中书左丞相史公。年六旬有七。至元丁卯九月间。因内伤自利数行。觉肢体沉重。不思饮食。
嗜卧懒言语。舌不知味。腹中疼痛。头亦痛而恶心。医以通圣散大作剂料服之。覆以浓衣。遂大汗
出。前证不除而反增剧。易数医。四月余不愈。予被召至燕。命予治之。予诊视得六脉沉细而微弦
。不欲食。食即呕吐。中气不调。滞于升降。口舌干躁。头目昏眩、肢体倦怠。足 冷。卧不欲起
。丞相素不饮酒。肢体本瘦。又因内伤自利。又复获汗。是重竭津液。脾胃愈虚。不能滋荣周身百
脉。故使然也。非甘辛、大温之剂。则不能温养其气。经云。脾欲缓急。食甘以缓之。又脾不足者
。以甘补之。黄 、人参之甘。补脾缓中。故以为君。形不足者温之以气。当归辛温。和血润燥。
木香辛温。升降滞气。生姜、益智、草豆蔻仁辛甘大热。以荡中寒。理其正气。白术、炙甘草、橘
皮。甘苦温乃浓肠胃。麦 面宽肠胃而和中。神曲辛热。导滞消食而为佐使也。上件 咀一两。水
煎服之。呕吐止。饮食进。越三日。前证悉去。左右侍者曰。前证虽去。九日不大便。如何。予曰。
丞相年高气弱。既利且汗。脾胃不足。阳气亏损。津液不润也。岂敢以寒凉有毒之剂下之。仲景曰
。大发汗后。小便数。大便坚。不可用承气汤。如此虽内结。宜以蜜煎导之。须臾去燥屎二十余块
。遂觉腹中空快。上下气调。又以前药服之。喜饮食。但有所伤。则以橘皮枳术丸消导之。至月余
。其病乃得平复。丞相曰。病既去矣。当服何药以
防其复来。予曰。不然。但慎言语。节饮食。不可服药。夫用药如用刑民。有罪则刑之。身有疾则
药之。无罪妄刑。是谓疟民。无病妄药。反伤正气。军志有曰。允当则归。服而舍之可也。丞相说
而然之。
【参术调中汤】治内伤自利。脐腹痛。肢体倦。不喜食。食即呕。嗜卧懒言。足 冷
。头目昏。
人参 黄 （各五钱） 当归身 浓朴（姜制）
益智仁 草豆蔻 木香 白术
甘草（炙） 神曲（炒） 麦 面 橘皮（各三钱）
上十二味、锉如麻豆大。每服一两。水二盏。生姜三片。煎至一盏。去滓温服。食前。
中书左丞相史公，年龄六十七岁。在至元丁卯年九月期间，因为内伤导致腹泻数次，感觉肢体沉重，不想吃东西，喜欢躺着懒得说话，舌头尝不出味道，腹部疼痛，头部也痛且伴有恶心。医生用通圣散（Tongsheng San）加大剂量让他服用，并用厚衣服覆盖，结果大汗淋漓。之前的症状没有消除反而加重了。更换了好几位医生，四个多月都没有痊愈。我被召到燕京，命令我治疗他。我诊察发现他的六脉沉细而微弦，不想进食，吃了就呕吐，中气不调，气机阻滞于升降之间，口舌干燥，头目昏眩，肢体倦怠，脚冷，躺下后不想起来。丞相平时不喝酒，身体本来消瘦，又因为内伤腹泻，再加上发汗，这是双重耗竭津液，脾胃更加虚弱，不能滋养周身百脉，所以导致这样的状况。如果不是甘辛、大温的药剂，就不能温养他的气。《内经》说：脾欲缓急，食甘以缓之。又说：脾不足者，以甘补之。黄芪、人参的甘味，能补脾缓中，所以作为君药。形体不足的人，用气来温养它。当归辛温，和血润燥；木香辛温，升降滞气；生姜、益智仁、草豆蔻仁辛甘大热，用来驱散中焦寒邪，调理正气；白术、炙甘草、陈皮，甘苦温，能增厚肠胃；小麦面宽缓肠胃而调和其中；神曲辛热，导滞消食，作为佐使药。以上药材切碎一两，用水煎服。呕吐停止，饮食进补。过了三天，之前的症状全部消失。旁边的侍从说：之前的症状虽然消失了，但九天没有大便，怎么办？我说：丞相年纪大，气弱，既腹泻又发汗，脾胃不足，阳气亏损，津液不滋润肠道。怎么敢用寒凉有毒的药物来攻下呢？张仲景说：大发汗后，小便频数，大便坚硬，不可用承气汤（Chengqi Tang）。像这样即使内部有结滞，应该用蜜煎导法（Hijian Dao Fa，蜂蜜栓剂）通便。不久排出了二十多块干硬的大便，于是觉得腹部空快，上下气机调畅。又继续服用前面的药物，喜欢饮食。如果有什么损伤，就用橘皮枳术丸（Jupi Zhizhu Wan）来消导。到了一个多月，病情才平复。丞相说：病已经去除了，应当服用什么药来防止复发？我说：不对。只要慎言语，节饮食，不要服药。用药就像使用刑罚对待百姓，有罪则惩罚，身有病则用药。无罪妄加刑罚，这叫虐民；无病妄自服药，反而伤害正气。军志上说：适当就归还（指停止行动），服用后舍弃即可。丞相认为说得对并采纳了。
【参术调中汤】治疗内伤导致的腹泻，脐部腹痛，肢体疲倦，不喜欢吃东西，吃了就呕吐，喜欢躺着懒得说话，脚冷，头目昏眩。
人参、黄芪（各五钱）、当归身、浓朴（姜制）、益智仁、草豆蔻、木香、白术、甘草（炙）、神曲（炒）、小麦面、陈皮（各三钱）。
以上十二味药，锉碎如麻豆大小。每次服用一两，水两盏，生姜三片，煎至一盏，去渣温服。饭前服用。
His Excellency Shi, Left Chancellor of the Secretariat, was sixty-seven years old. In September of the Dingmao year of Zhiyuan, due to internal injury causing diarrhea several times, he felt heavy limbs, loss of appetite, a desire to lie down and reluctance to speak, loss of taste in the tongue, abdominal pain, headache accompanied by nausea. A physician administered Tongsheng San (Great Calorie-Resisting Powder) in large doses, covered him with thick clothing, resulting in profuse sweating. The previous symptoms were not relieved but instead aggravated. Several physicians were consulted, but he remained unwell for over four months. I was summoned to Yanjing and ordered to treat him. Upon examination, his six pulses were deep, fine, and slightly wiry; he had no desire to eat, vomiting immediately after eating; middle Qi was disordered, stagnating in its ascending and descending movements; dry mouth and tongue, dizziness of head and eyes, limb fatigue, cold feet, and unwillingness to rise from bed. The Chancellor usually did not drink alcohol and was naturally thin. Furthermore, due to internal injury-induced diarrhea and subsequent sweating, this constituted a double depletion of body fluids, further weakening the Spleen and Stomach, which could no longer nourish the hundred vessels throughout the body, thus causing these conditions. Without sweet, acrid, and strongly warming agents, his Qi could not be warmed and nourished. The Classic states: "The Spleen desires relaxation; sweet flavors relax it." It also states: "For Spleen deficiency, use sweet flavors to tonify it." The sweetness of Huangqi (Astragali Radix) and Renshen (Ginseng Radix et Rhizoma) tonifies the Spleen and moderates the center, so they serve as the Sovereign drugs. For those lacking physical substance, warmth is provided through Qi. Danggui (Angelicae Sinensis Radix) is acrid and warm, harmonizing blood and moistening dryness; Muxiang (Aucklandiae Radix) is acrid and warm, regulating stagnant Qi; Shengjiang (Zingiberis Rhizoma Recens), Yizhiren (Alpiniae Oxyphyllae Fructus), and Caodoukou Ren (Cardamomi Fructus) are acrid, sweet, and strongly hot, dispelling cold in the middle Jiao and regulating righteous Qi; Baizhu (Atractylodis Macrocephalae Rhizoma), Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma), and Chenpi (Citri Reticulatae Pericarpium) are sweet, bitter, and warm, thickening the intestines and stomach; Xiaomai Mian (Tritici Venalis Farina) broadens and harmonizes the intestines and stomach; Shenqu (Massa Medicata Fermentata) is acrid and hot, guiding stagnation and digesting food, serving as Assistant and Envoy drugs. One tael of the above chopped herbs was decocted in water and taken orally. Vomiting ceased, and appetite returned. After three days, all previous symptoms disappeared. Attendants remarked: "Although the previous symptoms have vanished, there has been no bowel movement for nine days. What should be done?" I said: "The Chancellor is elderly and weak in Qi. Having suffered both diarrhea and sweating, his Spleen and Stomach are insufficient, Yang Qi is depleted, and body fluids fail to moisten. How dare I use cold, cool, and toxic purgatives? Zhang Zhongjing stated: 'After severe sweating, if urination is frequent and stool is hard, Chengqi Tang (Major Order the Qi Decoction) must not be used.' Even with internal accumulation, one should use Honey Suppository Method (Mi Jian Dao). Soon, more than twenty pieces of dry feces were expelled. He then felt relief in the abdomen, and the Qi above and below became regulated. He continued taking the previous prescription, enjoyed food, and if any dietary injury occurred, Jupi Zhizhu Wan (Tangerine Peel and Atractylodes Pill) was used to guide digestion. After more than a month, the illness subsided. The Chancellor asked: "Since the disease is gone, what medicine should I take to prevent recurrence?" I replied: "Incorrect. Simply guard speech, regulate diet, and do not take medicine. Using medicine is like administering punishment to the people; punish when there is guilt, medicate when there is illness. Unjust punishment is tyranny against the people; unnecessary medication harms righteous Qi. The Military Annals state: 'When appropriate, return.' Take the medicine and then discard it." The Chancellor agreed and accepted this advice.
[Shenzhu Tiaozhong Tang] Treats internal injury with diarrhea, umbilical abdominal pain, limb fatigue, anorexia, vomiting after eating, lethargy with reluctance to speak, cold feet, and dizziness.
Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix) (5 qian each); Danggui Shen (Angelicae Sinensis Radix), Houpo (Magnoliae Officinalis Cortex) (prepared with ginger); Yizhiren (Alpiniae Oxyphyllae Fructus), Caodoukou (Cardamomi Fructus), Muxiang (Aucklandiae Radix), Baizhu (Atractylodis Macrocephalae Rhizoma); Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma), Shenqu (Massa Medicata Fermentata), Xiaomai Mian (Tritici Venalis Farina), Chenpi (Citri Reticulatae Pericarpium) (3 qian each).
Twelve ingredients, crushed to the size of hemp seeds. Each dose consists of 1 tael, decocted with 2 cups of water and 3 slices of fresh ginger until reduced to 1 cup. Strain and take warm before meals.