吉长乃室。新秋病洒淅恶寒。寒已发热。渐生咳嗽。然病未甚也。服表散药不愈。体日瘦羸。延至初冬。
饮以参术补剂。转觉厌厌欲绝。食饮不思。有咳无声。泻利不止。危在旦暮。医者
议以人参五钱。附子三钱。加入姜桂白术之属。作一剂服。以止泻补虚。而收背水之捷。吉长 徨无措。延
仆诊毕。未及交语。前医自外亟至。见仆在坐。即令疏方。仆飘然而出。盖以渠见既讹。难与语至理耳。吉
长辞去前医。坚请用药。仆因谓曰。是病总繇误药所致。始先皮毛间洒淅恶寒发热。肺金为时令之燥所
伤也。用表散已为非法。至用参术补之。则肺气闭锢。而咳嗽之声不扬。胸腹饱胀。不思食饮。肺中之热无
处可宣。急奔大肠。食入则不待运化而直出。食不入。则肠中之垢污。亦随气奔而出。是以泻利无休也。
今以润肺之药兼润其肠。则源流俱清。寒热咳嗽泄泻。一齐俱止矣。但取药四剂。服之必安。不足虑也。
方用黄芩地骨皮甘草杏仁阿胶。初进一剂。泻即少止。四剂毕。而寒热俱除。再数剂而咳嗽俱全愈矣。设当
日与时辈商之。彼方执参附为是。能从我乎。又乡中王氏妇。秋月亦病寒热。服参术后。亦厌厌一息。但无
咳嗽。十余日不进粒米。亦无大便。时时晕去。不省人事。其夫来寓中。详述其症。求发补剂归服。余
以大黄芒硝石膏甘草四味。为粗末与之。彼不能辨。归而煎服。其妻云。此药甚咸。夫喜曰。咸果补药。
遂将二剂连服。顷之腹中努痛。下结粪数块。绝而复苏。进粥二盏。前病已如失矣。乡人致谢忱始知之。凡
此素有定见于中。故不为临歧所炫也。姑存是案。为治病者广其识焉。
胡卣臣先生曰。毫厘有差。千里悬绝。案中治法。似乎与症相反。究竟不爽。大难大难。
吴吉长的妻子。初秋时节患病，出现怕冷、战栗的症状。怕冷过后发热。逐渐产生咳嗽。然而病情并不严重。服用解表发散的药物后没有痊愈。身体日渐消瘦虚弱。拖延到初冬。
医生给她服用人参、白术等补益剂。反而觉得气息微弱，奄奄一息。不想吃东西。有咳嗽但没有声音。腹泻不止。生命危在旦夕。医生们
商议用人参五钱。附子三钱。加入生姜、肉桂、白术之类的药物。做成一剂服用。用来止泻并补虚。以取得背水一战般的胜利。吴吉长 惊慌失措。请
我诊治完毕。还没来得及交谈。之前的医生从外面急忙赶到。看见我在座。就让我开方。我飘然离去。因为他们的见解已经错误。难以与他们讲清真理。吴吉
长辞退了之前的医生。坚决请求用药。我于是对他说。这个病总归是由误药导致的。起初皮毛间怕冷、战栗、发热。是肺金被时令的燥邪所
伤。用解表发散的方法已经是非法的。到了用人参、白术补益的时候。则肺气闭阻禁锢。而咳嗽的声音不响亮。胸腹部饱胀。不想进食饮水。肺中的热邪无
处可宣泄。急奔大肠。食物吃进去则来不及运化而直接排出。食物不吃。则肠中的污垢。也随着气机奔涌而出。因此腹泻不停。
现在用润肺的药物同时滋润肠道。那么源头和流末都清澈了。寒热、咳嗽、泄泻。一齐都停止了。只要取四剂药。服用后必然平安。不必担心。
方子用黄芩、地骨皮、甘草、杏仁、阿胶。刚开始服用一剂。腹泻就稍微停止。四剂服完。而寒热都消除了。再服几剂而咳嗽全部痊愈了。假如当
时与那些庸医商量。他们正坚持认为人参、附子是正确的。能听从我的吗？又同乡中王氏妇人。秋天也患寒热病。服用人参、白术后。也气息微弱。只是没
有
咳嗽。十多天不进一粒米。也没有大便。时常晕倒。不省人事。她的丈夫来到寓所。详细陈述她的症状。请求开具补剂回去服用。我
用大黄、芒硝、石膏、甘草四味药。捣成粗末给她。她不能辨别。回去煎煮服用。她的妻子说。这药很咸。丈夫高兴地说。咸果然是补药。
于是将两剂药连续服用。不久腹中绞痛。排出结硬的粪便几块。昏厥过去后又苏醒过来。喝了两碗粥。前面的病已经像丢失了一样好了。同乡人致谢后才知
道。大凡
这些心中素有定见。所以不被临别时的迷惑所炫耀。暂且保存这个案例。为治病的人开阔见识。
胡卣臣先生说。毫厘之差。千里之远截然不同。案中的治法。似乎与症状相反。最终丝毫不差。太难了，太难了。
Wu Jichang's wife. In early autumn, she fell ill with chills and shivering (Saxi). After the chills subsided, fever developed. Gradually, a cough emerged. However, the condition was not severe. She took exterior-releasing and dispersing medicines without recovery. Her body became increasingly emaciated and weak. The illness dragged on until early winter.
She was given tonifying decoctions containing Ginseng Radix et Rhizoma (Renshen) and Atractylodis Macrocephalae Rhizoma (Baizhu). Instead of improving, she felt increasingly lethargic and near death. She had no appetite for food or drink. She had a cough but no voice. Diarrhea continued incessantly. Her life was in imminent danger. Physicians
discussed prescribing five qian of Ginseng Radix et Rhizoma (Renshen) and three qian of Aconiti Lateralis Radix Preparata (Fuzi), added to ingredients such as Zingiberis Rhizoma (Shengjiang), Cinnamomi Ramulus (Guizhi), and Atractylodis Macrocephalae Rhizoma (Baizhu). They intended to prepare one dose to stop diarrhea and tonify deficiency, aiming for a decisive victory against a desperate situation. Wu Jichang was panicked and at a loss. He invited me to diagnose her. After finishing the diagnosis, before any conversation could take place, the previous physician rushed in from outside. Seeing me present, he immediately asked me to prescribe. I left casually. This was because their diagnostic view was already erroneous, making it difficult to discuss profound principles with them. Wu Jichang dismissed the previous physician and firmly requested medication. I then said to him, "This illness is entirely caused by misprescription. Initially, the chills, shivering, and fever at the skin and hair level indicated that Lung Metal was injured by the seasonal dryness pathogen. Using exterior-releasing methods was already incorrect. Subsequently, using Ginseng Radix et Rhizoma (Renshen) and Atractylodis Macrocephalae Rhizoma (Baizhu) for tonification caused Lung Qi to become closed and obstructed, resulting in a muffled cough sound, chest and abdominal fullness, and lack of desire for food and drink. The heat within the Lung had nowhere to vent, so it rushed urgently into the Large Intestine. When food entered, it was not transformed and digested but passed through directly. When no food entered, the filth within the intestines also exited along with the rushing Qi. Hence, the diarrhea was unceasing.
Now, by using herbs that moisten the Lung while simultaneously moistening the intestines, both the source and the branches will be cleared. The cold, heat, cough, and diarrhea will all cease together. Just obtain four doses; upon taking them, she will surely recover. There is no need to worry."
The prescription consisted of Scutellariae Radix (Huangqin), Lycii Cortex (Digupi), Glycyrrhizae Radix et Rhizoma (Gancao), Armeniacae Semen Amarum (Xingren), and Equisetum Herba? No, Ophiopogonis Radix? No, Asini Corii Colla (Ejiao). Specifically: Huangqin, Digupi, Gancao, Xingren, Ejiao. Upon taking the first dose, the diarrhea stopped slightly. After completing four doses, the cold and heat were completely eliminated. After several more doses, the cough was fully cured. If I had consulted with those mediocre physicians on that day, they would have insisted that Ginseng Radix et Rhizoma (Renshen) and Aconiti Lateralis Radix Preparata (Fuzi) were correct. Would they have followed my advice?
Furthermore, a woman surnamed Wang in the same village also suffered from alternating chills and fever in autumn. After taking Ginseng Radix et Rhizoma (Renshen) and Atractylodis Macrocephalae Rhizoma (Baizhu), she too became lethargic with only a faint breath. However, she did not have a cough. For over ten days, she consumed no rice grains and had no bowel movements. She frequently fainted and lost consciousness. Her husband came to my residence, detailed her symptoms, and requested a tonifying prescription to take home. I prepared a coarse powder of Rheum Palmatum (Dahuang), Natrii Sulfas (Mangxiao), Gypsum Fibrosum (Shigao), and Glycyrrhizae Radix et Rhizoma (Gancao) for her. She could not distinguish the herbs. She returned home, decocted, and administered them. Her wife remarked, "This medicine is very salty." Her husband rejoiced, saying, "Salty indeed is a tonifying property." Thus, they took two doses consecutively. Soon, she experienced abdominal straining pain and passed several hard fecal masses. She fainted and then revived. After drinking two bowls of porridge, her previous ailments seemed to have vanished. The villagers expressed their gratitude only after learning this. All these cases demonstrate that having firm convictions internally prevents one from being dazzled by external confusion during critical moments. I preserve this case here to broaden the knowledge of those who treat diseases.
Mr. Hu Youchen stated, "A difference of a hair's breadth leads to a divergence of a thousand miles. The treatment method in this case seems contrary to the symptoms, yet ultimately it is flawless. It is truly difficult, truly difficult."