劳瘵与虚劳易混。虚劳之热浮泛无根据，劳瘵之热 熏骨，而眼中甚了，不如虚劳之
目中
不了了也。四花患门亦治劳瘵，而不能治虚劳。又妇人虚劳者，经水早绝，属血瘦也。劳瘵
者，有至病末末绝者。乃知二病自异也。
暴得痿病，腰足两股皆不仁， 而不能步，脉滑而力者，先与瓜蒂散吐之，后以术附剂
逐水则速愈。
雀目当审腹候。若少阳经拘急者，宜抑肝散类。若因脾胃郁热者，宜平胃散加大黄或黄
连，又用鸡肝亦佳。
积年发小疮痒不可忍者，可与杨梅一剂散，加蝮蛇多量，外以西河柳煎汁浴之。此方亦
治癣疮。
血燥皮肤为痒，及风热疮疥为痒痛者，宜当归饮子。凡一剂散证带血热者，非此方不能
治。
漏风当背七八九椎际恶寒者，属气虚，宜补中益气汤加附子。又觉手足爪间有风者，亦
属漏风一种，宜补中益气汤类。
哕逆因胃寒者，宜丁香柿蒂汤，兼用龙眼丸为佳。因痰饮者，宜橘皮枳实生姜汤。肺痿
吐涎沫者，与甘草干姜汤，兼用皂荚丸。
鼻僻者，多发中风。欲防中风者，宜灸章门穴。
中风证气之所虚，痰必凑之，故以顺气导痰为治法，又中风未发时头痛者，肾气厥逆也
，为不治。
病患服甘遂、大戟、桃花、大黄类，不下利反腹胀满者，当和胃气，宜甘草干姜汤加芍
药类。
带下之块多在卵门下，(斥卵巢耶。)按之则如绵裹，觉温软也。又妇人脚痛属带下者，
十有八九可详。
阴湿者，由谷气下流，宜减饮食，徐服萆 汤类。若其证轻者，地黄、枯矾等分为末，
和生姜汁贴之可也。
某侯一日垂钓于水滨，时有溺者自上流来，侯深悯之，命救之，几死。使侍医将一角末
以管
鼻，须臾吐水数升遂苏。台洲园有雉鸡误陷于井中，饮水数口，扶之出，殆绝。急将一角
末五分，和水服之，须臾吐水霍然痊，乃知一角能解水毒也。
血证脉弦数者，有不测之变，可恐矣。
下利兼香港脚者难治，以下焦虚故也。其他下部有旧疾而并香港脚者，不可不虑。癫痫有因
蓄血
者，当卒倒吐涎沫时，必咯血乃可去其蓄血。一妇人有此证，新产后霍然愈，乃蓄血尽故也
。
喉癣间有属胃热者，宜凉膈散类。
肠痈看法，往来寒热者属右厥阴，无寒热者属左阳明，是为左右别。又一种有二便共闭
者，
为小肠疽，详于《外科大成》。夫病在大肠则大便闭，在小肠则便闭，在中央则二便共闭，
理当然。而小大肠痈多在右，其在中央者形如硬块，或
于小便闭易混，学人宜于活物上而活看耳。治方不拘三痈∶宜选用如神汤，四味薏苡仁汤，
大黄牡丹皮汤。又有阴证者，当行附子也，若与下汤仍不通者，痈发于肠中，妨塞便道也。
又便肠垢者，宜四味薏苡仁汤加大黄，最初宜如神加大黄汤。一等重者，为大黄牡丹汤也。
缠喉风与喉痹易混。缠喉风发于喉中深处，不可针。喉痹发于浅处宜针，若其肿深者，
可吹
入矾蚕。喉痹宜玄参、升麻，或清咽利膈汤，副用冰硼散。缠喉风即有一方主之。(按∶一
方未详，余与以驱风解毒汤加桔梗、石膏捷效。)
血虚肿气似黄胖，其肿虽及右肘上不及左者，专在血分而不在气分也。古人以左右分气
血，可谓不诬矣。
肺痈其初痛阴阴咳则引胸中。而其痛多在左，治宜在始萌。若至其吐脓如米粥，则百可
治一二耳。
痘发热后不见点，通身肿满而死者，是表伏之证也，名曰肉胀。治方早与反鼻剂可发表
。
齿痛宜当归建中汤者，外以黑砂糖擦痛处则捷效。黑砂糖亦贴阴囊癜风，并牛皮癣不堪
痒者立应。
口肿有牙宣与胃热之辨，牙宣者，上齿或下齿必发于一方，而后波及上下，如胃热则否
。且
虽两证同出脓血，牙宣者脓多，胃热者少，是为其别。牙宣宜滋阴降火汤，胃热宜清胃加生
类。骨槽风自胃热来者，宜杨梅一剂散。
妇人妊娠七月以上，当与当归芍药散，逐水理血，否则分娩后多患下利也。又产后下利
者，
多因肠胃为胎压制者，一时得舒畅而水气下奔也，不如乘其势与生姜泻心汤，以尽水气也。
产后咳嗽，多水浸肺之所为，其治与下利略同。
痛风者，风热入骨节也，可发汗。宜麻黄汤，桂枝芍药知母汤亦主之。表证罢，当以禹
功散下之。
三井某年二十有余，腹中拘急，大便硬，饮食如常，但欲眠不能眠，来请诊。诊曰∶子
不能
眠者，非心气之所为，其病在胃中。经曰∶胃不和则卧不安是也。乃与桂枝加芍药大黄汤，
一剂而知，九剂而愈。
妇人积年有水块痛不解，或吐瘀液如淡黑色者，或如赤豆滓者，宜温脾汤，副用应丸。
若有
蓄血者，右脉闭塞莫怪，是血压经也。又不论何病，右脉闭塞者，脾胃衰也。不可不知。
因蓄血腹大胀满者，与血蛊异，其证发作有时，或至夜而胀，至旦则减之类，与桂枝茯
苓丸料效。
小儿卒下利发搐搦死者，所谓真中也，先与附子理中汤。余数年虽欲覃志焦神救活之，
未得其肯綮。
吐乳者，专用治吐乳一方，此证渐剧摇头者不治。
急惊风者，宜桂枝甘草龙骨蛎牡汤。慢惊风因攻击发者尤属虚，可禁针，宜甘草、干姜
，或芍药甘草汤、抱龙丸，《幼幼集成》用灵砂亦效。
诸病拘急者属闭证，仓卒勿错置，必有开期。纵使至死，一旦解而苏。
崩漏轻者，宜当归煎。重者，理中汤。其最剧者，加附子，兼饵食牛肉更佳。
芽儿衄血且鼻塞者，皆属胎毒，宜五香加大黄汤。又育不育之辨，大抵俟五十日判然。
详于《千金方》。
风水肿自面来。经曰∶面肿者风，足头肿者曰水是也。
诸疮翻花者，因荣卫衰也，宜黄 剂。又痔疾翻花者，胃气下陷也，宜升提剂。
痧病或以为《左传》所谓蜮，又云虫名沙工。吐沙人中之则为此证，此皆就沙字为说也
。按
∶此病本自沙漠之南来，故名痧。犹痘自北虏来，因名虏疮。疳疮自广东来，因名广疮也。
不可深拘焉。
湿痹但痹而无痛，其初痿弱，后发拘急也。病在表者当发汗，手足屈而不可伸者，宜四
物汤加犀角、桂枝。
一妇人年四十余，左足肿膝大而痛，不能步行者有年于兹，来请诊。余诊曰∶此证似鹤
膝风
而非也。鹤膝者，膝肿大而膝以下必瘦。今不瘦者，是带下所使。而其病在表，可发汗，乃
与杨梅一剂散，痛渐止，更逐带下毒而全愈。
脏毒者，五毒郁热流注之所致也。其形状与痔漏类难识别，然痔发于肛之左右，而不关
任督
之脉，脏毒发于任督之脉，而不关肛之左右，是为别也。脏毒破血不止者，宜补血汤加干姜
、附子，兼用独参汤。
风懿舌根如痿，言语不了然者，盖中风之类也。又有痰迷心窍，舌强而语言不如意者，
甚相似。然风懿者属阴多不治，痰迷者属阳多治。其痿者与强者，其治自别也。
肝疡古来无明辨。此证肝脏中生疡，后见腹中，故不治。其初当脊之右肝脏之里而发者
，
或可治，宜透脓散。此病与流注易混，世医动以肝疡为流注误矣，盖肝疡比流注甚少也。
鳖瘕在右肋下而冒胃，按之则坚不痛，是属饮癖。不早治，则后必至胀满不可治，用白
马溺为妙。
肺痛证《张氏医通》特论之。初起当中府云门而痛，后或吐血而死为难治。其初轻者，
宜沉香降气汤类。稍重者，宜补中益气汤合生脉散。
肺痈痛而咳，肺痿咳而不痛，肺痛不咳而痛。肺痈痛在一阳者可治，在二阳者难治。(
按∶末二句难解，姑书俟考。)
悬痈生于会阴之侧，多由湿毒，脏毒生于会阴，真中阴毒肿自会阴上斜向肛门之傍，脓
溃如刀割状，三者相似而异。悬痈、脏毒，宜朴硝、石榴皮之剂，阴毒宜内托剂。
凡病患右身有所患，则当为血分治之，是为血证看法。
鼻痔 瓜蒂，世之所知。湿家头痛者，亦以瓜蒂末点纸捻入鼻中，嚏出而愈。
小儿头疮为胎毒，治之无效者，因母有带下哺其乳而发也，速换乳母则愈。妇人头疮亦
有因
带下者，更与八味带下方，兼用坐药则愈。(按∶八味带下者，系本朝制方，奇良。当归、
川芎、茯苓、橘皮、金银花、通草、大黄
俱八味。)
吐乳胃虚者，宜附子理中汤、温脾汤类。若不愈者，与《本事方》青金丹。(按∶青金
丹治
霍乱吐泻不止，乃转筋诸药不效，硫黄三两研，水银八钱，上二味铫子内炒，柳木篦子不住
搅匀，更以柳枝蘸冷醋频频洒，候如铁色法如青金块方成，下再研如粉。)
神仙劳名始见董西园《医级》，(此书四部舶来、荻野福井各藏一本，余入江户。)此病
盖因胃
口蓄血而生，是以不食至数十年，蓄血能养胃气，故不死。用药亦非数年则无效，宜温胃汤
、后以禹神散攻之。(按∶医史丹溪翁传及垣赤道人吹影编。论似此证者，宜参考。)
凡胃中阳气盛则不倾，若胃阳虚则必侧垂，水饮因乘之，名曰 囊。然按之不应手，但
以腹
痛呕吐为征，宜温脾汤。若不愈者，服白牛酪效。(按∶时还读我书续录云∶荻野台州曰
囊者。《医学正传》引东垣云∶痞为窠囊者，用红花、桃仁。据此则 囊兼蓄血，宜温脾汤
，兼用血剂失笑散类。余尝观所吐物，与温疫蓄血所下物同色，故知其兼血也。)
肠覃在脐下子宫内，几与胎相似。而经水将来，其痛不可堪者，服白马溺效。(按∶用
砂亦佳，后条可征。)
砂能治产后腹痛。
带下者，其病从带脉下流，故名带下。盖其始水饮聚于冲脉，传于带脉，以入于子宫，
与血
凝结为带下也。故与生姜泻心汤去水饮，以坐药去凝结则愈。凡用坐药有法，深入子宫则其
痛不可耐，若但在于阴口则无效，正在阴中，稍近于子宫处为妙。妊娠者三月后不可施坐药
，固虽无害于胎，适脱胎则归其咎于此故也。(按∶台州园坐药方，杏仁、甘草各三分，丁
香一分，枯矾六分，片脑五厘，上五味为窜，三日一换之。)
妇人淋疾，与露蜂房散有捷效。(按∶露蜂房能酿乳，今与淋同其治妙。)
崩漏与带下同因。盖水血混淆则为带下，不混淆则为崩漏也。
肝气厥逆为耳聋。耳聋者，以瓜蒂散吐之，后与柴胡清肝散类。若虚者，先与清肝散，
候其实可吐之。大率百药无效者，得一吐必愈。
带下有成虚劳者，其初以寒热往来也。夫带下郁则生热，系少阳则成此证。子宫亦属厥
阴，故睡觉时唇舌干燥也。
劳瘵（肺痨）与虚劳容易混淆。虚劳的热象浮泛而无根基，劳瘵的热象则熏灼骨髓，且眼中症状尤为明显，不像虚劳那样眼中视物模糊不清。四花穴在《患门》中也被用于治疗劳瘵，但不能治疗虚劳。另外，患有虚劳的妇女，月经提前停止，属于血瘦（因血枯而消瘦）。而劳瘵患者，有的直到病危末期月经才断绝。由此可知这两种疾病是不同的。
突然患上痿病，腰部和双腿均感觉麻木不仁，不能行走，脉象滑利且有力，先用瓜蒂散催吐，随后用术附剂（白术、附子组成的方剂）逐水，即可迅速痊愈。
雀目（夜盲症）应当审查腹部征候。如果是少阳经拘急引起的，适宜使用抑肝散类方剂。如果是由于脾胃郁热引起的，适宜使用平胃散加大黄或黄连，同时服用鸡肝效果也很好。
长年发作小疮，瘙痒难忍，可以给予杨梅一剂散，加入大量蝮蛇，外用西河柳煎汁沐浴。此方也能治疗癣疮。
血燥导致皮肤瘙痒，以及风热疮疥引起痒痛者，适宜使用当归饮子。凡是符合一剂散证候且伴有血热的，非此方不能治愈。
漏风病若背部第七、八、九椎骨之间感到恶寒，属于气虚，适宜使用补中益气汤加附子。又如果感觉手足指甲缝隙间有风邪侵袭，也属于漏风的一种，适宜使用补中益气汤类方剂。
呃逆（哕逆）因胃寒引起的，适宜使用丁香柿蒂汤，兼用龙眼丸效果更佳。因痰饮引起的，适宜使用橘皮枳实生姜汤。肺痿吐涎沫者，给予甘草干姜汤，兼用皂荚丸。
鼻歪斜（鼻僻），多由中风引发。想要预防中风者，适宜灸章门穴。
中风证的本质是气虚，痰浊必然乘虚聚集，因此以顺气导痰为治疗方法。另外，中风未发作时出现头痛者，属于肾气厥逆，属于不治之症。
病人服用甘遂、大戟、桃花、大黄等药后，不仅没有腹泻，反而腹胀满，应当调和胃气，适宜使用甘草干姜汤加芍药类方剂。
带下病形成的肿块多在卵门（推测指卵巢）下方，按压时感觉像棉絮包裹一样，温热柔软。另外，妇人脚痛属于带下病的，十有八九可以详细辨治。
阴部潮湿，是由于谷气下流所致，适宜减少饮食，慢慢服用萆薢汤类方剂。如果病情较轻，可以将地黄、枯矾等分为末，调和生姜汁外贴患处即可。
某位侯爵一天在水边垂钓，当时有溺水者从上流漂来，侯爵深感怜悯，命人将其救起，那人几乎已死。让侍医将一角（犀角）磨成粉，通过管子灌入鼻孔，片刻后吐出几升水便苏醒过来。台洲家的园子里有一只野鸡误陷井中，喝了几口水，扶它出来时，气息奄奄。急忙取五分一角粉，和水服下，片刻后吐出积水，霍然痊愈，这才知道一角能解水毒。
血证脉象弦数者，有不测的变化，令人恐惧。
下利（腹泻）兼有香港脚（脚气）者难治，因为下焦虚损的缘故。其他下部有旧疾并并发香港脚者，不可不忧虑。癫痫有因蓄血引起的，当突然昏倒吐涎沫时，必须咯出血液才能去除蓄血。有一位妇人有此证，新产后霍然痊愈，是因为蓄血尽除的缘故。
肠痈的辨证看法：往来寒热者属于右厥阴，无寒热者属于左阳明，这是左右的区别。另一种情况是大便和小便共同闭塞的，称为小肠疽，详见《外科大成》。病在大肠则大便闭塞，在小肠则小便闭塞，在中央则二便共同闭塞，道理当然是这样。而且大小肠痈多在右侧，位于中央的形如硬块，有时容易与小肠闭尿混淆，学医者应当在活体上灵活看待。治疗方剂不拘泥于三种痈：适宜选用如神汤、四味薏苡仁汤、大黄牡丹皮汤。又有阴证者，应当使用附子，如果服用泻下汤剂仍然不通畅，说明痈发于肠中，阻塞了便道。另外，排出肠垢者，适宜使用四味薏苡仁汤加大黄，最初适宜使用如神汤加大黄汤。一等重的，是大黄牡丹汤。
缠喉风与喉痹容易混淆。缠喉风发于喉中深处，不可针刺。喉痹发于浅处适宜针刺，如果肿胀深者，可将矾蚕吹入患处。喉痹适宜使用玄参、升麻，或清咽利膈汤，辅助使用冰硼散。缠喉风即有一方主治。（按：一方不详，我给予驱风解毒汤加桔梗、石膏，见效快。）
血虚浮肿气色似黄胖，其肿虽波及右肘以上但不涉及左侧的，专在血分而不在气分。古人以左右区分气血，确实不是虚假的。
肺痈初起时疼痛隐隐，咳嗽牵引胸中。而其痛多在左侧，治疗宜在初期萌芽阶段进行。如果到了吐脓如米粥的程度，则百人中可治一二而已。
痘疹发热后不见出点，通身肿满而死者的，是表伏之证，名叫肉胀。治疗方剂早用反鼻剂（通关散之类）可以发表。
齿痛适宜使用当归建中汤者，外用黑砂糖擦拭痛处则见效快。黑砂糖也能贴敷阴囊白癜风和牛皮癣不堪忍受的瘙痒，立即见效。
口肿有牙宣与胃热之分。牙宣者，上齿或下齿必定先在一侧发作，然后波及上下；如果是胃热则不是这样。而且虽然两证都出脓血，牙宣者脓多，胃热者少，这是它们的区别。牙宣适宜使用滋阴降火汤，胃热适宜使用清胃散加生地黄类。骨槽风自胃热来的，适宜使用杨梅一剂散。
妇人妊娠七月以上，应当给予当归芍药散，逐水利血，否则分娩后多患下利。另外产后下利者，多因肠胃被胎压制，一时得到舒畅而水气下奔，不如趁其势给予生姜泻心汤，以尽除水气。
痛风者，是风热侵入骨节，可以发汗。适宜使用麻黄汤，桂枝芍药知母汤也主治此证。表证解除后，应当用禹功散攻下。
三井某人年二十多岁，腹中拘急，大便硬，饮食正常，只想睡觉却睡不着，前来求诊。我诊断说：你不能睡觉，不是心气的问题，病在胃中。经书说：胃不和则卧不安。于是给予桂枝加芍药大黄汤，一剂后好转，九剂后痊愈。
妇人积年有水块痛不解，或呕吐瘀液如淡黑色者，或如赤豆渣者，适宜使用温脾汤，辅助使用应丸。如果有蓄血者，右脉闭塞不要奇怪，这是血压经（血脉阻滞）的表现。另外不论什么病，右脉闭塞者，是脾胃衰弱的表现。不可不知道。
因蓄血导致腹大胀满者，与血蛊不同，其证候发作有定时，有的至夜间胀满，至早晨减轻，这类情况使用桂枝茯苓丸料有效。
小儿突然下利并发搐搦死者，所谓真中（中恶），先给予附子理中汤。我多年虽想潜心尽力救治，但未得其要领。
急惊风者，适宜使用桂枝甘草龙骨牡蛎汤。慢惊风因攻击（惊吓等）引发者尤其属于虚证，可禁止针刺，适宜使用甘草、干姜，或芍药甘草汤、抱龙丸，《幼幼集成》中使用灵砂也有效。
诸病拘急者属于闭证，仓促间不要错置，必有开期。即使至死，一旦解开束缚便会苏醒。
崩漏轻者，适宜使用当归煎。重者，使用理中汤。最剧烈的，加附子，兼食牛肉更佳。
婴儿鼻衄血且鼻塞者，皆属于胎毒，适宜使用五香加大黄汤。另外判断胎儿育与不育的大抵要等到五十天才能判然分明。详见《千金方》。
风水肿从面部开始。经书说：面肿者为风，足头肿者为水。
诸疮翻花者，因荣卫衰弱所致，适宜使用黄芪剂。另外痔疾翻花者，是胃气下陷所致，适宜使用升提剂。
痧病有人认为是《左传》所说的蜮，又说虫名沙工。吐沙人中之则为此证，这都是就“沙”字来解释。按：此病本自沙漠之南来，故名痧。犹如痘自北虏来，因名虏疮。疳疮自广东来，因名广疮。不可深拘泥于此。
湿痹但痹而无痛，初起痿弱，后发作拘急。病在表者当发汗，手足屈曲不可伸展者，适宜使用四物汤加犀角、桂枝。
一位四十多岁的妇人，左足肿膝大而痛，不能步行已有多年，前来求诊。我诊断说：此证似鹤膝风而非鹤膝风。鹤膝风是膝肿大而膝以下必瘦。现在不瘦，是带下病所致。而其病在表，可发汗，于是给予杨梅一剂散，痛渐止，再逐带下毒而全愈。
脏毒者，是五毒郁热流注所致。其形状与痔漏类似难以识别，然而痔发于肛门之左右，而不关乎任督之脉，脏毒发于任督之脉，而不关乎肛门之左右，这是它们的区别。脏毒破血不止者，适宜使用补血汤加干姜、附子，兼用独参汤。
风懿舌根如痿，言语不清者，盖是中风的类似病症。又有痰迷心窍，舌强而语言不如意者，非常相似。然而风懿者属阴多不治，痰迷者属阳多治。其痿者与强者，治疗方法自然不同。
肝疡古来没有明确辨别。此证肝脏中生疡，后来见于腹中，故不治。其初起当脊之右肝脏之里而发者，或许还可治，适宜使用透脓散。此病与流注易混，世医动辄以肝疡为流注误诊，大概肝疡比流注少见得多。
鳖瘕在右肋下而冒犯胃，按压则坚硬不痛，属于饮癖。不早治，则后必至胀满不可治，用白马溺（马尿）为妙。
肺痛证《张氏医通》专门论述过。初起当中府、云门穴而痛，后来或吐血而死为难治。其初轻者，适宜使用沉香降气汤类。稍重者，适宜使用补中益气汤合生脉散。
肺痈痛而咳，肺痿咳而不痛，肺痛不咳而痛。肺痈痛在一阳者可治，在二阳者难治。（按：末两句难解，暂记以待考证。）
悬痈生于会阴之侧，多由湿毒引起；脏毒生于会阴；真中阴毒肿自会阴上斜向肛门之旁，脓溃如刀割状，三者相似而异。悬痈、脏毒，适宜使用朴硝、石榴皮之剂，阴毒适宜使用内托剂。
凡病患右身有所患，则应当作为血分病来治疗，这是看血证的方法。
鼻痔用瓜蒂，世人所知。湿家头痛者，也以瓜蒂末点纸捻入鼻中，嚏出而愈。
小儿头疮为胎毒，治疗无效者，因母亲有带下哺其乳而发也，速换乳母则愈。妇人头疮也有因带下者，再给予八味带下方，兼用坐药则愈。（按：八味带下者，系本朝制方，奇良。当归、川芎、茯苓、橘皮、金银花、通草、大黄俱八味。）
吐乳胃虚者，适宜使用附子理中汤、温脾汤类。若不愈者，给予《本事方》青金丹。（按：青金丹治霍乱吐泻不止，乃转筋诸药不效，硫黄三两研，水银八钱，上二味铫子内炒，柳木篦子不住搅匀，更以柳枝蘸冷醋频频洒，候如铁色法如青金块方成，下再研如粉。）
神仙劳名始见董西园《医级》，（此书四部舶来、荻野福井各藏一本，余入江户。）此病盖因胃口蓄血而生，是以不食至数十年，蓄血能养胃气，故不死。用药亦非数年则无效，适宜使用温胃汤，后以禹功散攻之。（按：医史丹溪翁传及垣赤道人吹影编。论似此证者，宜参考。）
凡胃中阳气盛则不倾，若胃阳虚则必侧垂，水饮因乘之，名叫囊（痞）。然按之不应手，但以腹痛呕吐为征候，适宜使用温脾汤。若不愈者，服白牛酪有效。（按：时还读我书续录云：荻野台州曰囊者。《医学正传》引东垣云：痞为窠囊者，用红花、桃仁。据此则囊兼蓄血，宜温脾汤，兼用血剂失笑散类。余尝观所吐物，与温疫蓄血所下物同色，故知其兼血也。）
肠覃在脐下子宫内，几乎与胎相似。而经水将来，其痛不可堪者，服白马溺有效。（按：用砂亦佳，后条可征。）
带下者，其病从带脉下流，故名带下。盖其始水饮聚于冲脉，传于带脉，以入于子宫，与血凝结为带下也。故与生姜泻心汤去水饮，以坐药去凝结则愈。凡用坐药有法，深入子宫则其痛不可耐，若但在于阴口则无效，正在阴中，稍近于子宫处为妙。妊娠者三月后不可施坐药，固虽无害于胎，适脱胎则归其咎于此故也。（按：台州园坐药方，杏仁、甘草各三分，丁香一分，枯矾六分，片脑五厘，上五味为窜，三日一换之。）
妇人淋疾，与露蜂房散有捷效。（按：露蜂房能酿乳，今与淋同其治妙。）
Lao Zhai (pulmonary tuberculosis) and Xu Lao (deficiency consumption) are easily confused. The heat of Xu Lao floats superficially without a root, whereas the heat of Lao Zhai scorches the bones, and the symptoms in the eyes are particularly severe, unlike Xu Lao where vision is blurred. Si Hua points are also used in *Huan Men* to treat Lao Zhai, but cannot treat Xu Lao. Furthermore, women suffering from Xu Lao have their menstruation cease early, which belongs to Xue Shou (emaciation due to blood depletion). In contrast, patients with Lao Zhai may not have their menstruation cease until the very end of the illness. Thus, it is known that these two diseases are distinct.
Sudden onset of Wei Bing (flaccidity syndrome), with numbness in the waist and both thighs, inability to walk, slippery pulse yet sufficient strength: first administer Gouti San (Melon Seed Powder) to induce vomiting, then use Shu Fu Ji (A decoction of Atractylodis Rhizoma and Aconiti Lateralis Radix Preparata) to drain water for rapid recovery.
Que Mu (night blindness) should be examined via abdominal signs. If caused by tension in the Shaoyang channel, Yi Gan San (Liver-Calming Powder) or similar formulas are suitable. If caused by stagnant heat in the Spleen and Stomach, Ping Wei San (Calm the Stomach Powder) with Dahuang (Rhei Radix et Rhizoma) or Huanglian (Coptidis Rhizoma) is suitable; additionally, consuming chicken liver is beneficial.
For small sores recurring for years with unbearable itching, Yangmei Yi Ji San (One-Dose Powder of Myrica Rubra) with a large amount of Fushe (Agkistrodon Venom) can be given. Externally, wash with decoction of Xihe Liu (Tamarix Herba). This formula also treats tinea corporis.
For itching due to dry blood in the skin, and itching/pain from wind-heat sores and scabies, Dang Gui Yin Zi (Angelica Decoction) is suitable. For any case fitting the pattern of Yi Ji San accompanied by blood-heat, this formula is indispensable.
Lou Feng (wind leakage) characterized by aversion to cold between the 7th, 8th, and 9th thoracic vertebrae belongs to Qi deficiency; Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Fuzi (Prepared Aconite Root) is suitable. Also, feeling wind in the spaces between fingers and toes belongs to a type of Lou Feng; Buzhong Yiqi Tang or similar formulas are suitable.
Yue Ni (hiccups) due to Stomach cold: Dingxiang Shidi Tang (Clove and Persimmon Calyx Decoction) is suitable, combined with Longyan Wan (Longan Pill) for better effect. Due to phlegm-fluid retention: Chupi Zhishi Shengjiang Tang (Tangerine Peel, Immature Bitter Orange, and Fresh Ginger Decoction) is suitable. Fei Wei (lung atrophy) with spitting of saliva foam: Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction) is given, combined with Zhaojiao Wan (Soap Pod Pill).
Bi Pi (nasal deviation) often results from Zhong Feng (stroke). To prevent Zhong Feng, moxibustion on Zhangmen (LR13) is suitable.
Zhong Feng (stroke) involves Qi deficiency, causing Phlegm to gather; thus, regulating Qi and guiding out Phlegm is the treatment method. Additionally, headache before the onset of Zhong Feng indicates Kidney Qi rebellion, which is incurable.
If a patient takes Gansui (Kansui Root), Daji (Euphorbiae Pekinensis Radix), Taohua (Peach Blossom), Dahuang (Rhei Radix et Rhizoma), etc., and instead of diarrhea experiences abdominal fullness, harmonize the Stomach Qi. Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction) with Shaoyao (Peony Root) is suitable.
Masses from Dai Xia (leukorrhea) are mostly below the "egg gate" (likely ovaries); pressing feels like cotton-wrapped warmth/softness. Foot pain in women belonging to Dai Xia can be diagnosed in 80-90% of cases.
Yin Shi (genital dampness) flows downward from grain Qi; reduce diet and slowly take Bibi Tang (Bibii Decoction). For mild cases, equal parts Dihuang (Rehmanniae Radix) and Kufan (Alumen) powdered and applied with fresh ginger juice is effective.
A certain Marquis was fishing by the water when a drowning person floated down from upstream. Deeply pitying him, he ordered rescue. The victim was nearly dead. The attending physician ground one horn (Rhino Horn) into powder, inserted it through a tube into the nose. After a moment, several sheng (liters) of water were vomited, and the patient revived. At Tai Zhou's garden, a pheasant fell into a well, drank a few mouthfuls of water, and was pulled out nearly dead. Five fen of ground horn mixed with water was administered. After a moment, water was vomited, and the pheasant recovered completely. Thus, it is known that the horn can resolve water toxicity.
Blood disorders with wiry and rapid pulses portend unpredictable changes and are frightening.
Diarrhea complicated by Hong Kong Jiao (beriberi) is difficult to treat due to lower jiao deficiency. Other lower body old ailments combined with beriberi require caution. Epilepsy caused by accumulated blood: during sudden collapse and foaming at the mouth, hemoptysis must occur to remove the accumulated blood. A woman with this condition recovered suddenly after postpartum bleeding because the accumulated blood was exhausted.
Throat xuan (ulcers) occasionally belong to Stomach heat; Liang Ge San (Cool the Diaphragm Powder) is suitable.
Intestinal abscess differentiation: alternating chills and fever belong to Right Jueyin; absence of chills/fever belongs to Left Yangming. Another type with simultaneous constipation and urinary retention is called Xiao Chang Ju (small intestine carbuncle), detailed in *Waike Dacheng*. Disease in Large Intestine causes fecal obstruction; in Small Intestine, urinary obstruction; in the center, both obstruct. Intestinal abscesses are mostly on the right; central ones feel like hard lumps and may confuse with urinary retention. Practitioners must view them dynamically. Treatments include Rushen Tang (Divine Efficacy Decoction), Siwei Yiyiren Tang (Four-Ingredient Coix Seed Decoction), Dahuang Mudanpi Tang (Rhubarb and Moutan Decoction). For Yin patterns, use Fuzi (Aconite). If purgatives fail, the abscess blocks the bowel. Discharging intestinal mucus: Siwei Yiyiren Tang plus Dahuang; initially Rushen Tang plus Dahuang. Severe cases: Dahuang Mudan Tang.
Chan Hou Feng (winding throat wind) is confused with Hou Bi (sore throat). Chan Hou Feng originates deep in the throat; acupuncture is contraindicated. Hou Bi originates superficially; acupuncture is suitable. For deep swelling, blow Fan Can (Alum and Silkworm powder) into the throat. Hou Bi uses Xuanshen (Scrophulariae Radix), Shengma (Cimicifugae Rhizoma), or Qingyan Lige Tang (Clear Throat and Purge Diaphragm Decoction), supplemented with Bingpeng San (Ice and Borax Powder). Chan Hou Feng has its own specific formula. (Note: Formula unspecified; I used Qufeng Jiedu Tang [Wind-Expelling and Toxin-Resolving Decoction] plus Jiegeng (Platycodon Root) and Shigao (Gypsum), achieving quick results.)
Blood deficiency edema resembling yellow puffy complexion: if swelling extends above the right elbow but not the left, it is strictly in the Blood aspect, not Qi. Ancients dividing Qi and Blood by left/right sides were correct.
Fei Yong (lung abscess): initial dull pain radiating to chest upon coughing. Pain mostly on the left; treat at the萌芽 stage. If pus like rice porridge is expectorated, only 1-2 in 100 can be cured.
Measles/rubella fever without eruption, followed by generalized edema and death: this is latent exterior syndrome, named Rou Zhang (flesh distension). Early use of Fan Bi Ji (Nasal Revival Agent) can release the exterior.
Toothache suitable for Danggui Jianzhong Tang: apply black sugar externally to the painful area for quick effect. Black sugar also treats scrotal vitiligo and intractable psoriasis itch instantly.
Mouth swelling distinguishes Ya Xuan (gum recession/disease) from Stomach heat. Ya Xuan starts on one side (upper or lower teeth) then spreads; Stomach heat does not. Both may discharge pus/blood, but Ya Xuan has more pus, Stomach heat less. Ya Xuan uses Ziyin Jianghuo Tang (Nourish Yin and Descend Fire Decoction); Stomach heat uses Qingwei San (Clear Stomach Powder) plus Shengdi (Rehmannia Root). Gu Cao Feng (bone槽 wind) from Stomach heat uses Yangmei Yi Ji San.
Women pregnant over seven months should take Danggui Shaoyao San (Angelica and Peony Powder) to drain water and regulate blood; otherwise, postpartum diarrhea is likely. Postpartum diarrhea often occurs because intestines/stomach were compressed by the fetus; once relaxed, water qi rushes down. Use Shengjiang Xiexin Tang (Fresh Ginger Decoction to Drain the Epigastrium) to exhaust water qi. Postpartum cough is often due to water flooding the lungs; treatment is similar to diarrhea.
Tong Feng (gout) is wind-heat entering joints; induce sweating. Mahuang Tang (Ephedra Decoction) is suitable; Guizhi Shaoyao Zhimu Tang (Cinnamon Twig, Peony, and Anemarrhena Decoction) also treats it. After exterior syndrome resolves, use Yugong San (Yu Gong Powder) to purge.
San Jing, age 20+, had abdominal tension, hard stool, normal appetite, but sleeplessness. Diagnosis: Sleeplessness is not Heart Qi issue but Stomach disharmony ("When Stomach is not harmonious, sleep is uneasy"). Given Guizhi Jia Shaoyao Dahuang Tang (Cinnamon Twig Decoction plus Peony and Rhubarb). Improved after one dose, cured after nine.
Women with chronic water masses/pain, vomiting dark/black fluid or red bean dregs: Wen Pi Tang (Warm the Spleen Decoction) with Ying Wan (Ying Pill). If accumulated blood exists, right pulse occlusion is expected (blood pressure blockage). Right pulse occlusion generally indicates Spleen/Stomach decline.
Abdominal distension from accumulated blood differs from Xue Gu (blood蛊). Symptoms flare at times (worse at night, better morning); Guizhi Fuling Wan (Cinnamon Twig and Poria Pill) is effective.
Infants dying from sudden diarrhea and convulsions (Zhen Zhong/Evil Invasion): First give Fuzi Lizhong Tang (Aconite Decoction to Warm the Middle). Despite years of effort, I lacked the key to saving them.
Vomiting milk: Use specific formula for this. If accompanied by head shaking and worsening, it is incurable.
Ji Jing Feng (acute infantile convulsion): Guizhi Gancao Longgu Muli Tang (Cinnamon Twig, Licorice, Dragon Bone, and Oyster Shell Decoction). Man Jing Feng (chronic infantile convulsion) caused by attacks is especially deficient; avoid acupuncture. Use Gancao (Licorice), Ganjiang (Dried Ginger), Shaoyao Gancao Tang (Peony and Licorice Decoction), or Baolong Wan (Embrace Dragon Pill). Lingsha (Cinnabar) in *Youyou Jicheng* is also effective.
All stiffness/spasms belong to Bi Zheng (closed syndrome); do not panic, there will be an opening period. Even if near death, relief brings revival.
Beng Lou (metrorrhagia/metrostaxis) mild: Danggui Jian (Angelica Decoction). Severe: Lizhong Tang (Middle-Warming Decoction). Most severe: Add Fuzi (Aconite); eating beef is beneficial.
Infant epistaxis with nasal congestion: all belong to fetal toxin. Wuxiang Jia Dahuang Tang (Five-Aromatics Plus Rhubarb Decoction). Differentiating viable/non-viable fetus usually clear by day 50 (*Qianjin Fang*).
Feng Shui (wind edema) starts from face. Classics: Face swelling is wind; foot/head swelling is water.
Flowering ulcers: due to Ying/Wei deficiency; use Huangqi (Astragalus) formulas. Flowering hemorrhoids: due to sinking Spleen Qi; use lifting formulas.
Sha Bing (sand disease): Some link to *Zuo Zhuan* "Hu" or insect "Shagong". Others say inhaling sand causes it. Actually, the name comes from coming south of deserts, like "Du" (pox) from northern barbarians being called "Lu Chuang", and "Gan Chuang" from Guangdong. Do not be rigid.
Shi Bi (damp bi): Numbness without pain, initial weakness, later stiffness. Exterior disease: induce sweat. Bent limbs unable to extend: Siwu Tang (Four Substances Decoction) plus Xijiao (Rhinoceros Horn substitute) and Guizhi (Cinnamon Twig).
Woman, 40+, left leg swollen knee painful, unable to walk for years. Diagnosed as not He Xi Feng (crane knee deformity, where calf is thin). Here calf is not thin, indicating Dai Xia (leukorrhea). Exterior disease, induce sweat. Given Yangmei Yi Ji San; pain stopped, then treated leukorrhea toxin for cure.
Zang Du (visceral toxin): Caused by five toxins stagnant heat flowing. Similar to hemorrhoids/fistulas. Hemorrhoids are lateral to anus, not involving Ren/Du vessels; Zang Du involves Ren/Du vessels, not lateral anus. Bleeding Zang Du: Buyue Tang (Blood-Nourishing Decoction) plus Ganjiang/Fuzi, combined with Dushen Tang (Single Ginseng Decoction).
Feng Yi (wind stupor): Tongue root flaccid, speech unclear, similar to stroke. Phlegm confusing heart orifice: stiff tongue, unclear speech, similar. Feng Yi is Yin-heavy (incurable); Phlegm confusion is Yang-heavy (treatable). Treatments differ based on flaccidity vs stiffness.
Gan Yang (liver ulcer): Historically unclear. Ulcer forms in liver, appears in abdomen, usually incurable. If starting at right spine inside liver, might be treatable with Tou Nong San (Pus-Releasing Powder). Confused with Liu Zhu (flowing nodules); Gan Yang is rarer.
Die Xia (turtle mass): Under right rib, presses stomach, hard/painless, belongs to Yin Pi (fluid accumulation). Untreated leads to fatal distension. Horse urine is excellent.
Fei Tong (lung pain) discussed in *Zhangshi Yitong*. Starts at Zhongfu/Yunmen, later hemoptysis/death is hard to treat. Mild: Chenxiang Jiangqi Tang (Aquilaria Regulating Qi Decoction). Moderate: Buzhong Yiqi Tang combined with Shengmai San.
Fei Yong (abscess) hurts and coughs; Fei Wei (atrophy) coughs but doesn't hurt; Fei Tong (pain) doesn't cough but hurts. Fei Yong in One Yang is treatable; Two Yang is difficult. (Note: Last two sentences obscure, pending verification.)
Xuan Yong (hanging abscess): Side of perineum, damp toxin. Zang Du: Perineum. Zhen Zhong Yin Du (true middle yin toxin): Swelling from perineum slanting to anus, pus like knife cut. Three similar but different. Xuan Yong/Zang Du: Xiaoshi (Mirabilite) and Shiliupi (Pomegranate Rind). Yin Du: Neituo Ji (Interior-Supporting Formulas).
Right-sided body disease: Treat as Blood aspect.
Bi Zhi (nasal polyps) using Gouti (Melon Seed) is known. Headache in damp patients: Gouti powder in paper twist in nose induces sneezing/cure.
Infant head sore (fetal toxin) unresponsive to treatment: Mother's leukorrhea transmitted via breast milk. Change wet nurse to cure. Woman's head sore from leukorrhea: Babai Daixia Fang (Eight-Ingredient Leukorrhea Formula) + suppositories. (Note: Eight ingredients: Danggui, Chuanxiong, Fuling, Chenpi, Jinyinhua, Tongcao, Dahuang, plus one implied).
Vomiting milk due to Stomach deficiency: Fuzi Lizhong Tang, Wen Pi Tang. If ineffective: Ben Shi Fang Qingjin Dan (Blue Gold Pill). (Note: Recipe details provided).
Shenxian Lao (Immortal Consumption) first seen in Dong Xiyuan's *Yiji*. Caused by blood accumulation in stomach/orifice. Patient eats nothing for decades but survives because accumulated blood nourishes Stomach Qi. Treatment takes years. Wenwei Tang (Warm Stomach Decoction) then Yugong San to attack. (Note: Refer to Danxi biography and Yuan Chi Daoren's writings).
Stomach Yang abundant prevents tilting; deficiency causes sagging, water enters, named "Nang" (pouch/sack). Pressing yields no resistance; signs are abdominal pain/vomiting. Wen Pi Tang suitable. If ineffective, White Cow Cheese (fermented dairy) effective. (Note: Reference to *Shihuan Duwo Shu*: Nang involves accumulated blood; add Shixiao San).
Chang Qin (intestinal tumor): Below navel, inside uterus, resembles fetus. Severe pain before menstruation: Horse urine effective. (Note: Sandstone also good).
Sandstone treats postpartum abdominal pain.
Daixia (leukorrhea): Pathogen flows down Dai Mai. Initially fluid gathers in Chong Mai, transmits to Dai Mai, enters uterus, condenses with blood. Shengjiang Xiexin Tang drains fluid; suppositories remove condensation. Suppository technique: Too deep hurts; too shallow ineffective; place slightly inside vagina near cervix. Contraindicated after 3rd month pregnancy (risk of miscarriage). (Recipe: Apricot kernel, Licorice, Clove, Alumen, Borneol).
Female Lin Ji (dysuria): Lu Fengfang San (Honeycomb Powder) has quick effect. (Note: Honeycomb produces milk, treating dysuria is clever).
Beng Lou and Daixia share cause. Water/blood mix = Daixia; unmixed = Beng Lou.
Liver Qi rebellion causes deafness. Gouti San to vomit, then Chaihu Qinggan San. If deficient, start with Qinggan San, wait for excess to vomit. Generally, if hundred medicines fail, one vomit cures.
Daixia developing into Xu Lao: Initial alternating chills/fever. Daixia stagnation generates heat, linking to Shaoyang. Uterus belongs to Jueyin; dry lips/tongue upon waking.