本事方载宜和间。天庆观法师。行考召法极精严。时一妇人。投状求治病。师召祟至。
云非我为祸。别是一鬼。亦因病患命衰为祟耳。渠今已成形。在患人肺为虫。食其肺系。故
令吐血声嘶。师掠之。此虫还有畏忌否。久而无语。再掠之。良久曰。惟畏獭爪屑为末。以
酒服之则去。患家如其言而愈。此予所目见也。獭爪者。与肘后方治鬼疰。用獭肝一具。阴
干杵末。服方寸匙。日三。同一义。
〔附〕慎柔治一女子。寒热盗汗咳嗽。梦与鬼交。沉沉默默。不自知所苦。因反其唇。
视有白点。曰。此虫蚀肺也。急寻獭肝治之。不相信。果咯脓而殁。后闻其兄弟三人。皆夭
于此证。大凡久嗽。当视其两唇。若上唇有点。虫蚀上部。下唇有点。虫蚀下部。
袁州武节郎李应。有男女三人。长子买宅。久空。无人所居。入室。忽觉心动。背寒凛
凛。遂成痨瘵之疾。垂殆。传于次女。长子既殁。女病寻亟。又传于第三子。同一证候。应
大惧。每日设面饭以斋云水。冀遇异人。偶往开元寺。有一人衣俗士服。自称贫道。呼应曰
团练。闻宅上苦传尸痨。贫道有一药方奉传。即以授应。应留之饭。辞。与之钱。不受。
制服之。大下。得虫七枚。色如红 肉。长约一寸。阔七八分。前锐后方。腹下近前有一口
周身有足若鱼骨。细如针。尖而曲。已死。以铁箸札刺不能入。因取火焚之。病热顿减。
后又服一剂。得小虫四枚。自是遂安。其药用天灵盖三钱。酥炙黄色。虎粪内骨一钱。人骨
为上。兽骨次之。杀虎大肠内取者亦可用。以青蛇脑小豆许同酥涂炙。色转为度。如无青蛇
脑。只酥炙亦可。鳖甲极大者。酥炙黄色一两。九肋者尤妙。安息香半两。桃仁一个去皮尖
以上俱为末。另有青蒿取近梢者四寸。细锉六两。豉三百粒。葱二十一个。东引桃李柳桑
枝各七茎。粗如箸大。各长七寸细锉。枫叶二十一片。童便一升。水三升。煎至一升。去渣
入前末药。再煎至半升。亦去渣。另用槟榔一个。麝香一钱。俱为细末。冲入。早晨温服
以被盖出汗。恐汗内有细虫。以帛拭之。即焚此帛。相次须泻。必有虫下。如未死。以大
火焚之。并弃长流水内。所用药。切不能令病患知。日后亦然。十余日后。气体复元。再进
一服。根据前焚弃。至无虫而止。此药如病者未亟。可以取安。如已亟。俟其垂死。则令次已
传染者服之。可杜后患也。
震按传尸痨古有其名。今实未见。即一家之内。父子兄弟递以痨病死者。亦由其人禀赋
虚弱。气血衰损而致。并非痨虫为害也。徐氏医统王氏准绳详载之。并绘虫形。而慎柔五书
更侈张其说。有五凤丸、雷公丸、紫河车丸、天灵盖散等方。及纸糊病患所住之屋。服侍
者以安息香涂身。雄黄涂口耳目鼻等法。多属附会。不可深泥也。此亦如稽神志载一家以痨
死者数人。因取继起之病者置棺中钉之。弃于水。期绝传染之患。流至金山。有人闻棺中啼
哭。开视之。见一女子犹活。因取置鱼舍。多得鳗鱼食之。病遂愈。为渔人之妻焉。自此说
出而世人竞为鳗能治痨。今亦何曾见其效耶。再丹方有石膏一味。或桃仁一味。神授散之川
椒二斤。及童便酒煨猪腰子亦可。备临证者之参考。俱难必其效也。惟朱丹溪治临海刘兄久
嗽吐红。发热消瘦。众以为瘵。百方不应。朱视之。脉弦数。日轻夜重。用倒仓法而愈。次
年生子。此则圣于医者矣。何必崔氏之灸四花穴及癸亥夜二更之灸腰眼哉。
孙东宿治程道吾令眷。夜为梦魇所惊。时常晕厥。精神恍惚。一日三五发。咳嗽。面色
青。不思谷食。日惟啖牛肉脯数块而已。时师屡治无功。吴渤海认为寒痰作厥。投以附、桂
而厥尤加。孙诊之。左脉弦。右脉滑。两寸稍短。道吾先令眷二。皆卒于瘵。知其为传尸
瘵证也。不易治之。乃权以壮神补养之剂。消息调理。俟饮食进。胃气转。始可用正治之法
姑用参、苓、柏子仁、石菖蒲、远志、丹参、当归、石斛。以补养神气。加陈皮、贝母、
甘草、紫菀。化痰治嗽。服半月而无进退。乃制太上混元丹。用紫河车一具。辰砂、鳖甲、
犀角各一两。鹿角胶、紫石英、石斛各八钱。沉香、乳香、安息香、茯苓、紫菀、牛膝、人
参各五钱。麝香五分。蜜丸赤豆大。每早晚。盐汤或酒下三十六丸。又制霹雳出腊丹。用牛
黄、狗宝、阿魏、安息各一钱。虎头骨五钱。啄木鸟一只。獭爪一枚。败鼓心破皮三钱。麝
香五分。天灵盖一个。酥炙。炼蜜丸。雄黄三钱为衣。每五更。空心。葱白汤送下五分。三
五日服一次。与太上浑元丹相兼服。才服半月。精神顿异。不似前时恍惚矣。但小腹左边一
点疼。前煎药中。加白芍一钱。服之一月。精神大好。晕厥再不发矣。次年生一女。其宅瘵
疾。从此亦不再传。
震按此与袁州道士所授方更奇更好。盖彼则专于杀虫。此则杀虫而兼穿经透络搜邪补虚
喻嘉言治杨季登次女。食减肌削多汗。诊时见其筋掣肉颤。身倦气怯。乃曰。此大惊大
虚之候。法宜温补。并多加茯神、枣仁。然服十余剂。全不对病。喻徘徊自讦曰。非外感也
非内伤也。虚汗振掉不宁。能受补药而病无增减。且闺中处子。并无家难。其神情浑似丧
败之余。此曷故耶。忽而悟曰。此必邪祟之病也。诊时问其面色。曰时赤时黄。问其兼证。
曰每晚睡去。口流白沫。战栗而绝。以姜汤灌至良久方苏。挑灯侍寝防之。亦不能止。因恐
婿家传闻。故不敢明告。喻曰。何不早言。即可早愈。乃用犀角、羚羊角、龙齿、虎威骨
牡蛎粉、鹿角霜、人参、黄 等药。合末。以羊肉半斤。煎取浓汁三盏。尽调其末。一次服
之。果得安寝。竟不再发。相传以为神异。盖祟附于身。与人之神气交持。亦逼处不安。无
隙可出。故用诸多灵物之遗形。引以羊肉之膻。俾邪祟转附骨角。移从大便而出。仿上古移
精变气。祝繇遗事。而充其义耳。
震按此案笺方释证。直造轩岐之堂。后案酌古斟今。足分和缓之坐。
又熊仲纾幼男。髫龄得一奇证。食饮如常。但脉细神呆。气夺色夭。仲纾问嘉言曰。此
何病也。喻曰。病名 。左传所谓近女室晦。即是此病。彼因近女。又遭室晦。故不可为
令郎受室晦之邪而未近女。是可为也。即前方少加牛黄丸服而安。
〔附〕黄师文治一妇人。卧病垂三年。状若痨瘵。诸医以虚损治不瘥。黄视之曰。此食
阴物时遭惊也。问之。妇方省悟曰。曩者食米团时。忽人报吾夫坠水。由此一惊。病延至今
不能愈。黄以青木香丸。兼利下药与之。须臾下一块。抉之乃痰裹一米团耳。当时被惊。怏
怏在下而不自觉也。自后安康无恙。
震按此不载脉。何从取法。况痰裹米团在腹。似当如痞块状。或痛。或胀。或攻冲。乃
并不言及。将何所凭据而云然耶。想良工治病。亦如伯乐相马得之于牝牡骊黄之外邪。
〔附〕无锡游氏子。少年耽于酒色。旋得疾。久而弗愈。势危甚。忽语其家人曰。常见
两女子。服饰华丽。其长才三四寸。每缘吾足而行。冉冉至腰而没。家人以为祟。一名医至
扣之。曰。此肾神也。肾气绝则神不守舍。故病者见之。
震按此可为好淫者之戒。夫人生之来其原在肾。人病之来亦多在肾。肾者命之根也。奈
何纵情欲之乐以取死亡之祸乎。
【背景信息】
书名：古今医案按 作者：俞震篡 朝代：清 章节：痨瘵 类别：医论
【待处理原文翻译】
《本事方》记载，在宋徽宗宣和年间，天庆观的一位法师，施行考召法（一种道教驱邪仪式）极其精严。当时有一位妇人，递交状纸请求治病。法师召唤鬼祟到来，鬼祟说：“不是我作祸，而是另一只鬼，也是因为病人命衰而成为鬼祟罢了。”它现在已经成形，在病人的肺中化为虫，啃食肺系，所以导致吐血、声音嘶哑。法师鞭打这只鬼，问：“这虫还有畏惧忌讳的东西吗？”过了很久没有回答，再次鞭打，良久才说：“只畏惧獭爪磨成粉末，用酒送服就能去除。”患家按照他的话去做，病就好了。这是我亲眼所见的事。獭爪，与《肘后备急方》治疗鬼疰（一种具有传染性的慢性消耗性疾病），使用獭肝一具，阴干后捣碎成末，每次服用一方寸匕，每日三次，道理是一样的。
〔附〕慎柔治疗一名女子，出现寒热往来、盗汗、咳嗽，梦中与鬼交合，神情低沉沉默，自己不知道痛苦所在。于是让她张开嘴唇，看到有白点，说：“这是虫蚀肺。”急忙寻找獭肝治疗，家属不相信，果然咯出脓血而死。后来听说她的三个兄弟，都夭折于这种病症。大凡久咳，应当查看其双唇，如果上唇有点，是虫蚀上部；下唇有点，是虫蚀下部。
袁州武节郎李应，有三个子女。长子购买了一处宅院，长期空置，无人居住。进入室内，忽然觉得心跳不安，背部寒冷凛冽，于是成了痨瘵之疾，几乎濒死。病情传给次女，长子死后，女儿病情也危急，又传给第三子，症状相同。李应非常恐惧，每天设下面饭供养云游道士，希望遇到异人。偶然去开元寺，有一人身穿俗士衣服，自称贫道，呼唤他的官职团练，听说宅第苦于传染尸痨，贫道有一个药方奉献传授。随即交给李应。李应留他吃饭，他推辞了，给他钱，他也不接受。李应制服了他并让他服药，结果大泻，排出七枚虫，颜色像红肉，长约一寸，宽七八分，前端锐利后端方正，腹部靠近前方有一个口，周身有足像鱼骨一样，细如针，尖而弯曲，已经死了，用铁筷子刺入也不能进去。于是取火焚烧它们，病痛顿时减轻。后来又服一剂，排出小虫四枚，从此就安稳了。该药用天灵盖三钱，用酥油炙至黄色；虎粪中的骨头一钱，以人骨为上品，兽骨次之，杀虎的大肠内取得的也可以使用，用青蛇脑少许同酥油涂抹炙烤，颜色转变为止。如果没有青蛇脑，只用酥油炙烤也可以。鳖甲极大者，用酥油炙至黄色一两，九肋的尤其好；安息香半两；桃仁一个，去皮尖。以上都研为末。另有青蒿取近梢部分四寸，细锉六两；豆豉三百粒；葱二十一根；东向生长的桃李柳桑枝各七茎，粗如筷子，各长七寸，细锉；枫叶二十一片；童便一升，水三升，煎至一升，去渣，加入前面的药末，再煎至半升，也去渣。另外用槟榔一个，麝香一钱，都研为细末，冲入药液中。早晨温服，盖上被子出汗，恐怕汗中有细虫，用帛擦拭，立即焚烧此帛。相继必须腹泻，必然有虫排出。如果没死，用大火焚烧，并丢弃到长流水中。所用的药，绝对不能让病患知道，日后也是这样。十余日后，身体元气恢复，再进一服，根据前面焚烧丢弃的方法。直到没有虫排出为止。这个药如果病人尚未危急，可以求得安宁；如果已经危急，等到濒临死亡时，就让其次已感染的子女服用，可以杜绝后患。
俞震按语：传尸痨古时候有其名，现在实在没见到。即使一家之内，父子兄弟依次因痨病死去，也是由于这个人禀赋虚弱，气血衰损所致，并不是痨虫为害。徐氏《医统》、王氏《准绳》详细记载了此事，并绘制了虫形，而慎柔《五书》更夸大其说，有五凤丸、雷公丸、紫河车丸、天灵盖散等方，以及用纸糊住病患所住的屋子，侍奉者用安息香涂身、雄黄涂口耳目鼻等方法，大多属于附会，不可深究拘泥。这也如同《稽神志》记载一家因痨病死了几个人，于是把继起患病的人放在棺材中钉死，抛弃在水中，期望断绝传染的祸患，流到金山，有人听到棺中啼哭，打开看，见一女子还活着，于是把她放在鱼舍里，很多人吃鳗鱼，病就好了，成为了渔人的妻子。自从这种说法出来后，世人竞相认为鳗能治痨，如今又何曾见到其效果呢？另外丹方中有石膏一味，或桃仁一味，神授散的川椒二斤，以及童便酒煨猪腰子也可以，供临证者参考，都难以保证有效。只有朱丹溪治疗临海刘兄久咳吐红，发热消瘦，众人认为是瘵病，百方无效。朱丹溪诊视，脉弦数，日轻夜重，用倒仓法（一种通过大量食用肉类以清理肠胃的治疗方法）而痊愈。次年生子，这才是圣明的医者啊，何必学崔氏灸四花穴及癸亥夜二更灸腰眼呢？
孙东宿治疗程道吾的眷属，夜里被梦魇惊吓，时常晕厥，精神恍惚，一天发作三五次，咳嗽，面色青，不想进食，每天只吃几块牛肉脯而已。当时的医生多次治疗无效，吴渤海认为是寒痰导致的厥证，投用附子、肉桂，但厥逆更加严重。孙东宿诊察，左脉弦，右脉滑，两寸稍短。道吾之前有两个眷属，都死于瘵病，知道这是传尸瘵证，不容易治疗。于是权且用壮神补养的药剂，斟酌调理，等到饮食进步，胃气转复，才开始用正治之法。暂用人参、茯苓、柏子仁、石菖蒲、远志、丹参、当归、石斛，以补养神气；加陈皮、贝母、甘草、紫菀，化痰治嗽。服用半月而无进退。于是制作太上混元丹，用紫河车一具，辰砂、鳖甲、犀角各一两，鹿角胶、紫石英、石斛各八钱，沉香、乳香、安息香、茯苓、紫菀、牛膝、人参各五钱，麝香五分，蜜丸如赤豆大。每早晚，盐汤或酒送服三十六丸。又制作霹雳出腊丹，用牛黄、狗宝、阿魏、安息香各一钱，虎头骨五钱，啄木鸟一只，獭爪一枚，败鼓心破皮三钱，麝香五分，天灵盖一个，酥炙，炼蜜丸，雄黄三钱为衣。每五更，空腹，葱白汤送服五分，三五日服一次，与太上浑元丹相兼服用。才服用半月，精神顿时不同，不像以前那样恍惚了。只是小腹左边一点疼，在前面的煎药中加入白芍一钱，服用一个月，精神大好，晕厥不再发作。次年生一女，那宅子的瘵疾，从此也不再传染。
俞震按语：此案与袁州道士所授的药方更奇特更好。因为前者专于杀虫，后者则杀虫兼穿经透络、搜邪补虚。
喻嘉言治疗杨季登的次女，食欲减退，肌肉消瘦，多汗。诊视时见到她筋掣肉颤，身倦气怯，就说：“这是大惊大虚的候象，法宜温补。”并多加茯神、枣仁。然而服用十余剂，完全不对症。喻嘉言徘徊自责说：“不是外感，也不是内伤。虚汗振掉不宁，能受补药而病无增减，而且闺中处女，并无家难，其神情浑似丧败之余，这是什么缘故呢？”忽然领悟说：“这一定是邪祟的病。”诊视时问她的面色，她说有时红有时黄。问她的兼证，她说每晚睡去，口流白沫，战栗而昏厥，用姜汤灌下良久才苏醒。挑灯侍寝防范，也不能止住。因为怕女婿家传闻，所以不敢明告。喻嘉言说：“为什么不早说？就可以早愈。”于是用犀角、羚羊角、龙齿、虎威骨、牡蛎粉、鹿角霜、人参、黄芪等药，合为末，用羊肉半斤，煎取浓汁三盏，全部调匀药末，一次服下。果然得以安寝，竟不再发作。相传以为神异。大概邪祟附着于身，与人的神气交持，也逼处不安，无隙可出，所以用诸多灵物的遗形，引以羊肉的膻味，使邪祟转而依附骨角，移从大便而出。仿效上古移精变气、祝繇的遗事，而充实其义理罢了。
俞震按语：此案笺方释证，直造轩岐之堂。后案酌古斟今，足分和缓之坐。
又熊仲纾的小儿子，幼年得了一个奇证，饮食如常，但脉细神呆，气夺色夭。仲纾问嘉言说：“这是什么病？”喻嘉言说：“病名‘室晦’。《左传》所谓‘近女室晦’，就是此病。那人因为亲近女子，又遭遇室晦，所以不可为。令郎承受室晦之邪但未亲近女子，是可以治疗的。”即用前方少加牛黄丸服用而安。
〔附〕黄师文治疗一名妇人，卧病将近三年，状若痨瘵，诸医以虚损治疗不愈。黄师文诊视说：“这是吃阴物时遭到惊吓。”询问她，妇人方才醒悟说：“先前吃米团时，忽然有人报我丈夫坠水，由此一惊，病延至今不能愈。”黄师文用青木香丸，兼利下药给她。须臾下一块，抉开乃是痰裹一米团耳。当时被惊，怏怏在下而不自觉。自后安康无恙。
俞震按语：此案不载脉，从何取法？况且痰裹米团在腹，似乎应当像痞块状，或痛，或胀，或攻冲，却并不提及，将何所凭据而这样说呢？想良工治病，也像伯乐相马得之于牝牡骊黄之外吧。
〔附〕无锡游氏的儿子，少年沉迷于酒色，随即得病，久而不愈，形势危急。忽然对家人说：“常见两个女子，服饰华丽，身材才三四寸，每顺着我的脚行走，冉冉至腰而消失。”家人以为是鬼祟。一名医来扣问，说：“这是肾神。肾气绝则神不守舍，所以病者见之。”
俞震按语：这可以作为好淫者的戒律。人生之来，其原在肾；人病之来，也多在肾。肾者是命之根也，奈何纵情欲之乐以取死亡之祸乎？
[Background Information]
Book: *Gujin Yi An An* (Annotations on Medical Cases Ancient and Modern)
Author: Yu Zhen
Dynasty: Qing
Chapter: Lao Zhai (Consumption/Tuberculosis)
Category: Medical Discussion
[English Translation]
The *Benshi Fang* records that during the Xuanhe era of Emperor Huizong of Song, a Daoist priest at Tianqing Temple practiced the "Kaozhao" method (a Daoist exorcism ritual) with extreme rigor. At that time, a woman submitted a petition requesting treatment for her illness. The priest summoned the malevolent spirit, which said, "It is not I who cause harm, but another ghost, which also becomes a nuisance because the patient's life force is declining." It has now taken form, transforming into a worm within the patient's lung, devouring the lung system, thus causing hemoptysis (coughing up blood) and hoarseness. The priest whipped the ghost and asked, "Does this worm have any fears or taboos?" After a long silence, upon being whipped again, it replied after a while, "It only fears otter claws ground into powder, taken with wine to eliminate it." The patient's family followed his advice, and the illness was cured. This is something I witnessed with my own eyes. Otter claws share the same principle as the treatment for "Guizhu" (a contagious chronic wasting disease) in the *Zhouhou Beiji Fang*, which uses one whole liver of an otter, dried in the shade and pounded into powder, taken once per dose daily three times.
[Appendix] Shen Rou treated a young woman who presented with alternating chills and fever, night sweats, cough, dreams of sexual intercourse with ghosts, low spirits, and muteness, unaware of her own suffering. He asked her to open her mouth and observed white spots, stating, "This is worms eroding the lungs." He urgently sought otter liver for treatment, but the family did not believe him. She eventually expectorated pus and died. Later, it was heard that her three brothers all died young from this same condition. Generally, for chronic cough, one should examine the lips; if there are spots on the upper lip, the worms erode the upper part; if on the lower lip, they erode the lower part.
Li Ying, a Military Commander (Wu Jie Lang) from Yuanzhou, had three children. His eldest son purchased a house that had been vacant for a long time with no residents. Upon entering, he suddenly felt palpitations and severe coldness in his back, developing into a consumption disease (Lao Zhai), nearly dying. The illness passed to his second daughter. After the eldest son died, the daughter's condition became critical, and it then passed to the third son, presenting identical symptoms. Li Ying was terrified and offered noodles and rice daily to wandering Daoists, hoping to meet a miraculous person. One day, visiting Kaiyuan Temple, he met a man dressed in secular clothes claiming to be a poor Daoist. Addressing him by his official title "Tuanlian," the man said he heard the household suffered from contagious corpse-transmitting consumption and offered a prescription. Li Ying invited him to eat, but he declined. Li Ying offered money, which he refused. Li Ying compelled him to take medicine, resulting in severe diarrhea and the expulsion of seven worms. They were red like meat, about one cun long, and 7-8 fen wide, sharp at the front and square at the back, with a mouth near the front of the abdomen. They had feet resembling fish bones, thin as needles, sharp and curved, and already dead. Iron chopsticks could not pierce them. Li Ying burned them, and the fever subsided immediately. Another dose expelled four smaller worms, after which he recovered. The prescription used: Tianlinggai (Human Skull Cap) 3 qian, fried in butter until yellow; Tiger feces containing bone 1 qian (human bone is best, animal bone is secondary, bone from tiger intestines is also usable); fried in butter with a small amount of green snake brain until the color changes (if no green snake brain, butter frying alone is acceptable); Biejia (Turtle Shell) large pieces, fried in butter until yellow, 1 liang (nine-ribbed shells are superior); Anxi Xiang (Benzoin) half liang; Taoren (Peach Kernel) one piece, peeled and pitted. All above are powdered. Additionally, Qinghao (Artemisia Annua L.) tips, 4 cun, finely chopped, 6 liang; Chishao (Fermented Soybeans) 300 grains; Congbai (Scallion White) 21 stalks; Peach, Plum, Willow, and Mulberry branches growing eastward, 7 stalks each, thickness of chopsticks, length 7 cun, finely chopped; Fengye (Maple Leaf) 21 pieces; Tongbian (Child's Urine) 1 sheng; Water 3 sheng. Decoct to 1 sheng, strain, add the previous powders, decoct again to half a sheng, strain. Separate Binglang (Areca Seed) one piece and Shexiang (Musk) 1 qian, grind to fine powder, mix into the decoction. Take warm in the morning, cover with blankets to induce sweating. Wipe sweat with cloth and burn it immediately to prevent tiny worms from surviving. Diarrhea will follow, expelling worms. If alive, burn fiercely and discard in flowing water. The patient must not know the medication, nor later. After more than ten days, vitality returns. Take another dose, burning/discarding as before, until no worms appear. If the patient is not critical, this can bring peace; if critical, wait until near death, then let the next infected child take it to prevent future transmission.
Yu Zhen comments: "Chuanshi Lao" (Contagious Consumption) existed in ancient times by name, but is rarely seen today. Even when fathers, sons, and brothers in one family die sequentially from consumption, it is due to weak constitution and depletion of Qi and Blood, not caused by "consumption worms." Xu Shi's *Yitong* and Wang Shi's *Zhunsheng* record this in detail, drawing pictures of the worms. Shen Rou's *Wushu* exaggerates this theory, prescribing formulas like Wufeng Wan, Leigong Wan, Ziheche Wan, and Tianlinggai San, along with methods like papering the patient's room, servants smearing Anxi Xiang on their bodies, and Xionghuang (Realgar) around the mouth, ears, eyes, and nose. These are largely apocryphal and should not be strictly adhered to. This is similar to stories in *Jishen Zhi* where families bury living patients in coffins to stop contagion, only to find survivors later. Such tales led to the belief that eels cure consumption, yet efficacy is never proven. Other alchemical prescriptions include Gypsum, Peach Kernels, Sichuan Pepper (Chuanjiao) 2 jin from Shenshou San, or pig kidneys stewed with child's urine and wine. These are for reference but efficacy is uncertain. Only Zhu Danxi's case of treating Liu's brother from Linhai, who had chronic cough, hemoptysis, fever, and emaciation, mistaken for consumption and unresponsive to hundreds of remedies, stands out. Zhu diagnosed a wiry and rapid pulse, worse at night, and cured him using Daocang Fa (Meat Purging Method). He fathered a son the next year. This demonstrates true medical mastery, unlike Cui Shi's moxibustion at Sihua acupoints or at Yaoyan acupoints at 2 AM on Guihai nights.
Sun Dongsu treated the wife of Cheng Daowu, who was startled by nightmares nightly, frequently fainted, had erratic spirit, coughed, had a bluish complexion, and refused food, eating only a few slices of beef jerky daily. Previous doctors failed. Wu Bohai attributed it to Cold Phlegm causing Jue syndrome, administering Fuzi (Aconite Root) and Guizhi (Cinnamon Twig), worsening the Jue. Sun diagnosed a wiry left pulse, slippery right pulse, and slightly short both Cun pulses. Knowing two previous wives of Daowu died of consumption, he identified this as Chuanshi Zhai (Contagious Consumption), difficult to treat. He initially used tonifying and spirit-strengthening herbs to regulate diet and restore Stomach Qi before direct treatment. He used Renshen (Ginseng), Fuling (Poria), Baiziren (Biota Seed), Shichangpu (Acorus), Yuanzhi (Polygala), Danshen (Salvia), Danggui (Angelica Sinensis), Shihu (Dendrobium) to tonify spirit; added Chenpi (Tangerine Peel), Beimu (Fritillaria), Gancao (Licorice), Ziwan (Aster) to resolve phlegm and stop cough. After half a month with no progress, he formulated Taishang Hunyuan Dan: Ziheche (Placenta) one unit, Chensha (Cinnabar), Biejia (Turtle Shell), Xijiao (Rhinoceros Horn) each 1 liang; Lujiaojiao (Deer Antler Glue), Zishiying (Hematite), Shihu each 8 qian; Chenxiang (Agarwood), Rushiang (Frankincense), Anxi Xiang (Benzoin), Fuling (Poria), Ziwan (Aster), Niuxi (Achyranthes) each 5 qian; Shexiang (Musk) 5 fen. Honey-pilled size of adzuki beans. Take 36 pills morning and evening with salt water or wine. Also formulated Pili Chulai Dan: Niuhuang (Calculus Bovis), Goubao (Dog Gallstone),awei (Asafoetida), Anxi Xiang each 1 qian; Hutougu (Tiger Skull Bone) 5 qian; Woodpecker 1; Tazhao (Otter Claw) 1; Baiguxin (Old Drum Heart Skin) 3 qian; Shexiang (Musk) 5 fen; Tianlinggai (Human Skull Cap) 1, fried in butter. Honey-pilled, coated with 3 qian Xionghuang (Realgar). Take 5 fen at 5 AM on an empty stomach with Scallion White decoction, every 3-5 days, combined with Taishang Hunyuan Dan. After half a month, spirit improved significantly, no longer erratic. Slight pain in lower left abdomen required adding Baishao (White Peony Root) 1 qian to previous decoction. After one month, spirit greatly improved, fainting ceased. She gave birth to a daughter the next year, and the household's consumption contagion stopped.
Yu Zhen comments: This case and formula are more miraculous and better than the one given by the Daoist from Yuanzhou. The latter focused solely on killing worms; this one kills worms while penetrating meridians, searching for pathogens, and tonifying deficiency.
Yu Jiayan treated Yang Jideng's second daughter, who had reduced appetite, emaciation, and excessive sweating. During diagnosis, he saw muscle twitching and tremors, fatigue, and weak Qi. He stated, "This is a sign of great fright and great deficiency, requiring warming and tonification," adding Fushen (Poria with Hostwood) and Zaoren (Ziziphus Seed). However, after over ten doses, there was no effect. Yu hesitated and blamed himself: "Not external contraction, not internal injury. Sweating and trembling without rest, tolerating tonics without change. A maiden in the inner quarters with no family disaster, yet her demeanor resembles post-mourning exhaustion. Why?" Suddenly realizing, "This must be a disease of evil spirits." Asking about her complexion, she said it fluctuated between red and yellow. Regarding accompanying symptoms, she said every night when sleeping, she drooled white foam, trembled, and lost consciousness, reviving only after prolonged administration of Ginger Decoction. Lighting lamps to guard against it didn't help. Fearful of rumors from the husband's family, she hadn't disclosed this. Yu said, "Why not say so earlier? You would have healed sooner." He prescribed Xijiao (Rhinoceros Horn), Lingyangjiao (Antelope Horn), Longchi (Dragon Teeth), Huweigu (Tiger Power Bone), Muli Fen (Oyster Shell Powder), Lujiashuang (Deer Antler Frost), Renshen (Ginseng), Huangqi (Astragalus), etc., powdered. Decocted 0.5 jin of mutton to get 3 cups of thick broth, mixed with the powder, taken at once. She slept peacefully and never relapsed. It was rumored as miraculous. Evil spirits attach to the body, conflicting with human Qi, causing discomfort with no exit. Thus, spiritual relics were used, guided by the pungency of mutton, to transfer the evil to bones/horns, exiting via stool. This imitates ancient practices of transferring essence and changing Qi, fulfilling their meaning.
Yu Zhen comments: This case's annotation of formulas and explanation of syndromes reaches the hall of Xuanyuan and Qibo. The subsequent case balances ancient and modern, worthy of Bian Que's seat.
Xiong Zhongshu's young son had a strange symptom in childhood: normal diet, but fine pulse, dull spirit, depleted Qi, and premature aging appearance. Zhongshu asked Jiayan, "What disease is this?" Jiayan replied, "The disease is named 'Shihui'. As mentioned in *Zuo Zhuan*, 'approaching women leads to Shihui' refers to this. That person approached women and encountered Shihui, hence incurable. Your son encountered Shihui邪 (pathogen) but did not approach women, so it is treatable." He used the previous formula with minor addition of Niuhuang (Calculus Bovis), bringing peace.
[Appendix] Huang Shiwen treated a woman bedridden for nearly three years, resembling consumption, unresponsive to deficiency treatments. Huang diagnosed, "This is eating yin substances while being startled." Upon inquiry, she realized: "When eating rice dumplings, I was suddenly told my husband fell into water. Startled then, the illness persisted." Huang gave Qingmuxiang Wan (Magnolia Bark Pill) with purgatives. Soon, a mass was expelled, revealing a rice dumpling wrapped in phlegm. The shock kept it lodged unconsciously. She recovered healthily thereafter.
Yu Zhen comments: This case lacks pulse data, making it hard to emulate. A phlegm-wrapped dumpling in the abdomen should present as a mass, possibly painful, distended, or moving, yet none are mentioned. What is the basis? Perhaps skilled physicians diagnose beyond superficial appearances, like Bo Le judging horses beyond gender or color.
[Appendix] The son of the You family in Wuxi indulged in alcohol and lust, falling ill which worsened over time. He told his family, "I often see two women in gorgeous dress, only 3-4 cun tall, walking along my legs, disappearing at my waist." Family thought it was spirits. A doctor examined and said, "These are Kidney Spirits. When Kidney Qi is exhausted, spirits do not reside in their mansion, so the patient sees them."
Yu Zhen comments: This serves as a warning for those addicted to lust. Life originates in the Kidneys; diseases often originate in the Kidneys. The Kidneys are the root of life. How can one indulge in desires leading to death?