明哲。断非见不及此。念论及此。见病家破格专任之难。惟念既拟立前方。本案各方不便挨
拟。读者悉心揣摩。参理念注另案自悉。)
陈足甫溲后见血。管痛异常。减餐气短。孟英以元参生地知母楝实银花侧柏叶栀子桑叶丹皮
绿豆为方。藕汤煎服二剂。病大减。乃去丹皮柏叶。加西洋参熟地。服之而瘥。（管痛异常
二句。为阴虚肝热贼肺。故以元参生地知楝银花柏叶丹皮育阴凉血。兼泻血分之热。以栀子
桑叶绿豆皮清气分之热。减餐气短。肝热贼肺。肺伤则气不接续。有似乎短。肺实并非肺虚
。故用栀桑绿豆以治之。西洋参泻热下气。略兼补肺。并非单纯补品。元参片一两。大生地
八钱。二味开水泡汤。去渣用汤煎药。酒炒知母三钱。楝核杵先三钱。济银花八钱。酒炒侧
柏叶一钱。黑栀皮次入三钱。冬桑叶三钱。绿豆皮四钱。粉丹皮二钱。连皮藕二两切煨汤煎
药。更方去丹皮柏叶。加西洋参三钱清气。大熟地八钱育阴。开水同泡煎去渣。)
王开荣偶患腹中绞痛。自服治痧诸药。而大便泻血如注。孟英诊之。左颇和。右关尺弦大而
滑。面色油红。喘逆不寐。予苇茎汤合金铃子散加银花侧柏叶栀斛芩连。二剂后面红退。
血亦止。乃裁柏叶银花。加雪羹枯荷杆。又二剂始发热一夜。得大汗周身。而腹之痛胀爽
然若失。即能安寐进粥。改投沙参知母花粉桑叶枇杷叶石斛白芍橘络杏仁冬瓜子茅根荷杆。
三剂大解行而脉柔安谷。（痧分寒热两大门。寒痛痛止不移。热痛痛必不静。此阳动阴静之
定理。此证腹中绞痛。本系热痛。自服治痧诸药。必误服治寒痧之药。大便泻血如注。肺与
大肠相表里。香燥大伤肺阴。脉弦大为肝热挟虚。滑为肺有热痰。面色油红二句。皆肺阴大
伤
之明证。活水芦根二两。生冬瓜子八钱。生桃仁研三钱。济银花一两五钱。酒炒侧柏叶次入
一钱五分。川楝核杵先四钱。酒炒元胡索次入一钱五分。黑栀皮三钱。鲜石斛杵先一两。酒
炒枯芩三钱。酒炒川连一钱。二剂面红退血亦止。方义以清肺阴为君。泻肝热为臣。佐以银
花石斛栀皮。使以桃仁胡索。嗣裁柏叶银花。加雪羹枯荷杆连皮大荸荠二两打。泡淡海 二
两。枯荷杆三钱。大凡涉及气阴血阴温病。必由阴分血分反还于气分。周身得汗乃解。沙参
八钱。酒炒知母三钱。花粉四钱。桑叶三钱。枇叶刷包三钱。石斛杵先一两。酒炒白芍一钱
半。橘络一钱。苦杏仁一钱半。生冬瓜子茅根荷杆各三钱。)
陈叟久患痰嗽气逆。夏初因恶寒。自服理中汤。遂痰中带血。气喘而厥。二便不通。冷汗腹
胀。孟英察脉洪大。按腹如烙。予苇茎汤加栀楝旋贝花粉海蜇。外以田螺大蒜车前草捣贴脐
下。即溺行而平。（痰嗽气逆。则肺气不能充周于肌表。故畏寒。并非阳虚恶寒误服温补。
现
证如上。脉洪大为阴虚。按腹如烙。为热蒸气分。活水芦根二两。生冬瓜子八钱。黑栀皮三
钱。川楝核杵先四钱。旋复花绢包次入三钱。川贝母杵一两。南花粉四钱。淡海 先煎二两
。整田螺三个。生车前草一握。生大蒜六瓣。田螺介以潜阳。咸以 坚。车前草清凉导水。
大蒜辛温反佐。同捣贴脐下。外以本青布当脐横扎。)
高某患两膝筋络酸痛。略不红肿。卧则痛不可当彻夜危坐。孟英切脉虚细。苔色黄腻。咽燥
溺赤。予知斛栀楝牛膝豆卷桑枝竹沥为方。送虎潜丸。旬日而瘳。（此证为阴虚挟热。以豆
卷升知楝之苦寒于咽喉至高之处。证虽阴虚。苔色黄腻。滋腻难投。竹沥顾阴豁痰。两擅其
长。酒炒知母三钱。鲜石斛杵先八钱。黑栀皮三钱。川楝核杵先二钱。生牛膝五分。大豆卷
次入三钱。酒炒桑枝次入三钱。姜竹沥两酒杯冲。药送虎潜丸三钱。)
杨某方作事。不知背后有人潜立。回顾失惊。遂不言不食。不寐不便。别无他苦。孟英按脉
沉弦。以石菖蒲远志琥珀胆星旋贝竹黄杏仁省头草羚羊角为剂。化服苏合香丸。二剂大解行
而啜粥。夜得寐而能言。复予调气宁神蠲饮药。数日霍然。（大凡因惊得病。非阴分不足。
即素挟痰浊。脉弦为肝热挟虚。沉弦为热结为里。石菖蒲次入二钱。生远志肉一钱五分。西
毛珀研冲八分。旋复花绢包三钱。川贝母杵八钱。天竺黄三钱。陈胆星七分炖和服。苦杏仁
二钱。省头草次入一钱五分。羚角先煎四钱。药化服苏合香丸五分。调气宁神蠲饮方。鲜枇
叶刷包三钱。旋复花绢包三钱。胆汁炒枣仁一钱五分。酒炒川连八分。石草蒲一钱。赖氏橘
红一钱。川贝母杵一两。生冬瓜子四钱。)
赵听樵妹每汛至则腹胀呕吐。腰脊酸痛。两腿肿痛。筋掣脘痛。甚至痉厥。多药不效。孟
英以金铃子散合左金加二陈竹茹枳实桂苓数剂而愈。续用苁蓉菟丝淫羊杜仲桑葚木瓜续断香
附归芍茴楝调之。汛至如期。略无痛苦。（腹胀呕吐五句。病情系肝旺贼脾。惟肝阳侮胃。
病者阳气亦虚。故兼用二陈桂苓。川楝核多杵五钱先炭煨六句钟。玄胡索七分。酒炒川连一
钱。淡吴萸次入六
分。半夏曲杵二钱。薄橘红一钱。姜竹茹三钱。炒枳实一钱五分。肉桂心二分。云茯苓三钱
。续方淡苁蓉一钱半。菟丝饼四钱。淫羊藿二钱。绵杜仲二钱。干桑葚杵一钱半。陈木瓜三
钱。川续断一钱半。小茴香五分。酒炒香附七分。箱归身二钱。整大白芍杵先二两。川楝核
杵先四钱。)
濮姓女素禀阴虚。时发夜热。少餐不寐。仲夏患感发疹。汛不当期而至。孟英用犀羚知贝石
膏生地栀翘花粉甘草竹叶芦根等药。疹透神清。唯鼻燥异常。吸气入喉。辣痛难忍。甚至肢
冷。复于方中加玄参竹茹菊叶荷杆。各患始减。而心忡吐沫。彻夜不瞑。渴汗便黑。改投西
洋参生地麦冬小麦竹叶黄连真珠百合贝母石斛牡蛎龟板蔗汁诸药而愈。（阴虚肝旺。故多夜
热
。肝热伤肺胃之阴。故少餐不寐。发疹及汛不当期而至。为肝阳炽逆兼袭营分。故方中用犀
羚石膏息风镇胃。针治汛不当期而至。余皆清气之品。针治发痧。犀角先煎四钱。羚角先煎
四钱。酒沙知母四钱。川贝母杵八钱。生石膏先煎一两六钱。酒炒栀皮三钱。酒炒翘壳三钱
。
南花粉四钱。生粉草三钱。鲜竹叶二钱。活水芦根二两。大生地八钱。开水泡去渣冲服。鼻
燥异常四句。仍系肝阳贼肺。加玄参片一两。开水泡冲去渣。姜竹茹次入三钱。菊叶二钱。
荷杆三钱。尾方洋参小麦百合花麦冬各三钱。竹叶二钱。酒炒黄连一钱。珠粉二分舌 药
送
。川贝杵五钱。石斛一两先煎。大生地一两。青蔗二两绞冲。牡蛎六两。龟板三两。同先煨
六句钟。)
金亚伯外家产后恶露不行。渴泻痰多。孟英以北沙参滑石生薏苡生扁豆蛤壳豆卷石斛竹茹枇杷
叶琥珀茯苓等药。数剂而愈。（恶露不行病在血。渴泻痰多病在气。血病治气。泻止痰清。
则恶露自行。气为血帅也。故方中止滑石琥珀两味泻瘀。余皆气药。豆卷尤用得精确。大
凡清
肺下行药中。不可无升发上行之品以反佐之。经所谓将欲降之。必先升之。北沙参四钱。西
滑石先煎四钱。生苡仁八钱。生扁豆杵三钱。生蛤壳杵先五钱。大豆卷三钱。鲜石斛先八钱
。姜竹茹三钱。鲜枇叶刷包三钱。西毛珀研冲八分。云苓一钱半。)
顾女患感十余日。耳聋不语。昏不识人。而客未入室。彼反先知医以为祟。凡犀角地黄牛黄
清心复脉等汤遍服无效。延诊于孟英。脉至滑数。舌不能伸。苔色黄腻。遗溺便秘。目不交
睫
者已四昼夜。胸腹按之不柔。予白虎汤去米草加石菖蒲玄参犀角鳖甲花粉杏仁竹叶竹黄竹沥
。投一剂即谵语滔滔。孟英论曰∶不语者欲其语。是转机也。再投之大渴而喜极热之饮。渠
父母又疑凉药非宜。孟英姑应之曰∶再服一剂。更方可也。三投之痰果渐吐。四剂后舌伸便
下。神识渐清。乃去菖蒲石膏犀角鳖甲加生地石斛麦冬贝母数剂。热尽退而痰味甚咸。又去
杏贝竹黄加西洋参牡蛎龟板苁蓉。服之全愈。（原案叙脉证七语。皆肝风壅痰阻遏气机之象
。
生石膏先煎一两六钱酒炒知母四钱。石菖蒲次入二钱。玄参片一两。开水泡去渣冲。犀角先
煎四钱。血鳖甲一两先炭煨六句钟。南花粉四钱。苦杏仁次入二钱。鲜竹叶二钱。天竹黄三
钱。姜竹沥两大酒杯冲。初更方去菖蒲石膏犀角鳖甲。加大生地八钱。鲜石斛先煎八钱。花
麦冬四钱。川贝母杵一两。再更方去杏贝竹黄。加西洋参三钱。 牡蛎四两杵。血龟板二两
杵。同先煨六句钟。取汤代水煎药。淡苁蓉一钱半。)
邵鱼竹患感。杨某作疟治不应。孟英诊之。脉 汗多。热不甚壮。苔色浓腻。呕恶烦躁。痰
多腿酸。显是湿温。论曰∶湿温者湿蕴久而从时令之感以化热也。不可从表治。更勿畏虚率
补。予宣解一剂。各恙颇减。（此证前医必误作寒疟从表治。此证辨湿温。在热不甚壮及脉
。宣解方。石菖蒲次入一钱。苦杏泥次入二钱。姜栀皮一钱五分。生苡仁杵四钱。酒炒川
黄柏七分。建兰叶次入三钱。云苓片一钱五分。姜竹茹次入三钱。川贝母杵三钱。)
康伯侯妇久伤谋虑。心火外浮。面赤齿疼。因食西瓜。遂脘闷不舒。喜得热按。泄泻不食。
自觉舌浓数寸。苔色灰腻。孟英予浓朴滑石葱白薤白枇杷叶橘皮薄荷旋复省头草。一剂霍然
。（此系医食之药。心火外浮二语。本阴虚火升之象。误食西瓜过剂。遂致甘寒败脾。制浓
朴一钱。西滑石先煎三钱。鲜葱白一钱半。鲜薤白打一钱半。姜枇叶刷包三钱。陈橘皮一钱
五分。苏荷尖八分。旋复花绢包先煎一钱半。省头草三钱。此方得力尤在浓朴葱白。阴虚误
食甘寒伤脾。以辛凉分别升泄之。自然泻止苔化。)
叶杏江子患发热泄泻。医治十七日不效。骨瘦如柴。音嘶气逆。孟英诊之。脉数大渴。汗多
苔黄。以竹叶石膏汤加减。十余剂渐以向愈。大解反极坚燥。继予滋养而康。（脉数为阴虚
挟热。余皆热炽肺伤之象。鲜竹叶二钱。生石膏先煎一两二钱。酒炒知母四钱。活水芦根二
两。鲜枇叶刷包三钱。海浮石生蛤壳。各五钱。同杵先。旋复花绢包先煎三钱。淡海 先煎
一两。)
张某患发热。医知其非寒邪也。用清解药数剂。腿痛异常。身面渐黄。孟英诊之。脉滑实。
腹胀口干。予茵陈大黄汤两剂。便行而各恙霍然。（辨腑实在脉实。若非脉实虽腹胀并非下
证。此证脉系胃实。清解则升浮之表热已清。热邪下行结实于胃腑。脏病及腑。故燥矢结于
手阳明大肠。热邪上蒸而身面渐黄。胃主周身之机关。胃热下注。故腿痛异常。肝主周身之
筋。腿痛似肝病实胃病。故肝病治胃。酒炒西茵陈二钱。酒炒栀皮三钱。西洋参三钱。生粉
草三钱。生冬瓜子四钱。炒枳壳二钱。整大白芍杵先八钱。酒炒大黄先煎四钱。)
魏女患脚肿呕吐。寒热便秘。孟英予龙胆泻肝汤而立效。继有孙氏妇患此。亦以是药获痊。
（辨实证在呕吐便秘。姜汁炒胆草三钱。姜汁炒枯芩一钱。姜栀皮三钱。生泽泻三钱。细木
通一钱。车前子研先三钱。春柴胡次入三钱。)
冯媪患左目胞起瘰。继而痛及眉棱额角颠顶。脑后筋掣难忍。医投风剂。其势孔亟。孟英诊
脉弦劲。舌绛不饥。予固本合二至桑菊犀羚玄参牡蛎鳖甲白芍知母石斛丹皮细茶等出入互用
。匝月始愈。（病情本系肝阳勃升。风剂助纣为虐。脉弦劲二语。皆心肝阳邪逆升。气机不
降之象。息风方能降气。霜桑叶四钱。杭白菊二钱。犀角先煎四钱。羚角先煎四钱。玄参片
八钱。女贞子杵五钱。旱莲草四钱。 牡蛎杵四两。血鳖甲二两。整大白芍一两。鲜 石斛
杵一两。四味同煨六句钟。取汤代水煎药。酒炒知母四钱。数帖去犀羚桑菊。加大生地一两
。大熟地八钱。丹皮二钱。再更方去白芍。加明天冬切六钱。花麦冬四钱。终更方去丹皮。
加陈细茶三钱。)
濮妪于酷热之秋。浑身生疖如疔。痛楚难堪。小溲或秘或频。大便登圊非努挣不下。卧则不
能
收摄。人皆谓其虚也。孟英诊。脉滑数。舌紫苔黄而渴。予白虎加花粉竹叶栀子白薇紫菀石
斛黄柏。十余剂而痊。（脉滑数苔黄而渴。为肺胃热实。舌紫为兼挟瘀血。白薇行瘀。知母
泻肺热。黄柏泻肝热。生石膏先煎八钱。酒炒知母三钱。南花粉四钱。鲜竹叶二钱。酒炒栀
皮三钱。酒炒白薇三钱。紫菀茸一钱五分。鲜石斛杵先一两。酒炒川黄柏一钱五分。脉数为
阴虚挟热。花粉石斛顾阴。)
姚女初秋患寒热而汛适至。医用正气散两剂。遂壮热狂烦。目赤谵语。甚至欲刎欲缢。势不
可制。孟英按脉洪滑且数。苔色干黄尖绛。脘闷腹胀拒按。畏明口渴。气逆痰多。予桃仁承
气汤加犀角石膏知母花粉竹沥甘菊。人谓热虽炽而汛尚行。何必大破其血而又加以极寒之药
哉。孟英曰。叟勿过虑。恐一二剂尚不足以济事。果服两大剂始得大便。而神清苔化。目赤
明哲。断非见不及此。念论及此。见病家破格专任之难。惟念既拟立前方。本案各方不便挨 拟。读者悉心揣摩。参理念注另案自悉。)
陈足甫溲后见血。管痛异常。减餐气短。孟英以元参生地知母楝实银花侧柏叶栀子桑叶丹皮 绿豆为方。藕汤煎服二剂。病大减。乃去丹皮柏叶。加西洋参熟地。服之而瘥。（管痛异常 二句。为阴虚肝热贼肺。故以元参生地知楝银花柏叶丹皮育阴凉血。兼泻血分之热。以栀子 桑叶绿豆皮清气分之热。减餐气短。肝热贼肺。肺伤则气不接续。有似乎短。肺实并非肺虚 。故用栀桑绿豆以治之。西洋参泻热下气。略兼补肺。并非单纯补品。元参片一两。大生地 八钱。二味开水泡汤。去渣用汤煎药。酒炒知母三钱。楝核杵先三钱。济银花八钱。酒炒侧 柏叶一钱。黑栀皮次入三钱。冬桑叶三钱。绿豆皮四钱。粉丹皮二钱。连皮藕二两切煨汤煎 药。更方去丹皮柏叶。加西洋参三钱清气。大熟地八钱育阴。开水同泡煎去渣。)
王开荣偶患腹中绞痛。自服治痧诸药。而大便泻血如注。孟英诊之。左颇和。右关尺弦大而 滑。面色油红。喘逆不寐。予苇茎汤合金铃子散加银花侧柏叶栀斛芩连。二剂后面红退。 血亦止。乃裁柏叶银花。加雪羹枯荷杆。又二剂始发热一夜。得大汗周身。而腹之痛胀爽 然若失。即能安寐进粥。改投沙参知母花粉桑叶枇杷叶石斛白芍橘络杏仁冬瓜子茅根荷杆。 三剂大解行而脉柔安谷。（痧分寒热两大门。寒痛痛止不移。热痛痛必不静。此阳动阴静之 定理。此证腹中绞痛。本系热痛。自服治痧诸药。必误服治寒痧之药。大便泻血如注。肺与 大肠相表里。香燥大伤肺阴。脉弦大为肝热挟虚。滑为肺有热痰。面色油红二句。皆肺阴大 伤 之明证。活水芦根二两。生冬瓜子八钱。生桃仁研三钱。济银花一两五钱。酒炒侧柏叶次入 一钱五分。川楝核杵先四钱。酒炒元胡索次入一钱五分。黑栀皮三钱。鲜石斛杵先一两。酒 炒枯芩三钱。酒炒川连一钱。二剂面红退血亦止。方义以清肺阴为君。泻肝热为臣。佐以银 花石斛栀皮。使以桃仁胡索。嗣裁柏叶银花。加雪羹枯荷杆连皮大荸荠二两打。泡淡海蜇二 两。枯荷杆三钱。大凡涉及气阴血阴温病。必由阴分血分反还于气分。周身得汗乃解。沙参 八钱。酒炒知母三钱。花粉四钱。桑叶三钱。枇叶刷包三钱。石斛杵先一两。酒炒白芍一钱 半。橘络一钱。苦杏仁一钱半。生冬瓜子茅根荷杆各三钱。)
陈叟久患痰嗽气逆。夏初因恶寒。自服理中汤。遂痰中带血。气喘而厥。二便不通。冷汗腹 胀。孟英察脉洪大。按腹如烙。予苇茎汤加栀楝旋贝花粉海蜇。外以田螺大蒜车前草捣贴脐 下。即溺行而平。（痰嗽气逆。则肺气不能充周于肌表。故畏寒。并非阳虚恶寒误服温补。现 证如上。脉洪大为阴虚。按腹如烙。为热蒸气分。活水芦根二两。生冬瓜子八钱。黑栀皮三 钱。川楝核杵先四钱。旋复花绢包次入三钱。川贝母杵一两。南花粉四钱。淡海蜇先煎二两 。整田螺三个。生车前草一握。生大蒜六瓣。田螺介以潜阳。咸以软坚。车前草清凉导水。 大蒜辛温反佐。同捣贴脐下。外以本青布当脐横扎。)
高某患两膝筋络酸痛。略不红肿。卧则痛不可当彻夜危坐。孟英切脉虚细。苔色黄腻。咽燥 溺赤。予知斛栀楝牛膝豆卷桑枝竹沥为方。送虎潜丸。旬日而瘳。（此证为阴虚挟热。以豆 卷升知楝之苦寒于咽喉至高之处。证虽阴虚。苔色黄腻。滋腻难投。竹沥顾阴豁痰。两擅其 长。酒炒知母三钱。鲜石斛杵先八钱。黑栀皮三钱。川楝核杵先二钱。生牛膝五分。大豆卷 次入三钱。酒炒桑枝次入三钱。姜竹沥两酒杯冲。药送虎潜丸三钱。)
杨某方作事。不知背后有人潜立。回顾失惊。遂不言不食。不寐不便。别无他苦。孟英按脉 沉弦。以石菖蒲远志琥珀胆星旋贝竹黄杏仁省头草羚羊角为剂。化服苏合香丸。二剂大解行 而啜粥。夜得寐而能言。复予调气宁神蠲饮药。数日霍然。（大凡因惊得病。非阴分不足。 即素挟痰浊。脉弦为肝热挟虚。沉弦为热结为里。石菖蒲次入二钱。生远志肉一钱五分。西 毛珀研冲八分。旋复花绢包三钱。川贝母杵八钱。天竺黄三钱。陈胆星七分炖和服。苦杏仁 二钱。省头草次入一钱五分。羚角先煎四钱。药化服苏合香丸五分。调气宁神蠲饮方。鲜枇 叶刷包三钱。旋复花绢包三钱。胆汁炒枣仁一钱五分。酒炒川连八分。石草蒲一钱。赖氏橘 红一钱。川贝母杵一两。生冬瓜子四钱。)
赵听樵妹每汛至则腹胀呕吐。腰脊酸痛。两腿肿痛。筋掣脘痛。甚至痉厥。多药不效。孟 英以金铃子散合左金加二陈竹茹枳实桂苓数剂而愈。续用苁蓉菟丝淫羊杜仲桑葚木瓜续断香 附归芍茴楝调之。汛至如期。略无痛苦。（腹胀呕吐五句。病情系肝旺贼脾。惟肝阳侮胃。 病者阳气亦虚。故兼用二陈桂苓。川楝核多杵五钱先炭煨六句钟。玄胡索七分。酒炒川连一 钱。淡吴萸次入六 分。半夏曲杵二钱。薄橘红一钱。姜竹茹三钱。炒枳实一钱五分。肉桂心二分。云茯苓三钱 。续方淡苁蓉一钱半。菟丝饼四钱。淫羊藿二钱。绵杜仲二钱。干桑葚杵一钱半。陈木瓜三 钱。川续断一钱半。小茴香五分。酒炒香附七分。箱归身二钱。整大白芍杵先二两。川楝核 杵先四钱。)
濮姓女素禀阴虚。时发夜热。少餐不寐。仲夏患感发疹。汛不当期而至。孟英用犀羚知贝石 膏生地栀翘花粉甘草竹叶芦根等药。疹透神清。唯鼻燥异常。吸气入喉。辣痛难忍。甚至肢 冷。复于方中加玄参竹茹菊叶荷杆。各患始减。而心忡吐沫。彻夜不瞑。渴汗便黑。改投西 洋参生地麦冬小麦竹叶黄连真珠百合贝母石斛牡蛎龟板蔗汁诸药而愈。（阴虚肝旺。故多夜 热 。肝热伤肺胃之阴。故少餐不寐。发疹及汛不当期而至。为肝阳炽逆兼袭营分。故方中用犀 羚石膏息风镇胃。针治汛不当期而至。余皆清气之品。针治发痧。犀角先煎四钱。羚角先煎 四钱。酒沙知母四钱。川贝母杵八钱。生石膏先煎一两六钱。酒炒栀皮三钱。酒炒翘壳三钱 。 南花粉四钱。生粉草三钱。鲜竹叶二钱。活水芦根二两。大生地八钱。开水泡去渣冲服。鼻 燥异常四句。仍系肝阳贼肺。加玄参片一两。开水泡冲去渣。姜竹茹次入三钱。菊叶二钱。 荷杆三钱。尾方洋参小麦百合花麦冬各三钱。竹叶二钱。酒炒黄连一钱。珠粉二分舌 药 送 。川贝杵五钱。石斛一两先煎。大生地一两。青蔗二两绞冲。牡蛎六两。龟板三两。同先煨 六句钟。)
金亚伯外家产后恶露不行。渴泻痰多。孟英以北沙参滑石生薏苡生扁豆蛤壳豆卷石斛竹茹枇杷 叶琥珀茯苓等药。数剂而愈。（恶露不行病在血。渴泻痰多病在气。血病治气。泻止痰清。 则恶露自行。气为血帅也。故方中止滑石琥珀两味泻瘀。余皆气药。豆卷尤用得精确。大 凡清 肺下行药中。不可无升发上行之品以反佐之。经所谓将欲降之。必先升之。北沙参四钱。西 滑石先煎四钱。生苡仁八钱。生扁豆杵三钱。生蛤壳杵先五钱。大豆卷三钱。鲜石斛先八钱 。姜竹茹三钱。鲜枇叶刷包三钱。西毛珀研冲八分。云苓一钱半。)
顾女患感十余日。耳聋不语。昏不识人。而客未入室。彼反先知医以为祟。凡犀角地黄牛黄 清心复脉等汤遍服无效。延诊于孟英。脉至滑数。舌不能伸。苔色黄腻。遗溺便秘。目不交 睫 者已四昼夜。胸腹按之不柔。予白虎汤去米草加石菖蒲玄参犀角鳖甲花粉杏仁竹叶竹黄竹沥 。投一剂即谵语滔滔。孟英论曰∶不语者欲其语。是转机也。再投之大渴而喜极热之饮。渠 父母又疑凉药非宜。孟英姑应之曰∶再服一剂。更方可也。三投之痰果渐吐。四剂后舌伸便 下。神识渐清。乃去菖蒲石膏犀角鳖甲加生地石斛麦冬贝母数剂。热尽退而痰味甚咸。又去 杏贝竹黄加西洋参牡蛎龟板苁蓉。服之全愈。（原案叙脉证七语。皆肝风壅痰阻遏气机之象 。 生石膏先煎一两六钱酒炒知母四钱。石菖蒲次入二钱。玄参片一两。开水泡去渣冲。犀角先 煎四钱。血鳖甲一两先炭煨六句钟。南花粉四钱。苦杏仁次入二钱。鲜竹叶二钱。天竹黄三 钱。姜竹沥两大酒杯冲。初更方去菖蒲石膏犀角鳖甲。加大生地八钱。鲜石斛先煎八钱。花 麦冬四钱。川贝母杵一两。再更方去杏贝竹黄。加西洋参三钱。 牡蛎四两杵。血龟板二两 杵。同先煨六句钟。取汤代水煎药。淡苁蓉一钱半。)
邵鱼竹患感。杨某作疟治不应。孟英诊之。脉 汗多。热不甚壮。苔色浓腻。呕恶烦躁。痰 多腿酸。显是湿温。论曰∶湿温者湿蕴久而从时令之感以化热也。不可从表治。更勿畏虚率 补。予宣解一剂。各恙颇减。（此证前医必误作寒疟从表治。此证辨湿温。在热不甚壮及脉 。宣解方。石菖蒲次入一钱。苦杏泥次入二钱。姜栀皮一钱五分。生苡仁杵四钱。酒炒川 黄柏七分。建兰叶次入三钱。云苓片一钱五分。姜竹茹次入三钱。川贝母杵三钱。)
康伯侯妇久伤谋虑。心火外浮。面赤齿疼。因食西瓜。遂脘闷不舒。喜得热按。泄泻不食。 自觉舌浓数寸。苔色灰腻。孟英予浓朴滑石葱白薤白枇杷叶橘皮薄荷旋复省头草。一剂霍然 。（此系医食之药。心火外浮二语。本阴虚火升之象。误食西瓜过剂。遂致甘寒败脾。制浓 朴一钱。西滑石先煎三钱。鲜葱白一钱半。鲜薤白打一钱半。姜枇叶刷包三钱。陈橘皮一钱 五分。苏荷尖八分。旋复花绢包先煎一钱半。省头草三钱。此方得力尤在浓朴葱白。阴虚误 食甘寒伤脾。以辛凉分别升泄之。自然泻止苔化。)
叶杏江子患发热泄泻。医治十七日不效。骨瘦如柴。音嘶气逆。孟英诊之。脉数大渴。汗多 苔黄。以竹叶石膏汤加减。十余剂渐以向愈。大解反极坚燥。继予滋养而康。（脉数为阴虚 挟热。余皆热炽肺伤之象。鲜竹叶二钱。生石膏先煎一两二钱。酒炒知母四钱。活水芦根二 两。鲜枇叶刷包三钱。海浮石生蛤壳。各五钱。同杵先。旋复花绢包先煎三钱。淡海蜇先煎 一两。)
张某患发热。医知其非寒邪也。用清解药数剂。腿痛异常。身面渐黄。孟英诊之。脉滑实。 腹胀口干。予茵陈大黄汤两剂。便行而各恙霍然。（辨腑实在脉实。若非脉实虽腹胀并非下 证。此证脉系胃实。清解则升浮之表热已清。热邪下行结实于胃腑。脏病及腑。故燥矢结于 手阳明大肠。热邪上蒸而身面渐黄。胃主周身之机关。胃热下注。故腿痛异常。肝主周身之 筋。腿痛似肝病实胃病。故肝病治胃。酒炒西茵陈二钱。酒炒栀皮三钱。西洋参三钱。生粉 草三钱。生冬瓜子四钱。炒枳壳二钱。整大白芍杵先八钱。酒炒大黄先煎四钱。)
魏女患脚肿呕吐。寒热便秘。孟英予龙胆泻肝汤而立效。继有孙氏妇患此。亦以是药获痊。 （辨实证在呕吐便秘。姜汁炒胆草三钱。姜汁炒枯芩一钱。姜栀皮三钱。生泽泻三钱。细木 通一钱。车前子研先三钱。春柴胡次入三钱。)
冯媪患左目胞起瘰。继而痛及眉棱额角颠顶。脑后筋掣难忍。医投风剂。其势孔亟。孟英诊 脉弦劲。舌绛不饥。予固本合二至桑菊犀羚玄参牡蛎鳖甲白芍知母石斛丹皮细茶等出入互用 。匝月始愈。（病情本系肝阳勃升。风剂助纣为虐。脉弦劲二语。皆心肝阳邪逆升。气机不 降之象。息风方能降气。霜桑叶四钱。杭白菊二钱。犀角先煎四钱。羚角先煎四钱。玄参片 八钱。女贞子杵五钱。旱莲草四钱。 牡蛎杵四两。血鳖甲二两。整大白芍一两。鲜 石斛 杵一两。四味同煨六句钟。取汤代水煎药。酒炒知母四钱。数帖去犀羚桑菊。加大生地一两 。大熟地八钱。丹皮二钱。再更方去白芍。加明天冬切六钱。花麦冬四钱。终更方去丹皮。 加陈细茶三钱。)
濮妪于酷热之秋。浑身生疖如疔。痛楚难堪。小溲或秘或频。大便登圊非努挣不下。卧则不 能 收摄。人皆谓其虚也。孟英诊。脉滑数。舌紫苔黄而渴。予白虎加花粉竹叶栀子白薇紫菀石 斛黄柏。十余剂而痊。（脉滑数苔黄而渴。为肺胃热实。舌紫为兼挟瘀血。白薇行瘀。知母 泻肺热。黄柏泻肝热。生石膏先煎八钱。酒炒知母三钱。南花粉四钱。鲜竹叶二钱。酒炒栀 皮三钱。酒炒白薇三钱。紫菀茸一钱五分。鲜石斛杵先一两。酒炒川黄柏一钱五分。脉数为 阴虚挟热。花粉石斛顾阴。)
姚女初秋患寒热而汛适至。医用正气散两剂。遂壮热狂烦。目赤谵语。甚至欲刎欲缢。势不 可制。孟英按脉洪滑且数。苔色干黄尖绛。脘闷腹胀拒按。畏明口渴。气逆痰多。予桃仁承 气汤加犀角石膏知母花粉竹沥甘菊。人谓热虽炽而汛尚行。何必大破其血而又加以极寒之药 哉。孟英曰。叟勿过虑。恐一二剂尚不足以济事。果服两大剂始得大便。而神清苔化。目赤
Mingzhe. It is definitely not that the insight was lacking here. Thinking about this discussion, one sees the difficulty in obtaining a patient's extraordinary and exclusive trust. Since I have already proposed the previous prescription, it is inconvenient to draft prescriptions for each case in this file one by one. Readers should carefully ponder and refer to the annotations in other cases to understand fully.)
Chen Zufu saw blood after urination. The urethra suffered from abnormal pain. Reduced food intake led to shortness of breath. Mengying prescribed a formula containing Xuanshen (Radix Scrophulariae), Shengdi (Radix Rehmanniae Preparata), Zhimu (Rhizoma Anemarrhenae), Lianshi (Fructus Meliae Toosendan), Yinhua (Flos Lonicerae Japonicae), Ce Bai Ye (Cacumen Platycladi), Zhizi (Fructus Gardeniae), Sang Ye (Folium Mori), Danpi (Cortex Moutan), and Lv Dou (Semen Sojae Viridis). Decocted with Lotus Root Soup and taken for two doses, the illness greatly diminished. Then, Danpi and Bai Ye were removed, and Xiyangshen (Radix Panacis Quinquefolii) and Shudi (Radix Rehmanniae Preparata) were added. After taking it, he recovered. (The "abnormal urethral pain" indicates Yin deficiency with Liver Heat attacking the Lung. Thus, Xuanshen, Shengdi, Zhimu, Lianshi, Yinhua, Ce Bai Ye, and Danpi are used to nourish Yin and cool blood, simultaneously clearing heat in the Blood level. Zhizi, Sang Ye, and Lv Dou skin clear heat in the Qi level. Reduced food intake and shortness of breath occur because Liver Heat attacks the Lung; when the Lung is injured, Qi fails to connect continuously, appearing as shortness of breath. This is Lung Excess, not Lung Deficiency. Therefore, Zhizi, Sang Ye, and Lv Dou are used. Xiyangshen clears heat and directs Qi downward, slightly tonifying the Lung; it is not a simple tonic. Xuanshen slice 1 liang, Da Shengdi 8 qian. These two ingredients are soaked in boiling water to make a decoction base; dregs are discarded, and the liquid is used to decoct the remaining herbs. Jiuzao Zhimu 3 qian, Chuxian Lian He 3 qian. Ji Yinhua 8 qian. Jiuzao Ce Bai Ye 1 qian. Hei Zhipi added later 3 qian. Dong Sang Ye 3 qian. Lv Dou Pi 4 qian. Fen Danpi 2 qian. Lian Pi Ou 2 liang, cut and simmered to make soup for decocting the medicine. For the modified prescription, remove Danpi and Bai Ye, add Xiyangshen 3 qian to clear Qi, and Da Shudi 8 qian to nourish Yin. Soak together in boiling water, decoct, and discard dregs.)
Wang Kairong occasionally suffered from colicky abdominal pain. After self-medicating with various drugs for Sha (heat stroke/toxicity), his stool became bloody and flowed like a torrent. Mengying examined him: the left pulse was relatively harmonious; the right Guan and Chi positions showed a string-taut, large, and slippery pulse. His face was oily and red. He panted, reversed Qi, and could not sleep. Mengying prescribed Weijing Tang combined with Lingliaozi San, adding Yinhua, Ce Bai Ye, Zhizi, Shihu, Huangqin, and Huanglian. After two doses, facial redness subsided, and bleeding stopped. Then, Ce Bai Ye and Yinhua were reduced/removed, and Xue Geng (Snow Broth - composed of Water Chestnut and Dried Lotus Stem) and Ku He Gan (Dried Lotus Stem) were added. After another two doses, he developed a fever for one night, sweated profusely all over his body, and the abdominal pain and distension vanished completely. He could then sleep peacefully and eat congee. The prescription was changed to Shashen, Zhimu, Huafen, Sang Ye, Pipaye, Shihu, Baishao, Juluo, Xingren, Dongguazi, Maogen, and Hegan. After three doses, bowel movements occurred, the pulse became soft, and digestion stabilized. (Sha is divided into Cold and Heat categories. Cold pain stops without moving; Heat pain must be restless. This is the fixed principle of Yang moving and Yin still. This case of colicky abdominal pain was originally Heat pain. Self-medicating with Sha drugs likely involved taking Cold Sha remedies incorrectly. Bloody diarrhea indicates that aromatic-dry drugs severely damaged Lung Yin, as the Lung and Large Intestine are exterior-interior pairs. A string-taut large pulse indicates Liver Heat with deficiency; slippery indicates Phlegm-Heat in the Lung. Oily red face confirms severe Lung Yin damage. Huoshui Lugeng 2 liang, Sheng Dongguazi 8 qian, Sheng Taoren ground 3 qian. Ji Yinhua 1.5 liang. Jiuzao Ce Bai Ye added later 1.5 qian. Chuan Lian He Chuxian 4 qian. Jiuzao Yuanhushao added later 1.5 qian. Hei Zhipi 3 qian. Xian Shihu Chuxian 1 liang. Jiuzao Ku Huangqin 3 qian. Jiuzao Chuanlian 1 qian. After two doses, facial redness subsided and bleeding stopped. The prescription logic uses clearing Lung Yin as the Sovereign herb, draining Liver Heat as the Minister, assisting with Yinhua, Shihu, and Zhipi, and guiding with Taoren and Hushao. Subsequently, Ce Bai Ye and Yinhua were removed, and Xue Geng and Ku He Gan were added. Lian Pi Da Biqi 2 liang, pounded. Pao Dan Hai Zhe 2 liang. Ku He Gan 3 qian. Generally, in warm diseases involving Qi-Yin or Blood-Yin, recovery requires returning from the Yin/Blood levels back to the Qi level; sweating all over the body resolves the condition. Shashen 8 qian. Jiuzao Zhimu 3 qian. Huafen 4 qian. Sang Ye 3 qian. Piye Shubao 3 qian. Shihu Chuxian 1 liang. Jiuzao Baishao 1.5 qian. Juluo 1 qian. Ku Xingren 1.5 qian. Sheng Dongguazi, Maogen, Hegan each 3 qian.)
Old Man Chen suffered from chronic phlegm-cough and rebellious Qi. In early summer, due to aversion to cold, he self-administered Lizhong Tang. Consequently, blood appeared in his sputum, he experienced asthma and syncope, urinary and fecal retention, cold sweat, and abdominal distension. Mengying observed a洪大 (Surging-Large) pulse and an abdomen hot to the touch. He prescribed Weijing Tang plus Zhizi, Lianshi, Xuanfuhua, Beimu, Huafen, and Haizhe. Externally, Tianluo (Apple Snail), Dasuan (Garlic), and Cheqiancao were mashed and applied below the umbilicus. Urination resumed immediately, and he calmed down. (Phlegm-cough and rebellious Qi mean Lung Qi cannot circulate fully to the muscle surface, hence aversion to cold. This is not Yang Deficiency aversion to cold caused by mistaken warming-tonification. As shown above, a Surging-Large pulse indicates Yin deficiency; abdomen hot to touch indicates Heat steaming the Qi level. Huoshui Lugeng 2 liang, Sheng Dongguazi 8 qian. Hei Zhipi 3 qian. Chuan Lian He Chuxian 4 qian. Xuanfuhua wrapped in silk, added later 3 qian. Chuan Beimu Chuxian 1 liang. Nan Huafen 4 qian. Dan Hai Zhe decocted first 2 liang. Whole Tianluo 3. Sheng Cheqiancao one handful. Sheng Dasuan 6 cloves. Tianluo shell subdues Yang; Salty flavor softens hardness. Cheqiancao is cooling and guides water. Dasuan is pungent-warm, acting as an antagonist. Mash together and apply below the umbilicus. Externally, bind horizontally across the umbilicus with blue cloth.)
Gao suffered from soreness and pain in the tendons and collaterals of both knees, with slight swelling and redness. When lying down, the pain was unbearable, forcing him to sit upright all night. Mengying felt a deficient-thin pulse, yellow-greasy coating, dry throat, and red urine. He prescribed Zhimu, Shihu, Zhizi, Lianshi, Niuxi, Doujuan, Sangzhi, and Zhuli as a formula, administered with Huqian Wan. He recovered within ten days. (This case is Yin deficiency with accompanying Heat. Doujuan raises the bitter-cold nature of Zhimu and Lianshi to the high place of the throat. Although there is Yin deficiency, the yellow-greasy coating makes cloying tonics difficult to use. Zhuli protects Yin and resolves phlegm, excelling in both aspects. Jiuzao Zhimu 3 qian. Xian Shihu Chuxian 8 qian. Hei Zhipi 3 qian. Chuan Lian He Chuxian 2 qian. Sheng Niuxi 5 fen. Da Doujuan added later 3 qian. Jiuzao Sangzhi added later 3 qian. Jiang Zhuli two wine cups mixed in. Medicine taken with Huqian Wan 3 qian.)
Yang was working when he did not notice someone standing secretly behind him. Turning back, he was startled. Consequently, he ceased speaking and eating, could not sleep, and had no bowel movement, with no other suffering. Mengying palpated a deep-string pulse. He prescribed Shichangpu, Yuanzhi, Hupo, Dansheng, Xuanfuhua, Beimu, Zhuhuang, Xingren, Shentoucao, and Lingyangjiao as a dose. Suhe Xiang Wan was dissolved and taken. After two doses, bowel movements occurred, he drank congee, slept at night, and could speak. Mengying then gave Qi-regulating, Spirit-calming, and Phlegm-resolving medicines. He recovered in a few days. (Generally, illness caused by fright stems either from insufficient Yin level or inherent Phlegm-Turbidity. String pulse indicates Liver Heat with deficiency; Deep-String indicates Heat knotting internally. Shichangpu added later 2 qian. Sheng Yuanzhi Rou 1.5 qian. Xi Mao Po ground and mixed in 0.8 qian. Xuanfuhua wrapped in silk 3 qian. Chuan Beimu Chuxian 8 qian. Tian Zhu Huang 3 qian. Chen Dansheng 0.7 qian, stewed and taken with medicine. Ku Xingren 2 qian. Shentoucao added later 1.5 qian. Lingyangjiao decocted first 4 qian. Medicine dissolves Suhe Xiang Wan 0.5 qian. Qi-regulating, Spirit-calming, Phlegm-resolving formula: Xian Piye Shubao 3 qian. Xuanfuhua wrapped in silk 3 qian. Danzhi Zaoren 1.5 qian. Jiuzao Chuanlian 0.8 qian. Shichangpu 1 qian. Lai Shi Juhong 1 qian. Chuan Beimu Chuxian 1 liang. Sheng Dongguazi 4 qian.)
Zhao Tingqiao’s sister experienced abdominal distension and vomiting every time her menstruation arrived, along with soreness and pain in the waist and spine, swelling and pain in both legs, tendon spasms and epigastric pain, even convulsions and syncope. Many medicines failed. Mengying prescribed Lingliaozi San combined with Zuojin San, adding Erchen Tang, Zhuru, Zhishi, Rougui, and Fuling. After several doses, she recovered. Continuously using Rongrong, Tusisi, Yinyang, Duzhong, Sangshen, Mugua, Xuduan, Xiangfu, Danggui, Baishao, Huixiang, and Lianshi to regulate, her menstruation arrived on schedule with little pain. (Abdominal distension and vomiting indicate Liver Excess attacking Spleen. Liver Yang insults Stomach. The patient’s Yang Qi is also deficient, hence Erchen Tang and Guiling are used. Chuan Lian He pounded more 5 qian, charred and simmered for six hours. Xuanhushao 0.7 qian. Jiuzao Chuanlian 1 qian. Dan Wuyu added later 0.6 fen. Banxia Qu Chuxian 2 qian. Bo Juhong 1 qian. Jiang Zhuru 3 qian. Chao Zhishi 1.5 qian. Rouguixin 0.2 fen. Yun Fuling 3 qian. Continued formula: Dan Rongrong 1.5 qian. Tusibi 4 qian. Yinyanghuo 2 qian. Mian Duzhong 2 qian. Gan Sangshen Chuxian 1.5 qian. Chen Mugua 3 qian. Chuan Xuduan 1.5 qian. Xiao Huixiang 0.5 fen. Jiuzao Xiangfu 0.7 qian. Xiang Guishen 2 qian. Zheng Da Baishao Chuxian 2 liang. Chuan Lian He Chuxian 4 qian.)
Ms. Pu constitutionally had Yin deficiency, often experiencing night fevers, poor appetite, and insomnia. In mid-summer, she contracted a pathogen and developed rashes. Her menstruation came out of cycle. Mengying used Xijiao, Lingyang, Zhimu, Beimu, Shigao, Shengdi, Zhizi, Qiaoguo, Huafen, Gancao, Zhuye, and Lugeng. The rash emerged clearly, and her spirit cleared. Only her nose was abnormally dry; inhaling air into the throat caused burning pain, unbearable even to the point of cold limbs. Mengying added Xuanshen, Zhuru, Juye, and Hegan to the formula. Symptoms gradually decreased. However, palpitations, foamy vomiting, sleeplessness all night, thirst, sweating, and black stools ensued. The prescription was changed to Xiyangshen, Shengdi, Maidong, Xiaomai, Zhuye, Huanglian, Zhenzhu, Baihe, Beimu, Shihu, Muli, Guiban, and Zheshui. She recovered. (Yin deficiency with Liver Excess causes frequent night fevers. Liver Heat damages Lung and Stomach Yin, causing poor appetite and insomnia. Rash and irregular menstruation indicate blazing Liver Yang counterflow invading the Ying level. Hence Xijiao, Lingyang, and Shigao are used to extinguish Wind and calm the Stomach. Treating irregular menstruation involves these; the rest clear Qi level. Treating Sha: Xijiao decocted first 4 qian. Lingyang decocted first 4 qian. Jiuzao Zhimu 4 qian. Chuan Beimu Chuxian 8 qian. Sheng Shigao decocted first 1.6 liang. Jiuzao Zhipi 3 qian. Jiuzao Qiaoguo 3 qian. Nan Huafen 4 qian. Sheng Fangcao 3 qian. Xian Zhuye 2 qian. Huoshui Lugeng 2 liang. Da Shengdi 8 qian. Soaked in boiling water, dregs discarded, liquid taken. Abnormal nasal dryness indicates Liver Yang attacking Lung. Add Xuanshen slice 1 liang, soaked in boiling water, dregs discarded, liquid taken. Jiang Zhuru added later 3 qian. Juye 2 qian. Hegan 3 qian. Final formula: Yangshen, Xiaomai, Baihehua, Maidong each 3 qian. Zhuye 2 qian. Jiuzao Huanglian 1 qian. Zhufen 0.2 fen, taken with medicine. Chuan Beimu Chuxian 5 qian. Shihu 1 liang decocted first. Da Shengdi 1 liang. Qingzhe 2 liang, juice squeezed and mixed. Muli 6 liang. Guiban 3 liang. Simmered together first for six hours.)
Jin Yabo’s maternal relative suffered from retained lochia postpartum, thirst, diarrhea, and excessive phlegm. Mengying prescribed Beishashen, Huashi, Sheng Yiyiren, Sheng BianDou, Geke, Doujuan, Shihu, Zhuru, Pipaye, Hupo, and Fuling. After several doses, she recovered. (Retained lochia is a Blood disease; thirst, diarrhea, and phlegm are Qi diseases. Treating Blood disease via Qi regulation: once diarrhea stops and phlegm clears, lochia moves naturally. Qi is the commander of Blood. Hence only Huashi and Hupo in the formula drain stasis; the rest are Qi-moving herbs. Doujuan is particularly precise. Generally, in descending Lung-clearing medicines, ascending herbs must be included as antagonists. As the Classics say: "To descend, one must first ascend." Beishashen 4 qian. Xi Huashi decocted first 4 qian. Sheng Yiren 8 qian. Sheng Biandou Chuxian 3 qian. Sheng Geke Chuxian 5 qian. Da Doujuan 3 qian. Xian Shihu decocted first 8 qian. Jiang Zhuru 3 qian. Xian Piye Shubao 3 qian. Xi Mao Po ground and mixed in 0.8 qian. Yun Ling 1.5 qian.)
Girl Gu suffered from a pathogen for over ten days. Deaf, mute, unconscious, unable to recognize people. Guests hadn't entered the room, yet she knew beforehand, believing doctors were evil spirits. Various formulas like Xijiao Dihuang Wan, Niuhuang Qingxin Fupei Tang were tried without effect. Consulted Mengying. Pulse was slippery and rapid. Tongue could not extend. Coating yellow and greasy. Enuresis and constipation. Eyes open for four days and nights. Chest and abdomen hard to touch. Mengying prescribed Baihu Tang minus Rice and Licorice, adding Shichangpu, Xuanshen, Xijiao, Biejia, Huafen, Xingren, Zhuye, Zhuhuang, and Zhuli. One dose resulted in continuous delirium. Mengying commented: "Silence wanting to speak is a turning point." Another dose brought extreme thirst and preference for extremely hot drinks. Her parents doubted cooling medicines. Mengying agreed tentatively: "Take one more dose, then we will change the formula." After three doses, phlegm gradually expectorated. After four doses, tongue extended, bowels moved, consciousness cleared. Then Shichangpu, Shigao, Xijiao, and Biejia were removed, adding Shengdi, Shihu, Maidong, and Beimu for several doses. Heat completely subsided, phlegm tasted very salty. Xingren, Beimu, and Zhuhuang were removed, adding Xiyangshen, Muli, Guiban, and Rongrong. She fully recovered. (Original case description of seven pulse/symptom phrases indicates Liver Wind obstructing Qi mechanism with Phlegm. Sheng Shigao decocted first 1.6 liang, Jiuzao Zhimu 4 qian. Shichangpu added later 2 qian. Xuanshen slice 1 liang, soaked in boiling water, dregs discarded, liquid taken. Xijiao decocted first 4 qian. Xue Biejia 1 liang, charred and simmered first for six hours. Nan Huafen 4 qian. Ku Xingren added later 2 qian. Xian Zhuye 2 qian. Tian Zhuhuang 3 qian. Jiang Zhuli two large wine cups mixed in. First modification: remove Shichangpu, Shigao, Xijiao, Biejia. Add Da Shengdi 8 qian. Xian Shihu decocted first 8 qian. Hua Maidong 4 qian. Chuan Beimu Chuxian 1 liang. Second modification: remove Xingren, Beimu, Zhuhuang. Add Xiyangshen 3 qian. Muli 4 liang pounded. Xue Guiban 2 liang pounded. Simmer together first for six hours. Use liquid to decoct medicine instead of water. Dan Rongrong 1.5 qian.)
Shao Yuzhu suffered from a pathogen. Dr. Yang treated it as malaria without success. Mengying examined him: Pulse [obscured] with much sweating. Fever not very high. Coating thick and greasy. Vomiting, nausea, irritability. Excessive phlegm, leg soreness. Clearly Wet-Warm Disease. Commented: "Wet-Warm is dampness accumulating long-term transforming into heat following seasonal pathogens. Cannot treat from the Exterior. Do not fear deficiency and blindly tonify." Prescribed Xuanjie Tang. Symptoms greatly reduced. (Previous doctor likely mistook this for Cold Malaria and treated from Exterior. Differentiating Wet-Warm depends on fever not being very high and pulse characteristics. Xuanjie Formula: Shichangpu added later 1 qian. Ku Xingni added later 2 qian. Jiang Zhipi 1.5 qian. Sheng Yiren Chuxian 4 qian. Jiuzao Chuan Huangbai 0.7 fen. Jian Lan Ye added later 3 qian. Yun Ling Pian 1.5 qian. Jiang Zhuru added later 3 qian. Chuan Beimu Chuxian 3 qian.)
Kang Bohou’s wife suffered long-term mental strain. Heart Fire floated outward. Red face, toothache. Due to eating watermelon, epigastric stuffiness and discomfort arose. Preferred hot pressure. Diarrhea, inability to eat. Felt tongue swollen several inches. Coating gray and greasy. Mengying prescribed Houpo, Huashi, Congbai, Xiebai, Pipaye, Jupi, Bohe, Xuanfu, and Shentoucao. One dose brought recovery. (This is medical/dietary error. "Heart Fire floating outward" is image of Yin deficiency with Fire rising. Mistakenly eating too much watermelon caused Sweet-Cold to defeat Spleen. Zhi Houpo 1 qian. Xi Huashi decocted first 3 qian. Xian Congbai 1.5 qian. Xian Xiebai beaten 1.5 qian. Jiang Piye Shubao 3 qian. Chen Jupi 1.5 qian. Su Hejian 0.8 fen. Xuanfuhua wrapped in silk, decocted first 1.5 qian. Shentoucao 3 qian. This formula relies especially on Houpo and Congbai. Yin deficiency mistakenly eating Sweet-Cold injures Spleen. Using Pungent-Cool to separate, ascend, and drain naturally stops diarrhea and transforms coating.)
Ye Xingjiang’s son suffered fever and diarrhea. Treated for seventeen days without effect. Emaciated as firewood. Hoarse voice, rebellious Qi. Mengying examined: Rapid pulse, extreme thirst, much sweating, yellow coating. Prescribed Zhuye Shigao Tang modified. Over ten doses, gradually improved. Stool became extremely hard and dry. Continued with nourishing medicines, and he recovered. (Rapid pulse indicates Yin deficiency with Heat. Rest are images of intense Heat injuring Lung. Xian Zhuye 2 qian. Sheng Shigao decocted first 1.2 liang. Jiuzao Zhimu 4 qian. Huoshui Lugeng 2 liang. Xian Piye Shubao 3 qian. Haifushi, Sheng Geke each 5 qian, pounded first. Xuanfuhua wrapped in silk, decocted first 3 qian. Dan Hai Zhe decocted first 1 liang.)
Zhang suffered from fever. Doctor knew it was not Cold Pathogen. Used clearing/resolving medicines for several doses. Leg pain became abnormal. Body and face gradually turned yellow. Mengying examined: Slippery-solid pulse. Abdominal distension, dry mouth. Prescribed Yinchin Dahuang Tang for two doses. Bowels moved, symptoms resolved. (Differentiating Fu Organ Excess relies on solid pulse. Without solid pulse, even with distension, purgation is not indicated. This pulse indicates Stomach Excess. Clearing/resolving cleared the floating exterior Heat. Heat pathogen descended and solidified in Stomach Fu. Zang disease affecting Fu. Dry stool knots in Hand-Yangming Large Intestine. Heat steaming upward causes yellow face. Stomach governs body mechanisms. Stomach Heat pouring downward causes abnormal leg pain. Liver governs tendons. Leg pain seems Liver disease but is actually Stomach disease. Hence treating Liver disease via Stomach. Jiuzao Xi Yinchin 2 qian. Jiuzao Zhipi 3 qian. Xiyangshen 3 qian. Sheng Fangcao 3 qian. Sheng Dongguazi 4 qian. Chao Zhike 2 qian. Zheng Da Baishao Chuxian 8 qian. Jiuzao Dahuang decocted first 4 qian.)
Wei suffered from foot swelling, vomiting, alternating chills and fever, constipation. Mengying prescribed Longdan Xiegan Tang with immediate effect. Subsequently, Mrs. Sun suffered the same and recovered with the same medicine. (Differentiating Excess Syndrome in vomiting and constipation. Jiangzhi Chao Danshen 3 qian. Jiangzhi Chao Ku Huangqin 1 qian. Jiang Zhipi 3 qian. Sheng Zexie 3 qian. Xi Mutong 1 qian. Cheqianzi ground Chuxian 3 qian. Chun Chaihu added later 3 qian.)
Feng suffered from nodules on the left eyelid, subsequently pain spreading to brow, forehead angle, vertex, and nape. Tendons pulled unbearably. Doctors gave Wind-dispelling agents, condition worsened critically. Mengying palpated string-taut-strong pulse. Crimson tongue, no hunger. Prescribed Guben combined with Erzhi, Sangju, Xijiao, Lingyang, Xuanshen, Muli, Biejia, Baishao, Zhimu, Shihu, Danpi, and Xicha, varying and alternating. Recovered after a month. (Condition originally Liver Yang rising vigorously. Wind agents aided the villain. String-taut-strong pulse indicates Heart/Liver Yang Evil counter-flowing upward, Qi mechanism not descending. Extinguishing Wind can direct Qi downward. Shuang Sangye 4 qian. Hang Baiju 2 qian. Xijiao decocted first 4 qian. Lingyang decocted first 4 qian. Xuanshen slice 8 qian. Nvzhenzi Chuxian 5 qian. Hanliancǎo 4 qian. Muli pounded 4 liang. Xue Biejia 2 liang. Zheng Da Baishao 1 liang. Xian Shihu Chuxian 1 liang. Four ingredients simmered together for six hours. Use liquid to decoct medicine. Jiuzao Zhimu 4 qian. Several doses remove Xijiao, Sang, Ju. Add Da Shengdi 1 liang. Da Shudi 8 qian. Danpi 2 qian. Next modification remove Baishao. Add Ming Tiandong cut 6 qian. Hua Maidong 4 qian. Final modification remove Danpi. Add Chen Xicha 3 qian.)
Pu suffered from boils like carbuncles all over body in hot autumn. Unbearable pain. Urine either blocked or frequent. Bowel movement required straining. Lying down, could not control. People thought it was Deficiency. Mengying examined: Slippery-rapid pulse. Purple tongue, yellow coating, thirst. Prescribed Baihu plus Huafen, Zhuye, Zhizi, Baiwei, Ziwan, Shihu, Huangbai. Recovered after ten-plus doses. (Slippery-rapid pulse, yellow coating, thirst indicate Lung/Stomach Heat Excess. Purple tongue indicates accompanying Blood Stasis. Baiwei moves stasis. Zhimu drains Lung Heat. Huangbai drains Liver Heat. Sheng Shigao decocted first 8 qian. Jiuzao Zhimu 3 qian. Nan Huafen 4 qian. Xian Zhuye 2 qian. Jiuzao Zhipi 3 qian. Jiuzao Baiwei 3 qian. Ziwan Rong 1.5 qian. Xian Shihu Chuxian 1 liang. Jiuzao Chuan Huangbai 1.5 qian. Rapid pulse indicates Yin deficiency with Heat. Huafen and Shihu protect Yin.)
Yao suffered from chills and fever in early autumn, coinciding with menstruation. Doctor used Zhengqi San for two doses. Resulted in high fever, mania, red eyes, delirium, even desire to cut throat or hang self. Condition uncontrollable. Mengying palpated Surging-Slippery-Rapid pulse. Coating dry-yellow, tip crimson. Epigastric stuffiness, abdominal distension, refusal to press. Fear of light, thirst. Rebellious Qi, excessive phlegm. Prescribed Tao Ren Cheng Qi Tang plus Xijiao, Shigao, Zhimu, Huafen, Zhuli, Ganju. People said: "Though Heat is intense, menstruation is still flowing. Why break Blood heavily and add extreme Cold medicines?" Mengying said: "Do not worry excessively. Perhaps one or two doses are insufficient. Indeed, after taking two large doses, bowels finally moved, spirit cleared, coating transformed, red eyes..."