定邑状元桥恒三油坊伙友。家在慈 北乡。相去三百余里。舟楫往返。须三日。予因其肢厥脉伏。舌白苔浓。上如
腻粉。目瞪神昏。面色黧黑。且多油汗。辞不与治。他医以参、附、干姜、倭硫黄、吴萸、术、草、茯苓等治之。次日
肢渐温。目能动转。群以为庆。余曰。此乃回光返照。余烬易灭。不如急令归家为是。后果如余言。而殁于途。悲哉。
西门将军桥吴姓。年逾古稀。亦患是症。目瞪神昏。身强而牙关紧急。呼吸之气。有出无入。舌苔光滑淡红。中心
青色。余曰。此内挟风邪。风痰阻窍。真元又虚。询之果宿有风痹。亦辞不治。越二日而逝。
又一台州人。流寓在定之南门外。以挑泥度日。延余往诊。舌苔如宿猪肝。面青神昏。胁痛烦躁。脉伏肢冷。亦辞
不治。至日晡而死。此三症者。即内经所云大邪入脏。必卒死之候。录此以见不治之疾。非人力所能为也。
按是年霍乱甚广。治不得法。朝发夕死。故俗有子午症之名。经余治愈者五十余人。而死者仅此三人又皆不
治之症。其余如前鲍姓妇者最多。所以不概录者。因彼此有同异耳。
杨慎斋年四十许。素鸠酒。一日正午饮。忽杯落于地。家人急扶进床。急召余诊。目合神昏。面赤如朱。牙关紧闭。
鼻息如雷。痰涎上壅。脉洪大而数。急用针刺百会。及眉心。颊车。挖开牙关。连灌以至宝丹三粒。方用羚羊角、石菖
蒲、胆南星、天竺黄、橘红、钩藤、桑叶、僵蚕、菊花、薄荷、郁金、全蝎等。至酉刻而稍苏。次日复诊。脉仍数大。
仿资寿解语汤例。服三剂而始能言。舌本仍硬。大便不通。脉仍洪大。以防风通圣散每服五钱。更加大黄三钱。百沸汤
和服。一日三次。至次日而便通。二足痿软无力。两手关节皆痛。如历节白虎风症。乃遵古法针、灸、熨、摩、熏、蒸、
汤、丸、诸法并施。调理月余始痊。
定邑状元桥恒三油坊的伙计。家在慈北乡。相距三百多里。乘船往返。需要三天。我因为见他四肢厥冷、脉象伏匿、舌苔白厚且上面像腻粉一样、双目直视神志昏迷、面色黧黑、而且出很多油腻的汗。便推辞不给他治疗。其他医生用参（人参）、附（附子）、干姜、倭硫黄、吴茱萸、术（苍术或白术）、草（甘草）、茯苓等药治疗。第二天四肢渐渐回暖。眼睛能转动了。大家都为此感到庆幸。我说。这是回光返照。余烬容易熄灭。不如赶紧让他回家为好。后来果然如我所说的。他在途中去世了。可悲啊。
西门将军桥姓吴的人。年纪超过七十岁。也患这种病证。双目直视神志昏迷。身体僵硬且牙关紧闭。呼吸之气。只有出没有入。舌苔光滑淡红。中间呈青色。我说。这是内挟风邪。风痰阻塞清窍。真元又虚弱。询问后得知他以前就有风痹症。我也推辞不治疗。过了两天就去世了。
还有一个台州人。流寓在定海县城南门外。以挑泥巴为生。请我去诊治。舌苔像隔夜的猪肝色。面色青暗神志昏迷。胁肋疼痛烦躁不安。脉象伏匿四肢冰冷。我也推辞不治疗。到了傍晚就死了。这三个病例。就是《内经》所说的大邪侵入脏腑。必然突然死亡的征候。记录这些是为了说明不治之疾。不是人力所能挽回的。
按：这一年霍乱流行很广。治疗不得法。早晨发病晚上死亡。所以民间有“子午症”的名称。经我治愈的有五十多人。而死亡的仅此三人。而且都是不治之症。其余像前面鲍姓妇女那样的病人最多。之所以不一一记录。是因为彼此病情有同有异罢了。
杨慎斋年龄四十岁左右。平时喜欢喝酒。一天正午饮酒时。忽然杯子掉在地上。家人急忙扶他上床。紧急召我去诊治。两眼闭合神志昏迷。面色红得像朱砂一样。牙关紧闭。鼻息声如打雷。痰涎上涌阻塞气道。脉象洪大而数急。急忙用针刺百会穴。以及眉心、颊车穴。撬开牙关。连续灌服至宝丹三粒。方药用羚羊角、石菖蒲、胆南星、天竺黄、橘红、钩藤、桑叶、僵蚕、菊花、薄荷、郁金、全蝎等。到酉刻时稍微苏醒。第二天复诊。脉仍然数急洪大。仿照资寿解语汤的例方。服用三剂后才开始能说话。舌根仍然僵硬。大便不通。脉仍然洪大。用防风通圣散每服五钱。再加大黄三钱。用滚开水调和服用。一天三次。到第二天大便通畅。两脚痿软无力。两手关节都疼痛。像历节白虎风症那样。于是遵循古法。针、灸、熨、摩、熏、蒸、汤、丸等各种方法并用。调理一个多月才痊愈。
The assistant clerk of Hengsan Oil Mill at Zhuangyuan Bridge, Dingyi County. His home was in the north township of Cibi. The distance was over three hundred *li*. Traveling by boat back and forth required three days. Because I observed his cold limbs (Zhi Jue), hidden pulse (Mai Fu), white tongue coating thick like greasy powder, fixed gaze with unconsciousness (Shen Hun), dark complexion, and profuse oily sweating, I declined to treat him. Other physicians treated him with Ginseng Radix et Rhizoma (Renshen), Aconiti Lateralis Radix Praeparata (Fuzi), Zingiberis Rhizoma (Ganjiang), native sulfur (Wo Liuhuang), Evodiae Fructus (Wuyu), Atractylodis Rhizoma (Zhu/Bai Zhu), Glycyrrhizae Radix et Rhizoma (Gancao), and Poria (Fuling). The next day, his limbs gradually warmed, and his eyes could move. The crowd rejoiced. I said, "This is a false return of vitality (Hui Guang Fan Zhao); embers are easily extinguished. It is best to let him return home immediately." Later, it indeed happened as I predicted, and he died on the way. How sorrowful.
A Mr. Wu from Ximen General Bridge, aged over seventy, also suffered from this condition. He had a fixed gaze with unconsciousness, stiff body, and locked jaw (Ya Guan Jin Ji). His breathing was shallow, with exhalation but no inhalation. His tongue coating was smooth and pale red, with a cyan center. I said, "This involves internal wind pathogen, with wind-phlegm obstructing the orifices, and deficiency of true yuan (Zhen Yuan)." Upon inquiry, it was confirmed that he had a history of wind-bi syndrome (Feng Bi). I also declined treatment. He passed away two days later.
Another patient was a man from Taizhou, residing south of the city gate of Dinghai, making a living by carrying mud. He invited me to examine him. His tongue coating resembled the color of overnight pig liver, his face was cyan with unconsciousness, he suffered from hypochondriac pain and irritability, his pulse was hidden, and his limbs were cold. I also declined treatment. He died at dusk. These three cases correspond to what the *Neijing* describes as severe pathogens entering the zang organs, leading to sudden death. I record these to show that some incurable diseases cannot be remedied by human effort.
Note: That year, cholera (Huoluan) was widespread. Improper treatment led to death from morning to evening, hence the folk name "Ziwu Syndrome" (Ziwu Zheng). Over fifty patients were cured by me, while only three died, all of whom had incurable conditions. There were many other cases, such as Mrs. Bao mentioned earlier. They are not recorded in full because their conditions varied.
Yang Shenzhang, around forty years old, habitually consumed alcohol. One day at noon, while drinking, his cup suddenly fell to the ground. His family hurriedly helped him into bed and urgently summoned me. He had closed eyes with unconsciousness, a face red as cinnabar, locked jaw, snoring breath (nasal respiration like thunder), and phlegm-saliva obstructing upward. His pulse was surging (Hong) and rapid (Shu). I urgently used acupuncture on Baihui (GV20), the glabella (Meixin), and Jiache (ST6), pried open his jaw, and administered three pills of Zhibao Dan (Treasure of the Ultimate Pill) consecutively. The prescription included Antelope Horn (Lingyang Jiao), Acori Tatarinowii Rhizoma (Shichangpu), Arisaematis Cum Bile (Dannanxing), Bambusae Fructus (Tianzhuhuang), Citri Reticulatae Pericarpium (Juhong), Uncariae Ramulus cum Uncis (Gouteng), Mori Folium (Sangye), Bombyx Batryticatus (Jiangcan), Chrysanthemi Flos (Juhua), Menthae Haplocalycis Herba (Bohe), Curcumae Aromatae Rhizoma (Yujin), and Scorpio (Quanxie). By You hour (5-7 PM), he slightly regained consciousness. On the second day, upon re-examination, his pulse remained rapid and surging. Following the example of Zishou Jieyu Tang (Zishou Decoction for Unblocking Speech), he took three doses before he could speak. His tongue base remained stiff, and he had constipation. His pulse was still surging. He took Fangfeng Tongsheng San (Fangfeng Detoxifying Powder), five qian per dose, plus three qian of Rheum Palmatum (Dahuang), mixed with boiling water, taken three times a day. The next day, his bowels moved. His two legs were flaccid and weak, and both hands' joints hurt, resembling Lijie Baihu Feng syndrome (Joint Pain White Tiger Wind Syndrome). Thus, following ancient methods, acupuncture, moxibustion, hot compress (Yu), massage (Mo), fumigation (Xun), steaming (Zheng), decoctions (Tang), and pills (Wan) were all applied simultaneously. After more than a month of regulation, he recovered.