有曹姓讳镗者，九月重阳，以胸膈不舒畅，而谒南溪兄为治，诊未竟，予至。南溪兄起
语曹曰∶舍弟高手，浼诊之。诊讫未有言。而南溪私问曰∶曹何如脉？予曰∶不治。会易货者沓
至，予亦别去，曹果次年二月死。南溪兄问曰∶何曹无它病，而弟见脉即断不治，何也？予
曰∶其脉两寸洪滑搏指，两关微弦，两尺微弱，《难经》所谓溢脉也。九月深秋，木凋零时
也，不宜弦大，大则上盛下虚，至二月木旺，木能生火，火木性皆上升不下，下无真阴以相
济，是有阳无阴，有升无降，《内经》曰∶出入废则神机化灭，升降息则气立孤危。是以断
曹子二月当呕吐而死也。
嘉善之妓李双，号素琴，体虽肥，而性冲澹，态度闲雅端重，歌调娼家推其擅场，与予
邑程
芹溪处浓，患痛风，自二月起至仲冬，诸治不效。鸨母悭毒，遂视为痼疾，不为治。而
芹溪固恳予诊之，六脉大而无力，手足肢节肿痛，两跨亦痛，不能起止，肌肉消其半，日仅
进粥二碗，月汛两月一行，甚少。予曰∶此行痹也。芹溪问∶病可治否？予笑而应曰∶君能
娶，予能治之。芹溪曰∶嫁娶乃风月中套语，公长者，乃亦此言。予曰∶观此子虽堕风尘，
实有良家风度，予故怜之。且君断弦未续，而彼有心于君，或天缘也。芹溪曰∶诚吾素愿，
恐鸨母高其价而难与言。予谓∶乘其病而盟之，易与耳。芹溪以予言为然，乞为治之。以人
参、白术、苡仁各三钱，当归、枸杞、杜仲、龟板、苍耳子各二钱，晚蚕砂、秦艽、防风各
一钱，大附子、甘草、桂枝、黄柏各五分，十帖而痛止肿消。改用归芍六君子，加苡仁、丹
参、红花、石斛、紫荆皮，三十帖而痊愈。芹溪娶之，善持家，举族称贤，而亦羡予知人焉
。
有一位姓曹名镗的人，在九月重阳节时，因为胸膈部感觉不舒畅，便去拜访南溪兄请求治疗。诊脉尚未结束，我便到了。南溪兄起身对曹某说：“我弟弟医术高明，请他为您诊治。”诊脉完毕后，我没有说话。南溪兄私下问我：“曹某的脉象如何？”我说：“无法治愈。”恰逢交易货物的人接连到来，我也便告辞离开，曹某果然在次年二月去世。南溪兄问道：“为什么曹某没有其他疾病，而我一看到他的脉象就断定无法治愈呢？”我说：“他的两寸脉洪大滑利且搏指有力，两关脉微弦，两尺脉微弱，这是《难经》中所说的溢脉。九月是深秋时节，草木凋零之时，脉象不宜呈现弦大之象。脉大则表明上盛下虚，到了二月木气旺盛之时，木能生火，火和木的性质都是上升而不下降，下部没有真阴来济助，这就形成了有阳无阴、有升无降的局面。《内经》说：‘出入废则神机化灭，升降息则气立孤危。’因此我断定曹某在二月会因为呕吐而死。”
嘉善地方的妓女李双，号素琴，身体虽然肥胖，但性情冲淡平和，仪态闲雅端庄，唱歌调笑方面被认为是青楼中的佼佼者，与我同县的程芹溪关系亲密。她患有痛风，从二月一直持续到仲冬，各种治疗方法都无效。老鸨吝啬狠毒，于是把这视为顽固性疾病，不再为她治疗。程芹溪坚决恳求我为她诊治，发现她六脉大而无力，手足关节肿痛，两胯也痛，不能站立行走，肌肉消瘦了一半，每天只喝两碗粥，月经两个月来一次，量很少。我说：“这是行痹（风邪偏盛的痹证）。”程芹溪问：“病能治好吗？”我笑着回答说：“您如果能娶她为妻，我就能治好她的病。”程芹溪说：“嫁娶不过是风月场中的套话，您是长者，怎么也说这种话。”我说：“观察这个人虽然身处风尘，但实际上具有良家妇女的风度，所以我怜悯她。况且您丧偶未续弦，而她对您有意，或许是天定的缘分吧。”程芹溪说：“这确实是我平素的愿望，只是恐怕老鸨抬高身价，难以开口商量。”我对他说：“趁着她生病的时候与她定下婚约，很容易做到。”程芹溪认为我的话是对的，请求我为她治病。用人参、白术、薏苡仁各三钱，当归、枸杞、杜仲、龟板、苍耳子各二钱，晚蚕砂、秦艽、防风各一钱，大附子、甘草、桂枝、黄柏各五分，服用十帖后疼痛停止、肿胀消退。改用归芍六君子汤（当归、白芍、六君子汤），加入薏苡仁、丹参、红花、石斛、紫荆皮，服用三十帖后痊愈。程芹溪娶了她，她善于持家，全族人都称赞她贤惠，同时也羡慕我能识人。
There was a man surnamed Cao, named Tang. On the Double Ninth Festival in September, due to a feeling of discomfort and lack of smoothness in his chest and diaphragm, he visited Brother Nanxi for treatment. Before the pulse diagnosis was completed, I arrived. Brother Nanxi stood up and said to Cao: "My younger brother is highly skilled; please let him diagnose you." After the diagnosis was finished, I remained silent. Brother Nanxi privately asked me, "How is Cao's pulse?" I replied, "It is incurable." At that time, merchants dealing in goods came frequently, so I took my leave. Indeed, Cao died in February of the following year. Brother Nanxi asked, "Why did you declare it incurable upon seeing the pulse, given that Cao had no other illnesses?" I said, "His pulses at both Cun (inch) positions were surging, slippery, and striking the finger forcefully; the pulses at both Guan (middle) positions were slightly wiry; and the pulses at both Chi (cubit) positions were weak and faint. This is what the *Nan Jing* (Classic of Difficult Issues) calls the 'Overflowing Pulse' (Yi Mai). In September, during late autumn when trees wither, a wiry and large pulse is inappropriate. A large pulse indicates excess above and deficiency below. By February, when Wood energy is prosperous, Wood generates Fire. Both Wood and Fire have ascending natures and do not descend. Without True Yin in the lower body to harmonize them, there is Yang without Yin, and ascending without descending. The *Nei Jing* (Inner Canon) states: 'When entry and exit cease, the Spirit Mechanism perishes; when ascending and descending stop, Qi stands alone and in danger.' Therefore, I predicted that Cao would die from vomiting in February."
Li Shuang, a courtesan in Jiashan, styled Suzqin, although physically stout, possessed a calm and indifferent nature, with an elegant, dignified, and serious demeanor. She was considered the foremost talent in singing and entertainment among courtesans. She had a close relationship with Cheng Qinxu, a fellow townsman of mine. She suffered from gout (Tongfeng), which persisted from February until mid-winter, resisting all treatments. The brothel owner, being stingy and cruel, regarded this as an incurable chronic disease and ceased treatment. Cheng Qinxu earnestly requested my diagnosis. Her six pulses were large but powerless. Her hands, feet, and joints were swollen and painful, and her hips also hurt, making it impossible for her to stand or walk. Her muscles had wasted by half, she consumed only two bowls of porridge daily, and her menstrual cycle occurred only once every two months with scant flow. I said, "This is Xing Bi (Wandering Bi, characterized by wind predominance)." Cheng Qinxu asked, "Can this illness be cured?" I smiled and replied, "If you can marry her, I can cure her." Cheng Qinxu said, "Marriage talk is merely conventional rhetoric in the world of pleasure; you are a gentleman, why speak thus?" I said, "Observing this woman, though fallen into the dust of the profession, she actually possesses the demeanor of a virtuous family lady. Thus, I pity her. Moreover, you are widowed and unmarried, while she has feelings for you; perhaps it is destiny." Cheng Qinxu said, "This is indeed my long-held wish, but I fear the brothel owner will inflate the price, making negotiation difficult." I told him, "Propose marriage while she is ill; it will be easy to accomplish." Cheng Qinxu agreed with my words and begged me to treat her. I prescribed Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Rhizoma), Yi Yi Ren (Coicis Semen) each 3 qian; Dang Gui (Angelicae Sinensis Radix), Gou Qi Zi (Lycii Fructus), Du Zhong (Eucommiae Cortex), Gui Ban (Testudinis Carapax et Plastrum), Cang Er Zi (Xanthii Fructus) each 2 qian; Wan Can Sha (Bombyx Batryticatus), Qin Jiao (Gentianae Macrophyllae Radix), Fang Feng (Saposhnikoviae Radix) each 1 qian; Da Fu Zi (Aconiti Lateralis Radix Preparata), Gan Cao (Glycyrrhizae Radix et Rhizoma), Gui Zhi (Cinnamomi Ramulus), Huang Bo (Phellodendri Cortex) each 5 fen. After ten doses, the pain stopped and swelling subsided. The prescription was changed to Gui Shao Liu Jun Zi Tang (Guishao Liujunzi Decoction, consisting of Dang Gui, Bai Shao, and Six Gentlemen Decoction), added with Yi Yi Ren, Dan Shen (Salviae Miltiorrhizae Radix), Hong Hua (Carthami Flos), Shi Hu (Dendrobii Caulis), and Zi Jing Pi (Broussonetiae Cortex). After thirty doses, she recovered completely. Cheng Qinxu married her. She managed the household well, and the entire clan praised her virtue, admiring my ability to discern character.