陈（八岁） 童子咳呛内热，已经三年，证属童劳，治宜滋养化源，清降肺气。
党参 北沙参 茯苓 苡仁 地骨皮 桑皮 生冬术 麦冬 橘皮 炙草 枇杷叶
方立甚妙，童劳安得不愈？三年沉痼，四服而愈。
周氏（十四）兼旬进食辄呕，近日粥饮亦吐，神识潦倒，大为危候。皆因平素善怒，肝
血不足，木火易升，上凌胃土。拟苦辛酸法，必可纳谷，再商扶治。
党参（二钱） 半夏（一钱五分） 生白芍（一钱五分） 川连（六分） 生牡蛎（三钱） 橘白
（八分） 丹皮（一钱五分） 山栀（一钱五分） 吴茱萸（三分） 老姜渣（二钱）
服一剂，胸脘宽舒，纳食不呕，面青稍退，略有口苦，脐旁动气，宜养脾阴，切戒动怒
。
生地 归身 白芍 丹皮 牡蛎 桑叶 麦冬 甘草
数剂安然。后因不戒于怒复发，仍来招余，力辞难治，缠绵两月，竟成膈症而殁。
外母（五七） 丙午仲秋，患晨起呕吐黄水，腹痛泄泻，食物些微亦胀，神气潦倒，将成
重候
。切脉左浮弦，右沉涩，知为肝木不平，脾胃虚弱。用斯意调治不效，改投温通酸敛而愈。
因夏月喜饮井泉，及生冷瓜桃之类，脾胃虚寒，肝火上乘所致。
吴茱萸（六分） 干姜（一钱） 党参（一钱五分） 白术（二钱） 白芍（一钱五分） 乌梅肉
（七分） 煨木香（三分） 炙草（五分） 大枣（二枚）
一服呕止，再剂能下紫血数块，腹即不痛，纳食亦安，惟大便未实，换方∶
党参 炒白芍 茯苓 橘皮 破故纸 山药 肉果 炙草 菟丝饼
六服痊愈。
陈（四三） 病发先泻，既吐食并酸水，旬日一发，经历三年，欲成反胃。自述当临发时
，汗出寒栗。此病由于厥阴浊阴上僭，致脾胃气弱，传化无节，纳导无权。治当苦降辛散，
甘补酸收，法乌梅丸意，临发前一日服。
桂枝木 白蔻仁 半夏 川连 党参 生冬术 当归 白芍 乌梅 茯苓 炙草
张（十五） 咳呛弥月，呕吐饮食，便燥如栗。询述脐旁宿有块上攻，即咳吐食物。此系
厥阴之气犯胃，胃不下降所致，今以抑肝通腑润肠。
乌梅 鳖甲 生白芍 生地 半夏 通草 归身 麦冬 玉竹
又 病减大半，惟午餐吐尚未除，脉来短数，中气亦虚，前法兼补胃。
归身 白芍 生地 党参 蒸冬术 鳖甲 乌梅 麦冬 半夏
凡人病中，虚实不可不辨也。有神色惨淡，不能起坐，似乎虚极，而不知病气未去也。
何以
辨之？当察其胃中不快纳少，舌胎或黄或黑，便赤口渴，身有寒热，是其验也。设投补剂，
鲜不误事。无以上诸症，而见神色惨淡，起坐不能，方是真虚，惟胃闷纳少，更当辨其虚否
。
陈姓患儿（八岁）：出现儿童特有的咳嗽气喘伴体内发热，病程已达三年。此证属于“童劳”（小儿慢性虚损性疾病），治疗应当滋养化生之源，清降肺气。
处方：党参、北沙参、茯苓、薏苡仁、地骨皮、桑白皮、生白术、麦冬、橘皮、炙甘草、枇杷叶。
方剂配伍非常精妙，童劳之症怎能不愈？三年的沉疴痼疾，服用四剂便痊愈了。
周氏患者（十四岁）：连续二十多天进食即呕吐，近日连粥饮也吐出，神志昏沉萎靡，病情十分危重。这都是因为平时容易发怒，导致肝血不足，肝木之火易于升腾，向上侵犯胃土。拟用苦辛酸法治疗，必定能恢复进食，之后再商议扶正调理的方法。
处方：党参（二钱）、半夏（一钱五分）、生白芍（一钱五分）、黄连（六分）、生牡蛎（三钱）、橘白（八分）、丹皮（一钱五分）、山栀（一钱五分）、吴茱萸（三分）、老姜渣（二钱）。
服用一剂后，胸脘部宽舒通畅，进食不再呕吐，面色青暗稍退，但略有口苦，脐旁有动气感，适宜滋养脾阴，务必戒除愤怒情绪。
处方：生地、当归身、白芍、丹皮、牡蛎、桑叶、麦冬、甘草。
服用数剂后安然无恙。后来因未能戒怒而复发，再次邀请我诊治，我极力推辞认为难以治愈，缠绵病榻两个月，最终发展成噎膈症而死。
外祖母（五十七岁）：丙午年仲秋时节，患晨起呕吐黄水，腹痛泄泻，食物吃得很少也感到腹胀，神气萎靡，即将发展为重症。切脉左脉浮弦，右脉沉涩，判断为肝木不调，脾胃虚弱。先用疏肝理脾之意调治无效，改用温通兼酸敛之法而痊愈。
这是因为夏季喜欢饮用井泉水，以及生冷瓜果桃李之类，导致脾胃虚寒，肝火上乘所致。
处方：吴茱萸（六分）、干姜（一钱）、党参（一钱五分）、白术（二钱）、白芍（一钱五分）、乌梅肉（七分）、煨木香（三分）、炙甘草（五分）、大枣（两枚）。
服用一剂后呕吐停止，再服两剂能排出紫黑色血块几块，腹部立即不痛，进食也安稳，只是大便尚未成形，更换方剂：
处方：党参、炒白芍、茯苓、橘皮、补骨脂、山药、肉豆蔻、炙甘草、菟丝子饼。
服用六剂后痊愈。
陈姓患者（四十三岁）：发病时先腹泻，随后呕吐食物并伴有酸水，每十天发作一次，历经三年，想要发展成反胃症。自述在临发作时，出汗且畏寒战栗。此病由于厥阴经浊阴之气上逆僭越，导致脾胃气弱，传导消化失去节制，受纳运化无力。治疗应当采用苦降辛散、甘补酸收的方法，取法乌梅丸之意，在临发作前一天服用。
处方：桂枝木、白蔻仁、半夏、黄连、党参、生白术、当归、白芍、乌梅、茯苓、炙甘草。
张姓患者（十五岁）：咳嗽气喘持续一个月，呕吐饮食，大便干燥如栗子状。询问得知脐旁素有积块上攻，就会引发咳吐食物。这是厥阴之气侵犯胃腑，胃气不能下降所致，现以抑制肝气、通利腑气、润肠通便为治。
处方：乌梅、鳖甲、生白芍、生地、半夏、通草、当归身、麦冬、玉竹。
复诊：病情减轻大半，只有午餐后呕吐尚未消除，脉象短促而数，中气也虚弱，前法兼以补益胃气。
处方：当归身、白芍、生地、党参、蒸白术、鳖甲、乌梅、麦冬、半夏。
大凡人在患病期间，虚实不可不辨别清楚。有的人神色惨淡，不能起床坐立，似乎极度虚弱，却不知道病邪之气尚未去除。
如何辨别呢？应当观察其胃中不适、食欲减少，舌苔或黄或黑，小便赤红口渴，身体有寒热交替，这就是验证。如果此时投用补剂，几乎没有不误事的。如果没有上述症状，而见到神色惨淡、起坐不能，这才是真正的虚证，但如果伴有胃闷、食欲少，更应当辨别是否为虚证。
Chen (8 years old): Presented with pediatric cough and wheezing accompanied by internal heat, a condition persisting for three years. This syndrome belongs to "Tong Lao" (Pediatric Chronic Deficiency Syndrome), and treatment should focus on nourishing the source of transformation and descending lung Qi.
Prescription: Codonopsis Radix (Dangshen), Glehniae Radix (Beishashen), Poria (Fuling), Coicis Semen (Yiren), Cortex Lycii Radicis (Digupi), Pericarpium Mori Folii (Sangpi), Atractylodis Rhizoma Sheng (Sheng Dongzhu), Ophiopogonis Radix (Maidong), Citri Reticulatae Pericarpium (Jupi), Glycyrrhizae Radix et Rhizoma Zhi (Zhicao), Loquat Leaf (Pipaye).
The prescription is excellently formulated; how could Tong Lao fail to heal? The chronic ailment of three years was cured after four doses.
Zhou (14 years old): Vomited immediately after eating for twenty consecutive days; recently even porridge and drinks were vomited. Consciousness was dull and listless, indicating a critical condition. This resulted from a habitual tendency toward anger, leading to Liver Blood deficiency, allowing Liver Fire to ascend easily and oppress Stomach Earth. A Bitter-Acid-Pungent method is proposed to restore food intake, followed by further discussion on supporting treatment.
Prescription: Codonopsis Radix (Dangshen, 2 qian), Pinelliae Rhizoma (Banxia, 1.5 qian), Paeoniae Radix Alba Sheng (Baishao, 1.5 qian), Coptidis Rhizoma (Chuanlian, 6 fen), Ostreum Sheng (Muli, 3 qian), Citri Reticulatae Pericarpium (Jubai, 8 fen), Moutan Cortex (Danpi, 1.5 qian), Gardeniae Fructus (Shanzhi, 1.5 qian), Evodiae Fructus (Wuzhuyu, 3 fen), Ginger Residue Laojiangzha (2 qian).
After one dose, the chest and epigastrium felt relaxed, food intake ceased vomiting, the bluish complexion slightly receded, but slight bitter taste in the mouth and qi movement beside the umbilicus appeared. Nourishing Spleen Yin is appropriate, and anger must be strictly avoided.
Prescription: Rehmanniae Radix Recens (Shengdi), Angelicae Sinensis Radix (Guishen), Paeoniae Radix Alba (Baishao), Moutan Cortex (Danpi), Ostreum (Muli), Mori Folium (Sangye), Ophiopogonis Radix (Maidong), Glycyrrhizae Radix et Rhizoma (Gancao).
After several doses, the patient remained stable. Later, due to failure to avoid anger, the condition relapsed. I was invited again but declined firmly as it was difficult to treat. After lingering for two months, the patient died of Esophageal Obstruction (Ge Zheng).
Grandmother (57 years old): In mid-autumn of the Bingwu year, suffered from morning vomiting of yellow fluid, abdominal pain, diarrhea, and bloating even with minimal food intake. Spirit was listless, approaching a severe state. Pulse on the left was floating and wiry, on the right deep and choppy. It was identified as Liver Wood imbalance and Spleen-Stomach weakness. Initial treatment using Liver-soothing and Spleen-regulating ideas failed. Switched to warming, unblocking, and astringent methods, resulting in recovery.
This was caused by enjoying well water and cold raw fruits/vegetables in summer, leading to Spleen-Stomach deficiency-cold and Liver Fire riding upward.
Prescription: Evodiae Fructus (Wuzhuyu, 6 fen), Zingiberis Rhizoma (Ganjiang, 1 qian), Codonopsis Radix (Dangshen, 1.5 qian), Atractylodis Macrocephalae Rhizoma (Baizhu, 2 qian), Paeoniae Radix Alba (Baishao, 1.5 qian), Pruni Semen (Wumeirou, 7 fen), Aucklandiae Radix Wei (Weimuxiang, 3 fen), Glycyrrhizae Radix et Rhizoma Zhi (Zhicao, 5 fen), Jujubae Fructus (Dazao, 2 pieces).
One dose stopped vomiting. Two more doses led to the passage of several dark red blood clots, abdominal pain ceased, and food intake stabilized, though stool remained loose. Prescription changed to:
Prescription: Codonopsis Radix (Dangshen), Paeoniae Radix Alba Chao (Chao Baishao), Poria (Fuling), Citri Reticulatae Pericarpium (Jupi), Psoraleae Fructus (Buguzhi), Dioscoreae Rhizoma (Shanyao), Myristicae Semen (Rouguo), Glycyrrhizae Radix et Rhizoma Zhi (Zhicao), Cuscutae Semen (Tusizi bing).
Recovered after six doses.
Chen (43 years old): Illness began with diarrhea, followed by vomiting of food and sour fluid, occurring once every ten days for three years, threatening to become Reverse Regurgitation (Fanwei). The patient described sweating and chills during impending attacks. This disease stems from Turbid Yin of the Jueyin channel usurping upwards, causing weak Spleen-Stomach Qi, loss of regulation in transportation and transformation, and inability to receive and guide. Treatment should employ Bitter-Descent and Pungent-Dispersal, Sweet-Nourishment and Acid-Astringency, following the principle of Wumei Wan, taken one day before an attack.
Prescription: Cinnamomi Ramulus (Guizhimu), Amomi Fructus Rotundus (Baokouren), Pinelliae Rhizoma (Banxia), Coptidis Rhizoma (Chuanlian), Codonopsis Radix (Dangshen), Atractylodis Rhizoma Sheng (Sheng Dongzhu), Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Baishao), Pruni Semen (Wumei), Poria (Fuling), Glycyrrhizae Radix et Rhizoma Zhi (Zhicao).
Zhang (15 years old): Cough and wheezing persisted for a month, vomiting food and drink, dry stools like chestnuts. Inquiry revealed a pre-existing mass beside the umbilicus attacking upward, triggering cough and vomiting. This is due to Jueyin Qi invading the Stomach, preventing Stomach Qi from descending. Current treatment aims to suppress Liver, unblock Fu organs, and moisten intestines.
Prescription: Pruni Semen (Wumei), Testudinis et Chelonis Carapax et Plastrum (Biejia), Paeoniae Radix Alba Sheng (Baishao), Rehmanniae Radix Recens (Shengdi), Pinelliae Rhizoma (Banxia), Tectonae Caulis (Tongcao), Angelicae Sinensis Radix (Guishen), Ophiopogonis Radix (Maidong), Polygonati Odorati Rhizoma (Yuzhu).
Follow-up: Condition reduced by more than half, only lunchtime vomiting remains. Pulse is short and rapid, indicating Middle Qi deficiency. Previous method combined with Stomach tonification.
Prescription: Angelicae Sinensis Radix (Guishen), Paeoniae Radix Alba (Baishao), Rehmanniae Radix Recens (Shengdi), Codonopsis Radix (Dangshen), Atractylodis Rhizoma Zheng (Zheng Dongzhu), Testudinis et Chelonis Carapax et Plastrum (Biejia), Pruni Semen (Wumei), Ophiopogonis Radix (Maidong), Pinelliae Rhizoma (Banxia).
In general, when people are ill, Deficiency and Excess must not fail to be distinguished. Some present with pale/dull expression and inability to rise or sit, appearing extremely deficient, yet unaware that pathogenic Qi has not been expelled.
How to distinguish? Observe if there is gastric discomfort, reduced appetite, yellow or black tongue coating, red urine, thirst, and alternating chills and fever; these are the signs. If tonifying agents are administered at this stage, mistakes are almost inevitable. Only if none of the above symptoms exist, but pallor/dullness and inability to move are seen, is it true Deficiency. However, if accompanied by gastric stuffiness and poor appetite, one must further discern whether it is truly Deficiency.