进士刘华甫，停食腹痛泻黄，吐痰，服二陈、山栀、黄连、枳实之类，其症益甚，左关弦紧，
右关弦长，乃肝木克脾土，用六君加木香治之而愈。若食已消而泄未已，宜用异功散以补脾
胃，如不应，用补中益气升发阳气。凡泄利色黄，脾土亏损，真气下陷，必用前汤加木香、
肉蔻温补，如不应，当补其母，宜八味丸。
光禄柴黼庵，善饮，泄泻，腹胀，吐痰，作呕，口干，此脾胃之气虚，先用六君加神曲，痰呕已止
，再用补中益气加茯苓、半夏，泻、胀亦愈。此症若湿热壅滞，当用葛花解酲汤分消其湿，湿
既去而泻未已，须用六君加神曲，实脾土，化酒积。然虽为酒而作，实因脾土虚弱，不可专主湿
热。
旧僚钱可久，素善饮，面赤痰盛，大便不实，此肠胃湿痰壅滞，用二陈、芩、连、山栀、枳实
、干葛、泽泻、升麻，一剂，痰吐甚多，大便始实。此后日以黄连三钱泡汤饮之而安。但如此
禀浓者不多耳。
一儒者，善饮，便滑，溺涩，食减，胸满，腿足渐肿，症属脾肾虚寒，用加减金匮肾气丸，食进肿
消，更用八味丸，胃强脾健而愈。
一男子，侵晨或五更吐痰，或有酸味，此是脾气虚弱，用六君送四神丸而愈。若脾气郁滞，用
二陈加桔梗、山栀、送香连丸。若郁结伤脾，用归脾汤送香连丸。若胸膈不舒，归脾加柴胡、
山栀送左金丸。若胃气虚，津液不能运化，用补中益气送左金丸。
一羽士，停食泄泻，自用四苓、黄连、枳实、曲、柏益甚。余曰∶此脾肾泄也，当用六君加姜、
桂送四神丸。不信，又用沉香化气丸一服，卧床不食，咳则粪出，几至危殆，终践余言而愈
。盖化气之剂，峻厉猛烈，无经不伤，无脏不损，岂宜轻服？
嘉靖乙未，绍患肝克脾，面赤生风，大肠燥结，炎火冲上，久之遂致脏毒下血，肠鸣溏泄
，腹胀喘急，驯至绝谷，濒于殆矣。诸医方以枳实、黄连之剂投之，展转增剧，乃求于立
斋先生。先生曰∶尔病脾肾两虚，内真寒而外虚热，法当温补。遂以参、术为君，山药、黄
、肉果、姜、附为臣，茱萸、骨脂、五味、归、苓为佐，治十剂俾以次服之。诸医皆曰∶此
火病也，以火济火可乎?绍雅信先生，不为动，服之浃旬，尽剂而血止，诸疾遄已。先是三年
前，先生过绍，谓曰∶尔面部赤风，脾胃病也，不治将深。予心忧之，而怠缓以须，疾发又
惑于众论，几至不救，微先生吾其土矣。呜呼!先生之术亦神矣哉!绍无以报盛德，敬述梗概
，求附案末，以为四方抱患者告。庶用垂惠于无穷云。长洲朱绍。
进士刘华甫，因饮食停滞导致腹痛、泻下黄色稀便、呕吐痰涎。他服用了二陈汤、山栀、黄连、枳实等药物后，症状反而加重。诊见左关脉弦紧，右关脉弦长，这是肝木克制脾土所致。使用六君子汤加木香治疗，痊愈。如果食物已经消化但腹泻仍未停止，应当使用异功散来补益脾胃；如果无效，则使用补中益气汤以升发阳气。凡是泄泻颜色发黄，属于脾土亏损，真气下陷，必须用前文提到的方剂（指补中益气类）加木香、肉豆蔻进行温补；如果无效，应当“补其母”（即补肾），适宜使用八味丸。
光禄寺卿柴黼庵，喜欢饮酒，出现泄泻、腹胀、呕吐痰涎、作呕、口干等症状，这是脾胃之气虚弱所致。先用六君子汤加神曲，待痰多和呕吐停止后，再用补中益气汤加茯苓、半夏，腹泻和腹胀也随之痊愈。此症若属湿热壅滞，应当使用葛花解酲汤分消湿气；湿气去除而腹泻仍未止，需用六君子汤加神曲，以实脾土，化解酒积。虽然病因为饮酒引起，但实际上是因为脾土虚弱，不能单纯主治湿热。
旧同僚钱可久，素来喜欢饮酒，面色红赤、痰多，大便不成形，这是肠胃湿痰壅滞所致。使用二陈汤、黄芩、黄连、山栀、枳实、干葛、泽泻、升麻，服用一剂后，吐出大量痰涎，大便开始成形。此后每天用三钱黄连泡汤饮用而安适。但像这种体质禀赋浓厚的人并不多见。
一位儒生，喜欢饮酒，大便滑脱不禁，小便涩滞，食欲减退，胸部胀满，腿足逐渐浮肿，病症属于脾肾虚寒。使用加减金匮肾气丸，食欲增加，浮肿消退，随后改用八味丸，胃强脾健而痊愈。
一名男子，清晨或五更时分呕吐痰涎，有时带有酸味，这是脾气虚弱所致，用六君子汤送服四神丸而痊愈。若是脾气郁滞，用二陈汤加桔梗、山栀，送服香连丸。若是郁结损伤脾脏，用归脾汤送服香连丸。若是胸膈不舒，用归脾汤加柴胡、山栀，送服左金丸。若是胃气虚弱，津液不能运化，用补中益气汤送服左金丸。
一位道士，因饮食停滞导致泄泻，自行服用四苓散、黄连、枳实、神曲、黄柏等药，病情反而加重。我说：这是脾肾泄泻，应当用六君子汤加生姜、肉桂送服四神丸。他不相信，又服用了一服沉香化气丸，结果卧床不起，无法进食，咳嗽时粪便流出，几乎危及生命，最终听从了我的建议才痊愈。大概是因为沉香化气这类药剂峻烈猛烈，无经不伤，无脏不损，岂能轻易服用？
嘉靖乙未年，朱绍患肝木克制脾土，面赤生风，大肠干燥便秘，炎火冲上，久而久之导致脏毒下血，肠鸣溏泄，腹胀喘急，逐渐发展到绝食，濒临死亡。各位医生正用枳实、黄连的药剂投治，病情辗转加剧，于是向立斋先生（薛己）求医。先生说：你的病是脾肾两虚，内真寒而外虚热，治法应当温补。于是以人参、白术为君药，山药、黄芪、肉果、生姜、附子为臣药，吴茱萸、骨脂、五味子、当归、茯苓为佐药，配制十剂让依次服用。各位医生都说：这是火病，用火来济火可以吗？朱绍一向信任先生，不为所动，服药十天，服完所有药剂后出血停止，各种疾病迅速痊愈。在此之前三年前，先生经过朱绍处，对他说：你面部红赤生风，是脾胃的病，不治将会深入。我心里担忧，却怠慢拖延等待，疾病发作时又被众人的言论迷惑，几乎无法挽救，如果没有先生，我恐怕已成黄土了。唉！先生的医术真是神奇啊！朱绍无以报答盛德，恭敬叙述梗概，请求附在医案末尾，告知四方怀抱病痛的患者，希望能永远惠及后人。长洲朱绍。
Liu Huafu, a Jinshi (degree holder), suffered from abdominal pain and yellow diarrhea due to food stagnation, accompanied by vomiting of phlegm. After taking Er Chen Tang (Two Aged Decoction), Gardenia (Gardeniae Fructus), Coptis Rhizome (Coptidis Rhizoma), and Immature Bitter Orange (Aurantii Fructus Immaturus), his symptoms worsened. The pulse at the left Guan position was wiry and tight, and at the right Guan position was wiry and long, indicating Liver Wood overacting on Spleen Earth. He was cured using Liu Jun Zi Tang (Six Gentlemen Decoction) with added Amomum Fruit (Amomi Fructus). If food has digested but diarrhea persists, Yi Gong San (Yi Gong Powder) should be used to tonify the Spleen and Stomach; if ineffective, Bu Zhong Yi Qi Tang (Decoction for Supplementing the Middle and Augmenting the Qi) should be used to raise Yang Qi. For diarrhea with yellow color, it indicates Spleen Earth deficiency and sinking of True Qi; one must use the aforementioned decoction with added Amomum Fruit and Nutmeg (Myristicae Semen) for warming and tonifying. If ineffective, one should "tonify the mother" (Kidney), suitable for Ba Wei Wan (Eight-Ingredient Pill).
Chai Fu'an, an official of the Court of Imperial Entertainments, who enjoyed drinking, presented with diarrhea, abdominal distension, vomiting of phallgms, nausea, and dry mouth. This indicated deficiency of Spleen and Stomach Qi. Initially, Liu Jun Zi Tang (Six Gentlemen Decoction) with added Medicated Leaven (Shen Qu) was used. Once phlegm and vomiting ceased, Bu Zhong Yi Qi Tang (Decoction for Supplementing the Middle and Augmenting the Qi) with added Poria (Poria) and Pinellia Tuber (Pinelliae Rhizoma) was administered, resolving the diarrhea and distension. If this condition were due to damp-heat obstruction, Ge Hua Jie Cheng Tang (Kudzu Flower Decoction for Resolving Intoxication) would be used to dissipate dampness. After dampness is removed but diarrhea persists, Liu Jun Zi Tang (Six Gentlemen Decoction) with Shen Qu should be used to strengthen Spleen Earth and transform alcohol accumulation. Although caused by alcohol, the root is Spleen Earth weakness, so it cannot be treated solely as damp-heat.
Qian Kejiu, a former colleague, who habitually drank, presented with a red face, abundant phlegm, and loose stools. This indicated obstruction of damp-phlegm in the intestines and stomach. Er Chen Tang (Two Aged Decoction) with Scutellaria Root (Scutellariae Radix), Coptis Rhizome (Coptidis Rhizoma), Gardenia (Gardeniae Fructus), Immature Bitter Orange (Aurantii Fructus Immaturus), Kudzu Root (Puerariae Lobatae Radix), Alisma Rhizome (Alismatis Rhizoma), and Cimicifuga Rhizome (Cimicifugae Rhizoma) were used. After one dose, much phlegm was vomited, and stools became formed. Thereafter, he drank water infused with three qian of Coptis Rhizome daily and remained well. However, such individuals with strong constitution are rare.
A scholar, who enjoyed drinking, presented with slippery stools, difficult urination, reduced appetite, chest fullness, and gradual swelling of legs and feet. The syndrome belonged to Spleen and Kidney deficiency-cold. Jia Jian Jin Gui Shen Qi Wan (Modified Golden Cabinet Kidney Qi Pill) was used, resulting in increased appetite and resolution of swelling. Subsequently, Ba Wei Wan (Eight-Ingredient Pill) was used, leading to recovery through strong Stomach function and robust Spleen health.
A man presented with vomiting of phlegm in the early morning or during the fifth watch (3-5 AM), sometimes sour-tasting. This indicated Spleen Qi deficiency, cured by administering Liu Jun Zi Tang (Six Gentlemen Decoction) with Si Shen Wan (Four Spirit Pill). If Spleen Qi stagnation, Er Chen Tang (Two Aged Decoction) with Platycodon Root (Platycodi Radix) and Gardenia (Gardeniae Fructus), delivered with Xiang Lian Wan (Fragrant Coptis Pill), was used. If emotional constraint injured the Spleen, Gui Pi Tang (Restore the Spleen Decoction) with Xiang Lian Wan (Fragrant Coptis Pill) was used. If chest and diaphragm discomfort occurred, Gui Pi Tang (Restore the Spleen Decoction) with Bupleurum Root (Bupleuri Radix) and Gardenia (Gardeniae Fructus), delivered with Zuo Jin Wan (Left Metal Pill), was used. If Stomach Qi was deficient and fluids could not be transformed, Bu Zhong Yi Qi Tang (Decoction for Supplementing the Middle and Augmenting the Qi) with Zuo Jin Wan (Left Metal Pill) was used.
A Daoist priest suffered from diarrhea due to food stagnation. Self-medication with Si Ling San (Four Powders Powder), Coptis Rhizome (Coptidis Rhizoma), Immature Bitter Orange (Aurantii Fructus Immaturus), Shen Qu (Medicated Leaven), and Phellodendron Bark (Phellodendri Cortex) worsened the condition. I stated: This is Spleen-Kidney diarrhea; one should use Liu Jun Zi Tang (Six Gentlemen Decoction) with Ginger (Zingiberis Rhizoma) and Cinnamon Twig (Cinnamomi Ramulus) delivered with Si Shen Wan (Four Spirit Pill). Disbelieving, he took a dose of Chen Xiang Hua Qi Wan (Agarwood Transforming Qi Pill), resulting in bedridden state, inability to eat, and fecal incontinence upon coughing, nearly reaching a critical state. He eventually followed my advice and recovered. Agarwood-transforming agents are harsh and fierce, damaging all meridians and organs, and should not be taken lightly.
In the Yiwu year of the Jiajing era, Zhu Shao suffered from Liver Wood overacting on Spleen Earth, presenting with facial redness, wind generation, dry constipation, rising inflammatory fire, and eventually internal toxicity with bloody stool, borborygmus, loose stools, abdominal distension, and wheezing urgency, progressing to anorexia and near death. Physicians prescribed agents containing Immature Bitter Orange (Aurantii Fructus Immaturus) and Coptis Rhizome (Coptidis Rhizoma), causing worsening. He sought help from Mr. Lizhai (Xue Ji). Mr. Lizhai said: Your disease is dual deficiency of Spleen and Kidney, with true cold inside and false heat outside; the method should be warming and tonifying. Ginseng (Ren Shen) and Atractylodes Macrocephala Rhizome (Atractylodis Macrocephalae Rhizoma) were used as Sovereign herbs; Chinese Yam (Dioscoreae Rhizoma), Astragalus Root (Astragali Radix), Myristica Seed (Myristicae Semen), Ginger (Zingiberis Rhizoma), and Prepared Aconite Root (Aconiti Lateralis Radix Praeparata) as Minister herbs; Cornus Fruit (Corni Fructus), Drynaria Rhizome (Drynariae Rhizoma), Schisandra Fruit (Schisandrae Chinensis Fructus), Angelica Sinensis Root (Angelicae Sinensis Radix), and Poria (Poria) as Assistant herbs. Ten doses were prepared for sequential administration. Other physicians argued: This is a fire disease; can fire be augmented with fire? Zhu Shao trusted Mr. Lizhai and did not waver. After ten days of taking the medicine and completing the course, bleeding stopped, and all diseases rapidly resolved. Three years prior, Mr. Lizhai had passed by and said: Your facial redness and wind indicate a Spleen-Stomach disease; if untreated, it will deepen. I was worried but delayed action. When the disease struck, I was confused by public opinion and nearly died. Without Mr. Lizhai, I would have turned to earth. Alas! Mr. Lizhai's medical skill is truly miraculous! Zhu Shao, unable to repay such great virtue, respectfully narrates this summary and requests its inclusion at the end of the case records to inform patients everywhere, hoping to benefit future generations indefinitely. Zhu Shao of Changzhou.