诊之曰∶脉不浮紧，安得表耶？又不沉实，安得里耶？惟心部大而涩，此劳心而虚烦，乃类伤寒，非真伤寒也。若
禁饮食，则饿绝矣。便以粥与之，兼进归脾汤，五日而安。
张路玉治陈太仓夫人，素患虚羸骨蒸，经闭少食，偶风热咳嗽，误进滋阴清肺二剂，遂昏热痞闷异常。（凡
素患虚损人忽有外感，宜细审之。）诊之，人迎虚数，气口濡细，寸口瞥瞥，两尺抟指。此肝血与胃气皆虚，复
感风热之状，与更减葱白豆豉汤，一服热除痞止。但咳嗽头痛微汗，更与小剂保元汤而安。
王氏子，于四月间患感冒昏热，喘胀便闭，腹中雷鸣，服硝、黄不应。脉之气口弦滑，按之则芤，其腹胀
满，按之则濡。此痰湿挟瘀浊阴固闭之候，与黄龙汤去芒硝，易桂、芩、半夏、木香，下瘀垢甚多。因宿有五
更咳嗽，更以小剂异功加细辛润之。大抵腹中奔响之症，虽有内实当下，必无燥结，所以不用芒硝，而用木香、
芩、半也。用人参者，借以资助胃气，行其药力，则大黄辈得以振破敌之功，非谓虚而兼补也。当知黄龙汤中
用参，则硝、黄之力愈锐，用者慎之。
钱顺所素有内伤，因劳力感寒，发热头痛。表散数剂，胸膈痞闷不安；以大黄下之，痞闷益甚。更一医，
用消克破气药，过伤胃气，遂厥逆昏愦，势渐危。脉六部微细如蛛丝，舌上焦黑，燥涸异常。此热伤阴血，不
急下之，真阴立槁，救无及矣。因以生地黄连汤去黄芩、防风，加人中黄、麦冬、酒大黄，另以生地黄一两，
酒浸，捣汁和服。半夜下燥矢六七枚，天明复下一次，乃与生脉散二帖。以后竟不服药，日进糜粥调养，而大
便数日不行，魄门迸迫如火，令用导法通之，更与异功散调理而安。
杨乘六治沈氏妇感症，身热口苦，胁痛头眩。或投以表剂发散，身热益甚，舌黑唇焦，口渴烦躁，手足肿
痛，大便艰涩，小便短赤，寝食俱废。脉之，浮数无序，乃肝郁致感，因发散太过，血少阴虚，而火燥生风也。
以滋水清肝饮倍熟地，一剂诸症悉退。次用归脾汤去木香，加白芍、丹皮调理而愈。逾年产后，复因劳力致感，
乃恐蹈前辙，不敢发散，一味养阴，以致大便不实，饮食不进，气促如喘，昼夜不眠，合眼即见一白发老妪，
坐立面前，胸中战跳，恍惚不宁。仍邀诊，曰∶脱阳者见鬼，非真有鬼也。盖阳气大亏，则神不守舍，其所见
者，即其不守舍之元神也，所以男病必见男形，女病必见女形。且亏在某脏，则某色独见。脉之，浮细如丝，
沉则缓大无力，面色 白，眼光散大，舌干而嫩，且白滑。此中虚挟感，逼以寒凉，致阳气益虚，而阴气乘之
耳。乃与参附养荣汤，倍枣仁、白芍、五味，服后则老妪不见，而熟睡矣。继用补中益气加白芍、五味，数剂全愈。
简某病感症，发热饱闷，神思昏沉，不更衣者八日矣。诸医投发表攻中不效，且益甚。脉之，滑而有力，
面壅热通红，气粗，舌苔黄浓而燥，按其胸微痛。此感症兼食，俗名停食伤寒是也，乃用逍遥散加熟地二两。
或曰∶如许发热，又兼饱胀，何堪复用补药？曰∶此乃发表攻里之剂，用之以代麻、桂、硝、黄者也。（此法固妙，
要当用于发表攻中之后。）第服此，则汗至而便通，热自退，胀自除矣。一剂淋漓汗下，二剂下黑矢十余
枚，诸症悉愈。或问其旨，曰∶此症初起，本一逍遥合小柴胡，发汗开肌，助脾消食则愈矣。乃风燥混表，肠
胃干枯，宿物燥结，愈不能出。仍用逍遥散，重加熟地养阴，使阴水外溢，则汗自至，阴气下润，则便自通
也。继用六君、归、芍而愈。
吴某病感症，先微寒，继壮热，头眩恶心，吐沫不绝，胀闷懒言，气难布息，四肢麻木酸痛，腰痛如折，
寝食俱废，大便秘结。医与消暑解表消食，益热益胀，不时昏绝。脉左手沉细，右手缓大，皆无力，面 白，
舌苔嫩且白滑，知其多欲阳虚致感也，与养荣汤加附子。或疑热甚兼胀，而投温补何也？曰∶但服此，诸症自
退。若再用芩、连、枳、朴，则真误事矣。一剂即卧，醒则大叫冷甚，比及半时，汗出如雨。再剂胸宽食进，
便通热退。又以两腿外 疮肿烂臭，浓水淋漓，痛痒俱甚，一切膏丹洗帖不愈，已六七年。问治当何法？曰∶
病有内外，源无彼此，此因阳气素亏，不能下达，毒瓦斯时坠，不肯上升故也。第以前方作丸久服则阳分充足，
气血温和，而毒瓦斯自出，疮口自收矣。如言两月而愈。
潘某自京回南，劳顿感寒，发热，时作微寒，发散数剂，热渐炽，改用清火养阴数剂，热转甚。比到家，
舌苔已由白而黄，由黄而焦干燥裂，黑如炭色，神思昏沉，手足振掉，撮空自汗，危症 集矣。医见其热势，
谓寒之不寒，是无水也，与六味饮，不应。见其舌色，谓攻伐太过，胃阴干枯也，投左归饮，又不应。脉之，
左寸关大而缓，舌浮胖，谓症乃阳虚火衰，非阴虚火旺也。盖阴虚火旺者，其舌必坚敛苍老。今虽焦黑干燥，
而见胖嫩，且服六味、左归而症反加，（反加二字毋乃太过。）其为阳虚无疑矣。以养荣汤用人参五钱，加附
子三钱，一剂熟睡竟夜，次早舌上苔尽脱，变为红润而嫩矣。原方减人参二钱，附子一钱五分，四剂，回阳
作汗而愈。
戴氏子，年二十四，病感症寒热。或用发散，谵语发狂。又以苦寒下之，危症蜂起。又有用二冬、二地、
石斛、黄芩者，五六剂益狂悖不安。诊之，面白无神，舌滑无苔，脉细紧无力，知其脏寒真阳欲脱，以养荣汤
用人参五钱，加附子三钱。又知其为旁议所阻也，嘱其午后至申，察病患足冷至膝，则亥子之交，不可言矣。
已而果然，乃自戌至亥始尽剂，子时后由腰至足渐温，五鼓进粥半瓯而熟睡矣。又十余剂，诸症悉愈。未半月，
忽右足大指弯筋缩而痛，外科以乳香、没药敷之，痛剧呼叫。再诊之，乃因思虑伤脾，不能荣养本经筋脉，所
以筋弯燥病也，以归脾去木香加白芍数帖愈。
陆氏子病感症，发热咳嗽，气短如喘，发散转甚，痰涌如潮，谵妄撮空。脉之，轻按满指，重按则空。面
色白，眼眶宽大，神水散漫，舌苔嫩黄，中间焦燥，两手振掉。症由气虚致感，误用峻表，致阴被劫而将亡，
阳无附而欲脱，非救阴摄阳不能挽也。乃用左归去茯苓，加人参、五味，大剂浓煎。服讫即睡，六时许方寤，
则身凉嗽止，喘定痰消。继以生金滋水饮一剂，养荣汤四剂全瘳。又其母孀居，卧病不起二载矣。或作温，或
作痿，治之不效，并乞诊之。脉大而无力，面色萎黄，舌胖而滑。询其饮食不思，略食即饱，梦中常见鬼神，
醒则胸中战跳。此命门火衰，元神虚惫，脾土不生，以致四肢无力不能运动也。亦用养荣汤煎送八味丸，不一月而瘳。
沈某病感症，身热自汗，或乍寒，倦卧懒言，手足心热，日轻夜重。或与发散愈炽，口渴谵语，烦躁便秘。
又杂进寒凉解毒等剂，势垂危。脉之洪大而数，按之不鼓，面色浅红，游移不定，舌黑而润，手足厥冷。此假
热也，与八味饮加人参。诸医以火症悉具，力争参、桂、附不可食。曰∶外虽似实热，内甚虚寒。初误发散，
令精液伤而口渴便秘，烦躁谵妄。复用寒凉，重阴下逼，致龙雷之火不安其宅。非人参、附、桂何以挽回？公
等不信，但以附子作饼，热贴脐上时许便觉稍安矣。（外试法妙。）试之果然，乃进药，不及一时，面红立退，
谵妄烦躁悉除。次用生金滋水，补中益气，调理而愈。未半月，其父亦病感症危甚。杨验其舌黑而枯，满舌遍
裂人字纹，曰∶脉不必诊也。惊问故。曰∶此肾气凑心，亦八味症也，误用芩、连无救矣。盖昨一日夜，果服
芩、连两许。问何以知之？曰∶舌上明明现出耳。姑求一诊，以冀万一。曰∶脉隐而难凭，不若舌之显而可据
也，何必诊？逾日果殁。
诸某，年五十四，冬杪劳力致感冒，头痛发热，时作微寒。缘混表太过，只口干便秘，壮热不退，复用苦
寒泻火，头汗如油，下颔脱落，口角流涎，鼾声如锯，语言错乱，甚至循衣摸床撮空，诸恶毕备。脉之洪大躁
疾，重按全无，舌糙刺如沙皮，焦黄如烘糕，并舌底俱干燥，敛束如荔枝肉，而满舌却甚胖壮，日进稀糊碗许，
大便半月未行。乃曰∶若论外象，百无一治，幸脾气不泻，胃气不绝，尚有生理，第服药后神得收敛而睡，脉
得静细而沉乃佳。遂以大剂养荣汤，重加附子与之，服讫果睡，脉亦和。四剂舌转红润，恶症悉退，频进稀粥。
惟交阴分，尚有微热，咸疑阳药助火，欲去 、术、桂、附。曰∶劳伤脾肺，气虚发热，非甘温不能除，方嫌
火力不及，不能蒸土回阳推出邪气耳。俟其力到，地气升而为云，则天气降而为雨，顷刻为清凉世界矣。守方
十二剂，始战汗，汗后身冷如冰，问之不应，推之不理，或问其故。曰∶此病既到今日，断然不死，不过汗后
亏其外卫之阳，故身倦懒言，无气以动，子刻自平复。已而果然。次日欲便，扶至圊，虚坐努责。数日，忽小
水癃闭，点滴不能出，小腹胀痛不可言。此因大便弥月不行，肠胃所积已多，今频加努责，将宿物推迸大肠，
致壅塞膀胱，所以癃闭不出也。须以轻清之剂升降之，则小水自利。立煎补中益气与饮，顷刻即通，大便亦润。
继以养荣作丸，用补中益气汤煎送之，两月而健。
马元仪治沈某，发热恶寒，头身俱痛，燥渴谵语，脉之洪数而涩。此外感而病危者，以五志过极，阴气素
亏，邪复乘之，重伤其阴，而火热愈甚也。先与解肌一剂，恶寒已而热未除，谵语转增，神魂飞越。盖肝藏血
而舍魂，心藏脉而舍神，木火太过，不独自伤，且贼真阴之气，以肝肾为母子，其气相通也。心本制于肾，而
亦伤肾者，脏邪暴甚，反侮所不胜也。法当养肝之阴，使不诛求于肾，而水自充；抑心之阳，使不扰乱乎肾，
而水以安。用生地、知母、甘草、茯神、丹参、贝母、花粉等，一剂知，三剂已，调理而安。
丁某，经病二十余日，脉之左手弦数兼涩，右手涩结少神，发热神昏谵语，胸中满结拒按，舌苔黑刺，面
色枯瘁，时有咳嗽，日晡愈甚。此肝木内鼓，心火上炎，肺金失养，而胃土无滋也，用栝蒌、枳实、半夏曲、
芦根汁、紫菀、杏仁、苏子等。服后卧片时，神气顿清，右脉亦透，但涩象不减，重按少神，舌上苔刺去而复生。
此津液元气虚竭之甚，转用人参三钱，生首乌一两，知母、生地、川连、芦汁，两剂，脉涩减，症渐安。但胎未
尽去，中脘滞闷，前方加枳实、楂肉，一剂顿已。次用滋阴补虚之品，二剂诸症悉退，左脉尚和，右脉转浮而数，
微热发疹。此正气来复，余邪尽从外达也，与荆炭、牛蒡、干葛、防风、杏仁、桔梗、苏子、薄荷清透之品。
二剂后，再用益元散滋阴润燥，调理而愈。
一妇人，四旬外，头痛发热，口干便秘，不眠，已月余矣。此邪风外煽，实热内燔，表里邪结之候也。前所
用药，亦是发表攻里，而不愈者，药不胜病耳。今上下分消，表里交治，而于攻发之中，仍用温养，斯汗不伤
于过，下不伤于峻也。用荆、防、薄荷、麻黄轻阳发表，使邪从汗而散于上，大黄、芒硝、栀子、滑石通幽利
水，使邪从便而泄于下，黄芩、连翘清其上，白芍、甘草和其中，桔梗、石膏开其肺，川芎、归、芍养其肝，
一剂而减，三剂而安。
安氏子，年二十，初得恶寒发热身痛症，诊得内伤之脉，而显阳微之象，曰∶此病枝叶未害，根本先拨，
乃阳虚受邪症也。若误行表剂，则孤阳飞越，而危殆立至。当用参、术等大培元气，以摄虚阳，加桂枝透表以
散外邪。不信，越四日，发热不休，自汗不止，神气外扬。或且欲用柴胡解表之剂。乃曰∶此症似太阳，而得
少阴之脉，当是平素下虚，故真阳上越耳。遂定参 建中汤而别。或复谓外邪初入太阳，表散即愈，若徒进参、
，适助邪而滋患也。越三日，症变危笃。再诊，脉几微欲绝，汗出如雨，昏沉欲绝，此非大剂温补，不能挽
回，以人参六两，合附桂理中汤，连进三剂，汗渐收，脉微续，神气尚未安和也。复用人参三两，附子五钱，
方得阳气内充，余邪尽从外达，两颐透发，渐调而安。（ 按∶是症固属虚，而原有邪热，或与表散，未尝无
功。至汗出脉复，第以大剂养阴，其危立已。乃久用桂、附，遂致发颐，尚得为善治乎哉。）
魏玉横治杨氏子，年二十许，四月初，以啖面过饱，午睡觉即身热头痛。医与消散，至七日而愈。两日后，
因食水圆复病，仍与消运不应，乃以小承气下之，连下粪水二次，皆无燥矢。更医，与浓朴、山楂、陈皮、
枳壳之类，谷芽用至两许，月余病不减，而股肉尽落，枯瘠如柴，不食，日进米汤数盏，寒热往来，小便亦少。
最后一医教用胆汁导之，胆入而粪不出，又用油烛探之，烛化而粪亦不出。其胆汁与烛油凝注下部，楚不可堪，
呼叫之惨，四邻为动，时已四十余日，方治木，邀诊以决早晚。察其脉弦，而迢迢尚有神气，其声尚明亮，按
医生诊断说：脉象不浮紧，怎么能说是表证呢？又不沉实，怎么能说是里证呢？只有心部脉象大而涩，这是劳伤心神导致的虚烦，症状类似伤寒，但不是真正的伤寒。如果禁止饮食，病人就会因饥饿而衰竭。于是给病人喝粥，同时服用归脾汤，五天后病情安定。
张路玉治疗陈太仓的夫人，她平素患有身体虚弱消瘦、骨蒸潮热、月经闭止、食欲不振，偶然患上风热咳嗽，误服了滋阴清肺药两剂，随即出现昏迷、高热、胸脘痞闷异常。（凡是平素患有虚损的人忽然又患外感，应当仔细审察。）诊脉时，人迎脉虚数，气口脉濡细，寸口脉飘忽不定（瞥瞥），两尺脉搏指有力。这是肝血与胃气都虚弱，又感受了风热的表现。给予葱白豆豉汤小剂量服用，一服药后热退痞消。但仍有咳嗽、头痛和微汗，再给予小剂量的保元汤而痊愈。
王氏的儿子，在四月间患感冒，出现昏热、气喘腹胀、大便闭塞，腹部有雷鸣声，服用硝石、大黄无效。脉象气口部弦滑，重按则芤（中空），腹部胀满，按压则柔软。这是痰湿夹杂瘀浊阴邪固结闭塞的证候。给予黄龙汤去掉芒硝，改用桂枝、黄芩、半夏、木香，排出大量瘀积污秽之物。因为平素有五更时分咳嗽的宿疾，再用小剂量的异功散加细辛润燥治疗。大抵腹部有奔响声音的症状，虽然有内实应当攻下，但必定没有燥结，所以不用芒硝，而用木香、黄芩、半夏。用人参，是借以资助胃气，推动药力，使大黄等药物能够发挥攻破病邪的功效，并不是认为病人虚损而兼用补法。应当知道黄龙汤中用人参，会使硝石、大黄的药力更加锐利，使用者需谨慎。
钱顺所平素有内伤，因劳累受寒，出现发热头痛。使用发散解表药数剂后，胸膈痞闷不安；用大黄攻下后，痞闷更加严重。另一位医生，使用消导克伐破气的药物，过度损伤了胃气，导致四肢厥逆、神志昏愦，病情逐渐危急。诊脉六部微细如蛛丝，舌上焦黑，干燥枯竭异常。这是热邪伤了阴血，如果不紧急攻下，真阴立刻干枯，就救无可救了。因此用生地黄连汤去掉黄芩、防风，加入人中黄、麦冬、酒制大黄，另外取生地黄一两，用酒浸泡，捣汁混合服用。半夜排出干燥粪便六七枚，天亮后又排一次，随后给予生脉散两帖。此后竟不服药，每天进糜粥调养，但大便几天不通，肛门急迫如火烧，让人用导法通便，再用异功散调理而痊愈。
杨乘六治疗沈氏妇人患感症，身热口苦，胁痛头晕。有人投以解表发散药，身热更加严重，舌黑唇焦，口渴烦躁，手足肿痛，大便艰涩，小便短赤，寝食俱废。诊脉，浮数无序，这是肝郁导致的外感，因为发散太过，导致血少阴虚，火燥生风。用滋水清肝饮加倍熟地黄，一服药后诸症悉退。接着用归脾汤去掉木香，加白芍、丹皮调理而痊愈。过了一年产后，又因劳累感邪，恐怕重蹈覆辙，不敢发散，一味养阴，导致大便不实，饮食不进，气促如喘，昼夜不眠，一合眼就看见一个白发老妪，坐在站立面前，心中战栗跳动，恍惚不宁。再次邀请诊治，医生说：脱阳的人见鬼，并非真有鬼。这是因为阳气大亏，神不守舍，所见到的，就是那不守舍的元神，所以男病人必见男性形象，女病人必见女性形象。而且亏损在哪个脏腑，就只显现那个脏腑对应的颜色。诊脉，浮细如丝，沉取缓大无力，面色苍白，眼光散大，舌干而嫩，且白滑。这是中焦虚损夹杂外感，被寒凉药逼迫，导致阳气更虚，阴气乘虚而入。给予参附养荣汤，加倍酸枣仁、白芍、五味子，服用后老妪不再出现，安然入睡。继用补中益气汤加白芍、五味子，数剂后全愈。
简某患感症，发热饱闷，神思昏沉，八天未解大便。各位医生投以发表攻里的药物无效，且病情加重。诊脉，滑而有力，面部壅热通红，气粗，舌苔黄浓而干燥，按压胸部微痛。这是感症兼夹食滞，俗名停食伤寒。于是用逍遥散加熟地黄二两。有人说：如此发热，又兼饱胀，怎能再用补药？回答说：这是发表攻里的药剂，用它来代替麻黄、桂枝、芒硝、大黄。（此法固然巧妙，但要用于发表攻里之后。）只要服用此药，就会出汗且大便通畅，热自退，胀自除。一服药后淋漓出汗，二服药后排出黑色粪便十余枚，诸症悉愈。有人问其用意，回答说：此症初起，本应用逍遥散合小柴胡汤，发汗开肌，助脾消食即可痊愈。但因为风燥混于表，肠胃干枯，宿食燥结，越发不能排出。仍用逍遥散，重加熟地黄养阴，使阴液外溢则汗自至，阴气下润则便自通。继用六君子汤、当归、白芍而痊愈。
吴某患感症，先轻微恶寒，继而壮热，头晕恶心，吐沫不止，胀闷懒言，气息难布，四肢麻木酸痛，腰痛如折断，寝食俱废，大便秘结。医生给予消暑解表消食药，反而热更盛、胀更甚，不时昏厥。诊脉左手沉细，右手缓大，都无力，面色苍白，舌苔嫩且白滑，知道他多欲导致阳虚感邪，给予养荣汤加附子。有人怀疑热甚兼胀，为何投温补药？回答说：只要服用此药，诸症自然消退。若再用黄芩、黄连、枳实、厚朴，那就真正误事了。一服药后即能安卧，醒来则大叫极冷，不到半小时，汗出如雨。二服药后胸宽食进，便通热退。又有两腿外侧疮肿烂臭，脓水淋漓，痛痒俱甚，一切膏丹洗贴都不见效，已六七年。问治疗方法是什么？回答说：病有内外之分，源头没有彼此之别，这是因为阳气素来亏虚，不能下达，毒瓦斯时常下坠，不肯上升所致。只需将前方制成丸药久服，则阳分充足，气血温和，毒瓦斯自然排出，疮口自然收敛。照此办理，两个月痊愈。
潘某从京城回到南方，劳顿感寒，发热，时而微恶寒，发散数剂后，热势渐炽，改用清火养阴数剂，热势转甚。等到回家，舌苔已由白变黄，由黄变焦干燥裂，黑如炭色，神思昏沉，手足震颤，撮空理线，自汗，危症聚集。医生见其热势，说寒之不寒，是无水也，给予六味地黄饮，无效。见其舌色，说攻伐太过，胃阴干枯，投左归饮，又无效。诊脉，左寸关大而缓，舌浮胖，说病症乃阳虚火衰，非阴虚火旺。因为阴虚火旺者，其舌必坚敛苍老。现在虽然焦黑干燥，但见胖嫩，且服用六味、左归后症状反而加重，（“反加”二字或许过于夸张。）其为阳虚无疑。用养荣汤用人参五钱，加附子三钱，一服药后整夜熟睡，次日早晨舌上苔尽脱，变为红润而嫩。原方减人参二钱，附子一钱五分，四服药后，回阳作汗而痊愈。
戴氏的儿子，二十四岁，患感症寒热。有人用发散药，出现谵语发狂。又用苦寒药攻下，危症蜂起。又有用天冬、麦冬、生地、熟地、石斛、黄芩的，五六剂后更加狂悖不安。诊脉，面白无神，舌滑无苔，脉细紧无力，知道是脏寒真阳欲脱，用养荣汤用人参五钱，加附子三钱。又知道他被旁议所阻挠，嘱咐他在午后至申时，观察病患脚冷至膝盖，那么在亥子之交（晚上9点到凌晨1点），就没法说话了。后来果然如此，于是从戌时到亥时才开始喝完药，子时后腰至足渐温，五更时分喝了半碗粥后熟睡。又十余剂，诸症悉愈。未满半月，忽然右足大脚趾筋缩而痛，外科用乳香、没药敷之，疼痛剧烈呼叫。再诊，是因为思虑伤脾，不能荣养本经筋脉，所以筋弯燥病，用归脾汤去掉木香加白芍数帖痊愈。
陆氏的儿子患感症，发热咳嗽，气短如喘，发散后症状转甚，痰涌如潮，谵妄撮空。诊脉，轻按满指，重按则空。面色白，眼眶宽大，神水散漫，舌苔嫩黄，中间焦燥，两手震颤。病症由气虚致感，误用峻猛解表药，导致阴被劫夺而将亡，阳无依附而欲脱，非救阴摄阳不能挽回。于是用左归丸去掉茯苓，加人参、五味子，大剂浓煎。服完后即睡，约六小时才醒，则身凉嗽止，喘定痰消。继以生金滋水饮一剂，养荣汤四剂全愈。还有他的母亲寡居，卧病不起两年了。有人当作温病治，有人当作痿证治，治疗无效，一起请求诊治。脉大而无力，面色萎黄，舌胖而滑。询问其饮食不思，略食即饱，梦中常见鬼神，醒则胸中战栗跳动。这是命门火衰，元神虚惫，脾土不生，以致四肢无力不能运动。也用养荣汤煎送八味丸，不到一个月痊愈。
沈某患感症，身热自汗，或乍寒，倦卧懒言，手足心热，日轻夜重。有人给发散药则热更炽，口渴谵语，烦躁便秘。又杂进寒凉解毒等剂，势垂危。诊脉洪大而数，按之不鼓指，面色浅红，游移不定，舌黑而润，手足厥冷。这是假热，给予八味地黄饮加人参。各位医生认为具备火症特征，极力反对人参、肉桂、附子不可食用。回答说：外虽似实热，内甚虚寒。起初误用发散，令精液伤而口渴便秘，烦躁谵妄。复用寒凉，重阴下逼，致龙雷之火不安其宅。非人参、附子、肉桂何以挽回？你们不信，只拿附子做成饼，热贴脐上一时许便觉得稍安。（外用测试法很妙。）试之果然，乃进药，不到一小时，面红立退，谵妄烦躁悉除。次用生金滋水饮，补中益气汤，调理而愈。未满半月，其父也患感症危甚。杨验其舌黑而枯，满舌遍裂人字纹，说：脉不必诊了。惊恐地问原因。回答说：这是肾气凑心，也是八味地黄饮证，误用黄芩、黄连无救矣。因为昨天一整夜，果然服用了黄芩、黄连二两左右。问怎么知道的？回答说：舌上明明现出来了。姑且求一诊，以冀万一。回答说：脉隐而难凭，不如舌之显而可据，何必诊？逾日果然去世。
诸某，五十四岁，冬末劳累致感冒，头痛发热，时而微恶寒。因为混用解表药太过，只口干便秘，壮热不退，复用苦寒泻火，头汗如油，下颌脱落，口角流涎，鼾声如锯，语言错乱，甚至循衣摸床撮空，各种恶症备齐。诊脉洪大躁疾，重按全无，舌糙刺如沙皮，焦黄如烘糕，并舌底俱干燥，敛束如荔枝肉，而满舌却甚胖壮，每天进稀糊一碗左右，大便半月未行。于是说：若论外表现象，百无一治，幸好脾气不泻，胃气不绝，尚有生理，只是服药后神得收敛而睡，脉得静细而沉才好。遂以大剂养荣汤，重加附子给他，服完后果然睡，脉亦平和。四服药后舌转红润，恶症悉退，频进稀粥。只是进入阴分时，尚有微热，大家都怀疑阳药助火，想要去掉黄芪、白术、肉桂、附子。回答说：劳伤脾肺，气虚发热，非甘温不能除，方嫌火力不及，不能蒸土回阳推出邪气耳。等到药力到达，地气升而为云，则天气降而为雨，顷刻为清凉世界矣。守方十二剂，始战汗，汗后身冷如冰，问之不应，推之不理，有人问其原因。回答说：此病既到今日，断然不死，不过是汗后亏其外卫之阳，故身倦懒言，无气以动，子刻自平复。后来果然如此。次日想排便，扶至厕所，虚坐努责。数日后，忽然小便癃闭，点滴不能出，小腹胀痛不可言。这是因为大便弥月不行，肠胃所积已多，现在频繁加努责，将宿物推迸大肠，致壅塞膀胱，所以癃闭不出。须以轻清之剂升降之，则小水自利。立即煎补中益气汤与之饮用，顷刻即通，大便亦润。继以养荣汤作丸，用补中益气汤煎送之，两个月而健。
马元仪治疗沈某，发热恶寒，头身俱痛，燥渴谵语，诊脉洪数而涩。这是外感而病危者，因为五志过极，阴气素亏，邪复乘之，重伤其阴，而火热愈甚也。先与解肌药一剂，恶寒已去而热未除，谵语转增，神魂飞越。盖肝藏血而舍魂，心藏脉而舍神，木火太过，不独自伤，且贼真阴之气，以肝肾为母子，其气相通也。心本制于肾，而亦伤肾者，脏邪暴甚，反侮所不胜也。法当养肝之阴，使不诛求于肾，而水自充；抑心之阳，使不扰乱乎肾，而水以安。用生地、知母、甘草、茯神、丹参、贝母、花粉等，一服药见效，三服药痊愈，调理而安。
丁某，经期二十余天，诊脉左手弦数兼涩，右手涩结少神，发热神昏谵语，胸中满结拒按，舌苔黑刺，面色枯瘁，时有咳嗽，日晡愈甚。这是肝木内鼓，心火上炎，肺金失养，而胃土无滋也，用栝蒌、枳实、半夏曲、芦根汁、紫菀、杏仁、苏子等。服后卧片刻，神气顿清，右脉亦透，但涩象不减，重按少神，舌上苔刺去而复生。这是津液元气虚竭之甚，转用人参三钱，生首乌一两，知母、生地、川连、芦汁，两服药后，脉涩减，症渐安。但胎未尽去，中脘滞闷，前方加枳实、山楂肉，一服药顿愈。次用滋阴补虚之品，二服药后诸症悉退，左脉尚和，右脉转浮而数，微热发疹。这是正气来复，余邪尽从外达也，给予荆芥炭、牛蒡子、干葛、防风、杏仁、桔梗、苏子、薄荷清透之品。二服药后，再用益元散滋阴润燥，调理而愈。
一位妇人，四十多岁，头痛发热，口干便秘，不眠，已一个多月了。这是邪风外煽，实热内燔，表里邪结之候也。前所用药物，也是发表攻里，而不愈者，是药不胜病耳。今上下分消，表里交治，而于攻发之中，仍用温养，这样汗不伤于过，下不伤于峻也。用荆芥、防风、薄荷、麻黄轻阳发表，使邪从汗而散于上，大黄、芒硝、栀子、滑石通幽利水，使邪从便而泄于下，黄芩、连翘清其上，白芍、甘草和其中，桔梗、石膏开其肺，川芎、当归、白芍养其肝，一服药后减轻，三服药后安定。
安氏的儿子，二十岁，初得恶寒发热身痛症，诊得内伤之脉，而显阳微之象，说：此病枝叶未害，根本先拨，乃阳虚受邪症也。若误行表剂，则孤阳飞越，而危殆立至。当用参、术等大培元气，以摄虚阳，加桂枝透表以散外邪。不信，过了四天，发热不休，自汗不止，神气外扬。有人还想用柴胡解表之剂。于是说：此症似太阳，而得少阴之脉，当是平素下虚，故真阳上越耳。遂定参 建中汤而别。有人又说外邪初入太阳，表散即愈，若徒进参、 ，适助邪而滋患也。过了三天，症变危笃。再诊，脉几微欲绝，汗出如雨，昏沉欲绝，此非大剂温补，不能挽回，以人参六两，合附桂理中汤，连进三剂，汗渐收，脉微续，神气尚未安和也。复用人参三两，附子五钱，方得阳气内充，余邪尽从外达，两颐透发，渐调而安。（按：是症固属虚，而原有邪热，或与表散，未尝无功。至汗出脉复，第以大剂养阴，其危立已。乃久用桂、附，遂致发颐，尚得为善治乎哉？）
魏玉横治疗杨氏儿子，二十岁左右，四月初，因为吃面过饱，午睡醒后即身热头痛。医生给予消散药，到七天痊愈。两天后，因为吃汤圆又发病，仍给予消运药无效，于是用小承气汤攻下，连下粪水两次，皆无燥屎。换医生，给予浓朴、山楂、陈皮、枳壳之类，谷芽用至一两左右，一个多月病不减，而股肉尽落，枯瘠如柴，不食，每天进米汤数盏，寒热往来，小便亦少。最后一个医生教用胆汁导之，胆入而粪不出，又用油烛探之，烛化而粪亦不出。其胆汁与烛油凝注下部，楚不可堪，呼叫之惨，四邻为动，时已四十余日，方治木，邀诊以决早晚。察其脉弦，而迢迢尚有神气，其声尚明亮，按
The physician diagnosed: The pulse is neither floating and tight, how can it be a exterior syndrome? Nor is it deep and solid, how can it be an interior syndrome? Only the heart region shows a large and choppy pulse; this is deficiency vexation caused by overworking the mind. It resembles cold damage (Shanghan), but is not true cold damage. If food and drink are prohibited, the patient will perish from starvation. Therefore, porridge was given, along with Guipi Tang (Restore the Spleen Decoction), and the condition stabilized after five days.
Zhang Luyu treated the wife of Grand Secretary Chen, who had long suffered from emaciation and bone-steaming fever, amenorrhea, and poor appetite. She accidentally contracted wind-heat coughing and mistakenly took two doses of Ziyin Qingfei Tang (Nourish Yin Clear Lung Decoction), resulting in coma, high fever, and severe chest and epigastric oppression. (Generally, when a person with chronic deficiency suddenly contracts an external pathogen, careful examination is required.) Upon diagnosis, the Renying pulse was deficient and rapid, the Qikou pulse was soggy and fine, the Cunkou pulse was fleeting (Piepiewei), and both Chichi pulses were firm against the finger. This indicates deficiency of Liver blood and Stomach Qi, compounded by wind-heat invasion. A small dose of Congbai Douchi Tang (Scallion White and Fermented Soybean Decoction) was administered, relieving heat and oppression after one dose. However, cough, headache, and slight sweating persisted, so a small dose of Baoyuan Tang (Protect Origin Decoction) was given, leading to recovery.
Wang's son contracted a cold in April, presenting with confused fever, wheezing, abdominal distension, constipation, and borborygmi. He took Xiaoshi (Niter) and Dahuang (Rhubarb) without effect. The Qikou pulse was wiry and slippery, becoming hollow (Kou) upon pressure; the abdomen was full and soft to touch. This is a pattern of phlegm-dampness clumping with turbid yin pathogens causing closure. Huanglong Tang (Yellow Dragon Decoction) was modified by removing Mangxiao (Mirabilite) and replacing it with Guizhi (Cinnamon Twig), Huangqin (Scutellaria), Banxia (Pinellia), and Muxiang (Aucklandia), expelling much accumulated filth. Due to a chronic history of dawn cough, a small dose of Yigong San (Benefit the Work Powder) with Xixin (Asarum) was added for moistening. Generally, abdominal rumbling suggests internal excess requiring purgation, but here there is no dryness accumulation, hence Mangxiao is avoided in favor of Muxiang, Huangqin, and Banxia. Renshen (Ginseng) is used to support Stomach Qi and propel the medicinal force, allowing Dahuang and others to break through the enemy; it is not merely for tonifying deficiency. Note that using Renshen in Huanglong Tang sharpens the power of Xiaoshi and Dahuang; users must exercise caution.
Qian Shunsuo had chronic internal injury and contracted cold due to overexertion, presenting with fever and headache. Several doses of diaphoretics caused chest and diaphragmatic oppression; purging with Dahuang worsened the oppression. Another physician used qi-breaking and digesting drugs, excessively damaging Stomach Qi, leading to cold limbs, unconsciousness, and critical condition. The six-pulse positions were minute and fine as spider silk; the tongue was scorched black and extremely dry. This is heat injuring Yin blood; if not urgently purged, True Yin will wither instantly, making rescue impossible. Shengdi Huanglian Tang (Rehmannia and Coptis Decoction) was modified by removing Huangqin and Fangfeng, adding Renzhonghuang (Human Excrement Charcoal), Maidong (Ophiopogon), and Jiuhuang (Wine-processed Rhubarb). Additionally, 50g of Shengdihuang (Fresh Rehmannia Root), soaked in wine and juiced, was mixed and taken. At midnight, six or seven pieces of dry stool were passed; another passage occurred at dawn. Then, Shengmai San (Generate the Pulse Powder) was given for two doses. Thereafter, no medicine was taken; only millet porridge was consumed for nourishment. Although bowel movements ceased for several days, the anus felt burning and urgent, so a suppository method was used to unblock it, followed by Yigong San for regulation, leading to recovery.
Yang Chengliu treated Lady Shen suffering from a febrile disease, with body heat, bitter taste, hypochondriac pain, and dizziness. Diaphoretics were administered, worsening the heat, turning the tongue black, lips parched, causing thirst, irritability, swollen painful hands and feet, difficult defecation, and scanty dark urine, disrupting sleep and eating. The pulse was floating, rapid, and disordered, indicating liver depression leading to external contraction. Excessive diaphoresis led to blood deficiency and Yin deficiency, generating fire, dryness, and wind. Zishui Qinggan Yin (Nourish Water Clear Liver Infusion) with doubled Shudihuang (Prepared Rehmannia Root) was given; all symptoms resolved after one dose. Subsequently, Guipi Tang (Restore the Spleen Decoction) minus Muxiang, plus Baishao (White Peony) and Danpi (Moutan Bark), regulated the condition to cure. Over a year later, postpartum, she contracted illness again due to labor. Fearing recurrence, she avoided diaphoretics and solely used Yin-nourishing herbs, leading to loose stools, anorexia, shortness of breath like asthma, insomnia, and visual hallucinations of a white-haired old woman sitting before her, with palpitations and mental unrest. Upon re-diagnosis, the physician said: "Those who lose Yang see ghosts; these are not real ghosts." Great Yang deficiency causes the Spirit to leave its residence; what is seen is the unsettled Yuan Shen (Original Spirit). Men see male forms, women see female forms. Deficiency in a specific Zang organ manifests that organ's color. The pulse was floating and fine as silk, deep and slow-large but powerless; complexion pale, eyes scattered, tongue dry yet tender, white and slippery. This is Middle Jiao deficiency with external contraction, aggravated by cold-cooling herbs, further depleting Yang and allowing Yin to invade. Shenfu Yangrong Tang (Ginseng and Aconite Nourish Nutrient Decoction) with increased Zaoren (Sour Jujube Seed), Baishao, and Wuweizi (Schisandra) was given. The hallucination ceased, and she slept soundly. Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Baishao and Wuweizi cured her after several doses.
Jian suffered from a febrile disease with fever, fullness, and mental lethargy, having not defecated for eight days. Physicians' attempts at releasing the exterior and purging the interior failed, worsening the condition. The pulse was slippery and forceful; face congested and red, breathing coarse, tongue coating thick yellow and dry, slight chest pain on pressure. This is a febrile disease complicated by food stagnation, commonly called "Stagnant Food Cold Damage." Xiaoyao San (Free and Easy Wanderer Powder) with 60g of Shudihuang was prescribed. Someone asked: "With such fever and fullness, how can tonics be used?" The response: "This acts as a substitute for Mahuang (Ephedra), Guizhi, Mangxiao, and Dahuang in releasing the exterior and purging the interior." (This method is clever but should be used after attempting exterior release and interior purging.) After taking it, profuse sweating and bowel movement occurred, heat subsided, and distension resolved. One dose produced sweating; two doses expelled over ten pieces of black stool, curing all symptoms. Explaining the rationale: Initially, Xiaoyao San combined with Xiao Chaihu Tang (Minor Blue Green Dragon Decoction) should have been used to sweat open the muscles and assist the Spleen in digesting food. However, wind-dryness mixed with the exterior and dried intestines/stomach caused the old matter to bind tightly. Using Xiaoyao San with heavy Shudihuang nourishes Yin; overflowing Yin fluids induce sweating, and descending Yin moisture facilitates bowel movement. Liu Jun Zi Tang (Six Gentlemen Decoction), Danggui (Angelica Sinensis), and Baishao completed the cure.
Wu suffered from a febrile disease, starting with mild chills then high fever, dizziness, nausea, continuous salivation, distension, reluctance to speak, difficulty breathing, numb and sore limbs, severe lower back pain, loss of appetite and sleep, and constipation. Doctors gave summerheat-resolving, exterior-releasing, and digestion-promoting herbs, worsening heat and distension, causing frequent fainting. The left wrist pulse was deep and fine; the right was slow-large but powerless; complexion pale; tongue tender with white slippery coating. This indicates Yang deficiency from excessive sexual activity leading to external contraction. Yangrong Tang (Nourish Nutrient Decoction) with Fuzi (Aconite) was prescribed. Doubts arose: "Why use warm tonics for severe heat and distension?" The answer: "Take this, and symptoms will recede. Using Huangqin, Huanglian, Zhishi (Immature Bitter Orange), and Zhi Ke (Tangerine Peel) would be a grave error." One dose allowed sleep; waking brought complaints of extreme cold, followed by profuse sweating within half an hour. Two doses relieved chest tightness, improved appetite, normalized bowels, and reduced heat. Additionally, he had chronic ulcers on the outer thighs for six to seven years, oozing pus, painful and itchy, unresponsive to topical treatments. The physician explained: "Diseases have internal and external aspects, but share one source. This is due to chronic Yang deficiency preventing downward transmission, causing toxic factors to sink rather than rise." Taking the previous formula as pills long-term would replenish Yang, warm Qi and Blood, expel toxins, and heal the sores. Recovery occurred in two months.
Pan returned south from Beijing, exhausted and chilled, with fever and intermittent chills. Diaphoretics intensified the heat; clearing fire and nourishing Yin worsened it. Upon arrival home, the tongue coating turned from white to yellow, then scorched, dry, cracked, and black as charcoal. Mental lethargy, tremors, picking at empty air, spontaneous sweating, and critical signs appeared. Seeing the heat, a doctor attributed "cold not resolving" to water deficiency, prescribing Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia), which failed. Seeing the tongue, another attributed it to excessive purging drying Stomach Yin, prescribing Zuogui Yin (Left Restoring Infusion), which also failed. Diagnosis revealed the left Cun and Guan pulses were large and slow; the tongue was swollen and puffy. This indicates Yang deficiency and Fire decline, not Yin deficiency with Fire hyperactivity. Yin deficiency with Fire hyperactivity presents with a firm, shriveled, aged tongue. Although scorched and dry, the tongue is puffy and tender, and symptoms worsened with Liuwei and Zuogui, confirming Yang deficiency. Yangrong Tang with 15g Renshen and 9g Fuzi was given. One dose ensured a night's sleep; by morning, the coating vanished, revealing a tender, ruddy tongue. Reducing Renshen by 6g and Fuzi by 4.5g, four doses restored Yang, induced sweating, and cured the illness.
Dai's son, 24, had febrile disease with chills and fever. Diaphoretics caused delirium and mania. Bitter-cold purgatives caused multiple critical symptoms. Cooling and Yin-nourishing herbs (Donggu, Mudong, Shidi, Shudihuang, Shihu, Huangqin) for five to six doses worsened the mania. Diagnosis showed a spiritless white face, slippery tongue without coating, and fine-tight powerless pulse, indicating Cold in the Viscera and impending collapse of True Yang. Yangrong Tang with 15g Renshen and 9g Fuzi was prescribed. Knowing he was obstructed by dissenting opinions, the physician instructed monitoring his feet until they reached the knees between Wu and Shen hours (11 AM - 3 PM); if so, death would occur between Hai and Zi hours (9 PM - 1 AM). This proved true. Medication was administered from Xu to Hai hours. After Zi hour, warmth returned from waist to feet; half a bowl of porridge at Wugeng (3-5 AM) allowed sound sleep. Ten more doses cured all symptoms. Half a month later, sudden pain and contraction of the tendon in the right big toe occurred. Surgeons applied Rushiang (Frankincense) and Moyao (Myrrh), intensifying pain. Re-diagnosis revealed Spleen injury from worry failing to nourish the meridian tendons, causing tendon contraction and dryness. Guipi Tang minus Muxiang plus Baishao cured it in several doses.
Lu's son had a febrile disease with fever, cough, shortness of breath like asthma. Diaphoretics worsened it, causing tidal waves of phlegm, delirium, and picking at empty air. Light pressure on the pulse filled the fingers; heavy pressure was empty. Complexion pale, eye sockets wide, Shen Shui (Spirit Water) scattered, tongue coating tender yellow with scorched center, hand tremors. The disease originated from Qi deficiency contracting external pathogens; harsh diaphoretics robbed Yin, threatening its extinction, while Yang lacked attachment, threatening collapse. Saving Yin and grasping Yang was necessary. Zuogui Wan (Left Restoring Pill) minus Fuling (Poria) plus Renshen and Wuweizi, decocted strongly, was given. Sleep ensued immediately; waking after six hours, heat cooled, cough stopped, asthma settled, and phlegm cleared. Shengjin Zishui Yin (Generate Metal Nourish Water Infusion) for one dose, then Yangrong Tang for four doses, achieved complete recovery. His widowed mother had been bedridden for two years. Treated as Warm Disease or Flaccidity Syndrome with no effect. Her pulse was large but powerless; complexion sallow; tongue fat and slippery. Anorexia, early satiety, dreaming of ghosts, and chest palpitations upon waking indicated Mingmen Fire decline, Yuan Shen exhaustion, Spleen Earth failure to generate, and limb immobility. Yangrong Tang decocted with Bajun Wan (Eight-Gentleman Pill) cured her in less than a month.
Shen had a febrile disease with body heat, spontaneous sweating, alternating chills, fatigue, reluctance to speak, hot palms/soles, worse at night. Diaphoretics intensified heat, causing thirst, delirium, irritability, and constipation. Mixed cold-cooling and detoxifying herbs led to critical condition. Pulse was flooding, rapid, and non-resisting upon pressure; complexion pale red and shifting; tongue black and moist; cold extremities. This is false heat. Bawei Yin (Eight-Ingredient Infusion) with Renshen was prescribed. Physicians argued against Renshen, Rougui (Cinnamon Bark), and Fuzi due to apparent fire symptoms. The physician replied: "Externally resembling excess heat, internally severe cold. Initial misused diaphoretics damaged fluids causing thirst and constipation. Subsequent cold-coolers forced Yin down, disturbing Longlei Fire (Dragon and Thunder Fire). Only Renshen, Fuzi, and Rougui can reverse this." Skeptics tested applying a Fuzi cake to the umbilicus for an hour, feeling relief. Medicine was then administered; within an hour, facial redness vanished, and delirium/irritability ceased. Shengjin Zishui Yin and Buzhong Yiqi Tang regulated him to health. Half a month later, his father critically fell ill with a febrile disease. Tongue was black, withered, cracked with human-character patterns. The physician said: "No need to check the pulse." Asked why, he replied: "Kidney Qi rushing to the Heart; this is also a Bawei Yin pattern. Misusing Huangqin and Huanglian is incurable." Indeed, the father had taken those herbs. Asked how he knew, he said: "It is clearly shown on the tongue. Pulse is hidden and unreliable; tongue is manifest and evidence-based. Why check the pulse?" The father died the next day.
Zhu, 54, contracted a cold from winter labor, with headache, fever, and chills. Excessive exterior-releasing led to dry mouth, constipation, and persistent high fever. Bitter-cold fire-clearing herbs caused oily head sweat, mandibular detachment, drooling, sawing snore, confusion, picking at clothes, and grasping at air—every evil sign present. Pulse was flooding, rapid, and restless, vanishing under heavy pressure. Tongue rough, prickly like sandpaper, scorched yellow like baked cake, base dry, constricted like lychee flesh, yet the tongue body was very fat. Daily intake was only a bowl of thin paste; no bowel movement for half a month. The physician stated: "Exteriorly hopeless, but fortunately Spleen Qi hasn't collapsed and Stomach Qi remains, so life persists. Ideally, after medication, Spirit converges into sleep, and pulse becomes quiet, fine, and deep." Large-dose Yangrong Tang with heavy Fuzi was given. Sleep ensued, pulse harmonized. Four doses turned the tongue ruddy, evil signs retreated, and thin porridge was frequently consumed. During Yin hours, slight heat remained. Others suspected Yang herbs aided fire and wanted to remove Huangqi (Astragalus), Baizhu (Atractylodes), Rougui, and Fuzi. The physician explained: "Labor injury to Spleen/Lung, Qi deficiency fever requires sweet-warm herbs to resolve. I fear the fire power is insufficient to steam Earth, restore Yang, and expel pathogens. When potency arrives, Earth Qi rises as clouds, Heaven Qi descends as rain, creating a cool world instantly." Adhering to the formula for twelve doses triggered a battle-sweat. Post-sweat, body was ice-cold, unresponsive. The physician predicted survival, attributing weakness to Wei Qi Yang depletion, expecting recovery at Zi hour (11 PM - 1 AM). Recovery occurred. Next day, straining to defecate. Days later, acute urinary retention with lower abdominal pain. Prolonged constipation and excessive straining pushed old matter into the Large Intestine, blocking the Bladder. A light, ascending-descending formula (Buzhong Yiqi Tang) restored urination and moistened bowels. Yangrong Wan taken with Buzhong Yiqi Tang decoction cured him in two months.
Ma Yuanyi treated Shen with fever, chills, whole-body pain, dry thirst, and delirium. Pulse was flooding, rapid, and choppy. This critical external contraction resulted from extreme emotional stress and chronic Yin deficiency, allowing pathogens to injure Yin further, intensifying fire. Jieji (Release Muscle) herb resolved chills but not heat, increasing delirium and spirit flight. Liver stores Blood and houses Hun; Heart governs Pulse and houses Shen. Wood-Fire excess damages itself and steals True Yin. Liver and Kidney are mother-son, their Qi connected. Heart is controlled by Kidney, but here Heart Evil overwhelms, insulting the unconquerable (Water). Treatment: Nourish Liver Yin to stop demanding from Kidney, filling Water naturally; suppress Heart Yang to stop disturbing Kidney, stabilizing Water. Shengdi (Rehmannia), Zhimu (Anemarrhena), Gancao (Licorice), Fushen (Poria with Hostwood), Danshen (Salvia), Beimu (Fritillaria), Huafen (Trichosanthes Root) were used. Improvement in one dose, cure in three, followed by regulation.
Ding had menstruation lasting over twenty days. Left pulse wiry, rapid, choppy; right pulse choppy, knotted, lacking spirit. Fever, coma, delirium, chest fullness/pain refusing pressure, black prickly tongue coating, sallow complexion, occasional cough worse at dusk. Liver Wood stirring internally, Heart Fire flaming upward, Lung Metal losing nourishment, Stomach Earth lacking moisture. Gualou (Trichosanthes Fruit), Zhishi (Immature Bitter Orange), Banxia Qu (Pinellia Fermented), Lugen Juice (Reed Rhizome), Ziwan (Aster), Xingren (Apricot Seed), Suzi (Perilla Fruit) were prescribed. After resting, spirit cleared, Right pulse became accessible, but choppy nature persisted, coating prickle returned. Severe depletion of Jin Ye (Body Fluids) and Yuan Qi (Original Qi). Renshen (3g), Sheng Shouwu (Raw Polygonum Multiflorum, 30g), Zhimu, Shengdi, Chuanlian (Coptis), Lugen juice were used. Two doses reduced choppy pulse and stabilized symptoms. However, lochia remained, causing epigastric stagnation. Zhishi and Shanzha (Hawthorn) were added to the previous formula, curing it in one dose. Yin-nourishing and deficiency-tonifying herbs cured remaining symptoms in two doses. Left pulse harmonious; Right pulse floating-rapid with slight fever and rash. This indicates righteous Qi recovering, residual pathogens exiting externally. Jingtan (Charred荆芥), Niubangzi (Arctium), Gange (Pueraria), Fangfeng (Saposhnikovia), Xingren, Jiegeng (Platycodon), Suzi, Bohe (Mint) for clearing and venting. Yiyuan San (Benefit Origin Powder) for Yin-nourishing and moistening completed the cure.
A woman in her forties had headache, fever, dry mouth, constipation, and insomnia for over a month. Wind-evil fanning externally, excess heat blazing internally, exterior-interior pathogen binding. Previous exterior-releasing and interior-purging herbs failed because the medicine could not overcome the disease. Now, dispersing top/bottom and treating exterior/interior simultaneously, while using warm nourishment during purging/dispersing, prevents excessive sweating and harsh purging. Jingjie (Schizonepeta), Fangfeng, Bohe, Mahuang for light Yang exterior release, scattering pathogen via sweat upwards; Dahuang, Mangxiao, Zhizi (Gardenia), Huashi (Talc) for opening the obscure and promoting urination, draining pathogen via stool downwards; Huangqin, Lianqiao (Forsythia) clearing upper Jiao; Baishao, Gancao harmonizing middle; Jiegeng, Shigao (Gypsum) opening Lung; Chuanxiong (Ligusticum), Danggui, Baishao nourishing Liver. Improvement in one dose, stability in three.
An's son, 20, presented with chills, fever, and body pain. Internal injury pulse detected with Yang deficiency signs. "Branches are unaffected, root is uprooted; this is Yang deficiency contracting pathogen." Misusing exterior-releasers would cause lone Yang to fly away, leading to immediate danger. Renshen and Baizhu should heavily tonify Original Qi to grasp deficient Yang, plus Guizhi to vent exterior and scatter pathogen. Disbelieved. Four days later, unremitting fever, endless sweating, spirit projecting outward. Someone suggested Chaihu (Bupleurum) for exterior release. The physician said: "Resembles Taiyang but has Shaoyin pulse; chronic lower deficiency causing True Yang to float upward." Can Jianzhong Tang (Ginseng and Middle-Establishing Decoction) was prescribed. Others argued: "External pathogen just entered Taiyang; exterior release cures it. Adding Renshen and Huangqi aids pathogen." Three days later, critical condition. Re-diagnosis: pulse nearly imperceptible, sweating like rain, near coma. Only large-dose warm tonics can save. 180g Renshen combined with Fugui Lizhong Tang (Aconite and Cinnamon Regulate Middle Decoction) for three doses gradually stopped sweating, pulse revived slightly, spirit still unsettled. Another 90g Renshen and 15g Fuzi filled internal Yang, expelled residual pathogens via cheeks, and gradual regulation healed him. (Note: This case is indeed deficiency with original pathogenic heat. Exterior release might have had merit. Once sweating stopped and pulse returned, large-dose Yin nourishment should have sufficed. Prolonged use of Guizhi and Fuzi caused parotitis; is this truly good treatment?)
Wei Yuheng treated Yang's son, ~20 years old. Early April, overeating noodles caused fever and headache upon waking from nap. Doctors used dispersing herbs, curing him in seven days. Two days later, eating tangyuan (glutinous rice balls) caused relapse. Digestion-promoting herbs failed. Xiaochengqi Tang (Minor Yellow Dragon Decoction) was used for purging, passing fecal water twice without dry stool. Other doctors used Houpo (Magnolia Bark), Shanzha, Chenpi (Tangerine Peel), Zhike (Tangerine Peel), and massive amounts of Guya (Sprouted Grain) for over a month without improvement. Thigh muscles wasted away, emaciated as firewood, anorexia, drinking only a few cups of rice soup daily, alternating chills/fever, scanty urine. Last doctor advised bile enema; bile entered but no stool passed. Oil candle probe melted but no stool passed. Bile and oil condensed in the lower part, causing unbearable pain and screaming neighbors. After 40+ days, treatment stalled, consultation sought to predict lifespan. Pulse was wiry but long and spirited; voice bright. Palpating...