一仆妇，年三十，患瘟疫一月余矣，非劳复即食复，今则发热咳嗽，胸胁痛，耳聋口渴
，大
便七八日不行，不知人事。乃与柴胡、石膏各三钱，栝蒌、桔梗、枳壳各一钱五分，黄芩、
前胡各一钱，天花粉八分，甘草五分，黄连八分，急煎服之，人事稍清。因大便不行，次日
以大柴胡
汤下之，又次日大便虽行热仍不退，改以柴胡
二钱，白芍药、黄芩、麦门冬各一钱，天花粉、茯苓、甘草各六分，四帖而愈。
参军程方塘翁，年六十四，向以 胤服温补下元药太多，冬月下体着单裤立溪边督工，
受寒
致筋骨疼痛，肩井、缺盆、脚、膝、跟、踝、手肘、掌后及骨节动处皆红肿而痛，卧床褥三
年。吴中溪视为虚而用虎潜丸；吴渤海视为寒而用大附子、肉桂、鹿茸。徐东皋认为湿，周
认为血虚，张甲认为风，李乙认为历节，百治不瘳。腿间大肉尽消，惟各骨节处肿大而疼
。予适在程道吾宅，乃逆予。诊之，其脉弦涩有力，知其为湿热痰火被寒气凝滞固涩经络也
。第为药剂不对，故病日加。所取者目中精神尚在，胃气仍未全损，但小水解下，以瓦盆
盛之少顷则澄结为砂，色红而浊，两膝下及脚指皆生大疮，疮靥如靴钉状，此皆平昔服温补
春方所致。病虽久，年虽高，犹为有余之疾，不可因高年疾痼弃不治也。乃特为先驱逐经络
中
凝滞，然后健脾消痰，俾新痰不生，气血日长，最后以补剂收功，斯得矣。翁生平好补畏攻
，故进门者皆务迎合，予独反之。以新取威灵仙一斤，装新竹筒中，入烧酒二斤，塞筒口，
刮去筒外青皮，重汤煮三炷官香为度，取出威灵仙晒干为末，用竹沥打糊为丸，梧桐子大，
每
早晚酒送下一钱，一日服二次。五日后大便泻出稠粘痰积半桶，肿痛消去大半。改以人参、
石斛、苍术、黄柏、苡仁、苍耳子、牛膝、乌药叶、龟板、红花、犀角屑、木通煎服二十帖
，又用前末药服三日，又下痰积如前之半。仍以前煎药服半月，又将末药服三日，腹中痰渐
少，乃为制丸药，以虎骨、晚蚕砂、苍术、黄柏、丹参、杜牛膝茎叶、苡仁、红花、五加皮
、苍耳子、龟板打酒，面糊为丸，梧桐子大，每空心白汤送下七八十丸外，以丹溪保和丸食
后服半年痊愈，腿肉复完，步履如故。
有一位仆妇，三十岁，患瘟疫已一个多月了，病情因劳累或饮食不当而反复。如今出现发热、咳嗽、胸胁疼痛、耳聋、口渴，大便七八天不通，神志不清。于是给予柴胡、石膏各三钱，栝蒌、桔梗、枳壳各一钱五分，黄芩、前胡各一钱，天花粉八分，甘草五分，黄连八分，急火煎煮后服用，神志稍见清醒。因为大便仍不通畅，第二天用大柴胡汤（Major Bupleurum Decoction）攻下；又过一天，虽然大便通了，但热势仍未退去，于是改用柴胡二钱，白芍药、黄芩、麦门冬各一钱，天花粉、茯苓、甘草各六分，服用四帖后痊愈。
参军程方塘老先生，六十四岁，过去因为长期服用温补下焦元气的药物过多，冬天穿着单裤站在溪边监督工程，受寒导致筋骨疼痛。肩井穴、缺盆穴、脚、膝、脚跟、脚踝、手肘、手掌后方以及骨节活动处都红肿疼痛，卧床三年。吴中的医生赵视认为这是虚证，使用虎潜丸（Tiger Hiding Pill）；吴渤海的医生认为是寒证，使用大附子、肉桂、鹿茸。徐东皋认为是湿邪，周医生认为是血虚，张甲认为是风邪，李乙认为是历节病（一种以关节变形疼痛为特征的疾病），各种治疗都没有效果。大腿肌肉完全消瘦，只有各个骨节处肿大且疼痛。我恰好住在程道吾家中，被邀请去诊治。诊察发现，他的脉象弦涩有力，知道这是因为湿热痰火被寒气凝滞，固涩在经络中。只是之前的药方不对症，所以病情日益加重。所幸的是他眼中神采尚存，胃气也未完全损耗，只是小便浑浊，用瓦盆盛放片刻后沉淀结为砂石，颜色红浊，双膝以下及脚趾都生有大疮，疮痂像靴钉形状，这都是平时服用温补药物所致。病虽久，年龄虽高，但仍属于有余之实证，不能因为年老病重就放弃不治。于是特别先驱逐经络中凝滞的病邪，然后健脾消痰，使新痰不再产生，气血日渐增长，最后用补益剂收功，这样才能成功。老先生生平喜欢进补而畏惧攻伐，所以进门求医的医生都务求迎合他的喜好，唯独我反其道而行之。取新鲜的威灵仙一斤，装入新竹筒中，加入烧酒二斤，塞紧筒口，刮去竹筒外部的青皮，隔水加热蒸煮至燃烧三支官香的时间为止，取出威灵仙晒干研末，用竹沥调糊制成丸药，梧桐子大小，早晚各用酒送服一钱，一日两次。五天后，大便泻出粘稠痰积半桶，肿痛消退大半。改为服用由人参、石斛、苍术、黄柏、苡仁、苍耳子、牛膝、乌药叶、龟板、红花、犀角屑、木通组成的煎剂二十帖，同时继续服用前面的药末三天，又排出如前一半量的痰积。仍然以前面的煎剂服用半个月，又将药末服用三天，腹中痰积逐渐减少，于是为他制作丸药，用虎骨、晚蚕砂、苍术、黄柏、丹参、杜牛膝茎叶、苡仁、红花、五加皮、苍耳子、龟板浸泡酒中，面粉糊为丸，梧桐子大小，每次空腹用白开水送服七八十丸，另外饭后服用半年丹溪保和丸（Baohe Pill），最终痊愈，腿部肌肉恢复如初，行走如常。
A female servant, aged thirty, had suffered from plague (epidemic febrile disease) for over a month. Her condition relapsed due to fatigue or improper diet. Currently, she presented with fever, cough, pain in the chest and hypochondrium, deafness, thirst, constipation for seven to eight days, and unconsciousness. I prescribed Chai Hu (Bupleuri Radix) and Shi Gao (Gypsum Fibrosum), each 3 qian; Gua Lou (Trichosanthis Fructus), Jie Geng (Platycodonis Radix), and Zhi Ke (Aurantii Fructus), each 1.5 qian; Huang Qin (Scutellariae Radix) and Qian Hu (Peucedani Radix), each 1 qian; Tian Hua Fen (Trichosanthis Radix), 8 fen; Gan Cao (Glycyrrhizae Radix et Rhizoma), 5 fen; and Huang Lian (Coptidis Rhizoma), 8 fen. The decoction was prepared urgently and administered. Her consciousness slightly cleared. Since her bowels remained unopened, on the next day, Da Chai Hu Tang (Major Bupleurum Decoction) was used to purge the bowels. On the third day, although her bowels moved, the fever persisted. The prescription was changed to Chai Hu (Bupleuri Radix), 2 qian; Bai Shao Yao (Paeoniae Radix Alba), Huang Qin (Scutellariae Radix), and Mai Men Dong (Ophiopogonis Radix), each 1 qian; Tian Hua Fen (Trichosanthis Radix), Fu Ling (Poria), and Gan Cao (Glycyrrhizae Radix et Rhizoma), each 6 fen. After four doses, she recovered.
Cheng Fangtang, a military commissioner, aged sixty-four, had previously taken excessive warm-tonifying herbs to tonify the lower jiao yuan qi. One winter day, wearing only thin trousers while standing by a stream supervising construction work, he contracted cold, resulting in bone and tendon pain. The Jian Jing (GB21), Que Pen (Clavicular fossa), legs, knees, heels, ankles, elbows, posterior palms, and all movable joints became red, swollen, and painful. He had been bedridden for three years. Doctors in Wuzhong, Zhao Shi, diagnosed it as deficiency and prescribed Hu Qian Wan (Tiger Hiding Pill); doctors in Wobohai diagnosed it as cold and used large amounts of Fu Zi (Aconiti Lateralis Radix Preparata), Rou Gui (Cinnamomi Cortex), and Lu Rong (Cervi Cornu Pantotrichum). Xu Donggao attributed it to dampness; Dr. Zhou to blood deficiency; Zhang Jia to wind; Li Yi to Li Jie disease (a type of arthralgia with joint deformity). Various treatments failed. The muscles between the thighs were completely wasted, while only the joints remained swollen and painful. I happened to be staying at Cheng Daowu’s residence and was invited to consult. His pulse was wiry, choppy, and forceful. I determined that the pathogenic heat-dampness, phlegm, and fire were congealed and obstructed by cold qi within the meridians. The previous prescriptions were incorrect, causing the disease to worsen daily. Fortunately, his spirit in the eyes remained intact, and his stomach qi was not entirely depleted. However, his urine was turbid; when placed in a clay pot for a short time, it precipitated into reddish, turbid sand-like deposits. Large sores appeared below both knees and on the toes, with crusts resembling boot nails. These symptoms resulted from his habitual intake of warm-tonifying formulas. Although the illness was chronic and he was elderly, it was still an excess-type disease. It should not be abandoned due to advanced age and chronicity. Therefore, I first focused on expelling the stagnation in the meridians, then strengthened the spleen and resolved phlegm to prevent new phlegm formation, allowing qi and blood to grow daily, and finally used tonifying agents to conclude treatment. Mr. Cheng loved tonification and feared purgation, so visiting physicians tended to cater to this preference. I acted contrary to this. I took one jin of fresh Wei Ling Xian (Clematidis Radix et Rhizoma), placed it in a new bamboo tube, added two jin of distilled liquor, sealed the tube, scraped off the outer green skin, and boiled it in water until three incense sticks had burned down. The herb was removed, dried, and powdered. Bamboo juice (Zhu Li) was used to make paste for pills, sized like paulownia seeds. Taken with wine morning and evening, one qian per dose, twice daily. After five days, half a bucket of thick, sticky phlegm accumulation was discharged via stool, and swelling and pain decreased significantly. The prescription was changed to a decoction containing Ren Shen (Ginseng Radix), Shi Hu (Dendrobii Caulis), Cang Zhu (Atractylodis Rhizoma), Huang Bo (Phellodendri Cortex), Yi Yi Ren (Coicis Semen), Cang Er Zi (Xanthii Fructus), Niu Xi (Achyranthis Bidentatae Radix), Wu Yao Ye (Linderae Folium), Gui Ban (Testudinis Carapax et Plastrum), Hong Hua (Carthami Flos), Xi Jiao Xie (Rhinocerotis Cornu - *Note: Substitute with Buffalo Horn in modern practice*), and Mu Tong (Akebiae Caulis). Twenty doses were taken, along with the previous powder for three days, discharging another half-bucket of phlegm. The decoction continued for half a month, followed by three more days of the powder. Abdominal phlegm gradually decreased. Then, I prepared pills using Hu Gu (Pantheris Os - *Note: Substitute with legal alternatives*), Wan Can Sha (Bombyx Batryticatus), Cang Zhu (Atractylodis Rhizoma), Huang Bo (Phellodendri Cortex), Dan Shen (Salviae Miltiorrhizae Radix), Du Niu Xi (Cyathulae Radix stems and leaves), Yi Yi Ren (Coicis Semen), Hong Hua (Carthami Flos), Wu Jia Pi (Acanthopanacis Cortex), Cang Er Zi (Xanthii Fructus), and Gui Ban (Testudinis Carapax et Plastrum) soaked in liquor, bound with wheat flour paste into pills sized like paulownia seeds. Taken on an empty stomach with plain water, 70-80 pills per dose. Additionally, Bao He Wan (Harmony-Preserving Pill) by Danxi was taken after meals for half a year. He fully recovered, leg muscles returned to normal, and walking ability was restored.