查良本兄令眷，怒后偶食鱼头，骨梗于喉中，即以馒头粽肉等压之，骨虽下，便觉胸膈
不快
。又服消骨药两日，迨今乃七日矣。胸膈胀痛殊甚，饮食悉从背后而下，恶寒发热，六脉弦
数
。予思骨梗之后，用硬物压之，伤其胃脘，必有瘀血停留膈间，将食管逼在背后，故饮食觉
从背后下也。今但消去瘀血，使食管撤消，胸膈之痛可瘳矣。药以五灵脂为君，山楂、玄胡
索、桃仁、枳壳为臣，赤芍药、牡丹皮、香附、山栀仁为佐，柴胡、石菖蒲为使，水煎临服
入韭汁一酒杯饮之。其夜胸膈宽快，大便泻一次，痛减大半，饮食仍从右边而下。右边胸喉
稍痛，吞物甚艰若，吐出痰皆血腥气。改以山栀、赤芍药、归尾、桃仁、刘寄奴、五灵脂、
牡丹皮、穿山甲、煎，入韭菜汁服之，两帖全瘳。
后溪大兄孺人戴氏，勤笃严谨人也。秋患痢，所下皆血及屋漏水，内有血子如赤小豆者
不可
计数，昼夜五六十行，里急后重，哕恶不住声者，五日。予以刘守真芍药汤与三剂而病无进
退。适后溪兄在浙，侄女辈素信医博黄氏为女科专门，延而治之，投以芩、连、枳壳、槟榔
、山栀、地榆、黄柏、滑石之类，服已五日，始虽哕恶，一日尚有碗粥，今则粒米不进，腹
痛转加，必用重物压之乃稍定。神思昏弱，卧不能起，下午发热。女科仍以前剂加青皮、枳
实。侄孙尔嘉持药见予曰∶家姑酷信黄医为专门，今已任事五日，较前精神大瘁，叔翁为祖
父至交，宁无一语启愚乎？子曰∶吾非不言，欲诋黄，恐为妒妇之口，今子来，予可诊之。
六脉滑大无力。诊毕，慌语尔嘉曰∶事急，可速令人促乃祖归。否则，令姑女流，不谙医药
，吾安能施其巧？比有西席汪带川闻之，决尔嘉曰∶此事极要调停，留黄医以安女流心，黄
发之剂，搁而不进，以东宿之剂作黄剂进之，内外无猜则妥矣。予然其言，以人参、白术、
酒炒白芍各三钱，炙甘草一钱半，炮姜、肉桂各一钱，白茯苓、陈皮各八分，砂仁五分，大
枣二枚，水煎饮之。哕恶减半，其夜痢减十之五，惟腹痛不甚减。次早诊之，脉稍敛。黄医
以为渠功，大言自矜，药仍以芩连之类。予仍以前剂再加黄 。其日下午始纳粥一茶盏，腹
痛渐减。又次晨，黄医诊视，见夜来痢减其七，益得扬扬得志。语左右曰∶寒家业医五代，
似
此大病也不多见。自以为非彼也无能治也。尔嘉诘曰∶疟痢也寻常耳，何以为大？黄曰∶丹
溪云下痢身凉者生，身热者死；下痢纯血者死；脉洪大者死；如屋漏水者半死半生。今皆犯
之，故云去也。尔嘉曰∶然。然则今日当用何剂∶黄曰∶剂已投病，仍当确守前方，何敢轻
改
？尔嘉笑而点首，复向予求剂。予以理中汤倍加酒炒白芍药，以肉桂佐之。腹痛身热悉愈
。
痢十去九矣。后溪兄也浙回，尔嘉述病原，以黄方、予方呈看，后溪唏嘘叹息。乃辞谢黄而
诘予曰∶人言下赤痢者热，哕恶者热，又身热脉大，吾弟何独认为寒，而用此大热之剂成功
，曷故哉？予曰∶此虚虚实实之处，极能误人，尊嫂之热非真有余之热，乃内有虚寒逼真血
火上行，故哕恶潮热耳。脉大而无力仍作虚看，且向服寒凉不效，当自知警也。后溪兄曰∶
微弟几败乃事矣。
查良本兄的夫人，在发怒后偶然吃了鱼头，鱼骨卡在喉咙里，于是用馒头、粽肉等硬物强行压下，虽然骨头下去了，但随即感到胸膈部不适。又服用了两天化骨药，到现在已经七天了。胸膈胀痛非常严重，饮食完全从背部下方通过（感觉食物走背），伴有恶寒发热，六脉呈现弦数之象。我思考认为，鱼骨卡住后用硬物压迫，损伤了胃脘，必然导致瘀血停滞在膈间，将食管挤压到后方，所以感觉饮食是从背后通过的。现在只需消除瘀血，使食管恢复正常位置，胸膈的疼痛就可以痊愈了。用药以五灵脂为君药，山楂、玄胡索、桃仁、枳壳为臣药，赤芍药、牡丹皮、香附、山栀仁为佐药，柴胡、石菖蒲为使药，水煎煮，临服用时加入一杯韭菜汁饮下。当晚胸膈感到宽舒畅快，大便排泄一次，疼痛减轻大半，饮食仍从右侧通过。右侧胸喉稍痛，吞咽物体非常困难，吐出的痰都有血腥气味。改为以山栀、赤芍药、归尾、桃仁、刘寄奴、五灵脂、牡丹皮、穿山甲煎汤，加入韭菜汁服用，两剂药后完全康复。
后溪大兄的夫人戴氏，是一位勤勉笃实、严谨的人。秋季患痢疾，所下的都是血液和像屋漏滴水一样的污血，里面有像赤小豆大小的血块，数量不可计数，昼夜排便五六十次，有里急后重感，呃逆恶心不停声，持续了五天。我给予刘守真的芍药汤，服用三剂后病情没有进退变化。恰逢后溪兄在浙江，侄女辈一向信任精通医术的黄氏医生是妇科专家，便请她来治疗，投以黄芩、黄连、枳壳、槟榔、山栀、地榆、黄柏、滑石之类的药物，服用五天后，起初还有呃逆恶心，一天还能吃一碗粥，现在则粒米不进，腹痛加剧，必须用重物按压腹部才能稍微安定。神志昏沉虚弱，卧床不能起身，下午发热。妇科医生仍然以前方加上青皮、枳实。侄孙尔嘉拿着药来见我说道：“家姑非常信任黄医生是专家，现在已经诊治五天，相比之前精神更加憔悴，叔翁与祖父是至交好友，难道就没有一句话开导我吗？”我说：“我不是不说，想批评黄医生，怕被嫉妒妇人的嘴舌中伤，现在你来了，我可以为她诊察。”六脉滑大而无力。诊察完毕，慌张地对尔嘉说：“情况紧急，可速派人催促你的祖父回来。否则，家姑是女子，不懂医药，我怎么能施展我的技巧呢？”此时有位西席老师汪带川听到后，劝解尔嘉说：“这件事极需调和，留下黄医生以安女子的心，把黄医生的发散药剂搁置不喝，把东宿（指孙一奎）的药剂当作黄医生的药剂喝下去，内外没有猜疑就妥当了。”我认为他的话有道理，用人参、白术、酒炒白芍各三钱，炙甘草一钱半，炮姜、肉桂各一钱，白茯苓、陈皮各八分，砂仁五分，大枣二枚，水煎饮用。呃逆恶心减半，当晚痢疾减少十分之五，只有腹痛没有怎么减轻。第二天早晨诊察，脉象稍微收敛。黄医生认为是她的功劳，大声自夸，药方仍然使用黄芩、黄连之类的药物。我仍然用前一方再加黄 。当天下午才开始摄入茶盏大小的粥，腹痛逐渐减轻。又第二天早晨，黄医生诊视，看到夜间痢疾减少了十分之七，更加得意洋洋。对左右的人说：“寒门行医五代，像这样的大病也不多见。”自以为如果不是她就没有人能治好了。尔嘉质问说：“疟疾和痢疾是寻常病，为什么说是大病？”黄医生说：“丹溪说：下痢身体凉爽的能生，身体发热的死；下痢纯血的死；脉洪大的死；像屋漏水的半死半生。现在都犯了这些禁忌，所以说难治。”尔嘉说：“既然如此，那么今天应当用什么方剂？”黄医生说：“药已经投下，病情仍在，仍应当严格坚守前方，怎么敢轻易更改？”尔嘉笑着点头，又向我求方。我用理中汤加倍酒炒白芍药，以肉桂辅助它。腹痛和身热全部痊愈。痢疾去除了十分之九。后溪兄从浙江回来，尔嘉叙述病因，把黄医生的方子和我的方子呈给他看，后溪唏嘘叹息。于是辞谢了黄医生并责问我：“人们说下红痢的是热证，呃逆恶心的是热证，又有身热脉大，唯独弟弟您认为是寒证，而用这种大热的药剂取得成功，这是什么缘故？”我说：“这是虚虚实实的误治之处，极易误导人，尊嫂的热不是真正的有余之热，而是内有虚寒逼迫虚火上行，所以出现呃逆恶心和潮热。脉大而无力的仍按虚证看待，况且之前服用寒凉药无效，应当自己知道警惕了。”后溪兄说：“如果没有弟弟，几乎要败坏这件事了。”
Zha Liangben's wife, after experiencing anger, accidentally ate fish head. A bone got stuck in her throat. She then used hard foods such as steamed buns and zongzi meat to press it down. Although the bone went down, she immediately felt discomfort in the chest and diaphragm. She took bone-dissolving medicine for two days, and seven days have passed since then. The distending pain in the chest and diaphragm is severe. Food and drink seem to pass down through the back. She experiences aversion to cold and fever. The six pulses are wiry and rapid. I reasoned that after the bone was stuck, using hard objects to press it caused injury to the stomach region, leading to blood stasis stagnating between the diaphragm. This likely compressed the esophagus backward, which is why food feels like it passes from behind. Now, one only needs to eliminate the blood stasis so that the esophagus returns to its normal position, and the pain in the chest and diaphragm can be cured. The prescription uses Lingzhi (Trogopterus Dung) as the sovereign herb, Hawthorn Fruit (Shanzha), Corydalis Rhizome (Yanhusuo), Peach Kernel (Taoren), and Bitter Orange (Zhike) as minister herbs, Red Peony Root (Chishao), Moutan Cortex (Mudanpi), Cyperus Rhizome (Xiangfu), and Gardenia Seed (Shanzhiren) as assistant herbs, Bupleurum Root (Chaihu) and Acorus Rhizome (Shichangpu) as guide herbs. Decoct with water, and before taking, add one wine cup of Chinese Leek Juice (Jiu Zhi). That night, the chest and diaphragm felt relaxed and comfortable. There was one bowel movement, and the pain decreased by more than half. Food still passed down on the right side. The right chest and throat were slightly painful. Swallowing was very difficult. The expectorated phlegm had a bloody odor. The prescription was changed to Gardenia Seed (Shanzhi), Red Peony Root (Chishao), Angelica Sinensis Tail (Guiwei), Peach Kernel (Taoren), Liuji Nu, Lingzhi (Trogopterus Dung), Moutan Cortex (Mudanpi), and Pangolin Scales (Chuanshanjia) decocted together, taken with Chinese Leek Juice. After two doses, she was completely cured.
Houxi's wife, Lady Dai, was a diligent, earnest, and rigorous person. In autumn, she suffered from dysentery. What she passed consisted of blood and dirty fluid resembling dripping roof water. Inside were blood clots like red adzuki beans, countless in number. She defecated fifty to sixty times day and night, experiencing tenesmus (li ji hou zhong), and continuous hiccups and nausea for five days. I prescribed Shaoyao Decoction (Shaoyao Tang) by Liu Shouzhen. After three doses, there was no improvement or worsening. Coincidentally, Houxi was in Zhejiang. His nieces always believed that Dr. Huang, who was knowledgeable in medicine and specialized in gynecology, was an expert. They invited her to treat the patient. Dr. Huang administered herbs such as Scutellaria Root (Huangqin), Coptis Rhizome (Huanglian), Bitter Orange (Zhike), Areca Seed (Binglang), Gardenia Fruit (Shanzhi), Sanguisorba Root (Diyu), Phellodendron Bark (Huangbai), and Talcum (Huashi). After five days of taking these, although there was initially hiccups and nausea, she could still eat a bowl of porridge a day. Now, she cannot take even a grain of rice. Abdominal pain has worsened, requiring heavy pressure on the abdomen to find slight relief. Her mental state is confused and weak; she lies in bed unable to rise. She has afternoon fever. The gynecologist continued with the previous formula adding Green Tangerine Peel (Qingpi) and Immature Bitter Orange (Zhishi). Nephew Erjia brought the medicine to me and said: "My aunt strongly believes Dr. Huang is a specialist. She has been treating her for five days now, but her spirit is much more exhausted than before. Uncle, you are a close friend of my grandfather. Do you not have a word of advice?" I said: "I am not unwilling to speak, but if I criticize Dr. Huang, I fear being slandered by jealous tongues. Now that you have come, I can examine her." The six pulses were slippery, large, and powerless. After finishing the diagnosis, I anxiously told Erjia: "The situation is urgent. Quickly send someone to urge your grandfather to return. Otherwise, my aunt is a woman unfamiliar with medicine. How can I apply my skills?" At this time, a tutor named Wang Daichuan heard this and advised Erjia: "This matter requires careful mediation. Keep Dr. Huang to soothe the lady's mind. Do not administer Dr. Huang's dispersing agents. Instead, administer Dong Su's (Sun Yikui's) prescription as if it were Dr. Huang's. If there is no suspicion inside and outside, it will be proper." I agreed with his words. I prescribed Ginseng Radix et Rhizoma (Renshen), Atractylodes Macrocephala Rhizome (Baizhu), and White Peony Root (Baishao) stir-fried with wine, each 3 qian; Licorice Root (Gancao) roasted, 1.5 qian; Ginger Rhizoma (Shengjiang) processed, Cinnamon Twig (Rougui), each 1 qian; Poria (Fuling), and Tangerine Peel (Chenpi), each 8 fen; Amomum Fruit (Sharen), 5 fen; and Jujube (Dazao), 2 pieces. Decoct with water and drink. Hiccups and nausea decreased by half. That night, dysentery decreased by five-tenths. Only abdominal pain did not decrease significantly. The next morning, upon examination, the pulse had slightly converged. Dr. Huang claimed credit for this, boasting loudly, and kept prescribing Scutellaria and Coptis-like formulas. I continued with my previous formula, adding additional [herb name missing in source]. On the afternoon of that day, she finally consumed a teacup of porridge, and abdominal pain gradually decreased. The following morning, Dr. Huang examined her. Seeing that dysentery had decreased by seven-tenths overnight, she became extremely proud. She told those around her: "My family has practiced medicine for five generations. Such a severe illness is rarely seen." She assumed that without her, no one could cure it. Erjia questioned: "Malaria and dysentery are common ailments. Why do you call this a major illness?" Dr. Huang said: "Danxi stated: Those with dysentery and cool body temperature survive; those with fever die; those with pure blood discharge die; those with surging-large pulses die; those with discharge like dripping roof water are half-dead, half-alive. Now, all these conditions are present, hence I say it is difficult." Erjia said: "If so, what prescription should be used today?" Dr. Huang said: "The medicine has been administered, and the disease persists. We must strictly adhere to the previous formula. How dare I change it lightly?" Erjia smiled and nodded, then sought a prescription from me again. I prescribed Lizhong Decoction (Lizhong Tang) with doubled Wine-processed White Peony Root (Jiu Chao Baishao), assisted by Cinnamon Twig (Rougui). Abdominal pain and fever completely resolved. Dysentery improved by nine-tenths. When Houxi returned from Zhejiang, Erjia narrated the cause of the illness and presented both Dr. Huang's prescription and mine to him. Houxi sighed deeply. He then dismissed Dr. Huang and questioned me: "People say that passing red dysentery indicates heat, hiccups and nausea indicate heat, and fever with large pulses indicate heat. Why did you alone consider it cold and succeed with such hot-natured prescriptions? What is the reason?" I said: "This is the pitfall of 'deficiency creating deficiency' and 'excess creating excess,' which easily misleads people. The heat in your sister-in-law is not true excess heat. It is internal deficiency-cold forcing deficient fire upward, causing hiccups, nausea, and tidal fever. A large but powerless pulse should still be viewed as deficiency. Moreover, previous treatment with cold-natured herbs was ineffective. One should learn caution from this." Houxi said: "Without you, brother, I would have nearly ruined the case."