杨参谋名德。字仲实。年六十一岁。壬子年二月间。患头痛不可忍。昼夜不得眠。郎中曹通甫
邀予视之。其人云。近在燕京。初患头昏闷微痛。医作伤寒解之。汗出后。痛转加。复汗解。病转
加而头愈痛。遂归。每过郡邑。召医用药一同。到今痛甚不得安卧。恶风寒而不喜饮食。诊其六脉
弦细而微。气短而促。语言而懒。内经云。春气者病在头。年高气弱。清气不能上升头面。故昏闷
。此病本无表邪。因发汗过多。清阳之气愈亏损。不能上荣。亦不得外固。所以头苦痛而恶风寒。
气短弱而不喜食。正宜用顺气和中汤。此药升阳而补气。头痛自愈。
【顺气和中汤】
黄 （一钱半） 人参（一钱） 甘草（炙。七分） 白术
陈皮 当归 白芍（各五分） 升麻
柴胡（各三分） 细辛 蔓荆子 川芎（各二分）
上 咀。作一服。水二盏煎至一盏。去渣温服。食后服之。一服减半。再服全愈。内经云。阳
气者。卫外而为固也。今年高气弱。又加发汗。卫外之气愈损。故以黄 甘温补卫实表为君。人参甘温
、当归辛温、补血气。白芍酸寒。收卫气而为臣。白术、陈皮、炙甘草、苦甘温。养胃气。生发阳
气。上实皮毛。肥腠理。为佐。柴胡、升麻、苦平。引少阳阳明之气上升。通百脉灌溉周身者也。川
芎、蔓荆子、细辛辛温。体轻浮。清利空窍为使也。明年春。赴召之六盘山。曹郎中以古风见赠云
。东垣李明之。早以能医鸣。易水得奥诀。为竭黄金 。一灯静室穷内经。黄帝拊掌岐伯惊。日储
月积不易售。半世岂但三折肱。所长用药有活法。旧方堆案白鱼生。不闻李延同居且同病。一下一
汗俱得明早平。乃知古人一证有一方。后世以方合证此理殊未明。公心审是者谁子。直以异己喧谤
声。先生饮恨卧黄壤。门生赖汝卓卓医中英。活人事业将与相。一旦在己权非轻。连年应召天策府
。廉台草木皆欣荣。好藏漆叶青粘散。莫使樊阿独擅名。
杨参谋名叫德，字仲实。六十一岁。壬子年二月间，患头痛难以忍受，昼夜无法入睡。郎中曹通甫邀请我去诊治。他说，最近在燕京时，起初患头昏闷微痛，医生当作伤寒治疗，发汗后，疼痛反而加重。再次发汗解表，病情加重且头痛更甚，于是回家。每次经过郡县，都召请医生用药相同。到现在疼痛剧烈无法安卧，恶风寒而不喜欢饮食。诊察其六脉弦细而微，气短而急促，说话懒言。《内经》说：春气者病在头。年老气弱，清气不能上升到头面，所以昏闷。此病本来没有表邪，因为发汗过多，清阳之气更加亏损，不能上荣（滋养），也不能外固（护卫体表）。所以头部苦痛且恶风寒，气短弱而不喜欢进食。正适宜使用顺气和中汤。此药能升阳补气，头痛自然痊愈。
【顺气和中汤】
黄芪（一钱半） 人参（一钱） 甘草（炙，七分） 白术
陈皮 当归 白芍（各五分） 升麻
柴胡（各三分） 细辛 蔓荆子 川芎（各二分）
以上药材切碎，作为一剂服用。用水两盏煎至一盏，去渣温服。饭后服用。服一剂后疼痛减半，再服则完全痊愈。《内经》说：阳气者，卫外而为固也。今年老气弱，又加上发汗，卫外之气更加受损，所以用黄芪甘温补卫实表作为君药。人参甘温、当归辛温，补血气。白芍酸寒，收敛卫气作为臣药。白术、陈皮、炙甘草，苦甘温，养胃气，生发阳气，充实皮毛，肥厚腠理，作为佐药。柴胡、升麻，苦平，引导少阳阳明之气上升，通达百脉灌溉周身。川芎、蔓荆子、细辛，辛温，质地轻浮，清利空窍作为使药。第二年春天，赴召前往六盘山。曹郎中作古风诗赠予我说：东垣李明之，早年以医术闻名。易水得到奥妙诀要，耗尽黄金买药。在一盏灯的静室中穷究《内经》，黄帝抚掌赞叹，岐伯惊讶。日积月累不易出售，半世岂止三折肱（比喻经验丰富）。擅长用药有活法，旧方堆案白鱼生（指书虫蛀蚀书籍）。没听说李延同居且同病，一下汗俱得明早平。才知道古人一证有一方，后世以方合证此理殊未明。公心审是者谁子，直以异己喧谤声。先生饮恨卧黄壤，门生赖汝卓卓医中英。活人事业将与相，一旦在己权非轻。连年应召天策府，廉台草木皆欣荣。好藏漆叶青粘散，莫使樊阿独擅名。
Yang Canmou (Staff Officer), named De, courtesy name Zhongshi, was sixty-one years old. In the second month of the Renzi year, he suffered from unbearable headache, unable to sleep day or night. Physician Cao Tongfu invited me to examine him. He stated that recently in Yanjing, he initially experienced dizziness, stuffiness, and slight headache. The physician treated it as Taiyang disease (a syndrome caused by pathogenic factors affecting the Taiyang channel) and induced sweating. After sweating, the pain worsened. After inducing sweating again to resolve the exterior, the condition deteriorated further and the headache intensified, so he returned home. Whenever passing through commanderies or counties, he summoned physicians to prescribe identical medications. To this day, the pain is severe, preventing him from lying down comfortably; he dislikes wind and cold and has no appetite. Palpation revealed his six pulses were wiry, fine, and faint; he had shortness of breath with a hurried rhythm, and spoke lazily. The *Neijing* states: "In spring, diseases manifest in the head." Due to advanced age and weak qi, clear yang cannot ascend to the head and face, resulting in dizziness and stuffiness. This illness originally lacked exterior pathogens; however, excessive sweating further depleted the clear yang qi, which could neither nourish the upper body nor secure the exterior. Thus, he suffered from severe headache and aversion to wind and cold, along with shortness of breath, weakness, and loss of appetite. It is precisely suitable to use Shunqi Hezhong Tang (Harmonizing Qi and Center Decoction). This formula raises yang and tonifies qi, and the headache will heal spontaneously.
[Shunqi Hezhong Tang]
Huangqi (Astragali Radix, 1.5 qian)
Renshen (Ginseng Radix, 1 qian)
Gancao (Licorice Root, honey-fried, 0.7 qian)
Baizhu (Atractylodis Macrocephalae Rhizoma)
Chenpi (Citri Reticulatae Pericarpium)
Danggui (Angelicae Sinensis Radix)
Baishao (Paeoniae Radix Alba, each 0.5 qian)
Shengma (Cimicifugae Rhizoma)
Chaihu (Bupleuri Radix, each 0.3 qian)
Xixin (Asari Radix et Rhizoma)
Manjingzi (Vittariae Spora)
Chuanxiong (Ligustici Chuanxiong Rhizoma, each 0.2 qian)
Crush the above herbs into coarse powder. Take one dose. Decoct in two cups of water until one cup remains, remove the dregs, and take warm after meals. After one dose, pain reduces by half; after another dose, complete recovery occurs. The *Neijing* states: "The yang qi guards the exterior and secures the body." Due to advanced age and weak qi, compounded by sweating, the qi guarding the exterior is further damaged. Therefore, Huangqi (Astragali Radix), sweet and warm, tonifies wei qi (defensive qi) and strengthens the exterior as the sovereign herb. Renshen (Ginseng Radix), sweet and warm, and Danggui (Angelicae Sinensis Radix), acrid and warm, nourish blood and qi. Baishao (Paeoniae Radix Alba), sour and cold, collects wei qi as the minister herb. Baizhu (Atractylodis Macrocephalae Rhizoma), Chenpi (Citri Reticulatae Pericarpium), and Gancao (Licorice Root, honey-fried), bitter, sweet, and warm, nourish stomach qi, generate yang qi, fill the skin and hair, and thicken the cou li (skin and interstices) as the assistant herbs. Chaihu (Bupleuri Radix) and Shengma (Cimicifugae Rhizoma), bitter and neutral, guide Shaoyang and Yangming qi to ascend, unblocking the hundred vessels to irrigate the whole body. Chuanxiong (Ligustici Chuanxiong Rhizoma), Manjingzi (Vittariae Spora), and Xixin (Asari Radix et Rhizoma), acrid and warm, are light and floating, clearing and emptying the orifices as the envoy herbs.
In the following spring, upon being summoned to Liupanshan, Physician Cao presented an ancient-style poem praising me:
"Li Mingzhi of Dongyuan was famous early for his medical skill.
Obtaining profound secrets from Yishui, he exhausted gold on medicine.
In a quiet room lit by a single lamp, he exhaustively studied the Neijing.
The Yellow Emperor clapped his hands in praise, Qibo was astonished.
Day by day, month by month, accumulation made it hard to sell;
Half a lifetime, how could it be but three broken limbs [experienced]?
His strength lay in flexible application of medicines;
Old prescriptions piled on desks, white fish [bookworms] grew.
He did not hear of Li Yan living together and sharing the same disease,
One purgative, one sweat, both achieved clarity by morning.
Thus knowing ancients had one prescription per syndrome,
Later generations matching prescriptions to syndromes fail to understand this principle clearly.
Who among you examines with public heart?
Directly creating noise and slander against those different from oneself.
The master lies in yellow earth full of regret,
Disciples rely on you, outstanding among medical heroes.
Your life-saving endeavors will be like ministers,
Once in your hands, the power is not light.
Year after year summoned to Tiance Mansion,
Grass and trees at Liantai all rejoice.
Good at storing Qiyе Qingzhan San,
Do not let Fan A alone monopolize fame."