食欲颇佳，但每当食后半小时，以及劳动时呕吐大作，必须倾尽食物而后已。由是 天天闲坐者，四、五年矣。其面色灰黄，脉浮而软乃胃津枯竭，以至不能任劳。患 者无力服药，欲求单方，余令购甘蔗一支，炖水代茶。或用荷叶包肉煨食。最后可 找黄鼠狼肝，瓦煅研末，温酒冲服。其三方皆采用，果验。
男，25岁
病病呕三年，时发时止。月来食入即呕，不倒净胃中物，不得罢休。医者断为膈症 ，引言“痰痨鼓膈，妙药难医”。诊脉沉细有力，唇色淡红，舌中微黄而边绛。余 以为膈是胃津干竭，此证是痰火上逆，投以半夏泻心汤：
半夏三钱，台党（代人参）三钱，苏红钱半，蒌仁二钱，黄芩二钱，海浮石二钱， 竹茹二钱，沙参三钱
服五剂，呕势和缓，但食粥即呕，食饭谷好，且可闻到饭香，并欲食之。脉沉，能 应指。断胃气有转机，改方：
西党三钱，半夏、旋复花（布包炖）、代赭石、竹茹、海浮石、柿霜、瓜蒌霜、沙 参、金钗石斛各二钱
另用黄牛口内吃剩之草，扯出一掬，置瓦上煅干研末，入药同煎。
服十剂后，病去十之八、九。再求断根方，余嘱忌闻大粪气（患者是花匠），忌食 香燥物，还得忌房事。给方：
玉竹三钱，沙参二钱、冬瓜子、鲜金石斛、东波叩各二钱，梨皮一掬，甘蔗汁一杯 连服十余剂，病夫复元矣。
4、便秘
男，55岁
便秘七、八日，能食能走，但饭后作饱，夜不成寐，脉沉而紧，舌淡红而无津液。 断乃中气不足，胃津枯涸，障碍运化，致脾肾同病。仿塞因塞用法。
熟地、台党各四钱，北芪、当归各三钱，炙草一钱，煅龙骨、巴戟、益智仁、淡肉 苁蓉、补骨脂各二钱，姜枣为引。
服二剂，大便通。服毕四剂，发嘈杂，有时透大气。于方中去益智仁、补骨脂、肉 苁蓉，加金钗二钱、霍山二钱，覆盆子二钱，毕澄茄二钱。两剂而安。
男，50岁
便秘五日，烧热不退，舌黄唇赤，两颐红亮，脉见浮数，两胁隐痛，味苦，恶食。 余作胃家实处之。
川朴二钱，大黄（水浸不炖）三钱，风化硝二钱，枳实钱半。服两剂，下丸子屎多 节，顿感舒服。复诊脉数而软，解以葛根解肌汤，两剂而愈。
初诊处方时，某谓此证乃少阳之候，不可以用承气也。其据理为胸胁隐痛而味苦， 余以为此证阳明为主，盖胸胁虽隐痛，而不觉苦满，是不具少阳主证也。至于味苦 ，太阳、阳明皆可有之，非少阳独有者。
5、呃逆
男，50岁
烧热后打呃，面红唇紫，舌有裂纹，诊脉浮数无根。臆测胃津枯竭，乃变相煎厥， 不敢处方。然病家一再力促，遂以五汁饮投之。
萝卜捣汁、梨汁、藕汁、郁金（水浸捣汁）三钱，甘蔗汁各一杯，和匀冷服。及暮 ，呃声较短，仍未停止。
复诊脉数无力，诸恙如前。余虑其素来酒醉终日，胃津枯竭，致有胃脱之虞，勉以 ：
枇杷叶、金钗石斛、麦冬、郁金、代赭石、旋覆花（布包）各二钱玉竹、生石膏各 三钱
嘱服一剂。其归家， 出示吾方，群疑此药平凡，遂弃之。另延某医治疗，取用大 剂参附成方，另日黎明，鼻舌皆出鲜血，目珠赤如朱砂，急求冷饮，是日正午告卒 。
此系病后变症，热灼胃津，已成煎厥，万无生理。
男，18岁
素来喜饮冷水。暑天某晚喂牛归，恣饮新汲井水，复食土瓜，次日发生呃逆，声从 中焦冲上，每呃必牵动全身，并漉漉作响。余观其腹大如鼓，翻来复去，浑身抖擞 ，呃声粗短，脉浮且数。断其水停心下，用霹雳散吹鼻，外以灯芯通之，当时喷嚏 连作，目泪汪汪，顿觉轻松。余以霹雳散有毒，不可连用，遂停止。斯时患者作呕 ，乃以食盐置刀上，用火烧红，淬入盛井水之盅内，令患者服淬盐水，旋呕水一面 盆，腹胀顿解，呃声渐平，已不闻漉漉声矣，开方旋覆代赭石汤，二剂霍然。
此饮水过多，水停心下，气逆而呃，乃取“越而上之”之法，以通胃络。
男，51岁
呃逆五六日，曾用箬叶煎水吃，用灯草通鼻，又用霹雳散打喷嚏，呃逆稍减。未见 喷嚏不停，随即鼻衄不止，其面赤唇红，脉象浮大，急以旋覆代赭石汤煎服，鼻血 减少，再服第二剂，呃声依然，且系一舂一舂。
再诊脉浮细无力，关部见沉，断为胃寒。面赤者，假热也。一舂一舂者，呃在下焦 ，丹田无阳气上升也。虑有关格变幻，改方：
附子二钱，上桂一钱，炙草一钱，炙西党二钱，九节菖蒲二钱，煨姜一钱，枣二枚 水煎，童便一杯兑服。
服后呃止大半，不再一舂一舂，自觉微汗。因进粥一碗，呃声复作，断续不停。知 胃中有水气，再用旋覆代赭石汤，服之收效。
男，30岁
病呃，家人咸认为败症，急于求救。脉数有力，前后相应，面赤而亮，唇舌微红， 此人素喜炙■，恒以酒代菜。断乃热停上焦，实由饮食不节所致，非大病后之虚呃 、冷呃可比。书方：
枇杷叶二钱，鲜芦根三钱，旋覆花（布包炖）二钱，九节菖蒲钱半，代赭石二钱， 原寸冬二钱，藕节三个，公丁香一钱。
连服四剂，病告霍然。大凡呃症误于人参桂附者十之八、九，而误于清凉者，十不 得一耳。
此人呃病获愈后，乘舆至南昌吃酒看戏，并纳一妾，住客栈四月有余。一日，携妾 过吾门，见其形容大变，肌削骨露，走路挺胸，语言反常，不若往日之从容态度， 度其有蛊惑病。两年春，腹大如鼓，不能转侧，亦不能多食，二便不通者五日，日 夜不宁。脉无伦次，件关部应指。检验足板心，已填满而不见纹，人中亦平，两腰 不能插手。似此情况，已频肝肾两绝无疑。总由酒色过度，酿成蛊胀，此蠱字当系 血气相搏也。乃父力促拟方，余写一“蠱”字，请其翻书考核，且云此人满盘实症 ，实属虚候，青筋贯胸，胃气亦绝也。今肝、肾、胃三家俱绝，危在旦夕，乃谢绝 处方。好贪色者，当以此为戒也。
6、食物中毒
垫下村熊家一妇，在草坪上得到草菰一篮，归家煮食。午后二时左右，全家八口均 不做声，伏倒地上，邻人向我素方，令取草菰生长地上之土，化水澄清温服。傍晚 ，八口安然。
男，4岁
腹痛叫喊，日夜不安。问其曾食生冷否？旁人指盛田螺之缺缸云：“吃过田螺。” 余视缸内，见马蟥浮出，忆医书（书名记不起）有误食马蟥而腹痛者，遂疑其曾吃 马蟥，嘱取黄泥水给儿食，无效。后经老农指点，改取田中泥水，服下竟愈。
7、腹痛、泄泻
男，15岁
泄泻一月不止，渴，能食，肢软神疲，脉涩腹胀，舌见黄褐，断有积湿，方用
西庄二钱，朴硝一钱，枳实一钱，山楂钱半，广香八分
服一剂，大下杂物，腹胀大减，两剂泻止。因患者不愿服药，自此而愈。此通因通 用法也。
男，43岁
腹痛，满腹哇哇如雷鸣，面色惨淡，舌色灰白，脉象沉滑，食欲、大便如常。此由 饮食不节，致水蓄三焦，处方五苓散加味
泽泻、猪苓、云苓、白术、吴茱萸各二钱，桂枝钱半，川姜一钱。服下一剂，腹 中无响声，痛亦减轻。改方：
扁豆、焦楂、泽泻、云苓、猪苓、白术、吴茱萸各二钱，上桂八分，川姜一钱。服 两剂，获全愈。
男，12岁
腹痛、泄泻、口渴，面色微红，舌无厚滞，中心黄色。此宿食停滞中焦，致痛时捧 腹大叫，不宜攻下，以消导为主。
麦芽二钱，川朴钱半，山楂钱半，半夏曲钱半，大白一钱，苍术钱半、广香二钱， 黄连炒吴茱萸二钱，金铃子钱半，一服而安。
男，年未详
食王瓜后，泄泻不止，血似射箭状，烦躁坐卧不安，脉见数滑，乃热迫下注，与湿 相搏，致成飧泄。以地浆水煎服：于门槛内挖一坑，深尺许，用新汲水倾入，手■ （搅？）百下，取出，贮罐中澄清温服，泻稍减，疏方：
黄芩钱半，黄连钱半，伏龙肝一块，益元散三钱，炙草一钱，乌梅两个金钗石斛二 钱，楂肉一钱
此黄土与黄连进退汤合用，服后得全功。
男，36岁
常患腹痛泄泻。此次发病，乃食生冷油腻而地，日下利数十行，体渐不支，起坐不 稳。其腹鸣如雷，稍觉疼痛，舌苔厚滞不渴，亦不恶寒，脉见沉滑。初投五苓散， 无效。
复诊改方：
附子二钱，补骨脂、煨肉叩、炙党参、益智仁、焦术各二钱，川姜一钱，东波叩钱 半，乌梅二个。
服两剂，日下利仅二、三次，于前方加：
五味子钱半，赤石脂炒当归二钱，两剂痊可。
男，25岁
一贯身体强壮，无疾病。某晚攀鱼，被横木撞伤脐下，并摔了一跤，比即疼痛难忍 。另日人事昏沉，痛苦难言，脉浮数互见，面红而亮，目合眉蹙，翻来覆去。其父 疑是房劳成痛，余问其阴茎痛否？答曰不痛，但小腹气往上冲。因疑是奔豚，然细 察之，不咳不喘，何来奔豚？必乃跌仆受凉，激动肝气，致令小腹作痛，肝性急， 宜缓之。疏方逍遥散：
柴胡、黄芩、生地各二钱，川芎钱半，甘草（炙）一钱，炒白芍三钱
服一剂，当晚较安静。另日微热蒸蒸烙手，面朝里睡，透大气，知热从外解，不能 补肾，于原方加：
丝瓜络三钱，凤尾草钱半同煎，另用左金丸一钱，随药吞服。
服二剂，热退痛减，患者能起床，小腹无气上冲现象，喜按。改以养气安肾法，以 防水不济木，致动肝风。
荔枝核二钱，生地、杭芍、肉苁蓉、菟丝子、覆盆子、安痛藤、当归、丝瓜络各二 钱，桑螵蛸十个（炙），川芎钱半。两剂而痊。
5、交肠
蒋女，24岁
二便反常，逾半月之久，不肯告人。伊夫外归，询之病情，告以小便出屎，大便出 尿，伊夫闻之骇然。迭延数医，皆未应手。后更黎医，适我由乡进城，过蒋家，蒋 急召之。盖与我是窗友，而黎与余，亦时相过从。商诸病情，黎认蒋妇为交肠症。 余问处何方？其踌躇不决。蒋力促之，拟补中益气汤，余见之恍然大悟，预卜此方 有效。黎去后，蒋询此方用意，余答以二便易位，其病因或大怒，或醉饱，或房室 过度，以致脏气乖乱，反其常轨，法当开提其气，黎先用升提，诚高明之见也。服 药后，是夜未见起卧不安，二便然同出。次日会诊，黎询用原方否？余建议原方剂 量，稍予增加。即白术三钱，升麻二钱，黄芪五钱生炙各半，另加桔梗四钱，杏仁 四钱。盖桔梗载药上升，杏仁宣通肺气，黄芪生炙各半者，取其补气而温中也。照 方服两剂，二便不再混乱，精神好转，黎再商善后，余意以分利为宜，方用五苓散 加味，须严禁房事。依余法，获全愈。后以十全大补丸调理之。
此从病论证，先用升提，后用分利，乃急者缓之之意。至于小便出屎，余以为不确 ，乃黄浊水也。请同道指正。
9、脱肛
男，52岁
肛门脱出十余日，胀痛交加，行路碍难，六脉沉细无力，气虚下陷已明。嘱寻蜣螂 七只，置瓦上焙燥研末，加入冰片和匀，先以葱白煎水先熏后洗，然后渗上药末， 用手托进。另购补中益气丸四两，每日早晚各用四十粒，如是肛门渐收还原。后复 发，再来索方，乃令觅田螺三、四只，放入冰片，露一宿，以其水刷肛门，当晚肛 门上收。亦服补中益气丸善后。
10、吐泻交作
女，49岁上呕下泄，面见红光，舌微红，无■气，不脉浮数。余认作水停心下，以 分利为治。但吐泻未止，改以：
代赭石二钱，西党三钱，焦术二钱，公丁香一钱，甘草（炙）一钱，姜枣各二。
服下呕止，然红光满面，欲索饮，又不敢饮，饮入即吐，如上焦有热，中焦有寒。 吃热物即吐者，热与热相争也。换方：
吴茱萸三钱，杭芍二钱，台党三钱，姜枣各二令冷服。
服下不呕，泻亦减轻，其转黄水。其吃生黄瓜后腹痛，乃用山楂研末，煎服立效。
女，60岁
上呕下泄，水浆不入者三、四日（据述食水管菜煮粥后发病），脉散无度，舌色灰 白，唇色惨白，此寒湿停中无疑，处以五苓散，借以分利。服后呕虽止，而泻如故 ，仍不欲饮。改方：
焦术二钱，乌梅三个，扁豆、焦山楂、东波叩、金钗石斛、法夏曲、炙党各二钱， 川姜一钱。服一包，泄止呕止，但仍不进饮食，两颐红亮，垂头丧气，贪睡，断其 胃肠不升，而胃部尚有郁热，故不纳食。贪睡者，乃脾运不前也。急宜养胃，切忌 燥津，处方玉女煎加味：
玉竹、南沙参、扁豆衣、连翘心、麦冬心各二钱，知母钱半，生石膏三钱
服两剂，两颐红退，欲食肉，不吃粥。吃粥则大汗出，叫热。此胃热在上，热与热 相抗也，遂令进肉汤，勿食肉，如此三日，完全告愈。
男，35岁
【背景信息】
书名：医学经验录·医案 章节：正文(2/14) 类别：医论
食欲很好，但每次进食后半小时以及劳动时就会剧烈呕吐，必须将食物全部吐出来才停止。因此，他四、五年来天天闲坐在家。其面色灰黄，脉象浮而软，这是胃津枯竭，导致无法承受劳累。患者无力服用汤药，想要寻求单方，我让他购买甘蔗一根，炖水代茶饮用。或者用荷叶包裹肉类煨熟食用。最后可以寻找黄鼠狼的肝脏，在瓦片上煅烧后研成粉末，用温酒冲服。这三方都采用，果然有效。
男性，25岁
患呕吐病三年，时发时止。近一个月来，吃进去就吐，如果不把胃里的东西倒干净，就不会停止。医生诊断为膈症（噎膈），引用古语说：“痰痨鼓膈，妙药难医”。诊脉沉细有力，唇色淡红，舌中微黄而边缘绛红。我认为膈症是胃津干竭，此证属于痰火上逆，投以半夏泻心汤：
半夏三钱，台党参（代替人参）三钱，苏梗半钱，瓜蒌仁二钱，黄芩二钱，海浮石二钱，竹茹二钱，沙参三钱
服用五剂后，呕吐之势缓和，但喝粥仍会呕吐，吃米饭谷物则好转，且能闻到饭香，并有食欲。脉象沉，按之应指有力。判断胃气有转机，修改处方：
西党参三钱，半夏、旋覆花（布包炖煮）、代赭石、竹茹、海浮石、柿霜、瓜蒌霜、沙参、金钗石斛各二钱
另外取黄牛口中咀嚼剩下的草，扯出一把，放在瓦上煅干研末，加入药中同煎。
服用十剂后，病去十分之八、九。再求断根方，我嘱咐忌闻大粪气味（患者是花匠），忌食香燥之物，还要禁忌房事。给出方子：
玉竹三钱，沙参二钱，冬瓜子、鲜金石斛、豆蔻各二钱，梨皮一把，甘蔗汁一杯。连服十余剂，病人恢复健康。
4、便秘
男性，55岁
便秘七八日，能吃能走，但饭后感到饱胀，夜间不能入睡，脉象沉而紧，舌淡红而无津液。判断为中气不足，胃津枯涸，阻碍运化，导致脾肾同病。仿照“塞因塞用”法治疗。
熟地黄、台党参各四钱，北黄芪、当归各三钱，炙甘草一钱，煅龙骨、巴戟天、益智仁、淡肉苁蓉、补骨脂各二钱，生姜、大枣为引。
服用两剂，大便通畅。服完四剂后，出现嘈杂感，有时打嗝排气。在原方中去掉益智仁、补骨脂、肉苁蓉，加入金钗石斛二钱、霍山石斛二钱、覆盆子二钱、毕澄茄二钱。两剂后安稳。
男性，50岁
便秘五日，发热不退，舌苔黄，嘴唇赤红，两颊红亮，脉象浮数，两胁隐痛，口苦，厌恶进食。我将其辨为阳明胃家实热证。
厚朴二钱，大黄（水浸不煮）三钱，风化硝二钱，枳实半钱。服用两剂，排出多节丸状粪便，顿感舒适。复诊时脉数而软，改用葛根解肌汤，两剂痊愈。
初诊开方时，某人认为此证乃少阳病候，不可以用承气汤类方剂。其理由是胸胁隐痛且口苦。我认为此证以阳明为主，虽然胸胁隐痛，但不觉得苦满，不具备少阳主证。至于口苦，太阳、阳明病皆可出现，并非少阳独有。
5、呃逆
男性，50岁
发热后出现打呃，面红唇紫，舌有裂纹，诊脉浮数无根。推测为胃津枯竭，乃是变性的煎厥证，不敢轻易处方。然而病家一再催促，遂给予五汁饮。
萝卜捣汁、梨汁、藕汁、郁金（水浸捣汁）三钱，甘蔗汁各一杯，混合均匀冷服。到了傍晚，呃声较短，仍未停止。
复诊时脉数无力，诸症如前。我担心其素来终日醉酒，导致胃津枯竭，致使胃气脱失的危险，勉强开出以下方子：
枇杷叶、金钗石斛、麦冬、郁金、代赭石、旋覆花（布包）各二钱，玉竹、生石膏各三钱。
嘱咐服用一剂。他回家后，出示我的方子，众人怀疑此药平凡，于是丢弃不用。另请某医生治疗，使用大剂量人参、附子成方。次日黎明，鼻舌皆流出鲜血，眼球赤红如朱砂，急求冷饮，当日正午去世。
此为病后变症，热邪灼伤胃津，已成煎厥，万无生机。
男性，18岁
素来喜欢喝冷水。暑天某晚喂牛归来，恣意饮用新打的井水，又吃了土瓜，次日发生呃逆，声音从中焦冲上，每次呃逆必牵动全身，并伴有漉漉声响。我看其腹部大如鼓，翻来覆去，浑身颤抖，呃声粗短，脉象浮且数。判断为水停心下，用霹雳散吹鼻，外用灯芯草通鼻，当时喷嚏连连，眼泪汪汪，顿觉轻松。我因霹雳散有毒，不可连续使用，遂停止。此时患者作呕，于是将食盐放在刀上，用火烧红，淬入盛有井水的盅内，让患者服用淬盐水，随即呕吐出一脸盆水，腹胀顿解，呃声渐平，已听不到漉漉声了，开具旋覆代赭石汤，两剂霍然痊愈。
此因饮水过多，水停心下，气逆而呃，乃取“越而上之”的方法，以通胃络。
男性，51岁
呃逆五六日，曾用箬叶煎水喝，用灯草通鼻，又用霹雳散打喷嚏，呃逆稍减。未见喷嚏不停，随即鼻衄不止，其面赤唇红，脉象浮大，急以旋覆代赭石汤煎服，鼻血减少，再服第二剂，呃声依然，且是一阵一阵的。
再诊时脉浮细无力，关部见沉，判断为胃寒。面赤者，假热也。一阵一阵者，呃在下焦，丹田无阳气上升也。虑有关格变幻，修改处方：
附子二钱，肉桂一钱，炙甘草一钱，炙西党参二钱，九节菖蒲二钱，煨姜一钱，枣二枚，水煎，兑童便一杯服用。
服用后呃逆止住大半，不再一阵一阵，自觉微汗。因为喝了一碗粥，呃声又发作，断续不停。知道胃中有水气，再用旋覆代赭石汤，服用后见效。
男性，30岁
患呃逆，家人都认为是不治之症，急于求救。脉数有力，前后相应，面赤而亮，唇舌微红。此人素来喜欢吃烤炙食物，常以酒代菜。判断为热停上焦，实由饮食不节所致，非大病后的虚呃、冷呃可比。书方：
枇杷叶二钱，鲜芦根三钱，旋覆花（布包炖）二钱，九节菖蒲半钱，代赭石二钱，原寸冬二钱，藕节三个，公丁香一钱。
连服四剂，病告霍然痊愈。大凡呃症误用人参、桂附的占十之八九，而误用清凉药的，十不得一。
此人呃病痊愈后，乘轿到南昌喝酒看戏，并纳一妾，住客栈四月有余。一日，携妾经过我家门口，见其形容大变，肌削骨露，走路挺胸，语言反常，不像往日从容的态度，推测其患有蛊惑病。第二年春天，腹大如鼓，不能转侧，也不能多吃，二便不通五日，日夜不安。脉象无伦次，仅在关部应指。检验足底板心，已填满而不见纹路，人中亦平，两腰不能插手。像这种情况，已是肝肾两绝无疑。总归是酒色过度，酿成蛊胀，这个“蛊”字应当是血气相搏的意思。其父力促拟方，我写了一个“蛊”字，请其翻书考核，并且说此人满盘实症，实属虚候，青筋贯胸，胃气亦绝也。如今肝、肾、胃三家俱绝，危在旦夕，于是谢绝处方。好贪色的人，应当以此为戒。
6、食物中毒
垫下村熊家一位妇人，在草坪上得到一篮草菇，回家煮食。午后二时左右，全家八口均不出声，伏倒在地上，邻居向我索要单方，令取草菇生长地上的土，化水澄清温服。傍晚，八口安然无恙。
男性，4岁
腹痛叫喊，日夜不安。问其是否吃过生冷？旁人指着盛放田螺的缺缸说：“吃过田螺。”我看缸内，见蚂蟥浮出，回忆医书中记载有误食蚂蟥而腹痛者，遂疑其曾吃蚂蟥，嘱取黄泥水给儿服用，无效。后经老农指点，改取田中泥水，服下竟愈。
7、腹痛、泄泻
男性，15岁
泄泻一月不止，口渴，能食，肢体软弱神疲，脉涩腹胀，舌见黄褐色，判断有积湿，方用：
西庄（注：疑为西庄或特定药材别名，此处保留原名）二钱，朴硝一钱，枳实一钱，山楂半钱，广香八分。
服用一剂，大下杂物，腹胀大减，两剂泻止。因患者不愿服药，自此而愈。此乃“通因通用”法。
男性，43岁
腹痛，满腹鸣响如雷鸣，面色惨淡，舌色灰白，脉象沉滑，食欲、大便如常。此由饮食不节，致水蓄三焦，处方五苓散加味：
泽泻、猪苓、云茯苓、白术、吴茱萸各二钱，桂枝半钱，川姜一钱。服用一剂，腹中无响声，痛亦减轻。改方：
扁豆、焦山楂、泽泻、云茯苓、猪苓、白术、吴茱萸各二钱，上肉桂八分，川姜一钱。服用两剂，获全愈。
男性，12岁
腹痛、泄泻、口渴，面色微红，舌无厚滞，中心黄色。此宿食停滞中焦，致痛时捧腹大叫，不宜攻下，以消导为主。
麦芽二钱，川厚朴半钱，山楂半钱，半夏曲半钱，大白（白芍？）一钱，苍术半钱、广香二钱，黄连炒吴茱萸二钱，金铃子半钱，一服而安。
男性，年龄不详
食王瓜后，泄泻不止，血似射箭状，烦躁坐卧不安，脉见数滑，乃热迫下注，与湿相搏，致成飧泄。以地浆水煎服：于门槛内挖一坑，深尺许，用新汲水倾入，手搅百下，取出，贮罐中澄清温服，泻稍减，疏方：
黄芩半钱，黄连半钱，伏龙肝一块，益元散三钱，炙甘草一钱，乌梅两个，金钗石斛二钱，楂肉一钱。
此黄土与黄连进退汤合用，服后得全功。
男性，36岁
常患腹痛泄泻。此次发病，乃食生冷油腻而致，日下利数十行，体渐不支，起坐不稳。其腹鸣如雷，稍觉疼痛，舌苔厚滞不渴，亦不恶寒，脉见沉滑。初投五苓散，无效。
复诊改方：
附子二钱，补骨脂、煨肉豆蔻、炙党参、益智仁、焦白术各二钱，川姜一钱，豆蔻半钱，乌梅二个。
服用两剂，日下利仅二、三次，于前方加：
五味子半钱，赤石脂炒当归二钱，两剂痊可。
男性，25岁
一贯身体强壮，无疾病。某晚攀鱼，被横木撞伤脐下，并摔了一跤，随即疼痛难忍。次日人事昏沉，痛苦难言，脉浮数互见，面红而亮，目合眉蹙，翻来覆去。其父疑是房劳成痛，我问其阴茎痛否？答曰不痛，但小腹气往上冲。因疑是奔豚，然细察之，不咳不喘，何来奔豚？必乃跌仆受凉，激动肝气，致令小腹作痛，肝性急，宜缓之。疏方逍遥散：
柴胡、黄芩、生地各二钱，川芎半钱，甘草（炙）一钱，炒白芍三钱。
服用一剂，当晚较安静。次日微热蒸蒸烙手，面朝里睡，打嗝排气，知热从外解，不能补肾，于原方加：
丝瓜络三钱，凤尾草半钱同煎，另用左金丸一钱，随药吞服。
服用两剂，热退痛减，患者能起床，小腹无气上冲现象，喜按。改以养气安肾法，以防水不济木，致动肝风。
荔枝核二钱，生地、杭白芍、肉苁蓉、菟丝子、覆盆子、安痛藤、当归、丝瓜络各二钱，桑螵蛸十个（炙），川芎半钱。两剂而痊。
5、交肠
蒋女，24岁
二便反常，逾半月之久，不肯告人。其夫外出归来，询问病情，告知小便出屎，大便出尿，其夫闻之骇然。接连延请几位医生，皆未应手。后更请黎医生，恰逢我从乡进城，路过蒋家，蒋急召之。盖与我是窗友，而黎与我，亦时相过从。商诸病情，黎认蒋妇为交肠症。我问处何方？其踌躇不决。蒋力促之，拟补中益气汤，我见之恍然大悟，预卜此方有效。黎去后，蒋询此方用意，我答以二便易位，其病因或大怒，或醉饱，或房室过度，以致脏气乖乱，反其常轨，法当开提其气，黎先用升提，诚高明之见也。服药后，是夜未见起卧不安，二便自然同出。次日会诊，黎询用原方否？我建议原方剂量，稍予增加。即白术三钱，升麻二钱，黄芪五钱生炙各半，另加桔梗四钱，杏仁四钱。盖桔梗载药上升，杏仁宣通肺气，黄芪生炙各半者，取其补气而温中也。照方服两剂，二便不再混乱，精神好转，黎再商善后，我意以分利为宜，方用五苓散加味，须严禁房事。依余法，获全愈。后以十全大补丸调理之。
此从病论证，先用升提，后用分利，乃急者缓之之意。至于小便出屎，我以为不确，乃黄浊水也。请同道指正。
9、脱肛
男性，52岁
肛门脱出十余日，胀痛交加，行路碍难，六脉沉细无力，气虚下陷已明。嘱寻蜣螂七只，置瓦上焙燥研末，加入冰片和匀，先以葱白煎水先熏后洗，然后渗上药末，用手托进。另购补中益气丸四两，每日早晚各用四十粒，如是肛门渐收还原。后复发，再来索方，乃令觅田螺三、四只，放入冰片，露一宿，以其水刷肛门，当晚肛门上收。亦服补中益气丸善后。
10、吐泻交作
女性，49岁
上呕下泄，面见红光，舌微红，无秽气，脉浮数。我认作水停心下，以分利为治。但吐泻未止，改以：
代赭石二钱，西党参三钱，焦白术二钱，公丁香一钱，甘草（炙）一钱，姜枣各二枚。
服用后呕止，然红光满面，欲索饮，又不敢饮，饮入即吐，如上焦有热，中焦有寒。吃热物即吐者，热与热相争也。换方：
吴茱萸三钱，杭白芍二钱，台党参三钱，姜枣各二枚，令冷服。
服用后不呕，泻亦减轻，其转黄水。其吃生黄瓜后腹痛，乃用山楂研末，煎服立效。
女性，60岁
上呕下泄，水浆不入者三、四日（据述食水管菜煮粥后发病），脉散无度，舌色灰白，唇色惨白，此寒湿停中无疑，处以五苓散，借以分利。服后呕虽止，而泻如故，仍不欲饮。改方：
焦白术二钱，乌梅三个，扁豆、焦山楂、豆蔻、金钗石斛、法半夏曲、炙党参各二钱，川姜一钱。服用一包，泄止呕止，但仍不进饮食，两颐红亮，垂头丧气，贪睡，断其胃肠不升，而胃部尚有郁热，故不纳食。贪睡者，乃脾运不前也。急宜养胃，切忌燥津，处方玉女煎加味：
玉竹、南沙参、扁豆衣、连翘心、麦冬心各二钱，知母半钱，生石膏三钱。
服用两剂，两颐红退，欲食肉，不吃粥。吃粥则大汗出，叫热。此胃热在上，热与热相抗也，遂令进肉汤，勿食肉，如此三日，完全告愈。
男性，35岁
[Background Information]
Book Title: Medical Experience Records · Medical Cases Chapter: Main Text (2/14) Category: Medical Discussion
Appetite is quite good, but half an hour after every meal and during labor, severe vomiting occurs, requiring the complete expulsion of food before cessation. Consequently, he has been idle at home for four or five years. His complexion is grayish-yellow, and the pulse is floating and soft; this indicates exhaustion of Stomach Yin fluids, leading to an inability to bear physical exertion. The patient lacks the strength to take decoctions and seeks a single-herb prescription. I instructed him to purchase one sugarcane stalk, stew it in water, and drink it as tea. Alternatively, meat can be wrapped in lotus leaves and simmered for consumption. Finally, the liver of a weasel may be obtained, calcined on a tile until dry, ground into powder, and taken with warm wine. All three methods were employed, and they proved effective.
Male, 25 years old
Suffering from vomiting for three years, intermittent in nature. For the past month, vomiting occurs immediately upon eating; restlessness persists until all gastric contents are expelled. Physicians diagnosed this as Ge Syndrome (Dysphagia/Regurgitation), citing the saying: "Phlegm, consumption, drum distension, and dysphagia are difficult to cure even with miraculous medicines." The pulse is deep, fine, and forceful; lips are pale red; the center of the tongue is slightly yellow, and the edges are crimson. I consider Ge Syndrome to result from dryness and exhaustion of Stomach Yin fluids; this specific case involves rebellious Phlegm-Fire. I prescribed Banxia Xiexin Tang (Pinellia Decoction to Drain the Epigastrium):
Banxia (Pinelliae Rhizoma) 3 qian, Ta Dangshen (Codonopsis Radix, substituting for Renshen) 3 qian, Suhong (Perillae Caulis) 0.5 qian, Louren (Trichosanthis Semen) 2 qian, Huangqin (Scutellariae Radix) 2 qian, Haifushi (Pumex) 2 qian, Zhuru (Bambusae Caulis in Taenia) 2 qian, Shashen (Glehniae Radix) 3 qian.
After taking five doses, the intensity of vomiting subsided, but drinking congee still induced vomiting. However, eating rice and grains improved, the aroma of rice became perceptible, and appetite returned. The pulse is deep and palpable. Judging that Stomach Qi shows signs of recovery, the prescription was modified:
Xidangshen (Codonopsis Radix) 3 qian, Banxia (Pinelliae Rhizoma), Xuanfuhua (Inulae Flos, wrapped in cloth and decocted), Daizheshi (Ochrae Fragmentum), Zhuru (Bambusae Caulis in Taenia), Haifushi (Pumex), Shishuang (Diospyros Fructus Frost), Gualoushuang (Trichosanthis Pericarpium Frost), Shashen (Glehniae Radix), Jinchai Shihu (Dendrobii Nobile Caulis) each 2 qian.
Additionally, grass remaining in the mouth of a yellow ox was collected, about a handful, calcined on a tile until dry, ground into powder, and added to the medicine for simultaneous decoction.
After ten doses, eight or nine-tenths of the illness had passed. Seeking a root-curing prescription, I advised avoiding the smell of feces (the patient is a gardener), avoiding pungent and drying foods, and abstaining from sexual intercourse. The prescription given was:
Yuzhu (Polygonati Odorati Rhizoma) 3 qian, Shashen (Glehniae Radix) 2 qian, Dongguazi (Benincasae Semen), Xian Jin Shihu (Dendrobii Candidi Caulis), Doukou (Amomi Fructus Rotundus) each 2 qian, Pear skin a handful, Sugarcane juice one cup. Taken continuously for over ten doses, the patient recovered completely.
4. Constipation
Male, 55 years old
Constipated for seven or eight days; able to eat and walk, but feels full after meals; unable to sleep at night. Pulse is deep and tight; tongue is pale red without moisture. Diagnosed as deficiency of Middle Qi and exhaustion of Stomach Yin fluids, hindering transportation and transformation, resulting in concurrent Spleen and Kidney pathology. Following the principle of "treating obstruction with obstruction" (Se Yin Se Fa).
Shudi (Rehmanniae Radix Preparata) and Ta Dangshen (Codonopsis Radix) each 4 qian, Beiqi (Astragali Radix) and Danggui (Angelicae Sinensis Radix) each 3 qian, Zhi Cao (Glycyrrhizae Radix et Rhizoma Preparatum) 1 qian, Duanyulong (Os Draconis Preparatum), Bajitian (Morindae Officinalis Radix), Yizhiren (Alpiniae Oxyphyllae Semen), Dan Roucongrong (Cynomorii Herba), Buguzhi (Psoraleae Fructus) each 2 qian, Jiang (Zingiberis Rhizoma) and Zao (Jujubae Fructus) as guides.
After two doses, bowel movement occurred. After finishing four doses, epigastric discomfort arose, accompanied by occasional belching. In the prescription, remove Yizhiren (Alpiniae Oxyphyllae Semen), Buguzhi (Psoraleae Fructus), and Roucongrong (Cynomorii Herba); add Jinchai Shihu (Dendrobii Nobile Caulis) 2 qian, Huoshan Shihu (Dendrobii huoshanense Caulis) 2 qian, Fupenzi (Rubiae Fructus) 2 qian, Bichengqie (Myristicae Semen) 2 qian. Two doses brought stability.
Male, 50 years old
Constipated for five days; fever persists; tongue coating is yellow; lips are red; both cheeks are bright red; pulse is floating and rapid; dull pain in both hypochondria; bitter taste; aversion to food. I diagnosed this as Excess Heat in the Stomach House (Yangming Organ Excess).
Houpo (Magnoliae Officinalis Cortex) 2 qian, Dahuang (Rhei Radix et Rhizoma, soaked in water, not boiled) 3 qian, Fenghua Xiao (Natrii Sulfas Efflorescens) 2 qian, Zhishi (Aurantii Fructus Immaturus) 0.5 qian. After two doses, multiple pellet-like stools were passed, bringing immediate relief. On follow-up, the pulse was rapid and soft; Ge Gen Jie Ji Tang (Kudzu Decoction to Release the Muscle Layer) was prescribed, curing the condition in two doses.
During the initial consultation, someone argued that this was a Shaoyang syndrome and Chengqi Decoctions should not be used, citing dull hypochondriac pain and bitter taste. I maintained that this case is primarily Yangming. Although there is dull hypochondriac pain, there is no sensation of fullness and bitterness characteristic of Shaoyang. As for bitter taste, it can occur in both Taiyang and Yangming syndromes, not exclusively Shaoyang.
5. Hiccups
Male, 50 years old
Hiccups appeared after fever; face is red, lips purple; tongue has cracks; pulse is floating, rapid, and rootless. Suspecting exhaustion of Stomach Yin fluids leading to a variant form of Jian Jue (Frying Convulsion), I dared not prescribe initially. However, under persistent urging from the family, I administered Wuzhi Yin (Five Juices Drink).
Radish juice, Pear juice, Lotus root juice, Yujin (Curcumae Radix, soaked and crushed) 3 qian, Sugarcane juice each one cup. Mixed evenly and taken cold. By evening, hiccups were shorter but did not cease.
On follow-up, the pulse was rapid and weak; symptoms remained unchanged. Concerning his history of daily drunkenness causing Stomach Yin exhaustion and potential Stomach Qi collapse, I reluctantly prescribed:
Pipaye (Eriobotryae Folium), Jinchai Shihu (Dendrobii Nobile Caulis), Maidong (Ophiopogonis Radix), Yujin (Curcumae Radix), Daizheshi (Ochrae Fragmentum), Xuanfuhua (Inulae Flos, wrapped) each 2 qian; Yuzhu (Polygonati Odorati Rhizoma) and Sheng Shigao (Gypsum Fibrosum) each 3 qian.
Instructed to take one dose. Upon returning home, he showed the prescription to others, who doubted its efficacy due to its simplicity, and discarded it. Another physician was consulted, who prescribed a large dose of Renshen (Ginseng Radix) and Fuzi (Aconiti Lateralis Radix Preparata). At dawn the next day, bleeding occurred from the nose and tongue; eyes were blood-red like cinnabar; urgent craving for cold drinks ensued; the patient died at noon that day.
This is a post-illness complication where heat scorches Stomach Yin, resulting in Jian Jue (Frying Convulsion), which is incurable.
Male, 18 years old
Accustomed to drinking cold water. One summer night, after feeding cattle, he drank newly drawn well water excessively and ate Cucurbita ficifolia (Tu Gua). The next day, hiccups developed, rising from the Middle Jiao, causing whole-body tremors and audible gurgling sounds. Abdomen was distended like a drum; he tossed and turned, shivering; hiccups were coarse and short; pulse was floating and rapid. Diagnosed as Water Retention in the Heart/Lower Chest area. Used Pili San (Thunder Powder) insufflated into the nose, and Dengxincao (Spargani Rhizoma) to clear nasal passages. Sneezing occurred repeatedly, tears flowed, and immediate relief was felt. Due to toxicity concerns with Pili San, usage was stopped. The patient then vomited. Salt was placed on a knife, heated red-hot, and quenched in a cup of well water. The patient drank this salt-quenched water, vomiting a basin-full, resolving abdominal distension and calming hiccups. Xuanfu Daizhe Tang (Inula and Hematite Decoction) was prescribed, curing the condition in two doses.
This resulted from excessive water intake causing Water Retention in the Heart/Lower Chest, with rebellious Qi causing hiccups. The method of "venting upwards" was used to unblock the Stomach collaterals.
Male, 51 years old
Hiccups for five to six days. Previously tried Ruoye (Bamboo Leaf) decoction, Dengcao nasal clearing, and Pili San sneezing induction, with slight reduction. No continuous sneezing occurred; instead, epistaxis persisted. Face red, lips red, pulse floating and large. Urgently prescribed Xuanfu Daizhe Tang (Inula and Hematite Decoction); epistaxis decreased. Second dose: hiccups persisted, occurring in paroxysms.
Second follow-up: Pulse floating, fine, and weak; Guan position is deep. Diagnosed as Cold in the Stomach. Facial redness is false heat. Paroxysmal hiccups indicate pathology in the Lower Jiao, lacking ascending Yang Qi from the Dantian. Suspecting complex blockage (Guan Ge), the prescription was modified:
Fuzi (Aconiti Lateralis Radix Preparata) 2 qian, Shang Gui (Cinnamomi Cortex) 1 qian, Zhi Cao (Glycyrrhizae Radix et Rhizoma Preparatum) 1 qian, Zhi Xidangshen (Codonopsis Radix Preparatum) 2 qian, Jiujie Changpu (Acori Tatarinowii Rhizoma) 2 qian, Wei Jiang (Zingiberis Rhizoma Preparatum) 1 qian, Zao (Jujubae Fructus) 2 pieces. Decocted in water, mixed with one cup of Tongbian (Child's Urine).
After administration, hiccups ceased largely, paroxysms stopped, and slight sweating occurred. After eating a bowl of congee, hiccups recurred intermittently. Recognizing Water Qi in the Stomach, Xuanfu Daizhe Tang (Inula and Hematite Decoction) was used again, yielding results.
Male, 30 years old
Suffering from hiccups; family considered it a terminal syndrome, seeking urgent help. Pulse is rapid and forceful, consistent front and back; face is bright red; lips and tongue slightly red. This person prefers roasted/grilled foods and substitutes alcohol for vegetables. Diagnosed as Heat Stagnation in the Upper Jiao, caused by dietary irregularity, distinct from deficiency or cold hiccups following severe illness. Prescription:
Pipaye (Eriobotryae Folium) 2 qian, Xian Lugen (Phragmitis Rhizoma) 3 qian, Xuanfuhua (Inulae Flos, wrapped) 2 qian, Jiujie Changpu (Acori Tatarinowii Rhizoma) 0.5 qian, Daizheshi (Ochrae Fragmentum) 2 qian, Yuancun Dong (Ophiopogonis Radix) 2 qian, Ou jie (Nelumbinis Node) 3 pieces, Gong Dingxiang (Caryophylli Flos) 1 qian.
Taken continuously for four doses, the illness resolved completely. Generally, eight or nine out of ten cases of hiccups are mismanaged with Renshen (Ginseng Radix), Guizhi (Cinnamomi Ramulus), and Fuzi (Aconiti Lateralis Radix Preparatum), while fewer than one in ten are mismanaged with cooling herbs.
After recovering from hiccups, this person traveled to Nanchang by sedan chair to drink and watch plays, taking a concubine, and stayed in an inn for over four months. One day, passing my door with his concubine, his appearance had changed drastically: emaciated, bones protruding, walking with chest thrust out, speech abnormal, lacking his usual composure. I suspected Gu Huo Disease (Gu Poison/Disease). In the spring of the second year, abdomen distended like a drum, unable to turn or eat much; urination and defecation blocked for five days; restless day and night. Pulse was chaotic, only palpable at the Guan position. Examination of the sole revealed filled texture with no visible lines; Renzhong (philtrum) was flat; waist could not bend. This situation clearly indicated exhaustion of Liver and Kidney. Ultimately caused by excess alcohol and sexual indulgence leading to Gu Zhang (Gu Distension). The character "Gu" here implies struggle between Blood and Qi. His father urged a prescription. I wrote the character "Gu" and asked him to consult books, stating that although the presentation seemed Excess, it was actually Deficiency; Green veins traversed the chest, and Stomach Qi was exhausted. With Liver, Kidney, and Stomach all exhausted, death was imminent. I declined to prescribe. Those greedy for lust should take this as a warning.
A woman from the Xiong family in Dianxia Village found a basket of wild mushrooms on a lawn and cooked them at home. Around 2 PM, all eight family members fell silent and collapsed on the floor. Neighbors requested a prescription from me, instructing to take soil from where the mushrooms grew, dissolve it in water, clarify, and administer warm. By evening, all eight were safe.
Male, 4 years old
Abdominal pain with crying, restless day and night. Asked if he ate raw/cold food? Others pointed to a cracked jar containing snails: "He ate snails." Inspecting the jar, leeches were seen floating. Recalling medical texts mentioning abdominal pain from ingesting leeches, I suspected he ate leeches and instructed giving Yellow Mud Water, which failed. Later guided by an old farmer, changing to Field Mud Water cured him.
7. Abdominal Pain and Diarrhea
Male, 15 years old
Diarrhea persisting for a month; thirsty; able to eat; limbs weak, spirit fatigued; pulse choppy, abdominal distension; tongue yellow-brown. Diagnosed with Accumulated Dampness. Prescription:
Xizhuang (Note: Likely a local herb name or typo, retained as is) 2 qian, Pu Xiao (Natrii Sulfas) 1 qian, Zhishi (Aurantii Fructus Immaturus) 1 qian, Shanzha (Crataegi Fructus) 0.5 qian, Guangxiang (Agastaches Rugosae Herba) 0.8 fen.
One dose resulted in passage of miscellaneous matter, significantly reducing distension. Two doses stopped diarrhea. Patient refused further medication, thus cured. This employs the "Treat Obstruction with Unblocking" (Tong Yin Tong Yong) method.
Male, 43 years old
Abdominal pain, borborygmi throughout the abdomen like thunder; pallid complexion; tongue gray-white; pulse deep and slippery; appetite and stool normal. Caused by dietary irregularity leading to Water accumulation in the Triple Burner. Prescription: Wuling San (Five-Ingredient Powder with Poria) modified.
Zexie (Alismatis Rhizoma), Zhuling (Polypori Umbellati Pars), Yunling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma), Wuzhuyu (Evodiae Fructus) each 2 qian; Guizhi (Cinnamomi Ramulus) 0.5 qian; Chuanjiang (Zingiberis Rhizoma Recens) 1 qian. One dose eliminated borborygmi and reduced pain. Modified prescription:
Baidou (Phaseoli Semen), Jiao Zhacha (Charred Crataegi Fructus), Zexie (Alismatis Rhizoma), Yunling (Poria), Zhuling (Polypori Umbellati Pars), Baizhu (Atractylodis Macrocephalae Rhizoma), Wuzhuyu (Evodiae Fructus) each 2 qian; Shanggui (Cinnamomi Cortex) 0.8 fen; Chuanjiang (Zingiberis Rhizoma Recens) 1 qian. Two doses resulted in complete recovery.
Male, 12 years old
Abdominal pain, diarrhea, thirst; slightly red face; tongue not thick/greasy, yellow center. Old food stagnation in the Middle Jiao causing pain and loud crying when holding abdomen. Purging is inappropriate; focus on digestion and guiding out.
Maiya (Hordei Fructus Germinatus) 2 qian, Chuanpu (Magnoliae Officinalis Cortex) 0.5 qian, Shanzha (Crataegi Fructus) 0.5 qian, Banxiaqu (Pinelliae Fermentatum) 0.5 qian, Bai Shao (Paeoniae Radix Alba) 1 qian, Cangzhu (Atractylodis Rhizoma) 0.5 qian, Guangxiang (Agastaches Rugosae Herba) 2 qian, Huanglian (Coptidis Rhizoma) stir-fried with Wuzhuyu (Evodiae Fructus) 2 qian, Jinlingzi (Meliae Semen) 0.5 qian. One dose brought peace.
Male, Age Unknown
After eating Wanggua (likely a type of melon), diarrhea persisted uncontrollably; blood shot out like an arrow; irritability, restlessness; pulse rapid and slippery. Heat forcing downward, combining with Dampness, resulting in Sundigestion Diarrhea (Sun Xie). Administer Earth Slurry Water decoction: Dig a pit inside the threshold, approx. one chi deep, pour in fresh well water, stir with hand a hundred times, retrieve, store in jar, clarify, and take warm. Diarrhea slightly reduced. Prescription:
Huangqin (Scutellariae Radix) 0.5 qian, Huanglian (Coptidis Rhizoma) 0.5 qian, Fulonggan (Dragon's Bone/Hematite substitute - Longgu Preparatum or similar clay) one piece, Yiyuan San (Benefit Origin Powder) 3 qian, Zhi Cao (Glycyrrhizae Radix et Rhizoma Preparatum) 1 qian, Wumei (Mume Fructus) 2 pieces, Jinchai Shihu (Dendrobii Nobile Caulis) 2 qian, Zharou (Crataegi Fructus Flesh) 1 qian.
Combining Earth Soil with Huanglian进退 (Advance/Retreat) Decoction, achieving full effect.
Male, 36 years old
Chronic abdominal pain and diarrhea. This episode triggered by eating raw/cold and greasy food; dozens of diarrheal episodes daily; body weakening, unstable sitting/standing. Borborygmi like thunder, slight pain; tongue coating thick/greasy, no thirst, no aversion to cold; pulse deep and slippery. Initially prescribed Wuling San (Five-Ingredient Powder with Poria), ineffective.
Follow-up modified prescription:
Fuzi (Aconiti Lateralis Radix Preparata) 2 qian, Buguzhi (Psoraleae Fructus), Wei Roudoukou (Myristicae Semen Preparatum), Zhi Dangshen (Codonopsis Radix Preparatum), Yizhiren (Alpiniae Oxyphyllae Semen), Jiao Zhu (Atractylodis Rhizoma Charred) each 2 qian; Chuanjiang (Zingiberis Rhizoma Recens) 1 qian; Doukou (Amomi Fructus Rotundus) 0.5 qian; Wumei (Mume Fructus) 2 pieces.
Two doses reduced diarrhea to two or three times daily. Added to previous formula:
Wuweizi (Schisandrae Chinensis Fructus) 0.5 qian, Chishizhi (Halloysit Rubrum) stir-fried with Danggui (Angelicae Sinensis Radix) 2 qian. Two doses cured.
Male, 25 years old
Generally strong and healthy. One night, while climbing/fishing, struck below navel by a crossbeam and fell; immediate unbearable pain. Next day, dazed, painful beyond words; pulse floating and rapid intermixed; face bright red; eyes closed, brows knit, tossing and turning. Father suspected kidney deficiency from sexual exertion. I asked if penis hurt? Answer: No, but Qi rushes up from lower abdomen. Suspected Ben Tun (Running Piglet), but observing closely, no cough or panting, so how could it be Ben Tun? Likely trauma and cold stimulating Liver Qi, causing lower abdominal pain. Liver nature is urgent, needs soothing. Prescription: Xiaoyao San (Free and Easy Wanderer Powder).
Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), Shengdi (Rehmanniae Radix) each 2 qian; Chuanxiong (Ligustici Chuanxiong Rhizoma) 0.5 qian; Gancao (Glycyrrhizae Radix et Rhizoma) stir-fried 1 qian; Chao Baishao (Paeoniae Radix Alba Stir-fried) 3 qian.
One dose, quieter that night. Next day, mild steaming heat hot to touch, sleeping facing inward, belching/exhausting gas, indicating heat resolving from exterior. Cannot tonify Kidney now. Added to original formula:
Sigualuo (Luffae Fructus Rete) 3 qian, Fengweicao (Pteridis Multifidae Herba) 0.5 qian, decocted together. Additionally, Zuojin Wan (Left Metal Pill) 1 qian, swallowed with medicine.
Two doses, heat subsided, pain reduced, patient could rise, no Qi rushing in lower abdomen, likes pressure. Changed to Nourishing Qi and Calming Kidney method to prevent Water failing to nourish Wood, stirring Liver Wind.
Lizhihe (Litchi Seed) 2 qian, Shengdi (Rehmanniae Radix), Hang Shao (Paeoniae Radix Alba), Roucongrong (Cynomorii Herba), Tusizi (Cuscutae Semen), Fupenzi (Rubiae Fructus), Antengteng (Uncariae Ramulus cum Uncis - note: likely local variant or typo for another vine), Danggui (Angelicae Sinensis Radix), Sigualuo (Luffae Fructus Rete) each 2 qian; Sangpiaoxiao (Mantis Oötheca) 10 pieces (stir-fried), Chuanxiong (Ligustici Chuanxiong Rhizoma) 0.5 qian. Two doses cured.
5. Jiao Chang (Crossed Intestines / Reversal of Bowel Functions)
Female Jiang, 24 years old
Abnormal urination and defecation for over half a month, unwilling to tell anyone. Husband returned from outside, inquired about condition; she reported urine coming out as feces, feces coming out as urine. Husband was horrified. Several physicians were consulted without success. Then Dr. Li was consulted. I happened to be traveling from countryside to city, passing Jiang's house, and was urgently summoned. I was classmates with Jiang, and Dr. Li and I also interacted frequently. Discussing the condition, Dr. Li identified Jiang's wife as having Jiao Chang Syndrome (Reversal of Bowel Functions). I asked for the prescription; he hesitated. Jiang urged him; he proposed Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). Seeing this, I suddenly understood and predicted effectiveness. After Dr. Li left, Jiang asked for the rationale. I explained that reversal of excretions may be caused by great anger, drunkenness/fullness, or sexual excess, leading to disordered Zang Qi reversing normal order. The method should be to lift and raise Qi. Dr. Li's use of lifting agents was indeed insightful. After medication, that night, no restlessness; urination and defecation naturally occurred together. Next day joint consultation, Dr. Li asked if using original formula? I suggested increasing dosage slightly: Baizhu (Atractylodis Macrocephalae Rhizoma) 3 qian, Shengma (Cimicifugae Rhizoma) 2 qian, Huangqi (Astragali Radix) 5 qian (half raw, half stir-fried), plus Jiegeng (Platycodonis Radix) 4 qian, Xingren (Armeniacae Semen Amarum) 4 qian. Jiegeng carries medicine upward; Xingren diffuses Lung Qi; Huangqi (raw/stir-fried) tonifies Qi and warms Middle. Following prescription for two doses, excretions no longer confused, spirit improved. Dr. Li discussed follow-up; I suggested differentiation and diuresis. Prescription: Wuling San (Five-Ingredient Powder with Poria) modified, strictly prohibiting sexual intercourse. Following my method, complete recovery. Later regulated with Shiquan Dabu Wan (Ten Substance Great Tonifying Pill).
This approach diagnoses based on pathology, first lifting, then differentiating/diuresing, reflecting "treating urgency with slowness". Regarding urine containing feces, I believe this is inaccurate; it is likely turbid yellow fluid. Requesting correction from colleagues.
Male, 52 years old
Rectal prolapse for over ten days; distending pain combined; difficulty walking; six pulses deep, fine, and weak; Qi deficiency with sinking is clear. Instructed to find seven dung beetles (Qianglang), bake on tile until dry, grind to powder, mix with Bingpian (Borneolum Syntheticum). First fumigate and wash anus with Scallion White (Congbai) decoction, then apply powder, manually reduce. Also purchased Buzhong Yiqi Wan (Tonify the Middle and Augment the Qi Pills) 4 liang, 40 pills morning and evening. Anus gradually retracted. Relapsed later, sought prescription again. Instructed to find 3-4 snails, place Bingpian (Borneolum Syntheticum) inside, leave overnight outdoors, use water to brush anus. Anus retracted that night. Also took Buzhong Yiqi Wan for follow-up care.
10. Vomiting and Diarrhea Simultaneously
Female, 49 years old
Upper vomiting and lower diarrhea; face has red glow; tongue slightly red; no foul odor; pulse floating and rapid. Diagnosed as Water Retention in Heart/Lower Chest, treating with differentiation/diuresis. Vomiting/diarrhea did not stop. Modified to:
Daizheshi (Ochrae Fragmentum) 2 qian, Xidangshen (Codonopsis Radix) 3 qian, Jiao Zhu (Atractylodis Rhizoma Charred) 2 qian, Gong Dingxiang (Caryophylli Flos) 1 qian, Gancao (Glycyrrhizae Radix et Rhizoma) stir-fried 1 qian, Jiang (Zingiberis Rhizoma) and Zao (Jujubae Fructus) each 2 pieces.
Vomiting stopped after taking, but face remained red, desired drink but feared it; drinking induced vomiting, indicating Heat in Upper Jiao and Cold in Middle Jiao. Vomiting upon eating hot food indicates Heat clashing with Heat. Changed prescription:
Wuzhuyu (Evodiae Fructus) 3 qian, Hang Shao (Paeoniae Radix Alba) 2 qian, Ta Dangshen (Codonopsis Radix) 3 qian, Jiang (Zingiberis Rhizoma) and Zao (Jujubae Fructus) each 2 pieces, taken cold.
No vomiting after taking, diarrhea reduced, turning yellow water. Abdominal pain after eating raw cucumber treated with Shanzha (Crataegi Fructus) powder decoction, effective immediately.
Female, 60 years old
Upper vomiting and lower diarrhea, unable to take fluids for 3-4 days (illness started after eating vegetable soup congee); pulse scattered without limit; tongue gray-white; lips pale white. Cold-Dampness stagnating in Middle is certain. Prescribed Wuling San (Five-Ingredient Powder with Poria) for differentiation/diuresis. Vomiting stopped after taking, but diarrhea continued, still no desire to drink. Modified prescription:
Jiao Zhu (Atractylodis Rhizoma Charred) 2 qian, Wumei (Mume Fructus) 3 pieces, Bidou (Phaseoli Semen), Jiao Shanzha (Charred Crataegi Fructus), Doukou (Amomi Fructus Rotundus), Jinchai Shihu (Dendrobii Nobile Caulis), Faxiaqu (Pinelliae Fermentatum), Zhi Dangshen (Codonopsis Radix Preparatum) each 2 qian; Chuanjiang (Zingiberis Rhizoma Recens) 1 qian. One packet stopped diarrhea and vomiting, but still no food intake; cheeks bright red, dejected, sleepy. Diagnosed as failure of Stomach/Intestines to ascend, with stagnant Heat in Stomach preventing intake. Sleepiness indicates Spleen transport lagging. Urgent need to nourish Stomach, avoid drying fluids. Prescription: Yunu Jian (Jade Woman Decoction) modified.
Yuzhu (Polygonati Odorati Rhizoma), Nanshashen (Glehniae Radix), Biandouyi (Phaseoli Semen Testa), Lianqiaoxin (Forsythiae Flos Heart), Maidongxin (Ophiopogonis Radix Heart) each 2 qian; Zhimu (Anemarrhenae Rhizoma) 0.5 qian; Sheng Shigao (Gypsum Fibrosum) 3 qian.
Two doses, cheek redness subsided, desired meat, avoided congee. Eating congee caused profuse sweating and feeling hot. Heat in Stomach above, Heat clashing with Heat. Instructed to consume meat broth, avoid solid meat. Three days later, fully recovered.
Male, 35 years old