上舍张怀赤，每早晨肠鸣泻一二度，晚间泻一度，年四十二，且未有子。予诊之，尺寸
短弱
，右关滑大。予谓此中焦有湿痰，君相二火皆不足，故有此症。以六君子汤加破故纸、桂心
、益智仁、肉豆蔻煎服，泻遂减半。又以前药加杜仲为丸，服之而愈，次年生子。
臧七房二老妇人，年六十八，患痢，痢后过食熟菱与腐汤，以致大便滑泄不固，饮汤水
，径直
下不停，胸膈痞闷，语言无力，舌干口燥生疮，咽津液则喉疼。元气大虚而热，皆虚火所致
。且长素二十余年，又当痢后，益知非有余之症也。脉又尺寸俱弱，两关滑大。《内经》云
∶清气在下，必生飧泄；浊气在上，必生 胀，此之谓也。法当提清降浊，补助元气。用四
君子汤，加葛根、白芍药、黄连清虚热，止燥渴为君，桔梗辅佐葛根升提清气为臣，陈皮、
麦芽降其浊气，以消胸膈痞闷为佐，加乌梅为使。上使生津，下使止浊，连服二剂，尺寸之
脉稍起，饮食亦得停腹， ，然始有生气。仍以前方加白扁豆、神曲，打糊为丸，调理而
安。
蔡乐川令眷，患头痛，痛如物破，发根稍动，则痛延满头，晕倒不省人事，逾半时乃苏
。遍
身亦作疼，胸膈饱闷，饮汤水停膈间不下。先一日吐清水数次，蛔虫三条。原为怒起，今或
恶风，或恶热，口或渴，或不渴，大便秘，脉则六部皆滑大有力。予曰∶此痰厥头痛症也。
先以藿香正气散止其吐，继以牛黄丸、黑虎丹清其人事。头仍疼甚，又以天麻、 本各三钱
，半夏二钱，陈皮、白芷、薄荷、麻黄、生姜、葱白煎服，得少汗而头痛少止。至晚再服之
，五更痛止大半，而人事未全清。予谓此中焦痰盛，非下不可。乃用半夏五钱，巴霜一分
，面糊为丸，每服三十丸，生姜汤送下。下午大便行三次。皆稠粘痰积也。由此饮食少进，
余症瘥可，惟遍身仍略疼。改用二陈汤，加前胡、石膏、 本、薄荷、枳壳、黄芩、石菖蒲
，调理而安。
上舍张怀赤，每天早晨肠鸣腹泻一两次，晚上腹泻一次，四十二岁，且还没有孩子。我诊察他的脉象，寸部和尺部脉短而弱，右关脉滑大。我对他说这是中焦有湿痰，君火和相火都不足，所以出现这种症状。用六君子汤加破故纸、桂心、益智仁、肉豆蔻煎服，腹泻随即减少了一半。又用前面的药方加杜仲制成丸药，服用后痊愈，第二年生了孩子。
臧七房二老夫人，六十八岁，患痢疾，痢疾过后吃多了熟菱角和腐竹汤，导致大便滑泄不固，喝汤水径直往下流不停，胸膈痞闷，说话无力，舌干口燥生疮，吞咽唾液则喉咙疼。元气大虚而有热，都是虚火所致。况且她长期素食二十多年，又在痢疾之后，更知道这不是有余的实证。脉象又是寸部和尺部都弱，两关脉滑大。《内经》说：清气在下，必然产生飧泄；浊气在上，必然产生胀满，说的就是这种情况。治法应当提升清气、降下浊气，补助元气。用四君子汤，加葛根、白芍药、黄连清虚热，止燥渴作为主药，桔梗辅助葛根升提清气作为辅药，陈皮、麦芽降下浊气，以消除胸膈痞闷作为佐药，加乌梅作为使药。上能生津，下能止浊，连服两剂，寸尺脉稍起，饮食也能停在腹中，这才有了生气。仍然用前方加白扁豆、神曲，打糊做成丸药，调理而安。
蔡乐川的妻子，患头痛，痛得像东西打破一样，发根稍微一动，疼痛就蔓延到满头，晕倒不省人事，过了半个时辰才苏醒。全身也作疼，胸膈饱闷，喝汤水停在膈间下不去。前一天吐清水几次，吐出蛔虫三条。原本是因为愤怒而起病，现在有时怕风，有时怕热，口有时渴，有时不渴，大便秘结，脉象则是六部都滑大有力。我说：这是痰厥头痛症。先用藿香正气散止住呕吐，接着用牛黄丸、黑虎丹清心开窍。头仍然很疼，又用天麻、藁本各三钱，半夏二钱，陈皮、白芷、薄荷、麻黄、生姜、葱白煎服，得到少量出汗而头痛稍微停止。到了晚上再服一次，五更时疼痛停止大半，但神志没有完全清醒。我说这是中焦痰盛，非泻下不可。于是用半夏五钱，巴豆霜一分，面糊做成丸药，每次服三十丸，生姜汤送下。下午大便行了三次。都是稠粘的痰积。从此饮食稍微进食，其余症状好转，只有全身仍然略微作疼。改用二陈汤，加前胡、石膏、藁本、薄荷、枳壳、黄芩、石菖蒲，调理而安。
Shangshe Zhang Huaichi experienced bowel sounds and diarrhea once or twice every morning, and once in the evening. He was forty-two years old and had no children. Upon examination, his Cun (Inch) and Chi (Cubit) pulses were short and weak, while the Right Guan (Bar) pulse was slippery and large. I stated that this condition was due to damp-phlegm in the Middle Jiao (Middle Burner), with insufficiency of both Ministerial Fire (Xiang Huo) and Sovereign Fire (Jun Huo). I prescribed Liu Jun Zi Tang (Six Gentlemen Decoction) added with Semen Cuscutae (Pogu Zhi), Cortex Cinnamomi (Guixin), Fructus Alpiniae Oxyphyllae (Yizhiren), and Semen Myristicae (Roudoukou). The decoction was taken orally, and the diarrhea decreased by half. Subsequently, Du Zhong (Cortex Eucommiae) was added to the previous formula to make pills, which cured him; he fathered a child the following year.
The Second Old Madam of Zang Qifang, aged sixty-eight, suffered from dysentery. After overeating cooked water chestnuts and tofu skin soup post-dysentery, she developed loose stools with loss of control. Ingested liquids passed through directly without stopping. She experienced fullness and oppression in the chest and diaphragm, weakness in speech, dry tongue and mouth with sores, and throat pain upon swallowing saliva. Her Yuan Qi (Original Qi) was severely deficient yet presented with heat, all caused by Deficient Fire. Furthermore, having been a vegetarian for over twenty years and currently recovering from dysentery, it was evident that this was not an Excess syndrome. Her Cun and Chi pulses were both weak, and the Guan pulses on both sides were slippery and large. The *Nei Jing* (Inner Canon) states: "When Clear Qi descends below, Sundry Diarrhea (Sun Xie) occurs; when Turbid Qi remains above, Distension (Zhang) results." This is precisely such a case. The treatment method should be to raise the Clear Qi and descend the Turbid Qi, while tonifying the Yuan Qi. Si Jun Zi Tang (Four Gentlemen Decoction) was used as the base. Ge Gen (Radix Puerariae), Bai Shao Yao (Radix Paeoniae Alba), and Huang Lian (Rhizoma Coptidis) were added to clear Deficient Heat and stop dryness/thirst as the Sovereign herbs (Jun). Jie Geng (Radix Platycodi) assisted Ge Gen in raising Clear Qi as the Minister herbs (Chen). Chen Pi (Pericarpium Citri Reticulatae) and Mai Ya (Fructus Hordei Germinatus) were added to descend Turbid Qi and relieve chest fullness as the Assistant herbs (Zuo). Wu Mei (Fructus Mume) was added as the Envoy herb (Shi). The former promoted fluid generation above, and the latter stopped turbidity below. After two doses, the Cun and Chi pulses slightly recovered, food stayed in the stomach, and vitality returned. The same formula was continued with added Bai Bian Dou (Semen Dolichoris Lablabis) and Shen Qu (Massa Medicata Fermentata), mixed with paste to form pills, leading to recovery through regulation.
Madam Cai, wife of Magistrate Cai Lechuan, suffered from headache described as feeling like her head was breaking apart. Slight movement of the hair roots extended the pain throughout the entire head, accompanied by fainting and loss of consciousness, recovering only after half an hour. Her whole body ached, with fullness and oppression in the chest and diaphragm, and ingested fluids remained stuck in the epigastrium without descending. The day prior, she vomited clear fluid several times and expelled three roundworms. The illness originated from anger. Currently, she alternated between aversion to wind and aversion to heat, thirst and lack thereof, constipation, and her six positions (all pulses) were slippery, large, and forceful. I diagnosed this as Phlegm-Jue Headache. First, Huo Xiang Zheng Qi San (Agarweed Powder to Rectify the Qi) was used to stop vomiting, followed by Niu Huang Wan (Calculus Bovis Pill) and Hei Hu Dan (Black Tiger Pellet) to clear the mind and restore consciousness. However, the headache persisted severely. Tian Ma (Rhizoma Gastrodiae) and Xi Xin (Herba Asari, note: text says 本 likely referring to Gaoben/Ligusticum) each at 3 qian, Ban Xia (Rhizoma Pinelliae) at 2 qian, combined with Chen Pi, Bai Zhi, Bo He, Ma Huang, Sheng Jiang, and Cong Bai, were decocted and taken. Slight sweating occurred, and the headache subsided somewhat. Taking it again at night, by Wugeng (early morning), the pain ceased by more than half, though mental clarity was not fully restored. I reasoned that excessive phlegm in the Middle Jiao required purgation. Thus, Ban Xia (5 qian) and Ba Dou Shuang (1 fen) were made into pills with flour paste, thirty pills per dose, taken with Ginger Decoction. Three bowel movements occurred in the afternoon, consisting of thick, sticky phlegm accumulations. Consequently, food intake increased, other symptoms improved, except for slight body aches. Er Chen Tang (Two-Cured Decoction) was then modified with adding Qian Hu, Shi Gao, Xi Xin (Gaoben), Bo He, Zhi Ke, Huang Qin, and Shi Chang Pu, leading to recovery through regulation.