戴氏妇春令产后。恶露不多。用山楂益母草酒煎。连服数日。遂发热自汗。口渴不饥。眩晕
欲脱。彻夜不眠。孟英视之。曰∶此禀属阴亏。血已随胎而去。虽恶露甚少。但无胀痛之苦
者。
不可妄投药饵。酒煎益母山楂。不特伤阴。且能散气。汗泄口干。津液有立竭之势。即仲景
所谓无阳也。盖人身天真之气谓之阳。阳根于津。阴化于液。津液既夺。则阳气无根而眩晕
。阴血不生而无寐。若补气生阴。则舍本求末。阳气不能生津液也。惟有澄源洁流。使津液
充而气血自复。以西洋参生黄 龙骨牡蛎玉竹百合甘草麦冬生苡仁生扁豆石斛木瓜桑叶蔗浆
投之。一剂即安。数日而愈。后予滋填阴分。服之乃健。（血为阴类。阴亏血少。则恶露亦
不多。此证阴亏血少。无须行血。连服酒煎益母山楂发热自汗四句。皆耗气伤阴之明证。阴
亏补阴。理甚直捷。若欲补气以生阴。则阴生不可必。补气反愈伤阴。西洋参三钱。生黄
三钱。生龙骨一两杵先。 牡蛎四两杵先。二味炭煨六句钟。取汤代水煎药。肥玉竹三钱。
生甘草三钱。花麦冬四钱。生苡仁八钱。生扁豆杵三钱。钗石斛一两杵先。陈木瓜三钱。冬
桑叶四钱。青蔗汁一大酒杯冲。嗣予滋填阴分。方用大熟地八钱。大生地一两。明天冬六钱
切。山萸肉三钱。菟丝饼四钱。箱归身二钱。夜交藤三钱。甘枸杞三钱。肥玉竹三钱。龟板
胶二钱。炖和服。)
王某久患吐血。体极孱弱。孟英治之小愈。酷暑患霍乱转筋。大汗如雨。一息如丝。孟英视
曰。阴血久夺。暑热鸱张。吾霍乱论中缺典也。姑变法救之。用北沙参枇叶龙牡木瓜扁豆苡
仁西滑石桑叶蚕砂石斛豆卷投之良愈。嗣后每日调理。仍服滋补以治宿恙。（此证危险在大
汗如雨。汗为阴液。汗多则阴伤。汗止则阴复。阴复则转筋止。脉息起。阴血久夺句本病重
。暑热鸱张句标病轻。北沙参四钱。生龙骨杵二两。 牡蛎杵八两。二味炭先煨六句钟取汤
煎药。鲜枇叶刷包三钱。陈木瓜三钱。生扁豆杵三钱。生苡仁杵八钱。西滑石四钱包先。冬
桑叶四钱。晚蚕砂五钱。钗石斛杵先一两。大豆卷次入三钱。龙牡重镇止汗为君。沙参石斛
顾阴止汗为臣。木瓜扁豆酸涩止汗。苡仁滑石蚕砂清肝泻暑。使以枇叶桑叶轻浮止汗。豆卷
反佐清余热。豆卷在热霍乱证本禁药。入大剂重镇清肝药中。反能上清浮热。)
李氏女素禀怯弱。春间汛事不行。胁腹聚气如瘕。减餐肌削屡服温通之药。至孟秋加以微寒
壮热
。医仍作经闭治。势濒于危。孟英切脉时。壮热烙指。汗出如雨。汗珠落脉枕上。微有粉红
色。曰∶虚损是其本也。今暑热炽盛。先当治其客邪。书白虎汤加西洋参元参竹叶荷杆桑叶
。
服二帖。热果退。汗渐收。改用甘凉清余热。日以向安。继予调气养营阴。宿瘕亦消。培补
至仲冬。汛至而痊。（汛事不行。胁腹聚气如瘕。是血病及气。至减餐肌削。屡服温通。微
寒壮热。则血病及气。由气分而外达皮毛。先治客邪。急则治标之义。生石膏一两六钱先煎
。酒炒知母次入三钱。去草米。加西洋参三钱。元参片五钱开水泡冲去渣。鲜竹叶次入三钱
。鲜荷杆二尺。冬桑叶四钱。二帖后改用甘凉清余热。方用蜜炙枇叶刷包三钱。生甘草三钱
。鲜竹叶二钱。鲜茅根四钱。活水芦根二两。生苡仁八钱。鲜敛斛杵先一两。连皮梨切一两
。继予调气养营阴。方用鲜竹茹三钱。苦杏仁二钱。薄橘红一钱五分。紫菀茸一钱。旋复花
绢包一钱五分。连节藕切先二两。蒲桃干三钱。鲜茅根三钱。箱归身二钱。大生地八钱。女
贞杵先四钱。)
张氏妇患气机不舒。似喘非喘。似逆非逆。似太息非太息。似虚促非虚促。似短非短。似闷
非闷。面赤眩晕。不肌不卧。补虚清火行气消痰服之不应。孟英诊之。曰∶小恙耳。旬日可
安。但须惩忿是嘱。予黄连黄芩栀子楝实鳖甲羚角旋复赭石海 地栗为大剂。送当归龙荟丸
。未及十日汛至。其色如墨。其病已若失。后予养血和肝调理而康。（气机不舒以下十一句
。皆病不在气分之象。孟英诊曰小恙者。脉病患不病则病重。人病脉不病则病轻。此证必肝
脉沉实数有力。能受苦甘寒大剂。故曰小恙。属惩忿。人忿则全身气血颠倒。最易伤肝。肝
郁热亦易忿怒。酒炒川连八分。酒炒枯芩一钱五分。黑栀皮三钱。川楝实杵先三钱。血鳖甲
杵四两。生赭石一两杵。二味同先炭煨六句钟。取汤代水煎药。羚角磨冲一钱。旋复绢包三
钱。荸荠八钱。泡淡陈海 二两。药送当归龙荟丸二钱。此证血分中肝有实热。肝阴虚。肝
阳浮。养血和肝方。大生地八钱。连皮藕二两切先。箱归身二钱。蒲桃干三钱。干桑叶四钱
。陈木瓜三钱。酒炒桑枝次入三钱。生白蒺去刺次入三钱。血鳖甲杵先四两。夜交藤三钱。
生甘草三钱。)
王炳华室夏患臂痛。孙某曰。风也。服参 归芍数帖。臂稍愈而脘痛。孙曰。寒也。加以附
桂。痛不止而渐觉痰多。孙曰∶肝肾不足也。重用熟地枸杞。令其多服取效。不料愈服愈剧
。渐至昏厥。孙尚谓体虚药轻。前方加重。时时发厥。孟英诊之。脉沉而有弦滑且数之象。
此由过投温补。引动肝风。煽其津液为痰。痰复乘风而上。此晕厥之所由来也。余波则奔流
经络。四肢因而抽搐。阳气尽逆于上。宜乎。鼻塞面浮。浊气不能下达。是以便滞不饥。予
大剂甘寒息风化饮。佐以凉苦泄热清肝。厥果渐止。各恙递蠲。两月后康复如常。（此证臂
痛。本系阳虚挟痰。孙某过投温补。引动肝风。痰乘风上。脉沉为痰浊遏伏。脉弦滑为痰乘
风上。脉数为温补。以致阴虚挟热。方义以息风化饮为主治。尤重息风。风不息则饮不能化
。姜竹沥三两。和服花粉五钱。荸荠二两。泡淡海 一两。鲜敛斛一两杵先。冬桑叶四钱。
川楝实三钱。炒川黄柏一钱五分。胆星一钱炖和服。石菖蒲次入一钱。生白蒺去刺三钱。生
赭石一两，青果四钱杵。 牡蛎六两。石斛赭石楝实青果牡蛎五味。先炭煨六句钟。取汤代
水煎药。)庄半霞闱后患感。日作寒热七八次。神气昏迷。微斑隐隐。孟英视之。曰∶此平
昔饮酒。积热深蕴。挟感而发。理从清解。必误投温补。以致热势披猖若是。询之果三场皆
服参。且携枣子浸烧酒入闱。初病尚不至此。因连服羌防姜桂。渐以滋甚孟英先予白虎汤三
剂。斑化而寒热渐已。（日作寒热七八次三句。此外感之邪欲外达。温补锢邪。邪欲达而不
能径达。生石膏先煎八钱。酒炒知母三钱。去米草。加黑栀皮三钱。淡豆豉次入三钱。炒枳
实一钱。姜竹茹三钱。陈胆星炖和服八分。石菖蒲次入六分。赖橘红八分。姜川连六分。)
继用大苦寒之药泻其结热。所下黑矢皆作枣子气。（生厢黄三钱。开水泡冲去渣。炒枳实二
钱。生冬瓜子四钱。晚蚕砂五钱。制根朴一钱。鲜莱菔一两先煎。药送滚痰丸三钱。)旬日
后予甘润滋濡之法。两月始得全愈。（南花粉四钱。花麦冬三钱。蜜炙桑皮三钱。甜杏仁三
钱。蜜炙枇叶刷包三钱。大荸荠打三个，泡淡海 八钱。青蔗浆一酒杯和服。生粉草三钱。
)
金魁官九月患五色痢。日下数十行。七八日来口噤不纳。腹痛呻吟。危在旦夕。孟英
视之。曰∶暑挟食耳。误服热药矣。攻补皆不可施也。轻清取之。可即愈焉。以北沙参黄连
鲜莲子栀子黄芩枇叶石斛扁豆银花桔梗山楂神曲滑石为方。（痢日下数十行四句。病情皆在
气分。暑伤气阴。攻则伤正。补则助邪。经云上焦如羽。非轻不举。北沙参三钱。姜炒川连
六分。姜炒枯芩一钱五分。鲜莲子三钱。黑栀皮一钱五分。姜炒鲜枇叶刷包三钱。鲜石斛杵
先四钱。生扁豆杵一钱五分。济银花三钱。苦桔梗次入一钱。生山楂杵次入一钱。生神曲杵
次入一钱五分。西滑石包先三钱。)覆杯即安。旬日而起。孟英尝曰∶莲子最补胃气而镇虚
逆。若反胃由于胃虚而气冲不纳者。皆是热邪伤其胃中清和之气。故以黄连苦泄其邪。即仗
莲子甘镇其胃。鲜莲子清香不浑。镇胃之功独胜。附录孟英玉芝丸。猪肚一具。治净以莲子
去心入肚内。水煎糜烂。收干捣为丸服。凡胃气薄弱者。常服玉芝丸。令人肥健。
陈足甫禀质素弱。上年曾经吐血。今夏患感后咳嗽夜热。饮食渐减。医作损治。滋阴潜阳。
久服不效。秋杪孟英诊之。曰∶阴分诚虚。第感后余热逗留于肺。阻气机之肃降。搏津液以
为痰。此关不清。虽予滋填培补之药。亦焉能飞渡以行其药耶。先清肺气以补胃津。俾治节
行而灌溉输。然后以甘润浓浓之法补实真阴。始克有济。如法施之。果渐康复。（咳嗽夜
热。原有肺热血瘀两条。饮食渐减。则病情专在上焦气分。北沙参四钱。姜炒川连六分。姜
枯芩一钱。姜竹茹三钱。丝瓜络三钱。炒枳实一钱。姜枇叶刷包三钱。姜汁拌芦根八钱。陈
胆星八分炖和服。苦杏泥一钱五分。薄橘红一钱。苦桔梗次入三钱。)
胡蔚堂年近古稀。患囊肿小溲赤短。寒热如疟。孟英曰∶非外感也。乃久蕴之湿热下流。气
机尚未宣泄。予五苓合滋肾加楝实栀子木通。（囊肿而小溲赤短。乃湿邪结于下焦气分。上
蒸而为寒热。与外感之邪在上焦者各别。生泽泻三钱。生猪苓三钱。赤茯苓三钱。酒炒川黄
柏二钱。酒炒知母一钱。酒炒楝皮去核二钱。栀皮三钱。木通一钱。)两帖后囊间出腥粘黄
水甚多。小溲渐行。寒热亦去。继予知柏八味。去山药萸肉。加栀子楝实芍药苡仁等久服而
愈。（此必高年偏阳之体。不虑苦寒伤损肾阳。故去山药萸肉。酒炒知母三钱。酒炒川黄柏
一钱。酒炒楝皮去核二钱。大熟地五钱。白茯苓三钱。粉丹皮二钱。生泽泻三钱。黑栀皮三
钱。生苡仁杵八钱。湿热郁久则伤阴。小溲渐行。是小溲尚未畅行也。固由湿热未净。亦因
阴气不濡。故用熟地。一派苦寒泻热。不可不兼顾脾土。故用云苓。大凡苦寒沉降中。不用
轻扬之药。则气不行。故用栀皮。)
壬寅夏感受暑湿。误投温散。以致谵语神昏。势濒于危。肛前囊后溃出腥脓。疮口深大。疡
科
以为悬痈。敷治罔效。孟英诊曰。悬痈乃损怯证。成之以渐。今病来迅速。腥秽异常。是身
中久蕴浓味湿热之毒。挟外受之暑邪无所宣泄。下注而为此证。切勿敷药。以遏其外走之热
。但舌强而紫赤。脉细而滑数。客邪炽盛。伏热蕴隆。阴分甚亏。深虞津涸。先予清营之剂
。三投而神气渐清。（一人之身。前患湿热挟实。此患暑邪挟虚。编次具有苦心。温散伤阴
。故云阴分甚亏。常法治病先治气。后治血。此主清营。系变法医药之义。元参片一两。大
生地八钱。二味开水泡汤去渣冲入。酒炒川连六分。莲子心一钱。陈胆星炖和服八分。九节
蒲研次入一钱。生冬瓜子四钱。鲜茅根五钱。鲜荷杆三钱。竹叶卷心十个。木通一钱。)次
以凉润阳明。便畅而热蠲脓净。（清营系急则治标。心肺热邪。必由胃腑宣泄。故主凉润阳
明。方用生石膏八钱。酒炒知母三钱。南花粉四钱。姜竹沥两酒杯冲大荸荠三个打。花麦冬
三钱。钗石斛杵先八钱。鲜枇叶刷包三钱。生苡仁杵八钱。竹叶二钱。)改用甘柔滋养。月
余溃处肌平。善后参入参 。竟得康强如昔。（甘柔滋养方。大生地八钱。生甘草三钱。白
茯苓三钱。肥玉竹三钱。甜杏仁三钱。箱归身二钱。酒桑枝三钱。木瓜三钱。)
汪吉哉久疟不愈。医谓元气已虚。杂投温补。渐至肌瘦内燔。口干咳嗽寝汗溺赤。饮食不甘
。孟英视之。曰∶此热邪逗留血分也。予秦艽鳖甲散而瘳。（温补劫阴。内燔口干。寝汗溺
赤。为热邪逗留血分。左秦艽次入一钱五分。血鳖甲一两杵先煨六句钟。酒炒知母次入三钱
。去当归嫌其温腻。春柴胡次入三钱。地骨皮五钱。乌梅肉一钱五分。鲜青蒿次入八分。
)
堂兄汪养余亦患疟数月。多医药之罔效。肌瘦自汗。腰膝酸 。不能稍坐。极其畏冷。孟英
曰。此大虚证。胡反不补。犹以消导。是何居心。予参 术草熟地白芍五味杜仲山药龙骨牡
蛎桑枝大枣木瓜数十帖而起。（肌瘦自汗。为阳中之阴虚。腰膝酸为肝肾阴虚。腰膝 为肝
肾阳虚。极其畏冷。为气分阳虚。炒潞党五钱。炒西 五钱。炒白术三钱。炒甘草一钱。炒
熟地三钱。酒炒白芍一钱五分。五味子三钱杵先。绵杜仲五钱。炒山药三钱。醋 龙骨三钱
。醋 牡蛎八钱。二味同杵先。酒炒桑枝二钱。大枣三枚。扯破先煨。陈木瓜五钱先煎。)
王丈高年痰嗽。喘逆碍卧肢冷颧红。饮食不进。予真武汤而安。（高年痰嗽三句似热实证。
辨虚寒在饮食不进。炒干姜五钱。炒熟附片五钱。炒潞党三钱。白茯苓三钱。酒炒白芍一钱
五分。真武汤去白术。生姜改煨姜三钱。加制半夏三钱。炒焦陈皮一钱。陈木瓜三钱。)
频服温补药。甚觉畏冷。辛丑春延孟英诊之。脉甚数。曰∶阴
鲜芦菔（新鲜萝卜）一两。煎煮汤液代替水使用。
戴氏妇人春季产后。恶露排出量不多。医生用山楂、益母草加酒煎煮服用。连续服用数日后。出现发热、自汗、口渴、食欲不振、眩晕欲脱、彻夜不眠的症状。王孟英诊视后说∶此人体质属于阴血亏虚。血液已随胎儿娩出而流失。虽然恶露很少。但没有腹痛胀满的痛苦。不可胡乱投药。用酒煎煮益母草和山楂。不仅损伤阴液。而且耗散正气。汗出过多导致口干。津液有立即枯竭的趋势。这就是张仲景所说的“无阳”。所谓人身上的天真之气称为阳。阳气根源于津液。阴气化生于液。津液被夺走后。阳气失去根基而导致眩晕。阴血不生则无法入睡。如果采用补气来生阴的方法。则是舍本逐末。因为阳气不能直接生成津液。只有澄清源头、洁净水流。使津液充足而气血自然恢复。于是用西洋参、生黄芪、生龙骨、牡蛎、玉竹、百合、甘草、麦冬、生薏苡仁、生白扁豆、石斛、木瓜、桑叶、蔗浆组成的方剂投服。一剂后症状即缓解。数日后痊愈。后来给予滋补填精阴分的药物调理。身体才真正健壮。（血属于阴类。阴亏血少。那么恶露也会不多。这个证候是阴亏血少。不需要行血。连续服用酒煎益母草和山楂后出现的发热、自汗等四句。都是耗气伤阴的明显证据。阴亏应当补阴。道理非常直接。如果想通过补气来生阴。那么阴血不一定能生出来。补气反而更加损伤阴液。西洋参三钱。生黄芪三钱。生龙骨一两捣碎先煎。牡蛎四两捣碎先煎。这两味药炭火煨六小时。取汤液代替水煎煮其他药物。肥玉竹三钱。生甘草三钱。花麦冬四钱。生薏苡仁八钱。生白扁豆捣碎三钱。钗石斛一两捣碎先煎。陈木瓜三钱。冬桑叶四钱。青蔗汁一大酒杯冲入。随后给予滋补填精阴分的方剂。方用大熟地黄八钱。大生地黄一两。明天冬六钱切片。山萸肉三钱。菟丝饼四钱。箱归身二钱。夜交藤三钱。甘枸杞三钱。肥玉竹三钱。龟板胶二钱。炖化后混合服用。）
王某长期患有吐血。身体极其虚弱。王孟英治疗后稍有好转。在酷暑时节患上霍乱并出现转筋（肌肉痉挛）。大汗淋漓如雨。呼吸微弱如丝。王孟英诊视后说∶阴血长期亏损。暑热邪气猖獗。这是我的《霍乱论》中缺失的案例。暂且改变治疗方法来急救。用北沙参、枇杷叶、龙骨、牡蛎、木瓜、扁豆、薏苡仁、西滑石、桑叶、晚蚕砂、石斛、大豆卷组成的方剂投服。病情很快好转。此后每天进行调理。仍然服用滋补药物以治疗旧疾。（这个证候的危险在于大汗如雨。汗是阴液。汗多则阴伤。汗止则阴复。阴复则转筋停止。脉搏恢复。阴血长期亏损是本病严重。暑热猖獗是标病轻微。北沙参四钱。生龙骨捣碎二两。牡蛎捣碎八两。这两味药炭火先煨六小时。取汤液煎药。鲜枇杷叶刷净包煎三钱。陈木瓜三钱。生白扁豆捣碎三钱。生薏苡仁捣碎八钱。西滑石四钱包煎先下。冬桑叶四钱。晚蚕砂五钱。钗石斛捣碎先煎一两。大豆卷后下三钱。龙骨、牡蛎重镇止汗作为君药。沙参、石斛顾护阴液止汗作为臣药。木瓜、扁豆酸涩止汗。薏苡仁、滑石、蚕砂清肝泻暑。佐使药枇杷叶、桑叶轻浮止汗。大豆卷反佐清除余热。大豆卷在热霍乱证中本是禁用药。但加入大剂量重镇清肝药中。反而能上清浮热。）
李氏女子素来体质怯弱。春季月经未来潮。胁腹部位聚气形成像瘕积一样的肿块。食欲减退。肌肉消瘦。多次服用温通药物。到了初秋又加上微寒壮热。医生仍然当作经闭症治疗。病情危急。王孟英切脉时。患者壮热烫手。出汗如雨。汗珠落在脉枕上。微带粉红色。他说∶虚损是其根本。现在暑热炽盛。应当先治疗外来的邪气。开具白虎汤加西洋参、玄参、竹叶、荷杆、桑叶。服用两帖后。热果然退了。汗逐渐收敛。改用甘凉药物清除余热。每天病情向安。接着给予调气养营阴的药物。宿疾瘕积也消除了。培补到仲冬时节。月经来潮而痊愈。（月经不行。胁腹聚气如瘕。这是血病波及气分。到了食欲减退肌肉消瘦。多次服用温通药。微寒壮热。则是血病及气。由气分向外达于皮毛。先治外来邪气。这是急则治标的意义。生石膏一两六钱先煎。酒炒知母后下三钱。去草米。加西洋参三钱。玄参片五钱开水泡冲去渣。鲜竹叶后下三钱。鲜荷杆二尺。冬桑叶四钱。两帖后改用甘凉清余热。方用蜜炙枇杷叶刷包三钱。生甘草三钱。鲜竹叶二钱。鲜茅根四钱。活水芦根二两。生薏苡仁八钱。鲜敛斛捣碎先煎一两。连皮梨切片一两。接着给予调气养营阴。方用鲜竹茹三钱。苦杏仁二钱。薄橘红一钱五分。紫菀茸一钱。旋复花绢包一钱五分。连节藕切片先煎二两。蒲桃干三钱。鲜茅根三钱。箱归身二钱。大生地八钱。女贞子捣碎先煎四钱。）
张氏妇人患气机不舒畅。似喘非喘。似逆非逆。似叹息非叹息。似虚促非虚促。似短非短。似闷非闷。面色红赤。眩晕。不能进食。不能卧床。服用补虚、清火、行气、消痰药物无效。王孟英诊视后说∶只是小病。十天可以安宁。但必须戒除愤怒。给予黄连、黄芩、栀子、楝实、鳖甲、羚角、旋复花、赭石、海蜇、荸荠组成的大剂方药。送服当归龙荟丸。不到十天月经来潮。经色如墨。病已消失。后来给予养血和肝的药物调理而康复。（气机不舒以下十一句。都是病不在气分的征象。王孟英诊断为小恙。是因为脉象显示病重而人未显重病容则病轻。这个人病重而脉象正常则病轻。这个证候必然是肝脉沉实数有力。能承受苦寒大剂药物。所以说是小恙。关键在于戒除愤怒。人发怒则全身气血颠倒。最容易伤肝。肝郁热也容易发怒。酒炒川连八分。酒炒枯芩一钱五分。黑栀皮三钱。川楝实捣碎先煎三钱。血鳖甲捣碎四两。生赭石一两捣碎。这两味药同炭火煨六小时。取汤液代替水煎药。羚角磨冲一钱。旋复花绢包三钱。荸荠八钱。泡淡陈海蜇二两。药送当归龙荟丸二钱。这个证候是血分中肝有实热。肝阴虚。肝阳浮。养血和肝方。大生地八钱。连皮藕二两切片先煎。箱归身二钱。蒲桃干三钱。干桑叶四钱。陈木瓜三钱。酒炒桑枝后下三钱。生白蒺藜去刺后下三钱。血鳖甲捣碎先煎四两。夜交藤三钱。生甘草三钱。）
王炳华的妻子夏季患臂痛。孙某医生说∶是风邪。服用人参、黄芪、当归、芍药数帖。手臂稍愈但胃脘疼痛。孙某说∶是寒邪。加上附子、肉桂。疼痛不止而渐渐觉得痰多。孙某说∶是肝肾不足。重用熟地、枸杞。让他多服见效。没想到越服越严重。渐渐至昏厥。孙某还说体虚药力轻。前方加重剂量。时时发厥。王孟英诊视后。脉象沉而有弦滑且数的特征。这是由于过度投用温补药物。引动肝风。煽动津液化为痰。痰又乘风而上。这就是晕厥产生的原因。余波流窜经络。四肢因而抽搐。阳气全部逆乱于上。难怪鼻塞面浮。浊气不能下达。所以大便滞涩。食欲不振。给予大剂甘寒息风化饮药物。佐以凉苦泄热清肝。厥逆果然逐渐停止。各病依次消除。两个月后康复如常。（这个证候臂痛。本来是阳虚挟痰。孙某过度投用温补。引动肝风。痰乘风上。脉沉为痰浊遏伏。脉弦滑为痰乘风上。脉数为温补所致阴虚挟热。方义以息风化饮为主治。尤其重在息风。风不息则饮不能化。姜竹沥三两。和服花粉五钱。荸荠二两。泡淡海蜇一两。鲜敛斛一两捣碎先煎。冬桑叶四钱。川楝实三钱。炒川黄柏一钱五分。胆星一钱炖化后和服。石菖蒲后下一钱。生白蒺藜去刺三钱。生赭石一两。青果四钱捣碎。牡蛎六两。石斛、赭石、楝实、青果、牡蛎五味药。先炭火煨六小时。取汤液代替水煎药。）庄半霞科举考试后患感冒。每天发作寒热七八次。神气昏迷。微斑隐隐。王孟英诊视后说∶此人平素饮酒。积热深蕴。挟带外感而发病。理应从清解法治疗。必定是误投温补。以致热势如此猖獗。询问得知他在三场考试中都服用人参。并且携带枣子浸烧酒进入考场。初病时尚不至于此。因为连续服用羌活、防风、生姜、肉桂。渐渐加重。王孟英先给予白虎汤三剂。斑疹发出而寒热渐止。（每天发作寒热七八次三句。这是外感之邪想要外达。温补锢蔽邪气。邪气想达而不能径直达出。生石膏先煎八钱。酒炒知母三钱。去米草。加黑栀皮三钱。淡豆豉后下三钱。炒枳实一钱。姜竹茹三钱。陈胆星炖化后和服八分。石菖蒲后下六分。赖橘红八分。姜川连六分。）
继用大苦寒药物泻其结热。所下的黑屎都带有枣子气味。（生大黄三钱。开水泡冲去渣。炒枳实二钱。生冬瓜子四钱。晚蚕砂五钱。制厚朴一钱。鲜莱菔一两先煎。药送滚痰丸三钱。）旬日后给予甘润滋濡的方法。两个月才完全痊愈。（南花粉四钱。花麦冬三钱。蜜炙桑皮三钱。甜杏仁三钱。蜜炙枇杷叶刷包三钱。大荸荠打三个。泡淡海蜇八钱。青蔗浆一酒杯和服。生粉草三钱。）
金魁官九月患五色痢。每天腹泻数十次。七八天来口噤不能进食。腹痛呻吟。危在旦夕。王孟英诊视后说∶是暑邪挟食滞罢了。误服了热药。攻法和补法都不可施用。用轻清之法取效。可以立即痊愈。以北沙参、黄连、鲜莲子、栀子、黄芩、枇杷叶、石斛、扁豆、银花、桔梗、山楂、神曲、滑石为方。（痢疾每天腹泻数十次四句。病情都在气分。暑伤气阴。攻法则伤正气。补法则助长邪气。经文说上焦如羽。非轻不举。北沙参三钱。姜炒川连六分。姜炒枯芩一钱五分。鲜莲子三钱。黑栀皮一钱五分。姜炒鲜枇杷叶刷包三钱。鲜石斛捣碎先煎四钱。生白扁豆捣碎一钱五分。济银花三钱。苦桔梗后下一钱。生山楂捣碎后下一钱。生神曲捣碎后下一钱五分。西滑石包煎先下三钱。）喝下即安。旬日而起。王孟英曾说∶莲子最补胃气而镇虚逆。如果反胃是由于胃虚而气冲不纳者。都是热邪伤了胃中的清和之气。所以用黄连苦泄其邪。就仗莲子甘镇其胃。鲜莲子清香不浑。镇胃之功独胜。附录孟英玉芝丸。猪肚一个。洗净后将莲子去心放入肚内。水煎至糜烂。收干捣为丸服用。凡是胃气薄弱者。常服玉芝丸。令人肥健。
陈足甫禀赋体质素来虚弱。去年曾经吐血。今年夏天患感冒后咳嗽夜热。饮食逐渐减少。医生当作虚损治疗。滋阴潜阳。久服无效。秋末王孟英诊视后说∶阴分确实虚。只是感冒后余热逗留于肺。阻碍气机的肃降。搏结津液以为痰。这个关口不清。即使给予滋填培补的药物。怎么能飞渡以行其药呢。先清肺气以补胃津。使治节运行而灌溉输布。然后用甘润浓浓的方法补实真阴。才有希望。如法施治。果然逐渐康复。（咳嗽夜热。原有肺热血瘀两条。饮食渐减。则病情专在上焦气分。北沙参四钱。姜炒川连六分。姜炒枯芩一钱。姜竹茹三钱。丝瓜络三钱。炒枳实一钱。姜枇杷叶刷包三钱。姜汁拌芦根八钱。陈胆星八分炖化后和服。苦杏泥一钱五分。薄橘红一钱。苦桔梗后下三钱。）
胡蔚堂年近七十。患囊肿小便赤短。寒热如疟。王孟英说∶不是外感。乃是久蕴的湿热下流。气机尚未宣泄。给予五苓散合滋肾丸加楝实、栀子、木通。（囊肿而小便赤短。乃湿邪结于下焦气分。上蒸而为寒热。与外感之邪在上焦者各别。生泽泻三钱。生猪苓三钱。赤茯苓三钱。酒炒川黄柏二钱。酒炒知母一钱。酒炒楝皮去核二钱。栀皮三钱。木通一钱。）两帖后囊间流出腥粘黄水很多。小便渐行。寒热亦去。继予知柏八味丸。去掉山药、萸肉。加栀子、楝实、芍药、薏苡仁等久服而愈。（这一定是高年偏阳之体。不虑苦寒伤损肾阳。故去掉山药、萸肉。酒炒知母三钱。酒炒川黄柏一钱。酒炒楝皮去核二钱。大熟地五钱。白茯苓三钱。粉丹皮二钱。生泽泻三钱。黑栀皮三钱。生薏苡仁捣碎八钱。湿热郁久则伤阴。小便渐行。是小便尚未畅行也。固由湿热未净。亦因阴气不濡。故用熟地。一派苦寒泻热。不可不兼顾脾土。故用云苓。大凡苦寒沉降中。不用轻扬之药。则气不行。故用栀皮。）
壬寅年夏季感受暑湿。误投温散药物。以致谵语神昏。病情危急。肛前囊后溃出腥脓。疮口深大。疡科医生认为是悬痈。敷治无效。王孟英诊视后说∶悬痈是损怯证。慢慢形成。现在病来迅速。腥秽异常。是身中久蕴浓味湿热之毒。挟外受之暑邪无处宣泄。下注而为此证。切勿敷药。以遏其外走之热。但舌强而紫赤。脉细而滑数。客邪炽盛。伏热蕴隆。阴分甚亏。深恐津液枯竭。先给予清营之剂。三次投服而神气渐清。（一人之身。前患湿热挟实。此患暑邪挟虚。编次具有苦心。温散伤阴。故云阴分甚亏。常法治病先治气。后治血。此主清营。系变法医药之义。玄参片一两。大生地八钱。这两味药开水泡汤去渣冲入。酒炒川连六分。莲子心一钱。陈胆星炖化后和服八分。九节蒲研末后下一钱。生冬瓜子四钱。鲜茅根五钱。鲜荷杆三钱。竹叶卷心十个。木通一钱。）其次以凉润阳明。大便通畅而热退脓净。（清营是急则治标。心肺热邪。必由胃腑宣泄。故主凉润阳明。方用生石膏八钱。酒炒知母三钱。南花粉四钱。姜竹沥两酒杯冲大荸荠三个打碎。花麦冬三钱。钗石斛捣碎先煎八钱。鲜枇杷叶刷包三钱。生薏苡仁捣碎八钱。竹叶二钱。）改用甘柔滋养。月余溃处肌平。善后参入人参、黄芪。竟得康强如昔。（甘柔滋养方。大生地八钱。生甘草三钱。白茯苓三钱。肥玉竹三钱。甜杏仁三钱。箱归身二钱。酒桑枝三钱。木瓜三钱。）
汪吉哉久疟不愈。医生谓元气已虚。杂投温补。渐渐至肌肉消瘦内热燔灼。口干咳嗽盗汗尿赤。饮食不甘。王孟英诊视后说∶这是热邪逗留血分。给予秦艽鳖甲散而痊愈。（温补劫阴。内热燔灼口干。盗汗尿赤。为热邪逗留血分。左秦艽后下一钱五分。血鳖甲一两捣碎先煨六小时。酒炒知母后下三钱。去掉当归嫌其温腻。春柴胡后下三钱。地骨皮五钱。乌梅肉一钱五分。鲜青蒿后下八分。）
堂兄汪养余也患疟数月。多方医治无效。肌肉消瘦自汗。腰膝酸软。不能稍坐。极其畏冷。王孟英说∶这是大虚证。为何反而不补。还用消导法。是何居心。给予人参、黄芪、白术、甘草、熟地、白芍、五味子、杜仲、山药、龙骨、牡蛎、桑枝、大枣、木瓜数十帖而起身。（肌肉消瘦自汗。为阳中之阴虚。腰膝酸软为肝肾阴虚。腰膝冷痛为肝肾阳虚。极其畏冷。为气分阳虚。炒潞党五钱。炒黄芪五钱。炒白术三钱。炒甘草一钱。炒熟地三钱。酒炒白芍一钱五分。五味子三钱捣碎先煎。绵杜仲五钱。炒山药三钱。醋淬龙骨三钱。醋淬牡蛎八钱。这两味同捣碎先煎。酒炒桑枝二钱。大枣三枚。扯破先煨。陈木瓜五钱先煎。）
王丈高年痰嗽。喘逆碍卧肢冷颧红。饮食不进。给予真武汤而安。（高年痰嗽三句似热实证。辨虚寒在饮食不进。炒干姜五钱。炒熟附片五钱。炒潞党三钱。白茯苓三钱。酒炒白芍一钱五分。真武汤去白术。生姜改煨姜三钱。加制半夏三钱。炒焦陈皮一钱。陈木瓜三钱。）频服温补药。甚觉畏冷。辛丑春延请王孟英诊视。脉甚数。说∶阴
Fresh Radish (Raphani Fructus) 1 liang. Decoct in water and use the decoction to replace water for other medications.
Mrs. Dai, postpartum in spring, had scant lochia. The physician prescribed a wine-decoction of Hawthorn Fruit (Crataegi Fructus) and Motherwort Herb (Leonuri Herba). After taking it for several days consecutively, she developed fever, spontaneous sweating, thirst, anorexia, dizziness with a sensation of impending collapse, and insomnia throughout the night. Wang Mengying examined her and said: "This patient has a constitution of Yin deficiency. Blood was lost along with the fetus. Although lochia is scant, there is no pain or distension. One must not recklessly administer medicines. Wine-decocting Motherwort and Hawthorn not only damages Yin but also disperses Qi. Excessive sweating and dry mouth indicate that body fluids are on the verge of immediate exhaustion. This is what Zhang Zhongjing referred to as 'absence of Yang.' The innate Qi of the human body is called Yang. Yang is rooted in body fluids, and Yin is transformed from fluids. Once body fluids are depleted, Yang loses its root, causing dizziness; without the generation of Yin blood, sleep cannot occur. If one attempts to generate Yin by tonifying Qi, it is seeking the branch while abandoning the root, because Yang Qi cannot directly generate body fluids. Only by clarifying the source and purifying the flow can body fluids be replenished, allowing Qi and Blood to recover naturally. Therefore, I prescribe a formula containing American Ginseng (Radix Panacis Quinquefolii), Raw Astragalus Root (Astragali Radix), Raw Dragon Bone (Os Draconis), Oyster Shell (Concha Ostreae), Polygonatum Tuber (Polygonati Rhizoma), Lily Bulb (Lilii Bulbus), Licorice Root (Glycyrrhizae Radix et Rhizoma), Ophiopogon Tuber (Ophiopogonis Tuber), Raw Coix Seed (Coicis Semen), Raw Broad Bean (Faba Cruda), Dendrobium Stem (Dendrobii Caulis), Quince (Chaenomelis Fructus), Mulberry Leaf (Mori Folium), and Sugarcane Juice. After one dose, she stabilized. She recovered in a few days. Later, I administered formulas to nourish and fill the Yin aspect, after which she became robust. (Blood belongs to Yin. When Yin is deficient and blood is scant, lochia will also be scant. In this syndrome, due to Yin deficiency and blood scarcity, blood-invigorating methods are unnecessary. The symptoms of fever and spontaneous sweating after taking wine-decocted Motherwort and Hawthorn are clear evidence of Qi consumption and Yin damage. For Yin deficiency, tonifying Yin is the direct approach. Attempting to generate Yin by tonifying Qi may fail to produce Yin and could further damage it. American Ginseng 3 qian, Raw Astragalus Root 3 qian, Raw Dragon Bone 1 liang (crushed and decocted first), Oyster Shell 4 liang (crushed and decocted first). These two ingredients are charred and simmered for six hours; the resulting liquid is used to decoct the remaining herbs. Fat Polygonatum Tuber 3 qian, Raw Licorice Root 3 qian, Flower Ophiopogon Tuber 4 qian, Raw Coix Seed 8 qian, Raw Broad Bean 3 qian (crushed), Stalk Dendrobium 1 liang (crushed and decocted first), Aged Quince 3 qian, Winter Mulberry Leaf 4 qian, Fresh Sugarcane Juice one large wine cup added to the decoction. Subsequently, a formula to nourish and fill the Yin aspect was given: Great Prepared Rehmannia Root 8 qian, Great Raw Rehmannia Root 1 liang, Clear Sky Asparagus Tuber 6 qian (sliced), Cornelian Cherry Fruit 3 qian, Dodder Seed Cake 4 qian, Boxed Angelica Sinensis Root 2 qian, Night-joining Vine 3 qian, Sweet Goji Berry 3 qian, Fat Polygonatum Tuber 3 qian, Tortoise Shell Glue 2 qian (melted and mixed).)
Mr. Wang suffered from chronic hematemesis and was extremely emaciated. Wang Mengying treated him with slight improvement. However, during the intense heat of summer, he contracted cholera with muscle cramps (spasms). He sweated profusely like rain, and his pulse was faint as a thread. Wang Mengying examined him and said: "Yin blood has been long depleted, and summer-heat pathogen is rampant. This is a missing case in my treatise on Cholera. I shall temporarily alter the treatment strategy to save him." He prescribed a formula of North Glehnia Root (Glehniae Radix), Loquat Leaf (Eriobotryae Folium), Dragon Bone (Os Draconis), Oyster Shell (Concha Ostreae), Quince (Chaenomelis Fructus), Broad Bean (Faba), Coix Seed (Coicis Semen), Western Talcum (Talcum), Mulberry Leaf (Mori Folium), Silkworm Droppings (Bombyx Batryticatus), Dendrobium Stem (Dendrobii Caulis), and Soybean Sprout (Sojae Germen). The condition improved significantly. Thereafter, daily conditioning continued with tonic herbs to address the chronic ailment. (The danger in this case lies in the profuse sweating. Sweat is Yin fluid; excessive sweating injures Yin. When sweating stops, Yin recovers. When Yin recovers, spasms cease, and the pulse returns. "Long depletion of Yin blood" indicates the severity of the root disease; "rampant summer-heat" indicates the mildness of the branch disease. North Glehnia Root 4 qian, Raw Dragon Bone 2 liang (crushed), Oyster Shell 8 liang (crushed). These two are charred and simmered first for six hours to obtain liquid for decocting. Fresh Loquat Leaf 3 qian (brushed and bagged), Aged Quince 3 qian, Raw Broad Bean 3 qian (crushed), Raw Coix Seed 8 qian (crushed), Western Talcum 4 qian (bagged and decocted first), Winter Mulberry Leaf 4 qian, Evening Silkworm Sand 5 qian, Stalk Dendrobium 1 liang (crushed and decocted first), Soybean Sprout 3 qian (added later). Dragon Bone and Oyster Shell serve as the Sovereign herb for heavy settling and stopping sweat. Glehnia and Dendrobium act as Ministers to protect Yin and stop sweat. Quince and Broad Bean provide sour and astringent properties to stop sweat. Coix Seed, Talcum, and Silkworm Sand clear Liver heat and drain summer-heat. Loquat Leaf and Mulberry Leaf act as Guides/Assistants with their light and floating nature to stop sweat. Soybean Sprout acts as a counter-agent to clear residual heat. Although Soybean Sprout is contraindicated in hot cholera, within this heavy-settling and liver-clearing formula, it effectively clears floating heat.)
Miss Li had always had a timid and weak constitution. In spring, her menstruation did not arrive. Gas accumulated in the hypochondrium and abdomen, forming masses resembling *jia* (fixed masses). Her appetite decreased, and she wasted away. After repeatedly taking warming and unblocking medicines, in early autumn, she developed mild chills and high fever. Physicians still treated her for amenorrhea, and her condition became critical. When Wang Mengying palpated her pulse, her fever was burning hot to the touch, and she was sweating profusely like rain. Sweat droplets fell onto the pulse pillow, showing a faint pink hue. He said: "Deficiency is the root. Currently, summer-heat is blazing. We must first treat the exogenous pathogen." He prescribed Baihu Tang (White Tiger Decoction) plus American Ginseng (Radix Panacis Quinquefolii), Scrophularia Root (Scrophulariae Radix), Bamboo Leaf (Bambusae Folium), Lotus Stem (Nelumbinis Nodus), and Mulberry Leaf (Mori Folium). After two doses, the fever subsided, and sweating gradually stopped. He then switched to sweet-cool herbs to clear residual heat. Her condition improved daily. Subsequently, he regulated Qi and nourished Ying-Yin. The chronic masses dissipated. After tonic treatment until mid-winter, her menstruation returned, and she recovered. (Amenorrhea and gas accumulation resembling masses indicate blood pathology affecting Qi. Wasting and repeated use of warming/unblocking herbs leading to chills and high fever show blood pathology affecting Qi, which then reaches the skin and hair from the Qi level. Treating the exogenous pathogen first follows the principle of treating the acute branch. Raw Gypsum 1 liang 6 qian (decocted first), Wine-fried Anemarrhena Rhizome 3 qian (added later), grass rice removed. Add American Ginseng 3 qian, Scrophularia slices 5 qian (soaked in boiling water, strained, and added). Fresh Bamboo Leaf 3 qian (added later), Fresh Lotus Stem 2 chi, Winter Mulberry Leaf 4 qian. After two doses, switch to sweet-cool for residual heat: Honey-fried Loquat Leaf 3 qian (bagged), Raw Licorice Root 3 qian, Fresh Bamboo Leaf 2 qian, Fresh Imperata Rhizome 4 qian, Living Reed Rhizome 2 liang, Raw Coix Seed 8 qian, Fresh Dendrobium 1 liang (crushed and decocted first), Pear with peel 1 liang (sliced). To regulate Qi and nourish Ying-Yin: Fresh Bamboo Sap 3 qian, Bitter Apricot Kernel 2 qian, Thin Tangerina Peel 1.5 qian, Aster Root 1 qian, Inula Flower 1.5 qian (bagged), Lotus with nodes 2 liang (sliced and decocted first), Raisins 3 qian, Fresh Imperata Rhizome 3 qian, Boxed Angelica Sinensis Root 2 qian, Great Raw Rehmannia Root 8 qian, Ligustrum Fruit 4 qian (crushed and decocted first).)
Mrs. Zhang suffered from stagnant Qi mechanism. It resembled panting but was not, resembled reflux but was not, resembled sighing but was not, resembled deficiency-cursiveness but was not, resembled shortness of breath but was not, resembled oppression but was not. Her face was red, she experienced dizziness, could not eat, and could not lie down. Treatments for tonifying deficiency, clearing fire, moving Qi, and resolving phlegm were ineffective. Wang Mengying diagnosed: "It is a minor illness. It will resolve in ten days. But you must control anger." He prescribed a large dose of Coptis Rhizome (Coptidis Rhizoma), Scutellaria Root (Scutellariae Radix), Gardenia Fruit (Gardeniae Fructus), Chinaberry Fruit (Meliae Fructus), Turtle Shell (Testudinis Carapax et Plastrum), Antelope Horn (Cerbi Cornu), Inula Flower (Inulae Flos), Hematite (Hematitum), Marsh Plant Bulb (Alismatis Rhizoma), and Water Chestnut (Trapa Natans Fructus). He sent it with Danggui Longhui Wan (Angelica and Gardenia Pill). Menstruation arrived in less than ten days, dark in color, and the illness vanished. Later, she was conditioned with blood-nourishing and Liver-soothing herbs and recovered. (The eleven sentences describing the Qi stagnation indicate the pathology is not in the Qi level. Wang Mengying calls it a minor illness because "pulse shows disease but person does not appear sick" implies the disease is severe, whereas "person is sick but pulse is normal" implies the disease is mild. This case likely presents with a deep, solid, rapid, and forceful Liver pulse, indicating tolerance for bitter-cold large doses. Hence, it is called minor. The key is controlling anger. Anger causes global Qi and Blood reversal, easily injuring the Liver. Liver depression-heat also leads to irritability. Wine-fried Coptis 8 fen, Wine-fried Scutellaria 1.5 qian, Black Gardenia Skin 3 qian, Chinaberry Fruit 3 qian (crushed and decocted first), Blood Turtle Shell 4 liang (crushed), Raw Hematite 1 liang (crushed). These two are charred and simmered for six hours; the liquid is used for decocting. Antelope Horn 1 qian (ground and taken with liquid), Inula Flower 3 qian (bagged), Water Chestnut 8 qian, Soaked Light Sea Cucumber 2 liang. Sent with Danggui Longhui Wan 2 qian. This case involves excess heat in the Blood level, Liver Yin deficiency, and floating Liver Yang. Blood-nourishing and Liver-soothing formula: Great Raw Rehmannia Root 8 qian, Lotus with peel 2 liang (sliced and decocted first), Boxed Angelica Sinensis Root 2 qian, Raisins 3 qian, Dry Mulberry Leaf 4 qian, Aged Quince 3 qian, Wine-fried Mulberry Twig 3 qian (added later), Raw Tribulus Fruit 3 qian (thorns removed, added later), Blood Turtle Shell 4 liang (crushed and decocted first), Night-joining Vine 3 qian, Raw Licorice Root 3 qian.)
Mrs. Wang Binghua suffered from arm pain in summer. Physician Sun said: "It is Wind." She took Ginseng, Astragalus, Angelica, and Peony for several doses. Her arm improved slightly, but epigastric pain developed. Sun said: "It is Cold." He added Aconite and Cinnamon Twig. Pain persisted, and phlegm increased. Sun said: "It is Kidney and Liver insufficiency." He heavily used Prepared Rehmannia and Goji Berry, advising prolonged use for effect. Unexpectedly, the condition worsened. She gradually fainted. Sun claimed her constitution was too weak for the dosage and increased it. She fainted repeatedly. Wang Mengying palpated: the pulse was deep, wiry, slippery, and rapid. He said: "Overuse of warming tonics has stirred up Liver Wind, scorching body fluids into phlegm. Phlegm rides the Wind upward, causing syncope. Residual waves flow through collaterals, causing limb convulsions. Yang Qi rebels entirely upward. No wonder nasal congestion, facial edema, turbid Qi fails to descend, leading to constipation and anorexia." He prescribed a large dose of sweet-cold herbs to extinguish Wind and transform fluid, assisted by cool-bitter herbs to drain heat and clear the Liver. Syncope ceased gradually, and all ailments resolved. She recovered fully after two months. (Arm pain originally indicated Yang deficiency with phlegm. Sun's overuse of warming tonics stirred Liver Wind. Deep pulse indicates phlegm-turbidity suppression; wiry-slippy pulse indicates phlegm riding Wind; rapid pulse indicates Yin deficiency with heat from warming tonics. The prescription focuses on extinguishing Wind and transforming fluid, especially extinguishing Wind, as fluid cannot transform if Wind persists. Ginger-processed Bamboo Sap 3 liang, taken with Pollen 5 qian, Water Chestnut 2 liang, Soaked Light Sea Cucumber 1 liang, Fresh Dendrobium 1 liang (crushed and decocted first), Winter Mulberry Leaf 4 qian, Chinaberry Fruit 3 qian, Stir-fried Phellodendron Bark 1.5 qian, Gall-nut Star 1 qian (stewed and mixed). Stone Acorus 1 qian (added later), Raw Tribulus 3 qian (thorns removed), Raw Hematite 1 liang, Green Olive 4 qian (crushed), Oyster Shell 6 liang. Dendrobium, Hematite, Chinaberry, Green Olive, and Oyster Shell are charred and simmered for six hours; liquid is used for decocting.) Zhuang Banxia contracted a cold after the imperial examinations. He had chills and fever 7-8 times daily, coma, and faint macules. Wang Mengying said: "He drinks alcohol regularly, accumulating deep heat. Now it manifests with an external contraction. Treatment should be clearing and resolving. Misuse of warming tonics has caused rampant heat." Inquiry confirmed he took Ginseng during all three sessions and carried dates soaked in liquor. Initially, the illness was not this severe. Continuous use of Notopterygium, Saposhnikovia, Ginger, and Cinnamon aggravated it. Wang Mengying first gave Baihu Tang (White Tiger Decoction) for three doses. Macules erupted, and chills/fever subsided. (Chills and fever 7-8 times daily indicates exogenous pathogen attempting to exit. Warming tonics trap the pathogen. Raw Gypsum 8 qian (decocted first), Wine-fried Anemarrhena 3 qian, grass rice removed. Add Black Gardenia Skin 3 qian, Fermented Soybean 3 qian (added later), Stir-fried Immature Bitter Orange 1 qian, Ginger-processed Bamboo Sap 3 qian, Aged Gall-nut Star 0.8 fen (stewed and mixed), Stone Acorus 0.6 fen (added later), Chenpi 0.8 fen, Ginger-processed Coptis 0.6 fen.)
Subsequently, large bitter-cold herbs were used to drain consolidated heat. The black stools passed smelled of dates. (Raw Rhubarb 3 qian, soaked in boiling water, strained, and added. Stir-fried Immature Bitter Orange 2 qian, Raw Winter Melon Seed 4 qian, Evening Silkworm Sand 5 qian, Processed Mirabilite 1 qian, Fresh Radish 1 liang (decocted first). Sent with Gun Tan Wan (Rolling Phlegm Pill) 3 qian.) Ten days later, sweet-moistening methods were used. Full recovery took two months. (South Pollen 4 qian, Flower Ophiopogon 3 qian, Honey-fried Mulberry Bark 3 qian, Sweet Apricot Kernel 3 qian, Honey-fried Loquat Leaf 3 qian (bagged), Large Water Chestnut 3 (crushed), Soaked Light Sea Cucumber 8 qian, Fresh Sugarcane Juice one wine cup (mixed), Raw Licorice Root 3 qian.)
Jin Kuiguan contracted dysentery in September, passing stool dozens of times daily. For seven to eight days, his jaws were locked, unable to eat. Abdominal pain and groaning indicated imminent death. Wang Mengying said: "Summer-heat with food stagnation. Hot medicines were mistakenly taken. Neither purging nor tonifying is applicable. Use light-clearing methods for immediate cure." He prescribed North Glehnia Root, Coptis, Fresh Lotus Seed, Gardenia, Scutellaria, Loquat Leaf, Dendrobium, Broad Bean, Honeysuckle, Platycodon, Hawthorn, and Medicated Leaven. (Dysentery with frequent stools indicates pathology in the Qi level. Summer-heat injures Qi and Yin. Purging harms healthy Qi; tonifying aids pathogen. The Classic states: "Upper Jiao is like feathers; only light herbs can lift." North Glehnia Root 3 qian, Ginger-fried Coptis 0.6 fen, Ginger-fried Scutellaria 1.5 qian, Fresh Lotus Seed 3 qian, Black Gardenia Skin 1.5 qian, Ginger-fried Loquat Leaf 3 qian (bagged), Fresh Dendrobium 4 qian (crushed and decocted first), Raw Broad Bean 1.5 qian (crushed), Ji Honeysuckle 3 qian, Bitter Platycodon 1 qian (added later), Raw Hawthorn 1 qian (crushed, added later), Raw Medicated Leaven 1.5 qian (crushed, added later), Western Talcum 3 qian (bagged and decocted first). Relief came immediately upon drinking. Recovery in ten days. Wang Mengying once said: "Lotus seed best tonifies Stomach Qi and calms deficiency-reversal. If regurgitation is due to Stomach deficiency and Qi rushing upward without acceptance, it is heat damaging the Stomach's pure-harmonious Qi. Thus, Coptis bitter-drains the pathogen, while Lotus seed sweet-calms the Stomach. Fresh Lotus seed is clear and fragrant, excelling in calming the Stomach." Appendix: Mengying Yuzhi Wan. One pig stomach, cleaned, filled with heartless Lotus seeds. Simmered in water until soft. Dried and ground into pills. Those with weak Stomach Qi who take this regularly become fat and strong.
Chen Zufu had a weak constitution since birth. He had hematemesis last year. This summer, after a cold, he had cough and night fever. Appetite declined. Doctors treated it as consumption (deficiency), using Yin-nourishing and Yang-subduing methods. Long-term use failed. At late autumn, Wang Mengying diagnosed: "Yin level is indeed deficient. However, residual heat from the cold lingers in the Lung, obstructing the descending function of Qi, condensing fluids into phlegm. Unless this blockage is cleared, even tonifying medicines cannot reach their target. First, clear Lung Qi to benefit Stomach fluids, so regulation functions and irrigation occur. Then, use thick sweet-moistening methods to tonify true Yin." Following this, he gradually recovered. (Cough and night fever involve Lung heat and blood stasis. Declining appetite localizes pathology to Upper Jiao Qi level. North Glehnia Root 4 qian, Ginger-fried Coptis 0.6 fen, Ginger-fried Scutellaria 1 qian, Ginger-processed Bamboo Sap 3 qian, Luffa Network 3 qian, Stir-fried Immature Bitter Orange 1 qian, Ginger-processed Loquat Leaf 3 qian (bagged), Ginger-juiced Imperata Rhizome 8 qian, Aged Gall-nut Star 0.8 fen (stewed and mixed), Bitter Apricot Paste 1.5 qian, Thin Tangerina Peel 1 qian, Bitter Platycodon 3 qian (added later).)
Hu Weitang, nearly seventy, suffered from scrotal swelling, scant dark urine, and chills/fever like malaria. Wang Mengying said: "Not exogenous. It is long-accumulated damp-heat flowing downward, with Qi mechanism not yet vented." He prescribed Wuling San combined with Zishen Wan plus Chinaberry, Gardenia, and Akebia Stem. (Scrotal swelling and dark scant urine indicate dampness binding in Lower Jiao Qi level, steaming upward causing chills/fever, distinct from exogenous pathogens in Upper Jiao. Raw Alisma 3 qian, Raw Polyporus 3 qian, Red Poria 3 qian, Wine-fried Phellodendron 2 qian, Wine-fried Anemarrhena 1 qian, Wine-fried Chinaberry Bark 2 qian (pits removed), Gardenia Skin 3 qian, Akebia Stem 1 qian.) After two doses, much foul yellow sticky fluid discharged from the scrotum. Urination improved, chills/fever ceased. Subsequently, Zhi Bai Ba Wei Wan (Anemarrhena, Phellodendron, and Eight-Ingredient Pill) was used, removing Dioscorea and Cornelian Cherry, adding Gardenia, Chinaberry, Peony, and Coix Seed. Long-term use led to recovery. (Likely a constitution with Yang bias in old age, so bitter-cold does not harm Kidney Yang. Hence, Dioscorea and Cornelian Cherry are removed. Wine-fried Anemarrhena 3 qian, Wine-fried Phellodendron 1 qian, Wine-fried Chinaberry Bark 2 qian (pits removed), Great Prepared Rehmannia 5 qian, White Poria 3 qian, Moutan Cortex 2 qian, Raw Alisma 3 qian, Black Gardenia Skin 3 qian, Raw Coix Seed 8 qian (crushed). Damp-heat lingering injures Yin. Improved urination means it is not yet smooth. Due to incomplete damp-heat clearance and lack of Yin moistening, Prepared Rehmannia is used. In a batch of bitter-cold heat-draining herbs, Spleen Earth must be considered; hence Poria is used. Generally, in bitter-cold sinking herbs, light-floating herbs are needed to move Qi; hence Gardenia Skin is used.)
In the summer of Renyin, summer-dampness was contracted. Mistaken use of warming-dispersing herbs led to delirium and coma, nearing death. Pus oozed from between the anus and scrotum, with a deep, large wound. Surgeons diagnosed it as Xuan Yong (Hanging Perineal Abscess). External applications failed. Wang Mengying said: "Xuan Yong is a deficiency-consumption disease, developing gradually. This illness came rapidly with abnormal foulness. It is internal toxin from long-accumulated rich-food damp-heat, combined with external summer-heat, having no outlet, sinking downward. Do not apply external drugs to suppress outward-flowing heat. However, the tongue is stiff, purple-red; pulse is fine, slippery, and rapid. Exogenous pathogen is fierce, latent heat is abundant, Yin level is severely deficient. Fear of fluid exhaustion." He first prescribed Qingying Tang (Clear Nutrient Decoction). After three doses, spirit clarified. (One body: previous illness was damp-heat with excess; this is summer-heat with deficiency. The editor's arrangement shows care. Warming-dispersing injures Yin, hence "severe Yin deficiency." Standard treatment treats Qi first, then Blood. Here, clearing Ying is a modified method. Scrophularia 1 liang, Great Raw Rehmannia 8 qian. Soak in boiling water, strain, and add. Wine-fried Coptis 0.6 fen, Lotus Plumule 1 qian, Aged Gall-nut Star 0.8 fen (stewed and mixed), Nine-section Acorus 1 qian (powdered, added later), Raw Winter Melon Seed 4 qian, Fresh Imperata Rhizome 5 qian, Fresh Lotus Stem 3 qian, Bamboo Leaf Heart 10, Akebia Stem 1 qian.) Next, Yangming was cooled and moistened. Bowels moved freely, heat cleared, pus purified. (Qingying is emergency treatment of the branch. Heart-Lung heat must be vented via the Stomach Fu. Hence, cooling/moistening Yangming is primary. Raw Gypsum 8 qian, Wine-fried Anemarrhena 3 qian, South Pollen 4 qian, Ginger-processed Bamboo Sap 2 wine cups (with 3 crushed Water Chestnuts), Flower Ophiopogon 3 qian, Stalk Dendrobium 8 qian (crushed and decocted first), Fresh Loquat Leaf 3 qian (bagged), Raw Coix Seed 8 qian (crushed), Bamboo Leaf 2 qian.) Switched to sweet-gentle nourishment. After a month, the ulcer healed. Post-recovery included Ginseng and Astragalus. She regained robust health. (Sweet-gentle nourishment formula: Great Raw Rehmannia 8 qian, Raw Licorice Root 3 qian, White Poria 3 qian, Fat Polygonatum 3 qian, Sweet Apricot Kernel 3 qian, Boxed Angelica Sinensis 2 qian, Wine Mulberry Twig 3 qian, Quince 3 qian.)
Wang Jizai suffered from chronic malaria. Doctors said Yuan Qi was deficient and杂乱ly administered warming tonics. He became emaciated with internal burning, dry mouth, cough, night sweats, and dark urine. Food tasted bland. Wang Mengying said: "Heat pathogen lingers in the Blood level." He prescribed Qinjiao Biejia San (Gentian and Turtle Shell Powder), and he recovered. (Warming tonics rob Yin. Internal burning, dry mouth, night sweats, dark urine indicate heat lingering in Blood level. Left Gentian 1.5 qian (added later), Blood Turtle Shell 1 liang (crushed, charred, simmered for six hours), Wine-fried Anemarrhena 3 qian (added later). Angelica is removed for being warm and cloying. Spring Bupleurum 3 qian (added later), Groundcherry Root 5 qian, Dark Plum Meat 1.5 qian, Fresh Artemisia Annua 0.8 fen (added later).)
Brother-in-law Wang Yangyu also had malaria for months. Many medicines failed. Emaciation, spontaneous sweating, soreness/weakness of waist/knees, inability to sit, extreme aversion to cold. Wang Mengying said: "This is a major deficiency. Why not tonify? Using digestion-promoting herbs, what is your intent?" He prescribed Codonopsis, Astragalus, Atractylodes, Licorice, Prepared Rehmannia, White Peony, Schisandra, Eucommia, Dioscorea, Dragon Bone, Oyster Shell, Mulberry Twig, Jujube, and Quince for dozens of doses. He rose from bed. (Emaciation and sweating indicate Yin deficiency within Yang. Waist/knee soreness indicates Liver-Kidney Yin deficiency. Waist/knee coldness indicates Liver-Kidney Yang deficiency. Extreme cold aversion indicates Qi-level Yang deficiency. Fried Codonopsis 5 qian, Fried Astragalus 5 qian, Fried Atractylodes 3 qian, Fried Licorice 1 qian, Fried Prepared Rehmannia 3 qian, Wine-fried White Peony 1.5 qian, Schisandra 3 qian (crushed and decocted first), Soft Eucommia 5 qian, Fried Dioscorea 3 qian, Vinegar-treated Dragon Bone 3 qian, Vinegar-treated Oyster Shell 8 qian. These two crushed and decocted first. Wine-fried Mulberry Twig 2 qian, Jujube 3 pieces (torn and simmered first), Aged Quince 5 qian (decocted first).)
Elder Wang, in advanced age, had phlegm-cough, wheezing preventing lying down, cold limbs, and malar flush. No appetite. He was given Zhenwu Tang (True Warrior Decoction) and stabilized. (Advanced age phlegm-cough, wheezing, cold limbs, malar flush resemble heat-excess. Deficiency-cold is distinguished by no appetite. Fried Dried Ginger 5 qian, Fried Prepared Aconite 5 qian, Fried Codonopsis 3 qian, White Poria 3 qian, Wine-fried White Peony 1.5 qian. Zhenwu Tang minus Atractylodes. Ginger changed to Roasted Ginger 3 qian. Added Processed Pinellia 3 qian, Fried Chenpi 1 qian, Aged Quince 3 qian.) Frequently taking warming tonics made him feel very cold. In spring of Xinchou, Wang Mengying was consulted. Pulse was very rapid. He said: "Yin..."