川黄连各五分，一服吐止身凉，二服全愈。又服调理药，数剂而安。
陆养愚治沈立川内人，胸膈不舒，咽嗌不利，中脘少腹常疼，大便溏，经水淋沥，腰膝无力，倦怠头眩，
得食少可，食后则异常不快。半年间，顺气、清热、开郁、化痰、消食之药，服将百剂。脉之，左手沉数而细
右手沉弦而微。此肝脾燥热，忿郁积久而致。前属有余，今为不足，宜用补剂。沈曰∶前用人参五分，且有开
气之药，极痞满，恐补不能投。曰∶参少而兼开气，所以痞满也。乃用八物汤，人参一钱，服之大胀。乃加参
二钱，胀即减。加至三钱，竟不胀矣。又合六味丸，空心服之，调理二月而痊。
一妇郁怒忧思，胸腹胀痛，痛甚则四肢厥冷，口噤冷汗，用二陈汤加芍、归、乌药、青皮、枳壳、香附、
浓朴、苏叶，一剂痛胀即愈。后去苏叶，加姜炒黄连，再服一剂而安。
一妇郁怒不发，久之，噫声甚高，言谈不知终始， 杂易饥。经曰∶心病为噫。此因忧而血郁于心胸也，
用桃仁承气汤，（大黄、桃仁、桂枝、芒硝、甘草。）下蓄血数升而安。经曰∶血蓄在上则喜忘，在中则喜狂也。
一中年人，因郁悒，心下作痛，一块不移，日渐羸瘦，与桃仁承气汤一服，下黑物并痰碗许，永不再发。
薛立斋治一妇人，身颤振，口妄言，诸药不效。薛以为郁怒所致，询其故，盖为素嫌其夫，而含怒久也。
投以小柴胡汤稍可，又用加味归脾汤而愈。
一妇人，年六十有四，久郁怒，头痛寒热。春间，乳内时痛，服流气饮之类，益甚，不时有血如经行。又
因大惊恐，饮食不进，夜寐不宁。此因年高去血过多，至春无以生发肝木，血虚火燥，所以至晚阴旺则发热。
经云∶肝藏魂。魂无所附，故不能寐。先以逍遥散，加酒炒黑龙胆草一钱，山栀一钱五分，二剂肿痛顿退，又
二剂而全消。再用归脾汤加炒栀、贝母，诸症悉愈。
一妇人，因丧子怀抱不舒，腹胀少寐，饮食素少，痰涎上涌，月经频来。曰∶脾流血而主涎，此郁闷伤脾，
不能摄血制涎归源。遂用补中益气、济生归脾二汤而愈。又用八珍汤调理而愈。
秀才杨君爵，年将五十，胸痞少食，吐痰体倦，肌肉消瘦，所服方药，皆耗血破气化痰降火。曰∶此气郁
所伤，阳气未升越，属脾经血虚之症，当用归脾汤，能解郁结，生脾血，用补中益气，壮脾气，生发诸经，否
则必为中满气膈之患。不信，仍用前药，后果患前症而殁。
罗谦甫曰∶疏五过论云，常贵后贱，里不中邪，病从内生，名曰脱营。镇阳一士人，躯干魁梧，而意气
豪雄，喜交游，而有四方之志，年逾三旬，已入仕至五品，出入骑从塞途，姬侍满前，饮食起居，无不如意。
不三年，以事罢去，心思郁结，忧虑不已，以致饮食无味，精神日减，肌肤渐致瘦弱，无如之何。遂耽嗜于酒，
久而中满，始求医。医不审得病之情，辄以丸药五粒温水送，下二十余行。时值初秋，暑热犹盛，因而烦渴，
饮冷过多，遂成肠鸣腹痛，而为痢疾，有如鱼脑，以致困笃，命予治之。诊其脉，乍大乍小；其症，反复闷乱，
兀兀欲吐，叹息不绝。予料曰∶此症难治。启元子曰，神屈故也。以其贵之尊荣，贱之屈辱，心怀慕恋，志结
忧惶，虽不中邪，病从内生，血脉虚减，名曰脱营。或曰∶愿闻其理。《黄帝针经》有曰，宗气之道，内谷为
主，谷入于胃，乃传入于脉，流溢于中，布散于外。精专者行于经隧，周而复始，常营无已，是为天地之纪。
故气始从手太阴起，注于阳明，传流而终于足厥阴，循腹理，入缺盆，下注肺中，于是复注手太阴。此营气之
所行也，故昼夜气行五十营，漏水下百刻，凡一万三千五百息。所谓交通者，并行一数也。故五十营备，得尽
天地之寿矣。今病者，始药后苦，皆伤精气，精气竭绝，形体毁阻。暴喜伤阳，暴怒伤阴，喜怒不能自节。盖
心为君主，神明出焉。肺为辅相，主行荣卫，制节由之。主贪人欲，天理不明，则十二官相使，各失所司。使
道闭塞而不通，由是则经荣之气脱去，不能灌溉周身，百脉失其天度，形乃大伤。以此养生则殃，何疑之有？
马元仪治洪声远，恶寒发热，倦怠懒言，神气怯弱，两脉弦虚，此甲木内郁，生气不荣，而阳明受病也。
盖甲木乃少阳初生之气，勾萌始坼，其体柔脆，一有拂郁，即萎软抑遏而不上升，反下克脾土而为病矣。由
是枢机不利，虚邪入之，而与阴争则寒，顷之既去，而与阳争则热。倦怠者，胃病而约束之机关不利也；神怯
者，木脏伤而心脏之神明失养也，是皆木郁土衰之故。木气既郁，惟和风可以达之，阴雨可以滋之。柴胡风剂之平
者，能入少阳，清发升阳而行春气；当归、白芍，味辛而润，辛以疏其气，润以养其阴；白术、茯苓、陈皮、
炙甘草，以和中气而益脾土。两剂，脉象有神。四剂，寒热已。再用补中益气，升发生阳之令而康。（纯用薛立斋
法，木郁于肝脾之中，而血不亏者，可以用之。）
朱氏子，场屋不利，郁郁而归，遂神识不清，胸满谵语，上不得入，下不得出，已半月。诊之，两脉虚
涩兼结。此因郁所伤，肺金清肃之气不能下行，而反上壅，由是木寡于畏，水绝其源，邪火内扰，而津液干格。
胸中满结者，气不得下也；神昏谵语者，火乱于上也；上不得入，下不得出者，气化不清，而现晦塞之象也。
但通其肺气，诸症自已。用紫菀五钱，宣太阴以清气化；干葛二钱，透阳明以散火郁；枳、桔各一钱，散胸中
之结；杏仁、苏子各二钱，导肺中之痰。一剂而脉转神清，再剂而诸症悉退。改用归脾汤调理而痊。
顾霖苍妇，寒热如疟，便血不已，左胁有块，攻逆作楚，神气昏愦。诊之，两脉弦数兼涩。弦则为风，数
则为热，涩则气结。此脾肝之气，悒郁不宣，胸中阳和郁而成火，故神明不精。肝之应为风，肝气动则风从之，
故表见寒热也。人生左半，肝肾主之，左气逆，故左胁攻楚有块也。肝为藏血之地，肝伤则血不守，而风热益
胜，为亡血之由也。用生首乌一两，滋燥而兼搜风。黄连一钱，治火兼以解郁。柴胡以疏其表，黄芩、知母以
清其里，枳实、浓朴以和其中。一剂，脉起神清。再剂，便行热解而安。（方论俱佳。）
缪仲淳曰∶甲申夏，佣妇因郁火痰喘身热，手拳目张，半月不眠食。按其胃口不痛，诸医疑其虚也。或云
中暑，百药试之，痰喘滋急。以皂角末嚏鼻通窍，痰上逆如沸。延杨石林诊之，请亟吐之。先大夫曰∶病久矣，
虚甚，可奈何？石林曰∶经云，上部有脉，下部无脉，其人当吐，不吐则死。即以盐汤吞之，去白痰数碗，喘
定。先大夫曰∶何以药之？石林曰∶吐即药也。待其熟寝，勿服药，以养胃气。夜半，啜粥二碗。诘旦，投六
君子汤，数剂而起。石林者，里中博雅士，不行术而精医者也。（深得子和之法。）
姑苏张涟水治纪华山，雅，自负数奇，更无子，悒悒不快，渐至痞张，四年，肌肉削尽，自分死矣。张
诊而戏之曰∶公那须药？一第盒饭霍然。以当归六钱，菲菜子一两，香附童便炒八钱，下之。纪有难色，不得
已，减其半。张曰∶作二剂耶？即服，夜忽梦遗，举家恸哭。张拍案曰∶吾正欲其通耳。仍以前半剂进，胸膈
间若勇士猛力一拥，解黑粪数升，寻啜粥二碗。再明日，中栉起见客矣。逾年生一子，即是表弟汝占也。（《广笔记》。）
张意田治柯姓人，病剧。诊之，得脉浮大而空，左关沉候有微弦之象，左尺沉候有一丝之根。面目皆红，
鼻青耳聋，眼瞪神昏，自语不休，舌燥赤大，唇紫齿燥。（只此数端，便非戴阳症明矣。）初病发热咳嗽，已
七八日，所服乃伤风散解之药。昨日早间，连大便三四次，即卧床不省人事，今日忽然发昏。或谓戴阳症，
用熟地、附子等，未服。张思外症虽类戴阳，然症起无因。察其所言，皆平日之事，则似少阴之独语。至鼻现
青色，时在秋令，则肺气绝矣。然面有光亮，为表气不和，唇色深紫，宜有郁火。且左尺有根，本非无治；左
关微强，则别有致病之故。询之，乃昨早失手自碎粥罐，因怒不止，即大便昏迷，知为郁怒所伤，肝火上逆而
诸症蜂起，经所谓怒则气上是也，与戴阳相去远矣。用逍遥散去白术，加地黄、丹皮、炒栀之属而愈。病多隐
微，医不审察，误斯众矣。
一宦素谨言，一日，会堂属官筵中，有萝卜颇大，客羡之。主曰∶尚有大如人者，客皆笑以为无。主则悔
恨自咎曰∶人不见如此大者，而吾以是语之，宜以吾言为妄且笑也。因而致病，药不应。其子读书达事，思其
父素不轻言，因愧赧成病，必须实所言，庶可解释。遂遣人至家取萝卜如人大者至官所，复会堂属，强父扶病
而陪。陪至数巡，以车载萝卜至席前，客皆惊讶，其父大喜，厥旦疾愈。（《石山医案》。）
一女与母相爱，既嫁，母丧，女因思母成疾，精神短少，倦怠嗜卧，胸膈烦闷，日常恹恹，药不应。予视
之曰∶此病自思，非药可愈。彼俗酷信女巫，巫托降神言祸福，谓之卜童。因令其夫假托贿嘱之，托母言女与
我前世有冤，汝故托生于我，一以害我，是以汝之生命克我，我死皆汝之故。今在阴司，欲报汝仇，汝病恹恹，
实我所为，生则为母子，死则为寇仇。夫乃语其妇曰∶汝病若此，我他往，可请巫妇卜之何如？妇诺之。遂请
卜，一如夫所言。女闻大怒，诟曰∶我因母病，母反害我，我何思之？遂不思，病果愈，此以怒胜思也。
萧万舆治一妇，年四旬，怀抱郁结，呕痰少食，胸膈胀痛，虽盛暑犹着绵衣，六脉浮结，或烦渴不寐，
此命门火衰，元气虚寒也。以六君子加姜、桂及八味丸，不两月而症痊矣。
易思兰治徐文淙妻，卧病三年，身体羸瘦，畏寒战栗后发热，得汗始解，脊背拘痛，腰膝软弱，饮食不进，
则肠鸣作泻，心虚惊悸，胸肋气胀，畏风畏热，头眩目昏，月信愆期。易诊之曰∶此气郁病也。左寸脉心小肠
属火，当浮大而散，今心脉大而散，却不浮。盖心为一身之主，藏神而生血，宜常静而不宜多动。人能静养，
则心血充满，脉自浮大。若事事搅乱，心不宁则神不安而血不充，是以脉无力而不浮，怔忡惊悸之病，由之以
生。况诊七八至，或十二三至，又往关中一猎，有类以灰种火之状，此乃君火郁于下，而无离明之象也。据
脉论证，当有胸中烦闷，蒸蒸然不安，蒸出自汗，则内稍静，而腠理不密畏寒为验。左关肝胆属木，宜弦细而
长，今左关弦长而不细，又侵上寸部二分，推之于内，外见洪大有力，是肝气有余也。盖因火郁于中，下不能
承顺正化之源，木母太旺，上助心火，中侮脾土。肝藏血而主筋，病当头眩目昏，脊背项强，卒难转侧，背冷
如冰，甚则一点痛不可忍，下则腰膝软弱无力，脾胃不和等症为验。左尺肾与膀胱属水，脉宜沉濡而滑，惟此
部得其正。右寸肺与大肠属金，脉宜短涩而浮。兹诊得沉滞而大，按三五至或十数至一结，结乃积深，沉则气
滞，此正肺受火邪，气郁不行也。病当胸膈不利，或时闷痛，右肋胀满，饮食不进，大肠鸣泄等症为验。右关
脾胃属土，脉宜缓而大，此部虽无力，犹不失其本体。右尺三焦命门属相火，亦宜沉静，不宜浮大。此部浮取
三焦脉，浮而无力，侵上脾胃，是君火郁于下，而相火升于上，侮其金也，病主气满胸膈 杂，饮食不利等症
为验。详六部脉症，惟左尺得体，肾为寿元，根本尚固。右关脾土为木所侮，虽是少力，然来去缓大而不弦。
此五脏之源，生气有存，无足虑也。病症多端，要之不过气郁而已。丹溪云∶气有余便是火。火郁则发之，先
投以和中畅卫汤，用苏梗、桔梗开提其气，香附、抚芎、苍术、神曲解散其郁，贝母化其郁痰，砂仁快其滞气。
郁气散则金体坚，木平水王，何虑相火不降耶？若夫木当夏月，成功者退，虽王不必专治。服三剂而肺脉浮起，
胸次豁然，诸症顿减。继以清中实表，固其腠理，月信大行，久积尽去，表里皆空。用补阴固真之剂，并紫河
车丸，日进一服，月余全愈。
川黄连各五分，服用一剂后呕吐停止、身体转凉，服用两剂后完全痊愈。随后服用调理药物，经过数剂后病情安定。
陆养愚治疗沈立川的妻子，患者胸膈部感觉不舒畅，咽喉不利索，中脘及少腹部经常疼痛，大便稀溏，月经淋漓不尽，腰膝无力，倦怠且头晕，进食时稍感舒适，但食后则异常不适。半年间，顺气、清热、开郁、化痰、消食的药物，服用了将近一百剂。诊脉发现，左手脉沉数而细，右手脉沉弦而微。这是肝脾燥热，因愤怒和忧郁积久所致。此前属于有余之证，现在转为不足之证，应当使用补益药剂。沈立川说：“之前用人参五分，并配合开气药物，导致极度痞满，恐怕不能投用补药。”陆养愚说：“人参用量少且兼有开气药，所以才会导致痞满。”于是使用八物汤（Ba Wu Tang），人参用量为一钱，服用后腹部胀大严重。于是增加人参至二钱，腹胀随即减轻。再加至三钱，竟然不再腹胀了。又合用六味丸（Liu Wei Wan），空腹服用，调理两个月后痊愈。
一位妇女因郁怒忧思，出现胸腹胀痛，疼痛剧烈时四肢厥冷，口噤冷汗，使用二陈汤加芍药、当归、乌药、青皮、枳壳、香附、厚朴、苏叶，服用一剂后疼痛和腹胀即愈。后来去掉苏叶，加入姜炒黄连，再服用一剂后病情安定。
一位妇女因郁怒未能发泄，久而久之，嗳声很高，说话不知始末，容易饥饿。《内经》说：“心病表现为嗳气。”这是因为忧愁导致血郁于心胸，使用桃仁承气汤（Tao Ren Cheng Qi Tang）（大黄、桃仁、桂枝、芒硝、甘草），排出蓄积的瘀血数升后病情安定。《内经》说：“血蓄积在上则喜忘，在中则喜狂。”
一位中年人，因抑郁，心下作痛，有一块固定不移，日渐消瘦，给予桃仁承气汤一剂，排出黑色物质及痰液约一碗，从此永不复发。
薛立斋治疗一位妇人，身体颤抖振摇，胡言乱语，各种药物无效。薛立斋认为是郁怒所致，询问其原因，原来是平时嫌弃丈夫，含怒已久。投以小柴胡汤（Xiao Chai Hu Tang）后稍有好转，又使用加味归脾汤（Jia Wei Gui Pi Tang）而痊愈。
一位妇女，年龄六十四岁，长期郁怒，头痛寒热。春季时，乳房内部时常疼痛，服用流气饮（Liu Qi Yin）之类的药物，症状加重，不时有出血如月经来潮。又因大惊恐，饮食不进，夜间睡眠不安宁。这是因为年高失血过多，到了春季无法生发肝木，血虚火燥，所以到了晚上阴气旺盛时发热。《内经》说：“肝藏魂。”魂无所依附，所以不能入睡。先用逍遥散（Xiao Yao San），加酒炒黑龙胆草一钱，山栀一钱五分，两剂后肿痛顿退，又两剂后完全消退。再用归脾汤（Gui Pi Tang）加炒栀子、贝母，诸症悉愈。
一位妇女，因丧子怀抱不舒，腹胀少寐，饮食素少，痰涎上涌，月经频来。我说：“脾统血而主涎，这是郁闷伤脾，不能摄血制涎归源。”于是使用补中益气汤（Bu Zhong Yi Qi Tang）、济生归脾汤（Ji Sheng Gui Pi Tang）两方而愈。又用八珍汤（Ba Zhen Tang）调理而愈。
秀才杨君爵，年将五十，胸痞少食，吐痰体倦，肌肉消瘦，所服方药，都是耗血破气化痰降火的药物。我说：“这是气郁所伤，阳气未升越，属于脾经血虚之症，应当使用归脾汤，能解郁结，生脾血；用补中益气汤，壮脾气，生发诸经，否则必定患中满气膈之患。”他不相信，仍用前药，后果患前症而死亡。
罗谦甫说：《疏五过论》云，曾经尊贵后来卑贱，体内没有受外邪侵袭，病从内生，名叫脱营。镇阳的一位士人，身躯魁梧，意气豪雄，喜欢交游，且有四方之志，年过三十，已入仕做到五品官，出入时骑从塞路，姬妾侍从满前，饮食起居，无不如意。不到三年，因事被罢免，心思郁结，忧虑不已，以致饮食无味，精神日减，肌肤逐渐瘦弱，无可奈何。于是沉迷于饮酒，久而久之导致中满，才求医。医生不审察得病的实情，就用丸药五粒温水送服，腹泻二十多次。当时正值初秋，暑热犹盛，因而烦渴，饮冷过多，遂成肠鸣腹痛，而为痢疾，大便有如鱼脑，以致困顿危重，命令我治疗。诊其脉，乍大乍小；其症，反复闷乱，恶心欲吐，叹息不绝。我推测说：“此症难治。”启元子说，这是神气屈折的缘故。因为他由尊贵之尊荣变为卑贱之屈辱，心怀慕恋，志结忧惶，虽然不中邪，病从内生，血脉虚减，名叫脱营。有人问：“愿闻其理。”《黄帝针经》说，宗气的运行之道，以水谷为主，谷入于胃，乃传入于脉，流溢于中，布散于外。精专者行于经隧，周而复始，常营无已，这是天地的纲纪。所以气开始从手太阴肺经起，注入阳明经，传流而终于足厥阴肝经，循腹理，入缺盆，下注肺中，于是复注手太阴肺经。这是营气所行的路径，所以昼夜气行五十营，漏水下百刻，凡一万三千五百息。所谓交通者，并行一数也。所以五十营备，得尽天地之寿矣。现在病人，起初服药后受苦，都伤精气，精气竭绝，形体毁阻。暴喜伤阳，暴怒伤阴，喜怒不能自节。盖心为君主，神明出焉。肺为辅相，主行荣卫，制节由之。主贪人欲，天理不明，则十二官相使，各失所司。使道闭塞而不通，由是则经荣之气脱去，不能灌溉周身，百脉失其天度，形乃大伤。以此养生则殃，何疑之有？
马元仪治疗洪声远，恶寒发热，倦怠懒言，神气怯弱，两脉弦虚，这是甲木（胆气）内郁，生气不荣，而阳明受病也。盖甲木乃少阳初生之气，勾萌始坼，其体柔脆，一有拂郁，即萎软抑遏而不上升，反下克脾土而为病矣。由此枢机不利，虚邪入之，而与阴争则寒，顷之既去，而与阳争则热。倦怠者，胃病而约束之机关不利也；神怯者，木脏伤而心脏之神明失养也，是皆木郁土衰之故。木气既郁，惟和风可以达之，阴雨可以滋之。柴胡风剂之平者，能入少阳，清发升阳而行春气；当归、白芍，味辛而润，辛以疏其气，润以养其阴；白术、茯苓、陈皮、炙甘草，以和中气而益脾土。两剂，脉象有神。四剂，寒热已。再用补中益气汤，升发生阳之令而康。（纯用薛立斋法，木郁于肝脾之中，而血不亏者，可以用之。）
朱氏之子，科举不利，郁郁而归，遂神识不清，胸满谵语，上不得入，下不得出，已半月。诊之，两脉虚涩兼结。这是因郁所伤，肺金清肃之气不能下行，而反上壅，由此木寡于畏，水绝其源，邪火内扰，而津液干格。胸中满结者，气不得下也；神昏谵语者，火乱于上也；上不得入，下不得出者，气化不清，而现晦塞之象也。但通其肺气，诸症自已。用紫菀五钱，宣太阴以清气化；干葛二钱，透阳明以散火郁；枳、桔各一钱，散胸中之结；杏仁、苏子各二钱，导肺中之痰。一剂而脉转神清，再剂而诸症悉退。改用归脾汤调理而痊。
顾霖苍之妻，寒热如疟，便血不已，左胁有块，攻逆作楚，神气昏愦。诊之，两脉弦数兼涩。弦则为风，数则为热，涩则气结。这是脾肝之气，悒郁不宣，胸中阳和郁而成火，故神明不精。肝之应为风，肝气动则风从之，故表见寒热也。人生左半，肝肾主之，左气逆，故左胁攻楚有块也。肝为藏血之地，肝伤则血不守，而风热益胜，为亡血之由也。用生首乌一两，滋燥而兼搜风。黄连一钱，治火兼以解郁。柴胡以疏其表，黄芩、知母以清其里，枳实、浓朴以和其中。一剂，脉起神清。再剂，便行热解而安。（方论俱佳。）
缪仲淳说：甲申年夏天，佣妇因郁火痰喘身热，手拳目张，半月不眠食。按其胃口不痛，诸医疑其虚也。有人说中暑，百药试之，痰喘滋急。以皂角末嚏鼻通窍，痰上逆如沸。延请杨石林诊治，请求紧急催吐。先父说：“病久矣，虚甚，可奈何？”石林说：“《内经》云，上部有脉，下部无脉，其人当吐，不吐则死。”即以盐汤吞之，去白痰数碗，喘定。先父说：“何以药之？”石林说：“吐即药也。待其熟寝，勿服药，以养胃气。夜半，啜粥二碗。次日清晨，投六君子汤（Liu Jun Zi Tang），数剂而起。石林者，里中博雅士，不行术而精医者也。（深得子和之法。）”
姑苏张涟水治疗纪华山，高雅，自负命运不好，又没有儿子，郁郁不快，渐至痞胀，四年，肌肉削尽，自己认为必死无疑。张涟水诊脉后开玩笑说：“您哪里需要吃药？一个盒子饭就能霍然痊愈。”用当归六钱，韭菜子一两，香附童便炒八钱，下之。纪华山面有难色，不得已，减半剂量。张涟水说：“做成两剂吗？”即服，夜里忽然梦遗，举家恸哭。张涟水拍案说：“我正希望他通泄呢。”仍以前半剂进服，胸膈间若勇士猛力一拥，解黑粪数升，随即喝粥二碗。第二天早晨，梳头见客了。第二年生一子，即是表弟汝占也。（《广笔记》。）
张意田治疗柯姓人，病剧。诊之，得脉浮大而空，左关沉候有微弦之象，左尺沉候有一丝之根。面目皆红，鼻青耳聋，眼瞪神昏，自语不休，舌燥赤大，唇紫齿燥。（仅凭这几项，便明显不是戴阳症。）初病发热咳嗽，已经七八日，所服乃是伤风散解之药。昨日早间，连大便三四次，即卧床不省人事，今日忽然发昏。有人说戴阳症，用熟地、附子等，未服。张意田思考外症虽类戴阳，然症起无因。察其所言，皆平日之事，则似少阴之独语。至鼻现青色，时在秋令，则肺气绝矣。然面有光亮，为表气不和，唇色深紫，宜有郁火。且左尺有根，本非无治；左关微强，则别有致病之故。询之，乃昨早失手自碎粥罐，因怒不止，即大便昏迷，知为郁怒所伤，肝火上逆而诸症蜂起，经所谓怒则气上是也，与戴阳相去远矣。用逍遥散去白术，加地黄、丹皮、炒栀之属而愈。病多隐微，医不审察，误斯众矣。
一位宦官平时谨言慎行，一天，在堂属官员的宴席中，有萝卜颇大，客人羡慕它。主人说：“还有大如人的。”客人都笑以为无。主人则悔恨自咎说：“人没见过如此大的，而我说了这话，应该被认为妄言而被嘲笑吧。”因而致病，药不应。他的儿子读书通达事理，想到父亲平时不轻言，因羞愧赧颜成病，必须证实所言，庶可解释。于是派人至家取萝卜如人大者至官府，再会堂属，强父扶病而陪。陪至数巡，以车载萝卜至席前，客皆惊讶，其父大喜，次日疾病痊愈。（《石山医案》。）
一女与母亲相爱，既嫁，母亲丧，女儿因思母成疾，精神短少，倦怠嗜卧，胸膈烦闷，日常恹恹，药不应。我看视之曰：“此病自思，非药可愈。”彼俗酷信女巫，巫托降神言祸福，谓之卜童。于是让她的丈夫假托贿赂嘱咐女巫，托母言女与我前世有冤，汝故托生于我，一以害我，是以汝之生命克我，我死皆汝之故。今在阴司，欲报汝仇，汝病恹恹，实我所为，生则为母子，死则为寇仇。丈夫乃语其妇曰：“汝病若此，我他往，可请巫妇卜之何如？”妇诺之。遂请卜，一如夫所言。女闻大怒，诟曰：“我因母病，母反害我，我何思之？”遂不思，病果愈，此以怒胜思也。
萧万舆治疗一妇，年四十，怀抱郁结，呕痰少食，胸膈胀痛，虽盛暑犹着绵衣，六脉浮结，或烦渴不寐，这是命门火衰，元气虚寒也。以六君子汤加姜、桂及八味丸（Ba Wei Wan），不两月而症痊矣。
易思兰治疗徐文淙之妻，卧病三年，身体羸瘦，畏寒战栗后发热，得汗始解，脊背拘痛，腰膝软弱，饮食不进，则肠鸣作泻，心虚惊悸，胸肋气胀，畏风畏热，头眩目昏，月信愆期。易思兰诊之曰：“此气郁病也。”左寸脉心小肠属火，当浮大而散，今心脉大而散，却不浮。盖心为一身之主，藏神而生血，宜常静而不宜多动。人能静养，则心血充满，脉自浮大。若事事搅乱，心不宁则神不安而血不充，是以脉无力而不浮，怔忡惊悸之病，由之以生。况诊七八至，或十二三至，又往关中一猎，有类以灰种火之状，此乃君火郁于下，而无离明之象也。据脉论证，当有胸中烦闷，蒸蒸然不安，蒸出自汗，则内稍静，而腠理不密畏寒为验。左关肝胆属木，宜弦细而长，今左关弦长而不细，又侵上寸部二分，推之于内，外见洪大有力，是肝气有余也。盖因火郁于中，下不能承顺正化之源，木母太旺，上助心火，中侮脾土。肝藏血而主筋，病当头眩目昏，脊背项强，卒难转侧，背冷如冰，甚则一点痛不可忍，下则腰膝软弱无力，脾胃不和等症为验。左尺肾与膀胱属水，脉宜沉濡而滑，惟此部得其正。右寸肺与大肠属金，脉宜短涩而浮。兹诊得沉滞而大，按三五至或十数至一结，结乃积深，沉则气滞，此正肺受火邪，气郁不行也。病当胸膈不利，或时闷痛，右肋胀满，饮食不进，大肠鸣泄等症为验。右关脾胃属土，脉宜缓而大，此部虽无力，犹不失其本体。右尺三焦命门属相火，亦宜沉静，不宜浮大。此部浮取三焦脉，浮而无力，侵上脾胃，是君火郁于下，而相火升于上，侮其金也，病主气满胸膈杂，饮食不利等症为验。详六部脉症，惟左尺得体，肾为寿元，根本尚固。右关脾土为木所侮，虽是少力，然来去缓大而不弦。此五脏之源，生气有存，无足虑也。病症多端，要之不过气郁而已。丹溪云：“气有余便是火。”火郁则发之，先投以和中畅卫汤（He Zhong Chang Wei Tang），用苏梗、桔梗开提其气，香附、抚芎、苍术、神曲解散其郁，贝母化其郁痰，砂仁快其滞气。郁气散则金体坚，木平水王，何虑相火不降耶？若夫木当夏月，成功者退，虽王不必专治。服三剂而肺脉浮起，胸次豁然，诸症顿减。继以清中实表，固其腠理，月信大行，久积尽去，表里皆空。用补阴固真之剂，并紫河车丸（Zi He Che Wan），日进一服，月余全愈。
Coptidis Rhizoma (Huanglian) 5 fen each. After one dose, vomiting stopped and body temperature normalized; after two doses, full recovery was achieved. Subsequently, regulatory medicines were administered for several doses, leading to stability.
Lu Yangyu treated the wife of Shen Lichuan. The patient experienced discomfort in the chest and diaphragm, difficulty in the throat, frequent pain in the epigastrium and lower abdomen, loose stools, dripping menstrual flow, weakness in the waist and knees, fatigue, dizziness, slight comfort upon eating but extreme discomfort after meals. Over half a year, nearly one hundred doses of herbs for regulating qi, clearing heat, resolving depression, transforming phlegm, and digesting food had been taken. Pulse diagnosis revealed: left hand pulse was deep, rapid, and thin; right hand pulse was deep, wiry, and faint. This indicated dryness-heat in the Liver and Spleen caused by long-standing anger and depression. Previously, it was an excess condition; now it has become a deficiency condition, requiring tonifying formulas. Shen said, "Previously, using 5 fen of Ginseng Radix et Rhizoma (Renshen) combined with qi-regulating herbs caused severe stuffiness and fullness; I fear tonics cannot be used." Lu replied, "The small amount of Ginseng combined with qi-regulating herbs caused the stuffiness." Thus, Ba Wu Tang (Eight Substance Decoction) was prescribed with 1 qian of Ginseng Radix et Rhizoma. After taking it, severe abdominal distension occurred. The dosage of Ginseng was increased to 2 qian, and the distension decreased. It was further increased to 3 qian, and no more distension occurred. Liu Wei Wan (Six Ingredient Pill with Rehmanniae Root) was combined and taken on an empty stomach. After two months of regulation, she recovered.
A woman suffered from chest and abdominal distension and pain due to depression, anger, worry, and overthinking. When pain was severe, her four limbs became cold, her mouth closed tightly, and cold sweat appeared. Er Chen Tang (Two Aged Ingredients Decoction) was modified with Paeoniae Radix Alba (Shaoyao), Angelicae Sinensis Radix (Danggui), Linderae Radix (Wuyao), Citri Reticulatae Pericarpium (Qingpi), Aurantii Fructus Immaturus (Zhike), Cyperi Rhizoma (Xiangfu), Magnoliae Officinalis Cortex (Houpo), and Perillae Folium (Suye). After one dose, pain and distension resolved. Later, Perillae Folium was removed, and Ginger-fried Coptidis Rhizoma (Huanglian) was added. After another dose, she stabilized.
Another woman, whose depression and anger were suppressed, developed loud belching over time, spoke without coherence, and felt hungry frequently. The Classic states: "Heart disease manifests as belching." This was due to blood stasis in the heart and chest caused by sorrow. Tao Ren Cheng Qi Tang (Peach Kernel and Rheum Decoction) [composed of Rheum Radix et Rhizoma (Dahuang), Persicae Semen (Taoren), Cinnamomi Ramulus (Guizhi), Natrii Sulfas (Mangxiao), and Glycyrrhizae Radix et Rhizoma (Gancao)] was used. Several sheng of accumulated blood were purged, and she recovered. The Classic states: "Blood accumulation in the upper part leads to forgetfulness; in the middle part, it leads to mania."
A middle-aged man, depressed, experienced pain below the heart with a fixed mass, becoming increasingly emaciated. One dose of Tao Ren Cheng Qi Tang resulted in the passage of black matter and about one bowl of phlegm, preventing recurrence permanently.
Xue Lizhai treated a woman trembling and speaking deliriously, unresponsive to various medicines. Xue attributed it to depression and anger. Inquiry revealed she had harbored resentment toward her husband for a long time. Xiao Chai Hu Tang (Minor Bupleurum Decoction) provided slight relief, followed by Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction), which led to recovery.
A sixty-four-year-old woman, suffering from long-term depression and anger, had headache, aversion to cold, and fever. In spring, she experienced intermittent breast pain. Taking Liu Qi Yin (Flowing Qi Decoction) worsened symptoms, accompanied by irregular bleeding resembling menstruation. Following severe fright, she lost appetite and slept poorly at night. Due to age and excessive blood loss, liver wood could not generate in spring, leading to blood deficiency and fire dryness, causing evening fevers when yin is abundant. The Classic says: "The Liver stores the Hun (Ethereal Soul)." With no anchor for the Hun, insomnia occurred. Xiao Yao San (Free and Easy Wanderer Powder) was first used, modified with Wine-fried Black Gardenia Fruit (Shanzhi) 1 qian and Alcohol-fried Black Gentian Root (Longdan Cao) 1 qian. After two doses, swelling and pain subsided; after two more doses, they disappeared completely. Then, Gui Pi Tang (Restore the Spleen Decoction) with fried Gardenia and Fritillaria Bulb (Beimu) was used, resolving all symptoms.
A woman, grieving the loss of her child, suffered from abdominal distension, insomnia, poor diet, surging phlegm-saliva, and frequent menstruation. I stated: "The Spleen controls blood and governs saliva. Depression injured the Spleen, impairing its ability to control blood and regulate saliva." Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) and Ji Sheng Gui Pi Tang (Life-Preserving Restore the Spleen Decoction) cured her. Ba Zhen Tang (Eight Treasures Decoction) was then used for regulation.
Scholar Yang Junjue, nearing fifty, suffered from chest stuffiness, poor appetite, expectoration, fatigue, and emaciation. Previous prescriptions consumed blood, broke qi, transformed phlegm, and cleared fire. I diagnosed this as injury from qi stagnation, where yang qi failed to ascend, belonging to Spleen channel blood deficiency. Gui Pi Tang should resolve depression and generate Spleen blood; Bu Zhong Yi Qi Tang strengthens Spleen qi and generates qi for all channels. Otherwise, middle-fullness and qi obstruction would result. Disbelieving, he continued previous medicines, eventually dying from these symptoms.
Luo Qianfu cited the *Shu Wu Guo Lun*: "Once noble, now humble; internal organs not invaded by evil, disease arises internally, named Tuo Ying (Depleted Camp)." A scholar from Zhenyang was robust and heroic, fond of socializing, ambitious. By thirty, he reached fifth-rank officialdom, surrounded by attendants and concubines, living perfectly. Within three years, dismissed due to affairs, his mind became knotted with depression and worry. Appetite vanished, spirit declined, muscles wasted. Helpless, he indulged in alcohol, leading to middle-fullness, then sought medical help. The physician, failing to assess the condition accurately, gave five pills with warm water, causing over twenty diarrheal episodes. In early autumn, residual summer heat caused thirst and irritability; excessive cold drinks led to borborygmus, abdominal pain, and dysentery with fish-brain-like stool, bringing him to critical condition. My pulse diagnosis showed fluctuating size; symptoms included repeated confusion, nausea, sighing. I predicted difficulty. Qiyuanzi explained: "Spirit is屈 (constrained). From high honor to low humiliation, longing and fear bind the will. Though not invaded by external evil, disease arises internally, blood vessels weaken, named Tuo Ying." Asked for reasoning, the *Huangdi Zhenjing* states: Zong Qi relies on grain. Grain enters the Stomach, enters vessels, flows within, spreads without. Essence travels meridians, cycling endlessly. Qi starts at Hand Taiyin, moves to Yangming, ends at Foot Jueyin, enters Lung, returns to Hand Taiyin. This is Ying Qi circulation, fifty cycles per day/night, 13,500 breaths. Complete fifty cycles grants natural lifespan. Now, the patient suffers from medicine and bitterness, depleting essence. Essence exhaustion destroys form. Excessive joy injures Yang, excessive anger injures Yin. Heart is Monarch, Spirit emerges. Lung is Assistant, manages Ying and Wei. Greed obscures Heavenly Principle, Twelve Officials lose function. Orifices block, Ying Qi escapes, cannot nourish body, vessels lose measure, form severely damaged. How can one survive?
Ma Yuanyi treated Hong Shengyuan with aversion to cold, fever, fatigue, reluctance to speak, timid spirit, and wiry-empty pulses. This indicated internal depression of Jia Wood (Gallbladder Qi), lack of vital energy nourishment, and Yangming involvement. Jia Wood is Shaoyang's nascent qi, soft and fragile. Depression causes it to wither and suppress, failing to ascend, instead attacking Spleen Earth. Pivot dysfunction allows deficient evil to enter; fighting Yin causes cold, fighting Yang causes fever. Fatigue indicates Stomach disease affecting constraint mechanisms; timid spirit indicates Wood organ injury depriving Heart Spirit of nourishment. All stem from Wood depression and Spleen decline. Depressed Wood needs gentle wind to reach it and rainy clouds to moisten it. Mild Bupleurum wind agents enter Shaoyang, clear and raise Yang, promoting Spring Qi. Angelicae Sinensis Radix and Paeoniae Radix Alba are pungent and moistening, dispersing qi and nourishing Yin. Atractylodis Macrocephalae Rhizoma, Poria, Citri Reticulatae Pericarpium, and Honey-fried Licorice harmonize middle qi and benefit Spleen Earth. Two doses improved pulse spirit; four doses resolved cold and fever. Bu Zhong Yi Qi Tang was used again to raise and generate Yang Qi, restoring health. (Purely following Xue Lizhai's method; applicable when Wood is depressed in Liver/Spleen without blood deficiency.)
Son of Mr. Zhu, disappointed in imperial exams, returned depressed. Consciousness became unclear, chest fullness and delirious speech persisted for half a month, unable to go up or down. Pulses were deficient, choppy, and knotted. Depression injured Lung Metal's descending clarity, causing upward congestion. Wood lacked restraint, Water source dried, pathogenic fire disturbed internally, fluids dried. Chest fullness indicated qi failing to descend; delirium indicated fire disturbing above; inability to move indicated unclear qi transformation and turbid obstruction. Only by opening Lung Qi would symptoms resolve. Astagmis Flower (Ziwan) 5 qian promoted Taiyin to clear qi transformation; Kudzu Root (Gegen) 2 qian penetrated Yangming to scatter fire depression; Aurantii Fructus Immaturus and Platycodon Root (Jiegeng) 1 qian each dispersed chest knots; Apricot Seed (Xingren) and Perilla Fruit (Suzi) 2 qian each guided Lung phlegm. One dose improved pulse and consciousness; two doses resolved all symptoms. Modified Gui Pi Tang completed recovery.
Mrs. Gu Lin Cang had malaria-like chills and fever, persistent hematochezia, a mass in the left hypochondrium causing pain, and confused spirit. Pulses were wiry, rapid, and choppy. Wiry indicates Wind, Rapid indicates Heat, Choppy indicates Qi knotting. Spleen and Liver qi were depressed and unexpressed, Yang harmony in chest condensed into Fire, confusing Spirit. Liver corresponds to Wind; Liver Qi movement attracts Wind, manifesting as chills and fever. Left side governed by Liver/Kidney; Left Qi rebellion causes left hypochondriac pain and mass. Liver stores Blood; Liver injury fails to guard Blood, allowing Wind-Heat to prevail, causing blood loss. Raw Polygonum Multiflorum Preparatum (Shouwu) 1 liang moistened dryness and searched for Wind. Coptidis Rhizoma 1 qian treated Fire and resolved depression. Bupleuri Radix (Chaihu) released exterior; Scutellariae Radix (Huangqin) and Anemarrhenae Rhizoma (Zhimu) cleared interior; Aurantii Fructus Immaturus and Magnoliae Officinalis Cortex harmonized middle. One dose raised pulse and clarified spirit; two doses resolved heat and stool issues. (Prescription theory excellent.)
Miao Zhongchun recounted: Summer of Jiashen year, a maid servant suffered depression-fire, phlegm-wheezing, body heat, clenched fists, staring eyes, insomnia and fasting for half a month. Epigastrium non-tender; physicians suspected deficiency. Some suggested Summerheat; myriad drugs failed, worsening wheezing. Soapberry Fruit powder (Zaojiao) insufflated nose to open orifices, causing phlegm to surge like boiling water. Physician Yang Shilin requested urgent emesis. Miao's father asked how to treat such deficiency. Yang cited Classic: "Upper pulse present, lower pulse absent, patient must vomit, or die." Salt water induced vomiting, expelling several bowls of white phlegm, stopping wheezing. Father asked for medication. Yang replied: "Vomiting is the medicine. Let him sleep deeply, do not medicate, to nourish Stomach Qi. At midnight, drink two bowls of porridge. Next morning, administer Liu Jun Zi Tang (Six Gentlemen Decoction) for several doses to recover. Yang was a learned gentleman, skilled in medicine though not practicing professionally. (Deeply understood Hezi's methods.)"
Zhang Lianshui of Gusu treated Ji Huashan, elegant, feeling unlucky, childless, depressed, developing abdominal distension over four years, wasting away, expecting death. Zhang joked: "Why need medicine? A box meal will cure you instantly." Prescribed Angelicae Sinensis Radix 6 qian, Allii Tuberosi Semen (Jiucaizi) 1 liang, Cyperi Rhizoma stir-fried with boy's urine 8 qian, to purge. Ji hesitated, halved dose. Zhang asked if making two doses. Patient took them, emitted semen during sleep that night, family mourned. Zhang slammed table: "I intended for him to purge." Administered remaining half-dose. Sensation like a warrior pushing through chest/diaphragm, passing several sheng of black stool, drank two bowls porridge. Next morning, combed hair and received guests. Year later, son born (cousin Ru Zhan). (*Guang Biji*)
Zhang Yitian treated a Ke surname patient, critically ill. Pulse floating, large, empty; left Guan deep position faint wiry; left Chi deep position faint root. Face red, nose blue, deaf, staring eyes, confused, muttering, dry red enlarged tongue, purple lips, dry teeth. (Clearly not Dai Yang syndrome.) Initial fever/cough for 7-8 days, treated with wind-dispelling herbs. Yesterday morning, 3-4 bowel movements, then bedridden unconscious. Today sudden coma. Some suggested Dai Yang, prepared Rehmanniae Radix Preparata (Shudihuang) and Aconiti Lateralis Radix Preparata (Fuzi), not yet given. Zhang reasoned: Exterior resembles Dai Yang, but origin unknown. Speech related to past events, resembling Shaoyin solitary muttering. Nose blue in autumn suggests Lung Qi exhaustion. Face shiny indicates exterior qi disharmony; deep purple lips suggest depression-fire. Left Chi root indicates treatability; left Guan slightly strong suggests other cause. Inquiry: Broke porridge pot yesterday morning, furious, then diarrhea/coma. Diagnosis: Injury from depression/anger, Liver Fire rebelling upward, causing symptoms. Far from Dai Yang. Xiao Yao San minus Atractylodis Macrocephalae Rhizoma, plus Rehmanniae Radix, Moutan Cortex, fried Gardenia. Recovered. Diseases are subtle; physicians failing to examine correctly mislead many.
An eunuch, usually cautious, at a banquet, praised a large radish. Host claimed larger existed; guests laughed. Host regretted boasting, thinking himself mocked, fell ill, unresponsive to medicine. His scholarly son realized father's shame required validation. Sent for human-sized radish to officials, invited guests, forced father to attend. Radish brought to table, guests amazed, father delighted, cured next day. (*Shishan Yian*)
A daughter loved her mother. After marriage, mother died. Daughter pined for mother, becoming ill: low spirit, fatigue, somnolence, chest oppression, lethargy, unresponsive to medicine. I diagnosed: Illness from thought, not curable by medicine. Superstitious belief in witchcraft prevalent. Husband bribed witch to claim daughter harmed mother in previous life, causing mother's death, now seeking revenge in underworld. Husband told wife: "Your illness is severe; shall we consult the witch?" Wife agreed. Witch confirmed story. Daughter enraged: "Mother harmed me because of my love! Why think of her?" Thought ceased, illness cured. Anger overcomes thought.
Xiao Wanyu treated a forty-year-old woman, depressed, vomiting phlegm, poor appetite, chest distension/pain, wearing cotton in summer, floating-knotted pulses, irritability/thirst/insomnia. Diagnosis: Mingmen Fire decline, Yuan Qi deficiency-cold. Liu Jun Zi Tang plus Ginger and Cinnamon, plus Ba Wei Wan (Eight Flavor Pill). Recovered in two months.
Yi Silan treated wife of Xu Wencong, bedridden three years, emaciated, chills then fever relieved by sweat, back stiffness, weak waist/knees, anorexia, borborygmus/diarrhea, palpitations, chest/flank distension, aversion to wind/heat, dizziness/blurred vision, delayed menstruation. Yi diagnosed: Qi depression. Left Cun (Heart/Small Intestine/Fire) should be floating-large-scattered; now large-scattered but not floating. Heart is master, stores Spirit, generates Blood. Quietness fills Blood, pulse floats. Disturbance agitates Spirit, depletes Blood, pulse weak/not floating, causing palpitations. Pulse rate 7-8 or 12-13 beats, resembling ash-covered fire, indicates Minister Fire depressed below without brightness. Symptoms: chest oppression, restlessness, spontaneous sweating, aversion to cold due to loose pores. Left Guan (Liver/Gallbladder/Wood) should wiry-thin-long; now wiry-long not thin, invading Cun. Internally expansive, externally large-powerful, indicating Liver Qi excess. Fire depression prevents Water source, Wood too旺, assists Heart Fire, insults Spleen Earth. Liver stores Blood, governs sinews. Symptoms: dizziness, back stiffness, turning difficulty, cold back, pain, weak waist/knees, Spleen-Stomach disharmony. Left Chi (Kidney/Bladder/Water) should deep-moist-smooth; correct here. Right Cun (Lung/Large Intestine/Metal) should short-choppy-floating; now deep-stagnant-large, knotted every 3-5 or 10+ beats. Knot indicates deep accumulation, deep indicates Qi stagnation. Lung affected by Fire, Qi depressed. Symptoms: chest discomfort, occasional pain, right flank fullness, anorexia, intestinal diarrhea. Right Guan (Spleen/Stomach/Earth) should slow-large; weak but retains nature. Right Chi (Sanjiao/Mingmen/Minister Fire) should quiet; floating-weak, invading Spleen/Stomach, indicates Minister Fire rising, insulting Metal. Symptoms: chest fullness, poor digestion. Six positions examined, only Left Chi correct. Kidney is root of longevity, foundation solid. Right Guan Spleen insulted by Wood, weak but slow-large not wiry. Source of Five Zang, Sheng Qi exists, no worry. Symptoms essentially Qi depression. Danxi said: "Excess Qi becomes Fire." Fire depression requires dispersion. First, He Zhong Chang Wei Tang (Harmonize Middle and Smooth Defense Decoction): Perilla Stem (Sugeng), Platycodon Root, Cyperi Rhizoma, Ligusticum Chuanxiong (Fuxiong), Atractylodis Rhizoma (Cangzhu), Saccharomyces (Shenqu) to disperse depression; Fritillaria Bulb transforms phlegm; Amomum Fruit (Sharen) moves stagnant Qi. Once Qi disperses, Metal firm, Wood平和, Water prosperous, Minister Fire descends. Wood in summer retreats after success, no special treatment needed. Three doses: Lung pulse floated, chest opened, symptoms reduced. Then cleared middle, fortified exterior, secured pores. Menstruation heavy, old accumulation gone, exterior-interior empty. Tonify Yin, secure True Qi, plus Placenta Hominis (Ziheche) Pills, daily dose. Recovered in over a month.