予病脾胃久衰，视听半失，此阴盛乘阳，加之气短，精神不足，此由弦脉令虚，多言
之过，皆阳气衰弱，不得舒伸，伏匿于阴中耳。癸卯岁六七月间，淫雨阴寒，逾月不止，时
人多病泄利，湿多成五泄故也。一日，予体重、肢节疼痛，大便泄并下者三，而小便闭塞。
思其治法，按∶《内经·标本论》∶大小便不利，无问标本，先利大小便。又云∶在下者
，引而竭之，亦是先利小便也。又云∶诸泄利，小便不利，先分别之。又云∶治湿不利小便
，非其治也。皆当利其小便，必用淡味渗泄之剂以利之，是其法也。噫！圣人之法，虽布在
方册，其不尽者，可以求责耳。今客邪寒湿之淫，从外而入里，以暴加之，若从以上法度，
用淡渗之剂以除之，病虽即已，是降之又降，是复益其阴，而重竭其阳气矣，是阳气愈削，
而精神愈短矣，是阴重强而阳重衰矣，反助其邪之谓也。故必用升阳风药即瘥，以羌活、独
活、柴胡、升麻各一钱，防风根截半钱，炙甘草根截半钱，同 咀，水四中盏，煎至一
盏，去渣，稍热服。大法云∶湿寒之胜，助风以平之。又曰∶下者举之，得阳气升腾而
去矣。又法云∶客者除之，是因曲而为之直也。夫圣人之法，可以类推，举一而知百病者
，若不达升降浮沉之理，而一概施治，其愈者幸也。
戊申六月初，枢判白文举年六十二，素有脾胃虚损病，目疾时作，身面目睛俱黄，小
便或黄或白，大便不调，饮食减少，气短上气，怠惰嗜卧，四肢不收。至六月中，目疾复作
，医以泻肝散下数行，而前疾增剧。予谓大黄、牵牛，虽除湿热，而不能走经络。下咽，不
入肝经，先入胃中。大黄苦寒，重虚其胃；牵牛其味至辛，能泻气，重虚肺本，嗽大作，盖
标实不去，本虚愈甚。加之适当暑雨之际，素有黄证之人，所以增剧也。此当于脾胃肺之本
脏，泻外经中之湿热，制清神益气汤主之而愈。
我患脾胃久衰之病，视力和听力部分丧失，这是阴气盛而乘袭阳气所致；加上气短、精神不足，这是由于弦脉导致正气虚弱，以及多言耗气的过错，都是阳气衰弱，不能舒展伸张，潜伏隐匿在阴分中的缘故。癸卯年六七月间，淫雨连绵，阴寒之气过重，超过一个月不停止，当时许多人患病腹泻，这是因为湿气重容易形成五种泄泻病的缘故。有一天，我感到身体沉重、关节疼痛，大便泄泻且一天三次，同时小便闭塞不通。思考其治疗方法，查阅《内经·标本论》：大小便不利，无论标本缓急，都应先通利大小便。又说：病位在下者，通过引导使其从下排出，这也是先通利小便的意思。又说：各种泄泻痢疾，若小便不利，应先加以分辨。又说：治疗湿邪若不通利小便，就不是正确的治法。这些都说应当通利小便，必须使用淡味渗泄的药物来通利它，这是常规法则。唉！圣人的医法，虽然记载在书籍中，但其中未尽之意，可以通过推求来掌握。如今客邪寒湿之邪，从外侵入体内，突然加于人身，如果按照上述法则，使用淡渗药物来祛除它，病虽然立即痊愈，但这却是降之又降，反而增加了阴气，从而再次竭尽阳气了，这样阳气更加削弱，精神更加短少，阴气更加强盛而阳气更加衰弱，这反而是助长邪气的做法。所以必须使用升阳的风药才能痊愈，用羌活、独活、柴胡、升麻各一钱，防风根半钱，炙甘草根半钱，共同捣碎，用水四盏，煎煮至一盏，去渣，稍热服用。大法说：湿寒胜复，用风药来平抑它。又说：下陷者举之，使阳气升腾而病去。又一种说法是：客邪者除之，这是因势利导使之正直。圣人的医法，可以类推，举一反三，如果不通达升降浮沉的道理，而一概施治，能痊愈的只是侥幸罢了。
戊申年六月初，枢判白文举六十二岁，素有脾胃虚损之病，眼疾时常发作，全身、面目及眼珠都发黄，小便有时黄有时白，大便不调，饮食减少，气短且气上逆，倦怠嗜卧，四肢无力收持。到了六月中，眼疾再次发作，医生用泻肝散攻下数次，结果前面的疾病加重。我认为大黄、牵牛子，虽然能除湿热，但不能走窜经络。咽下后，不进入肝经，先进入胃中。大黄苦寒，严重损伤胃气；牵牛子味道极辛，能泻气，严重损伤肺之本脏，咳嗽大作，这是因为标实的邪气未去，本虚的体质更加严重。加之正值暑雨季节，素来有黄疸证的人，所以病情加重。这应当针对脾胃肺的本脏，清泻外经中的湿热，用清神益气汤主治而痊愈。
I suffered from long-standing Spleen and Stomach deficiency, with partial loss of vision and hearing. This is due to Yin excess encroaching upon Yang, compounded by shortness of breath and insufficient spirit. These conditions arise from the Xuan pulse (String-like pulse) indicating deficiency, and the fault of excessive talking. All are manifestations of weakened Yang Qi, unable to expand and extend, thus lying hidden within the Yin aspect. In the sixth and seventh months of the Gui-Mao year, continuous rain and excessive cold persisted for over a month. Many people at that time suffered from diarrhea and dysentery, as excessive dampness tends to form the five types of Xiexie (Diarrheal diseases). One day, I experienced heavy body weight and pain in the joints, frequent loose stools (three times), and urinary obstruction. Reflecting on the treatment method, according to the *Neijing·Biaoben Lun* (Treatise on Root and Branch): For difficulty in urination and defecation, regardless of root or branch priority, one should first promote urination and defecation. It also states: "For ailments below, guide and exhaust them," which implies promoting urination first. Furthermore: "For all diarrheal diseases, if urination is difficult, distinguish it first." And: "To treat dampness without promoting urination is not the correct method." All suggest promoting urination, necessarily using bland-flavored draining and leeching agents. This is the standard method. Alas! The methods of the Sages, though recorded in books, have unexpressed nuances that can be grasped through inference. Now, the pathogenic cold-dampness invades from the exterior to the interior, striking suddenly. If one follows the aforementioned rules and uses bland-draining agents to eliminate it, although the disease may resolve immediately, this represents "descending again and again," thereby increasing Yin and further depleting Yang Qi. Consequently, Yang Qi becomes more depleted, spirit becomes weaker, Yin becomes stronger while Yang becomes weaker; this actually assists the pathogen. Therefore, one must use ascending Wind herbs to achieve recovery: Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Chaihu (Bupleuri Radix), and Shengma (Cimicifugae Rhizoma), each 1 qian; Fangfenggen (Saposhnikoviae Radix), half a qian; Zhi Gancaogen (Glycyrrhizae Radix Preparata), half a qian. These are coarsely crushed, boiled in four cups of water until one cup remains, strained, and taken slightly warm. The general principle states: "When damp-cold prevails, assist with Wind herbs to pacify it." It also says: "What has sunk, lift it up; let the ascending Yang Qi carry it away." Another principle states: "Eliminate the intruder," which means correcting deviation by following its course. The Sages' methods can be inferred analogously; understanding one case reveals a hundred. Without comprehending the principles of Ascending-Descending and Floating-Sinking, applying treatments indiscriminately, recovery is merely fortunate.
In early June of the Wu-Shen year, Bai Wenju, Director of the Pivot Bureau, aged sixty-two, had a chronic history of Spleen and Stomach deficiency. His eye disorders occurred intermittently. His whole body, face, eyes, and sclera were yellowish. His urine was sometimes yellow, sometimes white. His bowel movements were irregular. He had reduced appetite, shortness of breath with qi rebellion, lethargy, propensity to sleep, and flaccidity of the four limbs. By mid-June, his eye disorder recurred. Physicians administered Xiegan San (Liver-Draining Powder) several times via purgation, causing the previous ailments to worsen. I reasoned that Dahuang (Rhei Radix et Rhizoma) and Qianniu (Pharbitidis Semen), although capable of clearing damp-heat, cannot travel through the meridians. Upon ingestion, they do not enter the Liver channel but first enter the Stomach. Dahuang is bitter and cold, severely weakening the Stomach; Qianniu is extremely pungent, capable of draining qi, and severely damages the Lung organ. This led to severe coughing. Because the excess at the branch level was not removed, the underlying deficiency became worse. Additionally, during the hot and rainy season, individuals predisposed to Huangzheng (Jaundice) would see exacerbation. Treatment should target the root organs of the Spleen, Stomach, and Lung, clearing damp-heat from the exterior meridians. Qing Shen Yi Qi Tang (Clear Spirit and Boost Qi Decoction) was prescribed, resulting in recovery.