丁文学长令姊，常患晕厥，吐痰碗许乃苏，一月三、五发。后又口渴，五更倒饱，肠鸣
腹疼
，泄泻，小水短涩，咳嗽。余脉之，两寸濡弱，两关滑大，此中焦痰积所致也。先与二陈汤
，
加苍术、山楂、麦芽以健脾祛湿为臣，以白芍药止痛为君，以滑石、泽泻引湿热从小便出为
佐，黄芩为裨佐。十帖，二阴之痛俱止，改以六味地黄丸加黄柏、知母、牛膝，服之而安。
有金良美者，年十八，患咳嗽吐红，下午潮热梦遗。市医进四物汤加天门冬、黄柏，知
母之
类，治半年，反加左胁胀疼，不能侧卧，声音渐哑，饮食辄恶心，肌肉大削，六脉俱数，医
告技穷，因就予治。观其面色白，又隐隐有清气夹之，两足痿弱无力，予语之曰∶此症气虚
血热，而肝脉甚弦，弦则木气太旺，脾土受亏，不能统血，殆始怒气所触，继为寒凉之剂所
伤，以致饮食恶心，肌肉瘦削。书云，脾胃一虚，肺气先绝。以肺金不足，则肝木愈不能制
。浊痰瘀血凝于肺窍，故咳嗽声哑，滞于肝，故左胁不能贴席而卧，病势危矣。喜在青年，
犹可措手。因急用人参二钱，鳖甲五钱为君，白术、白芍、陈皮、茯苓、通草、贝母各一钱
为臣，甘草、牡丹皮各七分为佐，桔梗五分为使。二十帖，潮热止，咳嗽减大半。三十帖，
声音开亮，左胁亦能贴席而卧。后以大造丸调理全安矣。乃嘱之曰∶病愈虽可喜，而弦脉未
退，须切忌怒气及劳心劳力之事，庶几可保无虞。苟不守予言，而劳怒相触，血来必不能御
，戒之防之。此后精神日旺，肌体半肥，六年无事。一日遇事拂意，大怒，而又结算劳心，
则
血如泉涌，顷刻盈盆，上唇黑肿，汗出淋漓。急请予诊，脉乱无伦。诊毕，渠语近侍欲大解
。予曰∶此死征也，阴阳乖离矣。辞而出，未离门而气绝。父母哭谢予曰∶始守翁训，苟活
六年，一旦不戒，遂如翁所料，死生虽命，亦不自慎致之。其为人也，量窄而紧于财，因记
此以戒世之重财轻生者。
丁文学的长姐，经常患晕厥病，吐出约一碗痰后才能苏醒，每月发作三到五次。后来出现口渴、五更时分胃脘胀满（倒饱）、肠鸣腹痛、腹泻、小便短少涩痛以及咳嗽等症状。我诊察其脉象，两寸脉濡弱，两关脉滑大，这是中焦痰湿积滞所致。先用二陈汤，加入苍术、山楂、麦芽作为臣药以健脾祛湿，以白芍药作为君药以止痛，以滑石、泽泻作为佐药引导湿热从小便排出，黄芩作为裨佐药。服用十剂后，下部阴分的疼痛全部停止，改为服用六味地黄丸加黄柏、知母、牛膝，服药后病情安定。
有个叫金良美的人，十八岁，患有咳嗽吐红（咯血），下午潮热并梦遗。当地医生给予四物汤加天门冬、黄柏、知母等药物治疗半年，反而导致左胁部胀痛，不能侧卧，声音逐渐嘶哑，饮食时容易恶心，肌肉大幅消瘦，六脉均数疾，医生表示医术穷尽无法治疗，于是来找我诊治。观察他的面色苍白，又隐隐夹杂青色，双足痿软无力，我对他说：此症属气虚血热，且肝脉甚为弦急，弦脉主木气太旺，导致脾土受亏，不能统摄血液，大概是因为起初受到怒气触动，继而又被寒凉药物所伤，以致饮食恶心，肌肉瘦削。医书说，脾胃一虚，肺气先绝。因为肺金不足，则肝木更加不能被制约。浊痰和瘀血凝结于肺窍，所以咳嗽声哑；停滞于肝脏，所以左胁不能贴席而卧，病势已经非常危险。好在患者正值青年，还可以施治。于是紧急使用人参二钱、鳖甲五钱作为君药，白术、白芍、陈皮、茯苓、通草、贝母各一钱作为臣药，甘草、牡丹皮各七分为佐药，桔梗五分为使药。服用二十剂后，潮热停止，咳嗽减轻大半。服用三十剂后，声音变得清亮，左胁也能贴席而卧。后来服用大造丸调理，完全康复。于是嘱咐他说：病愈虽然可喜，但弦脉未退，必须切忌发怒以及劳心劳力的事情，这样才能保证没有忧患。如果不遵守我的建议，因劳累和愤怒相触发，出血必然无法控制，要警惕防范。此后他精神日益旺盛，身体半肥，六年无事。有一天遇到事情不顺心，大怒，同时又结算账目劳心，于是吐血如泉涌，顷刻间盈满盆子，上唇黑肿，汗出淋漓。急忙请我诊脉，脉象混乱无章。诊完后，他对身边的侍从说要大便。我说：这是死征，阴阳乖离了。辞别出来，还没离开门口他就气绝身亡。父母哭着感谢我说：起初遵守您的教诲，苟活六年，一旦不谨慎，就像您预料的那样，生死虽是命运，也是因自己不慎重导致的。这个人器量狭窄且吝啬钱财，因此记录此事以告诫世人那些重财轻生的人。
The elder sister of Scholar Ding frequently suffered from syncope, regaining consciousness only after vomiting approximately one bowl of phlegm. This occurred three to five times a month. Later, she developed thirst, early morning epigastric fullness (Dao Bao), borborygmus, abdominal pain, diarrhea, scanty and dysuric urination, and coughing. Upon pulse diagnosis, the Cun positions on both wrists were soggy and weak (Ru Ruo), while the Guan positions were slippery and large (Hua Da). This indicated accumulation of phlegm-dampness in the Middle Jiao. I initially prescribed Er Chen Tang (Two-Cured Decoction), adding Cang Zhu (Atractylodis Rhizoma), Shan Zha (Crataegi Fructus), and Mai Ya (Hordei Fructus Germinatus) as Deputy Ministers (Chen) to strengthen the Spleen and dispel dampness; Bai Shao Yao (Paeoniae Radix Alba) as Sovereign (Jun) to alleviate pain; Hua Shi (Talcum) and Ze Xie (Alismatis Rhizoma) as Assistants (Zuo) to guide damp-heat out through urination; and Huang Qin (Scutellariae Radix) as an auxiliary assistant (Bi Zuo). After ten doses, the pain in the Yin aspects ceased. The prescription was then changed to Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) with added Huang Bo (Phellodendri Cortex), Zhi Mu (Anemarrhenae Rhizoma), and Niu Xi (Achyranthis Bidentatae Radix), which stabilized the condition.
A patient named Jin Liangmei, aged eighteen, suffered from coughing with hemoptysis (Tu Hong), afternoon tidal fever, and nocturnal emissions. Local physicians treated him for half a year with Si Wu Tang (Four-Substance Decoction) plus Tian Men Dong (Asparagi Radix), Huang Bo, and Zhi Mu. However, his condition worsened, presenting with distending pain in the left hypochondrium, inability to lie on the side, progressive hoarseness, nausea upon eating, and significant muscle wasting. All six pulses were rapid (Shu). The physicians declared their skills exhausted, so he sought my treatment. Observing his pale complexion with a faint bluish hue, and noting his flaccid and powerless lower limbs, I told him: "This syndrome involves Qi deficiency and Blood heat. The Liver pulse is very wiry (Xian). A wiry pulse indicates excessive Wood energy, which damages Earth (Spleen), causing it to fail in controlling blood. It likely originated from initial anger, followed by injury from cold-cooling agents, leading to nausea and emaciation. Medical texts state: 'When the Spleen and Stomach are deficient, Lung Qi perishes first.' Due to insufficient Lung Metal, Liver Wood becomes even less restrained. Turbid phlegm and stagnant blood congeal in the Lung orifices, causing cough and hoarseness; stagnation in the Liver causes the left hypochondrium to be unable to rest against the bed, indicating a critical condition. Fortunately, being young, treatment is still feasible." I urgently prescribed Ren Shen (Ginseng Radix) 2 qian and Bie Jia (Testudinis Carapax et Plastrum) 5 qian as Sovereigns; Bai Zhu (Atractylodis Macrocephalae Rhizoma), Bai Shao Yao, Chen Pi (Citri Reticulatae Pericarpium), Fu Ling (Poria), Tong Cao (Tetrapanacis Medulla), and Bei Mu (Fritillariae Thunbergii Bulbus) at 1 qian each as Deputies; Gan Cao (Glycyrrhizae Radix) and Mu Dan Pi (Moutan Cortex) at 7 fen each as Assistants; and Jie Geng (Platycodonis Radix) at 5 fen as Envoy (Shi). After twenty doses, the tidal fever ceased, and cough decreased by more than half. After thirty doses, his voice became clear, and he could lie with his left side against the bed. He was subsequently fully recovered after conditioning with Da Zao Wan (Great Creation Pill). I advised him: "Although recovery is gratifying, the wiry pulse has not disappeared. You must strictly avoid anger and mental/physical exertion to ensure safety. If you do not heed this advice and trigger bleeding through fatigue and anger, the hemorrhage will be uncontrollable. Beware and prevent this." Thereafter, his spirit grew vigorous daily, and his body became moderately plump. For six years, there were no incidents. One day, due to dissatisfaction with an event, he flew into a great rage and engaged in mental labor regarding accounts. Consequently, blood gushed like a spring, filling a basin in an instant. His upper lip became black and swollen, and he sweated profusely. I was urgently summoned to diagnose him; the pulse was chaotic and disordered. After the examination, he told his attendants that he needed to defecate. I said, "This is a sign of death; Yin and Yang have separated." I took my leave and exited the door. Before I had gone far, he expired. His parents wept and thanked me, saying: "Initially following your instructions, I survived for six years. Once I failed to be cautious, it happened exactly as you predicted. Life and death may be fate, but this was caused by my own lack of prudence." This person was narrow-minded and stingy with money. I record this case to warn those in the world who value wealth over life.