进士王汝和，因劳役失于调养，忽然昏愦，此元气虚火妄动，挟痰而作，急令灌童便，神思渐
爽。更用参、 各五钱，芎、归各三钱，玄参、柴胡、山栀、炙草各一钱，服之稍定。察其
形倦甚，又以十全大补汤加五味、麦门治之而安。凡人元气素弱，或因起居失宜，或因饮食
劳倦，或因用心太过，致遗精白浊，自汗盗汗；或内热、晡热，潮热发热；或口干作渴，喉
痛舌裂；或胸乳膨胀，胁肋作痛；或头颈肘痛，眩晕目花；或心神不宁，寤而不寐；或小便
赤涩，茎中作痛；或便溺余滴，脐腹阴冷；或形容不充，肢体畏寒；或鼻气急促；或更有一
切热症；皆是无根虚火，但服前汤固其根本，诸症自息，若攻其风热则误矣。
光禄高署丞，脾胃素虚，因饮食劳倦，腹痛胸痞，误用大黄等药下之，谵语烦躁，头痛喘汗吐
泻频频，时或昏愦，脉大而无伦次，用六君子加炮姜四剂而安。但倦怠少食，口干发热，六
脉浮数。欲用泻火之药。余曰∶不时发热，是无火也；脉浮大，是血虚也；脉虚浮，是气虚也。此
因胃虚五脏亏损，虚症发见。服补胃之剂，诸症悉退。
大尹徐克明，因饮食失宜，日晡发热，口干体倦，小便赤涩，两腿酸痛，余用补中益气汤治之
。彼知医自用四物、黄柏、知母之剂，反头眩目赤、耳鸣唇燥，寒热痰涌，大便热痛，小便
赤涩；又用四物、芩、连、枳实之类，胸膈痞满，饮食少思，汗出如水；再用二陈、芩、连
、黄柏、知母、麦门、五味，言语谵妄，两手举拂，屡治反甚；复求余，用参、 各五钱，
归、术各三钱，远志、茯神、酸枣仁、炙草各一钱，服之熟睡良久，四剂稍安；又用八珍汤
调补而愈。
夫阴虚乃脾虚也，脾为至阴，因脾虚而致前症，盖脾禀于胃，故用甘温之剂以生
发胃中元气，而除大热。胡乃反用苦寒，复伤脾血耶。若前症果属肾经阴虚，亦因肾经阳虚
不能生阴耳。经云∶无阳则阴无以生，无阴则阳无以化。又云∶虚则补其母，当用补中益气
、六味地黄以补其母，尤不宜用苦寒之药。世以脾虚误为肾虚，辄用黄柏、知母之类，反伤
胃中生气，害人多矣。
大凡足三阴虚，多因饮食劳役，以致肾不能生肝，肝不能生火而害脾
土，不能滋化，但补脾土，则金旺水生，木得平而自相生矣。
一男子，每遇劳役，食少胸痞，发热头痛，吐痰作渴，脉浮大。余曰∶此脾胃血虚病也，脾属
土，为至阴而生血，故曰阴虚。彼不信，服二陈、黄连、枳实、浓朴之类，诸症益甚；又服
四物、黄柏、知母、麦门，更腹痛作呕，脉洪数而无伦次。余先用六君加炮姜，痛呕渐愈；
又用补中益气痊愈。
秀才刘贯卿，劳役失宜，饮食失节，肢体倦怠，发热作渴，头痛恶寒，误用人参败毒散，痰喘
昏愦，扬手掷足，胸间发斑，如蚊所呐。余用补中益气加姜、桂、麦门、五味，补之而愈。
黄武选，饮食劳倦，发热恶寒，或用解表之药益甚，再剂昏愦，胸发黑斑。脉洪数而无力，余
欲用补中益气之剂，不从而殁。
一儒者，素勤苦，因饮食失节，大便下血，或赤或黯，半载之后，非便血则盗汗，非恶寒则发
热，血汗二药用之无效，六脉浮大，心脾则涩，此思伤心脾，不能摄血归源。然血即汗，汗
即血。其色赤黯，便血盗汗，皆火之升降微甚耳；恶寒发热，气血俱虚也。乃午前用
归脾加麦门、五味以补心脾之血，收耗散之液，不两
癸卯春人日，余在下堡顾氏会间，有儒者许梅村云∶余亲马生者，发热烦渴，时或头痛，昨
服发散药，反加喘急，腹痛，其汗如水，昼夜谵语。余意此劳伤元气，误汗所致，其腹必喜手
按。许往询之，果然。遂与十全大补加附子一钱，服之熟睡，唤而不醒，举家惊惶；及觉，诸
症顿退，再剂而痊。
凡人饮食劳役起居失宜，见一切火症，悉属内真寒而外假热，故肚腹喜
暖，口畏冷物，此乃形气病气俱属不足，法当纯补元气为善。
一儒者，日晡两目紧涩不能瞻视，此元气下陷，用补中益气倍加参、 数剂痊愈。
一男子，患症同前，服黄柏、知母之类，目疾益甚，更加便血，此脾气虚不能统血，肝气虚不
能藏血，用补中益气、六味地黄以补肝脾生肾水，诸症渐愈。
一男子，饮食劳倦，而发寒热，右手麻木，或误以为疔毒，敷服皆寒凉败毒，肿胀重坠，面色
痿黄，肢体倦怠，六脉浮大，按之如无，此脾胃之气虚也。询之果是销银匠，因热手入水梅
银寒凝隧道，前药益伤元气故耳。遂用补中益气及温和之药煎渍汤手而愈。
一儒者，修左足伤其大指甲少许，不见血，不作痛，形体如故。后因饮食劳倦，足重坠微肿痛
，或昼睡或夜寐，其足如故，误服败毒之剂，寒热肿痛。盖脾起于大指，此是脾气虚弱下
陷，用十全大补汤而愈。
余素性爱坐观书，久则倦怠，必服补中益气加麦门、五味、酒炒黑黄柏少许，方觉精神清妥
，否则夜间少寐，足内酸热，若再良久不寐，腿内亦然，且兼腿内筋似有抽缩意，致两腿左
右频移，展转不安，必至倦极方寐，此劳伤元气，阴火乘虚下注。
丁酉五十一岁，齿缝中有
如物塞，作胀不安，甚则口舌有疮然，日晡益甚，若睡良久，或服前药始安。至辛丑时五
十有五，昼间齿缝中作胀，服补中益气一剂，夜间得寐。至壬寅有内艰之变，日间虽服前剂
，夜间齿缝亦胀，每至午前诸齿并肢体方得稍健，午后仍胀，观此，可知血气日衰，治法
不同。
进士王汝和，因为过度劳累且缺乏调养，突然昏倒不省人事。这是元气虚弱导致虚火妄动，挟带痰浊上扰所致。紧急灌服童便（儿童尿液），神志逐渐清醒。随后使用人参、黄芪各五钱，川芎、当归各三钱，玄参、柴胡、山栀、炙甘草各一钱，服用后症状稍见稳定。观察他形体极度疲倦，又用十全大补汤加五味子、麦门冬治疗而痊愈。大凡人体元气素来虚弱，或因起居作息不当，或因饮食劳倦损伤，或因思虑过度，导致遗精、白浊，自汗或盗汗；或出现内热、傍晚发热、潮热或发热；或口干口渴，咽喉疼痛、舌体裂开；或胸部乳房胀满，胁肋部疼痛；或头颈肘部疼痛，头晕眼花；或心神不宁，醒着却无法入睡；或小便赤红涩痛，尿道中疼痛；或排尿后余沥不尽，脐腹部及阴部寒冷；或形体消瘦，肢体畏寒；或鼻息急促；或出现其他一切热症；这些都是无根之虚火，只需服用前面的方剂以固护根本，各种症状自然平息，如果误用祛风清热之法则是错误的。
光禄寺高署丞，脾胃素来虚弱，因饮食劳倦导致腹痛胸膈痞闷，误用大黄等泻下药攻下，出现谵语烦躁，头痛气喘出汗，呕吐腹泻频繁，时而昏倒不省人事，脉象宏大而无条理。使用六君子汤加炮姜四剂后病情安定。但仍有倦怠少食，口干发热，六脉浮数。想要使用泻火的药物。我说：不时发热，是阴虚火旺而非实火；脉象浮大，是血虚的表现；脉象虚浮，是气虚的表现。这是因为胃气虚弱导致五脏亏损，虚证显现。服用补益胃气的药剂后，各种症状全部消退。
大尹徐克明，因饮食失宜，傍晚发热，口干身体疲倦，小便赤红涩痛，双腿酸痛。我使用补中益气汤治疗他。他自己懂医，擅自服用四物汤、黄柏、知母的药剂，反而出现头晕目赤、耳鸣唇燥，寒热交替痰多涌出，大便热痛，小便赤红涩痛；又服用四物汤、黄芩、黄连、枳实之类的药物，导致胸膈痞满，饮食减少，出汗如水；再服用二陈汤、黄芩、黄连、黄柏、知母、麦门冬、五味子，出现言语错乱狂妄，双手抖动挥舞，多次治疗病情反而加重；再次求诊于我，我用人参、黄芪各五钱，当归、白术各三钱，远志、茯神、酸枣仁、炙甘草各一钱，服用后熟睡良久，四剂后稍见安宁；又用八珍汤调理补益而痊愈。
所谓阴虚，其实是脾虚。脾为至阴之脏，因脾虚而导致上述病症，因为脾禀受于胃，所以使用甘温的药剂以生发胃中的元气，从而消除大热。为何反而使用苦寒药物，再次损伤脾血呢？如果前述病症确实属于肾经阴虚，也是因为肾经阳虚不能生阴的缘故。经文说：没有阳则阴无法生成，没有阴则阳无法化生。又说：虚证应当补其母脏，应当使用补中益气汤、六味地黄丸来补益其母脏，尤其不宜使用苦寒的药物。世人将脾虚误认为是肾虚，辄次使用黄柏、知母之类的药物，反而损伤胃中的生气，害死的人太多了。
大凡足三阴经（肝、脾、肾）虚损，多因饮食劳役，导致肾不能生肝，肝不能生心火而伤害脾土，不能滋养化源。只要补益脾土，则肺金旺盛而生肾水，肝木得以平和而自然相生。
有一名男子，每次遇到劳累，食欲减退胸膈痞闷，发热头痛，吐痰口渴，脉象浮大。我说：这是脾胃血虚的病证，脾属土，为至阴之脏而生血，所以称为阴虚。他不相信，服用二陈汤、黄连、枳实、厚朴之类的药物，各种症状更加严重；又服用四物汤、黄柏、知母、麦门冬，更出现腹痛作呕，脉象洪大而无条理。我先用六君子汤加炮姜，腹痛呕吐逐渐痊愈；又用补中益气汤彻底治愈。
秀才刘贯卿，因劳累失当，饮食不节制，肢体倦怠，发热口渴，头痛恶寒，误用人参败毒散，导致痰喘昏倒，扬手掷足，胸部发出斑疹，如同被蚊虫叮咬一般。我用补中益气汤加生姜、肉桂、麦门冬、五味子，通过补益而痊愈。
黄武选，因饮食劳倦，发热恶寒，有人使用解表药物使病情加重，两剂后昏倒不省人事，胸部发出黑斑。脉象洪数但无力，我想用补中益气汤治疗，患者未听从而死亡。
有一位读书人，平时勤劳刻苦，因饮食不节制，大便下血，血色或红或暗。半年之后，不是便血就是盗汗，不是恶寒就是发热。止血止汗的药物使用无效，六脉浮大，心脾脉涩。这是思虑过度损伤心脾，不能摄血归源。然而血即汗，汗即血。血色赤暗，便血盗汗，都是火邪升降强弱不同的表现；恶寒发热，是气血俱虚。于是午前使用归脾汤加麦门冬、五味子以补益心脾之血，收敛耗散的津液。
癸卯年春正月初一，我在下堡顾氏聚会期间，有读书人许梅村说：我的亲戚马生，发热烦渴，时而头痛，昨天服用发散药物，反而加重气喘急促，腹痛，出汗如水，昼夜说胡话。我认为这是劳伤元气，误用发汗法所致，他的腹部一定喜欢用手按压。许梅村去询问，果然如此。于是给予十全大补汤加附子一钱，服用后熟睡，叫醒也不醒，全家惊慌；等到醒来，各种症状顿时消退，再服两剂而痊愈。
大凡人饮食劳倦起居失当，出现一切火症，都属于内真寒而外假热，所以腹部喜欢温暖，口畏冷物，这是形气和病气都属不足，治法应当纯补元气为好。
有一位读书人，傍晚时两眼紧绷干涩不能视物，这是元气下陷，用补中益气汤加倍人参、黄芪剂量，数剂后痊愈。
有一名男子，患病情况与前相同，服用黄柏、知母之类的药物，眼疾更加严重，更增加便血，这是脾气虚不能统血，肝气虚不能藏血，用补中益气汤、六味地黄丸以补肝脾以生肾水，各种症状逐渐痊愈。
有一名男子，因饮食劳倦，出现寒热，右手麻木，有人误以为是疔毒，敷药内服皆为寒凉败毒之药，导致肿胀沉重下垂，面色萎黄，肢体倦怠，六脉浮大，重按如无，这是脾胃之气虚。询问得知果然是销银匠，因热手入水熔银，寒气凝滞经络，之前的药物进一步损伤元气所致。于是用补中益气汤及温和的药物煎汤浸手而痊愈。
有一位读书人，修剪左脚指甲时伤及大脚趾甲少许，不见血，不疼痛，形体如常。后来因饮食劳倦，脚部沉重微肿疼痛，有时白天睡觉有时夜间睡眠，脚部症状依旧，误服败毒之剂，出现寒热肿痛。因为脾经起于大趾，这是脾气虚弱下陷，用十全大补汤而痊愈。
我平素喜欢坐着看书，久了就会倦怠，必须服用补中益气汤加麦门冬、五味子、酒炒黑黄柏少许，才觉得精神清爽妥当，否则夜间睡眠少，足内侧酸热，如果再长时间不睡觉，小腿内侧也是如此，并且兼有小腿内侧筋脉似有抽缩之意，导致双腿左右频繁移动，辗转不安，必须到极度疲倦才能入睡，这是劳伤元气，阴火乘虚下注。
丁酉年五十一岁时，齿缝中有异物堵塞感，胀痛不安，严重时口舌生疮，傍晚时加重，如果睡很久，或者服用前面的药物才安定。到了辛丑年五十五岁，白天齿缝中胀痛，服用补中益气汤一剂，夜间得以安睡。到了壬寅年遭遇父母丧事，白天虽然服用前面的药剂，夜间齿缝也胀痛，每到午前诸齿及肢体才稍微健康，午后仍然胀痛，看这些情况，可知血气日渐衰退，治疗方法不同。
Wang Ruhe, a Jinshi degree holder, suddenly fell into unconsciousness due to overexertion and lack of proper recuperation. This was caused by deficiency of Yuan Qi (Original Qi) leading to reckless movement of deficient fire, accompanied by phlegm. He was urgently administered with Tongbian (child's urine), after which his mental clarity gradually returned. Subsequently, he was prescribed Ren Shen (Ginseng Radix) and Huang Qi (Astragali Radix) each 5 qian, Xiong (Chuanxiong Rhizome) and Gui (Danggui Radix) each 3 qian, Xuan Shen (Scrophulariae Radix), Chai Hu (Bupleuri Radix), Shan Zhi (Gardeniae Fructus), and Zhi Cao (Prepared Licorice Root) each 1 qian. After ingestion, his condition stabilized slightly. Observing his extreme physical fatigue, he was further treated with Shiquan Dabu Tang (Decoction for Complete Great Tonification) added with Wu Wei Zi (Schisandrae Fructus) and Mai Men Dong (Ophiopogonis Tuber), resulting in recovery. Generally, when an individual has constitutionally weak Yuan Qi, it may be due to improper daily routine, dietary and physical overexertion, or excessive mental labor, leading to spermatorrhea and leukorrhea, spontaneous sweating or night sweats; or internal heat, afternoon fever, tidal fever, or general fever; or dry mouth and thirst, sore throat and cracked tongue; or distension and swelling of the chest and breasts, pain in the hypochondrium; or pain in the head, neck, and elbows, dizziness and blurred vision; or restlessness of the heart-mind, inability to sleep while awake; or dark and scanty urination with pain in the urethra; or dribbling after urination with coldness in the umbilical and abdominal regions and genitals; or emaciation and aversion to cold in the limbs; or rapid nasal breathing; or any other heat symptoms. These are all rootless deficient fires. By taking the aforementioned decoction to consolidate the root, all symptoms will naturally subside. If one mistakenly attacks the wind-heat, it would be an error.
Gao Shucheng, an official at the Guanglu Temple, had constitutionally weak Spleen and Stomach. Due to dietary and physical overexertion, he suffered from abdominal pain and chest fullness. Mistakenly using Da Huang (Rhei Radix et Rhizoma) and other purgatives led to delirium, irritability, headache, panting, sweating, frequent vomiting and diarrhea, and occasional unconsciousness. His pulse was large and disordered. He was treated with Liujunzi Tang (Six Gentlemen Decoction) added with Pao Jiang (Prepared Ginger) for four doses, after which he stabilized. However, he remained fatigued with poor appetite, dry mouth, and fever, with floating and rapid pulses in all six positions. There was a desire to use fire-draining herbs. I said: Intermittent fever indicates deficient fire rather than excess heat; a floating and large pulse indicates Blood deficiency; a void and floating pulse indicates Qi deficiency. This is because Stomach Qi deficiency leads to loss of the Five Zang organs, manifesting as deficiency syndromes. After taking tonics for the Stomach, all symptoms receded.
Xu Keming, a Dayin official, suffered from evening fever, dry mouth, body fatigue, dark and scanty urination, and soreness and pain in both legs due to improper diet. I treated him with Buzhong Yiqi Tang (Decoction for Boosting the Middle and Augmenting the Qi). Being knowledgeable in medicine, he self-prescribed Siwu Tang (Four Substance Decoction) combined with Huang Bo (Phellodendri Cortex) and Zhi Mu (Anemarrhenae Rhizoma). Instead, he developed dizziness, red eyes, tinnitus, dry lips, alternating chills and fever with abundant phlegm, painful hot stools, and dark scanty urination. He then took Siwu Tang combined with Huang Qin (Scutellariae Radix), Lian Zi (Coptidis Rhizoma), and Zhi Shi (Aurantii Fructus), leading to chest and diaphragm fullness, reduced appetite, and profuse sweating like water. He subsequently used Erchen Tang (Two Aged Herbs Decoction) with Huang Qin, Lian Zi, Huang Bo, Zhi Mu, Mai Men Dong, and Wu Wei Zi, resulting in delirious speech and shaking of the hands. The condition worsened with repeated treatments. Seeking my help again, I prescribed Ren Shen and Huang Qi each 5 qian, Gui and Bai Zhu (Atractylodis Macrocephalae Rhizoma) each 3 qian, Yuan Zhi (Polygalae Radix), Fu Shen (Poria with Hostwood), Suan Zao Ren (Ziziphi Spinosae Semen), and Zhi Cao each 1 qian. After taking it, he slept soundly for a long time, and after four doses, he felt somewhat relieved. He was then regulated and tonified with Bazhen Tang (Eight Treasures Decoction) until cured.
The term "Yin deficiency" actually refers to Spleen deficiency. The Spleen is the organ of supreme Yin. When previous symptoms arise from Spleen deficiency, it is because the Spleen derives from the Stomach. Therefore, sweet-warm agents should be used to generate Yuan Qi in the Stomach and eliminate great heat. Why use bitter-cold herbs to injure Spleen Blood? If the aforementioned symptoms indeed belonged to Kidney Meridian Yin deficiency, it would also be because Kidney Yang deficiency fails to generate Yin. The Classics state: Without Yang, Yin cannot be generated; without Yin, Yang cannot transform. It also states: For deficiency, tonify its mother. One should use Buzhong Yiqi Tang and Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) to tonify the mother. It is especially inappropriate to use bitter-cold drugs. People often mistake Spleen deficiency for Kidney deficiency and indiscriminately use Huang Bo and Zhi Mu, thereby injuring the vital Qi of the Stomach and harming many people.
Generally, deficiency of the Three Yin meridians of the foot (Liver, Spleen, Kidney) is often caused by dietary and physical overexertion, leading to the Kidney failing to generate the Liver, and the Liver failing to generate Heart Fire, thereby damaging Spleen Earth and failing to nourish and transform. If one only tonifies Spleen Earth, Lung Metal becomes prosperous and generates Kidney Water, Liver Wood becomes balanced and naturally generates itself.
A certain man, upon exertion, experienced reduced appetite, chest fullness, fever, headache, expectoration, and thirst, with a floating and large pulse. I said: This is a disease of Stomach and Spleen Blood deficiency. The Spleen belongs to Earth and is the organ of supreme Yin that generates Blood, hence it is called Yin deficiency. He did not believe this and took Erchen Tang, Huang Lian (Coptidis Rhizoma), Zhi Shi, and Hou Po (Magnoliae Officinalis Cortex), causing symptoms to worsen. He then took Siwu Tang, Huang Bo, Zhi Mu, and Mai Men Dong, leading to abdominal pain and vomiting, with a flooding and rapid pulse lacking order. I first used Liujunzi Tang added with Pao Jiang, alleviating pain and vomiting. Then, Buzhong Yiqi Tang completely cured him.
Liu Guanqing, a Xiucai degree holder, suffered from improper exertion and irregular diet, leading to limb fatigue, fever, thirst, headache, and aversion to cold. Mistakenly using Renshen Baidu San (Ginseng Detoxifying Powder) caused phlegm-panting, unconsciousness, flailing of arms and legs, and macules on the chest resembling mosquito bites. I treated him with Buzhong Yiqi Tang added with Sheng Jiang (Fresh Ginger), Rou Gui (Cinnamomi Cortex), Mai Men Dong, and Wu Wei Zi, curing him through tonification.
Huang Wuxuan, suffering from fever and aversion to cold due to dietary and physical overexertion, had his condition worsened by someone using exterior-releasing medicines. After two doses, he became unconscious with black macules on his chest. His pulse was flooding and rapid but forceless. I intended to use Buzhong Yiqi Tang, but he refused and died.
A scholar, accustomed to hard work, suffered from hematochezia (blood in stool) of either bright red or dark color due to irregular diet. Half a year later, he alternated between hematochezia and night sweats, or chills and fever. Hemostatic and antiperspirant drugs were ineffective. All six pulses were floating and large, while the Heart and Spleen pulses were choppy. This was due to excessive worry injuring the Heart and Spleen, failing to control blood and return it to its source. Blood is sweat, and sweat is blood. The red and dark colors of blood and sweat, along with hematochezia and night sweats, reflect the varying degrees of ascent and descent of Fire. Chills and fever indicate dual deficiency of Qi and Blood. Therefore, during the morning, Guipi Tang (Restore the Spleen Decoction) added with Mai Men Dong and Wu Wei Zi was used to tonify Heart and Spleen Blood and collect dissipating fluids.
On the first day of spring in the Gui Mao year, at a gathering at the Gu family residence in Xiabao, a scholar named Xu Meicun said: My relative, Master Ma, suffered from fever, irritability, and thirst, with occasional headaches. Yesterday, after taking dispersing medicines, his asthma and urgency worsened, accompanied by abdominal pain and profuse sweating like water, and delirium day and night. I suspected this was due to injury of Yuan Qi from exertion and mistaken sweating, and that his abdomen would prefer pressure. Xu went to inquire, and it was confirmed. Thus, Shiquan Dabu Tang added with Fu Zi (Aconiti Lateralis Radix Praeparata) 1 qian was given. After taking it, he slept soundly and could not be awakened, causing panic in the family. Upon waking, all symptoms instantly receded, and after two more doses, he recovered.
For ordinary people, improper diet, exertion, and daily routine leading to all kinds of fire symptoms belong to true cold inside and false heat outside. Therefore, the abdomen prefers warmth, and the mouth fears cold substances. This indicates insufficiency in both form/Qi and pathology/Qi. The method should be purely tonifying Yuan Qi.
A scholar suffered from tightness and dryness of both eyes in the late afternoon, unable to see clearly. This was sinking of Yuan Qi. He was treated with Buzhong Yiqi Tang with doubled amounts of Ren Shen and Huang Qi, recovering after several doses.
A man suffered from the same symptoms as above. After taking Huang Bo and Zhi Mu, his eye disease worsened, and he additionally suffered from hematochezia. This was because Spleen Qi deficiency failed to control blood, and Liver Qi deficiency failed to store blood. He was treated with Buzhong Yiqi Tang and Liuwei Dihuang Wan to tonify Liver and Spleen to generate Kidney Water, and all symptoms gradually improved.
A man suffered from chills and fever due to dietary and physical overexertion, with numbness in the right hand. Mistakenly diagnosed as Ding Du (carbuncle/toxic boil), he applied and ingested cold-cooling detoxifying agents, leading to swelling, heaviness, sallow complexion, limb fatigue, and floating, large pulses that vanished upon deep pressure. This was deficiency of Spleen and Stomach Qi. Inquiry revealed he was a silver refiner who immersed hot hands in water for melting silver, allowing cold to congeal in the collaterals, and previous medicines further injured Yuan Qi. He was cured with Buzhong Yiqi Tang and warm-tonifying medicinal baths for his hands.
A scholar accidentally nicked the nail of his big toe while trimming, with no bleeding or pain, and normal appearance. Later, due to dietary and physical overexertion, his foot became heavy, slightly swollen, and painful. Sleep patterns varied, but foot symptoms persisted. Mistakenly taking detoxifying agents caused chills, fever, swelling, and pain. Since the Spleen meridian originates at the big toe, this was sinking of weak Spleen Qi. He was cured with Shiquan Dabu Tang.
I personally enjoy sitting and reading books. Prolonged sitting leads to fatigue, requiring me to take Buzhong Yiqi Tang added with Mai Men Dong, Wu Wei Zi, and a small amount of wine-fried black Huang Bo to feel mentally clear. Otherwise, I suffer from insomnia at night, sourness and heat in the medial aspect of the feet. If insomnia persists, the medial calves become similarly affected, with a sensation of tendon contraction, causing frequent shifting of legs and restlessness until extreme exhaustion induces sleep. This is injury of Yuan Qi from exertion, with deficient fire pouring downward due to void.
In the Ding You year, at age 51, I felt a blockage-like sensation in the gum crevices, causing distension and discomfort, sometimes with oral ulcers, worsening in the afternoon. Long sleep or taking the aforementioned medicines provided relief. By the Xin Chou year, at age 55, daytime gum distension was relieved by one dose of Buzhong Yiqi Tang, allowing nighttime sleep. In the Ren Yin year, amidst family mourning, although I took the previous formula during the day, nighttime gum distension persisted. Only before noon did teeth and limbs feel relatively healthy; they distended again in the afternoon. Observing this, it is evident that Blood and Qi decline daily, necessitating different treatment methods.