孙如亭令政，年过四十，眼偶赤肿，两太阳疼痛，大便不行者三日。平时汛期一月仅二
日，令
行四日犹且未止。里有开化余云谷者，自谓眼科捷手，医治逾候，肿赤不消而右眼内 突生
一白泡，垂与鼻齐，大二寸余，余见而骇走，以为奇疾，莫能措剂。又见其呕吐眩晕，伏于
枕上，略不敢动，稍动则眩愈极，吐愈急，疑其变而不治。予为诊之，两寸关脉俱滑大有力
，
两尺沉微。予曰∶此中焦有痰，肝胆有火，必为怒气所触而然。《内经》云∶诸风掉眩皆属
肝木，诸逆冲上皆属于火。盖无痰不作晕也。眼 白泡乃火性急速，怒气加之，气乘于络，
上而不下，故直胀出眼外也。古壮士一怒而目 裂，与白泡胀出 外理同。肝为血海，故血
亦来不止。治当抑其肝木，清镇痰火，则诸症自瘳。先用姜汁益元丸压其痰火，以止其吐，
再以二陈汤加酒连、酒芩、天麻、滑石、吴茱萸、竹茹、枳实，煎饮。一帖吐止晕定，头稍
能动。改用二陈汤加芩、连、谷精草、香附、夏枯草、吴茱萸、薏苡仁两剂，赤肿消，白泡
敛。四剂痊愈，血海亦净，从是后不发。
吴勉斋，年近五十，有腹痛疾，或作或止，性极急，多躁多怒。今痛在当脐，不间昼夜
，市
里医者为下之已五日，大便虽泻，痛则尤甚，饮食不进，手足清冷，形神俱倦，脉仅四至，
重按则伏而有力。此由攻克太过，寒凉伤脾，脾虚则中气不运，积反凝滞，以故大便虽泻
而积不行，痛终不减也。治当创建中气为主，中气一回，痛当立止，先与王海藏五神丸一钱
，滚水送下，以止其痛。此丸补接元气，安和五脏，升降阴阳，极有神应，故名五神丸。方
出《医垒元戎》第十卷中。再用小建中汤调肝养脾。盖脐下乃肝经部位，唯此汤乃对症剂也
。白芍酒炒三钱，炙甘草一钱五分，桂心一钱，加香附一钱，生姜三片，水煎服。午牌进药
，未牌已报痛止，因其夜进粥太频，且食鸭汁，憾动余积，腹又作痛，且加胀闷，面有浮气
，里急后重，与四平丸而渐定，外以二陈汤加香附、砂仁、苍术、浓朴、山楂，腹中始觉宽
快，三日无恙。又纵恣口腹，大啖肥甘，糕、粽、肉、鸡之类，不饱不止，腹中大痛时刻难
存，欲吐则食已下膈，欲泻则食尚未入肠，自喊叫云，可取木香槟榔丸、大承气汤急与我下
之，虽死无憾。予谕之曰∶据痛虽甚，腹则不坚，顾今日适届冬节，礼曰先旺于至日，闭关
安静，以养微阳，曷敢以大寒峻剂，而汨天和乎？设不和已只须 树东行根上白皮一钱，长
流
水煎饮之，一服可愈也。夜已二鼓，觅而煎服，天明泻三五行，痛减大半，仍以小建中汤和
之，痛又旋减，唯脐下尚不脱然，常常以热手重熨之，大便欲行，及至厕，则又不解。知其
血少而气不调，用熟地三钱，白芍一钱，杏仁二钱，乌药一钱，木香五分，水煎饮既，下黑
粪甚多，十年腹痛沉 从此不再复萌。此后勉斋常语人曰∶吾得孙公五神丸、 根皮、小建
中汤三法，不啻脱胎换骨，数年来岂惟饮食增加，即步履轻便，捷若少壮，皆孙君赐也。亲
友有求其三法者，畀而服之，捷若桴鼓，彼家谓予殆三生夙缘云。
孙如亭的夫人，年龄超过四十岁，眼睛偶尔出现红肿，两侧太阳穴疼痛，大便三天没有排泄。平时月经周期一个月仅来两天，这次经期持续四天仍未停止。当地有一位叫余云谷的开化人，自称是眼科高手，治疗了很长时间，但红肿未消，右眼内部突然长出一个两寸多高的白色水泡，下垂至与鼻子齐平的高度。我见到后惊骇离去，认为这是奇难杂症，无法用药处理。又见她呕吐、眩晕，趴在枕头上，稍微不敢动弹，稍一活动则眩晕加剧，呕吐更急，怀疑病情恶化且难以治愈。我为她诊脉，两手寸关脉均滑大有力，两尺脉沉微。我说：这是中焦有痰湿，肝胆有火气，必定是被怒气触动所致。《内经》说：各种风证引起的动摇眩晕都属于肝木，各种逆气冲上症状都属于火。大概没有痰湿就不会发生眩晕。眼睛里的白泡是因为火性急速，加上怒气的影响，气机乘袭经络，向上而不向下，所以直接胀出眼外。古代壮士一发怒而眼球破裂，与白泡胀出眼外的道理相同。肝为血海，所以血液也流个不停。治疗应当抑制肝木，清镇痰火，那么各种症状自然痊愈。先用姜汁益元丸压制痰火，以止住呕吐，再用二陈汤加酒黄连、酒黄芩、天麻、滑石、吴茱萸、竹茹、枳实，煎服。服用一帖后呕吐停止，眩晕安定，头部可以稍微活动。改用二陈汤加黄芩、黄连、谷精草、香附、夏枯草、吴茱萸、薏苡仁，服用两剂后，红肿消退，白泡收敛。再服用四剂痊愈，血海干净，从此以后不再复发。
吴勉斋，年龄接近五十岁，患有腹痛病，有时发作有时停止，性格非常急躁，容易烦躁发怒。现在疼痛位于肚脐周围，不分昼夜。市井医生给他用了泻下法已经五天，虽然大便泄泻，但疼痛反而更加严重，饮食不进，手脚冰冷，形体和精神都非常疲倦，脉搏只有四次跳动（迟脉），重按则伏而有力。这是由于攻下太过，寒凉药物损伤脾脏，脾虚导致中气不运化，积滞反而凝结阻滞，因此虽然大便泄泻但积滞不行，疼痛始终不减。治疗应当以建立中气为主，中气恢复，疼痛就会立即停止。先给王海藏的五神丸一钱，用滚开水送下，以止住疼痛。这个药丸能补接元气，安和五脏，升降阴阳，极有神效，所以名叫五神丸。方子出自《医垒元戎》第十卷。再用小建中汤调理肝脏、滋养脾脏。因为脐下是肝经的部位，只有这个汤剂是对症的。白芍用酒炒三钱，炙甘草一钱五分，桂心一钱，加香附一钱，生姜三片，水煎服。中午时分服药，下午时分已经报告疼痛停止，因为他晚上喝粥太频繁，且吃了鸭肉汤汁，扰动残余积滞，腹部又作痛，并且加重胀闷，面部有浮肿之气，里急后重，给予四平丸逐渐安定，外用二陈汤加香附、砂仁、苍术、厚朴、山楂，腹中才觉得宽快，三天无事。后来又放纵口腹，大吃肥甘厚味，糕点、粽子、肉类、鸡肉之类，不饱足不止，腹部剧烈疼痛，时刻难以忍受，想吐则食物已下膈，想泻则食物尚未入肠，自己喊叫说，快取木香槟榔丸、大承气汤赶紧给我泻下，即使死了也无遗憾。我告诫他说：根据疼痛虽然严重，但腹部并不坚硬，况且今天正好是冬至节，礼制说阳气在冬至日最旺，应闭关安静，以养护微弱的阳气，怎敢用大寒峻猛的药物，来扰乱天和呢？如果不愈，只需取向东生长的树根上的白皮一钱，用长流水煎服，一服即可痊愈。夜里二鼓时分，找到并煎服，天亮时泻下三四五次，疼痛减轻大半，仍用小建中汤调和它，疼痛又迅速减轻，只有脐下尚不能完全解脱，常常用热手重重熨烫它，大便想排，等到厕所时，却又解不出。知道他是血少而气不调，用熟地黄三钱，白芍一钱，杏仁二钱，乌药一钱，木香五分，水煎服后，排出很多黑粪，十年的腹痛沉疴从此不再复发。此后勉斋常对人说：我得到孙公的五神丸、东行根白皮、小建中汤这三种方法，简直如同脱胎换骨，几年来岂止饮食增加，就连步履轻便，敏捷如少年壮士，都是孙君的恩赐。亲友中有求这三种方法的，给他们服用，见效如击鼓应声那样快，那家人说我大概是三生宿缘。
Ms. Sun Ruting, aged over forty, occasionally experienced redness and swelling of the eyes, with pain in both temporal regions, and no bowel movement for three days. Normally, her menstrual period lasted only two days per month; this time, it had continued for four days without stopping. A man named Yu Yungu from Kaihua, who claimed to be a skilled ophthalmologist, treated her for a long time, but the redness and swelling did not subside. Suddenly, a white blister more than two cun in diameter protruded from the inside of her right eye, hanging down to the level of her nose. I was shocked upon seeing it and left, considering it a rare disease that could not be treated with medicine. She also suffered from vomiting and vertigo, lying on her pillow, daring not to move slightly; any slight movement exacerbated the vertigo and intensified the vomiting. I suspected the condition was deteriorating and incurable. Upon palpation, her Cun and Guan pulses on both hands were slippery, large, and forceful, while her Chi pulses were deep, faint, and weak. I said: "There is phlegm-dampness in the Middle Jiao (Middle Burner), and fire-heat in the Liver and Gallbladder, likely triggered by anger. The *Neijing* states: 'All wind syndromes characterized by tremors and vertigo belong to Liver Wood; all rebellious qi rushing upward belongs to Fire.' Phlegm is essential for dizziness. The white blister in the eye arises because fire-nature is rapid; combined with anger, qi invades the collaterals, moving upward rather than downward, thus swelling outwards. This is similar to the case of an ancient strongman whose eyes burst from rage. Since the Liver is the Sea of Blood, the blood also flows incessantly. Treatment should suppress Liver Wood, clear and settle phlegm-fire, so that all symptoms will naturally heal. First, use Jiangzhi Yiwan Pill (Ginger Juice Benefiting Primordial Pill) to suppress phlegm-fire and stop vomiting. Then, use Erchen Tang (Two-Aged Decoction) added with Jiuhuanglian (Wine-processed Coptidis Rhizoma), Jiu Huangqin (Wine-processed Scutellariae Radix), Tianma (Gastrodiae Rhizoma), Huashi (Talcum), Wuzhuyu (Evodiae Fructus), Zhuru (Bambusae Caulis in Taeniam), and Zhishi (Aurantii Fructus Immaturus), decocted and drunk. After one dose, vomiting stopped, vertigo settled, and the head could move slightly. Switch to Erchen Tang added with Huangqin, Huanglian, Gujingcao (Euphrasiae Herba), Xiangfu (Cyperi Rhizoma), Xiakucao (Prunellae Spica), Wuzhuyu, and Yiyiren (Coicis Semen). After two doses, redness and swelling subsided, and the white blister retracted. After four doses, she recovered completely, the Sea of Blood cleared, and it never recurred thereafter.
Wu Mianzhai, nearing fifty years old, suffered from abdominal pain that came and went. His temperament was extremely irritable, prone to restlessness and anger. Currently, the pain was centered around the umbilicus, day and night. Local physicians had administered purgatives for five days. Although he had diarrhea, the pain worsened. He could not eat or drink, his hands and feet were cold, his physical form and spirit were exhausted, his pulse rate was slow (four beats per breath), and deep pressure revealed a hidden yet forceful pulse. This resulted from excessive purgation, where cold-natured herbs damaged the Spleen. Spleen deficiency led to failure of Middle Qi transformation, causing accumulation to stagnate further. Thus, although stool passed, the accumulation remained, and pain persisted. Treatment should focus on establishing Middle Qi; once restored, pain would cease immediately. First, administer one qian of Wang Haicang's Wushen Wan (Five-Spirits Pill) with boiling water to stop pain. This pill tonifies Yuan Qi (Primordial Qi), harmonizes the Five Zang Organs, and regulates the ascending and descending of Yin and Yang, showing miraculous efficacy, hence its name. The formula comes from Volume 10 of *Yilei Yuanrong*. Subsequently, use Xiaojianzhong Tang (Minor Construct the Middle Decoction) to soothe the Liver and nourish the Spleen. The area below the umbilicus belongs to the Liver Meridian, making this formula appropriate. Use Jiubaishao (Wine-fried Paeoniae Radix Alba) 3 qian, Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma) 1.5 qian, Guixin (Cinnamomi Cortex) 1 qian, plus Xiangfu 1 qian, and Shengjiang (Zingiberis Rhizoma Recens) 3 slices. Decoct in water and take orally. Medicine taken at noon; by afternoon, pain ceased. However, due to frequent consumption of congee and duck broth at night, residual accumulation was disturbed, causing abdominal pain again, accompanied by distension and oppression, facial edema, tenesmus, and heaviness in the lower abdomen. Given Siping Wan (Four-Pacifying Pill), symptoms gradually stabilized. Externally, Erchen Tang added with Xiangfu, Sharen (Amomi Fructus), Cangzhu (Atractylodis Rhizoma), Houpo (Magnoliae Officinalis Cortex), and Shanzha (Crataegi Fructus) was used, bringing relief to the abdomen. For three days, he was well. Later, he indulged in rich and sweet foods, such as pastries, zongzi, meat, and chicken, eating until full. Severe abdominal pain ensued, unbearable moment by moment. He felt food stuck below the diaphragm when trying to vomit, and undigested food remaining when trying to defecate. He shouted, "Quickly give me Muxiang Binglang Wan (Areca Seed and Costus Root Pill) and Dachengqi Tang (Major Order the Qi Decoction) to purge me; even if I die, I have no regrets." I admonished him: "Although the pain is severe, the abdomen is not hard. Moreover, today is the Winter Solstice. Rituals state that Yang Qi is strongest on this day; one should remain secluded and quiet to nurture subtle Yang. How dare we use harsh cold purgatives to disturb Heavenly Harmony? If not relieved, simply take one qian of the white bark from the east-facing roots of a tree, decocted in flowing water. One dose will cure you." At the second watch of the night, it was found and administered. By dawn, he defecated three to five times, and pain reduced by half. Xiaojianzhong Tang was used to harmonize, and pain decreased rapidly. Only the area below the umbilicus remained uncomfortable. He frequently applied hot hands to warm the area. He felt the urge to defecate, but none occurred in the toilet. Recognizing Blood deficiency and Qi dysregulation, I prescribed Shudi (Rehmanniae Radix Preparata) 3 qian, Baishao 1 qian, Xingren (Armeniacae Semen Amarum) 2 qian, Wuyao (Linderae Radix) 1 qian, and Muxiang (Aucklandiae Radix) 0.5 qian. After decoction and oral administration, a large amount of black stool was passed. The decade-long chronic abdominal pain never recurred. Thereafter, Mianzhai often told others: "I obtained Dr. Sun's Wushen Wan, East-Facing Root Bark, and Xiaojianzhong Tang. It was like being reborn. In recent years, not only has my appetite increased, but my gait has become light and agile like a young man, all thanks to Dr. Sun. Relatives and friends seeking these three methods took them, with effects as immediate as striking a drum. Their family says I must have a karmic connection from three lifetimes ago."