庚戌四月。乡妇吴氏病伤寒。头疼身热。下利不止。众医多以附子理中金液治之。烦躁而利
愈甚。予视之
曰。脉迟而沉。若脐下热。则协热利也。投三黄熟艾汤。三服而利止渴除。渐投以解肌汗药。而
得汗瘥。
丁未岁夏。族妹因伤寒。已汗后。呕吐不止。强。药不下。医以丁香硝石硫黄藿香等药治之。
盖作胃冷治也。予往视之。曰。此汗后余热尚留胃脘。若投以热药。如以火济火。安能止也。故
以香薷汤。竹茹汤。三服愈。
夏。钟离德全一夕病。上吐下泻。身冷。汗出如洗。心烦躁。予以香薷饮与服之。翌日遂定。
进理中等调之痊。
论曰。仲景云。病发热。头痛。身疼。恶寒。吐利者。此属何病。答曰此名霍乱。自吐下又利。
止而复作。更发热也。此病多由暑热。阴阳不和。清浊相干。饮食过伤。三焦溷乱。腹中撮痛。
烦渴不止。两足转筋。杀人颇急。不可缓也。
江西茶客吴某。病。头疼如裹。两脚自膝以下皆冷。胸间多汗。时时谵语。医作阴证。治以
附子辈。意其足冷而厥也。予诊其脉关濡尺急。遂断以湿温脉证。其病先日受湿。而又中 。湿
热相搏。故此证成。急以白虎三投而解。
有人伤寒。得汗数日。忽身热自汗。脉弦数。宛然复作。断之曰。劳心所致也。神之所舍。
未复其初。而又劳伤
其神。营卫失度。当补其子。益其脾。解其劳。庶几便愈。医者在座。难之曰。虚则补其母。今
补其子。出在何经也。予曰。出千金方论。子不知虚劳之证乎。难经曰。虚则补其母。实则泻其
子。此虚则当补其母也。千金方。心劳甚者。补脾气以益其心。脾旺则感于心矣。此劳则补其子
也。盖母生我者也。子继我助我者也。方治其虚。则补其生我者。与锦囊所谓本骸得气。遗体受
荫同义。方治其劳。则补其助我者。与荀子未有子富而父贫同义。故二者补法各自有理。医唯唯
而退。
庚戌年四月。乡间妇女吴某患伤寒。头痛身热。腹泻不止。众医生多用附子理中丸、金液丹治疗。结果烦躁且腹泻更加严重。我诊察后说：脉象迟而沉。如果脐下感觉发热，这就是协热利。给予三黄熟艾汤。服用三剂后腹泻停止、口渴消除。随后逐渐给予解肌发汗的药物，出汗后病愈。
丁未年夏天。族妹因患伤寒。已经发过汗后。呕吐不止。身体强直拘急。药物无法咽下。医生用丁香、硝石、硫黄、藿香等药物治疗。大概是将此症当作胃寒来治疗。我去诊视后说：这是发汗后余热仍留在胃脘。如果投以热性药物，如同用火救火，怎么能止住呢？因此使用香薷汤、竹茹汤。服用三剂后痊愈。
夏季。钟离德全某夜发病。上吐下泻。身体冰冷。出汗如洗澡一般。心中烦躁。我给他服用香薷饮。第二天病情就稳定了。后续服用理中汤调理而痊愈。
论述说：张仲景说：患病发热、头痛、身疼、恶寒、呕吐腹泻的，这属于什么病？回答说：这名叫霍乱。自行呕吐腹泻后又腹泻。停止后又发作。再次发热。这种病多由暑热引起。阴阳不和。清浊之气相互干扰。饮食过度损伤。三焦混乱。腹中绞痛。烦渴不止。两脚抽筋。杀人非常迅速。不可迟缓。
江西茶商吴某。患病。头痛如被包裹。双脚从膝盖以下皆冷。胸部多汗。时常胡言乱语。医生当作阴证治疗。使用附子类方药。认为他是脚冷导致四肢厥逆。我诊察他的脉象关部濡软尺部紧急。于是断定为湿温病的脉证。他的病是日前受湿邪侵袭。又中暑热。湿热相搏结。所以形成此证。急忙使用白虎汤。服用三剂而病解。
有人患伤寒。发汗数日后。忽然身体发热自汗。脉象弦数。完全像复发一样。诊断说是：劳心所致。神气所居之处。尚未恢复如初。而又劳伤其神气。营卫失去节度。应当补益其子脏（脾）。增益脾气。解除劳倦。差不多就能痊愈。在场的医生质疑说：虚证应当补其母脏。现在补其子脏。出自哪部经典呢？我说：出自《千金方》论著。你不知道虚劳的病证吗？《难经》说：虚则补其母。实则泻其子。这是虚证应当补其母的情况。《千金方》说：心劳严重的。补脾气以益心气。脾旺则感应于心。这是劳损则补其子的情况。盖母亲生养我。儿子继承并帮助我。治疗虚证时。则补益生养我的脏器。这与《锦囊》所说的“本骸得气。遗体受荫”意义相同。治疗劳损时。则补益帮助我的脏器。这与荀子所说的“未有子富而父贫”意义相同。所以这两种补法各自有理。医生连连称是退下。
In the fourth month of the Gengxu year, a rural woman surnamed Wu contracted Shanghan (Cold Damage). She suffered from headache and fever, with incessant diarrhea. Most physicians treated her with Fuzi Lizhong Wan (Aconite Pill to Regulate the Middle) and Jin Ye Dan (Golden Elixir), but her irritability and diarrhea worsened. Upon examination, I stated: "The pulse is slow and deep. If there is heat below the umbilicus, this is Xiere Li (Diarrhea associated with Heat)." I administered Sanhuang Shuai Ai Tang (Three-Yellow Decoction with Cooked Mugwort). After three doses, the diarrhea ceased and thirst was relieved. Subsequently, I gradually prescribed Jiemo Han Yao (Muscle-Releasing Sweating Medicines), and she recovered after sweating.
In the summer of the Dingwei year, my clan's younger sister contracted Shanghan. After having sweated, she suffered from incessant vomiting and rigidity, unable to swallow medicine. The physician treated her with drugs such as Dingxiang (Caryophylli Flos), Xiaoshi (Natrii Sulfas), Liuhuang (Sulfur), and Huoxiang (Agastaches Herba), likely treating it as Stomach Cold. Upon visiting, I said: "This is residual heat remaining in the epigastrium after sweating. Administering hot medicines here would be like adding fire to fire; how could it stop?" Therefore, I used Xiangru Tang (Mosla Decoction) and Zhuru Tang (Bamboo Rind Decoction). After three doses, she was cured.
In summer, Zhongli Dequan fell ill one night with vomiting and diarrhea, cold body, profuse sweating like bathing, and mental restlessness. I gave him Xiangru Yin (Mosla Drink). The next day, the condition stabilized. He was subsequently regulated with Lizhong Tang (Regulate the Middle Decoction) and recovered.
The commentary states: Zhang Zhongjing said, "When a patient has fever, headache, body pain, aversion to cold, vomiting, and diarrhea, what disease is this?" The answer is: This is called Huoluan (Cholera-like disorder). It involves spontaneous vomiting and diarrhea, which may stop and recur, accompanied by recurrent fever. This disease is mostly caused by summer-heat and dampness. There is disharmony between Ying and Wei (Defensive and Nutritive Qi), confusion of clear and turbid Qi, and overindulgence in food damaging the Sanjiao (Triple Burner). It causes abdominal cramping, incessant thirst and irritability, and calf cramps. It kills rapidly and cannot be delayed.
Wu, a tea merchant from Jiangxi, fell ill with a headache feeling like being wrapped, coldness in both legs below the knees, excessive sweating in the chest, and occasional delirium. Physicians diagnosed it as a Yin Syndrome and treated it with Aconite-type formulas, assuming the cold feet indicated Jue Ni (Reversal Cold). I palpated his pulse: the Guan position was soggy, and the Chi position was rapid/tight. I diagnosed it as the pulse and syndrome of Shiwen (Damp-Warmth). His illness resulted from contracting dampness previously, then suffering from summer-heat. Dampness and heat fought each other, forming this syndrome. I urgently administered Baihu Tang (White Tiger Decoction). After three doses, the illness resolved.
Someone contracted Shanghan. Several days after sweating, he suddenly had fever and spontaneous sweating, with a wiry and rapid pulse, appearing as if the disease had relapsed. I diagnosed it as: Caused by mental exertion. The residence of Shen (Spirit) had not returned to its original state, and further mental labor injured the Shen. Ying and Wei lost their rhythm. One should tonify the Son organ (Spleen), benefit the Spleen Qi, and resolve the mental fatigue, so that recovery is likely. A physician present questioned: "For deficiency, one should tonify the Mother. Now you tonify the Son. Which classic does this come from?" I replied: "It comes from the Treatises of Qianjin Fang." Do you not know about Xu Lao (Deficiency Consumption)? Nan Jing says: "Deficiency tonifies the Mother, Excess drains the Son." This refers to the case where deficiency requires tonifying the Mother. However, Qianjin Fang states: "For severe Heart labor, tonify Spleen Qi to benefit the Heart. When the Spleen is prosperous, it influences the Heart." This is the method of tonifying the Son for labor. The Mother generates me; the Son inherits and assists me. When treating deficiency, we tonify the one who generated us, consistent with the meaning of "Ben Hai De Qi, Yi Ti Shou Yin" (The root bone receives Qi, the remnant body receives influence). When treating labor, we tonify the one who assists us, consistent with Xunzi's saying "There has never been a son rich while the father is poor." Thus, both tonification methods have their own rationale. The physician agreed and withdrew.