医验随笔
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《医验随笔》提要
方书所载之因症脉治有定，而临床诊治则变幻无定。是故医生于精研方书之外，尤当熟玩医案，庶几神明变化，活法在人，不为疾病所困矣。本书系无锡中医友谊会理事沈奉江先生口述，门人周逢儒君笔记。案虽不多，而诊断之精确，用药之工稳，直可上追古人，下启来学。盖沈君为孟河马培之征君高足，学有根柢，识超侪辈，曾著《全球医通》一书，日久遗失，知者惜之。
《医验随笔》序
自古奉功伟节，奇才异能，非托之文字则阅世不足以传。汉司马迁修史，凡属艺文不论钜细，一字不肯割爱，千有余岁，吾人犹得取而读之者亦云幸矣。英儒密纳约翰向称为辩雄泰斗，著作等身，尝谓智者干虑必有寻失，愚者千虑必有一得，合者和之，否者正之，有寸长则不宜抹煞，闭塞民智，阻天下之言论自由，信斯言也。其巍然有济世之功者，宜何如宝重乎?余辑《无锡医学书目考》，深叹其有目无书，比校刊王旭高退思集类方歌注，益叹文献之易湮。访诸名医后裔，或以无暇著述，仅存方薄，或则秘为手泽，无意付刊，久而佚散。是以书目所有，百仅一二可见传布流通，吾侪之责。梁溪沈奉江先生，文学世家，赋性颖悟，伉爽不群，超逸如神仙中人。医学师事马徵君培之，生平治验，名公钜室，咸相信服。而先生飘然物外，如幽兰自芳，不以自炫，其心志之所存者大，形迹之所寄者小，而矫矫固足以名世也，先生医学湛深，尝慕逊清徐大椿，泰西裴乃德龙蒲束之为人，现为吾邑中医友谊会理事。向所著《全球医通》藏稿未刊，日久屡索不得，此则不即付诸手民之弊，殊为可惜。小儿逢儒读岐黄书，从先生游而诏医验甚伙，钦迟无己，属操笔札，随闻记录，积久成册，惟年湮岁远者，四诊或有阙略，录寄《三三医书》刊入专著，庶启悟学者之性灵，裨益医林，实非浅鲜也。因识其缘起如此。
民国第一甲子夏月无锡周小农别署伯华谨序
《医验随笔》序
昔韩昌黎见北平马公叹曰：犹高山深林，钜谷龙虎，变化不测，杰魁人也，自余始识。
沈丈奉江先生，瞻其岸然道貌，窃有味乎韩子之言。继又得见先生介弟葆三先生，葆三先生以名孝廉覃精内典，广长说法，得未曾有。因得读《棣萼集》，先生昆季唱和之作也，谢家嗣响，心仪者久之。先生师盂河马徵君，深入堂奥，而颖悟博洽复绝恒蹊，性疏旷寓居中隐院，一室图书，左右多蓄古金石。余每造谒，见病者踵趾相接，先生一一洞其癥结而活之。诊余编摩，殆不去手。或纵谭古今，上下旁及，世事议论，风发泉涌，不可方物，喜奖借人，有一长辄津津乐道不倦。与同志组织中医友谊会及《医刊》，主持坛坫，翕然悦服无间言，而先生欧如也。然后知先生果非常人也。甲子秋周君逢儒手录先生治验一册，示余嘱序。余读之狂喜曰：韩子之所谓龙虎变化不测者，此殆鳞爪矣乎!虽然余之服膺先生既如上述，又安敢晓舌哉！周君固请，重以先生之命，不获已，乃道其所得于先生者。而又幸夫周君好学之勤与先生之才之识，得此以广其传，世必有被其泽者，非细事也。
世晚张树铭伯倚谨序梁溪沈君事述
沈君祖复，字礼庵，号奉江，别署鲐翁。先世居浙江湖州，宋淳熙进士有开，官太常博士，立朝抗节著直声，为君迁锡始祖。累代高隐不仕，祖文炳通申韩家言，书工钟王法。父尧甲混迹商界素精计学，君生时父年四十，有弟二，兆英早卒，祖约登丁酉科贤书。君幼颖悟，读书史过目辄成诵，貌魁梧有独立，性伉爽不阿。年十三岁执笔论古人，不屑拾人牙慧。应郡县试辄冠其曹。郡尊长白桐公泽邑候浙江吴公观乐赏其文，录为门下士(校卷秀水沈大史卫，常熟庞主政宗瑚，南元陆公正福)。有风度端凝，芳兰竟体之誉。君为文词藻富丽，才气磅礴灏瀚，惟于风檐寸晷不暇推敲，以故屡摘屡踬。遂援例纳粟为国子生，赴乡闱郁不得志。因遨游古越，浏览西子湖名胜，谒岳王墓，憩冷泉亭，倏然有潇洒出尘风致。既权寓浙，课顾氏子祖瑛昆仲，读阅一载，以父衰病旋里。应城西高司马承祖、凌明经学颁聘，督课两家弟子，凡六七年。内顾家计，外任学赀力培植成名。说者咸谓君孝友出于天性云。岁甲午前出使英法义比大臣薜星使福成任满归国，犹子听聪彝明府，与君交莫逆，延校《天盖楼文集》者累月。适中日失和，君伤怀时事，淡于进取，平昔攻健全学，尝慨慕欧西裴乃德龙蒲束及国朝徐大椿为人，至是喟然曰：大丈夫不为良相，定为良医。遂执贽孟河马徵君文植门下。徵君者曾应诏入都，为今上慈禧皇太后请脉，恩赏叠稠，声誉满天下者也。君奉以为师，问难质疑，洞见癥结，所学日益粹。更随侍徵君，视盛宫保、俞军门、聂中丞、龙侍郎、吴廉访诸钜公疾，尤内翰先甲稔君医理堪深，特延聘为苏垣医局员，因事不果往。丁酉岁杪君为弟部署计偕北上，遂侨居崇安寺中隐院，其地即秋岩上人退隐处也。禅房清旷，花木扶疏，君小住三椽，清雅绝俗，居则一僮一剑自随，出则利济为怀，活人无算，遐迩传其名。邑宰泗州杨公士晟及守戎皖南汪公福林均心钦之，制额以赠。君年四十后，孑身寂处，不问家庭琐屑及田园生计事，惟渴爱才。凡邑中留学泰东西各国志士，类与研究新学，痛论时局，虽居恒绝志进取，而爱国忧世之心未尝一日忘。比年体羸多病，壬寅四月陡染虎列拉疾剧甚，某夜气垂绝，魂游深山石室间，四围峭壁千寻，上漏光一线，君箕踞兀坐，凝气练神，突来一异僧，状貌古朴，举腕破壁，携小裹囊负之出，顿苏。向母索蔗浆，豪饮数十杯，病若失。因更号曰"蔗生"，留纪念庆更生也。丙午夏又腹疾大作，屡濒于危，君弟与诸友惶急甚，君曰：甘蔗曾生我，以啖我可化险为夷。试之信然。君精气神由此益耗，筋痹举发，脊梁伛偻，自谓风前烛影，殆将以医士终其身矣。所著《医通》一卷，《锄经堂文稿》一卷，《棣华集》一卷，已刻入家乘。某与君弱冠订交，重以年谊，于君学行知之有素，辄忘其不文，略述梗概，以告当世之知言者。
光绪戊申年秋月同里年愚弟张文藻撰医验随笔
唐蔚芝先生之太翁若钦老先生年七十余，足上数发酒湿，忽而饮食少进，请城南某君诊视，用消运之品屡服如故。先生诊之曰：此高年气虚，无力运化，非用参术不可。若以消导，是更伤其中气矣。用补中益气汤加减，一服而胃醒，连服数剂，而饮食如常。蔚芝先生赠联云；少年学文，中年学道，不为良相，即为良医。
杨楚孙之夫人久病寒热不愈，甚至昏厥，不省人事，延王医诊治不效。转荐先生，即以王医之肩舆邀诊，入门见纸轿草履齐备，诊其脉沉伏，牙关紧闭，气不接续，按腹板硬。曰：此实证也，非攻下不可。但药已难进，恐夜半生变不测。如药能服下，或可挽回。用大黄、枳实、玉枢丹等，撬牙灌之。初不受，至天明喉中汨汨有声下降，神情转清，连去诊视，攻下之剂八九服，下结粪不少。楚孙曰：久不饮食，似不可再用攻下。先生曰：无妨也，有病则病当之。再下一二日，用扶正之品调治而愈。楚孙制联云：受药我知羊叔子，论功人比贾长沙。
凌敬叔一病半年，请先生诊视，脉弦大，苔黄腻，两目失神多眵，彻夜不寐，饮食不进者久矣。语无伦次，亲友疑有癫病也。先生曰：此痰火扰乱神明，且积滞未清，非用大黄、元明粉不可。家人畏不敢进，以久病恐虚脱。先生坚持此议，嘱服之，一剂下结粪。言稍有序，明日再将原方加减。又下燥粪，略兼溏薄，惟舌苔干黄厚措，拟芳香化浊不应。先生曰：此气阴虚而不能化也。用人参须、西洋参、羚羊角、珠粉等，数剂后舌苔渐化，再服数剂而苔化尽，得进饮食，病大转机。适其爱妾病亡，先生代为耽忧，恐此病再生波折。用种种劝解，始得病无变迁，常服益气养营之方，调理而愈。
惜谷局王晓峰先生年六十余矣，自少茹素，荤味未尝下箸，时时头痛不止，服桑叶、钩藤等药无效。先生曰：此因不茹荤而五脏滋液枯槁，肝肾之阴不足，非用阿胶、龟胶等血肉有情之品不可。王君曰：茹素已六十年余，不愿以荤味污我腹内清净之腑也。嗣后头痛愈甚，先生劝之曰：入药不为荤，何迂执乃尔。后仍照前方服之，数日而痛止。
医生张亮生先生之谱弟也，曾病伏暑，寒热交作一月有余，形瘦骨立，神情疲倦，两目失神，饮食不进，脉细无神，舌上已起白腐，时住岳家养疴其岳母见其病势垂危，欲送之返家。先生止之曰：不可，恐中途有变。议遂辍，因偕严康甫同诊，用柴白煎一剂热退，再服热清，续用扶正养阴之品而愈。至今精神且远胜于前焉。
邹律师之子病气逆，痰鸣喘急，不能平卧。先生诊视曰：此喉风也。用猴枣一分，同贝母、制胆星研末调服，服后喘热大定，得以安睡，呼之不应。家人以为昏迷也，孰知竟愈矣。又县下塘某妇病亦与此症相同，服药后亦昏睡如醉卧，当时稍觉惊骇，病亦由此而愈。考猴枣古书所无，马培之徵君首用此药，先生承师法继用之有效。今则人人皆知用此物矣。然惟风痰热痰可用，若寒痰湿痰用之，无怪凌永言君訾议之也。吾以为非药之咎，是医之不良于用药之过也。
打铁桥下郑元利洋货店锡君之妻病癫，终日喋喋自言语，命立则立，坐则终日呆坐，与食则食，不与亦不索，如是者年余矣，中西医均不效。一日先生遇郑君于新市桥，详述病状，邀至中隐诊所，为立一方，用羚羊角五分、贝母三钱、珠粉五分，并赠与马宝五分，研和，分三次服，稍愈，再合前方服，未过半病已爽然若失。逾月遂有娠，生一子，举家欣喜过望。因制银盾镌"饮上池水"四字以赠云。又高车渡农家子病痛风，每发四肢陡然抽搐，不省人事，四处就治，多年不效。一日来诊，先生亦用前法与服马宝等，后虽复发，不过两手蠢动耳。又服前方加熊胆一分同研。后问堵其人，云已久不发矣。按；时珍《纲目》马肾条下云：马有墨在肾，与牛黄、狗宝相类，而未详其功用。谅即马宝也。今先生尚藏四两许，色灰白，有宝光纹理，层层包裹，与牛黄、狗宝同。其大小无定，大者如瓜，小者如拳，先生云；马为火畜，其性必燥，病之有痰者宜之。又阅《医学问答初集》俞君鉴泉答裘君云：夫痴狂为神经病，心属神属火，马为火畜，行速不寐，能识途，确具神足心专之能力，以动物之体生此静物，故有安神定心之功欤。
陈赞廷室人患三阴大疟三年有余，诸药无效。延先生诊治，起伏时两目深红，脉弦舌绛。先生曰：此非寒也。疟久则肝阴伤而化火，温药万不可用。用羚羊角一钱、石决明等，一药而愈。
店桥头某妇从上海归，患三阴大疟已历四年，屡服各种截疟药及金鸡纳丸，而间二日寒热如故。先生用《医话》夜光丸，意加减鳖甲、夜明砂、花槟醋制、常山，半夏、草果等，再用雄精二分、辰砂二分，研末，服一剂而愈。又先生见许荣庭之子亦病三疟，有人传单方，以三十文至药肆购雄黄，店伙误闻为硫黄也，竟以硫黄付之，服后三疟竟愈，而头面周身黧黑，毫毛皆焦，无异黑种，终身如是。邑人见之皆绝倒。
洛社张巷张金钧培室人，经事前后无序，白带频下，饮食无味，阴户坠下一块宛如紫茄，咳则下，卧则缩，服药年余不效。先生诊之，阅前方皆云膀胱下坠，乃细询其形色何若，病者曰：其色紫黯，触之微痛。先生曰：此非膀胱也。夫膀胱之色白，小溲不能通利。此乃气虚不固，子宫下坠也，恐难一时见效。用黄芪、升麻、白术、人参须、葛根、芡实、牡蛎、陈皮、甜杏仁、白芍、神曲，服三剂而缩上矣。
大市桥王姓童子洗热浴后，赤足遇寒，回家半日觉牙龈肿胀腐碎，右足胫青紫异常，恶寒身热。先生诊曰：此青腿牙疳也，上病必治其下。用银针刺其足胫紫处，出恶血，内服活血去瘀，牙疳遂愈。
西门桥下温姓，壮热面油，脉洪舌绛，右臂红肿作痛。外科章某曰：此流注也。用温药桂枝、当归等。道生堂高君介绍先生诊视，已有一医用藤黄涂之。先生曰：此系热毒，名曰火炎疽，用解毒剂。是时神识尚清，既而胸前又多一红肿处。复延章医，仍谓流注。先生以为不然。决其热毒内走，势必毒陷神昏而死。至下午果暴殂。
医验随笔
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《医验随笔》提要
医书中记载的因症脉治虽有定法，但临床诊治却变幻莫测。因此，医生在精研医书之外，尤其应当熟读医案，这样才能神明变化，活法在人，不被疾病所困。本书系无锡中医友谊会理事沈奉江先生口述，门人周逢儒君记录整理。虽然医案不多，但其诊断之精确、用药之工稳，直可上追古人，下启来学。因为沈君是孟河马培之征君的高足，学问有根基，见识超越同辈，曾著有《全球医通》一书，日久遗失，知情者为之惋惜。
《医验随笔》序
自古以来，功业伟节、奇才异能，如果不借助文字流传，经过岁月洗礼就不足以传承。汉代司马迁修史，凡是属于艺文范畴，不论大小，一字都不肯割舍，千余年之后，我们还能读到这些内容，也算幸运了。英国学者约翰·密纳向来被称为辩论泰斗，著作等身，他曾说：“智者千虑必有一失，愚者千虑必有一得。”合乎道理的附和它，不合道理的纠正它，有一点长处就不应抹杀，以免闭塞民智，阻碍天下的言论自由。相信这话是对的。那么那些巍然具有济世之功的人，又该怎样珍重呢？我编纂《无锡医学书目考》，深深感叹其中有目无书；后来校刊王旭高的《退思集类方歌注》，更加感叹文献容易湮灭。访求名医后裔，有的因为没有时间著述，仅存方簿；有的则秘藏为手泽，无意付印，久而久之便散佚了。所以书目中记载的，百无一二可见流传流通，这是我们的责任。梁溪沈奉江先生，出身文学世家，赋性聪颖悟达，刚直不群，超逸如神仙中人。医学师从马徵君培之，生平治疗验证，名公巨室都相信佩服。而先生飘然物外，如幽兰自芳，不自我炫耀，其心志所在宏大，形迹所寄微小，而矫矫不凡足以名世。先生医学精深，曾经仰慕逊清徐大椿及西方裴乃德龙蒲束（Penndragon）等人的为人，现为吾邑中医友谊会理事。向来所著的《全球医通》藏稿未刊，日久屡索不得，这是不立即交付刻印的弊病，殊为可惜。小儿逢儒研读岐黄之书，跟随先生游历并请教，得到的医疗验证很多，钦慕不已，于是嘱托执笔记录，随闻随录，积久成册。只是年代久远者，四诊或有缺略，抄录寄给《三三医书》刊入专著，希望能启发学者的灵性，裨益医林，实在不是小事。因此记下缘起如此。
民国第一甲子夏月无锡周小农别署伯华谨序
《医验随笔》序
从前韩昌黎见到北平马公时感叹道：“犹如高山深林，巨谷龙虎，变化不测，真是杰魁之人啊，自从认识他以来。”
沈丈奉江先生，看他那庄重严肃的道貌，私下里体味到韩子的话很有道理。后来又见到先生的弟弟葆三先生，葆三先生以著名孝廉的身份潜心钻研佛典，广长说法，得到从未有过的体验。因此得以阅读《棣萼集》，这是先生兄弟唱和的作品，谢家嗣响，让人心仪已久。先生师从盂河马徵君，深入堂奥，而颖悟博洽又绝非凡俗路径，性格疏旷，寓居在中隐院，一室图书，左右多收藏古代金石。我每次拜访，见病人接踵而至，先生一一洞察其症结并治愈他们。诊余编撰，几乎不离手。有时纵谈古今，上下旁及，世事议论，风发泉涌，不可名状，喜欢奖掖后人，有一点长处就津津乐道不倦。与同志组织中医友谊会及《医刊》，主持坛坫，大家心悦诚服没有异议，而先生淡然处之。然后才知道先生果真是非常人。甲子秋周君逢儒手录先生治验一册，示给我并嘱托作序。我读后狂喜道：韩子所说的龙虎变化不测，这大概只是鳞爪罢了！虽然如此，我佩服先生既然像上述那样，又怎敢多嘴呢！周君坚决请求，加上先生的命令，不得已，才说出我从先生那里所得到的。而又庆幸周君好学之勤与先生之才之识，借此得以广泛传播，世上必定有人受到恩泽，这不是小事。
世晚张树铭伯倚谨序梁溪沈君事述
沈君祖复，字礼庵，号奉江，别署鲐翁。先世居住在浙江湖州，宋淳熙进士有开，官太常博士，立朝抗节著直声，为君迁锡始祖。累代高隐不仕，祖父文炳通晓申韩家言，书法工整钟王法度。父亲尧甲混迹商界素精计学，君生时父亲年四十，有两个弟弟，兆英早卒，祖父约登丁酉科贤书。君幼颖悟，读书史过目辄成诵，貌魁梧有独立，性格刚爽不阿。年十三岁执笔论古人，不屑拾人牙慧。应郡县试辄冠其曹。郡尊长白桐公泽邑候浙江吴公观乐赏其文，录为门下士（校卷秀水沈大史卫，常熟庞主政宗瑚，南元陆公正福）。有风度端凝，芳兰竟体之誉。君为文词藻富丽，才气磅礴灏瀚，惟于风檐寸晷不暇推敲，以故屡摘屡踬。遂援例纳粟为国子生，赴乡闱郁不得志。因遨游古越，浏览西子湖名胜，谒岳王墓，憩冷泉亭，倏然有潇洒出尘风致。既权寓浙，课顾氏子祖瑛昆仲，读阅一载，以父衰病旋里。应城西高司马承祖、凌明经学颁聘，督课两家弟子，凡六七年。内顾家计，外任学赀力培植成名。说者咸谓君孝友出于天性云。岁甲午前出使英法义比大臣薛星使福成任满归国，犹子听聪彝明府，与君交莫逆，延校《天盖楼文集》者累月。适中日失和，君伤怀时事，淡于进取，平昔攻健全学，尝慨慕欧西裴乃德龙蒲束及国朝徐大椿为人，至是喟然曰：大丈夫不为良相，定为良医。遂执贽孟河马徵君文植门下。徵君者曾应诏入都，为今上慈禧皇太后请脉，恩赏叠稠，声誉满天下者也。君奉以为师，问难质疑，洞见癥结，所学日益粹。更随侍徵君，视盛宫保、俞军门、聂中丞、龙侍郎、吴廉访诸钜公疾，尤内翰先甲稔君医理堪深，特延聘为苏垣医局员，因事不果往。丁酉岁杪君为弟部署计偕北上，遂侨居崇安寺中隐院，其地即秋岩上人退隐处也。禅房清旷，花木扶疏，君小住三椽，清雅绝俗，居则一僮一剑自随，出则利济为怀，活人无算，遐迩传其名。邑宰泗州杨公士晟及守戎皖南汪公福林均心钦之，制额以赠。君年四十后，孑身寂处，不问家庭琐屑及田园生计事，惟渴爱才。凡邑中留学泰东西各国志士，类与研究新学，痛论时局，虽居恒绝志进取，而爱国忧世之心未尝一日忘。比年体羸多病，壬寅四月陡染虎列拉疾剧甚，某夜气垂绝，魂游深山石室间，四围峭壁千寻，上漏光一线，君箕踞兀坐，凝气练神，突来一异僧，状貌古朴，举腕破壁，携小裹囊负之出，顿苏。向母索蔗浆，豪饮数十杯，病若失。因更号曰"蔗生"，留纪念庆更生也。丙午夏又腹疾大作，屡濒于危，君弟与诸友惶急甚，君曰：甘蔗曾生我，以啖我可化险为夷。试之信然。君精气神由此益耗，筋痹举发，脊梁伛偻，自谓风前烛影，殆将以医士终其身矣。所著《医通》一卷，《锄经堂文稿》一卷，《棣华集》一卷，已刻入家乘。某与君弱冠订交，重以年谊，于君学行知之有素，辄忘其不文，略述梗概，以告当世之知言者。
光绪戊申年秋月同里年愚弟张文藻撰医验随笔
唐蔚芝先生的祖父若钦老先生年七十余，足上数处发生酒湿（湿热下注之证），忽然饮食减少，请城南某君诊视，用消运之品屡服无效。先生诊之曰：此高年气虚，无力运化，非用人参、白术不可。如果用消导药，是更伤其中气了。用补中益气汤加减，一服而胃醒，连服数剂，而饮食如常。蔚芝先生赠联云：少年学文，中年学道，不为良相，即为良医。
杨楚孙的夫人久病寒热不愈，甚至昏厥，不省人事，延请王医诊治不效。转荐先生，即以王医的肩舆邀诊，入门见纸轿草履齐备，诊其脉沉伏，牙关紧闭，气不接续，按腹板硬。曰：此实证也，非攻下不可。但药已难进，恐夜半生变不测。如药能服下，或可挽回。用大黄、枳实、玉枢丹等，撬牙灌之。初不受，至天明喉中汨汨有声下降，神情转清，连去诊视，攻下之剂八九服，下结粪不少。楚孙曰：久不饮食，似不可再用攻下。先生曰：无妨也，有病则病当之。再下一二日，用扶正之品调治而愈。楚孙制联云：受药我知羊叔子，论功人比贾长沙。
凌敬叔一病半年，请先生诊视，脉弦大，苔黄腻，两目失神多眵，彻夜不寐，饮食不进者久矣。语无伦次，亲友疑有癫病也。先生曰：此痰火扰乱神明，且积滞未清，非用大黄、元明粉不可。家人畏不敢进，以久病恐虚脱。先生坚持此议，嘱服之，一剂下结粪。言稍有序，明日再将原方加减。又下燥粪，略兼溏薄，惟舌苔干黄厚措，拟芳香化浊不应。先生曰：此气阴虚而不能化也。用人参须、西洋参、羚羊角、珠粉等，数剂后舌苔渐化，再服数剂而苔化尽，得进饮食，病大转机。适其爱妾病亡，先生代为耽忧，恐此病再生波折。用种种劝解，始得病无变迁，常服益气养营之方，调理而愈。
惜谷局王晓峰先生年六十余矣，自少茹素，荤味未尝下箸，时时头痛不止，服桑叶、钩藤等药无效。先生曰：此因不茹荤而五脏滋液枯槁，肝肾之阴不足，非用阿胶、龟胶等血肉有情之品不可。王君曰：茹素已六十年余，不愿以荤味污我腹内清净之腑也。嗣后头痛愈甚，先生劝之曰：入药不为荤，何迂执乃尔。后仍照前方服之，数日而痛止。
医生张亮生先生的族弟也，曾病伏暑，寒热交作一月有余，形瘦骨立，神情疲倦，两目失神，饮食不进，脉细无神，舌上已起白腐，时住岳家养疴其岳母见其病势垂危，欲送之返家。先生止之曰：不可，恐中途有变。议遂辍，因偕严康甫同诊，用柴白煎一剂热退，再服热清，续用扶正养阴之品而愈。至今精神且远胜于前焉。
邹律师之子病气逆，痰鸣喘急，不能平卧。先生诊视曰：此喉风也。用猴枣一分，同贝母、制胆星研末调服，服后喘热大定，得以安睡，呼之不应。家人以为昏迷也，孰知竟愈矣。又县下塘某妇病亦与此症相同，服药后亦昏睡如醉卧，当时稍觉惊骇，病亦由此而愈。考猴枣古书所无，马培之徵君首用此药，先生承师法继用之有效。今则人人皆知用此物矣。然惟风痰热痰可用，若寒痰湿痰用之，无怪凌永言君訾议之也。吾以为非药之咎，是医之不良于用药之过也。
打铁桥下郑元利洋货店锡君之妻病癫，终日喋喋自言语，命立则立，坐则终日呆坐，与食则食，不与亦不索，如是者年余矣，中西医均不效。一日先生遇郑君于新市桥，详述病状，邀至中隐诊所，为立一方，用羚羊角五分、贝母三钱、珠粉五分，并赠与马宝五分，研和，分三次服，稍愈，再合前方服，未过半病已爽然若失。逾月遂有娠，生一子，举家欣喜过望。因制银盾镌"饮上池水"四字以赠云。又高车渡农家子病痛风，每发四肢陡然抽搐，不省人事，四处就治，多年不效。一日来诊，先生亦用前法与服马宝等，后虽复发，不过两手蠢动耳。又服前方加熊胆一分同研。后问堵其人，云已久不发矣。按；时珍《纲目》马肾条下云：马有墨在肾，与牛黄、狗宝相类，而未详其功用。谅即马宝也。今先生尚藏四两许，色灰白，有宝光纹理，层层包裹，与牛黄、狗宝同。其大小无定，大者如瓜，小者如拳，先生云；马为火畜，其性必燥，病之有痰者宜之。又阅《医学问答初集》俞君鉴泉答裘君云：夫痴狂为神经病，心属神属火，马为火畜，行速不寐，能识途，确具神足心专之能力，以动物之体生此静物，故有安神定心之功欤。
陈赞廷室人患三阴大疟三年有余，诸药无效。延先生诊治，起伏时两目深红，脉弦舌绛。先生曰：此非寒也。疟久则肝阴伤而化火，温药万不可用。用羚羊角一钱、石决明等，一药而愈。
店桥头某妇从上海归，患三阴大疟已历四年，屡服各种截疟药及金鸡纳丸，而间二日寒热如故。先生用《医话》夜光丸，意加减鳖甲、夜明砂、花槟醋制、常山，半夏、草果等，再用雄精二分、辰砂二分，研末，服一剂而愈。又先生见许荣庭之子亦病三疟，有人传单方，以三十文至药肆购雄黄，店伙误闻为硫黄也，竟以硫黄付之，服后三疟竟愈，而头面周身黧黑，毫毛皆焦，无异黑种，终身如是。邑人见之皆绝倒。
洛社张巷张金钧培室人，经事前后无序，白带频下，饮食无味，阴户坠下一块宛如紫茄，咳则下，卧则缩，服药年余不效。先生诊之，阅前方皆云膀胱下坠，乃细询其形色何若，病者曰：其色紫黯，触之微痛。先生曰：此非膀胱也。夫膀胱之色白，小溲不能通利。此乃气虚不固，子宫下坠也，恐难一时见效。用黄芪、升麻、白术、人参须、葛根、芡实、牡蛎、陈皮、甜杏仁、白芍、神曲，服三剂而缩上矣。
大市桥王姓童子洗热浴后，赤足遇寒，回家半日觉牙龈肿胀腐碎，右足胫青紫异常，恶寒身热。先生诊曰：此青腿牙疳也，上病必治其下。用银针刺其足胫紫处，出恶血，内服活血去瘀，牙疳遂愈。
西门桥下温姓，壮热面油，脉洪舌绛，右臂红肿作痛。外科章某曰：此流注也。用温药桂枝、当归等。道生堂高君介绍先生诊视，已有一医用藤黄涂之。先生曰：此系热毒，名曰火炎疽，用解毒剂。是时神识尚清，既而胸前又多一红肿处。复延章医，仍谓流注。先生以为不然。决其热毒内走，势必毒陷神昏而死。至下午果暴殂。
Yi Yan Sui Bi (Random Notes on Medical Experience)
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Summary of "Yi Yan Sui Bi"
Although the principles of syndrome differentiation, pulse diagnosis, and treatment recorded in medical books are fixed, clinical diagnosis and treatment are ever-changing. Therefore, besides meticulously studying medical books, doctors must also familiarize themselves with medical cases, so that they may achieve spiritual transformation and flexible application, not being trapped by diseases. This book is dictated by Mr. Shen Fengjiang, Director of the Wuxi Traditional Chinese Medicine Friendship Association, and recorded by his disciple Mr. Zhou Fengru. Although the cases are few, their precise diagnosis and stable medication can rival the ancients and inspire future generations. Since Mr. Shen was a distinguished student of Master Ma Peizhi of Menghe, his learning has deep roots, and his insight surpasses his peers. He once authored *Quan Qiu Yi Tong* (Global Medical Communication), which was lost over time, causing regret among those who knew it.
Preface to "Yi Yan Sui Bi"
Since ancient times, great merits and extraordinary talents, if not transmitted through writing, would not survive the test of time. Sima Qian of the Han Dynasty compiled history, sparing no detail in literature, whether large or small. Over a thousand years later, we can still read these works, which is fortunate. John Millner, a British scholar known as a master debater, wrote extensively. He once said: "The wise man may err in a thousand deliberations, but the fool may hit upon something right in a thousand." Agree with what is correct, correct what is wrong; do not suppress even minor strengths, lest you block the wisdom of the people and hinder freedom of speech. Believing this to be true, how much more should we cherish those who have achieved great benefits for the world? In compiling the *Bibliography of Wuxi Medical Books*, I deeply lamented that many titles existed without available texts. Later, when proofreading Wang Xugao's *Retrospective Collection of Formula Songs*, I further sighed at how easily documents are lost. Visiting descendants of famous doctors, some had no time to write, leaving only prescription notebooks; others kept manuscripts secret, unwilling to publish them, leading to eventual loss. Thus, out of all listed in bibliographies, only one or two percent are circulated. This is our responsibility. Mr. Shen Fengjiang of Liangxi, from a literary family, was intelligent, straightforward, and transcendent like an immortal. He studied medicine under Master Ma Peizhi, and his clinical experiences were trusted by nobles and prominent families. Yet he remained aloof, fragrant like an orchid, not seeking fame. His aspirations were grand, while his actions were humble, yet his integrity was sufficient to make him famous. His medical knowledge was profound. He admired Xu Dachun of the late Qing Dynasty and Western figures like Penndragon. He currently serves as a director of the local TCM Friendship Association. His manuscript *Quan Qiu Yi Tong* remains unpublished and lost, a pity due to delay in printing. My son Fengru studied Huangdi Neijing (Yellow Emperor's Inner Canon), followed Mr. Shen, and accumulated many verified cases. Admiring him endlessly, I asked him to record them. Over time, these became a volume. However, older cases lack complete four diagnostic methods. I sent them to *San San Yi Shu* for publication to enlighten students and benefit the medical field. Thus, I record the origin.
Zhou Xiaonong, pseudonym Bohua, Wuxi, Preface in Summer of the First Jiazi Year of the Republic of China
Preface to "Yi Yan Sui Bi"
Formerly, Han Changli saw Ma Gong in Beiping and exclaimed: "Like high mountains and deep forests, giant valleys, tigers and dragons, unpredictable in change, truly a杰出 person, since I met him."
Mr. Shen Fengjiang, seeing his solemn demeanor, privately appreciated Han Zi's words. Later, I met his younger brother, Mr. Baosang, a renowned filial scholar devoted to Buddhist scriptures, whose teachings were unprecedented. Thus, I read *Di E Ji* (Collection of Fraternally Harmonious Poems), poems exchanged between the brothers, reminiscent of the Xie family, inspiring long admiration. Mr. Shen studied under Master Ma of Menghe, penetrating its depths, yet his insight and erudition exceeded ordinary paths. He lived freely in Zhongyin Courtyard, surrounded by books and ancient artifacts. Whenever I visited, patients crowded in. Mr. Shen diagnosed each case accurately and cured them. Between consultations, he edited writings, rarely putting them down. Sometimes discussing past and present, his arguments flowed like springs, indescribable. He praised others' strengths enthusiastically. Organizing the TCM Friendship Association and *Medical Journal*, he led with authority, earning universal respect, while remaining indifferent. Only then did I realize he was indeed extraordinary. In Autumn of the Jiazi year, Mr. Zhou Fengru hand-copied a volume of Mr. Shen's cases and asked for a preface. Reading it, I rejoiced wildly: The "tigers and dragons" described by Han Zi are but scales and claws here! Although I admire Mr. Shen as stated, how dare I speak? Insisted by Mr. Zhou and ordered by Mr. Shen, I reluctantly share my insights. Fortunately, Mr. Zhou's diligence and Mr. Shen's talent will spread this widely, benefiting many. It is no small matter.
Zhang Shuming Boyi, Junior Generation, Preface
Narrative of Mr. Shen of Liangxi
Mr. Shen Zufu, courtesy name Lian'an, pseudonym Fengjiang, also known as Taiweng. Ancestors resided in Huzhou, Zhejiang. Youkai, a Jinshi in the Chunxi era of Song, served as Doctor of the Court of Imperial Sacrifices, known for integrity. He is the ancestor who moved to Xi (Wuxi). Generations lived in seclusion. Grandfather Wenbing mastered Legalist thought and calligraphy of Zhong and Wang. Father Yaojia worked in commerce, skilled in accounting. When Mr. Shen was born, his father was forty, with two younger brothers; Zhao Ying died young. Grandfather Yue passed the Dingyou examination. Mr. Shen was intelligent, memorizing histories after one reading. Tall and independent, straightforward and upright. At thirteen, he criticized ancients, refusing to copy others. Topped county exams. Governor Tong Ze and Prefect Wu Guanle appreciated his essays, accepting him as a student. He had dignified demeanor and fragrance like an orchid. His writing was rich in rhetoric and majestic in spirit, but lacked refinement due to haste, causing repeated failures. He purchased a Guozijian (Imperial Academy) degree. Frustrated in provincial exams, he traveled to Yue, visiting West Lake and Yue Fei's Tomb, developing an elegant detachment. He stayed in Zhejiang, tutoring the Gu family for a year, then returned home due to his father's illness. He taught for Gao Chengzu and Ling Xueban for six or seven years, supporting his family and students. Praised for filial piety and brotherhood. Before the Jiawu War, Envoy Xue Fucheng returned from Europe. His nephew Ting Congyi, a close friend of Mr. Shen, invited him to edit *Tian Gai Lou Wen Ji* for months. Amidst Sino-Japanese tensions, Mr. Shen, disillusioned with politics and admiring Western scholars and Xu Dachun, sighed: "A great man, if not a good minister, shall be a good doctor." He became a student of Ma Wenzhi of Menghe. Master Ma had treated Empress Dowager Cixi and was renowned. Mr. Shen learned deeply, diagnosing critically. He accompanied Master Ma to treat high officials like Sheng, Yu, Nie, Long, and Wu. Scholar Xian Jia, knowing his skill, invited him to Suzhou Medical Bureau, but he did not go. Late in Dingyou year, he helped his brother travel north, staying at Chong'an Temple's Zhongyin Courtyard, formerly retreat of Qiuyan Shangren. The temple was quiet, flowers lush. Mr. Shen lived simply, serving patients不计其数, gaining fame. Magistrates Yang Shisheng and Wang Fulin admired him, presenting plaques. After forty, he lived alone, ignoring domestic matters, loving talent. He supported patriotic students studying abroad. In recent years, frail and sick, in April of Renyin year, he contracted Cholera severely. One night, near death, his soul wandered cliffs. Sitting cross-legged, concentrating spirit, an odd monk appeared, broke the wall, carried him out, and he revived. He drank sugarcane juice, recovered. Changed his name to "Zhesheng" (Sugarcane Life) to commemorate rebirth. In summer of Bingwu year, severe abdominal illness nearly killed him again. His brother and friends panicked. He said: "Sugarcane saved me before; eating it will save me now." It worked. His essence depleted, rheumatism flared, spine bent. He thought he would die as a doctor. His works *Yi Tong*, *Chujing Tang Manuscripts*, and *Di Hua Ji* were printed in family records. I befriended him in youth, sharing age ties, knowing his character well. Forgetting my poor writing, I summarize briefly for discerning readers.
Zhang Wenzao, Fellow Villager, Preface in Autumn of Wushen Year of Guangxu Reign
Mr. Tang Weizhi's grandfather, Mr. Ruoqin, over seventy, had damp-heat lesions on feet. Appetite decreased. A doctor in South City used digestive herbs without effect. Mr. Shen diagnosed: "Elderly qi deficiency, unable to transform. Must use Ginseng and Atractylodes Macrocephala Rhizome. Digestives harm middle qi." Prescribed Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) modified. One dose awakened stomach function; several doses restored normal diet. Mr. Weizhi presented a couplet: "Learn literature in youth, Dao in middle age; if not a good minister, then a good doctor."
Mrs. Yang Chusun suffered chronic alternating chills and fever, fainting, unconsciousness. Dr. Wang failed to cure. Referred to Mr. Shen. Pulse deep and hidden, jaw clenched, breath irregular, abdomen hard. Mr. Shen said: "This is excess syndrome, requires purgation. Medicine difficult to administer, risk of midnight crisis. If taken, might recover." Used Rhubarb, Immature Bitter Orange, and Yushu Dan (Jade Pivot Pill) via forced administration. Initially refused, but by dawn, sounds of descent heard, consciousness cleared. Continued purgatives 8-9 doses, passing hardened stool. Mr. Chusun worried about purging after fasting. Mr. Shen said: "No matter. Disease bears the burden." After 1-2 days, tonics restored health. Mr. Chusun presented a couplet: "I know you accept medicine like Yang Shuzi; comparing merit, you are like Jia Changsha."
Ling Jingshu was ill for half a year. Pulse stringy and large, coating yellow and greasy, eyes dull with discharge, insomnia, no appetite. Speech incoherent, suspected epilepsy. Mr. Shen said: "Phlegm-fire disturbing mind, accumulation uncleaned. Must use Rhubarb and Mirabilite. Family feared deficiency collapse. Mr. Shen insisted. One dose passed hardened stool. Speech orderly next day. Modified formula passed dry stool mixed with loose stool. Coating dry, yellow, thick. Aromatic damp-resolving ineffective. Mr. Shen said: "Qi and Yin deficiency cannot transform." Used Ginseng Radix Tendril, American Ginseng, Antelope Horn, Pearl Powder. Coating resolved after several doses. Diet resumed, major turning point. Concubine died, Mr. Shen worried about relapse. Persuaded family, stabilized condition. Continued Qi-nourishing and Blood-supplementing formulas until recovery.
Mr. Wang Xiaofeng of Xigu Bureau, over sixty, vegetarian since youth, never ate meat. Chronic headache, Sangye (Mulberry Leaf) and Gouteng (Uncaria Ramulus) ineffective. Mr. Shen said: "Vegetarianism dried five zang fluids, Liver and Kidney Yin deficient. Must use Donkey-hide Gelatin and Turtle Shell Gelatin, products of flesh and blood." Mr. Wang refused, wanting to keep body pure. Headache worsened. Mr. Shen advised: "Medicine is not food, why be so rigid?" Mr. Wang took it, pain stopped in days.
Dr. Zhang Liangsheng's cousin suffered latent summerheat, alternating chills and fever for over a month, emaciated, tired, dull eyes, no appetite, fine pulse, white rot on tongue. Staying with mother-in-law, she wanted to send him home due to critical state. Mr. Shen stopped her: "Impossible, risk of change en route." Consulted with Yan Kangfu. Used Chai Bai Jian (Scutellaria and White Peony Decoction) one dose reduced fever, second cleared heat, then tonics restored Yin. Spirit far better than before.
Lawyer Zou's son had rebellious Qi, phlegm-rattle,急促 wheezing, unable to lie flat. Mr. Shen diagnosed: "Houfeng (Throat Wind)." Used Monkey Date (Hou Zao) 1 fen, Fritillaria Bulb, Processed Star Fruit, ground and mixed. Wheezing settled, slept soundly, unresponsive. Family thought coma, but he recovered. Another woman in Xiatang had similar symptoms, fell into drunken sleep after medicine, also recovered. Ancient texts lack Hou Zao; Master Ma Peizhi first used it effectively. Now everyone uses it. But only for wind-phlegm and heat-phlegm; using it for cold-damp phlegm invites criticism. I believe it is not the drug's fault, but the doctor's misuse.
Mrs. Zheng Yuanli, iron bridge shop owner, had mania, talking to self, standing/sitting呆滞, eating only when offered, for over a year. Western and Chinese medicine failed. Mr. Shen met Mr. Zheng, prescribed Antelope Horn 5 fen, Fritillaria Bulb 3 qian, Pearl Powder 5 fen, plus Horse Gallstone 5 fen, ground and divided into three doses. Slightly improved, continued, recovered quickly. Conceived a month later, gave birth to a son. Family gifted a silver shield inscribed "Drank Water from Upper Pool" (reference to Bian Que). Farmer's son in Gaochedu had gout, sudden limb convulsions, unconsciousness. Treated for years unsuccessfully. Mr. Shen used same method with Horse Gallstone. Recurred slightly, hands twitching. Added Bear Bile 1 fen. Later found cured. Note: Li Shizhen's Compendium mentions horse kidney ink, similar to Cow Bezoar and Dog Gallstone, functions unknown. Likely Horse Gallstone. Mr. Shen keeps ~4 liang, gray-white, layered texture. Horse is fire animal, nature dry, suitable for phlegm diseases. Yu Jianquan answered Qiu Jun: Madness is nerve disease. Heart belongs to spirit and fire. Horse is fire animal, fast, sleepless, knows path, possesses strong spirit and focus. Animal body producing static object thus calms heart and spirit.
Ms. Chen Zanting suffered severe Three-Yin Malaria for over three years, drugs ineffective. Eyes deep red during episodes, pulse stringy, tongue crimson. Mr. Shen said: "Not cold. Long-term malaria damages Liver Yin, transforming into fire. Warm drugs forbidden." Used Antelope Horn 1 qian, Abalone Shell, etc. Cured in one dose.
Woman returning from Shanghai suffered Three-Yin Malaria for four years, various antimalarials and Cinchona pills ineffective, every other day chills/fever. Mr. Shen used Yeguang Wan (Night-Luminous Pill) from *Yi Hua*, modified with Turtle Shell, Night-Shining Sand, Vinegar-processed Areca Seed, Oldenlandia, Pinellia, Tsaoko Cardamom. Plus Realgar 2 fen, Cinnabar 2 fen, ground. Cured in one dose. Mr. Shen saw Xu Rongting's son with triple malaria. Someone recommended single herb: buy Realgar for 30 coins. Shopkeeper misheard Sulfur. Patient took Sulfur. Malaria cured, but skin turned black, hair burnt, like Black race, lifelong. Locals laughed.
Ms. Zhang Jinjunpei of Luoshe Zhangxiang had irregular menstruation, frequent leukorrhea, tasteless food, vaginal prolapse like purple eggplant, protrudes when coughing, retracts when lying down. Drugs ineffective for a year. Mr. Shen examined previous prescriptions blaming bladder prolapse. Asked color/pain. Patient: Purple-dark, slight pain. Mr. Shen said: "Not bladder. Bladder is white, urinary difficulty. This is Qi deficiency failing to secure, uterine prolapse. Hard to see quick effect." Used Astragalus, Cimicifuga, Atractylodes, Ginseng Tendril, Kudzu Root, Euryale Seed, Oyster Shell, Tangerine Peel, Sweet Almond, White Peony, Medicated Leaven. Three doses, prolapse retracted.
Boy surnamed Wang at Dashiqiao bathed hot, barefoot exposed to cold. Half-day later, gums swollen/rotten, right shin blue-purple, chills/fever. Mr. Shen diagnosed: "Qingtui Yagan (Blue Leg Gum Rot). Upper disease treats lower." Silver needle pricked blue area, released bad blood. Internal blood-invigorating/stasis-resolving cured gum rot.
Mr. Wen under Ximen Bridge had high fever, oily face, surging pulse, crimson tongue, right arm red/swollen/painful. Surgeon Zhang said: "Liuzhu (Flowing Abscess)." Used warm Gui Zhi (Cinnamon Twig) and Dang Gui (Angelica Sinensis). Introduced to Mr. Shen by Gao Jun of Daoshengtang. Already applied Hedysarum. Mr. Shen said: "Heat-toxin, named Huoyan Ju (Fire Flare Carbuncle). Use detoxifying agents." Consciousness clear initially, then chest swelling appeared. Surgeon Zhang still called Liuzhu. Mr. Shen disagreed. Predicted toxin entering interior, leading to coma/death. Indeed, died suddenly in afternoon.