沈（二六） 阴平阳秘，水火既济，自然无病。今则反之，上热下寒，故所见咽痛音低，
咳嗽
涎痰，此属上热；足冷便泄，溲血，此属下寒，脉来浮数无根，损疾成痨，诚为重候。幸胃
气尚可，试投一方以补救之。
麦冬（二钱） 元参（一钱） 茅草根（二钱，以上三味轻清上焦之热） 党参（一钱五分）
蒸冬
术（一钱五分） 茯神（一钱五分） 山药（一钱五分，以上四味补土生金） 广皮（八分） 牛膝
（一钱五分，以上二味理气达下，使痰涎下行）
两服便实胃纳稍增，夜嗽未宁，前方加五味子十粒，早上服。补肾水，暖命门，引火归
元，加减金匮肾气丸。
熟地（三两） 萸肉（一两） 山药（一两） 茯苓（一两） 丹皮（一两） 泽泻（一两）
牛膝（一两） 桂心（四钱） 破故纸（一钱）
张（二六）形寒夜热，盗汗气短，咳呛脉，虚数而弦，绵延四载，叹从前医治，不遇
明眼。此积劳成损，急宜补土生金，兼治营血。
党参 蒸冬术 茯苓 苡仁 黄 熟地 五味子 橘皮 归身 炙草 大枣 浮小麦
四服知，又十剂，四年沉痼痊愈。此等虚症，若药料不道地，不能成功。所以业斯道者
，药物岂可不讲哉！设遇穷乡僻壤之人，尤宜指点某家药材妥当，莫轻其价，方为合法。前
方药品，乃贫家之人参也。黄 产陕西为上，余方多劣，但辨糯体无渣味甘，金井玉栏者为
佳耳。白术，台州宁国、江西诸处俱产，野生最上；台之种术，亦自功效，惟欲蒸透，防、
党验法同黄 。
沈某（二十六岁）：阴阳平衡协调，水火相济，身体自然健康无病。如今情况相反，出现上热下寒的症状，所以表现为咽喉疼痛、声音低微，咳嗽并伴有稀痰，这属于上热；双脚冰冷、大便泄泻、尿血，这属于下寒。脉象浮数且无根底，这是虚损疾病发展为痨病（慢性消耗性疾病），确实属于危重证候。幸好胃气尚可，尝试给予一方以补救治疗。
麦冬（二钱）、玄参（一钱）、白茅根（二钱，以上三味药轻清上焦之热）；党参（一钱五分）、炒白术（一钱五分）、茯神（一钱五分）、山药（一钱五分，以上四味药补益脾胃以生肺金）；广陈皮（八分）、牛膝（一钱五分，以上两味药调理气机引药下行，使痰涎下降）。
服用两剂后大便成形，胃纳稍增，但夜间咳嗽仍未平息。前方加入五味子十粒，早上服用。此法旨在补肾水、暖命门、引火归元，采用加减金匮肾气丸方。
熟地黄（三两）、山茱萸（一两）、山药（一两）、茯苓（一两）、牡丹皮（一两）、泽泻（一两）、牛膝（一两）、肉桂心（四钱）、补骨脂（一钱）。
张某（二十六岁）：形体畏寒，夜间发热，盗汗，气短，咳嗽气喘，脉象虚数而弦，病程绵延四年，感叹从前医治未遇明医。此为积劳成损（长期劳累导致的虚损），急宜补益脾胃以生肺金，兼治营血。
党参、炒白术、茯苓、薏苡仁、黄芪、熟地黄、五味子、橘皮、当归身、炙甘草、大枣、浮小麦。
服用四剂后病情好转，又服十剂，四年的沉疴痊愈。这类虚症，如果药材不地道，不能成功。所以从事中医这一行的人，怎么可以不讲究药物质量呢！如果遇到穷乡僻壤之人，尤其应该指点哪家药材妥当，不要轻视价格，这才是合乎法度。前方的药品，是贫家使用的人参。黄芪以陕西产为上品，其他方中多劣质，但只要辨别其质地糯实无渣、味甘，具有“金井玉栏”特征的就是佳品。白术，台州宁国、江西等地均有出产，野生最为上乘；台州的种植白术，也有功效，只是需要蒸透以防伪。防己、党参的鉴别方法与黄芪相同。
Shen (26 years old): When Yin and Yang are balanced and harmonious, and Water and Fire interact properly, the body is naturally free from disease. Currently, the situation is reversed, presenting with heat above and cold below. Thus, symptoms include sore throat, hoarseness, coughing with phlegm, which belong to upper heat; cold feet, diarrhea, and hematuria, which belong to lower cold. The pulse is floating and rapid without root. This indicates that a deficiency disease has progressed into tuberculosis (a chronic consumptive disease), which is indeed a critical condition. Fortunately, the Stomach Qi is still acceptable. A prescription is tentatively administered to remedy this.
Ophiopogon Radix (Mai Dong, 2 qian), Scrophulariae Radix (Yuan Shen, 1 qian), Imperatae Rhizoma (Maogen, 2 qian) — these three ingredients gently clear heat in the Upper Jiao; Codonopsis Radix (Dang Shen, 1.5 qian), Atractylodis Macrocephalae Rhizoma (Bai Zhu, stir-fried, 1.5 qian), Poria (Fu Shen, 1.5 qian), Dioscoreae Rhizoma (Shan Yao, 1.5 qian) — these four tonify the Earth to generate Metal (Spleen to Lung); Citri Reticulatae Pericarpium (Guang Pi, 0.8 fen), Achyranthis Bidentatae Radix (Niu Xi, 1.5 qian) — these two regulate Qi and guide downward, causing phlegm and saliva to descend.
After two doses, bowel movements became formed, and appetite slightly increased, but night cough persisted. Ten grains of Schisandrae Fructus (Wu Wei Zi) were added to the previous formula, taken in the morning. This method aims to tonify Kidney Water, warm the Gate of Vitality (Ming Men), and guide fire back to its source, using a modified Jin Gui Shen Qi Wan.
Rehmanniae Radix Preparata (Shu Di Huang, 3 liang), Corni Fructus (Yu Rou, 1 liang), Dioscoreae Rhizoma (Shan Yao, 1 liang), Poria (Fu Ling, 1 liang), Moutan Cortex (Dan Pi, 1 liang), Alismatis Rhizoma (Ze Xie, 1 liang), Achyranthis Bidentatae Radix (Niu Xi, 1 liang), Cinnamomi Cortex (Gui Xin, 4 qian), Psoraleae Fructus (Po Gu Zhi, 1 qian).
Zhang (26 years old): Fear of cold, night fever, spontaneous sweating during sleep (night sweats), shortness of breath, coughing and wheezing. The pulse is deficient, rapid, and wiry. The condition has persisted for four years. He sighs that previous treatments failed due to lack of skilled physicians. This is a deficiency caused by accumulated fatigue. It is urgent to tonify the Spleen (Earth) to generate the Lung (Metal) and simultaneously treat Ying (Nutritive) Blood.
Codonopsis Radix (Dang Shen), Atractylodis Macrocephalae Rhizoma (Bai Zhu, stir-fried), Poria, Coicis Semen (Yi Yi Ren), Astragali Radix (Huang Qi), Rehmanniae Radix Preparata (Shu Di Huang), Schisandrae Fructus (Wu Wei Zi), Citri Reticulatae Pericarpium (Ju Pi), Angelicae Sinensis Radix (Gui Shen), Glycyrrhizae Radix et Rhizoma Preparata (Zhi Gan Cao), Jujubae Fructus (Da Zao), Triticum Levis (Fu Xiao Mai).
After four doses, improvement was noted. After ten more doses, the four-year chronic ailment was completely cured. For such deficiency conditions, if the medicinal materials are not authentic, success cannot be achieved. Therefore, practitioners of this profession must pay attention to drug quality! Especially when treating people in remote areas, one should specifically point out which suppliers provide reliable herbs, advising them not to undervalue the price, which is the proper approach. The Ginseng Radix used in the previous prescription was sourced from a poor family's supply. Astragali Radix (Huang Qi) from Shaanxi is superior; other prescriptions often contain inferior quality. However, as long as it is identified as having a glutinous texture, no residue, sweet taste, and the characteristic "Golden Well and Jade Fence" appearance, it is considered good. Atractylodis Macrocephalae Rhizoma (Bai Zhu) is produced in Ningguo (Taizhou), Jiangxi, and other places; wild-grown is best. Cultivated Bai Zhu from Taizhou also has efficacy, provided it is thoroughly steamed to prevent adulteration. The verification methods for Saposhnikoviae Radix (Fang Feng) and Codonopsis Radix (Dang Shen) are similar to those for Huang Qi.