亏也。温补非宜。改服滋水培元之剂。颇为有效。夏间或劝以灸火云可以除百病。盖未知灼
艾之可以除百病者。谓可除寒湿凝滞。阳气不能宣通之证。非谓内伤外感。一切之病皆可灸
以除之也。故仲景有微数之脉慎不可灸之训。正以艾火大能伤阴也。灸后数日即寒少热多。
宛如疟疾。医者以为脾寒病。投以温散。日以滋甚。孟英切其脉滑数倍加。曰∶阴虚之体。
热自内生。灸之以艾。火气内攻。时当溽暑。天热外烁。三者相交。阴何以堪。再投温散。
如火益热。当从瘅疟治。专以甘寒息热。则阴津不致枯涸。而寒热不攻自去。所谓治病必求
其本也。竟不用一分表散药而治愈。（头眩脑鸣。阴本不足。温补畏冷。热深厥亦深也。脉
滑为痰。数为阴虚挟热。生石膏一两六钱包先。酒炒知母次入三钱。南花粉四钱。姜竹沥两
大酒杯冲服。活水芦根二两。鲜枇叶刷包三钱。生北梨三两。青甘蔗一两。皆不去皮。同榨
汁冲。)
陈芝田仲夏患感。诸医投以温散。延至旬日。神昏谵妄。肢搐耳聋。舌黑唇焦。囊缩溺滴。
胸口隐隐微斑。孟英诊之。脉细数而促曰∶阴亏热炽。液将涸矣。用西洋参元参生地二冬知
柏
楝实石斛白芍甘草梢银花木通犀角石菖蒲大剂投之。（此证可救。在溺滴胸口隐隐微斑脉细
数以促三句。肝阴绝则溺绝。胸口隐隐微斑。邪旺正亦旺。病邪尚能外达。脉细数而促。固
属热极风生。然系阳证阳脉。能任阴药。若脉 弱则不治。元参片一两。大生地八钱。明天
冬六钱切。花麦冬五钱。四味开水泡汤去渣用汤煎药。西洋参四钱。酒炒知母三钱。酒炒川
柏一钱五分。酒炒楝皮去核二钱。钗石斛一两杵先。整白芍杵先二两。生草梢三钱。济银花
一两五钱。细木通一钱。镑犀角片磨冲一钱。石菖蒲次入一钱。)次日其家人云。七八日来
小溲不过涓滴。昨服药后约六七个时辰解得小溲半杯。孟英曰∶此即转机也。然阴气枯竭。
甘凉濡润不厌其多。于前方再加龟板鳖甲百合须花粉大锅煎之。频灌勿歇。如是者八日。神
气始清。诸恙悉退。纯用滋阴之药。调理匝月而瘳。孟英尝云。温热液涸神昏。有投犀角地
黄
等药至十余剂。始得神清液复者。（药随气为升降。气不降则药亦不降。此证孟英如接诊即
用龟板鳖甲则不效。盖气火尚浮而上逆也。至添解小溲半杯。则阴津有濡润将复之机。故介
属加入能收效。但少用则药不胜病。宜用血龟板四两。血鳖甲四两同杵。先炭煨八句钟。百
合须四钱。南花粉五钱。频灌则药力不断。)
江小香病热危笃。孟英诊之。脉虚弦而小数。头痛偏于左后。子夜热躁。肢冷欲呕。口干不
欲饮。不饥不欲食。舌謇言涩。溺黄而频曰∶体属素虚。此由患感时过投温散。阴津阳气皆
伤。后来进补而势反剧者。滋腻妨其中运。刚烈动其内风。以致医者佥云表之不应补亦无功
竟成无药可治之证。虽然。不过难治耳。未可遽弃也。予秋石水拌制高丽参苁蓉首乌生白芍
牡
蛎楝实盐水炒橘红桑葚石斛蒺藜茯苓药吞饭丸肉桂心五分。一剂躁平呕止。各恙皆减。连投
数服。粥食渐安。（叙证惟肢冷及口干不欲饮不饥不欲食暨溺频属阳虚。余皆阴虚挟热之象
。秋石水拌制丽参三钱。淡苁蓉三钱。制首乌三钱生白芍四钱。 牡蛎一两杵。先煨六句钟
。
川楝实三钱杵先。盐水炒蛀陈皮一钱。干桑葚三钱。鲜石斛杵先八钱。生白蒺去刺次入三钱
。白茯苓三钱。药送饭丸肉桂心五分。此杂证杂治之法。须玩其从阳引阴，从阴引阳。机轴
灵
动。此证阴虚重于阳虚。)乃去首乌桂楝。加砂仁末拌炒熟地菊花枸杞。半月而瘳。（砂仁末
二分。炒松熟地四钱去砂仁。杭菊花二钱。甘枸杞三钱。)
溽暑之令。 疹盛行。幼科仅知套药。升柴防葛乱施。陈书芾女势最剧。以 甫出而汛适至
也。医者却走。孟英视之。脉滑而数，舌绛大渴。面赤音失。不食便泻。曰∶此由发散太过
。火盛风炽。气血两燔。气分之邪由泻而略泄其焰。营分之热由汛而稍解其焚。岂可畏其脱
陷。妄投止涩耶。予西洋参石膏知母麦冬犀角生地连翘甘草石斛丹皮桑叶竹叶大剂投之。三
日而愈。养阴善后。遂以渐安。其余或轻或重。孟英一以清解而痊。（脉滑而数。热邪皆在
气分。惟舌绛二字。热邪在血分。病邪以有出路为宜。泻泄其热。汛解其焚。正是此病生机
。畏脱陷。投止涩。系治虚证之法。此病系热实证。脉滑而数。数脉热中挟虚。故方中以麦
冬生
地等补之。病情气分热邪过于血分。故此方清气之药较多。西洋参三钱。生石膏先煎一两二
钱。酒炒知母 次入三钱。花麦冬四钱。镑犀角磨冲一钱。大生地开水泡冲八钱。连翘壳次
入三钱。生粉草三钱。粉丹皮二钱。鲜石斛杵先一两。冬桑叶四钱。鲜竹叶次入二钱。)
石诵羲夏杪患感。多医广药。病势日增。延逾一月。孟英诊焉。脉至右寸关滑数上溢。左手
弦数。耳聋口苦。热甚于夜。胸次迷闷。频吐粘沫。啜饮咽喉阻塞。便溏溺赤。间有谵语。
曰∶此暑热始终在肺。并不传经。一剂白虎汤可愈。何以久延。前方惟初诊顾听泉用清解肺
卫法为不谬。余则温散升提。滋阴凉血。皆不中病。病家因溏泄畏服石膏。告孟英以胸中一
团冷气。汤水皆须热呷。孟英答以邪在肺经。清肃之令不行。津液凝滞。结成涎沫。盘踞胸
中。升降之机亦窒。大气仅能旁趋而转旋。是一团涎沫之中。为气机所不能流行之地。其觉
冷也固宜。且予初诊时。即断为不传经之候。所以尚有今日。能自觉胸中之冷。若传入心包
。舌黑神昏。则合古年之犀角地黄汤。然虽不传经。延已逾月。热愈久。液愈涸。药愈乱。
病愈深。宜急投白虎。古云鼻塞治心。耳聋治肺。是皆白虎之专司。不可拘少阳而疑虚寒。
书方以白虎加西洋参贝母花粉黄芩紫菀杏仁冬瓜仁枇叶竹茹竹黄。一剂甫投。咽喉即利。三
服各恙皆去。糜粥渐安。改甘润生津调理而愈。（右寸关滑数上溢九句。热邪多在气分。惟
左手脉
弦数稍挟阴虚。但右不降则左升。法宜治肺。病邪此脏传彼脏名传经。热证右脉无力。便溏
则肺阳已败。忌服柔剂及石膏。热证右脉有力。则便溏为热邪出路。宜服阴剂及石膏。右寸
关滑数上溢。则右脉有力可知。故不忌白虎。左脉弦数。虽挟阴虚。惟清肺则肺阴能生肝阴
。且洋参花粉等一派清润。肃肺即以补肝。斯为一笔两用。一丝不漏。生石膏八钱先煎。西
洋参三钱。川贝母杵三钱。酒炒知母一钱。南花粉三钱。酒炒枯芩二钱。杏仁泥一钱五分。
紫菀茸一钱。生冬瓜子三钱。姜枇叶刷包三钱。鲜竹叶二钱。姜竹茹三钱。天竺黄三钱。甘
润生津方。生甘草三钱。花麦冬三钱。花粉四钱。北沙参四钱。甜杏仁三钱。蜜枇叶刷包三
钱。鲜地骨皮四钱。清阿胶炖和二钱。活水芦根八钱。)
刘廉方受暑。医治垂危。孟英诊之。裸卧昏狂。舌黑大渴。溺赤便秘。脉数而芤。予犀角地
黄
汤加减。服之神识已清。略能进粥。颇知问答。大有生机。仍处甘凉以赠之。嗣误热药致死
。（此证可生在大渴。大渴则肺阳尚旺。病情全系热邪由气传营之象。脉数而芤。芤为虚。
此证阴虚重于热实。磨犀角冲一钱。大生地八钱。元参片一两。二味开水泡汤。去渣用汤煎
药。
酒炒知母三钱。明天冬六钱。鲜地骨皮五钱。鲜石斛杵先一两。鲜茅根五钱。枯青果连核杵
先三个。云茯神三钱。龟板胶二钱炖和服。济银花次入八钱。神识已清。颇知问答。则营热
已解。亟宜清其气分之热。故处甘凉以赠之。方用生石膏先煎八钱。酒炒知母三钱。北沙参
八钱。花麦冬四钱。蜜炙枇叶刷包三钱。生粉草三钱。南花粉四钱。鲜地骨皮五钱。蜜水拌
鲜芦根一两。甜杏仁三钱冬桑叶三钱。青果连核杵先三个。)
孙楚楼途次患寒热如疟。胁痛痰嗽。面黧形瘦。医投疏散。甚不相安。孟英诊断阴亏。忌从
疟
治。以苇茎汤加北沙参熟地桑叶丹皮海石旋复贝母枇叶为剂。方义主肃肺润燥。滋肾清肝。
数
服而痊。（孟英诊断阴亏。必有脉情。疟分正疟时疟。正疟属寒挟实。时疟属热挟虚。疏散
甚不相安。其为阴亏何疑。胁痛痰嗽。为虚中挟实。鲜芦根二两。生冬瓜子四钱。生苡仁杵
八钱。生桃仁杵三钱。北沙参四钱。大熟地泡煎去渣八钱。冬桑叶三钱。粉丹皮二钱。海浮
石先煎五钱。旋复花绢包三钱。川贝母杵五钱。姜炙枇叶刷包三钱。)
姚雪樵母年逾花甲。患感两月。医皆束手。孟英诊之。身已不能转侧。水饮难于下咽。声音
不出。便溺不通。曰。此热邪逗遛不去。津液剥削殆尽。计其受病之时。正当酷暑。岂即温
补是投。但知其虚而不知其病耶。前方惟入手顾听泉从吸受暑邪轻清开上立治合法。余方与
病无涉。阮某小柴胡服之最多。医执此和解之法。谓不犯汗吐下三者之险。病家见其参胡并
用。谓补正祛邪。一举两全。孰知和解足少阳伤寒传经之剂。不可以概和各经各气之病。徒
使参胡提升热邪以上逆。致一身之治节无以清肃下行。而姜枣温腻湿浊于中焦。致运花之枢
机失其灌溉之布。气机愈窒。津液愈干。和解之剂愈进。气愈不和。病愈不解。今咽喉仅容
点滴。气结津枯已极。书甘凉濡润之方。属其不限时刻。不计多寡。频以水匙挑入。使其渐
渗下喉一日仅灌一小杯许。灌至旬余。气机始渐流行。药可服小半剂。坚守前法。日以向愈
。粥
食递加。惟大解久不行。孟英告以谷食安津液充则自解。若欲速妄攻。则久不纳谷之胃。尚
有何物以供其荡涤哉。至九月下旬。始有欲解之势。孟英连予补气益血之药。尚不能下。于
前方加蜣螂一对。热服即解。凡不更衣者计及五十日。继以平补善后而痊。（此病本系时疟
。医误作正疟治。以小柴治伤寒之法用人参补阳。非寒虚证。则愈伤阴。身已不能转侧四句
。
热邪皆在气分。气伤则津伤。甘凉濡润方。蜜炙枇叶刷包三钱。生甘草三钱。蜜炙桑白皮四
钱。南花粉三钱。鲜地骨皮四钱。甜杏仁三钱。海浮石先煎四钱。干桑葚杵先三钱。连皮青
蔗劈先一两。津回食进。宜兼补气。不可沿用凉润 。致伤阳气。补气益血方。潞党参三钱
。生黄 三钱。生粉草三钱。箱归身二钱。花麦冬三钱。云茯神人乳拌蒸三钱。大生地八钱
。乌梅肉三钱。)
盛少云严寒患痰嗽。夜热自汗不寐。左胁痛如针刺。肌削不饥。病来虽恶。未经误药。孟英
予固本加龟板鳖甲苁蓉知柏青黛石斛花粉白芍楝实海石旋复贝母蛤壳牛膝出入为大剂投之即
效。连服四五十帖而痊。（病情为邪正俱实。夜热自汗不寐。为兼挟阴虚。左胁痛为肝阳。
川贝母杵一两，酒炒知母三钱。旋复花绢包三钱。南花粉四钱。海浮石四钱。生蛤壳八钱。
二味同杵先。飞青黛一钱。更方去贝母知母花粉海石蛤壳。加酒炒川黄柏一钱五分。花麦冬
四
钱。整白芍杵先二两。钗石斛杵先一两。血鳖甲杵先四两。淡苁蓉三钱。酒制牛膝一钱川楝
实
杵先三钱。更方去鳖甲青黛麦冬旋复。加血龟板四两杵先。明天冬切六钱。大生地八钱。大
熟地一两。)
邵小墀妻春患汛愆。释医诊以为妊。广服保胎药。渐至腹胀跗肿。气逆碍卧。饮食不进。夏
延孟英视之。曰∶血虚气滞。误补成胀也。先以黄连浓朴山楂鸡内金橘皮大腹皮枳实茯苓栀
子楝
实杏仁紫菀旋复等药少佐参术服之。气机渐运。胀去食安。渐入滋阴养血之治。数月经行而
愈
。（胀分虚实两大门。此为实中挟虚。误补则气滞成胀。气不生血故血虚。重气滞不重血虚
。故方多气药。姜炒川连二钱。姜制根朴八分。焦楂肉杵一钱。炙鸡金三钱。蛀陈皮一钱
。
大腹皮酒洗一钱五分。炒枳实一钱。白茯苓三钱。焦栀皮三钱。次入川楝实杵先二钱。苦杏
泥一钱五分。紫菀茸一钱。潞党参一钱。炒白术七分。渐入滋阴养血之治。前方去连朴腹皮
枳栀紫菀。加肥玉竹三钱。箱归身二钱。大生地八钱。山萸肉三钱。酒制牛膝一钱。)
一人患晨泄有年。累治不效。春间尤甚孟英按脉曰。汝虽苦泻。而泻后腹中反觉舒畅。其人
对曰诚然。苟不泄泻。又胀闷减食矣。服四神附桂之药。其泻必加何故。曰∶此非温升补涩
之证。乃肝强脾弱。木土相凌。处一方令其常服。数帖即安。后竟无恙。方用白术苡仁黄连
楝实桑枝茯苓木瓜芍药蒺藜橘皮而已。（春间尤甚。已露肝强。泻后腹中反觉舒畅者。肝强
贼脾。得泄泻稍解其郁抑之苦。服四神附桂反加者。温热助肝贼脾。肝强脾弱。两脏俱病。
惟肝强较重。炒白术三钱。炒苡仁杵八钱。酒炒川连八分。川楝实杵先四钱。鲜桑枝三钱。
白茯苓四钱。陈木瓜三钱。整白芍杵先二两。生白蒺去刺三钱。蛀陈皮一钱五分。)
亏损。温补法并不适宜。改为服用滋补肾水、培补元气的方剂，效果颇为显著。夏季有人建议用艾灸，说可以治愈百病。大概是不了解艾灸能除百病的原理，是指可以祛除寒湿凝滞、阳气不能宣通的症状，并不是指内伤或外感等所有疾病都可以用艾灸来治愈。所以张仲景有“脉象微数者，千万不可施灸”的告诫，正是因为艾火大能损伤阴液。施灸后几天，患者出现寒少热多的症状，宛如疟疾。医生认为是脾寒病，投以温散药物，病情日益加重。孟英诊察其脉搏滑数加倍，说：“这是阴虚体质，热从内生。又用艾火灸治，火气内攻；正值酷暑，天热外灼。三者相交，阴液怎能承受？再投温散药，如同火上浇油。应当按瘅疟治疗，专门使用甘寒药物清热，这样阴津就不会枯竭，而寒热症状不攻自破。这就是所谓治病必求其本。”最终没有使用一分解表发散药而治愈。（头眩脑鸣，是因为阴本不足；畏冷是温补所致；热深则厥亦深。脉滑代表有痰，脉数代表阴虚挟热。生石膏一两（包先煎），酒炒知母三钱次入，南花粉四钱，姜竹沥两大酒杯冲服，活水芦根二两，鲜枇杷叶刷包三钱，生北梨三两，青甘蔗一两，均不去皮，同榨汁冲服。）
陈芝田在仲夏患感冒。众医投以温散药物，拖延至十天，出现神志昏迷、胡言乱语、肢体抽搐、耳聋、舌黑唇焦、阴囊收缩、小便点滴难出的症状，胸口隐隐可见微斑。孟英诊察，脉细数且急促，说：“阴亏热炽，津液即将枯竭。”使用西洋参、玄参、生地、二冬、知母、黄柏、楝实、石斛、白芍、甘草梢、银花、木通、犀角、石菖蒲，大剂量投服。（此证可救，关键在于“溺滴、胸口隐隐微斑、脉细数以促”这三句。肝阴绝则溺绝。胸口隐隐微斑，说明邪旺正亦旺，病邪尚能外达。脉细数而促，固然属于热极生风，但属于阳证阳脉，能承受阴药。若脉微弱则不治。玄参片一两，大生地八钱，明天冬六钱切，花麦冬五钱，四味开水泡汤去渣，用汤煎药。西洋参四钱，酒炒知母三钱，酒炒川柏一钱五分，酒炒楝皮去核二钱，钗石斛一两杵先，整白芍杵先二两，生草梢三钱，济银花一两五钱，细木通一钱，镑犀角片磨冲一钱，石菖蒲次入一钱。）第二天其家人说，七八天来小便不过涓滴，昨天服药后约六七个时辰解得小便半杯。孟英说：“这就是转机。然而阴气枯竭，甘凉濡润之药不厌其多。”在前方中加入龟板、鳖甲、百合须、花粉，大锅煎煮，频频灌服不停歇。像这样持续八天，神气才清醒，各种病症全部消退。纯用滋阴药调理一个月而痊愈。孟英曾云：温热病津液枯竭导致神昏，有投用犀角地黄等药至十余剂，才得神清液复的。（药随气升降，气不降则药亦不降。此证若孟英接诊即加龟板鳖甲则无效，因为气火尚浮而上逆。直到添加解出小溲半杯，说明阴津有濡润将复之机，故加入介类药能收效。但少用则药不胜病，宜用血龟板四两，血鳖甲四两同杵，先炭煨八刻钟，百合须四钱，南花粉五钱，频灌则药力不断。）
江小香患热病危重。孟英诊察，脉虚弦而小数，头痛偏于左后方，子夜发热烦躁，四肢发冷欲呕，口干但不欲饮，不饥不欲食，舌謇言涩，尿黄而频，说：“体质素虚，这是由于患感时过投温散药物，阴津和阳气都受伤。后来进补反而病情加剧，是因为滋腻妨碍了中焦运化，刚烈动摇了内风，以致医者都说表证不应治，补法也无效，竟成了无药可治之证。虽然如此，不过是难治罢了，不可轻易放弃。”给予秋石水拌制高丽参、肉苁蓉、首乌、生白芍、牡蛎、楝实、盐水炒橘红、桑葚、石斛、蒺藜、茯苓，药吞饭丸肉桂心五分。一剂后烦躁平息，呕吐停止，各症皆减。连投数服，粥食渐安。（叙述症状中只有肢冷、口干不欲饮、不饥不欲食及溺频属阳虚，其余都是阴虚挟热的表现。秋石水拌制丽参三钱，淡苁蓉三钱，制首乌三钱，生白芍四钱，牡蛎一两杵先煨六刻钟，川楝实三钱杵先，盐水炒蛀陈皮一钱，干桑葚三钱，鲜石斛杵先八钱，生白蒺去刺次入三钱，白茯苓三钱，药送饭丸肉桂心五分。这是杂证杂治之法，须玩味其从阳引阴、从阴引阳，机轴灵动。此证阴虚重于阳虚。）于是去掉首乌、桂、楝，加砂仁末拌炒熟地、菊花、枸杞。半月而愈。（砂仁末二分，炒松熟地四钱去砂仁，杭菊花二钱，甘枸杞三钱。）
暑湿盛行的季节，疹病盛行。儿科医生只知道套用成药，升麻、柴胡、防风、葛根乱用。陈书芾的女儿病情最重，因为疹子刚发出而月经正好来了。医生推辞不治。孟英诊视，脉滑而数，舌绛大渴，面赤失音，不食便泻，说：“这是因为发散太过，火盛风炽，气血两燔。气分之邪通过腹泻略微泄了其火势，营分之热通过月经稍微解了其焚烧。岂可害怕其脱陷，妄投止涩药呢？”给予西洋参、石膏、知母、麦冬、犀角、生地、连翘、甘草、石斛、丹皮、桑叶、竹叶，大剂量投服。三天而愈。养阴善后，遂渐安。其余或轻或重的，孟英一概用清解法而痊愈。（脉滑而数，热邪都在气分，只有舌绛二字，表示热邪在血分。病邪以有出路为宜，泻泄其热，月经解其焚，正是此病的生机。害怕脱陷，投止涩药，是治虚证的方法。此病系热实证，脉滑而数，数脉热中挟虚，故方中以麦冬、生地等补之。病情气分热邪过于血分，故此方清气之药较多。西洋参三钱，生石膏先煎一两二钱，酒炒知母次入三钱，花麦冬四钱，镑犀角磨冲一钱，大生地开水泡冲八钱，连翘壳次入三钱，生粉草三钱，粉丹皮二钱，鲜石斛杵先一两，冬桑叶四钱，鲜竹叶次入二钱。）
石诵羲夏末患感冒。多位医生广泛用药，病势日增，拖延超过一个月。孟英诊察，脉至右寸关滑数上溢，左手弦数，耳聋口苦，夜间热甚，胸中迷闷，频繁吐出粘沫，喝水咽喉阻塞，便溏尿赤，间有谵语，说：“这是暑热始终在肺，并不传经。一剂白虎汤即可痊愈，为何久延？前方只有初诊顾听泉用清解肺卫法为不谬，其余则是温散升提、滋阴凉血，都不中病。病家因溏泄害怕服用石膏，告诉孟英胸中有一团冷气，汤水都必须热喝。孟英回答说邪在肺经，清肃之令不行，津液凝滞，结成涎沫，盘踞胸中，升降之机也窒塞。大气仅能旁趋而转旋，是一团涎沫之中，为气机所不能流行之地，其感觉冷也是应该的。况且予初诊时，就断定为不传经的候象，所以尚有今日。若能自觉胸中之冷，若传入心包，舌黑神昏，则合古年之犀角地黄汤。然而虽不传经，拖延已超一月，热越久，液越枯，药越乱，病越深，宜急投白虎。古云鼻塞治心，耳聋治肺，这都是白虎汤的专司，不可拘泥于少阳而怀疑是虚寒。”开方用白虎加西洋参、贝母、花粉、黄芩、紫菀、杏仁、冬瓜仁、枇叶、竹茹、竹黄。一剂刚投，咽喉即利。三服各恙皆去，糜粥渐安。改甘润生津调理而愈。（右寸关滑数上溢九句，热邪多在气分，只有左手脉弦数稍挟阴虚。但右不降则左升，法宜治肺。病邪此脏传彼脏名传经。热证右脉无力，便溏则肺阳已败，忌服柔剂及石膏。热证右脉有力，则便溏为热邪出路，宜服阴剂及石膏。右寸关滑数上溢，则右脉有力可知，故不忌白虎。左脉弦数，虽挟阴虚，惟清肺则肺阴能生肝阴，且洋参花粉等一派清润，肃肺即以补肝，斯为一笔两用，一丝不漏。生石膏八钱先煎，西洋参三钱，川贝母杵三钱，酒炒知母一钱，南花粉三钱，酒炒枯芩二钱，杏仁泥一钱五分，紫菀茸一钱，生冬瓜子三钱，姜枇叶刷包三钱，鲜竹叶二钱，姜竹茹三钱，天竺黄三钱。甘润生津方：生甘草三钱，花麦冬三钱，花粉四钱，北沙参四钱，甜杏仁三钱，蜜枇叶刷包三钱，鲜地骨皮四钱，清阿胶炖和二钱，活水芦根八钱。）
刘廉方受暑，医治垂危。孟英诊察，裸卧昏狂，舌黑大渴，尿赤便秘，脉数而芤，给予犀角地黄汤加减。服后神识已清，略能进粥，颇知问答，大有生机。仍处甘凉药赠之。后来误服热药致死。（此证可生在大渴，大渴则肺阳尚旺。病情全系热邪由气传营之象。脉数而芤，芤为虚，此证阴虚重于热实。磨犀角冲一钱，大生地八钱，元参片一两，二味开水泡汤，去渣用汤煎药。酒炒知母三钱，明天冬六钱，鲜地骨皮五钱，鲜石斛杵先一两，鲜茅根五钱，枯青果连核杵先三个，云茯神三钱，龟板胶二钱炖和服，济银花次入八钱。神识已清，颇知问答，则营热已解，亟宜清其气分之热，故处甘凉以赠之。方用生石膏先煎八钱，酒炒知母三钱，北沙参八钱，花麦冬四钱，蜜炙枇叶刷包三钱，生粉草三钱，南花粉四钱，鲜地骨皮五钱，蜜水拌鲜芦根一两，甜杏仁三钱，冬桑叶三钱，青果连核杵先三个。）
孙楚楼途中患寒热如疟，胁痛痰嗽，面色黧黑形体消瘦。医生投以疏散药，甚不相安。孟英诊断阴亏，忌从疟治，以苇茎汤加北沙参、熟地、桑叶、丹皮、海石、旋复、贝母、枇叶为剂。方义主肃肺润燥，滋肾清肝。数服而痊。（孟英诊断阴亏，必有脉情。疟分正疟时疟，正疟属寒挟实，时疟属热挟虚。疏散甚不相安，其为阴亏何疑。胁痛痰嗽，为虚中挟实。鲜芦根二两，生冬瓜子四钱，生苡仁杵八钱，生桃仁杵三钱，北沙参四钱，大熟地泡煎去渣八钱，冬桑叶三钱，粉丹皮二钱，海浮石先煎五钱，旋复花绢包三钱，川贝母杵五钱，姜炙枇叶刷包三钱。）
姚雪樵的母亲年逾花甲，患感冒两个月，医生都束手无策。孟英诊察，身体已不能转侧，水饮难于下咽，声音不出，便溺不通，说：“这是热邪逗留不去，津液剥削殆尽。推算其受病之时，正当酷暑，岂能即投温补？只知其虚而不知其病吗？前方只有入手顾听泉从吸受暑邪轻清开上立治合法，其余方与病无涉。阮某小柴胡服之最多，医执此和解之法，谓不犯汗吐下三者之险。病家见其参胡并用，谓补正祛邪，一举两全。孰知和解足少阳伤寒传经之剂，不可以概和各经各气之病。徒使参胡提升热邪以上逆，致一身之治节无以清肃下行，而姜枣温腻湿浊于中焦，致运花之枢机失其灌溉之布，气机愈窒，津液愈干，和解之剂愈进，气愈不和，病愈不解。如今咽喉仅容点滴，气结津枯已极。书甘凉濡润之方，嘱其不限时刻，不计多寡，频以水匙挑入，使其渐渗下喉。一日仅灌一小杯许，灌至旬余，气机始渐流行，药可服小半剂。坚守前法，日以向愈，粥食递加。惟大解久不行，孟英告以谷食安津液充则自解，若欲速妄攻，则久不纳谷之胃，尚有何物以供其荡涤哉？至九月下旬，始有欲解之势。孟英连予补气益血之药，尚不能下，于前方加蜣螂一对，热服即解。凡不更衣者计及五十日，继以平补善后而痊。”（此病本系时疟，医误作正疟治，以小柴治伤寒之法用人参补阳，非寒虚证，则愈伤阴。身已不能转侧四句，热邪皆在气分，气伤则津伤。甘凉濡润方：蜜炙枇叶刷包三钱，生甘草三钱，蜜炙桑白皮四钱，南花粉三钱，鲜地骨皮四钱，甜杏仁三钱，海浮石先煎四钱，干桑葚杵先三钱，连皮青蔗劈先一两。津回食进，宜兼补气，不可沿用凉润，致伤阳气。补气益血方：潞党参三钱，生黄芪三钱，生粉草三钱，箱归身二钱，花麦冬三钱，云茯神人乳拌蒸三钱，大生地八钱，乌梅肉三钱。）
盛少云严寒患痰嗽，夜热自汗不寐，左胁痛如针刺，肌削不饥，病来虽恶，未经误药。孟英予固本加龟板、鳖甲、苁蓉、知柏、青黛、石斛、花粉、白芍、楝实、海石、旋复、贝母、蛤壳、牛膝出入为大剂投之即效，连服四五十帖而痊。（病情为邪正俱实，夜热自汗不寐，为兼挟阴虚，左胁痛为肝阳。川贝母杵一两，酒炒知母三钱，旋复花绢包三钱，南花粉四钱，海浮石四钱，生蛤壳八钱，二味同杵先，飞青黛一钱。更方去贝母、知母、花粉、海石、蛤壳，加酒炒川黄柏一钱五分，花麦冬四钱，整白芍杵先二两，钗石斛杵先一两，血鳖甲杵先四两，淡苁蓉三钱，酒制牛膝一钱，川楝实杵先三钱。更方去鳖甲、青黛、麦冬、旋复，加血龟板四两杵先，明天冬切六钱，大生地八钱，大熟地一两。）
邵小墀妻子春季患月经延期。释医诊以为怀孕，广服保胎药，渐至腹胀跗肿，气逆碍卧，饮食不进。夏季延孟英视之，说：“血虚气滞，误补成胀也。”先以黄连、浓朴、山楂、鸡内金、橘皮、大腹皮、枳实、茯苓、栀子、楝实、杏仁、紫菀、旋复等药，少佐参术服之。气机渐运，胀去食安，渐入滋阴养血之治，数月经行而愈。（胀分虚实两大门，此为实中挟虚，误补则气滞成胀，气不生血故血虚。重气滞不重血虚，故方多气药。姜炒川连二钱，姜制根朴八分，焦楂肉杵一钱，炙鸡金三钱，蛀陈皮一钱，大腹皮酒洗一钱五分，炒枳实一钱，白茯苓三钱，焦栀皮三钱，次入川楝实杵先二钱，苦杏泥一钱五分，紫菀茸一钱，潞党参一钱，炒白术七分。渐入滋阴养血之治，前方去连、朴、腹皮、枳、栀、紫菀，加肥玉竹三钱，箱归身二钱，大生地八钱，山萸肉三钱，酒制牛膝一钱。）
一人患晨泄多年，累治不效，春间尤甚。孟英按脉说：“你虽苦泻，而泻后腹中反觉舒畅。”其人回答说：“确实如此。若不泄泻，又胀闷减食矣。”服四神附桂之药，其泻必加，何故？孟英说：“这不是温升补涩之证，乃肝强脾弱，木土相凌。”处一方令其常服，数帖即安，后竟无恙。方用白术、苡仁、黄连、楝实、桑枝、茯苓、木瓜、芍药、蒺藜、橘皮而已。（春间尤甚，已露肝强。泻后腹中反觉舒畅者，肝强贼脾，得泄泻稍解其郁抑之苦。服四神附桂反加者，温热助肝贼脾。肝强脾弱，两脏俱病，惟肝强较重。炒白术三钱，炒苡仁杵八钱，酒炒川连八分，川楝实杵先四钱，鲜桑枝三钱，白茯苓四钱，陈木瓜三钱，整白芍杵先二两，生白蒺去刺三钱，蛀陈皮一钱五分。）
Deficiency. Warming and tonifying methods are not appropriate. Switch to administering decoctions that nourish Kidney Water (Shui, 肾水) and cultivate the Origin (Yuan, 元). The effect was quite significant. In summer, some advised moxibustion, claiming it could cure all diseases. This likely stems from a misunderstanding of the principle that moxibustion can "cure all diseases"; it refers specifically to dispelling cold-dampness stagnation and conditions where Yang Qi cannot circulate freely, not to saying that all internal injuries or external contractions can be cured by moxibustion. Therefore, Zhang Zhongjing gave the instruction: "If the pulse is slightly rapid, moxibustion must absolutely not be used," precisely because moxa fire greatly damages Yin fluids. A few days after moxibustion, the patient experienced less chills and more fever, resembling malaria. The physician diagnosed Spleen Cold (Pi Han, 脾寒) and administered warming and dispersing herbs, causing the condition to worsen daily. Mengying palpated the pulse, finding it slippery and rapid, doubled in intensity, and said: "This is a Yin-deficient constitution with heat generated internally. Moxibustion introduced fire qi inward; coinciding with humid summer heat scorching from outside, these three factors combined—how can the Yin endure? Administering more warming and dispersing herbs is like adding oil to fire. It should be treated as Dan Malaria (Dan Nue, 瘅疟), using exclusively sweet-cold herbs to clear heat, so that Yin fluids will not dry up, and the chills and fever will resolve spontaneously. This is what is meant by 'in treating disease, one must seek the root.'" Ultimately, it was cured without using a single grain of exterior-releasing herb. (Dizziness and tinnitus indicate underlying Yin insufficiency; aversion to cold resulted from warming tonification; deep heat leads to deep cold limbs [Re Shen Jue Shen, 热深厥深]. Slippery pulse indicates Phlegm; rapid pulse indicates Yin deficiency with heat. Sheng Shi Gao (Raw Gypsum Fibrosum) 1 liang, wrapped and decocted first; Jiu Chao Zhi Mu (Albiziae Cortex, prepared with wine) 3 qian, added later; Nan Hua Fen (Tubera Trichosanthis) 4 qian; Jiang Zhu Li (Ginger-infused Bamboo Sap) 2 large wine cups, mixed and taken; Huo Shui Lu Gen (Fresh Reed Rhizome) 2 liang; Xian Pi Ye (Fresh Foliium Broussonetiae Papyriferae) brushed and wrapped, 3 qian; Sheng Bei Li (Raw North Pear) 3 liang; Qing Gan Zhe (Green Sugarcane) 1 liang, all with skin on, juiced together and mixed.)
Chen Zhitian contracted an external pathogen in mid-summer. Various physicians administered warming and dispersing herbs, leading to a ten-day delay. He developed coma, delirium, limb convulsions, deafness, black tongue, scorched lips, retracted testicles, and scanty urination. Faint macules appeared faintly on his chest. Mengying palpated the pulse, finding it fine, rapid, and hurried, and said: "Yin deficiency with blazing heat; fluids are about to dry up." He prescribed a large dose of Xi Yang Shen (Radix Panacis Quinquefolii), Xuan Shen (Radix Scrophulariae), Sheng Di Huang (Radix Rehmanniae Preparata), Er Dong (Winter Melon Seeds and Ophiopogon Tuber), Zhi Mu (Rhizoma Anemarrhenae), Bai Zhu (Rhizoma Atractylodis Macrocephalae - *Note: Context implies Huang Bo/Bai Zhu confusion or specific pairing, text says Zhi Bai*, likely Huang Bo), Lian Shi (Fructus Toosendan), Shi Hu (Caulis Dendrobii), Bai Shao (Radix Paeoniae Alba), Cao Gan Cao Gao (Radix Glycyrrhizae Preparata tip), Yin Hua (Flos Lonicerae Japonicae), Mu Tong (Caulis Akebiae), Xi Jiao (Cornu Rhinocerotis), and Shi Chang Pu (Rhizoma Acori Tatarinowii). (This case is salvageable based on three points: scanty urination, faint macules on chest, and fine-rapid-hurried pulse. If Liver Yin is exhausted, urination ceases. Faint macules on the chest indicate that while pathogens are strong, righteous Qi is also strong, allowing pathogens to exit outward. Fine-rapid-hurried pulse indicates extreme heat generating wind, but being Yang syndrome with Yang pulse, it can tolerate Yin-nourishing herbs. If the pulse were weak, it would be untreatable. Xuan Shen Pian 1 liang, Da Sheng Di 8 qian, Ming Tian Dong 6 qian sliced, Hua Mai Dong 5 qian; soak the four ingredients in boiling water, remove dregs, and use the liquid to decoct the remaining herbs. Xi Yang Shen 4 qian, Jiu Chao Zhi Mu 3 qian, Jiu Chao Chuan Bai 1.5 qian, Jiu Chao Lian Pi (de-seeded) 2 qian, Cha Shi Hu 1 liang pounded first, Zheng Bai Shao 2 liang pounded first, Sheng Cao Gan Cao Gao 3 qian, Ji Yin Hua 1.5 liang, Xi Mu Tong 1 qian, Bang Xi Jiao slice ground and mixed in 1 qian, Shi Chang Pu added later 1 qian.) The next day, his family reported that for seven or eight days, urination had been merely drops, but after taking the medicine yesterday, he voided half a cup of urine after six or seven shichen (12-14 hours). Mengying said: "This is a turning point. However, since Yin Qi is depleted, sweet-cool and moistening herbs are never too many." He added Gui Ban (Carapax et Plastrum Testudinis), Bie Jia (Carapax et Plastrum Sinensis Synechii), Bai He Xu (Bulbus Lilii cum radicula), and Hua Fen to the previous formula, decocted in a large pot, and administered frequently without stopping. After eight days of this, his spirit cleared, and all ailments receded. Purely using Yin-nourishing herbs, he recovered after one month of regulation. Mengying once stated: In warm-heat diseases where fluids are depleted leading to coma, there are cases where over ten doses of Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction) were required before spirit cleared and fluids restored. (Medicines ascend and descend with Qi; if Qi does not descend, medicines do not descend. If Mengying had added Gui Ban and Bie Jia immediately upon consultation, it would have been ineffective because Qi and Fire were still floating upward. Only after urination resumed did it show signs of Yin fluid recovery, justifying the addition of shell/animal products. However, small doses would be insufficient against the disease; Blood Gui Ban 4 liang and Blood Bie Jia 4 liang should be pounded together, calcined over charcoal for eight ke (approx. 48 mins), along with Bai He Xu 4 qian and Nan Hua Fen 5 qian, administered frequently to ensure continuous medicinal power.)
Jiang Xiaoxiang suffered from critical heat illness. Mengying palpated the pulse, finding it deficient, wiry, slightly rapid, and small. Headache was localized to the left rear. Fever and restlessness occurred at midnight. Limbs were cold, nausea was desired. Mouth was dry but drinking was not desired. No hunger, no desire to eat. Speech was slurred and stiff. Urine was yellow and frequent. He said: "The constitution is inherently deficient. This resulted from excessive administration of warming and dispersing herbs during the initial infection, damaging both Yin fluids and Yang Qi. Later, tonics aggravated the condition because cloying substances hindered middle-jiao transportation, and harsh drugs stirred internal wind. Thus, physicians claimed that exterior treatment was ineffective and tonification failed, leaving the case seemingly untreatable. Nevertheless, it is merely difficult to treat, not hopeless." He prescribed Gao Li Shen (Korean Ginseng Root) processed with Qiu Shi Shui (Autumn Stone Water), Rong Rong (Cistanche Stem), Shou Wu (Polygonum Multiflorum Stem), Sheng Bai Shao (White Peony Root), Mu Li (Oyster Shell), Lian Shi (Toosendan Fruit), Yan Shui Chao Ju Hong (Tangerine Peel stir-fried with salt water), Sang Shen (Mulberry Fruit), Shi Hu (Dendrobium Stem), Ji Li (Tribulus Fruit), and Fu Ling (Poria), swallowed with rice pills containing Rou Gui Xin (Cinnamon Bark Heart) 5 fen. One dose calmed restlessness and stopped vomiting; all symptoms decreased. Several doses led to gradual tolerance of congee. (Among the described symptoms, only cold limbs, dry mouth without desire to drink, lack of hunger/appetite, and frequent urination belong to Yang deficiency; the rest are signs of Yin deficiency with heat. Gao Li Shen 3 qian processed with Autumn Stone Water, Dan Cong Rong 3 qian, Zhi Shou Wu 3 qian, Sheng Bai Shao 4 qian, Mu Li 1 liang pounded and decocted first for six ke, Chuan Lian Shi 3 qian pounded first, Yan Shui Chao Zhu Chen Pi 1 qian, Gan Sang Shen 3 qian, Xian Shi Hu 8 qian pounded first, Sheng Bai Ji Li (de-thorned) added later 3 qian, Bai Fu Ling 3 qian, taken with rice pill Rou Gui Xin 5 fen. This is a method of treating miscellaneous disorders, requiring appreciation of guiding Yang to draw Yin and Yin to draw Yang, with flexible mechanisms. Here, Yin deficiency outweighs Yang deficiency.) Then he removed Shou Wu, Gui, and Lian, adding Sha Ren end (Amomum Fruit Seed) mixed with Chao Shu Di (Prepared Rehmannia Root stir-fried), Ju Hua (Chrysanthemum Flower), and Gou Qi (Goji Berry). Recovery occurred within half a month. (Sha Ren end 2 fen, Chao Song Shu Di 4 qian removing Sha Ren, Hang Ju Hua 2 qian, Gan Gou Qi 3 qian.)
During the season of humid summer heat, rashes prevailed. Pediatricians only knew standard prescriptions, indiscriminately using Sheng Ma, Chai Hu, Fang Feng, and Ge Gen. Chen Shufu's daughter had the most severe case because her rash had just erupted when her menstruation arrived. Physicians declined treatment. Mengying examined her: pulse slippery and rapid, tongue crimson, intense thirst, red face, loss of voice, refusal to eat, diarrhea. He said: "This is due to excessive dispersion, resulting in blazing fire and vigorous wind, burning both Qi and Blood levels. The Qi-level pathogen has slightly vented its flame through diarrhea; the Ying-level heat has slightly resolved its burning through menstruation. How can one fear collapse and mistakenly administer astringents?" He prescribed a large dose of Xi Yang Shen, Shi Gao, Zhi Mu, Mai Dong, Xi Jiao, Sheng Di, Lian Qiao, Gan Cao, Shi Hu, Dan Pi, Sang Ye, and Zhu Ye. She recovered in three days. Nourishing Yin for aftercare led to gradual stability. Others, mild or severe, were cured uniformly by Mengying using clearing and resolving methods. (Slippery and rapid pulse indicates heat pathogens in the Qi level; only the crimson tongue indicates heat in the Blood level. Pathogens are best managed with an outlet; diarrhea vents heat, menstruation resolves burning—this is the vital sign of this disease. Fear of collapse and use of astringents are methods for deficiency syndromes. This is a heat-excess syndrome. Rapid pulse indicates heat with deficiency, hence Mai Dong and Sheng Di are used to tonify. Since Qi-level heat exceeds Blood-level heat, the formula contains more Qi-clearing herbs. Xi Yang Shen 3 qian, Sheng Shi Gao decocted first 1.2 liang, Jiu Chao Zhi Mu added later 3 qian, Hua Mai Dong 4 qian, Bang Xi Jiao ground and mixed 1 qian, Da Sheng Di soaked in boiling water and mixed 8 qian, Lian Qiao Ke added later 3 qian, Sheng Fen Cao 3 qian, Fen Dan Pi 2 qian, Xian Shi Hu pounded first 1 liang, Dong Sang Ye 4 qian, Xian Zhu Ye added later 2 qian.)
Shi Songxi contracted an external pathogen at the end of summer. Multiple doctors and wide-ranging medications increased the severity over a month. Mengying palpated: pulse slippery, rapid, and overflowing at the Right Cun and Guan positions; Left hand wiry and rapid. Deafness, bitter taste, worse heat at night, chest confusion/stuffiness, frequent vomiting of sticky saliva, throat obstruction when swallowing drinks, loose stools, dark urine, occasional delirium. He said: "This is Summer-Heat and Heat remaining in the Lung throughout, without transmitting meridians. One dose of Bai Hu Tang (White Tiger Decoction) would cure it. Why the delay? Only Gu Tingquan's initial diagnosis using clearing and resolving Lung-Wei method was correct; others used warming/dispersing, lifting, nourishing Yin, and cooling blood, missing the mark. The family feared Shi Gao due to loose stools, telling Mengying of a 'ball of cold air' in the chest requiring hot drinks. Mengying replied: The pathogen is in the Lung Meridian; the function of clearing and descending fails, causing Jin-Ye to stagnate and form phlegm-saliva, occupying the chest, blocking ascending-descending mechanisms. The Great Qi can only rotate peripherally, creating a zone where Qi mechanism cannot flow, hence the sensation of cold is expected. I initially diagnosed non-transmission, which is why the case persists. If it transmitted to the Pericardium, with black tongue and coma, Xi Jiao Di Huang Tang would be indicated. Although not transmitting, delaying over a month means prolonged heat depletes fluids, chaotic meds deepen the disease. Urgent administration of Bai Hu Tang is needed. Ancient texts say 'stuffy nose treats Heart, deafness treats Lung'; these are specialties of Bai Hu Tang. Do not confine to Shaoyang or suspect deficiency-cold." Prescription: Bai Hu Tang plus Xi Yang Shen, Bei Mu, Hua Fen, Huang Qin, Zi Wan, Xing Ren, Dong Gua Ren, Pi Ye, Zhu Ru, and Zhu Huang. One dose relieved the throat; three doses eliminated all ailments, congee intake improved. Changed to sweet-moistening and Jin-Ye generating herbs for recovery. (Right Cun/Guan slippery-rapid-overflowing nine sentences: Heat mostly in Qi level, Left wiry-rapid slightly involves Yin deficiency. But Right non-descent leads to Left ascent; method should treat Lung. Transmission between organs is named transmission. In heat syndromes, weak Right pulse with loose stools indicates failed Lung Yang, avoiding soft agents and Shi Gao. Strong Right pulse with loose stools indicates heat outlet, allowing Yin agents and Shi Gao. Right Cun/Guan overflow indicates strong Right pulse, thus Bai Hu is not contraindicated. Left wiry-rapid involves Yin deficiency, but clearing Lung generates Liver Yin. Xi Yang Shen and Hua Fen are clear-moistening; purifying Lung supplements Liver. This achieves two goals with one stroke. Sheng Shi Gao 8 qian decocted first, Xi Yang Shen 3 qian, Chuan Bei Mu pounded 3 qian, Jiu Chao Zhi Mu 1 qian, Nan Hua Fen 3 qian, Jiu Chao Ku Qin 2 qian, Xing Ren Ni 1.5 qian, Zi Wan Rong 1 qian, Sheng Dong Gua Zi 3 qian, Jiang Pi Ye brushed/wrapped 3 qian, Xian Zhu Ye 2 qian, Jiang Zhu Ru 3 qian, Tian Zhu Huang 3 qian. Sweet-Moistening Jin-Ye Formula: Sheng Gan Cao 3 qian, Hua Mai Dong 3 qian, Hua Fen 4 qian, Bei Sha Shen 4 qian, Tian Xing Ren 3 qian, Mi Pi Ye brushed/wrapped 3 qian, Xian Di Gu Pi 4 qian, Qing E Jiao stewed/mixed 2 qian, Huo Shui Lu Gen 8 qian.)
Liu Lianfang suffered from summer-heat, treatment nearly fatal. Mengying palpated: naked lying, coma/manic, black tongue, intense thirst, dark urine, constipation, pulse rapid and Kou (floating hollow). Prescribed modified Xi Jiao Di Huang Tang. Spirit cleared, slight congee intake, able to answer questions, showing great vitality. Prescribed sweet-cool herbs for continuation. Later died due to mistaken hot herbs. (Salvageability indicated by intense thirst, showing Lung Yang still robust. Condition is heat transmitting from Qi to Ying. Pulse rapid and Kou indicates deficiency; here Yin deficiency outweighs heat-excess. Xi Jiao ground/mixed 1 qian, Da Sheng Di 8 qian, Xuan Shen Pian 1 liang; soak two in boiling water, remove dregs, decoct remaining herbs. Jiu Chao Zhi Mu 3 qian, Ming Tian Dong 6 qian, Xian Di Gu Pi 5 qian, Xian Shi Hu pounded first 1 liang, Xian Mao Gen 5 qian, Ku Qing Guo with seed pounded first 3, Yun Fu Shen 3 qian, Gui Ban Jiao stewed/mixed 2 qian, Ji Yin Hua added later 8 qian. Clear spirit and ability to answer indicate Ying-heat resolved; urgently clear Qi-level heat, hence sweet-cool prescription. Formula: Sheng Shi Gao decocted first 8 qian, Jiu Chao Zhi Mu 3 qian, Bei Sha Shen 8 qian, Hua Mai Dong 4 qian, Mi Zhi Pi Ye brushed/wrapped 3 qian, Sheng Fen Cao 3 qian, Nan Hua Fen 4 qian, Xian Di Gu Pi 5 qian, Mi Shui Ban Xian Lu Gen 1 liang, Tian Xing Ren 3 qian, Dong Sang Ye 3 qian, Qing Guo with seed pounded first 3.)
Sun Chulou suffered chills and fever like malaria en route, hypochondriac pain, phlegm cough, sallow complexion, emaciation. Doctors used dispersing herbs, causing discomfort. Mengying diagnosed Yin deficiency, forbidding malaria treatment. Prescribed Wei Jing Tang plus Bei Sha Shen, Shu Di, Sang Ye, Dan Pi, Hai Shi, Xuan Fu, Bei Mu, Pi Ye. Principle: Purify Lung, moisten dryness, nourish Kidney, clear Liver. Recovered after several doses. (Diagnosis of Yin deficiency implies pulse evidence. Malaria divides into Zheng Malaria (Cold-excess) and Shi Malaria (Heat-deficiency). Dispersing herbs caused discomfort, confirming Yin deficiency. Hypochondriac pain and phlegm cough indicate deficiency with excess. Xian Lu Gen 2 liang, Sheng Dong Gua Zi 4 qian, Sheng Yi Ren pounded 8 qian, Sheng Tao Ren pounded 3 qian, Bei Sha Shen 4 qian, Da Shu Di soaked/decocted/strained 8 qian, Dong Sang Ye 3 qian, Fen Dan Pi 2 qian, Hai Fu Shi decocted first 5 qian, Xuan Fu Hua silk-wrapped 3 qian, Chuan Bei Mu pounded 5 qian, Jiang Zhi Pi Ye brushed/wrapped 3 qian.)
Yao Xueqiao's mother, over seventy, had a cold for two months, doctors helpless. Mengying palpated: unable to turn body, difficulty swallowing liquids, voice lost, inability to urinate/defecate. He said: "Heat pathogen lingers, fluids exhausted. Calculating onset during peak summer heat, how could warming tonics be appropriate? Knowing only deficiency but ignoring the pathogen." Only Gu Tingquan's initial approach of light-clearing upper jiao for inhaled summer-heat was correct; other formulas were irrelevant. Many took Xiao Chai Hu Tang; physicians insisted on harmonizing, claiming safety from sweating/vomiting/purging risks. Family saw Ginseng and Bupleurum as tonifying righteousness and expelling evil. Unaware that harmonizing Shaoyang Taiyang transmission formulas cannot apply to all meridians/qi diseases. Ginseng and Bupleurum lifted heat upward, obstructing downward descent of governance mechanisms. Ginger and Jujube warmed/cloyed damp-turbidity in Middle Jiao, losing irrigation distribution. Qi mechanism became more blocked, fluids drier, harmonizing agents worsened disharmony. Now throat accepts only drops, Qi knot and fluid depletion extreme. Prescribed sweet-cool moistening formula, instructed to take frequently regardless of time/amount, spoon-fed to seep down. One cup per day for over ten days until Qi mechanism flowed, allowing half dose. Persisted, improving daily, congee increased. Stool didn't move for long. Mengying said: Once food stabilizes and fluids fill, it will resolve naturally. Rushing with purgatives leaves nothing for the stomach to cleanse. Late September, urge to defecate appeared. Mengying gave Qi-tonifying and Blood-nourishing herbs, still no movement. Added one dung beetle (Qiang Lang), taken hot, resolved immediately. Total fifty days without bowel movement. Followed with mild tonification for aftercare, recovered. (Originally Shi Malaria, misdiagnosed as Zheng Malaria, treated with Xiao Chai Hu and Ginseng tonifying Yang; not cold-deficiency, thus further damaging Yin. Four symptoms of immobility/swallowing/speech/voiding indicate heat in Qi level; Qi damage leads to fluid damage. Sweet-cool moistening formula: Mi Zhi Pi Ye 3 qian, Sheng Gan Cao 3 qian, Mi Zhi Sang Bai Pi 4 qian, Nan Hua Fen 3 qian, Xian Di Gu Pi 4 qian, Tian Xing Ren 3 qian, Hai Fu Shi decocted first 4 qian, Gan Sang Shen pounded first 3 qian, Lian Pi Qing Zhe split first 1 liang. Once fluids return and appetite improves, combine Qi tonification, avoid lingering cool-moistening to spare Yang. Qi-Blood Tonifying Formula: Lu Dang Shen 3 qian, Sheng Huang Qi 3 qian, Sheng Fen Cao 3 qian, Xiang Gui Shen 2 qian, Hua Mai Dong 3 qian, Yun Fu Shen steamed with human milk 3 qian, Da Sheng Di 8 qian, Wu Mei Rou 3 qian.)
Sheng Shaoyun suffered phlegm-cough in severe cold, night fever, spontaneous sweating, insomnia, left hypochondriac stabbing pain, emaciation, anorexia. Illness was severe but no wrong meds. Mengying prescribed Gu Ben Tang modified with Gui Ban, Bie Jia, Rong Rong, Zhi Bai, Qing Dai, Shi Hu, Hua Fen, Bai Shao, Lian Shi, Hai Shi, Xuan Fu, Bei Mu, Ge Ke, Niu Xi as large dose, effective immediately. Forty-fifty doses for recovery. (Condition: Excess pathogen and excess righteous Qi. Night fever/sweating/insomnia indicates concurrent Yin deficiency. Left hypochondriac pain indicates Liver Yang. Chuan Bei Mu pounded 1 liang, Jiu Chao Zhi Mu 3 qian, Xuan Fu Hua silk-wrapped 3 qian, Nan Hua Fen 4 qian, Hai Fu Shi 4 qian, Sheng Ge Ke 8 qian, two pounded first, Fei Qing Dai 1 qian. Modified formula: Remove Bei Mu, Zhi Mu, Hua Fen, Hai Shi, Ge Ke; add Jiu Chao Chuan Huang Bo 1.5 qian, Hua Mai Dong 4 qian, Zheng Bai Shao pounded first 2 liang, Cha Shi Hu pounded first 1 liang, Xue Bie Jia pounded first 4 liang, Dan Cong Rong 3 qian, Jiu Zhi Niu Xi 1 qian, Chuan Lian Shi pounded first 3 qian. Further modified: Remove Bie Jia, Qing Dai, Mai Dong, Xuan Fu; add Xue Gui Ban pounded first 4 liang, Ming Tian Dong sliced 6 qian, Da Sheng Di 8 qian, Da Shu Di 1 liang.)
Shao Xiaochi's wife missed menstruation in spring. Monk physician diagnosed pregnancy, widely administered fetal-preserving herbs, leading to abdominal distension, ankle swelling, rebellious Qi preventing lying flat, anorexia. Summer, Mengying examined: "Blood deficiency with Qi stagnation, mistaken tonification caused distension." First prescribed Huang Lian, Hou Po, Shan Zha, Ji Nei Jin, Ju Pi, Da Fu Pi, Zhi Shi, Fu Ling, Zhi Zi, Lian Shi, Xing Ren, Zi Wan, Xuan Fu, etc., with minor amounts of Shen and Zhu. Qi mechanism gradually moved, distension resolved, appetite returned. Gradually shifted to nourishing Yin and Blood. Menstruation returned after several months, cured. (Distension divides into Deficiency and Excess. This is Excess with Deficiency; mistaken tonification causes Qi stagnation distension; Qi fails to generate Blood, hence Blood deficiency. Emphasize Qi stagnation over Blood deficiency, hence more Qi-moving herbs. Jiang Chuan Lian 2 qian, Jiang Zhi Gen Po 8 fen, Jiao Zha Rou pounded 1 qian, Zhi Ji Jin 3 qian, Zhu Chen Pi 1 qian, Da Fu Pi wine-washed 1.5 qian, Chao Zhi Shi 1 qian, Bai Fu Ling 3 qian, Jiao Zhi Pi 3 qian, Chuan Lian Shi pounded first added later 2 qian, Ku Xing Ni 1.5 qian, Zi Wan Rong 1 qian, Lu Dang Shen 1 qian, Chao Bai Zhu 7 fen. Shift to nourishing Yin/Blood: Remove Lian, Po, Fu Pi, Zhi, Zhi, Zi Wan; add Fei Yu Zhu 3 qian, Xiang Gui Shen 2 qian, Da Sheng Di 8 qian, Shan Yu Rou 3 qian, Jiu Zhi Niu Xi 1 qian.)
A man suffered morning diarrhea for years, treatments failed, worse in spring. Mengying palpated: "Though you suffer diarrhea, abdomen feels comfortable after stool." Patient replied: "True. Without diarrhea, bloating and reduced appetite occur." Taking Si Shen Wan with Fu Zi and Gui would worsen diarrhea. Why? Mengying said: "Not a warming/lifting/astringing syndrome, but Strong Liver and Weak Spleen, Wood insulting Earth." Prescribed a formula for regular use, safe after several doses. Formula: Bai Zhu, Yi Ren, Huang Lian, Lian Shi, Sang Zhi, Fu Ling, Mu Gua, Shao Yao, Ji Li, Ju Pi. (Worse in spring reveals Strong Liver. Comfort after stool: Strong Liver insults Spleen, diarrhea relieves depression. Si Shen/Fu/Gui worsens it: Warm-hot aids Liver insulting Spleen. Both organs diseased, Liver stronger. Chao Bai Zhu 3 qian, Chao Yi Ren pounded 8 qian, Jiu Chuan Lian 8 fen, Chuan Lian Shi pounded first 4 qian, Xian Sang Zhi 3 qian, Bai Fu Ling 4 qian, Chen Mu Gua 3 qian, Zheng Bai Shao pounded first 2 liang, Sheng Bai Ji Li (de-thorned) 3 qian, Zhu Chen Pi 1.5 qian.)