女科肝病为多，产后必病及八脉，即如少腹瘕聚，冲气攻心，必呕吐。逆上则喉间闭寒
水半年不来，越日常有寒热。凡下焦多属血病，症属气聚，瘕为血痹。病在冲脉，阴维阳维
混混施治，焉得入奇经。
延胡索 川楝子 蓬术 桃仁 生鳖甲 地鳖虫 麝香 楂炭
脉缓按之濡弱，谷少不食，浓味运化最迟。饮食不适，即欲痛泻，肤腠麻木，骨软筋痛。且
遇暴风骤冷，体中更觉不安，上年肠红，入夏方愈，种种脉症，是气弱阳微，脾胃少于运化
，湿郁生痰，致气机不能灵动，法当健阳佐运，即治痰驱湿之本。
人参 于术 茯苓 半夏 陈皮 益智仁 木瓜 天麻 生姜 大枣
女子四十九天癸当止，谓阳明脉衰，冲脉力怯，不能招集诸络之血，聚于血海，按月经行。
此向老皆然。今秋热致伤，客邪不重，已见带淋，肌麻血阻，内伤之势已露。况所患甚于腰
腹，是必脏阴内损，及于八脉，有形之血既去，无形之气掀旋，诸窍百骸，攻迫肆症，即身
中之阳气独行，不得真阴眷恋耳。熟地、五味，滋收固不甚谬，然不入奇经，法当介用潜阳
。咸味下引，酸味内收，或佐微苦微润。盖肝恶刚喜凉，肾恶燥喜暖，古人之制然矣。
盐水炒阿胶 茯苓 山萸肉炭 盐水炒鳖甲 知母 女贞子 盐水炒旱莲草 天冬 盐水炒黄柏
幼稚惊痫，古人有阳痫之分，据述自幼至今，不论寒暑，寐必汗泄，乃藏真不固，阳不内
根据，致内风灼筋牵强，冒窍神迷。且时时神馁恐惧，治在肝肾，用包举大气，内安肝肾。
熟地 石菖蒲 龙骨 五味子 远地 茯苓 琐阳 黄柏 萸肉
紫河车膏丸。
惊则动肝，肝气上逆，忧则伤肺，肺气失降，升降失司，中焦不运，气聚成形，风扰鸣泄。
仲景论上升吐蛔，下坠狐惑，都从胃虚起见，风木相侮，阳土日困，食减便溏有诸。由惊忧
偏逆致病，因病失治，延虚最难奏效。用药不过生化克制之理，培其受侮，平其冲扰，补阳
明以宣府，泄厥阴以平逆，如是而已。至于拔病根，在乎居恒颐养，当医药外求之。
人参 干姜 川椒 川楝子 茯苓 桂枝 白芍 乌梅
产育颇多，冲任先伤，其咳嗽失血，呕吐涎沫，都是下元不摄，冲气上逆所致。况晨刻
必泻
纳下元散失之真，固之摄之，尤虑弗及。若见血见嗽，用滋清沉降，非内热肺咳，奚益于病
。徒使迁延胃败。遂至废食，岂不危哉?
盐水炒补骨脂 石壳莲肉 熟地炭 炒黄山药 覆盆子 五味子 芡实
再诊
前方服二剂泻止，今去补骨脂、覆盆子，加青花龙骨。
三诊 自前方固摄之后，五六日精神颇觉向安，但寒在四肢背部，热在心前腹中，即《
内经》阳虚外寒，阴虚内热之旨。然产后气虚，必自阴分伤及阳位。张景岳云∶气因精而虚者，
当补精以化气。况产后八脉空虚，填补方中，必佐以收拾奇经之散亡也。
熟地炭 龙骨 湘莲 紫石英 五味子 人参 芡实 茯神
丸方
砂仁拌炒熟地 芡实 桑螵蛸 五味子 紫河车 茯苓 人参 远志 沙苑蒺藜
山药浆丸。
诊脉右弦左濡，久痔注血，致纳食不易运化，此脾营先伤，胃阳继困，府气不能宣畅，
大便不爽，温补未能通调，府气疏滞，更损脾胃生阳东垣每以治土，必先达木，不宜过投燥剂。
仿古治中汤法，佐以疏肝解郁。
人参 青皮 陈皮 木瓜 黑槐米 益智仁 楂肉 茯苓 黑地榆
水泛丸。
诊脉百至，左小涩结，右部弦大，绿高年中焦，清阳已微，浊阴渐阻，致脘中窒塞日盛
不能纳，下焦阴液枯槁，肠中气痹，溺少便涩。虞花溪云∶噎膈反胃，阴枯阳结为多，衰老
之象，最难调理。诚情志偏胜无形之伤也。若夫痰气瘀血积聚，亦有是病，有形有象，即易
为力矣。惟无形致伤，以有形之药饵施治，鲜有奏效。当以阴阳二气推求，在上为阳，在下
为阴，通则流通，守则呆钝。古人成法，宜遵其言，居恒颐养，不在药饵中矣。议宣通之味以翼小效。
大半夏汤加枳实、姜汁、川连。
脉右弦左濡，秋凉宿饮上泛，咳呛入夜，着枕欲寐，气冲胃脘，心悸震动，必欲起坐。
仲景
阳涤饮，与世俗仅以肺药疏降迥异，用小青龙减麻辛法。
桂枝 五味子 干姜 茯苓 白芍 炙草 半夏
丸方
八味去附。加沉香。
频因小产，奇脉不固，经来甚多，经过带下，早震大便溏滑，纳谷日少，时觉心悸震动
，始养血滋腻，即脘闷不思纳谷，此皆自下焦损伤，渐及中焦，致脾胃不能转运。近日拟用王荆
公妙香散，宣通补中，仍兼顾下，虽似相投，然于调和经带，其力未专，再议两去分治，中
鹿角霜 淡骨脂 青盐 炒黑小茴香 紫石英 禹余粮 当归 茯苓
用雄羊肾蒸熟捣丸，人参汤下。
男子血淋成块，尿出痛。医治一年妄效。夫淋属肝经，郁火湿热皆有是病，患少壮情欲勉强
，必致败精凝窍，精腐变于，理固有诸。用虎杖散法，服五六日痛减血少，晨溺尚有血丝，
此随窍中有未尽之败浊，宜通不宜涩。
人中白 琥珀 沉香 白牵牛 川柏
韭菜汁丸。
产育致虚，病情多歧，不能缕分。思产后八脉皆空，损伤非在一脏一腑，所以诸恙并起，稍
涉情志不适，药饵便少功效。沉痼宿恙，骤难奏功，阅病原，再诊脉，知内因虚损，小效病
复，实由于此。姑拟迩日再急，在腹胀洞泄，胁腹 痛，冀得少缓一二，为进商之步。
人参 鹿茸 茯苓 舶茴香 紫石英 补骨脂
另用禹余粮、赤石脂等分，糯米煮糊为丸，煎前方送廿丸。
香港脚古称南地，多因湿热，医用苦辛宣通开气，渗湿久进，病未祛除，而血液反耗。心
热气冲，目黄呕涎，烦躁头痛昏厥，四肢筋纵掣痉，大便艰涩。显然肝血衰涸，内风掀越，此风乃
阳气之化，非外来八风，同例而治。分经辨治，病在肝藏，扰动胃络，由气分湿热延中，血
中枯燥，静摄小安，焦烦必甚。盖内伤情怀，草木难解，斯为沉痼。
石决明 豆皮 天冬 生地 茺蔚子 阿胶
丸方
生地 白芍 天冬 桂圆肉 丹参 杞子 阿胶 麦冬 知母 茺蔚子 豆皮
乌骨鸡煮烂杵丸。
暑属阴邪，一种湿温秽浊之气，胶结于三焦，故苔灰边白，气喘脘结，周身痛难转侧，
小溲窒涩而痛。老年情气已衰，恐有内闭外脱之变。
鲜石菖蒲 浓朴 茯苓皮 橘红 白蔻仁 杏仁
另服苏合香丸。
病久反复，精气损伤，遂成虚怯。据说脐下闪闪升触，逆干咳嗽，兼痰多咽痹，明明元
海无
问医便投草木汤液，恐难久持。
鲜紫河车胶 秋石拌人参 云茯神
盐水炒紫衣胡桃肉。
经云∶脾气散精，上输于肺，地气上升也，肺主治节，通调水道，下输膀胱，天气下
降也。
和畅，至晨夕嘈杂，食少无味，下脘如纳粗物，病久胃汁枯，四肢无力，显然脾病。右胁少
腹作痛，升降有声，寅卯病进，午后病退，是清阳之气闭结。若仍勤劳家政，深秋关格是虑
香附 延胡索 黑山栀 归身 柏子霜 桂圆肉
诸动属阳，烦劳则损气。肝司藏血，拂郁则血菀于上，午后则气并于血。升降混淆为厥
，脉来浮数，退而细涩，面黄唇白，热势稍轻，神昏如故，胸膈隐痛，必非停滞，谅有瘀聚所致
。目 舌缩，为肾水竭绝之征，螈 不止，乃肝虚风动之象，病名暴厥。赵养葵所谓薄厥煎
厥之类，开心窍不应，勉以蒲黄散去瘀舒郁，续进滋养，天一之水，以翼风宁火熄。
妇科病中肝病居多，产后必定波及奇经八脉。就像少腹部的瘕聚（腹部结块），冲脉之气上攻于心，必然引起呕吐。气逆向上则喉间闭塞寒冷，水液代谢半年不来，过了一天常有寒热交替的现象。凡下焦的病多属于血分病变，症状表现为气机郁结，瘕证则是血行痹阻。病位在冲脉，阴维脉与阳维脉之气混杂，如果胡乱施治，怎么能进入奇经治疗呢？
脉象缓而按之濡弱，谷食摄入少且不思饮食，对浓厚滋腻食物的运化能力最迟。饮食稍有不适，就想腹痛腹泻，皮肤腠理麻木，骨骼软弱筋脉疼痛。而且遇到暴风骤冷时，身体更加感到不安，去年有肠红（便血）症状，到夏天才痊愈。种种脉症显示，这是气弱阳微，脾胃运化功能不足，湿气郁结而生痰，导致气机不能灵动。治法应当健补阳气辅助运化，即治疗痰湿的根本。
人参、于术（白术）、茯苓、半夏、陈皮、益智仁、木瓜、天麻、生姜、大枣。
女子四十九岁时天癸（月经/生殖精华）应当停止，这是因为阳明脉衰退，冲脉力量怯弱，不能招集各络脉的血液，汇聚于血海以按时来潮。这是年老女性常见的情况。今年秋季的热邪导致损伤，客邪不重，已经出现带下和淋证，肌肤麻木、血脉阻滞，内伤的形势已经显露。况且所患病症比腰腹更严重，这必然是脏阴内部受损，波及奇经八脉。有形之血既已亏去，无形之气掀旋扰动，诸窍百骸受到攻迫肆虐，就是身中阳气独行，得不到真阴眷恋的缘故。熟地黄、五味子，滋阴收敛固摄并不谬误，然而它们不入奇经，治法应当用介类潜阳。咸味药下行引导，酸味药向内收敛，或者佐以微苦微润的药物。因为肝厌恶刚燥喜欢清凉，肾厌恶燥热喜欢温暖，这是古人的制药法则。
盐水炒阿胶、茯苓、山萸肉炭、盐水炒鳖甲、知母、女贞子、盐水炒旱莲草、天冬、盐水炒黄柏。
儿童惊痫，古人分为阳痫等类型。据叙述自幼至今，不论寒暑，睡觉必定出汗，这是脏腑真气不固，阳气不能内守，导致内风灼伤筋脉牵引强直，蒙蔽清窍神志昏迷。而且时时精神萎靡恐惧，治疗应在肝肾，用包举大气的方法，内安肝肾。
熟地黄、石菖蒲、龙骨、五味子、远志、茯苓、琐阳、黄柏、山萸肉。紫河车膏丸。
惊恐则触动肝气，肝气上逆；忧愁则损伤肺气，肺气失于肃降。升降失常，中焦不运，气聚成形，风扰导致鸣响泄泻。张仲景论述上升吐蛔虫，下坠狐惑病，都是从胃虚的角度出发，风木相侮，土日困顿，食欲减退大便溏稀都有这些表现。由惊恐忧愁偏逆致病，因病失治，拖延成虚证最难奏效。用药不过遵循生化克制的道理，培补受侮的脏腑，平定冲逆扰乱，补益阳明以宣通腑气，泄降厥阴以平定逆气，如此而已。至于拔除病根，在于平日颐养，应当在药物之外寻求。
生育较多，冲任二脉先受伤，其咳嗽失血、呕吐涎沫，都是下元不摄纳，冲气上逆所致。况且早晨时刻必定腹泻，纳回下元散失的真气，固摄它，还担心做得不够。如果见血见咳，就用滋阴清降沉降的药，如果不是内热肺咳，对病情有什么益处呢？徒然使病情迁延导致胃败。遂至废食，难道不危险吗？
盐水炒补骨脂、石壳莲肉、熟地炭、炒黄山药、覆盆子、五味子、芡实。
再诊：前方服用两剂后腹泻停止，现在去掉补骨脂、覆盆子，加青花龙骨。
三诊：自前方固摄之后，五六日精神颇觉安宁，但四肢背部寒冷，心前腹中发热，即《内经》所说的阳虚外寒、阴虚内热的旨意。然而产后气虚，必定从阴分伤及阳位。张景岳说：“气因精而虚者，当补精以化气。”况且产后奇经八脉空虚，填补方中，必须佐以收拾奇经散亡之气的药物。
丸方：砂仁拌炒熟地、芡实、桑螵蛸、五味子、紫河车、茯苓、人参、远志、沙苑蒺藜。山药浆丸。
诊脉右弦左濡，久患痔疮注血，导致纳食不易运化，这是脾营先受伤，胃阳继而被困，腑气不能宣畅，大便不爽利，温补未能通调，腑气疏滞，更损伤脾胃生发之阳。李东垣每每以治土（脾胃）必先达木（肝），不宜过投燥剂。仿照古法治中汤，佐以疏肝解郁。
人参、青皮、陈皮、木瓜、黑槐米、益智仁、楂肉、茯苓、黑地榆。水泛丸。
诊脉一息百次，左脉小涩结，右部弦大。绿高年（患者名或代称）中年以后中焦清阳已微，浊阴渐阻，导致脘中窒塞日益加重不能纳食，下焦阴液枯槁，肠中气痹，尿少便涩。虞花溪说：“噎膈反胃，阴枯阳结为多”，是衰老之象，最难调理。确实是情志偏胜造成的无形之伤。至于痰气瘀血积聚，也有这种病，有形有象，就容易着力了。只有无形致伤，用有形之药饵治疗，很少奏效。应当以阴阳二气推求，在上为阳，在下为阴，通则流通，守则呆钝。古人成法，宜遵其言，平日颐养，不在药饵中了。议用宣通之味以期小效。大半夏汤加枳实、姜汁、川连。
脉右弦左濡，秋凉宿饮上泛，咳呛入夜，着枕欲睡，气冲胃脘，心悸震动，必欲起坐。张仲景论阳涤饮，与世俗仅以肺药疏降迥异，用小青龙汤减麻黄细辛法。
频繁因小产，奇脉不固，经来甚多，经过带下，早晨震栗大便溏滑，纳谷日少，时觉心悸震动。开始用养血滋腻药，即脘闷不思纳谷，这都是自下焦损伤，渐及中焦，导致脾胃不能转运。近日拟用王荆公妙香散，宣通补中，仍兼顾下，虽似相投，然于调和经带，其力未专，再议两去分治。
中鹿角霜、淡骨脂、青盐、炒黑小茴香、紫石英、禹余粮、当归、茯苓。用雄羊肾蒸熟捣丸，人参汤送下。
男子血淋成块，尿出痛。医治一年妄效。夫淋属肝经，郁火湿热皆有此病，患在少壮时期情欲勉强，必致败精凝窍，精腐变浊，理固有之。用虎杖散法，服五六日痛减血少，晨溺尚有血丝，这是随窍中有未尽之败浊，宜通不宜涩。
产育导致虚损，病情多歧，不能缕分。思产后八脉皆空，损伤非在一脏一腑，所以诸恙并起，稍涉情志不适，药饵便少功效。沉痼宿恙，骤难奏功，阅病原，再诊脉，知内因虚损，小效病复，实由于此。姑拟迩日再急，在腹胀洞泄，胁腹痛，冀得少缓一二，为进商之步。
人参、鹿茸、茯苓、舶茴香、紫石英、补骨脂。另用禹余粮、赤石脂等分，糯米煮糊为丸，煎前方送廿丸。
香港脚古称南地，多因湿热，医用苦辛宣通开气，渗湿久进，病未祛除，而血液反耗。心热气冲，目黄呕涎，烦躁头痛昏厥，四肢筋纵掣痉，大便艰涩。显然肝血衰涸，内风掀越，此风乃阳气之化，非外来八风，同例而治。分经辨治，病在肝藏，扰动胃络，由气分湿热延中，血中枯燥，静摄小安，焦烦必甚。盖内伤情怀，草木难解，斯为沉痼。
丸方：生地、白芍、天冬、桂圆肉、丹参、杞子、阿胶、麦冬、知母、茺蔚子、豆皮。乌骨鸡煮烂杵丸。
暑属阴邪，一种湿温秽浊之气，胶结于三焦，故苔灰边白，气喘脘结，周身痛难转侧，小溲窒涩而痛。老年情气已衰，恐有内闭外脱之变。
病久反复，精气损伤，遂成虚怯。据说脐下闪闪升触，逆干咳嗽，兼痰多咽痹，明明元海无根。问医便投草木汤液，恐难久持。
经云：“脾气散精，上输于肺，地气上升也；肺主治节，通调水道，下输膀胱，天气下降也。”和畅，至晨夕嘈杂，食少无味，下脘如纳粗物，病久胃汁枯，四肢无力，显然脾病。右胁少腹作痛，升降有声，寅卯病进，午后病退，是清阳之气闭结。若仍勤劳家政，深秋关格是虑。
诸动属阳，烦劳则损气。肝司藏血，拂郁则血菀于上，午后则气并于血。升降混淆为厥，脉来浮数，退而细涩，面黄唇白，热势稍轻，神昏如故，胸膈隐痛，必非停滞，谅有瘀聚所致。目瞤舌缩，为肾水竭绝之征，螈疭不止，乃肝虚风动之象，病名暴厥。赵养葵所谓薄厥、煎厥之类，开心窍不应，勉以蒲黄散去瘀舒郁，续进滋养，天一之水，以翼风宁火熄。
In gynecological diseases, liver disorders are common. Postpartum conditions inevitably affect the Eight Extraordinary Vessels (Eight Penetrating Vessels). For instance, masses in the lower abdomen (Zhang Ju), with Qi of the Chong Vessel attacking the heart, will certainly cause vomiting. If Qi rebels upward, it causes closure and coldness in the throat; water metabolism may cease for half a year, followed by alternating chills and fever daily. Diseases in the Lower Jiao mostly belong to blood pathologies; symptoms manifest as Qi aggregation, while Zhang (masses) is blood bi (obstruction). When the disease is located in the Chong Vessel, and the Yin Wei and Yang Wei vessels are mixed, indiscriminate treatment cannot enter the Extraordinary Vessels.
Rhizoma Corydalis (Yanhusuo), Fructus Toosendan (Chuanlianzi), Rhizoma Curcumae (Pengzhu), Semen Persicae (Taoren), Testudo Carapax et Plastrum (Sheng Biejia), Eupolyphaga Seu Steleophaga (Dibiechong), Moschus (Shexiang), Charred Crataegi Fructus (Zha Tan).
The pulse is slow, soft and weak upon pressure. There is little grain intake and anorexia; digestion of rich and heavy flavors is the slowest. Any dietary indiscretion leads to abdominal pain and diarrhea. The skin and pores feel numb, bones are soft, and sinews hurt. Moreover, encountering sudden wind and severe cold makes the body feel even more uneasy. Last year, there was intestinal bleeding (Chang Hong), which healed only in summer. These various pulses and symptoms indicate weak Qi and faint Yang, with the Spleen and Stomach lacking transformation capacity. Dampness stagnates and generates phlegm, causing Qi mechanism to lose its agility. The method should be to strengthen Yang and assist transformation, addressing the root of phlegm and dampness.
Ginseng Radix et Rhizoma (Renshen), Atractylodis Macrocephalae Rhizoma (Baizhu), Poria (Fuling), Pinelliae Tuber (Banxia), Citri Reticulatae Pericarpium (Chenpi), Alpiniae Oxyphyllae Fructus (Yizhiren), Papaveris Fructus (Mugua), Gastrodiae Rhizoma (Tianma), Zingiberis Rhizoma Recens (Shengjiang), Jujubae Fructus (Dazao).
At forty-nine years old, Tian Gui (menstrual essence/reproductive fluid) should cease in women. This is because the Maiyang (Stomach) vessel declines, and the Chong Vessel becomes weak, unable to gather blood from all collaterals into the Sea of Blood for regular menstruation. This is common in aging women. This autumn, heat caused injury. The external pathogen was not heavy, but leukorrhea and stranguria appeared, along with muscle numbness and blood stasis, revealing internal injury. Furthermore, the ailment is worse than waist and abdominal issues, indicating damage to Zang Yin affecting the Eight Extraordinary Vessels. Since substantial blood has been lost, insubstantial Qi swirls chaotically, attacking orifices and limbs. This is due to Yang Qi acting alone without the attachment of True Yin. Shu Dihuang (Rehmanniae Radix Praeparata) and Wuweizi (Schisandrae Fructus) for nourishing and astringing are not incorrect, but they do not enter the Extraordinary Vessels. The method should use shellfish/shell-based herbs to subdue Yang. Salty flavors guide downward, sour flavors collect inward, possibly assisted by slightly bitter and moistening herbs. The Liver dislikes rigidity and prefers coolness; the Kidney dislikes dryness and prefers warmth. This is the ancient principle of formulation.
Colla Corii Asini (Ejiao) stir-fried with salt water, Poria (Fuling), Corni Fructus (Shanzhuyu) charred, Testudo Carapax et Plastrum (Biejia) stir-fried with salt water, Anemarrhenae Rhizoma (Zhimu), Ligustri Lucidi Fructus (Nvzhenzi), Ecliptae Herba (Hanliancao) stir-fried with salt water, Asparagi Radix (Tian Dong), Phellodendri Cortex (Huangbai) stir-fried with salt water.
Pediatric epilepsy/jingxian: Ancient texts distinguish Yang Epilepsy. According to the history, since childhood until now, sweating occurs during sleep regardless of cold or heat. This indicates unstable Zang Zhen (True Qi) and Yang failing to reside internally, leading to internal wind scorching sinews, causing stiffness and convulsions, clouding the orifices and confusing the spirit. There is also frequent mental fatigue and fear. Treatment focuses on Liver and Kidney, using methods to encompass great Qi and internally calm Liver and Kidney.
Rehmanniae Radix Praeparata (Shudi), Acori Tatarinowii Rhizoma (Shichangpu), Os Draconis (Longgu), Schisandrae Fructus (Wuweizi), Polygalae Radix (Yuanzhi), Poria (Fuling), Cynomorii Herba (Suoyang), Phellodendri Cortex (Huangbai), Corni Fructus (Yurou). Prepared as pills with Placenta Humana (Ziheche) paste.
Fright moves Liver Qi, causing Liver Qi to rebel upward. Worry injures Lung Qi, causing Lung Qi to fail to descend. Loss of ascending and descending regulation leads to Middle Jiao dysfunction, Qi aggregation forming masses, and wind disturbance causing borborygmus and diarrhea. Zhang Zhongjing discussed upward regurgitation of roundworms and downward dragging in Huhuo syndrome, attributing them to Stomach deficiency. Wood insulting Earth traps Yang and Earth, leading to reduced appetite and loose stools. Disease caused by fright and worry deviation, neglected and prolonged into deficiency, is hard to treat. Medication follows principles of generation and restriction, supporting the insulted organ, calming rebellious disturbances, tonifying Yangming to unblock Fu organs, draining Jueyin to reverse rebellion. That is all. Removing the root requires daily nurturing, sought beyond medicine.
Ginseng Radix et Rhizoma (Renshen), Zingiberis Rhizoma (Ganjiang), Zanthoxyli Fructus (Chuanjiao), Fructus Toosendan (Chuanlianzi), Poria (Fuling), Cinnamomi Ramulus (Guizhi), Paeoniae Radix Alba (Baishao), Mume Fructus (Wumei).
Multiple births injure Chong and Ren vessels first. Coughing with blood loss and vomiting saliva are caused by Lower Yuan failing to secure and Chong Qi rebelling upward. Morning diarrhea further depletes the True Qi scattered in the Lower Yuan. Securing and capturing this is urgent. Using cooling and sinking drugs for blood and cough is ineffective unless it is internal heat lung cough, potentially worsening the condition by delaying and damaging the Stomach. This leads to food refusal, which is dangerous.
Psoraleae Fructus (Buguzhi) stir-fried with salt water, Nelumbinis Semen (Lianrou), Rehmanniae Radix Praeparata (Shudi) charred, Dioscoreae Rhizoma (Shanyao) stir-fried, Rubi Fructus (Fupenzi), Schisandrae Fructus (Wuweizi), Euryales Semen (Qianshi).
Second visit: Two doses of the previous formula stopped diarrhea. Remove Buguzhi and Fupenzi, add Qinghua Longgu (Dragon Bone).
Third visit: After securing with the previous formula, spirit improved over five to six days. However, cold in limbs and back, heat in chest and abdomen aligns with the Neijing principle: Yang deficiency causes exterior cold, Yin deficiency causes interior heat. Postpartum Qi deficiency injures Yang positions from Yin levels. Zhang Jingyue said: "When Qi is deficient due to Essence, tonify Essence to transform Qi." Since postpartum Extraordinary Vessels are empty, tonifying formulas must include herbs to gather scattered Qi of the Extraordinary Vessels.
Rehmanniae Radix Praeparata (Shudi) charred, Os Draconis (Longgu), Nelumbinis Semen (Xianglian), Psilostachyos Radix (Zishiying), Schisandrae Fructus (Wuweizi), Ginseng Radix et Rhizoma (Renshen), Euryales Semen (Qianshi), Poria (Fushen).
Pill Formula: Rehmanniae Radix Praeparata (Shudi) stir-fried with Amomi Fructus (Sharen), Euryales Semen (Qianshi), Sang Xiongshao, Schisandrae Fructus (Wuweizi), Placenta Humana (Ziheche), Poria (Fuling), Ginseng Radix et Rhizoma (Renshen), Polygalae Radix (Yuanzhi), Astragali Complanati Semen (Shayuanjili). Pilled with Yam (Shanyao) paste.
Pulse: Right wiry, Left soft. Chronic hemorrhoids with bleeding impair digestion. Spleen Ying (Nutritive Qi) injured first, Stomach Yang trapped subsequently. Fu Qi fails to circulate freely, bowel movements are unsatisfactory. Warm tonification fails to regulate; Fu Qi stagnation further damages Spleen/Stomach Yang. Li Dongyuan emphasized treating Earth (Spleen) requires reaching Wood (Liver); avoid excessive drying agents. Following the ancient Zhizhong Tang method, assist with soothing Liver and resolving depression.
Ginseng Radix et Rhizoma (Renshen), Aurantii Fructus Viridis (Qingpi), Citri Reticulatae Pericarpium (Chenpi), Papaveris Fructus (Mugua), Sophorae Flavescentis Flos (Heihuaimi), Alpiniae Oxyphyllae Fructus (Yizhiren), Crataegi Fructus (Zharou), Poria (Fuling), Sanguisorbae Radix (Hei Diyu). Water-pilled.
Pulse: 100 beats per breath. Left small, choppy, knotted; Right wiry and large. Patient Lü Hua Xi, in middle age, Middle Jiao Clear Yang is faint, Turbid Yin obstructing. Epigastric fullness worsens, inability to eat. Lower Jiao Yin fluids dried up, intestinal Qi obstruction, scanty urine and difficult defecation. Yu Huaxi stated: "Yige and Fanwei are mostly Yin exhaustion and Yang knotting," signs of aging, hardest to regulate. Indeed, emotional excess causes insubstantial injury. Phlegm, Qi, blood stasis accumulation can cause similar diseases; if substantial, it is easier to treat. Insubstantial injury treated with substantial drugs rarely works. Deduce via Yin/Yang Qi: Upper is Yang, Lower is Yin. Unblocked flows, blocked stagnates. Follow ancient rules; daily nurturing is key, not just medicine. Propose unblocking agents for slight effect. Ban Xia Hou Po Tang (Half Banxia Soup) plus Zhi Shi, Ginger Juice, Huang Lian.
Pulse: Right wiry, Left soft. Autumn chill causes retained fluid to rise. Coughing at night, desire to sleep when pillow touches head, Qi rushing to epigastrium, palpitations requiring sitting up. Zhang Zhongjing's Yang Ding Yin (Yang clearing fluid) differs from世俗 (common) lung-draining methods. Use Xiao Qing Long Tang minus Mahuang and Xixin.
Cinnamomi Ramulus (Guizhi), Schisandrae Fructus (Wuweizi), Zingiberis Rhizoma (Ganjiang), Poria (Fuling), Paeoniae Radix Alba (Baishao), Glycyrrhizae Radix et Rhizoma Preparata (Zhigancao), Pinelliae Tuber (Banxia).
Pill Formula: Ba Wei Wan minus Fuzi. Add Chenxiang.
Frequent miscarriages leave Extraordinary Vessels insecure. Heavy menstruation, leukorrhea after periods, morning tremors with loose stools, decreasing appetite, palpitations. Initial blood-nourishing greasy drugs caused epigastric fullness and anorexia. Injury started in Lower Jiao, spreading to Middle Jiao, impairing Spleen/Stomach transport. Recently proposed Wang Jinggong's Miao Xiang San to unblock and tonify Middle, attending to Lower. Though suitable, power to harmonize menses/leukorrhea is not specific. Re-discuss separating treatments.
Cervi Cornu Degelatinatum (Lujiaoshuang), Ostreae Concha (Danguzhi), Natrii Chloridum (Qingyan), Cuminum Fructus (Xiaohuixiang) stir-fried black, Psilostachyos Radix (Zishiying), Yuyuli Lithospermum (Yuyuliang), Angelicae Sinensis Radix (Danggui), Poria (Fuling). Pilled with steamed and mashed Male Sheep Kidney, taken with Ginseng decoction.
Male hematuria with clots and pain. One year of ineffective treatment. Lin belongs to Liver Meridian; stagnant fire and damp-heat cause this. Forced sexual activity in youth causes failed essence to condense in orifices, rotting essence becoming turbid. Use Huzhang San method. Pain decreased, blood lessened after 5-6 doses. Morning urine still has blood streaks, indicating residual turbid waste in orifices. Should unblock, not astringe.
Humanis Dentifricium Residuum (Renzhongbai), Succinum (Hupo), Aquilariae Lignum Resinatum (Chenxiang), Pharbitidis Semen (Baiqianniu), Phellodendri Cortex (Chuanbai). Pilled with Allii Tuberosi Juice.
Postpartum deficiency presents diverse symptoms, hard to detail. Postpartum Eight Extraordinary Vessels are empty; injury affects more than one Zang/Fu. Thus, multiple ailments arise. Slight emotional discomfort reduces drug efficacy. Chronic stubborn diseases are hard to cure quickly. Reviewing pathology and pulse reveals internal deficiency causes relapse after slight improvement. Tentatively addressing current urgency: abdominal distension, profuse diarrhea, hypochondriac/abdominal pain. Hope for slight relief before further discussion.
Ginseng Radix et Rhizoma (Renshen), Cervi Cornu Pantotrichum (Lurong), Poria (Fuling), Foeniculi Fructus (Bohuixiang), Psilostachyos Radix (Zishiying), Psoraleae Fructus (Buguzhi). Additionally, equal parts Yuyuli Lithospermum (Yuyuliang) and Halloysit Rubrum (Chishizhi), cooked with glutinous rice paste into pills, taken with the above decoction (20 pills).
Hongjiao (Podagra/Gout) was anciently called Nandi, often due to damp-heat. Doctors used bitter/acrid unblocking agents and long-term damp-draining, failing to remove disease but consuming blood. Heart heat Qi rushes, yellow eyes, vomiting saliva, irritability, headache, syncope, limb flaccidity/clonic spasms, difficult stool. Clearly Liver blood depletion, internal wind rising. This wind is transformation of Yang Qi, not external Eight Winds. Treat by channel differentiation. Disease in Liver Zang, disturbing Stomach collaterals. Damp-heat in Qi level extends to Blood level dryness. Rest brings slight peace, anxiety worsens. Emotional internal injury is hard to resolve with herbs, making it chronic.
Heteroconchi Concha (Shijueming), Phaseoli Coctilis Pericarpium (Doupí), Asparagi Radix (Tiandong), Rehmanniae Radix (Shengdi), Leonuri Fructus (Chongweizi), Colla Corii Asini (Ejiao).
Pill Formula: Rehmanniae Radix (Shengdi), Paeoniae Radix Alba (Baishao), Asparagi Radix (Tiandong), Longan Arillus (Guiyuanrou), Salviae Miltiorrhizae Radix et Rhizoma (Danshen), Lycii Fructus (Qizi), Colla Corii Asini (Ejiao), Ophiopogonis Radix (Maidong), Anemarrhenae Rhizoma (Zhimu), Leonuri Fructus (Chongweizi), Phaseoli Coctilis Pericarpium (Doupí). Pilled with boiled Black-bone Chicken.
Summer heat is a Yin pathogen, a damp-warm turbid Qi congealing in the Three Jiaos. Tongue coating gray with white edges, asthma, epigastric knotting, whole body pain difficult to turn, scanty painful urination. Elderly patient's Qi is declining; fear of internal closure and external collapse.
Fresh Acori Tatarinowii Rhizoma (Shichangpu), Magnoliae Officinalis Cortex (Houpo), Poria Peel (Fulingpi), Citri Reticulatae Pericarpium (Juhong), Amomi Fructus Rotundus (Baokouren), Armeniacae Semen (Xingren). Additionally take Suhexiang Wan.
Long-lasting recurring illness damages Jing and Qi, becoming Xu Qie (deficiency timidity). Umbilical area feels flickering/rising, dry cough with much phlegm and throat obstruction. Clearly Yuan Hai (Sea of Qi/Essence) lacks root. Asking doctors leads to herbal prescriptions, unlikely to sustain long-term.
Fresh Placenta Humana Gel (Ziheche Jiao), Human Urine Sediment (Qiushi) mixed with Ginseng Radix et Rhizoma (Renshen), Cloud Poria (Yunfushen). Walnut Kernels (Hetaoren) stir-fried with salt water.
Classic says: "Spleen Qi scatters essence, transports upward to Lung, Earth Qi rises. Lung governs regulation, unblocks water passages, transports downward to Bladder, Heaven Qi descends." Harmonious flow turns to morning/evening acid regurgitation, low appetite, tastelessness, lower epigastrium feeling like swallowing coarse matter. Long illness dries Stomach juices, limbs weak. Clearly Spleen disease. Right hypochondriac/lower abdominal pain, sounds of ascent/descent, worsening at Yin/Mao hours (3-7 AM), improving afternoon. Clear Yang Qi is closed/knotted. If continuing household labor, concern for Guange (obstruction syndrome) in late autumn.
Cyperi Rhizoma (Xiangfu), Rhizoma Corydalis (Yanhusuo), Gardeniae Fructus (Heishanzhi), Angelicae Sinensis Radix (Guishen), Platycladi Semen (Baiziren), Longan Arillus (Guiyuanrou).
All movements belong to Yang; fatigue damages Qi. Liver stores blood; frustration causes blood pooling upward. Afternoon Qi merges with blood. Ascending/descending confusion leads to Jue (syncope). Pulse floating rapid, retreating fine choppy. Yellow face, white lips, heat slightly lighter, spirit confused as before, hidden chest pain. Not stagnation, likely blood stasis. Eye twitching, tongue retraction, sign of Kidney Water exhaustion. Clonic spasms unceasing, sign of Liver deficiency wind movement. Disease name: Bao Jue (Sudden Syncope). Zhao Yangkui referred to Bo Jue/Jian Jue types. Opening orifices ineffective; tentatively use Puhuang San to remove stasis and soothe depression, continue nourishing Tianyi Water to hope for wind calming and fire extinguishing.