陈 气虚湿热下注，痔漏脱肛，脉象弦数，治宜调理。
水泛补中益气丸（四两） 加味槐角丸（四两。二丸和匀每日清晨午后空心开水送下五钱）
何左（正月） 脾欠健运，湿热留着阳明，加以操劳动肝，肝木乘脾，脾失统血，血痢纠
缠，更衣腹痛后重，脉弦缓。治宜两和汗脾为先。
真防党 焦当归 远志肉 东白芍 樗白皮 嫩绵 清炙草 炒枣仁 陈阿胶
真于术（东壁土炒） 云茯神 广木香 桂圆肉 桂圆肉（一枚），苦参子（五粒）包吞。
陈小孩（二月）寒水侮脾，水肿胀满，脉双弦而濡，治之非易易耳。
米仁 制香附 法半夏 广陈皮 车前子 绵茵陈 大腹绒 椒目 飞滑石 带皮
苓制川朴 地骷髅 冬瓜皮
此症小儿谓之瓠白，大人谓之水肿，同一病也。
许左（年三十一岁，八月三日） 伤于湿者下先受之，诸湿肿满皆属于脾，脾失运化之
权，湿热曾着阳明，太阴阳明之脉皆从足经而起，湿热下注其经气络不和，肿自足跗而起，膀胱气化失司，肿
及阴囊，小溲不利，脉象弦缓，治宜分利，方照陈孩水肿之方去香附大腹绒，加汉防己、晚蚕沙。
如湿热香港脚亦从此方，加萆 、汉防己、晚蚕沙。（按原稿无正方）
张（七月） 脾肺气虚，中焦失运化之权，湿热蕴留阳明，三焦气滞不和，肿自足跗而
起，延及四肢头面，腹胀少纳，四肢酸倦，小溲不利，脉右弦滑，治宜清利。
生于术 大腹绒 椒目 晚蚕沙（酒炒绢包） 车前草 炒枳实 新会皮 飞滑石 带
皮苓 制香附 法半夏 汉防己 地骷髅。
陈姓患者：气虚导致湿热下注，出现痔疮、漏管及脱肛症状，脉象弦数，治疗应当以调理为主。
方药：水泛补中益气丸（四两）配合加味槐角丸（四两）。将两种药丸混合均匀，每日清晨和午后空腹时，用开水送服五钱。
何姓患者左侧（正月就诊）：脾脏运化功能不足，湿热滞留于阳明经，加之操劳损伤肝脏，肝木克制脾土，脾脏失去统摄血液的功能，导致血痢缠绵难愈，排便时腹痛且有里急后重感，脉象弦缓。治疗应以调和肝脾为先。
方药：真防党参、焦当归、远志肉、东白芍、樗白皮、嫩绵芪、清炙甘草、炒枣仁、陈阿胶、真于术（用东壁土炒）、云茯神、广木香、桂圆肉、桂圆肉（一枚），苦参子（五粒）包裹吞服。
陈姓小孩（二月就诊）：寒水之气反侮脾土，导致水肿胀满，双脉呈弦而濡软之象，治疗颇为不易。
方药：米仁、制香附、法半夏、广陈皮、车前子、绵茵陈、大腹绒、椒目、飞滑石、带皮苓、制川朴、地骷髅。
按语：此症在小儿称为“瓠白”，在大人称为“水肿”，本质上是同一种疾病。
许姓患者左侧（三十一岁，八月三日就诊）：湿邪伤人，下部先受其害；各种湿邪导致的肿胀胀满都归属于脾。脾脏失去运化的职权，湿热曾附着于阳明经，太阴与阳明的经脉均起于足部经络，湿热下注导致经络之气不和，肿胀从足背开始，膀胱气化功能失调，肿胀波及阴囊，小便不利，脉象弦缓，治疗应当采用分利之法。处方参照陈姓小孩水肿的方剂，去掉香附和大腹绒，加入汉防己、晚蚕沙。
若为湿热引起的香港脚（足部湿热肿痛），也从此方加减，加入萆薢、汉防己、晚蚕沙。（按：原稿无正方记载）
张姓患者（七月就诊）：脾肺气虚，中焦失去运化职权，湿热蕴结滞留于阳明，三焦气机阻滞不和，肿胀从足背开始，蔓延至四肢头面，腹部胀满食欲减退，四肢酸软疲倦，小便不利，右脉弦滑，治疗应当清热利湿。
方药：生于术、大腹绒、椒目、晚蚕沙（酒炒并用绢布包裹）、车前草、炒枳实、新会皮、飞滑石、带皮苓、制香附、法半夏、汉防己、地骷髅。
Patient Chen: Qi deficiency leads to the downward pouring of damp-heat, resulting in hemorrhoids, fistulas, and rectal prolapse. The pulse is wiry and rapid; treatment should focus on regulation.
Formula: Shuibu Buzhong Yiqi Wan (Water-pelleted Buzhong Yiqi Pill) (4 liang) combined with Jiawei Huaijiao Wan (Modified Huaijiao Pill) (4 liang). Mix the two pills evenly. Take 5 qian each morning and afternoon on an empty stomach, washed down with warm water.
Patient He (Left side, January): Spleen transport and transformation function is insufficient; damp-heat lingers in the Yangming channel. Additionally, overwork injures the Liver; Liver Wood overacts on Spleen Earth, causing the Spleen to lose its function of controlling blood. This results in persistent bloody dysentery, abdominal pain during defecation, and tenesmus. The pulse is wiry and slow. Treatment should prioritize harmonizing the Liver and Spleen.
Prescription: Zhen Fangdang (Zhen Fangshen), Jiao Danggui (Scorched Angelicae Sinensis Radix), Yuanzhi Rou (Polygalae Radix Flesh), Dong Baishao (Dong Bai Shaoyao), Chubai Pi (Stemonae Radix Bark), Nen Mian (Tender Astragali Radix), Qing Zhigancao (Clear-fried Licorice Root), Chao Zaoren (Fried Ziziphus Seed), Chen Ejiao (Aged Donkey-hide Gelatin), Zhen Yushu (Zhen Atractylodis Macrocephalae Rhizoma, stir-fried with East Wall Soil), Yun Fushen (Cloud Poria with Hostwood), Guang Muxiang (Guang Aucklandiae Radix), Guiyuan Rou (Longan Aril), Guiyuan Rou (one piece), Kushenzi (Sophorae Tonkinensis Seed) wrapped for swallowing.
Pediatric Patient Chen (February): Cold Water insults the Spleen, leading to edema and distension. Both pulses are wiry and soggy; treatment is not easy.
Prescription: Miren (Coicis Semen), Zhi Xiangfu (Processed Cyperi Rhizoma), Fa Banxia (Prepared Pinelliae Tuber), Guang Chenpi (Guang Citri Reticulatae Pericarpium), Cheqianzi (Plantaginis Semen), Mian Yinchen (Artemisiae Scopariae Herba), Dafurong (Arecae Pericarpium), Jaomu (Capsici Fructus Seed), Fei Huashi (Flying Talcum), Daipi Ling (Poria with Peel), Zhi Chuanpo (Processed Magnoliae Officinalis Cortex), Dikutulou (Trichosanthis Radix).
Note: In children, this condition is called "Houbai"; in adults, it is called "Shuizhong" (Edema). It is the same disease.
Patient Xu (Left side, Age 31, August 3rd): When injured by dampness, the lower part is affected first. All dampness-induced swelling and fullness belong to the Spleen. The Spleen loses its authority over transport and transformation. Damp-heat has attached to the Yangming channel. The Taiyin and Yangming meridians both originate from the foot channels. Damp-heat pours downward, causing disharmony in the channel qi and collaterals. Swelling starts from the dorsum of the foot. Bladder qi transformation fails, so swelling extends to the scrotum. Urination is difficult. The pulse is wiry and slow. Treatment should employ separation and drainage. The formula follows that used for Pediatric Patient Chen's edema, removing Xiangfu and Dafurong, adding Hanfangji (Stephaniae Tetrandrae Radix) and Wancansha (Bombyx Batryticatus).
If it is damp-heat Hongkongjiao (Gouty arthritis/Damp-heat affecting the feet), use this formula as a base, adding Bibo (Dioscoreae Hypoglaucae Rhizoma), Hanfangji, and Wancansha. (Note: No main formula recorded in the original manuscript).
Patient Zhang (July): Spleen and Lung Qi deficiency causes the Middle Jiao to lose its authority over transport and transformation. Damp-heat accumulates and lingers in Yangming. Sanjiao (Triple Burner) qi stagnates and is disharmonious. Swelling starts from the dorsum of the foot, extending to the limbs, head, and face. Abdominal distension and poor appetite occur. Limbs feel sore and fatigued. Urination is difficult. The right pulse is wiry and slippery. Treatment should clear and drain.
Prescription: Sheng Yushu (Raw Atractylodis Macrocephalae Rhizoma), Dafurong (Arecae Pericarpium), Jaomu (Capsici Fructus Seed), Wancansha (Bombyx Batryticatus, wine-fried and wrapped in silk), Cheqiancao (Plantaginis Herba), Chao Zhishi (Fried Aurantii Fructus Immaturus), Xinhui Pi (Xinhui Citri Reticulatae Pericarpium), Fei Huashi (Flying Talcum), Daipi Ling (Poria with Peel), Zhi Xiangfu (Processed Cyperi Rhizoma), Fa Banxia (Prepared Pinelliae Tuber), Hanfangji (Stephaniae Tetrandrae Radix), Dikutulou (Trichosanthis Radix).