凤(四八)头重若裹。胸闷不食。并不渴饮。脉小。便溏。此属湿邪阻蔽气分。
白蔻仁(五分) 制半夏(一钱五分) 赤苓(三钱) 绵茵陈(三钱) 杏仁(三钱) 飞滑石(三钱) 浓朴
(一钱)
王(四三)头胀脘闷。便溏。肢节痛。目 黄。此属湿邪阻闭气分。郁而不宣。久则化热。传为瘅疟。
绵茵陈(三钱) 制半夏(一钱一分) 飞滑石(三钱) 白蔻仁(五分) 杏仁(三钱) 茯苓皮(三钱) 浓
朴(一钱)
岑 仍议育阴清邪。
原生地(四钱) 拣麦冬(一钱五分) 西洋参(八分) 豆皮(一钱五分) 上清一阿胶(二钱)
云茯神(二钱) 川斛(一钱五分) 炙甘草(五分) 加九孔石决明( 研,三钱)
又 舌绛已退。渴饮。身热未除。
川斛 原生地 连翘心 南花粉 西洋参 粉草 拣麦冬 豆皮
又 身凉渴解。
原生地(四钱) 洋参(四分) 白蒺藜(一钱五分) 拣麦冬(一钱五分) 粉草(三分) 块茯苓(三钱) 川
斛(一钱五分) 新会皮(盐水炒,一钱)
苏(廿五)肺胃素虚。咽干唇裂。上 干痛。频渴不多饮。脉偏大于右寸。此属秋燥致伤。拟甘寒生津。
霍石斛(一钱) 北沙参(一钱五分) 麦冬(二钱)
鲜生地(五钱) 玉竹(二钱) 生甘草(三分)
曹(三一)右脉数搏。肺胃交衰。鼻头胀。咽干。咯血。频渴不多饮。此属温邪化燥。良由阴分不足所致。拟清气
中热。未许速痊。
霜桑叶 杏仁 连翘壳 大沙参 地骨皮 黑山栀 象贝母 南花粉
沈妇(廿八)唇裂频呕。口干头痛。不寐足冷。左胁向有瘕聚。便秘。胸腹热炽。面色黄。脉左关弦大。右寸搏大。
此属温燥内郁。喉间呼吸有声。是症虽属痰喘之象。但麻黄一味大谬。议喻嘉言清燥救肺汤合肺肝之治。
霜桑叶(一钱) 生石膏(三钱) 白蒺藜(二钱) 鲜生地(五钱) 杏仁(三钱)
石决明(三钱) 拣麦冬(三钱) 生甘草(二分) 大麻仁(一钱五分) 加鲜枇杷叶二张(去毛,蜜炙)
又 呕频稍减。唇裂退。
霜桑叶 炒石膏 拣麦冬 真阿胶 杏仁 白蒺藜 制洋参 鲜生地 生甘草 加枇杷叶(三钱)
又 呕大减。润肺燥。益肝液。
鲜枇杷叶 北沙参 紫石英 白蒺藜 真川贝 真阿胶 甜杏仁 拣麦冬 炙鳖甲 霍山石斛 黑芝麻
又 呕减。潮热。咳乃胀痛。肝脉仍弦。大便秘。肺胃衰。肝阴亏。肝火上越。
紫菀草(一钱) 拣麦冬(三钱) 白蒺藜(二钱) 甜杏仁(三钱) 紫石英(五钱) 郁李仁 真石斛(二钱)
真阿胶(二钱) 咸苁蓉(五钱) 鲜枇杷叶(三钱) 小川莲(三分)
凤(四十八岁)头部沉重,如同被包裹一般。胸闷,食欲不振,并不口渴饮水。脉象细小,大便稀溏。这属于湿邪阻滞气分。
白蔻仁(五分) 制半夏(一钱五分) 赤茯苓(三钱) 绵茵陈(三钱) 杏仁(三钱) 飞滑石(三钱) 浓朴(一钱)
王(四十三岁)头部胀痛,胃脘部闷塞,大便稀溏,肢体关节疼痛,目睛发黄。这属于湿邪阻闭气分,郁结而不能宣散,日久则化热,传变为瘅疟(一种以高热、多汗为特征的疟疾)。
绵茵陈(三钱) 制半夏(一钱一分) 飞滑石(三钱) 白蔻仁(五分) 杏仁(三钱) 茯苓皮(三钱) 浓朴(一钱)
岑(患者名)仍建议采用滋养阴液、清除邪气的方法。
原生地(四钱) 拣麦冬(一钱五分) 西洋参(八分) 豆皮(一钱五分) 上清一阿胶(二钱)
云茯神(二钱) 川石斛(一钱五分) 炙甘草(五分) 加九孔石决明(研碎,三钱)
复诊:舌质红绛已退去,出现口渴饮水,身体发热仍未消除。
川石斛 原生地 连翘心 南花粉 西洋参 粉草 拣麦冬 豆皮
再诊:身体转凉,口渴解除。
原生地(四钱) 洋参(四分) 白蒺藜(一钱五分) 拣麦冬(一钱五分) 粉草(三分) 块茯苓(三钱) 川石斛(一钱五分) 新会皮(盐水炒,一钱)
苏(二十五岁)肺胃素来虚弱。咽干唇裂,上部干燥疼痛,频繁口渴但饮水不多。脉象右侧寸口偏大。这属于秋燥致病损伤津液。拟定使用甘寒之法生津液。
霍山石斛(一钱) 北沙参(一钱五分) 麦冬(二钱)
鲜生地(五钱) 玉竹(二钱) 生甘草(三分)
曹(三十一岁)右脉数而搏指有力,肺胃功能交相衰退。鼻头胀满,咽干,咯血,频繁口渴但饮水不多。这属于温邪转化为燥邪,良由阴分不足所致。拟定清气分中的热邪,但不能允许迅速痊愈。
霜桑叶 杏仁 连翘壳 大沙参 地骨皮 黑山栀 象贝母 南花粉
沈氏妇女(二十八岁)唇裂,频繁呕吐,口干头痛,失眠且足部发冷,左侧胁肋部向来有瘕聚(腹内结块),便秘,胸腹部热势炽盛,面色黄,脉象左关弦大,右寸搏大。这属于温燥内郁。喉间呼吸有声,此症虽然表现出痰喘的征象,但使用麻黄一味药是大错特错的。建议采用喻嘉言的清燥救肺汤结合调理肺肝的方法。
霜桑叶(一钱) 生石膏(三钱) 白蒺藜(二钱) 鲜生地(五钱) 杏仁(三钱)
石决明(三钱) 拣麦冬(三钱) 生甘草(二分) 大麻仁(一钱五分) 加鲜枇杷叶两张(去毛,蜜炙)
复诊:呕吐频率稍减,唇裂消退。
霜桑叶 炒石膏 拣麦冬 真阿胶 杏仁 白蒺藜 制洋参 鲜生地 生甘草 加枇杷叶(三钱)
再诊:呕吐大幅减少,滋润肺燥,补益肝液。
鲜枇杷叶 北沙参 紫石英 白蒺藜 真川贝 真阿胶 甜杏仁 拣麦冬 炙鳖甲 霍山石斛 黑芝麻
又诊:呕吐减轻,出现潮热,咳嗽伴有胀痛,肝脉仍然弦硬,大便秘结,肺胃衰弱,肝阴亏损,肝火上越。
紫菀草(一钱) 拣麦冬(三钱) 白蒺藜(二钱) 甜杏仁(三钱) 紫石英(五钱) 郁李仁 真石斛(二钱) 真阿胶(二钱) 咸苁蓉(五钱) 鲜枇杷叶(三钱) 小川莲(三分)
Feng (48 years old) experiences a heavy sensation in the head, as if wrapped. There is chest fullness, loss of appetite, no thirst for drinking, a small pulse, and loose stools. This belongs to damp-evil obstructing the Qi level.
Bai Kou Ren (White Cardamom Seed, 5 fen), Zhi Ban Xia (Prepared Pinellia Rhizome, 1.5 qian), Chi Ling (Red Poria, 3 qian), Mian Yin Chen (Artemisiae Scopariae Herba, 3 qian), Xing Ren (Apricot Seed, 3 qian), Fei Hua Shi (Precipitated Talcum, 3 qian), Nong Po (Magnolia Bark, 1 qian).
Wang (43 years old) presents with head distension and pain, epigastric fullness, loose stools, pain in the limbs and joints, and yellowing of the eyes. This belongs to damp-evil blocking the Qi level, stagnating without being dispersed; over time it transforms into heat and transmits to become Dan Yue (Jaundice-type Malaria).
Mian Yin Chen (Artemisiae Scopariae Herba, 3 qian), Zhi Ban Xia (Prepared Pinellia Rhizome, 1.1 qian), Fei Hua Shi (Precipitated Talcum, 3 qian), Bai Kou Ren (White Cardamom Seed, 5 fen), Xing Ren (Apricot Seed, 3 qian), Fu Ling Pi (Poria Peel, 3 qian), Nong Po (Magnolia Bark, 1 qian).
Cen: Still discussing nourishing Yin and clearing evil pathogens.
Yuan Sheng Di (Rehmanniae Radix Recens, 4 qian), Jian Mai Dong (Ophiopogonis Tuber, 1.5 qian), Xi Yang Shen (American Ginseng Root, 8 fen), Dou Pi (Soybean Hull, 1.5 qian), Shang Qing Yi E Jiao (Donkey-hide Gelatin, 2 qian); Yun Fu Shen (Poria with Hostwood, 2 qian), Chuan Hu (Dendrobii Caulis, 1.5 qian), Zhi Gan Cao (Honey-fried Licorice Root, 5 fen); add Jiu Kong Shi Jue Ming (Hinged Pearl Oyster Shell, ground, 3 qian).
Follow-up: The crimson tongue has receded, there is thirst for drinking, but body heat remains unremoved.
Chuan Hu, Yuan Sheng Di, Lian Qiao Xin (Gardenia Seed Heart), Nan Hua Fen (Trichosanthis Radix Powder), Xi Yang Shen, Fen Cao (Licorice Root Powder), Jian Mai Dou, Dou Pi.
Second follow-up: Body temperature has cooled, thirst has resolved.
Yuan Sheng Di (4 qian), Yang Shen (American Ginseng, 4 fen), Bai Ji Li (Tribuli Fructus, 1.5 qian), Jian Mai Dong (1.5 qian), Fen Cao (3 fen), Kuai Fu Ling (Poria, 3 qian), Chuan Hu (1.5 qian), Xin Hui Pi (Citri Reticulatae Pericarpium, stir-fried with salt water, 1 qian).
Su (25 years old): Lung and Stomach have been deficient since youth. Dry throat, cracked lips, upper dryness and pain, frequent thirst with little intake. The pulse is larger on the right Cun position. This belongs to injury caused by Autumn Dryness. Proposed method: Sweet-Cold to generate fluids.
Huo Shi Hu (Dendrobii Caulis, 1 qian), Bei Sha Shen (Glehniae Radix, 1.5 qian), Mai Dong (Ophiopogonis Tuber, 2 qian); Xian Sheng Di (Rehmanniae Radix Recens, 5 qian), Yu Zhu (Polygonati Odorati Rhizoma, 2 qian), Sheng Gan Cao (Raw Licorice Root, 3 fen).
Cao (31 years old): Right pulse is rapid and forceful; Lung and Stomach are mutually declining. Nasal tip distension, dry throat, hemoptysis, frequent thirst with little intake. This belongs to Warm Evil transforming into Dryness, caused by deficiency in the Yin aspect. Proposed method: Clear Heat in the Qi level; recovery will not be immediate.
Shuang Sang Ye (Mulberry Leaf), Xing Ren (Apricot Seed), Lian Qiao Ke (Forsythiae Fructus Shell), Da Sha Shen (Glehniae Radix), Di Gu Pi (Lycii Cortex), Hei Shan Zhi (Gardeniae Fructus), Xiang Bei Mu (Fritillariae Bulbus), Nan Hua Fen (Trichosanthis Radix Powder).
Mrs. Shen (28 years old): Cracked lips, frequent vomiting, dry mouth, headache, insomnia with cold feet, history of mass accumulation in the left hypochondrium, constipation, intense heat in chest and abdomen, sallow complexion. Pulse: Left Guan is wiry and large, Right Cun is forceful and large. This belongs to internal stagnation of Warm-Dryness. Audible breathing sounds in the throat; although this symptom resembles Phlegm-Wheezing, using Ma Huang (Ephedra Herb) alone is a major error. Proposed: Combine Yu Jiayan's Qing Zao Jiu Fei Tang (Clear Dryness Rescue the Lung Decoction) with treatment targeting Lung and Liver.
Shuang Sang Ye (Mulberry Leaf, 1 qian), Sheng Shi Gao (Gypsum Fibrosum, 3 qian), Bai Ji Li (Tribuli Fructus, 2 qian), Xian Sheng Di (Rehmanniae Radix Recens, 5 qian), Xing Ren (Apricot Seed, 3 qian); Shi Jue Ming (Hinged Pearl Oyster Shell, 3 qian), Jian Mai Dong (Ophiopogonis Tuber, 3 qian), Sheng Gan Cao (Raw Licorice Root, 2 fen), Da Ma Ren (Cannabis Seed, 1.5 qian); add Xian Pi Pa Ye (Loquat Leaf, fresh, two leaves, remove hairs, honey-fried).
Follow-up: Vomiting frequency slightly reduced, lip cracks receded.
Shuang Sang Ye, Chao Shi Gao (Stir-fried Gypsum Fibrosum), Jian Mai Dong, Zhen E Jiao (Donkey-hide Gelatin), Xing Ren, Bai Ji Li, Zhi Yang Shen (Prepared American Ginseng), Xian Sheng Di, Sheng Gan Cao; add Pi Pa Ye (Loquat Leaf, 3 qian).
Next visit: Vomiting greatly reduced, moistening Lung Dryness, benefiting Liver fluid.
Xian Pi Pa Ye (Loquat Leaf, fresh), Bei Sha Shen (Glehniae Radix), Zi Shi Ying (Hematitum), Bai Ji Li (Tribuli Fructus), Zhen Chuan Bei (Fritillariae Cirrhosae Bulbus), Zhen E Jiao (Donkey-hide Gelatin), Tian Xing Ren (Sweet Apricot Seed), Jian Mai Dong, Zhi Bie Jia (Testudinis Carapax et Plastrum, honey-fried), Huo Shan Shi Hu (Dendrobii Caulis), Hei Zhi Ma (Sesamum Fructus Niger).
Another visit: Vomiting decreased, tidal fever, cough accompanied by distending pain, Liver pulse remains wiry, severe constipation, Lung and Stomach decline, Liver Yin deficiency, Liver Fire surging upward.
Zi Wan Cao (Asteris Radix, 1 qian), Jian Mai Dong (Ophiopogonis Tuber, 3 qian), Bai Ji Li (Tribuli Fructus, 2 qian), Tian Xing Ren (Sweet Apricot Seed, 3 qian), Zi Shi Ying (Hematitum, 5 qian), Yu Li Ren (Prunus Semen), Zhen Shi Hu (Dendrobii Caulis, 2 qian), Zhen E Jiao (Donkey-hide Gelatin, 2 qian), Xian Cong Rong (Cistanche Stem, 5 qian), Xian Pi Pa Ye (Loquat Leaf, fresh, 3 qian), Xiao Chuan Lian (Coptidis Rhizoma, 3 fen).