（凡一十五则）
予在胎，为女医误。生来略具人形，无病不历，无日不药。太夫人妊疟，多病，早弃养
，固不孝之奉累也。岁辛酉，病作席舍，死而复苏。父兄乃诉罢生员业，既而走家难，技医
给旅，重游南北。慨惟病躯，又为人谋夫康宁，亦罔也。职此之由，得尚友天下，而缙绅人
豪，往往恕予疏狂，与之诗酒药物，似未为此生之不遇矣。或曰∶子之医道，市井寻常间，
恐未尽解。惟土大夫孰无慎疾之心，而亦有感子之愈其亲、活其幼者，何必孜孜入山之念也
。予不对。然予素贫，凡赎药之，仅了婚嫁，尝思浓禄故人，恒饥稚子之叹，固与城都卖
卜、道旁卖履者有间矣。是以悬壶医案滋多，今姑记其要领于后。
三士人求治其亲，高年咳嗽，气逆痰痞，甚切。予不欲以病例，精思一汤，以为甘旨，
名三子养亲汤。传梓四方。有太史氏为之赞曰∶夫三子者，出自老圃，其性度和平芬畅，善
佐饮食奉养，使人亲有勿药之喜，是以仁者取焉。老吾老以及人之老，其利博矣。《诗》曰
∶孝子不匮，永锡尔类。此之谓也。
两在北方，遇夏秋久雨，天行咳嗽、头痛，用古方益元散（滑石五两，甘草一两），姜、
葱汤调服，应手效。日发数十斤，经以彻夜。此盖甲巳士运湿令，痰壅肺气上窍，但泄其膀
胱下窍而已，不在咳嗽例也。
戊年楚春瘟，人不相吊，予以五瘟丹投泉水，率童子分给，日起数百人。
朝贵有东南人，素畏热药。病痰，辄云火痰，加芩、连。一日，冬雪寒冽，眩呕以死。
予以黑附子一片，砒一分，舂入姜汁劫之，大吐，又服暖药一剂而愈。此盖地气束人，岂可
拘执自误。况痰生于湿，湿生于寒乎！
一士人肥形白色，因《明医杂着》所载补阴丸，以为人皆阴不足，服至数年，胖至短气
。予反之以霞天膏，入辛热剂，决去滞余，而燥其重阴，然后和平无恙。此则未达方书，而
往往自误，不可不戒也！
贵人鼻中肉赘，臭不可近，痛不可摇，束手待毙。予但以白矾末加 砂少许吹其上，顷
之，化水而消；与胜湿汤加泻白散，二帖愈。此浓味拥湿热，蒸于肺门，如雨霁之地，突生
芝菌也。治此等病颇多，人每称奇，不知只此理尔！
凡沉 痼疾，癫狂风痫，痞积疮疡，一切有形之病及妇人 瘕，皆用霞天膏，投所
宜煎剂，汗、吐、下攻去污败浊物，无不成功。颇有独得之妙，如斫轮云。
瘫痪、蛊证年浅，元气未尽伤者，亦以霞天膏入两证煎剂攻治。湖海中曾起十余人。近
时霉疮，亦以膏入防风通圣散治愈。别着《杨梅疮论治方》一卷、《滇壶简易方》一纸，为
远近所传，用者辄效。
治色劳，先以古方地仙散（薄荷叶、地骨皮、防风、甘草梢、乌梅肉各等分）煎剂退潮热
，次以外鹿髓丸摩其腰，渐以内鹿髓丸或鹿 之丸复其元，其功颇烈。奈何鹿品难办
，不过循葛可久十药神方而斟酌之耳！
八岁以下小儿，予戒投药。有疾，但以所宜药为细末，调香油，令人热蘸，按摩患处，
或水调成膏贴之，或煎汤，用绢帛染拭，任意活法，但使药气由毛孔穴络熏蒸透达。如不能
检方用药，以油润手按摩牵引，手舞足蹈，未尝不愈其疾也。
将养小儿，制七味保婴汤，以应汤饮。家兄刊而论曰∶幼幼之心，人所易发，老老之心
，人或味焉。长长者宜乎寡矣。使爱亲如子，信人子尽曾参矣。又如司马君实爱兄如父焉，
予不能不三叹乎着方之余也。
悬壶轻 ∶百病黄鹤丹、妇人科青囊丸，小儿科天一丸，随宜引用。人见小效，疑有异
常，探索不已，殊可笑也。今并着他章，用之者，当思法外意云。
古针法，似与今者不同，予有志而无师授，而今者未之学焉。古砭无传，令之灸，赖有
精者，予常加药末入艾为炷，且以人气煨养灸痕，恐不可为典要，故不着。曾见贵人有木拐
按节法，其亦砭之遗意欤？
治殊方白虎历节风，久卧，尚巫而不能药者，以霞天膏和白芥子末作墨书字，入水，顿
服一缶，吐利交作，去胶涎臭汁数斗而起。谓予之符水有神。因思古有祝由科，全赖巫觋，
莫亦仁人出奇以活人，而遂失真者耶？并记吾过于此。
（共十五则医案）
我在母胎中时，曾遭女医误治。出生后勉强具备人形，无病不经历，无日不服药。母亲怀我时患疟疾，多病缠身，早早去世，这固然是我不孝的罪过连累了她。辛酉年，我病倒在席舍之间，死而复生。父兄于是劝我放弃生员的学业，随后遭遇家庭变故，凭借医术换取旅费，重新游历南北。感慨自己病弱的身躯，却又为别人谋划安康，这也是一种徒劳。正因为如此，得以结交天下朋友，那些士绅名流，往往宽恕我的疏狂，与我饮酒赋诗、交换药物，似乎也不算此生不幸。有人说：你的医术，在市井寻常之间，恐怕未能完全被理解。只有士大夫阶层谁没有谨慎对待疾病的心，但也有感激你治愈他们的亲人、救活他们幼子的人，何必执着于隐居山林的念头呢？我不回答。但我向来贫穷，凡是赎回药材的钱，仅够应付婚嫁之事，常常感叹俸禄微薄而故人常饥、稚子常饿的叹息，这确实与城市里卖卜的人、路边卖鞋的人有所不同。因此悬壶行医的案例增多，现在姑且记录其中的要领在后面。
三位士人请求治疗他们的长辈，老人高龄咳嗽，气逆痰阻，非常严重。我不想用普通的病例来记载，精心构思了一剂汤药，作为孝敬父母的甘美食品，命名为“三子养亲汤”。流传刻印到四方。有位太史氏为此作赞曰：这三味药，出自老农之手，其性味平和舒畅，善于辅助饮食调养，使父母有不用药的喜悦，所以仁者取法它。尊敬自己的长辈从而推广到尊敬别人的长辈，利益广大啊。《诗经》说：孝子的孝心不会穷尽，永远赐福给你的同类。说的就是这个道理。
两次在北方，遇到夏秋季节久雨，流行性咳嗽、头痛，使用古方益元散（滑石五两，甘草一两），用姜、葱汤调服，立刻见效。每天排出数十斤痰液，彻夜不停。这大概是甲己土运湿气当令，痰壅塞肺气上窍，只需泄去膀胱下窍即可，不属于普通咳嗽的范畴。
戊年春天，楚地发生瘟疫，人们互相哀悼，我用五瘟丹投入泉水中，率领童子分发给众人，每天救治数百人。
一位朝廷权贵是东南人，素来畏惧热性药物。患病有痰，总说是火痰，加入黄芩、黄连。有一天，冬雪寒冷刺骨，他眩晕呕吐而死。我用一片黑附子，一分砒霜，捣碎后加入姜汁催吐，让他大吐一场，又服用一剂暖药而痊愈。这大概是地域气候束缚了人体，岂可拘泥固执而自误。况且痰生于湿，湿生于寒吗！
一位士人体型肥胖面色白，因为《明医杂着》所载的补阴丸，认为人都阴不足，服用了数年，身体胖大却短气。我用霞天膏反治，加入辛热药剂，决断去除滞留的余邪，燥化重阴，然后才和平无恙。这是未通达方书原理，而往往自我误治，不可不警惕啊！
贵人鼻中有肉赘，臭得不能靠近，痛得不能摇动，束手待毙。我只用白矾末加少许砂粉吹在上面，片刻之后，化为水而消散；给予胜湿汤加泻白散，两帖即愈。这是浓味蕴积湿热，蒸腾于肺门，就像雨后初晴的地面，突然生出芝菌一样。治疗这类病很多，人们常称奇，不知道只是这个理罢了！
凡是沉疴痼疾，癫狂风痫，痞积疮疡，一切有形之病以及妇人瘕聚，都用霞天膏，配合适宜的煎剂，通过汗、吐、下法攻逐污败浊物，无不成功。颇有独得的妙处，如同斫轮的老匠人所说的那样。
瘫痪、蛊证年份尚浅，元气未尽损伤的，也用霞天膏加入两证的煎剂中攻治。湖海中曾救起十余人。近来梅毒，也用此膏加入防风通圣散治愈。另外著有《杨梅疮论治方》一卷、《滇壶简易方》一纸，为远近所传颂，使用者辄有效验。
治疗色劳（房劳过度导致的虚损），先用古方地仙散（薄荷叶、地骨皮、防风、甘草梢、乌梅肉各等分）煎剂退潮热，其次用外鹿髓丸按摩腰部，逐渐以内服鹿髓丸或鹿茸丸恢复元气，功效颇烈。奈何鹿类药材难办，不过遵循葛可久的十药神方而斟酌运用罢了！
八岁以下的小儿，我戒止投药。若有疾病，只用适宜的药物研成细末，调香油，让人加热蘸取，按摩患处，或用水调成膏贴敷，或煎汤，用绢帛浸染擦拭，任意灵活变通，只要使药气由毛孔穴络熏蒸透达即可。如果不能检查方药用药，用油润手按摩牵引，让患儿手舞足蹈，未曾不能治愈疾病。
调养小儿，配制七味保婴汤，以应对汤饮需求。家兄刊印并评论道：爱护幼小之心，是人容易发出的，但爱护年老之心，人们往往忽略。长者应当稀少些。如果爱亲人像爱子女一样，相信人人都是曾参了。又如司马君实爱兄长如父亲，我不能不对著方之余感到三次叹息。
悬壶轻症：百病黄鹤丹、妇人科青囊丸、小儿科天一丸，随宜引用。人们见到小效，怀疑有异常，探索不已，实在可笑。现在一并写在其他章节，使用者，应当思考法度之外的意旨。
古针法，似乎与今不同，我有志学习但没有老师传授，而今人并未学习它。古砭法无传承，现在的灸法，依赖精通者，我常常将药末加入艾绒做成艾炷，并且用人气煨养护灸痕，恐怕不能作为典章法则，所以不记载。曾见贵人有一种木拐按节法，那也许是砭法的遗意吧？
治疗殊方的白虎历节风，长期卧床，还信巫不信药的，用霞天膏和白芥子末制成墨汁写字，入水，顿服一缶，吐利交作，排出胶涎臭汁数斗而起。谓我的符水有神。因而想到古代有祝由科，全赖巫觋，莫非是仁人出奇以救人，而遂失真者耶？并记下我的过失在此。
(There are fifteen cases in total.)
When I was in the womb, I was mistakenly treated by a female physician. After birth, I barely took human form, experienced every disease, and took medicine every day. My mother suffered from malaria during pregnancy, was plagued by many illnesses, and passed away early; this was undoubtedly my unfilial burden on her. In the Xin You year, I fell ill in bed, died and then revived. My father and brothers advised me to give up my status as a Shengyuan (student), and subsequently, due to family difficulties, I used my medical skills to earn travel expenses, traveling north and south again. Lamenting my sickly body, yet planning for others' health and peace, it seemed futile. Because of this, I had the opportunity to befriend people across the world. The gentry and heroes often excused my eccentricity, sharing poetry, wine, and medicines with me, so it did not seem that I had encountered bad fortune in this life. Someone said: "Your medical skills, among the common folk in the market, may not be fully understood. Only the scholar-officials have no heart but caution against illness, and some have felt grateful that you cured their parents and saved their children. Why insist on the thought of living in seclusion?" I did not answer. However, I have always been poor. The money spent redeeming herbs was only enough for marriages. I often sigh about the poverty of old friends and the hunger of young children, which is indeed different from those who sell divination in the city or shoes by the road. Therefore, there are many cases of practicing medicine publicly. Now, I will briefly record the essentials below.
Three scholars requested treatment for their elder relative, an elderly person suffering from severe cough, rebellious Qi, and phlegm obstruction. I did not wish to record it as a ordinary case. After careful consideration, I devised a decoction to serve as a nourishing food for filial piety, naming it Sanzi Yangqin Tang (Three Seeds Decoction for Nourishing Parents). It was printed and circulated everywhere. A Grand Secretary praised it: "These three seeds come from old gardeners; their nature is mild and harmonious, fragrant and smooth. They assist dietary nourishment well, bringing joy to parents of being free from medication. Thus, benevolent people adopt them. Respect one's own elders and extend that respect to others' elders; its benefits are extensive." The Book of Songs says: "The filial son's devotion is inexhaustible, forever bestowing blessings upon your kind." This is what is meant.
Twice in the North, encountering long rains in summer and autumn, I treated epidemic cough and headache using the ancient formula Yiyuan San (Benefit Yuan Powder) [Hua Shi (Talcum), 5 liang; Gan Cao (Licorice Root), 1 liang], mixed with ginger and scallion decoction. It worked immediately. Dozens of jin of phlegm were discharged daily, lasting all night. This was likely due to the dampness mandate of the Jia-Ji Earth cycle, where phlegm obstructed the upper orifices of the Lung Qi. By draining the lower orifice of the Bladder, the condition resolved; it did not fall under the category of ordinary cough.
In the Wu year spring, a plague occurred in Chu. People mourned each other. I threw Wuwu Dan (Five Plagues Pill) into spring water and led children to distribute it, curing hundreds daily.
A court noble from the Southeast feared hot-natured medicines. When he had phlegm, he claimed it was fire-phlegm and added Huang Qin (Scutellaria Root) and Lian Zi (Lotus Plumule). One day, in biting winter snow, he fainted, vomited, and died. I used one slice of Hei Fuzi (Black Prepared Aconite Root) and one fen of Pi (Arsenic), pounded into ginger juice to induce vomiting. He vomited profusely, then took one dose of a warming medicine and recovered. This was likely because the local climate constrained the body; how could one rigidly adhere to preconceptions and harm oneself? Moreover, does not phlegm arise from dampness, and dampness from cold?
A scholar was fat with white skin. Believing in the Buyin Wan (Nourish Yin Pill) described in *Mingyi Zazhu*, he thought everyone lacked Yin. He took it for years, became obese, and suffered from shortness of breath. I treated him inversely with Xiatian Gao (Xitian Paste), adding acrid-hot agents to resolve stagnation and dry out excessive Yin, after which he returned to peace and health. This illustrates failing to understand formulas and thus harming oneself; one must beware!
A noble had a nasal polyp, so foul-smelling it couldn't be approached and so painful it couldn't be touched. He waited helplessly for death. I simply blew Bai Fan (Alumen) powder mixed with a little Sha Fen (Borax) onto it. In a moment, it dissolved into water and disappeared. I prescribed Shengshi Tang (Win Over Dampness Decoction) combined with Xiebai San (Drain White Powder). Two doses cured him. This was caused by rich flavors trapping damp-heat, steaming at the Lung gate, like mushrooms sprouting suddenly on ground after rain. I treat many such cases; people call it miraculous, unaware it is merely this principle!
For all chronic stubborn diseases, epilepsy, wind-phlegm, masses, ulcers, all tangible diseases, and women's jia-masses (abdominal masses), I use Xi Tian Gao (Xitian Paste) combined with appropriate decoctions. Through sweating, vomiting, and purging methods, I expel turbid filth. Success is assured. There is a unique subtlety, like the wheelwright's skill.
For paralysis and gu-poison (parasitic disease) of recent onset, where primordial Qi is not yet exhausted, I also use Xi Tian Gao added to the decoctions for these conditions. In the lakes and seas, I revived over ten people. Recently, for syphilis (yangmei chuang), I cured it by adding this paste to Fangfeng Tongsheng San (Saposhnikovia Unblocking Heroic Powder). I separately wrote a volume on *Yangmei Chuang* (Syphilis) treatment and a sheet of *Dian Hu Jianyi Fang* (Simple Formulas from Dian Pot), circulated widely, effective for users.
To treat se-lao (sexual exhaustion), first use the ancient formula Dixian San (Immortal Immune Powder) [Bohe Ye (Mint Leaf), Digupi (Ground Bark), Fangfeng (Saposhnikovia Root), Gancao Shao (Licorice Tip), Wumei Rou (Smoked Plum Flesh), equal parts] decoction to reduce tidal fever. Then massage the waist with external Luxui Wan (Deer Marrow Pill). Gradually restore primordial Qi with internal Luxui Wan or Lurong Wan (Deer Antler Pill). The effect is potent. Alas, deer products are hard to obtain; I merely deliberate based on Ge Kejiu's Ten Divine Medicines Formula.
For children under eight, I forbid administering medicine orally. If ill, I grind suitable herbs into fine powder, mix with sesame oil, heat it, and have someone dip their hand to massage the affected area. Or mix with water to make a paste for application, or decoct and wipe with silk. Use flexible methods, ensuring medicinal qi penetrates through pores and collaterals. Even if no specific formula is used, massaging with oiled hands to induce movement can cure the disease.
To nurture children, I formulated Qiwei Baoyin Tang (Seven-Ingredient Infant Protection Decoction) for oral administration. My elder brother published and commented: "The heart to protect the young is easy to evoke; the heart to care for the old is often neglected. Elders should be rare. If one loves relatives as one loves children, everyone would be like Zeng Shen. Like Sima Junshi loving his brother as his father, I cannot help but sigh thrice after writing these formulas."
Light ailments in public practice: Bai Bing Huanghe Dan (Yellow Crane Pill for Hundred Diseases), Qingnang Wan (Green Bag Pill for Gynecology), Tianyi Wan (Heaven One Pill for Pediatrics). Use as appropriate. People see minor effects, suspect something extraordinary, and inquire endlessly, which is ridiculous. These are recorded in other chapters. Users should ponder the meaning beyond the method.
Ancient acupuncture methods seem different from modern ones. I had the ambition but no teacher, and modern practitioners have not learned them. Ancient Bian stone therapy has no transmission. Current moxibustion relies on experts. I often add herb powder to mugwort for moxa cones and nurture the moxa marks with human warmth. This cannot be a standard rule, so I do not record it. I once saw nobles using a wooden crutch pressing joint method; perhaps this is the remnant intent of Bian stone therapy?
To treat Baihu Lijie Feng (White Tiger Joint Wind) from remote regions, where patients lie long-term, trusting shamans rather than medicine, I use Xi Tian Gao mixed with Baijiezi (White Mustard Seed) powder to write characters, dissolve in water, and drink a full jar at once. Vomiting and diarrhea occur simultaneously, expelling several dou of sticky saliva and foul fluid, leading to recovery. They claim my talisman water is divine. This makes me think of the ancient Zhuyou department (incantation healing), relying entirely on shamans. Was it benevolent people using unconventional means to save lives, thereby losing authenticity? I record my error here.