不能坐。孟英诊曰。口苦而渴乎。泻出如火乎。小溲不行乎。痰粘且韧乎。病者曰诚然。孟
英曰。只因时值小寒。哮喘霍乱。人皆误指为寒。予北沙参生苡仁冬瓜子丝瓜络竹茹石斛枇
叶贝母知母栀子芦根青果海 菔汁为方。一剂知。二剂已。（此证可治。除当日察脉外。全
在痰粘且韧一语。凡热证体实阳旺则痰粘韧。体虚阳衰则痰稀清。热证阳旺可治。阳虚不治
。北沙参四钱。生苡仁杵八钱。生冬瓜子四钱。丝瓜络三钱。姜竹茹三钱。鲜石斛杵先一两
。姜枇叶刷包三钱。川贝母杵五钱。酒炒知母三钱。黑栀皮三钱。鲜芦根二两。青果杵先三
枚。淡海 先一两。芦菔八钱。打汁和服。)
吴芸阁因壮年时患梅疮。过服寒凉之药。虚寒病起。改投温补。如金液丹大造丸之类获安。
医昧药为补偏救弊而设。漫无节制。率以为常。驯致血溢于上。便泄于下。食少痰多。喘逆
碍卧。两足不能屈伸。童某犹云寒湿。进以苓姜术桂多剂。势益剧。且溲渐碧而色绿如胆汁
。孟英诊之。脉弦硬无情。（胃阴已竭。)曰∶从前寒药戕阳。今则热药竭阴矣。胃中津液。
皆灼烁以为痰。五脏咸失所养。而见证如上。水源欲绝。小溲自然渐少。木火内焚。乃露东
方之色。与章虚谷所治暑结厥阴。用来复丹攻其邪从溺出而见深碧之色者。彼实此虚。判分
霄壤。寻果殁。（来复丹原方。玄精石一两。洋硫黄一两。生硝石一两。五灵脂一两。青皮
陈皮各一两。
醋糊丸米饮下。治伏暑泄泻身热脉弱。念按此必治阳虚伏暑。用此丹于阴药中。开泄其中焦
之伏暑。使从二便疏泄。)
戴氏妇年五十六。仲冬患感。初服杨某归柴丹参药一剂。继服朱某干姜苍术浓朴药五剂。遂
崩血一阵。孟英诊之。脉形空 促数。苔黑舌绛。足冷而强。息微善笑。询其汛断逾十载。
（此证可治。在汛断十载。阴精基础。尚不亏损。)曰∶冬温失于清解。营血暴脱于下。岂可
与热入血室同年而语耶。必由误服热药所致。检各方叹曰∶小柴胡汤与冬温何涉。即以伤寒
论。亦不能初感即投。况以丹参代人参。尤为悖谬。夫人参补气。丹参行血。主治天渊。不
论风寒暑湿。初起皆禁用血药。为其早用反致引邪深入也。既引而入。再误于辛热燥烈之数
投。焉得不将其仅存无几之血。逼迫而使之尽脱于下乎。女人以血为主。天癸既绝。无病者
尚不宜有所漏泄。况温邪方炽。而阴从下脱。可不畏哉。病家再四求治。孟英予西洋参生地
苁蓉犀角石斛生芍银花知母麦冬甘草蔗浆童溺两剂。得解酱粪。（西洋参三钱。大生地六钱
。淡苁蓉三钱。磨犀角冲五分。生白芍杵先四钱。酒炒银花五钱。酒炒知母一钱五分。整麦
冬三钱。生粉草二钱。蔗浆冲大半酒杯。童溺一酒杯煎去沫冲药温服。)脉数渐减而 益甚
。乃去犀角。加高丽参。（宜加丽参三钱。)数帖脉渐和。热退进粥。随以调补得安。
王开荣素患痰嗽。兼有红证。今夜病头痛发热。渴饮不饥。便溏溺少。谵语神昏。面赤痰喘
。
自述胸中冷气上冲。孟英诊之。脉滑且数。曰∶温邪挟宿饮上逆。法当清解。予北沙参冬瓜
子知母滑石花粉石菖蒲贝母杏仁芦根葱白淡豉竹沥。（脉滑为痰。数为阴虚挟热。头痛即系
阴虚。以葱豉升知母苦寒于至高之分。始能解其发热面赤痰喘。北沙参八钱。生冬瓜子四钱
。酒炒知母三钱。西滑石先煎四钱。石菖蒲次入一钱。川贝母杵五钱。南花粉四钱。苦杏仁
一钱五分。姜汁拌芦根一两次入。连须葱白打二钱。淡豆豉三钱同次入。姜竹沥大半酒杯和
服
。)两剂后面赤退。乃去葱豉。加麦冬桑叶枇叶。（花麦冬三钱。冬桑叶二钱。鲜枇叶刷包三
钱。)数帖热去泻减。谵语止。头痛息。喘定神清。乃去菖蒲。加梨汁地栗海 。（梨一两。
荸荠二两。同绞汁冲。淡海溺先煎一两。)服数日痰渐少。谷渐安。渴止溺行。始进养阴之
法遂愈。
石子章患腹胀。朱某予大剂温补之药。殊若相安。孟英曰∶形瘦脉数。舌色干红。此为阴虚
热胀。昔年范次侯妻暨杨改之外家之恙皆类是。多医攻补遍施。病无小效。吾以极苦泄热微辛
通络之法投之。应手而瘳。（白头翁一钱。炒川黄柏一钱五分。川楝核杵先三钱。青果杵先
三钱。生白蒺次入三钱。大生地开水泡汤煎药去渣八钱。鲜钗斛杵先一两。济银花八钱。元
参片泡煎去渣一两。陈木瓜三钱。生赭石杵先一两。旋复花绢包三钱。)今子初起时。胀不
碍食。证非气分可知。误信温补不助胀。遂服之不疑。不知阴愈耗。（温补劫阴。)络愈痹。
（阴虚者气随津布。津液耗则气不行。)胀虽不加。而肌愈削。（气不随津布则肉枯。)脉愈数
。（温补伤阴则脉数。)干呛气急。（温补伤阴。阳日见其有余。阴日见其不足。则干呛气急
。)与女子之风消息贲何以异耶。（女。子患阳有余阴不足。致水不涵木。则肝阳逆上。名内
风。风消者。言内风能消耗其肌肉。肉阴类。息贲者。贲训奔。言肺气有升无降。若人之奔
驰者言。以上皆温补劫阴所必致。)寻果不起。按喻氏嘉言始言男子亦有血蛊证。可见男
女虽别。而异中有同。同中有异。临证者不可胶柱鼓瑟。
沈某患脘痛呕吐。二便秘涩。诸治不效。孟英视之。脉弦 苔黄腻。曰∶此饮证也。岂沉湎
于酒乎。沈云不饮酒。素以武彝红茶熬浓饮之。茶经蒸遏为红。味变甘浊。全失整肃之气。
遂为酿疾之媒。医者不察。仅知呕吐为寒。姜萸沉附。不时与病相反。抑且更煽风阳。饮藉
风腾。但升不降。是以上不能纳。下不能通。宛似关格。然非阴枯阳结之候。以连楝栀芩旋
复竹茹枇叶橘半苓泽蛤壳荷茎生姜衣为方。送服震灵丹。数剂平。匝月起。（方义苦寒泻风
阳医药。辛温豁停饮医病。酒炒川连八分。黑栀皮三钱。酒炒楝核杵先二钱。酒炒枯芩一钱
五分。旋复花绢包三钱。姜竹茹次入三钱。姜枇叶刷包三钱。赖橘红一钱五分。制半夏四钱
。白茯苓三钱。炒泽泻一钱五分。生蛤壳杵先五钱。鲜荷茎三钱。生姜皮五分。药送震灵丹
三钱。)
石芷卿骤患腹胀。旬日后脐间出脓。外科视为肠痈。予温补内托之药。遂咳嗽不眠。腹中绞
痛异常。痰色红绿。大便不行。孟英诊之。脉弦细以数。舌绛而大渴。曰∶察脉候是真阴大
虚之证。 术归桂。皆为禁剂。以甘露饮加西洋参花粉贝母杏仁冬瓜子投之。痰咳即安。外
科谓此恙最忌泄泻。润药不宜多服。孟英曰∶阴虚液燥。津不易生。虽求其泻。不可得也。
乌可拘泥一偏。不知通变。仍以前法去杏贝花粉。加知母百合合欢为方。并属老医朱嵩年敷
治其外。如法施之。果渐向安。久之当脐痂落。如小儿蜕脐带状。脐内新肉莹然而愈。（出
脓较速。本非寒虚之证。加误温补。咳嗽不眠四句。热邪皆在气分。温补最易伤阴。大生地
八钱。明天冬切六钱。开水泡冲去渣。花麦冬四钱。南花粉五钱。川贝母杵一两。苦杏泥次
入二钱。钗石斛杵先一两。姜炒西茵陈二钱。姜炒枯芩一钱。姜炒枇叶刷包三钱。炒枳壳一
钱五分。更方去川贝花粉。加姜炒知母一钱五分。百合花三钱。合欢皮三钱。敷药亦宜辛凉
。)
袁某患噫。声闻于邻。俞某予理中汤暨旋复代赭汤皆不效。孟英诊之。尺中虚大。乃诘之。
曰∶尔自觉气自少腹上冲乎。病者曰诚然。孟英曰∶此病在下焦。用胡桃肉故纸韭子菟丝
小茴鹿角霜枸杞当归茯苓覆盆子龙齿牡蛎。服一剂。其冲气即至喉而止。不作声为噫矣。再
剂
寂然。多服竟愈。（此证认肾中阳虚。肾阳虚逆。在尺中虚大。连衣胡桃肉一两。炒故纸研
五钱。炒韭子研五钱。炒茺丝饼二钱。小茴香次入一钱五分。鹿角霜炖和服二钱。炒甘枸
杞二钱。箱归身二钱。云茯苓干切三钱。炒覆盆子研五钱。醋 龙齿四钱。醋 牡蛎八钱。
二味同先煨八句钟。)
沈春 母偶患咽喉微痛。服轻清药一剂。即觉稍安。且起居作劳如常。第六日忽云坐立不支
。甫就榻即昏沉如寐。王瘦石用犀角地黄汤化万氏牛黄丸灌之。孟英切其脉左数右滑。皆极
虚。（此证第六日甫就榻即昏沉如寐。阴虚之体。肝阳灼痰。逆升而厥。万不可拘先气后
营
常治之法。以犀角地黄清营。以牛黄化痰热。清营中仍兼清气。脉左数为血分挟热。右滑为
气分挟痰。皆极虚 。则阴液素虚。阳气不随津液为流布。阴虚病温。治最棘手。)曰∶所
见极是。但虽感冬温。邪尚轻微。因积劳久虚之体。肝阳内动。烁液成痰。逆升而厥。俨似
温邪内陷之候。方中犀角靖内风。牛黄化痰热。不妨借用。病可无虞。今日不必再投药饵矣
。翼日复诊。神气虽清。苔色将黑。（苔色将黑。此犀角地黄及牛黄丸之效力。犀角地黄息
风充液。牛黄化痰热。阴稍复。热稍轻。乃能托邪外出。现此将黑之苔。)孟英予肃肺蠲痰
。息风充液之剂。（姜竹茹三钱。姜竹沥一酒杯和服。干柿蒂一钱。淡海 先煎一两六钱。
川
贝母杵八钱。姜枇叶刷包三钱。酒炒知母三钱。半夏曲一钱五分。元参泡冲去渣五钱。黑栀
皮三钱。陈胆星炖和服八分。乌梅三钱。赖橘红次入一钱。)热退而苔色松浮。孟英曰∶舌
将蜕矣。仍予前药。越宿视之。苔果尽褪。宛如脱液之舌。且呕恶时作。大解未行。孟英于
甘润生津药内。仍佐竹茹竹沥柿蒂海 。（南花粉四钱。鲜芦根二两。生冬瓜子四钱。鲜钗
斛杵先一两。炒枳壳一钱五分。赖橘红一钱五分。姜炒枯芩一钱五分。川贝母一钱。淡姜汁
磨冲茹沥柿蒂海 同前方。)数剂呕止便行。而舌上忽布白腐之苔。以及齿龈唇颊满口遍生
。揩试不去。孟英坚守整肃肺胃。仍佐茹沥加青果银花建兰叶。（姜枇叶刷包三钱。黑栀皮
一钱五分。酒炒枯芩一钱五分。姜芦根八钱。陈胆星炖和服七分。苦杏泥一钱五分。赖橘红
八分。姜竹茹三钱。姜竹沥一酒杯冲。济银花次入五钱。建兰叶次入三钱。)数剂白腐渐脱
下。舌色始露。惟啜粥则胸次梗梗不舒。孟英曰∶胃汁不充。热痰未净也。仍守前议。（前
方去栀。皮芦根。加生姜自然汁磨冲枳实五分。连皮北梨一两。打汁和服。)既而吐痰渐少
。纳谷颇适。两胁又添辣痛。孟英诊脉左关弦数。曰∶必犯忿怒矣。诘之果然。加栀楝旱莲
女贞生白芍绿萼梅等。（前方去枯芩橘红竹茹枳实。加黑栀皮三钱。川楝核杵先四钱。女贞
子
杵先五钱。旱莲草四钱。生白芍先煎八钱。绿萼梅次入二钱。)数服各恙皆安。肤蜕成片。
而右腿肿痛。不能屈伸。或疑风气。思用艾炙孟英急止之曰。此阴亏耳。误炙必成废疾。但
难速效。书方以西洋参熟地苁蓉桑葚石斛木瓜归芍二冬杞菊楝实牛膝无核白葡萄干为剂。久
服果得向愈。（西洋参三钱。大熟地八钱。淡苁蓉三钱。干桑葚杵先三钱。鲜钗斛杵先一两
。陈木瓜三钱。箱归身二钱。生白芍四钱。明天冬切六钱。花麦冬四钱。甘枸杞三钱。川楝
核杵先四钱。杭白菊二钱。酒制牛膝一钱。无核白葡萄干三钱。)
孙执中春前四日。忽患鼻衄如注。诸法莫塞。孟英视之。脉弦而数。曰∶冬暖气泄。天令不
主闭藏。今晚雷声大震。人身应之。肝阳乃动。投以元参生地犀角牡蛎知母生白芍牛膝茯苓
侧柏叶童溺诸药。（元参片一两。大生地八钱。磨犀角冲一钱。 牡蛎杵先六两。酒炒知母
二钱。生大白芍一两。酒制牛膝一钱。白茯苓三钱。酒炒柏叶次入一钱五分。清童便一酒杯
冲。)既而胁痛流乳。孟英予甘露饮加女贞旱莲三甲而瘳。（大生地一两。大熟地八钱。明天
冬切六钱。女贞子杵五钱。旱莲草四钱。 牡蛎八两。血鳖甲四两。血龟板二两。合石斛先
炭煨八句钟。取汤代水煎药。石斛一两。酒炒枯芩一钱五分。蜜炙枇叶刷包三钱。大片生粉
草三钱。)
无法坐立。孟英诊察后问道：“口苦且口渴吗？腹泻像火一样灼热吗？小便不通畅吗？痰液粘稠且坚韧吗？”病人回答说：“确实如此。”孟英说：“只因正值小寒节气，哮喘和霍乱患者众多，人们都错误地将其归咎于寒邪。我开具北沙参、生薏苡仁、冬瓜子、丝瓜络、竹茹、石斛、枇杷叶、贝母、知母、栀子、芦根、青果、海螵蛸、萝卜汁作为方剂。服用一剂症状减轻，两剂痊愈。（此证可以治疗，除了当天诊察脉象外，全在于‘痰粘且韧’这一句话。凡是热证、体质壮实、阳气旺盛的人，痰液就会粘稠坚韧；体质虚弱、阳气衰微的人，痰液则稀薄清冷。热证阳气旺盛者可治，阳虚者难治。北沙参四钱，生薏苡仁捣碎八钱，生冬瓜子四钱，丝瓜络三钱，姜竹茹三钱，鲜石斛捣碎先煎一两，姜枇杷叶刷去毛包煎三钱，川贝母捣碎五钱，酒炒知母三钱，黑栀子皮三钱，鲜芦根二两，青果捣碎先煎三枚，淡海螵蛸先煎一两，萝卜八钱，打汁兑入药液中服用。）
吴芸阁在壮年时患梅毒疮，过量服用寒凉药物，导致虚寒病起，改投温补药物，如金液丹、大造丸之类得以安宁。医生不明白药物是为了纠正偏颇、补救弊端而设的，漫无节制，习以为常，逐渐导致血溢于上（吐血等），便泄于下（腹泻等），饮食减少，痰多，气喘逆乱难以平卧，两脚不能屈伸。童某仍说是寒湿，给予茯苓、干姜、白术、桂枝等多剂，病情更加严重。而且小便逐渐变碧绿色，颜色绿得像胆汁。孟英诊察他的脉象弦硬无情（胃阴已枯竭）。说：“从前寒凉药物损伤阳气，现在温热药物耗竭阴液了。胃中的津液，都被火热煎熬成为痰液，五脏都失去滋养，所以出现上述症状。水源将要枯竭，小便自然逐渐减少。木火在内焚烧，才显露出东方（肝）的颜色。这与章虚谷所治疗的暑邪结于厥阴，用来复丹攻逐邪气从尿排出而见深碧色的情况不同，彼为实证，此为虚证，相差如天地之别。”不久果然去世。（来复丹原方：玄精石一两，洋硫黄一两，生硝石一两，五灵脂一两，青皮陈皮各一两，醋糊丸，米饮送下。治疗伏暑泄泻身热脉弱。按语认为这必定是治疗阳虚伏暑，用此丹在滋阴药中，开泄其中焦的伏暑，使邪气从大小便疏泄。）
戴氏妇人五十六岁，仲冬时节患感冒。起初服用杨某开的当归、柴胡、丹参药一剂，继而又服用朱某开的干姜、苍术、厚朴药五剂，于是突然崩漏出血一阵。孟英诊察她的脉象空豁、促数，舌苔黑，舌质绛红，脚冷且僵硬，气息微弱但喜欢笑，询问她月经停止已超过十年。（此证可治，关键在于月经停止十年，阴精的基础尚不亏损。）说：“冬温失于清解，营血在下部暴脱，怎么能与热入血室相提并论呢？必定是由误服热药所致。检视各方感叹道：小柴胡汤与冬温有什么关系？即使以《伤寒论》来看，也不能在初感时立即投用。何况用丹参代替人参，更是荒谬。人参补气，丹参行血，主治功效天壤之别。不论风寒暑湿，初起皆禁用血分药，因为过早使用反而会导致引邪深入。既然已经引邪入内，再误用辛热燥烈的药物多次投服，怎能不将她仅存无几的血液逼迫使其全部脱失于下部呢？女子以血为主，天癸既绝，无病者尚不宜有所漏泄，何况温邪正炽盛，而阴血从下部脱失，能不令人畏惧吗？病家再三请求治疗，孟英给予西洋参、生地、肉苁蓉、犀角、石斛、生白芍、银花、知母、麦冬、甘草、蔗浆、童便两剂，排出酱色粪便。（西洋参三钱，大生地六钱，淡肉苁蓉三钱，磨犀角冲服五分，生白芍捣碎先煎四钱，酒炒银花五钱，酒炒知母一钱五分，整麦冬三钱，生粉草二钱，蔗浆冲大半酒杯，童便一酒杯煎去浮沫兑入药液温服。）脉数逐渐减少而涩象更加明显，于是去掉犀角，加入高丽参。（宜加丽参三钱。）几帖后脉象逐渐调和，热退进粥，随后通过调补得以安宁。
王开荣素患痰嗽，兼有咯血证。今夜发病头痛发热，口渴饮水但不思饮食，大便溏薄，小便少，谵语神昏，面赤痰喘。自述胸中有冷气上冲。孟英诊察脉滑且数，说：“温邪挟带宿饮上逆，法当清解。”给予北沙参、冬瓜子、知母、滑石、花粉、石菖蒲、贝母、杏仁、芦根、葱白、淡豆豉、竹沥。（脉滑主痰，数主阴虚挟热，头痛即系阴虚，用葱豉升散，知母苦寒作用于至高之分，才能解除其发热面赤痰喘。北沙参八钱，生冬瓜子四钱，酒炒知母三钱，西滑石先煎四钱，石菖蒲次入一钱，川贝母捣碎五钱，南花粉四钱，苦杏仁一钱五分，姜汁拌芦根一两次入，连须葱白捣碎二钱，淡豆豉三钱同次入，姜竹沥大半酒杯和服。）两剂后面赤退去，于是去掉葱豉，加入麦冬、桑叶、枇杷叶。（花麦冬三钱，冬桑叶二钱，鲜枇杷叶刷去毛包煎三钱。）数帖后热去泻减，谵语止，头痛息，喘定神清，于是去掉石菖蒲，加入梨汁、荸荠、海螵蛸。（梨一两，荸荠二两，同绞汁冲服，淡海螵蛸先煎一两。）服数日后痰渐少，饮食渐安，渴止溺行，才开始进养阴之法遂愈。
石子章患腹胀。朱某给予大剂温补药物，似乎相安无事。孟英说：“形体消瘦，脉数，舌色干红，这是阴虚热胀。昔年范次侯的妻子以及杨改之外家的病都类似于此。多位医生攻补遍施，病无小效。我用极苦泄热、微辛通络的方法投药，应手而愈。（白头翁一钱，炒川黄柏一钱五分，川楝核捣碎先煎三钱，青果捣碎先煎三钱，生白蒺藜次入三钱，大生地开水泡汤煎药去渣八钱，鲜钗石斛捣碎先煎一两，济银花八钱，元参片泡煎去渣一两，陈木瓜三钱，生赭石捣碎先煎一两，旋复花绢包三钱。）如今子初起时，胀不碍食，证非气分可知。误信温补不助胀，遂服之不疑，不知阴愈耗损。（温补劫阴。）络愈痹阻。（阴虚者气随津布，津液耗则气不行。）胀虽不加，而肌肉愈削。（气不随津布则肉枯。）脉愈数。（温补伤阴则脉数。）干呛气急。（温补伤阴，阳日见其有余，阴日见其不足，则干呛气急。）这与女子患风消息贲有何不同呢？（女，子患阳有余阴不足，致水不涵木，则肝阳逆上，名内风。风消者，言内风能消耗其肌肉，肉属阴类。息贲者，贲训奔，言肺气有升无降，若人之奔驰者言。以上皆温补劫阴所必致。）不久果然不起。按喻氏嘉言始言男子亦有血蛊证，可见男女虽别，而异中有同，同中有异，临证者不可胶柱鼓瑟。
沈某患脘痛呕吐，二便秘涩，诸治不效。孟英视之，脉弦涩，苔黄腻，说：“这是饮证。难道沉湎于酒吗？”沈某说不饮酒，平时以武夷红茶熬浓饮用。茶经蒸遏变为红色，味变甘浊，全失整肃之气，遂成为酿疾之媒。医者不察，仅知呕吐为寒，姜萸沉附，不时与病相反，抑且更煽风阳，饮藉风腾，但升不降，是以上不能纳，下不能通，宛似关格。然非阴枯阳结之候，以黄连、川楝、栀子、黄芩、旋复花、竹茹、枇杷叶、橘红、半夏、茯苓、泽泻、蛤壳、荷茎、生姜衣为方，送服震灵丹，数剂平复，匝月起。（方义苦寒泻风阳医药，辛温豁停饮医病。酒炒川连八分，黑栀子皮三钱，酒炒川楝核捣碎先煎二钱，酒炒枯芩一钱五分，旋复花绢包三钱，姜竹茹次入三钱，姜枇杷叶刷去毛包煎三钱，赖橘红一钱五分，制半夏四钱，白茯苓三钱，炒泽泻一钱五分，生蛤壳捣碎先煎五钱，鲜荷茎三钱，生姜皮五分，药送震灵丹三钱。）
石芷卿骤患腹胀。旬日后脐间出脓，外科视为肠痈，给予温补内托之药，遂咳嗽不眠，腹中绞痛异常，痰色红绿，大便不行。孟英诊察，脉弦细以数，舌绛而大渴，说：“察脉候是真阴大虚之证，白术、当归、桂枝皆为禁剂。”以甘露饮加西洋参、花粉、贝母、杏仁、冬瓜子投之，痰咳即安。外科谓此恙最忌泄泻，润药不宜多服。孟英说：“阴虚液燥，津不易生，虽求其泻，不可得也。乌可拘泥一偏，不知通变。”仍以前法去杏、贝、花粉，加知母、百合、合欢为方，并嘱老医朱嵩年敷治其外，如法施之，果渐向安。久之当脐痂落，如小儿蜕脐带状，脐内新肉莹然而愈。（出脓较速，本非寒虚之证，加误温补，咳嗽不眠四句，热邪皆在气分，温补最易伤阴。大生地八钱，明天冬切六钱，开水泡冲去渣，花麦冬四钱，南花粉五钱，川贝母捣碎一两，苦杏泥次入二钱，钗石斛捣碎先煎一两，姜炒西茵陈二钱，姜炒枯芩一钱，姜炒枇杷叶刷去毛包煎三钱，炒枳壳一钱五分，更方去川贝花粉，加姜炒知母一钱五分，百合花三钱，合欢皮三钱，敷药亦宜辛凉。）
袁某患噫气，声闻于邻。俞某予理中汤暨旋复代赭汤皆不效。孟英诊察，尺中虚大，乃诘之，说：“你自觉气自少腹上冲吗？”病人说：“确实如此。”孟英说：“此病在下焦。”用胡桃肉、故纸、韭子、菟丝子、小茴香、鹿角霜、枸杞、当归、茯苓、覆盆子、龙齿、牡蛎，服一剂，其冲气即至喉而止，不作声为噫矣。再剂寂然，多服竟愈。（此证认肾中阳虚，肾阳虚逆，在尺中虚大。连衣胡桃肉一两，炒故纸研五钱，炒韭子研五钱，炒茺丝饼二钱，小茴香次入一钱五分，鹿角霜炖和服二钱，炒甘枸杞二钱，箱归身二钱，云茯苓干切三钱，炒覆盆子研五钱，醋煅龙齿四钱，醋煅牡蛎八钱，二味同先煨八句钟。）
沈春之母偶患咽喉微痛，服轻清药一剂，即觉稍安，且起居作劳如常。第六日忽云坐立不支，甫就榻即昏沉如寐。王瘦石用犀角地黄汤化万氏牛黄丸灌之。孟英切其脉左数右滑，皆极虚。（此证第六日甫就榻即昏沉如寐，阴虚之体，肝阳灼痰，逆升而厥，万不可拘先气后营常治之法，以犀角地黄清营，以牛黄化痰热，清营中仍兼清气。脉左数为血分挟热，右滑为气分挟痰，皆极虚，则阴液素虚，阳气不随津液为流布，阴虚病温，治最棘手。）说：“所见极是。但虽感冬温，邪尚轻微，因积劳久虚之体，肝阳内动，烁液成痰，逆升而厥，俨似温邪内陷之候。方中犀角靖内风，牛黄化痰热，不妨借用，病可无虞。今日不必再投药饵矣。”翼日复诊，神气虽清，苔色将黑。（苔色将黑，此犀角地黄及牛黄丸之效力，犀角地黄息风充液，牛黄化痰热，阴稍复，热稍轻，乃能托邪外出，现此将黑之苔。）孟英予肃肺蠲痰、息风充液之剂。（姜竹茹三钱，姜竹沥一酒杯和服，干柿蒂一钱，淡海螵蛸先煎一两六钱，川贝母捣碎八钱，姜枇杷叶刷去毛包煎三钱，酒炒知母三钱，半夏曲一钱五分，元参泡冲去渣五钱，黑栀子皮三钱，陈胆星炖和服八分，乌梅三钱，赖橘红次入一钱。）热退而苔色松浮，孟英说：“舌将蜕矣。”仍予前药。越宿视之，苔果尽褪，宛如脱液之舌，且呕恶时作，大解未行。孟英于甘润生津药内，仍佐竹茹、竹沥、柿蒂、海螵蛸。（南花粉四钱，鲜芦根二两，生冬瓜子四钱，鲜钗石斛捣碎先煎一两，炒枳壳一钱五分，赖橘红一钱五分，姜炒枯芩一钱五分，川贝母一钱，淡姜汁磨冲茹沥柿蒂海螵蛸同前方。）数剂呕止便行，而舌上忽布白腐之苔，以及齿龈唇颊满口遍生，揩试不去。孟英坚守整肃肺胃，仍佐茹沥加青果、银花、建兰叶。（姜枇杷叶刷去毛包煎三钱，黑栀子皮一钱五分，酒炒枯芩一钱五分，姜芦根八钱，陈胆星炖和服七分，苦杏泥一钱五分，赖橘红八分，姜竹茹三钱，姜竹沥一酒杯冲，济银花次入五钱，建兰叶次入三钱。）数剂白腐渐脱下，舌色始露，惟啜粥则胸次梗梗不舒。孟英说：“胃汁不充，热痰未净也。”仍守前议。（前方去栀皮芦根，加生姜自然汁磨冲枳实五分，连皮北梨一两，打汁和服。）既而吐痰渐少，纳谷颇适，两胁又添辣痛。孟英诊脉左关弦数，说：“必犯忿怒矣。”诘之果然，加栀子、川楝、旱莲草、女贞子、生白芍、绿萼梅等。（前方去枯芩橘红竹茹枳实，加黑栀子皮三钱，川楝核捣碎先煎四钱，女贞子捣碎先煎五钱，旱莲草四钱，生白芍先煎八钱，绿萼梅次入二钱。）数服各恙皆安，肤蜕成片，而右腿肿痛，不能屈伸。或疑风气，思用艾炙。孟英急止之曰：“此阴亏耳，误炙必成废疾。但难速效。”书方以西洋参、熟地、苁蓉、桑葚、石斛、木瓜、归芍、二冬、杞菊、楝实、牛膝、无核白葡萄干为剂，久服果得向愈。（西洋参三钱，大熟地八钱，淡苁蓉三钱，干桑葚捣碎先煎三钱，鲜钗石斛捣碎先煎一两，陈木瓜三钱，箱归身二钱，生白芍四钱，明天冬切六钱，花麦冬四钱，甘枸杞三钱，川楝核捣碎先煎四钱，杭白菊二钱，酒制牛膝一钱，无核白葡萄干三钱。）
孙执中春前四日，忽患鼻衄如注，诸法莫塞。孟英视之，脉弦而数，说：“冬暖气泄，天令不主闭藏，今晚雷声大震，人身应之，肝阳乃动。”投以元参、生地、犀角、牡蛎、知母、生白芍、牛膝、茯苓、侧柏叶、童溺诸药。（元参片一两，大生地八钱，磨犀角冲一钱，煅牡蛎捣碎先煎六两，酒炒知母二钱，生大白芍一两，酒制牛膝一钱，白茯苓三钱，酒炒柏叶次入一钱五分，清童便一酒杯冲。）既而胁痛流乳，孟英予甘露饮加女贞、旱莲、三甲而瘳。（大生地一两，大熟地八钱，明天冬切六钱，女贞子捣碎五钱，旱莲草四钱，煅牡蛎八两，血鳖甲四两，血龟板二两，合石斛先炭煨八句钟，取汤代水煎药，石斛一两，酒炒枯芩一钱五分，蜜炙枇杷叶刷去毛包煎三钱，大片生甘草三钱。）
Unable to sit. Mengying examined the patient and asked, "Do you have a bitter taste in the mouth and thirst? Is the diarrhea burning like fire? Is urination obstructed? Is the phlegm sticky and tough?" The patient replied, "Indeed so." Mengying said, "It is merely because it is currently the Minor Cold solar term; asthma and cholera patients are numerous, and people mistakenly attribute them all to cold pathogens. I prescribe Beishashen (Glehniae Radix), Sheng Yiren (Coicis Semen), Dongguazi (Benincasae Semen), Sigualuo (Luffae Fructus Retinervus), Zhuru (Bambusae Caulis in Taeniam), Shihu (Dendrobii Caulis), Piyeye (Eriobotryae Folium), Beimu (Fritillariae Bulbus), Zhimu (Anemarrhenae Rhizoma), Zhizi (Gardeniae Fructus), Lugen (Phragmitis Rhizoma), Qingguo (Canarii Fructus), Hai (Sepiae Endoconcha), and Lu (Raphani Juice) as a formula. One dose brings relief, two doses cure. (This condition is treatable; besides examining the pulse on that day, it entirely depends on the phrase 'sticky and tough phlegm'. In heat syndromes with robust constitution and vigorous Yang, phlegm is sticky and tough; in weak constitutions with declining Yang, phlegm is thin and clear. Heat syndromes with vigorous Yang are treatable, while Yang deficiency is not. Beishashen 4 qian, Sheng Yiren pounded 8 qian, raw Dongguazi 4 qian, Sigualuo 3 qian, Jiang Zhuru 3 qian, fresh Shihu pounded and decocted first 1 liang, Jiang Piyete brushed and wrapped 3 qian, Chuan Beimu pounded 5 qian, Jiu Chao Zhimu 3 qian, Hei Zhipi 3 qian, fresh Lugen 2 liang, Qingguo pounded and decocted first 3 pieces, Dan Hai decocted first 1 liang, Lu 8 qian, juice pressed and mixed into the medicine.)
Wu Yunge suffered from syphilitic sores in his prime, took excessive cold-natured medicines, leading to a deficiency-cold syndrome. He switched to warm-tonifying medicines such as Jin Ye Dan (Golden Elixir Pill) and Da Zao Wan (Great Creation Pill) and found relief. Physicians did not understand that medicines are set to correct deviations and remedy defects; they administered them without restraint, making it a habit, gradually causing blood to overflow upwards (hematemesis, etc.), defecation downwards (diarrhea, etc.), reduced food intake, excessive phlegm, wheezing and counterflow making lying flat difficult, and inability to flex or extend both legs. Tong still claimed it was cold-dampness and prescribed multiple doses of Ling (Poria), Jiang (Zingiberis Rhizoma), Zhu (Atractylodis Macrocephalae Rhizoma), Gui (Cinnamomi Ramulus). The condition worsened. Urine gradually turned jade-green, green like bile. Mengying examined his pulse: wiry, stiff, and devoid of spirit (Stomach Yin has been exhausted). He said, "Previously, cold medicines damaged Yang; now, hot medicines have exhausted Yin. The fluids in the Stomach have been scorched into phlegm, and the Five Viscera have lost nourishment, hence the symptoms above. The source of water is about to dry up, so urine naturally decreases. Wood and Fire burn internally, revealing the color of the East (Liver). This differs significantly from Zhang Xugu's treatment of summer-heat binding in Jueyin, where Laifu Dan (Reviving Life Pill) was used to attack the pathogen excreting it through urine resulting in deep blue-green color; that was excess, this is deficiency, separated by heaven and earth." Soon after, he died. (Laifu Dan original formula: Xuanjingshi 1 liang, Yang Liuhuang 1 liang, Sheng Xiaoshi 1 liang, Wulingzhi 1 liang, Qingpi and Chenpi 1 liang each, pill made with vinegar paste, taken with rice drink. Treats latent summer-heat diarrhea with fever and weak pulse. Note: This must be treating Yang-deficient latent summer-heat; using this pill among Yin-nourishing medicines to open and drain latent summer-heat in the Middle Jiao, allowing excretion via bowels and urine.)
Madam Dai, aged fifty-six, contracted a cold in mid-winter. Initially, she took one dose of medicine containing Gui (Angelicae Sinensis Radix), Chaihu (Bupleuri Radix), Danshen (Salviae Miltiorrhizae Radix et Rhizoma) prescribed by Yang. Subsequently, she took five doses of Ganjiang (Zingiberis Rhizoma), Cangzhu (Atractylodis Rhizoma), Houpo (Magnoliae Officinalis Cortex) prescribed by Zhu. Suddenly, she experienced a burst of metrorrhagia. Mengying examined her pulse: empty, rapid, and hurried; tongue coating black, tongue body crimson; feet cold and stiff; breath faint but prone to laughter. He asked if her menstruation had ceased for over ten years. (This case is treatable; the key is that having ceased for ten years, the foundation of Yin essence remains undamaged.) He said, "Winter-warmth was neglected and not cleared; Ying-blood suddenly collapsed downwards. How can this be compared to heat entering the Blood Chamber? It must be caused by mistakenly taking hot medicines. Reviewing various prescriptions, I sigh: Xiao Chaihu Tang (Minor Bupleurum Decoction) has nothing to do with winter-warmth. Even according to Shanghan Lun (Treatise on Cold Damage), it cannot be administered immediately upon initial contraction. Moreover, replacing Renshen (Ginseng Radix) with Danshen is particularly absurd. Renshen tonifies Qi, Danshen moves Blood; their main indications are worlds apart. Regardless of wind, cold, summer-heat, or dampness, blood-moving herbs are contraindicated at the onset because early use draws the pathogen deeper. Having drawn it in, then mistakenly administering several doses of acrid-hot and drying-aromatic herbs, how could it not force her barely remaining blood to collapse completely downwards? Women take Blood as their master; once Tian Gui (menstruation) ceases, even healthy women should not suffer leakage. How much more so when warm pathogens are raging and Yin collapses from below? Can one not fear this? The family begged for treatment repeatedly. Mengying prescribed Xiyangshen (American Ginseng Radix), Shengdi (Rehmanniae Radix), Congrong (Cistanches Herba), Xijiao (Rhino CeratUs), Shihu, Sheng Shaoyao (Paeoniae Radix Alba), Yinhua (Lonicerae Japonicae Flos), Zhimu, Maidong (Ophiopogonis Radix), Gancao (Glycyrrhizae Radix), Zheshuang (Sacchari Sinaris Refinati), Tongni (Infantis Urine). Two doses resulted in the passage of soy-sauce-like stool. (Xiyangshen 3 qian, Dadi Shengdi 6 qian, Dan Congrong 3 qian, ground Xijiao mixed in 0.5 fen, Sheng Baishao pounded and decocted first 4 qian, Jiu Chao Yinhua 5 qian, Jiu Chao Zhimu 1.5 qian, whole Maidong 3 qian, Sheng Fugan 2 qian, Zheshuang mixed in half large wine cup, Tongni 1 wine cup decocted to remove foam, mixed with medicine and taken warm.) Pulse rate gradually decreased but thready sensation intensified; thus Xijiao was removed and Gaolishen (Korean Ginseng Radix) added. (Suitable to add Lishen 3 qian.) After several doses, the pulse harmonized, heat subsided, congee was consumed, and recovery followed through regulation and tonification.
Wang Kairong had long suffered from cough with phlegm and hemoptysis. Tonight, illness began with headache and fever, thirst with drinking but no appetite, loose stools, scanty urine, delirium and coma, red face, cough with phlegm and wheezing. He described cold air rushing up from the chest. Mengying examined the pulse: slippery and rapid. He said, "Warm pathogen carrying retained fluid rebels upward; the method should be clearing and resolving." He prescribed Beishashen, Dongguazi, Zhimu, Huashi (Talcum), Huafen (Trichosanthis Radix), Shichangpu (Acori Tatarinowii Rhizoma), Beimu, Xingren (Armeniaceae Semen), Lugen, Congbai (Allii Fistulosi Bulbus), Danshi (Sojae Seminis Preparatum), Zhuli (Bambusae Sap). (Slippery pulse indicates phlegm; rapid indicates Yin deficiency with heat; headache implies Yin deficiency. Using Cong and Shi to ascend, and Zhimu's bitter-cold to reach the highest part, only then can fever, red face, and phlegm-wheezing be resolved. Beishashen 8 qian, raw Dongguazi 4 qian, Jiu Chao Zhimu 3 qian, Xi Huashi decocted first 4 qian, Shichangpu added later 1 qian, Chuan Beimu pounded 5 qian, Nan Huafen 4 qian, Ku Xingren 1.5 qian, Lugen mixed with Jiangjiu 1-2 times added, Lianxu Congbai pounded 2 qian, Danshi 3 qian added together later, Jiang Zhuli half large wine cup mixed and taken.) After two doses, the red face faded; Cong and Shi were removed, and Maidong, Sangye (Mori Folium), Piyeye were added. (Hua Maidong 3 qian, Dong Sangye 2 qian, fresh Piyete brushed and wrapped 3 qian.) After several doses, heat left, diarrhea decreased, delirium stopped, headache ceased, breathing stabilized, mind cleared. Shichangpu was removed, and Lizhi (Pyrus Sinkiangensis Fructus), Dilie (Alismatis Rhizoma), Hai were added. (Li 1 liang, Dilie 2 liang, juice pressed and mixed; Dan Hai decocted first 1 liang.) After several days, phlegm gradually decreased, diet improved, thirst stopped, urination resumed. Only then was Yin-nourishing therapy initiated, leading to recovery.
Shi Zizhang suffered from abdominal distension. Zhu prescribed large doses of warm-tonifying medicines, seemingly bringing peace. Mengying said, "Emaciated form, rapid pulse, dry red tongue color; this is Yin-deficiency heat-distension. In past years, Fan Cihou's wife and Yang Gai's maternal relatives had similar ailments. Many doctors tried attacking and tonifying indiscriminately, with little effect. I used extremely bitter-draining-heat and slightly-acrid-unblocking-meridians methods, achieving immediate cure. (Baitouweng 1 qian, Chao Chuan Huangbo 1.5 qian, Chuan Liannu pounded and decocted first 3 qian, Qingguo pounded and decocted first 3 qian, Sheng Baijili added later 3 qian, Dadi soaked in boiling water to decoct other herbs, dregs discarded 8 qian, fresh Chai Shihu pounded and decocted first 1 liang, Ji Yinhua 8 qian, Yuanshen Pian soaked to decoct, dregs discarded 1 liang, Chen Mugua 3 qian, Sheng Zheshi pounded and decocted first 1 liang, Xuanfuhua wrapped in silk 3 qian.) Now, at the onset, distension did not hinder eating, indicating the syndrome is not in the Qi level. Misbelieving warm-tonics do not aggravate distension, he took them without doubt, unaware that Yin was further depleted. (Warm-tonics rob Yin.) Meridians became more blocked. (In Yin deficiency, Qi follows fluids; when fluids deplete, Qi does not move.) Distension did not increase, but muscles wasted away. (When Qi does not follow fluids, flesh withers.) Pulse became more rapid. (Warm-tonics damage Yin, causing rapid pulse.) Dry cough and shortness of breath. (Warm-tonics damage Yin; Yang appears increasingly excessive, Yin increasingly deficient, leading to dry cough and shortness of breath.) How is this different from women suffering from Fengxiao and Xiben? (Women suffer from excess Yang and insufficient Yin, causing Water to fail to nourish Wood, leading to rebellious Liver Yang, named Internal Wind. Fengxiao means internal wind consumes muscle; muscle belongs to Yin. Xiben means Lung Qi rises without descending, like running. All these are inevitable consequences of warm-tonics robbing Yin.) Soon after, he died. Note: Yu Jia Yan first stated that men also suffer from Blood Gu syndrome. Thus, although men and women differ, there is sameness in difference and difference in sameness. Clinicians must not adhere rigidly to fixed rules.
Shen suffered from epigastric pain and vomiting, constipation of both bowels and urine, unresponsive to various treatments. Mengying observed: wiry and choppy pulse, yellow greasy coating. He said, "This is a Fluid retention syndrome. Are you addicted to alcohol?" Shen said he did not drink alcohol but usually boiled strong Wuyi Black Tea. Tea steamed becomes red, taste turns sweet and turbid, losing its upright and austere nature, becoming a medium for disease. Physicians failed to observe, knowing only that vomiting is cold, frequently prescribing Jiang (Zingiberis Rhizoma), Yuyu (Evodiae Fructus), Chenzhu (Aucklandiae Radix), Fuzi (Aconiti Lateralis Radix Praeparata), which contradicted the pathology and fanned Wind-Yang. Fluids rode the Wind upwards, rising only without descending, hence upper inability to accept, lower inability to pass, resembling Guan Ge (obstruction and regurgitation). However, it was not a state of Yin exhaustion and Yang knotting. He prescribed Lian (Coptidis Rhizoma), Liannu (Toosendan Fructus), Zhizi, Huangqin (Scutellariae Radix), Xuanfuhua, Zhuru, Piyeye, Juhong (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma), Fuling (Poria), Zexie (Alismatis Rhizoma), Geke (Meretrix Shell), Hejing (Nelumbinis Petiolus), Shengjiangyi (Zingiberis Peridermis) as a formula, taken with Zhenling Dan (Shaking Spirit Pill). Several doses brought peace, recovered within a month. (Formula meaning: Bitter-cold clears Wind-Yang medicine, acrid-warm resolves retained-fluid sickness. Jiu Chao Chuanlian 0.8 fen, Hei Zhipi 3 qian, Jiu Chao Liannu pounded and decocted first 2 qian, Jiu Chao Ku Huangqin 1.5 qian, Xuanfuhua wrapped in silk 3 qian, Jiang Zhuru added later 3 qian, Jiang Piyete brushed and wrapped 3 qian, Lai Juhong 1.5 qian, Zhi Banxia 4 qian, Bai Fuling 3 qian, Chao Zexie 1.5 qian, Sheng Geke pounded and decocted first 5 qian, Xian Hejing 3 qian, Shengjiangpi 0.5 fen, medicine taken with Zhenling Dan 3 qian.)
Shi Zhiqing suddenly suffered from abdominal distension. Ten days later, pus emerged from the umbilicus. Surgeons viewed it as Changyong (intestinal abscess) and prescribed warm-tonifying and interior-supporting medicines. Consequently, he developed cough, insomnia, severe abdominal colic, red-green colored phlegm, and inability to defecate. Mengying examined: pulse wiry, fine, and rapid; tongue crimson with great thirst. He said, "Examining pulse and signs reveals severe True Yin deficiency. Baizhu (Atractylodis Macrocephalae Rhizoma), Guibai (Platycladi Cacumen - *Note: Text says Gui, likely Danggui based on context of forbidden herbs in Yin def, but text says Gui/Baizhu/Gui, assuming Danggui/Cinnamon*), Guizhi (Cinnamomi Ramulus) are all contraindicated." He administered Ganlu Yin (Sweet Dew Drink) plus Xiyangshen, Huafen, Beimu, Xingren, Dongguazi. Phlegm and cough settled quickly. Surgeons said this ailment strictly forbids diarrhea, moistening medicines should not be taken in excess. Mengying said, "Yin deficiency and fluid dryness make Jin hard to generate; even seeking diarrhea is impossible. How can one stick to one-sided views without adapting? Still using previous method, removing Xingren, Beimu, Huafen, adding Zhimu, Baihe (Lilii Bulbus), Hehuan (Albiziae Cortex)." He also instructed old physician Zhu Songnian to apply external treatment. Following the method, he gradually improved. Long afterwards, the scab at the umbilicus fell off like a baby's umbilical cord strip, new flesh inside the umbilicus appeared bright and healed. (Pus discharged quickly, originally not a cold-deficiency syndrome; adding mistaken warm-tonics led to the four sentences of cough/insomnia, heat pathogens in Qi level, warm-tonics easily damage Yin. Dadi 8 qian, Ming Tiandong cut 6 qian, soaked in boiling water mixed, dregs discarded; Hua Maidong 4 qian, Nan Huafen 5 qian, Chuan Beimu pounded 1 liang, Ku Xingni added later 2 qian, Chai Shihu pounded and decocted first 1 liang, Jiang Chao Xi Yinchern 2 qian, Jiang Chao Ku Huangqin 1 qian, Jiang Chao Piyete brushed and wrapped 3 qian, Chao Zhike 1.5 qian. Modified formula removed Chuan Beimu and Huafen, added Jiang Chao Zhimu 1.5 qian, Baihehua 3 qian, Hehuanpi 3 qian. External application should also be acrid-cool.)
Yuan suffered from belching, audible to neighbors. Yu prescribed Lizhong Tang (Regulate the Middle Decoction) and Xuanfu Daizhe Tang (Inula and Hematite Decoction) without effect. Mengying examined: Chi position empty and large. He questioned, "Do you feel Qi rushing up from the lower abdomen?" Patient said, "Indeed so." Mengying said, "This disease is in the Lower Jiao." He used Hutao Rou (Walnut Seed), Guzhi (Psoraleae Fructus), Feizi (Viciae Semen), Tusizi (Cuscutae Semen), Xiaohui (Foeniculi Fructus), Lujiaoshuang (Cornu Cervi Pantotrichum), Gouqi (Lycii Fructus), Danggui (Angelicae Sinensis Radix), Fuling, Fupenzi (Rubiae Fructus), Longchi (Draconis Os), Muli (Ostreae Concha). One dose stopped the rushing Qi at the throat, stopping the belching sound. Two doses brought silence, many doses cured completely. (This case recognizes Kidney Yang deficiency; Kidney Yang deficiency rebellion indicated by empty-large Chi pulse. Hutao Rou with skin 1 liang, Chao Guzhi ground 5 qian, Chao Feizi ground 5 qian, Chao Chongsi Bing 2 qian, Xiaohui added later 1.5 qian, Lujiaoshuang stewed and mixed 2 qian, Chao Gouqi 2 qian, Xiang Guishen 2 qian, Yun Fuling dried cut 3 qian, Chao Fupenzi ground 5 qian, Cu Jian Longchi 4 qian, Cu Jian Muli 8 qian, these two simmered first for eight periods.)
Shen Chun's mother occasionally suffered slight sore throat. Taking one dose of light-clearing medicine brought slight relief, daily activities remained normal. On the sixth day, she suddenly complained of inability to sit or stand, falling into lethargy like sleep as soon as she lay down. Wang Shoushi administered Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) transformed with Wan's Niuhuang Wan (Calculus Bovis Pill). Mengying felt the pulse: Left rapid, Right slippery, both extremely weak. (On the sixth day, lethargy upon lying down indicates Yin deficiency constitution; Liver Yang scorches Phlegm, rebelling upwards causing syncope. One must never adhere to the routine of treating Qi before Ying. Xijiao Dihuang clears Ying, Niuhuang transforms phlegm-heat, clearing Ying while also clearing Qi. Left rapid indicates Blood level with heat, Right slippery indicates Qi level with phlegm. Both extremely weak implies chronic Yin fluid deficiency, Yang unable to flow with fluids, Yin deficiency with warm pathogen, most difficult to treat.) He said, "Your observation is very correct. Although contracted winter-warmth, the pathogen is still mild. Due to the constitution of accumulated fatigue and chronic deficiency, Liver Yang moves internally, scorching fluids into phlegm, rebelling upwards causing syncope, resembling warm pathogen sinking inward. Xijiao in the formula calms internal wind, Niuhuang transforms phlegm-heat, borrowing them is acceptable, the illness will be safe. No need to administer medicine today." Next day, second visit: Spirit clear, tongue coating turning black. (Coating turning black is the effect of Xijiao Dihuang and Niuhuang Wan; Xijiao Dihuang extinguishes wind and replenishes fluids, Niuhuang transforms phlegm-heat; Yin slightly recovers, heat slightly lightens, pushing pathogen out, presenting this black coating.) Mengying prescribed肃肺蠲痰 (Lung-purging and phlegm-dispelling), 息风充液 (Wind-extinguishing and fluid-replenishing) agents. (Jiang Zhuru 3 qian, Jiang Zhuli mixed with 1 wine cup, Gan Shidi 1 qian, Dan Hai decocted first 1.6 liang, Chuan Beimu pounded 8 qian, Jiang Piyete brushed and wrapped 3 qian, Jiu Chao Zhimu 3 qian, Banxiaqu 1.5 qian, Yuanshen soaked mixed, dregs discarded 5 qian, Hei Zhipi 3 qian, Chen Danning stewed and mixed 0.8 fen, Wu Mei 3 qian, Lai Juhong added later 1 qian.) Heat subsided, coating became loose and floating. Mengying said, "The tongue is about to shed." Continued previous medicine. Overnight inspection: Coating indeed completely shed, tongue looked like fluid-depleted tongue, occasional nausea/vomiting, no bowel movement. Mengying added Zhuru, Zhuli, Shidi, Hai to sweet-moistening fluid-generating medicines. (Nan Huafen 4 qian, Xian Lugen 2 liang, Sheng Dongguazi 4 qian, Xian Chai Shihu pounded and decocted first 1 liang, Chao Zhike 1.5 qian, Lai Juhong 1.5 qian, Jiang Chao Ku Huangqin 1.5 qian, Chuan Beimu 1 qian, Dan Jiangzhi ground to mix with Zhuli, Shidi, Hai same as previous formula.) Several doses stopped vomiting, bowel movement resumed, but white rot-like coating suddenly spread on tongue, gums, lips, cheeks, filling the mouth, unable to be scraped off. Mengying adhered to rectifying Lung and Stomach, still assisting with Zhuli, adding Qingguo, Yinhua, Jianlan Ye (Orchid Leaf). (Jiang Piyete brushed and wrapped 3 qian, Hei Zhipi 1.5 qian, Jiu Chao Ku Huangqin 1.5 qian, Jiang Lugen 8 qian, Chen Danning stewed and mixed 0.7 fen, Ku Xingni 1.5 qian, Lai Juhong 0.8 fen, Jiang Zhuru 3 qian, Jiang Zhuli 1 wine cup mixed, Ji Yinhua added later 5 qian, Jianlan Ye added later 3 qian.) After several doses, white rot gradually shed, tongue color revealed. Only drinking congee caused chest discomfort. Mengying said, "Stomach juice insufficient, residual heat-phlegm not cleared." Adhered to previous plan. (Previous formula removed Zhipi and Lugen, added Shengjiang Ziran Zhi ground to mix Zhishi 0.5 fen, Lianpi Bei Li 1 liang, juice pressed and mixed.) Soon, expectoration decreased, appetite suitable, but stinging pain added to both hypochondria. Mengying examined pulse: Left Guan wiry and rapid. He said, "Must have angered." Questioned, confirmed true. Added Zhizi, Liannu, Hanlian Cao (Ecliptae Herba), Nvzhen Zi (Ligustri Lucidi Fructus), Sheng Baishao, Lüemei (Prunus mume Flower). (Previous formula removed Ku Huangqin, Juhong, Zhuru, Zhishi, added Hei Zhipi 3 qian, Chuan Liannu pounded and decocted first 4 qian, Nvzhenzi pounded and decocted first 5 qian, Hanliancao 4 qian, Sheng Baishao decocted first 8 qian, Lüemei added later 2 qian.) After several doses, all ailments pacified, skin shed in sheets, but right leg swollen painful, unable to flex/extend. Some suspected wind-dampness, thinking of moxibustion. Mengying urgently stopped him saying, "This is Yin deficiency. Moxibustion will surely cause disability. But quick effect is hard. Prescribed Xiyangshen, Shudi (Rehmanniae Radix Praeparata), Congrong, Sangshen (Mori Fructus), Shihu, Mugua (Chaenomelis Fructus), Guibai, Er Dong (Tiandong/Maidong), Qiju (Gouqi/Juhua), Liannu, Niuxi (Achyranthis Bidentatae Radix), Wuhe Baiputaogan (Seedless White Raisin) as agent. Long-term use indeed led to recovery. (Xiyangshen 3 qian, Da Shudi 8 qian, Dan Congrong 3 qian, Gan Sangshen pounded and decocted first 3 qian, Xian Chai Shihu pounded and decocted first 1 liang, Chen Mugua 3 qian, Xiang Guishen 2 qian, Sheng Baishao 4 qian, Ming Tiandong cut 6 qian, Hua Maidong 4 qian, Gan Gouqi 3 qian, Chuan Liannu pounded and decocted first 4 qian, Hang Baiju 2 qian, Jiu Zhi Niuxi 1 qian, Wuhe Baiputaogan 3 qian.)
Sun Zhizhong, four days before spring, suddenly suffered profuse epistaxis, all methods failed to stop it. Mengying observed: wiry and rapid pulse. He said, "Winter warmth leaks, Heaven's command does not govern storage. Tonight thunder shakes loudly, human body responds, Liver Yang moves." He administered Yuanshen, Shengdi, Xijiao, Muli, Zhimu, Sheng Baishao, Niuxi, Fuling, Cebei Ye (Biota Top Leaf), Tongni. (Yuanshen Pian 1 liang, Da Shengdi 8 qian, ground Xijiao mixed 1 qian, Jian Muli pounded and decocted first 6 liang, Jiu Chao Zhimu 2 qian, Sheng Da Baishao 1 liang, Jiu Zhi Niuxi 1 qian, Bai Fuling 3 qian, Jiu Chao Beiye added later 1.5 qian, Clear Tongbian 1 wine cup mixed.) Soon after, hypochondriac pain and lactation occurred. Mengying administered Ganlu Yin plus Nvzhen, Hanlian, Sanjia (Turtle Shell, Tortoise Shell, Oyster Shell) and cured. (Da Shengdi 1 liang, Da Shudi 8 qian, Ming Tiandong cut 6 qian, Nvzhenzi pounded 5 qian, Hanliancao 4 qian, Jian Muli 8 liang, Xue Biejia 4 liang, Xue Guiban 2 liang, combined with Shihu charred and simmered for eight periods, soup replaces water to decoct herbs, Shihu 1 liang, Jiu Chao Ku Huangqin 1.5 qian, Mi Zhi Piyete brushed and wrapped 3 qian, Da Pian Sheng Fangcao 3 qian.)