岩镇郑景南丈，病卧年余，百治不效。昔体丰腴，今瘦骨立，饮食少进，新都名士皆辞
不治
。其家闻昔年方士荣孺人蛊症，时师亦皆辞去，予为起之，因征余治。时则六月望也。诊其
脉，左弦大，右关滑大，两尺俱无，恶心，腹瘦削状如仰瓦，肠鸣如雷，昼夜不住，小水不
利，肌肤及眼珠色若黄金，腹中有块如盘，动跳不止，足膝以下皆冷，饮食不入。予详思其
病机，昔肥而今瘦者，痰也。形虽瘦，而目炯炯有神，先以五饮汤姑试之，以观其势，再为
加减。因用族复花八分，破故纸一钱，肉桂三分，白术、茯苓、泽泻、陈皮、半夏各八分，
生姜三片，水煎服之。二帖，恶心肠鸣皆止。次早饮食稍进，举家欣欣色喜。令岳程钟山公
，于予为石交，闻病有起意，心殊异之，不知为予，因而过访。见予，抚掌大叫称快，曰∶
吾固知是公也。指其甥而语之∶此即所尝与尔曹言者，闻久为西吴缙绅递留，不意今归，城
吾婿之幸也。相与谈对，两日而别。别之时，景南饮食稍加，小水利，肌肤面目黄气退，渐
有生机。不虞逾半月，为拂意事所激而怒，复吐痰，不思饮食，家人惊惶无措，亟请予诊，
两寸滑大，左关弦劲搏指，右关亦滑大有力，两尺沉微，予语之曰∶病甚重，脉非前比，且
不敢以万全许，第尽吾心尔。病以药力而回，君之福也。时为七月之朔，予因留视七日，日
进一剂，剂以人参、陈皮、半夏、茯苓、香附、白豆仁、黄连、旋复花、麦芽、甘草与服。
服三日，恶心止，大便有稠痰下，其中间有瘀血，此皆大怒所致。故经云∶怒则伤肝，甚则
呕血。并下泄上吐，亦或有红点子在痰中吐出，是其征也。后改用六君子汤，加麦芽、黄连
、枇杷叶、白扁豆调理，病势 向安，腹中如盘之块亦渐消去，大仅如指耳。肌肉亦生，
能下榻举足以步。市上之人称奇。
后闻腊月又被郁怒，颈发瘰 ，外科以烂药点溃，服蜈蚣败毒药，卒莫能收口而终。伤
哉!
岩镇郑景南先生，患病卧床一年多，各种治疗均无效。他过去身体肥胖丰满，如今瘦得只剩骨头，饮食摄入很少，新都的名士们都推辞不给他治病。他的家人听说以前方士荣孺人患有蛊症（一种腹部积聚如虫咬的疑难杂症），当时的医生也都辞职离去，我接手为他诊治，于是征求我的意见。当时是六月十五日。诊察他的脉象，左手脉弦大，右手关部脉滑大，两尺部脉均摸不到，恶心，腹部消瘦凹陷状如仰放的瓦片，肠鸣声如雷响，昼夜不停，小便不通利，肌肤及眼珠颜色像黄金一样黄，腹中有肿块如盘子大小，跳动不止，足膝以下皆冷，饮食无法进入。我仔细思考其病机，过去肥胖而今消瘦，是因为痰饮。形体虽然消瘦，但目光炯炯有神，先用五饮汤姑且试治，以观察病情变化，再作加减。因此使用旋复花八分，补骨脂一钱，肉桂三分，白术、茯苓、泽泻、陈皮、半夏各八分，生姜三片，水煎服。服用两帖后，恶心和肠鸣都停止了。第二天早上饮食稍能进用，全家欣喜色喜。他的岳父程钟山公，与我结为石交（莫逆之交），听说病人有起色，心中感到惊奇，不知道是我治好的，因而前来拜访。见到我，拍手大叫称快，说：“我本来就知道是您。”指着他的外甥对他说：“这就是我曾经跟你们说过的那位先生，听说长久被西吴地区的官员挽留，没想到现在回来了，真是我女婿的幸运啊。”彼此交谈对话，两天后分别。分别时，景南的饮食稍微增加，小便通利，肌肤面目的黄色消退，逐渐有了生机。没想到过了半个月，因为遇到不顺心的事激怒发火，又呕吐痰涎，不想吃东西，家人惊慌失措，急忙请我诊治，两手寸部脉滑大，左手关部脉弦劲搏指，右手关部也滑大有力，两尺部脉沉微。我对他说：“病很沉重，脉象与之前不同，我不敢保证能完全治愈，只能尽力而为罢了。病情靠药力挽回，是你的福气啊。”当时是七月初一，我因此留下观察七天，每天进服一剂，处方用人参、陈皮、半夏、茯苓、香附、白豆仁、黄连、旋复花、麦芽、甘草配合服用。服用三天后，恶心停止，大便排出稠痰，其中夹杂有瘀血，这都是大怒所致。所以《内经》说：怒则伤肝，严重时会导致呕血。并出现上吐下泄，或者在痰中吐出带红点的血丝，这是征象。后来改用六君子汤，加入麦芽、黄连、枇杷叶、白扁豆进行调理，病势趋向安定，腹中如盘大的肿块也逐渐消去，只剩下手指大小。肌肉也开始生长，能够下床抬脚行走。市场上的人对此感到惊奇。
后来听说腊月他又因郁结愤怒，颈部发生瘰疬（淋巴结结核），外科医生用腐蚀性药物点破溃烂，服用蜈蚣等败毒药物，最终伤口不能愈合而死亡。可悲啊！
Mr. Zheng Jingnan from Yanzhen had been bedridden for over a year, with all treatments proving ineffective. He was formerly robust and plump, but now emaciated to the point of being mere bones; his food intake was minimal, and distinguished scholars from Xindu all declined to treat him. His family mentioned that in previous years, Lady Rong, the concubine of Fangshi, suffered from *Gu* syndrome (a difficult abdominal accumulation disorder resembling insect bites), and contemporary physicians had also resigned their posts. I took up the case, seeking my consultation at that time. It was the fifteenth day of the sixth lunar month. Upon palpating his pulse, the left side was wiry and large (*Xian Da*), the right Guan position was slippery and large (*Hua Da*), while both Chi positions were imperceptible. He experienced nausea, his abdomen was sunken and thin like an inverted tile, borborygmi sounded like thunder without cease day or night, urination was obstructed, skin and sclerae were yellow like gold, there was a mass in the abdomen as large as a plate pulsating incessantly, feet and knees were cold below, and he could not retain food. After carefully contemplating the pathogenesis, I reasoned that the transition from obesity to emaciation indicated phlegm-fluid retention (*Tan Yin*). Although his body was thin, his eyes were bright and spirited. I initially prescribed *Wu Yin Tang* (Five Drinks Decoction) tentatively to observe the disease's trend before making further modifications. The prescription consisted of *Inulae Flos* (Xuanfu Hua) 8 fen, *Psoraleae Fructus* (Pogu Zhi) 1 qian, *Cinnamomi Ramulus* (Rou Gui) 3 fen, *Atractylodis Rhizoma* (Baizhu), *Poria* (Fuling), *Alismatis Rhizoma* (Zexie), *Citri Reticulatae Pericarpium* (Chenpi), and *Pinelliae Tuber* (Banxia) each 8 fen, along with three slices of *Zingiberis Rhizoma Recens* (Shengjiang), decocted in water and taken orally. After two doses, nausea and borborygmi ceased. By the next morning, food intake slightly improved, and the whole family was delighted. His father-in-law, Mr. Cheng Zhongshan, who was a bosom friend (*Shi Jiao*) of mine, heard of the patient's recovery and was surprised, unaware that it was due to my treatment, so he came to visit. Upon seeing me, he clapped his hands and shouted with joy, saying, "I knew it was you." Pointing to his nephew, he told him, "This is the gentleman I often spoke of to you. I heard he had been retained for a long time by gentry in West Wu, but unexpectedly returned; this is indeed the fortune of my son-in-law." We conversed for two days before parting. At the time of separation, Jingnan's diet had slightly increased, urination was smooth, the jaundice on his skin and face had faded, and signs of vitality gradually returned. Unexpectedly, more than half a month later, provoked by frustrating events, he became angry, vomited phlegm again, lost his appetite, and his family panicked. They urgently requested my diagnosis. The Cun positions on both wrists were slippery and large, the left Guan position was wiry, stiff, and beating against the finger, the right Guan position was also slippery, large, and forceful, while both Chi positions were deep and minute. I said to him, "The illness is severe, and the pulse differs from before. I dare not promise a complete cure, but I will do my utmost. The recovery is due to the efficacy of the medicine and your good fortune." It was the first day of the seventh lunar month. I stayed to observe him for seven days, administering one dose daily. The formula included *Ginseng Radix* (Renshen), *Citri Reticulatae Pericarpium* (Chenpi), *Pinelliae Tuber* (Banxia), *Poria* (Fuling), *Cyperi Rhizoma* (Xiangfu), *Oriza Sativa Semen* (Baidouren - likely referring to Coicis Semen/Job's tears or similar, contextually used here as Baidou Ren), *Coptidis Rhizoma* (Huanglian), *Inulae Flos* (Xuanfu Hua), *Malta* (Maiya), and *Glycyrrhizae Radix et Rhizoma* (Gancao). After three doses, nausea stopped, and thick phlegm was passed in the stool, containing blood stasis. This was caused by extreme anger. Thus, the Classics state: "Anger injures the Liver; severely, it leads to hematemesis." Upper vomiting and lower purging may also present with red spots in the sputum, which is a sign. Later, *Liu Junzi Tang* (Six Gentlemen Decoction) was modified with added *Malta* (Maiya), *Coptidis Rhizoma* (Huanglian), *Eriobotryae Folium* (Pipaye), and *Dolichos Lablab Semen Album* (Baibiandou) for regulation. The condition stabilized, and the plate-sized abdominal mass gradually diminished to the size of a finger. Muscle mass regenerated, allowing him to get out of bed and walk. People in the market marveled at this.
Later, it was reported that in the twelfth lunar month, he fell into depression and anger again, developing scrofula (*Luoli*) on his neck. A surgeon punctured and ulcerated it with caustic medicines, and he took centipede-based detoxifying drugs, but ultimately the wound failed to heal, leading to his death. How tragic!