25日三诊。服昨方后已不再吐，大便溏泻三次，色已转黄，此系胃阳来复之兆。烦乱已乎，神识亦清明，体温、脉搏已转正常。稍进食物，病势逐渐减退，大有转危为安之象，可期痊愈矣。唯阳神尚虚，邪阴未净，仍以扶阳扶正主之。
附片130克 干姜26克 上肉桂10克(研末，泡水兑入) 西砂
仁6克 法夏6克 炙远志6克 炙冬花6克 茯神15克
甘草6克
26日四诊。唇舌红润，脉较有神，精神较佳，饮食大增，已无他痛苦，继用黄芪四逆汤加昧调理数剂而愈。
附片130克 干姜26克 上肉桂10克(研末，泡水兑入) 北芪
15克 炙远志6克 生草6克 少 阴 头 痛
邓××，男，成年。初因受寒而起病，误服辛凉之剂，未效。病经十余日，头痛如斧劈，势不可忍，午后则恶寒体痛，脉沉弱无力，舌苔白滑而不渴饮。此乃寒客少阴，阻碍清阳不升，复以辛凉耗其真阳，正虚阳弱，阴寒遏滞经脉。头为诸阳之会，今为阴邪上僭攻于头，阳不足以运行，邪正相争，遂成是状。以辅正除邪之法，加味麻黄细辛附子汤治之。
附片100克 干姜36克 甘草6克 麻黄10克 细辛5克 羌
活10克
服一剂，痛减其半，再剂霍然而愈。
按：少阴头痛，依本法治之其效如响。方内寓一四逆汤，能温扶阳气上交于头，麻黄、羌活，细辛祛客寒达于太阳，由膀胱而化，此乃温经散寒，辅正除邪之实效矣。六经病皆有头痛，遵仲景六经辨证方法施治，均能获效，出方有绳，庶不至误。
少 阴 咽痛
王××，女，成年。始因受寒起病，恶寒，咽痛不适，误服苦寒清热养阴之剂后转成危证。余诊视之，患者头痛如劈，恶寒发热，体痛。咽痛，水浆不能下咽，痰涎涝甚，咽部红肿起白泡而破烂。舌苔白滑，脉沉细而兼紧象。不渴饮，此系寒入少阴，误用苦寒清热，致使阴邪夹寒水上逼，虚火上浮而成是状。取扶阳祛寒，引阳归舍之法，以加味麻黄细辛附子汤治之。
附片40克 干姜26克 北纲辛6克 麻黄5克 上肉桂6克
(研末，泡水兑入) 甘草6克
服一剂后寒热始退，咽部肿痛减去其半，再剂则痛去七、八，三剂尽，诸证霍然而愈。
按：少阴受寒误用苦寒清热养阴之剂，无异于雪上加霜。 《内经》云： “足少阴之脉……循喉咙，挟舌本。”风寒闭束少阴经络不通，虚火上浮冲于咽喉而肿痛者，宜用麻黄细辛附子汤治之。方中附予能扶阳驱寒，麻黄开发腠理，解散表寒，得细辛之辛湿，直入少阴以温散经脉寒邪，并能协同附予纳阳归肾，邪去正安，少阴咽痛自然获愈。
厥阴证(耐药性金黄色葡萄球菌性急性严重型肺脓疡)
海××，女，十九岁，昆明人，因病住昆明某医院。
1959年1月3日邀余会诊。
患者行剖腹产失血过多，经输血抢救后，突然高热40℃
以上。经用青霉素、链霉素等治疗，数日后体温降低，但一般情况反见恶化，神识昏愦，出现严重呼吸困难，白细胞高达二万以上。因病情危重，不敢搬动，故未做x线检查。当时西医未做出明确诊断，继续以大量广谱抗菌素治疗，并配合输液及吸入氧气，均未效。延某医则投以麻杏石甘汤一剂，病情更趋险峻，西医会诊亦提不出有效方案，乃延余诊视。
患者神志不清，面唇青紫灰黯，舌质青乌，鼻翼扑扑煽动，呼吸忽起忽落，似潮水往复，十指连甲青乌，脉弦硬而紧，按之无力而空。盖此病已入厥阴，肝肾之阴气内盛，非传经病，系真脏病，心肾之阳衰弱已极，下焦之真阳不升，上焦之阴邪不降，一线残阳将绝，已现衰脱之象，危殆费治。唯有扶阳抑阴，强心固肾，尽力抢救垂危。主以大剂回阳饮(即四逆汤加肉桂)。
附片150克 干姜50克 上肉桂10克(研末，泡水兑入)甘草20克
因附片需要先煨三、四小时，方能煨透无毒，故让患者先服上肉桂泡水，以强心急救之。并预告病家，服此方后可能有呕吐反应，如呕吐之后喉间痰声不响，气不喘促，舌质色较转红，尚有一线生机可以挽回。若不如此，则为难治，请注意为幸!
复诊。昨日服上方后果如余言，呕吐涎痰后已见转机，神识较前清醒，嗜卧无神，已能缓慢回答询问，可以吃流汁，舌尖已见淡红色，舌苔白滑厚腻，口唇青紫较退，两颊紫红，鼻翼不再煽动，n乎吸仍有困难，但已不再起伏如潮，开始咳嗽，咯大量脓痰，咏仍弦滑而紧，按之而空。衰脱危 候大为减轻，仍以扶阳温化主之。
附片150克 干姜50克 上肉桂10克(研末，池水兑入)半夏1 0克
茯苓20克甘草8克
三诊。神智清醒，语音清楚，面颊微转润红，指甲唇舌青紫已退十之八、九，鼻头，目眶微青，午后潮热，喘咳气短，咯大量脓痰，惟喉间时有痰阻，脉弦滑，病情已有转危为安之象，再以上方加减主之。
附片200克 干姜100克茯苓30克 上肉桂10克(研末，泡水兑
入) 公丁5克 法夏10克 橘红10克 甘草8克细辛5克
四诊。面颊微红润，口唇、舌质青紫已退，呼吸渐趋平稳，午后潮热已退，咳嗽、咯脓痰稍减少，胃气已开，能进食，人事言语已近常态。大便溏泻，系病除之兆。夜卧多梦，此系阳不胜阴，邪阴扰乱，神驰不宁所致。脉转和缓。
大病已初退，惟坎阳尚虚，寒温邪阴未净，再以扶阳温化主之。连服三、四剂可望康复。
此时患者情况好转，可以搬动，经x线检查发现双肺有多个大小不等的圆形空洞，内容物已大半排空。血液细菌培养报告，检出耐药性金黄色葡萄球菌。医院西医最后诊断为“耐药性金黄色葡萄球菌性急性严重型肺脓疡”。拟方。
附片150克 干姜50克广陈皮8克杏仁8克(捣) 炙麻
茸8克
连服四剂，一周后诊视，患者喜笑言谈自如，精神、饮食业已恢复，病状若失，至此痊愈。
按：病至危笃之时，处方用药非大剂不能奏效。若病重药 轻，犹兵不胜敌，不能克服。因此，处方用药应当随其病变而有不同。惟临床辨证，务须察明阴阳、表里、虚实、寒热，然后再针对证候之实据而下药。只要诊断确切，处方对证，药量充足，即能克故制胜，转危为安。古有“病大药大，病毒药毒”之说，故面临危重证侯勿须畏惧药“毒”而改投以轻剂。否则，杯水车薪敷衍塞责，贻误病机，则危殆难挽矣。
胁 痛(肝炎肝脏肿大疼痛)
魏××，男，廿五岁，原昆明市红十字会医院五官科主任。1958年12月30日门诊，患“肝炎”已半年余，右胁内疼痛，双目白睛发黄，色晦暗，面色亦黄而带青色，大便时溏，小便短少，其色如茶，右胁肋下触之有硬块作痛，此乃肝脏肿大疼痛。脉缓弱，舌苔白而厚腻，舌质边夹青色。此系里寒内盛，土湿木郁，肝木不得温升所致。法当温化寒湿，舒肝达木以治之，拟方茵陈四逆汤加味。
附片60克 干姜30克 佛手10克 败酱10克 苡仁20克 川
椒3克(炒去汗) 上肉桂5克(研末，泡水兑入) 茵陈10克
甘草5克
服三剂后，脉象沉弱而带弦长，厚腻舌苔已退其半，舌已转红，小便色转消，较前长，胁下疼痛大有缓减。继上方加减主之。
附片100克 干姜80克 青皮10克 北细辛10克 茵陈15克
桂枝30克 茯苓30克 上肉桂6克(研末，泡水兑入) 甘草6克
川椒6克(炒去汗)
三诊。服此方四剂后，胁痛肝大已减去十之六、七，脉转和缓，舌质红活苔薄白而润。面、目黄色退净，小便清长，饮食如常。继服下方八剂后，即告痊愈。
附片100克 干姜40克 元胡10克 茯苓36克 广木香5克
上肉桂10克(研末，泡水兑入) 北细辛10克 甘草10克
阴 瘅 证(慢性胆汁性肝硬化)
方××，男，二十八岁，未婚，河南省人，昆明军区某部战士。患者因肝脾肿大，全身发黄已八年，曾先后住昆明军区某医院及省市级医院治疗，效果不显著，继而出现腹水肿胀，腹围达98厘米，黄疸指数高达100单位，经军区医院行剖腹探查，取肝脏活体组织做病理检验，证实为“胆汁性肝硬化”。遂于1959年7月由市级某医院转来中医学院门诊部就诊。余见患者病体赢瘦，面色黄黯晦滞无光，巩膜深度黄染，周身皮肤亦呈深黯黄色，干枯搔痒而留见抓痕。精神倦怠，声低息短，少气懒言，不思食，不渴饮。小便短少，色深黄如浓茶水，腹水鼓胀，四肢瘦削，颜面及足跗以下浮肿，两胁疼痛，尤以肝区为甚。扪之，肝肿大于右肋沿下约 二横指，脾肿大于左肋沿下约三横指。脉沉取弦劲而紧，舌苔白滑厚腻而带黄色，少津。因阳虚水寒，肝气郁结不得温升，脾虚失其运化，湿浊阻遏中焦，胆液失其顺降，溢于肌肤，故全身发黄。阳虚则湿从寒化，水湿之邪泛滥于内，脾阳失其运化，日久则成为腹水肿胀之证。肤色黄黯不鲜，似阴黄之象。此病即所谓“阴瘅证”。法当扶阳抑阴，舒肝利胆，健脾除湿为治则。以四逆茵陈五苓散加减治之。
附片100克 干姜50克 肉桂15克(研末，泡水兑入) 吴萸15克
(炒) 败酱15克 茵陈30克 猪苓15克 茯苓50克 北细
辛8克 苍术2 0克 甘草8克
二诊。服上方十余剂后，黄疸已退去十之八、九，肝脾肿大已减小，小便色转清长，外肿内胀渐消，黄疸指数降至20单位，面部黄色减退，已渐现润红色，食欲增加，大便正常，精神转佳。然患病已久，肝肾极为虚寒，脾气尚弱，寒湿邪阴尚未肃清，宜再以扶阳温化主之。
附片150克 干姜80克 茵陈80克 茯苓30克 苡仁20克 肉
桂15克(研末，泡水兑入) 吴萸10克 白术20克 桂尖30克
甘草10克
三诊。服上方六剂后，肝脾已不肿大，胁痛若失，小便清利如常，面脚浮肿及腹水鼓胀已全消退，饮食、精神倍增，皮肤及巩膜已不见发黄色。到市级某医院复查，黄疸指数已降至3单位。脉象和缓，舌苔白润，厚腻苔已全退。此水湿之邪已除，元阳尚虚，再拟抉阳温化之剂调理之，促其正气早复，以图巩固效果。
附片150克 干姜80克 砂仁15克 郁金10克 肉桂15克(研
末，泡水兑入) 苡仁30克 佛手20克 甘草10克
服上方七、八剂后，患者已基本恢复健康。一年后询访，肝脾肿痛及黄疸诸证均未再发作。
按：以上病证，实由阳虚水寒，寒湿内滞，肝气郁结不舒所致。阳虚则水邪泛溢，肝郁则易克伐脾土，脾虚不能健运，湿从寒化，而至肝脾肿大、腹水、黄疸诸证丛生。余所拟用各方，旨在温暖肾寒、舒肝解郁，健运脾湿，化气行水。寒湿内滞之证，施以温化之剂，犹如春和日暖，冰雪消融，故能治之而愈。
肝 水肿(肝硬化腹水)
胡××，男，五十三岁，因患肝硬化腹水臌胀，住昆明某医院，于1958年12月，12日邀余会诊。
询及由来，病者始因患红白痢证一月余，继后渐感腹胀，逐渐发展而成腹水肿胀之证。余视之，面色黄暗，神情淡漠，卧床不起，腹部鼓胀膨窿，已有腹水内积，肝脏肿大，触之稍硬，小腹坠胀，小便短少，饮食不进。脉象缓弱，舌苔白滑，舌质含青色。此系下痢日久脾肾阳虚，寒湿内停，肝气郁结而致肝脏肿大，肺肾气虚，不能行司通调水遭、化气利水之职能，遂致寒水内停，日积月累而成腹水臌 胀证。法当温中扶阳化气逐水，拟四逆五苓散加减主之。
附片80克 干姜30克 上肉桂8克(研末，泡水兑入) 败酱15克
猪苓15克 茯苓30克 甘草10克
同时以大戟、芫花、甘遂各等量，研末和匀(即十枣汤粉剂)，日服6至10克。
服后次日，每日畅泻稀水大便数次。泻后腹水大减，精神稍欠，又继服上方，扶阳温化逐水。
1959年1月二诊。服上方三剂后，腹水已消去一半多，体重减轻二十市斤。诊其脉来沉缓，右脉较弱，系脾湿阳虚脉象。左肝脉带弦，系肝寒郁结，寒水内停之象。舌质较转．红润，自苔已退去其半，再照上方加减与服之。
附片80克 干姜40克 川椒6克(炒去汗) 上肉桂1 0克(研末，
泡水兑入) 吴萸10克 茯苓30克 苍术15克 公丁5克
如前法再服十枣汤粉剂二日。
三诊。服药后昨日又水泻十多次，吐一、二次，腹水消去十分之八，体重又减轻十市斤。患者面色已转为红润，精神不减，舌苔退，舌质亦转红活。小便清长，饮食转佳，已能下床行动，自行至厕所大小便。唯口中干，但思热饮而不多。
系泻水之后，肾阳尚虚，津液不升所致。继以扶阳温化主之。
附片80克 干姜40克砂仁10克枳壳8克上肉桂8克(研
末，泡水兑入) 猪苓10克 茯苓30克
服此方十余剂后，腹水、肝肿全消，食量增加，即告痊愈。
按：寒水内停为病之标，脾肾阳表为病之长。标实本虚治以攻补相兼之法，皆相得宜。所治之法一如离照当空，一如 凿渠引水，寒水坚冰何得不去焉!如不放胆用此峻猛之剂，姑息乔奸，于此危证，终不免肿胀癃闭，衰竭而逝。
胸痹心痛
25日第三次诊疗。服用昨天的方药后，患者已不再呕吐，大便溏泻三次，颜色转为黄色，这是胃阳恢复的征兆。烦乱症状已平息，神志也清醒了，体温和脉搏已恢复正常。稍微进食一些食物，病情逐渐减轻，大有转危为安的迹象，可以期待痊愈。只是阳气神气尚且虚弱，邪阴尚未清除，仍以扶助阳气、扶正固本为主治原则。
附片130克 干姜26克 上肉桂10克（研成粉末，泡水兑入） 西砂仁6克 法半夏6克 炙远志6克 炙款冬花6克 茯神15克 甘草6克
26日第四次诊疗。嘴唇和舌头红润，脉象较有神气，精神状态较好，饮食量大增，已没有其他痛苦，继续用黄芪四逆汤加减调理几剂后痊愈。
附片130克 干姜26克 上肉桂10克（研成粉末，泡水兑入） 北黄芪15克 炙远志6克 生甘草6克
少阴头痛
邓某某，男性，成年。起初因受寒而起病，误服辛凉药物，未见效。患病十余日后，头痛如斧劈般剧烈，难以忍受，午后则恶寒身痛，脉象沉弱无力，舌苔白滑且不渴饮。这是寒邪客居少阴，阻碍清阳上升，又因误用辛凉药物耗伤了真阳，导致正气虚弱、阳气微弱，阴寒阻滞经脉。头为诸阳之会，如今被阴邪上僭攻冲于头部，阳气不足以运行，邪正相争，遂形成这种状况。采用辅正除邪的方法，用加味麻黄细辛附子汤治疗。
附片100克 干姜36克 甘草6克 麻黄10克 细辛5克 羌活10克
服用一剂后，疼痛减轻了一半，再服一剂后霍然而愈。
按语：少阴头痛，依照本法治疗，其效如响。方中蕴含四逆汤之意，能温扶阳气上交于头部；麻黄、羌活、细辛祛除客寒达于太阳经，由膀胱经化解，这是温经散寒、辅正除邪的实际效果。六经病皆有头痛，遵循仲景六经辨证方法施治，均能获效，出方有法度，才不至于误治。
少阴咽痛
王某某，女性，成年。起初因受寒起病，恶寒，咽部疼痛不适，误服苦寒清热养阴的药物后转为危重证候。我诊视时，患者头痛如劈，恶寒发热，身体疼痛。咽痛严重，水浆不能下咽，痰涎极多，咽部红肿并起白泡而破烂。舌苔白滑，脉象沉细兼紧象。不渴饮，这是寒邪入少阴，误用苦寒清热，致使阴邪夹带寒水上逼，虚火上浮而形成的状况。采取扶阳祛寒、引阳归舍的方法，用加味麻黄细辛附子汤治疗。
附片40克 干姜26克 北细辛6克 麻黄5克 上肉桂6克（研成粉末，泡水兑入） 甘草6克
服用一剂后，寒热开始退去，咽部肿痛减去一半，再服一剂则疼痛去除七八成，三剂服完，各种症状霍然而愈。
按语：少阴受寒误用苦寒清热养阴的药物，无异于雪上加霜。《内经》说：“足少阴之脉……循喉咙，挟舌本。”风寒闭束少阴经络不通，虚火上浮冲于咽喉而导致肿痛者，宜用麻黄细辛附子汤治疗。方中附子能扶阳驱寒，麻黄开发腠理，解散表寒，得细辛之辛温，直入少阴以温散经脉寒邪，并能协同附子纳阳归肾，邪去正安，少阴咽痛自然痊愈。
厥阴证（耐药性金黄色葡萄球菌性急性严重型肺脓疡）
海某某，女性，十九岁，昆明人，因病住在昆明某医院。
1959年1月3日邀请我会诊。
患者行剖腹产失血过多，经输血抢救后，突然高热40℃以上。经用青霉素、链霉素等治疗，数日后体温降低，但一般情况反而恶化，神志昏愦，出现严重呼吸困难，白细胞高达二万以上。因病情危重，不敢搬动，故未做X线检查。当时西医未做出明确诊断，继续以大量广谱抗菌素治疗，并配合输液及吸入氧气，均未见效。延请某医生投以麻杏石甘汤一剂，病情更趋险峻，西医会诊也提不出有效方案，于是延请我诊视。
患者神志不清，面唇青紫灰暗，舌质青乌，鼻翼扇动，呼吸忽起忽落，似潮水往复，十指连甲青乌，脉弦硬而紧，按之无力而空。此病已入厥阴，肝肾之阴气内盛，非传经病，系真脏病，心肾之阳衰弱已极，下焦之真阳不升，上焦之阴邪不降，一线残阳将绝，已现衰脱之象，危殆难治。唯有扶阳抑阴，强心固肾，尽力抢救垂危。主以大剂回阳饮（即四逆汤加肉桂）。
附片150克 干姜50克 上肉桂10克（研成粉末，泡水兑入） 甘草20克
因附片需要先煨三、四个小时，方能煨透无毒，故让患者先服上肉桂泡水，以强心急救。并预告病家，服用此方后可能有呕吐反应，如果呕吐之后喉间痰声不响，气不喘促，舌质色较转红，尚有一线生机可以挽回。如果不如此，则为难治，请注意为幸！
复诊。昨天服用上方果然如我所言，呕吐涎痰后已见转机，神识较前清醒，嗜卧无神，已能缓慢回答询问，可以吃流汁，舌尖已见淡红色，舌苔白滑厚腻，口唇青紫较退，两颊紫红，鼻翼不再扇动，呼吸仍有困难，但已不再起伏如潮，开始咳嗽，咯大量脓痰，脉仍弦滑而紧，按之而空。衰脱危候大为减轻，仍以扶阳温化为主治原则。
附片150克 干姜50克 上肉桂10克（研成粉末，泡水兑入） 半夏10克 茯苓20克 甘草8克
三诊。神智清醒，语音清楚，面颊微转润红，指甲唇舌青紫已退十之八、九，鼻头、目眶微青，午后潮热，喘咳气短，咯大量脓痰，惟喉间时有痰阻，脉弦滑，病情已有转危为安之象，再以上方加减主治。
附片200克 干姜100克 茯苓30克 上肉桂10克（研成粉末，泡水兑入） 公丁香5克 法半夏10克 橘红10克 甘草8克 细辛5克
四诊。面颊微红润，口唇、舌质青紫已退，呼吸渐趋平稳，午后潮热已退，咳嗽、咯脓痰稍减少，胃气已开，能进食，人事言语已近常态。大便溏泻，是病除之兆。夜卧多梦，这是阳气不胜阴气，邪阴扰乱，神驰不宁所致。脉转和缓。
大病已初退，惟坎阳尚虚，寒温邪阴未净，再以扶阳温化为主治原则。连服三、四剂可望康复。
此时患者情况好转，可以搬动，经X线检查发现双肺有多个大小不等的圆形空洞，内容物已大半排空。血液细菌培养报告，检出耐药性金黄色葡萄球菌。医院西医最后诊断为“耐药性金黄色葡萄球菌性急性严重型肺脓疡”。拟方。
附片150克 干姜50克 广陈皮8克 杏仁8克（捣碎） 炙麻黄8克
连服四剂，一周后诊视，患者喜笑言谈自如，精神、饮食业已恢复，病状若失，至此痊愈。
按语：病至危笃之时，处方用药非大剂不能奏效。若病重药轻，犹兵不胜敌，不能克服。因此，处方用药应当随其病变而有不同。惟临床辨证，务须察明阴阳、表里、虚实、寒热，然后再针对证候之实据而下药。只要诊断确切，处方对证，药量充足，即能克敌制胜，转危为安。古有“病大药大，病毒药毒”之说，故面临危重证候勿须畏惧药“毒”而改投以轻剂。否则，杯水车薪敷衍塞责，贻误病机，则危殆难挽矣。
胁痛（肝炎肝脏肿大疼痛）
魏某某，男性，廿五岁，原昆明市红十字会医院五官科主任。1958年12月30日门诊，患“肝炎”已半年余，右胁内疼痛，双目白睛发黄，色晦暗，面色亦黄而带青色，大便时溏，小便短少，其色如茶，右胁肋下触之有硬块作痛，此为肝脏肿大疼痛。脉缓弱，舌苔白而厚腻，舌质边夹青色。此为里寒内盛，土湿木郁，肝木不得温升所致。法当温化寒湿，舒肝达木以治之，拟方茵陈四逆汤加味。
附片60克 干姜30克 佛手10克 败酱草10克 苡仁20克 川椒3克（炒去汗） 上肉桂5克（研成粉末，泡水兑入） 茵陈10克 甘草5克
服用三剂后，脉象沉弱而带弦长，厚腻舌苔已退其半，舌已转红，小便色转消，较前长，胁下疼痛大有缓减。继上方加减主治。
附片100克 干姜80克 青皮10克 北细辛10克 茵陈15克 桂枝30克 茯苓30克 上肉桂6克（研成粉末，泡水兑入） 甘草6克 川椒6克（炒去汗）
三诊。服用此方四剂后，胁痛肝大已减去十之六、七，脉转和缓，舌质红活苔薄白而润。面、目黄色退净，小便清长，饮食如常。继服下方八剂后，即告痊愈。
附片100克 干姜40克 元胡10克 茯苓36克 广木香5克 上肉桂10克（研成粉末，泡水兑入） 北细辛10克 甘草10克
阴疸证（慢性胆汁性肝硬化）
方某某，男性，二十八岁，未婚，河南省人，昆明军区某部战士。患者因肝脾肿大，全身发黄已八年，曾先后住昆明军区某医院及省市级医院治疗，效果不显著，继而出现腹水肿胀，腹围达98厘米，黄疸指数高达100单位，经军区医院行剖腹探查，取肝脏活体组织做病理检验，证实为“胆汁性肝硬化”。遂于1959年7月由市级某医院转来中医学院门诊部就诊。我见患者病体赢瘦，面色黄黯晦滞无光，巩膜深度黄染，周身皮肤亦呈深黯黄色，干枯搔痒而留见抓痕。精神倦怠，声低息短，少气懒言，不思食，不渴饮。小便短少，色深黄如浓茶水，腹水鼓胀，四肢瘦削，颜面及足跗以下浮肿，两胁疼痛，尤以肝区为甚。扪之，肝肿大于右肋沿下约二横指，脾肿大于左肋沿下约三横指。脉沉取弦劲而紧，舌苔白滑厚腻而带黄色，少津。因阳虚水寒，肝气郁结不得温升，脾虚失其运化，湿浊阻遏中焦，胆液失其顺降，溢于肌肤，故全身发黄。阳虚则湿从寒化，水湿之邪泛滥于内，脾阳失其运化，日久则成为腹水肿胀之证。肤色黄黯不鲜，似阴黄之象。此病即所谓“阴疸证”。法当扶阳抑阴，舒肝利胆，健脾除湿为治则。以四逆茵陈五苓散加减治之。
附片100克 干姜50克 肉桂15克（研成粉末，泡水兑入） 吴茱萸15克（炒） 败酱草15克 茵陈30克 猪苓15克 茯苓50克 北细辛8克 苍术20克 甘草8克
二诊。服用上方十余剂后，黄疸已退去十之八、九，肝脾肿大已减小，小便色转清长，外肿内胀渐消，黄疸指数降至20单位，面部黄色减退，已渐现润红色，食欲增加，大便正常，精神转佳。然患病已久，肝肾极为虚寒，脾气尚弱，寒湿邪阴尚未肃清，宜再以扶阳温化为主治原则。
附片150克 干姜80克 茵陈80克 茯苓30克 苡仁20克 肉桂15克（研成粉末，泡水兑入） 吴茱萸10克 白术20克 桂尖30克 甘草10克
三诊。服用上方六剂后，肝脾已不肿大，胁痛若失，小便清利如常，面脚浮肿及腹水鼓胀已全消退，饮食、精神倍增，皮肤及巩膜已不见发黄色。到市级某医院复查，黄疸指数已降至3单位。脉象和缓，舌苔白润，厚腻苔已全退。此水湿之邪已除，元阳尚虚，再拟抉阳温化之剂调理之，促其正气早复，以图巩固效果。
附片150克 干姜80克 砂仁15克 郁金10克 肉桂15克（研成粉末，泡水兑入） 苡仁30克 佛手20克 甘草10克
服用上方七、八剂后，患者已基本恢复健康。一年后询访，肝脾肿痛及黄疸诸证均未再发作。
按语：以上病证，实由阳虚水寒，寒湿内滞，肝气郁结不舒所致。阳虚则水邪泛溢，肝郁则易克伐脾土，脾虚不能健运，湿从寒化，而至肝脾肿大、腹水、黄疸诸证丛生。余所拟用各方，旨在温暖肾寒、舒肝解郁，健运脾湿，化气行水。寒湿内滞之证，施以温化之剂，犹如春和日暖，冰雪消融，故能治之而愈。
肝水肿（肝硬化腹水）
胡某某，男性，五十三岁，因患肝硬化腹水臌胀，住昆明某医院，于1958年12月12日邀我会诊。
询及由来，病者始因患红白痢证一月余，继后渐感腹胀，逐渐发展而成腹水肿胀之证。我视之，面色黄暗，神情淡漠，卧床不起，腹部鼓胀膨窿，已有腹水内积，肝脏肿大，触之稍硬，小腹坠胀，小便短少，饮食不进。脉象缓弱，舌苔白滑，舌质含青色。此为下痢日久脾肾阳虚，寒湿内停，肝气郁结而致肝脏肿大，肺肾气虚，不能行司通调水道、化气利水之职能，遂致寒水内停，日积月累而成腹水臌胀证。法当温中扶阳化气逐水，拟四逆五苓散加减主治。
附片80克 干姜30克 上肉桂8克（研成粉末，泡水兑入） 败酱草15克 猪苓15克 茯苓30克 甘草10克
同时以大戟、芫花、甘遂各等量，研末和匀（即十枣汤粉剂），日服6至10克。
服用后次日，每日畅泻稀水大便数次。泻后腹水大减，精神稍欠，又继服上方，扶阳温化逐水。
1959年1月二诊。服用上方三剂后，腹水已消去一半多，体重减轻二十市斤。诊其脉来沉缓，右脉较弱，系脾湿阳虚脉象。左肝脉带弦，系肝寒郁结，寒水内停之象。舌质较转红润，自苔已退去其半，再照上方加减与服之。
附片80克 干姜40克 川椒6克（炒去汗） 上肉桂10克（研成粉末，泡水兑入） 吴茱萸10克 茯苓30克 苍术15克 公丁香5克
如前法再服十枣汤粉剂二日。
三诊。服药后昨日又水泻十多次，吐一、二次，腹水消去十分之八，体重又减轻十市斤。患者面色已转为红润，精神不减，舌苔退，舌质亦转红活。小便清长，饮食转佳，已能下床行动，自行至厕所大小便。唯口中干，但思热饮而不多。
系泻水之后，肾阳尚虚，津液不升所致。继以扶阳温化为主治原则。
附片80克 干姜40克 砂仁10克 枳壳8克 上肉桂8克（研成粉末，泡水兑入） 猪苓10克 茯苓30克
服用此方十余剂后，腹水、肝肿全消，食量增加，即告痊愈。
按语：寒水内停为病之标，脾肾阳虚为病之本。标实本虚治以攻补相兼之法，皆相得宜。所治之法一如离照当空，一如凿渠引水，寒水坚冰何得不去焉！如不放胆用此峻猛之剂，姑息养奸，于此危证，终不免肿胀癃闭，衰竭而逝。
January 25, Third Consultation. After taking the prescription from yesterday, the patient no longer vomits. There have been three episodes of loose stools, which have turned yellow; this is a sign of the recovery of Stomach Yang. The restlessness has subsided, and consciousness is clear. Body temperature and pulse have returned to normal. With slight food intake, the disease trend gradually recedes, showing great promise of turning danger into safety, and recovery can be expected. However, Yang spirit remains deficient, and pathogenic Yin has not been fully cleared. Therefore, the main treatment principle remains to support Yang and strengthen Zheng (Righteous Qi).
Radix Aconiti Lateralis Preparata (Fupian) 130g, Rhizoma Zingiberis Preparatum (Ganjiang) 26g, Cortex Cinnamomi Cassiae (Shang Rougui) 10g (ground into powder, soaked in water, and added to the decoction), Fructus Amomi Rotundus (Xisharen) 6g, Rhizoma Pinelliae Preparatum (Faxia) 6g, Radix Polygalae Preparata (Zhi Yuanzhi) 6g, Flos Dendranthemi Morifolii Preparatus (Zhi Donghua) 6g, Sclerotium Poriae Cum Radice (Fushen) 15g, Radix Glycyrrhizae Preparata (Zhigancao) 6g.
January 26, Fourth Consultation. Lips and tongue are ruddy and moist. The pulse shows more vitality. Mental state is better. Appetite has increased significantly. There are no other sources of pain. Continuing with Huangqi Sini Tang (Astragalus Decoction for Reversing Collapse) modified for several doses leads to recovery.
Radix Aconiti Lateralis Preparata (Fupian) 130g, Rhizoma Zingiberis Preparatum (Ganjiang) 26g, Cortex Cinnamomi Cassiae (Shang Rougui) 10g (ground into powder, soaked in water, and added to the decoction), Radix Astragali (Beiqi) 15g, Radix Polygalae Preparata (Zhi Yuanzhi) 6g, Radix Glycyrrhizae (Shengcao) 6g.
Shaoyin Headache
Patient Deng XX, Male, Adult. Initially contracted due to cold exposure. Misused acrid-cool agents without effect. After more than ten days of illness, headache was severe as if split by an axe, unbearable. In the afternoon, aversion to cold and body pain occurred. Pulse was deep, weak, and forceless. Tongue coating was white and slippery, with no thirst or desire to drink. This indicates Cold lodging in Shaoyin, obstructing the ascent of Clear Yang. Furthermore, the misuse of acrid-cool agents consumed True Yang, leading to deficiency of Zheng Qi and weakness of Yang, with Yin-Cold stagnating in the meridians. The head is the meeting place of all Yang meridians. Now, pathogenic Yin attacks the head, and insufficient Yang cannot circulate. Pathogen and Righteous Qi struggle, resulting in this condition. Treatment employs supporting Zheng and eliminating pathogens using Jiawei Mahuang Xixin Fuzi Tang (Modified Ephedra, Asarum, and Prepared Aconite Decoction).
Radix Aconiti Lateralis Preparata (Fupian) 100g, Rhizoma Zingiberis Preparatum (Ganjiang) 36g, Radix Glycyrrhizae (Gancao) 6g, Herba Ephedrae (Mahuang) 10g, Radix et Rhizoma Asari (Xixin) 5g, Rhizoma Notopterygii (Qianghuo) 10g.
After one dose, pain reduced by half. After another dose, recovery was sudden and complete.
Commentary: For Shaoyin headache, following this method yields immediate results. The formula contains the essence of Sini Tang (Decoction for Reversing Collapse), which warms and supports Yang to ascend to the head. Mahuang, Qianghuo, and Xixin dispel external Cold reaching the Taiyang meridian, transforming it via the Bladder meridian. This achieves the practical effect of warming meridians, dispersing Cold, supporting Zheng, and eliminating pathogens. Headache occurs in all Six Meridians diseases. Following Zhang Zhongjing’s Six Meridians differentiation methods ensures efficacy. Prescriptions must follow strict principles to avoid error.
Shaoyin Sore Throat
Patient Wang XX, Female, Adult. Initially contracted due to cold exposure, presenting with aversion to cold and sore throat discomfort. Misused bitter-cold heat-clearing and Yin-nourishing agents, leading to a critical condition. Upon my examination, the patient had headache splitting like an axe, aversion to cold and fever, and body pain. Sore throat was severe, unable to swallow liquids. Saliva and phlegm were excessive. The throat was red, swollen, with white blisters and ulceration. Tongue coating was white and slippery. Pulse was deep, fine, and tight. No thirst or desire to drink. This indicates Cold entering Shaoyin. Misuse of bitter-cold agents caused Yin pathogens to carry Cold Water upward, with Deficient Fire floating up, creating this condition. Treatment adopts supporting Yang, dispelling Cold, and guiding Yang back to its residence using Jiawei Mahuang Xixin Fuzi Tang (Modified Ephedra, Asarum, and Prepared Aconite Decoction).
Radix Aconiti Lateralis Preparata (Fupian) 40g, Rhizoma Zingiberis Preparatum (Ganjiang) 26g, Radix et Rhizoma Asari (Xixin) 6g, Herba Ephedrae (Mahuang) 5g, Cortex Cinnamomi Cassiae (Shang Rougui) 6g (ground into powder, soaked in water, and added to the decoction), Radix Glycyrrhizae (Gancao) 6g.
After one dose, cold and fever began to subside. Throat swelling and pain reduced by half. After another dose, pain decreased by 70-80%. After three doses, all symptoms resolved suddenly.
Commentary: Misusing bitter-cold heat-clearing and Yin-nourishing agents for Shaoyin Cold contraction is like adding frost to snow. The *Neijing* states: "The Foot-Shaoyin meridian... follows the throat and binds to the root of the tongue." Wind-Cold constricts the Shaoyin meridians, causing blockage. Deficient Fire floats up to the throat, causing swelling and pain. Mahuang Xixin Fuzi Tang should be used. Fuzian supports Yang and drives out Cold. Mahuang opens the interstices and dissipates exterior Cold. Combined with the acrid-warm nature of Xixin, it enters Shaoyin directly to warm and disperse Cold in the meridians. It cooperates with Fuzi to guide Yang back to the Kidney. Once pathogens are gone and Zheng is secure, Shaoyin sore throat naturally heals.
Jueyin Syndrome (Drug-resistant Staphylococcus aureus Acute Severe Lung Abscess)
Patient Hai XX, Female, 19 years old, from Kunming. Hospitalized at a certain hospital in Kunming.
Invited for consultation on January 3, 1959.
The patient suffered excessive blood loss during a cesarean section. After rescue via blood transfusion, she suddenly developed high fever above 40°C. Treated with Penicillin and Streptomycin. After several days, temperature dropped, but general condition worsened. Consciousness became confused. Severe dyspnea appeared. White blood cell count exceeded 20,000. Due to critical condition, movement was avoided, so X-ray was not performed. Western medicine made no clear diagnosis. Continued treatment with large doses of broad-spectrum antibiotics, intravenous fluids, and oxygen inhalation, all ineffective. Another doctor prescribed Maxing Shigan Tang (Ephedra, Apricot Seed, Gypsum, and Licorice Decoction) for one dose, making the condition more perilous. Western medicine consultation offered no effective plan. I was invited to examine.
Patient was unconscious. Face and lips were cyanotic, gray, and dull. Tongue body was dark blue/purple. Alae nasi flared. Respiration was irregular, rising and falling like tidal waves. Fingernails were dark blue/purple. Pulse was wiry, hard, and tight, forceless and empty upon pressure. This disease has entered Jueyin. Yin Qi of Liver and Kidney is internally abundant. This is not a transmitted disease but a True Zang disease. Heart and Kidney Yang are extremely weakened. True Yang of the Lower Jiao does not ascend. Yin pathogens of the Upper Jiao do not descend. A thread of residual Yang is about to perish. Signs of collapse are present. Critical and difficult to treat. Only supporting Yang, suppressing Yin, strengthening Heart, and securing Kidney can attempt to save the critically ill. Main treatment uses large dose Huiyang Yin (Return Yang Drink, i.e., Sini Tang plus Cinnamon Bark).
Radix Aconiti Lateralis Preparata (Fupian) 150g, Rhizoma Zingiberis Preparatum (Ganjiang) 50g, Cortex Cinnamomi Cassiae (Shang Rougui) 10g (ground into powder, soaked in water, and added to the decoction), Radix Glycyrrhizae (Gancao) 20g.
Since Fupian requires simmering for 3-4 hours to become thoroughly cooked and non-toxic, the patient was first given Cortex Cinnamomi Cassiae soaked in water to strengthen the Heart and provide emergency rescue. The family was warned that vomiting might occur after taking this prescription. If, after vomiting, phlegm sounds in the throat cease, breathing becomes less labored, and tongue color turns redder, there is still a thread of vitality that can be saved. Otherwise, it is difficult to treat. Please note this carefully!
Follow-up. Yesterday, after taking the above prescription, events unfolded exactly as predicted. After vomiting saliva and phlegm, a turnaround was seen. Consciousness was clearer than before. Patient slept excessively with lack of spirit but could slowly answer questions. Could consume liquid diet. Tongue tip showed light red color. Tongue coating was white, slippery, thick, and greasy. Cyanosis of lips retreated slightly. Cheeks were purplish-red. Alae nasi no longer flared. Breathing was still difficult but no longer fluctuated like tides. Cough started, expectorating large amounts of purulent sputum. Pulse remained wiry, slippery, and tight, yet empty upon pressure. Critical signs of collapse greatly reduced. Main treatment remains supporting Yang and warming transformation.
Radix Aconiti Lateralis Preparata (Fupian) 150g, Rhizoma Zingiberis Preparatum (Ganjiang) 50g, Cortex Cinnamomi Cassiae (Shang Rougui) 10g (ground into powder, soaked in water, and added to the decoction), Rhizoma Pinelliae (Banxia) 10g, Poria (Fuling) 20g, Radix Glycyrrhizae (Gancao) 8g.
Third Consultation. Consciousness is clear. Speech is distinct. Cheeks slightly ruddy. Cyanosis of nails, lips, and tongue has receded 80-90%. Nose tip and eye sockets slightly blue. Afternoon tidal fever. Wheezing, cough, shortness of breath. Expectorating large amounts of purulent sputum. Occasional phlegm obstruction in throat. Pulse wiry and slippery. Disease trend shows signs of turning danger into safety. Continue modifying the above prescription.
Radix Aconiti Lateralis Preparata (Fupian) 200g, Rhizoma Zingiberis Preparatum (Ganjiang) 100g, Poria (Fuling) 30g, Cortex Cinnamomi Cassiae (Shang Rougui) 10g (ground into powder, soaked in water, and added to the decoction), Flos Caryophylli (Gongding) 5g, Rhizoma Pinelliae Preparatum (Faxia) 10g, Pericarpium Citri Reticulatae (Juhong) 10g, Radix Glycyrrhizae (Gancao) 8g, Radix et Rhizoma Asari (Xixin) 5g.
Fourth Consultation. Cheeks slightly ruddy. Cyanosis of lips and tongue body has receded. Breathing gradually stabilizes. Afternoon tidal fever has subsided. Cough and purulent sputum slightly reduced. Stomach Qi has opened. Able to eat. Speech and behavior near normal. Loose stools indicate disease removal. Frequent dreams at night result from Yang failing to overcome Yin, with pathogenic Yin disturbing the Spirit, causing restlessness. Pulse becomes harmonious and slow.
Major illness has initially receded. Kan (Kidney) Yang is still deficient. Cold and pathogenic Yin not fully cleared. Main treatment remains supporting Yang and warming transformation. Taking 3-4 doses continuously promises recovery.
At this time, patient condition improved, allowing movement. X-ray revealed multiple round cavities of varying sizes in both lungs, mostly emptied. Blood culture detected drug-resistant Staphylococcus aureus. Western medicine final diagnosis: "Drug-resistant Staphylococcus aureus acute severe lung abscess." Prescription formulated.
Radix Aconiti Lateralis Preparata (Fupian) 150g, Rhizoma Zingiberis Preparatum (Ganjiang) 50g, Pericarpium Citri Reticulatae (Guangchenpi) 8g, Semen Pruni Armeniacae (Xingren) 8g (crushed), Herba Ephedrae Preparata (Zhimahuang) 8g.
Taking four doses continuously. One week later, patient laughed and spoke freely. Spirit and diet recovered. Symptoms disappeared. Recovery achieved.
Commentary: When disease reaches critical extremity, prescriptions require large doses to be effective. If disease is heavy but medicine is light, it is like soldiers unable to defeat the enemy. Therefore, prescription and dosage must vary with pathological changes. Clinical differentiation must clearly ascertain Yin/Yang, Exterior/Interior, Deficiency/Excess, Cold/Heat. Then, administer medicine based on solid evidence of syndrome. If diagnosis is accurate, prescription matches syndrome, and dosage is sufficient, victory over the disease and turning danger to safety can be achieved. Ancient saying: "Great disease requires great medicine, toxic virus requires toxic medicine." Facing critical syndromes, one need not fear medicine "toxicity" and switch to mild agents. Otherwise, it is like pouring a cup of water on a cartload of burning wood—perfunctory and delaying the opportunity, making critical conditions irretrievable.
Hypochondriac Pain (Hepatitis with Hepatomegaly and Pain)
Patient Wei XX, Male, 25 years old. Former Director of ENT Department, Kunming Red Cross Hospital. Outpatient visit December 30, 1958. Suffered from "Hepatitis" for over half a year. Pain inside right hypochondrium. Whites of eyes yellow, dull color. Complexion yellow with bluish tint. Stools occasionally loose. Urine scanty, tea-colored. Palpable hard mass under right hypochondrium causing pain. This is hepatomegaly with pain. Pulse slow and weak. Tongue coating white, thick, and greasy. Tongue body edges show bluish tint. This indicates interior Cold excess, Earth dampness stifling Wood, Liver Wood unable to warm and ascend. Method: Warm and transform Cold-Damp, soothe Liver and unblock Wood. Formula: Yinchin Sini Tang (Artemisia Capillaris Decoction for Reversing Collapse) modified.
Radix Aconiti Lateralis Preparata (Fupian) 60g, Rhizoma Zingiberis Preparatum (Ganjiang) 30g, Fructus Aurantii (Foshou) 10g, Radix Patriniae (Baijiangcao) 10g, Semen Coicis (Yiren) 20g, Fructus Zanthoxyli (Chuanjiao) 3g (stir-fried to remove oil), Cortex Cinnamomi Cassiae (Shang Rougui) 5g (ground into powder, soaked in water, and added to the decoction), Herba Artemisiae Scopariae (Yinchen) 10g, Radix Glycyrrhizae (Gancao) 5g.
After three doses, pulse deep, weak, with wiry length. Thick greasy coating reduced by half. Tongue turned red. Urine color faded, volume increased. Hypochondriac pain greatly alleviated. Continue modifying the above prescription.
Radix Aconiti Lateralis Preparata (Fupian) 100g, Rhizoma Zingiberis Preparatum (Ganjiang) 80g, Pericarpium Citri Reticulatae Viride (Qingpi) 10g, Radix et Rhizoma Asari (Beixixin) 10g, Herba Artemisiae Scopariae (Yinchen) 15g, Ramulus Cinnamomi (Guizhi) 30g, Poria (Fuling) 30g, Cortex Cinnamomi Cassiae (Shang Rougui) 6g (ground into powder, soaked in water, and added to the decoction), Radix Glycyrrhizae (Gancao) 6g, Fructus Zanthoxyli (Chuanjiao) 6g (stir-fried to remove oil).
Third Consultation. After four doses of this prescription, hypochondriac pain and hepatomegaly reduced by 60-70%. Pulse harmonious. Tongue body red and vibrant, coating thin, white, and moist. Facial and ocular jaundice completely cleared. Urine clear and abundant. Diet normal. After eight more doses of the next prescription, recovery announced.
Radix Aconiti Lateralis Preparata (Fupian) 100g, Rhizoma Zingiberis Preparatum (Ganjiang) 40g, Radix Corydalis (Yanyan) 10g, Poria (Fuling) 36g, Radix Aucklandiae (Guangmuxiang) 5g, Cortex Cinnamomi Cassiae (Shang Rougui) 10g (ground into powder, soaked in water, and added to the decoction), Radix et Rhizoma Asari (Beixixin) 10g, Radix Glycyrrhizae (Gancao) 10g.
Yin Dan Syndrome (Chronic Biliary Cirrhosis)
Patient Fang XX, Male, 28 years old, unmarried, from Henan Province. Soldier in a unit of Kunming Military Region. Patient had hepatosplenomegaly and generalized jaundice for eight years. Treated successively at Kunming Military Region Hospital and provincial/municipal hospitals with insignificant effects. Subsequently developed abdominal edema and distension. Abdominal circumference reached 98 cm. Jaundice index up to 100 units. Exploratory laparotomy performed at military region hospital. Liver biopsy confirmed "Biliary Cirrhosis." Transferred to Traditional Chinese Medicine College Outpatient Department in July 1959. I observed patient emaciated. Complexion yellow, dark, dull, lusterless. Sclera deeply jaundiced. Whole body skin dark yellow, dry, itchy with scratch marks. Mental fatigue. Low voice, short breath. Little energy, reluctant to speak. No appetite. No thirst. Urine scanty, deep yellow like strong tea. Abdominal ascites distended. Limbs emaciated. Edema below face and feet. Hypochondriac pain, especially in liver area. Palpation: Liver enlarged approx. two finger-widths below right costal margin. Spleen enlarged approx. three finger-widths below left costal margin. Pulse deep, wiry, strong, and tight. Tongue coating white, slippery, thick, greasy, yellowish, scanty fluid. Due to Yang deficiency and Cold Water, Liver Qi stagnation fails to warm and ascend. Spleen deficiency loses transport function. Damp-Turbidity obstructs Middle Jiao. Bile fails to descend smoothly, overflowing into skin, causing generalized jaundice. Yang deficiency causes Dampness to transform into Cold. Water-Damp pathogens flood internally. Spleen Yang loses transport function. Long-term results in abdominal edema and distension. Skin color dark yellow, not bright, resembling Yin Jaundice. This disease is called "Yin Dan Syndrome." Method: Support Yang, suppress Yin, soothe Liver, benefit Gallbladder, strengthen Spleen, drain Dampness as treatment principles. Use Sini Yinchin Wuling San (Sini, Artemisia Capillaris, and Five-Ingredient Poria Decoction) modified.
Radix Aconiti Lateralis Preparata (Fupian) 100g, Rhizoma Zingiberis Preparatum (Ganjiang) 50g, Cortex Cinnamomi Cassiae (Rougui) 15g (ground into powder, soaked in water, and added to the decoction), Fructus Evodiae (Wuyu) 15g (stir-fried), Radix Patriniae (Baijiangcao) 15g, Herba Artemisiae Scopariae (Yinchen) 30g, Polyporus (Zhuling) 15g, Poria (Fuling) 50g, Radix et Rhizoma Asari (Beixixin) 8g, Rhizoma Atractylodis Macrocephalae (Cangzhu) 20g, Radix Glycyrrhizae (Gancao) 8g.
Second Consultation. After more than ten doses of the above prescription, jaundice receded 80-90%. Hepatosplenomegaly reduced. Urine color cleared and abundant. External swelling and internal distension gradually subsided. Jaundice index dropped to 20 units. Facial yellow faded, gradually showing ruddy color. Appetite increased. Stools normal. Spirit improved. However, long-standing illness makes Liver and Kidney extremely deficient and cold. Spleen Qi still weak. Cold-Damp pathogenic Yin not yet cleared. Suitable to continue supporting Yang and warming transformation as main treatment.
Radix Aconiti Lateralis Preparata (Fupian) 150g, Rhizoma Zingiberis Preparatum (Ganjiang) 80g, Herba Artemisiae Scopariae (Yinchen) 80g, Poria (Fuling) 30g, Semen Coicis (Yiren) 20g, Cortex Cinnamomi Cassiae (Rougui) 15g (ground into powder, soaked in water, and added to the decoction), Fructus Evodiae (Wuyu) 10g, Rhizoma Atractylodis Macrocephalae (Baizhu) 20g, Caulis Cinnamomi (Guijian) 30g, Radix Glycyrrhizae (Gancao) 10g.
Third Consultation. After six doses of the above prescription, hepatosplenomegaly no longer palpable. Hypochondriac pain vanished. Urine clear and free. Facial and foot edema and abdominal ascites completely resolved. Diet and spirit doubled. Skin and sclera no longer yellow. Re-examination at municipal hospital showed jaundice index dropped to 3 units. Pulse harmonious. Tongue coating white and moist. Thick greasy coating completely cleared. Water-Damp pathogens eliminated. Original Yang still deficient. Next, formulate Yang-supporting and warming transformation agents for regulation, promoting early recovery of Zheng Qi to consolidate effects.
Radix Aconiti Lateralis Preparata (Fupian) 150g, Rhizoma Zingiberis Preparatum (Ganjiang) 80g, Fructus Amomi (Sharen) 15g, Radix Curcumae Longae (Yujin) 10g, Cortex Cinnamomi Cassiae (Rougui) 15g (ground into powder, soaked in water, and added to the decoction), Semen Coicis (Yiren) 30g, Fructus Aurantii (Foshou) 20g, Radix Glycyrrhizae (Gancao) 10g.
After seven to eight doses of the above prescription, patient basically recovered health. Inquiry one year later: Hepatosplenomegaly pain and jaundice did not recur.
Commentary: The above syndromes are actually caused by Yang deficiency, Cold Water, internal stagnation of Cold-Damp, and unsmooth Liver Qi stagnation. Yang deficiency causes Water pathogens to overflow. Liver stagnation easily invades Spleen Earth. Spleen deficiency fails to transport. Dampness transforms into Cold. Resulting in hepatosplenomegaly, ascites, and various syndromes like jaundice. My prescribed formulas aim to warm Kidney Cold, soothe Liver and resolve stagnation, strengthen Spleen and transform Dampness, and promote Qi transformation to move Water. For syndromes of internal Cold-Damp stagnation, applying warming and transforming agents is like spring warmth melting ice and snow, thus achieving cure.
Liver Edema (Cirrhosis Ascites)
Patient Hu XX, Male, 53 years old. Hospitalized at a certain hospital in Kunming for cirrhosis ascites. Invited for consultation on December 12, 1958.
Inquiring into the origin: Patient initially suffered from bloody and white dysentery for over a month. Subsequently gradually felt abdominal distension, developing into abdominal edema and distension. I observed: Complexion yellow-dark. Expression indifferent. Bedridden. Abdomen distended and bulging. Internal accumulation of ascites. Hepatomegaly, slightly hard on touch. Lower abdominal bearing-down sensation. Urine scanty. No food intake. Pulse slow and weak. Tongue coating white and slippery. Tongue body contains bluish tint. This indicates long-term dysentery causing Spleen and Kidney Yang deficiency. Cold-Damp stops internally. Liver Qi stagnates causing hepatomegaly. Lung and Kidney Qi deficient, failing to perform functions of regulating water passages and transforming Qi to promote diuresis. Thus Cold Water stops internally. Accumulating day by day, it becomes abdominal ascites syndrome. Method: Warm Middle, support Yang, transform Qi, and purge Water. Formula: Sini Wuling San (Sini and Five-Ingredient Poria Decoction) modified.
Radix Aconiti Lateralis Preparata (Fupian) 80g, Rhizoma Zingiberis Preparatum (Ganjiang) 30g, Cortex Cinnamomi Cassiae (Shang Rougui) 8g (ground into powder, soaked in water, and added to the decoction), Radix Patriniae (Baijiangcao) 15g, Polyporus (Zhuling) 15g, Poria (Fuling) 30g, Radix Glycyrrhizae (Gancao) 10g.
Simultaneously, use equal parts of Radix Euphorbiae Kansui (Daji), Radix Genkwa (Yuanhua), and Radix Kansui (Gansui), ground into powder and mixed evenly (i.e., Shizao Tang powder). Take 6-10g daily.
The next day after taking, frequent watery diarrhea occurred multiple times daily. After diarrhea, ascites greatly reduced. Spirit slightly lacking. Continued taking the above prescription to support Yang, warm transformation, and purge Water.
January 1959, Second Consultation. After three doses of the above prescription, ascites reduced by more than half. Weight decreased by 20 jin (approx. 10kg). Pulse deep and slow. Right pulse weaker, indicating Spleen Dampness and Yang deficiency. Left Liver pulse wiry, indicating Liver Cold stagnation and internal Cold Water retention. Tongue body turned redder. Tongue coating receded by half. Continue modifying and taking the above prescription.
Radix Aconiti Lateralis Preparata (Fupian) 80g, Rhizoma Zingiberis Preparatum (Ganjiang) 40g, Fructus Zanthoxyli (Chuanjiao) 6g (stir-fried to remove oil), Cortex Cinnamomi Cassiae (Shang Rougui) 10g (ground into powder, soaked in water, and added to the decoction), Fructus Evodiae (Wuyu) 10g, Poria (Fuling) 30g, Rhizoma Atractylodis Macrocephalae (Cangzhu) 15g, Flos Caryophylli (Gongding) 5g.
Take Shizao Tang powder again for two days as before.
Third Consultation. After medication, yesterday had more than ten watery diarrheas, vomited once or twice. Ascites reduced by 80%. Weight decreased by another 10 jin. Patient complexion turned ruddy. Spirit unchanged. Tongue coating receded. Tongue body turned red and vibrant. Urine clear and abundant. Diet improved. Able to get out of bed and walk to toilet independently. Only mouth dry, desires hot drinks but not much.
This is due to post-water-purging Kidney Yang deficiency and failure of Jin Ye (Body Fluids) to ascend. Continue supporting Yang and warming transformation as main treatment.
Radix Aconiti Lateralis Preparata (Fupian) 80g, Rhizoma Zingiberis Preparatum (Ganjiang) 40g, Fructus Amomi (Sharen) 10g, Fructus Aurantii (Zhiqiao) 8g, Cortex Cinnamomi Cassiae (Shang Rougui) 8g (ground into powder, soaked in water, and added to the decoction), Polyporus (Zhuling) 10g, Poria (Fuling) 30g.
After more than ten doses of this prescription, ascites and hepatomegaly completely resolved. Food intake increased. Recovery announced.
Commentary: Internal Cold Water retention is the branch manifestation. Spleen and Kidney Yang deficiency is the root cause. Branch excess and Root deficiency treated with combined attacking and tonifying methods, both appropriate. The treatment method is like the sun shining brightly, or like digging a canal to guide water. How can Cold Water and hard ice not go away? If one does not dare to use these harsh and potent agents, being indulgent and compromising, for such critical conditions, one will inevitably end in swelling, urinary retention, exhaustion, and death.
Xiongbi and Heart Pain