1963年6月4曰，治一女性患者，霍××，40岁。腰椎骨折痊愈后三个月来，二便一直不能控制，先用针灸、西药治疗不见好转，继服中药收敛固脬、益气养阴亦不效。询其证见腰酸腰困，舌苔薄白，脉弦尺微。证脉合参，诊为肾督亏损，开阖失职，乃拟补益肾督，佐以固涩。龟鹿二仙胶加减：鹿茸0．9克(研、冲)，东参9克，枸杞子15克，龟甲15克，熟地15克，牡蛎15克，菟丝子30克，覆盆子30克，何首乌30克。4剂减，8剂竟愈。
李翰卿云：“审证难在审脉，脉象不明，则证难审清。尿失禁有肺、脾、肾、三焦、膀胱的不同脏腑和虚实寒热的差別，若不仔细分辨，徒用成方，药不中病，必难治愈。”此病之长期不效者，亦在此耳。
痰核流注
朱丹溪说：“结核或在项、在颈、在臂、在身皮里膜外，不红不肿不硬不作痛，多是痰注作核不散。”刘河间说：“结核火气热甚则郁结坚硬如果中核也，不须溃发，但热气散则自消。”阐明了痰核流注的表现和原因是因火气热甚郁结，结核不散形成的如核状物，发生的部位在颈、项、臂、身之皮里膜外，无明显的红、肿、热、痛。治疗原则是消散痰热。余宗其意，试用于颈、项、腋下的淋巴结核，慢性炎症和臂部、下肢、躯干的脂膜炎，风湿结节、脂肪瘤等无红肿热痛的核状物，常常使结核好转或消退。
例如：雷××，女，成。半年来两肩、臂发现20多个黄旦大的结节，两臂酸痛，持续低热不退，疲乏无力。经北京某医院病理切片确诊为脂膜炎。先用氯奎等治疗3个多月不效。诊时除上述主诉症状外，察其结核皮色不变，按压时有轻微疼痛感，手心热，神色无异常，舌苔薄白，脉弦滑。证脉合参，诊断为痰热阻滞经络，凝结为核，方拟清热化痰，软坚通络：钩藤30克，地龙13克，香橼10克，佛手10克，枳壳10克，木瓜10克，连翘10克，赤芍10克，丝瓜络10克，桑枝30克。连进4剂，结核有的开始缩小，上肢疼痛明显减轻，又继服20剂后，有的已经消失，有的明显缩小，又服30剂，以上症状及结核全部消失，数年来一直没有复发。周XX，女，成。3年多来，两小腿特别是踝关节附近，反复发生结节，开始为紫红色，以后紫红色逐渐消退，形成皮色不变的如杏仁或黄豆大的疼痛性结节，数个医院病理切片检查均为风湿结节。经泼尼松(强的松)、青霉素和中药凉血解毒、祛风除湿清热之剂等反复治疗无效，察其舌苔薄白，脉象弦滑。综合脉证，诊为风痰入络，凝结为核。乃拟上方7剂，10个月后来诊云：结核有的已经消失，有的明显缩小。乃继续服用原方20剂，结节竟大部消失，又连续服用40剂而愈。
又如麻××，女，成。数月来低烧不退，下肢出现广泛的出血点和结节，关节肌肉酸痛。××医院病理检查诊为嗜酸性肉芽肿。通过激素治疗已经基本控制，但停药后又复发如前，某医以祛风除湿清热的中药治之非但无效，反而症状更加严重。经察舌苔薄白，舌尖红，脉象弦滑。余云：痰热阻滞，凝结成核之证。乃拟清热化痰，软坚通络之剂，上方递进，10剂后身痛、结节、出血点、低烧等竟明显改善，又续服20剂而症状消失。停药20天后，患者恐怕以上症状复发，又请某医以祛风除湿，清热凉血之剂治之，以上症状又复出现，但较前为轻，乃改为清热化痰．软坚通络之剂两月而愈。其他如脂肪瘤，淋巴结核，因有专篇论述，不再多论。
积聚与腹壁肿瘤
积聚是腹内结块，或胀或痛或按之筑动的一种病证。其中有形有物，痛有定处，结而不散，有形有征，推之不移，属血属脏者，称为积。聚则成形，散则无物，走注不定，时作时止，时聚时散，发作时则有形可见，不发作时则无物可征，属气属腑者，称为聚。其治疗原则总起来讲有四种：一攻、二消、三散、四补。张景岳说：“凡积聚之治……然欲总其要不外四法：曰攻、曰消、曰散、曰补，四者而已。”“积坚气实者，非攻不能去。”“不堪攻击，只宜消导渐磨”，“无形气聚宜散”，“积痞势缓而攻补俱有未便者，当专以调理脾胃为主”，“脾胃不足及虚弱失调……无论其有形无形，但当察其缓急，皆以正虚为主”，“治积之要，在知攻补之宜，当于孰缓孰急中辨之：凡积聚未久，而元气未损者，治不宜缓，缓之则养成其势，反以难治，此其所急在积速攻可也；若积聚渐久，元气曰虚。此而攻之，则积气本远，攻不易及，胃气切近先受其伤，愈攻愈虚，则不死于积而死于攻矣。”《素问·六元正纪大论》说：“大积大聚其可犯也，衰其大半而止，过者死。”肝、脾、胰等脏器的囊肿、肿瘤等基本上属于中医所称的癥瘕积聚，因此它的治法不外攻、消、散、补四法。
例如：王××，女，60岁。3个月前，因饮食不慎，突然发生呕吐泄泻，经某医院住院治疗3个多月，呕吐泄泻虽然好转，但胃脘仍然胀痛，食欲不振，消瘦乏力。经检查发现上腹部有一鸭蛋大的肿物，超声波探查为7厘米×6厘米之胰腺囊肿，要求转入肿瘤医院治疗。转院后，因患者拒绝手术，转邀中医治疗。察其面色萎黄消瘦，神疲乏力，食纳欠佳，轻度浮肿，脘痞而痛，触之有7厘米×6厘米的柔韧肿物1个，轻度压痛，便溏，小便正常，舌苔白润，脉虚大。综合脉证诊为中气亏损，清阳不升，痰积不化。乃拟补中益气，消积温中之补中益气汤、小承气汤加减治之：黄芪15克，白术、党参、陈皮、当归、枳实、厚朴各9克，干姜4．5克，升麻、柴胡各6克，生姜3片，甘草6克。7剂后痛减．肿物减至核桃大；17剂后痛止，肿块缩至桃仁大，食欲大增，体重增加9千克，又继服35剂症状消失而愈。
又如：张××，女，成。3年前行两乳房乳腺增生切除术后，近半年来又发现两乳胀痛，并在胃脘部发现一鸡蛋大肿物，隐痛，食欲不振，某医院诊为“腹壁结核”，建议手术。因患者拒绝手术而邀余会诊治：察其两侧乳房有2厘米×4厘木、上腹部有一4厘米×4．5厘米的肿物，脘痞纳呆，乏力，舌苔薄白，脉虚大弦滑。诊为气血俱虚，痰积血瘀之证，乃拟补气养血，燥湿化痰，活血化瘀。参芪丹鸡黄精汤(方见臌胀)治之，8剂后未见进退，细思其两脉虚大，补之无功者在于药物人经之不明耳，乃改予补中益气汤合小承气汤加减：黄芪15克，白术、党参、陈皮、升麻、柴胡、当归、枳实、厚朴各9克，干姜、大黄各3克，甘草6克。连服21剂胃脘部肿物消失，乳房肿物未见缩小，并发现咽喉干燥，微咳。前方治脾，未治肝肺，故复加肝肺之品。黄芪30克，升麻、柴胡各9克，桔梗、枳实各15克，知母、厚朴、青皮、橘叶、赤芍各9克，干姜、大黄各3克。14剂后诸证消失，乃以上方30剂续服以巩固效果。《素问·至真要大论》说：“气有高下，病有远近，证有中外，治有轻重，适其至所为故也。”喻昌说：“凡治病不明脏腑经络，开口动手便错。”本例之效与不效者，在于脏腑经络之用药前后不同。
又如：耿××，女。左下腹肌纤维瘤3年，开始时仅有1个如桃核大，手术后半年在切口处又发生3个。切除后，3个月又在切口处出现6个同样大小的肿瘤，因不能继续手术，邀余试用中药治疗。察其神佳体健，脉见沉涩，乃以活络效灵丹加减：丹参15克，赤芍10克，乳香7克，没药7克，三棱3克，莪术3克。连服8个多月肿物消失。李翰卿先生云：“活络效灵丹加减方为实证而设，若正气不足者，应缓图为是，否则正气亏损，气血不行，癥瘕难疗。此方药所以量小之故也。”上例虽治疗8个多月，而仅服300剂左右即在于此。
震颤
吴鞠通云：“热邪久羁，吸烁真阴，或因误表，或因妄攻，神倦瘛疯，脉气虚弱，舌绛苔少，时时欲脱者，大定风珠主之。”又云：“此邪气已去八九，真阴仅存一二之治也。观脉虚苔少可知，故以大队浓浊塞隙，介属潜阳镇定。以鸡子黄一味，从足少阴，下安足三阴，上济手三阴，使上下交合，阴得安其位，斯阳可立根基，俾阴阳有眷属一家之义，庶可不致绝眼欤．”诸家多宗其热邪久羁，吸烁真阴之见，施于温热之病后期，阴精大亏，虚风旋扰之证，而于杂病之阴精大亏，虚风旋扰之证殊少论及。余宗阿胶、鸡子黄，取其血肉之品．以补阴液而熄内风；芍药、甘草、五味子甘酸化阴，补阴敛阳；更取三甲之介类潜阳；麦门冬、地黄滋阴润燥之义，施用于杂病真阴亏损，虚风内动者，亦效。
例如：患者董××，男，28岁。数年来四肢沉重，行动迟缓，手指运动不便，不能作精细动作，说话缓慢单调。某院始以安坦、东莨菪碱等而取效。但近一年来又日渐加重，某院诊为震颤麻痹。审其表情呆痴，很少眨眼，手指运动不便，不能拿笔写字，微颤，有时涎水不由自主的流出，平卧时翻身亦感困难，走路时躯干向前弯曲，头向前倾，呈急速小步，越走越快，不能即时止步或转弯，说话迟缓而困难，食欲正常，舌苔净，脉虚弱。综其脉证，诊为真阴亏损，虚风内动。乃拟大定风珠加减以滋填镇纳，安其龙雷，熄其虚风。处方：龟甲30克，鳖甲30克，牡蛎30克，阿胶10克(烊化)，炙甘草10克，麦冬10克，生地15克，五味子10克，白芍15克，火麻仁10克，鸡子黄2枚。某医云：大定风珠原为温病而设，老师何用于震颤麻痹?脉虚何不用参苓白术散之属?答云：“参苓白术散及化痰安神诸药，前医已用之不效，事实证明是不可再用，再思原方与病亦不合拍，本病乃阴精亏损，非急以填精补髓不可治，故以大定风珠，而不用参苓白术散。”药进7剂，诸证果减，口涎停止，继进14剂，精神大增，走路亦能跨步而前，再进14剂后，即上班开始工作，作拿中药和开处方等一般工作。
三叉神经痛
由于三叉神经痛常常表现为颊部、上齿剧烈疼痛，所以往往被诊为一般的牙痛而久治不效。余深研十年一直未得其法，偶读立斋、景岳之书才使我恍然大悟。薛立斋云：“齿痛……若因郁火所致用越鞠丸。”徐用诚云：“有诸经错杂之邪为患者。”张景岳说：“牙痛外传之药，惟辛温可以散热。”始知此病之难效者，正因解郁、散寒、清热之法未具备耳。
例如：郜××，女，45岁。右上齿、颊部疼痛3年，先在某医院诊为龋齿拔牙3个不效，后在某医院诊为三叉神经痛，中西药物，针灸治疗亦无效。邀余诊视。察其右上牙疼痛不止，不敢刷牙、洗脸、说话，舌苔白，脉弦紧。余云：此阳明胃热于内，寒邪闭塞于外所致也。法宜白虎清胃热，乌头搜风散寒以破阴霾：川乌10克，草乌10克，知母10克，玄参15克，生石膏30克，甘草6克，粳米15克。进药1剂疼痛果减，5剂即消失大半，15剂后疼痛消失，后果愈。
又如：董××，女，38岁。左颊及上齿疼痛，时轻时重3年多，先在某院拔牙2个不效，后在某院诊为三叉神经痛，中、西药物治疗1个多月仍不效。察其前方或以泻火，或以散寒；审其证见剧痛阵作，齿龈正常，头晕，头痛，心烦易怒，烧心泛酸，口苦口干，舌苔黄白，脉沉弦而涩。证脉合参，诊为寒热并见，肝木失达，乃以柴胡加龙骨牡蛎汤加减服之。处方：柴胡10克，半夏10克，黄芩10克，党参10克，桂枝10克，茯苓10克，生姜3片，甘草6克，大黄6克，龙骨10克，牡蛎15克，大枣5枚，仅进2剂，疼痛顿减，又进6剂，一直未作，再进6剂，果愈。
痉证
舞蹈病，大致包括在中医的痉病之中，痉病在宋代以前多从风寒湿进行论治。如《素问·至真要大论》说：“诸痉项强，皆属于湿。”“诸暴强直，皆属于风。”仲景分为刚、柔二痉，倡用葛根、栝蒌桂枝二汤，实亦宗《内经》风湿为痉之意。宋·陈言承前启后，提出血虚为痉之本，风寒湿热为痉病之标。他说：“夫人之筋，各随经络结束于身，血气内虚，外为风寒湿热之所中则痉……原其所因，多由亡血，筋无所营，故邪得以袭之，所以伤寒寒下过多，与夫病疮人，乃产后致斯疾者概可见矣。”金、元以来，朱丹溪主张：“大率属气血虚弱，有火有痰。”李梴主张：“然虽外因风寒湿气，内因六欲七情，皆必夹痰火而后发。”近人多宗其说，多从虚、痰、火、风等原因去论治，而外因中的风寒湿邪常被忽略，经络脏腑亦不甚重视，致使外因为病的痉证长期不愈。经过反复认真学习：“系统学习、全面掌握，继承发扬祖国医学遗产”的精神，才使我恍然有悟，于是决定全面学习古今医家之说。及读至薛立斋书，又与舞蹈病状相对照，使我开始对舞蹈病有了一点认识。薛立斋说：“若一边牵搐，一眼喁斜者，属少阳；及汗后不解，乍静乍乱，直视口噤，往来寒热，小柴胡汤加桂枝白芍。”又思仲景柴胡加龙骨牡蛎汤有桂枝配柴胡使内陷之邪从外而解，大黄和胃止谵语从下而解，茯苓安神志而除湿，复加龙骨、牡蛎镇静而止烦惊，比薛氏之法更较合拍，乃以柴胡加龙骨牡蛎汤用于舞蹈病，结果多见佳效。
1963年6月4日，诊治一名女性患者霍××，40岁。腰椎骨折痊愈后三个月来，大小便一直无法控制，先用针灸、西药治疗未见好转，继服中药收敛固脬（收敛膀胱以固摄尿液）、益气养阴亦无效。询问其症状见腰酸腰困，舌苔薄白，脉象弦而尺部微弱。证候与脉象合参，诊断为肾督亏损，开阖失职，于是拟定补益肾督，佐以固涩之法。方用龟鹿二仙胶加减：鹿茸0.9克（研末冲服），东参9克，枸杞子15克，龟甲15克，熟地15克，牡蛎15克，菟丝子30克，覆盆子30克，何首乌30克。服用4剂后症状减轻，8剂后竟痊愈。
李翰卿说：“审察证候的难点在于审察脉象，脉象不明，则证候难以审清。尿失禁有肺、脾、肾、三焦、膀胱等不同脏腑以及虚实寒热的差别，若不仔细分辨，徒然使用成方，药不对症，必定难以治愈。”此病长期不愈的原因，也在于此。
朱丹溪说：“结核或在项部、颈部、臂部、身体皮里膜外，不红不肿不硬不作痛，多是痰注形成结节不散。”刘河间说：“结核因火气热甚则郁结坚硬，如果中间有核状物，不需要溃破发散，只要热气消散则自然消除。”阐明了痰核流注的表现和原因是因火气热甚郁结，结核不散形成的如核状物，发生的部位在颈、项、臂、身之皮里膜外，无明显的红、肿、热、痛。治疗原则是消散痰热。我遵循其意，尝试用于颈、项、腋下的淋巴结核，慢性炎症和臂部、下肢、躯干的脂膜炎，风湿结节、脂肪瘤等无红肿热痛的核状物，常常使结核好转或消退。
例如：雷××，女，成年。半年来两肩、臂发现20多个黄豆大的结节，两臂酸痛，持续低热不退，疲乏无力。经北京某医院病理切片确诊为脂膜炎。先用氯奎等治疗3个多月无效。诊时除上述主诉症状外，观察其结核皮色不变，按压时有轻微疼痛感，手心热，神色无异常，舌苔薄白，脉象弦滑。证脉合参，诊断为痰热阻滞经络，凝结为核，方拟清热化痰，软坚通络：钩藤30克，地龙13克，香橼10克，佛手10克，枳壳10克，木瓜10克，连翘10克，赤芍10克，丝瓜络10克，桑枝30克。连续服用4剂，结核有的开始缩小，上肢疼痛明显减轻，又继服20剂后，有的已经消失，有的明显缩小，又服30剂，以上症状及结核全部消失，数年来一直没有复发。周XX，女，成年。3年多来，两小腿特别是踝关节附近，反复发生结节，开始为紫红色，以后紫红色逐渐消退，形成皮色不变的如杏仁或黄豆大的疼痛性结节，数个医院病理切片检查均为风湿结节。经泼尼松(强的松)、青霉素和中药凉血解毒、祛风除湿清热之剂等反复治疗无效，观察其舌苔薄白，脉象弦滑。综合脉证，诊为风痰入络，凝结为核。于是拟定上方7剂，10个月后来诊说：结核有的已经消失，有的明显缩小。于是继续服用原方20剂，结节竟大部消失，又连续服用40剂而痊愈。
又如麻××，女，成年。数月来低烧不退，下肢出现广泛的出血点和结节，关节肌肉酸痛。××医院病理检查诊为嗜酸性肉芽肿。通过激素治疗已经基本控制，但停药后又复发如前，某医以祛风除湿清热的中药治之非但无效，反而症状更加严重。经观察舌苔薄白，舌尖红，脉象弦滑。我说：痰热阻滞，凝结成核之证。于是拟定清热化痰，软坚通络之剂，上方递进，10剂后身痛、结节、出血点、低烧等竟明显改善，又续服20剂而症状消失。停药20天后，患者恐怕以上症状复发，又请某医以祛风除湿，清热凉血之剂治之，以上症状又复出现，但较前为轻，于是改为清热化痰．软坚通络之剂两月而痊愈。其他如脂肪瘤，淋巴结核，因有专篇论述，不再多论。
积聚与腹壁肿瘤
积聚是腹内结块，或胀或痛或按之筑动的一种病证。其中有形有物，痛有定处，结而不散，有形有征，推之不移，属血属脏者，称为积。聚则成形，散则无物，走注不定，时作时止，时聚时散，发作时则有形可见，不发作时则无物可征，属气属腑者，称为聚。其治疗原则总起来讲有四种：一攻、二消、三散、四补。张景岳说：“凡积聚之治……然而想要总结其要点不外乎四种方法：曰攻、曰消、曰散、曰补，只有这四种罢了。”“积坚气实者，非攻不能去。”“不堪攻击，只宜消导渐磨”，“无形气聚宜散”，“积痞势缓而攻补俱有未便者，当专以调理脾胃为主”，“脾胃不足及虚弱失调……无论其有形无形，但当察其缓急，皆以正虚为主”，“治积之要，在知攻补之宜，当于孰缓孰急中辨之：凡积聚未久，而元气未损者，治不宜缓，缓之则养成其势，反以难治，此其所急在积速攻可也；若积聚渐久，元气曰虚。此而攻之，则积气本远，攻不易及，胃气切近先受其伤，愈攻愈虚，则不死于积而死于攻矣。”《素问·六元正纪大论》说：“大积大聚其可犯也，衰其大半而止，过者死。”肝、脾、胰等脏器的囊肿、肿瘤等基本上属于中医所称的癥瘕积聚，因此它的治法不外攻、消、散、补四法。
例如：王××，女，60岁。3个月前，因饮食不慎，突然发生呕吐泄泻，经某医院住院治疗3个多月，呕吐泄泻虽然好转，但胃脘仍然胀痛，食欲不振，消瘦乏力。经检查发现上腹部有一鸭蛋大的肿物，超声波探查为7厘米×6厘米之胰腺囊肿，要求转入肿瘤医院治疗。转院后，因患者拒绝手术，转邀中医治疗。观察其面色萎黄消瘦，神疲乏力，食纳欠佳，轻度浮肿，脘痞而痛，触之有7厘米×6厘米的柔韧肿物1个，轻度压痛，便溏，小便正常，舌苔白润，脉虚大。综合脉证诊为中气亏损，清阳不升，痰积不化。于是拟定补中益气，消积温中之补中益气汤、小承气汤加减治之：黄芪15克，白术、党参、陈皮、当归、枳实、厚朴各9克，干姜4.5克，升麻、柴胡各6克，生姜3片，甘草6克。7剂后痛减．肿物减至核桃大；17剂后痛止，肿块缩至桃仁大，食欲大增，体重增加9千克，又继服35剂症状消失而痊愈。
又如：张××，女，成年。3年前行两乳房乳腺增生切除术后，近半年来又发现两乳胀痛，并在胃脘部发现一鸡蛋大肿物，隐痛，食欲不振，某医院诊为“腹壁结核”，建议手术。因患者拒绝手术而邀余会诊治：观察其两侧乳房有2厘米×4厘木、上腹部有一4厘米×4.5厘米的肿物，脘痞纳呆，乏力，舌苔薄白，脉虚大弦滑。诊为气血俱虚，痰积血瘀之证，于是拟定补气养血，燥湿化痰，活血化瘀。参芪丹鸡黄精汤(方见臌胀)治之，8剂后未见进退，细思其两脉虚大，补之无功者在于药物人经之不明耳，于是改予补中益气汤合小承气汤加减：黄芪15克，白术、党参、陈皮、升麻、柴胡、当归、枳实、厚朴各9克，干姜、大黄各3克，甘草6克。连服21剂胃脘部肿物消失，乳房肿物未见缩小，并发现咽喉干燥，微咳。前方治脾，未治肝肺，故复加肝肺之品。黄芪30克，升麻、柴胡各9克，桔梗、枳实各15克，知母、厚朴、青皮、橘叶、赤芍各9克，干姜、大黄各3克。14剂后诸证消失，乃以上方30剂续服以巩固效果。《素问·至真要大论》说：“气有高下，病有远近，证有中外，治有轻重，适其至所为故也。”喻昌说：“凡治病不明脏腑经络，开口动手便错。”本例之效与不效者，在于脏腑经络之用药前后不同。
又如：耿××，女。左下腹肌纤维瘤3年，开始时仅有1个如桃核大，手术后半年在切口处又发生3个。切除后，3个月又在切口处出现6个同样大小的肿瘤，因不能继续手术，邀余试用中药治疗。观察其神佳体健，脉见沉涩，于是以活络效灵丹加减：丹参15克，赤芍10克，乳香7克，没药7克，三棱3克，莪术3克。连服8个多月肿物消失。李翰卿先生云：“活络效灵丹加减方为实证而设，若正气不足者，应缓图为是，否则正气亏损，气血不行，癥瘕难疗。此方药所以量小之故也。”上例虽治疗8个多月，而仅服300剂左右即在于此。
吴鞠通云：“热邪久羁，吸烁真阴，或因误表，或因妄攻，神倦瘛疯，脉气虚弱，舌绛苔少，时时欲脱者，大定风珠主之。”又云：“此邪气已去八九，真阴仅存一二之治也。观脉虚苔少可知，故以大队浓浊塞隙，介属潜阳镇定。以鸡子黄一味，从足少阴，下安足三阴，上济手三阴，使上下交合，阴得安其位，斯阳可立根基，俾阴阳有眷属一家之义，庶可不致绝眼欤．”诸家多宗其热邪久羁，吸烁真阴之见，施于温热之病后期，阴精大亏，虚风旋扰之证，而于杂病之阴精大亏，虚风旋扰之证殊少论及。我遵循阿胶、鸡子黄，取其血肉之品．以补阴液而熄内风；芍药、甘草、五味子甘酸化阴，补阴敛阳；更取三甲之介类潜阳；麦门冬、地黄滋阴润燥之义，施用于杂病真阴亏损，虚风内动者，亦效。
例如：患者董××，男，28岁。数年来四肢沉重，行动迟缓，手指运动不便，不能作精细动作，说话缓慢单调。某院始以安坦、东莨菪碱等而取效。但近一年来又日渐加重，某院诊为震颤麻痹。审其表情呆痴，很少眨眼，手指运动不便，不能拿笔写字，微颤，有时涎水不由自主的流出，平卧时翻身亦感困难，走路时躯干向前弯曲，头向前倾，呈急速小步，越走越快，不能即时止步或转弯，说话迟缓而困难，食欲正常，舌苔净，脉虚弱。综其脉证，诊为真阴亏损，虚风内动。于是拟定大定风珠加减以滋填镇纳，安其龙雷，熄其虚风。处方：龟甲30克，鳖甲30克，牡蛎30克，阿胶10克(烊化)，炙甘草10克，麦冬10克，生地15克，五味子10克，白芍15克，火麻仁10克，鸡子黄2枚。某医云：大定风珠原为温病而设，老师何用于震颤麻痹?脉虚何不用参苓白术散之属?答云：“参苓白术散及化痰安神诸药，前医已用之不效，事实证明是不可再用，再思原方与病亦不合拍，本病乃阴精亏损，非急以填精补髓不可治，故以大定风珠，而不用参苓白术散。”药进7剂，诸证果减，口涎停止，继进14剂，精神大增，走路亦能跨步而前，再进14剂后，即上班开始工作，作拿中药和开处方等一般工作。
由于三叉神经痛常常表现为颊部、上齿剧烈疼痛，所以往往被诊为一般的牙痛而久治不效。我深研十年一直未得其法，偶读立斋、景岳之书才使我恍然大悟。薛立斋云：“齿痛……若因郁火所致用越鞠丸。”徐用诚云：“有诸经错杂之邪为患者。”张景岳说：“牙痛外传之药，惟辛温可以散热。”始知此病之难效者，正因解郁、散寒、清热之法未具备耳。
例如：郜××，女，45岁。右上齿、颊部疼痛3年，先在某医院诊为龋齿拔牙3个不效，后在某医院诊为三叉神经痛，中西药物，针灸治疗亦无效。邀余诊视。观察其右上牙疼痛不止，不敢刷牙、洗脸、说话，舌苔白，脉弦紧。我说：此阳明胃热于内，寒邪闭塞于外所致也。法宜白虎清胃热，乌头搜风散寒以破阴霾：川乌10克，草乌10克，知母10克，玄参15克，生石膏30克，甘草6克，粳米15克。进药1剂疼痛果减，5剂即消失大半，15剂后疼痛消失，后果痊愈。
又如：董××，女，38岁。左颊及上齿疼痛，时轻时重3年多，先在某院拔牙2个不效，后在某院诊为三叉神经痛，中、西药物治疗1个多月仍不效。观察其前方或以泻火，或以散寒；审其证见剧痛阵作，齿龈正常，头晕，头痛，心烦易怒，烧心泛酸，口苦口干，舌苔黄白，脉沉弦而涩。证脉合参，诊为寒热并见，肝木失达，于是以柴胡加龙骨牡蛎汤加减服之。处方：柴胡10克，半夏10克，黄芩10克，党参10克，桂枝10克，茯苓10克，生姜3片，甘草6克，大黄6克，龙骨10克，牡蛎15克，大枣5枚，仅进2剂，疼痛顿减，又进6剂，一直未作，再进6剂，果痊愈。
痉证
舞蹈病，大致包括在中医的痉病之中，痉病在宋代以前多从风寒湿进行论治。如《素问·至真要大论》说：“诸痉项强，皆属于湿。”“诸暴强直，皆属于风。”仲景分为刚、柔二痉，倡用葛根、栝蒌桂枝二汤，实亦宗《内经》风湿为痉之意。宋·陈言承前启后，提出血虚为痉之本，风寒湿热为痉病之标。他说：“夫人之筋，各随经络结束于身，血气内虚，外为风寒湿热之所中则痉……原其所因，多由亡血，筋无所营，故邪得以袭之，所以伤寒寒下过多，与夫病疮人，乃产后致斯疾者概可见矣。”金、元以来，朱丹溪主张：“大率属气血虚弱，有火有痰。”李梴主张：“然虽外因风寒湿气，内因六欲七情，皆必夹痰火而后发。”近人多宗其说，多从虚、痰、火、风等原因去论治，而外因中的风寒湿邪常被忽略，经络脏腑亦不甚重视，致使外因为病的痉证长期不愈。经过反复认真学习：“系统学习、全面掌握，继承发扬祖国医学遗产”的精神，才使我恍然有悟，于是决定全面学习古今医家之说。及读至薛立斋书，又与舞蹈病状相对照，使我开始对舞蹈病有了一点认识。薛立斋说：“若一边牵搐，一眼喁斜者，属少阳；及汗后不解，乍静乍乱，直视口噤，往来寒热，小柴胡汤加桂枝白芍。”又思仲景柴胡加龙骨牡蛎汤有桂枝配柴胡使内陷之邪从外而解，大黄和胃止谵语从下而解，茯苓安神志而除湿，复加龙骨、牡蛎镇静而止烦惊，比薛氏之法更较合拍，于是以柴胡加龙骨牡蛎汤用于舞蹈病，结果多见佳效。
On June 4, 1963, a female patient, Huo XX, aged 40, was treated. For three months following the recovery from a lumbar vertebral fracture, she had been unable to control her urination and defecation. Initial treatment with acupuncture and Western medicine showed no improvement, and subsequent administration of Chinese herbal medicine aimed at astringing and securing the bladder (astringing the bladder to consolidate urine) and tonifying Qi and nourishing Yin also proved ineffective. Inquiry revealed symptoms of soreness and heaviness in the lower back, a thin white tongue coating, and a wiry pulse with a faint root. Combining the syndrome differentiation with pulse diagnosis, the diagnosis was deficiency of the Kidney and Du Mai (Conception Vessel), leading to dysfunction of opening and closing mechanisms. The treatment principle was formulated as tonifying the Kidney and Du Mai, assisted by astringent methods. The prescription was Guilu Erxian Jiao (Turtle-Deer Two Immortals Decoction) modified: Lu Rong (Cervus Nippon Cornu, Deer Antler) 0.9g (powdered, taken with decoction), Dong Shen (Glehniae Radix) 9g, Gou Qi Zi (Lycii Fructus) 15g, Gui Jia (Testudinis Carapax et Plastrum) 15g, Shu Di Huang (Rehmanniae Radix Praeparata) 15g, Mu Li (Ostreae Concha) 15g, Tu Si Zi (Cuscutae Semen) 30g, Fu Pen Zi (Rubi Fructus) 30g, He Shou Wu (Polygoni Multiflori Radix) 30g. After 4 doses, symptoms decreased; after 8 doses, she was completely cured.
Li Hanqing stated: "The difficulty in syndrome differentiation lies in pulse diagnosis. If the pulse image is unclear, the syndrome cannot be accurately identified. Urinary incontinence varies among different Zang-Fu organs such as the Lung, Spleen, Kidney, San Jiao (Triple Burner), and Bladder, and differs in terms of excess/deficiency and cold/heat. Without careful differentiation, merely using established formulas will result in medication that does not target the disease, making cure difficult." The reason for the prolonged ineffectiveness in this case lay precisely in this aspect.
Phlegm Nodules and Flowing Deposits
Zhu Danxi said: "Nodules may occur in the nape, neck, arms, or within the fascia beneath the skin of the body. They are neither red nor swollen, hard nor painful; they are mostly caused by phlegm deposition forming nodules that do not dissipate." Liu Wansu said: "Nodules become hard due to severe stagnation of fire-heat. If a nodular mass forms, it does not require ulceration or discharge; once the heat dissipates, it will naturally resolve." This clarifies that the manifestation and cause of phlegm nodules and flowing deposits are nodular masses formed by severe fire-heat stagnation and failure of nodules to dissipate. These occur in the nape, neck, arms, and beneath the skin/fascia of the body, without obvious redness, swelling, heat, or pain. The treatment principle is to dissipate phlegm-heat. Following this intent, I have applied this approach to lymphatic tuberculosis in the neck, nape, and axilla; chronic inflammation; panniculitis in the arms, lower limbs, and trunk; rheumatic nodules; lipomas; and other nodular masses without redness, swelling, heat, or pain, often resulting in improvement or resolution of the nodules.
For example: Lei XX, female, adult. For half a year, over 20 soybean-sized nodules appeared on both shoulders and arms, accompanied by soreness and pain in the arms, persistent low-grade fever, fatigue, and weakness. Pathological biopsy at a hospital in Beijing confirmed a diagnosis of panniculitis. Treatment with Chloroquine etc. for over 3 months was ineffective. Upon examination, besides the aforementioned chief complaints, the nodules showed unchanged skin color, slight tenderness upon pressure, hot palms, normal mental expression, thin white tongue coating, and wiry-slippery pulse. Combining syndrome and pulse, the diagnosis was phlegm-heat obstructing the meridians, condensing into nodules. The formula prescribed was one clearing heat and resolving phlegm, softening hardness and unblocking collaterals: Gou Teng (Uncariae Ramulus cum Uncis) 30g, Di Long (Pheretima) 13g, Xiang Yuan (Citri Reticulatae Pericarpium Viride) 10g, Fo Shou (Citri Sarcodactylis Fructus) 10g, Zhi Qiao (Aurantii Fructus Immaturus) 10g, Mu Gua (Chaenomelis Fructus) 10g, Lian Qiao (Forsythiae Fructus) 10g, Chi Shao (Paeoniae Radix Rubra) 10g, Si Gua Luo (Luffae Fructus Retinervus) 10g, Sang Zhi (Mori Ramulus) 30g. After taking 4 consecutive doses, some nodules began to shrink, and upper limb pain significantly decreased. After another 20 doses, some disappeared completely, others shrank markedly. After an additional 30 doses, all symptoms and nodules vanished, with no recurrence for several years. Zhou XX, female, adult. For over 3 years, nodules recurred repeatedly on both lower legs, especially near the ankles. Initially purplish-red, the color gradually faded, leaving painful nodules the size of almond kernels or soybeans with unchanged skin color. Biopsies at several hospitals diagnosed them as rheumatic nodules. Repeated treatments with Prednisone, Penicillin, and Chinese herbs for cooling blood, detoxifying, dispelling wind, removing dampness, and clearing heat were ineffective. Examination showed a thin white tongue coating and wiry-slippery pulse. Synthesizing pulse and syndrome, the diagnosis was wind-phlegm entering the collaterals, condensing into nodules. The aforementioned formula was prescribed for 7 doses. Ten months later, the patient reported that some nodules had disappeared and others shrunk significantly. She continued the original formula for 20 doses, resulting in the majority of nodules disappearing. Another 40 doses led to full recovery.
Another example: Ma XX, female, adult. For several months, she suffered from persistent low-grade fever, widespread petechiae and nodules on the lower limbs, and soreness/pain in joints and muscles. Pathological examination at a certain hospital diagnosed eosinophilic granuloma. Hormone therapy had basically controlled the condition, but relapse occurred upon discontinuation. A physician treated her with Chinese herbs for dispelling wind, removing dampness, and clearing heat, which was ineffective and even worsened symptoms. Examination revealed a thin white tongue coating, red tongue tip, and wiry-slippery pulse. I stated: This is a syndrome of phlegm-heat obstruction, condensing into nodules. A formula for clearing heat, resolving phlegm, softening hardness, and unblocking collaterals was prescribed, advancing the previous formula. After 10 doses, body pain, nodules, petechiae, and low-grade fever improved significantly. After another 20 doses, symptoms disappeared. Twenty days after stopping medication, fearing relapse, the patient consulted another physician who prescribed herbs for dispelling wind, removing dampness, clearing heat, and cooling blood. Symptoms reappeared but were milder than before. The treatment was changed back to clearing heat, resolving phlegm, softening hardness, and unblocking collaterals, leading to recovery after two months. Other conditions like lipomas and lymphatic tuberculosis are discussed in dedicated chapters and will not be elaborated here.
Accumulation and Abdominal Wall Tumors
Accumulation (Ji Ju) refers to a pathological condition characterized by a mass in the abdomen, accompanied by distension, pain, or pulsation upon palpation. When there is a tangible object, fixed pain, non-dispersing knotting, clear signs, immobility upon pushing, and it belongs to Blood and Zang organs, it is called Ji (Accumulation). Ju (Gathering) takes form but disappears when dispersed, moves unpredictably, comes and goes intermittently, appears during attacks, and leaves no trace between attacks. It belongs to Qi and Fu organs and is called Ju. Generally, there are four treatment principles: Attack (Gong), Dissolve (Xiao), Disperse (San), and Tonify (Bu). Zhang Jingyue said: "In treating accumulation... the essentials can be summarized in four methods: Attack, Dissolve, Disperse, and Tonify." "For hard accumulations with excess Qi, only attack can remove them." "If the patient cannot withstand attack, gentle dissolution and gradual grinding are appropriate." "For formless Qi gathering, dispersion is suitable." "For slow-progressing accumulations where both attack and tonification are inconvenient, focus primarily on regulating the Spleen and Stomach." "For Spleen/Stomach insufficiency and weak dysregulation... regardless of formlessness or tangibility, observe urgency, prioritizing righteous Qi deficiency." "The key to treating accumulation lies in knowing the appropriateness of attack and tonification, distinguishing between urgency and slackness: For recent accumulations without damage to Yuan Qi, treatment should not be delayed; delay allows the pathogen to grow, making it harder to treat. Thus, rapid attack is urgent. However, if accumulation persists and Yuan Qi declines, attacking it means the pathogen is distant and hard to reach, while the Stomach Qi, being close, suffers first. More attack leads to more deficiency; death results not from accumulation but from the attack itself." *Su Wen: Liu Yuan Zheng Ji Da Lun* states: "For large accumulations, invasion is permissible, but stop when half is reduced; exceeding this leads to death." Cysts and tumors of organs like the Liver, Spleen, and Pancreas essentially belong to Zheng Jia Ji Ju (Masses and Accumulations) in TCM, so their treatment involves only these four methods.
For example: Wang XX, female, 60 years old. Three months ago, due to improper diet, sudden vomiting and diarrhea occurred. After over 3 months of hospitalization, vomiting and diarrhea improved, but epigastric distension and pain persisted, along with poor appetite, emaciation, and fatigue. Examination revealed an egg-sized mass in the upper abdomen; ultrasound showed a pancreatic cyst measuring 7cm x 6cm. Transfer to a cancer hospital was requested. Refusing surgery, the patient sought TCM treatment. Examination showed sallow, emaciated complexion, mental fatigue, poor appetite, mild edema, epigastric fullness and pain, a 7cm x 6cm tough mass upon palpation with mild tenderness, loose stools, normal urination, moist white tongue coating, and deficient-large pulse. Synthesizing pulse and syndrome, the diagnosis was Middle Qi deficiency, failure of Clear Yang to ascend, and unresolved phlegm accumulation. The treatment principle was tonifying Middle Qi, dissolving accumulation, and warming the middle. Modified Buzhong Yiqi Tang (Tonify the Middle and Boost Qi Decoction) combined with Xiaochengqi Tang (Minor Order the Yellow Decoction) was used: Huang Qi (Astragali Radix) 15g, Bai Zhu (Atractylodis Macrocephalae Rhizoma), Dang Shen (Codonopsis Radix), Chen Pi (Citri Reticulatae Pericarpium), Dang Gui (Angelicae Sinensis Radix), Zhi Shi (Aurantii Fructus Immaturus), Hou Po (Magnoliae Officinalis Cortex) each 9g, Gan Jiang (Zingiberis Rhizoma) 4.5g, Sheng Ma (Cimicifugae Rhizoma), Chai Hu (Bupleuri Radix) each 6g, Sheng Jiang (Zingiberis Rhizoma Recens) 3 slices, Gan Cao (Glycyrrhizae Radix et Rhizoma) 6g. After 7 doses, pain decreased, and the mass reduced to walnut size. After 17 doses, pain ceased, the mass shrank to apricot kernel size, appetite increased significantly, and weight gained 9kg. After another 35 doses, symptoms disappeared, and she recovered.
Another example: Zhang XX, female, adult. Three years prior, she underwent bilateral breast hyperplasia excision. For the past six months, bilateral breast distension and pain recurred, and an egg-sized mass appeared in the epigastrium with dull pain and poor appetite. A hospital diagnosed "abdominal wall tuberculosis" and recommended surgery. Refusing surgery, she sought consultation. Examination revealed 2cm x 4cm masses in both breasts and a 4cm x 4.5cm mass in the upper abdomen, epigastric fullness, poor appetite, fatigue, thin white tongue coating, and deficient-large-wiry-slippery pulse. Diagnosis was dual deficiency of Qi and Blood, with phlegm accumulation and blood stasis. The treatment principle was tonifying Qi and nourishing Blood, drying dampness and resolving phlegm, invigorating blood and resolving stasis. Shenqi Danji Huangjing Tang (see Ascites chapter) was used. After 8 doses, no progress was seen. Reflecting on the deficient-large pulses, the lack of efficacy was attributed to unclear meridian tropism of the herbs. Therefore, modified Buzhong Yiqi Tang combined with Xiaochengqi Tang was prescribed: Huang Qi 15g, Bai Zhu, Dang Shen, Chen Pi, Sheng Ma, Chai Hu, Dang Gui, Zhi Shi, Hou Po each 9g, Gan Jiang, Da Huang (Rhei Radix et Rhizoma) each 3g, Gan Cao 6g. After 21 consecutive doses, the epigastric mass disappeared. The breast masses did not shrink, and dry throat and mild cough appeared. The previous formula targeted the Spleen but neglected the Liver and Lung, so herbs for these organs were added: Huang Qi 30g, Sheng Ma, Chai Hu each 9g, Jie Geng (Platycodonis Radix), Zhi Shi each 15g, Zhi Mu (Anemarrhenae Rhizoma), Hou Po, Qing Pi (Citri Reticulatae Pericarpium Viride), Ju Ye (Citri Reticulatae Folium), Chi Shao each 9g, Gan Jiang, Da Huang each 3g. After 14 doses, all symptoms disappeared. The above formula was continued for 30 doses to consolidate effects. *Su Wen: Zhi Zhen Yao Da Lun* states: "Qi has high and low positions; diseases have distant and near locations; syndromes have interior and exterior aspects; treatments have light and heavy intensities. One must ensure the treatment reaches the target." Yu Chang said: "In treating diseases, if one does not understand Zang-Fu and meridians, any action taken will be erroneous." The difference in efficacy in this case lay in the differing use of herbs targeting specific Zang-Fu and meridians before and after.
Another example: Geng XX, female. Left lower abdominal muscle fibroma for 3 years. Initially, only one walnut-sized mass existed. Six months post-surgery, three masses appeared at the incision site. After excision, six similarly sized tumors appeared at the incision site three months later. Unable to undergo further surgery, she sought TCM treatment. Examination showed good spirit and health, with a deep-choppy pulse. Modified Huoluo Xiaoling Dan (Unblock Collaterals and Effectual Spirit Pill) was prescribed: Dan Shen (Salviae Miltiorrhizae Radix) 15g, Chi Shao 10g, Ru Xiang (Olibanum) 7g, Mo Yao (Myrrha) 7g, San Leng (Sparganii Rhizoma) 3g, E Zhu (Curcumae Rhizoma) 3g. After taking continuously for over 8 months, the masses disappeared. Mr. Li Hanqing stated: "Modified Huoluo Xiaoling Dan is designed for excess syndromes. If righteous Qi is insufficient, a slow approach is advisable; otherwise, righteous Qi depletion and stagnant Qi/Blood make treating masses difficult. This explains why the dosages in this formula are small." In the above case, although treatment lasted over 8 months, only about 300 doses were taken, which aligns with this principle.
Tremor
Wu Jutong stated: "When pathogenic heat lingers for a long time, it consumes True Yin. Due to mistaken sweating or reckless purging, if there is mental fatigue, convulsions, weak pulse, crimson tongue with little coating, and frequent sensations of collapse, Dading Fengzhu (Major Wind-Calming Pearl) is the primary formula." He further stated: "This treats cases where 80-90% of pathogenic evil has gone, but only 10-20% of True Yin remains. The deficient pulse and scant coating indicate this. Therefore, a large group of thick, turbent substances fill the gaps, and shell-type minerals subdue Yang and calm agitation. Using only Chicken Egg Yolk, it enters Foot Shaoyin, calms Foot Three Yin below, assists Hand Three Yin above, allowing upper and lower to interact, Yin to settle in its position, and Yang to establish its foundation, giving Yin and Yang the meaning of family unity, thus preventing severance." Most experts follow his view that lingering pathogenic heat consumes True Yin, applying it to the late stage of warm diseases with severe Yin essence deficiency and internal stirring of deficient wind. However, few discuss this in miscellaneous diseases with severe Yin essence deficiency and internal stirring of deficient wind. Following the logic of E Jiao (Asini Corii Colla) and Ji Zi Huang (Gallicolum Oviparum Albumen), utilizing animal-derived products to nourish Yin fluids and extinguish internal wind; using Shao Yao (Paeoniae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), and Wu Wei Zi (Schisandrae Chinensis Fructus) for sweet-acid transformation to generate Yin, nourishing Yin and restraining Yang; employing the three shells (Jia) for mineral-based Yang subduing; and adopting Mai Men Dong (Ophiopogonis Radix) and Di Huang (Rehmanniae Radix) for nourishing Yin and moistening dryness, I applied this to miscellaneous diseases with True Yin deficiency and internal stirring of deficient wind, achieving efficacy.
For example: Patient Dong XX, male, 28 years old. For several years, he experienced heaviness in limbs, slow movement, difficulty with finger movements and fine motor skills, and slow, monotonous speech. A hospital initially achieved effect with Artane and Scopolamine. However, symptoms worsened over the past year, and a hospital diagnosed Parkinson's disease. Examination revealed a blank expression, infrequent blinking, difficulty moving fingers, inability to hold a pen or write, slight tremor, involuntary salivation, difficulty turning over when supine, forward bending of the trunk and head while walking, rapid short steps accelerating with speed, inability to stop or turn instantly, and slow, difficult speech. Appetite was normal, tongue coating clean, and pulse weak. Synthesizing pulse and syndrome, the diagnosis was True Yin deficiency with internal stirring of deficient wind. Dading Fengzhu modified was prescribed to nourish and fill, anchor and absorb, calm the Dragon and Thunder (metaphor for erratic Yang), and extinguish deficient wind. Prescription: Gui Jia 30g, Bie Jia (Trionycis Carapax) 30g, Mu Li 30g, E Jiao 10g (melted), Zhi Gan Cao 10g, Mai Men Dong 10g, Sheng Di Huang (Rehmanniae Radix) 15g, Wu Wei Zi 10g, Bai Shao (Paeoniae Radix Alba) 15g, Huo Ma Ren (Cannabis Semen) 10g, Ji Zi Huang 2 eggs. A physician asked: "Dading Fengzhu was originally designed for warm diseases. Why did you use it for Parkinson's? Why not Shenling Baizhu San given the weak pulse?" I replied: "Shenling Baizhu San and various phlegm-resolving/calming herbs were previously used by other doctors without effect. Facts prove they cannot be reused again. Furthermore, the original formula does not match this disease. This illness is due to Yin essence deficiency, requiring urgent replenishment of essence and marrow. Hence, Dading Fengzhu was chosen over Shenling Baizhu San." After 7 doses, symptoms indeed decreased, and salivation stopped. After another 14 doses, mental energy increased significantly, and walking became possible with strides. After another 14 doses, he returned to work, performing general tasks like dispensing herbs and writing prescriptions.
Trigeminal Neuralgia
Since trigeminal neuralgia often presents as severe pain in the cheek and upper teeth, it is frequently misdiagnosed as ordinary toothache and treated unsuccessfully for long periods. I studied deeply for ten years without finding a method until reading the works of Lizhai and Jingyue suddenly enlightened me. Xue Lizhai said: "Toothache... if caused by constrained fire, use Yueju Wan." Xu Yongcheng said: "It is caused by mixed pathogens from various meridians." Zhang Jingyue said: "For external transmission of toothache drugs, only acrid-warm can disperse heat." Only then did I realize that the difficulty in treating this disease stemmed from the lack of methods for resolving constraint, dispersing cold, and clearing heat.
For example: Gao XX, female, 45 years old. Pain in right upper teeth and cheek for 3 years. Initially diagnosed as dental caries at a hospital; extraction of 3 teeth was ineffective. Later diagnosed as trigeminal neuralgia at another hospital; Chinese/Western medicines and acupuncture were also ineffective. Consulted me. Examination showed continuous pain in the right upper tooth, fear of brushing teeth, washing face, or speaking, white tongue coating, and wiry-tight pulse. I stated: This is caused by Yangming Stomach heat internally and Cold evil blocking externally. The method should use Baihu Tang to clear Stomach heat and Wu Tou (Aconiti Radix) to search out wind and disperse cold to break the gloom: Chuan Wu (Aconiti Radix Preparata) 10g, Cao Wu (Aconiti Kusnezoffii Radix) 10g, Zhi Mu 10g, Xuan Shen (Scrophulariae Radix) 15g, Sheng Shi Gao (Gypsum Fibrosum) 30g, Gan Cao 6g, Jing Mi (Oryzae Sativa Granum) 15g. After 1 dose, pain indeed decreased; after 5 doses, it disappeared largely; after 15 doses, pain vanished, and she subsequently recovered.
Another example: Dong XX, female, 38 years old. Pain in left cheek and upper teeth, fluctuating in severity for over 3 years. Initially extracted 2 teeth at a hospital without effect. Later diagnosed as trigeminal neuralgia at another hospital; Chinese/Western drug treatment for over 1 month was ineffective. Examination showed previous formulas either purged fire or dispersed cold. Syndrome analysis revealed paroxysmal severe pain, normal gums, dizziness, headache, irritability, heartburn, acid regurgitation, bitter taste, dry mouth, yellow-white tongue coating, and deep-wiry-choppy pulse. Combining syndrome and pulse, the diagnosis was simultaneous cold and heat, with Liver Wood failing to diffuse. Modified Chaihu Jia Longgu Muli Tang (Bupleurum Plus Dragon Bone and Oyster Shell Decoction) was administered. Prescription: Chai Hu 10g, Ban Xia (Pinelliae Rhizoma) 10g, Huang Qin (Scutellariae Radix) 10g, Dang Shen 10g, Gui Zhi (Cinnamomi Ramulus) 10g, Fu Ling (Poria) 10g, Sheng Jiang 3 slices, Gan Cao 6g, Da Huang 6g, Long Gu (Fossilia Ossis Mastodi) 10g, Mu Li 15g, Da Zao (Jujubae Fructus) 5 pieces. After only 2 doses, pain suddenly decreased; after another 6 doses, it never recurred; after another 6 doses, she was cured.
Spasm Syndrome
Chorea is roughly included within the TCM category of Spasm Syndrome (Jing Bing). Before the Song Dynasty, Spasm Syndrome was mostly treated based on Wind-Cold-Dampness. As *Su Wen: Zhi Zhen Yao Da Lun* states: "All spasms with stiff neck belong to Dampness." "All sudden stiffness and rigidity belong to Wind." Zhang Zhongjing divided it into Gang Jing (Stiff Spasm) and Rou Jing (Soft Spasm), advocating Ge Gen Tang and Gua Lou Gui Zhi Tang, actually following the *Nei Jing* concept of Wind-Damp causing spasm. Song Dynasty's Chen Yan bridged the past and future, proposing that Blood Deficiency is the root of spasm, while Wind-Cold-Damp-Heat are the branches. He said: "The tendons of humans bind to the body along meridians. Internal deficiency of Qi and Blood, combined with external invasion by Wind-Cold-Damp-Heat, causes spasm... Tracing the cause, it mostly stems from blood loss, leaving tendons without nourishment, allowing pathogens to invade. Thus, excessive sweating/purging in cold damage, patients with sores, and postpartum women are typical examples." Since Jin and Yuan dynasties, Zhu Danxi advocated: "Generally belonging to Qi and Blood deficiency, with Fire and Phlegm." Li Chan advocated: "Although external causes are Wind-Cold-Dampness and internal causes are Six Desires and Seven Emotions, they must involve Phlegm and Fire to manifest." Recent scholars mostly follow this, treating from perspectives of Deficiency, Phlegm, Fire, and Wind, often ignoring external Wind-Cold-Dampness and neglecting meridians and Zang-Fu organs, causing external-cause spasms to persist chronically. Through repeated serious study of the spirit: "Systematic learning, comprehensive mastery, inheriting and promoting the heritage of Chinese medicine," I suddenly realized and decided to comprehensively learn the theories of ancient and modern physicians. Reading Xue Lizhai's works and comparing them with chorea symptoms gave me initial understanding. Xue Lizhai said: "If pulling/twitching occurs on one side and one eye deviates, it belongs to Shaoyang; if unresolved after sweating, alternating stillness and chaos, staring straight, locked jaw, alternating chills and fever, Xiao Chai Hu Tang plus Gui Zhi and Bai Shao is indicated." Reflecting on Zhang Zhongjing's Chaihu Jia Longgu Muli Tang, Gui Zhi paired with Chai Hu resolves trapped pathogens from outside, Da Huang harmonizes Stomach and stops delirium from below, Fu Ling calms spirit and removes dampness, plus Long Gu and Mu Li for sedation and stopping fright. This fits better than Xue's method. Thus, I applied Chaihu Jia Longgu Muli Tang to chorea, often seeing excellent results.