余戚苕城沈妪，年七十四，忽头上右偏发中生一角，初起微痛，其后每觉痛则角稍大，
年，状如小指，角根之肉微肿，角坚如石，色微黄，角尖有三凹，纹色微黑如犀角，今已七
十六岁。（咸丰八年记。）按∶丹溪治郑经历嗜酒与煎爆，年五十余，额丝竹空穴涌出一角，
长短大小如鸡距，稍坚，丹溪谓宜断浓味，先解食毒，针灸以开泄壅滞，未易治也，郑惮烦
，召他医，以大黄、朴硝、脑子等冷药掩之，一夕豁开如酱蚶，径三寸，一二日后，血自蚶
中溅出，高数尺而死，此冷药外逼，热郁不得发，宜其发之暴如此。今沈妪食贫茹苦，从不
饮酒啖肉，其非食毒可知，不审何气使然，书之以俟识者。（又按∶《南史》孙谦末年头生
二肉角，各长一寸，此则有肉无骨，其形较异。又按∶赵云松《观察檐曝杂记》云∶梁武帝
时钟离人顾思远年一百十二岁，萧侯见其头有肉角长寸许（见传）。后余亦见二人，一江兰皋
，阳湖人，一徐姓，嘉兴人，头上皆有肉角，高寸许，年亦皆九十余，盖寿相也，然二人皆贫
苦，皆无子，则亦非去征。此亦可以相证，附录之。）
病有可预测其兆者。如手指麻木，知将患中风。一年前时时口干，手脚心热，或作渴思
饮茶井水，或食已即饥，知将患发背。三年内眉目骨痛，知将患大风疾。此有外症可凭者也。至
于察神色，审脉象，而能先识其 ，则非神乎技者不能矣。
《医碥》谓真心痛、（切牙噤口，舌青面黑，汗出不休，手足寒过节。）真头痛（全脑连
齿皆
子服之，以散其寒，或可死中求生。真头痛急与黑锡丹，灸百会穴，猛进参、沉、乌、附，
本生祖秋畦公捐馆舍时，（年七十有八），猝发心痛不可忍，半日即长逝，其时延医诊视
，只进治心痛通套药，使准此法以治，庶几稍可救药乎？
消渴、水肿、下疳、咳嗽、吐血等症，皆以戒盐为第一要义，若不能食淡，方药虽良，
病有见于此而应于彼者，约略举之，如青腿牙疳之症，牙病而必见于腿上，咳不止，脉无神
气，粪门生 ，此阳极而下，不治之症。 腮之症，（亦名肿腮。）初起恶寒发热，脉沉数，
耳前后肿痛，隐隐有红色，肿痛将退，睾丸忽胀，亦有误用发散药，体虚者，不任大表，邪
因内陷，传入厥阴脉络，睾丸肿痛，而耳后全消者，盖耳后乃少阳胆经部位，肝胆相为表里，
少阳感受风热，邪移于肝经也，若作疝症治之益误矣。此症惟汪蕴谷文绮《会心录》详言之
，并立方云∶肿腮体实者，甘桔汤加牛蒡、丹皮、当归之属，一二剂可消；体虚者，甘桔汤
加何首乌、玉竹、丹皮、当归之属，二三剂亦愈。如遗毒为害，必须救阴以回津液，补元以
生真气，俾邪热之毒，从肿处尽发，方用救阴保元汤，（黑豆三钱，熟地二钱，麦冬钱半，
丹皮，山药、南沙参、炙黄 各一钱，炙甘草八分），水煎服。又虏疮之症，亦有先喉痛者
，陈载庵之子所患，用《吴医会讲》中之法治之是也。（见“今人门”。）
我的亲戚苕城沈姓老妇，七十四岁时，忽然在头部右侧偏上方的头发中长出一个小角。初起时微痛，此后每次感到疼痛，那个角就会稍微变大一些。到了这一年（咸丰八年），形状像小指一样大，角根部的肉微微肿胀，角坚硬如石头，颜色微黄，角尖有三个凹陷，纹理颜色微黑如同犀角。如今她已七十六岁。（此记录于咸丰八年。）
按：朱丹溪曾治疗郑经历，此人嗜好饮酒和吃油炸爆炒的食物，五十多岁时，额头丝竹空穴处涌出一个角，长短大小像鸡爪距一样，质地稍硬。丹溪认为应当断绝浓味食物，先解除食毒，并用针灸来开通宣泄壅滞之气，但这病不容易治愈。郑经历害怕麻烦，召来其他医生，用大黄、朴硝、冰片等寒凉药物外敷掩盖。结果一夜之间破溃如酱蚶（一种贝类），直径三寸，一两天后，血液从破口溅出，高达数尺而死。这是因为寒凉药物从外部逼迫，导致热邪郁结无法发散，所以发作如此猛烈。现在的沈老妇生活贫困艰苦，从不喝酒吃肉，可知她的病并非由食毒引起，不知是什么气机导致的，记录下来以等待有见识的人解答。（另外按：《南史》记载孙谦末年头上长了两个肉角，各长一寸，这是只有肉没有骨头的，形态与沈妪不同。又按：赵云松在《观察檐曝杂记》中说：梁武帝时期钟离人顾思远一百一十二岁时，萧侯见他头上有一个肉角长约一寸（见传记）。后来我也见过两个人，一个是江兰皋，阳湖人；另一个姓徐，嘉兴人，他们头上都有肉角，高一寸左右，年龄也都九十多岁，这似乎是长寿之相。然而这两人都贫穷困苦，都没有儿子，那么也不是去官的征兆。这也足以相互印证，附录在这里。）
疾病中有可以预测其预兆的。比如手指麻木，知道将要患中风。一年前时常口干，手脚心发热，或者口渴想喝井水，或者吃完东西很快就饿，知道将要患发背疽。三年内眉目骨骼疼痛，知道将要患麻风病（大风疾）。这些是有外在症状可以凭据的。至于通过观察神色、审察脉象，就能预先识别病情，那就不是技艺高超的神医不能做到了。
《医碥》说真心痛（症状包括切牙紧闭、口噤不开、舌青面黑、汗出不止、手足寒冷超过肘膝关节），真头痛（全脑连牙齿都痛），如果子午时发病，半天内死亡。……（此处原文有缺漏或排版错误，推测为讨论预后）……服用以散其寒气，或许可以在死中求生。真头痛急症给予黑锡丹，灸百会穴，猛进人参、沉香、乌头、附子等药。
我祖父秋畦公去世时（享年七十八岁），突然发作心痛不可忍受，半天就去世了。当时延请医生诊治，只进了治疗心痛的一般通套药物，如果能按照上述方法治疗，或许还有救药的机会吗？
消渴、水肿、下疳、咳嗽、吐血等症状，都把戒盐作为第一要义。如果不能吃得清淡，方药虽然好，也无效。
疾病有表现于此而应验于彼的情况，粗略列举如下：如青腿牙疳症，牙病却必然表现在腿上；咳喘不止，脉象无神气，肛门生痔漏，这是阳极于上而下虚，属于不治之症。痄腮症（也叫肿腮），初起恶寒发热，脉沉数，耳前后肿痛，隐隐有红色。肿痛将退时，睾丸忽然肿胀。也有误用发散药，体质虚弱者，不能承受强烈的发汗解表，邪气因此内陷，传入厥阴脉络，导致睾丸肿痛，而耳后的症状完全消失。因为耳后是少阳胆经的部位，肝胆互为表里，少阳感受风热，邪气转移到了肝经。如果当作疝症治疗就更加错误了。这个病症只有汪蕴谷文绮在《会心录》中详细论述，并立处方说：痄腮体质壮实的，用甘桔汤加牛蒡子、牡丹皮、当归之类，一二剂可以消除；体质虚弱的，用甘桔汤加何首乌、玉竹、牡丹皮、当归之类，二三剂也能痊愈。如果有遗毒为害，必须救阴以恢复津液，补元气以生成真气，使邪热之毒从肿处全部发散出来，才用救阴保元汤（黑豆三钱，熟地黄二钱，麦冬一钱半，牡丹皮、山药、南沙参、炙黄芪各一钱，炙甘草八分），水煎服。又有虏疮症，也有先喉咙痛的，陈载庵的儿子所患的病，用《吴医会讲》中的方法治疗是对的。（见“今人门”）。
My relative, an elderly woman surnamed Shen from Tiaocheng, at the age of seventy-four, suddenly grew a horn-like growth in the hair on the right upper side of her head. Initially, it was slightly painful. Thereafter, every time she felt pain, the horn would grow slightly larger. By this year (Xianfeng 8th Year), its shape was like a small finger. The flesh at the base of the horn was slightly swollen; the horn itself was hard as stone, with a slightly yellow color. The tip of the horn had three depressions, and the texture was slightly black, resembling rhinoceros horn. She is now seventy-six years old. (Recorded in the 8th Year of Xianfeng.)
Note: Zhu Danxi treated Zheng Jingli, who had a habit of drinking alcohol and eating fried or roasted foods. In his fifties, a horn-like growth erupted from the Sizhukong acupoint (Sizhukong, EX-HN4) on his forehead. It was as long and large as a chicken spur, slightly hard. Danxi stated that one should cut off rich flavors, first resolve food toxicity, and use acupuncture to open and drain stagnation. This condition was not easy to treat. Zheng, fearing the trouble, summoned other physicians who applied cold medicines such as Rhubarb (Rhei Radix et Rhizoma), Mirabilite (Natrii Sulfas), and Borneol (Bingpian) externally to cover it. Overnight, it burst open like a mussel shell, with a diameter of three cun. One or two days later, blood splashed out from the wound, reaching several feet high, and he died after a day or two. This was because the cold medicines forced the pathogen outward from the exterior, causing heat to be constrained and unable to vent, leading to such a violent outbreak. Now, Old Lady Shen lives in poverty and hardship, never drinking alcohol or eating meat. It is clear that her condition is not caused by food toxicity. It is unknown what qi mechanism caused this. I record this for those with knowledge to explain. (Another note: *History of the Southern Dynasties* records that Sun Qian grew two fleshy horns on his head in his late years, each one cun long. These were fleshy without bone, differing in form from Old Lady Shen's. Another note: Zhao Yunsong, in *Observations from the Pavilion of Daily Exposure*, stated that Gu Siyuan, a person from Zhongli during the reign of Emperor Wu of Liang, lived to be 112 years old. Prince Xiao saw a fleshy horn on his head about one cun long (see biography). Later, I also met two people: one named Jiang Langao from Yanghu, and another surnamed Xu from Jiaxing. Both had fleshy horns on their heads, about one cun high, and both were over ninety years old. This seems to be a sign of longevity. However, both were poor and bitter, and both had no sons, so it was not a sign of losing office. This can corroborate each other and is appended here.)
There are diseases whose signs can be predicted. For example, numbness in the fingers indicates an impending stroke. Dry mouth occurring frequently for a year prior, along with heat in the palms and soles, or thirst desiring well water, or hunger immediately after eating, indicates an impending carbuncle of the back (Fabei). Bone pain in the eyebrows and eyes within three years indicates an impending case of Leprosy (Dafengji). These are conditions where external symptoms provide evidence. As for observing the spirit and complexion, examining the pulse, and being able to identify the disease beforehand, this requires skills beyond the ordinary, achievable only by a divine physician.
*Yi Bian* states that Zhen Xin Tong (True Heart Pain) [symptoms include clenched teeth, locked jaw, blue tongue, black face, incessant sweating, and cold limbs extending past elbows and knees] and Zhen Tou Tong (True Headache) [pain throughout the brain connecting to the teeth], if occurring at Zi or Wu hours, result in death within half a day... [text gap/error in original] ...taking medicine to disperse cold might allow survival amidst death. For acute Zhen Tou Tong, administer He Xi Dan (Black Tin Pill), moxa the Baihui acupoint (Baihui, GV20), and vigorously administer Ginseng (Renshen), Costus Root (Chenxiang), Aconite (Wutou), and Prepared Aconite Root (Fuzi).
When my grandfather, Mr. Qiuqi, passed away (at the age of seventy-eight), he suddenly suffered unbearable heart pain and died within half a day. Physicians were summoned, but only general remedies for heart pain were administered. If these methods had been used, perhaps there would have been some chance of saving him?
For conditions such as Xiao Ke (Wasting-Thirst), Shui Zhong (Edema), Xia Gan (Chancre), Ke Sou (Cough), and Tu Xue (Hematemesis), abstaining from salt is the primary principle. If one cannot eat bland food, even good prescriptions will be ineffective.
Some diseases manifest in one area but affect another. Briefly listed: Qing Tui Ya Gan (Blue Leg Gum Disease) manifests as gum disease but necessarily appears on the legs; incessant coughing with a pulse lacking spirit, and hemorrhoids/fistulas at the anus, indicate extreme yang sinking below, which is incurable. Za Sai (Mumps) [also known as Swollen Cheeks], initially presents with aversion to cold and fever, deep and rapid pulse, swelling and pain around the ears, with a faint redness. As the swelling and pain subside, the testicles suddenly swell. Sometimes, due to the misuse of diaphoretic herbs, patients with weak constitutions cannot tolerate strong sweating, causing the pathogen to sink internally and enter the Jueyin meridians, resulting in testicular swelling and pain while the post-auricular symptoms completely disappear. This is because the post-auricular region belongs to the Shaoyang Gallbladder Meridian. The Liver and Gallbladder are interior-exterior pairs. When Shaoyang contracts wind-heat, the pathogen shifts to the Liver Meridian. Treating this as a Hernia (Shan) would be a greater error. Only Wang Yungu Wenqi detailed this in *Huixin Lu* and prescribed: For robust patients with Mumps, Gan Jie Tang (Licorice and Platycodon Decoction) plus Arctii Fructus (Niubangzi), Paeoniae Radix Rubra (Danpi), and Angelicae Sinensis Radix (Danggui); one or two doses can resolve it. For weak patients, Gan Jie Tang plus Polygoni Multiflori Preparata Radix (Heshouwu), Polygonatum Odorati Rhizoma (Yuzhu), Danpi, and Danggui; two or three doses will also cure it. If residual toxins cause harm, one must nourish yin to restore fluids and tonify yuan qi to generate true qi, allowing the toxic heat to vent entirely through the swelling. Then use Jiu Yin Bao Yuan Tang (Rescue Yin and Protect Yuan Decoction) [Black Bean 3 qian, Prepared Rehmannia Root 2 qian, Ophiopogon Tuber 1.5 qian, Danpi, Dioscorea Rhizome, Adenophora Root, Prepared Astragalus Root each 1 qian, Prepared Licorice Root 0.8 qian], decocted in water and taken orally. Another condition, Lu Chuang (Barbarian Sore), may also begin with sore throat. The son of Chen Zai'an suffered from this, and treating it according to the methods in *Wu Yi Hui Jiang* was correct. (See "Contemporary Doctors" section).