慢性肾炎或肾盂肾炎的症状消退或大部症状消退后，继续保持大量蛋白尿，甚或合并红细胞、白细胞、管型的问题，长期来能彻底解决。这种情况有的应用激素、环磷酰胺、硫唑嘌呤、氮芥、氯喹、消炎痛等可以缓解，有的暂时缓解以后，刚刚停药不久又有大量的蛋白尿出现；有的则始终不见缓解，所以很多临床工作者纷纷从中、西药的配合上找办法或从中药上想办法。例如：有的主张用固涩药，有的主张用黄芪、党参，有的主张用活血逐瘀，有的主张用清热解毒等，但是由于临床上不能获得广泛的验证，所以一直不能普遍推广。
对于这个问题，我在1964年以后，曾经进行了一点探索，但至1973年没有取得一点进展。长期的、反复的挫折教训，使我认识到：单纯的，生搬硬套的采用别人的经验是行不通的。为此，我又反复的学习了辨证论治的概念。《说文》说：“辨，判也。”《广韻》说：“辨，别也。”证，《增韻》认为是“候”和“质”的含义，《宋书·沈约自序》认为是证据。《伤寒论》、《金匮要略》两书被认为是具体应用辨证论治于临床的先驱，它明确的阐明证、脉是进行辨证论治的两大依据。而细察治疗慢性肾炎、慢性肾盂肾炎大量蛋白尿的方剂和使用方法，大都违反这个原则。
在脉、证并重原则指导下，我对一些病证进行了认真的观察，发现大量蛋白尿的患者，大都具有以下特点：①全身没有任何自觉症状，仅有尿色黄赤，脉沉弦细涩；②全身没有任何曰觉症状，仅有尿色黄赤，排尿时泡沫多，脉弦细涩；③全身尢任何自觉症状，仅有尿色黄赤，脉滑小数；④全身无任何自苋症状，仅见尿色黄赤，面色皓白，脉弦滑稍大；⑤仅见尿色黄赤，咽喉干痛，脉浮；⑥仅见口渴口干，尿黄赤，舌苔薄黄或薄白，舌尖红赤，脉细；⑦仅见口干口渴，尿黄赤，舌苔白，舌尖红，脉弦滑；⑧仅见面色皓白，口干口渴，尿黄赤，脉虚弦滑；⑨仅见面色皓白，口干口渴，尿黄赤，腰酸，脉虚弦滑；⑩仅见面色皓白，轻度浮肿，口于口渴，腹满纳呆，腰酸，尿黄赤，脉虚弦滑；⑾仅见面色皓白，轻度浮肿，下肢沉重，尿黄赤，腰酸，脉虚弦滑；⑿下肢浮肿，沉重乏力，尿色黄赤，舌苔黄，脉浮滑等。事实证明，这些患者都没有明显的脾虚、肾虚、瘀血脉证，或很少具有脾虚、肾虚、瘀血的脉证。从此以后，我就以事实为根据对慢性肾炎、慢性肾盂肾炎的大量蛋白尿者进行了观察。例如：凡见尿黄赤者，即根据情况酌加知母、黄柏、连翘、瞿麦、萹蓄、茯苓、泽泻、茅根、木通；咽喉疼痛，鼻干者，酌加桑叶、蝉蜕、僵蚕、苏叶、牛蒡子、薄荷；若咽喉干痛久久不愈者，酌加元参、麦冬、生地；口干渴较甚者，酌加花粉、知母、生地、山药、元参，甚者加大黄、滑石；舌尖红赤者，酌加木通、滑石、连翘；面色皓白者，酌加黄芪、人参、党参、麦冬、五味子、当归；面色萎黄者，酌加健脾除湿之苍术、白术、苡米、山药、青皮、陈皮；腹满纳呆者，酌加苍术、白术、青皮、陈皮、茯苓；腰酸者，酌加生地、五味子、山萸肉；脉浮者，酌加蝉蜕、苏叶、薄荷、桑叶、牛蒡子、僵蚕；脉滑者，酌加清热之知母、黄柏、芦根、花粉，或化痰之半夏、竹茹、陈皮、桔梗；脉虚者，酌加补气养阴或补气养血之黄芪、当归、人参、党参、麦冬、五味子；脉濡者，酌加山药、苡米、白术、扁豆；脉弦者，酌加附子、肉桂；脉涩者，酌加温阳之附子、肉桂，活血之益母草、桃仁、红花，理气之青皮、陈皮。并分别根据桑菊饮、生脉散、防己茯苓汤、防己黄芪汤、当归补血汤、橘皮竹茹汤、瓜蒌瞿麦丸、六味地黄汤、资生丸、导赤散、升降散、芪脉地黄汤、十味温胆汤、参芪丹鸡黄精汤进行化裁，初步取得了一些疗效。例如：宋×，男，11岁。慢性肾炎3年多。先在某院以激素、环磷酰胺等治疗两年多，后又配合补脾补肾药治疗一年多，虽然浮肿已经消退，但却明显的出现向心性肥胖，尿蛋白++，红细胞+，白细胞+，激素减量后，尿蛋白很快上升至++++，红细胞++，白细胞++，颗粒管型2～3个。并反复感冒，咽喉干痛，疲乏无力，尿黄赤，腹满，舌苔黄白微腻，脉虚大弦滑。综其脉证，诊为气阴两虚，湿热不化，乃拟补气养阴，燥湿清热之剂，芪脉地黄汤加减：黄芪15克，麦冬10克，沙参10克，五味子10克，生地15克，山药15克，生苡米15克，苍术15克，白术10克，茯苓10克，泽泻10克，丹皮10克，茅根30克。服药2个月后，反复感冒、咽喉疼痛、疲乏无力、食欲不振等均明显改善，但此时因停激素太快，尿蛋白反而由++增至卅，红细胞+，白细胞+。此时患者因看不到中药的明显疗效，特别是发现尿蛋白反有增多的情况，又加激素内服。再审脉证，除咽喉疼痛，痰多，尿黄赤外，脉已转为浮象，此乃气阴大复，风热未除耳，乃拟疏风清热，化痰利咽之剂。处方：蝉蜕9克，僵蚕9克，桔梗9克，甘草9克，牛蒡子9克，苏叶9克，连翘9克，茅根30克。连续服药2个月后，又停服西药，但此次停药后，尿蛋白不但没有增加，反而降至+，红细胞、白细胞偶见。又继服上方一个月，尿蛋白不再下降，咽喉干痛继续存在。再审脉证，除小便黄赤外，脉见弦涩不调，别无所苦，此风热已除，膀胱之阳气有衰之故耳。乃拟肉桂1．5克以温膀胱助气化，知母15克、黄柏15克、茅根30克以除湿热。服药两个月后，诸证消失，尿常规正常，而愈。
马××，男，15岁。慢性肾炎一年多，经激素、环磷酰姣、中药等配合治疗浮肿消退后，尿蛋白仍然持续在+++～++++之间，红细胞、白细胞少许，透明管型、颗粒管型各l～3个。邀余诊视，初以益气养阴，燥湿清热治疗一个月，病无进退。停西药观察，一个月后，病情未见加重。再审脉证，口干而渴，尿黄赤，脉弦涩不调，别无所苦，乃以瓜蒌瞿麦丸加减予之。处方：天花粉12克，山药30克，瞿麦12克，茯苓10克，附子1．5克。服药3个月，尿检查已完全正常。但感冒后，仍有蛋白微量出现，此风热所致耳，予疏风清热之剂6剂而愈。
李××，女，23岁。慢性肾盂肾炎2年，前医以中药、抗生素等治疗后，虽然尿急尿频尿痛已经消失，尿培养已无病原菌。但仍经常疲乏无力，食欲不振，恶心痰多，失眠心悸，口干咽痛，尿蛋白卅，红细胞++，白细胞+，脓球少许。审其面色皓白无华，脉虚大弦滑。综合脉证，诊为气阴两虚，痰热不化。治以益气养阴，化痰清热。十味温胆汤加减：黄芪15克，当归10克，麦冬10克，党参10克，五味子10克，竹茹10克，半夏10克，陈皮10克，茯苓10克，甘草10克，菖蒲10克，远志10克，知母10克。服药三周后，精神、食欲、睡眠等证均好转，尿蛋白++，红细胞，白细胞少许，脓球消失。根据效不更方的原则，又服原方一个月，除口干，舌苔白，舌尖红赤外，症状大部消失，尿蛋白亦减为+，红细胞、白细胞消失。但此时再继续服用一个半月却不见明显效果。诊其脉沉滑小数，舌尖红赤，乃云：心火下移于小肠所致也，乃拟导赤散：生地10克，木通10克，甘草10克，竹叶10克。半月后，查尿蛋白微量，但此时脉象见微涩，乃改予：附子l克、知母10克、黄柏10克，一周后复查尿蛋白消失。其后为防止复发继服上方20剂，尿连续检查7次，均正常。
耿××，男，25岁。慢性肾炎二年多，经中、西药治疗后，虽然腹水、全身水肿均已大部消失，但仍时见下肢轻度浮肿，腰酸乏力，恶心呕吐，腹满不适。细审其证，除以上证候外，并见面色皓白，舌苔白，舌质淡而暗，面微浮，脉虚大弦滑，尿蛋白++++，红细胞100个，白细胞20个，颗粒管型3个，透明管型2个。综合脉证，诊为脾肾俱虚，湿热下注，为拟补气养阴，除湿清热，芪脉地黄汤加减：黄芪15克，党参10克，麦冬10克，五味子10克，当归10克，山药10克，茯苓10克，泽泻10克，丹皮10克，生地15克，茅根30克，苡米30克。服药3剂后，恶心呕吐消失，浮肿、乏力、食欲不振，腰酸等症好转。宗效不更方意，继服上方20剂，浮肿消失，尿蛋白减为++，红细胞+，白细胞+，又服药2个月，诸证消失，尿蛋白+，红细胞、白细胞少许，但连续服药60剂后，尿蛋白却不见减少。审其脉弦细涩，改予瓜蒌瞿麦丸，30剂后，尿全部正常。
颅内压增高性头痛与良性颅内压增高症
良性颅内压增高症与颅内压增高性头痛，中医诸书多无明确记载。审其症状表现似应包括在中医头痛一名中。然其治法为何?方用何方?药用何药?实属不够明确。故余亦缺乏恰当之方药。1966年8月1日。曾治一患者，头胀头痛，剧烈呕吐，视物不清。某院诊为脑瘤。先用降低脑压的西药，其痛不减。旋即邀余处以降低脑压的方，余因无方可施，乃婉言谢绝。后因他医亦拒绝用药，再邀余诊。查其脉弦紧而数且兼有涩意，舌苔白。云：头痛呕吐，吐物为水饮，且脉弦紧而数兼有涩意，乃中医所云之痰厥头痛也。柴胡加龙骨牡蛎汤，一者含小柴胡汤意，小柴胡汤者少阳肝胆药也；二者含苓桂甘枣汤意，苓桂甘枣汤者温阳化饮降冲药也；三者含桂枝甘草龙骨牡蛎汤意，桂枝甘草龙骨牡蛎汤者强心阳降冲逆药也。一方而兼二职，可予柴胡加龙骨牡蛎汤去铅丹加甘草方试之。处方：柴胡10克，半夏10克，党参10克，黄芩10克，甘草10克，生姜10克，大枣7个，桂枝10克，茯苓15克，熟军3克，龙骨15克，牡蛎15克。药进1剂，痛减呕止，尿量增多。继进3剂，痛止，视力增加。其后又遇一患者，女性。头痛，呕吐，视力下降。经脑电图、x线拍片确诊为脑瘤。欲到外地手术治疗，然因某些因素不能即刻前往。邀余处以降低脑压之方。查其脉弦紧而数时兼涩意，舌苔白，头痛呕吐，以早晨为甚，视力下降。处以柴胡加龙骨牡蛎汤去铅丹加甘草法。药后果然痛止呕愈，尿量增多。思之：此莫不是降低脑压之方?再试于良性颅内压增高症之患者，亦多有效。然久久用之，亦常有不见效果者。细查其证，多为饭水俱吐，脉弦紧而数。思之：痰水厥逆之吐，当但吐水，此者水、食俱见，乃厥阴寒逆之吐也。正如仲景《金匮要略》所云：“干呕，吐涎沫，头痛者，茱萸汤主之。”曾治患者齐×，女，19岁。头痛头胀难忍，视力下降，呕吐呈喷射状，不发热。医诊良性颅内压增高症。予降低脑压之西药与腰穿放液，症状时减时剧。近两天来，头脑剧痛不止，反复呕吐，视力下降，手足厥逆。急予加减柴胡龙骨牡蛎汤1剂，其效不著，改予吴茱萸汤加味。处方：吴茱萸10克，人参10克，当归10克，白芍10克，甘草10克，大枣7个。1剂后，痛止呕解。再剂，诸证全失。患者李×，男，18岁。头胀头痛，恶心呕吐，视力下降一年多。医诊良性颅内压增高症。先予腰穿放液、降低颅压的药物，症状时减时剧。后予中药养阴补肾、养心安神、养血平肝等，效果仍无。邀余诊视。审其头胀头痛，恶心呕吐，视力下降，脉弦紧而数。综合脉证，诊为肝寒厥逆之吐。予温肝降逆。吴茱萸汤加味。处方：吴茱萸10克，党参10克，甘草6克，大枣7个，当归10克，白芍10克。服药7剂，头痛大减。继服1月，诸证全失，愈。
阳强不倒
阴茎异常勃起，现代医学认为，多由精神因素及血流动力学改变所致；中医学认为，多因肝火、命门火衰、宗筋瘀滞所引起。《灵枢·经筋篇》云：“足厥阴之筋病——伤于热则纵挺不收。”《石室秘录》云：“阳强不倒，此属火炎上而肺金之气不能下行。”《本草经疏》云：“阳强不倒，属命门火实。”王琦云：“宗筋瘀滞是阴茎异常勃起的主要病机。其内在发病的主要脏腑则应责之于肝，其次在肾。肝主经筋，足厥阴之脉，循阴股，绕阴器，前阴为宗筋之会，宗筋乃诸筋之所聚，诸筋皆统于肝。精神情志失调及外伤等均可导致肝脉失和，茎络阻滞，瘀血停聚，宗筋瘀滞而纵挺不倒出现阴茎异常勃起。”因此多主张采用清泻肝火、滋阴降火、疏肝通络进行治疗。然余久用以上诸法却多不效。细思其因多为未宗仲景所训：“观其脉证，知犯何逆，随证治之”耳。
慢性肾炎或肾盂肾炎的症状消退或大部分症状消退后，若持续存在大量蛋白尿，甚至合并红细胞、白细胞、管型的问题，长期以来难以彻底解决。这种情况有的应用激素、环磷酰胺、硫唑嘌呤、氮芥、氯喹、消炎痛等可以缓解，有的暂时缓解以后，刚刚停药不久又有大量的蛋白尿出现；有的则始终不见缓解，所以很多临床工作者纷纷从中、西药的配合上找办法或从中药上想办法。例如：有的主张用固涩药，有的主张用黄芪、党参，有的主张用活血逐瘀，有的主张用清热解毒等，但是由于临床上不能获得广泛的验证，所以一直不能普遍推广。
对于这个问题，我在1964年以后，曾经进行了一点探索，但至1973年没有取得一点进展。长期的、反复的挫折教训，使我认识到：单纯的，生搬硬套的采用别人的经验是行不通的。为此，我又反复的学习了辨证论治的概念。《说文》说：“辨，判也。”《广韻》说：“辨，别也。”证，《增韻》认为是“候”和“质”的含义，《宋书·沈约自序》认为是证据。《伤寒论》、《金匮要略》两书被认为是具体应用辨证论治于临床的先驱，它明确的阐明证、脉是进行辨证论治的两大依据。而细察治疗慢性肾炎、慢性肾盂肾炎大量蛋白尿的方剂和使用方法，大都违反这个原则。
在脉、证并重原则指导下，我对一些病证进行了认真的观察，发现大量蛋白尿的患者，大都具有以下特点：①全身没有任何自觉症状，仅有尿色黄赤，脉沉弦细涩；②全身没有任何自觉症状，仅有尿色黄赤，排尿时泡沫多，脉弦细涩；③全身尢任何自觉症状，仅有尿色黄赤，脉滑小数；④全身无任何自苋症状，仅见尿色黄赤，面色皓白，脉弦滑稍大；⑤仅见尿色黄赤，咽喉干痛，脉浮；⑥仅见口渴口干，尿黄赤，舌苔薄黄或薄白，舌尖红赤，脉细；⑦仅见口干口渴，尿黄赤，舌苔白，舌尖红，脉弦滑；⑧仅见面色皓白，口干口渴，尿黄赤，脉虚弦滑；⑨仅见面色皓白，口干口渴，尿黄赤，腰酸，脉虚弦滑；⑩仅见面色皓白，轻度浮肿，口于口渴，腹满纳呆，腰酸，尿黄赤，脉虚弦滑；⑾仅见面色皓白，轻度浮肿，下肢沉重，尿黄赤，腰酸，脉虚弦滑；⑿下肢浮肿，沉重乏力，尿色黄赤，舌苔黄，脉浮滑等。事实证明，这些患者都没有明显的脾虚、肾虚、瘀血脉证，或很少具有脾虚、肾虚、瘀血的脉证。从此以后，我就以事实为根据对慢性肾炎、慢性肾盂肾炎的大量蛋白尿者进行了观察。例如：凡见尿黄赤者，即根据情况酌加知母、黄柏、连翘、瞿麦、萹蓄、茯苓、泽泻、茅根、木通；咽喉疼痛，鼻干者，酌加桑叶、蝉蜕、僵蚕、苏叶、牛蒡子、薄荷；若咽喉干痛久久不愈者，酌加元参、麦冬、生地；口干渴较甚者，酌加花粉、知母、生地、山药、元参，甚者加大黄、滑石；舌尖红赤者，酌加木通、滑石、连翘；面色皓白者，酌加黄芪、人参、党参、麦冬、五味子、当归；面色萎黄者，酌加健脾除湿之苍术、白术、苡米、山药、青皮、陈皮；腹满纳呆者，酌加苍术、白术、青皮、陈皮、茯苓；腰酸者，酌加生地、五味子、山萸肉；脉浮者，酌加蝉蜕、苏叶、薄荷、桑叶、牛蒡子、僵蚕；脉滑者，酌加清热之知母、黄柏、芦根、花粉，或化痰之半夏、竹茹、陈皮、桔梗；脉虚者，酌加补气养阴或补气养血之黄芪、当归、人参、党参、麦冬、五味子；脉濡者，酌加山药、苡米、白术、扁豆；脉弦者，酌加附子、肉桂；脉涩者，酌加温阳之附子、肉桂，活血之益母草、桃仁、红花，理气之青皮、陈皮。并分别根据桑菊饮、生脉散、防己茯苓汤、防己黄芪汤、当归补血汤、橘皮竹茹汤、瓜蒌瞿麦丸、六味地黄汤、资生丸、导赤散、升降散、芪脉地黄汤、十味温胆汤、参芪丹鸡黄精汤进行化裁，初步取得了一些疗效。
例如：宋×，男，11岁。慢性肾炎3年多。先在某院以激素、环磷酰胺等治疗两年多，后又配合补脾补肾药治疗一年多，虽然浮肿已经消退，但却明显的出现向心性肥胖，尿蛋白++，红细胞+，白细胞+，激素减量后，尿蛋白很快上升至++++，红细胞++，白细胞++，颗粒管型2～3个。并反复感冒，咽喉干痛，疲乏无力，尿黄赤，腹满，舌苔黄白微腻，脉虚大弦滑。综其脉证，诊为气阴两虚，湿热不化，乃拟补气养阴，燥湿清热之剂，芪脉地黄汤加减：黄芪15克，麦冬10克，沙参10克，五味子10克，生地15克，山药15克，生苡米15克，苍术15克，白术10克，茯苓10克，泽泻10克，丹皮10克，茅根30克。服药2个月后，反复感冒、咽喉疼痛、疲乏无力、食欲不振等均明显改善，但此时因停激素太快，尿蛋白反而由++增至卅，红细胞+，白细胞+。此时患者因看不到中药的明显疗效，特别是发现尿蛋白反有增多的情况，又加激素内服。再审脉证，除咽喉疼痛，痰多，尿黄赤外，脉已转为浮象，此乃气阴大复，风热未除耳，乃拟疏风清热，化痰利咽之剂。处方：蝉蜕9克，僵蚕9克，桔梗9克，甘草9克，牛蒡子9克，苏叶9克，连翘9克，茅根30克。连续服药2个月后，又停服西药，但此次停药后，尿蛋白不但没有增加，反而降至+，红细胞、白细胞偶见。又继服上方一个月，尿蛋白不再下降，咽喉干痛继续存在。再审脉证，除小便黄赤外，脉见弦涩不调，别无所苦，此风热已除，膀胱之阳气有衰之故耳。乃拟肉桂1．5克以温膀胱助气化，知母15克、黄柏15克、茅根30克以除湿热。服药两个月后，诸证消失，尿常规正常，而愈。
马××，男，15岁。慢性肾炎一年多，经激素、环磷酰姣、中药等配合治疗浮肿消退后，尿蛋白仍然持续在+++～++++之间，红细胞、白细胞少许，透明管型、颗粒管型各l～3个。邀余诊视，初以益气养阴，燥湿清热治疗一个月，病无进退。停西药观察，一个月后，病情未见加重。再审脉证，口干而渴，尿黄赤，脉弦涩不调，别无所苦，乃以瓜蒌瞿麦丸加减予之。处方：天花粉12克，山药30克，瞿麦12克，茯苓10克，附子1．5克。服药3个月，尿检查已完全正常。但感冒后，仍有蛋白微量出现，此风热所致耳，予疏风清热之剂6剂而愈。
李××，女，23岁。慢性肾盂肾炎2年，前医以中药、抗生素等治疗后，虽然尿急尿频尿痛已经消失，尿培养已无病原菌。但仍经常疲乏无力，食欲不振，恶心痰多，失眠心悸，口干咽痛，尿蛋白卅，红细胞++，白细胞+，脓球少许。审其面色皓白无华，脉虚大弦滑。综合脉证，诊为气阴两虚，痰热不化。治以益气养阴，化痰清热。十味温胆汤加减：黄芪15克，当归10克，麦冬10克，党参10克，五味子10克，竹茹10克，半夏10克，陈皮10克，茯苓10克，甘草10克，菖蒲10克，远志10克，知母10克。服药三周后，精神、食欲、睡眠等证均好转，尿蛋白++，红细胞，白细胞少许，脓球消失。根据效不更方的原则，又服原方一个月，除口干，舌苔白，舌尖红赤外，症状大部消失，尿蛋白亦减为+，红细胞、白细胞消失。但此时再继续服用一个半月却不见明显效果。诊其脉沉滑小数，舌尖红赤，乃云：心火下移于小肠所致也，乃拟导赤散：生地10克，木通10克，甘草10克，竹叶10克。半月后，查尿蛋白微量，但此时脉象见微涩，乃改予：附子l克、知母10克、黄柏10克，一周后复查尿蛋白消失。其后为防止复发继服上方20剂，尿连续检查7次，均正常。
耿××，男，25岁。慢性肾炎二年多，经中、西药治疗后，虽然腹水、全身水肿均已大部消失，但仍时见下肢轻度浮肿，腰酸乏力，恶心呕吐，腹满不适。细审其证，除以上证候外，并见面色皓白，舌苔白，舌质淡而暗，面微浮，脉虚大弦滑，尿蛋白++++，红细胞100个，白细胞20个，颗粒管型3个，透明管型2个。综合脉证，诊为脾肾俱虚，湿热下注，为拟补气养阴，除湿清热，芪脉地黄汤加减：黄芪15克，党参10克，麦冬10克，五味子10克，当归10克，山药10克，茯苓10克，泽泻10克，丹皮10克，生地15克，茅根30克，苡米30克。服药3剂后，恶心呕吐消失，浮肿、乏力、食欲不振，腰酸等症好转。宗效不更方意，继服上方20剂，浮肿消失，尿蛋白减为++，红细胞+，白细胞+，又服药2个月，诸证消失，尿蛋白+，红细胞、白细胞少许，但连续服药60剂后，尿蛋白却不见减少。审其脉弦细涩，改予瓜蒌瞿麦丸，30剂后，尿全部正常。
良性颅内压增高症与颅内压增高性头痛，中医诸书多无明确记载。审其症状表现似应包括在中医头痛一名中。然其治法为何?方用何方?药用何药?实属不够明确。故余亦缺乏恰当之方药。1966年8月1日。曾治一患者，头胀头痛，剧烈呕吐，视物不清。某院诊为脑瘤。先用降低脑压的西药，其痛不减。旋即邀余处以降低脑压的方，余因无方可施，乃婉言谢绝。后因他医亦拒绝用药，再邀余诊。查其脉弦紧而数且兼有涩意，舌苔白。云：头痛呕吐，吐物为水饮，且脉弦紧而数兼有涩意，乃中医所云之痰厥头痛也。柴胡加龙骨牡蛎汤，一者含小柴胡汤意，小柴胡汤者少阳肝胆药也；二者含苓桂甘枣汤意，苓桂甘枣汤者温阳化饮降冲药也；三者含桂枝甘草龙骨牡蛎汤意，桂枝甘草龙骨牡蛎汤者强心阳降冲逆药也。一方而兼二职，可予柴胡加龙骨牡蛎汤去铅丹加甘草方试之。处方：柴胡10克，半夏10克，党参10克，黄芩10克，甘草10克，生姜10克，大枣7个，桂枝10克，茯苓15克，熟军3克，龙骨15克，牡蛎15克。药进1剂，痛减呕止，尿量增多。继进3剂，痛止，视力增加。其后又遇一患者，女性。头痛，呕吐，视力下降。经脑电图、x线拍片确诊为脑瘤。欲到外地手术治疗，然因某些因素不能即刻前往。邀余处以降低脑压之方。查其脉弦紧而数时兼涩意，舌苔白，头痛呕吐，以早晨为甚，视力下降。处以柴胡加龙骨牡蛎汤去铅丹加甘草法。药后果然痛止呕愈，尿量增多。思之：此莫不是降低脑压之方?再试于良性颅内压增高症之患者，亦多有效。然久久用之，亦常有不见效果者。细查其证，多为饭水俱吐，脉弦紧而数。思之：痰水厥逆之吐，当但吐水，此者水、食俱见，乃厥阴寒逆之吐也。正如仲景《金匮要略》所云：“干呕，吐涎沫，头痛者，茱萸汤主之。”曾治患者齐×，女，19岁。头痛头胀难忍，视力下降，呕吐呈喷射状，不发热。医诊良性颅内压增高症。予降低脑压之西药与腰穿放液，症状时减时剧。近两天来，头脑剧痛不止，反复呕吐，视力下降，手足厥逆。急予加减柴胡龙骨牡蛎汤1剂，其效不著，改予吴茱萸汤加味。处方：吴茱萸10克，人参10克，当归10克，白芍10克，甘草10克，大枣7个。1剂后，痛止呕解。再剂，诸证全失。患者李×，男，18岁。头胀头痛，恶心呕吐，视力下降一年多。医诊良性颅内压增高症。先予腰穿放液、降低颅压的药物，症状时减时剧。后予中药养阴补肾、养心安神、养血平肝等，效果仍无。邀余诊视。审其头胀头痛，恶心呕吐，视力下降，脉弦紧而数。综合脉证，诊为肝寒厥逆之吐。予温肝降逆。吴茱萸汤加味。处方：吴茱萸10克，党参10克，甘草6克，大枣7个，当归10克，白芍10克。服药7剂，头痛大减。继服1月，诸证全失，愈。
阳强不倒
阴茎异常勃起，现代医学认为，多由精神因素及血流动力学改变所致；中医学认为，多因肝火、命门火衰、宗筋瘀滞所引起。《灵枢·经筋篇》云：“足厥阴之筋病——伤于热则纵挺不收。”《石室秘录》云：“阳强不倒，此属火炎上而肺金之气不能下行。”《本草经疏》云：“阳强不倒，属命门火实。”王琦云：“宗筋瘀滞是阴茎异常勃起的主要病机。其内在发病的主要脏腑则应责之于肝，其次在肾。肝主经筋，足厥阴之脉，循阴股，绕阴器，前阴为宗筋之会，宗筋乃诸筋之所聚，诸筋皆统于肝。精神情志失调及外伤等均可导致肝脉失和，茎络阻滞，瘀血停聚，宗筋瘀滞而纵挺不倒出现阴茎异常勃起。”因此多主张采用清泻肝火、滋阴降火、疏肝通络进行治疗。然余久用以上诸法却多不效。细思其因多为未宗仲景所训：“观其脉证，知犯何逆，随证治之”耳。
After the symptoms of chronic nephritis (chronic glomerulonephritis) or pyelonephritis (inflammation of the kidney pelvis and parenchyma) have subsided or largely resolved, if massive proteinuria persists, or is even accompanied by red blood cells, white blood cells, and casts, this problem has long been difficult to resolve completely. In some cases, treatment with hormones, cyclophosphamide, azathioprine, mechlorethamine, chloroquine, indomethacin, etc., can provide relief; in others, after temporary relief, massive proteinuria reappears shortly after stopping the medication; while in still others, there is no relief at all. Consequently, many clinicians have sought solutions through a combination of Chinese and Western medicines or solely from traditional Chinese medicine perspectives. For example, some advocate the use of astringent herbs, some recommend Huangqi (Astragali Radix) and Dangshen (Codonopsis Radix), some propose activating blood circulation and removing blood stasis, and some suggest clearing heat and detoxifying. However, due to the lack of widespread clinical validation, these methods have not been universally adopted.
Regarding this issue, I conducted some exploratory research after 1964 but made no progress until 1973. The long-term and repeated setbacks taught me that simply copying others' experiences rigidly is ineffective. Therefore, I repeatedly studied the concept of syndrome differentiation and treatment (Bian Zheng Lun Zhi). The *Shuowen Jiezi* states: "Bian means to judge." The *Guangyun* states: "Bian means to distinguish." According to the *Zengyun*, "Zheng" (Syndrome/Pattern) implies "manifestation" and "essence," while the *Book of Song: Preface to Shen Yue's Autobiography* considers it as evidence. The *Shanghan Lun* (Treatise on Cold Pathogenic Diseases) and *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) are regarded as pioneers in applying syndrome differentiation and treatment clinically, clearly elucidating that syndrome and pulse are the two major bases for this approach. Upon careful examination of prescriptions and usage methods for treating massive proteinuria in chronic nephritis and pyelonephritis, most violate this principle.
Guided by the principle of giving equal weight to pulse and syndrome, I carefully observed certain disease patterns and found that patients with massive proteinuria generally exhibited the following characteristics: ① No systemic subjective symptoms, only yellow-red urine, deep, wiry, fine, and choppy pulse; ② No systemic subjective symptoms, only yellow-red urine, excessive foam during urination, wiry, fine, and choppy pulse; ③ No systemic subjective symptoms, only yellow-red urine, slippery and slightly rapid pulse; ④ No systemic subjective symptoms, only yellow-red urine, bright white complexion, wiry-slippery and slightly large pulse; ⑤ Only yellow-red urine, dry and painful throat, floating pulse; ⑥ Only thirst and dry mouth, yellow-red urine, thin yellow or thin white tongue coating, red tongue tip, fine pulse; ⑦ Only dry mouth and thirst, yellow-red urine, white tongue coating, red tongue tip, wiry-slippery pulse; ⑧ Only bright white complexion, dry mouth and thirst, yellow-red urine, deficient-wiry-slippery pulse; ⑨ Only bright white complexion, dry mouth and thirst, yellow-red urine, soreness and weakness of the lower back, deficient-wiry-slippery pulse; ⑩ Only bright white complexion, mild edema, dry mouth and thirst, abdominal fullness and poor appetite, soreness and weakness of the lower back, yellow-red urine, deficient-wiry-slippery pulse; ⑪ Only bright white complexion, mild edema, heaviness in the lower limbs, yellow-red urine, soreness and weakness of the lower back, deficient-wiry-slippery pulse; ⑫ Edema in the lower limbs, heaviness and fatigue, yellow-red urine, yellow tongue coating, floating-slippery pulse, etc. Facts proved that these patients did not have obvious signs of Spleen deficiency, Kidney deficiency, or blood stasis pulses/syndromes, or had very few such signs. From then on, I based my observations of massive proteinuria in chronic nephritis and pyelonephritis on facts. For example: whenever yellow-red urine was seen, depending on the situation, Zhimu (Anemarrhenae Rhizoma), Huangbai (Phellodendri Cortex), Lianqiao (Forsythiae Fructus), Qumai (Dianthi Herba), Bianxu (Polygoni Avicularis Herba), Fuling (Poria), Zexie (Alismatis Rhizoma), Maogen (Imperatae Rhizoma), Mutong (Akebiae Caulis) were added appropriately; for sore throat and dry nose, Sangye (Mori Folium), Chantui (Cicadae Periostracum), Jiangcan (Bombyx Batryticatus), Ziye (Perillae Folium), Niubangzi (Arctii Fructus), Bohe (Menthae Haplocalycis Herba) were added appropriately; if dry and painful throat persisted, Yuan Shen (Scrophulariae Radix), Maidong (Ophiopogonis Radix), Shengdi (Rehmanniae Radix) were added appropriately; for severe dry mouth and thirst, Huafen (Trichosanthis Radix), Zhimu, Shengdi, Shanyao (Dioscoreae Rhizoma), Yuan Shen were added appropriately, and Dahuang (Rhei Radix et Rhizoma), Huashi (Talcum) for severe cases; for red tongue tip, Mutong, Huashi, Lianqiao were added appropriately; for bright white complexion, Huangqi, Renshen (Ginseng Radix), Dangshen, Maidong, Wuweizi (Schisandrae Chinensis Fructus), Danggui (Angelicae Sinensis Radix) were added appropriately; for sallow complexion, Cangzhu (Atractylodis Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Yimi (Coicis Semen), Shanyao, Qingpi (Citri Reticulatae Pericarpium Viride), Chenpi (Citri Reticulatae Pericarpium) for strengthening Spleen and draining dampness were added appropriately; for abdominal fullness and poor appetite, Cangzhu, Baizhu, Qingpi, Chenpi, Fuling were added appropriately; for soreness and weakness of the lower back, Shengdi, Wuweizi, Shanzhuyu (Corni Fructus) were added appropriately; for floating pulse, Chantui, Ziye, Bohe, Sangye, Niubangzi, Jiangcan were added appropriately; for slippery pulse, Zimu, Huangbai, Lugeng (Phragmitis Rhizoma), Huafen for clearing heat, or Banxia (Pinelliae Rhizoma), Zhuru (Bambusae Caulis in Taenia), Chenpi, Jiegeng (Platycodonis Radix) for resolving phlegm were added appropriately; for deficient pulse, Huangqi, Danggui, Renshen, Dangshen, Maidong, Wuweizi for tonifying Qi and nourishing Yin or tonifying Qi and nourishing Blood were added appropriately; for soggy pulse, Shanyao, Yimi, Baizhu, Bidou (Lablab Albus) were added appropriately; for wiry pulse, Fuzi (Aconiti Lateralis Radix Praeparata), Rougui (Cinnamomi Cortex) were added appropriately; for choppy pulse, Fuzi, Rougui for warming Yang, Yimucao (Leonuri Herba), Taoren (Persicae Semen), Honghua (Carthami Flos) for activating blood, Qingpi, Chenpi for regulating Qi were added appropriately. Modifications were also made based on Sangju Yin (Mulberry Leaf and Chrysanthemum Decoction), Shengmai San (Generate the Pulse Powder), Fangji Fuling Tang (Stephania and Poria Decoction), Fangji Huangqi Tang (Stephania and Astragalus Decoction), Danggui Buxue Tang (Angelica Tonify the Blood Decoction), Ju Pi Zhu Ru Tang (Tangerine Peel and Bamboo Sap Decoction), Gualou Qumai Wan (Trichosanthes Seed and Dianthus Pill), Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill), Zisheng Wan (Nourishing Life Pill), Dao Chi San (Direct Outward Red Powder), Shengjiang San (Ascending and Descending Powder), Qimai Dihuang Tang (Astragalus and Polygonatum Rehmannia Decoction), Shiwei Wandan Tang (Ten-Ingredient Warm Gallbladder Decoction), Shenqi Danji Huangjing Tang (Codonopsis, Astragalus, Salvia, Chicken, and Polygonatum Decoction), initially achieving some efficacy.
For example: Song X, male, 11 years old. Chronic nephritis for over 3 years. Initially treated for over 2 years with hormones and cyclophosphamide at another hospital, followed by over a year of treatment with Spleen and Kidney tonifying herbs. Although edema had subsided, central obesity appeared significantly, urine protein ++, red blood cells +, white blood cells +. After reducing hormone dosage, urine protein rapidly rose to ++++, red blood cells ++, white blood cells ++, granular casts 2-3. He also suffered from recurrent colds, dry and painful throat, fatigue, yellow-red urine, abdominal fullness, yellow-white slightly greasy tongue coating, deficient-large-wiry-slippery pulse. Synthesizing pulse and syndrome, diagnosed as Qi and Yin dual deficiency with damp-heat stagnation. Prescribed a formula to tonify Qi and nourish Yin, dry dampness and clear heat, modified Qimai Dihuang Tang: Huangqi 15g, Maidong 10g, Shashen 10g, Wuweizi 10g, Shengdi 15g, Shanyao 15g, raw Yimi 15g, Cangzhu 15g, Baizhu 10g, Fuling 10g, Zexie 10g, Danpi (Moutan Cortex) 10g, Maogen 30g. After 2 months of medication, recurrent colds, sore throat, fatigue, and loss of appetite improved significantly. However, due to stopping hormones too quickly, urine protein increased from ++ to +++, red blood cells +, white blood cells +. Seeing no obvious effect of Chinese medicine, especially the increase in urine protein, the patient resumed oral hormones. Re-evaluating pulse and syndrome, besides sore throat, excessive phlegm, and yellow-red urine, the pulse had turned floating. This indicated significant recovery of Qi and Yin, but wind-heat remained. Prescribed a formula to disperse wind, clear heat, resolve phlegm, and benefit the throat: Chantui 9g, Jiangcan 9g, Jiegeng 9g, Gancao (Licorice Root) 9g, Niubangzi 9g, Ziye 9g, Lianqiao 9g, Maogen 30g. After continuous administration for 2 months, Western medicine was stopped again. This time, urine protein did not increase but dropped to +, with occasional red and white blood cells. Continuing the above prescription for another month, urine protein no longer decreased, and dry throat pain persisted. Re-evaluating pulse and syndrome, besides yellow-red urine, the pulse was wiry-choppy and irregular, with no other discomfort. This indicated wind-heat had cleared, but Bladder Yang Qi was declining. Prescribed Rougui 1.5g to warm the Bladder and assist Qi transformation, Zhimu 15g, Huangbai 15g, Maogen 30g to drain damp-heat. After 2 months of medication, all symptoms disappeared, urine routine test was normal, and the patient recovered.
Ma XX, male, 15 years old. Chronic nephritis for over a year. After edema subsided with combined treatment of hormones, cyclophosphamide, and Chinese medicine, urine protein remained between +++ and ++++, with slight red and white blood cells, hyaline casts and granular casts 1-3 each. Invited me for consultation. Initially treated for one month with Qi tonification, Yin nourishment, damp-drying, and heat-clearing methods, with no improvement. Stopped Western medicine for observation; after one month, condition did not worsen. Re-evaluating pulse and syndrome: dry mouth and thirst, yellow-red urine, wiry-choppy and irregular pulse, no other discomfort. Prescribed modified Gualou Qumai Wan: Tianhuafen (Trichosanthis Radix) 12g, Shanyao 30g, Qumai 12g, Fuling 10g, Fuzi 1.5g. After 3 months of medication, urine examination was completely normal. However, after a cold, trace protein appeared, caused by wind-heat. Prescribed 6 doses of wind-dispersing and heat-clearing agents, leading to recovery.
Li XX, female, 23 years old. Chronic pyelonephritis for 2 years. After previous treatment with Chinese medicine and antibiotics, urinary urgency, frequency, and dysuria disappeared, and urine culture showed no pathogens. However, frequent fatigue, loss of appetite, nausea with excessive phlegm, insomnia and palpitations, dry mouth and sore throat, urine protein +++, red blood cells ++, white blood cells +, and slight pus cells persisted. Observing her bright white lusterless complexion and deficient-large-wiry-slippery pulse, synthesizing pulse and syndrome, diagnosed as Qi and Yin dual deficiency with phlegm-heat stagnation. Treated with Qi tonification, Yin nourishment, phlegm resolution, and heat clearing. Modified Shiwei Wandan Tang: Huangqi 15g, Danggui 10g, Maidong 10g, Dangshen 10g, Wuweizi 10g, Zhuru 10g, Banxia 10g, Chenpi 10g, Fuling 10g, Gancao 10g, Changpu (Acori Tatarinowii Rhizoma) 10g, Yuanzhi (Polygalae Radix) 10g, Zhimu 10g. After three weeks of medication, spirit, appetite, and sleep improved, urine protein ++, slight red and white blood cells, pus cells disappeared. Following the principle of not changing the formula when effective, continued the original prescription for one month. Except for dry mouth, white tongue coating, and red tongue tip, most symptoms disappeared, urine protein reduced to +, red and white blood cells disappeared. However, continuing for another 1.5 months showed no obvious effect. Diagnosing sinking-slippery-slightly rapid pulse and red tongue tip, stated: Heart Fire transferring to the Small Intestine. Prescribed Dao Chi San: Shengdi 10g, Mutong 10g, Gancao 10g, Zhuye (Bambusae Folium) 10g. Half a month later, trace urine protein was found, but the pulse showed slight choppy quality. Changed to: Fuzi 1g, Zhimu 10g, Huangbai 10g. One week later, urine protein disappeared. To prevent recurrence, continued the above prescription for 20 doses. Seven consecutive urine checks were all normal.
Geng XX, male, 25 years old. Chronic nephritis for over two years. After Chinese and Western medicine treatment, although ascites and general edema had largely subsided, mild lower limb edema, soreness and weakness of the lower back, nausea and vomiting, and abdominal fullness and discomfort occasionally occurred. Careful examination revealed, besides the above symptoms, bright white complexion, white tongue coating, pale and dark tongue body, slight facial swelling, deficient-large-wiry-slippery pulse, urine protein ++++, red blood cells 100, white blood cells 20, granular casts 3, hyaline casts 2. Synthesizing pulse and syndrome, diagnosed as Spleen and Kidney dual deficiency with damp-heat pouring downward. Prescribed Qi tonification, Yin nourishment, damp-draining, and heat-clearing, modified Qimai Dihuang Tang: Huangqi 15g, Dangshen 10g, Maidong 10g, Wuweizi 10g, Danggui 10g, Shanyao 10g, Fuling 10g, Zexie 10g, Danpi 10g, Shengdi 15g, Maogen 30g, Yimi 30g. After 3 doses, nausea and vomiting disappeared, edema, fatigue, loss of appetite, and lower back soreness improved. Following the intent of not changing the formula when effective, continued the above prescription for 20 doses. Edema disappeared, urine protein reduced to ++, red blood cells +, white blood cells +. After another 2 months of medication, all symptoms disappeared, urine protein +, slight red and white blood cells. However, after continuous administration of 60 doses, urine protein did not decrease. Examining wiry-fine-choppy pulse, changed to Gualou Qumai Wan. After 30 doses, urine tests were all normal.
Increased Intracranial Pressure Headache and Benign Intracranial Hypertension
Benign intracranial hypertension and increased intracranial pressure headache are not clearly recorded in most traditional Chinese medicine books. Their symptom manifestations seem to fall under the category of headache in TCM. However, the treatment method, prescription, and herbs used are unclear. Thus, I also lacked appropriate formulas and herbs. On August 1, 1966, I treated a patient with head distension and headache, severe vomiting, and blurred vision. Another hospital diagnosed brain tumor. Initial Western medicine to lower intracranial pressure did not relieve pain. Subsequently invited me to prescribe a formula to lower intracranial pressure. As I had no suitable formula, I politely declined. Later, other doctors also refused medication, and I was invited again. Examination showed wiry-tight-rapid pulse with choppy quality, white tongue coating. Stated: Headache and vomiting, vomitus is fluid retention, and wiry-tight-rapid pulse with choppy quality indicates Phlegm-Jue Headache in TCM. Chaihu Jia Longgu Muli Tang (Bupleurum plus Dragon Bone and Oyster Shell Decoction) contains the essence of Xiaochaihu Tang (Minor Bupleurum Decoction), which treats Shaoyang Liver-Gallbladder issues; it contains the essence of Linggui Gan Zao Tang (Poria, Cinnamon Twig, Licorice, and Jujube Decoction), which warms Yang, transforms fluid retention, and descends rebellious Qi; it contains the essence of Guizhi Gancao Longgu Muli Tang (Cinnamon Twig, Licorice, Dragon Bone, and Oyster Shell Decoction), which strengthens Heart Yang and descends rebellious Qi. One formula serving two functions, try Chaihu Jia Longgu Muli Tang minus lead oxide plus licorice. Prescription: Chaihu (Bupleuri Radix) 10g, Banxia 10g, Dangshen 10g, Huangqin (Scutellariae Radix) 10g, Gancao 10g, Shengjiang (Zingiberis Rhizoma Recens) 10g, Dazao (Ziziphi Jujubae Fructus) 7 pieces, Guizhi (Cinnamomi Ramulus) 10g, Fuling 15g, Shujun (Prepared Rhubarb) 3g, Longgu (Fossilia Ossis Mastodi) 15g, Muli (Concha Ostreae) 15g. After 1 dose, pain decreased, vomiting stopped, urine volume increased. After 3 more doses, pain ceased, vision improved. Later encountered another patient, female, with headache, vomiting, and decreased vision. Confirmed brain tumor via EEG and X-ray. Wanted surgery elsewhere but couldn't go immediately due to certain factors. Invited me to prescribe a formula to lower intracranial pressure. Examination showed wiry-tight-rapid pulse with occasional choppy quality, white tongue coating, headache and vomiting worse in the morning, decreased vision. Prescribed Chaihu Jia Longgu Muli Tang minus lead oxide plus licorice method. Medication indeed stopped pain and vomiting, increased urine volume. Thought: Could this be a formula to lower intracranial pressure? Tried it on patients with benign intracranial hypertension, mostly effective. However, long-term use often yielded no results. Careful examination of symptoms showed mostly vomiting both food and water, wiry-tight-rapid pulse. Thought: Vomiting due to phlegm-fluid rebellion should only vomit water; here both water and food are present, indicating Jueyin Cold-Rebellious Vomiting. As stated in Zhang Zhongjing's *Jingui Yaolue*: "Dry heaving, vomiting saliva and froth, with headache, Zhu Yu Tang (Evodia Decoction) governs." Treated patient Qi X, female, 19 years old. Unbearable headache and head distension, decreased vision, projectile vomiting, no fever. Diagnosed with benign intracranial hypertension. Given Western medicine to lower intracranial pressure and lumbar puncture drainage, symptoms fluctuated. For the past two days, severe continuous headache, repeated vomiting, decreased vision, cold hands and feet. Urgently prescribed modified Chaihu Longgu Muli Tang 1 dose, effect not obvious, changed to modified Zhu Yu Tang. Prescription: Zhu Yu (Evodiae Fructus) 10g, Renshen 10g, Danggui 10g, Baishao (Paeoniae Radix Alba) 10g, Gancao 10g, Dazao 7 pieces. After 1 dose, pain stopped, vomiting resolved. After another dose, all symptoms disappeared. Patient Li X, male, 18 years old. Head distension and headache, nausea and vomiting, decreased vision for over a year. Diagnosed with benign intracranial hypertension. Initially given lumbar puncture drainage and intracranial pressure-lowering drugs, symptoms fluctuated. Then given Chinese medicine for Yin nourishment, Kidney tonification, Heart calming, Spirit soothing, Blood nourishment, Liver pacifying, etc., with no effect. Invited me for consultation. Examined head distension and headache, nausea and vomiting, decreased vision, wiry-tight-rapid pulse. Synthesizing pulse and syndrome, diagnosed as Liver Cold Rebellious Vomiting. Prescribed warming Liver and descending rebellion. Modified Zhu Yu Tang: Zhu Yu 10g, Dangshen 10g, Gancao 6g, Dazao 7 pieces, Danggui 10g, Baishao 10g. After 7 doses, headache greatly reduced. Continued for 1 month, all symptoms disappeared, recovered.
Persistent Erection
Abnormal penile erection is considered by modern medicine to be mostly caused by psychological factors and hemodynamic changes; Traditional Chinese Medicine considers it mostly caused by Liver Fire, decline of Mingmen Fire, and stagnation of Zongjin (tendons of the genitals). *Ling Shu: Jing Jin Chapter* states: "Disease of the Foot Jueyin tendon—if injured by heat, it becomes flaccid and cannot retract." *Shishi Milu* states: "Persistent erection belongs to fire flaming upward while Lung Metal Qi cannot descend." *Bencao Jing Shu* states: "Persistent erection belongs to excess Mingmen Fire." Wang Qi states: "Stagnation of Zongjin is the main pathogenesis of abnormal penile erection. The internal organs primarily involved are the Liver,其次 the Kidney. The Liver governs tendons, the Foot Jueyin meridian runs along the inner thigh, circles the genitalia, and the anterior yin is the meeting point of Zongjin. Zongjin is the gathering place of all tendons, all governed by the Liver. Emotional disturbances and trauma can cause Liver meridian disharmony, blockage of penile collaterals, accumulation of blood stasis, stagnation of Zongjin, resulting in persistent erection." Therefore, it is mostly advocated to treat with clearing and purging Liver Fire, nourishing Yin and descending fire, and soothing Liver and unblocking collaterals. However, my long-term use of these methods was mostly ineffective. Carefully considering the reason, it is mostly because I did not follow Zhang Zhongjing's instruction: "Observe the pulse and syndrome, know what deviation has occurred, and treat according to the syndrome."