方悟为两位没有经验的医生所误，追悔不及。昨天友人告诉我，先生是一位救苦救难的医生，常在《新闻夜报》、《国医周刊》上给病者答复，都是把仁医仁术来为病者谋幸福，再造生趣。所以敝人把白尿的起因，和现在的病状，写给先生，请赐我一个详细的复函，感激得很。黄××敬上复函：贵恙寒热，经内科治愈，囊痈经外科治愈，平心而论，此两医不可谓无功，第小便色白，不曾愈耳。糖尿病是西医病名，中医书所不载，愧不敢对。小便如米泔水，原因极多，有因于热者，有因于湿者，亦有湿热两盛者，亦有因中虚气化无权者，尊函证据不备，恕不敢妄对。（凌波按：极有可能伤及精管，引起精液外漏，多半需行手术修补。）三十四、戴××君函：士谔先生道鉴：久仰德晖，神情时注，敬启者，因阅《金钢钻月刊》所载大作《诊馀随笔》，内有补品粥油一味，胜西药麦精鱼肝油万倍云，但鄙人素性愚钝，不解粥油意义，是否粳米粥之汁，抑或糙米粥之汁，其修治法，是否煮粥候冷上面结就之厚皮乎，甚为着疑，敢乞示教为感。事缘仆亦好学医，前年曾得陈静远道士授针灸之术，商馀研习已有数年，诊治本厂病者之外，乡间来求诊者亦不绝于门，惟屡逢阴虚气弱之贫穷病家，已不堪用针(因气血虚衰，有晕针之患，况针只能疏气、通筋、活血、利滞、去风，补虚实不能也。)，又无力服药，且仆又系个人施诊，依人度日，无馀力接济，甚可叹也。忽见先生所发明之粥油补品，既价廉而味美可食，何幸如之，不惟鄙人之幸，而我国民众得之能遵依长服，则却病强身，无东亚病夫之讥矣，如蒙不弃，祈指示一切则感德无涯也。戴××启复函：粥油即粳米粥面上之稠汁，不必候冷结衣，随便舀，随便服，不必定要糯米，惟粳糯均可，此物滋阴，专滋阴液兼能补精也。
三十五、太原《明星文艺日报社》函；敬启者，顷阅贵报《医林》栏内，载有《医药问答》，对于病因、治疗方法，解答甚详。兹有山西某君，在教育界服务，右臂操劳过度，于三年前得关节炎，经太原某大医院，北平某著名医院，先后用石膏绷带疗治六月，迨石膏绷带取后，病处开口七八处，流黄稠脓水，久不见愈。最近经某医院检查结果，肺胃肠各部均无病，右臂关节处烂骨甚多，惟除关节部分开口发青色外，右手动作自如，饮食睡眠亦均如常，医院主张锯臂，某君及其友好皆不愿，闻上海宝隆医院骨科甚负盛名，惟不悉该医院在何街巷，诊疗费如何计算，以及对此清苦人士，能否优待，均请贵编辑费神代为查询，示知为荷。此致《金钢钻报，医林》编辑部复函：此症即为石膏绷带久绷之故，因气血凝滞而成此死肌症耳，一误不可再误，及早回头，改延中医诊治，尚有希望，倘再请教西医，定成废人，内科之桂枝加附子汤，外科之阳和汤，似皆可服，希就近延请著名中医诊治，勿再打听西医也。
三十六、梁×君函：士谔先生大鉴：敬启者，仆患性病甚久，殊感痛苦，前因就事于穷乡僻壤，既无良医，返沪后，见悬牌专治性病之医生颇多。诚恐挂羊头而卖狗肉者，则不特无益，反受其损，故始终未敢冒然就医，先生医术高深，素所敬佩，复于报端长见为病家解答疑问，具见热心人群幸福也。今仆将病状及经过详列于下，上渎清神，尚乞赐予指示，俾复康健之躯，则感戴无既矣。敬颂道安。梁×。病状经过列下：仆今年28岁，从少多病，20岁时出外就事，偶涉足花间，即患白浊，治愈后不敢复游花下，乃以手淫解决性欲，一年后体觉不支，遗精病作，继而小便频数，遂乃戒除手淫恶习，而觅医调治，并由服药无数，医生开一方配丸，于秋冬时服用，但终未觉愈。今年结婚，遗精之症已止，而早泄之症又生，甫交即泄，快感毫无，且小便频数之症，令人甚苦，每一刻钟即须小便一次，且小便时无力而射不远，尿后返滴，性具缩小，龟头皮皱绉，手足冰冷，面黄肌瘦，以上各症，不知先生可为医治否?并请先生赐一补养方法。
复函：贵恙乃是肾亏精关不固，可向国药店购金锁固精丸吞服，每日空腹吞服三钱，连服至一个月，可见小效。
三十七、赵××君函：陆士谔先生台鉴：仰慕大名，响往已久，每于《钻报》上得睹先生论医宏文，渊博深邃，尤胜钦佩，更特辟《医林》，摛发国华，拔人痛苦，是诚吾人之幸运也。兹恳者，鄙人现廿一岁，患遗精之症，缘以16岁时误犯手淫，18岁结婚后数月，即远客异地，洁身自爱，讵意遗精之症，即于是时起矣，二三年来，月必三四次，常十馀日或六七日一次不等，且遗辄在午夜熟睡之际，不知不梦，醒来则淋漓满身，心殊怨恨，所异者鄙人孤食独宿，未尝有所胡思乱想，且上床依枕，便酣然入梦，从无失眠之症，自觉身体尚健，食胃亦佳，惟遗精之症终不见愈，若此延绵日久，有伤精神，心中私念悒悒，奚如先生大才，谅不吝良方见赐，载答《医林》，以蠲我不良之疾，盛情厚德，铭感心头矣。嵩此敬颂日祉赵××复函：贵恙宜向国药店购三才封髓丹，每日临卧吞服三钱，淡盐汤送下，服一个月当见微效，王道无近功，切勿性急。
三十八、胡××君函：士谔大夫台鉴：近阅报载，藉悉台端编辑方书，精心考订，辨论详明，诚我国医界之宝筏，病躯之金丹，至为钦仰。兹恳者鄙人以医理精微，生命所系，自惴愚陋，不敢翻阅，近以报载第威德补肾丸功效奇大，购服三年，不觉小便浑浊，后即停服，小便渐渐较难，必用力下蹲始得一次，夜则自遗不禁，近用手揉挤肛门前及肾囊等处，愈挤紧则溺易出，溺色带赤时多，清白色时少，内多涕液形物，将澄底涕液质，用白纸盛摊，沾于纸上，用手擦之，觉是多数白色细砂集成，亦有时现出黑砂，亦有时纯系细液质，并无黑白砂，医认此症为膏淋之一种，将成砂淋之候，脉象沉细，亦不迟不数，大便约二三日一次，常觉秘结，此外别无所苦，今已四年。医士以溺赤为膀胱结热，重加知、柏，而色愈赤，因服西瓜而色略清，遂谓热在气分。而涕液之汁终不能清，医谓系湿痰流入小肠、膀胱，服二陈[汤]除痰，亦不见效，改用冬葵、滑石、琥珀、海金砂、沉香、瞿麦等滑利之药，而溺愈多，日夜无次，点滴不止。医又以为气虚，用野参二钱不见妨碍，即改用补中益气[汤]，六味丸料服数日亦不见效。医又谓肝主疏泄，肾主闭藏，用调补肝肾药亦不见效。更医以为内风所致，用蝎、桂而溺转浑赤，似觉加剧，停止不服。又一医始终认定此症系肾与膀胱气虚不化，谓予年逾四旬，系肾水将虚之候，脉觉细亦阴虚之象，体肥色白又气虚之征，必用手于肛门前及近小便左右等处揉按，是肾与膀胱之气不按摩则不化，一得按摩之助力而气乃化，必将肾囊挤紧而溺易出，肾囊本系虚空，挤紧则气从前阴之虚窍而出，溺即随之而出，一切如涕如膏之浊物，亦即随之而出，其为气虚不化于此可见，况前服野参、桂圆，若非气虚必有饱胀，又可为气虚之证，不然向不饮酒，湿热当然不多，又不好色，梅毒当然不染，何以此症服药终不一效，但余对于此说，不无疑点，每见体虚之人，必精神不振，起居疲倦，饮食不多，从未有虚而不倦怠之人，余虽患此病四年，身体上精神上均不轻弱。医谓肾与膀胱之气专司下焦，不生化则滞积不通，只溺溲变为癃秘淋浊而已，非此正气虚精血应，则现萎弱形状，立方仍系补中益气加化气药，六味丸加化气药，并嘱多服久服，方可见效，并宜禁荤腻煎炙之味，久坐久劳均不合宜，余以补中、六味，前已服过无效，因不见信，兹阅台端医会，集现代名医研究，定有特见，用将贱恙经过情形，及医士辩论，是否有当，详细叙述，恳请卓鉴。遥指迷津，赐一妙剂见示，稍得寸效，定即赴叩，感谢再生，至为盼祷。敬候诊安。
胡××谨启复函：此乃中气不足，溲便为之变也，补中益气可谓对症发药，不必多疑。病之来既非一朝一夕，病之去亦当不能心急，病历四年，属虚可知，不能以精神无碍而自称不虚，请信任始终认定肾与膀胱气虚不化之医，任贤勿贰，必有良效，倘日易一医，纷纷聚讼，恐与贵恙未必有益。
三十九、黄××君函：士谔先生大鉴：久钦仪范，无缘识荆，屡从《钻报》得读大著，藉悉吾国医界，当此四面楚歌之际，乃有先生其人者，出而大声疾呼，诚足扫云雾而辟易千人，真所谓医界之韩柳[喻韩愈、柳宗元]，馀子何足道哉。华有慨医道之不振，西医进挟其最新发明之器械，与夫科学化之诊疗，蒞兹于中土，高视阔步，旁若无人，究其术则头痛医头，脚痛医脚，以人之四肢百骸，著豆剖而瓜分，虽法似精细，实乃大谬，且讲病菌之说，无病非菌，治菌而病仍不瘥，我国医则不然，审阴阳虚实，辨寒热六气，穷源竟委，提纲挈领，固未尝言菌，而病无不治，足见病菌之说不可恃也如此。今将敝戚林无竟君患痢之经中西医诊治情形及现状，另纸附奉台（癶/言）。究竟有否病菌为祟，益征西法之呆拙，与我国医较，确有天渊之隔矣。敝戚因鉴西法之未足尽信，病未愈，债台已高筑，数口之家，赖其维持，近且不能举爨，遑论医药，华不忍坐视，为特肃函清听，以先生之医术，诚无异仲景复生，斯世岂有病而不能治者乎，有嫌冒昧，尚希鉴谅，幸甚幸甚。专肃柢颂台绶黄××拜启附林××君患痢现状：敝友林××年35岁。男，无恶好，惟曾患神经衰弱、遗精、小便频数之病，身瘦，近年来体稍健康。自去年八月杪患痢，日夜数十行(脓血后重)，先服大黄、巴豆等单方，无效。口味无，不思饮食，数日后，目眶陷，音哑，仰卧则脐左旁寸半许稍高胀，痛甚，须转向右侧卧方可，遂入中医院调治，谓为湿痢，用化湿法，当进院旬日，病无进退，曾将大便送卫生所检验，无阿米巴虫[菌]，亦曾同时服用西药“治痢特效药”百馀粒，住院三十馀日，病依次退，距出院时，日仅便一次矣。是时胃口已照常，每顿可吃二碗半至三碗，但脓血仍夹少量，脐左旁仍隐隐作痛，虽再服中药不除根，西医则谓由急性变为慢性痢疾。直至本年七月间，其痛仍未断，大便带少量脓血不尽，若多劳动，则痛加剧连及小腹，大便亦时通时塞，脓血亦时多时少，渠以生计艰难，既无力再医，又不能长此受苦，于是由友人之助，赴某西医院住院治疗，复经西医检查数次，谓是慢性直肠炎，逐日灌肠一次，连续十三天，最后四天中，脓血绝迹，医谓已愈，可出院。既出院，第二日大便即不通，翌日复然，第三日乃用润肠丸得便，而脓血依然矣，令人丧气，有友告以服苦参子，可以断根，于是破壳取仁，研细包胶囊中，日三次，每一日每次用四粒，依日递加，加至十粒为止，大便每日畅通一次或二次，越二星期馀，而大便脓血及脐左侧痛均不除，若苦参子虽有微功，终不能断根。
复函：黄××君虽非医士，认林君之恙系肠部受创日久，失其传化之权，则一语中的，胜中西医诸公数倍矣，佩服之至。敬奉小方，连服三日，或有效乎？
黄条芩钱半生白芍钱半炙甘草钱半红枣六枚清水四大杯，文火煎熬成汁一大杯，去渣顿服。
四十、吴××函：士谔先生大鉴：仆有一弟，年18岁，三年前初由乡间来申学业，因事务繁忙，连，大小便亦竟无睱，更兼其素性胆小，不敢有疏业务，故每逢欲解小便时，即强行忍住不溺，久而久之，遂成小便不利之症。以后则欲小便时，则非用力久胀之不能溺出(但胀出后即能直泻如常人)，故此深感不便，遂于去岁至某国医处诊治，亦断为强忍小便所致，先后用渗湿、利水、清热、通气之方数剂，而末后用金匮肾气丸方加减为治，服之稍觉便利，但尚不能如常人之一溺即出，其后因迫于家况，遂即中止诊治，故至今日溺时仍觉不顺，然无其他变象，眠食如常，大便亦通，惟舌苔时觉滑腻且吐沫涎。惟最奇者，厥为直立而溺时则必久胀之始出，倘若坐于便桶上溺时，则通顺与常人无异，去岁于某国医处诊治时，亦曾明言及此，但此医亦未具道始末，只云肺气输膀胱之故。今敢请先生不嫌其繁而研究之，病源究属于何处?及如何用药?不胜感激，至盼至祷。专此敬肃，顺颂撰安。吴××谨上复函：病来如箭，病去如线。病之暴者，去之既如是之难，况此病之来，不是一朝一夕，当然去之之难，更十倍于普通一切病症，前医既已有效，不必心活他谋，望继续请前医诊治，至于立则闭坐则通，此理极易知晓，人生气机升降，立起则易升，坐下则易降，升闭，降则通也，请一读《国医新话》，对于此种知识，所得必不少。
四十一、强××君函：士谔先生大鉴：鄙人男性，幼以先天不足，体质素弱，及壮又操笔墨生涯，不免用脑过度，迄今55岁(鳏居才五年)，常患头痛，左肩背三叉筋不时酸疼，喜靠椅背，每晨必呕痰一次，食稍粗硬，即觉胸脘胀痛，食稀饭面包，则觉舒服，身有阴癣、脚癣，晨必大便一次，小便亦能畅行，晚欲混汤浴一次，睡眠尚安，惟头痛呕痰，以及胸腕胀痛，据内地医士谓，肝旺脾虚，脑元不足，积劳所致，乃服药以来，均不见效。
近则酸痛如故，脉左细右大，舌苔白腻，敢请先生指示，俾知医疗。
【背景信息】
书名：士谔医话 章节：正文(20/22) 类别：医论
（接上文）才明白是两位没有经验的医生误诊，追悔莫及。昨天朋友告诉我，先生是一位救苦救难的医生，常在《新闻夜报》、《国医周刊》上给病人答复，都是用仁心仁术为病人谋幸福，再造生机。所以我写下白尿的起因和现在的病情，写信给先生，请求赐给我一封详细的复信，非常感激。黄××敬上。
复信：您的寒热病症，经内科治愈；囊痈（阴囊肿胀疼痛的疾病）经外科治愈，平心而论，这两位医生不能说没有功劳，只是小便色白这一症状没有痊愈罢了。“糖尿病”是西医的病名，中医书籍中没有记载，我不敢妄加评论。小便像米泔水一样浑浊，原因极多，有的是因为热邪，有的是因为湿邪，也有的是湿热两盛，还有的是因为中气虚弱、气化功能无权所致。您的来信证据不充分，恕我不敢妄加对答。（凌波按：这极有可能伤及精管，引起精液外漏，多半需要行手术修补。）
三十四、戴××君的信：士谔先生道鉴：久仰您的德行光辉，神情时常关注。敬启者，因为阅读《金钢钻月刊》所载大作《诊馀随笔》，里面提到补品“粥油”一味，胜过西药麦精鱼肝油万倍。但我生性愚钝，不理解“粥油”的意义，它是否是粳米粥的汁液，或者是糙米粥的汁液？其制作方法，是否是煮粥冷却后上面结成的厚皮呢？心中非常疑惑，恳请指示教导，不胜感激。事情的原委是我自己也爱好学医，前年曾得到陈静远道士传授针灸之术，闲暇时研习已有数年，除了诊治本厂病人之外，乡间来求诊的人也络绎不绝。只是屡次遇到阴虚气弱的贫穷病人，已经不堪使用针法（因为气血虚衰，有晕针的危险，况且针只能疏理气机、疏通筋脉、活血、利滞、祛风，不能补虚泻实）。又无力服药，而且我又是个人施诊，依靠他人度日，没有余力接济，实在令人叹息。忽然看到先生发明的粥油补品，既价廉又味美可口，何幸如之！这不仅是我的幸运，如果我国民众能够遵照长期服用，就能祛病强身，不再有“东亚病夫”的讥讽了。如果不嫌弃，祈请指示一切，则感德无边。戴××启。
复信：粥油就是粳米粥面上的稠汁，不必等冷却结成衣膜，随便舀取，随便服用，不一定非要糯米，粳米和糯米都可以。此物能滋阴，专门滋补阴液，兼能补精。
三十五、太原《明星文艺日报社》的信：敬启者，刚才阅读贵报《医林》栏内载有的《医药问答》，对于病因、治疗方法，解答非常详细。现在有一位山西某君，在教育界服务，右臂操劳过度，于三年前得了关节炎，经过太原某大医院、北平某著名医院，先后用石膏绷带治疗六个月，等到石膏绷带取下后，患处开口七八处，流出黄稠脓水，久久不见愈合。最近经某医院检查结果，肺胃肠各部均无病，右臂关节处烂骨甚多，只有除关节部分开口发青色外，右手动作自如，饮食睡眠也都正常，医院主张锯掉手臂，某君及其亲友都不愿意。听说上海宝隆医院骨科很有名望，但不清楚该医院在什么街巷，诊疗费如何计算，以及对此清贫人士，能否优待，都请贵编辑费神代为查询，告知为荷。此致《金钢钻报·医林》编辑部。
复信：此症就是因为石膏绷带久绷的缘故，因气血凝滞而形成了这种死肌症。一错不可再错，及早回头，改延请中医诊治，尚有希望，如果再请教西医，定会成为废人。内科可用桂枝加附子汤，外科可用阳和汤，似乎都可以服用，希就近延请著名中医诊治，不要再打听西医了。
三十六、梁×君的信：士谔先生大鉴：敬启者，我患性病很久，深感痛苦。之前因为在穷乡僻壤工作，既没有好医生，返回上海后，见挂牌专治性病的医生很多。诚恐挂羊头卖狗肉的人，那不仅无益，反而受损，所以始终不敢贸然就医。先生医术高深，素来敬佩，又在报端经常为病人解答疑问，可见热心人群幸福。现在我详细列出病情和经过，冒昧打扰清神，恳请赐予指示，使身体恢复健康，则感激不尽。敬颂道安。梁×。病情经过如下：我今年28岁，从小多病，20岁时外出工作，偶然涉足花丛（指涉足妓院），即患白浊（尿道口流白色分泌物），治愈后不敢再去花丛，乃以手淫解决性欲，一年后体力不支，遗精病发作，继而小便频数，于是戒除手淫恶习，并寻找医生调治，且服用了无数药物。医生开一方配成丸药，于秋冬时服用，但终究未觉痊愈。今年结婚，遗精的症状已止，但早泄的症状又出现，刚交合即泄，快感毫无，且小便频数的症状，令人非常痛苦，每隔一刻钟就必须小便一次，且小便时无力且射不远，尿后有滴沥，性器官缩小，龟头皮肤皱缩，手足冰冷，面色黄肌肉消瘦。以上各症，不知先生是否可以医治？并请先生赐一补养方法。
复信：您的病症乃是肾亏精关不固，可向国药店购买金锁固精丸吞服，每日空腹吞服三钱，连服至一个月，可见小效。
三十七、赵××君的信：陆士谔先生台鉴：仰慕大名，向往已久，经常在《钻报》上看到先生的论医宏文，渊博深邃，尤其钦佩。更特别开辟《医林》，阐发中华医学精华，拔除人的痛苦，这真是我们的幸运。现在恳请的是，我现年二十一岁，患遗精症，原因是十六岁时误犯手淫，十八岁结婚后数月，即远客异地，洁身自爱，没想到遗精症就在这个时候开始了。二三年以来，每月必三四次，常十几天或六七天一次不等，且遗精总是在午夜熟睡之际，不知不觉做梦，醒来则淋漓满身，心里非常怨恨。所不同的是，我孤食独宿，未曾胡思乱想，且上床依枕，便酣然入梦，从无失眠症，自觉身体尚健，胃口亦佳，惟独遗精症始终不见愈。若这样拖延日久，有伤精神，心中私下郁闷，像先生大才，想必不吝良方见赐，刊登回答《医林》，以消除我的不良疾病，盛情厚德，铭感心头。谨此敬颂日祉。赵××。
复信：您的病症宜向国药店购买三才封髓丹，每日临睡前吞服三钱，淡盐汤送下，服一个月当见微效。王道无近功，切勿性急。
三十八、胡××君的信：士谔大夫台鉴：近期阅读报纸，得知您编辑方书，精心考订，辩论详明，诚为我国医界的宝筏，病躯的金丹，极为钦仰。现在恳请的是，我以医理精微，生命所系，自谦愚陋，不敢翻阅。近期因报纸载第威德补肾丸功效奇大，购服三年，不觉小便浑浊，后即停服，小便渐渐较难，必须用力下蹲始得一次，夜间则自遗不禁。近期用手揉挤肛门前及阴囊等处，愈挤紧则溺易出，溺色带赤时多，清白色时少，内多涕液形物，将澄底涕液质，用白纸盛摊，沾于纸上，用手擦之，觉是多数白色细砂集成，有时也现出黑砂，有时纯系细液质，并无黑白砂。医生认为此症为膏淋的一种，将成砂淋之候，脉象沉细，亦不迟不数，大便约二三日一次，常觉秘结，此外别无所苦，今已四年。医生以溺赤为膀胱结热，重加知母、黄柏，而色愈赤，因服西瓜而色略清，遂谓热在气分。而涕液之汁终不能清，医生谓系湿痰流入小肠、膀胱，服二陈汤除痰，亦不见效，改用冬葵、滑石、琥珀、海金砂、沉香、瞿麦等滑利之药，而溺愈多，日夜无次，点滴不止。医生又以为气虚，用野参二钱不见妨碍，即改用补中益气汤，六味丸料服数日亦不见效。医生又谓肝主疏泄，肾主闭藏，用调补肝肾药亦不见效。更医以为内风所致，用全蝎、桂枝而溺转浑赤，似觉加剧，停止不服。又一医始终认定此症系肾与膀胱气虚不化，谓予年逾四旬，系肾水将虚之候，脉觉细亦阴虚之象，体肥色白又气虚之征，必用手于肛门前及近小便左右等处揉按，是肾与膀胱之气不按摩则不化，一得按摩之助力而气乃化，必将肾囊挤紧而溺易出，肾囊本系虚空，挤紧则气从前阴之虚窍而出，溺即随之而出，一切如涕如膏之浊物，亦即随之而出，其为气虚不化于此可见，况前服野参、桂圆，若非气虚必有饱胀，又可为气虚之证，不然向不饮酒，湿热当然不多，又不好色，梅毒当然不染，何以此症服药终不一效？但余对于此说，不无疑点，每见体虚之人，必精神不振，起居疲倦，饮食不多，从未有虚而不倦怠之人，余虽患此病四年，身体上精神上均不轻弱。医谓肾与膀胱之气专司下焦，不生化则滞积不通，只溺溲变为癃秘淋浊而已，非此正气虚精血应，则现萎弱形状，立方仍系补中益气加化气药，六味丸加化气药，并嘱多服久服，方可见效，并宜禁荤腻煎炙之味，久坐久劳均不合宜，余以补中、六味，前已服过无效，因不见信，兹阅台端医会，集现代名医研究，定有特见，用将贱恙经过情形，及医士辩论，是否有当，详细叙述，恳请卓鉴。遥指迷津，赐一妙剂见示，稍得寸效，定即赴叩，感谢再生，至为盼祷。敬候诊安。
胡××谨启。
复信：这是中气不足，导致大小便异常，补中益气可谓对症发药，不必多疑。病之来既非一朝一夕，病之去亦当不能心急，病历四年，属虚可知，不能以精神无碍而自称不虚，请信任始终认定肾与膀胱气虚不化的医生，任贤勿贰，必有良效，倘日易一医，纷纷聚讼，恐与贵恙未必有益。
三十九、黄××君的信：士谔先生大鉴：久钦仪范，无缘识荆，屡从《钻报》得读大著，藉悉吾国医界，当此四面楚歌之际，乃有先生其人者，出而大声疾呼，诚足扫云雾而辟易千人，真所谓医界之韩柳（喻韩愈、柳宗元），馀子何足道哉。华有慨医道之不振，西医进挟其最新发明之器械，与夫科学化之诊疗，蒞兹于中土，高视阔步，旁若无人，究其术则头痛医头，脚痛医脚，以人之四肢百骸，著豆剖而瓜分，虽法似精细，实乃大谬，且讲病菌之说，无病非菌，治菌而病仍不瘥，我国医则不然，审阴阳虚实，辨寒热六气，穷源竟委，提纲挈领，固未尝言菌，而病无不治，足见病菌之说不可恃也如此。今将敝戚林无竟君患痢之经中西医诊治情形及现状，另纸附奉台（注：此处原文可能有误，应为“台端”或类似尊称）。究竟有否病菌为祟，益征西法之呆拙，与我国医较，确有天渊之隔矣。敝戚因鉴西法之未足尽信，病未愈，债台已高筑，数口之家，赖其维持，近且不能举爨，遑论医药，华不忍坐视，为特肃函清听，以先生之医术，诚无异仲景复生，斯世岂有病而不能治者乎，有嫌冒昧，尚希鉴谅，幸甚幸甚。专肃柢颂台绶。黄××拜启。
附林××君患痢现状：敝友林××年35岁，男，无恶好，惟曾患神经衰弱、遗精、小便频数之病，身瘦，近年来体稍健康。自去年八月末患痢，日夜数十行（脓血后重），先服大黄、巴豆等单方，无效。口味无，不思饮食，数日后，目眶陷，音哑，仰卧则脐左旁寸半许稍高胀，痛甚，须转向右侧卧方可，遂入中医院调治，谓为湿痢，用化湿法，当进院旬日，病无进退，曾将大便送卫生所检验，无阿米巴虫（菌），亦曾同时服用西药“治痢特效药”百余粒，住院三十馀日，病依次退，距出院时，日仅便一次矣。是时胃口已照常，每顿可吃二碗半至三碗，但脓血仍夹少量，脐左旁仍隐隐作痛，虽再服中药不除根，西医则谓由急性变为慢性痢疾。直至本年七月间，其痛仍未断，大便带少量脓血不尽，若多劳动，则痛加剧连及小腹，大便亦时通时塞，脓血亦时多时少，渠以生计艰难，既无力再医，又不能长此受苦，于是由友人之助，赴某西医院住院治疗，复经西医检查数次，谓是慢性直肠炎，逐日灌肠一次，连续十三天，最后四天中，脓血绝迹，医谓已愈，可出院。既出院，第二日大便即不通，翌日复然，第三日乃用润肠丸得便，而脓血依然矣，令人丧气，有友告以服苦参子，可以断根，于是破壳取仁，研细包胶囊中，日三次，每一日每次用四粒，依日递加，加至十粒为止，大便每日畅通一次或二次，越二星期馀，而大便脓血及脐左侧痛均不除，若苦参子虽有微功，终不能断根。
复信：黄××君虽非医士，认林君之恙系肠部受创日久，失其传化之权，则一语中的，胜中西医诸公数倍矣，佩服之至。敬奉小方，连服三日，或有效乎？
黄条芩（黄芩）钱半，生白芍钱半，炙甘草钱半，红枣六枚，清水四大杯，文火煎熬成汁一大杯，去渣顿服。
四十、吴××的信：士谔先生大鉴：仆有一弟，年18岁，三年前初由乡间来申学业，因事务繁忙，连大小便亦竟无暇，更兼其素性胆小，不敢有疏业务，故每逢欲解小便时，即强行忍住不溺，久而久之，遂成小便不利之症。以后则欲小便时，则非用力久胀之不能溺出（但胀出后即能直泻如常人），故此深感不便，遂于去岁至某国医处诊治，亦断为强忍小便所致，先后用渗湿、利水、清热、通气之方数剂，而末后用金匮肾气丸方加减为治，服之稍觉便利，但尚不能如常人之一溺即出，其后因迫于家况，遂即中止诊治，故至今日溺时仍觉不顺，然无其他变象，眠食如常，大便亦通，惟舌苔时觉滑腻且吐沫涎。惟最奇者，厥为直立而溺时则必久胀之始出，倘若坐于便桶上溺时，则通顺与常人无异，去岁于某国医处诊治时，亦曾明言及此，但此医亦未具道始末，只云肺气输膀胱之故。今敢请先生不嫌其繁而研究之，病源究属于何处？及如何用药？不胜感激，至盼至祷。专此敬肃，顺颂撰安。吴××谨上。
复信：病来如箭，病去如线。病之暴者，去之既如是之难，况此病之来，不是一朝一夕，当然去之之难，更十倍于普通一切病症，前医既已有效，不必心活他谋，望继续请前医诊治，至于立则闭坐则通，此理极易知晓，人生气机升降，立起则易升，坐下则易降，升闭，降则通也，请一读《国医新话》，对于此种知识，所得必不少。
四十一、强××君的信：士谔先生大鉴：鄙人男性，幼以先天不足，体质素弱，及壮又操笔墨生涯，不免用脑过度，迄今55岁（鳏居才五年），常患头痛，左肩背三叉筋不时酸疼，喜靠椅背，每晨必呕痰一次，食稍粗硬，即觉胸脘胀痛，食稀饭面包，则觉舒服，身有阴癣、脚癣，晨必大便一次，小便亦能畅行，晚欲混汤浴一次，睡眠尚安，惟头痛呕痰，以及胸腕胀痛，据内地医士谓，肝旺脾虚，脑元不足，积劳所致，乃服药以来，均不见效。
近则酸痛如故，脉左细右大，舌苔白腻，敢请先生指示，俾知医疗。
[Background Information]
Book: Shi E Yi Hua (Medical Conversations of Shi E)
Chapter: Main Text (20/22)
Category: Medical Discussion
(Understood that the previous cases were misdiagnosed by two inexperienced doctors, regretting it too late.) Yesterday, a friend told me that you are a doctor who saves people from suffering and danger. You often answer patients' inquiries in the *News Night Report* and the *National Medicine Weekly*, using benevolent medical skills to seek happiness for patients and recreate vitality. Therefore, I have written down the cause of the white urine and the current symptoms to you, requesting a detailed reply. I am extremely grateful. Huang XX respectfully submits.
Reply: Your chills and fever were cured by internal medicine; the scrotal abscess (scrotal swelling and pain) was cured by surgery. To be fair, these two doctors cannot be said to have no merit, except that the symptom of white urine has not been cured. "Diabetes" is a Western medical term not recorded in traditional Chinese medicine books; I dare not comment on it. Urine turbid like rice wash water has many causes: some due to heat pathogen, some due to dampness pathogen, some due to simultaneous excess of damp-heat, and some due to deficiency of middle qi with powerless qi transformation. Since your letter lacks sufficient evidence, I dare not make rash judgments. (Note by Ling Bo: This likely involves injury to the ejaculatory ducts causing semen leakage, mostly requiring surgical repair.)
34. Letter from Mr. Dai XX: Dear Mr. Shi E: I have long admired your virtue and pay close attention to your work. I read your article "Casual Notes After Diagnosis" in the *Diamond Monthly*, which mentioned that the supplement "Zhou You" (congee oil/rice porridge skin) is ten thousand times better than Western wheat malt extract and cod liver oil. However, being naturally dull, I do not understand the meaning of "Zhou You." Is it the juice of japonica rice congee or rough rice congee? Is its preparation method the thick skin formed on top after the congee cools? I am very confused and beg for your guidance. The reason I ask is that I also love studying medicine. Two years ago, I received acupuncture instruction from Daoist Chen Jingyuan and have studied during my spare time for several years. Besides treating patients in my factory, villagers come to me for diagnosis constantly. However, I frequently encounter poor patients with yin deficiency and weak qi, who cannot tolerate acupuncture (because qi and blood deficiency poses a risk of fainting, and needles can only regulate qi, unblock meridians, invigorate blood, remove stagnation, and dispel wind, but cannot tonify deficiency or drain excess). They also lack the means to take herbs. Moreover, as an individual practitioner living hand-to-mouth, I have no surplus resources to help them, which is truly lamentable. Suddenly seeing your invented supplement, Zhou You, which is cheap and delicious, what greater fortune could there be! Not only is it my luck, but if the people of our country could follow this long-term regimen, they would eliminate disease and strengthen their bodies, ending the ridicule of being "Sick Men of East Asia." If you do not disdain me, please instruct me in all aspects, and I will be infinitely grateful. Dai XX opens.
Reply: Zhou You is the thick liquid on the surface of japonica rice congee. There is no need to wait for it to cool and form a skin; scoop it at any time and consume it at any time. It does not necessarily require glutinous rice; both japonica and glutinous rice are suitable. This substance nourishes yin, specifically replenishing yin fluids and complementing essence.
35. Letter from Taiyuan *Star Literary Daily*: Respectfully stated: I just read the "Medical Q&A" section in your newspaper's "Medical Forest," which provided very detailed answers regarding etiology and treatment methods. Now, there is a gentleman from Shanxi working in education who suffered from arthritis in his right arm three years ago due to overwork. He was treated at a major hospital in Taiyuan and a famous hospital in Beijing, first with plaster bandages for six months. After the bandages were removed, seven or eight openings appeared on the affected area, oozing yellow, thick pus, which did not heal for a long time. Recent examinations by another hospital showed no disease in the lungs, stomach, or intestines, but significant bone necrosis in the right arm joint. Except for the bluish discoloration at the joint openings, his right hand moves freely, and his diet and sleep are normal. The hospital proposes amputating the arm, which the gentleman and his friends refuse. We hear that the orthopedics department at Shanghai Baolong Hospital is highly renowned, but we do not know its location, how fees are calculated, or if discounts are available for impoverished individuals. Please trouble yourself to inquire and inform us. Sincerely, *Diamond Newspaper, Medical Forest* Editorial Department.
Reply: This condition is caused by prolonged use of plaster bandages, leading to qi and blood stagnation resulting in dead flesh syndrome. Do not repeat the mistake; turn back early and seek traditional Chinese medicine treatment, where there is still hope. If you continue consulting Western medicine, you will surely become disabled. Internal medicine formulas such as Guizhi Jia Fuzi Tang (Cinnamon Twig Decoction plus Aconite Root) or external medicine formulas such as Yanghe Tang (Warming Yang Decoction) seem applicable. Please consult a famous TCM practitioner nearby and do not inquire further about Western medicine.
36. Letter from Liang X: Dear Mr. Shi E: Respectfully stated: I have suffered from a sexually transmitted disease for a long time and feel great pain. Previously, working in remote areas, I had no access to good doctors. Upon returning to Shanghai, I saw many doctors advertising specialized treatment for STDs. Fearing charlatans ("selling dog meat under a sheep's head sign"), which would be not only useless but harmful, I dared not seek medical attention rashly. Your medical skills are profound, which I have always admired, and your frequent answers to patients in the newspapers show your enthusiasm for public welfare. Now I list my symptoms and history in detail below, disturbing your peace, and beg for your guidance so that I may recover my healthy body, for which I will be eternally grateful. Respectfully wishing you peace. Liang X. Symptoms and History: I am 28 years old this year. Sickly since childhood, I went out to work at age 20. Once visiting a brothel, I contracted gonorrhea (white discharge). After curing it, I avoided brothels and resorted to masturbation to satisfy sexual desires. One year later, my physical strength declined, nocturnal emissions began, followed by frequent urination. I then quit masturbation and sought medical treatment, taking countless medicines. A doctor prescribed pills taken in autumn and winter, but I never felt cured. I married this year; nocturnal emissions stopped, but premature ejaculation developed. Ejaculation occurs immediately upon intercourse with no pleasure. Frequent urination is very distressing; I must urinate every 15 minutes. Urination is weak and short-range, with post-void dribbling. Sexual organs have shrunk, glans skin is wrinkled, hands and feet are cold, complexion is sallow, and muscles are wasted. Can you treat these symptoms? Please provide a nourishing method.
Reply: Your condition is kidney deficiency with insecure essence gate. Purchase Jin Suo Gu Jing Wan (Golden Lock Essence-Stabilizing Pill) from a national pharmacy. Take 3 qian on an empty stomach daily for one month to see minor effects.
37. Letter from Zhao XX: Dear Lu Shi E: I have long admired your fame and eagerly look forward to reading your profound medical essays in the *Zuan Bao*. You have specially opened the "Medical Forest" column to promote Chinese medicine and relieve suffering, which is truly our fortune. I request this: I am now 21 years old and suffer from nocturnal emissions. At 16, I mistakenly engaged in masturbation. After marrying at 18, I lived far from home and practiced abstinence. Unexpectedly, nocturnal emissions began then. For the past two or three years, it happens three or four times a month, or once every six to ten days. It always occurs during deep sleep at midnight without dreams, waking up soaked. I resent this greatly. Unlike others, I live alone and do not indulge in lustful thoughts. I fall asleep easily without insomnia, feel physically healthy, and have a good appetite. Only the nocturnal emission persists. Prolonged suffering damages spirit and mind. Given your great talent, I hope you will generously provide a prescription to publish in *Medical Forest* to cure my ailment. I will deeply remember your kindness. Respectfully wishing you daily blessings. Zhao XX.
Reply: Your condition should be treated with San Cai Feng Sui Dan (Three Talents Sealing Marrow Pill) purchased from a national pharmacy. Take 3 qian before bed daily, washed down with light salt water. Minor effects will appear after one month. The Way of Kings yields no quick results; do not be impatient.
38. Letter from Hu XX: Dear Doctor Shi E: Recently reading the newspaper, I learned you are editing medical texts with careful research and clear debates, truly a treasure for our medical field and a golden pill for the sick. I admire you greatly. Regarding medical principles, which are subtle and vital to life, I consider myself ignorant and dare not study them. Recently, seeing reports that Diweide Kidney-Tonifying Pill has miraculous effects, I took it for three years. Subsequently, my urine became turbid, so I stopped. Urination gradually became difficult, requiring squatting to force a stream. Nocturnal enuresis is uncontrollable. Recently, massaging the area in front of the anus and scrotum helps urination; the tighter the squeeze, the easier the flow. Urine is often reddish, rarely clear-white, containing mucus-like substances. When spread on paper, these appear as fine white sand grains, sometimes black sand, or pure liquid without sand. Doctors diagnosed this as a type of Gao Lin (paste-like urinary discharge) potentially becoming Sha Lin (sand-like urinary discharge). Pulse is deep and thin, neither slow nor rapid. Bowel movements occur every two to three days, often constipated. No other discomfort, duration four years. Doctors attributed red urine to bladder heat, adding Zhi Mu (Anemarrhena Rhizome) and Huang Bai (Phellodendron Bark), yet color worsened. Watermelon intake cleared it slightly, suggesting heat in the qi level. Mucus remains unclear. Doctors attributed mucus to damp-phlegm flowing into small intestine/bladder. Er Chen Tang (Two-Cured Decoction) failed. Changing to slippery drugs like Dong Kui Zi (Malva Seed), Hua Shi (Talcum), Hu Po (Amber), Hai Jin Sha (Lygodium Spore), Chen Xiang (Aquilaria Wood), and Qu Mai (Dianthus Herb) increased frequency and dripping day and night. Doctors then suspected qi deficiency. Ye Shen (Wild Ginseng) 2 qian was tolerated, so Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) and Liu Wei Wan (Six-Ingredient Pill with Rehmannia) were tried for days with no effect. Another doctor cited Liver governing dispersal and Kidney governing storage, trying Liver-Kidney tonification with no effect. Another attributed it to internal wind, using Quan Xie (Scorpion) and Gui Zhi (Cinnamon Twig), worsening urine to muddy red, so stopped. A final doctor insisted on Kidney and Bladder qi deficiency failing to transform. At over 40, he claimed Kidney water is depleting. Thin pulse indicates yin deficiency; fat and pale complexion indicate qi deficiency. He argued massage is needed because Kidney/Bladder qi requires stimulation to transform. Squeezing the scrotum forces qi out through the virtual opening of the anterior yin, bringing urine and turbid matter. He noted previous Wild Ginseng and Longan caused no bloating, proving qi deficiency. Lack of alcohol and lust rules out damp-heat and syphilis. Why did medication fail? I doubt this theory. Weak people usually lack spirit, feel tired, and eat little; I have never seen weakness without fatigue. Though sick for four years, my body and spirit are not weak. Doctors say Kidney/Bladder qi governs lower jiao; failure leads to retention and turbidity, not necessarily emaciation unless essence/blood are involved. Prescriptions remain Bu Zhong Yi Qi plus qi-transforming herbs and Liu Wei Wan plus qi-transforming herbs, advising long-term use and avoiding greasy/fried foods and sedentary labor. I already tried these with no effect. Reading your collection of modern名医 research, I trust you have unique insights. I narrate my case and debates with doctors in detail, begging your judgment. Guide me to the correct path, provide a miracle formula. Even slight improvement warrants a visit to thank you for saving my life. Hoping for your reply. Respectfully awaiting examination. Hu XX respectfully submits.
Reply: This is insufficient middle qi causing changes in urination and defecation. Bu Zhong Yi Tang is precisely indicated; do not doubt. Disease onset was not overnight, nor will resolution be quick. Four-year history indicates deficiency; do not claim non-deficiency based on mental alertness. Trust the doctor who consistently identified Kidney and Bladder qi deficiency failing to transform. Stick to one expert; there will be good results. Changing doctors daily leads to confusion and likely harms your condition.
39. Letter from Huang XX: Dear Mr. Shi E: I have long admired your demeanor but never met you. Reading your works in the *Zuan Bao*, I know that amidst the crisis facing our medical field, you speak out loudly, clearing clouds and inspiring thousands, truly the Han Yu and Liu Zongyuan of the medical world. Others are insignificant. I lament the decline of medical arts. Western medicine enters with latest instruments and scientific diagnostics, strutting arrogantly. Their method treats head when head hurts, foot when foot hurts, dissecting limbs and bones like beans and melons. Though seemingly precise, it is fundamentally wrong. They preach germs, claiming all diseases are bacterial; treating bacteria leaves disease uncured. Our medicine differs: examining yin/yang and deficiency/excess, distinguishing cold/heat and six qi, tracing origins and grasping essentials, never mentioning germs, yet curing all diseases. Thus, germ theory is unreliable. I attach details of my relative Lin Wu Jing's dysentery treatment by both systems and current status. Whether germs are the culprit further proves Western methods are rigid compared to the vast gap with our medicine. My relative, distrustful of Western methods, incurred high debts while ill, supporting a family of several, unable to cook, let alone afford medicine. I cannot stand by. Writing to you, whose skills rival Zhang Zhongjing reborn, asking if any disease is incurable? Apologizing for presumption, hoping for understanding. Sincerely, Huang XX bows.
Appendix: Status of Lin XX's Dysentery: Friend Lin XX, 35, male, no bad habits, history of neurasthenia, nocturnal emissions, frequent urination. Thin, recently healthier. Late last August, developed dysentery, dozens of stools daily (pus, blood, tenesmus). Took Da Huang (Rhubarb Root and Rhizome) and Ba Dou (Croton Seed) single herbs, ineffective. Loss of taste, anorexia. Days later, sunken eye sockets, hoarse voice. Lying supine, slight fullness/pain 1.5 cun left of umbilicus, severe pain relieved by lying on right side. Entered TCM hospital, diagnosed as Damp Dysentery, treated with damp-resolving methods. Ten days in, no progress. Stool tested negative for Amoeba/Bacteria. Also took over 100 Western "anti-dysentery special pills." Hospitalized 30+ days, symptoms receded, discharging with only one stool daily. Appetite returned, eating 2.5-3 bowls per meal, but stool still contained small amounts of pus/blood, left umbilical pain persisted. TCM didn't root out the issue; Westerners called it chronic dysentery. Pain continued until July this year, stool with trace pus/blood. Labor aggravated pain radiating to lower abdomen, stool alternating blockage/passing, pus/blood fluctuating. Due to poverty, unable to continue treatment, accepted friend's help to go to a Western hospital. Repeated exams diagnosed chronic proctitis. Daily enemas for 13 days. Last four days, pus/blood disappeared, declared cured, discharged. Next day, constipation. Third day, used Run Chang Wan (Moisten Intestines Pill) to pass stool, but pus/blood returned. Despairing. Friend suggested Ku Shen Zi (Sophora Fruit), shell removed, kernel ground into capsules. Three times daily, starting 4 pills, increasing daily to 10. Stool passed 1-2 times daily. After two weeks, pus/blood and left umbilical pain remained. Ku Shen Zi had minor effect but didn't cure.
Reply: Although Mr. Huang XX is not a doctor, identifying Lin Jun's ailment as long-term intestinal damage losing transmission/transformation power hits the mark, surpassing Western and TCM experts. I admire this greatly. Here is a small formula; take for three days, perhaps effective?
Huang Qin (Scutellaria Root) 1.5 qian, Sheng Bai Shao (Raw White Peony Root) 1.5 qian, Zhi Gan Cao (Honey-fried Licorice Root) 1.5 qian, Hong Zao (Jujube) 6 pieces. Four cups clear water, simmer slowly to one cup decoction. Remove dregs and drink in one dose.
40. Letter from Wu XX: Dear Mr. Shi E: I have a younger brother, 18 years old, came to Shanghai for studies three years ago. Busy with affairs, he neglected bathroom breaks. Being timid, he forced himself to hold urine whenever needed. Over time, this led to difficulty urinating. Later, he could only urinate after forcing and distending for a long time (but once started, flows normally like others). This caused inconvenience. Last year, consulted a TCM doctor, who also diagnosed forced holding as the cause. Used damp-draining, diuretic, heat-clearing, and qi-regulating formulas. Finally used modified Jin Gui Shen Qi Wan (Kidney Qi Pill from Golden Cabinet), feeling slightly better but not normal immediate voiding. Forced to stop due to family circumstances. Still feels obstruction now, though no other changes, sleep/diet normal, bowels open, tongue coating slippery/greasy with saliva foam. Most strangely, standing to urinate requires long distension, but sitting on a toilet allows normal flow. Last year's doctor mentioned this, attributing it to Lung qi transmitting to Bladder, but didn't explain fully. I beg you to study this complexity: where is the source, and how to medicate? Grateful and praying. Respectfully, Wu XX submits.
Reply: Disease comes like an arrow, goes like a thread. Acute diseases are hard to cure; this disease, developing over years, is ten times harder to resolve than ordinary illnesses. Since previous treatment was effective, do not seek other remedies. Continue with the previous doctor. Standing blocking and sitting conducting is easy to understand: human qi mechanism ascends when standing and descends when sitting. Ascension blocks, descent conducts. Read *Guo Xin Hua* (New Talk on National Medicine); you will gain much knowledge.
41. Letter from Qiang XX: Dear Mr. Shi E: I am male, congenitally deficient and weak constitution since youth. In adulthood, worked with pen and ink, overusing brain. Now 55 (widowed only five years). Often suffer headache, soreness/pain in left shoulder/back trapezius muscle, preferring to lean back. Vomiting phlegm once every morning. Coarse/hard food causes chest/epigastric distension/pain; soft food/bread feels comfortable. Have tinea cruris and tinea pedis. Morning bowel movement once, urination smooth. Evening hot bath, sleep okay. Headache, phlegm vomiting, and chest/abdominal distension persist. Local doctors attribute this to Liver hyperactivity, Spleen deficiency, Brain Yuan insufficiency, and accumulated fatigue. Medication has been ineffective.
Recently, soreness/pain continues. Pulse: left thin, right large. Tongue coating: white and greasy. Begging your guidance for treatment.