乱，舌上焦黑无芒刺干裂成皱者，亦为附子所宜。盖此证其脉虽浮洪或弦紧，必无根抵。与
附子，病势缓则脉必见虚候也。盖舌纯红者属阴虚，而焦黑者属虚火也。又有证具阳候而舌
上反无胎润泽者，为恶候。若此证必胸有所闭塞者，与药开达心胸，则舌上生胎也，为佳兆
。又虽与药制之热愈炽，胎不更生者，为不治之证。又服药后，舌胎一去其色不和者，有宜
石膏者，有宜附子者，有宜地黄者，当审别焉。要之舌与脉者，阴阳虚实之所判，不可不细
精，故吾门加四诊以腹舌而论定病因虚实也。世医不知之执腹诊，舍脉舌，可谓疏漏矣。(
拙轩曰∶宽政年间水户土田恕庵着舌图说一卷，据张路玉舌鉴等。附以己所见，颇为详明，
可谓得东郭翁之心者。)
舌上不论黄白带光滑而干燥者，附子所宜也。其红色者，益为附子的证矣。
病患舌上白胎，其下含紫黑色如牛舌者，为恶候。此舌候兼面戴阳，则更为危矣。
按舌候大概诸疫无异，故疫痘皆同诊。但至结毒则具一种舌色，不可不辨。(白胎中带
黯色
者，及舌下赤色中成皱纹者，又紫色如牛舌者，皆属结毒也。)崎 德见茂四郎者，(丝割符
年寄。)患鼻渊三年，诸医以为肺虚，百治无寸效。诊之两鼻流浊涕如檐滴，脉弦紧，腹拘
急。予曰∶此系肝火熏灼肺部，上下气隔塞之所为。世医不知之，漫认为肺病，或误为风邪
侵肺，徒用辛荑、白芷之类。宜乎不得其治也。乃与四逆散加吴茱萸、牡蛎服之，半月许，
病洒然愈。盖此等病宜详其脉腹，而处方不必四逆散也。
凡病患胸膈不开，则必下不宽，故欲制心下者，先治其胸膈，是医家一大紧要。窃比之
于净土门一枚誓词。
一妇产后经二旬，卒呕吐数日不止，左胁下冲逆痛剧，与吴茱萸汤(参用洋参)忽安。
产后腰膝痿弱者，多系 癖所为。盖其初妊时患水肿或香港脚，至产后气急者，与对证药
。前
证愈后，当详腹延医 癖，此证最要艾灸。若施汤流及艾灸 癖为之压不瘥者，与桂枝加术
附汤、麻黄附子细辛汤，而二三日或四五日之间，以紫圆下之则愈。此即先师东洞翁独得之
妙，而余则因其证与四逆散、理气汤、十全大补汤等，时时以紫圆下之，每得效。
紫圆以荡涤胸膈为主，故发狂上炎，甚者及产后痿弱，心膈气不能下降者，皆用之效。
昔东洞先生曾以此方治龟胸龟背，即此旨矣。
目疾属内瘴者，艾灸最效，而专门者忌之为可笑。其他如黄风雀目、肝虚雀目，不知其
辨动
误治。盖黄风者，白睛中生细皱发黄色，用滋阴明目汤、八味丸，单杨抱术等效。肝虚者，
乌睛白睛如常，但觉昏暗，故为难治。
松原一闲齐者，吉益东洞山胁东洋师友也，本为若狭候臣尝治龟胸龟背。及痿 沉痼者
，用
起废丸，其方大黄、生漆、二味研末为丸，未干时服一钱或二钱。服后大热发赤疹为知，而
因证与他药则全愈。
一闲齐门人桥诰顺治。治一妇人，头发发火，每梳之觉火气至即见光，与三黄加石膏汤
痊。
予亲见一妇归家，衣里有爆响，投之于暗处皆见火，此皆肝火之所为，不足怪矣。(拙轩曰
∶明郎瑛七种类稿卷二十六有衣火一条，与此同日之谈。又见张芳洲杂言∶按人发猫皮暗中
以手拂之，常见灯光，且闻爆响。西洋人以为电气发出之验，不必肝火之所为也。《医剩》
云∶先考蓝溪公所识一贵妇，每暗中更衣，火星爆出，同妇女栉发，于暗中及猫儿背毛逆摩
出火之类，盖体气盛者，偶有击而发光者，非真火也。)
十枣汤证有下痢者，因上迫势甚而热下陷为利也。故与脱利其趣迥异，如柴胡泻心下痢
亦然。
痘疹下利与伤寒合病下利同。但及十余日者，与少阴下利同辙，正为恶候。
大津小野又三郎者，患天行发呃逆，五六日微利，其脉变幼无测，众医以为脱候皆辞去
。予诊视半日许，谓旁人曰∶此脉非恶候，即肝火亢盛之所为。因四逆散加地黄、古金汁服
之，脉顿定，诸证随痊。
便毒无脓溃，势将消散者，内托剂更无效。与三物楸叶汤，若不起发者，加附子，服之
无效
者。概因疝瘕为之妨害，与四逆散加附子奇效。若终始无脓溃势者，与芎黄散加荞麦可下之
。
小儿胎毒系先天，而世医不知之，或言分娩时误饮瘀血为可笑。凡诊其毒，先以指头按
肋下
，心有凝结。而因其缓急，可察毒之轻重。又面色灰白，或暗黑，或过光泽，皆属胎毒也。
若受父母霉毒者，最为难治。
其人平生一手脉不应者，偶者之固无害。若四十以后，一手脉暴绝者，为恶候。此证多房者
多有之宜详。
大腹痛服建中汤无效者，认水分动气与莎 汤则愈。又左胁下逆抢痛甚，与诸药无效者
，有水分动则与地黄剂效。
水分动有三∶道属肝肾虚火者，为地黄薯蓣牡丹皮之所宜；其动在表泛应者，为茯苓之所
主；其动无根蒂，脐中齐鼓激者，所谓肾间动属不治
也。
京师书肆梅村氏曰∶江户千钟房有治积气血奇方，名顺气散，即四物汤、香附子等分研
末者。予以为此方有理，因制莎 汤屡验。
一男子年二十四，得病五年，右膝肿起如别束筋肉，不能行步，其状稍类鹤膝风，而其
诊腹
右脐下拘急最甚，按之右足挛痛甚，其性急不能堪物。予以为肝癖固结之所为，即与大黄
、附子加甘草汤，数日癖块发动，病稍缓，因与四逆散，加良姜、牡蛎、小连翘全愈。此证
世医不知，徒为脚疾，用葳灵仙、杜仲、牛膝宜矣，不得其治也。当详其腹候而治之，此即
余积年粉骨碎身之所得，殆为医家之新手段矣。(拙轩曰∶此治验翁极得意手段，读者宜究
心焉。)
发闲人事不省，药汁不下者，宜艾灸。最要大壮。不彻者，昼夜灸至七日为度。伤寒发
痫者
，亦宜此法，大灸至闲瘥，则邪亦随解。此理医经所不阐，故世医恐热忌灸，可笑矣。(窦
材曰∶医之治病用灸，如煮菜需新。今人不能治大病，良由不知针艾故也。又曰∶世俗用灸
，不过三五十壮，殊不知去小疾则愈，驻命根则难。故铜人针灸图经云∶凡大病宜灸脐下五
百壮，补接真气，即此法也。彼此同见，可谓海外子云矣。)
平素有疝瘕者，得大病其块忽移处者，甚为恶候。
患霉毒不外达，蕴结脏腑，兼见疝瘕者，不可徒治疝瘕，因疝瘕不急于霉毒焉；如已形
恶候者，亦当先顾疝瘕。
一闲齐门人桥诰顺治一婴儿痘疹入眼，久未退去赤翳，用生地黄、芍药、川芎、当归制
剂，日就愈瘳。是与余谓四味缓肝、润肝、疏肝、泻肝分取，其治肝病同出一意焉。
伤寒误下成结胸，用陷胸法者，是误下。乃下不及病之意，故陷胸法再下之愈。(拙轩
曰
∶此言未有见到者，曷能道之，误下误于轻下。正文原是失下，千古无人敢作如此解。)
承气汤攻霉有捷于汞剂。
患瘵疾便先溏者，建中剂可用。便未溏咳嗽晡热喘哕痰多者，非建中证焉，投之反剧。
瘵痨勿必由虚起，体质实者遇折伤久延，疮疡久不收，亦致痨瘵。然亦实者成虚也。
伤寒七八日不大便，小腹高突者，为恶候。
大津小野又三郎者，患天行愈后，症似痨瘵，咳嗽盗汗。余与地黄剂，众医强欲用建中
，五七日遂喘急，仍与地黄剂愈。(拙轩曰∶建中法必在瘵疾便溏者用之。)
久患便溏，到皮色皎白，肌肉脱削者，瘵疾已成。
痨瘵便先溏泄，艾圆灸天枢、膏肓、脾 、关元亦愈。灸膏肓可三七壮，灸关元可五七
壮。
发痫人艾灸当有忍心。
霉毒亦能致瘵疾。
瘵疾起时有咳嗽者，必失血。
余尝用薯蓣、生 、加入四物剂，治愈娠妊呕吐便溏，患白带不止，形体瘦， 癖结块
在腹亦愈。
癖块食积胸膈，紫圆效。
打扑瘀结，大黄 虫攻下即愈。余治一妇人打扑腹痛，月水欲来不通。萃冈青洲诊之曰
∶瘀结于腹，与余同，惟他药多剂不知。遂大黄 虫剂，即见黑瘀行而愈。
痢疾不得进药为噤口痢，然积食不消，胸膈癖块结实，亦哕恶不可进药，勿谓一律噤口
也。
婴儿吐乳，一吐直冲即止者易治。吐了再吐，吐出顺口而流也，不易治。当分别诊之。
伤寒失下多，误下少。
妊娠患伤寒当下之候，大承气亦可投。一妇人年二十有六，妊娠三个月有余，患伤寒已
十日
，手足冷，身热昏呓螈 ，大便秘结，口燥气盛，胎动不安，头额汗。众医以白虎证用生石
膏、知母、生 、多剂未知，危已极，胸膈闷急，腹硬而痛。余谓承气剂可效，投之果愈。
(拙轩曰∶有故无殒，此之谓也。临危之治疗，不可以有犹豫之意。不独治妊娠伤寒，如见
他证，亦当如是也。)
半身不遂，手足偏废于左为多。
痘证白色顶陷，保元汤效。
患霉毒者，兼发痘疮，多危候。
偏废症，亦有霉毒成之者。
中风证口开眼合撒手遗尿，亦有治者，余常用六君子加姜汁而愈。为市医者，宜审脉诊
神而治。
伤寒病后，因劳而复者少，因食而伤者多。
余治伤寒有用承气法大便至数十行，犹见胶黑粘腻之粪者，岂可执一下不可再下之说也
。(拙轩曰∶断病确，然后用药准。虽一下再下，自亦无妨，然于诊断不可不加之审也。)
喉痹多有急不及药者，若可进药，须急投之。
产后治法，市医必拘于生化汤。然亦有须审他证之急于去瘀生新也，不可不分别权衡。
产后中风，筋络拘急，手足螈 ，四物合薯蓣、生 、秦艽，补之则易愈，不可概作风
治。腹诊似较脉诊有据，舌诊尤较腹诊有据。
先师东洞翁屡以紫圆治痰粘胶结气逆者，盖亦善用紫圆之妙也。然亦用之当者方效。
松原一闲齐治一妇人，年三十有余，妊娠漏下，用补中益气合十全大补两剂，早晚间投
而愈
。又治一妇年二十，妊娠亦患漏下，他医曾用过补中益气剂、十全大补汤，均不见效，闲齐
用地黄剂即愈。盖一为气虚，一为血热，体质不同，治疗岂可不谛脉诊证而分别也。
桂枝汤治痹痛，亦能奏效。
香港脚上冲，先师东洞翁亦用紫圆治之。
艾圆灸足三里穴，可引香港脚不上攻。
疮疡用艾圆隔姜灸，奏效甚速。
桃花治痹泄，亦可通用。
黄胆证茵陈蒿汤不应者，合五苓散必应。
婴儿抽搐，不必一定，因风、因痰、因食、因热。如久患泻利，及大病后抽搐更多，与
附子
理中汤，每每奏效甚捷。市医有拘于惊风用麻桂各法，不救甚多。(拙轩曰∶唤醒群迷，活
人之功大矣。)
艾灸之效甚捷，痹痛亦有不可艾灸者，霉毒痹痛多不可用艾灸。灸则反剧，当慎之。
按摩法宜于婴儿症，因其投剂易误也。
解毒剂治风疹见愈者，仍有霉毒夹症。
霉疮症身体强壮之人，虽勿投剂，火毒渐清。用当归、生黄、芍药各治肝药，每得愈。
患伤寒者投承气汤大下，反见舌苔黄浓而焦者，必当再下。亦有下后热反盛者，亦宜再
下之而愈。市医多以一下不敢再下，但余见因下而死者少，失下而死者多。
龟背龟胸，由霉毒而成亦多。
瘰 亦有根于霉毒之作，不可不谛审也。
支饮易为肿胀，理中法合金匮肾气法得效。
余治一男子喘症，遇夏季必作，冬时反愈，与他人患喘症者相别。青龙法投之不效，香
薷合
六一散投之即愈。以治暑症之药治喘，盖其喘实因暑而起也。所以治病必求其本谓可信。征
韩一役，患喘甚多，青龙法不效，惜乎未谛审及此。
卒昏倒汗出，肢冷，面现红润者，决死。
老人卒昏倒，脉见弦紧革等者，为恶候。如支饮亦然，其面戴阳者，尤为凶。(温公诗
话云
∶平时充实而光泽可也，唯暴光泽特甚者，死兆也。是如草木将枯，精华顿发而生雀饧，
司命者不可不知矣。)
禀质强盛者，偶损下元，虚火上炎，加之以疫邪，医误为实，与大柴胡汤一下忽脱者有
焉。余故曰∶视色不以目，听声不以耳。
咳嗽有自心肺者，有自胃中者，不辨之，则治方无效。
腹痛诸药无效者，香苏散加青皮姜煎奇中，妊娠大腹痛者尤佳。(征韩役先哲既发明之
。而世医 ，实为可悯。)
患瘵疾者，襟际肉先脱，与他病羸瘦不同，宜熟察。(拙轩曰∶此诊瘵疾一大候，揭出
示学
者，可谓深切。按苏游传尸论云∶此病若脊膂肉消，及两臂饱肉消尽，胸前骨出入，即难疗
也。《灵枢·五变篇》云∶臂薄者，其髓不满，故善病寒热也。东郭说盖有所原焉。）
久患痫癖者，瘥后其性躁者，为恶候。
遗精白浊属疝者多，概不可为虚，如强中病亦然。
下血有下焦湿热而虚者，宜茵陈四苓加附子。属肠胃实火者，宜三黄汤。肠风下血，肠
胃中
蓄水饮者，宜四君子汤加黄 、白扁豆。胃中及下焦虚寒者，宜真武汤。如痔下血，亦可因
此法通治。
甘草粉蜜汤，治 囊病痛甚者效。
伤寒以大柴胡汤或柴胡加芒硝汤下之。热除后，肝气大动，谵言妄语如狂者，与竹茹温
胆汤则安。世医不知之，妄下误治者多矣。
出现舌面焦黑、无芒刺且干燥开裂呈皱纹状的情况，也适宜使用附子。因为这种证候虽然脉象浮洪或弦紧，但必定没有根基。给予附子后，如果病势缓和，脉象必然显现出虚象。舌色纯红属于阴虚，而焦黑则属于虚火。又有表现为阳热证候但舌面上反而没有苔垢且润泽的，这是恶候。像这样的证候，如果患者胸中闭塞，给予药物开通心胸气机，随后舌上生出苔垢，这是佳兆。如果虽然用药制约，但热势更加炽盛，舌苔不再新生的，属于不治之症。服药后，舌苔褪去且颜色不和的，有的适宜用石膏，有的适宜用附子，有的适宜用地黄，应当仔细辨别。总之，舌与脉是判断阴阳虚实的关键，不可不细致精确，所以我们这一门派增加腹诊和舌诊来判定病因的虚实。世间的医生不知道这一点，只执着于腹诊，舍弃脉诊和舌诊，可以说是疏漏了。（拙轩评论说：宽政年间，水户人土田恕庵撰写了一卷《舌图说》，依据张路玉的《舌鉴》等书，附上自己的所见，颇为详细明了，可以说是深得东郭翁的心意。）
舌面上无论苔色黄白，只要表面光滑而干燥，都适宜使用附子。舌色红色的，更是附子的适应证。
患者舌上有白色苔垢，其下透出紫黑色如同牛舌般的，属于恶候。这种舌象如果兼见面部泛红如妆（戴阳），则更为危险。
按察舌象大概与各种疫病没有不同，所以疫痘都可以用同样的方法诊断。但是到了结毒阶段，会呈现一种特殊的舌色，不可不加以辨别。（白苔中带暗色的，以及舌下赤色中出现皱纹的，还有紫色如同牛舌的，都属于结毒。）崎德见茂四郎（丝割符年寄），患鼻渊三年，各位医生认为是肺虚，百般治疗毫无寸效。我诊察发现他两鼻孔流浊涕如屋檐滴水般，脉象弦紧，腹部拘急。我说：这是肝火熏灼肺部，导致上下气机隔塞所致。世间的医生不知道这一点，随意认为是肺病，或者误认为是风邪侵肺，仅仅使用辛荑、白芷之类的药物。当然无法治愈。于是给予四逆散加吴茱萸、牡蛎服用，大约半个月，病洒然痊愈。像这类疾病应当详细诊察脉象和腹部，处方不一定非要用四逆散。
凡是患者胸膈不开阔，必然导致下部也不宽畅，所以要调理心下部位，必须先治疗胸膈，这是医家的一大紧要关键。我私下将其比作净土宗的一枚誓词（意指专一不二）。
一位产妇月经结束后二十天，突然呕吐数日不止，左胁下有冲逆剧痛，给予吴茱萸汤（参用西洋参）后忽然安定。
产后腰膝痿弱的，多系癖积所为。因为在怀孕初期患有水肿或脚气，到产后出现气急的，给予对症的药物。前证痊愈后，应当详细检查腹部并延请医生治疗癖积，此证最要紧的是艾灸。如果施用汤药及艾灸治疗癖积仍不能痊愈的，给予桂枝加术附汤、麻黄附子细辛汤，而在二三日或四五日之间，用紫圆攻下则能痊愈。这就是先师东洞翁独得的妙法，而我则是根据证候配合四逆散、理气汤、十全大补汤等，时常以紫圆攻下，每每获得疗效。
紫圆以荡涤胸膈为主，所以对于发狂上炎，严重到产后痿弱，心膈之气不能下降的，使用它都有效。昔日东洞先生曾用此方治疗龟胸龟背，就是这个宗旨。
目疾属于内瘴的，艾灸最有效，而专门从事眼科的医生忌讳艾灸，这真是可笑。其他如黄风雀目、肝虚雀目，如果不辨明动静而误治，后果严重。所谓黄风，是指白睛中生有细皱并发黄色，使用滋阴明目汤、八味丸、单杨抱术等有效。肝虚者，乌睛和白睛如常，只是觉得昏暗，所以难以治疗。
松原一闲齐，是吉益东洞的山胁东洋的师友，原本是为若狭侯臣，曾治疗龟胸龟背。对于痿废沉疴的患者，使用起废丸，其方由大黄、生漆两味研末为丸，未干时服用一钱或二钱。服药后出现大热并发赤疹为见效的标志，然后根据证候配合其他药物即可全愈。
一闲齐的门人桥诰顺治，治疗一位妇人，头发发热起火，每次梳理时感觉有火气到达就见到火光，给予三黄加石膏汤痊愈。
我曾亲眼看见一位妇人回家，衣襟里有爆响，投掷在暗处都能见到火光，这都是肝火所为，不足为怪。（拙轩评论说：明代郎瑛《七类稿》卷二十六有一条关于“衣火”的记载，与此同日之谈。又见于张芳洲《杂言》：按人发猫皮在暗中用手摩擦，常见灯光，且闻爆响。西洋人认为这是电气发出的验证，不必认为是肝火所为。《医剩》云：先父蓝溪公所认识的一位贵妇，每次在暗中更衣，火星爆出，同妇女梳头，在暗中及猫儿背毛逆摩出火之类，大概是体质气盛的人，偶尔有击打而发光的现象，并非真火。）
十枣汤证伴有下痢的，是因为上部逼迫之势很盛，热气下陷导致下利。所以这与脱利的趣味截然不同，如柴胡泻心汤治疗下利也是如此。
痘疹下利与伤寒合病下利相同。但如果持续十余日的，与少阴下利同辙，正是恶候。
大津小野又三郎，患天行病发呃逆，五六日后微利，脉象变得幼嫩无测，众医生认为是脱证都辞去了。我诊视了半天左右，对旁人说：这个脉象不是恶候，就是肝火亢盛所致。因此给予四逆散加地黄、古金汁服用，脉象顿时安定，诸证随之痊愈。
便毒无脓溃破，势将消散的，内托剂更无效。给予三物楸叶汤，如果不发起的，加附子，服用无效的。概因疝瘕为之妨害，给予四逆散加附子奇效。如果始终无脓溃破之势的，给予芎黄散加荞麦可攻下。
小儿胎毒系先天所得，而世间医生不知道这一点，有人说分娩时误饮瘀血，真是可笑。凡诊察其毒，先用指头按压肋下，心有凝结。根据其缓急，可以察知毒的轻重。另外面色灰白，或暗黑，或过于光泽，都属于胎毒。如果受父母霉毒的，最为难治。
其人平生有一只手的脉不应指，偶然的固然无害。如果在四十岁以后，一只手的脉突然断绝的，属于恶候。此证多房事者多有之，应当详察。
大腹痛服用建中汤无效的，认定为水分动气与莎草汤则愈。又左胁下逆抢痛甚，与诸药无效的，有水分动则与地黄剂有效。
水分动有三种：道属肝肾虚火的，是地黄、薯蓣、牡丹皮所适宜的；其动在表泛应的，是茯苓所主掌的；其动无根蒂，脐中齐鼓激的，所谓肾间动，属于不治之症。
京师书肆梅村氏说：江户千钟房有治疗积气血的奇方，名叫顺气散，即四物汤、香附子等分研末的。我认为此方有理，因此制作莎草汤屡验。
一男子二十四岁，得病五年，右膝肿起如别束筋肉，不能行走，其状稍类似鹤膝风，而其诊察腹部，右脐下拘急最甚，按之右足挛痛甚，其性急不能忍受物体。我认为这是肝癖固结所致，即给予大黄、附子加甘草汤，数日后癖块发动，病稍缓，因而给予四逆散，加良姜、牡蛎、小连翘全愈。此证世间医生不知道，徒然作为脚疾治疗，使用葳灵仙、杜仲、牛膝，当然不得其治。应当详察其腹候而治疗，这就是我积年粉骨碎身所得的经验，殆为医家的新手段。（拙轩评论说：此治验是翁极得意的手段，读者应当用心探究。）
发痫人事不省，药汁不下者，适宜艾灸。最要大壮。不彻底的，昼夜灸至七天为度。伤寒发痫的，也适宜此法，大灸至痫瘥，则邪气也随之解除。此理医经所未阐发，所以世间医生恐热忌灸，真是可笑。（窦材说：医生治病用灸，如同煮菜需新盐。今人不能治大病，确实是由于不知针艾的缘故。又说：世俗用灸，不过三五十壮，殊不知去小疾则愈，驻命根则难。所以铜人针灸图经云：凡大病宜灸脐下五百壮，补接真气，即此法也。彼此同见，可谓海外子云矣。）
患霉毒不外达，蕴结脏腑，兼见疝瘕的，不可徒治疝瘕，因为疝瘕不急于霉毒；如已形成恶候的，也应当先顾护疝瘕。
一闲齐门人桥诰顺治治疗一个婴儿痘疹入眼，久未退去赤翳，用生地黄、芍药、川芎、当归制剂，日渐痊愈。这是与我所说的四味缓肝、润肝、疏肝、泻肝分取，其治肝病同出一意。
伤寒误下成结胸，用陷胸法的，是误下。乃是下不及病之意，所以陷胸法再下之则愈。（拙轩评论说：此言未有见到者，曷能道之，误下误于轻下。正文原是失下，千古无人敢作如此解。）
承气汤攻霉有捷于汞剂。
患瘵疾便先溏的，建中剂可用。便未溏咳嗽晡热喘哕痰多的，非建中证，投之反剧。
瘵痨未必由虚起，体质实者遇折伤久延，疮疡久不收，亦致痨瘵。然而也是实者成虚。
大津小野又三郎，患天行病愈后，症似痨瘵，咳嗽盗汗。我给予地黄剂，众医强欲用建中，五七日遂喘急，仍与地黄剂愈。（拙轩评论说：建中法必在瘵疾便溏者用之。）
痨瘵便先溏泄，艾圆灸天枢、膏肓、脾俞、关元亦愈。灸膏肓可三七壮，灸关元可五七壮。
我曾使用薯蓣、生黄芪，加入四物剂，治愈妊娠呕吐便溏，患白带不止，形体瘦，癖结块在腹亦愈。
癖块食积胸膈，紫圆效。
打扑瘀结，大黄䗪虫攻下即愈。我治疗一妇人打扑腹痛，月水欲来不通。萃冈青洲诊之曰：瘀结于腹，与我同，惟他药多剂不知。遂用大黄䗪虫剂，即见黑瘀行而愈。
痢疾不得进药为噤口痢，然积食不消，胸膈癖块结实，亦哕恶不可进药，勿谓一律噤口也。
婴儿吐乳，一吐直冲即止的易治。吐了再吐，吐出顺口而流的，不易治。应当分别诊察。
伤寒失下多，误下少。
妊娠患伤寒当下之候，大承气亦可投。一妇人年二十有六，妊娠三个月有余，患伤寒已十日，手足冷，身热昏呓螈，大便秘结，口燥气盛，胎动不安，头额汗。众医以白虎证用生石膏、知母、生黄芪，多剂未知，危已极，胸膈闷急，腹硬而痛。我谓承气剂可效，投之果愈。（拙轩评论说：有故无殒，此之谓也。临危之治疗，不可以有犹豫之意。不独治妊娠伤寒，如见他证，亦当如是也。）
患霉毒的，兼发痘疮，多危候。
偏废症，亦有霉毒成之者。
中风证口开眼合撒手遗尿，亦有治者，我常用六君子加姜汁而愈。为市医者，宜审脉诊神而治。
我治伤寒有用承气法大便至数十行，犹见胶黑粘腻之粪的，岂可执一下不可再下之说也。（拙轩评论说：断病确，然后用药准。虽一下再下，自亦无妨，然于诊断不可不加之审也。）
喉痹多有急不及药的，若可进药，须急投之。
产后治法，市医必拘于生化汤。然亦有须审他证之急于去瘀生新的，不可不分别权衡。
产后中风，筋络拘急，手足螈，四物合薯蓣、生黄芪、秦艽，补之则易愈，不可概作风治。腹诊似较脉诊有据，舌诊尤较腹诊有据。
先师东洞翁屡以紫圆治痰粘胶结气逆的，盖亦善用紫圆之妙也。然亦用之当者方效。
松原一闲齐治一妇人，年三十有余，妊娠漏下，用补中益气合十全大补两剂，早晚间投而愈。又治一妇年二十，妊娠亦患漏下，他医曾用过补中益气剂、十全大补汤，均不见效，闲齐用地黄剂即愈。盖一为气虚，一为血热，体质不同，治疗岂可不谛脉诊证而分别也。
疮疡用艾圆隔姜灸，奏效甚速。
桃花治痹泄，亦可通用。
婴儿抽搐，不必一定，因风、因痰、因食、因热。如久患泻利，及大病后抽搐更多，与附子理中汤，每每奏效甚捷。市医有拘于惊风用麻桂各法，不救甚多。（拙轩评论说：唤醒群迷，活人之功大矣。）
艾灸之效甚捷，痹痛亦有不可艾灸的，霉毒痹痛多不可用艾灸。灸则反剧，当慎之。
按摩法宜于婴儿症，因其投剂易误也。
霉疮症身体强壮之人，虽勿投剂，火毒渐清。用当归、生黄芪、芍药各治肝药，每得愈。
患伤寒者投承气汤大下，反见舌苔黄浓而焦的，必当再下。亦有下后热反盛的，亦宜再下之而愈。市医多以一下不敢再下，但余见因下而死者少，失下而死者多。
我治疗一男子喘症，遇夏季必作，冬时反愈，与他人患喘症者相别。青龙法投之不效，香薷合六一散投之即愈。以治暑症之药治喘，盖其喘实因暑而起也。所以治病必求其本谓可信。征韩一役，患喘甚多，青龙法不效，惜乎未谛审及此。
老人卒昏倒，脉见弦紧革等的，为恶候。如支饮亦然，其面戴阳的，尤为凶。（温公诗话云：平时充实而光泽可也，唯暴光泽特甚的，死兆也。是如草木将枯，精华顿发而生雀饧，司命者不可不知矣。）
禀质强盛者，偶损下元，虚火上炎，加之以疫邪，医误为实，与大柴胡汤一下忽脱的有焉。我故曰：视色不以目，听声不以耳。
腹痛诸药无效的，香苏散加青皮姜煎奇中，妊娠大腹痛者尤佳。（征韩役先哲既发明之。而世医，实为可悯。）
患瘵疾的，襟际肉先脱，与他病羸瘦不同，宜熟察。（拙轩评论说：此诊瘵疾一大候，揭出示学者，可谓深切。按苏游传尸论云：此病若脊膂肉消，及两臂饱肉消尽，胸前骨出入，即难疗也。《灵枢·五变篇》云：臂薄者，其髓不满，故善病寒热也。东郭说盖有所原焉。）
下血有下焦湿热而虚的，宜茵陈四苓加附子。属肠胃实火的，宜三黄汤。肠风下血，肠胃中蓄水饮的，宜四君子汤加黄芪、白扁豆。胃中及下焦虚寒的，宜真武汤。如痔下血，亦可因此法通治。
甘草粉蜜汤，治囊病痛甚的效。
When the tongue surface is scorched black, without prickles, dry, cracked, and wrinkled, Aconite (Fuzi) is also suitable. This is because although the pulse in this syndrome may be floating and surging or wiry and tight, it definitely lacks a root. After administering Aconite, if the disease trend eases, the pulse will inevitably reveal deficiency signs. A purely red tongue indicates Yin deficiency, while a scorched black tongue indicates deficient fire. There are also cases presenting with Yang heat symptoms but with a tongue that instead lacks coating and remains moist; this is an ominous sign. In such cases, if the patient suffers from chest obstruction, administering medication to open and unblock the chest and heart qi, followed by the emergence of tongue coating, is a favorable omen. However, if despite medication intended to restrain the heat, the heat intensifies further and no new coating forms, it is an untreatable condition. After taking medicine, if the tongue coating sheds and the color becomes discordant, some cases require Gypsum (Shigao), some require Aconite (Fuzi), and some require Rehmannia (Dihuang); these must be carefully distinguished. In summary, the tongue and pulse are critical for judging Yin-Yang and deficiency-excess, and they must not be examined carelessly. Therefore, our school adds abdominal and tongue diagnosis to determine the etiology's deficiency or excess. Physicians of the world who do not understand this, relying solely on abdominal diagnosis while abandoning pulse and tongue diagnosis, can be considered negligent. (Zhuoxuan commented: During the Kansei era, Tsuchida Jotan of Mito wrote a volume titled *Tongue Diagram Explanation*, based on Zhang Luyu's *Tongue Diagnosis* and others, adding his own observations. It was quite detailed and clear, truly capturing the essence of Master Dongguo.)
Regardless of whether the tongue coating is yellow or white, if the surface is smooth and dry, Aconite (Fuzi) is suitable. If the tongue is red, it is even more indicative of an Aconite syndrome.
If a patient has a white coating on the tongue, with a purple-black hue showing underneath like a cow's tongue, it is an ominous sign. If this tongue presentation is accompanied by facial flushing (floating yang), it is even more critical.
Generally, tongue presentations in various epidemics are similar, so epidemic pox can be diagnosed using the same methods. However, in the case of syphilis (Jiedu), a specific tongue color appears, which must not fail to be distinguished. (White coating with dark spots, redness under the tongue forming wrinkles, and a purple color like a cow's tongue all belong to syphilis.) Saki Tokimori Shiro (a senior official of the Shigarashi clan) suffered from sinusitis (Bi Yuan) for three years. Various physicians attributed it to Lung deficiency, but hundred treatments yielded no effect. Upon examination, I found turbid discharge dripping from both nostrils like rainwater from eaves, a wiry and tight pulse, and abdominal tension. I said: This is caused by Liver fire scorching the Lungs, leading to blockage of Qi between the upper and lower bodies. Worldly physicians, unaware of this, casually attribute it to Lung disease or mistakenly diagnose wind-pathogen invading the Lungs, using only herbs like Xin Yi (Magnolia Flower) and Bai Zhi (Angelica Dahurica). No wonder treatment fails. I prescribed Si Ni San (Frigid Extremities Powder) added with Wu Zhu Yu (Evodia) and Mu Li (Oyster Shell). After about half a month, the illness resolved completely. For such diseases, one should carefully examine the pulse and abdomen; the prescription does not necessarily have to be Si Ni San.
Whenever a patient's chest and diaphragm are not open, the lower body will inevitably feel constrained. Therefore, to regulate the epigastrium, one must first treat the chest and diaphragm; this is a crucial point for physicians. I privately compare this to the single vow of the Pure Land sect (implying exclusive focus).
A woman, twenty days after menstruation, suddenly vomited continuously for several days, with severe rushing pain under the left hypochondrium. She was given Wu Zhu Yu Tang (Evodia Decoction) with American Ginseng (Yang Shen), and she suddenly stabilized.
Postpartum weakness of the waist and knees is often caused by Pi accumulation (masses). If edema or beriberi occurred during early pregnancy, and shortness of breath develops postpartum, administer symptomatic medication. After the previous symptoms resolve, one must carefully examine the abdomen and consult a physician to treat the Pi mass; moxibustion is most important here. If decoctions and moxibustion for Pi masses fail to cure, administer Guizhi Jia Zhu Fu Tang (Cinnamon Twig Decoction plus Atractylodes and Aconite) or Mahuang Fuzi Xixin Tang (Ephedra, Aconite, and Asarum Decoction), and within two to three or four to five days, purge with Zi Yuan (Purple Pill) to achieve recovery. This is the unique brilliance of my late master, Master Dongdong. I, however, combine this with Si Ni San, Li Qi Tang (Regulate Qi Decoction), or Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction), frequently purging with Zi Yuan, often achieving efficacy.
Zi Yuan primarily purges the chest and diaphragm. Thus, it is effective for mania with upward flaming, severe postpartum weakness, and conditions where Qi in the heart and diaphragm cannot descend. Formerly, Master Dongdong used this formula to treat turtle back and turtle chest, following this principle.
For eye diseases belonging to internal miasma, moxibustion is most effective, yet specialists who forbid it are laughable. Other conditions like Huang Feng (yellow wind) and Que Mu (night blindness) due to Liver deficiency require differentiation to avoid misdiagnosis. Huang Feng presents with fine wrinkles and yellow discoloration in the sclera; Ziyin Mingmu Tang (Nourish Yin and Brighten Eyes Decoction), Ba Wei Wan (Eight-Ingredient Pill), or Dan Yang Bao Zhu (Single Cnidium and Atractylodes) are effective. Liver deficiency presents with normal cornea and sclera but blurred vision, making it difficult to treat.
Matsubara Ikken Sai was a teacher and friend of Yoshitsune Dongdong and Yamawata Toyo. Originally a retainer of the Wakasa Lord, he treated turtle back and chest. For patients with chronic paralysis, he used Qi Fei Wan (Revive the Disabled Pill), composed of Rhubarb (Da Huang) and raw lacquer, ground into powder and formed into pills. Taken fresh (one or two qian), it causes intense heat and red rashes as a sign of efficacy, followed by complete recovery when combined with other medications according to the syndrome.
Ikken Sai's disciple, Hashimoto Junji, treated a woman whose hair felt hot and emitted sparks visible in the dark when combed. She recovered after taking San Huang Jia Shigao Tang (Three Yellows Plus Gypsum Decoction).
I personally witnessed a woman returning home whose clothes crackled audibly and emitted sparks in the dark. All these are manifestations of Liver fire and are not surprising. (Zhuoxuan commented: Lang Ying's *Seven Categories Draft*, Vol. 26, contains a section on "Clothing Fire," discussing this same topic. Also seen in Zhang Fangzhou's *Miscellaneous Sayings*: Rubbing human hair or cat skin in the dark produces light and crackling sounds. Westerners consider this evidence of electricity, not necessarily Liver fire. *Yi Sheng* records: My father, Lanxi, knew a noblewoman who sparked when changing clothes in the dark, and sparks flew when combing hair or rubbing against a cat's fur in the dark. This is likely due to strong constitution causing static discharge, not true fire.)
In Shi Zao Tang syndrome with diarrhea, the diarrhea results from intense upper pressure causing heat to sink downward. Thus, its therapeutic intent differs significantly from treating collapse-type diarrhea. Similarly, Chai Hu Xie Xin Tang treats diarrhea differently.
Diarrhea accompanying smallpox/rash is the same as diarrhea in Taiyang syndrome combined disease. However, if it persists for over ten days, it follows the pattern of Shaoyin diarrhea, which is an ominous sign.
Ono Matajuro of Otsu suffered from epidemic hiccups. After five or six days, mild diarrhea appeared, and the pulse became faint and unpredictable. Many physicians deemed it a collapse syndrome and resigned. After examining him for half a day, I told bystanders: This pulse is not ominous; it is caused by hyperactive Liver fire. I administered Si Ni San added with Dihuang (Rehmannia) and Gu Jin Zhi (Ancient Gold Juice). The pulse immediately stabilized, and all symptoms resolved.
For external abscesses (Bian Du) without pus formation, approaching resolution, internal support formulas are ineffective. Administer San Wu Qiu Ye Tang (Three Materials Mulberry Leaf Decoction). If it does not suppurate, add Aconite. If still ineffective, it is generally obstructed by Shan Xia (hernia/masses). Si Ni San added with Aconite yields miraculous results. If there is never any tendency to suppurate throughout, Xiong Huang San (Peony and Rhizoma Curcumae Powder) added with buckwheat can be used to purge.
Pediatric congenital toxins are innate. Worldly physicians ignore this, and those who claim infants accidentally drank lochia during birth are ridiculous. To diagnose this toxin, press the subcostal area with fingertips; condensation in the Heart region indicates the presence of toxin. Its severity can be judged by the urgency of the reaction. Grayish-white, dark, or overly lustrous complexions all indicate congenital toxin. Syphilitic toxin inherited from parents is the most difficult to treat.
If a person has always had one wrist pulse absent, occasional absence is harmless. However, if one wrist pulse suddenly disappears after age forty, it is an ominous sign. This condition is common among those with excessive sexual activity and requires careful observation.
For severe abdominal pain unresponsive to Jian Zhong Tang (Establish the Middle Decoction), diagnosing Water Movement Qi (Shui Fen Dong Qi) and treating with Sha Cao Tang (Sedge Grass Decoction) leads to recovery. For severe rebellious pain under the left hypochondrium unresponsive to various medicines, if Water Movement is present, Di Huang preparations (Rehmannia-based) are effective.
Water Movement manifests in three ways: Those belonging to deficiency-fire of the Liver and Kidneys are suited to Dihuang (Rehmannia), Shanyao (Dioscorea), and Mudanpi (Tree Peony Bark). Movements superficial and generalized are governed by Fuling (Poria). Movements lacking a root, with pulsation at the umbilicus, are known as Kidney Gate Movement and are untreatable.
Mei Cun, a bookseller in Kyoto, stated: Senkoubo in Edo has a miraculous formula for accumulating Qi and Blood called Shun Qi San (Smooth Qi Powder), consisting of equal parts Si Wu Tang (Four Substances Decoction) and Xiang Fu (Cyperus). I found logic in this formula and thus created Sha Cao Tang, which proved repeatedly effective.
A twenty-four-year-old man suffered for five years. His right knee swelled like bound muscles, preventing walking. The appearance resembled Crane Knee Wind, but abdominal examination revealed severe tension below the right umbilicus. Pressing caused severe cramping pain in the right foot, and his temperament was irritable. I diagnosed it as consolidated Liver Pi mass. I administered Da Huang (Rhubarb) and Fuzi (Aconite) added with Gancao (Licorice). After several days, the mass activated, and the condition eased. Then, I prescribed Si Ni San added with Liang Jiang (Galangal), Mu Li (Oyster Shell), and Xiao Lian Qiao (Small Forsythia), resulting in full recovery. Worldly physicians, unaware of this, treat it merely as a leg disease using Ling Xian Cao (Akebia), Du Zhong (Eucommia), and Niu Xi (Achyranthes), failing to cure. One must examine the abdominal signs to treat this. This represents my years of painstaking experience, a novel approach for physicians. (Zhuoxuan commented: This treatment is Master's greatest pride; readers should study it carefully.)
For patients with epilepsy who lose consciousness and cannot swallow medicine, moxibustion is suitable. Large moxa cones are essential. If not thorough, moxa daily and night for seven days. For epilepsy caused by Taiyang syndrome, this method is also suitable. Large moxibustion until epilepsy subsides resolves the pathogen. This principle is not elaborated in medical classics, so worldly physicians fear heat and avoid moxibustion, which is laughable. (Dou Cai said: Using moxibustion is like cooking with fresh salt. People today cannot treat major illnesses precisely because they do not know acupuncture and moxibustion. He also said: Laypeople use only 30-50 moxa cones, not realizing that while removing minor ailments is easy, preserving life is hard. The *Bronze Man Acupuncture and Moxibustion Classic* states: For major illnesses, moxa 500 cones below the umbilicus to tonify and connect True Qi. This is the method. Our views coincide, like Ziyun across the sea.)
Patients with pre-existing hernia/masses who suddenly move the mass location upon contracting a major illness face a very ominous prognosis.
When syphilis toxin fails to express externally, accumulates in the Zang-Fu, and is accompanied by hernia/masses, one must not merely treat the hernia/masses, as they are less urgent than the syphilis. If ominous signs form, one must prioritize protecting against the hernia/masses.
Ikken Sai's disciple, Hashimoto Junji, treated an infant with smallpox/rash affecting the eyes, leaving persistent red membranes. He used a preparation of Sheng Di Huang (Raw Rehmannia), Shao Yao (Peony), Chuan Xiong (Sichuan Lovage), and Dang Gui (Angelica Sinensis). The condition improved daily. This aligns with my teaching of using four flavors to soothe, moisten, disperse, and drain Liver heat, sharing the same intent for treating Liver diseases.
In Taiyang syndrome, mistaken purgation leading to Jie Xiong (chest binding) treated with Xian Xiong Fa (Depress Chest Method) implies the initial purgation was insufficient. Thus, the Depress Chest Method purges again to cure. (Zhuoxuan commented: This insight is rare. Mistaken purgation is often due to insufficient purgation. The original text implies failure to purge; no one since antiquity dared interpret it this way.)
Cheng Qi Tang (Order the Qi Decoction) acts faster against syphilis toxins than mercury agents.
For consumption (Lao Ke) with loose stools, Jian Zhong agents are usable. If stools are not loose but cough, afternoon fever, wheezing, hiccups, and phlegm are present, it is not a Jian Zhong syndrome; administering it worsens the condition.
Consumption does not necessarily start from deficiency. Individuals with strong constitutions suffering from prolonged fractures or non-healing ulcers can also develop consumption. However, this is essentially excess transforming into deficiency.
In Taiyang syndrome, if there is no bowel movement for seven to eight days and the lower abdomen protrudes, it is an ominous sign.
Ono Matajuro of Otsu, after recovering from an epidemic, presented with symptoms resembling consumption: cough and night sweats. I administered Dihuang preparations. Other physicians insisted on Jian Zhong, causing wheezing after five to seven days. Resuming Dihuang preparations cured him. (Zhuoxuan commented: Jian Zhong method must be used only when consumption presents with loose stools.)
Long-term loose stools leading to pale skin and muscle wasting indicate established consumption.
For consumption with loose stools, moxa cones on Tianshu (ST25), Gaohuang (BL43), Pishu (BL20), and Guanyuan (CV4) can also cure. Moxa Gaohuang 21-30 cones; moxa Guanyuan 35 cones.
Moxibustion for epilepsy requires endurance/pain tolerance.
Syphilis can also cause consumption.
Consumption starting with cough inevitably involves hemoptysis.
I once used Shanyao (Dioscorea) and Sheng Huang Qi (Raw Astragalus) added to Si Wu Tang (Four Substances Decoction) to treat pregnancy vomiting with loose stools, continuous leukorrhea, emaciation, and abdominal masses, curing all.
Pi masses and food stagnation in the chest/diaphragm respond well to Zi Yuan (Purple Pill).
Traumatic blood stasis responds to Da Huang Zhe Chong Wan (Rhubarb and Ground Beetle Pill) for purging. I treated a woman with abdominal pain from trauma and impending amenorrhea. Cui Gang Qingzhou diagnosed blood stasis in the abdomen, agreeing with me but noting previous multi-dose failures. Using Da Huang Zhe Chong Wan, black stasis passed, and she recovered.
Dysentery preventing medication intake is called Jin Kou Li (Clamped Mouth Dysentery). However, undigested food, chest/diaphragmatic masses, and hardness causing nausea/prevention of intake should not be uniformly labeled as clamped mouth dysentery.
Infant spitting up milk that shoots straight out and stops easily is easy to treat. Spitting up repeatedly, flowing smoothly, is difficult to treat. Differentiate accordingly.
Taiyang syndrome mistakes involve more missed purgations than incorrect ones.
For pregnancy complicated by Taiyang syndrome requiring purgation, Da Cheng Qi Tang (Major Order the Qi Decoction) can be administered. A twenty-six-year-old woman, over three months pregnant, suffered Taiyang syndrome for ten days. Symptoms included cold extremities, fever, delirium, convulsions, constipation, dry mouth, excessive Qi, restless fetus, and sweating on the forehead. Physicians diagnosed Bai Hu Syndrome (White Tiger Syndrome) and used Shigao (Gypsum), Zhimu (Anemarrhena), and Sheng Huang Qi (Raw Astragalus) for many doses without effect. Condition was critical: chest oppression, hard painful abdomen. I predicted Cheng Qi Tang would work; it did. (Zhuoxuan commented: "Having pathology, no injury." This applies. In critical situations, hesitation is forbidden. Not just for pregnancy Taiyang, but for other syndromes too.)
Hemiplegia affects the left side more often.
For smallpox/rash with white color and depressed tops, Bao Yuan Tang (Protect Origin Decoction) is effective.
Syphilis patients developing smallpox/rash often face critical conditions.
Hemiplegia can also be caused by syphilis.
Stroke presenting with open mouth, closed eyes, grasping hands, and urinary incontinence can be treated. I commonly use Liu Jun Zi Tang (Six Gentlemen Decoction) added with ginger juice to cure. Market physicians should carefully examine pulse and spirit before treating.
After Taiyang syndrome, relapse due to fatigue is rare; relapse due to dietary injury is common.
I treated Taiyang syndrome using Cheng Qi method, resulting in dozens of bowel movements, yet sticky black feces remained. How can one adhere to the theory of "one purge is enough"? (Zhuoxuan commented: Accurate diagnosis ensures precise medication. Multiple purgations are acceptable if necessary, but diagnosis must be rigorous.)
Throat bi (obstruction) often progresses too quickly for medication. If medication can be taken, administer urgently.
Postpartum treatment by market physicians rigidly adheres to Sheng Hua Tang (Generate Transformation Decoction). However, one must assess other syndromes prioritizing eliminating stasis and generating new blood. Weigh carefully.
Postpartum wind-stroke with tendon constriction and limb convulsions: Si Wu Tang combined with Shenyao (Dioscorea), Sheng Huang Qi (Raw Astragalus), and Qin Jiao (Gentiana Macrophylla) tonifies and cures easily. Do not simply treat as wind. Abdominal diagnosis seems more reliable than pulse diagnosis; tongue diagnosis is even more reliable than abdominal diagnosis.
My late master, Master Dongdong, frequently used Zi Yuan (Purple Pill) for sticky phlegm and rebellious Qi, demonstrating his skill. However, it is only effective when used appropriately.
Matsubara Ikken Sai treated a woman over thirty with pregnancy leakage. Two doses of Bu Zhong Yi Qi Tang (Tonify the Middle and Augment Qi Decoction) combined with Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction), taken morning and evening, cured her. He also treated a twenty-year-old pregnant woman with leakage. Previous physicians used Bu Zhong Yi Qi Tang and Shi Quan Da Bu Tang without effect. Ikken Sai used Dihuang (Rehmannia) preparations, curing her. One case was Qi deficiency, the other Blood heat. Constitutions differ; treatment must differentiate via pulse and syndrome.
Guizhi Tang (Cinnamon Twig Decoction) treats Bi pain (painful obstruction) effectively.
Beriberi with upward rushing: My late master, Master Dongdong, also used Zi Yuan (Purple Pill) to treat it.
Moxa cones on Zusanli (ST36) can prevent beriberi from rushing upward.
For sores/ulcers, ginger-separated moxibustion acts very quickly.
Taohua (Peach Seed) treats Bi diarrhea and can be used generally.
Jaundice unresponsive to Yin Chen Hao Tang (Artemisia Scoparia Decoction) responds when combined with Wu Ling San (Five Ingredient Powder with Poria).
Infant convulsions are not always due to wind; they can stem from phlegm, food, or heat. Convulsions after long-term diarrhea or major illness are common. Fuzi Lizhong Tang (Aconite and Ginger Warming Middle Decoction) often works rapidly. Market physicians rigidly stick to Jing Feng (Wind Shock) treatments using Ma Huang (Ephedra) and Gui Zhi (Cinnamon Twig) methods, saving few. (Zhuoxuan commented: Awakening the deluded masses, the merit of saving lives is great.)
Moxibustion is very effective, but some Bi pains cannot be treated with it. Syphilitic Bi pain mostly cannot use moxibustion; moxa worsens it. Be cautious.
Massage is suitable for infants because medication errors are easy.
Detoxifying agents curing wind rash may still have hidden syphilitic complications.
Strong individuals with syphilis may clear fire-toxin gradually without medication. Using Dang Gui (Angelica), Sheng Huang Qi (Raw Astragalus), and Shao Yao (Peony) to treat the Liver often achieves recovery.
After Taiyang syndrome, large purgation with Cheng Qi Tang may result in thick, scorched yellow tongue coating; re-purgation is necessary. Heat may intensify after purgation; re-purgation cures. Market physicians fear re-purgation, but I see fewer deaths from purgation and more from missed purgation.
Turtle back and chest are often caused by syphilis.
Scrofula (Luo Li) can also originate from syphilis; careful examination is required.
Zhi Yin (branching fluid) easily transforms into edema. Li Zhong Fa (Warming Middle Method) combined with Jin Gui Shen Qi Fa (Golden Cabinet Kidney Qi Method) is effective.
I treated a man with asthma worsening in summer and improving in winter, distinct from others. Qing Long Fa (Green Dragon Method) failed. Xiang Ru (Mosla) combined with Liu Yi San (Six-to-One Powder) cured him. Treating asthma with summerheat remedies worked because the asthma originated from summerheat. Thus, "seeking the root" is credible. During the Korean campaign, many suffered asthma; Green Dragon failed. Regrettably, I did not examine this deeply then.
Sudden fainting with sweating, cold limbs, and ruddy complexion indicates certain death.
Sudden fainting in the elderly with wiry, tight, or革 (leather-like) pulses is ominous. Same for Zhi Yin with floating yang on the face, which is especially fatal. (Wen Gong's Poetry Talks: Normal luster is fine, but sudden extreme luster is a death omen. Like dying grass flashing brilliance, physicians must know this.)
Those with strong constitutions occasionally damaging the Lower Origin, with deficient fire flaming upward, compounded by epidemic pathogens, may be misdiagnosed as excess and given Da Chai Hu Tang (Major Bupleurum Decoction). One purge may cause sudden collapse. Hence I say: Observe color not just with eyes, listen to sound not just with ears.
Cough originates from Heart/Lung or Stomach; failing to distinguish renders treatment ineffective.
Abdominal pain unresponsive to various medicines: Xiang Su San (Perilla and Tangerine Peel Powder) added with Qing Pi (Green Tangerine Peel) and ginger decoction hits miraculously, especially for severe pregnancy abdominal pain. (Pioneered by philosophers during the Korean campaign. Worldly physicians' ignorance is pitiable.)
Consumption patients show flesh loss at the collarbone first, different from general emaciation. Examine carefully. (Zhuoxuan commented: This is a major sign for diagnosing consumption, revealing it to students is profound. *Su You Zhuan Shi Lun* states: If spinal and arm muscles waste away, and chest bones protrude, it is hard to treat. *Ling Shu · Wu Bian Pian* states: Thin arms indicate insufficient marrow, prone to cold/heat. Dongguo's theory has origins.)
Long-term epilepsy/mass patients becoming irritable after recovery face an ominous prognosis.
Nocturnal emission and white turbidity often belong to hernia; generally not deficiency. Same for Qiang Zhong disease.
Lower bleeding due to damp-heat in Lower Jiao with deficiency: Yin Chen Si Ling Tang (Artemisia Four Poria Decoction) added with Fuzi (Aconite). Intestinal wind bleeding with water-fluid retention in intestines/stomach: Si Jun Zi Tang (Four Gentlemen Decoction) added with Huang Qi (Astragalus) and Bai Bian Dou (White Hyacinth Bean). Deficiency-cold in stomach and Lower Jiao: Zhen Wu Tang (True Warrior Decoction). Hemorrhoidal bleeding can also be treated generally by this method.
Gan Cao Fen Mi Tang (Licorice, Flour, and Honey Decoction) is effective for severe scrotal pain.
In Taiyang syndrome, purging with Da Chai Hu Tang or Chai Hu Jia Mang Xiao Tang. After heat removal, if Liver Qi moves violently causing delirium and madness, Zhu Ru Wen Dan Tang (Bamboo Shavings Warming Gallbladder Decoction) calms it. Worldly physicians, unaware, often mistreat with incorrect purgation.