至元庚辰六月，许伯威年五十四，中气本弱，病伤寒八九日，医者见其热甚，以凉药
下之，又食梨三、四枚，痛伤脾胃，四肢冷，时发昏愦。予诊其脉，动而中止，有时自还，
乃结脉也。心亦悸动，吃噫不绝，色变青黄，精神减少，目不欲开，倦卧，恶人语笑，以炙
甘草汤治之。成无己云∶补可去弱。人参、大枣之甘，以补不足之气；桂枝、生姜之辛，以
益正气。五脏痿弱，荣卫涸流，湿剂所以润之。麻仁、阿胶、麦门冬、地黄之甘，润经益血
，复脉通心是也。加以人参、桂枝，急扶正气，生地黄减半，恐伤阳气。锉一、两剂，服之
不效。予再候之，脉证相对，莫非药有陈腐者，致不效乎？再市药之气味浓者，煎服，其证
减半，再服而安。
凡药之昆虫草木，产之有地；根叶花实，采之有时。失其地，则性味少异矣；失其时，
则性味不全矣。又况新陈之不同，精粗之不等，倘不择而用之，其不效者，医之过也。《
内经》曰∶司岁备物。气味之精专也，修合之际，宜加谨焉。
病患服药，必择人煎药。能识煎熬制度，须令亲信恭诚至意者煎药，铫器除油垢、腥秽
。必用新净甜水为上，量水大小，斟酌以慢火煎熬分数。用纱滤去渣，取清汁服之，无不效
也。
在上不厌频而少，在下不厌顿而多，少服则滋荣于上，多服则峻补于下。
至元庚辰年六月，许伯威五十四岁，中气（脾胃之气）原本虚弱，患伤寒病（外感热病）八九日。医生见他热象严重，用寒凉药攻下，他又吃了三四个梨，导致脾胃受损，四肢发冷，时常昏厥迷糊。我诊察他的脉象，跳动中有中止，有时自行恢复，这是结脉（脉来缓慢而有不规则间歇）。心脏也悸动不安，打嗝不停，面色青黄，精神萎靡，眼睛不想睁开，疲倦卧床，厌恶别人说话笑声。我用炙甘草汤（以炙甘草为主药的方剂）治疗他。成无己说：补益法可以去除虚弱。人参、大枣的甘味，用来补充不足的气；桂枝、生姜的辛味，用来增益正气。五脏痿弱，营卫（营气和卫气）枯竭流动停滞，湿剂（滋润类药物）所以用来滋润它。麻仁、阿胶、麦门冬、地黄的甘味，滋润经脉增益血液，恢复脉搏通畅心脏，就是这个道理。加上人参、桂枝，急切扶持正气，生地黄减半，恐怕损伤阳气。锉碎一两剂，服用后没有效果。我再等待观察，脉象与证候相对照，莫非药物有陈旧腐败的，导致无效吗？再购买气味浓郁的药，煎煮服用，症状减轻一半，再服用就安稳了。
凡是药物的昆虫草木，产地有地域之分；根叶花实，采集有时间之分。失去适宜的地域，则性味稍有差异；失去适宜的时节，则性味不全。更何况新旧不同，精粗不等，如果不加选择而使用，那些无效的，是医生的过错。《内经》说：根据岁运准备药物。这是气味精专的道理，调配之际，应该加以谨慎。
病人服药，必须选择人煎药。能识别煎熬制度的人，必须让亲信恭敬诚实用心的人煎药，铫器（煎药器具）要清除油垢、腥秽。必须用新净甜水为最好，根据水量大小，斟酌用慢火煎熬分数。用纱布过滤去掉药渣，取清汁服用，没有不有效的。
病位在上部不厌烦频繁少量服用，在下部不厌烦顿服大量服用，少量服用则滋养荣气于上部，大量服用则峻补于下部。
In the sixth month of Gengchen year of Zhiyuan era, Xu Bowei was fifty-four years old. His Zhongqi (Qi of the Middle Jiao/Spleen and Stomach) was originally weak. He suffered from Shanghan disease (Exogenous febrile disease) for eight or nine days. The physician, seeing his severe heat syndrome, administered cold-natured purgative medicines. Additionally, he ate three or four pears, which injured the Spleen and Stomach. This resulted in cold limbs and frequent episodes of fainting and confusion. I palpated his pulse; it beat with intermittent pauses that sometimes recovered spontaneously, which is a Knotted Pulse (Jie Mai). His Heart also palpitated, and he had incessant belching. His complexion changed to greenish-yellow, his spirit diminished, he did not wish to open his eyes, lay fatigued, and disliked people speaking or laughing. I treated him with Zhigancao Tang (Honey-Fried Licorice Decoction). Cheng Wuji stated: "Tonification can remove weakness." The sweetness of Renshen (Ginseng Radix et Rhizoma) and Dazao (Ziziphus Jujuba Fruit) tonifies deficient Qi; the pungency of Guizhi (Cinnamon Twig) and Shengjiang (Zingiberis Rhizoma Recens) benefits righteous Qi. When the Five Zang organs are atrophic and weak, and Yingwei (Nutritive and Defensive Qi) flow is dried up, moistening agents are used to lubricate them. The sweetness of Haren (Arillus Jujubae), Ejiao (Colla Corii Asini), Maimendong (Ophiopogonis Radix), and Dihuang (Rehmanniae Radix) lubricates the meridians, benefits blood, restores the pulse, and unblocks the Heart. Adding Renshen and Guizhi urgently supports righteous Qi; Shengdi Huang (Rehmanniae Radix Preparata) is halved to avoid damaging Yang Qi. One or two doses were decocted and taken, but there was no effect. I waited again to observe. Comparing the pulse and symptoms, could it be that the medicines were stale or corrupted, causing the ineffectiveness? I purchased medicines with stronger aroma and flavor, decocted and administered them. The symptoms reduced by half, and after further administration, he became stable.
All medicinal insects, plants, and trees have specific origins; their roots, leaves, flowers, and fruits have specific harvesting times. If the origin is incorrect, the nature and flavor will differ slightly; if the timing is incorrect, the nature and flavor will be incomplete. Furthermore, new and old materials differ, as do refined and coarse qualities. If one uses them without selection, any ineffectiveness is the fault of the physician. The *Neijing* states: "Prepare substances according to the annual climate." This refers to the essence and specialization of aroma and flavor. During preparation, one must exercise caution.
When patients take medicine, one must select someone to decoct it. One who understands the rules of decoction should be trusted. It is necessary to have reliable, respectful, sincere, and attentive individuals decoct the medicine. The decoction vessel (Diao) must be free of grease and fishy odors. Fresh, clean, sweet water is best. The amount of water should be measured, and slow fire should be used for decoction according to the required proportion. Filter the dregs with gauze and administer the clear liquid. There will be no failure in efficacy.
For diseases located in the upper part, frequent small doses are preferred; for diseases in the lower part, large single doses are preferred. Small doses nourish Ying (Nutritive Qi) in the upper part, while large doses strongly tonify the lower part.