第三节妇科
外阴白色病变
谨遵脉象，参之于症，明辨病机，方得和融
冯××，女，35岁。外阴奇痒5～6年。医诊外阴白色病变。先以西药治疗1年多不效，继又配合中药滋阴养血、健脾温肾、滋补肝肾法，以及多种外洗剂治疗均无效。细察其证，除阴痒之外，别无所苦，舌苔白黄，脉弦紧。综合脉证，思之：脉弦紧者，风寒也。会阴者，肝经所络之位也；痒者，风也。舌苔白黄者，湿热也。合而论之，乃湿热夹风。治宜散风除湿清热。处方：当归15克，羌活10克，防风10克，荆芥10克，猪苓10克，泽泻10克，茵陈15克，黄芩10克，葛根15克，苦参15克，知母10克，甘草10克。
服药2剂，阴痒稍减，继服40剂，诸证消失，愈。
某医云：本方乃东垣当归拈痛汤也，东垣原用于脚气疮疡，后人用治诸疮甚验，今先生用于治阴痒者不知何故也?答日：当归拈痛汤由五部分药物组成，一者风药，二者升提药，三者燥湿清热药，四者利湿热药，五者养血活血药。其主用于湿热久蓄下焦证。因久蓄下焦之湿热但用利湿、燥湿不得解，非升之不除也。
盆腔炎
1．诸因纷繁，难下决断，谨遵其脉，调之和之，实为上法
万××，女，34岁。
小腹冷痛，白带增多，外阴奇痒4—5年。医诊慢性盆腔炎、尖锐湿疣。先用西药治疗2年多不效，继又配合中药除湿清热散风、温经活血等剂与理疗等治疗2～3年仍不效。细察其证，除少腹冷痛，外阴奇痒外，并见胃脘烦热悸动，逆气上冲，冲则心胸烦乱，冲到头则全身汗出，头晕头痛，心烦心悸，失眠健忘，口苦咽干，时或恶心呕吐，手足憋胀，指趾麻木疼痛，舌苔黄白厚腻，脉弦紧而数。综合脉证，思之：弦脉者，肝脉也；紧者，寒也，结也；弦紧相兼者，寒饮凝滞不化也。且其证见少阳，亦兼太阴，证见郁火，而兼寒湿。治宜宗《内经》所论和调之法。处方：柴胡10克，半夏10克，黄芩10克，人参10克，干姜3克，大枣5个，甘草10克，桂枝10克，茯苓10克，熟军3克，龙骨15克，牡蛎15克。
服药5剂，诸证均减，继服50剂，诸证全失，愈。
某医云：如此寒热俱见，虚实并存，病见少阳，而兼太阴之复杂证候，竞用柴胡加龙骨牡蛎而愈，其故何也?答曰：《内经》在论述复杂疾病的治法时，指出：有逆治，有从治，有从多，有从少，而从多从少必须“必伏其所主，而先其所因，”“逆之，从之，逆而从之，从而逆之，疏气令调，则其道也。”本病者，虚、实、寒、热俱有，少阳、太阴俱存，非和之不可，故取柴胡加龙骨牡蛎之有从，有逆，有和者治之。
2．腰痛腹痛，但抓主证，合之于脉，予以温经，其病得愈
文××，女，41岁。
小腹冷痛，白带增多，腰痛7～8个月。医诊慢性盆腔炎。先以西药、理疗治之不效，后以中药温肾补阳，调经止带亦效不显著。细审其证，腰骶重坠而痛，小腹冷痛，白带增多，月经或见涩少或见淋漓不断，舌苔薄白，脉弦涩不调。综合脉证，思之：腰骶重坠，小腹冷痛，白带增多，皆督带之病也。脉弦者，肝脉也，寒脉也；涩脉者，寒也，滞也，瘀也。合而议之，乃寒凝血滞证，正如《金匮要略》所云：“问日：妇人年五十所，病下利数十日不止，暮即发热，少腹里急，腹满，手掌烦热，唇口干燥，何也?师日：此病属带下。何以故?曾经半产，瘀血在少腹不去。何以知之?其唇口干燥；故知之。当以温经汤主之。”处方：当归10克，白芍10克，桂枝10克，吴茱萸6克，川芎10克，干姜3克，半夏10克，丹皮10克，麦冬10克，党参10克，甘草6克，阿胶10克(烊化)。
服药7剂，腰痛、腹痛、白带均好转，继服20剂，诸证消失。
3．谨察证舌，合之于脉，知其病性病位，予和解攻里，清热除湿，佐以温化始愈
郜××，女，48岁。
小腹胀痛7～8年。医诊盆腔炎。先用西药治疗不效，后与中药温经活血之剂而稍减。但近4个多月来，腹痛又突然加重，白带增多。医诊慢性盆腔炎急性发作。先以西药治疗效果不著，继又配合中药清热解毒之剂进行治疗，非但腹痛不减，反而更加剧烈。细察其证，除小腹胀痛，拒按，白带量多臭秽外，并见寒热往来，恶心欲吐，头晕头痛，心烦喜哭，口苦咽干，弯腰不能，大便不爽，舌苔黄白厚腻，脉弦滑数，并见促涩。综合脉证，思之：寒热往来，恶心欲吐，头晕头痛，心烦喜哭，口苦咽干者，少阳为病也。小腹胀痛，拒按，白带量多臭秽者，实热痈脓也。脉弦滑数者，少阳兼实热痈脓也。促者，热极也；涩者，寒滞也。治宜和解攻里，除湿清热，佐以温化。处方：柴胡15克，半夏12克，黄芩15克，枳实15克，赤芍15克，大黄4克，白芥子10克，干姜3克，败酱草40克，银花30克。
服药3剂，寒热往来，恶心呕吐消失，腹痛减轻六七，继服7剂，诸证消失。
4．谨察其证，参之于脉，注意兼挟，始得合拍
洛××，女，38岁。
发热呕吐，腹满胀痛4个月。医诊盆腔炎。先予西药2个月不但未见效果，反而出现尿脓、便脓、阴道流脓。经过认真检查诊为盆腔脓肿，阴道、直肠、膀胱瘘。细菌培养诊为绿脓杆菌、金黄色葡萄球菌、结核杆菌感染。再次改用针对性抗生素治疗20天，诸证仍然不见改善。不得已，又加用中药清热解毒之剂10天，诸证仍不见减。细察其证，寒热往来，体温40．1℃，恶心呕吐，腹满胀痛，按之石硬，痛不可触近，白带量多臭秽，尿脓便脓，脉弦滑数，舌苔黄白稍腻。综合脉证，思之：腹满痛而按之硬者，仲景所谓之大结胸证也；寒热往来，恶心呕吐者，少阳证也，仲景曾云：“伤寒十余日，热结在里，复往来寒热者，与大柴胡汤；但结胸，无大热者，此为水结在胸胁也，但头微汗出者，大陷胸汤主之。”今结胸而见大热，故只可以大柴胡汤，不可用大陷胸汤。又仲景云：“伤寒六七日，结胸热实，脉沉而紧，心下痛，按之石硬者，大陷胸汤主之。”而本证脉不见沉紧而见弦滑数，只可宗小陷胸汤意，予消痈散结排脓。处方：柴胡20克，半夏15克，黄芩15克，枳实15克，白芍15克，大黄3克，白芥子10克，干姜1克，败酱草30克。
服药2剂，腹痛发热，恶心呕吐均减，体温38．6℃；继服2剂，发热大减，体温37．5℃，恶心呕吐消失，腹痛减轻80％，尿脓、便脓、阴道流脓亦消失；再进20剂，诸证基本消失。
某医云：哪个药是治绿脓杆菌、结核杆菌的特效药?答云：不知也。中医治病的方法是辨证论治，不是辨病论治，余所宗者辨证论治耳。又问：如此之病竞用干姜1克，岂不使病情加剧乎?答曰：如此之重证当见舌质红，苔黄燥，而今反见舌质不红，舌苔不燥，此必夹有寒湿之微邪也，若不去其微邪，使阳气施化者，则痈脓难除也，故稍佐干姜1克于清热解毒药中，以促阳气之施化也。又问：何不用大剂清热解毒，消痈排脓药?答曰：前医已大用特用也。其所以不效者，就在于但用清热解毒而未注意调气，未注意阳施阴化也，故不宜大剂清热解毒予之也。
功能失调性月经紊乱
1．详察月经色质，参之与证，合之于脉，知其缓急，治之始愈
戈××，女，37岁。
月经淋漓不断，时而下血如崩，甚或出现失血性休克十几年。医诊功能失调性子宫出血。应用西药、刮宫等法治疗数年不效，继又以中药补气养血、健脾摄血、收敛止血、凉血止血、补益肝肾等治疗数年亦无明显效果。特别是近20多天来，虽然遍用中、西药物，但仍淋漓不断，且曾大量出血7天发生休克两次。细察其证，月经已淋漓不断20多天，经色紫黯，伴有大量紫黑血块，胃脘胀痛，腹满冷痛，纳呆食减，心烦不安，口苦咽干，舌苔黄白，脉弦紧滑涩，消瘦乏力。证脉合参，思之：此正虚邪实之证也。今脉见弦紧滑涩，弦紧之脉为寒凝血滞为主，还当急以活血止血温经为先。处方：炒灵脂40克，生灵脂30克，红糖250克。
服药2剂，经血大减，血块消失；继服4剂出血停止，腹痛亦大减。细察苔、脉，见脉弦细而涩，舌苔薄白。综合脉证，思之：脉已由弦紧滑涩转为弦细而涩，弦细之脉者气血俱虚，脾胃虚寒也。邪实已减，正虚为主，当以补益。治以健脾温中，大补气血阴阳。处方：黄芪15克，肉桂10克，党参10克，白术10克，茯苓10克，炙甘草10克，生地10克，川芎10克，白芍10克，当归10克，麦冬10克，半夏10克，附子10克，肉苁蓉15克，生姜3片，大枣5个。
服药25剂，脘腹疼痛消失，精神、食欲正常。此次月经如期来潮，经量不多，但稍有隐痛感，又服红糖50克、炒灵脂10克，10剂，愈。
某医云：余亦曾用活血止血，补气养血，温中散寒之药治之，然其不效者何也?答曰：《内经》、《金匮要略》两书为了解决这个问题均列专篇进行论述。你所应用药物恐未注意标本、缓急、先后也。标本、缓急、先后在诊断时应抓什么?应治什么?必须明确。根据我的经验，当数种病因、病机同时存在时，在诊断上要以脉为主，即脉表现什么证，就是什么证为急，脉表现什么证，就得先治什么证，然后再顾其他。否则，以症为主，以症为先，必然本末倒置，先后不分，治之不效。
2．病证繁多，中西乱投，不知标本，不审先后，其病不愈
古××，女，40岁。
风湿性心脏病、二尖瓣狭窄与闭锁不全、心房纤颤12年。慢性胃炎、十二指肠球部溃疡10年。血小板减少性紫癜5年，功能失调性子宫出血4年。医者先用西药治此害彼，治彼害此，始终难于奏效，后又改用中药补气养血、健脾温中、养心安神等病情日渐加重。细察其证，脘腹胀痛，疲乏无力，心悸心烦，失眠健忘，紫斑成片，消瘦乏力，纳呆食减，月经3个月一直淋漓不断，并曾崩血大下7天，发生休克2次，经过抢救才脱离危险，且趾指厥冷，手心烦热，口苦口干，舌苔白，舌质淡，脉虚大弦紧涩结。综合脉证，思之：脉虚大者，气血大虚也；弦紧者，寒凝也；涩者，滞也；结者，寒凝气结也，阴阳俱虚也。合而论之，乃仲景所云：“脉弦而大，弦则为减，大则为芤，减则为寒，芤则为虚，虚寒相搏，此名为革”意也。治宜健脾温中，补气养血，理气活血，阴阳并益。处方：黄芪15克，肉桂10克，当归10克，川芎10克，生地10克，白芍10克，人参10克，白术10克，茯苓_10克，炙甘草10克，附子10克，麦冬10克，半夏10克，淡大云15克，生姜3片，大枣5个。
服药5剂，食欲、精神、睡眠、脘腹冷痛均好转，经血减少；继服上药40剂，诸证消失，经血停止，体重增加5千克。又间断服药120剂，经过多个医院检查，除风湿性心脏病、二尖瓣狭窄与闭锁不全外，诸证皆愈。
某医云：此人病情繁杂，实难措手，余亦曾处方论治，然多一剂效，二剂剧，其故何也?答曰：此病气血阴阳俱虚，五脏俱病，然以中气虚寒为主，对于此类证候，东垣、谦甫多主张从脾胃论治，因其脾胃一生则诸脏从之也，今之所以采用十四味大建中汤治之者，即宗东垣、谦甫治法也。
第三节 妇科
严格遵循脉象，参考症状，明确辨析病机，才能调和融洽。
冯某某，女性，35岁。外阴剧烈瘙痒5至6年。医生诊断为外阴白色病变（Leukoplakia）。先使用西药治疗1年多无效，随后配合中药滋阴养血、健脾温肾、滋补肝肾的方法，以及多种外用洗剂治疗，均无效。仔细审查其证候，除了阴部瘙痒外，没有其他痛苦，舌苔白黄相间，脉象弦紧。综合脉象和症状思考：脉象弦紧，是风寒之邪。会阴部位，是肝经所络属的位置；瘙痒，是风邪所致。舌苔白黄，是湿热之邪。综合论述，乃是湿热夹杂风邪。治疗应当疏散风邪、除湿清热。处方：当归15克，羌活10克，防风10克，荆芥10克，猪苓10克，泽泻10克，茵陈15克，黄芩10克，葛根15克，苦参15克，知母10克，甘草10克。
服用2剂后，阴痒稍减，继续服用40剂，所有症状消失，痊愈。
某医生说：这个方子是李东垣的当归拈痛汤（Danggui Qiangtong Decoction），李东垣原本用于治疗脚气疮疡，后人用来治疗各种疮疡非常有效，现在先生用它来治疗阴痒，不知道是什么缘故？回答说：当归拈痛汤由五部分药物组成，一是风药，二是升提药，三是燥湿清热药，四是利湿热药，五是养血活血药。它主要适用于湿热长久蓄积在下焦的证候。因为长久蓄积在下焦的湿热，如果只用利湿、燥湿的方法不能解除，必须用升提之法才能去除。
1. 病因纷繁复杂，难以决断，严格遵循脉象，调和治理，确实是上策。
万某某，女性，34岁。
小腹冷痛，白带增多，外阴剧烈瘙痒4至5年。医生诊断为慢性盆腔炎、尖锐湿疣。先用西药治疗2年多无效，随后配合中药除湿清热散风、温经活血等药剂与理疗等治疗2至3年仍无效。仔细审查其证候，除了少腹冷痛、外阴奇痒外，还见胃脘部烦热悸动，逆气上冲，冲逆时心胸烦乱，冲到头部则全身出汗，头晕头痛，心烦心悸，失眠健忘，口苦咽干，时而恶心呕吐，手足憋胀，指趾麻木疼痛，舌苔黄白厚腻，脉象弦紧而数。综合脉象和症状思考：弦脉，是肝脉；紧脉，是寒邪，也是结滞；弦紧相兼，是寒饮凝滞不化。而且其证候涉及少阳，也兼有太阴，证候表现为郁火，同时兼有寒湿。治疗应当遵循《内经》所论述的调和之法。处方：柴胡10克，半夏10克，黄芩10克，人参10克，干姜3克，大枣5个，甘草10克，桂枝10克，茯苓10克，熟大黄3克，龙骨15克，牡蛎15克。
服用5剂后，所有症状均减轻，继续服用50剂，所有症状全部消失，痊愈。
某医生说：如此寒热并见，虚实并存，病在少阳，又兼太阴的复杂证候，竟然用柴胡加龙骨牡蛎汤（Chaihu Jia Longgu Muli Decoction）治愈，这是什么缘故呢？回答说：《内经》在论述复杂疾病的治疗方法时指出：有逆治，有从治，有从多，有从少，而从多从少必须“必伏其所主，而先其所因”，“逆之，从之，逆而从之，从而逆之，疏气令调，则其道也。”本病者，虚、实、寒、热俱有，少阳、太阴俱存，非调和不可，所以取柴胡加龙骨牡蛎汤中既有从治、又有逆治、还有调和作用的药物来治疗。
2. 腰痛腹痛，只要抓住主证，结合脉象，予以温经治疗，病就能愈。
文某某，女性，41岁。
小腹冷痛，白带增多，腰痛7至8个月。医生诊断为慢性盆腔炎。先用西药、理疗治疗无效，后用中药温肾补阳、调经止带也效果不显著。仔细审视其证候，腰骶部重坠而痛，小腹冷痛，白带增多，月经或见涩少或见淋漓不断，舌苔薄白，脉象弦涩不调。综合脉象和症状思考：腰骶重坠，小腹冷痛，白带增多，都是督脉和带脉的病。脉弦，是肝脉，也是寒脉；涩脉，是寒邪，是滞涩，是瘀血。综合讨论，乃是寒凝血滞证，正如《金匮要略》所说：“问曰：妇人年五十所，病下利数十日不止，暮即发热，少腹里急，腹满，手掌烦热，唇口干燥，何也？师曰：此病属带下。何以故？曾经半产，瘀血在少腹不去。何以知之？其唇口干燥；故知之。当以温经汤主之。”处方：当归10克，白芍10克，桂枝10克，吴茱萸6克，川芎10克，干姜3克，半夏10克，丹皮10克，麦冬10克，党参10克，甘草6克，阿胶10克（烊化）。
服用7剂后，腰痛、腹痛、白带均好转，继续服用20剂，所有症状消失。
3. 仔细审查证候和舌象，结合脉象，知道病的性质和部位，给予和解攻里、清热除湿，佐以温化始能痊愈。
郜某某，女性，48岁。
小腹胀痛7至8年。医生诊断为盆腔炎。先用西药治疗无效，后与中药温经活血之剂而稍减。但近4个多月来，腹痛又突然加重，白带增多。医生诊断为慢性盆腔炎急性发作。先用西药治疗效果不著，随后配合中药清热解毒之剂进行治疗，不但腹痛不减，反而更加剧烈。仔细审查其证候，除了小腹胀痛、拒按、白带量多臭秽外，还见寒热往来，恶心欲吐，头晕头痛，心烦喜哭，口苦咽干，弯腰不能，大便不爽，舌苔黄白厚腻，脉象弦滑数，并见促涩。综合脉象和症状思考：寒热往来，恶心欲吐，头晕头痛，心烦喜哭，口苦咽干，是少阳病。小腹胀痛，拒按，白带量多臭秽，是实热痈脓。脉弦滑数，是少阳兼实热痈脓。促脉，是热极；涩脉，是寒滞。治疗应当和解攻里，除湿清热，佐以温化。处方：柴胡15克，半夏12克，黄芩15克，枳实15克，赤芍15克，大黄4克，白芥子10克，干姜3克，败酱草40克，银花30克。
服用3剂后，寒热往来，恶心呕吐消失，腹痛减轻六七成，继续服用7剂，所有症状消失。
4. 仔细审查证候，参考脉象，注意兼挟之邪，始得合拍。
洛某某，女性，38岁。
发热呕吐，腹满胀痛4个月。医生诊断为盆腔炎。先予西药2个月不但未见效果，反而出现尿脓、便脓、阴道流脓。经过认真检查诊为盆腔脓肿，阴道、直肠、膀胱瘘。细菌培养诊为绿脓杆菌、金黄色葡萄球菌、结核杆菌感染。再次改用针对性抗生素治疗20天，所有症状仍然不见改善。不得已，又加用中药清热解毒之剂10天，所有症状仍不见减。仔细审查其证候，寒热往来，体温40.1℃，恶心呕吐，腹满胀痛，按之石硬，痛不可触近，白带量多臭秽，尿脓便脓，脉象弦滑数，舌苔黄白稍腻。综合脉象和症状思考：腹满痛而按之硬，是张仲景所谓的大结胸证；寒热往来，恶心呕吐，是少阳证，张仲景曾说：“伤寒十余日，热结在里，复往来寒热者，与大柴胡汤；但结胸，无大热者，此为水结在胸胁也，但头微汗出者，大陷胸汤主之。”如今结胸而见大热，所以只可以用大柴胡汤，不可以用大陷胸汤。又张仲景说：“伤寒六七日，结胸热实，脉沉而紧，心下痛，按之石硬者，大陷胸汤主之。”而本证脉不见沉紧而见弦滑数，只可宗小陷胸汤之意，给予消痈散结排脓。处方：柴胡20克，半夏15克，黄芩15克，枳实15克，白芍15克，大黄3克，白芥子10克，干姜1克，败酱草30克。
服用2剂后，腹痛发热，恶心呕吐均减，体温38.6℃；继续服用2剂，发热大减，体温37.5℃，恶心呕吐消失，腹痛减轻80%，尿脓、便脓、阴道流脓亦消失；再进20剂，所有症状基本消失。
某医生说：哪个药是治绿脓杆菌、结核杆菌的特效药？回答说：不知道。中医治病的方法是辨证论治，不是辨病论治，我所遵循的是辨证论治罢了。又问：如此之重的病竟然用干姜1克，岂不是使病情加剧吗？回答说：如此之重的证应当见舌质红，苔黄燥，而今反见舌质不红，舌苔不燥，这必定夹有寒湿的微邪，如果不除去其微邪，使阳气施化，那么痈脓难除，所以稍佐干姜1克于清热解毒药中，以促进阳气之施化。又问：为什么不用大剂清热解毒，消痈排脓药？回答说：前医已经大用特用了。其所以无效的原因，就在于只用清热解毒而未注意调气，未注意阳施阴化，所以不宜大剂清热解毒予之。
1. 详细审查月经颜色和质地，参考证候，结合脉象，知道病的缓急，治疗始能痊愈。
戈某某，女性，37岁。
月经淋漓不断，时而下血如崩，甚或出现失血性休克十几年。医生诊断为功能失调性子宫出血。应用西药、刮宫等方法治疗数年无效，随后又以中药补气养血、健脾摄血、收敛止血、凉血止血、补益肝肾等治疗数年亦无明显效果。特别是近20多天来，虽然遍用中、西药物，但仍淋漓不断，且曾大量出血7天发生休克两次。仔细审查其证候，月经已淋漓不断20多天，经色紫黯，伴有大量紫黑血块，胃脘胀痛，腹满冷痛，纳呆食减，心烦不安，口苦咽干，舌苔黄白，脉象弦紧滑涩，消瘦乏力。证脉合参，思考：这是正虚邪实的证候。如今脉见弦紧滑涩，弦紧之脉为寒凝血滞为主，还应当紧急以活血止血温经为先。处方：炒灵脂40克，生灵脂30克，红糖250克。
服用2剂后，经血大减，血块消失；继续服用4剂出血停止，腹痛亦大减。仔细审查苔、脉，见脉弦细而涩，舌苔薄白。综合脉象和症状思考：脉已由弦紧滑涩转为弦细而涩，弦细之脉者气血俱虚，脾胃虚寒也。邪实已减，正虚为主，应当以补益。治疗以健脾温中，大补气血阴阳。处方：黄芪15克，肉桂10克，党参10克，白术10克，茯苓10克，炙甘草10克，生地10克，川芎10克，白芍10克，当归10克，麦冬10克，半夏10克，附子10克，肉苁蓉15克，生姜3片，大枣5个。
服用25剂后，脘腹疼痛消失，精神、食欲正常。此次月经如期来潮，经量不多，但稍有隐痛感，又服红糖50克、炒灵脂10克，10剂，痊愈。
某医生说：我也曾用活血止血，补气养血，温中散寒之药治之，然而其无效的原因是什么呢？回答说：《内经》、《金匮要略》两书为了解决这个问题均列专篇进行论述。你所应用药物恐怕未注意标本、缓急、先后也。标本、缓急、先后在诊断时应抓什么？应治什么？必须明确。根据我的经验，当数种病因、病机同时存在时，在诊断上要以脉为主，即脉表现什么证，就是什么证为急，脉表现什么证，就得先治什么证，然后再顾其他。否则，以症为主，以症为先，必然本末倒置，先后不分，治之不效。
2. 病证繁多，中西乱投，不知标本，不审先后，其病不愈。
古某某，女性，40岁。
风湿性心脏病、二尖瓣狭窄与闭锁不全、心房纤颤12年。慢性胃炎、十二指肠球部溃疡10年。血小板减少性紫癜5年，功能失调性子宫出血4年。医者先用西药治此害彼，治彼害此，始终难于奏效，后又改用中药补气养血、健脾温中、养心安神等病情日渐加重。仔细审查其证候，脘腹胀痛，疲乏无力，心悸心烦，失眠健忘，紫斑成片，消瘦乏力，纳呆食减，月经3个月一直淋漓不断，并曾崩血大下7天，发生休克2次，经过抢救才脱离危险，且趾指厥冷，手心烦热，口苦口干，舌苔白，舌质淡，脉象虚大弦紧涩结。综合脉象和症状思考：脉虚大者，气血大虚也；弦紧者，寒凝也；涩者，滞也；结者，寒凝气结也，阴阳俱虚也。综合论述，乃是张仲景所说：“脉弦而大，弦则为减，大则为芤，减则为寒，芤则为虚，虚寒相搏，此名为革”之意。治疗应当健脾温中，补气养血，理气活血，阴阳并益。处方：黄芪15克，肉桂10克，当归10克，川芎10克，生地10克，白芍10克，人参10克，白术10克，茯苓10克，炙甘草10克，附子10克，麦冬10克，半夏10克，淡大云15克，生姜3片，大枣5个。
服用5剂后，食欲、精神、睡眠、脘腹冷痛均好转，经血减少；继续服用上述药物40剂，所有症状消失，经血停止，体重增加5千克。又间断服药120剂，经过多个医院检查，除风湿性心脏病、二尖瓣狭窄与闭锁不全外，所有症状皆愈。
某医生说：此人病情繁杂，实在难以着手，我也曾处方论治，然而多一剂有效，二剂剧增，这是什么缘故呢？回答说：此病气血阴阳俱虚，五脏俱病，然而以中气虚寒为主，对于此类证候，李东垣、朱丹溪多主张从脾胃论治，因为其脾胃一生则诸脏从之也，如今之所以采用十四味大建中汤（Shisiwei Dajianzhong Decoction）治之者，即遵循李东垣、朱丹溪的治法也。
Section 3: Gynecology
**Leukoplakia of the Vulva**
Strictly follow the pulse, refer to the symptoms, clearly differentiate the pathogenesis, and only then can harmony be achieved.
Patient Feng XX, female, 35 years old. Severe itching of the vulva for 5–6 years. Diagnosed with leukoplakia of the vulva by physicians. Treated with Western medicine for over one year without effect, followed by Chinese medicine methods of nourishing Yin and blood, strengthening Spleen and warming Kidney, tonifying Liver and Kidney, as well as various external washes, all without effect. Careful examination of the syndrome revealed that apart from vulvar itching, there was no other discomfort. The tongue coating was white and yellow, and the pulse was wiry and tight. Synthesizing the pulse and symptoms, I reasoned: A wiry and tight pulse indicates Wind-Cold. The perineum is the location where the Liver Meridian connects; itching is caused by Wind. A white and yellow tongue coating indicates Damp-Heat. In summary, this is Damp-Heat combined with Wind. The treatment should be to disperse Wind, eliminate Dampness, and clear Heat. Prescription: Dang Gui (Angelicae Sinensis Radix) 15g, Qiang Huo (Notopterygii Rhizoma et Radix) 10g, Fang Feng (Saposhnikoviae Radix) 10g, Jing Jie (Schizonepetae Spica) 10g, Zhu Ling (Polyporus) 10g, Ze Xie (Alismatis Rhizoma) 10g, Yin Chen (Artemisiae Scopariae Herba) 15g, Huang Qin (Scutellariae Radix) 10g, Ge Gen (Puerariae Lobatae Radix) 15g, Ku Shen (Sophorae Flavescentis Radix) 15g, Zhi Mu (Anemarrhenae Rhizoma) 10g, Gan Cao (Glycyrrhizae Radix et Rhizoma) 10g.
After taking 2 doses, vulvar itching decreased slightly. After continuing for 40 doses, all symptoms disappeared, and the patient recovered.
A certain physician asked: This formula is Li Dongyuan's Dang Gui Qiang Tong Tang (Danggui Qiangtong Decoction). Li Dongyuan originally used it for tinea and sores, and later generations found it very effective for various sores. Why did you use it to treat vulvar itching? I replied: Dang Gui Qiang Tong Tang consists of five parts of herbs: first, Wind-dispersing herbs; second, lifting herbs; third, drying Dampness and clearing Heat herbs; fourth, promoting urination to drain Damp-Heat herbs; fifth, nourishing Blood and activating Blood herbs. It is mainly indicated for syndromes where Damp-Heat has accumulated in the Lower Jiao for a long time. Because Damp-Heat accumulating in the Lower Jiao cannot be resolved by merely draining or drying Dampness, lifting herbs are necessary to remove it.
**Pelvic Inflammatory Disease (PID)**
1. Etiologies are complex and difficult to judge; strictly following the pulse and harmonizing the condition is indeed the best method.
Patient Wan XX, female, 34 years old.
Cold pain in the lower abdomen, increased vaginal discharge, severe vulvar itching for 4–5 years. Diagnosed with chronic pelvic inflammatory disease and condyloma acuminatum. Treated with Western medicine for over two years without effect, followed by Chinese medicine prescriptions for eliminating Dampness, clearing Heat, dispersing Wind, warming meridians, and activating Blood, along with physical therapy for 2–3 years, still without effect. Careful examination of the syndrome revealed, besides cold pain in the lower abdomen and severe vulvar itching, also heat and palpitations in the epigastrium, rebellious Qi rushing upward, causing mental restlessness when rushing, sweating all over the body when reaching the head, dizziness, headache, mental restlessness, palpitations, insomnia, poor memory, bitter taste in the mouth, dry throat, occasional nausea and vomiting, distension and fullness in hands and feet, numbness and pain in fingers and toes, thick greasy yellow-white tongue coating, and a wiry, tight, and rapid pulse. Synthesizing the pulse and symptoms, I reasoned: A wiry pulse belongs to the Liver; a tight pulse indicates Cold and stagnation; a wiry and tight pulse together indicate stagnation of Cold-Fluid. Moreover, the syndrome involves Shaoyang and also Taiyin, presenting with constrained Fire while simultaneously having Cold-Dampness. The treatment should follow the harmonizing method discussed in *Nei Jing*. Prescription: Chai Hu (Bupleuri Radix) 10g, Ban Xia (Pinelliae Rhizoma) 10g, Huang Qin (Scutellariae Radix) 10g, Ren Shen (Ginseng Radix) 10g, Gan Jiang (Zingiberis Rhizoma) 3g, Da Zao (Jujubae Fructus) 5 pieces, Gan Cao (Glycyrrhizae Radix et Rhizoma) 10g, Gui Zhi (Cinnamomi Ramulus) 10g, Fu Ling (Poria) 10g, Shu Jun (Prepared Rheum Palmatum Radix et Rhizoma) 3g, Long Gu (Fossilia Ossis Mastodi) 15g, Mu Li (Concha Ostreae) 15g.
After taking 5 doses, all symptoms decreased. After continuing for 50 doses, all symptoms disappeared, and the patient recovered.
A certain physician asked: Such a complex syndrome with simultaneous Cold and Heat, deficiency and excess, involving Shaoyang and Taiyin, was cured by Chai Hu Jia Long Gu Mu Li Tang (Chaihu Jia Longgu Muli Decoction). What is the reason? I replied: When discussing the treatment of complex diseases, *Nei Jing* states: There is contrary treatment, there is following treatment, there is treating based on the majority, and there is treating based on the minority. Treating based on the majority or minority must "subdue the dominant factor and address the root cause first," "contrary to it, follow it, contrary and follow it, follow and contrary to it, unblock Qi to make it harmonious, this is the way." This disease has both deficiency and excess, Cold and Heat, Shaoyang and Taiyin. It requires harmonization. Therefore, I used Chai Hu Jia Long Gu Mu Li Tang, which contains elements of following, contrary, and harmonizing treatments.
2. Lower back pain and abdominal pain: grasp the main syndrome, combine with the pulse, apply warming of meridians, and the disease will heal.
Patient Wen XX, female, 41 years old.
Cold pain in the lower abdomen, increased vaginal discharge, lower back pain for 7–8 months. Diagnosed with chronic pelvic inflammatory disease. Treated with Western medicine and physical therapy without effect, then treated with Chinese medicine to warm Kidney and tonify Yang, regulate menstruation and stop discharge, with insignificant effect. Careful examination of the syndrome revealed heavy and painful sensation in the lumbosacral region, cold pain in the lower abdomen, increased vaginal discharge, menstruation either scanty and sluggish or dripping continuously, thin white tongue coating, and a wiry, choppy, irregular pulse. Synthesizing the pulse and symptoms, I reasoned: Heavy and painful sensation in the lumbosacral region, cold pain in the lower abdomen, and increased vaginal discharge are diseases of the Du and Dai vessels. A wiry pulse is the Liver pulse and a Cold pulse; a choppy pulse indicates Cold, stagnation, and Blood stasis. In summary, this is a syndrome of Cold coagulation and Blood stagnation, just as stated in *Jin Gui Yao Lue*: "Question: A woman of fifty suffers from diarrhea for dozens of days without stopping, fever in the evening, urgency and fullness in the lower abdomen, hot palms, and dry lips and mouth. Why? Master said: This disease belongs to Dai disease. Why? Because she had a miscarriage, and Blood stasis remains in the lower abdomen. How do we know? Because her lips and mouth are dry; thus we know. It should be treated with Wen Jing Tang." Prescription: Dang Gui (Angelicae Sinensis Radix) 10g, Bai Shao (Paeoniae Radix Alba) 10g, Gui Zhi (Cinnamomi Ramulus) 10g, Wu Zhu Yu (Evodiae Fructus) 6g, Chuan Xiong (Ligustici Chuanxiong Rhizoma) 10g, Gan Jiang (Zingiberis Rhizoma) 3g, Ban Xia (Pinelliae Rhizoma) 10g, Dan Pi (Moutan Cortex) 10g, Mai Dong (Ophiopogonis Radix) 10g, Dang Shen (Codonopsis Radix) 10g, Gan Cao (Glycyrrhizae Radix et Rhizoma) 6g, E Jiao (Colla Corii Asini) 10g (melted).
After taking 7 doses, lower back pain, abdominal pain, and vaginal discharge improved. After continuing for 20 doses, all symptoms disappeared.
3. Carefully examine the syndrome and tongue, combine with the pulse, determine the nature and location of the disease, apply harmonizing and purging interior, clearing Heat and eliminating Dampness, assisted by warming transformation, and only then will recovery occur.
Patient Gao XX, female, 48 years old.
Distending pain in the lower abdomen for 7–8 years. Diagnosed with pelvic inflammatory disease. Treated with Western medicine without effect, then with Chinese medicine to warm meridians and activate Blood, with slight reduction. However, in the past four months, abdominal pain suddenly worsened, and vaginal discharge increased. Diagnosed with acute exacerbation of chronic pelvic inflammatory disease. Treated with Western medicine with little effect, then combined with Chinese medicine to clear Heat and detoxify, but abdominal pain not only did not decrease but became more severe. Careful examination of the syndrome revealed, besides distending pain in the lower abdomen, tenderness upon pressure, and large amount of foul-smelling vaginal discharge, also alternating chills and fever, nausea with desire to vomit, dizziness and headache, mental restlessness with tendency to cry, bitter taste in the mouth, dry throat, inability to bend forward, unsatisfactory defecation, thick greasy yellow-white tongue coating, wiry-slippery-rapid pulse, and intermittent choppy pulse. Synthesizing the pulse and symptoms, I reasoned: Alternating chills and fever, nausea with desire to vomit, dizziness and headache, mental restlessness with tendency to cry, bitter taste in the mouth, and dry throat indicate Shaoyang disease. Distending pain in the lower abdomen, tenderness upon pressure, and large amount of foul-smelling vaginal discharge indicate Excess-Heat abscess-pus formation. A wiry-slippery-rapid pulse indicates Shaoyang combined with Excess-Heat abscess-pus formation. An intermittent pulse indicates extreme Heat; a choppy pulse indicates Cold stagnation. The treatment should be to harmonize and purge the interior, eliminate Dampness and clear Heat, assisted by warming transformation. Prescription: Chai Hu (Bupleuri Radix) 15g, Ban Xia (Pinelliae Rhizoma) 12g, Huang Qin (Scutellariae Radix) 15g, Zhi Shi (Aurantii Fructus Immaturus) 15g, Chi Shao (Paeoniae Radix Rubra) 15g, Da Huang (Rhei Radix et Rhizoma) 4g, Bai Jie Zi (Sinapis Semen) 10g, Gan Jiang (Zingiberis Rhizoma) 3g, Bai Jiang Cao (Patriniae Herba) 40g, Yin Hua (Lonicerae Japonicae Flos) 30g.
After taking 3 doses, alternating chills and fever, nausea, and vomiting disappeared, and abdominal pain reduced by 60–70%. After continuing for 7 doses, all symptoms disappeared.
4. Carefully examine the syndrome, refer to the pulse, pay attention to concurrent pathogens, and only then will the treatment fit perfectly.
Patient Luo XX, female, 38 years old.
Fever, vomiting, abdominal fullness and distending pain for 4 months. Diagnosed with pelvic inflammatory disease. Treated with Western medicine for 2 months without effect, instead developing pus in urine, stool, and vagina. After careful examination, diagnosed with pelvic abscess, vesicovaginal, rectovaginal, and vesicorectal fistulas. Bacterial culture identified Pseudomonas aeruginosa, Staphylococcus aureus, and Mycobacterium tuberculosis infections. Switched to targeted antibiotics for 20 days, with no improvement in symptoms. Reluctantly added Chinese medicine to clear Heat and detoxify for 10 days, with no reduction in symptoms. Careful examination of the syndrome revealed alternating chills and fever, body temperature 40.1°C, nausea and vomiting, abdominal fullness and distending pain, hardness like stone upon pressure, pain intolerable to touch, large amount of foul-smelling vaginal discharge, pus in urine and stool, wiry-slippery-rapid pulse, and slightly greasy yellow-white tongue coating. Synthesizing the pulse and symptoms, I reasoned: Abdominal fullness and pain with hardness upon pressure is what Zhang Zhongjing called the Great Jie Xiong Syndrome (Major Chest Binding); alternating chills and fever, nausea and vomiting are Shaoyang syndrome. Zhang Zhongjing once said: "In Shang Han disease for ten-plus days, if Heat is bound internally and accompanied by alternating chills and fever, give Da Chai Hu Tang; if only Jie Xiong exists without significant heat, this is Water binding in the chest and hypochondrium, with slight sweating on the head only, Da Xian Xiong Tang is indicated." Now, Jie Xiong presents with high heat, so only Da Chai Hu Tang can be used, not Da Xian Xiong Tang. Zhang Zhongjing also said: "In Shang Han disease for six or seven days, if Jie Xiong is Heat-Excess, with deep and tight pulse, pain in the heart area, and hardness like stone upon pressure, Da Xian Xiong Tang is indicated." But this case's pulse is not deep and tight, but wiry-slippery-rapid. Only the principle of Xiao Xian Xiong Tang (Minor Chest Binding Decoction) can be followed, to resolve abscess, dissipate nodules, and drain pus. Prescription: Chai Hu (Bupleuri Radix) 20g, Ban Xia (Pinelliae Rhizoma) 15g, Huang Qin (Scutellariae Radix) 15g, Zhi Shi (Aurantii Fructus Immaturus) 15g, Bai Shao (Paeoniae Radix Alba) 15g, Da Huang (Rhei Radix et Rhizoma) 3g, Bai Jie Zi (Sinapis Semen) 10g, Gan Jiang (Zingiberis Rhizoma) 1g, Bai Jiang Cao (Patriniae Herba) 30g.
After taking 2 doses, abdominal pain, fever, nausea, and vomiting decreased, body temperature 38.6°C; after continuing for 2 doses, fever greatly decreased, body temperature 37.5°C, nausea and vomiting disappeared, abdominal pain reduced by 80%, and pus in urine, stool, and vagina disappeared; after another 20 doses, all symptoms basically disappeared.
A certain physician asked: Which herb is the specific effective drug for Pseudomonas aeruginosa and Mycobacterium tuberculosis? I replied: I do not know. The method of treating disease in Traditional Chinese Medicine is syndrome differentiation and treatment, not disease differentiation and treatment. What I follow is syndrome differentiation and treatment. He asked again: For such a severe disease, using only 1g of Gan Jiang, does it not aggravate the condition? I replied: Such a severe syndrome should present with a red tongue body and dry yellow coating, but now the tongue body is not red and the coating is not dry. This must involve a minor pathogen of Cold-Dampness. If this minor pathogen is not removed to allow Yang Qi to transform, the abscess-pus will be difficult to eliminate. Therefore, I slightly assisted with 1g of Gan Jiang among the Heat-clearing and detoxifying herbs to promote the transformation of Yang Qi. He asked again: Why not use a large dose of Heat-clearing, detoxifying, abscess-resolving, and pus-draining herbs? I replied: Previous physicians have already used large doses specifically. The reason for their ineffectiveness lies in using only Heat-clearing and detoxifying without paying attention to regulating Qi and the interaction of Yang transforming Yin. Therefore, it is inappropriate to give large doses of Heat-clearing and detoxifying herbs.
**Dysfunctional Menstrual Irregularities**
1. Detailed examination of menstrual color and texture, reference to symptoms, combination with pulse, determination of urgency, and treatment lead to recovery.
Patient Ge XX, female, 37 years old.
Menstruation dripping continuously for over ten years, sometimes bleeding heavily like a collapse, even experiencing hemorrhagic shock. Diagnosed with dysfunctional uterine bleeding. Treated with Western medicine and curettage for several years without effect, followed by Chinese medicine methods of tonifying Qi and nourishing Blood, strengthening Spleen and controlling Blood, astringing to stop bleeding, cooling Blood to stop bleeding, and tonifying Liver and Kidney for several years with no obvious effect. Especially in the past 20+ days, despite using various Chinese and Western medicines, bleeding continued, and there were two episodes of shock due to heavy bleeding lasting 7 days. Careful examination of the syndrome revealed continuous dripping menstruation for over 20 days, purple-dark menstrual blood with large amounts of purple-black clots, epigastric distending pain, cold pain and fullness in the abdomen, poor appetite, mental restlessness, bitter taste in the mouth, dry throat, yellow-white tongue coating, wiry-tight-slippery-choppy pulse, emaciation, and fatigue. Combining syndrome and pulse, I reasoned: This is a syndrome of Righteous Qi deficiency and Evil excess. The current pulse shows wiry-tight-slippery-choppy qualities. The wiry-tight quality indicates Cold coagulation and Blood stagnation as the primary issue. Urgent treatment should prioritize activating Blood, stopping bleeding, and warming meridians. Prescription: Chao Ling Zhi (Processed Pterocarpus Santalinus Lignum) 40g, Sheng Ling Zhi (Raw Pterocarpus Santalinus Lignum) 30g, Red Sugar 250g.
After taking 2 doses, menstrual flow greatly decreased, and clots disappeared; after continuing for 4 doses, bleeding stopped, and abdominal pain greatly decreased. Careful examination of tongue and pulse showed a wiry-thin-choppy pulse and thin white tongue coating. Synthesizing pulse and symptoms, I reasoned: The pulse has changed from wiry-tight-slippery-choppy to wiry-thin-choppy. A wiry-thin pulse indicates deficiency of both Qi and Blood, and deficiency-cold of the Spleen and Stomach. Evil excess has decreased, and Righteous Qi deficiency is primary. Tonification is needed. Treatment should strengthen Spleen and warm the Middle, greatly tonifying Qi, Blood, Yin, and Yang. Prescription: Huang Qi (Astragali Radix) 15g, Rou Gui (Cinnamomi Cortex) 10g, Dang Shen (Codonopsis Radix) 10g, Bai Zhu (Atractylodis Macrocephalae Rhizoma) 10g, Fu Ling (Poria) 10g, Zhi Gan Cao (Honey-fried Glycyrrhizae Radix et Rhizoma) 10g, Sheng Di (Rehmanniae Radix) 10g, Chuan Xiong (Ligustici Chuanxiong Rhizoma) 10g, Bai Shao (Paeoniae Radix Alba) 10g, Dang Gui (Angelicae Sinensis Radix) 10g, Mai Dong (Ophiopogonis Radix) 10g, Ban Xia (Pinelliae Rhizoma) 10g, Fu Zi (Aconiti Lateralis Radix Praeparata) 10g, Rou Cong Rong (Cistanches Herba) 15g, Sheng Jiang (Zingiberis Rhizoma Recens) 3 slices, Da Zao (Jujubae Fructus) 5 pieces.
After taking 25 doses, epigastric and abdominal pain disappeared, spirit and appetite normalized. Menstruation arrived on schedule this time, with moderate flow but slight dull pain. Another 50g of Red Sugar and 10g of Chao Ling Zhi were taken for 10 doses, leading to recovery.
A certain physician asked: I also used herbs to activate Blood and stop bleeding, tonify Qi and nourish Blood, warm the Middle and dispel Cold, but they were ineffective. Why? I replied: Both *Nei Jing* and *Jin Gui Yao Lue* have dedicated chapters addressing this issue. The herbs you used likely did not pay attention to Root/Branch, Urgency/Slowness, and Sequence. What should be grasped and treated regarding Root/Branch, Urgency/Slowness, and Sequence during diagnosis? This must be clear. Based on my experience, when multiple etiologies and pathogeneses exist simultaneously, diagnosis should prioritize the pulse. Whatever syndrome the pulse manifests is the urgent one; whatever syndrome the pulse manifests must be treated first, then attend to others. Otherwise, prioritizing symptoms leads to confusing Root and Branch, losing sequence, and resulting in treatment failure.
2. Numerous syndromes, indiscriminate use of Chinese and Western medicine, ignorance of Root/Branch, failure to assess sequence, disease does not heal.
Patient Gu XX, female, 40 years old.
Rheumatic heart disease, mitral stenosis and insufficiency, atrial fibrillation for 12 years. Chronic gastritis, duodenal bulb ulcer for 10 years. Thrombocytopenic purpura for 5 years, dysfunctional uterine bleeding for 4 years. Physicians initially used Western medicine, treating one condition harmed another, never achieving effectiveness. Then switched to Chinese medicine tonifying Qi and nourishing Blood, strengthening Spleen and warming Middle, nourishing Heart and calming Spirit, but the condition gradually worsened. Careful examination of the syndrome revealed epigastric and abdominal distending pain, fatigue, palpitations and mental restlessness, insomnia and poor memory,成片 purpura, emaciation and fatigue, poor appetite, menstruation dripping continuously for 3 months, with one episode of heavy bleeding for 7 days causing shock twice, requiring rescue to escape danger, cold toes and fingers, heat in palms, bitter and dry mouth, white tongue coating, pale tongue body, and deficient-large-wiry-tight-choppy-interrupted pulse. Synthesizing pulse and symptoms, I reasoned: A deficient-large pulse indicates severe deficiency of Qi and Blood; wiry-tight indicates Cold coagulation; choppy indicates stagnation; interrupted indicates Cold coagulation and Qi binding, and deficiency of both Yin and Yang. In summary, this aligns with Zhang Zhongjing's statement: "When the pulse is wiry and large, wiry implies reduction, large implies hollow. Reduction implies Cold, hollow implies deficiency. Deficiency and Cold interacting is named Ge [Leather] pulse." The treatment should strengthen Spleen and warm the Middle, tonify Qi and nourish Blood, regulate Qi and activate Blood, and benefit both Yin and Yang. Prescription: Huang Qi (Astragali Radix) 15g, Rou Gui (Cinnamomi Cortex) 10g, Dang Gui (Angelicae Sinensis Radix) 10g, Chuan Xiong (Ligustici Chuanxiong Rhizoma) 10g, Sheng Di (Rehmanniae Radix) 10g, Bai Shao (Paeoniae Radix Alba) 10g, Ren Shen (Ginseng Radix) 10g, Bai Zhu (Atractylodis Macrocephalae Rhizoma) 10g, Fu Ling (Poria) 10g, Zhi Gan Cao (Honey-fried Glycyrrhizae Radix et Rhizoma) 10g, Fu Zi (Aconiti Lateralis Radix Praeparata) 10g, Mai Dong (Ophiopogonis Radix) 10g, Ban Xia (Pinelliae Rhizoma) 10g, Dan Da Yun (Cistanches Herba) 15g, Sheng Jiang (Zingiberis Rhizoma Recens) 3 slices, Da Zao (Jujubae Fructus) 5 pieces.
After taking 5 doses, appetite, spirit, sleep, and epigastric-abdominal cold pain improved, and menstrual blood decreased; after continuing the above prescription for 40 doses, all symptoms disappeared, menstruation stopped, and weight increased by 5 kg. Taking the medication intermittently for another 120 doses, after examinations at multiple hospitals, except for rheumatic heart disease, mitral stenosis, and insufficiency, all other conditions were cured.
A certain physician asked: This patient's condition is complex and difficult to handle. I also prescribed treatment, but one dose was effective, and the second dose aggravated it. Why? I replied: This disease involves deficiency of Qi, Blood, Yin, and Yang, and dysfunction of all five Zang organs, but primarily deficiency-cold of Middle Qi. For such syndromes, Li Dongyuan and Zhu Danxi advocated treating from the perspective of Spleen and Stomach, because when Spleen and Stomach are healthy, all other Zang organs follow. The reason I used Shisiwei Dajianzhong Tang (Shisiwei Dajianzhong Decoction) is to follow the treatment methods of Li Dongyuan and Zhu Danxi.