何秀才一女子病。其父谓予曰。年十三时。五月间。因伤冷粉。腹中作痛。遂于市药铺中。赎
得神芎丸服之。脐腹渐加冷疼、时发时止。今逾七八年不已。何也。答曰。古人云。寒者热之。治
寒以热。良医不能废其绳墨而更其道也。据所伤之物。寒也。所攻之药。亦寒也。重寒伤胃。其为
冷痛。岂难知哉。凡人之脾胃。喜温而恶冷。况女子幼小。血气尚弱。不任其寒。故阳气潜伏。寒
毒留连。久而不除也。治病必先求其本。当用温中养气之药。以救前失。服之月余方愈。呜呼。康
子馈药。孔子拜而受之。以未达不敢尝。此保生之重者也。奈何常人命医。拱默而令切脉。以谓能
知病否。且脉者。人之血气附行于经络之间。热胜则脉疾。寒胜则脉迟。实则有力。虚则无力。至
于所伤何物。岂能别其形象乎。医者不可不审其病源。而主家不可不说其病源。
如何氏女子。不以病源告医。而求药于市铺。发药者亦不审其病源而以药付之。以致七八年之病。
皆昧此理也。孙真人云。未诊先问。最为有准。东坡云。只图愈疾。不图困医。二公之语。其有功
于世大矣。
高郎中家。好收方书。及得效药方。家人有病。自为处治。亦曾有效。中统庚申五月间。弟妇
产未盈月。食冷酪苦苣及新李数枚。渐觉腹中痛。太夫人以自合槟榔丸七十丸服之。至夜痛尤甚
。恐药力未达。又进五十丸。须臾间大吐且泻。其痛增极。肢体渐冷。口鼻气亦冷。急求医疗。未
至而卒。后太夫人见予。诉其由。曰天命耶。药之过耶。君试裁之。予曰。非难知也。凡医治病。
虚则补之。实则泻之。此定法也。人以血气为本。今新产血气皆损。胃气虚弱。不能腐熟生硬物。
故满而痛也。复以寒剂攻之。又况夏月阴气在内。重寒相合是大寒气入腹。使阴盛阳绝。其死何疑
。难经曰。实实虚虚。损不足而益有余如此死者。医杀之耳。非天命也。太夫人然其言。噫。曲礼
谓医不三世。不服其药。其慎如此。彼过已往而不可咎。后之用药者。当以此为戒之。
何秀才的一位女儿患病。她的父亲对我说道：“她十三岁那年，五月期间，因受冷米粉所伤，腹中疼痛。于是去药铺买得神芎丸服用。此后脐腹部逐渐加重冷痛，时发时止。如今已七八年未愈。这是为什么呢？”我回答说：“古人说：寒者热之，治疗寒证要用热药。高明的医生不能废弃规矩而改变其道。根据所伤之物，是寒性的；所用攻伐之药，也是寒性的。重寒损伤胃气，这冷痛的成因，难道难以知晓吗？大凡人的脾胃，喜欢温暖而厌恶寒冷。何况女子年幼，血气尚且虚弱，承受不了这种寒邪。因此阳气潜伏，寒毒留连不去，久而久之便无法消除。治病必须先探求病本，应当使用温中养气的药物，来补救之前的失误。服药月余才痊愈。唉！康子送药给孔子，孔子拜谢并收下，但因为不了解药性而不敢尝试，这是保养生命的重要原则。为何常人请医生看病，只是拱手沉默让医生切脉，认为这样就能知道病情如何？况且脉象，是人的血气依附运行于经络之间的表现。热盛则脉搏急促，寒盛则脉搏迟缓，实证则有力，虚证则无力。至于究竟受了什么伤害，怎么能通过脉象辨别其具体形象呢？医生不可不审慎探究病源，而家属也不可不说出病源。像何氏女子，不把病源告诉医生，反而向药铺求药；卖药的人也不审问病源就把药给她，导致七八年的疾病，都是因为不明白这个道理。孙思邈说：‘未诊先问，最为有准。’苏东坡说：‘只图治愈疾病，不顾及使医生陷入困境（指隐瞒病史）。’两位先生的话，对世人的益处很大。”
高郎中家中，喜欢收集方书以及有效的药方。家人有病，自行处方治疗，也曾有过效验。中统庚申年五月间，弟媳生产未满一个月，吃了冷酪、苦苣和几颗新李子，渐渐觉得腹中疼痛。太夫人用自制的槟榔丸七十丸给她服用。到了夜晚，疼痛更加剧烈。担心药力未到，又服用了五十丸。不一会儿，出现剧烈呕吐和腹泻，疼痛加剧至极点，肢体逐渐变冷，口鼻气息也变冷。急忙求医治疗，医生还未赶到就去世了。后来太夫人见到我，诉说原委，问道：“这是天命吗？还是药物的过错？请您评判。”我说：“这不难知道。大凡医生治病，虚证则补益，实证则泻除，这是定法。人以血气为本，现在刚生产完，血气都受损，胃气虚弱，不能消化生冷坚硬的食物，所以胀满而疼痛。再用寒凉药剂攻伐，况且夏季体内阴气旺盛，重寒相合，是大寒气进入腹部，使得阴盛阳绝，死亡有什么可疑的呢？《难经》说：‘实实虚虚，损不足而益有余。’像这样的死者，是医生杀死的罢了，并非天命。”太夫人认同我的话。唉！《曲礼》说：‘医不三世，不服其药。’谨慎到如此地步。过去的过错已经发生，无法责怪，后来的用药者，应当以此为戒。”
A daughter of Scholar He fell ill. Her father said to me, "When she was thirteen years old, in May, she suffered from cold rice noodles, which caused abdominal pain. She then purchased Shenxiong Wan (Divine Xiong Pill) from a pharmacy and took it. Since then, the cold pain in her navel and abdomen gradually worsened, coming and going intermittently. It has now persisted for seven or eight years without relief. Why is this?" I replied, "The ancients said: 'For cold conditions, use heat; treat cold with hot methods.' A skilled physician cannot abandon established principles and change their approach. The offending substance was cold in nature, and the purgative medicine used was also cold. Double cold damages the Stomach Qi. Is the cause of this cold pain not obvious? Generally, the Spleen and Stomach prefer warmth and dislike cold. Moreover, as a young girl, her Blood and Qi were still weak and could not withstand such cold pathogenic factors. Thus, Yang Qi became latent, and cold toxicity lingered, making it difficult to eliminate over time. To treat disease, one must first seek its root cause. One should have used medicines that warm the middle and nourish Qi to remedy the previous error. After taking them for over a month, she recovered. Alas! When Kang Zi offered medicine to Confucius, Confucius bowed and accepted it but dared not taste it because he did not understand its properties. This highlights the importance of preserving life. Why do ordinary people, when consulting a physician, merely stand with hands clasped in silence and allow the physician to palpate the pulse, believing this alone suffices to diagnose the illness? The pulse reflects the movement of Blood and Qi within the meridians. Excess heat results in a rapid pulse; excess cold results in a slow pulse. Excess patterns present with strength, while deficiency patterns lack strength. However, how can one distinguish the specific nature of the injury solely through the pulse? Physicians must carefully investigate the source of the disease, and families must disclose the history of the illness. In the case of Scholar He's daughter, failing to inform the physician of the cause and instead seeking medicine from a shop, coupled with the seller dispensing medicine without investigating the cause, led to a chronic condition lasting seven or eight years. All this stems from ignorance of this principle. Sun Simiao stated: 'Inquiring before diagnosing is most accurate.' Su Dongpo remarked: 'Seeking only cure, disregarding the plight of the physician.' These words by both gentlemen have greatly benefited the world."
The family of Vice-Director Gao liked to collect medical texts and effective prescriptions. When family members fell ill, they would self-prescribe and had achieved some success. In the fifth month of the Gengshen year of the Zhongtong era, the wife of his younger brother, who had given birth less than a month prior, consumed cold cheese, bitter lettuce, and several fresh plums. She gradually experienced abdominal pain. The Matriarch administered seventy pills of Binglang Wan (Betel Nut Pill), which she prepared herself. By nightfall, the pain intensified. Fearing the medicinal effect had not yet taken hold, another fifty pills were given. Shortly thereafter, severe vomiting and diarrhea occurred. The pain increased to an extreme degree, limbs gradually turned cold, and breath from the mouth and nose became cold. Emergency medical help was sought, but she passed away before the physician arrived. Later, the Matriarch met me and recounted the events, asking, "Was this destiny or an error of medication? Please judge." I said, "This is not difficult to understand. Generally, physicians treat deficiency by tonifying and excess by purging; this is a fixed rule. Humans rely on Blood and Qi as their foundation. Now, having just given birth, both Blood and Qi are depleted, and Stomach Qi is weak, unable to digest raw, cold, and hard foods, leading to fullness and pain. Furthermore, administering cold-purgative agents during summer, when Yin Qi resides internally, combines heavy cold with internal cold. This allows severe cold pathogenic factors to enter the abdomen, causing Yin to flourish and Yang to perish. Is there any doubt about death? The Nan Jing states: 'Reinforcing excess and depleting deficiency, damaging what is insufficient and benefiting what is surplus.' Such deaths are caused by the physician, not by destiny." The Matriarch agreed with my words. Alas! The Qu Li states: "Do not take medicine prescribed by physicians whose lineage does not extend three generations." Caution is required to this extent. Past errors cannot be blamed, but future prescribers should take this as a warning.