以焦白术熬膏，略入姜汁和匀为丸，少少参汤吞服，幸一二服俱不吐出，顷而腹痛大便
矣。余窃喜曰∶气能下达，吐可减矣，早晨仍以昨煎方作大剂，冲参汤饮之，幸亦不
呕，如是日进二剂，人参两余一日，第二日可进薄汤米饮，三四日后可进薄粥矣，余乃
令早晨以人参五钱，作生脉饮，送服八味丸，粥后食远，仍以八味去附子加牛膝、麦
冬、五味者，作大剂冲参汤服之，申酉刻照前方又一剂，七八日后可能吃饭半碗矣。后
以地黄归脾二汤加减，相须间服，调理半月之余，诸症渐退，精神日长，饮食倍常。
候选杨老先生，吐血之后，大渴不止，两寸脉洪，关尺并弱，此阴血暴亡，脏腑失
养，所以津液燥槁，阴火上炎，名为血渴也。余用熟地三两、麦冬五钱、五味子一
钱、附子二钱。浓煎二碗代茶饮之。如此一日三剂。始能渴止，而寸脉和平，渐思饮食
而愈。若以胃火为患，妄用石膏、栀子、芩连，反激阴火上炎，耗竭津液，益增烦躁喘
渴之患矣，故喻嘉言曰∶夫人之得以长享者，惟赖后天水谷之气，生此津液，津液结
则病，律液竭则死矣。故治病而不知救人之津液，真庸工也。
内阁部堂彭老先生之二令孙，年三岁，忽一日发热延治，余见其虽初发热，神气困
倦，脉按无力，肌肉 白，面颊微红，体虽热而久按则和，身有微汗，已知禀赋最
薄，外感轻而内伤重也。书曰∶外感少，内伤多者，但补其中，益其气而邪自退，不必
攻邪，奈病家必欲发散，余不敢应命而退。不意余回之后，渠家饮以葱头汤半钟，以薄
棉被覆之，令其邪从汗解也。无如自后溃汗不止，四肢不收，面青目闭，乳食不进，时
刻切牙，或以慢惊，或以为慢脾，俱立方而不敢下药，咸以为坏症也。所用之药皆天
麻、胆星、钩藤、半夏、僵蚕惊门之药也。余视之云∶此药非以治此病也。此乃先天源
已不足，今当外感少内伤多，理当温补之症，而更汗之，则阳亡矣。所以四肢不收，
僵卧不醒，汗者，血也，汗血溃亡，阴耗竭矣。牙属肾阴，今咬不止，肾将败也。急当
重滋肾水之中，以补真阳，冲入参汤，庶可保全，否则断难为力矣。余以八味去附子加
牛膝、麦冬、五味作汤，冲以人参三钱，无如彭老先生疑其药剂太大，人小不能抵当，
必欲减半，内肉桂止四分，人参止一钱五分，余不得已勉从其命，服后而竟安然，咬
牙顿止，至下半日，切牙诸势仍然发作，余曰∶此药小力短之验也。乃令以所减之半剂
补之，服后而其效如响，次日病家胆气已壮，乃仍照方大剂调服，三四日后，切牙全
止，始能手足移动，口能吮乳，然舌尚无力。如是调理半月痊愈，可见内伤认作外
感，葱汤薄被，几致伤生，何况元神发散，克伐寒凉者乎？纯阳之子尚然，何况元阳残
败者乎！
总宪蒋老先生三嗣君，精神素弱，才犯吐血阴亏之症，调治初愈，忽遇天明梦遗，
又作大吐不已，六脉沉细甚微。余曰∶梦遗俗名走阳，今天明走阳，阳更伤矣。大吐不
止，又亡阳矣。急以附子理中汤，去甘草投之，无如到口即吐，又以白通汤调人尿与之
亦吐。都中诸医遍请延医，所用之药不出四逆、理中、白通汤类，无如点水滴药，俱不
能受，沉困数日，上不能入，下不能出，虽有良方妙药亦无补也。适有敝门人罗丹臣在
寓，进西洋药酒一方，神治关格吐逆之症，余细察之，内皆一派纯阳之药，可以破格阳
之阴盛矣。况内用烧酒为煎。凡诸水诸酒，皆能吐出，独烧酒力猛卒烈，到口直透丹
田，无可吐出者，立方之心，可谓周而备矣。照方制服，竟安然而受，从此参附峻补
之药，俱能陆续渐进，调理而愈。如此良方不敢自秘，敬陈其方于关格门内，幸尊生者
珍之。
正蓝旗于太老先生，乃谦恭仁浓之长者也。向为刑部郎，因患偏枯之症，右臂浮
肿，或麻或痛，两足艰于步履，乃退归静养，无如嗣君止一，而早年出仕，太先生居
家劳碌，且待人接物，性最多情，即余在都，甚叨其爱，以致心神中气日虚，浮肿诸
症，因循如故，医者请谒，谓痰谓火谓风，无非清凉消克发散，余每在旁争曰∶脾虚不
能健运，津液凝滞为痰，且水不归源，肾阴愈槁，可消之乎，脾阳不能充达四肢，以致
臂肿脚软为麻为疼，可散之乎，阴水不足，龙火上乘，真阳益衰，火不生土，以致脾肾
皆虚，可寒之乎，奈太先生轻听术士之言，常常以身试药，一日忽昏迷不醒，痰喘溃
汗，六脉沉微，乃促余诊，余曰∶中气久虚不为峻补，反肆克削一但水落石出，大虚之
症全现矣。急为挽救，缓则无济于事也。乃用人参六两、炒黄白术四两、生附子一只，
去皮姜汁炒水煎一碗灌之，汗渐收而脉渐起，痰喘定而神始清，谨慎调补，一月而痊
愈，自后太先生始悟至理。凡痰因火上，则用八味汤加牛膝五味引而归之，归之之后，
则以归脾汤去木香，加肉桂五味子以调补之，每日早晨十补丸寒暑勿间也。如是调理
年余，不惟步履轻强，精神健旺，且喜更得一子，而骨格神气亦甚壮实，余见而甚喜，
谓太先生曰∶此小公郎实两年桂附之力也。
一汪姓儿年九岁，因惊痫屡发抽掣，语言不清，势甚危笃，来请余治，按其脉坚
弦，久而无力询其由，乃曰∶痘后未久，因跣足园中走动，忽脚面浮肿，疑其外染草露
之毒，乃服清凉解毒数剂，渐肿至腿，以为水肿，乃服五子五皮饮数剂，忽一日僵卧卒
倒，乃成惊痫之疾矣。余曰∶此非惊痫。痘后气血大虚，所以脚肿，误服清凉，乃肿至
腿，复加渗利削伐，所以虚火上乘，无故卒倒，犹大人中风症也。惟宜峻补气血，调益
中气，佐以舒经活络之药，乃用当归、白术、芍药、煨天麻、熟地黄、茯苓、牛膝、
金银花、秦艽、熟附子之类，三四剂后，其势稍缓，乃以前方冲人参汤调理一月而愈。
甚哉！用药之不可少误也。所云差之毫厘，失之千里，赵少辛形甚肥壮，而中气甚
虚，且年老乏嗣，所以心气既虚，而求子之念更切，其肾家真阴真阳亏损，不待言矣。
适夏日患疟，医者发散和解不愈，复以补中益气汤调补之，亦不应，发时寒热大作，喉
如鼾，脸红喘促，出多入少，其脉寸关豁大，而两尺甚微，势甚危困，而来延余治。
余曰∶谚云，少不可弱，老不可疟，益以少年欲火正旺，阴水愈亏耳。老年气血中气衰
微，不能任其大寒大热凌虐之状耳。况真阴真阳亏损，则犹树之无根矣。焉能当其疾风
暴雷，龙腾水涌之势耶！常多出其不意，一时暴绝，理直大补真阴真阳，仍佐下归敛纳
封藏之药。如八味加牛膝五味子为稳。若补中益气，恐益令孤阳上浮，阳亡于上，阴绝
于下，便有不测之患，况以阴亏阳损之躯，
而犯阴竭阴浮之病，复当阳浮阴耗之时，升浮之药，断非所宜。奈病家与医者，均以热
天热病，畏投桂附，补中益气，先哲良方，必欲进之，余甚怏怏而返，果服之后，喘促
愈加，夜半而逝。
山西翰院冯老先生，余之通谱老叔也。有三令孙年三岁，平时面色 白，囟门宽
大，颅骨开解，余劝以服药调理，叔以为无病忽之，未几随母归宁于外祖侍讲田老先生
家，无故一夜忽发微喘，不能睡倒，抱起稍可，至第二三日，虽抱起而喘急不减矣。渐
渐喘势愈凶，出多入少，两腿进急，乃即送回，招余视之，已知根本之病发作矣。理直
用病上疗下之法，恐以纯阳之子为执，不肯轻服是药，则无治法矣。不得已从权设词
云∶喘以多日，肺已虚矣。虚则补母，理之常也。宜以人参钱余，配生脉饮作汤，化服
启脾丸一大丸，当渐愈也。余急归寓，以八味丸杵作大丸代之，服后其喘日减一日，四
五日后喘症悉平，精神倍长，叔喜而索余之启脾丸方，余笑而不语，索之愈急，乃不得
已白之，叔甚骇异，复曰∶如果八味丸，我家藏尚有，可服之否？余曰∶方同力同，何
不可服，乃日以一钱五分生脉饮化服。如是两月，囟门与颅骨俱为长满矣。时二令孙滑
泄半载，肌肉瘦削，脾胃之药，备尝无效，乃出余视。余曰∶久痢不已，脾胃之中气固
虚，而肾家之下元更虚，闭藏之司失职矣。当勿事脾而事肾可也。亦以八味丸，用人参
炒老米，同煎汤化服，当自愈也。幸以余言是诺，照法服之，不一月而痊愈，可见用药
引子亦不可忽，同一八味，一用生脉饮，引至金木二脏而阴生，一用人参老米汤，引至
脾肾两家而阳生，奏功回别，故曰∶引子，古人因义命名，今人何罔顾名察义。
刑部郎王老先生，疝痛甚危，按其脉左，三脉弦洪而数，乃阴甚不足也。右关尺
洪大，而重按有力，此膏梁酒湿太过，房劳真水消亡，任其湿热下流，木失所养，筋无
所荣，湿热内攻，阴寒外遏，乃激其木性郁遏之火，所以为疼为胀之莫可忍也。余以熟
地二两、山茱山药各二钱。滋其肝肾，丹皮三钱、茯苓二钱、泽泻一钱五分，渗其湿
热，橘核三钱、疏其木郁，制附子一钱五分，盐酒炒褐色之，黄柏一钱二分，使寒药
为热药之向导，由是外寒散，内热除，真水生，雷火息，而疼胀乃瘳。
人身之腹中和暖，万物食入则化，清升浊降，气血冲和，百达调畅，可得长生者，
皆仗此丹田一点元阳运化，而为之也。若无一点元阳，则腹中冷矣，人不能以有生矣。
故夫感寒中寒直达于里者，以见里无火也。火即元阳也。书中并云∶即须温补，不可少
缓，以示元阳既亏，外寒复凑，几希之火，不急为温补以保之，则为阴寒所灭甚速耳。
奈何世人竟以风寒二字，连串称呼，认作外感有余之症，始而辛温发散，继而疏利开
豁，终以寒凉清理，不论阳风阴寒，不究邪正虚实，不详火之真假。如是治法习成故
套，不惟古人备药以卫生，今人用药以伤生，良可叹也。余治成章号唐友，忽然左足
左手骨节疼痛，渐至势如刀割，旦夕呼号，继而移至右手右足皆遍矣。医用祛风活络之
剂，而惧不效，见其口燥咽干，误作流火，投入凉药，幸而吐出，神气疲困，六脉洪
弦，延余视之，余曰∶要知筋骨中滋养充足，则血自荣于脉中，气自卫于脉外，继有
强邪，何能深入？今脂膏不足，筋骨失其养矣。血气久虚，荣卫失其职矣。试不思目得
血而能视，掌得血而能握，足得血而能步，人身上下大小，何物不仗此血？而各效乃
职。今无此血，则百职各废，任其虚火冲烁，愈疼而火愈升，愈升而疼愈甚，叫号伤
气，忍痛伤血，气血日伤，必至麻木瘫痪而后已。惟宜大用熟地、当归、白芍养血之药
为君，以金银花、秦艽风中之润药为臣，少借风势以达药力于筋骨，以牛膝、续断、杜
仲之类为佐，使以调筋骨忍痛受伤之所，更
用桂枝松节为引，以鼓舞药性横行于两臂，后疼势稍减，精神日疲，更加参术以固中培
元。如是调理半月之后，诸症渐轻，饮食渐进，更令早晨以生脉饮送八味丸之加牛膝、
杜仲、鹿茸、五味子者四五钱、日中仍服前剂，调理两月而始能步履，后以大补气血强
筋壮骨之药，以收全功，未几唐友令室，因日夜忱劳，亦患是症，六脉沉微，右手足疼
痛未儿，不流于左之肢节，而竟攻于里之胸脘，痞闷恶心，疼痛欲绝，余知其为内伤日
久、寒邪不为外达，而直中阴分矣。宜急温以保之，即用人参、白术各五钱、肉桂附子
各二钱，煎汁一钟，徐徐温服，夜半再服其渣，次早诊视，六脉少起，胸中之疼痛痞闷
已减大半，身有微热。而左略有疼之之意。余曰∶此阳气还表，寒邪外散之机也。照方
再服，内症渐平，惟有手足肢节疼楚，然亦不甚，余仍以参术补中之药为君，以归芍养
血之药为臣，以杜仲、断续、牛膝、秦艽、桂枝，外达舒筋活络为佐使。如是调理，不
月而愈，故于古方中求之。痛风止有五痹、皮痹、脉痹、肌痹、骨痹、筋痹，未闻有脏
腑之痹也。殊不知，《经》曰∶寒气胜者为痛痹。又曰∶其留连筋骨间者疼久，其留皮
肤间者易已，其入脏者死，可不慎与！
少司农王老先生孙女，年十三岁，因小便不通甚危，而延余治，时当初夏也。细问
其故，二三岁间，乳母恐其溺尿，切切醒戒，由是梦寐之中，以出小便为紧务，刻刻
在心，数年以来，日中七八次，夜中七八次，习以为常，渐有似淋非淋之象，年来益
甚，伊芳外舅颇知医道，以导赤利水之药投之，初服少应，久则反剧，点滴不通，故延
余治，诊其脉六脉洪数，久按无神，乃知梦寐惊恃，勉强小便，心肾久虚，又加常服利
水之药，真阴益槁，五脏既涸，津液何生？虽有气化之至，徒增胀闷之端，余以八味汤
加麦冬五味子取秋气降，白露生之意也。每剂熟地重用二两、连进二剂，使重浊以滋五
内之滋腴，为小便之张本，再进其渣，以探吐之，取其上窍既开，下窍自通，果连便数
次而愈。不意失于调理，一月之后正当盛暑，而其症复发，伊芳外祖悉以前进地黄汤二
用焦白术熬制成膏，稍微加入姜汁调和均匀做成丸药，少量用人参汤送服，幸好一二服药都没有吐出来，一会儿腹痛大便就通了。我暗自高兴地说：气机能下达，呕吐可以减轻了，早晨仍然用昨天煎好的方子加大剂量，冲入人参汤饮用，幸好也没有呕吐，像这样每天进两剂药，第一天人参用了一两多，第二天可以吃稀薄的米汤，三四天以后可以吃稀粥了，我才让他在早晨用人参五钱，做成生脉饮，送服八味丸，吃完粥后隔一段时间，仍然用去掉附子、加入牛膝、麦冬、五味子的八味丸，做成大剂量的药，冲入人参汤服用，申时酉时（下午3点到7点）按照前面的方子再服一剂，七八天后可能吃半碗饭了。后来用地黄汤和归脾汤加减，交替服用，调理了半个月多，各种症状逐渐消退，精神日益好转，饮食加倍于平常。
候选的杨老先生，吐血之后，大渴不止，两手寸脉洪大，关脉尺脉都弱，这是阴血突然亡失，脏腑失去滋养，所以津液干枯，阴火上炎，名叫血渴症。我用熟地黄三两、麦冬五钱、五味子一钱、附子二钱。浓煎成两碗代替茶水饮用。像这样一天三剂。才能止住口渴，而寸脉平和，渐渐想吃东西而痊愈。如果认为是胃火为患，胡乱使用石膏、栀子、黄芩、黄连，反而激发阴火上炎，耗竭津液，更加增加烦躁气喘口渴的祸患了，所以喻嘉言说：人能够长久享寿的，只依赖后天水谷之气，产生这些津液，津液凝结则生病，津液枯竭则死亡了。所以治病而不知道救护人的津液，真是庸医啊。
内阁部堂彭老先生的第二个孙子，年仅三岁，忽然有一天发热延请治疗，我看他虽然刚开始发热，但神气困倦，脉搏按之无力，肌肉苍白，面颊微红，身体虽然热但久按则温和，身上有微汗，已经知道禀赋最薄弱，外感轻而内伤重。医书说：外感少，内伤多的情况，只要补益其中气，增益其元气而邪气自然退去，不必攻伐邪气，无奈病家一定要发散解表，我不敢应命而退下。没想到我回去之后，他们家给他喝葱头汤半钟，用薄棉被盖住，让他邪气从汗解出。无奈从此出汗不止，四肢不能收持，面色青紫眼睛闭合，乳食不进，时刻咬紧牙关，有人以为是慢惊风，有人以为是慢脾风，都开了方子但不敢下药，都认为这是坏证了。所用的药都是天麻、胆星、钩藤、半夏、僵蚕等治惊风的药。我看后说：这些药不是用来治这个病的。这是先天本源已经不足，现在应当是外感少内伤多，按理应当温补的病症，却更用发汗法，那么阳气就要亡失了。所以四肢不能收持，僵硬躺着不醒，汗就是血，汗血溃散亡失，阴气耗竭了。牙齿属于肾阴，现在咬个不停，肾将要败坏了。急当在重滋肾水中，以补真阳，冲入人参汤，或许可以保全，否则断难有力挽救了。我用八味丸去掉附子加入牛膝、麦冬、五味子做成汤药，冲入人参三钱，无奈彭老先生怀疑药剂太大，孩子小不能承受，一定要减半，里面肉桂只四分，人参只一钱五分，我不得已勉强听从他的命令，服后竟然安然无恙，咬牙顿时停止，到了下半日，咬紧牙关的各种态势仍然发作，我说：这是药量小力量短的验证啊。于是让他把减少的那一半剂量补上，服后效果如回声般迅速，第二天病家胆子已壮，于是仍然照原方大剂量调服，三四天后，咬紧牙关完全停止，才开始手足能移动，口能吮吸乳汁，然而舌头还无力。像这样调理半月痊愈，可见内伤误认为外感，用葱汤薄被，几乎导致丧命，何况元神发散，克伐寒凉的呢？纯阳之子尚且如此，何况元阳残败的人呢！
总宪蒋老先生的第三个儿子，精神素来虚弱，才犯吐血阴亏的病症，调理初愈，忽然遇到天亮梦遗，又发生大口吐血不止，六脉沉细非常微弱。我说：梦遗俗名走阳，今天亮走阳，阳气更受伤了。大口吐血不止，又亡阳了。急用附子理中汤，去掉甘草投喂，无奈到口即吐，又用白通汤调和人尿给他也吐。京城里的医生遍请，所用的药不出四逆、理中、白通汤之类，无奈点滴水和药都不能受，沉困数日，上不能入，下不能出，虽然有良方妙药也无补益。恰好我的门人罗丹臣在寓所，进献西洋药酒一方，专门治疗关格吐逆的病症，我仔细察看它，里面都是一派纯阳的药，可以破除格拒阴盛的状况。况且里面用烧酒煎煮。凡诸水诸酒，都能吐出，唯独烧酒力猛卒烈，到口直透丹田，无可吐出的，立方的用心，可谓周到完备了。照方制服，竟然安然接受，从此参附峻补的药物，都能陆续渐进，调理而痊愈。如此良方不敢自秘，恭敬陈述其方在关格门内，希望尊重生命的人珍视它。
正蓝旗于太老先生，是谦恭仁厚的长者。向来担任刑部郎中，因为患偏枯的病症，右臂浮肿，或者麻木或者疼痛，两脚行走困难，于是退休回家静养，无奈继任者只有一人，而且早年出仕做官，太先生在家劳碌，并且待人接物，性情最多情，即使我在京城，很蒙受他的爱护，以致心神中气日渐虚弱，浮肿等症状，因循照旧，医生请教谒见，说是痰说是火说是风，无非清凉消克发散，我每次在旁边争辩说：脾虚不能健运，津液凝滞成为痰，而且水不归源，肾阴更加干枯，可以消导吗，脾阳不能充达四肢，以致手臂肿脚软麻木疼痛，可以发散吗，阴水不足，龙火上乘，真阳更加衰微，火不生土，以致脾肾都虚，可以寒凉吗，无奈太先生轻信术士的话，常常以身试药，一天忽然昏迷不醒，痰喘大汗，六脉沉微，于是催促我去诊脉，我说：中气久虚不为峻补，反而肆意克削，一旦水落石出，大虚的症状全现了。急为挽救，缓则无济于事。于是用人参六两、炒黄白术四两、生附子一只，去皮姜汁炒水煎一碗灌下去，汗渐渐收敛而脉渐渐起，痰喘定而神志才清醒，谨慎调补，一个月而痊愈，此后太先生才领悟至理。凡是痰因火上，就用八味汤加牛膝五味子引导而归之，归之之后，则以归脾汤去掉木香，加肉桂五味子来调补，每天早晨十补丸寒暑不间断。像这样调理年余，不但步履轻强，精神健旺，而且喜得一个儿子，而骨骼神气也很壮实，我看见很高兴，对太先生说：这个小公子确实是两年桂附的力量。
一个姓汪的孩子九岁，因为惊痫屡次发作抽搐，语言不清，形势非常危重，来请我治疗，按他的脉坚硬弦长，久而无力询问原因，他说：出痘后不久，因为光脚在园中走动，忽然脚面浮肿，怀疑是外染草露的毒，于是服清凉解毒几剂，渐渐肿到腿，以为是水肿，于是服五子五皮饮几剂，忽然一天僵硬躺着突然倒下，于是成了惊痫的疾病了。我说：这不是惊痫。出痘后气血大虚，所以脚肿，误服清凉药，于是肿到腿，再加渗利削伐，所以虚火上乘，无故突然倒下，就像大人中风症一样。只宜峻补气血，调益中气，佐以舒经活络的药，于是用当归、白术、芍药、煨天麻、熟地黄、茯苓、牛膝、金银花、秦艽、熟附子之类的药，三四剂后，形势稍缓，于是以前方冲人参汤调理一个月而痊愈。用药的不可少误啊！所说的差之毫厘，失之千里，赵少辛形体非常肥壮，而中气很虚，而且年老没有后代，所以心气既虚，而求子的念头更迫切，他的肾家真阴真阳亏损，不用说。适逢夏天患疟疾，医生发散和解不愈，再用补中益气汤调补，也不见效，发作时寒热大作，喉咙像打鼾，脸红气喘急促，出多入少，他的脉寸关豁大，而两尺非常微弱，形势非常危困，而来延请我治疗。我说：谚语说，少年不可弱，老年不可疟，加上少年欲火正旺，阴水更加亏损罢了。老年气血中气衰微，不能承受其大寒大热凌虐的状况。况且真阴真阳亏损，就像树没有根了。怎么能抵挡其疾风暴雷，龙腾水涌的态势呢！常常出其不意，一时暴绝，理应大补真阴真阳，仍佐以下行收敛封藏的药。如八味加牛膝五味子为稳妥。若用补中益气，恐怕更加令孤阳上浮，阳亡于上，阴绝于下，便有不测的祸患，何况以阴亏阳损的身体，而犯阴竭阴浮的病，又当阳浮阴耗的时候，升浮的药，断非适宜。无奈病家和医生，都以热天热病，畏惧投用桂附，补中益气是先哲良方，一定要进用，我很不高兴而返回，果然服后，气喘急促更加厉害，半夜而去世。
山西翰林院冯老先生，是我的同谱老叔。有三个孙子年仅三岁，平时面色苍白，囟门宽大，颅骨开解，我劝他服药调理，叔叔以为没病忽略它，不久随母亲回娘家侍奉外祖父侍讲田老先生家，无故一夜忽然发微喘，不能躺倒，抱起稍可缓解，到第二三天，虽然抱起而喘急不减了。渐渐喘势更凶，出多入少，两腿紧缩，于是立即送回，招我看诊，已经知道根本的病发作了。理应用病上疗下的方法，恐怕因为是纯阳之子固执，不肯轻服这种药，就没有治法了。不得已从权设词说：喘了好多天，肺已经虚了。虚则补母，是常理。应该用人参一两多，配生脉饮作汤，化服启脾丸一大丸，应当渐渐痊愈。我急忙回到寓所，用八味丸捣成大丸代替，服后他的喘一天天减少，四五天后喘症完全平息，精神倍增，叔叔高兴地向我要启脾丸方，我笑而不语，索要越急，不得已告诉他，叔叔非常惊异，又说：如果是八味丸，我家还有储藏，可以服用吗？我说：方同力同，为什么不可以服，于是每天用一钱五分生脉饮化服。像这样两个月，囟门与颅骨都长满了。当时第二个孙子滑泄半年，肌肉瘦削，脾胃的药，备尝无效，于是让我看诊。我说：久痢不已，脾胃的中气固虚，而肾家的下元更虚，闭藏的职能失职了。应当不要治脾而治肾也可以。也用八味丸，用人参炒老米，同煎汤化服，应当自愈。幸好依从我说的话，照法服用，不到一个月而痊愈，可见用药引子也不可忽视，同一八味丸，一个用生脉饮，引导至金木二脏而阴生，一个用人参老米汤，引导至脾肾两家而阳生，奏效区别很大，所以说：引子，古人因义命名，今人何不顾名思义。
刑部郎王老先生，疝痛非常危险，按他的脉左手三部脉弦洪而数，这是阴非常不足。右手关尺脉洪大，而重按有力，这是膏粱酒湿太过，房劳真水消亡，任由湿热下流，木失所养，筋无所荣，湿热内攻，阴寒外遏，于是激发其木性郁遏之火，所以为疼为胀的不可忍受。我用熟地黄二两、山茱萸山药各二钱。滋其肝肾，丹皮三钱、茯苓二钱、泽泻一钱五分，渗其湿热，橘核三钱，疏其木郁，制附子一钱五分，盐酒炒褐色，黄柏一钱二分，使寒药为热药的向导，由此外寒散，内热除，真水生，雷火息，而疼胀乃愈。
人身腹部中和暖，万物食入则化，清升浊降，气血冲和，百脉调畅，可得长生者，都仗此丹田一点元阳运化，而为之也。如果没有一点元阳，则腹中冷了，人不能生存了。所以感寒中寒直达于里的，是因为见到里没有火。火就是元阳。书中并说：即刻须温补，不可稍缓，以示元阳既亏，外寒复凑，微弱的火，不急为温补以保护它，则为阴寒所灭非常快。奈何世人竟以风寒二字，连串称呼，认作外感有余的病症，开始辛温发散，继而疏利开豁，终以寒凉清理，不论阳风阴寒，不究邪正虚实，不详火的真假。像这样的治法习成故套，不但古人备药以卫生，今人用药以伤生，实在可叹。我治疗成章号唐友，忽然左足左手骨节疼痛，渐渐到势如刀割，早晚呼号，继而移至右手右足都遍了。医生用祛风活络的药剂，而害怕不效，见他口燥咽干，误作流火，投入凉药，幸好吐出来，神气疲困，六脉洪弦，延我看诊，我说：要知道筋骨中滋养充足，则血自然荣于脉中，气自然卫于脉外，再有强邪，怎么能深入？现在脂膏不足，筋骨失去滋养了。血气久虚，营卫失职了。试不想眼睛得到血而能视，手掌得到血而能握，脚得到血而能步，人身上下大小，什么东西不仗此血？而各自效力尽职。现在没有此血，则百职各废，任由虚火冲烁，越疼而火越升，越升而疼越甚，叫号伤气，忍痛伤血，气血日伤，必至麻木瘫痪而后已。只宜大用熟地、当归、白芍养血药为君，以金银花、秦艽风中的润药为臣，少借风势以达药力于筋骨，以牛膝、续断、杜仲之类为佐，使以调筋骨忍痛受伤之所，更用桂枝松节为引，以鼓舞药性横行于两臂，后疼势稍减，精神日疲，更加参术以固中培元。像这样调理半月之后，诸症渐轻，饮食渐进，更让早晨用生脉饮送八味丸之加牛膝、杜仲、鹿茸、五味子的四五钱，日中仍服前剂，调理两个月才能步履，后用大补气血强筋壮骨的药，以收全功，不久唐友的妻子，因为日夜忧愁劳累，也患此症，六脉沉微，右手足疼痛不久，不流于左之肢节，而竟攻于里之胸脘，痞闷恶心，疼痛欲绝，我知道其为内伤日久、寒邪不为外达，而直中阴分了。宜急温以保之，即用人参、白术各五钱、肉桂附子各二钱，煎汁一钟，徐徐温服，半夜再服其渣，次早诊视，六脉稍起，胸中之疼痛痞闷已减大半，身有微热。而左边略有疼之意。我说：这是阳气还表，寒邪外散的机转。照方再服，内症渐平，惟有手足肢节疼楚，然而也不甚，我仍以参术补中之药为君，以归芍养血之药为臣，以杜仲、断续、牛膝、秦艽、桂枝，外达舒筋活络为佐使。像这样调理，不到一个月而愈，所以在古方中求之。痛风只有五痹、皮痹、脉痹、肌痹、骨痹、筋痹，未闻有脏腑之痹。殊不知，《内经》说：寒气胜者为痛痹。又说：其留连筋骨间者疼久，其留皮肤间者易已，其入脏者死，可不慎重吗！
少司农王老先生的孙女，十三岁，因为小便不通非常危险，而延请我治疗，当时是初夏。细问其原因，二三岁时，乳母怕她溺尿，切切醒戒，因此在梦寐之中，以出小便为紧急事务，刻刻在心，数年以来，白天七八次，夜里七八次，习以为常，渐渐有似淋非淋的现象，年来更甚，她的舅舅颇知医道，用导赤利水的药投喂，初服少应，久则反剧，点滴不通，所以延请我治疗，诊其脉六脉洪数，久按无神，才知道梦寐惊恃，勉强小便，心肾久虚，又加常服利水的药，真阴更加干枯，五脏既涸，津液何生？虽有气化之至，徒增胀闷之端，我用八味汤加麦冬五味子取秋气降，白露生的意思。每剂熟地黄重用二两、连进二剂，使重浊以滋五内的滋腴，为小便之张本，再进其渣，以探吐之，取其上窍既开，下窍自通，果然连便数次而愈。没想到失于调理，一月之后正当盛暑，而其症复发，她的外祖父悉以前进地黄汤二
Using scorched Atractylodis Rhizoma (Baizhu, 白术) boiled into a paste, slightly adding Ginger Juice (Jiangzhi, 姜汁) to mix evenly and form pills, swallowing with small amounts of Ginseng Decoction (Shen Tang, 参汤). Fortunately, after one or two doses, no vomiting occurred, and shortly thereafter, abdominal pain ceased and defecation took place. I secretly rejoiced, saying: "The Qi mechanism can now descend downward; vomiting should subside." In the morning, I still used the decoction from yesterday but in a larger dosage, mixed with Ginseng Decoction for drinking. Fortunately, there was also no vomiting. Like this, two doses were administered daily. On the first day, over one tael of Ren Shen (Ginseng, 人参) was used. By the second day, thin rice soup could be consumed, and after three to four days, thin porridge could be eaten. Only then did I instruct him to take five qian of Ren Shen (Ginseng, 人参) in the morning to make Sheng Mai Yin (Pulse-Generating Drink), to swallow Ba Wei Wan (Eight-Ingredient Pill), taken well after meals. Still using Ba Wei Wan (Eight-Ingredient Pill) with Fu Zi (Aconite Root, 附子) removed and Niu Xi (Achyranthes Root, 牛膝), Mai Dong (Ophiopogon Tuber, 麦冬), and Wu Wei Zi (Schisandra Fruit, 五味子) added, prepared as a large-dose decoction mixed with Ginseng Decoction. At Shen and You hours (3 PM to 7 PM), another dose according to the previous prescription was given. After seven or eight days, half a bowl of rice could be eaten. Later, Di Huang Tang (Rehmannia Decoction) and Gui Pi Tang (Spleen-Restoring Decoction) were modified and alternately taken for over half a month of regulation. Various symptoms gradually receded, spirit improved daily, and food intake doubled the usual amount.
Old Gentleman Yang, a candidate official, suffered from incessant great thirst after hematemesis (vomiting blood). The pulse at both Cun positions was surging (Hong, 洪), while Guan and Chi positions were weak. This indicated sudden loss of Yin Blood, causing organs and viscera to lose nourishment, leading to dryness and withering of body fluids, and flaming up of Ministerial Fire from Yin deficiency. This is named "Blood Thirst" (Xue Ke, 血渴). I used San liang of Shu Di Huang (Prepared Rehmannia Root, 熟地黄), five qian of Mai Dong (Ophiopogon Tuber, 麦冬), one qian of Wu Wei Zi (Schisandra Fruit, 五味子), and two qian of Fu Zi (Aconite Root, 附子). Boiled strongly into two bowls to be drunk instead of tea. Administered three doses per day like this. Only then could thirst stop, the Cun pulse become peaceful, appetite gradually return, and recovery ensue. If one mistakenly attributes this to Stomach Fire and recklessly uses Shi Gao (Gypsum Fibrosum, 石膏), Zhi Zi (Gardenia Fruit, 栀子), Huang Qin (Scutellaria Root, 黄芩), and Lian Qiao (Forsythia Fruit, 连翘 - *Note: Text says 芩连, usually Huang Qin and Huang Lian*), it would instead stimulate the flaming up of Ministerial Fire from Yin deficiency, deplete body fluids, and exacerbate irritability, panting, and thirst. Therefore, Yu Jiayan said: "Humans rely solely on the Qi of water and grain from the posterior heaven to generate these body fluids. If body fluids coagulate, disease arises; if body fluids are exhausted, death occurs." Thus, treating illness without knowing how to preserve human body fluids makes one truly an incompetent physician.
The second grandson of Old Gentleman Peng, a Cabinet Minister, was three years old when he suddenly developed fever and sought treatment. I observed that although he initially had a fever, his spirit was listless, his pulse was powerless upon pressure, muscles were pale white, cheeks were slightly red, his body was hot but felt warm upon prolonged pressing, and he had slight sweating. I already knew his constitution was extremely weak, with light external contraction and heavy internal injury. The medical texts state: "When external contraction is minor and internal injury major, only tonify the middle and benefit Qi, and the pathogenic factor will retreat naturally; there is no need to attack the pathogen." However, the family insisted on diaphoresis (sweating therapy). I dared not comply and withdrew. Unexpectedly, after my return, their family gave him half a cup of Scallion Head Decoction (Cong Tou Tang, 葱头汤) and covered him with a thin cotton quilt, intending to resolve the pathogen through sweating. Alas, since then, profuse sweating continued unceasingly, limbs became flaccid and unable to hold position, face turned cyan, eyes closed, milk and food were not accepted, teeth gnashing occurred constantly. Some diagnosed it as Slow Convulsion (Man Jing Feng, 慢惊风), others as Slow Spleen Wind (Man Pi Feng, 慢脾风). Prescriptions were made but drugs were not administered, all considering it a deteriorated condition. The medicines used were all Tian Ma (Gastrodia Rhizome, 天麻), Dan Xing (Arisaema with Bile, 胆星), Gou Teng (Uncaria Ramulus cum Uncis, 钩藤), Ban Xia (Pinellia Tuber, 半夏), and Jiang Can (Bombyx Batryticatus, 僵蚕)—medicines for the "Convulsion Gate". I examined him and said: "These medicines are not for treating this disease. This is due to insufficiency of the先天 (Constitutional Source). Now, with light external contraction and heavy internal injury, it should be treated with warming and tonifying. Instead, sweating was induced, leading to Yang collapse. Hence, limbs cannot hold position, lying stiffly unconscious. Sweat is blood; sweat and blood have溃散 (scattered and lost), Yin is exhausted. Teeth belong to Kidney Yin; now gnashing incessantly indicates Kidney is failing. Urgently, one must heavily nourish Kidney Water while supplementing True Yang, mixing in Ginseng Decoction, perhaps preserving life; otherwise, it is difficult to exert effort." I used Ba Wei Wan (Eight-Ingredient Pill) with Fu Zi (Aconite Root, 附子) removed, adding Niu Xi (Achyranthes Root, 牛膝), Mai Dong (Ophiopogon Tuber, 麦冬), and Wu Wei Zi (Schisandra Fruit, 五味子) as a decoction, mixed with three qian of Ren Shen (Ginseng, 人参). However, Old Gentleman Peng doubted the dosage was too large for a small child to bear and insisted on halving it. Gui Rou (Cinnamon Bark, 肉桂) was reduced to only four fen, and Ren Shen (Ginseng, 人参) to only one qian five fen. Reluctantly, I complied. After administration, he remained peaceful, and teeth gnashing stopped instantly. By the latter half of the day, the tendency to gnash teeth reappeared. I said: "This is evidence of insufficient dosage and weak potency." So I instructed him to make up the halved dose. After taking it, the effect was immediate. The next day, the family's courage strengthened, and they resumed the original large-dose prescription. After three to four days, teeth gnashing completely ceased, limbs and hands could move, and the mouth could suckle milk, though the tongue remained weak. Regulating like this for half a month led to recovery. It can be seen that mistaking internal injury for external contraction, using scallion soup and thin quilts, nearly caused death. How much more so for dispersing Yuan Shen (Primal Spirit) and using cold-cooling attacks? Even a pure-Yang child suffers thus, let alone one with depleted Primal Yang!
The third son of Chancellor Jiang, whose spirit was inherently weak, had just recovered from hematemesis due to Yin deficiency. Suddenly, experiencing nocturnal emission at dawn ("Zou Yang", 走阳), he suffered continuous severe hematemesis. The six pulses were deep, fine, and very faint. I said: "Nocturnal emission is vulgarly called 'Walking Yang'. Dawn emission injures Yang further. Continuous severe hematemesis causes Yang loss again." Urgently, I prescribed Fu Zi Li Zhong Tang (Aconite and Magnolia Root Decoction to Warm the Middle) with Gan Cao (Licorice Root, 甘草) removed. However, it was vomited immediately upon entering the mouth. Then Bai Tong Tang (White Conductor Decoction) mixed with human urine was given, but also vomited. Physicians throughout the capital were invited. Medicines used were within the categories of Si Ni Tang (Four Reversal Decoction), Li Zhong Tang (Magnolia Root Decoction to Warm the Middle), and Bai Tong Tang. Yet, even a drop of water or medicine could not be retained. Confined for several days, unable to ingest above or excrete below, good prescriptions and wonderful medicines were useless. Fortunately, my disciple Luo Danchen was present and proposed a Western medicinal wine formula specifically for Guan Ge (Obstruction and Rejection) with vomiting and regurgitation. Upon careful inspection, it consisted entirely of pure-Yang herbs capable of breaking through Yin excess rejecting Yang. Moreover, it used distilled spirits (Shao Jiu, 烧酒) for decoction. While most waters and wines cause vomiting, distilled spirits are fierce and penetrating, reaching the Dantian directly upon entry, leaving nothing to vomit. The formulation intent was thorough and complete. Following the prescription, he accepted it peacefully. From then on, strong tonics like Ren Shen (Ginseng, 人参) and Fu Zi (Aconite Root, 附子) could be gradually introduced, leading to recovery through regulation. Such a good prescription dare not keep secret; I respectfully present it in the Guan Ge section, hoping those who respect life will cherish it.
Old Gentleman Yu of the Plain Blue Banner, a man of humility and benevolence, formerly served as a Langzhong (Director) in the Ministry of Justice. He suffered from Pian Ku (Hemiplegia/Paralysis), with swelling in the right arm, alternating numbness and pain, and difficulty walking with both feet. He retired to rest quietly. However, having only one heir and having served early in life, Old Gentleman Yu labored at home, dealing with people and affairs, being very affectionate. Even when I was in the capital, I greatly benefited from his favor, causing my Heart Spirit and Middle Qi to decline daily. Swelling and other symptoms persisted unchanged. When physicians consulted, attributing the condition to Phlegm, Fire, or Wind, employing only cooling, resolving, attacking, and dispersing methods, I often argued beside him: "Spleen deficiency fails to transport and transform, causing body fluids to stagnate into Phlegm. Furthermore, water does not return to its source, drying Kidney Yin further. Can it be resolved? Spleen Yang fails to reach the limbs, causing arm swelling and leg softness, numbness, and pain. Can it be dispersed? Insufficient Yin Water allows Dragon Fire to ascend, weakening True Yang. Fire fails to generate Earth, making both Spleen and Kidney deficient. Can it be cooled?" Unfortunately, Old Gentleman Yu lightly listened to fortune tellers' words, frequently testing medicines on himself. One day, he suddenly fell into coma, with Phlegm-wheezing and profuse sweating. The six pulses were deep and faint. He urged me to diagnose. I said: "Middle Qi has been deficient for long; instead of strong tonification, aggressive draining was used. Now that turbidity clears, the full extent of Great Deficiency is revealed. Urgent rescue is needed; delay renders it futile." I used six liang of Ren Shen (Ginseng, 人参), four liang of Chao Huang Bai Zhu (Stir-fried Yellow Atractylodis Rhizoma, 炒黄白术), and one raw Fu Zi (Aconite Root, 附子), peeled and stir-fried with Ginger Juice, decocted in water to one bowl, and灌 (forced down). Sweating gradually stopped, pulse rose, Phlegm-wheezing settled, and consciousness cleared. Careful tonification led to recovery in one month. Thereafter, Old Gentleman Yu finally understood the profound truth. Whenever Phlegm arises from Fire, use Ba Wei Wan (Eight-Ingredient Pill) with Niu Xi (Achyranthes Root, 牛膝) and Wu Wei Zi (Schisandra Fruit, 五味子) to guide it back. After guiding it back, use Gui Pi Tang (Spleen-Restoring Decoction) with Mu Xiang (Aucklandia Root, 木香) removed, plus Gui Rou (Cinnamon Bark, 肉桂) and Wu Wei Zi (Schisandra Fruit, 五味子) for regulation. Every morning, take Shi Bu Wan (Ten-Tonifying Pill) without interruption by cold or heat. Regulating like this for over a year, not only did walking become light and strong, and spirit robust, but he also happily gained another son, with strong bones and vigorous spirit. Seeing this, I rejoiced and said to Old Gentleman Yu: "This young master is indeed the result of two years of Gui Rou (Cinnamon Bark, 肉桂) and Fu Zi (Aconite Root, 附子)."
A nine-year-old boy surnamed Wang suffered from frequent convulsions due to Jing Xian (Startling Epilepsy), with unclear speech, in critical condition. Seeking my treatment, his pulse was firm, wiry, and long, becoming powerless over time. Inquiry revealed: shortly after smallpox, he walked barefoot in the garden, and his instep suddenly swelled. Suspecting external poisoning from grass dew, he took several doses of cooling and detoxifying herbs. Swelling spread to the legs. Diagnosed as Edema (Shui Zhong, 水肿), he took several doses of Wu Zi Wu Pi Yin (Five Seeds and Five Skins Decoction). Suddenly, one day he lay stiffly and collapsed, developing Startling Epilepsy. I said: "This is not Startling Epilepsy. After smallpox, Qi and Blood are severely deficient, causing foot swelling. Mistaken use of cooling herbs caused swelling to spread to legs. Further diuretic and draining treatments led to Deficient Fire flaming upward, causing sudden collapse without cause, similar to Stroke in adults." Only strong tonification of Qi and Blood, regulating Middle Qi, assisted by herbs to soothe meridians and activate collaterals is suitable. I used Dang Gui (Angelica Sinensis Root, 当归), Bai Zhu (Atractylodis Rhizoma, 白术), Shao Yao (Peony Root, 芍药), Wei Tian Ma (Stir-fried Gastrodia Rhizome, 煨天麻), Shu Di Huang (Prepared Rehmannia Root, 熟地黄), Fu Ling (Poria, 茯苓), Niu Xi (Achyranthes Root, 牛膝), Jin Yin Hua (Lonicera Flower, 金银花), Qin Jiao (Gentiana Macrophylla Root, 秦艽), and Shu Fu Zi (Prepared Aconite Root, 熟附子). After three to four doses, the condition eased. Then, continuing the previous prescription mixed with Ginseng Decoction for one month of regulation led to recovery. Ah, how crucial medication errors are! As the saying goes: "A miss is as good as a mile." Zhao Shaoxin was very fat but had very weak Middle Qi. Being old and childless, his Heart Qi was deficient, and his desire for offspring was intense. His Kidney's True Yin and True Yang were undoubtedly damaged. In summer, he contracted Malaria. Diaphoretic and harmonizing treatments failed. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) for tonification also failed. During attacks, severe chills and fever occurred, throat sounded like snoring, face was red, panting was rapid, exhalation exceeded inhalation. Pulse at Cun and Guan was hollow and large, while Chi positions were very faint. Condition was critical, prompting him to seek my treatment. I said: "Proverb says: Youth should not be weak, elderly should not have malaria. Added to this, youthful lust fire is旺盛 (vigorous), further depleting Yin Water. Elderly Qi, Blood, and Middle Qi are declining, unable to withstand severe cold and heat assault. Moreover, damage to True Yin and True Yang is like a tree without roots. How can it withstand violent storms and surging waters? Often dying suddenly by surprise. Principle dictates strongly tonifying True Yin and True Yang, assisted by herbs that descend, gather, and store. Ba Wei Wan (Eight-Ingredient Pill) with Niu Xi (Achyranthes Root, 牛膝) and Wu Wei Zi (Schisandra Fruit, 五味子) is stable. Using Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) might cause Lone Yang to float upward, Yang collapsing above, Yin severing below, leading to unpredictable disaster. Especially for a body with Yin deficiency and Yang damage, suffering from Yin exhaustion and floating Yin, during a time of Yang floating and Yin consumption, ascending and floating herbs are definitely inappropriate. Unfortunately, the family and doctors, citing hot weather and hot disease, feared using Gui Rou (Cinnamon Bark, 肉桂) and Fu Zi (Aconite Root, 附子). Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is a worthy prescription of sages, insisting on its use. I returned very displeased. Indeed, after taking it, panting worsened, and he passed away at midnight."
Old Gentleman Feng of Shanxi Hanlin Academy, my elder uncle of the same lineage, had three grandsons aged three. Usually, their faces were pale white, fontanels wide, skull sutures open. I advised medication for regulation, but the uncle dismissed it as illness-free. Soon, accompanying his mother to visit her parents' home, where Grandfather Tian, a Lecturer, resided, he suddenly developed mild wheezing overnight, unable to lie down. Holding him helped slightly. By the second or third day, even holding him did not reduce wheezing. Gradually, wheezing worsened, exhalation exceeded inhalation, legs drew up tightly. Immediately sent back, summoning me. I knew the root disease had manifested. Principle dictates treating upper disease via lower method. Fearing the uncle would refuse such strong medicine for a pure-Yang child, leaving no treatment, I reluctantly devised an excuse: "Wheezing for many days means Lung is deficient. Deficiency requires tonifying the Mother, which is normal principle. Use over one qian of Ren Shen (Ginseng, 人参) paired with Sheng Mai Yin (Pulse-Generating Drink) as decoction, dissolving one large pill of Qi Pi Wan (Spleen-Initiating Pill). Should gradually improve." I hurried back to residence, using Ba Wei Wan (Eight-Ingredient Pill) pounded into large pills instead. After taking it, wheezing decreased daily. By four or five days, wheezing completely subsided, spirit doubled. Uncle happily asked for my Qi Pi Wan (Spleen-Initiating Pill) prescription. I smiled silently. Pressed harder, I reluctantly told him. Uncle was shocked, then said: "If it is Ba Wei Wan (Eight-Ingredient Pill), we have some stored at home. Can we use it?" I said: "Same prescription, same potency, why not?" So, daily, one qian five fen of Sheng Mai Yin (Pulse-Generating Drink) was used to dissolve it. Like this for two months, fontanel and skull sutures grew completely filled. At that time, the second grandson suffered diarrhea for half a year, muscles emaciated. Spleen-Stomach medicines tried in vain. Let me examine. I said: "Chronic dysentery implies Spleen-Stomach Middle Qi is deficient, and Kidney Lower Yuan is even more deficient. The function of closure and storage has failed. Should treat Kidney rather than Spleen." Also used Ba Wei Wan (Eight-Ingredient Pill), with Ren Shen (Ginseng, 人参) and roasted old rice, decocted together, dissolved in the soup, expecting self-recovery. Fortunately, he followed my advice. Taking according to method, recovered in less than a month. It can be seen that drug guides (Yin Zi, 引子) cannot be ignored. Same Ba Wei Wan (Eight-Ingredient Pill): one uses Sheng Mai Yin (Pulse-Generating Drink) to guide to Metal and Wood organs, generating Yin; one uses Ren Shen (Ginseng, 人参) and old rice soup to guide to Spleen and Kidney, generating Yang. Effects differ greatly. Thus: "Guide," ancients named based on meaning. Why do moderns ignore names and meanings?
Langzhong (Director) Wang of the Ministry of Justice suffered severe Hernia Pain (Shan Tong, 疝痛). Palpating his left pulse: three positions were wiry, surging, and rapid, indicating severe Yin insufficiency. Right Guan and Chi pulses were surging and large, forceful upon deep pressure, indicating excessive rich food, alcohol, and dampness. Sexual fatigue depleted True Water. Allowing Damp-Heat to flow downward, Wood lost nourishment, sinews lost prosperity. Damp-Heat attacked internally, Cold-Yin obstructed externally, stimulating郁遏 (stagnant) Fire of Wood nature, causing unbearable pain and distension. I used Er liang of Shu Di Huang (Prepared Rehmannia Root, 熟地黄), Shan Zhu Yu (Cornus Fruit, 山茱萸) and Shan Yao (Dioscorea Rhizome, 山药) each two qian to nourish Liver and Kidney. Dan Pi (Moutan Cortex, 牡丹皮) three qian, Fu Ling (Poria, 茯苓) two qian, Ze Xie (Alisma Rhizome, 泽泻) one qian five fen to drain Damp-Heat. Ju He (Tangerine Seed, 橘核) three qian to soothe Wood stagnation. Zhi Fu Zi (Processed Aconite Root, 制附子) one qian five fen, stir-fried with salt wine until brown. Huang Bo (Phellodendron Bark, 黄柏) one qian two fen, making cold herbs guides for hot herbs. Thus, external Cold scattered, internal Heat removed, True Water generated, Thunder Fire extinguished, pain and distension healed.
The abdomen of the human body is warm and neutral. Food enters and transforms, Clear rises, Turbid descends, Qi and Blood harmonize, hundred vessels regulate smoothly, achieving longevity relies on this single point of Yuan Yang (Primal Yang) in the Dantian driving transformation. Without this point of Yuan Yang (Primal Yang), the abdomen becomes cold, and humans cannot survive. Thus, contracting Cold or being struck by Cold reaching the interior indicates lack of Fire inside. Fire is Yuan Yang (Primal Yang). The book also states: "Immediately require warming and tonification, do not delay slightly," showing that once Yuan Yang (Primal Yang) is deficient and External Cold gathers, the faint fire must be urgently warmed and tonified to protect it, otherwise it is quickly extinguished by Yin Cold. Why do people today link "Wind-Cold" together, mistaking it for an Excess External Contraction syndrome? Starting with Acrid-Warm diaphoretics, then draining and opening, finally clearing with Cold-Cooling. Regardless of Yang-Wind or Yin-Cold, investigating neither Pathogenic vs. Healthy nor Excess vs. Deficiency, detailing not the true/false nature of Fire. Such treatment methods become habitual routines. Not only do ancients prepare medicines to protect health, but moderns use medicines to harm life. Truly lamentable. I treated Tang You of Zhangcheng Hao. Suddenly, left foot and left hand joints hurt, gradually becoming like knife-cutting, crying day and night. Then moved to right hand and right foot. Doctors used Wind-dispelling and Collateral-unblocking agents, fearing ineffectiveness. Seeing dry mouth and throat, mistakenly diagnosing Liu Huo (Flowing Fire), they administered Cold medicines. Fortunately, he vomited them out. Spirit weary, six pulses surging and wiry. Seeking my examination, I said: "Know that if nourishment in sinews and bones is sufficient, Blood naturally prospers in vessels, Qi naturally guards outside vessels. With strong pathogens, how can they penetrate deeply? Now, fat and marrow are insufficient, sinews and bones lose nourishment. Qi and Blood long deficient, Ying and Wei fail duties. Consider: Eyes see with Blood, palms grasp with Blood, feet walk with Blood. What part of the body does not rely on this Blood to perform its functions? Now lacking this Blood, all functions fail.任由 (Letting) Deficient Fire surge and scorch, the more painful, the higher Fire rises; the higher it rises, the worse the pain. Crying harms Qi, enduring pain harms Blood. Qi and Blood daily injured, inevitably leading to numbness and paralysis." Only strongly using Shu Di Huang (Prepared Rehmannia Root, 熟地黄), Dang Gui (Angelica Sinensis Root, 当归), and Bai Shao (White Peony Root, 白芍) as Blood-nourishing Sovereigns, with Jin Yin Hua (Lonicera Flower, 金银花) and Qin Jiao (Gentiana Macrophylla Root, 秦艽) as Moisten Wind Ministers, borrowing Wind momentum to deliver drug power to sinews and bones, assisted by Niu Xi (Achyranthes Root, 牛膝), Xu Duan (Dipsacus Root, 续断), Du Zhong (Eucommia Bark, 杜仲) to adjust sinews and bones enduring pain/injury, further using Gui Zhi (Cinnamon Twig, 桂枝) and Song Jie (Pine Joint, 松节) as Guides to encourage drug properties moving horizontally in arms. Afterwards, pain decreased slightly, spirit daily fatigued, adding Ren Shen (Ginseng, 人参) and Bai Zhu (Atractylodis Rhizoma, 白术) to solidify Middle and cultivate Origin. Regulating like this for half a month, symptoms gradually lightened, diet gradually advanced. Further instructed to take four or five qian of Ba Wei Wan (Eight-Ingredient Pill) with added Niu Xi (Achyranthes Root, 牛膝), Du Zhong (Eucommia Bark, 杜仲), Lu Rong (Deer Antler Velvet, 鹿茸), and Wu Wei Zi (Schisandra Fruit, 五味子) in Sheng Mai Yin (Pulse-Generating Drink) every morning, continuing previous prescription at noon. Regulating for two months allowed walking. Later, using strong Qi-Blood tonifying and Sinew-Bone strengthening medicines completed the cure. Soon, Tang You's wife, due to day-night worry and labor, also suffered this syndrome. Six pulses deep and faint. Right hand and foot pain soon did not flow to left joints but attacked inner chest and epigastrium, stuffiness, nausea, unbearable pain. Knowing it was long-term internal injury, Cold pathogen not exteriorized but directly striking Yin divisions, urgent warming to protect is needed. Immediately used Ren Shen (Ginseng, 人参) and Bai Zhu (Atractylodis Rhizoma, 白术) each five qian, Rou Gui (Cinnamon Bark, 肉桂) and Fu Zi (Aconite Root, 附子) each two qian, decocted to one cup, slowly taken warm. Half-night, dregs taken again. Next morning diagnosis: six pulses slightly rose, chest pain and stuffiness reduced by more than half, body had slight heat. Left side had slight pain tendency. I said: "This is Yang Qi returning to exterior, Cold pathogen dispersing outward. Continue prescription." Internal symptoms gradually leveled, only limb joint pain remained, not severe. I still used Ren Shen (Ginseng, 人参) and Bai Zhu (Atractylodis Rhizoma, 白术) as Sovereigns to tonify Middle, Dang Gui (Angelica Sinensis Root, 当归) and Bai Shao (White Peony Root, 白芍) as Ministers to nourish Blood, Du Zhong (Eucommia Bark, 杜仲), Xu Duan (Dipsacus Root, 续断), Niu Xi (Achyranthes Root, 牛膝), Qin Jiao (Gentiana Macrophylla Root, 秦艽), and Gui Zhi (Cinnamon Twig, 桂枝) as Assistants and Envoys to exteriorly reach, soothe sinews, and activate collaterals. Regulating like this, recovered in less than a month. Thus seeking in ancient prescriptions. Gout only has Wu Bi (Five Obstructions): Pi Bi (Skin Obstruction), Mai Bi (Vessel Obstruction), Ji Bi (Muscle Obstruction), Gu Bi (Bone Obstruction), Jin Bi (Sinew Obstruction). Never heard of Zang-Fu Obstruction. Little do they know, *Jing* (Classic) says: "Cold Qi prevailing causes Pain Obstruction." Also: "Remaining between sinews and bones causes long pain; remaining in skin easily heals; entering Zang leads to death." Can one not be cautious!
Granddaughter of Shaonong (Minister of Agriculture) Wang, aged thirteen, suffered critically from urinary retention, seeking my treatment. It was early summer. Detailed inquiry revealed: between ages two and three, wet nurse feared bedwetting, strictly warned her. Thus, in dreams, urination became urgent, constantly in mind. For years, seven to eight times day, seven to eight times night, becoming habit. Gradually resembling strangury but not quite. Worsening yearly. Her maternal uncle knew medicine somewhat, administering Dao Chi San (Guide Out the Red Powder) and diuretics. Initially slight response, later worsened. Droplets blocked. Hence seeking treatment. Pulse: six positions surging and rapid, powerless upon long pressing. Realized dream anxiety and forced urination caused long-term Heart-Kidney deficiency. Plus constant diuretic use, True Yin further dried. Five Zang dried, how can body fluids generate? Though Qi transformation exists, only increasing bloating. I used Ba Wei Wan (Eight-Ingredient Pill) with Mai Dong (Ophiopogon Tuber, 麦冬) and Wu Wei Zi (Schisandra Fruit, 五味子), taking meaning of Autumn Qi descending and White Dew generating. Each dose heavily used Er liang of Shu Di Huang (Prepared Rehmannia Root, 熟地黄). Continued two doses, letting heavy/turbid substances nourish five Zang, laying foundation for urination. Then drank dregs to induce vomiting, taking advantage that opening upper orifice opens lower orifice. Indeed, urinated several times and recovered. Unexpectedly, lacking regulation, one month later in peak summer, symptoms recurred. Her grandfather used previous Di Huang Tang (Rehmannia Decoction)...