封翁年愈古稀，恙患泄泻，公郎麦伦兄善岐黄，屡进温补脾肾诸药，淹缠日久，泻总不
止。
招予诊视。谓迈兄曰∶尊翁所患乃泻久肠胃滑脱之候也。十剂云∶补可去弱，涩可去脱，泻
久元气未有不虚，但补仅可益虚，未能固脱。仲景云∶理中者，理中焦，此利在下焦，赤石
脂禹余粮丸主之。李先知云∶下焦有病患难会，须用余粮赤石脂。况肠胃之空，非此不能填
，肠垢已去，非此不能复其粘着之性。喻西昌治陈彦质浦君艺泻利，久而不愈，用此俱奏奇
功，遂于原方内加入石脂余粮，服之果效。
安波按∶善师古人之法。
嘉庆辛未春，予患眩晕，不出户者累月。友人张汝功兄来，言洪梅翁病剧，述其证状，
起初
少腹痛，呕吐，医谓寒凝厥阴，投以暖肝煎，痛呕益甚，又谓肾气上冲，更用理阴煎合六君
子汤，每剂俱用人参，服之愈剧，脘痞畏食，昼夜呻吟，面目色黄，医称体亏病重，补之不
应，虑其虚脱，举室忧惶。复有指为疸证，欲进茵陈蒿汤者，嘱邀子诊以决之。予辞以疾，
汝兄强之，于是扶掖而往。诊毕笑谓翁曰∶病可无妨，但药只须数文一剂，毋大费主人物料
。方疏加味逍遥散，加郁金、陈皮、谷芽、兰叶。乃弟并锋翁曰∶家兄年将花甲，病经多日
，痛呕不食，胃气空虚，轻淡之品，恐不济事。予曰∶此非虚证，药不中病，致益剧耳。经
云∶诸痛属肝。病由肝郁不舒，气机遏抑，少腹乃厥阴部位，因而致痛。肝气上逆，冲胃为
呕，温补太过，木郁则火郁，诸逆冲上，皆属于火，食不得入，是有火也。至于面目色黄，
亦肝郁之所使然，非疸证也。逍遥一方，治木
郁而诸郁皆解，其说出赵氏《医贯》，予辑载拙集《医述》中。检书与阅，翁以为然。初服
各证均减，服至四剂，不痛不呕，黄色尽退，共服药十二剂，服食如常。是役也，翁病召诊
日，皆汝兄代邀，语予曰∶翁前服参药不应，自以为殆，予药如此之轻，见效如此之速，甚
为感佩，嘱予致意，容当图谢。予曰∶医者愈病，分所当然，惟自抱疾，为人疗病，行动蹒
跚，殊可笑耳。翁有盛情，拙集辑成，借代付梓，亦善果也，胜酬多矣。晤间翁问尊集成乎
?予曰∶未也。翁曰∶且俟脱稿，薄助剞劂。阅兹廿载，集成而翁已仙矣。集首阅书姓氏款
中，谨登翁名，不忘其言。
安波按∶治肝一法，不外辛散酸收甘缓，此古制逍遥散之妙也。但肝病已久，必盗母
气，故前贤有温暖肝肾，乙癸同源之治。如肾阴偏伤，木火内燃，虽滋肾阴一法以柔肝，然
肝最碍补，必须病久，或肾家素有宿疾，方为合符耳。第治肝以辛散酸收为多，以滋补收纳
者十中一二耳。
封翁年龄已超过七十岁，患有长期腹泻病症。他的儿子麦伦兄精通中医，多次使用温补脾肾的药物进行治疗，病情拖延日久，腹泻始终无法停止。
邀请我前去诊治。我对麦伦兄说：“令尊所患乃是因长期腹泻导致肠胃滑脱的证候。《十剂》中说：‘补法可以去除虚弱，涩法可以固摄滑脱’。长期腹泻元气没有不虚弱的，但单纯补益只能改善虚弱，不能固摄滑脱。张仲景说：‘理中汤是调理中焦的，此处的泄泻病位在下焦，应用赤石脂禹余粮丸治疗。’李先知说：‘下焦患病难以领会，必须使用禹余粮和赤石脂。’况且肠胃空虚，不用这些药物不能填补；肠垢已去，不用这些药物不能恢复其粘着之性。喻嘉言（喻西昌）治疗陈彦质、浦君艺的久泻不愈，使用此方都取得了奇效，于是我在原方中加入赤石脂和禹余粮，服用后果然见效。”
安波按语：善于效法古人的治法。
嘉庆辛未年春天，我患上眩晕症，连续几个月不出家门。友人张汝功兄前来，说洪梅渚翁病情严重，叙述其症状表现：起初少腹疼痛，呕吐，医生认为是寒邪凝滞厥阴经，投用暖肝煎，结果疼痛呕吐更加严重；又认为是肾气上冲，改用理阴煎合六君子汤，每剂药都加入人参，服用后病情愈发加重，出现胃脘痞满、畏惧进食，昼夜呻吟，面目颜色发黄，医生称体质亏损且病重，补益无效，担心虚脱，全家忧愁惶恐。又有医生诊断为黄疸证，想要使用茵陈蒿汤，嘱咐邀请我去诊治以决断。我以生病为由推辞，张兄强行邀请，于是我被人搀扶着前往。诊脉完毕后，我笑着对洪翁说：“这个病没什么大碍，只需几文钱一剂的药即可，不必让主人花费太多物资。”处方开具加味逍遥散，加入郁金、陈皮、谷芽、佩兰叶。他的弟弟并锋翁说：“家兄将近六十岁，患病多日，疼痛呕吐不能进食，胃气空虚，轻清淡薄的药物，恐怕不起作用。”我说：“这不是虚证，是因为用药不对症，导致病情加重罢了。《内经》说：‘各种疼痛归属于肝’。此病由肝气郁结不舒，气机遏制压抑所致，少腹是厥阴肝经的部位，因此导致疼痛。肝气上逆，冲犯胃部导致呕吐，温补太过，木郁则火郁，各种向上冲逆的症状，都属于火，食物不能进入，这是有火的表现。至于面目发黄，也是肝郁所致，并非黄疸证。逍遥散一方，能治疗木郁而诸郁皆解，这一说法出自赵献可的《医贯》，我将其辑录在我的拙作《医述》中。”查阅书籍给他看，洪翁认为说得对。初次服药各症状均减轻，服至四剂，不再疼痛呕吐，黄色完全消退，共服药十二剂，饮食恢复正常。这次诊疗中，洪翁生病召请我诊治的日子，都是张兄代为邀请，他对我说：“翁之前服用人参类药物无效，自认为快要死了，我的药如此轻灵，见效如此迅速，非常感激敬佩，嘱咐我致意，日后定当图报感谢。”我说：“医生治愈疾病，是分内理所当然的事，只是我自己抱着病体，却为人治病，行动蹒跚，实在可笑罢了。翁有盛情，我的拙作编辑完成，借这个机会付梓刊印，也是善果，胜过丰厚的酬谢。”交谈间翁问：“您的书集编成吗？”我说：“还没有。”翁说：“暂且等到脱稿，微薄资助刻印费用。”过了二十年，书集成而翁已经去世。在书集首页阅览者姓氏款目中，恭敬地登载翁的名字，不忘他的诺言。
安波按语：治疗肝病的方法，不外乎辛散、酸收、甘缓，这是古代逍遥散的奥妙所在。但肝病已久，必然盗取母脏之气，所以前贤有温暖肝肾、乙癸同源的治疗方法。如果肾阴偏伤，木火在内燃烧，虽然滋补肾阴以柔养肝脏是一法，然而肝最忌讳滋补，必须病久，或者肾家素有宿疾，才符合这一治法。总之，治疗肝病多以辛散酸收为主，以滋补收纳的占十分之一二而已。
The patient, an elderly gentleman (Feng Weng), was over seventy years old and suffered from chronic diarrhea. His son, Brother Mailun, was proficient in Traditional Chinese Medicine (TCM) and had repeatedly administered various formulas to warm and tonify the Spleen and Kidney. The illness dragged on for a long time, yet the diarrhea persisted without cessation.
I was invited to examine him. I said to Brother Mai: "Your father's condition is characterized by intestinal and gastric slippage due to prolonged diarrhea. The *Shi Ji* (Ten Categories of Medicinals) states: 'Tonification can remove weakness, and astringency can treat slippage.' Prolonged diarrhea inevitably depletes Yuan Qi (Original Qi); however, simple tonification can only address the deficiency but cannot secure the slippage. Zhang Zhongjing stated: 'Li Zhong Tang regulates the Middle Jiao; this case of dysentery/diarrhea lies in the Lower Jiao, so Chishizhi Yuyuliang Wan should be used.' Li Xianzhi said: 'Diseases of the Lower Jiao are difficult to comprehend; one must use Yuliang and Chishizhi.' Moreover, when the intestines and stomach are empty, these substances are needed to fill them; when the intestinal mucus has been lost, they are required to restore its adhesive nature. Yu Chang (Yu Xichang) treated Chen Yanzhi and Pu Junyi with persistent diarrhea using this formula and achieved miraculous results. Therefore, I added Chishizhi and Yuyuliang to the original prescription, which proved effective."
An Bo's commentary: This demonstrates skillful application of ancient methods.
In the spring of Xinwei year of the Jiaqing era, I suffered from vertigo and did not leave my house for months. My friend, Brother Zhang Rugong, visited and reported that Old Man Hong Meizhu was critically ill. He described the symptoms: initially, there was pain in the lower abdomen and vomiting. Physicians diagnosed it as Cold congealing in the Jueyin channel and prescribed Nuogan Jian (Warm Liver Decoction), which exacerbated the pain and vomiting. Others attributed it to Kidney Qi rushing upward and prescribed Liyin Jian combined with Liujunzi Tang, adding Ren Shen (Ginseng Radix et Rhizoma) to every dose. The condition worsened further, presenting with epigastric fullness, aversion to food, groaning day and night, and yellowing of the face and eyes. Physicians claimed his constitution was depleted and the disease severe, noting that tonification was ineffective and fearing collapse, causing panic throughout the household. Another physician diagnosed it as Jaundice (Dan Zheng) and proposed Yinchen Hao Tang. They asked me to diagnose and decide. I declined due to my own illness, but Brother Zhang insisted, so I went while being supported. After examining the pulse, I smiled and told the patient: "The illness is harmless. You only need medicine costing a few coins per dose; do not waste resources." I prescribed Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) with additions of Yujin (Curcuma Aromatica Rhizome), Chenpi (Citrus Reticulata Pericarpium), Guya (Setaria Italica Germinatio), and Lanye (Mentha Haplocalyx). His brother, Bingfeng Weng, said: "My elder brother is nearing sixty, has been ill for many days, suffers from pain, vomiting, and inability to eat, with empty Stomach Qi. Light and bland herbs may be insufficient." I replied: "This is not a deficiency syndrome. The previous medications were inappropriate, causing the worsening. The *Classic* states: 'All pain belongs to the Liver.' This disease arises from Liver Qi stagnation and suppression. The lower abdomen is the territory of the Jueyin channel, hence the pain. Liver Qi rebelling upward attacks the Stomach, causing vomiting. Excessive warming and tonification caused Wood stagnation leading to Fire stagnation. All rebellious Qi rushing upward belongs to Fire. Inability to ingest food indicates the presence of Fire. As for the yellow complexion, it is also caused by Liver stagnation, not Jaundice. Xiaoyao San treats Wood stagnation, resolving all other stagnations. This theory comes from Zhao Xianke's *Yi Guan*, which I recorded in my collection *Yi Shu*. Please check the book." The patient agreed. After the first dose, all symptoms decreased. After four doses, pain and vomiting ceased, and the yellow color completely faded. After twelve doses in total, his diet returned to normal. During this episode, Brother Zhang invited me on behalf of the patient. He told me: "Before, your father took Ginseng without effect and thought he was dying. Your medicine was so light, yet the effect was so rapid. We are deeply grateful and impressed. He asks me to convey his regards and promises to thank you properly." I said: "Curing disease is the physician's duty. It is amusing that I, who am sick myself, am treating others while walking unsteadily. The patient showed great kindness. When my book is published, including his name in the acknowledgments is a good deed, far surpassing material rewards." During our meeting, the patient asked: "Has your book been compiled?" I said: "Not yet." He said: "Wait until it is finished; I will provide modest assistance for printing." Twenty years later, the book was completed, but the patient had passed away. I respectfully listed his name among the readers at the beginning of the book, honoring his words.
An Bo's commentary: The treatment of Liver diseases primarily involves acrid dispersing, sour astringing, and sweet moderating, which is the essence of the ancient Xiaoyao San. However, since Liver disease persists for a long time, it inevitably drains the Qi of the Mother organ (Water/Kidney). Thus, ancient sages advocated warming the Liver and Kidney and recognizing the common origin of Yi (Liver/Wood) and Gui (Kidney/Water). If Kidney Yin is damaged, allowing Wood-Fire to burn internally, nourishing Kidney Yin to soften the Liver is one method. However, the Liver is most obstructed by tonification; this approach is only suitable if the disease has lasted long or if there is a pre-existing Kidney condition. Generally, treating the Liver relies mostly on acrid dispersing and sour astringing, while tonifying and collecting approaches account for only one or two out of ten cases.