谭侍御，但头痛即吐清水，不拘冬夏，吃姜便止，已三年矣。余作中气虚寒，用六君加当归、
黄、木香、炮姜而瘥。
一儒者，四时喜极热饮食，或吞酸嗳腐，或大便不实，足指缝湿痒。此脾气虚寒下陷，用六君
加姜、桂治之而愈。稍为失宜，诸疾仍作。用前药加附子钱许，数剂不再发。
一男子，形体倦怠，饮食适可，足指缝湿痒，行坐久则重坠。此脾胃气虚而下陷。用补中益气
加茯苓、半夏而愈。
一男子，食少胸满，手足逆冷，饮食畏寒，发热吐痰，时欲作呕，自用清气化痰及二陈、枳实
之类，胸腹膨胀，呕吐痰食，小便淋漓，又用四苓、连、柏、知母、车前，小便不利，诸病
益甚。余曰∶此脾胃虚寒无火之症，故食入不消而反出。遂用八味丸补火以生土，用补中益
气加姜、桂培养中宫，生发阳气寻愈。
一男子，每劳肢体时痛，或用清痰理气之剂，不劳常痛，加以导湿，臂痛漫肿，形体倦怠，内
热盗汗，脉浮大按之微细，此阳气虚寒，用补中益气加附子一钱、人参五钱，肿痛悉愈，又
以十全大补百余剂而康。彼计服过人参一十三斤，姜、附各斤余。
大雅云∶家母，年四十有二，嘉靖壬寅七月，患脾虚中满痰嗽发热，又因湿面冷茶吞酸呕吐绝食
，误服芩、连、青皮等药，益加寒热，口干流涎不收，且作渴，闻食则呕数日矣。迎先生视
之曰∶脾主涎，此脾虚不能约制，故涎自出也，欲用人参安胃散。惑于众论，以为胃经实火
宿食，治之病日增剧，忽思冬瓜，食如指甲一块，顿发呕吐酸水不止，仍服前药愈剧，复邀
先生视之，则神脱脉绝濒死矣，惟目睛尚动，先生曰∶寒淫于内，治以辛热，然药不能下矣
，急用盐附子炒热熨脐腹，以散寒回阳；又以口气补接母口之气；又以附子作饼，热贴脐
间，时许神气少苏，以参、术、附子为末，仍以是药加陈皮煎膏为丸如粟米大，入五七粒于
口，随津液咽下，即不呕，二日后加至十余粒，诸病少退，甘涎不止，五日后渐服煎剂一二
匙，胃气少复，乃思粥饮，后投以参、术等药温补脾胃，五十余剂而愈。
大雅敢述病状之奇
洲镬潭沈大雅顿首拜书。
谭侍御，只要头痛就会呕吐清水，不分冬夏季节，吃生姜就能缓解，这种情况已经持续三年了。我判断这是中气虚寒，使用六君子汤加入当归、黄芪、木香、炮姜，病就好了。
一位读书人，四季都喜欢喝极热的饮食，有时出现吞酸、嗳气有腐臭味，有时大便不成形，脚趾缝潮湿发痒。这是脾气虚寒且下陷，用六君子汤加入干姜、肉桂治疗而痊愈。稍微饮食不当，各种疾病又会发作。在前药基础上加入约一钱附子，服用几剂后不再复发。
一名男子，身体疲倦乏力，饮食适量，脚趾缝潮湿发痒，行走或久坐后感觉沉重下坠。这是脾胃气虚且下陷。用补中益气汤加入茯苓、半夏治疗而痊愈。
一名男子，进食少且胸脘胀满，手足逆冷，饮食怕冷，发热并吐痰，时常想要作呕。他自己服用清气化痰丸及二陈汤、枳实之类的药物，导致胸腹膨胀，呕吐痰食，小便淋漓不尽；又服用四苓散、黄连、黄柏、知母、车前子等药物，导致小便不利，各种病情更加严重。我说：这是脾胃虚寒、命门火衰的病症，所以食物入胃不能消化反而吐出。于是用八味丸（金匮肾气丸）温补命门之火以生脾土，用补中益气汤加入干姜、肉桂培养中焦脾胃之气，使阳气生发，逐渐痊愈。
一名男子，每次劳累时肢体疼痛，或者使用清化痰理气的药剂，不劳累时也常痛，再加上祛湿治疗，手臂疼痛且漫肿，身体疲倦乏力，内有热感且夜间盗汗，脉象浮大但重按微细，这是阳气虚寒。用补中益气汤加入一钱附子、五钱人参，肿痛全部痊愈，后又服用十全大补汤一百多剂而康复。他计算过服用人参十三斤，干姜、附子各一斤多。
沈大雅说：家母，年龄四十二岁，嘉靖壬寅年七月，患有脾虚导致的腹部胀满、痰嗽、发热，又因吃湿面、喝冷茶导致吞酸呕吐、绝食，误服黄芩、黄连、青皮等药物，加重了寒热症状，口干流涎无法控制，并且感到口渴，闻到食物气味就呕吐，持续数日。请先生诊治，先生说：脾主涎，这是脾虚不能制约津液，所以涎水自行流出，打算用人参安胃散。但因众人议论纷纷，认为是胃经实火和宿食，治疗后病情日益加重。忽然想吃冬瓜，只吃了一小块指甲大小的冬瓜，立刻引发剧烈呕吐酸水不止，仍服用之前的药物使病情更剧，再次邀请先生诊治，此时病人神志涣散、脉搏微弱近乎死亡，只有眼珠还在转动。先生说：寒邪盛于体内，应用辛热药物治疗，然而药物已无法咽下，急忙用盐附子炒热熨烫脐腹部，以散寒回阳；又用口对口的方式吹气以接续母亲口中气息；又将附子做成饼状，趁热贴敷在脐间，约一个时辰后神气稍许恢复，将人参、白术、附子研为末，仍将此药加陈皮煎成膏制成如粟米大小的丸药，放入五六粒在口中，随津液咽下，即不再呕吐，两天后增加至十余粒，各种病情稍退，但甘涎不止，五日后逐渐服用煎剂一二匙，胃气稍复，开始想喝粥饮，后来投以人参、白术等药物温补脾胃，五十多剂后痊愈。
沈大雅冒昧陈述病状的奇特之处。
洲镬潭沈大雅叩首拜书。
Tan Shiyu (Attendant Gentleman Tan) experienced vomiting of clear fluid whenever he had a headache, regardless of the season. Taking ginger provided relief. This condition persisted for three years. I diagnosed it as deficiency-cold of the Middle Qi (Middle Jiao energy). Using Liujunzi Tang (Six Gentlemen Decoction) added with Danggui (Angelicae Sinensis Radix), Huangqi (Astragali Radix), Muxiang (Aucklandiae Radix), and Paojiang (Prepared Ginger Rhizome), the patient recovered.
A scholar preferred extremely hot food and drinks throughout the four seasons. He sometimes experienced acid regurgitation and belching with a putrid odor, loose stools, and dampness with itching between the toes. This was diagnosed as deficiency-cold of the Spleen Qi with sinking. Treatment with Liujunzi Tang added with Ganjiang (Dried Ginger Rhizome) and Rougui (Cinnamon Bark) resulted in recovery. However, any slight dietary indiscretion caused the various ailments to recur. Adding about one qian of Fuzi (Aconiti Lateralis Radix Praeparata) to the previous prescription and administering several doses prevented further recurrence.
A male patient presented with physical fatigue and lassitude, adequate food intake, dampness and itching between the toes, and a sensation of heaviness and sinking after prolonged walking or sitting. This was diagnosed as deficiency and sinking of Spleen and Stomach Qi. Treatment with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Fuling (Poria) and Banxia (Pinelliae Rhizoma) led to recovery.
Another male patient suffered from poor appetite, chest and epigastric fullness, cold extremities, aversion to cold foods, fever with expectoration, and frequent nausea. Self-medication with Qingqi Huatan Wan (Clear Qi and Resolve Phlegm Pills) and Erchen Tang (Two Aged Things Decoction) along with Zhishi (Aurantii Fructus) caused abdominal distension, vomiting of phlegm and food, and dribbling urination. Subsequent self-medication with Siling San (Four Poria Powder), Huanglian (Coptidis Rhizoma), Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma), and Cheqianzi (Plantaginis Semen) resulted in difficulty in urination and exacerbation of all symptoms. I stated: "This is a syndrome of deficiency-cold of the Spleen and Stomach with lack of fire (Mingmen Fire). Therefore, ingested food fails to digest and is vomited back." Consequently, I used Bajiaowan (Eight-Ingredient Pill with Rehmannia Root, also known as Jin Gui Shenqi Wan) to tonify the fire to generate earth (Spleen), and Buzhong Yiqi Tang added with Ganjiang and Rougui to cultivate the Middle Palace (Spleen/Stomach) and promote the generation of Yang Qi. The patient gradually recovered.
A male patient experienced limb pain upon exertion. Use of formulas for clearing phlegm and regulating Qi did not help; even without exertion, pain persisted. After adding damp-draining treatments, arm pain became diffuse with swelling, accompanied by physical fatigue, internal heat, and night sweats. The pulse was floating and large but faint and fine upon deep pressure. This was diagnosed as deficiency-cold of Yang Qi. Treatment with Buzhong Yiqi Tang added with one qian of Fuzi and five qian of Renshen (Ginseng Radix et Rhizoma) resolved the swelling and pain completely. Subsequently, over one hundred doses of Shiquan Dabu Tang (Ten Great Tonifying Decoction) were administered until full health was restored. He calculated that he had consumed thirteen jin of Renshen, and over one jin each of Ganjiang and Fuzi.
Shen Daya stated: "My mother, aged forty-two, in the seventh month of the Renyin year of the Jiajing era, suffered from spleen deficiency causing abdominal fullness, phlegm-cough, and fever. Due to consuming wet noodles and cold tea, she experienced acid regurgitation, vomiting, and loss of appetite. Mistakenly taking drugs such as Huangqin (Scutellariae Radix), Huanglian, and Qingpi (Aurantii Pericarpium Viride) exacerbated her chills and fever. She experienced dry mouth, uncontrollable salivation, thirst, and vomiting at the sight or smell of food for several days. Upon consultation, I said: 'The Spleen governs saliva. This is due to spleen deficiency failing to control fluids, hence the spontaneous flow of saliva.' I intended to use Renshen Anwei San (Ginseng Stomach-Calming Powder). However, influenced by public opinion, others believed it was excess fire in the Stomach channel and retained food. Treatment worsened the condition daily. Suddenly desiring winter melon, she ate a piece the size of a fingernail, which immediately triggered incessant vomiting of sour water. Continuing the previous medications aggravated the condition further. Upon re-examination, the patient showed signs of spirit depletion and near-death pulse, with only eye movement remaining. I stated: 'Cold invades internally; treatment requires acrid-hot substances. However, oral medication cannot be retained.' Urgently, I used salted Fuzi heated and applied as a compress to the umbilicus and abdomen to dissipate cold and restore Yang. I also performed mouth-to-mouth resuscitation to replenish her breath. Additionally, I prepared Fuzi cakes and applied them hot to the umbilicus. After approximately one shi (two hours), her spirit and qi slightly revived. I powdered Renshen, Baizhu (Atractylodis Macrocephalae Rhizoma), and Fuzi, mixed them with Chenpi (Citri Reticulatae Pericarpium) into a paste, and formed pills the size of millet grains. Placing five to seven pills in the mouth allowed them to be swallowed with saliva, stopping the vomiting. After two days, the dosage increased to over ten pills, and symptoms subsided slightly. Salivation continued. After five days, small amounts (one or two spoons) of decoction were gradually administered. Stomach Qi slowly recovered, and she began craving porridge. Finally, warming and tonifying formulas containing Renshen and Baizhu were given. After more than fifty doses, she recovered."
Mr. Daya dares to record the peculiarity of this illness.
Shen Daya of Zhouhuotan bows and writes.