真定路总管刘仲美。年逾六旬。宿有脾胃虚寒之证。至元辛巳闰八月初。天气阴寒。因官事劳
役。渴而饮冷。夜半自利两行。平旦召予诊视。其脉弦细而微。四肢冷。手心寒。唇舌皆有褐色。
腹中微痛。气短而不思饮食。予思内经云。色青者肝也。肝属木。唇者、脾也。脾属土。木来克土
。故青色见于唇也。舌者心之苗。水挟木势。制火凌脾。故色青见于舌也。难经有云。见肝之病。
则知肝当传之于脾。故先实其脾气。今脾已受肝之邪矣。洁古先师云。假令五脏胜。各刑已胜。补
不胜而泻其胜。重实其不胜。微泻其胜。而以黄 建中汤加芍药附子主之。且芍药味酸。泻其肝木
。微泻其胜。黄 、甘草甘温。补其脾土。是重实其不胜。桂、附辛热。泻其寒水。又助阳退阴。
饴糖甘温。补脾之不足。肝苦急。急食甘以缓之。生姜、大枣、辛甘大温。生发脾胃升腾之气。行
其荣卫。又能缓其急。每服一两。根据法水煎服之。再服而愈。
【黄 建中汤】（劳倦门内有。不录于方中倍芍药。量虚实加附子）
参政杨公七旬有二。宿有风疾。于至元戊辰春。忽病头旅眼黑。目不见物。心神烦乱。兀兀欲
吐、复不吐。心中如懊 之状。头偏痛。微肿而赤色。腮颊亦赤色。足 冷。命予治之。予料之。
此少壮之时。喜饮酒。久积湿热于内。风痰内作。上热下寒。是阳不得交通。痞之象也。经云。治热
以寒。虽良工不敢废其绳墨。而更其道也。然而病有远近。治有轻重。参政今年高气弱。上焦虽盛
。岂敢用寒凉之剂。损其脾胃。经云。热则疾之。又
云。高巅之上。射而取之。予以三棱针约二十余处刺之。其血紫黑。如露珠之状。少顷。头目便觉
清利。诸证悉减。遂处方云。眼黑头旋。虚风内作。非天麻不能除。天麻苗谓之定风草。此草独不
为风所摇。故以为君。头偏痛者、乃少阳也。非柴胡、黄芩酒制不能治。黄连苦寒酒炒。以治上热
。又为因用。故以为臣。橘皮苦辛温。炙甘草甘温补中益气为佐。生姜、半夏辛温。能治风痰。茯
苓甘平利小便。导湿热引而下行。故以为使。服之数服。邪气平。生气复而安矣。
【天麻半夏汤】治风痰内作。胸膈不利。头旋眼黑。兀兀欲吐。上热下寒。不得安卧。
天麻 半夏（各一钱） 橘皮（去白） 柴胡（各七分）
黄芩（酒制炒） 甘草 白茯苓（去皮） 前胡（各五分）
黄连（三分。去须）
上九味 咀。都为一服。水二盏。生姜三片。煎至一盏。去渣。温服。食后。忌酒面生冷物。
真定路总管刘仲美，年龄超过六十岁。平素就有脾胃虚寒的病症。至元辛巳年闰八月初，天气阴冷寒冷，因为公务劳役，口渴喝了冷水，半夜腹泻两次。清晨请我诊治。他的脉象弦细而微弱，四肢冰冷，手心发凉，嘴唇和舌头都有褐色，腹部轻微疼痛，气短且不想吃东西。我思考《内经》说：颜色发青的是肝，肝属木；嘴唇对应脾，脾属土。木克土，所以青色出现在嘴唇上。舌是心的苗窍，水借助木的气势，克制火并凌犯脾，所以青色出现在舌头上。《难经》说：看到肝的病，就知道肝会传变到脾，所以先充实脾气。现在脾已经受到肝的邪气侵袭了。洁古先师说：假如五脏中某一行偏胜，就会刑克它所胜的一行，应当补益被克的一方而泻除偏胜的一方，重重地补益被克的一方，微微地泻除偏胜的一方。用黄芪建中汤加芍药、附子为主方。而且芍药味酸，能泻肝木，微微泻除偏胜；黄芪、甘草味甘性温，能补脾土，这是重重地补益被克的一方；桂枝、附子味辛性热，能泻寒水，又助阳退阴；饴糖味甘性温，补脾之不足。肝苦于急迫，急切时吃甘味食物以缓和它。生姜、大枣味辛甘大温，能生发脾胃升腾之气，运行营卫，又能缓解急迫。每次服用一两，按照方法用水煎服。再服后痊愈。
【黄芪建中汤】（在劳倦门内有记载，此处不录，方中倍用芍药，根据虚实情况加入附子）
参政杨公七十二岁，平素有风疾。在至元戊辰年春天，突然患病，头晕眼花，眼睛看不见东西，心神烦乱，昏昏欲吐却又吐不出来，心中像懊恼一样的感觉，头部一侧疼痛，轻微肿胀且发红，腮颊也发红，脚冷，请我治疗。我推测，这是因为他在年轻力壮的时候喜欢喝酒，长久以来湿热积聚在体内，风痰在内部发作，导致上热下寒，阳气不能交通，这是痞证的征象。经书说：治疗热证用寒凉药，即使是高明的医生也不敢废弃法度而改变原则。然而病有远近之分，治疗有轻重之别。参政今年年纪高气弱，上焦虽然盛实，怎敢用寒凉的药物，损伤他的脾胃？经书说：热证要快速治疗。又说：在高处（头部）的病，用针刺的方法取治。我用三棱针在大约二十多处刺络放血，流出的血紫黑，像露珠一样。过了一会儿，头目便觉得清爽通利，各种症状都减轻。于是处方说：眼黑头晕，是虚风在内部发作，非天麻不能去除。天麻的苗叫做定风草，这种草唯独不被风吹动，所以作为君药。头部一侧疼痛，属于少阳经，非柴胡、黄芩酒制不能治疗。黄连苦寒，酒炒后用来治疗上热，又因为是因应病情使用，所以作为臣药。橘皮苦辛温，炙甘草甘温补中益气作为佐药。生姜、半夏辛温，能治疗风痰。茯苓甘平利小便，引导湿热下行，所以作为使药。服用几剂后，邪气平息，生气恢复而痊愈。
【天麻半夏汤】治疗风痰在内部发作，胸膈不畅，头晕眼花，昏昏欲吐，上热下寒，无法安卧。
天麻 半夏（各一钱） 橘皮（去白） 柴胡（各七分）
黄芩（酒制炒） 甘草 白茯苓（去皮） 前胡（各五分）
黄连（三分，去须）
以上九味药捣碎，共为一服，水两盏，生姜三片，煎煮至一盏，去渣，温服，饭后服用，忌食酒、面食及生冷食物。
Liu Zhongmei, the Chief Administrator of Zhengding Circuit, was over sixty years old. He had a chronic condition of deficiency-cold in the Spleen and Stomach. In the leap eighth month of the Xin-Si year of Zhiyuan, the weather was cloudy and cold. Due to official duties and labor, he drank cold water when thirsty. At midnight, he suffered diarrhea twice. In the early morning, I was summoned to examine him. His pulse was wiry, fine, and faint. His four limbs were cold, and his palms were chilly. His lips and tongue exhibited a brownish hue. He had slight abdominal pain, shortness of breath, and no desire for food. I reflected on the *Neijing* (Classic of Internal Medicine), which states: "The color green corresponds to the Liver; the Liver belongs to Wood. The lips correspond to the Spleen; the Spleen belongs to Earth. Wood controls Earth, hence the green color appears on the lips." The tongue is the sprout of the Heart. Water, leveraging the momentum of Wood, suppresses Fire and insults the Spleen, hence the green color appears on the tongue. The *Nanjing* (Classic of Difficult Issues) states: "When seeing a disease of the Liver, one knows that the Liver will transmit it to the Spleen; therefore, first strengthen the Spleen Qi." Now, the Spleen has already been invaded by the pathogenic factor of the Liver. Master Jiegu said: "If any of the Five Zang organs is excessive, it will punish the organ it controls. One should tonify the deficient organ and drain the excessive one, heavily tonifying the deficient side and slightly draining the excessive side." Therefore, I used Huangqi Jianzhong Tang (Astragalus Decoction to Establish the Middle) with added Shaoyao (Peony Root) and Fuzi (Prepared Aconite Root). Shaoyao is sour in taste and drains Liver Wood, slightly reducing the excess. Huangqi (Astragali Radix) and Gancao (Licorice Root) are sweet and warm, tonifying Spleen Earth, thereby heavily strengthening the deficient side. Guizhi (Cinnamon Twig) and Fuzi are acrid and hot, draining Cold-Water, assisting Yang, and retreating Yin. Yitang (Maltose) is sweet and warm, supplementing Spleen insufficiency. The Liver dislikes tension; in cases of urgency, sweet substances should be eaten to relieve it. Shengjiang (Fresh Ginger Rhizome) and Dazao (Jujube Fruit) are acrid, sweet, and greatly warm, generating the ascending Qi of the Spleen and Stomach, circulating Ying and Wei (Nutritive and Defensive Qi), and relieving tension. Each dose was one liang, decocted in water according to the method. After two doses, he recovered.
[Huangqi Jianzhong Tang] (Recorded in the section on Fatigue and Overwork, not listed here in full; double the amount of Shaoyao in the formula, add Fuzi based on deficiency or excess.)
Canlang (Vice Minister) Yang was seventy-two years old. He had a chronic history of wind disorders. In the spring of the Wu-Chen year of Zhiyuan, he suddenly fell ill with dizziness, blurred vision, and blindness. His mind was restless and chaotic, feeling nauseous and wanting to vomit but unable to do so, experiencing a sensation of inner vexation. He had unilateral headache, slight swelling, and redness of the head, and his cheeks were also red. His feet were cold. I was asked to treat him. I deduced that in his youth, he enjoyed drinking alcohol, leading to long-term accumulation of Damp-Heat internally. Wind-Phlegm arose internally, causing Upper Heat and Lower Cold, preventing the communication of Yang. This is a manifestation of Pi Syndrome (Glomus). The classics state: "To treat heat with cold, even skilled physicians must adhere to their standards and not deviate from them." However, diseases have distant and near locations, and treatments have light and heavy degrees. The Canlang is now elderly with weak Qi. Although the Upper Jiao is abundant, how could I dare use cold-cooling agents to damage his Spleen and Stomach? The classics state: "For heat, treat it quickly." It also says: "For ailments at the high summit, use needle therapy." I used a three-edged needle to prick approximately twenty-plus points. The blood drawn was purple-black, resembling dewdrops. Shortly after, his head and eyes felt clear and beneficial, and all symptoms subsided. Thus, I prescribed: "Blurred vision and dizziness are caused by internal deficiency-wind; only Tianma (Gastrodiae Rhizoma) can eliminate it. The sprout of Tianma is called Dingfeng Cao (Wind-Calming Grass); this grass alone is not shaken by the wind, so it serves as the Sovereign herb." Unilateral headache belongs to the Shaoyang channel; only Chaihu (Bupleuri Radix) and Huangqin (Scutellariae Radix) processed with wine can treat it. Huanglian (Coptidis Rhizoma) is bitter and cold; stir-fried with wine to treat Upper Heat, serving as the Minister herb due to its specific indication. Jupi (Citri Reticulatae Pericarpium) is bitter, acrid, and warm; Zhi Gancao (Prepared Licorice Root) is sweet and warm, tonifying the Middle and benefiting Qi, serving as the Assistant herb. Shengjiang (Fresh Ginger Rhizome) and Banxia (Pinelliae Rhizoma) are acrid and warm, capable of treating Wind-Phlegm. Fuling (Poria) is sweet and neutral, promoting urination to guide Damp-Heat downward, serving as the Envoy herb. After several doses, the pathogenic factors were pacified, healthy Qi was restored, and he recovered.
[Tianma Banxia Tang] Treats internal Wind-Phlegm, chest and diaphragm discomfort, dizziness, blurred vision, nausea, Upper Heat and Lower Cold, and inability to sleep peacefully.
Tianma (Gastrodiae Rhizoma) and Banxia (Pinelliae Rhizoma) (each 1 qian), Jupi (Citri Reticulatae Pericarpium, peeled), Chaihu (Bupleuri Radix) (each 7 fen), Huangqin (Scutellariae Radix, wine-processed and fried), Gancao (Licorice Root), Fuling (Poria, peeled), Qianhu (Peucedani Radix) (each 5 fen), Huanglian (Coptidis Rhizoma, 3 fen, remove roots).
These nine ingredients are coarsely crushed. Take one dose, add two cups of water and three slices of fresh ginger. Decoct until one cup remains, strain, and take warm after meals. Avoid alcohol, wheat products, and raw/cold foods.