福建陆路提督程魁齐军门年六旬伤寒，时医以年老气衰，重用参芪补药，固邪于内，痰喘不眠，病剧，延余诊视。脉紧数，知系闭塞寒邪，化热痰喘。拟以小青龙汤加减解寒邪、疏通肺气、化痰之品。佥曰年老气衰，不可服。余曰：有症无损，开门逐盗之法，姑试少服。其弟从周军门天姿过人，以为然。嘱先服半，咳喘顿减，终服大好。依方加减，十日而愈。
京畿道胡岱青小姐年及笄时，腹痛如绞，时医均以受寒，重用姜附肉桂，其疼逾甚，延余诊视。脉涩，无寒症，因言人腹中有蛔、蚘、长、寸、线白等虫九种，长虫长一尺，不治。胡公言：曾便过尺长自由（自由不可解，盖为拼音输入错误，疑为之蚘）。余嘱即买花榻饼一个令服，再买榧子二斤炒如栗子，令吃数日，便出长白虫数尺长无算（无算即很多之意），遂愈。
王小岑洗马患目昏花不能视物，时医以为肝热，清风退火之药，病逾甚，延余视。诊脉沉细，知为气亏内障，拟以八味还晴散去风药，重加参芪。服三十余剂，遂能视书写字，适考试京察一等召见，简放襄阳知府。
陈紫蓬太守在京投供五年，与余契交，患脱肛肿痛，时医均为痔疮治之，肿疼逾甚，延余诊视。脉沉虚，年逾六旬，知为脱肛便血，急则治标。先以螺汁合梅片敷之减疼，内服滋阴清提补药顿缩；外用椅垫，日晒大热，轮换坐之；又以开水频洗，数日而愈。
李虹若小军机瘅疟，误服他医凉药，病剧，延余诊视。脉紧，间日一发，先冷后热，谵语，四时方退，已二十余日。自谓五脏皆空，病将不治。余言包治，拟以清脾饮加减。渠云最忌柴胡，余云此症必用柴胡和解少阳，姑试服之。过日又发，伊云柴胡不效，定不服矣。余诊脉见缓，知邪将解，复强令服。疟止，再以加减数服而愈，从此不信许（相信赞许意）济东大名医矣。
户部万锡珩夫妇咳嗽昼夜不止，痰吐成盆，时医用人参鹿茸等药，痰咳逾甚，延余诊视。脉洪数，知系风寒闭于肺中，拟以二陈导痰汤加麻黄，一服而愈。伊子书城黄疸秘结，十数日不便，时医治以承气汤。余诊脉沉细，知系虚黄秘结，拟以茵陈润导滋养气血，使下焦气化而能出矣。饮以猪蹄汤，十四日便通黄退，遂愈。
冯霖汝明府夫人胎中漏血，合家惊慌，延余诊。脉和缓，系胎漏而胎未动。拟以安胎养血之品，每月行血如经，十月而生，母子安然。
潘辉庭正郎令亲杨姓病狂上屋，他医均以犀角三黄汤，力主延余诊视。脉洪无力，知系风寒未解，虚火上炎，拟参苓甘露饮加柴胡和解等品。伊同乡多不为然，惟潘半信半疑，焚香拈阄，得余药方。嘱一剂作三服，初服、次服安眠，终服愈矣。
张书城侍御夫人病，每厥不省人事，诸医均以肝风治之不效，延余诊视。脉沉涩，知系郁结气厥，非肝风也。询夫人生育否？答以无。年几何？答以不惑。余曰：夫贵妻荣，何以气郁至此？夫人言理该如此，而事有不然者。余复询张公纳侧室否？张曰：今春买一妾。余曰：后妃能逮下而小星抱衿与调乐，只君子有何郁处（此二句之意未明，不知如何断句为是）？及至书房，余诘张公，具以告实，寝妾处时多。余曰：谁家郎能被汝呼也？无怪气厥耳。遂拟以调气和血之方，劝张公常宿夫人房为引，数服而愈。后遇张公笑余，医外医耳。
唐炳霖侍御小姐，年已及笄，病剧，延余诊视。脉涩，知为气郁。询以母氏，唐曰：故。余曰：俗语能从讨饭之母，不跟做官之父。小姐笑。复问兄嫂，唐曰：不和因得病。余曰：小姐自有家耳，诸事忍让，何气为询。婿谁家？唐曰：待字。余曰：有高绍祥者，年弱冠，宦家公子，才貌均佳，今科备中，堪为良偶。唐颔之。因拟以调气之品数服而愈。余与柳太守为媒，高允，请命于兄，津江县知系（应为知县）查核病故，事寝。旋说与某主政偕老矣。
祁子和尚书之孙君司马段少沧军机之婿夫人产后伤寒，谵语病重，延余诊视。脉紧有力，拟以葛根汤生化汤合参和解，一服汗澈而愈。
李有槻明府在京投供，患疟数月，病势沉重，诸医罔效，延余诊视。脉沉紧，知邪伏于太阴少阳之间。拟清脾饮加减，略重草果以解两经之邪。外用胡椒末合蒜捣烂，置两钱于两关脉上，置椒蒜泥，用布条扎紧，一伏时拔出白泡泄邪，遂愈。
李筱垣太史患喉痹甚重，如法治愈，遂信余医，过从有年。每逢公馆眷属失调，延余诊视立痊，故情谊逾厚也。
兵部王銕珊夫人，胎中漏血，向言无孕。余以诊脉流利不绝，认定为孕，以安胎养血之品治之。迨四个月后胎动，夫人犹曰无孕。王怒曰：私子也，何讳为？夫人亦恚其言秽。余劝曰：夫妇均年不惑无子，设他医误以病治，奈何？此情急之言，毋足怪。夫妇转怒为喜。后举一子，亲朋贺筵。余曰：私子也。众询颠末，具以告，咸大笑。
工部正郎杨枢孙暴受寒邪，上下气隔，汗出如珠，腹胀如鼓，诸药罔效，用稀涎散吐出两大盆痰涎遂愈。此医道所以有汗吐下和四要法也。
张文和公孙联恩正郎夫人病剧，延余诊视。脉细，知为气虚中满，非实胀也。拟以补中益气汤，数服遂愈。
冯杰观察子茂才进京乡试，病痢，日厕无数，他医重用桂附论斤。病剧，延余诊视。脉数，知系热邪，拟黄芩汤加减，一服见效。月余，痢仍一日数次，改真人养脏汤数服，全愈。
吴燮臣司业父刑部毓春公咳喘呃逆，延余诊视。脉七八至，将绝之候，服殿撰陈冠生方石膏、黄连多日，以至此剧。余拟肾气汤加减，以救垂绝之阴阳，服之见效。次早来请，以为得手，至则见喘已轻，呃逆已止，精神大好。原可挽回，复依原方加以滋阴扶阳之品。适陈冠生至，持方连曰：火上添油也。余请示姓名，知为殿撰。曰：何知为热？陈曰：脉数。曰：浮数为风热，沉数为寒热，洪数为大热，数而有力为实热，数而无力为虚热。今数而无力，不及之象，犹灯油将尽，拍拍欲绝之候，添油犹恐不燃，若加滴水即灭矣。陈曰：脉之理微。曰：诚然，然优人胡琴二弦，三指挑拨，五音合调，君能之乎？陈曰：未习也。曰：以此即知脉理，未习故不知也。遂辞。燮臣司业送出，询以病势，余曰：若听陈君主政，预备后事，不出三日也。旋陈病，自用苦寒之药亦亡。
王惠棠员外，四旬无子，不能御内，为之拟方滋补之剂，服数十帖。一日请诊视姨太太，脉阴搏阳别，左大右小。余曰：喜脉，弄璋之兆。按月请诊，果举一男，后连生子。
侍郎许筠庵胸脘绞痛，他医均为热症，延余诊视。脉沉，知为新受寒邪滞气，胃脘作痛，非心疼也，拟排气饮加减。公子樨筠内阁言素服肉桂，恐系受热。余以脉论，的寒非热，出诣李山农方伯，具以告。渠与许公郎舅至亲兼知医，急往请服余方，遂愈。
余往京十年，来往诊视名公巨卿随手而愈者，以举其人焉。（此处恐有脱漏）周锡恩，太史陈梅初，侍读吴祖农，太史冯孟华，探花蒯礼卿，太史陈桂生，侍郎陈桂溪，太史王茂庵，中书周葆，户部嗡（疑当为翁）鼎臣，工部颜曾，州判韦笃臣，户部宋芸子，太史陈嵋，户部冯赓如中（此处恐有误），国子监教授张拔臣，户部区德霖，吏部嵩润，御茶房总辨方芰塘，参议姚幼庵，户部李芝生，兵部彭积初，户部龚引生，刑部正郎龚怀西，太史刘蔼如，户部正郎李小出，户部邬质义，户部祁子和，工部尚书郭应中，工部徐乃秋，待御陈顺镶，中书汤承庆，附监刘味齐，户部许孝生，中书陈瑶圃，军机郭之全，军机范子荫，户部杨莲甫，太史李牧之，军机张弟兄秋（此处有疑问），太史左笏卿，刑部戴少怀，太史余鼎臣，总镇武克训，光禄寺觉罗炳成，考（此处有疑问），宗室徐葆生，刺史杨蔚霞，中书仇涞之，户部左蘧生，司马伍兰荪，中书何小溪，刑部张蔚森，工部郑芷轩，光禄寺正卿何润甫，工部员外王集，礼部员外郑皋，刑部李文田，侍郎黎大均，刑部熊润南，吏部刘金榜，通判杨爵修，典史曹兆福，正郎谢启华，户部朱光黻，太史沉桐，内阁朱珩，助教万郎庭，户部范幼坡，太史江忠立，户部丁栻之，侍御徐仲阮，兵部冯立齐，广州知府曹颛枚，侍御李模皋，侍御李文辉，山西知县祥荫大挑，光禄寺评事郑廷襄，侍御郑黻门，侍御高袖海，知县徐本立，河南知县曾重伯，太史俞恪士，刑部邻兰樵，知县汤伯英，优贡周甲三，太史裴五山，侍御张次山，侍御柏云卿，太史方德堃，四川合州知州陈香士，户部吴效曾，知府熊经仲，太史李钊，雷州知府魏时钜，太史王兆兰，河南开封知府徐道焜，侍御马吉璋，太史林贻书，太史陈兆文，太史丁道津，兵部黄书霖，知府彭向青，传胪王锦堂正郎赵芝珊，太史高理堂，侍御曾树椿，正郎孙筱园，刑部崇源小所校饶芝祥，太史陈香轮，侍御张畹农，军机郭清安，安徽副将濮紫泉，军机刘启翰，正郎王绍廉，太史徐古香，军机胡宝铎，军机章同知州杨知齐，海州知州徐寿衡，尚书吴渭滨，通州知州张弼臣，太史孙朝华，军机许介侯，太史翁庆麟，知县韦其廉，浙江知县韦鼎，乡试韦继贤，户部许凤文盐，过于大使张道宇，刑部刘光第，刑部朱益藩，太史凌文焕，广东知县黄儒荃，委署侍读吴平泉，安徽知县吴石卿，拣选知县许拔庵，内阁全芸轩大使舒云亭，江苏知县魏学恒，绥阳县知县魏理云，柳州知府俞耕齐，山东知县陆赓卿，吏部毛笱陔，户部毛笃山，知府吴堪，知县尹缉庵，知府李灼华，太史杨觐圭，兵部罗炳熔，知县徐本华，知县李小研，大常寺卿尹鹰若，太史岑云蜡太仆寺卿汪叔芾，内阁叶玉书，内阁关杏王宅正郎延清员，外藏济臣，洗马宫竹楼，山西平原知县洪禧，知县汪文衔，刑部昌颀，四晶宗室冯文蔚，阁学梁翎远，太史白曾焯，刑部赵延璜，员外陈文锐，礼部景恩，宗室镇国将军黄珊庵，侍御朱云甫，太史张友鹤，北通州冯志先同知杨望洲，知县杨艺芳，大名道郑芝岩，侍御京察，浙江粮道巢梦芝，知县赵心笙，南捕厅李新之，元亨金店叶铎人，太史王小航，礼部鲍印亭，记名道罗程青，四川定远县，胡额兰，举人王彦泉，太史杨树，内阁侍读汪春榜，兵部杨廷桂，守备湖南提塘周瑞銮，湖北东湖县知县孙启瑞，工科连总叔，军机王廷钰，宁津知县丁理堂，教谕陈金鳌，松藩总镇陈梓琴，知县袁葆生，兵部贾孝珍，山西知州徐子静，中允储冰芗，工部盖永贞，平泉州知州杨登甲，刑部孔樾，农部膝均，知县杨东皋，刑部杨维新，祟庆州钱开祜，户部王承陛，东河同知区海峰，刑部余鼎三，太史刘培元福，山总镇何庆涛，教习车诚一，内阁凌福彭，太史谢秀山，刑部魏学恒，山西河曲县知县曾纪隽，知县王庆禔教授王仲连，侍讲王季连，荫生王幼连，举人承荫，正郎周葆祯，县丞屠义容，昌平知州江瑞麟，知县曾景钊，刑部曾伯陶袭伯蔡学渊，户部何玉麟，知县陈嘉言，太史杨鼎，新甘肃知县关六生，军机张乐山，知县丁小春，同知县育甫，州判英心垣，小析校徐芷帆，太史邻亨先，员外邹经甫，礼部鲍心增，吏部聂楫臣，礼部员外詹黻廷，礼部正郎杨觐宸户部郭乔生，户部郭兰荪，观察汪范卿，宗人府主政袁葆生，兵部袁敏孙，正郎丁竹珊，中书黄笃瓒，中书朱梦霆，中书潜彝帆，中书林右臣，中书丁衡甫，吏部丁锡丞，吏部朱古科，刑部彭维镛，户部王承洛，司马陈虞延罗家玮，工科卞虞卿，花翎侍卫解兆鼎，金佐周沈兆，梁王治国马、少辅祁子修、徐寿干、张少山、张振邦，蓝翎侍卫许炳仪、秦辅亭、耿叙卿、叶少楼、饶居仁、马俊臣、严文卿、张玉卿、朱虎员，武举朱犀员武进士此均延。余胗视相得者，其他干人，逐日送诊，不可胜记。是以医名噪于京师，自愧何敢言医，聊以小道济人为怀耳。
《许氏医案》终
【背景信息】
书名：许氏医案 章节：正文(2/2) 类别：医论
福建陆路提督程魁齐军门，年六十岁，患伤寒（外感热病）。当时的医生认为他年老体弱、元气衰败，重用人参、黄芪等补益药物，导致邪气固结于体内，出现痰多气喘、无法入睡的症状，病情加重。于是请我诊治。诊得脉象紧而数，判断为寒邪闭塞，化热生痰导致气喘。我打算用小青龙汤（解表散寒、温肺化饮的方剂）加减，以解除寒邪、疏通肺气、化痰。众人都说：“他年老气衰，不能服用。”我说：“有实证就用攻法，这是‘开门逐盗’的方法，姑且让他少量试服。”他的弟弟从周军门天资过人，认为我的说法正确。嘱咐先服半剂，咳嗽气喘立刻减轻，最终服药后大病痊愈。依照方子加减，十天后完全康复。
京城道台胡岱青的小姐，到了十五岁（及笄之年），腹痛如绞。当时的医生都认为是受寒，重用干姜、附子、肉桂等大热之药，结果疼痛更加剧烈。于是请我诊治。诊得脉象涩滞，没有寒症表现。我便解释说，人体腹中有蛔虫、蚘虫、长虫、寸白虫、线虫等九种寄生虫，其中长虫长达一尺，若不及时治疗后果严重。胡公说：“曾经排出过一尺来长的虫子（‘自由’疑为拼音输入错误，应为‘蚘’或指虫体蠕动状态）。”我嘱咐立即买一个花榻饼让她服用，再买两斤榧子炒熟像栗子一样，让她吃几天，随后排出了几尺长的白色寄生虫无数（无算即很多之意），于是痊愈。
王小岑洗马患有眼睛昏花、不能视物的症状。当时的医生认为是肝热，使用清热退火的药物，病情反而加重。于是请我诊治。诊得脉象沉细，判断为气虚导致的内障眼病。我打算用八味还晴汤去掉祛风药物，重用人参、黄芪。服用三十多剂后，就能看书写字了。恰逢京察考试获得一等，被召见，简放为襄阳知府。
陈紫蓬太守在北京任职五年，与我交情深厚，患脱肛肿痛。当时的医生都按痔疮治疗，导致肿胀疼痛更加严重。于是请我诊治。诊得脉象沉虚，他年过六十，判断为脱肛便血，急则治其标。先用螺汁配合冰片外敷以减轻疼痛，内服滋阴清提补益药物使肛门迅速回缩；外用晒得大热的椅垫，轮换坐卧；又用开水频繁清洗，几天后痊愈。
李虹若小军机患瘅疟（一种热性疟疾），误服其他医生的寒凉药物，病情加重。于是请我诊治。脉象紧，每隔一天发作一次，先冷后热，说胡话，到四更天才退热，已经二十多天。他自己觉得五脏皆空，病将无法治愈。我说包治，打算用清脾饮加减。他说最忌用柴胡，我说此症必用柴胡和解少阳经邪气，姑且试服。过了几天又发作，他说柴胡无效，坚决不服了。我再诊脉见缓和，知道邪气将要解散，又强迫他继续服用。疟疾停止后，再加减服用几剂而痊愈。从此不再相信许济东这位大名医了。
户部万锡珩夫妇咳嗽昼夜不止，吐痰成盆。当时的医生用人参、鹿茸等药，导致痰咳更加严重。于是请我诊治。脉象洪大数急，判断为风寒闭阻于肺中。我打算用二陈导痰汤加麻黄，一剂药服下就痊愈了。他的儿子王书城患黄疸伴便秘，十几天不便秘。当时的医生用承气汤治疗。我诊得脉象沉细，判断为虚证黄疸伴便秘。我打算用茵陈润导滋养气血，使下焦气化功能恢复从而排便。喂服猪蹄汤，十四天后大便通畅、黄疸消退，于是痊愈。
冯霖汝明府夫人胎中漏血，全家惊慌。请我诊治。脉象和缓，属于胎漏但胎儿未动。我打算用安胎养血的药物。每月仍有类似月经的血行，十月分娩，母子平安。
潘辉庭正郎的亲戚杨姓病人发狂上房顶，其他医生都用犀角三黄汤。家属极力主张请我诊治。脉象洪大无力，判断为风寒未解，虚火上炎。我打算用参苓甘露饮加柴胡等和解药物。他的同乡大多不以为然，只有潘某半信半疑，焚香抽签，抽中了许某的药方。嘱咐一剂药分三次服，初服、次服后能安睡，终服后痊愈。
张书城侍御夫人的病，每次厥逆不省人事。各位医生都用治肝风的方法治疗，无效。请我诊治。脉象沉涩，判断为郁结气厥，不是肝风。询问夫人生育情况？回答没有。问年龄？回答四十岁。我说：“丈夫显贵妻子荣耀，为何气郁至此？”夫人说道理本该如此，但事实并非如此。我又问张公是否纳侧室？张公说今年春天买了一个妾。我说：“后妃能恩泽下属，小妾也能侍奉夫君并调和音乐，君子有什么可郁结的？”（这两句意思不明，不知如何断句为宜）。等到书房，我责问张公，他如实告知，因为常在妾处睡觉。我说：“哪家的郎君能被你这样呼喝呢？难怪会气厥。”于是拟定调气和血的方子，劝张公常宿在夫人房间作为引导，服用几剂后痊愈。后来遇到张公笑我，说是“医外医”（超越医学范畴的医生）。
唐炳霖侍御的女儿，已到十五岁，病情严重。请我诊治。脉象涩，判断为气郁。询问母亲情况，唐某说已故。我说：“俗语说宁愿跟随讨饭的母亲，也不跟做官的父亲。”小姐笑了。又问兄嫂关系，唐某说不和因而得病。我说：“小姐自有家庭，诸事忍让，有什么可气的？”问女婿是谁？唐某说待字闺中。我说：“有个叫高绍祥的人，二十岁左右，宦家公子，才貌双全，今年科举备中，可作为良偶。”唐某点头同意。于是拟定调气的药物，服用几剂后痊愈。我与柳太守做媒，高某允婚，请示兄长，津江县知县查核病故，此事作罢。不久又说与某主政结老了。
祁子和尚书的孙子君司马段少沧军机的岳父夫人，产后患伤寒，谵语病重。请我诊治。脉象紧有力，打算用葛根汤合生化汤加人参和解，一剂药汗出透彻而痊愈。
李有槻明府在北京任职，患疟疾几个月，病势沉重，各位医生无效。请我诊治。脉象沉紧，判断为邪气潜伏在太阴、少阳之间。打算用清脾饮加减，略加重草果以解两经之邪。外用胡椒末合蒜捣烂，取两钱放在两关脉上，敷上椒蒜泥，用布条扎紧，过一个时辰拔出白泡泄邪，于是痊愈。
李筱垣太史患喉痹非常严重，用同样的方法治愈，于是相信我的医术，交往多年。每逢公馆眷属失调，请我诊治立刻痊愈，所以情谊更深。
兵部王銕珊夫人，胎中漏血，向来声称无孕。我以诊脉流利不绝，认定为怀孕，用安胎养血药物治疗。等到四个月后面胎动，夫人还说无孕。王某怒道：“是私生子吧，何必隐瞒？”夫人也恼怒他的话污秽。我劝说道：“夫妇都不惑之年无子，假如其他医生误以为是病而治疗，怎么办？这是情急之下的话，不足为怪。”夫妇转怒为喜。后来生下一个儿子，亲朋贺宴。我说：“是私生子。”众人询问始末，如实告知，大家都大笑。
工部正郎杨枢的孙子暴受寒邪，上下气隔，汗出如珠，腹胀如鼓，各种药物无效。用稀涎散吐出两大盆痰涎，于是痊愈。这就是医道之所以有汗、吐、下、和四种主要治疗方法的原因。
张文和公孙联恩正郎的夫人病重。请我诊治。脉象细，判断为气虚中满，不是实胀。打算用补中益气汤，服用几剂后痊愈。
冯杰观察的儿子茂才进京参加乡试，患痢疾，每天上厕所无数次，其他医生重用桂枝、附子论斤称。病情加重。请我诊治。脉象数，判断为热邪。打算用黄芩汤加减，一剂见效。一个月后，痢疾仍一天数次，改用人参养脏汤服用几剂，完全痊愈。
吴燮臣司业的父亲刑部毓春公咳喘呃逆。请我诊治。脉象七八至，是将绝的征候。服用殿撰陈冠生的方子石膏、黄连多天，以至于病情严重。我打算用肾气汤加减，以救垂绝的阴阳，服用后见效。第二天早上来请，以为得手，到了那里看见气喘已轻，呃逆已止，精神大好。原本可以挽回，又依原方加上滋阴扶阳的药物。适逢陈冠生来到，拿着方子连声说：“火上添油啊。”我请示姓名，知道是殿撰。问：“怎么知道是热症？”陈说：“脉数。”我说：“浮数为风热，沉数为寒热，洪数为大热，数而有力为实热，数而无力为虚热。现在数而无力，是不及的征象，如同灯油将尽，拍拍欲绝的征候，添油还怕不燃，如果加滴水就灭了。”陈说：“脉理微妙。”我说：“诚然，然而优人拉二胡，三指挑拨，五音合调，你能做到吗？”陈说：“没学过。”我说：“以此类推就知道脉理，没学过所以不知道。”于是告辞。燮臣司业送客，询问病情，我说：“如果听陈君主政的，准备后事，不出三天。”不久陈生病，自用苦寒药物也死了。
王惠棠员外，四十岁无子，不能房事。为他拟定滋补方剂，服用几十帖。有一天请诊姨太太，脉象阴搏阳别，左大右小。我说：“喜脉，生男孩的征兆。”按月请诊，果然生一男，后来连生子。
侍郎许筠庵胸脘绞痛，其他医生都认为是热症。请我诊治。脉象沉，判断为新受寒邪滞气，胃脘作痛，不是心痛。打算用排气饮加减。公子樨筠内阁言素服肉桂，恐系受热。我以脉理论断，确是寒非热。出去找李山农方伯，详细告知。他与许公郎舅至亲兼知医，急忙前往请服我的方子，于是痊愈。
我在京城十年，来往诊治名公巨卿随手而愈者，列举其人。（此处恐有脱漏）周锡恩，太史陈梅初，侍读吴祖农，太史冯孟华，探花蒯礼卿，太史陈桂生，侍郎陈桂溪，太史王茂庵，中书周葆，户部翁鼎臣，工部颜曾，州判韦笃臣，户部宋芸子，太史陈嵋，户部冯赓如中（此处恐有误），国子监教授张拔臣，户部区德霖，吏部嵩润，御茶房总辨方芰塘，参议姚幼庵，户部李芝生，兵部彭积初，户部龚引生，刑部正郎龚怀西，太史刘蔼如，户部正郎李小出，户部邬质义，户部祁子和，工部尚书郭应中，工部徐乃秋，待御陈顺镶，中书汤承庆，附监刘味齐，户部许孝生，中书陈瑶圃，军机郭之全，军机范子荫，户部杨莲甫，太史李牧之，军机张弟兄秋（此处有疑问），太史左笏卿，刑部戴少怀，太史余鼎臣，总镇武克训，光禄寺觉罗炳成，考（此处有疑问），宗室徐葆生，刺史杨蔚霞，中书仇涞之，户部左蘧生，司马伍兰荪，中书何小溪，刑部张蔚森，工部郑芷轩，光禄寺正卿何润甫，工部员外王集，礼部员外郑皋，刑部李文田，侍郎黎大均，刑部熊润南，吏部刘金榜，通判杨爵修，典史曹兆福，正郎谢启华，户部朱光黻，太史沉桐，内阁朱珩，助教万郎庭，户部范幼坡，太史江忠立，户部丁栻之，侍御徐仲阮，兵部冯立齐，广州知府曹颛枚，侍御李模皋，侍御李文辉，山西知县祥荫大挑，光禄寺评事郑廷襄，侍御郑黻门，侍御高袖海，知县徐本立，河南知县曾重伯，太史俞恪士，刑部邻兰樵，知县汤伯英，优贡周甲三，太史裴五山，侍御张次山，侍御柏云卿，太史方德堃，四川合州知州陈香士，户部吴效曾，知府熊经仲，太史李钊，雷州知府魏时钜，太史王兆兰，河南开封知府徐道焜，侍御马吉璋，太史林贻书，太史陈兆文，太史丁道津，兵部黄书霖，知府彭向青，传胪王锦堂正郎赵芝珊，太史高理堂，侍御曾树椿，正郎孙筱园，刑部崇源小所校饶芝祥，太史陈香轮，侍御张畹农，军机郭清安，安徽副将濮紫泉，军机刘启翰，正郎王绍廉，太史徐古香，军机胡宝铎，军机章同知州杨知齐，海州知州徐寿衡，尚书吴渭滨，通州知州张弼臣，太史孙朝华，军机许介侯，太史翁庆麟，知县韦其廉，浙江知县韦鼎，乡试韦继贤，户部许凤文盐，过于大使张道宇，刑部刘光第，刑部朱益藩，太史凌文焕，广东知县黄儒荃，委署侍读吴平泉，安徽知县吴石卿，拣选知县许拔庵，内阁全芸轩大使舒云亭，江苏知县魏学恒，绥阳县知县魏理云，柳州知府俞耕齐，山东知县陆赓卿，吏部毛笱陔，户部毛笃山，知府吴堪，知县尹缉庵，知府李灼华，太史杨觐圭，兵部罗炳熔，知县徐本华，知县李小研，大常寺卿尹鹰若，太史岑云蜡太仆寺卿汪叔芾，内阁叶玉书，内阁关杏王宅正郎延清员，外藏济臣，洗马宫竹楼，山西平原知县洪禧，知县汪文衔，刑部昌颀，四晶宗室冯文蔚，阁学梁翎远，太史白曾焯，刑部赵延璜，员外陈文锐，礼部景恩，宗室镇国将军黄珊庵，侍御朱云甫，太史张友鹤，北通州冯志先同知杨望洲，知县杨艺芳，大名道郑芝岩，侍御京察，浙江粮道巢梦芝，知县赵心笙，南捕厅李新之，元亨金店叶铎人，太史王小航，礼部鲍印亭，记名道罗程青，四川定远县，胡额兰，举人王彦泉，太史杨树，内阁侍读汪春榜，兵部杨廷桂，守备湖南提塘周瑞銮，湖北东湖县知县孙启瑞，工科连总叔，军机王廷钰，宁津知县丁理堂，教谕陈金鳌，松藩总镇陈梓琴，知县袁葆生，兵部贾孝珍，山西知州徐子静，中允储冰芗，工部盖永贞，平泉州知州杨登甲，刑部孔樾，农部膝均，知县杨东皋，刑部杨维新，祟庆州钱开祜，户部王承陛，东河同知区海峰，刑部余鼎三，太史刘培元福，山总镇何庆涛，教习车诚一，内阁凌福彭，太史谢秀山，刑部魏学恒，山西河曲县知县曾纪隽，知县王庆禔教授王仲连，侍讲王季连，荫生王幼连，举人承荫，正郎周葆祯，县丞屠义容，昌平知州江瑞麟，知县曾景钊，刑部曾伯陶袭伯蔡学渊，户部何玉麟，知县陈嘉言，太史杨鼎，新甘肃知县关六生，军机张乐山，知县丁小春，同知县育甫，州判英心垣，小析校徐芷帆，太史邻亨先，员外邹经甫，礼部鲍心增，吏部聂楫臣，礼部员外詹黻廷，礼部正郎杨觐宸户部郭乔生，户部郭兰荪，观察汪范卿，宗人府主政袁葆生，兵部袁敏孙，正郎丁竹珊，中书黄笃瓒，中书朱梦霆，中书潜彝帆，中书林右臣，中书丁衡甫，吏部丁锡丞，吏部朱古科，刑部彭维镛，户部王承洛，司马陈虞延罗家玮，工科卞虞卿，花翎侍卫解兆鼎，金佐周沈兆，梁王治国马、少辅祁子修、徐寿干、张少山、张振邦，蓝翎侍卫许炳仪、秦辅亭、耿叙卿、叶少楼、饶居仁、马俊臣、严文卿、张玉卿、朱虎员，武举朱犀员武进士此均延。余胗视相得者，其他干人，逐日送诊，不可胜记。是以医名噪于京师，自愧何敢言医，聊以小道济人为怀耳。
《许氏医案》终
[Background Information]
Book Title: Xu's Medical Cases Chapter: Main Text (2/2) Category: Medical Discourse
Cheng Kuiqi, Military Commissioner of the Fujian Land Route, aged sixty, contracted Shanghan (an external febrile disease). Contemporary physicians, believing his advanced age indicated declining Qi and vitality, heavily prescribed tonifying herbs such as Renshen (Ginseng Root) and Huangqi (Astragalus Root). This caused pathogenic factors to become entrenched internally, resulting in phlegm, wheezing, and insomnia. The condition worsened, prompting a consultation with me. The pulse was tight and rapid. I determined that cold pathogens were obstructed and transforming into heat-phlegm causing wheezing. I proposed modifying Xiao Qing Long Tang (Minor Blue Dragon Decoction) to release cold pathogens, unblock Lung Qi, and resolve phlegm. Others objected, stating, "He is old and Qi-deficient; he cannot take this." I replied, "When there are excess symptoms, use draining methods; this is the strategy of 'opening the door to drive out the thief.' Let him try a small dose first." His younger brother, Military Commissioner Congzhou, possessed superior intellect and agreed. He instructed that half a dose be taken initially. Coughing and wheezing decreased immediately, and after completing the course, he recovered greatly. Following the prescription with modifications, he healed in ten days.
Miss Hu Daiqing, daughter of a Jingji Circuit Intendant, reached her coming-of-age (fifteen years old) and suffered from severe abdominal cramping pain. Contemporary physicians attributed it to cold invasion and heavily prescribed hot herbs such as Shengjiang (Dried Ginger), Fuzi (Prepared Aconite Root), and Rougui (Cinnamon Bark). Her pain intensified. Upon consultation, her pulse was choppy, and there were no signs of cold. I explained that the human abdomen harbors nine types of parasites, including Hui Chong (Roundworms), You Chong (Tapeworms), Chang Chong (Long worms), Cun Bai Chong (Pinworms), and Xian Chong (Threadworms). Chang Chong can grow up to one chi long and requires treatment. Mr. Hu stated, "I have previously passed a worm about one chi long ('Ziyou' is likely a pinyin input error for 'You' or refers to the worm's movement)." I instructed him to buy one Hua Ta Bing (Flower Mat Cake) for her to eat, and two jin of Feizi (Torreya Seed), stir-fried like chestnuts, to consume over several days. Subsequently, she passed numerous white worms several chi long ("Wu Suan" means countless), and she recovered.
Wang Xiaocen, Xi Ma (Hanlin Academy Editor), suffered from blurred vision and inability to see objects. Contemporary physicians diagnosed Liver Heat and prescribed cooling and fire-draining herbs, which worsened his condition. Upon consultation, his pulse was deep and fine. I diagnosed it as internal cataracts due to Qi deficiency. I proposed using Ba Wei Huan Qing San (Eight-Ingredient Vision-Restoring Powder), removing wind-dispelling herbs, and heavily increasing Renshen (Ginseng Root) and Huangqi (Astragalus Root). After taking more than thirty doses, he could read and write again. Coinciding with the capital inspection where he ranked first, he was summoned and appointed as Prefect of Xiangyang.
Chen Zipeng, Prefect, had served in Beijing for five years and was a close friend of mine. He suffered from prolapsed rectum with swelling and pain. Contemporary physicians treated it as hemorrhoids, causing increased swelling and pain. Upon consultation, his pulse was deep and deficient. Being over sixty, I diagnosed prolapsed rectum with bloody stools. Addressing the acute symptoms first, I applied Luo Zhi (Snail Juice) mixed with Mei Pian (Borneol) externally to reduce pain, and internally administered Yin-nourishing, clearing, lifting, and tonifying medicines to rapidly retract the prolapse. Externally, he used chair cushions heated by the sun, rotating them while sitting. Frequent washing with boiling water also contributed to his recovery within a few days.
Li Hongruo, a Junior Grand Secretary, suffered from Dan Nue (a type of malarial fever with high heat). Misusing cold-natured herbs from other doctors worsened his condition. Upon consultation, his pulse was tight. The fever occurred every other day, starting with chills followed by heat, accompanied by delirium, subsiding only at the fourth watch. It had persisted for over twenty days. He felt his five Zang organs were empty and believed the disease was incurable. I promised a cure and proposed modifying Qing Pi Yin (Clear the Spleen Decoction). He claimed to strictly avoid Chai Hu (Bupleurum Root). I stated that this case required Chai Hu to harmonize the Shaoyang channel and suggested a trial dose. After a few days, the fever recurred. He claimed Chai Hu was ineffective and refused further doses. Re-palpating, I found the pulse becoming moderate, indicating the pathogen was resolving. I insisted he continue taking it. The malaria stopped, and after a few more modified doses, he recovered. From then on, he ceased to believe in Xu Jidong, the famous doctor.
Wan Xiheng of the Ministry of Revenue and his wife suffered from ceaseless day-and-night coughing, expectorating basins full of phlegm. Contemporary physicians used Renshen (Ginseng Root) and Lurong (Deer Antler Velvet), worsening the phlegm and cough. Upon consultation, their pulses were surging and rapid. I diagnosed Wind-Cold obstructing the Lungs. I proposed Er Chen Dao Tan Tang (Two-Aged Phlegm-Guiding Decoction) with added Mahuang (Ephedra Stem). One dose resulted in a cure. His son, Wang Shucheng, suffered from Jaundice with constipation, unable to defecate for over ten days. Contemporary physicians used Cheng Qi Tang (Purge the Yang-Ming Decoction). My diagnosis revealed a deep, fine pulse, indicating Deficiency Jaundice with constipation. I proposed Yinchun Run Dao (Yinchen aiding moistening and guiding) to nourish Qi and Blood, restoring Lower Jiao Qi transformation to enable excretion. Administering Pig Trotter Soup, bowel movements normalized, jaundice faded, and he recovered in fourteen days.
Madam of Feng Linru, Ming Fu, suffered from uterine bleeding during pregnancy. The family was panicked. Upon consultation, her pulse was harmonious and moderate. This was identified as Tai Lou (Fetal Leakage) without fetal movement. I prescribed Fetal-Calming and Blood-Nourishing herbs. She experienced monthly bleeding similar to menstruation but delivered successfully after ten months, with both mother and child safe.
Mr. Yang, a relative of Pan Huiting, Zheng Lang, went mad and climbed onto roofs. Other physicians prescribed Xi Jiao San Huang Tang (Rhinoceros Horn Three-Yellow Decoction). The family strongly urged my consultation. His pulse was surging but forceless. I diagnosed unresolved Wind-Cold with Deficient Fire flaming upward. I proposed Shen Ling Gan Lu Yin (Ginseng and Poria Sweet Dew Drink) with Chai Hu (Bupleurum Root) to harmonize. His fellow townspeople largely disagreed. Only Pan was half-believing and half-doubting. He burned incense and drew lots, selecting my prescription. I instructed one dose divided into three servings. After the first and second servings, he slept peacefully; after the final serving, he recovered.
The wife of Zhang Shucheng, Shi Yu, suffered from syncope with loss of consciousness repeatedly. Various physicians treated it as Liver Wind without effect. Upon consultation, her pulse was deep and choppy. I diagnosed it as Qi Syncope due to emotional stagnation, not Liver Wind. I asked if she had given birth; she said no. I asked her age; she said forty. I remarked, "Your husband is noble and you honored; why is your Qi so stagnant?" She replied that while theoretically correct, reality differed. I asked if Mr. Zhang had taken a concubine. He admitted buying one in spring. I quoted, "Consorts extend grace to subordinates; concubines serve husbands and harmonize music. Where lies the gentleman's stagnation?" (The meaning of these two sentences is unclear; sentence structure is uncertain). In the study, I questioned Mr. Zhang, who confessed he spent most nights with the concubine. I asked, "Which household's master allows himself to be commanded thus? No wonder you suffer Qi Syncope." I prescribed a Qi-regulating and Blood-harmonizing formula, advising Mr. Zhang to frequently sleep in his wife's room as a therapeutic guide. After several doses, she recovered. Later, meeting Mr. Zhang, he laughed at me, calling me a "doctor beyond medicine."
Miss Tang Binglin, Shi Yu's daughter, reached her coming-of-age and fell severely ill. Upon consultation, her pulse was choppy, indicating Qi stagnation. I asked about her mother; Tang said she was deceased. I cited the proverb, "One would rather follow a begging mother than an official father." The young lady smiled. I asked about her relationship with her brother and sister-in-law; Tang said discord led to her illness. I said, "You will have your own family; enduring and yielding in all matters, what is there to be angry about?" I asked about her fiancé; Tang said she was unmarried. I mentioned Gao Shaoxiang, a young man of twenty from an official family, talented and handsome, passing the current examination, suitable as a good match. Tang nodded. I prescribed Qi-regulating herbs, and she recovered after several doses. I acted as matchmaker with Governor Liu. Gao agreed, consulted his elder brother, but the matter was shelved when the Tianjin County Magistrate reported Gao's death. Soon after, she was said to marry a certain Zhuzheng.
Madam of Duan Shaocang, Junji (Grand Secretary) and grandson of Minister Qi Zihe, contracted Shanghan postpartum with delirium and severe illness. Upon consultation, her pulse was tight and forceful. I proposed Ge Gen Tang (Kudzu Root Decoction) combined with Sheng Hua Tang (Generate the New Decoction) with Renshen (Ginseng Root) to harmonize. One dose induced thorough sweating, and she recovered.
Li Youkui, Ming Fu, served in Beijing and suffered from malaria for months with severe progression. Other physicians failed. Upon consultation, his pulse was deep and tight. I diagnosed pathogens latent between the Taiyin and Shaoyang channels. I proposed modifying Qing Pi Yin (Clear the Spleen Decoction), slightly increasing Cao Guo (Tsaoko Fruit) to resolve pathogens in both channels. Externally, I applied a paste of Pepper powder and Garlic mashed together. Two qian were placed on both Guan pulse positions, covered with pepper-garlic paste, and tightly bound with cloth strips. After one fu shi (approx. 2 hours), blisters appeared, releasing pathogens, and he recovered.
Li Xiaoyuan, Tai Shi (Hanlin Academician), suffered from severe Hou Bi (Sore Throat). Treated similarly, he recovered, believing in my medical skill, leading to years of association. Whenever officials' families suffered disharmony, consulting me led to immediate recovery, deepening our friendship.
Madam of Wang Tieshan, Bingbu (Ministry of War), suffered from uterine bleeding during pregnancy, claiming no pregnancy. I diagnosed pregnancy based on a smooth, uninterrupted pulse and prescribed Fetal-Calming and Blood-Nourishing herbs. Four months later, fetal movement occurred, yet she still denied pregnancy. Mr. Wang angrily said, "It's a bastard! Why hide it?" Madam was indignant at his vulgar words. I advised, "Both spouses are past forty without children. If other doctors mistakenly treat this as disease, what then? These are words spoken in urgency; do not blame them." The couple turned anger to joy. They later gave birth to a son, celebrated by relatives and friends. I joked, "It's a bastard." When asked for details, I explained, and everyone laughed heartily.
Grandson of Yang Shu, Zheng Lang of Gongbu (Ministry of Works), suddenly contracted Cold pathogens. Upper and lower Qi were blocked, sweat dripped like pearls, abdomen distended like a drum. Various drugs failed. Using Xi Yan San (Saliva-Thinning Powder), he vomited two large basins of phlegm and saliva, recovering. This illustrates the four essential methods of medicine: Sweating, Vomiting, Purging, and Harmonizing.
Madam of Sun Lian'en, Zheng Lang, granddaughter of Zhang Wenhe, fell severely ill. Upon consultation, her pulse was fine. I diagnosed Qi deficiency with Middle Jiao fullness, not excess distension. I prescribed Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). Several doses led to recovery.
Son of Feng Jie, Guancha, a Cai Ren (scholar), traveled to Beijing for the provincial examination and suffered from dysentery, visiting the toilet countless times daily. Other physicians heavily prescribed Guizhi (Cinnamon Twig) and Fuzi (Prepared Aconite Root) by weight. Condition worsened. Upon consultation, his pulse was rapid. I diagnosed Heat pathogens. I prescribed Huang Qin Tang (Scutellaria Decoction) with modifications. One dose showed effect. After a month, dysentery still occurred several times daily. I changed to Zhen Ren Yang Zang Tang (True Man Nourish the Viscera Decoction). Several doses led to complete recovery.
Father of Wu Xiechen, Siye, Yu Chun Gong of Xingbu (Ministry of Justice), suffered from cough, wheezing, and hiccups. Upon consultation, his pulse beat seven or eight times per breath, a sign of impending collapse. He had taken Shigao (Gypsum Fibrosum) and Huanglian (Coptis Rhizome) from Dianzhuan Chen Guansheng's prescription for many days, leading to this critical state. I prescribed Shen Qi Tang (Kidney Qi Decoction) with modifications to save the collapsing Yin and Yang. Effect was seen. The next morning, upon request, thinking I had succeeded, I arrived to find wheezing lighter, hiccups stopped, and spirit greatly improved. Originally recoverable, I added Yin-nourishing and Yang-supporting herbs to the original formula. Chen Guansheng arrived, holding the prescription, shouting, "Adding oil to fire!" I asked his name, learning he was Dianzhuan. I asked, "How do you know it is Heat?" He said, "Rapid pulse." I said, "Floating-rapid is Wind-Heat; Deep-rapid is Cold-Heat; Surging-rapid is Great Heat; Rapid-forceful is Excess Heat; Rapid-forceless is Deficient Heat. Now it is rapid-forceless, a sign of insufficiency, like lamp oil running out, on the verge of extinction. Adding oil might not even keep it burning; adding a drop of water would extinguish it." Chen said, "Pulse theory is subtle." I said, "Indeed. But can you play the erhu, plucking strings with three fingers to harmonize five tones?" He said, "I haven't learned." I said, "From this, one knows pulse theory; lack of practice leads to ignorance." I left. Wu Xiechen saw me off, asking about the condition. I said, "If you listened to Master Chen Zhuzheng, prepare for funeral affairs; within three days [he would die]." Soon, Chen fell ill and died from self-administered bitter-cold herbs.
Wang Huitang, Yuanwai, was forty without sons and impotent. I prescribed tonifying agents. After dozens of doses, he requested a consultation for his concubine. Her pulse showed Yin pulsating distinct from Yang, larger on the left, smaller on the right. I said, "Joyful pulse, omen of bearing a son." Monthly consultations confirmed the birth of a boy, followed by more sons.
Xu Yun'an, Shilang, suffered from chest and epigastric绞痛 (cramping pain). Other physicians diagnosed Heat. Upon consultation, his pulse was deep. I diagnosed new Cold pathogen stagnating Qi, causing stomach pain, not Heart pain. I prescribed Pai Qi Yin (Expel Qi Drink) with modifications. Son Xijun, Neige (Grand Secretariat) member, argued he usually takes Rougui (Cinnamon Bark) and feared Heat. I relied on pulse analysis, confirming Cold not Heat. I sought Li Shannong, Fangbo, who was related to Mr. Xu by marriage and knowledgeable in medicine. Urgently, he took my prescription, and Mr. Xu recovered.
In my ten years in Beijing, I cured many nobles and ministers instantly. Listing them here... (Text contains a long list of names and titles, mostly omitted for brevity in translation but acknowledged as part of the source). These are those I consulted and matched well with. Thousands others received daily consultations, too numerous to record. Thus, my medical fame spread in the capital. Ashamed, how dare I speak of medicine? I merely harbor the intention of saving people through this minor art.
End of "Xu's Medical Cases"