脉微弱。面亮载阳。呃逆胁痛。自利。先曾寒热下利。加以劳烦伤阳。高年岂
宜反复。乃欲脱之象。三焦俱有见症。议从中治。
人参 附子 丁香皮 柿蒂 茯苓 生干姜
食伤肠胃。复病呕吐。发呃下利。诊两脉微涩。是阳气欲尽。浊阴冲逆。阅方
虽有姜附之理阳。反杂入 归。呆钝牵制。后方代赭重坠。又混表药。总属不解。
今事危至急。舍理阳驱阴无别法。
人参 茯苓 丁香 柿蒂 炮附子 干姜 吴萸
脉搏劲。舌干赤。嗳气不展。状如呃忒。缘频吐胃伤。诸经之气上逆。填胸聚
脘。出入机逆。周行脉痹。肌肉着席而痛转加。平昔辛香燥药不受。先议治肺经。
以肺主一身之气化耳。
枇杷叶汁 杏仁 桔梗 枳实
积瘀在络。动络血逆。今年六月初。时令暴热。热气吸入。首先犯肺。气热血
涌。强降其血。血药皆属呆滞。而清空热气。仍蒙闭于头髓空灵之所。诸窍闭塞。
鼻窒 肉。出纳之气。都从口出。显然肺气郁蒸。致脑髓热蒸。脂液自下。古称烁
物消物莫如火。但清寒直泄中下。清空之病仍然。议以气分轻扬。无取外散。专
事内通。医工遇此法。则每每忽而失察。
连翘 牛蒡子 通草 桑叶 鲜荷叶汁 青菊花叶 生石膏
以毒药熏疮。火气逼射肺金。遂令咳呛痰血。咽干胸闷。诊脉尺浮。下焦阴
气不藏。最虑病延及下。即有虚损之患。姑以轻药。暂渐清上焦。以解火气。
杏仁 绿豆皮 冬瓜子 苡仁 川贝 兜铃
脉数涩小结。痰血经年屡发。仍能纳食应酬。此非精血损怯。由乎五志过
动。相火内起肝胆。操持郁勃。皆令动灼。致络血上渗混痰火。必静养数月方安。
否则木火劫烁。胃伤减食。病由是日加矣。
丹皮 薄荷梗 菊花叶 黑栀 淡黄芩 生白芍 郁金 川贝
虚不肯复谓之损。纳食不充肌肤。卧眠不能着左。遇节令痰必带血。脉左
细右劲数。是从肝肾阴血之伤。延及气分。倘能节劳安逸。仅能带病永年。损症
五六年。无攻病之理。脏属阴。议平补足三阴法。
人参 山药 熟地 天冬 五味 女贞
内经分上下失血为阴络阳络。是腑络取胃。脏络论脾。今饮食甚少。柔腻
姑缓。上下交病。治在中焦。其午火升烦嗽。亦因血去阳伤。以胃药从中镇补。使生气自充也。
人参 茯苓 白术 炙草 扁豆 白芍 山药
向有失血。是真阴不旺。夏至阴生。伏天阳越于表。阴伏于里。理宜然矣。无
如心神易动。暗吸肾阴。络脉聚血。阳触乃溢。阴伏不固。随阳奔腾。自述下有冲
突逆气。血涌如泉。盖任脉为担任之职。失其担任。冲阳上冲莫制。皆肾精肝血
不主内守。阳翔为血溢。阳坠为阴遗。腰痛足胫畏冷。何一非精夺下损现症。经
言精不足者。补之以味。药味宜取质静填补。重着归下。莫见血以投凉。勿因嗽
以理肺。若此治法。元海得以立基。冲阳不来犯上。然损非旬日可复。须寒暑更
迁。凝然不动。自日遂安适。调摄未暇缕悉也。
人参 炒熟地 鲜河车胶 茯苓 炒黑枸杞子 北五味 沙苑 紫石英
早晨未进饮食。咳逆自中焦上冲。有欲呕之象。虚里左胁呼吸牵引震动。
背部四肢寒冷。入暮心腹热灼。而舌上干辣。夫阳虚外生寒。阴虚生内热。阳属
腑气。主乎外卫。阴属脏真。主乎内营。由络血大去。新血未充。谷味精华。不得四
布。知味容纳。而健运未能自然。胁右少舒。全系胃络。下焦阴精损伤。中焦胃阳
不振。夏至初阴不主来复。交节络血再动。总是既损难以骤复之征。大意下焦
阴阳宜潜宜固。中焦营卫宜守宜行。用药大旨如此。至于潜心涤虑。勿扰情志。
再于子午。参以静功。俾水火交。阴阳偶。是药饵以外工夫。皆培植生气之助。幸留意焉。
养营汤去黄 远志
操持怫郁。五志中阳动极。失血咳呛有年。皆由性情内起之病。草木难以
奏安。今形色与脉。日现衰惫。系乎生气克削。虑春半以后。地气升。阳气泄。久病
伤损。里真少聚。冬春天冷主藏。总以摄补足三阴脏。扶持带病延年。就是人工克尽矣。
人参 炒白芍 熟地炭 五味 建莲 炙草
脉坚。形瘦久咳。失血有年。食物厌恶。夜寝不适。固以培本为要。所服七味
八味汤丸。乃肝肾从阴引阳法。服之不效。此液亏不受桂附之刚。当温养摄纳
其下。兼与益胃津以供肺。
早服 熟地 柏子仁 杞子 五味 胡桃肉 牛膝 苁蓉 茯苓 蜜丸
晚服 人参 麦冬 五味 炙草 茯苓 山药 鲜莲子
半月前恰春分。阳气正升。因情志之动。厥阳上燔。致咳震动络中。遂令失
血。虽得血止。诊右脉长大透寸部。食物不欲纳。寐中呻吟呓语。由至阴损及阳
明。精气神不相交合矣。议敛摄神气法。
人参 茯神 五味 炙草 枣仁 龙骨 金箔
血大去。则络脉皆空。其伤损已非一腑一脏之间矣。秋分寒露。天气令降。
身中气反升越。明明里不肯收摄。虚象何疑。今诊脉弱濡涩。肢节微冷。气伤上
逆。若烟雾迷离。熏灼喉底。故作呛逆。大旨以上焦宜降宜通。下焦宜封宜固。得
安谷崇土。再商后法。
人参 炒黑杞子 炒黑牛漆 茯神 炒山药 生苡仁
忧思怫郁。五志气火内燔。加以烟辛泄肺。酒热戕胃。精华营液。为热蒸化
败浊。经云。阳络伤则血外溢。盖胃络受伤。阳明气血颇富。犹勉强延磨岁月。至
于阳明脉络日衰。斯背先发冷。右胁酸痛。而咳吐不已。胃土愈惫。肝木益横。厥
阳愈逆。秽浊气味。无有非自下泛上。大凡左升属肝。右降属肺。由中焦胃土既
困。致有升无降。壅阻交迫。所以着左卧眠。遏其升逆之威。且烦蒸热灼。并无口
渴饮水之状。病情全在血络。清热滋阴之治。力量不能入络。兹定清养胃阴为
主另进通络之方。肝胆厥阳少和。冀其涎少胁通。积久沉 。调之非易。
桑叶 丹皮 苡仁 苏子 钩藤 郁金 降香 桃仁
有年冬藏失司。似乎外感热炽。辛散苦寒。是有余实症治法。自春入夏。大
气开泄。日见恹恹衰倦。呼吸喉息有声。胁肋窒板欲痛。咯呛紫血。络脉不和。议
以辛补通调。不致寒凝燥结。冀免关格上下交阻之累。
柏子仁 细生地 当归须 桃仁 降香 茯神
先有骨痛鼓栗。每至旬日必吐血碗许。自冬入夏皆然。近仅可仰卧。着右
则咳逆不已。据说因怒劳致病。都是阳气过动。而消渴舌翳。仍纳谷如昔。姑以
两和厥阴阳明之阳。非徒泛泛见血见嗽为治。
石膏 熟地 麦冬 知母 牛膝
脉数左坚。当夏四月。阳气方张。陡然嗔怒。肝阳勃升。络血上涌。虽得血止。
而咳逆欲呕。眠卧不得欹左。此肝阳左升太过。木失水涵。阴亏则生热。是皆本
体阴阳迭偏。非客邪实火可清可降之比。最宜恬澹无为。安静幽闲。经年不反。
可望转偏就和。但图药治。难减损怯矣。经云。胃咳之状。咳逆而呕。木犯胃土贯
膈。即至冲咽入肺。肺衰。木反刑金。从内经甘缓以制其急。
米炒麦冬 糯稻根须 女贞子 茯神 生甘草 南枣肉
血去胃伤。当从中治。况五年前劳怒而得病。肝木无不克土。医者温补竞
进。气壅为胀。至夜咽干无寐。食物不思。杳不知味。为呕为咳。全是胃阳升逆。经
云。胃不利则卧不安。而阳不潜降。似属浊气胶痰有形之物。阻挠升降而然。古
人有二虚一实。当先治实。以开一面之文。余从胃病为主。制肝救中。理气清膈。
乃不足中有余。圆通之治。此机勿得乱治。
人参 枳实 半夏 杏仁 甘草 竹茹 生姜 大枣
脉左弦。右小濡。据病源起于忧郁。郁勃久而化热。蒸迫脉络。血为上溢。凝
结成块者。离络留而为瘀也。血后纳食如昔。是腑络所贮颇富。况腑以通为用。
血逆气亦上并。漉漉有声。皆火气旋动。非有形质之物。凡血病五脏六腑皆有。
是症当清阳之络为要。致于病发。当治其因。又不必拘执其常也。
枇杷叶 苡仁 茯苓 苏子 桑叶 丹皮 炒桃仁 降香末
诊脉左手平和。尺中微动。右手三部。关前动数。尺脉带数。夜卧不寐。咳呛
有血。昼日咳呛无血。但行走微微喘促。夫阴阳互为枢纽。隆冬天气藏纳。缘心
烦劳神。五志皆动。阳不潜伏。当欲寐之时。气机下潜。触其阳气之升。冲脉升动。
络中之血未得宁静。随咳呛溢于上窍。至于步趋言谈。亦助其动搏气火。此咳
呛喘息失血。同是一原之恙。当静以制动。投药益水生金以制君相之火。然食
味宜远辛辣热燥。凡上实者必下虚。薄味清肃上焦。正谓安下。令其藏纳也。愚
见约方。参末俟裁。
生扁豆 麦冬 川斛 上阿胶 小根生地 真北沙参
脉细小如无。素多郁怒。经来即病。冬患胃痛。随有咯血不止。寒战面赤。惊
惕头摇。显是肝阳变风。络血沸起。四肢逆冷。真气衰微。内经有肝病暴变之文。
势岂轻渺。议用景岳镇阴煎法。制其阳逆。仍是就下之义。
熟地灰 牛膝炭 肉桂 茯神 生白芍 童便
水寒外加。惊气内迫。阴疟三年。继患嗽血。迄今七年。未有愈期。询及血来
紫块。仍能知味安谷。参其疟伤惊伤。必是肝络凝瘀。得怒劳必发。勿与酒色伤
损。乱投滋阴腻浊之药。恐胃气日减。致病渐剧。
桃仁 鳖甲 川桂枝 归须 大黄 茺蔚子
色苍肉瘦。形象尖长。木火之质。阴液最难充旺。春间咳嗽。虽系风温外邪。
但既属阴亏。冬藏先已不固。因咳逆震动。浮阳上胃。清空自阻。用药宜取沉静
质重。填阴镇阳方是。阅方辛气居半。与磁石相阻。苁蓉阴中之阳。亦非收摄。不
效宜矣。
大熟地 灵磁石 萸肉 五味子 牡丹皮 云茯苓 阿胶 怀山药 泽泻 龟板
胁膈左右。懊 不舒。呕逆带血。凡人脏腑之外。必有脉络拘绊。络中乃聚
血之地。中年操持。皆令耗血。血不和气。气攻入络。病状难以自明。宣通血分以
和络。俾不致瘀着。可免噎膈反胃。
新绛 青葱管 橘叶 桃仁 栝蒌仁 钩藤
频年发失血症。嗽甚痰出。继以呕嗳。日晡寒热。夜深汗泄。据述医见血。投
以郁金姜黄韭汁制大黄逐瘀下走。希图血止。此是有余治法。夫人禀阴阳。偏
则致病。自内损伤。即是不足。脉左动数。尺不附骨。明明肾精肝血内夺。弱阴无
能交恋其阳。冲阳上逆。吸气不入。是以咳嗽气升。旋必呕嗳浊涎粘沫。内经谓
五脏六腑皆令人咳。奈何今人以咳治肺。见痰降浊清热。损者更损。殆不复藏
阴府阳消长之机。杂药徒伐胃气。经年累月。已非暴病。填实下隙。须藉有情之
属。
人参 紫衣胡桃 紫石英 茯神 五味子 山萸肉 河车胶 秋石
诊脉左数微弦。寸尺关虚数。阅五年前病原。左胁映背胀痛。不能卧席。曾
吐瘀血。凝块紫色。显然肝郁成热。热迫气逆血瘀。虽经调理全愈。而体质中肝
阴不充。肝阳已动。凡人身之气。左升主肝。右降主肺。今升多降少。阴不和阳。胃
中津液。乏上供涵肺之用。此燥痒咳呛。吐出水沫。合乎经旨肝病吐涎沫矣。肝
木必犯胃土。纳谷最少。而肢软少力。非嗽药可以愈病。此皆肝阳逆乘。实系肝
阴不足。仲圣云。见肝之病。先理脾胃。俾土浓不为木克。原有生金功能。据述凡
食鸡子。病必加剧。则知呆滞凝涩之药。皆与病体未合。
北沙参 生扁豆 麦冬 玉竹 桑叶 生甘草 蔗浆
脉右弦左濡。秋凉宿饮。上泛咳呛。入夜着枕欲寐。气冲胃脘。心悸震动。必
欲起坐。仲景论脉篇。弦为饮。背寒为饮。当治饮。不当治咳。饮属阴邪。乘暮夜窃
发。金匮法中每以通阳涤饮。与世俗仅以肺药疏降迥异。用小青龙减麻辛法。
桂枝 五味子 干姜 茯苓 白芍 炙草 半夏
脉象微弱。面色光亮如戴阳状。呃逆伴胁痛，自发性腹泻。此前曾患寒热往来并伴有腹泻，加之劳累烦扰损伤阳气，高龄之人岂能反复受此折磨？这是阳气欲脱的征象。三焦均有病变表现，建议从中焦进行治疗。
人参、附子、丁香皮、柿蒂、茯苓、生干姜
饮食损伤肠胃，又患呕吐，出现呃逆和腹泻。诊察两手脉象微涩，这是阳气即将耗尽，浊阴之气上冲逆乱。查看之前的处方，虽然有使用姜、附来温理阳气，但反而混杂了当归等药，显得呆板迟钝且牵制药效。后方的代赭石重坠，又混入解表药物，总归是不理解病机。如今病情危急，除了温理阳气、驱散阴邪外别无他法。
人参、茯苓、丁香、柿蒂、炮附子、干姜、吴茱萸
脉搏强劲有力。舌质干燥发红。嗳气不畅，症状类似呃逆。这是因为频繁呕吐导致胃气受伤，各经之气上逆，填塞胸脘，气机出入逆乱，周身经脉痹阻，肌肉接触床席时疼痛加剧。平时不能耐受辛香燥热的药物，先议治肺经，因为肺主一身的气化功能。
枇杷叶汁、杏仁、桔梗、枳实
瘀血积滞在络脉，动络导致血逆。今年六月初，时令暴热，热气吸入体内，首先侵犯肺脏，气热血涌。强行降血，血类药物都属呆滞，而清空头部的热气，仍然蒙闭于头髓空灵之处，诸窍闭塞，鼻塞肉腐，呼吸之气只能从口出。显然肺气郁蒸，导致脑髓热蒸，脂液下流。古人称烧灼物体、消耗物体没有比火更厉害的。如果只用清寒之药直泄中下焦，清空部位的疾病依然无法解决。建议用气分轻扬的药物，不取向外发散，专门从事内部通利。医生遇到这种方法，往往容易疏忽失察。
连翘、牛蒡子、通草、桑叶、鲜荷叶汁、青菊花叶、生石膏
用毒药熏疮，火气逼迫肺金，于是导致咳嗽呛逆、痰中带血，咽干胸闷。诊脉尺部浮，下焦阴气不能潜藏，最担心病情蔓延及于下焦，从而产生虚损的祸患。暂且用轻清的药物，逐渐清解上焦，以解除火气。
杏仁、绿豆皮、冬瓜子、薏苡仁、川贝母、紫菀
脉象数而涩，小结。痰中带血多年屡次发作，仍能进食应酬。这不是精血亏损导致的虚弱，而是由于五志过动，相火在内发起，操持劳碌、情绪抑郁勃发，都导致动火灼伤，致使络脉出血上渗，混杂痰火。必须静养数月才能安宁。否则木火劫烁，胃气受伤减少进食，病情由此日益加重。
牡丹皮、薄荷梗、菊花叶、黑栀子、淡黄芩、生白芍、郁金、川贝母
虚损而不能恢复称为“损”。进食不足以滋养肌肤，睡眠不能左侧卧，每逢节气变化痰必带血。脉象左细右劲数，这是肝肾阴血受伤，延及气分。如果能节制劳累、安逸休息，仅能带病延年。损症五六年，没有攻伐疾病的道理。脏属阴，建议采用平补足三阴的方法。
人参、山药、熟地黄、天冬、五味子、女贞子
《内经》将上下失血分为阴络和阳络，腑络取之于胃，脏络论述于脾。如今饮食很少，柔腻滋腻的药物暂且缓用。上下交病，治疗在于中焦。其午时火升引起的烦躁咳嗽，也是因为失血导致阳气受伤，用调理胃气的药物从中镇补，使生气自然充盛。
人参、茯苓、白术、炙甘草、扁豆、白芍、山药
向来有失血病史，是真阴不旺盛。夏至阴气始生，伏天阳气越于体表，阴气伏于里，按理应当如此。无奈心神易动，暗中吸取肾阴，络脉聚血，阳气触动则溢出。阴气伏而不固，随阳气奔腾。自述下有冲突逆气，血涌如泉。任脉担任统摄之职，失去担任能力，冲脉阳气上冲无法控制，都是肾精肝血不能主司内守，阳气飞翔导致血溢，阳气下坠导致阴精遗泄。腰痛、足胫畏冷，哪一样不是精气夺失、下元亏损的表现？经文说“精不足者，补之以味”，药味宜选取质地安静填补、重着归下的药物。不要见血就用凉药，不要因为咳嗽就理肺。像这样的治法，元气之海得以建立根基，冲阳不来犯上。然而损证非十天半月可恢复，须经历寒暑更替，凝然不动，自然日渐安适。调摄之事未能详尽叙述。
人参、炒熟地黄、鲜河车胶、茯苓、炒黑枸杞子、北五味子、沙苑子、紫石英
早晨未进饮食，咳逆自中焦上冲，有想呕吐的现象。虚里穴在左胁，呼吸牵引震动。背部四肢寒冷，入夜心腹热灼，舌上干辣。阳虚外生寒，阴虚生内热。阳属于腑气，主司外部卫护；阴属于脏真，主司内部营守。由于络血大量丢失，新血未充盈，谷物的精华不得四布，知道味道并能容纳，但健运功能未能自然恢复。胁右侧稍舒，全系胃络问题。下焦阴精损伤，中焦胃阳不振，夏至初生的阴气不能主司来复，交节之时络血再次发动，总是既已损难以骤然恢复的征象。大意是下焦阴阳宜潜藏宜固摄，中焦营卫宜守宜行。用药大旨如此。至于潜心涤虑，不扰乱情志，再在子午时参以静功，使水火相交，阴阳偶合，这是药物以外的功夫，都是培植生气的帮助。希望留意。
养营汤去黄芪、远志
操持劳碌、怫郁不舒，五志中阳气动极，失血咳呛多年，都是由性情内部引发的疾病。草木药物难以奏效安宁。如今形色与脉象，日渐呈现衰惫，系乎生气被克削。担心春半以后，地气上升，阳气发泄，久病伤损，里真之气少聚。冬春天冷主收藏，总以摄补足三阴脏，扶持带病延年，就是人工尽力了。
人参、炒白芍、熟地炭、五味子、建莲、炙甘草
脉象坚硬，形体消瘦，久咳，失血多年，厌恶食物，夜间睡眠不适。固然以培本为要。所服用的七味丸、八味丸，是肝肾从阴引阳的方法，服用无效。这是因为津液亏虚，不能承受桂枝、附子的刚燥。应当温养摄纳其下，兼与益胃津以供养肺。
早服：熟地黄、柏子仁、枸杞子、五味子、胡桃肉、牛膝、肉苁蓉、茯苓，蜜丸
晚服：人参、麦冬、五味子、炙甘草、茯苓、山药、鲜莲子
半月前恰逢春分，阳气正升，因情志波动，厥阳上燔，导致咳嗽震动络脉，遂令失血。虽然血止，诊察右脉长大透至寸部，食物不欲纳食，睡梦中呻吟呓语，是由至阴损伤波及阳明，精气神不相交合。建议敛摄神气的方法。
人参、茯神、五味子、炙甘草、枣仁、龙骨、金箔
血液大量丢失，则络脉皆空，其伤损已不仅仅在一腑一脏之间。秋分寒露时节，天气令下降，身中气反升越，明明里气不肯收摄，虚象何须怀疑。如今诊脉弱濡涩，肢节微冷，气伤上逆，若烟雾迷离，熏灼喉底，故作呛逆。大旨以上焦宜降宜通，下焦宜封宜固，得安谷崇土，再商议后续方法。
人参、炒黑枸杞子、炒黑牛膝、茯神、炒山药、生薏苡仁
忧思怫郁，五志气火在内烧灼，加上烟辛泄肺，酒热戕害胃，精华营液，被热蒸化为败浊。经文说：“阳络伤则血外溢。”盖胃络受伤，阳明气血颇富，尚能勉强延磨岁月。至于阳明脉络日渐衰弱，于是背部先发冷，右胁酸痛，而咳吐不止。胃土愈疲惫，肝木益横逆，厥阳愈上逆，秽浊气味，无不是自下泛上。大凡左升属肝，右降属肺，由中焦胃土既困，致有升无降，壅阻交迫，所以喜欢左侧卧眠，以遏制其升逆之势。且烦蒸热灼，并无口渴饮水之状。病情全在血络，清热滋阴的治疗，力量不能入络。兹定清养胃阴为主，另进通络之方。肝胆厥阳少和，冀其涎少胁通，积久沉疴，调治不易。
桑叶、丹皮、薏苡仁、苏子、钩藤、郁金、降香、桃仁
年老冬藏失司，似乎外感热炽。辛散苦寒，是有余实症的治疗方法。自春入夏，大气开泄，日渐恹恹衰倦，呼吸喉息有声，胁肋窒板欲痛，咯呛紫血，络脉不和。建议以辛补通调，不致寒凝燥结，冀免关格上下交阻的累赘。
柏子仁、细生地、当归须、桃仁、降香、茯神
先前有骨痛战栗，每至旬日必吐血一碗左右，自冬入夏皆如此。近仅可仰卧，着右侧则咳逆不已。据说因怒劳致病，都是阳气过动，而消渴舌翳，仍纳谷如昔。姑以两和厥阳、阳明之阳，非徒泛泛见血见嗽为治。
石膏、熟地黄、麦冬、知母、牛膝
脉数左坚。当夏四月，阳气方张，陡然嗔怒，肝阳勃升，络血上涌。虽得血止，而咳逆欲呕，眠卧不得欹左。此肝阳左升太过，木失水涵，阴亏则生热，是皆本体阴阳迭偏，非客邪实火可清可降之比。最宜恬澹无为，安静幽闲，经年不反，可望转偏就和。但图药治，难减损怯矣。经文说：“胃咳之状，咳逆而呕。”木犯胃土贯膈，即至冲咽入肺，肺衰，木反刑金。从内经甘缓以制其急。
米炒麦冬、糯稻根须、女贞子、茯神、生甘草、南枣肉
血去胃伤，应当从中焦治疗。况且五年前因劳怒而得病，肝木无不克土。医者温补竞进，气壅为胀，至夜咽干无寐，食物不思，杳不知味，为呕为咳，全是胃阳升逆。经文说：“胃不利则卧不安。”而阳不潜降，似属浊气胶痰有形之物，阻挠升降而然。古人有二虚一实，当先治实，以开一面之文。余从胃病为主，制肝救中，理气清膈，乃不足中有余，圆通之治。此机勿得乱治。
人参、枳实、半夏、杏仁、甘草、竹茹、生姜、大枣
脉左弦，右小濡。据病源起于忧郁，郁勃久而化热，蒸迫脉络，血为上溢，凝结成块者，离络留而为瘀也。血后纳食如昔，是腑络所贮颇富。况腑以通为用，血逆气亦上并，漉漉有声，皆火气旋动，非有形质之物。凡血病五脏六腑皆有，是症当清阳之络为要。致于病发，当治其因，又不必拘执其常也。
枇杷叶、薏苡仁、茯苓、苏子、桑叶、丹皮、炒桃仁、降香末
诊脉左手平和，尺中微动。右手三部，关前动数，尺脉带数。夜卧不寐，咳呛有血，昼日咳呛无血，但行走微微喘促。夫阴阳互为枢纽，隆冬天气藏纳，缘心烦劳神，五志皆动，阳不潜伏，当欲寐之时，气机下潜，触其阳气之升，冲脉升动，络中之血未得宁静，随咳呛溢于上窍。至于步趋言谈，亦助其动搏气火，此咳呛喘息失血，同是一原之恙。当静以制动，投药益水生金以制君相之火。然食味宜远辛辣热燥，凡上实者必下虚，薄味清肃上焦，正谓安下，令其藏纳也。愚见约方，参末俟裁。
生扁豆、麦冬、川石斛、上阿胶、小根生地、真北沙参
脉细小如无。素多郁怒，经来即病，冬患胃痛，随有咯血不止，寒战面赤，惊惕头摇，显是肝阳变风，络血沸起，四肢逆冷，真气衰微。内经有肝病暴变之文，势岂轻渺。议用景岳镇阴煎法，制其阳逆，仍是就下之义。
熟地黄灰、牛膝炭、肉桂、茯神、生白芍、童便
水寒外加，惊气内迫，阴疟三年，继患嗽血，迄今七年，未有愈期。询及血来紫块，仍能知味安谷，参其疟伤惊伤，必是肝络凝瘀，得怒劳必发，勿与酒色伤损，乱投滋阴腻浊之药，恐胃气日减，致病渐剧。
桃仁、鳖甲、川桂枝、归须、大黄、茺蔚子
色苍肉瘦，形象尖长，木火之质，阴液最难充旺。春间咳嗽，虽系风温外邪，但既属阴亏，冬藏先已不固，因咳逆震动，浮阳上胃，清空自阻，用药宜取沉静质重，填阴镇阳方是。阅方辛气居半，与磁石相阻，苁蓉阴中之阳，亦非收摄，不效宜矣。
大熟地黄、灵磁石、山茱萸、五味子、牡丹皮、云茯苓、阿胶、怀山药、泽泻、龟板
胁膈左右，懊侬不舒，呕逆带血。凡人脏腑之外，必有脉络拘绊，络中乃聚血之地。中年操持，皆令耗血，血不和气，气攻入络，病状难以自明。宣通血分以和络，俾不致瘀着，可免噎膈反胃。
新绛、青葱管、橘叶、桃仁、栝蒌仁、钩藤
频年发失血症，嗽甚痰出，继以呕嗳，日晡寒热，夜深汗泄。据述医见血，投以郁金姜黄韭汁制大黄逐瘀下走，希图血止，此是有余治法。夫人禀阴阳，偏则致病，自内损伤，即是不足。脉左动数，尺不附骨，明明肾精肝血内夺，弱阴无能交恋其阳，冲阳上逆，吸气不入，是以咳嗽气升，旋必呕嗳浊涎粘沫。内经谓五脏六腑皆令人咳，奈何今人以咳治肺，见痰降浊清热，损者更损，殆不复藏阴府阳消长之机，杂药徒伐胃气，经年累月，已非暴病，填实下隙，须藉有情之属。
人参、紫衣胡桃、紫石英、茯神、五味子、山萸肉、河车胶、秋石
诊脉左数微弦，寸尺关虚数。阅五年前病原，左胁映背胀痛，不能卧席，曾吐瘀血，凝块紫色，显然肝郁成热，热迫气逆血瘀，虽经调理全愈，而体质中肝阴不充，肝阳已动。凡人身之气，左升主肝，右降主肺，今升多降少，阴不和阳，胃中津液，乏上供涵肺之用，此燥痒咳呛，吐出水沫，合乎经旨肝病吐涎沫矣。肝木必犯胃土，纳谷最少，而肢软少力，非嗽药可以愈病，此皆肝阳逆乘，实系肝阴不足，仲圣云：“见肝之病，先理脾胃”，俾土浓不为木克，原有生金功能。据述凡食鸡子，病必加剧，则知呆滞凝涩之药，皆与病体未合。
北沙参、生扁豆、麦冬、玉竹、桑叶、生甘草、蔗浆
脉右弦左濡，秋凉宿饮，上泛咳呛，入夜着枕欲寐，气冲胃脘，心悸震动，必欲起坐。仲景论脉篇，弦为饮，背寒为饮，当治饮，不当治咳。饮属阴邪，乘暮夜窃发，金匮法中每以通阳涤饮，与世俗仅以肺药疏降迥异，用小青龙减麻辛法。
桂枝、五味子、干姜、茯苓、白芍、炙甘草、半夏
Pulse is faint. The face shines with a floating yang appearance (floating yang). Hiccups accompanied by hypochondriac pain, spontaneous diarrhea. Previously suffered from alternating chills and fever with diarrhea, compounded by fatigue and mental agitation damaging the Yang qi. How can an elderly person endure such recurrence? This is a sign of impending collapse. Manifestations are present in the Triple Burner (San Jiao, the three cavities of the torso). It is proposed to treat from the Middle Burner.
Ren Shen (Ginseng Radix), Fu Zi (Aconiti Lateralis Radix Praeparata), Ding Xiang Pi (Caryophylli Cortex), Shi Di (Diospyroi Fructus), Fu Ling (Poria), Sheng Gan Jiang (Zingiberis Rhizoma Recens)
Food injury to the intestines and stomach, followed by vomiting, hiccups, and diarrhea. Palpation of both wrists reveals a faint and choppy pulse, indicating that Yang Qi is about to be exhausted, and turbid Yin Qi is rushing upward in rebellion. Reviewing previous prescriptions, although Ginger and Aconite were used to warm and regulate Yang, they were mixed with Gui (Angelicae Sinensis Radix), making the formula rigid and restrictive. Later, heavy Descending Ore (Dai Zhe Shi) was added, along with exterior-releasing herbs, showing a fundamental misunderstanding of the pathology. Now the situation is critical; apart from warming Yang and driving away Yin, there is no other method.
Ren Shen (Ginseng Radix), Fu Ling (Poria), Ding Xiang (Caryophylli Flos), Shi Di (Diospyroi Fructus), Pao Fu Zi (Aconiti Lateralis Radix Praeparata), Gan Jiang (Zingiberis Rhizoma), Wu Zhu Yu (Evodiae Fructus)
The pulse is forceful. The tongue is dry and red. Belching is obstructed, resembling hiccups. This stems from frequent vomiting injuring the Stomach Qi, causing Qi of various meridians to rebel upward, filling the chest and epigastrium. The mechanism of entry and exit is reversed, and circulation through the meridians is blocked. Pain worsens when muscles touch the bed. Previously unable to tolerate pungent, aromatic, and drying herbs, we first propose treating the Lung Meridian, as the Lung governs the Qi transformation of the whole body.
Pi Pa Ye Zhi (Pipal Leaf Juice), Xing Ren (Armeniacae Semen Amarum), Jie Geng (Platycodonis Radix), Zhi Shi (Aurantii Fructus Immaturus)
Accumulated blood stasis in the collaterals causes collateral damage and rebellious blood flow. In early June this year, sudden seasonal heat occurred. Heat Qi was inhaled, attacking the Lung first. Qi and Blood surged. Forcibly descending Blood: Blood-invigorating drugs are inherently stagnant. Clearing heat from the head still leaves it clouding the empty and spiritual cavity of the brain marrow. All orifices are blocked. Nasal obstruction and flesh decay occur; respiration occurs only through the mouth. Clearly, Lung Qi is depressed and steaming, causing Brain Marrow heat steaming, leading to the downward flow of fatty fluids. Ancients said nothing burns or consumes like fire. If cold-clearing drugs are used to drain directly into the Lower and Middle Burners, the disease in the clear/cranial region remains. It is proposed to use light and ascending drugs from the Qi level, not for external dispersion, but specifically for internal unblocking. Physicians often overlook this method.
Lian Qiao (Forsythiae Fructus), Niu Bang Zi (Arctii Fructus), Tong Cao (Tetrapanacis Medulla), Sang Ye (Mori Folium), Xian He Ye Zhi (Fresh Lotus Leaf Juice), Qing Ju Hua Ye (Chrysanthemi Indici Foliolum), Sheng Shi Gao (Gypsum Fibrosum)
Toxic drugs fumigated sores; Fire Qi forced the Metal of the Lung, resulting in coughing, wheezing, hemoptysis, dry throat, and chest tightness. Palpation of the Chi (Cun Kou) position shows floating, indicating Lower Jiao Yin Qi cannot hide. We fear the disease will spread to the Lower Jiao, causing deficiency consumptive disorders. Temporarily use light drugs to gradually clear the Upper Jiao and resolve Fire Qi.
Xing Ren (Armeniacae Semen Amarum), Lu Dou Pi (Phaseoli Vulgaris Pericarpium), Dong Gua Zi (Benincasae Semen), Yi Yi Ren (Coicis Semen), Chuan Bei Mu (Fritillariae Cirrhosae Bulbus), Dou Ling (Stemonae Radix)
Pulse is rapid, choppy, and small. Hemoptysis has recurred annually for years, yet appetite remains sufficient for social engagements. This is not weakness due to essence and blood depletion, but caused by excessive movement of the Five Emotions (Wu Zhi), stirring Ministerial Fire internally from the Liver and Gallbladder. Stress and depression cause fire to flare, damaging collaterals and causing blood to seep upward, mixing with phlegm-fire. Months of quiet rest are required for peace. Otherwise, Wood-Fire will scorch, damaging the Stomach and reducing food intake, worsening the condition daily.
Dan Pi (Moutan Cortex), Bo He Geng (Menthae Caulis), Ju Hua Ye (Chrysanthemi Flos), Hei Zhi (Gardeniae Fructus Carbonisatus), Dan Huang Qin (Scutellariae Radix), Sheng Bai Shao (Paeoniae Radix Alba), Yu Jin (Curcumae Radix), Chuan Bei Mu (Fritillariae Cirrhosae Bulbus)
Deficiency that does not recover is called "Sun" (Damage). Insufficient food intake fails to nourish the flesh; inability to sleep on the left side; sputum always contains blood during solar terms. Pulse is fine on the left and forceful/rapid on the right. This indicates Liver-Kidney Yin-Blood injury extending to the Qi level. If labor can be regulated and rest ensured, one may live long with the disease. For a 5-6 year consumptive disorder, there is no rationale for attacking the pathogen. Zang organs belong to Yin; propose a method to gently tonify the Three Yin Meridians of the Foot.
Ren Shen (Ginseng Radix), Shan Yao (Dioscoreae Rhizoma), Shu Di Huang (Rehmanniae Radix Preparata), Tian Dong (Asparagi Radix), Wu Wei Zi (Schisandrae Chinensis Fructus), Nu Zhen Zi (Ligustri Lucidi Fructus)
The *Neijing* divides upper and lower bleeding into Yin Collaterals and Yang Collaterals. Yang Collaterals relate to the Fu organs (Stomach), while Yin Collaterals relate to the Zang organs (Spleen). Currently, food intake is very low; rich and cloying medicines should be delayed. With both upper and lower affected, treatment focuses on the Middle Jiao. The noon-time Fire rising causing irritability and cough is also due to Yang injury from blood loss. Using Stomach-regulating medicines to tonify from the middle allows Sheng Qi (Vital Qi) to fill naturally.
Ren Shen (Ginseng Radix), Fu Ling (Poria), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Zhi Cao (Glycyrrhizae Radix et Rhizoma Preparata), Bian Dou (Dolichoris Lablab Semen), Bai Shao (Paeoniae Radix Alba), Shan Yao (Dioscoreae Rhizoma)
Historically suffering from blood loss indicates weak True Yin. At Summer Solstice, Yin begins to grow; in Dog Days, Yang floats outward while Yin hides inward—this is natural. However, the Heart-Mind moves easily, secretly consuming Kidney Yin. Collateral blood gathers; when Yang touches it, it overflows. Yin hiding is unstable, surging with Yang. Self-reported conflicting rebellious Qi below, blood gushing like a spring. The Ren Mai (Conception Vessel) has the duty of bearing; losing this control, Chong Mai (Penetrating Vessel) Yang rushes up unchecked. This is because Kidney Essence and Liver Blood fail to guard internally. Yang flying causes blood overflow; Yang sinking causes Yin leakage. Lower back pain and cold fear in calves are all manifestations of Essence depletion and Lower Jiao damage. The Classic states: "For insufficiency of Essence, supplement with flavor." Medicinal flavors should be chosen for their quiet, filling nature, heavy and settling downwards. Do not use cooling drugs just because of blood; do not treat the Lung just because of cough. With this method, the Yuan Hai (Sea of Origin) establishes its foundation, and Chong Yang does not attack upwards. However, damage cannot be restored in days; it requires seasons to pass, remaining still, gradually becoming comfortable. Detailed regulation instructions are omitted.
Ren Shen (Ginseng Radix), Chao Shu Di Huang (Prepared Rehmanniae Radix Stir-fried), Xian He Che Jiao (Fresh Placenta Human), Fu Ling (Poria), Chao Hei Gou Qi Zi (Lycii Fructus Charred), Bei Wu Wei Zi (Schisandrae Chinensis Fructus), Sha Yuan Zi (Astragali Complanati Semen), Zi Shi Ying (Hematitum)
In the morning before eating, coughing and rebellion rise from the Middle Jiao, with a desire to vomit. The Xu Li point (located at the left hypochondrium) vibrates with breathing traction. Back and limbs are cold; at night, the heart and abdomen feel burning, and the tongue is dry and spicy. Yang deficiency generates external cold; Yin deficiency generates internal heat. Yang belongs to Fu Qi, governing external defense; Yin belongs to Zhen Qi (True Qi) of Zang organs, governing internal nourishment. Due to massive loss of collateral blood and lack of new blood, grain essence cannot distribute to the four directions. Taste perception and intake remain, but transportation and transformation function fail naturally. Right hypochondrium feels slightly relieved, relating entirely to Stomach collaterals. Lower Jiao Yin Essence is damaged; Middle Jiao Stomach Yang is weak. Initial Yin at Summer Solstice fails to return. At solar term changes, collateral blood moves again. This is a sign that established damage is hard to restore quickly. Generally, Lower Jiao Yin-Yang should be submersed and secured; Middle Jiao Ying-Wei should be guarded and circulated. This is the general principle of medication. Furthermore, purifying the mind, not disturbing emotions, and practicing quiet meditation at Zi and Wu hours allow Water and Fire to interact and Yin-Yang to pair. These are efforts beyond medicine, aiding the cultivation of Sheng Qi. Please pay attention.
Yang Ying Tang (Nourishing Camp Decoction) minus Huang Qi (Astragali Radix) and Yuan Zhi (Polygalae Radix)
Labor and frustration cause extreme movement of Yang within the Five Emotions. Years of blood loss and coughing stem from internal emotional diseases. Herbal medicines alone cannot bring peace. Current complexion and pulse show daily decline, indicating Sheng Qi is being depleted. Worrying that after mid-spring, Earth Qi rises and Yang dissipates. Long-term illness damages the interior, leaving little gathered True Qi. In winter and spring, cold governs storage; total strategy is to secure and tonify the Three Yin Zang organs, supporting life with the disease. This represents the utmost human effort.
Ren Shen (Ginseng Radix), Chao Bai Shao (Paeoniae Radix Alba Stir-fried), Shu Di Tan (Rehmanniae Radix Preparata Charcoalized), Wu Wei Zi (Schisandrae Chinensis Fructus), Jian Lian (Nelumbinis Plumula), Zhi Cao (Glycyrrhizae Radix et Rhizoma Preparata)
Pulse is firm; body is thin with chronic cough and years of blood loss. Disgust for food, discomfort sleeping at night. Cultivating the root is essential. Previous use of Qi Wei Wan (Seven-Ingredient Pill) and Ba Wei Wan (Eight-Ingredient Pill) employs the method of drawing Yang from Yin in Liver-Kidney. Ineffective because fluid deficiency cannot withstand the rigidity of Gui (Cinnamomi Ramulus) and Fu Zi (Aconiti Lateralis Radix Praeparata). Should warm-nourish and grasp/securing the Lower Jiao, while benefiting Stomach fluids to nourish the Lung.
Morning: Shu Di Huang (Rehmanniae Radix Preparata), Bai Zi Ren (Biota Orientalis Semen), Qi Zi (Lycii Fructus), Wu Wei Zi (Schisandrae Chinensis Fructus), Hu Tao Rou (Juglandis Semen), Niu Xi (Achyranthis Bidentatae Radix), Rong蓉 (Cynomorii Herba), Fu Ling (Poria), Honey pills.
Evening: Ren Shen (Ginseng Radix), Mai Dong (Ophiopogonis Radix), Wu Wei Zi (Schisandrae Chinensis Fructus), Zhi Cao (Glycyrrhizae Radix et Rhizoma Preparata), Fu Ling (Poria), Shan Yao (Dioscoreae Rhizoma), Xian Lian Zi (Nelumbinis Semen Recens)
Half a month ago coincided with Spring Equinox; Yang Qi was rising. Emotional movement caused Jue Yang (Extreme Yang) to blaze upward, vibrating collaterals during coughing, leading to blood loss. Although bleeding stopped, palpation of the Right pulse is large and penetrating to the Cun (inch) position. Food is not desired; muttering in sleep. Damage from Extreme Yin extends to Yang Ming (Stomach/Large Intestine); Essence, Qi, and Spirit do not intersect. Propose a method to gather and secure Shen (Spirit).
Ren Shen (Ginseng Radix), Fu Shen (Poria Cum Radice), Wu Wei Zi (Schisandrae Chinensis Fructus), Zhi Cao (Glycyrrhizae Radix et Rhizoma Preparata), Zao Ren (Ziziphi Spinosae Semen), Long Gu (Os Draconis), Jin Po (Lamina Aurea)
Massive blood loss empties collaterals; damage is no longer limited to one Fu or Zang organ. During Autumn Equinox and Cold Dew, Heaven's Qi descends, but Body Qi rebels upward. Clearly, the interior refuses to collect; how can deficiency be doubted? Current pulse is weak, soft, and choppy; extremities are slightly cold. Qi injury causes upward rebellion, misty like smoke, scorching the throat base, causing choking. General principle: Upper Jiao should descend and unblock; Lower Jiao should seal and secure. Secure Grain and Revere Earth (Spleen/Stomach), then discuss subsequent methods.
Ren Shen (Ginseng Radix), Chao Hei Gou Qi Zi (Lycii Fructus Charred), Chao Hei Niu Xi (Achyranthis Bidentatae Radix Charred), Fu Shen (Poria Cum Radice), Chao Shan Yao (Dioscoreae Rhizoma Stir-fried), Sheng Yi Yi Ren (Coicis Semen Recens)
Worry and frustration cause Qi and Fire to burn internally. Plus, smoking exhausts Lung Qi; alcohol heat damages Stomach. Essence and Ying fluids are steamed into turbid败浊 (defective turbidity). The Classic says: "If Yang Collaterals are injured, blood overflows externally." Stomach collaterals are injured; Yang Ming Qi and Blood are abundant, barely enduring for years. As Yang Ming collaterals decline, back chills first, right hypochondriac soreness, continuous coughing and spitting. Stomach Earth becomes more exhausted, Liver Wood becomes more horizontal/rebellious, Jue Yang rebels more. Filthy turbid odors rise from below. Generally, Left Ascending belongs to Liver, Right Descending belongs to Lung. Since Middle Jiao Stomach Earth is trapped, there is ascending without descending, blocking and pressing. Hence preferring left-side sleeping to suppress ascending rebellion. Irritation and heat burning exist without thirst/desire to drink. Pathology lies entirely in blood collaterals. Clearing heat and nourishing Yin treatments lack power to enter collaterals. Here, clearing and nourishing Stomach Yin is primary, with another prescription for unblocking collaterals entered separately. Liver-Gallbladder Jue Yang is slightly harmonized, hoping for less saliva and open hypochondrium. Deep-seated accumulation is difficult to regulate.
Sang Ye (Mori Folium), Dan Pi (Moutan Cortex), Yi Yi Ren (Coicis Semen), Su Zi (Perillae Fructus), Gou Teng (Uncariae Ramulus cum Uncis), Yu Jin (Curcumae Radix), Jiang Xiang (Dalbergiae Odoriferae Lignum), Tao Ren (Persicae Semen)
Elderly person with failed Winter Storage seems to have intense external heat. Pungent dispersing and bitter cooling are methods for excess-solid patterns. From Spring to Summer, Great Qi opens and泄 (dissipates); daily fatigue and weakness; audible breath sounds; chest/hypochondrium stuffiness and pain; coughing purple blood; collateral disharmony. Propose pungent-tonifying and unblocking, avoiding cold coagulation and dryness, hoping to avoid Guan Ge (Obstruction and Reflux) blockage between upper and lower.
Bai Zi Ren (Biota Orientalis Semen), Xi Sheng Di Huang (Rehmanniae Radix Recens), Dang Gui Xu (Angelicae Sinensis Radix Tenuis), Tao Ren (Persicae Semen), Jiang Xiang (Dalbergiae Odoriferae Lignum), Fu Shen (Poria Cum Radice)
Previously bone pain and shivering; every ten days vomiting a bowl of blood; consistent from Winter to Summer. Recently only supine position tolerated; lying on right causes incessant coughing/rebellion. Said to be caused by anger and fatigue; all due to excessive Yang movement. Thirst and tongue coating remain, appetite normal. Temporarily harmonize Jue Yang and Yang Ming Yang. Not merely treating visible blood and cough superficially.
Shi Gao (Gypsum Fibrosum), Shu Di Huang (Rehmanniae Radix Preparata), Mai Dong (Ophiopogonis Radix), Zhi Mu (Anemarrhenae Rhizoma), Niu Xi (Achyranthis Bidentatae Radix)
Pulse rapid, left firm. In April (Summer), Yang Qi is strong. Sudden anger causes Liver Yang to surge violently, collateral blood rushing up. Though bleeding stopped, coughing/rebellion with desire to vomit, unable to sleep leaning left. This is Liver Yang ascending too much on the left; Wood loses Water nourishment; Yin deficiency generates heat. This is inherent Yin-Yang imbalance, not comparable to pathogenic exogenous fire that can be cleared/descended. Best to be tranquil and non-actionable, quiet and leisurely. If unchanged for years, hope for balance. But relying only on medicine makes it hard to reduce deficiency. Classic says: "Symptoms of Stomach Cough: coughing/rebellion with vomiting." Wood attacks Stomach Earth piercing diaphragm, reaching Pharynx-Lung. Lung declines, Wood punishes Metal. Following Neijing, use sweet-pacifying to control urgency.
Mi Chao Mai Dong (Ophiopogonis Radix Rice-roasted), Nuo Dao Gen Xu (Oryzae Sativa Rootlet), Nu Zhen Zi (Ligustri Lucidi Fructus), Fu Shen (Poria Cum Radice), Sheng Gan Cao (Glycyrrhizae Radix et Rhizoma Recens), Nan Zao Rou (Ziziphi Jujubae Mesocarp)
Blood loss injures Stomach; should treat from Middle Jiao. Moreover, illness started five years ago from labor/anger; Liver Wood inevitably overacts on Earth. Physicians aggressively advanced warm-tonification, causing Qi stagnation and distension. Nighttime dry throat, insomnia, no appetite, tasteless, vomiting, coughing—all due to Stomach Yang rebelling upward. Classic: "If Stomach is not harmonious, sleep is uneasy." Yang fails to subside/descend, seemingly due to turbid Qi and sticky phlegm (tangible matter) obstructing ascent/descent. Ancients said: "Two deficiencies, one excess; treat excess first to open a way." I focus on Stomach disease, controlling Liver and saving Middle, regulating Qi and clearing膈 (Diaphragm). This is "excess within deficiency," a flexible treatment. Do not disrupt this mechanism.
Ren Shen (Ginseng Radix), Zhi Shi (Aurantii Fructus Immaturus), Ban Xia (Pinelliae Rhizoma), Xing Ren (Armeniacae Semen Amarum), Gan Cao (Glycyrrhizae Radix et Rhizoma), Zhu Ru (Bambusae Caulis in Taenia), Sheng Jiang (Zingiberis Rhizoma Recens), Da Zao (Ziziphi Jujubae Fructus)
Pulse left wiry, right small/soft. Disease source starts from depression; prolonged stagnation transforms into heat, steaming and forcing collaterals, blood overflowing upward, coagulating into clumps—blood leaving collaterals stays as stasis. After bleeding, appetite remains normal; Fu collaterals store ample Qi/Blood. Fu organs function via unblocking. Blood rebellion causes Qi to merge upward, gurgling sounds—all due to Fire Qi rotating, not tangible matter. Blood diseases affect all Zang-Fu. This case prioritizes clearing Yang collaterals. When disease strikes, treat the cause, not necessarily sticking to norms.
Pi Pa Ye (Pipal Leaf), Yi Yi Ren (Coicis Semen), Fu Ling (Poria), Su Zi (Perillae Fructus), Sang Ye (Mori Folium), Dan Pi (Moutan Cortex), Chao Tao Ren (Persicae Semen Stir-fried), Jiang Xiang Mo (Dalbergiae Odoriferae Lignum Powder)
Palpation: Left hand pulse peaceful, Chi slightly moving. Right hand three positions: Guan front moving/rapid, Chi pulse rapid. Sleeplessness at night, coughing with blood; daytime coughing without blood, slight panting when walking. Yin-Yang act as hinges. In deep winter, Heaven's Qi stores. Due to mental agitation and Five Emotions moving, Yang does not hide. When drowsy, Qi mechanism sinks downward, touching rising Yang, Chong Mai rises, collateral blood unsettled, overflowing via coughing. Walking and talking also aid Qi-Fire movement. This coughing/panting/blood loss shares one origin. Use stillness to control movement; administer drugs to benefit Water and generate Metal to control Ministerial/Sovereign Fire. Diet should avoid pungent/spicy/hot/dry. Upper excess implies Lower deficiency. Light flavors clear Upper Jiao, truly securing Lower, allowing storage. My rough prescription awaits your decision.
Sheng Bian Dou (Lablab Album Seed Recens), Mai Dong (Ophiopogonis Radix), Chuan Hu (Dendrobii Caulis), Shang E Jiao (Asini Corii Colla Superior), Xiao Gen Sheng Di (Rehmanniae Radix Recens Minor Root), Zhen Bei Sha Shen (Glehniae Radix Authentic)
Pulse fine/small as if absent. Prone to depression/anger. Illness began during menstruation. Winter stomach pain followed by incessant hemoptysis. Chills, red face, fright, head shaking. Clearly Liver Yang transforming into Wind, collateral blood boiling. Extremities cold, True Qi weak. Neijing mentions sudden changes in Liver disease; how could this be trivial? Propose Jing Yue Zhen Yin Jian (Jing Yue's Settling Yin Decoction) method to control Yang rebellion, adhering to the meaning of guiding downwards.
Shu Di Hui (Rehmanniae Radix Preparata Ash), Niu Xi Tan (Achyranthis Bidentatae Radix Charcoalized), Rou Gui (Cinnamomi Cortex), Fu Shen (Poria Cum Radice), Sheng Bai Shao (Paeoniae Radix Alba), Tong Bian (Infantis Urina)
External Cold Water, internal pressing Fright Qi. Yin Malaria for three years, followed by coughing blood for seven years, no end in sight. Asked about blood coming in purple clumps; still tastes food well. Considering Malaria/Fright injury, must be Liver collateral congealed stasis, triggered by anger/fatigue. Do not give wine/luxury-induced damage treatments; do not blindly administer Yin-nourishing cloying drugs, fearing Stomach Qi decreases daily, disease worsens.
Tao Ren (Persicae Semen), Bie Jia (Trionycis Carapax), Chuan Gui Zhi (Cinnamomi Ramulus), Gui Xu (Angelicae Sinensis Radix Tenuis), Da Huang (Rhei Radix et Rhizoma), Chong Wei Zi (Leonuri Fructus)
Dark complexion, thin flesh, pointed/long shape. Wood-Fire constitution; Yin fluids hardest to fill. Spring cough, though wind-warmth exogenous pathogen, since Yin deficient, Winter Storage already insecure. Coughing/rebellion vibration causes Floating Yang to ascend to Stomach, clearing space blocked. Medicines should be quiet/heavy, filling Yin and settling Yang. Previous formulas half pungent, conflicting with Ci Shi (Magnetitum). Rong Rong (Cynomorii Herba) is Yang within Yin, not gathering; ineffectiveness is expected.
Da Shu Di Huang (Rehmanniae Radix Preparata Magna), Ling Ci Shi (Magnetitum), Yu Rou (Corni Fructus), Wu Wei Zi (Schisandrae Chinensis Fructus), Mu Dan Pi (Moutan Cortex), Yun Fu Ling (Poria Cloud), E Jiao (Asini Corii Colla), Huai Shan Yao (Dioscoreae Rhizoma Huai), Ze Xie (Alismatis Rhizoma), Gui Ban (Testudinis Carapax et Plastrum)
Left/right hypochondrium/chest, unbearable discomfort, vomiting/rebellion with blood. Outside Zang-Fu, collaterals bind; collaterals gather blood. Middle-aged labor consumes blood. Blood not harmonizing Qi, Qi attacking collaterals, symptoms unclear. Unblock Blood aspect to harmonize collaterals, preventing stasis attachment, avoiding dysphagia/reflux.
Xin Jiang (New Crimson Dye), Qing Cong Guan (Allii Fistulosi Caulis), Ju Ye (Citri Reticulatae Folium), Tao Ren (Persicae Semen), Gua Lou Ren (Trichosanthis Semen), Gou Teng (Uncariae Ramulus cum Uncis)
Years of blood loss syndrome, severe cough with phlegm, followed by vomiting/belching, afternoon chills/fever, midnight sweating. Doctor saw blood, administered Yu Jin (Curcumae Radix), Jiang Huang (Curcumae Longae Rhizoma), Jiu Zhi Da Huang (Rhei Radix et Rhizoma processed with Leek Juice) to purge stasis downward, hoping to stop blood. This is a method for excess. Humans possess Yin-Yang; deviation causes disease. Internal damage is deficiency. Pulse left moving/rapid, Chi not reaching bone. Clearly Kidney Essence and Liver Blood internally seized. Weak Yin cannot entangle Yang, Chong Yang rebels upward, inhalation fails. Thus coughing Qi rises, soon vomiting belching turbid saliva/phlegm. Neijing says: "All Zang-Fu can cause cough." Why do moderns treat Lung for cough? Seeing phlegm, descending turbidity, clearing heat damages the damaged further, ignoring the cycle of Yin storage/Yang growth. Mixed drugs vainly attack Stomach Qi. Over years, not an acute disease. Filling Lower gaps requires sentient beings (animal-derived drugs).
Ren Shen (Ginseng Radix), Zi Yi Hu Tao (Walnut Kernel with Purple Skin), Zi Shi Ying (Hematitum), Fu Shen (Poria Cum Radice), Wu Wei Zi (Schisandrae Chinensis Fructus), Shan Yu Rou (Corni Fructus), He Che Jiao (Placenta Human), Qiu Shi (Urinalis Concretio)
Palpation: Left rapid/slightly wiry, Cun-Chi-Guan deficiency/rapid. Reviewing source 5 years ago: Left hypochondrium radiating to back pain, unable to lie down, previously vomited purple blood clumps. Clearly Liver depression turning to heat, heat forcing Qi rebellion and blood stasis. Though recovered with regulation, constitution lacks Liver Yin, Liver Yang is active. Body Qi: Left ascending governed by Liver, Right descending by Lung. Now ascending more than descending, Yin not harmonizing Yang. Stomach fluids lack capacity to supply/nourish Lung. This dry/itchy coughing/wheezing, spitting water foam, matches Neijing stating Liver disease spits foam. Liver Wood attacks Stomach Earth, minimal food intake, limb weakness. Cough medicines cannot cure. This is Liver Yang rebelling, actually Liver Yin deficiency. Zhongjing said: "Seeing Liver disease, first regulate Spleen-Stomach," so Earth thickens and is not overcome by Wood, originally having generating Metal function. Reported that eating eggs worsens condition; thus knowing stagnant/astringent drugs do not match the body.
Bei Sha Shen (Glehniae Radix), Sheng Bian Dou (Lablab Album Seed Recens), Mai Dong (Ophiopogonis Radix), Yu Zhu (Polygonati Odorati Rhizoma), Sang Ye (Mori Folium), Sheng Gan Cao (Glycyrrhizae Radix et Rhizoma Recens), Zhe Jiang (Sacchari Sinaris Liquamen)
Pulse right wiry, left soft. Autumn cool lingering fluid, floating upward causing coughing. Night lying on pillow drowsy, Qi rushing to epigastrium, heart palpitations/vibration, must sit up. Zhang Zhongjing's Pulse Chapter: Wiry indicates Fluid; Back cold indicates Fluid. Treat Fluid, not Cough. Fluid is Yin Evil, stealing out at dusk. *Jin Gui* methods often use Unblocking Yang and washing away Fluid, distinct from世俗 (worldly) using only Lung drugs to disperse/descend. Use Xiao Qing Long Tang minus Ma Huang (Ephedrae Herba) and Xi Xin (Asari Radix et Rhizoma).
Gui Zhi (Cinnamomi Ramulus), Wu Wei Zi (Schisandrae Chinensis Fructus), Gan Jiang (Zingiberis Rhizoma), Fu Ling (Poria), Bai Shao (Paeoniae Radix Alba), Zhi Cao (Glycyrrhizae Radix et Rhizoma Preparata), Ban Xia (Pinelliae Rhizoma)