经历晋才卿。膏粱而饮。至春病衄。医曰。诸见血者为热。以清凉饮子投之。即止。越数日。
其疾复作。医又曰。药不胜病故也。遂投黄连解毒汤。既而或止。止而复作。易医数回。皆用苦寒
之剂。俱欲胜其热而已。然终不愈。而饮食起居。浸不及初。肌寒而时躁。言语无声。口气臭秽。
恶如冷风。然其衄之余波。则未绝也。或曰。诸见血者热。衄、热也。热而寒之。理也。今不惟不
愈而反害之。何哉。内经曰。以平为期。又言下工不可不慎也。彼惟知见血为热。而以苦寒攻之。
抑不知苦泻土。土、脾胃也。脾胃、人之所以为本者。今火为、病而泻其土。火固未尝除而土已病
矣。土病则胃虚。胃虚则营气不能滋荣百脉。元气不循天度。气随阴化而无声肌寒也。意粗工嘻嘻
以为可治。热病未已。寒病复起。此之谓也。
华严寺和上座代史侯出家。年未四十。至元癸酉四月间。因澡浴大汗出。还寺剃头。伤风寒。
头疼。四肢困倦。就市中购通圣散服之。又发之汗。头疼少减。再日复作。又以通圣散发之。发汗
数回。反添劳动喘促。自汗恶风。咳而有血。懒于言语。饮食减少。求医治之。医与药。多以生姜
为引子。至六月间。精神愈困。饮食减
少。形体羸瘦。或咳或唾红血极多。扶而后起。请予治之。具说前由。诊其脉。浮数七八至。按之
无力。予曰。不救矣。或曰。何谓不救。内经曰。血之与汗。异名而同类。夺汗者无血。夺血者无
汗。金匮要略云。肺痿之病。从何而得之。师曰。或从汗出。又被快药下利。重亡津液。故得之。
今肺气已虚。又以辛药泻之。重虚其肺。不死何待。藏气法时论曰。肺欲收。急食酸以收之。用酸
补之。辛泻之。盖不知内经之旨。仲景云。祸术浅狭。懵然不知病源为治。乃误发汗吐下之相反。
其祸至速。世上之士。但务彼翕习之荣。而莫见此倾危之败。惟明者居然能识其本。近取诸身。夫
何远之有焉。其僧不数日。果亡。
患者晋才卿，平时饮食肥甘厚味。到了春季发生鼻衄（鼻出血）。医生认为：凡是出现出血症状的都是热证，于是给予清凉饮子服用，出血随即停止。过了几天，疾病复发。医生又说：“这是因为药力不能战胜病邪的缘故。”于是投予黄连解毒汤。之后有时止血，但止住后又再次发作。更换了几位医生，都使用苦寒性质的药物，都想通过清热来战胜病邪。然而最终没有痊愈，而且饮食起居逐渐不如从前，肌肉发冷且时常烦躁，说话声音低微无力，口气臭秽，厌恶像冷风一样的感觉。然而他鼻衄的余波仍未断绝。有人说：凡是见血都是热证，鼻衄是热证，用寒凉药物治疗热证，这是合理的道理。现在不仅没有痊愈反而造成伤害，为什么呢？《内经》说：治疗以恢复平衡为准则。又说：下等的医生不可不谨慎。那些医生只知道见血就是热，而用苦寒药攻伐，却不知道苦味能泻土（脾胃）。土对应脾胃，脾胃是人生命的根本。现在因为火（热）致病而泻其土，火热固然没有清除，但脾胃已经生病。脾胃生病则胃气虚弱，胃虚则营气不能滋养全身血脉，元气不能遵循正常的生理节律，气随阴液耗损而化生不足，导致声音低微、肌肉寒冷。大意是粗心的医生嘻嘻哈哈地认为可以治愈，结果热病未愈，寒病又起，说的就是这种情况。
华严寺的上座和尚代史侯出家时不到四十岁。在至元癸酉年四月间，因为洗澡大汗出后，回到寺庙剃头，感受风寒。出现头痛、四肢困倦的症状。他在集市上购买通圣散服用，又发汗治疗。头痛稍微减轻，第二天又发作。再用通圣散发汗。多次发汗后，反而增加了劳累后的气喘急促，自汗、恶风，咳嗽并带有血丝，懒得说话，饮食减少。求医治疗，医生给药时多以生姜作为引经药。到了六月，精神更加困顿，饮食减少，形体消瘦。有时咳嗽或唾出大量红血，需要扶起来才能起身。请我诊治，详细说明了前面的经过。诊察他的脉象，浮取数急，一息七八至，重按无力。我说：“救不了了。”有人问：“为什么说救不了？”《内经》说：血与汗，名称不同但同类。夺汗者无血，夺血者无汗。《金匮要略》说：肺痿这个病，是怎么得的呢？老师说：有的因为出汗过多。又被峻下药利大便，严重亡失津液，所以得此病。现在肺气已经虚弱，又用辛散药物泻之，使肺气更虚，不死还等什么？《藏气法时论》说：肺喜欢收敛，急食酸味以收敛它，用酸味补肺，用辛味泻肺。大概是不懂《内经》的宗旨。仲景说：医术浅陋狭隘，糊涂地不知道病源进行治疗，竟然误用发汗、催吐、泻下的相反治法，祸患来得极快。世上的士人，只追求那种迎合世俗的虚荣，而不看到这种倾覆危败的后果。只有明智的人能够识别根本，就近取之于自身，有什么遥远的呢？那位僧人没过几天，果然去世。
The patient Jin Caiqing, accustomed to a diet rich in fats and sweets, suffered from epistaxis (nosebleed) in spring. The physician stated, "All cases of bleeding are due to heat," and administered Qingliang Yinzi (Clearing Heat Decoction), which stopped the bleeding. After a few days, the condition recurred. The physician remarked, "The medicine was insufficient to overcome the disease," and prescribed Huanglian Jiedu Tang (Coptis Decoction for Detoxification). Although it sometimes stopped the bleeding, it would recur after stopping. Several physicians were consulted, all using bitter-cold agents, aiming solely to conquer the heat. However, the patient did not recover; his diet and daily activities gradually deteriorated compared to the beginning. His muscles felt cold, yet he experienced occasional restlessness. His voice became faint, his breath foul, and he disliked drafts as if they were cold winds. Nevertheless, the residual effects of his epistaxis had not completely ceased. Some argued, "Bleeding indicates heat; epistaxis is heat. Treating heat with cold is logical. Why does it fail and cause harm now?" The *Neijing* states, "Treatment aims at restoring balance." It also warns, "Inferior physicians must be cautious." These physicians only knew that bleeding implies heat and used bitter-cold drugs to attack it, unaware that bitter flavors drain Earth (Spleen and Stomach). Earth corresponds to the Spleen and Stomach, which are the foundation of human life. By draining Earth because of Fire (Heat) pathology, although the Fire might not have been eliminated, the Earth had already become diseased. When Earth is diseased, Stomach Qi becomes deficient. Deficiency of Stomach Qi prevents Ying Qi (Nutritive Qi) from nourishing the collaterals. Yuan Qi (Original Qi) fails to follow its natural course. Qi transforms with Yin depletion, leading to faint voice and cold muscles. Essentially, careless physicians, dismissingly thinking it curable, allowed the heat disease to persist while inducing a cold disease. This is what is meant.
The abbot of Huayan Temple, Monk Dai Shihou, who had taken vows before age forty, suffered from wind-cold invasion in April of the Guiyou year of Zhiyuan. After bathing and sweating profusely, he returned to the temple to shave his head. He developed headache and fatigue in the four limbs. He purchased Tongsheng San (Unobstructed Holy Powder) from the market and took it, followed by diaphoresis (sweating-inducing treatment). His headache decreased slightly but recurred the next day. He underwent diaphoresis again with Tongsheng San. After several rounds of sweating, he developed worsening exertional dyspnea, spontaneous sweating, aversion to wind, coughing with blood streaks, reluctance to speak, and reduced appetite. Seeking medical help, physicians prescribed medicines often using Shengjiang (Zingiberis Rhizoma Recens, Fresh Ginger) as a guiding drug. By June, his spirit became increasingly lethargic, food intake decreased, and his body emaciated. He occasionally coughed or expectorated large amounts of bright red blood, requiring support to rise. I examined him and detailed the history. His pulse was floating and rapid, counting seven to eight beats per respiration, and weak upon deep pressure. I said, "It cannot be saved." Someone asked, "Why do you say it cannot be saved?" The *Neijing* states, "Blood and sweat are different names but of the same category. Those who lose sweat lose blood; those who lose blood lose sweat." The *Jinkui Yaolue* asks, "How is Fei Wei (Flaccidity of the Lung) obtained?" The Master replies, "Sometimes from excessive sweating. If further purged with drastic laxatives, causing severe loss of body fluids, this disease results." Now, Lung Qi is already deficient, and using acrid-draining herbs further depletes the Lung. How could death not be expected? The *Zangqi Fashi Lun* states, "The Lung desires consolidation; urgently eat sour to consolidate it. Use sour to tonify the Lung, and acrid to drain it." They likely misunderstood the essence of the *Neijing*. Zhongjing said, "Shallow and narrow medical knowledge, ignorant of the disease source, leads to erroneous treatments such as opposite methods of diaphoresis, emesis, and purgation. The disaster comes swiftly." Scholars of the world pursue superficial fame but ignore impending ruin. Only the wise can recognize the root. Taking reference from one's own body, how far is the truth? The monk died indeed within a few days.