钱（六二） 胸中之气，上冲清道，而痛即欲呕吐饮食，此为梅核气，噎症之渐也。近
添泄
泻，是系新病，理宜分治。推究病情，必是酒客好饮，谷减胃气必虚。盖阳明以降为顺，虚
则失其传导之权。更必气性多躁，木火上炎，直冲会厌，以成斯病，然乎否乎？病者首肯，
以为虽素知，亦不能如是明悉，况初诊乎？即请予处方。
人参（八分） 代赭石（一钱五分） 生白芍（一钱二分） 橘白（一钱） 半夏（一钱） 枳实（
六分） 旋复花（一钱） 川连（七分） 乌梅肉（六分）
服两剂，喉痛呕吐止，增减其味，以为丸料，常服可许脱然，切宜节饮戒性，庶得万全
。
潘妪 痞升脘痛，纳少难消，两脉沉伏，七情内伤，中阳失运，头疼畏风，亦是浊阴僭
上。
桂枝木（七分） 吴茱萸（五分） 半夏（一钱五分） 党参（一钱五分） 白术（一钱五分）
砂仁末（五分） 香附（一钱五分） 归身（一钱五分）
王氏（三六） 肩胛酸痛，经月不愈，属血虚，兼受风邪。
归身 黄 冬术 秦艽 川续断 羌活 防风
两服不知病之所在。
陈（五十） 肝火内煽，络脉受伤，胁肋大痛，疏痛气血。
桃仁（二钱） 红花（一钱） 生白芍（一钱五分） 丹皮（一钱五分） 橘皮（一钱） 延胡索
（一钱五分活血化气第一品） 旋复花（一钱） 青葱管（七寸二味能入络止痛）
周（四十） 肝阳犯胃，胁痛呕吐。
川楝肉 归须 生白芍 橘白 半夏 山栀 茯苓 炙草 老姜渣
三服痛止呕除，午后觉脘中嘈杂，六脉细软，胃土久受木侮，气虚不能健运。阳明以通
为补，以降为顺，所以补中须佐清降。
人参 蒸于术 茯苓 半夏 枳壳 橘皮 归身 白芍 炙草
张（二五） 木郁为热而胁痛，湿蕴则肌黄并见矣。
柴胡 薄荷 丹皮 黑栀 延胡索 旋复花 归须 桃仁 新绛 青葱管
久痛必入络脉，今三服既得减去什七，治黄新病要紧。纳少嗜卧，因脾气欠运，疸症之
常，此恙若平一二分痛，不治而瓦解矣。
柴胡 薄荷 夏枯草 川连 山栀 香附 广皮 木通 茵陈
徐（五一）右胁闪痛，咳呛腥痰，内痈之象。
苡仁 桑皮 地骨皮 橘红 茯苓 杏仁 党参 白术 甘草
六服竟愈。
陶（二八） 左肋痛如刀割，畏寒身热，神气昏惫，脉象模糊，势甚危急。此乃客邪干犯
，疏风兼治络，冀得速平，方保无事。多有变失血者，亦属瘀滞，流行无妨。
炒延胡 当归 红花 桃仁 橘红 生香附 旋复花 苏叶 青葱管
钱某（六十二岁）：胸中的气机上冲至清窍，随即出现疼痛并想要呕吐饮食，这是梅核气，是噎膈症的前兆。最近增添了腹泻症状，这属于新发的疾病，治疗上应当分开处理。推究病情，必定是因为患者是长期饮酒之人，谷食减少导致胃气必然虚弱。因为阳明经以通降为顺，胃气虚弱则失去了传导的功能。再加上患者性情急躁，肝木之火炎上，直冲会厌部位，从而形成此病，是这样吗？病人点头称是，认为即使是素来了解病情的人，也不能如此明察秋毫，更何况是初次诊治呢？于是请求我开处方。
人参（八分） 代赭石（一钱五分） 生白芍（一钱二分） 橘白（一钱） 半夏（一钱） 枳实（六分） 旋复花（一钱） 川连（七分） 乌梅肉（六分）
服用两剂后，喉痛和呕吐停止。根据情况增减药味，制成丸药，长期服用可以期望彻底痊愈。务必节制饮酒、戒除急躁性情，这样才能万无一失。
潘家老妇人：感觉痞塞感上逆，胃脘部疼痛，进食少且难以消化，两手脉象沉伏。这是由于七情内伤，中焦阳气失去运化功能，头痛怕风，也是浊阴之气僭越上逆所致。
桂枝木（七分） 吴茱萸（五分） 半夏（一钱五分） 党参（一钱五分） 白术（一钱五分） 砂仁末（五分） 香附（一钱五分） 归身（一钱五分）
王某（三十六岁）：肩胛部酸痛，持续一个月未愈，属于血虚，兼受风邪侵袭。
服用两剂后，不知病痛所在（意指症状缓解或定位不清）。
陈某（五十岁）：肝火在内煽动，络脉受伤，胁肋部剧烈疼痛，需疏通气血止痛。
桃仁（二钱） 红花（一钱） 生白芍（一钱五分） 丹皮（一钱五分） 橘皮（一钱） 延胡索（一钱五分，活血化气第一品） 旋复花（一钱） 青葱管（七寸，这两味药能入络止痛）
川楝肉 当归须 生白芍 橘白 半夏 山栀 茯苓 炙甘草 老姜渣
服用三剂后疼痛停止、呕吐消除。午后感觉胃中嘈杂，六脉细软，这是因为胃土长久受到肝木的克制，气虚不能健运。阳明经以通降为补益，以降为顺，所以在补益中必须佐以清降之法。
张某（二十五岁）：肝木郁结化为热邪而致胁痛，湿气蕴结则肌肤发黄同时出现。
柴胡 薄荷 丹皮 黑栀子 延胡索 旋复花 当归须 桃仁 新绛 青葱管
久病疼痛必然深入络脉，如今服用三剂后症状已减轻十分之七，治疗黄疸这一新发疾病是当务之急。进食少、嗜睡，是因为脾气运化不足，这是疸症的常态。此病如果疼痛减轻一二分，不治自解了。
徐某（五十一岁）：右胁部闪痛，咳嗽呛逆且痰带腥味，这是内痈的迹象。
服用六剂后竟然痊愈。
陶某（二十八岁）：左肋疼痛如刀割，畏寒且身体发热，神志昏沉疲惫，脉象模糊，形势非常危急。这是外邪侵犯所致，疏风兼治络脉，希望得以迅速平复，才能保无大碍。这种情况多有变为失血的，也属于瘀滞，只要流行通畅不妨事。
Mr. Qian (62 years old): The Qi in the chest rushes upward to the clear orifices, followed by pain and an urge to vomit food and drink. This is Plum-pit Qi (Meiheqi), a precursor to Dysphagia (Yezheng). Recently, diarrhea has been added; this is a new disease and should be treated separately. Investigating the pathology, it must be that the patient is a habitual drinker, and reduced grain intake has inevitably weakened Stomach Qi. The Yangming channel favors descending and smooth flow; when deficient, it loses its conduction authority. Furthermore, the patient likely has an irritable temperament, causing Liver Fire to flare upward, directly rushing to the epiglottis, thus forming this illness. Is this correct? The patient nodded in agreement, stating that even those who have known him for a long time could not understand so clearly, let alone during the first consultation. He then requested a prescription.
Ren Shen (8 fen) Daizhe Shi (1.5 qian) Sheng Bai Shao (1.2 qian) Ju Bai (1 qian) Ban Xia (1 qian) Zhi Shi (0.6 qian) Xuan Fu Hua (1 qian) Chuan Lian Zi / Huang Lian (0.7 qen) Wu Mei Rou (0.6 qian) [Note: Chuan Lian refers to Coptidis Rhizoma here as 'Chuan Lian' often implies Huanglian in some contexts or specific local usage, but standard is Huanglian. Text says 'Chuan Lian', likely shorthand for Huanglian or specific variety. I will use Coptidis Rhizoma].
After taking two doses, throat pain and vomiting ceased. Ingredients were adjusted and modified into pills for regular consumption, which can lead to complete recovery. It is crucial to moderate alcohol intake and control one's temper to ensure total safety.
Elderly Mrs. Pan: Sensation of fullness rising and epigastric pain, poor appetite with difficulty digesting, both pulses are deep and hidden. This is due to emotional injury affecting the interior, loss of middle Jiao Yang transformation, headache with aversion to wind, also caused by turbid Yin usurping the upper positions.
Gui Zhi Mu (0.7 qian) Wu Zhu Yu (0.5 qian) Ban Xia (1.5 qian) Dang Shen (1.5 qian) Bai Zhu (1.5 qian) Sha Ren Mo (0.5 qian) Xiang Fu (1.5 qian) Gui Shen (1.5 qian)
Ms. Wang (36 years old): Soreness and pain in the scapular region, persisting for a month without healing. This belongs to Blood deficiency combined with Wind pathogen invasion.
Dang Gui Shen Huang Qi Dong Zhu Qin Jiao Chuan Xu Duan Qiang Huo Fang Feng
After two doses, the location of the illness became unclear (symptoms alleviated).
Mr. Chen (50 years old): Liver Fire flaring internally, damaging the collaterals, causing severe pain in the hypochondrium. Treatment should soothe and move Qi and Blood.
Tao Ren (2 qian) Hong Hua (1 qian) Sheng Bai Shao (1.5 qian) Dan Pi (1.5 qian) Ju Pi (1 qian) Yan Hu Suo (1.5 qian, the premier herb for invigorating blood and moving Qi) Xuan Fu Hua (1 qian) Qing Cong Guan (7 cun, these two herbs enter the collaterals to relieve pain).
Mr. Zhou (40 years old): Liver Yang invading the Stomach, causing hypochondriac pain and vomiting.
Chuan Lian Rou Dang Gui Xu Sheng Bai Shao Ju Bai Ban Xia Shan Zhi Fu Ling Zhi Cao Lao Jiang Zha
After three doses, pain stopped and vomiting ceased. In the afternoon, a sensation of stomach discomfort (zajao) was felt, and all six pulses were fine and soft. This is because the Earth of the Stomach has long been oppressed by Wood, leading to Qi deficiency and inability to transform smoothly. The Yangming channel regards unobstructed flow as tonification and descending as compliance; therefore, tonification must be assisted by clearing and descending methods.
Ren Shen Zheng Yu Zhu Fu Ling Ban Xia Zhi Ke Ju Pi Dang Gui Shen Bai Shao Zhi Cao
Mr. Zhang (25 years old): Liver Wood stagnation transforming into heat causes hypochondriac pain; dampness accumulation manifests as yellow skin simultaneously.
Chai Hu Bo He Dan Pi Hei Zhi Yan Hu Suo Xuan Fu Hua Dang Gui Xu Tao Ren Xin Jiang Qing Cong Guan
Long-standing pain must enter the collaterals. Now, after three doses, symptoms have decreased by seventy percent. Treating the new jaundice is the priority. Poor appetite and drowsiness are due to insufficient Spleen Qi transformation, which is common in Jaundice (Danzheng). If the pain subsides by one or two points, the illness will resolve spontaneously.
Chai Hu Bo He Xia Ku Cao Chuan Lian Zi / Huang Lian Shan Zhi Xiang Fu Guang Pi Mu Tong Yin Chen [Note: Text says 'Chuan Lian', context suggests Huanglian or similar bitter cold herb for heat/damp. Given 'Hei Zhi' is present, 'Chuan Lian' might refer to Coptidis. I will translate as Coptidis Rhizoma based on typical formula composition for damp-heat].
Mr. Xu (51 years old): Flash-like pain in the right hypochondrium, coughing with foul-smelling sputum, indicative of an internal absorption (Neiyong).
Yi Yi Ren Sang Bai Pi Di Gu Pi Ju Hong Fu Ling Xing Ren Dang Shen Bai Zhu Gan Cao
After six doses, complete recovery was achieved.
Mr. Tao (28 years old): Pain in the left rib like knife-cutting, aversion to cold with body fever, dull and exhausted spirit, pulse is indistinct. The situation is critical. This is caused by exogenous pathogens invading. Dispersing Wind and treating the collaterals simultaneously is hoped to bring rapid relief, ensuring no further issues. Such cases often change into hemorrhage, which is also due to stasis; as long as circulation is unimpeded, it is not harmful.
Chao Yan Hu Suo Dang Gui Hong Hua Tao Ren Ju Hong Sheng Xiang Fu Xuan Fu Hua Su Ye Qing Cong Guan