枫亭医术自是高手，京师人传其起痼扶衰，悬决生死日时，多奇验。今就其门人所记医
按提
其要云。(拙轩曰∶枫亭翁喜读《千金》、《外台》，故其论病说方，多本其书。于先辈着
鞭之后，欲别开生面，不得不假手孙王二氏也，满清医人无此见解。)
世有面色萎黄，肌肤干枯如老耋，眼多眵泪，鼻流清涕，气逆心烦，胸中怫郁。按其腹
鸠尾
至脐腹，任脉拘急如张两纽，按之则痛，动悸甚，脉多滑，喜饮茶汤，或吃杂食，每眠睡，
心气懒惰，临事狐疑，或愤恚不乐，渐目下足胫生微肿，或中年夭折，或痴 全生者，医
以为黄胖，或以为痫，治之无验。特不知此病本因情欲不遂，饮食失宜，不胜其劳，遂蕴蓄
湿热。其热熏蒸为面黄，甚者郁热消烁肝胆，忧虑恐惧，百事不决，昼夜不能眠，以致此病
也。盖此证有虚实之分，肌肉敦阜者属实，身体羸瘦者属虚。虚证面部或足胫浮肿者无害，
若实证历日，足胫目下微肿者，脱候也，为可畏，余名之曰脾劳(《千金方》所谓脾劳与此
证大异，本草百病主治铁砂条，所谓脾黄病为稍近。)凡脾劳湿热泛溢于膜外为水肿者，宜
圣济紫苏煮散。若郁热流于肠中，为脱肛痔疾者，宜润下剂。但便难者，宜脾约丸。若下利
不食者，属虚也。若郁热侵胆府，则善衄。移热于肝脏，则善惊恐。热郁于胸背，则肩强。
左肋挛急，或咽喉不利如梅核气，或水饮客于冲脉咳嗽，或心下如盘，食不下时吐逆者，宜
半夏汤(《外台》方)。若嗳气吞酸心下痛者，宜四味枳壳散。盖此证郁热支冲脉，水饮不能
为之流通，因心下悸。若认为留饮治之，反生害。但解其热，则饮自去也。若其人羸瘦，津
液乏少。心下动甚，目下微肿，耳鸣目眩头晕者，属虚候，宜沉香降气汤。若热传于大肠下
血见前证者，宜铁刷汤。若能食，下血不止者，宜赤小豆当归散。若下利腹痛如五更泻者，
宜真武汤。若腹鸣下利者，宜半夏泻心汤。若不下利，心下右边当委食之府痛者，香砂平胃
散。若左肋下至少腹挛急冷痛者，柴胡鳖甲汤。若热熏蒸胸背，涌痰咳嗽，喘逆肩息似支饮
者，宜九味半夏汤。若两肋急胀，腹满不能食，头痛壮热，身体疼痛者，宜延年枳实汤(《
外台》方)。若旧年脾劳，冷热不调成癖，积食不下，虚满如水
状者，宜前胡枳实汤。若性禀薄弱，忧思不遂，久郁不解，血液枯燥，
往来寒热，盗汗咳嗽者，《圣济》所谓 癖成骨蒸也，宜秦艽鳖甲散。若热熏蒸脾胃，及肝
胆疑虑不决，心下如盘，舌上沉香色，其人如狂者，宜半夏汤加石膏。若心下痞闷，痛引乳
下，或冲脉支结，胸中牵痛者，宜柴胡白术散。近世患此病者颇多，盖现证有全似他病而属
脾劳之变态者，有他病为主脾劳为客者，能审辨之以处其方，则思过半矣。(此一种内伤病
，脾劳名未知当否。然其反复辨症处，溯流穷源，其次第用药处得心应手，近患此病者最多
。则其治法宜研究也。)中风病由，《素问》单云风，刘河间以为火，李东垣以为内伤，纷
纭难适从。但《外台》许仁则所论似是，此证先宜与《千金》竹沥汤。若不能服汤者，用乌
犀丸，可以开达咽喉。若胃气反逆呕吐者，百不治一。
一人年四十余，病温疫下血后，身重难转侧，四肢不收，口眼开脱，语言不出，其状如
塑人
，脉滑，舌上生芒刺，似欲冷冻饮料。余以为下证悉
具，即投以大承气汤服之。一帖，眼睛活动，语言少出，续服前方全愈。又一人患同病，而
精神稍爽，瞳子和，口中津液粘涸，不能语言，绝食数日，人以为死证。时患者动指，其状
似欲饮水，因与之，少得语言，如此数次。余试与白虎汤遂愈，盖承气汤主精神昏愦，不能
语
言。白虎汤主精神爽快，津液粘涸，不能语言。虽均属里实，二汤之所主自判然矣。(《中
西深斋名数解》有白虎承气，辨颇明晰。而枫亭得之于实际，宜彼此参稽处之无差误。)
肺痿有冷热之分，而《金匮》但载肺冷治方，不及肺热诸方，《千金》、《外台》亦从
无发
明。特《圣济总录》人参养荣汤论肺热证治，余试之效。若其热盛者，宜秦艽扶羸汤、知母
茯苓汤。若腹满者，秦艽鳖甲散加槟榔。盖肺热者，多属不治，肺冷者，反易治，不可不知
。
世有咽喉不利，似膈非膈，声音如小儿弄草笛，不能卧，脉数急，忽吐脓血一升余而死
者，此肺痈一证最为难治。
奔豚证。桂枝加桂汤主泄气，奔豚汤主和痛。若此证喜苦味者，宜奔豚汤。喜甘味者，
宜上方。
四饮中支饮最为可畏，此水饮停积胸膈间，支乘心故也。其初胸膈实痞强支心，心下反
濡，
咽喉喘逆，气急不能卧者，《圣济》旋复花汤尤效。若此证心下坚硬，水饮支结甚，或与此
汤再复者，宜木防己及去石加茯硝汤。此二方外余未见其效。(拙轩曰∶支饮之证，古人所
论不一，或以为心脏痞塞，或以为脾胃有不足，或以为肾气亏乏。予谓不然，凡人心肺之下
，有所谓膈膜者，水饮瘀到其间，则上致肺气不利，下致胃气上逆，心下痞坚，是支饮之候
也。《巢源》云∶水饮过多，停积于胸膈之间，支乘于心，故谓支饮。出方读便解录，为此
条注脚。)
水肿下利者，为恶候。先有水气而下利者，宜木防己汤，《外台》所论可征。先下利而
后见
肿者，属虚劳，为危候。香港脚肿下利者，急冲心而死。故水肿证概主利水而禁下药，若服利
水药下利者，亦为凶兆。
胸痹心痛，当心中及心下痛剧者，吐血而死，余往往视之皆然。
一人卒发心痛，手足厥冷，脉绝欲死，余投赤石脂丸料速愈。
妇人经水不调，小腹冷气属瘀血者，温经汤奇效。经后腹痛者，亦属瘀血，宜滑石散(
无尽
藏)。若行经中腹痛者，属气滞，宜四乌汤。若经水不调，气滞肥满有蓄血者，宜逍遥散，
正气天香汤。若产后瘀血上逆者，辰砂最效。若行经前患头痛者，属饮，宜桂枝、橘皮、干
姜等。(《医通》)
妊娠五月后堕胎者，概系癖块所为，早制其块，则多保全。先辈不知之徒，与滋补药更
无效
。(此说原于仲景最有理，惟恐女科专门徒由父祖传，未尝留心古学。而讲求夫通变化裁之
活用，固执温补为安胎之要药，受其害者不少。噫。)
产前水气微者不足畏。若上部有水气，气急喘逆者，产后忽冲心而死。或蓐中有肺血干
而吐血者，俱为可畏。又有产后汤浴感湿，邪为香港脚肿者，不早治则为不测之变。
黄胆烦渴吐逆腹胀者，为恶证。若夜不得眠，烦躁热渴者，不出二三日而死。
腹中有癖块，而一身发黄者，名曰癖黄胆，亦难治。
病者初脉沉数，忽变缓，似病解，而其人气郁，默默欲卧，身重食不进，小便如 汁者
，即发阴黄之候也。
虚人疟热与劳热为易混，但疟脉弦大而不数，劳脉数而不弦大，是为别。
虚人截疟以灸大椎为最，其法明旦三壮，午时三壮，将发时三壮。
疟病内热炽盛，频渴饮水，发露当风取凉，邪气不能发泄者，变为水肿，宜越婢加术
汤。余尝治此证，水气除而后再发疟，是其征也。
霍乱发振寒者，阳气复之候为佳兆。若虚人不堪振栗者，宜四逆汤。
卒然发呕吐者，有霍乱，有卒中风，其证相同。但中风吐后脉缓而不紧，手足不厥冷，
呕吐中能左右手足动摇，吐止半身不遂昏睡，是为别矣。
世医漫认足肿为香港脚，特不知香港脚以疼痛或挛急或懈怠或麻痹为征，不啻水气也。盖此
病
湿气胜则肿满，风气胜则不仁。有病在腹而后及足者，有在足而后及腹者，脉忌洪紧弦而不
忌
数。心下及人迎动高者，最在所忌也。
余治香港脚，先辨表里为治标，以肿满麻痹腰脚痿弱为表证，以发汗解毒为主；以风热炽
盛，
动气甚，气急腹满呕吐，为里证，以降气利水为主。世医动以表证为危笃，以里证为轻易，
治方乖错，生不测之变不鲜。
蛔虫有寒热之分。永田德本以太乙丸治热证虫积，以木香丸治冷证虫积为得。凡郁热盛
于膈
间，则必为蛔动，医概为蛔厥治之，误矣。(胃热吐蛔，吴又可既论之而无的治。陈治曰∶
温
热病而吐蛔者，此胃热也。胃虚有热，虫随热气上行，亦吐出也，宜犀角黄连汤。伤寒辨注
清中安蛔汤，治胃实热，呕吐长虫，亦为其合治。秋吉质曰∶吐死蛔者属热，吐活蛔者多属
胃寒。死蛔色白，活蛔微红色，是说似理而不可必矣。)
痢疾不论下利多少，以热之轻重为治法之标准。故先以调中汤(《外台》)，发汗后参用
大柴
胡汤、芍药汤和解。若谵语舌燥黑，赤白脓血下重甚者，以大承气汤、槟芍顺气汤下之，其
热解则利自止也。
噤口痢虚烦，宜竹叶石膏汤。《百一选方》人参、黄连、陈皮、莲肉四味者亦佳。此证
发哕逆者不治。
休息痢但下白滞者，宜真武汤加赤石脂。
张子和曰∶凡头疮发肿疡处，水气必凑焉，故宜下剂。余本其说头疮加苍术，即为去其
水气也。其实者，用牵牛子能奏效。亦同旨。
《金匮》泻心汤云∶心气不足吐血，衄血，其主治茫乎无据。按本草百病主治大黄条曰
∶下
瘀血血闷，心气不足，吐血衄血，胸胁刺痛胀，同黄连、黄芩煎服。余据此说治吐血衄血胸
胁刺痛者，百无一失也。
凡下齿痛者，灸肩井即效。肩井者，系阳明经之所行也。又奥齿下龈肿者刺之，血出则
愈。盖血气妄行，聚于齿龈之所尽故也。
骨槽风证详见《外科正宗》，此疮生于耳前颊骨，而腐溃穿孔，口中喷脓。其初欲发时
，或
为口眼 斜，后至上龈腐溃，不能饮食，遂有至死者。若因霉毒为此形状者，去其毒则愈。
骨槽初起者，宜医通茵陈散。(茵陈、荆芥、薄荷、连翘、麻黄、升麻、羌活、僵蚕、细辛
、大黄、黑丑，以上十一味。)
其人无咳，唯语声不出者，宜《外台》茯苓安神汤。平素嗜茶者，多发此证。盖有治不
治之
别，属上焦虚冷者，多不治。若上焦虚寒，语声不出者，宜《外台》黄 理中汤。若咽喉肿
或痒，咳嗽声不出者，宜圣济黄 汤。
后世中 外别设中暑名者，误矣。中 中暑及中热，皆一病，非别因。东垣不知之以动
而得
为中 ，以静而得为中暑，制清暑益气汤者，非矣。又世论古方者，谓伤寒外无中 ，亦益
非矣。《汉书·武帝纪》云∶夏大旱，民多 死，其来既在仲景前。且夏月身热汗出，恶寒
咽干，身重疼痛者，与仲景中 门白虎汤，则其效宛如溉水于炭火。又夏月卧寐中感冷气，
恶寒发热身体疼痛者，随伤寒治法，与桂枝麻黄则霍然而愈。此二者，岂可混焉哉。
后世以霍乱一证为止夏月者误矣，凡有吐泻而挥霍撩乱者，四时俱有，《外台》、《儒
门事
亲》可征焉。盖此证夏月多而冬月少者，冬时阳在内而温，夏时阳气走表，阴在内而冷，加
之贪冷冻饮料冷食，故多发此证。其状似伤食伤滞，然伤食伤滞者，腹满痛而吐泻如倾，则明日
霍然而愈。至霍乱则虽既吐泻，腹痛不止，反发热身疼痛，剧者手足厥冷，烦闷燥渴。此证
四时俱有，而夏月者尤重，故世或以霍乱为中暑，益误矣。
凡霍乱心下痛者必吐，脐下痛者必下利。
理，治也。中者，指中焦胃气而言。乃胃中虚冷，水谷不化，变乱吐下，譬之乱线，渐
理可
治，故名理中丸。建，健也，即健胃中之意，故名建中汤。其义颇异，世医不知之，合为一
方，名建理汤。非古意也。
半夏泻心汤，泻心下痞满也，后医以为泻心火，概治痫证，大误矣。
骨空论曰∶冲脉之为病也，气逆里急。凡冲脉不足而血燥，故鸠尾下痞满，或气上逆胸
中，腹
皮如贴背，为心悬痛者，谓之胸痹，故桂枝枳实生姜汤、枳实薤白桂枝汤之所治，皆邪客于
冲脉也。
心下动悸有三道∶一为寒气客于冲脉，支冲任而悸者，炙甘草汤、大建中汤所治是也；
一为
因水饮而悸者，桂枝茯苓白术甘草汤、真武汤所治是也；一为有毒悸者，香港脚冲逆是也。
凡狂痫证，狂走不安静者易治，唯妄言笑语者，即癫也，又名失心风，难治，《素问》
论阳
痫阴痫为可据。《本事方》茯苓散、宁志膏、狂气丸，皆阴阳通治方也。夜不得眠者，宜《
准绳》灵苑辰砂散。又吐唾不止者，宜局方养正丹。阳痫者，宜灌水。其证剧者，大桶蓄水
，乘病患不意，一时可灌沐。其实者，浴瀑水亦佳。是皆降阳气上升故也。
世称流注者，自胸至小腹腰间手足流转，甚则生块，其形平塌漫肿，以手抚之，不坚而
肉底
有块，其块溃则脓汁出，一块愈，一块又随发，重者至生三四块，终不治矣。此证发胸以上
者，为湿痰流注；发胸以下者，为瘀血流注。发胸以上或手足者易治，发小腹或腰边者难治
。瘀血流注者，将发其块，则腰脚难屈伸，微热。有发作急者，不出一月而死，缓者延半年
枫亭的医术自然是高手水平，京城人传说他能治愈顽固疾病、扶持衰弱的身体，甚至能准确预测生死的时间，大多有奇效。现在根据他门人所记录的医案，提取其中的要点如下。（拙轩评论说：枫亭老先生喜欢读《千金方》和《外台秘要》，所以他论病说方，大多依据这两本书。在先辈之后，想要别开生面，不得不借助孙思邈和王焘两位医家的著作。清朝的医生没有这种见解。）
世间有一种病症，表现为面色萎黄，肌肤干枯像老人一样，眼睛多眵泪（眼屎和泪水），鼻流清涕，气逆心烦，胸中郁结不畅。按压从鸠尾穴到脐腹部的任脉部位，感觉拘急紧绷像拉开的两根弓弦，按压则疼痛，动悸严重，脉象多滑，喜欢喝茶汤或吃杂食。每次睡觉时，心气懒惰，遇事犹豫不决，或者愤怒不乐，逐渐导致眼下和足胫出现轻微肿胀，有的中年夭折，有的变得痴傻。医生误以为是黄胖病（营养不良性水肿）或痫病，治疗无效。殊不知此病的根本原因是情欲不遂、饮食失宜、过度劳累，从而蕴蓄了湿热。热气熏蒸导致面黄，严重时郁热消烁肝胆，导致忧虑恐惧，百事不决，昼夜不能入睡，从而形成此病。
这个证候有虚实之分：肌肉厚实者属实证，身体消瘦者属虚证。虚证面部或足胫浮肿的无害；若实证经过长时间后，足胫和眼下微肿，这是脱证（危重之兆），令人畏惧。我将其命名为“脾劳”（《千金方》所说的脾劳与此证大不相同，《本草百病主治》铁砂条下所说的脾黄病稍微接近）。凡是脾劳湿热泛溢于膜外导致水肿的，宜用圣济紫苏煮散。若郁热流于肠中，导致脱肛痔疾的，宜用润下剂。但大便困难的，宜用脾约丸。若下利且不食的，属于虚证。若郁热侵扰胆腑，则容易鼻出血。热移于肝脏，则容易惊恐。热郁于胸背，则肩颈僵硬。左肋挛急，或咽喉不利像梅核气，或水饮客居于冲脉导致咳嗽，或心下像盘子一样硬，进食不下且时常呕吐的，宜用半夏汤（《外台》方）。若嗳气吞酸、心下痛的，宜用四味枳壳散。因为这个证候郁热支冲冲脉，水饮不能流通，因而心下悸动。如果认为是留饮而治疗，反而产生危害。只要解除其热，水饮自然去除。
若其人消瘦，津液缺乏，心下动悸严重，眼下微肿，耳鸣目眩头晕的，属于虚证，宜用沉香降气汤。若热传于大肠导致下血并见上述前证的，宜用铁刷汤。若能进食但下血不止的，宜用赤小豆当归散。若下利腹痛像五更泻的，宜用真武汤。若腹鸣下利的，宜用半夏泻心汤。若不下利，心下右边当胃府处疼痛的，用香砂平胃散。若左肋下至少腹挛急冷痛的，用柴胡鳖甲汤。若热熏蒸胸背，涌出痰涎咳嗽，喘逆肩息类似支饮的，宜用九味半夏汤。若两肋急胀，腹满不能食，头痛壮热，身体疼痛的，宜用延年枳实汤（《外台》方）。若旧年的脾劳，冷热不调形成癖块，积食不下，虚满像水状的，宜用前胡枳实汤。若禀赋薄弱，忧思不遂，久郁不解，血液枯燥，往来寒热，盗汗咳嗽的，是《圣济总录》所说的癖成骨蒸，宜用秦艽鳖甲散。若热熏蒸脾胃，及肝胆疑虑不决，心下像盘子一样硬，舌上呈沉香色，其人如狂的，宜用半夏汤加石膏。若心下痞闷，痛引乳下，或冲脉支结，胸中牵痛的，宜用柴胡白术散。近代患此病的人很多，大概现证有完全像其他病而属于脾劳变异的，也有以其他病为主、脾劳为客的，能审辨清楚来处方，就成功了一半了。（这种内伤病，名为脾劳不知是否恰当。然而其反复辨证之处，溯流穷源，其次第用药之处得心应手，近患此病者最多，所以其治法值得研究。）
中风病的由来，《素问》只说是风，刘河间认为是火，李东垣认为是内伤，纷纭难适从。只有《外台》许仁则所论述的比较合理，此证先宜给予《千金》竹沥汤。若不能服汤药者，用乌犀丸，可以开通咽喉。若胃气反逆呕吐的，百无一救。
有一人四十多岁，患温疫下血后，身体沉重难以转侧，四肢不收，口眼歪斜，不能说话，状如塑像，脉滑，舌上生芒刺，似乎想喝冷冻饮料。我认为下证悉具，即投以大承气汤服用。一帖后，眼睛活动，语言稍出，续服前方全愈。又一人患同病，精神稍爽，瞳子和缓，口中津液粘涸，不能说话，绝食数日，人以为死证。当时患者动指，状似想喝水，于是给他水，稍得语言，如此数次。我试给白虎汤遂愈，盖承气汤主治精神昏愦、不能言语。白虎汤主治精神爽快、津液粘涸、不能言语。虽然均属里实，二汤的主治自判然不同。（《中西深斋名数解》有白虎承气辨析，颇为明晰。而枫亭得之于实际，宜彼此参考处理无差误。）
肺痿有冷热之分，而《金匮要略》只记载肺冷的治方，不及肺热诸方，《千金方》、《外台秘要》也从未发明。只有《圣济总录》人参养荣汤论肺热证治，我试用有效。若其热盛者，宜用秦艽扶羸汤、知母茯苓汤。若腹满者，秦艽鳖甲散加槟榔。盖肺热者，多属不治，肺冷者，反易治，不可不知。
世间有一种咽喉不利，似膈非膈，声音像小儿弄草笛，不能卧，脉数急，忽吐脓血一升余而死者的，此肺痈一证最为难治。
奔豚证。桂枝加桂汤主治泄气，奔豚汤主治和痛。若此证喜苦味者，宜用奔豚汤。喜甘味者，宜用上方。
四饮中支饮最为可畏，此水饮停积胸膈间，支乘于心故也。其初胸膈实痞强支心，心下反濡，咽喉喘逆，气急不能卧者，《圣济总录》旋复花汤尤效。若此证心下坚硬，水饮支结甚，或与此汤再复者，宜用木防己及去石加茯硝汤。此二方外余未见其效。（拙轩评论说：支饮之证，古人所论不一，或以为心脏痞塞，或以为脾胃有不足，或以为肾气亏乏。我认为不然，凡人心肺之下，有所谓膈膜者，水饮瘀阻到其间，则上致肺气不利，下致胃气上逆，心下痞坚，是支饮之候也。《诸病源候论》云：水饮过多，停积于胸膈之间，支乘于心，故谓支饮。出方读便解录，为此条注脚。）
水肿下利者，为恶候。先有水气而下利者，宜用木防己汤，《外台秘要》所论可征。先下利而后见肿者，属虚劳，为危候。香港脚肿下利者，急冲心而死。故水肿证概主利水而禁下药，若服利水药下利者，亦为凶兆。
妇人经水不调，小腹冷气属瘀血者，温经汤奇效。经后腹痛者，亦属瘀血，宜用滑石散（无尽藏）。若行经中腹痛者，属气滞，宜用四乌汤。若经水不调，气滞肥满有蓄血者，宜用逍遥散，正气天香汤。若产后瘀血上逆者，辰砂最效。若行经前患头痛者，属饮，宜用桂枝、橘皮、干姜等。（《医通》）
妊娠五月后堕胎者，概系癖块所为，早制其块，则多保全。先辈不知之徒，与滋补药更无效。（此说原于仲景最有理，惟恐女科专门徒由父祖传，未尝留心古学。而讲求夫通变化裁之活用，固执温补为安胎之要药，受其害者不少。噫。）
产前水气微者不足畏。若上部有水气，气急喘逆者，产后忽冲心而死。或蓐中有肺血干而吐血者，俱为可畏。又有产后汤浴感湿，邪为香港脚肿者，不早治则为不测之变。
黄疸烦渴吐逆腹胀者，为恶证。若夜不得眠，烦躁热渴者，不出二三日而死。
病者初脉沉数，忽变缓，似病解，而其人气郁，默默欲卧，身重食不进，小便如汁者，即发阴黄之候也。
虚人疟热与劳热为易混，但疟脉弦大而不数，劳脉数而不弦大，是为区别。
虚人截疟以灸大椎为最，其法明旦三壮，午时三壮，将发时三壮。
疟病内热炽盛，频渴饮水，发露当风取凉，邪气不能发泄者，变为水肿，宜用越婢加术汤。我曾治此证，水气除而后再发疟，是其征也。
霍乱发振寒者，阳气复之候为佳兆。若虚人不堪振栗者，宜用四逆汤。
卒然发呕吐者，有霍乱，有卒中风，其证相同。但中风吐后脉缓而不紧，手足不厥冷，呕吐中能左右手足动摇，吐止半身不遂昏睡，是为区别矣。
世医漫认足肿为香港脚，特不知香港脚以疼痛或挛急或懈怠或麻痹为征，不啻水气也。盖此病湿气胜则肿满，风气胜则不仁。有病在腹而后及足者，有在足而后及腹者，脉忌洪紧弦而不忌数。心下及人迎动高者，最在所忌也。
我治香港脚，先辨表里为治标，以肿满麻痹腰脚痿弱为表证，以发汗解毒为主；以风热炽盛，动气甚，气急腹满呕吐，为里证，以降气利水为主。世医动以表证为危笃，以里证为轻易，治方乖错，生不测之变不鲜。
蛔虫有寒热之分。永田德本以太乙丸治热证虫积，以木香丸治冷证虫积为得。凡郁热盛于膈间，则必为蛔动，医概为蛔厥治之，误矣。（胃热吐蛔，吴又可既论之而无的治。陈治曰：温热病而吐蛔者，此胃热也。胃虚有热，虫随热气上行，亦吐出也，宜犀角黄连汤。伤寒辨注清中安蛔汤，治胃实热，呕吐长虫，亦为其合治。秋吉质曰：吐死蛔者属热，吐活蛔者多属胃寒。死蛔色白，活蛔微红色，是说似理而不可必矣。）
痢疾不论下利多少，以热之轻重为治法之标准。故先以调中汤（《外台》），发汗后参用大柴胡汤、芍药汤和解。若谵语舌燥黑，赤白脓血下重甚者，以大承气汤、槟芍顺气汤下之，其热解则利自止也。
噤口痢虚烦，宜用竹叶石膏汤。《百一选方》人参、黄连、陈皮、莲肉四味者亦佳。此证发哕逆者不治。
张子和曰：凡头疮发肿疡处，水气必凑焉，故宜下剂。我本其说头疮加苍术，即为去其水气也。其实者，用牵牛子能奏效。亦同旨。
《金匮要略》泻心汤云：心气不足吐血，衄血，其主治茫乎无据。按本草百病主治大黄条曰：下瘀血血闷，心气不足，吐血衄血，胸胁刺痛胀，同黄连、黄芩煎服。我据此说治吐血衄血胸胁刺痛者，百无一失也。
凡下齿痛者，灸肩井即效。肩井者，系阳明经之所行也。又奥齿下龈肿者刺之，血出则愈。盖血气妄行，聚于齿龈之所尽故也。
骨槽风证详见《外科正宗》，此疮生于耳前颊骨，而腐溃穿孔，口中喷脓。其初欲发时，或为口眼歪斜，后至上龈腐溃，不能饮食，遂有至死者。若因霉毒为此形状者，去其毒则愈。骨槽初起者，宜用医通茵陈散。（茵陈、荆芥、薄荷、连翘、麻黄、升麻、羌活、僵蚕、细辛、大黄、黑丑，以上十一味。）
其人无咳，唯语声不出者，宜用《外台》茯苓安神汤。平素嗜茶者，多发此证。盖有治不治之别，属上焦虚冷者，多不治。若上焦虚寒，语声不出者，宜用《外台》黄 理中汤。若咽喉肿或痒，咳嗽声不出者，宜用圣济黄 汤。
后世中 外别设中暑名者，误矣。中 中暑及中热，皆一病，非别因。东垣不知之以动而得为中 ，以静而得为中暑，制清暑益气汤者，非矣。又世论古方者，谓伤寒外无中 ，亦益非矣。《汉书·武帝纪》云：夏大旱，民多 死，其来既在仲景前。且夏月身热汗出，恶寒咽干，身重疼痛者，与仲景中 门白虎汤，则其效宛如溉水于炭火。又夏月卧寐中感冷气，恶寒发热身体疼痛者，随伤寒治法，与桂枝麻黄则霍然而愈。此二者，岂可混焉哉。
后世以霍乱一证为止夏月者误矣，凡有吐泻而挥霍撩乱者，四时俱有，《外台秘要》、《儒门事亲》可征焉。盖此证夏月多而冬月少者，冬时阳在内而温，夏时阳气走表，阴在内而冷，加之贪冷冻饮料冷食，故多发此证。其状似伤食伤滞，然伤食伤滞者，腹满痛而吐泻如倾，则明日霍然而愈。至霍乱则虽既吐泻，腹痛不止，反发热身疼痛，剧者手足厥冷，烦闷燥渴。此证四时俱有，而夏月者尤重，故世或以霍乱为中暑，益误矣。
理，治也。中者，指中焦胃气而言。乃胃中虚冷，水谷不化，变乱吐下，譬之乱线，渐理可治，故名理中丸。建，健也，即健胃中之意，故名建中汤。其义颇异，世医不知之，合为一方的，名建理汤。非古意也。
半夏泻心汤，泻心下痞满也，后医以为泻心火，概治痫证，大误矣。
骨空论曰：冲脉之为病也，气逆里急。凡冲脉不足而血燥，故鸠尾下痞满，或气上逆胸中，腹皮如贴背，为心悬痛者，谓之胸痹，故桂枝枳实生姜汤、枳实薤白桂枝汤之所治，皆邪客于冲脉也。
心下动悸有三道：一为寒气客于冲脉，支冲任而悸者，炙甘草汤、大建中汤所治是也；一为因水饮而悸者，桂枝茯苓白术甘草汤、真武汤所治是也；一为有毒悸者，香港脚冲逆是也。
凡狂痫证，狂走不安静者易治，唯妄言笑语者，即癫也，又名失心风，难治，《素问》论阳痫阴痫为可据。《本事方》茯苓散、宁志膏、狂气丸，皆阴阳通治方也。夜不得眠者，宜用《准绳》灵苑辰砂散。又吐唾不止者，宜用局方养正丹。阳痫者，宜灌水。其证剧者，大桶蓄水，乘病患不意，一时可灌沐。其实者，浴瀑水亦佳。是皆降阳气上升故也。
世称流注者，自胸至小腹腰间手足流转，甚则生块，其形平塌漫肿，以手抚之，不坚而肉底有块，其块溃则脓汁出，一块愈，一块又随发，重者至生三四块，终不治矣。此证发胸以上者，为湿痰流注；发胸以下者，为瘀血流注。发胸以上或手足者易治，发小腹或腰边者难治。瘀血流注者，将发其块，则腰脚难屈伸，微热。有发作急者，不出一月而死，缓者延半年
The medical skills of Fengting were naturally at a high level. People in the capital reported that he could cure stubborn diseases and support the frail, even predicting the exact time of death with many miraculous verifications. Now, based on the medical cases recorded by his disciples, I extract the key points as follows. (Zhuoxuan commented: Old Master Fengting liked to read *Qianjin Fang* and *Waitai Mi Yao*, so his discussions on diseases and prescriptions were mostly based on these two books. After the predecessors, wanting to open up a new path, he had to rely on the works of Sun Simiao and Wang Tao. Doctors of the Qing Dynasty did not have this insight.)
In the world, there is a condition characterized by a sallow complexion, dry and withered skin like that of an elderly person, excessive eye discharge and tears, runny nose, rebellious Qi causing irritability, and chest oppression. Pressing the Ren Mai (Conception Vessel) from Jiutui (CV15) to the umbilical and abdominal area feels tight and tense like two drawn bowstrings; pressing causes pain, palpitations are severe, the pulse is often slippery, and the patient desires tea or mixed foods. During sleep, the Heart Qi is lazy, indecisive about matters, or angry and unhappy, gradually leading to slight swelling under the eyes and on the shins. Some die prematurely in middle age, while others become foolish. Physicians mistakenly diagnose it as Huangpang disease (malnutrition edema) or epilepsy, but treatment fails. They do not know that the root cause of this disease is unfulfilled desires, improper diet, and overexertion, leading to the accumulation of damp-heat. The heat steaming upward causes sallow complexion; severely, stagnant heat consumes the Liver and Gallbladder, causing worry and fear, indecision, and insomnia day and night, resulting in this disease.
This syndrome has deficiency and excess aspects: thick muscles indicate excess, while emaciation indicates deficiency. Facial or shin edema in deficiency syndromes is harmless. However, if after a long duration, slight swelling appears on the shins and under the eyes in an excess syndrome, it is a collapse pattern (critical sign), which is feared. I name it "Pi Lao" (Spleen Labor). The Pi Lao mentioned in *Qianjin Fang* is very different from this syndrome; the Pi Huang disease mentioned in *Bencao Bai Bing Zhu Zhi* under the Iron Sand entry is slightly closer. Whenever Pi Lao damp-heat overflows outside the membranes causing edema, Shengji Zisu Zhusan (Holy Relief Perilla Decoction) is suitable. If stagnant heat flows into the intestines causing rectal prolapse or hemorrhoids, a lubricating purgative is suitable. But for those with difficult defecation, Piyue Wan (Spleen Restriction Pill) is suitable. For those with diarrhea and inability to eat, it belongs to deficiency. If stagnant heat invades the Gallbladder Fu organ, epistaxis occurs easily. Heat transferring to the Liver causes easy fright. Heat stagnating in the chest and back causes neck stiffness. Spasm of the left hypochondrium, or throat discomfort like Plum Pit Qi, or water-fluid retention in the Chong Mai (Penetrating Vessel) causing cough, or a plate-like hardness below the heart with food intolerance and frequent vomiting, are treated with Banxia Tang (Banxia Decoction, from *Waitai*). For belching, acid regurgitation, and subcardiac pain, Siwei Zhike San (Four-Ingredient Aurantium Powder) is suitable. Because in this syndrome, stagnant heat obstructs the Chong Mai, preventing fluid circulation, causing subcardiac palpitations. If treated as retained fluid, it causes harm. Only by resolving the heat will the fluid disappear naturally.
If the person is emaciated with insufficient body fluids, severe subcardiac palpitations, slight swelling under the eyes, tinnitus, dizziness, and vertigo, it belongs to a deficiency pattern, and Chenxiang Jiangqi Tang (Agarwood Descending Qi Decoction) is suitable. If heat transmits to the Large Intestine causing hematochezia along with the above symptoms, Tieshua Tang (Iron Brush Decoction) is suitable. If appetite is preserved but bleeding continues, Xiaodou Danggui San (Adzuki Bean and Angelica Powder) is suitable. For diarrhea with abdominal pain resembling dawn diarrhea, Zhenwu Tang (True Warrior Decoction) is suitable. For borborygmus and diarrhea, Banxia Xiexin Tang (Pinellia Decoction to Drain the Epigastrium) is suitable. For no diarrhea but pain in the right side of the subcardiac region corresponding to the Stomach Fu, Xiangsha Pingwei San (Aucklandia and Amomum Powder to Calm the Stomach) is used. For spasm and cold pain from the left hypochondrium to the lower abdomen, Chaihu Biejia Tang (Bupleurum and Turtle Shell Decoction) is used. If heat steams the chest and back, producing phlegm, cough, wheezing with shoulder breathing similar to Zhi Yin (Branch Fluid), Jiawei Banxia Tang (Nine-Ingredient Modified Pinellia Decoction) is suitable. For bilateral hypochondriac distension and urgency, abdominal fullness, inability to eat, headache, high fever, and body pain, Yannian Zhishi Tang (Longevity Aurantium Decoction, from *Waitai*) is suitable. For old-year Pi Lao where cold and heat are imbalanced forming a mass, undigested food, and false fullness like water, Qianhu Zhishi Tang (Peucedanum and Aurantium Decoction) is suitable. For those with weak constitution, unfulfilled worries and thoughts, long-standing stagnation, dry blood, alternating chills and fever, night sweats, and cough, this is what *Shengji Zonglu* calls Pi Cheng Gu Zheng (Mass Transforming into Bone Steaming), and Qinjiao Biejia San (Gentian and Turtle Shell Powder) is suitable. If heat steams the Spleen and Stomach, and Liver/Gallbladder indecision persists, subcardiac hardness like a plate,沉香-colored tongue, and manic behavior occur, Banxia Tang plus Shigao (Gypsum) is suitable. For subcardiac stuffiness and pain radiating to the breasts, or Chong Mai obstruction causing chest pulling pain, Chaihu Baizhu San (Bupleurum and Atractylodes Macrocephala Powder) is suitable. Recently, many suffer from this disease. Generally, current symptoms may completely resemble other diseases but belong to variations of Pi Lao, or other diseases may be primary with Pi Lao secondary. Careful differentiation allows for appropriate prescription, achieving half the success. (Regarding this internal injury disease, naming it Pi Lao may not be entirely accurate. However, its repeated symptom differentiation traces the source, and its step-by-step medication application is effective. Since many recently suffer from it, its treatment deserves study.)
The origin of Wind Stroke (*Zhong Feng*) varies: *Suwen* attributes it solely to Wind, Liu Hejian to Fire, and Li Dongyuan to Internal Injury, making it hard to follow. However, Xu Renze's discussion in *Waitai* seems reasonable. This syndrome should first be treated with Zhuli Tang (Bamboo Juice Decoction from *Qianjin*). If decoction cannot be taken, Wuxi Wan (Black Rhinoceros Horn Pill) can open the throat. If stomach Qi rebels causing vomiting, one in a hundred survives.
A man in his forties suffered from warm epidemic with hematochezia, followed by heavy body, difficulty turning, flaccid limbs, deviated mouth and eyes, aphasia, resembling a statue. His pulse was slippery, tongue had prickles, and he desired cold drinks. I judged all downward indications present and administered Dachengqi Tang (Major Order the Qi Decoction). After one dose, eyes moved, speech returned slightly; continuing the formula led to full recovery. Another patient had the same disease but slightly clearer spirit, relaxed pupils, sticky/dry mouth, aphagia, fasting for days, considered a death case. The patient moved fingers, seeming to want water. Giving water allowed slight speech, repeated several times. I tried giving Baihu Tang (White Tiger Decoction) and cured him. Dachengqi Tang governs mental confusion and aphasia; Baihu Tang governs clear spirit, sticky/dry fluids, and aphasia. Both are Interior Excess, but their indications are distinct. (*Zhongxi Shenzhai Mingshu Jie* distinguishes Baihu and Chengqi clearly. Fengting gained this from practice; both should be cross-referenced without error.)
Fei Wei (Lung Flaccidity) has cold and heat types. *Jinkui Yaolue* only records formulas for Lung Cold, omitting Lung Heat. *Qianjin Fang* and *Waitai Mi Yao* also lack clarification. Only *Shengji Zonglu* discusses Ren Shen Yang Rong Tang for Lung Heat treatment, which I found effective. For severe heat, Qinjiao Fulie Tang (Gentian Supporting Emaciation Decoction) or Zhimu Fuling Tang (Anemarrhena and Poria Decoction) are suitable. For abdominal fullness, Qinjiao Biejia San plus Binglang (Areca Seed) is suitable. Lung Heat is generally untreatable, while Lung Cold is easier to treat; this must be known.
There is a condition with throat discomfort, neither true Ge (Diaphragm) disease, voice like a child playing a grass flute, inability to lie down, rapid and urgent pulse, suddenly vomiting over a liter of pus and blood before death. This Fei Yong (Lung Abscess) is extremely difficult to treat.
Ben Tun (Running Piglet) Syndrome: Guizhi Jia Gui Tang (Cinnamon Twig Decoction Plus Cinnamon) governs escaping Qi; Bentun Tang (Running Piglet Decoction) harmonizes pain. If this syndrome prefers bitter taste, use Bentun Tang. If preferring sweet taste, use the former formula.
Among the Four Fluid Retentions, Zhi Yin (Branch Fluid) is most feared. This is water-fluid stagnating in the chest and diaphragm, branching onto the Heart. Initially, chest/diaphragm fullness strongly presses the Heart, subcardiac area feels moist, throat wheezing/rebellious Qi,急促 breathing, inability to lie down. *Shengji Zonglu* Xuanfuhua Tang (Inula Flower Decoction) is particularly effective. If subcardiac hardness is severe, fluid retention is tightly knotted, or recurs after this decoction, Mufangji Tang (Stephania Decoction) or Qu Shi Jia Fu Xiao Tang (Remove Gypsum Add Poria and Saltpeter Decoction) are suitable. Outside these two formulas, I have seen no efficacy. (Zhuoxuan commented: Ancient theories on Zhi Yin vary: some say Heart obstruction, some Spleen/Stomach deficiency, some Kidney Qi insufficiency. I disagree. Below the Heart and Lungs lies the Diaphragm membrane. When water-fluid stasis reaches here, it causes upper Lung Qi obstruction and lower Stomach Qi rebellion, leading to subcardiac hardness—this is Zhi Yin. *Zhubing Yuanhou Lun* says: Excessive water-fluid stagnates in chest/diaphragm, branches on Heart, hence called Zhi Yin. Recording formulas clarifies this note.)
Edema with diarrhea is a bad omen. Edema appearing before diarrhea suggests water-Qi; Mufangji Tang is suitable, confirmed by *Waitai*. Diarrhea appearing before edema indicates Deficiency Consumption, a critical omen. Hongjiao (Beriberi) swelling with diarrhea leads to sudden Heart attack and death. Therefore, edema generally promotes diuresis and forbids purgatives. If diuretics cause diarrhea, it is also an ominous sign.
Xiong Bi (Chest Bi) and Heart Pain: Severe pain in the center of the chest and subcardiac region leading to hematemesis and death is common in my observation.
A man suddenly developed Heart Pain, cold extremities, absent pulse, near death. I administered Chishizhi Wan (Halloysitum Pill), and he recovered quickly.
Women with irregular menstruation, cold Qi in lower abdomen due to Blood Stasis: Wenjing Tang (Warming the Menses Decoction) is miraculous. Post-menstrual abdominal pain also due to Blood Stasis: Huashi San (Talc Powder) is suitable. Abdominal pain during menstruation indicates Qi Stagnation: Siwu Tang (Four Substances Decoction) is suitable. Irregular menstruation with Qi stagnation, obesity, and Blood Stasis: Xiaoyao San (Free and Easy Wanderer Powder) or Zhengqi Tianxiang Tang (Righteous Qi Heavenly Fragrance Decoction). Postpartum Blood Stasis rebelling upward: Chen Sha (Cinnabar) is most effective. Headache before menstruation indicates Fluid Retention: Guizhi (Cinnamon Twig), Jupi (Tangerine Peel), Ganjiang (Dried Ginger) etc. are suitable. (*YiTong*)
Miscarriage after the fifth month of pregnancy is generally caused by masses. Controlling the mass early preserves the fetus. Predecessors ignorant of this add tonifying medicines, which are ineffective. (This theory originates from Zhang Zhongjing and is most logical. Female medicine specialists often inherit from fathers/grandfathers without studying ancient texts, failing to grasp flexible application. Clinging to warming/tonifying as essential for calming the fetus has harmed many. Alas.)
Slight water-Qi before childbirth is not feared. Water-Qi in the upper body with急促 breathing/wheezing leads to sudden Heart attack postpartum. Dry Lung Blood in the lying-in period causing hemoptysis is also feared. Postpartum bathing exposing to dampness causing Hongjiao swelling requires early treatment to avoid unpredictable changes.
Jaundice with irritability, thirst, vomiting, and abdominal distension is a bad syndrome. Inability to sleep at night, irritability, heat, and thirst lead to death within two to three days.
Abdominal mass with whole-body yellowing is named Pi Huang Dan (Mass Jaundice), also difficult to treat.
Patient initially has deep, rapid pulse, suddenly becoming slow, seeming like recovery, but with depressed Qi, silence, desire to lie down, heavy body, poor appetite, and urine like juice—this is the onset of Yin Huang (Yellow Jaundice).
Deficient persons' Malaria Heat and Labor Heat are easily confused. Malaria pulse is wiry and large but not rapid; Labor pulse is rapid but not wiry/large. This is the distinction.
For deficient persons stopping malaria, moxibustion on Dazhui (GV14) is best: three moxa cones at dawn, three at noon, three before onset.
Malaria with intense internal heat, frequent thirst, exposure to wind for cooling, preventing pathogen release, transforms into edema. Yuebi Jia Zhu Tang (Ma Huang Decoction Plus Atractylodes Macrocephala) is suitable. I once treated this; water-Qi removed then malaria recurred, confirming this.
Huo Luan (Cholera-like disorder) with chills indicates Yang Qi returning, a good omen. For deficient persons unable to tolerate trembling, Sini Tang (Reverse the Collapse Decoction) is suitable.
Sudden vomiting can be Huo Luan or acute Wind Stroke, with similar symptoms. Differentiation: post-vomit pulse in Wind Stroke is slow, not tight; extremities are not cold; hands/feet shake during vomiting; after vomiting, hemiplegia and somnolence occur.
Physicians mistakenly identify foot swelling as Hongjiao. Hongjiao is characterized by pain, spasm, flaccidity, or numbness, not merely water-Qi. Dampness dominance causes swelling/fullness; Wind dominance causes insensibility. Disease may start in abdomen spreading to feet, or feet spreading to abdomen. Pulse fears surging/tight/wiry but not rapid. Hyperactive pulses at Xin Xia (Subcardiac) and Yingchong (Renying, ST9) are strictly contraindicated.
I treat Hongjiao by distinguishing Exterior/Interior as the standard. Exterior signs: swelling, numbness, lumbar/foot weakness; treated primarily with sweating and detoxification. Interior signs: intense wind-heat, vigorous Qi movement,急促 breathing, abdominal fullness, vomiting; treated primarily with descending Qi and promoting urination. Physicians wrongly consider exterior signs critical and interior signs mild, leading to erroneous prescriptions and unpredictable deaths.
Roundworms have cold and heat types. Nagata Tokuhon used Taiyi Wan for heat-type worm accumulation and Muxiang Wan for cold-type, which is correct. Stagnant heat in the diaphragm causes roundworm movement; physicians generally treat as Hui Jue (Roundworm Reversal), which is mistaken. (Wu Keyi discussed stomach heat vomiting roundworms but lacked specific treatment. Chen Zhi said: Warm-heat disease vomiting roundworms is stomach heat. Stomach deficiency with heat, worms ascend with heat vapor, vomited out; Xijiao Huanglian Tang (Rhinoceros Horn and Coptis Decoction) is suitable. *Shanghan Bianzhu* Qingzhong Anhe Tang treats stomach excess heat vomiting long worms, also applicable. Akki Shitsu said: Vomiting dead roundworms indicates heat; living ones indicate stomach cold. Dead worms are white, living are reddish; this reasoning seems logical but is not absolute.)
Dysentery treatment depends on heat severity regardless of stool volume. First use Tiaozhong Tang (*Waitai*), then after sweating, combine with Da Chaihu Tang or Shaoyao Tang to harmonize. For delirium, dry/black tongue, severe tenesmus with red/white pus/blood, use Dachengqi Tang or Bingshao Shunqi Tang to purge; resolving heat stops diarrhea.
Jinkou Li (Closed-Mouth Dysentery) with empty irritability: Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) is suitable. *Baiyi Xuanfang* Ginseng, Huanglian, Chenpi, Lotus Seed (four ingredients) is also good. This syndrome with hiccups is untreatable.
Xixi Li (Intermittent Dysentery) with only white mucus: Zhenwu Tang plus Chishizhi (Halloysitum) is suitable.
Zhang Zihe said: Wherever head sores/swellings occur, water-Qi gathers, so purgatives are suitable. I added Cangzhu (Atractylodes Lancea) to head sores to remove water-Qi. For excess patterns, Qianniuzi (Pharbitis Seed) is effective. Same principle.
*Jinkui Yaolue* Xiexin Tang says: Insufficient Heart Qi causing hematemesis/epistaxis, but its indication is vague. According to *Bencao Bai Bing Zhu Zhi* under Dahuang (Rhubarb): Drains blood stasis/chest oppression, insufficient Heart Qi, hematemesis/epistaxis, chest/hypochondriac stabbing pain/distension, decocted with Huanglian (Coptis) and Huangqin (Scutellaria). Using this to treat hematemesis/epistaxis with chest/hypochondriac stabbing pain, I rarely fail.
For lower toothache, moxibustion on Jianjing (GB21) is effective. Jianjing is on the Yangming Meridian. For swollen lower gums, pricking releases blood and cures. Blood/Qi wandering and gathering at gums causes this.
Gu Cao Feng (Bone Tunnel Wind) is detailed in *Waike Zhengzong*. This sore arises behind the ear/jawbone, ulcerates/perforates, spraying pus from mouth. Initially, facial deviation may occur; later upper gum ulceration prevents eating, leading to death. If caused by syphilis toxin, removing toxin cures it. Early Gu Cao Feng: Yitong Yincheng San (Artemisia Capillaris Powder). (Ingredients: Yincheng, Jingjie, Bohe, Lianqiao, Mahuang, Shengma, Qianghuo, Jiangcan, Xixin, Dahuang, Heiqiu - 11 herbs.)
No cough but voice loss: Waitai Fuling Anshen Tang (Poria Calming Spirit Decoction) is suitable. Tea drinkers often get this. Distinction between treatable and untreatable: Upper Jiao deficiency-cold is mostly untreatable. Upper Jiao deficiency-cold with voice loss: Waitai Huang [missing character] Lizhong Tang. Swollen/itchy throat with cough and voice loss: Shengji Huang [missing character] Tang.
Later generations erroneously separated Zhong Shu (Heatstroke) and Zhong Re (Heat Illness) into different names. They are one disease, not different causes. Dongyuan failed to distinguish dynamic acquisition as Zhong Shu and static acquisition as Zhong Re, creating Qingshu Yiqi Tang, which is incorrect. Those arguing ancient formulas exclude Zhong Shu from Shanghan are also wrong. *Book of Han: Emperor Wu Annals* mentions summer drought and many deaths, predating Zhongjing. Summer heat/sweat/cold aversion/thirst/heaviness/pain responds like water on charcoal to Zhongjing's Baihu Tang. Summer sleeping in cold air causing cold/fever/pain responds to Guizhi/Mahuang per Shanghan methods. These two cannot be mixed.
It is wrong to limit Huo Luan to summer. Vomiting/diarrhea with chaos occurs in all seasons, confirmed by *Waitai* and *Rumen Shiqin*. More common in summer because winter Yang is inside (warm), summer Yang moves outside (cold inside), plus craving cold drinks/food. Resembles Food Stagnation, but Food Stagnation causes abdominal fullness/pain with profuse vomiting/diarrhea, resolving next day. Huo Luan continues pain after vomiting/diarrhea, adds fever/body pain, severe cases have cold extremities, irritability/thirst. Occurs in all seasons, heavier in summer, hence mistakenly called Heatstroke.
Huo Luan with subcardiac pain必然 vomits; umbilical pain必然 diarrhea.
Li means treat/control. Zhong refers to Middle Jiao Stomach Qi. Stomach deficiency-cold, undigested food, chaotic vomiting/diarrhea, like tangled thread, gradually untangled to treat, hence Lizhong Wan (Regulate Middle Pill). Jian means strengthen, strengthening Middle Jiao, hence Jianzhong Tang (Strengthen Middle Decoction). Meanings differ; physicians combining them into Jianli Tang is not ancient intent.
Banxia Xiexin Tang drains subcardiac fullness; later physicians thought it drained Heart Fire and treated epilepsy, a major error.
*Gukong Lun* says: Chong Mai disease involves rebellious Qi and interior tension. Chong Mai deficiency and dry blood cause Jiutui subcardiac fullness, Qi rebelling to chest, abdominal skin sticking to back, hanging Heart pain, called Xiong Bi. Guizhi Zhishi Shengjiang Tang and Zhishi Xiebai Guizhi Tang treat pathogens invading Chong Mai.
Subcardiac palpitations have three paths: 1. Cold Qi invading Chong Mai, branching Ren/Chong causing palpitation: Zhigancao Tang, Da Jianzhong Tang treat this. 2. Palpitation due to water-fluid: Guizhi Fuling Baizhu Gancao Tang, Zhenwu Tang treat this. 3. Toxic palpitation: Hongjiao rebelling upward.
Manic/Epileptic syndromes: Manic running/restlessness is easy to treat. Delirious laughter/speech is Dian (Depression), also called Lost Heart Wind, difficult to treat. *Suwen*'s Yang Dian/Yin Dian classification is reliable. *Benshi Fang* Fuling San, Ningzhi Gao, Kuangqi Wan treat both Yin/Yang. Insomnia: Zhunsun Lingyuan Chen Sha San. Continuous salivation: Jufang Yangzheng Dan. Yang Dian: Irrigation therapy. Severe cases: Fill large barrel with water, surprise patient, irrigate. Or bathe in waterfall. All descend rising Yang Qi.
Liuzhu (Flowing Nodule) described by世人: Flowing from chest to lower abdomen/waist/extremities, sometimes forming lumps, flat/swollen, soft but hard underneath. Ulceration discharges pus; one heals, another appears. Severe cases form 3-4 lumps, ultimately untreatable. Chest-up onset is Wet-Phlegm Liuzhu; Chest-down onset is Blood Stasis Liuzhu. Chest-up/extremities easy to treat; Lower abdomen/waist difficult. Blood Stasis Liuzhu: Before lump formation, lumbar/foot stiffness, slight fever. Acute onset dies within a month; chronic lasts half a year.