佥宪韩约斋老先生夫人，向来夜分脐腹疼极甚，必用炒盐熨之，两时久乃止。次日必头
痛，
两太阳如箍，遍身亦疼，此上盛下虚症也。先用柴胡、川芎、粉草、酒连、薄荷、天麻、橘
红、茯苓、半夏、蔓荆子、水煎服。数帖头痛全止，惟咳嗽胸前略痛。两寸脉浮滑，两尺弱
。再用鹿角霜、鹿角胶、补骨脂、远志、枸杞子、金铃子、香附子，炼蜜为丸，梧桐子大，
每空心及下午食前淡盐汤送下七十丸而瘳。
孝廉丁震澜丈令郎，才二岁，疟母上壅，咳嗽，每午后发热至子丑时乃退，终日啼哭不
止，鹅
口白屑，神气大弱，痘后遍身疮疥未愈。多方治之不效。有炙之者，有 之者，有以膏药贴
之者，种种施之，全然不应。予曰∶乳下婴孩，脏腑薄脆，不可乱攻乱补，参 足以增其嗽
，炙 适以惊其神，安能取效？予教以白术、鳖甲各一钱五分，青蒿、麦芽、陈皮各八分，
乌梅一枚，贝母、知母各六分，甘草三分，八帖痊愈。
武进令君孙康宇公子室，臧位宇丈女也。年十六，初产女，艰苦二日，偶感风邪，继
食面
饼。时师不察，竟以参术投之，即大热谵语，口渴，汗出如洗，气喘泄泻，泻皆黄水无粪，
一日夜不计遍数，小水短少，饮食不进，症甚危恶。时当六月初旬，女科见热不除，乃投黄
芩、芍药、黄连寒凉之剂，诸症更甚。又以参术大剂、肉果、干姜等止泻。一日计用人参二
两四钱，泻益频，热益剧，喘汗转加，谵语不彻口。医各缚手辞谢曰∶书云汗出如油，喘而
不休，死症也。又汗出而热不退，泻而热不止，且谵语神昏，产后而脉洪大，法皆犯逆，无
生路矣。惟附子理中汤，庶侥幸于万一。适予为顾太守肖溪公延至，即过为一诊，六脉乱而
无绪，七八至，独右关坚硬。踌躇久之。因思暑月汗出乃常事，但风邪面食瘀血皆未消熔，
补剂太骤。书云∶蓄血如见鬼。治当消瘀血、面食，解其暑气，犹可图生，勿遽弃也。有臧
玉宇者，位宇堂兄也。医有雅致，深以予言为然，而速予措剂。予曰；剂凭症发，难拘常套
，不常之症，须用不常之药。乃用益元散六钱，解暑气清热为君。仲景云∶渴而小便不利者
，当先利其小便。况水泻，尤当用之为君也。以糖球子三钱为臣；红曲、泽兰叶各一钱五分
，消瘀血、安魂为佐；香附一钱五分为裨佐；橘红、半夏曲、茯苓，乃统理脾气为使；京三
棱五分，消前参、术，决其壅滞为先锋。水煎饮之。饮下即稍睡，谵语竟止。连进二剂，其
晚大便减半。次日仍用前剂饮之，其夜热大减，大便只二次，有黄粪矣。恶露略行黑血数枚
。又次日诊之，脉始有绪，神亦收敛，进粥一盏，大有生意。前方减去京三棱、红曲，加白
扁豆。其夜大便一次，所下皆黑粪。从此热尽退，大便亦实。改用四君子汤加益元散、青蒿
、香附、白扁豆、酒炒白芍药、炮姜，调理而平。
佥宪韩约斋老先生的夫人，向来在半夜时分脐腹部疼痛非常剧烈，必须用炒热的盐袋熨烫，经过两个时辰（约四小时）后才能停止。第二天必定出现头痛，两侧太阳穴像被箍住一样紧痛，全身也感到疼痛，这是上盛下虚的证候。先用柴胡、川芎、粉甘草、酒黄连、薄荷、天麻、橘红、茯苓、半夏、蔓荆子，加水煎服。服用几帖后头痛完全停止，只剩下咳嗽和胸前轻微疼痛。此时两手寸脉浮滑，两手尺脉弱。再用鹿角霜、鹿角胶、补骨脂、远志、枸杞子、金铃子、香附子，炼蜜制成丸药，大小如梧桐子，每次空腹及下午饭前用淡盐水送服七十丸而痊愈。
孝廉丁震澜先生的公子，才两岁，患有疟母（脾脏肿大），气机上壅，咳嗽，每天午后发热直到子丑时（深夜23点至凌晨3点）才退热，整天啼哭不止，口腔内有鹅口疮白屑，精神气息非常虚弱，出痘疹后遍身的疮疥尚未痊愈。多方治疗都不见效。有的医生采用艾灸，有的采用针刺，有的用膏药贴敷，种种方法都用了，全然没有反应。我说：吃奶的婴儿，脏腑薄弱脆弱，不可胡乱攻伐或进补，人参足以增加他的咳嗽，艾灸恰好会惊扰他的神气，怎么能取得疗效呢？我教导使用白术、鳖甲各一钱五分，青蒿、麦芽、陈皮各八分，乌梅一枚，贝母、知母各六分，甘草三分，服用八帖后痊愈。
武进县令孙康宇公子的妻子，是臧位宇先生的女儿。十六岁，刚生下女儿，经历了两天的分娩艰辛，偶然感受风邪，接着吃了面饼。当时的医生不仔细诊察，竟然用人参、白术投喂，随即出现高热、说胡话、口渴、出汗如洗、气喘、泄泻，泻下的都是黄色水样便而无粪便残渣，一天一夜不计其数，小便短少，饮食不进，病情非常危重恶劣。当时正值六月初旬，妇科医生见热不退，就投入黄芩、芍药、黄连等寒凉药物，各种症状更加严重。又用大量人参、白术、肉豆蔻、干姜等来止泻。一天内共用人参二两四钱，腹泻反而更频繁，发热更剧烈，气喘出汗加重，说胡话不停歇。各位医生束手无策，推辞谢客说：医书说汗出如油，气喘不停，是死症。又是汗出而热不退，腹泻而热不止，且说胡话神志昏迷，产后脉象洪大，这些治法都犯了逆证，没有生路了。只有附子理中汤，或许能侥幸有一线生机。恰逢我为顾太守肖溪公聘请去诊治，立即过去诊脉，六脉杂乱无章，脉搏跳动七八次一息，唯独右关脉坚硬。犹豫了很久。于是想到暑月出汗是常事，但风邪、面食积滞、瘀血都没有消除，补益药太急骤。医书说：蓄血证会出现幻觉如见鬼怪。治疗应当消除瘀血、面食积滞，解除暑气，还可以图谋生机，不要轻易放弃。有一位叫臧玉宇的人，是位宇的堂兄，行医有雅致，非常赞同我的言论，并催促我开方。我说：方剂根据病症制定，难以拘泥于常规套路，不寻常的病症，须用不寻常的药物。于是使用益元散六钱，作为君药以解暑气清热。张仲景说：口渴且小便不利者，应当先通利小便。何况是水样腹泻，尤其应当用它作为君药。以糖球子三钱为臣药；红曲、泽兰叶各一钱五分，作为佐药以消瘀血、安魂；香附一钱五分作为辅佐；橘红、半夏曲、茯苓，作为使药以统理脾气；京三棱五分，作为先锋以消除之前人参、白术造成的壅滞。加水煎服。喝下后立即稍微入睡，说胡话竟停止了。连续服用两剂，当晚大便次数减半。第二天仍用前方服用，当晚热势大减，大便只有两次，且有黄色粪便了。恶露略行，排出黑色血块数枚。又过一天诊脉，脉象开始有序，神气也收敛，喝下一盏粥，大有生机。前方减去京三棱、红曲，加入白扁豆。当晚大便一次，所排出的都是黑色粪便。从此热势完全消退，大便也变得成形。改用四君子汤加益元散、青蒿、香附、白扁豆、酒炒白芍药、炮姜，调理而平复。
Madam, wife of Mr. Han Yuezhai (Official Title: Qianxian), who always suffered from severe pain in the umbilical and abdominal regions late at night, requiring hot salt compresses for two shi (approx. four hours) to relieve it. The next day, she invariably experienced headache, tightness in both Taiyang acupoints (lateral temples), and generalized body ache. This is a syndrome of excess above and deficiency below. Initially, Chaihu (Bupleuri Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Fencao (Glycyrrhizae Radix et Rhizoma Preparata), Jiu Lian (Coptidis Rhizoma prepared with wine), Bohe (Menthae Haplocalycis Herba), Tianma (Gastrodiae Rhizoma), Juhong (Citri Reticulatae Pericarpium), Fuling (Poria), Banxia (Pinelliae Rhizoma Preparatum), and Manjingzi (Vittariae Spora) were decocted in water and administered. After several doses, the headache completely ceased, leaving only cough and slight chest pain. The Cun positions of both wrists presented floating and slippery pulses, while the Chi positions were weak. Subsequently, Lu Jiao Shuang (Cornu Cervi Degelatinatum), Lu Jiao Jiao (Colla Cornus Cervi), Buguzhi (Psoraleae Fructus), Yuanzhi (Polygalae Radix), Gouqizi (Lycii Fructus), Jinlingzi (Meliae Fructus), and Xiangfuzi (Cyperi Rhizoma) were processed with refined honey into pills, sized like wutong seeds. Seventy pills were taken on an empty stomach and before afternoon meals, washed down with light salt water, resulting in recovery.
The young son of Mr. Ding Zhenlan (Xiaolian degree holder), aged only two, suffered from Nuomu (malaria-induced splenomegaly) with qi stagnation upward, cough, fever starting in the afternoon and subsiding around Zi-Chou hours (11 PM–3 AM), incessant crying, oral thrush (white patches resembling goose mouth), significant depletion of spirit and qi, and unresolved sores and scabies all over the body following smallpox/variolous eruption. Various treatments proved ineffective. Some employed moxibustion, others acupuncture, and some applied plaster; all methods failed. I stated: "Infants nursing at the breast have thin and fragile zang-fu organs; one must not indiscriminately attack or tonify. Ginseng may exacerbate his cough, and moxibustion may startle his spirit; how can these yield results?" I prescribed Baizhu (Atractylodis Macrocephalae Rhizoma) and Biejia (Trionycis Carapax et Plastrum), each 1.5 qian; Qinghao (Artemisiae Annuae Herba), Maiya (Hordei Fructus Germinatus), and Chenpi (Citri Reticulatae Pericarpium), each 0.8 qian; one Wumei (Mume Fructus); Beimu (Fritillariae Thunbergii Bulbus) and Zhimu (Anemarrhenae Rhizoma), each 0.6 qian; and Gancao (Glycyrrhizae Radix et Rhizoma) 0.3 qian. Eight doses resulted in complete recovery.
The wife of the son of Sun Kangyu, Magistrate of Wujin, was the daughter of Mr. Zang Weiyu. At sixteen years old, after delivering a daughter following two days of difficult labor, she accidentally contracted wind-pathogen and subsequently consumed wheat cake. The physicians at the time failed to examine carefully and administered Ren Shen (Ginseng Radix et Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma). Immediately thereafter, she developed high fever, delirium, thirst, profuse sweating as if washed, panting, and diarrhea consisting of yellow watery stool without fecal matter, occurring countless times within a day and night. Urine output was scant, food intake ceased, and the condition became critical. It was early June. The gynecological physician, seeing persistent heat, administered cold-natured herbs such as Huang Qin (Scutellariae Radix), Shaoyao (Paeoniae Radix Alba), and Huang Lian (Coptidis Rhizoma), causing symptoms to worsen. Then, large doses of Ren Shen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Rou Dou Kou (Myristicae Semen), and Gan Jiang (Zingiberis Rhizoma Preparatum) were used to stop diarrhea. In one day, 2 liang 4 qian of Ren Shen (Ginseng Radix et Rhizoma) was used, yet diarrhea increased in frequency, heat intensified, panting and sweating worsened, and delirium persisted. Physicians, hands tied by convention, declined further treatment, citing: "The classics state that sweat like oil and unceasing panting indicate a fatal case." Furthermore, sweat with unremitting heat, diarrhea with unremitting heat, delirium with coma, and a洪大 (surging-large) pulse postpartum are all contraindications with no hope of survival. Only Fuzi Lizhong Tang (Aconite Decoction to Regulate the Middle) might offer a slim chance. Fortunately, I was invited by Governor Gu Xiaoxi to treat him, and upon examining her, I found chaotic and disordered pulses throughout, beating seven to eight times per respiration, with the Right Guan position being particularly hard. After much deliberation, I reasoned that sweating in summer is common, but wind-pathogen, food stagnation from wheat cake, and blood stasis had not resolved; the tonification was too abrupt. The classics state: "Blood accumulation manifests as hallucinations, seeing ghosts." Treatment should focus on resolving blood stasis and food stagnation, clearing summerheat, and there is still hope for life; do not abandon her easily. Mr. Zang Yuyu, elder brother of Weiyu, a physician of refined taste, strongly agreed with my assessment and urged me to prescribe. I said: "Prescriptions follow symptoms and cannot be bound by routine; unusual symptoms require unusual medicines." Thus, Yi Yuan San (Benefit Primordial Powder) 6 qian was used as the Sovereign herb to resolve summerheat and clear heat. Zhang Zhongjing stated: "For those with thirst and difficulty urinating, one should first promote urination." Especially in watery diarrhea, this is essential as the Sovereign. Tang Qiu Zi (Sugar Ball Fruit) 3 qian served as the Minister; Hong Qu (Monascus Ruber) and Zelan Ye (Lycopus Lucidus Herba), each 1.5 qian, served as Assistant to resolve blood stasis and calm the spirit; Xiangfu (Cyperi Rhizoma) 1.5 qian served as Assistant-Assistant; Juhong (Citri Reticulatae Pericarpium), Banxia Qu (Pinelliae Fermented Rhizoma), and Fuling (Poria) served as Envoy to regulate spleen qi; Jing Sanleng (Sparganii Rhizoma) 0.5 qian served as Vanguard to break the stagnation caused by previous Ren Shen (Ginseng Radix et Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma). Decocted in water and drunk. Upon ingestion, she slept slightly, and delirium stopped. Two consecutive doses reduced bowel movements by half that night. The next day, the same prescription reduced heat significantly, with only two bowel movements containing yellow stool. Lochia flowed slightly, expelling a few dark blood clots. On the third day, pulses became ordered, spirit converged, and she drank a bowl of porridge, showing signs of vitality. Jing Sanleng (Sparganii Rhizoma) and Hong Qu (Monascus Ruber) were removed from the previous formula, and Bai Biandou (Dolichoris Lablab Semen Album) added. That night, one bowel movement occurred, passing black stool. Thereafter, heat completely subsided, and stools solidified. Si Jun Zi Tang (Four Gentlemen Decoction) combined with Yi Yuan San (Benefit Primordial Powder), Qinghao (Artemisiae Annuae Herba), Xiangfu (Cyperi Rhizoma), Bai Biandou (Dolichoris Lablab Semen Album), Jiu Chao Baishao Yao (Paeoniae Radix Alba prepared with wine), and Pao Jiang (Zingiberis Rhizoma Preparatum) was used for regulation until stability was achieved.