进贤三尹张思轩公，与潘少保印川公，皆受室于施氏，称联襟云。施故富家，而张公夫
人贤慧，治家勤笃，为人精洁周致，以产多而气血惫，又以婚嫁繁，而费用不支积忧，年将五十
，因病心痹，发则晕厥，小水短涩，胸膈痛不可忍，烦躁，干哕恶，内蒸热，气 上腾，
肌削骨立，月汛不止。苕城时辈，有认为气怯者，有认为膈食者，皆束手无措。尸寝浃旬，
浆粒不入口者五日，凶具备而待毙，举家计无所之，惟神是祷。予适在潘府，逆予诊之，脉
左弦大，右滑大而数。诊毕，予曰∶可生也。病机云∶诸逆吐酸，皆属于火；诸风掉眩，皆
属于木。法当调肝清热，开郁安神。诸医群然目摄而背谑曰∶书云骨蒸肉脱者死，形瘦脉
大胸中多气者死，绝谷食者死。孙君独许其生，果药王再世哉。予若不闻，而捡药以进。竹
茹、滑石各三钱，白豆蔻仁七分，半夏曲、橘红、姜连、茯苓各一钱，甘草五分，水煎，令
一口口咽之。服毕，哕止晕定。次日用温胆汤调辰砂益元散三钱，服之，胸膈顿开，渐进饮
食，小水通长，烦躁尽减， 然安若无事。后用逍遥散、六君子汤，加黄连、香附，三越
月而肌肉全，精神如旧。苕入骇然曰∶能起此病，信药王矣。
马二尹迪庵公，年五十五，以扫墓而过食鳗肉卷饼，心腹胀痛，市医不知用吐，而遽用
硝黄
下之，大便不行，胀痛愈增。继至者，又用木香槟榔丸，继又有下以小承气汤者，有下以大
承气汤者。十日多，胀痛益甚，饮食粒不能进，大便并不行，小水亦仅点滴。后医又以大黄
芒硝，多服不行，谓非白饼子不可。服五日，而胀痛尤加。又谓非备急丸不可，服三日，胀
痛益不可当。又用甘遂、芫花、大戟、牵牛之属。服三日，不惟大便不行，并小便点滴亦无
矣，胀不可言。众医大叫称怪。自三月初二日起、至是念二日矣。有名士王南野者，用灸法
灸中脘三十余壮，毫不为动，因断其越三日为念五，戌时当弃人间。迪老四子皆逢掖，闻言涕泗
。时有张太学怀赤者，迪老甥也，见予起张思轩夫人疾，喻亟请予。予至，观其色苍黑，神
藏不露，声音亮，惟腹大如覆箕，不能反侧，诊其脉，两手皆滑大，两尺尤有力。究其受病
之源，查其历服之药，予骇然以为未闻且见也。因思一治法，先用六君子汤，加木香、砂仁
，参、术俱用二钱。乃旁有钱小松者，自称家世受医，见剂争之。予曰∶非若所知也。彼
犹喋喋诘予，谓∶人言中满者，泻之于内，大小便不利者，当先利大小便，然欤？予曰∶非
人言，《素问》云云也。又云∶诸痛不得用参术，苍黑之人尤忌。先生既知《素问》，奈何
不用通而用塞也？予悄然不答，顾迪老诸子言曰∶钱君拘儒常见，何能起尊君病，尊君非中
满胀症，内伤症也。当始伤时，犹在上膈，法当用吐，《素问》云∶在上者，因而越之是也
。不用吐而用下药，以伤其脾，脾气伤则失运动之职，是以愈下愈伤，愈伤愈胀。不思脾气
伤而神不为用，药不能行，以峻厉味益下之，是遵何说也？予因脾伤，故用六君子汤以醒其
脾，木香、砂仁助其运动，再用吐法，吐出前药，予剂非治尊君之病，治诸君药也。予初欲
为诸君讳，何钱君激予，而使暴其短哉。且予不虑大便不行，独虑行之不止也。钱又谬言∶
急则治标，今法用尽不能使一行，何以不止为虑？予曰∶君试思，常人能服硝、黄几何？服巴
豆、白饼子几何？今硝、黄服过五斤，巴豆、白饼子之属服过五、六两，又加甘遂、牵牛、
芫花、大戟至悍至急之剂，幸而大便未行，药性未动，尚可为计。若一行，而诸药性动，譬
瓶水底漏，其中能蓄点滴哉？危矣!钱又诘∶迪老多服下药，而大便不行何也？予曰此易知之
。始为食伤，继为药伤，所伤在上、中二焦，下元未损，故两尺脉尚有神气。《难经》曰∶
人有两尺，如树之有根也。《内经》曰∶肾者，胃之关。盖肾主大便，观其色苍黑，神藏气
固，皆由根本未动，赖此犹可为也。服药后，腹中大痛，予知其药力已动，改用人参芦、防
风芦、升麻、桔梗各三钱，水煎服之，少顷，用鹅翎探喉中，令吐之。前服药物，一涌而出
十数碗。病者以手加额曰∶目前光矣。此巳时也。予曰∶酉时大便必行，可预买人参数斤，
以备不虞。至午进至宝丹一帖，以温中气，未申间，腹中 有声，浊气下滚，倾刻间，腹
宽数寸。至晚，大便行一次，小水略通。予即用人参、白术各五钱，炮姜三钱，茯苓二钱
，木香、甘草各五分，陈皮一钱，令急煎服。四鼓又大便一次，小水继至，胀痛渐减。次日
大便泻十次余，因以前理中汤剂为丸，与煎剂兼补，腹胀全消，饮食渐进，共泻七十二日，
服人参二斤余。苕人闻以补收功，群然异之。而钱小松始帖然心服。曰∶奇哉，奇哉!人多
用攻，孙君独用补，人多用下，孙君独用吐。由见之真，而所投者确也。医可易言哉？今而
后，知孙君之高矣。
进贤县三尹张思轩公，与潘少保印川公，都娶了施家的女儿为妻，互为连襟。施家本是富户，而张公的夫人贤惠聪慧，持家勤劳笃实，为人精细洁净周到，因为生育过多导致气血疲惫，又因婚嫁事务繁杂，费用入不敷出，长期忧愁，年近五十岁时，因病患上心痹（以心痛、胸闷为主症的疾病），发作时晕厥，小便短少涩滞，胸膈疼痛难以忍受，烦躁不安，干呕恶心，体内蒸热，气机上逆，肌肉消瘦骨骼显露，月经淋漓不止。当地同时代的医生，有的认为是气虚怯弱，有的认为是膈食（噎膈类疾病），都束手无策。病人卧床昏迷整整十天，五天未进食浆液和米粒，凶险之象具备，等待死亡，全家计谋无处施展，只能向神灵祈祷。我恰好住在潘府，被迎去诊脉，左脉弦大，右脉滑大而数。诊脉完毕，我说：可以治好。病机理论说：各种上逆呕吐酸水，都属于火；各种风证震颤眩晕，都属于木。治法应当调理肝脏、清热、开郁、安神。众医生瞪眼注视并背后嘲笑说：书上说骨蒸肉脱者死，形体消瘦脉大胸中多气者死，绝食者死。孙君唯独许诺她能活，难道是药王再世吗？我不理会他们的议论，拣选药物进献。竹茹、滑石各三钱，白豆蔻仁七分，半夏曲、橘红、姜黄连、茯苓各一钱，甘草五分，水煎，让病人一口口咽下。服完后，干呕停止，晕厥安定。第二天用温胆汤调辰砂益元散三钱服用，服后胸膈顿时开阔，逐渐能进食饮水，小便通畅延长，烦躁完全减轻，安然无恙如同没事一样。后来用逍遥散、六君子汤，加黄连、香附，三个月后肌肉丰满，精神恢复如旧。当地人惊骇地说：能治好这种病，真是药王啊。
马二尹迪庵公，五十五岁，因为扫墓而过食鳗鱼卷饼，导致心腹胀痛，市井医生不知道用催吐法，反而急忙用硝石、大黄攻下，大便不通，胀痛更加严重。继任的医生，又用木香槟榔丸，接着又有用小承气汤攻下的，有用大承气汤攻下的。十多天后，胀痛更甚，饮食一粒不能进，大便完全不通，小便也只有点滴。后来的医生又用大黄、芒硝，大量服用仍不行，说是非用白饼子不可。服用五天后，胀痛更加厉害。又说是非用备急丸不可，服用三天，胀痛更加无法忍受。又用甘遂、芫花、大戟、牵牛子之类峻烈泻下药。服用三天，不仅大便不通，连小便点滴也没有了，胀满得没法形容。众医生大叫称奇奇怪怪。从三月初二日起，到这天二十二日了。有位名士叫王南野的，用灸法灸中脘穴三十多壮，毫无反应，于是断定他再过三天是二十五日，戌时将离世。迪老四个儿子都是读书人，听到这话痛哭流涕。当时有太学生张怀赤，是迪老的外甥，看到我治好了张思轩夫人的病，急忙请求我去诊治。我到了，观察他的面色苍黑，神气内藏不外露，声音洪亮，只有腹部大得像倒扣的箕，不能翻身侧卧，诊其脉，两手都滑大，两尺脉尤其有力。探究他患病的根源，查考历次服用的药物，我惊骇地认为从未听说过也未曾见过。于是思考一种治法，先用六君子汤，加木香、砂仁，人参、白术都用二钱。旁边有个叫钱小松的人，自称家世行医，见到方剂争辩反对。我说：这不是你所知道的。他还喋喋不休地质问我，说：人们说中满（脘腹胀满）的病，要从内部泻除，大小便不利的病，应当先通利大小便，是这样吗？我说：不是人们的说法，《素问》里说的。又说：各种疼痛不能用参、术，面色苍黑的人尤其忌讳。先生既然知道《素问》，为什么不用通利的方法而用壅塞的方法呢？我沉默不答，看着迪老的几个儿子说：钱君是拘泥于常理的儒生，怎么能治好尊君的病，尊君得的不是中满胀症，而是内伤症。在刚开始受伤时，病位还在上膈，治法应当用催吐，《素问》说：病在上部的，因而用越（吐）法治疗。不用吐法而用下药，从而损伤脾胃，脾气受损就失去了运化的职能，所以越攻下越损伤，越损伤越胀满。没考虑到脾气受伤后神机不为所用，药物不能运行，再用峻厉的药继续攻下，遵循的是什么学说呢？我因为脾脏受伤，所以用六君子汤来唤醒脾的功能，木香、砂仁帮助其运动，再用吐法，吐出之前服用的药物，我的方剂不是治疗尊君的病，而是治疗各位医生开的药。我起初想为各位医生隐瞒，为什么钱君激怒我，使我暴露他们的错误呢？而且我不担心大便不通，只担心通了之后停不下来。钱又荒谬地说：急则治标，现在方法用尽不能使大便通行一次，怎么担心它不停止呢？我说：你试着想想，常人能服用多少硝石、大黄？服用巴豆、白饼子多少？现在硝石、大黄服用超过五斤，巴豆、白饼子之类的服用超过五六两，再加上甘遂、牵牛、芫花、大戟这些至悍至急的药物，幸好大便未通，药性未动，还可以想办法。如果一旦通便，诸药性动，就像瓶底漏水，其中还能蓄积点滴吗？危险啊！钱又质问：迪老多次服用下药，为什么大便不通呢？我说：这很容易知道。开始是饮食所伤，接着是药物所伤，所伤部位在上、中二焦，下元未损，所以两尺脉还有神气。《难经》说：人有两尺脉，像树有根一样。《内经》说：肾是胃的关口。大概肾主司大便，看他的面色苍黑，神气内藏，气息稳固，都是因为根本未动，依靠这个还可以挽救。服药后，腹中大痛，我知道药力已动，改用人参芦、防风芦、升麻、桔梗各三钱，水煎服，一会儿，用鹅毛探喉中，让他呕吐。之前服用的药物，涌吐出来十几碗。病人用手按着额头说：眼前光亮了。这是巳时。我说：酉时大便必定会通，可以预先买几斤人参，以备不测。到中午服至宝丹一帖，以温补中气，未时申时之间，腹中有声响，浊气向下翻滚，顷刻间，腹部宽了几寸。到了晚上，大便通了一次，小便略通。我立即用人参、白术各五钱，炮姜三钱，茯苓二钱，木香、甘草各五分，陈皮一钱，令其急煎服用。四鼓时分又大便一次，小便随后到来，胀痛逐渐减轻。第二天大便泻十多次，因此以前理中汤的方剂做成丸药，与煎剂兼用补益，腹胀全消，饮食逐渐增加，共腹泻七十二天，服用人参二斤多。当地人听说以补法收功，都感到惊奇。而钱小松才心悦诚服地说：奇妙啊，奇妙啊！别人多用攻伐，孙君唯独用补益；别人多用攻下，孙君唯独用催吐。由于见识真切，所以投药准确。医术岂可轻易言谈呢？从此以后，知道孙君的高明了。
Zhang Sixuan, Third Yin (Magistrate) of Jinxiang County, and Pan Shaobao (Vice Minister) Yinchuan, both married daughters of the Shi family, making them brothers-in-law. The Shi family was originally wealthy, and Mr. Zhang's wife was virtuous and intelligent, diligent and earnest in managing the household, meticulous and clean in her conduct. Due to multiple childbirths, her Qi and Blood became exhausted; furthermore, due to complex marriage arrangements, expenses exceeded income, leading to chronic worry. At nearly fifty years old, she fell ill with Xin Bi (Heart Bi Syndrome, characterized by chest pain and palpitations). Upon attack, she would faint, urination would be scanty and difficult, chest and diaphragm pain unbearable, accompanied by irritability, dry retching, nausea, internal steaming heat, rising Qi, emaciation with visible bones, and continuous menstrual bleeding. Local contemporaries diagnosed it variously as Qi deficiency or Ge Shi (Dysphagia/Regurgitation), but all were at a loss. She lay comatose for ten days, having taken no liquid or solid food for five days. With signs of impending death present and the family helpless, they prayed to deities. I happened to be at the Pan residence and was summoned to examine her pulse. The left pulse was wiry and large; the right pulse was slippery, large, and rapid. After examination, I said, "She can be saved." The pathogenesis states: "All rebellious vomiting and acid regurgitation belong to Fire; all wind syndromes with tremors and dizziness belong to Wood." The treatment method should regulate the Liver, clear Heat, resolve stagnation, and calm the Spirit. The other physicians stared and mocked behind my back, saying, "The classics state that bone-steaming flesh-emaciation is fatal, form emaciated with large pulse and excessive Qi in the chest is fatal, and starvation is fatal. Master Sun alone promises life. Is he the Medicine King reincarnated?" Ignoring them, I selected herbs and prescribed them. Zhu Ru (Bamboo Shavings) and Hua Shi (Talcum) each 3 qian, Bai Dou Kou Ren (Cardamom Seed Kernel) 0.7 fen, Ban Xia Qu (Pinellia Fermented Paste), Ju Hong (Tangerine Peel), Jiang Lian (Ginger-processed Coptis), Fu Ling (Poria) each 1 qian, Gan Cao (Licorice Root) 0.5 fen. Decoct in water and let the patient swallow slowly drop by drop. After finishing the dose, retching stopped and fainting ceased. The next day, Wen Dan Tang (Warm Gallbladder Decoction) was used to mix with 3 qian of Chen Sha Yi Yuan San (Cinnabar Benefit Origin Powder). After administration, the chest and diaphragm instantly opened, allowing gradual intake of fluids and food, urination became smooth and prolonged, irritability completely subsided, and she rested peacefully as if nothing had happened. Later, Xiao Yao San (Free and Easy Wanderer Powder) and Liu Jun Zi Tang (Six Gentlemen Decoction) were used, added with Huang Lian (Coptis Rhizome) and Xiang Fu (Cyperus Rhizome). After three months, muscle mass recovered, and spirit returned to normal. The locals were amazed, saying, "To cure such a disease, you are indeed the Medicine King."
Ma Di'an, Second Yin of Ma, aged fifty-five, overate eel rolls during tomb-sweeping, resulting in heart and abdominal distension and pain. City physicians, unaware of using emesis, hastily administered Xiao (Natrii Sulfas) and Huang Lian (Rhubarb Rhizome) to purge, but stool did not pass, and distension and pain increased. Subsequent physicians used Mu Xiang Bing Lang Wan (Aucklandia and Areca Pill), followed by Xiao Cheng Qi Tang (Minor Order the Qi Decoction), and then Da Cheng Qi Tang (Major Order the Qi Decoction). After more than ten days, distension and pain worsened significantly. No food could be ingested, stool was completely blocked, and urine was merely drops. Later physicians again used Da Huang (Rhubarb Rhizome) and Mang Xiao (Mirabilite), which failed even in large doses, claiming only Bai Bing Zi (White Cake Pill) would work. After five days of this, pain intensified further. Then Bei Ji Wan (Emergency Aid Pill) was claimed necessary; after three days, pain became unbearable. Subsequently, Gan Sui (Kansui Root), Yuan Hua (Genkwa Flower), Da Ji (Euphorbia Root), and Qian Niu (Pharbitis Seed) were used. After three days, not only was stool blocked, but urine also ceased entirely, with unbearable distension. Physicians shouted in astonishment. From the second day of the third lunar month to the twenty-second day, twenty days had passed. A scholar named Wang Nanye moxiated Zhongwan (CV12) for over thirty moxa cones, with no effect, and predicted death on the twenty-fifth day at Xu hour (7-9 PM). Di'an's four sons, all scholars, wept upon hearing this. Zhang Huaichi, a Taixue student and Di'an's nephew, having seen me cure Zhang Sixuan's wife, urgently requested my help. Upon arrival, his complexion was dark/black, spirit was concealed, voice was loud, but abdomen was large like an inverted basket, unable to turn sideways. Pulse was slippery and large in both hands, especially strong in the Chi (Kidney) positions. Investigating the origin of the disease and reviewing previous medications, I was shocked to have never seen such a case. I formulated a treatment plan, first prescribing Liu Jun Zi Tang (Six Gentlemen Decoction) with Mu Xiang (Aucklandia Root) and Sha Ren (Amomum Fruit), using 2 qian each of Ren Shen (Ginseng Root) and Bai Zhu (Atractylodes Macrocephala Rhizome). A man named Qiao Xiaosong nearby, claiming medical lineage, objected to the prescription. I said, "This is not what you know." He continued to question, citing, "It is said that for fullness in the middle, one should drain from within; for difficulty in urination and defecation, one should first promote urination and defecation. Is this correct?" I replied, "Not common sayings, but stated in Su Wen (Basic Questions)." He added, "Various pains should not use Ren Shen and Bai Zhu, especially for those with dark complexions. Since you know Su Wen, why use obstruction instead of unblocking?" I remained silent, then addressed Di'an's sons, "Master Qiao is a rigid Confucian who cannot cure your father. Your father does not have Middle Fullness Distension, but Internal Injury Syndrome. Initially, the injury was in the Upper Jiao (Upper Burner); the method should be emesis. Su Wen states: 'For diseases in the upper part, use the method of evacuation (emesis).' Using purgatives instead of emesis damages the Spleen. When Spleen Qi is damaged, its transportation function fails, leading to more purging causing more damage, and more damage causing more distension. Did you not consider that when Spleen Qi is damaged, the Shen (Spirit/Mind) cannot function, and medicines cannot move? Using harsh purgatives follows what principle? Because the Spleen is injured, I use Liu Jun Zi Tang to awaken the Spleen, and Mu Xiang and Sha Ren to assist movement. I will then use emesis to expel the previously ingested drugs. My prescription treats the doctors' errors, not your father's disease directly. I initially wished to spare the doctors, but Master Qiao provoked me to expose their faults. Moreover, I do not fear constipation, but fear that once it starts, it may not stop." Qiao absurdly asked, "In emergencies, treat the branch. Now methods fail to produce even one bowel movement, how can you worry about non-stop diarrhea?" I said, "Consider, how much Xia and Huang Lian can a normal person take? How much Ba Dou (Croton Seed) or Bai Bing Zi? Here, over 5 jin of Xia/Huang Lian and 5-6 liang of Ba Dou/Bai Bing Zi have been taken, plus harsh agents like Gan Sui, Qian Niu, Yuan Hua, and Da Ji. Fortunately, stool has not passed, and drug properties have not activated, so there is still time to act. If stool passes, all drug properties will activate, like a leaking bottle bottom; how much can remain? It is critical!" Qiao questioned again, "Why does frequent purging not produce stool?" I said, "Easy to understand. Initially food injury, then drug injury. Injury is in Upper and Middle Jiao, Lower Yuan (Kidney/Essence) is undamaged, hence Chi pulses still have spirit. Nan Jing states: 'The two Chi pulses are like roots of a tree.' Nei Jing states: 'The Kidney is the gate of the Stomach.' The Kidney governs defecation. His dark complexion and concealed spirit indicate the root is intact, relying on this, recovery is possible." After medication, severe abdominal pain occurred, indicating drug activation. I changed to Ren Shen Lu (Ginseng Stem), Fang Feng Lu (Saposhnikovia Root Stem), Sheng Ma (Cimicifuga Rhizome), and Jie Geng (Platycodon Root) each 3 qian, decocted and given. Shortly after, goose feather induced emesis. Over ten bowls of previously ingested drugs were vomited out. The patient held his forehead and said, "My vision is bright now." This was Si hour (9-11 AM). I said, "Stool will pass at You hour (5-7 PM). Buy several jin of Ren Shen in advance for emergencies." At noon, Zhi Bao Dan (Treasure-containing Pill) was given to warm Middle Qi. Between Wei and Shen hours (1-5 PM), sounds were heard in the abdomen, turbid Qi rolled downward, and the abdomen expanded by several inches within moments. By evening, one bowel movement occurred, and urination slightly resumed. I immediately prescribed Ren Shen and Bai Zhu each 5 qian, Pao Jiang (Prepared Ginger) 3 qian, Fu Ling 2 qian, Mu Xiang and Gan Cao each 0.5 fen, Chen Pi 1 qian, to be decocted urgently. At Fourth Drum (1-3 AM), another bowel movement occurred, followed by urination, and distension/pain gradually decreased. The next day, over ten diarrheal movements occurred. Therefore, Li Zhong Tang (Regulate the Middle Decoction) formula was made into pills, combined with decoctions for tonification. Abdominal distension completely resolved, diet gradually improved. Total diarrhea lasted 72 days, consuming over 2 jin of Ren Shen. Locals were surprised by the successful use of tonification. Qiao Xiaosong finally submitted, saying, "Marvelous! Marvelous! Others mostly use attacking methods, Master Sun uses tonification; others mostly use purging, Master Sun uses emesis. Due to true insight, the prescriptions were accurate. Medicine cannot be discussed lightly. Henceforth, I recognize Master Sun's greatness."