目赤脉贯瞳仁。
囟肿及陷。
鼻干黑。
鱼口气急。
吐虫不定。
泻不定精神好。
大渴不止，止之又渴。
吹鼻不喷。
病重口干不睡。
时气唇上青黑点。
颊深赤如涂胭脂。
鼻开张。
喘急不定。
李寺丞子，三岁，病搐，自卯至巳。数医不治，后召钱氏视之。搐目右视，大叫哭。李
曰∶
，发搐时无声，右视有声；女发时，右视无声，左视有声。所以然者，左肝右肺，肝木肺金
，男目右视，肺胜肝也；金来刑木，二脏相战，故有声也。治之，泻其强而补其弱。心实者
，亦当泻之，肺虚不可泻。肺虚之候，闷乱哽气，长出气，此病男反女，故男易治于女也。
假令女发搐目左视，肺之胜肝，又病在秋，即肺兼旺位，肝不能任，故哭叫。当大泻其肺，
然后治心续肝。所以俱言目反直视，乃肝主目也。凡搐者，风热相搏于内，风属肝，故引
见之于目也。钱用泻肺汤泻之，二日不闷乱，当知肺病退。后下地黄丸补肾，三服后，用泻
青丸、凉惊丸各二服。凡用泻心肝药，五日方愈，不妄治也。又言∶肺虚不可泻者何也？曰
∶设令男目右视，木反克金，肝旺胜肺，而但泻肝，若更病在春夏，金气极虚，故当补其肺
，慎勿泻也。
广亲宅七太尉，方七岁，潮热数日欲愈。钱谓其父二大王曰∶七使潮热方安，八使预防
惊搐
急搐。召钱治之，三日而愈。盖预见目直视而腮赤，必肝心俱热，更坐石机子，乃欲冷，此
热甚也。肌肤素肥盛，脉又急促，故必惊搐。所言语时者，自寅至午，皆心肝所用事时。治
之，泻心肝补肾，自安矣。
李司户孙病，生百日，发搐三五次。请众医治，作天钓或作胎惊痫，皆无应者。后钱
用大青膏如小豆许，作一服发之。复与涂囟法封之，及浴法，三日而愈。何以然？婴儿初生，肌
骨嫩怯，被风伤之，子不能任，故发搐。频发者，轻也。何者？客风在内，每遇不任即搐。搐稀
者，是五内发病，不可救也。搐频者。宜散风冷，故用大青膏。不可多服，盖儿至小，易虚易实
，多即生热，止一服而已，更当封浴，无
东都王氏子，吐泻，诸医药下之，至虚，变慢惊。其候，睡露睛，手足螈 而身冷。钱
曰∶
医留八正散等，数服不利而身复冷。令钱氏利小便。钱曰∶不当利小便，利之必身冷。王曰
∶已身冷矣，因抱出。钱曰∶不能食而胃中虚，若利大小便即死。久即脾胃俱虚，当身冷而
闭目，幸胎气实而难衰也。钱用益黄散、使君子丸，四服，令微饮食。至日午果能饮食。所
以然者，谓利大小便，脾胃虚寒，当补脾，不可别攻也。后又不语，诸医作失音治之。钱曰
∶既失音，开目而能饮食。又牙不紧，而口不紧也，诸医不能晓。钱以地黄丸补肾。所以然
者，用清药利小便，致脾肾俱虚，今脾已实，肾虚，故补肾必安。治之半月而能言，一月而
痊也。
东都药铺杜氏，有子五岁，自十一月病嗽，至三月末止。始得嗽而吐痰，乃外风寒蓄
入肺
丸、半夏丸、褊银丸诸法下之，其肺即虚而嗽甚。至春三月间尚未愈，召钱氏视之。其候
面
也。春三月者，肝之位也，肺衰之时也。嗽者，肺之病。肺之病，自十一月至三月，久即虚
痿。又曾下之，脾肺子母也，复为肝所胜，此为逆也，故嗽而喘促，哽气，长出气也。钱急
与泻青丸，泻后与阿胶散实肺。次日面青而不光，钱又补肺，而嗽如前，钱又泻肝，泻肝
未已，又加肺虚，唇白如练。钱曰∶此病必死，不可治也。何者？肝大旺而肺虚热，肺病不
得其时而肝胜之。今三泻肝而肝病不退，三补肺而肺证犹虚，此不久生，故言死也。此证病
于秋者，十救三四；春夏者，十难救一。果大喘而死。
京东转运使李公，有孙八岁，病嗽而胸满短气。医者言肺经有热，用竹叶汤、牛黄膏
各二
曰∶医已用竹叶汤、牛黄膏。钱曰∶何治也？医曰∶退热、退涎。钱曰∶何热所作？曰∶肺经热
而生嗽，嗽久不除生涎。钱曰∶本虚而风寒所作，何热也？若作肺热，何不治其肺而反调心？盖
竹叶汤、牛黄膏，治心药也。医有惭色。
东都张氏孙，九岁，病肺热。他医以犀、珠、龙、麝、生牛黄治之，一月不愈。其证∶
嗽喘
他医用凉药攻之，一月尚无效。钱曰∶凉药久则寒不能食。小儿虚不能食，当补脾，候饮
食如故，即泻肺经，病必愈矣。服补脾药二日，其子欲饮食。钱以泻白散泻其肺，遂愈。张
曰∶何以不虚？钱曰∶先实其脾，然后泻其肺，故不虚也。
睦亲宫十太尉，病疮疹，众医治之。王曰∶疹未出。属何脏腑？一医言谓大热，一医言
伤寒
脏也？医曰∶在脾胃。钱曰，既在脾胃，何以惊悸？医无对。钱曰∶夫胎在腹中，月至六七则已
成形，食母秽液，入儿五脏。食至十月，满胃脘中，至生之时，口有不洁。产母以手拭净，则无
疾病。俗以黄连汁压之，云下脐粪及涎秽也。此亦母之不洁，余气入儿脏中，本先因微寒入而成
。疮疹未出。五脏皆见病症，内一脏受秽
乍热，手足冷痹，面腮燥赤，咳嗽时嚏，此五脏证俱也。呵欠顿闷，肝也；时发惊悸，
心也；乍凉乍热，手足冷，脾也；面目腮颊赤，嗽嚏，肺也。惟肾无候，以在腑下，不能食
秽故也。凡疮疹乃五脏毒，若出归一证，则肝水 、肝脓 、心斑、脾疹，惟肾不食毒秽而
无诸证。疮黑者属肾，由不慎风冷而不饱，内虚也。又用抱龙丸数服愈。其别无他候，故未
发出，则见五脏证，已出则归一脏也。
四大王宫五太尉，因坠秋千发惊搐，医以发热药，治之不愈。钱氏曰∶本急惊，后生大
热，当先退其热。以大黄丸、玉露散、惺惺丸，加以牛黄、龙、麝解之。不愈。至三日，肌肤上
热。钱曰∶更二日不愈，必发斑疮。盖热不能出也。他医初用药发散，发散入表，表热即
斑生。本初惊时，当用利惊药下之，今发散乃逆也。后二日，果斑出。以必胜膏治之，七日
睦亲宅一大王，病疮疹，始用一李医，又召钱氏。钱留抱龙丸三服，李以药下之。其疹
稠密
可下也。但当用平和药，频与乳食，不受风冷可也。如疮疹三日不出，或出不快，即微发之
；微发不出即加药，不出即大发之。如大发后不多，及脉平无证者，即疮本稀，不可更发也
。有大热者，当利小便；小热者，当解毒，若出快，勿发勿下，故止用抱龙丸治之。疮痂若
起，能食者，大黄丸下一二行即止。今先下一日，疮疹未能出尽，而稠密甚，则难治，此误
也。纵得安，其病有三∶一者疥，二者痈，三者目赤。李不能治，经三日黑陷，复召钱氏。
曰∶幸不发寒而病未困也。遂用百祥丸治之，以牛李膏为助。若黑者，归肾也。肾主胜脾，
土不克水，故脾虚寒战则难治。所用百祥丸者，以泻膀胱之腑，腑若不实，脏自不盛也。何
以不泻肾？曰∶肾主虚，不受泻。若二服不效，即加
皇都徐氏子，三岁，病潮热，每日西则发搐，身微热而目微斜，反露睛，四肢冷而喘，
大便
斜露睛？曰∶搐则目斜。何肢冷？曰∶冷厥必内热。曰∶何喘？曰∶搐之甚也。曰∶何以治之
？曰∶嚏惊丸鼻中灌之，必搐止。钱又问曰∶既谓风病，温壮搐引，目斜露睛，内热肢冷，
及搐甚而喘，并以何药治之？李曰∶皆此药也。钱曰∶不然，搐者肝实也，故令搐。日西身
微热者，肺潮用事。肺主身，温且热者，为肺虚。所以目微斜、露睛者，肝肺相胜也。肢冷者
，脾虚也。肺若虚甚，用益黄散、阿胶散。得脾虚证退后，以泻青丸、导赤散、凉惊丸治之
。后九日平愈。
朱监簿子，五岁，夜发热，晓即如故。众医有作伤寒者，有作热治之，以凉药解之不愈
。其
白术散末煎一两，汁三升，使任其意取足服。朱生曰∶饮多不作泻否？钱曰∶无生水不能作
泻，纵荡不足怪也，但不可下耳。朱生曰∶先治何病？钱曰∶止渴治痰，退热清里，皆此药
也。至晚服尽。钱看之曰∶更可服三升。又煎白术散三升，服尽得消愈。第三日又服白术散
三升，其子不渴无涎。又投阿胶散，二服而愈。
朱监簿子，三岁，忽发热。医曰∶此心热，腮赤而唇红，烦躁引饮。遂用牛黄丸三服
，以
，
黄沫如何？曰∶胃气正，即泻自止，此虚热也。朱曰∶医用泻心汤何如？钱曰∶泻心汤者，
黄连性寒，多服则利，能寒脾胃也。坐久众医至，曰实热。钱曰虚热。若实热，何以泻心汤
下之不安，而又加面黄颊赤，五心烦躁，不食而引饮？医曰∶既虚热，何大便黄沫？钱笑曰∶
便黄沫者，服泻心汤多故也。钱后与胡黄连丸治愈。
张氏三子病，岁大者，汗遍身；次者，上至顶，下至胸；小者，但额有汗。众医以麦煎
散，治之不效。钱曰∶大者与香瓜丸；次者与益黄散；小者与石膏汤。各五日而愈。
广亲宅四大王宫五太尉，病吐泻不止，水谷不化。众医用补药，言用姜汁调服之。六
月中
服，并服之。众医皆言∶吐泻多而米谷不化，当补脾，何以用凉药？王信众医，又用丁香散
三服。钱后至曰∶不可服此。三日外必腹满身热，饮水吐逆。三日外一如所言。所以然者，
谓六月热甚，伏入腹中而令引饮，热伤脾胃，即大吐泻。他医又行温药，即上焦亦热，故喘
而引饮，三日当死。众医不能治，复召钱至宫中，见有热证，以白虎汤三服，更以白饼子下
之。一日减药二分，二日三日，又与白虎汤各二服，
、脑子、牛黄、天竺黄、茯苓，以朱砂为衣，与五丸
冯承务子，五岁，吐泻，壮热，不思食。钱曰∶目中黑睛少而白睛多，面色 白，神怯
黑睛少，肾虚也。黑睛属水，本怯而虚，故多病也。纵长成，必肌肤不壮，不耐寒暑，易虚易
实，脾胃亦怯。更不可纵酒欲，若不保养，不过壮年，面上常无精神光泽者，如妇人之失血
也。今吐利不食，壮热者，伤食也，不可下。下之虚入肺则嗽，入心则惊，入脾则泻，入肾
则益虚。此但以消积丸磨之，为微有食也。如伤食甚则可下，不下则成癖也。实食在内，乃
可下之，毕，补脾必愈。随其虚实，无不效者。
广亲宫七太尉，七岁，吐泻。是时七月，其证全不食而昏睡，睡觉而闷乱，哽气，干哕，大
便或有或无，不渴。众医作惊治之，疑睡故也。钱曰∶先补脾，后退热。与使君子丸补脾；
退热，石膏汤。次日又以水银、硫黄二物下之，生姜水调下一字。钱曰∶凡吐泻，五月内，
九分下而一分补；八月内，十分补而无一分下。此者是脾虚泻。医妄治之，至于虚损，下之
即死。当即补脾。若以使君子丸即缓。钱又留温胃益脾药止之。医者李生曰∶何食而哕？钱
曰∶脾虚而不能食，津少即哕逆。曰∶何泻青褐水？曰∶肠胃至虚，冷极故也。钱治而愈。
黄承务子，二岁，病泻。众医止之，十余日，其证便青白，乳物不消，身凉，加哽气、昏睡
。医谓病困笃。钱氏先以益脾散三服，补肺散三服。三日，身温而不哽气。后以白饼子微下
之，与益脾散二服，利止。何以然？利本脾虚伤食，初不与大下。 置十日，上实下虚，
脾气弱，引肺亦虚，补脾肺，病退即温，不哽气是也。有所伤食，仍下之也，何不先下后补
？曰∶便青为下脏冷，先下必大虚，先实脾肺，下之则不虚，而后更补之也。
睦亲宫中十大王，疮疹，云疮疹始终出，未有他证，不可下，但当用平和药，频与乳食，不
受风冷可也。如疮疹三日不出，或出不快，即微发之。如疮发后不多出，即加药；加药不
出，即大发之。如发后不多，及脉平无证，即疮本稀，不可更发也。有大热者，当利小便。
小热者，当解毒。若不快，勿发勿下攻，止用抱龙丸治之。疮疹若起能食者，大黄丸下一二
行即止。有大热者，当利小便；有小热者，宜解毒。若黑紫干陷者，百祥丸下之；不黑者，
甚，勿下。身热烦躁，腹满而喘，大小便涩，面赤闷乱大吐，此当利小便。不瘥者，宣风散
下之也。若五七日痂不焦，是内发热气，蒸于皮中，故疮不得焦痂也。宜宣风散导之，用生
犀角磨汁解之，使执不生必着痂矣。
辛氏女子，五岁，病虫痛。诸医以巴豆、干漆、 砂之属，治之不效。至五日外，多哭
仰睡卧不安，自按心腹，时大叫。面无正色，或青、或黄、或白、或黑，目无光而慢，唇白
吐沫。至六日，胸高而卧转不安。召钱到，钱详视之。用芜荑散三服，见目不除青色，大惊
曰∶此病大困，若更加泻，则为逆矣。至次日，辛见钱曰∶夜来三更果泻。钱与泻盆中看，
如药汁，以杖搅之，见有丸药。钱曰∶此子肌浓当气实，今证反虚，不可治也。辛曰∶此子
肌浓当气实，今证反虚，不可治也。辛曰∶何以然？钱曰∶脾虚胃冷则虫动，而今反目青，
此肝乘脾，又更加泻，知其气极虚也。而丸药随粪下，即脾胃已脱，兼形病不相应，故知死
病。后五日昏笃，七日而死。
目赤红，血脉贯穿瞳孔。
囟门肿胀或凹陷。
鼻部干燥且色黑。
口唇如鱼口般张开，呼吸急促。
呕吐虫体，发作无规律。
腹泻但精神尚好。
极度口渴不止，刚止渴后又感口渴。
吹入鼻腔药物后不喷嚏。
病情严重，口干无法入睡。
时行疫病，嘴唇上有青黑色斑点。
面颊深红，如同涂抹了胭脂。
鼻孔开张。
喘息急促，发作无定准。
李寺丞之子，三岁，患抽搐病，从卯时持续至巳时。多位医生治疗无效，后来请钱乙诊治。患儿抽搐时眼睛向右看，大声哭叫。李氏说：“儿子发病时无声，右视时有声；女儿发病时，右视无声，左视有声。之所以这样，是因为左边属肝，右边属肺，肝属木，肺属金。男孩发病时右视，是肺气胜肝气；金克木，两脏相争，所以有声音。治疗应泻其强盛之脏而补其虚弱之脏。心实证，也应当泻之，肺虚证不可泻。肺虚的症状，表现为胸闷烦乱、喉间哽气、长出气。此病在男孩身上表现为女孩子的脉证（即肺虚），所以男孩比女孩容易治疗。假如女孩发病时眼睛向左看，是肺胜肝，又正值秋季，肺处于旺位，肝不能承受克制，所以哭叫。此时应当大泻肺经，然后治心以续接肝气。所以说凡是目反直视，都是肝主目的缘故。凡抽搐者，是风热在内相搏结，风属于肝，所以反映在眼睛上。钱乙用泻肺汤泻之，两天后不再胸闷烦乱，可知肺病已退。随后用地黄丸补肾，三服之后，再用泻青丸、凉惊丸各二服。凡是使用泻心肝的药物，五天才能痊愈，不妄加治疗。又说：为什么说肺虚不可泻呢？回答说：假如男孩眼睛右视，若是木反克金，肝旺胜肺，只泻肝，若再正值春夏季节，金气极虚，所以应当补肺，切勿泻之。”
广亲宅七太尉，才七岁，潮热数日将要痊愈。钱乙对其父二大王说：“七使君潮热方安，八使君要预防惊搐急搐。”召钱乙诊治，三天而愈。原来是预见到他目直视而腮部红赤，必定是肝心俱热，再加上坐石凳，想要凉爽，这是热势很盛的表现。肌肤素来肥盛，脉象又急促，所以必然发生惊搐。所说的言语时间，从寅时至午时，都是心肝当令的时间。治疗上，泻心肝、补肾，自然安宁。
李司户之孙，出生百日，发作抽搐三五次。请众医治疗，有的诊断为天钓，有的诊断为胎惊痫，都没有效果。后来钱乙用大青膏如小豆大小，作为一服用药发汗。随后用涂囟法封贴，以及洗浴法，三天而愈。为什么这样呢？婴儿初生，肌骨嫩弱怯懦，被风邪所伤，身体不能承受，所以发生抽搐。频繁发作的，病情较轻。为什么呢？因为客风在内，每次遇到身体不能承受时就抽搐。抽搐稀少的，是五脏内部发病，不可救治。抽搐频繁的，适宜疏散风冷，所以用大青膏。不可多服，因为小儿太小，易虚易实，多服则生热，只需一服即可，另外应当进行封贴和洗浴。
东都王氏之子，吐泻，其他医生用攻下药，导致正气极虚，转变为慢惊风。其症状为睡觉时眼睑不合露出眼珠，手足蠕动抽搐而身体冰冷。钱乙说：“医生留用了八正散等药，数服后小便不利而身体复冷。命令钱乙通利小便。钱乙说：‘不应当利小便，利小便必然导致身体冰冷。’王某说：‘已经身体冰冷了，于是抱出来。’钱乙说：‘不能进食而胃中虚，如果利大小便就会死亡。时间久了脾胃俱虚，应当身体冰冷而闭目，幸好胎气充实而难以衰败。’钱乙用益黄散、使君子丸，四服，让少量饮食。到了中午果然能进食。之所以这样，是因为利大小便导致脾胃虚寒，应当补脾，不可再攻伐。后来又不说话，众医当作失音症治疗。钱乙说：‘既然失音，却睁着眼睛能进食。而且牙关不紧，口也不紧，众医不明白。’钱乙用地黄丸补肾。之所以这样，是因为用清利药利小便，导致脾肾俱虚，现在脾已实，肾虚，所以补肾必安。治疗半个月能说话，一个月痊愈。”
东都药铺杜氏，有一子五岁，自十一月咳嗽，到三月末才停止。开始咳嗽并吐痰，是外感风寒蓄积入肺。曾用丸药、半夏丸、褊银丸等方法攻下，导致肺虚而咳嗽加重。到春季三个月间仍未愈，召钱乙诊治。其症状为面色青白。春三月是肝之位，也是肺衰之时。咳嗽是肺的病。肺的病，从十一月到三月，久了就变成虚痿。又曾经过攻下，脾与肺是母子关系，又被肝所胜，此为逆证，所以咳嗽气喘，哽气，长出气。钱乙急忙给予泻青丸，泻后给予阿胶散实肺。次日面色青而不光泽，钱乙又补肺，而咳嗽如前，钱乙又泻肝，泻肝未止，又加上肺虚，唇白如绢。钱乙说：“此病必死，不可治。为什么？肝大旺而肺虚热，肺病不得其时而肝胜之。如今三次泻肝而肝病不退，三次补肺而肺证犹虚，这不久于人世，所以说死。此证若在秋季患病，十人能救三四；若在春夏季患病，十人难救一人。”果然大喘而死。
京东转运使李公，有一孙八岁，病咳嗽且胸满短气。医生说肺经有热，用竹叶汤、牛黄膏各二服。李公说：“医生已用竹叶汤、牛黄膏。钱乙问：‘怎么治疗？’医生说：‘退热、退涎。’钱乙问：‘什么热引起的？’医生说：‘肺经热而生咳，咳久不除生涎。’钱乙说：‘本是虚证，由风寒引起，有什么热？若作肺热治，为什么不治肺反而调心？盖竹叶汤、牛黄膏，是治心的药。’医生面有惭色。
东都张氏之孙，九岁，病肺热。其他医生用犀角、珍珠、龙骨、麝香、生牛黄治疗，一月不愈。其症状：咳嗽气喘。他医用凉药攻之，一月尚无效。钱乙说：“凉药久用则寒，不能进食。小儿虚不能食，应当补脾，待饮食如常，再泻肺经，病必愈。”服补脾药二日，其子欲饮食。钱乙用泻白散泻其肺，遂愈。张某说：“为什么不虚？”钱乙说：“先实其脾，然后泻其肺，所以不虚。”
睦亲宫十太尉，病疮疹，众医治疗。王说：“疹未出。属于何脏腑？”一医言是大热，一医言是伤寒。问属于何脏？医曰：“在脾胃。”钱乙说：“既在脾胃，为何惊悸？”医无言以对。钱乙说：“胎儿在腹中，月至六七个月则已成形，食用母体秽液，进入儿之五脏。食至十月，充满胃脘中，到出生时，口中有不洁之物。产母用手擦拭干净，则无疾病。俗人以黄连汁压舌，说是下脐粪及涎秽。这也是母之不洁，余气入儿脏中，本因微寒入而成。疮疹未出，五脏皆见病症，内一脏受秽浊之气。乍热，手足冷痹，面腮燥赤，咳嗽时嚏，这是五脏证俱现。呵欠顿闷，属肝；时发惊悸，属心；乍凉乍热，手足冷，属脾；面目腮颊赤，嗽嚏，属肺。惟肾无候，因为在腑下，不能食秽故也。凡疮疹乃五脏毒，若出归一证，则肝水疱、肝脓疱、心斑、脾疹，惟肾不食毒秽而无诸证。疮黑者属肾，由不慎风冷而不饱，内虚也。又用抱龙丸数服愈。其别无他候，故未发出，则见五脏证，已出则归一脏也。”
四大王宫五太尉，因坠秋千发惊搐，医以发热药，治之不愈。钱乙说：“本是急惊，后生大热，应当先退其热。”用大黄丸、玉露散、惺惺丸，加以牛黄、龙、麝解之。不愈。至三日，肌肤上热。钱乙说：“再过二日不愈，必发斑疮。因为热不能出也。他医初用药发散，发散入表，表热即斑生。本初惊时，应当用利惊药下之，今发散乃逆也。”后二日，果斑出。用必胜膏治之，七日愈。
睦亲宅一大王，病疮疹，始用一李医，又召钱乙。钱乙留抱龙丸三服，李医以药下之。其疹稠密。钱乙说：“可下也。但当用平和药，频与乳食，不受风冷可也。如疮疹三日不出，或出不快，即微发之；微发不出即加药，不出即大发之。如大发后不多，及脉平无证者，即疮本稀，不可更发也。有大热者，当利小便；小热者，当解毒，若出快，勿发勿下，故止用抱龙丸治之。疮痂若起，能食者，大黄丸下一二行即止。今先下一日，疮疹未能出尽，而稠密甚，则难治，此误也。纵得安，其病有三：一者疥，二者痈，三者目赤。李医不能治，经三日黑陷，复召钱乙。钱乙说：‘幸不发寒而病未困也。’遂用百祥丸治之，以牛李膏为助。若黑者，归肾也。肾主胜脾，土不克水，故脾虚寒战则难治。所用百祥丸者，以泻膀胱之腑，腑若不实，脏自不盛也。为什么不泻肾？曰：肾主虚，不受泻。若二服不效，即加……”
皇都徐氏子，三岁，病潮热，每日西则发搐，身微热而目微斜，反露睛，四肢冷而喘，大便……钱乙问：“为何目斜露睛？”曰：“搐则目斜。为何肢冷？”曰：“冷厥必内热。”曰：“为何喘？”曰：“搐之甚也。”曰：“何以治之？”曰：“嚏惊丸鼻中灌之，必搐止。”钱乙又问曰：“既谓风病，温壮搐引，目斜露睛，内热肢冷，及搐甚而喘，并以何药治之？”李医曰：“皆此药也。”钱乙说：“不然，搐者肝实也，故令搐。日西身微热者，肺潮用事。肺主身，温且热者，为肺虚。所以目微斜、露睛者，肝肺相胜也。肢冷者，脾虚也。肺若虚甚，用益黄散、阿胶散。得脾虚证退后，以泻青丸、导赤散、凉惊丸治之。后九日平愈。”
朱监簿子，五岁，夜发热，晓即如故。众医有作伤寒者，有作热治之，以凉药解之不愈。其……白术散末煎一两，汁三升，使任其意取足服。朱生说：“饮多不作泻否？”钱乙说：“无生水不能作泻，纵荡不足怪也，但不可下耳。”朱生说：“先治何病？”钱乙说：“止渴治痰，退热清里，皆此药也。”至晚服尽。钱乙看之曰：“更可服三升。”又煎白术散三升，服尽得消愈。第三日又服白术散三升，其子不渴无涎。又投阿胶散，二服而愈。
朱监簿子，三岁，忽发热。医曰：“此心热，腮赤而唇红，烦躁引饮。”遂用牛黄丸三服，以……黄沫如何？曰：“胃气正，即泻自止，此虚热也。”朱说：“医用泻心汤何如？”钱乙说：“泻心汤者，黄连性寒，多服则利，能寒脾胃也。”坐久众医至，曰实热。钱乙说：“虚热。若实热，何以泻心汤下之不安，而又加面黄颊赤，五心烦躁，不食而引饮？”医曰：“既虚热，何大便黄沫？”钱乙笑曰：“便黄沫者，服泻心汤多故也。”钱乙后与胡黄连丸治愈。
张氏三子病，岁大者，汗遍身；次者，上至顶，下至胸；小者，但额有汗。众医以麦煎散，治之不效。钱乙说：“大者与香瓜丸；次者与益黄散；小者与石膏汤。”各五日而愈。
广亲宅四大王宫五太尉，病吐泻不止，水谷不化。众医用补药，言用姜汁调服之。六月中……服，并服之。众医皆言：“吐泻多而米谷不化，当补脾，何以用凉药？”王信众医，又用丁香散三服。钱乙后至曰：“不可服此。三日外必腹满身热，饮水吐逆。”三日外一如所言。所以然者，谓六月热甚，伏入腹中而令引饮，热伤脾胃，即大吐泻。他医又行温药，即上焦亦热，故喘而引饮，三日当死。众医不能治，复召钱乙至宫中，见有热证，以白虎汤三服，更以白饼子下之。一日减药二分，二日三日，又与白虎汤各二服，……、脑子、牛黄、天竺黄、茯苓，以朱砂为衣，与五丸。
冯承务子，五岁，吐泻，壮热，不思食。钱乙说：“目中黑睛少而白睛多，面色㿠白，神怯。黑睛少，肾虚也。黑睛属水，本怯而虚，故多病也。纵长成，必肌肤不壮，不耐寒暑，易虚易实，脾胃亦怯。更不可纵酒欲，若不保养，不过壮年，面上常无精神光泽者，如妇人之失血也。今吐利不食，壮热者，伤食也，不可下。下之虚入肺则嗽，入心则惊，入脾则泻，入肾则益虚。此但以消积丸磨之，为微有食也。如伤食甚则可下，不下则成癖也。实食在内，乃可下之，毕，补脾必愈。随其虚实，无不效者。”
广亲宫七太尉，七岁，吐泻。是时七月，其证全不食而昏睡，睡觉而闷乱，哽气，干哕，大便或有或无，不渴。众医作惊治之，疑睡故也。钱乙说：“先补脾，后退热。”与使君子丸补脾；退热，石膏汤。次日又以水银、硫黄二物下之，生姜水调下一字。钱乙说：“凡吐泻，五月内，九分下而一分补；八月内，十分补而无一分下。此者是脾虚泻。医妄治之，至于虚损，下之即死。当即补脾。若以使君子丸即缓。钱乙又留温胃益脾药止之。医者李生曰：‘何食而哕？’钱乙说：‘脾虚而不能食，津少即哕逆。’曰：‘何泻青褐水？’曰：‘肠胃至虚，冷极故也。’钱乙治而愈。”
黄承务子，二岁，病泻。众医止之，十余日，其证便青白，乳物不消，身凉，加哽气、昏睡。医谓病困笃。钱乙先以益脾散三服，补肺散三服。三日，身温而不哽气。后以白饼子微下之，与益脾散二服，利止。何以然？利本脾虚伤食，初不与大下。 置十日，上实下虚，脾气弱，引肺亦虚，补脾肺，病退即温，不哽气是也。有所伤食，仍下之也，何不先下后补？曰：便青为下脏冷，先下必大虚，先实脾肺，下之则不虚，而后更补之也。
睦亲宫中十大王，疮疹，云疮疹始终出，未有他证，不可下，但当用平和药，频与乳食，不受风冷可也。如疮疹三日不出，或出不快，即微发之。如疮发后不多出，即加药；加药不出，即大发之。如发后不多，及脉平无证，即疮本稀，不可更发也。有大热者，当利小便。小热者，当解毒。若不快，勿发勿下攻，止用抱龙丸治之。疮疹若起能食者，大黄丸下一二行即止。有大热者，当利小便；有小热者，宜解毒。若黑紫干陷者，百祥丸下之；不黑者，甚，勿下。身热烦躁，腹满而喘，大小便涩，面赤闷乱大吐，此当利小便。不瘥者，宣风散下之也。若五七日痂不焦，是内发热气，蒸于皮中，故疮不得焦痂也。宜宣风散导之，用生犀角磨汁解之，使执不生必着痂矣。
辛氏女子，五岁，病虫痛。诸医以巴豆、干漆、硇砂之属，治之不效。至五日外，多哭仰睡卧不安，自按心腹，时大叫。面无正色，或青、或黄、或白、或黑，目无光而慢，唇白吐沫。至六日，胸高而卧转不安。召钱乙到，钱乙详视之。用芜荑散三服，见目不除青色，大惊曰：“此病大困，若更加泻，则为逆矣。”至次日，辛见钱乙曰：“夜来三更果泻。”钱乙与泻盆中看，如药汁，以杖搅之，见有丸药。钱乙说：“此子肌浓当气实，今证反虚，不可治也。”辛说：“此子肌浓当气实，今证反虚，不可治也。”辛说：“何以然？”钱乙说：“脾虚胃冷则虫动，而今反目青，此肝乘脾，又更加泻，知其气极虚也。而丸药随粪下，即脾胃已脱，兼形病不相应，故知死病。后五日昏笃，七日而死。”
Redness of the eyes with blood vessels extending across the pupil.
Swelling or depression of the fontanelle.
Dryness and blackening of the nose.
Mouth opening like a fish's mouth with rapid breathing.
Irregular vomiting of worms.
Diarrhea but with good spirit.
Extreme thirst that does not stop, returning immediately after relief.
No sneezing after blowing medication into the nose.
Severe illness with dry mouth and inability to sleep.
Seasonal epidemic with blue-black spots on the lips.
Deep red cheeks, as if painted with rouge.
Dilated nostrils.
Rapid and irregular panting.
The son of Li Siceng, aged three, suffered from convulsions lasting from Mao hour (5-7 AM) to Si hour (9-11 AM). Several physicians failed to treat him, so Qian Yi was summoned. During convulsions, the child looked to the right and cried loudly. Li said: "When my son has convulsions, he is silent when looking right; when my daughter has them, she is silent when looking left and makes noise when looking right. This is because the left corresponds to Liver and the right to Lung; Liver belongs to Wood and Lung to Metal. In boys, looking right indicates Lung Qi overcoming Liver Qi; Metal punishing Wood causes conflict between the two organs, hence the sound. Treatment should reduce the excess and tonify the deficiency. Heart Excess should also be reduced, but Lung Deficiency must not be reduced. Signs of Lung Deficiency include chest oppression, restlessness, throat choking, and deep sighing. This presentation in a boy mimics a girl's pattern (Lung Deficiency), making it easier to treat than in girls. If a girl looks left during convulsions, it indicates Lung overcoming Liver. If this occurs in autumn, Lung is at its peak, and Liver cannot withstand the restriction, causing crying. One should strongly drain the Lung, then treat the Heart to support the Liver. Thus, all cases of eyes rolling back and staring are due to the Liver governing the eyes. Convulsions result from Wind-Heat battling internally; Wind belongs to the Liver, hence manifested in the eyes. Qian Yi used Xie Fei Tang (Drain Lung Decoction) to drain it. After two days, without chest oppression, it was known that Lung disease had receded. Then Di Huang Wan (Rehmannia Pill) was used to tonify Kidney. After three doses, Xie Qing Wan (Drain Green Pill) and Liang Jing Wan (Cool Spirit Pill) were given, two doses each. When using herbs to drain Heart and Liver, five days are needed for recovery; do not treat recklessly. Why is Lung Deficiency not drained? If a boy looks right, and Wood counter-punishes Metal, with Liver Excess overcoming Lung, only draining Liver is insufficient. If it is spring or summer, Metal Qi is extremely deficient, so one should tonify Lung and never drain it."
Qi Taiwei of Guangqin Residence, aged seven, had tidal fever for several days and was about to recover. Qian Yi told his father, Er Dawang: "Qi Shi's tidal fever is just calming; Ba Shi needs prevention of sudden convulsions." Qian Yi treated him, and he recovered in three days. He had foreseen that straight-looking eyes and red cheeks indicated Heat in both Liver and Heart. Sitting on a stone stool showed a desire for coolness, indicating severe Heat. His body was plump, and pulse was rapid, predicting convulsions. The timing of symptoms from Yin to Wu hours corresponds to the times when Heart and Liver are active. Treatment involved draining Heart and Liver and tonifying Kidney, leading to calmness.
Grandson of Li Sihu, born one hundred days old, had convulsions three to five times. Various doctors diagnosed Tian Diao (Heavenly Hook) or Tai Jing Xian (Fetal Startling Epilepsy) with no effect. Qian Yi administered Da Qing Gao (Great Cyan Ointment), a dose the size of a soybean, to induce sweating. Then applied Xion Fa (fontanelle application) and bathing methods, recovering in three days. Why? Infants have tender bones and muscles; wind injury overwhelms their capacity, causing convulsions. Frequent convulsions indicate mild condition because external wind is internal and triggers convulsions upon weakness. Rare convulsions indicate internal organ disease, which is incurable. Frequent convulsions suit dispersing wind-cold, hence Da Qing Gao. Do not overdose as infants are prone to deficiency and excess; too much generates heat. One dose suffices, plus external treatments.
Son of Wang family in Dongdu, suffered vomiting and diarrhea. Other doctors used purgatives, causing extreme deficiency and transforming into Slow Convulsion Syndrome. Symptoms: sleeping with eyes open, writhing limbs, and cold body. Qian Yi said: "Doctors retained Ba Zheng San etc., taken multiple times without promoting urination, leading to cold body. Ordered Qian Yi to promote urination. Qian Yi said: 'Do not promote urination; doing so will cause cold body.' Wang said: 'Body is already cold, so brought out.' Qian Yi said: 'Cannot eat due to stomach deficiency; promoting urination/stool will cause death. Long-term leads to Spleen-Stomach deficiency, cold body, and closed eyes. Fortunately, prenatal Qi is solid and hard to deplete.' Qian Yi used Yi Huang San (Yellow Guard Powder) and Shi Jun Zi Wan (Quisqualis Pill), four doses, allowing light diet. By noon, he could eat. This is because promoting urination/stool causes Spleen-Stomach deficiency-cold; one should tonify Spleen, not attack further. Later became mute; doctors treated as loss of voice. Qian Yi said: 'If mute, yet opens eyes and eats. Teeth and mouth are not tight; doctors do not understand.' Qian Yi used Di Huang Wan (Rehmannia Pill) to tonify Kidney. Because clearing/draining herbs caused Spleen-Kidney deficiency; now Spleen is solid, Kidney deficient, so tonifying Kidney ensures safety. Spent half a month speaking, one month fully recovered."
Du family of Dongdu pharmacy had a son aged five. Cough started in November, ended late March. Initially coughing with phlegm due to external wind-cold accumulating in Lung. Used pills, Ban Xia Wan (Pinellia Pill), Bian Yin Wan etc. to purge, causing Lung deficiency and worsening cough. Not cured by spring. Qian Yi examined: face pale green. Spring months belong to Liver position, time of Lung decline. Cough is Lung disease. From Nov to Mar, long duration leads to deficiency flaccidity. Purging damaged Mother-Son relationship (Spleen-Lung); Liver overcomes Lung, an adverse pattern. Hence cough, panting, choking, deep sighs. Qian Yi urgently gave Xie Qing Wan (Drain Green Pill), followed by E Jiao San (Donkey-Hide Gelatin Powder) to strengthen Lung. Next day face was dull green; Qian Yi tonified Lung, cough persisted; Qian Yi drained Liver. Draining Liver continued, adding Lung deficiency, lips white as silk. Qian Yi said: "This case is fatal, untreatable. Liver is hyperactive, Lung is deficient-heat. Lung disease occurs out of season while Liver overcomes it. Three drains of Liver failed; three tonifications of Lung failed. Life is short, hence death. If in Autumn, 3-4 out of 10 saved; in Spring/Summer, less than 1 out of 10 saved." Died of severe panting.
Li Gong, Transport Commissioner of Jingdong, had an eight-year-old grandson with cough, chest fullness, and shortness of breath. Doctor said Lung Meridian Heat, used Zhu Ye Tang (Bamboo Leaf Decoction) and Niu Huang Gao (Calculus Bovis Ointment), two doses each. Li Gong reported this. Qian Yi asked: "How to treat?" Doctor: "Clear heat, resolve saliva." Qian Yi: "What heat?" Doctor: "Lung heat causes cough; long cough produces saliva." Qian Yi: "Originally deficiency caused by wind-cold, what heat? If Lung heat, why treat Heart instead of Lung? Zhu Ye Tang and Niu Huang Gao treat Heart." Doctor felt ashamed.
Grandson of Zhang family in Dongdu, aged nine, Lung Heat. Other doctors used Rhinoceros Horn, Pearl, Dragon Bone, Musk, raw Calculus Bovis for one month without cure. Symptoms: cough and panting. Cold medicines used for one month ineffective. Qian Yi said: "Long-term cold medicines cause coldness and anorexia. Children with deficiency cannot eat; tonify Spleen first. Wait for normal diet, then drain Lung. Disease will heal." Took Spleen-tonifying medicine for two days, desired food. Qian Yi used Xie Bai San (Drain White Powder) to drain Lung, cured. Zhang asked: "Why not deficient?" Qian Yi: "Solidified Spleen first, then drained Lung, thus not deficient."
Shi Taiwei of Muqin Palace, skin eruption (smallpox/measles). Doctors treated. Prince said: "Eruption not out. Which Zang organ?" One doctor said Great Heat; another said Cold Damage. Asked which Zang? Doctor: "Spleen-Stomach." Qian Yi: "If Spleen-Stomach, why palpitations?" Doctor silent. Qian Yi: "Fetus in womb, by 6-7 months formed, consumes maternal filth entering Five Zang. By 10 months, stomach full. At birth, mouth has unclean matter. Mother wipes clean, no disease. Common practice uses Coptis juice to press tongue, claiming to remove umbilical feces/phlegm. This is maternal filth entering Zang, originally due to slight cold. Eruption not out, Five Zang show signs, one Zang receives filth. Sudden heat, cold limbs, dry red cheeks, cough/sneeze, all Five Zang signs. Yawning/drowsiness is Liver; sudden palpitations is Heart; alternating cold/heat, cold limbs is Spleen; red face/cheeks, cough/sneeze is Lung. Only Kidney has no sign, located below Fu organs, does not consume filth. All eruptions are Five Zang toxins. If eruption unifies, Liver water blisters, Liver pus, Heart macules, Spleen papules; Kidney does not consume toxin/filth, hence no signs. Black eruption belongs to Kidney, due to careless wind-cold and undernourishment, internal deficiency. Also used Bao Long Wan (Embrace Dragon Pill) several doses to cure. No other signs, so before eruption, Five Zang signs appear; after eruption, unifies to one Zang."
Wu Taiwei of Si Dawang Palace, fell from swing, developed startle convulsions. Doctors used warming herbs, no cure. Qian Yi said: "Originally Acute Startle, later generated Great Heat, must clear heat first." Used Da Huang Wan (Rhubarb Pill), Yu Lu San (Jade Dew Powder), Xing Xing Wan (Bright Star Pill), plus Calculus Bovis, Dragon Bone, Musk to resolve. No cure. Day 3, skin hot. Qian Yi: "Two more days without cure, will develop macules. Heat cannot exit. Other doctors used diaphoretic herbs initially; diaphoresis enters exterior, exterior heat generates macules. Originally at startle, should use purgative to drain startle; diaphoresis is contrary." Two days later, macules appeared. Treated with Bi Sheng Gao (Invincible Ointment), cured in seven days.
Da Wang of Muqin Residence, skin eruption. Initially treated by Doctor Li, then Qian Yi summoned. Qian Yi prescribed Bao Long Wan three doses; Doctor Li used purgatives. Eruption dense. Qian Yi said: "Purgation is acceptable. But use mild herbs, frequent milk/food, avoid wind-cold. If eruption doesn't appear in three days or slow, slightly induce; if slight induction fails, add medicine; if still no, strongly induce. If strong induction yields few, and pulse/cases are calm, eruption was sparse, do not induce again. High heat: promote urination. Low heat: resolve toxicity. If erupting well, do not induce or purge; hence only Bao Long Wan used. If scabs form and can eat, Da Huang Wan one-two stools then stop. Now purged one day early, eruption not complete but very dense, difficult to treat, this is error. Even if safe, three diseases remain: scabies, carbuncle, red eyes. Doctor Li couldn't treat; after three days, black sinking, Qian Yi summoned again. Qian Yi: "Lucky no cold, disease not exhausted." Used Bai Xiang Wan (Hundred Auspicious Pills) assisted by Niu Li Gao (Ox Plum Ointment). Black returns to Kidney. Kidney overcomes Spleen, Earth cannot control Water, hence Spleen deficiency cold tremors are hard to treat. Bai Xiang Wan drains Bladder Fu; if Fu not solid, Zang naturally not excessive. Why not drain Kidney? Kidney governs deficiency, cannot be drained. If two doses fail, add..."
Son of Xu family in Huangdu, aged three, tidal fever, convulsions every evening, slight body heat, slight eye deviation, eyes open showing whites, cold limbs, panting, stool... Qian Yi asked: "Why eye deviation/open eyes?" Answer: "Convulsion causes deviation. Why cold limbs?" Answer: "Cold reversal implies internal heat. Why panting?" Answer: "Severe convulsion. How to treat?" Answer: "Tian Jing Wan (Startle Calming Pill) instilled in nose, convulsions will stop." Qian Yi asked: "Since wind disease, warm/strong convulsions, deviation/open eyes, internal heat/cold limbs, severe panting, what medicine treats all?" Doctor Li: "All this medicine." Qian Yi: "Incorrect. Convulsions are Liver Excess. Evening slight heat is Lung tide active. Lung governs body; warmth/heat indicates Lung Deficiency. Deviation/open eyes is Liver-Lung conflict. Cold limbs is Spleen Deficiency. If Lung very deficient, use Yi Huang San, E Jiao San. After Spleen deficiency signs recede, use Xie Qing Wan, Dao Chi San, Liang Jing Wan. Recovered in nine days."
Son of Zhu Jianbu, aged five, night fever, normal morning. Doctors treated as Cold Damage or Heat, cold medicines failed. ... Bai Zhu San powder decocted one liang, juice three sheng, drink as desired. Zhu Sheng asked: "Will drinking much cause diarrhea?" Qian Yi: "Without raw water, no diarrhea; even if loose, not strange, just don't purge." Zhu Sheng: "Which disease to treat first?" Qian Yi: "Stop thirst, resolve phlegm, clear heat, clear interior, all this medicine." Finished by evening. Qian Yi checked: "Can take three more sheng." Decocted another three sheng, finished, recovered. Third day took three sheng, no thirst/phlegm. Then E Jiao San, two doses cured.
Son of Zhu Jianbu, aged three, sudden fever. Doctor: "Heart Heat, red cheeks/lips, irritability, drinking." Used Niu Huang Wan three doses... Yellow stool mush? Answer: "Stomach Qi correct, diarrhea stops itself, this is Deficiency Heat." Zhu: "What about Xie Xin Tang (Drain Heart Decoction)?" Qian Yi: "Xie Xin Tang contains Huang Lian, nature cold; long use causes diarrhea, chills Spleen-Stomach." Sat long, other doctors arrived, said Excess Heat. Qian Yi: "Deficiency Heat. If Excess, why Xie Xin Tang didn't settle, added yellow face/red cheeks, five-center irritability, anorexia/thirst?" Doctor: "If Deficiency Heat, why yellow stool mush?" Qian Yi laughed: "Yellow stool mush is due to excessive Xie Xin Tang." Qian Yi later cured with Hu Huang Lian Wan (Picrorhiza Pill).
Three sons of Zhang family ill. Oldest: sweat all over; second: head to chest; youngest: forehead only. Doctors used Mai Jian San, ineffective. Qian Yi: "Oldest: Xiang Gua Wan (Melon Pill); Second: Yi Huang San; Youngest: Shi Gao Tang (Gypsum Decoction)." Each cured in five days.
Wu Taiwei of Si Dawang Palace, Guangqin Residence, continuous vomiting/diarrhea, undigested food/grain. Doctors used tonics with ginger juice. In June... took together. Doctors said: "Vomiting/diarrhea with undigested grain requires Spleen tonification, why cold medicine?" Prince believed doctors, used Ding Xiang San three doses. Qian Yi arrived late: "Do not take this. After three days, abdominal fullness, body heat, drinking, vomiting/regurgitation." Three days later, exactly as predicted. Reason: June heat severe, hidden in abdomen causing thirst; heat damages Spleen-Stomach, causing severe vomiting/diarrhea. Other doctors used warming herbs, Upper Jiao also hot, hence panting/thirst, death in three days. Doctors couldn't treat, summoned Qian Yi to palace, saw Heat signs, used Bai Hu Tang (White Tiger Decoction) three doses, then Bai Bing Zi (White Cake Pills) to purge. Reduced dose by two fen day one; days two-three, Bai Hu Tang two doses... Brain, Musk, Calculus Bovis, Tianshu Huang, Poria, cinnabar-coated, five pills.
Son of Feng Chengwu, aged five, vomiting/diarrhea, high fever, anorexia. Qian Yi: "Less black iris, more white sclera, pale face, timid spirit. Less black iris indicates Kidney Deficiency. Black iris belongs to Water, originally timid/deficient, hence often ill. Even growing up, muscles not strong, intolerant to cold/heat, prone to deficiency/excess, Spleen-Stomach also weak. Must not indulge desires; if not maintained, die before prime age, face lacks luster like women with blood loss. Now vomiting/diarrhea/anorexia/high fever is Food Injury, cannot purge. Purging sends deficiency to Lung (cough), Heart (startle), Spleen (diarrhea), Kidney (worse deficiency). Use Xiao Ji Wan (Eliminate Accumulation Pill) to grind, slight food accumulation. If severe food injury, can purge; if not, becomes mass. Solid food inside can be purged; after finishing, tonify Spleen, must heal. Follow deficiency/excess, no failure."
Qi Taiwei of Guangqin Palace, aged seven, vomiting/diarrhea. July. Symptoms: total anorexia, lethargy, waking restless, choking, dry heaving, intermittent stool, no thirst. Doctors treated as Startle, suspecting sleep. Qian Yi: "Tonify Spleen first, then clear heat." Gave Shi Jun Zi Wan to tonify Spleen; Shi Gao Tang to clear heat. Next day used Mercury and Sulfur to purge, mixed with ginger water, one zi dose. Qian Yi: "For vomiting/diarrhea, within May, nine parts purge, one part tonify; within August, ten parts tonify, zero purge. This is Spleen Deficiency Diarrhea. Doctors treated recklessly, leading to deficiency damage; purging causes death. Should tonify Spleen immediately. Shi Jun Zi Wan would be gentle. Qian Yi left Wen Wei Yi Pi (Warm Stomach Tonify Spleen) medicine to stop. Doctor Li Sheng asked: 'Why dry heaving after eating?' Qian Yi: 'Spleen deficiency cannot eat; little fluid causes regurgitation.' Asked: 'Why green-brown water stool?' Answer: 'Intestines extremely deficient, extreme cold.' Qian Yi cured."
Son of Huang Chengwu, aged two, diarrhea. Doctors stopped it, ten days later: green-white stool, undigested milk, cold body, choking, lethargy. Doctor said critical. Qian Yi first gave Yi Pi San three doses, Bu Fei San three doses. Three days later, warm body, no choking. Then Bai Bing Zi mildly purged, Yi Pi San two doses, diarrhea stopped. Why? Diarrhea originally Spleen Deficiency Food Injury, initially did not strongly purge. Placed ten days, upper excess lower deficiency, Spleen Qi weak, affecting Lung deficiency. Tonifying Spleen-Lung, disease recedes, warms, no choking. Has food injury, still purged. Why not purge then tonify? Answer: Green stool indicates lower organ cold; purging first causes great deficiency. First solidify Spleen-Lung, then purge without deficiency, then tonify again.
Da Wang of Muqin Palace, skin eruption. Said eruption always appears, no other signs, cannot purge, use mild herbs, frequent milk/food, avoid wind-cold. If eruption not out in three days or slow, slightly induce. If eruption not many after inducing, add medicine; if add medicine no eruption, strongly induce. If after inducing not many, pulse calm no signs, eruption sparse, do not induce again. High heat: promote urination. Low heat: resolve toxicity. If not fast, do not induce/purge, only Bao Long Wan. If scabs form and can eat, Da Huang Wan one-two stools then stop. High heat: promote urination. Low heat: resolve toxicity. If black-purple dry sinking, Bai Xiang Wan purge; if not black, severe, do not purge. Body heat irritability, abdominal fullness panting, difficult urination/stool, red face/restless severe vomiting, this promotes urination. If not better, Xuan Feng San purge. If 5-7 days scabs not dry, internal heat steams skin, scabs cannot dry. Use Xuan Feng San to guide, raw Rhinoceros Horn juice to resolve, ensuring scabs form.
Daughter of Xin family, aged five, worm pain. Doctors used Croton Seed, Dry Lacquer, Realgar etc., ineffective. After five days, crying, supine sleep uneasy, pressing heart/abdomen, occasional loud cry. Face colorless, varying blue/yellow/white/black, dull eyes, white lips foaming. Day six, high chest, lying uneasy. Summoned Qian Yi, examined carefully. Used Wu Yi San (Chelidonium Powder) three doses, saw eyes still blue, greatly alarmed: "Disease critical, if more diarrhea, adverse." Next day, Xin saw Qian Yi: "Midnight indeed diarrhea." Qian Yi looked in basin, like medicine juice, stirred with stick, saw pill fragments. Qian Yi: "Child flesh thick should be Qi Excess, now signs opposite Deficiency, untreatable." Xin repeated. Asked why? Qian Yi: "Spleen deficiency/Stomach cold causes worms moving, now eyes blue, Liver overcoming Spleen, plus diarrhea, knows Qi extremely deficient. Pill fragments follow stool, Spleen-Stomach detached, shape/sign mismatch, hence death disease. Five days later critical coma, died on seventh day."