筠翁长郎病失血。岁二三发。其后所出渐多。咳嗽发热。食减肌削。屡至小康。不以为意。夏秋间偶发寒
热如疟状。每夜达曙。微汗始解。嗣后寒热稍减。病转下利。医谓其虚也。进以参术。胸膈
迷闷。喉音窒塞。服茯苓山药预收红铅末。下黑血块数
升。胸喉顿舒。而容亦转。筠翁神之。以为得竹破竹补之法也。加用桂附二剂。于是下利一昼夜十数行。饮食
难入。神识不清。病增沉剧。仆诊其脾脉大而空。肾脉小而乱。肺脉沉而伏。筠翁自谓知医。令仆疏方。并问
此为何症。仆曰。此症患在亡阴。况所用峻热之药。如权臣悍帅。不至犯上无等不已。行期在立冬后三日。以
今计之。不过信宿。无以方为也。何以言之。经云。暴病非阳。久病非阴。则数年失血。其为阳盛阴虚无疑。
况食减而血不生。渐至肌削而血日槁。虚者益虚。盛者益盛。势必阴火大炽。上炎而伤肺金。咳嗽生痰。清肃
下行之令尽壅。繇是肾水无母气以生。不足以荫养百骸。柴闸极瘦损。每申酉时洒淅恶寒。转而热至天明。微汗
始退。正如夏日炎蒸。非雨不解。身中之象。明明有春夏无秋冬。用药方法。不亟使金寒水冷。以杀其势。一
往不返矣。乃因下利误用参术补剂。不知肺热已极。止有从皮毛透出一路。今补而不宣。势必移于大肠。所
谓肺移热于大肠。传为肠 者是也。至用红铅末下黑血者。盖阳分之血。随清气行者。久已呕出。其阴分之
血。随浊气行至胸中。为膜原所蔽。久瘀膈间者。得经水阴分下出之血。引之而走下窍。声应气求
之妙也。久积顿宽。面色稍转。言笑稍适者。得其下之之力。非得其补之之力也。乃平日预蓄此药。必为方士
所惑。见为真阳大药。遂放胆加用。桂附燥热。以尽劫其阴。惜此时未得止之。今则两尺脉乱。火燔而泉竭。
脾胃脉浮。下多阴亡。阳无所附。肺脉沉伏。金气缩敛不行。神识不清。而魄已先丧矣。昔医云。
乱世溷浊。有同火化。夫以火济火。董曹乘权用事。汉数焉得不终耶。
胡卣臣先生曰。论症论药。俱从卓识中流出。大有关系之作。
刘筠翁的长子患有失血病。每年发作两三次。后来出血量逐渐增多。伴有咳嗽、发热，食欲减退，肌肉消瘦。病情虽然多次暂时好转，但他并不在意。夏秋之间偶尔出现像疟疾一样的寒热症状，每晚持续到天亮，微微出汗后才缓解。此后寒热稍减，病症转为腹泻。医生认为这是虚证，给予人参、白术等补益药物服用后，胸膈部迷闷，喉间声音窒塞。又服用了茯苓、山药以及预先准备好的红铅末，结果排出了几升黑色血块，胸部和喉咙顿时舒畅，面色也稍有恢复。刘筠翁对此感到神奇，认为这是得到了“竹破竹补”（以同类之物修补受损之体）的方法。于是加用肉桂、附子各两剂，导致腹泻一昼夜达十几次，饮食难进，神志不清，病情加重且变得危重。
我诊察他的脾脉大而中空，肾脉小而紊乱，肺脉沉伏。刘筠翁自认为懂医，让我开方，并询问这是什么病症。我说：此症的根本在于亡阴。况且所使用的大辛大热之药，如同权臣悍将，不到犯上作乱的地步是不会罢休的。危险期在立冬后的第三天，按现在计算，不过两天时间，无法再开方治疗了。为什么这么说？《内经》说：突发急病多非纯阳证，久病多非纯阴证。那么数年的失血，显然是阳盛阴虚无疑。何况食欲减退导致血液生化无源，逐渐肌肉消瘦而血液日益枯竭。虚者更虚，盛者更盛，势必导致阴火大炽，向上炎灼损伤肺金，产生咳嗽生痰，清肃下行的功能完全壅滞。因此肾水缺乏母气（肺气）的滋生，不足以荫养全身筋骨。患者身体极度瘦损，每天申时、酉时（下午3-7点）洒淅恶寒，转而发热直到天明，微微出汗后才退去。这正如夏日炎热蒸腾，没有雨水就不会解除。人体内的景象，明明只有春夏（阳热）而没有秋冬（阴寒收敛）。用药方法，如果不紧急使金寒水冷，以遏制其势头，病情就会一发不可收拾。
然而因为腹泻误用人参、白术等补剂，不知道肺热已经极盛，本来只有从皮毛透发这一条出路。现在补益而不宣散，势必使热邪转移到大肠，这就是所谓的“肺移热于大肠，传为肠澼（痢疾）”。至于服用红铅末排出黑血块，是因为属于阳分的血液，随着清气运行，早已呕出；属于阴分的血液，随着浊气运行到胸中，被膜原遮蔽，长期瘀积在膈间。得到经血（此处指红铅，古人认为具有类似经血的阴分属性）从阴分下行引动，从而引导瘀血走下窍排出，这是声应气求的妙用。长期积聚的瘀血顿时宽松，面色稍转红润，言语欢笑稍感舒适，是得益于攻下的力量，而不是补益的力量。
然而他平日预先储备这种药，必定是被方士所迷惑，将其视为真阳大药，于是大胆加用。肉桂、附子燥热，彻底劫夺了他的阴液。可惜当时未能阻止。现在两尺脉紊乱，火燔烧而泉水枯竭；脾胃脉浮，因腹泻过多导致阴亡，阳气无所依附；肺脉沉伏，金气缩敛不行；神志不清，魄已先丧。古代医生说：乱世浑浊，犹如火化。用火来济助火，董贤、曹宫等人掌权用事，汉朝怎么能不终结呢？
胡卣臣先生说：对病症和药物的论述，都出自独到的见识，是关系重大的著作。
Mr. Liu Yunweng's eldest son suffered from a hemorrhagic disease, recurring two or three times a year. Later, the volume of blood loss gradually increased. He presented with cough, fever, reduced appetite, and emaciation. Although his condition improved temporarily on several occasions, he paid no attention to it. During summer and autumn, he occasionally experienced chills and fever resembling malaria (malaria-like syndrome), lasting until dawn each night, resolving only after slight sweating. Subsequently, the chills and fever subsided slightly, but the condition turned into diarrhea. The physician considered it a deficiency syndrome and administered tonics such as Ginseng Radix et Rhizoma (Renshen) and Atractylodis Macrocephalae Rhizoma (Baizhu). After taking these, he felt chest and diaphragmatic oppression and hoarseness with airway obstruction. He then took Poria (Fuling), Dioscoreae Rhizoma (Shanyao), and pre-prepared Red Lead Powder (Hongqianmo). This resulted in the passage of several sheng (a traditional Chinese unit of volume) of black blood clots. His chest and throat instantly felt relieved, and his complexion improved somewhat. Mr. Liu found this miraculous, believing he had discovered the method of "repairing bamboo with bamboo" (using similar substances to repair damaged tissues). Consequently, he added Cinnamon Twig (Guizhi) and Prepared Aconite Root (Fuzi) for two doses. This led to diarrhea occurring more than ten times in a day and night, difficulty in ingesting food, confusion of consciousness, and a severe worsening of the critical illness.
Upon examining his Spleen pulse, I found it large and empty; his Kidney pulse was small and chaotic; his Lung pulse was deep and hidden. Mr. Liu, claiming medical knowledge, asked me to prescribe and inquire about the diagnosis. I said: "The root of this syndrome lies in the exhaustion of Yin. Moreover, the harsh hot medicines used act like powerful ministers and fierce generals; they will not cease their rebellion against the upper body until they have caused chaos. The crisis is predicted to occur three days after the Start of Winter. Calculating from today, it will be no more than two nights. There is no point in prescribing further." Why do I say so? The Classic states: "Acute diseases are rarely purely Yang; chronic diseases are rarely purely Yin." Therefore, years of hemorrhage undoubtedly indicate Excess Yang and Deficiency of Yin. Furthermore, reduced appetite leads to insufficient generation of blood, resulting in progressive emaciation and daily depletion of blood. The deficient becomes more deficient, and the excessive becomes more excessive. This inevitably leads to intense blazing of Yin Fire, flaming upward and damaging Lung Metal, causing cough and phlegm production. The clear descending function becomes completely obstructed. Consequently, Kidney Water lacks the generating Qi (from Lung Metal) and fails to nourish the entire body. The patient is extremely emaciated, experiencing chills every Shen and You hours (3 PM–7 PM), which turn into fever until dawn, resolving only after slight sweating. This is exactly like the steaming heat of summer, which cannot be resolved without rain. The internal state clearly shows only Spring and Summer (Yang/Heat) without Autumn and Winter (Yin/Cold). The treatment method must urgently employ strategies to make the Metal cold and Water cool to suppress this momentum; otherwise, the condition will become irreversible.
However, due to the misapplication of Ginseng and Atractylodes tonics for diarrhea, the extreme Lung Heat was ignored. Originally, there was only one pathway for the heat to escape through the skin and hair. Now, tonification without dispersion forces the pathogen to shift to the Large Intestine. This is what is meant by 'Lung transferring heat to the Large Intestine, transmitting as intestinal dysentery' (Chang Pi). Regarding the expulsion of black blood clots via Red Lead Powder: Blood belonging to the Yang aspect, traveling with clear Qi, had long been vomited out. Blood belonging to the Yin aspect, traveling with turbid Qi to the chest, was obscured by the Membrane Source (Mo Yuan) and stagnated in the Diaphragm for a long time. The introduction of menstrual-type blood (Red Lead, possessing Yin characteristics) from below guided the stasis to exit through the lower orifices, demonstrating the subtle interaction of resonance between sound and Qi. The long-standing accumulation was suddenly relieved, the complexion improved slightly, and speech and laughter became more comfortable. This was due to the power of purgation (downward draining), not tonification.
He had previously stockpiled this medicine, likely misled by Daoist alchemists who regarded it as a supreme Yang tonic, leading him to boldly increase its dosage. Cinnamon and Aconite are dry and hot, thoroughly plundering his Yin fluids. It is regrettable that this was not stopped earlier. Now, both Chi pulses (Kidney positions) are chaotic, indicating fire blazing and spring water exhausted; the Spleen and Stomach pulses are floating, indicating Yin loss from excessive diarrhea, leaving Yang without attachment; the Lung pulse is deep and hidden, indicating Lung Metal Qi contracting and failing to circulate; consciousness is unclear, and the Po (Corporeal Soul) has already perished. As ancient physicians said: "In chaotic times, turbidity resembles cremation. To add fire to fire, while Dong Xian and Cao Gong hold power, how can the Han Dynasty not end?"
Mr. Hu Youchen stated: "The discussion of symptoms and medicines flows from profound insight. It is a work of great significance."