孙渭川令侄，亦患哮，气逆欲死。孟英视之∶口渴头汗，二便不行。径予∶生石膏 橘（皮） 贝（母）
桂（枝） （茯）苓 知母 花粉 杏（仁） （紫）菀 海蜇等药，服之而愈。
耳姓妇，回族，患哮。自以为寒，频饮烧酒，不但病加，更兼呕吐泄泻。两脚筋掣，既不能卧，又不能坐。孟
英诊曰∶口苦而渴乎？泄（泻）出如火乎？小溲不行乎？痰粘且韧乎？病者曰∶诚如君言，想为寒邪太重使然。
孟英曰∶汝何愚耶？见证如是，犹谓受寒，设遇他医，必然承教，况当此小寒之候，而哮喘与霍乱，世俗无不
硬指为寒者。误投姜、附，汝命休矣。予∶北沙参 生苡仁 冬瓜子 丝瓜络 竹茹 石斛 枇（杷）叶 贝
母知母 栀子 芦根 青果 海蜇 莱（菔）汁为方，一剂知，二剂已。
鲍继仲，患哮，每发于冬，医作虚寒治，更剧。孟英诊之∶脉滑，苔浓，溺赤，痰浓。予∶知母 花粉 冬
瓜子 杏（仁） 贝（母） 茯苓 滑石 栀子 石斛，服之而安。
萧某，素患痰多，常服六君子汤，偶延孟英诊之，脉细数而兼弦滑。曰∶六君子汤亟当屏绝。病由阴亏火
盛，津液受灼而成痰，须服壮水之剂，庶可杜患将来。萧因向吸鸦片烟，自疑虚寒，滋阴不敢频服。继患喉
痛，专科治而不效。仍乞诊于孟英，因谓曰∶早从吾策，奚至是耶？此阴虚于下，阳浮于上，喉科药不可试也。
大剂育阴潜阳，其痛日瘥，而喉 皆形白腐。孟英曰∶吸烟既久，毒瓦斯熏蒸之故耳。令吹锡类散，始得渐退。
愈后，复患滞下。孟英曰∶今秋痢虽盛行，而此独异于人，切勿以痢疾套药治之。盖火迫津液，结为痰饮，
酿以烟毒，熏成喉患，吾以“燃犀”之照，而投激浊扬清之治，病虽愈矣，内蕴之痰浊
尚多，奈向来为温补药所禁锢于肠胃曲折之间而不得出，今广投壮水之剂，不啻掘江河而涤陈
。岂可与时疫暑热之痢，同年而语耶？治不易法，食不减餐，日数十行，精神反加（佳），逾
月之后，大解始正。计服甘凉约（药）二百剂，肌肉复充，痰患若失。
定州杨素园明府宰宜黄，吏治有声，精于医学，其夫人多病，自治不痊，毗陵吴子和嘱其函恳酝香，屈孟英
诊视，而孟英因母老急欲旋里，坚辞不往。即据来信所述病状，拟方立案云∶
细阅病原，证延二十余年，始因啖杏，生冷伤乎胃阳，肝木乘虚，遂患胁痛挛掣，身躯素浓，湿盛为痰，
温药相投，是其效也。驯致积温成热，反助风阳，消烁胃津，渐形瘦削。而痰饮者，本水谷之悍气，缘肝升太
过，胃降无权，另辟窠囊，据为山险。初则气滞以停饮，继则饮蟠而气阻，气既阻痹，血亦愆其行度，积
以为瘀。前此神术丸、
控涎丹之涤饮；丹参饮、桃核承气汤之逐血。皆为杰构，已无遁情。迨延久元虚，即其气滞而实者，亦将转为散漫
而无把握矣。是以气升火浮，颧红面肿，气降火熄，黄瘦日增。苟情志不怡，病必陡发。以肝为刚脏，在志为怒，
血不濡养，性愈 张。胃土属阳，宜通宜降，通则不痛，（盖）六腑以通为用。更衣得畅，
体觉宽舒，是其征也。体已虚，病似实，虚则虚于胃之液，实则实于肝之阳。中虚原欲纳食，而肝逆蛔扰欲
呕，吐出之水，已见黑色，似属胃底之浊阴，风鼓波澜，翻空向上，势难再攻。承示脉至，两关中取似形鼓指，
重按杳然，讵为细故？际此春令，正鸢飞鱼跃之时，仰屋图维，参彻土绸缪之议，是否有当？仰就斤绳。
沙参（八钱） 鲜竹茹（四钱） 川椒红（二分） 乌梅肉炭（六分） 茯苓（三钱） 旋复（三钱） 金铃肉（二
钱） 柿蒂（十个） 仙半夏（一钱） 淡肉苁蓉（钱半） 吴茱萸（炒黄连，四分） 冬虫夏草（钱半）
另用炙龟板 藕（肉，各四两） 漂淡陈海蜇（二两） 凫茈（一两） 赭石（四钱），先煮清汤，代水煎药。（正
月十四日。）
一诊∶上拟方案，来差星夜 回，于十六日到宜（黄县），素园读案狂喜，以为洞
见脏腑，必欲孟英一诊，以冀霍然。遂夤夜备舆，专丁持函，求孟英暂缓归期。酝香（因）笃于情谊，（亦）
再四劝驾，并嘱四令郎偕行。孟英迫于情不可却，二十二日抵宜（黄县）署，初诊案云∶证窬二十年，右胁积气，
有升无降，饮阻
不宣，呕逆减餐，亦将半载，二便非攻不畅，容色改换不常，口苦吞酸，苔黄舌绛，渴喜冷冻饮料，畏食甘甜。以甘能
缓中，冷堪沃热，病机于此逗根，根深难即蠲除，标实本虚，求痊匪易。据述，脉亦屡迁，似无定象。夫既流善幻，
显属于痰。兹按脉∶左缓滑，右软迟，两尺有根，不甚弦涩，是汛愆因乎气阻，尚未至阴血之枯。春令肝木乘权，
胃土久受戕克，病已入络，法贵缓通，通则不痛，腑以通为补。
法难时变，不能舍“通”字以图功。布鼓雷门，诸希教正。
沙参（八钱） 鲜竹茹（四钱） 青黛（五分） 旋复（三钱） 酒炒黄连（六分） 白前（一钱） 生白蒺（藜，
三钱） 紫菀（一钱） 海石（五钱） 川楝肉（三钱） 川贝（一两） 黑栀（三钱）
另以∶生蛤粉 生冬瓜子 芦根 芦菔各一两，丝瓜络（五钱） 漂（海）蛰（二两） 柿蒂（十个） 先煮水，
代汤煎药，葱须二分后下。
再诊∶左脉如昨，兼弦，右寸亦转缓滑，中脘气渐下降，二便欲解不行，盖升降愆常，枢机窒涩，由乎风阳浮动，
治节横斜，肺既不主整肃，则一身之气皆滞也。轻可去实，先廓上游。
前方去海石，加栝蒌三钱、枳实一钱。
三诊∶脉来较静，小溲渐行，虽未更衣，已能安谷，浊得下行，导以清通。
前方去贝（母）、楝（肉），加归尾钱半、桃仁十粒、送服导水丸十粒。
四诊∶腿凉便滞，气少下趋，颧面时红，火炎上僭，两胁较热，络聚痰瘀。叠授
清宣，更衣色黑，噫气渐罢，酸水不吐，纳谷颇增，脉稍和缓。法仍缓导，冀刈根株。
前方去枳实、归尾，减导水丸五粒。
五诊∶各恙皆减，眠食渐安，火犹易升，头痛面赤，颊（颈）酸结核，胁热未蠲，脉渐柔和，且参清养。
前方去白前、青黛、紫菀、黄连，加银花、贝母、黄菊（花）、丹参、陈细茶、橄榄。
六诊∶积痰下降，颈核渐平，舌紫口干，卯辰热僭，阴虚木旺，气道尚未整肃。养血靖风，自可使其向愈。
前方去陈细茶、葱须，加石斛。
留赠善后方∶（便色转正后，用此。）
沙参（八钱） 冬虫夏草（二钱） 女贞（三钱） 丹参（三钱） 鲜竹茹（四钱） 川斛（五钱） 盐水泡橘红
（八分） 黄菊（三钱） 旋复（三钱） 黑栀（仁，三钱） 川贝（四钱） 金铃肉（钱半） 另以∶炙鳖甲 漂（海）
蛰（各一两） 苇根（二两） 丝瓜络（五钱），煮汤代水煎药。
又∶诸恙尽瘳，用此滋养。
前方去橘红、菊花、金铃子、栀子、旋复，加石英、沙蒺藜、茯苓各三钱，苁蓉、当归各钱半。汤引去
苇根，加炙坎版一两，藕二两。
古云∶肥白之人多气虚。又云∶痰饮须以温药和之。
儒医顾听泉，体丰色白，平昔多痰，晨起必喘逆，饱食稍安，颇有气虚之象。季冬感冒，自服疏解未效，
迓孟英诊焉。左关弦，寸滑如珠，尺细而干，舌尖甚绛。乃真阴素亏，水不涵木，风阳内炽，搏液成痰，谋虑
操持，心阳太扰，肺金受烁，治节不伸。苔虽白而已干，热虽微而睛赤，忌投温燥，宜与轻清。用∶元参 石
斛栀子 竹茹 旋复 蛤壳 贝母 枇杷叶 竹叶 兰叶 莲心为剂，三啜而安。
自谓气虚，遽服党参、枸杞、当归等药，下咽之后，即觉火升气逆，渐至言语支离，溲频自汗，夤夜复迎孟
英延医，脉已虚促不调。即投∶牡蛎 龟板 鳖甲 女贞 旱莲 元参 甘草 小麦 竹叶 莲心以和心肝之阳，
而镇龙雷之奋，一剂而平。继又作劳复感，仍授轻清之法，两剂后，又因怫怒萦思，肝阳复僭，颧红目赤，左
耳时聋，夜不成眠，神情烦躁。越日陡然大汗，湿透衣衿。再速孟英图之，脉极弦数而细，仍为阴虚阳越，不
可误认阳虚，而妄施桂、附，先令熏以醋炭，扑以蛎粉，随灌以大剂“二
至”（丸）“二冬”“三甲” 元参 丹参 人参 黄连 童溲而瘳。继与多剂育阴清肝，始得痊愈。
附录∶
偶然事耳，如前年五月间，偶诊顾听泉明经之脉，即谓家篪伯茂才云∶顾君不可以
冬。盖死象已见也，后竟殁于立冬之时。
朱大镛令大父，患四肢冷颤，常服温补，延久不痊，孟英切其脉，弦而缓。曰∶非虚也，与通络方，
吞（服）指迷茯苓丸而瘥。
金叶仙大令病，其媳 股以进，因（固）无效也。悲哀欲绝，遂发热，胡某治以
伤寒药，而神迷自汗，惊惕畏冷，改换补药，乃气逆不进水谷矣。孟英视之，是七情有伤，痰因火迫，堵诸空
灵之所也，予∶沙参 元参 丹参 丹皮 茯苓 麦冬 连翘 竹茹 竹叶 莲心 小麦，加以川贝母一两投
之，数剂而瘥。
孙渭川的侄子，也患有哮喘，气息上逆，几乎要窒息。孟英诊察后看到：口渴、头部出汗，大小便不通畅。直接给予生石膏、陈皮、贝母、桂枝、茯苓、知母、天花粉、杏仁、紫菀、海蜇等药物，服用后痊愈。
姓耳的妇女，回族，患有哮喘。她自认为是寒证，频繁饮用烧酒，不仅病情加重，还兼有呕吐和腹泻。两腿筋脉拘挛抽搐，既不能躺卧，也不能坐立。孟英诊断时问道：“口苦且渴吗？泻下物像火一样热吗？小便不通畅吗？痰液粘稠且坚韧吗？”病人回答说：“确实像您说的那样，我想是因为寒邪太重导致的。”孟英说：“你多么愚蠢啊！症状如此明显，还说是受寒，如果遇到其他医生，必然听从他们的建议，何况正值小寒时节，世俗之人无不硬把哮喘和霍乱指认为寒证。如果误投姜、附子等温热药，你的性命就完了。”给予北沙参、生薏苡仁、冬瓜子、丝瓜络、竹茹、石斛、枇杷叶、贝母、知母、栀子、芦根、青果、海蜇、莱菔汁为方剂，一服药见效，两服药痊愈。
鲍继仲，患有哮喘，每次都在冬季发作，医生当作虚寒证治疗，病情反而加剧。孟英诊察他：脉象滑，舌苔厚腻，小便赤红，痰液浓稠。给予知母、天花粉、冬瓜子、杏仁、贝母、茯苓、滑石、栀子、石斛，服用后病情安定。
萧某，平时患痰多症，常服用六君子汤，偶然请孟英诊察，脉象细数且兼有弦滑。孟英说：“六君子汤应当立即停用。病因为阴液亏损、火势旺盛，津液被灼烧而成痰，必须服用滋阴壮水之剂，才可以杜绝未来的祸患。”萧某因为向来吸食鸦片烟，自己怀疑是虚寒证，不敢频繁服用滋阴药。后来患上喉痛，专科医生治疗无效。仍请求孟英诊治，孟英于是对他说：“早听我的策略，怎么会到这种地步呢？这是下焦阴虚，阳气浮越于上，喉科药物不可尝试。大剂量使用育阴潜阳之法，疼痛日渐减轻，但咽喉都呈现白色腐烂状。孟英说：‘吸烟日久，毒气熏蒸的缘故。’令其吹锡类散，才得以逐渐消退。痊愈后，又患痢疾。孟英说：‘今年秋季痢疾虽然盛行，但这人的病症唯独与众不同，千万不要用治疗痢疾的常规药物来治。这是因为火热逼迫津液，凝结成痰饮，酿成烟毒，熏蒸导致喉部病患。我以“燃犀”般的明察，施以激浊扬清的治疗，病虽然好了，但体内蕴藏的痰浊还很多，无奈向来被温补药禁锢在肠胃曲折之间而无法排出，现在广泛投用壮水（滋阴）之剂，不啻于挖掘江河冲刷陈积污垢。这岂能与时疫暑热引起的痢疾相提并论呢？治疗方法不易改变，饮食不减，每天排便数十次，精神反而更好，一个月之后，大便才恢复正常。共计服用甘凉药约二百剂，肌肉重新丰满，痰患仿佛消失。
定州杨素园明府（县令）治理宜黄县，吏治有声望，精通医学，他的夫人多病，自行治疗未痊愈，毗陵吴子和嘱咐他写信恳求酝香，邀请孟英诊治，而孟英因为母亲年老急欲返回家乡，坚决推辞不去。随即根据来信所述的病情，拟定方剂并记录案卷说：
仔细查阅病因，病症延续二十多年，起初因为吃杏子，生冷损伤了胃阳，肝木乘虚侵袭，于是患胁痛拘挛抽搐，身体原本肥胖，湿气盛而生痰，使用温药相配合，是其有效的方面。逐渐导致积温成热，反而助长风阳，消烁胃中津液，渐渐形体消瘦。而痰饮，本是水谷的精悍之气，因为肝气升发太过，胃气下降无力，另辟巢穴，占据险地。起初是气滞导致停饮，接着是饮邪盘踞导致气机受阻，气既阻滞痹塞，血液也违背其运行规律，积聚成为瘀血。此前神术丸、控涎丹涤除饮邪；丹参饮、桃核承气汤逐除瘀血。都是杰出的构思，已经无处遁形。等到拖延日久元气虚弱，即使是那些气滞而实的证候，也将转为散漫而无把握。因此气升火浮，颧骨发红面部浮肿，气降火熄，面色黄瘦日益增加。倘若情志不愉快，病必定突然发作。因为肝为刚脏，在志为怒，血液不能濡养肝脏，性情更加亢张。胃土属阳，宜通利宜下降，通则不痛，（盖）六腑以通为用。大便通畅，身体感觉宽舒，这是征象。体质已虚，病似实证，虚在于胃之津液，实则在于肝之阳气。中焦虚弱原本想纳食，但肝气上逆蛔虫扰动想要呕吐，吐出的水，已经见黑色，似乎属于胃底的浊阴，风鼓动波澜，翻空向上，势难再攻。承示脉象，两手关部取脉似有鼓指感，重按却杳无音信，难道是小问题吗？值此春季，正是鸢飞鱼跃之时，仰望屋顶思考，参考土气绸缪（调理脾胃）的建议，是否恰当？敬请斧正。
北沙参（八钱）、鲜竹茹（四钱）、川椒红（二分）、乌梅肉炭（六分）、茯苓（三钱）、旋覆花（三钱）、金铃子肉（二钱）、柿蒂（十个）、仙半夏（一钱）、淡肉苁蓉（钱半）、吴茱萸（炒黄连，四分）、冬虫夏草（钱半）。
另用炙龟板、藕肉（各四两）、漂淡陈海蜇（二两）、凫茈（一两）、赭石（四钱），先煮清汤，代替水煎药。（正月十四日。）
初诊：上述方案，差役星夜赶回，于十六日到宜黄县，素园读案狂喜，以为洞见脏腑，一定要孟英亲自诊治，希望彻底痊愈。于是连夜准备车舆，派专人持信，请求孟英暂缓归期。酝香因为笃于情谊，也再三劝驾，并嘱咐四个儿子同行。孟英迫于情面不可推却，二十二日抵达宜黄县衙署，初诊案卷说：病症逾二十年，右胁积气，只有上升没有下降，饮邪阻滞不能宣通，呕吐逆气减少进食，也将近半年，大小便非攻下则不畅，容貌神色改变无常，口苦吞酸，舌苔黄舌质绛红，口渴喜欢冷冻饮料，畏惧食用甘甜食物。因为甘味能缓中，冷能沃热，病机在此扎根，根深难即消除，标实本虚，求痊愈不容易。据述，脉象也多次变迁，似乎没有固定形象。既然流善幻变，显属于痰。现在按脉：左脉缓滑，右脉软迟，两尺脉有根，不甚弦涩，这是月经推迟因为气机阻滞，尚未到阴血枯竭的地步。春季肝木当权，胃土久受克制，病已入络，法贵缓通，通则不痛，腑以通为补。
法难随时变化，不能舍弃“通”字来图谋功效。布鼓雷门（比喻拙劣的技艺在行家面前卖弄），诸希教正。
北沙参（八钱）、鲜竹茹（四钱）、青黛（五分）、旋覆花（三钱）、酒炒黄连（六分）、白前（一钱）、生白蒺藜（三钱）、紫菀（一钱）、海浮石（五钱）、川楝子肉（三钱）、川贝母（一两）、黑栀子（三钱）。
另用：生蛤粉、生冬瓜子、芦根、芦菔各一两，丝瓜络（五钱）、漂海蜇（二两）、柿蒂（十个），先煮水，代替汤药煎药，葱须二分后下。
再诊：左脉如昨日，兼有弦象，右寸脉也转缓滑，中脘气渐下降，大小便想解却不行，大概升降失常，枢机窒涩，由于风阳浮动，治节横斜，肺既不主整肃，则一身之气皆滞也。轻可去实，先廓清上游。
前方去掉海浮石，加栝蒌三钱、枳实一钱。
三诊：脉来较静，小便渐行，虽未大便，已能安谷（进食），浊气得以下行，导以清通之法。
前方去掉贝母、楝肉，加当归尾钱半、桃仁十粒，送服导水丸十粒。
四诊：腿凉便滞，气少下趋，颧面时而发红，火炎上僭，两胁较热，络聚痰瘀。屡次授予清宣之法，大便色黑，嗳气渐止，酸水不吐，纳谷颇增，脉稍和缓。法仍缓导，希望铲除病根。
前方去掉枳实、归尾，减导水丸五粒。
五诊：各病皆减，眠食渐安，火犹易升，头痛面赤，颈项酸痛结核，胁热未除，脉渐柔和，且参清养之法。
前方去掉白前、青黛、紫菀、黄连，加银花、贝母、黄菊花、丹参、陈细茶、橄榄。
六诊：积痰下降，颈核渐平，舌紫口干，卯辰时热势上僭，阴虚木旺，气道尚未整肃。养血靖风，自然可使其向愈。
前方去掉陈细茶、葱须，加石斛。
留赠善后方：（大便颜色转正后，用此方。）
北沙参（八钱）、冬虫夏草（二钱）、女贞子（三钱）、丹参（三钱）、鲜竹茹（四钱）、川石斛（五钱）、盐水泡橘红（八分）、黄菊花（三钱）、旋覆花（三钱）、黑栀子仁（三钱）、川贝母（四钱）、金铃子肉（钱半）。另用：炙鳖甲、漂海蜇（各一两）、苇根（二两）、丝瓜络（五钱），煮汤代水煎药。
又：诸病尽愈，用此滋养。
前方去掉橘红、菊花、金铃子、栀子、旋覆花，加石英、沙蒺藜、茯苓各三钱，肉苁蓉、当归各钱半。汤引去掉苇根，加炙坎版（龟板）一两，藕二两。
儒医顾听泉，体型丰腴肤色白，平时多痰，晨起必喘逆，饱食稍安，颇有气虚之象。季冬感冒，自行服用疏解药未效，迎接孟英诊治。左关脉弦，寸脉滑如珠，尺脉细而干，舌尖甚红。乃真阴素亏，水不涵木，风阳内炽，搏液成痰，谋虑操持，心阳太扰，肺金受烁，治节不伸。舌苔虽白而已干，热虽微而眼睛红，忌投温燥，宜与轻清之剂。用玄参、石斛、栀子、竹茹、旋覆花、蛤壳、贝母、枇杷叶、竹叶、兰叶、莲心为剂，喝三次而安。
自认为气虚，遽然服用党参、枸杞、当归等药，下咽之后，即觉火升气逆，渐至言语支离，尿频自汗，深夜再次迎孟英延医，脉已虚促不调。即投牡蛎、龟板、鳖甲、女贞子、旱莲草、玄参、甘草、小麦、竹叶、莲心以和心肝之阳，而镇龙雷之奋，一剂而平。继又作劳复感，仍授轻清之法，两剂后，又因怫怒萦思，肝阳复僭，颧红目赤，左耳时聋，夜不成眠，神情烦躁。越日陡然大汗，湿透衣襟。再速孟英图之，脉极弦数而细，仍为阴虚阳越，不可误认阳虚，而妄施桂枝、附子，先令熏以醋炭，扑以蛎粉，随灌以大剂“二至丸”、“二冬”、“三甲”、玄参、丹参、人参、黄连、童便而瘳。继与多剂育阴清肝，始得痊愈。
附录：
偶然事耳，如前年五月间，偶诊顾听泉明经之脉，即谓家篪伯茂才云：“顾君不可以过冬。”盖死象已见也，后竟殁于立冬之时。
朱大镛的祖父，患四肢冷颤，常服温补药，拖延久了未痊愈，孟英切其脉，弦而缓。说：“不是虚证，给予通络方，吞服指迷茯苓丸而痊愈。”
金叶仙大令的病，其儿媳大腿进补，因此无效。悲哀欲绝，遂发热，胡某治以伤寒药，而神迷自汗，惊惕畏冷，改换补药，乃气逆不进饮食。孟英视之，是七情有伤，痰因火迫，堵诸空灵之所也，给予沙参、玄参、丹参、丹皮、茯苓、麦冬、连翘、竹茹、竹叶、莲心、小麦，加以川贝母一两投之，数剂而痊愈。
Sun Weichuan's nephew also suffered from asthma (Xiao Zheng, wheezing and dyspnea), with rebellious Qi nearly causing suffocation. Meng Ying examined him and observed: thirst, sweating on the head, and obstruction of both urination and defecation. He directly prescribed Sheng Shigao (Raw Gypsum Fibrosum), Ju Pi (Citri Reticulatae Pericarpium), Bei Mu (Fritillariae Bulbus), Gui Zhi (Cinnamomi Ramulus), Fu Ling (Poria), Zhi Mu (Anemarrhenae Rhizoma), Hua Fen (Trichosanthis Radix), Xing Ren (Armeniacae Semen Amarum), Zi Wan (Asteris Radix), Hai Zhe (Metapenaeus ensis) and other herbs. The patient recovered after taking them.
Mrs. Ear, a Hui Muslim woman, suffered from asthma. She believed it was due to cold and frequently drank distilled liquor. Not only did her condition worsen, but she also developed vomiting and diarrhea. Her leg tendons cramped and twitched; she could neither lie down nor sit. Meng Ying diagnosed and asked: "Is your mouth bitter and thirsty? Is the discharge from your bowels hot like fire? Is urination obstructed? Is the phlegm sticky and tough?" The patient replied: "It is exactly as you say; I think it must be caused by severe cold pathogen." Meng Ying said: "How foolish you are! With such evident symptoms, you still claim to have contracted cold. If you had seen another doctor, they would surely have agreed with you. Moreover, during this minor cold period, laypeople invariably attribute asthma and cholera-like symptoms to cold. Had you been mistakenly given Jiang (Zingiberis Rhizoma) and Fu Zi (Aconiti Lateralis Radix Praeparata), your life would have been forfeit." He prescribed Bei Sha Shen (Glehniae Radix), Sheng Yi Ren (Coicis Semen), Dong Gua Zi (Benincasae Semen), Si Gua Luo (Luffae Fructus Retinervus), Zhu Ru (Bambusae Caulis in Taedia), Shi Hu (Dendrobii Caulis), Pi Pa Ye (Eriobotryae Folium), Bei Mu (Fritillariae Bulbus), Zhi Mu (Anemarrhenae Rhizoma), Zhi Zi (Gardeniae Fructus), Lu Gen (Imperatae Rhizoma), Qing Guo (Canarii Fructus), Hai Zhe (Metapenaeus ensis), and Lai Fu Zhi (Raphani Semen) as a formula. One dose showed improvement, and two doses resulted in recovery.
Bao Jizhong suffered from asthma, which flared up every winter. Doctors treated it as deficiency-cold, making the condition worse. Meng Ying examined him: the pulse was slippery, the tongue coating thick and greasy, urine red, and phlegm thick. He prescribed Zhi Mu (Anemarrhenae Rhizoma), Hua Fen (Trichosanthis Radix), Dong Gua Zi (Benincasae Semen), Xing Ren (Armeniacae Semen Amarum), Bei Mu (Fritillariae Bulbus), Fu Ling (Poria), Hua Shi (Talcum), Zhi Zi (Gardeniae Fructus), and Shi Hu (Dendrobii Caulis). The patient stabilized after taking them.
Mr. Xiao usually suffered from excessive phlegm and often took Liu Jun Zi Tang (Six Gentlemen Decoction). He occasionally consulted Meng Ying, whose pulse was fine, rapid, and accompanied by wiry and slippery qualities. Meng Ying said: "Liu Jun Zi Tang must be abandoned immediately. The disease arises from Yin deficiency and flourishing fire, where body fluids are scorched into phlegm. You must take formulas that nourish water (Yin) to prevent future troubles." Mr. Xiao, accustomed to smoking opium, suspected himself of being deficient-cold and dared not frequently take Yin-nourishing medicines. Later, he developed a sore throat, which specialist treatment failed to cure. He again requested Meng Ying's consultation. Meng Ying said: "If you had followed my advice earlier, how would you have reached this state? This is Yin deficiency below with floating Yang above. Throat specialists' medications should not be tried. Use large doses of formulas to nourish Yin and submerge Yang. The pain will gradually subside, but the throat may appear white and putrid." Meng Ying explained: "This is due to long-term smoking, where toxic fumes have steamed and scorched the area." He instructed the application of Xi Lei San (Tin-Type Powder), allowing gradual recovery. After healing, he suffered from dysentery. Meng Ying said: "Although dysentery is prevalent this autumn, this case is unique. Do not treat it with standard dysentery remedies. Fire forces body fluids to congeal into phlegm and fluid retention, brewed with tobacco toxicity, steaming to cause throat afflictions. Using my 'burning rhinoceros horn' insight, I employed methods to stir up turbidity and raise clarity. Although the illness healed, much internal turbid phlegm remains. Previously confined by warming and tonifying herbs in the twists and turns of the intestines and stomach, now, by broadly administering water-nourishing (Yin-tonifying) agents, it is like digging rivers to wash away accumulated filth. How can this be compared to epidemic summer-heat dysentery? The treatment method remains unchanged; food intake does not decrease; bowel movements occur dozens of times daily, yet spirit improves. After more than a month, defecation normalized. Approximately 200 doses of sweet-cool herbs were taken, muscles became plump again, and the phlegm affliction seemed lost."
Yang Suyuan, Prefect of Dingzhou and Magistrate of Yihuang, was renowned for his administration and skilled in medicine. His wife was frequently ill and self-medication failed. Wu Zihe from Piling urged him to write to Yunxiang, requesting Meng Ying's visit. However, Meng Ying, eager to return home due to his elderly mother, firmly declined. Based on the letter describing the symptoms, he drafted a prescription and case record:
"Carefully reviewing the etiology, the syndrome has persisted for over twenty years. Initially, eating apricots and cold/raw foods damaged Stomach Yang. Liver Wood exploited the deficiency, leading to hypochondriac pain and tendon cramping. The constitution was originally robust, with dampness generating phlegm; thus, warming herbs were effective. Gradually, accumulated warmth turned into heat, further assisting Wind-Yang, consuming Stomach fluids, and causing emaciation. Phlegm-fluids, originally the vigorous qi of grain and water, arose because Liver ascent was excessive and Stomach descent powerless, creating new nests and occupying strategic positions. Initially, Qi stagnation stopped fluid flow; subsequently, fluid accumulation blocked Qi. Once Qi was obstructed, Blood also deviated from its course, accumulating into stasis. Previous prescriptions like Shen Shu Wan (Divine Skill Pill) and Kong Yan Dan (Control Fluids Pill) cleared fluids; Dan Shen Yin (Salvia Drink) and Tao He Cheng Qi Tang (Peach Pit Decoction to Order the Qi) expelled blood stasis. These were masterful constructions, leaving no room for concealment. As time passed and Yuan Qi depleted, even previously stagnant and excess conditions became diffuse and ungraspable. Thus, Qi rises and Fire floats, causing malar flush and facial swelling; when Qi descends and Fire extinguishes, yellow emaciation increases. If emotions are displeased, the disease will suddenly flare. The Liver is a rigid organ, associated with anger; without blood nourishment, its nature becomes hyperactive. Stomach Earth belongs to Yang, favoring free flow and descent; free flow means no pain, and the Six Fu organs function through free flow. Smooth bowel movements bring bodily comfort, which is a sign. The constitution is deficient, yet the disease appears excess; deficiency lies in Stomach fluids, while excess lies in Liver Yang. Middle Jiao deficiency desires food intake, but Liver rebellion and roundworm disturbance cause vomiting. The vomited fluid shows black color, resembling turbid Yin at the stomach bottom. Wind agitates waves, turning upward against gravity, making further attack difficult. You indicated the pulse: Guan position feels drum-like superficially, but vanishes upon deep pressure. Is this trivial? In spring, when kites fly and fish leap, I ponder deeply, referencing strategies to secure the Earth (Spleen/Stomach). Is this appropriate? I await your correction.
Bei Sha Shen (8 qian), Xian Zhu Ru (4 qian), Chuan Jiao Hong (2 fen), Wu Mei Rou Tan (6 fen), Fu Ling (3 qian), Xuan Fu (3 qian), Jin Ling Rou (2 qian), Shi Di (10 pieces), Xian Ban Xia (1 qian), Dan Rou Cong Rong (1.5 qian), Wu Zhu Yu (with fried Huang Lian, 4 fen), Dong Chong Xia Cao (1.5 qian).
Separately, use Zhi Gui Ban (Prepared Tortoise Shell), Ou Rou (Lotus Root Flesh, 4 liang each), Piao Dan Chen Hai Zhe (Drifted Aged Sea Squid, 2 liang), Fu Ci (Eleocharis tubers, 1 liang), Zhe Shi (Hematitum, 4 qian). Boil clear soup first, using it to decoct the herbs. (14th day of the first lunar month.)
First Visit: The above plan was returned overnight by the messenger, arriving in Yihuang County on the 16th. Suyuan read the case with wild joy, believing it penetrated the viscera. He insisted Meng Ying visit personally to hope for complete recovery. Overnight, carriages were prepared, and an envoy held a letter requesting Meng Ying delay his return. Yunxiang, valuing friendship, repeatedly urged him, instructing his four sons to accompany him. Compelled by social obligation, Meng Ying arrived at Yihuang County Office on the 22nd. First visit case record: The syndrome exceeds twenty years. Right hypochondriac Qi accumulation ascends but does not descend; fluid obstruction prevents dissemination. Vomiting and rebellion reduce food intake for nearly half a year. Bowel and bladder movements require purgatives to flow. Complexion changes constantly. Mouth is bitter with acid regurgitation. Tongue coating is yellow, substance crimson. Thirst favors cold drinks. Fears sweet foods. Sweetness moderates the middle; cold irrigates heat. The disease mechanism takes root here. Deep roots are hard to eradicate quickly. Marked excess with root deficiency makes cure difficult. Pulse descriptions vary, lacking fixed characteristics. Since manifestations are illusory, it clearly belongs to Phlegm. Current pulse: Left is slow and slippery; Right is soft and slow. Both Chi pulses have root, not wiry or choppy. Menstrual delay is due to Qi obstruction, not yet Yin-blood exhaustion. Spring allows Liver Wood dominance; Stomach Earth has been damaged for long. Disease enters collaterals. Method values slow free flow; free flow brings no pain; Fu organs benefit from free flow.
Methods cannot change with time; one cannot abandon the character 'Free Flow' to achieve results. Displaying dull drums at the Thunder Gate (showing off poor skills before experts), I seek your correction.
Bei Sha Shen (8 qian), Xian Zhu Ru (4 qian), Qing Dai (Indigo Naturalis, 5 fen), Xuan Fu (3 qian), Jiu Chao Huang Lian (Wine-fried Coptidis Rhizoma, 6 fen), Bai Qian (Cynanchi Stauntonii Caulis et Folium, 1 qian), Sheng Bai Ji Li (Tribuli Fructus, 3 qian), Zi Wan (1 qian), Hai Shi (Floating Stone, 5 qian), Chuan Lian Rou (Toosendan Fruit Flesh, 3 qian), Chuan Bei Mu (Fritillariae Cirrhosae Bulbus, 1 liang), Hei Zhi (Black Gardeniae Fructus, 3 qian).
Separately: Sheng Ha Fen (Margarita Pulvis mixed with Trichosanthis Semen), Sheng Dong Gua Zi (1 liang each), Lu Gen (1 liang), Lu Fu (Radish Juice, 1 liang), Si Gua Luo (5 qian), Piao Hai Zhe (Sea Squid, 2 liang), Shi Di (10 pieces). Boil water first, use as decoction medium. Add Cong Xu (Green Onion Roots, 2 fen) later.
Second Visit: Left pulse same as yesterday, slightly wiry. Right Cun pulse also turned slow and slippery. Qi in Zhong Wan (Middle Epigastrium) gradually descends. Urination and defecation desire exists but fails to execute. Ascension and descent are abnormal; pivot mechanism is obstructed due to floating Wind-Yang. Governance is skewed. Lung fails to maintain order, so whole-body Qi stagnates. Light substances remove excess; first clear the upper source.
Remove Hai Shi from previous formula, add Gua Lou (Trichosanthis Fructus, 3 qian), Zhi Shi (Aurantii Fructus Immaturus, 1 qian).
Third Visit: Pulse calmer. Urination gradually flows. Though defecation hasn't occurred, appetite stabilizes. Turbid matter descends; guide with clearing and flowing methods.
Remove Bei Mu and Lian Rou from previous formula. Add Gui Wei (Angelicae Sinensis Radix Tail, 1.5 qian), Tao Ren (Persicae Semen, 10 grains). Take with Dao Shui Wan (Water-Guiding Pills, 10 grains).
Fourth Visit: Legs cool, stool sluggish. Qi tends downward. Malar flush occurs intermittently. Fire flares upward. Hypochondria feel hot. Collaterals accumulate phlegm and stasis. Repeated clear-and-disperse methods led to black stools. Belching ceased. Acid regurgitation stopped. Appetite increased significantly. Pulse slightly harmonized and slow. Method remains slow guidance, hoping to eradicate the root.
Remove Zhi Shi and Gui Wei from previous formula. Reduce Dao Shui Wan by 5 grains.
Fifth Visit: All ailments reduced. Sleep and diet improving. Fire still easily ascends. Headache and facial redness. Neck soreness and lymph node swelling. Hypochondriac heat not eliminated. Pulse becoming gentle. Incorporate clearing and nourishing methods.
Remove Bai Qian, Qing Dai, Zi Wan, Huang Lian from previous formula. Add Yin Hua (Jasminis Flos), Bei Mu (Fritillariae Bulbus), Huang Ju Hua (Chrysanthemi Indici Flos), Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma), Chen Xi Cha (Old Fine Tea), Gan Lan (Canarium Album Resina).
Sixth Visit: Accumulated phlegm descends. Cervical nodes flattening. Tongue purple, mouth dry. Heat flares during Mao-Chen hours (5-9 AM). Yin deficiency with Wood hyperactivity. Airway not yet orderly. Nourish Blood and calm Wind; natural recovery follows.
Remove Chen Xi Cha and Cong Xu from previous formula. Add Shi Hu (Dendrobii Caulis).
Prescribed Follow-up Formula (Use after stool color normalizes):
Bei Sha Shen (8 qian), Dong Chong Xia Cao (2 qian), Nu Zhen (Ligustri Lucidi Fructus, 3 qian), Dan Shen (3 qian), Xian Zhu Ru (4 qian), Chuan Hu (Dendrobii Caulis, 5 qian), Yan Shui Pao Ju Hong (Salt-water soaked Citri Reticulatae Pericarpium Rubrum, 8 fen), Huang Ju (Chrysanthemi Indici Flos, 3 qian), Xuan Fu (3 qian), Hei Zhi Ren (Black Gardeniae Fructus, 3 qian), Chuan Bei Mu (4 qian), Jin Ling Rou (Toosendan Fruit Flesh, 1.5 qian). Separately: Zhi Bie Jia (Prepared Turtle Shell), Piao Hai Zhe (Sea Squid, 1 liang each), Wei Gen (Phragmitis Rhizoma, 2 liang), Si Gua Luo (5 qian). Boil soup, use to decoct herbs.
Another: For full recovery, use this for nourishment.
Remove Ju Hong, Ju Hua, Jin Ling Zi, Zhi Zi, Xuan Fu from previous formula. Add Shi Ying (Quartzum), Sha Ji Li (Tribuli Fructus), Fu Ling (Poria, 3 qian each), Rou Cong Rong (Cistanche Stem), Dang Gui (Angelicae Sinensis Radix, 1.5 qian each). Decoction medium removes Wei Gen, adds Zhi Kan Ban (Prepared Tortoise Plastron, 1 liang), Ou (Lotus Root, 2 liang).
Ancient saying: Fat and pale people often have Qi deficiency. Another says: Phlegm-fluids must be harmonized with warm herbs.
Confucian physician Gu Tianquan, robust and fair-skinned, usually had excessive phlegm. Morning breathlessness improved after full meals, showing signs of Qi deficiency. In late winter, he caught a cold. Self-administered dispersing herbs failed. Meng Ying was invited. Left Guan pulse wiry; Cun pulse slippery like pearls; Chi pulse fine and dry. Tip of tongue very crimson. True Yin was chronically deficient; Water failed to nourish Wood. Internal Wind-Yang blazed, condensing fluids into phlegm. Mental exertion disturbed Heart Yang excessively. Lung Metal was scorched; governance mechanisms stalled. Tongue coating white but dry; heat slight but eyes red. Avoid warm-drying herbs; prefer light-clearing ones. Prescribed Xuan Shen (Scrophulariae Radix), Shi Hu (Dendrobii Caulis), Zhi Zi (Gardeniae Fructus), Zhu Ru (Bambusae Caulis in Taedia), Xuan Fu (Inulae Flos), Ge Qiao (Trischi Testudinis Carapax et Plastrum), Bei Mu (Fritillariae Bulbus), Pi Pa Ye (Eriobotryae Folium), Zhu Ye (Bambusae Folium), Lan Ye (Orchid Leaf), Lian Xin (Nelumbinis Plumula). Three doses brought peace.
Believing himself Qi deficient, he hastily took Dang Shen (Codonopsis Radix), Gou Qi (Lycii Fructus), Dang Gui (Angelicae Sinensis Radix). After swallowing, he felt fire rising and Qi rebelling. Speech became disjointed. Frequent urination and spontaneous sweating. Late night, Meng Ying was summoned again. Pulse was deficient, hurried, and irregular. Immediately administered Mu Li (Ostreae Concha), Gui Ban (Testudinis Carapax et Plastrum), Bie Jia (Trionychis Carapax), Nu Zhen (Ligustri Lucidi Fructus), Han Lian (Ecliptae Herba), Xuan Shen (Scrophulariae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), Xiao Mai (Tritici Fructus), Zhu Ye (Bambusae Folium), Lian Xin (Nelumbinis Plumula) to harmonize Heart and Liver Yang, suppressing Dragon and Thunder fire. One dose stabilized him. Subsequently, fatigue relapse with infection occurred. Light-clearing methods were used again. After two doses, anger and rumination caused Liver Yang to rebel again. Malar flush, red eyes, intermittent left ear deafness, insomnia, irritability. Next day, sudden profuse sweating soaked clothes. Meng Ying was rushed to consult. Pulse extremely wiry, rapid, and fine. Still Yin deficiency with Yang floating. Do not mistake for Yang deficiency and recklessly use Gui Zhi (Cinnamomi Ramulus) and Fu Zi (Aconiti Lateralis Radix Praeparata). First, fumigate with vinegar-soaked charcoal, dust with Oyster Shell powder. Then administer large doses of Er Zhi Wan (Two Solitudes Pill), Er Dong (Two Winter Herbs), San Jia (Three Shells), Xuan Shen (Scrophulariae Radix), Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma), Ren Shen (Ginseng Radix), Huang Lian (Coptidis Rhizoma), Tong Su (Child's Urine). Recovery ensued. Continued with multiple doses of Yin-nourishing and Liver-clearing herbs until fully cured.
Appendix:
Merely a coincidence. Last May, upon casually checking Gu Tianquan's pulse, I told Jia Chi Bo Maocai: 'Mr. Gu cannot survive the winter.' Signs of death were already visible. He indeed died at the Start of Winter.
Zhu Dayong's grandfather suffered from cold trembling limbs. Long-term warming and tonifying failed. Meng Ying palpated the pulse: wiry and slow. Said: "Not deficiency." Prescribed collateral-freezing formula. Swallowing Zhi Mi Fu Ling Wan (Guiding Confusion Poria Pill) led to recovery.
Jin Yexian's son-in-law's illness involved his daughter-in-law. Large-scale tonification for her thigh was ineffective. Overcome with grief, she developed fever. Dr. Hu treated it as Cold Damage (Shang Han), causing mental confusion, spontaneous sweating, fright, and aversion to cold. Switching to tonics caused Qi rebellion and refusal of food/water. Meng Ying viewed it as injury from Seven Emotions. Phlegm forced by fire blocked the hollow and spiritual spaces. Prescribed Sha Shen (Glehniae Radix), Xuan Shen (Scrophulariae Radix), Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma), Dan Pi (Moutan Cortex), Fu Ling (Poria), Mai Dong (Ophiopogonis Tuber), Lian Qiao (Forsythiae Fructus), Zhu Ru (Bambusae Caulis in Taedia), Zhu Ye (Bambusae Folium), Lian Xin (Nelumbinis Plumula), Xiao Mai (Tritici Fructus), plus 1 liang of Chuan Bei Mu (Fritillariae Cirrhosae Bulbus). Several doses led to recovery.