玉翁大郎，童年曾患头昏，诸药不愈。予作肝风治，疏归芍地黄汤。佥谓头昏是有风寒
，童
子不可轻服熟地。翁排众议，根据方多服而瘳。次春又患腹痛，呕吐便泻，延诊，药用温中调
气，两服未愈，家人着急，令更他医，日请数人。或以为虫，或以为血，或以为火，治总不
验，淹缠旬余，痛甚不止，呕泻不停，寝食俱废。复邀诊视，脉细面青，呻吟疲惫。予思病
势增剧，玉翁固虽相信，然旁议纷纷，难与着手，转荐同道余朗亭先生延医。初投五苓散，
续进真武汤，亦俱不应。玉翁坚嘱想法，予曰∶非不欲为借筹，奈令郎病久，胃气必空，轻
剂谅不济事，若背城借一，尊公爱孙如珍，见方骇然，焉肯与服。翁沉吟云∶有一善策，今
早友人谈及邻村有扶鸾治病者，家人欲往求方，予呵止之。祈拟一方，予持语家人云，是乩
仙所开，自必信服。予曰∶策固善矣，治法尚难。令郎之病，起初不过寒凝气滞，本无大害
，因求速效，诸治庞杂，痛久伤气，吐多伤胃，泻多伤脾，故困顿若此。倘仍见病疗病，必
至土败气脱，计惟扶阳益气，以拯其急。爱议附子理中汤，米水煎饮。气固胃安，庶堪保守
。诘朝玉翁来舍，喜云∶曩服他药，如水投石，昨服尊方，不但病减，并可啜粥。家人信为
神丹，相烦往视，恳为加减。予曰∶药已对证，勿轻易辙。今日照方仍服一剂，明日再为斟
酌。次早往诊，病势大转，因其体素阴虚，方内除去附子，又服两日。更用参苓白术散，调
理而痊。是役也，非玉翁平素信心，兼施权变，安能图成?志此以见医家临证，不特病情
之难窥，而人情之难处尤甚也。
安波按∶人情难处，近今为尤甚。杏翁处嘉道盛世之际，而不见光绪医生之吃苦乎。
今日之医，必须一剂知，二剂已之技，否则另商他人矣。可见人心不古，愈流愈下。
许玉书老先生的大儿子，童年时曾患头晕，服用多种药物均未痊愈。我将其作为肝风证治疗，开具了归芍地黄汤。众人都认为头晕是由于风寒引起的，小孩子不能轻易服用熟地黄。许老排除众人的异议，按照方子让病人多服了几次，最终病愈。第二年春天，他又患上腹痛，伴有呕吐和腹泻，请我去诊治。我用药以温中调气为主，服了两剂后未见好转，家人非常着急，要求更换其他医生，每天请好几位医生来看。有人认为是虫积，有人认为是瘀血，有人认为是火邪，治疗始终没有效果，病情拖延了十几天，疼痛剧烈不止，呕吐和腹泻不停，睡觉和吃饭都废弛了。再次邀请我诊治，见脉象细弱，面色发青，呻吟且疲惫不堪。我考虑到病情加重，虽然许老原本信任我，但周围议论纷纷，难以着手治疗，于是转荐给同道好友余朗亭先生来医治。起初投用五苓散，随后进服真武汤，也都无效。许老坚决嘱咐想办法救治，我说：“不是我不想为他筹划，无奈令郎患病日久，胃气必然空虚，轻剂量的药恐怕无济于事，如果背水一战，尊公像珍视宝贝一样疼爱孙子，看到方子会感到惊骇，怎么肯让他服用呢？”许老沉思后说：“有一个好办法，今天早上朋友谈到邻村有扶乩治病的人，家人想去求方，被我呵斥制止了。请您拟定一方，我拿给家人看时说这是乩仙所开，他们自然信服。”我说：“计策固然好，但治法还难确定。令郎的病，起初不过是寒凝气滞，本无大害，因为追求速效，各种治疗杂乱无章，痛久损伤了气，吐多损伤了胃，泻多损伤了脾，所以困顿到这种地步。如果还是见病疗病，必定会导致土败气脱，唯一的办法是扶阳益气，来挽救危急。因此商议使用附子理中汤，用米和水煎煮饮用。使气固胃安，才堪当保守治疗。”第二天早上许老来到我家，高兴地说：“以前服用的其他药，如同水浇在石头上（毫无反应），昨天服用了您的方子，不但病情减轻，还可以喝粥了。”家人相信这是神丹妙药，麻烦我再去看望，恳请我为他加减药味。我说：“药已经对症，不要轻易改变。今天照原方再服一剂，明天再斟酌调整。”第二天早上去诊治，病情大大好转，因为他体质素来阴虚，方中去掉了附子，又服用了两天。后来改用参苓白术散进行调理，最终痊愈。这次诊疗，如果不是许老平时的信心，加上灵活变通，怎么能成功呢？记录此事是为了说明医家在临证时，不仅病情难以窥探，而人情世故的难处更是甚于病情啊。
安波按语：人情世故的难处，当今时代尤为严重。杏轩老前辈处于嘉庆、道光盛世之际，难道没看到光绪年间医生的辛苦吗？现在的医生，必须具备“一剂见效，二剂痊愈”的技术，否则就会被另请他人。可见人心不古，风气愈流愈下。
The eldest son of Mr. Xu Yushu suffered from dizziness (dizziness) in his childhood, which did not respond to various medications. I treated it as Liver Wind (Liver Wind), prescribing Guizhi Dihuang Tang (Cinnamon Twig and Rehmannia Decoction). Everyone claimed that dizziness was caused by Wind-Cold (Wind-Cold) and that a child should not easily consume Shudi (Prepared Rehmannia Root). Mr. Xu disregarded the dissenting opinions, had him take the prescription repeatedly, and he recovered. The following spring, he suffered from abdominal pain (abdominal pain) with vomiting and diarrhea. Upon consultation, I prescribed herbs to warm the Middle Jiao (Middle Jiao) and regulate Qi (Qi). After two doses, there was no improvement. His family became anxious and requested other doctors, inviting several daily. Some attributed it to parasites (parasites), others to Blood stasis (Blood stasis), and others to Fire (Fire), but none of the treatments were effective. The condition dragged on for over ten days with severe, unceasing pain and continuous vomiting and diarrhea, leading to neglect of sleep and eating. I was invited again to consult. His pulse was fine (fine pulse) and his complexion was cyanotic (cyanosis); he was moaning and exhausted. Considering the worsening condition, although Mr. Xu trusted me, the surrounding criticism made it difficult to proceed. I referred him to my colleague, Mr. Yu Langting. Initially, Wuling San (Five-Ingredient Poria Powder) was administered, followed by Zhenwu Tang (True Warrior Decoction), but neither worked. Mr. Xu firmly urged me to find a solution. I said, "It is not that I do not wish to plan for him, but his illness has been prolonged, so his Stomach Qi (Stomach Qi) must be depleted. Light doses will likely be ineffective. If we resort to a desperate measure, your lordship loves your grandson like a treasure; seeing the prescription, he would be startled and unlikely to allow him to take it." Mr. Xu pondered and said, "There is a good strategy. This morning, a friend mentioned a neighbor village where someone practices Fu Luan (spirit writing) for healing. My family wanted to seek a prescription there, but I scolded them. Please draft a prescription. I will tell my family that it was opened by a spirit immortal, so they will surely believe and accept it." I replied, "The strategy is indeed good, but the treatment method remains difficult. Your son's illness initially was merely Cold coagulation and Qi stagnation (Cold coagulation and Qi stagnation), which was not serious. Because you sought quick results, the treatments became chaotic. Prolonged pain damaged Qi (Qi), excessive vomiting damaged the Stomach (Stomach), and excessive diarrhea damaged the Spleen (Spleen), hence this debility. If we continue to treat symptoms individually, it will lead to Earth failure and Qi collapse (Earth failure and Qi collapse). The only way is to support Yang (Yang) and tonify Qi (Qi) to save the emergency. Therefore, I propose Fuzi Lizhong Tang (Aconite and Ginger Decoction to Regulate the Middle), decocted with rice water. This will consolidate Qi (Qi) and calm the Stomach (Stomach), allowing for conservative management." The next morning, Mr. Xu came to my residence, happily saying, "Previous medicines were like water thrown on stone (ineffective). Yesterday, after taking your prescription, not only did the illness subside, but he could also drink congee." His family believed it to be a miraculous pill and asked me to visit again to adjust the formula. I said, "The medicine matches the syndrome (syndrome differentiation), do not change it lightly. Take one more dose according to the original prescription today, and we will reconsider tomorrow." The next morning upon consultation, the condition improved significantly. Since his constitution was inherently Yin deficient (Yin deficiency), I removed Fuzi (Prepared Aconite Root) from the formula, and he took it for another two days. Subsequently, Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) was used for regulation, leading to full recovery. In this case, without Mr. Xu's usual trust and flexibility, success would have been impossible. I record this to illustrate that for physicians in clinical practice, not only is the disease condition hard to discern, but the difficulty of navigating human relations is even greater.
An Bo's Note: The difficulty of human relations is even more pronounced nowadays. Old Xingxian lived during the prosperous era of Emperor Jiaqing and Daoguang; does he not see the hardships faced by doctors in the Guangxu era? Today's physicians must possess the skill to achieve results with one dose and cure with two, otherwise, patients will seek others. This shows that ancient virtues are lost, and morals decline further.