因外疡复烦劳。致营卫交损。寒热咳嗽盗汗。经阻两月。渐延干血瘵疾。
左关弦。来去躁疾。右细涩。食减。阳明困顿。血液暗耗。日久恐有偏枯之累。此刻当理阳
金斛 茯苓 半曲 橘红 钩藤 桑叶
温养下焦。佐泄厥阴。
巴戟天 茯苓 胡芦巴 菟丝子 川楝子 桂心 小茴香 补骨脂
劳伤肝阳络松失血。左脉弦。
生地 豆皮 藕节 茯神 白牛膝 珠菜
气不宣达。胸痹。大便不行。
枇杷叶 紫菀 枳壳 土蒌皮 杏仁 桔梗
血后咳嗽。宜益肺胃。
北沙参 麦冬 霍斛 白扁豆 茯神
右关沉涩。左脉弦劲。此木火内亢。阳明络泣。脘痛嘈杂头旋。
桑叶 桃仁 黑芝麻 柏仁 红花 大淡菜
脉弦腹膨。气逆动怒致此。肝邪冲逆阳明也。切勿嗔怒。势恐变幻。慎之慎之。
川楝子 茯苓 化橘红 大麦芽 青皮 砂仁壳
火郁发热齿痛。
薄荷 花粉 黑栀 生草 赤芍
寒暖不调。邪阻肺卫。哮喘痰血。
旋复花 米仁 橘红 霜蒌仁 苏子 浙苓
脾阳下陷。便溏肠红。
失血咳呛梦泄。皆属下焦不藏。
熟地 北沙参 天冬 旱莲草 茯神 川石斛 山药 女贞子
右寸独大。
饮逆呕恶。
半夏 干姜 茯苓
复受客邪。身痛脘闷。
苏梗 半夏 枳壳 橘红 杏仁 麦芽
气阻脘痹。
苏梗汁 香附汁 枳壳汁 桔梗汁
阳微。湿阻汗泄。
因患外科疮疡，又加过度劳累。导致营气与卫气双重受损。出现寒热往来、咳嗽、盗汗等症状。月经停止两个月。病情逐渐发展为干血劳（一种以阴虚血枯为主的慢性虚损性疾病）。
左侧关部脉象弦紧，脉搏来去急促躁动；右侧脉象细而涩滞。食欲减退，阳明胃气困顿虚弱。血液暗中耗损。日久恐怕会有半身不遂的祸患。此刻应当调理上焦肺金。
[方药]：金斛、茯苓、神曲、橘红、钩藤、桑叶。
温养下焦。辅以清泄厥阴肝经之邪。
[方药]：巴戟天、茯苓、胡芦巴、菟丝子、川楝子、桂心、小茴香、补骨脂。
劳损伤及肝阳，络脉松弛导致失血。左脉弦。
[方药]：生地、丹皮、藕节、茯神、怀牛膝、珠菜。
气机不能宣通达畅。出现胸痹（胸部闷痛）。大便不通。
[方药]：枇杷叶、紫菀、枳壳、土瓜蒌皮、杏仁、桔梗。
失血后咳嗽，适宜补益肺胃。
[方药]：北沙参、麦冬、霍山石斛、白扁豆、茯神。
右侧关部脉沉而涩，左侧脉弦劲有力。这是木火内盛亢逆，阳明络脉泣滞（气血运行不畅）。脘腹疼痛、嘈杂不适、头晕。
[方药]：桑叶、桃仁、黑芝麻、柏子仁、红花、大淡菜。
脉弦且腹部膨隆。因气逆和发怒导致此症。肝邪冲逆侵犯阳明胃腑。切勿嗔怒。病情恐怕会发生变化。务必谨慎。
[方药]：川楝子、茯苓、化橘红、大麦芽、青皮、砂仁壳。
火邪郁结发热，牙齿疼痛。
[方药]：薄荷、花粉、黑栀子、生甘草、赤芍。
寒暖调节失调，邪气阻滞肺卫。哮喘伴有痰中带血。
[方药]：旋复花、薏苡仁、橘红、霜瓜蒌仁、苏子、浙贝母/茯苓（注：原文“浙苓”通常指浙贝或茯苓，此处依语境及常见配伍，若指化痰多指浙贝，若指利水多指茯苓，结合前文已有茯苓，此处暂译作浙贝母或保留原意，考虑到WHO术语，Zhe Bei Mu更常见于此类清热化痰方，但原文写浙苓，可能为浙江产茯苓或笔误，此处按字面译为Zhejiang Poria 或 Zhe Bei。鉴于“哮喘痰血”，浙贝母可能性大，但严格忠实原文“浙苓”译为 Zhejiang Poria 或注明。此处为了学术准确，若“浙苓”指代不明，通常中医古籍中“浙苓”较少见，多为“浙贝”之误或特定产地茯苓。此处译为 Zhejiang Poria (Zhejiang Fuling) 以保真，或根据上下文“哮喘”推测为化痰药。*修正*：在叶天士医案中，“浙苓”常指浙江产的茯苓，或者有时是“浙贝”的简写。但看方剂组成：旋复花、米仁、橘红、霜蒌仁、苏子，均为降气化痰平喘药，缺一味主要化痰散结药。若为茯苓则偏渗湿。此处暂译为 Zhejiang Poria。) *再次修正*：查阅叶氏医案习惯，"浙苓"多指浙江产的茯苓。故译为 Zhejiang Poria。
失血、咳嗽呛逆、梦遗，都属于下焦封藏失职。
[方药]：熟地、北沙参、天冬、旱莲草、茯神、川石斛、山药、女贞子。
右侧寸部脉独大。
再次感受外邪。身体疼痛，脘腹闷胀。
[方药]：苏梗、半夏、枳壳、橘红、杏仁、麦芽。
气机阻滞，脘部痹阻。
[方药]：苏梗汁、香附汁、枳壳汁、桔梗汁。
阳气微弱。湿气阻滞，汗出泄泻。
Due to external sores and subsequent overexertion, both Ying (Nutritive) and Wei (Defensive) Qi were damaged. Symptoms included alternating chills and fever, coughing, night sweats, and amenorrhea for two months. The condition gradually progressed into Ganxue Zhai (Dry Blood Consumption Disease, a chronic consumptive disease characterized by Yin deficiency and blood exhaustion).
The pulse at the left Guan position was wiry, rapid, and restless; the right pulse was fine and choppy. Appetite decreased, indicating stagnation and weakness of the Yangming Stomach Qi. Blood was being secretly consumed. If prolonged, there is a fear of hemiplegia. At this stage, it is necessary to regulate the Lung Metal of the Upper Jiao.
[Formula]: Jinhu (Dendrobium officinale), Fuling (Poria cocos), Banqu (Medicated Leaven), Juhong (Exocarpium Citri Reticulatae Viride), Gouteng (Uncaria rhynchophylla), Sangye (Folium Mori).
To warm and nourish the Lower Jiao, assisted by draining the Jueyin Liver channel.
[Formula]: Bajitian (Morinda officinalis), Fuling (Poria cocos), Huluhaba (Phaseolus vulgaris seed), Tusizi (Cuscutae Semen), Chuanlianzi (Fructus Toosendan), Guixin (Cortex Cinnamomi), Xiaohuixiang (Fructus Foeniculi), Buguzhi (Fructus Psoraleae).
Labor injury damaged Liver Yang, causing loose collaterals and bleeding. The left pulse is wiry.
[Formula]: Shengdi (Rehmanniae Radix Preparata), Dapi (Moutan Cortex), Oujie (Rhizoma Nelumbinis Nuciferae), Fushen (Poria cum Radice Pinelliae), Huainiuxi (Achyranthis Bidentatae Radix), Zhuccai (likely a local or specific herb name, possibly referring to a type of vegetable or medicinal plant, kept as Zhuccai).
Qi fails to circulate freely. Chest Bi (obstruction syndrome with chest pain) occurs, accompanied by constipation.
[Formula]: Pipaye (Folium Eriobotryae), Ziwan (Asteris Radix), Zhike (Aurantii Fructus Immaturus), Tuloupi (Pericarpium Trichosanthis), Xingren (Armeniacae Semen Amarum), Jiegeng (Platycodonis Radix).
For coughing after blood loss, it is appropriate to tonify the Lung and Stomach.
[Formula]: Beishashen (Glehniae Radix), Maidong (Ophiopogonis Tuber), Huoxu (Dendrobium huoshanense), Baibiandou (Dolichoris Lablab Semen Album), Fushen (Poria cum Radice Pinelliae).
The right Guan pulse is deep and choppy; the left pulse is wiry and forceful. This indicates internal hyperactivity of Wood-Fire, with stagnation in the Yangming collaterals. Symptoms include epigastric pain, acid regurgitation/burning sensation, and dizziness.
[Formula]: Sangye (Folium Mori), Taoren (Persicae Semen), Heihemaizi (Sesami Nigris Semen), Bairén (Platycladi Semen), Honghua (Carthami Flos), Da Dancai (Mytilus edulis).
Wiry pulse and abdominal distension. Caused by rebellious Qi and anger. Liver pathogenic factors are rebelling against the Yangming Stomach. Do not become angry. The condition may change drastically. Be extremely cautious.
[Formula]: Chuanlianzi (Fructus Toosendan), Fuling (Poria cocos), Huajuhong (Exocarpium Citri Reticulatae Viride), Dayamai (Hordei Fructus Germinatus), Qingpi (Citri Reticulatae Pericarpium Viride), Sharenqiao (Cardamomi Fructus Shell).
Fire depression causing fever and toothache.
[Formula]: Bohe (Menthae Haplocalycis Herba), Huafen (Trichosanthis Radix), Heizhi (Gardeniae Fructus Carbonized), Shengcao (Glycyrrhizae Radix et Rhizoma Preparata), Chishao (Paeoniae Radix Rubra).
Imbalance of cold and warmth allows pathogens to obstruct the Lung and Wei defenses. Asthma with bloody sputum.
[Formula]: Xuanfuhua (Inulae Flos), Yiren (Coicis Semen), Juhong (Exocarpium Citri Reticulatae Viride), Shuang Louren (Trichosanthis Semen), Suzi (Perillae Fructus), Zhe Ling (Zhejiang Poria / potentially Zhe Bei Mu, translated here as Zhejiang Poria based on literal text).
Spleen Yang sinking. Loose stools and intestinal bleeding.
Hemorrhage, coughing, and nocturnal emission all belong to the failure of the Lower Jiao to secure and store.
[Formula]: Shudi (Rehmanniae Radix Preparata), Beishashen (Glehniae Radix), Tiandong (Asparagi Tuber), Hanliancao (Ecliptae Herba), Fushen (Poria cum Radice Pinelliae), Chuanshihu (Dendrobii Caulis), Shanyao (Dioscoreae Rhizoma), Nvzhenzi (Ligustri Lucidi Fructus).
The right Cun pulse alone is large.
Rebellious fluid retention, vomiting, and nausea.
[Formula]: Banxia (Pinelliae Rhizoma), Ganjiang (Zingiberis Rhizoma), Fuling (Poria cocos).
Secondary exposure to exogenous pathogens. Body pain and epigastric stuffiness.
[Formula]: Sugeng (Perillae Caulis), Banxia (Pinelliae Rhizoma), Zhike (Aurantii Fructus Immaturus), Juhong (Exocarpium Citri Reticulatae Viride), Xingren (Armeniacae Semen Amarum), Maiya (Hordei Fructus Germinatus).
Qi obstruction causing epigastric Bi syndrome.
[Formula]: Sugeng juice, Xiangfu juice, Zhike juice, Jiegeng juice.
Yang deficiency. Dampness obstruction leading to sweating and diarrhea.