徐岳生躯盛气充。昔年因食指微伤见血。以冷水濯之。遂至血凝不散。肿溃出脓血数升。小筋脱出三节。
指废不伸。迩来两足间。才至秋月。便觉畏冷。重绵蔽之。外拊仍热。内揣独觉其寒。近日从踵至膝后。
筋痛不便远行。云间老医。令服八味丸。深中其意。及仆诊。自云平素脉难摸索。乃肝肺二部。反见
洪大。大为病进。况在冬月木落金寒时。尤为不宜。方来之势。将有不可向迩者。八味丸之桂附。未可轻
服也。何也。筋者肝之合也。附筋之血。既经食指之挹取。存留无几。不能荣养筋脉。加以忿怒。数动肝火。
传热于筋。足跗之大筋。得热而短。是以牵强不便于行也。然肝之所主者惟肺。木性畏金。禀令拥戴。若
君主然。故必肺气先清。周身气乃下行。今肺脉大。则肺气又为心主所伤。壅窒不清。是以阳气不能下达而足
寒也。然则所患虽微。已犯三逆。平素脉细。而今脉大。一逆也。肝脉大而热下传。二逆也。肺脉大而气上
壅。三逆也。设误以桂附治之。热者愈热。壅者愈壅。即日便成痿痹矣。此际用药。渊乎微乎。有寻
常不能测识者。盖筋脉短劲。肝气内锢。须亟讲于金伐木荣之道。以金伐木。而木反荣。筋反舒。匪深通玄造
者。其孰能知之。然非金气自壅。则木且奉令不暇。何敢内拒。惟金失其刚。转而为柔。是以木失其柔。转而
为刚。故治此患。先以清金为第一义也。然清金又先以清胃为第一义。不清其胃。则饮酒焉。而热气
输于肺矣。浓味焉。而浊气输于肺矣。药力几何。能胜清金之任哉。金不清。如大敌在前。主将懦弱。已不能
望其成功。况舍清金而更加以助火烁金。倒行逆施以为治耶。必不得之数矣。
翁见药石之言。漫无忌讳。反疑为张大其说。而莫之信。竟服八味丸。一月后。痿痹之情悉着。不幸所
言果验。乃卧床一载。必不令仆一见。闻最后阳道尽缩。小水全无。乃肺金之气。
先绝于上。所以致此。明明言之。而竟蹈之。奈何奈何。
胡卣臣先生曰。此治痿痹证之妙法莲华经也。不当作文本亵视。
徐岳生身体壮实，气血充沛。早年因食指轻微受伤出血，用冷水冲洗伤口，导致血液凝结不散，肿胀溃烂流出脓血数升，小筋脱出三节，手指废用无法伸直。近来两脚之间，刚到秋天就感到畏冷，即使盖上厚重的棉絮遮挡，外部抚摸仍感觉发热，内部触摸却独自觉得寒冷。近日从脚跟到膝盖后方，筋脉疼痛不便远行。云间的老医生，让他服用八味丸，认为这非常符合病情。等到我诊察时，他自述平时脉搏难以摸取，唯独肝部和肺部的脉象反而呈现洪大之象。脉大为病势进展，何况在冬季草木凋零、金气寒凉的时候，更为不宜。未来的病势，将有不可阻挡的严重情况。八味丸中的肉桂和附子，不可轻易服用。为什么呢？筋是肝的外合组织。依附于筋的血液，既然经过食指的耗损，留存无几，不能滋养筋脉。再加上愤怒，多次引动肝火，热邪传导至筋脉。足背的大筋，受热而缩短，因此牵强不便行走。然而肝所主宰的是肺，木性畏惧金，禀受金的命令而拥戴它，如同君主一样。所以必须肺气先清肃，周身的气才能下行。现在肺脉大，说明肺气又被心主（心火）所伤，壅滞窒塞不清，因此阳气不能下达而导致足部寒冷。既然如此，虽然患病看似轻微，但已犯了三种逆证：平时脉细，如今脉大，这是一逆；肝脉大而热邪下传，这是二逆；肺脉大而气机上壅，这是三逆。如果误用肉桂、附子治疗，热者会更热，壅者会更壅，当天就会形成痿痹证。此刻用药，深奥微妙，有寻常人不能测度的地方。大概是因为筋脉短缩劲急，肝气内里固结，必须急切地讲究“以金伐木，使木反荣”的道理。通过金来制约木，木反而繁荣，筋脉反而舒展。如果不是深深通晓造化玄机的人，谁能知道这些呢？然而如果不是金气自身壅滞，那么木还会奉令不暇，怎么敢在内里抗拒？只是金失去了刚强，转而变得柔弱，因此木失去了柔顺，转而变得刚强。所以治疗此患，首先以清金为第一要义。然而清金又首先要以清胃为第一要义。不清理胃腑，那么饮酒，热气就会输送到肺；浓味厚腻的食物，浊气就会输送到肺。药物的力量有多少，能胜任清金的任务呢？金不清，就像大敌当前，主将懦弱，已经不能指望成功。何况舍弃清金而再加助火烁金，倒行逆施作为治疗，必然不得要领。
老先生看到我对药石直言无忌讳，反而怀疑我在夸大其词，并不相信。竟然服用了八味丸。一个月后，痿痹的症状完全显现，不幸所说的果然应验。于是卧床一年，必定不让我见一面。听说最后阳具完全萎缩，小便全无。这是因为肺金之气，先在上部断绝，从而导致这种结果。明明说清楚了，竟然还重蹈覆辙，真是无可奈何啊。
Xu Yuesheng had a robust physique and abundant qi and blood. In past years, due to a minor injury to his index finger causing bleeding, he washed it with cold water. This led to blood coagulation that did not disperse, resulting in swelling, ulceration, and the discharge of several sheng (a traditional unit of volume) of pus and blood. The small tendons protruded for three segments, rendering the finger useless and unable to extend. Recently, between his two feet, as soon as autumn arrived, he felt aversion to cold. Even when covered with heavy cotton quilts, external palpation still felt hot, while internal palpation alone felt cold. In recent days, from the heel to behind the knee, tendon pain made long-distance walking inconvenient. An old physician from Yunjian prescribed Bawei Wan (Eight-Ingredient Pill), believing it deeply suited the condition. When I examined him, he stated that his pulse was usually difficult to feel, yet the positions corresponding to the Liver and Lung organs showed a surging and large (Hong Da) pulse. A large pulse indicates disease progression; moreover, during winter when wood is barren and metal is cold, this is particularly unfavorable. The impending trend of the disease will be unstoppable. The Cinnamon Twig (Guizhi) and Aconite Root (Fuzi) in Bawei Wan should not be taken lightly. Why? Tendons are the exterior correspondence of the Liver. The blood adhering to the tendons, having been depleted by the injury to the index finger, is left in scant amounts and cannot nourish the tendons and vessels. Added to this is anger, which repeatedly stirs up Liver Fire, transmitting heat to the tendons. The large tendons on the dorsum of the foot,受热 (shòu rè - receiving heat), shorten, thereby causing stiffness and inconvenience in walking. However, what the Liver governs is primarily the Lung. The nature of Wood fears Metal, obeying its commands and supporting it like a monarch. Therefore, Lung Qi must first be clear and pure for the qi of the whole body to descend. Now, since the Lung pulse is large, it indicates that Lung Qi has been injured by the Heart Master (Heart Fire), becoming obstructed and turbid, thus preventing Yang Qi from descending and causing coldness in the feet. Thus, although the ailment seems minor, it violates three principles of contrariety: normally the pulse is fine, but now it is large—this is the first contrariety; the Liver pulse is large with heat transmitting downward—this is the second contrariety; the Lung pulse is large with qi obstructing upward—this is the third contrariety. If mistakenly treated with Cinnamon Twig and Aconite, the heat will increase, and the obstruction will worsen, leading to Wei Bi syndrome (Atrophy and Obstruction Syndrome) immediately. At this juncture, medication is profound and subtle, beyond the comprehension of ordinary people. It is because the tendons and vessels are shortened and tense, and Liver Qi is internally constrained. One must urgently employ the method of "Metal subduing Wood, so that Wood flourishes." By using Metal to restrain Wood, Wood instead thrives, and the tendons relax. Only those who deeply understand the mysteries of creation can know this. However, if Metal Qi were not itself obstructed, Wood would have no time but to obey its command, let alone resist internally. It is only because Metal has lost its rigidity and turned soft that Wood, losing its flexibility, turns rigid. Therefore, in treating this condition, clearing Metal is the primary principle. Yet, clearing Metal first requires clearing the Stomach as the primary principle. If the Stomach is not cleared, then drinking alcohol allows heat qi to transmit to the Lung; rich and heavy flavors allow turbid qi to transmit to the Lung. How much medicinal power can suffice to undertake the task of clearing Metal? If Metal is not cleared, it is like facing a great enemy with a weak commander; success cannot be expected. Moreover, abandoning the clearing of Metal to further aid fire and scorch Metal, acting contrary to reason in treatment, will certainly fail.
The old gentleman, seeing my unreserved remarks regarding medicine, suspected I was exaggerating and did not believe me. He actually took Bawei Wan. After one month, the symptoms of Wei Bi syndrome fully manifested, unfortunately confirming my prediction. He lay in bed for a year, refusing to see me. I heard that finally, the Yang organ completely retracted, and there was no urine at all. This resulted from the Qi of Lung Metal failing first in the upper jiao. Although clearly explained, he repeated the mistake. What can be done?
Mr. Hu Youchen said: "This is the 'Sutra of the Lotus Flower of the Wonderful Dharma' for treating Wei Bi syndrome. It should not be viewed lightly as an ordinary text."