张鉴录年逾花甲。中秋夜猝仆于地。孟英脉之。弦滑而大。曰∶痰气食相并而逆于上也。先
以乌梅擦开牙关。横一竹箸于口。灌以淡盐姜汤。随入鹅翎探之。太息一声而苏。次予调气
和中而愈。（暴病无虚。脉弦滑为痰食。脉大为气虚。淡盐淡字注意。盐多则沉降不行。)
姚树庭古稀久泻。群医不效。孟英曰∶弦象独见于右关。按之极弱。乃土虚木贼也。前方皆
主温补升阳。理原不背。义则未尽。如姜附肉蔻骨脂之类。气热味辣。虽温脾脏。反助肝阳
。肝愈强则脾愈受戕。且辛走气而性能通泄。与脱者收之之义大相刺谬。鹿茸升麻。可治
气
陷之泻。非斡旋枢机之品。至熟地味浓滋阴。更非土受木克。脾失健行之所宜。纵加砂仁酒
炒。终不能革其腻滞之性。方方用之。无怪乎愈服愈泻。徒借景岳穷必及肾为口实也。予异
功散加山药扁豆莲子乌梅木瓜芍药石脂余粮。服之果效。恪守百日。竟得康强。（右关脉主
脾胃。切脉以沉分为主。土虚木贼。土虚则木贼之。偏重土虚。木贼则兼证也。潞党参五钱
。炒白术四钱。白茯苓三钱。炒甘草三钱。炒焦蛀陈皮一钱。炒山药三钱。炒扁豆三钱。生
建莲去心不去皮三钱。乌梅肉三钱。陈木瓜三钱。土炒白芍一钱五分。炒白蒺藜去刺六分。
土炒赤石脂余粮各一钱。药和服。四君合山药扁豆莲子补土虚为正治。莲子留皮去敛涩。去
心恐苦寒败土。无陈皮。则一派补土中无宣降之品。炒焦者恐其辛窜。乌梅木瓜白芍为兼证
肝阳药。白芍减用恐微寒。蒺藜又为乌梅木瓜白芍反佐之品。石脂余粮和服。取其涩肠止泻
。急则治标之义也。)
张雨农体气羸惫。孟英曰∶公殆久不作嚏。答曰然。此阳气不宣布。古惟仲景论及未立法。
今
拟方博一嚏。高丽参干姜五味石菖蒲酒炒薤白半夏橘皮紫菀桔梗甘草为剂。服后舆行二十里
得嚏。（高丽参五钱。生干姜次入三钱。五味子杵先一钱。石菖蒲次入一钱。酒炒薤白次入
三钱。制半夏米四钱。赖橘红一钱五分。紫菀茸一钱。苦桔梗次入三钱。炒甘草三钱。五味
用
得极精。将欲升之。必先降之。气未有不能降而能升者也。此证阳气以虚而不宣。)
倪怀周
妻夏产数日。泄泻自汗。呕吐不纳。专科谓犯三禁。不敢肩任。孟英诊脉虚微欲绝。证极可
虞。宜急补之。迟不及矣。用东洋参 术龙牡酒炒白芍桑枝木瓜扁豆茯神橘皮紫石英黑大豆
投之。四剂渐以向安。（辨阳虚在脉虚微欲绝。案中数日及专科不敢肩任两层不可忽。盖病
期不久。幸未误药。此证阳虚微挟阴虚。于方中用龙牡黑大豆知之。高丽参五钱。炒西 五
钱。炒白术三钱。酒炒白芍一钱五分。酒炒桑枝三钱。陈木瓜四钱。炒扁豆三钱。云茯神三
钱。赖氏橘红一钱五分。紫石英五钱。醋 龙骨一钱。醋 牡蛎三钱。三味同杵先。炒黑大
豆杵三钱。参 术茯正治阳虚。龙牡石英重镇。合木瓜白芍扁豆之敛涩。以止泄泻自汗呕吐
。橘红宣中。桑枝通络。茯神坐镇中枢。黑大豆入阴止汗。)
张养之侄女汛愆。饮食渐减。于某予通经药。服之尤恶谷。孟英诊之。脉缓滑。曰∶此痰气
凝滞。经隧不宣。病由安坐不劳。法应豁痰流气。勿投血药。经自流通。及服孟英药。果渐
吐
痰而病遂愈。（汛愆而饮食渐减。是病在气分。于某予通经药。服之尤恶谷。病在气分明矣
。气病治血。宜乎不效。脉缓为阳虚。脉滑为痰郁生热。制半夏米五钱。赖橘红一钱五分。
旋复花绢包一钱五分。九节蒲研次入一钱。陈胆星炖和服七分。焦麦芽四钱。炒枳实一钱。
紫菀茸一钱。)
毛允之戌年冬患感。初治以温散。继治以滋阴。延至次春。病日以剧。凤山
僧补以升柴 术。丁卯桥下以轻粉巴霜。杂药遍投。形神日瘁。孟英视之。脉来涩数上溢。
呃忒口腻。虽觉嗜饮。而水难下咽。频吐涎沫。便秘溺赤。潮热往来。少腹如烙。按之亦不
坚满。此病原属冬温。治以表散。则津液伤而热乃炽。继以滋填。热邪愈锢。再施温补。气
机更窒。升柴 术。欲升其清。而反助其逆。巴霜轻粉。欲降其浊。而尽劫其阴。病及三月
。发热不是表邪。便秘旬余。结涩非关积滞。且脉涩为津液之已伤。数是热邪之留着。溢乃
气机为热邪所壅而不得下行。岂非温邪未去。得补而胶固难除。徒使其内烁真阴。上熏清道
。以致一身之气。尽失整肃之令。法当搜剔余邪。使热去津存。即是培元之道。伸其治节。
得浊气下趋。乃为宣达之机。以北沙参麦冬知母花粉兰草石斛丹皮黄芩桑叶栀子黄连木通银
花橘皮竹茹芦根橄榄枇杷叶地栗海 等出入为方。服之各恙降序。糜粥渐加。半月后始得大
解。而腹热全消。谷食亦安。乃予滋阴善后而痊。（论证略尽原案。脉来涩数上溢九句。合
言之皆热邪窒肺之象。析言之。虽觉嗜饮。水难下咽。热邪煽痰逆升阻气。气不降则水不入
。少腹如烙。按之亦不坚满。则热邪不在血分可知。北沙参四钱。姜制黄连八分。姜制枯芩
二钱。黑栀皮三钱。姜制竹茹三钱。活水芦根一两。细木通一钱。赖橘红次入一钱五分。姜
枇叶刷包三钱。更方去沙参栀皮竹茹枇叶。加南花粉四钱。鲜石斛杵先一两。建兰叶次入三
钱。再更方去连芩花粉兰叶。加花麦冬三钱。酒炒知母三钱。粉丹皮三钱。冬桑叶三钱。济
银花八钱次入。鲜青果连核杵先两个。地栗泡淡海 各一两。每五日易一方。)
李某戊年冬醉饮夜归。受人惊吓。神志渐昏。治之罔效。至于不避亲疏。裸衣笑骂。力大无
制。粪秽不知。己年夏孟英视之。用石菖蒲远志龙齿龟板犀角羚角元参丹参知柏栀子龙胆草
枳实黄连竹黄竹沥石膏赭石黑铅铁落出入为方。十余帖吐泻胶痰甚多。继予磁朱丸。渐以向
愈。（此必阳实阴虚挟痰之证。玩案中力大无制可知。若今日阳虚疯痰。断断无治。石菖蒲
一钱次入。生远志次入二钱。黑栀皮三钱。姜竹沥冲服两大酒杯。镑犀角片磨冲五分。羚角
磨冲一钱。酒炒雅连二钱。炒枳实一钱五分。元参片五钱。生石膏先煎八钱。更方去栀皮犀
羚川连石膏。加天竺黄三钱。紫丹参三钱。酒炒胆草三钱。生龙齿二两。生赭石一两。二味
同杵先。再更方去胆草龙齿赭石。加黑铅三两。铁落五钱。加酒炒川黄柏二钱。酒炒知母一
钱。再更方去黑铅铁落。加血龟板杵先四两。)
祝叟年近古稀。春赴席。忽仆地痰涌。肢强眼斜。舌謇不语。孟英视之。投六君加蝎梢羚
角胆星石菖蒲竹沥姜汁而瘳。（此脾虚兼挟肝阳之证。潞党参四钱。炒白术三钱。白茯苓三
钱。炒甘草二钱。制半夏四钱。赖橘红一钱五分。蝎梢次入六分。羚角磨冲五分。石菖蒲次
入六分。姜竹沥五钱冲服。)
翁嘉润患腰疽。愈而复发者五年。孟英切其脉。弦细以数。曰∶此内损证。外科乌乎知。予
大剂甘润滋填之药。匝月而痊。后不复发。（脉弦细数为阴虚。大熟地八钱。明天冬切六钱
。女贞子杵五钱。酒炒桑枝三钱。山萸肉三钱。枸杞子三钱。净归身二钱。济银花五钱。菟
丝饼四钱。龟板胶炖和服二钱。)
潘妪年逾古稀。患霍乱转筋濒危。孟英用自制蚕矢汤而瘳。蚕砂五钱。生苡仁四钱。大豆黄
卷次入一钱五分。陈木瓜三钱。姜汁炒川连二钱。制半夏一钱。酒炒枯芩一钱。通草一钱。
焦栀皮一钱五分。淡吴萸次入三分。地浆或阴阳水煎稍凉徐服。（肝主筋。肝热极则筋转。
蚕砂清凉化浊。能平肝木为君。苡仁能泻肝热。木瓜合川连为酸苦。泄肝极效。豆卷系用麻
黄水炒。能升连芩苦寒之性于至高之肺络以涤热。半夏吴萸辛通中焦为反佐。栀皮清其皮毛
。通草清其水道。)
一少妇分娩。胞水早破。胎涩不能下。俗谓之沥浆生。催生药遍试不应。孟英令买鲜猪肉一
二斤。洗净切大块。急火煎汤。吹去浮油恣饮之。即产。母子皆生。且云猪为水畜。其肉最
腴。大补肾阴而生津液。用治肾水枯涸之消渴。阴虚阳越之喘嗽。并着奇效。仲景治少阴咽
痛用猪肤。亦取其补阴虚而戢浮阳也。后贤不察。反指为有毒之物。汪 庵非之是矣。惟外
感初愈及虚寒滑泻湿盛生痰之证概不可食。以其滋腻更甚于阿胶熟地龙眼也。猪以浙产为良
。北猪不堪用。杭州燥肉 。即猪皮为之。入药最简当。勿谓皮与肤字面有别。（胎凭血
送
。产难阴虚者十之九。胎涩不能下。涩字着眼。猪肉斤许。急火煎汤。吹去浮油恣饮。即偏
证偏治之法。)
某母秋初猝仆于地。孟英诊之。脉浮弦以滑。用羚角胆星牡蛎石菖蒲丹参茯苓钩藤桑叶贝母
橘红蒺藜等。以顺气蠲痰息风降火而痊。（羚角磨冲二钱。陈胆星炖和服一钱五分。石菖
蒲次入一钱。紫丹参四钱。白茯苓三钱。钩藤钩次入五钱。冬桑叶四钱。川贝母杵一两。赖
橘
红次入一钱五分。白蒺藜三钱。 牡蛎八两杵。炭先煨六句钟。取汤代水煎药。此证以息风
降火为主治。顺气蠲痰为辅佐。)嗣其人至某年春前数日。忽欠伸而厥。孟英切脉微弱而弦
曰。病虽与前相似。而证则异矣。以高丽参白术何首乌山茱萸枸杞桑椹石斛牛膝蒺藜橘红等
镇补摄纳以瘳。（脉微弱固为阳虚。弦亦虚脉。既厥则肝阳亦旺。高丽参五钱。炒白术三钱
。制首乌四钱。山萸肉三钱。甘枸杞二钱。干桑葚四钱。钗石斛八钱。制牛膝四钱。白蒺藜
三钱。赖橘红一钱五分。 牡蛎六两杵。炭先煨六句钟。取汤代水煎药。参术针对脉微弱。
补其气分阳虚。杞子桑葚石斛顾阴敛肝。首乌山萸。补其阴中之阳。乃能使阴中一线之阳上
升。牛膝引药下行。蒺藜反佐舒肝。牡蛎镇怯潜阳。橘红反佐全方以行使。)
张养之病延七载。经百十三医之手不愈。体怯面青。易招外感。夏月亦着复衣。频吐白沫。
阳痿多年。常服温辛之药。九月患恶寒头痛。自饵温散不效。孟英诊之。脉极沉。重按至骨
。则弦滑隐然。卧曲房密帐之中。炉火重裘不足御寒。且涎沫仍吐。毫不作渴。胸腹无胀闷
之苦。咳嗽无暂辍之时。惟大解坚燥。小溲不多。口气极重耳。此积热深锢。气机郁而不达
。非大苦寒以泻之不可。二三帖后病不略减。（中略)连服苦寒。病无增减。不比平淡之剂。
误投数帖。尚不见害。实由热伏深锢。药未及病。今日再重用硝黄犀角。冀顽邪蕴毒。得以
通泄下行。则周身之气机自然流布矣。如法服之。越二日大便下如胶漆。臭达户外。畏寒递
减。糜粥日增。旬日后粪色始正。（热伤肺。气不流行则恶寒。头痛为肝阳。若感寒则温散
已效。脉极沉。已见胃腑积滞。重按至骨则弦滑隐然。更见痰热遏伏。炉火不足御寒。热深
厥亦深也。涎沫仍吐。毫不作渴。痰虽热有滑润性质。故不作渴。胸腹无胀闷。病不在气分
。咳嗽无暂辍。则胃热逆冲于肺。大解坚燥为热结固已。热证溲多则愈。溲竭则死。口气
重
为肺胃之热逆冲。镑犀角磨冲六分。元明粉一钱。生大黄三钱。二味开水同泡冲。炒枳实一
钱。元参片五钱。黑栀皮三钱。苦桔梗次下三钱。赖氏橘红一钱。姜竹茹三钱。白茅根三钱
。丝瓜络三钱。石菖蒲一钱。陈胆星一钱炖和服。更方去桔梗竹茹茅根栀皮丝瓜络。加镑犀
角磨冲一钱。元明粉二钱。生大黄五钱。开水同泡冲。炒枳实二钱。制根朴一钱。赖橘红一
钱五分。川贝母杵一两。石菖蒲次入一钱。陈胆星二钱炖和服。)
孙午泉患哮。痰多气逆。不能着枕。服温散滋纳药皆不效。孟英予北沙参桑枝茯苓花粉杏仁
冬瓜仁丝瓜络枇叶旋复海石蛤壳等药。覆杯即卧。数日而痊。（服温散不效。则哮非风寒。
服滋纳不效。则哮非肝肾阴虚。肺热则气逆。此证系热痰伏于肺络。北沙参四钱。姜汁炒桑
枝三钱。白茯
苓三钱。川贝母杵四钱。南花粉三钱。苦杏泥次入一钱五分。生冬瓜子三钱。丝瓜络三钱。
姜汁炒枇叶刷包三钱。旋复绢包三钱。海石蛤壳各四钱。同杵先。)
石符生患疟。医以小柴胡汤加姜桂投之。不效。即用四兽休疟等法。反致恶寒日甚。谷食不
进。惟饮烧酒姜汤。围火榻前。胸腹痞闷。喜以热熨。犹觉冷气上冲。频吐粘稠痰沫。延至
腊初。疲惫不堪。孟英诊之。脉沉而滑数。苔色黄腻不渴。便溏溺赤。曰∶是途次所受之暑
湿。失于清解。复以温补之品从而附益之。酿成痰饮。盘踞三焦。气机为之阻塞。所以喜得
热
熨热饮。气冲反觉如冰。（中略)以脉情兼证并究。其为真热假寒。昭昭若揭。予大剂苦寒之
药。以芦菔汤煎。渐服渐不畏寒。痰渐少。谷渐增。继用甘凉善后。（疟分寒热虚实。此证
本非寒疟虚疟。小柴非。四兽亦非。论证尽于原案。便溏忌用硝黄。姜制黄连八分。姜炒枯
芩三钱。赖橘红一钱。净橘络七分。石菖蒲六分。炒枳实一钱五分。川贝母八钱。贫者以生
冬瓜子八钱代之。生莱菔子研和服一钱。陈胆星炖和服一钱。姜竹茹三钱，丝瓜络三钱，
张鉴录年过六十。中秋之夜突然昏倒在地上。孟英诊察他的脉象，呈现弦、滑且大的特征。他说：这是痰浊、气逆和食积相互搏结，并向上冲逆所致。先用乌梅擦拭以张开牙关，在口中横放一根竹筷，灌服淡盐水姜汤。随后用鹅毛管探入咽喉催吐。病人长叹一声后苏醒过来。接着给予调理气机、和中健脾的方药，病就好了。（暴发性疾病通常没有虚证。脉象弦滑代表有痰食阻滞，脉大则提示气虚。此处强调使用“淡”盐，因为盐分过多会导致药性沉降而不能上行发挥作用。）
姚树庭年逾七十，长期腹泻。多位医生治疗无效。孟英说：只有右关脉呈现弦象，按之极弱，这是脾土虚弱而肝木乘克（土虚木贼）。之前的方子都主张温补升阳，道理上并不违背，但含义未尽善。像干姜、附子、肉豆蔻、骨碎补这类药物，性质温热味道辛辣，虽然能温补脾脏，反而助长了肝阳。肝气越亢盛，脾脏就越受伤害。而且辛味药物走窜气分，其性能通泄，这与脱证应当收敛的原则大相径庭。鹿茸、升麻可以治疗中气下陷导致的腹泻，但不是斡旋枢机的药物。至于熟地黄，味道浓厚用于滋阴，更不适合脾土受肝木克制、脾失健运的情况。即使加入砂仁酒炒，终究不能改变其黏腻滞碍的性质。方方都用这些药，难怪越吃泻得越厉害，只是借用了张景岳“穷必及肾”的理论作为借口罢了。我给予异功散加山药、扁豆、莲子、乌梅、木瓜、芍药、赤石脂、禹余粮。服用后果然见效。坚持服药百日，竟然恢复了健康强壮。（右关脉主要主管脾胃，切脉应以沉分为主。土虚木贼，意思是土虚导致木来乘克，重点在于土虚，木贼是兼夹症状。处方：潞党参五钱，炒白术四钱，白茯苓三钱，炒甘草三钱，炒焦蛀陈皮一钱，炒山药三钱，炒扁豆三钱，生建莲去心不去皮三钱，乌梅肉三钱，陈木瓜三钱，土炒白芍一钱五分，炒白蒺藜去刺六分，土炒赤石脂、禹余粮各一钱。药液调和服用。四君子汤合山药、扁豆、莲子是为了补益脾土的正治法。莲子留皮以取其敛涩之功，去心是担心苦寒败坏脾土。如果没有陈皮，这一派补土药中就缺乏宣发降逆的药物。炒焦陈皮是担心其辛窜太过。乌梅、木瓜、白芍是针对兼夹证的肝阳药物。白芍减量是因为恐其微寒。蒺藜又是乌梅、木瓜、白芍的反佐药物。石脂、余粮调和服用，取其涩肠止泻之意，这是急则治标的原则。）
张雨农体质羸弱疲惫。孟英说：您大概很久没有打喷嚏了。张雨农回答说：是的。这是阳气不能宣通散布。古代只有张仲景论述过这种情况而未确立治法。现在拟一方让您打个喷嚏。用高丽参、干姜、五味子、石菖蒲、酒炒薤白、半夏、橘皮、紫菀、桔梗、甘草组成方剂。服用后坐车行走二十里，终于打出了喷嚏。（处方：高丽参五钱，生干姜后下三钱，五味子捣碎先煎一钱，石菖蒲后下一钱，酒炒薤白后下三钱，制半夏米四钱，赖氏橘红一钱五分，紫菀茸一钱，苦桔梗后下三钱，炒甘草三钱。使用五味子非常精妙，想要提升阳气，必须先降气。气没有不能下降而能上升的。此证阳气因虚而不能宣通。）
倪怀周的妻子产后数日，出现泄泻、自汗、呕吐且无法进食。专科医生认为违反了产后“三禁”，不敢承担责任。孟英诊察脉象虚微欲绝，病情极其危险，应当紧急进补，再迟就来不及了。使用东洋人参、白术、龙骨、牡蛎、酒炒白芍、桑枝、木瓜、扁豆、茯神、橘皮、紫石英、黑大豆投药。服用四剂后逐渐安稳。（辨析：阳虚体现在脉象虚微欲绝。案中提到的病程不久以及专科医生不敢担责这两点不可忽视。因为病期短，幸好没有被误治。此证阳虚微兼阴虚，从方中使用龙齿、牡蛎、黑大豆可知。处方：高丽参五钱，炒西洋参五钱，炒白术三钱，酒炒白芍一钱五分，酒炒桑枝三钱，陈木瓜四钱，炒扁豆三钱，云茯神三钱，赖氏橘红一钱五分，紫石英五钱，醋煅龙骨一钱，醋煅牡蛎三钱。前三味同捣先煎，炒黑大豆捣碎三钱。参、术、茯神正治阳虚；龙、牡、石英重镇安神；配合木瓜、白芍、扁豆的敛涩作用，以止泄泻、自汗、呕吐；橘红宣畅中焦；桑枝疏通经络；茯神坐镇中枢；黑大豆入阴分止汗。）
张养的侄女月经停闭。饮食逐渐减少。于某医生给予通经药物，服用后更加厌恶谷物。孟英诊察，脉象缓滑。他说：这是痰气凝滞，经络不通。病因是久坐不劳，治法应当豁痰理气，不要投用活血药，月经自然流通。等到服用孟英的药，果然逐渐吐出痰涎，病就好了。（月经停闭且饮食渐减，说明病在气分。于某医生给予通经药，服用后更加厌恶谷物，证明病确实在气分。气病治血，当然无效。脉缓为阳虚，脉滑为痰郁生热。处方：制半夏米五钱，赖氏橘红一钱五分，旋复花绢包一钱五分，九节蒲研末后下一钱，陈胆星炖和服七分，焦麦芽四钱，炒枳实一钱，紫菀茸一钱。）
毛允之在戌年冬天患感冒。起初用温散法治疗，继之用滋阴法治疗，拖延到次年春天，病情日益加重。凤山僧人用升麻、柴胡、白术补益，丁卯桥下医生用轻粉、巴豆霜攻下，各种药物乱投，形体和精神日渐憔悴。孟英诊视，脉象涩数且上溢至寸口，呃逆，口中有腻感，虽然觉得想喝水，但水难以下咽，频繁吐出涎沫，便秘，小便赤黄，潮热往来，少腹灼热如烙铁，但按压也不坚硬胀满。这个病原本属于冬温，用表散法治疗，导致津液受伤而热势炽盛；继用滋填法，热邪更加固结；再用温补，气机更加窒塞。升麻、柴胡、白术，本想升举清气，反而助长气逆；巴豆霜、轻粉，本想降泄浊气，却劫夺了阴液。病延三月，发热已不是表邪，便秘旬余，结涩并非因为积滞。而且脉涩表示津液已伤，数表示热邪留着，上溢表示气机被热邪壅遏而不能下行。这难道不是温邪未去，得到补益而胶固难除吗？只会使其内灼真阴，上熏清窍，导致一身之气失去整肃的职能。治法应当搜剔余邪，使热去津存，这就是培元之道；舒展治节，使浊气下趋，这才是宣达的机枢。以北沙参、麦冬、知母、花粉、兰草、石斛、丹皮、黄芩、桑叶、栀子、黄连、木通、银花、橘皮、竹茹、芦根、橄榄、枇杷叶、地栗、海蜇等出入组方。服用后各症依次减轻，糜粥逐渐增加，半月后才大便通畅，腹部热感全消，谷食也安适。于是给予滋阴善后而痊愈。（论证详尽分析了原案。脉来涩数上溢九句，合而言之都是热邪窒塞肺部的征象。析而言之，虽觉嗜饮，水难下咽，是热邪煽动痰浊逆升阻碍气机，气不降则水不入；少腹如烙，按压亦不坚满，说明热邪不在血分。处方：北沙参四钱，姜制黄连八分，姜制枯芩二钱，黑栀皮三钱，姜制竹茹三钱，活水芦根一两，细木通一钱，赖氏橘红后下一钱五分，姜枇杷叶刷包三钱。更方去掉沙参、栀皮、竹茹、枇叶，加南花粉四钱，鲜石斛捣碎先煎一两，建兰叶后下三钱。再更方去掉连、芩、花粉、兰叶，加花麦冬三钱，酒炒知母三钱，粉丹皮三钱，冬桑叶三钱，济银花八钱后下，鲜青果连核捣碎先煎两个，地栗泡淡、海蜇各一两。每五天更换一方。）
李某在戊年冬天醉酒夜归，受人惊吓，神志逐渐昏迷。治疗无效，发展到不避亲疏，裸衣笑骂，力气大无法控制，大小便失禁不知秽物。己年夏天孟英诊视，用石菖蒲、远志、龙齿、龟板、犀角、羚角、元参、丹参、知母、黄柏、栀子、龙胆草、枳实、黄连、竹黄、竹沥、石膏、赭石、黑铅、铁落等出入组方。服用十余帖后，吐出和泻出大量胶状痰涎。接着给予磁朱丸，逐渐好转。（这一定是阳实阴虚挟痰的证候，从案中力气大无法控制可知。如果是今天的阳虚疯痰，绝对无治。处方：石菖蒲一钱后下，生远志后下二钱，黑栀皮三钱，姜竹沥冲服两大酒杯，镑犀角片磨冲五分，羚角磨冲一钱，酒炒雅连二钱，炒枳实一钱五分，元参片五钱，生石膏先煎八钱。更方去掉栀皮、犀角、羚角、川连、石膏，加天竺黄三钱，紫丹参三钱，酒炒胆草三钱，生龙齿二两，生赭石一两。二味同捣先煎。再更方去掉胆草、龙齿、赭石，加黑铅三两，铁落五钱，加酒炒川黄柏二钱，酒炒知母一钱。再更方去掉黑铅、铁落，加血龟板捣碎先煎四两。）
祝叟年近七十。春天赴宴，突然倒地，痰涌，肢体强直，眼斜，舌謇不语。孟英诊视，投予六君子汤加蝎梢、羚角、胆星、石菖蒲、竹沥、姜汁，病愈。（这是脾虚兼挟肝阳的证候。处方：潞党参四钱，炒白术三钱，白茯苓三钱，炒甘草二钱，制半夏四钱，赖氏橘红一钱五分，蝎梢后下六分，羚角磨冲五分，石菖蒲后下六分，姜竹沥五钱冲服。）
翁嘉润患腰疽，好了又复发长达五年。孟英切其脉，弦细而数。他说：这是内损证，外科医生怎么懂呢？给予大剂甘润滋填的药物，一个月痊愈，后来不再复发。（脉弦细数为阴虚。处方：大熟地八钱，明天冬切片六钱，女贞子捣碎五钱，酒炒桑枝三钱，山萸肉三钱，枸杞子三钱，净归身二钱，济银花五钱，菟丝饼四钱，龟板胶炖和服二钱。）
潘妪年过七十，患霍乱转筋，生命垂危。孟英用自制的蚕矢汤治愈。蚕砂五钱，生苡仁四钱，大豆黄卷后下一钱五分，陈木瓜三钱，姜汁炒川连二钱，制半夏一钱，酒炒枯芩一钱，通草一钱，焦栀皮一钱五分，淡吴萸后下三分，地浆或阴阳水煎，稍凉后徐徐服用。（肝主筋，肝热极则筋转。蚕砂清凉化浊，能平肝木为君药；苡仁能泻肝热；木瓜合川连为酸苦之法，泄肝热极效；豆卷是用麻黄水炒的，能升提连、芩苦寒之性至高之肺络以涤热；半夏、吴萸辛通中焦为反佐；栀皮清皮毛之热；通草清水道之热。）
一位少妇分娩，胞水早破，胎涩不能下，俗称为沥浆生。催生药遍试无效。孟英让人买鲜猪肉一二斤，洗净切大块，急火煎汤，吹去浮油，恣意饮用。随即生产，母子皆活。并且说猪为水畜，其肉最肥美，大补肾阴而生津液，用于治疗肾水枯涸之消渴，阴虚阳越之喘嗽，都有奇效。张仲景治少阴咽痛用猪肤，也是取其补阴虚而潜浮阳的作用。后世贤者不加考察，反而指其为有毒之物，汪讱庵批评这种观点是正确的。只是外感初愈及虚寒滑泻湿盛生痰的证候一概不可食用，因为其滋腻程度甚至超过阿胶、熟地、龙眼。浙江产的猪为好，北方猪不堪使用。杭州的燥肉脬，即由猪皮制成，入药最简单恰当，不要以为皮与肤字面有别。（胎儿凭血送下，产难阴虚者十之八九。胎涩不能下，“涩”字是关键。猪肉一斤许，急火煎汤，吹去浮油恣意饮用，这是偏证偏治的方法。）
某人的母亲秋初突然倒地。孟英诊察，脉浮弦而滑。用羚角、胆星、牡蛎、石菖蒲、丹参、茯苓、钩藤、桑叶、贝母、橘红、蒺藜等药，顺气蠲痰、息风降火而痊愈。（处方：羚角磨冲二钱，陈胆星炖和服一钱五分，石菖蒲后下一钱，紫丹参四钱，白茯苓三钱，钩藤钩后下五钱，冬桑叶四钱，川贝母杵一两，赖氏橘红后下一钱五分，白蒺藜三钱，煅牡蛎八两捣碎，炭先煨六小时，取汤代水煎药。此证以息风降火为主治，顺气蠲痰为辅佐。）后来此人到了某年春前几天，忽然欠伸后厥逆。孟英切脉微弱而弦，说：病虽然与前相似，但证候不同了。用高丽参、白术、何首乌、山茱萸、枸杞、桑椹、石斛、牛膝、蒺藜、橘红等镇补摄纳而痊愈。（脉微弱固然是阳虚，弦也是虚脉。既已厥逆，则肝阳亦旺。处方：高丽参五钱，炒白术三钱，制首乌四钱，山萸肉三钱，甘枸杞二钱，干桑葚四钱，钗石斛八钱，制牛膝四钱，白蒺藜三钱，赖氏橘红一钱五分，煅牡蛎六两捣碎，炭先煨六小时，取汤代水煎药。参、术针对脉微弱，补其气分阳虚；杞子、桑葚、石斛顾护阴分收敛肝阳；首乌、山萸补其阴中之阳，才能使阴中一线之阳上升；牛膝引药下行；蒺藜反佐舒肝；牡蛎镇怯潜阳；橘红反佐全方以行使。）
张养患病拖延七年，经过一百一十三位医生之手未愈。体质虚弱面色青，容易招致外感。夏天也穿厚衣，频繁吐出白沫。阳痿多年，常服温辛药物。九月患恶寒头痛，自行服用温散药无效。孟英诊察，脉极沉，重按至骨，则弦滑隐现。卧在密闭房间帷帐之中，炉火重裘不足以御寒。且仍吐涎沫，毫不作渴，胸腹无胀闷之苦，咳嗽无暂歇之时，只是大便坚燥，小便不多，口气极重而已。这是积热深锢，气机郁而不达，非大苦寒以泻之不可。服用二三帖后病未略减。（中间省略）连服苦寒药，病无增减，不像平淡之剂，误投数帖尚不见害。实由热伏深锢，药未及病。今日再重用硝石、大黄、犀角，希望顽邪蕴毒得以通泄下行，则周身之气机自然流布矣。照法服用，过了两天大便下如胶漆，臭气达户外，畏寒逐渐减少，糜粥日增，旬日后粪色始正。（热伤肺，气不流行则恶寒。头痛为肝阳，若感寒则温散已效。脉极沉，已见胃腑积滞，重按至骨则弦滑隐然，更见痰热遏伏。炉火不足御寒，是热深厥亦深。涎沫仍吐，毫不作渴，痰虽热但有滑润性质，故不作渴。胸腹无胀闷，病不在气分。咳嗽无暂歇，则胃热逆冲于肺。大解坚燥为热结固已。热证溲多则愈，溲竭则死。口气重为肺胃之热逆冲。处方：镑犀角磨冲六分，元明粉一钱，生大黄三钱。二味开水同泡冲。炒枳实一钱，元参片五钱，黑栀皮三钱，苦桔梗后下三钱，赖氏橘红一钱，姜竹茹三钱，白茅根三钱，丝瓜络三钱，石菖蒲一钱，陈胆星一钱炖和服。更方去掉桔梗、竹茹、茅根、栀皮、丝瓜络，加镑犀角磨冲一钱，元明粉二钱，生大黄五钱，开水同泡冲，炒枳实二钱，制根朴一钱，赖橘红一钱五分，川贝母杵一两，石菖蒲后下一钱，陈胆星二钱炖和服。）
孙午泉患哮，痰多气逆，不能着枕。服用温散、滋纳药皆无效。孟英给予北沙参、桑枝、茯苓、花粉、杏仁、冬瓜仁、丝瓜络、枇叶、旋复、海石、蛤壳等药，覆杯即卧，数日而痊。（服用温散无效，则哮非风寒。服用滋纳无效，则哮非肝肾阴虚。肺热则气逆，此证系热痰伏于肺络。处方：北沙参四钱，姜汁炒桑枝三钱，白茯苓三钱，川贝母杵四钱，南花粉三钱，苦杏泥后下一钱五分，生冬瓜子三钱，丝瓜络三钱，姜汁炒枇叶刷包三钱，旋复绢包三钱，海石蛤壳各四钱，同捣先煎。）
石符生患疟疾。医生用小柴胡汤加姜桂投之，无效。即用四兽休疟等法，反而导致恶寒日甚，谷食不进，只喝烧酒姜汤，围火榻前，胸腹痞闷，喜以热熨，犹觉冷气上冲，频繁吐出粘稠痰沫，拖延到腊月初，疲惫不堪。孟英诊察，脉沉而滑数，苔色黄腻不渴，便溏溺赤。他说：这是在旅途中感受的暑湿，失于清解，又以温补之品从而附益之，酿成痰饮，盘踞三焦，气机为之阻塞。所以喜得热熨热饮，气冲反觉如冰。（中间省略）以脉情兼证并究，其为真热假寒，昭昭若揭。给予大剂苦寒之药，以芦菔汤煎，渐服渐不畏寒，痰渐少，谷渐增，继用甘凉善后。（疟分寒热虚实，此证本非寒疟虚疟，小柴胡不对，四兽也不对，论证尽于原案。便溏忌用硝黄。处方：姜制黄连八分，姜炒枯芩三钱，赖橘红一钱，净橘络七分，石菖蒲六分，炒枳实一钱五分，川贝母八钱，贫者以生冬瓜子八钱代之，生莱菔子研和服一钱，陈胆星炖和服一钱，姜竹茹三钱，丝瓜络三钱。）
Zhang Jianlu, aged over sixty, suddenly collapsed on the ground on the night of the Mid-Autumn Festival. Mengying palpated his pulse, which was wiry (Xian), slippery (Hua), and large (Da). He said: This is caused by phlegm turbidity, rebellious Qi, and food stagnation clashing and rebelling upward. First, apply a dried plum (Wumei) to wipe open the jaw. Place a bamboo chopstick horizontally in the mouth, and pour in light salt water with ginger soup. Then, use a goose feather to stimulate the throat for vomiting. The patient let out a long sigh and regained consciousness. Subsequently, administer formulas to regulate Qi and harmonize the Middle Jiao, and he recovered. (Acute illnesses usually do not involve deficiency. A wiry and slippery pulse indicates phlegm and food retention; a large pulse suggests Qi deficiency. Note the emphasis on "light" salt here; too much salt causes the medicinal properties to sink and fail to ascend.)
Yao Shuting, over seventy years old, suffered from chronic diarrhea. Many physicians failed to cure him. Mengying said: Only the Right Guan position shows a wiry pulse, which is extremely weak upon deep pressure. This is Spleen Earth deficiency with Liver Wood encroaching (Tu Xu Mu Zei). Previous prescriptions all advocated warming tonification and raising Yang. While the principle was not incorrect, it was incomplete. Herbs like dried ginger (Jiang), prepared aconite (Fu Zi), nutmeg (Rou Kou), and bone drynattia (Gu Zhi) are warm and pungent. Although they warm the Spleen, they inadvertently assist Liver Yang. As Liver Qi becomes more hyperactive, the Spleen suffers more damage. Moreover, pungent herbs move Qi and have a draining nature, which contradicts the principle of astringing for collapse syndromes. Deer antler (Lu Rong) and cimicifuga (Sheng Ma) can treat diarrhea due to Qi sinking, but they are not agents that pivot the mechanism. As for rehmannia (Shu Di), its rich flavor nourishes Yin, which is even less suitable for Spleen Earth being overcome by Liver Wood and losing its transportive function. Even if added with amomum (Sha Ren) fried in wine, its cloying and stagnant nature cannot be changed. Using these formulas repeatedly explains why the diarrhea worsened with continued use, merely borrowing Zhang Jingyue's theory that "extreme depletion reaches the Kidney" as an excuse. I prescribed Yi Gong San (Modified Four Gentlemen Decoction) added with Chinese yam (Shan Yao), coix seed (Bian Dou), lotus seed (Lian Zi), dried plum (Wu Mei), papaya (Mu Gua), peony (Shao Yao), red kaolin (Chi Shi Zhi), and halloysitum rubrum (Yu Liang). It proved effective immediately. Adhering to this regimen for one hundred days, he eventually regained robust health. (The Right Guan pulse governs the Spleen and Stomach; pulse diagnosis should focus on the deep level. Tu Xu Mu Zei means Earth deficiency leads to Wood encroachment; the emphasis is on Earth deficiency, while Wood encroachment is a concurrent symptom. Prescription: Lu Dang Shen 5 qian, Chao Bai Zhu 4 qian, Bai Fu Ling 3 qian, Chao Gan Cao 3 qian, Chao Jiao Zhu Chen Pi 1 qian, Chao Shan Yao 3 qian, Chao Bian Dou 3 qian, Sheng Jian Lian (heart removed, skin retained) 3 qian, Wu Mei Rou 3 qian, Chen Mu Gua 3 qian, Tu Chao Bai Shao 1.5 qian, Chao Bai Ji Li (thorns removed) 0.6 fen, Tu Chao Chi Shi Zhi and Yu Liang each 1 qian. Mix and take the decoction. Si Jun Zi Tang combined with Shan Yao, Bian Dou, and Lian Zi tonifies Earth deficiency, which is the correct treatment. Retaining the lotus skin utilizes its astringent property; removing the heart avoids bitter-cold damaging Earth. Without Chen Pi, the Earth-tonifying formula lacks dispersing and descending agents. Chao Jiao Chen Pi is used to prevent excessive pungent dispersion. Wu Mei, Mu Gua, and Bai Shao address the concurrent Liver Yang syndrome. Bai Shao is reduced in dose to avoid slight coldness. Ji Li acts as a counter-agent to Wu Mei, Mu Gua, and Bai Shao. Chi Shi Zhi and Yu Liang are taken together to astringe the intestines and stop diarrhea, following the principle of treating acute symptoms first.)
Zhang Yunong had a frail and exhausted constitution. Mengying said: You likely haven't sneezed for a long time. Zhang replied: Correct. This is Yang Qi failing to disperse and circulate. Ancient texts only discussed this without establishing a method. Now, I propose a formula to induce a sneeze. Use Korean ginseng (Gao Li Shen), dried ginger (Gan Jiang), schisandra (Wu Wei Zi), acorus (Shi Chang Pu), scallion white (Xie Bai) fried in wine, pinellia (Ban Xia), tangerine peel (Ju Pi), aster (Zi Wan), platycodon (Jie Geng), and licorice (Gan Cao). After taking it, ride a cart for twenty li, and you will sneeze. (Prescription: Gao Li Shen 5 qian, Sheng Gan Jiang added later 3 qian, Wu Wei Zi crushed and decocted first 1 qian, Shi Chang Pu added later 1 qian, Jiu Chao Xie Bai added later 3 qian, Zhi Ban Xia Mi 4 qian, Lai Shi Ju Hong 1.5 qian, Zi Wan Rong 1 qian, Ku Jie Geng added later 3 qian, Chao Gan Cao 3 qian. The use of Wu Wei Zi is exquisite; to raise, one must first lower. Qi cannot rise without first descending. In this case, Yang Qi fails to disperse due to deficiency.)
Ni Huaizhou's wife, several days postpartum, experienced diarrhea, spontaneous sweating, vomiting, and inability to eat. Specialists claimed she violated the "Three Prohibitions" of postpartum care and refused to treat her. Mengying palpated a pulse that was deficient, minute, and nearly imperceptible. The condition was extremely perilous, requiring urgent tonification; delay would be fatal. Use Dong Yang Shen, Bai Zhu, Long Gu, Mu Li, Jiu Chao Bai Shao, Sang Zhi, Mu Gua, Bian Dou, Fu Shen, Ju Pi, Zi Shi Ying, and Hei Da Dou. After four doses, she gradually stabilized. (Analysis: Yang deficiency is indicated by the deficient, minute, and nearly imperceptible pulse. The short duration of illness and the specialists' refusal to take responsibility are crucial points. Since the illness was recent, accidental misprescription was avoided. This case involves Yang deficiency slightly complicated by Yin deficiency, evidenced by the use of Long Gu, Mu Li, and Hei Da Dou in the formula. Prescription: Dong Yang Shen 5 qian, Chao Xi Yang Shen 5 qian, Chao Bai Zhu 3 qian, Jiu Chao Bai Shao 1.5 qian, Jiu Chao Sang Zhi 3 qian, Chen Mu Gua 4 qian, Chao Bian Dou 3 qian, Yun Fu Shen 3 qian, Lai Shi Ju Hong 1.5 qian, Zi Shi Ying 5 qian, Cu Yan Long Gu 1 qian, Cu Yan Mu Li 3 qian. The first three ingredients are crushed and decocted first; Chao Hei Da Dou crushed 3 qian. Shen, Bai Zhu, and Fu Shen correctly treat Yang deficiency; Long Gu, Mu Li, and Zi Shi Ying provide heavy sedation; combined with the astringent properties of Mu Gua, Bai Shao, and Bian Dou to stop diarrhea, sweating, and vomiting; Ju Hong promotes middle Jiao circulation; Sang Zhi unblocks collaterals; Fu Shen stabilizes the central pivot; Hei Da Dou enters the Yin level to stop sweating.)
Zhang Yang's niece had amenorrhea. Her diet gradually decreased. Dr. Yu prescribed blood-invigorating and menstruation-promoting drugs, which made her more averse to grain. Mengying palpated a slow (Huan) and slippery (Hua) pulse. He said: This is phlegm-Qi stagnation blocking the meridians. The cause is sedentary lifestyle and lack of labor. The method should be to resolve phlegm and move Qi; do not use blood-activating drugs. Menstruation will flow naturally. After taking Mengying's medicine, she gradually expectorated phlegm, and the disease resolved. (Amenorrhea with decreasing appetite indicates the pathology is in the Qi level. Dr. Yu's use of blood-invigorating drugs worsening aversion to grain confirms the Qi-level pathology. Treating Qi disease with blood methods is bound to fail. Huan pulse indicates Yang deficiency; Hua pulse indicates phlegm stagnation generating heat. Prescription: Zhi Ban Xia Mi 5 qian, Lai Shi Ju Hong 1.5 qian, Xuan Fu Hua wrapped in silk 1.5 qian, Jiu Jie Pu ground and added later 1 qian, Chen Dan Ting stewed and taken together 0.7 qian, Jiao Mai Ya 4 qian, Chao Zhi Shi 1 qian, Zi Wan Rong 1 qian.)
Mao Yuzhi contracted a cold in winter of the Xu year. Initial treatment used warming dispersants; subsequent treatment used yin-nourishing agents. By the following spring, the condition worsened daily. Monk Fengshan used sheng ma, chai hu, and bai zhu for tonification; Doctor Ding used calomel (Qing Fen) and croton (Ba Shuang) for purging. Various medicines were indiscriminately administered, causing physical and mental deterioration. Mengying examined him: the pulse was choppy (Se) and rapid (Shu), overflowing upwards to the Cun position; he had hiccups, a greasy mouth sensation, desired drinking but could not swallow water, frequently spat saliva, had constipation, dark urine, tidal fever, alternating chills, and a burning sensation in the lower abdomen that was not hard or distended on palpation. This disease originally belonged to Winter Warmth. Surface-dispersing treatment damaged fluids and intensified heat; yin-nourishing treatment entrenched the pathogenic heat; warming tonification further obstructed Qi mechanism. Sheng Ma, Chai Hu, and Bai Zhu intended to raise clear Yang but instead assisted rebellion; Ba Shuang and Qing Fen intended to descend turbid Yin but instead depleted Yin. After three months, the fever was no longer a exterior pathogen; constipation for ten days was not due to accumulation. Choppy pulse indicates fluid injury; rapid pulse indicates lingering heat; upward overflow indicates Qi mechanism blocked by heat preventing downward flow. Is this not Warm Pathogen remaining, becoming fixed and difficult to remove due to tonification? It only scorches True Yin and steams the Clear Orifices, causing the body's Qi to lose its orderly regulation. The method should be to search out and eliminate residual pathogens, preserving fluids as heat leaves, which is the way to tonify Yuan Qi; extending the governance mechanism allows turbid Qi to descend, achieving dissemination. Use Bei Sha Shen, Mai Dong, Zhi Mu, Hua Fen, Lan Cao, Shi Hu, Dan Pi, Huang Qin, Sang Ye, Zhi Zi, Huang Lian, Mu Tong, Yin Hua, Ju Pi, Zhu Ru, Lu Gen, Gan Lan, Pi Pa Ye, Di Li, Hai Zhe, etc., in varying combinations. Symptoms subsided sequentially; congee intake increased; after half a month, bowel movement occurred, abdominal heat vanished, and digestion normalized. Finally, yin-nourishing follow-up treatment led to recovery. (Argument fully analyzes the original case. The nine phrases regarding the choppy, rapid, and overflowing pulse collectively indicate Heat Pathogen obstructing the Lung. Specifically: desire to drink but inability to swallow indicates Heat stirring Phlegm rebelliously upward, obstructing Qi; without descending Qi, Water cannot enter; burning lower abdomen without hardness indicates Heat is not in the Blood level. Prescription: Bei Sha Shen 4 qian, Jiang Zhi Huang Lian 0.8 fen, Jiang Zhi Ku Qin 2 qian, Hei Zhi Pi 3 qian, Jiang Zhi Zhu Ru 3 qian, Huo Shui Lu Gen 1 liang, Xi Mu Tong 1 qian, Lai Shi Ju Hong added later 1.5 qian, Jiang Pi Ye brushed and wrapped 3 qian. Modified formula removes Sha Shen, Zhi Pi, Zhu Ru, Pi Ye; adds Nan Hua Fen 4 qian, Xian Shi Hu crushed and decocted first 1 liang, Jian Lan Ye added later 3 qian. Further modified formula removes Lian, Qin, Hua Fen, Lan Ye; adds Hua Mai Dong 3 qian, Jiu Chao Zhi Mu 3 qian, Fen Dan Pi 3 qian, Dong Sang Ye 3 qian, Ji Yin Hua 8 qian added later, Xian Qing Guo with core crushed and decocted first 2 pieces, Di Li soaked in light brine and Hai Zhe each 1 liang. Change prescription every five days.)
Li Mou returned home drunk in winter of the Wu year, was startled, and gradually lost consciousness. Treatment failed, progressing to ignoring social norms, stripping clothes, laughing and cursing, uncontrollable strength, and incontinence unaware of filth. In summer of the Ji year, Mengying treated him using Shi Chang Pu, Yuan Zhi, Long Chi, Gui Ban, Xi Jiao, Ling Jiao, Yuan Shen, Dan Shen, Zhi Mu, Bai Zhu, Zhi Zi, Long Dan Cao, Zhi Shi, Huang Lian, Zhu Huang, Zhu Li, Shi Gao, Zhe Shi, Hei Qian, Tie Luo, etc., in varying combinations. After more than ten doses, he vomited and purged large amounts of sticky phlegm. Subsequently, Ci Zhu Wan was given, leading to gradual recovery. (This must be a syndrome of Excess Yang, Deficient Yin, and Phlegm complication, evident from the uncontrollable strength. If it were today's Yang-deficiency madness-phlegm, it would be incurable. Prescription: Shi Chang Pu 1 qian added later, Sheng Yuan Zhi added later 2 qian, Hei Zhi Pi 3 qian, Jiang Zhu Li mixed and taken 2 large cups, Bang Xi Jiao slice ground and mixed 0.5 fen, Ling Jiao ground and mixed 1 qian, Jiu Chao Ya Lian 2 qian, Chao Zhi Shi 1.5 qian, Yuan Shen Pian 5 qian, Sheng Shi Gao decocted first 8 qian. Modified formula removes Zhi Pi, Xi Jiao, Ling Jiao, Chuan Lian, Shi Gao; adds Tian Zhu Huang 3 qian, Zi Dan Shen 3 qian, Jiu Chao Dan Cao 3 qian, Sheng Long Chi 2 liang, Sheng Zhe Shi 1 liang. These two are crushed and decocted first. Further modified formula removes Dan Cao, Long Chi, Zhe Shi; adds Hei Qian 3 liang, Tie Luo 5 qian, Jiu Chao Chuan Huang Bo 2 qian, Jiu Chao Zhi Mu 1 qian. Further modified formula removes Hei Qian, Tie Luo; adds Xue Gui Ban crushed and decocted first 4 liang.)
Old Man Zhu, near seventy, attended a banquet in spring, suddenly collapsed with phlegm surging, limb rigidity, eye deviation, aphasia. Mengying treated him with Liu Jun Zi Tang added with Xie Shao, Ling Jiao, Dan Ting, Shi Chang Pu, Zhu Li, and Jiang Zhi, resulting in recovery. (This is Spleen deficiency with concurrent Liver Yang hyperactivity. Prescription: Lu Dang Shen 4 qian, Chao Bai Zhu 3 qian, Bai Fu Ling 3 qian, Chao Gan Cao 2 qian, Zhi Ban Xia 4 qian, Lai Shi Ju Hong 1.5 qian, Xie Shao added later 0.6 fen, Ling Jiao ground and mixed 0.5 fen, Shi Chang Pu added later 0.6 fen, Jiang Zhu Li mixed and taken 5 qian.)
Weng Jiarun suffered from a lumbar carbuncle that recurred for five years after healing. Mengying palpated a wiry, fine, and rapid pulse. He said: This is an internal damage syndrome; how could surgeons understand it? Prescribe large doses of sweet, moistening, and filling herbs. He recovered in a month and did not relapse. (Wiry, fine, and rapid pulse indicates Yin deficiency. Prescription: Da Shu Di 8 qian, Ming Tian Dong sliced 6 qian, Nv Zhen Zi crushed 5 qian, Jiu Chao Sang Zhi 3 qian, Shan Yu Rou 3 qian, Gou Qi Zi 3 qian, Jing Gui Shen 2 qian, Ji Yin Hua 5 qian, Tu Si Bing 4 qian, Gui Ban Jiao stewed and taken together 2 qian.)
Old Woman Pan, over seventy, suffered from cholera with tendon contraction, nearing death. Mengying cured her with his self-made Can Shi Tang. Can Sha 5 qian, Sheng Yi Ren 4 qian, Da Dou Huang Juan added later 1.5 qian, Chen Mu Gua 3 qian, Jiang Zhi Chuan Lian 2 qian, Zhi Ban Xia 1 qian, Jiu Chao Ku Qin 1 qian, Tong Cao 1 qian, Jiao Zhi Pi 1.5 qian, Dan Wu Yu added later 0.3 fen, Di Jiang or Yin-Yang Water decocted, taken slowly when slightly cool. (Liver governs tendons; extreme Liver Heat causes tendon twisting. Can Sha is cool and resolves turbidity, pacifying Liver Wood as the sovereign herb; Yi Ren drains Liver Heat; Mu Gua combined with Chuan Lian forms sour-bitter method, extremely effective in draining Liver Heat; Dou Juan is fried with ephedra water, lifting the bitter-cold nature of Lian and Qin to the highest Lung collaterals to wash away heat; Ban Xia and Wu Yu are pungent and open the Middle Jiao as counter-agents; Zhi Pi clears skin/surface heat; Tong Cao clears water pathways.)
A young woman gave birth; amniotic fluid broke early, fetus stuck and could not descend,俗称 "Li Sheng". Ecbolic drugs failed. Mengying instructed buying 1-2 jin of fresh pork, washed and cut into large chunks, boiled rapidly, skimmed off floating oil, and drunk freely. Delivery succeeded, mother and child survived. He stated: Pig is a water animal; its meat is richest, greatly tonifying Kidney Yin and generating fluids. It treats Xiao Ke (wasting-thirst) from Kidney Water exhaustion and Chuan Sou (panting/cough) from Yin deficiency with Floating Yang. Zhang Zhongjing used Zhu Fu for Shaoyin sore throat to tonify Yin deficiency and subdue Floating Yang. Later scholars, failing to investigate, wrongly called it toxic. Wang Ren'an was right to criticize this. However, it is contraindicated in early stages of exterior diseases, deficiency-cold loose stools, dampness abundance, and phlegm generation, as its cloying nature exceeds Ejiao, Shu Di, and Long Yan. Zhejiang pigs are best; northern pigs are unsuitable. Hangzhou's Zao Rou Pao is made from pig skin, simplest and most appropriate for medicine. Do not confuse skin (Pi) and dermis (Fu). (Fetus relies on blood for delivery; nine out of ten difficult labors are due to Yin deficiency. Fetal stickiness emphasizes the character "Se" (astringent/stuck). One jin of pork, rapid boil, skim oil, drink freely; this is a specific treatment for a specific syndrome.)
Mother of a certain person collapsed suddenly in early autumn. Mengying palpated a floating, wiry, and slippery pulse. Used Ling Jiao, Dan Ting, Mu Li, Shi Chang Pu, Dan Shen, Fu Ling, Gou Teng, Sang Ye, Bei Mu, Ju Hong, Ji Li, etc., to smooth Qi, dispel phlegm, extinguish wind, and descend fire, resulting in recovery. (Prescription: Ling Jiao ground and mixed 2 qian, Chen Dan Ting stewed and taken together 1.5 qian, Shi Chang Pu added later 1 qian, Zi Dan Shen 4 qian, Bai Fu Ling 3 qian, Gou Teng Gou added later 5 qian, Dong Sang Ye 4 qian, Chuan Bei Mu crushed 1 liang, Lai Shi Ju Hong added later 1.5 qian, Bai Ji Li 3 qian, Yan Mu Li 8 liang crushed, Tan Xian Wei 6 hours, use soup to decoct herbs. This case focuses on extinguishing wind and descending fire as main treatment, smoothing Qi and dispelling phlegm as auxiliary.) Later, in spring of a certain year, a few days prior, he suddenly stretched and fainted. Mengying palpated a weak and wiry pulse, saying: Though similar to before, the syndrome differs. Use Gao Li Shen, Bai Zhu, He Shou Wu, Shan Zhu Yu, Gou Qi, Sang Shen, Shi Hu, Niu Xi, Ji Li, Ju Hong, etc., for sedative tonification and grasping, resulting in recovery. (Weak pulse indicates Yang deficiency; wiry is also a deficiency pulse. Fainting indicates Liver Yang hyperactivity. Prescription: Gao Li Shen 5 qian, Chao Bai Zhu 3 qian, Zhi Shou Wu 4 qian, Shan Yu Rou 3 qian, Gan Gou Qi 2 qian, Gan Sang Shen 4 qian, Cha Shi Hu 8 qian, Zhi Niu Xi 4 qian, Bai Ji Li 3 qian, Lai Shi Ju Hong 1.5 qian, Yan Mu Li 6 liang crushed, Tan Xian Wei 6 hours, use soup to decoct herbs. Shen and Bai Zhu target weak pulse, tonifying Qi and Yang; Gou Qi, Sang Shen, Shi Hu protect Yin and constrain Liver; Shou Wu, Shan Yu Rou tonify Yang within Yin, allowing a thread of Yang to ascend; Niu Xi guides herbs down; Ji Li counter-agents to soothe Liver; Mu Li sedates fear and anchors Yang; Ju Hong counter-agents to facilitate the formula's action.)
Zhang Yang's illness lasted seven years, passing through 113 doctors without cure. Frail constitution, greenish face, prone to exterior infections. Wore thick clothes in summer, frequently spat white foam. Impotence for years, often took warming-pungent drugs. In September, developed aversion to cold and headache, self-medicated with warming dispersants without effect. Mengying palpated an extremely deep pulse; pressing to the bone revealed hidden wiry and slippery qualities. Lying in a sealed room with curtains, stove fire and heavy furs were insufficient for warmth. Still spitting foam, no thirst, no chest/abdominal distension, continuous cough, hard dry stool, scanty urine, foul breath. This is deep-seated accumulated heat, Qi mechanism depressed and unexpressed, requiring major bitter-cold purgatives. After 2-3 doses, no improvement. (Middle omitted) Continuous bitter-cold use showed no change, unlike mild formulas where errors might not show harm. Actually, heat is deeply entrenched, medicine hasn't reached the disease. Today, heavily reuse Xiao (Niter), Huang (Rhubarb), Xi Jiao (Rhinoceros Horn - substitute with Buffalo Horn clinically), hoping stubborn pathogen and accumulated toxin can be drained downward, allowing whole-body Qi mechanism to flow. Taken as directed, after two days, stool passed like glue/lacquer, odor reaching outside, aversion to cold decreased, congee intake increased, stool color normalized after ten days. (Heat damages Lung; Qi stagnation causes aversion to cold. Headache is Liver Yang; if cold invasion, warming dispersants would work. Extremely deep pulse indicates Stomach/Fu accumulation; deep pressure revealing wiry/slippery indicates Phlegm-Heat suppression. Stove/fire insufficient for warmth indicates "Deep Heat leads to Deep Cold" (Re Shen Jue Shen). Spitting foam without thirst: Phlegm-Heat has slippery/moist nature, hence no thirst. No chest/abdominal distension: Disease not in Qi level. Continuous cough: Stomach Heat rebels against Lung. Hard stool: Heat knotting established. Heat syndrome with abundant urine heals; urine exhaustion dies. Foul breath: Lung/Stomach Heat rebellion. Prescription: Bang Xi Jiao ground and mixed 0.6 fen, Yuan Ming Fen 1 qian, Sheng Da Huang 3 qian. Two items soaked in boiling water and mixed. Chao Zhi Shi 1 qian, Yuan Shen Pian 5 qian, Hei Zhi Pi 3 qian, Ku Jie Geng added later 3 qian, Lai Shi Ju Hong 1 qian, Jiang Zhu Ru 3 qian, Bai Mao Gen 3 qian, Si Gua Luo 3 qian, Shi Chang Pu 1 qian, Chen Dan Ting 1 qian stewed and taken together. Modified formula removes Jie Geng, Zhu Ru, Mao Gen, Zhi Pi, Si Gua Luo; adds Bang Xi Jiao ground and mixed 1 qian, Yuan Ming Fen 2 qian, Sheng Da Huang 5 qian, soaked in boiling water and mixed, Chao Zhi Shi 2 qian, Zhi Gen Po 1 qian, Lai Ju Hong 1.5 qian, Chuan Bei Mu crushed 1 liang, Shi Chang Pu added later 1 qian, Chen Dan Ting 2 qian stewed and taken together.)
Sun Wuquan suffered from asthma, excessive phlegm, rebellious Qi, unable to rest head on pillow. Warming dispersants and nourishing-grasping drugs failed. Mengying prescribed Bei Sha Shen, Sang Zhi, Fu Ling, Hua Fen, Xing Ren, Dong Gua Ren, Si Gua Luo, Pi Ye, Xuan Fu, Hai Shi, Ge Ke, etc. Slept immediately after one cup, recovered in days. (Warming dispersants failed: Asthma is not Wind-Cold. Nourishing-grasping failed: Asthma is not Liver/Kidney Yin deficiency. Lung Heat causes Qi rebellion. This case is Heat-Phlegm latent in Lung collaterals. Prescription: Bei Sha Shen 4 qian, Jiang Zhi Sang Zhi 3 qian, Bai Fu Ling 3 qian, Chuan Bei Mu crushed 4 qian, Nan Hua Fen 3 qian, Ku Xing Ni added later 1.5 qian, Sheng Dong Gua Zi 3 qian, Si Gua Luo 3 qian, Jiang Zhi Pi Ye brushed and wrapped 3 qian, Xuan Fu wrapped in silk 3 qian, Hai Shi and Ge Ke each 4 qian, crushed and decocted first.)
Shi Fusheng suffered from malaria. Doctor used Xiao Chai Hu Tang plus Jiang and Gui without effect. Then used Si Shou and other anti-malaria methods, worsening aversion to cold, loss of appetite, only drinking hot wine/ginger soup, sitting by fire, chest/abdominal fullness, preferring hot compresses, feeling cold air rushing up, frequent spit of sticky phlegm. By early La month, exhausted. Mengying palpated deep, slippery, rapid pulse; yellow greasy coating, no thirst, loose stool, dark urine. He said: Summer-dampness contracted during travel, failed to clear/resolve, then aided by warming tonics, brewing Phlegm-Fluid, occupying San Jiao, blocking Qi mechanism. Hence preference for heat compress/drink, yet air rush feels like ice. (Middle omitted) Investigating pulse and symptoms reveals True Heat False Cold clearly. Prescribe large doses of bitter-cold herbs, decocted in Radish Soup. Gradually less afraid of cold, less phlegm, more appetite, followed by sweet-cool follow-up. (Malaria divides into Cold/Hot/Deficiency/Excess. This is neither Cold nor Deficiency Malaria; Xiao Chai Hu and Si Shou are inappropriate. Argument fully analyzed in original case. Loose stool contraindicates Xiao/Huang. Prescription: Jiang Zhi Huang Lian 0.8 fen, Jiang Chao Ku Qin 3 qian, Lai Ju Hong 1 qian, Jing Ju Luo 0.7 fen, Shi Chang Pu 0.6 fen, Chao Zhi Shi 1.5 qian, Chuan Bei Mu 8 qian, poor patients substitute Sheng Dong Gua Zi 8 qian, Sheng Lai Fu Zi ground and taken together 1 qian, Chen Dan Ting stewed and taken together 1 qian, Jiang Zhu Ru 3 qian, Si Gua Luo 3 qian.)