吴某尝富后贫，体虚多郁，病患时疟，坚不服药，已半月矣。一夕忽发热不退，胸闷干
呕，
医投小柴胡汤不应，热盛汗多，神昏体倦，脉细无力，呓语音低。急延予诊。按仲师云∶谵
语有虚有实，实则谵语，虚则郑声。《素问》云∶言而微，终日乃复言者，此夺气也。用补
元煎合生脉散，两服霍然。
族叔晓堂，向在吴地贸易，情志不舒，抑郁成病，神迷谵妄，诸医无效。同人虑有不测
，送
回里中，诊脉弦急搏指，知其因郁生火，因火生痰，痰火扰其神明，蒙其心窍，是以语言不
正，举动异常，与阳明胃实狂乱之候不同，故前医用下药不应。病久正气固虚，补之又恐助
其痰火。爰仿服蛮煎加梨尖铁琥珀辰砂为引。初服谵妄稍定，再剂寝食渐安，共服十二剂，
神清语正，举止如常。盖此方能清心肝之热，而通神明，故效速如此。
族人联升，患休息痢，淹缠两载，药如清火固涩，补中升提，遍尝无效。偶遇诸涂，望
其色
萎气怯，知为脱血之候。谓曰∶尔病已深，不治将殆。渠告其故，予曰∶吾寓有药，能愈尔
病。盍往取之。比随至寓付药，再服即愈。渠以两年之疾，百治不瘳，此药效速如此，称为
神丹。方用鸦胆子一味，去壳取仁，外包桂圆肉捻丸，每早米汤送下三十粒，旋以食压之。
此方初得之人，传专治休息痢，并治肠风便血，少则一二服，多则三四服，无不应验。其物
不载本草，无从稽考，其味极苦，似属性寒，后阅幼幼集成书云∶痢久邪附大肠屈曲之处，
药力所不能到，用此奇效。思治虚怯沉 ，参 归地有用数斤愈者，治伤寒热病，姜附硝黄
有用数两愈者。何此物每用不过二三分，治积年之病，其效如神，物理真不可测。先哲云∶
千方易得，一效难求。信矣。
吴某曾经富裕后来贫穷，体质虚弱且多郁结，患有时行疟疾，坚决不服药，已经半个月了。一天晚上突然发热不退，胸闷干呕，医生投用小柴胡汤没有见效，热势亢盛汗出较多，神志昏迷身体疲倦，脉象细弱无力，说胡话声音低微。急忙请我去诊治。按照张仲景所说：说胡话有虚证和实证之分，实证表现为谵语（神志不清，胡言乱语），虚证表现为郑声（语言重复，声音低微）。《素问》说：说话声音细微，整天才再说一次，这是元气大伤的表现。使用补元煎合生脉散，服用两剂后病霍然而愈。
族叔晓堂，以前在吴地经商，情志不舒畅，抑郁而成病，精神迷乱说胡话发狂，多位医生治疗无效。同乡人担心发生意外，将他送回老家，诊察脉象弦急有力搏指，知道他是因郁结而生火，因火而生痰，痰火扰乱心神，蒙蔽心窍，所以言语不正，举动异常，这与阳明胃实导致的狂乱症状不同，所以之前医生使用泻下药没有效果。病程长久正气已经虚弱，进补又恐怕助长痰火。于是仿照服蛮煎，加梨尖、铁锈、琥珀、辰砂作为药引。初次服用后谵妄稍定，再服两剂睡眠饮食逐渐安稳，共服用十二剂，神志清醒言语正常，举止如常。大概这个方子能清心肝之热，而通达神明，所以见效如此迅速。
族人联升，患有休息痢，缠绵两年，药物如清热固涩、补中升提等，遍尝无效。偶然在路上遇见，看他的面色萎黄气息怯弱，知道这是失血的症状。我对他说：你的病已经很深，不治将会危险。他告诉了我病情经过，我说：我住处有药，能治好你的病。何不前去取药。随即随我到住处付药，再服即愈。他以两年的疾病，百治不愈，此药效速如此，称之为神丹。方子只用鸦胆子一味药，去壳取仁，外包桂圆肉捻成丸，每早用米汤送下三十粒，随即进食以压住药味。这个方子是初得之人传授，专门治疗休息痢，并治疗肠风便血，少则一二服，多则三四服，没有不应验的。这种药材不载于本草，无从考证，它的味道极苦，似乎属性寒，后来阅读《幼幼集成》一书说：痢疾日久邪气附着在大肠屈曲之处，药力所不能到达，用此药有奇效。思考治疗虚怯沉疴，人参、当归、地黄有用数斤治愈的案例，治疗伤寒热病，干姜、附子、芒硝、大黄有用数两治愈的案例。为什么此物每次只用不过二三分，治疗多年的疾病，其效如神，物理真不可测度。先哲说：千方易得，一效难求。确实如此。
Wu, who had once been wealthy but later became poor, had a weak constitution and was prone to depression. He suffered from intermittent malaria (Shi Nue, 时疟) but firmly refused medication for half a month. One night, he suddenly developed persistent fever, chest tightness, and dry retching. The physician prescribed Xiaochaihu Tang (Minor Bupleurum Decoction), but it was ineffective. His heat intensified with profuse sweating, leading to coma, physical fatigue, a fine and forceless pulse, and mumbling speech in a low voice. I was urgently summoned to diagnose him. According to Zhang Zhongjing: Delirious speech (Chan Yu, 谵语) can be either deficiency or excess; excess manifests as Chan Yu, while deficiency manifests as Zheng Sheng (repetitive speech). The *Suwen* states: "Speaking faintly, only repeating words after a whole day, this is depletion of Qi." I used Buyuan Jian (Tonify Origin Decoction) combined with Shengmai San (Generate the Pulse Powder). After two doses, he recovered miraculously.
My clan uncle, Xiaotang, had previously traded in the Wu region. Due to emotional distress and depression, he fell ill with mental confusion, delirium, and madness. Various physicians failed to cure him. Fearing an adverse outcome, his peers sent him back to his hometown. His pulse was wiry, rapid, and bounding against the finger. I determined that his condition arose from depression generating fire, and fire generating phlegm. Phlegm-fire disturbed his Shen (Spirit) and clouded his heart orifices, causing abnormal speech and behavior. This differed from the mania caused by Yangming stomach excess, which explains why previous physicians' use of purgatives was ineffective. Having been ill for a long time, his healthy Qi was deficient; tonification might aggravate the phlegm-fire. Therefore, I imitated the formula Fuman Jian, adding pear tips, iron rust, Amber, and Cinnabar as guides. After the first dose, his delirium stabilized slightly; after two more doses, his sleep and appetite gradually improved. After a total of twelve doses, his spirit cleared, speech normalized, and behavior returned to usual. This formula clears heat from the Heart and Liver and unblocks the Shen, hence its rapid effect.
Another clansman, Liansheng, suffered from dysentery with remissions and exacerbations (Xiuxi Li, 休息痢) for two years. Treatments such as clearing heat, astringing, tonifying the Middle, and lifting yang were tried without success. Upon meeting him on the road, I observed his sallow complexion and timid breath, recognizing signs of blood loss. I told him, "Your illness is deep; if untreated, it will be fatal." He explained his history. I said, "I have medicine at my residence that can cure you. Why not go fetch it?" He followed me, received the prescription, and was cured after two doses. Having endured two years of illness with hundred treatments failing, he marveled at the speed of this remedy, calling it a divine pill. The formula consisted solely of Brucea javanica (Yadanszi, 鸦胆子). The shells were removed, the kernels taken, wrapped in Longan aril, and formed into pills. Each morning, thirty pills were taken with rice gruel, followed immediately by food to suppress the taste. This formula was transmitted by its original discoverer, specifically treating Xiuxi Li and also intestinal wind with bloody stool. One to two doses, or three to four doses at most, were invariably effective. This herb is not recorded in the *Bencao*, so its origins are unknown. Its taste is extremely bitter, suggesting a cold nature. Later, reading the book *Youyou Jicheng*, I found: "In chronic dysentery, pathogens attach to the tortuous parts of the large intestine where medicinal power cannot reach; this herb yields miraculous results." Reflecting on cases where massive amounts (several jin) of Ginseng, Angelica sinensis, and Rehmannia cured chronic deficiency, or several liang of Dried Ginger, Aconite, Mirabilite, and Rhubarb cured Shanghan febrile diseases, it is puzzling why such a small amount (two or three fen) of this herb cures chronic ailments with god-like efficacy. The principles of nature are truly unfathomable. As the ancients said, "Thousands of formulas are easy to obtain, but one effective result is hard to seek." This is indeed true.