幼时瘦弱，阴虚也。痘后头痛，肝邪旺也。不论外感何邪，头必痛者，阴虚肝旺容易上升
也。十三四岁精气通，真元早泄，此时反胖，且兼痰火头疼，喜于敲者，郁得敲而松也。每发
于春秋，甚于长夏，春分以后秋分以前，温热令行也，补则病无增减，虚能受也，即服消痰
清火亦不见其长短，有病则病当之也。胸腹胀痛而用消克暂快一时，胃得下行为顺之常也。
从前痛时在额，此更前后左右引及者，肝有伏风，善行数变，不惟痰之为物，随气升降，无处
不到也。口中之臭、鼻间之热，胃逆上冲也。睡不足，如在云雾之中，腰脊不能支持，诸阳气
浮而无从也。手足之热，黄白之苔，面发之块热而且痒，有时头晕，阳明中土万物所归，上
而跃也。竹沥可医，上病降而下之也。饮食芳香可受，否则不能者，胃少冲和之气也。不欲
水果，脾不耐寒也。又恶甜腻，胃多湿热也。偏喜肉食、水畜、咸寒，疗肾气虚热也。近更胖
者，温热痰火扶助，一身元气扩充，脾胃反见有余也。因男子二八而精通，通在十三四岁
时，肝之疏泄早行，肾之封藏不固，如此犹可相安于无病，不过知其阳之太过而已。乃于幼
时瘦弱，已昭阴气之虚；痘后头疼更着，肝家之旺。甚至不论何部从外而感，痛如应响，每
发于春秋，甚于长夏。明明春分以后，秋分以前，在天地郁蒸湿热大行之时候，土中素有之
湿热，尚且同声相应，而况二五妙合之时，早
以湿热为种。身中常行春夏之生长，而少秋冬之收藏，大生广生之候，即大病特病之时。张
氏云∶素禀湿热而挟阴虚，此等症是也。虚则补之，实则泻之，各得其所。故免久而生气之
弊。然阳明中万物所归，湿热痰火无不归之于胃。此口中之臭，鼻间之火，黄白之苔，手足之
热，面发之块痒而且热之等象，失其下行为顺之常，有升无降，病无虚日矣。一俟肝阳化风，
习习内动，头之自额而痛者，前后左右靡不引之，以昭风性善行数变，愈转愈深。且至于睡
不足时，如在云雾之中，腰脊不能支持，诸阳气浮，无所根据从，间或眩晕并行，出于不意，阴
虚则失基，亦云甚矣。若论头痛，发明只须竹沥一味可以愈者，降而下之也。此乃暂行之
事，而胃少冲和，所食者仅以芳香可受；脾难健运，所食者竟以水果为嫌。所恶之甜腻，所
喜之肉食，一因湿热内多，一因阴气虚极，不问可知。自始至终，既不外阴虚湿热，无怪乎
其驾驭湿热者反能扶助作为，已胖而益胖也。然阴虚与湿热又不两立，窃恐中年以后贻患
无穷也，不能不早为之计焉。附方请政。
大熟地（八钱） 丹皮（三钱） 泽泻（二钱） 淮山药（四钱） 云苓（三钱） 白芍（二钱）
石决明（三钱） 黄柏（一钱） 知母（二钱） 青盐（二钱） 甘菊（一钱） 女贞子（三钱） 旱莲草（三
钱） 沉香化气丸（三钱）
为末，取忍冬藤五斤，洗净寸截，煎汤，去渣，成膏。入前药量，加白蜜糊丸。每服三钱，
早晚两服，盐汤送下。
幼时身体瘦弱，这是阴虚的表现。出痘之后出现头痛，是肝邪亢盛所致。无论感受何种外邪，头部必定疼痛，这是因为阴虚且肝气旺盛，容易导致气机上逆。十三四岁时精气通畅，真元过早耗泄，此时身体反而发胖，并且兼有痰火引起的头痛，喜欢敲击头部，是因为通过敲击使郁结之气得以舒缓。头痛每逢春秋季节发作，在长夏时节加重，春分之后、秋分之前，正值温热气候盛行之时，服用补益药物病情无增减，说明身体虚弱能够承受补药；即使服用消痰清火的药物，也看不出明显疗效，这是因为有病邪存在，药物作用被病邪所抵消。胸腹胀痛时使用消导攻伐的药物暂时感到痛快，因为胃气以下行为顺是其正常生理规律。从前头痛部位在额头，现在扩展到前后左右牵引疼痛，这是因为肝内有潜伏的风邪，风性善行数变，不仅痰湿这种病理产物会随着气机的升降而流动，无处不到。口中异味、鼻间发热，是胃气上逆冲撞所致。睡眠不足，感觉头昏脑胀如在云雾之中，腰脊无法支撑，这是因为诸阳气浮越而无根基。手足发热，舌苔黄白，面部皮肤出现肿块且热痒，有时头晕，阳明经（胃）作为中土，是万物归聚之所，气机上跃。竹沥可以治疗，是因为它能引上部的病邪向下消退。饮食中能接受芳香的食物，否则不能接受，这是因为胃中缺乏冲和之气。不喜欢吃水果，是因为脾脏不耐受寒凉。又厌恶甜腻食物，是因为胃中湿热较多。特别喜欢吃肉类、水产以及咸寒食物，是为了调理肾气的虚热。最近身体更胖，是因为温热痰火助长了元气，使得一身元气扩充，脾胃反而显得有余。
男子十六岁左右精通，如果在十三四岁时就精气通畅，说明肝的疏泄功能过早行使，肾的封藏功能不坚固。像这样尚且能相安无事没有大病，不过只是知道阳气太过而已。然而幼时瘦弱，已经显示出阴气虚弱；出痘后头痛更加严重，显示肝家亢旺。甚至不论从哪个部位感受外邪，疼痛如回声相应，每逢春秋发作，长夏加重。明明是在春分之后、秋分之前，天地之间郁蒸湿热大行的时候，体内素有的湿热，尚且同声相应，何况在父母阴阳二气结合之时，早已以湿热为种子。身体常行春夏的生长之气，而缺少秋冬的收藏之气，处于大生广生的状态，也就是大病特病发生的时候。张氏说：素体禀赋湿热而夹杂阴虚，这类病症就是如此。虚则补之，实则泻之，各得其所，从而避免日久损伤生气的弊端。然而阳明经是万物归聚之所，湿热痰火无不归于胃。这些口中的臭气、鼻间的火热、黄白的舌苔、手足的热感、面部肿块痒且热等现象，失去了下行为顺的正常规律，只有上升没有下降，疾病就没有空闲的日子了。一旦肝阳化风，习习内动，头痛从额头开始，前后左右无不牵引，以显示风性善行数变，病情愈转愈深。以至于睡眠不足时，感觉如在云雾之中，腰脊不能支持，诸阳气浮越，无所依托，偶尔眩晕并发，出乎意料，阴虚则失去根基，情况已经很严重了。如果论及头痛，发明只需一味竹沥就可以治愈，这是为了降而下之。这仅仅是权宜之计，而胃中缺乏冲和之气，所吃的食物仅能以芳香类为可接受；脾脏难以健运，所吃的食物竟然以水果为忌讳。所厌恶的甜腻，所喜欢的肉食，一方面是因为湿热内多，一方面是因为阴气极度虚弱，不问可知。自始至终，无非是外阴虚湿热，难怪那些驾驭湿热的人反而能扶助作为，已经肥胖却更加肥胖。然而阴虚与湿热又不相容，恐怕中年以后会遗留无穷祸患，不能不提前为之打算。附上方剂请指正。
大熟地（八钱） 丹皮（三钱） 泽泻（二钱） 淮山药（四钱） 云苓（三钱） 白芍（二钱） 石决明（三钱） 黄柏（一钱） 知母（二钱） 青盐（二钱） 甘菊（一钱） 女贞子（三钱） 旱莲草（三钱） 沉香化气丸（三钱）
研为细末，取忍冬藤五斤，洗净切成寸段，煎汤，去渣，浓缩成膏。加入前面的药量，加白蜜制成糊丸。每次服用三钱，早晚各一次，用盐汤送服。
In childhood, the body was thin and weak, indicating Yin deficiency. Headache after smallpox indicates hyperactive Liver pathogenic factors. Regardless of what external pathogen is contracted, the head must hurt because Yin deficiency and Liver hyperactivity easily lead to upward rising. At thirteen or fourteen years old, essence and Qi were open, but true Yuan Qi leaked early; at this time, the body became fat, accompanied by headache due to Phlegm-Fire, and a preference for knocking on the head because knocking relaxes the stagnation. Attacks occur in Spring and Autumn, worsening in Late Summer. From Jingzhe (Spring Equinox) to Bai Lu (Autumn Equinox), warm-heat seasons prevail. Tonification does not change the condition, as the deficiency can tolerate it; even taking phlegm-resolving and fire-clearing herbs shows no significant effect, because the disease itself absorbs the therapeutic action. Chest and abdominal distension and pain temporarily relieved by resolving and purging methods, as Stomach Qi descending smoothly is its normal physiological state. Previously, pain was located in the forehead; now it radiates to the front, back, left, and right, indicating latent Wind in the Liver, which is agile and changes rapidly. Not only do pathological products like Phlegm move with Qi ascending and descending, reaching everywhere. Bad breath and heat in the nose indicate rebellious Stomach Qi rushing upward. Insufficient sleep leads to a sensation of being in clouds/fog, inability to support the waist and spine, due to floating Yang Qi lacking a foundation. Heat in hands and feet, yellow-white tongue coating, lumps on the face that are hot and itchy, occasional dizziness: Yangming Earth (Stomach) is where all things gather, leading to upward leaping. Zhu Li (Bamboo Sap) can cure this, by lowering the pathology from above. Aromatic foods are acceptable, otherwise not, due to lack of harmonious Qi in the Stomach. Dislike for fruits indicates Spleen's intolerance to cold. Aversion to sweet and greasy foods indicates damp-heat in the Stomach. Preference for meat, aquatic animals, and salty-cold foods treats Kidney Qi deficiency heat. Recent weight gain is due to warm-heat and Phlegm-Fire supporting Yuan Qi, expanding the whole body's vitality, making the Spleen and Stomach appear surplus.
Men typically reach seminal emission around sixteen (two eights). If emission occurs at thirteen or fourteen, Liver's draining and dispersing function acts too early, while Kidney's storing and sealing function is not solid. Such a state may remain relatively peaceful without major illness, merely showing excessive Yang. However, childhood thinness already revealed Yin Qi deficiency; post-smallpox headache worsened, revealing Liver excess. Even when contracting pathogens from any part externally, pain resonates immediately, occurring in Spring/Autumn and worsening in Late Summer. Clearly, during the period after Spring Equinox and before Autumn Equinox, when Heaven and Earth are dominated by stagnant, steaming damp-heat, the internal damp-heat naturally resonates. How much more so when the parents' Yin and Yang combined, planting damp-heat as a seed? The body constantly undergoes Spring-Summer growth, lacking Autumn-Winter storage. This state of vigorous generation is also the time for major diseases. Zhang Shi said: "Constitutional damp-heat mixed with Yin deficiency" describes such cases. Deficiency requires tonification, excess requires purging, each finding its place, thereby avoiding long-term damage to Sheng Qi (vitality). However, Yangming is where all things gather; damp-heat, Phlegm, and Fire all converge in the Stomach. Symptoms like bad breath, nasal fire, yellow-white coating, hand/foot heat, and itchy/hot facial lumps show a loss of the normal downward flow, having only ascent without descent, leaving no days free of disease. Once Liver Yang transforms into Wind, moving internally, headache starting from the forehead radiates everywhere, demonstrating Wind's agility and rapid changes, deepening progressively. When sleep is insufficient, one feels like in clouds, unable to support the waist/spine, with floating Yang Qi lacking foundation, occasionally suffering sudden vertigo. Yin deficiency means loss of foundation, which is severe. Regarding headache, if only Zhu Li is needed to cure it, it is to lower and descend. This is a temporary measure. Due to lack of harmonious Qi in the Stomach, only aromatic foods are tolerated; due to Spleen's difficulty in transportation and transformation, fruits are avoided. Aversion to sweet/greasy and preference for meat stem from internal damp-heat and extreme Yin deficiency, respectively, which is obvious. Throughout, it is nothing but exterior Yin deficiency and internal damp-heat. No wonder those managing damp-heat actually assist it, causing obesity to increase. However, Yin deficiency and damp-heat are incompatible. I fear endless troubles after middle age, so planning must be made early. Attached prescription for correction.
Prepared Rehmanniae Radix Preparata (8 qian), Moutan Cortex (3 qian), Alisma Rhizoma (2 qian), Dioscoreae Rhizoma (4 qian), Poria (3 qian), White Peony Root (2 qian), Abalone Shell (3 qian), Phellodendri Cortex (1 qian), Anemarrhenae Rhizoma (2 qian), Blue Salt (2 qian), Chrysanthemi Flos (1 qian), Ligustri Lucidi Fructus (3 qian), Ecliptae Herba (3 qian), Chenxiang Huqi Wan (3 qian).
Pulverize. Take five jin of Lonicerae Japonicae Caulis (Honeysuckle Vine), wash clean, cut into inch-lengths, decoct in water, remove dregs, and concentrate into a paste. Mix with the aforementioned powders, add white honey to form pills. Take 3 qian per dose, morning and evening, washed down with salt water.