裴兆期曰∶凡人偶得潮热往来之候，未可遽执为外感风寒，辄服发表之药。盖其间亦或有元气内损而然者，
一或少瘥，则阴症立至，多死少生矣。吾乡一高年绅，只一子，年三十余，素恃形气强伟，不知节慎。六月间，
因母寿，连日宴客，应酬劳倦，遂发往来潮热。渠宿与一医相善，即邀以治之。值医他往，其徒代为之视，辄
投以羌活、紫苏、防风等药。一剂后，汗大出不止，乃求治于余，六脉已细数无伦矣。举方用人参、黄 各五
钱，桂、附各二钱，当归三钱，浮小麦一撮，令急煎服。药剂甫煎成，而所善之医适至，亦认为外感，倾弃予
药，仍以前药表之，汗更大出，深夜而毙。须知膏粱子弟，外强中干，不可见其气强形伟，而遂视之为大椿也。
万密斋治董氏子，年十七，病请治。诊其脉浮大无力。问其症，无恶寒头痛，但身热口渴，四肢倦怠。曰∶
似白虎症而脉虚，乃饥渴劳力得之。黄 炙、当归酒洗各一两，作汤服之而愈。
陈正夫，万之母舅也。病三日后，胸中痞胀，小便少，大便不通。万闻，往问疾。时近城一医，欲以大柴
胡汤下之。察脉症不可下，内伤中气不运，故上窍闭而下气不通也。丹溪云∶二陈汤加苍术、白术、升麻、柴
胡，则大便润而小便长。与之一服而安。
龚子才治刘太府，因劳役太过，发热憎寒，头疼身痛，口干发渴，呕恶心烦。或以羌活汤，或以藿香正气
散，愈甚。手足无处着落，心慌神乱，坐卧不安，汤水不入，闻药亦吐。（皆由风燥之剂鼓动其火而然。）诊之，
六脉洪数，气口紧盛，此内伤元气也。以补中益气加远志、枣仁、竹茹、麦冬，一剂即熟睡，再进一服全安。
陈三农治一老人，患头痛恶寒，骨节疼痛，无汗谵语，自服参苏饮取汗，脉洪数而左甚。此胃虚作劳，阳
明虽受邪气，不可攻击，当补其虚，俟胃气充足，必自汗而解。以参、 、归、术、陈皮、炙草，加熟附子，
四五剂，诸症虽减，但口干，热未退。遂去附子，加白芍，渐思食，汗出而安。
陆养愚治丛邑宰，烦劳忿怒，饮食不思，已数月矣。初春，患左胁痛，不能向左眠，又感冒，遂咳嗽喘促，
汗出恶风，呕恶饮冷，胸脘痞塞，烦躁泄泻，耳鸣，手指肉 ，振摇不已。脉之，两寸微浮而涩，关尺微虚不
固，曰∶凡靠左不得眠者肝胀，靠右不得眠者肺胀，及咳嗽、自汗、喘促、下泄，俱难治。况涩脉见于春时，
金来克木，亦可畏。幸神气尚未乏，两寸带浮，尚有微阳，小便稠黄犹长，面色焦黑，而微有黄气，犹可疗也。
仲景云∶脉虚微弱下无阳。又云∶微虚相搏，乃为短气。又云∶微浮，伤客热。东垣云∶阴先亡，阳欲得去，
乃见热壅口鼻，谓之假热之症。此盖得之七情伤阴，烦劳伤阳，风寒乘虚入客，胸膈痞塞。因邪在半表半里，
又为冷水停凝，症似支饮结胁，侧不能卧，寐觉痛作。虽饮留肝实，亦是元气不充不调。合之诸症，俱属正气
已伤，宜调养气血，使邪自散。用顺气养荣汤加桂枝、甘草，二剂，诸症顿减。易以补中益气，少佐小青龙汤
一二分，以和荣卫，二剂，自汗喘呕病已除。第痞塞胁痛不甚减，更以六君子倍半夏、陈皮，少佐蔻仁、木香，
胸痞胁痛亦止。又与四神丸实脾，肾气丸固本，调治月余而痊。
朱少湖，仲冬夜间忽头项微强，身体微痛，疑是伤寒，连夜用紫苏二大把，生姜十片，浓煎热服，浓覆大
汗之，身体觉轻，自谓愈矣。至明日之夜，复觉拘急，反增沉重，复如前取汗不解，身体如石，烦躁口干，睡
卧不安。天明延一医诊之，谓脉极浮数，冬月伤寒，非麻、桂不解，姜、苏轻剂，岂能疗此大病乎？拟用大青
龙汤，病家疑而卜之，不吉，复延陆同议。诊之，脉浮数而微细如蛛丝，按之欲绝。曰∶阳虚症也，原不宜汗，
况经谓冬三月，闭藏之令，无扰乎阳，无泄皮肤，使气亟夺。一之为甚，其可再乎？彼医曰∶仲景云，阴盛阳
虚，汗之即愈。既曰阳虚，何为不可汗？况麻、桂、青龙，正为冬时虚寒而设。如拘闭藏之令不宜汗，则仲景
此等汤剂，必待春夏伤寒而后用乎。陆不能辨，但徐曰∶议论甚高，第恐此脉不相应耳。病家问当用何药？曰∶
惟建中、生脉酌而用之。彼医谓邪在表而补敛之，不死何待？陆曰∶汗之而愈，则补误，补之而愈，则汗误，
原不两是也。病家不能决，卜之，谓补吉汗凶，乃以建中、生脉合投之，烦躁仍剧，噫气不绝，足胫逆冷，身
不能转，彼医谓毙可立而俟也。陆曰∶误汗者再，药轻病重，故未效耳。仍前方倍人参加附子、浓煎冷服，少
顷，烦躁顿定。数剂，诸症悉除。月余，时出虚汗不能起，用人参数两方获安。（此驳未尝无理。陆不径指为内
伤，而泛引经文，致招如此驳诘，又不肯明指其失而喻之。第含糊其词以示意，亦名医之习气也。）
喻嘉言治刘筠之，七旬御女不辍，此先天素浓也，然以房中之术，数扰其阳，又值夏月阳气在外，阴气在
内，偶不快，饮食起居如常，医者以壮年伤暑之药，香薷、黄柏、石膏、知母、滑石、车前、木通投之，即刻
不支。诊时，则身僵颈硬，舌强喉哑，无生理矣。曰∶此症虽危，然因误药所致，甫隔一晚，尚可以药速追。
急以大附子、干姜、人参、白术各五钱，甘草三钱，大剂煎服，可解此厄。众议不决，姑以前方四分之一服之，
安贴，再煎未迟。灌下一寸香之久，大呕一声，醒而能言，呼诸子乳名云∶适才见州官回。询其所由，开目视
之不语，转问医者何人。曰∶江西喻。遂抬手一拱。又云∶门缝有风来塞塞。喻促煎所存之药续进，而姻族杂
进，商以肩舆送其回寓，另进他药，哑 如前，越二日而逝。
李士材治程幼安，食少腹闷，食粥者久之，偶食蒸饼，遂发热作渴，头痛呕逆。或以伤寒治之，或以化食
破气之药投之，俱不效，势甚危。诊之曰∶脉无停滞之象，诊之软且涩，是脾土大虚之症也，法当以参、术理
之。聚皆不然。李曰∶病势已亟，岂容再误？遂以四君子汤加沉香、炮姜与之，数剂而减，一月而安。
倪文学素劳积郁，胸膈饱闷，不能饮食，服消食理气行痰开郁清火，凡百余剂，不效，病势日增。李诊之，
脉大而软，喟然叹曰∶明是火衰不能生土，以伐气寒凉药投之，何异入井而又下石乎？遂以六君子汤加干姜、
肉桂、益智仁各一钱，十剂少愈。然食甚少也，遂加附子一钱，兼用八味丸调补，百余日而痊。
卢不远治戴养吾夫人，体常困倦，眩晕不食，胸膈痞满。脉之寸关不透，以为肝脾之气不伸，用八珍加升
麻、柴胡而愈。后每病，用前方即安。若稍为加减，便不获效。凡十五年，皆倚恃焉。盖夫人性静体浓，起居
安适，是以气血不振而消沮，故于补气血药中加开提之剂，得其性情，故可久服。
何介甫病脾数年，饮食少而精神悴。卒酉七月就诊，两关软弱，不透于寸，用参、苓、归、芍、陈皮、防
风、甘草，数十剂，遂善啖肥浓，数年之疾脱然。问曰∶予疾有年，补脾补肾，法非不详，而未之效，君何从
平易得之？曰∶君疾在肝，非脾肾病也。凡诊病者，当穷其源，无为症惑。如饮食少，虽关脾胃，其所以致脾
胃病者何故？此当审者。今君两关脉弱，不透于寸，右固脾虚明矣。左则何谓？此脾体不足，而脾用不行也。
盖脾之用，肝也。星家取克我者为用神，脾体无肝木为之用，则气血便不条畅，运化迟钝，而脾胃转困矣。且
秋来金肃，肝更不伸，乃为补助肝木之气，使之扬溢，则脾土伸舒，精神油然外发，虽不治脾，实所以治也，
安用奇特之法哉。
冯楚瞻治王慎瞻，平日过劳，乃远行，途中食冷面羊肉，及归，胸中疼胀不堪。医所用无非楂、菔、枳、
朴之类，服之益甚，渐至心如压扁，昏晕闷绝，少减则苏。曰∶食乃有形之物，惟入肠胃，滞则为胀为疼，着
而不移，岂能升降于胸次乎？盖胸为心肺之部，止受无形之气，不能藏有形之物也。且六脉弦细而数，身不热，
语言无力，皆非伤食之候，乃积劳所伤，无根之气上逆于心，以致胀痛不堪耳。当用塞因塞用之法，乃以枣仁、
朱砂、乳香为细末，剖猪心血为丸，用人参五六钱，煎浓汤送服。少顷，以莲子煮白米粥压之，令忍胀，强吞
半碗。如是数日，疼胀渐减。继以胸膈自觉甚空，虽多食不饱，而大便出者无几。盖劳役太过，脏腑脂膏耗竭，
状如中消，食物入腹，销铄无余，故多入少出也。
谈铨部病热数日，医以为伤寒，投以发散，禁其饮食，日渐危笃。脉之，弦缓无力，乃劳伤发热也。先以
浓粥汤半碗进之，觉香美，甚甘饮食，目顿清亮。遂与归脾汤，令以薄粥继之，三四日后，神气顿复而愈。
（以饮食调之，最是补虚妙法。）
徐主政夫人，年逾七十，江行惊恐，早晚积劳，到家未几，壮热头疼。医作伤寒，发散数剂，渐至面色
烦躁，神昏不语，头与手足移动，日夜无宁刻。脉之，细数无伦，重取无力，此劳极发热。热者，乃元阳浮越
于表也，更发散之，阴阳将竭矣，非重剂挽之无及。熟地一两六钱，炒麦冬、炒白术各三钱，牛膝二钱，五味
子八分，制附子一钱二分，另用人参六钱，浓煎冲服。二三剂后，病减神清。后用八味、归脾二汤加减全愈。
洪氏子因劳伤发热头疼，咳嗽胁痛。医谓伤寒，大用发散。一剂，汗大出，热更甚，神昏见鬼，躁渴舌黑，
身重足冷，彻夜不寐，困顿欲绝，脉细数无伦，胃脉微极。此劳伤中气发热，东垣补中益气汤，为此等病而设，
令阴阳气和，自能出汗而解。今更虚其虚，阳气发泄殆尽，所以身愈热而神愈昏，阴阳既脱，自尔目盲见鬼。
津液既亡，所以舌黑足冷。至于身重异常，此尤足少阴极虚之症。盖肾主骨，骨有气以举则轻，否则重也。与
熟地二两，炒麦冬四钱，乳炒白术五钱，牛膝三钱，五味子一钱，附子二钱，浓煎，人参一两煎汁冲服。口渴，
另用熟地二两，麦冬五钱，人参八钱，浓煎代茶。三四剂后，汗收热退，舌润神清，嗽止食进。后用生脉饮，
送十补丸四五钱，再以归脾加减，煎膏成丸弹子大，圆眼汤化服，全愈。
刘君乡试入都，长途冒暑，气已伤矣。复日夜课诵，未几，壮热头疼，咳嗽干哕，不寐，神疲。脉之两寸
俱洪，两尺俱弱，右关沉取则无，此犯无胃气之症矣，非温补脾肾无济也。而以暑天热病，坚不肯服，乃坐视
数日，热益甚。复延诊，其脉转躁涩无力，此久热阴阳愈伤也。与大剂熟地、人参、白术、麦冬、五味子、牛
膝，二剂，诸症渐愈。惟哕声间作，胃脉不起，犹不喜食，乃早以生脉饮送八味丸去丹皮、泽泻，加鹿茸、五
味子、牛膝，晚以归脾汤去木香、甘草，加五味、肉桂，一补先天，一补后天，全愈。又同时，彭公子亦患是
病，身热两月，服补中益气加减，已数十剂，不知此方乃为虚人发散而设，不宜久服。且时当夏月，阳气上浮，
致令阴阳离决，精气乃绝，面青浮肿，肚腹胀硬，心下痞膈，咳嗽咽痛，口多甜涎，壮热畏寒，五心燥热，口
干不渴，足胫常冷。脉则两寸乍洪乍数，两关无力，两尺更微，上盛下虚已极。以前方重剂，另煎人参一两冲
服，旬余渐愈。复惑旁言，再用发散消痰，及补中、六君加减，遂不起。
太亲家高年，且患足疾，初愈，乃途中遇雨，疾趋而回，遂身热自汗，头疼咳嗽，继而吐血，饮食不思，
精神野狼狈。脉之，两寸皆洪大而数，右关两尺甚弱。此劳伤中气，脾不统血也。咳嗽者，火烁于肺也；身热者，
元阳浮越也；自汗者，气虚不能摄液也；头疼者，血虚火冒也。与熟地一两，麦冬四钱，炒白芍六钱，牛膝三
钱，五味子一钱，制附子一钱二分，另煎人参汤冲服，数剂，咳嗽吐血俱止。早晨生脉饮送加减肾气，午后
加减归脾汤，服之全愈。
高鼓峰治吕用晦病热症，造榻与语，察其神气，内伤症也。询其致病之由，曰∶偶夜半从卧室出庭外，与
人语，移时就枕，次日便不爽快，渐次发热，饮食俱废，不更衣者，数日矣，服药无效。曰∶杂工皆以为风露
所伤，故重用辛散，不进饮食，便曰停食，妄用消导，孰知邪之所凑，其气必虚。若投以补中益气汤，则汗至便
通，热自退矣。用晦欣然，辄命取药，立煎饮之。旁观者皆以热甚，又兼饱闷，遽投补药，必致祸。慰之曰∶
无庸惊扰，即便矣。顷之，下燥矢数十块，觉胸膈通泰，旁观者始贺。是晚熟寐，至五鼓热退进粥，连服前方而愈。
范中行感冒风寒，又过于房劳，发热昏闷，医以为伤寒也，羌活、柴胡投之不应。又以为阴症也，肉桂、
木香投之，又不应，热且愈甚，饮食俱废，舌黑如炭，八日不便，医正议下。诊之，脉细数而沉，曰∶阴亏甚
矣，胃气将绝矣，非温和甘润之剂，弗能救也。急以左归及滋水清肝等药，重加参、 服之。他医以为不大便
奈何议补？高曰∶子以为承气症也，误矣，第服药必得便。至第四日，果下黑矢升许，热退，舌亦红润。但尚
裴兆期说：凡是偶尔出现潮热往来症状的患者，不能立刻断定是外感风寒，就随意服用发汗解表的药物。因为其中也有可能是元气内部受损导致的。一旦稍微好转，阴寒证候就会立即发作，这种情况大多死亡，很少能存活。我家乡有一位年长的绅士，只有一个儿子，三十多岁，一向仗着自己身体强壮魁梧，不知道节制谨慎。六月间，因为母亲的寿辰，连续几天宴请客人，应酬劳累疲倦，于是引发了潮热往来。他平时与一位医生关系很好，便邀请这位医生来诊治。恰逢那位医生外出，由他的徒弟代为诊视，随即投用羌活、紫苏、防风等药物。服用一剂后，大汗淋漓不止，于是来找我求治，此时六脉已经细数到了极点。我开具处方用人参、黄芪各五钱，桂枝、附子各二钱，当归三钱，浮小麦一撮，命令急火煎服。药刚刚煎好，那位相好的医生恰好赶到，也认为是外感病，将我的药倾倒丢弃，仍然使用之前的药物进行发汗治疗，结果汗出更多，深夜便去世了。必须知道那些富贵子弟，外表强壮内心空虚，不能看到他们气壮形伟，就误以为他们是长寿的大椿树一样坚固。
万密斋治疗董家的儿子，十七岁，生病请求诊治。诊察他的脉搏浮大但无力。询问症状，没有恶寒头痛，只是身体发热口渴，四肢倦怠。万密斋说：这看起来像白虎汤证，但脉象虚弱，这是因饥饿、口渴和过度劳累引起的。给予炙黄芪、酒洗当归各一两，煎汤服用而痊愈。
陈正夫是万密斋母亲的舅舅。生病三天后，胸中痞闷胀满，小便量少，大便不通。万密斋听说后，前去探问病情。当时靠近城的一位医生，打算用大柴胡汤攻下。万密斋观察脉症，认为不可攻下，这是内伤导致中气不运，所以上窍闭塞而下气不通。丹溪曾说：二陈汤加入苍术、白术、升麻、柴胡，就能使大便滋润而小便通畅。给他服用一剂便安稳了。
龚子才治疗刘太府，因为劳役过度，出现发热怕冷，头痛身痛，口干发渴，呕吐恶心心烦。有人用羌活汤，有人用藿香正气散，病情反而加重。手足无处安放，心慌神乱，坐卧不安，汤水无法入口，听到药味也会呕吐。（这都是因为风燥的药物鼓动了体内的火邪所致。）诊察发现，六脉洪数，气口脉紧盛，这是内伤元气。给予补中益气汤加入远志、枣仁、竹茹、麦冬，服用一剂后立即熟睡，再服用一剂完全康复。
陈三农治疗一位老人，患头痛恶寒，骨节疼痛，无汗且谵语，自行服用参苏饮想要发汗，脉象洪数且左侧更甚。这是胃虚劳作所致，虽然阳明经受邪气，不可攻击，应当补其虚损，等到胃气充足，必然通过自汗而解。给予人参、黄芪、当归、白术、陈皮、炙甘草，加入熟附子，服用四五剂后，各种症状虽然减轻，但口干，热未退。于是去掉附子，加入白芍，逐渐思食，出汗后安稳。
陆养愚治疗丛邑宰，烦劳愤怒，饮食不思，已经几个月了。初春时，患左胁痛，不能向左躺卧，又感冒，于是咳嗽喘促，出汗恶风，呕吐厌恶冷饮，胸脘痞塞，烦躁泄泻，耳鸣，手指肌肉跳动，摇动不停。诊脉，两寸微浮而涩，关尺微虚不固。陆养愚说：凡是靠左不得眠的是肝胀，靠右不得眠的是肺胀，以及咳嗽、自汗、喘促、下泄，都难治。何况涩脉出现在春季，金来克木，也可畏惧。幸好神气尚未衰竭，两寸带浮，尚有微阳，小便稠黄且长，面色焦黑而微有黄气，还可以治疗。仲景说：脉虚微弱下无阳。又说：微虚相搏，乃是短气。又说：微浮，伤客热。东垣说：阴先亡，阳欲得去，见到热壅口鼻，称为假热之症。这大概是七情伤阴，烦劳伤阳，风寒乘虚侵入，胸膈痞塞。因为邪在半表半里，又被冷水停凝，症状类似支饮结胁，侧卧不能，睡觉醒来疼痛发作。虽然饮留肝实，也是元气不充不调。综合各种症状，都属于正气已伤，宜调养气血，使邪气自然消散。使用顺气养荣汤加桂枝、甘草，两剂后，各种症状顿时减轻。改用补中益气汤，少佐小青龙汤一二分，以调和营卫，两剂后，自汗、喘、呕的病除去了。只是痞塞胁痛不甚减轻，再用六君子汤加倍半夏、陈皮，少佐蔻仁、木香，胸痞胁痛也止住了。又给予四神丸实脾，肾气丸固本，调治月余而痊愈。
朱少湖，仲冬夜间忽然头项微强，身体微痛，怀疑是伤寒，连夜用紫苏二大把，生姜十片，浓煎热服，厚盖被子大发其汗，身体觉得轻快，自以为痊愈了。到了第二天晚上，又觉得拘急，反而增加沉重，再次像前法取汗不解，身体如石头般僵硬，烦躁口干，睡卧不安。天明请一位医生诊察，说脉极浮数，冬月伤寒，不用麻黄、桂枝不能解，姜、苏是轻剂，怎么能治疗这种大病呢？打算用大青龙汤，病家怀疑并占卜，不吉利，又请陆养愚同议。诊察发现，脉浮数而微细如蛛丝，按之欲绝。陆养愚说：这是阳虚证，原本不宜发汗，况且经书说冬三月，是闭藏的时令，不要扰动阳气，不要发泄皮肤，使气机屡次夺失。一次已经很过分了，难道可以再来一次吗？那位医生说：仲景说，阴盛阳虚，发汗即愈。既然说是阳虚，为什么不可以发汗？况且麻黄、桂枝、青龙汤，正是为冬季虚寒而设的。如果遵守闭藏之令不宜发汗，那么仲景的这些汤剂，一定要等到春夏伤寒后才用吗？陆养愚不能辩驳，只是慢慢说：议论很高明，只怕这个脉象不相符合罢了。病家问应当用什么药？陆养愚说：只有建中汤、生脉散斟酌使用。那位医生说：邪在表而用补敛之法，不死还等什么？陆养愚说：发汗而愈，则是补法错误；补法而愈，则是发汗错误，原本不是两者都对。病家不能决定，占卜，说补吉汗凶，于是将建中汤、生脉散合用，烦躁依然剧烈，打嗝不停，足胫逆冷，身体不能转动，那位医生说：死亡可以立刻等待了。陆养愚说：误汗两次，药轻病重，所以没见效。仍然用前方倍加人参，加入附子，浓煎冷服，一会儿，烦躁顿时安定。几剂后，各种症状全部消除。月余，时常出虚汗不能起床，用人参一两方获得安宁。（这个反驳并非没有道理。陆养愚不直接指出是内伤，而是广泛引用经文，招致如此驳诘，又不肯明确指出其失误并开导病人家属。只是含糊其词以示意向，这也是名医的习气啊。）
喻嘉言治疗刘筠之，七十岁仍纵欲不休，这是先天禀赋浓厚，然而用房中之术，多次扰动阳气，又正值夏季阳气在外，阴气在内，偶然不舒服，饮食起居如常，医生用壮年伤暑的药，香薷、黄柏、石膏、知母、滑石、车前、木通投予，立刻支撑不住。诊察时，则身体僵硬颈硬，舌强喉哑，没有生机了。喻嘉言说：这个症状虽然危险，但因为误药所致，刚过一晚，还可以用药迅速挽回。急忙用大附子、干姜、人参、白术各五钱，甘草三钱，大剂煎服，可以解除这个厄运。众人意见不一，暂且以前方四分之一的剂量服用，安贴后再煎也不迟。灌下一寸香的时间，大声呕吐一声，醒后能说话，呼唤诸子乳名说：刚才看见州官回来了。询问其原因，睁眼看着不说话，转而问医生是谁。说：江西喻。于是抬手一拱。又说：门缝有风吹进来瑟瑟作响。喻嘉言催促煎存留的药继续进服，而姻亲族人混杂进其他药，商量用轿子送他回寓所，另进其他药，哑症如前，过了两天便去世了。
李士材治疗程幼安，食少腹闷，吃粥很久，偶然吃了蒸饼，于是发热作渴，头痛呕逆。有人用治伤寒的方法，有人用化食破气的药投予，都不见效，形势很危急。诊察说：脉象没有停滞之象，诊之软且涩，这是脾土大虚的症状，法度上应当用人参、白术调理。大家都不同意。李士材说：病势已急，岂容再误？于是用四君子汤加沉香、炮姜给他，几剂后减轻，一月后安宁。
倪文学素来劳累积郁，胸膈饱闷，不能饮食，服用消食理气行痰开郁清火的药，共一百多剂，无效，病势日益增加。李士材诊察，脉大而软，叹息说：明明是火衰不能生土，用伐气寒凉药投予，何异于让人掉进井里又往下扔石头呢？于是用六君子汤加干姜、肉桂、益智仁各一钱，十剂后稍好。然而吃得很少，于是加附子一钱，兼用八味丸调补，百余日而痊愈。
卢不远治疗戴养吾夫人，身体常困倦，眩晕不食，胸膈痞满。诊脉寸关不透，认为是肝脾之气不伸，用八珍汤加升麻、柴胡而痊愈。后来每次生病，用前方即安。如果稍微加减，就不能获效。凡十五年，都倚赖这个方子。大概夫人性格安静体质浓厚，起居安适，所以气血不振而消沮，因此在补气血药中加入开提之剂，符合她的性情，所以可以久服。
何介甫患脾病数年，饮食少而精神憔悴。卒酉七月就诊，两关软弱，不透于寸，用人参、茯苓、当归、白芍、陈皮、防风、甘草，几十剂后，遂能善啖肥浓，几年的疾病脱然痊愈。问他说：我的病有多年，补脾补肾，方法不是不详细，却没有效果，您怎么从平易处得到疗效的？回答说：您的病在肝，不是脾肾病。凡是诊病的人，应当穷究其源，不要被症状迷惑。如饮食少，虽然关乎脾胃，但导致脾胃病的原因是什么？这是应当审察的。现在您两关脉弱，不透于寸，右边确实是脾虚明了。左边是什么呢？这是脾体不足，而脾用不行。脾的用，在于肝。星家取克我者为用神，脾体无肝木为之用，则气血便不条畅，运化迟钝，而脾胃转困了。况且秋来金肃，肝更不伸，乃补助肝木之气，使之扬溢，则脾土伸舒，精神油然外发，虽然不治脾，实则是治脾，哪里用得着奇特之法呢。
冯楚瞻治疗王慎瞻，平日过劳，又远行，途中吃冷面羊肉，及归家，胸中疼胀不堪。医生所用无非山楂、萝卜、枳实、厚朴之类，服用后更加严重，渐至心如压扁，昏晕闷绝，稍减则苏醒。冯楚瞻说：食物是有形的物体，只有进入肠胃，滞则为胀为疼，附着而不移动，怎么能升降于胸次呢？大概胸是心肺的部位，只受无形之气，不能藏有形之物。而且六脉弦细而数，身不热，语言无力，都不是伤食的征候，乃是积劳所伤，无根之气上逆于心，以致胀痛不堪。当用塞因塞用的方法，于是用枣仁、朱砂、乳香为细末，剖猪心血为丸，用人参五六钱，煎浓汤送服。一会儿，用莲子煮白米粥压之，令忍胀，强吞半碗。像这样几天，疼胀渐减。继以胸膈自觉甚空，虽多食不饱，而大便出的很少。大概劳役太过，脏腑脂膏耗竭，状如中消，食物入腹，销铄无余，故多入少出也。
谈铨部病热数日，医生以为是伤寒，投以发散药，禁止饮食，日渐危笃。诊脉，弦缓无力，乃是劳伤发热。先用浓粥汤半碗进之，觉得香美，甚甘饮食，眼睛顿时清亮。于是给予归脾汤，令以薄粥继之，三四日后，神气顿复而痊愈。（用饮食调理，最是补虚妙法。）
徐主政夫人，年逾七十，江行惊恐，早晚积劳，到家未几，壮热头疼。医生作伤寒治，发散数剂，渐至面色烦躁，神昏不语，头与手足移动，日夜无宁刻。诊脉，细数无伦，重取无力，这是劳极发热。热，乃是元阳浮越于表，再发散，阴阳将竭，非重剂挽回来不及。熟地一两六钱，炒麦冬、炒白术各三钱，牛膝二钱，五味子八分，制附子一钱二分，另用人参六钱，浓煎冲服。二三剂后，病减神清。后用八味丸、归脾汤二方加减全愈。
洪氏子因劳伤发热头疼，咳嗽胁痛。医生谓伤寒，大用发散。一剂，汗大出，热更甚，神昏见鬼，躁渴舌黑，身重足冷，彻夜不寐，困顿欲绝，脉细数无伦，胃脉微极。这是劳伤中气发热，东垣补中益气汤，为此等病而设，令阴阳气和，自能出汗而解。今更虚其虚，阳气发泄殆尽，所以身愈热而神愈昏，阴阳既脱，自尔目盲见鬼。津液既亡，所以舌黑足冷。至于身重异常，此尤足少阴极虚之症。盖肾主骨，骨有气以举则轻，否则重也。给予熟地二两，炒麦冬四钱，乳炒白术五钱，牛膝三钱，五味子一钱，附子二钱，浓煎，人参一两煎汁冲服。口渴，另用熟地二两，麦冬五钱，人参八钱，浓煎代茶。三四剂后，汗收热退，舌润神清，嗽止食进。后用生脉饮，送十补丸四五钱，再以归脾加减，煎膏成丸弹子大，圆眼汤化服，全愈。
刘君乡试入都，长途冒暑，气已伤矣。复日夜课诵，未几，壮热头疼，咳嗽干哕，不寐，神疲。诊脉两寸俱洪，两尺俱弱，右关沉取则无，这是犯无胃气之症，非温补脾肾无济也。而以暑天热病，坚不肯服，乃坐视数日，热益甚。复延诊，其脉转躁涩无力，这是久热阴阳愈伤也。给予大剂熟地、人参、白术、麦冬、五味子、牛膝，二剂，诸症渐愈。惟哕声间作，胃脉不起，犹不喜食，乃早以生脉饮送八味丸去丹皮、泽泻，加鹿茸、五味子、牛膝，晚以归脾汤去木香、甘草，加五味、肉桂，一补先天，一补后天，全愈。又同时，彭公子亦患是病，身热两月，服补中益气加减，已数十剂，不知此方乃为虚人发散而设，不宜久服。且时当夏月，阳气上浮，致令阴阳离决，精气乃绝，面青浮肿，肚腹胀硬，心下痞膈，咳嗽咽痛，口多甜涎，壮热畏寒，五心燥热，口干不渴，足胫常冷。脉则两寸乍洪乍数，两关无力，两尺更微，上盛下虚已极。以前方重剂，另煎人参一两冲服，旬余渐愈。复惑旁言，再用发散消痰，及补中、六君加减，遂不起。
太亲家高年，且患足疾，初愈，乃途中遇雨，疾趋而回，遂身热自汗，头疼咳嗽，继而吐血，饮食不思，精神野狼狈。诊脉，两寸皆洪大而数，右关两尺甚弱。这是劳伤中气，脾不统血也。咳嗽者，火烁于肺也；身热者，元阳浮越也；自汗者，气虚不能摄液也；头疼者，血虚火冒也。给予熟地一两，麦冬四钱，炒白芍六钱，牛膝三钱，五味子一钱，制附子一钱二分，另煎人参汤冲服，数剂，咳嗽吐血俱止。早晨生脉饮送加减肾气，午后加减归脾汤，服之全愈。
高鼓峰治疗吕用晦病热症，造榻与语，察其神气，内伤症也。询问其致病之由，说：偶夜半从卧室出庭外，与人语，移时就枕，次日便不爽快，渐次发热，饮食俱废，不更衣者，数日矣，服药无效。说：杂工皆以为风露所伤，故重用辛散，不进饮食，便曰停食，妄用消导，孰知邪之所凑，其气必虚。若投以补中益气汤，则汗至便通，热自退矣。用晦欣然，辄命取药，立煎饮之。旁观者皆以热甚，又兼饱闷，遽投补药，必致祸。慰之说：无庸惊扰，即便矣。顷之，下燥矢数十块，觉胸膈通泰，旁观者始贺。是晚熟寐，至五鼓热退进粥，连服前方而愈。
范中行感冒风寒，又过于房劳，发热昏闷，医生以为是伤寒，羌活、柴胡投之不应。又以为是阴症，肉桂、木香投之，又不应，热且愈甚，饮食俱废，舌黑如炭，八日不便，医生正议下。诊脉，细数而沉，说：阴亏甚矣，胃气将绝矣，非温和甘润之剂，弗能救也。急忙用左归丸及滋水清肝等药，重加人参、黄芪服用。其他医生以为不大便奈何议补？高曰：你以为承气症，误矣，第服药必得便。至第四日，果下黑矢升许，热退，舌亦红润。但尚
Pei Zhaoqi stated: Whenever a patient occasionally presents with alternating tidal fever, one should not hastily diagnose it as an exterior contraction of wind-cold and indiscriminately administer diaphoretic (sweat-inducing) formulas. This is because there are cases where the root cause is an internal damage to Yuan Qi (Primary Energy). If treatment is slightly effective initially, Yin syndromes may immediately manifest, leading to death in most cases with few survivors. In my hometown, there was an elderly gentleman who had only one son, over thirty years old. He always relied on his robust physique and did not practice moderation or caution. In June, due to his mother's birthday celebration, he entertained guests for several consecutive days, resulting from social obligations and fatigue. Consequently, he developed alternating tidal fever. He had a close relationship with a certain physician and invited him for treatment. However, the physician was away, so his apprentice examined the patient and prescribed herbs such as Qianghuo (Notopterygii Rhizoma et Radix), Zisu (Perillae Folium), and Fangfeng (Saposhnikoviae Radix). After one dose, profuse sweating occurred uncontrollably. The patient then sought my treatment; his six pulses were already extremely fine and rapid. I prescribed a formula containing Renshen (Ginseng Radix et Rhizoma) and Huangqi (Astragali Radix), each 5 qian; Guizhi (Cinnamomi Ramulus) and Fuzi (Aconiti Lateralis Radix Praeparata), each 2 qian; Danggui (Angelicae Sinensis Radix) 3 qian; and Xiaomai (Tritici Fructus) a pinch. I ordered it to be decocted and taken urgently. Just as the medicine was ready, the familiar physician arrived. He also diagnosed it as an exterior contraction, discarded my prescription, and continued with the previous diaphoretic herbs. The sweating became even more severe, and the patient died late at night. One must understand that sons of wealthy families often appear strong externally but are hollow internally. One cannot see their vigorous qi and sturdy form and mistakenly regard them as indestructible like the ancient giant trees (Dachun).
Wan Mizhai treated the son of the Dong family, aged seventeen. Upon examination, his pulse was floating, large, yet powerless. Inquiry into symptoms revealed no aversion to cold or headache, only body heat, thirst, and limb fatigue. Wan Mizhai said: "This resembles Baihu Tang (White Tiger Decoction) syndrome, but the pulse is deficient. It is caused by hunger, thirst, and overexertion." He prescribed Zhigan Huangqi (Honey-fried Astragali Radix) and Jiuxi Danggui (Wine-washed Angelicae Sinensis Radix), each 1 liang, decocted as a soup. The patient recovered.
Chen Zhengfu, the maternal uncle of Wan Mizhai's mother, suffered for three days with chest fullness and distension, scanty urination, and constipation. Upon hearing this, Wan Mizhai visited to inquire about the illness. A physician near the city intended to use Daxiehu Tang (Major Yellow Dragon Decoction) to purge. Observing the pulse and symptoms, Wan Mizhai determined purging was contraindicated. This was an internal injury causing stagnation of Middle Qi, resulting in closure of the upper orifices and blockage of lower Qi flow. Danxi stated: "Erchen Tang (Two-Aged Decoction) added with Cangzhu (Atractylodis Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma), Shengma (Cimicifugae Rhizoma), and Chaihu (Bupleuri Radix) will moisten the stool and increase urine output." One dose brought relief.
Gong Zicai treated Liu Taifu, who suffered from excessive labor, presenting with fever, aversion to cold, headache, body pain, dry mouth, thirst, nausea, vomiting, and irritability. Some used Qianghuo Tang, others Huoxiang Zhengqi San (Agastache Powder to Rectify the Qi), but the condition worsened. His limbs felt restless, his heart panicked, his spirit chaotic, unable to sit or lie comfortably, unable to swallow liquids, and vomiting upon smelling medicine. (This was caused by wind-drying agents stirring up internal fire.) Examination revealed six pulses were flooding and rapid, with the Qi Kou (Radial Artery at the wrist) tight and full. This indicated internal injury to Yuan Qi. He prescribed Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi) with Yuanzhi (Polygalae Radix), Zaoren (Ziziphi Spinosae Semen), Zhuru (Bambusae Caulis in Taenia), and Maidong (Ophiopogonis Radix). After one dose, he slept soundly; after another dose, he fully recovered.
Chen Sansan treated an elderly man suffering from headache, aversion to cold, joint pain, absence of sweat, and delirium. He had self-administered Shenru Yin (Ginseng and Perilla Drink) to induce sweating. His pulse was flooding and rapid, especially on the left. This was stomach deficiency due to labor. Although the Yangming channel received pathogenic factors, attack/purging was contraindicated. One should tonify the deficiency; once Stomach Qi is sufficient, spontaneous sweating will resolve the condition. He prescribed Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Chenpi (Citri Reticulatae Pericarpium), and Zhigancao (Honey-fried Glycyrrhizae Radix et Rhizoma), plus Shufuzi (Prepared Aconiti Lateralis Radix). After four to five doses, symptoms decreased, but dry mouth and fever persisted. Fuzi was removed, and Shaoyao (Paeoniae Radix Alba) was added. Gradually, appetite returned, sweating occurred, and he stabilized.
Lu Yangyu treated Cong Yizai, who suffered from mental fatigue and anger, loss of appetite for months. In early spring, he developed left hypochondriac pain, unable to sleep on his left side. He contracted a cold, leading to cough, wheezing, sweating, aversion to wind, vomiting, aversion to cold drinks, chest/epigastric fullness, irritability, diarrhea, tinnitus, and twitching/fasciculation of finger muscles. Pulse: both Cun (inch) positions were slightly floating and choppy; Guan (bar) and Chi (cubit) positions were slightly deficient and unstable. Lu said: "Inability to sleep on the left indicates Liver swelling; inability to sleep on the right indicates Lung swelling. Combined with cough, spontaneous sweating, wheezing, and diarrhea, these are difficult to treat. Moreover, a choppy pulse in spring suggests Metal overcoming Wood, which is alarming. Fortunately, Shen Qi (Spiritual Energy) is not exhausted, Cun positions show slight floating indicating residual Yang, urine is thick yellow and copious, complexion is scorched black but with a faint yellow hue, so it is still treatable." Zhang Zhongjing stated: "Deficient and weak pulse below indicates absence of Yang." Also: "Micro and deficient combined results in shortness of breath." Also: "Slightly floating indicates invasion of exogenous heat." Li Dongyuan stated: "When Yin is first depleted and Yang desires to leave, heat congestion in the mouth and nose appears, called false heat syndrome." This case resulted from emotional injury depleting Yin, mental fatigue injuring Yang, and wind-cold invading due to deficiency, causing chest fullness. Because the pathogen was half-exterior half-interior, compounded by stagnant cold water, symptoms resembled Zhi Yin (Fluid Retention in Hypochondrium) binding the ribs, preventing lateral sleeping, with pain upon waking. Although fluid retention in the Liver seems excess, it is fundamentally insufficient and unregulated Yuan Qi. Synthesizing all symptoms, this belongs to injured Righteous Qi. Treatment should nourish Qi and Blood to allow pathogens to dissipate naturally. He used Shunqi Yangrong Tang (Regulate Qi and Nourish Blood Decoction) plus Guizhi (Cinnamomi Ramulus) and Gancao (Glycyrrhizae Radix et Rhizoma). Two doses significantly reduced symptoms. Then switched to Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi) with a small amount of Xiao Qinglong Tang (Minor Green Dragon Decoction) to harmonize Ying and Wei (Nutritive and Defensive levels). Two doses resolved spontaneous sweating, wheezing, and vomiting. However, fullness and hypochondriac pain persisted. He then used Liujunzi Tang (Six Gentlemen Decoction) with doubled Banxia (Pinelliae Rhizoma) and Chenpi (Citri Reticulatae Pericarpium), plus a little Cardamomi Fructus and Muxiang (Aucklandiae Radix). Chest fullness and pain ceased. Then administered Sishen Wan (Four Spirits Pill) to strengthen the Spleen and Shenqi Wan (Kidney Qi Pill) to consolidate the root. After a month of regulation, he recovered.
Zhu Shaohu, in mid-winter, suddenly experienced slight stiffness of the head and neck and mild body pain. Suspecting Shanghan (Cold Damage), he used two large handfuls of Zisu (Perillae Folium) and ten slices of Shengjiang (Zingiberis Rhizoma Recens), decocted strongly and taken hot, covered heavily to induce profuse sweating. He felt lighter and thought he was cured. That night, he felt stiff again, heavier than before. Repeating the sweating method failed; his body felt like stone, irritable, thirsty, and restless. At dawn, a physician diagnosed an extremely floating and rapid pulse. "Winter Shanghan requires Mahuang (Ephedrae Herba) and Guizhi (Cinnamomi Ramulus) to resolve; ginger and perilla are too light for such a serious disease." He proposed Da Qinglong Tang (Major Green Dragon Decoction). The family doubted and divined, receiving an inauspicious result, so they consulted Lu Yangyu. Lu found the pulse floating and rapid but micro-fine like spider silk, nearly imperceptible upon pressure. Lu said: "This is Yang deficiency. Sweating was originally contraindicated. Furthermore, the Classics state that during the three winter months, the command is storage; do not disturb Yang, do not vent the skin to cause frequent Qi depletion. Once is enough, can you do it again?" The other physician argued: "Zhongjing said, Yin excess and Yang deficiency are cured by sweating. If it is Yang deficiency, why not sweat? Besides, Mahuang, Guizhi, and Qinglong Tang are designed for winter deficiency-cold. If we follow storage and avoid sweating, should Zhongjing's formulas only be used for summer-heat/cold damage?" Lu could not refute verbally but slowly said: "Your argument is high-minded, but I fear it does not match this pulse." The family asked what to use. Lu said: "Only Jianzhong Tang (Middle-Builder Decoction) and Shengmai San (Generate the Pulse Powder) should be considered." The other physician said: "Pathogen is in the exterior; using tonifying/astringent methods invites death!" Lu replied: "If sweating cures, the tonification was wrong; if tonification cures, the sweating was wrong. They are not both correct." The family couldn't decide, divined again (tonification auspicious, sweating inauspicious), and combined Jianzhong and Shengmai. Irritability worsened, belching continued, legs turned cold, body immobile. The other physician predicted imminent death. Lu said: "We have sweated wrongly twice; the medicine was too light for the severity, hence no effect." He kept the previous formula, doubled Renshen (Ginseng Radix et Rhizoma), added Fuzi (Aconiti Lateralis Radix Praeparata), decocted strongly, and administered cold. Soon, irritability settled. Several doses cleared all symptoms. A month later, occasional spontaneous sweating prevented him from rising; one liang of Renshen resolved this. (This refutation has merit. Lu did not directly identify it as internal injury but cited classics broadly, inviting such debate, and refused to explicitly point out the error to educate the family. He used vague language, a common habit among famous physicians.)
Yu Jiayan treated Liu Yunzhi, seventy years old, who continued sexual activity without restraint, indicating strong congenital constitution. However, misuse of sexual techniques repeatedly disturbed Yang. Coinciding with summer when Yang is external and Yin internal, he felt slightly unwell but ate and lived normally. Physicians used herbs for young adults' summer-heat injury: Xiangru (Elsholtziae Herba), Huangbai (Phellodendri Cortex), Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma), Huashi (Hua Shi), Cheqiancao (Plantaginis Herba), Mutong (Akebiae Caulis). He collapsed immediately. Examination showed rigid body and neck, stiff tongue, hoarse throat, seemingly lifeless. Yu said: "Though critical, this is due to mismedication. Only one night has passed; it can still be rapidly reversed with medicine." He urgently prescribed Fu Zi (Aconiti Lateralis Radix Praeparata), Gan Jiang (Zingiberis Rhizoma), Renshen (Ginseng Radix et Rhizoma), and Baizhu (Atractylodis Macrocephalae Rhizoma), each 5 qian, Gancao (Glycyrrhizae Radix et Rhizoma) 3 qian, in a large dose. Others hesitated; they tried one-quarter of the dose. He stabilized. After an inch of incense burned time, he vomited loudly, woke up, spoke, and called his children by nicknames: "I just saw the Prefect return." Asked why, he opened his eyes, didn't speak, then asked who the doctor was. "Jiangxi Yu." He raised his hand in a salute. Said: "Wind coming through the door crack." Yu urged continuing the remaining medicine. Relatives mixed other medicines. He was carried home in a sedan chair. The aphasia recurred, and he died two days later.
Li Shicai treated Cheng You'an, who had poor appetite and abdominal fullness. After eating congee for a long time, he accidentally ate steamed wheat cakes, leading to fever, thirst, headache, and vomiting. Treated as Shanghan or with food-resolving/qi-breaking herbs, none worked; condition critical. Li diagnosed: "No stagnation in pulse; soft and choppy. This is severe Spleen Earth deficiency. Method: use Renshen and Baizhu." Everyone disagreed. Li said: "Condition is urgent; how can we err again?" He prescribed Sijunzi Tang (Four Gentlemen Decoction) with Chenxiang (Aquilariae Lignum) and Paojiang (Roasted Zingiberis Rhizoma). Reduced after several doses, stable after one month.
Ni Wenxue, chronically fatigued and depressed, had chest fullness and inability to eat. Took over a hundred doses of food-resolving, qi-regulating, phlegm-draining, depression-opening, fire-clearing herbs, with no effect; condition worsened. Li diagnosed: "Pulse large and soft. Clearly Fire failure failing to generate Earth. Using qi-depleting cold-cool herbs is like dropping stones into a well." Prescribed Liujunzi Tang (Six Gentlemen Decoction) with Ganjiang (Zingiberis Rhizoma), Rougui (Cinnamomi Cortex), and Yizhiren (Alpiniae Oxyphyllae Fructus), each 1 qian. Improved after ten doses. Appetite remained low; added Fuzi (Aconiti Lateralis Radix Praeparata) 1 qian, combined with Bawei Wan (Eight-Ingredient Pill) for regulation. Recovered after over a hundred days.
Lu Buanyuan treated Dai Yangwu's wife, who was chronically fatigued, dizzy, anorexic, with chest fullness. Pulse Cun and Guan did not penetrate. Diagnosed as Liver-Spleen Qi stagnation. Used Bazhen Tang (Eight-Treasure Decoction) plus Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix). Cured. Subsequent illnesses responded to the same formula; modifications failed. For fifteen years, she relied on it. Her nature was quiet, constitution robust, lifestyle comfortable, leading to Qi-Blood decline. Adding lifting agents to tonics suited her temperament, allowing long-term use.
He Jiefu suffered Spleen disease for years, poor diet, emaciated spirit. Consulted in July. Guan pulses weak, not reaching Cun. Used Renshen (Ginseng Radix et Rhizoma), Fuling (Poria), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Chenpi (Citri Reticulatae Pericarpium), Fangfeng (Saposhnikoviae Radix), Gancao (Glycyrrhizae Radix et Rhizoma). Dozens of doses allowed him to eat rich foods; years-long disease vanished. Asked how he succeeded where detailed Spleen/Kidney tonification failed. Answered: "Your disease is in the Liver, not Spleen/Kidney. Seek the source, don't be confused by symptoms. Poor diet involves Spleen/Stomach, but what causes it? Your Guan pulses are weak, not reaching Cun. Right indicates Spleen deficiency. Left? Spleen Body is insufficient, Spleen Function fails. Spleen Function relies on Liver. In astrology, the element that controls me is the Useful God. Without Liver Wood activating Spleen Body, Qi-Blood becomes unsmooth, transformation sluggish, Spleen/Stomach distressed. Autumn Metal restricts Liver further. Tonify Liver Wood to spread, allowing Spleen Earth to expand, Spirit to emerge. Though not treating Spleen directly, this treats Spleen. Why use strange methods?"
Feng Chuzhan treated Wang Shenzhan, chronically overworked, traveled far, ate cold noodles and mutton en route. Upon return, unbearable chest pain/distension. Doctors used Hawthorn, Radish, Zhishi (Aurantii Fructus), Zhipo (Magnoliae Officinalis Cortex). Condition worsened to feeling heart flattened, fainting, regaining consciousness slightly. Feng said: "Food is solid. Only enters intestines/stomach; stagnation causes distension/pain, adheres fixedly. How can it rise/fall in the chest? Chest is Heart/Lung domain, receiving only Formless Qi, not storing Solid objects. Six pulses string-tight, fine, rapid; no fever; weak speech. Not food stagnation. It is accumulation-labor injury, Rootless Qi reversing upward to Heart, causing pain. Use 'Tonify Obstruction with Obstruction' method." Prescribed Zaoren (Ziziphi Spinosae Semen), Zhusha (Cinnabaris), Xurxiang (Frankincense) powdered, pills made with Pig Heart Blood. Administered with Renshen (Ginseng Radix et Rhizoma) 5-6 qian decoction. Later, Lotus seed and rice porridge pressed down, forcing half bowl despite bloating. Days later, pain decreased. Chest felt empty, ate much but defecated little. Overwork depleted organ fats, resembling Zhongxiao (Middle Wasting-Thirst); food consumed instantly.
Tan Quanbu had fever for days. Doctor diagnosed Shanghan, gave diaphoretics, restricted diet. Condition critical. Pulse string-slow, powerless. Labor-injury fever. First gave half bowl strong congee soup. Found it delicious, appetite returned, eyes bright. Gave Guipi Tang (Restore the Spleen Decoction), continued with thin congee. Spirit recovered in 3-4 days. (Dietary regulation is the best subtle method for deficiency.)
Xu Zhuzheng's wife, over seventy, frightened during river travel, accumulated fatigue morning/evening. Returned home, developed high fever, headache. Doctor treated as Shanghan, diaphoretics several doses. Face became irritable/red, spirit confused, mute, head/hands/feet moving restlessly day/night. Pulse fine-rapid, powerless on deep press. Extreme labor fever. Heat is Yuan Yang floating outward. More diaphoretics would exhaust Yin-Yang. Heavy tonics needed. Shudi (Rehmanniae Radix Preparata) 1 liang 6 qian, Chaomaidong (Stir-fried Ophiopogonis Radix) 3 qian, Chaobaizhu (Stir-fried Atractylodis Macrocephalae Rhizoma) 3 qian, Niuxi (Achyranthis Bidentatae Radix) 2 qian, Wuweizi (Schisandrae Fructus) 8 fen, Zhifuzi (Prepared Aconiti Lateralis Radix) 1.2 qian. Separate Renshen (Ginseng Radix et Rhizoma) 6 qian, strong decoction, mix in. 2-3 doses reduced fever, clarified spirit. Later, Babui Wan (Eight-Ingredient Pill) and Guipi Tang modified cured her.
Hong's son had labor-injury fever, headache, cough, hypochondriac pain. Doctor diagnosed Shanghan, heavy diaphoretics. One dose: profuse sweat, worse fever, confusion, seeing ghosts, irritability/thirst, black tongue, heavy body, cold feet, insomnia, exhaustion. Pulse fine-rapid, Stomach pulse micro-extreme. Labor-injury Middle Qi fever. Li Dongyuan's Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi) is for this, harmonizing Yin-Yang for spontaneous resolution. Now further depleted Yang, expelled completely. Hence hotter body, darker spirit. Yin-Yang separation causes blindness/visions. Fluid loss causes black tongue/cold feet. Extreme heaviness indicates Foot Shaoyin extreme deficiency. Kidney governs bones; bone Qi lifts makes it light, otherwise heavy. Gave Shudi (Rehmanniae Radix Preparata) 2 liang, Chaomaidong (Stir-fried Ophiopogonis Radix) 4 qian, Rumeng Baizhu (Milk-roasted Atractylodis Macrocephalae Rhizoma) 5 qian, Niuxi (Achyranthis Bidentatae Radix) 3 qian, Wuweizi (Schisandrae Fructus) 1 qian, Fuzi (Aconiti Lateralis Radix Praeparata) 2 qian, strong decoction. Renshen (Ginseng Radix et Rhizoma) 1 liang juice mixed in. Thirst: separate Shudi 2 liang, Maidong 5 qian, Renshen 8 qian, strong decoction as tea. 3-4 doses: sweat stopped, fever retreated, tongue moist, spirit clear, cough stopped, appetite returned. Later, Shengmai San (Generate the Pulse Powder) with Shibao Wan (Ten-Tonify Pill) 4-5 qian, then Guipi Tang modified, decocted to paste, rolled into pill size of loquat seeds, dissolved in Longan soup. Fully cured.
Liu Jun went to capital for exam, traveled long distance in summer heat, Qi already injured. Studied day/night, soon high fever, headache, cough, dry retching, insomnia, fatigue. Pulse: both Cun flooding, both Chi weak, Right Guan empty on deep press. Violation of Stomach Qi. Non-warm-tonic Spleen/Kidney would fail. Due to summer heat disease, firmly refused to take it. Watched for days, fever increased. Re-examined: pulse restless-choppy-powerless. Long fever injured Yin-Yang further. Large dose Shudi (Rehmanniae Radix Preparata), Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Maidong (Ophiopogonis Radix), Wuweizi (Schisandrae Fructus), Niuxi (Achyranthis Bidentatae Radix). Two doses improved. Hiccups intermittent, Stomach pulse inactive, no appetite. Morning: Shengmai San (Generate the Pulse Powder) with Bawei Wan (Eight-Ingredient Pill) minus Mudanpi (Moutan Cortex) and Zexie (Alismatis Rhizoma), plus Lurong (Cervi Cornus Pantotrix Depilatus), Wuweizi, Niuxi. Evening: Guipi Tang (Restore the Spleen Decoction) minus Muxiang (Aucklandiae Radix) and Gancao (Glycyrrhizae Radix et Rhizoma), plus Wuweizi, Rougui (Cinnamomi Cortex). Tonify Pre-heaven and Post-heaven. Cured. Simultaneously, Peng Gongzi had same disease, fever two months, took Buzhong Yiqi Tang modified dozens of doses. Unaware this formula is for dispersing in deficient people, not for long use. Summer Yang floats up, causing Yin-Yang separation, Essence-Qi extinction. Blue face, edema, hard abdomen, epigastric fullness, cough/sore throat, sweet saliva, high fever/aversion to cold, Five Hearts heat, dry mouth no thirst, cold calves. Pulse: Cun fluctuates flooding/rapid, Guan powerless, Chi micro. Upper excess, Lower deficiency extreme. Heavy dose previous formula, separate Renshen 1 liang mixed in. Improved in 10+ days. Confused by others, used diaphoretics/phlegm-resolvers, Buzhong/Liujunzi modified. Died.
Father-in-law, advanced age, recovering from foot disease, caught rain, hurried back. Fever, spontaneous sweat, headache, cough, then hemoptysis, anorexia, dispirited. Pulse: both Cun flooding-large-rapid, Right Guan/Chi very weak. Labor-injury Middle Qi, Spleen failing to control blood. Cough: Fire scorching Lung. Fever: Yuan Yang floating. Sweat: Qi deficiency failing to secure fluids. Headache: Blood deficiency Fire rushing up. Gave Shudi (Rehmanniae Radix Preparata) 1 liang, Maidong (Ophiopogonis Radix) 4 qian, Chaobaishao (Stir-fried Paeoniae Radix Alba) 6 qian, Niuxi (Achyranthis Bidentatae Radix) 3 qian, Wuweizi (Schisandrae Fructus) 1 qian, Zhifuzi (Prepared Aconiti Lateralis Radix) 1.2 qian. Separate Renshen decoction mixed in. Several doses stopped cough/hemoptysis. Morning: Shengmai San (Generate the Pulse Powder) with modified Shenqi Wan (Kidney Qi Pill). Afternoon: modified Guipi Tang (Restore the Spleen Decoction). Cured.
Gao Gugeng treated Lü Yonghui with fever syndrome. Examined spirit, diagnosed internal injury. Cause:半夜 (midnight) walked from bedroom to courtyard, talked, lay down next day felt unwell, gradually fever, stopped eating/digestion, no bowel movement for days, meds ineffective. Others blamed wind/dew, used heavy acrid-dispersants. No food intake led to diagnosis of food stagnation, used blind digestive aids. Did not know "Where pathogen gathers, Qi must be deficient." If given Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi), sweat would come, bowels open, fever retreat. Lü happily ordered meds. Decocted and drank. Onlookers worried: high fever + fullness + sudden tonics = disaster. Comforted: "Don't panic." Soon, passed dozens of dry stools. Chest felt open. Onlookers congratulated. Slept soundly that night. By fifth watch, fever retreated, ate congee. Continued formula, cured.
Fan Zhongxing contracted wind-cold, excessive sexual activity, fever/confusion. Doctor diagnosed Shanghan, gave Qianghuo (Notopterygii Rhizoma et Radix), Chaihu (Bupleuri Radix). No response. Diagnosed Yin syndrome, gave Rougui (Cinnamomi Cortex), Muxiang (Aucklandiae Radix). No response, fever worsened, anorexic, black tongue like charcoal, no bowel movement eight days. Doctor discussed purging. Pulse fine-rapid-deep. Fan said: "Yin severely deficient, Stomach Qi about to perish. Only mild-warm-sweet-moistening agents can save." Urgently used Zuogui Wan (Left Restoring Pill) and Zishui Qinggan Tang (Nourish Water Clear Liver Decoction), heavily adding Renshen (Ginseng Radix et Rhizoma) and Huangqi (Astragali Radix). Other doctors questioned: "How to tonify with constipation?" Gao said: "You think Chengqi syndrome, mistaken. Taking meds will bring bowel movement." Fourth day, passed black stools, fever retreated, tongue red-moist. But still...