动，而臀已磨穿矣。予甘凉育阴药，续解黑矢又五次，便溺之色始正。投以滋养，日渐向安。
其弟翰云，患左胯间肿硬而疼，暮热溺赤，舌绛而渴，孟英按脉，细数，径用∶西洋参 生地 麦冬 楝实
知母 花粉 银花 连翘 甘草 黄柏等，服旬余而愈。
许自堂令孙子社，患感，延至秋杪，证交二十八日，诸医束手。渠伯母鲍玉士夫人，荐孟英诊之，左部
数，右手俨若“鱼翔”，痰嗽气促，自汗螈 ，苔色灰浓，渴无一息之停。垂危若是，而皓首之祖，孀母少
妻，相依为命，环乞拯救，甚可悯也。孟英曰∶据脉莫能下手，吾且竭力勉图。第恐一齐众楚，信任不坚，则
绝无可望之机矣。其母长跽而言曰∶唯君所命，虽砒鸩勿疑也。于是，先以
竹叶石膏汤加减，至五剂，气平嗽减，汗亦渐收，苔色转黑，舌尖露绛。改投∶元参 生地 犀角 石膏
知母 花粉 竹叶 银花等药，又五剂，
螈渐减，舌绛渐退。彼妇翁召羽士为之拜斗，飞符 水，鼓乐喧阗，病者即谵妄不安，神昏如醉，羽士反为
吓退。夤夜速（延）孟英视之，与紫雪钱余，神即清爽，仍用前方，重加竹沥，服八剂，始解黑如胶漆之大便。
而黑苔渐退，右脉之至数始清，惟烦渴不减。令其恣啖北梨，舌才不燥，痰出亦多，又六剂，舌色乃淡，溲出管
痛，热邪得从下行矣。凡十二日之间，共服大剂寒凉、已二十四帖，计用犀角三两有奇，而险浪始平。续以前
法缓制，服六剂，又解黑矢五次，手足始知为已有。又五剂，筋络之振惕始定，略能侧卧，呓语乃息，渐进稀
糜，继灌甘润充其胃汁。七八剂后，渴止知饥，脉皆和缓。又浃旬，谷食乃复。又旬
余，便溲之色始正。前后共下黑矢四十余次，苔色亦净，授滋填善后而康。
是役也，凡同道暨许之族人戚友，莫不以为秋冬之交，用药偏寒。况病延已久，败象毕呈，苟不即投峻
补，必致失手。既闻鲍夫人云∶归许氏二十余年，目击多人，无不死于温补。此等病曾见之，此等药盖未尝闻
也。孰知如此之证，有如此之治，求之古案，亦未前闻，传诸后贤，亦难追步。盖学识可造，而肠热胆坚，
非人力所能及，此孟英所以为不世出之良医也。
陈 眉令郎，孟秋患感，医与表散温补，病随药剧，至八月初，渠叔祖陈霭山延孟英视之，目瞪神呆，
气喘时作，舌绛不语，便泻稀水、肢搐而厥，人皆以为必死矣。察其脉，弦而实数。乃阴亏肝盛之质，提表
助其升逆，温补滞其枢机，痰饮 ，风阳肆横。祷神驱祟，有何益哉？与∶鳖甲 龙（骨） 牡（蛎） 旋（
复） 赭（石） （黄）芩 （黄）连 楝（实） 贝（母） 葛（蒲） （竹）茹 胆星 犀（角）
羚（羊角）等药，熄风镇逆，清热蠲痰，数帖即平。
龚念匏室，故舍人汪小米之女也。患秋感，服温散药而日重。渠叔母韩宜人，请援于孟英，脉见弦数软
滑，苔黑肢 ，疏方用∶沙参 元参 知母 花粉 犀（角） 羚（羊角） （竹）茹 贝（母） 栀（子） 菖
（蒲）等药，曰∶亟饵之，否将厥矣。时念匏幂于江南
，族人皆应试入场，侍疾者多母党，伊芳叔少洪疑药凉，不敢予服，迨暮，果欲厥矣。众皆皇皇，幸彼女兄为
故孝廉金访叔之室，颇具卓识，急煎孟英方灌之，遂得生机。次日复诊，脉较和，一路清凉，渐以向愈。
李竹虚令郎，初秋患感，医闻便溏而止之，乃至目赤谵妄，舌绛苔黄，溲涩善呕，粒米不能下咽。孟英先予∶犀
角石膏 竹叶 竹茹 枇杷叶 茅根 知母 花粉 栀子以清之。呕止神清，热亦渐缓。继以承气汤加减，
三下黑矢，黄苔始退，即能啜粥。以右关尺迟缓有力，故知有燥矢也。续投甘凉，调理而瘥。
许芷卿之太夫人，秋间患感，连服温散，转为肢厥便秘，面赤冷汗，脉来一息一歇，举家惶惶，虑即脱
变。孟英视其舌苔黄腻，不渴，按其胸，闷而不舒；且闻其嗅诸食物，无不极臭。断为暑湿内伏，挟痰阻肺。肺
主一身之气，气壅不行，法宜开降。是虚脱之反面也。设投补药，则内闭而外脱。昧者犹以为投补迟疑而不及
救，孰知“真实类虚”，不必以老年怀成见，总须以对证为良药。果一剂而脉至不歇，转为弦滑。再服汗
止肢和，便行进粥。数帖而痊。方用∶紫菀 白前 竹茹 枳实 旋（复） 贝（母） 杏（仁） （栝）蒌
铃 枇杷叶也。
姚小蘅太史令侄女，初秋患寒热而汛适至，医用正气散二帖，遂壮热狂躁，目赤谵语，甚至欲刎欲缢，
势不可制。孟英按脉，洪滑且数，苔色干黄，尖绛，脘闷，腹胀拒按，畏明口渴，气逆痰多。予桃仁承气汤
加犀角、石膏、知母、花粉、竹沥、甘菊。人谓热虽炽而汛尚行，何必大破其血，而又加极寒之药哉？孟英曰∶
叟勿过虑，恐一二剂尚不足以济事。果服两大剂，始得大便，而神清苔化，目赤亦退。改用甘寒以清之，继而
又不更衣，即脉滑苔黄而腹胀，更与小承气汤两帖，便行而各恙乃已。数日后，又如此，仍投小承气汤两帖。
凡前后六投下剂，才得波浪不兴，渐以清养而瘳。季秋，适江右上高令孙明府之子沛堂为室。
吴酝香孝廉三令嫒，患感，诸医首以升散，继进温补，至三月下旬，证交三十五日，昏痉谵语，六昼夜
不交睫，旬日不沾米饮。许芷卿视之，俨似养云室证，即拉孟英、暨顾听泉、赵笛楼会诊∶
脉弦滑而微数，齿不能开，窥其舌缩苔垢。孟英曰∶舌虽卷，舌犹红润，且二便不秘，尚有一线生机未绝也。
揆其受病原不甚重，只因谬治逾月，误药酿成大证，势虽危险，吾侪当竭力援之，第勿再犯一味悖药，事或有
济。酝香颇极信从。孟英复询其服侍婢媪曰∶病已逾月，腰以下得毋有磨坏之虞乎？皆曰∶无之。惟数日前易
其所遗，略有血渍，必月事之不愆也。孟英颇疑之，嘱其再易之时，留心细察。疏方以∶犀角（四钱） 石菖蒲（两
钱） 贝母（二两） 整块朱砂（两许） 竹沥（碗许） 佐以竹叶 竺黄 知母 花粉 元参 旋复 丝瓜络
苇茎 银花 鳖甲，调下紫雪丹。
次日，诸君复会，渠母徐夫人即云∶王君明视隔垣，小女腰下果已磨穿，糜溃如
。婢媪粗忽，竟未之知也。昨药服后，证亦少减。孟英仍主原方。四服后，夜始眠，痉才息，舌甫伸，
苔仍黑。孟英于前方去鳖甲、朱砂。菖蒲，加生地、栀子。数服后，苔转黄，大便黑如胶漆，且有痰色
粘液。盖从前大解黄色，似乎无甚大热，不知热由补药所酿，滞于肠胃曲折之地，
而不能下行，势必熏蒸于上，致有内陷入脏之逆也。黑矢下而神气渐清，余热复从气分而达，痰嗽不爽，右脉
滑搏，孟英主用竹叶石膏汤加减，四剂渐安。而外患痛楚，彻夜呻吟，虽敷以珠黄（散），滋以甘润，未能向
愈。孟英令以大蟾蜍治净煮汤，煎育阴充液之药服之，果痛止肌生，眠食渐进，汛事如期而瘳。冬间适张舟甫
之子为室。或疑其病虽愈，而过饵凉药，恐难受孕。迨戊申夏，已得子矣。
濮树堂室病，孟英甫为诊愈，而树堂继焉。起即四肢厥逆，脉伏、恶寒、发热、头痛，左为甚。惟口
渴，因与葱豉（汤）两帖，热虽退，脉仍伏，四肢冷过肘膝，大解
频行。人皆疑为虚寒。孟英曰∶此证俨似阴厥，然独渴饮、溲赤，真情已露，岂可疑于一起即厥，而必定其为
寒乎？径投凉解，热果复发，而肢冷脉伏如故。幸病者坚信，服药不疑。至第七日，大便泻出红水，溺则管痛，
呕恶烦躁，彻夜不瞑。人更危之。孟英曰∶热邪既已下行，可望转机，以∶白头翁汤加银花、通草、（黄）芩、
（白）芍、（竹）茹、滑（石）、知（母）、（石）斛、（山）栀、楝（实）、羚（羊角）之类，投三日，红
水始止，四肢渐和，颇有昏瞀谵语。用王氏犀角地黄汤一剂，四肢热而脉显滑数，苔转灰黄，大渴遗溺，病患
自述如卧烘箱上。于昨方加入元参、银花、竹叶、生石膏、知母、贝母、（山）栀、（石）斛，服一剂，
夜间即安寐，而苔转黑燥。于昨方复加花粉，服一剂热退，而头面汗多，懒言倦寐，小溲欲解不通。诸戚友咸
以为危，各举所知，而群医佥云挽救不及，病家皇皇。孟英曰∶此证幸初起即余诊视，得尽力以为死里求生之
举，非比他人之病，皆因误治致危。然不明言其险者，恐病家惶惑，而筑室于道傍也。今生机已得，不过邪去
而真阴未复，但当恪守余法，自然水到渠成，切勿二三其德，以致为山亏篑。赖有一二知音，竟从孟英议。服∶
西洋参 生地 苁蓉 麦冬 （楝）实 芍药 知（母） （石）斛，一剂溺行索粥，再服黑苔退，三服而神清
音朗，舌润津回。唯有韧痰不能吐，左偏头痛微。于原方加二至（丸）、桑（叶）、菊（花）、贝（母）、牡
蛎，又服五剂，得解硬屎一次，各恙始安，眠食渐适而瘳。
孙某，患感，医投温散，竟无汗泄。延至十一日，始请孟英视之，业已神昏囊缩，面赤舌绛，目不识人，口
不出声，胸膈微 ，便泻而小溲不行者，已三日矣。医皆束手，或议大投温补，以冀转机。孟英急止之曰∶阴分素
亏，温散劫津，而热邪愈炽，则营卫不行，岂可妄云“漏底”，欲以温燥竭其欲绝之阴乎？曩
浦上林先生治余先君（王氏之父亲）之病云∶“泄泻为热邪之出路”。求之不可得者，胡可止也。以∶
西洋参 生地 麦冬 丹皮 连翘 生芍（药） 石菖蒲 盐水炒黄连 甘草稍 百合 茯苓 贝母 银花 紫
菀为方，一剂即周身微汗而 退，三剂始得小溲一杯而识人，四剂乃得大汗，而身热退，面赤去，茎亦舒，复
解小溲二杯。次日于方中减连翘、菖蒲、丹皮、黄连，加知母、葳蕤、竹叶，投之，舌始润，神始清，知渴索
水。孟英令将蔗、藜等榨汁频灌勿歇，其汗如雨下者三昼夜始休。于是，粥渐进，泻渐止，
溲渐长。前方又去贝母、银花、紫菀，加石斛、龙眼肉，服之痊愈。
朱敦书令正，患感，吴某与表药二帖，发出赤疹，神气渐昏。叶某知其素患耳聋目障，为阴虚之体，改
用犀角地黄汤二剂，而遗溺痉厥。始延孟英视之，曰∶虽形瘦阴亏，邪易扰营，幸非湿甚之躯，尚可设法。
但心下拒按，呃逆便秘，是痰热尚阻气分，误服升提，每成结胸，地黄滋滞，实为禁药。今人临症不能详审，
往往用非所当用。本年败证甚多，余每见神未全昏，便不甚闭，惟胸前痞结，不可救药而死者，皆升提之误进，
或腻滞之早投也。石北涯在旁闻之叹曰∶无怪乎君素以犀角地黄汤奏奇绩，而他人效尤则屡偾事，岂非能与人规
矩，不能与人以巧耶？于是以∶犀角 元参 （竹）茹 贝（母） 旋（复） （栝）蒌 枇（杷叶） （紫）
菀白前 菖蒲为方，调紫雪，两服。呃逆止，神渐清，而咽痛口渴，乃去紫雪、（白）前、菖（蒲），
加射干、山豆根、知母、花粉，吹以锡类散。二日，咽喉即愈，胸次渐舒，疹回热退。去犀角、紫菀、射干、
豆根，加银花、栀子、竹叶，海 、凫茈，渐安眠食。唯大解久
不行，孟英曰∶腹无痛苦，体虚只宜润养。佐以∶苁蓉、麻仁、当归、生地等药，多服而下。遂愈。
张篪伯纪纲李贵，患感数日，忽然昏厥。比沿途求孟英往视，业已薄暮。主人谓∶“自朝至此，一息奄
奄，恐不及灌药矣，实不便屈诊”。孟英曰∶余既来，且视之。见其面色灰黯，戴眼口开，按其脉，尚不绝。
与∶菖蒲、胆星、竹茹、旋复等为剂，和入童溺，调以牛黄至宝丹灌之，覆杯而起。
魏翎谷浼孟英视其郁甥之病，热逾半月，自胸次胀及少腹，痛不可以抚摩，便秘溺赤，舌黑口干，自汗
烦躁，六脉弦强无胃。曰∶此恙酷似《伤寒（论）》“大结胸症”，“结胸烦躁”，无药可治。越二日，便行而殁。
孟英曰∶伤寒之邪在表，误下则邪陷而成“结胸”，未经误下，不为结胸。温热之邪在里，逆传于心包，
误汗则内闭以外脱，若顺传于胃腑，误汗则盘踞而结胸。前人但云误汗劫夺胃汁，而未及于结胸者，因结胸之
症不多见耳，然不可不知，故谨志之。郁某之病，初起，某医用葛根（汤）一剂，继则胡某用柴、葛、羌、防
十余剂，酿成是证。
吴忻山之子，素禀虚怯，滋补颇投。医不察其患温发热，佥谓阴虚，竟投腻滞培元之剂，乃至舌黑卷短，
唇焦溺赤。孟英一诊，即云不救。顾听泉竭力图维，终不能愈，按虚人受感，每蹈此辙，特录以为戒。
汪左泉，病滞下，昼夜数十行，而即日须补岁考遗才，浼孟英商速愈之策。切脉弦滑，苔黄满布，曰∶
易事耳。重用（黄）芩 （黄）连 佐以（山）楂 （浓）朴，送服青麟丸四钱，投匕而痊，略无他恙。
翁嘉顺之母，染温病。孟英诊曰∶高年阴气太亏，邪气偏盛，《玉版论要》云∶“温病虚甚死”。言人之
真阴甚虚，曷足以御邪热而息燎原？可虞在两候之期，至十四日果殒。
（病情）发作时，臀部皮肤已被磨穿。我给予甘凉育阴的药物，随后又排出了五次黑色粪便，大小便的颜色才恢复正常。接着投以滋养之剂，病情日渐好转。
他的弟弟翰云，患左胯间肿胀坚硬且疼痛，傍晚发热，小便短赤，舌质深红而口渴。孟英诊脉，脉象细数，直接使用了西洋参、生地、麦冬、楝实、知母、花粉、银花、连翘、甘草、黄柏等药，服用十余天后痊愈。
许自堂的孙子许子社，患外感病，拖延到秋末，病程已达二十八天，众医生束手无策。他的伯母鲍玉士夫人推荐孟英诊治。孟英诊得左部脉数，右手脉象宛如“鱼翔”（脉搏微弱欲绝），伴有痰嗽气促、自汗抽搐，舌苔灰厚浓浊，口渴不停。病情危重至此，而他是一位白发苍苍的老人，家中还有守寡的母亲和年轻的妻子，相依为命，众人环绕乞求拯救，十分可怜。孟英说：“根据脉象难以下手，我将竭力勉强治疗。只怕众人意见不一，信任不坚定，那就完全没有希望了。”他的母亲长跪说道：“全听您的吩咐，即使是砒霜鸩酒也不怀疑。”于是，先用竹叶石膏汤加减，服至五剂，气息平复，咳嗽减少，汗也渐渐收敛，舌苔转为黑色，舌尖显露深红色。改投元参、生地、犀角、石膏、知母、花粉、竹叶、银花等药，又服五剂，抽搐逐渐减轻，舌色深红逐渐消退。那位妇女的公公召来道士为他拜斗祈福，飞符泼水，鼓乐喧天，病人随即出现谵妄不安、神志昏迷如醉酒状，道士反而被吓退。深夜急忙延请孟英诊治，给予紫雪丹少许，神志即清爽，仍用前方，加重竹沥，服八剂后，才排出黑如胶漆般的大便。黑色的舌苔逐渐消退，右脉的至数才开始清晰，只是烦渴不减。让他大量吃北方的梨，舌头才不再干燥，痰液也多能咳出，又服六剂，舌色才变淡，排尿时尿道疼痛，热邪得以从下焦排出。在十二天之间，共服大剂寒凉药二十四帖，计用犀角三两多，险情才平息。继续以前法缓制，服六剂，又排出黑色粪便五次，手脚才知觉属于自己。又服五剂，筋络的震颤惊惕才安定，略微能侧卧，胡言乱语才停止，逐渐进稀粥，继而又灌服甘润之品以补充胃汁。七八剂后，口渴停止，知道饥饿，脉象皆和缓。又过十天，谷食才恢复。又过十多天，大小便的颜色才正常。前后共排出黑色粪便四十多次，舌苔也干净了，给予滋补填精的善后调理而康复。
这次诊疗中，凡同道的医生以及许家的族人亲戚朋友，都认为在秋冬之交，用药过于偏寒。况且病程已延长很久，败象毕现，如果不立即投用峻补之药，必定会导致失误。既然听了鲍夫人的话：嫁给许家二十多年，亲眼目睹多人，没有不是死于温补治疗的。这种病曾见过，这种药却从未听说过。谁知道这样的病症，有这样的治法，寻求古代医案，也未曾听闻，传给后世贤者，也难以追随效仿。大概学识可以造就，但那种肠热胆坚（指对病机判断准确、敢于用药的胆识），不是人力所能达到的，这就是孟英之所以成为不世出的良医的原因。
陈眉的公子，孟秋时节患外感，医生给予解表发散和温补药物，病情随服药而加重，到八月初，他的叔祖陈霭山延请孟英诊治。病人眼睛瞪视、神志呆滞，气喘不时发作，舌质深红不能言语，大便泻稀水，四肢抽搐而厥冷，人们都以为必死无疑。察其脉象，弦而实数。这是阴亏肝盛的体质，发表助长了气机的升逆，温补阻滞了枢机的运转，导致痰饮内停，风阳肆虐。祈祷神灵驱鬼，有什么益处呢？给予鳖甲、龙骨、牡蛎、旋覆花、代赭石、黄芩、黄连、楝实、贝母、石菖蒲、竹茹、胆星、犀角、羚羊角等药，熄风镇逆，清热化痰，数帖即平复。
龚念匏的妻子，是原舍人汪小米的女儿。患秋季外感，服用温散药物后日益加重。他的叔母韩宜人向孟英求助，脉见弦数软滑，舌苔黑，四肢抽搐。开方使用沙参、元参、知母、花粉、犀角、羚羊角、竹茹、贝母、栀子、石菖蒲等药，说：“赶快服用，否则将要发生厥逆。”当时念匏在江南经商，族人都在参加科举考试入场应试，侍候病人多是娘家人，他的叔叔少洪怀疑药性太凉，不敢给病人服用，等到傍晚，果然要发生厥逆了。众人都惊慌失措，幸好她的姐姐是已故孝廉金访叔的妻子，颇具卓识，急忙煎煮孟英的药灌下去，才得以生机。次日复诊，脉象较平和，一路清凉，逐渐向好。
李竹虚的公子，初秋患外感，医生听说大便溏泄就停止了治疗，以至于出现目赤谵妄，舌质深红苔黄，小便涩滞善于呕吐，一粒米也不能咽下。孟英先给予犀角、石膏、竹叶、竹茹、枇杷叶、茅根、知母、花粉、栀子以清解。呕吐停止，神志清醒，热势也逐渐缓和。继以承气汤加减，三次攻下黑色粪便，黄苔才消退，就能喝粥了。因为右关尺脉迟缓有力，所以知道有燥屎内结。续投甘凉之剂，调理而痊愈。
许芷卿的太夫人，秋季患外感，连续服用温散药物，转变为四肢厥冷便秘，面赤冷汗，脉象一息一跳且有间歇，全家惶恐，担心立即发生脱证变化。孟英看他的舌苔黄腻，不口渴，按压胸部，闷而不舒；并且闻他嗅各种食物，无不觉得极臭。断定为暑湿内伏，挟痰阻肺。肺主一身之气，气机壅塞不行，法宜开降。这是虚脱的反面。如果投用补药，则会导致内闭而外脱。庸俗的人还以为投用补药迟疑而未能及时救治，谁知道这是“真实类虚”，不必因为年老就怀有成见，总须以对证为良药。果然一剂后脉象跳动不再有间歇，转为弦滑。再服后汗止肢和，大便通利进粥。数帖而痊愈。方用：紫菀、白前、竹茹、枳实、旋覆花、贝母、杏仁、瓜蒌、铃铛花、枇杷叶。
姚小蘅太史的侄女，初秋患寒热往来，月经适至，医生用正气散两帖，遂致壮热狂躁，目赤谵语，甚至想要割颈上吊，势头不可控制。孟英按脉，洪滑且数，舌苔干黄，舌尖深红，脘腹闷胀，腹胀拒按，畏光口渴，气逆痰多。给予桃仁承气汤加犀角、石膏、知母、花粉、竹沥、甘菊。别人说热势虽然炽盛，但月经还在行，何必大破其血，而又加入极寒的药物呢？孟英说：“老先生不要过分忧虑，恐怕一两剂还不足以见效。”果然服两大剂，才得大便，而神志清醒，舌苔化解，目赤也消退。改用甘寒以清解，继而又不排便，即使脉滑苔黄而腹胀，更与小承气汤两帖，大便通而各症乃止。数日后，又如此，仍投小承气汤两帖。前后共六次投用下剂，才得波浪不惊，逐渐以清养之法而痊愈。季秋，嫁给了江右上高县令孙明府的儿子沛堂为妻。
吴酝香孝廉的三女儿，患外感，众医生首先用升散药，继进温补药，到三月下旬，病程交三十五日，昏痉谵语，六昼夜不睡觉，十天不沾米饮。许芷卿查看，俨似养云室（指之前提到的许子社家）的证候，即拉孟英、暨顾听泉、赵笛楼会诊：脉弦滑而微数，牙齿不能张开，窥其舌缩苔垢。孟英说：“舌虽卷曲，但舌体红润，且二便不通秘，尚有一线生机未绝也。推测其受病原不甚重，只因误治超过一个月，误药酿成大证，势头虽危险，我们应当竭力救援，只要不再犯一味悖逆的药，事情或许有救。”酝香非常信服听从。孟英又询问服侍的婢女说：“病已超过一个月，腰以下难道没有磨坏的危险吗？”都说：“没有。”只有数日前更换她留下的衣物，略有血渍，必定是月经没有错乱。孟英颇怀疑此事，嘱咐再次更换时，留心细察。开方以：犀角（四钱）、石菖蒲（一两）、贝母（二两）、整块朱砂（一两许）、竹沥（一碗许），佐以竹叶、竺黄、知母、花粉、元参、旋覆花、丝瓜络、苇茎、银花、鳖甲，调下紫雪丹。
次日，各位医生再次会诊，她的母亲徐夫人就说：“王君明察秋毫，隔着墙都能看见，小女的腰下果然已经磨穿，糜烂溃烂像……（原文缺字，意指严重）。婢女粗心大意，竟然不知道。昨天服药后，症状也稍减。孟英仍坚持原方。服四剂后，夜里才开始睡眠，痉挛才停止，舌头才能伸出，舌苔仍然黑。孟英于前方去掉鳖甲、朱砂、菖蒲，加生地、栀子。数服后，舌苔转黄，大便黑如胶漆，且有痰色粘液。盖从前大便黄色，似乎没有很大的热，不知道热是由补药所酿成，滞留在肠胃曲折之地，而不能下行，势必熏蒸于上，导致内陷入脏的逆证。黑色粪便排出而神气渐清，余热又从气分透出，痰嗽不爽，右脉滑搏，孟英主用竹叶石膏汤加减，四剂渐安。而外部患处痛楚，彻夜呻吟，虽然敷以珠黄散，滋以甘润，未能向愈。孟英令以大蟾蜍洗净煮汤，煎育阴充液的药服用，果然痛止肌生，眠食渐进，月经如期而痊愈。冬天嫁给了张舟甫的儿子为妻。有人怀疑她病虽愈，而过服凉药，恐怕难受孕。等到戊申年夏天，已经得子了。
濮树堂的妻子生病，孟英刚为她诊愈，而树堂接着病了。起身即四肢厥逆，脉伏、恶寒、发热、头痛，左侧为甚。唯独口渴，因此给予葱豉汤两帖，热虽退，脉仍伏，四肢冷过肘膝，大便频频而行。人们都怀疑为虚寒。孟英说：“此证俨似阴厥，但独独口渴饮水、小便赤，真情已露，岂可因为一起病就厥逆，而必定其为寒吗？”径投凉解药，热果复发，而肢冷脉伏如故。幸好病人坚信，服药不疑。到第七日，大便泻出红水，小便则尿道疼痛，呕恶烦躁，彻夜不眠。人们更加认为危险。孟英说：“热邪既已下行，可望转机，以白头翁汤加银花、通草、黄芩、白芍、竹茹、滑石、知母、石斛、栀子、楝实、羚羊角之类，投药三日，红水才止，四肢渐和，颇有昏瞀谵语。用王氏犀角地黄汤一剂，四肢热而脉显滑数，舌苔转灰黄，大渴遗溺，病患自述如卧烘箱上。于昨方加入元参、银花、竹叶、生石膏、知母、贝母、栀子、石斛，服一剂，夜间即安寐，而舌苔转黑燥。于昨方复加花粉，服一剂热退，而头面汗多，懒言倦寐，小便欲解不通。各位亲戚朋友都认为是危症，各自举荐所知，而群医都说挽救不及，病家惶恐。孟英说：“此证幸亏初起就是我诊视，得以尽力作为死里求生之举，不像他人的病，皆因误治致危。然而不明言其险者，是怕病家惶惑，而筑室道谋（指人多口杂，难成一事）。现在生机已得，不过是邪去而真阴未复，只当恪守我的法度，自然水到渠成，切勿三心二意，以致为山九仞功亏一篑。幸有一二知音，竟从孟英议。服用西洋参、生地、肉苁蓉、麦冬、楝实、芍药、知母、石斛，一剂后小便通利索粥，再服黑苔退，三服而神清音朗，舌润津回。唯有韧痰不能吐，左偏头痛微。于原方加二至丸、桑叶、菊花、贝母、牡蛎，又服五剂，得解硬屎一次，各恙始安，眠食渐适而痊愈。
孙某，患外感，医生投用温散药，竟然无汗泄。拖延到十一日，才请孟英诊治，业已神昏囊缩，面赤舌绛，目不识人，口不出声，胸膈微闷，大便泻而小便不行者，已三天了。医生都束手无策，有人建议大投温补，以冀转机。孟英急忙制止说：“阴分素亏，温散劫夺津液，而热邪愈炽，则营卫不行，岂可妄称‘漏底’（指久泻不止），想用温燥竭其欲绝之阴吗？从前浦上林先生治疗我的父亲（王氏之父亲）的病时说：‘泄泻为热邪之出路’。求之不可得者，怎么可以止住呢？”以西洋参、生地、麦冬、丹皮、连翘、生芍药、石菖蒲、盐水炒黄连、甘草稍、百合、茯苓、贝母、银花、紫菀为方，一剂即周身微汗而胸闷退，三剂始得小便一杯而识人，四剂乃得大汗，而身热退，面赤去，阴茎亦舒展，复解小便二杯。次日于方中减连翘、菖蒲、丹皮、黄连，加知母、葳蕤、竹叶，投之，舌始润，神始清，知渴索水。孟英令将甘蔗、藜芦等榨汁频灌勿歇，其汗如雨下者三昼夜才休。于是，粥渐进，泻渐止，小便渐长。前方又去贝母、银花、紫菀，加石斛、龙眼肉，服之痊愈。
朱敦书的正室，患外感，吴某给予解表药两帖，发出赤疹，神气渐昏。叶某知道他素患耳聋目障，为阴虚之体，改用犀角地黄汤两剂，而遗溺痉厥。始延孟英诊治，说：“虽然形瘦阴亏，邪易扰营，幸非湿甚之躯，尚可设法。但心下拒按，呃逆便秘，是痰热尚阻气分，误服升提，每成结胸，地黄滋滞，实为禁药。今人临症不能详审，往往用非所当用。本年败证甚多，我每见神未全昏，便不甚闭，惟胸前痞结，不可救药而死者，皆升提之误进，或腻滞之早投也。”石北涯在旁边听后感叹说：“难怪你素以犀角地黄汤奏奇绩，而他人效尤则屡偾事，岂不是能给人规矩，不能给人技巧耶？”于是以犀角、元参、竹茹、贝母、旋覆花、瓜蒌、枇杷叶、紫菀、白前、菖蒲为方，调紫雪，两服。呃逆止，神渐清，而咽痛口渴，乃去紫雪、白前、菖蒲，加射干、山豆根、知母、花粉，吹以锡类散。二日，咽喉即愈，胸次渐舒，疹回热退。去犀角、紫菀、射干、豆根，加银花、栀子、竹叶、海浮石、凫茈，渐安眠食。唯大便久不行，孟英说：“腹部无痛苦，体虚只宜润养。佐以肉苁蓉、麻仁、当归、生地等药，多服而下。遂愈。
张篪伯的管家李贵，患外感数日，忽然昏厥。等到沿途求孟英前往诊治，业已薄暮。主人说：“自早晨至此，一息奄奄，恐怕来不及灌药了，实在不便屈尊诊脉”。孟英说：“我既然来了，且看看。”见其面色灰黯，戴眼口开，按其脉，尚不绝。给予菖蒲、胆星、竹茹、旋覆花等为剂，和入童尿，调以牛黄至宝丹灌之，覆杯而起（指药效迅速）。
魏翎谷委托孟英诊治其郁姓外甥的病，热逾半月，自胸次胀及少腹，痛不可以抚摩，便秘溺赤，舌黑口干，自汗烦躁，六脉弦强无胃气。说：“此病酷似《伤寒论》‘大结胸症’，‘结胸烦躁’，无药可治。越二日，便行而殁。”孟英说：“伤寒之邪在表，误下则邪陷而成‘结胸’，未经误下，不为结胸。温热之邪在里，逆传于心包，误汗则内闭以外脱，若顺传于胃腑，误汗则盘踞而结胸。前人但云误汗劫夺胃汁，而未及于结胸者，因结胸之症不多见耳，然不可不知，故谨志之。郁某之病，初起，某医用葛根汤一剂，继则胡某用柴胡、葛根、羌活、防风十余剂，酿成是证。”
吴忻山的儿子，素禀虚怯，滋补颇投合。医生不察其患温发热，众谓阴虚，竟投腻滞培元之剂，乃至舌黑卷短，唇焦溺赤。孟英一诊，即云不救。顾听泉竭力图维，终不能愈，按虚人受感，每蹈此辙，特录以为戒。
汪左泉，患痢疾，昼夜数十行，而即日须补岁考遗才，委托孟英商量速愈之策。切脉弦滑，苔黄满布，说：“易事耳。重用黄芩、黄连，佐以山楂、厚朴，送服青麟丸四钱，投匕而痊，略无他恙。”
翁嘉顺的母亲，染温病。孟英诊曰：“高年阴气太亏，邪气偏盛，《玉版论要》云：‘温病虚甚死’。言人之真阴甚虚，曷足以御邪热而息燎原？可虞在两候之期，至十四日果殒。”
(The condition) flared up, and the buttocks were already worn through. I administered sweet-cool yin-nourishing medicines. After five more passages of black stools, the color of urine and feces finally returned to normal. Nourishing tonics were then given, and the condition gradually improved.
His younger brother, Han Yun, suffered from swelling, hardness, and pain in the left hip area, with evening fever, dark red urine, a crimson tongue, and thirst. Mengying palpated the pulse as fine and rapid, and prescribed directly: *Panax ginseng* var. *americanus* (American Ginseng), *Rehmanniae Radix* (Shengdi), *Ophiopogonis Radix* (Maidong), *Meliae Fructus* (Lianshi), *Anemarrhenae Rhizoma* (Zhimu), *Bletillae Rhizoma* (Huafen), *Lonicerae Japonicae Flos* (Jinyinhua), *Schizonepetae Spica* (Jingjie), *Glycyrrhizae Radix et Rhizoma* (Gancao), *Phellodendri Cortex* (Huangbai), etc. He recovered after taking them for over ten days.
Xu Zitang's grandson, Xu Zishe, contracted an exogenous pathogen, which dragged on until late autumn. The illness had lasted twenty-eight days, and all physicians were at a loss. His aunt-in-law, Lady Bao Yushi, recommended Mengying for consultation. Mengying found the left pulse rapid, while the right pulse resembled "fish swimming" (a sign of impending collapse). Symptoms included phlegm-cough, shortness of breath, spontaneous sweating, convulsions, thick gray coating on the tongue, and ceaseless thirst. The patient was in such critical condition; yet he was an elderly man with white hair, supported by his widowed mother and young wife. Everyone surrounded him begging for salvation, which was truly pitiable. Mengying said, "Based on the pulse, it is difficult to proceed. I will try my best. However, if there is lack of unified trust among the family, there will be no hope." His mother knelt long and said, "We follow your orders completely; even if you prescribe arsenic or poison, we will not doubt." Thus, *Zhuye Shigao Tang* (Folium Bambusae and Gypsum Decoction) modified was used first. After five doses, breathing stabilized, cough decreased, sweating subsided, the tongue coating turned black, and the tip revealed crimson. The prescription was changed to: *Scrophulariae Radix* (Yuanshen), *Rehmanniae Radix* (Shengdi), *Rhinocerotis Cornu* (Xijiao), *Gypsum Fibrosum* (Shigao), *Anemarrhenae Rhizoma* (Zhimu), *Bletillae Rhizoma* (Huafen), *Folium Bambusae* (Zhuye), *Lonicerae Japonicae Flos* (Jinyinhua), etc. After another five doses, convulsions lessened, and the crimson tongue receded. The woman's father-in-law summoned Daoist priests to perform rituals for reducing bad luck, flying talismans, splashing water, and loud music. The patient became delirious and restless, confused like a drunkard, and the priests were frightened away. In the deep night, Mengying was urgently consulted. A small amount of *Zixue San* (Purple Snow Powder) was given, and consciousness cleared immediately. The previous formula was continued with added *Bambusa Textilis* juice (Zhuli). After eight doses, black stools like glue and lacquer were passed. The black tongue coating gradually faded, and the right pulse became clear, though irritability and thirst persisted. He was advised to eat northern pears freely, which moistened the tongue and promoted expectoration. After six more doses, the tongue color lightened, and dysuria occurred, indicating that heat pathogens were draining downward. Within twelve days, twenty-four large doses of cold-clearing herbs were taken, including over three taels of rhino horn. The crisis finally subsided. Continuing with a milder approach, six doses were given, resulting in five more black stools, and sensation returned to the limbs. Five more doses settled the tremors of sinews and collaterals, allowing side-lying sleep, stopping muttering, and permitting thin gruel. Sweet-moistening fluids were infused to replenish stomach juices. After seven or eight doses, thirst ceased, hunger appeared, and pulses became harmonious and slow. Grain food resumed after ten days. Stool and urine colors normalized after another ten-plus days. Over forty black stools were passed in total, and the tongue coating cleared. Nourishing and filling post-care led to recovery.
During this case, colleagues and Xu's relatives believed that using cold medicines in late autumn/winter was inappropriate. Given the prolonged illness and signs of collapse, they argued that strong tonics should have been used immediately to avoid failure. Hearing Lady Bao say she had seen many die from warm-tonic treatments during her twenty years in the Xu family, they claimed such cases and cures were unprecedented in ancient records and hard for future generations to emulate. Perhaps medical knowledge can be acquired, but the intestinal heat and gallbladder courage (decisiveness) required are beyond human effort. This explains why Mengying is considered a rare physician.
Chen Mei's son contracted an exogenous pathogen in early autumn. Physicians gave dispersing and warming-tonic medicines, worsening the condition. By early August, Chen Aishan (his great-uncle) invited Mengying. The patient stared blankly, gasped intermittently, had a crimson tongue and aphasia, diarrhea with watery stool, limb twitching, and cold extremities. Everyone deemed it fatal. The pulse was wiry, solid, and rapid. This indicated a constitution of yin deficiency and liver excess. Dispersing aggravated ascending rebellion; warming tonics stagnated the pivot mechanism, leading to phlegm-fluid retention and rampant wind-yang. Prayer offered no help. Prescribed: *Trionycis Carapax et Plastrum* (Biejia), *Ostreae Concha* (Muli), *Concha Meretricis et Cyclinae* (Muli), *Inulae Flos* (Xuanfu), *Hematitum* (Zheishi), *Scutellariae Radix* (Huangqin), *Coptidis Rhizoma* (Huanglian), *Meliae Fructus* (Lianshi), *Fritillariae Thunbergii Bulbus* (Beimu), *Acori Tatarinowii Rhizoma* (Shichangpu), *Bambusa Textilis* juice (Zhuru), *Arisaema cum Bile* (Danning), *Rhinocerotis Cornu* (Xijiao), *Capricornus Cervi* (Lingyangjiao), etc. These extinguished wind, suppressed rebellion, cleared heat, and resolved phlegm. Peace returned in a few doses.
Gong Nianpao's wife, daughter of former Scholar Wang Xiaomi, suffered from autumnal exogenous pathogen, worsening with warm-dispersing meds. Her aunt, Lady Han, sought Mengying's help. Pulse was wiry, rapid, soft, and slippery; tongue coating black; limbs twitching. Formula: *Glehniae Radix* (Shashen), *Scrophulariae Radix* (Yuanshen), *Anemarrhenae Rhizoma* (Zhimu), *Bletillae Rhizoma* (Huafen), *Rhinocerotis Cornu* (Xijiao), *Capricornus Cervi* (Lingyangjiao), *Bambusa Textilis* juice (Zhuru), *Fritillariae Thunbergii Bulbus* (Beimu), *Gardeniae Fructus* (Zhizi), *Acori Tatarinowii Rhizoma* (Shichangpu). Mengying warned, "Take it urgently, or syncope will occur." Nianpao was away in Jiangnan; clan members were taking exams. Servants from her natal family doubted the cold nature of the medicine. By evening, syncope threatened. Panic ensued. Fortunately, her elder sister, married to the late Jin Fushu, had good judgment, boiled the medicine, and forced it down, saving his life. Next day, pulse harmonized, cooling continued, and recovery progressed.
Li Zhuxu's son contracted an exogenous pathogen in early autumn. Doctors stopped treatment due to loose stools, leading to red eyes, delirium, crimson tongue with yellow coating, scanty painful urination, vomiting, and inability to swallow food. Mengying first cleared heat with: *Rhinocerotis Cornu* (Xijiao), *Gypsum Fibrosum* (Shigao), *Folium Bambusae* (Zhuye), *Bambusa Textilis* juice (Zhuru), *Loquat Leaf* (Pipaye), *Imperatae Rhizoma* (Magen), *Anemarrhenae Rhizoma* (Zhimu), *Bletillae Rhizoma* (Huafen), *Gardeniae Fructus* (Zhizi). Vomiting stopped, spirit cleared, heat eased. Then *Chengqi Tang* (Descending the Qi Decoction) modified was used. Three purgations of black stools cleared the yellow coating, allowing porridge intake. Right guan/ch chi pulses were slow but forceful, indicating dry feces. Sweet-cooling tonics followed for recovery.
Lady Xu Zhiqing's mother-in-law contracted an exogenous pathogen in autumn. Continuous warm-dispersing meds caused cold limbs, constipation, red face, cold sweat, and intermittent pulse (one beat every two beats). Family feared collapse. Mengying observed yellow-greasy tongue coating, no thirst, chest oppression upon pressure, and foul odor from foods. Diagnosis: Summerheat-dampness latent inside, obstructing lungs with phlegm. Lung governs qi; obstruction requires opening and descending. This is the opposite of collapse. Tonics would cause internal closure and external collapse. Laypeople might blame hesitation, but this is "true excess mimicking deficiency." Age bias must be set aside for correct syndrome differentiation. One dose restored pulse regularity to wiry-slippery. Second dose stopped sweating, harmonized limbs, allowed bowel movement and porridge. Several doses cured. Formula: *Asterae Radix* (Ziwan), *Cynanchi Stauntonii Caulis* (Baiqian), *Bambusa Textilis* juice (Zhuru), *Immature Bitter Orange* (Zhishi), *Inulae Flos* (Xuanfu), *Fritillariae Thunbergii Bulbus* (Beimu), *Apricot Seed* (Xingren), *Trichosanthis Fructus* (Gualou), *Campanulae Radix* (Tongling), *Loquat Leaf* (Pipaye).
Yao Xiaoheng's niece contracted alternating chills and fever in early autumn during menstruation. Two doses of *Zhengqi San* (Regular Qi Powder) caused high fever, mania, red eyes, delirium, and suicidal tendencies. Mengying found pulse洪滑且数 (surging, slippery, rapid); dry yellow coating; crimson tip; epigastric fullness; abdominal distension with refusal to press; photophobia; thirst; rebellious qi; profuse phlegm. Prescribed *Taoren Chengqi Tang* (Peach Kernel and Cathartic Decoction) plus *Rhinocerotis Cornu* (Xijiao), *Gypsum Fibrosum* (Shigao), *Anemarrhenae Rhizoma* (Zhimu), *Bletillae Rhizoma* (Huafen), *Bambusa Textilis* juice (Zhuli), *Chrysanthemi Flos* (Ganju). Critics asked why blood-breaking and extreme cold herbs were needed during menstruation. Mengying replied, "One or two doses may not suffice." Two large doses eventually produced stool, clearing spirit and coating, reducing eye redness. Sweet-cooling cleared residual heat. Constipation returned with slippery pulse and yellow coating; *Xiao Chengqi Tang* (Minor Cathartic Decoction) twice moved bowels. Recurrence required two more doses. Six purgative doses total calmed the storm. Gradual nourishment healed her. She married Sun Peitang, son of Governor Sun of Gaosheng, Jiangsu, in late autumn.
Wu Yunxiang's third daughter contracted an exogenous pathogen. Physicians used ascending-dispersing then warming-tonic meds. By late March (35th day), she suffered coma, spasms, delirium, six nights without sleep, and ten days without food/drink. Xu Zhiqing recognized similarities to the Xu Zishe case and invited Mengying, Gu Tingquan, and Zhao Dilou. Pulse wiry-slippery slightly rapid; teeth clenched; tongue retracted with dirty coating. Mengying noted tongue was still reddish, bowels/bladder not blocked, so a thread of life remained. Cause was mismanagement over a month turning mild illness severe. Danger existed, but rescue was possible if wrong meds ceased. Yunxiang trusted him. Mengying asked maids if the lower body was abraded from lying down for a month. They denied it, noting only slight blood stains recently, confirming regular menstruation. Mengying suspected abrasion and ordered careful inspection. Formula: *Rhinocerotis Cornu* (4 qian), *Acori Tatarinowii Rhizoma* (1 liang), *Fritillariae Thunbergii Bulbus* (2 liang), *Cinnabaris* (1 liang), *Bambusa Textilis* juice (1 bowl), plus *Folium Bambusae*, *Bambusa Textilis* powder, *Anemarrhenae Rhizoma*, *Bletillae Rhizoma*, *Scrophulariae Radix*, *Inulae Flos*, *Luffae Reticulata Caulis*, *Asparagi Radix*, *Lonicerae Japonicae Flos*, *Trionycis Carapax et Plastrum*, mixed with *Zixue Dan* (Purple Snow Powder).
Next day, Mother Xu reported Mengying saw through walls: the waist was indeed worn through and ulcerated. Maids missed it. Meds helped slightly. Mengying kept the formula. Four doses allowed night sleep, stopped spasms, extended tongue, though coating remained black. Mengying removed *Trionycis Carapax et Plastrum*, *Cinnabaris*, *Acori Tatarinowii Rhizoma*; added *Rehmanniae Radix*, *Gardeniae Fructus*. Coating turned yellow; black glue-like stool and phlegm-mucus passed. Previous yellow stool masked heat generated by tonics, stagnating in gut curves, steaming upward causing internal invasion. Black stool passage cleared spirit; residual heat exited via qi level. Phlegm-cough persisted; right pulse slippery-forceful. *Zhuye Shigao Tang* modified brought peace in four doses. External wound pain caused night crying; *Zhuhuang San* (Pearl and Gold Powder) and moisteners failed. Mengying instructed boiling *Bufo bufo gargarizans* (Chanhu) soup to decoct yin-nourishing meds. Pain stopped, flesh grew, sleep/food improved, menstruation returned normally. She married Zhang Zhoufu's son in winter. Doubts arose about cold meds affecting fertility, but she bore a son in summer of Wushen year.
Pu Shutang's wife was cured by Mengying, then Shutang fell ill. Limb coldness, hidden pulse, aversion to cold, fever, headache (worse on left). Only thirst present. *Congchi Tang* (Scallion and Fermented Soybean Decoction) two doses reduced fever but pulse remained hidden, limbs colder than elbows/knees, frequent loose stools. Suspected deficiency-cold. Mengying said, "Resembles yin syncope, but thirst for water and red urine reveal true heat. Cannot assume cold just because of immediate syncope." Cold-clearing meds caused fever recurrence and persistent cold limbs/hidden pulse. Patient trusted Mengying. On day 7, bloody diarrhea, dysuria, vomiting, irritability, insomnia. Mengying said heat moving down offers hope. *Baitouweng Tang* (Pulsatilla Decoction) plus *Lonicerae Japonicae Flos*, *Thlaspi Herba* (Tongcao), *Scutellariae Radix*, *Paeoniae Radix Alba*, *Bambusa Textilis* juice, *Talcum* (Huashi), *Anemarrhenae Rhizoma*, *Dendrobii Caulis*, *Gardeniae Fructus*, *Meliae Fructus*, *Capricornus Cervi*, etc. Three doses stopped bloody diarrhea, harmonized limbs, but dizziness/delirium appeared. *Wangshi Xijiao Dihuang Tang* one dose warmed limbs, pulse became slippery-rapid, coating gray-yellow, intense thirst, enuresis. Patient felt like lying on a roasting oven. Added *Scrophulariae Radix*, *Lonicerae Japonicae Flos*, *Folium Bambusae*, *Gypsum Fibrosum*, *Anemarrhenae Rhizoma*, *Fritillariae Thunbergii Bulbus*, *Gardeniae Fructus*, *Dendrobii Caulis*. One dose allowed sleep, coating turned black-dry. Added *Bletillae Rhizoma*. Heat subsided, head/facial sweating increased, lethargy, urinary retention. Relatives panicked; doctors despaired. Mengying explained early diagnosis allowed life-saving effort, unlike others' mismanaged cases. Kept quiet about danger to prevent family confusion. Vitality secured; yin not yet restored. Stick to method. Few trusted him. *Panax ginseng* var. *americanus*, *Rehmanniae Radix*, *Cynomorii Herba*, *Ophiopogonis Radix*, *Meliae Fructus*, *Paeoniae Radix*, *Anemarrhenae Rhizoma*, *Dendrobii Caulis*. One dose: urination, appetite. Two doses: black coating faded. Three doses: clear spirit/voice, moist tongue. Sticky phlegm and left-sided headache remained. Added *Erzhi Wan*, *Mori Folium*, *Chrysanthemi Flos*, *Fritillariae Thunbergii Bulbus*, *Ostreae Concha*. Five doses: hard stool passed, symptoms settled, recovery complete.
Sun Mou contracted exogenous pathogen. Warm-dispersing meds failed to induce sweat. Eleven days later, Mengying found coma, scrotal retraction, red face, crimson tongue, unrecognizing eyes, mute, slight chest oppression, diarrhea, no urination for three days. Doctors suggested strong tonics. Mengying stopped them: "Yin deficient constitution; warm dispersing depleted fluids, intensifying heat, blocking Ying-Wei. Do not call it 'bottom leak' and use warm-dry to exhaust dying yin." Cited Lin Pushang treating his father: "Diarrhea is the exit for heat pathogens. If not obtainable, how can it be stopped?" Formula: *Panax ginseng* var. *americanus*, *Rehmanniae Radix*, *Ophiopogonis Radix*, *Moutan Cortex*, *Schizonepetae Spica*, *Paeoniae Radix Rubra*, *Acori Tatarinowii Rhizoma*, *Coptidis Rhizoma* (salt-fried), *Glycyrrhizae Radix et Rhizoma* (tip), *Lilii Bulbus*, *Poria*, *Fritillariae Thunbergii Bulbus*, *Lonicerae Japonicae Flos*, *Asterae Radix*. One dose: slight whole-body sweat, chest oppression relieved. Three doses: one cup urine, recognition returned. Four doses: heavy sweat, fever/subside, face redness gone, penis relaxed, two cups urine. Next day: removed *Schizonepetae Spica*, *Acori Tatarinowii Rhizoma*, *Moutan Cortex*, *Coptidis Rhizoma*; added *Anemarrhenae Rhizoma*, *Polygonati Odorati Rhizoma*, *Folium Bambusae*. Tongue moistened, spirit cleared, thirst for water. Sugarcane and *Lepidium apetalum* juice frequently administered. Sweat如雨 for three days. Porridge advanced, diarrhea stopped, urine increased. Removed *Fritillariae Thunbergii Bulbus*, *Lonicerae Japonicae Flos*, *Asterae Radix*; added *Dendrobii Caulis*, *Longan Arillus*. Recovery.
Zhu Dunshu's wife contracted exogenous pathogen. Wu Mou gave two dispersing doses, causing red rash and fading spirit. Ye Mou, knowing her chronic deafness/vision issues (yin deficiency), switched to *Xijiao Dihuang Tang* two doses, causing enuresis and spasms. Mengying consulted: "Thin, yin deficient, pathogen disturbs Ying. Not damp-heavy, so treatable. But epigastric tenderness, hiccups, constipation indicate phlegm-heat blocking Qi level. Ascending meds cause Jie Xiong (chest knot); Rehmannia is cloying/prohibited. Modern doctors fail to examine carefully, using wrong meds. Many failures this year: those with partial coma, non-severe constipation, chest fullness dying were misled by ascending or cloying meds." Shi Beiya sighed: "No wonder your *Xijiao Dihuang Tang* works, but others copying fails. You give rules, not skill." Formula: *Rhinocerotis Cornu*, *Scrophulariae Radix*, *Bambusa Textilis* juice, *Fritillariae Thunbergii Bulbus*, *Inulae Flos*, *Trichosanthis Fructus*, *Loquat Leaf*, *Asterae Radix*, *Cynanchi Stauntonii Caulis*, *Acori Tatarinowii Rhizoma*, mixed with *Zixue San*. Two doses: hiccups stopped, spirit cleared, throat pain/thirst. Removed *Zixue San*, *Cynanchi Stauntonii Caulis*, *Acori Tatarinowii Rhizoma*; added *Belamcandae Rhizoma*, *Sophorae Tonkinensis Radix*, *Anemarrhenae Rhizoma*, *Bletillae Rhizoma*, applied *Xilei San*. Two days: throat healed, chest comfort, rash receded, heat subsided. Removed *Rhinocerotis Cornu*, *Asterae Radix*, *Belamcandae Rhizoma*, *Sophorae Tonkinensis Radix*; added *Lonicerae Japonicae Flos*, *Gardeniae Fructus*, *Folium Bambusae*, *Pinelliae Tuber* (Haifushi), *Eleocharis Tubers* (Fuci). Sleep/food improved. Constipation persisted. Mengying: "No abdominal pain, deficiency needs moistening. Add *Cynomorii Herba*, *Cannabis Seed* (Maren), *Angelicae Sinensis Radix*, *Rehmanniae Radix*. Passed after multiple doses. Cured.
Li Gui, steward of Zhang Chibo, collapsed suddenly after days of exogenous pathogen. Mengying arrived at dusk. Owner said, "Breathing faint since morning, too late for meds, inconvenient to pulse." Mengying insisted. Gray-dark face, staring eyes, open mouth, pulse faint but present. Formula: *Acori Tatarinowii Rhizoma*, *Arisaema cum Bile*, *Bambusa Textilis* juice, *Inulae Flos*, mixed with child's urine, *Niuhuang Zhibao Dan* (Cow-bezoar Precious Treasure Pill). Recovered quickly.
Wei Linggu asked Mengying to treat his nephew Yu. Fever >15 days, distension from chest to lower abdomen, unbearable pain, constipation, red urine, black tongue, dry mouth, sweating, irritability, wiry-strong pulse without stomach qi. "Resembles *Shanghan Lun* 'Major Jie Xiong Syndrome'. 'Jie Xiong with irritability' is untreatable." Died two days later after stool passage. Mengying commented: "Shanghan pathogen in exterior; mistaken purgation causes sinking into Jie Xiong. Without mistaken purgation, no Jie Xiong. Warm-heat pathogen in interior; reverse transmission to Pericardium; mistaken sweating causes internal closure/external collapse. If transmitting to Stomach, mistaken sweating causes stagnation/Jie Xiong. Ancients mentioned fluid depletion but not Jie Xiong often, hence recorded here. Yu's case: started with Gegen Tang, then Chaihu/Gegen/Qianghuo/Fangfeng for 10+ doses,酿成了 this."
Wu Xinshan's son, constitutionally weak, benefited from tonics. Doctors mistook warm-fever for yin deficiency, giving cloying yuan-nourishing meds. Result: black curled tongue, cracked lips, red urine. Mengying declared incurable. Gu Tingquan tried but failed. Recorded as warning for deficient patients contracting pathogens.
Wang Zuoquan had dysentery, dozens of movements daily, needing quick cure for exam. Pulse wiry-slippery, yellow coating everywhere. "Easy." Heavy *Scutellariae Radix*, *Coptidis Rhizoma*, aided by *Crataegi Fructus*, *Magnoliae Officinalis Cortex*, delivered with *Qinglin Wan* (Green Unicorn Pill). Cured instantly.
Weng Jiashun's mother had warm disease. Mengying: "Elderly, severe yin deficiency, pathogen strong. *Yuban Lunyao* says: 'Warm disease with severe deficiency dies.' True yin too weak to resist heat. Feared death within two weeks. Died on day 14."