两浙江淮都漕运使崔君长男云卿。年二十有五。体本丰肥。奉养膏粱。时有热证。友人劝食寒
凉物。及服寒凉药。于至元庚辰秋。病疟久不除。医以砒霜等药治之。新汲水送下。禁食热物。疟
病不除。反添吐泻。脾胃复伤。中气愈虚。腹痛肠鸣。时复胃脘当心而痛。不任其苦。屡易医药。未尝有效。至冬还家。
百般治疗而不瘥。延至四月间。因劳役烦恼过度。前证大作。请予治之。具说其由。诊
得脉弦细而微。手足稍冷。面色青黄而不泽。情思不乐。恶人烦冗。饮食减少。微饱则心下痞闷。
呕吐酸水。发作疼痛。冷汗时出。气促闷乱不安。须人额相抵而坐。少时易之。予思内经云。中气
不足。溲便为之变。肠为之苦鸣。下气不足。则为痿厥心冤。又曰寒气客于肠胃之间。则卒然而痛
。得炅则已。炅者、热也。非甘辛大热之剂。则不能愈。遂制此方。
【扶阳助胃汤】
干姜（炮。一钱半） 拣参 草豆蔻仁 甘草（炙）
官桂 白芍药（各一钱） 陈皮 白术
吴茱萸（各五分） 黑附子（炮去皮。二钱） 益智仁（五分。一方一钱）
上 咀。都作一服。水三盏。生姜三片。枣子两个。煎至一盏。去渣。温服。食前。三服大势
皆去。痛减过半。至秋先灸中脘三七壮。以助胃气。次灸气海百余壮。生发元气。滋荣百脉。以还
少丹服之。则喜饮食。添肌肉。润皮肤。明年春。灸三里二七壮。乃胃之合穴也。亦助胃气。又引
气下行。春以芳香助脾。复以育气汤加白檀香平治之。戒以惩忿窒欲。慎言语。节饮食。一年而平
复。
内经曰。寒淫于内。治以辛热。佐以苦温。附子、干姜大辛热。温中散寒。故以为君。草豆
寇仁、益智仁、辛甘大热。治客寒犯胃为佐。脾不足者以甘补之。炙甘草甘温。白术、橘皮苦温。
补脾养气。水挟木势。亦来侮土。故作急痛。桂辛热以退寒水。芍药味酸以泻木克土。吴茱萸苦热
。泄厥气上逆于胸中。以为使也。
两浙江淮都漕运使崔君的大儿子云卿，二十五岁。他身体本来肥胖丰腴，饮食多为精细油腻的高热量食物（膏粱厚味），时常出现热证。朋友劝他吃寒凉性质的食物，他也服用了寒凉药物。到了至元庚辰年秋天，患疟疾（一种以寒战、高热、汗出为特征的疾病）长久不愈。医生用砒霜等药物来治疗，并用刚打来的冷水送服，同时禁止食用热性食物。结果疟疾没有好，反而增添了呕吐和腹泻的症状，脾胃再次受到损伤，中气更加虚弱，出现腹痛、肠鸣，时常感到胃脘部当心位置疼痛，难以忍受这种痛苦。多次更换医生和药物，都没有效果。到了冬天回到家乡，经过百般治疗仍未痊愈。拖延到第二年四月间，因为劳累过度且烦恼过多，之前的病症剧烈发作。请我诊治。他详细叙述了病情经过。诊察发现脉象弦细而微弱，手脚稍微发冷，面色青黄而没有光泽，情绪抑郁不乐，讨厌别人打扰烦扰，饮食减少，稍微吃饱一点就觉得心下痞塞闷胀，呕吐酸水，发作时疼痛，出冷汗，呼吸急促，胸闷烦躁不安，需要让人额头相抵坐着休息，过一会儿又要换人。我思考《内经》说：中气不足，大小二便就会发生异常，肠道会发出痛苦的鸣响；下气不足，就会导致痿厥和心中冤结郁痛。又说：寒气侵入肠胃之间，就会突然疼痛，得到温热就会缓解。“炅”就是热的意思。如果不是甘辛大热的药剂，就不能治愈。于是制定了这个方子。
【扶阳助胃汤】
干姜（炮制，一钱半）、人参（拣选好的）、草豆蔻仁、甘草（炙）、官桂、白芍药（各一钱）、陈皮、白术、吴茱萸（各五分）、黑附子（炮制去皮，二钱）、益智仁（五分，另一版本为一钱）。
以上药材切碎，作为一剂服用。加水三盏，生姜三片，大枣两个，煎煮至一盏，去渣，温服，饭前服用。服用三剂后，主要症状大多消除，疼痛减轻了一半以上。到了秋天，先灸中脘穴三十壮，以辅助胃气；再灸气海穴一百多壮，以生发元气，滋养荣润全身血脉，并服用还少丹，这样就能喜欢饮食，增加肌肉，润泽皮肤。第二年春天，灸足三里穴十四壮，这是胃的合穴，也能辅助胃气，并且引导气机下行。春季使用芳香药物辅助脾脏，又用育气汤加入白檀香进行平调治疗。告诫他要克制愤怒，节制欲望，谨慎言语，节制饮食。一年后完全康复。
《内经》说：寒邪淫溢于体内，要用辛热药物治疗，辅以苦温药物。附子、干姜是大辛大热的药物，能温中散寒，所以作为君药。草豆蔻仁、益智仁，辛甘大热，治疗客寒侵犯胃腑，作为佐药。脾脏不足的，用甘味补益，炙甘草甘温，白术、橘皮苦温，补脾益气。水气挟带木势，也会来侮害土气，所以导致急痛。桂枝辛热以退除寒水，芍药味酸以泻除木克土的病机，吴茱萸苦热，泄除厥逆之气上冲胸中，作为使药。
Cui Jun, the Regional Transport Commissioner of Zhejiang and Huaihe Rivers, had an eldest son named Yunqing. He was twenty-five years old. His physique was naturally robust and plump, and his diet consisted mainly of rich and greasy foods (Gao Liang Hou Wei). He frequently presented with heat syndromes. Friends advised him to consume cold-natured foods, and he also took cold-natured medicines. In the autumn of the Gengchen year of the Zhiyuan era, he suffered from malaria (a disease characterized by chills, high fever, and sweating) that persisted for a long time. Physicians treated him with arsenic trioxide (Pishuang) and other drugs, administered with freshly drawn cold water, and prohibited the consumption of warm-natured foods. Consequently, the malaria did not resolve; instead, vomiting and diarrhea were added. The Spleen and Stomach were further injured, the Middle Qi became increasingly deficient, leading to abdominal pain and borborygmus. He frequently experienced pain in the epigastric region at the heart's location, which was unbearable. Multiple changes of physicians and prescriptions yielded no effect. By winter, upon returning home, despite various treatments, he remained unwell. By April of the following year, due to excessive physical exertion and mental distress, the previous symptoms exacerbated severely. He requested my treatment and recounted the history of his illness. Upon pulse diagnosis, the pulse was wiry, thin, and faint. His hands and feet were slightly cold. His complexion was greenish-yellow and lusterless. He was emotionally depressed, disliked being disturbed or bothered, had reduced appetite, and felt stifling fullness below the heart after eating even a small amount. He vomited sour fluid, experienced painful episodes, broke out in cold sweats, suffered from shortness of breath, chest tightness, restlessness, and anxiety. He needed someone to sit with their foreheads touching him for support, changing persons frequently. I reflected on the *Neijing* (Inner Canon), which states: "When Middle Qi is insufficient, urination and defecation become abnormal, and the intestines suffer from loud rumbling." It also states: "When Lower Qi is insufficient, it leads to flaccidity, cold extremities, and internal oppression/pain." Furthermore, it says: "When cold pathogenic factors invade between the stomach and intestines, sudden pain occurs, which resolves upon receiving warmth." "Jiong" refers to heat. Without potent sweet and acrid hot formulas, cure would be impossible. Thus, I formulated this prescription.
[Fuyang Zhuwei Tang (Support Yang and Assist Stomach Decoction)]
Dried Ginger (Pao, 1.5 qian), Ginseng Radix et Rhizoma (Ren Shen, selected), Alpiniae Katsumadai Semen (Caodoukou Ren), Licorice Root (Zhi Gancao, honey-fried), Cinnamon Twig (Guigui), White Peony Root (Baishaoyao) (each 1 qian), Tangerine Peel (Chenpi), Atractylodes Macrocephala Rhizome (Baizhu), Evodia Fruit (Wuzhuyu) (each 0.5 qian), Prepared Aconite Lateralis Radix (Hei Fuzi, Pao, peeled, 2 qian), Alpinia Oxyphylla Fruit (Yizhiren) (0.5 qian, another version prescribes 1 qian).
The above herbs are coarsely crushed. Prepare as one dose. Add three zhen of water, three slices of fresh ginger, and two jujubes. Decoct until one zhen remains. Strain and discard the dregs. Take warm, before meals. After three doses, the major symptoms largely disappeared, and pain decreased by more than half. In autumn, moxibustion was applied to Zhongwan (CV12) for thirty moxa cones to assist Stomach Qi. Subsequently, moxibustion was applied to Qihai (CV6) for over one hundred moxa cones to generate Yuan Qi, nourish the blood vessels, and restore vitality. He also took Hushao Dan (Lesser Age Pill), which improved his appetite, increased muscle mass, and moisturized the skin. In the spring of the next year, moxibustion was applied to Zusanli (ST36) for fourteen moxa cones. This is the He-Sea point of the Stomach channel, which also assists Stomach Qi and guides Qi downward. In spring, aromatic herbs were used to assist the Spleen, and Yuqi Tang (Nourish Qi Decoction) with added White Sandalwood (Baitanxiang) was used for regulation. He was advised to restrain anger, curb desires, speak sparingly, and regulate his diet. One year later, he fully recovered.
The *Neijing* states: "When cold excesses internally, treat with acrid-hot substances, assisted by bitter-warm substances." Aconite and Dried Ginger are highly acrid and hot, warming the middle and dispersing cold, thus serving as the Sovereign (Jun) herbs. Alpinia Katsumadai Seed and Alpinia Oxyphylla Fruit are acrid, sweet, and highly hot, treating exogenous cold invading the stomach, serving as Assistant (Zuo) herbs. For Spleen deficiency, tonify with sweet flavors; Honey-fried Licorice is sweet and warm, while Atractylodes and Tangerine Peel are bitter and warm, tonifying the Spleen and nourishing Qi. Water qi, carrying Wood energy, may insult Earth, causing acute pain. Cinnamon Twig is acrid and hot to dispel cold-water; White Peony Root is sour to drain Wood insulting Earth; Evodia Fruit is bitter and hot to drain rebellious Jue Qi ascending to the chest, serving as Envoy (Shi) herbs.