中痞者。肠满。四肢倦。行立艰难。食已呕吐。冒昧。减食或渴者是也。宜用后方。
大黄（一两。湿纸十重包裹。煨令香熟。切作片子） 槟榔（一枚） 木香（一分）
上为末。生蜜为丸。如桐子大。每服三十丸。生姜汤下。食后日午。日进二服。未减。加之。效。即勿再服。附方。
桂（五钱。不见火） 槟榔（一个） 黑牵牛（四两。生为末二两）
上为末蜜酒调二钱。以利为度。
下痞者。小便不利。脐下满硬。语言謇滞。腰背疼痛。脚重不能行立者是也。宜用后方。
瞿麦头子（一两） 官桂（一分） 甘遂（三分） 车前子（一两炒）
上件为末。以 猪肾一个。去筋膜。薄批开入药末二钱。匀糁。湿纸裹。慢火煨熟。空心细嚼。温酒送下。以
大利为度。小便未利。脐腹未软。更服附方。
葱白一寸。去心。入 砂末一钱。安葱心中。两头以线子系之。湿纸包。煨熟。用冷醇酒送下。空心服。以
效为度。
夫病者。有宜汤者。有宜丸者。有宜散者。有宜下者。有宜吐者。有宜汗者。有宜灸者。有宜针者。有宜补者。有
宜按摩者。有宜导引者。有宜蒸熨者。有宜澡洗者。有宜悦愉者。有宜和缓者。有宜水者。有宜火者。种种之
法岂能一也。若非良善精博。难为取愈。其庸下识浅。乱投汤丸。下汗补吐。动使交错。轻者令重。重者令死。
举世皆然。且汤。可以荡涤脏腑。开通经络。调品阴阳。祛分邪恶。润泽枯朽。悦养皮肤。益充气力。扶助困竭。
莫离于汤也。丸。可以逐风冷。破坚症。消积聚。进饮食。舒荣卫。开关窍。缓缓然参合。无出于丸也。散者。能祛
风寒暑湿之气。摅寒湿秽毒之邪。发扬四肢之壅滞。除剪五脏之结伏。开肠和胃。行脉通经。莫过于散也。
下。则疏豁闭塞。补。则益助虚乏。灸。则起阴通阳。针。则行荣引卫。导引。则可以遂客邪于关节。按摩。则可以
驱浮淫于肌肉。蒸熨。辟冷暖。洗生阳。悦愉。爽神。和缓。安气。若实而不下。则使人心腹胀满。烦乱。鼓肿。若虚
而不补则使人气血消散。精神耗亡。肌肉脱失。志意昏迷。可汗而不汗。则使人毛孔关塞。闷绝而终合吐
而不吐则使人结胸上喘。水食不入而死。当灸而不灸。则使人冷气重凝阴毒内聚。厥气上冲。分遂不散。
以致消减。当针而不针。则使人荣卫不行。经络不利。邪渐胜真。冒昧而昏。宜导引而不导引。则使人邪侵
关节。固结难通。宜按摩而不按摩。则使人淫随肌肉。久留不消。宜蒸熨而不蒸熨。则使人冷气潜伏渐成
痹厥。宜澡洗而不澡洗。则使人阳气上行。阴邪相害。不当下而下。则使人开肠荡胃。洞泄不禁。不当汗而
汗。则使人肌肉消绝。津液枯耗。不当吐而吐。则使人心神烦乱。脏腑奔冲不当灸而灸。则使人重伤经络。
内蓄炎毒。反害中和致于不可救不当针而针。则使人气血散失。关机细缩。不当导引而导引。则使人真
气劳败。邪气妄行。不当按摩而按摩。则使人肌肉 胀。筋骨舒张。不当蒸熨而蒸熨。则使人阳气偏行。阴
气内聚。不当淋渫而淋渫。则使人湿侵皮肤。热生肌体。不当悦愉而悦愉。则使人神失气消。精神不快。不
当和缓而和缓。则使人气停意（此下。赵写本俱缺。）折。健忘。伤志。大凡治疗要合其宜。脉状病候少陈于后。凡脉不
紧数。则勿发其汗。脉不疾数。不可以下。心胸不闭。尺脉微弱。不可以吐。关节不急。荣卫不壅。不可以针。阴
气不盛。阳气不衰。勿灸。内无客邪。勿导引。外无淫气。勿按摩。皮肤不痹。勿蒸熨。肌肉不寒。勿暖洗。神不凝
迷。勿悦愉。气不急奔。勿和缓。顺此者生。逆此者死耳。脉病之法。备说在前。
Zhongpi (Middle Epigastric Fullness) is characterized by intestinal fullness, fatigue and weakness of the four limbs, difficulty in walking and standing, vomiting after eating, dizziness, reduced appetite, or thirst. The following formula should be used.
Dahuang (Rhei Radix et Rhizoma, 1 liang, wrapped in ten layers of wet paper, roasted until fragrant and ripe, sliced) Binglang (Arecae Semen, 1 piece) Muxiang (Aucklandiae Radix, 1 fen)
Grind the above ingredients into powder. Form pills using raw honey, sized like wutongzi (seeds of Koelreuteria paniculata). Take 30 pills per dose, administered with Shengjiang Tang (Fresh Ginger Decoction), after meals at noon. Take twice daily. If symptoms do not subside, increase the dosage. If effective, stop taking it immediately. Supplementary Formula:
Guizhi (Cinnamomi Ramulus, 5 qian, not exposed to fire) Binglang (Arecae Semen, 1 piece) Qeian Niu (Pharbitidis Semen, 4 liang, raw ground into powder, use 2 liang)
Grind the above ingredients into powder. Mix 2 qian with honey and wine. Administer until diarrhea occurs as the therapeutic goal.
Xiapi (Lower Epigastric Fullness) is characterized by difficult urination, fullness and hardness below the umbilicus, slurred speech, pain in the lower back, and heaviness in the legs making walking and standing difficult. The following formula should be used.
Qumai (Dianthi Herba, specifically the seed head, 1 liang) Guigui (Cinnamomi Cortex, 1 fen) Gansui (Kansui Radix, 3 fen) Cheqianzi (Plantaginis Semen, 1 liang, stir-fried)
Grind the above ingredients into powder. Take one Zhu Shen (Porcine Kidney), remove the fascia, slice thinly, insert 2 qian of the medicine powder evenly inside. Wrap in wet paper and roast slowly over low heat until cooked. Chew thoroughly on an empty stomach and swallow with warm wine. Continue until free bowel movement is achieved. If urination remains difficult and the abdomen below the navel remains hard, take the supplementary formula:
Congbai (Allii Fistulosi Bulbus, 1 cun, remove the center), insert 1 qian of Sha (likely referring to a mineral salt or specific preparation, contextually ambiguous but kept as 'Sha') into the hollow of the scallion. Tie both ends with thread, wrap in wet paper, and roast until cooked. Take with cold pure wine on an empty stomach. Stop when effective.
Generally, for diseases, some are suitable for Tang (Decoction), some for Wan (Pills), some for San (Powder), some for Xia (Purgation), some for Tu (Emesis), some for Han (Sweating), some for Jiu (Moxibustion), some for Zhen (Acupuncture), some for Bu (Tonification), some for Anmo (Massage), some for Daoyin (Guiding and Pulling exercises), some for Zhengwen (Steaming and Fomenting), some for Zaoxi (Bathing/Washing), some for Yuyu (Joyful/Emotional Regulation), some for Hehuan (Harmonizing/Relaxing), some for Shui (Water therapy), and some for Huo (Fire therapy). How can all methods be the same? Unless one is a virtuous and proficient doctor, it is difficult to achieve cure. Mediocre doctors with shallow knowledge recklessly administer decoctions and pills, confusing purgation, sweating, tonification, and emesis. This causes mild conditions to become severe and severe conditions to result in death. This is common throughout the world.
Decoctions (Tang) can cleanse the zang-fu organs, open meridians and collaterals, regulate Yin and Yang, dispel evil qi, moisten dryness, nourish skin, replenish Qi and strength, and support exhaustion. Nothing is better than Decoctions. Pills (Wan) can expel wind-cold, break stagnations, dissipate accumulations, promote appetite, soothe Ying and Wei, open orifices, and provide gradual comprehensive regulation. Nothing is better than Pills. Powders (San) can dispel wind, cold, summer-heat, and dampness; relieve cold-damp and turbid toxins; resolve stagnation in the four limbs; eliminate knots in the five zang organs; harmonize intestines and stomach; and promote pulse and meridian flow. Nothing is better than Powders.
Purgation (Xia) opens blockages; Tonification (Bu) supplements deficiency; Moxibustion (Jiu) raises Yin and unblocks Yang; Acupuncture (Zhen) circulates Ying blood and guides Wei Qi; Daoyin (Guiding and Pulling) can guide pathogenic factors out of joints; Massage (Anmo) can drive floating pathogens from muscles; Steaming and Fomenting (Zhengwen) ward off cold and warmth; Bathing (Zaoxi) generates Yang Qi; Joyful Regulation (Yuyu) refreshes the spirit; Harmonizing (Hehuan) calms Qi.
If excess conditions are not purged, it leads to abdominal distension, irritability, and edema. If deficiency conditions are not tonified, it leads to dissipation of Qi and Blood, loss of spirit, muscle wasting, and confusion. If sweating is indicated but not performed, pores close, leading to suffocation and death. If emesis is indicated but not performed, it leads to chest binding, panting, and inability to eat or drink, resulting in death. If moxibustion is indicated but not performed, cold qi condenses, Yin toxins accumulate, and rebellious Qi rushes upward, leading to wasting. If acupuncture is indicated but not performed, Ying and Wei fail to circulate, meridians become obstructed, evil overcomes healthy Qi, leading to dizziness and coma. If Daoyin is indicated but not performed, pathogens invade joints, causing stubborn blockage. If massage is indicated but not performed, pathogens linger in muscles. If steaming/fomenting is indicated but not performed, cold qi lingers, leading to Bi syndrome and cold limbs. If bathing is indicated but not performed, Yang Qi rises abnormally, and Yin pathogens harm the body.
Inappropriate purgation damages the intestines and stomach, causing uncontrollable diarrhea. Inappropriate sweating destroys muscles and depletes fluids. Inappropriate emesis disturbs the heart-mind and causes chaotic organ function. Inappropriate moxibustion injures meridians, accumulates internal heat toxin, disrupts harmony, and becomes incurable. Inappropriate acupuncture scatters Qi and Blood and constricts joints. Inappropriate Daoyin exhausts True Qi and allows pathogens to act wildly. Inappropriate massage causes muscle swelling and ligament laxity. Inappropriate steaming/fomenting causes Yang to deviate and Yin to accumulate internally. Inappropriate washing/bathing introduces dampness and heat. Inappropriate emotional regulation depletes spirit and Qi. Inappropriate harmonizing causes Qi stagnation, forgetfulness, and injury to will.
Generally, treatment must be appropriate. Pulse and symptom patterns are briefly described below: If the pulse is not tight and rapid, do not induce sweating. If the pulse is not urgent and rapid, do not use purgation. If the chest is not closed and the Chi pulse is weak, do not induce emesis. If joints are not urgent and Ying/Wei are not stagnant, do not use acupuncture. If Yin is not excessive and Yang is not deficient, do not use moxibustion. If there is no external pathogen, do not use Daoyin. If there is no floating pathogen externally, do not use massage. If skin is not bi-syndrome affected, do not use steaming/fomenting. If muscles are not cold, do not use warming baths. If spirit is not confused, do not use emotional regulation. If Qi is not rushing urgently, do not use harmonizing. Following these principles leads to life; violating them leads to death. The methods of pulse and disease diagnosis have been fully discussed previously.