又静修庵一老尼。年五十许。患腹痛。自作痧治。刺刮不效。乃延余治。诊之右关脉洪大搏指。余部浮数。余问腹
旁痛处。有无微肿。脚挛屈否。曰腹之右旁一块。坚硬拒按。右足屈不能伸。余曰。此乃大肠生痈。非痧症也。彼大骇。
余曰无妨。肠痈初起。医治不误。十可痊十。大忌外科开刀。腐肠穿膜。为不治耳。乃用银花、当归、大黄、桃仁、丹
皮、乳香、没药、穿山甲、焦楂肉、蒲公英等。服两剂而脓血从大便下。臭秽难闻。肿消脚伸。腹亦不痛。但续续下痢
脓血。复排脓消毒之品。如银花、生甘草、桃仁、归芍、丹参、丹皮、薏苡、乳香、没药、白芷、贝母等数剂而愈。凡
诊脉如一部独异。须当深究根源。痛处拒按。微肿。非损伤血瘀。定是内痈。须平日留心临症。方能知之。
牛羊司巷陈铬甫世兄。年十三。身长如二十余。十二岁而阳已发动。是以骨力不坚。试观草木易于荣长者。而枝
干必娇嫩。其理一也。丁亥春患咳嗽痰多食少体倦。两足痿弱。不能起立。目合则遗精。甚至日间心有所思。夜则
梦寐不安。乃延余治。诊脉左关弦数。右关虚大。两寸两尺。俱虚软无力。余曰。症属木强土虚。肾气不坚。心火刑克
肺金。治当先保肺胃之阴。取土金相生之义。且胃为后天之本。土能生化万物。经云。纳谷者昌。待胃气渐旺。然后
可用血肉有情。同类相感。补精益血。病自渐愈。于是先用桑叶、沙参、钗斛、炒麦冬、枇杷叶、白蒺藜、仙半夏、橘
红、竹茹、谷芽、茯苓、茯神、紫菀、百合、毛燕屑、女贞子、莲子、淮山、芡实等清淡之品。出入为方。服二三十剂。
而痰渐少。胃气开。乃用舒养筋脉。滋血和肝之药、如归芍、金樱子、钗斛、山药、山萸、续断、杜仲、麦冬、西洋参、
五味子、阿胶、沙苑蒺藜、参贝、陈皮、人乳蒸茯神、龙骨、牡蛎、芡实、丹参等又三十余剂。遗精梦寐等皆愈。但足
仍无力。后用血肉有情之品。收合成膏。如吴鞠通天根月窟膏法。每服五六钱。一日早晚两次。至戊子春。步履如常。
强壮逾于平昔。可见补益之药。必久服乃效。
又有一位静修庵的老尼姑，年龄五十岁左右。她患有腹痛，自作主张按痧症治疗，采用刺络和刮痧的方法，但都没有效果，于是请我诊治。诊察时发现她右关脉洪大有力，搏指明显，其他部位的脉象浮而数。我问她腹部疼痛的地方是否有轻微肿胀，脚部是否拘挛弯曲。她说腹部右侧有一块地方，坚硬且拒按，右腿屈曲不能伸直。我说：“这是大肠生痈（肠道内化脓性炎症），不是痧症。”她非常惊恐。我说：“不要紧。肠痈初起时，如果治疗得当，十个可以治愈十个。最忌讳的是外科开刀，导致腐坏肠壁、穿透腹膜，那样就变成不治之症了。”于是使用金银花、当归、大黄、桃仁、牡丹皮、乳香、没药、穿山甲、焦山楂肉、蒲公英等药材。服用两剂后，脓血从大便排出，气味恶臭难闻，肿胀消退，腿脚伸直，腹部也不再疼痛。但是随后持续排出脓血样痢疾，于是再次排用排脓消毒的药物，如金银花、生甘草、桃仁、当归、白芍、丹参、牡丹皮、薏苡仁、乳香、没药、白芷、贝母等，服用数剂后痊愈。凡是诊脉时如果发现某一部脉象特别异常，必须深入探究其根源。疼痛部位拒按且有轻微肿胀，如果不是外伤导致的血瘀，必定是内脏痈肿。必须平时留心临床诊疗，才能知晓这些道理。
牛羊司巷的陈铬甫世兄，年龄十三岁。身高像二十多岁的人。十二岁时阳气就已经发动，因此骨骼力量不坚固。观察草木容易茂盛生长，但枝干必然娇嫩，道理是一样的。丁亥年春季患咳嗽、痰多、食少、身体疲倦，两足痿弱无力，不能站立。眼睛一闭合就会遗精，甚至白天心里有所思念，晚上就睡不安稳。于是请我诊治。诊脉发现左关脉弦而数，右关脉虚大，两寸和两尺脉都虚软无力。我说：“病症属于肝木过强而脾土虚弱，肾气不坚固，心火刑克肺金。治疗应当先保护肺胃的阴液，取‘土能生金’的道理。而且胃是后天之本，土能生化万物。经书说：‘能进食者昌’。待胃气逐渐旺盛之后，然后可以使用血肉有情之品，通过同类相感的作用，补精益血，病自然会逐渐痊愈。”于是先用桑叶、沙参、石斛、炒麦冬、枇杷叶、白蒺藜、仙半夏、橘红、竹茹、谷芽、茯苓、茯神、紫菀、百合、毛燕屑、女贞子、莲子、淮山药、芡实等清淡的药物，随证加减为方。服用二三十剂后，痰逐渐减少，胃气开通。接着使用舒养筋脉、滋血和肝的药物，如当归、白芍、金樱子、石斛、山药、山茱萸、续断、杜仲、麦冬、西洋参、五味子、阿胶、沙苑蒺藜、人参、贝母、陈皮、人乳蒸制的茯神、龙骨、牡蛎、芡实、丹参等，又服用三十多剂，遗精、多梦等症状都痊愈了。但是脚仍然没有力气。后来使用血肉有情之品，收膏成剂，仿照吴鞠通的“天根月窟膏”方法。每次服用五六钱，早晚各一次。到了戊子年春季，行走步态恢复正常，体质强壮超过以前。可见补益类的药物，必须长期服用才能见效。
Another elderly nun from Jingxiu Nunnery, aged about fifty, suffered from abdominal pain. She self-treated it as Sha disease (a condition often associated with summerheat and dampness toxins), using bloodletting and scraping methods without effect, and then invited me to treat her. Upon examination, her Right Guan pulse was surging and forceful, beating against the finger, while pulses in other positions were floating and rapid. I asked if there was any slight swelling at the painful area on the side of the abdomen and whether her legs were cramped or flexed. She replied that there was a hard mass on the right side of her abdomen that resisted pressure, and her right leg was flexed and could not be extended. I said, "This is Chang Yong (intestinal abscess), not Sha disease." She was greatly alarmed. I said, "Do not worry. If intestinal abscess is treated correctly in its early stage, ten cases can all be cured. The greatest taboo is surgical incision by surgeons, which leads to rotting of the intestines and perforation of the membranes, resulting in an incurable condition." Therefore, I prescribed Honeysuckle Flower (Jinyinhua), Angelica Root (Danggui), Rhubarb (Dahuang), Peach Kernel (Taoren), Moutan Bark (Danpi), Frankincense (Ruxiang), Myrrh (Moyao), Pangolin Scales (Chuanshanjia), Charred Hawthorn Fruit (Jiao Zhari Rou), and Dandelion (Pugongying). After taking two doses, pus and blood were discharged from the stool, with a foul odor. The swelling subsided, the leg extended, and the abdominal pain ceased. However, she continued to pass dysenteric pus and blood. Subsequently, I used herbs for draining pus and detoxifying, such as Honeysuckle Flower, Raw Licorice Root (Sheng Gancao), Peach Kernel, Angelica Root, White Peony Root (Baishao), Salvia Root (Danshen), Moutan Bark, Coix Seed (Yiyi Ren), Frankincense, Myrrh, Angelica Dahurica (Baizhi), and Fritillaria Bulb (Beimu), among others. After several doses, she recovered. Whenever a specific position of the pulse is found to be distinctly abnormal during diagnosis, one must deeply investigate the root cause. Painful areas that resist pressure and show slight swelling, if not due to traumatic blood stasis, are definitely internal abscesses. One must pay attention to clinical practice daily to know these principles.
Chen Chifu, a young gentleman from Niuyangsi Alley, was thirteen years old but had the stature of someone over twenty. His yang qi had already activated at age twelve, resulting in weak bone strength. Just as plants that grow rapidly tend to have tender branches and trunks, the principle is the same. In the spring of Dinghai year, he suffered from cough, excessive phlegm, poor appetite, fatigue, and flaccidity of both legs, making him unable to stand. He experienced nocturnal emissions whenever his eyes closed, and even when thinking about things during the day, he suffered from restless sleep at night. I was invited to treat him. His Left Guan pulse was wiry and rapid, his Right Guan pulse was deficient and large, and both Cun and Chi pulses were deficient and soft without strength. I said, "The syndrome belongs to hyperactive Liver Wood and deficient Spleen Earth, with insecure Kidney Qi, and Heart Fire insulting Lung Metal. Treatment should first protect the yin of the Lungs and Stomach, following the principle of 'Earth generating Metal.' Moreover, the Stomach is the foundation of acquired constitution; Earth generates all things. As the classics state: 'Those who can eat thrive.' Once the Stomach Qi gradually strengthens, then we can use substances with flesh and blood nature (blood-and-flesh有情之品) to nourish essence and blood through resonance of similar kinds, and the illness will gradually heal." Thus, I initially prescribed light-natured herbs such as Mulberry Leaf (Sangye), Glehnia Root (Shashen), Dendrobium Stem (Chaihu/Cihu - note: context implies Tie Pi Shi Hu), Stir-fried Ophiopogon Tuber (Chao Maidong), Loquat Leaf (Pipaye), Tribulus Fruit (Bajili), Pinellia Ternata (Xian Banxia), Tangerine Peel (Juhong), Bamboo Shavings (Zhuru), Sprouted Grain (Guya), Poria (Fuling), Poria with Hostwood (Fushen), Aster Root (Ziwan), Lily Bulb (Baihe), Bird's Nest fragments (Maoyan Xie), Ligustrum Fruit (Nvzhenzi), Lotus Seed (Lianzi), Chinese Yam (Huai Shan), and Euryale Seed (Qianshi), adjusting the formula as needed. After taking 20-30 doses, the phlegm gradually decreased, and the Stomach Qi opened. Then, I used herbs to soothe and nourish the sinews, nourish blood, and harmonize the Liver, such as Angelica Root, White Peony Root, Rangoon Creeper Fruit (Jinyingzi), Dendrobium Stem, Chinese Yam, Cornus Fruit (Shanzhuyu), Teasel Root (Xuduan), Eucommia Bark (Duzhong), Ophiopogon Tuber, American Ginseng (Xiyangshen), Schisandra Berry (Wuweizi), Donkey-hide Gelatin (Ejiao), Astragalus Complanatus Seed (Shayuan Jili), Ginseng, Fritillaria Bulb, Tangerine Peel, Poria steamed in human milk, Dragon Bone (Longgu), Oyster Shell (Muli), Euryale Seed, and Salvia Root. After another 30+ doses, nocturnal emissions and dream-disturbed sleep were cured. However, his feet remained weak. Later, I used substances with flesh and blood nature to make a paste, following Wu Juzhong's method of Tian Gen Yue Ku Gao (Heavenly Root and Lunar Cavity Paste). Each dose was 5-6 qian, taken twice daily, morning and evening. By the spring of Wuzi year, his gait returned to normal, and his physical strength exceeded that of before. This shows that tonifying medicines must be taken for a long time to be effective.