余闻轩岐事业遐哉邈矣，其言说流布至今未尽泯也。然传者或效或否，岂其书不可尽信耶，
是信乎人焉耳。语曰医不通儒，不可以言医，其以是欤。太医院使薛君立斋雅近于儒，其以
医名世也固宜。君尝以日所施活者，述其病原，详其脉候，着其方，验有所得，辄录之积汇
成帙，标曰∶《家居医录》。他日呈于大司马中丞约 翁，翁览而善之，授余以锓诸梓、且
命申其说。余曰∶嘻!是仁者之心哉，或曰何谓也?夫医，术也，而心术观焉。世之医者，得
一方辄以自秘，取一效即以自多，人病在身而渠病在心，且弗之药是尚可以言医，薛君以名
医致身，不自秘而以示人，将欲致人人于名医。中丞翁抚绥畿辅，振衰剔弊，既登斯民仁寿
之域，复布其医书，欲寿斯民于无穷，兹非仁者之事哉。是宜梓之，以训于世，观者毋徒执
其方而求得其心焉，则是录也，其可传矣。
嘉靖戊申春正月吉剑江存所范庆书
经曰∶饮食入胃，游溢精气，上输于脾，脾气散精，上归于肺，通调水道，下输膀胱，水经
四布，五经并行。故心脾平和，则经候如常。苟或七情，内伤六淫，外侵饮食失节，起居失
宜，脾胃虚损，则月经不调矣。若先期而至者，有因脾经血燥，有因脾经郁滞，有因肝经怒
火，有因血分有热，有因劳役火动；其过期而至者，有因脾经血虚，有因肝经血少，有因气
虚血弱。主治之法，脾经血燥者，加味逍遥散；脾经郁滞者，归脾汤；肝经怒火者，加味小
柴胡汤；血分有热者，加味四物汤；劳役火动者，补中益气汤；脾经血虚者，人参养荣汤；
肝经血少者，六味地黄丸；气虚血弱者，八珍汤。盖血生于脾土，故云脾统血。凡血病当用
苦甘之剂，以助其阳气而生阴血，俱属不足。大凡肝脾
血燥，四物为主；肝脾血弱，补中益气为主；肝脾郁结，归脾汤为主；肝经怒火，加味逍遥为主。
治验
（肝经怒火风热等症附）
一妇人内热作渴，饮食少思，腹内近左初如鸡卵，渐大四寸许，经水三月一至，肢体消瘦，
齿颊似疮，脉洪数而虚，左关尤甚，此肝脾郁结之症，外贴阿魏膏，午前用补中益气汤，午
后以加味归脾汤。两月许，肝火少退，脾土少健，仍与前汤送六味地黄丸，午后又用逍遥散
送归脾丸。又月余，日用芦荟丸二服，空心以逍遥散下，日晡以归脾汤下，喜其谨疾，调理
年余而愈。
一妇人腹内一块，不时上攻，或痛作声，吞酸痞闷，月经不调，小便不利，二年余矣。面色
青黄相兼，余作肝脾气滞，以六君子加芎、归、柴胡、炒连、木香、吴茱各少许二剂，却与
归脾汤下芦荟丸。三月余，肝脾和而诸症退，又与调中益气加茯苓、丹皮，中气健而经自调
一妇人发热口干，月经不调，两腿无力，服祛风渗湿之剂，腿痛体倦，二膝浮肿，经事不
通，余作肝脾肾三经血虚火燥症，名鹤膝风，用六味、八味二丸兼服，两月形体渐健，饮食
渐进，膝肿渐消，不半载而痊。前症若脾肾虚寒，腿足软痛，或足膝枯细，用八味丸。若饮
食过多，腿足或臀内酸胀，或浮肿作痛，用补中益气加茯苓、半夏主之。
一妇人性沉静，勤于女工，善怒，小腹内结一块，或作痛，或痞闷，月经不调，恪服伐肝之
剂，内热寒热，胸膈不利，饮食不甘，形体日瘦，牙龈蚀烂，此脾土不能生肺金，肺金不能
生肾水，肾水不能生肝木，当滋化源，用补中益气、六味地黄，至仲春而愈。
松江太守何恭人，性善怒，腹聚一块，年余，形体骨立，倏热往来， 蚀透腮，或泥春旺木
克土，仍行伐肝，时季冬，肝脉洪数，按之弦紧，余脉微弱。余曰∶洪数弦紧，肝经真气虚
而邪气实也，自保不及，何能克土?况面色青中隐白，乃肾水不足，肝木亏损，肺金克制，
惟虑至春木不能发生耳。勉用壮脾胃滋肾水之剂，肝脉悉退。后大怒，耳内出血，肝脉仍大
，按之如无，烦躁作渴，此无根之火，以前药加肉桂二剂，肝脉仍敛，热渴顿退。复因大怒
，以致饮食不进，果卒于季冬辛巳日。此木衰弱而金刑克，信夫。
一妇人经候过期，发热倦怠，或用四物、黄连之类，反两月一度，且少而成块，又用峻药通
之，两目如帛所蔽。余曰∶脾为诸阴之首，目为血脉之宗，此脾伤五脏，皆为失所，不能归
于目矣。遂用补中益气、济生归脾二汤，专主脾胃，年余寻愈。
一妇人两眉棱痛，后及太阳，面青喜怒，余作胆经风热，用选奇汤合逍遥散，加山栀、天麻
、黄 、半夏、黄芩而愈。此症失治，多致伤目，或两耳出脓，则危矣。
一妇人耳鸣内热，经行不调，肢体倦怠，饮食无味，余以为肝脾虚热，用四君加柴胡、山栀
一妇人素勤苦，冬初患咳嗽发热，久而吐血盗汗，经水两三月一至，遍身作痛，或用化痰降
火，口噤筋挛，谓余曰∶何也?余曰∶此血虚而药益损耳。遂用加减八味丸及补中益气加麦
门、五味、山药治之，年余而痊。
一妇人耳内或耳后项侧作痛，寒热口苦，月经不调，余以为肝火气滞而血凝，用小柴胡加山
栀、川芎、丹皮治之，诸症悉退。
一妇人年四十，素性急，先因饮食难化，月经不调，服理气化痰药，反肚腹膨胀，大便泄泻
；又加乌药、蓬术，肚腹肿胀，小便不利；加猪苓、泽泻，痰喘气急，手足厥冷，头面肢体
肿胀，指按成窟，脉沉细，右寸为甚。余曰∶此脾肺之气虚寒，不能通调水道，下输膀胱，
渗泄之令不行，生化之气不运。即东垣所云∶水饮留积，若土之在雨中，则为泥矣，得和风
暖日，水湿去而阳化自然，万物生长。喜其脉相应，遂与金匮加减肾气丸料服之，小便即通
，数剂肿胀消半，四肢渐温，自能转侧，又与六君加木香、肉桂、炮姜，治之痊愈。后不戒
七情饮食，即为泄泻，仍用前药，加附子五分而安。
一妇人饮食每用碗许，稍加非大便不实，必吞酸嗳腐，或以为胃火，用二陈、黄连、枳实，
加内热作呕。余曰∶此未传寒中，故嗳气吞酸，胀满痞闷。不信，仍作火治虚症，并至月经
不止，始信。余以六君加炮姜、木香数剂，元气渐复，饮食渐进。又以补中益气加炮姜、木
香、茯苓、半夏，数剂痊愈。后因饮食劳倦，兼之怒气，饮食顿少，元气顿怯，用前药更加
发热，诚似实火，脉洪大，按之而虚，两尺如无，此命门火衰，用补中益气加姜、桂及八味
丸，兼服两月余，诸症悉愈。此症若因中气虚弱者，用人参理中汤或六君子加木香、炮姜，
不应，用左金丸，或越鞠丸，虚寒者，加附子，或附子理中汤，无有不愈。
一妇人素有头晕，不时而作，月经迟而少，余以为中气虚，不能上升而头晕，不能下化而经
少，用补中益气汤而愈。后因劳而仆，月经如涌，此劳伤火动，用前汤加五味子一剂，服之
即愈。前症虽云亡血过多，气无所附，实因脾气亏损耳。
一妇人年四十，劳则足跟热痛，余以为阴血虚极，急用圣愈汤而痊。后遍身搔痒，误服风药
，发热抽搐，肝脉洪数，此乃肝家血虚火盛而生风，以天竺、胆星为丸，用四物、麦门、五
味、芩、连、炙草、山栀、柴胡，煎送而愈。
一妇人两足发热，日晡益甚，小便自遗，或时不利，余以为肝热阴挺，不能约制，午前用白
术、茯苓、丹皮、泽泻各五分，干山药、山茱、麦门各一钱，熟地四钱，酒炒黑黄柏七分，
知母五分，不数剂而诸症悉愈。若用分利之剂，愈损真阴，必致不起。
一妇人月事未期而至，发热自汗，服清热止汗之剂，反作渴头痛，手掉身麻，此因肝经风热
，用柴胡、炒芩连、炒山栀、归、芍、生地、丹皮各一钱，参、 、苓、术各一钱五分，川
芎七分，甘草五分，二剂其汗全止，更以补中益气而愈。凡发热久者，阳气亦自病，须调补之。
一妇人经行后，劳役失调，忽然昏愦，面赤吐痰，此元气虚火妄动，急饮童便，神思渐爽，
更用参、 各五钱，芎、归各三钱，玄参、柴胡、山栀、炙草各一钱一剂，又用逍遥散加五
味、麦门稍定。但体倦面黄，此脾土真虚之色也，又以十全大补加五味、麦门，治之而愈。
若投以发散之剂，祸在反掌，慎之。
西宾钱思习子室年三十，尚无嗣，月经淋沥无期，夫妇异处者几年矣，思习欲为娶外家，以谋
诸余。余曰∶此郁怒伤肝，脾虚火动，而血不归经，乃肝不能藏，脾不能摄也，当清肝火，
补脾气。遂与加味归脾、逍遥二药四剂，送至其家，仍告其姑曰∶服此病自愈，而当受胎，
外家可无娶也。果病愈，次年生子。
一妇人多怒，经行或数日，或半月即止，三年后淋沥无期，肌体倦瘦，口干内热，盗汗如洗
，日晡热甚，余用参、 、归、术、茯神、远志、枣仁、麦门、五味、丹皮、龙眼肉、炙草
、柴胡、升麻，治之获痊。此症先因怒动肝火，血热妄行，后乃脾气下陷，不能摄血归源，
故用前药。若胃热亡津液，而经不行，宜清胃。若心火亢甚者，宜清心。若服燥药过多者，
宜养血。若病久气血衰，宜健脾胃。
一妇人年五十，内热晡热，经水两三月一来，此血虚而有热。用逍遥散加山茱治之而愈。若
兼有痰作渴，或小便不调，或头晕白带，宜用肾气丸。
一妇人气血素虚，经行不调，饮食少思，日晡热甚，用十全大补加山茱、山药、丹皮、麦门
、五味而愈。次年秋患寒热，或用清脾饮，而元气愈弱，余仍以前药而愈。
一妇人生七胎矣，月经不调，两足发热，年余而身亦热，劳则足酸痛。又年许，唇肿裂痛。
又半年，唇裂见血，形体瘦倦，饮食无味，月水不通，唇下肿如黑枣。或用通经丸等药而死。
一妇人善怒，经不调，唇肿裂，服消毒药，唇胀出血，年余矣。余曰∶当培养脾胃，以滋化
源。不信，仍服前药及追蚀，状如翻花瘤而死。
一膏粱之妇，产后月经不调，唇裂内热，每 作，服寒凉之剂。后不时出水，余用加味清胃
散而愈。后值春令，兼怒，唇口肿胀，寒热作呕，痰甚少食，用小柴胡加山栀、茯苓、桔梗
，诸症顿愈，但内热仍作，乃以加味逍遥散，调理而安。
一妇人性善怒，产后唇肿内热，用清热败毒，唇口肿胀，日晡热甚，月水不调；用降火化痰
，食少作呕，大便不实，唇出血水；用理气消导，胸膈痞满，头目不清，唇肿经闭；用清胃
行血，肢体倦怠，发热烦躁，涎水涌出，欲用通经之剂。余曰∶病本七情，肝脾亏损，数行
攻伐，元气益虚故耳，法当补阴益阳。遂以加味归脾汤、加味逍遥散、补中益气汤，如法调
治，元气渐复，唇疮亦愈。后因怒，寒热耳痛，胸膈胀闷，唇 肿甚，此是怒动肝火而血伤
，遂用四物合小柴胡加山栀顿愈。后又怒，胁乳作胀，肚腹作痛，呕吐酸涎，饮食不入，小
水不利，此是怒动肝木克脾土，乃用补脾气、养脾血而愈。又因劳役怒气，饮食失时，发热
喘渴，体倦不食，去血如崩，唇肿炽甚，此是肝经有火，脾经气虚，遂用补中益气加炒黑山
栀、芍药、丹皮而愈。此症每见，但治其疮，不固其本，而死者多矣。
我听说黄帝、岐伯的医学事业遥远而深邃，他们的言论流传至今尚未完全消失。然而，传承者有的有效，有的无效，难道是因为这些书不可全信吗？这其实在于相信人罢了。俗话说：医生如果不通晓儒家学问，就不能称为真正的医生，大概就是这个道理吧。太医院使薛立斋先生高雅地接近儒者风范，他以医术闻名于世，是理所当然的。先生曾经把每天救治病人的情况，叙述其病因，详细记录脉象，制定方剂，验证有所心得，就记录下来，积累成册，题名为《家居医录》。后来呈给大司马中丞约翁看，约翁阅览后认为很好，交给我刻印梓行，并且命令我阐发其中的学说。我说：唉！这是仁者的用心啊。有人说：这是什么意思呢？医学，是一种技艺，但可以从心术来观察。世上的医生，得到一方子就自己秘藏，取得一点疗效就自夸，病人病在身上，而他却病在心里，这种人尚且不可以谈论医学。薛先生以名医的身份显达，不自我秘藏而展示给人看，是想让每个人都成为名医。中丞翁安抚京城附近地区，振兴衰败，剔除弊端，既让百姓进入仁爱的长寿境界，又布施他的医书，想让百姓获得无穷的生命，这难道不是仁者的事情吗？这应该刻印它，用来训诫世人，读者不要只执着于方子，而要从中探求仁者的心意，那么这部书，就可以流传了。
嘉靖戊申年（1548年）春正月吉日，剑江存所范庆书写。
《内经》说：饮食进入胃中，游溢精气，向上输送到脾，脾气散布精微物质，向上归于肺，通调水道，向下输送到膀胱，水液经过四处布散，五脏经脉并行运行。所以心和脾平和，月经就会正常。如果因为七情内伤，六淫外侵，饮食失节，起居不当，导致脾胃虚损，就会月经不调。如果是月经先期而至的，有因脾经血燥引起的，有因脾经郁滞引起的，有因肝经怒火引起的，有因血分有热引起的，有因劳役火动引起的；如果是月经过期而至的，有因脾经血虚引起的，有因肝经血少引起的，有因气虚血弱引起的。主治的方法：脾经血燥的，用加味逍遥散；脾经郁滞的，用归脾汤；肝经怒火的，用加味小柴胡汤；血分有热的，用加味四物汤；劳役火动的，用补中益气汤；脾经血虚的，用人参养荣汤；肝经血少的，用六味地黄丸；气虚血弱的，用八珍汤。大概血生于脾土，所以说脾统血。凡是血病应当用苦甘味的药剂，以助阳气而生阴血，都属于不足之证。大凡肝脾血燥，以四物汤为主；肝脾血弱，以补中益气汤为主；肝脾郁结，以归脾汤为主；肝经怒火，以加味逍遥散为主。
治验
（附肝经怒火风热等症）
有一位妇人，体内发热口渴，饮食减少不想吃，腹部左侧起初像鸡蛋大小，逐渐增大到四寸左右，月经三个月来一次，肢体消瘦，牙齿和脸颊像生疮一样，脉象洪大而数且虚弱，左关脉尤其明显，这是肝脾郁结的病证，外部贴阿魏膏，午前服用补中益气汤，午后服用加味归脾汤。两个月左右，肝火稍微减退，脾土稍微强健，仍然用前面的汤药送服六味地黄丸，午后又用逍遥散送服归脾丸。又过了一个多月，每天早晚各服用芦荟丸二服，空腹时用逍遥散送下，傍晚时用归脾汤送下，庆幸她谨慎治病，调理了一年多而痊愈。
有一位妇人，腹内有肿块，不时向上攻冲，有时疼痛发出声音，吞酸痞闷，月经不调，小便不利，两年多了。面色青黄相间，我认为是肝脾气滞，用六君子汤加川芎、当归、柴胡、炒黄连、木香、吴茱萸各少许，两剂后，再用归脾汤送服芦荟丸。三个多月后，肝脾调和而各种症状消退，又用调中益气汤加茯苓、丹皮，中气健旺而月经自然调顺。
有一位妇人，发热口干，月经不调，两条腿无力，服用祛风渗湿的药物，导致腿痛身体疲倦，两个膝盖浮肿，月经不通，我认为是肝脾肾三经血虚火燥的病证，命名为鹤膝风，用六味地黄丸、八味地黄丸两丸兼服，两个月后形体渐渐健壮，饮食逐渐增加，膝盖肿胀渐渐消退，不到半年而痊愈。前症如果是脾肾虚寒，腿足软痛，或者足膝枯细，用八味地黄丸。如果饮食过多，腿足或者臀部内酸胀，或者浮肿作痛，用补中益气汤加茯苓、半夏为主治疗。
有一位妇人性情沉静，勤于女红，容易发怒，小腹内结成一团块，有时疼痛，有时痞闷，月经不调，严格服用伐肝的药物，出现内热寒热往来，胸膈不畅，饮食不甘美，形体日渐消瘦，牙龈蚀烂，这是脾土不能生肺金，肺金不能生肾水，肾水不能生肝木，应当滋生化之源，用补中益气汤、六味地黄丸，到了仲春时节而痊愈。
松江太守何恭人，性情易怒，腹聚成一团块，一年多了，形体骨瘦如柴，忽冷忽热，腮部溃烂穿透，有人说是春天旺盛的木气克制土气，仍然进行伐肝治疗，当时是季冬，肝脉洪数，按之弦紧，其他脉微弱。我说：洪数弦紧，是肝经真气虚而邪气实，自身保全都来不及，怎么能克土？况且面色青中隐白，是肾水不足，肝木亏损，肺金克制，只担心到了春天木气不能发生。勉强使用壮脾胃滋肾水的药剂，肝脉全部消退。后来大怒，耳内出血，肝脉仍然大，按之好像没有，烦躁口渴，这是无根之火，用前面的药加肉桂两剂，肝脉收敛，热渴顿时消退。又因为大怒，导致饮食不进，果然在季冬辛巳日去世。这是木衰弱而被金刑克，确实如此。
有一位妇人，月经过期，发热倦怠，有人用四物汤、黄连之类的药物，反而变成两个月来一次，而且量少而成块，又用峻猛药物通经，导致两眼像被帛布遮蔽一样模糊。我说：脾为诸阴之首，目为血脉之宗，这是脾受伤五脏，都失去所依，不能上注于目了。于是用补中益气汤、济生归脾汤两方，专门主治脾胃，一年多寻得痊愈。
有一位妇人，两眉棱骨痛，后来波及太阳穴，面青喜怒无常，我认为是胆经风热，用选奇汤合逍遥散，加山栀、天麻、黄柏、半夏、黄芩而痊愈。此症如果失治，多会导致伤目，或者两耳出脓，那就危险了。
有一位妇人耳鸣内热，经期不调，肢体倦怠，饮食无味，我认为是肝脾虚热，用四君子汤加柴胡、山栀。
有一位妇人平时勤劳辛苦，冬初患咳嗽发热，久了吐血盗汗，月经两三个月来一次，遍身疼痛，有人用化痰降火的药物，导致口噤筋挛，问我：为什么呢？我说：这是血虚而药物更加损伤。于是用加减八味丸及补中益气汤加麦门冬、五味子、山药治疗，一年多而痊愈。
有一位妇人耳内或耳后项侧作痛，寒热口苦，月经不调，我认为是肝火气滞而血凝，用小柴胡汤加山栀、川芎、丹皮治疗，各种症状全部消退。
有一位妇人四十岁，平素性急，先前因为饮食难消化，月经不调，服用理气化痰药，反而肚腹膨胀，大便泄泻；又加乌药、蓬术，肚腹肿胀，小便不利；加猪苓、泽泻，痰喘气急，手足厥冷，头面肢体肿胀，指按成窟，脉沉细，右寸脉尤为明显。我说：这是脾肺之气虚寒，不能通调水道，下输膀胱，渗泄的命令不行，生化之气不运。就是李东垣所说的：水饮留积，就像土在雨中，就成为泥了，得到和风暖日，水湿去而阳气化自然，万物生长。庆幸她的脉象相应，于是给予金匮加减肾气丸料服用，小便即通，几剂后肿胀消了一半，四肢渐渐温暖，自己能转动，又用六君子汤加木香、肉桂、炮姜，治疗痊愈。后来不节制七情饮食，就发生泄泻，仍然用前面的药，加附子五分而安。
有一位妇人饮食每顿用碗许，稍加量就不是大便不实，必定吞酸嗳腐，有人以为是胃火，用二陈汤、黄连、枳实，加上内热作呕。我说：这是未传寒中，所以嗳气吞酸，胀满痞闷。不信，仍然按火治虚症，甚至到了月经不止，才相信。我用六君子汤加炮姜、木香几剂，元气渐渐恢复，饮食渐渐增加。又用补中益气汤加炮姜、木香、茯苓、半夏，几剂痊愈。后来因为饮食劳倦，加之怒气，饮食顿少，元气顿怯，用前面的药更加发热，诚然像实火，脉洪大，按之而虚，两尺脉像没有一样，这是命门火衰，用补中益气汤加姜、桂及八味地黄丸，兼服两个多月，各种症状全部痊愈。此症如果是因中气虚弱者，用人参理中汤或六君子汤加木香、炮姜，不应效，用左金丸，或越鞠丸，虚寒者，加附子，或附子理中汤，没有不愈的。
有一位妇人平素有头晕，不时发作，月经迟而少，我认为是中气虚，不能上升而头晕，不能下化而经少，用补中益气汤而痊愈。后来因为劳累而跌倒，月经如涌，这是劳伤火动，用前面的汤加五味子一剂，服用后即愈。前症虽然说是亡血过多，气无所附，实际上是因脾气亏损所致。
有一位妇人四十岁，劳累则足跟热痛，我认为是阴血虚极，急忙用圣愈汤而痊愈。后来遍身搔痒，误服风药，发热抽搐，肝脉洪数，这是肝家血虚火盛而生风，以天竺黄、胆星做成丸药，用四物汤、麦门冬、五味子、黄芩、黄连、炙甘草、山栀、柴胡，煎汤送服而痊愈。
有一位妇人两足发热，傍晚更严重，小便自遗，有时不利，我认为是肝热阴挺，不能约制，午前用白术、茯苓、丹皮、泽泻各五分，干山药、山茱萸、麦门冬各一钱，熟地黄四钱，酒炒黑黄柏七分，知母五分，不多几剂而各种症状全部痊愈。如果用分利之剂，更加损伤真阴，必然导致不治。
有一位妇人月事未到预期而至，发热自汗，服用清热止汗之剂，反而作渴头痛，手抖身麻，这是因为肝经风热，用柴胡、炒黄芩、炒黄连、炒山栀、当归、芍药、生地、丹皮各一钱，人参、黄芪、茯苓、白术各一钱五分，川芎七分，甘草五分，两剂其汗全止，再用补中益气汤而痊愈。凡发热久者，阳气也生病，必须调补。
有一位妇人经行后，劳役失调，忽然昏愦，面赤吐痰，这是元气虚火妄动，急忙饮用童便，神思渐渐清爽，再用人参、黄芪各五钱，川芎、当归各三钱，玄参、柴胡、山栀、炙甘草各一钱，一剂后，又用逍遥散加五味子、麦门冬稍定。只是体倦面黄，这是脾土真虚的颜色，又以十全大补汤加五味子、麦门冬，治疗而痊愈。如果投以发散之剂，祸在反掌之间，务必谨慎。
西宾钱思习的妻子三十岁，还没有后代，月经淋漓无期，夫妇分居几年了，思习想为她娶妾，来征求我的意见。我说：这是郁怒伤肝，脾虚火动，而血不归经，是肝不能藏，脾不能摄，应当清肝火，补脾气。于是给予加味归脾汤、逍遥散两种药四剂，送到她家，仍告诉她的婆婆说：服用此病自愈，并且会受孕，可以不用娶妾了。果然病愈，次年生子。
有一位妇人容易发怒，经期或几天，或半个月就停止，三年后淋漓无期，肌体疲倦消瘦，口干内热，盗汗如洗，傍晚热甚，我用人参、黄芪、当归、白术、茯神、远志、枣仁、麦门冬、五味子、丹皮、龙眼肉、炙甘草、柴胡、升麻，治疗获得痊愈。此症先前因为怒动肝火，血热妄行，后来脾气下陷，不能摄血归源，所以用前面的药。如果胃热亡津液，而经不行，宜清胃。如果心火亢盛甚者，宜清心。如果服燥药过多者，宜养血。如果病久气血衰，宜健脾胃。
有一位妇人五十岁，内热傍晚热，月经两三个月来一次，这是血虚而有热。用逍遥散加山茱萸治疗而痊愈。如果兼有痰作渴，或小便不调，或头晕白带，宜用肾气丸。
有一位妇人气血平素虚，经期不调，饮食少思，傍晚热甚，用十全大补汤加山茱萸、山药、丹皮、麦门冬、五味子而痊愈。次年秋患寒热，有人用清脾饮，而元气更弱，我仍然用前面的药而痊愈。
有一位妇人生了七个孩子，月经不调，两足发热，一年多而全身也热，劳累则足酸痛。又过一年多，嘴唇肿裂痛。又半年，唇裂见血，形体瘦倦，饮食无味，月经不通，唇下肿如黑枣。有人用通经丸等药而死。
有一位妇人容易发怒，经期不调，嘴唇肿裂，服用消毒药，嘴唇胀出血，一年多了。我说：应当培养脾胃，以滋生化之源。不信，仍然服用前面的药及追蚀药，状如翻花瘤而死。
一位富贵人家的妇人，产后月经不调，唇裂内热，每次发作，服用寒凉之剂。后来不时出水，我用加味清胃散而痊愈。后来正值春季，兼有怒气，唇口肿胀，寒热作呕，痰很少食少，用小柴胡汤加山栀、茯苓、桔梗，各种症状顿时痊愈，但内热仍发作，于是用加味逍遥散，调理而安。
有一位妇人性情易怒，产后唇肿内热，用清热败毒，导致唇口肿胀，傍晚热甚，月经不调；用降火化痰，食少作呕，大便不实，唇出血水；用理气消导，胸膈痞满，头目不清，唇肿经闭；用清胃行血，肢体倦怠，发热烦躁，涎水涌出，想用通经之剂。我说：病本源于七情，肝脾亏损，多次攻伐，元气更加虚弱，法当补阴益阳。于是用加味归脾汤、加味逍遥散、补中益气汤，依法调治，元气渐渐恢复，唇疮也痊愈。后来因为发怒，寒热耳痛，胸膈胀闷，唇肿甚，这是怒动肝火而血伤，于是用四物汤合小柴胡汤加山栀顿时痊愈。后来又发怒，胁乳作胀，肚腹作痛，呕吐酸涎，饮食不入，小便不利，这是怒动肝木克脾土，于是用补脾气、养脾血而痊愈。又因为劳役怒气，饮食失时，发热喘渴，体倦不食，去血如崩，唇肿炽甚，这是肝经有火，脾经气虚，于是用补中益气汤加炒黑山栀、芍药、丹皮而痊愈。此症常见，只治疗其疮，不固其本，而死者很多了。
I have heard that the medical achievements of Huangdi (Yellow Emperor) and Qibo are distant and profound, and their words have been transmitted to this day without completely disappearing. However, some who transmit them find them effective, while others do not. Is it because these books cannot be fully trusted? It actually lies in trusting the person. As the saying goes: "A physician who does not understand Confucianism cannot speak of medicine." This is likely the reason. Xue Lizhai, the Director of the Imperial Medical Bureau, elegantly approaches the demeanor of a Confucian scholar; it is only natural that he became famous for his medical skills. He once recorded the causes of diseases, detailed pulse conditions, and prescribed formulas based on his daily treatments, verifying his insights. These records accumulated into a volume titled *Jiaju Yilu* (Home Medical Records). Later, he presented it to Grand Marshal Zhongcheng Yue Weng, who reviewed it favorably, entrusted me with its printing, and instructed me to elaborate on its theories. I said, "Ah! This is the heart of a benevolent person." Some asked, "What do you mean?" Medicine is an art, but it can be observed through one's moral intent. Physicians of the world often keep a prescription secret after obtaining it and boast about a single success. The patient suffers physically, while the physician suffers morally; such people should not even discuss medicine. Mr. Xue, a renowned physician, did not keep his knowledge secret but shared it, intending to make everyone a renowned physician. Lord Zhongcheng pacified the capital region, revitalized decay, and eliminated abuses, bringing people into a realm of benevolence and longevity. He further disseminated his medical books, wishing to extend the lives of the people infinitely. Is this not the act of a benevolent person? It should be printed to instruct the world. Readers should not merely focus on the prescriptions but seek the benevolent heart behind them. Thus, this record is worthy of transmission.
Written by Fan Qing of Jianjiang Cunso on an auspicious day in the first month of the spring of the Wushen year of the Jiajing era (1548).
The *Neijing* (Inner Canon) states: "When food and drink enter the stomach, they generate qi and fluids, which are transported upward to the Spleen. The Spleen scatters the essence, sending it upward to the Lung. The Lung regulates the water passages, transporting it downward to the Bladder. Water flows through all directions, and the five meridians operate in parallel." Therefore, when the Heart and Spleen are harmonious, menstruation remains regular. If internal injury from the Seven Emotions, external invasion by the Six Evils, irregular diet, or improper living habits cause deficiency and damage to the Spleen and Stomach, menstrual irregularities will occur. For early menstruation, causes may include Dryness of Blood in the Spleen Meridian, Stagnation in the Spleen Meridian, Fire of Anger in the Liver Meridian, Heat in the Blood Level, or Fire movement due to overwork. For delayed menstruation, causes may include Blood Deficiency in the Spleen Meridian, Blood Scarcity in the Liver Meridian, or Qi and Blood Weakness. The treatment methods are as follows: For Dryness of Blood in the Spleen Meridian, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder); for Stagnation in the Spleen Meridian, use Guipi Tang (Restore the Spleen Decoction); for Fire of Anger in the Liver Meridian, use Jiawei Xiao Chaihu Tang (Modified Minor White Dragon Decoction); for Heat in the Blood Level, use Jiawei Siwu Tang (Modified Four Substance Decoction); for Fire movement due to overwork, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction); for Blood Deficiency in the Spleen Meridian, use Renshen Yangrong Tang (Ginseng Nourishing the Vigor Decoction); for Blood Scarcity in the Liver Meridian, use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill); for Qi and Blood Weakness, use Bazhen Tang (Eight Treasure Decoction). Generally, Blood is born from Spleen Earth, hence it is said that the Spleen controls Blood. For blood disorders, bitter and sweet agents should be used to assist Yang Qi and generate Yin Blood, as these belong to deficiency patterns. Generally, for Liver-Spleen Blood Dryness, Siwu Tang (Four Substance Decoction) is primary; for Liver-Spleen Blood Weakness, Buzhong Yiqi Tang is primary; for Liver-Spleen Stagnation, Guipi Tang is primary; for Liver Meridian Fire of Anger, Jiawei Xiaoyao San is primary.
Clinical Cases
(Attached: Symptoms of Liver Meridian Fire of Anger and Wind-Heat)
Case 1: A woman suffered from internal heat and thirst, reduced appetite, and a mass in the left abdomen initially the size of a chicken egg, gradually growing to four cun. Her menstruation occurred every three months. She was emaciated, her teeth and cheeks resembled ulcers, and her pulse was surging, rapid, and deficient, especially at the Left Guan position. This was diagnosed as Liver-Spleen Stagnation. External application of Awei Gao (Asafoetida Plaster) was used. In the morning, she took Buzhong Yiqi Tang; in the afternoon, Jiawei Guipi Tang. After two months, Liver Fire slightly subsided, and Spleen Earth strengthened. She continued with the previous decoctions administered with Liuwei Dihuang Wan in the morning and Xiaoyao San with Guipi Wan in the afternoon. After another month, she took Lulu Wan (Aloe Pill) twice daily, taken with Xiaoyao San on an empty stomach and Guipi Tang in the late afternoon. Fortunately, she was diligent in her care. After more than a year of regulation, she recovered.
Case 2: A woman had a mass in her abdomen that attacked upward intermittently, accompanied by painful sounds, acid regurgitation, chest fullness, irregular menstruation, and difficult urination for over two years. Her complexion was mixed green and yellow. I diagnosed Liver-Stomach Qi Stagnation. I prescribed Liujunzi Tang (Six Gentlemen Decoction) plus Chuanxiong, Danggui, Chaihu, fried Huanglian, Muxiang, and Wuzhuyu in small amounts for two doses, followed by Guipi Tang administered with Lulu Wan. After three months, Liver and Spleen harmonized, symptoms receded, and TiaoZhong Yiqi Tang plus Fuling and Danpi was given to strengthen Middle Qi, resulting in regular menstruation.
Case 3: A woman had fever, dry mouth, irregular menstruation, and weak legs. After taking wind-dispelling and damp-draining herbs, she developed leg pain, fatigue, and swollen knees, with amenorrhea. I diagnosed this as Blood Deficiency and Fire Dryness in the Liver, Spleen, and Kidney meridians, naming it He Xi Feng (Crane Knee Wind). She took Liuwei Dihuang Wan and Bawei Dihuang Wan concurrently. After two months, her physique improved, appetite increased, and knee swelling subsided. She recovered within half a year. If the preceding condition were Spleen-Kidney Yang Deficiency Cold, presenting with soft/painful legs or thin knees, Bawei Dihuang Wan would be used. If excessive eating caused soreness/swelling in legs/buttocks or edema pain, Buzhong Yiqi Tang plus Fuling and Banxia would be used.
Case 4: A woman was quiet, diligent in needlework, but prone to anger. She had a lump in the lower abdomen causing pain or fullness and irregular menstruation. After strictly taking Liver-suppressing herbs, she developed internal heat, alternating chills/fever, chest discomfort, poor appetite, emaciation, and gum erosion. This indicated Spleen Earth failing to generate Lung Metal, Lung Metal failing to generate Kidney Water, and Kidney Water failing to generate Liver Wood. The source of transformation needed nourishment. She took Buzhong Yiqi Tang and Liuwei Dihuang Wan, recovering by mid-spring.
Case 5: Lady He, wife of the Prefect of Songjiang, was prone to anger and had an abdominal mass for over a year, becoming emaciated with alternating hot/cold flashes and facial ulcers. Some attributed this to Spring Wood overcoming Earth and advised Liver suppression. In late winter, her Liver pulse was surging/rapid and wiry/tight upon pressure, while other pulses were weak. I stated: Surging/rapid/wiry/tight indicates true Qi deficiency and pathogenic excess in the Liver. How can it overcome Earth when it cannot even sustain itself? Her greenish-white complexion indicated Kidney Water insufficiency and Liver Wood depletion, suppressed by Lung Metal. I feared Wood would fail to sprout in Spring. I reluctantly prescribed herbs to strengthen Spleen/Stomach and nourish Kidney Water, resolving the Liver pulse. Later, extreme anger caused ear bleeding; the Liver pulse remained large but felt empty upon pressure, with irritability and thirst, indicating Rootless Fire. Adding Rougui (Cinnamon Bark) to the previous formula for two doses收敛ed the Liver pulse and resolved heat/thirst. Subsequent anger led to anorexia, and she died on a XinSi day in late winter. This confirms Wood weakness leading to Metal oppression.
Case 6: A woman had delayed menstruation, fever, and fatigue. Others used Siwu Tang and Huanglian, worsening it to bi-monthly cycles with clots. Harsh purgatives blurred her vision. I stated: The Spleen is the head of all Yin; eyes are the gathering of blood vessels. Spleen injury affects all Zang organs, preventing nourishment of the eyes. I used Buzhong Yiqi Tang and Jisheng Guipi Tang, focusing on Spleen/Stomach, achieving recovery in over a year.
Case 7: A woman had pain in the brow bones spreading to the temples, with a green face and mood swings. I diagnosed Gallbladder Meridian Wind-Heat. Xuanqi Tang combined with Xiaoyao San, plus Shanzhi, Tianma, Huangbo, Banxia, and Huangqin cured her. Untreated, this often damages eyes or causes ear suppuration, which is critical.
Case 8: A woman had tinnitus, internal heat, irregular menstruation, fatigue, and tastelessness. I diagnosed Liver-Spleen Deficient Heat, prescribing Sijunzi Tang plus Chaihu and Shanzhi.
Case 9: A hardworking woman developed cough and fever in early winter, progressing to hemoptysis and night sweats, with menstruation every 2-3 months and body pain. Phlegm-resolving and fire-clearing herbs caused lockjaw and tendon spasms. I diagnosed Blood Deficiency exacerbated by medication. Jiajian Bawei Wan and Buzhong Yiqi Tang plus Maidong, Wuweizi, and Shanyao cured her in over a year.
Case 10: A woman had pain in/behind ears and neck, alternating chills/fever, bitter taste, and irregular menstruation. I diagnosed Liver Fire Qi Stagnation and Blood Coagulation. Xiao Chaihu Tang plus Shanzhi, Chuanxiong, and Danpi resolved all symptoms.
Case 11: A forty-year-old woman, naturally impatient, had indigestion and irregular menstruation. Regulating Qi and resolving phlegm herbs caused abdominal distension and diarrhea. Adding Wuyao and Pengzhi worsened swelling and urinary difficulty. Adding Zhuling and Zexie caused panting, cold extremities, and pitting edema. Pulse was deep/fine, especially Right Cun. I diagnosed Spleen-Lung Qi Deficiency Cold, failing to regulate water passages. Like mud in rain, water stagnates until warm sun evaporates it. I prescribed Jin Gui Jiajian Shenqi Wan material. Urination resumed, swelling halved, limbs warmed. Liujunzi Tang plus Muxiang, Rougui, and Paojiang completed the cure. Later, dietary/emotional indiscretion caused diarrhea; adding Fuzi (Aconite) restored health.
Case 12: A woman could eat a bowl but not more, experiencing acid regurgitation and belching. Others suspected Stomach Fire and used Erchen Tang, Huanglian, and Zhishi, causing vomiting and internal heat. I diagnosed Cold transforming in the Middle, causing belching/fullness. Ignoring this and treating as Fire/Deficiency led to menorrhagia. Only then did she believe me. Liujunzi Tang plus Paojiang and Muxiang restored Qi and appetite. Buzhong Yiqi Tang plus Paojiang, Muxiang, Fuling, and Banxia cured her. Later, stress and anger caused anorexia and fear-like weakness with fever resembling Excess Fire (surging pulse, empty upon pressure, absent Chi pulses), indicating Mingmen Fire Decline. Buzhong Yiqi Tang plus Ginger/Cinnamon and Bawei Wan cured her in two months. For Middle Qi Deficiency, Ren Shen Li Zhong Tang or Liujunzi Tang plus Muxiang/Paojiang is used; if ineffective, Zuojin Wan or Yueju Wan; for Deficient Cold, add Fuzi or use Fuzi Li Zhong Tang.
Case 13: A woman had intermittent dizziness and scant/delayed menstruation. I diagnosed Middle Qi Deficiency failing to ascend (dizziness) and descend (scant menses). Buzhong Yiqi Tang cured her. Later, exertion caused hemorrhage (Fire movement from injury). One dose of the previous decoction plus Wuweizi cured her. Though attributed to blood loss, the root was Spleen Qi damage.
Case 14: A forty-year-old woman had hot/painful heels upon exertion, diagnosed as extreme Yin Blood Deficiency. Shengyu Tang cured her. Later, itching led to misusing Wind herbs, causing fever, convulsions, and surging Liver pulse. This was Liver Blood Deficiency with Fire generating Wind. Tianzhuru and Dansheng pills, taken with Siwu Tang plus Maidong, Wuweizi, Huangqin, Huanglian, Gancao, Shanzhi, and Chaihu, cured her.
Case 15: A woman had hot feet worsening in the evening, urinary incontinence/retention. I diagnosed Liver Heat with Yin prolapse failing to constrain. Baizhu, Fuling, Danpi, Zexia, Shanyao, Shanzhuyu, Maidong, Shudihuang, Jiu Chao Hei Huangbai, and Zhimu cured her quickly. Diuretics would damage True Yin and prove fatal.
Case 16: A woman had premature menstruation, fever, and spontaneous sweating. Heat-clearing/sweat-stopping herbs caused thirst, headache, tremors, and numbness. I diagnosed Liver Meridian Wind-Heat. Chaihu, fried Huangqin/Huanglian, fried Shanzhi, Danggui, Shaoyao, Shengdi, Danpi, Renshen, Huangqi, Fuling, Baizhu, Chuanxiong, and Gancao stopped sweating in two doses. Buzhong Yiqi Tang completed the cure. Prolonged fever damages Yang Qi, requiring tonification.
Case 17: A woman fainted after menstruation due to overwork, with red face and phlegm spitting. This was Deficient Qi allowing False Fire to flare. Drinking Child's Urine cleared her mind. Renshen, Huangqi, Chuanxiong, Danggui, Xuanshen, Chaihu, Shanzhi, and Gancao cured her. Xiaoyao San plus Wuweizi and Maidong stabilized her. Fatigue and sallow complexion indicated Spleen Deficiency. Shiquan Dabu Tang plus Wuweizi and Maidong cured her. Dispersants would be disastrous.
Case 18: Wife of Qian Sixi, thirty, childless, with prolonged spotting. Husband wanted a concubine. I diagnosed Depression/Anger injuring Liver, Spleen Deficiency with Fire moving Blood out of channels (Liver failing to store, Spleen failing to control). Jiawei Guipi Tang and Xiaoyao San cured her, and she conceived the next year.
Case 19: A woman prone to anger had short periods progressing to prolonged spotting, emaciation, dry mouth, internal heat, and night sweats. Renshen, Huangqi, Danggui, Baizhu, Fushen, Yuanzhi, Zaoren, Maidong, Wuweizi, Danpi, Longyanrou, Gancao, Chaihu, and Shengma cured her. Initial Liver Fire caused reckless bleeding; later Spleen Qi sinking failed to control blood. If Stomach Heat depleted fluids, clear Stomach. If Heart Fire hyperactive, clear Heart. If dry herbs damaged, nourish Blood. If chronic Qi/Blood decline, strengthen Spleen/Stomach.
Case 20: A fifty-year-old woman had evening fevers and irregular menstruation (Blood Deficiency with Heat). Xiaoyao San plus Shanzhuyu cured her. If phlegm/thirst or urinary issues/leukorrhea occurred, Shenqi Wan was indicated.
Case 21: A woman with inherent Qi/Blood Deficiency had irregular menstruation, poor appetite, and evening fever. Shiquan Dabu Tang plus Shanzhuyu, Shanyao, Danpi, Maidong, and Wuweizi cured her. Later autumn chills/fevers treated with Qingspi Yin weakened her further; returning to the previous formula cured her.
Case 22: A woman with seven children had irregular menstruation, hot feet, whole-body heat, and foot soreness. Later, lip swelling/cracking/blood appeared, emaciation, anorexia, and amenorrhea with black-date-like swelling under lips. Tongjing Wan killed her.
Case 23: Another angry woman with irregular menstruation and lip cracking took detoxifying herbs, causing lip bleeding and swelling for a year. I advised nourishing Spleen/Stomach to generate sources. Ignoring this and using corrosives led to death from a fungating tumor.
Case 24: A wealthy woman had postpartum irregular menstruation, lip cracking, and internal heat. Cold herbs caused weeping lesions. Jiawei Qingwei San cured her. In Spring, anger caused lip swelling, chills/fever, vomiting, and scant appetite. Xiao Chaihu Tang plus Shanzhi, Fuling, and Jiegeng cured acute symptoms. Lingering heat was managed with Jiawei Xiaoyao San.
Case 25: An angry woman had postpartum lip swelling/heat. Cooling/toxic-resolving herbs worsened swelling/fever/menstrual issues. Fire-clearing/phlegm-resolving herbs caused vomiting/loose stools/lip bleeding. Qi-regulating/digestive herbs caused chest fullness/closed menses. Blood-invigorating/stomach-clearing herbs caused fatigue/restlessness/salivation. I diagnosed Seven Emotions damaging Liver/Spleen, exacerbated by attacks. Tonifying Yin/Yang with Jiawei Guipi Tang, Jiawei Xiaoyao San, and Buzhong Yiqi Tang restored Qi and healed lips. Subsequent anger caused ear pain/chest fullness; Siwu Tang + Xiao Chaihu Tang + Shanzhi cured it. Further anger caused hypochondriac/breast distension/abdominal pain/vomiting/urinary difficulty; strengthening Spleen Qi/Blood cured it. Finally, overwork/anger/dietary error caused fever/panting/thirst/anorexia/hemorrhage/severe lip swelling. Liver Fire with Spleen Qi Deficiency required Buzhong Yiqi Tang plus fried Shanzhi, Shaoyao, and Danpi. Treating only the sores without securing the root often leads to death.