邵敬圃令眷，常胃脘痛，由气郁而起。近以产后下痢红白，而胃脘之痛不止，汗多，六
脉滑
大无力，法当收敛。以小建中汤为主，白芍药酒炒四钱，炙甘草一钱半，桂皮、五灵脂醋炒
各一钱，香附、糖球子各八分，水煎饮之，痛减，汗未全敛。次日前方加御米壳醋炒过一钱
，两帖全止。
苏文学望台，患疟一日一发，先寒后热，热多寒少，胸膈痞闷，口渴，小便混浊，腥臊
不可
近。医五越月不效，面黄肌瘦，饮食减少，喘息呻吟，精神疲惫，起须人扶，乃敦予治。脉
得沉弦而数。公问曰∶是疟否？予曰∶是。公曰∶吾闻之，真病不治，治之无功。盖真者，
死候也。疟，殆常病，不过寒热虚实表里。诸名家曾认为表症者，麻黄、羌活、柴胡等汗之
矣
；有认为里症者大柴胡汤辈下之矣；有认为痰饮者，常山、矾石吐之矣；有认为虚寒者，附
子理中汤、人参服过三斤矣；有认为实热，用白虎汤、枳实、青皮、槟榔、草果消之矣。尽
法备尝，绝无一应，疟岂亦有真而卒至于死
耶？言讫泪潸潸下。予曰∶观公色脉，疟将发矣，不暇辩，第饮予药不死也。以柴胡、滑石
各五钱为君，鳖甲三钱为臣，黄连、知母各一钱为佐，枳实、甘草各五分，黑豆四十九粒为
使。水煎送下昆布鳖甲丸，申刻疟至，戌初便止。公喜曰∶向者，疟发未申，夜半尚不能止
，即止犹倦怠懒言。适饮先生药，不两时而止，止便能言，先生之功也。予曰∶偶耳。今日
服药已晏，明日五更幸早服之。服讫竟日不发。又次日，前方加人参、白术，小水腥臊之气
已无，精神徒长。公又喜曰∶两日无苦，先生之功也。予曰∶偶然耳。公曰∶嘻，吾疟几
半载，休、歙之名公莫不历试，卒无影响，先生一举奏奇，有而不居，益见所养，不审汤名
何剂，乞指示之，以诏将来。予曰∶公何以名为哉。老子曰∶无名天地之始，矧医亦道也，
即道亦是强名。医贵识病，苟识病，一、二、三品，便能成剂立功。经云∶约方如约囊。又
曰∶方以类聚，方凭病立。苟不识病，即尽本草一千六百五十六品并而服之，未见其益也。
疟固常疾，治亦不易。仲景有言曰∶治疟当分六经。予谓即六经之中，又各有寒热虚实阴阳
在
焉，是六六而三十六也。即三十六之中又有挟痰、挟食、挟气者，禀弱者，曷能枚举？人与
天地、阴阳一致，天地变化无穷，人身灾患不一，岂拘拘一百一十三方、三百九十七法所能
概哉？王节斋曰∶古人因病以立方，非立方以待病也。斯言深得轩岐立方大意。然予今日所
用之剂，和剂也。仲景谓汗吐下后而邪热不减者，是为坏症。以小柴胡汤加鳖甲治之。予特
仿仲景小柴胡例，加益元散撤邪热从小便中出。鳖甲虽治坏症，又能截疟。公曰∶噫嘻，前
此诸公看病不过曰寒、曰热、曰虚实而已，未尝有此妙论，诚空谷跫音也。吾闻先生从祝令
君潘去华辈，六邑会中讨究理致，又曾览先生序大易彀、序翼飞，乃知先生融三教而萃于医
。先生之医得之于性命窍中，故能全人性命也有如此。
邵敬圃的夫人，经常胃脘部疼痛，这是由于气机郁结引起的。最近因为产后患下痢（痢疾），排出红白脓血，导致胃脘痛持续不止，且出汗很多，六脉滑大但无力，治疗法则应当以收敛为主。以小建中汤作为主方，用酒炒白芍药四钱，炙甘草一钱半，桂皮、五灵脂（醋炒）各一钱，香附、糖球子（即乌梅或类似收涩果类，此处指代具体药材，通常指乌梅或榧子等，依原文保留原名“糖球子”）各八分，水煎服用。服药后疼痛减轻，但汗仍未完全止住。第二天在前方基础上加入醋炒御米壳（罂粟壳）一钱，服用两帖后症状完全停止。
苏文学望台，患疟疾，每日发作一次，先恶寒后发热，热多寒少，胸膈部痞塞闷胀，口渴，小便浑浊，气味腥臊难闻。医生治疗了五个月没有效果，患者面色发黄，肌肉消瘦，饮食减少，喘息呻吟，精神疲惫，起床需要人搀扶，于是诚恳地邀请我诊治。脉象沉弦而数。我问：“这是疟疾吗？”他说：“是。”我说：“我听说，真正的绝症是不治的，治了也没有功效。所谓‘真病’，是指死候。疟疾大概是常见病，不过是寒热虚实表里的变化。各位名医有的认为是表证，用麻黄、羌活、柴胡等发汗；有的认为是里证，用大柴胡汤之类攻下；有的认为是痰饮，用常山、矾石催吐；有的认为是虚寒，服用了附子理中汤、人参多达三斤；有的认为是实热，用白虎汤、枳实、青皮、槟榔、草果等消导清热。各种方法都试过了，完全没有反应，难道疟疾也有真正不治而最终致死的吗？”说完泪流满面。我说：“看您的神色和脉象，疟疾即将发作，没空辩论，只管喝我的药，不会死人。”我用柴胡、滑石各五钱为君药，鳖甲三钱为臣药，黄连、知母各一钱为佐药，枳实、甘草各五分，黑豆四十九粒为使药。水煎送服昆布鳖甲丸。申时疟疾发作，戌初便停止了。他高兴地说：“以前，疟疾发作不到申时就已开始，半夜还不能停止，即使停止也倦怠懒言。刚才喝了先生的药，不到两个时辰就停止了，停止后就能说话，这是先生的功劳。”我说：“只是偶然罢了。今天服药已经晚了，明天五更天希望早点服用。”服完后整天都没有再发作。又过了一天，前方加入人参、白术，小便腥臊的气味已经消失，精神逐渐恢复。他又高兴地说：“两天没有痛苦，是先生的功劳。”我说：“也是偶然。”他说：“唉，我患疟疾将近半年，休宁、歙县的名医无不尝试过，最终毫无效果，先生一举奏效却不居功，更加可见您的修养深厚。不知这方剂叫什么名字，恳请指示，以便昭示后人。”我说：“您为什么要问名字呢？老子说：‘无名，天地之始’，何况医学也是道，即使是‘道’也是勉强命名的。医学贵在识别病症，如果认识了病症，无论是一品、二品还是三品的药物，都能组成方剂并建立疗效。经书说：‘约方如约囊’（约束方剂就像约束口袋一样有法度）。又说：‘方以类聚，方凭病立’。如果不认识病症，即使把本草中的一千六百五十六种药物全部合起来服用，也看不到益处。疟疾虽然是常见病，治疗也不容易。张仲景说过：‘治疟当分六经’。我认为即使在六经之中，又各有寒热虚实阴阳的区别，这样就是六六三十六种情况。在这三十六种情况中，又有挟痰、挟食、挟气的，体质虚弱的，怎么能一一列举？人与天地、阴阳是一致的，天地变化无穷，人身灾患不一，岂能拘泥于一百一十三首方剂、三百九十七种治法所能概括呢？王节斋说：‘古人因病以立方，非立方以待病也。’这句话深得黄帝、岐伯创立方剂的深意。然而我今天所用的方剂，是和缓的方剂。张仲景说：发汗、催吐、攻下之后，邪热不减的，称为坏症。用小柴胡汤加鳖甲治疗。我特别模仿张仲景小柴胡汤的体例，加入益元散使邪热从小便排出。鳖甲虽然能治坏症，又能截断疟疾。”他说：“唉呀，此前各位大夫看病不过说是寒、说是热、说是虚实而已，从未有过如此精妙的论述，真是空谷足音啊。我听说先生跟随祝令君、潘去华等人，在六邑会中探讨医理，又曾阅读先生写的《大易彀序》、《翼飞序》，才知道先生融合儒释道三教而汇聚于医学。先生的医术得之于性命窍妙之中，所以能保全人的性命达到如此境界。”
Shao Jingpu's wife frequently suffered from epigastric pain (stomach region pain), originating from Qi stagnation (Qi mechanism depression). Recently, due to postpartum dysentery (dysentery with red and white discharge), the epigastric pain persisted, accompanied by profuse sweating. The six pulses were slippery, large, but powerless. The treatment principle should be astringency (to consolidate and stop leakage). Xiao Jianzhong Tang (Minor Construct the Middle Decoction) was used as the main formula: Bai Shao Yao (Radix Paeoniae Alba) stir-fried with wine, 4 qian; Zhi Gan Cao (Honey-fried Radix Glycyrrhizae) 1.5 qian; Gui Pi (Cortex Cinnamomi) and Wu Ling Zhi (Gallus Fermented) each stir-fried with vinegar, 1 qian; Xiang Fu (Rhizoma Cyperi) and Tang Qiu Zi (Fruit of Diospyros kaki or similar astringent fruit, kept as original name) each 8 fen. Decocted in water and drunk. The pain decreased, but sweating had not completely stopped. The next day, Yu Mi Ke (Pericarpium Papaveris Rubi / Poppy Shell) stir-fried with vinegar, 1 qian, was added to the previous formula. After two doses, symptoms ceased completely.
Su Wenxue Wangtai suffered from malaria (Jue disease), occurring once daily, starting with chills followed by fever, with more heat and less cold. He experienced chest and diaphragm fullness and oppression, thirst, turbid urine with a foul, fishy odor. Physicians treated him for five months without effect. His face was sallow, muscles emaciated, food intake reduced, he panted and groaned, spirit was exhausted, and he needed support to stand. He earnestly invited me to treat him. The pulse was deep, wiry, and rapid. I asked, "Is this malaria?" He said, "Yes." I said, "I have heard that true terminal illnesses are untreatable; treating them yields no merit. 'True illness' refers to a death omen. Malaria is likely a common disease, involving merely excess/deficiency, cold/heat, exterior/interior patterns. Some famous physicians considered it an exterior syndrome and induced sweating with Ma Huang (Ephedrae Herba), Qiang Huo (Notopterygii Rhizoma et Radix), Chai Hu (Bupleuri Radix), etc.; some considered it an interior syndrome and purged it with Da Chai Hu Tang (Major Bupleurum Decoction); some considered it phlegm-fluid retention and induced vomiting with Chang Shan (Dichroae Radix), Fan Shi (Alumen); some considered it deficiency-cold and administered Fu Zi Li Zhong Tang (Aconite Regulate the Middle Decoction) and Ren Shen (Ginseng Radix) totaling three jin; some considered it excess-heat and used Bai Hu Tang (White Tiger Decoction), Zhi Shi (Fructus Aurantii Immaturus), Qing Pi (Exocarpium Citri Reticulatae Viride), Bing Lang (Arecae Semen), Cao Guo (Fructus Tsaoko) to dissipate heat. All methods were tried, yet absolutely no response. Could malaria also be truly incurable leading to death?" Upon finishing speaking, tears flowed down. I said, "Observing your complexion and pulse, the malaria is about to attack. There is no time to debate; just drink my medicine, and you will not die." I used Chai Hu (Bupleuri Radix) and Hua Shi (Talcum) each 5 qian as Sovereign drugs; Bie Jia (Carapax et Plastrum Testudinis) 3 qian as Minister drugs; Huang Lian (Coptidis Rhizoma) and Zhi Mu (Anemarrhenae Rhizoma) each 1 qian as Assistant drugs; Zhi Shi (Fructus Aurantii Immaturus) and Gan Cao (Radix Glycyrrhizae) each 5 fen, and Hei Dou (Sojaes Semen Nigrum) 49 grains as Envoy drugs. Taken with water, accompanied by Kun Bu Bie Jia Wan (Kelp and Turtle Shell Pill). At Shen hour (3-5 PM), the malaria arrived, and by Xu hour (7-9 PM), it had stopped. He rejoiced, saying, "Previously, the malaria started before Shen hour and could not stop until midnight. Even when it stopped, I was listless and reluctant to speak. Just now, after drinking your medicine, it stopped in less than two hours, and I could speak immediately. This is your merit." I said, "It was merely chance. Today the medicine was taken late; tomorrow at Wugeng (3-5 AM), please take it early." After taking it, there was no recurrence all day. On the second day, Ren Shen (Ginseng Radix) and Bai Zhu (Atractylodis Macrocephalae Rhizoma) were added to the previous formula. The foul smell of urine disappeared, and spirit gradually increased. He rejoiced again, saying, "No suffering for two days, this is your merit." I said, "Also chance." He said, "Alas, I have suffered from malaria for nearly half a year. Distinguished physicians in Xiuyi have all tried, yet with no result. You achieved a miraculous cure but do not claim credit, further revealing your cultivation. I wonder what this formula is named? Please instruct me so as to enlighten future generations." I said, "Why ask for a name? Laozi said: 'Nameless is the beginning of heaven and earth.' How much more so is medicine a Dao? Even 'Dao' is a forced name. Medicine values recognizing the disease. If the disease is recognized, whether using first, second, or third-grade herbs, one can form a prescription and achieve efficacy. The Classics say: 'Constrain the prescription like constraining a bag.' It also says: 'Prescriptions gather by category; prescriptions are established based on diseases.' If the disease is not recognized, even if one takes all 1656 species listed in Ben Cao together, no benefit will be seen. Malaria is indeed a common disease, yet its treatment is not easy. Zhang Zhongjing said: 'Treating malaria requires distinguishing the Six Channels.' I believe that within the Six Channels, there are further distinctions of cold/heat, excess/deficiency, and Yin/Yang, making thirty-six categories. Within these thirty-six, there are cases complicated by phlegm, food stagnation, Qi stagnation, or weak constitution. How can they all be enumerated? Humans are consistent with Heaven, Earth, Yin, and Yang. Heaven and Earth change infinitely; human ailments are diverse. How can they be summarized by merely 113 prescriptions and 397 methods? Wang Jiezhai said: 'The ancients formed prescriptions according to diseases, not formed prescriptions to wait for diseases.' This statement deeply captures the general intent of Huangdi and Qibo in establishing prescriptions. However, the prescription I used today is a harmonizing formula. Zhang Zhongjing stated: 'After sweating, vomiting, or purging, if pathogenic heat does not decrease, it is called a damaged syndrome.' It is treated with Xiao Chai Hu Tang (Minor Bupleurum Decoction) plus Bie Jia. I specifically imitated Zhang Zhongjing's Xiao Chai Hu Tang example, adding Yi Yuan San (Benefit Primordial Powder) to eliminate pathogenic heat via urination. Although Bie Jia treats damaged syndromes, it also arrests malaria." He said, "Alas! Previous physicians only spoke of cold, heat, and excess/deficiency. They never offered such profound theories. Truly, it is like hearing footsteps in an empty valley. I hear that you studied principles with officials like Zhu Lingjun and Pan Quhua among the Six Counties, and read your prefaces to 'Da Yi Gou' and 'Yi Fei'. Thus I know you integrate the Three Teachings into medicine. Your medical skill derives from the mysteries of life and nature, which is why you can preserve human life so effectively."