德于乡闾者也。着有《脉法须知》三卷，咸丰五年，其同里计二田上舍光昕，为锓板以传，
贻余读之，盖荟萃诸家之说，而出之以精确，非积学有得者不能也。其《问法要略》一篇，
语约而意详，胜于张景岳之十问，备识于此。入国问俗，入家问讳，上堂问礼，临病问便，慎
之至也。问男女老幼贵贱，得病何日，
受病何从，饮食便利，情怀劳逸，今昔何如，曾服何药，日夜起居，寤寐有无，痰嗽呕嗳，
胀闷汗渴烦悸，头目耳鼻口咽喉胸胁腰背腹痛，手掌冷热，喜恶寒热，膝酸足肿，曾患何疾
，疮伤中毒，痞血病久，或汗下过伤，所嗜何味何物，或纵酒，或长斋，或房室，或泄滑，
问妇女月水，有孕果动否。寡妇室女，气血凝滞，两尺多滑，非胎也。心腹痛当问新久，懒
言惟点头，中气虚也，昏愦不知人，或暴厥，或久病，妇人僵厥，多中气，宜辨之。小便黄
赤为湿热，清之渗之，小便色白，无热也，不可治热，利则气顺，涩则痰滞，重坠牵掣为虚
，烦闷拘急为实，喜热恶利为虚，喜利恶热为实。
嘉善名医俞东扶先生震，《古今医案按》十卷，乾隆四十三年自序刊行，其书选择简严
，论
说精透，可为医林圭臬，惜坊间流传甚少，道光时，重修《嘉兴府志·方技门》，不为先生
立传，撰述志亦不载此书，缺点也。其书甚推尊叶氏，所录治案，多《临证指南》所未载，
卷三痢门有曰∶嘉善一妪，常便血，时发时止，至五旬外，夏月便鲜血，里急后重，时或不
禁，脉软不数，用五苓、建中转甚。因向宜凉血药，仍以四物加槐、榆、楂、曲，亦无效。
叶天士先生以生苍术、生浓朴、炒陈皮、炙甘草、鸡内金、砂仁壳、丁香柄丸服全愈。又有
一童子久痢，叶亦用此方全愈。人不解其故，震读徐春圃《医统》，因见此方，名醉乡玉屑
，治小儿食瓜果致痢，久不愈，乃服先生之典博也云云。余尝以此方加车前子、泽泻治食伤
水泻，亦多获效。
吴恕《伤寒指掌》十卷，见殷方叔《医藏目录》。皇甫中《伤寒指掌》十四卷，见《四
库全
书》医家类存目。二书皆少传本，嘉庆初，苕南吴坤安（贞），又着《伤寒指掌》四卷，以南
方近日之伤寒，大半属于温热，治法与伤寒不侔，伤寒入足经，而温邪兼入手经，伤寒宜表
，而温邪忌汗，伤寒药宜辛温，而温邪药宜辛凉，苟不辨明，必有误治，故其书既述六经本
病，而特参以温热立论，兼及类伤寒之症，先古法，后新法，条分缕晰，既精且详，余从乌
程邵蔼人茂才楠借录一部，为蔼人之尊人仙根先生所评择，阐发曲畅，令阅者心开目明。仙根
先生治病二十余年，屡拯危笃，盖得力于此书为多。
本朝医学极盛，医书亦大备，伤寒之书，喻嘉言（《尚论篇》）、柯韵伯（《来苏集》）、
王晋
三（《古方选注》）俱独出手眼，直抉心源，伤寒六经兼诸症，柯氏发其端，温热等病究三焦
，叶氏宣其旨，苕南吴坤安荟萃群言，勒为成书（《伤寒指掌》），而伤寒之学无余蕴矣。杂
病之书，首称叶天士（《临证指南》），而张石顽（《医通》）、秦皇士（《证因脉治》）次之，
他若吴鞠通之温，（《温热条辨》），戴麟郊（《广温疫论》）、刘松峰（《松峰说疫》）、余师
愚（《疫症一得》）之疫，吴师朗（《不居集》）之虚劳，萧慎斋（《女科经纶》）、沈尧峰（《
女科辑要》）之女科，程凤雏之幼科（《慈幼筏》），叶大椿之痘科（《痘学真传》），顾澄江
之外科（《疡医大全》），皆突过前贤。本草之书，刘若金（《本草述》）、卢子繇（《本草乘
雅半偈》）、倪纯宇（《本草汇言》）、张隐庵（《本草崇原》）、张潞玉（《本经逢原》）、邹
润庵（《本经疏证》）、赵恕轩（《本草纲目拾遗》），罔不领异标新，足资玩索。医案之书，
魏玉璜之博大（《续名医类案》），俞东扶之精深（《古今医案按》），顾晓园之灵巧，（《吴
门治验录》），并堪垂范来世。辨正之书，徐灵胎之（《医贯砭》），孔以立之（《医门普度》
），刘松峰之（《温疫论类编》），姚颐真之（《景岳全书发挥》，坊贾假托叶天士，其实乃姚
所撰也。）均可觉迷振愦。单方之书，毛达可之（《济世养生集》、《便易经验集》），亦为
医门珍笈。其余着述如林，尚难悉数，有志于学人，诵习古书，而又潜研诸家，弃驳取纯，
融会而贯通之，何患道之不明不行乎？
高丽康命吉《济众新编》，采集众书而成，无甚创解，惟添加“管见”一条，论服人参
、附
子之害，语特精当，足以警世，录之。无论大人小儿，人参、附子，用之于热在阳分，则其
害立死，医者即觉，若用之于热在阴分，则外似无害，或至数两而死，或致数斤而死，死亦
不悔，医者病者终不觉悟，盖病在阴分，用热药熬尽其津液，然后命尽故也，如此死者，频
频见之。
西国医士合信氏《西医略论》，略内症而详外症，其割肉锯骨等法，皆中国医人所不敢
用者
，内治之法，亦与中国异，如治疟用信石酒，霍乱用雅片膏、樟脑滚酒和服，使中国医人用
之悖矣，其诊脉至数验以时表，取其旋运有准，谓华人用鼻息呼吸，恐有迟速长短，不如时
表之准也。
吴门顾松园靖远，少日有声黉序，后因父患热病，为庸医投参附所杀，于是发愤习医，
寒暑
靡间者，阅三十年，求治者踵相接，曾供直御医院，以亲老归，着《医镜》十六卷，徐侍郎
秉义为之序，称其简而明，约而该，切于时用而必效，非虚语也。尝治汪缵功患时感症，见
症属阳明，因立白虎方，每剂用石膏三两，二服热症顿减，郡中著名老医谓遍身冷汗，肢冷
发呃，非参附勿克回阳，诸医和之，群哗白虎再投必毙，顾引仲景“热深厥亦深”之文，及
嘉言“阳症忽变阴厥，万中无一”之说，淳淳力辩，诸医固执不从，投参附回阳敛汗之剂，
汗益多而体益冷，反诋白虎之害，微阳脱在旦暮，势甚危，举家惊惶，复来求诊，顾仍用白
虎，用石膏三两，大剂二服，汗止身温，后仍用前汤加减，数服全愈，遂着《辨治论》，以
为温热病中宜用白虎汤，（此说与余师愚《疫症一得》相合，学人当参观之），并不伤人，以
解世俗之感。顾有秘方，载在《医镜》，一为治膈再造丹，川黄连二两，（去毛细切，用水
九碗，煎至六碗，又加六碗，煎至三碗，下赤金一锭，重二两，纹银一锭，重二两，浸汤内
），大田螺五十枚，（仰放盘中，以黄连汁挑点螺眼，顷刻化为水，用绢滤收），莱菔子煎汁
、韭菜汁、侧柏叶汁、梨汁、竹沥、童便（各小半碗），人乳、羊乳、牛乳（各一大碗），将黄
连水同金银田螺汁煎至碗半，次下莱菔汁煎至碗半，次下韭汁，次下侧柏叶汁，次下梨汁，
次下竹沥，次下童便，俱以煎至半碗为候，将金银取起，下人乳煎，次下羊乳，次下牛乳，
俱以煎至一碗为候，成膏，入瓷罐内封口，埋土内一夜，每用一茶匙，白滚汤下，极重者三
服全愈。如汤水不能进者，将膏挑置舌上，随津咽服，自能饮食，然愈后须食縻粥一月，方
可用饭，此方清火、消痰、去瘀、滋阴、养血、润燥，得之何氏（按∶京江何培元《济生方
》中有此方）家传，谓能挽回垂绝之症，故以“再造”名之。一为治痧硫矾丸，明矾、硫黄
各四两，先将二味为末，用豆腐浆在砂罐内煮一昼夜，取出，去豆腐，渣仍入罐，微火熬至
干燥，贮入瓷瓶，埋地深三尺，三日后取出，矾硫化紫金色，最下一层，有渣泥不用，再将
茯苓、山药各三两，同蒸晒露一宿，酒炒当归、白蒺藜各四两，乌药、半夏炒各三两，杏仁
焙一两半，陈皮去白、炒小茴香各一两，以上各药共研细末，枣泥为丸，清晨盐汤下一钱，
临卧白汤下一钱，此方为断除痧根之神剂。有人病痧十年，或十日，或一季半年时一举发，
痛不可忍，叫喊惊人，甚即晕去，或用探吐，或用醋炭熏搐，略得解醒，不能断除，后用此
丸数服，而病霍然如失。此症深入骨髓，百无一救，幸得此方，竟可起死回生，且余屡经试
验，其效若神，真千金不易之圣药，故亟为表示，以公诸世。顾又有治虚劳方，用生地、熟
地、天冬、麦冬、龟板、桂圆、玉竹、茯苓、人乳、山药，《吴医汇讲》乃属之汪缵功，方
中增入牛膝一味，岂顾着《医镜》一书，为汪氏所窃取耶？附志于此，俟后之君子详考焉。（
《医镜》一书，世无刊本，其中自制方佳者甚多，己未岁从直隶李参军晋恒假录全部，庚申杭
州遇乱失去，深可惋惜。）
咸丰戊午冬月，吴晓钲应京兆试归，寄我《齐氏医案》六卷，乃四川叙州齐有堂秉惠所
着，
自序作于嘉庆十一年，内有效方数则，录之。救劳杀虫丹，鳖甲一斤酒醋浸透，茯苓五两，
熟地、山药、沙参、地骨皮各一斤，山萸肉八两，白芥子、白薇各五两，人参二两，鳗鲤鱼
重一斤余或二斤更好，先将鳗捣烂，和前药为细末，粳米饭碾成丸，梧子大，每夜五更时洗
脸，北面向天念北斗咒，（北斗咒云∶瘵神瘵神，害我生人，吾奉帝敕，服药保生，急急如
律令。）七遍，即以开水送丸五钱，服毕，南面吸生气入腹中，烧降香置床下，午时又根据前法
吞服。曾以此法治曹三思，服至半料，虫尽化水，由小便下，状若稀糊，半载而康，连生五
子。（按∶《仁斋直指劳瘵方》有北斗咒，其辞相同，其药则异，又有用天灵盖并咒，不若
齐氏方之纯正。）神应散，治时气缠喉，水药不下，牙关紧闭，不省人事等症，余以此方活人
甚多，修合之，佩以济人，德莫大焉。用明雄黄（水飞）、枯矾（ 研）、藜芦（生用）、牙皂（
炙黄）等分为末，瓷瓶收贮，每用豆大一粒，吹入鼻内，取嚏吐痰神效。神仙通隘散，治
咽喉肿痛，生疮声哑，危急之甚，并治虚劳声嘶咽痛，用硼砂、儿茶、青黛、寒水石各二钱
，蒲黄、牙硝、枯矾、川连、黄柏各六分，冰片、潮脑各二分，共研极细末，瓷瓶收贮，每
用吹鼻立效。齐尝出游，舆夫发痧，昏晕欲绝，仓卒无药，一老翁告曰∶可即透取烟管中油
如豆大，放舌下，捧水饮之。如法治之，少顷，舆夫起曰∶真灵丹也！我病去如失矣。乃抬
齐回家。老翁又言此法不特治痧，尤能治毒蛇咬伤，以烟管烧热，滴油擦患处立效，后以试
用果验。
大兴刘继庄献廷，负经世才，于学无不淹贯，所着《广阳杂记》，间有及医事者，述之
以资
多识。有妇人患小腹中痛，气冲上不得卧，百药不效，已骨立矣，有吴人诊之曰∶此乃经时
不谨所致。用白芍二两，香菌一两，猪外肾一对，煎汤，滑石、白矾各五分，共为末，以豆
腐衣包之，煎汤送下，下黑血甚多，一剂而愈，亦奇方也。
龚首骧夫人病头风已数年矣，每发时痛欲死，骨节间格格有声，已坏一目而痛不止，延
余诊
之，定一方用酥炙龟板二钱，麻黄、 本各一钱，甘草五分，后更为定一方，用何首乌、苡
仁、牛膝，令服二剂而愈。
明末高邮袁体庵，神医也。有举子举于乡，喜极发狂，笑不止，求体庵诊之，惊曰∶疾
不可
为矣，不以旬数矣，宜急归，迟恐不及矣。道过镇江，必更求何氏诊之，遂以一书寄何，其
人至镇江而疾已愈，以书致何，何以书示之曰∶某公喜极而狂，喜则心窍开张，不可复合，
非药石之所能治，故以危言惧之以死，令其忧愁抑郁，则心窍闭，至镇江当已愈矣。其人乃
北向再拜而去。
太平崔默庵医多神验，有一少年新娶，未几出痘，遍身皆肿，头面如斗，诸医束手，延
默庵
诊之，默庵诊症，苟不得其情，必相对数日沉思，反复诊视，必得其因而后已，诊此少年时
，六脉平和，惟稍虚耳，骤不得其故，时因肩舆道远腹饿，即在病者榻前进食，见病者以手
擘目观其饮啖，盖目眶尽肿不可开合也，问思食否，曰∶甚思之，奈为医者戒余勿食何？崔
曰∶此症何碍于食？遂命之食，饮啖甚健，愈不解，久之，视其室中床榻桌椅漆器熏人，忽
大悟曰∶余得之矣！亟命别迁一室，以螃蟹数斤生捣，遍敷其身，不一二日肿消痘现，则极
顺之症也，盖其人为漆所咬，他医皆不识云。
新安程云来（林），博究群书，所着《医暇卮言》，乃深于格致之学人，余尤爱其论夜卧
一则
，有裨于养生，录之。夜卧能使气降，昼卧能使气升。人至暮劳极，眼白昏而带赤，静卧一
宵，诘朝对镜，清澈如故，此气降之验也。昼倦当静坐片时，或散步玩物，睡愁自解，若因
而沉寝，则初觉之时，目白必赤，此因卧而气反升之验也。盖昼当与阳俱开，乃逆其候而闭
之，譬如夜当与阴俱闭，乃故狂呼豪饮，皆伤寿源。古人云∶夙兴夜寐，出作入息，天之命
，人之纪也。愚一生劝人夙兴，不劝人夜坐。
吴门朱东樵（ ），有《本草诗笺》，钱塘陆典三文谟，亦有《本草诗》，而陆为胜，征
引亦
（这段文字主要论述了乡里的德行。）著有《脉法须知》三卷，咸丰五年，他的同乡计二田上舍光昕，刻印此书以流传，送给我阅读。这本书荟萃了各家的学说，表达精确，不是学识渊博且有心得的人是不能写成的。其中《问法要略》一篇，语言简练而意思详尽，胜过张景岳的十问法，这里详细记录于此。进入国家要了解风俗，进入家庭要了解避讳，登上厅堂要了解礼节，面对病人要了解病情，这是非常谨慎的态度。询问男女老幼贵贱，得病哪一天，受病的原因，饮食和大便小便的情况，心情劳逸，现在和过去有什么不同，曾经服用过什么药，日夜起居，睡眠有无，痰嗽呕嗳，胀闷汗渴烦悸，头目耳鼻口咽喉胸胁腰背腹痛，手掌冷热，喜恶寒热，膝酸足肿，曾经患过什么疾病，疮伤中毒，痞血病久，或者发汗攻下过度损伤，嗜好什么味道和食物，或者纵酒，或者长期吃素，或者房事过度，或者泄泻滑脱，询问妇女月经情况，怀孕是否真的动了胎气。寡妇和未婚女子，气血凝滞，两尺脉多滑，但不是怀孕。心腹痛应当询问新病还是久病，懒言只是点头，是中气虚的表现，昏愦不知人，或者是暴厥，或者是久病，妇人僵厥，多属于中气问题，应当辨别清楚。小便黄赤是湿热，用清热利湿的方法；小便色白，没有热邪，不可治疗热邪，利尿则气顺，涩滞则痰滞，重坠牵掣为虚证，烦闷拘急为实证，喜热恶利为虚证，喜利恶热为实证。
嘉善名医俞东扶先生震，著有《古今医案按》十卷，乾隆四十三年自序刊行，这本书选择严谨，论说精透，可以作为医学界的准则，可惜坊间流传很少，道光年间，重修《嘉兴府志·方技门》，不为先生立传，撰述志也不记载这本书，这是缺点。这本书非常推崇叶天士，所记录的治案，很多是《临证指南》所未记载的，卷三痢疾门有说：嘉善一位老妇，经常便血，时发时止，到了五十岁外，夏天便鲜血，里急后重，有时不禁，脉软不数，用五苓散、建中汤治疗很有效。因为向来应该用凉血药，仍然用四物汤加槐花、榆皮、山楂、神曲，也无效。叶天士先生用生苍术、生厚朴、炒陈皮、炙甘草、鸡内金、砂仁壳、丁香柄制成丸药服用，完全痊愈。又有一个童子久痢，叶天士也用这个方子完全痊愈。人们不理解其中的缘故，震读徐春圃的《医统》，因此看到这个方子，名叫醉乡玉屑，治疗小儿吃瓜果导致痢疾，久不愈，于是佩服先生的博学云云。我曾经用这个方子加车前子、泽泻治疗食伤水泻，也多获得疗效。
吴恕的《伤寒指掌》十卷，见于殷方叔的《医藏目录》。皇甫中的《伤寒指掌》十四卷，见于《四库全书》医家类存目。这两本书都很少有传本，嘉庆初年，苕南吴坤安（贞），又著《伤寒指掌》四卷，认为南方近日的伤寒，大半属于温热，治法与伤寒不同，伤寒入足经，而温邪兼入手经，伤寒宜解表，而温邪忌发汗，伤寒药宜辛温，而温邪药宜辛凉，如果不辨明，必有误治，所以他的书既叙述六经本病，而特别参以温热立论，兼及类伤寒的症状，先古法，后新法，条理分明，既精且详，我从乌程邵蔼人茂才楠那里借录一部，是蔼人的父亲仙根先生所评择，阐发曲畅，让读者心开目明。仙根先生治病二十多年，屡次拯救危重病人，大概得力于这本书为多。
本朝医学极盛，医书也大大完备，关于伤寒的书，喻嘉言（《尚论篇》）、柯韵伯（《来苏集》）、王晋三（《古方选注》）都独具眼光，直抉心源，伤寒六经兼诸症，柯氏发其端，温热等病究三焦，叶氏宣其旨，苕南吴坤安荟萃群言，勒为成书（《伤寒指掌》），而伤寒之学无余蕴矣。杂病的书，首称叶天士（《临证指南》），而张石顽（《医通》）、秦皇士（《证因脉治》）次之，其他如吴鞠通的温病（《温热条辨》），戴麟郊（《广温疫论》）、刘松峰（《松峰说疫》）、余师愚（《疫症一得》）的瘟疫，吴师朗（《不居集》）的虚劳，萧慎斋（《女科经纶》）、沈尧峰（《女科辑要》）的女科，程凤雏的儿科（《慈幼筏》），叶大椿的痘科（《痘学真传》），顾澄江的外科（《疡医大全》），都突过前贤。本草的书，刘若金（《本草述》）、卢子繇（《本草乘雅半偈》）、倪纯宇（《本草汇言》）、张隐庵（《本草崇原》）、张潞玉（《本经逢原》）、邹润庵（《本经疏证》）、赵恕轩（《本草纲目拾遗》），无不领异标新，足以资玩索。医案的书，魏玉璜的博大（《续名医类案》），俞东扶的精深（《古今医案按》），顾晓园的灵巧（《吴门治验录》），并堪垂范来世。辨正的书，徐灵胎的（《医贯砭》），孔以立的（《医门普度》），刘松峰的（《温疫论类编》），姚颐真的（《景岳全书发挥》，坊贾假托叶天士，其实乃姚所撰也。）均可觉迷振愦。单方的书，毛达可的（《济世养生集》、《便易经验集》），也为医门珍笈。其余著述如林，尚难悉数，有志于学的士人，诵读古书，而又潜研诸家，弃驳取纯，融会而贯通之，何患道之不明不行乎？
高丽康命吉的《济众新编》，采集众书而成，无甚创解，惟添加“管见”一条，论服人参、附子的害处，语特精当，足以警世，录之。无论大人小孩，人参、附子，用之于热在阳分，则其害立死，医者即觉，若用之于热在阴分，则外似无害，或至数两而死，或致数斤而死，死亦不悔，医者病者终不觉悟，盖病在阴分，用热药熬尽其津液，然后命尽故也，如此死者，频频见之。
西国医士合信氏的《西医略论》，略内症而详外症，其割肉锯骨等法，皆中国医人所不敢用者，内治之法，亦与中国异，如治疟用信石酒，霍乱用雅片膏、樟脑滚酒和服，使中国医人用之悖矣，其诊脉至数验以时表，取其旋运有准，谓华人用鼻息呼吸，恐有迟速长短，不如时表之准也。
吴门顾松园靖远，少年时在黉序有声望，后因父亲患热病，被庸医投人参附子所杀，于是发愤习医，寒暑无间者，阅三十年，求治者踵相接，曾供职御医院，因父母年老归家，著《医镜》十六卷，徐侍郎秉义为之序，称其简而明，约而该，切于时用而必效，非虚语也。曾治汪缵功患时感症，见症属阳明，因立白虎汤方，每剂用石膏三两，二服热症顿减，郡中著名老医谓遍身冷汗，肢冷发呃，非人参附子勿克回阳，诸医和之，群哗白虎再投必毙，顾引仲景“热深厥亦深”之文，及嘉言“阳症忽变阴厥，万中无一”之说，淳淳力辩，诸医固执不从，投人参附子回阳敛汗之剂，汗益多而体益冷，反诋白虎之害，微阳脱在旦暮，势甚危，举家惊惶，复来求诊，顾仍用白虎汤，用石膏三两，大剂二服，汗止身温，后仍用前汤加减，数服全愈，遂著《辨治论》，以为温热病中宜用白虎汤，（此说与余师愚《疫症一得》相合，学人当参观之），并不伤人，以解世俗之感。顾有秘方，载在《医镜》，一为治膈再造丹，川黄连二两，（去毛细切，用水九碗，煎至六碗，又加六碗，煎至三碗，下赤金一锭，重二两，纹银一锭，重二两，浸汤内），大田螺五十枚，（仰放盘中，以黄连汁挑点螺眼，顷刻化为水，用绢滤收），莱菔子煎汁、韭菜汁、侧柏叶汁、梨汁、竹沥、童便（各小半碗），人乳、羊乳、牛乳（各一大碗），将黄连水同金银田螺汁煎至碗半，次下莱菔汁煎至碗半，次下韭汁，次下侧柏叶汁，次下梨汁，次下竹沥，次下童便，俱以煎至半碗为候，将金银取起，下人乳煎，次下羊乳，次下牛乳，俱以煎至一碗为候，成膏，入瓷罐内封口，埋土内一夜，每用一茶匙，白滚汤下，极重者三服全愈。如汤水不能进者，将膏挑置舌上，随津咽服，自能饮食，然愈后须食糜粥一月，方才可用饭，此方清火、消痰、去瘀、滋阴、养血、润燥，得之何氏（按：京江何培元《济生方》中有此方）家传，谓能挽回垂绝之症，故以“再造”名之。一为治痧硫矾丸，明矾、硫黄各四两，先将二味为末，用豆腐浆在砂罐内煮一昼夜，取出，去豆腐，渣仍入罐，微火熬至干燥，贮入瓷瓶，埋地深三尺，三日后取出，矾硫化紫金色，最下一层，有渣泥不用，再将茯苓、山药各三两，同蒸晒露一宿，酒炒当归、白蒺藜各四两，乌药、半夏炒各三两，杏仁焙一两半，陈皮去白、炒小茴香各一两，以上各药共研细末，枣泥为丸，清晨盐汤下一钱，临卧白汤下一钱，此方为断除痧根之神剂。有人病痧十年，或十日，或一季半年时一举发，痛不可忍，叫喊惊人，甚即晕去，或用探吐，或用醋炭熏搐，略得解醒，不能断除，后用此丸数服，而病霍然如失。此症深入骨髓，百无一救，幸得此方，竟可起死回生，且余屡经试验，其效若神，真千金不易之圣药，故亟为表示，以公诸世。顾又有治虚劳方，用地黄、熟地黄、天冬、麦冬、龟板、桂圆、玉竹、茯苓、人乳、山药，《吴医汇讲》乃属之汪缵功，方中增入牛膝一味，岂顾著《医镜》一书，为汪氏所窃取耶？附志于此，俟后之君子详考焉。（《医镜》一书，世无刊本，其中自制方佳者甚多，己未岁从直隶李参军晋恒假录全部，庚申杭州遇乱失去，深可惋惜。）
咸丰戊午冬月，吴晓钲应京兆试归，寄我《齐氏医案》六卷，乃四川叙州齐有堂秉惠所著，自序作于嘉庆十一年，内有有效方数则，录之。救劳杀虫丹，鳖甲一斤酒醋浸透，茯苓五两，熟地黄、山药、沙参、地骨皮各一斤，山萸肉八两，白芥子、白薇各五两，人参二两，鳗鲤鱼重一斤余或二斤更好，先将鳗捣烂，和前药为细末，粳米饭碾成丸，梧子大，每夜五更时洗脸，北面向天念北斗咒，（北斗咒云：瘵神瘵神，害我生人，吾奉帝敕，服药保生，急急如律令。）七遍，即以开水送丸五钱，服毕，南面吸生气入腹中，烧降香置床下，午时又根据前法吞服。曾以此法治曹三思，服至半料，虫尽化水，由小便下，状若稀糊，半载而康，连生五子。（按：《仁斋直指劳瘵方》有北斗咒，其辞相同，其药则异，又有用天灵盖并咒，不若齐氏方之纯正。）神应散，治时气缠喉，水药不下，牙关紧闭，不省人事等症，余以此方活人甚多，修合之，佩以济人，德莫大焉。用明雄黄（水飞）、枯矾（研）、藜芦（生用）、牙皂（炙黄）等分为末，瓷瓶收贮，每用豆大一粒，吹入鼻内，取嚏吐痰神效。神仙通隘散，治咽喉肿痛，生疮声哑，危急之甚，并治虚劳声嘶咽痛，用硼砂、儿茶、青黛、寒水石各二钱，蒲黄、牙硝、枯矾、川连、黄柏各六分，冰片、潮脑各二分，共研极细末，瓷瓶收贮，每用吹鼻立效。齐尝出游，舆夫发痧，昏晕欲绝，仓卒无药，一老翁告曰：可即透取烟管中油如豆大，放舌下，捧水饮之。如法治之，少顷，舆夫起曰：真灵丹也！我病去如失矣。乃抬齐回家。老翁又言此法不特治痧，尤能治毒蛇咬伤，以烟管烧热，滴油擦患处立效，后以试用果验。
大兴刘继庄献廷，负经世才，于学无不淹贯，所著《广阳杂记》，间有及医事者，述之以资多识。有妇人患小腹中痛，气冲上不得卧，百药不效，已骨立矣，有吴人诊之曰：此乃经时不谨所致。用白芍二两，香菌一两，猪外肾一对，煎汤，滑石、白矾各五分，共为末，以豆腐衣包之，煎汤送下，下黑血甚多，一剂而愈，亦奇方也。
龚首骧夫人病头风已数年矣，每发时痛欲死，骨节间格格有声，已坏一目而痛不止，延余诊之，定一方用酥炙龟板二钱，麻黄、 本各一钱，甘草五分，后更为定一方，用何首乌、苡仁、牛膝，令服二剂而愈。
明末高邮袁体庵，神医也。有举子举于乡，喜极发狂，笑不止，求体庵诊之，惊曰：疾不可为矣，不以旬数矣，宜急归，迟恐不及矣。道过镇江，必更求何氏诊之，遂以一书寄何，其人至镇江而疾已愈，以书致何，何以书示之曰：某公喜极而狂，喜则心窍开张，不可复合，非药石之所能治，故以危言惧之以死，令其忧愁抑郁，则心窍闭，至镇江当已愈矣。其人乃北向再拜而去。
太平崔默庵医多神验，有一少年新娶，未几出痘，遍身皆肿，头面如斗，诸医束手，延默庵诊之，默庵诊症，苟不得其情，必相对数日沉思，反复诊视，必得其因而后已，诊此少年时，六脉平和，惟稍虚耳，骤不得其故，时因肩舆道远腹饿，即在病者榻前进食，见病者以手擘目观其饮啖，盖目眶尽肿不可开合也，问思食否，曰：甚思之，奈为医者戒余勿食何？崔曰：此症何碍于食？遂命之食，饮啖甚健，愈不解，久之，视其室中床榻桌椅漆器熏人，忽大悟曰：余得之矣！亟命别迁一室，以螃蟹数斤生捣，遍敷其身，不一二日肿消痘现，则极顺之症也，盖其人为漆所咬，他医皆不识云。
新安程云来（林），博究群书，所著《医暇卮言》，乃深于格致之学人，余尤爱其论夜卧一则，有裨于养生，录之。夜卧能使气降，昼卧能使气升。人至暮劳极，眼白昏而带赤，静卧一宵，诘朝对镜，清澈如故，此气降之验也。昼倦当静坐片时，或散步玩物，睡愁自解，若因而沉寝，则初觉之时，目白必赤，此因卧而气反升之验也。盖昼当与阳俱开，乃逆其候而闭之，譬如夜当与阴俱闭，乃故狂呼豪饮，皆伤寿源。古人云：夙兴夜寐，出作入息，天之命，人之纪也。愚一生劝人夙兴，不劝人夜坐。
(This passage primarily discusses the virtue of a person in his hometown.) He authored *Malfax Xu Zhi* (Pulse Method Essentials), three volumes. In the fifth year of Xianfeng, his fellow townsman Ji Ertian, Shangshe Guangxin, had it printed and circulated, presenting it to me for reading. This book synthesizes theories from various schools, expressed with precision; only one with profound learning and insight could have written it. The chapter "Wenfa Yaolue" (Brief Outline of Inquiry Methods) is concise yet detailed, surpassing Zhang Jingyue's Ten Questions. It is recorded here in full. Entering a country, inquire about its customs; entering a home, inquire about taboos; ascending the hall, inquire about etiquette; attending to a patient, inquire about their condition. This is utmost caution. Inquire about gender, age, and social status; when did the illness begin; what was the cause of the illness; diet and bowel/bladder habits; emotional state and exertion; how things are now compared to the past; what medicines were previously taken; daily routine and sleep patterns; presence or absence of phlegm, cough, vomiting, belching; distension, stifling sensation, sweating, thirst, irritability, palpitations; pain in head, eyes, ears, nose, mouth, throat, chest, hypochondrium, lower back, abdomen; temperature of palms; preference for cold or heat; soreness of knees, swelling of feet; previous illnesses; sores, injuries, poisoning; chronic conditions like masses, blood stasis; whether excessive sweating or purgation caused damage; dietary preferences; indulgence in alcohol; long-term vegetarianism; sexual activity; diarrhea or loose stools; for women, menstrual status and whether pregnancy has affected the fetus. For widows and unmarried women, Qi and Blood stagnation often causes slippery pulses at the Chi position, but this is not pregnancy. For heart and abdominal pain, distinguish between new and old onset. Reluctance to speak, merely nodding, indicates deficiency of Middle Qi. Confusion and unconsciousness may be sudden syncope or chronic illness; female rigidity and syncope often relate to Middle Qi issues and must be differentiated. Yellow-red urine indicates Damp-Heat; treat by clearing and leaching out Damp-Heat. White urine indicates no Heat; do not treat Heat. Diuresis promotes smooth Qi flow; obstruction leads to Phlegm stagnation. Heavy dragging sensation indicates Deficiency; irritability and stiffness indicate Excess. Preference for warmth and aversion to diuresis indicates Deficiency; preference for diuresis and aversion to heat indicates Excess.
Yu Dongfu (Zhen), a renowned physician from Jiashan, authored *Gujin Yi An An* (Commentary on Ancient and Modern Medical Cases), ten volumes, preface dated the 43rd year of Qianlong. The book is rigorously selected and profoundly argued, serving as a standard for the medical field. Unfortunately, few copies circulated. During the Daoguang reign, when compiling the *Jiaxing Prefecture Gazetteer*, under the section on Technical Arts, no biography was written for him, nor was this book recorded, which is a shortcoming. The book highly praises Ye Tianshi. Many cases recorded are not found in *Linzheng Zhinan*. Volume 3, Dysentery Section, states: An elderly woman in Jiashan frequently passed blood, intermittently. After fifty, she passed fresh blood in summer, with tenesmus and occasional incontinence. Her pulse was soft and not rapid. Wuling San and Jianzhong Tang were very effective. Since cooling-blood herbs were usually indicated, Siwu Tang plus Huaihua, Yupi, Shanzha, and Shenqu were used, but without effect. Mr. Ye Tianshi used raw Cangzhu, raw Houpo, stir-fried Chenpi, honey-fried Gancao, Jineijin, Sha Ren Ke, and Dingxiang Bing to make pills, resulting in complete recovery. A boy with chronic dysentery was also cured by this formula. People did not understand why. Zhen read Xu Chunpu's *Yitong* and found this formula, named Zuixiang Yuxie, treating pediatric dysentery caused by eating melons/fruits that persisted. This shows the erudition of Mr. Yu. I once added Cheqianzi and Zexie to this formula to treat watery diarrhea due to food injury, achieving good results.
Wu Shu's *Shanghan Zhizhang* (Guiding Principles for Cold Damage), ten volumes, appears in Yin Fangshu's *Yicang Mulu*. Huangfu Zhong's *Shanghan Zhizhang*, fourteen volumes, is listed in the *Siku Quanshu*. Both books are rare. In the early Jiaqing period, Wu Kun'an (Zhen) from Raonan wrote another *Shanghan Zhizhang*, four volumes. He noted that recent cold damage in the South mostly belongs to Warmth pathogens, and treatment differs from traditional Cold Damage. Cold Damage affects Foot meridians, while Warmth pathogens affect Hand meridians. Cold Damage requires release via sweating, while Warmth pathogens contraindicate sweating. Cold Damage drugs should be Acrid-Warm, while Warmth pathogen drugs should be Acrid-Cool. If not distinguished, misdiagnosis will occur. Thus, his book describes the primary diseases of the Six Channels but specifically incorporates Warmth theory, including Cold Damage-like symptoms, prioritizing ancient methods then new ones, clearly categorized and detailed. I borrowed a copy from Shao Airén (Nan) of Wucheng, annotated and selected by Airén's father, Mr. Xiangen. His annotations clarified obscure points, enlightening readers. Mr. Xiangen treated patients for over twenty years, saving many critical cases, largely benefiting from this book.
Medicine flourished greatly in our dynasty, with comprehensive medical texts. Regarding Cold Damage, Yu Jiayan (*Shanglun Pian*), Ke Yunbo (*Laisu Ji*), and Wang Jinshan (*Gufang Xuanzhu*) all showed unique insights, penetrating the core. Ke Yunbo initiated the discussion on Six Channels and various symptoms; Ye Tianshi elucidated the investigation of Three Burners for Warmth diseases. Wu Kun'an synthesized these views into *Shanghan Zhizhang*, completing the study of Cold Damage. For miscellaneous diseases, Ye Tianshi (*Linzheng Zhinan*) is foremost, followed by Zhang Shiwan (*Yitong*) and Qin Huangshi (*Zhengyin Maizhi*). Others include Wu Jutong on Warmth (*Wenre Tiaobian*), Dai Linjiao (*Guangwenyi Lun*), Liu Songfeng (*Songfeng Shuoyi*), Yu Shiyu on Epidemics (*Yizheng Yide*), Wu Shilang on Consumption (*Buju Ji*), Xiao Shenzhai and Shen Yaofeng on Gynecology (*Nuke Jinglun*, *Nuke Jiyao*), Cheng Fengchu on Pediatrics (*Ciyou Fa*), Ye Dachun on Smallpox (*Douxue Zhenshuan*), and Gu Chengjiang on Surgery (*Yangyi Daquan*), all surpassing predecessors. Materia Medica works include Liu Ruojin (*Bencao Shu*), Lu Ziyao (*Bencao Chengya Banji*), Ni Chongyu (*Bencao Huiyan*), Zhang Yin'an (*Bencao Chongyuan*), Zhang Luyu (*Benjing Fengyuan*), Zou Run'an (*Benjing Shuzheng*), and Zhao Shuxuan (*Bencao Gangmu Shiyi*), all innovative and worthy of study. Case records include Wei Yuhuang's breadth (*Xu Mingyi Leian*), Yu Dongfu's depth (*Gujin Yi An An*), and Gu Xiaoyuan's skill (*Wumen Zhiyanlu*), all exemplary. Corrective works include Xu Lingtai (*Yiguan Bian*), Kong Yili (*Yimen Pudu*), Liu Songfeng (*Wenyi Lun Leibian*), and Yao Yizhen (*Jingquan Quanshu Fahui*—marketed falsely as Ye Tianshi's work). Single remedies include Mao Dakke (*Jishi Yangsheng Ji*, *Bianyi Jingyan Ji*). There are countless other works. Scholars who study classics and analyze various schools, discarding errors and retaining purity, integrating them, need not worry about the Way not being understood or practiced.
Kang Myeong-gil of Korea's *Jizhong Xinbian* compiles various books without much innovation, except adding a "Personal View" section discussing the harms of Ginseng and Aconite. The language is precise and warning. Regardless of age, if Ginseng and Aconite are used for Heat in the Yang aspect, death is immediate. If used for Heat in the Yin aspect, harm seems absent externally, but death may occur after consuming ounces or even jin of the medicine, with neither doctor nor patient realizing the error. This is because Heat in the Yin aspect consumes Body Fluids using hot medicines, leading to death. Such deaths are frequent.
Mr. Hobson's *Xiyi Lüelun* (Western Medicine Brief Theory) details external symptoms more than internal ones. Methods like flesh-cutting and bone-sawing are unacceptable to Chinese physicians. Internal treatments differ too, e.g., using Realgar wine for Malaria, Opium paste and Camphor wine for Cholera, which contradicts Chinese practice. Pulse diagnosis uses a clock for accuracy, arguing human breath varies unlike mechanical time.
Gu Songyuan (Jingyuan) of Wumen was famous in his youth. After his father died from improper use of Ginseng and Aconite by a quack, he studied medicine diligently for thirty years. Patients flocked to him. He served in the Imperial Hospital but returned home due to aging parents. He authored *Yijing* (Medical Mirror), sixteen volumes, prefaced by Vice Minister Xu Bingyi, praising its clarity and efficacy. He treated Wang Zanguan with a seasonal pathogenic factor syndrome belonging to Yangming. He prescribed Baihu Tang with 3 liang of Shigao per dose. After two doses, fever subsided. Senior local doctors argued that cold sweat and cold limbs required Renshen and Fuzi to restore Yang. They warned Baihu Tang would kill the patient. Gu cited Zhang Zhongjing's "Deep heat leads to deep cold" and Yu Jiayan's "Yang syndromes rarely turn to Yin cold," debating fiercely. Doctors insisted on Renshen and Fuzi. Sweating increased, body grew colder, and they blamed Baihu Tang for causing Yang collapse. The situation became critical. The family panicked and sought Gu again. Gu continued Baihu Tang with 3 liang Shigao. After two large doses, sweating stopped, body warmed, and subsequent adjustments led to full recovery. He wrote *Bianzhi Lun* advocating Baihu Tang for Warmth diseases, aligning with Yu Shiyu's view, to dispel public fear. Gu had secret formulas in *Yijing*. One is Zaizao Dan for Esophageal Obstruction: Chuan Lianlian (2 liang, processed with water and gold/silver ingots), 50 river snails (processed with Lianlian juice), Radish seed juice, Leek juice, Cebaiye juice, Pear juice, Bamboo sap, Child's urine, Human milk, Goat milk, Cow milk. Processed into a paste, buried overnight. Taken with warm water. Cures severe cases in three doses. If unable to swallow, place on tongue. Requires porridge diet for a month post-recovery. Clears fire, resolves phlegm, removes stasis, nourishes Yin/Blood, moistens dryness. Another is Liufan Wan for Sha disease: Mingfan and Liuhuang (4 liang each), boiled in tofu brine, dried, buried. Mixed with Fuling, Shanyao, Danggui, Bijieli, Wuyao, Banxia, Xingren, Chenpi, Xiaohuixiang. Taken with salt water morning and white water night. Cures Sha disease rooted deeply. A case of ten-year Sha disease was cured. Gu also had a formula for Consumption: Shudi, Shudihuang, Tiandong, Maidong, Guiban, Guiyuan, Yuzhu, Fuling, Renru, Shanyao. *Wu Yi Huijiang* attributes this to Wang Zanguan with Niuxi added. Was *Yijing* stolen? Recorded here for future verification. (*Yijing* has no printed edition; I copied it from Li Jinheng in Jiwei year, lost in Hangzhou during unrest in Gengshen year.)
In winter of Xianfeng Wuwu, Wu Xiaozheng sent me *Qi Shi Yi An* (Six Volumes) by Qi Youtang (Binghui) from Xuzhou, Sichuan, preface dated Jiaqing 11. Includes effective formulas. Jiu Lao Shachong Dan: Biejia soaked in wine/vinegar, Fuling, Shudi, Shanyao, Shashen, Digupi, Shanzhuyu, Baijiezi, Baiwei, Renshen, Moray eel. Made into pills with rice. Recite Big Dipper mantra seven times facing North at dawn, take with warm water, face South inhale vital Qi, burn Jiangxiang under bed. Take again at noon. Cured Cao Sansi of parasites; worms dissolved and passed in urine. Recovered in six months, fathered five sons. Shenyingsan treats throat constriction from seasonal pathogens, inability to swallow, locked jaw, unconsciousness. Blow into nose to induce sneezing/phlegm expulsion. Shenxian Tong'ai San treats swollen/painful throat, ulcers, hoarseness. Borax, Ercha, Qingdai, Hanshuishi, Puhuang, Yanxiao, Kufan, Chuanlian, Huangbai, Bingpian, Chaonao. Blown into nose for immediate relief. Qi once traveled, carriage driver suffered Sha, fainting. An old man suggested sucking oil from a tobacco pipe onto the tongue with water. Driver recovered instantly. Old man said this also cures snakebites by heating pipe and applying oil. Verified later.
Liu Jizhuang (Xianting) of Daxing had worldly talent and broad knowledge. *Guangyang Zaji* mentions medical matters. A woman had lower abdominal pain, Qi rushing up preventing sleep, emaciated. A Wu doctor diagnosed improper menstruation care. Used Baishao, Xiangjun, Pig kidney decoction, with Shihuo and Baifan powder wrapped in tofu skin. Passed black blood, cured in one dose.
Mrs. Gong Shouxiang suffered Head Wind for years, excruciating pain, joint cracking, one eye ruined. I prescribed Su Zhi Guiban, Mahuang, Bencao, Gancao. Later changed to Heshouwu, Yiren, Niuxi. Cured in two doses.
Yuan Ti'an of Gaoyou, late Ming, was a divine healer. A scholar went mad from joy after passing provincial exams. Yuan predicted death soon, advised returning home and consulting He in Zhenjiang. Scholar went to Zhenjiang, healed. He explained: Joy opens Heart Orifices irreversibly; cannot be treated by medicine. Fear of death induces sorrow/depression, closing orifices, curing the madness. Scholar bowed and left.
Cui Mo'an of Taiping had miraculous cures. A young groom developed smallpox, swollen face/head. Cui pondered for days. Noticed patient opening swollen eyes to watch him eat. Asked if hungry; patient wanted to eat but feared doctor's prohibition. Cui allowed eating. Patient ate well. Cui realized room smelled of lacquerware. Moved patient to another room, applied crushed raw crab. Swelling subsided, rash appeared, favorable course. Patient was allergic to lacquer, unrecognized by others.
Cheng Yunlai (Lin) of Xin'an wrote *Yixia Zhiyan*. Loved his view on sleeping: Night sleep lowers Qi; day sleep raises Qi. Evening fatigue with red-whites of eyes clears after night sleep (Qi lowering). Day drowsiness resolved by sitting/walking; deep sleep makes whites red (Qi raising). Day should open with Yang; sleeping closes it against nature. Night should close with Yin; drinking/laughing damages longevity. Ancients said rise early, sleep late, work/rest according to Heaven's mandate. I advise rising early, not staying up late.
Zhu Dongqiao of Wumen wrote *Bencao Shijian*. Lu Dianwu (Sanmo) of Qiantang wrote *Bencao Shi*, superior in citations.