少宰汪涵斋，头晕，白浊，余用补中益气加茯苓、半夏，愈而复患腰痛，用山药、山茱、五味、
萆、远志顿愈。又因劳心，盗汗，白浊，以归脾汤加五味而愈。后不时眩晕，用八味丸全愈。
南银台许函谷，因劳发热作渴，小便自遗，或时闭涩，余作肝火血虚，阴挺不能约制，午前用
补中益气加山药、山茱，午后服地黄丸，月余诸症悉退。
司厅陈石镜，久患白浊，发热体倦，用补中益气加炮姜四剂，白浊稍止，再用六味地黄丸兼服，
诸症悉愈。
光禄柴黼庵，因劳患赤白浊，用济生归脾、十全大补二汤，间服而愈。
司厅张裣斋，阴中肿痛，时发寒热，若小腹作痛，则茎出白津，用小柴胡加山栀、胆草、茱萸
、芎、归而愈。
朱工部，劳则遗精，齿牙即痛，用补中益气加半夏、茯苓、芍药，并六味地黄丸渐愈，更以十全
大补加麦门、五味而痊。
一男子，白浊梦遗，口干作渴，大便闭涩，午后热甚，用补中益气加芍药、玄参，并加减八味
丸而愈。
一男子，茎中痛，出白津，小便秘，时作痒，用小柴胡加山栀、泽泻、炒连、木通、胆草、茯苓，
二剂顿愈，又兼六味地黄丸而痊。
一男子，发热，便血，精滑。一男子尿血，发热。一男子发热，遗精，或小便不禁。俱属肾经亏损，
用地黄丸、益气汤以滋化源，并皆得愈。
一男子，鳏居数年，素勤苦，劳则吐血，发热烦躁，服犀角地黄汤，气高而喘，前病益盛，更遗
精白浊，形体倦怠，饮食少思，脉洪大举按有力，服十全大补加麦门、五味、山茱、山药而
愈。
儒者杨启元，素勤苦，吐血发痉，不知人事，余以为脾胃虚损，用十全大补汤及加减八味丸而
痊愈，再用归脾汤而血止。
一儒者，因饮食劳役及恼怒，眉发脱落，余以为劳伤精血，阴火上炎所致，用补中益气加麦门
、五味，及六味地黄丸加五味，眉发顿生如故。
一男子，年二十，巅毛脱尽，用六味地黄丸，不数日，发生寸许，两月复旧。吴江史万湖云∶有男
女偶合，眉发脱落，无药调治，至数月后复生。
一童子，年十四，发热吐血，余谓宜补中益气以滋化源。不信，用寒凉降火，愈甚。始谓余曰∶童
子未室，何肾虚之有?参、 补气，奚为用之？余述丹溪先生云∶肾主闭藏，肝主疏泄，二脏
俱有相火，而其系上属于心，心为君火，为物所感则易动于心，心动则相火翕然而随，虽不交
会，其精亦暗耗矣。又《精血篇》云∶男子精未满而御女以通其精，则五脏有不满之处，异
日有难状之疾。遂用补中益气及地黄丸而瘥。
一男子，咳嗽吐血，热渴痰盛，盗汗遗精，用地黄丸料加麦门、五味治之而愈。后因劳怒，忽
吐紫血块，先用花蕊石散，又用独参汤渐愈。后劳则吐血一、二口，脾肺肾三脉皆洪数，
用补中益气、六味地黄而痊愈。
辛丑夏，余在嘉兴屠内翰第，遇星士张东谷谈命时，出中庭吐血一，二口，云∶久有此症，遇劳
即作。余意此劳伤肺气，其血必散，视之果然，与补中益气加麦门、五味、山药、熟地、茯
神、远志，服之而愈。翌早请见，云∶每服四物、黄连、山栀之类，血益多而倦益甚，今得公
一匕，吐血顿止，神思如故，何也?余曰∶脾统血，肺主气，此劳伤脾肺，致血妄行，故用前
药健脾肺之气，而嘘血归源耳！后率其子以师余，余曰∶管见已行于世矣，子宜览之。
Wang Hanzhai, Vice Minister of Personnel, presented with dizziness and white turbidity in urine. I treated him with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Fuling (Poria) and Banxia (Pinellia Rhizome). The illness was cured but later relapsed with lower back pain. I then used Shanyao (Dioscorea Rhizome), Shanzhuyu (Cornus Fruit), Wuweizi (Schisandra Fruit), Bibai (Dioscorea Hypoglauca Rhizome), and Yuanzhi (Polygala Root), resulting in immediate recovery. Later, due to mental overexertion, he experienced night sweats and white turbidity in urine. He was cured using Guipi Tang (Restore the Spleen Decoction) added with Wuweizi. Subsequently, he suffered from intermittent vertigo, which was completely cured by Bayi Wan (Eight-Ingredient Pill with Rehmannia).
Xu Hanggu, Southern Censorate Attendant, developed fever and thirst due to fatigue, accompanied by involuntary urination or occasional urinary retention and dysuria. I diagnosed this as Liver Fire combined with Blood Deficiency, causing flaccidity of the genitalia without control. In the morning, he took Buzhong Yiqi Tang added with Shanyao and Shanzhuyu; in the afternoon, he took Dihuang Wan (Rehmannia Pill). After more than a month, all symptoms subsided.
Chen Shijing, Department Hall Official, suffered from chronic white turbidity in urine, fever, and body fatigue. I prescribed Buzhong Yiqi Tang added with Paojiang (Prepared Ginger). After four doses, the turbidity slightly stopped. Then, Dihuang Wan (Six-Ingredient Pill with Rehmannia) was taken concurrently, leading to complete recovery of all symptoms.
Chai Fu'an, Guanglu Temple Official, developed red and white turbidity in urine due to fatigue. He was cured by alternately taking Jisheng Guipi Tang (Guipi Decoction for Saving Life) and Shiquan Dabu Tang (Perfect Ten Great Tonifying Decoction).
Zhan Lianzhai, Department Hall Official, presented with swelling and pain in the genitalia, alternating chills and fever. If abdominal pain occurred, white fluid would discharge from the urethra. He was cured using Xiaochaihu Tang (Minor Blue-Green Decoction) added with Zhizi (Gardenia Fruit), Dancao (Gentiana Root), Zhuyu (Evodia Fruit), Xiong (Ligusticum Rhizome), and Danggui (Angelica Sinensis Root).
Zhu Gongbu, Ministry of Works Official, experienced spermatorrhea upon exertion, followed immediately by toothache. I treated him with Buzhong Yiqi Tang added with Banxia, Fuling, and Shaoyao (Peony Root), along with Dihuang Wan. His condition gradually improved. He was finally cured by adding Maimendong (Ophiopogon Tuber) and Wuweizi to Shiquan Dabu Tang.
A male patient presented with white turbidity in urine and nocturnal emission, dry mouth and thirst, constipation, and severe fever in the afternoon. He was cured using Buzhong Yiqi Tang added with Shaoyao and Xuanshen (Scrophularia Root), along with Jiajian Bayi Wan (Modified Eight-Ingredient Pill).
Another male patient presented with pain in the penis, discharge of white fluid, difficult urination, and occasional itching. He was cured after two doses of Xiaochaihu Tang added with Zhizi, Zexie (Alisma Rhizome), Chailian (Fried Scutellaria Root), Mutong (Akebia Stem), Dancao, and Fuling. He was further cured by concurrently taking Dihuang Wan.
One male patient presented with fever, hematochezia (blood in stool), and seminal emission. Another presented with hematuria (blood in urine) and fever. A third presented with fever, spermatorrhea, and occasional urinary incontinence. All were attributed to Kidney Meridian Deficiency. They were cured using Dihuang Wan and Yiqi Tang (Qi-Tonifying Decoction) to nourish the source of transformation and generation.
A male patient who had been widowed for several years and was usually hardworking, presented with hematemesis (vomiting blood), fever, and irritability upon exertion. After taking Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction), he developed shortness of breath with wheezing, and his previous symptoms worsened, accompanied by spermatorrhea and white turbidity. He appeared fatigued, had poor appetite, and his pulse was large and forceful even when pressed deeply. I treated him with Shiquan Dabu Tang added with Maimendong, Wuweizi, Shanzhuyu, and Shanyao, resulting in recovery.
Yang Qiyuan, a scholar, who was usually hardworking, presented with hematemesis, spasms, and loss of consciousness. I diagnosed this as Spleen and Stomach Deficiency and Damage. He was cured using Shiquan Dabu Tang and Jiajian Bayi Wan. Guipi Tang was then used to stop the bleeding.
A scholar, due to dietary irregularities, physical labor, and anger, experienced loss of eyebrows and hair. I diagnosed this as damage to essence and blood due to fatigue, causing Yin Fire to flare upward. He was treated with Buzhong Yiqi Tang added with Maimendong and Wuweizi, and Liuwei Dihuang Wan added with Wuweizi. His eyebrows and hair grew back instantly as before.
A twenty-year-old male patient had lost all his scalp hair. He was treated with Liuwei Dihuang Wan. Within a few days, hair grew one cun long, and within two months, it returned to normal. Shi Wanhu of Wujiang stated: There are cases where men and women engage in sexual intercourse occasionally, leading to loss of eyebrows and hair, without medicinal treatment, which regrows after several months.
A fourteen-year-old boy presented with fever and hematemesis. I advised using Buzhong Yiqi Tang to nourish the source of transformation and generation. Disbelieving this, he used cold-natured fire-clearing medicines, which worsened his condition. He initially asked me, "The boy is unmarried, how can there be Kidney Deficiency? Why use Renshen (Ginseng) and Huangqi (Astragalus) to tonify Qi?" I quoted Master Danxi: "The Kidney governs storage, and the Liver governs dispersion. Both viscera contain Ministerial Fire, whose meridians connect upwards to the Heart. The Heart is the Sovereign Fire. When affected by external stimuli, the Heart moves easily; when the Heart moves, Ministerial Fire rises spontaneously. Even without sexual intercourse, essence is secretly consumed." Furthermore, the *Jingxue Pian* (Chapter on Essence and Blood) states: "If a man whose essence is not yet full engages in intercourse to release it, the five viscera will have unmet needs, leading to difficult-to-describe diseases in later years." Thus, he was cured using Buzhong Yiqi Tang and Dihuang Wan.
A male patient presented with cough, hematemesis, heat-thirst, profuse phlegm, night sweats, and spermatorrhea. He was cured using Dihuang Wan formula added with Maimendong and Wuweizi. Later, due to fatigue and anger, he suddenly vomited purple blood clots. He was first treated with Huarui Shi San (Flower Ochre Stone Powder) and then with Dushen Tang (Single Ginseng Decoction), gradually recovering. Later, upon exertion, he vomited one or two mouthfuls of blood. The pulses of the Spleen, Lung, and Kidney were all rapid and large. He was cured using Buzhong Yiqi Tang and Liuwei Dihuang Wan.
In the summer of the Xinchou year, while at the residence of Neihan Tu in Jiaxing, I met the fortune-teller Zhang Donggu. While discussing fate in the courtyard, he vomited one or two mouthfuls of blood, stating he had suffered from this for a long time, triggered by fatigue. I reasoned that this was Lung Qi deficiency due to fatigue, causing scattered blood, which proved true. I prescribed Buzhong Yiqi Tang added with Maimendong, Wuweizi, Shanyao, Shudihuang (Prepared Rehmannia Root), Fushen (Poria with Hostwood), and Yuanzhi. He recovered after taking it. The next morning, he visited me and said, "Every time I take medicines like Siwu Tang (Four Substance Decoction), Huanglian (Coptis Rhizome), or Zhizi, my bleeding increases and fatigue worsens. Today, with just one dose from you, my bleeding stopped instantly, and my spirit returned to normal. Why?" I replied, "The Spleen controls blood, and the Lung governs Qi. This is Spleen and Lung damage due to fatigue, causing reckless blood movement. Therefore, I used the aforementioned medicines to tonify Spleen and Lung Qi, guiding the blood back to its source." Later, he brought his son to study under me. I said, "My insights are already published in the world; you should read them."