氏目击心伤。所以慎疾刍言有制剂之说也。拙稿本卷第二条言。“用药治病。先须权衡病。人胃气。”亦此意也。
乃医家病家。往往不达此理。以致误药伤生。可慨已。洄溪一案。备录于后。足为世鉴焉。郡中朱姓。有饮癖。在左胁
下。发则胀痛呕吐。始发甚轻。医者每以补剂疗之。发益勤而甚。余戒之曰。“此饮癖也。患者甚多。惟以清饮通气
为主。断不可用温补。补则成坚癖。不可治矣。”不信也。后因有郁结之事。其病大发。痛极呕逆。神疲力倦。医者乃
大进参附。热气上冲。痰饮闭塞。其痛增剧。肢冷脉微。医者益加参附。助其闭塞。饮药一口。如刀箭攒心。哀求免服。
妻子环跪泣求曰。“名医四人。合议立方。岂有谬误。人参如此贵重。岂有不效。”朱曰。“我岂不欲生。此药实不
能受。使我少缓痛苦。死亦甘心耳。必欲使我痛极而死。亦命也。”勉饮其半。火沸痰壅。呼号宛转而绝。大凡富贵
人之死。大半皆然。但不若是之甚耳。要知中病之药。不必入口而知。闻其气即喜乐欲饮。若不中病之药。闻其气
即厌恶之。故服药而勉强苦难者。皆与病相违者也。内经云。“临病患。问所便。”此真治病之妙诀也。若孟子所
云。“药不瞑眩。厥疾不瘳。”此乃指攻邪破积而言。非一例也。此案载王孟英归砚录。自注云。“余编洄溪医案。
漏此一条。迨刻竣始知之。不便补镌。故录于此。”按洄溪医案为王孟英所编刻。其中疑有托名之案。又慎疾刍
言一书。其序文与徐氏六书各序。文笔极不类。疑亦是托名者。然观古人书。立议处方。平正通达。便足师法。否则。
即使真本。亦难信从。正不必辨其真伪也。
〔三十四〕单方治食羊肉成积。煮栗壳汤饮之。立效。壳用外层有毛刺者。阅白云集（钱唐张绣虎贲着。）载“姑苏
钱禹功之父守默。疗病多神异。长洲王司寇二子对食羊肉。腹膨胀。气垂绝。令沸酒一石。徐沃其腹。饮栗壳汤。立愈。
栗能令羊瘦。羊系栗下。食其壳则羸瘠。出杂志中。本草所无也。”乃知单方亦有来历。又治一贵人患痫。笑不止。令满
堂陈红氍毹五色缯以相乐。顷之。一伧父突入。满身垢尽污之。贵人大怒。起逐伧父。绕堂走。逸去。不可得。贵人力
惫。鼾卧三日夜。乃起。疾竟脱。贵人病在脾。性素悭。激其怒。以肝胜之也。二案推究物理人情。深得古圣治病遗意
后一案不特激肝怒以治脾病。且使劳动之。动则阳生。所以治阴滞也。正内经“逸者行之”之旨也。
〔仲圭按〕存存斋医话稿。何廉臣叙中云。共五卷。但镌版行世者。只此而已。即此二卷。据余所见。仅大小两种
木刻版本。今且绝版无购处矣。三卷 疹痧疹二节。录自绍兴医药月报第一卷五六两号。注者杨质安。系赵
氏弟子。蛰庐不知与赵氏有无渊源也。
〔吉生按〕赵氏后辈。藏有散稿。不事整理。先人手泽。湮没不传。洵为可惜。蛰庐。即杨先生之别号。
这位先生目睹了这些惨状，内心深感悲痛。因此，在《慎疾刍言》中提出了关于药物制剂（指药物的炮制、剂型及配伍比例等）的见解。拙作本卷第二条中提到：“用药治病，必须先权衡病情与患者胃气的强弱。”也是这个意思。
然而，医生和病人往往不理解这个道理，导致误用药物伤害生命，真是令人感慨啊。徐灵胎（号洄溪）的一个医案，详细记录在后面，足以作为世人的借鉴。
郡城中有一位朱姓患者，患有饮癖（水饮停聚形成的积块），位于左胁下。发作时胀痛并伴有呕吐。起初发病很轻微，医生每次都用补益剂治疗，结果发作越来越频繁且严重。我告诫他说：“这是饮癖病。患这种病的患者很多，治疗应以清化水饮、疏通气机为主，绝对不可使用温补法。如果用了温补，就会形成坚硬的积块，那就无法治愈了。”他不相信。后来因为遇到郁结的事情，病情大发，疼痛剧烈，呕吐逆乱，精神疲惫，身体倦怠。医生于是大量进用人参、附子等大热之药。热气上冲，痰饮闭塞，疼痛更加剧烈，四肢冰冷，脉象微弱。医生反而更增加人参、附子的用量，加重了闭塞。患者喝下一口药，感觉像刀箭刺心一样痛苦，哀求不再服用。妻子和儿女围跪在地上哭泣请求说：“四位名医共同商议开方，怎么会有错误？人参如此贵重，怎么会没有效果？”朱某说：“我难道不想活吗？但这药实在承受不了。让我稍微缓解痛苦，死了也甘心。如果一定要让我痛极而死，那也是命吧。”勉强喝了一半，体内火热沸腾，痰液壅塞，他呼号辗转而亡。大凡富贵之人的死亡，大半都是这样，只是不像这个案例这么严重罢了。要知道，对症的药物，不必入口就能知道；闻到它的气味就会感到喜悦想要饮用。如果不对症的药物，闻到气味就会厌恶。所以服药时觉得勉强、难受痛苦的，都是因为药物与病情相违背的缘故。《内经》说：“诊治病人时，要询问病人的喜好（以便顺应其情志或体质）。”这确实是治病的妙诀。至于孟子所说的“药不瞑眩，厥疾不瘳”（服药后如果没有出现头晕目眩等反应，重病就不会痊愈），这是针对攻邪破积类药物而言的，不能一概而论。
这个医案记载在王孟英的《归砚录》中，他自己注释说：“我编纂《洄溪医案》时，漏掉了这一条，等到刻版完成才知道，不便再补刻，所以记录在这里。”按：《洄溪医案》是由王孟英编纂刊刻的，其中怀疑有托名之作。另外，《慎疾刍言》一书的序文与徐氏《六书》的各篇序文，文笔风格极不相似，怀疑也是托名之作。但是，看古人的书籍，只要立论处方平正通达，就足以效法。否则，即使是真本，也难以让人信服。正不必去辨别它的真伪。
〔三十四〕单方治疗因吃羊肉导致的食积，煮栗壳汤饮用，立刻见效。栗壳要用外层有毛刺的那种。查阅《白云集》（钱塘张绣虎著）记载：“姑苏钱禹功的父亲钱守默，治病多有神异之处。长洲王司寇的两个儿子同时吃羊肉，腹部膨胀，气息垂危。钱守默让人烧沸一石酒，慢慢浇在他们的腹部，并让他们喝栗壳汤，立刻痊愈。栗子能使羊瘦，羊拴在栗树下，吃栗壳就会变得瘦弱，出自杂记中，本草书中没有记载。”这才知道单方也是有来历的。又有一个案例，治疗一位贵人患痫病，笑个不停。钱守默让人在满堂陈列红色的毛毯和五种颜色的丝绸来取乐。过了一会儿，一个粗鄙的人突然闯入，满身污垢弄脏了他们。贵人大怒，起身追赶那个粗鄙人，绕着堂屋跑，那人逃跑了，追不到。贵人用力过猛，精疲力竭，鼾睡了三昼夜，然后起来，病竟然好了。这位贵人的病在脾，性格向来吝啬，激发他的怒气，以肝木克脾土的原理来治疗。这两个案例推究物理人情，深得古代圣人治病的遗意。后一个案例不仅通过激发肝怒来治疗脾病，而且使病人活动，动则阳气生发，所以能治疗阴寒凝滞之证，正是《内经》“逸者行之”（对于安逸不动的病证，要用运动的方法治疗）的宗旨。
〔仲圭按〕《存存斋医话稿》，何廉臣在序中说共有五卷，但刻版流传于世的，只有这两卷而已。就这两卷而言，据我所见，仅有大小两种木刻版本，现在已经绝版，无处购买了。第三卷中的“疹痧”两节，摘录自《绍兴医药月报》第一卷第五、六两期，注者是杨质安，是赵晴的弟子。蛰庐（编者别号）不知道与赵氏是否有渊源关系。
〔吉生按〕赵氏的后辈藏有散乱的稿件，没有进行整理。先人的手泽（遗留的手迹或著作），埋没失传，确实可惜。蛰庐，就是杨先生的别号。
The physician witnessed these tragic scenes with a sorrowful heart. Therefore, in *Shenji Chuyan* (Cautious Words on Preventing Illness), he proposed theories regarding **drug preparation** (Zhi Ji, referring to the processing, dosage forms, and compatibility of herbs). In Article 2 of this volume of my humble manuscript, it is stated: "When using medication to treat disease, one must first weigh the condition of the disease against the strength of the patient's Stomach Qi." This conveys the same meaning.
However, physicians and patients often fail to understand this principle, leading to erroneous medication that harms life, which is truly lamentable. A medical case from Xu Lingtai (pseudonym Huixi) is recorded in detail below, serving as a warning for future generations.
In our prefecture, there was a surnamed Zhu who suffered from **Yin Pi** (a accumulation caused by retained fluids), located under the left hypochondrium. Upon onset, it presented with distending pain and vomiting. Initially, the attacks were mild. Physicians treated him repeatedly with tonifying formulas, resulting in more frequent and severe exacerbations. I warned him, saying, "This is Yin Pi. Many patients suffer from this; treatment should focus primarily on clearing fluids and promoting Qi circulation. Warm-tonifying methods must absolutely be avoided. If used, they will form hard accumulations that become incurable." He did not believe me. Later, due to emotional stagnation, his illness flared up severely. The pain was extreme, accompanied by violent vomiting, mental exhaustion, and physical fatigue. The physicians then aggressively administered large doses of Ginseng Radix et Rhizoma (Renshen) and Aconiti Lateralis Radix Praeparata (Fuzi). Heat surged upward, phlegm-fluids obstructed the channels, and the pain intensified. His limbs became cold, and his pulse was faint. The physicians increased the dosage of Renshen and Fuzi further, exacerbating the obstruction. After swallowing just one mouthful of the medicine, he felt as if knives and arrows were piercing his heart. He pleaded to stop taking it. His wife and children knelt around him, weeping and begging, "Four renowned physicians collaborated on this prescription; how could it be wrong? Renshen is so precious; how could it be ineffective?" Mr. Zhu said, "Do I not wish to live? But this medicine is truly unbearable. Let me alleviate my suffering slightly, and I would accept death willingly. If you insist on making me die in extreme pain, that is my fate." He reluctantly drank half. Internal heat boiled, phlegm became congested, and he cried out, rolled about, and then passed away. Most deaths among the wealthy follow this pattern, though not as severely as this case. One must know that appropriate medication can be recognized before ingestion; upon smelling its aroma, one feels joy and desires to drink it. Conversely, inappropriate medication causes aversion upon smelling it. Therefore, those who find taking medication forced and painful are taking drugs that contradict their condition. The *Neijing* states, "When attending to patients, inquire about their preferences." This is indeed the subtle secret of healing. As Mencius said, "If the medicine does not cause dizziness or vertigo, the serious disease will not be cured." This statement refers specifically to herbs that attack pathogens and break down accumulations, and cannot be applied universally.
This case is recorded in Wang Mengying's *Guiyan Lu* (Records from the Inkstone), where he added a note: "I omitted this entry when compiling *Huixi Yian*. I only realized it after the printing was completed. It was inconvenient to add it to the blocks, so I recorded it here." Note: *Huixi Yian* was compiled and printed by Wang Mengying. There is suspicion that some cases within it are pseudonymous. Furthermore, the preface to *Shenji Chuyan* differs significantly in style from the prefaces in Xu's *Liushu*, suggesting it may also be pseudonymous. However, when reading ancient texts, if the arguments and prescriptions are sound and accessible, they are worthy of emulation regardless. Otherwise, even authentic texts may be difficult to trust. Thus, distinguishing between authentic and forged works is not strictly necessary.
[34] A single herb remedy for food retention caused by eating mutton: decoct chestnut shells (Litchi Chinensis Exocarpium) and drink the soup. Immediate effect. Use the outer shell with spines. According to *Baiyun Ji* (written by Zhang Xiu Hu of Qiantang): "Qian Shoumo, father of Qian Yugong from Gusu, had miraculous healing abilities. The two sons of Minister Wang of Changzhou ate mutton simultaneously, resulting in abdominal distension and critical breathing. Qian Shoumo ordered one stone of boiling wine to be slowly poured over their abdomen, and instructed them to drink chestnut shell soup. They recovered immediately. Chestnuts can make sheep thin; sheep tethered under chestnut trees that eat the shells become emaciated. This comes from miscellaneous records and is not found in the *Bencao*." Thus, single-herb remedies have historical origins. Another case involved treating a nobleman suffering from epilepsy with uncontrollable laughter. Qian Shoumo ordered red carpets and five-colored silks to be displayed in the hall to amuse him. Suddenly, a rough man burst in, covering everyone with filth. The nobleman flew into a rage, chased the rough man around the hall, but the man escaped. Exhausted by the exertion, the nobleman slept heavily for three days and nights. Upon waking, his illness had completely vanished. The nobleman's disease was in the Spleen, and his nature was inherently stingy. By provoking anger (Liver Wood), it counteracted the Spleen Earth. These two cases demonstrate a deep understanding of natural laws and human emotions, inheriting the wisdom of ancient sages. The latter case not only used provoked Liver anger to treat Spleen disease but also induced movement. Movement generates Yang, thereby treating Yin stagnation, aligning with the *Neijing* principle: "For those who are sedentary, promote movement."
[Zhonggui's Note] In He Lianchen's preface to *Cuncunzhai Yihua Gao*, it is stated that the work consists of five volumes. However, only these two volumes were printed and circulated. Of these two, based on my observation, only large and small woodblock editions exist. They are now out of print and unavailable for purchase. The sections on "Rash" and "Sha" in Volume 3 were excerpted from Volumes 5 and 6 of Issue 1 of the *Shaoxing Medical Monthly*. The annotator was Yang Zhian, a disciple of Zhao Qing. It is unknown if Zhe Lu (the editor's pseudonym) had any connection to Zhao Qing.
[Jisheng's Note] Descendants of Zhao Qing possess scattered manuscripts that have not been organized. The legacy of their ancestors is lost and untransmitted, which is truly regrettable. Zhe Lu is the pseudonym of Mr. Yang.