戊子之春，予由旌邑至孙村汪生德辉家，伊芳族绍由翁尊堂病剧延诊，比至，已治木矣。
入见
病者色白如盐，切脉弦劲少胃。予曰∶此脱证也，何以至此?翁述病原云∶家慈年近古稀，
体虚多忧，向患气痛，服辛香之品稍快。旧夏病目，眼科疗治，其目已盲。今春又因痰嗽，
药如二陈、枳、桔、杏仁、苏子，服经多日，前夕忽心慌晕汗，至今不止。畏食懒言。出所
服诸
方，予阅之曰∶病伤犹可治，药伤最难医。今离线甚速，驷马追之，尚恐不及，奈何?翁恳
举方，商以两仪煎合生脉散，每剂拟用人参三钱，熟地八钱。翁云∶家慈因患气痛，补剂向
不取尝，分两过重，虑其不受，请小试之如何。予曰∶亦可。但大厦摇摇，一木恐难支耳。
姑用人参一钱，熟地三钱，麦冬一钱五分，五味子五分。予下榻汪生宅中。次早翁郎岷山兄
来云∶家祖母昨夕服妙药后，安睡片时，汗敛晕定，略啜稀粥，稍能言语，幸已获效，乞求
复诊。予曰∶子归先煎人参二钱，熟地五钱备用。往察脉证颇有起色，仍守原方，续仿《千
金》复脉汤以救阴液，再加茯神、归、芍、牡蛎、女贞、石斛，柔肝养胃，渐次而瘥。
商翁夫人，本质虚寒，常多疾病。旧春曾为延医，药投温补有效。今春因乃郎心疾，昼
夜看
守辛劳，风寒之邪，乘虚袭络，比时不觉，渐致颈脊酸痛，喜暖畏寒，欲人揉打，纠缠两月
。医用羌独防风以驱风，香砂陈皮以理气，屡服不应。季夏，予至孙村，延诊。谓曰∶此风
寒袭络之证也。夫初痛在经，久痛在络。经主气，络主血。考督脉并于脊里，至风府入属于
脑。素问云∶痛者，寒气多也。寒则泣而不流，温则消而去之。大法治风先治血，血行风自
灭。理当养血为君，佐以温通脉络，非驱风理气所能治也。方定当归、枸杞、杜仲、巴戟天
、附子、鹿角胶霜、狗脊、五加皮、秦艽、桑枝，四剂全愈。
安波按∶此内风症也，名以风寒袭络，似属不切，不然前医驱风已效灵矣。
戊子年春季，我从旌邑前往孙村汪生德辉家中，他的同族长辈绍由翁的尊堂（母亲）病情危重，邀请我去诊治。等我赶到时，病人已经接受过其他医生的治疗了。
进入病房见到病人，面色苍白如盐色，切脉弦劲而缺乏胃气（柔和之象）。我说：“这是脱证（正气极度虚弱、阴阳离决的危重证候），怎么会发展到这种地步？”绍由翁叙述病因说：“家母年近七十，体质虚弱且多忧虑，一向患有气痛病，服用辛香类药物后稍感舒适。去年夏天患眼疾，经眼科治疗后双目失明。今年春天又因痰嗽，服用二陈汤、枳壳、桔梗、杏仁、苏子等药，服用了多天。前一天晚上突然心慌、头晕、出汗，至今未止。畏食懒言。”拿出所服的各种方剂给我看，我阅后说：“病邪损伤尚可治疗，药物损伤最难医治。现在距离危险时刻已经很近，即使快马加鞭追赶恐怕也来不及了，怎么办？”绍由翁恳请我开方，我建议用两仪煎合生脉散，每剂拟用人参三钱，熟地黄八钱。绍由翁说：“家母因为患有气痛病，向来不接受补剂，分量过重，担心她身体承受不住，请让我先小剂量尝试一下如何？”我说：“也可以。但是大厦将倾，一根木头恐怕难以支撑。”于是暂用人参一钱，熟地黄三钱，麦冬一钱五分，五味子五分。我住在汪生宅中。第二天早上，绍由翁的儿子岷山兄来找我，说：“家祖母昨晚服用妙药后，安稳睡了一会儿，汗止晕定，稍微喝了一点稀粥，能稍微说点话，幸好已经见效，请求再次诊治。”我说：“你先回去煎好人参二钱，熟地黄五钱备用。”我去诊察脉证，发现颇有起色，仍守原方，接着仿照《千金》复脉汤以救阴液，再加茯神、当归、白芍、牡蛎、女贞子、石斛，柔肝养胃，逐渐痊愈。
商翁夫人，本质虚寒，经常生病。去年春天曾请医生诊治，用药温补有效。今年春天因为儿子有心疾，日夜看守辛劳，风寒之邪乘虚侵袭经络，当时没有察觉，逐渐导致颈脊酸痛，喜欢温暖害怕寒冷，想要人揉打按摩，纠缠了两个多月。医生用羌活、独活、防风来驱风，香附、砂仁、陈皮来理气，多次服用无效。夏末，我到孙村，被邀请去诊治。我说：“这是风寒袭络的证候。起初疼痛在经脉，久病疼痛在络脉。经脉主气，络脉主血。考察督脉并行于脊柱内部，至风府穴入属于脑。《素问》说：‘痛者，寒气多也。’寒则血液凝涩而不流通，温则消散而去掉它。大法治风先治血，血行风自灭。应当以养血为君药，佐以温通脉络的药物，不是驱风理气所能治疗的。”方剂定为当归、枸杞、杜仲、巴戟天、附子、鹿角胶霜、狗脊、五加皮、秦艽、桑枝，四剂后完全痊愈。
In the spring of the Wuzi year, I traveled from Jingyi to Sun Village, to the home of Mr. Wang Dehui. His clansman's elder, Master Shaoyou's mother (Zuntang), was critically ill and invited me for consultation. Upon my arrival, she had already received treatment from other physicians.
Entering the room, I observed that the patient's complexion was pale as salt. Her pulse was wiry and forceful but lacked the "stomach qi" (the harmonious and gentle quality indicating healthy digestive function). I said, "This is a condition of collapse (a critical syndrome characterized by extreme deficiency of vital energy and impending separation of yin and yang). How did it reach this state?" Master Shaoyou explained the etiology: "My mother is nearly seventy years old, constitutionally weak and prone to worry. She has long suffered from Qi pain, finding slight relief with acrid-aromatic herbs. Last summer, she suffered from an eye disease; after ophthalmic treatment, she became blind. This spring, due to phlegm-cough, she took Er Chen Tang (Two-Cured Decoction), along with Zhi Qiao (Aurantium Fructus), Jie Geng (Platycodon Root), Xing Ren (Prunus Seed), and Su Zi (Perilla Fruit) for many days. The night before yesterday, she suddenly experienced palpitations, dizziness, and sweating, which have persisted since. She fears eating and is reluctant to speak." He presented the various prescriptions she had taken. After reviewing them, I said, "Pathogenic injury may still be treatable, but iatrogenic injury (harm caused by medication) is the most difficult to cure. The situation is now perilously close to crisis; even with swift horses chasing, we might not catch up. What shall we do?" Master Shaoyou earnestly requested a prescription. I proposed combining Liang Yi Jian (Two-Yi Decoction) with Sheng Mai San (Generate the Pulse Powder), prescribing three qian of Renshen (Ginseng Radix) and eight qian of Shu Di Huang (Rehmanniae Radix Praeparata) per dose. Master Shaoyou replied, "Because my mother suffers from Qi pain, she has never tolerated tonic formulas. Such heavy dosages might overwhelm her system. May I try a small test dose first?" I said, "That is acceptable. However, when a great house is shaking, a single piece of wood may hardly support it." Thus, I initially prescribed one qian of Renshen, three qian of Shu Di Huang, 1.5 qian of Maidong (Ophiopogonis Radix), and half a qian of Wuweizi (Schisandrae Fructus). I stayed at Mr. Wang's residence. The next morning, Master Shaoyou's son, Brother Minshan, came to say, "Last night, after taking your wonderful medicine, my grandmother slept peacefully for a while. The sweating stopped, dizziness resolved, she drank some thin porridge, and could speak slightly. Fortunately, there is improvement. We request another consultation." I said, "Go back and decoct two qian of Renshen and five qian of Shu Di Huang in advance for preparation." Upon examining her pulse and symptoms again, I found significant improvement. I maintained the original formula, then imitated the Fu Mai Tang (Restore the Pulse Decoction) from *Qian Jin Fang* to nourish Yin fluids, adding Fushen (Poria with Hostwood), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Muli (Concha Ostreae), Nvzhenzi (Ligustri Lucidi Fructus), and Shihu (Dendrobii Caulis). These herbs soften the Liver and nourish the Stomach. Gradually, she recovered.
Madam Shang, Master Shang's wife, had a constitution of deficiency and cold, often falling ill. In the previous spring, a physician was consulted, and warm-tonic medications were effective. This spring, due to her son's heart disease, she labored day and night in care. Wind-cold pathogens invaded the collaterals taking advantage of the deficiency. Initially unnoticed, this gradually led to soreness and pain in the neck and spine, preference for warmth and aversion to cold, and a desire for massage or rubbing. This persisted for over two months. Physicians used Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), and Fangfeng (Saposhnikoviae Radix) to dispel wind, and Xiangfu (Cyperi Rhizoma), Sharen (Amomi Fructus Rotundus), and Chenpi (Citri Reticulatae Pericarpium) to regulate Qi. Multiple administrations yielded no effect. In late summer, I arrived at Sun Village and was invited to consult. I stated, "This is a syndrome of wind-cold invading the collaterals. Initial pain resides in the meridians; chronic pain resides in the collaterals. Meridians govern Qi, while collaterals govern Blood. Examining the Du Meridian (Governor Vessel), it runs parallel within the spine, entering the brain at Fengfu (DU16). As stated in *Su Wen*: 'Pain is caused by excessive cold.' Cold causes stagnation and lack of flow; warmth dissipates and removes it. The general principle for treating wind is to first treat the blood; when blood flows, wind extinguishes itself. Therefore, one should prioritize nourishing blood as the sovereign herb, assisted by herbs that warm and unblock the collaterals. This cannot be treated merely by dispelling wind and regulating Qi." The prescription consisted of Danggui (Angelicae Sinensis Radix), Gouqi (Lycii Fructus), Duzhong (Eucommiae Cortex), Bajitian (Morindae Officinalis Radix), Fuzi (Aconiti Lateralis Radix Praeparata), Lu Jiao Jiao Shuang (Deer Antler Glue Frost), Gouji (Cibotii Rhizoma), Wujia Pi (Acanthopanacis Cortex), Qinjiao (Gentianae Macrophyllae Radix), and Sangzhi (Mori Ramulus). After four doses, she was completely cured.
An Bo's commentary: This is an internal wind syndrome. Naming it "wind-cold invading collaterals" seems inaccurate; otherwise, the previous physicians' wind-dispelling treatments would have been effective.