一小童上达，年十六，忽面大肿，足也微肿，喘息不安，此脾虚湿气壅盛所致。酒芩、桑白
皮、防风、葶苈子、陈皮、羌活、升麻、甘草、泽泻、白术，此上下分消法也。服后肿势稍
退，但正气甚虚，以六君子汤加麦芽、泽泻调理而安。一日因多饮食，且感风寒，痰涌吐逆
，见鬼面掉，手足角弓反张，唇口色黑，势极危急，此痫症也。以胆星、半夏、天麻、僵蚕
、橘红、炙甘草、枳实、麦芽、白术、紫苏子、杏仁、前胡、白茯苓，姜三片，水煎饮之一剂而愈，此后再不复发。
族侄良诠，患血痢腹痛，里急后重。时师治以香连丸、黄芩芍药汤不愈，反增痛，面赤
唇红
，有似涂朱，喊叫之声，四舍悚骇。比有太学宁宇者，仁心为质人也。怜其家贫莫 ，拉予为
诊。六脉洪大，伏于床间，两眼泪而不能言。太学会其意语予曰∶症诚急，彼以后事无措而难
于言。予曰∶诺，吾能起之。以生熟白芍药六钱，生熟甘草二钱，干姜、肉桂各一钱，木香
五分，枣二枚，水煎饮之。饮竟嗒焉而卧。太学心疑，归嘱家奴曰∶倘有急，叩门可即报我
。及明，见无动静，仍令人觇病者何若∶复曰∶夜来痢减十之五，痛减十之七，早间已啜粥
半盏矣。太学喜而叩予曰∶渠面赤唇红，脉大，所下皆血，症皆属热，叔乃复投热剂，吾甚
恐一夜不能寐，乃今疾已减半，生有望焉。不卜今日用何剂？予曰∶比昨剂差小耳，方仍昨
也
。太学曰∶吾惑矣，何视热为寒耶？予曰∶君知脉大为热，不知大而无力乃虚寒也。面赤唇
红由中寒而火不能下，阴盛格阳之症。设是真热腹痛，其人体仰而舒，寒则引而伏，所下血
色带晦，均是假热，寒症明矣，前剂果再进而全瘳。太学复书报予曰∶昨闻虚实真假之论，
非饮上池水者不能道也。幸注之以诏后世。
有一个名叫上达的男孩，十六岁，突然面部严重肿胀，双脚也有轻微肿胀，呼吸急促不安，这是脾虚导致湿气壅盛引起的。使用酒炒黄芩、桑白皮、防风、葶苈子、陈皮、羌活、升麻、甘草、泽泻、白术，这是上下分消（通过上下途径消除病邪）的治疗方法。服药后肿胀稍微消退，但正气非常虚弱，于是用六君子汤（由人参、白术、茯苓、甘草、陈皮、半夏组成，具有健脾益气、燥湿化痰功效的方剂）加入麦芽、泽泻进行调理，病情得以安定。一天因为饮食过多，又感受风寒，痰液涌盛导致呕吐逆气，出现幻视见鬼、面部抽搐、手足呈角弓反张状、嘴唇和口唇颜色发黑，形势极其危急，这是痫症（癫痫类疾病）。使用胆南星、半夏、天麻、僵蚕、橘红、炙甘草、枳实、麦芽、白术、紫苏子、杏仁、前胡、白茯苓，加生姜三片，水煎服，一剂药后痊愈，此后不再复发。
族侄良诠，患有血痢伴随腹痛，有里急后重（想排便但排不出或排便不畅的感觉）的症状。当时的医生用香连丸、黄芩芍药汤治疗没有见效，反而增加了疼痛，面色发红，嘴唇红润，像涂了朱砂一样，喊叫的声音让邻居都感到恐惧害怕。当时有一位太学生宁宇，心地仁慈，同情他家里贫穷无法医治，便拉我去诊治。六脉洪大，但按之无力（伏于床间形容脉象深沉且患者痛苦卧姿），两眼流泪不能说话。太学生领会他的意思告诉我：病症确实紧急，他因为对后事无能为力而难以开口。我说：好的，我能治好他。使用生白芍药和熟白芍药各六钱，生甘草和熟甘草各二钱，干姜、肉桂各一钱，木香五分，大枣两枚，水煎服。喝完药后，他安静地躺下休息。太学生心里怀疑，回家后嘱咐家仆说：如果有紧急情况，敲门立即报告我。到了第二天早上，看到没有动静，仍然派人观察病人情况：回来报告说：昨晚腹泻减少了十分之五，疼痛减少了十分之七，早上已经喝了半盏粥了。太学生高兴地问我说：他面色发红，嘴唇红润，脉象大，排泄物全是血，症状都属于热证，您却反而投用热性药物，我非常担心一夜睡不着觉，没想到现在疾病已经减半，有了生机。不知道今天用什么药方？我说：比昨天的药方剂量稍小一些，方子还是昨天的那个。太学生说：我很困惑，为什么把热证看作寒证呢？我说：您知道脉大为热证，但不知道脉大而无力才是虚寒证。面色发红、嘴唇红润是由于中焦寒盛导致阳气不能下行，属于阴盛格阳（阴寒内盛，逼迫阳气浮越于外）的病证。如果是真正的热证腹痛，病人身体会仰卧舒展；如果是寒证，病人身体会蜷缩伏卧；排泄的血色晦暗，这些都是假热，寒证很明显，前面的药方如果继续服用就能完全康复。太学生又写信告诉我：昨天听到关于虚实真假的论述，不是喝过上池之水（传说饮上池水能知病理，代指医术高明者）的人是不能说出来的。希望您记录下来以昭示后世。
A boy named Shangda, aged sixteen, suddenly developed severe facial swelling and slight swelling in his feet, accompanied by restless panting. This was caused by Spleen deficiency leading to an accumulation of dampness. The treatment employed Jiu Huangqin (Scutellariae Radix processed with wine), Sangbaipi (Mori Cortex), Fangfeng (Saposhnikoviae Radix), Tinglizi (Lepidii Semen), Chenpi (Citri Reticulatae Pericarpium), Qianghuo (Notopterygii Rhizoma et Radix), Shengma (Cimicifugae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Zexie (Alismatis Rhizoma), and Baizhu (Atractylodis Macrocephalae Rhizoma). This method is known as "Shangxia Fenxiao" (eliminating pathogenic factors through upper and lower pathways). After taking the medicine, the swelling subsided slightly, but the Zhengqi (Vital Qi) was extremely deficient. Therefore, Liu Junzi Tang (Six Gentlemen Decoction) was administered with added Maiya (Hordei Fructus Germinatus) and Zexie for regulation, resulting in stabilization. One day, due to overeating and exposure to wind-cold, he experienced surging phlegm, vomiting, hallucinations of seeing ghosts, facial twitching, opisthotonos (rigidity of the body with arching backward), and blackening of the lips and mouth. The condition was extremely critical, diagnosed as Xianzheng (Epilepsy). The prescription included Danning (Arisaematis Cum Bile), Banxia (Pinelliae Rhizoma), Tianma (Gastrodiae Rhizoma), Jiangcan (Bombyx Batryticatus), Juhong (Citri Reticulatae Pericarpium Rubrum), Zhigancao (Glycyrrhizae Radix et Rhizoma Preparatum), Zhishi (Aurantii Fructus Immaturus), Maiya, Baizhu, Zisuzi (Perillae Fructus), Xingren (Armeniacae Semen Amarum), Qianhu (Peucedani Radix), Bai Fuling (Poria), and three slices of Shengjiang (Zingiberis Rhizoma Recens). Taken as a water decoction, one dose cured him, and there was no recurrence thereafter.
My clan nephew Liangquan suffered from bloody dysentery with abdominal pain and tenesmus (the feeling of incomplete defecation). Contemporary physicians treated him with Xianglian Wan (Fragrant Link Pill) and Huangqin Shaoyao Tang (Scutellaria and Peony Decoction) without success; instead, the pain increased. His face turned red, and his lips were bright red, resembling cinnabar paint. His shouting terrified the neighbors. At that time, a student of the Imperial Academy named Ningyu, who was benevolent, pitied his family's poverty and inability to afford proper care, and invited me to examine him. The six pulses were flooding (Hongda) yet deep and forceless upon pressure (Fu yu chuang jian), and his eyes were filled with tears, rendering him unable to speak. Student Ningyu understood his meaning and told me: "The condition is indeed urgent; he finds it difficult to speak because he has no means to arrange his affairs." I said: "Very well, I can cure him." I prescribed Sheng Baishao (Raw Paeoniae Radix Alba) and Shu Baishao (Prepared Paeoniae Radix Alba), each 6 qian; Sheng Gancao (Raw Glycyrrhizae Radix) and Shu Gancao (Prepared Glycyrrhizae Radix), each 2 qian; Ganjiang (Zingiberis Rhizoma), Rougui (Cinnamomi Cortex), each 1 qian; Muxiang (Aucklandiae Radix), 5 fen; and two Jujubae Fructus (Jujube dates). These were decocted in water and administered. After finishing the drink, he lay down quietly. Student Ningyu was suspicious and instructed his servant at home: "If there is any emergency, knock on the door and report to me immediately." By morning, seeing no movement, he sent someone again to observe the patient. The report came back: "Last night, the dysentery decreased by five-tenths, and the pain decreased by seven-tenths. In the morning, he had already consumed half a cup of porridge." Student Ningyu happily asked me: "His face is red, lips are red, the pulse is large, and what he passes is all blood. All symptoms belong to Heat. Yet you administered hot-natured herbs. I was very afraid I would not sleep all night. Now the illness has halved, and there is hope for life. What formula did you use today?" I said: "It is slightly smaller in dosage than yesterday's formula, but the prescription remains the same." Student Ningyu said: "I am confused. Why do you treat Heat as Cold?" I said: "You know that a large pulse indicates Heat, but you do not know that a large pulse that is forceless indicates Deficiency-Cold. The red face and red lips are due to Cold in the Middle Jiao preventing Fire from descending, a syndrome of Yin Excess repelling Yang (Yin Cheng Ge Yang). If it were true Heat causing abdominal pain, the patient would lie supine and relaxed; if Cold, he would curl up and flex. The passed blood is dark and dull. All these are false Heat, clearly indicating a Cold syndrome. If the previous formula had been continued, full recovery would have occurred." Student Ningyu wrote to me again: "Yesterday, hearing your discussion on the truth and falsity of Deficiency and Excess, only one who has drunk from the Upper Pool (a metaphor for profound medical wisdom) could speak thus. I hope you record this to instruct future generations."