李继江三二年来。尝苦咳嗽生痰。胸膈不宽。今夏秋间卧床不起。濒亡者再。其人以白手致素封。因
无子自危。将家事分拨。安心服死。忽觉稍安。亦心死则身康之一征也。未几仍与家事。其病复作。然时作
时止。疑为不死之病也。闻余善议病。托戚友领之就诊。见其两颐旁。有小小垒块数十高出。即已知其
病之所在。因诘之曰。尔为何病。曰咳嗽。曰嗽中情状。试详述之。曰内中之事。愚者不知。是以求明耳。
余为哂曰。尔寒暑饥渴。悉不自知耶。观尔脉盛筋强。必多好色。而喜任奔走。本病宜发痈疽。所以得免者。
以未享膏粱之奉。且火才一动。便从精孔泄出耳。然虽不病痈。而病之所造。今更深矣。尔胸背肩
间。 岩如乱石插天。栉比如新笋出土。嵌空如蜂莲之房。芒锐如棘栗之刺。每当火动气升。痰壅紧逼之时。
百苦交煎。求生不生。求死不死。比桁杨之罪人十倍过之。尚不自知耶。渠变容顿
足而泣曰。果实如此。但吾说不出。亦无人说到耳。昔年背生痈疖。幸未至大害。然自疖愈。咳嗽至今。想因
误治所成。亦未可知。余曰不然。由尔好色作劳。气不归元。腾空而上。入于肝肺散叶空隙之间。膜原之内
者。日续一日。久久渐成熟路。只俟肾气一动。千军万马。乘机一时奔辏。有入无出。如潮不返。海潮
兼天涌至。倘后潮不熄。则前后古今。冤于此病者。不知其几。但尔体坚堪耐。是以病至太甚。尚自无患。
不然者久已打破昆仑关矣。尔宜归家休心息神。如同死去。俾火不妄动。则痰气不为助虐。而胸背之坚垒。始
有隙可入。吾急备药。为尔覆巢捣穴。可得痊也。渠骇然以为遇仙。托主僧请以五金购药。十金为酬
而去。次日复思病未即死。且往乡征租。旬日襄事。购药未迟。至则因劳陡发。暴不可言。痰出如泉。声响如
锯。面大舌胀。喉硬目突。二日而卒于乡。真所谓打破昆仑关也。其人遇而不遇。
亦顾家罔顾身之炯戒矣。治法详阴病论。
胡卣臣先生曰。论病从外灼内。因流识源。精鉴全非影响。
李继江这两三年来，常常苦于咳嗽生痰，胸膈部感觉不宽畅。今年夏秋之间卧床不起，两次濒临死亡。他凭借双手劳作而获得丰厚的家产，因为没有儿子而感到自身处境危险，便将家事分派妥当，安心等待死亡。忽然觉得身体稍微好转，这也是“心死则身康”的一个征兆啊。不久后他又重新过问家事，病情便再次发作。然而病情时好时坏，让人怀疑这是不会致死的病。听说我善于分析病情，便托亲戚朋友领他来就诊。
我看他两腮旁边，有几十个小小隆起的肿块高出皮肤，就已经知道他的病根所在了。于是问他：“你患的是什么病？”他说：“是咳嗽。”我又问：“咳嗽时的具体情况，请详细叙述一下。”他说：“体内的情况，愚笨的人是不清楚的，所以来求您明示。”
我笑着说：“你对于寒暑饥渴这些外在感受，难道都不清楚吗？观察你的脉象盛大、筋脉强硬，必定是喜好女色，并且喜欢奔走劳累。这种体质本容易引发痈疽，之所以能避免，是因为没有享受过肥甘厚味的供养，而且只要相火一动，精气就从精窍泄出罢了。虽然不得痈疽之病，但致病的原因造成的损害，如今已经更深了。你看你胸背肩间，那些坚硬的肿块像乱石插天一样高耸，像新笋出土一样密集排列，中间空洞像蜂巢莲房，尖端锐利像棘刺栗子。每当相火妄动、气机上逆、痰液壅盛紧逼的时候，各种痛苦交织煎熬，想活活不了，想死死不成，比受刑的罪人还要痛苦十倍，竟然自己还不知道吗？”
他脸色大变，跺脚哭泣说：“确实是这样，只是我说不出，也没人说到这个地步。往年背上生过痈疖，幸好没有造成大害。但是自从疖子痊愈后，咳嗽一直持续到现在，想想可能是误治造成的，也未可知。”
我说：“不对。这是由于你好色且过度劳累，导致气不能回归本源，反而腾空而上，进入肝肺散叶的空隙之间、膜原之内。日复一日，久而久之逐渐形成了通路，只等肾气一动，千军万马便乘机一时奔涌汇聚，有入无出，就像潮水不再返回，海潮兼天涌至。如果后面的潮头不停息，那么古今以来冤死于这个病的，不知有多少人。只是你身体坚固能够忍耐，所以病虽极重，暂时还没有生命危险。否则早就‘打破昆仑关’了。你应该回家修养心神，如同死去一般，使相火不妄动，那么痰气就不会助纣为虐，胸背间的坚硬堡垒才开始有缝隙可攻。我急忙准备药物，为你覆巢捣穴，是可以治愈的。”
他惊恐万分，以为遇到了仙人，托主僧请求用五金（重金）购买药物，并承诺十金作为酬谢才离开。第二天又想到病并没有立刻致死，况且去乡下征收租税，十天办完事再买药也不迟。等到回来时，因为劳累突然发病，暴烈得无法形容。痰液涌出如泉水，声音像拉锯，面部肿大舌头肿胀，喉咙僵硬眼睛突出，两天后在乡下去世。这真是所谓的“打破昆仑关”啊。这个人遇到良医却没有抓住机会，也是只顾家庭不顾身体的鲜明警戒啊。具体的治疗方法详见《阴病论》。
胡卣臣先生说：“论述病情从外部症状洞察内部病变，顺着流变追溯源头，精准的鉴别完全不是凭空想象或表面现象。”
Li Jijiang had suffered from coughing and phlegm production for the past two or three years, accompanied by a sensation of tightness in the chest and diaphragm. During the summer and autumn of this year, he was bedridden and faced death twice. He had accumulated considerable wealth through his own labor. Lacking an heir, he felt precarious about his future, settled his family affairs, and resigned himself to death. Suddenly, he felt slightly better, which is a sign that "when the mind dies, the body becomes healthy." Shortly after, he resumed managing family affairs, and his illness recurred. However, the symptoms came and went, leading people to suspect it was a non-fatal disease. Hearing that I was skilled at analyzing diseases, he was brought to see me by relatives and friends.
I observed dozens of small, raised nodules on both sides of his cheeks and immediately knew the location of his pathology. I asked him, "What disease do you have?" He replied, "Coughing." I then said, "Describe the specific sensations during the coughing in detail." He answered, "The internal conditions are unknown to the ignorant, which is why I seek your clarification."
I smiled and said, "Do you not know whether you are cold, hot, hungry, or thirsty? Observing your vigorous pulse and strong sinews, I deduce that you must be fond of sexual indulgence and prone to physical exertion. Such a constitution is prone to developing carbuncles and sores (Yong Ju). The reason you avoided them is that you did not consume rich and greasy foods, and whenever the ministerial fire moved, essence was discharged through the seminal aperture. Although you did not suffer from carbuncles, the damage caused by the pathological factors has now deepened. Look at your chest, back, and shoulders; the hard masses stand tall like chaotic rocks piercing the sky, dense like new bamboo shoots emerging from the ground, hollow like honeycombs or lotus pods, and sharp like thorns or burrs. Whenever the ministerial fire flares up, qi ascends, and phlegm obstructs tightly, various pains torment you simultaneously. You cannot live, nor can you die; you suffer ten times more than a criminal under torture, yet you remain unaware."
His expression changed, and he stamped his feet and wept, saying, "It is indeed so, but I cannot articulate it, nor has anyone else pointed it out. In previous years, I had carbuncles and boils on my back, fortunately without major harm. However, since those healed, the cough has persisted. It might be due to misdiagnosis and mistreatment."
I said, "Incorrect. This results from your sexual indulgence and overwork, causing qi to fail to return to its root and instead ascend vacuously into the interstices of the liver and lung leaves, and within the membrane source (Mo Yuan). Day by day, year by year, pathways gradually formed, waiting only for the kidney qi to move. Then, thousands of troops would rush in at once, entering but not exiting, like tides that do not recede, surging with the sea and sky. If the subsequent tides do not cease, countless people throughout history have died unjustly from this disease. It is only because your physique is robust and enduring that, despite the severity, you are not yet in immediate danger. Otherwise, you would long ago have 'broken through the Kunlun Pass.' You should return home, rest your mind, and quiet your spirit, as if dead. This will prevent the ministerial fire from moving recklessly, thereby stopping phlegm and qi from exacerbating the condition. Only then will there be gaps in the hard fortresses of your chest and back for treatment to penetrate. I will urgently prepare medicine to destroy their nest and batter their citadel, and you can be cured."
He was terrified, thinking he had met an immortal. He entrusted the head monk to purchase the medicine with five units of precious metal and promised ten units as remuneration before leaving. The next day, he reasoned that the disease had not killed him immediately and that he could go to the countryside to collect rents. After ten days of completing the task, buying the medicine would not be too late. Upon his return, however, the disease erupted suddenly due to fatigue, violently beyond description. Phlegm gushed like a spring, his voice sounded like sawing wood, his face swelled, his tongue enlarged, his throat stiffened, and his eyes protruded. He died in the countryside two days later. This was truly what is called 'breaking through the Kunlun Pass.' This person encountered a capable physician but failed to seize the opportunity, serving as a stark warning against caring for one's family while neglecting one's own body. The detailed treatment method is described in *Treatise on Yin Diseases*.
Mr. Hu Youchen stated: "Analyzing disease by observing external signs to perceive internal changes, and tracing the source from the flow, demonstrates precise diagnostic insight that is far from superficial or illusory."