〔一〕医话不知始于何人。殆滥觞于诗话而有是目。余所见者。愿体医话友渔斋医话柳洲医话潜斋医话凡四
种。愿体医话中重载良方。惟前列医话十二则。故一名愿体医话良方。友渔斋医话则分一览延龄橘旁杂论上
池涓滴肘后偶钞证治指南药笼短剧为六种。柳洲医话乃王孟英辑魏柳洲玉横续名医类按中按语单方。为
柳洲医话。故一名柳洲医话。良方。潜斋医话则录简效方于前。载医话于后。故一名潜斋简效方。同一医话。其体
例不同有如是。余自已冠后。喜读医书。有所见闻。随手识之。间附以心得。以备他日之参考。然已遗失者多矣。戊
寅秋。杜门养 。因检旧笥。得若干条。命儿子录出成帙。重为芟润之。标其名为医话稿。盖话所见。话所闻。并话所
得。拉杂不分门类。亦全无体例也。称稿者。明非定本也。条首编以数目字者。欲教我者有可专指。且前条于理有
误。后条可纠正。于义未尽。可重申。有意同者。可参合。有引证者。可披寻。所以清眉目也。引用书有购求数年而始
得。有辗转借阅者。内有世少传本之书。均记作者姓氏年世。思存古书之名目也。先得二卷。友人姚静庵广文见
而韪之。以为可以问世。嘱乃弟秋岩付诸手民。余固辞不获。惟有道君子。指其谬疵。而进以高深。则幸甚。〔仲圭
按〕此条乃作者自叙。
〔二〕愿体医话曰。“今创一议。无论内外大小。一年之中。岂无一二奇证。若怀之胸臆。则近于秘道不传。若登之
枣梨。又碍于少难成帙。何不于三五知己中。每于岁底。各出所治奇病。观何证。服何药。如何疗。如何愈。共成一卷。
以为医按。多年增广。亦是不朽之举。庶使后人有迹可循。而无识认不真之憾矣。功不在卢扁下也。然近日又有
一种时弊。凡遇疾病危险。诸医会集。其中学术平常者。不过轻描淡写。而识见高明者。若欲另立意见。惟恐招人
妒忌。万一不效。又虑损名。瞻前顾后。亦是大同小异了事。殊不知上天赋我聪明才智。若临证之际。不费一番思
索。不用一番心血。代天宣化。救济苍生。只于此中求富贵。顾声名。以他人性命。痛痒无关。生死听天。清夜思之。
能无自愧。”按愿体医话一卷。扬州史 臣典所着。皆时医药石之言。多急救生全之法。孳孳为善。可谓无微不至。
陈文恭公谓“史君饱谙世故。曲体人情。其言质直而透切。智愚易晓。”偶录一则。蔼然仁者之言。切中时弊之
论。窥见一斑矣。
〔三〕柯韵伯先生“气上腾便是水”一语。最足玩味。盖阳气凝结。津液不得上升。以致枯燥。治宜温热助阳。俾
阴精上交阳位。如釜底加薪。釜中之水气上腾。而润泽有立至者。仲圣以八味肾气丸治消渴。亦此义。以肺为五
脏六腑之华盖。下有暖气上蒸。即润而不渴。若下虚极。则阳气不能升。故肺干而渴。譬如釜中有水。以板盖之。下
有火力。暖气上腾。而板能润。无火力。则水气不能上板。终不可得而润也。然枯燥由于阴竭者。则是泉源既竭。必
须大剂濡养频服。如救焚然。始克有济。同一枯燥证。有阴凝阴竭之分。二证霄壤悬殊。万一误投。死生立判。不可
不细审也。
〔四〕痰属湿。为津液所化。盖行则为液。聚则为痰。流则为津。止则为涎。其所以流行聚止者。皆气为之也。庞
安常有言。“人身无倒上之痰。天下无逆流之水。故善治痰者。不治痰而治气。气顺。则一身之津液亦随气而顺矣。”
余谓“不治痰而治气”一语。为治痰妙谛。盖痰之患由于液不化。液之结由于气不化。气之为病不一。故痰之
为病亦不一。必本其所因之气。而后可治其所结之痰。医旨绪余曰。“治痰当察其源。”倘以二陈统治诸痰。因
于湿者固宜。使无湿则何以当之。如因于火。则当治火。火降金清。秋令乃行。水无壅遏。痰安从生。丹溪朱氏曰。“
黄芩治痰。假其下火。”正谓此也。余可类推。
〔五〕河间刘氏曰。“肠胃郁结。谷气内发而不能宣通于肠胃之外。故善噫而或下气也。”余谓噫与下气。即属
宣通。所以肝胃病往往得噫与下气稍瘥也。虽不能宣通于肠胃之外。而犹得宣通于肠胃之上下也。
〔六〕大黄同附桂用。是温下法。叶氏医按痢门。姚颐真用大剂肉苁蓉配姜附。是即温下法化为温滑法。泻心汤
姜连并用。是苦辛开降法。马元仪印机草中干姜同栝蒌用。是即苦辛开降法化为辛润开解法。栝蒌润燥开结。
荡热涤痰。为胸膈热郁之圣药。其性濡润。谓之滑肠则可。若代大黄作下药用则不可。吾乡章虚谷有蒌仁辨。言之甚详。
〔七〕余治一暑湿证。已热退神清。胃动进食矣。忽急柬邀诊。仍发热神昏。更加气喘。细询因吃粥油三四盏。遂
致此。余力辞。病竟不起。阅本草纲目拾遗言。“粥油能实毛窍。滋阴之功胜熟地。”暑湿初愈服此。安得不复发而
增剧耶。又袁了凡先生曰。“煮粥饭。中有浓汁滚作一团者。此米之精液。食之最能补精。”又紫竹林单方治精
清不孕方。用粥油。日日取起。加炼过盐少许。空心服下。其精自浓。
〔八〕人知息道从口鼻出入。不知遍身毛窍。俱暗随呼吸之气以为鼓伏。所以外感表实证。毛窍阻而气机不能
相引。则发喘。内伤表虚证。汗多亡阳。毛窍开而气机过泄。则息微。
〔九〕洄溪徐氏谓天士叶氏。每以络字欺人。其实徐氏躯壳脏腑经络论有云。“人有皮肉筋骨。所谓躯壳也。而
虚其中。则有脏腑以实之。其连续贯通者。则有经有络。贯乎脏腑之内。运乎躯壳之中。为之道路。以传变周流者
也。”是明知有络。而每诋之。何也。或云。徐批叶案非真本。乃托名者。
〔十〕朴硝火硝咸名硝石。咸生卤地。假水火二大以为形质。朴硝属水。味咸气寒。性下走。故能推荡肠胃积滞。
折治三焦邪火。火硝属火。味辛带苦微咸。而气大温。性上升。故能破积散坚。治诸热病。升散三焦火郁。朴硝治热之
结。火硝治热之郁。一就下。一达上也。火硝投之火中则焰生。朴硝则否。其性从可知矣。紫雪丹中二硝并用。是热
郁欲其达。热结欲其降也。濒湖李氏曰。“火硝与硫黄同用。则配类二气。均调阴阳。有升降水火之功。治冷热缓
急之病。 制礞石。则除积滞痰饮。”盖硫暖而利。其性下行。火硝暖而散。其性上行。礞石之性寒而下。火硝之性
暖而上。一升一降。一阴一阳。此制方之妙也。奈汪 庵医方集解中礞石滚痰丸。误以朴硝制礞石。药肆不察。竟
遵其法。盖同名硝石。汪氏不及详考。而一字之讹。药性顿异。大背古人立方之意矣。用辨明之。
〔十一〕世间真虚损少。假虚损多。自患虚损者少。做成虚损者多。歙南吴师朗有鉴于此。着不居集一书。取易传
“变动不居”之义而名其书也。书分上下二集。上集内损。以阴阳五脏内亏立论。下集外损。以六淫外入。似损
非损立论。盖缘内外不分。真假莫辨。印定滋阴降火之一法。以治无定万变之病情。不虚而做成虚。不损而做成
损。良可浩叹。是书纠缪绳愆。独开生面。厥功岂不伟哉。惜其论治立方。铺排门面。无甚精义可咀嚼。窃恐仿其法
而施治。未必的有效验。然能唤醒病家医家。俾共知有外损之一途。不徒从事于蛮补。由是深思其故。神而明之。
则此书安可不读。（师朗名澄。其自序在乾隆四年。刊书在道光十五年。）〔仲圭按〕虚损之范围甚广。近世流行之肺劳遗
精等病。殆亦虚损之属。治肺劳以十药神书为最佳。而保真保和二汤尤妥。治久遗则林屋山人之加减地黄汤。亦平正可
法。
〔十二〕洄溪医案治毛姓痰喘。乃上实下虚证。用清肺消痰饮。以人参一钱。切小块送下。二剂而愈。毛曰。“徐君
学术固深。但人参切块之法。此聪明人以之炫奇耳。”后病复作。照前方加人参入煎。而喘愈甚。复延徐。谓“服
旧方而病有加。”徐曰。“得非人参与药同煎耶。”曰“然。”曰“宜其增病也。”仍以参作块服之。亦二剂而
愈。盖下虚固当补。但痰火在上。补必增剧。惟作块后入。则参性未发。而清肺之药已得力。迨过腹中。而参性始发。
已达下焦。方有益而无害也。此等治法。古人有行之者。特不察耳。按清肺消痰饮加人参。方也。参切块吞下。法也。
古人有方必有法。如桂枝汤服已。须啜热稀粥。以助药力而取汗。附子泻心汤。附子用煎。三味用泡。扶阳欲其熟
而性重。开痞欲其生而性轻。若此之类。不胜枚举。其方其法。丝丝入蔻。细心体会。妙义始见。族侄柏堂谓余言。二
十一岁时。酒后寐中受风。遍身肌肤麻痹。搔之不知痛痒。饮食如常时。淮阴吴鞠通适寓伊芳家。请诊。吴用桂枝汤。
桂枝五钱。白芍四钱。甘草三钱。生姜三片。大枣两枚。水三杯。煮二杯。先服一杯。得汗止后服。不汗再服。并属弗
夜膳。临睡腹觉饥。服药一杯。须臾啜热稀粥一碗。覆被取汗。柏堂如其法。只一服。便由头面至足。遍身 得微汗。
汗到处以手搔之。辄知痛痒。次日病若失。此用古方古法也。假令此证知用桂枝汤。而不知啜热稀粥。恐未必得
汗。即使稍有汗。去病岂能若是之尽且速耶。
〔十三〕慎斋遗书曰。“一妇泄泻。两尺无神。此肾燥不合也。医用茯苓益智仁即发晕。因用肉苁蓉三钱以润之。
五味子八分以固之。人参一钱以益其气。归身八分以养其血。白芍甘草以和其中。炮姜二分以安其肾。二帖效。
十帖愈。丸即前方加倍。蜜丸。”张东扶曰。“余因慎斋‘肾燥不合’之语。因思精滑一证。理亦同情。盖肾属水。
水亏则燥。水燥则无以养肝。木无水养。则燥而生火。肾既失其封蛰之职。不合而开。肝遂恣其疏泄之性。因开而
泄。愈泄则愈燥。愈燥则愈开。此时徒清火。徒兜涩。无益也。必用润药润其肾。则燥而不合者可以复合。而且肝得
所养。火亦不炽。何致疏泄之性。一往不返哉。立方之法。润肾为君。而兼用清肺补肝之品。”按“肾燥不合”一语。
未经人道。似奇创。然具有至理。凡物润则坚密无缝。燥则绽裂有痕。肾开窍于二阴。肾耗而燥。其窍开而不合矣。
〔十四〕疟证以日作者轻。间日者重。此不可拘。若日作而寒热之时短。其势又不甚。则诚轻。倘势盛而时又长。
反不如间日者尚有休息之一日也。胡可云轻。又疟发渐早为易痊。渐晏为未止。亦不可拘。如发渐早而热退之时
照旧。则其寒热加长矣。愈长则正气愈虚而加剧。如发渐迟而热退之时照旧。则其寒热渐短矣。短则邪气愈衰
而自止。又夜疟皆云邪入血分。当用血药。以提其邪。说固可通。景岳归柴饮。鼓峰香红饮。二方俱佳。然初起在夜。
嗣后不早不晏。始终发于夜者是也。设趱前渐近日昃。缩后已至日出。皆不得谓之夜疟矣。此古今医案按中语
也。此语亦未经人道。古今医案按。嘉善俞东扶震所着。嘉庆时人。
〔十五〕本草谓猪肉助火生痰。发风动气。于人有损无益。邹润安谓坎为豕。在地支则属亥。不但养胃。其补肾水
有专能。本草损人之说。汪 庵亦不以为然。惟脾虚湿盛之人。有酿痰滑泻之弊。时疫流行之际。有壅浊召疾之
虞耳。制为兰薰。俗呼火腿。补虚开胃。病后最宜。按古人以猪肉作药物者不多见。续名医类案中一则。特录出。汪
赤治张姓夏月途行受暑。医药半月。水浆不入。大便不通。唇焦舌黑。骨立皮干。目合肢冷。诊脉模糊。此因邪热
熏灼。津血已枯。形肉已脱。亡可立待。若仅以草木根皮。滋养气血。何能速生。嘱市猪肉四两。粳米三合。用汁一碗。
又梨汁一杯。蜜半杯。与米肉汁和匀。一昼夜呷尽。目微开。手足微动。喉间微作呻吟。如是者三日。唇舌转润。退去
黑壳一层。始开目能言。是夜下燥屎。脉稍应指。再与养阴。匝月而愈。（温热经纬言。温疫证邪火已衰。津不能回者。
宜用鲜猪肉数斤。切大块。急火煮清汤。吹净浮油。恣意凉饮。乃急救津液之无上妙品。按此法必须用在邪火已衰之后。）
因忆族兄云涛病痰饮气喘。身躯肥胖。行不数武。辄喘甚。因偕同志聘吴鞠通来绍。时道光乙酉也。吴以大剂石膏半夏
等。治之数月。喘渐平。痰亦少。身躯顿瘦。愈后即登高亦不作喘。案载吴氏医案中。鞠通归淮阴。濒行时。嘱弗食猪
肉。后偶食之。即觉痰多。身躯复骤胖。嗣后终身不敢食猪肉。此痰湿证忌食猪肉之一征也。又失音证忌食火腿及皮蛋。
余亲见患失音人食二物增剧。
〔十六〕营卫之气。出入脏腑。流布经络。本生于谷。复消磨其谷。营卫非谷不能充。谷非营卫不能化。是营卫者。
生身之大关键。不特营卫自病当注意。即脏腑有病。亦当顾及营卫也。内经谓“五脏之道皆出于经隧。以行血气。
血气不和。百病乃生。是故守经隧焉。”夫所谓经隧者。非营卫所行之道路乎。出于经隧。以行血气者。是由内而
外行于营卫。血气不和。百病乃生者。是由内而外行之血气。或行之不及。或行之太过。或偏于营。或偏于卫。皆为
〔一〕医话这种文体不知道是从什么时候、由谁开始的。大概是从“诗话”衍生出来而有了这个名称。我所见过的，有《愿体医话》、《友渔斋医话》、《柳洲医话》、《潜斋医话》，共四种。《愿体医话》中大量收录了良方，只是前面列出了十二则医话，所以它又有一个名字叫《愿体医话良方》。《友渔斋医话》则分为《一览》、《延龄》、《橘旁杂论》、《上池涓滴》、《肘后偶钞》、《证治指南》、《药笼短剧》这六种。《柳洲医话》是王孟英辑录魏柳洲在《玉横续名医类按》中的按语和单方，编成《柳洲医话》，所以它又有一个名字叫《柳洲医话良方》。《潜斋医话》则在前面记录简效方，后面记载医话，所以它又有一个名字叫《潜斋简效方》。同样是医话，其体例竟然如此不同。我自从给自己著作加上序言以来，喜欢阅读医书，有所见闻，就随手记录下来，偶尔附上自己的心得，以备日后参考。然而已经遗失的很多了。戊寅年秋天，我闭门修养，于是检查旧时的书箱，得到若干条记录，命令儿子抄录成册，重新进行删减润色。给它命名为《医话稿》。这是谈论所见、所闻以及所得的内容，杂乱地堆砌在一起，不分门类，也完全没有体例。称为“稿”，表明这不是定本。条目开头用数字编号，是为了让指教我的人有明确的指向，并且前一条如果道理有误，后一条可以纠正；意义未尽之处，可以重申；意思相同的，可以参合；有引用出处的，可以查找。以此来理清眉目。引用的书籍，有的购买多年才得到，有的辗转借阅，其中有世上很少流传的版本，都记录了作者的姓氏和年代，是想保存古书的名称。先完成了两卷，友人姚静庵广文看了认为很好，认为可以问世，嘱咐他的弟弟秋岩交给刻工刊印。我坚决推辞但未能成功，只希望有道义的君子指出其中的谬误瑕疵，并教导更高深的知识，那就非常幸运了。（仲圭按：这一条是作者的自述。）
〔二〕《愿体医话》说：“现在提出一个建议，无论内科还是外科，病情是大是小，一年之中，难道没有一两例奇特的病证吗？如果藏在心里，就近乎秘术不传；如果刊登在书上，又碍于篇幅少难以成书。为什么不向三五知己提议，每年年底，各自拿出所治疗的奇病，观察是什么证候，服用什么药物，如何治疗，如何痊愈，共同汇编成一卷，作为医案。多年增补扩充，也是不朽的举动。这样使后人有所遵循，而没有辨认不清的遗憾了。功德不在卢扁（卢医扁鹊）之下啊。然而近日又有一种时弊，凡是遇到疾病危险，各位医生聚集在一起，其中医术平常的人，不过轻描淡写地应付；而见识高明的人，如果想另立意见，又怕招致嫉妒，万一无效，又担心损害名声，瞻前顾后，也只是大同小异地了事。殊不知上天赋予我们聪明才智，如果在临证之际，不费一番思索，不用一番心血，代天宣化，救济苍生，只在这其中追求富贵，顾惜声名，把别人的性命痛痒当作无关紧要，生死听凭天命，深夜反省思考，能不感到羞愧吗？”按：《愿体医话》一卷，是扬州史臣典所著，都是当时医药救治的话，多包含急救保全生命的方法，孜孜为善，可谓无微不至。陈文恭公评价说：“史君饱谙世故，曲体人情，他的话质朴直率而透彻，智者和愚者都能明白。”偶然摘录一则，是仁厚者的言语，切中时弊的议论，由此可以窥见一斑。
〔三〕柯韵伯先生“气上腾便是水”这句话，最值得玩味。这是因为阳气凝结，津液不能上升，导致枯燥。治疗应当用温热药助阳，使阴精上交于阳位，就像在锅底添加柴火，锅中的水汽上腾，润泽立刻就能到达。张仲景用八味肾气丸治疗消渴，也是这个道理。肺是五脏六腑的华盖，下面有暖气上蒸，就会滋润而不口渴。如果下焦虚极，阳气就不能上升，所以肺干而渴。这就好比锅中有水，上面盖着板子，下面有火力，暖气上腾，板子就能湿润；如果没有火力，水气就不能上达板子，终究无法湿润。然而，枯燥如果是由于阴液枯竭造成的，那就是泉源已竭，必须用大剂量的濡养药频频服用，像救火一样急切，才能见效。同样是枯燥证，有阴凝和阴竭的区别，这两种证候相差悬殊，万一误投药物，生死立判，不可不仔细审察。
〔四〕痰属于湿，是由津液转化而来的。流动就是液，积聚就是痰，流布就是津，停止就是涎。它们之所以流行或聚止，都是因为气的作用。庞安常曾说：“人身没有倒向上流的痰，天下没有逆流的水。所以善于治痰的人，不治痰而治气。气顺，那么全身的津液也就随着气而顺畅了。”我认为“不治痰而治气”这句话，是治痰的妙理。因为痰的患害是由于液不能化，液的结聚是由于气不能化。气致病的情况不一，所以痰致病的情况也不一。必须根据引起的气的病因，然后才可以治疗所结聚的痰。《医旨绪余》说：“治痰应当考察其源头。”如果用二陈汤统管各种痰，对于因湿引起的固然适宜，但如果无湿，又用什么来应对呢？如果是因火引起的，就应当治火。火降金清，秋令乃行，水没有壅遏，痰从哪里产生呢？丹溪朱氏说：“黄芩治痰，是借助它降火。”正是说的这个意思。我可以以此类推。
〔五〕河间刘氏说：“肠胃郁结，谷气内发而不能宣通于肠胃之外，所以容易打嗝或者排气。”我认为打嗝与排气，本身就属于宣通的表现。所以肝病胃病往往通过打嗝与排气而稍微好转。虽然不能宣通于肠胃之外，但仍然能够宣通于肠胃的上下之间。
〔六〕大黄同附子、肉桂一起使用，是温下法。叶氏医案中痢疾门，姚颐真用大剂量肉苁蓉配伍姜、附，这就是将温下法化为温滑法。泻心汤中姜、连并用，是苦辛开降法。马元仪《印机草》中干姜同瓜蒌一起使用，这就是将苦辛开降法化为辛润开解法。瓜蒌润燥开结，荡热涤痰，是胸膈热郁的圣药。它的性质濡润，说是滑肠是可以的，但如果代替大黄做下药使用就不行。我的同乡章虚谷有《蒌仁辨》，讲得很详细。
〔七〕我治疗过一个暑湿证患者，已经热退神清，胃气发动开始进食了。忽然紧急请我去诊病，仍然发热神昏，更加气喘。仔细询问原因，是因为吃了三四碗粥油，才导致这样的。我极力推辞不去诊治，病人最终没能治好。看《本草纲目拾遗》说：“粥油能充实毛窍，滋阴的功效胜过熟地黄。”暑湿初愈服用这个，怎么能不复发而且加重呢？另外袁了凡先生说：“煮粥饭，里面有浓汁滚作一团的东西，这是米的精液，吃它最能补精。”还有紫竹林单方治疗精清不孕方，用粥油，每天取起来，加少许炼过的盐，空腹服下，精液自然浓稠。
〔八〕人们知道呼吸之道从口鼻出入，不知道遍身的毛窍，也都暗中随着呼吸之气而起伏。所以外感表实证，毛窍阻塞而气机不能相互牵引，就会发喘；内伤表虚证，汗多亡阳，毛窍开张而气机过度泄散，就会气息微弱。
〔九〕洄溪徐氏说叶天士每以“络”字欺骗人。其实徐氏在《躯壳脏腑经络论》中说：“人有皮肉筋骨，所谓躯壳。而在其中空虚的地方，则有脏腑来充实它。那些连续贯通的，则有经有络，贯穿在脏腑之内，运行在躯壳之中，作为道路，用来传变周流的。”这是明明知道有络脉，却每每诋毁它，为什么呢？有人说，徐批叶案不是真本，是托名的人写的。
〔十〕朴硝、火硝都名叫硝石。都生于盐卤之地，借水火两大元素形成形质。朴硝属水，味咸气寒，性向下走，所以能推荡肠胃积滞，折治三焦邪火。火硝属火，味辛带苦微咸，而气大温，性向上行，所以能破积散坚，治各种热病，升散三焦火郁。朴硝治疗热的结聚，火硝治疗火的郁结，一个趋向于下，一个通达于上。火硝投入火中火焰就生起，朴硝则不然，它们的性质从这里就可以知道了。紫雪丹中二硝并用，是热郁想要它通达，热结想要它下降。濒湖李氏说：“火硝与硫黄同用，则配合两类气，均调阴阳，有升降水火之功，治疗冷热缓急的病。用硝石制礞石，则能消除积滞痰饮。”大概硫黄暖而利，其性下行；火硝暖而散，其性上行；礞石的性质寒而下；火硝的性质暖而上。一升一降，一阴一阳，这是制方的妙处。无奈汪昂《医方集解》中礞石滚痰丸，错误地用朴硝来制礞石。药店不加考察，竟然遵照这个方法。大概是同名硝石，汪氏没有详细考证，而一字之差，药性顿时不同，大大违背了古人立方的本意。这里加以辨明。
〔十一〕世间真正的虚损少，假虚损多。自己患有虚损的少，人为造成虚损的多。歙县南部的吴师朗对此有鉴于此，写了《不居集》一书，取《易经》“变动不居”的意思来命名这本书。书分上下两集，上集讲内损，以阴阳五脏内亏立论；下集讲外损，以六淫外入，似损非损立论。大概是因为内外不分，真假莫辨，固守滋阴降火这一种方法，来治疗变化万端的病情。不虚而做成虚，不损而做成损，实在令人浩叹。这本书纠缪绳愆，独开生面，其功劳难道不伟大吗？可惜它的论治立方，铺排门面，没有什么精义可供咀嚼。我私下担心模仿它的方法来施治，未必有效验。然而能唤醒病家和医生，使他们共同知道有外损这一途径，不仅仅从事于蛮补，由此深思其中的缘故，神而明之，那么这本书怎么可以不读呢？（师朗名澄，他的自序在乾隆四年，刊书在道光十五年。）（仲圭按：虚损的范围很广，近代流行的肺劳、遗精等疾病，大概也属于虚损。治疗肺劳以《十药神书》为最佳，而保真汤、保和汤尤其稳妥。治疗久遗则林屋山人的加减地黄汤，也平正可取法。）
〔十二〕洄溪医案中治疗姓毛的痰喘患者，是上实下虚证。用清肺消痰饮，用人参一钱，切成小块送服，两剂而愈。毛某说：“徐君学术固然深厚，但人参切块的方法，这是聪明人在炫耀奇特罢了。”后来病复发，照前方加入人参煎煮，而气喘更严重。再次请徐医生，说：“服旧方而病情加重。”徐医生说：“莫非是人参与药同煎吗？”回答说：“是的。”徐医生说：“难怪会加重病情。”仍然让人参作块服用，也是两剂而愈。因为下虚固然应当补，但痰火在上，补益必然加重病情。只有切成块后放入，那么人参的药性尚未发散，而清肺的药物已经得力。等到经过腹中，人参的药性才开始发挥，此时已经到达下焦，才有益而无害。这种治法，古人有实行的，只是不被察觉罢了。按：清肺消痰饮加人参，是方子。人参切块吞下，是用法。古人有方必有法，比如桂枝汤服完后，须喝热稀粥，以助药力而取汗。附子泻心汤，附子用煎，其他三味用泡，扶阳想要它熟而性重，开痞想要它生而性轻。像这类情况，不胜枚举。其方其法，丝丝入扣，细心体会，妙义才能显现。族侄柏堂对我说，二十一岁时，酒后睡觉中受风，遍身肌肤麻痹，搔之不知痛痒，饮食如常。淮阴吴鞠通恰好寓居在他家，请他诊病。吴鞠通用桂枝汤，桂枝五钱，白芍四钱，甘草三钱，生姜三片，大枣两枚，水三杯，煮取二杯，先服一杯，得汗停服，不出汗再服，并嘱咐不要晚上吃饭。临睡时肚子觉得饿，服药一杯，一会儿喝热稀粥一碗，盖上被子取汗。柏堂按照这个方法，只服了一次，就从头面到足，遍身微微出汗。汗到的地方用手搔之，就知道痛痒了。第二天病若失。这是用古方古法。假如这个证候知道用桂枝汤，而不知道喝热稀粥，恐怕未必能得汗。即使稍有汗，去除疾病怎么能如此彻底且迅速呢？
〔十三〕《慎斋遗书》说：“一个妇人泄泻，两尺脉无神，这是肾燥不合。医生用茯苓、益智仁，随即发生头晕。因此用肉苁蓉三钱来润它，五味子八分来固它，人参一钱来益气，当归身八分来养血，白芍、甘草来和中，炮姜二分来安肾。两帖见效，十帖痊愈。丸药即前方加倍，蜜丸。”张东扶说：“我因为慎斋‘肾燥不合’这句话，想到精滑一证，道理也是同情的。因为肾属水，水亏则燥，水燥则无以养肝，木无水养，则燥而生火。肾既然失去了封蛰的职责，不合而开，肝遂放纵其疏泄的本性，因开而泄，越泄就越燥，越燥就越开。这个时候徒然清火，徒然兜涩，没有益处。必须用润药润其肾，那么燥而不合的可以重新复合。而且肝得到滋养，火也不会炽盛，何至于疏泄的本性一去不返呢。立方之法，以润肾为君药，而兼用清肺补肝的药物。”按：“肾燥不合”这句话，未经人道，似乎新奇独创，然而具有至理。凡是物体润则坚密无缝，燥则绽裂有痕。肾开窍于二阴，肾耗而燥，其窍开而不合了。
〔十四〕疟疾证以每日发作的为轻，隔日发作的为重，这是不可拘泥的。如果每日发作而寒热的时间短，病势又不甚严重，那确实是轻症。倘若病势盛而时间又长，反而不如隔日发作的还有一天休息的时间。怎么可以说轻呢？另外，疟疾发作逐渐提前为易痊愈，逐渐推迟为未停止，也不可拘泥。如发作逐渐提前而热退的时间照旧，那么寒热的时间就加长了。愈长则正气愈虚而加剧。如发作逐渐推迟而热退的时间照旧，那么寒热的时间就渐渐缩短了。短则邪气愈衰而自止。又说夜疟都是邪入血分，当用血药，以提其邪，这种说法固然可通。景岳的归柴饮，鼓峰的香红饮，两个方子都很好。但是初起在夜间，嗣后不早不晚，始终发于夜间的才是夜疟。如果逐渐提前接近日落，逐渐推迟已到日出，都不能称之为夜疟了。这是《古今医案按》中的话。这句话也未经人道。《古今医案按》是嘉善俞东扶震所著，嘉庆时人。
〔十五〕《本草》说猪肉助火生痰，发风动气，于人有害无益。邹润安说坎卦为豕，在地支则属亥，不但养胃，其补肾水有专能。《本草》损人之说，汪昂也不以为然。只有脾虚湿盛的人，有酿痰滑泻的弊端，时疫流行之际，有壅浊召疾的忧虑罢了。制成兰薰，俗呼火腿，补虚开胃，病后最宜。按：古人以猪肉作药物的不多见，《续名医类案》中一则，特别录出。汪赤治疗张姓患者夏天路途行走受暑，医药半个月，水浆不入，大便不通，唇焦舌黑，骨立皮干，目合肢冷，诊脉模糊。这是因为邪热熏灼，津血已枯，形肉已脱，死亡就在眼前。如果仅用草木根皮，滋养气血，怎么能速生？嘱咐买猪肉四两，粳米三合，用水煎取汁一碗，又梨汁一杯，蜜半杯，与米肉汁和匀，一昼夜呷尽。眼睛微开，手足微动，喉间微作呻吟。像这样的情况三天，唇舌转润，退去黑壳一层，才开始睁眼能说话。这天夜里排出燥屎，脉稍应指。再给予养阴药，一个月而痊愈。（《温热经纬》说，温疫证邪火已衰，津液不能回复的，宜用鲜猪肉数斤，切大块，急火煮清汤，吹净浮油，恣意凉饮，乃是急救津液的无上妙品。按：这种方法必须用在邪火已衰之后。）因而想起族兄云涛患痰饮气喘，身躯肥胖，走不了几步，就气喘得很厉害。于是偕同志同道合的朋友聘请吴鞠通来绍兴。当时是道光乙酉年。吴鞠通用大剂量石膏、半夏等，治疗几个月，气喘渐渐平息，痰也少了，身躯顿时瘦下来，痊愈后即登高也不作喘。案载于吴氏医案中。鞠通回淮阴，临行时，嘱咐不要吃猪肉。后来偶然吃了，就觉得痰多，身躯又骤然胖起来。嗣后终身不敢吃猪肉。这是痰湿证忌食猪肉的一个征象。另外失音证忌食火腿及皮蛋，我亲眼见到患失音的人吃这两种东西病情加重。
〔十六〕营卫之气，出入脏腑，流布经络，本来生于谷气，又消磨谷气。营卫不是谷气就不能充盛，谷气不是营卫就不能化生。所以营卫是生身的大关键。不仅营卫自病应当注意，即使脏腑有病，也应当顾及营卫。《内经》说“五脏之道皆出于经隧，以行血气。血气不和，百病乃生。是故守经隧焉。”所谓经隧，不就是营卫所走的道路吗？出于经隧，以行血气，是由内而外行于营卫。血气不和，百病乃生，是由内而外行的血气，或者行之不及，或者行之太过，或者偏于营，或者偏于卫，都算是
[1] It is unknown when or by whom the genre of "Yihua" (Medical Conversations/Notes) originated. It likely evolved from "Shihua" (Poetry Notes). The ones I have seen include *Yuanti Yihua*, *Youyuzhai Yihua*, *Liuzhou Yihua*, and *Qianzhai Yihua*, totaling four types. *Yuanti Yihua* heavily records excellent prescriptions, but lists only twelve medical cases at the beginning; thus it is also known as *Yuanti Yihua Liangfang* (Excellent Prescriptions of Yuanti Medical Notes). *Youyuzhai Yihua* is divided into six parts: *Yilan*, *Yanling*, *Jupang Zalan*, *Shangchi Juandi*, *Zhouhou Ouchao*, *Zhengzhi Zhinan*, and *Yaolong Duanju*. *Liuzhou Yihua* was compiled by Wang Mengying from the annotations and single prescriptions in Wei Liuzhou's *Yuheng Xu Mingyi Lei An* (Continuation of Classified Cases of Famous Physicians based on Yuheng), forming *Liuzhou Yihua*; hence it is also called *Liuzhou Yihua Liangfang*. *Qianzhai Yihua* records simple effective formulas first and medical notes later, so it is also named *Qianzhai Jianxiaofang* (Simple Effective Formulas of Qianzhai). The same genre, "Yihua," has such different formats. Since I added a preface to my own writings, I have enjoyed reading medical books. Whenever I had observations or insights, I recorded them casually, occasionally adding my personal reflections for future reference. However, many have been lost. In the autumn of the Wuyin year, while staying indoors for recuperation, I checked an old chest and found several entries. I ordered my son to transcribe them into a booklet and revised them again. I titled it *Yihua Gao* (Draft of Medical Conversations). It discusses what I have seen, heard, and learned, piled together杂乱ly without categorization or format. Calling it a "Gao" (Draft) indicates it is not a final version. Numbering the items at the beginning allows those who instruct me to refer specifically to them. If the logic of a previous item is wrong, the next can correct it; if the meaning is incomplete, it can be reiterated; if ideas are similar, they can be combined; if citations exist, they can be traced. This clarifies the structure. Some cited books were acquired after years of searching, others borrowed through intermediaries, including rare editions. I recorded the authors' names and eras to preserve the titles of ancient texts. The first two volumes were completed. My friend Yao Jing'an Guangwen read them, approved, and suggested publication, asking his brother Qiuyan to entrust them to the printers. I declined firmly but could not prevail. I only hope that gentlemen of the Way will point out errors and flaws and guide me to higher depths, which would be a great fortune. [Note by Zhonggui: This section is the author's autobiography.]
[2] *Yuanti Yihua* states: "I propose a new idea. Regardless of internal or external medicine, major or minor conditions, surely there are one or two strange cases each year. If kept in mind, it borders on secret transmission; if published, it may be too brief to form a book. Why not suggest this among three or five close friends? At the end of each year, each presents the strange diseases they treated, observing the syndrome, the herbs taken, the treatment method, and the cure, compiling them into one volume as medical cases. Over years of expansion, this would be an immortal act, allowing future generations to follow the traces and avoiding regret over misidentification. The merit would rival Lu Bian (Bian Que). However, there is a current malpractice: whenever a disease is critical and doctors gather, those with average skills merely skim over it, while those with high insight, fearing jealousy if they propose different opinions, and worrying about damage to reputation if ineffective, look forward and backward, settling for similarities. They fail to realize that Heaven endowed us with wisdom. When treating patients, if we do not think deeply and expend effort to act as Heaven's agent to save lives, seeking only wealth and fame while disregarding others' suffering, listening to fate for life and death, how can we not feel ashamed upon midnight reflection?" Note: *Yuanti Yihua* is a volume by Shi Chendi of Yangzhou, containing contemporary medical advice, mostly emergency preservation methods, striving for good deeds meticulously. Chen Wengong commented: "Master Shi knows the world well and understands human nature; his words are plain yet penetrating, understandable to both wise and foolish." I excerpted one passage, showing the words of a benevolent person and a critique of current malpractices, offering a glimpse of the whole.
[3] Mr. Ke Yunbo's statement "When Qi ascends, it becomes Water" is most worthy of contemplation. This is because Yang Qi condenses, preventing Jin Ye (Body Fluids) from ascending, leading to dryness. Treatment should use warm/hot herbs to assist Yang, allowing Yin Essence to ascend to the Yang position, like adding firewood to the bottom of a pot; the water vapor rises, providing immediate moisture. Zhang Zhongjing used Ba Wei Shen Qi Wan (Eight-Ingredient Kidney Qi Pill) to treat Xiao Ke (Wasting-Thirst), following this principle. The Lung is the canopy of the five zang and six fu organs. With warm air steaming up from below, it remains moist and thirst-free. If the lower jiao is extremely deficient, Yang Qi cannot rise, causing lung dryness and thirst. It is like a pot with water covered by a board; with heat below, vapor rises and moistens the board; without heat, vapor cannot reach the board, remaining dry. However, if dryness is due to Yin exhaustion, the spring source is depleted. Large doses of nourishing herbs must be taken frequently, urgently like fighting a fire, to be effective. Although both are dryness syndromes, one is Yin stagnation and the other Yin exhaustion; they differ vastly. Misdiagnosis leads to immediate life or death consequences, so careful examination is essential.
[4] Tan (Phlegm) belongs to Shi (Dampness) and is transformed from Jin Ye. Flowing it is Ye (Fluids); gathering it is Tan; flowing it is Jin; stopping it is Xian (Saliva). Their movement or stasis is governed by Qi. Pang Anchang said: "There is no upward-flowing phlegm in the body, nor reverse-flowing water in the world. Therefore, skilled phlegm-treaters do not treat phlegm directly but treat Qi. When Qi is smooth, all body fluids follow Qi smoothly." I consider "treating Qi rather than Phlegm" the profound truth of phlegm treatment. Phlegm issues arise from fluids not transforming; fluid knotting arises from Qi not transforming. Qi causes various diseases, so Phlegm causes various diseases. One must address the Qi cause to treat the Phlegm knot. *Yizhi Xuyu* says: "Treat phlegm by investigating its source." Using Er Chen Tang for all phlegm is suitable only for damp-origin phlegm. If there is no dampness, what applies? If caused by Fire, treat the Fire. As Fire descends and Metal clears, Autumn energy acts, Water flows freely, and Phlegm has no origin. Zhu Danxi said: "Huang Qin (Scutellaria Root) treats phlegm by borrowing its ability to descend Fire." This is exactly what he meant. I can infer similarly.
[5] Liu Hejian said: "Intestinal and stomach stagnation causes Grain Qi to emerge internally but not circulate externally, leading to belching or passing gas." I believe belching and passing gas are forms of circulation/diffusion. Thus, Liver and Stomach diseases often improve slightly after belching or passing gas. Although not circulating outside the intestines/stomach, they still circulate above and below them.
[6] Da Huang (Rhubarb Root) used with Fu Zi (Aconite Root) and Gui Zhi (Cinnamon Twig) is the Warm-Purging Method. In Ye Tianshi's *Medical Cases*, under Dysentery, Yao Yizhen used large doses of Rou Cong Rong (Cistanche Stem) paired with Jiang (Ginger) and Fu Zi, which transforms Warm-Purging into Warm-Sliding Method. Xie Xin Tang uses Jiang and Lian together, representing the Bitter-Acrid Opening-Descending Method. Ma Yuanyi's *Yinji Cao* uses Gan Jiang (Dried Ginger) with Gua Lou (Trichosanthes Fruit), transforming Bitter-Acrid Opening-Descending into Acrid-Moistening Opening-Resolving Method. Gua Lou moistens dryness and resolves knots, clearing heat and washing away phlegm, a holy herb for chest-diaphragm heat stagnation. Its nature is moistening; calling it sliding-intestine is acceptable, but replacing Da Huang as a purgative is not. My fellow townsman Zhang Xugu wrote *Lou Ren Bian* (Discussion on Trichosanthes Seed), explaining in detail.
[7] I treated a case of Summer-Dampness where fever subsided, spirit cleared, and stomach activity returned with food intake. Suddenly, an urgent summons found him febrile, comatose, and panting. Inquiry revealed he ate three or four bowls of congee oil (rice gruel surface film), causing this. I declined treatment; the patient died. *Bencao Gangmu Shiyi* states: "Congee oil solidifies pores and nourishes Yin better than Shu Di Huang (Prepared Rehmannia Root)." Taking this after initial recovery of Summer-Dampness naturally causes relapse and aggravation. Yuan Liaofan said: "The thick liquid rolling into a ball in cooked congee is the essence of rice; eating it best tonifies Essence." Also, a single prescription from Purple Bamboo Grove for infertility due to thin semen uses congee oil, collected daily, mixed with refined salt, taken fasting to thicken semen.
[8] People know respiration enters/exits via mouth and nose, unaware that all body pores subtly rise and fall with respiratory Qi. Thus, in Exterior Excess patterns of External Contraction, blocked pores prevent Qi mechanism interaction, causing asthma. In Interior Deficiency Exterior Deficiency patterns, excessive sweating leads to Yang loss, open pores cause excessive Qi leakage, resulting in faint breathing.
[9] Xu Dachun (Xixi) claimed Ye Tianshi deceived people with the word "Luo" (Collaterals). Yet Xu himself wrote in *Quke Zangfu Jingluo Lun*: "Humans have skin, flesh, sinews, bones—the shell. Inside the hollow are Zang-Fu organs filling it. Connecting and penetrating are Jing (Channels) and Luo (Collaterals), running inside Zang-Fu and through the shell, serving as roads for transformation and circulation." He clearly knew of Collaterals yet disparaged them. Why? Some say Xu's commentary on Ye's cases is not authentic but pseudonymous.
[10] Pu Xiao (Raw Mirabilite) and Huo Xiao (Niter) are both named Xiao Shi (Niter). Both born in saline lands, formed by Water and Fire elements. Pu Xiao belongs to Water, salty/cold, descending nature, pushing intestinal stagnation and suppressing San Jiao pathogenic fire. Huo Xiao belongs to Fire, pungent/bitter/salty, hot nature, ascending, breaking accumulation, dispersing hardness, treating heat diseases, ascending/dispersing San Jiao fire stagnation. Pu Xiao treats Heat Knots; Huo Xiao treats Heat Stagnation; one goes down, one goes up. Huo Xiao ignites in fire; Pu Xiao does not, revealing their natures. Zi Xue Dan uses both Niter to resolve stagnation (ascending) and knots (descending). Li Shizhen said: "Huo Xiao with Sulfur combines two energies, balances Yin/Yang, regulates ascending/descending Water/Fire, treating cold/heat/rigid/soft diseases. Processing Meng Shi (Hydrocalcite) with Niter eliminates stagnation/phlegm-fluids." Sulfur is warm/advancing, descending; Huo Xiao is warm/dispersing, ascending; Meng Shi is cold/descending; Huo Xiao is warm/ascending. Ascend/Descend, Yin/Yang—this is the subtlety of formula making. Unfortunately, Wang Ang's *Yifang Jijie* mistakenly used Pu Xiao to process Meng Shi for Meng Shi Gun Tan Wan. Pharmacies followed suit. Due to the same name, Wang failed to verify carefully; a single character error changed drug properties, contradicting ancient intent. I clarify this.
[11] True deficiency consumptions are rare; fake ones are common. Few suffer true deficiency; many create it artificially. Wu Shilang of southern She County, seeing this, wrote *Buju Ji* (Collection of Non-Abiding), naming it after the *I Ching* concept "Change abides nowhere." Upper volume discusses Internal Consumption (Yin/Yang/Five Zang internal deficit); Lower volume discusses External Consumption (Six Evils invading, appearing as consumption but not truly so). Because internal/external are confused, true/false indistinguishable, sticking to one method of nourishing Yin/descending Fire to treat variable conditions creates non-deficiency into deficiency. This sigh-worthy error is corrected by this book, opening new paths. Its merit is great. However, its treatment/formulation rhetoric lacks deep substance. Mimicking it may lack efficacy. Yet, awakening patients/doctors to External Consumption, avoiding blind tonification, and reflecting deeply makes this book essential reading. (Shilang, name Cheng; preface 1739; published 1835.) [Note by Zhonggui: Consumption scope is broad; modern Pulmonary Tuberculosis/Spermatorrhea belong here. Best for Pulmonary TB: *Shiyao Shenshu*; Baozhen/Baohe Decoctions are good. For chronic spermatorrhea: Linwushanshan's Modified Dihuang Tang is standard.]
[12] Xuxi Medical Cases treated a surnamed Mao's Phlegm-Asthma, a Upper Excess/Lower Deficiency pattern, using Qingfei Xiaotan Yin. Ren Shen (Ginseng Root) 1 qian, cut small, swallowed. Cured in two doses. Mao said: "Dr. Xu's scholarship is deep, but cutting Ginseng is just a clever trick." Relapse occurred. Same formula, Ginseng decocted. Asthma worsened. Xu asked: "Did you decoct Ginseng?" Yes. "No wonder it worsened." Used cut Ginseng again. Cured in two doses. Lower deficiency needs tonification, but Phlegm-Fire above makes tonification aggravate. Cutting Ginseng delays its action; Lung-clearing herbs work first. By the time it passes the abdomen, Ginseng acts in the Lower Jiao, benefiting without harm. Ancients did this, unnoticed. Qingfei Xiaotan Yin + Ren Shen is the Formula; swallowing cut Ginseng is the Method. Ancients had formulas and methods. Guizhi Tang requires hot thin porridge after ingestion to aid potency and induce sweat. Fuzi Xiexin Tang decocts Fuzi but infuses other three; tonifying Yang needs cooked/heavy nature; resolving痞 (fullness) needs raw/light nature. Such examples are endless. Formulas and methods interlock; careful appreciation reveals profound meanings. Cousin Botang told me: At 21, wind struck during sleep after drinking. Body numb, insensitive to pain/itch, digestion normal. Wu Jutong of Huaiyin visited. Used Guizhi Tang: Guizhi 5 qian, Baishao 4 qian, Gancao 3 qian, Shengjiang 3 slices, Dazao 2 pieces. Water 3 cups, boil to 2 cups. Drink 1 cup first; stop if sweat; repeat if no sweat. Advised no dinner. Hungry before bed, drank 1 cup, then hot thin porridge, covered blanket for sweat. Botang followed. One dose induced slight sweat from head to feet. Scratching sweaty areas restored sensation. Next day, cured. This uses ancient formula/method. Without hot porridge, sweat might not occur; even if slight, cure wouldn't be so complete/fast.
[13] *Shenzhai Yishu* says: "A woman with diarrhea, empty Chi pulses, indicates Kidney Dryness mismatch. Doctor used Fuling (Poria) and Yizhiren (Bennet Seed), causing dizziness. Used Rongshen (Cistanche) 3 qian to moisten, Wuweizi (Schisandra) 0.8 fen to secure, Ren Shen 1 qian to boost Qi, Dangshen 0.8 fen to nourish Blood, Baishao/Gancao to harmonize Middle, Paojiang (Fried Ginger) 0.2 fen to calm Kidney. Two doses effective, ten doses cured. Pills double the dose, honey pills." Zhang Dongfu said: "Inspired by 'Kidney Dryness Mismatch,' I realized Spermatorrhea shares similar logic. Kidney is Water; Water deficit causes Dryness; Dry Water fails to nourish Liver; Wood without Water nourishment generates Fire. Kidney loses sealing function, opens instead of closing; Liver indulges draining nature, leaking more, drying more, opening more. Clearing Fire/astringing helps nothing. Must moisten Kidney to restore closure. Liver gets nourished, Fire subsides, preventing relentless draining. Formula: Moisten Kidney as Sovereign, accompany with Lung-clearing/Liver-tonifying herbs." Note: "Kidney Dryness Mismatch" is novel yet logical. Moist objects are tight/seamless; dry objects crack. Kidney opens to two yins; Kidney depletion/dryness causes opening/mismatch.
[14] Malaria daily onset is light, intermittent heavy—but don't rigidly apply. Daily with short fever/chills and mild severity is indeed light. Severe/long daily attacks are worse than intermittent which has rest days. How can severe be light? Early onset eases; late onset persists—don't rigidly apply. Early onset with same resolution time means longer chills/fever, worsening Qi deficiency. Late onset with same resolution means shorter chills/fever, weakening pathogen, self-resolving. Night malaria implies Pathogen in Blood level, use Blood herbs to lift pathogen. Reasonable. Jingyue's Guichai Yin and Gufeng's Xianghong Yin are good. But night malaria starts at night, stays at night. Advancing toward sunset or retreating to sunrise disqualifies it as night malaria. This is from *Gujin Yi An An* by Yu Dongfu Zhenso of Jiashan, Jiaqing era. Unheard-before wisdom.
[15] *Bencao* claims Pork aids Fire, generates Phlegm, triggers Wind/Qi, harmful. Zou Run'an says Kan trigram is Pig, Earthly Branch Hai; nourishes Stomach, uniquely tonifies Kidney Water. Wang Ang disagrees with *Bencao*'s harm view. Only for Spleen Deficiency/Damp Abundance (phlegm/diarrhea risk) or Epidemic times (turbidity/disease risk) is it problematic. Made into Ham (Lanxun), tonifies deficiency, opens appetite, suitable post-illness. Ancient use of Pork as medicine is rare. *Xu Mingyi Lei An* records one: Wang Chi treated Zhang, summer travel heatstroke, 15 days meds, unable to eat/drink, constipation, black lips/tongue, emaciated, cold limbs, faint pulse. Heat scorched fluids/blood, flesh gone, death imminent. Herbs slow. Bought 4 liang Pork, 3 he Rice, boiled to 1 bowl juice. Mixed with 1 cup Pear Juice, 0.5 cup Honey. Sip over 24 hours. Eyes opened slightly, limbs moved, groaned. After 3 days, lips/tongue moist, black crust shed, spoke. That night passed dry stool, pulse responded. Continued Yin-nourishing, cured in month. (*Wenre Jingwei* says for Post-Epidemic Heat decline with fluid failure, fresh Pork large chunks, quick boil clear soup, remove oil, drink cold freely—supreme fluid rescue. Must use after Heat declines.) Recalled cousin Yuntao with Phlegm-Fluid Asthma, obese, panting after few steps. Hired Wu Jutong in 1825. Wu used large Gaoshi (Gypsum), Banxia (Pinellia) etc., months to calm asthma/reduce phlegm, weight loss, climbed heights without panting. Before leaving Huaiyin, Wu forbade Pork. Ate once, phlegm increased, weight surged. Never ate Pork again. Sign of Phlegm-Damp contraindication. Hoarse voice contraindicates Ham/Preserved Egg; I saw aggravation.
[16] Ying (Nutritive) and Wei (Defensive) Qi enter/exit Zang-Fu, spread through Jing-Luo, born from Grain, digest Grain. Ying/Wei need Grain to fill; Grain needs Ying/Wei to transform. Thus, Ying/Wei are key to life. Not only treat Ying/Wei disease, but consider them in Zang-Fu disease. *Neijing* says: "Paths of Five Zang emerge from Jing-Tui (Vessels) to move Blood-Qi. Disharmony of Blood-Qi generates hundred diseases. Guard Jing-Tui." Jing-Tui are paths of Ying/Wei. Moving Blood-Qi from inside-out through Ying/Wei. Disharmony (too little/too much, biased Ying/Way) causes disease.