阁老梁浓斋，气短有痰，小便赤涩，足跟作痛，尺脉浮大，按之则涩，此肾虚而痰饮也，用四
物送六味丸，不月而康。仲景先生云∶气虚有饮，用肾气丸补而逐之。诚开后学之蒙 ，济
无穷之夭枉，肾气丸即六味丸也。
都宪孟有涯，气短痰晕，服辛香之剂，痰盛，遗尿，两尺浮大，按之如无，余以为肾家不能纳气
归源，香燥致甚耳，用八味丸料，三剂而愈。
孙都宪，形体丰浓，劳神善怒，面带阳色，口渴吐痰，或头目眩晕，或热从腹起，左三脉洪而
有力，右三脉洪而无力，余谓足三阴亏损，用补中益气加麦门、五味及加减八味丸而愈。若
人少有老态，不耐寒暑，不胜劳役，四时迭病，皆因少时气血方长，而劳心亏损；或精血未
满，而御女过伤，故其见症难以悉状，此精气不足，但滋化源，其病自痊。又若饮食劳役、七
情失宜，以致诸症，亦当治以前法。设或六淫所侵，而致诸症，亦因真气内虚，而外邪乘袭
，尤当固胃气为主。盖胃为五脏之根本，故黄柏、知母不宜轻用，恐复伤胃气也。
大凡杂症
属内因，乃形气病气俱不足，当补不当泻，伤寒虽属外因，亦宜分其表、里、虚、实，治当审之。
昌平守王天成，头晕恶寒，形体倦怠，得食稍愈，劳而益甚，寸关脉浮大，此脾肺虚弱，用补
中益气加蔓荆子而愈。后因劳役，发热恶寒，谵言不寐，得食稍安，用补中益气汤而痊。
大尹祝支山，因怒头晕，拗内筋挛，时或寒热，日晡热甚，此肝火筋挛，气虚头晕，用八珍
加柴胡、山栀、牡丹皮，二十余剂而愈。
上舍顾桐石，会饮于周上舍节，问余曰∶向孟有涯、陈东谷俱为无嗣，纳宠已而得疾，皆头晕吐
痰，并用苏合香丸，惟有涯得生，何也?余曰∶二症因肾虚不能纳气，而为头晕；不能制水而
为痰涎。东谷专主攻痰行气，有涯专于益火补气故耳。后余应杭人之请，桐石房劳过度，亦
患前症，或用清气化痰愈甚，顾曰∶我病是肾虚不能纳气归源。治者不悟而殁。惜哉!
一男子，素浓味，胸满痰盛。余曰∶膏粱之人，内多积热。与法制清气化痰丸而愈。彼为有验
，修合馈送，脾胃虚者，无不受害。
先兄，体貌丰伟，唾痰甚多，脉洪有力，殊不耐劳，遇风头晕欲仆，口舌破裂，或至赤烂，误
食姜蒜少许，口疮益甚，服八味丸及补中益气加附子钱许即愈。停药月余，诸症仍作，此命
门虚火不归源也。
阁老梁浓斋，呼吸短促且有痰，小便颜色红赤且排尿涩痛，足跟疼痛，尺脉浮大，重按则感觉涩滞，这是肾虚兼有痰饮所致，用四物汤送服六味丸，不到一个月便康复了。张仲景先生说：“气虚而有痰饮，应用肾气丸补益并驱逐痰饮。”这确实开启了后学的蒙昧，挽救了无数早夭的生命，肾气丸就是六味丸（注：此处原文意指肾气丸由六味丸加桂枝、附子组成，或指代关系，依原文直译）。
都宪孟有涯，呼吸短促、痰多眩晕，服用辛香类药物后，痰症加重，出现遗尿，两尺脉浮大，重按似无，我认为这是肾脏不能纳气归元，辛香燥烈之药导致病情加剧，于是用八味丸的方料，服用三剂后痊愈。
孙都宪，身体肥胖丰满，劳神过度且容易发怒，面色偏红，口渴吐痰，有时头目眩晕，有时热气从腹部升起，左手三部脉洪大有力，右手三部脉洪大无力，我认为是足三阴经亏损，用补中益气汤加上麦门冬、五味子以及加减八味丸而治愈。这类人稍微显露出衰老之态，就不能耐受寒暑变化，不能胜任劳累，四季交替时容易生病，都是因为年轻时气血正在生长，却用心过度导致亏损；或者精血尚未充盈，就因房事过度而受伤，所以出现的症状难以完全描述清楚，这都是精气不足，只要滋生化之源，病自然痊愈。又如因饮食不节、劳累过度、七情失调导致的各种病症，也应当用上述方法治疗。假如被六淫邪气侵袭而导致各种病症，也是因为真气内部虚弱，外邪趁机侵袭，尤其应当以固护胃气为主。因为胃是五脏的根本，所以黄柏、知母不宜轻易使用，恐怕会再次损伤胃气。
大凡杂病属于内因，乃是形体之气和病气都不足，应当补益而不应当泻下。伤寒虽然属于外因，也应当分辨表里、虚实，治疗时必须审慎。
昌平守王天成，头晕怕冷，身体倦怠，进食后稍有好转，劳累后症状加重，寸关脉浮大，这是脾肺虚弱，用补中益气汤加上蔓荆子而治愈。后来因为劳累，出现发热怕冷，胡言乱语无法入睡，进食后稍安，用补中益气汤而痊愈。
大尹祝支山，因为发怒导致头晕，体内筋脉拘挛，时而寒热往来，傍晚时分热势更重，这是肝火引起的筋脉拘挛和气虚引起的头晕，用八珍汤加上柴胡、山栀、牡丹皮，二十多剂后痊愈。
上舍顾桐石，在周上舍节家饮酒聚会时，问我道：“以前孟有涯、陈东谷都没有后代，娶妾之后得了疾病，都是头晕吐痰，都用苏合香丸治疗，只有孟有涯活了下来，为什么呢？”我说：“这两个病症都是因为肾虚不能纳气，所以头晕；不能制约水液，所以生痰涎。陈东谷专门攻逐痰饮、行气，孟有涯专门温补命门之火、补气，所以如此。”后来我应杭州人的邀请，顾桐石房事过度，也患上了前面的病症，有人用清气化痰丸治疗反而加重，顾说：“我的病是肾虚不能纳气归元。”医生不明白而让他死了，可惜啊！
有一个男子，平时喜好肥甘厚味，胸膈满闷，痰多。我说：“富贵之人，体内多有积热。”给予法制清气化痰丸而治愈。他见有效，制作好赠送他人，脾胃虚弱的人服用，没有不受损害的。
我的哥哥，体态相貌魁梧高大，唾痰非常多，脉象洪大有力，非常不耐疲劳，遇到风就头晕欲倒，口舌破裂，甚至红肿溃烂，误食少许姜蒜，口疮更加严重，服用八味丸及补中益气汤加附子一钱左右即愈。停药一个多月后，各种症状又发作，这是命门虚火不归元所致。
Liang Nongzhai, a Grand Secretary, suffered from shortness of breath with phlegm, red and difficult urination, and pain in the heels. The Chi pulse (Kidney pulse) was floating and large, but rough upon deep pressure. This indicated Kidney deficiency with Phlegm-Fluid retention. He was treated with Siwu Tang (Four Substance Decoction) to deliver Liuwei Wan (Six-Ingredient Pill with Rehmannia), and recovered in less than a month. Master Zhang Zhongjing stated: "In cases of Qi deficiency with Fluid retention, Shengqi Wan (Kidney Qi Pill) should be used to tonify and expel." This indeed enlightened later scholars and saved countless lives from premature death. Shengqi Wan is derived from Liuwei Wan.
Meng Youya, a Censor-in-Chief, presented with shortness of breath, dizziness due to phlegm. After taking acrid-aromatic agents, his phlegm increased, and he experienced urinary incontinence. His bilateral Chi pulses were floating and large, yet seemed absent upon deep pressure. I diagnosed this as the Kidneys' failure to grasp Qi and return it to its source, exacerbated by the drying nature of aromatic herbs. He was treated with the ingredients of Bawei Wan (Eight-Ingredient Pill with Rehmannia) for three doses and recovered.
Sun, a Censor-in-Chief, had a robust and plump physique, overworked his mind, and was prone to anger. His face appeared reddish, he had thirst and expectorated phlegm, occasionally suffered from dizziness of the head and eyes, or felt heat rising from the abdomen. The three pulses on the left hand were surging and forceful, while those on the right were surging but weak. I diagnosed this as a deficiency of the Three Yin meridities of the Foot. He was cured using Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) supplemented with Maimendong (Ophiopogon Root), Wuweizi (Schisandra Fruit), and Jiajian Bawei Wan (Modified Eight-Ingredient Pill). Such individuals, showing signs of premature aging, cannot tolerate cold or heat, nor withstand physical labor, and fall ill with seasonal changes. This is because when young, their Qi and Blood were still growing, yet they exhausted their minds; or their Essence and Blood were not fully developed, yet they indulged in sexual activity excessively. Thus, symptoms are hard to describe completely. It is essentially a deficiency of Essence and Qi; if the Source of Transformation is nourished, the illness will heal spontaneously. Similarly, disorders caused by improper diet, overwork, or emotional imbalance should be treated with the aforementioned methods. If invaded by the Six Excesses (pathogenic factors), leading to various symptoms, it is also due to internal deficiency of True Qi allowing external pathogens to attack. In such cases, protecting Stomach Qi is paramount. Since the Stomach is the root of the Five Zang organs, Huangbai (Phellodendron Bark) and Zhimu (Anemarrhena Rhizome) should not be used lightly, lest they further damage Stomach Qi.
Generally, miscellaneous diseases attributed to internal causes involve insufficiency of both Form-Qi and Disease-Qi, requiring tonification rather than purgation. Although Shanghan (Cold Damage) is attributed to external causes, one must distinguish between Exterior/Interior and Deficiency/Excess, treating with caution.
Wang Tiancheng, Prefect of Changping, suffered from dizziness, aversion to cold, and bodily fatigue. Symptoms improved slightly after eating and worsened with exertion. The Cun and Guan pulses were floating and large, indicating Spleen and Lung deficiency. He was cured using Buzhong Yiqi Tang plus Manjingzi (Vitex Seed). Later, due to overwork, he developed fever, aversion to cold, delirium, and insomnia, with slight relief after eating. He recovered using Buzhong Yiqi Tang.
Zhu Zhishan, a Magistrate's Assistant, suffered from dizziness due to anger, internal tendon contraction, alternating chills and fever, and severe heat in the late afternoon. This was diagnosed as Liver Fire causing tendon contraction and Qi deficiency causing dizziness. He was cured after more than twenty doses of Bazhen Tang (Eight-Treasure Decoction) supplemented with Chaihu (Bupleurum Root), Zhizi (Gardenia Fruit), and Mudanpi (Moutan Cortex).
Gu Tongshi, a Jinshi degree holder, asked me during a banquet at the residence of Zhou, a Jinshi degree holder: "Previously, Meng Youya and Chen Donggu had no heirs. After taking concubines, they fell ill with dizziness and expectoration. Both were treated with Suhexiang Wan (Styrax Pill), yet only Meng survived. Why?" I replied: "Both conditions resulted from Kidney deficiency failing to grasp Qi, causing dizziness, and failing to control Water, causing phlegm-saliva. Donggu was treated specifically to attack phlegm and move Qi, whereas Youya was treated specifically to tonify Fire and supplement Qi." Later, responding to an invitation from Hangzhou residents, Gu Tongshi engaged in excessive sexual activity and suffered from the same symptoms. Someone treated him with Qingqi Huatan Wan (Clear Qi and Resolve Phlegm Pill), which aggravated his condition. Gu said: "My illness is Kidney deficiency failing to grasp Qi and return to its source." The physician failed to understand, and he died. What a pity!
A man who usually consumed rich and greasy foods presented with chest fullness and abundant phlegm. I said: "Those who consume rich foods often have accumulated heat internally." He was cured with Fazhi Qingqi Huatan Wan (Processed Clear Qi and Resolve Phlegm Pill). Seeing its efficacy, he prepared it to give away. Those with Spleen-Stomach deficiency would inevitably suffer harm from it.
My elder brother had a grand and imposing physique, produced much saliva-phlegm, and had a surging and forceful pulse. He could not endure fatigue well. Upon exposure to wind, he felt dizzy and nearly fainted. His mouth and tongue cracked, sometimes becoming red and ulcerated. After accidentally consuming a small amount of ginger and garlic, his mouth ulcers worsened. He recovered after taking Bawei Wan and Buzhong Yiqi Tang with Qian (one qian) of Fuzi (Prepared Aconite Root). More than a month after stopping medication, all symptoms recurred. This was due to deficient Fire of the Mingmen (Gate of Life) failing to return to its source.