张 二十七岁 甲子三月十三日 脐右有积气，以故右脉沉细弦沉伏，阳微之极，浊阴
太甚
克之也。溯其初原从左胁注痛而起，其为肝着之咳无疑。此症不必治咳，但宣通肝之阴络，
久病在络故也。使浊阴得有出路，病可自已，所谓治病必求其本者也。如不识纲领而妄冀速
愈，必致剥削阳气殆尽而亡。
桂枝尖（三钱） 小茴香（三钱） 降香末（二钱） 桃仁（三钱） 川楝子（二钱） 青皮络（
二钱
）炒广皮（一钱） 归须（三钱） 乌药（三钱） 苏子霜（三钱） 旋复花（三钱，新绛纱包）
十九日 服通络药，已见小效，脉气大为回转，但右胁着席则咳甚，胁下支饮故也，议
于前方内去桃仁、川楝、小茴，加∶
生香附（三钱） 半夏（六钱） 杏仁（三钱） 肉桂（八分）
再服四帖。
二十三日 先痛后便而见血，议通阴络法。
苏子霜（三钱） 归须（二钱） 降香末（三钱） 桃仁（二钱） 两头尖（三钱） 丹皮（三钱）
藏红花（一钱） 半夏（五钱） 小茴香（三钱） 香附（二钱） 广木香（一钱） 广陈皮（一钱）
张 二十八岁 脐左 瘕，面黄，肢倦，食少，不能作文，看书亦不能久，宛如虚损
，与∶
化 回生丹。
缓通阴络法，每日空心服一丸，亦有早晚服一丸，时服之二年有余，计服化 回生丹六
百丸之多， 始化净，气体撤消，看书作文，始举进士。
吴 三十一岁 脐右结 ，径广五寸，睾如鹅卵大，以受重凉，又加暴怒而得，痛不可
忍，
不能立，不能坐，并不能卧，服辛香流气饮，三日服五帖，重加附子、肉桂，至五七钱之多
，丝毫无效，因服天台乌药散，初服二钱，满腹如火烧，
明知药至脐右患处，如搏物然，痛加十倍，少时腹中起蓓蕾无数，凡一蓓蕾，
下浊气一次，如是者二三十次，腹中痛楚松快。少时痛又大作，服药如前，腹中热痛，起蓓
蕾，下浊气亦如前，但少轻耳。自巳初服药起，至亥正共服五次，每次轻一等。次一日腹微
痛，再服乌药散，则腹中不知热矣。以后每日服二三次，七日后肿痛全消。后以习射助阳而
体壮。
叶 四十五岁 乙酉四月二十八月 无论 瘕，虽有气血之分，然皆系阴病结于阴部，
岂有用阴药之理，维日已久沉寒痼冷疾，非巴豆不能除根。用∶
天台乌药散
六月初九日 业已见效，未能除根，照常服前药，早晚各五分， 瘕痛发时服二钱，舌
苔浓白，面色淡黄而暗，左脉沉细阳微，再与汤药行湿通阳。
云茯苓块（五钱） 益智仁（钱半） 萆 （四钱） 白蔻仁（一钱，连皮） 生苡仁（五钱）
半夏（五钱） 广陈皮（二钱） 桂枝（二钱） 白通草（一钱）
服至舌苔退为度。
甘 二十九岁 乙酉年五月初一日 十年瘕气，六脉弦细而紧。
淡吴萸（三钱） 乌药（三钱） 川椒炭（五钱） 归须（二钱） 良姜（二钱） 小茴香（五钱，炒
黑）
煮三杯，分三次服。已服五帖。
初九日 病减者减其制，每日服半帖。
王氏 四十岁 乙酉五月二十一日 六脉弦紧，心下伏梁，非易化之症。一生忧泣，肝
之郁也，又当燥金太乙天符之年，金来克木，痛愈甚矣。与温络法，其吐血亦络中寒也。
降香末（三钱） 川椒炭（二钱） 香附（三钱） 半夏（三钱） 枳实（三钱） 归须（三钱）
公丁香（八分） 广皮
服四帖。
二十五日 诸症皆效，自觉气上阻咽。加∶
旋复花（五钱）
二十九日 效不更方，再服。
六月初二日 加吴萸（三钱）
余氏 三十岁 乙酉五月二十四日 瘕结脐左，经来必痛，六脉沉细，阳微。
吴茱萸（三钱） 川楝子（三钱） 公丁香（一钱） 良姜（二钱） 全当归（三钱） 降香末（
三钱） 小茴香（三钱） 艾炭（三钱）
煮三杯，分三次服，服七帖后，接服丸药。
六月初二日 业已见效，每日服半帖，再服十天。
二十日 每行经前三日，腹微痛时，空心服化 回生丹一丸，服至经尽后，腹中丝毫不
痛为止。下月经行，腹痛发时，再如此服法。 瘕痛亦服回生，空心服一丸，化净为度。
车 五十五岁 须发已白大半，脐左坚大如盘，隐隐微痛，不大便十数日。先延外科治
之，
外科谓肠痈，以大承气下之，三四次终不通。延余诊视，按之坚冷如石，面色青黄，脉短涩
而迟，先尚能食，屡下之后，糜粥不进，不大便已四十九日。余曰∶此 也，金气之所结也
，以肝木抑郁，又感秋金燥气，邪中入里，久而结成，愈久愈坚，非下不可。然寒下非其治
也，以天台乌药散二钱，加巴豆一分，姜汤和服。设三服以待之，如不通，第二次加巴豆霜
分半，再不通，第三次加巴豆霜二分，服至三次后，始下黑亮球四十九枚，坚莫能破，继以
苦温甘辛之法调理，渐次能食。又十五日不大便，余如前法，下至第二次而通，下黑亮球十
五枚，虽亦坚结，然破之能碎，但燥极耳，外以香油熬川椒熨其坚处，内服芳香透络，月余
化净。于此证方知燥金之气伤人如此，而温下之法，断不容紊也。
乙酉年 治通廷尉久疝不愈，时六十八岁，先是通廷外任时，每发疝，医者必用人参，
故留
邪在久不得愈。至乙丑季夏，受凉复发，坚结肛门，坐卧不得，胀痛不可忍，汗如雨下，七
日不大便。余曰∶疝本寒邪，凡坚结牢固，皆属金象，况现下势甚危急，非温下不可。亦用
天台乌药散一钱，巴豆霜分许，下至三次始通，通后痛渐定，调以倭硫黄丸，兼用金匮蜘蛛
散，渐次化净。
【医案一】
患者张某，二十七岁。甲子年三月十三日就诊。其右侧脐部有积气聚集，因此右脉呈现沉、细、弦、伏之象，这是阳气极度微弱、阴寒浊邪过盛克制阳气的表现。追溯病因，起初是从左胁肋部注痛开始，这无疑是“肝着”病引起的咳嗽。此症不必专门治疗咳嗽，只需宣通肝脏的阴络（肝脏深层的血络），因为久病往往深入络脉。只要使阴寒浊邪有出路排出，疾病自然痊愈，这就是所谓治病必求其本的原则。如果不识辨这一纲领而妄图速愈，必然导致阳气被剥削殆尽而死亡。
处方：桂枝尖（三钱）、小茴香（三钱）、降香末（二钱）、桃仁（三钱）、川楝子（二钱）、青皮络（二钱）、炒广陈皮（一钱）、当归须（三钱）、乌药（三钱）、苏子霜（三钱）、旋复花（三钱，用新绛纱包裹）。
三月十九日：服用通络药物后，已见轻微疗效，脉气大为回转。但右侧胁肋部贴着床席时咳嗽加重，这是因为胁下有支饮（水饮停聚于胁下）所致。建议在前方基础上去掉桃仁、川楝子、小茴香，加入：生香附（三钱）、半夏（六钱）、杏仁（三钱）、肉桂（八分）。再服用四剂。
三月二十三日：先疼痛随后大便带血，建议采用通利阴络的方法治疗。
处方：苏子霜（三钱）、当归须（二钱）、降香末（三钱）、桃仁（二钱）、两头尖（三钱）、丹皮（三钱）、藏红花（一钱）、半夏（五钱）、小茴香（三钱）、香附（二钱）、广木香（一钱）、广陈皮（一钱）。
【医案二】
患者张某，二十八岁。左侧脐部有瘕聚（腹内结块，推之可移，聚散无常），面色黄，肢体倦怠，食欲少，不能从事脑力劳动，看书也不能持久，症状宛如虚损劳伤。给予化回生丹。
采用缓慢疏通阴络的方法，每日空腹服用一丸，也有早晚各服一丸。坚持服用两年多，共服用化回生丹六百丸之多，才将病邪化净，身体恢复，能够看书写作，最终考中进士。
【医案三】
患者吴某，三十一岁。右侧脐部结成硬块，直径五寸，睾丸肿大如鹅卵大。因感受严重寒凉，又加上暴怒而致病，疼痛难以忍受，不能站立，不能坐卧。曾服用辛香流气饮，三天服用五剂，并重加附子、肉桂，用量达五至七钱之多，却丝毫无效。后来服用天台乌药散，初次服用二钱，感觉满腹如火烧，明知药力到达右侧脐部患处，如同搏击物体一般，疼痛加剧十倍。不久腹中出现无数蓓蕾状突起，每一个蓓蕾出现，就排下一次浊气，如此反复二三十次，腹中疼痛舒缓轻松。过了一会儿疼痛再次大作，再次服药如前法，腹中热痛，起蓓蕾，下浊气也如前法，但程度稍轻。从巳初（上午9-11点）开始服药，到亥正（晚上9-11点）共服用五次，每次疼痛减轻一等。次日腹部微痛，再服用乌药散，则腹中不再感到发热。此后每日服用二三次，七日后肿痛完全消除。后来通过练习射箭以助阳气，身体变得强壮。
【医案四】
患者叶某，四十五岁。乙酉年四月二十八日就诊。无论是瘕还是聚，虽然气血有所区分，但都属于阴寒之邪结聚于阴部，岂有用阴柔药物的道理？况且日久已是沉寒痼冷之疾，非巴豆不能除根。使用天台乌药散。
六月初九日：已经见效，但未能除根，照常服用前药，早晚各五分；瘕聚疼痛发作时服用二钱。舌苔浓白，面色淡黄而暗，左脉沉细且阳气微弱，再用汤药行湿通阳。
处方：云茯苓块（五钱）、益智仁（钱半）、萆薢（四钱）、白蔻仁（一钱，连皮）、生苡仁（五钱）、半夏（五钱）、广陈皮（二钱）、桂枝（二钱）、白通草（一钱）。
服用至舌苔退去为止。
【医案五】
患者甘某，二十九岁。乙酉年五月初一日就诊。十年瘕气病史，六脉弦细而紧。
处方：淡吴茱萸（三钱）、乌药（三钱）、川椒炭（五钱）、当归须（二钱）、良姜（二钱）、小茴香（五钱，炒黑）。
煮取三杯，分三次服用。已服用五剂。
初九日：病情减轻则减少药量，每日服用半剂。
【医案六】
患者王某，四十岁。乙酉年五月二十一日就诊。六脉弦紧，心下部位有伏梁（腹内结块，固定不移），这不是容易化解的病症。一生忧愁哭泣，导致肝气郁结，又逢燥金太乙天符之年，金来克木，疼痛更加剧烈。采用温通络脉的方法，其吐血也是由于络中有寒所致。
处方：降香末（三钱）、川椒炭（二钱）、香附（三钱）、半夏（三钱）、枳实（三钱）、当归须（三钱）、公丁香（八分）、广陈皮。
服用四剂。
二十五日：诸症皆有效，自觉气机上阻咽喉。加入：旋复花（五钱）。
二十九日：疗效显著不更方，继续服用。
六月初二日：加入吴茱萸（三钱）。
【医案七】
患者余氏，三十岁。乙酉年五月二十四日就诊。瘕聚结于左侧脐部，月经来潮时必定疼痛，六脉沉细，阳气微弱。
处方：吴茱萸（三钱）、川楝子（三钱）、公丁香（一钱）、良姜（二钱）、全当归（三钱）、降香末（三钱）、小茴香（三钱）、艾炭（三钱）。
煮取三杯，分三次服用。服用七剂后，接续服用丸药。
六月初二日：已经见效，每日服用半剂，再服用十天。
二十日：每次月经前三天，腹部微痛时，空腹服用化回生丹一丸，服用至月经结束后，腹中丝毫不痛为止。下个月经行期间，腹痛发作时，再按此法服用。瘕聚疼痛时也服用回生丹，空腹服用一丸，直到病邪化净为度。
【医案八】
患者车某，五十五岁。须发大半已白，左侧脐部坚硬肿大如盘，隐隐微痛，十几天不大便。先前延请外科医生治疗，外科医生诊断为肠痈，用大承气汤攻下，三四次终未通便。延请我诊治，按压患处坚硬冰冷如石头，面色青黄，脉短涩而迟。起初还能进食，经过多次攻下之后，连糜粥都进不去，已有四十九天不大便。我说：这是积聚，是金气所结聚。因肝木抑郁，又感受秋季燥金之气，邪气入里，久而久之结成，越久越坚硬，非攻下不可。然而寒下法不是正确的治法，于是用天台乌药散二钱，加巴豆一分，用姜汤调和服用。设定三次服药方案以待观察：如不通，第二次加巴豆霜半分；再不通，第三次加巴豆霜二分。服用至第三次后，才排出黑色光亮球状粪便四十九枚，坚硬无法打破。继以苦温甘辛之法调理，逐渐能进食。又过了十五天不大便，我用前法，下至第二次而通，排出黑色光亮球状粪便十五枚，虽然也坚结，但破碎后可碎，只是过于干燥罢了。外用香油熬制川椒熨烫坚硬处，内服芳香透络药物，月余病邪化净。从这个病例才知道燥金之气伤人如此厉害，而温下法绝不容许紊乱。
【医案九】
乙酉年，治疗通廷尉长期疝气不愈，当时六十八岁。起初通廷外任时，每次疝气发作，医生必用人参，故留邪在体内久久不得痊愈。到了乙丑年季夏（夏季最后一个月），受凉复发，坚硬结聚于肛门，坐卧不得，胀痛难以忍受，汗如雨下，七天不大便。我说：疝气本是寒邪，凡是坚硬结聚牢固的，都属于金象，何况现在形势危急，非温下不可。也用天台乌药散一钱，巴豆霜分许，下至第三次才通畅。通畅后疼痛逐渐安定，用倭硫黄丸调理，兼用金匮蜘蛛散，逐渐病邪化净。
[Case 1]
Patient Zhang, aged 27. On the 13th day of the 3rd month in the Jiazi year, there was an accumulation of Qi on the right side of the umbilicus. Consequently, the right pulse was deep (Chen), fine (Xi), wiry (Xian), and hidden (Fu). This indicates extreme deficiency of Yang Qi and excessive Yin turbidity overcoming Yang. Tracing back to the origin, it began with shooting pain from the left hypochondrium, which undoubtedly belongs to "Gan Zhuo" (Liver Fixation) causing cough. This condition does not require treating the cough directly; instead, one should ventilate and unblock the Yin collaterals of the Liver, as chronic diseases often reside in the collaterals. If the Yin turbidity is given a way out, the disease will resolve itself. This is what is meant by "treating the disease requires seeking its root." If one fails to recognize this principle and recklessly hopes for a quick cure, it will inevitably lead to the depletion of Yang Qi and death.
Prescription: Guizhi Jian (Cinnamon Twig Tip, 3 qian), Xiaohui Xiang (Fennel, 3 qian), Jiangxiang Mo (Dalbergia Odorifera Powder, 2 qian), Taoren (Peach Kernel, 3 qian), Chuanlianzi (Sichuan Chinaberry, 2 qian), Qingpi Luo (Green Tangerina Peel Collateral, 2 qian), Chao Guangpi (Stir-fried Citrus Reticulata Peel, 1 qian), Guixu (Angelica Sinensis Root Tip, 3 qian), Wuyao (Lindera Root, 3 qian), Suzi Shuang (Perilla Fruit Frost, 3 qian), Xuanfuhua (Inula Flower, 3 qian, wrapped in Xinjiang Sha/New Crimson Gauze).
On the 19th day: After taking the collateral-unblocking medicine, slight efficacy was seen, and the pulse Qi significantly recovered. However, coughing worsened when lying on the right hypochondrium due to "Zhi Yin" (Fluid retention under the ribs). It is proposed to remove Taoren, Chuanlianzi, and Xiaohui Xiang from the previous formula and add: Sheng Xiangfu (Cyperi Rhizome, 3 qian), Banxia (Pinellia Tuber, 6 qian), Xingren (Apricot Seed, 3 qian), Rougui (Cinnamon Bark, 8 fen). Take four more doses.
On the 23rd day: Pain preceded by blood in stool. Propose the method of unblocking the Yin collaterals.
Prescription: Suzi Shuang (Perilla Fruit Frost, 3 qian), Guixu (Angelica Sinensis Root Tip, 2 qian), Jiangxiang Mo (Dalbergia Odorifera Powder, 3 qian), Taoren (Peach Kernel, 2 qian), Liangtoujian (Aconitum Lateralis Preparatum, 3 qian), Danpi (Moutan Cortex, 3 qian), Zanghonghua (Saffron, 1 qian), Banxia (Pinellia Tuber, 5 qian), Xiaohui Xiang (Fennel, 3 qian), Xiangfu (Cyperi Rhizome, 2 qian), Guangmuxiang (Costus Root, 1 qian), Guang Chenpi (Citrus Reticulata Peel, 1 qian).
[Case 2]
Patient Zhang, aged 28. A "Jia" mass (mobile abdominal mass) on the left side of the umbilicus. Yellow complexion, limb fatigue, poor appetite, inability to engage in mental work or read for long periods, resembling consumptive disease. Prescribed Huasheng Dan (Revitalizing Pill).
Adopted the method of slowly unblocking the Yin collaterals. Taken one pill daily on an empty stomach, or sometimes morning and evening. Continued for over two years, consuming a total of 600 pills of Huasheng Dan. Only then was the pathogen completely resolved, the body restored, allowing him to study and write, eventually passing the imperial examination.
[Case 3]
Patient Wu, aged 31. A hard knot formed on the right side of the umbilicus, five cun in diameter. The testicle swelled like a goose egg. Caused by severe cold exposure compounded by sudden rage. Pain was unbearable; unable to stand, sit, or lie down. Took Xinxiang Liuqi Yin (Acrid-Aromatic Qi-Flowing Decoction), five doses over three days, with added Fuzi (Prepared Aconite Root) and Rougui (Cinnamon Bark) up to 5-7 qian, but with no effect. Then took Tiantai Wuyao San (Tiantai Lindera Powder). Upon taking the first 2 qian, felt heat like fire burning throughout the abdomen. Knew the medicine reached the affected area at the right umbilicus, feeling like striking an object, pain increased tenfold. Soon, numerous bud-like swellings appeared in the abdomen. Each swelling corresponded to the discharge of one batch of turbid gas. This happened 20-30 times, bringing relief from abdominal pain. Later, pain flared up again. Took medicine as before; abdominal heat and pain returned, buds appeared, turbid gas discharged similarly, but slightly milder. From Si Chu (9-11 AM) to Hai Zheng (9-11 PM), took medicine five times, each time reducing pain severity. Next day, mild abdominal pain remained. Took Wuyao San again; abdominal heat disappeared. Thereafter, took it 2-3 times daily. After seven days, swelling and pain completely subsided. Later, practiced archery to boost Yang Qi, resulting in robust health.
[Case 4]
Patient Ye, aged 45. On the 28th day of the 4th month in the Yiyu year. Whether "Jia" (mass) or "Ju" (accumulation), although distinguished by Qi and Blood, both are Yin pathogens binding in Yin regions. How could Yin-nourishing herbs be appropriate? Moreover, it has been a chronic cold-deep-seated disease for a long time; only Radix Crotonis Fructus (Badou, Castor Bean) can eradicate the root. Used Tiantai Wuyao San (Tiantai Lindera Powder).
On the 9th day of the 6th lunar month: Efficacy seen, but root not eradicated. Continue previous medicine, 5 fen morning and evening; take 2 qian when Jia pain occurs. Thick white tongue coating, pale yellow and dark complexion, left pulse deep, fine, and Yang deficient. Further prescribe decoction to move dampness and unblock Yang.
Prescription: Yun Fuling Kuai (Poria Block, 5 qian), Yizhiren (Bitter Apricot Seed, 1.5 qian), Bi Xie (Dioscorea Hypoglauca Rhizome, 4 qian), Baiko Ren (White Cardamom Seed, 1 qian, with skin), Sheng Yiren (Coix Seed, 5 qian), Banxia (Pinellia Tuber, 5 qian), Guang Chenpi (Citrus Reticulata Peel, 2 qian), Guizhi (Cinnamon Twig, 2 qian), Bai Tongcao (Tetrapanax Pith, 1 qian).
Take until tongue coating recedes.
[Case 5]
Patient Gan, aged 29. On the 1st day of the 5th month in the Yiyu year. Ten-year history of Jia Qi. Six pulses are wiry, fine, and tight.
Prescription: Dan Wuyu (Light Evodia Fruit, 3 qian), Wuyao (Lindera Root, 3 qian), Chuanjiao Tan (Charred Sichuan Pepper, 5 qian), Guixu (Angelica Sinensis Root Tip, 2 qian), Liangjiang (Galangal Rhizome, 2 qian), Xiaohui Xiang (Fennel, 5 qian, stir-fried black).
Boil to yield three cups, divide into three doses. Already taken five doses.
On the 9th day: Disease reduced, so reduce dosage. Take half a dose daily.
[Case 6]
Patient Wang, aged 40. On the 21st day of the 5th month in the Yiyu year. Six pulses are wiry and tight. "Fuliang" (fixed subcardiac mass) below the heart. Not an easy-to-resolve condition. A life of sorrow and weeping causes Liver Qi stagnation. Furthermore, it is a year of Taiyi Tianfu with strong Metal energy, where Metal overcomes Wood, exacerbating pain. Apply warming collateral method. Hematemesis is also due to cold in the collaterals.
Prescription: Jiangxiang Mo (Dalbergia Odorifera Powder, 3 qian), Chuanjiao Tan (Charred Sichuan Pepper, 2 qian), Xiangfu (Cyperi Rhizome, 3 qian), Banxia (Pinellia Tuber, 3 qian), Zhishi (Immature Bitter Orange, 3 qian), Guixu (Angelica Sinensis Root Tip, 3 qian), Gong Dingxiang (Clove, 8 fen), Guangpi (Citrus Reticulata Peel).
Take four doses.
On the 25th day: All symptoms responded well. Patient feels Qi obstructing the throat. Add: Xuanfuhua (Inula Flower, 5 qian).
On the 29th day: Efficacy maintained, do not change prescription. Take again.
On the 2nd day of the 6th lunar month: Add Wuyu (Evodia Fruit, 3 qian).
[Case 7]
Patient Yu, aged 30. On the 24th day of the 5th month in the Yiyu year. Jia knot on the left side of the umbilicus. Menstrual pain is inevitable. Six pulses are deep, fine, and Yang deficient.
Prescription: Wuyu (Evodia Fruit, 3 qian), Chuanlianzi (Sichuan Chinaberry, 3 qian), Gong Dingxiang (Clove, 1 qian), Liangjiang (Galangal Rhizome, 2 qian), Quandanggui (Whole Angelica Sinensis, 3 qian), Jiangxiang Mo (Dalbergia Odorifera Powder, 3 qian), Xiaohui Xiang (Fennel, 3 qian), Aitan (Mugwort Charcoal, 3 qian).
Boil to yield three cups, divide into three doses. After taking seven doses, follow with pill medicine.
On the 2nd day of the 6th lunar month: Efficacy seen. Take half a dose daily for another ten days.
On the 20th day: Three days before menstruation, when mild abdominal pain occurs, take one pill of Huasheng Dan on an empty stomach. Continue until after menstruation ends and abdominal pain ceases completely. For the next menstrual cycle, if abdominal pain occurs, repeat this method. For Jia pain, also take Huasheng Dan, one pill on an empty stomach, until the pathogen is resolved.
[Case 8]
Patient Che, aged 55. Hair and beard mostly white. Hard, large mass on the left side of the umbilicus, like a plate, with dull mild pain. No bowel movement for over ten days. Initially treated by surgeons, who diagnosed Intestinal Abscess (Chang Yong) and used Dachengqi Tang (Major Order the Qi Decoction) for purgation. Three to four times failed to induce passage. Consulted me. Palpation revealed hardness and coldness like stone. Complexion greenish-yellow. Pulse short, choppy, and slow. Initially able to eat, but after repeated purgation, even gruel was refused. No bowel movement for 49 days. I said: This is accumulation,結由 Metal Qi. Due to Liver Wood depression and autumn Dry-Metal Qi invasion, pathogens entered the interior and formed knots over time. The longer it persists, the harder it becomes. Purging is necessary. However, cold purging is incorrect. Therefore, use Tiantai Wuyao San (2 qian) plus Badou (Castor Bean, 1 fen), mixed with Ginger Decoction. Set three dosing stages: if no result, second dose adds Badou Frost (Ban fen); if still no result, third dose adds Badou Frost (2 fen). After the third dose, passed 49 black, shiny, ball-shaped stools, extremely hard. Subsequently regulated with Bitter-Warm-Sweet-Acrid method, gradually able to eat. Fifteen days later, no bowel movement again. Used previous method; passed on second attempt, 15 black, shiny balls. Also hard but breakable, merely dry. Externally applied hot pepper fried in sesame oil to the hard area. Internally took aromatic collateral-penetrating herbs. Resolved within a month. From this case, one realizes how severely Dry-Metal Qi harms the body, and that Warm-Purgative methods must not be confused.
[Case 9]
In the Yiyu year, treated Tong Tingwei for chronic hernia lasting long, aged 68. Previously, during his provincial posting, every hernia attack was treated with Ginseng by other doctors, thus retaining pathogens and preventing cure. In the late summer of the Yichou year, relapse occurred due to cold exposure. Hard knot formed in the anus, unable to sit or lie down, unbearable distending pain, sweating profusely, no bowel movement for seven days. I said: Hernia is originally Cold Pathogen. Any hard, firm knot belongs to the Metal image. Given the critical situation, warm purging is essential. Used Tiantai Wuyao San (1 qian) plus Badou Frost (approx. 1 fen). Passed stool after three doses. Pain settled afterwards. Regulated with Wowuhuang Wan (Malay Sulfur Pill), combined with Jingui Zhizhu San (Golden Cabinet Spider Powder). Gradually resolved.