病者长夏霉天奔走。内踝重坠发斑。下焦痛起。继而筋掣。及于腰窝左臂。
经云。伤于湿者。下先受之。夫下焦奇脉不流行。内踝重着。阴维受邪。久必化热
烁血。风动内舍乎肝胆。所谓少阳行身之侧也。诊得右脉缓。左脉实。湿热混处
血络之中。搜逐甚难。此由湿痹之症。失治。延为痿废沉 矣。三年病根。非仓猝
迅攻。姑进先通营络。参之奇经为治。考古圣治痿痹独取阳明。惟通则溜邪可拔耳。
鹿角霜 生白术 桂枝 茯苓 抚芎 归须 白蒺藜 黄菊花
四肢经隧之中。遇天冷阴晦。疼痛拘挛。痈疽疡溃脓。其病不发。疡愈。病复
至。抑且时常衄鼽。经以风寒湿三气。合而为痹。然经年累月。外邪留着。气血皆
伤。其化为败瘀凝痰。混处经络。盖有诸矣。倘失其治。年多气衰。延至废弃沉 。
当归须 干地龙 穿山甲 白芥子 小抚芎 生白蒺藜 酒水各半泛丸
从来痹症。每以风寒湿三气杂感主治。召恙之不同。由乎暑 外加之湿
热。水谷内蕴之湿热。外来之邪。着于经络。内受之邪。着于腑络。故辛解汗出。热
痛不减。余以急清阳明。而致小愈。病中复反者。口鼻复吸暑热也。是病后宜薄
味。使阳明气爽。斯清阳流行不息。肢节脉络舒通。而痿痹之根尽拔。至若温补
而图速效。又非壮盛所宜。
人参 茯苓 半夏 广皮 生于术 枳实 川连 泽泻 竹沥姜汁泛丸
风湿肿痹。举世皆以客邪宜散。愈治愈剧。不明先因劳倦内伤也。盖邪之
所凑。其气必虚。参术益气。佐以风药。气壮托出其邪。痛斯止矣。病患自云。手足
如堕如无。讵非阳微不及行乎四末乎。此皆误治。致参药过费耳。
人参 生于术 黄 归身 肉桂 炙草 煨姜 南枣
风湿客邪留于经络。上下四肢。流走而痛。邪行触犯。不拘一处。古称周痹。
且数十年之久。岂区区汤散可效。凡新邪宜急散。宿邪宜缓攻。
蜣螂虫 全蝎 地龙 穿山甲 蜂房 川乌 麝香 乳香 以无灰酒煮黑大豆泛丸
左脉弦大。面赤痰多。大便不爽。此劳怒动肝。令阳气不交于阴。阳维阳
二脉无血营养。内风烁筋。跗HT 痹痛。暮夜为甚者。厥阴旺时也。病在脉络。
金斛 晚蚕沙 汉防己 黄柏 半夏 萆 大槟榔汁
冬月温暖。真气未得潜藏。邪乘内虚而伏。因惊蛰节。春阳内动。伏气乃发。
初受风寒。已从热化。兼以夜坐不眠。身中阳气。亦为泄越。医者但执风寒湿三
邪合成为痹。不晓病随时变之理。羌防葛根。再泄其阳。必致增剧矣。焉望痛缓。
议用仲景木防己汤法。
木防己 石膏 桂枝 片姜黄 杏仁 桑皮
烦劳郁勃之阳。变现热气内风。内经以热淫风消。必用甘寒。前议谓酒客
不喜甘味。且痰多食少。亦忌甘腻滋滞。用清少阳胆热者。酒气先入肝胆也。酒
汁湿着。肠胃受之。理肠以通胃。胃肠气机流行。食加。滑泄颇腻。今者气热。当午
上冒。经络痹痛。亦减于平日主以和阳甘寒。宣通经脉佐之。
童桑 羚羊角 天门冬 枸杞子 白蒺藜 丹皮 茯苓 霍山斛 共熬膏
辛香走窜。宣通经隧壅结气分之湿。有却病之能。无补虚之益。大凡药饵。
先由中宫以布诸经。中焦为营气之本。营气失养。转旋自钝。然攻病必藉药气
之偏。朝夕更改。岂是去疾务尽之道。另于暮夜进营养一帖。
人参 茯苓 桂枝木 炙草 当归 炒白芍 南枣
周礼采毒药。以供医事。盖因顽钝沉痼着于驱壳。非脏腑虚损。故必以有
毒攻拔。使邪不留存。凝着气血。乃效。既效矣。经云。大毒治病。十去其五。当此只
宜爱护身体。勿劳情志。便是全功道理。愚人必曰。以药除根。不知天地之气有
胜有复。人身亦然。谷饮养生。可御一生。药饵偏胜。岂可久服。不观方士炼服金
石丹药。疽发而死者比比。
何首乌 黑芝麻 桑枝 桂枝汤泛丸
用养肝血熄风方。右指仍麻。行走则屈伸不舒。戌亥必心热烦蒸。想前法
不效。杞归辛温。阳动风亦动矣。议去辛用咸。若疑虑途次疟邪未尽。致脉络留
滞。兼以通逐。缓攻亦妙。
熟地 龟胶 阿胶 秋石 天冬 麦冬 五味 茯神 密丸晨服
桃仁 穿山甲 干地龙抚芎 归须 丹皮 红花 沙苑 香附汁丸夜服
背痛得按摩愈痛。吐涎沫。短气腹满。小腹坚。小便不通。大便自利。下体麻
木。不得移动。不食不寐。烦则汗出。病机多端。无缕治成法。思冷浊窃踞。阳微不
行。为痞塞之象。二气既乖。岂可忽略。引仲景少阴例。急进通阳为要。议用白通
加人尿猪胆汁汤。
去须葱白 淡干姜 生炮附子 人尿猪胆汁调下
脉弦右大。弦则为饮。大则胃阳已虚。缘操持萦思。积劳阳虚。致不饥不食。
勉纳食物不运。 怒兼以夜卧不安。多寤少寐恍惚中心 懊。忽而腹鸣气震。
四肢筋骱。痿弱无力。起病时晨必寒痉。足跗微冷。按是脉症有年。阳虚为本。而
痰饮气逆。因虚而聚。夫虚则生寒。实则生热寝食不安。将及半载。已交四之气
中。长夏湿土乘侮脾胃。虑及肌肿腹胀。故周身束筋利机。阳明胃脉是赖。阅医
药。气血淆混。寒热互投。不以阴阳偏着。调理宜乎不应。议通补理胃阳为主。疏
肝为辅。气宣阳苏。何虑痰浊之蒙昧。以茯苓饮法减术。合薛氏星附六君子意。
人参 茯苓 香附 苏梗 白附 半夏 姜汁 陈皮
周身掣痛。头不可转。手不能握。足不能运。两脉浮虚。浮虽风象。而内虚者。
脉亦浮而无力。以脉参症。当是劳倦伤中。阳明不治之候。阳明者。五脏六腑之
海。主束筋骨而利机关。阳明不治。则气血不荣。十二经络无所禀受而不用矣。
卫中空虚。营行不利。相搏而痛。有由然也。法当大补阳明气血。不与风寒湿所
致成痹者同治。
人参 黄 归身 甘草 桂枝木 秦艽 白术
长夏湿痹。经脉流行气钝。兼以下元脉络已虚。痿弱不能走趋。脊膂常似
酸楚。大便或结或溏。都属肝肾奇经为病。盖必佐宣通脉络为正治法。倘徒呆
补。夏季后必滋湿扰。须为预理。
肉苁蓉 小茴香 巴戟天 归身 远志 鹿角霜 桑椹子 生茅术 茯苓 熟地
金毛狗脊 煎膏和丸
脉微而涩。微为阳气虚。涩为阴血伤。去冬已下肢独冷。步趋无力。高年内
乏藏纳之司。入夏身动加喘。肉腠麻痹若虫行。此真阳失蛰。胃阳失护。生生意
少。岂攻病药石所宜。喻嘉言先生所谓大封大固。莫令真阳泄尽而暴脱。皆为
此也。录严氏三因方。
人参 白术 附子
据述缘季秋外邪变疟。延及百日始愈。凡秋疟。是夏月暑湿热内伏。新凉
外触。引动伏邪而发。俗医但知柴葛解肌。暑湿伤在气分。因药动血。血伤挛痹。
筋热则弛。筋寒则急。遂至酿成痿痹难效症。
当归身 桑寄生 生虎骨 枸杞子 川抚芎 沙苑蒺藜
血伤骤加惊恐。气郁热升风旋。清神受蒙为厥。凡厥皆隶厥阴。今左股麻
痹。忽爽忽迷。皆肝胆中相火内风。未得宁静。病延数日。左脉小濡。热胜。津液暗
伤。不宜纯与攻涤苦寒。经旨以肝为刚脏。与胃腑对待。柔缓濡润。阳和液复。可免痫症。
鲜生地 石菖蒲 柏子仁 阿胶 天冬 茯神
偏枯症。风论云。邪中五脏六腑之俞穴。各入门户为病。则四肢不举。然阳
主左而阴主右也。又云。汗出偏沮。使人偏枯。此外感之邪。或营卫皆虚。邪乘虚
入。或虚风内动。皆有之。医者治之。当补正以逐邪。未可逐邪而罔顾本元。然治
之之法。以阳明为主。
生 白芍 当归 防风 续断 萆 蚕砂 橘红 虎骨 秦艽
患者于长夏梅雨季节奔走劳作。内踝沉重下坠并出现斑疹，下焦疼痛发作，继而筋脉抽搐，波及腰窝及左臂。
《内经》说：“伤于湿邪的，下部先受邪。”这是因为下焦奇经八脉气血运行不畅，导致内踝沉重，阴维脉受邪，日久必然化热灼伤血液，引动内风，内舍于肝胆。这正是少阳胆经循行身体侧面的道理。诊察发现右脉缓，左脉实，湿热混杂在血络之中，搜剔驱逐非常困难。这是由湿痹病症，因失治而拖延成痿废沉疴。三年的病根，不能仓促猛烈攻伐，暂且先通调营分脉络，参酌奇经八脉进行调理。古代圣医治疗痿痹主张独取阳明经，只有通畅才能引导邪气拔出。
鹿角霜、生白术、桂枝、茯苓、抚芎（川芎）、归须（当归尾）、白蒺藜、黄菊花。
四肢经络隧道中，遇到天冷阴晦时，疼痛拘挛。痈疽溃疡溃破流脓时，病邪潜伏不发；疮疡愈合后，病邪又至。并且时常鼻出血或鼻塞流涕。《内经》认为风寒湿三气合而为痹。然而经年累月，外邪留着不去，气血皆受伤，化为败瘀和凝痰，混杂在经络中，这种情况是有的。如果失去治疗，年久气衰，拖延至废弃沉疴。
当归须、干地龙、穿山甲、白芥子、小抚芎、生白蒺藜，用酒和水各半泛丸。
历来治疗痹症，多以风寒湿三气杂感为主治。致病不同，在于暑湿外加的热湿，以及水谷内蕴的湿热。外来的邪气，附着于经络；内受的邪气，附着于腑络。所以辛散解表发汗后，热痛不减。我用急清阳明经的方法，才使病情稍愈。病中反复，是因为口鼻再次吸入暑热。病后宜清淡饮食，使阳明胃气清爽，这样清阳之气流行不息，肢节脉络舒通，痿痹的病根才能尽除。至于温补以求速效，又不适合壮盛之体。
人参、茯苓、半夏、广皮（陈皮）、生于术（生白术）、枳实、川连（黄连）、泽泻、竹沥、姜汁泛丸。
风湿肿痹，举世都认为客邪应当发散，结果越治愈越严重，不明白起因是劳倦内伤。大概邪气聚集的地方，正气必定虚弱。用人参、白术益气，佐以风药，气壮则托出邪气，疼痛就停止了。病患自己说，手足像堕落了一样没有知觉，难道不是阳气微弱不能到达四肢末端吗？这都是误治，导致人参药物浪费过多罢了。
风湿客邪留滞于经络，上下四肢，流走而痛，邪气行走触犯，不拘泥于一处，古称周痹。而且几十年之久，岂是普通的汤剂散剂能奏效的。凡新邪应当急散，宿邪应当缓攻。
蜣螂虫、全蝎、地龙、穿山甲、蜂房、川乌、麝香、乳香，用无灰酒煮黑大豆泛丸。
左脉弦大，面赤痰多，大便不爽，这是劳怒触动肝木，令阳气不能交于阴，阳维脉、阳跷脉无血营养，内风灼伤筋脉，足背痹痛，夜间加重，因为厥阴肝经旺于此时。病在脉络。
冬季温暖，真气未能潜藏，邪气乘内虚而伏藏。因惊蛰节气，春阳内动，伏气乃发。初受风寒，已从热化，兼以夜坐不眠，身中阳气，也为泄越。医者只执着于风寒湿三邪合成为痹，不懂疾病随时间变化的道理，再用羌活、防风、葛根等药，再次泄其阳气，必然导致病情加重，哪里指望疼痛缓解呢？建议用仲景木防己汤法。
烦劳郁勃之阳，变现热气内风。《内经》说热淫风消，必用甘寒。前议认为酒客不喜欢甘味，且痰多食少，也忌甘腻滋滞。用清少阳胆热的方法，因为酒气先入肝胆。酒汁湿着，肠胃受之，理肠以通胃，胃肠气机流行，食欲增加，但滑泄颇腻。如今气热，当午上冒，经络痹痛，也比平日减轻。主以和阳甘寒，宣通经脉，佐以调理。
童桑（嫩桑枝）、羚羊角、天门冬、枸杞子、白蒺藜、丹皮、茯苓、霍山斛，共熬膏。
辛香走窜之药，宣通经隧壅结气分之湿，有祛病的能力，无补虚的益处。大凡药饵，先从脾胃布散到诸经。中焦是营气的根本，营气失养，运转自然迟钝。然而攻病必须借助药气的偏性，朝夕更改，这不是去疾务尽的道理。另外在暮夜进服营养一帖。
《周礼》采集毒药，以供医事使用。大概因为顽钝沉痼附着于躯壳，并非脏腑虚损，所以必须用有毒的药物攻拔，使邪气不留存，凝着气血，才能见效。既然见效了，《内经》说：大毒治病，十去其五。此时只宜爱护身体，勿劳情志，便是全功的道理。愚人一定说，用药除根，不知天地之气有胜有复，人身亦然。谷物饮食养生，可御一生，药饵偏胜，岂可久服？不看方士炼服金石丹药，疽发而死的人比比皆是。
用养肝血熄风的方子，右手指仍然麻木，行走时屈伸不舒，戌亥时（晚上7-11点）必定心热烦蒸。想之前的方法不效，杞归辛温，阳动风亦动矣。建议去辛用咸，若疑虑途中疟邪未尽，致脉络留滞，兼以通逐，缓攻也是妙法。
熟地、龟胶、阿胶、秋石、天冬、麦冬、五味子、茯神，密丸晨服。
桃仁、穿山甲、干地龙、抚芎、归须、丹皮、红花、沙苑、香附汁丸夜服。
背痛得按摩反而更痛，吐涎沫，短气腹满，小腹坚硬，小便不通，大便自利，下体麻木，不能移动，不食不寐，烦躁则汗出，病机多端，无法缕析治成法。思虑冷浊窃踞，阳气微弱不行，为痞塞之象。二气既乖违，岂可忽略。引用仲景少阴例，急进通阳为要。建议用白通加人尿猪胆汁汤。
脉弦右大，弦则为饮，大则胃阳已虚。缘于操持萦思，积劳阳虚，导致不饥不食。勉强进食食物不运化，愤怒兼以夜卧不安，多醒少睡恍惚心中懊恼，忽而腹鸣气震，四肢筋骨痿弱无力。起病时早晨必寒痉，足跗微冷。按此脉症有年，阳虚为本，而痰饮气逆，因虚而聚。夫虚则生寒，实则生热，寝食不安，将及半载，已交四之气中。长夏湿土乘侮脾胃，虑及肌肿腹胀，故周身束筋利机，依赖阳明胃脉。阅医医药，气血淆混，寒热互投，不以阴阳偏着，调理宜乎不应。议通补理胃阳为主，疏肝为辅。气宣阳苏，何虑痰浊之蒙昧。以茯苓饮法减术，合薛氏星附六君子意。
周身掣痛，头不可转，手不能握，足不能运，两脉浮虚。浮虽风象，而内虚者，脉亦浮而无力。以脉参症，当是劳倦伤中，阳明不治之候。阳明者，五脏六腑之海，主束筋骨而利机关。阳明不治，则气血不荣，十二经络无所禀受而不用矣。卫中空虚，营行不利，相搏而痛，有由然也。法当大补阳明气血，不与风寒湿所致成痹者同治。
长夏湿痹，经脉流行气钝，兼以下元脉络已虚，痿弱不能走趋，脊膂常似酸楚，大便或结或溏，都属肝肾奇经为病。盖必佐宣通脉络为正治法，倘徒呆补，夏季后必滋湿扰，须为预理。
肉苁蓉、小茴香、巴戟天、归身、远志、鹿角霜、桑椹子、生茅术、茯苓、熟地、金毛狗脊，煎膏和丸。
脉微而涩，微为阳气虚，涩为阴血伤。去冬已下肢独冷，步趋无力，高年内乏藏纳之司，入夏身动加喘，肉腠麻痹若虫行，此真阳失蛰，胃阳失护，生生意少，岂攻病药石所宜。喻嘉言先生所谓大封大固，莫令真阳泄尽而暴脱，皆为为此也。录严氏三因方。
人参、白术、附子。
据述缘季秋外邪变疟，延及百日始愈。凡秋疟，是夏月暑湿热内伏，新凉外触，引动伏邪而发。俗医但知柴葛解肌，暑湿伤在气分，因药动血，血伤挛痹，筋热则弛，筋寒则急，遂至酿成痿痹难效症。
血伤骤加惊恐，气郁热升风旋，清神受蒙为厥。凡厥皆隶厥阴。今左股麻痹，忽爽忽迷，皆肝胆中相火内风，未得宁静。病延数日，左脉小濡，热胜，津液暗伤，不宜纯与攻涤苦寒。经旨以肝为刚脏，与胃腑对待，柔缓濡润，阳和液复，可免痫症。
偏枯症，风论云：邪中五脏六腑之俞穴，各入门户为病，则四肢不举。然阳主左而阴主右也。又云：汗出偏沮，使人偏枯。此外感之邪，或营卫皆虚，邪乘虚入，或虚风内动，皆有之。医者治之，当补正以逐邪，未可逐邪而罔顾本元。然治之之法，以阳明为主。
The patient ran about during the plum rain season of late summer. The inner ankle felt heavy and drooping with macules appearing, lower jiao pain started, followed by tendon spasms extending to the popliteal fossa and left arm.
The *Classic* states: "Those injured by dampness, the lower part receives it first." This is because the flow of the extraordinary vessels in the lower jiao is obstructed, causing heaviness in the inner ankle; the Yin Wei vessel is affected, and over time, it must transform into heat that scorches blood, stirring internal wind which enters internally to store in the Liver and Gallbladder. This is what is meant by the Shaoyang channel running along the side of the body. The pulse diagnosis reveals a slow right pulse and a solid left pulse. Damp-heat is mixed within the blood collaterals, making it very difficult to search out and expel. This condition originated from damp-bi syndrome, neglected treatment, and prolonged into flaccidity and chronic illness. A three-year root disease cannot be attacked hastily and violently; for now, we tentatively advance methods to first unblock the Ying (Nutrient) collaterals, incorporating treatment of the extraordinary vessels. Ancient sages treated flaccidity and bi by focusing solely on the Yangming channel; only by unblocking can evil be extracted.
Deer Antler Frost, Raw Atractylodis Macrocephalae Rhizoma, Cinnamon Twig, Poria, Chuanxiong Rhizoma, Angelica Sinensis Tail, Tribulus Fruit, Yellow Chrysanthemum Flower.
In the meridians and collaterals of the four limbs, when the weather is cold and gloomy, pain and spasms occur. When carbuncles, sores, or ulcers suppurate, the disease lies dormant; after the ulcer heals, the disease returns. Moreover, epistaxis or nasal congestion occurs frequently. The *Classic* holds that Wind, Cold, and Dampness combine to form Bi. However, over years and months, external evils linger, injuring Qi and Blood, transforming into failed stasis and congealed phlegm, mixing within the meridians. If treatment is lost, Qi declines with age, leading to disability and chronic illness.
Angelica Sinensis Tail, Earthworm, Pangolin Scales, White Mustard Seed, Chuanxiong Rhizoma, Tribulus Fruit, made into pills with half wine and half water.
Historically, treating Bi syndrome focuses on the miscellany of Wind, Cold, and Dampness. The difference in illness arises from external Summerheat-Dampness and internal Damp-Heat retained from food and drink. External evils attach to meridians; internal evils attach to fu organ collaterals. Thus, after acrid-warm sweating, heat and pain do not decrease. I used urgent clearing of the Yangming channel, resulting in slight improvement. Recurrence during illness is due to inhaling Summerheat through mouth and nose. Post-illness requires bland diet to refresh Yangming Qi, allowing Clear Yang to flow continuously, relaxing limb joints and collaterals, uprooting flaccidity and bi. Warm tonification seeking quick effects is unsuitable for robust constitutions.
Ginseng, Poria, Pinellia Tuber, Tangerine Peel, Raw Atractylodis Macrocephalae Rhizoma, Immature Bitter Orange, Coptis Rhizome, Alisma Rhizome, Bamboo Sap, Ginger Juice, made into pills.
For rheumatic swelling and bi, the world believes guest evils should be dispersed, yet treatment worsens the condition, failing to understand the initial cause was fatigue and internal injury. Where evil gathers, Qi must be deficient. Ginseng and Atractylodes tonify Qi, assisted by wind-dispelling herbs; strong Qi pushes out evil, stopping pain. The patient claims hands and feet feel like they have fallen off, indicating Yang deficiency failing to reach the extremities. These are errors in treatment, wasting Ginseng.
Ginseng, Raw Atractylodis Macrocephalae Rhizoma, Astragalus Root, Angelica Sinensis Root Body, Cinnamon Bark, Honey-fried Licorice Root, Roasted Ginger, Southern Jujube.
Rheumatic guest evils remain in meridians, moving up and down the four limbs, causing wandering pain, touching various places without staying fixed, anciently called Zhou Bi. After decades, simple decoctions and powders cannot work. New evils should be dispersed urgently; old evils should be attacked slowly.
Dung Beetle, Whole Scorpion, Earthworm, Pangolin Scales, Beehive, Aconite Root, Musk, Frankincense, made into pills with black soybeans boiled in pure wine.
Left pulse is wiry and large, face red, much phlegm, bowel movement unsatisfactory. This is labor and anger stirring Liver, preventing Yang Qi from interacting with Yin. Yang Wei and Yang Qiao vessels lack blood nourishment, internal wind scorches tendons, dorsal foot bi pain, worse at night when Jueyin is prosperous. Disease is in the collaterals.
Dendrobium, Silkworm Frass, Stephania Tetrandra, Phellodendron Bark, Pinellia Tuber, Dioscorea Hypoglauca Rhizome, Betel Nut Juice.
Winter warmth prevents True Qi from hiding; evil hides due to internal deficiency. At Jingzhe solar term, Spring Yang moves internally, triggering latent qi. Initial Wind-Cold transforms into Heat; sitting up late at night leaks Yang Qi. Physicians stick to Wind-Cold-Damp forming Bi, ignoring disease transformation over time. Using Notopterygium, Saposhnikovia, and Kudzu Root again leaks Yang, worsening the condition. Propose Zhang Zhongjing's Mufangji Decoction method.
Stephania Tetrandra, Gypsum Fibrosum, Cinnamon Twig, Turmeric Rhizome, Apricot Seed, Mulberry Bark.
Yang constrained by fatigue manifests as internal heat and wind. The *Inner Classic* says heat causes wind to dissipate, requiring Sweet-Cold herbs. Previous discussion noted wine drinkers dislike sweet taste, and with much phlegm and little appetite, sweet-greasy cloying herbs are contraindicated. Clearing Shaoyang Gallbladder heat works as wine enters Liver/Gallbladder first. Wine dampness affects intestines/stomach; regulating intestines unblocks stomach. Stomach-intestine Qi mechanism flows, appetite increases, but slippery discharge is greasy. Now Qi is hot, rising at noon, meridian bi pain is less than usual. Mainly harmonize Yang with Sweet-Cold, promote meridians, assist regulation.
Young Mulberry Twig, Antelope Horn, Asparagus Fern Tuber, Lycium Fruit, Tribulus Fruit, Moutan Cortex, Poria, Huoshan Dendrobium, boiled into paste.
Acrid-aromatic penetrating herbs unblock Qi-level dampness in congested meridians, having disease-resolving ability but no tonifying benefit. Generally, medicines spread from the Middle Palace to all meridians. Middle Jiao is the root of Ying Qi; if Ying Qi lacks nourishment, rotation becomes dull. Attacking disease relies on medicinal bias; changing morning and evening is not the way to completely remove disease. Additionally, take a nourishing prescription at night.
Ginseng, Poria, Cinnamon Twig Wood, Honey-fried Licorice Root, Angelica Sinensis, Stir-fried White Peony Root, Southern Jujube.
*Rites of Zhou* collects toxic drugs for medical use. Because stubborn chronic illnesses attach to the shell/body, not necessarily Zang-Fu deficiency, toxic drugs are needed to attack and extract, preventing evil from lingering in Qi and Blood. Once effective, the *Classic* says: treat with great toxicity, remove five-tenths. Now one should only care for the body, avoid emotional labor, achieving full merit. Fools say medicine removes roots, not knowing Heaven and Earth Qi has victory and return, similarly humans. Grain drinks nourish life, but medicinal bias cannot be taken long-term. Observe alchemists taking metal/stone elixirs, dying from carbuncles frequently.
Polygonum Multiflorum, Black Sesame Seed, Mulberry Twig, Cinnamon Twig Decoction, made into pills.
Using Liver-blood tonifying and wind-extinguishing formula, right fingers still numb, walking causes stiffness, Xu-Hai hours (7-11 PM) bring heart heat and vexation. Previous methods ineffective; Goji and Angelica are acrid-warm, Yang moves so wind moves. Propose removing acrid using salty. If suspecting residual malaria pathogen from travel causing meridian stagnation, combine with unblocking, slow attack is also good.
Prepared Rehmannia Root, Tortoise Shell Glue, Donkey-hide Gelatin, Autumn Stone, Asparagus Fern Tuber, Ophiopogon Tuber, Schisandra Berry, Spirit of Poria, honey pills taken in morning.
Peach Kernel, Pangolin Scales, Earthworm, Chuanxiong Rhizoma, Angelica Sinensis Tail, Moutan Cortex, Safflower, Astragalus Complanatus Seed, Cyperus Rhizome Juice, pills taken at night.
Back pain worsens with massage, spitting saliva foam, shortness of breath, abdominal fullness, lower abdomen hard, urinary retention, spontaneous loose stools, lower body numbness, immobility, anorexia, insomnia, sweating with vexation. Pathogenesis is complex, no standard method. Thinking cold turbidity occupies, Yang deficiency fails to move, presenting as obstruction. Two Qi are discordant, cannot ignore. Citing Zhang Zhongjing's Shaoyin example, urgently advancing Yang unblocking is key. Propose Baotong Decoction plus Human Urine and Pig Bile.
Scallion White (without roots), Mild Dried Ginger, Raw and Fried Aconite Root, Human Urine and Pig Bile mixed for administration.
Pulse wiry, right large. Wiry indicates fluid retention; large indicates Stomach Yang deficiency. Due to mental strain and accumulation of fatigue, Yang deficiency leads to lack of hunger and appetite. Forced food intake is not transported. Anger combined with restless sleep, waking more than sleeping, inner vexation, sudden abdominal borborygmus and Qi rumbling, four limbs tendons and joints weak and powerless. Onset had morning cold spasms, slight coldness on dorsal foot. Following pulse/symptoms for years, Yang deficiency is root, while phlegm-fluid and Qi rebellion gather due to deficiency. Deficiency generates cold, excess generates heat. Restless sleep/appetite nearly half a year, entering fourth Qi period. Late Summer damp earth insults Spleen/Stomach, worrying about muscle swelling and abdominal distension. Thus whole body binding tendons and benefiting joints relies on Yangming Stomach Meridian. Reviewing medical prescriptions, Qi/Blood mixed, Cold/Heat intermixed, not focusing on Yin/Yang bias, regulation should not respond. Propose tonifying/regulating Stomach Yang as main, soothing Liver as auxiliary. Qi spreads, Yang revives, why worry about turbid phlegm obscuring? Use Fuling Yin reducing Atractylodes, combining Xue's Star and Aconitum Liujunzi intent.
Ginseng, Poria, Cyperus Rhizome, Perilla Stem, Typhonium Rhizome, Pinellia Tuber, Ginger Juice, Tangerine Peel.
Whole body pulling pain, head cannot turn, hand cannot grasp, foot cannot move, both pulses floating and deficient. Floating is Wind image, but internal deficiency also presents floating and weak pulse. Combining pulse and symptoms, this is fatigue injuring Middle, Yangming failing. Yangming is the Sea of Five Zang and Six Fu, binding sinews and bones and benefiting joints. Yangming failure means Qi/Blood do not nourish, twelve meridians receive nothing and do not function. Wei (Defensive) empty, Ying (Nutrient) flow unfavorable, struggling causing pain, naturally so. Method should greatly tonify Yangming Qi and Blood, not treating same as Wind-Cold-Damp Bi.
Ginseng, Astragalus Root, Angelica Sinensis Root Body, Licorice Root, Cinnamon Twig Wood, Gentian Root, Atractylodis Macrocephalae Rhizoma.
Late Summer damp bi, meridian flow Qi sluggish, plus lower origin collaterals already deficient, flaccidity unable to walk, spine often sore. Bowels either constipated or loose, all belong to Liver/Kidney extraordinary vessel disease. Must assist unblocking collaterals as correct treatment. If merely static tonification, later summer will surely generate damp disturbance, must plan ahead.
Cistanche Deserticola, Small Fennel Seed, Morinda Officinalis Root, Angelica Sinensis Root Body, Polygala Tuber, Deer Antler Frost, Mulberry Fruit, Raw Atractylodis Rhizoma, Poria, Prepared Rehmannia Root, Cystopteris Filix-mas, boiled into paste and made into pills.
Pulse faint and choppy. Faint is Yang Qi deficiency, choppy is Yin Blood injury. Last winter lower limbs alone were cold, walking weak. High age lacks storage function. Entering summer, body movement adds panting, skin/muscle paralysis like insects crawling. This is True Yang losing hibernation, Stomach Yang losing protection, vitality scarce. Not suitable for attacking disease drugs. Mr. Yu Jiayan said seal and fix greatly, do not let True Yang leak out and collapse suddenly, this applies here. Record Yan's Three Causes Formula.
Ginseng, Atractylodis Rhizoma, Aconite Root.
According to description, autumn external evil changed to malaria, lasting 100 days to heal. Autumn malaria is Summerheat-Damp-Heat hidden internally in summer, triggered by new coolness externally. Vulgar physicians only know Chai Ge Jie Ji, thinking Summerheat-Damp injures Qi level. Medicine moves Blood, Blood injury causes spasm/bi. Heat tendons relax, cold tendons contract, eventually forming refractory flaccidity-bi.
Angelica Sinensis Root Body, Taxillus Chinensis, Tiger Bone (Synthetic/Substitute implied), Lycium Fruit, Chuanxiong Rhizoma, Astragalus Complanatus Tribulus.
Blood injury suddenly adds fright, Qi depression heat rises wind spins, clear spirit obscured becomes Jue. All Jue belongs to Jueyin. Now left thigh numbness/paralysis, alternating clarity/confusion, all Liver/Gallbladder Minister Fire and internal wind not quiet. Disease extends days, left pulse small and soggy, heat wins, fluids secretly injured. Should not purely use attacking bitter-cold. Classic states Liver is rigid organ, opposing Stomach. Softening and moistening, Yang harmony and fluid recovery can prevent epilepsy.
Fresh Rehmannia Root, Acorus Tatarinowii Rhizome, Biota Seed, Donkey-hide Gelatin, Asparagus Fern Tuber, Spirit of Poria.
Hemiplegia, Wind theory says: Evil strikes Shu points of Five Zang and Six Fu, entering gates to cause disease, then four limbs cannot rise. Yang governs left, Yin governs right. Also says: Sweating on one side causes hemiplegia. This is external evil, or Ying/Wei both deficient, evil enters via deficiency, or internal void wind moves. Physicians treating should tonify Zheng to expel evil, not expel evil neglecting Yuan Qi. Treatment method focuses on Yangming.
Astragalus Root, White Peony Root, Angelica Sinensis, Saposhnikovia Root, Teasel Root, Dioscorea Hypoglauca Rhizome, Silkworm Frass, Tangerine Peel, Tiger Bone (Synthetic/Substitute implied), Gentian Root.