钱叔翁太老先生。形体清瘦。平素多火少痰。迩年内蕴之热。蒸湿为痰。辛巳夏秋间。湿热交胜时。忽患
右足麻木。冷如冰石。盖热极似寒。如暑月反雨冰雹之类。医者以其足跗之冷
也。不细察其为热极似寒。误以牛膝木瓜防己加皮羌独之属温
之。甚且认为下元虚惫。误用附桂河车之属补之。以火济火。以热益热。由是肿溃出脓水。浸淫数月。踝骨以
下。足背指踵。废而不用。总为误治而至此极耳。其理甚明。无难于辨。若果寒痰下坠。不过坚凝不散止耳。
甚者不过痿痹不仁止耳。何至肿而且溃。黄水淋漓。腐肉穿筋耶。太翁不知为医药所误。乃委咎于
方隅神煞所致。岂其然哉。此与伤寒坏证。热邪深入经络而为流注。无少异也。所用参膏。但可颛理元气。而
无清解湿热之药以佐之。是以未显厥效。以元老之官。不可以理烦剧。设与竹沥同事。人参固其经。竹沥通
其络。则甘寒气味。相得益彰矣。徐太掖先生服人参以治虚风。误佐以附子之热。迄今筋脉短缩。不便行持。
亦繇不识甘寒可通经络也。且太翁用参膏后。脾气亦既大旺。健运有加矣。此时倘能撙节饮食。俾脾中所生之
阳气。得颛力以驱痰驱热。则痰热不留行。而足患并可结局。乃日食而外。加以夜食。虽脾气之旺。不为食所
伤。然以参力所生之脾气。不用之运痰运热。止用之以运食。诚可惜也。今者食入亦不易运。以助长而反得
衰。乃至痰饮胶结于胸中。为饱为闷。为频咳而痰不应。总为脾失其健。不为胃行津液。而饮食反以生
痰。渐渍充满肺窍。咳不易出。虽以治痰为急。然治痰之药。大率耗气动虚。恐痰未出。而风先入也。唯是
确以甘寒之药。杜风消热润燥补虚豁痰。乃为合法。至于辛热之药。断断不可再误矣。医者明明见此。辄用桂
附无算。想必因脓水易干。认为辛热之功。而极力以催之结局耳。可胜诛哉。
胡卣臣先生曰。湿热伤足。自上而下也。足寒伤心。自下而上也。自
上下者。先清其上。自下上者。先温其下。观此而民病伤国。可知治先在民矣。
钱叔翁老先生，身体清瘦。平时体内火旺而痰少。近年来，体内的蕴热蒸腾湿气化为痰饮。在辛巳年的夏秋之际，正值湿热交替盛行的时候，突然患上右足麻木，感觉冷如冰石。这其实是热极似寒的表现，就像盛夏时节反而降下冰雹一样。医生只看到他脚背冰冷，没有仔细辨别这是热极似寒的证候，错误地使用了牛膝、木瓜、防己、加皮、羌活、独活等温热性质的药物来治疗他。甚至有人认为他是下元（肾与命门）虚惫，错误地使用了附子、肉桂、紫河车等温补药物来进补。这就好比用火烧火，用热助热。因此导致患处肿胀溃烂，流出脓水，浸淫数月不止，踝骨以下、足背、脚趾和脚跟部位功能丧失，无法使用。这一切都是因为误治才导致了如此严重的后果。其中的道理非常明白，并不难于辨析。如果真的是寒痰下坠，不过是坚硬凝结不散罢了；严重些也不过是痿痹不仁而已。怎么会发展到肿胀且溃烂，黄水淋漓，腐肉穿筋的地步呢？钱老先生不知道是医药误治，反而归咎于方位神煞的影响，难道真是这样吗？这种情况与伤寒病中因误治导致的坏证，热邪深入经络形成流注（一种慢性化脓性炎症），几乎没有区别。当时所用的参膏，只能专门调理元气，却没有清热解湿的药物来辅助，所以没有显现出显著疗效。这就好比让德高望重的元老去处理繁杂琐碎的事务，是不合适的。假如配合竹沥一起使用，人参固护经脉，竹沥疏通络脉，那么甘寒的气味就能相得益彰了。徐太掖先生服用参膏治疗虚风，错误地辅以附子的热性，至今导致筋脉短缩，行动不便。这也是因为不懂得甘寒之品可以通利经络的缘故。况且钱老先生在使用参膏之后，脾气已经大旺，运化功能增强了。这时候如果能够节制饮食，使脾中所产生的阳气，能够专心致力于驱除痰饮和热邪，那么痰热就不会滞留流行，足部的疾病也可以痊愈。然而他在日常饮食之外，又加上夜宵，虽然脾气的旺盛没有被食物所损伤，但是由参力所产生的脾气，不去用来运化痰热，却只用来运化食物，这实在是很可惜的。现在食物进入体内也不容易运化，原本想通过补益来增强正气，反而导致正气衰退。以至于痰饮胶结在胸中，表现为饱胀、胸闷、频繁咳嗽但痰液难以咳出。这都是因为脾失去了健运的功能，不能为胃传输津液，导致饮食反而生痰，逐渐浸渍充满肺窍，咳嗽难以排出。虽然目前以治痰为急务，但是治疗痰饮的药物，大多耗气伤正，恐怕痰还未排出，外风先侵入体内了。唯有确切地使用甘寒的药物，来杜绝风邪、消除热邪、润燥补虚、豁痰开窍，才是合法的治疗方案。至于辛热性质的药物，绝对不可以再误用了。医生明明看到了这些情况，却反复使用桂枝、附子等药，想必是因为脓水容易干燥，认为是辛热药物的功效，从而极力催促其愈合罢了。这种错误真是令人痛惜啊！
胡卣臣先生说：湿热伤害足部，是从上往下的；足部受寒伤心，是从下往上的。从上往下传的病症，应当先清解上部的邪气；从下往上传的病症，应当先温补下部的正气。观察这个案例，就可以知道百姓生病如同国家受损，治理国家应当把关注点放在百姓身上。
Mr. Qian Shuweng, an elder gentleman, had a slender physique. He typically suffered from excessive internal heat with scant phlegm. In recent years, the latent heat within his body steamed and transformed dampness into phlegm. During the summer and autumn of the Xinsi year, when damp-heat was alternating in dominance, he suddenly developed numbness in his right foot, feeling as cold as ice or stone. This is actually a manifestation of extreme heat resembling cold, similar to hail falling during the height of summer. The physician, observing only the coldness of his dorsal foot, failed to carefully distinguish this condition of "extreme heat resembling cold." He erroneously treated him with warming herbs such as Achyranthis Radix (Niuxi), Chaenomelis Fructus (Mugua), Stephaniae Radix (Fangji), Phellodendri Cortex (Jiapí), Notopterygii Rhizoma et Radix (Qianghuo), and Saposhnikoviae Radix (Duhuo). Furthermore, some believed it was a deficiency and exhaustion of the Lower Yuan (Kidney and Mingmen) and erroneously used warming tonics like Aconiti Lateralis Radix Praeparata (Fuzi), Cinnamomi Ramulus (Guizhi), and Placentae Hominis (Heche). This approach was akin to adding fire to fire and heat to heat. Consequently, the area swelled and ulcerated, discharging pus for several months. The area below the ankle, the dorsum of the foot, toes, and heels became disabled and unusable. All this resulted from misdiagnosis and mistreatment reaching its extreme. The principle is clear and not difficult to discern. If it were truly lower-sinking cold-phlegm, it would merely be hard and congealed without dispersing; at worst, it might cause flaccidity, bi-syndrome, and loss of sensation. How could it progress to swelling, ulceration, profuse yellow discharge, rotting flesh, and penetrating sinews? Mr. Qian did not realize he was harmed by medical error but instead blamed the malefic influences of directional spirits. Is this really the case? This condition is no different from the "ruined syndrome" (Huai Zheng) in Cold Damage diseases, where pathogenic heat penetrates deeply into the meridians causing migratory abscesses (Liuzhu). The Ginseng Paste used at that time could only specifically regulate primordial Qi, lacking herbs to clear and resolve damp-heat as assistants, hence showing little effect. It is like assigning a senior statesman to handle trivial and complex affairs; it is inappropriate. If Bamboo Sap (Zhuli) had been used concurrently, Ginseng would have secured the channels while Bamboo Sap unblocked the collaterals; their sweet-cold properties would have complemented each other perfectly. Mr. Xu Taiye took Ginseng Paste to treat deficient wind but erroneously combined it with the heat of Aconite, resulting in shortened sinews and tendons and difficulty walking to this day. This too stems from a failure to understand that sweet-cold substances can unblock meridians. Moreover, after Mr. Qian used the Ginseng Paste, his Spleen Qi became robust, and transportive functions increased significantly. At this juncture, if he had regulated his diet, allowing the Yang Qi generated by the Spleen to focus on expelling phlegm and heat, the phlegm-heat would not have lingered, and the foot ailment could have resolved. However, he added night snacks to his daily meals. Although the robust Spleen Qi was not damaged by food, the Spleen Qi generated by the Ginseng's power was not utilized to transform phlegm and heat but solely to digest food, which is truly regrettable. Now, even ingested food is difficult to transport; what was intended to strengthen vitality has led to decline. Phlegm-fluids have become sticky and knotted in the chest, causing fullness, oppression, frequent coughing with ineffective expectoration. This is all due to the Spleen losing its healthful function of transporting fluids for the Stomach, causing food to generate phlegm instead. This phlegm gradually infiltrates and fills the lung orifices, making coughs difficult to expel. Although treating phlegm is urgent, most phlegm-resolving drugs consume Qi and damage deficiency. There is a fear that before the phlegm is expelled, wind pathogens may enter first. Therefore, the correct method is to firmly use sweet-cold herbs to block wind, eliminate heat, moisten dryness, tonify deficiency, and resolve phlegm. Pungent-warm herbs must absolutely not be used again. The physicians clearly saw these signs yet repeatedly used Cinnamon Twig and Prepared Aconite. They likely assumed that because the pus dried easily, it was due to the efficacy of pungent-warm herbs, and thus vigorously promoted this outcome to conclude the treatment. Such errors are unpardonable.
Mr. Hu Youchen stated: Damp-heat injuring the feet transmits from top to bottom; foot cold harming the Heart transmits from bottom to top. For transmissions from top to bottom, one should first clear the upper part; for transmissions from bottom to top, one should first warm the lower part. Observing this case reveals that just as people's illness harms the state, governance must prioritize the people.