证逾三候，始而寒热溷淆，继则不寒单热，日晡热甚，黎明渐退。阅方初投逍遥，次用
桃仁
承气，愈医愈剧。食少便泻，足肿腹胀，热甚胀亦甚，热缓胀亦缓。若云肝气，未必发热，
亦不必胀随热至。若云血痹，当在下焦，不应胀在中脘。求诸病因，非关气滞血凝，乃伏邪
留着故也。《己任编》云∶秋时晚发，感证似疟，本是伏暑之病，暑必挟湿，盘踞膜原，膜
原即中焦部位，邪伏既久，乘时而发。自里达表，是以外热内胀。至于便泻足肿，更属湿病
无疑。欲消其胀，须祛其邪。邪一日不去，胀一日不除。所谓伤寒究六经，温暑辨三焦。上
焦不解，势必蔓延，中下淡渗，佐以微辛。盖无形之邪，未可作有形攻击耳。前议服药汗出
，热退胀减，伏邪外达之机。盖暑湿伏邪，与风寒外邪不同，新邪当先彻表，伏邪当先清里
，里清表自解也。日来兼见咳嗽，泻仍未止，按外感以嗽为轻，腑病以通为补，嗽泻均系伏
邪之出路，不可止遏。
安波按∶拟薄荷、山栀辛苦以清里热，茯苓皮、大豆卷、滑石、通草之甘淡以渗外湿
，杏仁、橘红以开肺，半夏、佩兰以醒脾。
女子二七而天癸至，任脉通，太冲脉盛，月事以时下，故曰月经。经者常也，反常则为
病矣
。是以妇人首重调经，经调则百病不生，失调则诸证蜂起。夫血生于心，藏于肝，统于脾。
而冲为血海，血犹水也。若江河之流行，设有枯涸崩决，其为患也大矣。求其致病之因，有
谓血枯者，盖女子以肝为先天，索性多郁，木郁生火，火灼阴伤，以致经血日耗，地道不通
。经言二阳之病发心脾，有不得隐曲，女子不月者，此也。有谓崩决者，崩如山冢 崩，决
如波涛横决，盖血属阴，静则循经营内，动则错经妄行。经言。阴虚阳搏谓之崩，阳气内动
，发为心下崩者，此也。病经日久，形瘦阴亏，木火郁勃，旧春经阻崩晕，现又愆期两月，
勿愁血之不行，切恐崩患复发。议养肾阴以济心阳，兼培冲任，冀其生生有自，血气调匀，
无错妄之虞，复经常之度，不徒病去人安，更可勿药有喜。
安波按∶拟自制补炼丸养肾阴以济心阳，培冲任以赞其职。
施姓妇女患感证已逾三周，起初寒热混杂不清，随后变为不恶寒只发热，傍晚时分热度加重，黎明时分逐渐消退。查看之前的处方，初用逍遥散，接着用桃仁承气汤，越治病情越重。食欲减退，大便稀溏，足部肿胀，腹部胀满，热度高时胀满也严重，热度缓解时胀满也减轻。如果说这是肝气郁结，未必会发热，也不必出现胀满随热度波动的情况。如果说这是血痹，病位应当在下焦，不应表现为中脘部的胀满。探究病因，并非气滞血凝所致，而是伏邪留滞的缘故。《己任编》中说：秋季晚发的感证，症状类似疟疾，这本是伏暑病，暑邪必然挟带湿邪，盘踞在膜原（即中焦部位），邪气潜伏时间久，乘时而发。病势由里达表，所以表现为外热内胀。至于大便稀溏、足部肿胀，更属于湿病的表现无疑。想要消除胀满，必须祛除邪气。邪气一天不除去，胀满一天不消除。这就是所说的伤寒要究辨六经，温病暑病要辨明三焦。上焦的病不解，势必蔓延，治疗中下焦宜用淡渗利湿之法，佐以微辛之品。因为无形的邪气，不可当作有形的实邪来攻逐。之前建议服药后出汗，热退胀减，这是伏邪向外透达的机转。因为暑湿伏邪与风寒外邪不同，新感的外邪应当先解表，伏邪应当先清里，里热清了，表证自然解除。近日兼见咳嗽，腹泻仍未停止，按外感病来看，咳嗽属轻症；按腑病来看，通降即为补益，咳嗽和腹泻都是伏邪排出的途径，不可强行止遏。
安波按：拟定薄荷、山栀，用辛苦之味以清泄里热；茯苓皮、大豆卷、滑石、通草，用甘淡之味以渗利外湿；杏仁、橘红以开宣肺气；半夏、佩兰以醒脾化湿。
女子十四岁左右天癸至（促进生殖功能成熟的物质），任脉通畅，太冲脉旺盛，月经按时来潮，所以称为月经。经，就是常的意思，反乎常态就是病了。因此妇人首重调理月经，月经调和则百病不生，失调则各种病症蜂拥而起。血液由心所生，藏于肝，统摄于脾。而冲脉为血海，血液就像水一样。如同江河的流行，如果出现枯竭或决堤，造成的危害就大了。探究其致病原因，有的说是血枯，大概是因为女子以肝为先天，性情多抑郁，肝木郁结而生火，火热灼伤阴液，导致经血日渐消耗，月经通道不通。医经说二阳（胃与大肠）的病发于心脾，有难以言说的隐情，女子闭经的，就是这个道理。有的说是崩漏决裂，崩如山陵崩塌，决如波涛横溢，盖因血属阴，安静时则循行于经脉之内，躁动时则错乱妄行。医经说阴虚阳搏谓之崩，阳气在内躁动，引发心下出血（指阴道大量出血）的，就是这个道理。病程日久，形体消瘦，阴液亏损，肝火郁勃，去年春天曾出现经闭、崩漏、晕厥，现在又延期两个月，不要担忧血液不行，切恐崩漏之患复发。议定滋养肾阴以济助心阳，兼培补冲任二脉，希望其生生不息，气血调匀，没有错乱妄行的忧虑，恢复正常的周期，不仅病去人安，更可不用药而自愈。
Ms. Shi has suffered from a pathogenic sensation syndrome for over three weeks (21 days). Initially, chills and fever were mixed and indistinguishable; subsequently, she experienced fever without chills, with heat intensifying in the late afternoon (Shi Wu) and gradually subsiding at dawn. Reviewing previous prescriptions, Xiaoyao San (Free and Easy Wanderer Powder) was administered first, followed by Taoren Chengqi Tang (Peach Kernel and Rhubarb Decoction), yet the condition worsened with each treatment. She had poor appetite, loose stools, swollen feet, and abdominal distension; the severity of distension correlated with the degree of fever—worse when hot, better when cool. If this were Liver Qi stagnation, fever would not necessarily occur, nor would distension fluctuate with heat. If this were Blood Bi (Blood Stasis Obstruction), the pathology should be in the Lower Jiao (Lower Burner), not manifesting as distension in the Middle Wan (Epigastrium). Investigating the etiology, it is not due to Qi stagnation or Blood coagulation, but rather the lingering of latent pathogens. *Jiren Bian* states: "Late-onset sensations in autumn, resembling malaria, are essentially diseases of latent Summerheat. Summerheat invariably carries Dampness, lodging in the Mo Yuan (Membrane Source), which corresponds to the Middle Jiao. After long-term latent residence, the pathogen erupts according to timing. Moving from interior to exterior, this results in external heat and internal distension. Regarding loose stools and foot swelling, these undoubtedly belong to Dampness diseases." To eliminate distension, one must dispel the pathogen. As long as the pathogen remains, distension persists. This illustrates the principle that Shanghan (Cold Damage) requires differentiation of the Six Channels, while Wenbing (Warm Diseases) and Summerheat require differentiation of the Three Jiaos. If the Upper Jiao is not resolved, the disease will inevitably spread; for the Middle and Lower Jiao, mild diuresis (Dan Shen) combined with slightly acrid herbs is used. This is because formless pathogens cannot be attacked as if they were tangible excesses. The previous proposal suggested that sweating after medication, leading to reduced fever and distension, indicates the mechanism of latent pathogens reaching the exterior. Latent Summerheat-Damp pathogens differ from Wind-Cold exterior pathogens; new exterior pathogens should first be cleared via the exterior, whereas latent pathogens should first be cleared from the interior. Once the interior is clear, the exterior resolves spontaneously. Recently, cough has appeared, and diarrhea persists. In exterior diseases, cough is considered mild; in Fu organ diseases, unblocking constitutes tonification. Both cough and diarrhea serve as outlets for latent pathogens and should not be forcibly suppressed.
An Bo notes: Prescribed Bohe (Mint) and Shanzhi (Gardenia Fruit), using bitter and acrid flavors to clear interior heat; Fuling Pi (Poria Peel), Dadou Juan (Soybean Sprout), Huashi (Talcum), and Tongcao (Akebia Stem), using sweet and bland flavors to leach out exterior dampness; Xingren (Apricot Seed) and Juhong (Citrus Reticulata Pericarpium) to open Lung Qi; Banxia (Pinellia Tuber) and Peilan (Eupatorium Fortunei) to awaken the Spleen.
At age fourteen (two sevens), Tian Gui (menstrual essence/substance promoting reproductive maturity) arrives, the Ren Mai (Conception Vessel) becomes unobstructed, and the Chong Mai (Penetrating Vessel) becomes abundant, causing menstruation to arrive on time; hence it is called Menstruation (Jing). "Jing" means regularity; deviation from regularity constitutes disease. Therefore, regulating menstruation is paramount for women; if regulated, hundred diseases do not arise; if disregulated, various symptoms swarm forth. Blood is generated by the Heart, stored in the Liver, and controlled by the Spleen. The Chong Mai is the Sea of Blood; blood is like water. Just as rivers flow, if they dry up or burst their banks, the disaster is great. Investigating the causes of illness, some attribute it to Blood depletion. Generally, women regard the Liver as their先天 (primary foundation); they are prone to depression. Liver Wood stagnation generates Fire, which scorches Yin and damages fluids, causing menstrual blood to deplete daily and the menstrual pathway to become obstructed. The Classics state: "Diseases of the Two Yang (Stomach and Large Intestine) originate from the Heart and Spleen; those with hidden grievances who do not menstruate exemplify this." Others attribute it to Bing Jue (Metrorrhagia and Metrostaxis). "Bing" is like the collapse of a mountain peak; "Jue" is like waves bursting forth. Since Blood belongs to Yin, when quiet, it circulates within the vessels; when agitated, it flows erratically. The Classics state: "Yin deficiency with Yang pulsation is termed Bing." When Yang Qi moves internally, it causes Xin Xia Beng (subcutaneous bleeding/menstrual flooding); this exemplifies such cases. Having been ill for a long time, her physique is emaciated and Yin is deficient, with Liver Fire stagnant and vigorous. Last spring, she experienced amenorrhea, metrorrhagia, and syncope; now her period is delayed by two months. Do not worry about the lack of blood flow; rather, fear the recurrence of metrorrhagia. The proposed treatment is to nourish Kidney Yin to assist Heart Yang, while simultaneously cultivating the Chong and Ren vessels, hoping for continuous vitality, balanced Qi and Blood, no risk of erratic flow, and restoration of normal cycles. Not only will the disease depart and the person be safe, but health may return even without medication.
An Bo notes: Prescribed self-made Bulian Wan (Nourishing Refining Pill) to nourish Kidney Yin and assist Heart Yang, and to cultivate the Chong and Ren vessels to support their functions.