旧宪治公祖江鼎寰先生。望七之龄。精神健旺。脉气坚实。声音洪亮。晋接不厌其繁。纷丝尚能兼理。
不羡洛社耆英。行见熙朝元老矣。偶有胸膈弗爽。肺气不清。鼻多浊涕小恙。召诊日
兼患齿痛。谨馈以天冬熟地石枣丹皮枸杞五味等。收摄肾气药
四剂。入桂些少为引经。服之齿痛顿止。鼻气亦清。第因喉中作干。未肯多服。门下医者素逢主。见治标热。
不治本虚。特为辨曰。祖翁所禀先天阳气甚浓。冬月尚仍早兴晚寝。饮蔗啖梨。是以服药多喜清畏补。然补
有阴阳之不同。阳气虽旺于上。阴气未必旺于下。髭鬓则黑。步履则迟。其一征也。运臂则轻。举腰
则重。其一征也。阳道易兴。精液难固。其一征也。胃能多受。肠弗久留。其一征也。下本不虚。下之精华。
暗输于上。是以虚也。上本不实。清阳之分。为阴所凑。似乎实也。故阴凑于上而开窍于目。则为泪。开窍
于鼻。则为涕。开窍于口。则为涎为唾。经云。五十始衰。谓阴气至是始衰也。阴气衰。故不能自主而从阳上
行。其屑越者。皆身中之至宝。向非收摄归元。将何底极。是以事亲养老诸方。皆以温补下元为务。诚有见
于老少不同。治少年人惟恐有火。高年人惟恐无火。无火则运化艰而易衰。有火则精神健而难老。有火者老人
性命之根。未可以水轻折也。昔贤治喉干。谓八味丸为圣药。譬之釜底加薪。则釜中津气上腾。理则然矣。可见
下虚者。不但真阴虚。究竟真阳亦虚。何也。阳气以潜藏为贵。潜则弗亢。潜则可久。易道也。盏中加油。则
灯愈明。炉中覆灰。则火不熄。与其孤阳上浮为热。曷若一并收归于下。则鼻中之浊涕不作。口中之清液常
生。虽日进桂附。尚不觉其为热。矧清利润下之剂。而反致疑乎。是为辨。
胡卣臣先生曰。吾乡诸老。享有遐龄者最多。鼎寰廉访年来绝欲忘
机。怡情悦性。大药不藉草木之偏。上寿更无涯 可测。此案第借为高年立法。理自不诬。
前任宪台江鼎寰先生。年届七十。精神健旺。脉气坚实。声音洪亮。接待宾客不厌其烦。繁杂的公务尚能兼顾处理。
他不羡慕洛社（指洛阳耆英会，代指退休高官雅集）中的老前辈们，看来将成为太平盛世的老臣了。偶尔有些胸膈不适、肺气不清爽、鼻中多浊涕的小毛病。请诊时又说兼患牙痛。我恭敬地开出了天冬、熟地黄、山茱萸、牡丹皮、枸杞子、五味子等收摄肾气的药物四剂，加入少许桂枝作为引经药。服用后牙痛立刻停止，鼻气也清爽了。只是因为喉咙发干，他不敢多服。门下的医生一向逢迎主人，只见治标的热象，不治本体的虚损。特地辨析说：祖翁所禀受的先天阳气非常浓厚，冬天仍然早起晚睡，喝甘蔗汁吃梨子。所以服药大多喜欢清凉而畏惧温补。然而补益有阴阳的不同。阳气虽然旺盛于上焦，阴气未必旺盛于下焦。胡须鬓角还是黑的，但步履迟缓，这是其一征候。运臂轻松，但举腰沉重，这是其二征候。性功能容易兴奋，但精液难以固摄，这是其三征候。胃能容纳较多食物，但肠道不能久留，这是其四征候。下焦根本并不虚，下焦的精华暗中输送到了上焦，所以上焦显得虚。上焦本来就不充实，清阳之分野被阴邪凑聚，似乎显得实证。所以阴邪凑聚于上并开窍于目，就产生泪；开窍于鼻，就产生涕；开窍于口，就产生涎和唾。《内经》说：五十岁开始衰老，是说阴气到这个时候才开始衰退。阴气衰退，所以不能自主控制而随阳气上行。那些流失的，都是身体中的至宝。如果不是收摄回归本源，将会有什么尽头呢？因此侍奉父母养老的各种方剂，都以温补下元为要务。确实看到了老少不同，治疗年轻人惟恐有火，治疗老年人惟恐无火。没有火则运化艰难且容易衰败，有火则精神健旺却难衰老。有火是老人性命的根本，不可以用水轻易折损它。以前的贤人治疗喉干，认为八味丸（金匮肾气丸）是圣药。就像在锅底加柴火，那么锅中的津气就会上腾，道理就是这样。可见下焦虚的人，不仅是真阴虚，究竟真阳也是虚的。为什么呢？阳气以潜藏为贵。潜藏则不亢奋，潜藏则可持久，这是易道的原理。盏中加油，灯就更明亮；炉中覆盖灰烬，火就不会熄灭。与其让孤阳上浮产生热症，不如一并收归于下焦，那么鼻中的浊涕就不会产生，口中的清液常生。即使每天进服桂枝、附子，还不觉其为热，何况是清利润下的药剂，反而让人怀疑吗？这就是我的辨析。
胡卣臣先生说：我们乡里的老人们，享有长寿的最多。鼎寰观察使近年来断绝欲望、忘却心机，怡情悦性。大药不借助草木药物的偏性，高寿更没有边际可以测量。这个医案只是借用来为高龄者树立法则，道理自然无误。
Mr. Jiang Dinghuan, former Xiantai (Provincial Surveillance Commissioner), was in his seventies. His spirit was vigorous, his pulse qi firm and solid, his voice resonant. He did not tire of receiving guests frequently and could still manage complex official duties.
He did not envy the elders of the Luoshe (a gathering of retired dignitaries), and it seemed he would become a veteran statesman of this prosperous era. Occasionally, he suffered from minor ailments such as chest and diaphragm discomfort, unclear lung qi, and excessive turbid nasal discharge. Upon consultation, he also mentioned toothache. I respectfully prescribed four doses of herbs to consolidate Kidney Qi, including Tian Dong (Asparagi Radix), Shu Di Huang (Rehmanniae Radix Preparata), Shan Zhu Yu (Corni Fructus), Mu Dan Pi (Moutan Cortex), Gou Qi Zi (Lycii Fructus), and Wu Wei Zi (Schisandrae Fructus), with a small amount of Gui Zhi (Cinnamomi Ramulus) added as a guiding herb. After taking them, the toothache stopped immediately, and the nasal breathing became clear. However, due to dryness in the throat, he was unwilling to take more. The physicians in my gate, who were accustomed to flattering the host, saw only the superficial heat and ignored the root deficiency. They specifically argued:
The Ancestor's innate Yang Qi is very strong. In winter, he still rises early and sleeps late, drinking sugarcane juice and eating pears. Therefore, he prefers cooling medicines and fears tonifying ones. However, tonification differs in Yin and Yang. Although Yang Qi is abundant in the upper jiao, Yin Qi may not be abundant in the lower jiao. His beard and temples are black, yet his steps are slow; this is one sign. His arms move lightly, but lifting his waist feels heavy; this is another sign. His sexual function is easily aroused, but his essence is difficult to secure; this is a third sign. His stomach can accept much food, but his intestines do not retain it long; this is a fourth sign. The lower root is not deficient; the essence of the lower jiao secretly transfers to the upper jiao, making the upper appear deficient. The upper jiao is originally not substantial; the realm of clear Yang is invaded by Yin pathogens, appearing as an excess syndrome. Thus, when Yin invades the upper and opens into the eyes, tears are produced; when it opens into the nose, nasal discharge is produced; when it opens into the mouth, saliva and sputum are produced. The Classic says: "At fifty, decline begins," meaning that Yin Qi begins to decline at this age. Because Yin Qi declines, it cannot control itself and follows Yang Qi upward. What is lost are the supreme treasures of the body. If they are not gathered and returned to the source, where will it end? Therefore, all prescriptions for caring for parents and the elderly focus on warming and tonifying the lower Yuan. It is truly observed that young and old differ: treating the young, we fear fire; treating the elderly, we fear lack of fire. Without fire, transformation is difficult and decline is easy; with fire, spirit is vigorous but aging is hard. Fire is the root of life for the elderly; it should not be easily extinguished with water. Former sages treated throat dryness, regarding Ba Wei Wan (Eight-Ingredient Pill with Rehmannia) as a sacred medicine. It is like adding firewood to the bottom of a pot, causing the fluids and qi within the pot to rise; the principle is sound. Thus, it is seen that those with lower deficiency suffer not only from True Yin deficiency but ultimately from True Yang deficiency as well. Why? Because Yang Qi values submergence. Submerged, it does not hyperactive; submerged, it lasts long. This is the way of Yi Jing. Adding oil to a lamp makes the light brighter; covering ashes on a stove keeps the fire from extinguishing. Rather than allowing solitary Yang to float upward causing heat, why not gather it back to the lower jiao? Then turbid nasal discharge will not occur, and clear fluids in the mouth will constantly generate. Even if Gui Zhi (Cinnamomi Ramulus) and Fu Zi (Aconiti Lateralis Radix Preparata) are taken daily, one would not feel heat. How much less so for clearing and lubricating agents that descend, which might cause suspicion? This is my argument.
Mr. Hu Youchen said: Among the elders in our hometown, many enjoy long life. Dinghuan, the Inspector, has recently abstained from desires and forgotten worldly schemes, finding joy in his nature. The great medicine does not rely on the biases of herbal plants; extreme longevity is immeasurable. This case merely uses him as a model for the elderly; the principle is undoubtedly correct.