红枣等。服后酣睡两小时。而呃不作矣。翌日来复诊。病患感谢至于泣下。然则此二药者
。殆真有止呃之特效乎。特痰滞壅阻。人实证实之呃。则当先豁其痰。未可骤用此药也。
丁未七月。予由苏旋里。道出京口。适童道生君病虐甚重。医治未效。因偕家兄往候之。见
其汗出淋漓。身热口渴。神气疲惫。因问病起几日。何以如此困顿。曰虐发已五日。每至下
午八时始发。但热不寒。热甚则汗出。甚至湿透衣衾。至天明始退。心烦口渴。不能安寐。
因诊其脉。两手皆细数。按之极虚。溲赤而热。舌燥无津。并无苔垢。阅前服方。则清脾饮
二陈汤等法。盖暑病而得草果、槟榔等辛温克削之品。耗损阴津而助邪热。热甚则迫液外泄
。故有大汗淋漓。烦躁不寐之现状也。急宜甘凉滋润退热存津。庶几有瘳。乃与西洋参、百
合、地骨皮、白芍、知母各三钱。川连五分。鳖甲五钱。元参三钱。甘草一钱。浮麦、红枣
同煎。覆杯而愈。
吴德和年四十余。病虐。每发。但恶寒战栗。头疼身重。骨节酸疼。毫不发热。胸闷无汗。
舌苔白腻。口和不渴。按其脉沉缓而滑。盖贪凉饮冷太过。风寒外袭。冷滞内停。而为病也
。与葱豉汤合平胃散。加桂枝、紫苏。一服大出冷汗而瘥。
杨某由江北来镇。病虐甚重。盖已发数次矣。间日一发。发则大热烦渴。欲饮冷水。心烦不
安。溲赤而热。诊其脉与平人无大异。但略兼滑数之象耳。盖暑气深伏为患也。用竹叶石膏
汤去人参、半夏、加茈胡、青蒿、黄芩、天花粉、知母、苡仁等。石膏用四钱。余药各二三
钱。作煎剂服。明日复诊。述昨药服后。如饮甘露。爽适异常。仍以原方接服一剂。隔两日
来。述病已去大半。颇思饮食。遂改用沙参、石斛、苡仁、麦冬、佩兰、花粉等。养胃生津之
品而愈。
卢某年约三旬。癸丑八月间。予方午餐。见其走来。旁一人扶之。犹踉跄不能自
立。呻吟不已。予见其状。遂立即诊视。脉息滑数。身热甚重。盖虐病发数日矣。烧热不能
耐。溲赤而热。舌苔干燥。与竹叶石膏汤去人参、半夏。加黄芩、知母、木通、茈胡等。石
膏用四钱。黄芩用三钱。余药各一二钱。明日复诊。述昨药服后。觉小腹部如有重物压之。
一夜未尝离汗。遍体舒适。能自行走。遂以原方减轻其剂。二剂而痊。此病用石膏后。觉小
腹如物重压。与赵藜村治袁随园之案略同。殆由石膏重镇之力。生理上起此特别之现象欤。
张姓妇年二十五岁。患虐病。先由西医延医。服金 哪霜。虐止。数日后复发。仍由西医
用金鸡哪霜。如是者数月。而虐终不断。延予延医。虐症变为间二日一发。面黄头晕。胸闷
作胀。但尚能饮食。舌苔白薄。脉息缓滑。盖暑湿痰滞蕴伏于中。营卫不能和调。金 哪霜
虽能止虐。而性热有毒。且兼补性。不免有闭塞病气之弊。且服之日久。则中其毒。遂与茈
胡桂枝汤合平胃散。两剂。胸胀遂松。虐来亦轻。遍身发出疹块。上自巅顶。下及两腿。其
痒异常。盖病气外泄之征也。仍以原方。接服两剂而痊。大抵金鸡哪霜治虐。只可一二服。不效
。则须另用他药矣。
吴性宜君夫人。年逾四旬。寒热往来。头晕心悸。彻夜不寐。胸闷食
少
茈胡汤合增液汤。加枣仁、茯神、青蒿、佩兰、香橼皮。二剂而解。复以养血舒郁之方。以
善其后。
徐姓妇年近三旬。病虐数日。始犹起居如常。继则不能起坐。每至虐发时。口
渴自汗。头晕心虚。欲坠。手指蠕动。舌边破裂。苔薄黄不燥。大便溏。小便热。左脉细数。右
脉小滑而亦兼有数象。盖生育已多。血液素亏。而又感受时令之暑气也。用西洋参、麦冬、
元参、柏子仁、茯神、地骨皮、知母、白芍、青蒿、甘草。稍加黄连为剂。服后诸症顿退。
但关节酸痛。舌现白苔。胸次略闷。乃以原方去黄连、知母。加橘皮、半夏、当归、枣仁、
生姜、红枣等。接服三日而痊。
己酉秋。友人陶冶青君病虐。始发时。尚能行走。继则不能起坐。延医服药。殊无大效。
适予因事旋里。为诊之。脉沉弦滑。舌苔滞腻。胸闷身重。骨节酸疼。但恶寒身微热。口不燥
。盖寒湿痰饮冰伏中焦。阳气不能健运。非阳和之力不能使之消融。乃以茈胡姜桂汤合平
胃散。加薤白、蔻仁、沉香等。浓朴、干姜、豆蔻。均各用一钱。沉香八分。余药各二三钱
。煎服。吐出稀痰水饮甚多。胸闷略宽。恶寒始解。仍以前方减轻其剂。接服三日。遂知饥
能食。后以香砂六君子丸。调养半月而安。
冶青介弟冠三君病虐。每日午后发。发时先觉恶寒。旋即大热。口渴心烦。头晕不支。脉息
细数。左尺尤甚。溲赤苔少。盖平日用脑太过。阴液素衰。而复受暑也。乃与青蒿鳖甲汤去
生地、丹皮。加川连、苡仁、沙参、银茈胡、元胡、六一散等。覆杯而愈。
红枣等。服用后酣睡两小时，呃逆便停止了。第二天来复诊，病人感激得流下眼泪。然而这两种药，难道真有止住呃逆的特效吗？只是痰浊停滞壅塞阻滞，属于实证、实证的呃逆，则应当先豁除其痰浊，不可骤然使用此药。
丁未年七月，我从苏州返回故里，途经京口。恰逢童道生先生疟疾发作非常严重，医治无效，于是我和家兄前去探望他。见他汗出淋漓，身体发热口渴，神气疲惫。于是询问病起几天了，为何如此困顿。他说疟疾发作已五天，每到下午八时才开始发作，只发热不恶寒，热势严重时出汗，甚至湿透衣服和被褥，直到天亮才退热。心烦口渴，不能安睡。于是诊察他的脉象，两手脉都细数，按之极虚，小便赤涩而热，舌燥无津液，并没有苔垢。查阅之前服用的方剂，则是清脾饮、二陈汤等方法。大概是暑病却用了草果、槟榔等辛温克削的药物，耗损阴津而助长邪热。热势甚重则逼迫津液外泄，所以有大汗淋漓、烦躁不寐的现状。急宜用甘凉滋润之法退热存津，或许有痊愈的希望。于是给予西洋参、百合、地骨皮、白芍、知母各三钱，川黄连五分，鳖甲五钱，元参三钱，甘草一钱，浮小麦、红枣同煎，喝完一杯药就痊愈了。
吴德和四十多岁，患疟疾，每次发作，只恶寒战栗，头疼身重，骨节酸痛，完全不发热，胸闷无汗，舌苔白腻，口中和而不渴。按其脉沉缓而滑，大概是贪凉饮冷太过，风寒外袭，冷滞内停，从而致病。给予葱豉汤合平胃散，加桂枝、紫苏，一服药后大出冷汗而痊愈。
杨某从江北来到镇江，患疟疾非常严重，大概已经发作几次了。隔日发作一次，发作时大热烦渴，想喝冷水，心烦不安，小便赤涩而热。诊察他的脉象与常人没有太大差异，只是略微兼有滑数的象。大概是暑气深伏体内为患。用竹叶石膏汤去掉人参、半夏，加柴胡、青蒿、黄芩、天花粉、知母、薏苡仁等。石膏用四钱，其余药物各二三钱，作煎剂服用。第二天复诊，叙述昨天服药后，如饮甘露，爽快舒适异常。仍然用原方接着服一剂。隔两天再来，叙述病已去大半，颇思饮食，于是改用沙参、石斛、薏苡仁、麦冬、佩兰、花粉等养胃生津的药物而痊愈。
卢某约三十岁，癸丑年八月间，我正在吃午饭，见他一瘸一拐走来，旁边一人搀扶着他，还踉跄不能自立，呻吟不止。我见他的状况，立即诊视。脉息滑数，身热很重，大概是疟疾发作几天了。烧热难以忍受，小便赤涩而热，舌苔干燥，给予竹叶石膏汤去掉人参、半夏，加黄芩、知母、木通、柴胡等。石膏用四钱，黄芩用三钱，其余药物各一二钱。第二天复诊，叙述昨天服药后，觉得小腹部如有重物压迫，一夜未曾离开汗水，遍体舒适，能自行行走。于是用原方减轻剂量，两剂而痊愈。这个病用石膏后，觉得小腹如物重压，与赵藜村治疗袁随园的医案大致相同，大概是由石膏重镇的力量，在生理上引起这种特别的现象吧。
张姓妇女二十五岁，患疟疾。起初由西医延请医生，服用金鸡纳霜，疟疾停止，几天后复发，仍由西医用金鸡纳霜，像这样几个月，而疟疾始终不断。延请我诊治，疟症变为隔两天发作一次，面色黄头晕，胸闷作胀，但还能饮食，舌苔白薄，脉息缓滑。大概是暑湿痰滞蕴伏于中焦，营卫不能和调。金鸡纳霜虽然能止疟，但其性热有毒，且兼有补性，不免有闭塞病气的弊端，而且服用日久，则中毒其中。于是给予柴胡桂枝汤合平胃散，两剂，胸胀随即缓解，疟疾发作也减轻，遍身发出疹块，上自头顶，下至双腿，瘙痒异常，这是病气外泄的征象。仍然用原方，接着服两剂而痊愈。大抵金鸡纳霜治疟，只可服用一两次，如果不效，则须另外使用其他药物了。
吴性宜先生的夫人，年龄超过四十岁，寒热往来，头晕心悸，彻夜不寐，胸闷食少。给予柴胡汤合增液汤，加枣仁、茯神、青蒿、佩兰、香橼皮，两剂而解。随后用养血舒郁的方子，以善其后。
徐姓妇女近三十岁，患疟疾几天。起初起居如常，后来则不能起坐，每到疟疾发作时，口渴自汗，头晕心虚，欲坠，手指蠕动，舌边破裂，苔薄黄不燥，大便溏，小便热，左脉细数，右脉小滑而也兼有数象。大概是生育已多，血液素亏，而又感受时令的暑气。用西洋参、麦冬、元参、柏子仁、茯神、地骨皮、知母、白芍、青蒿、甘草，稍加黄连为剂，服用后诸症顿退。但关节酸痛，舌现白苔，胸次略闷，于是用原方去掉黄连、知母，加橘皮、半夏、当归、枣仁、生姜、红枣等，接着服三天而痊愈。
己酉年秋天，友人陶冶青先生患疟疾，刚开始发作时，尚能行走，后来则不能起坐，延医服药，殊无大效。恰好我因事返回故里，为他诊察。脉沉弦滑，舌苔滞腻，胸闷身重，骨节酸痛，只恶寒身微热，口不燥。大概是寒湿痰饮冰伏中焦，阳气不能健运，非阳和之力不能使之消融。于是给予柴胡姜桂汤合平胃散，加薤白、蔻仁、沉香等。厚朴、干姜、豆蔻，均各用一钱，沉香八分，其余药物各二三钱，煎服。吐出稀痰水饮很多，胸闷略微宽舒，恶寒开始解除。仍然用前方减轻剂量，接着服三天，于是知道饥饿能进食，后用香砂六君子丸，调养半月而安。
冶青介弟冠三先生患疟疾，每天午后发作，发作时先觉恶寒，旋即大热，口渴心烦，头晕不支，脉息细数，左尺尤甚，小便赤苔少。大概是平日用脑太过，阴液素衰，而又受暑。于是给予青蒿鳖甲汤去掉生地、丹皮，加川连、薏苡仁、沙参、银柴胡、元胡、六一散等，喝完一杯药就痊愈了。
Red dates, etc. After taking the medicine, he slept soundly for two hours, and the hiccups ceased. He came for a follow-up visit the next day, moved to tears with gratitude. However, do these two medicines truly have a specific effect on stopping hiccups? It is merely that phlegm stagnation obstructs and blocks; in cases of excess syndrome manifesting as hiccups (excess-type hiccup), one should first resolve the phlegm, and it is inadvisable to use this medicine abruptly.
In July of the Dingwei year, I returned from Suzhou to my hometown, passing through Jingkou. At that time, Mr. Tong Daosheng was suffering severely from malaria (Jue disease), and previous treatments had been ineffective. Accompanied by my elder brother, I went to visit him. I observed profuse sweating, fever, thirst, and mental fatigue. I asked how long he had been ill and why he was so exhausted. He replied that the malaria had been recurring for five days, starting every day at 8 PM. He experienced fever without chills; when the heat was severe, he sweated profusely, soaking his clothes and bedding, only subsiding at dawn. He felt restless, thirsty, and unable to sleep. Upon palpating his pulse, both hands were fine and rapid, extremely deficient upon pressure. His urine was red and hot, his tongue dry without fluids, and devoid of coating. Reviewing the previous prescriptions, they included methods such as Qingpi Yin (Clear the Spleen Decoction) and Erchen Tang (Two Aged Things Decoction). It appeared that for a summerheat disease, acrid-warm and draining herbs like Cao Guo (Tsaoko Fruit) and Bing Lang (Areca Seed) had been used, damaging yin fluids and assisting pathogenic heat. Severe heat forces fluids to leak outwards, hence the current state of profuse sweating, restlessness, and insomnia. Urgently, sweet-cool and moistening methods should be employed to clear heat and preserve fluids, perhaps leading to recovery. Thus, I prescribed Xi Yang Shen (American Ginseng), Bai He (Lily Bulb), Di Gu Pi (Cortex Lycii), Bai Shao (White Peony Root), and Zhi Mu (Anemarrhena Rhizome), each 3 qian; Chuan Lian (Coptis Rhizome) 0.5 qian; Bie Jia (Carapax Trionycis) 5 qian; Yuan Shen (Scrophulariae Radix) 3 qian; Gan Cao (Licorice Root) 1 qian; Fu Mai (Floating Wheat) and Hong Zao (Red Date) decocted together. He recovered after finishing just one cup.
Wu Dehe, over forty years old, suffered from malaria. Each episode involved only aversion to cold and shivering, headache, heavy body, and sore joints, with no fever. He had chest tightness, no sweat, a white greasy tongue coating, and a mouth that felt neutral without thirst. His pulse was deep, slow, and slippery. This was likely due to excessive indulgence in cooling foods and drinks, causing wind-cold to attack externally and cold stagnation to remain internally. I prescribed Cong Chi Tang (Scallion and Fermented Soybean Decoction) combined with Ping Wei San (Calm the Stomach Powder), adding Gui Zhi (Cinnamon Twig) and Zi Su (Perilla Leaf). After one dose, he sweated profusely and recovered.
Mr. Yang came from Jiangbei to Zhenjiang, suffering severely from malaria, having had several episodes. It occurred every other day; during attacks, he had high fever, restlessness, and intense thirst for cold water, along with mental agitation and red, hot urine. His pulse was largely similar to that of a healthy person, but slightly slippery and rapid. This indicated deep-seated summerheat pathogen. I used Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction), removing Ren Shen (Ginseng) and Ban Xia (Pinellia Tuber), and adding Chai Hu (Bupleurum Root), Qing Hao (Artemisia Annua), Huang Qin (Scutellaria Root), Tian Hua Fen (Trichosanthes Root), Zhi Mu (Anemarrhena Rhizome), and Yi Yi Ren (Coix Seed). Shi Gao (Gypsum Fibrosum) was used at 4 qian, and other herbs at 2-3 qian each, prepared as a decoction. On the next day's follow-up, he reported that the medicine felt like drinking sweet dew, bringing exceptional comfort. The original prescription was continued for another dose. Two days later, he reported that the illness had diminished significantly, and he desired food. I then switched to Sha Shen (Glehnia Root), Shi Hu (Dendrobium Stem), Yi Yi Ren (Coix Seed), Mai Dong (Ophiopogon Tuber), Pei Lan (Eupatorium Fortunei), and Hua Fen (Trichosanthes Root), herbs that nourish the stomach and generate fluids, leading to recovery.
Mr. Lu, approximately thirty years old, in August of the Guichou year, approached me while I was eating lunch. He was supported by another person, staggering and unable to stand independently, groaning incessantly. Seeing his condition, I examined him immediately. His pulse was slippery and rapid, and his body heat was severe. The malaria had been active for several days. The burning heat was unbearable, urine was red and hot, and the tongue coating was dry. I prescribed Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction), removing Ren Shen (Ginseng) and Ban Xia (Pinellia Tuber), and adding Huang Qin (Scutellaria Root), Zhi Mu (Anemarrhena Rhizome), Mu Tong (Akebia Caulis), and Chai Hu (Bupleurum Root). Shi Gao (Gypsum Fibrosum) was used at 4 qian, Huang Qin (Scutellaria Root) at 3 qian, and other herbs at 1-2 qian each. On the next day's follow-up, he reported that after taking the medicine the previous day, he felt a heavy weight pressing on his lower abdomen, sweated throughout the night, yet felt comfortable all over and could walk independently. The dosage of the original prescription was reduced, and he recovered after two doses. In this case, the sensation of heavy pressure in the lower abdomen after using Shi Gao (Gypsum Fibrosum) was similar to the case treated by Zhao Licun for Yuan Suianyuan. This phenomenon may be physiologically induced by the heavy-sedating power of Shi Gao (Gypsum Fibrosum).
Mrs. Zhang, twenty-five years old, suffered from malaria. Initially treated by Western doctors who administered Cinchona Bark (Jin Ji Na Shuang), which stopped the malaria, but it recurred after a few days. The Western doctor continued using Cinchona Bark (Jin Ji Na Shuang) for months, yet the malaria persisted. I was consulted, and the malaria had changed to occurring every third day. She had a sallow complexion, dizziness, chest tightness and distension, but could still eat. Her tongue coating was thin and white, and her pulse was slow and slippery. This indicated summer-dampness and phlegm-stagnation hidden in the middle jiao, with Ying and Wei qi failing to harmonize. Although Cinchona Bark (Jin Ji Na Shuang) can stop malaria, its nature is hot and toxic, and it has tonifying properties, which inevitably risks closing off the pathogenic qi. Prolonged use leads to toxicity. I prescribed Chai Hu Gui Zhi Tang (Bupleurum and Cinnamon Twig Decoction) combined with Ping Wei San (Calm the Stomach Powder). After two doses, the chest distension relaxed, and the malaria attacks became milder. Rashes appeared all over her body, from the top of the head to the legs, with extreme itching, indicating the expulsion of pathogenic qi. The original prescription was continued for two more doses, leading to recovery. Generally, Cinchona Bark (Jin Ji Na Shuang) for malaria should only be used for one or two doses; if ineffective, other medicines must be used.
The wife of Mr. Wu Xingyi, over forty years old, experienced alternating chills and fever, dizziness, palpitations, insomnia throughout the night, chest tightness, and poor appetite. I prescribed Chai Hu Tang (Bupleurum Decoction) combined with Zeng Ye Tang (Increase Fluids Decoction), adding Zao Ren (Ziziphus Seed), Fu Shen (Poria with Hostwood), Qing Hao (Artemisia Annua), Pei Lan (Eupatorium Fortunei), and Xiang Yuan Pi (Citron Peel). After two doses, the symptoms resolved. Subsequently, a formula to nourish blood and soothe depression was used to conclude the treatment.
Mrs. Xu, nearly thirty years old, had suffered from malaria for several days. Initially, her daily activities were normal, but later she could not sit up. During malaria attacks, she had thirst, spontaneous sweating, dizziness, and a feeling of faintness, with twitching fingers. Her tongue edges were cracked, the coating thin and yellow but not dry, stool was loose, and urine was hot. The left pulse was fine and rapid, and the right pulse was small, slippery, and also rapid. This was likely due to multiple pregnancies causing inherent blood deficiency, compounded by seasonal summerheat. I prescribed Xi Yang Shen (American Ginseng), Mai Dong (Ophiopogon Tuber), Yuan Shen (Scrophulariae Radix), Bai Zi Ren (Biota Seed), Fu Shen (Poria with Hostwood), Di Gu Pi (Cortex Lycii), Zhi Mu (Anemarrhena Rhizome), Bai Shao (White Peony Root), Qing Hao (Artemisia Annua), and Gan Cao (Licorice Root), with a slight addition of Huang Lian (Coptis Rhizome). After taking it, all symptoms subsided suddenly. However, joint soreness appeared, a white tongue coating emerged, and there was slight chest stuffiness. Therefore, Huang Lian (Coptis Rhizome) and Zhi Mu (Anemarrhena Rhizome) were removed from the original prescription, and Ju Pi (Tangerine Peel), Ban Xia (Pinellia Tuber), Dang Gui (Angelica Sinensis), Zao Ren (Ziziphus Seed), Sheng Jiang (Fresh Ginger), and Hong Zao (Red Date) were added. She recovered after three consecutive doses.
In the autumn of the Jiyi year, my friend Tao Yeqing suffered from malaria. Initially, he could walk, but later could not sit up. Medical treatment and medication yielded little effect. As I happened to return to my hometown, I examined him. His pulse was deep, wiry, and slippery; the tongue coating was turbid and greasy; he had chest tightness, heavy body, and joint soreness. He only had aversion to cold and slight fever, with no dry mouth. This indicated cold-dampness and phlegm-fluid frozen in the middle jiao, preventing the healthy yang qi from functioning normally. Only warm-yang resolving power could melt this stagnation. I prescribed Chai Hu Jiang Gui Tang (Bupleurum, Ginger, and Cinnamon Twig Decoction) combined with Ping Wei San (Calm the Stomach Powder), adding Xie Bai (Macrostemon Bulb), Kou Ren (Black Cardamom Seed), and Chen Xiang (Aquilaria Wood). Hou Po (Magnolia Bark), Gan Jiang (Dried Ginger), and Dou Kou (Cardamom) were each used at 1 qian; Chen Xiang (Aquilaria Wood) at 0.8 fen; and other herbs at 2-3 qian each. After decocting and taking it, he vomited a large amount of thin phlegm and fluid, the chest tightness slightly relieved, and the aversion to cold resolved. The previous prescription was continued with reduced dosage for three days, after which he felt hungry and could eat. Later, he took Xiang Sha Liu Jun Zi Wan (Aucklandia and Amomum Six Gentlemen Pills) for half a month to recuperate.
Mr. Guan San, the younger brother of Yeqing, suffered from malaria, occurring daily in the afternoon. Before the attack, he felt aversion to cold, followed quickly by high fever, thirst, mental restlessness, and dizziness with exhaustion. His pulse was fine and rapid, especially at the left Chi position. Urine was red, and the tongue coating was scant. This was likely due to excessive mental labor depleting yin fluids, compounded by summerheat exposure. I prescribed Qing Hao Bie Jia Tang (Artemisia Annua and Carapax Trionycis Decoction), removing Di Huang (Rehmannia Root) and Dan Pi (Moutan Cortex), and adding Chuan Lian (Coptis Rhizome), Yi Yi Ren (Coix Seed), Sha Shen (Glehnia Root), Yin Chai Hu (Stellaria Root), Yuan Hu (Corydalis Rhizome), and Liu Yi San (Six-to-One Powder). He recovered after finishing just one cup.