玉翁次郎，形貌丰腴，向无疾病，丁亥季秋望后，陡作寒热，延予次儿光墀延医。药投
温解
，其热即退。嗣后单寒不热，肢麻指凉，口吐冷涎，脐腹隐痛，便溏畏食。知系伏寒凝冱，
方换姜附六君附子。初用八分，增至一钱，未见松动。邀予商酌，切脉迟细无力，望色面白
舌润。予曰∶此正仲圣所谓无热恶寒，发于阴也。前方不谬，尚恐病重药轻，附子加用二钱
，更加吴萸、肉桂、砂仁、川椒。次日复诊，病状仿佛，思火为土母，阳虚生寒，温理脾阳
不应，非补火生土不可。王冰所谓益火之原，以消阴翳也。仿生生子壮原汤加吴茱萸、葫芦
巴、肉果、巴戟天，附子增至三钱，以为必效矣。诘朝脉证依然，玉翁问故。予曰无他，药
力未到耳。盖市中种附力薄，况经制透，其味更淡，可增四钱，再加鹿茸、枸兔峻补真阳。
自可春回 谷。根据法服之。证仍如旧。翁侄召成兄私询予曰∶舍弟之病，先生审属阴寒，第
用如许热药，毫不见功，理殊不解。且附子大毒，今已服过数两，久而增加，可无患否?予
曰∶其他勿论，时下秋燥，此等纯阳之药，若不对证，一匕亦不能堪，况其多乎。夫攻病之
药皆有毒，无毒之品不能攻病。凡伤寒中阴等证，非附子不能驱阴回阳，有病则病受之，何
有余性，遗留作毒，即使有毒而生，不胜于无毒而死乎。仍守原方，附子加至五钱，维时旁
议沸腾，幸玉翁信而不疑。予告之曰∶此证确属沉寒痼冷，然煎剂温药止矣。再得硫黄丸佐
之，庶有裨益。于是煎丸并进，渐见好机，热药稍减，参入熟地河车杜仲。予与墀儿日为诊
视，两阅月始得全愈。共计服过附子一斤，硫黄丸二两，干姜六两，鹿茸一架，党参三斤，
高丽人参共十余两，其他肉桂、吴萸、川椒等，不可胜计。予生平治阴证用温药，未有若斯
之多，而效验亦无如此之迟也。
安波按∶病家相信，医家放胆，所以为医一道，非易事也。
玉翁的次子，身体形态丰满，向来没有疾病。丁亥年深秋望日之后，突然发作寒热交替的症状，其子光墀邀请我去诊治。投用温散解表的药物后，发热随即消退。此后只有恶寒而没有发热，肢体麻木、手指发凉，口中吐出冷涎，脐腹部隐隐作痛，大便稀溏、畏惧进食。我判断这是伏寒凝结深固所致，于是更换方剂为姜附六君汤（即六君子汤加干姜、附子）。起初使用附子八分，逐渐增加至一钱，但病情未见松动缓解。于是邀请我共同商讨，诊脉见脉象迟、细且无力，望面色苍白、舌苔润泽。我说：“这正是仲景所说的‘无热恶寒，发于阴经’。前方的用药没有错误，只是恐怕病重药轻，将附子的用量增加到二钱，并加入吴茱萸、肉桂、砂仁、川椒。第二天复诊，症状仿佛依旧。我想火是土的母亲，阳虚则生寒，单纯温补脾阳既然无效，就必须采用补火以生土的方法。正如王冰所说：‘益火之原，以消阴翳’。”于是仿照生生子壮原汤，加入吴茱萸、葫芦巴、肉豆蔻、巴戟天，附子增至三钱，认为必定有效。第二天早晨脉证依然如故，玉翁询问原因。我说：“没有其他原因，是药力尚未到达病所罢了。因为市面上种植的附子药力薄弱，况且经过炮制透心，味道更加淡薄，可以增加到四钱，再加入鹿茸、枸杞兔（此处原文疑为枸杞或类似补益药，依文意理解为峻补真阳之品，暂译作枸杞等）来峻补真阳。自然可以像春回大地般恢复生机。”按照这个方法服用，症状仍然没有变化。玉翁的侄子召成私下问我：“舍弟的病，先生确认为阴寒证，但使用如此多的热性药物，却毫无功效，道理上实在难以理解。而且附子是大毒之药，现在已经服用了数两，长期增加剂量，难道不会有祸患吗？”我说：“其他的不必多论，时下正值秋燥季节，这种纯阳的药物，如果不对证，哪怕只是一匕的量也承受不了，何况这么多呢？凡是攻治病邪的药物都有毒性，无毒的药物不能攻治病邪。凡是伤寒中的阴证等病症，非附子不能驱除阴寒、回复阳气。有病则病邪承受药力，哪里会有多余的药性残留成为毒素？即使有毒而致死，难道不比无毒而病死好吗？”仍然坚守原方，将附子增加至五钱。当时旁人的议论纷纷沸腾，幸好玉翁信任而不怀疑。我告诉他说：“这个病症确实属于沉寒痼冷，但是煎剂的温热药物已经用到极限了。再配合硫黄丸来辅助治疗，或许会有益处。”于是煎剂和丸药并进，渐渐见到好转的迹象，热性药物稍微减少，参入熟地黄、紫河车、杜仲。我和光墀每天为他诊治，过了两个月才完全痊愈。共计服用了附子一斤，硫黄丸二两，干姜六两，鹿茸一架，党参三斤，高丽人参共十余两，其他的肉桂、吴茱萸、川椒等，数量多得不可胜计。我生平治疗阴证使用温性药物，从来没有像这样多的，而疗效也没有像这样迟缓的。
安波按语：病人相信医生，医生放手大胆治疗，所以行医这一道，不是容易的事啊。
The second son of Master Yu, whose physique was robust and plump, had been free from illness. In the late autumn of the Dinghai year, after the full moon day, he suddenly developed alternating chills and fever. His son, Guangchi, invited me to consult. After administering warm-releasing (Wen Jie) prescriptions, the fever subsided. Subsequently, only chills remained without fever; his limbs felt numb, fingers were cold, he spat out cold saliva, experienced dull pain in the umbilical and abdominal regions, suffered from loose stools, and lost his appetite. I determined this to be due to latent cold congealing and freezing deep within. Thus, I changed the prescription to Jiang Fu Liu Jun Tang (Six Gentlemen Decoction with Dried Ginger and Aconite). Initially, Aconite (Fuzi) was used at 8 fen, increased to 1 qian, but no loosening or relief was observed. I was invited to deliberate. The pulse was slow, fine, and powerless; the complexion was pale, and the tongue was moist. I said, "This is precisely what Zhongjing described as 'no fever but aversion to cold, originating from the Yin.'" The previous prescription was not erroneous; it is merely feared that the disease is severe while the medicine is light. I increased the dosage of Aconite to 2 qian and added Evodia (Wuyu), Cinnamon Bark (Rougui), Amomum (Sharen), and Sichuan Pepper (Chuanjiao). On the next day's follow-up, the symptoms seemed unchanged. I reasoned that Fire is the mother of Earth; Yang deficiency generates cold. Since warming and regulating Spleen Yang was ineffective, one must employ tonifying Fire to generate Earth. As Wang Bing stated: "Benefit the source of Fire to dissipate the shadows of Yin." I modeled the prescription after Shengsheng Zizhuangyuan Tang, adding Evodia, Trichosanthes Seed (Huluba - *Note: likely refers to Trichosanthes or similar, context implies kidney tonics*), Nutmeg (Rouguo), and Morinda (Bajitian). Aconite was increased to 3 qian, and I believed efficacy would surely follow. The next morning, the pulse and symptoms remained identical. Master Yu asked for an explanation. I replied, "There is nothing else; the medicinal force has not yet reached the site of the disease. The Aconite cultivated in the market has weak potency, especially after being thoroughly processed, making its flavor even lighter. It can be increased to 4 qian, and further supplemented with Deer Antler (Lurong) and Goji Berry (Gouqi) to vigorously tonify True Yang. Naturally, vitality will return like spring reviving the valley." Following this method, the condition remained unchanged. Master Yu's nephew, Zhao Cheng, privately consulted me, saying, "My younger brother's illness, you have diagnosed as Yin-Cold, yet using such large amounts of hot medicines yields no effect, which is hard to understand. Moreover, Aconite is highly toxic. He has already consumed several taels; increasing it over time, could there be no harm?" I said, "Let us set aside other matters. Currently, it is the season of Autumn Dryness. Such purely Yang medicines, if not indicated, cannot be tolerated even in a single dose, let alone so much. All medicines that attack pathogens are toxic; non-toxic substances cannot attack diseases. For Yin syndromes in Cold Damage, only Aconite can expel Yin and restore Yang. When there is disease, the disease receives the medication; where would excess properties remain to become toxic? Even if death occurs due to toxicity, is it not better than dying without treatment?" I adhered to the original prescription, increasing Aconite to 5 qian. At that time, discussions among bystanders boiled over, but fortunately, Master Yu trusted me without doubt. I told him, "This case indeed belongs to entrenched cold and chronic chill. However, the decoction of warm medicines has reached its limit. By supplementing with Sulphur Pill (Liuhuang Wan), there might be some benefit." Thus, decoctions and pills were administered together. Gradually, signs of improvement appeared. The hot medicines were slightly reduced, and prepared Rehmannia (Shudi), Placenta (Heche), and Eucommia (Duzhong) were incorporated. Myself and Guangchi examined him daily. After two months, he fully recovered. In total, he consumed 1 jin of Aconite, 2 liang of Sulphur Pills, 6 liang of Dried Ginger, one rack of Deer Antler, 3 jin of Codonopsis (Dangshen), and over 10 liang of Korean Ginseng (Gaolirenshen). Other herbs like Cinnamon Bark, Evodia, and Sichuan Pepper were countless. Throughout my life, treating Yin syndromes with warm medicines, I have never used such quantities, nor has the therapeutic effect been so delayed.
An Bo's Note: The patient's trust in the physician, and the physician's boldness in treatment, demonstrate that the art of medicine is not an easy undertaking.