朱 气逆浊饮上升，甚则中夜起坐。医用二陈兼旋复代赭汤不应，诊脉乃阳微浊逆，用外台茯苓饮加干
姜、沉香汁，愈。
侄 脉沉弦为停饮，由脾阳不运输，水湿留胃，故食后清稀宿水倾吐而出。按仲景论饮邪，当以温药
和之。《金匮》治痰饮胸胁支满，苓桂术甘汤主之。今仿其法而更其制，以茯苓泄水，桂枝通阳，白术燥湿，
甘草和中，加砂仁、半夏、枳壳、苏子，运脾以降浊。研末服，姜汤下，积饮遂除。
贡 饮症吐青绿苦沫，乃胆气所溢。用温胆汤加吴萸、干姜、苍术，逐湿涤饮，吐止。嗣用苍半苓陈
散加益智仁、焦术、粳米，共为末。姜汤调服，温理脾阳而安。
丁 积年痰饮，脉虚，右尺大，宿 因劳力中虚而发。用六君子汤加薏苡、煨姜、椒目，服效。
贡 痰饮久嗽，清晨浊沫上干，必倾咳吐出，膈上乃宽。此由宿食化痰，趁胃虚随气上升故也。然
细参症脉，必肾中阳虚，仲景所谓肾虚水泛为痰，以肾气丸补而逐之。向服崔氏八味丸，虽未速效，犹是对症
主治，惟客岁自用倒仓法，洗涤停痰宿饮，乃为间道出奇。王节斋《明医杂着》云∶肠胃为仓，仓中有陈腐
败谷，须倒出之，肠胃中有痰血积滞，须荡涤之，若病不属肠胃，不可轻用。据此宜乎用之无益。
王 脉沉弦，始则头痛闷呕，舌白恶食，继则气阻脘痛，攻注腰脐，随触辄呕，背寒心悸，下利溺少，
九昼夜不能着枕，固是湿阻气痹。但医者混治，谬托消和，不知饮邪入络，上干为头痛，下渗为泻利，渍入
太阳为背寒，停于心下为悸动。《金匮》云∶口干不欲饮水者，为饮邪未去故也。今饮入支络，不用辛温通
逐，痛呕焉止。仿小半夏汤加茯苓、川椒目、枳壳、吴萸、桂枝、沉香（磨汁），日再服，痛缓得卧，糜
粥得下，背寒心悸俱却，惟脐腹 结，时呕时痛，乃支络浊滞未净，改用通络导滞。归须、小茴香、生楂肉、
橘核（青盐拌炒）、山栀（姜汁炒）、茯苓、枳壳、降香末，痛呕悉平。改用和中运湿，制半夏、砂仁、茯苓、
炙草、谷芽、大豆黄卷、薏苡、陈皮，全瘳。
Patient Zhu: Qi rebellion and turbid fluid rising, severe cases involve waking up to sit in the middle of the night. The physician used Er Chen Tang (Two-Cured Decoction) combined with Xuan Fu Dai Zhe Tang (Inula and Hematite Decoction) without effect. Pulse diagnosis revealed deficient Yang and rebellious turbidity. Wai Tai Fu Ling Yin (External Treasury Poria Decoction) was prescribed with added Gan Jiang (Dried Ginger, *Zingiberis Rhizoma*) and Chen Xiang juice (Aquilaria Juice), resulting in a cure.
Nephew: A deep and wiry pulse indicates retained fluid, caused by Spleen Yang failing to transport, leading to water-dampness stagnating in the Stomach. Consequently, clear and thin old food residue is vomited after eating. According to Zhang Zhongjing’s discussion on fluid pathogens, warm herbs should be used to harmonize. In *Jin Gui Yao Lue* (Essential Prescriptions from the Golden Cabinet), for phlegm-fluid causing fullness and distension in the chest and hypochondrium, Ling Gui Zhu Gan Tang (Poria, Cinnamon Twig, Atractylodes Macrocephala and Licorice Decoction) is the primary formula. Here, we follow its method but modify its composition: using Fu Ling (Poria, *Poria*) to drain water, Gui Zhi (Cinnamon Twig, *Cinnamomi Ramulus*) to unblock Yang, Bai Zhu (Atractylodes Macrocephala, *Atractylodis Macrocephalae Rhizoma*) to dry dampness, and Gan Cao (Licorice, *Glycyrrhizae Radix et Rhizoma*) to harmonize the Middle Jiao. Sha Ren (Amomum Fruit, *Amomi Fructus*), Ban Xia (Pinellia Tuber, *Pinelliae Rhizoma*), Zhi Ke (Bitter Orange, *Citri Reticulatae Pericarpium*), and Su Zi (Perilla Seed, *Perillae Fructus*) are added to transform the Spleen and descend turbidity. Taken as powder with Ginger Decoction, the accumulated fluid is eliminated.
Patient Gong: Fluid disease presenting with vomiting of greenish-yellow bitter foam, indicating overflowing Gallbladder Qi. Wen Dan Tang (Warm the Gallbladder Decoction) was used with added Wu Zhu Yu (Evodia Fruit, *Evodiae Fructus*), Gan Jiang (Dried Ginger, *Zingiberis Rhizoma*), and Cang Zhu (Atractylodes Lancea, *Atractylodis Rhizoma*). This expelled dampness and purified fluid, stopping the vomiting. Subsequently, Cang Ban Ling Chen San (Powder of Cang Zhu, Ban Xia, Fu Ling, and Chen Pi) was modified with Yi Zhi Ren (Alpinia Oxyphylla Fruit, *Alpiniae Oxypyllae Fructus*), Chao Bai Zhu (Stir-fried Atractylodes Macrocephala, *Atractylodis Macrocephalae Rhizoma*), and Jing Mi (Rice, *Oryzae Sativae Semen*). All were powdered and taken with Ginger Decoction to warm and regulate Spleen Yang, bringing peace.
Patient Ding: Chronic phlegm-fluid, weak pulse, enlarged Right Chi position. The chronic condition was triggered by labor-induced deficiency in the Middle Jiao. Liu Jun Zi Tang (Six-Gentlemen Decoction) was prescribed with added Yi Yi Ren (Coix Seed, *Coicis Semen*), Wei Jiang (Roasted Ginger, *Zingiberis Rhizoma Recens*), and Jiao Mu (Chili Pepper Seed, *Capsici Fructus*). Effective.
Patient Gong: Chronic cough due to phlegm-fluid, with turbid foam rising in the early morning, requiring forceful coughing to expel, after which the upper Diaphragm feels relieved. This is caused by old food transforming into phlegm, ascending with Qi due to Stomach deficiency. However, careful analysis of symptoms and pulse reveals Kidney Yang deficiency, as described by Zhang Zhongjing: "Kidney deficiency leads to water flooding and phlegm formation." Shen Qi Wan (Kidney Qi Pill) was used to tonify and expel fluid. Previously, Cui Shi Ba Wei Wan (Cui's Eight-Ingredient Pill, i.e., Jin Gui Shen Qi Wan) was taken; although slow-acting, it was appropriate. Last year, self-administered Dao Cang Fa (Reversing Granary Method, a purgative therapy) was used to wash away retained phlegm and fluid, which was an unconventional approach. Wang Jiezhai in *Ming Yi Za Zhu* (Miscellaneous Writings of Famous Physicians) stated: "The intestines and stomach are like granaries; if there is stale grain, it must be emptied; if there is phlegm-blood stasis, it must be purged. If the disease does not belong to the intestines and stomach, do not use lightly." Based on this, this method was ineffective for him.
Patient Wang: Deep and wiry pulse. Initially, headache, stuffiness, vomiting, white tongue coating, and aversion to food. Later, Qi obstruction causing epigastric pain radiating to the waist and umbilicus, vomiting upon any touch, cold back, palpitations, diarrhea, and scant urine. Unable to sleep for nine days. This is indeed Dampness obstructing Qi and Bi syndrome. However, the physician treated indiscriminately, mistakenly relying on resolving and harmonizing methods, unaware that fluid pathogens entering the collaterals cause headache when disturbing upwards, diarrhea when seeping downwards, cold back when soaking the Taiyang channel, and palpitations when staying at the Heart's lower region. *Jin Gui Yao Lue* states: "Dry mouth but no desire to drink indicates fluid pathogen remains." Since fluid has entered the branch collaterals, pungent-warm unblocking and expelling methods are required; otherwise, how can pain and vomiting cease? Xiao Ban Xia Tang (Minor Pinellia Decoction) was modeled with added Fu Ling (Poria, *Poria*), Chuan Jiao Mu (Sichuan Chili Pepper Seed, *Capsici Fructus*), Zhi Ke (Bitter Orange, *Citri Reticulatae Pericarpium*), Wu Zhu Yu (Evodia Fruit, *Evodiae Fructus*), Gui Zhi (Cinnamon Twig, *Cinnamomi Ramulus*), and Chen Xiang (Aquilaria Wood, *Aquilariae Lignum Resinatum*). Taken twice daily, pain eased, allowing rest; gruel could be swallowed; cold back and palpitations resolved. Only umbilical/abdominal knotting remained, with intermittent vomiting and pain, indicating residual turbidity in branch collaterals. Tong Luo Dao Zhi (Unblocking Collaterals and Guiding Out Stagnation) method was adopted: Dang Gui Xu (Angelica Sinensis Root Tip, *Angelicae Sinensis Radix*), Xiao Hui Xiang (Fennel Fruit, *Foeniculi Fructus*), Sheng Zha Rou (Raw Hawthorn Flesh, *Crataegi Fructus*), Ju He (Tangerine Seed, *Citri Reticulatae Semen*) stir-fried with Qing Yan (Green Salt), Shan Zhi (Gardenia Fruit, *Gardeniae Fructus*) stir-fried with Jiang Zhi (Ginger Juice), Fu Ling (Poria, *Poria*), Zhi Ke (Bitter Orange, *Citri Reticulatae Pericarpium*), and Jiang Xiang Mo (Agarwood Powder, *Aquilariae Lignum Resinatum*). Pain and vomiting ceased completely. Then, He Zhong Yun Shi (Harmonizing Middle and Transforming Dampness) method was used: Zhi Ban Xia (Prepared Pinellia Tuber, *Pinelliae Rhizoma Praeparatum*), Sha Ren (Amomum Fruit, *Amomi Fructus*), Fu Ling (Poria, *Poria*), Zhi Gan Cao (Honey-fried Licorice, *Glycyrrhizae Radix et Rhizoma*), Gu Ya (Sprouted Millet, *Setariae Italicae Fructus Germinatus*), Da Dou Huang Juan (Fermented Soybean, *Sojae Semen Praeparatum*), Yi Yi Ren (Coix Seed, *Coicis Semen*), and Chen Pi (Aged Tangerine Peel, *Citri Reticulatae Pericarpium*). Full recovery achieved.