钱塘魏玉璜之 ，《续名医类案》六十卷，世无刊本，余从文澜阁借四库本录一部，凡六十
六万八千余言，采取繁富，间有辨论，亦皆精当。玉璜自述医案数十，其治病尤长于胁痛
，（肝燥）、胃脘痛（肝木上乘）、疝瘕等证，谓医家治此，每用香燥药，耗竭肝阴，往往初服
小效，久则致死，乃自创一方，名一贯煎，统治胁痛、吞酸吐酸、疝瘕，及一切肝病，惟因
痰饮者不宜，方用沙参、麦冬、地黄、归身、枸杞子、川楝子，六味出入加减，投之应如桴
鼓。口苦燥者，加酒连尤捷。余仿其法治此数证，获效甚神，特表其功用，以告世之误用香燥药者。
（炳章）按∶凡痰瘀袭络胁痛，肝郁血瘀，痰凝疝瘕，宜用叶氏辛润通络法，合金铃子散
，为最效，以通化为要，此方粘补，恐非所宜。
《程杏轩医案》，历叙生平治验，颇有心得。惟治张汝功之女暑风，用葛根、防风等药
，遂致邪陷心包，神昏肢厥，旋用清络热开里窍之剂，而势益剧，变成痉证而殁。因谓暑入心包
，至危至急，不可救药，而不知暑风大忌辛温升散，其初方用葛根、防风，劫耗阴津，遂致
热邪入里，观此可见学医之难。忆道光癸巳仲秋，三弟以灏，年十五，患伏暑症，初见发热
恶寒头痛，延同里某医治之，某医宿负盛名，诊视匆遽，误为感寒，用桂枝、葛根、防风等
药二剂，而神昏肢冷，余时方自郡城归，更延茅平斋治之，以为热邪入里，用生地、元参、
银花、连翘、竹叶等味，竟不能痊，人皆归咎于茅，而不知实误于某也。并记于此，以明学
医之宜慎焉。
（炳章）按∶暑温暑风，伏热在内，皆忌辛温升散，劫耗阴津，苟误用之，邪必内陷入里
，非寒在表内无热之伤寒可比。
钱塘人魏玉璜编纂的《续名医类案》共六十卷，当时世上没有刻印版本，我从文澜阁借来四库全书本抄录了一部，全书共六十六万余字，内容采择丰富，其中夹杂的一些辨析议论，也都精当恰当。魏玉璜自述其医案数十则，他治疗疾病尤其擅长胁痛（肝阴不足导致肝体失养）、胃脘痛（肝气横逆侵犯脾胃）以及疝瘕等病证。他认为医生治疗这些病症，往往使用香燥类药物，这会耗竭肝阴，通常刚开始服用时效果微小，时间久了反而会导致死亡。于是他自创一方，名为一贯煎，统治胁痛、吞酸吐酸、疝瘕以及一切肝病，只有因痰饮引起的才不适用。方药组成包括沙参、麦冬、地黄、当归身、枸杞子、川楝子，这六味药根据病情出入加减，服用后疗效迅速，如同鼓槌击鼓般应验。若伴有口苦、口干者，加入酒炒黄连尤为快捷有效。我模仿他的方法治疗这几类病证，获得非常神奇的疗效，特此表彰其功用，以此告诫世间那些误用香燥药物的医者。
（炳章）按语：凡是痰瘀阻滞经络导致的胁痛，肝郁血瘀，痰凝形成的疝瘕，适宜采用叶天士的辛润通络法，配合金铃子散，最为有效，以疏通化为关键。一贯煎性质黏腻滋补，恐怕并不适宜此类病症。
《程杏轩医案》，详细叙述了他生平的治疗经验，颇有心得。但是他在治疗张汝功之女的中暑风证时，使用了葛根、防风等药物，致使邪气陷入心包，出现神志昏迷、四肢厥冷，随后虽然改用清解络热、开通里窍的药物，但病情更加严重，最终变成痉证而死亡。因此他认为暑邪侵入心包，是至危至急、不可救药的病症，却不知道“暑风”大忌使用辛温升散的药物，起初方剂中使用葛根、防风，劫夺耗伤阴津，致使热邪入里。从这件事可以看出学习医学之难。回忆道光癸巳年仲秋时节，我的三弟以灏，年仅十五岁，患伏暑症，初起表现为发热、恶寒、头痛，延请同乡某位医生治疗。这位医生素负盛名，诊视匆忙草率，误认为是感寒，使用了桂枝、葛根、防风等药物两剂，结果导致患者神志昏迷、四肢冰冷。我当时刚从郡城回来，又延请茅平斋诊治，认为这是热邪入里，使用了生地、元参、银花、连翘、竹叶等药物，竟然未能痊愈。人们都归咎于茅平斋，却不知道实际上是误在先前的那位医生。一并记录在此，以阐明学医应当谨慎的道理。
（炳章）按语：暑温和暑风，伏热在内，都忌讳使用辛温升散的药物，以免劫夺耗伤阴津。如果误用，邪气必定内陷深入，这与寒邪在体表且内部无热的伤寒病不可相提并论。
Wei Yuhuang of Qiantang compiled the *Xu Mingyi Leian* (Continued Cases of Famous Physicians), consisting of sixty volumes. At that time, there was no printed edition in the world. I borrowed a copy from the Siku Quanshu collection at the Wenlan Pavilion and transcribed it. The work contains over 668,000 characters, with extensive citations and occasional critical discussions, all of which are precise and appropriate. Wei Yuhuang recorded dozens of his own medical cases. He was particularly skilled in treating hypochondriac pain (hypochondriac pain due to Liver dryness), epigastric pain (epigastric pain due to Liver Wood overacting on Stomach Earth), and hernia masses (hernia and abdominal masses). He stated that physicians often use aromatic-dry herbs to treat these conditions, which depletes Liver Yin. Initially, there might be a slight effect, but long-term use can lead to death. Therefore, he created a formula named *Yiguan Jian* (One-Glance Decoction) to treat hypochondriac pain, acid regurgitation, hernia masses, and all Liver diseases, except those caused by Phlegm-Fluid retention. The formula consists of *Shashen* (Adenophorae Radix), *Maidong* (Ophiopogonis Tuber), *Dihuang* (Rehmanniae Radix), *Guishen* (Angelicae Sinensis Radix), *Gouqizi* (Lycii Fructus), and *Chuanlianzi* (Meliae Toosendan Fructus). These six herbs are modified according to the condition. The therapeutic effect is immediate, like striking a drum. If accompanied by bitter taste and dry mouth, adding *Jiu Lian* (Coptidis Rhizoma processed with wine) is especially effective. I imitated his method to treat these conditions and achieved miraculous results. I hereby highlight its efficacy to warn physicians against the misuse of aromatic-dry herbs.
(Bingzhang) Commentary: For hypochondriac pain caused by Phlegm-Stasis obstructing collaterals, Liver Qi stagnation with Blood stasis, and hernia masses formed by Phlegm coagulation, Ye Tianshi’s method of acrid-moistening unblocking collaterals combined with *Jinlingzi San* (Golden Bell Powder) is most effective, emphasizing unblocking and transforming. *Yiguan Jian* is sticky and tonifying, which is likely unsuitable for such cases.
The *Cheng Yanxuan Yi'an* (Medical Cases of Cheng Yanxuan) details his clinical experiences, showing considerable insight. However, when treating the daughter of Zhang Rugong who suffered from Summerheat-Wind (Summerheat pathogen causing wind-stroke symptoms), he used *Gegen* (Puerariae Lobatae Radix) and *Fangfeng* (Saposhnikoviae Radix). This caused the pathogen to sink into the Pericardium, resulting in coma and cold limbs. Although he subsequently used formulas to clear collateral heat and open the orifices, the condition worsened, leading to convulsions and death. He concluded that Summerheat entering the Pericardium is extremely critical and incurable. However, he failed to realize that Summerheat-Wind strictly contraindicates acrid-warm ascending and dispersing herbs. The initial use of *Gegen* and *Fangfeng* depleted Yin fluids, allowing Heat pathogens to enter the interior. This illustrates the difficulty of learning medicine. Recalling the mid-autumn of the Gui-Si year of the Daoguang era, my third brother, Yihao, aged fifteen, suffered from latent Summerheat syndrome. Initial symptoms included fever, aversion to cold, and headache. A local physician, renowned for his reputation, examined him hastily and misdiagnosed it as Cold invasion. He prescribed two doses of *Guizhi* (Cinnamomi Ramulus), *Gegen*, and *Fangfeng*. Consequently, the patient developed coma and cold limbs. I had just returned from the prefectural city and invited Mao Pingzhai to treat him. Mao diagnosed Heat pathogens entering the interior and prescribed *Dihuang* (Rehmanniae Radix), *Yuanshen* (Scrophulariae Radix), *Yinhua* (Lonicerae Japonicae Flos), *Lianqiao* (Forsythiae Fructus), and *Zhuye* (Bambusae Folium). The patient did not recover. People blamed Mao Pingzhai, unaware that the error originated with the first physician. I record this to emphasize the necessity of caution in studying medicine.
(Bingzhang) Commentary: Both Summerheat-Warmth and Summerheat-Wind involve latent Heat within, and both strictly contraindicate acrid-warm ascending and dispersing herbs to avoid depleting Yin fluids. Misuse causes the pathogen to sink deeply into the interior, which is incomparable to Exterior-Cold Shaoyang disease where there is no internal Heat.