萃翁公郎，禀质向亏，诵读烦劳，心神伤耗。初病浮火上升，继则阳强不密，精时自下
。诊
脉虚细无力，方定六味地黄汤。除茯苓泽泻，加麦冬五味远志枣仁牡蛎芡实，期以功成。百
日服药数剂未应，更医病状依然，复召诊视。予曰∶此水火失济象也，岂能速效。仍用前方
再加龙骨蒺藜桑螵蛸莲蕊须，合乎滑者涩之之意。守服两旬，虚阳渐敛，精下日减。但病久
形羸食少，究由脾胃有亏。经云∶肾者主水，受五脏六腑之精而藏之，是精藏于肾，非生于
肾也。譬诸钱粮，虽贮库中，然非库中自出。须补脾胃化源，欲于前方内参入脾药，嫌其杂
而不专，乃从脾肾分治之法，早用参苓白术散，晚间仍进前药。服之益效，续拟丸方，调养
而瘳。
余氏子八龄，形瘦阴虚，夏患瘅疟，愈后失调。值秋燥时，偶作寒热，幼科泛投疏散之
剂，
转致躁扰搐搦，危证百出。余翁求视，以决死生。予见其儿，肢掣痰鸣，身热烦躁，势颇危
笃。诊脉神根未败，予曰∶疾固剧矣，然尚可生。翁喜叩其说，予曰∶惊风一证，时世无传
，小儿受害，不可胜数。喻氏虽辟其谬，特重外感，轻内伤，经曰∶东方青色，入通于肝。
其病发惊骇，医昧病因，用方通套，偶遇强实而应者有之，特此儿所患，本非外因，良由肾
水下虚，肝失所养，木逢金制，故作寒热。状似外感，误投疏散，津液更伤。因而肝风鼓动
，变幻若此。予尚望其生者，因其脉犹未败耳。方拟六味地黄汤，滋水生木，更加归芍甘草
钩藤之属，和阳熄风，风熄而惊自定矣。翁闻言甚悦，服药痰平热退，不搐不烦，另制膏子
药与服全愈。
萃园翁的公子，先天体质向来虚弱，因读书用脑过度，耗伤了心神。起初表现为虚火上炎，随后出现阳强而不固摄，精液时常自行滑出。诊察其脉象虚细无力，因此确定使用六味地黄汤作为基础方剂。去掉方中的茯苓和泽泻，加入麦冬、五味子、远志、酸枣仁、牡蛎、芡实，期望能取得疗效。然而服用百余日，仅服用了数剂药却未见效果，更换医生后病情依旧，于是再次请我诊治。我说：这是水火不能既济（心肾不交）的表现，怎么可能迅速见效？仍然沿用前面的方剂，再加入龙骨、蒺藜、桑螵蛸、莲须，符合“滑者涩之”（对于滑脱不禁的病证，采用收敛固涩的方法治疗）的治疗原则。坚持服用二十天，虚阳逐渐收敛，遗精次数每日减少。但是病久导致形体消瘦、食欲减退，究其根源在于脾胃亏损。《内经》说：肾主水，接受五脏六腑的精气而贮藏它，这说明精虽然藏于肾，但并非由肾单独生成。这就好比钱粮，虽然储存在仓库中，但并非仓库自己生产出来的。必须补益脾胃以生化源泉，想在前方中加入健脾药物，又担心药性杂乱而不专一，于是采取脾肾分治的方法，早上服用参苓白术散，晚上继续服用之前的方药。服药后效果更加显著，随后拟定丸药方剂，经过调养而痊愈。
余家的儿子八岁，身体瘦弱，属于阴虚体质。夏天患过瘅疟（一种热势亢盛的疟疾），病愈后调护不当。正值秋季燥邪当令时，偶尔出现寒热往来的症状，儿科医生盲目投用疏散解表的药剂，反而导致烦躁不安、抽搐惊厥，各种危重证候纷纷出现。余翁请求诊治，以判断生死预后。我看那孩子，四肢抽搐、喉间痰鸣，身体发热、烦躁不安，形势相当危急。诊察其脉象，神根尚未败绝，我说：疾病固然严重，但还可以救治。翁高兴地向我问询其中的道理，我说：惊风这一证候，当今时代缺乏正确的传承，小儿受害，不可胜数。喻嘉言先生虽然批判了其谬误，特别重视外感病，轻视内伤病，《内经》说：东方青色，入通于肝。其发病表现为惊骇，医生不明白病因，使用通用的套方，偶尔遇到体质强实而奏效的，但这孩子所患的，本就不是外因所致，确实是由于肾水下虚，肝失所养，肝木受到肺金的克制，所以出现寒热往来。症状看似外感，误用疏散药物，进一步损伤津液。因而导致肝风鼓动，变幻出这样的症状。我还希望他能存活，是因为他的脉象还没有败绝。处方拟定六味地黄汤，滋补肾水以涵养肝木，再加上当归、白芍、甘草、钩藤等药物，调和阳气、平息肝风，风熄则惊自然安定。翁听后非常高兴，服药后痰平热退，不再抽搐烦躁，另外制作膏剂药物服用，最终完全痊愈。
Mr. Cuiyuan's son had a constitution that was inherently deficient. Due to the mental exertion of reading and studying, his heart and spirit were damaged and depleted. Initially, floating fire rose upward; subsequently, yang became strong but not secure, causing semen to slip out spontaneously. His pulse was weak, fine, and powerless. Therefore, Liuwei Dihuang Decoction (Six-Ingredient Rehmannia Root Pill) was prescribed as the base formula. Fuling (Poria) and Zexie (Alisma Rhizome) were removed from the formula, and Maidong (Ophiopogon Tuber), Wuweizi (Schisandra Fruit), Yuanzhi (Polygala Root), Zaoren (Ziziphus Seed), Muli (Oyster Shell), and Qianshi (Euryale Seed) were added, with the expectation of achieving therapeutic success. However, after taking several doses over a hundred days, there was no response. After consulting other physicians, the condition remained unchanged, so he summoned me again for consultation. I stated: "This is a manifestation of water and fire failing to interact harmoniously (heart-kidney non-interaction). How can rapid efficacy be expected?" I continued using the previous formula, adding Longgu (Fossilized Bone), Jili (Tribulus Fruit), Sangpiaoxiao (Mantis Egg Case), and Lianruxu (Lotus Stamen), adhering to the principle of "astringing what is slipping" (using astringent methods for incontinence or seminal emission). After persistently taking the medicine for twenty days, the deficient yang gradually敛 (gathered/consolidated), and the frequency of seminal emission decreased daily. However, due to the chronic nature of the illness, his physique became emaciated and appetite diminished. Ultimately, this stemmed from spleen and stomach deficiency. The Classic states: "The Kidney governs water and receives the essence of the five zang and six fu organs to store it." This indicates that while essence is stored in the kidney, it is not generated solely by the kidney. It is like money and grain: although stored in the treasury, they are not produced within the treasury itself. One must tonify the spleen and stomach to replenish the source of transformation. Adding spleen-tonifying herbs to the current formula was deemed too mixed and lacking in focus. Therefore, a method of treating the spleen and kidney separately was adopted: Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) was taken in the morning, while the previous prescription was continued at night. The efficacy improved significantly. Subsequently, a pill formula was devised for convalescence, leading to recovery.
The eight-year-old son of the Yu family was thin and yin-deficient. In summer, he suffered from Danmalaria (a type of malaria with intense heat), and after recovery, he was improperly cared for. When autumn dryness prevailed, he occasionally experienced alternating chills and fever. Pediatric practitioners indiscriminately administered dispersing and releasing agents, which led to restlessness, convulsions, and various critical symptoms. Mr. Yu sought my consultation to determine his prognosis. Upon seeing the child, I observed limb jerking, phlegm rattle in the throat, body heat, and irritability, indicating a critical condition. His pulse still retained its root and spirit. I said: "Although the disease is severe, survival is still possible." The father joyfully asked for an explanation. I replied: "The syndrome of 'Jingfeng' (Convulsive Wind) lacks proper transmission in contemporary times, and countless children have suffered from it. Although Dr. Yu Jiabian criticized its fallacies, emphasizing external pathogens over internal injuries, the Classic states: 'East corresponds to Wood, color green, and communicates with the Liver. Diseases manifesting here involve fright and terror.' Physicians often fail to identify the etiology and use generic formulas. Occasionally, such treatments succeed in patients with robust constitutions, but this child's condition was not caused by external factors. It was indeed due to deficiency of lower jiao kidney water, leading to liver malnourishment. Wood being controlled by Metal resulted in alternating chills and fever. The presentation resembled an external contraction, but the misuse of dispersing agents further injured body fluids. Consequently, liver wind stirred internally, causing these transformations. I hoped for his survival because his pulse had not yet failed." I prescribed Liuwei Dihuang Decoction (Six-Ingredient Rehmannia Root Pill) to nourish kidney water to generate liver wood, adding Danggui (Angelica Sinensis Root), Shaoyao (Peony Root), Gancao (Licorice Root), and Gouteng (Uncaria Ramulus cum Uncis) to harmonize yang and extinguish wind. Once the wind was extinguished, the fright naturally settled. The father was very pleased. After taking the medicine, the phlegm subsided, heat receded, and convulsions and irritability ceased. A separate paste preparation was made and administered, resulting in complete recovery.