犀角，以黑如漆，黄如粟，上下相透，云头雨脚分明者为佳。近人多巧伪，药染汤煮，无
所不至，然亦易辨。犀不可见日并贮，若犯之，则色理粗燥。凡蜜犀角嫩者，以凤仙花染之。
犀有水、旱二种，以水犀为上。凡心、胆、肝三经之热，允为良药。
《梦溪笔谈》云∶医用艾一灼，谓之一壮者，以壮人为法。其言若干，壮人当根据此数也；
若老幼羸弱，当量力减之，不可拘执以误人。
余幼时见水蛭，恶而溺之数四，化为水。又一日见之，以蜜一匙滴之，即缩不动，久之
亦化为水。嗣后虽经阴雨不复活。二物之能制蛭毒如此（物性相制之理，不可不知，以备
一时缓急之需，亦不可少也）。而昔人有蛭者，
医者见之，乃极劳扰，惜乎其不知此也。又云∶医者所论，人须、发、眉虽皆毛类，而所主五脏
各异。故有老而须白、眉发不白者，脏有所偏故也。大率发属心，禀火气，故上生；须属肾，
禀水气，故下生；眉属肝，故侧生。男子肾气外行，上为须，下为势。女子、宫人无势，则亦无
须，而眉、发无异于男子，则知不属肾也。又云∶四明生奉真，良医也。天章阁待制许元，江
淮发运使奏课于京师，方欲入对而其子疾亟，瞑而不食， 欲逾宿矣。奉真视之，曰∶脾已
绝，不可治，死在明日。元曰∶观其疾势，固知其不可救，今方有事，须陛对，能延数日之期
否？奉真曰∶如此事可。诸脏皆以衰，唯肝脏独过，脾为肝所胜，其气先绝，一脏绝即死。若
急泻肝气，肝气衰则脾少缓，可延三日，过此无药也。乃投药。至晚，乃能张目，稍稍复啜
粥，明日渐苏而能食。元曰∶甚喜！奉真笑曰∶此不足喜，肝气渐舒耳，无能为也。后三日果卒。
所载各论，多采前哲指迷之言。以下高氏续补，乃增原书不及，细心研究。胜读书十年，识者自知。
酿酒之时，寒之则甘，热之则酸。酸则蛤粉、田螺之类投之，凉其热也；甘则以 火绵
包，而悬酒中，温其寒也。又有酒酸而以官桂、砂仁之类救之，亦医家从治之法也。
治大风眉发脱落
苦参（末，半斤） 生槿皮（末，四两）
上炼蜜丸弹子大，每服一丸，日进三服，清茶送下。
治天泡疮单方
用香滋一味。
治杨梅疮毒
羌活 当归 白芍药 金银花 牙皂（各五钱） 冷饭团（四两，即鲜土茯苓）
共煎服。若加蟾蜍一只、陈酒四两同煎，其效尤捷。
又治一妇，面目朝肿，腿足午后肿甚，六脉浮濡，诸治莫效，而乞余方治。此证由风湿
而起，《内经》云∶面肿曰风，足胜肿曰水。以麻黄、防风开表逐风，五苓利湿行水，十服诸恙俱瘳。
此即《金匮》所谓风水症是也。自此以下十三条，原抄本所载，殷氏校板则无，今从原本补入，以广智识。
又治一妇，面目、周身黄如染金，腹胀气促。始由果斋用仲景栀子柏皮汤治之，不应。
余诊脉濡而沉，此属湿蕴日久，水窜腠理，未能外达，郁湿化热而发黄，投以茵陈蒿汤加
栀、柏、大黄，以泄湿热，外用金麟黑脊活鲫鱼七尾，剪鱼尾贴脐之四围，当脐勿贴，干则易
之，未及四时，水由脐出，其黄渐退，如是旬日厥疾以瘳。
按∶此法捷效。（寿）仿其方法，屡治屡验，缘世罕见，今特志之，以启后迸。然此方《准
绳》中未载，偶阅《秘旨》，有一方与此仿佛。后质之椿田，亦云李冠仙用之，亦效若桴鼓，第
不知始自何人，容再查明，以待博雅教政（澜志）。
果斋治妇人吐血盈盆，诸药罔效，因思前哲有以血导血归源法，嘱其取吐出之血，瓦器
盛之，候凝，铜锅炒血黑色，以绵纸盛放地上一周时，出火毒，研极细末，用鲜侧柏叶五钱，
麦冬一钱煎汤，调血炭末五分，二三服，血自归源。屡验屡效。又，治吐血宜用苦寒者，有
戒用苦寒者，尤当随症择用，未可执一以误人也。
《楼氏纲目》治吐血，皆用诸药炭，亦颇捷效。今以血导血归源，亦师其意而变化敏捷，取效昭着。
按∶余治一妇，吐血倾盆，数日不止，目闭神昏，面赤肢软，息粗难卧，脉左沉、右洪，重
按幸尚有根，此郁火久蒸肺胃，复缘暑热外逼，伤及阳络，致血海不敛，危在顷刻。因思止
血诸药，着寒者多投之，必呕，乃变通成法，先用甘寒，冀其人胃清、上血止，再商二贴血止，
亦创见也。服后夜寐甚安，血止，神清，惟神倦懒言，奄奄一息。脉虽稍平，右愈浮大无力。此
血去太多，恐延虚脱之患，经云∶血脱者，益其气。遂师其意用人参（七分，秋石水拌）、黄
（七分，黄芩水炙黑）、归身（一钱，炒黑）、怀山药（钱半）、茯苓（三钱）、大麦冬（钱半，去心）、
蒸北五味（七粒），和入甘蔗汁、梨汁、藕汁，服三帖，食进、神健而瘳。观此，知病有虚实，体
有强弱，本难执一。但今人吐血，挟虚者多，而医者辄用苦寒，是昧于虚实，宜乎得愈者少而
夭枉者多矣。今将八汁饮方附后，以备明哲商酌而教正之幸甚。又方∶甘蔗汁、藕汁、芦根汁
（各一酒杯）、白果汁（二匙）、白萝卜汁（半酒杯）、梨汁（一酒杯）、西瓜汁（一酒杯，生冲）、
鲜荷叶汁（三匙），七汁和匀，隔水炖热，冲入瓜汁，不住口缓缓频饮。凡属虚火，转危为安，
用之屡效。若非夏令，无瓜、荷二汁，即以梨、藕二汁，倍用天冬、百合榨汁，亦可代之。前方
中人参价昂，可用真西洋参一钱五分代之。
消渴一症，今医惯用凉药，愈治愈剧。间阅孙东宿治一消渴，小便色清而长，其味甘，
脉细数。用肾气丸加桂心、北五味、鹿角胶、益智仁而效。又一人，喜热饮而恶凉，大便秘，小
便清长，夜尤甚，脉浮按数大，而重按更无力。余思此病，由火不能制水，故饮一斗，小便亦一斗，《金匮》
言之详矣。今师其意，不泥其方，用肾气丸减车前、牛膝，加益智仁、人参胶糊丸，服逾月而痊。
按∶消渴症小便多者，皆由火虚难以化水、故饮一溲一，上见口渴，而水不消。小便多
者，每用益火之源以消阴翳而获效；若属中消，每用黄草汤下其热，又不可拘执成法而不
达变通以误人者。另有治验，详言之集，溢不赘，当参。
合脉症而研究，自获桴鼓之应也。曾忆《秘旨》云∶大凡消渴，服药获效，必须戒食盐
两月，可免反复。若不能食淡，方药虽良，终难永年。慎之，懔之！
《秘旨》云∶温热愈后，余邪往往归之于足，发热肿痛，不亟治，则痛甚而死者多，至轻
亦成残废，幸也，名曰截足风。今附验方于后，
以济斯厄。
广胶一两，入糟、醋、姜、葱汁四味，烊化成膏，摊绵纸或红布上，贴患处，痛立止（糟入
醋中，将糟凿碎，调匀，滤出汁，去糟渣勿用。姜汁不必多，只用少许，葱汁较姜汁多一半，
糟醋汁须三四倍于葱汁）。
按∶此方曾治王木匠，年三十余，患温热二候，乞余治之，用白虎汤加味而瘳，伊芳未服
善后药而赴任务。从事七日，发热恶寒，两足疼痛不能行、立，请同人抬至敝庐，诊其脉洪
大而两尺濡细，知是温热余邪下注，已成截足风之危候。即用此方外敷、内服导赤五苓散以
清余热，仅三日而病如失。后又治多人。皆获全瘳，今特拈出，广为传布。煎方以嫩桑枝五
钱易桂枝，加淮牛膝三钱。鲜车前为引。
又云∶切牙噤口，舌青面黑，汗出不休，手足寒过节，谓之真心痛。若全脑连齿皆痛，手
足寒至节，谓之真头痛。旦发夕死，百难治一，皆直中之危候。
按∶真心痛症，曾治一人∶证势危，不忍坐视，用麻黄、附子、干姜、桂心各二钱，猪肝煎
汤，频灌，渐次转温，死中求生之一法也。若真头痛，急灸百会穴数壮，再用乌、附、参各二
钱，姜浓煎，吞黑锡丹三十粒，非此猛剂，不足以追失散之元阳，而散其外真之寒邪。余遇一
急痧，证势仿佛，用上法以挽之而痊。皆属三阴直中危证也。
又云∶凡病之未现，可以预测其兆者，如手脚心热，作渴，思饮茶水，或食已即饥，知将
患发背；三年内眉眶骨痛，知将患厉风；如手指麻木三年来，必骤然中风。古人观神、察色、
审脉象而能先识其病，所以扁鹊知齐桓之疾不可为矣。则非神乎技者，不能步其后矣。
按∶《内经》云∶圣人治未病而不治已病。能知色脉，可以万全，此之谓也。然今之医不
及也，每有症象昭着，显而易见之 ，尚游移不决，若是者等而下之也。
成无已曰∶凡厥，若始得之手足便厥而不温者，是阴经受邪，阳气不足，可用四逆汤；若
手足自热而至温，从四逆而至厥者，传经之邪也，四逆散主之。至于六气之感，异于伤寒之传经者，惟舌较为
可凭∶阴症亦有黑胎、焦黄胎，然其胎必浮胖，或滑润而不枯。皆辨症之要法，尤宜三复斯言。
按∶医病非难，难在疑似之辨，不可人云亦云，随波逐流，误人匪浅。余于六月中旬，治
戴姓一证，体厥，脉虚，肢冷，周身赤点、隐于皮肤，口渴，谵妄。前医不明，妄用辛温回阳，
几危，因辨之曰∶此乃阳症似阴之象。况时当盛暑，拟用温热急下存阴法治之，以西洋参三
钱、锦纹军三钱、枳壳一钱、生甘草八分、风化硝二钱和冲，服后得下黑矢如胶者甚多，小便
赤涩亦减；以本方去硝黄，加连翘、山栀、银花，数帖而安。若非力辨辛温之误，岂不死于
庸俗之手。而人皆以三阴症而不疑，吾所以知非阴症者，因口渴、谵妄、欲饮、舌苔焦黄而
燥、肢体厥逆，乃热深厥深之现象，于是用河间温热例治之而愈。
虞天民治一妇，夜间发热、早晨即退，五心烦热，无休止已延八阅月。诊其脉，六部皆
数伏而牢，浮取全不应。与东垣升阳散火汤，四帖热减其半，胸中觉清快胜前，连投二服，
热悉退。后用四物汤加知母、酒炒黄柏，少佐炮姜，二十余服，热不复作而瘳。
按∶夜热、脉数乃阴虚之候，若非明眼，直进滋阴降火而不疑，是抱薪救火矣。今因脉伏
且牢、浮取不应，故用升阳散火得效。妙在炮姜合知、柏以清血分之热，而与阴虚治法有
间，所以名医异于庸俗者此也。
《秘冒》云∶一切感证，热入心胞、神昏谵语者，每用犀角、羚羊角、连翘、金银花、元参、
生地、人中黄等味送下至宝丹，往往获效。其有热邪深入、发痉者，亦宜以此疗之。世人遇
小儿患此证者，妄谓惊风，用针刺之，走泄真气，阴阳乖逆，转致不救。
按∶神昏谵语、发痉，由于温热、痰、暑转变者多。世间无知女流，妄听妖言，谓是惊风，
以针挑之，病势转剧者，多误人不浅。有等老
媪或尼姑等，自名神于惊风，惯用挑刺，无知妇女奉之若神，以致虽受其害而不能知。特志之以示戒。
龚云林云∶暑邪内干，往往忽然头痛、恶心，或腹痛、腰疼、偏身作痛，不治之，神昏、痉
厥，朝发夕毙。惟用白虎丸一服，当时血散而愈。较之砭刺之耗损其血，不若此丸敏捷神
效。方用千年锻石，刮去杂色泥土，研极细末，清水飞过，丸如桐子大。每服五十丸，视痧之
轻重加减，烧酒送下，真神方也。
按∶此丸顺气散血，化痰消渴，为治痧之仙剂。又治心腹痛，及妇人崩漏、赤白带下，或
久患赤白痢疾，跌打内伤，血不能散，服之均效。余恒合此丸以济世，获效果捷。千年锻石
不可得，用古墓中锻石亦可。寒痧用酒、热痧用开水温服，随证酌用，切勿拘执。然痧胀由于十二经清浊不
分，流溢于奇经，致奇经脉现，则为病也，乃邪气滞于经络，每见刮刺，开通经络，而效尤捷也。
《秘旨》载∶目中起星，足气中热，宜将两足浸温水中，搓擦足心，引热下降，初起亟治。
另用白蒺藜三钱，煎汤洗目，日四五次，屡验。或用谷精珠代茶。数日即瘳。
按∶目中起星，由于脾火上冲，肝热挟风凝结。或用碧云散搐鼻，散滞气，恒濯其足，使
热气下降；或用新橘皮塞鼻中，约六时后即退。不可误用寒凉点药，致凝血不散，转生云翳。慎之。
王光庵杂着云∶中食之证，状似中风，非详究病因，难取捷效。曾治一人，忽得暴疾，口
噤难言，目不识人，四肢不举，急投苏合香丸，不效。因询其致病之由，曰∶适方陪客，饮食后
忽得此证。遂教以煎生姜淡盐汤多饮，探吐之，吐出饮食数碗。后服白术陈皮半夏麦芽汤
而愈。此即食厥，若不问明致病之因，徒以痰药、风药治之，戕伐脾胃，而病日剧，是医之过也。
按∶中食之证，亦各有致病之因，未可拘执一端而论。余少时文期匆促，每饭后无暇散
步，录抄课艺，日无暇晷，饱餐后即倚案挥毫，因时患腹痛、胸膈满闷、便秘、痞胀，食不知
饥，服保和丸及查、曲、米炭等不效。有一老友云∶三世医验中，润字丸最妙。遂照方配合服
之，便通，诸恙均瘳。陆氏润字丸功效甚多，略举数端以启后进∶凡温热、湿痰等症，量病轻
重，随宜增减分量，服之最灵、最捷，今特拈出。
犀角，以颜色黑得像漆、黄得像小米、上下通透、云头和雨脚纹路分明者为上品。近来很多人弄虚作假，用药染色或汤煮，无所不用其极，但也容易辨别。犀角不能见太阳直射并储存，如果犯了这个禁忌，颜色和纹理就会变得粗糙干燥。凡是蜜制的嫩犀角，是用凤仙花染色的。犀角有水犀和旱犀两种，以水犀为上品。对于心、胆、肝三经的热证，确实是良药。
《梦溪笔谈》说：医生用艾草灸治一次，称为“一壮”，是以身体强壮的成年人为标准。文中说的若干壮，强壮的人应当依据这个数目；如果是老人、儿童或瘦弱的人，应当根据体力酌情减少，不可拘泥固执而误人。
我小时候见到水蛭，厌恶它，小便了几次，它就化为水了。又有一天见到它，滴上一匙蜂蜜，它就缩住不动，很久也化为水。此后虽然经过阴雨天也不会复活。这两种东西能制服水蛭的毒性如此（物性相克的道理，不可不知道，以备一时紧急之需，也是不可缺少的）。而以前有人身上有水蛭，医生见了，非常劳碌惊扰，可惜他们不知道这个方法。又说：医生们讨论，人的胡须、头发、眉毛虽然都属于毛发一类，但所主司的五脏各不相同。所以有年老而胡须变白、眉毛头发却不白的，是因为脏腑之气偏颇的缘故。大抵头发属心，禀受火气，所以向上生长；胡须属肾，禀受水气，所以向下生长；眉毛属肝，所以向侧面生长。男子的肾气向外运行，上行成为胡须，下行成为生殖器。女子和宫女没有生殖器，也就没有胡须，而眉毛、头发与男子无异，这就知道胡须不属肾了。又说：四明人奉真是位良医。天章阁待制许元，在京城汇报江淮发运使的政绩考核，正打算入宫面圣，但他的儿子病重，闭目不食，快要过了一夜。奉真诊视后说：脾脏已经绝败，无法治疗，明天就会死。许元说：看他的病情，确实知道救不活了，现在我正有事，必须陛见，能延长几天的期限吗？奉真说：这样的事可以办到。各脏器都衰弱，只有肝脏之气独盛，脾被肝克制，脾气先绝，一旦一脏气绝就会死亡。如果急泻肝气，肝气衰则脾稍得缓解，可以延长三天，过了这三天就没有药可救了。于是给药。到了晚上，病人能张开眼睛，慢慢开始喝粥，第二天逐渐苏醒并能进食。许元说：非常高兴！奉真笑着说：这不足为喜，只是肝气渐渐舒展罢了，无能为力了。三天后果然去世。
所载的各种论述，大多采录前代哲人指点迷津的话。以下高氏续补的内容，是增加了原书未及之处，细心研究所得。胜过读书十年，懂行的人自然明白。
酿酒的时候，寒冷就甘甜，热了就变酸。酸了就用蛤粉、田螺之类投入，以凉制热；甘甜就用火绵包裹，悬挂在酒中，以温制寒。又有酒变酸而用官桂、砂仁之类来补救的，这也是医家“从治”的方法。
治疗大麻风导致的眉毛头发脱落
苦参（研末，半斤） 生槿皮（研末，四两）
以上药材炼蜜制成弹子大小的丸药，每次服用一丸，每天三次，清茶送服。
治疗杨梅疮毒
羌活、当归、白芍药、金银花、牙皂（各五钱）、冷饭团（四两，即鲜土茯苓）
共同煎煮服用。如果加一只蟾蜍、陈酒四两同煎，效果尤其迅速。
又治疗一位妇女，早晨面目浮肿，下午腿足肿得厉害，六脉浮濡，各种治疗无效，来求我开方治疗。此证由风湿引起，《内经》说：面部浮肿叫风，足部严重浮肿叫水。用麻黄、防风开泄肌表驱逐风邪，五苓散利湿行水，服用十剂后各种病症都痊愈了。这就是《金匮要略》所说的风水症。从此以下的十三条，原抄本记载，殷氏校勘刻印时没有，现在从原本补入，以广博见识。
又治疗一位妇女，面目、周身黄得像染了金子，腹胀气促。起初由果斋用张仲景的栀子柏皮汤治疗，没有见效。
我诊脉象濡而沉，这属于湿气蕴结日久，水气窜入腠理，未能向外透达，郁积的湿气化热而发黄，投以茵陈蒿汤加上栀子、黄柏、大黄，以泄湿热，外用金麟黑脊活鲫鱼七条，剪下鱼尾贴在肚脐周围，正对肚脐的地方不要贴，干了就更换，不到四个时辰，水从肚脐流出，黄色逐渐消退，像这样十天，重病就好了。
按：此法见效快。（寿）模仿这个方法，多次治疗多次验证，因为世间罕见，现在特意记录，以启发后人。然而此方在《准绳》中没有记载，偶然阅读《秘旨》，有一方与此相似。后来请教椿田，也说李冠仙用过，效果如响斯应，只是不知道始自何人，容我再查明，以待博学之士指正（澜志）。
果斋治疗妇人吐血满盆，各种药物无效，于是想到前哲有“以血导血归源”的方法，嘱咐取吐出的血，用瓦器盛放，等凝固后，用铜锅炒成黑色，用绵纸包好放在地上放置一周时间，去除火毒，研成极细粉末，用鲜侧柏叶五钱、麦冬一钱煎汤，调血炭末五分，二三服后，血自然归源。多次验证有效。另外，治疗吐血宜用苦寒药的，也有告诫不要用苦寒药的，尤其应当随症状选择使用，不可固执一端而误人。
《楼氏纲目》治疗吐血，都用各种药炭，也很见效。现在用“以血导血归源”，也是师承其意而变化敏捷，取效显著。
按：我治疗一位妇女，吐血倾盆，数日不止，闭目神昏，面红肢软，呼吸粗重难以卧倒，脉左沉、右洪，重按幸而有根，这是郁火久蒸肺胃，又因暑热外逼，伤及阳络，导致血海不收敛，危在旦夕。于是想到止血诸药，性质寒凉的多了投用，必然呕吐，于是变通成法，先用甘寒之药，希望其人胃气清和、上部出血停止，再商量二帖后血止，这也是创见。服药后夜间睡眠很安稳，血止，神志清醒，只是精神疲倦懒言，气息微弱。脉虽稍平，右脉更浮大无力。这是失血太多，恐怕延续虚脱的祸患，《内经》说：血脱者，益其气。于是师承其意用人参（七分，秋石水拌）、黄芪（七分，黄芩水炙黑）、归身（一钱，炒黑）、怀山药（钱半）、茯苓（三钱）、大麦冬（钱半，去心）、蒸北五味子（七粒），加入甘蔗汁、梨汁、藕汁，服用三帖，饮食进增、精神健旺而痊愈。看这个案例，就知道病有虚实，体质有强弱，本来很难固执一端。但现在人吐血，夹杂虚证的很多，而医生却都用苦寒药，这是不明虚实，应该治愈者少而夭折者多啊。现在将八汁饮方附在后面，以备明智之士商酌指正，那是万幸。又一方：甘蔗汁、藕汁、芦根汁（各一杯酒杯量）、白果汁（两匙）、白萝卜汁（半酒杯量）、梨汁（一杯酒杯量）、西瓜汁（一杯酒杯量，生冲）、鲜荷叶汁（三匙），七种汁液混合均匀，隔水炖热，冲入瓜汁，不停地缓缓频饮。凡属虚火，转危为安，用它多次有效。如果不是夏季，没有西瓜、荷叶二汁，就用梨、藕二汁，加倍使用天冬、百合榨汁，也可以替代。前方中人参价格昂贵，可用真西洋参一钱五分替代。
消渴一症，现在的医生习惯用凉药，越治越严重。偶尔读到孙东宿治疗一例消渴，小便色清而长，味道甜，脉细数。用肾气丸加桂心、北五味子、鹿角胶、益智仁而见效。又一人，喜欢热饮而厌恶凉饮，大便秘结，小便清长，夜间尤其严重，脉浮按数大，而重按更无力。我思考这个病，是由于火不能制水，所以饮一斗，小便也一斗，《金匮要略》说得详细了。现在师承其意，不拘泥其方，用肾气丸减去车前子、牛膝，加益智仁、人参，用胶糊为丸，服用超过一个月而痊愈。
按：消渴症小便多的，都是由火虚难以化水，所以饮一溲一，上面出现口渴，而水不消化。小便多的，常用益火之源以消除阴翳而获效；若属中消，常用黄草汤下其热，又不可拘执成法而不达变通而误人。另有治疗验案，详细说明在集中，篇幅溢出不再赘述，应当参考。
结合脉症进行研究，自然能获得如鼓应桴般的疗效。曾记得《秘旨》说：大凡消渴，服药获效，必须戒食盐两个月，可以避免反复。如果不能吃淡食，方药虽好，终究难保长寿。谨慎啊，敬畏啊！
《秘旨》说：温热病愈后，余邪往往归于足部，发热肿痛，不紧急治疗，则痛甚而死的多，即使最轻的也会变成残废，侥幸存活，名叫截足风。现在附上验方在后面，以救济这种厄难。
广胶一两，加入糟、醋、姜、葱汁四味，烊化成膏，摊在绵纸或红布上，贴患处，疼痛立即停止（糟放入醋中，将糟凿碎，调匀，滤出汁，去掉糟渣不用。姜汁不必多，只用少许，葱汁比姜汁多一半，糟醋汁须三四倍于葱汁）。
按：此方曾治疗王木匠，三十多岁，患温热病两个阶段，求我治疗，用白虎汤加味而痊愈，他没有服用善后药就去执行任务。从事劳动七天，发热恶寒，两足疼痛不能行走站立，请同事抬到我住处，诊其脉洪大而两尺濡细，知道是温热余邪下注，已成截足风的危候。立即用此方外敷，内服导赤五苓散以清余热，仅三天病如消失。后来又治疗多人，都完全痊愈，现在特意提出，广为传播。煎方以嫩桑枝五钱代替桂枝，加淮牛膝三钱。鲜车前草为引。
又说：咬牙闭口，舌青面黑，汗出不止，手足寒冷超过关节，叫做真心痛。如果全脑连牙齿都痛，手足寒冷至关节，叫做真头痛。早上发病晚上死，百难治一，都是直中的危候。
按：真心痛症，曾治疗一人：病情危急，不忍坐视，用麻黄、附子、干姜、桂心各二钱，猪肝煎汤，频频灌服，渐渐转温，这是死中求生的一法。若真头痛，急灸百会穴数壮，再用乌头、附子、人参各二钱，姜浓煎，吞服黑锡丹三十粒，非此猛剂，不足以追回失散的元阳，而驱散外来的真寒邪气。我遇到一例急痧，病情相似，用上法挽回而痊愈。都属于三阴直中的危证。
又说：凡是疾病未发作前，可以预测其征兆的，如手脚心热，口渴想喝茶水，或者吃完就饿，知道将要患发背疽；三年内眉眶骨痛，知道将要患麻风病；如手指麻木三年，必定突然中风。古人观察神色、察面色、审脉象就能先识别疾病，所以扁鹊知道齐桓公的病不可治了。那么不是技艺神妙的人，不能追随其后。
按：《内经》说：圣人治未病而不治已病。能知色脉，可以万无一失，说的就是这个道理。然而现在的医生达不到这个境界，每每有症状明显、显而易见的，还游移不决，像这样的人就低一等了。
成无己说：凡是厥证，如果刚得病手足就厥冷不温的，是阴经受邪，阳气不足，可用四逆汤；如果手足自己发热而至温暖，从四肢温暖变为厥冷的，是传经之邪，用四逆散主治。至于六气之感，不同于伤寒的传经，只有舌苔较为可信：阴症也有黑胎、焦黄胎，但其舌苔必浮胖，或滑润而不枯。这都是辨症的要法，尤其应当反复玩味这些话。
按：治病不难，难在疑似之症的辨别，不可人云亦云，随波逐流，误人不浅。我在六月下旬，治疗戴姓一例，身体厥冷，脉虚，肢冷，周身赤点隐于皮肤，口渴，谵妄。前医不明白，妄用辛温回阳，几乎危及生命，于是我辨别说：这是阳症似阴的现象。况且时值盛夏，拟用温热急下存阴法治之，用西洋参三钱、锦纹军（大黄）三钱、枳壳一钱、生甘草八分、风化硝二钱和冲，服后排出很多如胶的黑便，小便赤涩也减轻；用本方去掉硝黄，加连翘、山栀、银花，几帖后安定。如果不是力辨辛温之误，岂不死于庸俗之手。而人都认为是三阴症而不怀疑，我知道不是阴症的原因，是因为口渴、谵妄、想喝水、舌苔焦黄而燥、肢体厥逆，这是热深厥深的现象，于是用河间温热例治疗而痊愈。
虞天民治疗一位妇女，夜间发热、早晨即退，五心烦热，无休止地延宕了八个月。诊其脉，六部皆数伏而牢，浮取全然不应。给予东垣升阳散火汤，四帖后热减其半，胸中觉得清爽胜过之前，连续投二服，热悉退。后用四物汤加知母、酒炒黄柏，少佐炮姜，二十余服，热不复作而痊愈。
按：夜热、脉数是阴虚的征候，如果不是明眼人，直接进滋阴降火而不疑，是抱薪救火啊。现在因为脉伏且牢、浮取不应，所以用升阳散火得效。妙在炮姜合知母、黄柏以清血分之热，而与阴虚治法有别，所以名医异于庸俗之处在于此。
《秘旨》说：一切感证，热入心胞、神昏谵语者，每用犀角、羚羊角、连翘、金银花、元参、生地、人中黄等味送下至宝丹，往往获效。其有热邪深入、发痉者，也适宜以此疗法。世人遇小儿患此证者，妄谓惊风，用针刺之，走泄真气，阴阳乖逆，转而致不救。
按：神昏谵语、发痉，由于温热、痰、暑转变的多。世间无知妇女，妄听妖言，谓是惊风，以针挑之，病势转剧的，多误人不浅。有等老妇或尼姑等，自名神于惊风，惯用挑刺，无知妇女奉之若神，以致虽受其害而不能知。特意记录以示警戒。
龚云林说：暑邪内干，往往忽然头痛、恶心，或腹痛、腰疼、偏身作痛，不治疗的，神昏、痉厥，早上发病晚上毙命。惟有用白虎丸一服，当时血散而愈。比起砭刺耗损其血，不如此丸敏捷神效。方用千年锻石，刮去杂色泥土，研极细末，清水飞过，丸如桐子大。每次服五十丸，视痧的轻重加减，烧酒送下，真是神方。
按：此丸顺气散血，化痰消渴，为治痧的仙剂。又治心腹痛，及妇人崩漏、赤白带下，或久患赤白痢疾，跌打内伤，血不能散，服用均有效。我经常合制此丸以济世，获得效果快捷。千年锻石不可得，用古墓中的锻石也可以。寒痧用酒、热痧用开水温服，随证酌用，切勿拘执。然而痧胀由于十二经清浊不分，流溢于奇经，致奇经脉现，则为病也，乃邪气滞于经络，每见刮刺，开通经络，而效尤捷也。
《秘旨》载：目中起星，足气中热，宜将两足浸温水中，搓擦足心，引热下降，初起亟治。另用白蒺藜三钱，煎汤洗目，日四五次，屡验。或用谷精珠代茶。数日即瘳。
按：目中起星，由于脾火上冲，肝热挟风凝结。或用碧云散搐鼻，散滞气，常濯其足，使热气下降；或用新橘皮塞鼻中，约六时后即退。不可误用寒凉点药，致凝血不散，转生云翳。谨慎。
王光庵杂着说：中食之证，状似中风，不详细究病因，难取捷效。曾治疗一人，忽得暴疾，口噤难言，目不识人，四肢不举，急投苏合香丸，无效。于是询问致病原因，说：刚才陪客，饮食后忽然得此证。于是教他煎生姜淡盐汤多饮，探吐之，吐出饮食数碗。后服白术陈皮半夏麦芽汤而愈。这就是食厥，如果不问明致病之因，徒以痰药、风药治之，戕伐脾胃，而病日剧，是医生的过错。
按：中食之证，也各有致病之因，不可拘执一端而论。我年轻时文章期限匆忙，每饭后无暇散步，录抄课艺，日无暇晷，饱餐后即倚案挥毫，因此时常患腹痛、胸膈满闷、便秘、痞胀，食不知饥，服保和丸及查、曲、米炭等不效。有一位老友说：三世医验中，润字丸最妙。于是照方配合服用，便通，诸恙均瘳。陆氏润字丸功效甚多，略举数端以启后进：凡温热、湿痰等症，量病轻重，随宜增减分量，服用最灵、最捷，现在特意提出。
Rhinoceros horn is of the best quality when it is black as lacquer, yellow like millet, transparent from top to bottom, and with distinct cloud-head and rain-foot patterns. Recently, many people resort to cunning falsification, dyeing or boiling in decoction, going to any lengths, yet it is also easy to distinguish. Rhinoceros horn should not be exposed to sunlight during storage; if this taboo is violated, its color and texture will become coarse and dry. Any tender rhinoceros horn treated with honey is dyed with *Impatiens balsamina* (Fengxianhua, 凤仙花). There are two types of rhinoceros horn: water rhino and land rhino, with water rhino being superior. It is indeed a good medicine for heat in the Heart, Gallbladder, and Liver meridians.
*Mengxi Bitan* states: When doctors use moxibustion with mugwort once, it is called one "Zhuang" (a unit of moxa cones), based on the standard of a robust adult. The number of Zhuang mentioned refers to this count for strong individuals; for the elderly, children, or frail persons, it should be reduced according to their physical capacity. One must not rigidly adhere to the standard so as to cause harm.
In my childhood, I saw a leech and, disgusted by it, urinated on it several times until it dissolved into water. Another day, seeing one, I dripped a spoonful of honey on it; it shrank and remained motionless, eventually dissolving into water after a long time. Even after passing through rainy days, it did not revive. These two substances can neutralize leech toxicity so effectively (The principle of mutual inhibition among substances must be known, to prepare for emergencies, which is indispensable). Previously, someone had a leech attached, and the doctor was extremely distressed and troubled, unfortunately unaware of this method. It is also said that although human beard, hair, and eyebrows all belong to the category of hair, they correspond to different Zang organs. Thus, some people have white beards but non-white eyebrows and hair due to the bias of their organ Qi. Generally, hair belongs to the Heart, inheriting Fire Qi, hence growing upwards; beard belongs to the Kidney, inheriting Water Qi, hence growing downwards; eyebrows belong to the Liver, hence growing sideways. In men, Kidney Qi flows outward, ascending to form the beard and descending to form the genitals. Women and palace maids lack genitals, thus also lack beards, while their eyebrows and hair are no different from men's, indicating that beards do not belong to the Kidney. It is also said that Feng Zhen from Siming was a skilled physician. Xu Yuan, a waiting scholar at Tianzhang Pavilion, reported on the performance assessment of the Jianghuai Grain Transport Commissioner in the capital. Just as he was about to enter for an audience, his son fell critically ill, closing his eyes and refusing food, nearing a night's passage. Feng Zhen examined him and said: "The Spleen has already failed; it is incurable, death will occur tomorrow." Xu Yuan said: "Observing the severity, I know it is hopeless, but I have official duties and must present myself to the Emperor. Can you extend his life by a few days?" Feng Zhen replied: "This can be done. All Zang organs are declining, but the Liver Qi is excessively strong. The Spleen is controlled by the Liver, so its Qi fails first. Once one Zang fails, death ensues. If we urgently drain the Liver Qi, the Liver will weaken, allowing the Spleen to recover slightly, extending life by three days. Beyond this, there is no medicine." He administered the prescription. By evening, the patient could open his eyes and slowly sip porridge. The next day, he gradually revived and could eat. Xu Yuan said: "I am very pleased!" Feng Zhen smiled and said: "There is no need for such joy; the Liver Qi has merely relaxed slightly. Nothing more can be done." Three days later, he indeed passed away.
The various discussions recorded here mostly draw upon the enlightening words of past sages. The following supplements by Gao Shi add content not covered in the original text, resulting from careful study. This surpasses ten years of reading; those who understand will know.
When brewing wine, coldness makes it sweet, and heat makes it sour. If it becomes sour, add things like clam powder or river snails to cool the heat; if it remains sweet, wrap it in fire-cotton and hang it in the wine to warm the cold. There are also cases where sour wine is remedied with herbs like Guizhi Tang (Cinnamon Twig Decoction) and Amomum fruit, which is also a "following treatment" method used by physicians.
Treatment for alopecia caused by severe wind-dampness (Leprosy/Mal-feng):
*Bitter Sophora Root* (Powder, half jin / ~250g)
*Hibiscus Tiliaceus Bark* (Powder, four liang / ~125g)
Process these with refined honey to make pills the size of弹子 (bullet seeds). Take one pill per dose, three times daily, washed down with clear tea.
Single prescription for treating Bullous Impetigo (Tianpao Chuang):
Use only Xiangzi (Aromatic Herb).
Treatment for Yamei Chuang (Syphilis/Kapok Sores) Toxicity:
Qianghuo (Notopterygium Root), Danggui (Angelica Sinensis), Baishao (White Peony Root), Jinyinhua (Honeysuckle Flower), Ya Zao (Gleditsia Sinensis Fruit) (each five qian / ~15g), Leng Fan Tuan (Four liang / ~125g, i.e., fresh *Smilax glabra* rhizome).
Decoct and take together. If adding one toad and four liang (~125g) of aged rice wine to the decoction, the effect is even more rapid.
Also treated a woman whose face and eyes swelled in the morning, and legs and feet swelled severely in the afternoon. Her six pulses were floating and soft. Various treatments failed, so she sought my prescription. This condition arises from wind-dampness. *Neijing* states: Swelling of the face is Wind; severe swelling of the feet is Water. Use Mahuang Tang (Ephedra Decoction) with Fangfeng (Saposhnikovia Root) to open the exterior and expel wind, and Wuling San (Five-Ingredient Powder with Poria) to promote diuresis and move water. After ten doses, all symptoms resolved. This is what *Jingui Yaolue* calls Fengshui (Wind-Water Edema). From here onwards, thirteen entries are recorded in the original manuscript but omitted in Yin Shi's printed edition; now added back from the original to broaden knowledge.
Also treated a woman whose face and whole body were yellow as if dyed gold, with abdominal distension and shortness of breath. Initially, Guozhai treated her with Zhang Zhongjing's Zhizi Bopi Tang (Gardenia and Phellodendron Decoction), without effect.
I palpated her pulse as soggy and deep. This belongs to dampness accumulating over a long period, with water qi invading the interstices (Couli) and failing to reach the exterior. The stagnant dampness transforms into heat, causing jaundice. I prescribed Yinchen Hao Tang (Artemisia Scoparia and Coix Seed Decoction) plus Zhizi (Gardenia), Bopi (Phellodendron Bark), and Dahuang (Rhubarb) to drain damp-heat. Externally, I used seven live crucian carp (Golden Lin Black-spined variety), cutting off the tails and applying them around the navel (avoiding direct contact with the umbilicus itself). Replace when dry. Within less than four hours (Shichen), fluid drained from the navel, and the yellow discoloration gradually faded. After ten days, the chronic illness was cured.
Note: This method yields rapid results. Shou imitated this method and achieved consistent success. Since it is rare in the world, I record it here to inspire future generations. However, this formula is not recorded in *Zhunsheng*. Upon偶然ly reading *Mizhi*, I found a similar formula. Later, consulting Chuntian, he also stated that Li Guanxian used it with effects like a drum responding to a strike. I do not know its origin and will investigate further for correction by scholars (recorded by Lan).
Guozhai treated a woman vomiting blood full basins, with all medicines ineffective. Recalling the ancients' method of "using blood to guide blood back to its source," he instructed to collect the vomited blood, store it in a clay vessel, wait for coagulation, stir-fry it in a copper pot until black, place it on cotton paper on the ground for a week to remove fire toxicity, grind into fine powder. Mix five fen (~1.5g) of this blood charcoal powder with decoction of five qian (~15g) fresh Ce Bai Ye (Biota Tops) and one qian (~3g) Maidong (Ophiopogon Tuber). Take two or three doses, and the blood naturally returns to its source. Verified effective repeatedly. Additionally, regarding the use of bitter-cold herbs for hematemesis, some warn against them. One must select based on symptoms and not rigidly adhere to one approach to avoid error.
*Lou Shi Gangmu* treats hematemesis using various herb charcoals, which is also quite effective. Now, "using blood to guide blood back to its source" follows this intent but changes agilely, achieving obvious results.
Note: I treated a woman vomiting blood profusely for days, with closed eyes and unconsciousness, red face, weak limbs, rough breathing making lying difficult. Left pulse was deep, right pulse was surging; heavy pressure still felt a root. This was long-standing stifled fire steaming the Lung and Stomach, compounded by summer-heat forcing externally, damaging the Yang collaterals, causing the Blood Sea to fail to contain blood, critical moment. Thinking that most hemostatic herbs are cold-natured and would cause vomiting if used heavily, I varied the standard method, first using sweet-cold herbs hoping to clear the Stomach Qi and stop upper bleeding. After two doses, bleeding stopped—this was a novel approach. After taking it, she slept peacefully at night, bleeding stopped, consciousness cleared, but she was fatigued and spoke little, with faint breath. Pulse smoothed slightly, but the right pulse became more floating, large, and powerless. This indicated excessive blood loss, risking deficiency collapse. *Jingui* says: "In blood depletion, benefit the Qi." Following this intent, I used Renshen (Seven fen / ~2.1g, mixed with Qiushi water), Huangqi (Seven fen / ~2.1g, stir-fried black with Huangqin water), Guishen (One qian / ~3g, stir-fried black), Huai Shanyao (One and a half qian / ~4.5g), Fuling (Three qian / ~9g), Maidong (One and a half qian / ~4.5g, heart removed), Zheng Beiwuzi (Seven grains), mixed with Sugarcane juice, Pear juice, and Lotus root juice. After three doses, appetite improved, spirit strengthened, and she recovered. From this, we see diseases have deficiency/excess, constitutions have strength/weakness; one cannot rigidly adhere to one method. Nowadays, most hematemesis cases involve deficiency, yet doctors often use bitter-cold herbs, ignoring deficiency/excess, leading to few cures and many premature deaths. I attach the Eight-Juice Drink formula below for wise consultation. Another formula: Sugarcane juice, Lotus root juice, Reed rhizome juice (each one wine-glass measure), White fruit juice (two spoons), White radish juice (half wine-glass), Pear juice (one wine-glass), Watermelon juice (one wine-glass, taken raw), Fresh Lotus leaf juice (three spoons). Mix evenly, warm in a double boiler, mix in melon juice, and drink slowly and frequently. For deficiency-fire turning crisis to safety, it is often effective. If not in summer, lacking watermelon and lotus leaf juices, use doubled Pear and Lotus root juices, with increased Tian Dong (Asparagus Tuber) and Baihe (Lily Bulb) juice as substitutes. In the previous formula, Renshen is expensive; substitute with Zhen Xiyangshen (American Ginseng) one and a half qian (~4.5g).
Xiao Ke (Wasting-Thirst) syndrome: Modern doctors habitually use cooling medicines, worsening the condition with each treatment. Occasionally reading Sun Dongsu's case of Xiao Ke: urine was clear and long, sweet-tasting, pulse fine and rapid. Used Shenqi Wan (Kidney Qi Pill) plus Guixin (Cinnamon Bark), Bei Wuwei Zi (Schisandra Berry), Lujiao Jiao (Deer Antler Glue), and Yizhiren (Bennet Seed) with effect. Another case: Patient preferred hot drinks, disliked cold, constipation, clear and copious urination, worse at night. Pulse floating and rapid/large on light pressure, but weaker on heavy pressure. I reasoned this disease stems from Fire failing to control Water, hence "drinking one dou, urinating one dou," as detailed in *Jingui Yaolue*. Following the intent but not the exact formula, I used Shenqi Wan minus Cheqian Zi (Plantago Seed) and Niuxi (Achyranthes Root), plus Yizhiren and Renshen, made into pills with glue paste. Taken for over a month, the patient recovered.
Note: In Xiao Ke with polyuria, it is due to deficient Fire failing to transform water, hence drinking one and urinating one, with thirst above but water not absorbed. For polyuria, using "benefiting the source of Fire to eliminate Yin shadows" often works; for Middle Xiao Ke, using Huangcao Tang to drain heat is appropriate. One must not rigidly stick to established methods without adapting to change to avoid error. Other verified cases are detailed elsewhere; refer to them.
Combining pulse and symptoms for research naturally yields prompt results. I recall *Mizhi* stating: Generally, for Xiao Ke to respond to medicine, salt must be abstained from for two months to prevent recurrence. If one cannot eat bland food, even good prescriptions will not ensure longevity. Be cautious! Be reverent!
*Mizhi* states: After recovery from warm-heat diseases, residual pathogens often settle in the feet, causing fever, swelling, and pain. If not treated urgently, severe pain leads to death, or even mild cases result in disability. Fortunately surviving cases are named "Jiezu Feng" (Foot-Cutting Wind). I attach a verified formula below to relieve this distress.
Guangjiao (Gelatin) one liang (~30g), mixed with lees, vinegar, ginger juice, and scallion juice, melted into a paste, spread on cotton paper or red cloth, applied to the affected area; pain stops immediately. (Lees should be crushed in vinegar, mixed well, filtered to extract juice, discard dregs. Ginger juice should be minimal; scallion juice should be half again as much as ginger juice; the lees-vinegar juice should be three to four times the amount of scallion juice).
Note: This formula treated Carpenter Wang, over thirty years old, who suffered from warm-heat disease stages. I treated him with modified Baihu Tang (White Tiger Decoction) and he recovered. He did not take convalescent medicine and went to work. After seven days, he developed fever, aversion to cold, and severe pain in both feet, unable to walk or stand. Colleagues carried him to my residence. His pulse was surging and large, but the two Chi (Kidney) positions were soggy and fine. I knew this was residual warm-heat pathogens sinking downward, becoming critical Jiezu Feng. I immediately used this formula externally and internally administered Daochi Wuling San (Guide Out Redness and Five-Ingredient Powder with Poria) to clear residual heat. In just three days, the illness vanished. I later treated many others with complete recovery. I highlight this now for wide dissemination. For decoction, replace Guizhi (Cinnamon Twig) with N Sangzhi (Young Mulberry Twig) five qian (~15g), add Huainiuxi (Achyranthes Bidentata Root) three qian (~9g). Use fresh Cheqian Cao (Plantago Leaf) as a guiding herb.
It is also said: Grinding teeth, locked jaw, blue tongue, black face, incessant sweating, and cold hands/feet extending beyond joints is called Zhenxintong (True Heart Pain). If the entire head and teeth hurt, and cold extends to joints, it is called Zhen Toutong (True Head Pain). Morning onset means evening death; one in a hundred survives. These are critical conditions of direct invasion.
Note: I treated one case of Zhenxintong: The condition was critical, and I could not sit idle. I used Mahuang (Ephedra), Fuzi (Prepared Aconite), Ganjiang (Dried Ginger), and Guixin (Cinnamon Heart) each two qian (~6g), decocted in pork liver soup, administered frequently. Gradually, warmth returned—a method of seeking life from death. For Zhen Toutong, urgently moxa Baihui (GV20) several Zhuang, then use Wutou (Aconite), Fuzi, and Renshen each two qian (~6g), decoct strongly with ginger, swallow thirty pellets of Hexi Dan (Black Tin Pill). Only such potent agents can retrieve scattered Primordial Yang and disperse external true cold pathogens. I encountered one case of acute Sha (Plague/Toxin) with similar symptoms and saved the patient using this method. All belong to critical conditions of direct invasion of the Three Yin.
It is also said: Before diseases manifest, signs can predict them. For example, heat in palms and soles, thirst for tea/water, or hunger immediately after eating indicates impending Fabai (Back Carbuncle); orbital bone pain within three years indicates impending Mal-feng (Leprosy); finger numbness for three years predicts sudden stroke. Ancients observed spirit, complexion, and pulse to identify disease beforehand, which is why Bian Que knew Duke Huan of Qi's illness was incurable. Only those with divine skill can follow in their footsteps.
Note: *Neijing* states: The sage treats disease before it arises, not after. Knowing color and pulse ensures perfection. This is what is meant. However, modern doctors fall short. Often, when symptoms are obvious and clear, they hesitate. Such practitioners are inferior.
Cheng Wuji said: Regarding Jue (Cold Extremities), if hands and feet are cold from the onset, it is pathogen in Yin meridians with insufficient Yang Qi; Si Ni Tang (Four Counterflow Decoction) can be used. If hands/feet start hot and become warm, or go from warm to cold, it is transmitted pathogen; Si Ni San (Four Counterflow Powder) governs it. Regarding Six Qi influences differing from Shanghan transmission, the tongue coating is the most reliable indicator: Yin syndromes may have black or scorched-yellow coatings, but they are always swollen/floating, or slippery/moist, not dry. These are key methods for differentiation; one should ponder these words repeatedly.
Note: Treating disease is not hard; the difficulty lies in distinguishing doubtful cases. Do not echo others or drift with the tide, or you will harm people significantly. In mid-June, I treated a Dai family case: Body cold, pulse empty, cold limbs, crimson spots hidden under skin, thirst, delirium. Previous doctors misunderstood, wrongly using acrid-warm Yang-restoring methods, nearly causing danger. I differentiated it as: This is a Yang syndrome resembling Yin. Moreover, it was peak summer. I proposed using warm/acrid methods to purge urgently to preserve Yin. I used Xiyangshen (American Ginseng) three qian (~9g), Jinwen Jun (Da Huang/Rhubarb) three qian (~9g), Zhike (Bitter Orange) one qian (~3g), Sheng Gancao (Raw Licorice) eight fen (~2.4g), Fenghua Xiao (Effloresced Mirabilite) two qian (~6g), mixed and taken. After ingestion, much black stool like glue was passed, and red/scanty urination decreased. Using the same formula minus Xiao and Da Huang, adding Lianqiao (Forsythia), Shanzhi (Gardenia), and Yinhua (Honeysuckle), the patient stabilized after several doses. If I hadn't firmly refuted the error of acrid-warm herbs, wouldn't I have died at the hands of mediocrity? Everyone assumed it was a Three Yin syndrome without suspicion. I knew it wasn't Yin because of thirst, delirium, desire to drink, scorched-yellow/dry tongue coating, and cold extremities—these are phenomena of "deep heat causing deep cold" (Re Shen Jue Shen). Thus, I treated it according to He Jian's warm-heat examples and cured it.
Yu Tianmin treated a woman with night fever subsiding by morning, five-palm heat, unceasing for eight months. Her pulse was rapid, hidden, and firm in all six positions, completely unresponsive to light pressure. I gave Dongyuan's Shengyang Sanhuo Tang (Raise Yang and Scatter Fire Decoction). After four doses, fever halved, chest felt clearer than before. Continuing two doses, fever completely subsided. Afterwards, using Siwu Tang (Four Substance Decoction) plus Zhimu (Anemarrhena), Jiuhuangbai (Wine-fried Phellodendron), with a hint of Paojiang (Roasted Ginger). After twenty-plus doses, fever did not return, and she recovered.
Note: Night fever and rapid pulse indicate Yin deficiency. Without keen insight, one might blindly use Yin-nourishing and fire-draining methods, which is like adding firewood to a fire. Here, because the pulse was hidden/firm and unresponsive to light pressure, Shengyang Sanhuo Tang worked. The brilliance lies in combining Paojiang with Zhimu and Huangbai to clear blood-level heat, differing from standard Yin-deficiency treatment. This is why famous doctors differ from mediocrities.
*Mizhi* states: For all infection syndromes where heat enters the Pericardium causing coma and delirium, using Xijiao (Rhinoceros Horn), Lingyangjiao (Antelope Horn), Lianqiao (Forsythia), Jinyinhua (Honeysuckle), Yuanshen (Scrophularia), Shengdi (Rehmannia), Renzhonghuang (Human Manure Yellow) etc., delivered with Zhibao Dan (Precious Treasure Pill) often yields results. For deep-seated heat pathogens causing spasms, this therapy is also suitable. People encountering children with this condition wrongly call it Jingfeng (Convulsive Wind) and use needle pricking, leaking True Qi, causing Yin-Yang reversal and untreatable conditions.
Note: Coma, delirium, and spasms often result from transformation of warm-heat, phlegm, or summer-heat. Ignorant women, listening to superstition, call it Convulsive Wind and prick with needles, worsening the condition and harming people greatly. Some old women or nuns claim divinity in treating Convulsive Wind,惯用挑刺 (habitually using pricking/thorn therapy). Ignorant women revere them as gods, suffering harm unknowingly. I record this as a warning.
Gong Yunlin said: Summer-heat pathogen interfering internally often causes sudden headache, nausea, or abdominal/back pain, or generalized pain. If untreated, coma, spasms, and syncope occur, dying from morning to evening. Only one dose of Baihu Wan (White Tiger Pill) disperses blood and cures instantly. Compared to bloodletting which depletes blood, this pill is more agile and miraculous. Formula uses Qiannian Duanshi (Millennium Forge Stone), scrape off impurities, grind to fine powder, wash with clear water, make pills size of Toad seeds. Take fifty pills per dose, adjust based on Sha severity, wash down with rice wine. Truly a miraculous formula.
Note: This pill regulates Qi, disperses blood, resolves phlegm, and quenches thirst; it is a fairy medicine for Sha. It also treats heart/abdominal pain, uterine flooding, red/white leukorrhea, chronic dysentery, traumatic internal injury with stagnant blood; effective for all. I frequently compound this pill to help the world, achieving quick results. Millennium Forge Stone is unavailable; forge stone from ancient tombs can be used. For Cold Sha, take with wine; for Hot Sha, take warm with boiled water. Adjust according to syndrome; do not rigidly adhere. However, Sha distension arises from unclear separation of pure/turbid in the Twelve Meridians, overflowing into Extraordinary Vessels, causing vessel manifestation and disease. Pathogens stagnate in collaterals; scraping/pricking opens collaterals, yielding even faster effects.
*Mizhi* records: Star-like spots in eyes, heat in feet from dampness, soak feet in warm water, rub soles to draw heat downward; treat urgently at onset. Alternatively, decoct three qian (~9g) Baijili (Tribulus Fruit) to wash eyes, four to five times daily, verified effective. Or use Gujingzhu (Eyebright) as tea. Cured in a few days.
Note: Eye stars arise from Spleen Fire rushing up, Liver heat binding with wind. Use Biyun San (Green Cloud Powder) insufflated into nose to dissipate stagnant Qi, frequently wash feet to descend heat; or stuff new Tangerine peel (Ju Pi) into nose, recedes in about six hours. Do not mistakenly use cold-cooling eye drops, causing blood stasis and cloudiness. Be cautious.
Wang Guang'an Miscellaneous Essays state: Food-stagnation syndrome resembles stroke; without investigating etiology, quick results are hard to achieve. I treated one person with sudden illness, locked jaw, inability to speak, blindness to recognition, paralyzed limbs. Urgently administered Suhexiang Wan (Styrax Pill), ineffective. Asked about cause: "Just accompanied guests, ate and suddenly got this." Taught to drink plenty of ginger-salt water and induce vomiting, expelled several bowls of food. Then took Baizhu Chenpi Banxia Maiya Tang (Atractylodes, Citrus Peel, Pinellia, Malt Decoction) and recovered. This is Shi Jue (Food Syncope). If etiology is not asked, and treated merely with phlegm/wind herbs, damaging Spleen/Stomach, disease worsens daily—this is the doctor's fault.
Note: Food-stagnation cases have varying etiologies; one cannot argue from a single perspective. In my youth, exam deadlines were tight. After meals, no time to walk, copying essays left no leisure. Writing at desk after full meals often caused abdominal pain, chest oppression, constipation, bloating, loss of appetite. Baohe Wan and Chaqu (Tea/Curds) plus Rice Charcoal were ineffective. An old friend said: In *Sanshi Yixian*, Runzi Wan is best. I followed the formula, took it, bowel movement cleared, all symptoms resolved. Lu Shi's Runzi Wan has many effects. Briefly listing a few to inspire juniors: For warm-heat, damp-phlegm etc., adjust dosage by severity. Most spiritual and swift. Highlighting this now.