陈（八岁） 童子咳呛内热，已经三年，证属童劳，治宜滋养化源，清降肺气。
党参 北沙参 茯苓 苡仁 地骨皮 桑皮 生冬术 麦冬 橘皮 炙草 枇杷叶
方立甚妙，童劳安得不愈？三年沉痼，四服而愈。
周氏（十四）兼旬进食辄呕，近日粥饮亦吐，神识潦倒，大为危候。皆因平素善怒，肝
血不足，木火易升，上凌胃土。拟苦辛酸法，必可纳谷，再商扶治。
党参（二钱） 半夏（一钱五分） 生白芍（一钱五分） 川连（六分） 生牡蛎（三钱） 橘白
（八分） 丹皮（一钱五分） 山栀（一钱五分） 吴茱萸（三分） 老姜渣（二钱）
服一剂，胸脘宽舒，纳食不呕，面青稍退，略有口苦，脐旁动气，宜养脾阴，切戒动怒
。
生地 归身 白芍 丹皮 牡蛎 桑叶 麦冬 甘草
数剂安然。后因不戒于怒复发，仍来招余，力辞难治，缠绵两月，竟成膈症而殁。
外母（五七） 丙午仲秋，患晨起呕吐黄水，腹痛泄泻，食物些微亦胀，神气潦倒，将成
重候
。切脉左浮弦，右沉涩，知为肝木不平，脾胃虚弱。用斯意调治不效，改投温通酸敛而愈。
因夏月喜饮井泉，及生冷瓜桃之类，脾胃虚寒，肝火上乘所致。
吴茱萸（六分） 干姜（一钱） 党参（一钱五分） 白术（二钱） 白芍（一钱五分） 乌梅肉
（七分） 煨木香（三分） 炙草（五分） 大枣（二枚）
一服呕止，再剂能下紫血数块，腹即不痛，纳食亦安，惟大便未实，换方∶
党参 炒白芍 茯苓 橘皮 破故纸 山药 肉果 炙草 菟丝饼
六服痊愈。
陈（四三） 病发先泻，既吐食并酸水，旬日一发，经历三年，欲成反胃。自述当临发时
，汗出寒栗。此病由于厥阴浊阴上僭，致脾胃气弱，传化无节，纳导无权。治当苦降辛散，
甘补酸收，法乌梅丸意，临发前一日服。
桂枝木 白蔻仁 半夏 川连 党参 生冬术 当归 白芍 乌梅 茯苓 炙草
张（十五） 咳呛弥月，呕吐饮食，便燥如栗。询述脐旁宿有块上攻，即咳吐食物。此系
厥阴之气犯胃，胃不下降所致，今以抑肝通腑润肠。
乌梅 鳖甲 生白芍 生地 半夏 通草 归身 麦冬 玉竹
又 病减大半，惟午餐吐尚未除，脉来短数，中气亦虚，前法兼补胃。
归身 白芍 生地 党参 蒸冬术 鳖甲 乌梅 麦冬 半夏
凡人病中，虚实不可不辨也。有神色惨淡，不能起坐，似乎虚极，而不知病气未去也。
何以
辨之？当察其胃中不快纳少，舌胎或黄或黑，便赤口渴，身有寒热，是其验也。设投补剂，
鲜不误事。无以上诸症，而见神色惨淡，起坐不能，方是真虚，惟胃闷纳少，更当辨其虚否
。
Chen (8 years old): Presented with pediatric cough and wheezing accompanied by internal heat, a condition persisting for three years. This syndrome belongs to "Tong Lao" (Pediatric Chronic Deficiency Syndrome), and treatment should focus on nourishing the source of transformation and descending lung Qi.
Prescription: Codonopsis Radix (Dangshen), Glehniae Radix (Beishashen), Poria (Fuling), Coicis Semen (Yiren), Cortex Lycii Radicis (Digupi), Pericarpium Mori Folii (Sangpi), Atractylodis Rhizoma Sheng (Sheng Dongzhu), Ophiopogonis Radix (Maidong), Citri Reticulatae Pericarpium (Jupi), Glycyrrhizae Radix et Rhizoma Zhi (Zhicao), Loquat Leaf (Pipaye).
The prescription is excellently formulated; how could Tong Lao fail to heal? The chronic ailment of three years was cured after four doses.
Zhou (14 years old): Vomited immediately after eating for twenty consecutive days; recently even porridge and drinks were vomited. Consciousness was dull and listless, indicating a critical condition. This resulted from a habitual tendency toward anger, leading to Liver Blood deficiency, allowing Liver Fire to ascend easily and oppress Stomach Earth. A Bitter-Acid-Pungent method is proposed to restore food intake, followed by further discussion on supporting treatment.
Prescription: Codonopsis Radix (Dangshen, 2 qian), Pinelliae Rhizoma (Banxia, 1.5 qian), Paeoniae Radix Alba Sheng (Baishao, 1.5 qian), Coptidis Rhizoma (Chuanlian, 6 fen), Ostreum Sheng (Muli, 3 qian), Citri Reticulatae Pericarpium (Jubai, 8 fen), Moutan Cortex (Danpi, 1.5 qian), Gardeniae Fructus (Shanzhi, 1.5 qian), Evodiae Fructus (Wuzhuyu, 3 fen), Ginger Residue Laojiangzha (2 qian).
After one dose, the chest and epigastrium felt relaxed, food intake ceased vomiting, the bluish complexion slightly receded, but slight bitter taste in the mouth and qi movement beside the umbilicus appeared. Nourishing Spleen Yin is appropriate, and anger must be strictly avoided.
Prescription: Rehmanniae Radix Recens (Shengdi), Angelicae Sinensis Radix (Guishen), Paeoniae Radix Alba (Baishao), Moutan Cortex (Danpi), Ostreum (Muli), Mori Folium (Sangye), Ophiopogonis Radix (Maidong), Glycyrrhizae Radix et Rhizoma (Gancao).
After several doses, the patient remained stable. Later, due to failure to avoid anger, the condition relapsed. I was invited again but declined firmly as it was difficult to treat. After lingering for two months, the patient died of Esophageal Obstruction (Ge Zheng).
Grandmother (57 years old): In mid-autumn of the Bingwu year, suffered from morning vomiting of yellow fluid, abdominal pain, diarrhea, and bloating even with minimal food intake. Spirit was listless, approaching a severe state. Pulse on the left was floating and wiry, on the right deep and choppy. It was identified as Liver Wood imbalance and Spleen-Stomach weakness. Initial treatment using Liver-soothing and Spleen-regulating ideas failed. Switched to warming, unblocking, and astringent methods, resulting in recovery.
This was caused by enjoying well water and cold raw fruits/vegetables in summer, leading to Spleen-Stomach deficiency-cold and Liver Fire riding upward.
Prescription: Evodiae Fructus (Wuzhuyu, 6 fen), Zingiberis Rhizoma (Ganjiang, 1 qian), Codonopsis Radix (Dangshen, 1.5 qian), Atractylodis Macrocephalae Rhizoma (Baizhu, 2 qian), Paeoniae Radix Alba (Baishao, 1.5 qian), Pruni Semen (Wumeirou, 7 fen), Aucklandiae Radix Wei (Weimuxiang, 3 fen), Glycyrrhizae Radix et Rhizoma Zhi (Zhicao, 5 fen), Jujubae Fructus (Dazao, 2 pieces).
One dose stopped vomiting. Two more doses led to the passage of several dark red blood clots, abdominal pain ceased, and food intake stabilized, though stool remained loose. Prescription changed to:
Prescription: Codonopsis Radix (Dangshen), Paeoniae Radix Alba Chao (Chao Baishao), Poria (Fuling), Citri Reticulatae Pericarpium (Jupi), Psoraleae Fructus (Buguzhi), Dioscoreae Rhizoma (Shanyao), Myristicae Semen (Rouguo), Glycyrrhizae Radix et Rhizoma Zhi (Zhicao), Cuscutae Semen (Tusizi bing).
Recovered after six doses.
Chen (43 years old): Illness began with diarrhea, followed by vomiting of food and sour fluid, occurring once every ten days for three years, threatening to become Reverse Regurgitation (Fanwei). The patient described sweating and chills during impending attacks. This disease stems from Turbid Yin of the Jueyin channel usurping upwards, causing weak Spleen-Stomach Qi, loss of regulation in transportation and transformation, and inability to receive and guide. Treatment should employ Bitter-Descent and Pungent-Dispersal, Sweet-Nourishment and Acid-Astringency, following the principle of Wumei Wan, taken one day before an attack.
Prescription: Cinnamomi Ramulus (Guizhimu), Amomi Fructus Rotundus (Baokouren), Pinelliae Rhizoma (Banxia), Coptidis Rhizoma (Chuanlian), Codonopsis Radix (Dangshen), Atractylodis Rhizoma Sheng (Sheng Dongzhu), Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Baishao), Pruni Semen (Wumei), Poria (Fuling), Glycyrrhizae Radix et Rhizoma Zhi (Zhicao).
Zhang (15 years old): Cough and wheezing persisted for a month, vomiting food and drink, dry stools like chestnuts. Inquiry revealed a pre-existing mass beside the umbilicus attacking upward, triggering cough and vomiting. This is due to Jueyin Qi invading the Stomach, preventing Stomach Qi from descending. Current treatment aims to suppress Liver, unblock Fu organs, and moisten intestines.
Prescription: Pruni Semen (Wumei), Testudinis et Chelonis Carapax et Plastrum (Biejia), Paeoniae Radix Alba Sheng (Baishao), Rehmanniae Radix Recens (Shengdi), Pinelliae Rhizoma (Banxia), Tectonae Caulis (Tongcao), Angelicae Sinensis Radix (Guishen), Ophiopogonis Radix (Maidong), Polygonati Odorati Rhizoma (Yuzhu).
Follow-up: Condition reduced by more than half, only lunchtime vomiting remains. Pulse is short and rapid, indicating Middle Qi deficiency. Previous method combined with Stomach tonification.
Prescription: Angelicae Sinensis Radix (Guishen), Paeoniae Radix Alba (Baishao), Rehmanniae Radix Recens (Shengdi), Codonopsis Radix (Dangshen), Atractylodis Rhizoma Zheng (Zheng Dongzhu), Testudinis et Chelonis Carapax et Plastrum (Biejia), Pruni Semen (Wumei), Ophiopogonis Radix (Maidong), Pinelliae Rhizoma (Banxia).
In general, when people are ill, Deficiency and Excess must not fail to be distinguished. Some present with pale/dull expression and inability to rise or sit, appearing extremely deficient, yet unaware that pathogenic Qi has not been expelled.
How to distinguish? Observe if there is gastric discomfort, reduced appetite, yellow or black tongue coating, red urine, thirst, and alternating chills and fever; these are the signs. If tonifying agents are administered at this stage, mistakes are almost inevitable. Only if none of the above symptoms exist, but pallor/dullness and inability to move are seen, is it true Deficiency. However, if accompanied by gastric stuffiness and poor appetite, one must further discern whether it is truly Deficiency.