矣。余诊脉甚滑数，面赤口干。因问足冷乎？溲热乎？耳鸣无寐乎？向来辄服温补乎？皆曰然。幸能安谷，是药
病也；幸涩之不止，药力尚有分势也。投以大剂清热坚阴之法，服数十剂．仲冬余复游禾，已能踵寓就诊矣。
秀水吴君小渔，年近七旬。平昔善饮，久患便泻带血，日夜十余次，溺不单行，广治罔效，聘余往视。脉虚
以弦，用补中益气汤去归、柴，加乌梅、黄柏、白芍、茯苓，不十剂而痊。其季郎雅轩，素有失血之患，近由穹
窿山归，途次发热，兼以咳逆见血，医治两旬不应。余诊之，脉弦数而上溢，气冲则自觉血腥，喘汗睛红，面黧
足冷，饥不能食，胁痛耳鸣，苔
腻口干，小溲短赤，寤不成寐，痰色甚浓，乃禀赋阴亏，水不涵木，心火内炽，肺金受戕，兼感客邪，胃浊不降。
甚难措手，即欲辞归，而虞君梅亭、胡君春田力乞疏方，勉图一二。爰以沙参五钱，蛤粉四钱，冬瓜子六钱，浮
石、茯苓、石斛各三钱，桑皮二钱，竹茹、枇杷叶各一钱五分，丝瓜络、桃仁各一钱，芦根汤煎服。是清心肝以
靖浮越之阳，肃肺胃而廓逗遛之热也。一剂脉色转和，气冲亦减。余留七日返棹，已热退便行，能安眠食，惟不
能慎口腹，戒忿怒，故痰嗽胁痛未能尽蠲。逾二月，余游闻川过禾，因喉痛复邀过诊，仍是心肝之火上炎，为留
三日，与龚萍江茂才内外协治而瘥。但病源匪浅，情性不柔，春令深时，恐兴险浪。临别与其友人余姚岑君九鼎
言之，以为左券。
贤倡桥朱君兰坡令堂，年已六旬。素患跗肿，夏季患疟转痢，痢止而腹之疼胀不休，渐至脘闷面浮，一身尽
肿，遍治罔效，卧榻百日，后事皆备。闻余游禾，谆乞一诊。左极弦细，右弱如无，舌赤无津，呻吟呕沫，不眠
不食，溲短目眵。系肝旺之体，中土受伤，运化无权，气液两竭。如何措手，勉尽人谋。方用参须、石菖蒲、仙
夏各一钱，石斛、冬瓜皮、建兰叶各三钱，竹茹一钱五分，姜汁炒川连四分，陈米汤煎服。诘朝兰坡忻忻然有喜
色而相告曰∶已转机矣。求再诊。余往视，面浮已减。病者冁然曰∶胸腹中舒服多矣，故不呻吟。且进稀粥，按
脉略起。遂于原方加冬虫夏草一钱，乌梅肉炭四分，服后连得大解，色酱而夹蠕蠕之虫盈万，腹之疼胀遂蠲，肢
肿亦消，舌润进粥。又邀余诊，色脉皆和，喜出望外。初亦不知其
虫病也，所用连、梅，不过为泄热生津、柔肝和胃之计，竟能暗合病情，殆兰坡孝心感格，故危险至是，可以一、
二剂取效。谨识之，以见重证不可轻弃，而余侥幸成功，实深惭恧。将返棹，留与善后方，惟加燕窝根、薏苡、
白蒲桃干而已。冬初余再游禾，询其所亲，云已出房，因索原方案归录之。
邱氏妇年四十余，患少腹瘕聚，时欲上冲，昏晕而厥，卧榻数月，足冷面红，寤不成寐，诸治不应。余按脉
虚细而弦，口干无液。与大剂一贯煎，覆杯即愈。人咸诧异称神，余却愧抄来墨卷也。
秀水严小亭令正，五十八岁。因数年前家有讼事，屡遭惊吓而起，辄疑自欲吞金，虽己衣不敢用钮扣，并时
絷手足，即夫媳儿孙，皆屏绝不许入房，云恐自摘他人之衣扣环饰咽下也。仅留一媪，在室服侍，而饮食起居如
常人。医皆谓其神虚，率投镇补。今秋患右腿青紫肿痛，牙龈臭腐。季秋延余视之，脉弦滑而数。曰∶此病不在
心而在胆，故能记忆往事而善谋虑，岂可指为神志不足乎？胆热则善疑，愈补则热愈炽，炽极则传于胃，胃热蕴
隆，乃成青腿牙疳也。锢疾已六、七年，宜先治其新病。以菖蒲、胆星、石膏、胆草、知母、元参、银花、栀子、
白薇、竹茹、黄连煎调玉枢丹，并令购白马乳饮之。六剂而病减，半月新病愈。仲冬余又游禾，复诊脉较平，而
胆亦稍和，盖白马乳善清胆胃之热也。
朱君庆雨次郎，夙有痫证，因劳伤之后，发冷吐酸，不饥神惫，服药数剂，遂致故恙日作数次，医者技穷。
余脉之，弦细若伏，而肢冷如冰，苔白如砂，涎沫频吐，头疼而晕，重裘不知温。是热深厥深，误投热药，而饮
邪内盛，故热邪隐伏
不显也。询其小溲果甚赤，以导痰汤去草合雪羹，加芩、连、栀、茹、木通煎吞当归龙荟丸，覆杯而愈。
管君锡棠仲郎兰谷之室，季秋患寒热，娠已八月矣。继因其子患惊，忧劳数月，遂兼痰嗽，而舌糜口臭。服
药数帖而娩，其胎已腐，然寒热、咳嗽、口糜诸恙不减。医以其产后也，用药益无把握，驯致气逆自汗，面赤无
眠，束手嘱备后事矣。适余游武原归，延诊。其脉寸关弦滑右大，恶露流通，二便无阻。是下焦无病，虽在产后
而病与产后无涉。若云产后宜温，固是谬说，而此之口舌糜臭，亦非大热，毋庸重剂凉解。良由胎已早殒，失于
早下，以致浊气熏蒸于肺胃，故见以上诸证。既见诸证而早为整肃，则源澄流洁，奚至是耶？设再误作产后虚喘
而妄投补剂，则虽死而莫知其所以死也。爰以南沙参、省头草、浓朴、杏仁、菖蒲、桑皮、竹茹、枇杷叶、冬瓜
子、丝瓜络为方，蔷薇叶、芦根煮汤煎服，两剂气顺嗽蠲，知饥进谷；去杏、朴，加苡仁、甘草，口舌随愈，寒
热亦休；惟骨节 疼，合目即汗，改清热养阴而起榻；腰足尚 软，授滋补气血而痊。
管授青翁季郎蓉舫之室，初冬患寒热，耳聋胸闷，便秘，带下如注，呕渴不眠，粒米不沾者旬余矣，人皆危
之。余按脉弦数，舌绛无苔，气逆面红，自求速死。此肝郁深沉，木火内烁，耗津阻气，出入无权。小柴胡汤、
逍遥散皆貌合而神离，误施必然决裂，此辨证用药之所以难也。幸其乔梓深信，遂以小陷胸加菖、茹、旋复、栀、
芩，芦根汤煎服，一剂胸渐舒，气渐平，再剂稍寐，三剂呕止进粥，五剂便行溺畅，寒热亦休，苔布知饥，始改
柔养而瘳。
金氏妇，自仲夏堕胎，迄今四月有余，恶露淋漓不断，两臂近复患疮，浑身肤痒，脉数而弦，多药罔效，亦
为产后宜温之谬说所误也。用西洋参、银花各二钱，生地、龟版各四钱，冬瓜皮三钱，栀炭、竹茹各一钱五分，
白薇、青蒿、黄柏各一钱，甘草六分，不十剂愈矣。
沈君雪江令嫒，黎里徐少岩刑部之媳也。胎前患泻，娩后不瘳，半载以来，诸药莫效。余按脉弦数而尺滑，
询知带盛口干，腰 咽痛，溲热善噫，肢冷畏烦。乃肝热而风行于胃，液走则阴血日亏。与白头翁汤加余粮、石
脂、熟地、龟版、竹茹、青蒿、砂仁，频服而痊。
沈君云峰令正，诞子后患身热痰嗽，白 头疼，腹痛便溏，不饮口渴。医者治此碍彼，专事模棱。至九朝，
余抵禾，视脉滑数，苔微黄，胎前感受冬温也。主以清解法，或疑有碍便溏。余曰∶便溏为肺热之去路，设便闭
则将喘逆矣。况夏间余尝治其胎前溺涩，群医渗利而不应，余专清肺而得手，今虽产后，体脏未更，兼有客热外
侵，所谓有病则病受也。连服多剂，果即向安。
仲冬余游姑苏，有长洲朱姓患久疟求诊。面肿目黄，声音不爽，溲赤腹胀，脉滑而弦，湿热蕴隆，失于宣解，
苔腻无汗，食少痰多。与清化方，嘱其慎口腹，戒甜腻。渠云此间名手皆曰药饵之外，须日饮糖汤，庶久疟易愈。
余曰∶渠但知表散可以发汗解邪，糖汤可以和中已疟，而愈散愈不解，愈和愈不已者，是执死法以限活病也。再
信其言，必成疟臌。病患闻之悚然，亟服余方数帖，得汗而愈。
秀水怀某，三十五岁。自春前偶失血一日，嗣即频发，所
吐渐多，延至季冬，聘余往视。左脉虚弦而数，右软大，气逆自汗，足冷面红，夜不成眠，食不甘味，音低神惫，
时欲呕酸。此由心境不怡，肝多怫郁，而脉候如斯，有气散血竭之虞。坚欲返，然既邀余至，不得不勉写一方，
聊慰其意。而病者强作解事，反以所疏舒郁之品为不然，执意要用五味、山萸、姜、桂之类。性情刚愎，此病之
所由来，而执迷不悟，更为速死之道矣。既而其妻出诊，脉至弦细，顶癣头疼，心悸带多，不饥五热，亦是水亏
木旺。退而谓其所亲曰∶兹二人何郁之深耶？始知其无子，欲买外家而妻不许，遂以反目成病。及病成而妻乃忧悔
交萦，因亦致疾。此与曩视省垣顾金城之病同，因家拥巨资，故壮年即虑无子，亦可谓欲速不达矣。而愚妇不知
大计，径为一“妒”字，以致溃败决裂。此时虽亟为置外家，亦无济矣！即以身殉，亦何益乎？录之以垂炯戒。
一少年久患内热，鼻衄龈宣，溺赤便艰，睛红口渴。热象毕露，因阳萎经年，医者但知为阳虚之证，而不知
有因热而萎之病。遂进温补，其热愈炽。父母不知，为之毕姻。少年大窘，求治于余。脉滑而数，曰无伤也。与
元参、丹皮、知、柏、薇、栀、石菖蒲、丝瓜络、沙参、蛤壳、竹茹，服六剂，来报昨夜忽然梦遗。余曰∶此郁
热泄而阳事通矣。已而果然。
娼女荣瑛就诊于余。自述本良家子，十四岁而天癸至，二十二岁而适人，二十五岁初产，但觉腰腹微 ，子
即堕地，三十二岁再产亦尔，兹又嫁二夫，向不自乳，而产育渐频，分娩渐慢，今春诞子为第十胎，腹痛逾四时
而始生，在他人犹以为极快，而我已觉渐徐，且年虽五十，天癸不衰，锢疾全无，向不服药，素有微带，迩年渐
无，惟每日吐痰，别无他苦，恐此
后有难产之虞，求为设法。余闻而讶之，其貌虽不甚都，而粉黛不施，风致嫣然，肌肤尚似三十许人，真尤物也。
始信鸡皮三少之说为不诬。按脉六部皆缓滑而长，左寸关带弦数，是聪明有寿之征，故年愈长而气愈固，是以分
娩渐慢也。向有带而近有痰，以左寸关合之，火搏其液而不下趋也。嘱以六君子加减为常服之方，设再孕至七、
八月，以束胎饮频服，可期易娩。渠闻之忻然，受方而去。录之以见赋体之奇。
余口上齿下牙密排各十六，虽从无痛楚，而自幼不能决硬物，故侵晨必以盐擦而冷水漱之，无间寒暑。今年
春夏以来，饭食日减，右之第六齿渐不能嚼，偶触坚韧之物，痛不可忍，且畏冷漱。以为去年一病，遂形衰象，
初不介意。余天性不饮，而颇识杯中趣，曩侍先慈晚膳，辄陪一、二杯。因去冬苦络虚不能转侧，戚友咸劝日饮
醇酒数杯，以和气血。遂习以为常，然不敢纵肆，未尝一醉也。十二月十八夜，寐中忽为右龈痛觉，诘朝即碍于
饮食，而是日已订有青镇之游，遂携一针登舟，频刺痛处，出血不少，午后渐松。次日归，饮食如常，以为无患
矣。二十一日立春，晨起痛胀复作，刺亦不应，继以凛寒身热，偏右之巅、额、 、 、颧、颊、颐、颏，无不
掣痛，苔色未露，谓是风火外侵，用艽、翘、蚕、芷、桑，薄等，二剂恶寒虽已，而足冷面热，溺赤苔黄，且鼻
窍不塞，而右流浊涕如脓，时欲哼而出之，不则自上 流下，臭苦不堪，右面尽肿，满口唇疮，肿处极其畏寒，
须以热物熨之为快，而时时火升。自问素不服丸散，又不啖肥甘，的系饮酒经年，湿热久蕴而上熏。盖以酒之热
归于胆，上移于脑则为鼻渊，其实移脑者即移胃也，故见证皆在少阳、阳明分野。遂以元参、桑叶、菊花、
花粉、银花、枳 子、丝瓜络、冬瓜子、芦根为剂，和入芦菔汁，调以玉枢丹，两服而苔化火平，二便亦畅，外
用盐卤热洗右面而肿渐消；去玉枢丹又二服，可以嚼饭，日啖北梨，至戊午元旦，而臭浊之涕始稀。初五、六连
日出门，适大风，初七日午后右龈复痛，上连头角耳门，右之第六齿复长出而碍食，凛寒畏风。乃用桑叶、菊花、
生甘草、绿豆皮、元参、苡仁、银花、栀炭、薄荷、钩藤，以清散风热，一服肿出痛减；去薄、钩，加枇杷叶，
四剂痛平，而右之第六齿已内外分裂矣。其根仍固，但碍于嚼物，而龈肿直至夏初消尽。既而头面四肢遍发斑块
瘰，肿而且痒，游行无定，手十指、足十趾、两手掌、两足心无处不到，用力搔之，微出紫血，结痂坚黑，痕
如痘疤，至秋杪始痊。痒时以盐卤洗之，内服银花、绿豆、生苡仁汤，戒口腹者八阅月。嘻，酒之为害如此！深
愧悟之不早，从此一滴不敢沾唇。忆二十年前海丰张雨农司马招游东瓯，临行妹尝戒余勿饮酒，佩不敢忘，故向
无酒病。年来自问衰颓，稍尔放溢，遂酿此恙，幸而资格尚浅，药治未误，不致延成锢疾。盖天性不饮者，虽少
饮亦能为患也。详录之，以为世鉴。余妹天性孝友，又极贤明，幼佐先慈操井臼、理家务，有北宫婴儿之志，余
强之适金氏，十载而嫠。余深悔之，附录以志余过。
余襁褓时患泻经年，迨三岁种痘，而痘科不知其天花已将出也，复以苗助之，遂及于险。先慈抱而膝行于床
者五昼夜，赖任六嘉先生救全，因而体气甚弱，童年畏劳，稍动即鼻衄，故恒静坐。十二岁夏间患温甚剧，父母
深忧之，病中见诸神将相谓曰∶此一路福星也。遂醒而汗出以瘳。失怙后远游于婺，遵母氏之训，诸凡谨慎，弱
冠后衄病始痊。隆冬可不挟纩，但略犯生冷即便泻，偶食炙爆则咽痛。己丑受室。甲午举家患疫，
罢了。我诊察他的脉象非常滑数，面色红赤，口干舌燥。于是问他脚冷吗？小便热吗？耳鸣且失眠吗？平时总是服用温补药物吗？大家都说是这样。幸好还能安稳进食，这是药不对症（药病）；幸好涩肠止泻的药力未能完全遏制病情，说明药力还有部分起效。于是投以大剂量的清热坚阴之法，服用了数十剂。仲冬时节我再次游览禾地，他已经能来到寓所就诊了。
秀水吴君小渔，年龄近七十岁。平时喜欢饮酒，长期患有大便泄泻带血，每天十几次，小便不能单独排出（与大便混行），广泛治疗无效，聘请我去诊治。脉象虚而弦，使用补中益气汤去掉当归、柴胡，加入乌梅、黄柏、白芍、茯苓，不到十剂便痊愈了。他的次子雅轩，素有失血的毛病，最近从穹窿山回来，途中发热，兼有咳嗽逆气并见血，医治二十天没有效果。我诊察他，脉象弦数而上溢，气冲上来时自觉有血腥味，气喘出汗眼睛红，面色黑晦脚冷，饥饿但不能进食，胁痛耳鸣，舌苔腻口干，小便短赤，睡觉不能入睡，痰色很浓，这是禀赋阴亏，水不涵木，心火内炽，肺金受损伤，兼感外邪，胃浊不降。很难着手治疗，本想辞别回去，但虞君梅亭、胡君春田极力恳求开方，勉强尝试一二。于是用沙参五钱，蛤粉四钱，冬瓜子六钱，浮石、茯苓、石斛各三钱，桑皮二钱，竹茹、枇杷叶各一钱五分，丝瓜络、桃仁各一钱，用芦根汤煎服。这是为了清心肝以平息浮越之阳，肃清肺胃而廓清逗留之热。一剂后脉色转和，气冲也减轻。我停留七天返航，已经热退大便正常，能安稳睡眠进食，只是不能慎守口腹欲望，戒除忿怒，所以痰嗽胁痛未能完全消除。过了两个月，我游览闻川经过禾地，因为喉痛又邀请我去诊治，仍然是心肝之火上炎，为他停留三天，与龚萍江茂才内外协同治疗而痊愈。但病源不浅，性情不柔和，春季深时，恐怕会有危险。临别时告诉他的友人余姚岑君九鼎，认为这是确凿无疑的预言。
贤倡桥朱君兰坡的母亲，年龄已六十岁。素来患有足背浮肿，夏季患疟疾转为痢疾，痢疾停止后腹部疼痛胀满不停，逐渐发展到胃脘闷塞面部浮肿，全身尽肿，遍治无效，卧床百日，后事都准备好了。听说我游览禾地，诚恳请求诊治。左脉极弦细，右脉弱得好像没有，舌头红赤无津液，呻吟呕吐泡沫，不眠不食，小便短少眼屎多。属于肝旺体质，中土受伤，运化无权，气液两竭。如何着手，勉强尽人力谋划。方用参须、石菖蒲、仙半夏各一钱，石斛、冬瓜皮、建兰叶各三钱，竹茹一钱五分，姜汁炒黄连四分，陈米汤煎服。第二天兰坡高兴地说：已经转机了。请求再诊。我去看，面部浮肿已减轻。病人笑着说：胸腹中舒服多了，所以不再呻吟。并且喝稀粥，按脉略起。于是在原方加冬虫夏草一钱，乌梅肉炭四分，服后连得大便，颜色酱色且夹着蠕动的虫子上万条，腹部的疼痛胀满于是消除，肢体浮肿也消，舌润进粥。又邀请我诊治，神色脉象都调和，喜出望外。起初也不知道是虫病，所用的黄连、乌梅，不过是泄热生津、柔肝和胃的计划，竟然能暗合病情，大概是兰坡孝心感格，所以危险至此，可以用一两剂取效。谨记录此事，以见重病不可轻易放弃，而我侥幸成功，实在深感惭愧。将要返航，留下善后方，只是加了燕窝根、薏苡仁、白蒲桃干而已。冬初我再次游览禾地，询问他的亲人，说已经走出房门，于是索取原方案归录。
邱氏妇人四十多岁，患少腹瘕聚，时常想要上冲，昏晕厥逆，卧床数月，脚冷面红，睡觉不能入睡，各种治疗无效。我按脉虚细而弦，口干无津液。给予大剂一贯煎，喝完杯子即愈。人们都诧异称神，我却惭愧是抄来的旧方。
秀水严小亭的正室，五十八岁。因为几年前家里打官司，屡遭惊吓而起病，总是怀疑自己想吞金子，即使穿好的衣服也不敢用纽扣，并时常捆绑手脚，即使是丈夫儿媳儿孙，都屏退不允许进入房间，说恐怕自己摘下别人的衣扣环饰咽下去。只留一个老妇人在室内服侍，而饮食起居像常人一样。医生都认为她是神志虚弱，一律投用镇惊补益药。今年秋天患右腿青紫肿痛，牙龈臭腐。季秋请我去诊治，脉象弦滑而数。我说：这病不在心而在胆，所以能记忆往事而善于谋虑，岂可指为神志不足呢？胆热则多疑，越补则热越炽盛，炽盛至极则传于胃，胃热蕴积隆盛，乃成青腿牙疳。顽固疾病已有六七年，应该先治新病。用石菖蒲、胆南星、石膏、龙胆草、知母、元参、银花、栀子、白薇、竹茹、黄连煎调玉枢丹，并令购买白马乳饮用。六剂病减，半月新病痊愈。仲冬我又游览禾地，复诊脉较平，而胆气也稍和，大概白马乳善于清胆胃之热。
朱君庆雨的次子，素来有痫证，因劳伤之后，发冷吐酸，不饥神疲，服药几剂，导致旧病每天发作数次，医生技术穷尽。我诊脉，弦细若伏，而四肢冷如冰，舌苔白如砂，涎沫频吐，头疼而晕，穿厚皮衣不知温暖。这是热深厥深，误投热药，而饮邪内盛，所以热邪隐伏不显。询问他小便果然很红，用导痰汤去掉甘草合雪羹，加黄芩、黄连、栀子、竹茹、木通煎吞当归龙荟丸，喝完杯子即愈。
管君锡棠的次子兰谷的妻子，季秋患寒热，怀孕已八个月了。接着因为儿子患惊风，忧劳数月，于是兼有痰嗽，而舌糜口臭。服药几帖而分娩，胎儿已经腐烂，然而寒热、咳嗽、口糜诸病不减。医生因为她产后，用药更没有把握，逐渐导致气逆自汗，面赤无眠，束手准备后事。恰好我游览武原回来，延请诊治。其脉寸关弦滑右大，恶露流通，二便无阻。这是下焦无病，虽然在产后而病与产后无关。如果说产后宜温，固然是谬说，而此处的口舌糜臭，也不是大热，不需要重剂凉解。确实是因为胎儿早已死亡，失于早下，以致浊气熏蒸于肺胃，所以见到以上诸证。既然见到诸证而早为整理肃清，那么源澄流洁，何至于此呢？假如再误作产后虚喘而妄投补剂，那么即使死了也不知道死的原因。于是用南沙参、省头草、浓朴、杏仁、菖蒲、桑皮、竹茹、枇杷叶、冬瓜子、丝瓜络为方，蔷薇叶、芦根煮汤煎服，两剂气顺咳止，知道饥饿进食谷物；去掉杏仁、浓朴，加薏苡仁、甘草，口舌随即痊愈，寒热也停；只有骨节疼，闭目即汗，改为清热养阴而起床；腰足尚软，授以滋补气血而痊愈。
管授青翁的次子蓉舫的妻子，初冬患寒热，耳聋胸闷，便秘，带下如注，呕渴不眠，粒米不沾者十余天，人都认为危险。我按脉弦数，舌绛无苔，气逆面红，自己求速死。这是肝郁深沉，木火内烁，耗津阻气，出入无权。小柴胡汤、逍遥散都是貌合神离，误施必然决裂，这就是辨证用药之所以难。幸好他们父子深信，于是用小陷胸加菖蒲、竹茹、旋覆花、栀子、黄芩，芦根汤煎服，一剂胸渐舒，气渐平，再剂稍睡，三剂呕止进粥，五剂大便行小便畅，寒热也停，舌苔布展知道饥饿，才改柔养而痊愈。
金氏妇人，自仲夏堕胎，迄今四月有余，恶露淋漓不断，两臂近又患疮，浑身肤痒，脉数而弦，多药无效，也是被产后宜温的谬说所误。用西洋参、银花各二钱，生地、龟版各四钱，冬瓜皮三钱，栀炭、竹茹各一钱五分，白薇、青蒿、黄柏各一钱，甘草六分，不到十剂痊愈。
沈君雪江的女儿，黎里徐少岩刑部的媳妇。胎前患泻，娩后不愈，半年来，各种药物无效。我按脉弦数而尺滑，询问知道带下多口干，腰痛咽痛，小便热善叹气，肢冷畏烦。这是肝热而风行于胃，津液流失则阴血日亏。给予白头翁汤加余粮石脂、熟地、龟版、竹茹、青蒿、砂仁，频服而痊愈。
沈君云峰的正室，生子后患身热痰嗽，头痛，腹痛便溏，不饮口渴。医生治此碍彼，专事模棱两可。到了第九天，我到达禾地，视脉滑数，苔微黄，是胎前感受冬温。主以清解法，有人怀疑有碍便溏。我说：便溏是肺热的去路，如果便闭则将喘逆了。况且夏天我曾治她胎前尿涩，群医渗利而不应，我专清肺而得手，现在虽然产后，体脏未更，兼有客热外侵，所谓有病则病受。连服多剂，果然即向安。
仲冬我游览姑苏，有长洲朱姓患久疟求诊。面肿目黄，声音不爽，小便赤腹胀，脉滑而弦，湿热蕴积隆盛，失于宣解，苔腻无汗，食少痰多。给予清化方，嘱其慎口腹，戒甜腻。他说这里的名手都说药饵之外，须每日饮糖汤，否则久疟难愈。我说：他们只知道表散可以发汗解邪，糖汤可以和中已疟，而愈散愈不解，愈和愈不已者，是执死法以限活病也。再信其言，必成疟臌。病患听了惊恐，赶紧服我的方数帖，得汗而愈。
秀水怀某，三十五岁。自春前偶失血一日，随后即频发，所吐渐多，延至季冬，聘请我去诊治。左脉虚弦而数，右软大，气逆自汗，足冷面红，夜不成眠，食不甘味，音低神疲，时欲呕酸。这是由于心境不怡，肝多怫郁，而脉候如此，有气散血竭的忧虑。坚决要返回，然而既然邀我至，不得不勉强写一方，聊慰其意。而病人强作解事，反而以我所疏舒郁之品为不然，执意要用五味、山萸、姜、桂之类。性情刚愎，这是病的由来，而执迷不悟，更是速死之道。后来其妻出来诊脉，脉至弦细，顶癣头疼，心悸带多，不饥五热，也是水亏木旺。回去对其亲人说：这两人为什么郁结这么深呢？才知道他们没有儿子，想买妾而妻子不许，于是反目成病。及病成而妻子乃忧悔交萦，因此也致病。这与先前诊治省垣顾金城之病相同，因为家拥巨资，所以壮年即虑无子，也可谓欲速不达。而愚妇不知大计，径为一“妒”字，以致溃败决裂。此时虽然亟为置妾，也无济于事！即以身体殉葬，又有什么益处呢？记录下来以垂警戒。
一少年久患内热，鼻衄龈宣，溺赤便艰，睛红口渴。热象毕露，因阳痿经年，医生只知道是阳虚之证，而不知道有因热而萎的病。于是进温补，其热愈炽。父母不知，为之结婚。少年大窘，求治于我。脉滑而数，说无伤。给予元参、丹皮、知母、黄柏、白薇、栀子、石菖蒲、丝瓜络、沙参、蛤壳、竹茹，服六剂，来报昨夜忽然梦遗。我说：这是郁热泄而阳事通矣。后来果然如此。
娼女荣瑛就诊于我。自述本是良家子，十四岁而天癸至，二十二岁而嫁人，二十五岁初产，只觉腰腹微痛，子即堕地，三十二岁再产亦然，现在又嫁二夫，向来不自乳，而产育渐频，分娩渐慢，今春诞子为第十胎，腹痛逾四小时才生，在他人还以为是极快，而我已经觉得渐慢，而且年虽五十，天癸不衰，锢疾全无，向来不服药，素有微带，近年渐无，惟每日吐痰，别无他苦，恐此后有难产之虞，求为设法。我听了惊讶，她的相貌虽然不甚漂亮，而粉黛不施，风致嫣然，肌肤尚似三十许人，真是尤物。始信鸡皮三少之说为不诬。按脉六部皆缓滑而长，左寸关带弦数，是聪明有寿之征，故年愈长而气愈固，是以分娩渐慢也。向来有带而近有痰，以左寸关合之，火搏其液而不下趋也。嘱以六君子加减为常服之方，设再孕至七、八月，以束胎饮频服，可期易娩。她听了很高兴，受方而去。记录下来以见赋体之奇。
我口上齿下牙密排各十六，虽从未痛楚，而自幼不能咬硬物，所以清晨必以盐擦而冷水漱之，无间寒暑。今年春夏以来，饭食日减，右侧第六齿渐不能嚼，偶触坚韧之物，痛不可忍，且畏冷漱。以为去年一病，遂形衰象，初不介意。我天性不饮酒，而颇识杯中趣，从前侍奉先慈晚膳，辄陪一、二杯。因为去冬苦络虚不能转侧，亲戚朋友都劝每日饮醇酒数杯，以和气血。于是习以为常，然不敢纵肆，未尝一醉也。十二月十八夜，睡梦中忽然被右龈痛惊醒，第二天即碍于饮食，而是日已订有青镇之游，遂携一针登舟，频频刺痛处，出血不少，午后渐松。次日归，饮食如常，以为无患矣。二十一日立春，晨起痛胀复作，刺亦不应，继以凛寒身热，偏右之巅、额、颧、颊、颐、颏，无不掣痛，苔色未露，谓是风火外侵，用秦艽、连翘、蝉蜕、白芷、桑叶、薄荷等，二剂恶寒虽已，而足冷面热，溺赤苔黄，且鼻窍不塞，而右流浊涕如脓，时欲哼而出之，不则自上流下，臭苦不堪，右面尽肿，满口唇疮，肿处极其畏寒，须以热物熨之为快，而时时火升。自问素不服丸散，又不啖肥甘，确实是饮酒经年，湿热久蕴而上熏。盖以酒之热归于胆，上移于脑则为鼻渊，其实移脑者即移胃也，故见证皆在少阳、阳明分野。遂用元参、桑叶、菊花、花粉、银花、枳棋子、丝瓜络、冬瓜子、芦根为剂，和入芦菔汁，调以玉枢丹，两服而苔化火平，二便亦畅，外用盐卤热洗右面而肿渐消；去玉枢丹又二服，可以嚼饭，日啖北梨，至戊午元旦，而臭浊之涕始稀。初五、六连日出门，适大风，初七日午后右龈复痛，上连头角耳门，右侧第六齿复长出而碍食，凛寒畏风。乃用桑叶、菊花、生甘草、绿豆皮、元参、薏苡仁、银花、栀炭、薄荷、钩藤，以清散风热，一服肿出痛减；去薄荷、钩藤，加枇杷叶，四剂痛平，而右侧第六齿已内外分裂矣。其根仍固，但碍于嚼物，而龈肿直至夏初消尽。继而头面四肢遍发斑块瘰疬，肿而且痒，游行无定，手十指、足十趾、两手掌、两足心无处不到，用力搔之，微出紫血，结痂坚黑，痕如痘疤，至秋末始痊。痒时以盐卤洗之，内服银花、绿豆、生薏苡仁汤，戒口腹者八阅月。唉，酒之为害如此！深愧悟之不早，从此一滴不敢沾唇。忆二十年前海丰张雨农司马招游东瓯，临行妹妹曾戒我勿饮酒，佩不敢忘，故向无酒病。年来自问衰颓，稍尔放溢，遂酿此恙，幸而资格尚浅，药治未误，不致延成锢疾。盖天性不饮者，虽少饮亦能为患也。详细记录，以为世鉴。我妹妹天性孝友，又极贤明，幼佐先慈操井臼、理家务，有北宫婴儿之志，我强之适金氏，十载而寡。我深悔之，附录以志余过。
我襁褓时患泻经年，等到三岁种痘，而痘科不知其天花已将出也，复以苗助之，遂及于险。先慈抱而膝行于床者五昼夜，赖任六嘉先生救全，因而体气甚弱，童年畏劳，稍动即鼻衄，故恒静坐。十二岁夏间患温甚剧，父母深忧之，病中见诸神将相谓曰：此一路福星也。遂醒而汗出以瘳。失怙后远游于婺，遵母氏之训，诸凡谨慎，弱冠后衄病始痊。隆冬可不挟纩，但略犯生冷即便泻，偶食炙爆则咽痛。己丑受室。甲午举家患疫，
It is over. I examined his pulse, which was very slippery and rapid; his face was red, and his mouth was dry. I asked him: "Are your feet cold? Is your urine hot? Do you have tinnitus and insomnia? Do you usually take warming and tonifying medicines?" All replied in the affirmative. Fortunately, he could eat peacefully; this indicates that the medicine was not matching the disease (Yao Bing). Fortunately, the astringent action to stop diarrhea was not completely effective, indicating that the medicinal force still had some effect. Therefore, I administered a large dose of methods for clearing heat and solidifying Yin. After taking dozens of doses, in mid-winter when I visited He again, he was able to come to my residence for consultation.
Mr. Xiaoyu Wu from Xiushui, nearly seventy years old. He used to enjoy drinking and had long suffered from bloody diarrhea, occurring more than ten times a day, with urine mixed with stool. Extensive treatments were ineffective, so he invited me to examine him. His pulse was deficient and wiry. I used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), removing Dang Gui (Angelicae Sinensis Radix) and Chai Hu (Bupleuri Radix), and adding Mei Zi (Mume Fructus), Huang Bo (Phellodendri Cortex), Bai Shao (Paeoniae Radix Alba), and Fu Ling (Poria). He recovered in less than ten doses. His second son, Yaxuan, had a history of blood loss. Recently returning from Qionglong Mountain, he developed fever on the way, accompanied by coughing, rebellious Qi, and hemoptysis. Medical treatment for twenty days yielded no results. Upon examination, his pulse was wiry and rapid with an upward surging quality. When Qi surged upward, he felt a metallic/bloody taste. He suffered from panting, sweating, red eyes, dark complexion, cold feet, hunger without appetite, hypochondriac pain, tinnitus, greasy tongue coating, dry mouth, scanty dark urine, and inability to sleep. The sputum was thick. This constitution indicated Yin deficiency, Water failing to nourish Wood, excessive internal Heart Fire, damage to Lung Metal, combined with external pathogenic factors, and failure of Stomach turbidity to descend. It was difficult to treat, and I initially wanted to decline and return. However, Mr. Meiting Yu and Mr. Chuntian Hu earnestly requested a prescription, so I reluctantly attempted a remedy. I prescribed Sha Shen (Glehniae Radix) 5 qian, Ge Fen (Concha Meretricis et Cyclinae Pulvis) 4 qian, Dong Gua Zi (Benincasae Semen) 6 qian, Fu Shi (Pumex), Fu Ling (Poria), and Shi Hu (Dendrobii Caulis) each 3 qian, Sang Bai Pi (Mori Cortex) 2 qian, Zhu Ru (Bambusae Caulis in Taeniam) and Pi Pa Ye (Eriobotryae Folium) each 1.5 qian, Si Gua Luo (Luffae Fructus Retinervia) and Tao Ren (Persicae Semen) each 1 qian, decocted in Lu Gen (Reed Rhizome) water. This formula clears the Heart and Liver to pacify floating Yang, and肃ifies the Lungs and Stomach to clear lingering Heat. After one dose, the pulse and complexion harmonized, and the Qi surge decreased. I stayed for seven days before departing; his fever had subsided, bowel movements normalized, and he could sleep and eat peacefully. However, due to lack of dietary restraint and anger management, the cough with sputum and hypochondriac pain did not fully resolve. Two months later, while visiting Wen Chuan via He, he invited me again due to sore throat. The condition remained Heart and Liver Fire flaming upward. I stayed for three days, and with internal and external coordination by Gong Pingjiang Maocai, he recovered. However, the root cause was deep, and his unyielding temperament suggested potential danger in late spring. Before parting, I informed his friend, Mr. Jiuding Cen of Yuyue, regarding this prognosis as a certainty.
Madam Zhu Lanpo of Xianchang Bridge, sixty years old. She had chronic edema of the dorsum of the foot. In summer, malaria transformed into dysentery. After the dysentery stopped, abdominal pain and distension persisted, progressing to epigastric stuffiness, facial edema, and generalized edema. Treatments failed, and she lay bedridden for a hundred days, preparing her funeral affairs. Hearing I was in He, she earnestly requested a consultation. The left pulse was extremely wiry and fine; the right pulse was weak, almost imperceptible. The tongue was red and devoid of fluids. She groaned, vomited foam, slept and ate nothing, and had scanty urine and eye discharge. This belonged to a Liver-excess constitution with injury to the Spleen/Stomach (Zhong Tu), loss of transformation and transportation, and exhaustion of Qi and fluids. How to proceed? I tried my best. The prescription consisted of Shen Xu (Ginseng Radicule), Shi Chang Pu (Acori Tatarinowii Rhizoma), and Xian Xia (Pinelliae Preparata) each 1 qian; Shi Hu (Dendrobii Caulis), Dong Gua Pi (Benincasae Exocarpium), and Jian Lan Ye (Cymbidii Folium) each 3 qian; Zhu Ru (Bambusae Caulis in Taeniam) 1.5 qian; Chuan Lian (Coptidis Rhizoma) stir-fried with ginger juice 0.4 qian; decocted in Chen Mi Tang (aged rice water). The next day, Lanpo reported happily: "The condition has turned." He requested another visit. I found facial edema reduced. The patient smiled and said: "My chest and abdomen feel much better, hence no groaning." He drank thin congee, and the pulse rose slightly. I added Dong Chong Xia Cao (Cordyceps) 1 qian and Wu Mei Rou Tan (Carbonized Mume Flesh) 0.4 qian to the original formula. After ingestion, he passed large stools containing thousands of wriggling worms. Abdominal pain and distension ceased, limb edema resolved, the tongue became moist, and he resumed eating congee. Upon further consultation, his complexion and pulse were harmonious, and he was overjoyed. Initially, we did not know it was a parasitic disease. The use of Lian (Coptidis Rhizoma) and Mei (Mume Fructus) was merely intended to drain heat, generate fluids, soften the Liver, and harmonize the Stomach, yet it coincidentally matched the pathology. Perhaps Lanpo’s filial piety moved the heavens, allowing such critical illness to be cured in one or two doses. I record this to show that severe cases should not be abandoned lightly, and I feel deeply ashamed of my lucky success. Before departing, I left a follow-up prescription adding Yan Wo Gen (Swallow's Nest Root), Yi Yi Ren (Coicis Semen), and Bai Pu Tao Gan (White Grape Dried). In early winter, visiting He again, I learned from relatives that she had left her room, so I retrieved the original case for recording.
Madam Qiu, over forty years old, suffered from a mass in the lower abdomen (Jia Ju) that would occasionally surge upward, causing fainting and syncope. She lay bedridden for months, with cold feet and a red face, unable to sleep. Various treatments failed. Her pulse was deficient, fine, and wiry, with a dry mouth lacking fluids. I administered a large dose of Yi Guan Jian (Connecting the Liver Decoction), and she recovered immediately after finishing the cup. People marveled at its efficacy, but I felt ashamed, admitting it was merely a copied standard prescription.
Madam Yan Xiaoting of Xiushui, fifty-eight years old. Her illness began years ago due to family litigation and repeated frights. She constantly suspected she wanted to swallow gold, refused to wear buttons even on good clothes, tied her hands and feet, and barred husband, daughter-in-law, children, and grandchildren from entering her room, fearing she might swallow their clothing fasteners. Only one old maid served her, and her daily routine resembled that of a normal person. Physicians attributed this to Spirit deficiency and universally prescribed sedating and tonifying herbs. This autumn, she developed cyanotic swelling and pain in the right leg, and foul-smelling, rotting gums. In late autumn, I examined her. The pulse was wiry, slippery, and rapid. I stated: "This disease lies not in the Heart but in the Gallbladder. Thus, she can remember past events and plan well. How can it be called Spirit insufficiency? Gallbladder Heat causes suspicion; further tonification increases Heat. When Heat becomes extreme, it transmits to the Stomach. Stomach Heat accumulation leads to Cyanotic Leg and Gingival Gangrene (Qing Tui Ya Gan). This entrenched disease has lasted six or seven years; we must first treat the new acute condition." I prescribed Shi Chang Pu (Acori Tatarinowii Rhizoma), Dan Xing (Arisaematis Cum Bile), Shi Gao (Gypsum Fibrosum), Long Dan Cao (Gentianae Radix), Zhi Mu (Anemarrhenae Rhizoma), Yuan Shen (Scrophulariae Radix), Yin Hua (Lonicerae Japonicae Flos), Zhi Zi (Gardeniae Fructus), Bai Wei (Cynanchi Atrati Radix), Zhu Ru (Bambusae Caulis in Taeniam), and Huang Lian (Coptidis Rhizoma), decocted and mixed with Yu Shu Dan (Jade Pivot Pill). She was also instructed to drink White Horse Milk. After six doses, symptoms decreased; within half a month, the new condition healed. In mid-winter, I revisited He. The pulse was calmer, and the Gallbladder Qi was more harmonious, likely because White Horse Milk effectively clears Gallbladder and Stomach Heat.
Mr. Qingyu Zhu’s second son had a history of epilepsy. After physical exhaustion, he developed chills, acid regurgitation, lack of appetite, and mental fatigue. After several doses of medication, his old condition recurred several times daily, leaving physicians helpless. His pulse was wiry, fine, and seemingly hidden; limbs were ice-cold; tongue coating was white like sand; saliva foamed frequently; headache and dizziness occurred; and despite wearing heavy fur, he felt no warmth. This was "Deep Heat leading to Deep Cold" (Re Shen Jue Shen). Misuse of warming drugs caused internal retention of fluid-pathogens, hiding the Heat. Inquiry revealed very dark urine. I used Dao Tan Tang (Guide Out Phlegm Decoction) minus Gan Cao (Licorice Root), combined with Xue Geng (Snow Soup), plus Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Zhi Zi (Gardeniae Fructus), Zhu Ru (Bambusae Caulis in Taeniam), and Mu Tong (Akebiae Caulis). He swallowed Dang Gui Long Hui Wan (Angelica and Gentian Pill). He recovered immediately.
Mrs. Lan Gu, wife of Mr. Xin Tang Guan’s second son, suffered from alternating chills and fever in late autumn, having been pregnant for eight months. Subsequently, due to worry and labor over her son’s convulsions for months, she developed phlegm-cough, aphthous ulcers in the mouth, and bad breath. She delivered after several doses of medicine, but the fetus was already decomposed. However, chills, fever, cough, and oral ulcers persisted. Physicians, citing postpartum status, lacked confidence in treatment, leading to rebellious Qi, spontaneous sweating, red face, and insomnia. They despaired and prepared for death. I happened to return from Wuyuan and was consulted. Her pulse was wiry and slippery at Cun and Guan positions, large on the right. Lochia flowed freely, and bowels/bladder were unobstructed. There was no disease in the Lower Jiao. Although postpartum, the illness was unrelated to childbirth. The notion that postpartum patients require warming is erroneous. The oral ulcers were not due to extreme Heat, nor did they require heavy cooling agents. Indeed, the fetus died early and was not expelled promptly, causing turbid Qi to steam the Lungs and Stomach, producing these symptoms. If treated promptly upon symptom onset, the source would be clear. Had we mistaken it for postpartum deficiency wheezing and wrongly administered tonics, death would have been inevitable. I prescribed Na Sha Shen (Glehniae Radix), Sheng Tou Cao (Houttuyniae Herba), Hou Po (Magnoliae Officinalis Cortex), Xing Ren (Armeniacae Semen Amarum), Shi Chang Pu (Acori Tatarinowii Rhizoma), Sang Bai Pi (Mori Cortex), Zhu Ru (Bambusae Caulis in Taeniam), Pi Pa Ye (Eriobotryae Folium), Dong Gua Zi (Benincasae Semen), and Si Gua Luo (Luffae Fructus Retinervia), decocted in Qiang Wei Ye (Rosae Chinensis Folium) and Lu Gen (Reed Rhizome) water. After two doses, Qi smoothed, cough ceased, and appetite returned. I removed Xing Ren and Hou Po, added Yi Yi Ren (Coicis Semen) and Gan Cao (Licorice Root); oral ulcers healed, and chills/fever stopped. Only joint pain and night sweats remained. I switched to clearing Heat and nourishing Yin, allowing her to rise. For soft waist and legs, I prescribed Qi and Blood tonics, leading to recovery.
Mrs. Rong Fang, wife of Mr. Qing Rong Fang’s second son (son of Guan Shu Qing), suffered from chills and fever in early winter, with deafness, chest fullness, constipation, profuse leukorrhea, vomiting, thirst, and insomnia, refusing food for over ten days. Everyone considered it critical. Her pulse was wiry and rapid; tongue crimson without coating; Qi rebelled, face red; she sought quick death. This was deep Liver depression, Wood-Fire internal scorching, consuming fluids, obstructing Qi, and impairing opening/closing mechanisms. Xiao Chai Hu Tang and Xiao Yao San were superficially similar but fundamentally different; misuse would lead to disaster. This illustrates the difficulty of syndrome differentiation. Fortunately, father and son trusted me completely. I prescribed Xiao Xian Xiong Tang (Small Chest-Trap Decoction) plus Shi Chang Pu (Acori Tatarinowii Rhizoma), Zhu Ru (Bambusae Caulis in Taeniam), Xuan Fu Hua (Inulae Flos), Zhi Zi (Gardeniae Fructus), and Huang Qin (Scutellariae Radix), decocted in Lu Gen (Reed Rhizome) water. After one dose, chest comfort improved, Qi stabilized; after two doses, slight sleep occurred; after three doses, vomiting stopped, congee intake resumed; after five doses, bowel/bladder function normalized, chills/fever ceased, tongue coating appeared, and appetite returned. Then I switched to gentle nourishment, leading to recovery.
Madam Jin, miscarried in mid-summer. For over four months, lochia dripped continuously. Recently, she developed sores on both arms and generalized pruritus. Pulse was rapid and wiry. Multiple medications failed, misled by the erroneous postpartum warming theory. I prescribed Xi Yang Shen (American Ginseng) and Yin Hua (Lonicerae Japonicae Flos) each 2 qian; Sheng Di (Rehmanniae Radix) and Gui Ban (Testudinis Carapax et Plastrum) each 4 qian; Dong Gua Pi (Benincasae Exocarpium) 3 qian; Zhi Tan (Charred Gardeniae Fructus) and Zhu Ru (Bambusae Caulis in Taeniam) each 1.5 qian; Bai Wei (Cynanchi Atrati Radix), Qing Hao (Artemisiae Annuae Herba), and Huang Bo (Phellodendri Cortex) each 1 qian; Gan Cao (Licorice Root) 0.6 qian. She recovered in less than ten doses.
Miss Shen Xuejiang, daughter of Mr. Shen Yun Feng and daughter-in-law of Minister Xu Shaoyan of Lili. She suffered diarrhea during pregnancy, which persisted postpartum. For half a year, various drugs failed. Her pulse was wiry, rapid, and slippery at Chi position. Inquiry revealed abundant leukorrhea, dry mouth, lower back and throat pain, hot urine, frequent belching, cold limbs, and irritability. This indicated Liver Heat with Wind moving in the Stomach; fluid loss led to daily depletion of Yin-Blood. I prescribed Bai Tou Weng Tang (Pulsatilla Decoction) plus Yu Liang Shi Zhi (Kaolin and Hematite), Shu Di (Prepared Rehmanniae Radix), Gui Ban (Testudinis Carapax et Plastrum), Zhu Ru (Bambusae Caulis in Taeniam), Qing Hao (Artemisiae Annuae Herba), and Sha Ren (Amomi Fructus). Frequent administration led to recovery.
Madam Shen Yun Feng, wife of Mr. Shen Yun Feng, developed body heat, phlegm-cough, headache, abdominal pain, loose stools, and thirst after childbirth. Physicians treated one symptom while aggravating another, remaining ambiguous. By the ninth day, I arrived in He. Pulse was slippery and rapid; coating slightly yellow. This was Winter-Warmth contracted during pregnancy. I primarily used clearing and resolving methods. Some doubted this due to loose stools. I said: "Loose stools are a pathway for Lung Heat elimination; if stools become constipated, wheezing will ensue. Moreover, in summer, I treated her urinary difficulty during pregnancy; diuretics failed, but clearing the Lung succeeded. Although now postpartum, her organ functions remain unchanged, compounded by external pathogenic Heat. As the saying goes, 'When there is disease, the disease receives the treatment.'" Continuous administration brought peace.
In mid-winter, visiting Suzhou, a Mr. Zhu from Changzhou sought treatment for chronic malaria. Facial edema, yellow eyes, hoarse voice, dark urine, abdominal distension. Pulse slippery and wiry. Damp-Heat accumulated, lacking resolution. Coating greasy, no sweat, poor appetite, profuse phlegm. I prescribed a Clearing and Transforming formula, advising dietary restraint and avoiding sweets/grease. He claimed local experts insisted on daily sugar water alongside medicine for cure. I said: "They only know that dispersing induces sweating to expel pathogens, and sugar harmonizes the middle to stop malaria. But the more you disperse, the less it resolves; the more you harmonize, the less it stops. This is applying rigid rules to dynamic diseases. Believing them will lead to Malaria Ascites." The patient was alarmed, took my prescription, sweated, and recovered.
Mr. Huai from Xiushui, thirty-five years old. Spontaneous bleeding occurred once in early spring, then frequently, with increasing volume. By late winter, I was consulted. Left pulse deficient, wiry, rapid; right pulse soft and large. Rebellious Qi, spontaneous sweating, cold feet, red face, insomnia, bland taste, low voice, mental fatigue, occasional acid regurgitation. This stemmed from emotional distress, Liver stagnation, with a pulse suggesting Qi dispersion and Blood exhaustion. He insisted on returning home. Since invited, I reluctantly wrote a prescription to appease him. However, the patient, pretending to understand, rejected my Liver-soothing herbs, insisting on Wu Wei Zi (Schisandrae Fructus), Shan Yu (Corni Fructus), Jiang (Zingiberis Rhizoma), and Gui (Cinnamomi Cortex). His obstinate nature caused the disease; stubbornness accelerated death. Later, his wife’s pulse was wiry, fine, with scalp psoriasis, headache, palpitations, leukorrhea, anorexia, and five-palm heat, indicating Yin deficiency and Liver excess. I told relatives: "Why are these two so depressed?" I learned they had no sons; the husband wanted to take a concubine, but the wife refused, leading to discord and illness. The wife’s subsequent remorse also caused her illness. This mirrored Mr. Jin Chengcheng of Sheng Province, who, wealthy in youth, feared childlessness. This is "haste makes waste." The foolish wife, driven by jealousy, caused ruin. Even acquiring a concubine now would help not; suicide would benefit nothing. I record this as a warning.
A young man suffered chronic internal heat, epistaxis, gingival bleeding, dark urine, difficult defecation, red eyes, and thirst. Heat signs were obvious. Due to long-term impotence, doctors diagnosed Yang deficiency and prescribed warming tonics, exacerbating heat. Parents, unaware, arranged marriage. The young man, distressed, sought my help. Pulse slippery and rapid. I said: "No harm." I prescribed Yuan Shen (Scrophulariae Radix), Dan Pi (Moutan Cortex), Zhi Mu (Anemarrhenae Rhizoma), Bai Wei (Cynanchi Atrati Radix), Zhi Zi (Gardeniae Fructus), Shi Chang Pu (Acori Tatarinowii Rhizoma), Si Gua Luo (Luffae Fructus Retinervia), Sha Shen (Glehniae Radix), Ge Qiao (Concha Tridacnae), and Zhu Ru (Bambusae Caulis in Taeniam). After six doses, he reported nocturnal emission. I said: "Depressed Heat drained, Yang function restored." It proved true.
Prostitute Rong Ying consulted me. Originally from a good family, menstruation started at fourteen, married at twenty-two, first birth at twenty-five. She noted mild lower back/abdominal pain followed by delivery. Second birth at thirty-two was similar. Married twice more, never breastfed, births became frequent, deliveries slower. This spring, her tenth child required over four hours of labor. Others thought it fast; she felt it slow. At fifty, menses continued, no chronic diseases, rarely took medicine, had slight leukorrhea which recently ceased, but daily expectorated phlegm. Fearing future dystocia, she sought advice. I was surprised. Though not beautiful, she wore no makeup, looked elegant, skin resembling a thirty-year-old. Truly a rare beauty. Confirmed the saying "Three Scarcities of Chicken Skin" are valid. Six pulses were slow, slippery, and long; Left Cun/Guan wiry and rapid, indicating intelligence and longevity. With age, Qi solidified, slowing delivery. Previous leukorrhea and current phlegm, combined with Left Cun/Guan, indicated Fire boiling fluids, preventing downward flow. I advised Liu Jun Zi Tang (Six Gentlemen Decoction) modifications for daily use. If pregnant again at seven/eight months, frequent Shu Tai Yin (Fetus-Binding Decoction) would ensure easy delivery. She left happy. Recorded to show unique constitutions.
I have sixteen upper and sixteen lower teeth. Never painful, but unable to bite hard objects since childhood. I brush with salt and rinse with cold water every morning, regardless of season. Since spring/summer this year, food intake decreased. The sixth tooth on the right gradually couldn't chew. Touching tough food caused unbearable pain and sensitivity to cold rinses. I attributed this to decline after last year's illness, ignoring it. I don't drink alcohol naturally but appreciated it. Previously, I drank one or two cups with my mother. Last winter, suffering from meridian deficiency unable to turn in bed, friends advised daily wine to harmonize Qi/Blood. I became accustomed, never drunk. On the night of Dec 18, I woke with right gum pain. Next day, eating hindered. I had planned a trip to Qingzhen, so I carried a needle, pricked the area frequently, releasing blood. Afternoon relief. Returned next day, eating normally, thinking all was well. Feb 21 (Start of Spring), pain/swelling returned; needling ineffective. Followed by chills, fever, pulling pain on the right side of vertex, forehead, cheekbone, cheek, jaw, chin. Coating not visible. Diagnosed Wind-Fire external invasion. Used Qiong Jie (Notopterygii Rhizoma), Qiao (Forsythiae Fructus), Chan Tui (Cicadae Periostracum), Zhi (Peucedani Radix), Sang Ye (Mori Folium), Bo He (Menthae Haplocalycis Herba). Two doses: chills stopped, but feet cold, face hot, dark urine, yellow coating. Nasal passage not blocked, but right nostril discharged pus-like turbid discharge, sometimes flowing down from above, foul and bitter. Right face swollen, lip sores. Swollen areas feared cold, needing hot compresses, yet internal fire surged. I don't take pills/powders or eat rich food. Clearly, years of alcohol consumption caused long-standing Damp-Heat steaming upward. Alcohol Heat enters Gallbladder, moves to Brain causing Bi Yuan (Nasal Sinusitis). Moving to Brain is actually moving to Stomach. Symptoms manifested in Shaoyang and Yangming sectors. Prescribed Yuan Shen (Scrophulariae Radix), Sang Ye (Mori Folium), Ju Hua (Chrysanthemi Flos), Hua Fen (Trichosanthis Radix), Yin Hua (Lonicerae Japonicae Flos), Zhi Zi (Gardeniae Fructus), Si Gua Luo (Luffae Fructus Retinervia), Dong Gua Zi (Benincasae Semen), Lu Gen (Reed Rhizome). Mixed with Lu Fu Zhi (Radish Juice), adjusted with Yu Shu Dan (Jade Pivot Pill). Two doses: coating dissolved, fire calmed, bowels/bl畅通. External wash with salty brine reduced swelling. Two more doses without Yu Shu Dan: chewing possible, daily North Pear consumption. By New Year's Day, foul discharge thinned. Days 5-6: went out in strong wind. Day 7 afternoon: right gum pain returned, radiating to temple/ear. Sixth tooth erupted, hindering eating, chills/fear of wind. Used Sang Ye (Mori Folium), Ju Hua (Chrysanthemi Flos), Sheng Gan Cao (Raw Licorice Root), Lv Dou Pi (Vigna Radiata Testa), Yuan Shen (Scrophulariae Radix), Yi Yi Ren (Coicis Semen), Yin Hua (Lonicerae Japonicae Flos), Zhi Tan (Charred Gardeniae Fructus), Bo He (Menthae Haplocalycis Herba), Gou Teng (Uncariae Ramulus cum Uncis). To clear/disperse Wind-Heat. One dose: swelling/pain reduced. Removed Bo He/Gou Teng, added Pi Pa Ye (Eriobotryae Folium). Four doses: pain flat, sixth tooth split internally/externally. Root firm, but chewing hindered. Gum swelling resolved by early summer. Later, patches/lumps appeared on head/face/limbs, swollen, itchy, migrating. Involved fingers, toes, palms, soles. Scratching released purple blood, forming black scabs like smallpox marks. Resolved by late autumn. Washed with salty brine when itchy; internal Silver Flower/Mung Bean/Coix Decoction; dietary restraint for eight months. Alas, the harm of alcohol! Regret late realization; vowed never to touch it. Remembering twenty years ago, Zhang Yunong invited me to Dong Ou; sister warned against drinking. I obeyed, having no alcohol illness. Recently, feeling frail, indulged slightly, causing this ailment. Lucky that stage was shallow, treatment correct, preventing entrenched disease. Naturally non-drinkers suffer even from little. Detailed record as warning. My sister, filial and wise, helped mother with household chores since childhood. I forced her to marry the Jin family; widowed after ten years. I regret deeply, appending this to note my fault.
I suffered diarrhea for a year as an infant. At three, vaccinated for smallpox. The physician didn't realize variola major was emerging and added vaccine material, leading to danger. My mother carried me, crawling on knees for five days/nights. Saved by Mr. Ren Liujia, my constitution remained weak. In childhood, I feared labor; slight movement caused epistaxis, so I sat quietly. In summer at twelve, severe Warmth disease. Parents worried. In delirium, I saw gods saying: "This is a Lucky Star." Woke with sweating, recovered. After losing father, traveled far to Wu. Following mother's training, cautious. After adulthood, epistaxis cured. In deep winter, no need for cotton padding, but slight raw/cold food caused diarrhea; roasted food caused sore throat. Married in Ji Chou year. In Jia Wu year, whole family suffered epidemic,