麻黄石膏，恐不可以治此，症或有误
杨(五十二岁) 气从左升，自肝而出，酸水涌上，食入呕出，胃中乏阳营运，木来克土
。当
此年岁，反胃妨食，乃大症也(既系木来克土，吴萸虽能泄肝而干姜、胡芦巴、川椒俱是辛
温，恐益助肝之震烈，尚须斟酌)。
人参 茯苓 吴萸 干姜 胡芦巴 炒黑川椒
此方尚应安顿肝木药参入二三味。
沈(五十三岁) 吞酸嘈杂，不化食味(宣泄气火)。
藿香 橘白 川连 金石斛 茯苓 黑栀皮
胡(用直，四十六岁) 望色瘦少膏泽，按脉弦促而芤。问纳谷不旺，病几数年，每春夏
阳升
气泄，偶加烦冗，或情志不适，血必溢出上窍，已交中年，非少壮阴火相同(清真切当。)夫
心主血，脾统血，肝藏血，脏阴内虚，阳动乃溢，常服归脾汤减 、术、木香加芍，和肝脾
之阳，久进有益。宜静摄不宜烦劳，乃王道养正善药，不计骤功者。
徐(富郎中巷，四十三岁) 向来纳谷不旺，自失血咳嗽以来，仅能静坐。若身动必加气
喘，问仍在操持应接，脉来虚濡，此皆内损脏真。若见血投凉，因嗽理肺，即是谬药。
人参 茯苓 黄精 炙草 枸杞子 白芨 枣仁 桂元肉
黄(六十九岁) 凡食腥油浊物，胃脘必痛，老人营运之阳已衰(脾阳已衰，阳不胜阴，
不主
为胃行其津液。)浊味皆阴凝内痛，必以取气阳药。沉香，白蔻破泄真气，误用则刺其凶。
人参 小熟附子 生姜 白蜜 桂枝 茯苓
陈(十八岁) 暑伤热入于阴，瘅疟。
生淡鳖甲 肥白知母 粉牡丹皮 川贝母 大原生地 地骨皮 麦门冬肉 生粉甘草
张(二十五岁) 血色浓浓，是肝肾阴虚。凡劳心情欲，必要禁忌，医药以寒凉滋清，久
则胃伤减食变凶。
熟地 芡实 山药(炒) 湖莲肉 川石斛 茯苓
方中皆补而不滞之品。
邵(三十三岁) 五液变痰涎，皆肾液之化，阴不承载，咳痹痛甚，乃劳怯之未传，能勉
强纳谷，可望久延。
阿胶 鸡子黄 黑豆皮 川石斛 戎盐
药用咸降。
叶(十七岁) 冲气自下而起，丹溪谓上升从肝而出，木侮胃，食少呛逆，不得着枕卧眠
。
夏热时风迎胸痛，艾炙稍安，久恙阳微，须用甘温。前法皆以疏通不效，本虚无疑，《
金匮
》见肝之病，必先理脾胃，防患于克制耳(惟中上之阳气不充，是以下焦冲气得以自肝而出
，人参建中充实中上之阳，下焦浊气何能上升，此君明臣良，下民安靖矣。)
[Yuebi Method]
Mahuang (Ephedrae Herba) and Shigao (Gypsum Fibrosum) are likely inappropriate for treating this condition; the diagnosis may be erroneous.
Patient Yang (52 years old): Qi ascends from the left, originating from the Liver. Sour fluid surges upward, and food is vomited immediately after ingestion. The Stomach lacks Yang Qi to facilitate transportation and transformation. Wood (Liver) overacts on Earth (Spleen/Stomach). At this age, regurgitation hindering food intake constitutes a severe disease. (Since it is indeed Wood overacting on Earth, although Wuzhuyu (Evodiae Fructus) can vent the Liver, Ganjiang (Zingiberis Rhizoma), Hulusiba (Blasiae Spora), and Chuanjiao (Zanthoxyli Pericarpium) are all acrid and warm, which might further assist the violent nature of Liver Qi. Further deliberation is required.)
Prescription: Renshen (Ginseng Radix et Rhizoma), Fuling (Poria), Wuzhuyu (Evodiae Fructus), Ganjiang (Zingiberis Rhizoma), Hulusiba (Blasiae Spora), Chaohei Chuanjiao (Stir-fried Black Zanthoxyli Pericarpium).
This prescription should incorporate two or three herbs that soothe and settle Liver Wood.
Patient Shen (53 years old): Acid regurgitation and epigastric discomfort with indigestion. (Treatment should vent Qi and Fire.)
Prescription: Huoxiang (Agastaches Herba), Ju Bai (Citri Reticulatae Pericarpium), Chuanlian (Coptidis Rhizoma), Jinshihu (Dendrobii Caulis), Fuling (Poria), Hei Zhipi (Gardeniae Cortex).
Hu Yongzhi (46 years old): Complexion is emaciated and lacks luster. Pulse is wiry, rapid, and hollow (Kou). Appetite is poor. The illness has persisted for several years. Every spring and summer, when Yang Qi ascends and dissipates, occasional irritability arises, or due to emotional distress, blood inevitably bleeds from the upper orifices. Having entered middle age, this differs from the Yin deficiency fire of youth. (The analysis in Qing Qie Zhen Dang is accurate.) The Heart governs Blood, the Spleen controls Blood, and the Liver stores Blood. Internal deficiency of Zang Yin leads to overflow due to Yang hyperactivity. Regularly consuming Guipi Tang (Restore the Spleen Decoction), reducing Baizhu (Atractylodis Macrocephalae Rhizoma) and Muxiang (Aucklandiae Radix), and adding Shaoyao (Paeoniae Radix), harmonizes the Yang of the Liver and Spleen. Long-term consumption is beneficial. One should rest quietly and avoid overexertion. This is a "King's Way" medicine that supports righteous Qi, not one that seeks immediate results.
Patient Xu (Fulangzhong Lane, 43 years old): Historically poor appetite. Since hemoptysis and cough began, he can only sit quietly. Any physical movement exacerbates asthma/wheezing. He reports continuing to manage affairs and social engagements. The pulse is deficient and soft (Ru). These indicate internal damage to the Zhen Qi (True Qi) of the Zang organs. Using cooling herbs upon seeing blood, or regulating the Lung due to cough, would be erroneous medication.
Prescription: Renshen (Ginseng Radix et Rhizoma), Fuling (Poria), Huangjing (Polygonati Rhizoma), Zhi Cao (Honey-fried Glycyrrhizae Radix et Rhizoma), Gouqizi (Lycii Fructus), Baiji (Bletillae Rhizoma), Zaoren (Ziziphi Spinosae Semen), Guiyuanrou (Longan Arillus).
Patient Huang (69 years old): Whenever greasy, fishy, or turbid foods are consumed, epigastric pain occurs. The transportive Yang Qi of the elderly has declined (Spleen Yang is deficient; Yang cannot overcome Yin, failing to distribute fluids for the Stomach). Turbid flavors are Yin congealing internally causing pain. One must use Yang herbs that extract Qi. Chenxiang (Aquilariae Lignum Resinatum) and Baokou (Amomi Fructus Rotundus) break and drain True Qi; misuse will provoke凶险 (dangerous conditions).
Prescription: Renshen (Ginseng Radix et Rhizoma), Xiao Shu Fuzi (Prepared Aconiti Lateralis Radix), Shengjiang (Zingiberis Rhizoma Recens), Baimi (Apis Mellifera), Guizhi (Cinnamomi Ramulus), Fuling (Poria).
Patient Chen (18 years old): Summerheat injures Yin; heat enters Yin, resulting in Dan Nue (Febrile Malaria).
Prescription: Sheng Dan Biejia (Raw Trionycis Carapax), Fei Baizhimu (Anemarrhenae Rhizoma), Fen Mudanpi (Paeoniae Moutan Cortex), Chuan Beimu (Fritillariae Cirrhosae Bulbus), Da Yuan Shengdi (Rehmanniae Radix Praeparata), Digupi (Lycii Cortex), Maimendong (Ophiopogonis Tuber), Sheng Fen Gancao (Raw Powdered Glycyrrhizae Radix et Rhizoma).
Patient Zhang (25 years old): Blood color is thick and dark, indicating Liver and Kidney Yin deficiency. Laboring the mind and indulging in sexual desire must be strictly contraindicated. Medical treatment should use cold and cooling nourishing and clearing methods, but long-term use damages the Stomach, reduces appetite, and leads to dangerous outcomes.
Prescription: Shudi (Rehmanniae Radix Praeparata), Qianshi (Nelumbinis Semen), Shanyao (Dioscoreae Rhizoma, stir-fried), Huliannour (Nelumbinis Plumula), Chuan Shihu (Dendrobii Caulis), Fuling (Poria).
All items in this formula are tonifying without causing stagnation.
Patient Shao (33 years old): The five fluids transform into phlegm and saliva, which is the transformation of Kidney fluids. Yin fails to contain Yang, leading to severe cough and bi-syndrome pain. This is pre-laojie (consumptive weakness) before transmission. If he can barely maintain food intake, prolongation of life is possible.
Prescription: Ejiao (Asini Corii Colla), Jizihuang (Galli Ovi Album), Heidoupi (Phaseoli Semen Cutis), Chuan Shihu (Dendrobii Caulis), Rongyan (Natrii Chloridum).
Medicines utilize salty flavor to descend.
Patient Ye (17 years old): Chong Qi (Revolt Qi) rises from below. Danxi stated that ascending Qi originates from the Liver. Wood insults the Stomach, leading to poor appetite, hiccups/retching, and inability to lie down with a pillow. In summer heat, wind invasion causes chest pain; moxibustion provides slight relief. Chronic illness indicates weak Yang, requiring sweet and warm methods. Previous dredging methods were ineffective; root deficiency is undeniable. As stated in *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet): When treating Liver disease, one must first regulate the Spleen and Stomach to prevent Wood from overacting on Earth. (Only because the Yang Qi of the Middle and Upper Jiao is insufficient does the Lower Jiao Chong Qi ascend via the Liver channel. Renshen establishes the Middle and enriches the Yang of the Middle and Upper Jiao; how can turbid Qi from the Lower Jiao rise? This is like a wise ruler and virtuous ministers, ensuring peace among the people.)