子钦兄幼年质弱，偶因停感，发热腹痛，儿科药用荆防查曲，服后热退痛止，以为应验
。距
意次日卧床不起，头重目阖，气怯懒言，不饮不食。急延予至，见其形状倦怠，切脉细软无
神，维时伊芳舅柳荫千兄在座，予告之曰∶令甥之恙，乃元气不支，切恐虚脱，亟宜峻补，迟
则难救。荫兄云∶舍甥病才两日，消散又未过剂，童质固虚，何至遽脱?岂可骤投重补耶?予
曰∶小儿脏气易为虚实，脉证疲惫如斯，舍此别无他策。仿补元煎方法与服二剂，病仍未转
，伊芳乃堂忧甚，予曰∶凡治病，补虚与攻实不同，攻实可求速效，补虚本无近功。服药病既
不增，虚能受补，即为见效。古称填补，如地有陷阱，方能容填。若平地填之，成敦阜矣。
仍根据原方加入 术、茯、神、枣仁合归脾汤，守服浃旬，头竖目开，饮食照常，俨如无病。
安波按∶于庚辰岁治余杭金姓稚子，年甫五龄，形颇肮脏，忽患暴注下迫，形神顿减
，小尿
短滴，幼医以消导之属，靡不备尝，或有以暴泻属热者，需胡黄连之类，其泻转甚，延余诊
治。脉之细弱乏神，按之则空，胎微黑不渴，曰寒邪直中太阴所致，非附子理中汤不可，迟
则恐变，乃尊曰∶邪中太阴，已领教矣。然小儿体若纯阳，胡可以热济之乎。余曰∶医贵活
泼，不可纽执一说，以塞见闻。彼以为然，投之果应。此症与斯案相类，险为肤见所阻，故
录出为固执者鉴。
鲍子钦兄幼年时体质虚弱，偶然因外感风邪兼有食积停滞，出现发热和腹痛的症状。儿科医生使用了荆防败毒散加山楂、神曲等药物，服用后热退痛止，大家以为这是治疗有效的验证。
然而第二天，他突然卧床不起，头部沉重，眼睛闭合，气息怯弱，懒于说话，不喝水也不进食。急忙请我前往诊治，见他神情倦怠，切脉细软且无神气。当时他的舅舅柳荫千兄也在座，我对他说：“令甥的病证，是元气不能支撑，恐怕会发生虚脱，必须立即使用峻猛的补益法，拖延则难以救治。”
柳荫千兄说：“舍甥患病才两天，之前的消散药也没有过量，虽然孩童体质本来虚弱，怎么会突然虚脱呢？怎么能骤然投用重剂量的补药呢？”
我说：“小儿脏腑之气容易在虚实之间转化，现在脉象和症状都如此疲惫不堪，除了这个方法别无他策。”于是仿照补元煎的方法让他服用两剂，病情仍未好转。他的堂兄非常担忧，我说：“大凡治病，补虚与攻实不同。攻实可以求得速效，而补虚本来就没有近功（快速见效）。服药后病情既不增加，说明身体能接受补益，这就是见效的表现。古人所说的填补，就像地上有陷阱，才能容纳填充物。如果在平地上填土，就会变成高耸的山丘了。”
于是仍然根据原方加入白术、茯苓、远志、酸枣仁，合用归脾汤，坚持服用十天（浃旬），他头能竖起，眼睛睁开，饮食恢复正常，简直像没有生病一样。
安波按：我在庚辰年治疗余杭金姓的一个幼童，年仅五岁，形体颇为肮脏（指面色晦暗或污垢未洗），忽然患上暴注下迫（急性剧烈腹泻伴里急后重），形神顿时减退，小便短少点滴。年幼的医生用了消导类的药物，各种方法都试遍了。有人因为暴泻属于热证，需要用胡黄连之类的寒凉药，结果腹泻反而加重。后来延请我诊治。诊其脉细弱乏神，按之空虚，舌苔微黑且不口渴，判断为寒邪直中太阴所致，非附子理中汤不可，拖延恐怕会发生变化。孩子的父亲说：“邪气中于太阴，我已经领教过了。但是小儿体质若是纯阳，怎么可以用热药来济助呢？”我说：“医学贵在灵活变通，不可拘泥执着一说，以闭塞见闻。”那人认为对，投用此药果然应验。这个病症与此案相似，险些被肤浅的见解所阻碍，所以记录出来给固执的人作为借鉴。
Brother Bao Ziqin had a weak constitution in his childhood. He accidentally contracted an external pathogen accompanied by food stagnation, resulting in fever and abdominal pain. The pediatrician prescribed Jingfang Baidu San (Astragalus and Saposhnikovia Decoction) with added Hawthorn Fruit (Shanzha, 山楂) and Medicated Leaven (Shenqu, 神曲). After administration, the fever subsided and pain ceased, which was regarded as a verification of therapeutic efficacy.
However, on the following day, he suddenly became bedridden, with a heavy head, closed eyes, timid breath, reluctance to speak, and refusal to drink or eat. I was urgently summoned to attend him. Observing his fatigued appearance, I palpated his pulse, which was fine, soft, and devoid of spirit. At that time, his maternal uncle, Brother Liu Yinqian, was present. I told him: "Your nephew's condition is due to the inability of Yuan Qi (Primary Qi) to sustain itself; there is a fear of collapse (Xu Tuo, 虚脱). It is imperative to use vigorous tonification immediately; delay will make rescue difficult."
Uncle Liu said: "My nephew has been ill for only two days. The resolving medicines were not overdosed. Although children's constitutions are inherently deficient, how could it lead to sudden collapse? How can one abruptly administer heavy doses of tonics?"
I replied: "The Qi of the Zang-Fu organs in children is prone to shifts between deficiency and excess. Given that the pulse and symptoms are so exhausted, there is no other strategy but this." Therefore, I imitated the method of Buyuan Jian (Tonify the Origin Decoction) and administered two doses. The illness did not yet turn for the better. His cousin was deeply worried. I said: "In treating diseases, tonifying deficiency differs from attacking excess. Attacking excess can seek rapid effect, whereas tonifying deficiency inherently lacks immediate results. If the condition does not worsen after taking medicine, it indicates that the deficiency can accept tonification, which constitutes a sign of efficacy. The ancients described 'filling' as requiring a pit or depression in the ground to accommodate the fill. If one fills flat ground, it becomes a high mound."
Consequently, I retained the original formula and added Atractylodes Rhizome (Baizhu, 白术), Poria (Fuling, 茯苓), Polygalae Radix (Yuanzhi, 远志), and Ziziphus Seed (Suanzaoren, 酸枣仁), combining them with Guipi Tang (Restore the Spleen Decoction). Adhering to this regimen for ten days (Jia Xun, 浃旬), his head could be held upright, his eyes opened, and his diet returned to normal, appearing as if he were perfectly healthy.
Note by Anbo: In the Gengchen year, I treated a young child surnamed Jin from Yuhang, aged five. His complexion was rather dull/dirty. Suddenly, he suffered from violent diarrhea with tenesmus (Bao Zhu Xia Po, 暴注下迫), causing a sudden decline in form and spirit. His urination was scanty and drop-like. Young physicians employed digestive/resolving agents, trying all available methods. Some attributed the violent diarrhea to heat, requiring herbs like Coptis Rhizoma (Huanglian, 黄连) or Picrorhiza Rhizome (Huhuanglian, 胡黄连); however, the diarrhea intensified. I was then consulted. His pulse was fine, weak, and lacking spirit, feeling empty upon pressure. The tongue coating was slightly black, and he felt no thirst. I diagnosed this as Cold Pathogen directly invading the Taiyin (Spleen/Stomach) channel, stating that only Fuzi Lizhong Tang (Aconite Decoction to Warm the Middle) would suffice; delay might lead to transformation of the disease. The father said: "I have already learned about pathogens invading Taiyin. However, children's bodies are considered Pure Yang (Chun Yang, 纯阳); how can heat be used to assist them?" I replied: "Medicine values flexibility and adaptability; one must not adhere rigidly to a single theory to limit understanding." He agreed, administered the prescription, and the result was indeed effective. This case is similar to the preceding one; it was nearly hindered by superficial views, so I recorded it as a warning for those who are stubborn.