大尹沈用之，不时发热，日饮冰水数碗，寒药二剂，热、渴益甚，形体日瘦，尺脉洪大而数，时
或无力。王太仆曰∶热之不热，责其无火；寒之不寒，责其无水。又云∶倏热往来，是无火
也；时作时止，是无水也。法当补肾，用加减八味丸，不月而愈。
通安桥顾大有父，年七十有九，仲冬将出，少外家入房，致头痛发热，眩晕，喘急，痰涎壅盛，小
便频数，口干引饮，遍舌生刺，缩敛如荔枝然，下唇黑裂，面目俱赤，烦躁不寐，或时喉间
如烟火上冲，急饮凉茶少解，已滨于死。脉洪大而无伦，且有力，扪其身，烙手，此肾经虚火
游行于外，投以十全大补加山茱、泽泻、丹皮、山药、麦门、五味、附子。一钟熟寐良久，
脉症各减三四，再与八味丸，服之诸症悉退，后畏冷物而痊。
下堡顾仁成，年六十有一，痢后入房，精滑自遗，二日方止。又房劳感寒，怒气遂发寒热，右胁
痛连心胸，腹痞，自汗、盗汗如雨，四肢厥冷，睡中惊悸，或觉上升如浮，或觉下陷如堕，遂
致废寝，或用补药二剂，益甚，脉浮大洪数，按之微细，此属无火虚热，急与十全大补加山药
、山茱、丹皮、附子。一剂诸症顿愈而痊。此等元气百无一二。（二顾是父子也）。
一儒者，口干，发热，小便频浊，大便秘结，盗汗，梦遗，遂致废寝，用当归六黄汤二剂，盗汗顿
止，用六味地黄丸，二便调和，用十全大补汤及前丸兼服，月余悉愈。
州同韩用之，年四十有六，时仲夏，色欲过度，烦热作渴，饮水不绝，小便淋沥，大便秘结，唾
痰如涌，面目俱赤，满舌生刺，两唇燥裂，遍身发热，或时如芒刺而无定处，两足心如烙，
以冰折之作痛，脉洪而无伦，此肾阴虚，阳无所附而发于外，非火也。盖大热而甚，寒之不
寒是无水也。当峻补其阴，遂以加减八味丸料一斤内肉桂一两，以水顿煎六碗，冰冷与饮
，半饷已用大半，睡觉而食温粥一碗，复睡至晚，乃以前药温饮一碗，乃睡至晓，食热粥二
碗，诸症悉退。翌日畏寒，足冷至膝，诸症仍至，或以为伤寒。余曰∶非也，大寒而甚，热
之不热，是无火也。阳气亦虚矣，急以八味丸一剂服之稍缓，四剂诸症复退。大便至十三日
不通，以猪胆导之，诸症复作，急用十全大补汤数剂方应。
举人陈履贤，色欲过度，丁酉孟冬发热无时，饮水不绝，遗精不止，小便淋沥。或用四物、芩
、连之类，前症益甚，更加痰涎上涌，口舌生疮。服二陈、黄柏、知母之类，胸膈不利，饮
食少思。更加枳壳、香附，肚腹作胀，大便不实，脉浮大按之微细。余朝用四君为主，佐以
熟地、当归，夕用加减八味丸，更以附子唾津调搽涌泉穴，渐愈。后用十全大补汤，其大便
不通，小腹作胀，此直肠干涩，令猪胆通之，形体殊倦，痰热顿增，急用独参汤而安，再用
前药而愈。但劳发热无时，其脉浮洪，余谓其当慎起居，否则难治。彼以余言为迂，至乙巳
夏复作，乃服四物、黄柏、知母而殁。
吴江晚生沈察，顿首云云∶仆年二十有六，所禀虚弱，兼之劳心，癸巳春发热吐痰，甲午冬为
甚，其热时起于小腹，吐痰而无定时，治者谓脾经湿痰郁火，用芩、连、枳实、二陈，或专
主心火，用三黄丸之类，至乙未冬其热多起足心，亦无定时，吐痰不绝，或遍身如芒刺然。
治者又以为阴火生痰，用四物、二陈、黄柏、知母之类，俱无验，丙申夏，痰热愈甚，盗汗，
作渴。果属痰火耶？阴虚耶？乞高明裁示云云。余曰∶此症乃肾经亏损，火不归经，当壮水之主
，以镇阳光。乃就诊于余，果尺脉洪大，余却虚浮，遂用补中益气及六味地黄而愈。后不守
禁，其脉复作，余谓火令可忧，当慎调摄，会试且缓，但彼忽略，至戊戌夏，果殁于京。
大尹沈用之，不时出现发热症状，每天喝几碗冰水，服用两剂寒凉药物后，发热和口渴反而更加严重，身体日渐消瘦。尺脉洪大而数，有时又显得无力。王太仆曾说：“用热药治疗却不见温热效果，责任在于肾阳不足（无火）；用寒药治疗却不见清凉效果，责任在于肾阴不足（无水）。”又说：“忽冷忽热往来，是肾阳虚（无火）的表现；时作时止，是肾阴虚（无水）的表现。”治疗方法应当补肾，使用加减八味丸，不到一个月就痊愈了。
通安桥顾大有的父亲，年龄七十九岁，仲冬时节即将出门前，因少量进入内室行房事，导致头痛发热、眩晕、气喘急促、痰涎壅盛、小便频数、口干想喝水、满舌生刺且收缩像荔枝核一样、下唇黑裂、面目通红、烦躁无法入睡，有时感觉喉咙间有烟火上冲的感觉，急忙喝点凉茶稍微缓解，病情已接近死亡。脉象洪大无序且有力，触摸身体烫手，这是肾经虚火游行于体表所致，投以十全大补汤加入山茱萸、泽泻、牡丹皮、山药、麦门冬、五味子、附子。服一剂后熟睡良久，脉象和症状各减轻三四成，再给予八味丸服用，所有症状全部消退，后来因为畏惧寒冷物体而痊愈。
下堡顾仁成，年龄六十一岁，痢疾后行房事，精液滑脱自遗，两天才停止。又因房劳感寒，加上愤怒，于是发作寒热，右胁痛牵连心胸，腹部痞满，自汗、盗汗如雨下，四肢厥冷，睡中惊悸，有时感觉身体上升如漂浮，有时感觉下陷如坠落，于是导致废寝忘食。有人用补药两剂，病情反而加重，脉象浮大洪数，重按则微细，这属于无火虚热，急予十全大补汤加入山药、山茱萸、牡丹皮、附子。一剂后诸症顿愈而康复。这类元气亏虚的情况百人中难有一二。（这两位姓顾的是父子关系）。
一位儒者，口干，发热，小便频数浑浊，大便秘结，盗汗，梦遗，于是导致废寝忘食。使用当归六黄汤两剂，盗汗立刻停止，使用六味地黄丸，大小便调和，使用十全大补汤及前方丸剂兼服，一个多月全部痊愈。
州同韩用之，年龄四十六岁，正值仲夏，色欲过度，烦热作渴，饮水不停，小便淋沥，大便秘结，唾痰如涌出，面目通红，满舌生刺，双唇燥裂，遍身发热，有时像芒刺一样但位置不定，两足心像被烙铁烫过一样，用冰块折断它都会感到疼痛，脉象洪大无序，这是肾阴虚，阳气无所依附而发于体表，并非实火。大概是大热甚极，用寒药治疗却不凉，是因为肾阴不足（无水）。应当峻补其阴，于是用加减八味丸料一斤内加入肉桂一两，用水一次性煎煮成六碗，冰冷地给他饮用，半顿饭工夫已经喝了大半，睡觉醒来吃温粥一碗，再次睡到晚上，然后以前药温饮一碗，一直睡到天亮，吃热粥两碗，所有症状全部消退。第二天畏寒，脚冷至膝盖，诸症复发，有人认为是伤寒。我说：“不是，大寒甚极，用热药治疗却不热，是因为肾阳不足（无火）。阳气也虚弱了，急用八味丸一剂服用稍缓，四剂后诸症复退。大便直到十三日不通，用猪胆汁导引通便，诸症复发，急用十全大补汤数剂才见效。
举人陈履贤，色欲过度，丁酉年孟冬时节发热无定时，饮水不停，遗精不止，小便淋沥。有人用四物汤、黄芩、黄连之类，前述症状更加严重，加上痰涎上涌，口舌生疮。服用二陈汤、黄柏、知母之类，胸膈不利，饮食少思。再加枳壳、香附，肚腹作胀，大便不成形，脉象浮大按之微细。我早晨用四君子汤为主，佐以熟地黄、当归，晚上用加减八味丸，再用附子调唾液涂抹涌泉穴，逐渐痊愈。后用十全大补汤，此时大便不通，小腹作胀，这是直肠干涩，令用猪胆通之，形体非常疲倦，痰热顿时增加，急用独参汤才安定，再用前药而痊愈。但是劳累发热无定时，脉象浮洪，我认为他应当谨慎起居，否则难以治愈。他认为我的话迂腐，到了乙巳年夏天复发，于是服用四物汤、黄柏、知母而死亡。
吴江晚生沈察，叩首云云：我年龄二十六岁，禀赋虚弱，加之劳心，癸巳年春季发热吐痰，甲午冬季更严重，其热时起于小腹，吐痰无定时，治疗者说是脾经湿痰郁火，用黄芩、黄连、枳实、二陈汤，或者专主心火，用三黄丸之类，到了乙未冬季其热多起于足心，也无定时，吐痰不绝，或遍身如芒刺一般。治疗者又以为是阴火生痰，用四物汤、二陈汤、黄柏、知母之类，都没有验证有效，丙申夏季，痰热更甚，盗汗，作渴。果真是痰火吗？还是阴虚呢？乞求高明裁示云云。我说：“此症乃肾经亏损，火不归经，应当壮水之主，以镇阳光。”于是就诊于我，果然尺脉洪大，余部脉虚浮，遂用补中益气汤及六味地黄丸而痊愈。后来不遵守禁忌，脉象复发，我说火令季节令人担忧，应当谨慎调摄，会试暂且推迟，但他忽略不顾，到了戊戌年夏天，果然死于京城。
Shen Yongzhi, a Da Yin (Chief Magistrate), experienced intermittent fever. He drank several bowls of ice water daily and took two doses of cold-natured medicines, yet his fever and thirst worsened, and his body became increasingly emaciated. His Chi pulse (Kidney pulse) was surging and rapid, yet sometimes weak. Wang Taipu stated: "If heating treatment fails to produce warmth, the fault lies in the lack of Fire (Kidney Yang deficiency); if cooling treatment fails to produce coolness, the fault lies in the lack of Water (Kidney Yin deficiency)." He further said: "Sudden alternating hot and cold indicates the absence of Fire; symptoms that come and go indicate the absence of Water." The method should be to tonify the Kidney, using Jiajian Bawei Wan (Modified Eight-Ingredient Pill). He recovered in less than a month.
The father of Gu Dayou from Tong'an Bridge, aged seventy-nine, engaged in sexual intercourse shortly before going out in mid-winter. This resulted in headache, fever, vertigo, panting, excessive phlegm-saliva, frequent urination, dry mouth with desire to drink, prickles all over the tongue causing it to shrink like a lychee pit, black cracking of the lower lip, redness of the face and eyes, irritability, insomnia, and a sensation of fire/smoke rushing up the throat. Drinking cool tea provided slight relief, but he was near death. His pulse was surging, chaotic, and forceful; his body felt burning hot to the touch. This was deficient Fire of the Kidney channel wandering on the exterior. He was administered Shiquan Dabu Tang (Complete Great Tonifying Decoction) added with Cornus officinalis Fruit (Shanzhuyu), Alisma Rhizome (Zexie), Moutan Cortex (Danpi), Dioscorea Rhizome (Shanyao), Ophiopogon Tuber (Maimendong), Schisandra Fruit (Wuweizi), and Aconite Lateral Root (Fuzi). After one dose, he slept soundly for a long time, and his pulse and symptoms each decreased by three or four tenths. He was then given Bawei Wan (Eight-Ingredient Pill), after which all symptoms subsided. He eventually recovered, becoming averse to cold objects.
Gu Rencheng from Xiabao, aged sixty-one, had sexual intercourse after dysentery, resulting in seminal emission, which stopped only after two days. Subsequently, due to sexual fatigue and exposure to cold, combined with anger, he developed chills and fever, pain in the right hypochondrium radiating to the chest and heart, abdominal fullness, spontaneous sweating, and night sweats profuse as rain. His limbs were cold, he experienced palpitations during sleep, and sensations of floating upwards or falling downwards, leading to neglect of food and rest. Two doses of tonifying medicines taken by others worsened his condition. His pulse was floating, large, surging, and rapid, but fine and subtle upon deep pressure. This belonged to deficient heat without Fire. Urgently, he was given Shiquan Dabu Tang added with Dioscorea Rhizome (Shanyao), Cornus officinalis Fruit (Shanzhuyu), Moutan Cortex (Danpi), and Aconite Lateral Root (Fuzi). After one dose, all symptoms resolved, and he recovered. Such cases of severe Yuan Qi (Original Qi) deficiency are rare, one in a hundred. (These two Gu men were father and son.)
A scholar presented with dry mouth, fever, frequent and turbid urination, constipation, night sweats, and nocturnal emissions, leading to neglect of food and rest. He was given Danggui Liuhuang Tang (Angelica Hexapartite Decoction) for two doses, after which night sweats ceased immediately. Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) was used to harmonize bowel movements and urination. Shiquan Dabu Tang and the aforementioned pill were taken concurrently, and he fully recovered after more than a month.
Han Yongzhi, a Zhou Tong (Assistant Prefect), aged forty-six, in mid-summer, suffered from excessive sexual indulgence, resulting in vexatious heat, thirst, incessant drinking, dribbling urination, constipation, profuse sputum, redness of the face and eyes, prickles all over the tongue, dry cracked lips, generalized fever, occasional pricking sensations without fixed location, and soles of feet feeling like they were branded. Even breaking ice caused pain. His pulse was surging and chaotic. This was Kidney Yin deficiency, where Yang had no anchor and floated outward; it was not excess Fire. Generally, extreme heat that does not respond to cold indicates lack of Water. One must severely tonify Yin. Thus, Jiajian Bawei Wan ingredients (one jin) were mixed with Cinnamon Twig (Rougui, one liang), decocted once in water to yield six bowls. It was given cold to drink. In half a meal's time, more than half was consumed. Upon waking, he ate a bowl of warm porridge, then slept until evening, drank a bowl of the medicine warm, and slept until dawn, eating two bowls of hot porridge. All symptoms subsided. The next day, he feared cold, his feet were cold to the knees, and symptoms returned. Some thought it was Shanghan (Cold Damage). I said, "No. Extreme cold that does not respond to heat indicates lack of Fire. Yang Qi is also deficient." Urgently, one dose of Bawei Wan brought slight relief; four doses made symptoms recede again. Constipation persisted until the thirteenth day; pig bile suppository was used, causing symptoms to recur. Urgently, several doses of Shiquan Dabu Tang were required to resolve it.
Chen Luxian, a Juren (Graduate), suffered from excessive sexual indulgence. In early winter of the Dingyou year, he had irregular fever, incessant drinking, continuous nocturnal emissions, and dribbling urination. Treatment with Siwu Tang (Four Substance Decoction), Scutellaria Root (Qin), and Phellodendron Bark (Lian) worsened previous symptoms, adding surging phlegm-saliva and mouth/tongue ulcers. Taking Erchen Tang (Two-Aged Decoction), Phellodendron Bark (Huangbai), and Anemarrhena Rhizome (Zhimu) caused chest/epigastric discomfort and poor appetite. Adding Bitter Orange Peel (Zhiqiao) and Cyperus Rhizome (Xiangfu) caused abdominal distension and loose stools. His pulse was floating and large but fine/subtle upon pressure. In the morning, I used Sijunzi Tang (Four Gentlemen Decoction) as the main formula, assisted by Prepared Rehmannia Root (Shudi) and Angelica Sinensis Root (Danggui). In the evening, Jiajian Bawei Wan was used. Additionally, Aconite Lateral Root (Fuzi) mixed with saliva was applied to Yongquan (KI 1). Gradually, he improved. Later, Shiquan Dabu Tang was used. When constipation and abdominal distension occurred due to rectal dryness, pig bile was used to unblock him. His physique became extremely fatigued, and phlegm-heat suddenly increased. Urgently, Ginseng Single Herb Decoction (Dushen Tang) stabilized him, followed by previous medicines for recovery. However, regarding irregular fever from labor with a floating/surging pulse, I advised careful daily regimen management, otherwise it would be difficult to treat. He considered my advice pedantic. In summer of the Yisi year, it relapsed. He took Siwu Tang, Phellodendron Bark, and Anemarrhena Rhizome and died.
Shen Cha, a junior scholar from Wujiang, bowed and said: "I am twenty-six years old, constitutionally weak, and have labored my mind. In spring of the Guisi year, I had fever and expectorated phlegm; in winter of the Jiawu year, it worsened. The heat originated from the lower abdomen, with irregular expectoration. Physicians attributed it to damp-phlegm and stagnant fire of the Spleen channel, using Scutellaria Root, Phellodendron Bark, Immature Bitter Orange, and Erchen Tang. Or they focused on Heart fire, using Sanhuang Wan (Three Yellow Pill). By winter of the Yiwei year, heat often originated from the soles of the feet, irregularly, with continuous expectoration and generalized pricking sensations. Physicians attributed this to yin-fire generating phlegm, using Siwu Tang, Erchen Tang, Phellodendron Bark, and Anemarrhena Rhizome, without effect. In summer of the Bing Shen year, phlegm-heat worsened, with night sweats and thirst. Is it truly phlegm-fire? Or yin deficiency? I beg your high wisdom to adjudicate." I said: "This condition is Kidney channel deficiency with Fire not returning to its source. One must strengthen the Master of Water (Kidney Yin) to suppress the Sunlight (Deficient Fire)." Upon examination, his Chi pulse was surging, while other pulses were deficient and floating. He was treated with Buzhong Yiqi Tang (Middle-Joint Boosting Qi-Enhancing Decoction) and Liuwei Dihuang Wan, and recovered. Later, failing to observe dietary/lifestyle restrictions, his pulse returned. I warned that the Fire season was concerning and advised careful regulation, suggesting postponing the metropolitan examination. He ignored this. In summer of the Wuxu year, he indeed died in the capital.