时(六一)痰火上实。头晕。
桑叶(一钱) 炒焦半曲(一钱五分) 钩藤(三钱) 羚羊角(一钱五分) 广皮白(一钱) 白甘菊(一钱) 明
天麻(二钱煨)
冯(六三)肝风内动。眩晕。
制首乌(四钱) 黄甘菊(一钱) 白蒺藜(一钱五分) 豆皮(三钱) 杞子(二钱) 云茯神(二钱) 霜
桑叶(一钱)
倪(四六)烦劳则阳气张大。脉来寸急尺缓。为呕逆眩晕。是厥阳变化。内风鼓动。而后上凭诸窍。病不在乎中上。
经云。上实下虚。为厥巅疾。信斯言也。
熟地(四钱) 杞子(二钱) 白蒺藜(一钱五分) 清阿胶(二钱) 菊花炭(一钱) 云茯神(二钱) 豆
皮(三钱)
赵(四五)右偏头风痛。目赤。少阳郁火未熄。
霜桑叶(一钱) 丹皮(一钱) 白蒺藜(炒一钱五分) 豆皮(二钱) 黄甘菊(一钱) 云茯神(二钱) 制
首乌(三钱) 杞子(二钱)
卫(五二)头风痛。呕吐便秘。肝阳化风上冒。拟柔缓和阳。复脉去参、姜、桂。加牡蛎。
生左牡蛎(三钱) 细生地(三钱) 炙甘草(五分) 清阿胶(二钱) 麦冬(二钱) 南枣(三钱) 大麻仁
(一钱五分)
吴(五四)二气交衰。怯冷。气急妨食。且护阳。扶过一阳萌动再商。
人参(一钱) 制淡川附子(一钱) 茯苓(三钱) 老姜汁(临服冲入五分) 广皮白(一钱) 炒焦半曲(一
钱)
陆(三二)经病阴损未复。气浮咳嗽。胃纳颇减。兼有吞酸。此属下焦元海已竭。生气不至。假借太阴面目。非苦
辛泄肺所宜。
熟地炭(四钱) 远志(八分炒) 杞子(炒一钱五分) 五味子(一钱五分) 萸肉炭(二钱) 紫衣胡桃肉(一
两) 茯苓(三钱)
戴(三四)二气已偏。热炽气急。跗肿便溏。当此夏令升泄。难望久延。
人参(一钱) 河车胶(二钱) 胡桃肉(五钱) 熟地炭(三钱) 五味子(五分) 云茯神(二钱) 川斛(四
钱)
王(三六)胃气方苏。肺阴未复。咳逆便秘。非泄肺所能治之。
北沙参(二钱) 拣麦冬(一钱五分) 叭哒杏仁(三钱) 肥玉竹(二钱) 川贝(二钱) 南枣(三钱) 云
茯神(二钱) 紫菀(一钱) 生甘草(三分) 上药十帖熬膏。
董 骨蒸潮热。便溏。
大生地(四钱) 真小清胶(二钱) 地骨皮(三钱) 炙鳖甲(五钱) 川连(三分) 玉竹(二钱) 钗石斛
(三钱)
王(十二)呛逆。咽痛。便泄。
霜桑叶(一钱) 叭哒杏仁(三钱) 苡仁(二钱) 象贝(一钱五分) 炙草(四分) 块茯苓(三钱) 嫩元
参(一钱五分) 炒焦建曲(一钱五分)
又 溏泄已止。痰咳俱减。治宜扶土生金。
蒸于术(二钱) 苡仁(二钱) 真川贝(一钱五分) 拣麦冬(去心,一钱五分) 新会皮(一钱) 块茯苓(三
钱) 南沙参(一钱五分) 党参(一钱)
【案例一】患者六一,证属痰火内盛、上扰清窍。症状表现为头晕。
处方:桑叶(一钱),炒焦神曲(一钱五分),钩藤(三钱),羚羊角(一钱五分),广陈皮白(一钱),白甘菊(一钱),明天麻(二钱,煨制)。
【案例二】患者冯某,六十三岁,证属肝风内动。症状表现为眩晕。
处方:制何首乌(四钱),黄甘菊(一钱),白蒺藜(一钱五分),豆皮(三钱),枸杞子(二钱),云茯神(二钱),霜桑叶(一钱)。
【案例三】患者倪某,四十六岁,因烦劳导致阳气亢盛张大。脉象表现为寸部急数、尺部缓弱。症状为呕吐逆气、眩晕。此乃厥阳之气变化,引动内风,进而向上冲击头面诸窍。病机关键在于下虚而非中上焦实邪。
《黄帝内经》云:“上实下虚,为厥巅疾。”确是如此。
处方:熟地黄(四钱),枸杞子(二钱),白蒺藜(一钱五分),清阿胶(二钱),菊花炭(一钱),云茯神(二钱),豆皮(三钱)。
【案例四】患者赵某,四十五岁,右侧偏头痛,目赤红肿。证属少阳经郁火未清。
处方:霜桑叶(一钱),牡丹皮(一钱),白蒺藜(炒,一钱五分),豆皮(二钱),黄甘菊(一钱),云茯神(二钱),制何首乌(三钱),枸杞子(二钱)。
【案例五】患者卫某,五十二岁,患头风痛,伴有呕吐、便秘。证属肝阳化风,上冲头部。治拟柔肝缓和、调和阴阳之法。仿复脉汤之意,去人参、生姜、桂枝,加牡蛎。
处方:生左牡蛎(三钱),细生地(三钱),炙甘草(五分),清阿胶(二钱),麦冬(二钱),南枣(三钱),大麻仁(一钱五分)。
【案例六】患者吴某,五十四岁,阴阳二气交相衰弱,出现畏寒怕冷、气促且妨碍进食。治疗当以护阳为主,扶助阳气度过一阳初生之期后再作商议。
处方:人参(一钱),制淡川附子(一钱),茯苓(三钱),老姜汁(临服时冲入五分),广陈皮白(一钱),炒焦神曲(一钱)。
【案例七】患者陆某,三十二岁,经病导致阴精亏损未能恢复,气浮于上而咳嗽,胃纳显著减退,兼有吞酸症状。此属下焦元海枯竭,生气不至,表面看似太阴肺脾之病,但非苦辛泄肺法所宜。
处方:熟地炭(四钱),远志(八分,炒),枸杞子(炒,一钱五分),五味子(一钱五分),萸肉炭(二钱),紫衣胡桃肉(一两),茯苓(三钱)。
【案例八】患者戴某,三十四岁,阴阳二气已偏颇,热势炽盛,气促,足背浮肿,大便溏薄。正值夏令升泄之时,病情难望长久延续。
处方:人参(一钱),河车胶(二钱),胡桃肉(五钱),熟地炭(三钱),五味子(五分),云茯神(二钱),川石斛(四钱)。
【案例九】患者王某,三十六岁,胃气刚刚苏醒,肺阴尚未恢复,出现咳逆、便秘。此非单纯泄肺法所能治愈。
处方:北沙参(二钱),拣麦冬(一钱五分),叭哒杏仁(三钱),肥玉竹(二钱),川贝母(二钱),南枣(三钱),云茯神(二钱),紫菀(一钱),生甘草(三分)。以上十帖药熬制成膏。
【案例十】董姓患者,骨蒸潮热,大便溏薄。
处方:大生地(四钱),真小清胶(二钱),地骨皮(三钱),炙鳖甲(五钱),川黄连(三分),玉竹(二钱),钗石斛(三钱)。
【案例十一】王某,十二岁,呛咳逆气,咽痛,大便泄泻。
处方:霜桑叶(一钱),叭哒杏仁(三钱),薏苡仁(二钱),象贝母(一钱五分),炙甘草(四分),块茯苓(三钱),嫩元参(一钱五分),炒焦建曲(一钱五分)。
复诊:溏泄已止,痰咳俱减。治宜扶土生金。
处方:蒸于术(二钱),薏苡仁(二钱),真川贝母(一钱五分),拣麦冬(去心,一钱五分),新会皮(一钱),块茯苓(三钱),南沙参(一钱五分),党参(一钱)。
[Case 1] Patient Liu Yi (61), presenting with Phlegm-Fire Excess at the Upper Jiao. Symptoms include dizziness.
Prescription: Sangye (Cassiae Ramulus, 1 qian), Chaojiao Banqu (Fried Shenqu, 1.5 qian), Gouteng (Uncariae Ramulus cum Uncis, 3 qian), Lingyangjiao (Saiga Tataricae Cornu, 1.5 qian), Guangpi Bai (Exocarpium Citri Reticulatae Albedo, 1 qian), Bai Ganju (Chrysanthemi Flos, 1 qian), Ming Tianma (Gastrodiae Rhizoma, 2 qian, prepared by roasting).
[Case 2] Patient Feng (63), presenting with Internal Stirring of Liver Wind. Symptoms include vertigo and dizziness.
Prescription: Zhi Shouwu (Prepared Polygoni Multiflori Radix, 4 qian), Huang Ganju (Chrysanthemi Flos, 1 qian), Bai Jili (Tribuli Fructus, 1.5 qian), Doupi (Pericarpium Phaseoli Sojae, 3 qian), Qizi (Lycii Fructus, 2 qian), Yun Fushen (Poria with Hostwood, 2 qian), Shuang Sangye (Frost-covered Cassiae Ramulus, 1 qian).
[Case 3] Patient Ni (46), due to mental fatigue, Yang Qi becomes hyperactive and expansive. Pulse is rapid at the Cun position and slow at the Chi position. Symptoms include vomiting, regurgitation, and vertigo. This indicates transformation of Jue-Yang and stirring of Internal Wind, which then ascends to affect the orifices. The pathology lies not in the Middle or Upper Jiao but stems from deficiency below.
The Classic states: "Excess above and deficiency below leads to Jue diseases of the head." This statement is confirmed.
Prescription: Shudi (Rehmanniae Radix Preparata, 4 qian), Qizi (Lycii Fructus, 2 qian), Bai Jili (Tribuli Fructus, 1.5 qian), Qing Ejiao (Donkey-hide Gelatin, 2 qian), Juhua Tan (Charred Chrysanthemi Flos, 1 qian), Yun Fushen (Poria with Hostwood, 2 qian), Doupi (Pericarpium Phaseoli Sojae, 3 qian).
[Case 4] Patient Zhao (45), suffering from right-sided hemicephalic pain and red eyes. Pathogenesis involves unextinguished Depressed Fire in the Shaoyang channel.
Prescription: Shuang Sangye (Frost-covered Cassiae Ramulus, 1 qian), Danpi (Moutan Cortex, 1 qian), Bai Jili (Tribuli Fructus, fried, 1.5 qian), Doupi (Pericarpium Phaseoli Sojae, 2 qian), Huang Ganju (Chrysanthemi Flos, 1 qian), Yun Fushen (Poria with Hostwood, 2 qian), Zhi Shouwu (Prepared Polygoni Multiflori Radix, 3 qian), Qizi (Lycii Fructus, 2 qian).
[Case 5] Patient Wei (52), suffering from Cephalalgia due to Head Wind, accompanied by vomiting and constipation. Pathogenesis involves Liver Yang transforming into Wind and rushing upward. Treatment aims to soften the Liver, harmonize, and balance Yin and Yang. A modified Fumai Tang (Restore the Pulse Decoction) is used, removing Renshen (Ginseng Radix et Rhizoma), Shengjiang (Zingiberis Rhizoma Recens), and Guizhi (Cinnamomi Ramulus), adding Muli (Ostreae Concha).
Prescription: Sheng Zuomuli (Raw Left Ostreae Concha, 3 qian), Xi Shengdi (Rehmanniae Radix, 3 qian), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma, 0.5 qian), Qing Ejiao (Donkey-hide Gelatin, 2 qian), Maidong (Ophiopogonis Radix, 2 qian), Nanzao (Jujubae Fructus, 3 qian), Damaoren (Cannabis Semen, 1.5 qian).
[Case 6] Patient Wu (54), decline of both Yin and Yang Qi. Symptoms include aversion to cold, shortness of breath, and anorexia. Treatment should focus on protecting Yang Qi, supporting it through the phase of initial Yang generation before further discussion.
Prescription: Renshen (Ginseng Radix et Rhizoma, 1 qian), Zhi Dan Chuanfuzi (Prepared Aconiti Lateralis Radix Preparata, 1 qian), Fuling (Poria, 3 qian), Lao Jiangzhi (Old Ginger Juice, 0.5 qian added just before administration), Guangpi Bai (Exocarpium Citri Reticulatae Albedo, 1 qian), Chaojiao Banqu (Fried Shenqu, 1 qian).
[Case 7] Patient Lu (32), Yin damage from menstrual disorders has not recovered. Floating Qi causes cough, appetite is significantly reduced, accompanied by acid regurgitation. This indicates exhaustion of the Yuan Sea in the Lower Jiao and failure of Vital Qi to arrive. It mimics Taiyin disease but is not suitable for Bitter-Spicy Lung-draining methods.
Prescription: Shuditan (Charred Rehmanniae Radix Preparata, 4 qian), Yuanzhi (Polygalae Radix, fried, 0.8 fen), Qizi (Lycii Fructus, fried, 1.5 qian), Wubeizi (Schisandrae Fructus, 1.5 qian), Yurou Tan (Charred Corni Fructus, 2 qian), Ziyi Hutao Rou (Walnut Seed with Purple Membrane, 1 liang), Fuling (Poria, 3 qian).
[Case 8] Patient Dai (34), imbalance of Yin and Yang Qi. High fever, shortness of breath, edema of the dorsum of feet, and loose stools. During the summer season of ascending and dispersing, a prolonged recovery is difficult to expect.
Prescription: Renshen (Ginseng Radix et Rhizoma, 1 qian), Hechejiao (Placenta Hominis Gelatin, 2 qian), Hutao Rou (Walnut Seed, 5 qian), Shuditan (Charred Rehmanniae Radix Preparata, 3 qian), Wubeizi (Schisandrae Fructus, 0.5 fen), Yun Fushen (Poria with Hostwood, 2 qian), Chuanhu (Dendrobii Caulis, 4 qian).
[Case 9] Patient Wang (36), Stomach Qi is just recovering, Lung Yin is not yet restored. Cough with reverse flow and constipation are present. This cannot be treated merely by draining the Lung.
Prescription: Beishashen (Glehniae Radix, 2 qian), Jian Maidong (Ophiopogonis Radix, selected, 1.5 qian), Badaxing (Prunus Armeniacae Amarum Semen, 3 qian), Fei Yuzhu (Polygonati Odorati Rhizoma, plump, 2 qian), Chuanbei (Fritillariae Thunbergii Bulbus, 2 qian), Nanzao (Jujubae Fructus, 3 qian), Yun Fushen (Poria with Hostwood, 2 qian), Ziwan (Astagi Herba, 1 qian), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma, 0.3 fen). Ten doses of these herbs are decocted into a paste.
[Case 10] Patient Dong, bone-steaming tidal fever and loose stools.
Prescription: Dashengdi (Rehmanniae Radix, large, 4 qian), Zhen Xiaoqingjiao (True Small Clear Gelatin, 2 qian), Digupi (Bark of Groundcherry Root, 3 qian), Zhi Biejia (Testudinis Carapax et Plastrum, prepared, 5 qian), Chuanlian (Coptidis Rhizoma, 0.3 fen), Yuzhu (Polygonati Odorati Rhizoma, 2 qian), Chai Shihu (Dendrobii Caulis, 3 qian).
[Case 11] Patient Wang (12), choking cough, sore throat, and diarrhea.
Prescription: Shuang Sangye (Frost-covered Cassiae Ramulus, 1 qian), Badaxing (Prunus Armeniacae Amarum Semen, 3 qian), Yiren (Coicis Semen, 2 qian), Xiangbei (Fritillariae Cirrhosae Bulbus, 1.5 qian), Zhicao (Prepared Glycyrrhizae Radix et Rhizoma, 0.4 fen), Kuai Fuling (Poria, 3 qian), Nen Yuanshen (Scrophulariae Radix, tender, 1.5 qian), Chaojiao Jianqu (Fried Jianqu, 1.5 qian).
Follow-up: Diarrhea has stopped, phlegm and cough have decreased. Treatment should strengthen Earth to generate Metal.
Prescription: Zheng Baizhu (Atractylodis Macrocephalae Rhizoma, steamed, 2 qian), Yiren (Coicis Semen, 2 qian), Zhen Chuanbei (Fritillariae Thunbergii Bulbus, authentic, 1.5 qian), Jian Maidong (Ophiopogonis Radix, selected, heart removed, 1.5 qian), Xinhui Pi (Exocarpium Citri Reticulatae, Xin-hui origin, 1 qian), Kuai Fuling (Poria, 3 qian), NanShashen (Glehniae Radix, 1.5 qian), Dangshen (Codonopsis Radix, 1 qian).