口等法，都没有效果。病情更加严重。他的岳家童姓亲戚推荐我来治疗。此时津液大亏，热邪燔灼于上焦。热邪不难解除，只是咽喉全部腐烂且阴液亏耗，绝不是实证可比，危险已极。幸好神志不昏迷，呼吸不急促，不烦躁，还可以挽救。拟定方剂以增液汤为主。鲜生地一两，麦门冬、元参各三钱，加鲜石斛、金银花、连翘各三钱，黄芩一钱，天花粉二钱，知母一钱，甘草六分。煎服。外用锡类散吹喉。先用淡盐汤漱口，漱后吹药。金先生自己用体温计放在患者口中测量热度，已经达到一百零五度之高。我对他说，体温计虽然能测量热度高低，但不能分辨虚实，万不可拘泥于此来论病。如果只根据体温计测量的热度来决定治法，那就应该用三黄白虎汤。然而就脉象舌色来看，不仅三黄白虎汤不可误投，即西药中的退热剂，也不适宜。否则危亡立见，后悔莫及。金先生认为我说的对，于是用我的方剂煎服。
十六日复诊，四肢不热，身热也轻了。舌色红艳而光，毫无苔垢，大便通畅，小便黄浊，言语多，口不渴，彻夜不寐，喉咙腐烂如故。脉息虚数。原方去掉黄芩、花粉、知母、鲜生地，加西洋参一钱五分，枣仁、朱拌茯神各三钱，干地黄五钱，用百合一枚煎汤代水煎药。
十七日复诊，舌上红色转淡，夜间能睡一二个小时，谵语也减少了，咽喉上部腐烂较退。只有下部及隔帘等处，仍然腐烂。精神疲惫，脉息虚细无神。这是气血大虚的六种征候。急宜培补。拟定方剂以大补元煎合增液汤法。西洋参二钱，炒熟地炭三钱，干地黄四钱，怀山药三钱，朱染茯神四钱，麦门冬、元参、石斛各二钱，人中黄四分。吹药仍用锡类散，每天吹数次。
十八日复诊，夜间睡眠很安稳，谵语也停止了，稍能进粥汤，喉咙腐烂减退大半，脉息仍细弱无神。仍用原方，熟地加至四钱，又加莲子三钱，女贞子三钱。
十九日复诊，喉咙腐烂全退，用毛笔蘸水擦拭，腐物随笔而出，全部呈现好肉，不像前几天那样粘韧难拭。脉息也较有神，而出现滑象。舌色仍淡无苔，小便清，能进薄粥。仍用原方，熟地减用三钱，去掉石斛，加扁豆三钱。
二十日复诊，饮食较多，于是用原方减轻剂量，接续服用两天，眠食俱安。但忽然又发热，或轻或重，而且发热的时间又不一致。金先生又用体温计测量，仍在105度到103-4度之间，非常担忧。我说，不要怕。这是因为气血未能撤消，营卫未能调和，而邪热内伏者，仍不免有余蕴。况且现在喉咙腐烂全愈，眠食俱安，种种生机，与七天以前的危险现状，相去不啻天渊之别。于是用前方去掉熟地，酌加青蒿、佩兰、苡仁、地骨皮等药，接续服用两剂，遍身发出白痦（一种皮疹），如水晶，如粟米，而热遂退，饮食也渐多。但仍不能起床行立，嘱咐以饮食培养，如鸡鸭汤、粥饭之类，尽量吃。从此就不再服药。过了几天，为他祖母诊病，这孩子还未能起床，但饮食很多，每日夜须吃六七餐。到半个月后，才稍能行动，一个月后才能出卧室，可以想见他病的危重，体质的虚弱。在他未能出卧室的时候，也有间或发热便秘，面目浮肿等现象，都没有用药治疗。因为这是病后应有的现象，一旦气血精神恢复常态，自然痊愈。这个病得以痊愈，固然由于病家始终坚信，旁无掣肘之人，而夏君子雨的赞助之力，也值得称道。我用熟地时，病家不敢服，担心其滋补。赖夏君为之解说。因为夏与金本是旧交，而且也是精通医术的人。
金平卿先生的母亲，年过五十，体质向来肥胖。今年六月，背部长疽。先由西医刘某医治多天，溃烂很深，而不能生长肌肉，遍身发生小疖，形如豆大，疼痛异常，手臂动摇，腿也颤动，不能起坐，彻夜不寐。西医见状退走，称为不治之症，并断定死期不出一个星期之外。金先生闻之大恐。恰好我正在为他公子治喉症，便邀请我延医，并说，只是想尽人子的职分而已。他的意思大概是深以为病势危重，恐怕最终不能治愈。我诊其脉洪大不柔，左手寸部尤觉大硬，舌光赤无苔，也无津液。盖因高年阴液大亏，孤阳独炽，外症出脓后，津血益伤，加上西医治疗方法，只知道消毒防腐，而不知道培养气血为根本之计，难怪越治越坏，变症百出。当时也有夏君子雨同诊，于是共同商量治法。用复脉汤去掉桂枝、姜、酒，加枣仁、茯神、黄芪、熟地、枸杞子、鸡子黄等药。加重剂量，黄芪、熟地、干地黄、党参、枣仁、茯神等均用五钱，其余药物也都用三四钱，鸡子黄一枚，生冲和服。接续服用三剂，夜间稍稍能睡，背部患处也稍见新肉，而脉息也较收敛了。接续服用至十剂，患处新肉日见增高，遍身小疖也均出脓而消，舌色也淡了，饮食也稍能进，手臂两腿也均不摇动了。只是精神疲弱，时欲睡眠，脉息转虚滑。仍以原方减轻剂量，又服十剂，患处肌肉渐平，而腰以下又发一痈，出脓碗许。仍以前方培养气血。过了几天，病患忽然不能安寐，自欲奔走，几乎像发狂。舌仍光赤。盖因脓出后阴液复亏，虚火复炽。于是用原方去掉参、芪，重用干地黄、柏子仁、枣仁、麦冬，加莲子心。两剂而安。再用培补气血的药，服用至一个月才痊愈。
牛瑞堂先生的儿媳，筱川兄的夫人。今年二月患喉痧症，服药无效。筱川邀我诊治。痧出鲜红，咽喉右边破烂，色红而兼有白腐，并不大肿。舌前半红赤无苔，颧红唇红，作恶，汤水不能下咽。脉数身热。这是阴液素亏，感受温热为病。先宜养阴清热解毒。拟定方用细生地、麦冬、金银花、紫花地丁、连翘各三钱，贝母、知母各二钱，甘草五分，橄榄三枚。煎服。
仍用原方。下午十时复诊，诸恙无大进退，只是舌光红无津，片刻不饮茶，则燥硬不柔，身微热，不能寐。盖因日间亲戚问病者多，言语劳神，以阴亏之病，骤然劳神，则津液益亏脑力益衰，而虚火亦益炽。这就是舌头燥硬，光赤无津，不能寐的原因。不是大剂养液安神之法，断难有效。幸得筱川父子信任，于是以大剂增液汤为主。干地黄五钱，麦冬、元参各三钱，加鲜石斛三钱，朱拌茯神、枣仁各四钱，百合三钱，甘草五分，莲子心四分。我坐着等待煎药，并且监视其煎药之法。第三日复诊，诸恙悉减，喉烂也退了，只是精神疲弱，夜间不能多寐。仍以原方，减轻剂量，并加茅根、沙参、地骨皮等药，接续服用两剂，喉烂全平，身热也退，痧也脱皮，但不思饮食，舌淡无苔，脉息细小，而兼有滑象。盖因津液虽复，胃气尚虚。于是用四君子汤，加干地黄、炒熟地炭、生谷芽、炒扁豆、莲肉等药，调补数日而痊愈。
刘子衡先生的母亲，年六十三岁。今年夏天，因孙儿病逝，悲哭太过，遂患喉症，请我治疗。我看她头发白如霜，舌红如朱，中间略有薄苔，咽喉两旁满布白腐，用毛笔蘸水擦拭，则依然是鲜红的好肉，并不溃烂。烦躁不宁，彻夜不寐，脉息虚弱。盖因劳神太过，虚火上升，心肾不能相交，水火不能既济的病。何况守节四十年，持斋二十载，她的精血之衰脑力之耗，到了什么程度呢？于是给予增液汤。干地黄五钱，麦冬、元参各三钱，加西洋参二钱，鲜石斛、枣仁、朱拌茯神、百合各三钱。一服烦躁定，能安睡，接续服用四剂全愈。
张文卿先生的夫人，年三十岁。今年五月初十日来诊，咽喉两旁肿塞，汤水不能下咽，连口津也不能咽，胀塞非常，口有秽气。两旁既肿塞，而其下复溃烂，身热口渴，舌苔白腻，脉息滑数有力。盖因温毒痰热，蓄积上焦，污血壅阻，而成喉痈。治不得法，致肿势日盛，将成喉闭而死。救急之法，当先放血以开其闭，否则牙关拘急，口不能张，呼吸闭塞，神丹莫救。于是用刀刺喉内肿处，出紫黑血块甚多，盖都是毒血。随即以蓬莱雪吹之，并以金银花、紫花地丁、黄芩、贝母、栝蒌、金果榄各三钱，鲜生地八钱，干生地四钱，川连八分，橘皮一钱。煎服，加梨汁一酒杯和服。下午复诊，喉内见粘，有稠脓，于是用毛笔蘸水洗涤，洗出稠脓甚多，喉肿觉松，又在两臂曲池穴，针刺出血，以分毒血上行之势。仍以原方，再进一剂。明日大雨倾盆，未来得及来诊。第三日来复诊，则热全退，喉肿大消，能进薄粥两碗，舌苔也退了，又得大便，脉息也转滑了。换方以金银花、贝母、花粉、苡仁、茯苓各三钱，佩兰一钱，元参、麦冬各二钱，干生地三钱，接续服用两剂全愈。凡喉痈肿势过甚者，皆由污血为患，急宜刀刺放血，万万不可姑息。
朱姓妇人年五十一岁，素有脑病，发作则突然昏倒，口噤不语，惟心中尚觉了然，过了一会儿才苏醒。他家本来住在盐城，因为其子在此经商，所以常往来。壬子年九月，其媳分娩，三朝日，贺客盈庭，稍形劳碌，始觉头晕口燥，旋即昏倒口噤，不能言语，两手指痉挛，口眼歪斜。到次日清晨，仍未苏醒。其亲戚李某请我诊治，已全不省人事，面色晦惨，几乎像死人，身不发热，手指微凉，脉息小数。因其手指痉搐不柔，诊脉殊多困难，用筷子启齿看舌，则光而微现白色薄苔。盖因血液亏耗，脑力素衰，复因劳役动火，因而发为痉厥。于是用增液汤加羚羊角、贝母、石菖蒲、西洋参、白芍、花粉、橘皮为煎剂，并以至宝丹一粒，研碎和入，徐徐灌之。午后七时复诊，则药已灌下多时，而病患也稍能言语，口也能张，看其舌色，则红赤而光，微有白苔数点，面色也转活润，但手指尚痉挛如故，大便溏泻，脉息与前无异，口干欲饮茶，是药已大见功效。于是于前方去掉至宝丹、石菖蒲、羚羊角，加枸杞子、竹茹、枣仁、柏子仁，接续服用三日，痉挛全止，能饮食起坐。今年六月，来我医院诊病，则貌颇丰润，精力亦佳，我几乎不认识他了。
城内磨刀巷李善门先生，年四十余，呃逆不止，呃声震床帐。先是李先生生病，经某医屡用汗药，微有呃逆，随后又改延某医，断为湿温病，用大承气汤，说非下则呃不能止。病家信之，岂知承气汤服后，不惟呃逆加甚，且不能坐，不能言。我看他舌质焦燥无津，按其脉尚有胃气，摸其身则不发热，遂勉强担任。用北沙参、麦冬、玉竹、石斛、干地黄各三钱，贝母一钱五分，甘草一钱，莲肉十粒。煎服，并非专为治呃，不过以其津枯气弱，命在垂危，姑以此药救其津液。不料此药服后，安睡两小时，呃声顿止。特醒后则呃又作。我因此告诫其家人，今日之药，服后宜任其熟睡，不可频频呼唤，扰其元神，等他自醒，则自然不呃了。第三日复诊，果然如我所言，呃全止，且能进粥。只是神气呆滞，状若痴愚，其家甚以为忧，且恐我药之误。我说，不要怕，再过半月，就不痴了。于是用六君子汤养胃汤出入，培养胃气，接续服用数日而起。据近世生理学家，谓呃逆由于横膈膜之痉挛，麦冬、地黄，为补液制痉之圣药，故能止呃。特未见前人发明及此，而西医之治呃，又仅有吗啡麻醉之一法，然则李先生之病，于医学界乃有绝大之关系。这个病治愈，次年六月，有王某者，也病呃。先是王在南京与人涉讼，被拘多日，遂病回镇江。我看他呃逆连声，言语阻碍，询其病状，则胸闷不舒，不饥不食，舌苔白腻，脉息沉小。盖因郁抑过甚，痰水停结于胸膈间而不能消化。于是给予浓朴半夏汤加茈胡、黄芩、香橼皮、佛手、沉香，接续服用两剂，胸闷松，能饮食，惟呃逆如故，其苦异常。于是想起李善门之事，用麦冬三钱，干地黄四钱，少佐木香、香橼、半夏、生姜……
In the winter of the Gui Chou year, the wife of Mr. Yi Fangjun from the Yuchang Timber Company, aged twenty-six and three months pregnant, suddenly experienced abdominal pain accompanied by vaginal bleeding. She suffered from both pain and distension; when the pain was severe, cold sweat appeared on her head, her hands and feet became cold, her nose felt cold, she had chest tightness and vomiting, and both the anterior and posterior orifices were obstructed with unbearable distension. The pulse at the left hand was deep and hidden (Fu Mai), not visible, while the pulse at the right hand was weak and small. Her complexion was pale yellow-white without luster, and her tongue was pale with no coating. This presented a pattern of Qi and Blood deficiency and Cold. It was likely caused by fatigue combined with exposure to Cold. Because Yang Qi in the Middle and Lower Jiao was insufficient, exposure of the abdomen to Cold caused stagnation in blood circulation, leading to pain and distension; Cold affecting the Stomach organ stopped digestion, causing vomiting; rupture of uterine vessels led to bleeding. A deep and hidden pulse at the left hand indicated that Blood was congealed by Cold, resulting in dysfunction of Ying and Wei (Nutritive and Defensive Qi). A weak and small pulse at the right hand reflected the root constitution of Qi and Blood deficiency and Cold. Obstruction and distension in the anterior and posterior orifices and abdomen, which rejected pressure, indicated that Blood was congealed by Cold and Yang Qi could not circulate. Coldness of the forehead, nose, and hands, along with a lack of spirit in the complexion, were all manifestations of intrinsic deficiency and Cold. This illness was similar to Shaoyin disease (Cold damage directly invading the Yin meridians) in Shanghan syndrome, except that it occurred in a pregnant woman with abnormal uterine bleeding, differing from ordinary cases. Upon inquiry, it was confirmed that she had attended her uncle's funeral, stayed up late playing mahjong, taken a sedan chair up a mountain at dawn, and been exposed to wind and cold, falling ill immediately upon returning home. The prescribed formula combined Jiao Ai Tang (Colla Corii Asini and Mugwort Decoction) with Jian Zhong Tang (Build the Middle Decoction). Dang Gui (Angelicae Sinensis Radix) and Di Huang (Rehmanniae Radix) each 4 qian, Chuan Xiong (Ligustici Chuanxiong Rhizoma) 2 qian, and E Jiao (Colla Corii Asini) 3 qian were used to stop bleeding and calm the fetus. Rou Gui (Cinnamomi Cortex) 8 fen, Zhi Fu Zi (Aconiti Lateralis Radix Praeparata) 1.5 qian, Gui Zhi (Ramulus Cinnamomi) 2 qian, and Chao Bai Shao (Paeoniae Radix Alba Preparata) 3 qian were used to restore Yang, relieve pain, and dispel Cold. Sha Ren (Amomi Fructus Rotundus) 1 qian and Mu Xiang (Aucklandiae Radix) 1.5 qian warmed the Stomach, resolved stagnation, and relieved obstruction. Dang Shen (Codonopsis Radix) 3 qian, Hong Zao (Jujubae Fructus) 3 pieces, and Sheng Jiang (Zingiberis Rhizoma Recens) 3 slices supported Yuan Qi (Original Qi) and harmonized Ying and Wei. The decoction was administered orally.
On the second day, during follow-up, the pain and distension had significantly subsided, vomiting had ceased, she could converse with me, and could consume porridge. The left pulse had reappeared, and her complexion showed more vitality. However, vaginal bleeding persisted, and she felt a sensation of emptiness in the heart. Therefore, Mu Xiang, Sha Ren, Gui Zhi, and Chuan Xiong were removed from the original formula, and the dosages of Rou Gui and Zhi Fu Zi were slightly reduced. Di Huang was changed to Shu Di Huang (Prepared Rehmanniae Radix), and Dang Gui was reduced to 2 qian. Gou Qi Zi (Lycii Fructus) 3 qian and Hui Xiang (Foeniculi Fructus) 2 qian were added. After taking three doses, her diet and daily activities returned to normal. One month later, her physical strength recovered, but the fetus was lost, having miscarried during the heavy bleeding.
Mr. Jin Pingqing’s son, aged eight, had always been thin. In March of this year, he suffered from scarlet fever (Sha Zhen), followed by pustules. By early June, he developed throat scarlet fever (Hou Sha), with fever and sore throat. Initially treated by Western doctor Jiang using cold wet towels on the neck, water baths, Aspirin (Anzhibilin), and saltwater gargles, none were effective, and the condition worsened. Recommended by a relative, I treated him. At this time, body fluids were severely depleted, and Heat pathogen was blazing in the Upper Jiao. Although Heat is easy to resolve, the complete ulceration of the throat combined with Yin fluid depletion made this unlike an Excess pattern; the danger was extreme. Fortunately, his spirit was clear, breathing was not rapid, and there was no restlessness, so rescue was possible. The prescription centered on Zeng Ye Tang (Increase Fluids Decoction): Xian Sheng Di (Fresh Rehmanniae Radix) 1 liang, Mai Men Dong (Ophiopogonis Tuber) and Xuan Shen (Scrophulariae Radix) each 3 qian, plus Xian Shi Hu (Dendrobii Caulis) 3 qian, Jin Yin Hua (Lonicerae Japonicae Flos) 3 qian, Lian Qiao (Forsythiae Fructum) 3 qian, Huang Qin (Scutellariae Radix) 1 qian, Tian Hua Fen (Trichosanthis Radix) 2 qian, Zhi Mu (Anemarrhenae Rhizoma) 1 qian, and Gan Cao (Glycyrrhizae Radix et Rhizoma) 6 fen as a decoction. Externally, Xi Lei San (Xi Lei Powder) was blown into the throat after rinsing with light salt water. Mr. Jin measured the patient's temperature with a thermometer, reaching 105°F. I stated that while thermometers measure heat, they cannot distinguish between Deficiency and Excess patterns, and treatment should not be based solely on temperature. If treatment were dictated only by temperature, San Huang Bai Hu Tang (Three Yellows White Tiger Decoction) would be indicated. However, based on the pulse and tongue, neither San Huang Bai Hu Tang nor Western antipyretics were suitable; otherwise, death would be imminent. Mr. Jin agreed, and the decoction was administered.
On the sixteenth day, follow-up revealed cool limbs and reduced body heat. The tongue was bright red and glossy with no coating. Bowels moved freely, urine was yellow and turbid, speech was frequent, mouth was not thirsty, and there was insomnia throughout the night. Throat ulceration remained unchanged. The pulse was deficient and rapid. Huang Qin, Tian Hua Fen, Zhi Mu, and Xian Sheng Di were removed from the original formula. Xi Yang Shen (American Ginseng Radix) 1.5 qian, Zao Ren (Ziziphi Spinosae Semen) 3 qian, Zhu Ban Fu Shen (Poria with Polysporum and Red Ochre) 3 qian, and Gan Di Huang (Dried Rehmanniae Radix) 5 qian were added. One Lily Bulb (Bai He) was decocted in water to cook the herbs.
On the seventeenth day, the redness on the tongue faded, allowing for one to two hours of sleep at night. Delirium decreased, and upper throat ulceration improved. Ulceration persisted in the lower throat and velum. Spirit was exhausted, and the pulse was deficient, fine, and lacking spirit, indicating severe Qi and Blood deficiency requiring urgent tonification. The prescription combined Da Bu Yuan Jian (Great Tonify Source Decoction) with Zeng Ye Tang: Xi Yang Shen 2 qian, Chao Shu Di Tan (Charred Prepared Rehmanniae Radix) 3 qian, Gan Di Huang 4 qian, Huai Shan Yao (Dioscoreae Hypoglaucae Rhizoma) 3 qian, Zhu Ran Fu Shen 4 qian, Mai Men Dong, Xuan Shen, and Shi Hu each 2 qian, and Ren Zhong Huang (Human Waste Charcoal) 4 fen. Xi Lei San was applied several times daily.
On the eighteenth day, sleep was peaceful, delirium ceased, and he could take some porridge. Throat ulceration reduced by half. The pulse remained fine, weak, and lacking spirit. The original formula was continued, with Shu Di increased to 4 qian, adding Lian Zi (Nelumbinis Semen) 3 qian and Nv Zhen Zi (Ligustri Lucidi Fructus) 3 qian.
On the nineteenth day, throat ulceration completely resolved. Wiping with a wet brush removed necrotic tissue easily, revealing healthy flesh, unlike previous days. The pulse had spirit and showed a slippery quality. The tongue was pale with no coating, urine was clear, and he could eat thin porridge. The original formula was continued, with Shu Di reduced to 3 qian, Shi Hu removed, and Bian Dou (Vigna Semen) 3 qian added.
On the twentieth day, appetite increased. The dose was reduced, and two doses were taken, resulting in good sleep and appetite. Suddenly, fever recurred with variable intensity. Mr. Jin measured the temperature again at 103–105°F and was worried. I reassured him that this was due to unresolved Qi and Blood imbalance and lingering latent Heat pathogen. Since the throat was healed and vital signs were stable compared to seven days prior, Shu Di was removed from the formula, and Qing Hao (Artemisiae Annuae Herba), Pei Lan (Eupatorii Herba), Yi Yi Ren (Coicis Semen), and Di Gu Pi (Lycii Cortex) were added. After two doses, white macules (Bai Pu) appeared all over the body like crystal grains, and the fever subsided. Appetite gradually improved, but he still could not get out of bed. Dietary nourishment with chicken/duck soup and porridge was advised. Medication was discontinued. Several days later, while treating his grandmother, the child still could not rise but ate frequently (6–7 meals/day). After half a month, he could move slightly; after one month, he could leave the bedroom, demonstrating the severity of the illness and weakness of his constitution. During confinement, intermittent fever, constipation, and facial edema occurred but required no treatment, as these are expected post-illness phenomena that resolve as Qi, Blood, and Spirit recover. Recovery was aided by the family’s trust and the support of Xia Ziyu, who explained the use of Shu Di to the wary family. Xia and Jin were old friends, and Xia was also medically knowledgeable.
Mrs. Mother of Mr. Jin Pingqing, over fifty years old, was naturally obese. In June of this year, she developed a carbuncle on the back. Western doctor Liu treated her for days, but the ulceration was deep with no granulation. Small boils appeared all over the body, bean-sized, with extreme pain. Her arms shook, legs trembled, she could not sit or stand, and suffered insomnia. Western doctors declared it incurable and predicted death within a week. Mr. Jin, terrified, invited me while I was treating his son. I diagnosed a surging and non-gentle pulse, particularly large and hard at the Left Cun position. The tongue was bare, crimson, and dry. This indicated severe Yin depletion in an elderly person with lone Yang blazing. Post-purulent loss of fluids and blood, compounded by Western treatments focusing only on disinfection rather than nurturing Qi and Blood, led to worsening symptoms. With Dr. Xia Ziyu present, we decided on Fu Mai Tang (Restore the Pulse Decoction) removing Gui Zhi, Sheng Jiang, and wine, adding Zao Ren, Fu Shen, Huang Qi (Astragali Radix), Shu Di, Gou Qi Zi, and Ji Zi Huang (Chicken Egg Yolk). Dosages were increased: Huang Qi, Shu Di, Gan Di Huang, Dang Shen, Zao Ren, and Fu Shen each 5 qian; other herbs 3–4 qian; one raw egg yolk mixed in. After three doses, she slept slightly, new flesh appeared on the back, and the pulse became more restrained. After ten doses, granulation improved, boils drained and resolved, tongue color normalized, appetite improved, and limb tremors ceased. Only fatigue and drowsiness remained with a deficient-slippery pulse. The dose was reduced, and ten more doses were given. Muscle healing progressed, but a boil appeared below the waist, draining a bowl of pus. The original formula continued. Days later, she became restless, wanting to run, resembling mania, with a bare crimson tongue, indicating renewed Yin depletion and empty Fire after pus drainage. Shen and Huang Qi were removed from the original formula, and Gan Di Huang, Bai Zi Ren (Biota Semen), Zao Ren, and Mai Dong were heavily dosed, adding Lian Zi Xin (Nelumbinis Plumula). Two doses calmed her. Tonifying Qi and Blood continued for a month until recovery.
Mrs. Wife of Brother Xiaochuan, daughter-in-law of Mr. Niu Ruitang, suffered from throat scarlet fever in February this year without improvement. Rash was bright red, right throat ulcerated with redness and white necrosis, without significant swelling. Anterior tongue was crimson with no coating, malar flush and red lips, aversion to bad smells, inability to swallow liquids. Pulse was rapid, body hot. This was Yin deficiency complicated by Warm-Thermal pathogen. Initial treatment focused on nourishing Yin, clearing Heat, and detoxifying: Xi Sheng Di (Fresh Rehmanniae Radix), Mai Dong, Jin Yin Hua, Zi Hua Di Ding (Viola Herba), Lian Qiao each 3 qian, Bei Mu (Fritillariae Bulbus) 2 qian, Zhi Mu 2 qian, Gan Cao 5 fen, and Gan Lan (Canarium Fructus) 3 pieces as a decoction.
Follow-up at 10 PM using the same formula showed little change, except the tongue was glossy red without fluids, becoming dry and stiff if not sipping tea. Mild fever and insomnia persisted. Frequent visitors talking exhausted her, worsening Yin deficiency, depleting fluids and brain power, intensifying empty Fire. This caused the dry, stiff, glossy tongue and insomnia. Large doses of fluids and calming spirits were needed. Trusting the Xiaochuan family, I prescribed a large dose of Zeng Ye Tang: Gan Di Huang 5 qian, Mai Dong and Xuan Shen each 3 qian, plus Xian Shi Hu 3 qian, Zhu Ban Fu Shen 4 qian, Zao Ren 4 qian, Bai He 3 qian, Gan Cao 5 fen, Lian Zi Xin 4 fen. I supervised the decoction process. On the third day, symptoms reduced, throat ulcers receded, but fatigue and poor night sleep remained. The dose was reduced, adding Bai Mao Gen (Imperatae Rhizoma), Sha Shen (Glehniae Radix), and Di Gu Pi. After two doses, ulcers healed, fever subsided, rash desquamated, but appetite was absent. Tongue was pale with no coating, pulse was fine-small with a slippery quality, indicating restored fluids but weak Stomach Qi. Si Jun Zi Tang (Four Gentlemen Decoction) with Gan Di Huang, Chao Shu Di Tan, Sheng Gu Ya (Sprouted Grain), Chao Bian Dou, and Lian Rou was used to tonify for several days until recovery.
Mother of Mr. Liu Ziheng, aged sixty-three, suffered throat illness in summer due to excessive grief over her grandson’s death. Hair was white as frost, tongue red as vermilion with slight central coating, throat sides covered in white necrosis. Wiping with wet brush revealed healthy red flesh underneath, not ulcerated. Restless, insomnia, pulse deficient. Caused by mental exhaustion rising empty Fire, failing to connect Heart and Kidney, preventing Water and Fire interaction. Forty years of widowhood and twenty years of vegetarianism further depleted essence and blood. Prescribed Zeng Ye Tang: Gan Di Huang 5 qian, Mai Dong and Xuan Shen each 3 qian, plus Xi Yang Shen 2 qian, Xian Shi Hu, Zao Ren, Zhu Ban Fu Shen, Bai He each 3 qian. One dose settled restlessness and enabled sleep; four doses resulted in full recovery.
Wife of Mr. Zhang Wenqing, aged thirty, visited on May 10th. Sides of throat swollen and blocked, unable to swallow liquids or saliva, severe distension, foul breath. Swelling accompanied by underlying ulceration, fever, thirst, white greasy tongue coating, slippery-rapid-forceful pulse. Warm-toxic phlegm-heat accumulated in Upper Jiao, toxic blood stasis formed Hou Yong (Throat Abscess). Improper treatment led to worsening swelling threatening airway closure. Emergency method: bleed to open obstruction. Otherwise, trismus and respiratory failure would occur. Incised swollen area in throat, releasing much dark purple toxic blood. Applied Peng Lai Xue powder. Decoction: Jin Yin Hua, Zi Hua Di Ding, Huang Qin, Bei Mu, Gua Lou (Trichosanthis Fructus), Jin Guo Lan each 3 qian, Xian Sheng Di 8 qian, Gan Sheng Di 4 qian, Chuan Lian (Coptidis Rhizoma) 8 fen, Ju Pi (Citri Reticulatae Pericarpium) 1 qian. Mixed with one cup of Pear Juice. Follow-up afternoon: sticky thick pus found, washed out with wet brush, swelling relaxed. Pricked Qu Chi (LI11) on both arms to bleed, diverting toxic blood upward. Continued original formula. Next day, heavy rain prevented visit. Third day follow-up: fever gone, swelling reduced, could eat two bowls of thin porridge, coating receded, bowel movement achieved, pulse turned slippery. Changed formula to Jin Yin Hua, Bei Mu, Hua Fen, Yi Yi Ren, Fu Ling each 3 qian, Pei Lan 1 qian, Xuan Shen and Mai Dong each 2 qian, Gan Sheng Di 3 qian. Two doses cured. Severe throat abscesses are caused by toxic blood; immediate incision and bleeding are essential, never tolerate delay.
Ms. Zhu, aged fifty-one, had chronic brain illness characterized by sudden fainting, locked jaw, and muteness, though consciousness remained internally. Revival took time. Living in Yancheng but visiting her son in business, in September of Ren Zi year, after attending her daughter-in-law’s delivery celebration, she felt dizzy and dry-mouthed, then fainted with locked jaw, muteness, finger spasms, and facial deviation. Unconscious next morning. Relative Li invited me. Patient unresponsive, dull complexion, nearly dead-like, no fever, slightly cool fingers, fine-small pulse. Finger spasms made pulse diagnosis difficult. Opening mouth with chopsticks revealed a glossy tongue with slight white coating. Blood deficiency and mental exhaustion exacerbated by labor-induced Fire caused Jing Jue (Spasm and Convulsion). Prescribed Zeng Ye Tang plus Ling Yang Jiao (Capricornis Cornu), Bei Mu, Shi Chang Pu (Acori Tatarinowii Rhizoma), Xi Yang Shen, Bai Shao, Hua Fen, Ju Pi as decoction, plus one pill of Zhi Bao Dan (Treasure Precious Pill) crushed and mixed, slowly administered. Follow-up at 7 PM: medication absorbed, patient spoke slightly, mouth opened, tongue crimson glossy with few white spots, complexion lively, but finger spasms persisted, loose stool, pulse unchanged, dry mouth craving tea. Medicine effective. Removed Zhi Bao Dan, Shi Chang Pu, Ling Yang Jiao; added Gou Qi Zi, Zhu Ru (Bambusae Caulis in Taenia), Zao Ren, Bai Zi Ren. Three doses stopped spasms, allowed eating and sitting. In June this year, visited my clinic, looking plump and energetic, hardly recognizable.
Mr. Li Shanmen of Modao Alley, city center, over forty, suffered persistent hiccups shaking the bed curtains. Previously treated with diaphoretics by one doctor, causing mild hiccups. Another doctor diagnosed Damp-Warmth, prescribed Da Cheng Qi Tang (Major Order the Qi Decoction), claiming purgation was necessary. Family complied, but hiccups worsened, and patient could not sit or speak. Tongue was scorched dry without fluids, pulse still had Stomach Qi, body not hot. I tentatively treated with Bei Sha Shen (Glehniae Radix), Mai Dong, Yu Zhu (Polygonati Odorati Rhizoma), Shi Hu, Gan Di Huang each 3 qian, Bei Mu 1.5 qian, Gan Cao 1 qian, Lian Rou 10 pieces. Not specifically for hiccups, but to save fluids in critical dehydration and Qi weakness. After sleeping two hours, hiccups stopped. Upon waking, they returned. I instructed family to let him sleep deeply without disturbing his Yuan Shen. Third day follow-up: hiccups stopped, could eat porridge. Spirit was dull, appearing foolish. Family worried about my error. I predicted recovery in half a month. Used Liu Jun Zi Tang (Six Gentlemen Decoction) modified with Yang Wei Tang to nourish Stomach Qi. Several doses restored health. Modern physiologists attribute hiccups to diaphragm spasm; Mai Dong and Di Huang are holy medicines for replenishing fluids and controlling spasms, thus stopping hiccups. Western medicine relies only on morphine anesthesia. This case has great significance for medical science.
Next June, Mr. Wang also suffered hiccups. After legal troubles and detention in Nanjing, he fell ill in Zhenjiang. Hiccups continuous, speech hindered, chest tightness, no hunger/appetite, white greasy coating, deep-small pulse. Severe depression caused Phlegm-Water accumulation in Chest/Diaphragm. Prescribed Hou Po Ban Xia Tang (Magnolia Bark and Pinellia Decoction) plus Chai Hu (Bupleuri Radix), Huang Qin, Xiang Yuan Pi (Citri Reticulatae Pericarpium), Fo Shou (Citri Sarcodactylis Fructus), Chen Xiang (Aquilariae Lignum Resinatum). Two doses relieved chest tightness and restored appetite, but hiccups persisted bitterly. Recalling Mr. Li’s case, used Mai Dong 3 qian, Gan Di Huang 4 qian, with minor amounts of Mu Xiang, Xiang Yuan, Ban Xia, Sheng Jiang…