大司马王浚川，呕吐宿滞，脐腹痛甚，手足俱冷，脉微细，用附子理中丸一服益甚，脉浮大按
之而细，用参附汤一剂顿愈。
赵吏部文卿，患吐不止，吐出皆酸味，气口脉大于人迎二三倍，速予投剂。予曰∶此食郁上，宜
吐，不须用药，乃候。其吐清水无酸气，寸脉渐减，足脉渐复。翌早吐止，至午脉俱平复，勿
药自安。后抚陕右过苏，顾访倾盖清谈，浓过于昔，且念余在林下，频以言慰之。
一儒者，面色痿黄，胸膈不利，吞酸嗳腐，恪服理气化痰之药，大便不实，食少体倦，此脾胃
虚寒，用六君加炮姜、木香渐愈，兼用四神丸而元气复。此症若中气虚弱者，用人参理中
汤，或补中益气加木香、干姜，不应，送左金丸或越鞠丸。若中气虚寒，必加附子，或附子
理中汤，无有不愈。
一上舍，饮食失宜，胸腹膨胀，嗳气吞酸，以自知医，用二陈、枳实、黄连、苍术、黄柏之类
，前症益甚，更加足趾肿痛，趾缝出水，余用补中益气加茯苓、半夏，治之而愈。若腿足浮
肿，或 肿，寒热，呕吐，亦用前药。
儒者胡济之，场屋不利，胸膈膨闷，饮食无味，服枳术丸，不时作呕；用二陈、黄连、枳实，
痰涌气促；加紫苏、枳壳，喘嗽，腹胀；加浓朴、腹皮，小便不利；加槟榔、莪术，泄泻，腹痛
。悉属虚寒，用六君加姜、桂二剂，不应，更加附子一钱，二剂稍退，数剂十愈六七，乃以
八味丸痊愈。
一上舍，呕吐痰涎，发热作渴，胸膈痞满，或用清气化痰降火，前症益甚，痰涎自出。余曰∶
呕吐痰涎，胃气虚寒；发热作渴，胃不生津；胸膈痞满，脾气虚弱。须用参、 、归、术之
类，温补脾胃，生发阳气，诸病自退。彼不信，仍服前药，虚症悉至，复请治。余曰∶饮食
不入，吃逆不绝，泄泻，腹痛，手足逆冷，是谓五虚；烦热作渴，虚阳越于外也；脉洪大，脉
欲绝也；死期迫矣。或曰，若然，殒于日乎，夜乎?余曰∶脉洪大。当殒于昼。果然。
余母太宜人，年六十有五，己卯春二月，饮食后偶闻外言，忤意，呕吐酸水，内热作渴，饮食不
进，惟饮冷水，气口脉大而无伦，面色青赤，此胃中湿热郁火，投之以药，入口即吐，第三
日吐酸物，第七日吐酸黄水，十一日吐苦水，脉益洪大，仍喜冷水，以黄连一味煎汤，冷冻饮料
少许，至二十日加白术、白茯苓，至二十五日加陈皮，三十七日加当归、炙甘草，至六十日
，始进清米饮半盏，渐进薄粥，调理得痊。
一妇人，吞酸嗳腐，呕吐痰涎，面色纯白，或用二陈、黄连、枳实之类，加发热作渴，肚腹胀
满。余曰∶此脾胃亏损，末传寒中。不信，仍作火治，肢体肿胀如蛊，余以六君加附子、木
香治之，胃气渐醒，饮食渐进，虚火归经，又以补中益气加炮姜、木香、茯苓、半夏，兼服
痊愈。
一妇人，性沉静多虑，胸膈不利，饮食少思，腹胀吞酸，面色青黄，用疏利之剂。余曰∶此脾
虚痞满，当益胃气。不信，仍用之，胸膈果满，饮食愈少，余以调中益气加香砂、炮姜渐愈
，后以六君、芎、归、贝母、桔梗、炮姜而愈。
云，家母久患心腹疼痛，每作必胸满，呕吐，厥逆，面赤唇麻，咽干舌燥，寒热不时，而脉洪
大，众以痰火治之，屡止屡作，迨乙巳春，发热频甚，用药反剧，有朱存默氏，谓服寒凉药所致
，欲用参、术等剂，余疑痛无补法，乃请立斋先生以折中焉。先生诊而叹曰∶此寒凉损真之故
，内真寒而外假热也，且脉息弦洪而有怪状，乃脾气亏损，肝脉乘之而然。惟当温补其胃。
遂与补中益气加半夏、茯苓、吴茱、木香，一服而效。家母病发月余，竟夕不安，今熟寐彻
晓，洪脉顿敛，怪脉顿除，诸症释然。先生之见，盖有本欤！家母余龄，皆先生所赐。杏林
报德，没齿不忘。谨述此，乞附医案，谅有太史者采入仓公诸篇，以垂不朽，将使后者观省
焉。嘉靖乙巳春月吉日，陈湖眷生陆 顿首谨书。
一妇人，年三十余，忽不进饮食，日饮清茶三、五碗，并少用水果，三年余矣，经行每次过期而少
，余以为脾气郁结，用归脾加吴茱，不数剂而饮食如常。若人脾肾虚而不饮食，当以四神丸
治之。
一妇人，年逾二十，不进饮食二年矣，日饮清茶果品之类，面部微黄，浮肿，形体如常，仍能步
履，但体倦怠，肝脾二脉弦浮，按之微而结滞。余用六君加木香、吴茱，下痰积甚多，饮食
顿进，形体如瘦，卧床月余，仍服六君之类而安。
妇人患此，见《女科撮要》。
大司马王浚川，出现呕吐宿食停滞、脐腹部剧烈疼痛、手足冰冷、脉象微细的症状。服用附子理中丸后病情反而加重，此时脉象浮大但重按则细，改用参附汤一剂后立刻痊愈。
赵吏部文卿，患呕吐不止，吐出的东西都有酸味，气口脉比人迎脉大二三倍，急忙让我开药。我说：“这是食积郁结在上焦，应当催吐，不需要用药。”于是等待他自己呕吐。他吐出清水且没有酸气，寸脉逐渐减弱，足部脉象逐渐恢复。第二天早上呕吐停止，到中午脉象全部平复，不用药也自然安宁。后来他在陕西任职路过苏州时，特意拜访我，清谈甚欢，情谊比从前更深厚，并且挂念我在乡间隐居，经常用言语安慰我。
一位儒生，面色萎黄，胸膈部不适，吞酸嗳腐（打嗝有腐败食物气味），严格服用了理气化痰的药物，导致大便不成形，食欲减退，身体疲倦。这是脾胃虚寒，使用六君子汤加入炮姜、木香，逐渐好转，同时兼用四神丸，元气得以恢复。这种病症如果是中气虚弱者，用人参理中汤，或者补中益气汤加入木香、干姜；如果无效，送服左金丸或越鞠丸。如果是中气虚寒，必须加入附子，或者使用附子理中汤，没有不愈的。
一位上舍（国子监学生），饮食不当，导致胸腹部膨胀，嗳气吞酸。因为他自己懂医，使用了二陈汤、枳实、黄连、苍术、黄柏之类的药物，前面的症状更加严重，又加上足趾肿痛，趾缝渗水。我用补中益气汤加入茯苓、半夏治疗，治好了。如果是腿脚浮肿，或者伴有寒热、呕吐，也使用前面的药物。
儒生胡济之，科举考试不利，导致胸膈胀闷，饮食无味。服用枳术丸后，不时作呕；服用二陈汤、黄连、枳实后，痰多涌出，气促；加紫苏、枳壳后，出现喘咳，腹胀；加厚朴、腹皮后，小便不利；加槟榔、莪术后，出现泄泻，腹痛。这些都属于虚寒证，使用六君子汤加入生姜、肉桂两剂，未见明显效果，再加附子一钱，两剂后症状稍退，数剂后痊愈六七成，最后用八味丸彻底治愈。
一位上舍，呕吐痰涎，发热口渴，胸膈痞满。有人用清气化痰降火的药，前面的症状更加严重，痰涎自行流出。我说：“呕吐痰涎，是胃气虚寒；发热口渴，是胃不能生津液；胸膈痞满，是脾气虚弱。必须用人参、[此处原文缺字，通常指黄芪或白术等补气药]、当归、白术之类的药物，温补脾胃，生发阳气，各种疾病自然会消退。”他不相信，仍然服用前面的药，虚证全部出现，再次请求治疗。我说：“饮食无法进入，呃逆不停，泄泻，腹痛，手足逆冷，这叫做‘五虚’；烦热口渴，是虚阳外越；脉象洪大，但脉搏欲绝；死期迫近了。”有人说，既然如此，是白天死还是晚上死？我说：“脉象洪大，应当在白天死。”果然如此。
我的母亲太宜人，六十五岁，己卯年春二月，饭后偶然听到外面的闲言碎语，心里不愉快，呕吐酸水，内热口渴，饮食不进，只喝冷水，气口脉大而无条理，面色青赤。这是胃中湿热郁火，投药入口即吐。第三天吐酸物，第七天吐酸黄水，第十一天吐苦水，脉象更加洪大，仍然喜欢喝冷水。先用黄连一味煎汤，冷冻后少量饮用，到第二十天加白术、白茯苓，到第二十五天加陈皮，第三十七天加当归、炙甘草，到第六十天，才开始进清米饮半盏，逐渐进薄粥，调理得痊愈。
一位妇人，吞酸嗳腐，呕吐痰涎，面色纯白。有人用二陈汤、黄连、枳实之类的药，加上发热口渴，肚腹胀满。我说：“这是脾胃亏损，最终传变为寒中。”她不信，仍然当作火热证治疗，肢体肿胀如蛊病。我用六君子汤加入附子、木香治疗，胃气逐渐清醒，饮食逐渐进步，虚火归经，又以补中益气汤加入炮姜、木香、茯苓、半夏，兼服而痊愈。
一位妇人，性格沉静多虑，胸膈不适，饮食少思，腹胀吞酸，面色青黄。有人用疏利（疏通气机）的药剂。我说：“这是脾虚痞满，应当益胃气。”她不信，仍然使用疏利药，胸膈果然胀满，饮食更少。我用调中益气汤加入香附、砂仁、炮姜，逐渐好转，后来用六君子汤、川芎、当归、贝母、桔梗、炮姜而痊愈。
陆某说：家母长期患心腹疼痛，每次发作必定胸满，呕吐，四肢厥逆，面赤唇麻，咽干舌燥，寒热不时，脉象洪大。众人以痰火论治，屡次止住又屡次发作。等到乙巳年春天，发热频繁且严重，用药反而加剧。有位朱存默先生，说是服用寒凉药所致，想用参、术等药剂。我怀疑疼痛没有补法，于是请立斋先生（薛己号）来折中评判。先生诊察后感叹道：“这是寒凉药损伤真阳的缘故，内真寒而外假热，而且脉息弦洪且有怪状，这是脾气亏损，肝脉乘袭所致。只应当温补其胃。”于是给予补中益气汤加入半夏、茯苓、吴茱萸、木香，一服就见效。家母发病月余，整夜不安，现在熟睡直到天亮，洪脉顿时收敛，怪脉顿时消除，各种症状豁然解除。先生的见解，大概是有根据的吧！家母的余生，都是先生赐予的。杏林报德，至死不忘。谨述此事，乞求附上医案，希望有太史令那样的人采入仓公（淳于意）诸篇，以流传不朽，将使后人观看反省。嘉靖乙巳年春月吉日，陈湖眷生陆某顿首谨书。
一位妇人，三十多岁，忽然不进饮食，每天喝三四五碗清茶，并少吃水果，三年多了，月经每次过期且量少。我认为这是脾气郁结，用归脾汤加入吴茱萸，不到几剂药，饮食就恢复正常。如果人的脾肾虚而不进食，应当用四神丸治疗。
一位妇人，二十多岁，两年不进饮食，每天喝清茶果品之类，面部微黄，浮肿，形体如常，仍能步履，但身体倦怠，肝脾二脉弦浮，重按微而结滞。我用六君子汤加入木香、吴茱萸，排出很多痰积，饮食突然增加，形体消瘦，卧床月余，仍然服用六君子汤之类的药而安稳。
妇人患此症，见《女科撮要》。
Wang Junchuan, Grand Marshal, presented with vomiting of retained food stagnation, severe pain in the umbilical and abdominal region, coldness of both hands and feet, and a faint and fine pulse. After taking Fuzi Lizhong Wan (Aconite Pill to Regulate the Middle), his condition worsened; his pulse became floating and large but fine upon deep pressure. He was then prescribed Shenfu Tang (Ginseng and Aconite Decoction) for one dose and recovered immediately.
Zhao Wenqing, Clerk of the Ministry, suffered from incessant vomiting, expelling sour-tasting material. The Qi Kou pulse at the radial artery was two to three times larger than the Ren Ying pulse at the carotid artery. He urgently requested medication. I said, "This is food stagnation constrained in the upper jiao; it should be induced to vomit, no medicine is needed." We waited for him to vomit naturally. He expelled clear fluid without sour odor, the Cun pulse gradually diminished, and the pulses at the feet gradually recovered. By the next morning, vomiting ceased, and by noon, all pulses returned to normal, and he remained peaceful without further medication. Later, when he passed through Suzhou while serving in Shaanxi, he visited me, engaging in refreshing conversation with greater warmth than before. He often comforted me verbally, mindful of my retirement in the countryside.
A scholar presented with sallow complexion, discomfort in the chest and diaphragm, acid regurgitation, and belching of rotten odors. Having strictly taken Qi Li Hua Tan (Regulating Qi and Resolving Phlegm) medicines, he developed loose stools, poor appetite, and fatigue. This was Spleen and Stomach Deficiency Cold. He was treated with Liu Jun Zi Tang (Six Gentlemen Decoction) plus Pao Jiang (Prepared Ginger) and Mu Xiang (Aucklandia Root), gradually improving, while simultaneously taking Si Shen Wan (Four Spirits Pill) to restore Yuan Qi. For such cases where Middle Qi is deficient, Ren Shen Li Zhong Tang (Ginseng Pill to Regulate the Middle) or Bu Zhong Yi Qi Tang (Pill to Supplement the Middle and Enrich the Qi) plus Mu Xiang and Gan Jiang (Dried Ginger) may be used. If ineffective, Zuo Jin Wan (Left Metal Pill) or Yue Ju Wan (Pill to Resolve Depression) may be sent. If there is Middle Qi Deficiency Cold, Fu Zi (Aconite Root) must be added, or Fu Zi Li Zhong Tang (Aconite Pill to Regulate the Middle) used, which invariably leads to recovery.
A Guozijian student (Shangshe), due to improper diet, developed distension in the chest and abdomen, belching, and acid regurgitation. Self-prescribing Er Chen Tang (Two-Cured Decoction), Zhi Shi (Immature Bitter Orange), Huang Lian (Coptis Rhizome), Cang Zhu (Atractylodes Rhizome), and Huang Bai (Phellodendron Bark), his previous symptoms worsened, and he additionally developed swelling and pain in the toes with exudate between the toe webs. I treated him with Bu Zhong Yi Qi Tang plus Fu Ling (Poria) and Ban Xia (Pinellia Tuber), resulting in recovery. For edema of the legs and feet, or if accompanied by aversion to cold and fever, vomiting, the same formula is used.
Hu Zhizhi, a scholar, after failing the imperial examinations, developed fullness and oppression in the chest and diaphragm, and loss of taste in food. Taking Zhi Zhu Wan (Immature Bitter Orange and Atractylodes Macrocephala Pill) caused intermittent vomiting; taking Er Chen Tang, Huang Lian, and Zhi Shi caused phlegm surging and shortness of breath; adding Zi Su (Perilla Leaf) and Zhi Ke (Bitter Orange Peel) led to wheezing, coughing, and abdominal distension; adding Hou Po (Magnolia Bark) and Fu Pi (Areca Peel) resulted in difficult urination; adding Bing Lang (Areca Seed) and E Zhu (Curcuma Rhizome) caused diarrhea and abdominal pain. All belonged to Deficiency Cold. Six Jun Zi Tang plus Sheng Jiang (Fresh Ginger) and Rou Gui (Cinnamon Bark) was given for two doses with little effect. An additional 1 qian of Fu Zi was added; after two doses, symptoms slightly receded, and after several doses, six or seven parts out of ten improved. Finally, Ba Wei Wan (Eight-Ingredient Pill) cured him completely.
Another Shangshe presented with vomiting of phlegm-saliva, fever, thirst, and chest diaphragm stuffiness. Using Qing Qi Hua Tan (Clearing Qi and Transforming Phlegm) and Fire-Descending medicines worsened the previous symptoms, leading to spontaneous discharge of phlegm-saliva. I said, "Vomiting phlegm-saliva indicates Stomach Qi Deficiency Cold; fever and thirst indicate the Stomach's inability to generate fluids; chest diaphragm stuffiness indicates Spleen Qi deficiency. One must use Ren Shen (Ginseng Root), [missing character, likely Huang Qi or Bai Zhu], Dang Gui (Angelica Sinensis), and Bai Zhu (Atractylodes Macrocephala Rhizome) to warm and tonify the Spleen and Stomach, generate Yang Qi, and let all diseases retreat." He did not believe this, continued taking the previous medicines, and all deficiency symptoms appeared. He requested treatment again. I said, "Inability to eat, incessant hiccups, diarrhea, abdominal pain, and cold extremities constitute the 'Five Deficiencies'; irritability, heat, and thirst indicate Floating Yang escaping outward; a flooding pulse that feels like it is about to vanish indicates imminent death." Someone asked, "If so, will he die during the day or night?" I said, "With a flooding pulse, he will die during the day." It proved true.
My mother, Tai Yi Ren, aged sixty-five, in February of the spring of Ji Mao year, after hearing external gossip post-prandially, felt offended. She vomited sour water, experienced internal heat and thirst, refused solid food, drank only cold water, had an unruly large Qi Kou pulse, and a bluish-red face. This was Damp-Heat and Depressed Fire in the Stomach. Medications taken orally were immediately vomited up. On the third day, she vomited sour matter; on the seventh day, sour yellow water; on the eleventh day, bitter water. The pulse became increasingly flooding, and she still preferred cold water. Initially, a decoction of Huang Lian alone was prepared, chilled, and given in small amounts. By the twentieth day, Bai Zhu and Bai Fu Ling (White Poria) were added. By the twenty-fifth day, Chen Pi (Tangerine Peel) was added. By the thirty-seventh day, Dang Gui and Zhi Gan Cao (Honey-fried Licorice Root) were added. By the sixtieth day, she could take half a cup of clear rice drink, gradually advancing to thin congee, and recovered through regulation.
A woman presented with acid regurgitation, belching of rotten odors, vomiting of phlegm-saliva, and a pure white complexion. Using Er Chen Tang, Huang Lian, and Zhi Shi caused fever, thirst, and abdominal distension. I said, "This is Spleen and Stomach damage, ultimately transmitting to Cold in the Middle." Disbelieving, she continued treating it as Fire, resulting in limb swelling resembling Gu disease (abdominal tumor/ascites). I treated her with Liu Jun Zi Tang plus Fu Zi and Mu Xiang. Her Stomach Qi gradually awakened, food intake increased, and the Deficient Fire returned to its channel. Subsequently, Bu Zhong Yi Qi Tang plus Pao Jiang, Mu Xiang, Fu Ling, and Ban Xia was taken concurrently, leading to complete recovery.
Another woman, quiet and prone to worry, presented with chest diaphragm discomfort, poor appetite, abdominal distension, acid regurgitation, and a bluish-yellow face. Others used Shu Li (Ventilating and Draining) agents. I said, "This is Spleen Deficiency with Fullness; one must benefit Stomach Qi." Disbelieving, she continued using them. Her chest diaphragm indeed became full, and food intake decreased further. I treated her with Tiao Zhong Yi Qi Tang plus Xiang Fu (Cyperus Rhizome), Sha Ren (Amomum Fruit), and Pao Jiang, gradually improving. Later, she recovered with Liu Jun Zi Tang plus Chuan Xiong (Ligusticum Rhizome), Dang Gui, Bei Mu (Fritillaria Bulb), Jie Geng (Platycodon Root), and Pao Jiang.
Lu stated: My mother has long suffered from heart and abdominal pain. Each attack was accompanied by chest fullness, vomiting,厥逆 (Jue Ni - reversal cold/extremity coldness), red face, numb lips, dry throat and tongue, intermittent chills and fever, and a flooding pulse. The masses treated it as Phlegm-Fire; it stopped repeatedly but recurred. In the spring of Yisi year, fever became frequent and severe, and medications aggravated it. Mr. Zhu Cunmo claimed it was caused by cold-cooling medicines and wished to use Ren Shen and Bai Zhu formulas. I doubted that pain admits of tonification, so I invited Mr. Lizhai (Xue Ji) to judge. Upon diagnosis, the Master sighed, "This is due to cold-cooling medicines damaging True Yang; Interior True Cold with Exterior False Heat. Moreover, the pulse is wiry and flooding with abnormal characteristics, indicating Spleen Qi damage with Liver Pulse overacting. One must only warm and tonify the Stomach." He prescribed Bu Zhong Yi Qi Tang plus Ban Xia, Fu Ling, Wu Zhu Yu (Evodia Fruit), and Mu Xiang. One dose showed efficacy. My mother had been restless all night for over a month since the onset; now she sleeps soundly until dawn, the flooding pulse instantly收敛 (contracts), abnormal pulses vanish, and all symptoms are resolved. The Master's insight must have a foundation! My mother's remaining years are bestowed by the Master. Gratitude for the medical virtue shall never be forgotten till death. I respectfully record this, begging that it be attached as a medical case and collected by historians into the chapters of Cang Gong (Chunyu Yi), to remain immortal, allowing future generations to observe and reflect. On an auspicious day in the spring of Yisi, Jiajing era, Lu, a devoted son from Chen Lake, bowed and wrote.
A woman, over thirty years old, suddenly lost her appetite, drinking three to five bowls of clear tea daily and eating little fruit for over three years. Her menstruation was always delayed and scanty. I considered this Spleen Qi depression and used Gui Pi Tang (Restore the Spleen Decoction) plus Wu Zhu Yu. Within a few doses, her diet returned to normal. If a person suffers from Spleen and Kidney Deficiency leading to anorexia, Si Shen Wan should be used.
A woman, over twenty years old, had not eaten properly for two years, consuming only clear tea and fruits daily. Her face was slightly yellow and puffy, her body shape normal, able to walk, but she felt fatigued. The Liver and Spleen pulses were wiry and floating, faint and stagnant upon deep pressure. I used Liu Jun Zi Tang plus Mu Xiang and Wu Zhu Yu. She discharged much phlegm accumulation, her appetite suddenly improved, though she became emaciated and bedridden for over a month. Continued administration of Liu Jun Zi Tang-like formulas brought stability.
For women suffering from this condition, see *Nv Ke Cuo Yao* (Essentials of Gynecology).