儒者杨泽之，性躁嗜色，缺盆结一核，此肝火血燥筋挛，法当滋肾水生肝血。不信，乃内服降火化痰，
外敷南显、商陆，转大如碗。余用补中益气及六味地黄，间以芦荟丸，年余，元气渐复而消。
一男子，素善怒，左项微肿，渐大如升，用清痰理气，而大热作渴，小便频浊。余谓肾水亏损，用六味地
黄、补中盖气而愈。亦有胸腹等处，大如升斗，或破而如菌如榴，不问大小，俱治如前法。
举人江节夫，颈臂胁肋各结一核，误服祛痰降火软坚之剂，益甚。余曰∶此肝胆经血少而火作也。彼执
前药，至明年六月，各核皆溃，脉浮大而涩。余断以秋金将旺，肝木被克，必不起，果然。
顾大有父，年七十有九，仲冬将出，少外家入房，致头疼发热，眩运喘急，痰涎壅盛,小便频数，口干引
饮，遍舌生刺，缩敛如荔枝然，下唇黑裂，而目俱赤，烦躁不寐，或时喉内如烟火上冲，急饮冷茶少解，已
濒于危。脉大而无伦且有力，扪其身烙手。此肾经虚火游行于外，投以十全大补加山萸、泽泻、丹皮、山药、
麦冬、五味、附子一钟，熟寐良久，脉证各减三四。再与八味丸，服之诸证悉退，后畏冷物而痊。
顾仁成，年六十有一，痢后入房，精滑自遗，二日方止。
又房劳、感寒怒气，遂发寒热，右胁痛连心腹，胸痞，自汗盗汗如雨，四肢厥冷，睡中惊悸，或觉上升如浮，
或觉下陷如坠，遂致废寝。或用补药二剂益甚。脉大洪数，按之微细。此属无火虚热，急与十全大补加山药、
山萸、丹皮、附子，一剂，诸证顿愈。此等元气，百无一二。二顾氏，父子是也。
州同韩用之，年四十有六，时仲夏，色欲过度，烦热作渴，饮水不绝，小便淋沥，大便秘结，唾痰如涌，
面目俱赤，满舌生刺，两唇燥裂，遍身发热，或时如芒刺而无定处，两足心如烙，以冰折之作痛，脉洪而无
伦，此肾阴虚而阳无所附，而发于外，非火也。盖大热而甚，寒之不寒，是无水也，当峻补其阴，遂以加减八
味丸料一斤，内肉桂一两，以水顿煎六碗，冰冷与饮。半响已用大半，睡觉而食温粥一碗，复睡至晚，乃以
前药温饮一碗，乃睡至晓，食热粥二碗，诸证悉退。翌日畏寒，足冷至膝，诸证仍至，或以为伤寒。余曰∶
非也，大寒而甚，热之不热，是无火也，阳气亦虚矣。急以八味丸一剂，服之稍缓。四剂，诸证悉退。大便
至十三日不通，以猪胆导之，诸证复作，急用十全大补，数剂方愈。
有一位读书人叫杨泽之，性格急躁且好色，锁骨部位结了一个肿块。这是肝火旺盛、血液干枯导致筋脉拘挛的病症，治法应当滋补肾水以滋养肝血。他不听劝告，反而内服降火化痰的药物，外敷南星和商陆，结果肿块变得像碗一样大。我使用补中益气汤和六味地黄丸，间杂服用芦荟丸，经过一年多时间，他的元气逐渐恢复，肿块也随之消散。
有一个男子，平时容易发怒，左侧颈部轻微肿胀，逐渐增大如升斗大小。之前医生用清痰理气的方法治疗，导致他出现高热、口渴、小便频繁且浑浊的症状。我判断这是肾水亏损，于是使用六味地黄丸和补中益气汤，治愈了他。也有人在胸腹等部位出现如升斗大小的肿块，或者溃破后形状像蘑菇或石榴，无论大小，都按照上述方法治疗。
举人江节夫，颈部、手臂、胁肋各结一个肿块，误服了祛痰、降火、软坚散结的药物，病情加重。我说：“这是肝胆经血液不足而虚火妄动所致。”他坚持服用之前的药物，到了第二年六月，各个肿块都溃烂，脉象浮大而涩。我推断秋季金气将旺，克制肝木，病人必定无法存活，果然应验。
顾大有的父亲，七十九岁，深冬时节即将出门时，去少妻房中行房事，导致头痛发热，眩晕气喘急促，痰涎壅盛，小便频数，口干想喝水，满舌生刺，舌头收缩像荔枝核一样，下唇黑裂，双眼发红，烦躁失眠，有时感觉喉咙内有烟火上冲，急忙喝冷茶稍作缓解，已经濒临危险。脉象大而无序且有力，触摸身体烫手。这是肾经虚火游行于体表，投予十全大补汤加山茱萸、泽泻、牡丹皮、山药、麦冬、五味子、附子一剂，熟睡良久后，脉象和症状都减轻了三四成。再给予八味丸（即金匮肾气丸），服用后所有症状全部消退，后来因为畏寒凉之物而痊愈。
顾仁成，六十一岁，痢疾后行房事，精液滑脱自遗，两天才停止。又因房劳过度、感受寒邪及愤怒情绪，于是发作寒热往来，右胁痛牵连心腹，胸膈痞闷，自汗盗汗如雨下，四肢厥冷，睡梦中惊悸，有时感觉身体上浮，有时感觉下坠，导致废寝忘食。有人给他用了两剂补药，病情反而加重。脉象洪大数急，但重按则微细。这属于无火之虚热，急忙给予十全大补汤加山药、山茱萸、牡丹皮、附子，一剂后，所有症状顿时痊愈。这种元气极度亏虚的情况，百人中难有一二。这两位姓顾的是父子关系。
州同韩用之，四十六岁，正值仲夏，因色欲过度，感到烦热口渴，饮水不止，小便淋沥不尽，大便秘结，唾痰如涌出，面目皆红，满舌生刺，双唇干燥开裂，全身发热，有时感觉像芒刺在身且位置不定，两脚心像被烙铁烫过一样，用冰块摩擦会疼痛，脉象洪大无序。这是肾阴虚而阳气无所依附，发散于体表，并非实火。大概是大热至极，用寒凉药不能退热，是因为没有阴水制约，应当峻补其阴，于是用加减八味丸料一斤，内加肉桂一两，用水一次性煎煮成六碗，冰冷地给病人饮用。半个时辰已喝了大半，睡觉醒来吃一碗温粥，继续睡到晚上，再用前药温服一碗，一直睡到天亮，吃热粥两碗，所有症状全部消退。第二天怕冷，脚冷至膝盖，各种症状再次出现，有人认为是伤寒。我说：“不是，大寒至极，用温热药不能回暖，是没有阳气了，阳气也虚弱了。”急忙给予八味丸一剂，服用后稍见缓和。连服四剂，所有症状全部消退。大便直到十三天不通，用猪胆汁导便，各种症状复发，急忙使用十全大补汤，经过几剂才痊愈。
A scholar named Yang Zezhi had an irritable temperament and was fond of sexual indulgence. A nodule formed in his supraclavicular fossa (Quepen). This was a condition of Liver Fire causing blood dryness and tendon contraction; the treatment principle should be to nourish Kidney Water to generate Liver Blood. He did not believe this, instead taking internal medicine to descend fire and resolve phlegm, and applying external poultices containing Arisaema Cum Bile (Nanxing) and Phytolaccae Radix (Shanglu). Consequently, the swelling enlarged to the size of a bowl. I used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill), interspersed with Lushui Wan (Aloe Pill). After more than a year, his Yuan Qi (Original Qi) gradually recovered, and the swelling subsided.
A man who was prone to anger had slight swelling on the left side of his neck, which gradually enlarged to the size of a sheng (a unit of volume). Previous treatment with methods to clear phlegm and regulate Qi resulted in high fever, thirst, frequent urination, and turbid urine. I diagnosed it as Kidney Water deficiency and treated him with Liuwei Dihuang Wan and Buzhong Yiqi Tang, resulting in a cure. Similarly, for swellings in the chest or abdomen the size of a sheng or dou (units of volume), or those that ulcerated resembling mushrooms or pomegranates, regardless of size, the same method was applied.
Juren Jiang Jiefu had nodules in his neck, arm, and hypochondrium. Misusing drugs that dispel phlegm, descend fire, and soften hardness aggravated his condition. I stated, "This is due to blood deficiency in the Liver and Gallbladder meridians with hyperactive fire." He persisted with the previous medication. By June of the following year, all nodules ulcerated, and the pulse was floating, large, and choppy. I predicted that since Metal (Autumn) would become prosperous and overcome Wood (Liver), he would not survive, which proved true.
Gu Dayou’s father, aged seventy-nine, engaged in sexual activity with a young wife just before going out in mid-winter. This caused headache and fever, dizziness, vertigo, panting, excessive saliva and phlegm, frequent urination, dry mouth with desire to drink, thorns growing over the entire tongue, tongue retraction resembling a lychee pit, black cracking of the lower lip, red eyes, irritability, insomnia, and occasional sensations of smoke and fire rushing up the throat. Drinking cold tea provided slight relief, but he was near death. The pulse was large, disordered, and forceful; his body felt burning hot to the touch. This was deficient fire from the Kidney meridian wandering externally. I administered Shiquan Dabu Tang (Ten-Agent Great Tonifying Decoction) augmented with Cornus Fructus (Shanzhuyu), Alisma Rhizoma (Zexie), Moutan Cortex (Danpi), Dioscoreae Rhizoma (Shanyao), Ophiopogonis Radix (Maidong), Schisandrae Fructus (Wuweizi), and Aconiti Lateralis Radix Praeparata (Fuzi). After one dose, he slept soundly for a long time, and his pulse and symptoms decreased by three or four parts. He then took Bawei Wan (Eight-Ingredient Pill, i.e., Jin Gui Shenqi Wan), after which all symptoms receded. He later recovered, though he remained averse to cold substances.
Gu Rencheng, aged sixty-one, experienced seminal emission after dysentery and sexual activity, which lasted two days. Subsequently, due to sexual exhaustion, exposure to cold, and anger, he developed alternating chills and fever, pain in the right hypochondrium radiating to the heart and abdomen, chest oppression, spontaneous sweating, night sweats like rain, cold limbs, palpitations during sleep, sensations of floating upward or sinking downward, leading to neglect of food and rest. Two doses of tonifying medicines taken by others worsened his condition. The pulse was large, surging, and rapid, but fine and weak upon deep pressure. This belonged to deficiency heat without fire. Urgently, I prescribed Shiquan Dabu Tang augmented with Dioscoreae Rhizoma, Cornus Fructus, Moutan Cortex, and Aconiti Lateralis Radix Praeparata. After one dose, all symptoms instantly resolved. Such extreme depletion of Yuan Qi is rare, occurring in less than one in a hundred. The two Gu family members were father and son.
Zhou Tong Han Yongzhi, aged forty-six, suffered from vexation, heat, and thirst due to excessive sexual desire in mid-summer. He drank incessantly, had dribbling urination, constipation, profuse expectoration, red face and eyes, thorns on the tongue, dry and cracked lips, generalized fever, intermittent prickling sensations without fixed location, and burning soles of the feet that hurt when touched with ice. The pulse was surging and disordered. This was Kidney Yin deficiency with Yang having no attachment, manifesting externally; it was not excess fire. Generally, intense heat that does not respond to cooling indicates a lack of Water; thus, severe tonification of Yin is required. I prepared Jiajian Bawei Wan (Modified Eight-Ingredient Pill) material weighing one jin, added Rougui (Cinnamon Bark), boiled it in water to make six bowls, and served it cold. After half an hour, he had consumed most of it. Upon waking, he ate a bowl of warm congee, slept until evening, then took another bowl of the decoction warmed. He slept until dawn, ate two bowls of hot congee, and all symptoms subsided. The next day, he felt cold, with coldness extending to his knees, and symptoms returned. Others suspected Cold Damage (Shanghan). I said, "No. Intense cold that does not respond to warming indicates a lack of Fire; Yang Qi is also deficient." I urgently prescribed Bawei Wan. After one dose, he improved slightly. After four doses, all symptoms vanished. His stool remained unpassed for thirteen days; using pig bile suppositories caused symptoms to recur. Urgently, I used Shiquan Dabu Tang, and after several doses, he recovered.