满舌肿硬，难于语言进食，为盘舌痈。由湿火熏灼心君而然，内服犀角汤，待五六朝，
看舌上中心起高点，以刀刺出血，又刺舌下或出脓血，自可渐松。
肛门四围红肿作痛，速宜凉血利湿药消之。若消不去，一处出脓者为肛痈，每易成
漏。有数处溃开者，名盘肛痈，甚至大小便不通。须早顺下流势之处开门，免使溃大淌
粪，不可收拾。如在大小便之介中处溃孔者，即海底漏，极难收口。总当培养本元，外插
提脓药，往往获痊者，不一而足。
妇人月经，若闭至四五十日，遂觉头眩，目昏身困重，常懒怯，胸闷呕吐痰水，虚者
尤甚，不欲饮食，或择食物，嗜卧面色如故，脉缓滑，每误认是病，治多不效，抑知经停
血虚，则胎气上逆，中焦为之壅塞，是恶阻也。须顺胎方数剂，乃安。
当归 白芍 枳壳 苏梗 香附 浓朴 木香 陈皮 有寒加砂仁 有热加黄芩
有小儿忽软弱无力，手足不能举动，初无寒热，亦无痛肿，若痹症，应有隐疼，至
大人亦每有之。乃阴虚热蕴，上熏肺金，使肺叶焦损，则生痿 ，失治遂成废人，须养
阴清热，徐图自效。（附方）
熟地 制首乌 生龟板 女贞子 丹皮 黑料豆 阿胶 生白芍 沙苑子 北沙参
医者不先辨症施治，何能取效？即如冬令之伤寒，始由足经血分传入气分，脉浮紧无汗
恶风，先恶寒，后发热是也。伤风，有汗，恶风，脉浮缓也。其余传变诸症张长沙已详言之。以
及治法，备载伤寒书中。若夫时邪，始由手经气分，传入血分，右脉洪数过于左脉，（若脉沉
弱为阳病阴脉，多不治。）亦先恶寒，后发热，其热自内达表，午后热甚，头痛烦闷，初宜辛凉
透表，轻剂可得，战汗而解。（汗后脉静者生，烦躁脉疾者死。）国朝叶君天士卓识炯见，补千古
之未备，须玩索其书而有得焉。盖初春所发者，为春温。若鼻塞，咳嗽，声重浊烦闷，为风
温，当轻疏其邪。至春末夏初而发者，为温邪，以温者热之渐也。交夏至后，发者为热病，此
时病端杂出，当细辨明。李笠翁不云乎，使天只有春秋冬三时而无夏，则人之病也必稀，以
天时热盛，则损人元气，人之皮毛因而虚张，百病易于乘机而窃发。热病者，微恶寒，后发
热，头痛烦渴，或起病即壮热，或数日后现斑点者，若传染诸人者，为瘟疫也。若头重，鼻
塞，咳嗽，微烦热者，风暑也。当轻疏风邪，兼解其暑。若发热畏寒，头重，烦渴，汗大出，脉
虚者，静中伤暑也，宜香薷饮。又有劳苦烈日中而得者为中热，身热而痛，大汗烦躁，宜审
虚实用药。更有每逢立夏后似乎有病，右脉虚大，微发热，身倦，头昏，烦闷，不思饮食者，疰
夏病也，当清暑益气汤。若头如裹痛，四肢沉困，身重板痛胸痞，纵病有日，舌不干燥，因天
之炎暑一盛，地之湿气上升，暑湿交并，着于人身，由初夏所发者，始名湿温。直至秋末，乃
无此病，他时不得混称也。治莫妙于三白汤。夫初秋所发者，为秋邪，治病莫难于此时。以
天地之暑湿，久伏人身，新凉甫临，人之毛孔，骤为收密，则外凉引动内邪所发之症，治难速
效。一不得法，便入险途，若秋时过于旱燥，便出咳嗽发热，名秋燥症，当清燥救肺汤。乃
燥能生火，刑克当令，肺金而成病也。到深秋而发头痛，烦渴面赤者，谓之伏暑晚发。更属
迁绵，须法活心灵，方可见功。每逢冬令，固多伤寒。设冬当寒而反温，感此温厉气而发者，
遂为冬温，不宜辛热药劫散，只须轻宣其表。至于时邪初起，即壮热，神昏谵语，或懒言神
倦，或微发热，不识人，皆由正虚阴弱，而热势扰乱神明者，此犹可治。若见病即神昏不语，
手足抽搐，牙关紧闭者，或一病即见斑点者，或有病三四日，出斑不多，过二三日又发斑，
比前更密者，此皆难救。有起病神清，至七八日后忽神昏妄语，暴躁不安者，此邪犯心胞，
惟仲景复脉汤（去肉桂）滋其化源，兼至宝丹或紫雪丹三分，凉水和服，藉辛香通窍，逐秽，或有
效者。若有病数日忽气喘（邪热熏肺，）呃忒，（肾气下竭，）手足掣搐（邪热伤肝），肢冷（热陷阴分，）
牙紧，舌苔灰黑，（不干燥，肾阴欲绝。）凡得此者，速死之候，多发于体虚之人也。若病至六
七日，发热腹满，拒按，大便闭小便涩，或神昏谵语，脉沉数有力者，当承气汤下之。腑气一
通，其病可解。
满舌肿胀僵硬，难以言语和进食，称为盘舌痈。这是由于湿火熏灼心君所致，内服犀角汤，等待五六天，观察舌面中心是否出现高点，用刀刺破出血，再刺舌下若流出脓血，自然可以逐渐缓解。
肛门四周红肿疼痛，应立即使用凉血利湿的药物消除。如果无法消除，一处出脓的称为肛痈，容易形成瘘管。如果有数处溃烂开口的，称为盘肛痈，甚至导致大小便不通。必须尽早顺着流势较低的地方切开引流，避免溃烂扩大导致粪便溢出，难以收拾。如果在大小便之间的部位溃孔，即称为海底漏，极难收口。总之应当培养本元，外用提脓药物，往往能痊愈的例子不胜枚举。
妇女月经，如果闭止四五十天，随即感到头晕，眼睛昏花，身体困重，常常懒怠怯弱，胸闷呕吐痰水，体虚者尤为严重，不想饮食，或者挑食，嗜睡面色如常，脉象缓滑，常被误认为是其他疾病，治疗多无效，岂不知经停血虚，则胎气上逆，中焦为之壅塞，这是恶阻（妊娠呕吐）。需要服用顺胎方数剂，才能安宁。
当归、白芍、枳壳、苏梗、香附、浓朴、木香、陈皮；有寒加砂仁，有热加黄芩。
有小儿忽然软弱无力，手足不能举动，起初没有寒热，也没有痛肿，如果是痹症，应该有隐痛，到了成年也常有这种情况。这是阴虚热蕴，上熏肺金，使肺叶焦损，从而产生痿证，失治遂成废人，需要养阴清热，慢慢图谋见效。（附方）
熟地、制首乌、生龟板、女贞子、丹皮、黑料豆、阿胶、生白芍、沙苑子、北沙参。
医生不先辨证施治，怎么能取得疗效？就像冬季的伤寒，开始由足经血分传入气分，脉浮紧无汗恶风，先恶寒，后发热是这种情况。伤风，有汗，恶风，脉浮缓。其余传变诸症张仲景已经详细论述了。以及治法，都记载在《伤寒论》书中。至于时邪，开始由手经气分传入血分，右脉洪数超过左脉，（如果脉沉弱为阳病阴脉，大多不治。）也是先恶寒，后发热，其热自内达表，午后热甚，头痛烦闷，初宜辛凉透表，轻剂可得，战汗而解。（汗后脉静者生，烦躁脉疾者死。）本朝叶天士卓识炯见，补千古之未备，须玩索其书而有得焉。盖初春所发者，为春温。若鼻塞，咳嗽，声重浊烦闷，为风温，当轻疏其邪。至春末夏初而发者，为温邪，以温者热之渐也。交夏至后，发者为热病，此时病端杂出，当细辨明。李笠翁不云乎，使天只有春秋冬三时而无夏，则人之病也必稀，以天时热盛，则损人元气，人之皮毛因而虚张，百病易于乘机而窃发。热病者，微恶寒，后发热，头痛烦渴，或起病即壮热，或数日后现斑点者，若传染诸人者，为瘟疫也。若头重，鼻塞，咳嗽，微烦热者，风暑也。当轻疏风邪，兼解其暑。若发热畏寒，头重，烦渴，汗大出，脉虚者，静中伤暑也，宜香薷饮。又有劳苦烈日中而得者为中热，身热而痛，大汗烦躁，宜审虚实用药。更有每逢立夏后似乎有病，右脉虚大，微发热，身倦，头昏，烦闷，不思饮食者，疰夏病也，当清暑益气汤。若头如裹痛，四肢沉困，身重板痛胸痞，纵病有日，舌不干燥，因天之炎暑一盛，地之湿气上升，暑湿交并，着于人身，由初夏所发者，始名湿温。直至秋末，乃无此病，他时不得混称也。治莫妙于三白汤。夫初秋所发者，为秋邪，治病莫难于此时。以天地之暑湿，久伏人身，新凉甫临，人之毛孔，骤为收密，则外凉引动内邪所发之症，治难速效。一不得法，便入险途，若秋时过于旱燥，便出咳嗽发热，名秋燥症，当清燥救肺汤。乃燥能生火，刑克当令，肺金而成病也。到深秋而发头痛，烦渴面赤者，谓之伏暑晚发。更属迁绵，须法活心灵，方可见功。每逢冬令，固多伤寒。设冬当寒而反温，感此温厉气而发者，遂为冬温，不宜辛热药劫散，只须轻宣其表。至于时邪初起，即壮热，神昏谵语，或懒言神倦，或微发热，不识人，皆由正虚阴弱，而热势扰乱神明者，此犹可治。若见病即神昏不语，手足抽搐，牙关紧闭者，或一病即见斑点者，或有病三四日，出斑不多，过二三日又发斑，比前更密者，此皆难救。有起病神清，至七八日后忽神昏妄语，暴躁不安者，此邪犯心胞，惟仲景复脉汤（去肉桂）滋其化源，兼至宝丹或紫雪丹三分，凉水和服，藉辛香通窍，逐秽，或有效者。若有病数日忽气喘（邪热熏肺，）呃忒，（肾气下竭，）手足掣搐（邪热伤肝），肢冷（热陷阴分，）牙紧，舌苔灰黑，（不干燥，肾阴欲绝。）凡得此者，速死之候，多发于体虚之人也。若病至六七日，发热腹满，拒按，大便闭小便涩，或神昏谵语，脉沉数有力者，当承气汤下之。腑气一通，其病可解。
The entire tongue swells and becomes stiff, making it difficult to speak and eat; this is called Pan She Yong (Plaque Tongue Abscess). It arises from damp-heat fire scorching the Heart君主 (Heart Sovereign). Internally administer Xijiao Tang (Rhinoceros Horn Decoction). After five or six days, observe whether a high point appears in the center of the tongue. Puncture it with a knife to release blood, and puncture under the tongue; if pus and blood are discharged, relief will gradually occur.
Redness, swelling, and pain around the anus should be quickly eliminated with blood-cooling and damp-draining herbs. If they cannot be resolved, an abscess at one site is called Gang Yong (Anal Abscess), which easily forms a fistula. If several sites ulcerate, it is named Pan Gang Yong (Plaque Anal Abscess), potentially leading to obstruction of urination and defecation. One must early on open a drain at the lowest point of flow to prevent extensive ulceration and uncontrollable fecal discharge. If the ulcer occurs between the urinary and anal openings, it is called Hai Di Lou (Sea Bottom Leak), which is extremely difficult to heal. Generally, one should nourish the Yuan Source (Primordial Origin) and apply external herbs to promote pus drainage; many such cases recover successfully.
In women, if menstruation is absent for forty to fifty days, dizziness, blurred vision, heavy body sensation, lethargy, and timidity may follow, accompanied by chest fullness, vomiting of phlegm-fluids, and worsened symptoms in deficiency patterns. There is loss of appetite or selective eating, excessive sleepiness, normal complexion, and a slow, slippery pulse. This is often misdiagnosed, leading to ineffective treatment. One should realize that amenorrhea with blood deficiency causes fetal Qi to rebel upward, causing congestion in the Middle Jiao; this is E Zu (Morning Sickness/Obstruction of Nausea). Several doses of Shun Tai Fang (Fetus-Calming Formula) are required to bring peace.
Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba), Zhi Qiao (Aurantii Fructus), Su Geng (Perillae Caulis), Xiang Fu (Cyperi Rhizoma), Hou Po (Magnoliae Officinalis Cortex), Mu Xiang (Aucklandiae Radix), Chen Pi (Citri Reticulatae Pericarpium); add Sha Ren (Amomi Fructus Rotundus) if cold, add Huang Qin (Scutellariae Radix) if heat.
A child suddenly becomes weak and powerless, unable to move hands and feet, without initial chills or fever, nor pain or swelling. If it were Bi Syndrome (Obstruction Syndrome), there would be hidden pain; adults also frequently experience this. This is Yin deficiency with heat accumulation, steaming upward to damage Lung Metal, causing the lung leaves to become dry and damaged, resulting in Wei Syndrome (Flaccidity Syndrome). If untreated, it leads to disability. Treatment requires nourishing Yin and clearing heat, expecting gradual efficacy. (Attached Formula)
Shu Di Huang (Rehmanniae Radix Preparata), Zhi He Shou Wu (Polygoni Multiflori Radix Preparata), Sheng Gui Ban (Testudinis Carapax et Plastrum), Nu Zhen Zi (Ligustri Lucidi Fructus), Dan Pi (Moutan Cortex), Hei Liao Dou (Sojae Semen Nigrum), E Jiao (Asini Corii Colla), Sheng Bai Shao (Paeoniae Radix Alba), Sha Yuan Zi (Astragali Complanati Semen), Bei Sha Shen (Glehniae Radix).
How can a physician achieve efficacy without first differentiating syndromes and prescribing treatment? Take winter Shang Han (Cold Damage) as an example: it begins in the Blood level of the Foot meridians and transmits to the Qi level. The pulse is floating and tight, with no sweat and aversion to wind; initially there is aversion to cold, followed by fever. Shang Feng (Wind Injury) presents with sweat, aversion to wind, and a floating, moderate pulse. Zhang Changsha (Zhang Zhongjing) has already detailed other transmission syndromes and treatments in the Shang Han Lun (Treatise on Cold Damage). Regarding Shi Xie (Seasonal Pathogens), they begin in the Qi level of the Hand meridians and transmit to the Blood level. The right pulse is surging and rapid, exceeding the left pulse. (If the pulse is deep and weak, it indicates Yang disease with Yin pulse, mostly untreatable.) There is also initial aversion to cold followed by fever, with heat radiating from inside to outside, worsening in the afternoon, accompanied by headache and restlessness. Initially, acrid-cool herbs should be used to vent the exterior; light formulas can resolve it through Chhan Han (Shivering Sweat). (If the pulse becomes calm after sweating, survival is indicated; if restless with a rapid pulse, death ensues.) Mr. Ye Tianshi of our dynasty possessed profound insight, supplementing what was lacking for millennia; one must study his works to gain understanding. What occurs in early spring is Chun Wen (Spring Warmth). If there is nasal congestion, cough, heavy voice, and restlessness, it is Feng Wen (Wind Warmth); one should lightly disperse the pathogen. What occurs in late spring and early summer is Wen Xie (Warm Pathogen), as warmth is the gradual onset of heat. After the Summer Solstice, what occurs is Re Bing (Heat Disease); at this time, various disease presentations emerge and must be carefully differentiated. As Li Likeng said, if heaven had only Spring, Autumn, and Winter without Summer, human diseases would surely be rare, because intense seasonal heat damages the Yuan Qi (Primordial Qi), causing the skin and hair pores to expand vacuously, allowing hundred diseases to take advantage and secretly arise. Re Bing presents with slight aversion to cold, followed by fever, headache, and thirst; or immediate high fever upon onset, or macules appearing after several days. If contagious among people, it is Wen Yi (Plague). If there is heavy head, nasal congestion, cough, and slight restlessness/heat, it is Feng Shu (Wind-Dampness). One should lightly disperse wind pathogens and simultaneously resolve dampness. If there is fever, aversion to cold, heavy head, thirst, profuse sweating, and a deficient pulse, it is Jing Zhong Shang Shu (Summerheat Injury in Stillness); Xiang Ru Yin (Mosla Decumbens Decoction) is appropriate. Those who work hard under the scorching sun contract Zhong Re (Heat Stroke), presenting with body heat and pain, profuse sweating, and restlessness; one must judge deficiency and excess before prescribing. Furthermore, after Start of Summer, if one seems ill with a large, empty right pulse, slight fever, fatigue, dizziness, restlessness, and loss of appetite, it is Zhu Xia Bing (Stagnant Summer Disease); Qing Shu Yi Qi Tang (Clear Summerheat and Boost Qi Decoction) is indicated. If the head feels wrapped with pain, limbs are heavy and tired, body feels heavy with board-like pain and chest fullness, despite having been ill for days, and the tongue is not dry, this is due to intense summer heat causing earth moisture to rise; summer-dampness combines and attaches to the person. When occurring in early summer, it is named Shi Wen (Damp-Warmth). This disease does not occur until late autumn, and should not be confused with other times. The best treatment is San Bai Tang (Three Whites Decoction). What occurs in early autumn is Qiu Xie (Autumn Pathogen); treating disease at this time is most difficult. Because summer-dampness has long lain dormant in the body, and when new coolness arrives, pores suddenly tighten, external coolness draws out internal pathogens, making treatment difficult to achieve quick results. If methods are incorrect, one enters dangerous territory. If autumn is excessively dry, cough and fever appear, named Qiu Zao Zheng (Autumn Dryness Syndrome); Qing Zao Jiu Fei Tang (Clear Dryness and Rescue Lung Decoction) is indicated. Dryness generates fire, punishing the ruling organ, damaging Lung Metal. Headache, thirst, and red face occurring in late autumn are called Fu Shu Wan Fa (Late Onset of Hidden Summerheat). This is even more lingering; flexible thinking and methods are required for success. Winter naturally sees much Shang Han. If winter should be cold but turns warm, contracting this warm pestilential Qi results in Dong Wen (Winter Warmth); acrid-hot dispersing drugs should not be used to forcibly sweat, only light exterior venting is needed. As for the initial stage of Shi Xie, if there is immediate high fever, confusion, delirious speech, or lethargy with mental fatigue, or slight fever and inability to recognize people, all result from righteous deficiency and Yin weakness, with heat disturbing the Shen (Spirit); this is still treatable. If upon onset there is immediate confusion and silence, convulsions of hands and feet, locked jaw, or immediate appearance of macules, or few macules after three to four days followed by denser macules two or three days later, these are all difficult to save. If one starts clear-minded but suddenly becomes confused, speaks wildly, and is irritable after seven or eight days, this is pathogen invading the Xin Bao (Pericardium). Only Zhang Zhongjing's Mai Mai Tang (Pulse-Nourishing Decoction) (remove Rou Gui/Cinnamon Twig) to nourish the source of transformation, combined with Zhi Bao Dan (Treasure of the Heart Pill) or Zi Xue Dan (Purple Snow Pill) 3 fen, taken with cool water, utilizing acrid-aromatic herbs to unblock orifices and expel turbidity, may be effective. If after several days of illness there is sudden panting (pathogenic heat steaming the Lung), hiccuping (exhaustion of Kidney Qi below), convulsions of hands and feet (pathogenic heat injuring Liver), cold limbs (heat sinking into Yin level), locked jaw, and gray-black tongue coating (not dry, indicating approaching exhaustion of Kidney Yin), these are signs of imminent death, mostly occurring in those with deficient constitutions. If by the sixth or seventh day of illness there is fever, abdominal fullness, tenderness upon pressure, constipation, dysuria, or confusion with delirious speech, and a deep, rapid, forceful pulse, Cheng Qi Tang (Order the Qi Decoction) should be used to purge. Once the Fu Organ Qi flows freely, the disease can be resolved.