一妇咳嗽，痰中有红，大便一日五六度，饮食极难下膈，才下膈，腹中即不安，立时欲
泻必
尽泻出乃止，肌肉消瘦，下午发热，热将发时，四肢先麻，两足膝皆战摇。两寸关脉滑数，
两尺沉细，此虚中有实疾痰饮之候也。脉虽数，午后虽发热，不敢轻用寒凉，特为温补下元
，庶关门有守，泻可止也。山茱萸、菟丝子、人参、破故纸、杜仲、山药、茯苓、泽泻、桂
心、砂仁服下甚安，四剂后下体不战摇矣。但饮食腹中微疼，即欲蹲厕，前方减去山萸加白
术、肉果、木香，八帖愈。
族侄煌，春温后忽鼻衄寒战，小水不利，舌上焦黄，目珠极红，六脉伏而不见，举室惶
惶。
予曰∶此作汗之兆，由热极使然也。因先时汗未透彻，阳明余热在经迫血上行越出鼻窍，故
有此症，以石膏、滑石、生地黄、升麻、赤芍药、牡丹皮、麦门冬、天花粉、甘草，煎而服
之，汗出如雨，直至两踝，舌润而苔尽退，衄亦止，目珠色淡，脉乃渐出。改用人参、麦门
冬、五味子、白芍药、甘草、知母、黄芩、柴胡、竹叶、石膏，服下。大便原五日未通，今
亦始行，精神大转，饮食亦渐进矣。
富昨汪氏妇，对河程门女也，年仅三八，经不行者半载，腹大如斗，坚如石，时或作痛
。里
医尽技以治月余，弗瘳。乃举歙友为翼，又治月余，腹转胀急，小水涓滴不通，乃仿予治孙
仲暗法，而用温补下元之剂，则胀急欲裂，自经求尽。文学南瀛怜之，荐予，诊其脉两关洪
滑鼓指，按之不下，乃有余之候也，症虽重，机可生。询其致病之源，由乃姑治家严而过俭
，其母极事姑息，常令女童袖熟鸡、牛舌之类私授之。因 食冷物，积而渐成鼓胀。前任事
者并不察病源，不审脉候，误作气虚中满治之，因胀而欲裂，宜其然也。乃用积块丸，三下
之而胀消积去，后以丹溪保和丸调养一月而愈。积块丸列赤水玄珠第五卷虫蛊后。
一位妇女咳嗽，痰中带血，每天大便五六次，饮食极难咽下，刚咽下去，腹中就不舒服，立刻想泻，必须完全泻出才停止，肌肉消瘦，下午发热，热将要发作时，四肢先麻木，两足膝盖都颤抖摇晃。两手寸、关脉滑数，两尺脉沉细，这是虚证中夹杂实邪，属于痰饮的征候。脉象虽然数，午后虽然发热，不敢轻易使用寒凉药物，特意采用温补下元的方法，希望肾关有守，腹泻可以停止。服用山茱萸、菟丝子、人参、破故纸（补骨脂）、杜仲、山药、茯苓、泽泻、桂心、砂仁后感觉非常舒适，四剂后下肢不再颤抖摇晃了。但是饮食后腹中微痛，就想蹲厕所，前方减去山茱萸，加入白术、肉豆蔻、木香，八帖后痊愈。
族侄孙煌，在春温病后忽然鼻出血、寒战，小便不通利，舌上焦黄，眼珠极红，六脉伏匿不见，全家惊慌失措。我说：这是作汗的征兆，由热极所致。因为先前出汗不透彻，阳明经余热逼迫血液上行溢出鼻窍，所以出现这些症状，用石膏、滑石、生地黄、升麻、赤芍药、牡丹皮、麦门冬、天花粉、甘草，煎服后，汗出如雨，直到两脚踝，舌润而苔尽退，鼻衄也停止，眼珠颜色变淡，脉象才逐渐显现。改用人参、麦门冬、五味子、白芍药、甘草、知母、黄芩、柴胡、竹叶、石膏，煎服。大便原本五天未通，现在也开始排便，精神大转，饮食也逐渐进补了。
富阳汪氏妇，是对河程家的女儿，年仅三十六岁，月经半年不行，腹部大如斗，坚硬如石，有时疼痛。当地医生尽力治疗一个多月，没有好转。于是请歙县的朋友来协助，又治疗一个多月，腹部反而胀急，小便涓滴不通，于是模仿我治疗孙仲暗的方法，使用温补下元的药剂，结果胀急欲裂，经血淋漓不尽。文学南瀛怜悯她，推荐给我诊治，诊其脉两关洪滑鼓指，按之不下，这是有余的征候，症虽重，生机可存。询问致病之源，是因为她的婆婆治家过于节俭，其母亲极尽姑息之能事，常让女童袖藏熟鸡、牛舌之类私下给她吃。因为吃了冷物，积滞渐成鼓胀。前任医者并不察看病源，不审察脉候，误作气虚中满治疗，因此胀急欲裂，理所当然。于是使用积块丸，三次攻下后胀消积去，后来用丹溪保和丸调养一个月而痊愈。积块丸列于《赤水玄珠》第五卷虫蛊之后。
A woman suffered from coughing with blood in the sputum, defecating five to six times a day, and extreme difficulty swallowing food. As soon as food passed the throat, she felt discomfort in the abdomen, immediately desired to defecate, and relief came only after complete evacuation. She exhibited emaciation, afternoon fever, numbness of the four limbs preceding the onset of fever, and trembling of both knees. The pulse at the Cun (inch) and Guan (bar) positions on both wrists was slippery and rapid, while the Chi (cubit) positions were deep and fine. This indicates a condition of deficiency complicated by excess, specifically phlegm-fluid retention. Although the pulse was rapid and there was afternoon fever, cold-natured herbs were not lightly employed. Instead, warming and tonifying the Lower Yuan (Lower Burner/Kidney system) was adopted to secure the "gate" (anal sphincter/kidney control), thereby stopping diarrhea. After taking Cornus Fructus (Shanzhuyu), Dodder Seed (Tusizi), Ginseng Radix et Rhizoma (Renshen), Psoralea Fructus (Pogu Zhi), Eucommia Bark (Duzhong), Dioscorea Rhizome (Shanyao), Poria (Fuling), Alisma Rhizome (Zexie), Cinnamon Heart (Guixin), and Amomum Fruit (Sharen), she felt very comfortable. After four doses, the trembling of the lower body ceased. However, mild abdominal pain followed by an urge to defecate occurred after eating. Cornus Fructus was removed from the previous formula, and Atractylodes Macrocephala Rhizome (Baizhu), Myristica Seed (Rouguo), and Aucklandiae Radix (Muxiang) were added. The condition was cured after eight doses.
My clan nephew, Huang, suddenly experienced epistaxis and chills following a Spring-Warmth disease. His urination was difficult, the upper part of his tongue was yellow, his eyeballs were extremely red, and all six pulses were hidden and imperceptible, causing panic throughout the household. I stated: "This is a sign of sweating, caused by extreme heat. Because perspiration was not thorough previously, residual heat in the Yangming channel forced blood upward, overflowing through the nasal cavity." Therefore, Gypsum Fibrosum (Shigao), Talcum (Huashi), Rehmanniae Radix (Sheng Dihuang), Cimicifugae Rhizoma (Shengma), Red Peony Root (Chishao), Moutan Cortex (Mudanpi), Ophiopogon Tuber (Maimendong), and Trichosanthes Root (Tianhuafen), along with Licorice Root (Gancao), were decocted and administered. Sweat poured like rain down to both ankles, the tongue became moist, the coating disappeared completely, epistaxis stopped, the color of the eyeballs faded, and the pulse gradually emerged. The prescription was changed to Ginseng Radix et Rhizoma (Renshen), Ophiopogon Tuber (Maimendong), Schisandra Fruit (Wuweizi), White Peony Root (Baishao), Licorice Root (Gancao), Anemarrhena Rhizome (Zhimu), Scutellaria Root (Huangqin), Bupleuri Radix (Chaihu), Bamboo Leaf (Zhuye), and Gypsum Fibrosum (Shigao), decocted and taken. His stool, which had been retained for five days, began to pass. His spirit greatly improved, and his diet gradually increased.
Mrs. Wang of Fuyang, a daughter of the Cheng family across the river, was only thirty-six years old. Her menstruation had ceased for half a year, her abdomen was enlarged like a bucket, hard as stone, and occasionally painful. Local physicians treated her for over a month without success. Friends from Shexian were invited to assist, and treatment continued for another month, yet the abdominal distension worsened, becoming urgent, with no urine passing drop by drop. Mimicking my method for treating Sun Zhongan, warm-tonifying formulas for the Lower Yuan were used, resulting in severe distending pain threatening rupture and continuous vaginal bleeding. Nan Ying, a literary scholar, pitied her and recommended me. Upon examination, the pulse at the Guan positions on both wrists was surging, slippery, and forceful against the fingers, unyielding to pressure, indicating an excess pattern. Although the condition was severe, there was hope for recovery. Inquiring about the cause, it was found that her mother-in-law was extremely frugal, and her own mother indulged her, often having young girls hide cooked chicken tongues and beef tongues in their sleeves to secretly feed her. Due to consuming cold foods, stagnation accumulated, gradually forming abdominal distension (Gu Zhang). Previous practitioners failed to identify the source or examine the pulse, mistakenly treating it as Qi deficiency with middle fullness, hence the severe distending pain. Ji Kuai Wan (Accumulation Mass Pill) was administered three times to purge, resolving the distension and removing the accumulation. Subsequently, Bao He Wan (Preserve Harmony Pill) by Danxi was used for one month of recuperation until cure. Ji Kuai Wan is listed in Volume 5 of *Chishui Xuanzhu* after the section on insect-related abdominal masses.