某 阳升 杂。（阳升）
麦冬（三钱） 生地（二钱） 柏子仁（一钱） 川斛（三钱） 茯神（三钱） 黑 豆皮（三钱）
某 心中烦热。头上汗泄。汗止自安。易 。（心阳热）
淮小麦 柏子仁 茯神 炙草 南枣 辰砂
程（氏） 血虚心 。咽呛。（血虚）
生地 天冬 麦冬 女贞子 生白芍 炙草 茯神 麻仁
某（氏） 经半月一至。夜 痛。（肝阴虚）
生地 阿胶 天冬 茯神 白芍 丹参
有虚实真伪。其病总在于胃。经云饮入于胃。游溢精气。上输于脾。脾气散精。上归于肺。
又云脾与胃以膜相连耳。又云脾主为胃行其津液者也。由此观之。脾属阴。主乎血。胃属
阳。主乎气。胃易燥。全赖脾阴以和之。脾易湿。必赖胃阳以运之。故一阴一阳。互相表里。合
冲和之德。而为后天生化之源也。若脾阴一虚。则胃家饮食游溢之精气。全输于脾。不能
稍留津液以自润。则胃过于燥而有火矣。故欲得食以自资。稍迟则 杂愈甚。得食则
可暂止。若失治则延便闭三消噎膈之症。治当补脾阴。养营血。兼补胃阴。甘凉濡润。或稍
佐微酸。此乃脾阴之虚而致胃家之燥也。更有一切热病之后。胃气虽渐复。津液尚未充。
亦有是症。此但以饮食调之。可以自愈。此二种。乃为虚 症。所谓实者。年岁壮盛。脾胃生
发之气。与肾阳充旺。食易消磨。多食易饥而 。得食即止。此非病也。不必服药。以上皆是
真症。所云伪者。因胃有痰火。以致饮食输化不清。或现恶心。吞酸。微烦。眩晕。少寐。似饥
非饥。虽饱食亦不能止。此乃痰火为患。治宜清胃。稍佐降痰。苦寒及腻滞之药。不宜多用。
又有胃阳衰微。以致积饮内聚。水气泛溢。似有凌心之状。凄凄戚戚。似酸非酸。似辣非辣。
饮食减少。此属脾胃阳虚。治宜温通。仿痰饮门而治之。此二种乃似 之伪症。若夫所云
心者误也。心但有烦而无 。胃但有 而无烦。亦不可不辨明之。今先生之法。仅有四
案。倘有心之士更能搜采补入。则幸甚。（华岫云）
某患者，阳气上亢，出现杂症。（病机：阳气上亢）
麦冬（三钱） 生地（二钱） 柏子仁（一钱） 川石斛（三钱） 茯神（三钱） 黑豆皮（三钱）
某患者，心中烦热。头部出汗，汗止后身体自安。病机为心阳热盛。（易方：补益心脾、安神定志）
淮小麦 柏子仁 茯神 炙甘草 南枣 辰砂
程氏患者，血虚导致心悸怔忡。咽喉呛咳。（病机：血虚）
生地 天冬 麦冬 女贞子 生白芍 炙甘草 茯神 火麻仁
某氏患者，月经半月一行。夜间腹痛。（病机：肝阴虚）
生地 阿胶 天冬 茯神 白芍 丹参
疾病有虚实真伪之分，其病总归在于胃。《内经》说：饮食进入胃中，精气游溢散布，向上输送给脾。脾气散精，向上归于肺。
又说：脾与胃仅以膜相连。又说：脾的主要功能是替胃运行津液。由此看来，脾属阴，主司血；胃属阳，主司气。胃容易干燥，全赖脾阴来调和它。脾容易湿滞，必赖胃阳来运化它。所以一阴一阳，互为表里，融合冲和之德，成为后天化生的源泉。如果脾阴虚弱，那么胃中饮食游溢的精气，全部输送到脾，不能稍留津液以滋润自身，则胃过于干燥而生火。所以想要进食来资助自己，稍微延迟则嘈杂感更加严重。进食后可以暂时停止。如果失治，则会拖延成便秘、消渴、噎膈等症状。治疗应当补脾阴，养营血，兼补胃阴，用甘凉濡润之法，或者稍加微酸之品。这是脾阴虚弱而导致胃家干燥的情况。另外有一种情况是，在一切热病之后，胃气虽然逐渐恢复，但津液尚未充盈，也有这种症状。这种情况只需通过饮食调理，可以自愈。这两种情况，属于虚性嘈杂症。所谓实性的，是年岁壮盛，脾胃生发之气，与肾阳充旺，食物容易消化，多吃容易饥饿而嘈杂，进食后即停止。这并非疾病，不必服药。以上这些都是真实的症状。所说的伪症，是因为胃中有痰火，导致饮食输布转化不清，或者出现恶心、吞酸、轻微烦躁、眩晕、少寐，似饥非饥，即使吃饱了也不能停止。这是痰火为患，治疗宜清胃，稍加降痰之药。苦寒及腻滞的药物，不宜多用。又有胃阳衰微，导致水饮内聚，水气泛溢，似乎有凌心的状貌，凄凄戚戚，似酸非酸，似辣非辣，饮食减少。这属于脾胃阳虚，治疗宜温通，仿照痰饮门的方法来治疗。这两种情况乃是似嘈杂的伪症。至于有人说这是心病，是错误的。心只有烦而没有嘈杂，胃只有嘈杂而没有烦，也不可不明辨清楚。如今先生的医案中，仅有四案。如果有用心的人能进一步搜集采录补充进去，那就太好了。（华岫云按语）
Patient A, with hyperactive Yang Qi, presents with miscellaneous symptoms. (Pathogenesis: Hyperactive Yang Qi)
Ophiopogonis Radix (San Qian) Rehmanniae Radix (Er Qian) Placenta Semen (Yi Qian) Dendrobii Caulis (San Qian) Poria Cum Radix Pini (San Qian) Phaseoli Vulgaris Testa Nigrae (San Qian)
Patient B, experiences mental restlessness and heat in the heart. Sweating from the head; upon cessation of sweating, the body feels at ease. Pathogenesis: Heat in Heart Yang. (Alternative Formula: Tonify Heart and Spleen, Calm Spirit)
Tritici Sativi Fructus (Huai Xiao Mai) Placenta Semen Bai Zi Ren) Poria Cum Radix Pini (Fu Shen) Glycyrrhizae Radix et Rhizoma Praeparata (Zhi Cao) Jujubae Fructus (Nan Zao) Cinnabar (Chen Sha)
Patient Cheng, suffers from palpitations due to Blood deficiency. Choking cough in the throat. (Pathogenesis: Blood Deficiency)
Rehmanniae Radix Asparagi Radix Ophiopogonis Radix Ligustri Lucidi Fructus Paeoniae Radix Alba Cruda Glycyrrhizae Radix et Rhizoma Praeparata Poria Cum Radix Pini Cannabis Fructus (Huo Ma Ren)
Patient C, menstruation occurs once every half month. Abdominal pain at night. (Pathogenesis: Liver Yin Deficiency)
Rehmanniae Radix Ecliptae Herba (E Jiao) Asparagi Radix Ophiopogonis Radix Poria Cum Radix Pini Paeoniae Radix Alba Salviae Miltiorrhizae Radix
Diseases have distinctions of excess/deficiency and true/false. The pathology generally resides in the Stomach. The *Classic of Internal Medicine* states: When food and drink enter the Stomach, their essence floats and spreads, transporting upwards to the Spleen. The Spleen scatters the essence, sending it upwards to return to the Lung.
It is also stated: The Spleen and Stomach are connected only by a membrane. It is further stated: The Spleen’s primary function is to transport fluids on behalf of the Stomach. From this perspective, the Spleen belongs to Yin and governs Blood; the Stomach belongs to Yang and governs Qi. The Stomach tends toward dryness, relying entirely on Spleen Yin to harmonize it. The Spleen tends toward dampness, relying on Stomach Yang to transform it. Thus, one Yin and one Yang, mutually exterior-interior, integrating the virtue of harmony, serve as the source of postnatal transformation. If Spleen Yin becomes deficient, the essence floating from dietary intake in the Stomach is entirely transported to the Spleen, unable to retain any fluid to moisten itself. Consequently, the Stomach becomes overly dry and generates fire. Therefore, the patient desires food to nourish themselves; if delayed slightly, the sensation of gastric discomfort (tsao-za) worsens. After eating, it can temporarily cease. If untreated, it may progress to constipation, wasting-thirst (Xiao Ke), or dysphagia (Ye Ge). Treatment should tonify Spleen Yin, nourish Ying-Blood, and concurrently tonify Stomach Yin, using sweet-cool and moistening methods, or slightly assisting with mildly sour agents. This is gastric dryness caused by Spleen Yin deficiency. Additionally, after various febrile diseases, although Stomach Qi gradually recovers, fluids are not yet sufficient, presenting similar symptoms. This type can heal itself through dietary regulation. These two types constitute deficiency-type tsao-za. The so-called "excess" type refers to individuals in their prime, where the generating Qi of the Spleen and Stomach, along with Kidney Yang, is robust. Food digests easily, leading to frequent hunger and tsao-za with increased intake, which stops immediately after eating. This is not a disease, and medication is unnecessary. All the above are true symptoms. The so-called "false" symptoms arise because Phlegm-Fire exists in the Stomach, causing unclear distribution and transformation of dietary intake, manifesting as nausea, acid regurgitation, slight irritability, dizziness, insomnia, a sensation of hunger that is not true hunger, and inability to stop even after full meals. This is caused by Phlegm-Fire. Treatment should clear the Stomach and slightly assist with phlegm-resolving herbs. Bitter-cold and cloying/stagnant drugs should not be used excessively. Furthermore, when Stomach Yang is severely deficient, accumulated fluids gather internally, water qi overflows, resembling a condition of Water attacking the Heart, feeling desolate and sad, resembling sourness but not quite sour, resembling pungency but not quite pungent, with reduced dietary intake. This belongs to Spleen-Stomach Yang Deficiency. Treatment should warm and unblock, following the methods for Phlegm-Fluid disorders. These two types are false symptoms resembling tsao-za. To claim this is a Heart disease is erroneous. The Heart has irritability but no tsao-za; the Stomach has tsao-za but no irritability. This distinction must be clarified. Currently, the Master’s medical records contain only four cases. It would be fortunate if diligent practitioners could search for and supplement more cases. (Commentary by Hua Xiuyun)