或曰∶小便频数、遗尿不禁，有火有虚，有分别乎？余曰∶有溺时玉茎内疼痛，尿一点
一滴
开张，尿流而不知，名曰遗尿。不禁者，尿欲出而人禁止不溺，尿仍自出。此专指小便自病
而言。若半身不遂，兼小便频数，遗尿不禁，绝无玉茎疼痛之苦，此是气虚不固提也。
或曰∶说话不真，古名语言蹇涩。前人论舌之本有痰有火，此理想来不错？余曰∶非痰
火也
能动，舌亦半边无气，亦不能全动，故说话不真。试看小儿气不足不能行走时，高年人气衰
时，说话俱不真，是其证也。
或曰∶既无风火，如何口噤切牙？余曰∶口噤自是口噤，切牙自是切牙，古人以口噤、
切牙
伤寒、瘟疫、杂症、妇科，有虚证口噤者，有实证切牙者。独半身不遂，有口噤，绝无切牙
，亦有口噤太甚，下牙里收，其声如锉似切牙，实非切牙，亦虚症也。如无半身不遂，又无
他症相兼，忽然口噤不开，乃风邪阻滞经络，气不上达之所致，用疏通经络之剂即愈。
或曰∶元气既亏之后，未得半身不遂以前，有虚症可查乎？余生平治之最多，知之最悉
。每
故一阵风响者，有耳内无故一阵蝉鸣者，有下眼皮常跳动者，有一只眼渐渐小者，有无故一
阵眼睛发直者，有眼前常见旋风者，有常向鼻中攒冷气者，有上嘴唇一阵跳动者，有上下嘴
唇相凑发紧者，有睡卧口流涎沫者，有平素聪明忽然无记性者，有忽然说话少头无尾、语无
伦次者，有无故一阵气喘者，有一手常战者，有两手常战者，有手无名指每日有一时屈而不
伸者，有手大指无故自动者，有胳膊无故发麻者，有腿无故发麻者，有肌肉无故跳动者，有
手指甲缝一阵阵出冷气者，有脚指甲缝一阵阵出冷气者，有两腿膝缝出冷气者，有脚孤拐骨
一阵发软、向外棱倒者，有腿无故抽筋者，有脚指无故抽筋者，有行走两腿如拌蒜者，有心
口一阵气堵者，有心口一阵发空、气不接者，有心口一阵发忙者，有头项无故一阵发直者，
有睡卧自觉身子沉者，皆是元气渐亏之症，因不痛不痒，无寒无热，无碍饮食起居，人最易
于疏忽。
有人问：小便次数频繁、遗尿且无法控制，是有实火还是虚证，二者有区别吗？我回答说：排尿时尿道内部疼痛，尿液一点一点地流出，排尿过程意识不清，这叫做遗尿。所谓“不禁”，是指想要排尿但人为忍住不排，尿液却仍然自行流出。这里专门指的是小便本身发生的病变。如果是半身不遂，同时伴有小便频数、遗尿不禁，完全没有尿道疼痛的痛苦，这是气虚不能固摄提举所致。
有人问：说话口齿不清，古代称为语言蹇涩。前人论述舌头的毛病是因为有痰或有火，这种理解难道不对吗？我回答说：并不是痰或火能够导致这种情况，而是舌头半边没有气血濡养，也不能完全活动，所以说话不真。请看那些小儿气不足不能行走时，或者老年人元气衰退时，说话都不清楚，这就是证据。
有人问：既然没有风邪和火邪，为什么会出现牙关紧闭（口噤）和磨牙（切牙）的现象？我回答说：口噤就是口噤，切牙就是切牙，古人将口噤和切牙归入伤寒、瘟疫、杂症、妇科等范畴。其中有虚证导致的口噤，也有实证导致的切牙。唯独半身不遂患者，出现口噤，却绝无切牙现象；也有的人口噤非常严重，下牙向内收缩，声音像锉刀摩擦一样类似切牙，其实并非真正的切牙，这也属于虚证。如果没有半身不遂，也没有其他病症伴随，突然发生口噤张不开嘴，这是风邪阻滞经络，导致气机不能上达所引起的，使用疏通经络的药剂即可痊愈。
有人问：元气亏损之后，在尚未发生半身不遂之前，是否有可以查证的虚证表现呢？我平生治疗这类病例最多，了解得最为详细。经常听到耳边像刮风一样的响声的，有耳内无故一阵蝉鸣的，有下眼皮经常跳动的，有一只眼睛渐渐变小的，有无故一阵眼睛发直的，有眼前经常看到旋风的，有常向鼻中吸入冷气的，有上嘴唇一阵跳动的，有上下嘴唇相凑感到发紧的，有睡觉时流口水的，有平时聪明忽然失去记忆的，有忽然说话没头没尾、语无伦次的，有无故一阵气喘的，有一只手经常颤抖的，有两只手经常颤抖的，有手无名指每天有一段时间弯曲而不能伸直的，有大拇指无故自动活动的，有胳膊无故发麻的，有腿无故发麻的，有肌肉无故跳动的，有手指甲缝一阵阵出冷气的，有脚指甲缝一阵阵出冷气的，有两腿膝盖缝出冷气的，有脚外踝骨一阵发软、向外侧倾斜倒下的，有腿无故抽筋的，有脚趾无故抽筋的，有行走时两腿像拌蒜一样不稳的，有心口一阵气堵的，有心口一阵发空、气息接不上的，有心口一阵慌乱忙的，有头颈无故一阵发直的，有睡觉时自觉身体沉重的，这些都是元气逐渐亏损的症状，因为不痛不痒，无寒无热，不影响饮食起居，人们最容易疏忽大意。
It is asked: Regarding frequent urination, enuresis (involuntary urination), and incontinence of urine, are there distinctions between excess fire (Shi Huo) and deficiency (Xu)? I reply: When urinating, if there is pain inside the urethra, with urine dripping out drop by drop, and the flow occurs without awareness, this is termed enuresis. "Incontinence" refers to a situation where one attempts to hold back urine but it still flows out spontaneously. This specifically refers to pathology originating from the urinary tract itself. However, if hemiplegia (half-body paralysis) is accompanied by frequent urination and enuresis/incontinence, without any pain in the urethra, this is caused by Qi deficiency failing to secure and lift.
It is asked: Slurred speech was anciently called "speech impediment due to tongue stiffness" (Yu Yan Jian Se). The predecessors argued that tongue disorders were caused by phlegm or fire; is this understanding not correct? I reply: It is not phlegm or fire that causes this. Rather, half of the tongue lacks Qi and Blood, preventing full movement, thus resulting in unclear speech. Observe children who cannot walk due to insufficient Qi, or elderly people whose vitality declines; their speech becomes unclear. This serves as evidence.
It is asked: Since there is no wind or fire, why does trismus (lockjaw/mouth clenching) and bruxism (teeth grinding) occur? I reply: Trismus is trismus, and bruxism is bruxism. The ancients categorized these symptoms under cold damage (Shang Han), epidemic febrile diseases (Wen Yi), miscellaneous diseases, and gynecology. There are cases of trismus due to deficiency syndromes and bruxism due to excess syndromes. Specifically, in patients with hemiplegia, trismus occurs, but bruxism is absolutely absent. In some cases, trismus is so severe that the lower teeth retract inward, producing a sound like filing, resembling bruxism, but it is actually not true bruxism; this too is a deficiency syndrome. If there is no hemiplegia nor other accompanying symptoms, and sudden trismus occurs where the mouth cannot open, this is caused by wind pathogen blocking the meridians, preventing Qi from ascending. Using formulas to unblock the meridians will lead to recovery.
It is asked: After Yuan Qi (Original Qi) has been depleted, before the onset of hemiplegia, are there deficiency signs that can be observed? I have treated the most such cases in my life and know them most thoroughly. Common manifestations include: hearing wind-like sounds in the ears; experiencing spontaneous cicada-like ringing in the ears; frequent twitching of the lower eyelid; one eye gradually becoming smaller; sudden staring straight ahead with eyes; frequently seeing whirlwinds before the eyes; constantly inhaling cold air into the nose; twitching of the upper lip; tightness when upper and lower lips come together; drooling during sleep; sudden loss of memory in previously intelligent individuals; suddenly speaking without beginning or end, incoherently; spontaneous shortness of breath; trembling of one hand; trembling of both hands; the ring finger bending and unable to extend for a period each day; spontaneous movement of the thumb; numbness of the arms without cause; numbness of the legs without cause; spontaneous twitching of muscles; sensation of cold air coming from fingernail seams; sensation of cold air coming from toenail seams; sensation of cold air from knee joints; sudden weakness and outward tilting of the ankle bone; spontaneous cramping of the legs; spontaneous cramping of the toes; walking with legs tangled like garlic stems; sudden chest congestion; feeling empty in the chest with disconnected breath; sudden palpitations or anxiety in the chest; sudden straightening of the head and neck; feeling heavy in the body while sleeping. All these are signs of gradual depletion of Yuan Qi. Because they involve no pain, no itching, no cold, no heat, and do not hinder diet or daily activities, people easily neglect them.