金道宾之诊。左尺脉和平。右尺脉如控弦。如贯索。上中甚锐。予为之骇曰。是病枝叶未有害。本实先
拨。必得之醉而使内也。曰。诚有之。但已绝欲三年。服人参斤许。迄今诸无所苦。惟
闭目转盼。则身非己有。恍若离魂者然。不识可治与否。予曰。可治。再四令疏方。未知方中之意。归语
门人。因请立案。予曰。凡人佳冶当前。贾勇以明得意。又助之以曲 。五脏翻覆。宗筋纵弛。百脉动摇。
以供一时之乐。不知难为继也。尝有未离女躯。倾刻告殒者矣。是病之有今日者幸也。绝欲三年。此丈夫之
行。可收桑榆者。但不知能之不为乎。抑为之不能乎。不为者。一阳时生。斗柄尝运。不能者。相安于无事而
已。夫人身之阴阳。相抱而不脱。是以百年有尝。故阳欲上脱。阴下吸之。不能脱也。阴欲下脱。阳上吸之。
不能脱也。即病能非一。阴阳时有亢战。旋必两协其平。惟大醉大劳。乱其常度。二气乘之。脱离所争。不必
其多。即寸中脱出一分。此一分便孤而无耦。使营魄不能自主。治法要在寻其罅漏而缄固之。断鳌立极。炼
石补天。非饰说也。若不识病所。而博搜以冀弋获。虽日服人参。徒竭重赀。究鲜实益。盖上脱者。妄见妄
闻。有如神灵。下脱者。不见不闻。有如聋 。上脱者。身轻快而汗多淋漓。下脱者。身重着而
肉多青紫。昔有新贵人。马上扬扬得意。未及回寓。一笑而逝者。此上脱也。又有入寝而遭魇。身如被杖。
九窍出血者。此下脱也。其有上下一时俱脱者。此则暴而又暴。不多经见者。其有左右相畸而脱者。右从下。
左从上。魂升魄降同例也。但治分新久。药贵引用。新病者。阴阳相乖。补偏救敝。宜用其偏。久病
者。阴阳渐入。扶元养正。宜用其平。若久病误以重药投之。转增其竭绝耳。引用之法。上脱者。用七分阳
药。三分阴药而夜服。从阴以引其阳。下脱者。用七分阴药。三分阳药而昼服。从阳以引其阴。引之又引。阴
阳忽不觉其相抱。虽登高临深无所恐。发表攻里无所伤矣。经云。阴平阳秘。精神乃治。正谓此也。
善调者。使坎中之真阳上升。则周身之气。如冬至一阳初生。便葭管飞灰。天地翕然从其阳。使离中之真阴下
降。则周身之气。如夏至一阴初生。便 蜩迭应。天地翕然从其阴。是身中原有
大药。岂区区草木所能方其万一者耶。
胡卣臣先生曰。言脱微矣。言治脱更微。盖天地其犹橐龠。理固然也。
金道宾的诊察情况。左尺脉平和，右尺脉像拉紧的弓弦，又像贯穿的绳索，寸部和关部尤为锐利。我为此感到惊骇地说：这病枝叶尚未受损，但根本已经动摇，一定是因为醉酒之后行房事所致。他说：确实有过这种情况，但已经戒欲三年，服用了约一斤人参，至今没有其它痛苦，只是闭上眼睛转动眼珠时，就觉得身体不属于自己，恍惚得像灵魂离体一样。不知道是否可以治疗。我说：可以治疗。多次让他开方，但他不明白方中的用意，回去告诉门人，于是请求我写病历。我说：凡人在美色当前，鼓起勇气以显示得意，又借助于酒力，导致五脏翻腾，宗筋松弛，百脉动摇，来供应一时的快乐，却不知道难以维持。曾经有未离开女性身体，顷刻间就死亡的例子。这个病人能发展到今天这样，算是幸运了。戒欲三年，这是大丈夫的行为，是可以挽回晚景的。但不知道是他不做呢，还是做了却做不到？不做的，一阳初生，斗柄运转；做不到的，不过是相安无事罢了。人体的阴阳，相互抱持而不脱离，所以能活到百岁。因此阳气想要上脱，阴气在下吸引它，就不能上脱；阴气想要下脱，阳气在上吸引它，就不能下脱。即使病因不一，阴阳时常有亢盛交战，最终必须两者协调平衡。只有大醉和大劳，扰乱了正常规律，二气趁机争夺，导致脱离。不需要太多，只要寸脉中脱出一分，这一分便孤立而无配偶，使得营魄不能自主。治疗方法关键在于寻找其漏洞并加以封闭巩固，如同断鳌足立四极、炼五色石补苍天，这不是虚饰之说。如果不认识病症所在，而广泛搜索希望侥幸获得疗效，虽然每天服用的人参，白白耗费重金，终究很少实际益处。一般来说，上脱者，妄见妄闻，好像有神灵附体；下脱者，不见不闻，好像聋哑人。上脱者，身体轻快而汗多淋漓；下脱者，身体沉重而肌肉多有青紫。过去有位新贵，在马上扬扬得意，还没回到住所，一笑而去世，这是上脱。又有进入卧室遭遇鬼压床，身体像被杖打，九窍出血的，这是下脱。那些上下同时脱失的，则是暴烈而又暴烈，不常常见到的。那些左右偏斜而脱失的，右侧从下脱，左侧从上脱，魂升魄降是同样的道理。但治疗要区分新病和久病，用药贵在引导。新病患者，阴阳乖违，补偏救弊，宜用偏性之药；久病患者，阴阳渐入正轨，扶元养正，宜用平和之药。如果久病误用重药投喂，反而增加其枯竭绝灭。引导的方法：上脱者，用七分阳药，三分阴药，夜间服用，从阴来引导阳；下脱者，用七分阴药，三分阳药，白天服用，从阳来引导阴。引导又引导，阴阳忽然不知不觉地相互抱持，即使登高临深也不恐惧，发表攻里也不会受伤了。经书说：阴平秘，精神乃治，正是说的这个意思。善于调理的人，使坎卦中的真阳上升，那么周身之气，就像冬至一阳初生，葭莩灰飞，天地都顺从它的阳；使离卦中的真阴下降，那么周身之气，就像夏至一阴初生，寒蝉相应，天地都顺从它的阴。这是身体中原有的大药，难道区区草木所能比得上万一吗？
胡卣臣先生说：论脱失的道理很微妙，论治疗脱失的道理更微妙。大概天地就像风箱一样，道理本来就是这样的。
Diagnosis of Jin Daobin. The left chi pulse is harmonious, while the right chi pulse resembles a taut bowstring or a passing rope, with the cun and guan positions being particularly sharp. I was startled by this and said: "The branches and leaves of this illness have not yet been harmed, but the root has already been shaken. It must have resulted from intercourse after excessive drinking." He replied: "It is true that such occurred, but I have abstained from sexual activity for three years and consumed approximately one jin of Ren Shen (Ginseng Radix et Rhizoma). Since then, I have suffered no other distress. However, when I close my eyes and move them, I feel as if my body does not belong to me,恍惚ly resembling a soul leaving the body. I wonder if it can be treated." I said: "It can be treated." I repeatedly instructed him to prescribe formulas, but he did not understand the intent behind them. Upon returning home, he told his disciples, who then requested that I write up the case record. I said: "When a person is faced with beauty, they summon courage to show off their satisfaction, further aided by alcohol. This causes the five zang organs to overturn, the sinews to relax, and the hundred vessels to tremble, all in service of momentary pleasure, unaware that such vitality cannot be sustained. There have been cases where death occurred instantaneously before even leaving the woman's chamber. For this patient to reach the current state is fortunate. Abstaining from sex for three years is an act of a great man, capable of recovering one's later years. But the question remains: is it because he does not engage in it, or because he engages but fails? If he does not engage, the initial yang arises, and the Dipper rotates; if he engages but fails, it merely results in a state of peace without incident. In the human body, yin and yang embrace each other without separating, thus allowing one to live to a hundred years. Therefore, if yang desires to escape upwards, yin below attracts it, preventing escape; if yin desires to escape downwards, yang above attracts it, preventing escape. Although diseases vary, and yin and yang may frequently clash in hyperactivity, they must eventually coordinate and balance. Only excessive drunkenness and fatigue disrupt normal rhythms, allowing the two qi to contend and separate. It need not be extensive; if even one fen separates at the cun position, that portion becomes isolated without a counterpart, causing Ying (Nutritive) and Po (Corporeal Soul) to lose autonomy. The treatment method lies in finding the leakage and sealing it firmly, akin to breaking the legs of a giant turtle to support the four poles or refining colored stones to mend the sky; this is not mere rhetoric. If one does not recognize the nature of the disease and searches broadly hoping for accidental success, although daily consumption of Ren Shen (Ginseng Radix et Rhizoma) incurs great expense, it yields little real benefit. Generally, in upper escape, there are hallucinations and delusions as if possessed by spirits; in lower escape, there is a lack of sight and hearing, resembling deafness and muteness. In upper escape, the body feels light and comfortable with profuse sweating; in lower escape, the body feels heavy with bluish-purple discoloration of the muscles. In the past, a newly ennobled nobleman rode proudly on horseback and died laughing before returning to his residence; this was upper escape. Another case involved someone encountering sleep paralysis in bed, feeling as if beaten, with bleeding from the nine orifices; this was lower escape. Cases where both upper and lower escape occur simultaneously are extremely violent and rarely seen. Cases where left and right sides deviate and escape involve the right escaping from below and the left from above, following the same principle as Hun (Ethereal Soul) ascending and Po descending. However, treatment must distinguish between new and chronic conditions, and emphasis should be placed on guidance. For new illnesses, where yin and yang are discordant, correcting bias and saving defects requires using biased medicines. For chronic illnesses, where yin and yang gradually return to order, supporting the primordial and nourishing righteousness requires using balanced medicines. If chronic patients are mistakenly given heavy medicines, it will only exacerbate their depletion. The method of guidance is as follows: for upper escape, use seventy percent yang medicine and thirty percent yin medicine, taken at night, guiding yang through yin; for lower escape, use seventy percent yin medicine and thirty percent yang medicine, taken during the day, guiding yin through yang. Through continuous guidance, yin and yang will unconsciously embrace again, so that even climbing heights or approaching depths causes no fear, and releasing the exterior or purging the interior causes no harm. The Classics state: 'When yin is peaceful and yang is secure, spirit and mind are regulated,' which precisely refers to this. A skilled regulator causes the True Yang within Kan (Water) to ascend, so that the qi throughout the body is like the initial birth of yang at Winter Solstice, where reed ash flies and heaven and earth follow its yang. Causing the True Yin within Li (Fire) to descend makes the qi throughout the body like the initial birth of yin at Summer Solstice, where cicadas respond, and heaven and earth follow its yin. Is there not a great medicine originally within the body? How could mere herbs compare to even a fraction of it?"
Mr. Hu Youchen said: "The discussion of escape is subtle; the discussion of treating escape is even more so. Heaven and earth are like bellows; this principle is indeed so."