甲申孟春连友蜚天素体孱弱。喜亲芸案。便赤梦遗。灯宵竞逐。触事忤意。遂患前症。
嗽痰
甚多。初疗降气清火之剂不瘥。至二十一日延余诊视。脉两寸洪大虚阔关尺浮缓无力。余曰
血症本非难治。但元气虚脱上浮。肝肾皆得克脉。幸喜不数然须久服参 纯王之剂方得平复
若用苦寒错治。必至成瘵。议以加减八珍汤。彼疑参难疗血。仍延前医。及二十四日增剧。
复再延余。投以前议药四剂。唾血遂止。经旬潮热亦减。惟脉未复。每多言痰嗽不止。少劳
梦遗频作。余曰心肾不交阴阳虚极必经年勿辍良剂。自可奏效。始信余言恪守禁忌。计复过
丸
剂七斤。汤剂八十余帖而愈。至酉春乃兄延余蜚天亦以脉求胗。察其六脉相生。和缓有神两
尺沉实。当主有喜。蜚天曰已得孕两月矣。至秋果举一子。
又
同时有西关外陈子珍庠生亦患前症。因疗数月不瘥。至四月十一日延余察其病源脉症。皆与连
蜚天相同。余议投参术熟地主治。彼谓血无补法。熟地性温。参术助火。误服宁不丧生。反
生议诮。仍照前医治恪服苦寒清金之剂。经年渐笃。至次夏呕血不止。又用止塞之剂。致肠
结胀痛。逾旬滨死。别请疡医。令其刀刺肛门。溃脓数盂而殁。
癸酉夏家大人署临邛。因较生童。邀学博彭予白先生衙斋阅卷。余得与促膝谭欢五晨夕。先
生尝以病脱血为苦。叹屡治不瘥。察原委盖为素下帷诵着。无间寒暄积劳所致余以为劳伤脾
肺即肾家伎巧亦为之竭矣问曰得无遇事过极。时而火热升燎首面乎。先生曰政苦有此兼症。
叠投芩连清火之剂。漫不应。法几穷矣。脉之六部沉缓。投以六味加五味肉桂人参一丸方。
先生复云血症可投温剂乎余谓其脉沉缓属虚寒。非温剂不能愈血症也。仍陈以薛立斋医案。
始信服。初只每日服钱许越数期渐效乃增至数钱。经三月五载沉 顿瘳嗣登甲戌第司理漳郡
。家大人以丙子岁归田。先生邀抵官衙。余亦往从。款洽逾昔。询前症不作。犹服六味方无
间云。
甲申年孟春（正月），我的朋友蜚天，素来体质虚弱。喜欢亲近书案读书，导致小便色赤、梦中遗精。在灯节夜晚竞相追逐游乐，遇事违心如意，于是患上了前面的病症。
咳嗽痰多。起初治疗使用降气清火的药剂，病情没有好转。到了二十一日，请我诊视。两手寸脉洪大虚阔，关尺脉浮缓无力。我说：血症本来并非难治之症，但元气虚脱上浮，肝肾都出现了克伐的脉象。幸好脉搏不数（快），然而必须长期服用纯补元气的药剂才能平复。如果使用苦寒药物错误治疗，必定会发展成痨瘵（慢性消耗性疾病）。建议用加减八珍汤。他怀疑人参难以治疗血证，仍然延请之前的医生。到了二十四日，病情加重，再次延请我。投用之前建议的药物四剂，吐血停止。过了十天，潮热也减轻，只有脉象尚未恢复。他常常多说导致痰嗽不止，稍微劳累就梦遗频作。我说：心肾不交，阴阳极度虚弱，必须长年不间断服用良方，自然可以奏效。他才相信我的话，恪守禁忌，共计服过丸药七斤，汤药八十多帖而痊愈。到了酉年春天，他的哥哥请我为蜚天诊脉，观察他的六脉相生，和缓有神，两尺脉沉实，应当主有喜兆。蜚天说已经怀孕两个月了。到了秋天果然生了一个儿子。
同时，西关外的陈子珍，庠生（秀才），也患上前一种病症。因为治疗几个月没有好转，到了四月十一日，请我探查病源脉症，都与连蜚天相同。我建议投用参、术、熟地主治。他说血证没有补法，熟地性温，参术助火，误服岂不丧命？反而产生议论讥笑。仍然照前医的方法，严格服用苦寒清金（清肺）的药剂。经过一年，病情逐渐加重，到了次年夏天呕血不止，又用止塞的药剂，导致肠道结滞胀痛。超过十天濒临死亡，另外请外科医生，让他用刀刺破肛门，溃脓几盆后死亡。
癸酉年夏天，家父代理临邛县令。因为考核生童，邀请学博彭予白先生到衙门书房阅卷。我有机会与他促膝长谈五个早晨和晚上。先生曾经以病中脱血为痛苦，感叹多次治疗没有好转。考察原委，大概是因为平时闭门诵读，不分寒暑，积劳所致。我认为劳伤脾肺，就连肾家的伎巧（生殖功能）也会为之枯竭。我问：难道不是遇事过分极端，时而火热升腾烧灼头面吗？先生说：正苦恼有此兼症。屡次投用黄芩、黄连清火的药剂，毫无反应，方法几乎穷尽了。诊察六部脉象沉缓，投用六味地黄丸加五味子、肉桂、人参一丸方。先生又说：血证可以投用温性药剂吗？我说他的脉象沉缓属于虚寒，不用温性药剂不能治愈血证。仍然陈述薛立斋的医案，才信服。起初只每天服用几钱，过了几个阶段逐渐见效，于是增加到几钱。经过三个月，五年的沉疴顿时痊愈，随后考中甲戌科进士，担任漳郡司理。家父在丙子年辞官归田，先生邀请我到官衙，我也前往跟随。款待融洽超过以往，询问前症不再发作，还说继续服用六味方不间断。
In the first month of Jiashen year, my friend Feitian, whose constitution was inherently weak, loved to study at his desk. This led to dark urine and nocturnal emissions. During the Lantern Festival nights, he competed in chasing and playing, and when matters did not go as he wished, he suffered from the aforementioned symptoms.
He coughed up excessive phlegm. Initially, treatment with agents that descend qi and clear fire failed to improve the condition. On the 21st day, I was invited to examine him. The cun pulses on both hands were large, hollow, and expansive; the guan and chi pulses were floating, slow, and powerless. I said: Hemoptysis is not inherently difficult to treat, but when primordial qi is deficient and floats upward, the liver and kidney meridians show signs of being overcome by pathological factors. Fortunately, the pulse is not rapid, but it requires long-term administration of pure tonifying agents to restore balance. If bitter-cold agents are used erroneously, it will inevitably develop into a consumptive disease (lao zhai). I proposed Jiajian Bazhen Tang (Modified Eight-Treasure Decoction). He doubted that Ren Shen (Ginseng Radix) could treat blood disorders and still consulted the previous physician. By the 24th day, the condition worsened, and I was summoned again. After administering four doses of the previously recommended medicine, the hemoptysis stopped. After ten days, tidal fever also subsided, except that the pulse had not yet recovered. He spoke excessively, leading to persistent coughing with phlegm, and slight exertion caused frequent nocturnal emissions. I said: When Heart and Kidney fail to interact, and yin and yang are extremely deficient, one must persistently take effective prescriptions for years to achieve results. Only then did he believe my words, strictly observe dietary and lifestyle taboos, and ultimately consume seven jin of pills and over eighty decoctions before recovering. In the spring of You year, his brother invited me to examine Feitian’s pulse. Observing that the six pulses generated each other harmoniously, were gentle and vigorous, and that the two chi pulses were deep and solid, I predicted good news. Feitian stated he had been pregnant for two months. Indeed, in autumn, a son was born.
At the same time, Chen Zizhen, a xiangsheng (scholar) from outside West Gate, suffered from the same condition. After several months of ineffective treatment, on April 11th, I examined his pathology, pulse, and symptoms, which were identical to those of Lian Feitian. I proposed treating with Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Rhizoma), and Shu Di Huang (Rehmanniae Radix Preparata). He argued that there is no tonification method for blood disorders, that Shu Di Huang is warm, and that Ren Shen and Bai Zhu promote fire; taking them mistakenly would cost his life. He mocked this advice and continued strictly following the previous doctor’s regimen of bitter-cold lung-clearing agents. Over a year, his condition deteriorated. By the following summer, he vomited blood incessantly. Another attempt to stop bleeding with astringent agents caused intestinal obstruction and painful distension. After more than ten days, he was near death. A surgeon was called who incised the anus with a knife, draining several basins of pus before he died.
In the summer of Guiyou year, my father, acting as magistrate of Linqiong, invited Scholar Peng Yubai to review examination papers in the official residence. I had the opportunity to converse intimately with him for five mornings and evenings. Mr. Peng often suffered from hemorrhage due to illness and sighed that repeated treatments failed. Investigating the cause, it seemed to result from prolonged study without regard for cold or heat, leading to accumulated fatigue. I believed that labor injuring Spleen and Lung would also exhaust the reproductive essence of the Kidney. I asked: Is it not because you push yourself too extreme, causing fire-heat to rise and scorch the head and face? He replied: Yes, I suffer from these accompanying symptoms. I repeatedly administered Huang Qin (Scutellariae Radix) and Huang Lian (Coptidis Rhizoma) to clear fire, but they were ineffective; my methods seemed exhausted. His six pulses were deep and slow. I prescribed Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) added with Wu Wei Zi (Schisandrae Fructus), Rou Gui (Cinnamomi Cortex), and Ren Shen (Ginseng Radix). Mr. Peng asked: Can warming agents be used for blood disorders? I said: His deep and slow pulses indicate deficiency-cold; only warming agents can cure this type of hemoptysis. I cited medical cases from Xue Lizhai, after which he finally accepted the treatment. Initially taking only a few qian per day, gradual improvement occurred over several periods, so the dose was increased to several qian. After three months, a chronic ailment lasting five years was cured. He subsequently passed the Jiaxu imperial examination and served as a judicial officer in Zhang Commandery. When my father retired in Bingzi year, Mr. Peng invited me to the official residence, where we enjoyed even closer relations than before. He inquired about his former condition, stating it had not recurred, and that he continued taking Liuwei Dihuang Wan without interruption.