马(廿五)肝络久虚。少腹坠痛。此属气疝。宗子和方。
川楝子(二钱) 归须(一钱五分) 炒橘核(一钱五分) 延胡(炒,一钱) 青木香(八分) 青皮(一钱) 粗
桂枝(一钱) 炒小茴香(七分)
宗(十一)稚年阴囊肿大。小溲通利。此属水疝。开太阳以驱邪。
川桂木(五分) 桑白皮(一钱五分) 姜皮(四分) 汉防己(一钱五分) 苡仁(二钱) 茯苓皮(三钱) 浓
朴(一钱)
曾(廿五)湿伤于下。足胫浮肿。此属香港脚。
制茅术(一钱五分) 汉防己(一钱五分) 苡仁(二钱) 川黄柏(一钱)
木瓜(一钱) 川萆 (二钱) 牛膝(二钱)
田(十六)泄泻初愈。足胫浮肿。宜温通太阴。
煨益智(八分) 苡仁(二钱) 姜炭(四分) 汉防己(一钱五分) 茯苓皮(三钱) 桂枝木(五分) 木瓜
(一钱五分)
沈(五二)寒湿内郁。泄泻腹痛。小便频数。面痿跗肿。
煨益智(八分) 汉防己(一钱五分) 炮姜炭(六分) 炒焦浓朴(一钱) 木瓜(一钱五分) 苡仁(三钱) 桂
枝木(八分)
又 跗肿。泄泻。腹痛。
西党参(二钱) 汉防己(一钱五分) 炮姜炭(六分) 淡吴萸(八分) 炒木瓜(一钱五分) 苡仁(三钱) 茯
苓(三钱) 煨益智(八分) 桂枝(八分) 加台药(一钱)
陈(五八)溏泄跗肿。晨起略爽。下午病剧。是脾肾阳惫残。何疑。
党参(二钱) 淡吴萸(八分) 炒焦小茴香(八分) 胡芦巴(一钱五分) 巴戟天(一钱五分) 茯苓(二钱)
制川乌(一钱五分)
尚 昨进抑肝蠲痰。喘象宁静。所谓急则治标之方。而脾肾阳惫。是病之本。今咽痛肛坠。虚火未熄。且性情躁动。
心阳肝火亦为跌仆之形。即属上实下虚之验。身有微热。防其复喘。拟扶阳抑肝。以导浮火。再商。
制洋参(二钱) 陈半曲(一钱五分) 钗石斛(一钱五分) 白蒺藜(去刺炒,一钱五分) 橘红(一钱) 茯
苓(三钱) 煨天麻(二钱)
又 拘束已减。夜寤稍寐。肚坠便积。痰气下降。跗肿全消。脉右搏大。今现于左部。痰积下坠。浮火已熄。总之。
宁湿内郁。蕴痰酿积。非温经通络。焉克有济。再拟通积消瘀痰。扶脾佐之。
粗桂枝(八分) 炒黑蜀漆(一钱) 茯苓(三钱) 生白术(一钱) 炮黑川乌(一钱) 炙草(四分) 浓朴
(八分)
又 积滞已稀。痰哮不寐。阳衰窃发。
制洋参(八分) 制半夏(一钱五分) 石菖蒲根(四分) 浓朴(八分) 一剂后加猪胆汁一枚临
服冲入 茯苓(三钱) 蒸白术(二钱) 炮黑川乌(八分)
又
桂枝(八分) 制半夏(一钱五分) 淡干姜(六分) 生白芍(一钱五分) 五味子(八分) 茯苓(三钱) 炙
草(五分)
又 议真武汤去白芍。加炙草。合大半夏汤。
人参(五分) 制川附子(五分) 炙草(四分) 蒸白术(二钱) 炒焦陈半曲(一钱五分) 老姜汁(临服冲
入五分) 茯苓(二钱)
又 阳衰痰饮窃踞。气塞至咽。欲坐不卧。暂进微通胸中之阳。
薤白头(三钱) 制半夏(一钱五分) 淡干姜(八分) 栝蒌皮(一钱五分) 草郁金(一钱) 茯苓(三钱) 桂
枝(八分) 临服冲入白酒半杯为导引
马(二十五岁):肝络长期虚弱。少腹部坠胀疼痛。这属于气疝。采用宗子的方剂。
川楝子(二钱) 归须(当归尾,一钱五分) 炒橘核(一钱五分) 延胡索(炒,一钱) 青木香(八分) 青皮(一钱) 粗桂枝(一钱) 炒小茴香(七分)
宗(十一岁):幼童阴囊肿大。小便通畅。这属于水疝。通过开通太阳经以驱除邪气。
川桂木(五分) 桑白皮(一钱五分) 姜皮(四分) 汉防己(一钱五分) 薏苡仁(二钱) 茯苓皮(三钱) 浓朴(一钱)
曾(二十五岁):湿邪损伤下部。足胫部浮肿。这属于香港脚(湿热下注之证)。
制茅术(苍术,一钱五分) 汉防己(一钱五分) 薏苡仁(二钱) 川黄柏(一钱)
木瓜(一钱) 川萆薢(二钱) 牛膝(二钱)
田(十六岁):泄泻刚刚痊愈。足胫部浮肿。适宜温通太阴脾经。
煨益智(益智仁,八分) 薏苡仁(二钱) 姜炭(四分) 汉防己(一钱五分) 茯苓皮(三钱) 桂枝木(五分) 木瓜(一钱五分)
沈(五十二岁):寒湿内郁结。泄泻腹痛。小便频数。面部及足背浮肿。
煨益智(益智仁,八分) 汉防己(一钱五分) 炮姜炭(六分) 炒焦浓朴(一钱) 木瓜(一钱五分) 薏苡仁(三钱) 桂枝木(八分)
复诊:足背浮肿。泄泻。腹痛。
西党参(二钱) 汉防己(一钱五分) 炮姜炭(六分) 淡吴茱萸(八分) 炒木瓜(一钱五分) 薏苡仁(三钱) 茯苓(三钱) 煨益智(益智仁,八分) 桂枝(八分) 加台药(陈皮,一钱)
陈(五十八岁):大便溏泄且足背浮肿。早晨起床时稍感舒适,下午病情加重。这是脾肾阳气衰竭残存的表现,有何可疑?
党参(二钱) 淡吴茱萸(八分) 炒焦小茴香(八分) 胡芦巴(一钱五分) 巴戟天(一钱五分) 茯苓(二钱) 制川乌(一钱五分)
尚先生:昨日服用平抑肝气、祛除痰浊的方剂后,喘息症状趋于平静。这就是所谓“急则治标”的方剂。但脾肾阳气衰竭是疾病的根本。如今出现咽痛、肛门下坠,说明虚火未熄。加上性情急躁,心阳与肝火也因跌仆受伤而显现。这属于上实下虚的验证。身体有微热,防止其再次喘息。拟用扶阳抑肝的方法,以引导浮游之火。再行商议。
制西洋参(二钱) 陈半夏曲(一钱五分) 钗石斛(一钱五分) 白蒺藜(去刺炒,一钱五分) 橘红(一钱) 茯苓(三钱) 煨天麻(二钱)
复诊:拘束感已减轻,夜间睡眠稍好。腹部下坠,大便积滞,痰气下降,足背浮肿完全消退。脉象右侧搏动大而现于左部。痰积下坠,浮火已熄。总之,宁可湿气内郁,蕴生痰浊酿成积滞,若不温经通络,怎能有益处?再拟定通积消瘀化痰之法,辅以健脾。
粗桂枝(八分) 炒黑蜀漆(一钱) 茯苓(三钱) 生白术(一钱) 炮黑川乌(一钱) 炙甘草(四分) 浓朴(八分)
复诊:积滞已减少,但痰哮导致失眠,阳气衰微暗中发作。
制西洋参(八分) 制半夏(一钱五分) 石菖蒲根(四分) 浓朴(八分) 一剂药煎好后,加入猪胆汁一枚,服药前冲入。茯苓(三钱) 蒸白术(二钱) 炮黑川乌(八分)
复诊:
桂枝(八分) 制半夏(一钱五分) 淡干姜(六分) 生白芍(一钱五分) 五味子(八分) 茯苓(三钱) 炙甘草(五分)
复诊:建议真武汤去掉白芍,加入炙甘草,合大半夏汤使用。
人参(五分) 制川附子(五分) 炙甘草(四分) 蒸白术(二钱) 炒焦陈半夏曲(一钱五分) 老姜汁(服药前冲入五分) 茯苓(二钱)
复诊:阳气衰微,痰饮暗中占据,气塞至咽喉,想要坐起不能平卧。暂时进服轻微疏通胸中阳气的方剂。
薤白头(三钱) 制半夏(一钱五分) 淡干姜(八分) 栝蒌皮(一钱五分) 草郁金(一钱) 茯苓(三钱) 桂枝(八分) 服药前冲入白酒半杯作为引导
Ma (25 years old): The collateral vessels of the Liver have been deficient for a long time. There is a bearing-down pain in the lower abdomen. This belongs to Qi Hernia (Qi-type hernia). Prescribed Zongzi's Formula.
Fructus Toosendan (Chuanlianzi, 2 qian) Caudex and Radix Angelicae Sinensis Tail (Guixu, 1.5 qian) Stir-fried Pericarpium Citri Reticulatae Viride (Qingpi, 1 qian) Rhizoma Cyperi Rotundi (Caojuhe, 1.5 qian) Rhizoma Zedoariae (Zeyu, 1 qian, stir-fried) Radix Aucklandiae (Qingmuxiang, 0.8 fen) Ramulus Cinnamomi (Guzhi, 1 qian) Fructus Foeniculi (Xiaohuixiang, 0.7 qian, stir-fried)
Zong (11 years old): In childhood, swelling and enlargement of the scrotum. Urination is smooth. This belongs to Water Hernia (Water-type hernia). Open the Taiyang channel to drive out pathogenic factors.
Ramulus Cinnamomi (Chuangui, 0.5 fen) Cortex Mori Radicis (Sangbaipi, 1.5 qian) Pericarpium Zingiberis Recens (Jiangpi, 0.4 fen) Radix Stephaniae Tetrandrae (Hanfangji, 1.5 qian) Semen Coicis (Yiren, 2 qian) Cortex Poriae (Fulingpi, 3 qian) Cortex Magnoliae Officinalis (Nanpu, 1 qian)
Zeng (25 years old): Dampness injured the lower part. Swelling of the shins and feet. This belongs to Hong Kong Foot (Hongkong Foot/Charley Horse due to damp-heat).
Rhizoma Atractylodis Macrocephalae Processed (Zhimaozhu, 1.5 qian) Radix Stephaniae Tetrandrae (Hanfangji, 1.5 qian) Semen Coicis (Yiren, 2 qian) Cortex Phellodendri Chinensis (Chuanhuangbai, 1 qian)
Pericarpium Papaveris (Mugua, 1 qian) Rhizoma Dioscoreae Hypoglaucae (Chuanbi, 2 qian) Radix Achyranthis Bidentatae (Niuxi, 2 qian)
Tian (16 years old): Diarrhea has just recovered. Swelling of the shins and feet. It is appropriate to warm and unblock the Taiyin Spleen channel.
Fructus Alpiniae Oxyphyllae Roasted (Weiyizhi, 0.8 fen) Semen Coicis (Yiren, 2 qian) Charred Ginger (Jiantan, 0.4 fen) Radix Stephaniae Tetrandrae (Hanfangji, 1.5 qian) Cortex Poriae (Fulingpi, 3 qian) Ramulus Cinnamomi (Guizhimu, 0.5 fen) Pericarpium Papaveris (Mugua, 1.5 qian)
Shen (52 years old): Cold-dampness stagnates internally. Diarrhea with abdominal pain. Frequent urination. Edema of the face and dorsum of the foot.
Fructus Alpiniae Oxyphyllae Roasted (Weiyizhi, 0.8 fen) Radix Stephaniae Tetrandrae (Hanfangji, 1.5 qian) Charred Ginger (Paojiangtan, 0.6 fen) Stir-fried Charred Cortex Magnoliae Officinalis (Chaojiao Nanpu, 1 qian) Pericarpium Papaveris (Mugua, 1.5 qian) Semen Coicis (Yiren, 3 qian) Ramulus Cinnamomi (Guizhimu, 0.8 fen)
Follow-up: Edema of the dorsum of the foot. Diarrhea. Abdominal pain.
Radix Codonopsis Pilosae (Xidangshen, 2 qian) Radix Stephaniae Tetrandrae (Hanfangji, 1.5 qian) Charred Ginger (Paojiangtan, 0.6 fen) Fructus Evodiae (Danwuyu, 0.8 fen) Stir-fried Pericarpium Papaveris (Chao Mugua, 1.5 qian) Semen Coicis (Yiren, 3 qian) Poria (Fuling, 3 qian) Fructus Alpiniae Oxyphyllae Roasted (Weiyizhi, 0.8 fen) Ramulus Cinnamomi (Guizhi, 0.8 fen) Add Taoye (Taopi/Tangerine Peel, 1 qian)
Chen (58 years old): Loose stools and edema of the dorsum of the foot. Slightly relieved upon waking in the morning; worsened in the afternoon. This is residual deficiency of Spleen and Kidney Yang. What doubt is there?
Radix Codonopsis Pilosae (Dangshen, 2 qian) Fructus Evodiae (Danwuyu, 0.8 fen) Stir-fried Charred Fructus Foeniculi (Chaojiao Xiaohuixiang, 0.8 fen) Semen Trichosanthis (Huluba, 1.5 qian) Radix Morindae Officinalis (Bajitian, 1.5 qian) Poria (Fuling, 2 qian) Radix Aconiti Lateralis Preparata (Zhichuanwu, 1.5 qian)
Mr. Shang: Yesterday, after administering the formula to suppress Liver Qi and eliminate phlegm, the wheezing symptoms calmed down. This is the so-called "treat the acute symptoms first" formula. However, the deficiency of Spleen and Kidney Yang is the root of the disease. Now, throat pain and anal prolapse indicate that the defire fire has not subsided. Coupled with an irritable temperament, Heart Yang and Liver Fire are also manifesting due to the fall. This is evidence of excess above and deficiency below. There is slight fever in the body, preventing recurrence of wheezing. Propose to support Yang and suppress Liver, to guide floating fire. Re-discuss.
Radix Panacis Quinquefolii Preparated (Zhiyangshen, 2 qian) Massa Medicamentae Fermentatae Chinensis Chenpi Banqu (Chenbanqu, 1.5 qian) Caulis Dendrobii Nudae (Chai Shihu, 1.5 qian) Fructus Tribuli (Bajili, 1.5 qian, thorns removed, stir-fried) Exocarpium Citri Reticulatae (Juhong, 1 qian) Poria (Fuling, 3 qian) Rhizoma Gastrodiae Elatae Roasted (Wei Tianma, 2 qian)
Follow-up: Restraint has decreased. Sleep at night is slightly better. Abdominal bearing-down and fecal accumulation. Phlegm-Qi descends. Edema of the dorsum of the foot completely disappears. Pulse is large and beating on the right, now appearing on the left side. Phlegm accumulation bears down. Floating fire has subsided. In short, it is better to have internal damp-stagnation generating phlegm and accumulation than not to warm the channels and unblock collaterals. How else could there be benefit? Re-propose to unblock accumulation, resolve stasis, and transform phlegm, assisting with strengthening the Spleen.
Ramulus Cinnamomi (Guzhi, 0.8 fen) Stir-fried Black Kudzu Root (Chaohei Shuji, 1 qian) Poria (Fuling, 3 qian) Rhizoma Atractylodis Macrocephalae Raw (Sheng Baizhu, 1 qian) Charred Black Radix Aconiti Lateralis (Paohéi Chuanwu, 1 qian) Honey-fried Licorice Root (Zhigancao, 0.4 fen) Cortex Magnoliae Officinalis (Nanpu, 0.8 fen)
Follow-up: Accumulation has thinned. Phlegm-wheeze causes insomnia. Yang decline secretly emerges.
Radix Panacis Quinquefolii Preparated (Zhiyangshen, 0.8 fen) Rhizoma Pinelliae Preparatum (Zhibanxia, 1.5 qian) Rhizoma Acori Tatarinowii (Shichangpu, 0.4 fen) Cortex Magnoliae Officinalis (Nanpu, 0.8 fen) After one dose, add one pig gallbladder, mix into the decoction before taking. Poria (Fuling, 3 qian) Steamed Rhizoma Atractylodis Macrocephalae (Zheng Baizhu, 2 qian) Charred Black Radix Aconiti Lateralis (Paohéi Chuanwu, 0.8 fen)
Follow-up:
Ramulus Cinnamomi (Guizhi, 0.8 fen) Rhizoma Pinelliae Preparatum (Zhibanxia, 1.5 qian) Dried Ginger (Danganjiang, 0.6 fen) Raw Radix Paeoniae Alba (Sheng Baishao, 1.5 qian) Fructus Schisandrae Chinensis (Wuweizi, 0.8 fen) Poria (Fuling, 3 qian) Honey-fried Licorice Root (Zhigancao, 0.5 fen)
Follow-up: Discuss using Zhenwu Decoction removing Radix Paeoniae Alba, adding Honey-fried Licorice Root, combined with Da Banxia Decoction.
Radix Ginseng (Renshen, 0.5 fen) Radix Aconiti Lateralis Preparata (Zhichuanfuzi, 0.5 fen) Honey-fried Licorice Root (Zhigancao, 0.4 fen) Steamed Rhizoma Atractylodis Macrocephalae (Zheng Baizhu, 2 qian) Stir-fried Charred Massa Medicamentae Fermentatae Chinensis Chenpi Banqu (Chaojiao Chenbanqu, 1.5 qian) Juice of Old Ginger (Laojiangzhi, 0.5 fen, mix in before taking) Poria (Fuling, 2 qian)
Follow-up: Yang decline, phlegm-fluid secretly occupies. Qi blocks up to the throat. Desires to sit but cannot lie down. Temporarily administer a mild formula to unblock Yang in the chest.
Stolon of Allii Macrostemonis (Xiebaitou, 3 qian) Rhizoma Pinelliae Preparatum (Zhibanxia, 1.5 qian) Dried Ginger (Danganjiang, 0.8 fen) Pericarpium Trichosanthis (Gualoupi, 1.5 qian) Rhizoma Curcumae Longae (Caoyujin, 1 qian) Poria (Fuling, 3 qian) Ramulus Cinnamomi (Guizhi, 0.8 fen) Mix in half cup of white wine before taking as a guiding agent