歙潜口汪召南令郎，年十四，患蛊胀大如覆箕。经医三十余人，见症皆骇而走，独市之
幼科
汪养直者，调理数数见效。第此子溺于豢养，纵口腹，不守戒忌，病多反复。一日语召南曰
∶郎君之症，非求之孙生生者不能成功。召南曰∶闻此公多游吴浙缙绅间，何可以月日致也
？养直曰∶归矣!吾有妹适罗田，为方与石丘嫂也，旧岁患症如蛊，治经弥岁无功，生生子立全
之。吾推毂孙君者，岂有他肠，为郎君也。召南即 罗田延予。予至，日已晡矣。观病者，
腹胀
大极，青筋缕缕如蚯蚓大，上自胸脯，至上脘而止，惟喜其不下现也。脐平，四肢面目皆浮
大，两足 骨上各裂开，大出清水，一日间数为更衣易被，阴囊光肿如泡，淫淫渗湿，发寒
热，脉以手肿不能取，必推开其肿下指，重按浮而六至。予曰∶症可谓重之极矣。仅可恃者
，目瞳子有神耳，余皆险恶，将何以治？养直知予至，亟过相陪，宣言曰∶病重不必言，引
领先生久矣。幸为投剂，生死无憾。予曰∶且先为理表，若表彻稍得微汗，使肺气少利，则
小水可通。召南喜而亟请药。乃用紫苏叶、苏子、陈皮、麻黄各一钱，桑白皮八分，防风
、杏仁各七分，炙甘草、桂枝各二分，生姜三片，水煎服之。五更乃有微汗，次早面上气稍
消，胸脯青筋皆退，余症虽仍旧，机栝则可生矣。仍投前药，次日腹与四肢皆有皱纹，惟小
水未利。乃改用破故纸、苍术、赤茯苓、泽泻、桑白皮、赤小豆、桂心、木香，二帖而小水
利， 已有生意，乃以饮食过度，大便作泻，又以四君子汤加苡仁、破故纸、泽泻、山楂
、砂仁调理而全安。此症予阅历者不下数十，然青筋未有如此之粗。足时出水有之，未有出
水处如 鱼口之大，而取效亦未有如此之速。盖此子体未破而真全，故症虽重而收功速也。
数十人间有五六不能成功者，由其纵欲恣情，不守禁忌，非药之罪也，召南昆仲见人谈医，
则以不佞为称首。予笑曰∶君得无到处逢人说项斯者耶，乃汪养直亦医道中白眉，乃不收功
于后，病者不忌口过耳，于养直何尤？养直不矜己之功，亦不忮人之功，所谓忠浓长者非耶？
歙县潜口的汪召南先生的公子，年仅十四岁，患蛊胀病，腹部肿大得像倒扣的簸箕。经过三十多位医生诊治，看到症状的人都惊恐地离开，只有市井中的儿科医生汪养直，经过多次调理后见效。但是这个孩子沉溺于被过度喂养，放纵口腹之欲，不遵守饮食禁忌，导致病情反复无常。有一天汪养直对汪召南说：“公子的病症，除了找孙生生（孙一奎）治疗外，没有人能成功。”汪召南说：“听说这位先生经常游历于吴浙地区的士大夫之间，怎么能用几天时间请到他呢？”汪养直说：“他已经回来了！我的妹妹嫁到罗田，是方与石丘的嫂子，去年她患了类似蛊胀的病，治疗了一年都没有效果，是孙生生的儿子治好了她。我推荐孙君，难道有其他私心吗？完全是为了令郎啊。”汪召南随即去罗田聘请我。我到达时，天色已近黄昏。观察病人，腹胀极大，腹部青筋条条凸起，像蚯蚓一样粗，从胸脯向上延伸至中脘穴处停止，值得庆幸的是没有向下蔓延。肚脐平坦，四肢和面部都浮肿变大，两小腿胫骨上方各裂开一道口子，流出大量清水，一天之内多次更换衣物和被褥。阴囊光亮肿胀如水泡，不断渗出湿液，伴有寒热往来，由于肢体肿胀严重无法直接切脉，必须推开肿胀部位才能按压，重按时脉搏浮取而六至（每呼吸一次脉跳六次）。我说：“这个病症可以说是严重到了极点。唯一可以依靠的，是患者瞳孔中还有神气，其余都是险恶之象，该如何治疗呢？”汪养直知道我到了，急忙过来陪伴，公开说道：“病情重不必多说，引领先生来此已久。希望您能投药救治，无论生死我都无憾。”我说：“暂且先解表，如果表证解除并微微出汗，使肺气稍微通畅，那么小便就可以通利。”汪召南高兴且急切地请求开药。于是使用紫苏叶、苏子、陈皮、麻黄各一钱，桑白皮八分，防风、杏仁各七分，炙甘草、桂枝各二分，生姜三片，水煎服用。五更天时微微出汗，第二天早上面部气肿稍消，胸脯青筋全部消退，其他症状虽然依旧，但生机已经出现。继续投予前药，第二天腹部和四肢都出现了皱纹，只是小便尚未通利。于是改用补骨脂、苍术、赤茯苓、泽泻、桑白皮、赤小豆、桂心、木香，服用两帖后小便通利，已有生机，但因为饮食过量导致大便泄泻，又用四君子汤加薏苡仁、补骨脂、泽泻、山楂、砂仁进行调理，最终完全康复。这个病症我经历过的不下数十例，然而青筋如此粗大的从未见过。足部出水的情况有过，但出水口像鱼口这么大的从未见过，而且取得疗效如此迅速的也从未有过。大概因为这个孩子身体元气未破而真元保全，所以虽然病症严重但收效迅速。几十个人中间有五六人不能成功的，是因为他们纵欲肆意，不遵守禁忌，这不是药物的过错。汪召南兄弟在与人谈论医术时，都以我为首。我笑着说：“您是不是到处逢人说项斯（比喻到处替人说好话）呢？”其实汪养直也是医道中的佼佼者，只是没有在最后阶段收功，是因为病人没有忌口罢了，这又能怪罪汪养直什么呢？汪养直不夸耀自己的功劳，也不嫉妒别人的功劳，这不就是所说的忠厚长者吗？
The young master of Mr. Wang Zhaonan from Qiankou, Shexian, was fourteen years old when he suffered from Gu Zhang (Ascites/Gu Syndrome), with his abdomen swollen as large as an inverted winnowing basket. More than thirty physicians had treated him; upon seeing the symptoms, all were terrified and fled. Only Wang Yangzhi, a pediatrician in the market, achieved repeated effectiveness through conditioning. However, this boy was indulged in excessive feeding, allowed unrestrained eating and drinking, and did not observe dietary taboos, causing the illness to recur repeatedly. One day, Wang Yangzhi said to Wang Zhaonan: "For the young master's condition, only Sun Shengsheng (Sun Yikui) can achieve success." Wang Zhaonan replied: "I have heard that this gentleman often travels among the gentry in Wu and Zhejiang. How can we summon him within days?" Wang Yangzhi said: "He has returned! My sister is married to the Luo family in Luotian, who is the sister-in-law of Fang Yu Shiqiu. Last year, she suffered from a condition resembling Gu Zhang. Treatment lasted over a year without effect, until Sun Shengsheng's son cured her. My recommendation of Master Sun is not for any ulterior motive, but solely for your young master." Wang Zhaonan then went to Luotian to invite me. Upon my arrival, it was already late afternoon. Observing the patient, the abdominal distension was extreme, with blue veins protruding like earthworms, extending from the chest up to the Zhongwan (CV12) point, fortunately stopping there and not spreading downward. The umbilicus was flat. The limbs and face were edematous and enlarged. Each leg above the tibia had split open, oozing clear fluid profusely; clothes and bedding had to be changed multiple times a day. The scrotum was shiny and swollen like a blister, continuously exuding dampness, accompanied by alternating chills and fever. Due to severe swelling, the pulse could not be taken directly; one had to push aside the swelling to press, revealing a floating pulse at heavy pressure with six beats per respiration. I said: "This condition is extremely critical. The only hope lies in the spirit visible in the pupils; otherwise, the prognosis is perilous. How shall we treat it?" Knowing I had arrived, Wang Yangzhi hurriedly came to accompany me and declared publicly: "There is no need to speak of the severity of the illness; you have been invited here for a long time. Please administer medicine. Whether life or death, I shall have no regrets." I said: "First, let us resolve the exterior syndrome. If the exterior is cleared and slight sweating occurs, allowing the Lung Qi to become slightly unobstructed, then urination may become free." Wang Zhaonan was pleased and urgently requested prescription. Thus, Zi Su Ye (Perilla Leaf), Su Zi (Perilla Fruit), Chen Pi (Tangerine Peel), and Ma Huang (Ephedra Herb) were each used in 1 qian, Sang Bai Pi (Mulberry Root Bark) in 8 fen, Fang Feng (Saposhnikovia Root) and Xing Ren (Apricot Seed) each in 7 fen, Zhi Gan Cao (Honey-fried Licorice Root) and Gui Zhi (Cinnamon Twig) each in 2 fen, along with three slices of Sheng Jiang (Fresh Ginger), decocted in water and taken orally. At Wugeng (around 3-5 AM), slight sweating occurred. By the next morning, facial edema subsided slightly, and the blue veins on the chest receded. Although other symptoms remained, signs of vitality appeared. The same prescription was continued. The next day, wrinkles appeared on the abdomen and limbs, though urination was still not free. Therefore, the formula was changed to Bu Gu Zhi (Psoralea Fruit), Cang Zhu (Atractylodes Rhizome), Chi Fu Ling (Red Poria), Ze Xie (Alisma Rhizome), Sang Bai Pi (Mulberry Root Bark), Chi Xiao Dou (Adzuki Bean), Gui Xin (Cinnamon Heart), and Mu Xiang (Aucklandia Root). After two doses, urination became free, indicating renewed vitality. However, due to overeating, diarrhea occurred. The patient was then conditioned with Si Jun Zi Tang (Four Gentlemen Decoction) added with Yi Yi Ren (Coix Seed), Bu Gu Zhi (Psoralea Fruit), Ze Xie (Alisma Rhizome), Shan Zha (Hawthorn Fruit), and Sha Ren (Amomum Fruit), leading to complete recovery. I have encountered dozens of such cases, but never before have I seen blue veins so coarse. While leg edema with oozing has occurred, I have never seen an opening as large as a fish mouth, nor have I ever achieved such rapid results. This is likely because the boy's constitutional essence was intact and not depleted, so although the disease was severe, the response was swift. Among dozens of patients, five or six failed to recover because they indulged in desires and disregarded taboos; this is not the fault of the medicine. When the brothers Wang discussed medical treatment with others, they ranked me first. I smiled and said: "Are you praising me everywhere like 'telling people about Xiang Si'?" In fact, Wang Yangzhi is also a outstanding figure in the medical field, but the final cure failed because the patient did not observe dietary restrictions. What blame can be placed on Wang Yangzhi? Wang Yangzhi did not boast of his own merits, nor did he envy others' achievements. Is this not what is meant by a loyal and honest elder?"