未过五旬，形脉色俱衰，叩之连丧三子，得不如是耶，况复伤其孙乎!此非药饵所能疗
川贝母 生地 茯苓 麦冬
脉得数而且弦，此阴亏症也，并非外感。今以虚火升而头痛，渐有金水两伤之势，静摄
乃得，药饵其次也。
熟地 女贞子 麦冬 龟板 元参 澹秋石
枣浆为丸，开水送下。
肺为水主，热淫则融，融则水源竭矣。土为金母，不承则金无生。土金水三藏日澌，苟
无玉液，神精安能返?既惫之有形，虽拟禁方，亦据古人之常谈耳。
心阴虚则易汗，肺阴虚则多嗽，肝阴虚则火升，肾阴虚则发热，脾阳虚则便溏，非一真
阴乎，怯症之渐也。但知头痛医头之为良医，不知履霜坚冰至，君子其为忧危之心也。
炒白芍 小生地 麦冬 枣 桂枝木 炙甘草 青蒿梗 云苓
诊得脉细数而微，舌干黄，下利，身焦燥而不润，此为下多伤阴，热邪因之而内陷，大
可虑也。治法轻以清其邪，苦以泄其热，未识应否。
川连 小生地 人中黄 淡豆豉 木通 金银花
饮食不和者，太阴亏也。葛稚川肘后方，有一味治虚劳之法，少阴厥阴亏者，鹿角散。
太阴亏者，神曲散。今用神曲散。
真陈六神曲研细炒香四两，每食后，用开水调服二钱。
中焦为气血津液朝会之所，今诊得胃气不能脉中流布，其亦元气中馁也。酸以摄泄，辛
以流动，惟甘以培养，因增肿患而却之。拟方备阅。
橘白 灼艾 醒头草 麦冬 木瓜 五味子
厥有十四，泄为一法，镇为一法。盖因曲直太过，不特下侮土，并其上不畏金，镇法恐
其格不相入，宜因其势而利导之，然后润之滋之，鲜有不济者。
羚羊角 金铃肉 生甘草 淡吴萸 黑 豆 生白芍 云茯苓 川郁金汁
仲景书云∶疟脉自弦一句，开尽人天眼目，今三部九候之中，并无一毫弦象可见。与正
气相战者，非比春之风夏之暑，南方之瘴也，于此推之，思过半矣。
草果仁 炒浓朴 陈皮 白茯苓 制苍术 炙草
脉愈按愈大，可知阴气不足，疟邪得以深入，漏芦、鳖甲补阴太过，非花甲劳心之体所
宜。
人参 蔻仁 淡黄芩 生牡蛎 生地 陈皮 小青皮 生首乌 新谷 姜汁
明系肝风上冒，右尺脉碎乱搏指，此乙癸同源，肾肝同病也。但少阴之脉，不至于巅，
惟厥阴能至，以肝为重，肾次之。
羚羊角 生地 半夏 白芍 当归身 陈皮 茯苓 菊花 女贞子
此由金水不相承挹，故咳久不愈，切勿理肺，肺为娇藏，愈理愈虚，证不可泛然滋阴。
北沙参 整玉竹 云茯神 川石斛 甜杏仁 生扁豆
短气失音，喉中时作水鸡声，右脉如革，面浮色痿，肺胃应之，心下痞硬，补泻纷更，
动无一效，甚于水冷，剧于春候。拟进苇茎越婢成汤，进饮三剂。
石膏 桂枝木 白芍 杏仁 冬瓜子 生米仁
木属湿温。犯在三焦，先斥腠理，误伤手太阴足太阳之气，必致渐入虚损一途，非病之
过，治之过也。必移入高明静虚之室，治以百日之遥，庶几得之。拟言开太阳，益太阴。
淡干姜(同五味子捣烂) 茯苓 地骨皮 桑叶 生扁豆 生甘草
弦动无情之脉，即名胃少，虽非难经所谓但弦无胃，而久病有此不宜，莫因失血而久进
纯阴之药，阳气抑而阴无所恃也。拙见且进甘温。
建中汤加人参、炙绵 、归身。
病在奇经，治他经不应，要知血行清道，便知清气不肃，所以鼻红昏晕二者皆出督脉，
好异无用，以古法之法治之自效。
生地 犀角 广圆核 侧柏叶
上蜜丸，早服五钱，晚服三钱，开水下。
暑者，热中之阴邪也，心先受之，侵入胞络，怠惰不语，神昏肢冷，为不治。今脉迟软，渐
有是机，四末渐冷，竟有内闭外脱之虞。急用通阳救逆之法，仿右大顺散之义，未识何如。
桂枝 半夏 焦白芍 炙甘草
右脉芤搏，耳聋，血下溢，寒热不已，阴络所伤，而厥阴不摄，当从至阴中宣出热邪，
是存阴第一义也。
青蒿 白知母 生白芍 炒黄柏 鳖甲 鲜荷叶
元米一合，泡汤为水。
右脉一息七重弦，左脉一息六至紧，咳而不得息，阴气已弱，金水同受病，且议景岳六
君煎投之。
患者未满五十岁，形体、脉象、气色均显衰败，接连丧子三人，难道不是因为这个原因吗？何况又伤了孙子！这种情况并非药物所能治愈。
川贝母 生地 茯苓 麦冬
脉象数而且弦，这是阴液亏损的病症，并不是外感病。如今因虚火上炎而头痛，逐渐呈现出金（肺）水（肾）两伤的态势，只有静养摄生才能好转，药物治疗是次要的。
熟地 女贞子 麦冬 龟板 元参 澹秋石
用枣浆制成丸药，开水送服。
肺为水之上源，热邪过盛则津液融化耗竭，水源枯竭。脾土为肺金之母，若土不生金，则肺气无生化之源。脾、肺、肾三脏日渐衰竭，如果没有滋润的津液，精神怎能恢复？既然身体已经极度疲惫，虽然拟定禁方，也不过是依据古人的常谈罢了。
心阴虚则容易出汗，肺阴虚则多咳嗽，肝阴虚则火气上升，肾阴虚则发热，脾阳虚则大便溏泄，这难道不是真阴亏损的表现吗？这是怯症（慢性虚弱性疾病）逐渐形成的征兆。只知道头痛医头的是良医，不知道履霜坚冰至（见微知著），君子应当有忧患警惕之心。
炒白芍 小生地 麦冬 枣 桂枝木 炙甘草 青蒿梗 云苓
诊得脉细数而微弱，舌干黄，下利，身体焦躁而不润泽，这是因为泻下过多损伤了阴液，热邪因此内陷，非常令人担忧。治疗方法宜轻清以祛邪，苦寒以泄热，不知是否有效。
川连 小生地 人中黄 淡豆豉 木通 金银花
饮食不和，是太阴（脾）亏虚所致。葛稚川《肘后方》中有一味治疗虚劳的方法，少阴、厥阴亏虚者，用鹿角散。太阴亏虚者，用神曲散。如今使用神曲散。
真陈六神曲研细炒香四两，每餐饭后，用开水调服二钱。
中焦是气血津液汇聚之所，如今诊得胃气不能在脉中流布，这也是元气中气不足的表现。酸味以收敛固涩，辛味以流通运行，唯有甘味以培养补益，因为增加了肿胀的病患而将其去除。拟定方剂供审阅。
橘白 灼艾 醒头草 麦冬 木瓜 五味子
厥逆有十四种，泄法是一种治法，镇法是另一种治法。大概是因为肝木曲直太过，不仅下侮脾土，而且上不畏肺金。镇法恐怕其格不相入，适宜顺应病势而引导之，然后润之滋之，鲜有不成功的。
羚羊角 金铃肉 生甘草 淡吴萸 黑 豆 生白芍 云茯苓 川郁金汁
张仲景书中说：“疟脉自弦”一句，开启了世人的眼目，如今三部九候之中，并没有丝毫弦象可见。与正气相战的邪气，不像春风、夏暑、南方的瘴气那样，由此推断，思过半矣。
草果仁 炒浓朴 陈皮 白茯苓 制苍术 炙草
脉象越按越大，可知阴气不足，疟邪得以深入。漏芦、鳖甲补阴太过，不适合花甲之年（六十岁）劳心之体。
人参 蔻仁 淡黄芩 生牡蛎 生地 陈皮 小青皮 生首乌 新谷 姜汁
明显是肝风上冒，右尺脉碎乱搏指，这是乙癸同源（肝肾同源），肾肝同病。但少阴之脉，不至于头顶，只有厥阴能到达，以肝为重，肾次之。
羚羊角 生地 半夏 白芍 当归身 陈皮 茯苓 菊花 女贞子
这是由于金（肺）水（肾）不相承挹，所以咳嗽久不愈，切勿单纯理肺，肺为娇脏，愈理愈虚，证候不可泛然滋阴。
北沙参 整玉竹 云茯神 川石斛 甜杏仁 生扁豆
短气失音，喉中时常发出水鸡声（哮鸣音），右脉如革，面色浮肿萎黄，肺胃应之，心下痞硬，补泻交替变化，动无一效，甚于水冷，剧于春候。拟进苇茎越婢成汤，进饮三剂。
石膏 桂枝木 白芍 杏仁 冬瓜子 生米仁
木属湿温。侵犯在三焦，先斥腠理，误伤手太阴（肺）、足太阳（膀胱）之气，必致渐入虚损一途，这不是病的过错，是治疗的过错。必须移入高明静虚之室，治疗以百日为期，庶几得之。拟言开太阳，益太阴。
淡干姜(同五味子捣烂) 茯苓 地骨皮 桑叶 生扁豆 生甘草
弦动无情之脉，即名胃少，虽然不是《难经》所谓“但弦无胃”，但久病有此脉象不宜，不要因为失血而久进纯阴之药，阳气被抑制而阴无所恃也。拙见且进甘温。
建中汤加人参、炙绵 、归身。
病在奇经，治他经不应，要知血行清道，便知清气不肃，所以鼻红昏晕二者皆出督脉，好异无用，以古法之法治之自效。
生地 犀角 广圆核 侧柏叶
上蜜丸，早服五钱，晚服三钱，开水下。
暑者，热中之阴邪也，心先受之，侵入胞络，怠惰不语，神昏肢冷，为不治。今脉迟软，渐有是机，四末渐冷，竟有内闭外脱之虞。急用通阳救逆之法，仿右大顺散之义，未识何如。
桂枝 半夏 焦白芍 炙甘草
右脉芤搏，耳聋，血下溢，寒热不已，阴络所伤，而厥阴不摄，当从至阴中宣出热邪，是存阴第一义也。
青蒿 白知母 生白芍 炒黄柏 鳖甲 鲜荷叶
元米一合，泡汤为水。
Before the age of fifty, the patient's form, pulse, and complexion were all declining. Having lost three sons in succession, could it not be for this reason? How much more so when a grandson is also harmed! This condition cannot be cured by medication alone.
Fritillariae Thunbergii Bulbus (Chuanbeimu), Rehmanniae Radix Preparata (Shengdi), Poria (Fuling), Ophiopogonis Radix (Maidong)
The pulse is rapid and wiry; this is a syndrome of Yin deficiency, not an external contraction. Now, due to deficient fire rising, there is headache, gradually showing signs of simultaneous injury to Metal (Lung) and Water (Kidney). Only quiet rest and preservation can bring improvement; medication is secondary.
Rehmanniae Radix Preparata (Shudi), Ligustrum Lucidum Fructus (Nvzhenzi), Ophiopogonis Radix (Maidong), Testudinis Carapax et Plastrum (Guiban), Scrophulariae Radix (Yuanshen), Dan Zhu Shi (Dan Zhushi)
Form pills with jujube paste, take with warm water.
The Lung is the source of Water; excessive heat melts it, leading to the exhaustion of the water source. Spleen Earth is the mother of Lung Metal; if Earth does not generate Metal, Lung Qi has no source of generation. The Spleen, Lung, and Kidney are daily deteriorating. Without moistening fluids, how can spirit and essence return? Since the physical body is already exhausted, even if a secret prescription is formulated, it merely follows ancient common talk.
Heart Yin deficiency leads to easy sweating; Lung Yin deficiency leads to frequent coughing; Liver Yin deficiency leads to rising fire; Kidney Yin deficiency leads to fever; Spleen Yang deficiency leads to loose stools. Is this not true Yin deficiency? It is the gradual onset of a consumptive disease (Qie Zheng). One who knows only to treat the head for a headache is a good doctor; one who does not know that "treading on frost implies hard ice is coming" lacks the cautionary heart of a gentleman.
Stir-fried White Peony Root (Chao Baishao), Small Rehmannia Root (Xiao Shengdi), Ophiopogonis Radix (Maidong), Jujube (Zao), Cinnamon Twig Wood (Guizhi Mu), Honey-fried Licorice Root (Zhi Gancao), Artemisia Annua Stem (Qinghao Geng), Cloud Poria (Yunling)
The pulse is fine, rapid, and slightly weak; the tongue is dry and yellow; there is diarrhea; the body is scorched and dry without moisture. This is because excessive purgation injured Yin, allowing pathogenic heat to sink inward. This is highly concerning. The treatment method should use light clearing to dispel pathogens and bitter cold to drain heat. Whether this will work remains to be seen.
Coptis Rhizome (Chuanlian), Small Rehmannia Root (Xiao Shengdi), Human Coprolite (Renzhonghuang), Light Fermented Soybean (Dandouchi), Akebia Caulis (Mutong), Lonicerae Japonicae Flos (Jinyinhua)
Dietary irregularity indicates Taiyin (Spleen) deficiency. Ge Yichuan's *Elbow Formulas* contains a single-herb method for treating consumptive fatigue: for Shaoyin and Jueyin deficiency, use Deer Horn Powder. For Taiyin deficiency, use Divine Leaven Powder. Now, using Divine Leaven Powder.
True aged Liu Shen Qu (Six-God Leaven), ground fine and stir-fried until fragrant, four taels. After each meal, mix two qian with warm water and take.
The Middle Jiao is where Qi, Blood, and Body Fluids gather. Currently, the Stomach Qi cannot circulate in the pulse, indicating insufficiency of Yuan Qi (Primordial Qi). Sour flavors astringe and prevent leakage; pungent flavors promote flow; only sweet flavors nourish and cultivate. Because swelling issues have increased, they are rejected. A prescription is drafted for review.
Tangerine Peel (Ju Bai), Moxa (Zhu Ai), Xing Tou Cao (Xingtoucao), Ophiopogonis Radix (Maidong), Chaenomelis Fructus (Mu Gua), Schisandrae Fructus (Wuweizi)
There are fourteen types of Jue (reversal cold/convulsion), Xie (draining) is one method, Zhen (calming/pacifying) is another. Generally, because Liver Wood bends and stretches excessively, it not only insults Spleen Earth below but also disregards Lung Metal above. The calming method may face rejection/incompatibility; it is better to follow the trend and guide it, then moisten and nourish. Few would fail.
Antelope Horn (Lingyangjiao), Golden Bell Fruit (Jinling Rou), Raw Licorice Root (Sheng Gancao), Light Evodia Fruit (Dan Wuyu), Black Bean (Heidou), Raw White Peony Root (Sheng Baishao), Cloud Poria (Yun Fuling), Curcuma Aromatica Juice (Chuan Yujin Zhi)
Zhang Zhongjing stated in his book: "The malaria pulse is naturally wiry," opening the eyes of humanity. Yet, among the Three Regions and Nine Positions, not a trace of wiriness is visible. The pathogen fighting healthy Qi is not like spring wind, summer heat, or southern miasma. From this, one can deduce half the truth.
Areca Seed Kernel (Caoguoren), Stir-fried Magnolia Bark (Chao Houpo), Tangerine Peel (Chenpi), White Poria (Bai Fuling), Processed Atractylodes Macrocephala Rhizome (Zhi Cangzhu), Honey-fried Licorice Root (Zhi Cao)
The deeper the pulse is pressed, the larger it becomes, indicating insufficient Yin Qi, allowing malaria pathogens to penetrate deeply. Rhapontic Rhizome (Loulu) and Turtle Shell (Biejia) tonify Yin too excessively, which is not suitable for a sixty-year-old who labors their mind.
Ginseng Radix (Renshen), Amomum Cardamomum Seed (Kouren), Light Scutellaria Root (Dan Huangqin), Raw Oyster Shell (Sheng Muli), Rehmanniae Radix (Shengdi), Tangerine Peel (Chenpi), Small Green Tangerine Peel (Xiao Qingpi), Raw Polygonum Multiflorum Root (Sheng Shouwu), New Grain (Xingu), Ginger Juice (Jiangzhi)
Clearly, Liver Wind is ascending. The Right Chi pulse is fragmented and pounding against the finger. This is Yi-Gui same source (Liver-Kidney homology); Kidney and Liver diseases occur together. However, the Shaoyin meridian does not reach the vertex; only Jueyin reaches it. The Liver is primary, the Kidney secondary.
Antelope Horn (Lingyangjiao), Rehmanniae Radix (Shengdi), Pinelliae Tuber (Banxia), White Peony Root (Baishao), Angelica Sinensis Radix Body (Danggui Shen), Tangerine Peel (Chenpi), Poria (Fuling), Chrysanthemum Flower (Juhua), Ligustrum Lucidum Fructus (Nvzhenzi)
This is due to Metal (Lung) and Water (Kidney) failing to support each other, hence chronic cough persists. Do not merely treat the Lung. The Lung is a delicate organ; treating it further causes deficiency. The syndrome should not be treated with generic Yin-nourishing methods.
Glehniae Radix (Beishashen), Whole Solomon's Seal Rhizome (Zheng Yuzhu), Cloud Poria Spirit (Yun Fushen), Dendrobii Caulis (Chuan Shihu), Sweet Almond Seed (Tian Xingren), Raw Coix Seed (Sheng Bian Dou)
Shortness of breath and loss of voice, with a frog-like sound in the throat at times. The Right pulse is like leather. Facial edema and sallow complexion indicate Lung and Stomach involvement. Epigastric fullness and hardness. Tonification and purgation alternate, yet none are effective. It is worse than cold water, more severe than spring conditions. Propose administering Weijing Yu Bi Cheng Tang, drink three doses.
Gypsum Fibrosum (Shigao), Cinnamon Twig Wood (Guizhi Mu), White Peony Root (Baishao), Apricot Seed (Xingren), Benincasa Hispidas Pericarpium (Donggua Zi), Raw Coix Seed (Sheng Yiren)
Wood belongs to Damp-Warmth. Invading the Sanjiao, first repelling the Couli (pores/skin), mistakenly injuring the Qi of Hand-Taiyin (Lung) and Foot-Taiyin (Bladder), inevitably leading to gradual decline into deficiency consumption. This is not the fault of the disease, but the fault of treatment. Must move to a bright, quiet room. Treatment should last nearly a hundred days. Propose opening Taiyang, benefiting Taiyin.
Light Dried Ginger (with Wuweizi pounded), Poria (Fuling), Groundcherry Root Bark (Digupi), Mulberry Leaf (Sangye), Raw Coix Seed (Sheng Bian Dou), Raw Licorice Root (Sheng Gancao)
A wiry and moving pulse devoid of vitality is named "Stomach Qi Deficiency." Although not exactly "only wiry without Stomach" as described in *Nan Jing*, having this pulse in chronic illness is inadvisable. Do not administer pure Yin herbs for a long time due to blood loss; Yang Qi is suppressed, leaving Yin without support. My humble opinion is to administer Sweet-Warm formulas.
Jianzhong Decoction added with Ginseng Radix (Renshen), Honey-fried Astragalus Root (Zhi Huangqi), Angelica Sinensis Radix Body (Guishen).
The disease is in the Extraordinary Vessels; treating other meridians yields no response. Know that blood flows through clear pathways; thus, knowing Clear Qi is not肃 (purified/clear), both nasal bleeding and dizziness originate from the Du Mai (Governor Vessel). Seeking novelty is useless; using ancient methods will yield efficacy.
Rehmanniae Radix (Shengdi), Rhinoceros Horn (Xijiao - *Note: Substitute with Buffalo Horn in modern practice*), Broad Nutmeg Core (Guang Yuanye), Platycladi Cacumen (Cebaiye)
Make honey pills. Take five qian in the morning, three qian in the evening, with warm water.
Summerheat is a Yin pathogen within Heat. The Heart receives it first. Invading the Bao Luo (Pericardium), causing lethargy, muteness, mental confusion, and cold limbs, it is untreatable. Now the pulse is slow and soft, gradually showing these signs. The extremities are gradually cold, posing a risk of internal closure and external collapse. Urgently apply the method of unblocking Yang and rescuing reversal, imitating the principle of You Da Shun San. Whether this works remains to be seen.
Cinnamon Twig (Guizhi), Pinelliae Tuber (Banxia), Stir-fried White Peony Root (Jiao Baishao), Honey-fried Licorice Root (Zhi Gancao)
The Right pulse is hollow and bounding. Deafness, lower bleeding, unremitting alternating chills and fever. The Yin collaterals are injured, and Jueyin fails to control. Heat pathogens should be vented from the Extreme Yin. This is the primary principle of preserving Yin.
Artemisiae Annuae Herba (Qinghao), Anemarrhenae Rhizoma (Baizhimu), Raw White Peony Root (Sheng Baishao), Stir-fried Phellodendri Cortex (Chao Huangbai), Turtle Shell (Biejia), Fresh Lotus Leaf (Xian Heye)
One he of Rice (Yuanmi), soak in water to make liquid.
The Right pulse is seven beats per respiration, wiry. The Left pulse is six beats per respiration, tight. Coughing without ability to breathe out fully. Yin Qi is already weak. Metal and Water suffer simultaneously. Discuss administering Jingyue's Liu Jun Jian.