张裕斋，恶寒，痰多，作呃，胸膈不宽。两寸俱短弱，关洪大，尺涩。此上焦气虚，中
焦有
痰，下元不实也。法当清中补下。不然，后将有中风之患。二陈汤加白蔻仁、香附、藿香以
开胃气，白芥子、萝卜子、杏仁以降痰而润大便。两帖诸症悉去。乃录八味肾气丸方与之，
令自调理。
大柱史严印台夫人，年近六十，已孀居十年余，以孀居而食长素。其婿张怀赤善予，语
曰∶
外母近鼻塞，大便泻，胸膈不畅，医者下之益甚。予曰∶王海藏有云，杂病酒积，下之早必
成痞满，所当慎也。用拉予诊之，两寸沉弱，关弦大，两尺亦弱。予曰∶此阳气其弱，脾气
大虚，不当下而误下之，故鼻作塞而胸痞闷也。用苍术、川芎、桂枝、白芷、防风、桔梗，
以疏风而升阳气，白蔻仁、萝卜子，宽胸利膈，麦芽以助脾气。服后鼻不塞而胸犹痞，复用
东垣木香化滞汤，加吴茱萸、干姜而安。乃嘱之曰∶病虽渐愈，第阳气虚，脾气弱，不宜久
食素，恐中气不充，防作中满，谨识之，谨识之!
王谷泉，大便作泻，上身热，耳中壅塞，头眩晕，胸膈不宽，口渴，痰多，咳嗽，六脉
俱濡
弱，汗大出。此正气大虚，或由克伐太过所致，当以补养为先。人参、白术、白芍药酒炒各
四钱，柴胡、石菖蒲、陈皮各一钱，炙甘草五分，泽泻、茯苓各一钱。两服而神清、膈宽、
脾健，惟汗不敛，眩晕未除。再与人参、白术、黄 、酒炒白芍药各二钱，炙甘草五分，大
附子五分，桂枝三分，泽泻一钱而愈。
张裕斋，出现恶寒、痰多、打呃、胸膈不宽畅的症状。两手寸脉都短而弱，关脉洪大，尺脉涩。这是上焦气虚，中焦有痰，下元（肾与命门）不充实的表现。治疗法则应当清化中焦痰湿并补益下元。如果不这样，日后可能会有中风的风险。使用二陈汤加白蔻仁、香附、藿香来开胃气，加白芥子、萝卜子、杏仁来降痰并润通大便。服用两帖后，所有症状全部消除。于是记录八味肾气丸的方子给他，让他自行调理身体。
大柱史严印台夫人，年龄接近六十岁，已经守寡居住十多年了，因为守寡而长期吃素食。她的女婿张怀赤善于施予帮助，对我说：“岳母最近鼻塞，大便泄泻，胸膈不畅快，医生用攻下法治疗后病情反而加重。”我说：“王海藏说过，杂病中的酒积，如果过早使用攻下法，必定形成痞满证，这一点必须谨慎。”于是拉我去诊脉，发现两手寸脉沉弱，关脉弦大，两尺脉也弱。我说：“这是阳气虚弱，脾气大虚，本不该用攻下法却误用了攻下法，所以导致鼻子堵塞和胸膈痞闷。使用苍术、川芎、桂枝、白芷、防风、桔梗，来疏风并升发阳气；用白蔻仁、萝卜子，宽胸利膈；用麦芽来助脾气。服药后鼻子不再堵塞但胸膈仍然痞闷，再次使用东垣的木香化滞汤，加入吴茱萸、干姜后病情安定。于是嘱咐她说：‘病虽然逐渐好转，但是阳气虚，脾气弱，不宜长期吃素食，恐怕中气不能充盈，预防发生中满证，务必记住，务必记住！’”
王谷泉，大便泄泻，上身发热，耳朵壅塞不通，头晕目眩，胸膈不宽畅，口渴，痰多，咳嗽，六脉都濡弱，大汗出。这是正气大虚，可能是由于过度使用攻伐药物所致，应当以补养为先。用人参、白术、白芍药（酒炒）各四钱，柴胡、石菖蒲、陈皮各一钱，炙甘草五分，泽泻、茯苓各一钱。服用两剂后神志清醒、胸膈宽畅、脾气健运，只有汗液未收敛，眩晕未除。再给人参、白术、黄芪、酒炒白芍药各二钱，炙甘草五分，大附子五分，桂枝三分，泽泻一钱，病就好了。
Zhang Yuzhai presented with aversion to cold, profuse phlegm, hiccups, and a sensation of fullness/stuffiness in the chest and diaphragm. Both cun (inch) pulses were short and weak, the guan (bar) pulse was surging and large, and the chi (foot) pulse was choppy. This indicates deficiency of qi in the upper jiao (upper burner), presence of phlegm in the middle jiao (middle burner), and insufficiency of the lower yuan (lower origin/kidney and mingmen). The treatment principle should be to clear the middle jiao and tonify the lower jiao. Otherwise, there will be a risk of stroke later. Er Chen Tang (Two-Cured Decoction) was prescribed with added Bai Kou Ren (Amomi Fructus Rotundus), Xiang Fu (Cyperi Rhizoma), and Huo Xiang (Agastachis Herba) to open the stomach qi; plus Bai Jie Zi (Sinapis Semen), Luo Bo Zi (Brassicae Semens), and Xing Ren (Armeniaceae Semen) to descend phlegm and moisten the bowels. After two doses, all symptoms disappeared. Then, the formula for Ba Wei Shen Qi Wan (Eight-Ingredient Kidney Qi Pill) was recorded for him to use for self-regulation.
Madam Yan Yintai, wife of Grand Secretary Yan, was nearly sixty years old and had been a widow for over ten years, maintaining a vegetarian diet due to her widowhood. Her son-in-law, Zhang Huaichi, who was generous, said to me: "My mother-in-law recently has nasal congestion, loose stools, and discomfort in the chest and diaphragm. A physician treated her with purgatives, which worsened her condition." I replied: "Wang Haizang stated that in miscellaneous diseases involving wine accumulation, premature use of purgatives will inevitably lead to pi man (stuffiness and fullness); this must be handled with caution." Consequently, I examined her pulse. Both cun pulses were deep and weak, the guan pulse was wiry and large, and both chi pulses were also weak. I said: "This is weakness of yang qi and severe deficiency of spleen qi. It should not have been treated with purgatives, but rather was mistakenly purged, causing nasal congestion and chest stuffiness. Cang Zhu (Atractylodis Rhizoma), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Gui Zhi (Cinnamomi Ramulus), Bai Zhi (Angelicae Dahuricae Radix), Fang Feng (Saposhnikoviae Radix), and Jie Geng (Platycodonis Radix) were used to disperse wind and raise yang qi; Bai Kou Ren (Amomi Fructus Rotundus) and Luo Bo Zi (Brassicae Semens) were used to broaden the chest and benefit the diaphragm; Mai Ya (Hordei Fructus Germinatus) was used to assist spleen qi. After taking the medicine, the nasal congestion resolved, but the chest remained stuffy. Dong Yuan's Mu Xiang Hua Zhi Tang (Costus Regulating Stagnation Decoction) was then prescribed with added Wu Zhu Yu (Evodiae Fructus) and Gan Jiang (Zingiberis Rhizoma), after which she stabilized. I advised her: 'Although the illness is gradually improving, your yang qi is deficient and spleen qi is weak. You should not continue a long-term vegetarian diet, lest the central qi fail to fill up, preventing the occurrence of zhong man (central fullness). Remember this well, remember this well!'"
Wang Guquan presented with loose stools, heat in the upper body, ear blockage/fullness, dizziness and vertigo, chest and diaphragm discomfort, thirst, profuse phlegm, cough, soggy and weak pulses throughout all six positions, and profuse sweating. This indicates severe deficiency of righteous qi, possibly caused by excessive use of attacking/draining methods. Tonification and nourishment should be prioritized. Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), and Bai Shao Yao (Paeoniae Radix Alba, stir-fried with wine) each 4 qian; Chai Hu (Bupleuri Radix), Shi Chang Pu (Acori Tatarinowii Rhizoma), and Chen Pi (Citri Reticulatae Pericarpium) each 1 qian; Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle) 5 fen; Ze Xie (Alismatis Rhizoma) and Fu Ling (Poria) each 1 qian. After two doses, mental clarity returned, the diaphragm felt open, and spleen function improved, except that sweating did not cease and dizziness persisted. Subsequently, Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Huang Qi (Astragali Radix), and wine-fried Bai Shao Yao (Paeoniae Radix Alba) each 2 qian; Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle) 5 fen; Da Fu Zi (Aconiti Lateralis Radix Preparata) 5 fen; Gui Zhi (Cinnamomi Ramulus) 3 fen; and Ze Xie (Alismatis Rhizoma) 1 qian were administered, resulting in recovery.