一是编次序，先外感，次内伤，次杂病，古则取法金匮，近则以准绳医通诸家为准。
一每病以主病为纲，而相类者附之，如类中附于中风门是。
一六经病总名伤寒，而东南之区，真伤寒少，温病为多。内经云、热病者，皆伤寒之类也。南阳于中风
伤寒后，即继以温病风温两条。难经则云伤寒有五。窃谓伤寒与温病，南北对峙，伤寒可以该温
病，温病亦可以该伤寒，在冬为冬温，在春为风温，在夏为温热，长夏为湿温，交三伏后则为伏暑，
在秋为秋燥，俗亦谓秋温，此就时令言之也。南阳则以温病之重者为风温，今人亦或谓之伏温，
故以风温为温病之提纲，而冬温温热秋燥皆附之。惟湿温与伏暑截燃不同，另立专门。鄙陋之
见向所得诸师承加以数年之涉猎，略述编次之意如下。
一平时论著及改窜门下之作，先师向有编订付刊之志，而未竟厥功原稿为哲嗣借出，去岁哲嗣
云亡追寻不得姑将旧抄若干篇，附于本案之后片鳞半爪，不忍抛弃汇而集之，不屑贻讥于大雅也。
三吴古多良医，明清之世，松江李中梓、常熟缪希雍、吴江徐大椿、吴县叶桂、元和陆懋修，闻望着述，后
先辉映，虽所诣有纯驳，可谓卓然能树立者矣。其后乃有无锡张聿青先生，先生讳乃修，父工医，先生
少承家学，益孟晋， 思博稽，以仲景之书为宗，而斟酌刘李朱薛诸家之说，论病处方，变化万端，非姝
姝守一先生之言者。平生论述甚多，散佚不存，仅得其诸论一二，其论霍乱云、霍乱热多寒少，孟英固
自言之。但其论寒热二证，有一定之据，如热病则于未病之前数日，先有目中溜火肛门灼热等象。然
历见患病者，一吐一泻，无不肢冷粘汗，脉伏不起，大烦大渴，螺文缩陷，甚则失音目陷，虽投白虎得生
之热证，未必于未病之前如孟英所云也。而投理中四逆得生之寒症，未必不烦不渴，神情狂越，与热
证相似也。村医每见肢冷脉伏，不问口渴，不验舌色，妄投四逆而霍然向愈。亦有肢冷脉伏，大烦大渴，
渴而能饮，投白虎地浆而竟毙者。余以三十年阅历，始知热证于未病前先见火象之说，殊难为信。惟
一经芳开，热象发现，对病用药，方无误治。盖热症有湿邪外遏，寒证为阳气闭塞，芳开之法，亦分温清。
然热证而投以温开，亦可透发，寒证而投以清开，则反凝涩，此大害也。尤可恶者，随意呼名，如绞肠、吊
脚、瘪螺之类，霍乱之甚者，螺文无不瘪，经云、卫气者所以温分肉，充皮肤，肥腠理，司开合者也。霍乱则
卫气闭塞譬如纳手于水，湿气抑遏卫气不行亦致螺陷，即此意也其论燥曰、秋分以后或病咳热，或
渴或否，其变险也，气喘痰鸣，痰浓而稠，毙者甚多，论者目为风温，此燥症也。秋令久燥，金乘所胜，所不
胜来复其克金也势若燎原壮火食气，则肺气伤火烁津液则肺阴伤。粘痰即被熬之津液也，然痰色
多黄则又挟湿火为燥之复，气湿即燥之化气也。吴鞠通谓伏气为火，化气为湿，复而且化，故痰兼湿
黄化少复多，故湿不能济其燥。是知复气伤肺，由内而起之枯燥，与天气清冷之燥，判若霄渊有舌可
验，有脉可凭，有象可稽也。晚年居沪上，名益重，远方求治者踵相接。当是时，天下大医，群萃上海，青浦
陈莲舫、武进费绳甫尤着，其人善夤缘冒进，借声势，或称御医以撼庸俗、饵高糈，然其术亦浅。无虑内
伤外感虚实寒热，一切以不关病之药，羼 成方，以尝试而已。先生初至少知者。一日林某喘作，人有
言先生至，御医陈莲舫在焉，慢不为礼，视其方皆玉蝴蝶溷沌衣浓朴花等一派似药非药者先生曰、
下材浅薄请有所问，浓朴花性味何等也陈曰、本草详之耳。曰、本草多矣。若某某若某某，吾皆诵习之，
未见有此药也，敢问何出。陈语塞，久乃言曰、大约与浓朴相似耳。先生正色曰、愿君诫之。治病非儿戏，
陈唯唯不能答。先生遂定方，用熟地肉桂等。陈与病家皆难之。先生毅然曰、如不信，啜二之一，夜半知，
明日继进，失事抵吾命可也。如其言尽剂而安。由是论者翕然，佥谓先生之学，实有本矣。今略述其他
治案以备观览。朱葆三病脘痛吐涎水。脘中漉漉，得呕而快。西医治之不效。先生曰、此水饮伤胃也，乘
其元气未虚，尚可攻逐。用半夏黄连干姜腹皮茯苓枳实竹茹控涎丹，服后泻出冷水，呕即平复，用苓
桂术甘加椒目数剂，脘舒溲行，尚有嘈杂，用芩连橘半桂芍蒺藜杏仁，通降抑木而瘳丁姓温邪大热
大渴，烦躁神昏红疹隐约，医用羚羊牛黄等剂不应。先生视其目不瞑，知有痰浊，加远志竺黄，病不减，
再诊舌绛中有薄白，时嗳气肢冷知为湿遏热伏，改用三仁去朴，加黄芩知母菖蒲，躁闷大退，红斑遍
发，用化斑汤重用犀角石膏而愈。龚氏妇咳嗽吐血咽痛失音，内热口燥，诸医投养阴法无效，日羸削，
先生询其病得之感寒，瞿然曰、此谚所谓寒包火也。投麻杏甘膏蝉衣象贝桑叶茯苓黑归藕节，咳退
音清，继进清咽宁肺而安。劳某，不寐经年，某名医谓虚阳不敛投养阴法及珠粉，屡服二十剂，胸闷胃
钝，仍不得寐。先生曰、此痰火也。予温胆汤而瘳。杨子萱湿温三候，汗 不得畅，背脊恶寒，热势起伏，群
医束手。先生曰、此宜坚壁清野法，勿犯谷气以郁金杏仁桔梗藿香薏苡通草滑石半夏等连服使邪
与湿分气行汗畅而愈。粤商林不纳不饥便闭四旬一行医谓阳虚，进苁蓉肉桂及半硫丸仍不效。先
生曰、此胃阴虚也。投甘凉而痊。巨商丁剧饮后醉而不醒。搐搦痉厥，医谓挟阴伤寒先生曰、此酒热引
动肝阳耳。与咸降法一剂知二剂已。龙湛霖患不寐，他医初投温补，继以育阴，皆不验先生曰、此痰热
内阻心肾不交也。用玳瑁珠母龙齿羚羊胆星半夏栝蒌竹茹，二剂病失。方维卿痢剧发呃，七日夜不
止，将治木矣。先生诊其脉沉弦，审知有脘痛病，用泻心加黑白丑丁香，一剂呃止复用清六饮加二苓
薏滑香砂琥珀，痢亦止。凡先生治验，就所知者止此，及门百人，或更有悉其详及神于此者，要其剖析
豪，洞彻 结，原本经论超然神解，不外乎此先生卒年六十余，至今称张氏医法。
箫蜕曰、予二十七岁时，负笈先生门。观其丰神清峻，音词朗鬯，辄心仪之，以为近世杰士隐于艺者，岂
偶然也。医虽小道，非有高世拔俗之想，轻财重义之风，不可以言深造。先生治病，遇贫贱者不取一钱，
皆随手效。昆季八九人，皆早世，卵翼群从，各有名业。清光绪间诏征天下名医，诸贵人推毂，先生力却
之。凡此皆人所难即其志可以审其艺矣。
一是编排次序，先讲外感病，再讲内伤病，最后讲杂病。古代则效法《金匮要略》，近代则以《医宗必读》及《医学准绳六要》等各家著作为准则。
一每类疾病以主病为纲领，将相类似的病症附在后面，例如类中风（类似中风的病证）附在中风门之后。
一六经病总称为伤寒，但东南地区，真正的伤寒较少，温病较多。《内经》说：“热病者，皆伤寒之类也。”张仲景在论述了中风、伤寒之后，紧接着又列出了温病和风温两条。《难经》则说“伤寒有五”。我认为伤寒与温病，南北方各有侧重，伤寒可以涵盖温病，温病也可以涵盖伤寒。在冬季发生的叫冬温，在春季发生的叫风温，在夏季发生的叫温热，长夏季节发生的叫湿温，过了三伏天以后发生的叫伏暑，在秋季发生的叫秋燥，民间也称秋温，这是就时令而言的。张仲景则将温病中较重的一类称为风温，现在的人有时也称它为伏温，所以以风温作为温病的提纲，而冬温、温热、秋燥都附属于它。只有湿温和伏暑截然不同，另外设立专门章节。这是我浅陋的看法，结合从前从师学习的经验以及这几年的广泛涉猎，简要陈述编撰的意思如下。
一平时论著及修改弟子作品的部分，先师向来有编订付印的志向，但未完成。原稿被他的儿子借出，去年他儿子去世，追寻原稿不得，只好将旧抄录的若干篇，附在本医案之后。这些只是片鳞半爪，不忍心抛弃，汇集而成集，也不屑于被高雅之士讥笑。
三吴地自古多良医，明清时期，松江的李中梓、常熟的缪希雍、吴江的徐大椿、吴县的叶天士、元和的陆懋修，他们的名声和著作前后辉映，虽然造诣有纯驳之分，但可谓卓然自立的大师。其后则有无锡的张聿青先生。先生名乃修，父亲精通医术，先生少年时继承家学，更加勤奋进取，思虑广博考证，以张仲景的书籍为宗旨，同时斟酌刘完素、李东垣、朱丹溪、薛己诸家的学说，论病处方，变化万千，不是拘泥守旧、只固守一家之言的人。平生论述很多，散失不存，仅得到其中一二。他关于霍乱的论述说：霍乱热多寒少，王孟英固然自己说过。但他论述寒热两证，有确定的依据，比如热证则在发病前几天，先出现眼中冒火、肛门灼热等现象。然而我历见患病者，一旦呕吐腹泻，无不四肢冰冷、粘汗、脉伏不起、极度烦躁口渴、肌肉痉挛收缩凹陷，甚至失音、目眶下陷，即使是投用白虎汤能治愈的热证，也未必在发病前像王孟英所说的那样先见火象。而投用理中汤、四逆汤能治愈的寒证，也未必不烦躁口渴、神情狂越，与热证相似。乡村医生每见四肢冰冷、脉伏，不问是否口渴，不查验舌色，妄投四逆汤反而霍然向愈。也有四肢冰冷、脉伏、极度烦躁口渴、渴而能饮，投用白虎汤加地浆水反而死亡的案例。我以三十年的阅历，才知道热证在发病前先见火象的说法，实在难以相信。只有等到芳香开窍药使用后，热象显现，对病用药，才没有误治。因为热症有湿邪外遏，寒证为阳气闭塞，芳香开窍的方法，也分温开和清开。然而热证投用温开，也可以透发；寒证投用清开，则反而凝滞涩结，这是大害。更可恶的是随意命名，如绞肠痧、吊脚痧、瘪螺痧之类。霍乱严重的，螺纹（指手指螺纹处的皮肤皱缩）无不瘪陷。《内经》说：“卫气者，所以温分肉，充皮肤，肥腠理，司开合者也。”霍乱则卫气闭塞，譬如把手伸进水里，湿气抑制卫气不行，也会导致螺陷，就是这个意思。他论述燥症说：秋分以后，或者病咳发热，或者口渴或不渴，其变险的情况是气喘痰鸣，痰浓稠，死亡者很多，论者目为风温，这其实是燥症。秋季久旱无雨，金气乘其所胜（肺金克肝木），所不胜（肝木）来复克金，火势若燎原，壮火食气，则肺气受伤；火烁津液，则肺阴受伤。粘痰就是被煎熬的津液，然而痰色多黄，则是又挟带湿火成为燥的报复之气，气湿即燥之化气。吴鞠通说伏气为火，化气为湿，复而且化，所以痰兼湿黄；化少复多，所以湿不能济其燥。由此可知，复气伤肺，由内而起之枯燥，与天气清冷之燥，判若霄壤，有舌可验，有脉可凭，有象可稽。晚年居住在上海，名声更重，远方求治者接踵而至。当时，天下名医群聚上海，青浦的陈莲舫、武进的费绳甫尤其著名，这些人善于攀附权贵冒进，借声势，有的自称御医以震撼庸俗之人，骗取高额诊金，然而他们的医术也很浅薄。不论内伤外感、虚实寒热，一切用不关乎病情的药物，混杂成方，用来尝试而已。先生初到上海时知道的人不多。有一天林某人哮喘发作，有人说先生到了，御医陈莲舫也在，傲慢无礼，不看先生的方子，全是玉蝴蝶、混沌衣、厚朴花等一派似药非药的东西。先生说：“我才疏学浅，请允许我问一下，厚朴花的性味是什么？”陈说：“本草书上有详细记载。”先生说：“本草书多了去了，像某某药、像某某药，我都诵读学习过，没见过这种药，敢问出自哪里？”陈语塞，许久才说：“大约与厚朴相似罢了。”先生正色道：“希望你告诫他们。治病不是儿戏。”陈连连答应不能回答。先生于是定方，用熟地黄、肉桂等。陈与病家都感到为难。先生毅然说：“如果不信，喝一半，半夜知晓效果，明天继续服用，出事抵我的命也可以。”照他的话全部服完而安。从此议论一致，都认为先生的学问，确实有本源。现在略述其他治疗案例以备观览。朱葆三病胃脘痛吐涎水。胃中漉漉有声，得呕吐后感觉爽快。西医治疗无效。先生说：“这是水饮伤胃，趁着元气未虚，还可以攻逐。”用半夏、黄连、干姜、腹皮、茯苓、枳实、竹茹、控涎丹，服后泻出冷水，呕吐即平复，用苓桂术甘汤加椒目数剂，胃舒小便通利，尚有嘈杂感，用黄芩、黄连、橘红、半夏、桂枝、白芍、蒺藜、杏仁，通降抑木而痊愈。丁姓患温邪，大热大渴，烦躁神昏，红疹隐约，医生用羚羊角、牛黄等剂无效。先生看他不闭眼，知道有痰浊，加远志、竺黄，病不减，再诊舌绛中有薄白苔，时常嗳气、肢冷，知道是湿遏热伏，改用三仁汤去厚朴，加黄芩、知母、石菖蒲，躁闷大退，红斑遍发，用化斑汤重用犀角、石膏而愈。龚氏妇咳嗽吐血咽痛失音，内热口燥，诸医投养阴法无效，日渐消瘦，先生询问得知病起因于感寒，惊愕地说：“这就是谚语所说的寒包火。”投麻杏甘膏汤、蝉衣、象贝、桑叶、茯苓、黑归身、藕节，咳退音清，继进清咽宁肺汤而安。劳某，不寐经年，某名医谓虚阳不敛，投养阴法及珠粉，屡服二十剂，胸闷胃钝，仍不得寐。先生说：“这是痰火。”予温胆汤而愈。杨子萱患湿温三候，汗不得畅，背脊恶寒，热势起伏，群医束手。先生说：“此宜坚壁清野法，勿犯谷气。”用郁金、杏仁、桔梗、藿香、薏苡仁、通草、滑石、半夏等连服，使邪与湿分，气行汗畅而愈。粤商林某不纳便闭，四十日一行，医生谓阳虚，进肉苁蓉、肉桂及半硫丸仍无效。先生说：“这是胃阴虚。”投甘凉药而痊。巨商丁某剧饮后醉而不醒，搐搦痉厥，医生谓挟阴伤寒。先生说：“这是酒热引动肝阳耳。”与咸降法，一剂知，二剂已。龙湛霖患不寐，他医初投温补，继以育阴，皆不验。先生说：“这是痰热内阻，心肾不交也。”用玳瑁、珠母、龙齿、羚羊角、胆南星、半夏、栝楼、竹茹，二剂病失。方维卿痢疾剧烈发呃逆，七日夜不止，将治木矣。先生诊其脉沉弦，审知有脘痛病史，用泻心汤加黑白丑、丁香，一剂呃止，复用清六饮加二苓、薏苡仁、滑石、香附、砂仁、琥珀，痢亦止。凡先生治验，就我所知的仅此而已，及门弟子百人，或许还有深知其详及神于此者，总之其剖析毫厘，洞彻郁结，原本经论，超然神解，不外乎此。先生卒年六十余岁，至今人称张氏医法。
箫蜕说：我二十七岁时，背着书箱在先生门下求学。观察他丰神清峻，音词朗鬯，辄心仪之，以为近世杰士隐于艺者，岂偶然也。医虽小道，非有高世拔俗之想，轻财重义之风，不可以言深造。先生治病，遇贫贱者不取一钱，皆随手效。昆季八九人，皆早世，卵翼群从，各有名业。清光绪间诏征天下名医，诸贵人推毂，先生力却之。凡此皆人所难即其志可以审其艺矣。
First, the arrangement of order: external contraction diseases are discussed first, followed by internal injury diseases, and finally miscellaneous diseases. Anciently, the *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) is taken as the model; recently, *Yizong Bidu* (Readings for Medical Practitioners) and *Yixue Zhunsheng Liuyao* (Six Essentials of the Standard for Medicine) along with other schools' works are used as standards.
Second, each disease takes the principal disease as the outline, with similar ones attached to it, such as Lei Zhongfeng (Diseases resembling Stroke) being attached to the Zhongfeng (Stroke) section.
Third, the Six Channels diseases are collectively named Shanghan (Cold Damage). However, in the southeastern region, true Shanghan is rare, while Wenbing (Warm Diseases) are common. The *Neijing* (Inner Canon) states: "All heat diseases belong to the category of Shanghan." Zhang Zhongjing, after discussing Zhongfeng and Shanghan, immediately follows with two sections on Wenbing and Fengwen (Wind-Warmth). The *Nanjing* (Classic of Difficult Issues) states that "Shanghan has five types." I believe that Shanghan and Wenbing stand in opposition between North and South; Shanghan can encompass Wenbing, and Wenbing can also encompass Shanghan. Occurring in winter, it is called Dongwen (Winter Warmth); in spring, Fengwen; in summer, Wenre (Warm-Heat); in late summer, Shiwet (Damp-Warmth); after the Sanfu days, Fushu (Hidden Summerheat); in autumn, Qiuzao (Autumn Dryness), also commonly known as Qiuwen (Autumn Warmth). This is speaking according to seasonal timing. Zhang Zhongjing considers the severe type of Wenbing as Fengwen, and modern people sometimes call it Fuwen (Hidden Warmth). Therefore, Fengwen is taken as the outline of Wenbing, while Dongwen, Wenre, and Qiuzao are all attached to it. Only Shiwet and Fushu are distinctly different and are established as separate specialized topics. This is my humble view, combining previous learning from masters and several years of extensive study, briefly stating the intent of compilation as follows.
Regarding平时的论著及改窜门下之作 (平时的论著及修改弟子作品): The late master always had the intention to compile and publish, but did not complete it. The original manuscript was borrowed by his son. Last year, after his son passed away, the manuscript could not be found. Thus, several chapters from old copies are attached after this medical case record. These are but fragments, which I cannot bear to discard, so they are collected together, not caring about being ridiculed by the elegant scholars.
Third, Wu region has long been home to many good physicians. During the Ming and Qing dynasties, Li Zhongzi of Songjiang, Miao Xiyong of Changshu, Xu Dachun of Wujiang, Ye Tianshi of Wuxian, and Lu Mouxiu of Yuanhe, their fame and writings shone brightly one after another. Although their attainments varied in purity and impurity, they can be considered outstanding founders of their own schools. Later came Mr. Zhang Yuqing of Wuxi. His courtesy name was Naixiu. His father was skilled in medicine. Mr. Zhang inherited family learning in his youth, furthered his studies diligently, thought broadly and verified extensively. He took Zhang Zhongjing's books as his main reference, while carefully considering the theories of Liu Wansu, Li Dongyuan, Zhu Danxi, and Xue Ji. In diagnosing diseases and prescribing formulas, his methods were infinitely variable, not sticking rigidly to the words of a single school. He wrote many theoretical discussions in his lifetime, most of which were lost. Only a few remain. Regarding Huoluan (Cholera-like disorder), he stated: "Huoluan involves more heat than cold," a point Wang Mengying had indeed made. However, regarding the differentiation of cold and heat syndromes, he had definite criteria. For example, in heat syndromes, several days before onset, symptoms like fire flashing in the eyes and burning sensation in the anus would appear. However, in my experience, patients suffering from vomiting and diarrhea invariably present with cold limbs, sticky sweat, hidden pulse, extreme restlessness and thirst, muscle spasms and retraction, and even loss of voice and sunken eyes. Even if a heat syndrome cured by Baihu Tang (White Tiger Decoction) does not necessarily show these pre-onset fire signs as Wang Mengying described, a cold syndrome cured by Lizhong Tang (Regulate the Middle Decoction) or Sini Tang (Recover the Prostrate Decoction) might not lack restlessness and thirst, nor present with manic behavior resembling heat syndromes. Village doctors often see cold limbs and hidden pulses, without asking about thirst or examining the tongue, and blindly prescribe Sini Tang, resulting in sudden recovery. Conversely, there are cases of cold limbs, hidden pulse, extreme restlessness and thirst, where drinking is possible, yet prescription of Baihu Tang with Earth Spring Water leads to death. Based on thirty years of clinical experience, I find the theory that heat syndromes show fire signs before onset difficult to believe. Only after using aromatic opening methods do heat signs manifest, allowing for accurate treatment against the disease. Heat syndromes may have dampness obstructing externally, while cold syndromes involve obstruction of Yang Qi. Aromatic opening methods are divided into warm-opening and clear-opening. Prescribing warm-opening for heat syndromes can still allow release; however, prescribing clear-opening for cold syndromes causes stagnation and blockage, which is a major harm. What is detestable is the arbitrary naming of conditions, such as Jiaochang Sha (Intestinal Twisting Sha), Diaojiao Sha (Leg-Hanging Sha), and Bie Luo Sha (Shrunken Spiral Sha). In severe Huoluan, the skin spirals on fingers invariably shrink. The *Neijing* states: "Wei Qi (Defensive Qi) warms the flesh, fills the skin, plumps the interstices, and controls opening and closing." In Huoluan, Wei Qi is obstructed, like putting a hand in water; dampness suppresses Wei Qi, leading to spiral shrinking, which is the meaning here. Regarding Dryness Syndrome: After the Autumn Equinox, one may suffer from cough with fever, thirst or no thirst. The dangerous transformation involves panting and rattling phlegm, thick and sticky sputum, with many deaths. Discussants label this as Fengwen, but it is actually Dryness Syndrome. Prolonged dryness in autumn allows Metal to overcome its controlled element (Wood), and the uncontrolled element (Wood) retaliates against Metal. The fire spreads like a prairie fire; strong fire consumes Qi, injuring Lung Qi; fire scorches fluids, injuring Lung Yin. Sticky phlegm is the boiled-down fluid. If phlegm color is mostly yellow, it indicates complication with damp-fire as a retaliation of dryness. Qi-damp is the transformed Qi of dryness. Wu Jutong said latent Qi transforms into fire, and transformed Qi becomes damp. Retaliation and transformation occur together, so phlegm contains dampness and is yellow; transformation is less, retaliation is more, so dampness cannot moisten dryness. Thus, we know that retaliatory Qi injuring the Lung causes internal dryness, which is distinct from the external cold-dryness of weather, verifiable by tongue, palpable by pulse, and observable in signs. In his later years living in Shanghai, his reputation grew heavier, and seekers from afar came in succession. At that time, famous physicians gathered in Shanghai, especially Chen Lianfang from Qingpu and Fei Shengfu from Wujin. These people were good at climbing social ladders, borrowing prestige, some claiming to be Imperial Physicians to shock the vulgar and extract high fees, yet their skills were shallow. Regardless of internal injury, external contraction, deficiency, excess, cold, or heat, they mixed ineffective drugs into existing formulas just to try. When Mr. Zhang first arrived in Shanghai, few knew him. One day, Mr. Lin suffered an asthma attack. Someone said Mr. Zhang had arrived. Imperial Physician Chen Lianfang was present, treated him with arrogance, and looked at his prescription, which consisted entirely of Jade Butterfly, Hundun Yi, Houpo Hua (Magnolia Flower), and other pseudo-medicinal substances. Mr. Zhang said, "I am shallow and unskilled, please allow me to ask: what are the nature and flavor of Houpo Hua?" Chen replied, "It is detailed in the Materia Medica." Mr. Zhang said, "There are many Materia Medicas. I have studied XX and XX, but I have never seen this drug. May I ask where it comes from?" Chen was speechless. After a long time, he said, "It is probably similar to Houpo." Mr. Zhang said solemnly, "I hope you warn them. Treating disease is not child's play." Chen nodded repeatedly, unable to answer. Mr. Zhang then prescribed a formula using Shudi (Prepared Rehmannia Root) and Rougui (Cinnamon Bark). Chen and the patient's family hesitated. Mr. Zhang firmly said, "If you do not believe, drink half, and you will know by midnight. Continue tomorrow. If something goes wrong, take my life." They followed his advice, finished the dose, and recovered. From then on, opinions unified, acknowledging that Mr. Zhang's learning truly had a foundation. Now, briefly describing other cases for review.
Zhu Baosan suffered from epigastric pain and salivation. There was gurgling sound in the epigastrium, feeling relieved after vomiting. Western medicine failed. Mr. Zhang said, "This is Water-Drink injuring the Stomach. Since Yuan Qi is not yet deficient, it can still be attacked and purged." Prescribed Banxia (Pinellia Rhizome), Huanglian (Coptis Rhizome), Ganjiang (Dried Ginger), Fupi (Tangerine Peel), Fuling (Poria), Zhishi (Immature Bitter Orange), Zhuru (Bamboo Shavings), and Kongxian Dan (Phlegm-Draining Pill). After taking it, cold water was purged, vomiting stopped. Then Linggui Zhugan Tang (Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction) plus Jiaomu (Black Pepper Seed) for several doses. Epigastric comfort returned, urination normalized, but heartburn remained. Prescribed Qin (Scutellaria), Lian (Coptis), Ju (Tangerine Peel), Ban (Pinellia), Gui (Cinnamon), Shao (Peony), Jili (Tribulus), Xingren (Apricot Seed) to descend turbidity and suppress Liver Wood, resulting in cure.
Mr. Ding suffered from Warm Pathogen with high fever, extreme thirst, restlessness, coma, and faint red rash. Doctors used Lingyangjiao (Antelope Horn) and Niuhuang (Calculus Bovis) without effect. Mr. Zhang observed his eyes were open, knowing there was Phlegm-Turbidity, added Yuanzhi (Polygala Root) and Zhuhuang (Bamboo Residue). Condition did not improve. Second visit: tongue crimson with thin white coating, occasional belching, cold limbs. Known as Dampness suppressing Heat-Latency. Changed to Sanren Tang (Three Seeds Decoction) removing Houpo, adding Huangqin (Scutellaria Root), Zhimu (Anemarrhena Rhizome), Shichangpu (Acorus Rhizome). Restlessness greatly subsided, red spots appeared all over. Used Huaban Tang (Spot-Resolving Decoction) with heavy doses of Xijiao (Rhinoceros Horn - now substituted with Buffalo Horn) and Shigao (Gypsum), resulting in cure.
Mrs. Gong suffered from cough, hemoptysis, sore throat, loss of voice, internal heat, and dry mouth. Various doctors used Yin-nourishing methods without effect; she wasted away daily. Mr. Zhang asked and learned the illness started from Cold invasion. Startled, he said, "This is the proverbial 'Cold Wrapping Fire'." Prescribed Maxing Gan Shi Tang (Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction), Chan Yi (Cicada Slough), Xiangbei (Fritillaria Bulb), Sangye (Mulberry Leaf), Fuling, Hei Guishen (Blackened Angelica Sinensis Root), Ou Jie (Lotus Node). Cough ceased, voice cleared. Continued with Qingyan Ningfei Tang (Clear Throat and Calm Lung Decoction) for recovery.
Lao suffered from insomnia for years. A famous doctor attributed it to Uncontained Deficient Yang, prescribed Yin-nourishing methods and Pearl Powder. After twenty doses, chest fullness and stomach dullness persisted, still no sleep. Mr. Zhang said, "This is Phlegm-Fire." Prescribed Wendan Tang (Warm Gallbladder Decoction), resulting in cure.
Yang Zixuan suffered from Wet-Warmth for three periods, sweating not profuse, chills on back and spine, fluctuating fever. Doctors were helpless. Mr. Zhang said, "This requires the strategy of 'Fortifying Walls and Clearing Fields', do not violate Grain Qi." Prescribed Yujin (Curcuma Rhizome), Xingren, Jiegeng (Platycodon Root), Huoxiang (Patchouli), Yiyiren (Coix Seed), Tongcao (Akebia Stem), Huashi (Talcum), Banxia. Continuous administration separated pathogen from dampness, allowed Qi movement and profuse sweating, resulting in cure.
Guangdong merchant Lin had no appetite and constipation, bowel movement once every forty days. Doctor attributed it to Yang Deficiency, prescribed Rongrong (Cistanche), Rougui, and Banshu Wan (Half-Sulfur Pill) without effect. Mr. Zhang said, "This is Stomach Yin Deficiency." Prescribed Sweet-Cool herbs, resulting in recovery.
Merchant Ding drank heavily, became drunk and unconscious, convulsions and tetanus. Doctor attributed it to Cold Damage with Yin involvement. Mr. Zhang said, "This is Wine-Heat stirring up Liver Yang." Prescribed Salty-Descending method. One dose showed improvement, two doses resolved.
Long Zhanlin suffered from insomnia. Other doctors first used Warm-Tonifying, then Yin-Nourishing, both ineffective. Mr. Zhang said, "This is Phlegm-Heat internally obstructing, Heart-Kidney non-interaction." Prescribed Dai Mao (Hawkbit Shell), Zhumu (Mother-of-Pearl), Longchi (Dragon Bone), Lingyangjiao, Dansheng (Arisaema with Bear Bile), Banxia, Gualou (Trichosanthes Fruit), Zhuru. Two doses, illness disappeared.
Fang Weiqing suffered from severe dysentery with hiccups, continuous for seven days and nights, nearly dying. Mr. Zhang palpated deep and wiry pulse, confirmed history of epigastric pain. Prescribed Xiexin Tang (Drain the Epigastrium Decoction) plus Heibai Chou (Black and White Morning Glory Seeds), Dingxiang (Clove). One dose, hiccups stopped. Reused Qingliu Yin (Clear Six Drinks) plus Erling (Polyporus and Alisma), Yiyiren, Huashi, Xiangfu (Cyperus Rhizome), Sharen (Amomum Fruit), Hupo (Fossilized Wood). Dysentery also stopped.
All curative experiences of Mr. Zhang known to me end here. Among his hundred disciples, perhaps some know details or understand deeply. Essentially, his analysis is precise, penetrating obstructions, rooted in Classics, transcendent understanding, none of this is outside the scope. Mr. Zhang died in his sixties. To this day, his methods are called Zhang's Medical Methods.
Xiao Tui said: When I was twenty-seven, I carried my book box to study under Mr. Zhang. Observing his clear and lofty demeanor, bright and resonant voice, I admired him, thinking him a杰出 scholar hiding in art, how could this be accidental? Medicine, though a minor skill, cannot speak of profound mastery without lofty aspirations above the world, style of valuing righteousness over wealth. Mr. Zhang treated the poor and lowly without charging a penny, all effective instantly. He had eight or nine brothers, all died young. He raised his nephews, who each achieved fame. In the Guangxu reign of Qing, edict summoned famous physicians nationwide. Nobles recommended him, but Mr. Zhang strongly refused. All these are difficult for others; thus his ambition reveals his skill.