汪石山治萧师训。年逾五十。形肥色紫。气从脐下逆冲而上。睡卧不安。饮食少。精神
倦。汪诊之。脉皆浮濡而缓。曰。气虚也。问曰。丹溪云气从脐下起者。阴火也。何谓气虚
汪曰。难执定论。丹溪又云。肥人气虚。脉缓亦气虚。今据形与脉。当作气虚论治。遂以
参、 为君。白术、白芍为臣。归身、熟地为佐。黄柏、甘、陈为使。煎服十余帖。稍安。
彼以胸膈不利。陈皮加作七分。气冲上。仍守前方。月余而愈。
震按此条仍合丹溪二说同用之。非专主气虚也。惟汪公于濡缓脉。多以参、 加麦冬、
黄柏。不加附子。想系一生得手处。至如陈皮加作七分。气即冲上。此尤气虚之显然者。前
方可操券取效也。窃忆生平治气冲证。用熟地、归、杞、牛膝、紫石英、胡桃肉、坎气、青
铅等药而愈者。不计其数。又有用肾气丸而愈者。用大补阴丸、三才丸而愈者。总不出丹溪
之训。唯一陆姓书生。形瘦。饮食如常。别无他病。而气自脐下上冲。始仅抵胸。后渐至喉
又渐达巅顶。又渐从脑后由督脉及夹脊两傍而下。又渐至腿踝足心。仍入少腹。再复上冲
其冲甚慢。约一年而上下周到。谷食降序。肌肉愈削。共两年半而其人方死。凡温凉补泻
靡药不尝。针灸祝由。无法不试。震固不能愈之。而就医于吴门叶薛两先生。亦无寸效。
此种病。恨不遇张戴人喻西昌周慎斋诸公。听其议论以开茅塞也。又按魏志华佗传。载一士
大夫不快。佗曰。君病深。当破腹取。然君寿亦不过十年。病不能杀君。忍病十岁。寿俱当
尽。不足故自刳裂。士大夫不耐痛痒。必欲除之。佗遂下手。所患寻瘥。十年竟死。震读此
益慨然于术之疏也。设华公遇此陆生。即早知其十年后以气冲证寿当尽矣。何药之能为。
马元仪治袁玉行。小腹厥气上冲。即吐。得饮则吐愈甚。诸药不效。马诊之。两脉虚涩
右尺独见弦急。此下焦浊气上胜。则胸中阳气不布。故饮入于胃。上壅而不下达。宜通其
地道。用调胃承气汤。下宿秽甚多。继渐培中气而愈。
震按凡病皆有虚实。勿谓气冲证皆系阴虚气虚也。故选此条。别开一例。然必是暴病或
便秘。乃从右尺脉印其机耳。昔年曾与杜良一先生治下焦肾虚。上焦气冲者。杜用六味地黄
汤。合五磨饮子去木香。以汁和服而效。又一新翻式样也。
汪石山治疗萧师训。年过五十岁。形体肥胖面色紫暗。气从脐下逆冲而上。睡眠卧躺不安稳。饮食减少。精神疲倦。汪石山诊察他的脉象。脉象都浮而濡软且缓。说。这是气虚证。有人问。朱丹溪说气从脐下起的是阴火证。为什么说是气虚？
汪石山说。不能固执于定论。朱丹溪又说。肥胖的人多气虚。脉缓也是气虚的表现。现在根据病人的形体和脉象。应当作为气虚证来治疗。于是以人参、（药名缺失，据上下文推测可能为黄芪或类似补气药，此处依原文留空或补全为常见搭配，但严格依原文应为“参、[缺]”）为君药。白术、白芍为臣药。当归身、熟地为佐药。黄柏、甘草、陈皮为使药。煎服十余帖后。病情稍安。
病人因为胸膈部不利。将陈皮加量至七分。结果气上冲的症状又出现。仍然坚守前方不变。月余后痊愈。
俞震按语：这一条案例仍然结合朱丹溪的两种说法同时使用。并非专门主治气虚。只是汪公对于濡缓脉。多以人参、（缺）、麦冬、黄柏配伍。不加附子。想必是他一生得心应手的经验之处。至于像陈皮加到七分。气就向上冲。这更是气虚的明显表现。前面的方子可以稳操胜券取得疗效。
我私下回忆生平治疗气冲证。用熟地、当归、枸杞、牛膝、紫石英、胡桃肉、坎气、青铅等药物而治愈的。不计其数。又有用肾气丸而治愈的。用大补阴丸、三才丸而治愈的。总不出朱丹溪的教诲范围。唯独有一个姓陆的书生。形体消瘦。饮食如常。没有其他病症。但气从脐下向上冲。开始仅抵胸部。后来逐渐到达咽喉。又逐渐达到头顶。又逐渐从脑后沿督脉及夹脊两旁向下。又逐渐到达腿踝足心。仍进入少腹。再重新向上冲。其冲势很慢。约一年时间上下周到。谷物食物下降有序。肌肉日益消瘦。共两年半这个人就死了。凡是温凉补泻的药物没有不尝试的。针灸祝由之术。没有方法不试用的。俞震固然不能治愈他。而请教于苏州吴门的叶薛两位先生。也没有丝毫效果。
这种病。遗憾没有遇到张戴人、喻西昌、周慎斋诸位先生。听他们的议论来开启茅塞。又按《三国志·魏书·华佗传》记载。有一位士大夫身体不适。华佗说。您的病很深。应当剖开腹部取出病灶。然而您的寿命也不过十年了。疾病不能杀死您。忍受病痛十年。寿命也就到头了。不值得自己割裂身体。士大夫忍受不了痛痒。一定要去除病根。华佗于是动手手术。所患疾病很快痊愈。十年后果然死去。俞震读到这里更加感慨医术的疏漏。假设华佗遇到这个姓陆的生员。即使早就知道他在十年后因气冲证寿命将尽。又能用什么药呢？
马元仪治疗袁玉行。小腹有厥逆之气上冲。随即呕吐。喝水则吐得更厉害。各种药物无效。马元仪诊察他的脉象。两脉虚涩。右尺脉单独呈现弦急。这是下焦浊气上盛。导致胸中阳气不能布散。所以饮水入胃。向上壅滞而不能下达。应当通利地道。用调胃承气汤。排出宿便秽物很多。接着逐渐培补中气而痊愈。
俞震按语：凡病都有虚实之分。不要认为气冲证都是阴虚气虚。所以选录这一条。别开一例。然而必须是暴病或便秘。才能通过右尺脉印证其机理。昔年曾与杜良一先生一起治疗下焦肾虚、上焦气冲的病人。杜先生用六味地黄汤。合五磨饮子去掉木香。以汁液调和服用而见效。这也是一种新的式样。
Wang Shishan treated Scholar Xiao. He was over fifty years old, with a fat body and purplish complexion. Qi rushed upward from below the navel, causing restlessness in sleep and lying down, reduced appetite, and mental fatigue. Wang examined his pulse, finding it floating, soggy (Ru), and slow throughout. He stated, "This is Qi deficiency." The questioner asked, "Danxi said that Qi rising from below the navel is due to Yin Fire. Why do you call it Qi deficiency?" Wang replied, "One cannot adhere rigidly to fixed theories. Danxi also said that fat people often have Qi deficiency, and a slow pulse also indicates Qi deficiency. Now, based on the patient's physique and pulse, we should treat this as Qi deficiency." Thus, he used [missing herb] and Ginseng Radix (Renshen) as the sovereign drug, Atractylodis Macrocephalae Rhizoma (Baizhu) and White Peony Root (Baishao) as the minister drugs, Angelicae Sinensis Radix (Guishen) and Prepared Rehmanniae Radix (Shudi) as the assistant drugs, Phellodendri Cortex (Huangbai), Licorice Root (Gancao), and Tangerine Peel (Chenpi) as the envoy drugs. After taking more than ten doses of the decoction, the condition slightly improved. Because the patient experienced discomfort in the chest and diaphragm, Chenpi was increased to 7 fen. However, the upward rushing of Qi recurred. Wang adhered to the original prescription. The patient recovered after more than a month.
Zhen commented: This case still combines both of Danxi's theories simultaneously; it does not exclusively focus on Qi deficiency. It seems that for soggy and slow pulses, Master Wang frequently combined Ginseng Radix (Renshen), [missing herb], Ophiopogonis Radix (Maidong), and Phellodendri Cortex (Huangbai), without adding Aconiti Lateralis Radix Praeparata (Fuzi). This must be an experience where he excelled throughout his life. Regarding the fact that increasing Chenpi to 7 fen caused the Qi to rush upward, this is a clear manifestation of Qi deficiency. The previous formula could surely achieve efficacy. I privately recall treating numerous cases of Qi rushing syndrome in my life using Prepared Rehmanniae Radix (Shudi), Angelicae Sinensis Radix (Danggui), Lycii Fructus (Gouqi), Achyranthis Bidentatae Radix (Niuxi), Hematitum (Zishiying), Juglandis Semen (Hetaoren), Penis Bovis (Kanzi), and Lead (Qingqian), resulting in cures, which are too many to count. There were also cases cured by Shenqi Wan (Kidney Qi Pill), Dabu Yin Wan (Great Yin Tonifying Pill), and Sancai Wan (Three Talents Pill). All these methods did not deviate from Danxi's teachings. However, there was one scholar surnamed Lu, who was thin, had normal appetite, and no other illnesses, yet Qi rushed upward from below the navel. Initially, it only reached the chest, then gradually ascended to the throat, then to the vertex, then descended from the back of the head along the Du Meridian and the sides of the spine, then to the ankles and soles of the feet, re-entering the lower abdomen, and then rushing upward again. The rushing was very slow, taking about one year to complete a full cycle up and down. Food digestion proceeded normally, but muscles wasted away. After two and a half years, the patient died. He tried every kind of warming, cooling, tonifying, and draining medicine, and tested all acupuncture and exorcism methods. Zhen could not cure him, nor could the two masters Ye and Xue in Wu men (Suzhou) achieve any effect. For such a disease, I regret not meeting Zhang Dairen, Yu Xichang, or Zhou Shenzhai to listen to their discussions and open my mind. Furthermore, according to the Biography of Hua Tuo in the Records of Wei (Wei Shu), a gentleman suffered from discomfort. Hua Tuo said, "Your illness is deep; the abdomen must be opened to remove the pathology. However, your lifespan will not exceed ten years. The disease will not kill you; endure the pain for ten years, and your lifespan will end naturally. It is not worth mutilating yourself." The gentleman could not tolerate the pain and itching and insisted on removing the disease. Hua Tuo performed surgery, and the illness quickly healed. Ten years later, he indeed died. Reading this, Zhen further lamented the limitations of medical art. If Master Hua had encountered this scholar Lu, even if he knew early on that the scholar would die of Qi rushing syndrome in ten years, what medicine could be done?
Ma Yuanyi treated Yuan Yuxing. There was rebellious Qi rushing upward from the lower abdomen, accompanied by vomiting. Drinking water exacerbated the vomiting. Various medicines were ineffective. Ma examined his pulse, finding both wrists deficient and choppy (Se), while the right Chi position alone showed a wiry and rapid (Xian Ji) quality. This indicated turbid Qi in the lower jiao overpowering upwards, preventing the Yang Qi in the chest from distributing. Thus, when water entered the stomach, it obstructed upward and failed to descend. The method should be to unblock the "earthly pathway" (intestines). He used Tiaowei Chengqi Tang (Regulating the Stomach and Directing Downward Decoction). A large amount of retained feces was discharged. Subsequently, the middle Qi was gradually fortified, and the patient recovered.
Zhen commented: All diseases have deficiency and excess aspects. One should not assume that Qi rushing syndrome is always due to Yin or Qi deficiency. Therefore, this case was selected to present a different example. However, it must be an acute illness or constipation for the right Chi pulse to confirm the mechanism. In the past, I once treated a patient with Kidney Deficiency in the lower jiao and Qi rushing in the upper jiao together with Mr. Du Liangyi. Mr. Du used Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) combined with Wumo Yinzi (Five-Monk Drink) with Xiangru removed, taken as a liquid mixture, which was effective. This represents another new approach.