镇郡陶骏声君令阃。肿胀呕吐。缠延月余。先是胎前足肿。产后肿
益甚。咳嗽呕吐。经此间诸名医治之。叠进舟车丸。五皮饮。栝
蒌薤白白酒汤。及八珍汤等弗效。且面目肢体悉肿。腹胀如鼓
吐后亦能饮食。诊其脉弦滑而有胃气。言语亦甚清晰。初用小半夏汤加干姜、
五味子。及浓朴半夏甘草人参汤。枳术汤等。无大效。且呕吐大发。其时有人荐他医治之。
亦
膈闷塞。则知病将复发。必吐出痰水数碗。然后始觉宽畅。近日又觉闷塞异常
。呼吸几不能通。今虽吐后。犹嫌闷塞。咳嗽不得卧。予沉思久之。恍然
曰。此肺中气管为痰饮闭塞不得通也。气管之所以闭塞者。缘腹胀溺少。胃中及膈膜间均为痰饮充塞之地。
膈中痰饮充塞。则溢于肺中气管。肺中气管亦充塞
则激而上出而为呕吐。以故盈盆盈碗。皆痰涎水沫。痰水既出。则膈膜肺胃等处皆松。故知饥能
食。待数日后痰水聚多。又复作矣。是则此病之真谛也。治法以驱痰饮为要。而驱肺中气管之饮为尤要。苦思
半晌。为立一方。用三子养亲汤。合二陈汤。加麝香五厘和服。以白芥子能横开肺
中之饮。麝香香窜。能通气管及膈膜间之闭塞。
且能止吐。明日复诊。述昨药服后。觉药性走窜不已。上窜至咽。下窜至小腹
。胸博尤觉窜走。随窜随呕。吐出痰涎甚多。半夜未能安枕。而胸闷觉宽。呼吸便利。呕吐
亦止。盖气管之闭塞通矣。遂以原方去麝香。接服三剂。而胸次大舒。咳嗽亦减。仍以原方
加冬虫、夏草、北沙参、生姜、红枣。又三剂而浮肿亦消。咳嗽大定。但腹胀如故。坚满不舒
。乃停煎剂。每日单服禹余粮丸二次。每服三钱。忌盐酱等物。五日后胀渐消。十日后胀消
及半。而精神疲惫。自觉心内及脏腑空虚。盖饮滞消而气血虚也。令以前丸减半服。并以参
、术、归、芍、山药、茯苓等煎剂相间服之。不十日而胀全消。病竟愈。闻者莫不叹服。迄
今六年。病未复发。且已经孕育矣。
庚戌四月广安祥糖栈。袁尧宽君患温病。初由章绶卿君延医。服药数剂。病未大减。嗣章君
往江北放赈。转荐予治。壮热谵语。见人则笑。口渴溲赤。每日只能进薄粥汤少许。舌苔黄
薄而干燥无津。体胖脉息滑数。右部尤甚。盖温病也。热邪蕴伏日久。蓄之久而发之暴。故病
情危重若是。治法当以解热为主。而佐以豁痰润燥。方用三黄石膏汤。合小陷胸汤。去麻黄
、豆豉、半夏。加贝母、连翘、青蒿、梨汁。接服二日。热未大退。至第三剂后。乃作战汗
而解。但余热未清。复以前方去石膏、芩、连、栝蒌。加苡仁、滑石、芦根、花粉、沙参等
清化余邪。数剂而瘥。凡温病之解多从战汗。刘河间吴又可发之于前。叶天士王九峰畅之
于后。证以予所经历。洵精确不易之学说也。盖前人于此。皆从经验中得来。惟必俟服药多
剂。始能奏功。而作汗之时。必先战栗。其状可骇。医家当此。何可无定识定力耶。
金峙生君令堂。年近五旬。发热身痛。舌苔白腻。溲热胸闷脉滑。予初以三仁汤加连翘、山
栀。接服两剂。热愈甚。口渴心烦。舌苔转燥。脉亦转数。盖伏邪病热。邪蕴伏甚重。遂易
方。以黄芩、栝蒌、地骨皮、青蒿各三钱。连翘、知母各四钱。木通一钱。银茈胡二钱。芦
根、茅根、鲜生地各一两。梨汁一酒钟和服。一剂热少平。二剂后。病患忽战栗恶寒。震动
床帐。盖欲作战汗也。病家误会。谓药之误。议延他医。幸其弟陶骏声君来告。速予往救。
予谓此战汗也。病退之机。不可妄动。及予至其家。则战栗已止。身出大汗。而脉静身凉。
神气亦甚安静。但觉疲倦而已。随用薄粥汤与饮。以扶胃气。并以沙参、麦冬、百合、苡仁
、石斛、花粉、甘草、茯苓等调养两日而痊。
庚戌四月。史汉泉君患温病。昏沉不语。面垢目赤。鼻孔如烟煤。壮热烁手。汗 然。舌
苔黑燥。手臂搐搦。两手脉数疾。溲赤。问不能言几日矣。曰。昨犹谵语。今始不能言。然大
声唤之。犹瞠目视人。问近日大便通否。曰。始病曾泄泻。今不大便已三日矣。问服何药。
则取前医之方示予。盖皆不出银翘散。三仁汤。增液汤之范围。予谓此热病未用清药。阳明
热极胃家实之病也。非下不可。乃与调胃承气汤。合三黄石膏汤。去麻黄、豆豉。加犀角、
蒌仁。接服两剂。竟未得下。惟矢气极臭。溲色若血。神识较清。而身热舌黑如故。原方去
元明粉、大黄。加鲜生地、并令恣饮梨汁、莱菔汁。于是热减神清。黑苔渐退。脉息亦较平
。时吐粘痰。目睛转黄。遂改用小陷胸汤加芦根、茅根、青蒿、菖蒲、竹茹、贝母、冬瓜仁
、木通等芳香清洌之品。以分消膈中痰热。接服四剂。胸博头项间遍出白 。如水晶珠。腹部
腿畔亦发白 。于是身热全清。知饥进粥。但精神疲弱耳。复以西洋参、麦冬、石斛、苡仁
、贝母、竹茹、枇杷叶等调养数日。始解黑燥屎数次。当时两进大黄。而不下者。盖其戚友
中有知医者。潜将大黄减去一钱。每剂只用二钱。故但有解毒之功。而无攻下之力。而奏效
亦较缓也。然究胜于粗工之滥用硝黄。而偾事者矣。
姚某子十五岁。三月间由学校归家。自觉恶寒欲睡。旋即发热头痛。身痛谵语。不能识人。
按其脉滑数。溲赤。当以栀豉汤银翘散出入为方。下午四时复诊。神昏谵语如故。身热自汗
然不止。面赤口渴欲饮水。脉息滑而不数。舌苔薄腻。不黄不燥。因思
伤寒论云。阳明病、发热汗多者急下之。而面赤神昏。又皆当下之症。遂改用小承气汤。
大黄三钱、浓朴五分、枳壳二钱。加黄芩、连翘、知母各二钱。服后解大便两次。神清安睡
。汗止热解。自能起坐。知饥欲食。其家以为病愈。不复延诊。越三日。复发热有汗。口渴。
脉滑数。与白虎合小陷胸汤。石膏用三钱。服后热退神清。惟咳嗽痰中带血而已。复与泻白
散加黄芩、知母、茅根等二剂全愈。
张兆魁君室人。年约三旬。体质瘦小。发热谵语。口
渴心烦。欲食冷物。胸闷溲热。舌苔黄腻不燥。两脉俱数。与小陷胸汤加茈胡、黄芩。不效
。烧热益甚。遂改用凉膈散。大黄、元明粉各用三钱。服后得下两次。并得战汗而热全退。
惟精神萎弱。懒于言动。复以党参、麦冬、枸杞子、干地黄、黄 、炙甘草等补养气血之
药。两剂而起居饮食如常矣。
鸿泰糖栈陈祝山。年约三旬。今年七月患伏暑病。延某医延医。服药四五日。不效。壮热头
疼。胸闷咽喉作燥。口渴舌绛苔薄焦燥无津。大便七八日不通。溲赤脉数。盖暑热蕴伏肠胃
热结之病。治法当先通大便。以解肠胃之焚。乃以生大黄二钱。元明粉三钱。枳壳、黄芩、
麦冬、天花粉各二钱。甘草五分。此药服后。得大便两次。热全退。头痛亦轻。舌苔转白腻
。脉缓不数。小便仍红。知饥欲食。乃易方以连翘、苡仁、佩兰、花粉、沙参、贝母等以解
余邪。越两日。又复发热口渴胸闷。是余邪欲出也。以小陷胸汤合小茈胡汤。去人参、姜、
枣。加连翘、青蒿。接服两剂。得汗而安。大凡应用硝黄之病。决非他药所能代。若畏而
不用。必致缠延误事。但须辨认真切。用之有方。不可颟顸孟浪耳。
丁未夏耳。予游吴门。适该处霍乱流行。死亡接踵。有神仙庙旁纸店孀妇。亦染此病。吐泻
交作。医投五苓散。玉枢丹。附子理中汤。左金丸等法。入口即吐。已延三日。视其目陷形
消。四肢逆冷。心烦不能安卧。口苦渴欲冷冻饮料。舌红根有腻苔。头有微汗。两脉皆数。重按
无神。盖暑病也。与黄连香薷饮。去浓朴。加苡仁、蚕砂、半夏、石斛、沙参、黄柏、枇杷
叶。服后吐止神安。手足转温。二剂利减。能进粥汤。嗣以前方去黄柏、蚕砂。减轻川连。
利止。惟心悸腰酸头晕。精神疲惫。不能起坐。两脉细小。此病去而气血虚也。以西洋参、
白术、石斛、山药、杜仲、枣仁、茯神、当归、甘草、红枣等。调补三日而痊。
苏州阊门外营盘场。有程姓少年。亦病霍乱。吐泻不已。烦躁畏热。身无寸缕。而犹畏热异
常。欲卧冷地。四肢悉冷。胸腹部亦均不热。口渴欲食西瓜。小便短赤。头项微汗。脚腓痉
挛。脉息寸关俱数。舌苔黄燥无津。此暑热内伏。热深厥深。内真热而外假寒之病也。乃以
白虎汤合黄连香薷饮。去浓朴、粳米。加麦冬、苡仁、石斛。阴阳水煎。一服吐止。再剂利
亦止。而烦渴亦大定矣。惟肢体尚冷。嘱以稀粥与饮。安睡一夜。体温遂复常度。于是但以
饮食调养。不劳他药而瘳。
徐某年约三旬。秋间陡患腹痛吐利。发热口渴。烦躁不安。舌苔黄腻。脉息滑数。盖暑湿蕴伏
中焦。肠胃中有宿滞也。与黄连香薷饮合平胃散。一服吐利止。身热退。接服一剂。知饥欲
食矣。大凡黄连石膏之病。其舌苔必黄腻。或黄燥。其小便亦必红赤。若小便清长舌光无苔
。则膏连二药皆为禁剂。盖舌质之光否。可觇胃脏之虚实也。
朱姓子八岁。秋间病霍乱吐泻。手足悉冷。口渴欲饮水。目陷形消。不食不饥。舌苔黄腻。
脉息小数。用姜汁炒川连三分、法半夏一钱、扁豆三钱、苡仁三钱、木香五分、北沙参二钱
。服后吐泻止。手足温。舌苔亦退。能进稀粥。但口渴殊甚。遂改用麦冬、天花粉各一钱五
分。北沙参二钱。白术一钱。苡仁、扁豆各三钱。两剂瘥。
张姓妇年四十余。先于四月间
病心悸怔忡。头眩发热。予以天王补心丹加青蒿、地骨等药治愈矣。及至夏间。陡患腹痛上
冲于心。呕吐清水。下利红白。痛甚则手足俱冷。汗出神疲。按其脉沉迟而小。望其色则面
白唇淡。盖阳虚中寒之病。殆由乘凉饮冷所致。问之。果连日卧竹床乘凉。且稍食西瓜等物
也。与附子理中汤加吴茱萸、桂枝、白芍、砂仁。一服痛稍缓。两剂痛始平。手足温。遂以
原方去附子。减轻姜、萸。自是利止食进。复以归芍六君子汤。调治数日而痊。
詹云溪先生幼子。甫生数月。夏间因服荷叶露、银花露过多。下利手冷。面色 白。口吐
涎沫。其家以为难活矣。予用理中汤加丁香。减小其剂。一服利止。而涎沫亦不吐矣。二服神气
充。手转温。复以五味异功散。培养胃气而安。今已十岁。为国小校之学生矣。
张星五大令(绍棠桐城人)宰昆山时。其如君年四十余。患血崩症。经医治愈。自是遂不能寐
。精神疲惫。饮食不多。延予治之。左脉细小。心脉尤弱。脐左有动气勃勃。甚则上冲。心
悸多汗。劲胸间尝觉筋掣。盖血舍空虚。筋无血养。而虚阳不能敛纳也。乃与阿胶鸡子黄
汤
稍能寐。遂接服至十五剂。病大退。饮食亦较多矣。嗣以原方加生地、熟地。制成膏剂。常
服全瘳。
庚戌三月。叶姓妇卧病垂危。其子来邀予诊。行色怆惶。口称已经某医延医数日。称为不治
。并求速往。视之果神色大衰。时出冷汗。手冷额冷。面色萎黄。心悸头晕。精神不支。脉
息小弱。盖阳气大虚。亡阳在即之危候也。遂以四逆加人参汤。再加黄 、白术、枣仁、白
芍、红枣等。姜、附各用一钱五分。参、 、术均用三钱。急煎与服。旋即汗止手温。神气
亦转。能进米粥。原方去附子。稍轻其剂。接服三日全安。
朱姓妇因病小产。旋即手冷恶寒。自汗不止。胸闷不欲食。脉息 滑而小。舌苔薄白。此产
后阳虚。而兼有痰湿阻滞也。用黄 建中汤去饴糖。加橘皮、半夏。一剂汗收手暖。二剂全愈
。
壬寅腊月。家慈因侍先外祖母病。及经营丧葬事。悲劳过度。复冒风雪。遂患关节疼痛
。不能起于床。服千金独活寄生汤数剂。痛止。亦稍稍能起坐矣。越两日晨间。忽大汗淋漓
。目直视。手冷。家人见之。惶骇不已。以为不祥之征也。家君入视后。取吉林人参半枝
。红枣约十数枚。急火煎服。才下咽而神色即觉宁靖。汗亦渐收。复以理中汤加黄 。接
服两日而安。距今已十三年。未尝患病。此亦予家得力于医之一事也。
方兆珍君令媳。年二十余。卧病经旬。服药多剂。而烦躁谵语。卒不能平。延予治之。见躁
扰不安。妄言骂詈。欲食冷物。手冷。脉息沉弱。口虽渴而不能饮。唇虽焦而舌则润泽。且
舌色不红。面色黄淡。身不发热。予谓此虚寒病也。殆寒凉发散太过乎。检阅前方。果皆芩
、连、羌活、栝蒌、海石之类。病家问既系寒病。何以烦躁欲食冷物。而谵语不能寐也。予
应之曰。寒病有常有变。凡恶寒手冷。下利清谷。口中和而不渴者。此其常也。若躁扰不安
。欲卧冷地。欲食冷物。则其变也。何谓之变。以其寒病而反现热象也。其所以现此热象者。因
阳气虚寒。龙雷之火浮越于外。古人所谓阴盛格阳。又曰内真寒而外假热之病也。治宜引火归元
。否则凉药入口则立毙矣。乃与四逆汤。干姜、附子各二钱。加肉桂八分。党参、白术、熟
地、枣仁、茯神各三钱。煎成冷服。果躁扰渐宁。接服一剂。能安睡矣。自是神安能食。不
镇海郡陶骏声先生的夫人。出现肿胀和呕吐症状，缠绵拖延了一个多月。起初是怀孕期间脚部浮肿，产后肿胀更加严重，伴有咳嗽和呕吐。经过当地多位名医治疗，先后使用了舟车丸、五皮饮、瓜蒌薤白白酒汤以及八珍汤等方剂，但都没有效果。而且现在面部、眼睛和四肢全部浮肿，腹部胀大像鼓一样，虽然呕吐后也能进食。诊察她的脉象弦滑且带有胃气（指脉象柔和有力，表示脾胃功能尚存），言语也非常清晰。起初我使用小半夏汤加干姜、五味子，以及厚朴半夏甘草人参汤、枳术汤等方剂，也没有太大效果，反而呕吐加剧。当时有人推荐其他医生诊治，服药后也感到胸膈闷塞，知道病情即将复发，必定要吐出几碗痰水，然后才觉得舒畅。最近又觉得异常闷塞，呼吸几乎不通畅。虽然现在吐过之后，仍然觉得闷塞，咳嗽得不能躺下。我沉思良久，恍然大悟地说：这是肺中的气管被痰饮闭塞导致不通畅。气管之所以闭塞，是因为腹胀尿少，胃中和膈膜间都是痰饮充塞的地方。膈中痰饮充塞，就会溢入肺中的气管；肺中气管也被充塞，就会激荡向上排出而成为呕吐。因此吐出的都是满盆满碗的痰涎水沫。痰水排出后，膈膜、肺、胃等处就松缓了，所以知道饥饿并能进食。等到几天后痰水积聚多了，又会再次发作。这就是此病的真谛所在。治疗方法以驱除痰饮为关键，而驱除肺中气管的痰饮尤为重要。苦思半晌后，为她制定一方，使用三子养亲汤合二陈汤，加麝香五厘调和服用。因为白芥子能横向开通肺中的痰饮，麝香气味辛窜，能通利气管及膈膜间的闭塞，并且能止吐。第二天复诊，患者叙述昨天服药后，感觉药性走窜不停，上窜至咽喉，下窜至小腹，胸部尤其感觉窜动，随窜动随呕吐，吐出很多痰涎，半夜无法安睡，但胸闷觉得宽舒，呼吸便利，呕吐也停止了。这是因为气管的闭塞通畅了。于是用原方去掉麝香，接着服用三剂，胸部非常舒展，咳嗽也减少。仍以原方加冬虫夏草、北沙参、生姜、红枣，又服三剂，浮肿也消退了，咳嗽基本停止。只是腹部胀大依旧，坚硬满闷不舒服。于是停服煎剂，每天单独服用禹余粮丸两次，每次三钱，忌食盐酱等物。五日后腹胀逐渐消退，十日后腹胀消了一半，但精神疲惫，自觉心内及脏腑空虚。这是因为饮邪停滞消除而气血虚弱了。令她以前丸减半服用，并以人参、白术、当归、白芍、山药、茯苓等药材煎剂交替服用。不到十日，腹胀完全消退，病竟痊愈。听到的人无不叹服。至今六年，病未复发，而且已经怀孕生育了。
庚戌年四月，广安祥糖栈袁尧宽先生患温病。起初由章绶卿先生请医诊治，服药数剂，病情没有明显减轻。后来章先生去江北放赈，转荐给我诊治。表现为壮热、说胡话，见到人就笑，口渴，小便红赤，每天只能进少量稀薄粥汤。舌苔黄薄而干燥无津液，身体肥胖，脉息滑数，右部尤为明显。这是温病。热邪蕴藏潜伏日久，积蓄久了爆发猛烈，所以病情危重如此。治疗方法应当以解热为主，辅以豁痰润燥。方用三黄石膏汤合小陷胸汤，去掉麻黄、豆豉、半夏，加贝母、连翘、青蒿、梨汁。连续服用两天，热势没有大幅减退。到第三剂后，发生战汗而病解。但余热未清，又用前方去掉石膏、黄芩、黄连、瓜蒌，加薏苡仁、滑石、芦根、天花粉、沙参等清除化解残余邪气。数剂后痊愈。凡是温病的解除多从战汗开始，刘河间、吴又可在前阐发，叶天士、王九峰在后发扬光大，结合我所经历的，确实是精确不易的理论学说。盖前人在此方面，都是从经验中得来的，只有必须等待服用多剂药物，才能奏效，而在出汗的时候，必须先战栗，那样子很吓人。医生遇到这种情况，怎么能没有坚定的认识和定力呢？
金峙生先生的母亲，年龄近五十岁，发热身痛，舌苔白腻，小便热，胸闷，脉滑。我起初用三仁汤加连翘、山栀，连续服用两剂，热势更甚，口渴心烦，舌苔转燥，脉也转数。这是伏邪病热，邪气蕴伏很重，于是更换方剂，用黄芩、瓜蒌、地骨皮、青蒿各三钱，连翘、知母各四钱，木通一钱，银柴胡二钱，芦根、茅根、鲜生地各一两，梨汁一杯调和服用。一剂后热势稍平，两剂后，病人突然战栗恶寒，震动床帐，这是准备发生战汗。病家误解，认为是药误，商议请其他医生。幸好他弟弟陶骏声先生来告知，急忙让我前往救治。我说这是战汗，是病退的机转，不可妄动。等我到他家时，战栗已经停止，身上出大汗，脉静身凉，神气也很安静，只感到疲倦而已。随即用稀薄粥汤给她喝，以扶助胃气，并用沙参、麦冬、百合、薏苡仁、石斛、天花粉、甘草、茯苓等调养两天而痊愈。
庚戌年四月，史汉泉先生患温病，昏沉不语，面色垢浊，眼睛红赤，鼻孔像烟煤一样黑，壮热烫手，汗出不止，舌苔黑燥，手臂抽搐，两手脉数疾，小便红赤。问不能说话几天了，回答说：昨天还说胡话，今天才开始不能说话。但是大声呼唤，还能瞪眼看人。问近日大便通吗？回答说：刚开始生病时曾腹泻，现在不大便已经三天了。问服了什么药，取出前医的方子给我看，大概都不出银翘散、三仁汤、增液汤的范围。我说这是热病未用清热药，属于阳明热极、胃家实的病证，非用攻下法不可。于是给予调胃承气汤合三黄石膏汤，去掉麻黄、豆豉，加犀角、瓜蒌仁。连续服用两剂，竟然没有排便，只是放屁极臭，小便颜色像血，神识较之前清醒，但身热舌黑如故。原方去掉元明粉、大黄，加鲜生地，并让人恣意饮用梨汁、莱菔汁。于是热减神清，黑苔逐渐消退，脉息也比较平稳。时常吐出粘痰，眼珠转黄，于是改用小陷胸汤加芦根、茅根、青蒿、石菖蒲、竹茹、贝母、冬瓜仁、木通等芳香清冽的药物，以分消膈中的痰热。连续服用四剂，胸部、头项间遍出白痦（一种细小的白色疱疹，如水晶珠），腹部、腿畔也发出白痦。于是身热全清，知道饥饿吃粥，只是精神疲弱罢了。再用西洋参、麦冬、石斛、薏苡仁、贝母、竹茹、枇杷叶等调养数日，才解下几次黑燥屎。当时两次使用大黄，而没有排下的原因，大概是他的亲戚朋友中有懂医的人，偷偷将大黄减去一钱，每剂只用二钱，所以只有解毒的功效，而没有攻下的力量，因而奏效也比较缓慢。然而终究比那些粗工滥用硝石、大黄而导致败事要好得多。
姚某的儿子十五岁，三月间从学校回家，自觉恶寒想睡，随即发热头痛，身痛谵语，不能辨认人。按摸其脉滑数，小便红赤。应当以栀子豉汤、银翘散加减为方。下午四时复诊，神昏谵语如旧，身热自汗出不止，面赤口渴想喝水，脉息滑而不数，舌苔薄腻，不黄不燥。想到《伤寒论》说：阳明病，发热汗多的，急用攻下法。而面赤神昏，也都是应当攻下的症状。于是改用小承气汤，大黄三钱，厚朴五分，枳壳二钱，加黄芩、连翘、知母各二钱。服后解大便两次，神识清醒安睡，汗止热退，自己能起坐，知道饥饿想吃东西。家属以为病愈，不再请医生诊治。过了三天，又发热有汗，口渴，脉滑数。给予白虎汤合小陷胸汤，石膏用三钱。服后热退神清，只是咳嗽痰中带血而已。再给泻白散加黄芩、知母、茅根等，两剂痊愈。
张兆魁先生的妻子，年龄约三十岁，体质瘦小，发热谵语，口渴心烦，想吃冷物，胸闷小便热，舌苔黄腻不燥，两脉都数。给予小陷胸汤加柴胡、黄芩，无效。烧热更厉害，于是改用凉膈散，大黄、元明粉各用三钱。服后得下两次，并发生战汗而热全退。只是精神萎弱，懒于言动。再用党参、麦冬、枸杞子、干地黄、黄芪、炙甘草等补养气血的药物，两剂后起居饮食如常。
鸿泰糖栈陈祝山，年龄约三十岁，今年七月患伏暑病。请某医生诊治，服药四五日，无效。壮热头疼，胸闷咽喉干燥，口渴舌绛苔薄焦燥无津，大便七八日不通，小便红赤脉数。这是暑热蕴伏肠胃，热结的病证。治疗方法应当先通大便，以解肠胃之焚。于是用生大黄二钱，元明粉三钱，枳壳、黄芩、麦冬、天花粉各二钱，甘草五分。此药服后，得大便两次，热全退，头痛也轻了，舌苔转白腻，脉缓不数，小便仍红，知道饥饿想吃东西。于是换方用连翘、薏苡仁、佩兰、天花粉、沙参、贝母等以解余邪。过了两天，又发热口渴胸闷，这是余邪欲出的表现。用小陷胸汤合小柴胡汤，去掉人参、姜、枣，加连翘、青蒿。连续服用两剂，得汗而安。凡是应用硝石、大黄这类药物的病，绝不是其他药所能替代。如果畏惧而不用，必定导致缠绵延误事情。只要辨认真切，用药有方，不可糊涂鲁莽罢了。
丁未年夏天，我在苏州游玩，恰逢当地霍乱流行，死亡接踵而至。有神仙庙旁纸店的寡妇，也染上此病，吐泻交作。医生投用五苓散、玉枢丹、附子理中汤、左金丸等方法，入口即吐，已经拖延三天。看她目陷形消，四肢逆冷，心烦不能安卧，口苦渴欲冷冻饮料，舌红根有腻苔，头有微汗，两脉皆数，重按无神。这是暑病。给予黄连香薷饮，去掉厚朴，加薏苡仁、蚕砂、半夏、石斛、沙参、黄柏、枇杷叶。服后吐止神安，手足转温，两剂后利减，能进粥汤。随后用前方去掉黄柏、蚕砂，减轻川连，利止。只是心悸腰酸头晕，精神疲惫，不能起坐，两脉细小。这是病去而气血虚了。用西洋参、白术、石斛、山药、杜仲、枣仁、茯神、当归、甘草、红枣等，调补三天而痊愈。
苏州阊门外营盘场，有个姓程的少年，也患霍乱，吐泻不止，烦躁畏热，身上没穿衣服，却还异常畏热，想睡在冷地上，四肢悉冷，胸腹部也不热，口渴想吃西瓜，小便短赤，头项微汗，小腿肚痉挛，脉息寸关俱数，舌苔黄燥无津。这是暑热内伏，热深厥深，内真热而外假寒的病证。于是用白虎汤合黄连香薷饮，去掉厚朴、粳米，加麦冬、薏苡仁、石斛，用阴阳水煎煮。一服吐止，再剂利也止，烦渴也大大安定。只是肢体尚冷，嘱咐喝稀粥，安睡一夜，体温遂恢复正常。于是仅以饮食调养，不需其他药物而痊愈。
徐某年龄约三十岁，秋天突然患腹痛吐利，发热口渴，烦躁不安，舌苔黄腻，脉息滑数。这是暑湿蕴伏中焦，肠胃中有宿滞。给予黄连香薷饮合平胃散，一服吐利止，身热退，接服一剂，知道饥饿想吃东西了。凡是黄连石膏适用的病，其舌苔必黄腻或黄燥，其小便也必红赤。若小便清长舌光无苔，则黄连、石膏两药皆为禁忌。因为舌质是否光润，可以窥探胃脏的虚实。
朱姓儿子八岁，秋天患霍乱吐泻，手足悉冷，口渴想喝水，目陷形消，不吃不饿，舌苔黄腻，脉息小数。用姜汁炒川连三分、法半夏一钱、扁豆三钱、薏苡仁三钱、木香五分、北沙参二钱。服后吐泻止，手足温，舌苔也退，能进稀粥。但口渴特别严重，于是改用麦冬、天花粉各一钱五分，北沙参二钱，白术一钱，薏苡仁、扁豆各三钱，两剂痊愈。
张姓妇女四十多岁，先在四月间患心悸怔忡，头眩发热，我用天王补心丹加青蒿、地骨皮等药治愈了。到了夏天，突然患腹痛上冲于心，呕吐清水，下利红白，痛甚则手足俱冷，汗出神疲。按摸其脉沉迟而小，望其色则面白唇淡。这是阳虚中寒的病证，大概是由乘凉饮冷所致。问之，果然连日卧竹床乘凉，且稍吃西瓜等物。给予附子理中汤加吴茱萸、桂枝、白芍、砂仁。一服痛稍缓，两剂痛始平，手足温。于是用原方去掉附子，减轻姜、萸的量，自此利止食进，再用归芍六君子汤，调治数日而痊愈。
詹云溪先生的幼子，刚出生几个月，夏天因服用荷叶露、银花露过多，下利手冷，面色㿠白，口吐涎沫。家属认为难以存活。我用理中汤加丁香，减小剂量，一服利止，而涎沫也不吐了。二服神气充盈，手转温。再用五味异功散，培养胃气而安。现在已经十岁，是国小的学生了。
张星五大令（绍棠，桐城人）任昆山知县时，他的夫人四十多岁，患血崩症，经医生治愈，从此就不能入睡，精神疲惫，饮食不多。请我诊治。左脉细小，心脉尤弱，脐左有动气勃勃，甚则上冲，心悸多汗，劲胸间常觉筋掣。这是血舍空虚，筋无血养，而虚阳不能敛纳。于是给予阿胶鸡子黄汤，稍能寐，于是接服至十五剂，病大退，饮食也较多。随后用原方加生地、熟地，制成膏剂，常服全愈。
庚戌年三月，叶姓妇人卧病垂危，其子来邀我诊治，行色仓皇，口称已经请某医生诊治数日，称为不治，并求速往。看她的神色大衰，时时出冷汗，手冷额冷，面色萎黄，心悸头晕，精神不支，脉息小弱。这是阳气大虚，亡阳在即的危候。于是用四逆加人参汤，再加黄芪、白术、枣仁、白芍、红枣等，姜、附各用一钱五分，参、芪、术均用三钱，急煎与服。旋即汗止手温，神气也转，能进米粥。原方去掉附子，稍轻其剂量，接服三日全安。
朱姓妇人因病小产，随即手冷恶寒，自汗不止，胸闷不欲食，脉息濡滑而小，舌苔薄白。这是产后阳虚，而兼有痰湿阻滞。用黄芪建中汤去掉饴糖，加橘皮、半夏。一剂汗收手暖，二剂痊愈。
壬寅年腊月，家慈因为侍奉先外祖母病，以及经营丧葬事，悲劳过度，又冒风雪，于是患关节疼痛，不能起床。服用千金独活寄生汤数剂，痛止，也稍稍能起坐。过了两天早晨，忽然大汗淋漓，目直视，手冷，家人见了，惶骇不已，以为不祥之征。家君进去查看后，取吉林人参半枝，红枣约十数枚，急火煎服。才下咽而神色即觉宁靖，汗也渐收。再用理中汤加黄芪，接服两日而安。距今已十三年，未曾患病。这也是我家得力于医术的一件事。
方兆珍先生的儿媳，年龄二十多岁，卧病经旬，服药多剂，而烦躁谵语，始终不能平静。请我诊治。见躁扰不安，妄言骂詈，想吃冷物，手冷，脉息沉弱，口虽渴而不能饮，唇虽焦而舌则润泽，且舌色不红，面色黄淡，身不发热。我说这是虚寒病，大概是寒凉发散太过吧。检阅前方，果皆是黄芩、黄连、羌活、瓜蒌、海浮石之类。病家问既然是寒病，为什么烦躁想吃冷物，而谵语不能寐呢？我回答说：寒病有常有变。凡恶寒手冷，下利清谷，口中和而不渴者，这是常理。若躁扰不安，想睡冷地，想吃冷物，则是变局。什么叫变？因为寒病反而现出热象。之所以现此热象，是因为阳气虚寒，龙雷之火浮越于外，古人所谓阴盛格阳，又说内真寒而外假热的病证。治疗宜引火归元，否则凉药入口则立即毙命。于是给予四逆汤，干姜、附子各二钱，加肉桂八分，党参、白术、熟地、枣仁、茯神各三钱，煎成冷服。果然躁扰渐宁，接服一剂，能安睡。自此神安能食，不...
The lady of Mr. Tao Junsheng in the town of Zhenhai suffered from edema and vomiting, which persisted for over a month. Initially, there was swelling of the feet during pregnancy, which worsened significantly postpartum, accompanied by coughing and vomiting. Several renowned physicians in the area treated her, administering sequentially Zhouche Wan (Boat and Cart Pill), Wupi Yin (Five-Peel Decoction), Gualou Xiebai Baijiu Tang (Trichosanthes Rhizome, Macrostemon Tuber, and White Wine Decoction), and Bazhen Tang (Eight-Treasure Decoction), but to no avail. Her face, eyes, and limbs were all swollen, and her abdomen was distended like a drum. Although she could eat after vomiting, her pulse was wiry and slippery yet retained Stomach Qi (an indication of preserved Spleen-Stomach function). Her speech was clear. I initially prescribed Xiaobanxia Tang (Minor Pinellia Decoction) with added Ganjiang (Dried Ginger) and Wuweizi (Schisandra Berry), as well Houpo Banxia Gancao Renshen Tang (Magnolia Bark, Pinellia, Licorice, and Ginseng Decoction) and Zhizhu Tang (Immature Bitter Orange and Atractylodes Macrocephala Decoction), but without significant effect; her vomiting even intensified. Another physician was recommended, but his treatment also resulted in chest oppression, indicating an impending relapse where she would vomit several bowls of phlegm-fluids before feeling relief. Recently, she felt extreme oppression, almost unable to breathe. Even after vomiting, she still felt oppressed, with coughing preventing her from lying down. After deep contemplation, I realized: "This is due to the airways in the lungs being blocked by phlegm-fluids." The blockage occurs because abdominal distension and oliguria indicate that the stomach and diaphragm are filled with phlegm-fluids. When these fluids fill the diaphragm, they overflow into the lung airways; when the airways are filled, they stir upward, causing vomiting. Hence, the vomitus consists of basins and bowls full of saliva and foam. Once expelled, the diaphragm, lungs, and stomach relax, allowing hunger and eating. However, after a few days, accumulation recurs. This is the essence of the disease. The treatment must focus on expelling phlegm-fluids, especially those in the lung airways. After much thought, I prescribed Sanzi Yangqin Tang (Three-Seed Decoction to Nourish the Elderly) combined with Erchen Tang (Two-Aged Decoction), plus 5 li of Shexiang (Musk) taken with the decoction. Baixiaoziren (White Mustard Seed) can horizontally open lung phlegm; Shexiang's pungent penetration unblocks airways and diaphragm obstruction and stops vomiting.
On the next day's follow-up, the patient reported that after taking the medicine, she felt its penetrating nature moving incessantly, up to the throat and down to the lower abdomen, especially in the chest. With this movement came vomiting of copious phlegm-saliva, preventing sleep until midnight. However, chest oppression eased, breathing became smooth, and vomiting stopped, indicating the airway blockage had cleared. I removed Shexiang from the original formula and administered three more doses. Chest comfort improved significantly, and cough decreased. I then added Dongchongxiacao (Cordyceps), Beishashen (Glehnia Root), Shengjiang (Fresh Ginger), and Dazao (Jujube) to the original formula for another three doses. Edema resolved, and cough largely ceased. However, abdominal distension remained hard and uncomfortable. I suspended the decoction and prescribed Yuyuliang Wan (Hematite Pill) twice daily, 3 qian per dose, avoiding salt and soy sauce. After five days, distension subsided; after ten days, it halved. She felt mentally exhausted and empty inside her heart and organs, indicating Qi and Blood deficiency following the resolution of fluid retention. I instructed her to take half the dose of the pill and alternate with a decoction of Renshen (Ginseng), Baizhu (Atractylodes), Danggui (Angelica Sinensis), Shaoyao (Peony), Shanyao (Dioscorea), and Fuling (Poria). Within ten days, distension fully resolved, and the disease was cured. Everyone marveled at this. Six years later, the disease had not recurred, and she had successfully given birth.
In the fourth month of Gengxu year, Mr. Yuan Yaokuan of Guang'anxiang Sugar Warehouse suffered from Warm Disease (Wen Bing). Initially treated by Dr. Zhang Shouqing, several doses failed to reduce the illness. Later, Dr. Zhang went to Jiangbei to distribute relief grain and referred me. Symptoms included high fever, delirium, smiling upon seeing people, thirst, red urine, and ability to consume only small amounts of thin porridge soup. Tongue coating was yellow, thin, dry, and devoid of fluids. The body was obese, and the pulse was slippery and rapid, especially on the right side. This is Warm Disease, where heat pathogens have been concealed for a long time and erupted violently, making the condition critical. Treatment should prioritize clearing heat, assisted by resolving phlegm and moistening dryness. I prescribed Sanhuang Shigao Tang (Three-Yellow and Gypsum Decoction) combined with Xiao Xiexiong Tang (Minor Trap-the-Chest Decoction), removing Mahuang (Ephedra), Douchi (Fermented Soybean), and Banxia (Pinellia), adding Bei Mu (Fritillaria), Lianqiao (Forsythia), Qinghao (Artemisia Annua), and Lizhi (Pear Juice). After two days, heat did not subside significantly. On the third dose, Battle Sweat (Zhan Han) occurred, leading to resolution. Residual heat remained, so I modified the formula by removing Shigao (Gypsum), Huangqin (Scutellaria), Huanglian (Coptis), and Gualou (Trichosanthes), adding Yiyiren (Coix Seed), Huashi (Talc), Lugeng (Reed Rhizome), Huafen (Trichosanthes Root), and Shashen (Glehnia) to clear residual pathogens. After several doses, recovery was achieved. It is said that Warm Diseases often resolve through Battle Sweat, a theory pioneered by Liu Hejian and Wu Youke, and expanded by Ye Tianshi and Wang Jiufeng. Based on my experience, this is indeed an accurate and unchangeable doctrine. Previous physicians derived this from experience; efficacy requires multiple doses, and sweating is preceded by shivering, which can be frightening. Physicians must possess firm conviction and stability in such situations.
Mrs. Jin Zhisheng, nearly fifty years old, presented with fever, body pain, white greasy tongue coating, hot urine, chest oppression, and slippery pulse. I initially used Sanren Tang (Three-Seed Decoction) with Lianqiao and Shanzhi (Gardenia). After two doses, heat intensified, with thirst, irritability, dry tongue coating, and rapid pulse. This indicated severe hidden pathogenic heat. I changed the prescription to Huangqin, Gualou, Digupi (Groundcherry Root Bark), and Qinghao each 3 qian; Lianqiao and Zhimu (Anemarrhena) each 4 qian; Mutong (Akebia) 1 qian; Yin Chaihu (Stellaria Root) 2 qian; Lugeng, Maogen (Imperata Rhizome), and Xianshengdi (Fresh Rehmannia) each 1 liang; mixed with one cup of Lizhi. After one dose, heat slightly stabilized. After two doses, the patient suddenly experienced chills and shaking, shaking the bed curtains, indicating impending Battle Sweat. The family misunderstood this as a medication error and planned to call another doctor. Fortunately, her brother Tao Junsheng informed me, and I rushed to treat her. I explained this was Battle Sweat, a sign of disease retreat, and advised against interference. Upon arrival, the shaking had stopped, profuse sweating occurred, pulse was calm, body temperature normalized, and spirit was quiet, though fatigue remained. I gave thin porridge soup to support Stomach Qi and prescribed Shashen, Maidong (Ophiopogon), Baihe (Lily Bulb), Yiyiren, Shihu (Dendrobium), Huafen, Gancao (Licorice), and Fuling for two days of recuperation, resulting in full recovery.
In April of Gengxu year, Mr. Shi Hanquan suffered from Warm Disease, presenting with lethargy, muteness, dirty complexion, red eyes, black nostrils resembling soot, high fever burning to the touch, continuous sweating, black dry tongue coating, arm spasms, rapid and frantic pulses, and red urine. He had been mute since yesterday, previously delirious. Loud calls elicited eye contact. Bowel movements: diarrhea at onset, now constipated for three days. Previous prescriptions were within the scope of Yinqiao San (Honeysuckle and Forsythia Powder), Sanren Tang, and Zengye Tang (Fluid-Increasing Decoction). I diagnosed this as Yangming Extreme Heat and Stomach Excess, requiring purgation. I prescribed Tiaowei Chengqi Tang (Regulating the Stomach and Directing Downward Decoction) combined with Sanhuang Shigao Tang, removing Mahuang and Douchi, adding Xijiao (Rhinoceros Horn - *note: substitute with Niuxi or other suitable herb in modern practice*) and Gualou Ren (Trichosanthes Seed). After two doses, no stool passed, only foul flatus, blood-colored urine, clearer consciousness, but persistent fever and black tongue. I removed Yuanmingfen (Mirabilite) and Dahuang (Rhubarb), added fresh Shengdi (Rehmannia), and advised liberal consumption of Lizhi and Laifu (Radish) juice. Heat reduced, consciousness cleared, black tongue faded, pulse stabilized. Sticky phlegm was expectorated, eyes turned yellow. I switched to Xiao Xiexiong Tang with Lugeng, Maogen, Qinghao, Shichangpu (Acorus), Zhuru (Bamboo Shavings), Beimu, Dongguaren (Winter Melon Seed), and Mutong to resolve phlegm-heat in the diaphragm. After four doses, white miliary rash (Bai Ping) appeared on the chest, head, neck, abdomen, and legs, resembling crystal beads. Fever cleared completely, appetite returned, though spirit remained weak. I then used Xiyangshen (American Ginseng), Maidong, Shihu, Yiyiren, Beimu, Zhuru, and Pipaye (Loquat Leaf) for several days of nourishment. Only then did he pass several stools of black, dry feces. The previous failure of Dahuang was due to relatives secretly reducing the dose by one qian per prescription (using only 2 qian instead of 3), providing detoxification but lacking purgative force, thus slowing efficacy. Nevertheless, this was superior to reckless use of Mirabilite and Rhubarb by incompetent physicians.
Yao's son, fifteen years old, returned from school in March complaining of aversion to cold and drowsiness, followed by fever, headache, body pain, delirium, and inability to recognize people. Pulse was slippery and rapid; urine was red. I initially considered Zhi Chi Tang (Gardenia and Fermented Soybean Decoction) and Yinqiao San. At the afternoon follow-up, symptoms persisted: coma, delirium, continuous sweating, red face, thirst for water, slippery but not rapid pulse, thin greasy tongue coating (not yellow or dry). Recalling the Shanghan Lun: "Yangming disease with fever and profuse sweating requires urgent purgation." Red face and coma also indicate need for purgation. I switched to Xiao Chengqi Tang: Dahuang 3 qian, Houpo 5 fen, Zhike (Immature Bitter Orange) 2 qian, plus Huangqin, Lianqiao, and Zhimu each 2 qian. After administration, two bowel movements occurred, consciousness cleared, sleep was peaceful, sweating and fever stopped, and he sat up independently, expressing hunger. The family believed he was cured and discontinued medical care. Three days later, fever, sweating, and thirst recurred with a slippery-rapid pulse. I prescribed Baihu Tang (White Tiger Decoction) combined with Xiao Xiexiong Tang, using 3 qian of Shigao. Heat and delirium resolved, leaving only cough with blood-streaked sputum. Two doses of Xiebai San (Lung-Clearing Powder) with Huangqin, Zhimu, and Maogen cured him.
Mrs. Zhang Zhaokui, about thirty years old, slender, presented with fever, delirium, thirst, irritability, craving for cold food, chest oppression, hot urine, yellow greasy non-dry tongue coating, and bilateral rapid pulses. Xiao Xiexiong Tang with Chaihu (Bupleurum) and Huangqin was ineffective; heat increased. I switched to Liangge San (Cool the Diaphragm Powder) with Dahuang and Yuanmingfen each 3 qian. Two bowel movements and Battle Sweat ensued, resolving the fever. Spirit was weak and lethargic. I prescribed Dangshen (Codonopsis), Maidong, Gouqizi (Goji Berry), Dihuang (Rehmannia), Huangqi (Astragalus), and Zhi Gancao (Honey-fried Licorice) to tonify Qi and Blood. Two doses restored normal activity and diet.
Chen Zhushan of Hongtai Sugar Warehouse, about thirty years old, suffered from latent Summerheat in July. After four to five days of ineffective treatment by another doctor, he presented with high fever, headache, chest oppression, dry throat, thirst, crimson tongue with thin scorched dry coating, constipation for seven to eight days, red urine, and rapid pulse. This was latent Summerheat with intestinal heat binding. Treatment required opening the bowels to relieve intestinal burning. I prescribed raw Dahuang 2 qian, Yuanmingfen 3 qian, Zhike, Huangqin, Maidong, and Huafen each 2 qian, Gancao 5 fen. Two bowel movements occurred, heat resolved, headache lightened, tongue coating turned white greasy, pulse slowed, urine remained red, and appetite returned. I switched to Lianqiao, Yiyiren, Peilan (Plagiorheuma), Huafen, Shashen, and Beimu to clear residual pathogens. Two days later, fever, thirst, and chest oppression recurred, indicating residual pathogens attempting to exit. I used Xiao Xiexiong Tang combined with Xiao Chaihu Tang (Minor Bupleurum Decoction), removing Renshen, Shengjiang, and Dazao, adding Lianqiao and Qinghao. Two doses induced sweating and peace. For diseases requiring Mirabilite and Rhubarb, no other herbs can substitute. Fear of their use leads to prolonged illness. Accurate differentiation and proper application are essential; one must not be reckless.
In summer of Dingwei year, while visiting Suzhou, Cholera (Huoluan) was epidemic. A widow near Shenxian Temple contracted it, suffering from simultaneous vomiting and diarrhea. Treatments with Wuling San (Five-Ling Powder), Yushu Dan (Jade Pivot Pill), Fuzi Lizhong Tang (Aconite and Poria Decoction), and Zuojin Wan (Left Metal Pill) caused immediate vomiting upon ingestion. After three days, she exhibited sunken eyes, emaciation, cold limbs, irritability, inability to lie comfortably, bitter taste, craving for cold drinks, red tongue with greasy root coating, slight head sweat, and rapid pulses lacking spirit upon heavy pressure. This was Summerheat disease. I prescribed Huanglian Xiangru Yin (Coptis and Elsholtzia Decoction), removing Houpo, adding Yiyiren, Can Sha (Silkworm Sand), Banxia, Shihu, Shashen, Huangbo (Phellodendron), and Pipaye. Vomiting and irritability stopped, limbs warmed, diarrhea decreased after two doses, and she could eat porridge. I then removed Huangbo and Can Sha, reduced Huanglian (Coptis), stopping diarrhea. Remaining symptoms: palpitations, sore back, dizziness, fatigue, inability to sit, fine-small pulses. This indicated Qi and Blood deficiency post-illness. I prescribed Xiyangshen, Baizhu, Shihu, Shanyao, Duzhong (Eucommia), Zaoren (Sour Jujube Seed), Fushen (Poria with Hostwood), Danggui, Gancao, and Dazao for three days of tonification, resulting in recovery.
A young man surnamed Cheng from Yingpangchang outside Changmen Gate, Suzhou, also had Cholera with continuous vomiting and diarrhea, irritability, aversion to heat, nakedness despite extreme heat sensitivity, desire to lie on cold ground, cold limbs, cool chest/abdomen, thirst for watermelon, short red urine, slight head/neck sweat, calf cramps, rapid cun-guan pulses, and yellow dry tongue coating. This was latent Summerheat with deep heat causing cold extremities (True Heat, False Cold). I prescribed Baihu Tang combined with Huanglian Xiangru Yin, removing Houpo and Jingmi (Glutinous Rice), adding Maidong, Yiyiren, and Shihu, brewed with Yin-Yang Water. One dose stopped vomiting, two doses stopped diarrhea and calmed thirst. Limbs remained cold; I advised thin porridge and sleep. Body temperature normalized overnight. Dietary management alone led to recovery.
Mr. Xu, about thirty years old, suddenly developed abdominal pain, vomiting, diarrhea, fever, thirst, irritability, yellow greasy tongue coating, and slippery-rapid pulse in autumn. This was Summer-dampness stagnating in the Middle Jiao with food retention. I prescribed Huanglian Xiangru Yin combined with Pingwei San (Calm the Stomach Powder). One dose stopped vomiting/diarrhea and reduced fever; a second dose restored appetite. For diseases suitable for Huanglian and Shigao, the tongue coating must be yellow greasy or dry, and urine red. If urine is clear/profuse and tongue is bare/smooth, these herbs are contraindicated, as tongue texture indicates Stomach deficiency/excess.
Zhu's eight-year-old son had Cholera in autumn with cold limbs, thirst, sunken eyes, emaciation, anorexia, yellow greasy tongue coating, and small-rapid pulse. I used Jiangzhi Chao Chuanlian (Ginger-fried Coptis) 3 fen, Faxia Banxia (Processed Pinellia) 1 qian, Biandou (Lablab Bean) 3 qian, Yiyiren 3 qian, Muxiang (Aucklandia) 5 fen, and Beishashen 2 qian. Vomiting/diarrhea stopped, limbs warmed, tongue coating cleared, and he ate porridge. Severe thirst remained, so I switched to Maidong and Huafen each 1.5 qian, Beishashen 2 qian, Baizhu 1 qian, Yiyiren and Biandou each 3 qian. Two doses cured him.
Mrs. Zhang, over forty, had palpitations, vertigo, and fever in April, cured by Tianwang Buxin Dan (Heavenly Emperor Heart-Nourishing Pill) with Qinghao and Digupi. In summer, she suddenly developed abdominal pain radiating to the heart, vomiting clear fluid, dysentery (red and white discharge), cold limbs, sweating, and fatigue during severe pain. Pulse was deep, slow, and small; complexion pale with light lips. This was Yang deficiency and Middle Cold, likely from sleeping on bamboo beds and eating watermelon. I prescribed Fuzi Lizhong Tang with Wuzhuyu (Evodia), Guizhi (Cinnamon Twig), Shaoyao, and Sharen (Amomum). Pain eased after one dose, resolved after two, limbs warmed. I removed Fuzi, reduced Ginger and Evodia. Diarrhea stopped, appetite returned. Guishao Liujunzi Tang (Angelica and Peony Six-Gentlemen Decoction) for several days completed the cure.
Mr. Zhan Yunxi's infant son, a few months old, consumed too much Helu Lu (Lotus Leaf Dew) and Yinhua Lu (Honeysuckle Dew) in summer, resulting in diarrhea, cold hands, pale face, and salivation. Family despaired. I used Lizhong Tang (Middle-Regulating Decoction) with Dingxiang (Clove), in a smaller dose. One dose stopped diarrhea and salivation; two doses restored spirit and warmth. Wuyi Yigong San (Five-Agent Success Formula) cultivated Stomach Qi. Now ten years old, he is a primary school student.
Mr. Zhang Xingda (Shoutang, from Tongcheng), Magistrate of Kunshan, had a wife in her forties who recovered from Metrorrhagia (Blood Flooding) but subsequently suffered insomnia, fatigue, and poor appetite. Left pulse was fine-small, Heart pulse particularly weak. Pulsatile movement below the left umbilicus, sometimes rising upward, with palpitations, sweating, and tendon twitching in the chest. This indicated Blood deficiency failing to nourish tendons and floating deficient Yang. I prescribed Ejiao Jizihuang Tang (Donkey-Hide Gelatin and Chicken Egg Yolk Decoction). Sleep improved slightly; fifteen doses greatly reduced symptoms and improved appetite. I then added Shengdi and Shudi (Prepared Rehmannia) to make a paste for regular use, achieving full recovery.
In March of Gengxu year, Mrs. Ye was critically ill. Her son invited me urgently, stating previous doctors deemed it incurable. She showed severe decline, cold sweats, cold hands/forehead, sallow complexion, palpitations, dizziness, exhaustion, and weak-small pulse. This was severe Yang deficiency, imminent Yang collapse. I prescribed Sini Jia Renshen Tang (Cold Extremity Plus Ginseng Decoction) with Huangqi, Baizhu, Zaoren, Shaoyao, and Dazao. Jiang (Ginger) and Fuzi (Aconite) each 1.5 qian; Renshen, Huangqi, Baizhu each 3 qian. Decocted urgently. Sweating and coldness stopped, limbs warmed, spirit recovered, and she ate rice porridge. I removed Fuzi, reduced dosage, and continued for three days until stable.
Mrs. Zhu, after a miscarriage, developed cold limbs, aversion to cold, continuous spontaneous sweating, chest oppression, anorexia, soft-slippery-small pulse, and thin-white tongue coating. This was postpartum Yang deficiency with Phlegm-Damp obstruction. I prescribed Huangqi Jianzhong Tang (Astragalus and Middle-Regulating Decoction) without Yitang (Maltose), adding Chenpi (Tangerine Peel) and Banxia. One dose stopped sweating and warmed limbs; two doses cured her.
In December of Renyin year, my mother, exhausted by caring for my grandmother and funeral arrangements, exposed herself to wind and snow, developing joint pain unable to leave bed. Qianjin Du Huo Jisheng Tang (Thousand Gold Notopterygium and Taxillus Decoction) relieved pain, allowing sitting up. Two days later, sudden profuse sweating, staring eyes, and cold hands occurred. Family panicked. My father took 0.5 branch of Jilin Renshen (Ginseng) and ten jujubes, decocted quickly. Consciousness calmed, sweating stopped. Lizhong Tang with Huangqi continued for two days. Stable for thirteen years since, never ill. This demonstrates the benefit of medical knowledge in our family.
Mrs. Fang Zhaozhen, twenty-something, had been ill for ten days with multiple ineffective prescriptions, presenting with restlessness, delirium, cursing, craving cold food, cold hands, deep-weak pulse, thirst but inability to drink, dry lips but moist tongue (non-red), sallow complexion, and no fever. I diagnosed deficiency-cold, likely from excessive cold/purgative herbs. Previous prescriptions contained Huangqin, Huanglian, Qianghuo (Notopterygium), Gualou, and Haishi (Floating Quartz). Family asked why a cold disease presents with heat signs like restlessness and craving cold. I explained: Cold diseases have standard and variant presentations. Standard: aversion to cold, cold limbs, clear watery diarrhea, neutral mouth, no thirst. Variant: restlessness, desire for cold floor/food. This variant arises from deficient-cold Yang causing "Dragon-Leopard Fire" to float outward, known as Yin excess repelling Yang or True Cold-False Heat. Treatment requires guiding fire back to its source; otherwise, cold herbs will cause death. I prescribed Sini Tang with Ganjiang and Fuzi each 2 qian, Rougui (Cinnamon Bark) 8 fen, Dangshen, Baizhu, Shudi, Zaoren, and Fushen each 3 qian, taken cold. Restlessness subsided, sleep returned after one dose. Spirit calmed, appetite returned...