征南副元帅大忒木儿。年六旬有八。戊午秋征南。予从之。过扬州十里。时仲冬。病自利完谷
不化。脐腹冷疼。足 寒。以手搔之。不知痛痒。尝烧石以温之。亦不得暖。予诊之。脉沉细而微
。予思之。年高气弱。深入敌境。军事烦冗。朝暮形寒。饮食失节。多饮乳酪。履于卑湿。阳不能
外固。由是清湿袭虚。病起于下。故 寒而逆。内经云。感于寒而受病。微则为咳。盛则为泄为痛
。此寒湿相合而为病也。法当急退寒湿之邪。峻补其阳。非灸不能病已。先以大艾炷于气海。灸百
壮。补下焦阳虚。次灸三里二穴各三七壮。治 寒而逆。且接引阳气下行。又灸三阴交二穴。以散
足受寒湿之邪。遂处方云。寒淫所胜。治以辛热。湿淫于外。平以苦热。以苦发之。以附子大辛热
助阳退阴。温经散寒。故以为君。干姜、官桂、大热辛甘。亦除寒湿。白术、半夏、苦辛
温而燥脾湿。故以为臣。人参、草豆蔻、炙甘草、甘辛大温。温中益气。生姜大辛温。能散清湿之
邪。葱白辛温。以通上焦阳气。故以为佐。又云。补下治下。制以急。急则气味浓。故大作剂服之
。不数服泻止痛减。足 渐温。调其饮食。逾十日平复。明年秋。过襄阳。值霖雨。阅旬余。前证
复作。再根据前灸添阳辅。各灸三七壮。再以前药投之。数服良愈。
【加减白通汤】治形寒饮冷。大便自利。完谷不化。脐腹冷痛。足 寒而逆。
附子（炮。去皮脐） 干姜（炮。各一两） 官桂（去皮） 甘草（炙）
半夏（汤泡七次） 草豆蔻（面裹煨） 人参 白术（各半两）
上八味 咀。每服五钱。水二盏半。生姜五片。葱白五茎。煎一盏三分。去渣。空心宿食消尽
。温服。气海一穴。在脐下一寸五分。任脉所发。
三里二穴。在膝下三寸 外廉两筋间。取足举之。足阳明脉所入合也。可灸三壮。针入五分。
三阴交二穴。足内踝上三寸骨下陷中。足太阴少阴。厥阴之交会。可灸三壮。针入三分。
髓会绝骨。针经云。脑髓消。胫酸耳鸣。绝骨在外踝上辅骨下当胫中是也。髓会之处也。洁古
老人云。头热如火。足冷如冰。可灸阳辅穴。又云。 酸冷。绝骨取之。
阳辅二穴。在足外踝上四寸辅骨前绝骨端。如前三分。去丘墟七寸。足少阳脉之所行也。可灸
三七壮。针入五分。由是副帅疾愈。以医道为重。待予弥浓。
征南副元帅大忒木儿，六十八岁。戊午年秋天出征，我跟随他同行。经过扬州十里处时，正值仲冬（冬季的第二个月），他出现腹泻且大便中含有未消化的食物，脐腹部冷痛，双脚寒冷，用手抓挠脚部，感觉不到疼痛和瘙痒。曾经烧烫石头来温暖双脚，也无法变暖。我诊察他的脉象，脉沉细而微弱。我思考病因：患者年老气弱，深入敌境，军务繁忙冗杂，早晚受寒，饮食不节制，大量饮用乳酪，又处于低洼潮湿之地，导致阳气不能在外固护，因此清湿之邪侵袭虚弱之处，病起于下部，所以足部寒冷且逆冷。《内经》说：“感受寒邪而致病，轻则咳嗽，重则泄泻、疼痛。”这是寒湿相合而成的疾病。治疗法则应当紧急驱除寒湿之邪，峻补阳气，非艾灸不能治愈。先用大艾炷在气海穴灸一百壮，以补下焦阳虚；其次灸足三里两穴各三七壮，治疗足寒而逆，并且引导阳气下行；又灸三阴交两穴，以消散足部受到的寒湿之邪。于是处方如下：寒淫胜复，用辛热之法治疗；湿淫于外，用苦热之法平抑；用苦味药发散。以附子大辛大热助阳退阴，温经散寒，故作为君药。干姜、官桂，大热辛甘，也能祛除寒湿；白术、半夏，苦辛温燥脾湿，故作为臣药。人参、草豆蔻、炙甘草，甘辛大温，能温中益气；生姜大辛温，能散清湿之邪；葱白辛温，能通上焦阳气，故作为佐药。又说：“补下治下，制剂宜急，急则气味浓厚。”所以制成大剂量服用。服数剂后，腹泻停止，疼痛减轻，双脚逐渐回暖。调理饮食，十多天后痊愈。第二年秋天，经过襄阳，遇到连绵阴雨，过了十几天，前症复发。再次依据前面的艾灸方法添加阳辅穴，每穴各灸三七壮。再用前面的药物投服，服数剂后良愈。
【加减白通汤】治疗形寒饮冷，大便自利，完谷不化，脐腹冷痛，足寒而逆。
附子（炮制，去皮脐）一两，干姜（炮制）一两，官桂（去皮），甘草（炙），半夏（汤泡七次），草豆蔻（面裹煨），人参，白术（各半两）。
以上八味药捣碎。每次服用五钱，加水二盏半，生姜五片，葱白五茎，煎至一盏三分，去渣。空腹宿食消尽后，温服。
气海一穴，位于脐下一寸五分，为任脉所发。
足三里两穴，位于膝下三寸，胫骨外侧两筋之间，取穴时屈足举之，为足阳明脉所入合之处。可灸三壮，针入五分。
三阴交两穴，位于足内踝上三寸骨下陷中，为足太阴、少阴、厥阴三经交会之处。可灸三壮，针入三分。
髓会绝骨。《针经》说：“脑髓消，胫酸耳鸣”，绝骨位于外踝上辅骨下当胫中，是髓会之处。洁古老人说：“头热如火，足冷如冰”，可灸阳辅穴。又说：“腨（小腿肚）酸冷”，取绝骨穴。
阳辅两穴，位于足外踝上四寸，辅骨前，绝骨端，如前所述三分处，距离丘墟七寸，为足少阳脉所行之处。可灸三七壮，针入五分。
由此副帅的疾病痊愈，因为重视医道，对待我更加深厚浓烈。
Deputy Marshal of the Southern Expedition, Da Teimur, was sixty-eight years old. In the autumn of the Wuwu year, during the southern expedition, I accompanied him. When passing ten li from Yangzhou, in the second month of winter (Zhongdong), he suffered from diarrhea with undigested food in the stool, cold pain in the umbilical and abdominal regions, and coldness in the feet. Scratching his feet with hands failed to elicit any sensation of pain or itch. Burning stones to warm them also failed to produce warmth. Upon diagnosis, his pulse was deep, fine, and faint. Reflecting on the etiology: due to advanced age and weak qi, entering enemy territory, heavy military duties, exposure to cold morning and evening, irregular diet, excessive consumption of milk and cheese, and dwelling in low-lying damp areas, yang qi failed to secure the exterior. Consequently, clear dampness invaded the deficiency, causing disease to arise from below, resulting in cold and reversal in the feet. The *Neijing* states: "Contracting cold leads to disease; mild cases manifest as cough, severe cases as diarrhea and pain." This is a disease caused by the combination of cold and dampness. The treatment principle should urgently dispel cold-damp pathogens and vigorously tonify yang. Only moxibustion can cure this condition. First, apply large moxa cones at Qihai (CV6) for one hundred burns to tonify lower jiao yang deficiency. Second, moxa Zusanli (ST36) bilaterally, thirty-seven burns each, to treat cold and reversal in the feet, and to guide yang qi downward. Third, moxa Sanyinjiao (SP6) bilaterally to dissipate cold-damp pathogens affecting the feet. Thus, the prescription was formulated as follows: For excess cold, treat with acrid-hot methods. For external dampness, level with bitter-hot methods. Use bitter flavors to disperse. Fuzi (Prepared Aconiti Lateralis Radix), extremely acrid and hot, assists yang and retreats yin, warms meridians and disperses cold, thus serving as the Sovereign herb. Ganjiang (Zingiberis Rhizoma) and Guigui (Cinnamomi Cortex), extremely hot, acrid, and sweet, also dispel cold and dampness. Baizhu (Atractylodis Macrocephalae Rhizoma) and Banxia (Pinelliae Rhizoma), bitter, acrid, and warm, dry spleen dampness, thus serving as Ministers. Renshen (Ginseng Radix), Caodoukou (Alpiniae Katsumadai Semen), and Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata), sweet, acrid, and extremely warm, warm the middle and benefit qi. Shengjiang (Zingiberis Rhizoma Recens), extremely acrid and warm, disperses clear-damp pathogens. Congbai (Allii Fistulosi Bulbus), acrid and warm, unblocks upper jiao yang qi, thus serving as Assistants. It is stated: "Tonifying and treating the lower requires urgent preparation; urgency implies strong flavor and potency." Therefore, a large dose was prepared and administered. After several doses, diarrhea ceased, pain decreased, and feet gradually warmed. With dietary regulation, recovery occurred within ten days. The following autumn, passing through Xiangyang, continuous rain persisted for over ten days, and previous symptoms recurred. Moxibustion was repeated according to the previous method, adding Yangfu (GB38), thirty-seven burns per acupoint. The previous herbal medicine was administered again, resulting in excellent recovery after several doses.
[Jiajian Baitong Decoction] Treats chilling of the body and drinking of cold substances, spontaneous diarrhea, undigested food in stool, cold pain in the umbilical and abdominal regions, and coldness with reversal in the feet.
Fuzi (Prepared Aconiti Lateralis Radix, processed, skin and embryo removed) 1 liang, Ganjiang (Zingiberis Rhizoma, processed) 1 liang, Guigui (Cinnamomi Cortex, peeled), Zhigancao (Glycyrrhizae Radix et Rhizoma, honey-fried), Banxia (Pinelliae Rhizoma, soaked in boiling water seven times), Caodoukou (Alpiniae Katsumadai Semen, roasted in flour wrapper), Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma) (each 0.5 liang).
The above eight ingredients are crushed. Take 5 qian per dose, add 2.5 zhan of water, 5 slices of Shengjiang (Zingiberis Rhizoma Recens), and 5 stalks of Congbai (Allii Fistulosi Bulbus). Decoct until 1.3 zhan remains, strain. Administer warm on an empty stomach after overnight food has digested.
Qihai (CV6): One point, located 1.5 cun below the umbilicus, originating from the Ren Mai (Conception Vessel).
Zusanli (ST36): Two points, located 3 cun below the knee, between the two tendons on the lateral side of the tibia. To locate, flex the foot and lift it. This is where the Foot-Yangming Stomach Meridian enters and combines. Moxa 3 burns, needle insert 5 fen.
Sanyinjiao (SP6): Two points, located in the depression below the bone, 3 cun above the medial malleolus. Intersection of the Foot-Taiyin Spleen, Foot-Shaoyin Kidney, and Foot-Jueyin Liver meridians. Moxa 3 burns, needle insert 3 fen.
Marrow Meeting Juegu (GB39). The *Zhenjing* states: "Brain marrow diminishes, shank soreness, tinnitus." Juegu is located below the auxiliary bone above the lateral malleolus, corresponding to the center of the tibia, which is the site of the Marrow Meeting. Elder Jiegu said: "Head hot as fire, feet cold as ice," moxa Yangfu (GB38). Also stated: "Calf soreness and coldness," select Juegu (GB39).
Yangfu (GB38): Two points, located 4 cun above the lateral malleolus, anterior to the auxiliary bone, at the end of Juegu, approximately 3 fen as described previously, 7 cun from Qiuxu (GB40). This is where the Foot-Shaoyang Gallbladder Meridian travels. Moxa 37 burns, needle insert 5 fen.
Thus, the Deputy Marshal's illness was cured. Valuing the medical art, he treated me with profound respect.