族侄孙仲登，因与堂兄构讼城中方归，时值二月末旬，醉后房事二，起而小溲随即脐下
作痛
，水泻肠鸣一日十数度，发热头痛。里医进理中汤，一帖反而呕逆，烦躁口渴。敦予诊之，
左脉弦大，右洪大，俱七至，饮食不能下咽，昼夜不得睡，面赤唇燥，舌上黄苔深浓。诊毕
语予曰∶我房失后阴症伤寒也，小腹痛且漏底，幸叔祖救之。予笑而应曰∶以子所言决为阴
症
，以予指下辨之当是春温阳症也。且外症亦阳，乌得为有房事而遽以理中进之乎？族中相知
者交为予言，渠病的属阴症，故呕吐水泻，不可因其面赤便认为阳，顾戴阳症与此近似，幸
加察之。吾辈正拟于理中汤内再加大附子、肉桂，庶可保全。予极言∶不可。仲景有云，桂
枝下咽，阳盛则毙，况附子理中者乎。阴阳寒热之间，辨之不真，生死反掌耳。兹当舍症而
从脉也，以温胆汤加姜汁炒黄连，柴胡、干葛，与二帖，嘱令当夜饮尽，俾明日不它传也。
予别后，渠一服而呕逆止，余症悉在。诘朝予诊，竟扣渠曰∶夜来二药必未服完，不然何两
手之脉洪大搏指如是？佥曰∶因有竹茹、黄连，恐非房失后所宜，故仅服一。予曰∶不服黄
连，致热转剧，今日非石膏不能已。乃与白虎汤加竹茹两剂，临别嘱渠曰∶今症非昨日可比
，用石膏者岂得已哉!设当用不用，使经中之热传入于腑，非大黄不能瘳，切勿失时误事。
讵知别后又有惑之者，仍只服一帖，泻即随止，余小腹之痛具在。次日予诊毕语渠曰∶昨临
行时嘱之再三，何乃又不服完？今脉洪长坚硬，邪已入腑奈何？奈何？对曰∶众谓石膏大寒，
恐小腹加痛，实只服一帖而已。予曰∶惧服石膏，今且服大黄矣。皆失时误事之过。周金人
铭云∶荧荧不灭，炎炎奈何，其斯之谓欤。思非桃仁承气汤不可。乃觌面煎服，连饮二剂，
下极黑燥粪五六枚，痛热俱减。再为诊之，六脉皆缓弱，迨是病方尽去，改以四君子汤加白
芍药、黄连、香附，调养数日而愈。
族侄孙仲登，在城中与堂兄打官司后刚回来，当时正值二月下旬，醉酒后进行了两次房事，起身小便时随即感到脐下疼痛，伴有水样腹泻、肠鸣音亢进，一天发作十几次，同时出现发热和头痛。
家里的医生给他服用了理中汤，服用一剂后反而出现呕吐逆气、烦躁不安、口渴的症状。
大家请我诊治，我发现他左脉弦大，右脉洪大，每息七至（脉搏极快），饮食无法咽下，昼夜无法入睡，面色发红，嘴唇干燥，舌苔黄厚浓重。
诊脉结束后，他对我说：“我在房事后患的是阴症伤寒，小腹痛且腹泻不止，希望叔祖救救我。”
我笑着回答说：“根据你所说的情况，判断为阴症；但根据我的指下脉象辨别，这应当是春温阳症。而且外在症状也是阳证，怎么能因为有房事就立即用理中汤治疗呢？”
族中了解病情的人纷纷对我说：“他的病确实属于阴症，所以呕吐水泻，不能因为他面赤就认为是阳证。不过戴阳证与此相似，希望您仔细察辨。我们正打算在理中汤内再加大附子、肉桂，或许可以保全性命。”
我极力反对说：“不可以。张仲景说过，‘桂枝下咽，阳盛则毙’，何况是附子理中汤这样的热药呢？阴阳寒热之间，如果辨别不真切，生死就在反掌之间。现在应当舍症从脉，使用温胆汤加姜汁炒黄连、柴胡、干葛，给他两剂，嘱咐他当晚全部喝完，以便防止明天病情传变。”
我离开后，他喝了一剂药，呕吐逆气停止了，其余症状仍在。第二天早晨我诊治时，竟然质问他：“昨晚两剂药一定没有喝完，否则为什么两手脉象依然洪大搏指如此明显？”
大家都说：“因为药中有竹茹、黄连，恐怕不适合房事后的身体，所以只喝了一剂。”
我说：“不服用黄连，导致热势更加剧烈，今天非用石膏不可了。”
于是给他开了白虎汤加竹茹，两剂药。临别时嘱咐他说：“现在的病情已不同于昨天，使用石膏是不得已而为之！如果该用而不用，使经络中的热邪传入腑脏，非用大黄不能治愈，千万不要耽误时机误了事。”
谁知离开后又有人迷惑他，仍然只服了一剂药，腹泻随即停止，其余小腹疼痛依然存在。
第二天我诊治完后对他说：“昨天临走时再三嘱咐，为什么又没有喝完？现在脉象洪长坚硬，邪气已经入腑，这可怎么办？这可怎么办？”
他回答说：“众人说石膏大寒，恐怕加重小腹疼痛，实际上只服了一剂。”
我说：“因为害怕服用石膏，现在只好服用大黄了。这都是耽误时机、误了事情的过错。周金人铭文中说：‘小火苗不灭，大火起时奈何’，说的就是这种情况吧。我想非桃仁承气汤不可了。”
于是当面煎药让他服用，连续喝了两天，排出了五六枚极黑极燥的大便，疼痛和发热都减轻了。
The patient, Sun Zhongdeng, my clan's nephew, had just returned to the city after a lawsuit with his cousin. It was late February. After drinking alcohol heavily, he engaged in sexual intercourse twice. Upon rising to urinate, he immediately experienced pain below the umbilicus, watery diarrhea with hyperactive bowel sounds occurring more than ten times a day, fever, and headache.
The family physician administered Lizhong Tang (Replenish the Middle Decoction). After one dose, he instead developed vomiting and regurgitation, irritability, restlessness, and thirst.
Everyone invited me to examine him. I found his left pulse string-taut and large (Xian Da), and his right pulse flooding and large (Hong Da), both beating seven times per breath (indicating rapid pulse rate). He could not swallow food or drink, could not sleep day or night, his face was red, lips were dry, and the tongue coating was deep yellow and thick.
After the diagnosis, he said to me: "I contracted Yin-pattern Cold Damage (Yin Zheng Shang Han) after sexual activity. My lower abdomen hurts and diarrhea persists; I hope my great-uncle will save me."
I smiled and replied: "Based on what you say, it is determined as a Yin pattern; but based on my palpation, it should be identified as Spring Warmth Yang pattern (Chun Wen Yang Zheng). Moreover, the external symptoms are also Yang. How can we immediately prescribe Lizhong Tang simply because of sexual activity?"
Clansmen who knew the condition told me repeatedly: "His disease indeed belongs to the Yin pattern, hence the vomiting and watery diarrhea. One must not assume it is Yang just because of the red face. However, Floating Yang syndrome (Dai Yang Zheng) is similar to this; please examine carefully. We were planning to add Fuzi (Prepared Aconite Root) and Rougui (Cinnamon Bark) to Lizhong Tang, which might preserve his life."
I strongly objected: "No. Zhang Zhongjing said, 'If Guizhi Tang (Cinnamon Twig Decoction) enters the throat while Yang is abundant, death ensues.' How much more so for Fuzi Lizhong Tang? Between Yin and Yang, Cold and Heat, if the differentiation is not precise, life and death turn over like a palm. Here, we must abandon the symptoms and follow the pulse. Prescribe Wendan Tang (Gallbladder-Warming Decoction) with ginger-juice-fried Huanglian (Coptis Rhizome), Chaihu (Bupleurum Root), and Gegen (Pueraria Root). Give two doses, instructing him to finish them all that night, so that tomorrow there will be no further transmission."
After I left, after taking one dose, his vomiting and regurgitation stopped, but the other symptoms remained. The next morning, upon examining him, I questioned him directly: "Last night, you certainly did not finish the two doses; otherwise, why are both hands' pulses still flooding and forceful against the finger?"
They all said: "Because it contained Zhuru (Bamboo Shavings) and Huanglian, we feared it was not suitable for post-coital deficiency, so we only took one dose."
I said: "Not taking Huanglian caused the heat to intensify. Today, only Shigao (Gypsum Fibrosum) will suffice."
Therefore, I prescribed Baihu Tang (White Tiger Decoction) with added Zhuru, two doses. Before leaving, I instructed him: "The current condition is incomparable to yesterday. Using Shigao is a last resort! If it should be used but is not, and the heat from the meridions transmits to the fu-organs, only Dahuang (Rhubarb Root) can cure it. Do not lose time and cause mishaps."
Unexpectedly, after I left, others confused him again, and he still only took one dose. The diarrhea stopped immediately, but the lower abdominal pain persisted.
The next day, after finishing the examination, I said to him: "Yesterday, before leaving, I urged you repeatedly. Why did you not finish the medicine? Now the pulse is flooding, long, and hard. The pathogenic factor has entered the fu-organs. What shall we do? What shall we do?"
He replied: "The crowd said Shigao is extremely cold, fearing it would worsen the lower abdominal pain. In reality, I only took one dose."
I said: "Fearing the intake of Shigao, now we must use Dahuang. This is the fault of losing time and causing mishaps. As Zhou Jinren's inscription says: 'If the flickering flame is not extinguished, how to handle the blazing fire?' This is exactly what it refers to. I think Tao Ren Chengqi Tang (Peach Kernel Draining the Interior Decoction) is indispensable."
Therefore, I prepared the decoction in front of him for immediate consumption. He drank it continuously for two doses. He passed five or six pellets of extremely black and dry feces. The pain and heat both decreased.
Upon re-examination, all six pulses were slow and weak. Only then was the disease completely eliminated. The prescription was changed to Sijunzi Tang (Four Gentlemen Decoction) with added Baishao (White Peony Root), Huanglian, and Xiangfu (Cyperus Rhizome). After several days of recuperation, he recovered.