古廉韩子玉父。年逾六旬有三。病消渴。至冬添躁热。须裸袒。以冰水喷胸腋乃快。日食肉面
数回。顷时即饥。如此月余。命予治疗。诊得脉沉细而疾。予以死决之。子玉及弟泣跪予前曰。
病固危笃。君尽心救治。则死而无悔。予答曰。夫消之为病。其名不一。曰食亦。曰消中。曰宣疾
。此膏粱之所致也。阳明化燥火。津液不能停。自汗小便数。故饮一溲二。胃热则消谷善饥。能食
而瘦。王叔和云。多食亦饥虚是也。此病仲景所谓春夏剧。秋冬瘥。时制故也。令尊今当瘥之时反
剧。乃肾水干涸不能制其心火。而独旺于不胜之时。经曰。当所胜之时而不能制。名曰真强。乃孤
阳绝阴者也。且人之身为主。天令为客。此天令大寒。尚不能制其热。何药能及。内经曰。主胜逆
。客胜从。正以此也。设从君治疗。徒劳而已。固辞而归。遂易医与灸。不数日而卒。其后子玉感
予之诚。相好愈浓。
北京按察书吏李仲宽。年逾五旬。至元己巳春。患风证。半身不遂。四肢麻痹。言语謇涩。精
神昏愦。一友处一法。用大黄半斤。黑豆三升。水一斗。同煮豆熟。去大黄。新汲水淘净黑豆。每
日服二三合。则风热自去。服之过半。又一友云。通圣散、四物汤、黄连解毒汤。相合服之。其效
尤速。服月余。精神愈困。遂还真定。归家养病。亲旧献方无数。不能悉录。又增喑哑不能言。气冷
手足寒。命予诊视。细询前由。尽得其说。予诊之。六脉如蛛丝细。予谓之曰。夫病有表里虚实寒
热不等。药有君臣佐使大小奇偶之制。君所服药无考凭。故病愈甚。今为不救。君自取耳。未几而
死。有曹通甫外郎妻萧氏。六旬有余。孤寒无根据。春月忽患风疾。半身不遂。语言謇涩。精神昏愦
。口眼 斜。与李仲宽证同。予刺十二经井穴。接其经络不通。又灸肩井、曲池。详病时月。处药
服之。减半。予曰。不须服药。病将自愈。明年春。张子敬郎中家见行步如故。予叹曰。夫人病全
得不乱服药之力。由此论李仲宽乱服药。终身不救。萧氏贫困。恬 自如获安。内经曰。用药无据
。反为气贼。圣人戒之。一日。姚雪斋举许先生之言曰。富贵人有二事反不如贫贱人。有过恶不能
匡救。有病不能医疗。噫。其李氏之谓欤。
古廉人韩子玉的父亲，年龄超过六十三岁。患有消渴病（以多饮、多食、多尿、身体消瘦为特征的疾病），到了冬天增添了躁热感，必须裸露身体，用冰水喷洒胸部和腋下才感到舒适。每天吃几次肉和面食，一会儿就饿了。如此持续了一个多月，请我治疗。诊得脉象沉细而快速，我判定其为死证。子玉及其弟弟在我面前哭泣跪拜说：“病情固然危急，如果您尽心救治，即使死了也无悔恨。”我回答说：“消渴这类疾病，名称不一，有叫‘食亦’的，有叫‘消中’的，有叫‘宣疾’的。这些都是由于食用肥甘厚味所致。阳明经化生燥火，津液无法停留，导致自汗、小便频数，所以喝一份水排两份尿。胃中有热则消化食物快且容易饥饿，能吃但身体消瘦。王叔和说：‘多吃也容易感到饥饿虚弱’，说的就是这种情况。这种病正如张仲景所说，春夏季节加重，秋冬季节缓解，这是时令规律使然。令尊现在本该缓解的时候反而加重，这是因为肾水干涸不能制约心火，而在不胜之时独自旺盛。《内经》说：‘在应当被制约的时节却不能被制约，名叫真强’，这是孤阳绝阴的情况。而且人体为主，天令为客。此时天令是大寒，尚且不能制约体内的热邪，什么药物能比得上呢？《内经》说：‘主胜为逆，客胜为从’，正是这个意思。如果顺从您的请求进行治疗，只是徒劳而已。”坚决推辞后回家。于是更换医生并采用艾灸治疗，不到几天就去世了。后来子玉感激我的真诚，我们之间的关系更加亲密。
北京按察司书吏李仲宽，年龄超过五十岁。至元己巳年春天，患风证，半身不遂，四肢麻木，言语不清，精神昏乱。一位朋友提供一个方法，使用大黄半斤，黑豆三升，水一斗，一起煮到豆熟，去掉大黄，用新汲水洗净黑豆，每天服用二三合（容量单位），则风热自然去除。服用过半后，另一位朋友说：“通圣散、四物汤、黄连解毒汤”混合服用，效果尤其迅速。服用一个多月后，精神更加困倦，于是回到真定，在家养病。亲戚朋友献上方子无数，不能全部记录。又增加了失音不能说话、气冷手足寒冷的症状，请我诊视。仔细询问前因后果，完全了解了情况。我诊察他的脉象，六脉像蛛丝一样细微。我对他说：“疾病有表里虚实寒热等不同性质，药物有君臣佐使大小奇偶的不同制法。您所服用的药物没有依据和凭据，所以病情越来越重。现在已经是不可救治了，是您自己造成的。”不久就去世了。
有曹通甫外郎的妻子萧氏，六十多岁，孤苦贫寒无依无靠。春天忽然患风疾，半身不遂，语言不清，精神昏乱，口眼歪斜，与李仲宽的证候相同。我针刺十二经的井穴，以疏通经络不通畅的情况，又艾灸肩井穴、曲池穴，详细考察发病的时间月份，开具药物让她服用，病情减半。我说：“不需要再服药，病将自愈。”第二年春天，在张子敬郎中家见到她行走如常。我感叹道：“人的疾病全赖不乱服药的力量。由此看来，李仲宽乱服药，终身无法救治；萧氏虽然贫困，却恬淡自如获得安宁。《内经》说：‘用药没有依据，反而成为气的贼害’。圣人对此加以告诫。”有一天，姚雪斋引用许先生的话说：“富贵人有两件事反而不如贫贱人，有过错不能匡正挽救，有病不能医疗。”唉，这说的就是李氏这样的人吧。
Han Ziyu, a native of Gu Lian, had a father who was over sixty-three years old. He suffered from Xiao Ke (Xiao Ke disease, characterized by excessive thirst, hunger, urination, and emaciation). In winter, he developed restlessness and heat, requiring him to expose his body and spray ice water on his chest and axillae to find relief. He ate meat and wheat products several times a day and felt hungry shortly after eating. This condition persisted for over a month, prompting him to seek my treatment. His pulse was deep, fine, and rapid. I diagnosed it as a fatal case. Ziyu and his brother wept and knelt before me, saying, "Although the illness is critical, if you treat us with all your heart, we will have no regrets even if he dies." I replied, "The disease known as Xiao Ke has various names: Shi Yi (Shi Yi, excessive eating without weight gain), Xiao Zhong (Xiao Zhong, middle consumption), and Xuan Ji (Xuan Ji, spreading illness). These are caused by the consumption of rich and sweet foods. The Yangming channel transforms into dryness and fire, preventing fluids from being retained, leading to spontaneous sweating and frequent urination; thus, one drink results in two parts excreted. Stomach heat causes rapid digestion and easy hunger; the patient can eat but becomes emaciated. Wang Shuhe stated, 'Eating much yet still feeling hungry and weak,' which refers to this condition. As Zhang Zhongjing described, this disease worsens in spring and summer and improves in autumn and winter due to seasonal influences. Your father should be improving at this time but instead worsened. This is because Kidney Water is dried up and cannot control Heart Fire, which flares independently during a time when it is not dominant. The Classic says, 'When what should be controlled fails to be controlled, it is called True Strength,' indicating isolated Yang and exhausted Yin. Furthermore, the human body is the host, and seasonal climate is the guest. The current seasonal climate is severe cold, yet it cannot control the internal heat; how could any medicine do so? The Inner Canon states, 'Host dominance is adverse, guest dominance is compliant,' which applies here. If I were to treat him according to your request, it would be futile." I firmly declined and returned home. They changed physicians and used moxibustion. Within a few days, he passed away. Later, Ziyu appreciated my sincerity, and our friendship deepened.
Li Zhongkuan, a clerk in the Beijing Surveillance Commission, was over fifty years old. In the spring of the Jisi year of the Zhiyuan era, he contracted Wind Syndrome, resulting in hemiplegia, numbness in the four limbs, slurred speech, and mental confusion. A friend prescribed a method using half a jin of Da Huang (Rhubarb Rhizome) and three sheng of Hei Dou (Black Soybean Seed), boiled together in ten dou of water until the beans were cooked. The Da Huang was removed, and the Hei Dou was washed clean with fresh well water. He was to take two or three he (a small unit of volume) daily, claiming this would eliminate wind-heat. After taking more than half the course, another friend suggested combining Tong Sheng San (Tong Sheng Powder), Si Wu Tang (Four Substances Decoction), and Huang Lian Jie Du Tang (Coptis Decoction to Relieve Toxicity). They claimed this combination would be even faster. After taking these for over a month, his spirit became increasingly lethargic. He returned to Zhending to recuperate at home. Relatives and friends offered countless prescriptions, which I did not record. His condition worsened with aphonia (loss of voice), cold qi, and cold extremities. He sought my consultation. After inquiring about the history, I understood the full context. His six pulses were thread-like and fine. I told him, "Diseases vary in exterior/interior, deficiency/excess, cold/heat. Medicines vary in sovereign/minister/assistant/courier roles and odd/even formulations. The medicines you took lacked basis and evidence, hence the worsening condition. It is now incurable; you brought this upon yourself." Shortly thereafter, he died.
Mrs. Xiao, wife of Cao Tongfu, an external official, was over sixty years old, lonely, poor, and without support. In spring, she suddenly contracted Wind Disease, presenting with hemiplegia, slurred speech, mental confusion, and deviation of the mouth and eyes, identical to Li Zhongkuan's symptoms. I punctured the Jing-Well acupoints of the twelve channels to unblock the meridians and moxibusted Jian Jing (GB21) and Qu Chi (LI11). Considering the timing of the illness, I prescribed herbal medicine, which reduced her symptoms by half. I said, "No further medication is needed; the illness will heal itself." The following spring, I saw her walking normally at the residence of Physician Zhang Zijing. I sighed, "A person's recovery relies entirely on not taking medications indiscriminately. Thus, Li Zhongkuan's indiscriminate medication made him incurable throughout his life, while Mrs. Xiao, despite her poverty, remained tranquil and found peace. The Inner Canon states, 'Medication without basis becomes a thief of Qi.' Sages warn against this." One day, Yao Xuezhai quoted Mr. Xu: "Rich and noble people have two things inferior to the poor and lowly: they cannot correct their faults, nor can they receive medical treatment for illnesses." Alas, this describes Mr. Li.