汪石山治一妇，经行必泻三日，然后行，诊其脉皆濡弱，此脾虚也。脾属血属湿，经水
将动，脾血先已流注血海，然后下流为经。脾血既亏，则虚而不能营运其湿（濡弱二字，足征脾虚，此脾气虚而非脾血
虚也，用药当矣。而血亏不运之说欠妥）。今作参苓白术
一妇年逾四十，形长色脆，病经不行，右脉浮软而大，左脉虚软而小近快，常时经前作
泄。今年四月感风咳嗽，用汤洗浴汗多，因泄一月；六月复因洗浴，发疟六七次，疟虽止而
神思不爽；至八月尽，而经水过多，白带时下，泻泄，觉右脚疼痛，旧曾闪肭脚跟，今则假
此延痛臀腿腰胁、尻骨颈项，右边筋脉皆掣痛，或咳嗽一声，则腰眼痛如腰札，日轻夜重，
叫号不已，幸痛稍止，饮食如常。今详月水过多，白带时下，日轻夜重，泻泄无时，亦属下
多亡阴，宜作血虚论治，服四物止痛之剂益甚（据脉审证，明是脾虚下陷，岂得谓亡阴而补血乎？大谬大谬）。九月汪
复诊视，始悟此病，乃合仲景所谓
阳生则阴长之法矣。夫经水多，白带下，常泄泻，皆由阳虚陷下而然，命曰阳脱是也。日轻
夜重，盖日阳旺，而得健运之职，故血亦无凝滞之患，而日故轻；夜则阴旺，而阳不得其任
，失其健运之常，血亦随滞，故夜重。遂以参、术助阳之药（据愚意当用补中益气加续断、杜仲、茯苓），煎服五七帖
痛减。此亦病证之
汪石山治疗一位妇女，每次月经来潮必然腹泻三天，然后月经才正式行经。诊察其脉象均为濡弱（细软无力），这是脾虚的表现。脾在五行中属土，主运化水湿并统摄血液。当月经即将发动时，脾血先流注于血海（冲脉），然后下行成为经血。既然脾血已经亏虚，就会导致虚弱而不能正常运化体内的湿气。（注：原文括号内为后世医家按语，指出“濡弱”二字足以证明是脾气虚而非脾血虚，用药得当；但认为“血亏不运”的说法欠妥。）
另一位四十多岁的妇女，身形修长但面色脆弱，患有闭经症。右脉浮软而大，左脉虚软而小且接近数脉。平时在经期前会出现腹泻。今年四月因感受风邪咳嗽，用汤药洗浴后出汗过多，因此导致腹泻持续一个月；六月再次因为洗浴，发作疟疾六七次，虽然疟疾停止，但精神思维不清爽；到了八月末，月经量过多，白带不时下泄，伴有腹泻，感觉右脚疼痛。她以前曾扭伤脚跟，现在借此牵连至臀部、腿部、腰部、胁肋、尾骨及颈项部位，右侧筋脉都出现牵引性疼痛。有时咳嗽一声，腰眼处就像被针刺一样疼痛，白天轻晚上重，痛苦呼叫不止。幸好疼痛稍止，饮食如常。如今详细分析，月经量多，白带时下，白天轻晚上重，腹泻无定时，这也属于下部失血导致阴液亡失，应当作为血虚论治，服用四物汤加止痛药物反而更加严重。（注：原文括号内为后世医家按语，指出根据脉象审察证候，明明是脾虚下陷，怎么能说是亡阴而补血呢？这是极大的错误。）九月汪石山再次诊视，才明白这个病，符合张仲景所说的“阳生则阴长”的方法。月经量多，白带下泄，经常腹泻，都是由阳气虚弱下陷所致，这叫做阳脱。白天轻晚上重，是因为白天阳气旺盛，能够行使健运的功能，所以血液也没有凝滞的隐患，因此白天症状轻；夜晚则是阴气旺盛，阳气不能胜任，失去了健运的常态，血液随之停滞，所以晚上症状重。于是使用人参、白术等助阳的药物（注：原文括号内为后世医家建议，认为应当使用补中益气汤加续断、杜仲、茯苓），煎服五到七帖后疼痛减轻。这也是病症……
Wang Shishan treated a woman who experienced diarrhea for three days with every menstrual period, which would only cease after the menstruation began. Upon examining her pulse, it was found to be soggy and weak (soggy and weak indicates deficiency), pointing to Spleen deficiency. The Spleen belongs to Earth and governs dampness and blood. When menstruation is about to commence, Spleen-blood first flows into the Sea of Blood (Chong Mai) and then descends as menstrual flow. Since Spleen-blood has become deficient, it becomes too weak to properly transport and transform internal dampness. [Commentary: The terms "soggy and weak" suffice to prove Qi deficiency of the Spleen rather than Blood deficiency; the medication used was appropriate. However, the theory that "blood deficiency fails to transport" is questionable.]
Another woman, over forty years old, tall in stature but fragile in complexion, suffered from amenorrhea. Her right pulse was floating, soft, and large, while her left pulse was deficient, soft, small, and approaching rapidity. Normally, she experienced diarrhea before her menstrual period. In April of this year, she contracted wind-cold causing coughing; after taking herbal decoctions and bathing, she sweated excessively, leading to diarrhea lasting for a month. In June, following another bath, she suffered from malaria six or seven times. Although the malaria subsided, her mental clarity remained impaired. By the end of August, her menstrual flow became excessive, leukorrhea occurred intermittently, and diarrhea persisted. She felt pain in her right foot. Previously, she had sprained her heel, but now the pain extended to the buttocks, legs, waist, hypochondrium, sacrum, and neck, with pulling pain in the meridians on the right side. A single cough caused sharp, stabbing pain in the lumbar region. The symptoms were lighter during the day and heavier at night, accompanied by incessant cries of pain. Fortunately, the pain subsided slightly, and her appetite remained normal. Upon detailed analysis, excessive menstrual flow, intermittent leukorrhea, diurnal lightness with nocturnal heaviness, and unregulated diarrhea all point to Yin depletion due to lower body hemorrhage. It should be treated as Blood deficiency. However, administering Siwu Tang (Four Substances Decoction) with pain-relieving herbs exacerbated the condition. [Commentary: Based on the pulse and syndrome differentiation, this is clearly Spleen Qi sinking. How can it be considered Yin depletion requiring Blood tonification? This is a grave error.] In September, Wang Shishan re-examined the patient and realized that this case aligns with Zhang Zhongjing’s principle of "Yang generation leads to Yin growth." Excessive menstruation, leukorrhea, and chronic diarrhea are all caused by Yang deficiency and sinking. This is termed Yang collapse. The pattern of being lighter during the day and heavier at night occurs because daytime Yang is vigorous, allowing the Spleen to perform its transporting functions effectively, thus preventing Blood stasis, resulting in lighter symptoms. At night, Yin is dominant, and Yang cannot fulfill its role, losing its normal transporting function, causing Blood to stagnate, hence heavier symptoms. Consequently, he prescribed herbs that assist Yang, such as Renshen (Radix Ginseng) and Baizhu (Rhizoma Atractylodis Macrocephalae). After taking five to seven doses, the pain decreased. This also illustrates...