平湖张振西，壁邻失火受惊，越数日而病发，无大寒热，烦闷不食，昏倦不寐。余视之，颇作寒喧语，而神不接。余曰:此失魂之证，不但风寒深人，而神志亦伤，不能速愈，亦不可用重剂，以煎方祛邪，以丸散安神，乃可渐复。时正岁除，酌与半月之药而归。至新正元宵，始知身在卧室间，问前所为，俱不知也。至二月身已健，同其弟元若来谢，候余山中。且曰:我昨晚脑后起一瘰，微痛。余视之，惊曰:此玉枕疽也。大险之证，此地乏药，急同之归，外提内托，诸法并用。其弟不能久留先归。明晨我子大惊呼余日:张君危矣。余起视之，头大如斗，唇厚寸余，目止细缝，自顶及肩，脓泡数千，惟神不昏愤，毒未攻心，尚可施救。急遣舟招其弟。余先以护心药灌之，毋令毒气攻内，乃用煎剂从内托出，外用软坚消肿解毒提脓之药敷之，一日而出毒水斗余.至晚肿渐消，皮皱。明日口舌转动能食，竟不成疽，疮口仅如钱大，数日结痂。其弟闻信而至，已愈八九矣。凡病有留邪而无出路，必发肿毒，患者甚多，而医者则鲜能治之也。
扬州吴运台夫人，患消证，昼夜食粥数十碗，气逆火炎，通夕不寐。余诊之，六脉细数不伦，神不清爽。余曰:此似祟脉，必有他故。其家未信，忽一日仆妇晨起入候，见床上一女盛妆危坐，以为夫人也，谛视则无有，因以告。夫人曰:此女常卧我床内，以此不能成寐，而烦渴欲饮耳。服余药未甚效。一夕夜将半，病者大呼曰:速请三舅爷来，切不可启门，启门则我魂必走出。三舅爷者，即其弟唐君悔生也。卧室辽隔，呼之不能闻，女仆私启门邀之，魂即随出，遍历厅堂廊庑，及平昔足未经行者，遇唐君趋至，魂坚执其辫，仍返房，见己身卧床上，唐君抚之，魂遂归附于身。问所寓目皆不爽，细考所见之女，乃运台聘室也，未成婚而卒，卒之时，嘱其父母，谓吴郎必显贵，我死须恳其血食我，而葬我于祖墓。运台服官后，未暇办，故为祟。运台谓余曰:君言有为祟者，考果验，真神人也。将何以慰之?余曰:鬼有所归，乃不为厉，公当迎柩厝墓，立位而祀之可也。运台依余言以行，然后服药有功，而病根永除矣。
祟 病
同里朱翁元亮，侨居郡城。岁初，其媳往郡拜贺其舅，舟过娄门，见城上蛇王庙，俗云烧香能免生疮肿，因往谒焉。归即狂言昏冒，舌动如蛇，称蛇王使二女仆一男仆来迎。延余诊视，以至宝丹一丸遣老岖灌之，病者言此系毒药，必不可服，含药喷妪，妪亦仆，不省人事，舌伸颈转，亦作蛇形。另易一人灌药讫，病者言一女使被烧死矣。凡鬼皆以朱砂为火也。次日煎药，内用鬼箭羽，病者又言一男使又被射死矣，鬼以鬼箭为矢也。从此渐安，调以消痰安神之品，月余而愈。此亦客许之类也，非金石及通灵之药，不能奏效。
林家巷周宅看门人之妻缢死，遇救得苏，余适寓周氏，随众往看，急以紫金锭捣烂，水灌之而醒。明日又缢亦遇救，余仍以前药灌之。因询其求死之故，则曰:我患心疼甚，有老妪劝我将绳系颈，则痛除矣，故从之，非求死也。余曰:此妪今安在?则曰:在里床。视之无有。则曰:相公来，已去矣。余曰:此缢死鬼，汝痛亦由彼作祟，今后若来，汝即嚼余药喷之。妇依余言，妪至，曰:尔口中何物，欲害我耶?詈骂而去。其自述如此，盖紫金锭之辟邪神效若此。
同学李鸣古，性诚笃而能文，八分书为一时冠，家贫不得志，遂得奇疾。日夜有人骂之，闻声而不见其形，其骂语恶毒不堪，遂恼恨终日，不寝不食，多方晓之不喻也。其世叔何小山先生甚怜之，同同余往诊。李曰:我无病，惟有人骂我耳。余曰:此即病也。不信，小山喻之曰:子之学问人品，人人钦服，岂有骂汝之人耶。李变色泣下曰:他人劝我犹可，世叔亦来劝我，则不情甚矣。昨日在间壁骂我一日，即世叔也，何今日反来面谀耶?小山云:我昨在某处竟日，安得来此?且汝间壁是谁家，我何从入?愈辨愈疑，惟垂首浩叹而已，卒以忧死。
瘟 疫
雍正十年，昆山瘟疫大行，因上年海啸，近海流民数万，皆死于昆，埋之城下。至夏暑蒸尸气，触之成病，死者数千人。汪翁天成亦染此症，身热神昏，闷乱烦躁，脉数无定。余以清凉芳烈，如鲜菖蒲、泽兰叶、薄荷、青蒿、芦根、茅根等药，兼用辟邪解毒丸散进之，渐知人事；因自述其昏晕时所历之境，虽言之凿凿，终虚妄不足载也。余始至昆时，惧应酬不令人知，会翁已愈，余将归矣。不妨施济，语出而求治者二十七家，检其所服，皆香燥升提之药，与证相反。余仍用前法疗之，归后有叶生为记姓氏，愈者二十四，死者止三人，又皆为他医所误者，因知死者皆枉。凡治病不可不知运气之转移，去岁因水湿得病，湿甚之极，必兼燥化，《内经》言之甚明，况因证用药，变化随机，岂可执定往年所治祛风逐湿之方，而以治瘟邪燥火之证耶。
雄按:风湿之邪，一经化热，即宜清解，温升之药，咸在禁例。喻氏论疫，主以解毒，韪矣。而独表彰败毒散一方，不知此方虽名败毒，而群集升散之品，凡温邪燥火之证.犯之即死，用者审之。
暑
—同学赵子云，居太湖之滨，患暑痢甚危，留治三日而愈。时值亢早，人忙而舟亦绝少，余欲归不能。惟邻家有一舟，适有病人气方绝，欲往震泽买棺，乞借一日不许。有一老妪指余曰:此即治赵某病愈之人也。今此妇少年恋生甚，故气不即断，盍求一诊。余许之，脉绝而心尚温，皮色未变，此暑邪闭塞诸窍，未即死也。为处清暑通气方，病家以情不能却，借舟以归。越数日，子云之子来，询之，一剂而有声，二剂能转侧，三剂起矣。
余寓郡中林家巷，时值盛暑，优人某之母，忽呕吐厥僵，其形如尸，而齿噤不开，已办后事矣。居停之，仆怂优求救于余。余因近邻往诊，以著启其齿，咬著不能出。余曰:此暑邪闭塞诸窍耳。以紫金锭二粒水磨灌之，得下，再服清暑通气之方。明日，余泛舟游虎阜，其室临河，一老妪坐窗口榻上，仿佛病者。归访之，是夜黄昏即能言，更服煎剂而全愈。此等治法，极浅极易，而知者绝少。盖邪逆上，诸窍皆闭，非芳香通灵之药，不能即令通达，徒以煎剂灌之，即使中病，亦不能人于经窍，况又误用相反之药，岂能起死回生乎。
芦墟迮耕石，暑热坏证，脉微欲绝，遗尿谵语，寻衣摸床，此阳越之证，将大汗出而脱。急以参附加童便饮之，少苏而未识人也。余以事往郡，戒其家曰:如醒而能言，则来载我。越三日来请，亟往。果生矣。医者谓前药已效，仍用前方煎成未饮。余至，曰:阳已回，火复炽，阴欲竭矣。附子入咽即危，命以西瓜啖之，病者大喜，连日啖数枚，更饮以清暑养胃而愈。后来谢述昏迷所见，有一黑人立其前欲啖之，即寒冷入骨，一小儿以扇驱之，曰:汝不怕霹雳耶?黑人曰:熬尔三霹雳，奈我何?小儿日:再加十个西瓜何如?黑人惶恐而退。余曰:附子古名霹雳散，果服三剂，非西瓜则伏暑何由退，其言皆有证据，亦奇事也。
雄按:袁简斋太史作《灵胎先生传》载此案云，先投一剂，须臾目暝能言，再饮以汤，竟跃然起。故张柳吟先生以为再饮之汤，当是白虎汤。今原案以西瓜啖之，因西瓜有天生白虎汤之名。而袁氏遂下一汤字，致启后人之疑。序事不可不慎，此类是矣。
毛履和之子介堂，暑病热极，大汗不止，脉微肢冷，面赤气短，医者仍作热证治。余曰:此即刻亡阳矣，急进参附以回其阳。其祖有难色。余曰:辱在相好，故不忍坐视，亦岂有不自信而尝试之理，死则愿甘偿命。乃勉饮之。一剂而汗止，身温得寐，更易以方，不十日而起。同时东山许心一之孙伦五，病形无异，余亦以参附进，举室皆疑骇，其外舅席际飞笃信余，力主用之，亦一剂而复。但此证乃热病所变，因热甚汗出而阳亡，苟非脉微足冷，汗出舌润，则仍是热证，误用即死，死者甚多，伤心惨目。此等方非有实见，不可试也。雄按:舌润二字，最宜切记。
闾门内香店某姓，患暑热之证，服药既误，而楼小向西，楼下又香燥之气，薰烁津液，厥不知人，舌焦目裂。其家去店三里，欲从烈日中抬归以待毙。余曰:此证固危，然服药得法，或尚有生机。若更暴于烈日之中，必死于道矣。先进以至宝丹，随以黄连香薷饮，兼竹叶石膏汤加芦根，诸清凉滋润之品徐徐灌之。一夕而目赤退，有声，神气复而能转侧；二日而身和，能食稀粥，乃归家调养而痊。雄按:此证已津液受烁，舌焦目裂矣，则用至宝丹，不如用紫雪，而香薷亦可议也。
常熟席湘北，患暑热证，已十余日，身如炽炭，手不可近，烦躁昏沉，聚诸汗药，终无点汗。余曰:热极津枯，汗何从生?处以滋润清芳之品，三剂。头先有汗，渐及手臂，继及遍身而热解。盖发汗有二法，湿邪则用香燥之药，发汗即以去湿；燥病则用滋润之药，滋水即以作汗。其理易知，而医者茫然，可慨也。
洞庭后山席姓者，暑邪内结，厥逆如尸，惟身未冷，脉尚微存，所谓尸厥也。余谓其父曰:邪气充塞，逼魂于外，通其诸窍，魂自返耳。先以紫金锭磨服，后用西瓜、芦根、萝卜、甘蔗打汁，时时灌之，一日两夜，纳二大碗而渐苏。问之，则曰:我坐新庙前大石上三日，见某家老妪，某家童子，忽闻香气扑鼻，渐知身在室中，有一人卧床上，我与之相并，乃能开目视物矣。新庙者，前山往后山必由之路，果有大石，询两家老妪、童子俱实有其事。此类甚多，不能尽述，其理固然，非好言怪也。
闾门龚孝维，患热病，忽手足拘挛，呻吟不断，瞀乱昏迷，延余诊视，脉微而躁，肤冷汗出，阳将脱矣。急处以参附方。亲戚满座，谓大暑之时，热病方剧，力屏不用。其兄素信余，违众服之，身稍安。明日更进一剂，渐苏能言，余乃处以消暑养阴之方而愈。
郡中友人蒋奕兰，气体壮健，暑月于亲戚家祝寿，吃汤饼过多，回至闾门，又触臭秽，痧暑夹食，身热闷乱。延医治之，告以故，勉用轻药一剂，亦未能中病也。况食未消而暑未退，岂能一剂而愈。明日复诊曰:服清理而不愈，则必虚矣。即用参附，是夕烦躁发昏，四肢厥冷，复延名医治之，曰:此虚极矣。更重用参附，明日热冒昏厥而毙。余往唁之，伤心惨目，因念如此死者，遍地皆然，此风何时得息?又伤亲故多遭此祸，归而作《慎疾刍言》，刻印万册，广送诸人，冀世人之或悟也。
雄按:《慎疾刍言》，今罕流传，海丰张柳吟先生加以按语，改题日《医砭》，欲以砭庸流之陋习也。余已刊入丛书。
暑邪热呃
东山席士后者，暑月感冒，邪留上焦，神昏呃逆，医者以为坏证不治，进以参附等药，呃益甚。余曰:此热呃也。呃在上焦，令食西瓜，群医大哗。病者闻余言即欲食，食之呃渐止，进以清降之药，二剂而诸病渐愈。
又有戚沈君伦者，年七十，时邪内陷而呃逆，是时余有扬州之行，乃嘱相好尤君在泾曰:此热呃也，君以枇把叶、鲜芦根等清降之品饮之必愈。尤君依余治之亦痊。盖呃逆本有二因:由于虚寒，逆从脐下而起，其根在肾，为难治。由于热者，逆止在胸臆间，其根在胃，为易治，轻重悬绝。世人谓之冷呃，而概从寒治，无不死者，死之后，则云凡呃逆者，俱为绝证。不知无病之人，先冷物，后热物，冷热相争，亦可呃逆，不治自愈，人所共见，何不思也。
洞庭姜锡常长郎佩芳，体素弱而患久疟，时余应山前叶氏之招，便道往唔，佩芳出，诊色夭脉微，而动易出汗。余骇曰:汝今夕当大汗出而亡阳矣，急进参附，或可挽回。其父子犹未全信，姑以西洋参三钱，偕附子饮之，仍回叶宅。夜二鼓叩门声甚急，启门，而锡常以肩舆来迎，至则汗出如膏，两目直视，气有出无入，犹赖服过参附，阳未逮脱，适余偶带人参钱许，同附子、童便灌入，天明而汗止阳回，始知人事。然犹闻声即晕，倦卧不能起者两月，而后起坐。上工治未病，此之谓也。如此危急之证，不但误治必死，即治之稍迟，亦不及挽回。养生者，医理不可不知也。
痢
崇明施姓，迁居郡之盘门，其子患暑毒血痢，昼夜百余行，痛苦欲绝。嘉定张雨亭，其姻戚也，力恳余诊之。余曰:此热毒蕴结。治之以黄连、阿胶等药，一服而去十之七八矣。明日再往，神清气爽，面有喜色。余有事归家，约隔日重来。归后遇风潮，连日行舟断绝，三日后乃得往诊。病者怒目视余，问以安否?厉声而对曰:用得好药，病益重矣。余心疑之，问其父，曾服他人药否?隐而不言。余甚疑之，辞出。有二医者人门，因托雨亭访其故，其父因余不至，延郡中名医，仍进以人参、干姜等药。绐病者曰:视汝脉者此地名医，而药则用徐先生方也。及服而痛愈剧，痢益增，故恨余入骨耳，岂不冤哉!又闻服药之后，口干如出火，欲啖西瓜。医者云:痢疾吃西瓜必死。欲求凉水，尤禁不与，因绐其童取井水嗽口，夺盆中水饮其半，号呼两日而死。近日治暑痢者，皆用《伤寒论》中治阴寒入脏之寒痢法，以理中汤加减，无不腐脏惨死，甚至有七窍流血者，而医家病家视为一定治法，死者接踵，全不知悔，最可衰也。
平湖人张振西，因邻居失火受惊，过了几天病发，没有明显的寒热症状，只是心烦胸闷、不想吃饭、昏沉疲倦且无法入睡。我诊察时，见他说话有些像寒暄客套，但精神恍惚，神志不接。我说：这是失魂的证候，不仅是风寒之邪深入体内，而且神志也受到了损伤，不能快速痊愈，也不可用重剂，应当用汤药祛除邪气，用丸散安神，这样才能逐渐恢复。当时正值除夕，我斟酌开了半个月的药让他回去。到了正月十五元宵节，才知道他人在卧室里，问他之前的事，全都不记得了。到了二月身体已经康复，他和弟弟元若一起来山中感谢我。他还说：我昨晚脑后起了一个瘰疬，微痛。我看后，惊讶地说：这是玉枕疽。这是一个非常危险的证候，这里缺乏药物，急忙让他跟我回去，采用外提内托的方法，各种疗法并用。他的弟弟不能久留先回去了。第二天清晨，我的儿子大声惊呼告诉我：张先生危险了。我起来查看，发现他头大如斗，嘴唇厚达一寸多，眼睛只剩细缝，从头顶到肩膀，有数千个脓泡，幸好神志没有昏迷，毒气没有攻心，还可以施救。急忙派人乘船去叫他的弟弟。我先用护心药灌服他，不让毒气攻入内脏，然后用煎剂从内部托出毒邪，外用软坚消肿解毒提脓的药物敷贴，一天就排出了毒水一斗多。到了晚上肿胀逐渐消退，皮肤起皱。第二天口舌转动灵活，能够进食，最终没有形成严重的疽，疮口仅如铜钱大小，几天后结痂。他的弟弟听到消息赶来，他已经好了八九成。凡是病邪滞留而没有出路，一定会发生肿毒，患者很多，但医生很少能治好的。
扬州吴运台夫人，患消渴证，昼夜喝几十碗粥，气逆火炎，整夜无法入睡。我诊脉，六脉细数杂乱，神志不清爽。我说：这像是中邪的脉象，必定有其他原因。他们家不信，忽然有一天早晨仆妇起床进去问候，看见床上坐着一个盛装的女子，以为是夫人，仔细看却发现没有人，于是告诉了夫人。夫人说：这个女子常睡在我的床里，因此我不能入睡，感到烦渴想喝水。服用我的药后效果不明显。一天夜里半夜时分，病人突然大喊：快请三舅爷来，千万不要开门，开门我的魂就会走出去。三舅爷就是她的弟弟唐君悔生。卧室相隔很远，喊声听不见，女仆私自开门邀请他，魂随即跟了出来，遍游厅堂廊屋，甚至平时未曾走过的地方，遇到唐君快步走来，魂紧紧抓住他的辫子，返回房间，看到自己身体躺在床上，唐君抚摸她，魂便归附于身。问她所见所闻都很清楚，仔细考证那个女子，是运台已聘但未成婚的妻子，未婚而亡，死时嘱咐父母，说吴郎必显贵，我死后必须恳求他祭祀我，并葬我在祖墓。运台做官后，没空办理，所以被作祟。运台对我说：你说有作祟之事，考证果然应验，真是神人。用什么来安慰她呢？我说：鬼有所归，才不为厉，你应该迎接灵柩安葬在墓地，设立牌位祭祀就可以了。运台依从我说的话去做，然后服药见效，病根永除。
同乡朱翁元亮，侨居在郡城。年初，他的儿媳去郡城拜贺舅舅，船经过娄门，看见城上的蛇王庙，俗传烧香能免生疮肿，于是前往参拜。回来后就狂言昏冒，舌头动得像蛇，称蛇王派了两个女仆和一个男仆来接。请我去诊视，我用至宝丹一丸让老妪灌服，病人说这是毒药，绝对不能吃，含着药喷向老妪，老妪也倒下，不省人事，舌头伸出脖子转动，也做出蛇形。换一个人灌药完毕，病人说一个女使被烧死了。凡鬼都以朱砂为火。第二天煎药，里面用了鬼箭羽，病人又说一个男使又被射死了，鬼把鬼箭当作箭矢。从此逐渐安定，用消痰安神的药物调理，一个多月痊愈。这也是客许（附体）之类，如果不是金石及通灵的药，不能奏效。
林家巷周宅看门人的妻子上吊自杀，遇救苏醒，我正好住在周家，随众人前往查看，急忙将紫金锭捣烂，用水灌服而醒。第二天又上吊，又遇救，我还是用前药灌服。于是询问她求死的原因，她说：我心痛得很厉害，有个老妪劝我将绳子系在脖子上，痛就消除了，所以我照做了，并不是求死。我说：这个老妪现在在哪里？她说：在里床。看去没有。又说：相公来了，已经走了。我说：这是缢死的鬼，你的痛也是由它作祟，今后如果再来，你就嚼我的药喷它。妇人依从我说的话，老妪来了，说：你嘴里有什么东西，想害我吗？骂着离开了。她自己叙述如此，大概紫金锭辟邪的神效就是这样。
同学李鸣古，性格诚实笃厚且能写文章，八分书是当时的第一，家里贫穷不得志，于是得了奇疾。日夜有人骂他，听见声音却看不见形状，骂语恶毒不堪，于是他恼恨终日，不睡觉不吃饭，多方开导他不明白。他的世叔何小山先生很怜惜他，一同和我去诊视。李说：我没病，只是有人骂我罢了。我说：这就是病。他不信，小山劝导他说：你的学问人品，人人都钦佩信服，哪里有骂你的人呢。李变色流泪说：别人劝我还可，世叔也来劝我，那就太不合情理了。昨天在隔壁骂我一天，就是世叔您，为什么今天反而当面阿谀呢？小山说：我昨天在某处整天都在，怎么能来这里？况且你隔壁是谁家，我从哪里进去？越辩越疑，只是低头长叹而已，最终因为忧愤而死。
雍正十年，昆山瘟疫盛行，因为上年海啸，近海流民数万，都死在昆山，埋在城下。到了夏天暑气蒸腾尸气，触之成病，死者数千人。汪翁天成也染上此症，身热神昏，闷乱烦躁，脉数无定。我用清凉芳烈之药，如鲜菖蒲、泽兰叶、薄荷、青蒿、芦根、茅根等药，兼用辟邪解毒丸散进服，逐渐知晓人事；因为他自述昏晕时所经历的境界，虽然言之凿凿，终究虚妄不值得记载。我刚到昆山时，怕应酬不让人知道，恰逢翁已痊愈，我准备回去了。不妨施济，话一说出口，求治的有二十七家，检查他们所服用的药，都是香燥升提的药，与证候相反。我仍用前面的方法治疗，回去后有叶生记录了姓氏，痊愈的二十四人，死亡的只有三人，又都是被其他医生误治的，因此知道死者都是枉死。凡是治病不可不知运气之转移，去年因水湿得病，湿气极甚，必然兼有燥化，《内经》说得非常明白，何况因证用药，变化随机，岂可固执往年所治祛风逐湿的方子，用来治疗瘟邪燥火的证候呢。
雄按：风湿之邪，一经化热，就宜清解，温升之药，都在禁忌之列。喻氏论疫，主张以解毒为主，是对的。但唯独表彰败毒散一方，不知道此方虽名败毒，而聚集的都是升散之品，凡是温邪燥火的证候，犯了就会死，使用者要审慎。
暑
同学赵子云，居住在太湖边，患暑痢非常危急，留治三天而愈。当时正值亢旱，人忙而船只也极少，我想回不能回。只有邻家有一艘船，恰好有个人气刚断，想去震泽买棺材，乞求借一天不许。有一个老妪指着我说：这就是治赵某病愈的人。现在这个妇人年轻贪恋生命，所以气没有立即断绝，何不请求诊视。我答应了她，脉绝而心尚温，皮色未变，这是暑邪闭塞诸窍，没有立即死。为她开了清暑通气方，病家因为情面不能推辞，借船让我回去。过了几天，子云的儿子来，询问情况，一剂药就有声音，二剂能翻身，三剂就能起来了。
我寓居在郡中林家巷，当时正值盛夏，优伶某的母亲，忽然呕吐厥僵，形体如尸体，牙齿紧闭不开，已经办好后事了。房东的仆人怂恿优伶向我求救。我因邻近前往诊视，用箸启开他的牙齿，咬著不能取出。我说：这是暑邪闭塞诸窍。用紫金锭两粒水磨灌服，得以咽下，再服清暑通气之方。第二天，我泛舟游虎阜，那屋子临河，一个老妪坐在窗口榻上，仿佛病人。回去探访，那天黄昏就能说话，再服煎剂而全愈。这种治法，极浅极易，但知道的人极少。大概邪气逆上，诸窍皆闭，不是芳香通灵之药，不能即刻令其通达，徒然用煎剂灌服，即使中病，也不能进入经窍，何况又误用相反的药，怎能起死回生呢。
芦墟迮耕石，暑热坏证，脉微欲绝，遗尿谵语，寻衣摸床，这是阳越的证候，将要大汗出而脱阳。急忙用人参加童便饮服，稍苏醒但不能识人。我因事往郡城，告诫他家说：如果醒来能说话，就来载我。过了三天来请，急忙前往。果然活过来了。医生说前药已有效，仍用前方煎成未饮。我到了，说：阳已回，火复炽，阴欲竭了。附子入口即危险，命令吃西瓜，病人很高兴，连日吃了几枚，更饮以清暑养胃药而愈。后来感谢时叙述昏迷所见，有一个黑人站在面前想吃他，即寒冷入骨，一个小男孩用扇子驱赶，说：你不怕霹雳吗？黑人说：熬你三个霹雳，奈我何？小男孩说：再加十个西瓜如何？黑人惶恐而退。我说：附子古名霹雳散，果然服三剂，不是西瓜则伏暑怎么退，他的话都有证据，也是奇事。
雄按：袁简斋太史作《灵胎先生传》记载此案说，先投一剂，片刻后闭眼能说话，再饮以汤，竟然跃然起身。所以张柳吟先生认为再饮之汤，当是白虎汤。现在原案说是吃西瓜，因为西瓜有天生白虎汤之名。而袁氏遂用一个“汤”字，导致引起后人怀疑。叙事不可不慎，此类就是。
毛履和之子介堂，暑病热极，大汗不止，脉微肢冷，面赤气短，医生仍作热证治。我说：这是即刻亡阳了，急进人参附子以回阳。他的祖父有难色。我说：承蒙相好，所以不忍坐视，难道有不自信而尝试的道理，死了愿甘偿命。于是勉强饮服。一剂而汗止，身温得寐，更易以方，不到十天就好了。同时东山许心一的孙子伦五，病形无异，我也用人参附子进服，全家都疑骇，他的外舅席际飞笃信我，力主使用，也是一剂而复。但这种证候乃热病所变，因热甚汗出而阳亡，如果不是脉微足冷，汗出舌润，则仍是热证，误用即死，死者甚多，伤心惨目。这种方子非有实见，不可试也。雄按：“舌润”二字，最宜切记。
闾门内香店某姓，患暑热之证，服药既误，而楼小向西，楼下又是香燥之气，薰烁津液，厥不知人，舌焦目裂。他家离店三里，想在烈日中抬回去等待死亡。我说：此证固然危险，但如果服药得法，或许还有生机。如果在烈日中暴晒，必死于道上了。先进用以宝丹，随即用黄连香薷饮，兼竹叶石膏汤加芦根，各种清凉滋润之品徐徐灌服。一晚而目赤退，有声，神气复而能转侧；两天而身和，能吃稀粥，于是回家调养而痊愈。雄按：此证已津液受烁，舌焦目裂了，那么用至宝丹，不如用紫雪，而香薷也可议。
常熟席湘北，患暑热证，已十余天，身如炽炭，手不可近，烦躁昏沉，聚诸汗药，终无点汗。我说：热极津枯，汗从哪里生？处以滋润清芳之品，三剂。头先有汗，渐及手臂，继及遍身而热解。大概发汗有二法，湿邪则用香燥之药，发汗即以去湿；燥病则用滋润之药，滋水即以作汗。其理易知，而医生茫然，可悲啊。
洞庭后山席姓者，暑邪内结，厥逆如尸，惟身未冷，脉尚微存，所谓尸厥。我对他父亲说：邪气充塞，逼魂于外，通其诸窍，魂自然返回。先用紫金锭磨服，后用西瓜、芦根、萝卜、甘蔗打汁，时时灌服，一天两夜，纳二大碗而渐苏。问之，则说：我坐在新庙前大石上三天，看见某家老妪，某家童子，忽然闻香气扑鼻，渐知身在室中，有一人卧在床上，我与之相并，才能开目视物了。新庙是前山往后山必经之路，果有大石，询问两家老妪、童子俱实有其事。此类很多，不能尽述，其理固然，不是喜欢说怪事。
闾门龚孝维，患热病，忽然手足拘挛，呻吟不断，瞀乱昏迷，延请我诊视，脉微而躁，肤冷汗出，阳将脱了。急处以参附方。亲戚满座，谓大暑之时，热病正剧，极力屏弃不用。他哥哥素信我，违众服之，身体稍安。第二天再进一剂，渐苏能言，我才处以消暑养阴之方而愈。
郡中友人蒋奕兰，气体壮健，暑月在亲戚家祝寿，吃汤饼过多，回到闾门，又触臭秽，痧暑夹食，身热闷乱。延请医生医治，告诉他缘故，勉强用轻药一剂，也未能中病。况且食未消而暑未退，岂能一剂而愈。第二天复诊说：服清理而不愈，则必虚了。即用参附，当晚烦躁发昏，四肢厥冷，又延请名医医治，说：此虚极了。更重用参附，第二天热冒昏厥而毙。我去吊唁，伤心惨目，因而想到如此死者，遍地皆然，这种风气何时得息？又伤亲故多遭此祸，回去作《慎疾刍言》，刻印万册，广送诸人，希望世人或许能醒悟。
雄按：《慎疾刍言》，如今罕流传，海丰张柳吟先生加以按语，改题曰《医砭》，想用砭庸流之陋习。我已刊入丛书。
暑邪热呃
东山席士后者，暑月感冒，邪留上焦，神昏呃逆，医生以为坏证不治，进以参附等药，呃逆更严重。我说：这是热呃。呃在上焦，令其吃西瓜，群医大哗。病人听我话就想吃，吃了呃逆渐止，进以清降之药，二剂而诸病渐愈。
又有戚沈君伦者，年七十，时邪内陷而呃逆，这时我有扬州之行，于是嘱托相好尤君在泾说：这是热呃，你用枇杷叶、鲜芦根等清降之品饮服必愈。尤君依从我治疗也痊愈。大概呃逆本有二因：由于虚寒，逆从脐下而起，其根在肾，为难治。由于热者，逆止在胸臆间，其根在胃，为易治，轻重悬绝。世人谓之冷呃，而一概从寒治，无不死者，死之后，则说凡呃逆者，俱为绝证。不知道无病之人，先冷物，后热物，冷热相争，亦可呃逆，不治自愈，人所共见，为何不思呢。
洞庭姜锡常长子佩芳，体质素弱而患久疟，当时我正应山前叶氏之招，顺路前往会晤，佩芳出来，诊色夭脉微，而动易出汗。我惊骇地说：你今晚当大汗出而亡阳了，急进参附，或可挽回。他父子犹未全信，姑且以西洋参三钱，偕附子饮服，仍回叶宅。夜里二鼓叩门声甚急，开门，而锡常以肩舆来迎，到了则汗出如膏，两目直视，气有出无入，还赖服过参附，阳未逮脱，适逢我偶带人参钱许，同附子、童便灌入，天明而汗止阳回，始知人事。然而还闻声即晕，倦卧不能起者两个月，而后起坐。上工治未病，说的就是这个。如此危急之证，不但误治必死，即治之稍迟，也不及挽回。养生者，医理不可不知。
痢
崇明施姓，迁居郡之盘门，其子患暑毒血痢，昼夜百余行，痛苦欲绝。嘉定张雨亭，是他的姻戚，极力恳请我诊视。我说：这是热毒蕴结。治之以黄连、阿胶等药，一服而去十之七八了。第二天再去，神清气爽，面有喜色。我有事回家，约隔日重来。回家后遇风潮，连日行舟断绝，三天后才得以去诊视。病人怒目视我，问我安好否？厉声回答说：用好药，病更重了。我心里怀疑，问其父，曾服他人药否？隐瞒不言。我很怀疑，辞出。有两个医生进门，于是托雨亭访其原因，其父因为我不到，延请郡中名医，仍进以人参、干姜等药。欺骗病人说：为你诊脉的是此地名医，而药则是用徐先生的方子。等到服了而痛更剧烈，痢更增，所以恨我入骨，岂不冤哉！又听说服药之后，口干如出火，想吃西瓜。医生说：痢疾吃西瓜必死。想求凉水，尤其禁止不给，于是骗他童儿取井水漱口，夺盆中水喝了一半，号呼两天而死。近日治暑痢者，都用《伤寒论》中治阴寒入脏之寒痢法，以理中汤加减，无不腐脏惨死，甚至有七窍流血者，而医家病家视为一定治法，死者接踵，全不知悔，最可哀也。
Zhang Zhenxi from Pinghu, startled by a fire in the neighboring house, fell ill after several days. He had no significant chills or fever, but suffered from mental restlessness, chest oppression, anorexia, lethargy, and insomnia. Upon examination, he spoke as if engaging in casual conversation, yet his spirit was disconnected. I said: This is a syndrome of lost soul (Shi Hun). Not only has the pathogenic wind-cold penetrated deeply, but the Shen (Spirit) and Zhi (Intellect) are also injured. It cannot be cured quickly, nor should heavy decoctions be used. Decoctions should be used to expel pathogens, and pills/powders to calm the Shen; only then can gradual recovery occur. At that time, it was New Year's Eve. I prescribed medication for half a month, and he returned home. By the Lantern Festival, it was learned that he remained in his bedroom, and when asked about previous events, he knew nothing. By February, his health had recovered. He came with his younger brother, Yuanruo, to thank me in the mountains. He added: Last night, a scrofula (Luo Li) appeared at the back of my head, slightly painful. Upon inspection, I exclaimed: This is Yuzhen Ju (Yuzhen Carbuncle/Ulcus). This is a very dangerous condition. Medicines are scarce here. I urgently took him back, employing external extraction and internal support methods, combining various therapies. His brother could not stay long and returned first. The next morning, my son shouted in alarm: Master Zhang is in critical condition! I rose to examine him. His head was large as a basin, lips thickened by more than an inch, eyes reduced to narrow slits. From crown to shoulders, there were thousands of pustules. Fortunately, his Shen was not confused, and the toxin had not attacked the Heart; rescue was still possible. I urgently sent a boat to fetch his brother. First, I administered heart-protective medicine to prevent the toxin from attacking the interior. Then, I used a decoction to push the toxin out from within, and applied external medicines to soften hardness, reduce swelling, detoxify, and promote pus discharge. Over one day, more than a dou (approx. 10 liters) of toxic fluid was discharged. By evening, the swelling subsided, and the skin wrinkled. The next day, his mouth and tongue moved freely, and he could eat. Ultimately, it did not develop into a severe carbuncle; the wound was only coin-sized and scabbed over in a few days. When his brother arrived, he was already 80-90% recovered. Whenever pathogens remain without an exit, they must manifest as swellings or sores. Many patients suffer this, but few doctors can treat it.
Madam Wu Yuntai from Yangzhou suffered from Xiao Ke (Wasting and Thirsting Syndrome). She drank dozens of bowls of porridge day and night, experienced rebellious Qi and flaming Fire, and could not sleep all night. My pulse diagnosis revealed six pulses that were fine, rapid, and disordered; her Shen was unclear. I said: This resembles a pulse of possession (Chong Mai), indicating another cause. Her family did not believe. Suddenly, one morning, a maid entered to greet her, saw a beautifully dressed woman sitting upright on the bed, thought it was Madam Wu, but upon closer inspection, saw no one. She reported this. Madam Wu said: This girl often lies in my bed, preventing me from sleeping and causing irritability and thirst. My medicine had little effect. One night around midnight, the patient suddenly shouted: Quickly invite Third Uncle! Do not open the door, or my soul will leave. Third Uncle is her brother, Tang Jun Huisheng. The bedroom was far apart, so she could not hear the call. A female servant secretly opened the door to invite him. The soul followed out, touring the halls and corridors, even places never visited before. Meeting Tang Jun approaching, the soul firmly held his braid and returned to the room. Seeing her own body lying on the bed, Tang Jun stroked her, and the soul attached itself to the body. Asked about what she saw, everything was clear. Careful investigation revealed the woman was Yun Tai's betrothed wife, who died before marriage. Before dying, she instructed her parents that Wu Lang would become noble, and begged to be sacrificed to and buried in the ancestral tomb. After Yun Tai became an official, he had no time to arrange this, hence the possession. Yun Tai told me: You said there was possession; verification proved true. You are truly divine. How shall we appease her? I said: When ghosts have a place to return to, they do not become malevolent. You should welcome the coffin to the tomb, set up a tablet, and sacrifice to her. Yun Tai followed my advice. Then the medicine worked, and the root of the disease was permanently removed.
Possession Disease (Chong Bing)
Zhu Weng Yuanliang, a fellow townsman, lived temporarily in the commandery city. At the beginning of the year, his daughter-in-law went to the city to congratulate her uncle. Passing Lou Gate, she saw the Snake King Temple on the city wall. Folk custom says burning incense prevents sores and swellings, so she went to worship. Upon returning, she spoke madly and fainted, her tongue moving like a snake, claiming the Snake King sent two female servants and one male servant to welcome her. I was invited to diagnose. I gave one pill of Zhibao Dan (Treasure Protecting Pill) to an old woman to administer. The patient said this is poison and must not be taken. She spat the medicine at the old woman, who also collapsed, unconscious, tongue extended, neck turning, mimicking a snake shape. Another person administered the medicine. The patient said a female servant was burned to death. All ghosts fear Cinnabar (Zhusha) as fire. The next day, decocting medicine containing Arisaematis Cum Bile (Gu Jian Yu), the patient said a male servant was shot dead; ghosts use Gu Jian as arrows. Gradually, she calmed down. Regulated with phlegm-resolving and Shen-calming herbs, she recovered in over a month. This is also a case of possession (Ke Xu). Without mineral or spiritually penetrating medicines, efficacy cannot be achieved.
The wife of the gatekeeper at the Zhou residence in Linjia Alley hanged herself. Saved and revived, I happened to be staying at the Zhou house. Following others to inspect, I urgently crushed Zijin Ding (Purple Gold Pill) and administered it with water to wake her. The next day, she hanged herself again, was saved again, and I administered the same medicine. Asking the reason for seeking death, she said: My heart pain was severe. An old woman advised me to tie a rope around my neck to remove the pain, so I complied. I did not seek death. I asked: Where is this old woman now? She said: On the inner bed. Looking, there was none. She said: The Xianggong (Scholar) has come, and she has left. I said: This is a ghost of a hanged woman. Your pain is caused by her possession. If she comes again, chew my medicine and spit at her. The woman followed my advice. When the old woman arrived, she said: What is in your mouth? Do you want to harm me? She cursed and left. As she narrated, the spiritual efficacy of Zijin Ding in dispelling evil is thus.
My classmate Li Minggu was honest, sincere, and literate. His Ba Fen calligraphy was the best of the time. Poor and frustrated, he developed a strange illness. People cursed him day and night; he heard voices but saw no form. The curses were vicious. He was angry and resentful all day, neither sleeping nor eating. Despite many attempts to enlighten him, he did not understand. His great-uncle, Mr. He Xiaoshan, pitied him greatly and went with me to diagnose. Li said: I am not sick; people just curse me. I said: This is the illness. He did not believe. Xiaoshan persuaded him: Your learning and character are admired by all. Who would curse you? Li changed color and cried: Others persuading me is acceptable, but if my great-uncle also persuades me, it is too unreasonable. Yesterday, someone cursed me all day in the next door; it was you, Great-Uncle. Why are you flattering me face-to-face today? Xiaoshan said: I was somewhere else all day yesterday. How could I come here? And who lives next door? How could I enter? The more he argued, the more suspicious Li became. He only bowed his head and sighed heavily. Ultimately, he died of sorrow.
Plague (Wen Yi)
In the 10th year of Yongzheng, a plague raged in Kunshan. Due to a tsunami the previous year, tens of thousands of refugees from coastal areas died in Kunshan and were buried under the city walls. In summer, heat steamed the corpse gas. Contact with it caused illness, killing thousands. Wang Weng Tiancheng also contracted this. He had fever, coma, oppression, confusion, irritability, and irregular rapid pulse. I used cooling, aromatic, and potent herbs such as fresh Rhizoma Acori Tatarinowii (Xian Changpu), Folium Eupatorii (Zelan Ye), Folium Menthae Haplocalycis (Bohe), Herba Artemisiae Annuae (Qinghao), Radix Imperatae (Lugen), and Radix Imperatae Alterniflorae (Maogen), combined with anti-possession and detoxifying pills/powders. He gradually regained consciousness. He described his experiences during fainting; although vivid, they were ultimately illusory and not worth recording. When I first arrived in Kunshan, fearing social engagements would reveal my presence, I found Wang had recovered and I was preparing to leave. However, charity was offered. Words spoken attracted 27 families seeking treatment. Checking their previous medications, all were aromatic, drying, and ascending drugs, contrary to the syndrome. I continued using the previous method. Upon return, Ye Sheng recorded names. 24 recovered, only 3 died, all due to misdiagnosis by other doctors. Thus, I knew the deaths were unjust. In treating diseases, one must know the shift of Qi and Yun (Luck/Climate). Last year, illness was due to water-dampness. Extreme dampness must transform into dryness. The *Neijing* states this clearly. Moreover, medication must change according to symptoms. How can one rigidly stick to last year's wind-dispelling and damp-expelling formulas to treat plague pathogens and dry-fire syndromes?
Xiong's Note: Wind-damp pathogens, once transforming into heat, should be cleared and resolved. Warming and ascending drugs are strictly prohibited. Yu Shi discussed plague, advocating detoxification, which is correct. But exclusively praising Bai Du San (Defeat Toxin Powder) is wrong. Although named "Defeat Toxin," it gathers many ascending and dispersing agents. For warm-pathogen and dry-fire syndromes, using it causes death. Users must be cautious.
Summerheat (Shu)
Classmate Zhao Ziyun, living by Lake Tai, suffered critically from Summerheat Dysentery. I treated him for three days until he recovered. It was extremely dry, people were busy, and boats were rare. I wanted to return but couldn't. Only one neighbor's boat was available, borrowed because a man had just died and needed to go to Zhenze to buy a coffin. Borrowing for one day was refused. An old woman pointed at me and said: This is the one who cured Zhao's illness. This young woman clings to life strongly, so her Qi hasn't completely cut off. Why not request a diagnosis? I agreed. Pulse was absent, but heart was still warm, skin color unchanged. This is Summerheat pathogen blocking the orifices; death is not immediate. I prescribed Qing Shu Tong Qi Fang (Clear Summerheat Unblock Orifices Formula). The family, unable to refuse out of courtesy, lent the boat. Days later, Ziyun's son came. One dose produced sound; two doses allowed turning over; three doses enabled getting up.
I was staying in Linjia Alley, commandery city, during peak summer. A certain actor's mother suddenly vomited, fainted, and stiffened, resembling a corpse, with teeth clenched shut. Funeral arrangements were made. The landlord's servant urged the actor to seek my help. Going nearby to diagnose, I used chopsticks to pry open his teeth, but he bit down hard. I said: This is Summerheat pathogen blocking the orifices. I ground two Zijin Dings in water and administered them. They went down. Then administered Qing Shu Tong Qi Fang. The next day, boating to Tiger Hill, I saw a room by the river. An old woman sat on a window couch, resembling the patient. Returning to visit, that evening at dusk, she could speak. Taking decoction, she fully recovered. Such treatments are very simple and easy, but known by few. When pathogen rebels upward, all orifices close. Only aromatic and spiritually penetrating medicines can immediately open them. Merely pouring decoctions, even if accurate, cannot enter the meridians and orifices. Especially when wrongly using contrary drugs, how can one revive the dead?
Zhe Gengshi from Luxu, suffering from ruined Summerheat syndrome, had a faint, nearly imperceptible pulse, urinary incontinence, delirium, and picking at clothes/bed sheets. This is Yang floating away syndrome, about to sweat profusely and collapse. Urgently administered Renshen (Ginseng Radix) and Fuzi (Aconiti Lateralis Radix Praeparata) with child's urine. Slightly revived but unrecognized. I went to the city for business, instructing his family: If he wakes and speaks, send a boat to fetch me. Three days later, they summoned me. He was alive. Doctors said previous medicine worked and continued the same decoction. I arrived and said: Yang has returned, Fire is blazing, Yin is exhausted. Fuzi entering the throat is dangerous. Ordered him to eat watermelon. Patient was delighted, ate several daily. Further treated with Qing Shu Yang Wei (Clear Summerheat Nourish Stomach) formula, and recovered. Later, thanking me, he recounted his coma vision: A black man stood before him wanting to eat him, causing bone-chilling cold. A child drove him away with a fan, saying: Aren't you afraid of thunderbolts? Black man said: Endure three thunderbolts from you, what can you do? Child said: How about ten more watermelons? Black man retreated in fear. I said: Fuzi's ancient name is Pi Li San (Thunderbolt Powder). Indeed, taking three doses, without watermelon, how would latent Summerheat retreat? His words have evidence; it is a marvel.
Xiong's Note: Yuan Jianzhai's *Biography of Mr. Lingtai* records this case: First dose given, soon eyes closed but could speak. Second dose of soup, jumped up. So Mr. Zhang Liuyin believed the second soup should be Baihu Tang (White Tiger Decoction). The original case says watermelon was eaten, because watermelon is called "Natural White Tiger Soup." Yuan used the word "soup," causing later doubt. Narration must be careful; this is an example.
Mao Lühe's son Jietang, suffering from extreme Summerheat heat, had continuous profuse sweating, faint pulse, cold limbs, red face, and shortness of breath. Doctors still treated it as Heat syndrome. I said: This is immediate Yang collapse. Urgently advance Renshen and Fuzi to restore Yang. His grandfather showed hesitation. I said: Out of friendship, I cannot sit idly by. Is there any reason to lack self-confidence and try? If he dies, I am willing to pay with my life. Reluctantly, he drank it. One dose stopped sweating, body warmed, slept. Formula changed. Recovered in less than ten days. Meanwhile, Xu Xin yi's grandson Lunwu from Dongshan had identical symptoms. I also used Renshen and Fuzi. The whole family was shocked and suspicious. His maternal uncle, Xi Jifei, trusted me firmly and insisted on usage. Also recovered in one dose. But this syndrome is transformed from Heat disease. Due to extreme heat and sweating, Yang collapses. Unless pulse is faint, feet cold, sweating, and tongue moist, it remains Heat syndrome. Wrong usage causes death. Many die, heartbreaking. Such formulas should not be tried without solid insight. Xiong's Note: "Tongue moist" must be remembered carefully.
A certain surname running a spice shop inside Lumen Gate suffered Summerheat syndrome. Medication was mistaken. The room was small and west-facing; downstairs was spicy/dry aroma, scorching fluids. Fainted, unconscious, tongue scorched, eyes cracked. Family lived 3 li from the shop, wanted to carry him in the scorching sun to wait for death. I said: This syndrome is critical, but if medication is correct, there may be hope. Exposing to scorching sun guarantees death on the road. First administer Zhibao Dan, then Huanglian Xiangru Yin (Coptis and Mosla Drink), combined with Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) plus Lugen. Slowly administer various cooling and moistening medicines. Overnight, eye redness subsided, sound returned, Shen recovered, able to turn. Two days later, body harmonized, could eat thin porridge. Returned home to recuperate and healed. Xiong's Note: Fluids are scorched, tongue scorched, eyes cracked. Using Zhibao Dan is inferior to using Zixue (Purple Snow). Xiangru is also debatable.
Xi Xiangbei from Changshu, suffered Summerheat syndrome for over ten days. Body like hot charcoal, hands could not touch, irritability, drowsiness. Gathered various sweating drugs, but no sweat. I said: Extreme heat, fluid exhaustion. How can sweat generate? Prescribed moistening and clearing aromatic herbs. Three doses. Sweat started on head, spread to arms, then whole body, heat resolved. Sweating has two methods: For damp pathogen, use aromatic-drying herbs; sweating removes dampness. For dry disease, use moistening herbs; nourishing water generates sweat. Principle is easy to know, but doctors are ignorant. Tragic.
A Xi surnamed person from back mountain of Dongting Island, Summerheat pathogen knotted internally. Cold limbs like a corpse, body not cold, pulse barely present. This is Shi Jue (Corpse Syncope). I told his father: Pathogen fills and blocks, forcing Hun (Ethereal Soul) outside. Open the orifices, and Hun returns naturally. First grind and take Zijin Ding. Then use juice from watermelon, Lugen, radish, sugarcane, administered frequently. One day and night, consumed two large bowls, gradually revived. Asked, he said: I sat on a big stone in front of the new temple for three days. Saw an old woman and a boy from certain families. Suddenly smelled fragrant aroma. Gradually realized I was in a room. Someone lying on bed, I lay beside him, then could open eyes and see. New temple is the必经 route from front to back mountain. Indeed, there is a big stone. Inquiry confirmed the old woman and boy existed. Many such cases, cannot list all. Principle is natural, not liking to speak of miracles.
Gong Xiaowei from Lumen Gate, suffered Heat disease. Suddenly limbs convulsed, groaning continuously, confused and comatose. Invited me to diagnose. Pulse faint and restless, cool skin, sweating. Yang about to collapse. Urgently prescribed Shen Fu Tang (Ginseng and Aconite Decoction). Relatives filled the room, saying in peak summer, Heat disease is intense, strongly opposed using it. His brother, trusting me, defied crowd and took it. Body slightly stabilized. Next day, another dose. Gradually revived and spoke. Then prescribed Xiaoshu Yang Yin (Cool Summerheat Nourish Yin) formula, and healed.
Friend Jiang Yilan in the commandery, robust constitution. Celebrated birthday at relative's house in summer, ate too much noodle soup. Returning to Lumen Gate, exposed to foul smell. Sha (Sand) Summerheat mixed with food stagnation. Fever, oppression, confusion. Doctor treated, told the cause, reluctantly used light medicine one dose, failed to hit the mark. Food undigested, Summerheat unremoved, how can one dose cure? Next day re-diagnosed: Clearing didn't work, must be deficiency. Immediately used Renshen and Fuzi. That night, irritability, coma, cold limbs. Famous doctor treated again: Extreme deficiency. Increased Renshen and Fuzi dosage. Next day, heat, coma, and death. I mourned, heartbreaking. Thinking such deaths are everywhere, when will this trend stop? Relatives and friends suffered this fate. Returned and wrote *Shen Ji Chu Yan* (Admonitions on Cautious Illness), printed 10,000 copies, distributed widely, hoping people might awaken.
Xiong's Note: *Shen Ji Chu Yan* is rarely circulated now. Mr. Zhang Liuyin of Haifeng added notes, retitled *Yi Bian* (Medical Critique), aiming to critique the ignorance of mediocre doctors. I have included it in the series.
Summerheat Heat Hiccups (Shu Re E)
Xi Shihou from Dongshan, caught cold in summer. Pathogen remained in Upper Jiao. Coma and hiccups. Doctors considered it a ruined syndrome, untreatable. Advanced Renshen and Fuzi. Hiccups worsened. I said: This is Heat Hiccup. Hiccup is in Upper Jiao. Ordered eating watermelon. Doctors uproar. Patient, hearing me, wanted to eat. Ate, hiccups gradually stopped. Advanced descending/clearing herbs. Two doses, all illnesses gradually improved.
Another relative, Shen Junlun, age 70. Seasonal pathogen sank internally causing hiccups. I was going to Yangzhou, entrusted friend You Jun in Jing: This is Heat Hiccup. Use Bi Pa Ye (Loquat Leaf), fresh Lugen, etc., descending/clearing herbs. Must recover. You Jun followed, healed. Hiccups have two causes: Deficiency-Cold, rising from below navel, root in Kidney, difficult to treat. Heat, stopping in chest/diaphragm, root in Stomach, easy to treat. Severity differs vastly. People call it Cold Hiccup, generally treat as Cold. All die. After death, say all hiccups are terminal signs. Don't know healthy people, eating cold then hot things, cold-hot conflict, can also hiccup. Self-heals without treatment, commonly seen. Why not think?
Malaria (Nüe)
Jiang Xichang's eldest son Peifang from Dongting Island, constitution weak, suffered chronic Malaria. I was invited by Ye family in Shanqian, passed by to meet. Peifang came out. Complexion dull, pulse faint, movement induced sweating. I was alarmed: Tonight you will sweat profusely and lose Yang. Urgently advance Renshen and Fuzi, perhaps salvage. Father and son didn't fully believe. Tentatively gave 3 qian of American Ginseng (Xi Yang Shen) with Fuzi. Returned to Ye house. Midnight, urgent knocking. Opened door, Xichang arrived in sedan chair. Arrived, sweating like paste, eyes staring straight, breathing out but not in. Still relied on having taken Renshen/Fuzi, Yang not yet collapsed. Happily, I carried a small amount of Renshen. Mixed with Fuzi and child's urine, administered. Dawn, sweat stopped, Yang returned, conscious. Yet still fainted at sound, too weak to rise for two months, then sat up. Superior doctors treat before disease arises; this is it. Such critical conditions, not only wrong treatment causes death, but delayed treatment also fails to save. Those who value life must know medical principles.
Dysentery (Li)
Shi family from Chongming, moved to Panmen Gate, commandery. Son suffered Summerheat-Toxin Bloody Dysentery. Over 100 times day and night, extreme pain. Zhang Yuting from Jiading, relative by marriage, earnestly requested diagnosis. I said: Heat-toxin accumulation. Treat with Huanglian (Coptidis Rhizoma) and Ejiao (Asini Corii Colla). One dose, 70-80% gone. Next day, spirit clear, face happy. Had business, returned home, planned to revisit in two days. Weather prevented travel for three days. Went to diagnose. Patient glared, asked if well, replied harshly: Used good medicine, illness worsened. I suspected. Asked father: Took other medicine? Father hid it. Very suspicious, left. Two doctors entered. Entrusted Yuting to investigate. Father, because I didn't come, invited famous city doctor, advanced Renshen and Ganjiang (Zingiberis Rhizoma). Lied to patient: City famous doctor diagnosed, but medicine uses Mr. Xu's formula. Took it, pain intensified, dysentery increased. Hated me to the bone. Unjust! Heard after medicine, mouth dry like fire, wanted watermelon. Doctor said: Dysentery eating watermelon means death. Wanted cool water, forbidden. Deceived child to get well water to rinse mouth, stole half bowl to drink. Screamed for two days, died. Recently treating Summerheat Dysentery, all use *Shanghan Lun* methods for Cold Dysentery (Yin-Cold invading viscera). Modify Lizhong Tang. All rot viscera and die miserably, some bleeding from seven orifices. Doctors and families view as fixed method. Deaths follow each other, no repentance. Most lamentable.