此乃怪症也，世间亦偶有之。产后两乳伸长，形细如鸡肠，垂过小腹，痛难刻忍。急用
川芎
、当归各一个，先各取四两，切片水煎，时服。以所余斤半，切大块，产妇面前放一桌，下
放火炉，将芎、归入炉慢烧，令妇伏于桌上，口鼻及乳吸烟。如叶尽未痊，再如前法煎服熏
吸，便可缩上。倘不能复救，取蓖麻子一粒，冷水磨涂头顶，见缩复旧，实时洗去乃愈。愈
后倘日后再产，必复发不救。
故膏药不可以蓖麻煎入，倘贴孕妇下体疮疖即小产。产后尚不觉膏，故再贴致命。可见
巴豆、蓖麻之害如此。
马曰∶此是古方，平妥可用。如不应，再加黄 八两煎服，即效。
陶曰∶用缠足妇女臭裹布扎缚其乳，亦收上矣。
谚云∶千学不如一见。是以从师习道，必经师率而视症，以冀见广识多，使遇症无疑。余故
以四十余年之临证，摘其一二奇险危笃者，或用测度推原之治，悉录于下，以备学人目之，
可免师率视症云尔。
阊门龚姓，腰患一疽，根盘围阔二尺余，前连腹，后接骨，不红不肿，不痛不软，按之
如木
。初延余治，以肉桂、炮姜，书于方首。别后另延苏城内外三四名家，众视余方，皆曰酷暑
安可用此热剂。以余为非，议用攻托清凉，连治五日，病者神昏无胃。复延余治，患仍不痛
，色如隔宿猪肝，言语不清，饮食不进。余曰∶能过今晚再商。是夜即毙。然其至死不痛。
不久伊芳戚亦患此症，延余治，以阳和汤服下，次日觉松，又服，疽消小半，才以犀黄丸与阳
和汤逐日早晚轮服，第五日痊愈。后有发背相若者，照治而愈。
一壮年新婚百日，妻往母家，盈月方回。日值酷暑，未必欲毕贪凉多扇，五鼓时喉痛气
逆
，寒热交作。余问之，则曰∶三日前喉间略有微痛，今早五鼓胀肿痛甚。视其小舌，肿如胖
人
拇指，知系心肾虚实之火，并欲后经风，风火两闭之恙。若用发表，虚上加虚，若投寒剂，
风火被罨，即用前胡、苏子、连翘、元参、赤芍、浙贝、甘、桔八味煎服，立愈。
一邻友，余家饮酒，二鼓而别，次早伊芳仆云∶阳物肿胀，痛难小便，遣来索药。度其酒
归行
房，妻以前用未洗之绢抹之，此绢必经毒虫咬过。即用仙人对坐草以解蛇毒，割人藤以解蜈
蚣毒，二草捣烂取汁，调雄黄末涂上，立刻止痛消肿，下午痊愈。
无锡村妇，年三旬，五月望日下午，腹饥，正取面食，将举箸，忽喉疼难食。彼地一医
以射
干、赤芍、翘、芩、花粉、牛蒡等煎服，服即痰升满口，响若鼾声，痰不出齿，口有痰护。
余问始知骤起，况服凉药增险，此阴寒无疑也。但痰塞一口，万难进药，即取鹅羽蘸桐油厘
许，入喉一卷，痰随羽出，吐有升许，以肉桂、炮姜、生甘草各五分，入碗内，以滚水冲浸
，以碗仍顿汤中，用匙取药与咽一口，病者即称好了，连呷三四口，人起说饥，问余要饭吃
可否，余曰∶与粥最宜。
南濠一匠，半夜请治喉症，问之不能回答。旁人云∶昨吃夜饭好好，唱歌作乐，睡着忽
喉痛而醒。余以炙附如细粞一粒，放其舌上，咽津数口，痊愈。
一妇小腿经烫，被医者用冰片研入雪水敷之，不一刻，腿肿如斗，痛极难忍。请余治，
妇曰
∶只求止痛，死亦甘心。余曰∶幸在小腿下体硬地，倘烫腰腹，用此一罨，火毒入腹，难以
挽回。以地榆研细，调油拂上，半刻痛止。令伊芳自拂，一二次痊愈。一使女炭火烫足背，烂
一孔，以伏龙散乳调敷，不三日而愈。又邻家一孩，炉上滚汤浇腹，因痛自手扒破腹皮，油
拂上一次痛息，以地榆末干撒于破处，次日肌生，未破者痊愈。
宜兴冯悠也，右足背连小腿转弯处，初起不过烫毒而成烂腿。三十余年，四起硬肛，小
腿足
肿如斗，烂腿可容大拳，有时出血，有时常流臭浆，满室难闻。自以布包如砖一块，以填孔
内，否则空痛。时年七十有四，雍正六年，延余治，以老蟾破腹，蟾身刺数孔，以肚杂代包
，填入孔内，蟾身覆盖孔外，每日煎葱椒汤，俟温，早晚各洗一次，以蟾易贴。内服醒消丸
，亦早晚二服，三日后，取地丁大力鲜草，捣烂填孔，外盖乌金膏，仍以醒消丸日服。其肛
口外四起硬块，内有皮中渗出清水者，以嫩膏加五美散敷。内有发痒者，以白花膏贴。内有
块硬如石者，以生商陆捣烂涂。因孔内常有血出，先以参三七末撒内，次用地丁、牛蒡叶、
根捣填，如此二十余日，腿始退肿痒息，而其硬块及硬肛皆平，皮色退黑，内肉鲜红，患口
收小平浅，可以不用草填，日以五宝散撒上，仍贴乌金膏。因老翁精神不衰，饮食不减，始
终不补收功。
宜兴徐玉梧子，周岁半。太阳一毒，背上心脐对处二毒，颈后口对处一毒，腰腹二毒，
两腿
五毒，共患十一毒，皆皮色不异。其大腿二毒，已经伊芳处医者开刀。闻余至，请治。以小金
丹令日服二次，第五日消其九毒，消后又以小金丹服一次。因孩小，令其添一乳母，十日后
，二孔皆红润，以保元汤， 、草皆生，加肉桂三分，煎杯许。另水煎参六分和服。半月后
，以 、草易炙服愈，一月收功。
常熟赵太元长君，患横 ，被医家开刀。延余治，余问开刀几月矣，彼云已有半月也。
余曰∶此患破则难治，还有九月之寿。即辞别。别后三百日，伊芳戚在苏来云，已死月余。
兴邑路姓七岁童，顶门只寸许，并患三疽，溃久不敛，孔如棋大，浅而无脓，干而色灰
，人
倦无神。因服凉剂过多，饮食不进，延余治。余曰∶色似香灰，乃气血两丧；无脓干枯，精
神已绝。兼值不食，难以延久，何能治之！次日而夭。
枫镇闵姓，年十上，颈患瘰 ，烂成 片，延烂耳腋及腰，如手掌大者数处，瘦弱成怯
。初
以洞天救苦丹与服，毒水大流，十日后以阳和汤、醒消丸每日早晚各服一次，十日项能舒转
，饮食日增。外贴阳和膏，内服大枣丸。嗣后仍以前膏贴之，始终用荆芥汤洗，以山莲散
敷，九十日收功。因未服子龙、小金二丸，其毒根未除，后腋生恶核，仍以子龙丸消之杜患
。
山塘姚姓媛，年二十九，小产月余。左肩手搭处，先发一毒，周有尺五，患后半月，背
脊添
出一毒，自上至下，计长一尺三寸，上阔下尖，皆白陷。十日后始请余治，其势甚笃，连服
阳和汤三剂，人能坐起，五剂自能大小便，十二剂其续发者全消。先发之搭手，余地皆消，
只剩患顶有脓者，如棋子大，脓足不痛而穿，四日收功。后言背上如负一板，舒转不快，以
小金丹十丸，每日二丸，服毕，肌肤不板，神色复元。
程姓母年七十，膝下患一阴毒流注，溃经数月，患下及旁，又起硬肿二块，与旧患相连
。延
一医，以新发之毒，误为旧患旁肿，不识流注，竟以托毒之剂与服。服二剂，致新发者被托
发痛，始延余治。余以阳和汤与服三剂，新发之二毒皆消，接服小金丹十丸，后进滋阴温补
，以杏仁散敷，半月脓浓，令服保元汤加肉桂，十余剂愈。
王姓媳，颈内瘰 数个，两腋恶核三个，又大腿患一毒，不作疼痒。百余日后，日渐发
大，
形几如斗，按之如石，皮现青筋，常用抽痛。经治数人，皆称曰瘤。余曰∶瘤系软者，世无
石硬之瘤，乃石疽也。问可治否，答曰∶初起时皆可消，日久发大，上现筋纹，虽按之如石
，其根下已成脓矣。如偶作一抽之痛，乃是有脓之证，上现青筋者，其内已作黄浆，可治。
如上现小块，高低如石岩者，不治。三百日后，主发大痛，不溃而死。如现红筋者，其内已
痛，血枯不治。倘生斑点，即自溃之证。溃即放血，三日内毙。今患所现青筋，医至患软为
半功，溃后脓变浓浓，可冀收功也。外以活商陆捣涂，内服阳和汤，十日则止一抽之痛，十
三剂里外作痒，十六剂顶软，十八剂通患全软。其颈项之 块，两腋之恶核，尽行消散，一
无形迹。只剩石疽未平，内脓袋下，令服参一钱，因在筋络之处，先以银针刺穿，后以刀阔
其口，以纸钉塞入孔内，次入两次流水斗许。大剂滋补托里，删去人参，倍增生 ，连进十
剂，相安已极。适有伊芳戚，亦行外科道者，令其 、草换炙，服不三日，四外发肿，内作疼
痛。复延余治，余令以照前方服，又服二十余剂，外以阳和膏，随其根盘贴满，独留患孔，
加以布捆绑。人问何以既用膏贴，又加布绑，答曰∶凡属阴疽，外皮活，内膜生，故开刀伤
膜，膜烂则死。所出之脓，在皮里膜外，仅似空弄，又不能以生肌药放入，故内服温补滋阴
活血之剂，外贴活血温暖膏药，加之以捆，使其皮膜相连，易于脓尽，且又易于连接生肌。
绑后数日，内脓浓浓，加参服两月收功。
宜兴一舟子，阴囊形大如斗。被走方者穿之，不数日，烂见肾子，如鸡蛋大，旁有一筋
，六
七寸长，形若鸡肠双环，随肾子落出，臭气难闻。令以紫苏煎汤洗净其筋上烂腐，问其肾子
、小便、小肚痛否？彼曰∶皆不痛。余曰∶此三处作痛难治，今不痛者，可治。日以紫苏汤
洗，洗后以苏梗为末撒上，用青荷叶包之。内服黄连、归尾、黄芩、甘草、木通等药十剂。
五日后肾子收上，烂孔收小。此非患毒，乃是损伤，口既收小，肌色红白，内服地黄汤，外
敷生肌散而愈。
福建客，满身广豆，又患横 。余想横 乃阴虚之症，药宜温补；广豆系火毒之症，药
宜凉
解，二症相背，既利于毒，必害于疽，务使二症皆宜之药，非犀黄丸，外无他法。令其每日
空心时，酒送三钱，十服，二症痊愈。后一人毒重者，倍服而愈。
妇，项痰核三处，年久生管，延治。以拔管药插入，日易，半月愈两，惟有一管，浅如
一粞
。不意根据夫远归，两日管深如旧。余曰∶此刻治，定无功效，容日商治。伊芳母问余，余曰∶
俟令婿出外，半月亦可收功。数日后，接女归，延治而愈。又，壮年，臂有二管，问伊芳可有
暗疾，曰∶有梦遗。余以六味删去泽泻，增线胶、龙骨、芡实、莲须为丸，鹿含草煎汤，晨
夕各送三钱，服完，二管皆痊。
一妇，两乳皆患乳岩，两载如桂圆大，从未延医。因子死悲哭发威，形大如杯，以五通
、犀
黄丸，每日早晚轮服，九日全消。又，男子乳亦患，因邻送鲫鱼膏粘贴，两日发大如拳，色
红始来。令其揭下，与服阳和四剂，倘色转白可救。色若仍红，无救矣。四日，患色仍红，
哀恳求治，以犀黄丸、阳和汤轮服，服至十六日，四余皆消，独患顶溃，用蟾拔毒三日，半
月收功。
洞庭秦卜年，项腋恶核十二处，服连翘、昆布等药病重，又被刺破，烂经三载，始来就
医。
以阳和汤、犀黄丸轮服半月，十中愈八，喜甚，带药而回。路见凉粉买食，至家又食冷水激
面，次日二便皆闭，第五日死。此病者自不惜命，故记以为病者之戒。
南濠客叶姓，耳下并患恶核，一被针穿生管，一大如杯，以阳和、小金轮服，未溃者全
消。
彼问管可易愈否？余曰∶消管甚易，管消即敛。倘将敛，一经走泄，管即复生，愈期难订。
彼系真诚，果即敛。
洞庭钱永泰子，患痘毒，医用清火解毒之剂，以一医毒增六七，再医毒生二十，医至第
二年
，孔皆有管，日流臭浆，右足缩不能行，坐卧三载，始来就治。以阳和、小金、犀黄等丸与
服，内用化管药，半月愈半，一月管化，有多骨者亦出。彼欲领子回家，才以生肌散并调和
气血之丸与回。任子率性，欲食即与，不洗即止，不敷即停，日以酸橙石榴等果消闲，严冬
复臭难闻。余曰∶臭则烂，香则生。肌寒疽未敛，日食酸涩，领回三月，患管复旧，乃父母
害之也。
妇，乳患一白疽，寒热痛甚，余以阳和丸同二陈汤煎服，得睡痛息，连进三服痊愈。
又妇，患者相告，伊芳弟亦习外科，以夏枯、花粉、连翘、橘叶等药，连服五剂，号痛不
绝。
延治，余视向白色变微红，难以全消，即书肉桂、炮姜、麻黄，加二陈汤，令伊芳煎服，当晚
痛止能睡，明日皱皮缩小，服下果然，连进数剂，患项不痛而溃。贴阳和解凝膏收功。
木渎镇谈姓妇，背患如碗，初起色白，近已转红，痛甚，时值三伏，余以阳和汤书毕，
旁人
云∶此暑天缘何用麻黄发表，桂、姜之热剂，余曰∶此阴症也。彼云∶患色转红，阴已变阳
。余因其说，恐患家疑惧，立令等候煎服，服不超时，痛息，接服四剂，患消七分，其有脓
之三分，不痛而溃，五日收功。
一童十一岁，手足臂腿及指头面遍身浮肿，数日后，日增沉重，以致气喘不能眠。偶有
远
客，令觅黄皮柑子一只，同酒酿二斤，煎至将干，去柑内核，取连酒酿食之，二次痊愈。
马曰∶以上方案，瑕瑜互见，已于各症内声明，兹不赘述。
这是怪异的病症，世间偶尔也有发生。产后两乳房伸长，形状细长如鸡肠，下垂超过小腹，疼痛难以忍受。急需使用川芎、当归各一两（注：原文“一个”疑为“一两”之误，或指单位，此处依语境译为常用剂量单位或保留原意，鉴于后文有斤半，此处暂译为“各取适量”，但根据中医古籍习惯及后文“四两”，推测前文“一个”可能为排版错误或特定计量，结合下文“先各取四两”，此处翻译为：急用川芎、当归，先各取四两），切片用水煎煮，不时服用。将剩余的斤半药材切成大块，在产妇面前放一张桌子，桌下放置火炉，将川芎、当归放入炉中慢火烘烤，让妇女伏在桌上，用口鼻吸入药烟。如果药味散尽病仍未愈，再按前面的方法煎服并熏吸，乳房便可缩回。倘若无法挽救，取蓖麻子一粒，用冷水磨成汁涂抹头顶，见乳房缩回原状，立即洗去即可痊愈。痊愈后如果日后再次生产，必定复发且无法救治。
因此膏药不可以用蓖麻煎制加入，如果贴在孕妇下体的疮疖上会导致小产。产后尚且不觉得膏药有害，所以再次贴敷会致命。可见巴豆、蓖麻的危害如此之大。
马氏说：这是古方，平稳妥当可以使用。如果无效，再加黄芩八两煎服，即见效。
陶氏说：用缠足妇女的臭裹布扎缚其乳房，也能使其缩回。
谚语说：千次学习不如亲眼一见。因此跟随老师学习医术，必须经过老师的率领和现场观察病症，希望见识广博、知识丰富，使得遇到病症时没有疑惑。我因此将四十多年的临证经验，摘录其中一两个奇特、危险、危重的病例，或者采用推测推究病因的治疗方法，全部记录在下面，供学习者参考，可以免去老师现场率领观察病症的辛劳罢了。
阊门龚姓人家，腰部患疽，根盘周围宽二尺多，前面连到腹部，后面接至骨骼，不红不肿，不痛不软，按压起来像木头一样。起初请我治疗，我在处方开头写了肉桂、炮姜。分别后，他又另外延请苏州城内外三四位名医，大家看了我的处方，都说酷暑天怎么可以用这种热性药剂。认为我错了，商议用攻托清凉的方法，连续治疗五天，病人神志昏迷，胃气衰败。又请我治疗，患处仍然不痛，颜色像隔夜的猪肝，言语不清，饮食不进。我说：能熬过今晚再商量。当天晚上就去世了。然而他直到死都不感到疼痛。不久他的亲戚也患了此症，请我治疗，服用阳和汤，第二天感觉轻松，继续服用，疽消减了不到一半，才用犀黄丸与阳和汤轮流早晚服用，第五天痊愈。后来有发背症状相似的，照此治疗而愈。
一位壮年男子新婚百日，妻子回娘家，满月才回来。正值酷暑，未必是纵欲贪凉多扇扇子，五更天时喉咙痛、气逆，寒热交替发作。我问情况，他说：三天前喉间略有微痛，今早五更时胀痛剧烈。看他的悬雍垂（小舌），肿胀得像胖人的拇指，知道这是心肾虚实之火，加上想要行房事受风，风火两闭的病症。如果用发表药，虚上加虚；如果用寒凉药，风火被郁闭在内。于是使用前胡、苏子、连翘、玄参、赤芍、浙贝母、甘草、桔梗八味药煎服，立刻痊愈。
一位邻居朋友，来我家饮酒，二更时分告别，次日早晨他的仆人说：阴茎肿胀，疼痛难忍小便，派来索要药物。推测他是酒后行房，妻子用以前未洗的绢布擦拭，这块绢布必然经过毒虫咬过。立即用仙人对坐草以解蛇毒，割人藤以解蜈蚣毒，将这两种草药捣烂取汁，调和雄黄末涂在上面，立刻止痛消肿，下午痊愈。
无锡村妇，三十岁，五月十五日下午，肚子饿，正拿面食，筷子刚举起，忽然喉咙痛无法进食。当地一位医生用射干、赤芍、连翘、黄芩、花粉、牛蒡子等煎服，服药后立即痰涌满口，声音像打鼾，痰不出牙齿，口中有痰护住。我问明始末，知道是突然发作，况且服用凉药增加了危险，这无疑是阴寒之症。但痰堵塞一口，万难进药，于是取鹅毛蘸桐油少许，伸入喉咙卷一下，痰随鹅毛出来，吐出约一升，用肉桂、炮姜、生甘草各五分，放入碗中，用滚水冲浸，再将碗放在热水中保温，用勺子取药喂咽下一口，病人就说好了，连喝三四口，起身说饿了，问我能不能吃饭，我说：喝粥最合适。
南濠一位工匠，半夜请治喉症，问他不能回答。旁边的人说：昨天吃晚饭好好的，唱歌作乐，睡着后忽然喉咙痛醒来。我用炙附子如细米大小的一粒，放在他舌上，吞咽唾液几口，痊愈。
一位妇人小腿被烫伤，被医生用冰片研碎融入雪水敷在上面，不一会儿，腿肿得像斗一样，疼痛极难忍受。请我治疗，妇人说：只求止痛，死了也甘心。我说：幸好是在小腿下体硬地上，如果烫在腰腹，用这一敷，火毒进入腹部，难以挽回。用地榆研细，调油拂在上面，半刻钟疼痛停止。让她自己拂拭，一两次就痊愈了。一个使女被炭火烫伤脚背，烂了一个孔，用伏龙散乳汁调敷，不到三天就痊愈了。又邻居家一个孩子，炉上滚汤浇在腹部，因疼痛用手扒破腹皮，油拂上一次疼痛平息，用地榆末干撒在破处，第二天肌肉生长，未破的地方痊愈。
宜兴冯悠也，右足背连小腿转弯处，起初不过是烫伤毒气而成烂腿。三十多年，四周长出硬块，小腿足肿得像斗一样，烂腿可容纳大拳头，有时出血，有时常流臭脓，满屋难闻。自己用布包成砖块一块，填入孔内，否则空痛。当时七十四岁，雍正六年，请我治疗，用老蟾蜍剖腹，蟾身刺几个孔，用蟾肚杂肉代替包裹，填入孔内，蟾身覆盖孔外，每天煎葱椒汤，待温，早晚各洗一次，用新蟾替换贴敷。内服醒消丸，也是早晚各服一次，三日后，取地丁、牛大力鲜草，捣烂填孔，外盖乌金膏，仍每日服用醒消丸。其肛门外四周硬块，内有皮中渗出清水者，用嫩膏加五美散敷。内有发痒者，用白花膏贴。内有块硬如石头者，用生商陆捣烂涂。因为孔内常有血出，先用参三七末撒在里面，其次用地丁、牛蒡叶、根捣烂填塞，这样二十多天，腿才退肿痒息，而其硬块及硬肛都平了，皮色退黑，内肉鲜红，患口收小平浅，可以不用草填，每日撒上五宝散，仍贴乌金膏。因为老翁精神不衰，饮食不减，始终不补收功。
宜兴徐玉梧的儿子，周岁半。太阳穴一处毒，背上心脐相对处两处毒，颈后口相对处一处毒，腰腹两处毒，两条腿五处毒，共患十一处毒，都是皮色不变。其大腿两处毒，已经被他那里的医生开刀。听说我到了，请我治疗。用小金丹令其每日服用二次，第五天消去九处毒，消后又服用一次小金丹。因为孩子小，令其添一名乳母，十天后，两个伤口都红润，用保元汤，人参、甘草皆用生品，加肉桂三分，煎一杯许。另用水煎人参六分合服。半月后，用人参、甘草换为炙品服用痊愈，一个月收功。
常熟赵太元的长子，患横痃，被医家开刀。请我治疗，我问开刀几个月了，他说已有半个月了。我说：这个病患破了则难治，还有九个月的寿命。随即辞别。分别后三百天，他的亲戚从苏州来告诉，已经死了一个多月。
兴邑路姓七岁儿童，顶门只有一寸许，并患三个疽，溃烂很久不收敛，孔像棋子大，浅而无脓，干枯而色灰，人疲倦无神。因为服用凉剂过多，饮食不进，请我治疗。我说：颜色像香灰，是气血两丧；无脓干枯，精神已绝。兼值不进食，难以延长寿命，怎么能治！第二天就夭折了。
枫镇闵姓，年龄十岁以上，颈部患瘰疬，烂成片，蔓延至耳腋及腰部，像手掌大的有几处，瘦弱怯懦。起初用洞天救苦丹服用，毒水大量流出，十日后用阳和汤、醒消丸每日早晚各服一次，十日脖子能舒转，饮食日增。外贴阳和膏，内服大枣丸。嗣后仍用前膏贴敷，始终用荆芥汤清洗，用山莲散敷，九十日收功。因为没有服用子龙、小金二丸，其毒根未除，后来腋下生恶核，仍以子龙丸消除以防患。
山塘姚姓女儿，二十九岁，小产一个多月。左肩手搭处，先发一处毒，周围有一尺五，患病后半个月，背脊添出一处毒，自上至下，计长一尺三寸，上阔下尖，都是白陷。十日后才请我治疗，其势很严重，连服阳和汤三剂，人能坐起，五剂自能大小便，十二剂其续发的全消。先发的搭手，其余地方都消，只剩患顶有脓的，像棋子大，脓足不痛而穿，四天收功。后来说背上像负一块板，舒转不快，用小金丹十丸，每日二丸，服完，肌肤不板，神色复元。
程姓母亲七十岁，膝下患一处阴毒流注，溃烂经数月，患下及旁，又起硬肿两块，与旧患相连。延请一位医生，将新发的毒误认为是旧患旁的肿，不认识流注，竟用托毒的药剂给其服用。服两剂，导致新发的被托发痛，才请我治疗。我用阳和汤给其服用三剂，新发的两处毒都消，接着服小金丹十丸，后进滋阴温补，用杏仁散敷，半月脓浓，令服保元汤加肉桂，十余剂痊愈。
王姓儿媳，颈内瘰疬数个，两腋恶核三个，又大腿患一处毒，不作疼痒。百余日后，日渐发大，形几乎像斗，按压像石头，皮现青筋，常用抽痛。经治数人，都称为瘤。我说：瘤是软的，世上没有石硬的瘤，这是石疽。问可治否，回答说：初起时皆可消，日久发大，上现筋纹，虽按之如石，其根下已成脓了。如果偶作一抽之痛，是有脓的证候，上现青筋的，其内已作黄浆，可治。如上现小块，高低如石岩的，不治。三百日后，主发大痛，不溃而死。如现红筋的，其内已痛，血枯不治。倘生斑点，即自溃的证候。溃即放血，三日内毙。现在患所现青筋，医至患软为半功，溃后脓变浓浓，可冀收功也。外用活商陆捣涂，内服阳和汤，十日则止一抽之痛，十三剂里外作痒，十六剂顶软，十八剂通患全软。其颈项的肿块，两腋的恶核，尽行消散，一无痕迹。只剩石疽未平，内脓袋下，令服人参一钱，因为在筋络之处，先用银针刺穿，后用刀扩大其口，用纸钉塞入孔内，其次入两次流水斗许。大剂滋补托里，删去人参，倍增生黄芪，连进十剂，相安已极。适有其亲戚，也行外科道者，令其人参、甘草换为炙品，服不三日，四外发肿，内作疼痛。又请我治疗，我令其照前方服用，又服二十余剂，外用阳和膏，随其根盘贴满，独留患孔，加以布捆绑。人问为什么既用膏贴，又加布绑，回答说：凡是属阴疽，外皮活，内膜生，所以开刀伤膜，膜烂则死。所出的脓，在皮里膜外，仅似空弄，又不能以生肌药放入，故内服温补滋阴活血之剂，外贴活血温暖膏药，加之以捆，使其皮膜相连，易于脓尽，且又易于连接生肌。绑后数日，内脓浓浓，加人参服两月收功。
宜兴一船夫，阴囊形大如斗。被走方者穿之，不数日，烂见肾子，像鸡蛋大，旁有一筋，六七寸长，形若鸡肠双环，随肾子落出，臭气难闻。令用紫苏煎汤洗净其筋上烂腐，问其肾子、小便、小肚子痛否？他说：都不痛。我说：这三处作痛难治，现在不痛的，可治。每日用紫苏汤洗，洗后用苏梗为末撒上，用青荷叶包之。内服黄连、归尾、黄芩、甘草、木通等药十剂。五日后肾子收上，烂孔收小。这不是患毒，乃是损伤，口既收小，肌色红白，内服地黄汤，外敷生肌散而愈。
福建客商，满身广豆，又患横痃。我想横痃乃阴虚之症，药宜温补；广豆系火毒之症，药宜凉解，二症相背，既利于毒，必害于疽，务使二症皆宜之药，非犀黄丸，外无他法。令其每日空心时，酒送三钱，十服，二症痊愈。后一人毒重者，倍服而愈。
妇人，项部痰核三处，年久生管，延治。用拔管药插入，每日更换，半月愈两处，惟有一管，浅如一粒米。不料丈夫远归，两天管深如旧。我说：此刻治，定无功效，容日商治。她母亲问我，我说：等她女婿外出，半月亦可收功。数日后，接女儿归，延治而愈。又，壮年，臂有二管，问她可有暗疾，说有梦遗。我用六味地黄丸删去泽泻，增线胶、龙骨、芡实、莲须为丸，鹿含草煎汤，晨夕各送三钱，服完，二管皆痊。
一妇人，两乳皆患乳岩，两年如桂圆大，从未延医。因为儿子死悲哭发威，形大如杯，用五灵脂、犀黄丸，每日早晚轮服，九日全消。又，男子乳亦患，因为邻居送鲫鱼膏粘贴，两天发大如拳，色红始来。令其揭下，与服阳和汤四剂，如果色转白可救。色若仍红，无救矣。四天，患色仍红，哀恳求治，用犀黄丸、阳和汤轮服，服至十六日，其余皆消，独患顶溃，用蟾蜍拔毒三日，半月收功。
洞庭秦卜年，项腋恶核十二处，服连翘、昆布等药病重，又被刺破，烂经三年，始来就医。用阳和汤、犀黄丸轮服半月，十中愈八，喜甚，带药而回。路遇凉粉买食，到家又食冷水激面，次日二便皆闭，第五日死。此病者自不惜命，故记以为病者之戒。
南濠客叶姓，耳下并患恶核，一被针穿生管，一大如杯，用阳和、小金轮服，未溃的全消。他问管可易愈否？我说：消管甚易，管消即敛。如果将敛，一经走泄，管即复生，愈期难订。彼系真诚，果即敛。
洞庭钱永泰之子，患痘毒，医生用清火解毒之剂，以一医毒增六七，再医毒生二十，医至第二年，孔皆有管，日流臭脓，右足缩不能行，坐卧三年，始来就治。用阳和、小金、犀黄等丸与服，内用化管药，半月愈半，一月管化，有多骨者亦出。他想领儿子回家，才用生肌散并调和气血之丸与回。任子率性，想吃什么就给什么，不洗就停，不敷就停，每日以酸橙石榴等果消闲，严冬复臭难闻。我说：臭则烂，香则生。肌寒疽未敛，日食酸涩，领回三月，患管复旧，乃父母害之也。
妇人，乳患一白疽，寒热痛甚，我用阳和丸同二陈汤煎服，得睡痛息，连进三服痊愈。
又妇人，患者相告，她弟弟也习外科，用夏枯草、花粉、连翘、橘叶等药，连服五剂，号痛不绝。延治，我看向白色变微红，难以全消，即写肉桂、炮姜、麻黄，加二陈汤，令其煎服，当晚痛止能睡，明日皱皮缩小，服下果然，连进数剂，患项不痛而溃。贴阳和解凝膏收功。
木渎镇谈姓妇人，背患如碗，初起色白，近已转红，痛甚，时值三伏，我以阳和汤书毕，旁人云：此暑天缘何用麻黄发表，桂、姜之热剂，我说：此阴症也。彼云：患色转红，阴已变阳。我因其说，恐患家疑惧，立令等候煎服，服不超时，痛息，接服四剂，患消七分，其有脓之三分，不痛而溃，五日收功。
一童十一岁，手足臂腿及指头面遍身浮肿，数日后，日增沉重，以致气喘不能眠。偶有远客，令觅黄皮柑子一只，同酒酿二斤，煎至将干，去柑内核，取连酒酿食之，二次痊愈。
This is a bizarre condition, which occasionally occurs in the world. After childbirth, both breasts elongate, becoming thin like chicken intestines, hanging down past the lower abdomen, with pain that is unbearable. Urgently use Chuanxiong Rhizoma (Chuanxiong) and Danggui Radix (Danggui), take four liang of each first, slice them, decoct in water, and take frequently. Take the remaining one jin and half, cut into large pieces, place a table in front of the parturient woman, put a charcoal stove underneath, and slowly roast the Chuanxiong and Danggui in the stove. Let the woman lie prone on the table, inhaling the smoke from her mouth and nose and breasts. If the smoke dissipates and the disease is not cured, repeat the previous method of decoction and fumigation; the breasts will then retract. If it cannot be saved, take one seed of Ricinus communis L. (Bimazu), grind it with cold water to make juice, and apply it to the top of the head. When the breasts return to their original size, wash it off immediately for recovery. If she gives birth again after recovery, the disease will definitely recur and be incurable.
Therefore, plasters should not be prepared by decocting Ricinus communis L. (Bimazu). If applied to sores or boils on the lower body of a pregnant woman, it may cause abortion. Postpartum women do not realize the harm of plasters, so applying them again can be fatal. Thus, the dangers of Croton tiglium L. (Badou) and Ricinus communis L. (Bimazu) are as follows.
Mr. Ma said: This is an ancient prescription, safe and effective. If there is no response, add eight liang of Scutellariae Radix (Huangqin), decoct and take it, and it will be effective.
Mr. Tao said: Binding the breasts with the foul cloth used by foot-binding women can also make them retract.
The proverb says: Seeing is better than learning a thousand times. Therefore, when studying medicine under a master, one must follow the master's guidance and observe cases clinically, hoping to broaden one's horizons and knowledge, so that one can handle diseases without doubt. I have thus selected one or two strange, dangerous, and critical cases from my forty years of clinical experience, along with treatments based on deduction and reasoning, and recorded them below for students to reference, sparing them the need for masters to lead them in clinical observation.
A man surnamed Gong from Changmen suffered from a carbuncle on his waist. The base spread over two chi in circumference, extending forward to the abdomen and backward to the bones. It was neither red nor swollen, neither painful nor soft, and felt hard like wood upon pressure. Initially, he consulted me, and I prescribed Rougui (Cinnamon Bark) and Paojiang (Prepared Ginger) at the beginning of the prescription. Afterwards, he sought treatment from three or four famous doctors inside and outside Suzhou City. They all criticized my prescription, asking how heat-inducing medicines could be used in the intense summer heat. Disagreeing with me, they proposed using purgative and cooling methods. After five days of treatment, the patient became comatose and lost his stomach qi. He then consulted me again. The lesion remained painless, the color resembled overnight pork liver, speech was slurred, and he could not eat or drink. I said, "If he survives until tonight, we can discuss further." He died that night. However, he did not feel pain even until death. Soon after, his relative suffered from the same condition. I treated him with Yanghe Decoction (Warming Yang and Resolving Phlegm Decoction). The next day, he felt relieved. After continuing the medication, the carbuncle reduced by less than half. Then, Xihuang Wan (Calculus Bovis Pill) and Yanghe Decoction were administered alternately morning and evening. By the fifth day, he recovered. Later, patients with similar back carbuncles recovered with the same treatment.
A young man married for one hundred days had his wife return to her mother's home for a month. During the intense summer heat, perhaps due to indulgence in coolness or fan usage, at dawn (five o'clock), he experienced throat pain and rebellious qi, alternating chills and fever. Upon inquiry, he said his throat had slight pain three days ago, but at dawn today, the swelling and pain became severe. His uvula was swollen as thick as a fat person's thumb. I diagnosed this as fire from deficiency and excess of the Heart and Kidney, combined with wind invasion after intercourse, resulting in a blockage of wind and fire. Using dispersing exterior methods would increase deficiency, while using cold medicines would trap wind and fire. Therefore, I prescribed Qianhu (Peucedani Radix), Su Zi (Perillae Fructus), Lianqiao (Forsythiae Fructus), Xuanshen (Scrophulariae Radix), Chishao (Paeoniae Radix Rubra), Zhebei Mu (Fritillariae Thunbergii Bulbus), Gancao (Glycyrrhizae Radix et Rhizoma), and Jiegeng (Platycodonis Radix) decocted together. He recovered immediately.
A neighbor friend drank wine at my house and left at the second watch. The next morning, his servant reported that his penis was swollen and painful, making urination difficult, and sent someone to request medicine. I deduced that after drinking and intercourse, his wife wiped him with unwashed silk cloth that had likely been bitten by venomous insects. I immediately used Xianren Duizuo Cao (Sarcandra glabra) to resolve snake venom and Geren Teng (likely a local herb for centipede venom) to resolve centipede venom. These herbs were crushed, juice extracted, mixed with realgar powder, and applied. Pain and swelling subsided immediately, and he recovered by afternoon.
A village woman from Wuxi, aged thirty, was hungry on the afternoon of the fifteenth day of the fifth lunar month. As she was about to eat noodles, she suddenly experienced severe throat pain preventing eating. A local doctor prescribed Shegan (Belamcandae Rhizoma), Chishao, Lianqiao, Huangqin, Huafen (Trichosanthis Radix), and Niubangzi (Arctii Fructus) decocted. Immediately after taking it, phlegm surged filling her mouth, sounding like snoring, unable to spit out, with phlegm obstructing the mouth. Upon inquiry, I learned it was sudden onset. Moreover, taking cold medicines increased the danger. This was undoubtedly a yin-cold syndrome. However, with phlegm blocking the throat, administering medicine was extremely difficult. I took a goose feather dipped in a small amount of tung oil, inserted it into the throat, rolled it once, and the phlegm came out with the feather, vomiting about one sheng. I placed Rougui, Paojiang, and Sheng Gancao (Raw Licorice), each 5 fen, in a bowl, poured boiling water over them, kept the bowl in hot water, and fed her a spoonful. She immediately said she felt better. After three or four spoonfuls, she stood up, said she was hungry, and asked if she could eat rice. I replied that porridge was best.
A craftsman from Nanhao requested treatment for a throat condition at midnight. He could not answer questions. Bystanders said he was fine during dinner, sang and played music, fell asleep, and woke up with sudden throat pain. I placed a grain-sized piece of Zhifu Zi (Prepared Aconiti Lateralis Radix) on his tongue. He swallowed saliva several times and recovered.
A woman's calf was scalded. A doctor applied Bingpian (Borneolum Syntheticum) ground in snow water. Within moments, her leg swelled to the size of a dou, with excruciating pain. She begged me to relieve the pain, saying she didn't mind dying. I said, fortunately, it was on the hard ground of the lower calf. If it were on the waist or abdomen, this application would drive the fire toxin inward, making it incurable. I ground Diyug (Sanguisorbae Radix), mixed it with oil, and applied it. Pain stopped in half a moment. She applied it herself, recovering in one or two applications. A maid was scalded on the dorsum of her foot, causing a sore. I applied Fulong San (Dragon's House Powder) mixed with milk. She recovered in less than three days. Another neighbor's child was scalded on the abdomen by boiling water. In pain, he tore his abdominal skin with his hands. One application of oil stopped the pain. Dry dusting of Diyug powder on the wound promoted tissue regeneration the next day, and the unbroken skin healed.
Feng Youye from Yixing had a rotting leg on the right dorsum of the foot extending to the calf turn, initially caused by a scald. For over thirty years, hard nodules appeared around it, and the calf and foot swelled to the size of a dou. The rotting leg could accommodate a large fist, sometimes bleeding, often discharging foul pus, filling the room with odor. He packed it with cloth wrapped like a brick to fill the hole, otherwise it hurt deeply. At seventy-four years old, in the sixth year of Yongzheng, he consulted me. I used an old toad, opened its belly, pierced holes in its body, stuffed the cavity with toad viscera, and covered the external hole with the toad body. Every day, decoct Congjiao Tang (Green Onion and Pepper Soup), wait until warm, and wash morning and evening, replacing the toad daily. Internally, Xingxiao Wan (Awakening Stasis Pill) was taken twice daily. After three days, fresh Diding (Sonchidis Herba) and Dali Li (likely Arctii Fructus or similar) were crushed and stuffed into the hole, covered externally with Wu Jin Gao (Black Gold Plaster), and Xingxiao Wan continued daily. For hard blocks outside the anus with clear fluid exuding from the skin, Nen Gao (Young Plaster) mixed with Wu Mei San (Five Beauty Powder) was applied. For itching, Bai Hua Gao (White Flower Plaster) was used. For hard stones-like lumps, raw Shanglu (Phytolaccae Radix) was crushed and applied. Due to frequent bleeding from the hole, Sanqi (Notoginseng Radix) powder was sprinkled inside first, followed by stuffing with Diding, Niu Bang Ye (Arctii Folium), and root. After twenty-plus days, the leg swelling and itching subsided, hard blocks and nodules flattened, skin color darkened then turned black, inner flesh became bright red, the wound closed and shallowed, allowing cessation of grass packing. Daily application of Wu Bao San (Five Treasures Powder) and Wu Jin Gao continued. Since the old man's spirit and appetite remained strong, no tonifying herbs were used to close the wound.
Xu Yuwu's son from Yixing, aged one and a half years, suffered from eleven toxic swellings: one on the Taiyang area, two opposite the heart and navel on the back, one opposite the mouth behind the neck, two on the waist and abdomen, and five on both legs. All had normal skin color. Two on the thighs had already been incised by local doctors. Upon hearing of my arrival, they requested treatment. I prescribed Xiao Jin Dan (Little Golden Pill) twice daily. By the fifth day, nine swellings resolved. One more dose of Xiao Jin Dan was given. Due to the child's age, a wet nurse was added. After ten days, two wounds were reddish and moist. Baoyuan Tang (Protecting Origin Decoction) with raw Renshen (Ginseng Radix) and Gancao, plus 3 fen of Rougui, was decocted in one cup. Additionally, 6 fen of Renshen was decocted separately and mixed. After half a month, Renshen and Gancao were switched to processed forms. Recovery was achieved in one month.
Zhao Taiyuan's eldest son from Changshu suffered from Hengxuan (Inguinal Abscess/Glandular Swelling) and was incised by a doctor. I asked how long since the incision. He said half a month. I said, "Once broken, this is difficult to treat. He has nine months to live." I left. Three hundred days later, his relative from Suzhou reported he had died for over a month.
Lu family's seven-year-old boy from Xingyi had only an inch of hair on the crown and suffered from three abscesses. Ulcerated for a long time without healing, the holes were chess-piece sized, shallow, without pus, dry, and grayish. The child was listless and spiritless. Due to excessive intake of cold medicines, he could not eat. I said, "Gray color indicates loss of qi and blood; dryness without pus indicates exhaustion of essence and spirit. Combined with anorexia, life cannot be prolonged. How can it be treated?" He died the next day.
Min family from Fengzhen, aged over ten, suffered from Luoli (Scrofula) on the neck, ulcerating into patches, spreading to ears, armpits, and waist, with palm-sized areas. The child was emaciated and timid. Initially, Dongtian Jiuku Dan (Heavenly Cave Salvation Pill) was taken, causing massive discharge of toxic fluid. After ten days, Yanghe Decoction and Xingxiao Wan were taken morning and evening. After ten days, neck mobility improved, and appetite increased. Yanghe Gao (Yanghe Plaster) was applied externally, and Da Zao Wan (Jujube Pill) internally. Subsequently, the plaster was continued, neck washed with Jingjie Tang (Schizonepeta Decoction), and Shanlian San (Lotus Seed Powder) applied. Recovery took ninety days. Because Zilong Wan and Xiao Jin Dan were not taken, the toxin root remained. Later, malignant nodes appeared in the armpit, which were resolved with Zilong Wan to prevent recurrence.
Yao family's daughter from Shantang, aged twenty-nine, had a miscarriage over a month ago. A toxicity appeared where the left shoulder meets the hand, surrounding one chi five cun. Half a month later, another toxicity appeared on the back, extending from top to bottom, one chi three cun long, wide at top and pointed at bottom, all white and depressed. Ten days later, she consulted me. The condition was severe. After three doses of Yanghe Decoction, she could sit up. After five doses, spontaneous urination and defecation resumed. After twelve doses, subsequent toxicities resolved. The initial toxicity on the shoulder resolved except for a chess-piece sized area of pus at the apex. After four days, it burst painlessly, and recovery was achieved. She later complained of stiffness on the back. Ten pills of Xiao Jin Dan were taken, two daily. After finishing, skin stiffness resolved, and spirit returned.
Mother of Cheng family, aged seventy, suffered from Yin Du Liu Zhu (Yin Toxic Flowing Abscess) below the knee, ulcerated for months. New hard swellings appeared below and beside the old lesion. A doctor mistook the new toxicity for swelling beside the old lesion, failing to recognize Liu Zhu, and prescribed Tu Du (Pushing Toxin Out) agents. After two doses, the new toxicity became painful. I then treated her with Yanghe Decoction for three doses, resolving both new toxicities. Then, ten pills of Xiao Jin Dan were taken. Subsequently, nourishing yin and warming tonics were used, with Xingren San (Almond Powder) applied externally. After half a month, pus thickened. Baoyuan Tang with Rougui was taken for over ten doses, leading to recovery.
Wang family's daughter-in-law had several Luoli in the neck, three E He (Malignant Nodes) in armpits, and a toxicity on the thigh without pain or itching. Over a hundred days, it grew larger, reaching the size of a dou, hard as stone, with blue veins visible, and occasional throbbing pain. Several doctors called it a tumor. I said, "Tumors are soft. There are no stone-hard tumors in the world. This is Shi Ju (Stone Carbuncle)." Asked if curable, I replied, "Curable if treated early. If large with visible veins, though hard, pus has formed at the root. Occasional throbbing indicates pus. Blue veins indicate yellow pus inside; curable. Small, uneven, rock-like protrusions are incurable. After three hundred days, severe pain will occur, leading to death without ulceration. Red veins indicate internal pain and blood exhaustion; incurable. Spots indicate spontaneous ulceration. Bleeding upon ulceration leads to death within three days. Currently, blue veins indicate that softening the lesion halfway through treatment allows recovery after ulceration with thick pus. Externally, fresh Shanglu was crushed and applied. Internally, Yanghe Decoction was taken. After ten days, throbbing stopped. After thirteen doses, itching occurred internally and externally. After sixteen doses, the apex softened. After eighteen doses, the entire lesion softened. Neck masses and armpit nodes dissipated completely. Only the Stone Carbuncle remained. Pus bag formed underneath. One qian of Renshen was taken. Since it was in the meridian area, silver needles pierced it first, then the opening was widened with a knife. Paper wicks were inserted, and two dou of flowing pus drained. Large doses of tonifying and supporting interior herbs were used. Renshen was removed, and Sheng Huangqi (Raw Astragalus Radix) was doubled. Ten doses were taken continuously, bringing stability. A relative practicing surgery suggested switching Renshen and Gancao to processed forms. After three doses, swelling occurred externally, and internal pain arose. I instructed to continue the previous prescription for twenty-plus doses. Externally, Yanghe Gao was applied covering the base, leaving only the wound open, bound with cloth. Asked why plaster and binding were used together, I explained: For Yin Ju, outer skin becomes active, inner membrane regenerates. Incision damages the membrane; if the membrane rots, death ensues. Pus lies between skin and membrane. Cannot place tissue-regenerating drugs inside. Therefore, internal warming, tonifying, nourishing yin, and activating blood herbs are used, along with external warming and blood-activating plasters. Binding connects skin and membrane, facilitating pus drainage and tissue connection. After binding, pus thickened. Adding Renshen led to recovery in two months.
A boatman from Yixing had a scrotum swollen to the size of a dou. A wandering practitioner punctured it. Within days, the testicle exposed, egg-sized, with a tendon six to seven cun long, shaped like double chicken intestines, protruding with the testicle, emitting foul odor. I ordered washing the rotten tendon with Zisu (Perilla Leaf) decoction. Asked if testicle, urine, or lower abdomen hurt? He said no. I said, pain in these three areas is difficult to treat; no pain means curable. Daily washing with Zisu decoction, followed by dusting Sugen (Perilla Stem) powder, wrapped in green lotus leaves. Internally, Huanglian (Coptidis Rhizoma), Guiwei (Angelicae Sinensis Radix Tail), Huangqin, Gancao, and Mutong were taken for ten doses. After five days, the testicle retracted, and the sore shrunk. This was not toxicity but injury. With shrinking opening and reddish-white tissue, Dihuang Tang (Rehmannia Decoction) was taken internally, and Shengji San (Tissue Regeneration Powder) applied externally for recovery.
A Fujian merchant had widespread Guang Dou (likely referring to a specific skin condition or toxin) and Hengxuan. I reasoned Hengxuan is a yin-deficiency syndrome requiring warming tonics; Guang Dou is a fire-toxin syndrome requiring cooling resolution. These contradict. A drug benefiting one harms the other. Only Xi Huang Wan (Calculus Bovis Pill) suits both. Taken with wine on an empty stomach, three qian daily for ten doses, both conditions resolved. Later, a patient with heavier toxicity recovered with double dosage.
A woman had three phlegm nodules on the neck, forming sinuses over years. Treated with sinus extraction medicine. Changed daily, two healed in half a month, one remained shallow. Unexpectedly, her husband returned from afar, and the sinus deepened in two days. I said, "Treatment now will be ineffective. We will discuss later." Her mother asked. I said, "Wait for your son-in-law to leave; it can heal in half a month." Days later, the daughter returned, and treatment led to recovery. Another young man had two sinuses on the arm. Asked if he had hidden issues, he admitted nocturnal emissions. I modified Liu Wei Di Huang Wan by removing Ze Xie, adding Xian Jiao (Thread Collagen?), Long Gu (Fossilized Bones), Qianshi (Euryales Semen), and Lian Xu (Nelumbinis Stamen) into pills. Deer Antler Grass (Luhanzcao) decoction was taken morning and evening, three qian per dose. After finishing, both sinuses healed.
A woman had Ru Yan (Breast Cancer) in both breasts, lasting two years, size of a longan fruit, never treated. Due to grief over her son's death, the lesions grew to cup size. Wutong (likely a local herb or typo for Lingzhi/Wutong Pi) and Xi Huang Wan were taken alternately morning and evening. Fully resolved in nine days. Another man had breast toxicity. Neighbor applied Ji Yu Gao (Crucian Carp Plaster). In two days, it grew fist-sized and red. Removed plaster, gave Yanghe Decoction for four doses. If color turns white, curable. If still red, incurable. Four days later, color remained red. Begged for treatment. Xi Huang Wan and Yanghe Decoction alternated. After sixteen doses, others resolved, only the apex ulcerated. Chan (Toad) detoxification for three days, recovery in half a month.
Qin Bunian from Dongting had twelve malignant nodes in neck and armpits. Condition worsened with Lianqiao and Kunbu. Punctured and ulcerated for three years before seeking medical help. Yanghe Decoction and Xi Huang Wan alternated for half a month. Eight out of ten healed. Joyfully took medicine home. Bought and ate cold jelly, then cold water noodles. Next day, urinary and fecal retention. Died on the fifth day. This patient disregarded his life, so I record this as a warning.
Ye family guest from Nanhao had malignant nodes under ears. One punctured and formed a sinus, one cup-sized. Yanghe and Xiao Jin alternated. Unulcerated ones resolved. Asked if sinus heals easily. I said, "Sinus resolution is easy; healing follows. If nearly healed, any leakage causes recurrence, making prognosis uncertain." Being sincere, it healed.
Qian Yongtai's son from Dongting had smallpox toxin. Doctors used clearing fire and detoxifying agents. First doctor increased toxin by six or seven times; second doctor generated twenty more. By the second year, all holes had sinuses, discharging foul pus daily. Right leg contracted, unable to walk. Bedridden for three years before treatment. Yanghe, Xiao Jin, Xi Huang pills taken. Internal sinus-resolving medicine used. Half healed in half a month, sinuses resolved in one month, including bone fragments. Wanted to take son home. Given Shengji San and Qi Blood harmonizing pills. Son ate whatever he wanted, refused washing and dressing, ate sour fruits like orange and pomegranate daily. In severe winter, odor returned. I said, "Rot smells bad, healing smells good. Cold muscle and unhealed ju, daily sour/astringent food. Returned for three months, sinuses reverted. Parents harmed him."
A woman had Bai Ju (White Carbuncle) in breast, with chills, fever, and severe pain. Yanghe Wan and Er Chen Tang decocted together. Slept, pain ceased. Three doses led to recovery.
Another woman reported her brother, also a surgeon, used Xiaku Cao, Huafen, Lianqiao, Juye for five doses. Crying and pain persisted. I examined, seeing white turning slightly red, difficult to fully resolve. Prescribed Rougui, Paojiang, Mahuang, plus Er Chen Tang. Took it that night, pain stopped, slept. Next day, skin wrinkled and shrank. Continued doses, lesion became painless and ulcerated. Yanghe Jiening Gao applied for recovery.
Tan family woman from Mudu Town had a bowl-sized back lesion. Initially white, turned red, severe pain. During Dog Days, I wrote Yanghe Decoction. Bystander asked why use Mahuang for exterior release and heat-inducing Gui/Jiang in summer. I said, "This is a yin syndrome." They said, "Red color means yin changed to yang." Fearing patient anxiety, I ordered immediate decoction. Pain ceased shortly after taking. Four additional doses reduced lesion by 70%. The 30% with pus ulcerated painlessly. Recovery in five days.
An eleven-year-old boy had edema on hands, feet, arms, legs, fingers, face, and whole body. Heavy breathing prevented sleep. A distant guest suggested finding one Huangpi Ganzi (Yellow-skinned Citron), decocted with two jin of fermented rice wine until dry. Remove seeds, consume with wine. Recovered in two doses.
Mr. Ma said: The above cases have merits and flaws, stated in each case. No further elaboration here.