凡久病服寒凉。气伐过多。以至三阳气衰。痰凝气滞。以调元之剂治之。阳气一动。则
少阳先升。少阳欲先出。前有太阳。后有阳明。遏截不能伸。少阳之气至太阳。太阳与之并
则寒。与阳明并则热。适成寒热疟状。非真疟也。其太阳气达。遂有伤风之状。鼻塞恶风寒
之症见矣。阳明气达。则有作泻之症。此时正当调脾补元。分头施治。则旧病尽脱矣。
损病。六脉俱数。声哑口中生疮。昼夜发热无间。经云。数则脾气虚。此真阴虚也。用
四君。加黄 山药莲肉白芍五味子麦冬煎。去头煎不用。止服第二三煎。此为养脾阴秘法也。
服十余日。发热渐退。口疮渐好。方用丸剂。如参苓白术散。亦去头煎。晒干为末。陈米锅
焦打糊为丸。如绿豆大。每日服三钱。或上午一钱。百沸汤下。盖煎去头煎。则燥气尽。遂
成甘淡之味。淡养胃气。微甘养脾阴。师师相授之语。毋轻忽焉。
愚按。煎去头煎不用。黄履素（讳承昊）折眩漫录。亦云神妙秘法。
又按。以淡补脾之说。余一时亦不能会悟。后得徐灵胎书。谓五味各有所属。味甘属土。
然土实无味也。故洪范论五行之味。润下作咸。炎上作苦。曲直作酸。从KT 作辛。皆即
其物言之。惟于土则曰稼穑作甘不指土而指土之所生者。可知土本无味也。无味即为淡。淡
者。五味之所从出。即土之正味也。故味之淡者。皆属于土。如茯苓山药石斛之类是也。五
脏皆受气于脾。故脾为五脏之本。五味皆托始于淡。故淡为五味之本。慎柔黄履素煎去头煎。
取无味之味以补脾。诚秘法也。
凡是久病服用寒凉药物，攻伐之气过多，导致三阳经气衰微，痰湿凝结、气机阻滞，应当用调补元气之剂来治疗。一旦阳气发动，少阳经气首先升发。少阳经气想要外出，前方有太阳经，后方有阳明经，受到遏制截断而不能舒展。当少阳经气运行到太阳经时，与太阳经气相并合则出现恶寒；与阳明经气相并合则出现发热，恰好形成类似寒热往来的疟疾症状，但这并非真正的疟疾。等到太阳经气通达后，就会出现伤风的症状，鼻塞、怕冷怕风等症状显现出来。当阳明经气通达后，则会出现腹泻的症状。此时正当调理脾胃、补益元气，分头施治，那么旧有的疾病就能完全摆脱了。
虚损类疾病，六脉都呈现数象（脉搏快），声音嘶哑，口中生疮，昼夜发热没有间歇。医经说：“脉数表示脾气虚弱。”这实际上是真阴亏损。使用四君子汤，加入黄精、山药、莲肉、白芍、五味子、麦冬煎煮。去掉第一遍煎出的药汁不用，只服用第二、第三遍煎出的药汁。这是滋养脾阴的秘法。服用十余日后，发热逐渐消退，口疮逐渐好转。随后改用丸剂，如参苓白术散，也去掉第一遍煎出的药汁，晒干研成粉末，用陈年米锅底的焦糊打浆做成丸药，大小如绿豆。每天服用三钱，或者上午服用一钱，用滚开水送服。因为煎煮时去掉第一遍药汁，燥气就尽去了，于是变成了甘淡的味道。淡味能养胃气，微甘能养脾阴。这是师徒相传的经验之语，不可轻视。
我按语：煎煮时去掉第一遍药汁不用，黄履素（名承昊）在《折眩漫录》中也称其为神妙的秘法。
另外按语：关于以“淡”味补脾的说法，我一时也不能领悟。后来得到徐灵胎的书信，其中提到五味各有归属，味甘属土。然而土本身是没有味道的。所以《洪范》论述五行之味时，水润下作咸，火炎上作苦，木曲直作酸，金从革作辛，都是直接指事物本身的性质而言。唯独对于土，说是“稼穑作甘”，不直接指土本身，而是指土所生长的作物。由此可知土本无味。无味就是淡。淡，是五味的来源，也就是土的纯正味道。所以味道淡的药材，都属于土，如茯苓、山药、石斛等。五脏的气血都受之于脾，所以脾是五脏的根本。五味都依托于淡而产生，所以淡是五味的根本。慎柔和黄履素煎药时去掉第一遍药汁，取无味的味道来补脾，确实是秘法。
In cases of chronic illness where cold-cooling herbs have been taken excessively, leading to an over-attack on vital energy and resulting in the decline of Qi in the Three Yang channels (Taiyang, Shaoyang, Yangming), with phlegm coagulation and Qi stagnation, one should treat it with formulas that regulate and replenish primordial Yuan Qi. Once Yang Qi is activated, the Qi of the Shaoyang channel rises first. As Shaoyang Qi attempts to emerge, it is blocked by Taiyang ahead and Yangming behind, preventing its free expansion. When Shaoyang Qi reaches Taiyang and merges with it, chills occur; when it merges with Yangming, heat occurs. This creates a pattern resembling the alternating chills and fever of malaria, but it is not true malaria. Once Taiyang Qi becomes unobstructed, symptoms of wind-strike appear, such as nasal congestion and aversion to wind and cold. Once Yangming Qi becomes unobstructed, diarrhea ensues. At this stage, one should regulate the Spleen and tonify Yuan Qi, treating each aspect separately, so that the old ailments will be completely resolved.
In consumptive diseases, if all six pulses are rapid (Shu), accompanied by hoarseness, oral ulcers, and continuous day-and-night fever without respite, the Classics state: "Rapid pulses indicate deficiency of Spleen Qi." This is actually a deficiency of True Yin. Use Si Jun Zi Tang (Four Gentlemen Decoction) supplemented with Huang Jing (Polygonatum Rhizome), Shan Yao (Dioscorea Rhizome), Lian Rou (Lotus Seed Flesh), Bai Shao (White Peony Root), Wu Wei Zi (Schisandra Fruit), and Mai Dong (Ophiopogon Tuber). Discard the first decoction and consume only the second and third decoctions. This is a secret method for nourishing Spleen Yin. After taking this for more than ten days, the fever gradually subsides, and the oral ulcers heal. Subsequently, switch to pill preparations, such as Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder). Also discard the first decoction, dry and powder it, then use the charred residue from cooking aged rice in a pot as a binder to form pills the size of mung beans. Take three qian daily, or one qian in the morning, washed down with boiling water. By discarding the first decoction, the drying properties are removed, leaving a sweet and bland flavor. Blandness nourishes Stomach Qi, while slight sweetness nourishes Spleen Yin. These are teachings passed down from master to disciple; do not neglect them lightly.
My commentary: Discarding the first decoction is also described as a miraculous secret method by Huang Lv Su (courtesy name Cheng Hao) in his *Zhe Xuan Man Lu*.
Further commentary: I initially could not comprehend the theory of using blandness to tonify the Spleen. Later, I read works by Xu Ling Tai, which stated that the Five Flavors correspond to specific elements: Sweetness belongs to Earth. However, Earth itself has no flavor. Thus, in the *Hong Fan* (Great Plan), the flavors of the Five Elements are described as follows: Water's nature is moistening and downward, yielding Saltiness; Fire's nature is flaming upward, yielding Bitterness; Wood's nature is bending and straightening, yielding Acidity; Metal's nature is cutting and transforming, yielding Pungency. These descriptions refer directly to the substances themselves. Only regarding Earth does it say "cultivation and harvesting yield Sweetness," referring not to Earth itself but to what Earth produces. This indicates that Earth inherently has no flavor. No flavor is equivalent to Blandness. Blandness is the source from which the Five Flavors arise and is the true flavor of Earth. Therefore, herbs with a bland taste belong to Earth, such as Fu Ling (Poria), Shan Yao (Dioscorea Rhizome), and Shi Hu (Dendrobium Stem). The Five Zang organs derive their Qi from the Spleen; thus, the Spleen is the root of the Five Zang. The Five Flavors all originate from Blandness; therefore, Blandness is the root of the Five Flavors. Chen Rou and Huang Lv Su discarded the first decoction to extract the flavorless flavor to tonify the Spleen. This is indeed a secret method.