儒者杨泽之，性躁嗜色，缺盆结一核，此肝火血燥筋挛，法当滋肾水生肝血。不信，乃内服降
火化痰，外敷南星、商陆，转大如碗。余用补中益气及六味地黄，间以芦荟丸，年余元气渐
复而肿消。
一男子，素善怒，左项微肿，渐大如升，用清痰理气，而大热作渴，小便频浊。余谓肾水亏损
，用六味地黄，补中益气而愈。亦有胸胁等处，大如升斗，或破而如菌如榴，不问大小，俱治
以前法。
一男子，颈间结核，大溃年余，一男子眉间一核，初如豆粒，二年渐大如桃，悉用清肝火、养肝
血、益元气而愈。
举人江节夫，颈、臂、胁肋各结一核，恪服祛痰降火软坚之剂，益甚。余曰∶此肝胆经血少而火燥
也。彼执前药，至明年六月各核皆溃，脉浮大而涩。余断以秋金将旺，肝木被克，必不起，
大尹刘天锡，内有湿热，大便滑利，小便涩滞，服淡渗之剂，愈加滴沥，小腹、腿、膝皆肿，两眼
胀痛，此肾虚热在下焦，淡渗导损阳气，阴无以化，遂用地黄、滋肾二丸，小便如故。更以
补中益气加麦门、五味、兼服而愈。
州守王用之，先因肚腹膨胀，饮食少思，服二陈、枳实之类，小便不利，大便不实，咳痰，腹胀
，用淡渗破气之剂，手足俱冷，此足三阴虚寒之症也，用金匮肾气丸，不月而康。
州同刘禹功，素不慎起居、七情，以致饮食不甘，胸膈不利，用消导顺气，肚腹痞满，吐痰气
逆；用化痰降火，食少泄泻，小便作胀；用分利降火，小便涩滞，气喘痰涌；服清气化痰丸
，小便愈涩，大便愈泻，肚腹胀大，肚脐突出，不能寝卧，六脉微细，左寸虚甚，右寸短促
，此命门火衰，脾肾虚寒之危症也。先用金匮加减肾气丸料，肉桂、附各一钱五分。二剂，下瘀
秽甚多；又以补中益气送二神丸，二剂，诸症悉退五六；又用前药数剂，并附子之类，贴腰脐
及涌泉穴，寸脉渐复而安。后因怒腹闷，惑于人言，服沉香化气丸，大便下血，诸症悉至。
余曰∶此阴络伤也。辞不治，果殁。
一富商，饮食起居失宜，大便干结，常服润肠等丸，后胸腹不利，饮食不甘，口干体倦，发热
吐痰，服二陈、黄连之类，前症益甚，小便滴沥，大便泄泻，腹胀少食，服五苓、瞿麦之类
，小便不通，体肿喘嗽，用金匮肾气丸、补中益气汤而愈。
一儒者，失于调养，饮食难化，胸膈不利。或用行气消导药，咳嗽喘促；服行气化痰药，肚腹
渐胀；服行气分利药，睡卧不能，两足浮肿，小便不利，大便不实，脉浮大，按之微细两寸皆
短。此脾肾亏损，朝用补中益气加姜、附，夕用金匮肾气加骨脂、肉果，各数剂，诸症渐愈，
再佐以八味丸，两月乃能步履，却服补中、八味，半载而康。
一男子，素不善调摄，唾痰口干，饮食不美。服化痰行气之剂，胸满腹胀，痰涎愈盛。服导痰
理脾之剂，肚腹膨胀，二便不利。服分气利水之剂，腹大胁痛，睡卧不得。服破血消导之剂
，两足皆肿，脉浮大不及于寸口。朝用金匮加减肾气丸，夕用补中益气汤煎送前丸，月余诸
症渐退，饮食渐进，再用八味丸、补中汤，月余自能转侧，又两月而能步履，却服大补汤、
还少丹，又半载而康。后稍失调理，其腹仍胀，服前药即愈。
一男子，患前症，余为壮火补土渐愈，彼欲速，服攻积之剂，下血甚多。余诊之曰∶此阴络伤，故
血内溢，非所宜也。后果殁。
一男子，胸膈痞闷，专服破气之药。余曰∶此血虚之病也，血生于脾土，若服前药，脾气弱而
血愈虚矣。不信，又用内伤之药，反吐血。余曰∶此阳络伤也。后果然。
大方世家湖乡，离群索居，山妻赵氏，忽婴痰热，治者多以寒凉，偶得小愈，三四年余，屡进
屡退，于是元气消烁，庚子夏，遍身浮肿，手足麻冷，日夜咳嗽，烦躁引饮，小水不利，大肉
尽去，势将危殆。幸遇先生诊之，脉洪大而无伦，按之如无，此虚热无火，法当壮火之源，
以生脾土，与金匮肾气丸料服之，顿觉小水溃决如泉，俾日服前丸，及大补之药，二十余剂而
愈，三、四年间平康无恙。迄今甲辰仲春，悲哀动中，前症复作，体如焚燎，口肉尽腐，胸腹
肿满，食不下咽者四日，夫妇相顾，束手待毙而已。又承先生视之，投以八味丸二服，神思
清爽，服金匮肾气丸料加参、 、归、术，未竟夕而胸次渐舒，陟然思食，不三日而病去五
六矣，嗣后日用前二丸，间服，逾月而起。至秋初，复患痢，又服金匮肾气丸料加参、 、归、
术、黄连、吴茱、木香，痢遂止，但觉后重，又用补中益气加木香、黄连、吴茱、五味，数
剂而愈。
大方自分寒素，命亦蹇剥，山妻抱病沉痼，本难调摄，苟非先生援救，填壑未免
，今不肖奔走衣食于外，而可无内顾之忧矣。然则先生之仁庇，固不肖全家之福，亦不消全
家之感也。斯言也，当置之座右，以为子孙世诵之，不肖尝待先生之侧，检阅医案，始知山
妻奏效巅末，遂秉书纪二丸药之圣，且彰先生用药之神万一云。吴门晚学生沈大方履文再拜
顿首谨书。
有一位读书人叫杨泽之，性格急躁且好色，锁骨部位结了一个硬块，这是肝火旺盛导致血燥、筋脉拘挛，治法应当滋补肾水以滋养肝血。他不听劝告，反而内服降火化痰的药物，外敷天南星、商陆，结果肿块变得像碗一样大。我使用补中益气汤和六味地黄丸，间或服用芦荟丸，经过一年多时间，他的元气逐渐恢复，肿胀消退。
有一个男子，平时容易发怒，左侧颈部轻微肿胀，逐渐增大如升斗大小，之前用清痰理气的方法治疗，导致高热发作、口渴、小便频繁浑浊。我对他说这是肾水亏损，使用六味地黄丸配合补中益气汤而痊愈。也有胸部、胁肋等处肿块大如升斗，或者溃破后形状像菌类或石榴的，无论大小，都以前述方法治疗。
有一个男子，颈部有结核，溃烂一年多；还有一个男子，眉心长了一个核，起初像豆粒，两年后逐渐增大如桃子，这些病例全部采用清肝火、养肝血、益元气的治疗方法而痊愈。
举人江节夫，颈部、手臂、胁肋各结一个核，严格服用祛痰、降火、软坚散结的药物，病情反而加重。我说：“这是肝胆经血少而火燥。”他坚持服用之前的药物，到了第二年六月，各个核都溃破，脉象浮大而涩。我判断说秋天金气将旺，克制肝木，必定无法治愈。
大尹刘天锡，体内有湿热，大便滑利，小便涩滞，服用淡渗利湿的药物，更加点滴难出，小腹、腿部、膝盖都肿胀，双眼胀痛，这是肾虚热在下焦，淡渗利湿损伤了阳气，阴液无法化生，于是使用地黄丸、滋肾丸，小便恢复正常。再用补中益气汤加麦门冬、五味子，兼服而痊愈。
州守王用之，先前因为肚腹膨胀，饮食减少思虑，服用二陈汤、枳实之类的药物，导致小便不利，大便不成形，咳嗽吐痰，腹胀，又服用淡渗破气的药物，手足都变冷，这是足三阴虚寒的症状，使用金匮肾气丸，不到一个月就康复了。
州同刘禹功，平时不注意起居规律和七情调节，导致饮食无味，胸膈不畅，用消导顺气的方法，出现肚腹痞满，吐痰气逆；用化痰降火的方法，食少泄泻，小便胀闷；用分利降火的方法，小便涩滞，气喘痰涌；服用清气化痰丸，小便更涩，大便更泻，肚腹胀大，肚脐突出，不能躺卧，六脉微细，左寸脉虚甚，右寸脉短促，这是命门火衰，脾肾虚寒的危重症状。先用金匮加减肾气丸料，肉桂、附子各一钱五分。两剂药后，排出很多瘀秽之物；再用补中益气汤送服二神丸，两剂后，各种症状消退五六成；又用前面的药物几剂，并配合附子等药贴敷腰脐及涌泉穴，寸脉逐渐恢复而安定。后来因为生气感到腹部闷堵，听信他人言语，服用沉香化气丸，大便下血，各种症状再次出现。我说：“这是阴络受伤。”推辞不治疗，果然去世。
一个富商，饮食起居不当，大便干结，常服用润肠等丸药，后来胸腹不适，饮食无味，口干体倦，发热吐痰，服用二陈汤、黄连之类的药物，前面的症状更加严重，小便点滴难出，大便泄泻，腹胀少食，服用五苓散、瞿麦之类的药物，小便不通，身体肿胀喘咳，使用金匮肾气丸、补中益气汤而痊愈。
一个读书人，疏于调养，饮食难以消化，胸膈不畅。有人用行气消导药，导致咳嗽喘促；服用行气化痰药，肚腹逐渐胀大；服用行气分利药，睡觉不能安卧，两脚浮肿，小便不利，大便不成形，脉象浮大，按之微细，两寸脉皆短。这是脾肾亏损，早晨服用补中益气汤加生姜、附子，晚上服用金匮肾气丸加骨脂、肉果，各服几剂，各种症状逐渐好转，再辅以八味丸，两个月后能行走，继续服用补中益气汤和八味丸，半年后康复。
一个男子，平时不善于调理摄生，唾痰口干，饮食不佳。服用化痰行气的药物，胸满腹胀，痰涎更多。服用导痰理脾的药物，肚腹膨胀，二便不通。服用分气利水的药物，腹大胁痛，睡卧不安。服用破血消导的药物，两脚都肿，脉象浮大不及于寸口。早晨服用金匮加减肾气丸，晚上服用补中益气汤煎汤送服前面的丸药，一个多月各种症状逐渐消退，饮食逐渐增加，再用八味丸、补中汤，一个多月后能自行翻身，又两个月后能行走，接着服用大补汤、还少丹，又过了半年才康复。后来稍微失去调理，肚子又胀，服用前面的药就好了。
一个男子，患上述病症，我为其壮火补土，逐渐好转，但他求快，服用攻积的药物，导致大量下血。我诊察后说：“这是阴络受伤，所以血液内溢，不适合这样治疗。”后果然去世。
一个男子，胸膈痞闷，专门服用破气的药物。我说：“这是血虚的病，血生于脾土，如果服用前面的药物，脾气虚弱而血更虚了。”他不听，又用治疗内伤的药物，反而吐血。我说：“这是阳络受伤。”后果然如此。
大方世家住在湖乡，离群索居，妻子赵氏，忽然患上痰热病，医生多用寒凉药物治疗，偶尔得到一点小愈，三四年间，病情反复进退，于是元气消损耗竭，庚子年夏天，遍身浮肿，手足麻木冰冷，日夜咳嗽，烦躁引饮，小便不利，肌肉消瘦殆尽，形势危急。幸好遇到先生诊察，脉象洪大而无条理，按之空虚，这是虚热无火，治法应当壮火之源，以生脾土，给予金匮肾气丸料服用，顿时觉得小便像泉水一样涌出，让他每天服用前面的丸药及大补的药物，二十多剂后痊愈，三四年间平安无事。直到甲辰年仲春，因悲哀触动内心，前面的症状复发，身体如火烧燎原，口腔肌肉腐烂，胸腹肿胀，四天吃不下东西，夫妇相对，束手待毙。又承蒙先生诊治，投以八味丸两服，神志清爽，服用金匮肾气丸料加人参、[缺字]、当归、白术，不到一晚胸次逐渐舒展，突然想吃东西，不到三天病去五六成，此后每天服用前两种丸药，间或服用，超过一个月就能起床。到秋初，又患痢疾，又服用金匮肾气丸料加人参、[缺字]、当归、白术、黄连、吴茱萸、木香，痢疾停止，但觉得里急后重，又用补中益气汤加木香、黄连、吴茱萸、五味子，几剂后痊愈。
大方自认为贫寒，命运坎坷，妻子抱持沉疴痼疾，本来难以调理，如果不是先生救援，难免落入沟壑（死亡），现在我不肖之子在外奔波谋生，就没有后顾之忧了。然而先生的仁德庇护，固然是我不肖全家的福气，也是我不消全家感激的地方。这话，应当放在座右，作为子孙世代诵读，我不肖曾在先生身边，检阅医案，才知道妻子的疗效始末，于是秉笔记录这两种丸药的圣效，并且彰显先生用药的神奇万一。吴门晚学生沈大方履文再拜顿首谨书。
A scholar named Yang Zezhi had an irritable temperament and was fond of sexual indulgence. A nodule formed in the supraclavicular fossa (quepen). This was due to Liver Fire causing blood dryness and tendon contraction. The treatment method should be to nourish Kidney Water to generate Liver Blood. He did not believe this, instead taking internal medicine to descend fire and resolve phlegm, and applying external poultices of Arisaema Rhizoma (Nanxing) and Mercurialis Herb (Shanglu). The swelling turned as large as a bowl. I used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill), interspersed with Luohui Wan (Aloe Pill). After more than a year, his Yuan Qi (Original Qi) gradually recovered, and the swelling subsided.
A man who was prone to anger had slight swelling on the left side of his neck, which gradually enlarged to the size of a sheng (a unit of volume). Previous treatment with methods to clear phlegm and regulate Qi resulted in high fever, thirst, and frequent, turbid urination. I stated that this was Kidney Water deficiency, and treated him with Liuwei Dihuang Wan and Buzhong Yiqi Tang, resulting in recovery. Cases where nodules in the chest or hypochondrium enlarged to the size of a sheng or dou, or even ulcerated into shapes resembling fungi or pomegranates, were all treated with the aforementioned methods regardless of size.
One man had cervical tubercles that had been ulcerated for over a year. Another man had a nodule between his eyebrows, initially bean-sized, which gradually grew to peach-sized over two years. All were cured by clearing Liver Fire, nourishing Liver Blood, and benefiting Yuan Qi.
Juren Jiang Jiefu had nodules in his neck, arms, and hypochondrium. He strictly took medicines to expel phlegm, descend fire, and soften hardness, but his condition worsened. I said, "This is due to blood deficiency and fire dryness in the Liver and Gallbladder meridians." He persisted with the previous medications. By June of the following year, all nodules ulcerated, and the pulse was floating, large, and choppy. I predicted that since Metal (Autumn) would be strong and overcome Wood (Liver), he would not survive.
Dayin Liu Tianxi had damp-heat internally, with loose stools and obstructed urination. Taking diaphoretic and leeching agents made the dribbling worse, causing swelling in the lower abdomen, legs, and knees, and distending pain in both eyes. This was Kidney deficiency heat in the Lower Jiao. Leeching agents damaged Yang Qi, preventing Yin from transforming. Thus, Dihuang Wan and Zishen Wan were used, restoring normal urination. Subsequently, Buzhong Yiqi Tang plus Ophiopogonis Radix (Maimen) and Schisandrae Fructus (Wuweizi) was taken concurrently, leading to recovery.
Zhoushou Wang Yongzhi initially suffered from abdominal distension and poor appetite. After taking Erchen Tang and Zhi Shi-like agents, he developed obstructed urination, loose stools, cough with phlegm, and abdominal distension. Further use of leeching and Qi-breaking agents caused cold hands and feet. This was a syndrome of deficiency-cold in the three Foot Yin meridians. Jin Kui Shenqi Wan was administered, and he recovered within a month.
Zhoutong Liu Yugong neglected his daily routine and emotional regulation, leading to poor taste in food and chest/epigastric discomfort. Treatment with digestion-promoting and Qi-smoothing agents resulted in epigastric fullness, vomiting of phlegm, and rebellious Qi. Treatment with phlegm-resolving and fire-descending agents led to poor appetite, diarrhea, and urinary distension. Treatment with separating and draining agents to descend fire caused obstructed urination, asthma, and surging phlegm. Taking Qingqi Huatan Wan made urination more obstructed and diarrhea worse, leading to abdominal distension, umbilical protrusion, and inability to lie down. The six pulses were faint and fine; the Left Cun pulse was very deficient, and the Right Cun pulse was short and hurried. This was a critical syndrome of Mingmen Fire decline and Spleen-Kidney deficiency-cold. Initially, Jin Kui Modified Shenqi Wan ingredients, including Cinnamon Twig (Rougui) and Aconite Root (Fuzi) at 1.5 qian each, were used. After two doses, much stasis and filth were discharged. Then, Buzhong Yiqi Tang was used to deliverershenshen Wan. After two doses, five to six parts of all symptoms receded. Several more doses of the previous medicine, along with Fuzi applied to the Yaoqi and Yongquan acupoints, gradually restored the Cun pulse and stability. Later, due to anger and abdominal stuffiness, and influenced by others' words, he took Chenxiang Huaqi Wan, resulting in bloody stool and the return of all symptoms. I said, "This is injury to the Yin collaterals." I declined further treatment, and he indeed died.
A wealthy merchant had improper diet and lifestyle, with dry stools. He often ran Changfu Runchang Wan (Moisten Intestines Pills). Later, he experienced chest/abdominal discomfort, poor taste in food, dry mouth, fatigue, fever, and phlegm cough. Taking Erchen Tang and Coptidis Rhizoma (Huanglian) worsened these symptoms, leading to dribbling urination and diarrhea. Taking Wuling San and Polygonum Aviculare Herb (Qumai) resulted in complete urinary retention, body swelling, and asthma/cough. Jin Kui Shenqi Wan and Buzhong Yiqi Tang cured him.
A scholar neglected health maintenance, leading to indigestion and chest/epigastric discomfort. Using Qi-moving and digestion-promoting drugs caused cough and asthma. Taking Qi-moving and phlegm-resolving drugs led to gradual abdominal distension. Taking Qi-moving and separating-draining drugs caused inability to sleep, edema of both feet, obstructed urination, and loose stools. The pulse was floating and large, but fine upon pressure, with both Cun pulses short. This was Spleen-Kidney deficiency. Morning: Buzhong Yiqi Tang plus Ginger and Aconite. Evening: Jin Kui Shenqi Wan plus Psoraleae Fructus (Guzhi) and Myristica Seed (Rouguo). Each taken for several doses, symptoms gradually improved. Assisted by Bawei Wan, he could walk after two months. Continuing Buzhong Yiqi Tang and Bawei Wan, he recovered after half a year.
A man who was poor at self-care had salivary phlegm, dry mouth, and poor appetite. Taking phlegm-resolving and Qi-moving agents caused chest fullness, abdominal distension, and increased saliva/phlegm. Taking Phlegm-guiding and Spleen-regulating agents caused abdominal distension and obstruction of both bowels and urine. Taking Qi-separating and water-draining agents caused abdominal enlargement, hypochondriac pain, and insomnia. Taking Blood-breaking and digestion-promoting agents caused bilateral foot edema, with a floating and large pulse not reaching the Cun position. Morning: Jin Kui Modified Shenqi Wan. Evening: Buzhong Yiqi Tang decoction to deliver the previous pills. After over a month, symptoms gradually receded, and diet improved. Using Bawei Wan and Buzhong Tang, he could turn over after a month, and walk after another two months. Then taking Dabu Tang and Huan Shao Dan, he recovered after half a year. Later, slight neglect of regulation caused abdominal bloating again, which resolved with the previous medicines.
A man suffering from the aforementioned condition improved gradually under my treatment of strengthening Fire to tonify Earth. Desiring speed, he took accumulation-attacking agents, resulting in significant bleeding. Upon diagnosis, I said, "This is injury to the Yin collaterals, causing internal blood overflow; this is inappropriate." He subsequently died.
A man with chest/epigastric stuffiness exclusively took Qi-breaking drugs. I said, "This is a Blood deficiency disease. Blood is generated from Spleen Earth. If you take such drugs, Spleen Qi will weaken, and Blood will become more deficient." He did not listen, used internal-injury medicines, and instead vomited blood. I said, "This is injury to the Yang collaterals." It proved true.
Shen Dafang, a family from Dafang living in the lakeside countryside, lived in isolation. His wife, Lady Zhao, suddenly contracted Phlegm-Heat. Physicians mostly used cold-cool substances. She achieved slight temporary relief, but over three to four years, the condition repeatedly advanced and retreated, consuming her Yuan Qi. In the summer of Gengzi, she had generalized edema, numbness and coldness of hands and feet, day-and-night coughing, irritability with desire to drink, obstructed urination, and severe muscle wasting. The situation was critical. Fortunately, Mr. [Xue Ji] examined her. The pulse was洪大 (surging and large) without order, and empty upon pressure. This was deficiency-heat without Fire. The method should be to strengthen the source of Fire to generate Spleen Earth. Jin Kui Shenqi Wan ingredients were given. Immediately, urination flowed like a spring. Daily administration of the previous pill and major tonifying medicines for over twenty doses led to recovery. She remained healthy for three to four years. In mid-spring of Jiachen, grief triggered the recurrence of previous symptoms. Her body felt like burning, oral mucosa rotted, chest/abdomen were swollen, and she could not swallow food for four days. The couple looked at each other, helpless, awaiting death. Mr. [Xue Ji] examined her again. Two doses of Bawei Wan cleared her spirit. Jin Kui Shenqi Wan ingredients plus Ginseng Radix (Renshen), [missing character], Angelicae Sinensis Radix (Danggui), and Atractylodis Macrocephalae Rhizoma (Baizhu) were given. Before night ended, the chest relaxed, appetite returned, and within three days, five to six parts of the illness disappeared. Thereafter, using the two pills daily, interspersed, she rose after over a month. In early autumn, she contracted dysentery. Jin Kui Shenqi Wan ingredients plus Ginseng, [missing character], Danggui, Baizhu, Coptidis Rhizoma (Huanglian), Evodiae Fructus (Wuzhuyu), and Aucklandiae Radix (Muxiang) stopped the dysentery, though tenesmus remained. Buzhong Yiqi Tang plus Muxiang, Huanglian, Wuzhuyu, and Wuweizi cured it after several doses.
Dafang considers himself poor and ill-fated. His wife's chronic illness was hard to manage. Without Mr.'s rescue, death would have been inevitable. Now, as I struggle for livelihood outside, I have no internal worries. Mr.'s benevolent protection is indeed the fortune of my whole family and the gratitude we cannot repay. These words should be placed by the bedside for descendants to recite forever. Having served near Mr., I reviewed medical cases and learned the details of my wife's cure. Thus, I record the efficacy of the two pills and highlight the miraculous nature of Mr.'s prescription. Shen Dafang Lüwen, junior student of Wumen, bows deeply and writes respectfully.