宜兴令君胡镜阳老先生夫人。夜间热，口渴，经行过十日复行，小腹痛，两寸关短弱，
两尺
洪滑。予诊毕，语曰∶此《内经》所谓阴虚阳搏之候也。可预防之。以川芎、当归、条芩、
蒲黄、白芍、侧柏叶、生地、荆芥进之。下午热甚，口中气如火喷，血下如倾，内有紫块，
小腹仍痛。乃用川芎二钱，当归四钱，地榆、香附各一钱半，黄芩一钱，莲蓬壳一枚烧灰，
煎服两帖而止。
太史徐检老，向为 疝所苦，而妨生育。辛巳孟秋，有江右陈苓泉者，以是症为专科，
寓无
锡，翁延而治，谓将烂药煮竹片夹阴囊，俾阴囊烂见子，又以烂药点开肾子，使其中蓄积臭
水
溃出，然后用生肌药长肉收功。翁以此治与道中诸友商之，无有劝者，而谋于予。予曰∶翁
疾非常疾，则治当非常治也。陈能为翁治于外，予当佐陈补于内，内外兼治，必可成功。翁
因予言而决用陈，是时，予有湖州之役，而陈用其术治一月，囊烂子开，洞见水泡，第不能
使泡破水出也。由是胸中气满，汗出如流，终夜不寐，饮食减三分之二，面青肌肉瘦其半，
形气弱而大便艰涩，腰肾俱痛，苦不可殚述。将令人急予。予适自湖州至荆溪，主吴少溪公
家。翁时杜门谢客，闻予至，大喜而促予，诊脉两寸软弱，右尺大，右关滑。予诊毕曰∶向
许佐陈治内，今其时也，比陈技已竭，而水不得出，翁又难于痛，业已用收口药矣。予曰∶
无伤，痛由元气虚惫，而汗亦因痛来，汗去多则心血不足，心血不足则神失养，故不寐，脾
胃为痛所伤，故饮食减，今只大补血气，不惟痛止疾除，即水泡亦可出也。陈谓用补收口生
肌，或可使泡出水，或未必然。予曰∶三日后，当自见，翁曰∶补甚善，奈生平不能服参何
？予曰∶翁体非昔比也。脉症皆可服，又何忧？乃用人参、黄 各三钱，当归、白芍、石斛各
一钱五分，陈皮、贝母、红花、粉甘草各八分，饮下即睡。次早汗敛，且索粥，胸膈顿宽。
连服二日，痛减大半，饮食顿加，精神亦爽。乃陈恐予夺功，私谮之曰∶孙君之药虽善，但
非
外科所急，服之恐生肌收口后，而水终不得出也。翁谓必如何而后可。陈曰∶当于前药加羌
活、防风、白芷、远志。减去石斛，则外内两得矣。翁然其说，且服其药，饮未半而痛立至
，汗立出，头热如火，气逆上升，夜竟不寐，种种病复矣。极索予剂，予知陈之忌而行谮也
。乃宣言曰∶予实佐尔成功耳，尔何自败？尔知翁之痛乎，元气虚而毒药凝滞，故补而助之
，活动其血，则毒药自行，药行则泡可溃，水方可出。翁之谢尔已有成议。予雅善翁，来者
为义，非为利也，鄙见与寻常较不牟矣。陈闻言而语塞，亦以投剂无功，遂乘机而听予治。
仍用前方，加酸枣仁、枸杞子、皂角刺各一钱，两帖而泡溃，出臭水五六碗，囊随消瘪
。陈拊掌曰∶今而后知用补之神，其老先生之福也。太史受补自此始。
宜兴县令胡镜阳老先生的夫人。夜间发热，口渴，月经刚结束十天又再次来潮，小腹部疼痛，两手寸部和关部脉象短而弱，两尺部脉象洪大滑数。我诊察完毕后，对她说：这是《内经》中所说的阴虚阳搏的证候。可以提前预防。于是用川芎、当归、黄芩（条芩）、蒲黄、白芍、侧柏叶、生地黄、荆芥给她服用。下午时发热加重，口中呼出的气像火喷一样热，阴道出血如倾泻般多，血中有紫黑色的血块，小腹部仍然疼痛。于是改用川芎二钱，当归四钱，地榆、香附各一钱半，黄芩一钱，莲蓬壳一枚烧成炭灰，煎汤服用两剂后出血停止。
太史徐检老，一向被疝气所苦，并且影响了生育能力。辛巳年孟秋时节，江西人陈苓泉以治疗此症为专科，居住在无锡，徐老先生邀请他来诊治。陈苓泉说要用腐烂的药物煮竹片夹在阴囊上，使阴囊溃烂露出睾丸，又用腐烂药物点破睾丸，使其内部蓄积的臭水溃排出来，然后用生肌药让肌肉生长以收功。徐老先生将这种治疗方法与道中的各位朋友商量，没有人劝阻，于是来咨询于我。我说：陈医生的病不是普通的病，那么治疗也应当采用非常的手段。陈医生能在外部进行治疗，我应当在内部辅助补益，内外兼治，必定能够成功。徐老先生因为我的话而决定采用陈医生的方法。当时，我有湖州的任务在身，而陈医生使用他的方法治疗了一个月，阴囊溃烂，睾丸暴露，洞见水泡，只是不能使水泡破裂水流出来。因此胸中气满，出汗如流水，整夜不睡觉，饮食减少了三分之二，面色青暗，肌肉消瘦了一半，形体和气都很虚弱，大便艰涩，腰部和肾脏都疼痛，痛苦不可尽述。急忙派人来请我。我恰好从湖州回到荆溪，住在吴少溪公家中。徐老先生当时闭门谢客，听说我到了，非常高兴并催促我去诊治。诊察脉搏，两手寸部软弱，右尺部脉大，右关部脉滑。我诊察完毕后说：先前答应辅助陈医生进行内部治疗，现在正是时候了。相比陈医生的技术已经用尽，而水无法排出，徐老先生又难以忍受疼痛，业已使用了收口药。我说：不要紧，疼痛是因为元气虚惫，而出汗也是因为疼痛引起的，汗出多了则心血不足，心血不足则神志失去滋养，所以失眠，脾胃被疼痛所伤，所以饮食减少，现在只需大补气血，不仅疼痛停止疾病消除，就是水泡也可以排出。陈医生说如果用补法配合收口生肌，或许可以使水泡出水，或者未必如此。我说：三天后，自然会见分晓。徐先生说：补益很好，无奈我一辈子都不能服用人参。我说：您的体质已经不是从前了。脉象和症状都可以服用，又有什么可担忧的？于是用人参、黄芪各三钱，当归、白芍、石斛各一钱五分，陈皮、贝母、红花、粉甘草各八分，喝下去后立即入睡。第二天早上汗止住了，并且索要粥喝，胸膈顿时宽舒。连续服用两天，疼痛减轻大半，饮食立刻增加，精神也清爽起来。这时陈医生恐怕我会夺取功劳，私下诽谤我说：孙医生的药虽然好，但这不是外科急需的，服用它恐怕在生肌收口之后，水终究还是排不出来。徐先生问必须怎样才可以。陈医生说：应当在前面的药中加入羌活、防风、白芷、远志。减去石斛，那么内外两得。徐先生认为他说得对，并且服用了他的药，药还没喝一半，疼痛立即到来，出汗立即出现，头部热如火，气逆上升，整夜不睡觉，各种病症又复发了。极力索取我的方剂，我知道陈医生嫉妒而行诽谤。于是公开宣布说：我确实是辅助您成功的，您为何自己败坏？您知道徐老先生的疼痛吗？元气虚弱而毒药凝滞，所以用补法来助益他，活动其血液，那么毒药自行消散，药行则水泡可以溃破，水才可以排出。徐老先生拒绝您已经有了定论。我素来与徐老先生交好，前来是为了义理，不是为了利益，我的见解与寻常之人比较并不谋取私利。陈医生听了这话语塞，也因为投药无效，于是趁机听从我的治疗。仍然用前面的方子，加入酸枣仁、枸杞子、皂角刺各一钱，两剂后水泡溃破，流出臭水五六碗，阴囊随之消瘪。陈医生拍手说：从今以后才知道用补法的神奇，这是老先生的福气啊。太史接受补益治疗从此开始。
The wife of Mr. Hu Jingyang, the magistrate of Yixing County. She experienced night fever, thirst, and menstruation recurring ten days after it had just ended, accompanied by lower abdominal pain. Her pulse at both cun (inch) and guan (bar) positions was short and weak, while the chi (cubit) positions were surging and slippery. After completing the diagnosis, I said to her: This is what the *Neijing* (Classic of Internal Medicine) refers to as the syndrome of Yin deficiency with Yang pulsation. It can be prevented in advance. I prescribed Chuanxiong Rhizome (Chuanxiong), Angelicae Sinensis Radix (Danggui), Scutellariae Radix (Tiaoqin), Poria Cocos (Puhuang - *Note: Text says Puhuang which is usually Typhae Pollen, but context implies hemostasis, likely Typhae Pollen*), Paeoniae Radix Alba (Baishao), Platycladi Cacumen (Cebaiye), Rehmanniae Radix Recens (Shengdi), and Schizonepetae Spica (Jingjie). In the afternoon, the fever intensified, breath felt like fire spraying from the mouth, vaginal bleeding poured out like a flood, containing dark purple clots, and lower abdominal pain persisted. Therefore, I used Chuanxiong Rhizome (Chuanxiong) 2 qian, Angelicae Sinensis Radix (Danggui) 4 qian, Sanguisorbae Radix (Diyu), Cyperi Rhizoma (Xiangfu) each 1.5 qian, Scutellariae Radix (Huangqin) 1 qian, and one lotus pod shell burnt to ash, decocted and taken orally for two doses, which stopped the bleeding.
Grand Secretary Xu Jianlao had long suffered from hernia (*shan*), which hindered his fertility. In the early autumn of the Xinsi year, Chen Lingquan from Jiangxi, specializing in this condition, resided in Wuxi. The old gentleman invited him for treatment. Chen stated that he would use rotten medicine to boil bamboo slices to clamp onto the scrotum, causing the scrotum to ulcerate and expose the testicles, and then use rotten medicine to puncture the testicles to allow accumulated foul water to drain out, followed by using flesh-regenerating medicines to complete the healing. The old gentleman discussed this treatment method with friends along the way; no one advised against it, so he consulted me. I said: If the illness is extraordinary, the treatment should be extraordinary. Dr. Chen can treat externally; I will assist with internal tonification. Treating both internally and externally will surely succeed. Relying on my words, the old gentleman decided to employ Dr. Chen. At that time, I was engaged in a mission in Huzhou. Dr. Chen used his technique for one month; the scrotum ulcerated, the testicles were exposed, and blisters were visible, but the blisters could not be ruptured to release the fluid. Consequently, there was chest fullness of qi, profuse sweating like flowing water, insomnia throughout the night, food intake reduced by two-thirds, a blueish complexion, half-body muscle wasting, weak form and qi, difficult defecation, and pain in the waist and kidneys, unbearable to describe fully. He urgently sent someone to fetch me. I happened to return from Huzhou to Jingxi, staying at the residence of Mr. Wu Shaoxi. The old gentleman, who had been closing his door to guests, was overjoyed upon hearing of my arrival and urged me to visit. His pulse at both cun positions was weak and soft, the right chi position was large, and the right guan position was slippery. After diagnosing, I said: Previously, I promised to assist Dr. Chen with internal treatment; now is the time. Compared to Dr. Chen's techniques being exhausted and the inability to drain the water, the old gentleman is also suffering from severe pain, and has already used astringent/healing agents. I said: Do not worry. The pain is due to exhaustion of Yuan Qi (Original Qi), and sweating is caused by the pain. Excessive loss of sweat leads to insufficient Heart Blood; insufficient Heart Blood fails to nourish the Shen (Spirit), hence insomnia. The Spleen and Stomach are injured by pain, hence reduced appetite. Now, only by greatly tonifying Blood and Qi will the pain cease and the disease be removed; even the blisters can be drained. Dr. Chen said that using tonification combined with astringent/flesh-regulating methods might allow blister drainage, or perhaps not. I said: See in three days. The old gentleman said: Tonification is good, but I have never been able to take Ginseng Radix et Rhizoma (Renshen) in my life. I said: Your constitution is no longer what it was. Both pulse and symptoms indicate you can take it; why worry? Thus, I prescribed Ginseng Radix et Rhizoma (Renshen) and Astragali Radix (Huangqi) each 3 qian, Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Baishao), Dendrobii Caulis (Shihu) each 1.5 qian, Tangerine Peel (Chenpi), Fritillariae Bulbus (Beimu), Carthami Flos (Honghua), and Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (Feng Gancao) each 0.8 qian. After drinking it, he slept immediately. The next morning, sweating ceased, he asked for porridge, and his chest and diaphragm felt instantly relaxed. After taking it for two consecutive days, pain decreased by more than half, food intake increased suddenly, and spirit became refreshed. Then, fearing I would steal his credit, Dr. Chen privately slandered me saying: Although Dr. Sun's medicine is good, it is not urgent for surgery; taking it may prevent water drainage even after flesh regeneration and wound closure. The old gentleman asked how to proceed. Dr. Chen said: Add Notopterygii Rhizoma et Radix (Qianghuo), Saposhnikoviae Radix (Fangfeng), Angelicae Dahuricae Radix (Baizhi), and Polygalae Radix (Yuanzhi) to the previous prescription. Remove Dendrobii Caulis (Shihu), and both internal and external aspects will be addressed. The old gentleman agreed and took his medicine. Before finishing half the dose, pain returned immediately, sweating ensued, head heat felt like fire, qi rebelled upward, and he remained awake all night; various diseases recurred. He desperately sought my prescription. Knowing Dr. Chen's jealousy and slander, I publicly declared: I am indeed assisting you to succeed; why do you ruin it yourself? Do you know the old gentleman's pain? His Original Qi is deficient, and toxic drugs cause stagnation; thus, we tonify to assist him, move the blood, so the toxic drugs dissipate naturally. When the medicine moves, the blisters can rupture, and water can drain. The old gentleman's rejection of you is already decided. I have always been friendly with the old gentleman; I come for righteousness, not profit. My views differ from ordinary people seeking gain. Hearing this, Dr. Chen was speechless. Also because his prescriptions failed, he took the opportunity to submit to my treatment. I still used the previous formula, adding Ziziphi Spinosae Semen (Suanzaoren), Lycii Fructus (Gouqizi), and Gleditsiae Spina (Zaogelaci) each 1 qian. After two doses, the blisters ruptured, draining five to six bowls of foul water, and the scrotum subsided and collapsed. Dr. Chen clapped his hands and said: From now on, I know the miracle of using tonification; this is the old gentleman's fortune. Grand Secretary Xu began receiving tonification therapy from this point onward.