临海洪虞邻《南沙文集》曰∶余家有经纪人，劳苦呕血数升，延医视之，用川连、人参
、大
是速之死也。亟命勿药，老米粥、浓滋味，令寝食数日，不一旬而强健如故。盖劳苦之人，
未尝享有饮食之美，数晨夕之安，得此胜于良药多矣，其愈也固宜。又有舆夫素无疾，忽腰
痛肚饱不食，医进以大补药，其夜腰痛益甚，腹大气喘且死。翌日医复视之曰∶此中鬼箭也
，药物无所施，亟宜禳遣。余叹曰∶奈何嫁罪于鬼哉！是中寒伤食者，饮以祛寒化食两大剂
，第三日其人抬轿如故。书之以告世之误信庸医者。余谓误信庸医，由于不谙方书，不能不
求援于医耳。所可恨者，为医而不深究医理，强作解人，以致误事而不自知也。
吴郡某医，得许叔微《伤寒九十论》，奉为秘本。见其屡用麻黄汤，适治一女子热病无
汗，谓是足太阳表证，投以麻黄服之，汗出不止而殒。盖南人少真伤寒，凡热病无汗，以紫苏、
葱白、豆豉、薄荷等治之足矣，岂可泥古法乎？
朱子暮年香港脚发作，俞梦达荐医士张修之诊视云∶须略攻治，去其壅滞，方得气脉流通
。先生初难之，张执甚力，遂用其药。初制黄 、粟壳等，服之小效，遂用巴豆、三棱、莪术等
药，觉气快足轻，向时遇食多不下膈之病皆去，继而大腑又秘结，再服温白丸数粒，脏腑通
而泄泻不止矣，黄芽、岁丹作大剂投之，皆不效，遂至大故。蔡九峰《梦葬记》详载之。观
此知高年人治病，慎不可用攻药也。
祥符县医生胡某，操技精良，当道皆慕名延致。都督某之女，与人私，偶感寒疾，招胡
。故谓此孕脉也。某曰∶先生之言信乎？故曰∶非识之真，不敢妄言也。某乃呼女出，以
刀剖其腹，视之信然。故大骇晕仆，良久始苏，归病数月即卒。胡之艺工矣！惜乎其不知顾
忌也。（先祖秋畦公宰密县时谂知此事，先生祖母顾太孺人恒为以HT 言之。）
近世医者，能读《内经》鲜矣，更有妄引经语，致成笑端者。如治不得寐，引“半夏秫
米汤
，足生大疔”，以为确征。不知足者，能也，非专指足而言。又有治瘅疟证，以“阴气先伤
，阳气独发”，为《已任编》之言，盖未读《内经》、《金匮》，第见《已任编》有是语耳
。疏陋若此，乃皆出于悬壶而知名者也。
医贵专门。歙吴章侯太守端甫攒花《易简良方》中“劝行医说，言之甚为切至，特录之
。古法行医，各有专科。近见悬壶之辈，往往明日出道，今日从师，牌书内、外两师传授，甚至
兼治痧痘咽喉。探其根底，一无擅长，不过取门数之多，以博钱财。抑知赋质有限，何能兼
善？病者不知，恒被贻误。曾见有人患风痧，医视为漆咬而误用清药。又有患火焰疔者，医
视为热疮而误用发散诸品，几致不治。此皆不专门故也，可不慎哉？
苏州曹某，状修伟多髯，医名著一时，而声价自高，贫家延请每不至。巨室某翁有女，
闺中，因病遣仆延曹，仆素憎曹， 以女已出嫁，今孕数月矣。吴俗大家妇女避客，医至则
于床帏中出手使诊，曹按女脉，漫云是孕，翁大骇异。次日，延医至，使其子伪为女诊之，
复云是孕。其子褰帏启 视之曰∶“我男也而有孕乎？诬我犹可，诬我妹不可恕也！”叱仆殴
之，并饮之以粪，跪泣求免，乃剃其髯，以
粉笔涂其面，纵之去。归家谢客，半载不出，声望顿衰。太湖滨疡医谢某，技精药良，而居
心贪谲，往往乘人之急以为利。邻村某农母患疽求治，以其贫拒之，疽溃遂死。某愤甚。谢
有拳勇，数十人不能近。某持刀伏稻间，伺其出，突起刺其腰，谢以所制药敷治将痊，怒某
之刺已也，亟诉之县，循例抬验，县官揭其衣，用力重，衣开皮裂，冒风复溃而卒。某按律
抵罪，后遇赦得生。此二人医术皆良，乃一则以傲败名，一则以贪伤身，皆可为戒，故并志之。
徐灵胎《慎疾刍言》曰∶少时见前辈老医，必审贫富而后用药。尤见居心长浓，况是时
参价
称名医，恒喜用新奇之药，以炫其博，价值之昂不计也。甚至为药肆所饵，凡诊富人疾，必
入贵重之品，俾药肆获利，此尤可鄙。
《扬州府志·辨高邮州志》称袁体庵班按脉极捷，以为医之切脉，以审慎为工，捷于按
市医苟且之为，班断不如是云云。吁！今之医者，鲜不以捷为工，即延医者，亦皆以捷为能，盍深味此言？
南方有割螳螂子之术，小儿蒙其害。（徐灵胎《兰台轨范》详辨之，谓即妒乳法，用青
钱，元明粉三钱，硼砂一钱，薄荷五分，冰片一分，同研细擦口内两颐，一日四五次。）北
方有割 之术，妇人蒙其害，兼及小儿。（吴鞠通《温病条辨杂说》辨之谓∶ 字，考之字
书并无是字，焉有是病？）此皆庸俗伪造其名，而劣妇秘传其技，借以欺世图利者，明识之人，慎勿为其所惑。
吾人不能遍拯斯民疾苦，宜广传良方，庶几稍尽利剂之心。每见得一秘方，深自隐匿，甚至
借以图利，挟索重赀，殊甚鄙恶。唐白华秘发背方，遂遭虎厄。歙蒋紫垣秘解砒毒方，竟获冥谴。可以为鉴。
乌程钮羹梅福浓，由中书历官郎中，在都门十余年，声望翕然。咸丰八年三月，偶患风温，
恶寒自足而起，渐及四肢，身热脉浮，舌苔白。医谓是风寒，用柴胡、葛根、防风、苍耳子
等药，遂至神昏躁厥，苔黄便结，更医用石膏、大黄等药，病益危笃。（医皆都门有名者，
而悖谬乃若此。）更医又用理阴煎，复脉汤等，卒不能救而殁，年仅五十有六。羹梅为余舅
氏，周愚堂先生之婿，好学敦品，气度雍容，咸谓可享上寿而跻显秩，乃为庸医所戕，亦可
惜矣！余见风温、湿温等证，凡用风药升提，伏热陷入心胞，无不神昏厥逆而毙，当此即用
清营汤、至宝丹、紫雪丹等、湔涤中宫，犹可挽回于万一。使认为阳明经腑症，一误再误，则生路绝矣。
作事宜从容详慎，为医尤慎。不特审病当然，即立方亦不可欲速贻误。杭州某医治热病，用
犀角七分，误书七钱，服药后胸痛气促而殒。病家将控之官，重贿乃已。某医治暑症用六一
散又用滑石，服之不效，大为病家所诟。此皆由疏忽致咎也。
治痈疽之法，不可轻用刀，破脓针疾之法，必先精究穴道，一或不慎，适以伤人。过事有可
以为鉴者。杭城有善者，设局延医以拯贫人，外科李某与焉。农夫某脚生痈，李开刀伤其大
筋，遂成废人，农夫家众殴李几毙。吾里有走方医人治某哮病，以针贯胸，伤其心；立时殒命，医即日遁去。
乌程周岷帆学士学源，才藻华美，咸丰九年，大考一等第二，由编修擢侍讲学士，旋丁外艰
，回籍十一年，避乱苕南，臀生瘤有年矣。因坐卧不便，就菱湖疡医费某治之。费谓可用药
攻去，予以三品一条枪，大痛数日，患处溃烂翻花，复投以五虎散，药用蜈蚣、蜣榔、全蝎等味
，服后体疲神愦遽卒，年仅四旬。往岁余馆湖城，及寓京邸，恒与岷帆谈艺论时，昕夕忘倦
，今闻其逝也，深恨庸医之毒烈，无异寇盗，特书于此，以志恫焉。（是年余避难柳丝，有
邻女陈桂姐手生痈毒，亦为费某开刀伤筋，痛甚不能收口，就余医治得痊。大抵近世疡医，
皆从《外科正宗》治法，专用霸功，误人甚多，学人当以为戒。）
临海人洪虞邻在《南沙文集》中说：我家有个经纪人，因劳累辛苦而呕血数升，请医生诊治，医生用了川黄连、人参等大寒大补的药物，这是加速他的死亡。急忙命令停止用药，只让他喝老米粥，吃味道浓厚的食物，让他休息饮食几天，不到十天就恢复得像以前一样强健。大概是因为劳累辛苦的人，平时未曾享受过美食，能有一两顿安稳的饭食，这比良药好多了，他痊愈也是理所当然的。又有轿夫平时没有病，忽然腰痛、肚子胀满不想吃东西，医生给他进服大补药，当天夜里腰痛更加严重，腹部胀大气喘几乎死去。第二天医生又去查看说：“这是中了鬼箭（一种邪祟），药物无法施展作用，应该赶紧祈祷驱邪。”我叹息说：“为什么要把罪责推给鬼神呢！”这是中寒伤食，给他服用祛寒化食的两剂药，第三天那人又能抬轿如常了。写下来告诉世上那些误信庸医的人。我认为误信庸医，是因为不熟悉医书，不能不求助于医生罢了。可恨的是，做医生的如果不深入探究医理，强行装作懂行的人，以致误事而自己却不知道。
吴郡有个医生，得到许叔微的《伤寒九十论》，奉为秘密版本。见他多次使用麻黄汤，恰好治疗一个女子热病无汗，说是足太阳经表证，投以麻黄汤服用，结果汗出不止而死。大概南方人少有真正的伤寒病，凡是热病无汗，用紫苏、葱白、豆豉、薄荷等药物治疗就够了，怎么能拘泥于古法呢？
朱熹晚年脚气病发作，俞梦达推荐医生张修之诊视，说：“必须稍微攻伐治疗，去除体内的壅滞，才能使气血脉道流通。”先生起初为难，张修之坚持用力，于是用了他的药。起初配制大黄、粟壳等药，服用后有一点小效，于是改用巴豆、三棱、莪术等药，觉得气息畅快脚步轻快，以前遇到食物多不下咽的毛病都去除了，接着大便又秘结不通，再服用几粒温白丸，脏腑通畅却导致泄泻不止，于是用大量黄芽（指人参或补气药）、岁丹（指某种丹药）投服，都不见效，最终去世。蔡九峰的《梦葬记》详细记载了这件事。看这件事就知道，对于高龄病人治病，千万不可使用攻伐药物。
祥符县有个姓胡的医生，医术精良，当权的人都慕名聘请他。某都督的女儿与人私通，偶然感受寒疾，招请胡医生。胡医生故意为此诊断说是怀孕的脉象。都督问：“先生的话可信吗？”胡医生说：“如果不是认识真切，不敢妄言。”都督于是叫女儿出来，用刀剖开她的腹部，看果然如此。胡医生大惊晕倒，很久才苏醒，回家后生病几个月就去世了。胡医生的技艺确实精巧！可惜他不知道顾忌。（我的先祖秋畦公在密县做县令时得知此事，祖母顾太孺人经常为此事谈论。）
近世的医生，能读《内经》的很少了，更有胡乱引用经文，成为笑柄的。比如治疗失眠，引用“半夏秫米汤”，足生大疔（原文此处似有脱漏或误植，结合语境应为引用错误经文），以为确凿证据。不知道“足”是能够的意思，不是专指脚部。又有治疗瘅疟证的，把“阴气先伤，阳气独发”当作《已任编》里的话，大概是没读过《内经》、《金匮要略》，只是看见《已任编》里有这句话罢了。粗疏浅陋到这种地步，竟然都是靠悬壶济世而出名的人。
医生贵在专门。歙县人吴章侯太守端甫在《易简良方》中的“劝行医说”，话说得非常恳切，特意记录下来。古代行医，各有专科。近来见到那些行医的人，往往明天出道，今天拜师，招牌上写着内外两位师傅传授，甚至兼治痧痘咽喉。探求他们的根底，一无擅长，不过是取门派数量多，来博取钱财。岂不知人的资质有限，怎么能兼善多种技能？病人不懂，常常被贻误。曾见有人患风痧，医生看作漆咬而误用清热药。又有患火焰疔的，医生看作热疮而误用发散类药物，几乎导致不治。这都是因为不专门造成的，能不谨慎吗？
苏州有个姓曹的，身材高大多胡须，医术在当时很有名气，但自视甚高，贫穷人家请他往往不去。某大户人家的翁公有个女儿，在闺房中，因病派仆人请曹医生，仆人向来憎恨曹医生，便谎称女儿已经出嫁，现在怀孕几个月了。吴地风俗大户妇女避客，医生到了就在床帐中伸出手让医生诊脉，曹医生按了女儿的脉，随口说是怀孕，翁公非常惊异。第二天，请另一位医生来，让他的儿子假装是女儿诊脉，也说怀孕。他的儿子掀开帐子打开门一看说：“我是男子怎么会有孕？诬陷我还可，诬陷我妹妹不可饶恕！”叱责仆人殴打曹医生，并灌他粪便，跪下哭泣求免，才剃掉他的胡须，用粉笔涂黑他的脸，放他离开。回家后谢绝客人，半年不出门，声望顿时衰落。太湖边有个外科医生谢某，技术精湛药物优良，但居心贪婪狡诈，往往趁人之急来谋取利益。邻村某农妇患疽疮求治，因为他贫穷拒绝了他，疽疮溃烂后死了。某人非常愤怒。谢某有拳勇，几十个人不能靠近。某人持刀埋伏在稻田里，伺机等他出来，突然刺他的腰部，谢某用他自己制的药敷治将愈，恼怒某人刺伤自己，急忙向县衙告状，按照惯例抬尸检验，县官揭开衣服，用力过重，衣服裂开皮肤破裂，受风后又溃烂而死。某人按法律抵罪，后来遇到赦免得以生存。这两个人医术都好，一个因为傲慢败坏名声，一个因为贪婪伤害身体，都可以作为警戒，所以一并记录。
徐灵胎在《慎疾刍言》中说：年轻时见前辈老医，一定要审察贫富然后用药。尤其见到居心不良的人，当时参价昂贵，号称名医，喜欢用新奇昂贵的药，来炫耀自己的博学，不计较价值高昂。甚至被药店收买，凡是诊断富人的病，一定加入贵重药材，使药店获利，这尤其可鄙。
《扬州府志·辨高邮州志》称袁体庵把脉极快，认为医生切脉，以审慎为工巧，快速不如这样。市井医生苟且行事，袁先生断然不像那样。唉！现在的医生，很少不以快速为工巧，就连请医生的人，也都以快速为能干，何不深味这句话？
南方有割螳螂子的法术，小儿蒙受其害。（徐灵胎《兰台轨范》详细辨析，说是妒乳法，用青钱、元明粉三钱、硼砂一钱、薄荷五分、冰片一分，同研细擦口腔两颊内侧，一天四五次。）北方有割脐带的法术，妇人蒙受其害，兼及小儿。（吴鞠通《温病条辨杂说》辨析说：字，考之字书并无是字，焉有是病？）这都是庸俗之人伪造其名，而劣妇秘传其技，借以欺世图利的人，明智的人，千万不要被他们迷惑。
我们不能遍救百姓疾苦，应该广泛传播良方，或许能稍微尽到利他的心意。每见得到秘方，深深隐藏，甚至借此图利，勒索重资，非常卑鄙可恶。唐代白华秘藏治疗发背的方子，竟遭老虎祸害。歙县蒋紫垣秘藏解砒霜毒的方子，竟获冥界谴责。可以作为借鉴。
乌程人钮羹梅福浓，由中书郎历任郎中，在京城十多年，声望很高。咸丰八年三月，偶然患风温病，恶寒从脚起，渐渐波及四肢，身热脉浮，舌苔白。医生说是风寒，用柴胡、葛根、防风、苍耳子等药，导致神昏躁动厥逆，苔黄便秘，换医生用石膏、大黄等药，病情更加危重。（医生都是京城有名的，却荒谬到这种地步。）换医生又用理阴煎、复脉汤等，最终不能挽救而死亡，年仅五十六岁。羹梅是我的舅氏，周愚堂先生的女婿，好学品德端正，气度雍容，大家都说他可享高寿且显贵，却被庸医残害，也很可惜！我看见风温、湿温等证，凡是用风药升提，伏热陷入心包，无不神昏厥逆而死，此时如果用清营汤、至宝丹、紫雪丹等，洗涤中宫，还可以挽回万一。如果认为是阳明经腑症，一误再误，那么生路就断了。
做事应该从容详慎，做医生尤其要谨慎。不仅审察病情应当如此，就是开方也不可以求快而贻误。杭州有个医生治热病，用犀角七分，误写成七钱，服药后胸痛气促而死。病家要告官，重金贿赂才作罢。有个医生治暑症用六一散又加滑石，服用无效，被病家大为诟骂。这都是由疏忽导致的过错。
治疗痈疽的方法，不可轻易用刀，破脓针治疾病，必须先精究穴位，一旦不慎，正好伤人。过去的事可以作为借鉴。杭州城有个善人，设局延请医生拯救穷人，外科李某在其中。农夫某脚生痈，李某开刀伤了他的主筋，遂成废人，农夫家人殴打李某几乎致死。我们乡里有走方医人治某哮喘病，用针贯穿胸部，伤了心脏；立即死亡，医生当天逃遁而去。
乌程周岷帆学士学源，才华华美，咸丰九年，大考一等第二，由编修提拔为侍讲学士，不久遭遇父丧，回乡十一年，在苕南避乱，臀部生瘤多年了。因为坐卧不便，找菱湖外科医生费某治疗。费某说可以用药攻去，给予三品一条枪，大痛数日，患处溃烂翻花，又投以五虎散，药用蜈蚣、蜣螂、全蝎等味，服用后体疲神昏突然死亡，年仅四十岁。往年我在湖州城教书，以及寓居京城，常与岷帆谈艺论时，早晚忘倦，现在听说他去世，深深痛恨庸医的毒烈，无异于寇盗，特书写于此，以表达悲痛。（这一年我避难柳丝，有邻女陈桂姐手生痈毒，也被费某开刀伤筋，痛甚不能收口，找我医治得痊愈。大抵近世外科医生，都从《外科正宗》治法，专用猛药，误人很多，学人应当以此为戒。）
Linhai native Hong Yulin stated in his "Nansha Wenshi": My family had a broker who vomited several sheng of blood due to overwork and hardship. A doctor was summoned, who prescribed Chuanlian (Coptidis Rhizoma) and Renshen (Ginseng Radix et Rhizoma), drugs that are excessively cold and tonifying; this accelerated his death. I urgently ordered the cessation of medication, instructed him to consume old rice porridge and rich-tasting foods, and allowed him to rest and eat for several days. Within ten days, he recovered his former strength. This is because people subjected to hard labor rarely enjoy good food; being able to have a few meals at peace is better than fine medicine, so his recovery was inevitable. There was also a sedan-chair porter who was usually healthy but suddenly suffered from lower back pain, abdominal distension, and loss of appetite. The doctor administered strong tonic medicines. That night, his back pain worsened significantly, his abdomen became distended, and he suffered from asthma-like breathing, nearly dying. The next day, the doctor examined him again and said, "This is an affliction by 'Ghost Arrows' (a type of malevolent spirit); medicines cannot work; one must urgently perform exorcism rituals." I sighed, "Why blame ghosts for this!" It was actually Cold Injury with Food Retention. He was given two doses of medicines to dispel cold and transform food retention. By the third day, he could carry passengers as usual. I write this to warn those in the world who mistakenly trust quack doctors. I believe that trusting quacks stems from a lack of familiarity with medical texts, forcing them to seek help from doctors. What is truly hateful is that physicians do not deeply investigate medical principles, yet force themselves to act as experts, causing errors without realizing it.
A physician in Wu Commandery obtained Xu Shuwei's "Shanghan Jiushi Lun" (Ninety Cases of Cold Damage) and treated it as a secret text. Noticing its frequent use of Mahuang Tang (Ephedra Decoction), he treated a woman with febrile disease and no sweating, diagnosing it as a Taiyang Exterior Syndrome of the Foot-Taiyang channel. He administered Mahuang Tang, resulting in unceasing sweating and her death. Generally, true Shanghan (Cold Damage) is rare among southern people. For febrile diseases with no sweating, treating with Zisu (Perillae Folium), Congbai (Allii Fistulosi Bulbus), Douchi (Fermented Soybean), Bohe (Menthae Haplocalycis Herba), etc., is sufficient. How can one rigidly adhere to ancient methods?
Zhu Xi suffered from gout attacks in his later years. Yu Mengda recommended a physician named Zhang Xiuzhi for consultation. Zhang said, "It is necessary to slightly attack and treat the condition to remove stagnation, so that Qi and blood vessels can flow smoothly." Zhu initially hesitated, but Zhang insisted strongly, so Zhu took the medicine. Initially, Huangqi (Astragali Radix) and Husu (Papaveris Pericarpium) were prepared; after taking them, there was slight improvement. Then Baidu (Crotonis Fructus), Sanleng (Sparganii Rhizoma), and Ezhu (Curcumae Rhizoma) were used. He felt his Qi was smooth and steps light, and previous symptoms of food sticking in the esophagus disappeared. However, his large bowels became constipated again. Taking a few pills of Wenbai Wan (Warm White Pill) smoothed the viscera but caused incessant diarrhea. Large doses of Huangya (likely referring to Renshen or similar tonics) and Suidan (a specific pill) were administered, but all were ineffective, leading to his death. Cai Jiufeng's "Mengzang Ji" records this in detail. From this, we know that for elderly patients, one must be extremely cautious about using attacking/draining medicines.
A physician surnamed Hu from Xiangfu County practiced with excellent skill, and officials invited him out of admiration. The daughter of a certain Dudu (Military Governor) had an illicit affair and accidentally contracted a cold illness, summoning Dr. Hu. Dr. Hu deliberately diagnosed her pulse as indicating pregnancy. The Dudu asked, "Is your statement reliable?" Dr. Hu replied, "If I did not recognize it truly, I would not dare to speak rashly." The Dudu then called his daughter forth and cut open her abdomen to verify; it was indeed true. Dr. Hu was terrified and fainted, recovering only after a long time. He fell ill upon returning home and died months later. Dr. Hu's skills were indeed exquisite! Alas, he lacked caution. (My ancestor, Mr. Qiuqi, learned of this while serving as magistrate of Mixian County; my grandmother, Lady Gu, often discussed this matter.)
In recent times, few physicians read the "Neijing" (Inner Canon). Some even arbitrarily quote classics, becoming subjects of ridicule. For example, when treating insomnia, some cite "Banxia Shumi Tang" (Pinellia and Millet Decoction) and "Zusheng Ding" (sores arising from the foot), believing these to be definitive signs. They do not know that "zu" here means "can/able to," not specifically referring to the foot. Others treating Danmalaria (Febrile Malaria) cite "Yinqi xian shang, Yangqi du fa" (Yin qi is injured first, Yang qi acts alone) as a quote from "Yiren Bian," likely having never read the "Neijing" or "Jingui Yaolue," merely seeing this phrase in "Yiren Bian." Such ignorance and crudeness come from those famous for practicing medicine.
Physicians should specialize. Wu Zhanghou, Prefect Duanfu from She County, wrote very earnestly in the "Quan Xingyi Shuo" (Advice on Practicing Medicine) within "Yijian Liangfang." I record it here. In ancient times, physicians each had their own specialty. Recently, I see practitioners who start practicing tomorrow and study today, advertising instruction from both Internal and External masters, even treating Sha, smallpox, and throat diseases. Probing their foundation, they excel in nothing; they merely accumulate many schools to gain wealth. Do they not know that human constitution is limited, how can one excel in everything? Patients do not understand and are often misled. I once saw someone suffering from Fengsha (Wind Rash), whom a doctor mistook for a lacquer allergy and wrongly used clearing/cold medicines. Another patient with Huoyan Ding (Flame Carbuncle) was mistaken by a doctor for a heat sore and wrongly used dispersing medicines, nearly leading to untreatable conditions. All this is due to lack of specialization; how can one not be cautious?
A man surnamed Cao from Suzhou was tall, bearded, and famous for his medical skills, but he held himself in high esteem. Poor families inviting him were often ignored. An old man from a wealthy family had a daughter confined to her boudoir who fell ill and sent a servant to invite Cao. The servant, who hated Cao, lied and said the daughter was already married and pregnant for several months. In Wu customs, women of great families avoided guests; when the doctor arrived, he was to extend his hand through the bed curtains for pulse diagnosis. Cao palpated the daughter's pulse and casually said it indicated pregnancy. The old man was greatly startled. The next day, another doctor was invited, and the old man's son pretended to be the daughter for diagnosis, also saying it was pregnancy. The son lifted the curtain and opened the door, saying, "I am a male, how could I be pregnant? You may slander me, but slandering my sister is unforgivable!" He scolded the servant, beat Cao, forced him to drink feces, and made him kneel and cry for mercy. Only then did they shave his beard, smear chalk powder on his face, and let him go. He returned home, declined visitors, and did not appear for half a year; his reputation plummeted.
Another surgeon, Xie, from the banks of Taihu Lake, had refined skills and good medicines but was greedy and deceitful, often exploiting people's emergencies for profit. When a farmer's mother from a neighboring village sought treatment for a carbuncle, he refused her due to poverty; she died after the carbuncle ulcerated. Someone was furious. Xie was skilled in martial arts, and dozens of men could not approach him. This person hid with a knife in the rice fields, waiting for Xie to emerge, and suddenly stabbed him in the waist. Xie applied his own medicine to heal, but angry at the stabbing, he urgently sued the attacker. Following regulations, the body was inspected. The county official lifted the clothes with excessive force, causing skin rupture; exposure to wind led to re-ulceration and death. The attacker was sentenced according to law but survived after a general amnesty. Both these men had good medical skills; one ruined his name through arrogance, the other harmed his life through greed. Both serve as warnings, so I record them together.
Xu Lingtai stated in "Shenji Chu Yan": In my youth, I saw senior old physicians who carefully assessed the patient's wealth before prescribing. I especially saw those with malicious intentions; at that time, Ginseng prices were high. Physicians claiming fame often liked to use novel/expensive drugs to show off their erudition, disregarding cost. Even worse, some were bribed by pharmacies; whenever diagnosing the rich, they necessarily included expensive ingredients to benefit the pharmacy, which is particularly despicable.
The "Yangzhou Prefecture Gazetteer" notes that Yuan Ti'an's pulse-taking was extremely fast. It states that a physician's pulse diagnosis values prudence as skill, and speed is inferior to such caution. Market physicians act carelessly; Yuan certainly did not do so. Alas! Today's physicians rarely consider speed as skill, and those seeking physicians also value speed. Why not ponder this deeply?
In the south, there is a technique of "cutting mantis eggs," harming children. (Xu Lingtai's "Lantai Guidfan" analyzes this in detail, stating it is the "Jealous Breastfeeding Method," using green coins, 3 qian of Yuanming Powder, 1 qian of Borax, 5 fen of Menthae Haplocalycis Herba, and 1 fen of Borneolum Syntheticum, ground finely and rubbed on the inner cheeks four to five times a day.) In the north, there is a technique of "cutting the navel cord," harming women and children. (Wu Jutong's "Wenbing Tiaobian Zasuo" analyzes this, stating: The character [specific character omitted] does not exist in dictionaries; how can such a disease exist?) These are names fabricated by vulgar people, with techniques secretly passed down by wicked women to deceive the world for profit. Wise people must not be confused by them.
Since we cannot save all people from suffering, we should widely disseminate good prescriptions to fulfill our desire to benefit others. I often see people keeping secret formulas hidden, even using them for profit or extorting heavy fees, which is extremely despicable. Bai Hua of the Tang Dynasty kept a formula for treating back carbuncles secret and subsequently suffered a tiger attack. Jiang Ziyuan of She County kept a formula for antidoting arsenic secret and allegedly received divine punishment. These can serve as warnings.
Niu Gengmei Funong from Wucheng rose from Zhongshu Lang to Langzhong, enjoying great prestige in the capital for over ten years. In March of the 8th year of Xianfeng, he accidentally contracted Wind-Warmth. Chills started from the feet and spread to limbs; body heat, floating pulse, white tongue coating. The doctor diagnosed Wind-Cold and used Chaihu (Bupleuri Radix), Gegen (Puerariae Lobatae Radix), Fangfeng (Saposhnikoviae Radix), Cang'erzi (Xanthii Fructus), etc., leading to coma, agitation, and cold extremities. The coating turned yellow, bowels became constipated. A changing doctor used Shigao (Gypsum Fibrosum) and Dahuang (Rhei Radix et Rhizoma), making the condition critical. Another doctor used Liyin Jian (Replenish Yin Decoction) and Fumai Tang (Restore Pulse Decoction), but ultimately failed to save him. He died at age 56. Gengmei was my uncle-in-law, husband of Mr. Zhou Yutang's daughter. He was studious, virtuous, and dignified; everyone thought he would live a long life and achieve high rank, yet he was killed by quack doctors. It is regrettable! I observe that in Wind-Warmth and Damp-Warmth syndromes, if wind-dispersing ascending drugs are used, latent heat sinks into the Pericardium, inevitably leading to coma and cold extremities leading to death. At this point, using Qingying Tang (Clear Nutrient Decoction), Zhibao Dan (Treasure of Wisdom Pill), or Zixue Dan (Purple Snow Pill) to cleanse the Middle Jiao might still salvage the situation. If misdiagnosed as Yangming Channel/Fu syndrome and errors repeat, the path to life is cut off.
Work should be done calmly and cautiously; medicine requires even more caution. Not only must the disease be accurately diagnosed, but prescriptions must not be rushed to avoid error. A Hangzhou physician treating febrile disease prescribed 7 fen of Xijiao (Rhinocerotis Cornu), but mistakenly wrote 7 qian. After ingestion, chest pain and shortness of breath led to death. The patient's family threatened legal action, resolved only by heavy bribery. Another physician treating Summerheat used Liuyi San (Six-to-One Powder) plus Huashi (Talcum), which was ineffective and heavily criticized by the patient's family. All these faults stem from negligence.
The method for treating carbuncles and ulcers should not lightly use knives. For puncturing abscesses, one must precisely study acupoints; otherwise, inadvertence will harm the patient. Past events serve as warnings. In Hangzhou, a benevolent person set up a bureau to invite doctors to save the poor. Surgeon Li was among them. A farmer had a carbuncle on his foot; Li's incision severed a major tendon, rendering him disabled. The farmer's family beat Li nearly to death. In our village, a wandering practitioner treated asthma by piercing the chest with a needle, injuring the heart; the patient died instantly, and the doctor fled that day.
Zhou Minfan Xueyuan Xueyuan from Wucheng was talented and elegant. In the 9th year of Xianfeng, he ranked second in the First Class of the Grand Examination, promoted from Compiler to Assistant Scholar of the Hanlin Academy. Soon after, he suffered mourning for his father, returned home for eleven years, and hid from turmoil in southern Tiao. He had had a tumor on his buttock for years. Due to inconvenience in sitting and lying, he sought treatment from Surgeon Fei of Linghu. Fei said it could be removed with medicine, administering "Sanpin Yitiaoqiang" (Three-Piece Single-Barrel Gun, a toxic herb preparation). After severe pain for several days, the lesion ulcerated and everted. Then "Wuhu San" (Five-Tiger Powder) containing Wugong (Scolopendra), Qianglang (Staphylinidae), and Quanxie (Scorpio) was administered. After ingestion, he became physically exhausted and mentally confused, dying suddenly at age forty. In past years, when I taught in Huzhou and resided in Beijing, I often discussed arts and current affairs with Minfan, forgetting fatigue morning and night. Hearing of his death, I deeply hate the toxicity of quack doctors, comparing them to bandits. I write this to express grief. (That year, while hiding in Liusi, a neighbor girl Chen Guijie had a carbuncle on her hand. She was also operated on by Fei, who severed tendons, causing severe pain and inability to heal. She came to me for treatment and recovered. Generally, modern surgeons follow the methods of "Waike Zhengzong" (Orthodox Manual of External Medicine), using only harsh/potent drugs, harming many. Students should take this as a warning.)