中医治病，必分虚实而后定方，此二症中西医均有汗、下二法，并非错误，但学者对于汗、下二字，须切记系指病者元气未虚、得病未久，或在热性病中之实证而言，万不可以此二法施之于久病缠绵、脉虚体弱之肿胀，再加以参看后列医验，自然明了余对此症之立论，并非偏于温补矣。
余每遇极重之肿胀，内脏肿故自觉胀闷。即本此独具之理论，毅然排除古书不合理之说法，谨慎施治，只要病家信仰，始终一致，从未遇一失败之例。本编付梓时，正遇一极重之肿症，且已经过多数医者之治疗，未能收效者，现已完全依此理论治愈之。此可谓最近最确实之一证，兹将此医案，摘录于后，以告学者。此症为赵夫人，住北京西四牌楼大拐棒胡同九号，为大律师李鹤鸣君之妗母，有欲研究此重症以证余言者，不难访问也。
（医验）张夫人住德县南门东街，年三十馀岁，此系余友张松泉君之夫人，于民圃十四年患肿胀，日甚一日，其初仅觉胀满，四肢畏寒，手足指尖浮肿，饮食日减，继则腹肿，小便短，大便燥，或溏，约年馀腹肿更甚，脐部突出，且有水浸润，腹部恒觉有水潴留，已成重症，以前服药，率皆理气消导利水之品，经年未效。经余诊断，见左右手脉皆沉细而濡，认为心脾虚弱心脏衰弱，血行障碍，易水肿，此西医病理。睥弱不运之说，则中医病理也。已极，亟应补心气以壮血行，培脾胃以利运化，冀以中西医理，相互治疗，无不应手奏效。但此症最忌发汗、泻下等药，猛烈攻伐之品，葶苈、甘遂等，尤为大忌，即顺气之药，例枳实、槟榔、陈皮、厚朴之类，亦应谨慎。余治此症，不下数十例，从未失败，亲见误于医药，死于以上治法者，不知凡几。最近乎绥铁路局一张姓科员，先误于汗，又误服硫苦泻药，至丧其生命，故余明白揭示，愿病家医家大注意也。原方列下：大台参六钱炙黄芪六钱土炒白术八钱苍术二钱茯苓皮一钱姜皮四钱怀山药六钱紫蔻仁五分姜枣引。此症约改数方，大意均如此，服药四、五十剂，其中加减，不过一、二味，率皆补养之品，绝无泽泻、车前、大腹皮、枳实等药，以此症改方太多，为节省文字，故未全录。奉方用参、芪，即所以补心气也，此症愈后，曾服人乳数月，故健康恢复较易，至今已十馀年康健如昔。
赵夫人，年四十七岁，住北京西四牌楼大拐棒胡同九号，于二十七年十月十六日就诊，据云病已经年，前已经过多医，现症为浮肿，以前仅手足微肿，渐肿至腿及胸腹，均现高肿，头面、颈项、口唇亦肿，时觉呼吸困难，喉中每觉有热气上冲，舌上口内，并起红泡，咽干、无涕、无泪、无汗、无痰、无唾、呕吐，小便短少色重，不能饮食，腹内恒觉胀满，呃气不出，每日大便约泻一、二次，不思饮水，两手脉沉濡细微，全身衰弱已极，断为阳虚脾弱，一切假热现象，亟应舍症从脉，大剂培补阳气，以冀挽救。（此危笃臌症病者，自称难愈）原方列下：中药类怀山药白术茯苓皮姜皮熟附片猪苓苡仁人参炙黄芪蔻仁牛膝龙眼肉姜枣引西药类利尿剂收敛剂维他命剂健胃剂漱口剂本病已至危候，治疗殊觉棘手，脉症既不相符，又兼接治之初，患者闻药即吐，不能下咽，但余既认定其唯一原因，纯系虚寒致肿，一切热征，均系假象，故敢毅然决定治法，但病已太重，服药不能立效，然余绝不因其未见大效，稍存犹疑，始终执定余之定见，与此病相周旋，立方加减，消息缓急，中西共济，自二十七年十月，至二十八年二月，此可畏之臌症，已完全治愈。所立药方太多，不能全录，撮其大要如此。此症若在缺乏经验之医者，着手一见不效，立即改变治法，必致贻误。余虽庸工然认定病因，从不妄事变动，卒能收效亦快事也。本书二十七年十二月已出版，因欲补入此医案，重复印订，实以此例日期最近，疑难之点颇多，且又经过多医，颇有研究之价值，故不忍割爱，追加报告，愿医坛师友共讨论也。
久泻（六）久泻此症与上条肿胀，有连带关系，学者应以意会。但久泻二字，似不足为病名，余以中医关于虚弱之泻症，名目繁多，徒乱人意，故定此名，以资取法，凡日久泄泻，皆包括在内，但新得之泻及痢疾，不出数星期者，不在此例，此久宇应特别注意。
（原因）此症唯一原因即为肠之衰弱，大约均由实证转变而来，例如原病系新得之痢疾，实证因治不得法，耽延日久，数月或数年遂变为久泄。或大病之后，饮食不摄生，或身体素弱，又有不良嗜好，饮酒及手淫等或肺结核之蔓延，或营养不良，或高年衰弱，皆为本病原因。西医所称之慢性肠（炎）加答儿症，即属此症，中医则责之脾肾虚寒，其理一也。
（症候）一日之中，不断如厕，或二、三次，或四、五次，晨起及夜间，尤易泄泻，其大便多溏稀，或下利如白油，或腹微痛胀满，不思饮食，日渐衰弱，全身违和，肌肤甲错，发脱气促，虚汗，数月或数年之后，全身衰弱已极，渐致不起，在小儿尤危险，参阅后慢惊风症。卒能因此断送生命。
（治法）此症治法，第一须严禁固形食物，在治疗期间，每日饮食，尤应以流动而易消化者为准。其药品，中药则以收涩、例如粟壳、桑螵蛸等补气、例如参、芪补脾例如白术、山药、茯苓补肾、例如补骨脂补阳，例如附子、肉桂皆有大效。至若调胃之药，不过加入少许例如豆蔻三分以防补药太重，妨碍胃气。西药则以阿片末，次硝酸苍铅，单那儿并为特效。单宁酸太害胃，不宜过用。
余治此症甚多，率于着手施治之始，预用小量之泻剂，先刷清其肠胃。例如硫苦、重曹次则禁止固形食物，次即入于正式药物治疗法，以硝苍等西药，自晨至下午五点钟，分三次与服，此指成人而言，小儿不必用西药。至十点钟以后，令服中药一次，约一星期，必见大效。以后即将西药分量酌减，仍分三次一日嗣即再将中药分量酌减，在此时期，斟酌病情，中西药亦可酌加。或变换其服药时间，久久自能治愈矣，但此症只服中药，或只服西药，多不易根本治愈。
此症服药方法，例如临睡时令服西药，第二日晨，仍服西药，午仍服西药，下午五点钟，服中药一次，临睡再服中药一次，如此可以试服一星期。病势渐减，则减去西药，（或偶服一、二次）将中药一剂之分量加重，一日三次，尽服中药，约一星期。
再将中药改作膏剂，每日三次与服，大约一、二月之中，必能治愈，此症中西药互用，读者必有相当疑虑，实则此用药法，余已实验多年，毫无危险，但在小儿病，最忌阿片，故不可滥用西药也。此症最易确认，只要常年累月泄泻频频，即可以此法治之。不论腹痛及所泻有似痢疾之物与否，一律概从虚治。万不可迷惑于中医湿成五泄及噤口休息痢等说，一入此迷阵，万无治愈希望，且恐治丝愈棼，纠缠不清也。
（医验）门君，住北京齐化门内，北豆芽菜胡同四号，年五十二岁。前曾患红白痢疾，一年前未能根本治愈后即渐渐泄泻，每日五、六次。黎明之时，必泻一次，腹微痛，所泻有白油样脓粘物，亦有微痛，有时泻稀溏粪，所服药品复杂，久治不愈，病已年馀，渐渐衰弱。于廿六年七月就诊，左脉弦细，右脉沉濡，认为脾肾虚寒，肠神经衰弱治宜涩补。其方列下：第一方（西药）此药晨服一次，午服一次，下午三点钟服一次。（晚十点钟，服中药一次）。
次硝酸苍铅六·○人参精○·二分六包，一日三次，二日分服。此方服后立见效，每日只泻二次，又与下方，令掉换服之。
第二方（西药）此药服法，与前第一方同，仍兼服中药，遂收大效。
次硝酸苍铅四·○单那儿并三·○分六包，一日三次，二日分服。此方服后，每日泻二次，后又加人参精○·二仍分六包，约服二星期，每日只泻一次，三星期后，此方分量减一倍，此后每日服二次，或一次。
弟二方（中药）此症根本非中药不治，然中药效力稍缓，故以西药救济之，不可只用西药也。
土炒白术四钱怀山药六钱炒茯苓四钱白扁豆五钱杵大台参四钱炙黄芪四钱炮姜一钱补骨脂一钱酒炒砂仁米三分杵粟壳二钱炙甘草一钱姜枣引。此方效力极大，加减约服二十馀剂即痊愈。先停止西药，又将此中药方，加重分量，制成膏剂，一日三次，白开水化服一茶匙，约一月痊愈。
第四方（中药）此方系病愈后，已逾一年，患者又觉渐有泄泻，来诊，与以此方。嘱其每隔五，六日，即服一剂，至今健康已恢复。
炒山药四钱云茯苓四钱土炒白术四钱粟壳四钱台参三钱炙黄芪三钱炮姜钱半补骨脂三钱桑螵蛸二钱熟附片一钱豆蔻五分炙甘草一钱姜枣引，煎服。此症最忌用一切治痢疾之药，及清凉等药，而中药之内，所习用之一切药味；凡重浊不快之品，例如吴茱萸，乌梅、五味子等，均不宜用，以患者胃气已衰，不能胜此等药味，故有损无益也。其余顺气破气之药，一概禁用，丸药恐害胃亦禁用，改用膏剂纵有虚胀，调其饮食可也。
慢惊风（七）慢惊风此即小儿久泻衰弱之症，一名慢脾风，此症可与上条久泻症参看。
仁原因）此症虽属虚弱，然亦多由实证转变而来，例如小儿暴得之吐泻症，西医病名日久转为此症者极多。其余或因疟疾，或因痢疾，或因痘后、疹后，或因饮食油腻厚味，瓜果生冷，积滞日久，过用攻伐及泻药，或因热病过服凉药，或因先天薄弱，乳食缺乏，或因贫困，滋养不足，皆为本病原因。日久注意此二字失治，全身衰弱，脾肾虚寒，气血两亏，即成此症。
（症候）此症唯一病状，即为脉多细小，日久泄泻，愈泻愈虚，遂现全身神经衰弱，皮肤甲错，骨瘦如柴，头发渐渐稀细而黄，渐渐脱落。颈项细长，嗜卧不语，或呕吐，再重则神昏，睡时二目不能紧合，甚则—日之间，二目不能全开，庸医往往疑为目疾，则大谬矣。气喘咳嗽，或日晡发热，或忽冷忽热，手足惊搐，俗云抽风面色苍白，或二目如蒙，小便清白，或有白粉沉淀口鼻气冷，虽有口唇干裂出血，须记清此条久病，口中气凉，不喜饮水，即是虚证，不可误认为真热也。或泻利冷汗，或完谷不化，或四肢冰冷，喉内痰鸣，角弓反张，二目天吊，自汗盗汗，囱门下陷，以致痉厥衰败而死。此症发热，唇焦，最易令医者犹豫不决，须切记日久二字，必为虚热无疑也。
（治法）此症唯一治法，第一要着，即在止泻，其他现象，只要泻止，一律皆去，是以参、芪、白术、白芍、熟地，为必不可少之品。再重则附子、肉桂、干姜、补骨脂、粟壳，亦为要药。虽有发热，万不可认为实证，医者诊察明白，即应放胆治疗，起死回生，实有奇效。最重之症，必不得巳时，中药与西药互用，无不收效。参看医验但小儿科总以不用此种西药为宜，以药量倘有错误，立致危险，故余郑重声明于此。
（医验）张宅幼童，年四岁。住崇文门外，铁欐欐把胡同四号。此余友栾翔云君之内侄，于民国十七年三月患疹疾，经过半年，遂衰弱泄泻，久治不愈。来诊时，大脉细微，气喘神昏，发热，骨瘦如柴，呕吐，咳嗽，泄泻不止，完谷不化，睡时二目不能紧合，察其前服药方，率皆指为疹后馀毒未尽，所用之药，仍是清凉分利解毒之品。余认此症已成慢惊重症，即以脾肾虚寒论治，处方如下：中医命门相火之说，精妙玄奥，实能阐发吾人生活之原理，绝非有形质之物，故余于前编生理，下取命门即精囊乏说，参看自明。
第一方大党参二钱炙黄芪二钱土炒白术三钱怀山药四钱炒茯苓三钱炒白芍四钱大熟地三钱补骨脂一钱炙甘草一钱姜枣引。煎一杯分六次，一日夜眼完。此药一剂即大效，第二日热退大半，泻亦减，精神稍旺，吐亦止，渐能饮食，此症改方约四次，大意均不出此。余治此症最多，兹录两案取其近在北京，易调查也。
此症最忌寒凉、顺气、消食、分利等品，例如黄连、黄芩、半夏、神曲、麦芽、山楂、厚朴、枳实、陈皮、车前子、泽泻之类，误用此品，杀人最速，医者戒之。
余表弟卢玉如之公子，年四岁，一日延余诊病，至则见其身热、大喘、大喝、呼冷饮、脉已绝，病已不治。询其以前病状，则以因患温症腹泻对，请其出最近所服药方，则某庸医之大补剂也。此医因常见余以此等药治愈小儿之泄泻，乃不分虚实，骤然与之，真可恨也。呜呼，此子系新得之实证，何可用补剂，而某医一见腹泻，即以参、芪、术、地等品与之，其杀人之速，较之误用顺气消食之药者，更觉可畏，录此一则，可见此种起死回生之实验良方，若用之于新得之实证，则万万不可也。
王宅幼女，年五岁，住阜城门外内巡捕厅胡同二十九号。于民国二十七年九月来诊，据称此症已经过多医，以前病状，泄泻咳嗽，已经数月，诊疗未愈。近则咳嗽泄泻，所泻之物且有如白痢状者，每日鼻塞不通，上午二目不能睁开，泄泻亦在上午为甚，诊其六脉细如游丝，全身衰弱已极，且有虚热，认为慢惊风重症，处方如下：此症检查以前药方，多将各种病象认为另一独立病症，分别施治，是大错误，不忍不言。
中医治疗疾病，必须首先辨别虚实，然后才能确定方药。这两种病症（肿胀和久泻），中西医都有发汗和解下两种治法，这并非错误。但是，学者们必须牢记，“发汗”和“解下”这两个字，是指患者的元气尚未虚弱、患病时间不长，或者是在热性病中的实证而言。绝不可以将这两种方法应用于病程长久缠绵、脉象虚弱、体质衰弱的肿胀病，再结合后文所列的医案参考，自然就会明白我对此类病症的立论，并不是偏重于温补疗法了。
每当我遇到极严重的肿胀病，因为内脏肿大，患者自觉胀闷不适。我就依据这一独特的理论，毅然排除古书中不合理的说法，谨慎地进行治疗。只要病人家属信任，始终一致，从未遇到过失败的案例。本编付梓印刷时，正遇到一个极重的肿胀病例，且已经过多位医生的治疗，未能见效，现在已经完全依照此理论治愈了。这可以说是最近最确实的一个证明，现将这个医案摘录在后面，以告知学者们。这个病例是赵夫人，住在北京西四牌楼大拐棒胡同九号，是大律师李鹤鸣先生的舅母，有兴趣研究这个重症以验证我言论的人，不难去访问她。
（医验）张夫人住在德县南门东街，三十多岁，这是我朋友张松泉先生的夫人，于民国十四年患肿胀病，一天比一天严重。起初只觉得胀满，四肢怕冷，手足指尖浮肿，饮食日渐减少，随后腹部肿胀，小便短少，大便干燥或溏稀，大约一年后腹肿更甚，肚脐突出，且有水液浸润，腹部常觉得有水潴留，已成重症。以前服用的药物，大多是理气、消导、利水的药品，经过一年没有效果。经我诊断，见左右手脉象都沉细而濡软，认为这是心脾虚弱（心脏衰弱，血行障碍，易水肿，这是西医病理；脾弱不运的说法，则是中医病理）。病情已极严重，亟应补心气以增强血行，培补脾胃以利运化，希望以中西医理相互参证治疗，无不应手奏效。但此症最忌讳发汗、泻下等药，以及猛烈攻伐的药物，葶苈子、甘遂等尤为大忌，即使是顺气的药，如枳实、槟榔、陈皮、厚朴之类，也应谨慎使用。我治疗此症，不下数十例，从未失败，亲眼见到因误用医药，死于以上治法的，不知有多少。最近在绥铁路局有一位姓张的科员，先误用发汗法，又误服硫苦泻药，以致丧命，所以我明白揭示这一点，希望病家和医家大大注意。原方列在下面：大台参六钱，炙黄芪六钱，土炒白术八钱，苍术二钱，茯苓皮一钱，姜皮四钱，怀山药六钱，紫蔻仁五分，姜枣为引。此症大约改了几次方，大意都是如此，服药四五十剂，其中的加减，不过一两味，大多是补养的药品，绝无泽泻、车前子、大腹皮、枳实等药，因为这个病症改方太多，为了节省文字，所以没有全部记录。奉方使用人参、黄芪，就是用来补心气的，此症痊愈后，曾服用人乳几个月，所以健康恢复比较容易，到现在十多年了，健康如昔。
赵夫人，四十七岁，住在北京西四牌楼大拐棒胡同九号，于二十七年十月十六日就诊，据她说病已经一年，之前已经过很多医生诊治，现在症状为浮肿，以前只是手脚轻微浮肿，逐渐肿到腿及胸腹，都呈现高肿，头面、颈项、口唇也肿，时常觉得呼吸困难，喉中每觉得有热气上冲，舌头上口腔内，并起红泡，咽干、无涕、无泪、无汗、无痰、无唾、呕吐，小便短少色重，不能饮食，腹内常觉胀满，呃气不出，每天大便约泻一、二次，不想喝水，两手脉象沉濡细微，全身衰弱已极，断定为阳虚脾弱，一切假热现象，亟应舍症从脉，用大剂量的药物培补阳气，希望能挽救。（此危笃臌症病人，自称难愈）原方列在下面：中药类：怀山药、白术、茯苓皮、姜皮、熟附片、猪苓、薏苡仁、人参、炙黄芪、蔻仁、牛膝、龙眼肉、姜枣为引。西药类：利尿剂、收敛剂、维他命剂、健胃剂、漱口剂。本病已到危候，治疗觉得很棘手，脉象和症状既不相符，又在接治之初，患者闻药即吐，不能下咽，但我既然认定其唯一原因，纯系虚寒致肿，一切热征，均系假象，所以敢毅然决定治法，但病已太重，服药不能立即见效，然而我绝不因为未见大效，稍存犹疑，始终坚持我的定见，与此病周旋，立方加减，斟酌缓急，中西药共同救治，自二十七年十月，至二十八年二月，这个可畏的臌症，已经完全治愈。所立的药方太多，不能全部记录，撮取其主要内容如此。此症如果在缺乏经验的医者手里，着手一见不效，立即改变治法，必定导致延误。我虽然是个平庸的医生，但认定病因，从不妄事变动，最终能收到效果，也是快事。本书二十七年十二月已出版，因为想补入这个医案，重新印刷修订，实在是因为这个例子日期最近，疑难点颇多，且又经过多位医生诊治，颇有研究价值，所以不忍割爱，追加报告，希望医坛师友共同讨论。
久泻（六）久泻这个病症与上一条肿胀，有连带关系，学者们应该用心领会。但“久泻”二字，似乎不足以作为病名，我考虑到中医关于虚弱之泻症的名称繁多，徒然扰乱人意，所以定此名，以供取法，凡是日久泄泻，都包括在内，但新得的泻痢及痢疾，不出数星期的，不在此例，这个“久”字应特别注意。
（原因）此症唯一的原因即为肠道的衰弱，大约都是由实证转变而来，例如原病是新得的痢疾，实证因为治疗不得法，拖延日久，数月或数年遂变为久泻。或者大病之后，饮食不注意养生，或者身体素来虚弱，又有不良嗜好，饮酒及手淫等，或者肺结核的蔓延，或者营养不良，或者高龄衰弱，都是本病的原因。西医所称的慢性肠炎（加答儿症），即属于此症，中医则归责于脾肾虚寒，道理是一样的。
（症候）一天之中，不断上厕所，或两三次，或四五次，晨起及夜间，尤其容易泄泻，其大便多溏稀，或下利如白油状，或腹部微痛胀满，不思饮食，日渐衰弱，全身不适，肌肤甲错（皮肤粗糙如鳞甲），头发脱落，气促，虚汗，数月或数年之后，全身衰弱已极，渐渐导致不起，在小儿尤其危险，参阅后面的慢惊风症。最终因此断送生命。
（治法）此症治法，第一须严禁固形食物，在治疗期间，每日饮食，应以流动而易消化的为准。其药品，中药则以收涩药，例如粟壳、桑螵蛸等；补气药，例如人参、黄芪；补脾药，例如白术、山药、茯苓；补肾药，例如补骨脂；补阳药，例如附子、肉桂，都有大效。至于调理胃气的药，不过是加入少许，例如豆蔻三分，以防补药太重，妨碍胃气。西药则以阿片末、次硝酸铋铅、单宁酸并为特效。单宁酸太伤胃，不宜多用。
我治疗此症很多，通常在着手施治之初，预先用小量泻剂，先刷清肠胃。例如硫苦、重曹，其次禁止固形食物，随即进入正式药物治疗法，以硝苍等西药，自晨至下午五点钟，分三次服用，这指成人而言，小儿不必用西药。至十点钟以后，令服中药一次，约一星期，必见大效。以后即将西药分量酌减，仍分三次一日服用，随即再将中药分量酌减，在此时期，斟酌病情，中西药亦可酌情添加。或变换其服药时间，久久自然能治愈，但此症只服中药，或只服西药，大多不易根本治愈。
此症服药方法，例如临睡时令服西药，第二日晨，仍服西药，午仍服西药，下午五点钟，服中药一次，临睡再服中药一次，如此可以试服一星期。病势渐减，则减去西药（或偶服一两次），将中药一剂的分量加重，一日三次，尽服中药，约一星期。
再将中药改为膏剂，每日三次服用，大约一两个月之中，必能治愈，此症中西药互用，读者必有相当疑虑，实则这种用药法，我已实验多年，毫无危险，但在小儿病，最忌阿片，所以不可滥用西药。此症最容易确认，只要常年累月泄泻频频，就可以以此法治之。不论腹痛及所泻有似痢疾之物与否，一律概从虚治。万不可迷惑于中医湿成五泄及噤口休息痢等说，一入此迷阵，万无治愈希望，且恐治丝愈棼，纠缠不清。
（医验）门君，住在北京齐化门内，北豆芽菜胡同四号，五十二岁。以前曾患红白痢疾，一年前未能根本治愈后即渐渐泄泻，每日五六次。黎明之时，必泻一次，腹部微痛，所泻有白油样脓粘物，也有微痛，有时泻稀溏粪，所服药品复杂，久治不愈，病已一年多，渐渐衰弱。于廿六年七月就诊，左脉弦细，右脉沉濡，认为是脾肾虚寒，肠神经衰弱，治宜涩补。其方列下：
第一方（西药）此药晨服一次，午服一次，下午三点钟服一次。（晚十点钟，服中药一次）。
次硝酸铋铅六·○，人参精○·二分，六包，一日三次，二日分服。此方服后立见效，每日只泻二次，又与下方，令掉换服之。
第二方（西药）此药服法，与前第一方同，仍兼服中药，遂收大效。
次硝酸铋铅四·○，单宁酸并三·○，分六包，一日三次，二日分服。此方服后，每日泻二次，后又加人参精○·二，仍分六包，约服二星期，每日只泻一次，三星期后，此方分量减一倍，此后每日服二次，或一次。
第三方（中药）此症根本非中药不治，然中药效力稍缓，故以西药救济之，不可只用西药也。
土炒白术四钱，怀山药六钱，炒茯苓四钱，白扁豆五钱，杵大台参四钱，炙黄芪四钱，炮姜一钱，补骨脂一钱，酒炒砂仁米三分，杵粟壳二钱，炙甘草一钱，姜枣为引。此方效力极大，加减约服二十余剂即痊愈。先停止西药，又将此中药方，加重分量，制成膏剂，一日三次，白开水化服一茶匙，约一月痊愈。
第四方（中药）此方系病愈后，已逾一年，患者又觉渐渐有泄泻，来诊，给予此方。嘱其每隔五、六日，即服一剂，至今健康已恢复。
炒山药四钱，云茯苓四钱，土炒白术四钱，粟壳四钱，台参三钱，炙黄芪三钱，炮姜钱半，补骨脂三钱，桑螵蛸二钱，熟附片一钱，豆蔻五分，炙甘草一钱，姜枣为引，煎服。此症最忌用一切治痢疾之药，及清凉等药，而中药之内，所习用之一切药味，凡重浊不快之品，例如吴茱萸、乌梅、五味子等，均不宜用，以患者胃气已衰，不能胜此等药味，故有损无益。其余顺气破气之药，一概禁用，丸药恐害胃亦禁用，改用膏剂，纵有虚胀，调其饮食即可。
慢惊风（七）慢惊风，这就是小儿久泻衰弱之症，一名慢脾风，此症可与上条久泻症参看。
（原因）此症虽属虚弱，然也多由实证转变而来，例如小儿暴得之吐泻症，西医病名日久转为此症者极多。其余或因疟疾，或因痢疾，或因痘后、疹后，或因饮食油腻厚味、瓜果生冷，积滞日久，过用攻伐及泻药，或因热病过服凉药，或因先天薄弱，乳食缺乏，或因贫困，滋养不足，都是本病原因。日久注意此二字，失治，全身衰弱，脾肾虚寒，气血两亏，即成此症。
（症候）此症唯一病状，即为脉多细小，日久泄泻，愈泻愈虚，遂现全身神经衰弱，皮肤甲错，骨瘦如柴，头发渐渐稀细而黄，渐渐脱落。颈项细长，嗜卧不语，或呕吐，再重则神昏，睡时二目不能紧合，甚至一日之间，二目不能全开，庸医往往疑为目疾，则大谬矣。气喘咳嗽，或日晡发热，或忽冷忽热，手足惊搐，俗云抽风，面色苍白，或二目如蒙，小便清白，或有白粉沉淀，口鼻气冷，虽有口唇干裂出血，须记清此条久病，口中气凉，不喜饮水，即是虚证，不可误认为真热。或泻利冷汗，或完谷不化，或四肢冰冷，喉内痰鸣，角弓反张，二目天吊，自汗盗汗，囟门下陷，以致痉厥衰败而死。此症发热，唇焦，最易令医者犹豫不决，须切记日久二字，必为虚热无疑。
（治法）此症唯一治法，第一要着，即在止泻，其他现象，只要泻止，一律皆去，是以人参、黄芪、白术、白芍、熟地，为必不可少之品。再重则附子、肉桂、干姜、补骨脂、粟壳，亦为要药。虽有发热，万不可认为实证，医者诊察明白，即应放胆治疗，起死回生，实有奇效。最重之症，必不得已时，中药与西药互用，无不收效。参看医验，但小儿科总以不用此种西药为宜，以药量倘有错误，立致危险，故余郑重声明于此。
（医验）张宅幼童，四岁。住在崇文门外，铁欐欐把胡同四号。这是我朋友栾翔云先生的内侄，于民国十七年三月患疹疾，经过半年，遂衰弱泄泻，久治不愈。来诊时，大脉细微，气喘神昏，发热，骨瘦如柴，呕吐，咳嗽，泄泻不止，完谷不化，睡时二目不能紧合，察其前服药方，率皆指为疹后馀毒未尽，所用之药，仍是清凉分利解毒之品。我认此症已成慢惊重症，即以脾肾虚寒论治，处方如下：中医命门相火之说，精妙玄奥，实能阐发吾人生活之原理，绝非有形质之物，故余于前编生理，下取命门即精囊乏说，参看自明。
第一方：大党参二钱，炙黄芪二钱，土炒白术三钱，怀山药四钱，炒茯苓三钱，炒白芍四钱，大熟地三钱，补骨脂一钱，炙甘草一钱，姜枣为引。煎一杯分六次，一日夜服完。此药一剂即大效，第二日热退大半，泻亦减，精神稍旺，吐亦止，渐能饮食，此症改方约四次，大意均不出此。我治疗此症最多，兹录两案取其近在北京，易调查也。
此症最忌寒凉、顺气、消食、分利等品，例如黄连、黄芩、半夏、神曲、麦芽、山楂、厚朴、枳实、陈皮、车前子、泽泻之类，误用此品，杀人最速，医者戒之。
我表弟卢玉如的公子，四岁，一日延我诊病，至则见其身热、大喘、大喝、呼冷饮、脉已绝，病已不治。询问其以前病状，则以因患温症腹泻对，请其出最近所服药方，则某庸医之大补剂也。此医因常见我以这些药治愈小儿之泄泻，乃不分虚实，骤然与之，真可恨。呜呼，此子系新得之实证，何可用补剂，而某医一见腹泻，即以人参、黄芪、白术、熟地等品与之，其杀人之速，较之误用顺气消食之药者，更觉可畏，录此一则，可见此种起死回生之实验良方，若用之于新得之实证，则万万不可。
王宅幼女，五岁，住在阜城门外内巡捕厅胡同二十九号。于民国二十七年九月来诊，据称此症已经过很多医生诊治，以前病状，泄泻咳嗽，已经数月，诊疗未愈。近则咳嗽泄泻，所泻之物且有如白痢状者，每日鼻塞不通，上午二目不能睁开，泄泻亦在上午为甚，诊其六脉细如游丝，全身衰弱已极，且有虚热，认为是慢惊风重症，处方如下：此症检查以前药方，多将各种病象认为另一独立病症，分别施治，是大错误，不忍不言。
In the treatment of diseases, Traditional Chinese Medicine (TCM) must first differentiate between deficiency (Xu, 虚) and excess (Shi, 实) before determining the prescription. For these two conditions—edema (Zhong Zhang, 肿胀) and chronic diarrhea (Jiu Xie, 久泻)—both Western medicine and TCM employ diaphoresis (Han Fa, 汗法) and purgation (Xia Fa, 下法), which is not erroneous. However, practitioners must bear in mind that "diaphoresis" and "purgation" refer specifically to cases where the patient's primordial Qi (Yuan Qi, 元气) has not yet become deficient, the disease duration is short, or it is an excess pattern within a febrile disease. These two methods should absolutely not be applied to edema characterized by a long-standing, lingering course, a weak pulse, and a frail constitution. By referring to the medical cases listed below, one will naturally understand that my theoretical stance on this condition does not favor warm-tonifying therapies exclusively.
Whenever I encounter severe cases of edema, where internal organ swelling causes a subjective sensation of distension and oppression, I adhere to this unique theory. I resolutely discard unreasonable assertions found in ancient texts and treat with caution. As long as the patient's family maintains consistent trust, I have never encountered a failure. At the time of this book's publication, I treated a very severe case of edema that had been seen by multiple physicians without effect; it was completely cured following this theory. This serves as the most recent and convincing evidence. The case is recorded below for the study of practitioners. The patient is Mrs. Zhao, residing at No. 9 Dagua Bang Hutong, West Four Pagoda Plaza, Beijing, aunt-by-marriage of Mr. Li Heming, a prominent lawyer. Those interested in studying this severe condition to verify my claims may easily visit her.
(Medical Case 1) Mrs. Zhang, aged over thirty, resides on Dong Street South Gate, De County. She is the wife of my friend, Mr. Zhang Songquan. In the 14th year of the Republic of China (1925), she developed edema, worsening daily. Initially, she felt only fullness, cold intolerance in the four limbs, and edema of the fingertips. Her diet decreased day by day. Subsequently, abdominal swelling occurred, accompanied by scanty urine and dry or loose stools. After approximately one year, abdominal swelling intensified, with umbilical protrusion and fluid infiltration. She constantly felt fluid retention in the abdomen, constituting a severe condition. Previous medications consisted mainly of Qi-regulating, digestive-promoting, and diuretic agents, yielding no results after a year. Upon diagnosis, her pulses on both hands were deep (Chen, 沉), fine (Xi, 细), and soggy (Ru, 濡). I diagnosed Heart-Spleen Deficiency (Xin Pi Xu Ruo, 心脾虚弱). From a Western pathological perspective, this indicates cardiac weakness, impaired blood circulation, and susceptibility to edema; from a TCM perspective, it reflects Spleen weakness failing to transport and transform (Pi Ruo Bu Yun, 脾弱不运). The condition was extremely critical, requiring immediate tonification of Heart Qi to strengthen blood circulation and cultivation of the Spleen and Stomach to facilitate transformation and transportation. Aiming for mutual therapeutic efficacy through integration of Western and TCM principles, success was expected. However, this condition strictly contraindicates diaphoretic and purgative drugs, as well as harsh attacking agents. Veratrum seeds (Ting Li Zi, 葶苈子) and Kansui root (Gan Sui, 甘遂) are particularly taboo. Even Qi-regulating herbs such as Immature Bitter Orange (Zhi Shi, 枳实), Areca Seed (Bing Lang, 槟榔), Tangerine Peel (Chen Pi, 陈皮), and Magnolia Bark (Hou Po, 厚朴) must be used with caution. I have treated dozens of such cases without failure, witnessing numerous deaths caused by misapplication of these methods. Recently, a clerk surnamed Zhang at the Suide Railway Bureau died after being mistakenly treated with diaphoresis and subsequently taking Epsom salt purgatives. Therefore, I explicitly highlight this warning for patients and physicians. The original prescription is as follows: Ren Shen (Radix Ginseng) 6 qian, Zhi Huang Qi (Prepared Astragalus Root) 6 qian, Tu Chao Bai Zhu (Earth-fried Atractylodes Rhizome) 8 qian, Cang Zhu (Atractylodes Rhizome) 2 qian, Fu Ling Pi (Poria Peel) 1 qian, Jiang Pi (Ginger Peel) 4 qian, Huai Shan Yao (Chinese Yam) 6 qian, Zi Kou Ren (Black Cardamom Seed) 0.5 fen, with Ginger and Jujube as guides. The prescription was modified several times with similar principles. After 40-50 doses, modifications involved only one or two herbs, mostly tonic agents. Diuretics such as Alisma (Ze Xie, 泽泻), Plantago Seed (Che Qian Zi, 车前子), Betel Nut Peel (Da Fu Pi, 大腹皮), and Immature Bitter Orange were entirely absent. Due to frequent modifications, the full record is omitted for brevity. The use of Ren Shen and Huang Qi aims to tonify Heart Qi. After recovery, she consumed human milk for several months, facilitating easier health restoration. She has remained healthy for over ten years.
Mrs. Zhao, aged forty-seven, residing at No. 9 Dagua Bang Hutong, West Four Pagoda Plaza, Beijing, consulted on October 16, Year 27 (1938). She reported a one-year history of illness, having seen many physicians. Current symptoms included generalized edema, progressing from mild hand/foot swelling to severe swelling of the legs, chest, abdomen, face, neck, and lips. She experienced dyspnea, a sensation of heat rushing up the throat, red blisters on the tongue and oral cavity, dry throat, absence of nasal discharge, tears, sweat, phlegm, and saliva, vomiting, scanty dark urine, inability to eat, constant abdominal fullness, hiccups without eructation, 1-2 loose stools daily, lack of thirst, and deep, soggy, fine pulses in both hands. General debility was extreme. I diagnosed Yang Deficiency and Spleen Weakness (Yang Xu Pi Ruo, 阳虚脾弱). All apparent heat signs were deemed false. Urgent treatment required abandoning symptom-based differentiation in favor of pulse-based differentiation, using large doses of Yang-tonifying herbs to attempt rescue. (The patient described this severe鼓症 [Gu Syndrome] as incurable.) Original prescription: TCM: Huai Shan Yao, Bai Zhu, Fu Ling Pi, Jiang Pi, Shu Fu Pian (Prepared Aconite Slice), Zhu Ling (Polyporus), Yi Yi Ren (Coix Seed), Ren Shen, Zhi Huang Qi, Kou Ren (Cardamom Seed), Niu Xi (Achyranthes Root), Long Yan Rou (Longan Aril), Ginger and Jujube as guides. Western Medicine: Diuretics, Astringents, Vitamins, Stomachics, Mouthwash. The condition was critical and difficult to treat due to pulse-symptom mismatch and vomiting upon ingestion of medicine. However, recognizing the sole cause as deficiency-cold leading to edema, with all heat signs being false, I firmly decided on the treatment plan. Although the disease was too severe for immediate effect, I did not hesitate despite initial lack of dramatic improvement, persisting with my conviction, adjusting prescriptions, and integrating Chinese and Western treatments. From October 1938 to February 1939, this formidable Gu Syndrome was completely cured. Too many prescriptions were generated to list fully; the essence is summarized here. Inexperienced physicians might change methods upon seeing no immediate effect, causing delay. Although I am an ordinary practitioner, by identifying the etiology and avoiding arbitrary changes, I achieved rapid results. This book was published in December 1938; I added this case because it is recent, complex, multi-treated, and valuable for research. I hope colleagues will discuss it.
Chronic Diarrhea (6): This condition is related to the previous section on edema; students should comprehend the connection. "Chronic Diarrhea" may not suffice as a formal disease name. Given the multitude of TCM terms for deficiency-type diarrhea, which can be confusing, I adopt this term for standardization. It encompasses all long-term diarrhea, excluding acute diarrhea or dysentery lasting less than a few weeks. The character "Chronic" (Jiu, 久) requires special attention.
(Etiology): The sole cause is intestinal weakness, usually transforming from an excess pattern. For example, acute dysentery, if improperly treated and prolonged for months or years, becomes chronic diarrhea. Other causes include poor dietary management after severe illness, inherent physical weakness, bad habits like alcoholism or masturbation, progression of pulmonary tuberculosis, malnutrition, or senile debility. Western medicine's "chronic enteritis" corresponds to this condition; TCM attributes it to Spleen-Kidney Deficiency-Cold, sharing the same rationale.
(Symptoms): Frequent defecation throughout the day, 2-5 times, especially in the morning and night. Stools are often loose or resemble white oil. Mild abdominal pain and fullness, anorexia, progressive debility, general malaise, xerosis cutis (skin scaling like fish scales), hair loss, shortness of breath, spontaneous sweating. After months or years, extreme debility ensues, potentially fatal, especially in children (see Slow Convulsion). Death eventually occurs.
(Treatment): First, strictly prohibit solid foods; diet should consist of liquid, easily digestible items. Medications: TCM uses astringents (e.g., Poppy Shell [Su Ke, 粟壳], Mantis Egg Case [Sang Piao Xiao, 桑螵蛸]); Qi tonics (e.g., Ginseng [Ren Shen, 人参], Astragalus [Huang Qi, 黄芪]); Spleen tonics (e.g., Atractylodes [Bai Zhu, 白术], Yam [Shan Yao, 山药], Poria [Fu Ling, 茯苓]); Kidney tonics (e.g., Psoralea [Bu Gu Zhi, 补骨脂]); Yang tonics (e.g., Aconite [Fu Zi, 附子], Cinnamon Bark [Rou Gui, 肉桂]). To prevent cloying effects of heavy tonics, add small amounts of stomach-regulating herbs like Cardamom (Dou Kou, 豆蔻). Western medicines: Opium powder, Bismuth Subnitrate Lead, and Tannic Acid are effective. Tannic Acid is harsh on the stomach and should not be overused.
I treat many such cases. Initially, I administer small doses of laxatives (e.g., Epsom Salt, Sodium Bicarbonate) to clear the intestines, then prohibit solids, followed by formal medication. Western medicines (e.g., Bismuth compounds) are given three times daily until 5 PM for adults; not for children. After 10 PM, TCM is administered. Significant improvement is expected within a week. Western medicine dosage is then reduced, while TCM dosage is adjusted. Both may be varied based on condition. Changing administration times aids recovery. Using only TCM or only Western medicine rarely yields a fundamental cure.
Administration method: Example: Western medicine at bedtime, next morning, noon, and 5 PM; TCM at 5 PM and bedtime. Trial for one week. As symptoms subside, reduce Western medicine (occasional use), increase TCM dose to three times daily for one week. Then convert TCM to paste, taken three times daily. Cure expected within 1-2 months. While readers may doubt combined therapy, I have tested this safely for years. Opium is strictly contraindicated in children. Chronic frequent diarrhea confirms the indication. Regardless of abdominal pain or dysentery-like stool, treat as deficiency. Do not be misled by TCM concepts of "Five Diarrheas due to Dampness" or "Silent Dysentery." Entering this confusion eliminates hope of cure and complicates treatment.
(Medical Case 2) Mr. Men, aged fifty-two, resides at No. 4 Beidouya Cai Hutong, inside Qihua Gate, Beijing. He suffered from bloody-purulent dysentery one year ago, which was not fundamentally cured, leading to gradual diarrhea, 5-6 times daily. Morning defecation is mandatory, with mild abdominal pain and passage of white oily pus-like mucus. Sometimes loose stools occur. Complex medications failed to cure him over a year, leading to gradual debility. Consulted in July, Year 26 (1937). Left pulse: Wiry-Fine; Right pulse: Deep-Soggy. Diagnosed as Spleen-Kidney Deficiency-Cold and Intestinal Neurasthenia. Treatment: Astringency and Tonification.
Prescription 1 (Western Medicine): Taken once in the morning, once at noon, once at 3 PM. (TCM taken at 10 PM). Bismuth Subnitrate Lead 6.0, Ginseng Essence 0.2 fen, 6 packets, divided into three doses over two days. Immediate effect: diarrhea reduced to twice daily. Switched to next prescription.
Prescription 2 (Western Medicine): Same administration as Prescription 1, continued with TCM, achieving great effect. Bismuth Subnitrate Lead 4.0, Tannic Acid 3.0, 6 packets, divided into three doses over two days. Effect: diarrhea twice daily. Added Ginseng Essence 0.2, 6 packets, taken for two weeks. Diarrhea reduced to once daily. After three weeks, dosage halved, taken twice or once daily.
Prescription 3 (TCM): Fundamental cure requires TCM, but its action is slow; thus, Western medicine assists. Do not rely solely on Western medicine. Earth-fried Bai Zhu 4 qian, Huai Shan Yao 6 qian, Fried Fu Ling 4 qian, White Hyacinth Bean 5 qian, Ground Da Tai Shen 4 qian, Zhi Huang Qi 4 qian, Pao Jiang 1 qian, Bu Gu Zhi 1 qian, Wine-fried Sha Ren Mi 3 fen, Ground Su Ke 2 qian, Zhi Gan Cao 1 qian, Ginger and Jujube as guide. Highly effective; cured after ~20 doses with modifications. Stop Western medicine, increase TCM dose, make into paste, take 1 teaspoon dissolved in warm water three times daily. Cured in one month.
Prescription 4 (TCM): Prescribed one year after recovery when mild diarrhea recurred. Take one dose every 5-6 days. Health remains restored. Fried Shan Yao 4 qian, Yun Fu Ling 4 qian, Earth-fried Bai Zhu 4 qian, Su Ke 4 qian, Tai Shen 3 qian, Zhi Huang Qi 3 qian, Pao Jiang 0.5 qian, Bu Gu Zhi 3 qian, Sang Piao Xiao 2 qian, Shu Fu Pian 1 qian, Dou Kou 0.5 fen, Zhi Gan Cao 1 qian, Ginger and Jujube as guide, decoct and drink. Contraindications: All dysentery treatments and cooling herbs. Heavy/cloying herbs like Evodia (Wu Zhu Yu, 吴茱萸), Mume Fruit (Wu Mei, 乌梅), and Schisandra (Wu Wei Zi, 五味子) are unsuitable as Stomach Qi is depleted. Qi-moving and breaking herbs are banned. Pills are banned to protect the stomach; use paste instead. Adjust diet for any residual distension.
Slow Convulsion (7): Also known as Slow Spleen Wind (Man Pi Feng, 慢脾风), this is the condition of pediatric debility following chronic diarrhea. Refer to the Chronic Diarrhea section.
(Etiology): Though deficiency-based, it often transforms from excess patterns. For instance, acute vomiting/diarrhea in children may evolve into this condition over time. Other causes: malaria, dysentery, post-smallpox/rubella complications, excessive intake of greasy/thick flavors or raw/cold fruits, prolonged food stagnation, overuse of attacking/purgative drugs, excessive cooling drugs for febrile diseases, congenital weakness, insufficient breastfeeding, poverty/nutritional deficiency. Neglecting the "long duration" leads to systemic debility, Spleen-Kidney Deficiency-Cold, and Qi-Blood dual deficiency.
(Symptoms): Pulse is typically fine and small. Chronic diarrhea worsens deficiency, leading to systemic neurasthenia, xerosis cutis, emaciation, thinning/yellowing/hair loss. Thin neck, lethargy, muteness, or vomiting. Severe cases: coma, incomplete eye closure during sleep, or inability to open eyes fully during the day. Quacks may mistake this for eye disease, which is a major error. Asthma, cough, afternoon fever, alternating chills/fever, limb convulsions ("wind drawing"), pale complexion, cloudy eyes, clear urine with white sediment, cold breath from mouth/nose. Despite cracked/bleeding lips, remember: long-standing disease, cool breath, aversion to drinking indicates deficiency, not true heat. Diarrhea with cold sweat, undigested food, cold limbs, phlegm rattle in throat, opisthotonos, upward gaze, spontaneous/night sweats, sunken fontanelle, leading to spasm, collapse, and death. Fever and scorched lips often cause hesitation. Remember "long duration" implies deficiency-heat.
(Treatment): The primary goal is stopping diarrhea; other symptoms resolve once diarrhea stops. Essential herbs: Ginseng, Astragalus, Atractylodes, White Peony Root, Prepared Rehmannia. Severe cases require Aconite, Cinnamon Bark, Dried Ginger, Psoralea, Poppy Shell. Do not mistake fever for excess. Clear diagnosis allows bold treatment with miraculous results. In critical cases, combine TCM and Western medicine if necessary. However, pediatrics prefers avoiding these Western drugs due to dosage risks. I state this clearly.
(Medical Case 3) Child of the Zhang family, aged four, resides at Tie Lili Ba Hutong, outside Chongwen Gate, Beijing. Nephew of my friend Mr. Luan Xiangyun. Contracted rubella in March, Year 17 (1928). After six months, developed debility and diarrhea, unresponsive to treatment. On consultation: pulse fine/small, asthma, coma, fever, emaciation, vomiting, cough, incessant diarrhea, undigested food, incomplete eye closure. Previous prescriptions attributed symptoms to residual toxins post-rubella, using cooling, separating, and detoxifying herbs. I diagnosed severe Slow Convulsion due to Spleen-Kidney Deficiency-Cold. Prescription:
Prescription 1: Dang Shen 2 qian, Zhi Huang Qi 2 qian, Earth-fried Bai Zhu 3 qian, Huai Shan Yao 4 qian, Fried Fu Ling 3 qian, Fried Bai Shao 4 qian, Da Shu Di 3 qian, Bu Gu Zhi 1 qian, Zhi Gan Cao 1 qian, Ginger and Jujube as guide. Decoct one cup, divide into six doses, consume within 24 hours. One dose yielded significant effect: fever subsided largely, diarrhea reduced, spirit improved, vomiting stopped, appetite returned. Prescription modified four times with similar principles. I treat many such cases; these two are recorded for proximity and ease of verification.
Contraindications: Cooling, Qi-moving, digestive, and separating herbs (e.g., Coptis, Scutellaria, Pinellia, Medicated Leaven, Malt, Hawthorn, Magnolia Bark, Immature Bitter Orange, Tangerine Peel, Plantago Seed, Alisma). Misuse kills rapidly. Physicians beware.
My cousin Lu Yuru's son, aged four, consulted one day. Symptoms: high fever, severe panting, loud crying, craving cold drinks, pulse imperceptible. Condition deemed untreatable. History: fever-disease with diarrhea. Recent prescription by a quack was a strong tonic. This doctor, accustomed to curing pediatric diarrhea with tonics, prescribed them indiscriminately regardless of deficiency/excess. Tragic! This child had an acute excess pattern; tonics were inappropriate. This doctor saw diarrhea and immediately gave Ginseng, Astragalus, Atractylodes, Rehmannia. The speed of fatality exceeded that of misusing Qi-moving/digestive herbs. Recorded to warn that life-saving formulas must not be used for acute excess patterns.
Young girl of the Wang family, aged five, resides at No. 29 Neixunbu Ting Hutong, outside Fucheng Gate, Beijing. Consulted in September, Year 27 (1938). Seen by many physicians previously. History: diarrhea and cough for months, untreated. Recent symptoms: cough, diarrhea with white dysentery-like stool, nasal congestion, inability to open eyes in the morning, worse diarrhea in the morning. Six pulses fine as wandering silk, extreme debility, deficiency-heat. Diagnosed as severe Slow Convulsion. Prescription: Previous prescriptions incorrectly treated various symptoms as independent diseases. This is a major error, which I cannot help but point out.