雅也。且谓此书虽尽删其不经之法。而不能尽绝其传。故述其大概如是。业医者不可不知。（串雅中方。多有散见于
诸书者。如内编首列韩飞霞黄鹤丹。青囊丸。推为游方之祖方云。）
〔十〕偶阅孙文垣三吴治验医案。次日有一人来就诊。其病情与孙案一则相仿佛。遂用其方治之。两帖愈。于以
见古人对证发药。效如桴鼓。其案曰。“倪姓右颊车浮肿而痛。直冲太阳。发寒热。两手寸关俱洪大有力。此阳明
经风热交扇所致。以软石膏三钱。白芷升麻各一钱。葛根二钱。生熟甘草一钱。薄荷。山栀。丹皮。连翘。各七分。天
花粉。贯众。各一钱半。两帖肿痛全消。”
〔十一〕相传天士叶氏治痘多活法。一子病痘闭。诸医束手。先生命取新漆桌十余张。裸儿卧于上。以手转辗之。
桌热即易。如是殆遍。至夜痘怒发得生。又尝于肩舆中见一采桑妇。先生命舆人往搂之。妇大怒詈。其夫将扭舆
人殴。先生晓之曰。“汝妇痘已在皮膜间。因气滞闭不能出。吾特激之使怒。今夜可遽发。否则殆矣。”已而果然。又
一人。壮年患痘闭。先生令取鸡屎若干。以醇酒热调如糊。遍涂其身面手足。越宿鸡矢燥裂剥落。而痘已出矣。又
先生之外孙。甫一龄。痘闭不出。母乃抱归求救。先生视之甚逆。沉思良久。裸儿键置空室中。禁女弗启视。迨夜深。
始出之。痘已遍体。粒粒如珠。因空屋多蚊。借其嘬肤以发也。此虽“神而明之”之治。第寻绎其意旨之所在。转
辗于漆桌者。火闭也。激之使怒者。气闭也。涂以鸡矢醴者。寒闭也。借蚊口以嘬之者。血闭也。咸有分别之妙义焉。
录之亦可发人之慧悟。
〔十二〕孙文垣先生治潘姓患白浊。精淫淫下。三年不愈。脉来两寸短弱。两关滑。两尺洪滑。曰。疾易瘳。第必
明年春仲。一剂可痊。问故。曰。素问曰。必先岁气。毋伐天和。所患为湿痰下流证也。而脉洪大见于尺部。为阳乘于
阴。法当从阴引阳。今冬令为闭藏之候。冬之闭藏。实为来春发生根本。天人一理。若强升提之。是逆天时而泄元气也。
后医者接踵。迄无效。至春分。孙以白螺蛳壳火 四两为君。牡蛎二两为臣。半夏葛根柴胡苦参各一两为佐。黄
柏一两为使。面糊为丸。名端本丸。今早晚服之。不终剂而愈。按古名医治病。无不以阴阳升降为剂量准。卷一第
二十六条已具言之。此案端本丸方义固佳。其持论则深明天人合一之理。读内经“冬三月。此谓闭藏。使志若
伏若匿。若有私意。若已有得。逆之则春生者少。”若伏者。若抱雏养蛰也。若匿者。若隐避踪迹也。若有私意者。恐
败露也。若已有得者。韬晦无觖望也。凡所以重藏精也。有冬月之闭藏。然后有来春之发生。一味发扬。而无翕聚
之本。譬诸无源之水。其涸可立而待。
〔十三〕白芥子气味辛温。善能利气豁痰。观治冷哮。用白芥子末涂肺俞膏肓百劳等穴。涂后麻瞀疼痛。防痘入
目。用白芥子末涂足心。引毒归下。外用功效如是。其性烈从可知矣。其末水发。擂入食品。食些少。辄令人目泪鼻
涕交出。其性开发走液。亦从可知矣。缪仲醇本草经疏云。“能搜剔内外痰结。及胸膈寒痰冷涎壅塞者。”然肺
经有热。与阴火虚炎。咳嗽生痰者。法在所忌。奈世医狃于三子养亲汤一方。不论燥证火证。动辄用之。甚且用至
数钱。其意原在利气豁痰。殊不知辛烈之品。烁液劫津。耗气动火。其害甚大。余尝见风温咳嗽证。误用白芥子。致
动血见红。甚至喉痛声哑。但罔有归咎于白芥子者。损人而不任过。白芥子抑何幸欤。诸本草均云肺经有热虚
火亢者忌用。岂未之见耶。
〔十四〕古人随证以立方。非立方以待病。熟察病情。详审用药。味味与病针锋相对。无滥无遗。适至其所。如写
真焉。肖其人而止。不可以意增减也。千变万化之中。具有一定不易之理。活泼圆机。有非语言文本所能解说。在学
者心领神会而已。其所以设立方名者。规矩准绳。昭示来学。非谓某方一定治某病。某病一定用某方也。古方伙
矣。岂能尽记。纵能尽记。而未能变通。虽多奚益。即如桂枝汤一方。加桂枝分两。名曰桂枝加桂汤。加芍药分两。名
曰桂枝加芍药汤。去芍药。名曰桂枝去芍药汤。桂枝甘草二味。名曰桂枝甘草汤。芍药甘草二味。名曰芍药甘草
汤。甘草一味。名曰甘草汤。信手拈来。头头是道。一方可分为数方。数方可合为一方。增一药之分两。即所以减他
药之分两。而另名为一方。取一味二味。即名为一方。药随病为转移。方随证为增减。因物付物。何容心焉。设悬拟
一方。以治一病。印定后人眼目。天下岂有呆板之病证。待呆板之方药耶。奈何张景岳新方八阵及黄元御八种
书内。自制之法。不一而足。岂以古方为不足用。而有待于新制乎。集数味药。辄名一方。方不可胜穷。徒眩人意耳。
〔十五〕王龙 先生调息法曰。息有四种。一风。二喘。三气。四息。前三为不调相。后一为调相。坐时鼻息出入
觉有声。是风相也。息虽无声。而出入结滞不通。是喘相也。息虽无声。亦无结滞。而出入不细。是气相也。坐时无声。
不结不粗。出入绵绵。若存若亡。神资冲融。情抱豫悦。是息相也。守风则散。守喘则戾。守气则劳。守息则密。前为
假息。后为真息。欲习静以调息为入门。使心有所寄。神气相守。亦权法也。调息与数息不同。数为有意。调为无意。
委心虚无。不沉不乱。息调则心定。心定则息愈调。真息往来。呼吸之机。自能夺天地之造化。心息相根据。是谓息息归
根。命之蒂也。一念微明。常惺常寂。范围三教之宗。吾儒谓之“燕息。”佛氏谓之“反息。”老氏谓之“踵息。”造化
阖辟之元机也。以此征学。亦以此卫生。了此便是彻上彻下之道。阅智 大师小止观中。有坐禅调息法。其说与
龙先生同。汪 庵医方集解勿药元诠内。亦载调息法。余窃谓以药疗病。弗计其功。先防其弊。盖弊无。则其功
乃为真功。修养何莫不然。调息法之功效。在行之者自知之。岂容悬揣。若言流弊。则断断无之。何也。出于自然。不
出于勉强也。至勿药元诠内载“小周天”法。闭息运送。苟无口诀真传。不可根据法乱做。恐稍不得法。流弊无穷。
尝见妄做丹道工夫。多有致疾者。或发痈疽。或结 瘕。或疝或淋。或癫或狂。盖以人身气血。升降出入。自然而然。
肓修瞎炼。矫揉造作。精气拂乱。必随其所伤而致种种疾苦耳。惟得明师良友的的真传。乃为有功无弊。〔仲圭
按〕修仙学佛。多有从呼吸入手者。此则须有明师指示。未可妄做。若为强身却病。似可按法练习。大约呼气吸
气。以细长而徐缓为要诀。吾杭伤科虞祥林氏。倡气功疗养法于西湖中医虚损疗养院。倩董志仁君编述肺病
特殊疗养法一书。分送各界。其法与一般深呼吸不同者。一为呼吸之室。须置炽红之炭一盆。人坐其旁呼吸。二
为呼吸时皆有声如鼾。苟能恒心仿行。亦有愈病功效。惟余总觉吸入之气宜鲜洁。室内不如室外为佳。况更闭
窗户。置火盆耶。至呼吸时声巨如鼾。即坐龙溪先生风相之弊。衡以学理。究有未安耳。
〔十六〕戊辰秋初。友人陶姓。以暑热证来就诊。邪热表里充斥。病势颇重。乃仿三黄石膏汤意。为两解之剂。服
一剂。次日其兄来转方。述服药后。大渴大汗。汗至床席皆淋湿。余以为邪热在阳明经。白虎汤证也。竟与白虎汤一
剂。隔日雇小舟来诊。病患忽发狂。舟将颠覆。急折回。乃邀诊。至则病大变。身重苔黑。如狂见鬼。大便不解。胸腹
硬痛。脉沉数促涩。模糊不清。时时发厥。余大骇异曰。奚至此乎。其兄曰。昨述汗流卧席。归后细询家人。乃小便。
非汗也。余顿足曰。误矣误矣。小便多。岂得作大汗治哉。此等重证。本不能悬拟处方。况又误述乎。营热未透达。服
白虎逼入血分矣。男子亦有热结血室证。所以证现如狂见鬼。小便自利。大便不通也。势急矣。奈之何。沉思久之。书
犀角地黄汤合桃核承气汤与之。方内大黄令用醋拌炒黑。次日复赴诊。已便解疹透神清矣。详述药成已二鼓。才
服半杯。胸腹骤痛不可忍。其父促饮之。尽一杯。则目瞪口噤。肢厥僵卧。奄然气尽。家人哭泣环守之。夜半。忽大喊。
便坚黑粪累累。目开身略动。至天明。遍身发疹。胸背间无隙地。便神清思汤饮。诊其脉数滑。至数分明。余曰。险哉。
幸年才二十余。正元充足。能运药力与邪战。一战而捷。不然。一去不复返矣。后与清热养阴。不匝月全愈。阅三世
医验陆祖愚先生治董姓。因伤食纳凉。困倦熟寐。致头痛身热。骨节烦疼。胸腹痞满。医以丸药下之。表证未除。胸
满兼痛。一医又行表汗。头痛瘥。胸痛更甚。似此或消导。或推逐。其痛渐下。病将两月。陆诊脉涩数。面色黄白。舌
苔灰黑。按其胸腹柔软。脐下坚硬。晡时发热。夜半退。小水自利。大便不通。此蓄血证也。用桃核承气汤。下咽后。
满腹搅刺。烦躁不安。求死不得。父母痛其决死。深咎药过。哭泣骂詈。陆心知其无妨。然再三解说。终不信。会天暮
不得进城。下榻楼上。夜将半。闻步履声。其父携灯至榻前笑谓曰。适才大便。所去黑粪 血约若干。腹宽神爽。诚再
生之恩也。后改用调理之剂。半月渐愈。与余所治证。大略相同。特余不留宿。得不闻泣骂声。为幸多矣。陶姓现游幕。
晤时道及此。犹言服药后。胸膈间痛如刀割。不可忍。渐次入腹。后痛极。遂不省人事。噫。瞑眩药入人口腹若是哉。
第此证倘与轻药。当无生理。记此又可见病家述病情。有疑似处。当反更审问。余不敏。误听误药。几至病不救。而
病家日夕侍病者之侧。切须熟察病情。以告医者。设或因误告。致误治。咎将安归耶。
〔十七〕古圣人治病之法。针灸为先。灵素所论。多为针灸而设。今时治病。用针者极少。用灸者尚多。但病非一
概可灸也。大抵脉沉迟。阳气陷下者最宜。若阳盛阴虚者。断不宜灸。仲圣伤寒论云。“微数之脉。慎不可灸。因火为
邪。则为烦热。追虚逐实。血散脉中。火气虽微。内攻有力。焦骨伤筋。血难复也。”脉见微数。则是阴虚而阳炽重。以
火力追逐其血。有筋骨焦伤耳。又云。“脉浮热甚。反灸之。此为实。实以虚治。因火而动。必咽燥吐血。”脉浮热甚。
阳气实也。反灸之。是阳实以阳虚治。火上加火。咽因火势上逼而枯燥。血随火势上炎而妄行。在所必至矣。此二
条垂戒。虽在伤寒论中。然不专指伤寒而言。所以不言证而但言脉也。奈何阴虚血热。人甘受痛苦而妄灸。致阴
益虚。而阳益炽也。吾乡不辨证而妄灸者。妇女居多。缘操是业者。皆女尼村妪之类。易为所惑耳。（不可妄灸之说。他
书具载。何用赘言。窃以为告诫之辞。冀人觉悟。再四丁宁。不厌重复。拙稿中类是者颇多。阅者幸弗以剿袭旧说訾之。）
〔十八〕萧山一士人。因戒鸦片烟瘾而求似续。购服秘制药水。极灵验。不但烟瘾除。胃口胜常。精神焕发。阳事
倍于平时。未几。与友人立谈。倏觉下体无力。顿跌仆后。遂痿废。月余告毙。其所服药水中。大抵有硫黄等霸道药。
所以得效甚捷。祸不旋踵。凡服些少药。辄得骤效者。切须留心。盖非霸道药。服些少岂能得骤效。谨劝世人。慎弗误
认为仙丹妙药。为其所惑。致祸发莫救。阅微草堂笔记云∶“艺花者培以硫黄。则冒寒吐蕊。然盛开之后。其树必
枯。盖郁热蒸于下。则精华涌于上。涌尽则立槁耳。”观此。则服药后种种灵验。正谚所谓“尽根拔”也。
〔十九〕经验良方。刊刻印送。救人疾苦。此诚仁人之用心也。第所集者。虽皆试验之方。而用方者未能确辨其证。
往往检方试病。不效。则更方再试。轻证轻方。当无大碍。若病涉深重。药属猛烈。其堪屡试乎。如近今验方新编。不
迳而走。几至家置一编。其中不无庞杂。间有峻厉之方。意编书者似于医事未尝有精诣也。然善化鲍氏。费二十
年心力。汇集诸方。校雠不倦。其活人济世之心。正足令人钦仰。原在用方之人。自己斟酌去取耳。昔李明之先生
尝言。“苏沈良方。犹唐宋类诗。”盖言不能诗者之集诗。犹不知方者之集方也。一诗之不善。诚不过费纸而已。
一方之不善。则其祸有不可胜言者。夫试验方岂有不善。不对证或适与证相反。乃为不善耳。愿集方者遇峻厉
方。可删则删之。万不可删。则于方下详细注明病情现证。如何者可用。如何者不可用。庶几用者可以对证检方。
不致轻试浪投。是亦古人慎疾之意欤。
〔二十〕古人治血积。每用虻虫水蛭。以其善吮血。然其性极毒。人多患之。不若改用夜明砂。以其食蚊而化者也。
蚊之吮血。不减蛭虫。本草称其能下死胎。则其能攻蓄血明矣。此说出于不居集。录出备采。
〔二十一〕陆氏子。患咳失音。医治殆遍。不得效。乌程汪谢城孝廉。司铎会稽。因求诊。曰。“此虫咳证也。”为
这是雅正的说法。况且认为这本书虽然删去了那些不正规的方法，却不能完全断绝其流传，所以叙述其大概情况如此。从事医疗工作的人不可不知道。（《串雅》中的方子，有很多散见于其他书籍中。比如内编首先列出韩飞霞的“黄鹤丹”、“青囊丸”，推崇它们为游方医生的祖传方剂。）
〔十〕偶然阅读孙文垣的《三吴治验》医案，第二天有一个人来就诊，他的病情与孙文垣医案中一则记载非常相似，于是使用那个方子治疗，服两帖后痊愈。由此可以看出古人对证用药，疗效如击鼓应响般迅速。该医案记载：“倪姓患者右颊车穴处浮肿疼痛，痛势直冲太阳经，出现恶寒发热，两手寸关脉均洪大有力。这是阳明经风热交相煽动所致。用软石膏三钱，白芷、升麻各一钱，葛根二钱，生甘草、熟甘草各一钱，薄荷、山栀、丹皮、连翘各七分，天花粉、贯众各一钱半。服两帖后肿痛全消。”
〔十一〕相传叶天士治疗痘疹多有灵活变通之法。有一人的儿子患痘疹闭塞不出，众医生束手无策。先生命令取十几张新漆的桌子，让患儿赤裸身体躺在上面，用手推动使其辗转滚动。桌子热了就更换。这样几乎遍滚了一遍。到了晚上，痘疹怒发而出，孩子得以存活。又曾在肩舆（轿子）中见到一个采桑的妇女，先生命令轿夫去搂抱她。那妇人非常愤怒地辱骂，她的丈夫正要扭送轿夫去殴打。先生劝解道：“你的妻子痘疹已经在皮膜之间，因为气机阻滞闭塞不能发出。我特意激怒她使她生气，今晚痘疹就可以突然发出，否则就危险了。”后来果然如此。又有一个人，壮年患痘疹闭塞不出。先生让人取若干鸡屎，用醇酒调热成糊状，遍涂于其身、面、手、足。过了一夜，鸡屎干燥裂开剥落，而痘疹已经发出了。还有先生的外孙，刚满一岁，痘疹闭塞不出。母亲便抱着回来求救。先生查看后认为病情很危重，沉思良久，将孩子赤裸身体放在空室中，禁止女儿进去探视。等到夜深，才把孩子抱出来。痘疹已经遍布全身，颗粒像珠子一样。这是因为空屋里蚊子多，借蚊子叮咬皮肤来发散痘毒。这虽然是“神而明之”的治疗，但推究其意旨所在，在漆桌上辗转滚动，是火闭；激怒使生气，是气闭；涂抹鸡屎醴，是寒闭；借蚊口叮咬，是血闭。都有分别治疗的微妙义理。记录下来也可以启发人的智慧领悟。
〔十二〕孙文垣先生治疗潘姓患者患白浊症，精液滑泄不止，三年不愈。脉象两寸短弱，两关滑，两尺洪滑。先生说：病容易治愈，但必须等到明年仲春时节，一剂药即可痊愈。问原因，说：《素问》说：必须先了解岁气，不要破坏天和之气。所患的是湿痰下流的证候。而脉象洪大出现在尺部，是阳乘于阴，治法应当从阴引阳。现在冬季是闭藏的时令，冬季的闭藏，实际上是来年春天发生的根本。天人道理一致。如果强行升提，是违背天时而泄露元气。后来的医生接踵而至，始终没有效果。到了春分，孙文垣用经过火烧处理的白螺蛳壳四两作为君药，牡蛎二两作为臣药，半夏、葛根、柴胡、苦参各一两作为佐药，黄柏一两作为使药，用面糊做成丸药，名叫“端本丸”。现在早晚服用，不用服完一剂就痊愈了。按：古代名医治病，无不以阴阳升降作为剂量标准，卷一第二十六条已经详细说明。此案中端本丸的方义固然好，但其持论则深刻阐明了天人合一的道理。读《内经》“冬三月，这叫闭藏，使情志如同潜伏隐匿，好像有私心秘密，好像已经有所收获，违背它则春天的生机就少。”所谓伏者，如同孵卵养蛰虫；所谓匿者，如同隐藏踪迹；所谓有私意者，恐怕败露；所谓已有得者，韬光养晦没有怨望。这些都是为了重视藏精。有了冬天的闭藏，然后才有来春的生机。一味发扬，而没有收敛聚集的根本，就像无源之水，枯竭是可以立刻等待到的。
〔十三〕白芥子气味辛温，善于利气豁痰。看治疗冷哮，用白芥子末涂抹肺俞、膏肓、百劳等穴位，涂抹后感到麻木眩晕疼痛。预防痘疹入目，用白芥子末涂抹足心，引毒下行。外用功效如此，其药性猛烈可以从这里知道了。它的粉末用水调和，研磨加入食品中，吃一点点，就会让人眼泪鼻涕直流。其性开发走窜津液，也可以从这里知道了。缪仲醇在《本草经疏》中说：“能搜剔内外痰结，以及胸膈寒痰冷涎壅塞的病症。”然而肺经有热，与阴火虚炎，咳嗽生痰的，是治法所禁忌的。无奈世间的医生拘泥于“三子养亲汤”一方，不论燥证火证，动辄使用它，甚至用到数钱。其用意原本在于利气豁痰，却不知道辛烈之品，会烧灼津液劫夺阴津，耗气动火，危害很大。我曾经见过风温咳嗽证，误用白芥子，导致动血见红，甚至喉咙痛声音嘶哑。但没有归咎于白芥子的。损害人而不承担过错，白芥子是多么幸运啊。各种本草都说是肺经有热虚火亢盛者忌用，难道没看见吗？
〔十四〕古人随证候来制定方剂，不是制定方剂来等待疾病。仔细考察病情，详细审察用药，每一味药都与病证针锋相对，没有滥用也没有遗漏，恰好达到病所。就像画肖像画一样，像那个人就停止，不可以凭主观意图增减。在千变万化之中，具有一定不变的道理。活泼圆通的机枢，不是语言文字所能解释的，在于学习者心领神会罢了。之所以设立方名，是为了规矩准绳，昭示后来学者，不是说某方一定治某病，某病一定用某方。古方很多，怎么能全部记住。即使能全部记住，而不能变通，虽然多又有什么益处。就像桂枝汤一方，增加桂枝分量，名叫桂枝加桂汤；增加芍药分量，名叫桂枝加芍药汤；去掉芍药，名叫桂枝去芍药汤；只有桂枝甘草两味药，名叫桂枝甘草汤；只有芍药甘草两味药，名叫芍药甘草汤；只有甘草一味药，名叫甘草汤。信手拈来，头头是道。一方可以分为数方，数方可以合为一方。增加一味药的分量，就是减少其他药的分量，而另名为一方；取一味或两味药，就名为一方。药随病证转移，方随证候增减。因物付物，何必用心刻意。如果预设一方来治一病，印定后人的眼目，天下哪有呆板的病证，等待呆板的方药呢？为什么张景岳的《新方八阵》及黄元御的八种书内，自制的方法，不一而足。难道以为古方不够用，而有待于新制吗？收集几味药，就命名为一方，方剂不可穷尽，只是徒然眩惑人心罢了。
〔十五〕王龙溪先生调息法说：呼吸有四种。一是风，二是喘，三是气，四是息。前三者为不调相，后一种为调相。坐时鼻息出入觉得有声，是风相。呼吸虽无声，但出入结滞不通，是喘相。呼吸虽无声，也无结滞，但出入不细，是气相。坐时无声，不结不粗，出入绵绵，若存若亡，神资冲融，情抱豫悦，是息相。守风则散乱，守喘则乖戾，守气则劳累，守息则严密。前三种为假息，后一种是真息。想要习静，以调息为入门，使心有所寄托，神气相守，也是权宜之法。调息与数息不同。数是有意，调是无意。委心虚无，不沉不乱，息调则心定，心定则息愈调。真息往来，呼吸之机，自然能夺天地之造化。心息相依，这叫息息归根，是命蒂。一念微明，常惺常寂。这是统摄儒释道三教的宗旨。儒家称为“燕息”，佛家称为“反息”，道家称为“踵息”。这是造化阖辟的玄机。以此检验学问，也以此保养生命。明白这个就是彻上彻下的道。阅读智顗大师《小止观》中有坐禅调息法，其说法与龙溪先生相同。汪昂《医方集解·勿药元诠》内，也记载调息法。我私下认为以药疗病，不计较其功效，先防止其弊端。因为如果没有弊端，那么其功效才是真功效。修养何尝不是如此。调息法的功效，在实行的人自己知道。岂容凭空揣测。如果说流弊，则绝对没有。为什么呢？出于自然，不出于勉强。至于《勿药元诠》内记载“小周天”法，闭息运送，如果没有口诀真传，不可以根据方法乱做。恐怕稍微不得法，流弊无穷。曾经看见妄做丹道工夫的，多有导致疾病的。或者发痈疽，或者结瘕块，或者疝气或者淋证，或者癫狂。盖因为人身气血，升降出入，是自然而然的。胡乱修炼瞎炼，矫揉造作，精气拂乱，必定随着所伤而导致种种疾苦。只有得到明师良友的真传，才是有功无弊。（仲圭按：修仙学佛，多有从呼吸入手的。这必须有明师指示，不可妄做。如果是为了强身却病，似乎可以按照方法练习。大约呼气吸气，以细长而徐缓为要诀。我们杭州伤科虞祥林家，倡导气功疗养法于西湖中医虚损疗养院，请董志仁君编述《肺病特殊疗养法》一书，分送各界。其方法与一般深呼吸不同之处在于：一为呼吸的房间，须放置一盆炽红的炭，人坐在旁边呼吸；二为呼吸时皆有声如打鼾。如果能恒心仿行，也有愈病功效。但我总觉得吸入的空气宜鲜洁，室内不如室外为佳，何况还关闭窗户，放置火盆呢？至于呼吸时声音巨大如鼾，就是坐龙溪先生所说的风相的弊端。衡量以学理，终究有不妥当的地方。）
〔十六〕戊辰年秋初，友人陶姓，因暑热证来就诊。邪热表里充斥，病势颇重。于是模仿三黄石膏汤的意思，制成两解之剂。服一剂后，第二天他的哥哥来转方，叙述服药后，大渴大汗，汗出至床席都淋湿。我以为邪热在阳明经，是白虎汤证。竟然给予白虎汤一剂。隔日雇小船来诊，病患忽然发狂，船将要颠覆，急忙折回。于是邀请诊治。到了那里，病情大变，身重苔黑，如狂见鬼，大便不解，胸腹硬痛，脉沉数促涩，模糊不清，时时发厥。我非常惊骇诧异说：怎么到这种地步了呢？他哥哥说：昨天叙述汗流卧席，回家后仔细询问家人，原来是小便，不是汗。我顿足说：误了误了。小便多，怎么能当作大汗治疗呢？这种重证，本来不能悬拟处方，何况又误述呢？营热未透达，服白虎汤逼入血分了。男子也有热结血室证。所以证现如狂见鬼，小便自利，大便不通。形势紧急了，怎么办？沉思很久，写下犀角地黄汤合桃核承气汤给他。方内大黄令用醋拌炒黑。第二天再去诊治，已经大便解，疹透神清了。详细叙述药成已是二更天，才喝半杯，胸腹骤然疼痛不可忍受。他的父亲催促饮用，喝完一杯，则目瞪口噤，四肢厥冷僵卧，奄奄一息。家人哭泣环绕守护。半夜，忽然大喊，排出坚硬黑粪累累，眼睛睁开身体略动，到天亮，遍身发疹，胸背间无隙地，大便后神清思汤饮。诊其脉数滑，至数分明。我说：险啊。幸好年龄才二十多岁，正气充足，能运药力与邪战。一战而捷，不然，一去不复返了。后来给予清热养阴，不到一个月全愈。阅三世医验，陆祖愚先生治疗董姓。因伤食纳凉，困倦熟睡，致头痛身热，骨节烦疼，胸腹痞满。医生用丸药攻下。表证未除，胸满兼痛。一个医生又行表汗，头痛好转，胸痛更甚。像这样或消导，或推逐，其痛渐下，病将两个月。陆诊脉涩数，面色黄白，舌苔灰黑，按其胸腹柔软，脐下坚硬，下午发热，半夜退，小水自利，大便不通。这是蓄血证。用桃核承气汤。下咽后，满腹搅刺，烦躁不安，求死不得。父母痛惜其决死，深深责怪药过，哭泣骂詈。陆心里知道无妨，然而再三解说，终不信。恰逢天暮不得进城，下榻楼上。夜将半，听到脚步声，其父提灯至榻前笑着说：刚才大便，所去黑粪瘀血约若干，腹宽神爽，真是再生之恩啊。后来改用调理之剂，半月渐愈。与我治疗的证，大致相同。只是我不留宿，得不闻泣骂声，为幸多矣。陶姓现在游幕，晤面时谈及此事，犹言服药后，胸膈间痛如刀割，不可忍，渐次入腹，后痛极，遂不省人事。唉，瞑眩药入口腹若是哉。只是此证如果给予轻药，当无生理。记录这个又可见病家述病情，有疑似处，应当反复审问。我不敏，误听误药，几乎至病不救。而病家日夕侍病者之侧，切须熟察病情，以告医者。设或因误告，致误治，罪责将归于哪里呢？
〔十七〕古圣人治病之法，针灸为先。《灵枢》《素问》所论，多为针灸而设。今时治病，用针者极少，用灸者尚多。但病不是一概可灸的。大抵脉沉迟，阳气陷下者最适宜。若阳盛阴虚者，断不宜灸。仲景《伤寒论》说：“微数之脉，慎不可灸。因火为邪，则为烦热。追虚逐实，血散脉中。火气虽微，内攻有力。焦骨伤筋，血难复也。”脉见微数，则是阴虚而阳炽重，以火力追逐其血，有筋骨焦伤耳。又说：“脉浮热甚，反灸之。此为实。实以虚治，因火而动，必咽燥吐血。”脉浮热甚，阳气实也。反灸之，是阳实以阳虚治，火上加火，咽因火势上逼而枯燥，血随火势上炎而妄行，在所必至矣。这两条垂戒，虽然在《伤寒论》中，然而不专指伤寒而言。所以不言证而但言脉也。奈何阴虚血热，人甘受痛苦而妄灸，致阴益虚，而阳益炽也。我家乡不辨证而妄灸的，妇女居多。缘操是业者，皆女尼村妪之类，易为所惑耳。（不可妄灸之说，他书具载，何用赘言。窃以为告诫之辞，冀人觉悟，再四丁宁，不厌重复。拙稿中类是者颇多。阅者幸弗以剿袭旧说訾之。）
〔十八〕萧山一位士人，因戒鸦片烟瘾而求生育延续。购买服用秘制药水，极灵验。不但烟瘾除，胃口胜常，精神焕发，阳事倍于平时。不久，与友人立谈，倏觉下体无力，顿时跌倒仆倒，遂痿废。月余告毙。其所服药水中，大抵有硫黄等霸道药。所以得效甚捷，祸不旋踵。凡服些少药，辄得骤效者，切须留心。盖非霸道药，服些少岂能得骤效。谨劝世人，慎弗误认为仙丹妙药，为其所惑，致祸发莫救。阅微草堂笔记云：“艺花者培以硫黄，则冒寒吐蕊。然盛开之后，其树必枯。盖郁热蒸于下，则精华涌于上。涌尽则立槁耳。”观此，则服药后种种灵验，正谚所谓“尽根拔”也。
〔十九〕经验良方，刊刻印送，救人疾苦，此诚仁人之用心也。第所集者，虽皆试验之方，而用方者未能确辨其证，往往检方试病，不效，则更方再试。轻证轻方，当无大碍。若病涉深重，药属猛烈，其堪屡试乎？如近今验方新编，不迳而走，几至家置一编。其中不无庞杂，间有峻厉之方。意编书者似于医事未尝有精诣也。然善化鲍氏，费二十年心力，汇集诸方，校雠不倦，其活人济世之心，正足令人钦仰。原在用方之人，自己斟酌去取耳。昔李明之先生尝言：“苏沈良方，犹唐宋类诗。”盖言不能诗者之集诗，犹不知方者之集方也。一诗之不善，诚不过费纸而已。一方之不善，则其祸有不可胜言者。夫试验方岂有不善。不对证或适与证相反，乃为不善耳。愿集方者遇峻厉方，可删则删之。万不可删，则于方下详细注明病情现证。如何者可用。如何者不可用。庶几用者可以对证检方，不致轻试浪投。是亦古人慎疾之意欤。
〔二十〕古人治血积，每用虻虫水蛭，以其善吮血。然其性极毒，人多患之。不若改用夜明砂，以其食蚊而化者也。蚊之吮血，不减蛭虫。本草称其能下死胎，则其能攻蓄血明矣。此说出于不居集，录出备采。
〔二十一〕陆氏子，患咳失音，医治殆遍，不得效。乌程汪谢城孝廉，司铎会稽，因求诊。曰：“此虫咳证也。”为
This is an elegant and orthodox statement. Furthermore, it is believed that although this book has deleted all unorthodox methods, it cannot completely stop their transmission; therefore, the general situation is described as follows. Medical practitioners must be aware of this. (Many prescriptions in *Chuan Ya* [Collection of Itinerant Doctors' Prescriptions] are scattered among various other books. For instance, the internal compilation first lists Han Feixia's "Huanghe Dan" [Yellow Crane Pill] and "Qingnang Wan" [Green Bag Pill], promoting them as ancestral prescriptions for itinerant doctors.)
[10] I happened to read Sun Wenyuan's medical cases from *San Wu Zhi Yan* [Verified Treatments in the Three Wu Regions]. The next day, a patient came for consultation. His condition was very similar to one case recorded by Sun Wenyuan. Thus, I used his prescription for treatment. After two doses, he recovered. This demonstrates that ancient physicians prescribed medication according to the syndrome, achieving efficacy as immediate as a drumbeat. The case record states: "A patient surnamed Ni had swelling and pain at the Right Jiache acupoint [ST6, Jawbone], with pain radiating directly to the Taiyang channel [Bladder Channel], accompanied by aversion to cold and fever. Both Cun [Inch] and Guan [Carpal] pulses on both hands were flooding, large, and forceful. This was caused by wind-heat interacting and fanning each other in the Yangming channel [Stomach Channel]. Using 3 qian of Soft Gypsum [Rou Shigao], 1 qian each of Bai Zhi [Angelicae Dahuricae Radix] and Sheng Ma [Cimicifugae Rhizoma], 2 qian of Ge Gen [Puerariae Lobatae Radix], 1 qian each of raw Gan Cao [Glycyrrhizae Radix] and cooked Gan Cao [Glycyrrhizae Radix Preparata], and 7 fen each of Bo He [Menthae Haplocalycis Herba], Shan Zhi [Gardeniae Fructus], Dan Pi [Moutan Cortex], Lian Qiao [Forsythiae Fructus], Tian Hua Fen [Trichosanthis Radix], and Guan Zhong [Cyathiophyllae Herba], the swelling and pain completely subsided after two doses."
[11] It is said that Ye Tianshi [Ye Gui] often employed flexible methods in treating variola [smallpox]. One man's son suffered from variola that failed to erupt. All physicians were at a loss. Master Ye ordered more than ten newly lacquered tables to be brought. The child was laid naked on them, and Master Ye pushed him back and forth with his hands. When the table became hot, it was replaced. This was repeated almost entirely. By nightfall, the variola erupted vigorously, and the child survived. Once, while in a sedan chair, he saw a mulberry-picking woman. Master Ye instructed the bearers to embrace her. The woman was furious and cursed them. Her husband was about to seize the bearer to beat him. Master Ye explained, "Your wife's variola is already between the skin and membrane but cannot erupt due to qi stagnation and closure. I deliberately provoked her anger so that tonight the variola will suddenly erupt; otherwise, she is in danger." Later, it proved true. Another man, in his prime, suffered from variola that failed to erupt. Master Ye ordered taking some chicken droppings, mixing them with strong wine heated into a paste, and applying it all over his body, face, hands, and feet. Overnight, the chicken droppings dried, cracked, and peeled off, and the variola had erupted. There was also Master Ye's grandson, only one year old, whose variola failed to erupt. His mother brought him back seeking help. Master Ye examined him and considered the condition very adverse. After deep contemplation, he placed the naked child in an empty room and forbade his daughter from entering to check on him. Only when it was late at night did they take him out. The variola had covered his whole body, grain-like like pearls. This was because there were many mosquitoes in the empty room; their bites helped to vent the toxin. Although this is a treatment of "divine illumination," tracing its intent reveals that rolling on the lacquered table addressed fire-closure; provoking anger addressed qi-closure; applying chicken droppings addressed cold-closure; and borrowing mosquito bites addressed blood-closure. Each has subtle distinctions in meaning. Recording this can also inspire human wisdom.
[12] Mr. Sun Wenyuan treated a patient surnamed Pan who suffered from white turbidity [leukorrhea or spermatorrhea], with continuous seminal discharge, which persisted for three years without cure. The pulse was short and weak at both Cun positions, slippery at both Guan positions, and flooding and slippery at both Chi [Cubit] positions. He said, "The disease is easy to cure, but it must wait until mid-spring of next year. One dose will suffice." Asked for the reason, he replied, "The *Su Wen* [Basic Questions] states: 'One must first know the seasonal qi and not violate the harmony of heaven and humanity.' The affliction is a syndrome of damp-phlegm flowing downward. However, the flooding pulse appears at the Chi position, indicating yang invading yin. The method should be to draw yang from yin. Now, winter is the season of storage and concealment. Winter's concealment is actually the root for spring's generation. Heaven and humanity follow the same principle. If one forcibly lifts and raises, it violates heavenly timing and leaks vital qi. Subsequent doctors followed one after another, but none were effective. At the Spring Equinox, Sun used four liang of calcined White Snail Shell [Bai Luosi Ke] as the sovereign drug, two liang of Oyster Shell [Mu Li] as the minister drug, one liang each of Ban Xia [Pinelliae Rhizoma], Ge Gen [Puerariae Lobatae Radix], Chai Hu [Bupleuri Radix], and Ku Shen [Sophorae Flavescentis Radix] as the assistant drugs, and one liang of Huang Bo [Phellodendri Cortex] as the guide drug. Made into pills with wheat paste, named *Duanben Wan* [Root-Setting Pill]. Take it morning and evening. The disease would be cured before finishing one dose." Note: Ancient famous physicians always used the balance of yin and yang ascending and descending as the standard for dosage, as detailed in Article 26 of Volume 1. The rationale of *Duanben Wan* in this case is indeed excellent, and its theoretical stance profoundly elucidates the principle of unity of heaven and humanity. Reading the *Nei Jing* [Inner Canon]: "The three months of winter are called concealment. Let your wills be as if hidden, as if having private intentions, as if already satisfied. Violating this results in less spring generation." 'As if hidden' means like incubating eggs or nurturing hibernating insects; 'as if concealed' means hiding one's tracks; 'having private intentions' means fearing exposure; 'already satisfied' means keeping a low profile without resentment. All these emphasize storing essence. Only with winter's concealment can there be spring's generation. Indiscriminate expansion without a foundation of gathering is like water without a source; its drying up is imminent.
[13] Bai Jie Zi [White Mustard Seed] has a pungent and warm flavor and is good at benefiting qi and resolving phlegm. In treating cold asthma, Bai Jie Zi powder is applied to the Feishu [BL13], Gaohuang [BL43], and Bailao [EX-B1] acupoints. After application, numbness, dizziness, and pain occur. To prevent smallpox from entering the eyes, Bai Jie Zi powder is applied to the soles of the feet to draw toxicity downward. Such external efficacy shows its intense nature. When its powder is mixed with water and ground into food, consuming even a little causes tears and nasal mucus to flow profusely. Its nature of opening and dispersing fluids is thus known. Miao Zhongchun stated in *Bencao Jing Shu* [Supplement to the Compendium of Materia Medica]: "It can search out and eliminate internal and external phlegm accumulations, as well as cold phlegm and cold saliva obstructing the chest and diaphragm." However, for lung heat and deficiency-fire flaring upward causing cough and phlegm, it is contraindicated. Regrettably, modern physicians are stuck on the formula *Sanzi Yangqin Tang* [Three Seeds Nourishing the Family Decoction], using it indiscriminately for dry or fire syndromes, sometimes up to several qian. Their intention is originally to benefit qi and resolve phlegm, but they do not realize that pungent and intense substances scorch fluids and rob yin, deplete qi and stir fire, causing great harm. I have seen cases of wind-warmth cough where Bai Jie Zi was mistakenly used, leading to bleeding and redness, even throat pain and hoarseness. Yet, no one blames Bai Jie Zi. It harms people without bearing responsibility; how fortunate is Bai Jie Zi! All materia medica state that those with lung heat and hyperactive deficiency-fire should avoid it. Have they not seen this?
[14] Ancients formulated prescriptions according to syndromes, not formulated prescriptions waiting for diseases. Carefully observing the condition and meticulously selecting medications, every ingredient corresponds precisely to the disease, neither excessive nor omitted, reaching exactly where needed. Like painting a portrait, it resembles the person and stops there; one cannot arbitrarily add or subtract based on personal opinion. Among thousands of changes, there is a constant, unchanging principle. The lively and flexible mechanism cannot be fully explained by language or text; it lies in the learner's intuitive understanding. The reason for establishing prescription names is to provide rules and standards for future students, not to say that a certain prescription definitely treats a certain disease, or a certain disease definitely uses a certain prescription. There are countless ancient prescriptions; how can they all be memorized? Even if memorized, without flexibility, what good is abundance? Take the Guizhi Tang [Cinnamon Twig Decoction] as an example. Increasing the amount of Guizhi [Cinnamomi Ramulus] makes it Guizhi Jia Guizhi Tang [Cinnamon Twig Plus Cinnamon Twig Decoction]; increasing Shaoyao [Paeoniae Radix Alba] makes it Guizhi Jia Shaoyao Tang [Cinnamon Twig Plus Paeonia Decoction]; removing Shaoyao makes it Guizhi Qu Shaoyao Tang [Cinnamon Twig Minus Paeonia Decoction]; using only Guizhi and Gan Cao [Glycyrrhizae Radix] makes it Guizhi Gancao Tang [Cinnamon Twig and Licorice Decoction]; using only Shaoyao and Gan Cao makes it Shaoyao Gancao Tang [Paeonia and Licorice Decoction]; using only Gan Cao makes it Gancao Tang [Licorice Decoction]. Picked up casually, everything is logical. One prescription can be divided into several; several can be combined into one. Increasing the dosage of one herb and decreasing others creates a new name. Taking one or two herbs forms a prescription. Medicines shift with the disease; prescriptions increase or decrease with the syndrome. Adapting to circumstances, why exert artificial effort? If one presumes a single prescription to treat a single disease, fixing the eyes of later generations, are there rigid diseases in the world waiting for rigid prescriptions? Why do Zhang Jingyue's *Xin Fang Ba Zhen* [Eight Arrays of New Prescriptions] and Huang Yuanyu's eight books contain numerous self-made methods? Do they think ancient prescriptions are insufficient and need new creations? Collecting a few herbs and naming them a prescription makes prescriptions infinite, merely dazzling people's minds.
[15] Mr. Wang Longxi's breathing regulation method states: There are four types of breath. One is Wind, two is Panting, three is Qi, and four is Xi [True Breath]. The first three are irregular phases; the last is the regulated phase. When sitting, if nasal inhalation and exhalation produce sound, it is the Wind phase. If the breath is silent but entry and exit are stagnant and blocked, it is the Panting phase. If silent and not stagnant but not fine, it is the Qi phase. When sitting, if there is no sound, no stagnation, no coarseness, entry and exit are continuous, seeming to exist and seem to vanish, spirit merges harmoniously, and mood is joyful, it is the Xi phase. Guarding Wind leads to scattering; guarding Panting leads to deviation; guarding Qi leads to fatigue; guarding Xi leads to density. The former are false breaths; the latter is the true breath. To practice stillness, regulating breath is the entry point, giving the mind something to rest upon, allowing spirit and qi to guard each other; this is also a provisional method. Regulating breath differs from counting breath. Counting is intentional; regulating is unintentional. Surrendering the mind to emptiness, neither sinking nor chaotic, when breath regulates, the mind settles; when the mind settles, breath regulates further. True breath flows back and forth; the mechanism of respiration naturally captures the creation of heaven and earth. Mind and breath rely on each other, called "breath returning to the root," the tip of life. A slight clarity of thought, ever alert and ever still, encompasses the essence of the three teachings. Confucians call it "Yan Xi" [Resting Breath]; Buddhists call it "Fan Xi" [Returning Breath]; Daoists call it "Zhong Xi" [Heel Breath]. This is the primal mechanism of creation's opening and closing. Use this to examine learning and to preserve health. Understanding this is the way from top to bottom. Reading Master Zhiji's [Zhiyi's] *Xiao Zhiguan* [Little Stopping Observations], there is a sitting meditation breathing method. Its theory is the same as Mr. Longxi's. Wang Ang's *Yi Fang Ji Jie* [Collected Explanations of Medical Prescriptions] within *Wu Yao Yuan Quan* [Origin of Healing Without Medicine] also records breathing regulation methods. I privately believe that treating illness with medicine, one should not focus solely on efficacy but first prevent drawbacks. If there are no drawbacks, then the efficacy is true efficacy. Is cultivation not the same? The efficacy of breathing regulation is known only to the practitioner. How can it be guessed? As for drawbacks, there are absolutely none. Why? Because it comes from nature, not from coercion. Regarding the "Small Heavenly Circuit" method recorded in *Wu Yao Yuan Quan*, holding breath and transporting qi, without authentic oral transmission, one must not blindly follow the method. Slight deviation from the correct method leads to endless drawbacks. I have seen those who recklessly practice alchemical techniques often causing illness: either carbuncles and sores, or abdominal masses, or hernias or strangury, or epilepsy or madness. This is because the body's qi and blood, ascending, descending, entering, and exiting, are natural. Blind cultivation and artificial manipulation disrupt jing and qi, inevitably leading to various sufferings according to the injury. Only obtaining authentic transmission from a wise teacher and good friend ensures merit without drawback. (Zhonggui notes: Those cultivating immortality or studying Buddhism often start with breathing. This requires guidance from a wise teacher and must not be done recklessly. If for strengthening the body and eliminating disease, one might practice according to the method. Generally, exhalation and inhalation should be long, thin, slow, and gentle as the key. Mr. Yu Xianglin of Hangzhou, a trauma specialist, advocated qigong therapy at the West Lake Chinese Medicine Deficiency Sanatorium, inviting Mr. Dong Zhiren to compile *Special Therapy Methods for Lung Diseases*, distributed to various sectors. Its difference from general deep breathing is: first, the breathing room must have a basin of glowing charcoal, and the person sits beside it breathing; second, breathing produces sounds like snoring. If practiced consistently, it may cure diseases. However, I feel inhaled air should be fresh and clean; indoors is inferior to outdoors, especially with closed windows and charcoal basins. Breathing loudly like snoring is the drawback of the Wind phase mentioned by Mr. Longxi. Measured against academic principles, it remains unsatisfactory.)
[16] Early autumn of the Wuchen year, a friend surnamed Tao consulted me for summer-heat syndrome. Pathogenic heat filled interior and exterior; the condition was severe. I imitated the intent of Sanhuang Shigao Tang [Three Yellows and Gypsum Decoction] to create a dual-resolving agent. After one dose, his brother came the next day to change the prescription, describing that after taking the medicine, the patient experienced extreme thirst and sweating, wetting the bed sheets. I thought the pathogenic heat was in the Yangming channel, a Baihu Tang [White Tiger Decoction] syndrome. I prescribed Baihu Tang. Two days later, hired a small boat for consultation. The patient suddenly went mad; the boat nearly capsized. We turned back urgently and invited consultation. Upon arrival, the condition had changed drastically: heavy body, black coating, delirium seeing ghosts, constipation, hard and painful chest and abdomen, deep, rapid, choppy, and intermittent pulse, unclear, with frequent syncope. I was greatly shocked and asked, "How did it come to this?" His brother said, "Yesterday he described sweating on the bed. After returning home, I carefully asked the family; it was urination, not sweat." I stamped my foot and said, "Mistake, mistake! Frequent urination cannot be treated as massive sweating. Such severe conditions should not be treated with presumptive prescriptions, especially with misreported symptoms. Ying-heat had not yet penetrated; taking Baihu Tang forced it into the Blood level. Men can also have Heat-Confinement in the Blood Chamber syndrome. Hence the symptoms of delirium seeing ghosts, free urination, and constipation. The situation is urgent; what to do?" After deep contemplation, I wrote Xijiao Dihuang Tang [Rhino Horn and Rehmannia Decoction] combined with Taohe Chengqi Tang [Peach Kernel and Cathartic Decoction]. The Dahuang [Rhei Radix et Rhizoma] in the formula was instructed to be fried black with vinegar. The next day, upon visiting, the stool had passed, rash appeared, and spirit cleared. Detailed account: Medicine was ready at the second watch. Only half a cup was taken. Suddenly, unbearable chest and abdominal pain ensued. His father urged him to drink it all. After finishing one cup, his eyes stared wide, mouth clenched, limbs cold and stiff, lying motionless, barely breathing. Family wept and guarded around him. At midnight, he suddenly shouted, passing hard black stools repeatedly. Eyes opened, body moved slightly. By dawn, rash covered the whole body, no gap on chest and back. After stool, spirit cleared, desiring soup. Pulse was rapid and slippery, distinct rhythm. I said, "Dangerous! Fortunately, he is only twenty-something, with sufficient upright qi, able to mobilize medicinal power to fight the pathogen. One battle won victory. Otherwise, it would have been fatal." Later, given clearing-heat and nourishing-yin treatments, he fully recovered within a month. Reading *San Shi Yi Yan* [Medical Cases of Three Generations], Mr. Lu Zuyu treated a patient surnamed Dong. Due to overeating and cooling down, falling into deep sleep, he suffered headache, fever, bone joint pain, and chest/abdominal fullness. Physicians used pill purgatives. Exterior syndrome remained, chest fullness and pain persisted. One physician induced sweating; headache improved, but chest pain worsened. Like this, whether digesting or purging, pain gradually decreased. Disease lasted nearly two months. Lu diagnosed choppy and rapid pulse, yellow-white complexion, gray-black tongue coating. Palpating chest and abdomen, soft, but hard below the umbilicus. Fever in late afternoon, subsiding at midnight. Free urination, constipation. This is Blood-Stasis syndrome. Used Taohe Chengqi Tang. After swallowing, abdomen churned and pierced, restless, unable to die. Parents, pained by his determination to die, blamed the medicine excessively, weeping and cursing. Lu knew internally it was harmless, but despite repeated explanations, they did not believe. Evening fell, unable to enter the city, stayed upstairs. Near midnight, heard footsteps. Father brought lamp to bedside, smiling, saying, "Just now during bowel movement, expelled black stool and blood, abdomen feels loose, spirit refreshed. Truly a grace of rebirth." Later changed to regulating agents, gradually recovered in half a month. Similar to my case, except I did not stay overnight, avoiding hearing weeping and cursing, which was fortunate. Mr. Tao is currently traveling as a guest official. Meeting him, he recounted this, still saying that after taking medicine, chest and diaphragm pain felt like knife-cutting, unbearable, gradually moving to abdomen. Extreme pain led to unconsciousness. Alas, how potent are detoxifying medicines! However, if light medicines were given for this syndrome, there would be no hope. Recording this shows that when patients describe conditions ambiguously, one must question repeatedly. I am not sharp; mishearing and mistreating nearly caused untreatable disease. Those serving the sick day and night must carefully observe conditions and inform the physician. If misreporting leads to mistreatment, who bears the blame?
[17] Ancient sages prioritized acupuncture and moxibustion for treating diseases. Discussions in *Ling Shu* [Spiritual Pivot] and *Su Wen* [Basic Questions] were mostly set for acupuncture and moxibustion. Today, few use needles; many still use moxa. But not all diseases are suitable for moxibustion. Generally, deep and slow pulses with sinking yang qi are most suitable. If yang excess and yin deficiency, moxibustion is strictly contraindicated. Master Zhongjing's *Shanghan Lun* [Treatise on Cold Damage] says: "With a faint and rapid pulse, moxibustion must be avoided. Fire becomes pathogenic, causing irritability and heat. Pursuing deficiency and chasing excess, blood scatters in vessels. Though fire qi is slight, its internal attack is powerful. Scorched bones and injured sinews, blood is hard to restore." A faint and rapid pulse indicates yin deficiency and intense yang. Using fire to chase blood risks scorched bones and sinews. It also says: "With a floating pulse and severe heat, reversing with moxibustion constitutes excess. Treating excess as deficiency, fire moves things,必然 causing dry throat and hemoptysis." Floating pulse and severe heat indicate yang excess. Reversing with moxibustion treats yang excess as yang deficiency, adding fire to fire. Throat becomes dry from fire forcing upward; blood follows fire flaming upward and bleeding randomly, which is inevitable. These two warnings, though in *Shanghan Lun*, do not specifically refer to cold damage. Hence, no syndrome is mentioned, only pulse. Why do people with yin deficiency and blood heat willingly endure pain and recklessly moxa, making yin more deficient and yang more intense? In my hometown, women are mostly those who moxa without differentiating syndromes. Those practicing this are mostly nuns or village women, easily misled. (The warning against reckless moxibustion is recorded in other books; why add words here? I consider these admonitions hoping for awakening, repeating diligently without tiring. My draft contains many such instances. Readers please do not criticize me for plagiarizing old theories.)
[18] A scholar from Xiaoshan sought fertility continuation while quitting opium addiction. Purchased and took secret medicinal water, extremely effective. Not only was the addiction cured, appetite exceeded normal, spirit refreshed, and sexual potency doubled. Soon, while standing and talking with a friend, suddenly felt weakness in the lower body, stumbled and fell, becoming impotent. Died after a month. The secret water likely contained aggressive substances like sulfur. Hence, effects were swift, but disaster followed quickly. Whenever taking a small amount of medicine yields sudden effect, one must be vigilant. Non-aggressive medicines cannot yield sudden effects in small doses. I earnestly advise世人 to beware of mistaking them for immortal elixirs, being deceived, causing incurable disaster. *Yuewei Caotang Biji* [Notes from the Yuewei Thatched Cottage] says: "Flower growers cultivate with sulfur, causing flowers to bloom in cold. But after blooming, the tree must wither. Heat stifles below, essence surges above. Once surged, it dies immediately." Observing this, the various efficacies after taking medicine are exactly what the proverb calls "pulling up the roots."
[19] Compiling and printing good experiential prescriptions to save people from suffering is indeed the heart of a benevolent person. However, although the collected ones are all tested prescriptions, users fail to accurately differentiate syndromes. Often checking prescriptions to test diseases, if ineffective, changing prescriptions to try again. Light conditions with light prescriptions cause no major harm. But if the disease is deep and severe, and the medicine is fierce, can it withstand repeated testing? Like recent *Yanfang Xinbian* [New Compilation of Verified Prescriptions], spreading rapidly, almost every household owns a copy. It is not without complexity, occasionally containing fierce prescriptions. The compiler seems to lack profound expertise in medicine. However, Mr. Bao of Shan Hua spent twenty years collecting various prescriptions, proofreading tirelessly. His heart to save lives and help the world is admirable. Originally, it depends on the user to deliberate and select. Formerly, Mr. Li Mingzhi once said: "*Su Shen Liangfang* [Good Prescriptions of Su and Shen] is like Tang-Song poetry anthologies." Meaning collectors of poetry who cannot write poetry are like collectors of prescriptions who do not understand them. One bad poem costs only paper. One bad prescription brings unspeakable disaster. Are tested prescriptions not good? Being mismatched to the syndrome or opposite to it makes them bad. I wish compilers encountering fierce prescriptions could delete them if possible. If absolutely not deletable, clearly note the current syndrome below the prescription: what can be used, what cannot. Thus, users can match prescriptions to syndromes, avoiding reckless trials. This is also the ancients' intention of caution in disease.
[20] Ancients treating blood stasis often used Mayfly larvae [Meng Chong] and Leeches [Shui Zhi], because they suck blood well. However, their nature is extremely toxic, and many suffer from it. Better to replace with Ye Ming Sha [Cacumen Tremellae] [Bat Droppings], because it transforms from eating mosquitoes. Mosquitoes sucking blood is no less than leeches. Materia medica claim it can expel dead fetus, thus its ability to attack stored blood is clear. This theory comes from *Buju Ji* [Collection of Unsettled House], recorded for reference.
[21] Mr. Lu's son suffered from cough and loss of voice. Treatments were exhausted without effect. Wang Xiecheng, a Jinshi from Wucheng, teaching in Kuaiji, sought consultation. He said, "This is insect-cough syndrome." For