程家内眷，藏溪汪氏女也。乃夫殁于疫疠，新寡七日，疫即及之。大热头疼，口渴，胸
胁并
痛。医与小柴胡汤，夜忽梦夫交泄而觉，冷汗淫淫，四肢如解，略不能动，神昏谵语，面如
土色，舌若焦煤、强硬。迓予诊之，六脉沉弦而数，大小便俱秘，此亦阴阳易类也。疫后有
是，危已极矣。予以生脉汤加柴胡、黄芩、桂枝、甘草，水煎成，将乃夫昔穿旧裤裆烧灰调
下两剂而神醒，体温，汗敛，舌始柔和，焦也渐退。次日，仍以前方加酸枣仁、竹茹，四肢
始能运动，乃饮粥汤。仅一子甫十岁，一女甫十四，继被疫困，均以六神通解散汗之而安。
妯娌及婢辈六人皆六神通解散瘳之。举家德予，以为再造。
族侄太学从明，夏初由客邸患滞下，调半痊而归，因食隔宿猪首而复，里急后重，昼
夜三
四十度，日渐沉困，口渴，胸膈焦辣，手必热，腹微痛，小水少。每解时先干哕，呕恶，汗
出飞飞，下皆稠粘紫黑血，无粪。彼素知医，且慎重，不轻服人药。敦予诊之，脉左沉弦，
右滑数，面色外黑内黄，饮食不入，肛门辣痛。予以渠原禀薄弱，今远归，途次不能无劳，
不敢疏下。姑以胃风汤加黄连，与二帖不效，腹稍加胀。渠叮予曰∶古云无积不成痢，顾积
势胶固，切勿用补，无以体素弱为疑。予曰∶诺!改用黄芩芍药汤三剂无进退。乃私语渠侄
元亮曰∶令伯之症，实实虚虚，热热寒寒，实不易治，且谷食噤口不入，干哕可虑，须得明
哲参治。元亮从容言之，欲得方古墩为翼，诸相契及内眷递相赞言。太学不从。曰∶吾岂不
重命而吝费哉？顾新都之医，无如叔最明，吾之交无如叔最浓，舍叔安所倚？元亮曰，叔祖善
矣，能用人之长，得一隽商榷，可无后虑。太学拂然曰∶知莫过于知心，吾知其心久矣，专
任勿疑也。予知渠信任坚若金石，益加研究，图欲先开胃口，使新谷食净宿秽压出，或补或
攻，视缓急以为方略。乃背嘱元亮曰∶令伯非人参不可，幸且勿露，俾予得以尽技。元亮曰
∶诺。乃仿朱丹溪法，用人参、黄连各二钱，煎浓，细细呷之，但得一呷下咽，胃口便开，
哕恶便止。盖胃口虚热冲上为哕也。其日用之，哕恶即止大半。连与两日，觉胸腹胀，即以
保和丸应之。觉小水不利，又以清六丸应之。里急后重以，参术加芩、连、木香、槟榔、滑
石、桃仁应之。人参皆背加，太学不知也。渠每诊必叮予曰∶日来疾稍平，叔之力也。幸忽
遽补，恐废前功。予曰∶如教。讵知人参已服过十日，计二两许矣。此后脉仅四至，软而无
力。忆丹溪云∶虚回而痢自止。又云∶气虚甚者，非附子不能行参 。乃以胃风汤加黄 、
附子、姜炭四剂而血全无，后重也止，惟大便泻而不实，所下俱黄粪。渠知积滞己尽，始欲
理脾，用参苓白术散服十日，便仍不实。乃问予曰∶补脾而泻不止奈何？予曰∶据脉乃下元
虚寒，殆肾泄非脾泄也，温补下元则固矣。盖肾者胃之关，初不敢用下剂者，虑有今日也。
教以菟丝子、破故纸、杜仲、山茱萸、人参、大附子、白茯苓、泽泻，四帖全瘳。里中称太
学能知人，而予不负所任也。
程家的一位女性亲属，是藏溪汪氏的女儿。她的丈夫死于瘟疫，她新寡七日，瘟疫便传染给了她。出现高热、头痛、口渴，胸胁部都疼痛。医生给她服用小柴胡汤，夜里忽然梦见与亡夫交合泄精而醒来，冷汗淋漓，四肢松弛无力，几乎不能动弹，神志昏迷且胡言乱语，面色如土，舌苔像烧焦的煤块一样黑且僵硬。请我来诊察，六脉沉弦而数，大小便都闭塞不通，这属于阴阳易类的病证。瘟疫后出现这种情况，病情极其危重。我给予生脉汤加柴胡、黄芩、桂枝、甘草，水煎成后，让她将亡夫以前穿过的旧裤裆烧成灰调服两剂，于是神志清醒，体温恢复正常，汗液收敛，舌头开始变得柔和，焦黑的舌苔逐渐消退。第二天，仍然用前方加入酸枣仁、竹茹，四肢才开始能活动，于是喝粥汤。她只有一个刚十岁的儿子和一个刚十四岁的女儿，随后也被瘟疫困扰，都用六神通解散发汗治疗而痊愈。妯娌及婢女等六人也都用六神通解散治愈了。全家感激我，认为我是他们的再生父母。
族侄太学从明，夏初在客居地患上痢疾，调理到半愈时回家，因为吃了隔夜的猪头肉而复发，出现里急后重，昼夜发作三四十次，日渐沉重困倦，口渴，胸膈部感觉焦辣，手摸上去发热，腹部微痛，小便少。每次排便前先干呕，恶心呕吐，出汗如雨，排出的都是稠粘的紫黑色血，没有粪便。他平时懂医，且行事慎重，不轻易服用别人的药。恳请我来诊察，脉象左手沉弦，右手滑数，面色外黑内黄，饮食无法入口，肛门辣痛。我认为他原本禀赋薄弱，如今远途归来，途中难免劳累，不敢轻易使用攻下法。姑且用胃风汤加黄连，给他两帖，但无效，腹部稍微更加胀满。他叮嘱我说：“古话说无积不成痢，现在积滞之势胶固，千万不要用补法，不要因为我素体虚弱就有所疑虑。”我说：“好吧！”改用黄芩芍药汤三剂，病情没有进退。于是私下对他的侄子元亮说：“令伯的病症，虚实夹杂，寒热错杂，确实不易治疗，而且谷食噤口不入，干呕令人担忧，需要得明智之人共同参详治疗。”元亮从容地转达了他的话，想要得到方古墩作为辅助，各位亲友及家中女性亲属也相继赞同。太学不同意，说：“我难道不是看重生命而吝惜费用吗？只是新都的医生，没有谁像我叔父最高明，我的交情没有谁像我叔父最深厚，除了叔父我还依靠谁呢？”元亮说：“叔祖医术精湛，善于用人之长，找一个杰出的人商讨，就可以没有后顾之忧。”太学生气地说：“了解人莫过于了解内心，我了解您的用心已经很久了，专门任用您，不要怀疑。”我知道他信任坚定如金石，更加深入研究，图谋先打开胃口，使新摄入的食物洗净宿积秽物排出，或者补或者攻，视缓急情况制定方略。于是背着他嘱咐元亮说：“令伯非人参不可，希望暂时不要透露，让我得以施展技艺。”元亮说：“好的。”于是模仿朱丹溪的方法，用人参、黄连各二钱，煎浓汁，细细呷服，只要有一呷咽下，胃口便开，干呕恶心便停止。这是因为胃口虚热冲上导致干呕。这样每天使用，干呕恶心便止住大半。连续用了两天，觉得胸腹胀闷，就用保和丸应对。觉得小便不利，就用清六丸应对。里急后重用党参、白术加黄芩、黄连、木香、槟榔、滑石、桃仁应对。人参都是暗中添加的，太学并不知道。他每次诊察必叮嘱我说：“近日疾病稍平，是叔父的功劳。希望不要急于进补，恐怕会破坏之前的成果。”我说：“遵命。”岂知人参已服用过十天，共计约二两。此后脉象仅四至，软弱无力。想起朱丹溪说：“虚象恢复而痢疾自然停止。”又说：“气虚甚重的，非附子不能行参力。”于是用胃风汤加黄芪、附子、姜炭四剂，而血全无，后重也停止，只是大便泻而不实，所下的都是黄色粪便。他知道积滞已尽，才想调理脾胃，用参苓白术散服用十日，大便仍不实。于是问我：“补脾而腹泻不止怎么办？”我说：“根据脉象，这是下元虚寒，大概是肾泄而非脾泄，温补下元就能固摄了。肾是胃的关口，起初不敢用下剂，就是考虑到会有今天的情况。”教他用菟丝子、破故纸、杜仲、山茱萸、人参、大附子、白茯苓、泽泻，四剂全愈。乡里称赞太学能识人，而我也不辜负他的信任。
The female relative of the Cheng family, a daughter of the Wang clan from Zangxi, contracted the epidemic seven days after her husband's death from the pestilence. She presented with high fever, headache, thirst, and pain in the chest and hypochondrium. The physician administered Xiao Chai Hu Tang (Minor Bupleurum Decoction). Suddenly, during the night, she dreamed of sexual intercourse with her deceased husband and ejaculated upon waking. Cold sweat poured down, her limbs felt flaccid as if dislocated, and she could barely move. Her spirit was confused, she spoke deliriously, her face was like earth, and her tongue was black and stiff like burnt coal. I was summoned to examine her. The six pulses were deep, wiry, and rapid. Both urination and defecation were obstructed. This is a case resembling Yin-Yang Exchange (a condition where pathogenic factors are transmitted between spouses, often after one has recovered from an epidemic disease). Such symptoms appearing after an epidemic are extremely critical. I prescribed Sheng Mai San (Generate the Pulse Powder) modified with Chai Hu (Bupleuri Radix), Huang Qin (Scutellariae Radix), Gui Zhi (Cinnamomi Ramulus), and Gan Cao (Glycyrrhizae Radix). The decoction was prepared, and she took two doses mixed with ash from her late husband's old undergarment. Consequently, her consciousness cleared, body temperature normalized, sweating ceased, her tongue became soft, and the black coating gradually receded. The next day, the same formula was used with added Suan Zao Ren (Ziziphi Spinosae Semen) and Zhu Ru (Bambusae Caulis in Taeniae). Only then could her limbs move, and she began to drink rice gruel. Her only son, aged ten, and daughter, aged fourteen, were subsequently afflicted by the epidemic. Both were treated with Liu Shen Tong San (Six-Unity Dispelling Powder) to induce sweating and recovered. Six other women, including sisters-in-law and maids, were also cured by Liu Shen Tong San. The entire family regarded me as their savior and expressed profound gratitude.
My clan nephew, Tai Xue Cong Ming, suffered from dysentery (Li Ji, 滞下) while staying away from home in early summer. He returned home when his condition had improved by half, but relapsed after eating leftover pork head. He experienced tenesmus (Li Ji Hou Zhong, 里急后重), occurring thirty to forty times a day, becoming increasingly weak and lethargic. Symptoms included thirst, a burning sensation in the chest and epigastrium, hot hands, mild abdominal pain, and scanty urine. Before each bowel movement, he experienced dry retching, nausea, vomiting, and profuse sweating. The stool consisted solely of thick, sticky, purple-black blood without feces. Being knowledgeable in medicine and cautious, he did not readily accept medication from others. He earnestly requested my consultation. His pulse was deep and wiry on the left, and slippery and rapid on the right. His complexion was dark on the outside and yellow within. He could not take food or drink, and his anus burned and hurt. Considering his original constitution was weak and that he had endured travel fatigue, I dared not use harsh purgatives. I tentatively prescribed Wei Feng Tang (Stomach Wind Decoction) with added Huang Lian (Coptidis Rhizoma). After two doses, there was no improvement, and abdominal distension increased slightly. He urged me, saying, "Ancient texts state that no accumulation means no dysentery. The current accumulation is stubborn; do not use tonics. Do not let my weak constitution deter you." I agreed and switched to Huang Qin Shao Yao Tang (Scutellaria and Peony Decoction) for three doses, but the condition remained static. I privately told his nephew, Yuan Liang, "Your uncle's condition involves both excess and deficiency, heat and cold, making it difficult to treat. Moreover, the inability to eat and the dry retching are concerning. We need a wise colleague to consult together." Yuan Liang conveyed this respectfully, suggesting Fang Gudun as a consultant, and other relatives supported this idea. Tai Xue refused, stating, "Do you think I value life less or am stingy with money? Among physicians in Xindu, none surpass my uncle in wisdom. Among my friends, none share a deeper bond with me than my uncle. Whom else can I rely on?" Yuan Liang replied, "Your grandfather is skilled and good at utilizing others' strengths. Consulting with a capable expert will ensure no future regrets." Tai Xue said angrily, "Knowing a person is knowing their heart. I have known your intentions for a long time. Appoint you exclusively; do not doubt." Knowing his trust was firm as metal and stone, I studied the case more deeply. My strategy was first to open the stomach appetite so that new food would help expel old stagnation, then decide whether to tonify or purge based on urgency. I secretly instructed Yuan Liang, "Your uncle requires Ginseng Root (Ren Shen); please keep this secret so I may fully apply my skills." Yuan Liang agreed. Following the method of Zhu Danxi, I used two qian of Ginseng Root and Coptidis Rhizoma, decocted into a concentrated liquid, which he sipped slowly. After just one sip, his appetite opened, and retching stopped. This was due to deficient heat in the stomach rising up. Using this daily, the retching and nausea subsided by more than half. After two consecutive days, he felt chest and abdominal fullness, so I administered Bao He Wan (Preserve Harmony Pill) to address it. When he reported difficulty in urination, I used Qing Liu Wan (Clear Six Pill) to resolve it. For tenesmus, I used Dang Shen (Codonopsis Radix) and Bai Zhu (Atractylodis Macrocephalae Rhizoma) combined with Huang Qin, Huang Lian, Mu Xiang (Aucklandiae Radix), Bing Lang (Arecae Semen), Hua Shi (Talcum), and Tao Ren (Persicae Semen). The Ginseng was added secretly, unknown to Tai Xue. At every visit, he would say, "The illness has stabilized recently thanks to you. Please do not rush to tonify, lest you undo previous efforts." I replied, "As you command." Unbeknownst to him, he had taken Ginseng for ten days, totaling approximately two liang. Thereafter, his pulse slowed to four beats per cycle, becoming soft and forceless. Recalling Zhu Danxi's words: "When deficiency recovers, dysentery stops naturally," and "For severe Qi deficiency, only Aconite Root (Fu Zi) can facilitate the action of Ginseng," I prescribed Wei Feng Tang modified with Huang Qi (Astragali Radix), Fu Zi, and Jiang Tan (Charred Ginger). After four doses, the bleeding ceased completely, and tenesmus stopped. However, the stool remained loose and unformed, consisting of yellow feces. Realizing the stagnation was exhausted, he wished to regulate the spleen and took Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) for ten days, but the loose stools persisted. He asked, "If tonifying the spleen does not stop the diarrhea, what should be done?" I said, "Based on the pulse, this is deficiency-cold of the lower origin. It is likely Kidney-type Diarrhea (Shen Xie, 肾泄) rather than Spleen-type. Tonifying and warming the lower origin will secure it. The Kidney acts as the gate of the Stomach. I initially avoided purgatives precisely because I anticipated this outcome." I prescribed Tu Si Zi (Cuscutae Semen), Po Gu Zhi (Psoraleae Fructus), Du Zhong (Eucommiae Cortex), Shan Zhu Yu (Corni Fructus), Ren Shen, Da Fu Zi, Bai Fu Ling (Poria), and Ze Xie (Alismatis Rhizoma). After four doses, he was fully cured. The villagers praised Tai Xue for discerning talent, and I for fulfilling his trust.