之，病不少杀。余曰，阴脉细矣，按之至骨则坚，未可竟以虚责也。况两膝如绯，拊之烙手，当以
黄柏五钱为君，木通四钱为佐，槟榔一钱为使，日进两剂，可使遄已。笠泽颔余言，遂遵服之。
十余剂后，竟安适如常矣。
文学朱文哉，遍体如虫螫，口舌糜烂，寅卯时必见二鬼执盘餐以献。向余恸哭曰，余年未满
三十，高堂有垂白之亲，膝下无承欢之子，一旦抱 ，二鬼来侵，决无生理。倘邀如天之赐，得
以不死，即今日之秦越人矣。遂叩头流血。诊其寸脉，乍大乍小，亦意其为祟矣。细察两关，弦
滑且大，遂断定为痰饮之 。投滚痰丸一服，微有所下，而病患如故。更以小胃丹下痰及积，
身痛减半，至明日而鬼亦不见矣。更以参、术煎汤送小胃丹，复下数行，病若失矣。
内侄陆文蔚之内，自上脘抵少腹奇痛欲绝，有以山栀、枳、朴为治者，痛反弥甚。余曰，脉诚数
矣，独不察其沉则软乎？不第土惫，抑且火衰。六君子加姜、桂大剂饮之，痛且应手减矣。而原
医者犹曰，是火证也，复以火助之，痛得劫而暂伏，未几将不可知已。文蔚鄙其言竟信余勿
疑。调治一月，而康复如常。
门人薜昙孚之内，十五岁，腹痛异甚，面黄体瘦。幼科与之清热，女科与之通经疏气，大方与
之补血养气，越一月而腹痛转剧。余察其皮肤甲错，左尺独数，是小肠有痈。今脉数，知脓已
成，当以药溃之。与葵根一两，皂角刺二钱，陈皮三钱，两剂而脓血大下。更以太乙膏为丸，参、
汤送，一月而愈。
光禄卿吴玄水夫人，腹满而痛，喘急不能食。或以中满治之，无效。余诊其脉，右尺偏大，皮肤
甲错。余曰，此大肠痈也。先与黄 、白术、陈皮、当归、白芷托里，三日而脉始数，数则脓已熟矣。
用黄 、皂刺、白芷、穿山甲加葵根五钱，连投两剂而脓溃如注，昏晕不能支。即饮独参一两，
更以八珍汤补养一月始康。
邑宰夏彝仲太夫人，年届八帙。因彝仲还任闽中，忧思成疾，忽发热头疼。诸医误作伤寒，夺
其饮食，恣行发散。才一剂而汗出如洗，气促而喘，神昏而倦，业已治凶具矣。始问治于余，诊
其脉，大而无力。余曰，即令进食而投参、 ，犹惧或失之；反夺其食而攻之，未遽绝者幸耳。用
人参、黄 各五钱，白术三钱，橘、半各一钱五分，甘草六分，煨姜三钱。诸医皆曰，喘为气壅，参、
入口，即不可救。余百口陈辨。赖许霞城至，力赞决之。甫一剂而喘汗瘥减。倍用参、术至一
两，证愈七八，惟食未强耳。此火衰不能生土，加熟附二钱，干姜一钱，服二月乃痊。
儒者吴君明，伤寒六日，谵狂笑语，头痛有汗，大便不通，小便自利。众议承气下之。余诊其脉，
浮而大；察其腹，不硬不痛。因思仲景云∶“伤寒不大便六七日，头疼有热，小便清，知不在里，
仍在表也。”方今仲冬严寒，宜与桂枝汤。众皆咋舌云，谵狂为阳盛，桂枝入口必死。余笑曰，
汗多神昏，故有妄语。虽不大便，腹无所苦，和其营卫，必自愈耳。遂违众用之。及夜而笑语皆
止，明日大便自通。故夫病变多端，不可胶执。既有谵语，而能察为表证者，百不得一也。向使
病家狐疑，误行下剂，其不立毙者几希。
医者王月怀，伤寒五六日以来，下利日数十行，懊 目胀。一时名医共议以山药、苡仁补之。
且曰，不服是药，泻将脱矣。余独曰，脉沉且数，按其腹便攒眉作楚，此协热自利，谓之旁流，非
正粪也，当有燥屎。饮以承气汤，果得结粪数枚，利乃止，懊 乃定。
明经俞元济，背心一点痛，久而渐大。每用行气和血，绝不取效。余问之曰，遇天阴觉痛增否？
元济曰，天阴痛即甚。余曰，脉既滑而遇阴辄甚，其为湿痰无疑。以胃苓汤加半夏三钱，数剂
而不知痛所在矣。
刑部主政徐凌如，劳与怒并，遂汗出昏倦，语言错乱，危笃殆甚。迎余视之，脉滑而软，为气大
虚而痰上涌，以补中益气汤加半夏、附子，四日而稍苏。更以六君子加姜汁、熟附，几两月而
病乃却。
文学张方之，久忧暴惊，遂发颠妄。或补心神，或逐痰涎，均无裨也。求治于余。余曰，六脉结而
有力，非大下其痰，无由痊也。先服宁志膏三日，遂以小胃丹下之。三月之内，服小胃丹数次，
去痰积始尽。更以归脾、妙香加牛黄、龙骨为丸，剂毕而康。向使不与下之，或虽下之未必屡
屡下之，以尽其痰，遂成痼疾矣。
邑侯张孟端夫人，忧愤交乘，食下辄噎，胸中隐隐痛。余诊曰，阳脉滑而阴脉搏，痰血互凝之
象也。以二陈汤加归尾、桃仁、郁金、五灵脂，连进四剂，证犹未衰。因思人参与五灵脂同剂，善
于浚血。即以前剂入人参二钱，倍用五灵脂，再剂而血从大便出，十剂而噎止，弥月而竟安矣。
金元之之内患噎，胸腹有奇痛。以经阻故，诸医咸以瘀血处疗。余察其脉，细为气衰，沉为寒
痼，反与攻血，岂非加霜于雪乎？况自上及下处处皆痛，明征非血矣。参、 、术各二钱，木香、姜、
桂各一钱，煎成，和醇酒进之。甫入口便快，半月而痛去如扫矣。自是岁服理中汤，数年弗辍。
顾淡之，劳神之后，躁热异甚，头角掣痛，时作时止。医者夺其食而与之解表，越四日而热不
衰，议将攻里。余细视之，脉不浮紧，安得表耶？又不沉实，安得里耶？只有少阴大而无力，为劳
神太过，乃虚烦类伤寒也。若禁其食，即益其疾耳。便以糜粥与之，且与大剂归脾汤，不十日
安矣。
钱台石年近六帙，肢体不能转侧，昏倦不能语言，鼻窍不利，二便俱秘。是心肺俱虚，为类中
风也。日伐其气，并攻其痰，已濒于危矣。比余诊之，六脉洪盛，按之搏指。此至虚有盛候，以形
色验之灼然也。法当从证不从脉，补中为主，方可回生。举家惑于他言，两日不决。余曰，今日
不进药，将为性命忧矣。若补之而病进，余独任其咎。乃以补中益气加秦艽、天麻、竹沥、姜汁，
再剂而神清，十日而转侧利便。珍摄半载，始获全愈。
大宗伯董玄宰少外家，吐血喘嗽，蒸热烦心。先与清火，继进补中，药饵杂投，竟无少效，而后乞
治于余。余曰，两尺沉且坚，小腹按之即痛，此有下焦瘀血，法当以峻剂行之。若与平和之剂
行血，则坚血不得行也。以四物汤加郁金、穿山甲、 虫、大黄，武火煎服。一剂而黑血下二碗。
而痛犹未去。更与一服，又下三四碗而痛方止。遂以十全大补丸四斤，而康复如常。
文学顾明华，十年哮喘，遍治无功，始向余叩首乞哀，泪潸然下。余诊其两寸俱涩，余部俱实。
涩者痰凝之象，实者气壅之征。非吐利交行，则根深蒂固之痰，何能去耶？幸其恪遵余言，半
载之间，吐者五次，下者七次，更以补中之剂加鸡子、秋石，期年而永绝其根。
王邃初，老于经商，患哮喘者二十年矣。偶值舟次谈及，问余尚可治否？余曰，年望六旬，困顿
日久，恐不可治。姑与诊之，喜其脉尚有神，右寸浮滑，是风痰胶固于太阴之经。以杏仁、防风、
甘、桔、白芥子、麻黄，连进三剂，而病状大减。因以丹溪治哮丸与之，仍日进六君子汤。喜其不
畏药饵，连服无间，经岁而痊。
张远公，久嗽。得药如水，委命待尽。一日以他事晤谈，自谓必不可治，姑乞诊之。余曰，饥时胸
中痛否？远公曰，大痛。视其上唇有白点，痛发则口角流涎，此虫啮其肺，故咳嗽耳。用百部、乌
梅煎膏与服。居十日而痛如失，嗽竟止矣。令其家人从净桶中索之，得寸白虫数十条，自是
永不复发。
上舍宋敬夫，心腹大痛，伛偻不可以仰。日与行气和血，无益也。余诊其左寸滑而急，视其气
不能以息，偶得一咳，攒眉欲绝。此为心疝无疑。亟令其以酱姜进粥。乃取小茴香、川楝子、青
木香、广木香、茱萸、木通、玄胡索、归身、青皮，一服而痛减，五日而安。
先兄念山，谪官浙江按察，郁怒之余又当炎暑，小便不通，气高而喘。以自知医，频服胃苓汤
不效。余曰，六脉且大且结，乃气滞也。但以盐炒枳壳八钱，木通三钱，生姜五大片，急火煎服。
一剂遂通，四剂霍然矣。
邑宰章生公，南都应试。时八月初五日，心脾痛甚，食饮皆废。诊其两寸，涩而无力。与大剂归
脾汤加人参三钱，官桂二钱。生公曰，尝闻痛无补法，骤补实所不敢，得无碍场期乎？余曰，第
能信而服之，敢力保其无碍。若误投破气与寒凉，其碍也必矣。遂煎服之，不超时而痛减；续
进一剂，痛竟止，而场事获峻。
陈邃玄令郎，年十六岁，发尽脱落，无一茎存者。其脉数而大。余曰，肾之合骨也，其荣发也。多
食甘则骨痛而发落，此《内经》之言也。揣其股髀间骨，果觉大痛。遂以还少丹加生地、当归
作丸，日服一两。兼进清胃汤。半载之间，发尽出矣。
孝廉俞彦直，肌肤灼热，神气昏闷，闻食即呕，强进即吐，困惫不能支。医者欲与温补，而众论
挠之。彼告彦直云，必延李士材商之。比余至，按之热处在骨间，脉亦沉而搏，此伏火也。不敢
徇情面而违至理。乃以黄连一钱五分，山栀、黄柏各一钱，枳壳、陈皮各二钱，甘草五分，煎成
入姜汁三匙。服之四剂而痊。更以六味丸加生脉散，调摄浃岁。
章仲舆令嫒，未出阁时，困于邪祟，终日谵妄。日与安神化痰祛邪辛香之剂，已无遗用，病不
少间也。余曰，六脉忽大忽小，忽浮忽沉，确为祟象。内服八毒赤丸。外以帛紧拴两臂，复以二
拇指相并扎定，以小艾炷于两介甲侧肉处灼之。甫十壮而乞哀愿去。更与四壮，旦日复报
七壮，而祟遂绝矣。
鞠上舍，有所抑郁，蒸热如焚，引饮不休。奄奄床褥，喃喃呓语。每言户外事，历历如见。始则指
为伤寒，继则疑为鬼祟。药饵日投，病且日进，方来乞治于余。诊得肝脉浮濡，肺脉沉数。余曰，
木性虽浮，肝则藏血藏魂，而隶于下焦，脉当沉长而弦。金性虽沉，肺则主气藏魄，而居乎至
高，脉当浮短而涩。肺燥而失其相傅之权，则肝为将军之官，无所畏制，遂飞扬而上越，不能
自藏其魂耳。尝闻魄强者魂安，今魄弱而魂不肯退藏，乃逐虚阳而放荡，此名离魂。魂既离
矣，则出入无时，故户外事皆能闻且见也。当急救肺金之燥，使金气足而肝木有制，则归魂
不难耳。因以清燥汤加减，人参、黄 、天冬、麦冬、五味子、当归以润肺养气，芍药、枣仁、栀子、甘
草以摄肝归魂，橘红、沉香使九天之阳下降，升麻、柴胡使九地之阴上升。两剂而呓语顿止，
十剂而烦渴皆除。摄治一月，而病魔永遁。
燕都王湛六兄，以脾泄求治，神疲色瘁。诊得促脉，或十四五至得一止，或十七八至得一止。
余谓其原医者曰，法在不治。而医者争之曰，此非代脉，不过促耳，何先生之轻命耶？余曰∶是
真元败坏，阴阳交穷，而促脉呈形，与稽留凝泣而见促者，不相侔也。医者，唯唯。居一月而果殁。
善化令黄桂岩，心疼夺食，脉三动一止，良久不能自还。原医云五脏之气不至，法当旦夕死。
余曰，古人谓痛甚者脉多代。周梅屋云∶“少得代脉者死，老得代脉者生。”今桂岩春秋高矣，
而胸腹负痛，虽有代脉，安足虑乎？果越两旬而桂岩起矣。故欲穷脉之变者，非博学人不能也。
（前文略）病情并未明显减轻。我说，阴脉虽然细弱，但重按至骨时感觉坚硬，不能简单地归结为虚证。况且双膝皮肤发红，触摸时烫手，应当以黄柏五钱为君药，木通四钱为佐药，槟榔一钱为使药，每天服用两剂，可以使疾病迅速痊愈。笠泽点头赞同我的话，于是遵照服用。服药十余剂后，竟然恢复得和平常一样舒适。
文学朱文哉，全身感觉像被虫子叮咬一样疼痛，口舌糜烂，在寅时到卯时（凌晨3点到7点）必定出现两个鬼拿着盘餐来进献。他曾经对着我痛哭说：“我年龄不到三十岁，父母年迈白发苍苍，膝下没有承欢侍奉的儿子，一旦患病，又有鬼魅侵扰，肯定没有活路了。如果蒙受上天恩赐得以不死，我就是当今的扁鹊再世。”于是磕头直到流血。诊察他的寸脉，忽大忽小，我也曾怀疑是邪祟作怪。仔细察视左右关脉，弦滑且大，于是断定为痰饮之病。投服滚痰丸一剂，轻微排泄了一些积滞，但病患症状依旧。接着用小胃丹攻下痰积，身体疼痛减半，到了第二天鬼魅也不见了。再用参、术煎汤送服小胃丹，又排泄数次，病就像消失了一样。
内侄陆文蔚的妻子，从上脘穴一直延伸到少腹部剧烈疼痛，几乎让人无法忍受。有人用山栀、枳实、厚朴治疗，疼痛反而更加严重。我说：“脉象确实数，难道没观察到沉取时脉象软吗？不仅是脾气疲惫，而且命门火衰。用六君子汤加生姜、肉桂大剂量服用，疼痛立刻减轻。而原来的医生还说这是火证，用火性药物助热，疼痛只是暂时被压制，不久后将不可收拾。文蔚鄙视他的话，完全相信我没有怀疑。调理治疗一个月，便康复如常。
门人薜昙孚的妻子，十五岁，腹痛异常剧烈，面色发黄，身体消瘦。儿科医生给她清热，妇科医生给她通经疏气，内科医生给她补血养气，过了一个月腹痛反而加剧。我观察她皮肤粗糙如鳞甲，左尺脉独数，这是小肠有痈肿。现在脉数，知道脓已经形成，应当用药攻破它。给予葵根一两，皂角刺二钱，陈皮三钱，两剂药后脓血大量排出。再用太乙膏制成丸药，用人参汤送服，一个月痊愈。
光禄卿吴玄水的夫人，腹部胀满且疼痛，气喘急促不能进食。有人用治疗中满的方法治疗，无效。我诊察她的脉，右尺脉偏大，皮肤粗糙如鳞甲。我说：“这是大肠痈。先用黄芪、白术、陈皮、当归、白芷托里排脓，三天后脉才开始变数，脉数说明脓已成熟。用黄芪、皂角刺、白芷、穿山甲加葵根五钱，连续服用两剂，脓溃破如注，病人昏晕难以支撑。立即饮用独参汤一两，再用八珍汤补养一个月才康复。
县令夏彝仲的母亲，年近八十。因为夏彝仲回福建任职，忧思成疾，突然发热头痛。众医误当作伤寒，剥夺她的饮食，肆意使用发散药物。刚服一剂就汗出如洗，气促喘息，神志昏迷疲倦，已经准备好凶丧器具了。才来问我治疗。诊察她的脉，大而无力。我说：“即使让她进食并投予参、芪，还担心会有失误；反而剥夺她的食物去攻伐，没有立即死亡已经是幸运了。用人参、黄芪各五钱，白术三钱，橘红、半夏各一钱五分，甘草六分，煨姜三钱。众医都说，气喘是因为气机壅滞，人参、黄芪入口，就无法救治了。我极力辩驳。幸亏许霞城到来，大力赞成我的决定。刚服一剂，气喘出汗就减轻。加倍使用参、术至一两，症状好了七八成，只是食欲还未增强罢了。这是因为火衰不能生土，加熟附子二钱，干姜一钱，服用两个月才痊愈。
儒者吴君明，患伤寒六天，胡言乱语、狂笑，头痛有汗，大便不通，小便自利。众人议论用承气汤攻下。我诊察他的脉，浮而大；观察他的腹部，不硬不痛。因此想到张仲景说：‘伤寒不大便六七天，头疼有热，小便清，知道病不在里，仍在表。’如今正值仲冬严寒，适宜给予桂枝汤。众人都咋舌说，胡言乱语是阳盛，桂枝入口必死。我笑着说，汗多导致神志昏沉，所以有妄语。虽然不大便，腹部没有痛苦，调和营卫，必然自愈。于是违背众人意见使用此方。到了晚上笑语都停止，第二天大便自然通畅。所以病变多种多样，不可固执拘泥。既有谵语，又能识别为表证的，百人中难得一个。假如病家犹豫不决，误用下剂，不立即死亡的很少见。
医者王月怀，患伤寒五六天以来，腹泻每天几十次，心中烦闷眼睛胀痛。一时名医共同商议用山药、薏苡仁补益。并且说，不服这些药，泻脱就要发生了。我独自说，脉沉且数，按压腹部就皱眉痛苦，这是协热自利，称为旁流，不是正常的粪便，应当有燥屎。给予承气汤饮用，果然得到几枚结粪，腹泻才停止，烦闷才安定。
明经俞元济，背心一点疼痛，久了逐渐变大。每次用行气和血的方法，绝不见效。我问他说：“遇到阴天觉得疼痛加重吗？”俞元济说：“阴天疼痛就厉害。”我说：“脉既滑而遇阴辄甚，这肯定是湿痰无疑。用胃苓汤加半夏三钱，几剂药后就不觉得痛在哪里了。
刑部主政徐凌如，劳累与愤怒并发，于是汗出昏倦，语言错乱，危重得很。请我去看，脉滑而软，是大气大虚而痰上涌，用补中益气汤加半夏、附子，四天稍微苏醒。再用六君子汤加姜汁、熟附，将近两个月病才退去。
文学张方之，长期忧愁突然受惊，于是发癫狂。有的补心神，有的逐痰涎，都没有帮助。求治于我。我说：“六脉结而有力，不大力攻下其痰，没有办法痊愈。先服宁志膏三天，然后用小胃丹攻下。三个月内，服用小胃丹数次，去除痰积才干净。再用归脾汤、妙香散加牛黄、龙骨制成丸药，药服完就康复了。假如当时不攻下，或者虽然攻下未必多次攻下以尽除痰，就会成为顽固疾病了。
县侯张孟端夫人，忧愤交加，吃东西就噎住，胸中隐隐作痛。我诊察说：“阳脉滑而阴脉搏动，是痰血互凝的现象。用二陈汤加归尾、桃仁、郁金、五灵脂，连续服用四剂，症状还没有减退。想到人参和五灵脂同用，善于疏通瘀血。就在前方中加入人参二钱，加倍使用五灵脂，再服两剂，血从大便排出，十剂后噎止，满月后完全安康。
金元之的妻子患噎膈，胸腹有剧烈疼痛。因为月经阻滞的缘故，众医都用治疗瘀血的方法。我察视她的脉，细表示气衰，沉表示寒邪久留，反而用攻血的方法，岂不是雪上加霜吗？况且从上到下处处都痛，明确证明不是血瘀。用人参、黄芪、白术各二钱，木香、生姜、肉桂各一钱，煎成，混合醇酒服用。刚入口就觉得爽快，半个月疼痛扫除一空。从此每年服用理中汤，几年不停。
顾淡之，劳神之后，躁热异常，头角掣痛，时作时止。医生剥夺他的食物给他解表，过了四天热不退，议论将要攻里。我仔细看他的脉，不浮紧，怎么能说是表证呢？又不沉实，怎么能说是里证呢？只有少阴脉大而无力，是劳神太过，属于虚烦类伤寒。如果禁止他进食，就是增加他的疾病。便给他糜粥，并且给予大剂归脾汤，不到十天就安康了。
钱台石年近六十，肢体不能转动，昏倦不能说话，鼻窍不利，大小便都闭塞。这是心肺俱虚，属于类中风。天天耗损他的正气，并攻伐他的痰，已经濒临危险了。等到我诊察，六脉洪盛，按之搏指。这是至虚有盛候，通过形色验证非常明显。法度应当从证不从脉，以补益为主，才可以起死回生。全家被其他言论迷惑，两天不能决定。我说：“今天如果不进药，就要担忧性命了。如果补益后病情加重，我独自承担罪责。”于是用补中益气汤加秦艽、天麻、竹沥、姜汁，再服两剂神志清醒，十天就能转动侧身方便了。精心调养半年，才获得全愈。
大宗伯董玄宰的外甥家，吐血喘嗽，蒸热烦心。先用清火药，继用补中益气药，药物杂投，竟然没有少许效果，后来乞求我治疗。我说：“两尺脉沉且坚，小腹按压就痛，这是有下焦瘀血，法度应当用峻剂攻逐。如果用平和的药物行血，则坚硬的瘀血不能运行。用四物汤加郁金、穿山甲、虻虫、大黄，武火煎服。一剂后黑血排出两碗。而疼痛还没有去除。再给一服，又排出三四碗疼痛才停止。于是用十全大补丸四斤，康复如常。
文学顾明华，十年哮喘，遍治无功，开始向我叩首哀求，泪潸然落下。我诊察他的两寸脉都涩，其余部位脉都实。涩是痰凝的现象，实是气壅的标志。如果不吐利交行，根深蒂固的痰，怎么能去除呢？幸好他严格遵守我的话，半年之间，吐了五次，下了七次，再用补中的药剂加鸡蛋、秋石，一年就永远断绝了病根。
王邃初，老于行商，患哮喘二十年。偶然在船上谈到，问我还可以治吗？我说：“年纪望六十，困顿日久，恐怕不可治。姑且给他诊察，高兴的是脉还有神，右寸浮滑，是风痰胶固于太阴经。用杏仁、防风、甘草、桔梗、白芥子、麻黄，连续服用三剂，病状大减。于是用丹溪治哮丸给他，仍然每天服用六君子汤。高兴的是他不畏药饵，连续服用不间断，经过一年痊愈。
张远公，长期咳嗽。吃药像喝水一样，听天由命等待死亡。一天因为别的事见面交谈，自己认为必不可治，姑且请求诊察。我说：“饥饿时胸中痛吗？”张远公说：“非常痛。”看他上唇有白点，痛发作时口角流涎，这是虫咬噬肺部，所以咳嗽。用百部、乌梅煎膏服用。住了十天疼痛消失，咳嗽竟停止了。让家人从净桶中寻找，得到寸白虫数十条，从此永不复发。
上舍宋敬夫，心腹大痛，弯腰曲背不能仰卧。每天用行气和血的方法，没有益处。我诊察他的左寸脉滑而急，看他的气息不能顺畅呼吸，偶尔咳一声，皱眉欲绝。这肯定是心疝。急忙让他用酱姜配粥吃。然后取小茴香、川楝子、青木香、广木香、吴茱萸、木通、玄胡索、当归身、青皮，一剂后疼痛减轻，五天安康。
先兄念山，贬官浙江按察使，郁怒之余又逢炎暑，小便不通，气逆而上喘息。因为他自己懂医，频繁服用胃苓汤无效。我说：“六脉且大且结，是气滞。只用盐炒枳壳八钱，木通三钱，生姜五大片，急火煎服。一剂就通，四剂霍然痊愈。
县令章生公，去南京应试。当时八月初五日，心脾痛甚，饮食皆废。诊察他的两寸脉，涩而无力。给予大剂归脾汤加人参三钱，官桂二钱。章生公说：“曾听说痛无补法，骤然补益实在不敢，难道不会妨碍考试日期吗？”我说：“只要能相信并服用，敢力保不妨碍。如果误投破气与寒凉，那一定会妨碍。于是煎服，不超过时辰疼痛减轻；续进一剂，疼痛竟止，而考试事情顺利结束。
陈邃玄的公子，十六岁，头发全部脱落，没有一根留存。他的脉数而大。我说：“肾合骨，其华在发。多吃甘味则骨痛而发落，这是《内经》的话。揣摸他的大腿髀间骨头，果然觉得大痛。于是用还少丹加生地、当归制成丸药，每天服用一两。兼进清胃汤。半年之间，头发全部长出来了。
孝廉俞彦直，肌肤灼热，神气昏闷，闻食即呕，强行进食就吐，困惫不能支撑。医生想要温补，而众论阻挠。他告诉俞彦直说：“必须请李士材商量。等我到了，按摸热度在骨间，脉也沉而搏指，这是伏火。不敢徇情面而违背至理。于是用黄连一钱五分，山栀、黄柏各一钱，枳壳、陈皮各二钱，甘草五分，煎成加入姜汁三匙。服用四剂痊愈。再用六味丸加生脉散，调养一年。
章仲舆的女儿，未出嫁时，困于邪祟，整天谵妄。每天用安神化痰祛邪辛香之剂，已经没有剩余的药可用，病没有稍好。我说：“六脉忽大忽小，忽浮忽沉，确实是邪祟现象。内服八毒赤丸。外用帛紧紧拴住双臂，再用两个拇指并拢扎定，用小艾炷在两介甲侧肉处灼烧。刚十壮就乞求哀愿离去。再给四壮，第二天早上又报告七壮，邪祟就绝迹了。
鞠上舍，有所抑郁，蒸热如火，引水不休。奄奄一息在床上，喃喃呓语。每说户外的事情，历历在目。起初指为伤寒，继而疑为鬼祟。药饵日投，病却日进，才来乞求我治疗。诊得肝脉浮濡，肺脉沉数。我说：“木性虽浮，肝藏血藏魂，隶属下焦，脉当沉长而弦。金性虽沉，肺主气藏魄，居于至高，脉当浮短而涩。肺燥而失去相傅之权，则肝为将军之官，无所畏惧制约，于是飞扬而上越，不能自藏其魂耳。曾听说魄强者魂安，现在魄弱而魂不肯退藏，于是追逐虚阳而放荡，这名叫离魂。魂既然离开了，出入无时，所以户外的事情都能听见看见。应当急救肺金之燥，使金气足而肝木有制，则归魂不难。于是用清燥汤加减，人参、黄芪、天冬、麦冬、五味子、当归以润肺养气，芍药、枣仁、栀子、甘草以摄肝归魂，橘红、沉香使九天之阳下降，升麻、柴胡使九地之阴上升。两剂后呓语顿止，十剂后烦渴皆除。摄治一月，病魔永遁。
燕都王湛六兄，因脾泄求治，神疲色瘁。诊得促脉，有时十四五次跳动得一止，有时十七八次跳动得一止。我对原医生说：“法度在不治。而医生争辩说：“这不是代脉，不过是促脉，为什么先生轻视生命呢？”我说：“这是真元败坏，阴阳交穷，而促脉呈形，与稽留凝泣而见促者，不相类似。医生，唯唯诺诺。过一个月果然去世。
善化令黄桂岩，心疼夺食，脉三动一止，很久不能自还。原医说五脏之气不至，法当旦夕死。我说：“古人谓痛甚者脉多代。周梅屋说：‘少得代脉者死，老得代脉者生。’现在桂岩年纪大了，而胸腹负痛，虽有代脉，有什么可忧虑的呢？果然超过二十天黄桂岩起来了。所以想要穷尽脉的变化，不是博学的人不能做到。”
(Prior text omitted) The illness did not significantly subside. I stated, "Although the Yin pulse is fine, it feels firm when pressed to the bone; it cannot simply be attributed to deficiency. Moreover, both knees are red and feel hot to the touch. The treatment should prioritize Huangbai (Phellodendri Cortex) at 5 qian as the sovereign herb, Mutong (Akebiae Caulis) at 4 qian as the assistant herb, and Binglang (Arecae Semen) at 1 qian as the guide herb. Administering two doses daily can lead to a rapid recovery." Lizhe nodded in agreement with my words and followed the prescription. After more than ten doses, he recovered completely and returned to normal comfort.
The scholar Zhu Wen'ai suffered from a sensation all over his body as if being bitten by insects, along with erosion of the mouth and tongue. During the Yin and Mao hours (3:00 AM to 7:00 AM), he would invariably see two ghosts offering him food on trays. He once wept bitterly before me, saying, "I am under thirty years old, my parents are elderly with white hair, and I have no children to serve them. If I fall ill and am invaded by ghosts, there is surely no hope for life. If I am blessed by Heaven to survive, I shall be like Bian Que today." He kowtowed until blood flowed. Upon examining his Cun (inch) pulse, it fluctuated between large and small, leading me to suspect demonic influence initially. However, upon carefully observing the Guan (bar) pulses on both sides, they were wiry, slippery, and large. I thus diagnosed it as Phlegm-Fluid retention. I administered Guntan Wan (Rolling Phlegm Pill) once; although there was slight evacuation, the patient's symptoms remained unchanged. Subsequently, I used Xiaoweidan (Minor Stomach Pill) to purge phlegm and accumulation. His body pain reduced by half, and by the next day, the ghosts disappeared. I then used a decoction of Renshen (Ginseng Radix et Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma) to deliver Xiaoweidan, resulting in several more evacuations, after which the illness seemed to vanish.
My nephew Lu Wenwei's wife suffered from severe pain extending from the Shangwan point down to the lower abdomen, almost unbearable. Someone treated her with Zhizi (Gardeniae Fructus), Zhishi (Aurantii Fructus Immaturus), and Houpo (Magnoliae Officinalis Cortex), but the pain intensified. I said, "The pulse is indeed rapid, but have you not observed that it is soft when pressed deeply? This is not only Spleen Qi exhaustion but also Fire decline. I prescribed Liujunzi Tang (Six-Gentleman Decoction) supplemented with Shengjiang (Zingiberis Rhizoma Recens) and Rougui (Cinnamomi Cortex) in a large dose. The pain subsided immediately upon administration. However, the original physician insisted it was a Fire syndrome and argued that using warming herbs would exacerbate the heat, suppressing the pain temporarily but leading to unknown consequences later. Wenwei despised his words and trusted me without doubt. After one month of regulation and treatment, she recovered fully.
The wife of my student Xie Tanfu, aged fifteen, suffered from extremely severe abdominal pain, yellowish complexion, and emaciation. Pediatricians treated her with clearing heat, gynecologists with regulating menstruation and soothing Qi, and internal medicine physicians with nourishing Blood and Qi. After a month, her abdominal pain worsened. I observed her skin was rough like scales, and her Left Chi (cubit) pulse was exclusively rapid. This indicated an abscess in the Small Intestine. Given the rapid pulse, I knew pus had formed and decided to use medication to rupture it. I prescribed Kuigen (Malvae Root) 1 liang, Zaojiaoci (Gleditsiae Spina) 2 qian, and Chenpi (Citri Reticulatae Pericarpium) 3 qian. After two doses, a large amount of pus and blood was discharged. I then prepared Taiyi Gao (Taiyi Ointment) into pills, delivered with Ginseng decoction, and she recovered within a month.
The wife of Guanglu Qing Wu Xuanshui suffered from abdominal fullness and pain, shortness of breath, and inability to eat. Treatment for middle-jiao fullness proved ineffective. Her Right Chi pulse was disproportionately large, and her skin was rough like scales. I diagnosed this as Large Intestine Abscess. Initially, I used Huangqi (Astragali Radix), Baizhu, Chenpi, Danggui (Angelicae Sinensis Radix), and Baizhi (Angelicae Dahuricae Radix) to support the interior and expel pus. After three days, the pulse became rapid, indicating mature pus. I then added Zaojiaoci, Baizhi, Chanshanjia (Manis Squama), and increased Kuigen to 5 qian. After two consecutive doses, the pus ruptured profusely, causing fainting and weakness. I immediately administered Dushen Tang (Single-Ginseng Decoction) with 1 liang of Renshen. She was further nourished with Bazhen Tang (Eight-Treasure Decoction) for a month until she recovered.
The mother of County Magistrate Xia Yizhong, nearing eighty years old, fell ill due to worry and grief after her son returned to his post in Fujian. She suddenly developed fever and headache. Physicians mistakenly treated it as Taiyang Disease (Exogenous Cold Damage), deprived her of food, and excessively used diaphoretic methods. After just one dose, she sweated profusely, experienced shortness of breath and panting, became comatose and fatigued, and funeral preparations were made. Only then did they seek my treatment. Her pulse was large but forceless. I said, "Even if we feed her and administer Renshen and Huangqi, we must fear making mistakes; instead, depriving her of food and attacking the pathogen is fortunate to have not caused immediate death." I prescribed Renshen and Huangqi each 5 qian, Baizhu 3 qian, Juhong (Tangerine Peel) and Banxia (Pinelliae Rhizoma) each 1.5 qian, Gancao (Glycyrrhizae Radix et Rhizoma) 6 fen, and Wei Jiang (Prepared Ginger) 3 qian. Other physicians argued that panting was due to Qi stagnation and that Renshen and Huangqi would be fatal. I defended my position vigorously. Fortunately, Xu Xiacheng arrived and strongly supported my decision. After one dose, the panting and sweating subsided. Doubling the dosage of Renshen and Baizhu to 1 liang improved symptoms by 70-80%, though appetite remained weak. This was due to Fire failing to generate Earth. I added Shu Fuzi (Prepared Aconiti Lateralis Radix) 2 qian and Ganjiang (Zingiberis Rhizoma) 1 qian. She recovered after two months of treatment.
The Confucian scholar Wu Junming, suffering from Exogenous Cold Damage for six days, exhibited delirious speech, manic laughter, headache with sweating, constipation, and spontaneous urination. The consensus was to use Chengqi Tang (Stomach-Clearing Decoction) to purge. However, his pulse was floating and large, and his abdomen was neither hard nor painful. Recalling Zhang Zhongjing's statement: 'In Exogenous Cold Damage with constipation for six or seven days, headache, fever, and clear urine indicate the pathogen is still in the exterior, not the interior.' Given the severe cold of mid-winter, I prescribed Guizhi Tang (Cinnamon Twig Decoction). Others gasped, arguing that delirium indicated Yang excess and that Guizhi Tang would be fatal. I smiled and said, "Profuse sweating causes mental confusion, leading to妄语 (delirious speech). Although constipated, there is no abdominal distress. Harmonizing Ying and Wei will lead to self-healing." Defying the crowd, I used this formula. By night, the laughter and speech ceased, and the next day, bowel movements normalized naturally. Thus, pathological changes are diverse and should not be rigidly adhered to. Identifying exterior syndromes amidst delirium is rare; had the family hesitated and used purgatives, death would likely have been immediate.
Physician Wang Yuehuai, suffering from Exogenous Cold Damage for five to six days, experienced diarrhea dozens of times daily, accompanied by inner restlessness and eye distension. Prominent physicians collectively recommended Shanyao (Dioscoreae Rhizoma) and Yiren (Coicis Semen) for tonification, warning that without them, collapse from diarrhea would occur. I alone stated, "The pulse is deep and rapid, and pressing the abdomen causes frowning in pain. This is Diarrhea with Accompanying Heat, known as Paradoxical Flow (Pangliu), not normal stool, but rather indicates Dry Stool impaction." I administered Chengqi Tang, and indeed, several pieces of hardened stool were passed, stopping the diarrhea and resolving the restlessness.
Jingbo Yu Yuanji suffered from a localized pain on his back that gradually enlarged over time. Treatments promoting Qi circulation and Blood movement were ineffective. I asked, "Does the pain worsen on cloudy days?" He replied, "Yes, it intensifies on cloudy days." I said, "Given the slippery pulse and aggravation by yin weather, this is undoubtedly Damp-Phlegm." I prescribed Weiling Tang (Stomach-Ling Decoction) with Banxia added (3 qian). After several doses, the location of the pain became indistinguishable.
Xingbu Zhuzheng Xu Lingru suffered from simultaneous labor and anger, resulting in sweating, dizziness, fatigue, and disordered speech, in a critical state. Upon examination, his pulse was slippery and soft, indicating severe Qi deficiency with Phlegm surging upward. I prescribed Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Banxia and Fuzi. After four days, he slightly regained consciousness. Subsequently, Liujunzi Tang with Jiangzhi (Ginger Juice) and Shu Fuzi was used, and after nearly two months, the illness receded.
Scholar Zhang Fangzhi, suffering from long-term worry and sudden fright, developed mania. Treatments tonifying Heart-Shen or expelling Phlegm were ineffective. Seeking my help, I found his six pulses knotted yet forceful. I concluded that without vigorous purging of Phlegm, recovery was impossible. He first took Ningzhi Gao (Soothe Mind Paste) for three days, followed by Xiaoweidan. Within three months, Xiaoweidan was taken several times until Phlegm accumulations were exhausted. Finally, Guipi Tang (Restore the Spleen Decoction) and Miaoxiang San (Wonderful Incense Powder) with Niuhuang (Calculus Bovis) and Longgu (Fossilia Ossis Mastodi) were formulated into pills. Upon completion of the course, he recovered. Had purging not been performed, or performed insufficiently, this would have become a chronic disease.
Madam Zhang Mengduan, wife of County Marquis Zhang, suffered from alternating worry and indignation, dysphagia after eating, and dull chest pain. My diagnosis revealed slippery Yang pulses and forceful Yin pulses, indicating intermingled Phlegm and Blood stasis. I prescribed Erchen Tang (Two-Aged Decoction) with Guiwei (Angelicae Sinensis Radix Tail), Taoren (Persicae Semen), Yujin (Curcumae Radix), and Wulingzhi (Trogopterori Faeces). After four doses, symptoms persisted. Recalling that Renshen and Wulingzhi together effectively resolve Blood stasis, I added Renshen (2 qian) and doubled Wulingzhi in the previous formula. After two more doses, blood was passed via stool. After ten doses, dysphagia stopped, and she was fully recovered after a month.
Madam Jin Yuanzhi suffered from dysphagia with severe chest and abdominal pain. Due to menstrual obstruction, physicians treated her for Blood stasis. I observed her pulse: thin indicated Qi decline, deep indicated chronic Cold. Using blood-invigorating methods would only worsen the condition ("adding frost to snow"). Since pain occurred everywhere from top to bottom, it was clearly not Blood stasis. I prescribed Renshen, Huangqi, and Baizhu each 2 qian, Muxiang (Aucklandiae Radix), Shengjiang, and Rougui each 1 qian, decocted and taken with mellow wine. Relief was immediate, and pain vanished within half a month. Thereafter, Lizhong Tang (Middle-Warming Decoction) was taken annually for several years without interruption.
Gu Danzhi, after mental exertion, suffered from extreme irritability and heat, pulling pain in the temples, intermittent. Physicians deprived him of food and used exterior-releasing methods. After four days, fever persisted, and discussions turned to interior-purging. Careful observation showed a pulse that was neither floating-tight (exterior) nor deep-solid (interior). Only the Shaoyin pulse was large and forceless, indicating excessive mental exertion leading to Empty Heat resembling Exogenous Cold. Prohibiting food would only exacerbate the illness. I provided millet porridge and a large dose of Guipi Tang. He recovered within ten days.
Qian Taishi, nearing sixty, could not turn his limbs, was comatose and unable to speak, had nasal obstruction, and constipation/urinary retention. This was Heart and Lung Qi deficiency, classified as Stroke-like Syndrome (Lei Zhong Feng). Daily depletion of Qi and Phlegm had brought him to the brink of death. Upon my examination, the six pulses were flooding and forceful, striking the finger firmly. This is "Extreme Deficiency presenting with Excess Signs," evident from his physical appearance. The method must follow the syndrome, not the pulse, prioritizing tonification to save his life. The family was confused by other opinions for two days. I warned, "If no medicine is taken today, life is at risk. If tonification worsens the condition, I bear sole responsibility." I prescribed Buzhong Yiqi Tang with Qinjiao (Sophorae Flavescentis Radix), Tianma (Gastrodiae Rhizoma), Zhuli (Bambusa Caulis in Taenia), and Jiangzhi. After two doses, clarity returned; after ten days, limb movement improved. With careful nursing for half a year, he fully recovered.
The nephew of Grand Secretary Dong Xuanzai suffered from hemoptysis, panting, cough, steaming fever, and vexation. Initial treatment involved clearing fire, followed by tonifying the middle. Mixed medications yielded no effect. Seeking my care, I found both Chi pulses deep and firm, with tenderness upon pressing the lower abdomen. This indicated Lower Jiao Blood stasis, requiring harsh purgatives. Mild blood-moving agents would fail to move hardened stasis. I prescribed Siwu Tang (Four-Agent Decoction) with Yujin, Chanshanjia, Machong (Blatta Orientalis), and Dahuang (Rhei Radix et Rhizoma), decocted with strong fire. One dose expelled two bowls of black blood. Pain persisted. A second dose expelled three to four more bowls, finally stopping the pain. He then took forty jin of Shiquan Dabu Wan (Ten-Full Great Tonifying Pills) and recovered fully.
Scholar Gu Minghua suffered from asthma for ten years with no success in various treatments. He kowtowed to me in despair. His Cun pulses were choppy, while other positions were solid. Choppy indicates Phlegm condensation; solid indicates Qi stagnation. Without combined vomiting and purging, how could deep-rooted Phlegm be removed? Fortunately, he strictly followed my advice. Over half a year, he vomited five times and purged seven times. Finally, tonifying formulas with Ji Zi (Galli Ovum) and Qiushi (Natrii Uras) were used. After one year, the root of the disease was eradicated.
Wang Suichu, an experienced merchant, suffered from asthma for twenty years. When asked if it was treatable, I noted his age near sixty and prolonged debility, suggesting it might be incurable. However, his pulse still had spirit, with the Right Cun floating and slippery, indicating Wind-Phlegm congealed in the Taiyin Meridian. I prescribed Xingren (Armeniacae Semen Amarum), Fangfeng (Saposhnikoviae Radix), Gancao, Jiegeng (Platycodonis Radix), Baijiezi (Brassicae Semen), and Mahuang (Ephedrae Herba). After three doses, symptoms greatly reduced. He was then given Danxi's Asthma Pill and continued taking Liujunzi Tang daily. His willingness to take medication consistently led to recovery after one year.
Zhang Yuangong suffered from chronic cough. Taking medicine was like drinking water, and he resigned himself to death. During a casual conversation, admitting hopelessness, he requested a pulse diagnosis. I asked, "Does your chest hurt when hungry?" He replied, "Severely." Observing white spots on his upper lip and salivation during pain attacks, I diagnosed lung parasitism ("worms biting the lung") causing the cough. I administered a paste of Baibu (Stemonae Radix) and Wumei (Mume Fructus). After ten days, pain ceased, and cough stopped. Family members retrieved dozens of tapeworms from the chamber pot, and the disease never recurred.
Shangshe Song Jingfu suffered from severe heart and abdominal pain, unable to straighten his back. Daily Qi and Blood regulation was ineffective. His Left Cun pulse was slippery and urgent. He struggled to breathe, and even a single cough caused him to grimace in agony. This was undoubtedly Heart Hernia (Xin Han). I urgently instructed him to eat congee with pickled ginger. Then I prescribed Xiaohuixiang (Foeniculi Fructus), Chuanlianzi (Meliosmae Fructus), Qingmuxiang (Aucklandiae Radix), Guangmuxiang (Costi Rhizoma), Zhuyu (Evodiae Fructus), Mutong, Yanhusuo (Corydalis Rhizoma), Dangshen (Codonopsis Radix - *Note: Text says Guishen/Danggui*, corrected to Danggui based on context of blood/qi), and Qingpi (Citri Reticulatae Pericarpium Viride). One dose reduced pain; five days later, he was well.
My elder brother Nianshan, demoted to Zhejiang Surveillance Commissioner, suffered from Qi stagnation and panting after anger and exposure to summer heat, with urinary retention. Self-medicating with Weiling Tang failed. His six pulses were large and knotted, indicating Qi stagnation. I prescribed Salt-fried Zhike (Aurantii Fructus) 8 qian, Mutong 3 qian, and 5 large slices of Shengjiang, decocted rapidly. One dose restored urination; four doses led to complete recovery.
County Magistrate Zhang Shenggong, taking exams in Nanjing on August 5th, suffered severe Heart-Spleen pain, unable to eat or drink. His Cun pulses were choppy and forceless. I prescribed a large dose of Guipi Tang with Renshen 3 qian and Guigui (Cinnamomi Ramulus) 2 qian. Zhang said, "I've heard pain has no tonification method. Sudden tonification scares me; won't it delay my exam?" I assured him, "Trust and take it; I guarantee no delay. Misusing Qi-breaking or cold-cooling herbs would certainly cause delay." He took the decoction. Pain subsided within the hour; a second dose stopped it completely, allowing him to finish the exam successfully.
Chen Suixuan's son, aged sixteen, had lost all his hair. His pulse was rapid and large. I cited the Neijing: "Kidney governs bone, its luster is in the hair. Excessive sweet intake causes bone pain and hair loss." Palpating his thighs, I confirmed severe bone pain. I prescribed Huan Shao Dan (Return to Youth Pill) with Shengdi (Rehmanniae Radix) and Danggui, formulated into pills, taken at 1 liang daily, alongside Qingwei Tang (Clear Stomach Decoction). Within half a year, his hair grew back completely.
Xiaolian Yu Yanzhi suffered from burning skin, mental confusion, nausea upon smelling food, and vomiting upon forced intake, too weak to sustain himself. Physicians wanted to tonify with warmth, but public opinion opposed it. He suggested consulting Li Shicai. Upon arrival, I found heat concentrated in the bones, with a deep, forceful pulse, indicating Hidden Fire. Refusing to compromise principle for face, I prescribed Huanglian (Coptidis Rhizoma) 1.5 qian, Shanzhi (Gardeniae Fructus) and Huangbai each 1 qian, Zhike and Chenpi each 2 qian, Gancao 5 fen, decocted with 3 spoons of Jiangzhi. After four doses, he recovered. He was then maintained with Liuwei Wan (Six-Ingredient Pill with Rehmanniae) plus Shengmai San for a year.
Miss Zhang Zhongyu, before marriage, was afflicted by evil spirits, experiencing constant delirium. Various calming, phlegm-resolving, and spirit-expelling aromatic medicines had been exhausted without relief. I found her six pulses fluctuating in size and depth, confirming spiritual affliction. Internally, she took Badu Chi Wan (Eight-Toxic Red Pill). Externally, silk was tightly bound around both arms, thumbs tied together, and moxa cones burned on the lateral flesh of the fingernails. After ten burns, she begged for it to stop. Four more burns were applied; the next morning, seven more were reported, and the affliction ceased.
Shangshe Ju suffered from depression, steaming heat, excessive thirst, bedridden state, and muttering dreams. He described outdoor events vividly. Initially diagnosed as Exogenous Cold, then suspected as spiritual. Medications worsened the condition. Liver pulse was floating and soft; Lung pulse was deep and rapid. I explained: Wood floats, but Liver stores Blood and Hun (Ethereal Soul), residing in the Lower Jiao, so its pulse should be deep, long, and wiry. Metal sinks, but Lung governs Qi and Po (Corporeal Soul), residing highest, so its pulse should be floating, short, and choppy. Lung dryness loses its governing authority; thus, the General (Liver) acts unchecked, flying upward, unable to store its Hun. This is called "Hun Separation." Since Hun wanders, he perceives external things. I aimed to rescue Lung Metal dryness, strengthening Metal to control Wood, facilitating Hun's return. I modified Qingzao Tang: Renshen, Huangqi, Tiandong, Maidong, Wuweizi, Danggui to moisten Lung and tonify Qi; Shaoyao, Zaoren, Zhizi, Gancao to calm Liver and gather Hun; Juhong, Chenxiang to descend Yang; Shengma, Chaihu to ascend Yin. After two doses, dream-speech stopped; after ten doses, vexation and thirst resolved. After one month of care, the illness vanished.
Brother Wang Zhanliu of Yandu sought treatment for Spleen Diarrhea, appearing spiritless and emaciated. His pulse was Cu (Hasty), stopping every 14-15 beats or 17-18 beats. I told the original physician, "This is untreatable." The physician argued, "This is not Dai (Intermittent) pulse, merely Cu. Why dismiss life?" I replied, "This is true Yuan Qi destruction and Yin-Yang exhaustion manifesting as Cu pulse, distinct from Cu pulse caused by stagnation. The physician agreed silently. He died exactly one month later.
Magistrate Huang Guiyan of Shan Hua suffered from heart pain preventing eating, with a pulse stopping every three beats, taking long to recover. The original physician said, "Qi of Five Zang fails to arrive; death is imminent." I said, "Ancients say severe pain often presents with Dai pulse. Zhou Meiwo said: 'Young people with Dai pulse die; elderly with Dai pulse live.' Guiyan is advanced in age and suffers chest/abdominal pain. Despite the Dai pulse, why worry?" Indeed, Guiyan recovered after twenty days. Thus, mastering pulse variations requires profound learning.