查少川公，年四十三，夙有哮喘疾，每发则遍身如燎，气贲贲上腾，息息短促，候中痰
声响
若汤沸。经七昼夜，汗而渐平。居常嗜饮，通宵不辍，醉后纵欲，不避风寒。族中有教以石
膏、麻黄、杏仁、枳壳、细茶各一两，作大剂饮之，名曰五虎汤，喘至即以此御之，随饮而
止，屡发屡进，应若桴鼓。公喜甚，持为保命丹。寓大通一月，邑中麻黄、石膏为之缺市。
讵
知情欲无穷，胃中冲和有限，三年之间，饮五虎者殆不可以数计，而胃中之冲和者，亦不知
损之何若也。因而腹大若复箕，两腿光肿如柱，内外 、疥疮中清水涓涓流之不竭，昼夜腥
气逼人，不能伏枕而卧者五越月。自仪(征)杨(州)医起，问京口(镇江)之医如何如何，张者
最良，遍延治之弥月，卒无一验。又舍京口抵姑苏，历嘉杭，凡有名者，悉迎疗之，而势益
剧，舁回至岩镇，镇医擅名者吴与方也。先诣吴，吴骇辞不治；就方，方诊视久之曰∶公疾
非常，必得非常人乃可已。公曰∶先生世家大方，昔在两淮且人人引领，愿得先生一诊为快
，何我弃而使需非常人也？今世非常人舍先生其谁？方曰∶嘻，公贵邑孙生生者，名动三吴，
今归不出，亟迎治之，或可无恙。公扣孙生生居何里，状何若，方书予姓氏里居与之。归即
恳程公山氏绍介迓予，时长至后一日也。至则见公坐高椅之上，气高而喘，身热而烦，复以
绵被，足纳火箱，前后左右，环火五盆，首戴绒帽，帽外笼以貂套，套外仍束一帕，鼻用绒
套笼之。门设重幔，犹凛凛怯寒。诊其脉浮大无力，睇其色，白中隐青。徐问公曰∶恶寒
身热从何时起？公曰∶十日。予曰∶据色据脉，予已得其概矣，公历数府名家，认为何症，
拟何汤剂，请详述之。公曰∶众论落落不一，先生学博见真，愿惟命。予曰∶公疾乃气虚中
满，法当温补下元。人徒知利小水，不知小水不利者由下焦之气不充，不能渗从膀胱故道而
行，若利之急，则汛滥而横流肌肤，下于阴囊，甚则胀裂，崩塌而出，若使下焦壮盛，则小
水自通。譬之甑炊釜底，水火交旺，甑中之气自然蒸腾，若雾若露。《内经》曰∶上焦开发
，宣五谷味，熏身充肤、泽毛，若雾露之灌溉，是谓气。故曰上焦如雾也。清阳升则浊阴降
，降下则为小水，故曰下焦如渎也。渎者，水也。言下焦为决水之官，水道出焉者是也。人
之汗即此雾露之气，小水即降下之气。盖气者水之母，由气化而为水，故又曰气化则能出矣
。融众理而观之，总由下焦元气壮盛，斯能升降变化，清阳升，浊阴降，即地天交之泰。阳
不升，阴不降，即天地不交之否。痞者，塞也。此胀满之所由生也。公之疾起于五虎汤，致
脏寒生满病也。公曰∶善。吾乃今始知致病之源。第近来身热、手热、膈内焦辣，而外恶寒
竟不解，孰为热、孰为寒也？予曰∶仲景云伤寒必恶寒，由寒邪在表而然，合先散之。胸膈
焦辣者，乃阴盛格阳，虚阳之火被寒气驱逼上行，非真热也。经云水流湿、火就燥，但得下
元一温，热自下行。公曰∶然，惟先生命剂。予以紫苏、马蹄莘、炙甘草、防风、白豆仁、
苍术、陈皮、人参、羌活、生姜，一帖而得微汗。悉彻去环列之火，仅存足底一盆，首上所
覆之帕也去。独鼻寒如初，乃用防风、黄 二两煎汤置器中，令熏其鼻，饮顷而止，一日凡
三熏，次日鼻套也除。呕恶不止，用人参温胆汤加丁香进之，一帖而止。又谓鲤鱼能利水，
一日尽二斤半。夜胀极，乃告急于予。予曰∶病势如是，固乃纵恣若此，等闭之剂曷能消释
？沉思久之，以平胃散一两，入橄榄肉一两，水煎饮之，两剂而定。独腹胀，小水不利，不
能伏枕为苦。乃以附子理中汤加砂仁、补骨脂、赤小豆、桂心，连进四帖，小水略长。继以
尊重丸日三服之，每服五丸，五日后小水通利，可贴席而睡。守此调理，腹胀渐消，两月
大平，三月而公出市。市中人信予实从公始。
查少川先生，四十三岁，素来患有哮喘病。每次发作时，全身感觉像火烧一样，气机壅盛上逆，呼吸急促短浅，脉象中痰鸣声响亮，如同水沸腾一般。经过七昼夜的喘息，通过发汗才逐渐平息。他平时嗜好饮酒，通宵达旦不停止，醉酒后纵欲行房，不躲避风寒。族中有人教他用石膏、麻黄、杏仁、枳壳、细茶各一两，煎煮成大剂量的汤药服用，名叫“五虎汤”，哮喘一发作就用这个方子来抵御，喝完随即停止，屡次发作屡次服用，效果立竿见影（如槌击鼓应）。先生非常高兴，将其视为保命仙丹。寓居大通一个月期间，县城中麻黄和石膏因此缺货断市。
哪里知道情欲是无穷的，而胃中的冲和之气是有限的。三年之间，饮用五虎汤的次数多得无法计算，但胃中的冲和之气，也不知道被损伤到了什么程度。于是导致腹部大得像倒扣的簸箕，两条腿光亮肿胀如同柱子，内外皮肤溃烂，疥疮中清水涓涓流出，日夜腥气逼人，不能伏枕睡觉长达五个月。从仪征到扬州请医生，又询问京口（镇江）的医生如何如何，认为姓张的最为高明，遍请医治了一个月，最终毫无疗效。又离开京口抵达姑苏，经过嘉兴、杭州，凡是名望高的医生，都迎接来治疗，但病情更加严重，抬回岩镇，镇上名医是吴与方。先去拜访吴医生，吴医生惊恐推辞不治；就去见方医生，方医生诊视很久说：“先生的病非同寻常，必须得到非凡的人才能治愈。”先生说：“先生出身于大方之家，以前在两淮地区人人仰慕，希望能得到先生的一诊以解心头之快，为何抛弃我而让我寻求非凡之人呢？当今世上非凡的人除了先生还有谁？”方医生说：“唉，先生贵乡的孙生生先生，名声震动三吴之地，如今回乡不出门，赶快迎接他来治疗，或许可以平安无事。”先生询问孙生生住在哪个里巷，长什么样，方医生写下我的姓氏、里居交给他。回来后便恳请程公山氏介绍迎接我，当时是大寒过后第一天。
到达后见到先生坐在高椅上，气息高亢而喘促，身体发热而烦躁，又盖上绵被，脚放入火箱，前后左右环绕着五盆火，头上戴着绒帽，帽外罩着貂皮套，套外仍束着一条帕子，鼻子用绒套笼住。门口设置多重帷幔，仍然凛冽怯寒。诊察他的脉象浮大无力，观察他的面色，白色中隐现青色。慢慢问先生说：“恶寒和身体发热是从什么时候开始的？”先生说：“十天了。”我说：“根据面色和脉象，我已经大概了解病情了，先生历经几府的名家诊治，认为是什麽病症，拟定什麽汤剂，请详细叙述。”先生说：“众人的议论各不相同，先生学识渊博见解独到，愿意听从您的命令。”我说：“先生的病乃是气虚导致的腹中胀满，治法应当温补下元。人们只知道通利小便，却不知道小便不利是因为下焦之气不充盛，不能渗入膀胱通道而行，如果急于利小便，则水流泛滥横流肌肤，下注阴囊，甚至胀裂崩塌而出，如果使下焦壮盛，则小便自然通畅。譬如蒸饭的甑在釜底燃烧，水火交旺，甑中的气自然蒸腾，像雾像露。《内经》说：‘上焦开发，宣五谷味，熏身充肤、泽毛，若雾露之灌溉’，这叫做气。所以说上焦如雾。清阳上升则浊阴下降，下降就成为小便，所以说下焦如渎。渎就是水道。说的是下焦是决渎之官，水道由此而出。人的汗液就是这种雾露之气，小便就是下降之气。盖气是水之母，由气化而为水，所以又说‘气化则能出矣’。综合各种道理来看，总归是由于下焦元气壮盛，才能升降变化，清阳升，浊阴降，这就是地天交泰。阳气不升，阴气不降，这就是天地不交的否卦。痞，就是闭塞。这就是胀满产生的原因。先生的病起于五虎汤，导致脏腑寒冷产生胀满病。”先生说：“好，我现在才知道致病的根源。只是近来身体热、手热、胸膈内焦辣，而体外恶寒竟然不解，哪一个是热，哪一个是寒呢？”我说：“仲景说伤寒必定恶寒，是因为寒邪在表所致，应当先发散它。胸膈焦辣，乃是阴盛格阳，虚阳之火被寒气驱逼上行，不是真热。经云‘水流湿、火就燥’，只要下元一温暖，热气自然下行。”先生说：“对，只听先生处方用药。”
我给予紫苏、马蹄莘、炙甘草、防风、白豆仁、苍术、陈皮、人参、羌活、生姜，一帖药就出了微汗。全部撤去环绕的火盆，仅保留脚底一盆，头上的帕子也去掉。唯独鼻子还像原来一样怕冷，于是用防风、黄芪二两煎汤放在容器中，让蒸汽熏鼻子，喝一顿饭工夫就停止，一天熏三次，第二天鼻套也除去了。呕吐不止，用人参温胆汤加丁香服用，一帖就停止了。又听说鲤鱼能利水，一天吃掉了二斤半。夜里胀得厉害，于是向我告急。我说：“病情如此严重，固然因为您放纵恣意至此，等闭阻的药剂怎么能消除呢？”沉思良久，用平胃散一两，加入橄榄肉一两，水煎服用，两剂后安定下来。唯独腹胀，小便不利，不能伏枕睡觉成为痛苦。于是用附子理中汤加砂仁、补骨脂、赤小豆、桂心，连续服用四帖，小便稍微增多。继而又服用尊重丸，每天服三次，每服五丸，五天后小便通利，可以贴着席子睡觉。坚守此法调理，腹胀渐渐消退，两个月后基本平复，三个月后先生走出集市。市中人相信我是从先生这里开始确立声誉的。
Mr. Zha Shaochuan, aged forty-three, had a long-standing history of asthma (asthma). Each time it attacked, his whole body felt as if burning, qi (vital energy) surged upward, breathing was short and rapid, and the pulse indicated loud phlegm sounds like boiling water. After seven days and nights of wheezing, he gradually calmed down through sweating (diaphoresis). He usually indulged in drinking alcohol without stopping all night, engaged in sexual intercourse after getting drunk, and did not avoid wind and cold. A clan member taught him to use Shi Gao (Gypsum Fibrosum), Ma Huang (Ephedrae Herba), Xing Ren (Armeniacae Semen Amarum), Zhi Qiao (Aurantii Fructus), and Xi Cha (Fine Tea), each one liang, decocted into a large dose and drunk, named "Wu Hu Tang" (Five Tigers Decoction). Whenever asthma struck, he used this to ward it off; upon drinking it, the attack stopped immediately. It worked repeatedly with each recurrence, effective as quickly as a drumstick hitting a drum. He was very pleased and regarded it as a life-preserving elixir. During his stay in Datong for one month, Ma Huang and Shi Gao became scarce in the county market.
Little did he know that desires are infinite, while the harmonious qi (vital energy) in the stomach is limited. Within three years, the number of times he drank Wu Hu Tang could hardly be counted, yet no one knew how much the harmonious qi in his stomach had been damaged. Consequently, his abdomen became distended like an inverted winnowing basket, and both legs swelled smoothly and stiffly like pillars. Clear fluid oozed incessantly from sores and ulcers inside and outside his body, emitting a fishy odor day and night, making it impossible for him to sleep on a pillow for five months. Doctors were summoned from Yizheng to Yangzhou, and inquiries were made about doctors in Jingkou (Zhenjiang); Mr. Zhang was considered the best. He was consulted extensively for a month, but there was no effect whatsoever. Then, leaving Jingkou for Gusu, passing through Jiaxing and Hangzhou, all famous doctors were invited to treat him, but the condition worsened. He was carried back to Yanzhen Town, where the renowned local doctor was Wu Yu Fang. First, he visited Dr. Wu, who declined out of fear; then he went to Dr. Fang, who examined him for a long time and said, "Your illness is extraordinary; only an extraordinary person can cure it." Mr. Zha said, "Sir comes from a family of great physicians; previously in Lianghuai, everyone looked up to you. I wish to enjoy your diagnosis. Why abandon me and make me seek an extraordinary person? Who else in this world is extraordinary but you?" Dr. Fang said, "Alas, Mr. Sun Shengsheng from your noble hometown has a reputation shaking the Three Wu regions. He has returned home and stays indoors. You must urgently invite him to treat you, or you may recover safely." Mr. Zha asked which village Mr. Sun Shengsheng lived in and what he looked like. Dr. Fang wrote down my surname, residence, and location and gave it to him. Upon returning, he earnestly requested Mr. Cheng Gongshan to introduce and welcome me. This was one day after the Major Cold solar term.
Upon arrival, I saw Mr. Zha sitting on a high chair, breathing heavily and wheezing, his body hot and restless. He was wrapped in cotton quilts, his feet placed in a fire box, surrounded by five basins of fire front, back, left, and right. He wore a velvet hat, covered with a marten fur hood, and over that, a cloth band. His nose was covered with a velvet sleeve. Heavy curtains were set at the door, yet he still shivered with fear of cold. His pulse was floating, large, and powerless. His complexion showed white with hidden bluish hues. I slowly asked, "When did the aversion to cold and body heat begin?" He replied, "Ten days ago." I said, "Based on the complexion and pulse, I have grasped the general picture. Having seen many famous doctors in several prefectures, what diagnosis did they give, and what prescriptions did they propose? Please describe them in detail." He said, "The opinions varied greatly. Sir's learning is profound and insight true; I am willing to follow your command." I said, "Your illness is abdominal fullness due to qi deficiency. The treatment method should be to warm and tonify the lower yuan (lower energizer). People only know how to promote urination, not realizing that difficulty in urination stems from insufficient qi in the lower jiao (lower burner), which cannot seep into the bladder channel to flow. If one promotes urination too hastily, water will overflow and flood the skin, flowing down to the scrotum, even causing swelling, rupture, and collapse. If the lower jiao is strengthened, urination will naturally become smooth. Imagine a steamer pot: when fire burns underneath, the water and fire intensify, and the qi within the steamer naturally rises like mist or dew. The *Neijing* states: 'The upper jiao opens and develops, disseminates the flavors of grain and food, warms the body, fills the flesh, moistens the hair, like mist and dew irrigating.' This is called qi. Thus, it is said that the upper jiao is like mist. When clear yang rises, turbid yin descends; descending, it becomes urine. Thus, it is said that the lower jiao is like a ditch. Ditch refers to water channels. It means the lower jiao is the official of drainage, from which waterways emerge. Human sweat is this mist and dew qi; urine is the descending qi. Qi is the mother of water; water is transformed from qi. Hence, it is also said: 'Qi transformation allows for excretion.' Viewing all principles together, the root cause is the robustness of the primordial qi in the lower jiao, enabling ascending and descending changes. Clear yang rises, turbid yin descends, representing the harmony of Heaven and Earth (Tai hexagram). If yang does not rise and yin does not descend, it represents the stagnation of Heaven and Earth (Pi hexagram). Pi means obstruction/blockage. This is how distension and fullness arise. Your illness originated from Wu Hu Tang, leading to cold in the zang organs and generating fullness disease." He said, "Good. Now I finally know the source of my illness. However, recently my body is hot, hands are hot, and there is a burning sensation in the chest and diaphragm, while external aversion to cold persists. Which is heat and which is cold?" I said, "Zhongjing stated that cold damage (Shanghan) must involve aversion to cold because the pathogenic cold is in the exterior; it should first be dispersed. The burning sensation in the chest and diaphragm is due to yin excess repelling yang, where deficient yang fire is driven upward by cold pathogens; it is not true heat. The classics say 'water flows to wetness, fire goes to dryness.' Once the lower yuan is warmed, the heat will naturally descend." He said, "Yes, I leave the prescription entirely to you."
I prescribed Zi Su Ye (Perillae Folium), Ma Ti Xin (likely a local herb or typo for another, kept as is), Zhi Gan Cao (Prepared Licorice Root), Fang Feng (Saposhnikoviae Radix), Bai Dou Ren (Arecae Seed), Cang Zhu (Atractylodis Rhizoma), Chen Pi (Citri Reticulatae Pericarpium), Ren Shen (Ginseng Radix), Qiang Huo (Notopterygii Rhizoma et Radix), and Sheng Jiang (Zingiberis Rhizoma Recens). One dose resulted in slight sweating. All surrounding fires were removed, leaving only one basin under the feet, and the head covering was taken off. Only the nose remained sensitive to cold. Therefore, I used Fang Feng and Huang Qi (Astragali Radix), two liang each, decocted in water, placed in a vessel, and let the steam fumigate the nose. After the time it takes to drink a meal, it stopped. Fumigation was done three times a day. The next day, the nose cover was also removed. Vomiting persisted, so Ren Shen Wen Dan Tang (Ginseng Warm Gallbladder Decoction) with Ding Xiang (Caryophylli Flos) was administered, stopping vomiting after one dose. Hearing that carp promotes urination, he ate two jin half ounces of carp in one day. At night, the distension became extreme, and he urgently sought my help. I said, "With the disease severity like this, undoubtedly due to such indulgence, how can astringent agents resolve it?" After deep contemplation, I used Ping Wei San (Peaceful Stomach Powder), one liang, mixed with one liang of olive flesh, decocted in water and drunk. Two doses stabilized the condition. However, abdominal distension and difficulty in urination prevented him from sleeping on a pillow. Therefore, I used Fu Zi Li Zhong Tang (Aconite Regulate the Middle Decoction) added with Sha Ren (Amomi Fructus), Bu Gu Zhi (Psoraleae Fructus), Chi Xiao Dou (Vigna Semen Rubrum), and Gui Xin (Cinnamomi Ramulus), administered continuously for four doses, resulting in slightly increased urination. Subsequently, Zun Zhong Wan (Respect Pill) was taken three times daily, five pills per dose. After five days, urination became smooth, allowing him to sleep directly on the mat. Adhering to this regimen, abdominal distension gradually subsided. In two months, he was mostly recovered; in three months, he walked in the marketplace. The townspeople believed my reputation began with treating Mr. Zha.