当区别以处之。不可因释老之故，而概视缁黄为非类。盖有畸人逸士， 傺无聊，遁迹于其间者矣。
怪证奇疾，间或有之，不可谓古书尽诬也。即寻常病证之奇幻，亦有古书所未载者。少所见而多所怪，陋
矣；强不知以
为知，妄矣。不陋不妄，可为名医。
（注）病形奇怪，变幻万端，古书所有者，时或见之，古书所无者，时亦闻之。盖造物之化工莫测，病机
之酿疾无穷也。
（校）《宋史》吕夏卿得奇疾，身体渐缩，卒时才如小儿。他书亦有载此证者。揆之以理，其人必平时多
饵丹石热药，以致消缩，而窦材云此证宜服丹、附，最属不经。
（刊）梁应来云∶姑丈葛秋生病瘵，卒时身首缩小，名缩骨劳。可见近时亦有此证也。窦材乃妄人耳，自
诩越人再世，所着《扁鹊心书》专尚丹石，欺世盗名，害人不浅。嗣有陈远公，所着《石室秘录》，论证列方，
颇皆入理，奈蹈窦材故辙，假托轩、岐、仲景，诬圣愚人，贻讥后世，毛达可尝叹惜之。顷见番禺潘氏《海山
仙馆丛书》，所收女科书三卷，文理粗鄙，剿袭甚多，托名傅青主先生手着之秘本。潘氏不知医理，误信梓行，
玷辱青主矣。无知妄作，固不足论，以远公之学而托诸鬼神，诫不可解也，更有王养吾者，将郭氏《痧胀玉衡》
窃为己有，假托深山野人之秘授，编其原方为六十四卦，未免伤及事主。而沈芊绿不察，采入《尊生》，何丹
流受愚，重灾梨枣，案虽未破，君子病之。
医家临诊辨证，最要凝神定气。如曾世荣于船中治王千户子头疼额赤，诸治不效，动即大哭，细审知为船
篷小篾刺入囟上皮内，镊去即愈。苟不细心审视而率意妄治，吾恐医者道少、病者人费矣。
（注）凝神定气，惟心小胆大者能之，忍辱负重，惟智圆行方者能之。不如是，不足以为名医。如临一大
证，学识不足以当之，则宜举贤让能，不可蚊负以偾事；学识苟足以当之，而同道之识见不一，各抒议论者有
之，簧鼓惑听者有之，阴谋排
挤者有之，加以亲友之好恶，戚党之疑信，或热心关切，或乐祸幸灾，投剂果然渐效，群议自息，病或稍有波
澜，众楚交咻，斯时也若执德不宏，悻悻然委而去之，病付庸手，坐视其危，岂不轻弃人命乎？且事败之后，
亦未必竟无归咎之语。故非凝神定气之心思，不足以辨疑难险恶之大证，无含蓄坚忍之才力，不足以负扶危持
颠之重任也。其学识全无，不知轻重，乱投药石，惟利是图者，乃无耻之徒，不可与忍辱负重同语矣。
（校）龙儿偶患足指 肿胀痛，适山妻往侍外姑疾，疡科治之益剧，日夜啼泣不止。山妻闻而遗归，涤去
敷药谛视之，乃剃下短发一茎刺入甲 。时盛暑，小儿频脱袜，此必剃发落于鞋内所致也。镊而出之，遂愈。
正与曾案相类矣。
（刊）刺不镊出而误药妄治，在头者其祸稍轻，在趾者必至溃腐脱落而成残废。缘先慈耳目之聪明迥异于
人，故至老不衰，而又善体人情，事上抚下，无不欣感，烹饪汤药，靡不周至，戚族中如有大病，必延往主裁
，是以病情药性，诸练亦深。雄未冠以前，读《景岳全书》而喜之，遇证亦效其治法。先慈闻而痛戒曰∶信道
不笃，见异思迁，汝将为杀人之事乎？吾之阅历病证者多矣，无论外感不可妄投温补，即内伤证，必求其所伤
何病而先治其伤，则病去而元自复。古人不曰内虚而曰内伤，顾名思义，则纯虚之证殊罕见也。汝何懵乎？雄
聆训恍然渐有定见。三十年来，员不能起死人而生之，尚不致酿活病为死证者，先慈启迪之教也。今刊此案，
不禁思亲之感。
滋补丸药，最难消化，脾胃不健者，断勿轻服。香岩先生
云∶湖州沈赤文，年甫冠，读书明敏，父母爱之如掌珠。将毕姻，合全鹿丸一料，少年四人分服。赤文于冬令
服至春初，忽患浑身作痛，有如痛风，渐至腹中作痛，有形之块累累于肠，饮食不进，肌肉消瘦。诸医治之，
乃父畏用消导清火之药，惟以参、术补方是从。至秋初邀余诊视，问曰∶小儿晚间去黑粪如拳大者一块，目下
遍身如火，欲饮井水，不知何故？余按脉数大，身体骨立，验其所下之块，黑而坚硬，意为瘀血结成，
与酒蒸大黄丸二钱，下黑块不计，用水浸之，胖如黑豆。详询所以，乃全鹿丸未化也。始知为药所误，不数日
热极而死，同服三少年，一患喉痹而死，一患肛门毒而死，一患吐血咳嗽而死。此皆无病而喜服温补之害也，
录此以劝世人不必好补而服药。
（注）世人之爱其子也，始忧其不长，衣帛食肉以揠苗，继虑其虚羸，朝丸暮药为常馔，逢节则参，遇劳
则参，酿疾延劳，半由乎此。虽曰爱之，其实害之。愚谓富贵之家，何不将此终年无病所服参药之费，延医合
药，施诊贫病，报施不爽，则我之子孙自然康强逢吉，不必虑其虚羸而为无病之呻矣。岂不美哉！
香岩先生治痘多活法。尝于肩舆中见采桑妇，先生令舆人往搂之。妇大怒詈，其夫将扭舆人殴打。先生晓
之曰∶汝妇痘已在皮膜间，因气滞闭不能出，吾特激之使怒，今夜可遽发，否则殆矣，已而果验。又一富家子
病痘闭，诸医束手，先生命取新洁大漆桌十余张，裸儿卧于上，以手展转之，桌热即易，如是殆遍，至夜痘怒
发得生。又先生之外孙甫一龄，痘闭
不出，母乃抱归求救。先生视之甚逆，沉思良久，裸儿键置空室中，禁女弗启视。迨夜深始出之，痘已遍体粒
粒如珠。因空屋多蚊，借其 肤以发也。又汪益美布铺伙友壮年患痘闭，群医不能措手。先生令取鸡粪若干，
以醇酒热调如糊，遍涂其身面手足。越宿鸡矢燥落裂剥，而痘已出矣。此皆神而明之之治，录之亦可发人之慧
悟。然激之使发者，气闭也，展转于新漆之桌者，火闭也，假蚊口以嘬之者，血闭也；涂之以鸡矢醴者，寒闭
也。虽外治也，而有分别之妙义焉。苟欲效颦，亦当审谛。
（校）上论治案。
（刊）徐洄溪云∶痘证因时而变，不但历代不同，隔数十年亦有小变。余谓痘证每因时邪引动而发，万密
斋尝言之，王清任亦论之，故不但数十年有小变，即一、二年间亦有判然迥异者。盖痘有痘疫， 有 疫，儿
科拘守古法，但可以治常痘，此建中《琐言》之所以有救偏良法也。后人不知此义，辄訾其浪用石膏、大黄为
偏，谓止可以救惯用热药之偏，岂为知人论世之言哉！但痘挟疫邪，非用费氏之法不可。惜幼科罕读其书，不
识病因，往往阖境沿村，夭枉载道，诿诸天数，岂尽然欤！吾先慈幼时患痘，头面虽少，遍身密布，紫黑焦枯，
略无润泽，诸医束手。老医包士安曰∶此名螺疔痘，用大黄、石膏多剂，毫无起色，奄奄一息，已绝望矣。偶
亲串中遣一越人陈妪来探疾，见而 云∶尚可图也。亟以银针将遍身之痘逐粒挑出如黑豆者一颗，随以珍珠八
宝丹糁入，外用朱养心家碧玉膏封之，即能进粥，不劳余药而生。又定州杨素园大令云∶
阜平赵功甫邃于医，凡一切丸散，人所不能辨其中为何药者，赵一嗅而知之，历试不爽，殆与离娄之明、易牙
之舌，皆为天畀之独也。生平长于治痘，痘始萌，一望已知其结局，虽极危之证，治之无不收功。自云一生疗
痘，无药不用，而从未有用附子者。并识之，以质治痘名家。
开物成务之圣人，悯民疾苦，救其夭札，而垂以药治病之教，诚辅相裁成之大道也。乃秦政、汉武，穷奢
极欲，妄求不死，于是方伎进、邪说兴焉。故今世所传《神农本草经》、《黄帝内经》等书，皆有方伎之言附
会其中，如轻身不老、久服延年等语是也。即班氏《艺文志》亦承其陋，谓方伎之别有四∶曰医经，曰经方，
曰房中，曰神仙。夫医理经方，皆圣王康济苍生之术，岂可与房中、神仙之邪说并列为方伎哉！后人惑之，沦
于杂学，幸天纵长沙，集医经、经方之大成，置房中、神仙于不论，炎黄大道，赖以复明。于戏！此其所以为
医圣也。或老年血气衰弱，精力不充，藉药饵以佐谷肉果菜所未逮，亦人子竭力孝养之一端，固未可尽非焉。
但弗惑于邪说，妄求长生而服金石等药，以速其死耳。古书惟《元和纪用经》以不用桂、附、石药者为上丹，
犹为近理，故首录其方于下。
上丹 平补气血，健力加餐。
北五味（八两，夏月再加四两） 百部（酒宿浸焙） 菟丝子（酒宿浸焙） 淡肉苁蓉（酒浸各二两，四
季土旺，苁蓉再加六两） 杜仲（炒） 巴戟肉 远志肉（各二两，冬月远志再加六两） 甘枸杞（二两，秋
月再加六两） 防风（无叉枝者） 白茯苓 蛇床子（炒） 柏子仁（另研） 干薯蓣（各二两）
上十三味，用甘泉、桑柴火、砂锅，煎至味尽去滓，将
药汁慢火熬成膏，瓷器收盛。封置泥地或冷水中拔去火气。每晨淡盐汤调服数钱，春月用枣汤化服。
（注）医书有肥儿丸，无养老方，可见人情之浓于慈、薄于孝，故《韩氏医通》尝三叹焉。先府君年逾大
耋，神明不衰，虽知医而素不服药，独谆谆以养老为言。夫良医不治老，老岂能治之转少哉？然药以扶老，使
之康健而少病，未始非怡清养志之先务，虽以药扶老，实以孝治人耳。上丹本是丸方，恐老人脾气不健，运化
殊难，改丸为膏，俾易融洽。酒宿浸者，酒浸一宿也。
集灵膏 人年五十，阴气先衰，老人阴亏者多，此方滋养真阴，柔和筋骨。
西洋参（取结实壮大者，刮去皮，饭上蒸九次，日中晒九次） 甘杞子 怀牛膝（酒蒸） 天冬 麦冬
怀生地 怀熟地 仙灵脾
上八味，等分，熬成膏，白汤或温酒调服。
（注）此方始见于《广笔记》，无仙灵脾，云出内府，又载于《治法汇》，并无牛膝。方后法血虚加当归
四两，脾弱加白术四两或八两。且云治一切气血两虚，身弱咳嗽者，罔不获效。凡少年但觉气弱倦怠，津液少
，虚火上炎，急宜服之，免成劳损。后惟魏玉横先生善用此方，《续名医类案》极言其功效。愚谓即人参固本
加味也，峻补肝肾之阴，实无出此方之上者。原方用人参，近年参价甚昂，非大力者不能致，易以西洋
参，可与贫富共之矣。方名“集灵”，则以有仙灵脾者为是。《理虚元鉴》治劳嗽，于原方去参、膝，加甘、
桔、元参。
（刊）如治阴虚遗带，宜去牛膝，加黄柏。凡便滑者，亦宜
去牛膝，重加生薏苡仁。
草灵丹 老人阳气偏虚，便溺不禁者，用此温补下元，可以耐冷。
茅山苍术（泔水浸，刮去皮，饭锅上酒蒸透） 川椒红（各四两） 怀熟地 干薯蓣（各三两） 炙甘
草茯苓（各二两） 茴香（二两盐水炒） 川乌（制一两）
上八味，将六味研细末，以熟地杵膏、薯蓣煮糊，共杵丸，梧子大。每三十丸，空心淡盐汤下，以干食物
压之。
（注）脾肾两亏，内挟寒湿者，此方宜方。若阴虚火盛之人，不可服也。
十灰散 治吐血、咯血、嗽血，先用此药止之。
大蓟 小蓟 荷叶 扁柏叶 茅根 茜根 栀子 大黄 丹皮 棕榈皮
上十味，等分烧灰存性，研极细末，以纸包置泥地上一夕出火气。每服五钱，藕汁或芦菔汁或京墨汁半碗
调服。
（注）按原注云∶吐血者竞推葛氏，而先生首以此方止血，明明劫剂，毫无顾忌，细玩始知先生意之到、
理之精也，人生于阳，根于阴，阴气亏则阳自胜，上气为之喘促，咳吐痰沫，发热面红，无不相因而至，故留
得一分自家之血，即减得一分上升之火，易为收拾。何今日之医动以引火归经为谈，不可概用止血之味，甚至
有吐出亦美，壅反为害，遂令迁延时日，阴虚阳旺，煎熬不止。至于不救。果谁之咎？执引经而缓时日，冀复
元神，吾恐有形之血岂能使之速生，而无偶之阳何法使之速降？此先生所以急于止血之大旨也。
（刊）诸药烧黑，皆能止血，故以“十灰”名其方。然止涩
之品仅棕榈一味，余皆清血之热、行血之滞、破血之瘀者，合以为剂，虽主止血而无兜涩留瘀之弊，雄每用之
，并无后患，何可视为劫剂乎？
太平丸 治久嗽肺萎肺痈。
天冬 麦冬 知母 川贝母 款冬花（各三两） 杏仁 当归 熟地 生地 黄连（各一两五钱） 蒲
黄京墨 桔梗 薄荷（各一两）
上十四味，研细末和匀，以白蜜四两，于银石器中炼熟，再入黑驴皮胶一两五钱，俟烊后下诸药末搅匀，
再入麝香少许，熬二、三沸，即丸弹子大。食后细嚼一丸，薄荷汤缓缓化下。临卧噙此丸仰卧，使药流入肺窍
，则肺清嗽减。凡咳嗽服此，七日自痊。
（注）肺居膈上，汤药荡涤宜下，已过病所，宜乎难效，此噙化法之所以妙也。后庄一生治气郁痰凝，胸
膈痞塞，用人参、贝母、苦参、沉香、薄荷，为末蜜丸，噙口中听其自化，徐徐沁入。可谓善得师者。
润肺膏 治久嗽肺燥肺萎。
羊肺（一具） 杏仁（净研） 柿霜 真酥 真粉（各一两） 白蜜（二两）
上将羊肺洗净，次将五味入水搅粘，灌入肺中，白水煮熟，如常服食。
应当加以区别对待。不能因为释教（佛教）和道教的原因，就一概视僧侣道士为非同类之人。大概有那些性格怪僻、超脱世俗的人，因感到无聊，而隐居在佛道之中。
怪异的病症，偶尔也会有，不能说古书全是虚妄的。即使是寻常病证的奇特变化，也有古书未曾记载的。见识少就觉得奇怪，这是浅陋；不懂装懂，这是狂妄。不浅陋不狂妄，才可以成为名医。
（注）病情形态奇怪，变幻万端，古书中有的，有时也能见到；古书中没有的，有时也听说过。大概是造化的神奇莫测，病机酿成疾病的无穷无尽啊。
（校）《宋史》记载吕夏卿得了奇疾，身体逐渐缩小，死时只有小孩那么大。其他书籍也有记载此证的。推究其理，此人平时一定多服用丹石类热药，导致身体消缩，而窦材说此证适宜服用丹砂、附子，最属荒谬不经。
（刊）梁应来说：姑丈葛秋天生病患痨病，死时身体头部缩小，名叫“缩骨劳”。可见近代也有此证。窦材是个狂妄之人，自诩为扁鹊再生，所著《扁鹊心书》专门崇尚丹石之药，欺世盗名，害人匪浅。后来有陈远公，所著《石室秘录》，论证列方，颇为入理，奈何蹈袭窦材的老路，假托轩辕、岐伯、张仲景之名，诬蔑圣人愚弄愚人，被后世讥笑，毛达可曾对此叹息惋惜。近来见到番禺潘氏《海山仙馆丛书》，所收录的女科书三卷，文理粗俗鄙陋，抄袭很多，托名傅青主先生手著的秘本。潘氏不懂医理，误信并刊印，玷污了傅青主的名声。无知妄作，本来不值得谈论，但像陈远公那样以学问假托鬼神，实在令人不解。更有王养吾者，将郭氏的《痧胀玉衡》窃为己有，假托深山野人的秘密传授，将其原方编排为六十四卦，未免伤害了原作者。而沈芊绿不加考察，采录入《尊生集》，何丹流受人愚弄，再次刻印，案件虽未侦破，君子对此感到痛心。
医家临诊辨证，最重要的是凝神定气。比如曾世荣在船上治疗王千户儿子的头疼额赤，各种治疗都不见效，一动就大哭，仔细审察知道是船篷的小竹刺扎入囟门上皮内，镊去后就痊愈了。如果不细心审视而随意乱治，我恐怕医生道行浅薄、病人白白花费钱财了。
（注）凝神定气，只有小心谨慎、胆量宏大的人才能做到；忍辱负重，只有智慧圆通、行为方正的人才能做到。不这样，不足以成为名医。比如面对一个重大疑难病症，学识不足以胜任，就应该举荐贤能，不可勉强承担而导致事情失败；学识如果足以胜任，而同行的见识不一，各自发表议论的有之，摇唇鼓舌迷惑听众的有之，阴谋排挤的有之，再加上亲友的好恶，亲戚党羽的怀疑或信任，有的热心关切，有的幸灾乐祸。投药果然逐渐见效，众人的议论自然停止；病情稍有波动，众人便纷纷指责。在这个时候，如果道德修养不宏大，愤愤不平地辞职离去，把病人交给庸医，坐视其危险，难道不是轻弃人命吗？况且事情败露之后，也未必完全没有归咎的话语。所以没有凝神定气的思想，不足以辨别疑难险恶的重大病症；没有含蓄坚忍的才力，不足以承担扶危救急的重任。那些学识全无、不知轻重、乱投药石、唯利是图的，乃是无耻之徒，不可以与他们谈论忍辱负重。
（校）龙儿偶然患足趾肿胀疼痛，适逢妻子去侍奉婆婆的病，外科医生治疗反而加重，日夜啼哭不止。妻子听说后赶回来，洗去敷药仔细查看，原来是剃下的短发一根刺入指甲中。当时正值盛夏，小儿频繁脱袜子，这一定是剃发落在鞋内所致。镊出头发，于是痊愈。正与曾世荣的案例相似。
（刊）刺入物不镊出而误用药物乱治，在头部的祸害稍轻，在脚趾的必然导致溃烂腐坏脱落而成残废。因为我母亲耳目聪明异于常人，所以到老不衰，又善于体察人情，侍奉长辈抚育晚辈，无不欣喜感动，烹饪汤药，无不周到细致，亲戚族人中如有大病，必请她前往主持裁决，所以对病情药性，练习得非常深。我雄在未成年以前，读《景岳全书》而喜欢它，遇到病症也效仿其治法。先母听说后严厉告诫说：信仰不坚定，见异思迁，你要做杀人的事吗？我阅历过的病证很多了，无论外感病不可妄投温补药，就是内伤病，必须探求其所伤的是什么病而先治其伤，那么病去元气自然恢复。古人不说内虚而说内伤，顾名思义，纯虚的证候非常罕见。你怎么这么糊涂呢？我聆听教诲恍然渐有定见。三十年来，虽然不能让死人复活，尚不至于把活人治成死证，这都是先母启迪教导的结果。现在刊印此案，不禁产生思念亲人的感慨。
滋补丸药，最难消化，脾胃不健的人，千万不要轻易服用。香岩先生说：湖州沈赤文，刚成年，读书聪明敏捷，父母爱他如掌上明珠。即将结婚，配制了一料全鹿丸，四个少年分服。赤文在冬天服用到春初，忽然患浑身疼痛，好像痛风，逐渐发展到腹中疼痛，肠中有形肿块累累，饮食不进，肌肉消瘦。众医生治疗，其父畏惧使用消导清火的药，只听从人参、白术等补方。到秋初邀请我诊治，问他说：小孩子晚上排出拳头大的一块黑粪，眼下全身如火烧，想喝井水，不知道什么原因？我按脉象数大，身体瘦骨嶙峋，检验他所排出的肿块，黑而坚硬，认为是瘀血结成，给予酒蒸大黄丸二钱，排出黑块无数，用水浸泡，肿得像黑豆一样。详细询问原因，原来是全鹿丸没有消化。这才知道是被药物所误，不到几天热极而死，同服的三个少年，一个患喉痹而死，一个患肛门毒而死，一个患吐血咳嗽而死。这都是无病而喜欢服用温补药的害处，记录此案例以劝告世人不必喜好进补而服药。
（注）世人爱护自己的儿子，开始担忧他不长高，穿丝绸吃肉来拔苗助长，接着担心他虚弱羸弱，早晚吃药当作常饭，逢节日则吃人参，遇劳累则吃人参，酿成疾病延长病程，一半由此造成。虽然说爱他，其实是害他。我认为富贵人家，何不把这终年无病所服参药的费用，延请医生合药，施诊给贫苦病人，报应不爽，那么我的子孙自然康强吉祥，不必担心他们虚弱羸弱而无病呻吟了。难道不美好吗！
香岩先生治疗痘疹有很多活法。曾经在轿中看见采桑妇人，先生让轿夫去搂抱她。妇人大怒辱骂，她的丈夫将要扭打轿夫。先生开导他说：你妻子的痘疹已经在皮膜间，因为气滞闭塞不能发出，我特意激怒她使她生气，今晚可以迅速发出，否则就危险了，后来果然应验。又一个富家子弟患痘疹闭塞，众医生束手无策，先生命令取新洁的大漆桌十几张，让婴儿裸身躺在上面，用手翻动，桌子热了就换，如此几乎遍遍，到了晚上痘疹怒发得以生存。还有先生的外孙刚满一岁，痘疹闭而不发，母亲抱着回来求救。先生看他的症状很逆，沉思良久，让婴儿裸身锁在空室中，禁止女儿进去看。等到夜深才出来，痘疹已经遍布全身颗粒如珠。因为空屋蚊子多，借蚊子叮咬皮肤来发散痘毒。还有汪益美布铺伙计壮年患痘疹闭塞，群医不能措手。先生命令取鸡粪若干，用醇酒热调成糊状，遍涂其身面手足。过了一夜鸡屎干燥脱落裂开，而痘疹已经发出了。这些都是神妙明察的治疗，记录下来也可以启发人的智慧悟性。然而激怒使其发出的，是气闭；在新漆桌子上翻动的，是火闭；借蚊子口吸吮的，是血闭；涂抹鸡矢醪的，是寒闭。虽然是外治法，却有分别治疗的微妙义理。如果想要模仿，也应当审慎观察。
（校）以上论述治疗案例。
（刊）徐洄溪说：痘证随着时代而变化，不但历代不同，隔几十年也有小变。我认为痘证每因时邪引动而发，万密斋曾经说过，王清任也论述过，所以不但数十年有小变，就是一两年间也有判然迥异者。大概痘有痘疫，有痘疹，儿科拘守古法，只能治疗常痘，这是建中《琐言》之所以有纠正偏颇的良好方法。后人不懂这个意义，往往指责其浪用石膏、大黄为偏颇，说只能救治惯用热药的偏颇，这难道是知人论世的话吗！但是痘挟带疫邪，非用费伯雄的方法不可。可惜幼科医生很少读他的书，不认识病因，往往整个境界沿村，夭折载道，推委给天数，难道都是这样吗！我母亲小时候患痘疹，头面虽然少，遍身密布，紫黑焦枯，毫无润泽，众医生束手。老医生包士安说：这叫螺疔痘，用大黄、石膏多剂，毫无起色，奄奄一息，已经绝望了。偶然亲戚中派一位姓陈的老妪来探病，看了说：还可以图谋治疗。急忙用银针将遍身的痘疹逐粒挑出如黑豆大小的一颗，随即撒上珍珠八宝丹，外用朱养心家的碧玉膏封住，就能进粥，不需其余药物而生还。又有定州杨素园县令说：阜平赵功甫精通医术，凡是一切丸散，别人不能辨认其中是什么药的，赵一闻就知道，历试不爽，大概与离娄的眼睛明亮、易牙的舌头灵敏，都是天赋的独特才能。生平擅长治疗痘疹，痘疹刚开始萌芽，一望已知其结局，即使极危险的证候，治疗无不收功。自称一生疗痘，无药不用，却从未有用附子的。一并记下，以此向治痘名家请教。
开物成务的圣人，怜悯百姓疾苦，拯救他们的夭折，而留下用药治病的教导，确实是辅助天地裁成万物的大道啊。然而秦始皇、汉武帝，穷奢极欲，妄求不死，于是方技进献，邪说兴起。所以现在流传的《神农本草经》、《黄帝内经》等书，都有方技之言附会其中，如轻身不老、久服延年等话语就是。就连班固的《艺文志》也承袭这种陋习，谓方技的区别有四：曰医经，曰经方，曰房中，曰神仙。医理经方，都是圣王救济苍生的技术，岂可与房中、神仙的邪说并列为方技呢！后人迷惑于此，沦于杂学，幸好上天赋予长沙王（指张仲景，曾任长沙太守）集医经、经方之大成，置房中、神仙于不论，炎黄大道，赖以重新光明。唉！这就是他被称为医圣的原因。或者老年人血气衰弱，精力不充，借助药饵来补充谷肉果菜所不及的地方，也是子女竭力孝养的一个方面，本来也不可谓全非。只是不要被邪说迷惑，妄求长生而服用金石等药，加速死亡罢了。古书中只有《元和纪用经》以不用桂枝、附子、石药者为上丹，还算接近道理，所以首先收录其方在下面。
上丹 平补气血，健力加餐。
北五味子（八两，夏季月再加四两） 百部（酒浸一夜焙干） 菟丝子（酒浸一夜焙干） 淡肉苁蓉（酒浸各二两，四季土旺之时，苁蓉再加六两） 杜仲（炒） 巴戟天肉 远志肉（各二两，冬季月远志再加六两） 甘枸杞（二两，秋季月再加六两） 防风（无叉枝者） 白茯苓 蛇床子（炒） 柏子仁（另研） 干山药（各二两）
以上十三味，用甘泉、桑柴火、砂锅，煎至味道尽出去掉药渣，将药汁慢火熬成膏，瓷器收盛。密封放置在泥地或冷水中拔去火气。每晨淡盐汤调服数钱，春季用枣汤化服。
（注）医书有肥儿丸，没有养老方，可见人情重于慈爱、薄于孝顺，所以《韩氏医通》曾三次感叹。先父年过八十，神明不衰，虽然懂医而平时不服药，唯独谆谆教导以养老为重。良医不治老人，老人岂能治好转年轻呢？然而药以扶助老人，使他们康健而少病，未尝不是怡情清雅养志的先务，虽然以药扶老，实则是以孝道治理人心。上丹本是丸方，恐怕老人脾气不健，运化特别困难，改丸为膏，使之容易消化吸收。酒浸一夜，就是酒浸一宿。
集灵膏 人年五十，阴气先衰，老人阴亏的多，此方滋养真阴，柔和筋骨。
西洋参（取结实壮大者，刮去皮，饭上蒸九次，日中晒九次） 甘枸杞 怀牛膝（酒蒸） 天冬 麦冬 怀生地 怀熟地 淫羊藿
以上八味，等分，熬成膏，白开水或温酒调服。
（注）此方始见于《广笔记》，没有淫羊藿，说是出自内府，又记载于《治法汇》，并没有牛膝。方后注明血虚加当归四两，脾弱加白术四两或八两。并且说治疗一切气血两虚，身体虚弱咳嗽者，无不获效。凡是少年只觉得气弱倦怠，津液少，虚火上炎，急宜服用，以免成为劳损。后来只有魏玉横先生善用此方，《续名医类案》极力赞扬其功效。我认为这就是人参固本汤加味，峻补肝肾之阴，实在没有超过此方的。原方用人参，近年人参价格甚昂，不是财力雄厚者不能得到，改用西洋参，可以与贫富共用。方名“集灵”，是因为有淫羊藿的缘故。《理虚元鉴》治疗劳嗽，在原方中去掉人参、牛膝，加甘草、桔梗、玄参。
（刊）如治疗阴虚遗精白带，宜去掉牛膝，加黄柏。凡是大便滑泄的，也宜去掉牛膝，重加生薏苡仁。
草灵丹 老人阳气偏虚，小便失禁的，用此温补下元，可以耐冷。
茅山苍术（泔水浸，刮去皮，饭锅上酒蒸透） 川椒红（各四两） 怀熟地 干山药（各三两） 炙甘草 茯苓（各二两） 茴香（二两盐水炒） 川乌（制一两）
以上八味，将六味研细末，以熟地捣膏、山药煮糊，共同捣丸，梧桐子大。每三十丸，空腹淡盐汤送下，以干食物压住。
（注）脾肾两亏，内挟寒湿的，此方适宜。若阴虚火盛的人，不可服用。
十灰散 治疗吐血、咯血、嗽血，先用此药止之。
大蓟 小蓟 荷叶 侧柏叶 茅根 茜根 栀子 大黄 丹皮 棕榈皮
以上十味，等分烧灰存性，研极细末，用纸包放置泥地上一晚出火气。每服五钱，藕汁或芦菔汁或京墨汁半碗调服。
（注）按原注说：吐血者竞相推崇葛氏（葛洪），而先生首先以此方止血，明明是劫剂，毫无顾忌，细细玩味才知道先生意旨到位、道理精微。人生于阳，根于阴，阴气亏则阳自胜，上气为之喘促，咳吐痰沫，发热面红，无不相因而至，所以留得一分自家之血，即减得一分上升之火，容易收拾。为什么今天的医生动不动就以引火归经为谈资，不可概用止血之味，甚至有认为吐出也好，壅塞反而为害，遂令迁延时日，阴虚阳旺，煎熬不止。至于无法救治。究竟是谁的过错？执着引经而缓时日，希望恢复元神，我恐怕有形之血岂能使之速生，而无偶之阳何法使之速降？这就是先生急于止血的大旨。
（刊）诸药烧黑，都能止血，所以以“十灰”命名其方。然而止涩之品仅棕榈一味，其余都是清血热、行血滞、破血瘀的，合以为剂，虽主止血而无兜涩留瘀的弊病，我每次使用，并无后患，怎么可以视为劫剂呢？
太平丸 治疗久嗽肺萎肺痈。
天冬 麦冬 知母 川贝母 款冬花（各三两） 杏仁 当归 熟地 生地 黄连（各一两五钱） 蒲黄 京墨 桔梗 薄荷（各一两）
以上十四味，研细末和匀，以白蜜四两，在银石器中炼熟，再入黑驴皮胶一两五钱，待融化后下诸药末搅匀，再入麝香少许，熬二、三沸，即丸弹子大。食后细嚼一丸，薄荷汤缓缓化下。临卧含此丸仰卧，使药流入肺窍，则肺清嗽减。凡咳嗽服此，七日自痊。
（注）肺居膈上，汤药荡涤宜下行，已过病所，理应难效，此噙化法之所以妙也。后来庄一生治疗气郁痰凝，胸膈痞塞，用人参、贝母、苦参、沉香、薄荷，为末蜜丸，含在口中听其自然融化，徐徐沁入。可以说是善于学习老师的人。
润肺膏 治疗久嗽肺燥肺萎。
羊肺（一具） 杏仁（净研） 柿霜 真酥 真粉（各一两） 白蜜（二两）
上将羊肺洗净，其次将五味入水搅粘，灌入肺中，白水煮熟，如常服食。
One must distinguish and treat accordingly. One should not, due to the influence of Buddhism (Shi) and Daoism (Lao), generally regard monks and priests as belonging to a different category. There are indeed eccentric and reclusive individuals who, feeling bored or unappreciated, hide themselves within these religious communities.
Strange diseases occasionally occur; one cannot claim that ancient texts are entirely false. Even the bizarre manifestations of ordinary diseases may be unrecorded in ancient books. To find strange what one has rarely seen is ignorance; to pretend to know what one does not know is presumption. Being neither ignorant nor presumptuous qualifies one to be a renowned physician.
(Note): Disease presentations are strange and changeable. What is recorded in ancient texts is sometimes seen; what is not recorded is sometimes heard of. This is because the creative power of nature is unfathomable, and the pathogenesis of disease is infinite.
(Collation): *History of Song* records that Lü Xiaqing suffered from a strange disease where his body gradually shrank, and at death he was only the size of a child. Other books also record this condition. Reasoning logically, such a person likely consumed many hot medicines like cinnabar and stone minerals regularly, causing the shrinkage. Dou Cai's claim that this condition should be treated with cinnabar and Aconite (*Fuzi*) is most absurd.
(Publication): Liang Yinglai stated: My uncle-in-law Ge Qiutian suffered from consumption (*Zhai*), and upon death, his body and head had shrunk, a condition named "Bone-Shrinking Consumption" (*Suogu Lao*). Thus, this condition exists in modern times. Dou Cai was a reckless man, boasting of being Bian Que reborn. His work *Bianque Xinshu* (*Heart Book of Bianque*) exclusively advocates mineral drugs, deceiving the world for fame and harming people significantly. Later, Chen Yuan Gong wrote *Shishi Milu* (*Secret Records of the Stone Chamber*). His discussions and prescriptions were quite reasonable, yet he followed Dou Cai's old path, falsely claiming endorsement by Xuanyuan, Qibo, and Zhang Zhongjing, insulting sages and fooling fools, thereby earning ridicule from later generations. Mao Dakai once sighed over this. Recently, I saw the *Haishan Xianguan Congshu* published by the Pan family of Panyu, which included three volumes of gynecological texts. The prose was crude and plagiarized heavily, falsely attributed to Mr. Fu Qingzhu's secret manuscripts. Mr. Pan, lacking medical knowledge, mistakenly believed and printed them, disgracing Mr. Qingzhu. Ignorant and reckless acts are hardly worth discussing, but it is incomprehensible how someone with Chen Yuan Gong's learning would resort to ghosts and gods. Furthermore, Wang Yangwu stole Guo Shi's *Shazhang Yuheng* (*Jade Balance for Sha Distension*), claiming it was secretly taught by hermits in deep mountains, and arranged its original formulas into the sixty-four hexagrams, which harmed the original author. Shen Qianlü, without investigation, included it in *Zunsheng Ji*, and He Danliu, deceived, reprinted it. Although the case is unsolved, gentlemen lament it.
When physicians examine patients and differentiate syndromes, the most crucial aspect is to concentrate their spirit and stabilize their qi. For example, Zeng Shirong treated the headache and red forehead of the son of Commander Wang on a boat. Various treatments failed, and the boy cried loudly whenever moved. Upon careful examination, Zeng discovered a small bamboo splinter from the boat canopy had pierced the skin above the anterior fontanelle. Removing it with tweezers cured him immediately. If one does not examine carefully and treats rashly, I fear the physician will lack depth in their art, and the patient will suffer unnecessary costs.
(Note): Concentrating spirit and stabilizing qi can only be achieved by those who are cautious yet bold. Bearing humiliation and heavy responsibility can only be achieved by those who are wise and upright. Without these qualities, one cannot be a renowned physician. When facing a major critical illness, if one's knowledge is insufficient, one should recommend a capable colleague rather than forcing oneself to act and failing. If one's knowledge is sufficient, but colleagues have differing views—some arguing, some confusing listeners with rhetoric, some conspiring to exclude—one must also deal with the preferences of relatives and friends, and the suspicion or trust of clansmen. Some may be warmly concerned, while others rejoice in disaster. If the prescribed medicine gradually takes effect, public criticism will cease; if the condition fluctuates slightly, everyone will criticize. At such times, if one lacks broad moral integrity and leaves resentfully, handing the patient to an incompetent doctor and watching them perish, is this not abandoning human life lightly? Moreover, after failure, there will inevitably be blame. Therefore, without a concentrated and stable mind, one cannot discern difficult and dangerous syndromes; without tolerance and endurance, one cannot bear the heavy responsibility of rescuing the critically ill. Those with no knowledge, who do not understand gravity, throw medicines around blindly, and seek only profit, are shameless scoundrels and cannot be compared to those who bear humiliation and responsibility.
(Collation): Long'er once suffered from swelling and pain in his toe. His wife was away caring for her mother-in-law, and the surgeon's treatment worsened the condition, causing the child to cry day and night. Upon returning, his wife washed off the applied medicine and examined closely, discovering a single hair from a haircut had pierced the nail bed. It was midsummer, and the child frequently took off socks; the hair must have fallen into the shoe. Removing it with tweezers cured him. This is similar to Zeng's case.
(Publication): If a foreign body is not removed and is treated with mistaken medications, the consequences in the head are slightly less severe, but in the toe, it will certainly lead to ulceration, necrosis, and amputation. My mother possessed exceptional hearing and vision, remaining sharp until old age. She was adept at understanding human feelings, treating elders and juniors with joy and gratitude. Her cooking and preparation of medicinal decoctions were meticulous. Whenever serious illnesses occurred among relatives, she was invited to preside over the treatment, so she had deep experience with disease conditions and drug properties. Before I came of age, I read *Jingyue Quanshu* (*Complete Works of Jingyue*) and admired it, often imitating its treatment methods when encountering cases. My mother sternly warned me: "If your faith in the Way is not firm and you are swayed by different ideas, will you become a killer? I have experienced many disease conditions. Regardless of external contraction, one must not recklessly use warming and tonifying herbs. Even for internal injury, one must first determine the nature of the injury and treat that first. Then the disease will leave, and the primordial qi will recover. The ancients did not say 'internal deficiency' but 'internal injury'; by name and meaning, pure deficiency is rare. Why are you so confused?" Hearing this instruction, I gradually gained clarity and resolve. For thirty years, although I cannot bring the dead back to life, I have not turned living patients into dying ones, thanks to my mother's enlightenment. Publishing this case now, I cannot help but feel longing for my parent.
Tonifying pill medicines are hardest to digest. Those with weak spleen and stomach should never take them lightly. Mr. Xiangyan said: Shen Chiwen from Huzhou, just coming of age, was bright and studious, loved by his parents like a pearl. Just before his marriage, he and three other young men shared a dose of Quanlu Wan (*Whole Deer Pill*). Chiwen took it from winter into early spring, then suddenly suffered whole-body pain resembling gout, progressing to abdominal pain with palpable lumps in the intestines, loss of appetite, and emaciation. Various doctors treated him, but his father feared using digestive and clearing-fire herbs, relying solely on Ginseng (*Renshen*) and Atractylodes (*Baizhu*) tonics. In early autumn, he invited me to consult. I asked: "Does the child pass a fist-sized black stool at night? Is his body burning hot now, desiring well water?" I felt his pulse: rapid and large. His body was skeletal. Examining the passed lump, it was black and hard, suggesting blood stasis. I gave him two qian of Jiu Zheng Dahuang Wan (*Wine-Steamed Rhubarb Pill*). He passed numerous black lumps; soaking one in water made it swell like a black soybean. Detailed inquiry revealed the cause: the Quanlu Pill had not digested. Realizing the error, he died of extreme heat within days. Of the three youths who took it together, one died of throat obstruction (*Houbi*), one of anal toxicity, and one of hemoptysis and cough. These are harms of taking warming tonics without illness. Recording this to advise people not to love tonics and take medicine unnecessarily.
(Note): People love their children, worrying initially about their growth, feeding them silk and meat to force growth (like pulling shoots to help them grow). Later, worrying about their weakness, they make pills and medicines daily meals. They take Ginseng (*Renshen*) on festivals and when tired, breeding disease and chronic fatigue, half due to this. Though called love, it is actually harm. I suggest wealthy families: why not spend the money used on Ginseng taken year-round without illness, hire a doctor to prepare medicine, and give it to the poor and sick? Retribution is sure. Then our descendants will naturally be healthy and auspicious, without needing to worry about weakness or moan without illness. How beautiful!
Mr. Xiangyan had many flexible methods for treating smallpox. Once, seeing a mulberry-picking woman from his sedan chair, he ordered the carriers to embrace her. The woman cursed angrily, and her husband tried to beat the carriers. Mr. Xiangyan explained: "Your wife's smallpox is between the skin and membrane, blocked by stagnant qi and unable to erupt. I deliberately angered her to promote eruption tonight; otherwise, it will be fatal." It proved true. Another rich family's son had closed smallpox; doctors were helpless. Mr. Xiangyan ordered ten new, clean lacquered tables. The naked child lay on them, and Mr. Xiangyan rolled him back and forth. When the table heated up, it was replaced. After many repetitions, the smallpox erupted vigorously at night, saving the child. Again, Mr. Xiangyan's grandson, aged one, had closed smallpox. The mother brought him for rescue. Mr. Xiangyan observed the adverse signs, pondered for a long time, then locked the naked child in an empty room, forbidding his daughter from entering. At nightfall, he emerged; the smallpox had covered the body like pearls. Because the empty room had many mosquitoes, their bites helped induce eruption. Also, Wang Yimei, a clerk in a cloth shop, suffered from closed smallpox in his prime. Doctors could not handle it. Mr. Xiangyan ordered chicken feces mixed with strong wine into a paste, applied all over the body, face, hands, and feet. Overnight, the chicken dung dried, cracked, and fell off, and the smallpox had erupted. These are divine and insightful treatments, recorded to inspire wisdom. However, inducing eruption by anger addresses qi closure; rolling on lacquered tables addresses fire closure; mosquito bites address blood closure; applying chicken dung addresses cold closure. Although external treatments, they have subtle distinctions. Imitators must examine carefully.
(Collation): Above discusses treatment cases.
(Publication): Xu Huixi said: Smallpox changes with the times, not only differing across dynasties but also having minor variations every few decades. I believe smallpox often erupts triggered by seasonal pathogens. Wan Mizhai mentioned this, and Wang Qingren discussed it. Thus, there are significant differences even within one or two years. Smallpox includes epidemic smallpox and regular smallpox. Pediatricians sticking to ancient methods can only treat regular smallpox. This is why Jianzhong's *Suoyan* (*Trivial Words*) offers good methods to correct biases. Later generations, not understanding this, criticize the liberal use of Gypsum (*Shigao*) and Rhubarb (*Dahuang*) as biased, saying it only corrects the bias of habitual heat-drug use. Is this truly knowing the person and their era? But when smallpox carries epidemic pathogens, Fei Yi's methods are indispensable. Regrettably, pediatricians rarely read his book, failing to recognize the etiology, leading to mass deaths across villages, blaming fate. Is it really so? My mother suffered from smallpox in childhood. Though sparse on the head and face, it was dense all over the body, purple-black, scorched, and dry. Doctors were helpless. Old Doctor Bao Shian said: "This is called Snail Carbuncle Smallpox (*Luoding Dou*). Using multiple doses of Rhubarb and Gypsum showed no improvement. She was dying, hope lost." Coincidentally, a relative sent an old woman surnamed Chen to visit. Seeing the case, she said: "It can still be treated." She quickly used silver needles to prick each smallpox pustule the size of a black bean, sprinkled Zhenzhu Babao Dan (*Pearl Eight-Treasure Powder*), and sealed it externally with Zhu Yangxin's Biyu Gao (*Jasper Ointment*). The patient could eat porridge and survived without further medicine. Director Yang Suyuan from Dingzhou said: Zhao Gongfu from Fuping was profound in medicine. For any pills or powders, others couldn't identify the ingredients, but Zhao knew by smell alone, always accurate. Like Llou's keen eyes or Yi Ya's sensitive tongue, it was a unique heavenly gift. He specialized in smallpox. From the first bud, he could foresee the outcome. Even in critical cases, treatment succeeded. He claimed to have used every medicine in his life but never Aconite (*Fuzi*). I record this to consult smallpox experts.
The sage who opens things and accomplishes affairs, pitying people's suffering and saving them from premature death, left teachings on using medicine to cure diseases. This is indeed the great way of assisting heaven and earth in nurturing creation. However, Qin Shi Huang and Han Wu Di, indulging in luxury and desire, sought immortality wildly. Thus, artisans advanced, and heretical theories arose. Therefore, transmitted texts like *Shennong Bencao Jing* (*Divine Farmer's Materia Medica*) and *Huangdi Neijing* (*Yellow Emperor's Inner Canon*) contain artisanal additions, such as "lightening the body," "not aging," and "longevity with prolonged use." Even Ban Gu's *Yiwenzhi* (*Treatise on Literature*) inherited this prejudice, classifying arts into four: Medical Classics, Classic Prescriptions, Bedroom Arts, and Immortals. Medical classics and classic prescriptions are techniques of sage kings to save the people. How can they be listed alongside the heresies of bedroom arts and immortals? Later generations were confused, falling into miscellaneous studies. Fortunately, Heaven endowed Changsha (Zhang Zhongjing) with the greatness of integrating medical classics and classic prescriptions, disregarding bedroom arts and immortals. The Great Way of Yan and Huang was thus revived. Alas! This is why he is the Sage of Medicine. Or, for elderly people with declining blood and qi and insufficient energy, using medicine to supplement grains, meats, fruits, and vegetables is one aspect of filial piety. It is not entirely wrong. But one must not be confused by heresies, seeking immortality by taking metal and stone drugs, which accelerates death. Among ancient books, only *Yuanhe Jiyong Jing* considers formulas without Cinnamon Twig (*Guizhi*), Aconite (*Fuzi*), or mineral drugs as "Upper Elixir" (*Shangdan*), which is reasonable. So, I record its formula below.
**Upper Elixir (*Shangdan*)**: Balances and tonifies qi and blood, strengthens strength, and increases appetite.
* Schisandra Berry (*Beiwuweizi*) (8 liang, add 4 liang in summer)
* Stemona Tuber (*Baibu*) (soaked in wine overnight, baked)
* Dodder Seed (*Tusizi*) (soaked in wine overnight, baked)
* Cistanche Stem (*Dan Rongcongrou*) (soaked in wine, 2 liang each; during Earth months of four seasons, add 6 liang of Cistanche)
* Eucommia Bark (*Duzhong*) (stir-fried)
* Morinda Root (*Bajirou*)
* Polygala Root (*Yuanzhi rou*) (2 liang each; in winter, add 6 liang of Polygala)
* Goji Berry (*Gan Gouqi*) (2 liang; in autumn, add 6 liang)
* Saposhnikovia Root (*Fangfeng*) (without forked branches)
* Poria (*Bai Fuling*)
* Cnidium Fruit (*Shechuangzi*) (stir-fried)
* Biota Seed (*Baizi ren*) (separately ground)
* Yam (*Gan Shuyao*) (2 liang each)
Thirteen ingredients above. Use sweet spring water and mulberry wood fire in a clay pot. Decoct until flavor is exhausted, remove dregs. Slowly boil the decoction into an extract. Store in porcelain. Seal and place in mud or cold water to remove fire qi. Take several qian mixed with light salt soup every morning. In spring, dissolve with jujube soup.
(Note): Medical books have *Fei'er Wan* (*Child-Fattening Pill*) but no geriatric formulas. This shows human affection is thicker towards mercy/love for the young and thinner towards filial piety for the old. Hence, *Han Shi Yi Tong* (*General Knowledge of Medicine by Han*) sighs three times. My late father lived past eighty, with undiminished spirit. Though knowledgeable in medicine, he never took medicine himself, only earnestly advising on geriatric care. Good doctors do not treat the old; how can the old treat themselves to regain youth? However, medicine to support the elderly, keeping them healthy and less sick, is a primary task for cultivating peace and filial intent. Although using medicine to support the old, it is essentially governing people through filial piety. *Shangdan* is originally a pill formula. Fearing the elderly spleen and stomach are weak and digestion is difficult, it is changed to an extract for easier assimilation. "Soaked in wine overnight" means soaked in wine for one night.
**Jiling Gao (*Gathering Spirit Extract*)**: At age fifty, yin qi declines first. Elderly people often have yin deficiency. This formula nourishes true yin and softens sinews and bones.
* American Ginseng (*Xiyangshen*) (choose solid and large ones, scrape skin, steam nine times over rice, sun-dry nine times)
* Goji Berry (*Gan Qizi*)
* Achyranthes Root (*Huainiuxi*) (wine-steamed)
* Asparagus Tuber (*Tiandong*)
* Ophiopogon Tuber (*Maidong*)
* Rehmannia Root (*Huai Shengdi*)
* Prepared Rehmannia Root (*Huai Shudi*)
* Epimedium Herb (*Xianlingpi*)
Eight ingredients above, equal parts. Boil into an extract. Take with plain water or warm wine.
(Note): This formula first appeared in *Guang Biji*, without Epimedium, said to come from the imperial palace. It was also recorded in *Zhifa Hui*, without Achyranthes. The post-formula notes: add Angelica Sinensis (*Danggui*) 4 liang for blood deficiency; add Atractylodes Macrocephala (*Baizhu*) 4 or 8 liang for weak spleen. It also states it treats all qi and blood dual deficiency, weak body, and cough, with universal efficacy. Whenever youths feel weak, fatigued, low in fluids, with deficient fire flaming upward, they should take it urgently to prevent consumptive disease. Later, only Mr. Wei Yuheng skillfully used this formula. *Xu Mingyi Leian* (*Continued Cases of Famous Physicians*) praises its efficacy greatly. I consider this Ren Shen Gu Ben Tang (*Ginseng Solidify the Root Decoction*) with modifications. It fiercely tonifies liver and kidney yin; nothing surpasses this formula. The original formula uses Ginseng (*Renshen*). Recently, Ginseng prices are very high, inaccessible to most. Replacing it with American Ginseng makes it accessible to both rich and poor. The name "Jiling" (*Gathering Spirit*) is because it contains Epimedium (*Xianlingpi*). *Lixu Yuanjian* (*Original Mirror for Consumptive Diseases*) treats consumptive cough by removing Ginseng and Achyranthes from the original formula, adding Licorice (*Gancao*), Platycodon (*Jiegeng*), and Scrophularia (*Yuanshen*).
(Publication): For treating yin deficiency with spermatorrhea and leukorrhea, remove Achyranthes and add Phellodendron Bark (*Huangbai*). For loose stools, also remove Achyranthes and heavily add Coix Seed (*Sheng Yiyiren*).
**Caoling Dan (*Grass Spirit Pill*)**: Elderly people often have yang deficiency, leading to urinary incontinence. Use this to warm and tonify the lower origin, enabling cold tolerance.
* Atractylodes Lancea (*Maoshan Cangzhu*) (soaked in rice water, scrape skin, steam thoroughly with wine in a rice cooker)
* Sichuan Pepper Red (*Chuanjiao hong*) (4 liang each)
* Prepared Rehmannia Root (*Huai Shudi*)
* Yam (*Gan Shuyao*) (3 liang each)
* Honey-fried Licorice Root (*Zhi Gancao*)
* Poria (*Fuling*) (2 liang each)
* Fennel Seed (*Huixiang*) (2 liang, stir-fried with salt water)
* Processed Aconite Root (*Chuanwu*) (1 liang)
Eight ingredients above. Grind six ingredients into fine powder. Mash Prepared Rehmannia into a paste, boil Yam into a paste. Mix all and form pills the size of wutong seeds. Take thirty pills on an empty stomach with light salt soup, pressing down with dry food.
(Note): Suitable for spleen and kidney dual deficiency with internal cold-dampness. Not suitable for those with yin deficiency and vigorous fire.
**Shihui San (*Ten Ashes Powder*)**: Treats hematemesis, hemoptysis, and coughing blood. Use this medicine first to stop bleeding.
* Great Thistle Root (*Daji*)
* Small Thistle Root (*Xiaoji*)
* Lotus Leaf (*Heye*)
* Biota Top (*Bai Baiye*)
* Imperata Rhizome (*Maogen*)
* Rubia Root (*Qian Gen*)
* Gardenia Fruit (*Zhizi*)
* Rhubarb Root (*Dahuang*)
* Moutan Cortex (*Danpi*)
* Palm Fiber (*Zonglupi*)
Ten ingredients above, equal parts. Charcoalize to retain nature, grind to extremely fine powder. Wrap in paper and place on mud for one night to remove fire qi. Take 5 qian mixed with half a bowl of lotus root juice, radish juice, or Beijing ink juice.
(Note): According to the original note: For hematemesis, Ge Hong's methods are preferred, but Mr. Xiangyan prioritizes this formula to stop bleeding. It is clearly a drastic agent (*jie ji*), without hesitation. Careful study reveals the precision of his intent and logic. Humans are born from yang, rooted in yin. Yin deficiency leads to yang excess. Upper qi causes panting, coughing frothy sputum, fever, and red face, all following sequentially. Thus, retaining one part of one's own blood reduces one part of rising fire, making it easier to manage. Why do today's doctors talk endlessly about "guiding fire back to its source" and refuse to use general hemostatics? Some even think vomiting is good, believing stagnation causes harm, delaying time, leading to yin deficiency and yang hyperactivity, endless frying, and untreatable conditions. Whose fault is it? Clinging to meridian-guiding herbs and delaying time, hoping to restore primordial yuan, I fear how can solid blood be generated quickly, and how can unpaired yang be lowered quickly? This is Mr. Xiangyan's main point in urgently stopping bleeding.
(Publication): All medicines charred black can stop bleeding, hence the name "Ten Ashes." However, among astringents, only Palm Fiber (*Zonglupi*) is one. The rest clear blood heat, move blood stasis, and break blood clots. Combined, although primarily stopping bleeding, they avoid the drawback of astringency leaving stasis. I use it often with no sequelae. How can it be considered merely a drastic agent?
**Taiping Wan (*Peace Pill*)**: Treats chronic cough, lung atrophy, and lung abscess.
* Asparagus Tuber (*Tiandong*)
* Ophiopogon Tuber (*Maidong*)
* Anemarrhena Rhizome (*Zhimu*)
* Fritillaria Bulb (*Chuan Beimu*)
* Coltsfoot Flower (*Kuandonghua*) (3 liang each)
* Apricot Seed (*Xingren*)
* Angelica Sinensis (*Danggui*)
* Prepared Rehmannia Root (*Shudi*)
* Raw Rehmannia Root (*Shengdi*)
* Coptis Rhizome (*Huanglian*) (1.5 liang each)
* Polygonum Knotweed Rhizome (*Puhuang*)
* Beijing Ink (*Jingmo*)
* Platycodon Root (*Jiegeng*)
* Mint (*Bohe*) (1 liang each)
Fourteen ingredients above. Grind to fine powder and mix evenly. Refine 4 liang of white honey in a silver or earthenware vessel. Add 1.5 liang of Black Donkey-hide Gelatin (*Ejiao*). After melting, add herb powder and stir. Add a little Musk (*Shexiang*). Boil two or three times. Form pills the size of弹子 (bullet seeds). After meals, chew one pill slowly, dissolving with mint soup. Before sleep, hold the pill in the mouth while lying supine, allowing medicine to flow into lung orifices, clearing lungs and reducing cough. For any cough, taking this cures in seven days.
(Note): The lung resides above the diaphragm. Decoctions wash downwards, passing the disease site, making them less effective. This is why the method of holding the pill in the mouth (*qinhua*) is wonderful. Later, Zhuang Yisheng treated qi stagnation and phlegm condensation causing chest fullness with Ginseng (*Renshen*), Fritillaria (*Beimu*), Sophora Root (*Kushen*), Aquilaria Wood (*Chenxiang*), and Mint (*Bohe*), formed into honey pills. Held in the mouth to dissolve naturally, seeping in slowly. One could say he was a good disciple.
**Runfei Gao (*Moisten Lung Extract*)**: Treats chronic cough, lung dryness, and lung atrophy.
* Sheep Lung (one piece)
* Apricot Seed (*Xingren*) (cleanly ground)
* Persimmon Frost (*Shishuang*)
* True Butter (*Zhen Su*)
* True Rice Flour (*Zhen Fen*) (1 liang each)
* White Honey (*Baimi*) (2 liang)
Clean the sheep lung. Mix the five ingredients with water to make sticky. Pour into the lung. Boil in plain water. Eat as usual.