吴九宜先生，每早晨腹痛泄泻者半年，粪色青，腹膨 ，人皆认为脾肾泄也。为灸关元
三十
壮，服补脾肾之药皆不效。自亦知医，谓其尺寸俱无脉，惟两关沉滑，大以为忧，以人言泄
久而六脉将绝也。予为诊之曰∶君无忧，此中焦食积痰泄也，积胶于中，故尺寸脉隐伏不见
。法当下去其积，诸公用补，谬矣!渠谓∶敢下耶？予曰∶何伤。《素问》云∶有故无殒亦无
殒也。若不乘时，久则元气愈弱，再下难矣。以丹溪保和丸二钱，加备急丸三粒，五更服之
，巳刻下稠积半桶，胀痛随愈。次日六脉齐见。再以东垣木香化滞汤，调理而安。渠称谢言
曰∶人皆谓六脉将绝为虚极，公独见之真而下之，由公究理深邃，故见之行事，着之谈论，
皆自理学中来，他人何敢望其后尘。
沈大官，左膝肿痛，不能起止者年半，大便泻，一日三次。诊其脉弦紧，予曰∶此脾虚
有湿
热凝于经络，流于下部也。古谓肿属湿，痛属火。用苍术、黄柏、薏苡仁为君，泽泻、猪苓
、五加皮为臣，炙甘草、防风、桂枝为佐，木通为使，四帖痛减肿消，泄泻亦止。改用苍术
、苍耳子、五加皮、苡仁、当归、枸杞子、杜仲、丹参、黄柏、乌药叶，酒糊为丸，调理月
余，步履如故。
沈继庵先生，下痢十二日，腹痛，脱肛，后重，嗳气，不知饥。一友用补中益气加白芍
药，
腹痛愈加，后重亦甚。予脉之，右关滑大搏指，曰∶此积滞固结肠胃间，故后重脱肛也。当
为推荡，以其素弱多郁，不敢，只为调气而兼消导。木香、山楂、槟榔、枳实、川芎、白芍
药、黄连、黄芩、秦艽。服后稍宽。次日用七伤丸，二帖痊愈。
其内人患发热头痛，遍身痛，干呕口渴，胸膈胀闷，坐卧不安。医与以参苏饮，干呕愈
甚，
又加烦躁。予诊之，右手洪大倍于左，左浮数。予曰∶干霍乱症也。与以藿香正气散，减去
白术、桔梗，加白扁豆、香薷。一帖吐止食进，遍身痛除，惟口渴额痛未除，小水不利，以
石膏、香薷、滑石各五钱，橘红、藿香、葛根各二钱，槟榔、木瓜各一钱，甘草五分，姜三
片，一帖而愈。
吴九宜先生，每早晨腹痛泄泻已有半年，粪便颜色发青，腹部胀满，大家都认为是脾肾虚弱导致的泄泻。对他施灸关元穴三十壮，服用补益脾肾的药物均无效。他自己也懂医理，认为寸脉和尺脉都摸不到脉搏，只有两关脉沉滑，非常担忧，因为别人说泄泻久了六脉将要断绝。我为他诊脉后说：“您不用担心，这是中焦食积痰湿引起的泄泻，积滞胶结在中焦，所以寸尺脉隐伏不见。”治法应当攻下积滞，各位医生用补法，是错误的！他说：“敢用攻下法吗？”我说：“有什么妨害？《素问》说：‘有病则病受之，不会伤及正气。’如果不趁此时机治疗，时间久了元气会更弱，再想攻下就难了。”于是给他服用丹溪保和丸二钱，加备急丸三粒，五更时分服用，巳时排出稠厚积滞半桶，胀痛随即痊愈。第二天六脉全部显现。随后改用东垣木香化滞汤调理而安。他感激地说：“人都说六脉将绝是极度虚损，唯独您看得真切并采用攻下法，这是因为您探究道理深邃，所以所见、所行、所言，都是从理学中来的，他人哪里敢望其后尘。”
沈大官，左膝肿痛，不能站立行走已一年半，大便稀溏，一天三次。诊其脉象弦紧，我说：“这是脾虚有湿热凝滞于经络，流注于下部。”古人说肿属于湿，痛属于火。用苍术、黄柏、薏苡仁作为君药，泽泻、猪苓、五加皮作为臣药，炙甘草、防风、桂枝作为佐药，木通作为使药，四帖后疼痛减轻、肿胀消退，泄泻也停止了。后来改用苍术、苍耳子、五加皮、薏苡仁、当归、枸杞子、杜仲、丹参、黄柏、乌药叶，酒糊为丸，调理一个多月，步履恢复如常。
沈继庵先生，下痢十二天，腹痛，脱肛，里急后重，嗳气，不知饥饿。一位朋友用补中益气汤加白芍药，结果腹痛更加严重，里急后重也更厉害。我诊其脉，右关脉滑大搏指，说：“这是积滞固结在肠胃之间，所以出现里急后重和脱肛。”应当推荡积滞，但因为他平时体弱多郁，不敢猛攻，只为他调气兼以消导。用药为木香、山楂、槟榔、枳实、川芎、白芍药、黄连、黄芩、秦艽。服药后稍感宽舒。次日服用七伤丸，两帖后痊愈。
他的妻子患发热头痛，遍身疼痛，干呕口渴，胸膈胀闷，坐卧不安。医生给她服参苏饮，干呕反而更甚，又加上烦躁。我诊脉，右手脉洪大倍于左手，左手脉浮数。我说：“这是干霍乱症。”给予藿香正气散，减去白术、桔梗，加白扁豆、香薷。一帖后呕吐停止、能进食，遍身疼痛消除，惟独口渴额痛未除，小便不利，再用石膏、香薷、滑石各五钱，橘红、藿香、葛根各二钱，槟榔、木瓜各一钱，甘草五分，生姜三片，一帖而愈。
Mr. Wu Jiuyi suffered from abdominal pain and diarrhea every morning for half a year. His stool was green, and his abdomen was distended. Everyone considered it to be spleen-kidney deficiency diarrhea (Pi Shen Xie). He underwent moxibustion at Guanyuan (CV-4) for thirty cones and took herbs to tonify the spleen and kidney, but all were ineffective. He himself understood medicine and believed that since both the Cun (inch) and Chi (cubit) pulses were imperceptible, while only the Guan (bar) pulses were deep and slippery, he was deeply worried, as others claimed that prolonged diarrhea would lead to the extinction of the six pulses. I examined his pulse and said, "Do not worry. This is diarrhea caused by food stagnation and phlegm-dampness in the Middle Jiao. The accumulation is sticky and lodged in the center, causing the Cun and Chi pulses to be hidden and invisible. The treatment method should be to purge the accumulation below. Your use of tonifying methods was erroneous!" He asked, "Dare we use purgatives?" I replied, "What harm could there be? The *Su Wen* states: 'When there is a pathogen, there is no injury [to the healthy qi], nor is there injury [from the treatment].' If we do not seize this opportunity, the Yuan Qi will become weaker over time, making subsequent purgation difficult." I prescribed Baohe Wan (Harmonize the Stomach Pill) by Danxi, 2 qian, combined with three Beiji Wan (Emergency Rescue Pills), administered at wu geng (3–5 AM). By si ke (9–11 AM), he passed half a bucket of thick, stagnant material, and the distension and pain resolved immediately. The next day, all six pulses became visible. Subsequently, he was treated with Muxiang Huazhi Tang (Aucklandia Decoction to Transform Stagnation) by Dongyuan for regulation, leading to recovery. He expressed gratitude, saying, "Everyone believes that the impending extinction of the six pulses indicates extreme deficiency, yet you alone perceived the truth and employed purgation. This is because your investigation into principles is profound; thus, your insights, actions, and discussions all stem from Neo-Confucian scholarship. How dare others follow in your footsteps?"
Shen Daguan suffered from swelling and pain in his left knee for one and a half years, unable to stand or walk. His stool was loose, occurring three times a day. His pulse was wiry and tight. I said, "This is damp-heat condensing in the collaterals due to spleen deficiency, flowing downward." The ancients stated that swelling belongs to dampness, and pain belongs to fire. The prescription used Cang Zhu (Atractylodis Rhizoma), Huang Bo (Phellodendri Cortex), and Yi Yi Ren (Coicis Semen) as sovereign drugs; Ze Xie (Alismatis Rhizoma), Zhu Ling (Polypori Sclerotium), and Wu Jia Pi (Acanthopanacis Cortex) as minister drugs; Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma), Fang Feng (Saposhnikoviae Radix), and Gui Zhi (Cinnamomi Ramulus) as assistant drugs; and Mu Tong (Akebiae Caulis) as envoy drug. After four doses, the pain decreased, the swelling subsided, and the diarrhea stopped. Later, a pill formula was prepared using Cang Zhu, Cang Er Zi (Xanthii Fructus), Wu Jia Pi, Yi Yi Ren, Dang Gui (Angelicae Sinensis Radix), Gou Qi Zi (Lycii Fructus), Du Zhong (Eucommiae Cortex), Dan Shen (Salviae Miltiorrhizae Radix), Huang Bo, and Wu Yao Ye (Litseae Folium), bound with wine paste. After more than a month of regulation, his gait returned to normal.
Mr. Shen Jian'an suffered from dysentery for twelve days, accompanied by abdominal pain, rectal prolapse, tenesmus, belching, and loss of appetite. A friend treated him with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Bai Shao Yao (Paeoniae Radix Alba), which exacerbated the abdominal pain and tenesmus. Upon palpating his pulse, I found the Right Guan pulse slippery, large, and forceful against the fingers. I said, "This is accumulation and stagnation firmly knotted in the intestines and stomach, causing tenesmus and rectal prolapse." It should have been pushed out via purgation, but since he was constitutionally weak and prone to depression, I dared not use harsh methods. Instead, I regulated the qi and aided digestion. The prescription consisted of Mu Xiang (Vladimiriae Radix), Shan Zha (Crataegi Fructus), Bing Lang (Arecae Semen), Zhi Shi (Aurantii Fructus Immaturus), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Bai Shao Yao, Huang Lian (Coptidis Rhizoma), Huang Qin (Scutellariae Radix), and Qin Jiao (Gentianae Macrophyllae Radix). After taking the medicine, he felt somewhat relieved. The next day, he took Qishang Wan (Seven Injuries Pill) for two doses and recovered completely.
His wife suffered from fever, headache, generalized body pain, dry retching, thirst, chest and diaphragmatic fullness and oppression, and restlessness. Physicians prescribed Shen Su Yin (Ginseng and Perilla Infusion), which worsened the dry retching and added irritability. I examined her pulse: the Right hand pulse was flooding and large, twice as strong as the Left, which was floating and rapid. I diagnosed this as Gan Huoluan (Dry Cholera). I prescribed Huoxiang Zhengqi San (Agarwood and Patchouli Powder to Rectify the Qi), removing Bai Zhu (Atractylodis Macrocephalae Rhizoma) and Jie Geng (Platycodi Radix), and adding Bai Bian Dou (Phaseoli Semen Album) and Xiang Ru (Moslae Herba). After one dose, vomiting ceased, appetite returned, and generalized body pain disappeared. However, thirst, frontal headache, and difficulty urinating persisted. I then prescribed Shi Gao (Gypsum Fibrosum), Xiang Ru, and Hua Shi (Talcum), each 5 qian; Ju Hong (Citri Reticulatae Pericarpium Rubrum), Huo Xiang (Agastaches Herba), and Ge Gen (Puerariae Lobatae Radix), each 2 qian; Bing Lang, and Mu Gua (Chaenomelis Fructus), each 1 qian; Gan Cao (Glycyrrhizae Radix et Rhizoma), 0.5 qian; and three slices of Jiang (Zingiberis Rhizoma Recens). After one dose, she was cured.