病势转甚，延治。问曰∶肚中饥否？曰∶饥。索其日所用药，则芩、连、枳壳、花粉、浓朴之属。笑曰∶但吃
饭，病即除矣，无庸此等药也。病者喜甚，曰∶吾本无食，医言有食，故耐此数日饥耳。然便秘云何？曰∶致
新则推陈矣。胃中久无谷气，故前物积而不下，且子之发热多汗，一味虚症，遂用参、术调理而愈。
立斋治州同刘禹功，素不慎起居七情，以致饮食不甘，胸膈不利。用消导顺气，肚腹痞闷，吐痰气逆。用
化痰降火，食少泄泻，小腹作胀。用分利降火，小便涩滞，气喘痰涌。服清气化痰丸，小便愈滞，大便愈泻，
肚腹胀大，肚脐突出，不能寝卧。六脉微细，左寸甚虚，右手短促，此命门火衰，脾肾虚寒之危症也。先用
《金匮》加减肾气丸料，肉桂、附各一钱二分，二剂，下瘀秽甚多。又以补中益气送二神丸，二剂，诸症悉退五
六。又用前药数剂，并附子之类，贴腰脐及涌泉穴，六脉渐和而安。后因怒腹闷，惑于人言，服沉香化气丸，
大便下血，诸症悉至。曰∶此阴络伤也，辞不治，果段。
吴浓先治薛氏子，吐血止后，忽患心跳振衣，或时惊恐，用熟地一两，山药五钱，女负、山萸、枸杞各三
钱，服二十余帖，本方加元武胶为丸，症顿减。间药一日即跳动，偶一医用六君子，加补心镇心之品，症复增。
吴曰∶此心跳，乃虚里之动也。经曰∶胃之大络名虚里，贯膈络肺，出于左乳下，其动应衣，宗气泄也。凡患
肾虚劳怯者，多见此症。肾属水而肺主气，气为水母，肾虚不纳，故宗气上泄，而肾水愈竭于下。欲纳气归元，
惟补阴配阳为是耳。
按∶凡治小儿，不论诸症，宜先揣此穴。若跳动甚者，不可攻伐，以其先天不足故也。幼科能遵吾言，
造福无涯矣。此千古未泄之秘也，诊之贵之。
高鼓峰诊杨在公，六脉动甚，因语之曰∶脉紧而弦，不出一月危病至矣。定方而别，斯时无甚病。至十月
中，忽患咳嗽，医作风寒治，数以羌活与之。十余日，遂大吼喘，痰涌如潮，作 声，不得卧，坐一人于床，
以额俯靠其背，稍抬头即喘急欲死。走人邀诊，曰∶以前脉推之，病根固深，然不宜困败如此之速也。此殆攻
伐之药，逼成之耳，无救矣。病家只哀求定喘。曰∶定喘不难，无如脉色皆去，纵喘定之后，仍虚脱而死矣。
遂朝用参、 、归、芍，暮用加减八味，三日而能卧，饮食倍进，其家甚喜，以为得生。高曰∶出入废则神机
化减，升降息则气立孤危。今出入升降俱废息矣，纵挽回何施？兹不过暂留命门一丝未断之气，逾十日必死矣。
已而果然。向使病未见之先，预行补救，可以消患于未萌。即已见之后，医能以大剂填补峻补之药投之，即不
能如奋，尚可稍延岁月，不至若是之促。此可为妄肆攻伐之戒。
徐次 病咳嗽，高细诊其脉，六部皆动。因问徐嗜酒乎？曰∶然。服天麦冬、知、贝母、生地等类乎？曰∶
服逾斤许矣。高曰∶君病与此药相反，可禁勿服。写归脾汤、六味丸两方与之。高归语友人曰∶次 病，即《素
问》所谓二阳病发心脾也。其人必劳心过度，又嗜酒多欲，急救三阴，乃为良法。医以阴寒逼之，火无所发泄，
遂成燎原之病。今六脉纯是阴火，有出无入，不逾年死矣。或谓次 无恙，不过患伤寒耳，何遽至是？曰∶脉
法当如是耳。八月中，高适寓孤山，徐邀游天竺。曰∶闻子善太素脉，乞为我诊，辛丑可得第否？高曰∶太素
两字，出在三坟，后入窃之，以欺天下之耳目，且造为歌诀，妄言祸福，轩岐无是也。但《素问》自有一种荣
枯寿夭，贫富贵贱，得失成败之说，要不出乎吉凶悔吝，善恶逆从之理，其道精微，然我能约略言之，诊毕，
语之曰∶辛丑固好，然不若甲辰更得当也。（云云者，固知其将死，欲阻其北上耳。）次问寿。曰∶子年甫
三十外，不必问寿。察其意，惟以科名为急耳。不及病情，难以直言。因语其尊人，使急返石门。告之曰∶令
郎脉气不佳，如北上其不返乎？曷阻之。曰∶予固阻之，弗能止也。固为制大料参膏，令戒酒绝色，服之庶可
冀其还家。如或似火而用寒凉药则殆矣。到京后，闽人有以前说进者，信之，用发散寒凉，不十剂，吐血而殁。
张路玉治颜氏女，虚羸寒热，腹痛里急，自汗喘嗽者三月余，屡更医不愈，忽然吐血数口。脉之，气口虚
涩不调，左皆弦微，而尺微尤甚。令与黄 建中加当归、细辛。或曰∶虚涩失血，曷不用滋阴降火，反行辛燥
乎？曰∶不然。虚劳之成，未必皆本虚也，大抵皆由误药所致。今病欲成劳，乘其根蒂未固，急以辛温之药，
提出阳分，庶几挽回前失。若仍用阴药，则阴愈亢，（亢字未妥。）而血愈逆上矣。从古治劳，莫若《金匮》诸法，
如虚劳里急诸不足，用黄 建中汤。即腹痛悸衄，亦不出此。加当归以和荣血，细辛以利肺气，毋虑辛燥伤血
也。遂与数帖，血止。次以桂枝人参汤，数服腹痛寒热顿除。后用六味丸，以枣仁易萸肉，或时间进保元、异
功、当归补血之类，随症调理而安。
胡念安治王在廷之室，病虚劳十余载，喘促吐沫，呕血不食，形体骨立，诸医束手。诊之，见其平日之方
皆滋阴润肺温平之剂，曰∶以如是之病，用如是之药，自然日趋鬼道矣，焉望生机？仲景云∶咳者则剧，数吐
痰沫，以脾虚也。又昔贤云∶肾家生阳，不能上交于肺则喘。又云∶脾虚而失生化之原则喘。今脾肾败脱，用
药如此，安望其生？乃重投参、 、姜、附等，二剂而喘定。缘泄泻更甚，加萸、寇十余剂而病减十七。又灸
关元，因畏痛，只灸五十壮，迄今十余年，体大健。（《医林指月》。凡虚损病，能受温补者，原极易治。古人
医案所载，大半俱系此症，其实与阴虚内热之虚劳病，了没交涉也。）
一董姓者，壅正三年初冬来求诊脉，其脉或二动一止，或七动一止，或十二动，或十七动一止，此心绝脉
也。仲冬水旺，其何能生？姑定参、 、茸、附、河车、脐带、桂心、枣仁等方与之。服十剂，脉之歇止参差，
不似前之有定数也。又十剂，而歇止少矣。又十剂，六脉如常矣。噫！不可谓之无功也。且知治早，虽不用丹、
艾，亦有可生全者。（同上。）
昔蜀中一道人，童颜漆发，眉字疏秀，自歌曰∶尾闾不禁沧海竭，九转神丹都漫说，惟有斑龙顶上珠，
能补玉堂关下穴。按∶斑龙珠乃鹿茸，鹿之精血结而为角，性温大补精血，元阳相火虚者宜之。或加于六味
地黄丸中，亦妙。（《治法汇》，张三锡。）
张三锡治一人咳嗽，已成劳极，用四物、知、柏不愈，乃以秦艽鳖甲散，加二母、二冬，十数剂而愈。
陆祖愚诊傅小泉室，高年患湿痰症。暑月，或与香燥过多，反增头晕口渴，眼花不寐，饮食少进，骨节酸
疼。诊得左寸洪数，关尺细涩，右手浮滑，关尺沉细，且九至一止，曰∶此血虚痰火也。论症尚有治法，独是
右关尺歇止有常数，便不可为矣。凡血虚症，即是肝病，大都庚日笃，辛日危，况立秋在迩乎。或闻而非之，
乃与养血清火，消痰顺气之剂，果觉有验。十剂后，竟可步至中堂，料理家务，每日约进粥十余碗，人皆谓能
起死为生矣。忽一日小腹作痛，冷汗不止，至夜半，不知人事，次日酉时死矣。小泉不忘前言，检历视之，果
是辛日也。
陈三农弟，昏倦发热，头痛恶风。因中气太虚，元气下陷，阳气不充而头痛，形气衰少而内热。用调中益
气汤加葛根一剂而安。更制脾肾丸，服逾月而愈。
治一贵妇，咳嗽泄泻，咳嗽甚则泄泻愈，泄泻甚则咳嗽略止，午前微寒，午后微热。此皆脾胃虚弱，痰涎
随虚火上潮，则咳甚而泻止，痰涎随虚火下注，则泄甚而咳止。不必治其诸症，但补养脾胃自愈。用保元汤，
加炒松花、干姜、五味、破故纸，八剂而咳嗽寒热皆除，又八剂而泄止。（雄按∶未必尽然，须凭于脉。）
薛立斋治一妇人，发热晡热，盗汗自汗，殊畏风寒，饮食少思，或腹痛吞酸，或大便不实。此脾胃诸经不
足，气血亏损，朝用补中益气，夕用八珍汤，倍用参、 、白术，各二十余剂，寻症渐愈。因丧母哀伤，盗汗
便血，用加味归脾汤，数剂而止。仍用前二药，又五十余剂，寻愈。月经两月而至，适因怒，去血过多，发热
作渴，肢体酸倦，头目晕痛，用逍遥散，加味归脾汤二药调补痊。
一妇人饮食少思，胸膈不利，或胸中作痛，或大便作泻，或小便不利，用逍遥散加山栀、茯神、远志、木
香而愈。后因怒，寒热往来，倦怠烦热，以前药加炒黑黄连三分顿愈，用八珍汤调理。后因怒，吐血燥渴，用
人参五钱，芩、术、当归各三钱，陈皮、甘草各一钱，治之而愈。
一妇人内热口干，头晕吐痰，带下体倦，饮食少思。此脾气虚弱而不能生肺金，用补中益气汤加茯苓、半
夏，脾气渐强，饮食渐进，诸症渐退。再用加味逍遥散治之，寻愈。
一妇人日晡热甚，月水不调，饮食少思，大便不实，胸膈痞满，头目不清，肢体倦怠，发热烦躁。此七情
肝脾亏损之症，用济生归脾汤，加味逍遥散，补中益气汤调治，元气渐复而愈。
一妇人胸胁膨满，小腹闷坠，内热晡热，饮食不甘，体倦面黄，日晡则赤，洒淅恶寒。此脾肺气虚，先用
六君加川芎、当归，诸症渐愈。又用补中益气加茯苓、半夏，诸症全愈。然饮食失节，劳怒，恶寒发热，不食，
用加味小柴胡，二剂而热退。用逍遥散、归脾汤，调理而愈。
一妇人月经不调，饮食少思，日晡热甚。此肝脾气血俱虚，用十全大补加山药、山茱、丹皮、麦冬、五味
而愈。次年秋，寒热如疟，仍用前药而愈。
沈大方室赵氏，初患痰喘热渴，或以降火散气治之，肌日削而气日索。延至甲辰，木旺痰盛，身热口腐，
腹胀神昏，绝食。此乃虚热无火，薛投壮水生土之剂随愈。至戊申夏初，坐则头坠不能视，卧则背冷透体，烦
热晕眩，咳呕痰涌，手足麻冷，势成危殆。薛曰∶此内真寒，而外假热也。遂与姜、附大补之剂，三四剂，势渐
安。仍以前药加减而愈。（此沈自述之案。）
胡念庵治一中年妇，夜热咳嗽，本小疾耳。为张、李二医合用滋阴退热药（应是苦寒之剂。）月余，致面青
脉急，喘促吐血呕沫，日数升，饮食不进，二医束手，覆而不治。胡为重用参、附十余剂而安。此非其本原
受亏，乃误药所致，故易收功也。（《医林指月》。）
立斋治一儒者，每春夏口干发热，劳则头痛。服清凉化痰药，泻喘烦躁。用香薷饮，神思昏愦，脉大而虚。
此因闭藏之际，（冬月。）不远帏 为患，名曰注夏。（凡禀赋薄弱，即小儿亦多此病。）用补中益气汤去升麻、
柴胡，加五味、麦冬、炮姜，一剂脉益甚。仍用前药，加肉桂五分，服之即苏。更用六味丸而痊。
司空何燕泉，小便赤短，体倦食少，缺盆作痛。此脾肺虚弱，不能生肾水，当滋化源，用补中益气、六味
丸，加五味而安。
庶吉士黄伯邻，发热吐痰，口干体倦，自服补中益气汤不应。薛谓此金水俱虚之症，兼服地黄丸而愈。后
背患一疖，烦痛寒热，彼尝偕视郭主政背疽，郭不经意，决其殒于金旺之日。果然。已而郭氏妻孥感其毒，皆
患恶疮，黄所患与郭同，心甚恐。曰∶此小疮也，憎寒等症，皆阴虚旧症，果是疮毒，亦当补气血。乃以地黄
丸料煎与服之，即睡良久，各症顿退。自后常有头面耳目口舌作痛，或吐痰眩晕，服四物、黄连、黄柏愈。
少司空何潇川，足热口干，吐痰头晕，服四物、黄连、黄柏，饮食即减，痰热益甚。用十全大补加麦冬、
五味、山药、山茱萸而愈。
薛甥凌云霄，年十五，壬寅夏，见其面赤唇燥，形体消瘦，曰∶子病将进矣。癸卯冬，复见之。曰∶子病
愈深矣。至甲辰夏，胃经部分有青色，此木乘土也，始求治。先以六君加柴胡、白芍、山栀、芜荑、炒黑连，
数剂，及四味肥儿、六味地黄二丸，及参、苓、白术、归、芍、山栀、麦冬、五味、炙草，三十余剂，肝火渐
退。更加柴胡、胆草二十余剂，乃去芍加肉桂，三十余剂，及加减八味丸，元气渐次而复。
一儒者因屡婚，脚腿软痛，面黑食减，恶寒足肿，小腹胀痛，上气痰喘。此少阴亏损，阳气虚寒之症，用
八味丸料煎服，诸症顿除。又服丸剂半载，元气渐充，形体如故。
一男子年逾二十，早于斫丧，梦遗精滑，睡中盗汗，唾痰见血，足热痿软，服黄柏、知母之类。曰∶此阳
虚而阴弱也，当滋其化源。不信，恪服之，前症益甚，其头渐大，囟门渐开，视物皆大，吐痰喊叫。乃如法调
补，诸症渐退，头囟渐敛而安。
一儒者口干发热，小便频浊，大便秘结，盗汗梦遗，遂致废寝，用当归六黄汤二剂，盗汗顿止。用六味地
黄丸，二便调和。用十全大补汤，及前剂兼服月余，诸症悉愈。
朱丹溪治王，二十四，大发热，胁痛，咳嗽红痰，口渴，大便秘，倦怠，脉稍数而虚。询之，发热曾饮水一
病情加重，延请医生诊治。医生问：“肚子里觉得饿吗？”患者回答：“饿。”医生索要患者当天服用的药物，发现是黄芩、黄连、枳壳、天花粉、厚朴之类的药。医生笑着说：“只要好好吃饭，病自然就好了，不需要用这些药。”患者非常高兴，说：“我本来就没有食欲，医生说是食积，所以我忍着这几天的饥饿罢了。但是便秘怎么办？”医生回答说：“进食后就能推动糟粕排出。”因为患者胃中长久没有谷气（食物之气），所以之前的积滞无法下行。况且你的发热多汗，纯粹是虚证，于是使用人参、白术进行调理，最终痊愈。
立斋治疗州同刘禹功，他平时不注意起居和七情调节，导致饮食无味，胸膈不畅。先用消食导滞、顺气的药，出现肚腹痞闷、呕吐痰涎、气逆的症状。再用化痰降火的药，出现食少、泄泻、小腹胀痛。又用分利湿热、降火的药，出现小便涩滞、气喘、痰涌。服用清气化痰丸后，小便更加滞涩，大便更加稀泻，肚腹胀大，肚脐突出，不能躺卧。六脉微细，左寸脉特别虚弱，右手脉短促。这是命门火衰、脾肾虚寒的危重病症。先用《金匮要略》中的加减肾气丸方料，肉桂、附子各一钱二分，服用两剂，排出大量污秽之物。接着用补中益气汤送服二神丸，服用两剂，各种症状消退了五六成。又用前面的药物几剂，并配合附子等药贴敷腰脐及涌泉穴，六脉逐渐调和而安定。后来因为发怒导致腹部闷胀，听信他人言论，服用沉香化气丸，导致大便下血，所有症状再次发作。医生说：“这是阴络受伤了。”推辞不再医治，果然不久去世。
吴浓先治疗薛氏的儿子，吐血停止后，突然患有心跳剧烈、身体颤抖，有时惊恐不安。用熟地黄一两，山药五钱，女贞子、山茱萸、枸杞子各三钱，服用二十多帖，在原方基础上加入龟板胶制成丸药，症状立刻减轻。停药一天就再次跳动，偶然一位医生使用六君子汤，加入补心镇心的药物，症状反而加重。吴医生说：“这种心跳，是虚里的跳动。经书说：‘胃的大络名叫虚里，贯穿横膈联络肺脏，出于左侧乳头下方，其跳动可以透过衣服看到，这是宗气外泄的表现。’凡是患有肾虚劳损怯弱病的患者，多见此症。肾属水而肺主气，气为水之母，肾虚不能纳气，所以宗气上泄，而肾水在下更加枯竭。想要纳气归元，只有补阴配阳才是正确的。”
按语：凡是治疗小儿，不论什么病症，适宜先诊察虚里穴。如果跳动严重的，不可攻伐，因为其先天不足的原因。儿科医生若能遵循我的话，造福将无穷无尽。这是千古未泄露的秘密，诊断时要重视。
高鼓峰诊断杨在公，六脉动数明显，因此对他说：“脉象紧而弦，不出一个月就会有危重病到来。”开方告别，当时并没有很重的病。到了十月中，突然患咳嗽，医生当作风寒治疗，多次给予羌活。十余日后，突然大声吼叫喘息，痰涌如潮，发出声音，不能平卧，让人坐在床边，额头靠在对方背上，稍微抬头就喘急想死。派人邀请医生诊治，医生说：“根据以前的脉象推断，病根固然深，但不至于败坏得这么快。这大概是攻伐的药物逼迫而成的，无法挽救了。”病人家属只是哀求定喘。医生说：“定喘不难，无奈脉象和面色都已败坏，即使喘定之后，仍然会因虚脱而死。”于是早晨用人参、黄芪、当归、芍药，晚上用加减八味丸，三天后能躺卧，饮食加倍增加，家人非常高兴，以为能活下来。高医生说：“出入废则神机化减，升降息则气立孤危。现在出入升降都废弃停止了，即使挽回有什么办法呢？这不过是暂时留住命门一丝未断的气，超过十天必定死亡。”不久果然如此。假如病未见之前，预先补救，可以在祸患未发生前消除它。即使已经见到之后，医生能用大剂量的填补峻补药物投治，即使不能像奋起那样迅速恢复，还可以稍微延长岁月，不至于像这样急促。这可以作为妄自滥用攻伐药物的警戒。
徐次生病咳嗽，高细诊察他的脉，六部皆动。于是问徐是否嗜酒？回答说：“是的。”是否服用了天冬、麦冬、知母、贝母、生地等类药物？回答说：“服用了超过一斤。”高医生说：“您的病与这些药相反，可以禁止不要再服。”写归脾汤、六味丸两个方子给他。高归对朋友说：“次生的病，就是《素问》所说的‘二阳病发心脾’。这个人一定劳心过度，又嗜酒多欲，急救三阴，才是好方法。医生用阴寒药逼迫他，火无处发泄，遂成燎原之病。现在六脉纯是阴火，有出无入，不超过一年就会死。”有人说次生没事，不过是患伤寒而已，怎么这么快就死了？医生说：“脉法应当是这样。八月中秋时，高正好住在孤山，徐邀请游览天竺。说：‘听说你擅长太素脉，请求为我诊脉，辛丑年我能考中吗？’高医生说：‘太素两个字，出自三坟，后来被人窃取，用来欺骗天下人的耳目，并且编造歌诀，妄言祸福，轩辕岐伯没有这个。’但《素问》自有一种关于荣枯寿夭、贫富贵贱、得失成败的说法，总离不开吉凶悔吝、善恶逆从的道理，其道精微，但我能大概说说。诊毕，对他说：‘辛丑年固然好，但不如甲辰年更得当。（云云者，固知其将死，欲阻其北上耳。）’次生问寿命。医生说：‘您年纪刚过三十，不必问寿命。’观察他的心意，只以科名为急迫。不及病情，难以直言。于是告诉他的父亲，让他急忙返回石门。告诉他：‘令郎脉气不佳，如果北上就不回来了吗？何不阻止他。’回答说：‘我确实阻止过他，不能止住。’坚决为他配制大料参膏，让他戒酒绝色，服用或许可以希望他回家。如果用似火而用寒凉药那就危险了。到京城后，福建人把以前的说法进献给他，相信了，用发散寒凉药，不到十剂，吐血而死。”
张路玉治疗颜氏女儿，身体虚弱消瘦，寒热往来，腹痛里急，自汗喘嗽三个多月，多次更换医生不愈，忽然吐血几口。诊脉，气口脉虚涩不调，左脉皆弦微，而尺脉微尤其严重。命令服用黄芪建中汤加当归、细辛。有人说：“虚涩失血，为何不用滋阴降火，反而用辛燥药？”医生说：“不对。虚劳的形成，未必都是本虚，大体都是由误药导致的。现在病欲成劳，趁着根基未固，紧急用辛温药，提出阳分，或许可以挽回前失。如果仍用阴药，则阴更亢盛，而血更逆上。”从古治疗劳损，不如《金匮》诸法，如虚劳里急诸不足，用黄芪建中汤。即腹痛悸衄，也不出此范围。加当归以和营血，细辛以利肺气，不用担心辛燥伤血。于是给几帖，血止。接着用桂枝人参汤，几服后腹痛寒热顿除。后用六味丸，用枣仁代替山茱萸，或间进保元汤、异功散、当归补血汤之类，随症调理而安。
胡念安治疗王在廷的妻子，患虚劳十多年，喘促吐沫，呕血不食，形体骨瘦如柴，众医束手。诊察，见她平时的方子都是滋阴润肺温平的药剂，说：“用这样的病，用这样的药，自然是日趋死亡，哪里指望生机？仲景说：‘咳者则剧，数吐痰沫，以脾虚也。’又说：‘肾家生阳，不能上交于肺则喘。’又说：‘脾虚而失生化之源则喘。’现在脾肾败脱，用药如此，哪里指望她活？于是重用参、芪、姜、附等药，两剂后喘定。因为泄泻更严重，加山茱萸、豆蔻十余剂而病减十分之七。又灸关元穴，因为怕痛，只灸五十壮，至今十多年，身体非常健康。（《医林指月》。凡虚损病，能受温补者，原极易治。古人医案所载，大半俱系此症，其实与阴虚内热之虚劳病，了没交涉也。）”
一个姓董的人，雍正三年初冬来求诊脉，其脉或两次跳动停一次，或七次跳动停一次，或十二次跳动停一次，或十七次跳动停一次，这是心绝脉。仲冬水旺，怎么能生？暂且定人参、黄芪、鹿茸、附子、紫河车、脐带、桂心、枣仁等方给他。服用十剂，脉的歇止参差不齐，不像以前那样有定数。又十剂，歇止少了。又十剂，六脉如常了。唉！不能说没有功效。而且知道治疗早，虽然不用丹砂、艾灸，也有可保全的。（同上。）
从前蜀地有一个道人，童颜黑发，眉宇疏秀，自己唱歌说：“尾闾不禁沧海竭，九转神丹都漫说，惟有斑龙顶上珠，能补玉堂关下穴。”按：斑龙珠乃鹿茸，鹿的精血结而为角，性温大补精血，元阳相火虚者适宜。或者加入六味地黄丸中，也很好。（《治法汇》，张三锡。）
张三锡治疗一个人咳嗽，已成劳极，用四物汤、知母、黄柏不愈，于是用秦艽鳖甲散，加知母、贝母、天冬、麦冬，十几剂而愈。
陆祖愚诊断傅小泉的妻子，高龄患湿痰症。暑月，有人给予香燥药过多，反而增加头晕口渴，眼花不寐，饮食少进，骨节酸痛。诊得左寸洪数，关尺细涩，右手浮滑，关尺沉细，且九至一止，说：“这是血虚痰火也。论症尚有治法，独是右关尺歇止有常数，便不可为矣。凡血虚症，即是肝病，大都庚日笃，辛日危，况立秋在迩乎。”有人听到后非议他，于是给予养血清火，消痰顺气的药剂，果然觉得有效。十剂后，竟可步至中堂，料理家务，每日约进粥十余碗，人都谓能起死为生矣。忽一日小腹作痛，冷汗不止，至夜半，不知人事，次日酉时死矣。小泉不忘前言，检历视之，果是辛日也。
陈三农弟弟，昏倦发热，头痛恶风。因中气太虚，元气下陷，阳气不充而头痛，形气衰少而内热。用调中益气汤加葛根一剂而安。更制脾肾丸，服逾月而愈。
治疗一个贵妇，咳嗽泄泻，咳嗽甚则泄泻愈，泄泻甚则咳嗽略止，午前微寒，午后微热。此皆脾胃虚弱，痰涎随虚火上潮，则咳甚而泻止，痰涎随虚火下注，则泄甚而咳止。不必治其诸症，但补养脾胃自愈。用保元汤，加炒松花、干姜、五味、破故纸，八剂而咳嗽寒热皆除，又八剂而泄止。（雄按∶未必尽然，须凭于脉。）
薛立斋治疗一个妇人，发热晡热，盗汗自汗，殊畏风寒，饮食少思，或腹痛吞酸，或大便不实。此脾胃诸经不足，气血亏损，朝用补中益气，夕用八珍汤，倍用参、芪、白术，各二十余剂，寻症渐愈。因丧母哀伤，盗汗便血，用加味归脾汤，数剂而止。仍用前二药，又五十余剂，寻愈。月经两月而至，适因怒，去血过多，发热作渴，肢体酸倦，头目晕痛，用逍遥散，加味归脾汤二药调补痊。
一个妇人饮食少思，胸膈不利，或胸中作痛，或大便作泻，或小便不利，用逍遥散加山栀、茯神、远志、木香而愈。后因怒，寒热往来，倦怠烦热，以前药加炒黑黄连三分顿愈，用八珍汤调理。后因怒，吐血燥渴，用人参五钱，芩、术、当归各三钱，陈皮、甘草各一钱，治之而愈。
一个妇人内热口干，头晕吐痰，带下体倦，饮食少思。此脾气虚弱而不能生肺金，用补中益气汤加茯苓、半夏，脾气渐强，饮食渐进，诸症渐退。再用加味逍遥散治之，寻愈。
一个妇人日晡热甚，月水不调，饮食少思，大便不实，胸膈痞满，头目不清，肢体倦怠，发热烦躁。此七情肝脾亏损之症，用济生归脾汤，加味逍遥散，补中益气汤调治，元气渐复而愈。
一个妇人胸胁膨满，小腹闷坠，内热晡热，饮食不甘，体倦面黄，日晡则赤，洒淅恶寒。此脾肺气虚，先用六君加川芎、当归，诸症渐愈。又用补中益气加茯苓、半夏，诸症全愈。然饮食失节，劳怒，恶寒发热，不食，用加味小柴胡，二剂而热退。用逍遥散、归脾汤，调理而愈。
一个妇人月经不调，饮食少思，日晡热甚。此肝脾气血俱虚，用十全大补加山药、山茱、丹皮、麦冬、五味而愈。次年秋，寒热如疟，仍用前药而愈。
沈大方妻子赵氏，初患痰喘热渴，或以降火散气治之，肌日削而气日索。延至甲辰，木旺痰盛，身热口腐，腹胀神昏，绝食。此乃虚热无火，薛投壮水生土之剂随愈。至戊申夏初，坐则头坠不能视，卧则背冷透体，烦热晕眩，咳呕痰涌，手足麻冷，势成危殆。薛曰∶此内真寒，而外假热也。遂与姜、附大补之剂，三四剂，势渐安。仍以前药加减而愈。（此沈自述之案。）
胡念庵治疗一个中年妇人，夜热咳嗽，本小疾耳。为张、李二医合用滋阴退热药（应是苦寒之剂。）月余，致面青脉急，喘促吐血呕沫，日数升，饮食不进，二医束手，覆而不治。胡为重用参、附十余剂而安。此非其本原受亏，乃误药所致，故易收功也。（《医林指月》。）
立斋治疗一个儒者，每春夏口干发热，劳则头痛。服清凉化痰药，泻喘烦躁。用香薷饮，神思昏愦，脉大而虚。此因闭藏之际，（冬月。）不远帏 为患，名曰注夏。（凡禀赋薄弱，即小儿亦多此病。）用补中益气汤去升麻、柴胡，加五味、麦冬、炮姜，一剂脉益甚。仍用前药，加肉桂五分，服之即苏。更用六味丸而痊。
司空何燕泉，小便赤短，体倦食少，缺盆作痛。此脾肺虚弱，不能生肾水，当滋化源，用补中益气、六味丸，加五味而安。
庶吉士黄伯邻，发热吐痰，口干体倦，自服补中益气汤不应。薛谓此金水俱虚之症，兼服地黄丸而愈。后背患一疖，烦痛寒热，彼尝偕视郭主政背疽，郭不经意，决其殒于金旺之日。果然。已而郭氏妻孥感其毒，皆患恶疮，黄所患与郭同，心甚恐。曰∶此小疮也，憎寒等症，皆阴虚旧症，果是疮毒，亦当补气血。乃以地黄丸料煎与服之，即睡良久，各症顿退。自后常有头面耳目口舌作痛，或吐痰眩晕，服四物、黄连、黄柏愈。
少司空何潇川，足热口干，吐痰头晕，服四物、黄连、黄柏，饮食即减，痰热益甚。用十全大补加麦冬、五味、山药、山茱萸而愈。
薛甥凌云霄，年十五，壬寅夏，见其面赤唇燥，形体消瘦，曰∶子病将进矣。癸卯冬，复见之。曰∶子病愈深矣。至甲辰夏，胃经部分有青色，此木乘土也，始求治。先以六君加柴胡、白芍、山栀、芜荑、炒黑连，数剂，及四味肥儿、六味地黄二丸，及参、苓、白术、归、芍、山栀、麦冬、五味、炙草，三十余剂，肝火渐退。更加柴胡、胆草二十余剂，乃去芍加肉桂，三十余剂，及加减八味丸，元气渐次而复。
一个儒者因屡婚，脚腿软痛，面黑食减，恶寒足肿，小腹胀痛，上气痰喘。此少阴亏损，阳气虚寒之症，用八味丸料煎服，诸症顿除。又服丸剂半载，元气渐充，形体如故。
一个男子年逾二十，早于斫丧，梦遗精滑，睡中盗汗，唾痰见血，足热痿软，服黄柏、知母之类。曰∶此阳虚而阴弱也，当滋其化源。不信，恪服之，前症益甚，其头渐大，囟门渐开，视物皆大，吐痰喊叫。乃如法调补，诸症渐退，头囟渐敛而安。
一个儒者口干发热，小便频浊，大便秘结，盗汗梦遗，遂致废寝，用当归六黄汤二剂，盗汗顿止。用六味地黄丸，二便调和。用十全大补汤，及前剂兼服月余，诸症悉愈。
The disease condition worsened, and a doctor was invited for treatment. The doctor asked, "Do you feel hungry?" The patient replied, "Yes." The doctor requested to see the medicine taken that day and found it consisted of Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), Aurantii Fructus (Zhike), Trichosanthis Radix (Huafen), and Magnoliae Officinalis Cortex (Houpo). The doctor smiled and said, "Just eat properly, and the illness will resolve; there is no need for these medicines." The patient was very pleased and said, "I originally had no appetite; the doctor said it was food stagnation, so I endured this hunger for several days. But what about my constipation?" The doctor replied, "Once you eat, it will promote the expulsion of waste." Because the stomach had long lacked Guqi (Grain Qi/food energy), previous accumulations could not move downward. Moreover, your fever and excessive sweating are purely due to deficiency. Therefore, treatment with Ginseng Radix (Renshen) and Atractylodis Macrocephalae Rhizoma (Baizhu) was used for regulation, resulting in recovery.
Lizhai treated Liu Yugong, the Prefectural Assistant, who neglected his daily routine and emotional balance, leading to poor appetite and chest diaphragm discomfort. Initially, digestion-promoting and qi-regulating herbs were used, causing abdominal fullness, vomiting of phlegm, and rebellious qi. Then, phlegm-resolving and fire-clearing herbs were administered, resulting in poor appetite, diarrhea, and lower abdominal distension. Subsequently, diuretic and fire-clearing herbs were given, causing dysuria, asthma, and surging phlegm. After taking Qingqi Huatan Wan (Clearing Qi and Resolving Phlegm Pill), dysuria worsened, diarrhea intensified, abdominal distension increased, the umbilicus protruded, and lying down became impossible. The six pulses were faint and thin; the left Cun pulse was particularly deficient, and the right hand pulses were short and rapid. This indicated a critical condition of Mingmen Fire Decline (Declining Fire of the Gate of Life) and Spleen-Kidney Deficiency-Cold. First, modified Shenqi Wan formula from *Jinkui Yaolue* was used, with Cinnamomi Ramulus (Rougui) and Aconiti Lateralis Radix Praeparata (Fuzi) each at one qian two fen. After two doses, a large amount of turbid matter was discharged. Next, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) was used to deliverershenshen Wan (Two Spirits Pill). After two doses, five or six out of ten symptoms subsided. Several more doses of the previous medicine were given, along with Fuzi applied to the waist-umbilical area and Yongquan (KI1). The six pulses gradually harmonized, and the patient stabilized. Later, due to anger causing abdominal stuffiness, and influenced by others' advice, he took Chenxiang Huaqi Wan (Agarwood Transforming Qi Pill), which led to hematochezia and the recurrence of all symptoms. The doctor said, "This is injury to the Yin collaterals," declined further treatment, and the patient indeed passed away shortly after.
Wu Nongxian treated the son of the Xue family. After hematemesis stopped, he suddenly experienced violent palpitations, body tremors, and occasional fright. He was prescribed Rehmanniae Radix Preparata (Shudi) one liang, Dioscoreae Rhizoma (Shanyao) five qian, Ligustri Lucidi Fructus (Nvzhenzi), Corni Officinalis Fructus (Shanzhuyu), and Lycii Fructus (Gouqi) each three qian. After more than twenty doses, Guijiao (Tortoise Shell Glue) was added to the base formula to make pills, and symptoms decreased significantly. Upon stopping medication for one day, palpitations returned. An accidental visit by another doctor using Liujunzi Tang (Six Gentlemen Decoction) with heart-nourishing and calming agents caused symptoms to worsen. Wu said, "This palpitation is the movement of Xuli (Empty Stomach). The classics state: 'The great collateral of the stomach is named Xuli, piercing the diaphragm and connecting to the lungs, emerging below the left breast; its movement can be seen through clothing, indicating leakage of Zongqi (Gathering Qi).' Patients with Kidney deficiency and consumptive weakness often exhibit this symptom. The Kidney belongs to Water, while the Lung governs Qi; Qi is the mother of Water. Kidney deficiency fails to grasp Qi, causing Zongqi to leak upward, further depleting Kidney Water below. To grasp Qi and return it to its origin, nourishing Yin to match Yang is the correct approach."
Note: When treating children, regardless of the condition, it is advisable to first palpate the Xuli point. If the movement is severe, attacking methods should not be used due to congenital insufficiency. Pediatricians who follow this advice will bring boundless benefit. This is a secret unshared for millennia; diagnosis requires great care.
Gaofeng diagnosed Yang Zaigong. The six pulses were markedly hyperactive. He told him, "The pulse is tight and wiry; within a month, a critical illness will arise." He prescribed medicine and departed. At that time, there were no serious symptoms. In mid-October, he suddenly developed cough. Doctors treated it as Wind-Cold, repeatedly administering Notopterygii Rhizoma et Radix (Qianghuo). After ten days, he suddenly roared with asthma, with phlegm surging like waves, making sounds, unable to lie flat. He had to sit on the bed, leaning his forehead against someone's back; any slight head lift caused suffocating asthma. Invited doctors said, "Based on previous pulses, the root of the disease is deep, but deterioration should not have been this rapid. This is likely forced by attacking medicines; there is no hope." The family begged only for asthma relief. The doctor said, "Relieving asthma is easy, but the pulse and complexion are already ruined. Even if asthma stops, death from collapse will follow." Morning treatment used Ginseng Radix (Renshen), Astragali Radix (Huangqi), Angelicae Sinensis Radix (Danggui), and Paeoniae Radix Alba (Baishao); evening treatment used Jiawei Bawei Wan (Modified Eight Flavor Pill). After three days, he could lie down, and appetite doubled. The family rejoiced, thinking he would survive. Gaosaid, "When exit and entry cease, the Spirit Mechanism diminishes; when ascent and descent stop, Qi Establishment becomes precarious. Now both are ceased. What can be done even if we try to reverse it? This merely temporarily retains a thread of Qi in the Gate of Life. Death will occur within ten days." Indeed, it happened. If remediation had been performed before symptoms appeared, disaster could have been prevented. Even after appearance, if large doses of tonifying and reinforcing medicines had been used, survival might have been extended, though perhaps not fully recovered. This serves as a warning against reckless attacking therapies.
Xu Cisheng suffered from cough. Gao Xi palpated his pulses, finding them active in all six positions. He asked if Xu drank alcohol. Xu confirmed. He asked if Xu had taken Asparagi Radix (Tiandong), Ophiopogonis Radix (Maidong), Anemarrhenae Rhizoma (Zhimu), Fritillariae Bulbus (Beimu), and Rehmanniae Radix (Shengdi). Xu admitted to consuming over one jin. Gao said, "Your condition contradicts these medicines; you must stop taking them." He prescribed Guipi Tang (Restore the Spleen Decoction) and Liuwei Wan (Six Flavor Pill). Gao Gui told friends, "Cisheng's illness corresponds to what *Suwen* calls 'Er Yang disease affecting Heart and Spleen.' This person likely overworked his mind, indulged in alcohol and desire. Urgently saving the Three Yin is the proper method. Doctors used Yin-cold medicines to suppress him, trapping Fire without outlet, creating a prairie fire. Now all six pulses show pure Yin Fire, exiting without entering; he will die within a year." Some argued Cisheng was fine, suffering only from Cold Damage, how could he die so soon? Gao replied, "Pulse methodology dictates this." In August, Gao stayed at Gushan. Xu invited him to tour Tianzhu. Xu said, "I hear you excel at Taisu Pulse reading; please diagnose me. Can I pass the exams in Xin Chou year?" Gao said, "Taisu originates from Sanfen, later stolen to deceive the world, fabricating rhymes to predict fortune. Huangdi and Qibo did not teach this." However, *Suwen* does discuss prosperity, decline, longevity, death, wealth, poverty, gain, loss, success, and failure, rooted in auspicious/inauspicious, regret/greed, good/evil, compliance/rebellion principles. It is subtle, but I can summarize. After diagnosis, he told Xu, "Xin Chou is good, but Jia Chen is better." (Knowing he would die, he wanted to prevent his northward journey.) Xu asked about lifespan. Gao said, "You are just past thirty; do not ask about lifespan." Observing Xu's urgency for examination success, Gao avoided direct medical prognosis. He told Xu's father to urge his return, saying, "Your son's pulse Qi is poor; if he goes north, he may not return. Why not stop him?" The father replied, "I tried, but failed." Gao firmly prepared a large dose of Ginseng Paste, advising abstinence from alcohol and sex, hoping it would help him return. Using cold-cooling medicines for apparent heat would be dangerous. Upon reaching Beijing, Fujian people repeated previous predictions. Trusting them, Xu used dispersing and cold-cooling medicines. Within ten doses, he vomited blood and died.
Zhang Luyu treated Miss Yan. She had emaciation, alternating chills and fever, abdominal pain with tenesmus, spontaneous sweating, and cough for over three months. Multiple doctors failed to cure her until she suddenly vomited blood. Palpation showed the Qi Kou pulse was deficient, choppy, and irregular; left pulses were wiry and faint, especially the Chi pulse. He prescribed Huangqi Jianzhong Tang (Astragalus Build the Middle Decoction) plus Danggui and Xixin. Someone asked, "In deficient-choppy bleeding, why not use Yin-nourishing and Fire-descending herbs, but instead use acrid-dry ones?" Zhang said, "Incorrect. Consumptive disease formation is not always primary deficiency; mostly it results from misprescription. Now that consumption is forming, while the root is not yet solid, urgently using acrid-warm herbs to raise Yang may recover the situation. If Yin herbs are still used, Yin will become hyperactive, and Blood will rebel upward." Since ancient times, treating consumption best follows *Jinkui* methods. For deficiency-consumption with abdominal tightness and general insufficiency, Huangqi Jianzhong Tang is used. Abdominal pain, palpitations, and epistaxis also fall under this category. Adding Danggui harmonizes Ying Blood; Xixin benefits Lung Qi. There is no need to worry about acrid-dryness injuring Blood. After several doses, bleeding stopped. Then Guizhi Renshen Tang (Cinnamon Twig and Ginseng Decoction) was used; after a few doses, abdominal pain and chills/fever resolved. Later, Liuwei Wan (Six Flavor Pill) was used, replacing Shanzhuyu with Suanzaoren. Occasionally, Baoyuan Tang, Yigong San, and Danggui Buxue Tang were advanced according to symptoms, leading to recovery.
Hu Nian'an treated Mrs. Wang Zaiting, who suffered from consumptive disease for over ten years, with panting, spitting foam, hematemesis, anorexia, and skeletal emaciation. Doctors were helpless. Diagnosis revealed her usual prescriptions were Yin-nourishing, Lung-moistening, and neutral-warm agents. Hu said, "With such illness, using such medicines naturally leads to death; how can life be expected? Zhongjing said: 'Severe cough with frequent spitting of foam indicates Spleen deficiency.' Also, ancients said: 'Kidney Yang failing to ascend to the Lung causes panting.' And: 'Spleen deficiency losing its transforming source causes panting.' Now Spleen and Kidney are failing and collapsing; with such medication, how can life be expected?" He heavily prescribed Renshen, Huangqi, Shengjiang (Fresh Ginger), and Fuzi. After two doses, panting settled. Due to worsening diarrhea, Shanzhuyu and Doukou were added for over ten doses, reducing illness by seventy percent. Moxibustion was applied to Guanyuan (CV4); fearing pain, only fifty moxa cones were used. Over ten years since then, her health has been excellent. (*Yilin Zhiyue*. For all deficiency-consumption diseases, those tolerating warm-tonification are easy to treat. Most cases recorded by ancients belong to this type; they have nothing to do with deficiency-consumption with internal heat.)
A surnamed Dong sought pulse diagnosis in early winter of Yongzheng Year 3. His pulse showed intermittent pauses: sometimes after two beats, sometimes seven, twelve, or seventeen beats. This is the pulse of Heart Exhaustion. In mid-winter, Water is prosperous; how can it generate? Temporarily, a prescription of Renshen, Huangqi, Deer Antler (Lurong), Fuzi, Placenta Humanis (Heche), Umbilical Cord (Qidai), Cinnamomi Cortex (Guixin), and Ziziphi Spinosae Semen (Suanzaoren) was given. After ten doses, pulse pauses became irregular, losing their fixed rhythm. After another ten doses, pauses decreased. After ten more doses, all six pulses were normal. Alas! One cannot say there was no merit. Early treatment allows for potential recovery even without Dansha (Cinnabar) and Aiye (Mugwort Moxa). (Same source.)
Formerly, a Daoist priest in Shu had youthful features and black hair, reciting: "The tailgate cannot hold back the drying of the vast sea; nine-turn elixirs are dismissed; only the pearl on the斑龙 (Spotted Dragon) head can supplement the acupoints below the Jade Palace and Guanxia." Note: Banlong Pearl refers to Deer Antler (Lurong), formed from deer essence and blood knotting into horns. It is warm and greatly tonifies Essence and Blood, suitable for Yuan Yang and Ministerial Fire deficiency. It can also be added to Liuwei Dihuang Wan (Six Flavor Rehmannia Pill). ( *Zhifa Hui*, Zhang Sanxi.)
Zhang Sanxi treated a man with cough, progressing to extreme consumption. Siwu Tang (Four Substance Decoction), Zhimu, and Huangbai were ineffective. Qinjiao Biejia San (Gentian and Turtle Shell Powder) was used, adding Zhimu, Beimu, Tiandong, and Maidong. After more than ten doses, he recovered.
Lu Zuyu diagnosed Mrs. Fu Xiaoquan, an elderly woman with damp-phlegm syndrome. In summer, excessive aromatic-dry herbs caused dizziness, thirst, blurred vision, insomnia, poor appetite, and joint soreness. Left Cun was flooding and rapid; Guan and Chi were fine and choppy. Right hand was floating and slippery; Guan and Chi were deep and fine, with nine beats per breath followed by a pause. Lu said, "This is Blood deficiency with Phlegm-Fire. Symptomatically, there is a treatment method. However, the fixed pause in the right Guan and Chi makes it incurable. All Blood deficiency syndromes relate to Liver disease; generally, Geng days worsen, Xin days are critical. With Liqiu (Start of Autumn) approaching..." Others criticized him, so he prescribed Blood-nourishing, Fire-clearing, phlegm-resolving, and qi-regulating herbs. Symptoms improved. After ten doses, she could walk to the central hall, manage household affairs, eating over ten bowls of porridge daily. People thought she was resurrected. Suddenly, one day, lower abdominal pain occurred, continuous cold sweat, unconsciousness by midnight, and death at You hour the next day. Xiaoquan remembered the prediction, checked the calendar, and it was indeed a Xin day.
Chen Sanshan's younger brother suffered from lethargy, fever, headache, and aversion to wind. Due to severe Middle Qi deficiency, Yuan Qi sinking, and insufficient Yang Qi causing headache, and declining form/Qi causing internal heat, Tiaozhong Yiqi Tang (Regulate Middle and Augment Qi Decoction) plus Gegen (Kudzu Root) cured him in one dose. Pipi Wan (Spleen-Kidney Pill) was formulated; after over a month, he recovered.
A noblewoman suffered from cough and diarrhea. Severe cough relieved diarrhea; severe diarrhea slightly stopped cough. Slight chills in the morning, slight fever in the afternoon. This is due to Spleen-Stomach weakness; phlegm-fluids rise with deficient fire causing severe cough and stopped diarrhea; phlegm-fluids descend with deficient fire causing severe diarrhea and stopped cough. No need to treat individual symptoms; tonifying Spleen and Stomach alone leads to self-healing. Baoyuan Tang (Preserve Origin Decoction) was used, adding fried Pine Flower, Ganjiang (Dried Ginger), Wuweizi (Schisandra), and Pugu Zhi (Cibotium Rhizome). After eight doses, cough and chills/fever resolved. After another eight doses, diarrhea stopped. (Xiong notes: Not necessarily always so; must rely on pulse.)
Xue Lizhai treated a woman with fever, afternoon fever, night sweats, spontaneous sweating, extreme aversion to wind/cold, poor appetite, abdominal pain with acid regurgitation, or loose stools. This indicates insufficiency of Spleen-Stomach and various meridians, with Qi and Blood depletion. Morning treatment used Buzhong Yiqi Tang; evening treatment used Bazhen Tang (Eight Treasures Decoction), doubling Renshen, Huangqi, and Baizhu. After over twenty doses of each, symptoms gradually improved. Due to grief from her mother's death, night sweats and hematochezia occurred. Jiawei Guipi Tang (Modified Restore the Spleen Decoction) stopped them after several doses. Continuing the previous two medicines for another fifty doses led to recovery. Menstruation returned every two months. Anger caused excessive bleeding, fever, thirst, limb soreness, and dizziness/headache. Xiaoyao San (Free and Easy Wanderer Powder) and Jiawei Guipi Tang restored health.
A woman with poor appetite and chest diaphragm discomfort, occasional chest pain, diarrhea, or dysuria, was cured with Xiaoyao San adding Zhizi (Gardenia), Fushen (Poria with Hostwood), Yuanzhi (Polygalae Radix), and Muxiang (Aucklandiae Radix). Later, anger caused alternating chills/fever, fatigue, and irritability. Adding fried Huanglian (Coptis) to the previous formula cured her instantly; Bazhen Tang regulated her. Later, anger caused hematemesis, dry mouth, and thirst. Five qian of Renshen, three qian each of Huangqin, Baizhu, and Danggui, one qian each of Chenpi (Tangerine Peel) and Gancao (Licorice) cured her.
A woman with internal heat, dry mouth, dizziness, phlegm vomiting, leukorrhea, fatigue, and poor appetite. This is Spleen Qi weakness failing to generate Lung Metal. Buzhong Yiqi Tang plus Fuling (Poria) and Banxia (Pinellia) strengthened Spleen Qi, improving appetite and resolving symptoms. Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) completed the cure.
A woman with severe afternoon fever, irregular menstruation, poor appetite, loose stools, chest diaphragm fullness, unclear head/eyes, limb fatigue, fever, and irritability. This is Liver-Spleen damage from Seven Emotions. Jisheng Guipi Tang, Jiawei Xiaoyao San, and Buzhong Yiqi Tang regulated Qi and Blood, restoring Yuan Qi and curing her.
A woman with chest/hypochondriac distension, lower abdominal heaviness, internal/afternoon fever, poor appetite, fatigue, yellow complexion, redness in the afternoon, and aversion to cold/chills. This is Spleen-Lung Qi deficiency. Liujunzi Tang (Six Gentlemen Decoction) plus Chuanxiong and Danggui gradually improved symptoms. Buzhong Yiqi Tang plus Fuling and Banxia completely resolved them. However, irregular diet, labor, anger, chills/fever, and anorexia were treated with Jiawei Xiaochaihu Tang (Modified Minor Bupleurum Decoction), resolving fever in two doses. Xiaoyao San and Guipi Tang regulated her to recovery.
A woman with irregular menstruation, poor appetite, and severe afternoon fever. This is Liver-Spleen Qi and Blood dual deficiency. Shiquan Dabu Tang (Ten Great Tonics) plus Shanyao, Shanzhuyu, Danpi (Moutan Cortex), Maidong, and Wuweizi cured her. The following autumn, chills/fever resembling malaria occurred; the same medicines cured her again.
Shen Dafang's wife, Ms. Zhao, initially suffered from phlegm-asthma, fever, and thirst. Treated with fire-clearing and qi-scattering herbs, her muscles wasted away, and Qi depleted. By Jia Chen year, Wood was prosperous, phlegm abundant, with body heat, oral ulcers, abdominal distension, coma, and anorexia. This was deficiency-heat without true fire. Xue prescribed strengthening Water to generate Earth agents, leading to recovery. In early Wushen summer, sitting caused head drooping and inability to see; lying caused cold penetrating the back, irritability, dizziness, cough/vomiting of surging phlegm, and numb/cold limbs. Critical danger. Xue said, "This is true internal cold with false external heat." Large tonifying agents with Jiang (Ginger) and Fuzi were given. After three to four doses, condition stabilized. Modified previous medicines cured her. (Case described by Shen himself.)
Hu Nian'an treated a middle-aged woman with night fever and cough, a minor ailment. Doctors Zhang and Li combined Yin-nourishing and fever-reducing herbs (likely bitter-cold) for over a month, causing blue face, urgent pulse, panting, hematemesis, spitting foam (several sheng daily), and anorexia. Both doctors were helpless and abandoned treatment. Hu used heavy doses of Renshen and Fuzi for over ten doses, achieving stability. This was not original deficiency but drug-induced error, hence quick recovery. (*Yilin Zhiyue*.)
Lizhai treated a scholar who suffered dry mouth and fever in spring/summer, and headache upon exertion. Cooling and phlegm-resolving herbs caused diarrhea, asthma, and irritability. Xiangru Yin (Elsholtzia Decoction) caused mental confusion and large-deficient pulse. This resulted from failing to guard against cold during winter storage ("Zhu Xia" - Summer Injection). For constitutionally weak individuals, including children, this is common. Buzhong Yiqi Tang without Shengma and Chaihu, adding Wuweizi, Maidong, and Paojiang (Prepared Ginger), made pulse worse after one dose. Adding Rougui (Cinnamon Bark) five fen to the previous formula revived him immediately. Liuwei Wan (Six Flavor Pill) completed the cure.
Simao He Yanquan had red/short urine, fatigue, poor appetite, and clavicular pain. Spleen-Lung weakness failing to generate Kidney Water required nourishing the source. Buzhong Yiqi Tang and Liuwei Wan plus Wuweizi brought peace.
Shuji Shi Huang Bolin had fever, phlegm vomiting, dry mouth, and fatigue. Self-administered Buzhong Yiqi Tang failed. Xue identified this as Metal-Water dual deficiency; combined with Dihuang Wan (Rehmannia Pill), he recovered. Later, a boil appeared on his back with irritability, pain, chills, and fever. Having previously observed Official Guo's back abscess, Guo predicted his death on a Metal-prosperous day. Indeed, it happened. Later, Guo's family contracted the toxin and developed malignant sores. Huang's condition matched Guo's; he was terrified. Xue said, "This is a minor sore; chills etc. are old Yin deficiency symptoms. If it is sore toxin, Qi and Blood must still be tonified." Dihuang Wan ingredients were decocted and given. He slept for a long time, and symptoms subsided. Afterwards, frequent pain in head/face/ears/eyes/mouth/tongue, phlegm vomiting, and dizziness were cured by Siwu Tang plus Huanglian and Huangbai.
Shaokong He Xiaochuan had hot feet, dry mouth, phlegm vomiting, and dizziness. Siwu Tang plus Huanglian and Huangbai reduced appetite and worsened phlegm-heat. Shiquan Dabu Tang plus Maidong, Wuweizi, Shanyao, and Shanzhuyu cured him.
Xue's nephew Ling Yunxiao, age fifteen, in Renyin summer, had red face, dry lips, and emaciation. Xue said, "Your disease will progress." In Gui Mao winter, he saw him again: "Your disease has deepened." In Jia Chen summer, green color appeared in the Stomach meridian region, indicating Wood invading Earth. Treatment began. First, Liujunzi Tang plus Chaihu, Baishao, Zhizi, Wuyi (Meloidogyne), and fried Huanglian for several doses. Then Siwei Fei'er Wan and Liuwei Dihuang Wan, plus Renshen, Fuling, Baizhu, Danggui, Baishao, Zhizi, Maidong, Wuweizi, and Zhi Cao (Honey-fried Licorice) for over thirty doses, gradually subduing Liver Fire. Adding Chaihu and Longdancao (Gentian Root) for over twenty doses. Then removing Baishao, adding Rougui, for thirty doses, plus Jiawei Bawei Wan. Yuan Qi gradually recovered.
A scholar, due to frequent marriages, suffered soft/painful legs, dark face, reduced appetite, aversion to cold, swollen feet, lower abdominal pain/distension, rebellious Qi, and phlegm-asthma. This is Shaoyin deficiency with Yang deficiency-cold. Babai Wan (Eight Flavor Pill) ingredients decocted and taken cured symptoms instantly. Taking pills for half a year gradually filled Yuan Qi, restoring his physique.
A man over twenty, exhausted early, suffered nocturnal emissions, spermatorrhea, night sweats during sleep, bloody phlegm, hot/weak feet. He took Huangbai and Zhimu. Xue said, "This is Yang deficiency with Yin weakness; nourish the source." Disbelieving, he persisted, worsening symptoms. Head enlarged, fontanelle opened, objects appeared large, phlegm vomiting and shouting ensued. Proper tonification gradually resolved symptoms, closing the fontanelle and stabilizing him.
A scholar with dry mouth, fever, frequent/turbid urination, constipation, night sweats, and nocturnal emissions neglected sleep. Danggui Liuhuang Tang (Angelica Six Yellow Decoction) stopped night sweats in two doses. Liuwei Dihuang Wan harmonized bowels/bladder. Shiquan Dabu Tang combined with previous formulas for over a month cured all symptoms.
Zhu Danxi treated Wang, age twenty-four, with high fever, hypochondriac pain, cough with red phlegm, thirst, constipation, fatigue, and slightly rapid-deficient pulse. Inquiry revealed...