周凤亭公，年五十有八。正月肠风下血，又饮食过伤，大吐。而朱友以枸杞地黄膏一斤
进之
。不知此公肝气素盛，中焦原有痰积，且多思伤脾，又值卯木正旺之月，投以地黄、枸杞，
适以滋其湿而溢滞其痰耳。由是饮食减少，肌肉日消，腹中痞滞。又吴友以归脾汤进之。讵
知湿热未除，先用温补，是以油扑火，势成燎原。以致大便燥结，口干舌燥。据巳午未三时
，中焦蒸蒸发热，烦闷，酉时而退。此皆湿热壅滞于脾无疑矣。且面色黄中带黑，下午足面
有浮气，皆是湿势伤脾之征。法宜清肃中焦，彻去湿热，则饮食自加，而新痰不生，宿痰磨
去，庶五谷精华不生痰而生血矣。血充则精神长，而肌肉可复，且秋来无疟痢之患。公曰∶
清肃中焦，当用何剂？予曰∶二陈汤加薏苡仁、酒炒白芍药、麦芽以养脾而消痰，以枳实、
黄连泄痞而去热，以青蒿分利阴阳而消其黄，葛根升引清阳之气，使肌热清，而口渴可止矣
，
当服十剂。公曰∶先生之方善，但枳实、黄连恐体虚者不足以当之。予曰∶惟此二味，适可
以去公之病根，舍是则不效。缘中焦有余之疾，非此不能去，亦非它药所能代。公半信半疑
，服四剂而诸疾皆愈。公遽中止，不复服完。至七日尽，果发疟疾，而以木香槟榔丸下去稠
积甚多，乃追悔予言，而延之诊。予教以前方仍服十剂，夜以丹溪保和丸调理，则永无疟痢
之患矣。
周凤亭先生，五十八岁。正月时患肠风便血，加上饮食过度损伤，导致剧烈呕吐。此时朱姓医生给他服用了整整一斤枸杞地黄膏。却不知道这位先生肝气素来旺盛，中焦原本就有痰湿积聚，且因多思虑损伤了脾气，又正值卯月（春季木气最旺之时），此时投用熟地黄、枸杞子，恰好助长了体内的湿气并更加阻滞了痰浊。因此出现饮食减少，肌肉日渐消瘦，腹部痞满滞塞。随后吴姓医生又给他服用归脾汤。岂知湿热之邪尚未清除，反而先使用温补之法，这如同油上浇火，火势蔓延成灾。导致大便干燥结硬，口干舌燥。在巳、午、未三个时辰（上午9点至下午5点），中焦蒸蒸发热，烦闷不适，到了酉时（下午5-7点）热度消退。这显然是湿热壅滞于脾脏无疑。而且面色黄中带黑，下午足背有浮肿之气，这些都是湿邪伤脾的征象。治法应当清肃中焦，彻底去除湿热，那么饮食自然增加，新痰不再产生，旧痰得以消磨，这样五谷的精微物质就不会生痰而是化生血液了。血液充盈则精神增长，肌肉可以恢复，且秋天也不会有疟疾和痢疾的祸患。先生说：“要清肃中焦，应当用什么方剂？”我说：“二陈汤加薏苡仁、酒炒白芍药、麦芽，以滋养脾气而消除痰浊；用枳实、黄连泻除痞满而去热；用青蒿分利阴阳而消除黄疸；用葛根升提引带清阳之气，使肌表之热清除，口渴即可停止。”应当服用十剂。先生说：“先生的方子很好，但枳实、黄连恐怕体质虚弱的人承受不住。”我说：“只有这两味药，才恰好能去除您的病根，舍弃它们则无效。因为中焦有余的实邪，不用这些药不能去除，也不是其他药物所能替代的。”先生半信半疑，服用了四剂后各种疾病都痊愈了。先生突然停药，不再服完剩余的药剂。到了第七天结束，果然发作了疟疾，并且通过服用木香槟榔丸排出了很多稠厚的积滞，这才后悔听从了我的话，于是再次延请我诊治。我教他继续以前方再服十剂，夜间用丹溪保和丸调理，那么就永远没有疟疾和痢疾的祸患了。
Mr. Zhou Fengting, aged fifty-eight. In the first month, he suffered from intestinal wind with blood in the stool (Changfeng Xiexue), and due to excessive dietary intake causing injury, he experienced severe vomiting. At this time, a physician named Zhu administered one jin of Gouqi Dihuang Gao (Lycium Fruit and Rehmannia Paste). Unaware that this gentleman’s Liver Qi was naturally vigorous, and that there were originally phlegm accumulations in the Middle Jiao, compounded by overthinking injuring the Spleen, and occurring during the Mao month (when Wood Qi is at its peak), the administration of Shudihuang (Prepared Rehmannia Root) and Gouqizi (Lycium Fruit) merely nourished dampness and further obstructed phlegm. Consequently, food intake decreased, muscles wasted away daily, and abdominal distension and stagnation occurred. Subsequently, a physician named Wu administered Guipi Tang (Restore the Spleen Decoction). Little did they know that the Damp-Heat had not been eliminated; using warm tonification first was like adding oil to fire, leading to an uncontrollable blaze. This resulted in dry and hard stools, dry mouth, and dry tongue. During the Si, Wu, and Wei hours (9:00 AM to 5:00 PM), there was steaming heat in the Middle Jiao, accompanied by irritability and闷 (stifling sensation), which subsided at the You hour (5:00 PM - 7:00 PM). This undoubtedly indicates Damp-Heat stagnation in the Spleen. Furthermore, the yellowish complexion with black undertones, and the floating edema on the dorsum of the feet in the afternoon, are all signs of Dampness injuring the Spleen. The treatment method should be to clear and purify the Middle Jiao, thoroughly eliminating Damp-Heat. Then, appetite will naturally increase, new phlegm will not be generated, old phlegm will be ground down, and thus the essence of the five grains will generate Blood rather than Phlegm. When Blood is sufficient, Spirit will grow, muscles will recover, and there will be no risk of Malaria or Dysentery in autumn. Mr. Zhou said, "To clear and purify the Middle Jiao, what formula should be used?" I replied, "Erchen Tang (Two Aged Decoction) added with Yiyiren (Coix Seed), Jiuchao Baishaoyao (Wine-fried White Peony Root), and Maiya (Malt) to nourish the Spleen and eliminate phlegm; Zhishi (Immature Bitter Orange) and Huanglian (Coptis Rhizome) to drain fullness and clear heat; Qinghao (Sweet Wormwood) to differentiate Yin and Yang and resolve jaundice; Gegen (Kudzu Root) to ascend and guide Clear Yang Qi, clearing muscular heat and stopping thirst." Ten doses should be taken. Mr. Zhou said, "Your prescription is good, but Zhishi and Huanglian may be too harsh for a constitutionally weak person." I said, "Only these two ingredients can precisely remove the root of your disease; without them, there will be no effect. Because the excess pathogen in the Middle Jiao cannot be removed without these, nor can it be replaced by other herbs." Half-believing and half-doubting, he took four doses, and all ailments were cured. He abruptly stopped medication and did not finish the remaining doses. By the end of the seventh day, Malaria indeed manifested, and after taking Muxiang Binglang Wan (Aucklandia and Areca Pill), a large amount of thick accumulation was expelled. He then regretted not following my advice and invited me again for consultation. I instructed him to continue with the previous prescription for ten more doses, and at night, regulate with Danxi Baohe Wan (Danxi Harmonize the Stomach Pill), so that he would never suffer from Malaria or Dysentery again.