故阴道未能平复，嗣后口渴殊甚，饮汤水如甘露焉。虽数十杯不足满其欲也。余次年入
都，劝其大为壮水主之，佐以引火归原之饵，则木升火降，消渴之热自除，变生之症
可休，奈视为忽略，虽服数剂，口渴略减，即停药饵，至四月间背上忽隐隐疼痛，渐渐
疼甚肉硬，亦未知其为疽也。半月之余，背上疼极重极，招余诊视，当脊少偏半寸，外
虽不肿，肉分坚实碗大矣。余曰∶久渴不治，阴水日亏、阴火日烁，荣卫失调，故书
有脑疽、背疽之预防也。今外虽不肿，阴分已成形受伤矣。亟为托出阳分，使毒瓦斯勿致
逗留，陷入脏腑也。乃外用大黄二两、芙蓉叶赤芍各一两、白芨、白蔹各五钱，为末，
鸡子清调敷毒四围，内则重滋阴水，兼为解托。如熟地、山药、川贝、角刺、天虫、甲
片、生甘草、连翘、金银花之类，及其形肿既成，乃早晨空心吞服八味丸五六钱，以培
先天之水火，食远服。大补荣卫及排脓托里之剂，以助后天气血，如人参、生黄 、当
归、白术、白芍、无虫、甲片、角刺、金银花、甘草节、白芷之类，日服二剂，外以古
方太乙膏，加男发、蓖麻子、乳香、没药，煎膏贴毒，以呼毒瓦斯出外，四围仍敷，以杜
散慢。如是调理，不旬日而 肿日高，四围红肿日消，疼痛日减，背肿日轻。已有脓
势，奈有力举一专门外科视之，去其四围敷药，内进清凉解毒，外用敷药，漫涂毒上二
三日间，平塌日甚，根脚复大，疼痛难忍，且云∶内溃己甚，黑烂深大。口出无稽之
语，司农心骇。乃复延余视，知其毒势溃漫无拘，且乘正虚，复有内袭之虑矣。急去其
所敷，仍前外围内托，照前加减，每剂更加肉桂钱余，数剂之后，仍前高肿而红活，竟
如些小肿硬，溃脓而愈，毫不大伤肌肉，不待珍珠掺药，而疮口渐平，口渴诸症尽退，
故要知一切肿毒，原非毒也。乃气血不和，留结所致，调其气血而毒自解。若以清凉解
毒为事，则反伤胃气，气血愈虚，虽欲解毒，毒滞于中，况遇清凉冰伏于内，反成大
害，可不慎之。
少司马胡老先生之二令郎，患痘初起甚
危，都中善治痘者一老医，断其必死，胡老先生乃延余同治，余见其方寒凉太甚，所以
冰伏不出，有腹胀喘急诸症也。先以酒酿鸡冠血，调下独胜散一服，解其冰伏之势，已
喘热俱减，痘有出势，其医必以不救为争，余曰∶无若是以重主人之忧，望为同事，吉
则为君之功，凶则皆我之过，其医愠色，肆言无忌，胡老先生唯日夜痛哭而已，勉留余
寓，早晚调治，痘愈八九，主人仍然不乐，余莫能解，孰知其医每日私来诊视，谆谆断
以时日凶变，直至结痂痊愈，胡老先生乃喜形于色，悔听蛊惑，几至败事！余每次入
都，往还如同至戚焉。一宝坻王姓，久患重痢，因候选扶病入都，来延余视，时当六
月，肚以上至阴囊，皆重绵浓裹，稍薄则肚痛顿甚，其两足心又觉甚热，时刻难受，要
人重扇始可，饮食不思，势甚危困，其脉则寸强关尺并弱，余曰∶此中气久虚，气不升
降，阴阳阻隔，似痢非痢，误用香连苦寒之剂。以致抑遏阳气于九地之下，而中宫藏阳
纳气之所，反已空虚，且久痢阴阳两亡，故足心之热，阴虚所致，脏腹之寒，阳虚所
由，中宫之阳宜温而补，下陷之阳宜清而升，理难并行，余但先去其中寒之阻隔，则
郁遏下极之火，自能上升，大用附子理中汤，加五味子以敛之，二三剂后肚寒足热俱
减六七，乃以归脾汤加肉桂五味，煎汤送服八味丸而痊愈。
宛平王中堂，忽患一寐，即梦持重搬运，甚觉困乏而醒，醒来复甚野狼狈而睡，无
如睡去，其梦仍如故，醒而睡，睡而醒，一夜数十次，医用人参、枣仁、茯神、远志、
归身养血安神之剂，愈服愈甚。乃延余治，按其两寸甚洪有力，左寸更大，两关洪大兼
弦，两尺虽洪，弦而无力，余始知为药之误也。盖寐者心神藏纳于肾阴，乃水火相见，
阴阳既济之时也。心犹人也。肾犹舍也。今心阴不足，惟火独光，乃遂上炎之性，而失
下交之象矣。肾气又虚，不能升腾收摄，离阴而失延纳闭藏之职矣。犹人徒恃火性，勇
力向前。而不能退藏于舍，其房室亦甚破败，不能藏纳其人，人但知心象火而肾属
水，而竟不思离心坎肾乎！尽言心中之水，乃真水也。肾中之火，乃真火也。水火互藏
其根，故心能下交，肾能上摄，今心阴不足，肾气衰微，已成不交之象，昧者复补心
神，愈增炎上之势，焉能使其阳会于阴，元神凝聚于内乎？静功有云∶神必附物，精能
凝神，此至理也。乃重剂八味加牛膝五味子，用灯心莲子作引煎服而愈。
工科掌中谭老先生，年六十有余，正当衙门办事，卒然昏晕仆倒，痰涎涌盛，不省
人事，顷而吐痰碗许少苏，长班用力拥之与中，挟其两腿而归，于是腿疼之因，从兹始
矣。归寓之后，医家以清热疏风豁痰为事，究竟调治旬余，痰涎不减，烦躁倍常，头痛
腿疼更甚，日夜为苦。乃延余视，按其脉两寸甚洪大，两尺右关甚沉微，此孤阳独亢于
上，弱阴不能敛纳，且中宫脾土虚阳无退藏之舍，所以上浮巅顶为胀为疼，自觉重而且
大，莫之能忍，理宜壮水以制之，培土以藏之，补火以导之，佐以滋肺清金，以成秋降
之令，下趋收敛，以得归源封蛰之藏，故以熟地八钱为君，乳炒白术五钱为臣，米炒麦
冬三钱、牛膝二钱、五味子一钱为佐，制附子一钱五分为使，前药其剂煎成，另用人参
五钱、熬汁冲服，盖恐元气虚弱，药性力大，一时阴翳之火骤消，诸虚之真象并见，
用之既可驾驱药力，复能托住本元，进服之后，头疼顿减，诸症渐痊，但腿痛如故，不
能成寐，其所疼之处，长班向挟五指之手印在焉。余曰∶此外困也。当外治之，乃用猪
肘生精肉捣烂，入肉桂细末，葱白食盐和匀，浓 疼处，一昼夜而安，其血凝滞之
手印，亦消靡矣。后原素患晨泻，多年不愈，以致饮食不甘，予令早晨空心参汤送服
八味丸，午间食前，以炒黄白术三十两、制熟附三两，共熬成膏，以人参细末六两，收
成细丸，日中食前白汤吞服三钱、半月之余，脾胃顿强，精神倍长。
文选司司老先生，素患痰喘，发则饮食不进，旦夕不寐，调治数月不效，乃延余
治，按其脉两寸少洪，余皆沉弱，其右关尺微细更甚，乃知命门之火衰极，无根虚阳上
浮，且久服克削，脾元亏损，愈不能渗湿消痰，以致痰涎益盛，更不能按纳藏元，以致
虚气愈逆，乃立一方，以炒黄白术八钱，固中气为君，炒燥麦冬三钱清肺，引气降下为
臣，炮姜二钱，温中导火，牛膝二钱，下趋接引，五味子一钱。敛纳收藏，并以为佐，
制附子一钱五分，承上药力，真达丹田，以为使。如是数剂，痰退喘止，饮食进而精神
强，久服八味丸而不再发。
凡肾气虚者，脾气必弱，脾气弱者，肾气必虚，盖肾为先天祖气，脾为后天生气，
而生气必宗于祖也。余五儿干吉，向来禀赋脾肾两亏，体肥而白，外似有余，内实不
足，壬申年随余在都，时年四岁，当五月而出痘，发热一二日，便已神气困倦，汗出如
砌，热至将二日而见痘，余因汗多阳虚，故一切疏解，毫不少进，不意三日外，汗出不
止，内则清利甚频，所见之痘反隐隐退缩，未出者尤气弱不能出矣。余思书云∶气弱不
能出者，当微补其气，气和则能出矣。况有是病，而服是药，当无碍也。三朝便投人
参、炒白木各三钱、炙草八分以固中为君，天虫三钱、角刺一钱、土炒甲片六分，攻托
以为臣，川芎八分升提而兼辛发，肉桂六分温经而兼外达以为佐，四朝汗泻少减，出者
少长，未出者见形，乃仍用人参、白术、芎、归、炙草、天虫、角刺、甲片、肉桂，
加枣煎服，五朝起胀者少有脓色，后出者亦有起胀之势，但面上之痘，淡红无光彩，身
背之痘，紫陷不润泽，余思淡红无光彩者，气血两虚之明验也。紫陷不润泽者，实非血
热，乃血滞而不荣也。然血之滞者由气虚不能健运也。只以温补气血为主，仍用人参、
黄、芎归、山药、肉桂、天虫、角刺、甲片、粘米圆肉煎服，六朝痘色红活，但皮薄
而亮，脓色清稀，四肢水泡，余知气血弱而脾土更虚也。欲投白术，恐久服乃渗酿脓湿
润之气，欲投归 ，气血并补，恐开泄泻走泄之端，计惟温补阳分使阴从阳长，乃用保
元汤，加桂、人参五钱，滋补元气以为君，生黄 二钱，充补卫气以为臣，炙草六分缓
中补土，粘米一撮，内壮胃气，外酿脓浆，以为佐，肉桂宣通血脉，鼓舞补托以为使，
次日七朝脓色大长，乃和平养浆之剂，俾浆浓毒化而痂，究竟痘不甚密，奈先天后天薄
极，脾肾肺气并虚，故如是，早为温补，尚然两腿手足之浆，悉皆清淡，势类水泡，多
日而靥，痘后晨泻，复重温补而痊。
侍讲余老先生抱病数年，参药久服，或时气逆上攻，或时气坠下迫，二阴皆重，失
气甚频，大便虽溏，复甚不快，脉则细数无力，要知中气虚极，阳气不能外达，伏于内
而陷于下也。向复补中益气，殊不知愈升则气愈降，况略兼陈皮辛散，便为走泄之端，
而反盗泄元气矣。岂不闻塞因塞用之谓乎，但久服补气，而气不长，则未经补气之根
也。盖真水为阴血之根，真火为阳气之根，根本不立，气从何生？乃以八味加鹿茸、补
骨脂、五味子为丸，参汤吞服，于空心复以嫩防风三两、酒煮取汁，拌炒黄 一斤、炒
黄白术二十四两、熟附子四两，三味煎汁去渣熬膏，以人参六两，收成细丸，日中食
远，白汤吞服四钱。 能升托，术能固中，参能补里，附能回阳，四味共剂奏功，何虑
虚陷者不为振作发生也！服后精神渐长，下坠失气，及气逆上攻，皆为减退。
凡危症遇一医疗治，而医疗治一危病，皆前缘凑合，非偶然也。余丙寅在都年余，
积劳成病，且以葬亲念切，急于南回，属因冗绊不果，每月朔日，问卜于关夫子前，无
一不验，至八月朔，得吉人相遇，本和同之签。殊不能解，乃决意辞行而已，正在束
装。忽海昌翰院许老先生驰至，言趟老先生大病甚危，汝必疗之，方可去也。即赴诊
视，面赤如装，不省人事，口多谵语，手足躁动，无宁刻，六脉洪大搏指，向因大贵人
所用之医，而亦服其药，即其方乃柴胡、黄芩、陈皮、半夏之类也。幸其剂小，不能为
害，殊不知真阴失守，虚阳上浮，神气欲脱，手足无措，神明已乱，谵妄不省，补救
尚虞不及，敢此清利以速其危，必得大用人参，方可立方用药，众皆疑信莫决，愈担延
而势愈笃。友人张子韶赵宅之西席也，学问甚优，而更知医，见余所论甚合渠意，力主
煎药服之，每剂人参八钱、其药熟地、麦冬、丹参、芍药、茯神、远志、牛膝、姜炭
之类，然全家惶惶，皆有惧色，余夜半而思及前签，恍然大悟，于斯验矣。赵老先生之
病可速愈，而余之南回可果也。正欣喜间，而子韶至，见余喜状而问之，余述以故，吉
人天水，主人之名姓也。人力不劳，将来不大费手也。事成功倍，笑谈中余疗愈此病，
而南回可必也。每日二剂，果数日后，渐见康强而愈，遣使送回，过蒙奖誉，赠我诗
云∶携琴来帝里，郎鉴动公候，肱羡能三折，情方寄一丘，林成杏已满，井在橘堪
酬，郊外攀辕遍，飘然未肯留。
王府侍卫常公，乃浙省朱抚台之令婿也。余甲子初夏入都部试，渠病甚笃，来延
余视，询之已病八旬矣。据云感冒得之，医院投以发散、继以凉解之药，已五六十剂，
粒米不食，每日惟饮凉水而已，下体寒冷而木，渐至胸腹皆冷而实，手足面目肌肉痛痒
不知，语言无音，难以布息，医院命以速备后事，渠舅朱老先生情剧，力延余视，按其
脉沉微欲脱，势不可缓，乃以人参一两、附子三钱，早晚各进，保此一线之元阳，服后
倘暂有烦躁无虑也。二三日间，果初服烦躁，渐即相安，数日后脉稍有起势，而肢体
之冷，亦非若前之彻骨矣。乃以附子理中汤去甘草，早晚各一剂，令以温米汤压之，数
日后又觉冷减，神气稍觉清爽，乃早仍服前方理中，午后以浓参汁冲服去丹皮加牛膝、
杜仲之八味汤，数日后骨节疼痛不堪，余曰∶阳回冰解之象也，毋复虑矣。照前调服
半月，始能薄粥，后以八味去丹皮、泽泻，加鹿茸、虎胫骨、牛膝、杜仲为丸，早晚参
汤各服五钱、随以加减十全大补汤送之，日渐轻强，粥饭喜进，两月之后，言语渐闻有
声，然手足肌肤，尚未甚知痛痒也。三四月后，始能坐立步履，年余始能鞍马，精神如
旧，但每年数月，常患腹痛几死，必服温暖数剂而愈，且尺脉常微，自此病后，得女甚
多而易育，得男甚少而难存，可见寒凉贻祸，不独自己一身也。余劝以常服八味丸而
安，久而生子。
九和典中戚宅室人，腹中有块作痛，发则攻心欲死，上则不进饮食，下则泄泻无
因此，阴经的邪气未能平复，随后口渴非常严重，喝汤水就像喝了甘露一样。虽然喝了几十杯也不足以满足他的欲望。我第二年进入京城，劝他大剂量使用滋补肾水的药物为主，辅以引火归元的药物，这样就能使肝木上升、心火下降，消渴的热症自然消除，变生的症状也可以停止，无奈他对此掉以轻心，虽然服用了几剂药，口渴稍微减轻，就停止了服药和进补。到了四月间，背上忽然隐隐作痛，渐渐疼痛加剧且肌肉变硬，也不知道那是疽病。半个多月后，背部疼痛极其剧烈，就诊时脊柱略微偏向一侧半寸，外部虽然不肿胀，但肌肉部分坚实如碗口大小。我说：久渴不治疗，阴液每日亏损，虚火每日灼烧，营卫失调，所以医书中有对脑疽、背疽进行预防的说法。现在外部虽然不肿，但阴分已经成形并受伤了。必须尽快将其托出到阳分，使毒气不要逗留，陷入脏腑。于是外用大黄二两、芙蓉叶和赤芍各一两、白芨和白蔹各五钱，研成粉末，用鸡蛋清调匀敷在病灶周围；内服则重用滋阴之水，兼以解毒托毒。如熟地黄、山药、川贝母、皂角刺、僵蚕、穿山甲、生甘草、连翘、金银花之类。等到肿块形成之后，早晨空腹吞服八味丸五六钱，以培补先天的水火（肾阴肾阳），饭后服用。再配合大补营卫及排脓托里的药剂，以助后天气血，如人参、生黄芪、当归、白术、白芍、无虫（指去尽虫体的全蝎）、穿山甲、皂角刺、金银花、甘草节、白芷之类，每天服用两剂。外用古方太乙膏，加入男发、蓖麻子、乳香、没药，煎制成膏药贴在病灶上，以呼出毒气向外发散，四周仍然敷药，以防止毒气散漫。像这样调理，不到十天，肿胀日渐高起，四周红肿日渐消退，疼痛日渐减轻，背部肿胀日渐轻减。已经有化脓的趋势，无奈有一位专门的外科医生被请来诊治，他去掉了四周的敷药，内服清凉解毒的药物，外用药也漫涂在病灶上两三天，结果患处平塌日益严重，根脚反而扩大，疼痛难以忍受，并且说：内部溃烂已经很严重，黑色腐烂面积深大。说出没有根据的话，让司农（官职名）心中惊骇。于是再次请我去诊治，知道毒势溃漫无拘束，且趁着正气虚弱，又有向内侵袭的忧虑了。急忙去掉所敷的药物，仍然按照之前的外围包裹和内托方法，照前法加减，每剂药多加肉桂一钱多，几剂之后，患处又恢复高肿且红活，竟然像小的肿硬一样，溃破流脓而痊愈，毫不损伤肌肉，不需要使用珍珠粉等掺药，疮口逐渐平复，口渴等症状全部退去。所以要明白一切肿毒，原本不是毒气，而是气血不和，留滞凝结所致，调和气血而毒气自然解除。如果以清凉解毒为事，反而会损伤胃气，气血更加虚弱，虽然想要解毒，毒气却停滞在中焦，况且遇到清凉药物冰伏于体内，反而造成大害，能不谨慎吗？
少司马胡老先生的二公子，患痘疹初起时非常危险，京城擅长治疗痘疹的一位老医生，断定他必死无疑，胡老先生于是请我一同治疗。我看他的处方寒凉太过，导致冰伏不出，出现腹胀喘急等症状。先用酒酿鸡冠血，调下独胜散一服，解除其冰伏之势，已经喘热俱减，痘疹有外出的趋势。那位医生必定以无法救治相争辩，我说：请不要以此加重主人的忧愁，希望我们能共同协作，吉利则是您的功劳，凶险则都是我的过错。那位医生面带怒色，肆无忌惮地乱说话，胡老先生只是日夜痛哭罢了，勉强将我留在寓所，早晚调治，痘疹好了八九成，主人仍然不快乐，我也不能理解，谁知道那位医生每天私下前来诊视，谆谆告诫说是时日凶险变化，直到结痂痊愈，胡老先生才喜形于色，后悔听信蛊惑，几乎败坏大事！我每次进入京城，往来如同至亲一般。有一个宝坻姓王的人，长期患有严重的痢疾，因为候选官员扶病进入京城，来请我诊治。当时是六月，肚脐以上至阴囊，都用厚重的棉絮紧紧包裹，稍微薄一点肚子就疼痛剧烈，他的两个脚心又觉得非常热，时刻难受，要人用力扇风才可以，饮食不想吃，形势非常危困。他的脉象寸部强盛，关部和尺部都弱。我说：这是中气长期虚弱，气机升降失常，阴阳阻隔，似痢非痢，误用了香连丸等苦寒的药物。以致压抑遏制阳气于九地之下，而中宫（脾胃）藏阳纳气的地方，反而已经空虚，而且久痢导致阴阳两亡，所以脚心发热是阴虚所致，脏腑寒冷是阳虚的原因。中宫的阳气应该温补，下陷的阳气应该清升，道理上难以同时进行，我只先去其中寒的阻隔，那么郁遏在下极的火气，自然能上升，大量使用附子理中汤，加五味子以收敛它，二三剂后肚子寒冷和脚心发热都减少了六七成，然后用归脾汤加肉桂、五味子，煎汤送服八味丸而痊愈。
宛平王中堂，忽然患了一种病，一睡觉就梦见拿着重物搬运，觉得很困乏而醒来，醒来后又很狼狈地睡去，没办法睡着，那个梦仍然如故，醒着睡，睡着醒，一夜几十次。医生用人参、酸枣仁、茯神、远志、当归身养血安神的药剂，越服越严重。于是请我诊治，按摸他的两手寸脉非常洪大有力，左寸更大，两手关脉洪大兼弦，两手尺脉虽然洪大，但弦而无力。我开始知道是药物的错误。大概睡眠是心神藏纳于肾阴，是水火相见，阴阳既济的时候。心就像人，肾就像房舍。现在心阴不足，只有火独自发光，于是有了上炎的习性，而失去了下交的形象。肾气又虚，不能升腾收摄，离阴而失去了延纳闭藏的职能了。就像人只依仗火性，勇力向前，而不能退藏于房舍，那房室也很破败，不能藏纳其人。人们只知道心象火而肾属水，竟然不去思考心坎和肾乎！完全讲明心中的水，是真水。肾中的火，是真火。水火互藏其根，所以心能下交，肾能上摄。现在心阴不足，肾气衰微，已经成为不交的形象，愚昧的人反而补益心神，更加增加了炎上的势头，怎么能使其阳会于阴，元神凝聚于内呢？静功有说：神必须依附物体，精能凝神，这是至理。于是用重剂量的八味丸加牛膝、五味子，用灯心草、莲子作为引子煎服而痊愈。
工科掌中谭老先生，年龄六十多岁，正当在衙门办事，突然昏晕仆倒，痰涎涌盛，不省人事，一会儿吐出约一碗痰稍许清醒，长班（差役）用力搀扶他上车，夹着他的两条腿回家，于是腿疼的原因，从此开始了。回到寓所后，医生以清热疏风豁痰为事，究竟调治了十几天，痰涎不减，烦躁加倍平常，头痛腿疼更甚，日夜受苦。于是请我诊治，按摸他的脉象两手寸脉非常洪大，两手尺脉右关脉非常沉微，这是孤阳独亢于上，弱阴不能敛纳，而且中宫脾土虚阳没有退藏的处所，所以上浮巅顶成为胀疼，自觉沉重而且大，不能忍受，理应壮水以制约它，培土以藏纳它，补火以引导它，佐以滋肺清金，以成就秋降的令行，下趋收敛，以得到归源封蛰的收藏，所以用熟地黄八钱为君药，乳炒白术五钱为臣药，米炒麦冬三钱、牛膝二钱、五味子一钱为佐药，制附子一钱五分为使药。前面的药煎成后，另外用人参五钱，熬汁冲服，大概是担心元气虚弱，药性力大，一时阴翳之火骤消，各种虚证的真相并见，用它既可以驾驭药力，又能托住本元。进服之后，头疼顿时减轻，各种症状逐渐痊愈，但腿痛如故，不能入睡，他所疼痛的地方，长班先前挟持留下的五指手印还在。我说：这是外部受困。应当外治，于是用猪肘生精肉捣烂，加入肉桂细末、葱白、食盐和匀，浓敷在疼痛处，一昼夜而安宁，其血凝滞的手印，也消散了。后来他素来患有晨泻，多年不愈，以致饮食不甘，我让他早晨空腹用参汤送服八味丸，午间食前，用炒黄的白术三十两、制熟附子三两，共同熬成膏，用人参细末六两，收成细丸，日中食前用白开水吞服三钱，半个月左右，脾胃顿时强壮，精神倍增。
文选司司老先生，素来患有痰喘，发作时饮食不进，早晚不寐，调治几个月无效，于是请我诊治，按摸他的脉象两手寸脉稍洪，其余皆沉弱，其右关尺脉微细更甚，于是知道命门之火衰极，无根虚阳上浮，而且长期服用克削的药物，脾元亏损，更不能渗湿消痰，以致痰涎更加旺盛，更不能按纳藏元，以致虚气更加逆乱，于是立一方，用炒黄的白术八钱，固护中气为君药，炒燥麦冬三钱清肺，引气降下为臣药，炮姜二钱，温中导火，牛膝二钱，下趋接引，五味子一钱，敛纳收藏，并以为佐药，制附子一钱五分，承上药力，直达丹田，以为使药。像这样几剂，痰退喘止，饮食进而精神强，久服八味丸而不再发作。
凡是肾气虚的人，脾气必然弱，脾气弱的人，肾气必然虚，盖肾为先天祖气，脾为后天生气，而后天生气必宗奉于祖气。我的第五个儿子干吉，向来禀赋脾肾两亏，身体肥胖而白，外表似乎有余，内里其实不足，壬申年随我在京城，当时四岁，当五月时出痘，发热一二日，便已神气困倦，汗出如砌（形容汗水多），热至将近二日才见到痘疹，我因为汗多阳虚，所以一切疏解的药物，丝毫不少进用，没想到三日外，汗出不止，内里清利很频繁，所见到的痘疹反而隐隐退缩，未出的尤其气弱不能出。我思考医书说：气弱不能出的，应当微微补其气，气和顺则能出了。况且有这个病，而服这个药，应当没有妨碍。第三朝便投人参、炒白术各三钱、炙甘草八分以固护中气为君药，僵蚕三钱、皂角刺一钱、土炒穿山甲六分，攻托以为臣药，川芎八分升提而兼辛发，肉桂六分温经而兼外达以为佐药，第四朝汗泻稍减，出的痘少长，未出的见到形态，于是仍用人参、白术、川芎、当归、炙甘草、僵蚕、皂角刺、穿山甲、肉桂，加红枣煎服，第五朝起胀的少有脓色，后出的也有起胀的趋势，但面上的痘，淡红无光彩，身背的痘，紫陷不润泽，我思考淡红无光彩的，是气血两虚的明显验证。紫陷不润泽的，实在不是血热，而是血滞而不荣养。然而血的滞涩是由气虚不能健运所致。只以温补气血为主，仍用人参、黄芪、川芎、当归、山药、肉桂、僵蚕、皂角刺、穿山甲、粘米圆肉煎服，第六朝痘色红活，但皮薄而亮，脓色清稀，四肢水泡，我知道气血弱而脾土更虚了。想投白术，恐怕久服乃渗酿脓湿润之气，想投当归黄芪，气血并补，恐怕开泄泻走泄之端，计策唯有温补阳分使阴从阳长，于是用保元汤，加桂枝、人参五钱，滋补元气以为君药，生黄芪二钱，充补卫气以为臣药，炙甘草六分缓中补土，粘米一撮，内壮胃气，外酿脓浆，以为佐药，肉桂宣通血脉，鼓舞补托以为使药，次日七朝脓色大长，乃是和平养浆的药剂，使浆浓毒化而结痂，究竟痘不甚密，无奈先天后天薄弱至极，脾肾肺气并虚，所以如此，早为温补，尚然两腿手足的浆，悉皆清淡，形势类同水泡，多日而靥，痘后晨泻，重新温补而痊愈。
侍讲余老先生抱病数年，人参药久服，有时气逆上攻，有时气坠下迫，二阴皆重，失气很频繁，大便虽溏，复甚不快，脉则细数无力，要知道中气虚极，阳气不能外达，伏于内而陷于下也。先前又补中益气，殊不知愈升则气愈降，况且略兼陈皮辛散，便为走泄之端，而反盗泄元气矣。岂不闻塞因塞用之谓乎，但久服补气，而气不长，则未经补气之根也。盖真水为阴血之根，真火为阳气之根，根本不立，气从何生？于是用八味丸加鹿茸、补骨脂、五味子为丸，参汤吞服，于空心复以嫩防风三两、酒煮取汁，拌炒黄芪一斤、炒黄白术二十四两、熟附子四两，三味煎汁去渣熬膏，用人参六两，收成细丸，日中食远，白开水吞服四钱。防风能升托，白术能固中，人参能补里，附子能回阳，四味共剂奏功，何虑虚陷者不为振作发生也！服后精神渐长，下坠失气，及气逆上攻，皆为减退。
凡是危症遇到一个医生治疗，而医生治疗一个危病，都是前缘凑合，并非偶然。我丙寅年在京城一年多，积劳成病，而且因为葬亲念切，急于南回，属于因冗绊不果，每月朔日，问卜于关夫子前，无一不验，至八月朔，得吉人相遇，本和同之签。殊不能解，乃决意辞行而已，正在束装。忽然海昌翰院许老先生飞驰而至，言赵老先生大病甚危，你必须治疗他，才可以离开。即赴诊视，面赤如妆，不省人事，口多谵语，手足躁动，无宁刻，六脉洪大搏指，向因大贵人所用之医，而亦服其药，即其方乃柴胡、黄芩、陈皮、半夏之类也。幸其剂小，不能为害，殊不知真阴失守，虚阳上浮，神气欲脱，手足无措，神明已乱，谵妄不省，补救尚虞不及，敢此清利以速其危，必得大用人参，方可立方用药，众皆疑信莫决，愈担延而势愈笃。友人张子韶赵宅之西席也，学问甚优，而更知医，见余所论甚合渠意，力主煎药服之，每剂人参八钱、其药熟地、麦冬、丹参、芍药、茯神、远志、牛膝、姜炭之类，然全家惶惶，皆有惧色，余夜半而思及前签，恍然大悟，于斯验矣。赵老先生之病可速愈，而余之南回可果也。正欣喜间，而子韶至，见余喜状而问之，余述以故，吉人天水，主人之名姓也。人力不劳，将来不大费手也。事成功倍，笑谈中余疗愈此病，而南回可必也。每日二剂，果数日后，渐见康强而愈，遣使送回，过蒙奖誉，赠我诗云：携琴来帝里，郎鉴动公候，肱羡能三折，情方寄一丘，林成杏已满，井在橘堪酬，郊外攀辕遍，飘然未肯留。
王府侍卫常公，是浙省朱抚台的乘龙快婿。我甲子初夏进入京城部试，他病得很重，来请我诊治，询问得知已经病了八十天了。据他说感冒得的，医院投以发散、继以凉解的药物，已经五六十剂，粒米不食，每日惟饮凉水而已，下体寒冷而麻木，渐至胸腹皆冷而实，手足面目肌肉痛痒不知，语言无音，难以布息，医院命以速备后事，他舅舅朱老先生情剧，力请我诊治，按摸他的脉象沉微欲脱，形势不可迟缓，于是用人参一两、附子三钱，早晚各进，保此一线之元阳，服后倘若暂时有烦躁不用担心。二三天间，果然初服烦躁，渐渐即相安，数日后脉稍有起势，而肢体的冷，也不是若前之彻骨了。于是用附子理中汤去甘草，早晚各一剂，令以温米汤压之，数日后又觉冷减，神气稍觉清爽，于是早仍服前方理中，午后以浓参汁冲服去丹皮加牛膝、杜仲的八味汤，数日后骨节疼痛不堪，我说：这是阳回冰解的现象，不要再忧虑了。照前调服半月，始能薄粥，后以八味去丹皮、泽泻，加鹿茸、虎胫骨、牛膝、杜仲为丸，早晚参汤各服五钱、随即以加减十全大补汤送之，日渐轻强，粥饭喜进，两月之后，言语渐闻有声，然手足肌肤，尚未甚知痛痒也。三四月后，始能坐立步履，年余始能鞍马，精神如旧，但每年数月，常患腹痛几死，必服温暖数剂而愈，且尺脉常微，自此病后，得女甚多而易育，得男甚少而难存，可见寒凉贻祸，不独自己一身也。我劝他以常服八味丸而安，久而生子。
九和典中戚宅室人，腹中有块作痛，发作时攻心欲死，上则不进饮食，下则泄泻无
Therefore, the pathogenic factors in the Yin meridians failed to subside. Subsequently, extreme thirst developed, and drinking soup or water felt like drinking sweet dew. Although dozens of cups were consumed, they were insufficient to satisfy the desire. The following year, when I entered the capital, I advised him to primarily use a large dose of medicines to nourish Kidney Water (Kidney Yin), assisted by agents that guide fire back to its source. This would allow Liver Wood to ascend and Heart Fire to descend, naturally eliminating the heat of Xiao Ke (Wasting and Thirsting Syndrome) and stopping the emergence of secondary symptoms. However, he neglected this advice. Although he took several doses, his thirst slightly decreased, after which he stopped taking medication and tonics. By April, sudden dull pain appeared on his back, gradually worsening with hardening of the flesh. He did not realize it was a Ju (carbuncle). After more than half a month, the back pain became extremely severe. Upon my examination, his spine deviated slightly by half a cun to one side. Although there was no external swelling, the flesh was firm and the size of a bowl. I said: "Untreated prolonged thirst causes daily depletion of Yin fluids and daily scorching by deficient fire, leading to disharmony of Ying and Wei (Nutritive and Defensive Qi). Therefore, medical texts mention prevention for Nao Ju (Brain Carbuncle) and Bei Ju (Back Carbuncle). Although there is no external swelling now, the Yin aspect has already formed pathology and suffered injury. We must urgently expel it to the Yang aspect to prevent the toxic qi from lingering and sinking into the Zang-Fu organs." Externally, we used two liang of Da Huang (Rhubarb Root), one liang each of Fu Rong Ye (Hibiscus Leaf) and Chi Shao (Red Peony Root), and five qian each of Bai Ji (Bletilla Rhizome) and Bai Lian (Akebia Rhizome), ground into powder, mixed with egg white, and applied around the lesion. Internally, we heavily nourished Yin fluids while resolving toxicity and expelling pus. Ingredients included Shu Di Huang (Prepared Rehmannia Root), Shan Yao (Dioscorea Rhizome), Chuan Bei Mu (Fritillaria Bulb), Jiao Ci (Gleditsia Spine), Tian Chong (Stiff Silkworm), Jia Pian (Tartar Shell), Sheng Gan Cao (Raw Licorice Root), Lian Qiao (Forsythia Fruit), and Jin Yin Hua (Honeysuckle Flower). Once the swelling formed, he swallowed five to six qian of Ba Wei Wan (Eight-Ingredient Pill with Rehmannia) early in the morning on an empty stomach to cultivate the primordial Water and Fire (Kidney Yin and Yang), taken after meals. We also administered decoctions to greatly tonify Ying and Wei and promote pus discharge and interior support, such as Ren Shen (Ginseng Root), Sheng Huang Qi (Raw Astragalus Root), Dang Gui (Angelica Sinensis Root), Bai Zhu (Atractylodes Rhizome), Bai Shao (White Peony Root), Wu Chong (Scorpion without legs), Jia Pian (Tartar Shell), Jiao Ci (Gleditsia Spine), Jin Yin Hua (Honeysuckle Flower), Gan Cao Jie (Licorice Joint), and Bai Zhi (Angelica Dahurica Root), taken twice daily. Externally, we used the ancient formula Tai Yi Gao (Great One Ointment) added with human hair, Bi Ma Zi (Castor Seed), Ru Xiang (Frankincense), and Mo Yao (Myrrh), boiled into an ointment and applied to the lesion to draw out toxic qi outward. The surrounding area was still covered with powder to prevent dispersion. With such regulation, within ten days, the swelling rose daily, peripheral redness subsided, pain decreased, and back swelling lightened. Pus formation was imminent. However, a specialist surgeon was invited who removed the peripheral poultices, prescribed internal cooling and detoxifying herbs, and applied external medicine diffusely over the lesion for two to three days. Consequently, the lesion became increasingly flat and sunken, the base expanded, pain became unbearable, and he claimed: "Internal ulceration is severe, black and rotting deeply and widely." He spoke nonsense, alarming the Minister of Agriculture. I was re-invited and determined that the toxic pathogen was spreading uncontrollably, exploiting the deficiency of healthy Qi, with risk of internal invasion. I urgently removed the applied medicines and resumed the previous method of peripheral wrapping and internal support, adjusting formulas as before, adding slightly more than one qian of Rou Gui (Cinnamon Bark) per dose. After several doses, the lesion returned to high swelling and vibrant redness, resembling a small hard swelling, eventually ruptured and discharged pus, healing without significant muscle damage. It healed gradually without needing Pearl Powder (Zhen Zhu San), and all symptoms like thirst receded. Thus, one must understand that all swellings and toxins are originally not toxins themselves, but result from disharmony and stagnation of Qi and Blood. Harmonizing Qi and Blood resolves the toxin naturally. If one focuses on cooling and detoxifying, it damages Stomach Qi, making Qi and Blood more deficient. Even if one wishes to detoxify, the toxin remains stagnant in the middle. Moreover, cooling agents freezing internally cause great harm. Can one not be cautious?
The second son of Vice Minister Hu suffered critically from smallpox at onset. An old doctor in the capital skilled in treating smallpox declared he would certainly die. Mr. Hu invited me to treat him jointly. I saw his prescription was excessively cold and cooling, causing 'ice-stagnation' preventing eruption, leading to abdominal distension and rapid breathing. First, I used fermented rice wine mixed with chicken comb blood, administered with one dose of Du Sheng San (Sole Victory Powder) to resolve the ice-stagnation. His wheezing and heat decreased, and the smallpox showed signs of erupting. The other doctor insisted on non-curability. I said: "Do not add to the master's sorrow. Let us cooperate. If successful, it is your merit; if fatal, it is my fault." The doctor was angry and spoke recklessly. Mr. Hu only wept day and night. I stayed reluctantly, treating him morning and evening. The smallpox improved by 80-90%, yet the master remained unhappy. I could not understand why, until I learned the doctor visited privately daily, predicting doom until scabbing and recovery. Only then did Mr. Hu show joy, regretting being misled and nearly ruining the case. Every time I visited the capital, our interactions were like close relatives.
A man surnamed Wang from Baodi suffered from severe dysentery for a long time. He came to the capital ill while awaiting official appointment. I treated him in June. From his navel to the scrotum, he wrapped himself in thick cotton; thinning it caused severe abdominal pain. His soles felt very hot, intolerable, requiring strong fanning. He had no appetite, and his condition was critical. His pulse was strong at the Cun (inch) position but weak at Guan (middle) and Chi (cubit) positions. I said: "This is chronic deficiency of Middle Qi, failure of Qi ascending and descending, and blockage between Yin and Yang. It resembles dysentery but is not. Misuse of bitter-cold agents like Xiang Lian Wan suppressed Yang Qi deep below. The Middle Palace (Spleen/Stomach), where Yang Qi resides, is empty. Chronic dysentery leads to exhaustion of both Yin and Yang. Heat in the soles is due to Yin deficiency; cold in viscera is due to Yang deficiency. The Yang of the Middle Palace should be warmed and tonified; the sunken Yang should be cleared and raised. These principles are hard to apply simultaneously. I will first remove the cold blockage in the middle, allowing the depressed fire at the bottom to rise naturally." I used a heavy dose of Fu Zi Li Zhong Tang (Aconite Regulate the Middle Decoction) plus Wu Wei Zi (Schisandra Berry) to astringe. After two or three doses, abdominal cold and foot heat reduced by 60-70%. Then, using Gui Pi Tang (Restore the Spleen Decoction) added with Rou Gui (Cinnamon Bark) and Wu Wei Zi, decocted to swallow Ba Wei Wan (Eight-Ingredient Pill), he recovered.
Wang Zhongtang from Wanping suddenly suffered from a condition where every sleep involved dreaming of carrying heavy loads, waking exhausted, then falling back asleep in distress. This cycle repeated dozens of times a night. Doctors used Ren Shen (Ginseng), Suan Zao Ren (Zizyphus Seed), Fu Shen (Poria with Hostwood), Yuan Zhi (Polygala Root), and Dang Gui Shen (Angelica Root Heart) to nourish Blood and calm Spirit, but symptoms worsened. I examined him: both Cun pulses were surging and forceful, left Cun even larger; both Guan pulses were surging, large, and wiry; both Chi pulses were surging but wiry and weak. I realized the error of previous treatment. Sleep is when the Heart Spirit rests in Kidney Yin, a time of Water and Fire meeting and Yin-Yang balance. The Heart is like a person; the Kidney is like a house. Now, Heart Yin is insufficient, leaving Fire blazing alone, rising upward instead of descending. Kidney Qi is also weak, unable to ascend and gather, losing its function of receiving and storing. It is like a person relying solely on fiery energy, rushing forward, unable to retreat and store in the house, which is dilapidated and cannot shelter him. People know Heart is Fire and Kidney is Water, but fail to consider the True Water in the Heart and True Fire in the Kidney. Water and Fire hide their roots in each other, allowing Heart to descend and Kidney to ascend. Now, Heart Yin is deficient, Kidney Qi is weak, showing non-interaction. Fools tonify Heart Spirit, increasing the rising fire, preventing Yang from joining Yin and Yuan Shen from condensing internally. As static meditation states: "Spirit attaches to objects; Essence concentrates Spirit." I used a heavy dose of Ba Wei Wan (Eight-Ingredient Pill) added with Niu Xi (Achyranthes Root) and Wu Wei Zi (Schisandra Berry), using Deng Xin Cao (Juncus Effusus Pith) and Lian Zi (Lotus Seed) as guides, decocted and administered. He recovered.
Director Tan of the Ministry of Works, over sixty years old, suddenly fainted while working in the yamen, with profuse phlegm and saliva, unconscious. After vomiting about a bowl of phlegm, he slightly revived. Attendants carried him forcefully, gripping his legs, causing leg pain thereafter. Back home, doctors treated with clearing heat, dispersing wind, and resolving phlegm. After ten days, phlegm persisted, irritability doubled, headache and leg pain worsened. I examined him: both Cun pulses were very surging and large; both Chi and right Guan pulses were very deep and faint. This indicates solitary Yang hyperactivity above, weak Yin failing to contain, and deficient Yang in the Middle Palace (Spleen Earth) having no place to reside, floating to the vertex causing distension and pain, feeling heavy and unbearable. Treatment should strengthen Water to control it, cultivate Earth to store it, tonify Fire to guide it, assist with moistening Lung and clearing Metal to achieve autumnal descent and convergence, returning to the source. I used Shu Di Huang (Prepared Rehmannia Root) eight qian as Sovereign, Milk-fried Bai Zhu (Atractylodes Rhizome) five qian as Minister, Rice-fried Mai Dong (Ophiopogon Tuber) three qian, Niu Xi (Achyranthes Root) two qian, and Wu Wei Zi (Schisandra Berry) one qian as Assistants, and Zhi Fu Zi (Processed Aconite Root) one qian 5 fen as Envoy. After decocting, separately decoct Ren Shen (Ginseng Root) five qian and mix the juice. Fearful that Yuan Qi is weak and drug potency too strong might cause sudden elimination of shadow-fire and reveal all deficiency signs, this addition drives drug power and supports original essence. After ingestion, headache instantly decreased, symptoms improved, but leg pain persisted, preventing sleep. The painful spot bore finger marks from attendants' grip. I said: "This is external constraint. Treat externally." I mashed fresh pork elbow meat, mixed with fine Rou Gui (Cinnamon Bark) powder, green onion white, and salt, applying thickly to the pain site. Peace came within a day and night; the blood-stagnant hand marks vanished. Later, he suffered morning diarrhea for years, affecting appetite. I instructed him to take Ba Wei Wan (Eight-Ingredient Pill) with Ginseng Soup on an empty stomach in the morning. Before noon meals, he took pills made from thirty liang of fried Bai Zhu, three liang of processed Shu Fu Zi, boiled into paste, gathered with six liang of fine Ren Shen powder. Swallow three qian with plain water before midday meals. Within half a month, Spleen and Stomach strengthened, spirit increased.
Director Si of the Selection Department suffered chronic Phlegm-Wheezing. Attacks prevented eating and sleeping for months despite treatment. I examined him: slight surging at both Cun, otherwise deep and weak; right Guan and Chi were particularly fine and faint. I knew Ming Men Fire (Gate of Life Fire) was extremely deficient, rootless deficient Yang floating up. Long-term use of draining drugs damaged Spleen Yuan, reducing ability to transform dampness and resolve phlegm, increasing phlegm. Inability to anchor Yuan Qi led to rebellious deficient Qi. I prescribed: Fried Bai Zhu (Atractylodes Rhizome) eight qian to secure Middle Qi as Sovereign; Fried Dry Mai Dong (Ophiopogon Tuber) three qian to clear Lung and guide Qi down as Minister; Pao Jiang (Roasted Ginger) two qian to warm middle and guide fire; Niu Xi (Achyranthes Root) two qian to guide downward; Wu Wei Zi (Schisandra Berry) one qian to astringe and store. All as Assistants. Zhi Fu Zi (Processed Aconite Root) one qian 5 fen to carry drug power to Dantian as Envoy. After several doses, phlegm receded, wheezing stopped, appetite returned, spirit strengthened. Long-term use of Ba Wei Wan (Eight-Ingredient Pill) prevented recurrence.
Generally, if Kidney Qi is deficient, Spleen Qi must be weak; if Spleen Qi is weak, Kidney Qi must be deficient. Kidney is the ancestral Qi of Pre-Heaven; Spleen is the generating Qi of Post-Heaven. Generating Qi relies on Ancestral Qi. My fifth son, Ganji, had inherent Spleen-Kidney deficiency. He was fat and pale, appearing robust externally but deficient internally. In the year Ren Shen, at age four, accompanying me in the capital, he contracted smallpox in May. After one or two days of fever, he became lethargic with sweat like rain. Smallpox appeared near the end of the second day. Due to excessive sweating indicating Yang deficiency, I avoided all dispersing agents. Unexpectedly, after three days, sweating continued incessantly, frequent urination occurred, visible smallpox receded, and un-erupted ones lacked Qi to emerge. Recalling texts: "When Qi is weak and cannot emerge, slightly tonify Qi; harmonized Qi can emerge." Given the disease and appropriate medicine, there should be no harm. On the third day, I used Ren Shen (Ginseng Root) and fried Bai Zhu (Atractylodes Rhizome) three qian each, Zhi Gan Cao (Honey-fried Licorice Root) eight fen to secure Middle Qi as Sovereign; Tian Chong (Stiff Silkworm) three qian, Jiao Ci (Gleditsia Spine) one qian, Earth-fried Jia Pian (Tartar Shell) six fen to attack and support as Ministers; Chuan Xiong (Sichuan Lovage Rhizome) eight fen to lift and disperse; Rou Gui (Cinnamon Bark) six fen to warm meridians and reach exterior as Assistants. By the fourth day, sweat and diarrhea decreased, erupted spots grew slightly, un-erupted ones showed shape. I continued with Ren Shen, Bai Zhu, Chuan Xiong, Dang Gui, Zhi Gan Cao, Tian Chong, Jiao Ci, Jia Pian, Rou Gui, added with Jujube, decocted. On the fifth day, few erupted spots had pustules; later ones showed rising tendency. Facial spots were pale red without luster; body/back spots were purple, sunken, and dry. Pale red without luster indicates Qi-Blood deficiency. Purple sunken dryness indicates Blood stagnation lacking nourishment, caused by Qi deficiency failing to transport. I focused on warming and tonifying Qi-Blood, using Ren Shen, Huang Qi (Astragalus Root), Chuan Xiong, Dang Gui, Shan Yao, Rou Gui, Tian Chong, Jiao Ci, Jia Pian, Nian Mi (Glutinous Rice), and Yuan Rou (Longan Aril). By the sixth day, spots were vibrant red, but skin thin and shiny, pus clear and thin, limbs had blisters. I knew Qi-Blood were weak and Spleen Earth more deficient. Using Bai Zhu feared long-term dampness promoting pus; using Dang Gui and Huang Qi feared opening leakage. Strategy: Warm-tonify Yang so Yin grows from Yang. Used Bao Yuan Tang (Protect Origin Decoction) added with Gui Zhi (Cinnamon Twig) and Ren Shen five qian to tonify Yuan Qi as Sovereign; Sheng Huang Qi (Raw Astragalus Root) two qian to supplement Wei Qi as Minister; Zhi Gan Cao (Honey-fried Licorice Root) six fen to moderate middle and tonify Earth; Nian Mi (Glutinous Rice) a pinch to strengthen Stomach Qi internally and brew pus externally as Assistants; Rou Gui (Cinnamon Bark) to unblock vessels and encourage support as Envoy. Next day, seventh day, pus increased significantly. This is a mild agent for nurturing pus, thickening it to resolve toxicity and form scabs. Smallpox was not dense due to extreme Pre- and Post-Heaven deficiency, Spleen-Kidney-Lung Qi deficiency. Early warming-tonification helped. Leg and hand pus remained thin like blisters, resolving after many days. Morning diarrhea post-smallpox cured with renewed warming-tonification.
Assistant Scholar Mr. Yu suffered illness for years, long-term use of Ren Shen. Sometimes Qi rebelled upward, sometimes sank downward. Both orifices felt heavy, frequent flatulence. Stool was loose but unsatisfactory. Pulse was fine, rapid, and weak. Middle Qi was extremely deficient, Yang Qi unable to reach exterior, trapped inside and sinking. Previously using Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) was wrong; lifting too much causes sinking. Plus Chen Pi (Tangerine Peel) disperses, leaking Yuan Qi. Did you not hear of "treating obstruction with obstruction"? Long-term Qi tonification without growth means lacking the root of Qi. True Water is root of Yin Blood; True Fire is root of Yang Qi. Without root, how can Qi generate? I used Ba Wei Wan (Eight-Ingredient Pill) added with Lu Rong (Deer Antler Velvet), Gu Pu Zi (Psoralea Fruit), and Wu Wei Zi (Schisandra Berry) as pills, swallowed with Ginseng Soup. On empty stomach, I also used tender Fang Feng (Saposhnikovia Root) three liang, wine-boiled for juice, mixed with fried Huang Qi (Astragalus Root) one jin, fried Bai Zhu (Atractylodes Rhizome) twenty-four liang, Shu Fu Zi (Prepared Aconite Root) four liang. Decoct three ingredients, strain, boil into paste, gather with six liang of Ren Shen powder into fine pills. Swallow four qian with plain water far from meals. Fang Feng lifts and supports; Bai Zhu secures middle; Ren Shen tonifies interior; Fu Zi restores Yang. Four ingredients work together. Why worry about deficiency collapse not reviving? After taking, spirit grew, sinking/flatulence/rebellious Qi decreased.
Critical cases meeting a doctor, and a doctor meeting a critical case, are destined coincidences, not accidental. In Bing Yin year, I stayed in the capital over a year, accumulating fatigue and illness. Eager to return south due to funeral duties, delayed by busywork. On the first day of each month, I divined before Lord Guan. All accurate. On August first, I drew a lot for "meeting auspicious people," meaning harmony. I couldn't understand, decided to leave. While packing, Hanlin Academician Mr. Xu from Haichang arrived urgently, saying Mr. Zhao was critically ill, I must treat him before leaving. I examined him: face red like makeup, unconscious, delirious speech, restless limbs, no peace. Six pulses were surging and forceful against fingers. Previously treated by doctors of nobility with Chai Hu (Bupleurum Root), Huang Qin (Scutellaria Root), Chen Pi (Tangerine Peel), Ban Xia (Pinellia Tuber). Fortunately, doses were small, avoiding harm. But True Yin was lost, deficient Yang floated up, Shen Qi desired escape, limbs helpless, mind chaotic, delirious unconsciousness. Remedying this was urgent enough; daring to use clearing/draining agents accelerated danger. Must use large doses of Ren Shen (Ginseng Root) to formulate. Everyone doubted. Delay worsened condition. Friend Zhang Zishao, tutor at Zhao residence, excellent scholar and knowledgeable in medicine, agreed with my theory, strongly supported decoction. Each dose contained eight qian of Ren Shen, plus Shu Di Huang (Prepared Rehmannia Root), Mai Dong (Ophiopogon Tuber), Dan Shen (Salvia Root), Shao Yao (Peony Root), Fu Shen (Poria with Hostwood), Yuan Zhi (Polygala Root), Niu Xi (Achyranthes Root), Jiang Tan (Charred Ginger), etc. Family panicked. At midnight, I remembered the lot: "Meeting auspicious people." Realized verification. Mr. Zhao would recover quickly, my return confirmed. Joyfully, Zishao arrived, asked why happy. I explained. "Ji Ren" (Auspicious Person) and "Tian Shui" (Heavenly Water) were the master's name. No labor required, future effort minimal. Success double, laughing, I cured him, certain of return. Two doses daily. Indeed, after several days, health improved. Sent back, praised highly, gifted poem: "Bringing zither to imperial city, your judgment moves dukes. Envious of arm breaking thrice [skill], emotion sent to one hill. Forest of apricots full, well of oranges repayable. Crowds climbing carriage outside, drifting away unwilling to stay."
Guard Chang of Prince's Mansion, son-in-law of Governor Zhu of Zhejiang. In early summer of Jia Zi year, entering capital for exam, he was critically ill. Invited me. Ill for 80 days. Claimed caught cold. Hospital gave dispersing then cooling/detoxifying drugs, 50-60 doses. Ate nothing, drank only cold water. Lower body cold and numb, chest/abdomen cold and solid. Hands/feet/face/muscles insensitive to pain/itch. Voiceless, difficult breathing. Hospital prepared funeral. Uncle Mr. Zhu urgently invited me. Pulse deep, faint, nearing collapse. Urgent. Used Ren Shen (Ginseng Root) one liang, Fu Zi (Aconite Root) three qian, morning and evening, preserving a thread of Yuan Yang. Temporary irritability after dosing is normal. After 2-3 days, initial irritability settled. After several days, pulse slightly rose, limb cold less penetrating. Used Fu Zi Li Zhong Tang (Aconite Regulate the Middle Decoction) minus Gan Cao, morning/evening, pressing with warm rice soup. Cold reduced, spirit clearer. Morning continued Li Zhong, afternoon took concentrated Ginseng juice mixed with Ba Wei Tang (Eight-Ingredient Decoction) minus Dan Pi, added Niu Xi (Achyranthes Root) and Du Zhong (Eucommia Bark). Bone/joint pain unbearable. I said: "Sign of Yang returning and ice melting. Do not worry." Continued regulation for half month, tolerated thin congee. Later, Ba Wei Wan (Eight-Ingredient Pill) minus Dan Pi, Ze Xie (Alisma Rhizome), added Lu Rong (Deer Antler Velvet), Hu Jing Gu (Tiger Tibia Bone - note: modern ethics prohibit, historical text preserved), Niu Xi, Du Zhong as pills. Five qian with Ginseng Soup morning/evening, followed by modified Shi Quan Da Bu Tang (Ten Significant Tonifying Decoction). Gradually stronger, ate porridge/rice. After two months, voice audible. Limbs still insensitive. After 3-4 months, could sit/stand/walk. After one year, could ride horse, spirit normal. But monthly abdominal pain nearly killed him, cured by warm doses. Chi pulse often faint. Since illness, had many daughters (easy to raise), few sons (hard to keep). Shows cold-cooling harm affects not just self. Advised regular Ba Wei Wan for stability and fertility.
Wife of relative in Jiuhe Pawnshop, mass in abdomen causing pain. Attacks attacked heart, near death. Upper: no food intake. Lower: diarrhea without...