石膏(三两) 滑石(一两)
初七日 加∶
浓朴(三钱) 姜夏(五钱)
丸方∶痹症夹痰饮疝瘕,六脉洪大,用诸痹独取太阴法,脉洪大者小,《难经》所谓人
病脉
不病者生。但脉虽平而瘕胀痹痛未除,议以乌药散退瘕痹之所难退者,以久病在络故也。再
以丸药缓通脉络法,脉若复大,仍服前方数帖,见小即止。
蜣螂虫(一两) 归须(四两) 两头尖(二两) 穿山甲(三两) 降香末(三钱) 小茴香(
三两
,炒) 海桐皮(三两) 乳香(一两) 片姜黄(三两) 麝香(三钱) 地龙(一两,去泥) 川
楝子(三两,炒)
共细末,酒水各半为丸,每服二钱,日二三次,从此服蜣螂丸起两月而止。
三月二十四日 痹症夹痰饮,脉本洪数,前用辛凉脉减,兼用通络散、瘕丸散亦效,现
在六脉中部仍洪,但不数耳。议暂用辛凉宣肺。
生石膏(四两) 小枳实(四钱) 桂枝(八钱) 杏仁(八钱) 防己(六钱) 广皮(二钱)
云苓块(一两) 全归(三钱) 半夏(八钱) 飞滑石(二两) 海桐皮(三钱)
二十六日 诊右脉更大,小便反短,用苦辛淡法,于前方内加∶
炒黄柏(三钱)
四月十六日 痹痛夹痰饮。
生石膏(八钱) 苡仁(五钱) 防己(四钱) 云苓皮(五钱) 杏仁(五钱) 蚕砂(三钱)
桂枝(五钱) 白通草(钱半) 半夏(五钱) 广皮(三钱)
煮三杯,三次服。
十七日 内而胁痛,外而腰痹痛,是气血兼痹也。
桂枝尖(五钱) 归须(二钱) 白蔻仁(钱半) 杏仁(五钱) 云苓皮(三钱) 片姜黄(二
钱)
旋复花(三钱,包) 防己(三钱) 生苡仁(三钱) 小枳实(四钱) 半夏(四钱) 郁金(二钱)
广皮(三钱)
二十五日 痰饮踞于中焦,痹痛结于太阳,气上冲胸,二便不利。
桂枝(八钱) 姜半夏(五钱) 通草(钱半) 云苓皮(二两二钱) 防己(六钱) 杏仁(八
钱) 枳实(六钱) 广皮(三钱) 滑石(六钱)
煮四杯,四次服。
五月初三日 大凡腹胀之疾,不责之太阴,即责之厥阴。此症自正月以来,开太阳之药
,未
有不泄太阴者,他症虽减其半,则尚未除。其故有三∶一者病起肝郁;二者肝主疏泄,误补
致壅;三者自正月以来,以右脉洪大之故,痹症甚重。治在肺经,经有诸痹独取太阴之明训
。兹右脉平而左脉大,不得着于前议,暂与泄厥阴之络,久病在络故也。
旋复花(五钱,包) 黄芩(三钱) 归须(三钱) 老川朴(五钱) 杉皮(三钱) 半夏(五
钱)
小枳实(五钱) 晚蚕砂(三钱) 广皮(三钱) 郁金(三钱) 苏子霜(三钱) 降香末(三钱)
煮三杯。三次服。
二十三日 左胁痛胀,卧不着席胸亦闷胀,气短,肝脉络胸之故。
新绛纱(三钱) 香附(四钱) 半夏(五钱) 旋复花(三钱,包) 归须(三钱) 小枳实(
四钱)
苏子霜(三钱) 降香末(三钱) 郁金(三钱) 广皮(三钱) 川椒炭(四钱) 青皮(三钱)
煮三大杯,三次服。七帖。
六月初一日 痰饮肝郁,脉弦细,气上冲胸。
旋复花(四钱) 枳实(三钱) 公丁香(二钱) 苏子霜(三钱) 半夏(六钱) 片姜黄(三
钱) 降香末(三钱) 郁金(三钱) 青皮(三钱) 广皮(五钱) 桂枝尖(三钱)
煮三杯,分三次服。
初三日 痰饮上泛,咳嗽稀痰,兼发痹症。
桂枝(六钱) 防己(六钱) 杏仁(五钱) 川乌头(三钱) 云苓皮(五钱) 枳实(四钱)
广皮(五钱) 桂心(二钱) 苡仁(三钱) 白通草(二钱) 滑石(四钱) 炒黄柏(三钱炒)
煮三杯,分三次服。
初六日 小便不畅,下焦湿聚,于原方加滋肾丸法。
十一日 痹症未尽除,痰饮未全消,当盛暑流行之际,逐饮开痹,即所以防暑。
云苓块(六钱) 小枳实(二钱) 半夏(六钱) 防己(三钱) 生苡仁(六钱) 杏仁(三钱)
广皮(二钱) 桂枝(三钱)
煮三杯,三次服。
十三日 暑泄,腹胀,舌黄,其人本有痰饮痹症,议五苓加减。
桂枝(三钱) 猪苓(四钱) 泽泻(四钱) 云苓皮(五钱) 滑石(六钱) 川朴(三钱) 杉
皮(
三钱) 木香(钱半) 半夏(三钱) 藿梗(三钱) 白蔻仁(三钱) 川椒炭(二钱) 真山连(一
钱)
十五日 脉缓,服前方。
十六日 脉缓甚,服前方。
二十一日 久病在络,其本病统俟丸药立方,但逐痰饮,宣气化湿,捍时令之暑湿而已
。
半夏(六钱) 云苓块(五钱) 生香附(三钱) 川朴(二钱) 广皮(三钱) 杉皮(三钱)
大腹皮(三钱) 小枳实(三钱)
煮三杯,三次服。
六月二十六日 服化 回生丹起,每日一丸。
二十七日 脉浮,筋骨酸痛,气短,五心烦热,新感暑湿之气,加以辛凉,与三焦。
连翘(三钱) 苡仁(五钱) 银花(三钱) 白蔻仁(二钱) 藿香叶(三钱) 杏仁(三钱)
广皮(三钱) 小枳实(三钱)
煮三杯,三次服。
七月初二日 背痛甚,先与通太阳之痹。
桂枝(六钱) 枳实(五钱,打) 防己(五钱) 云苓皮(八钱) 半夏(五钱) 杏仁(三钱)
川椒炭(二钱)
煮三杯,三次服,亥初令完。
初九日 近日阴雨连绵,背痛腹胀不减,二便不爽,非嗳则哕,脉小于前,与宣痹开郁
,兼去陈 。
桂枝(八钱) 茯苓(八钱,带皮) 白通草(钱半) 川朴(五钱) 公丁香(三钱) 防己(
六钱) 杏仁(六钱) 晚蚕砂(三钱) 小茴香(三钱) 枳实(五钱) 白蔻仁(三钱)
煮四杯,四次服。
二十一日 寒湿发痹,脉缓甚,中有痰饮。
桂枝(六钱) 茯苓(六钱) 白通草(钱半) 防己(五钱) 苡仁(四钱) 薤白(三钱) 枳
实
(三钱) 杏仁(四钱) 熟附子(二钱) 川乌头(二钱) 广皮(五钱) 萆 (五钱) 片姜黄(三
钱)
煮三杯,三次服,已服五帖。
二十八日 脉弦紧,痰饮痹症 瘕,因燥气而发,脏腑经络俱痹,故肢冷而畏寒也,峻
与通阳。
桂枝(一两) 广皮(六钱) 归须(二钱) 防己(五钱) 小枳实(四钱) 杏仁(五钱) 半
夏
(三钱) 穿山甲(一钱) 泽泻(三钱) 公丁香(三钱) 川椒炭(五钱,炒) 片姜黄(三钱)
煮四杯,四次服。
自六月二十六日起,每日空心服化 回生丹一丸,七月二十九以后,每日服天台乌药散
三分
五分一钱二钱不等。至十月十二日,每两乌药散中,加巴霜一分,每晚服三分五分不等,间
有服至一钱者,十一月初一日以后,每晚间服奇经丸。
十二月初十日 痹痛,饮咳,脉弦细。
桂枝(八钱) 苡仁(五钱) 滑石(四钱) 川乌头(三钱) 云苓皮(六钱) 枳实(三钱)
川萆 (五钱) 杏仁(四钱) 防己(五钱) 川椒炭(三钱)
十二日 冲气上动畏寒,脉沉细,与桂枝加桂汤法,直伐冲气。
桂枝尖(一两二钱) 紫石英(六钱,研) 云苓块(三两) 桂心(八钱) 小茴香(五钱)
煮四杯,分四次服。
十三日 大寒节冲气未止,脉反弦紧。于原方内加∶
当归(五钱) 川芎(三钱)
服二帖,脉中阳气生动,冲气平,畏寒止,仍然早服化 回生丹一丸,晚服奇经丸三钱
。
【背景信息】
书名:吴鞠通医案 作者:吴鞠通 朝代:清 章节:痹(2/2) 类别:医论
石膏(三两) 滑石(一两)
初七日 加∶
浓朴(三钱) 姜夏(五钱)
丸方∶痹症夹痰饮疝瘕,六脉洪大,用诸痹独取太阴法,脉洪大者小,《难经》所谓人
病脉
不病者生。但脉虽平而瘕胀痹痛未除,议以乌药散退瘕痹之所难退者,以久病在络故也。再
以丸药缓通脉络法,脉若复大,仍服前方数帖,见小即止。
蜣螂虫(一两) 归须(四两) 两头尖(二两) 穿山甲(三两) 降香末(三钱) 小茴香(
三两
,炒) 海桐皮(三两) 乳香(一两) 片姜黄(三两) 麝香(三钱) 地龙(一两,去泥) 川
楝子(三两,炒)
共细末,酒水各半为丸,每服二钱,日二三次,从此服蜣螂丸起两月而止。
三月二十四日 痹症夹痰饮,脉本洪数,前用辛凉脉减,兼用通络散、瘕丸散亦效,现
在六脉中部仍洪,但不数耳。议暂用辛凉宣肺。
生石膏(四两) 小枳实(四钱) 桂枝(八钱) 杏仁(八钱) 防己(六钱) 广皮(二钱)
云苓块(一两) 全归(三钱) 半夏(八钱) 飞滑石(二两) 海桐皮(三钱)
二十六日 诊右脉更大,小便反短,用苦辛淡法,于前方内加∶
炒黄柏(三钱)
四月十六日 痹痛夹痰饮。
生石膏(八钱) 苡仁(五钱) 防己(四钱) 云苓皮(五钱) 杏仁(五钱) 蚕砂(三钱)
桂枝(五钱) 白通草(钱半) 半夏(五钱) 广皮(三钱)
煮三杯,三次服。
十七日 内而胁痛,外而腰痹痛,是气血兼痹也。
桂枝尖(五钱) 归须(二钱) 白蔻仁(钱半) 杏仁(五钱) 云苓皮(三钱) 片姜黄(二
钱)
旋复花(三钱,包) 防己(三钱) 生苡仁(三钱) 小枳实(四钱) 半夏(四钱) 郁金(二钱)
广皮(三钱)
二十五日 痰饮踞于中焦,痹痛结于太阳,气上冲胸,二便不利。
桂枝(八钱) 姜半夏(五钱) 通草(钱半) 云苓皮(二两二钱) 防己(六钱) 杏仁(八
钱) 枳实(六钱) 广皮(三钱) 滑石(六钱)
煮四杯,四次服。
五月初三日 大凡腹胀之疾,不责之太阴,即责之厥阴。此症自正月以来,开太阳之药
,未
有不泄太阴者,他症虽减其半,则尚未除。其故有三∶一者病起肝郁;二者肝主疏泄,误补
致壅;三者自正月以来,以右脉洪大之故,痹症甚重。治在肺经,经有诸痹独取太阴之明训
。兹右脉平而左脉大,不得着于前议,暂与泄厥阴之络,久病在络故也。
旋复花(五钱,包) 黄芩(三钱) 归须(三钱) 老川朴(五钱) 杉皮(三钱) 半夏(五
钱)
小枳实(五钱) 晚蚕砂(三钱) 广皮(三钱) 郁金(三钱) 苏子霜(三钱) 降香末(三钱)
煮三杯。三次服。
二十三日 左胁痛胀,卧不着席胸亦闷胀,气短,肝脉络胸之故。
新绛纱(三钱) 香附(四钱) 半夏(五钱) 旋复花(三钱,包) 归须(三钱) 小枳实(
四钱)
苏子霜(三钱) 降香末(三钱) 郁金(三钱) 广皮(三钱) 川椒炭(四钱) 青皮(三钱)
煮三大杯,三次服。七帖。
六月初一日 痰饮肝郁,脉弦细,气上冲胸。
旋复花(四钱) 枳实(三钱) 公丁香(二钱) 苏子霜(三钱) 半夏(六钱) 片姜黄(三
钱) 降香末(三钱) 郁金(三钱) 青皮(三钱) 广皮(五钱) 桂枝尖(三钱)
煮三杯,分三次服。
初三日 痰饮上泛,咳嗽稀痰,兼发痹症。
桂枝(六钱) 防己(六钱) 杏仁(五钱) 川乌头(三钱) 云苓皮(五钱) 枳实(四钱)
广皮(五钱) 桂心(二钱) 苡仁(三钱) 白通草(二钱) 滑石(四钱) 炒黄柏(三钱炒)
煮三杯,分三次服。
初六日 小便不畅,下焦湿聚,于原方加滋肾丸法。
十一日 痹症未尽除,痰饮未全消,当盛暑流行之际,逐饮开痹,即所以防暑。
云苓块(六钱) 小枳实(二钱) 半夏(六钱) 防己(三钱) 生苡仁(六钱) 杏仁(三钱)
广皮(二钱) 桂枝(三钱)
煮三杯,三次服。
十三日 暑泄,腹胀,舌黄,其人本有痰饮痹症,议五苓加减。
桂枝(三钱) 猪苓(四钱) 泽泻(四钱) 云苓皮(五钱) 滑石(六钱) 川朴(三钱) 杉
皮(
三钱) 木香(钱半) 半夏(三钱) 藿梗(三钱) 白蔻仁(三钱) 川椒炭(二钱) 真山连(一
钱)
十五日 脉缓,服前方。
十六日 脉缓甚,服前方。
二十一日 久病在络,其本病统俟丸药立方,但逐痰饮,宣气化湿,捍时令之暑湿而已
。
半夏(六钱) 云苓块(五钱) 生香附(三钱) 川朴(二钱) 广皮(三钱) 杉皮(三钱)
大腹皮(三钱) 小枳实(三钱)
煮三杯,三次服。
六月二十六日 服化 回生丹起,每日一丸。
二十七日 脉浮,筋骨酸痛,气短,五心烦热,新感暑湿之气,加以辛凉,与三焦。
连翘(三钱) 苡仁(五钱) 银花(三钱) 白蔻仁(二钱) 藿香叶(三钱) 杏仁(三钱)
广皮(三钱) 小枳实(三钱)
煮三杯,三次服。
七月初二日 背痛甚,先与通太阳之痹。
桂枝(六钱) 枳实(五钱,打) 防己(五钱) 云苓皮(八钱) 半夏(五钱) 杏仁(三钱)
川椒炭(二钱)
煮三杯,三次服,亥初令完。
初九日 近日阴雨连绵,背痛腹胀不减,二便不爽,非嗳则哕,脉小于前,与宣痹开郁
,兼去陈 。
桂枝(八钱) 茯苓(八钱,带皮) 白通草(钱半) 川朴(五钱) 公丁香(三钱) 防己(
六钱) 杏仁(六钱) 晚蚕砂(三钱) 小茴香(三钱) 枳实(五钱) 白蔻仁(三钱)
煮四杯,四次服。
二十一日 寒湿发痹,脉缓甚,中有痰饮。
桂枝(六钱) 茯苓(六钱) 白通草(钱半) 防己(五钱) 苡仁(四钱) 薤白(三钱) 枳
实
(三钱) 杏仁(四钱) 熟附子(二钱) 川乌头(二钱) 广皮(五钱) 萆 (五钱) 片姜黄(三
钱)
煮三杯,三次服,已服五帖。
二十八日 脉弦紧,痰饮痹症 瘕,因燥气而发,脏腑经络俱痹,故肢冷而畏寒也,峻
与通阳。
桂枝(一两) 广皮(六钱) 归须(二钱) 防己(五钱) 小枳实(四钱) 杏仁(五钱) 半
夏
(三钱) 穿山甲(一钱) 泽泻(三钱) 公丁香(三钱) 川椒炭(五钱,炒) 片姜黄(三钱)
煮四杯,四次服。
自六月二十六日起,每日空心服化 回生丹一丸,七月二十九以后,每日服天台乌药散
三分
五分一钱二钱不等。至十月十二日,每两乌药散中,加巴霜一分,每晚服三分五分不等,间
有服至一钱者,十一月初一日以后,每晚间服奇经丸。
十二月初十日 痹痛,饮咳,脉弦细。
桂枝(八钱) 苡仁(五钱) 滑石(四钱) 川乌头(三钱) 云苓皮(六钱) 枳实(三钱)
川萆 (五钱) 杏仁(四钱) 防己(五钱) 川椒炭(三钱)
十二日 冲气上动畏寒,脉沉细,与桂枝加桂汤法,直伐冲气。
桂枝尖(一两二钱) 紫石英(六钱,研) 云苓块(三两) 桂心(八钱) 小茴香(五钱)
煮四杯,分四次服。
十三日 大寒节冲气未止,脉反弦紧。于原方内加∶
当归(五钱) 川芎(三钱)
服二帖,脉中阳气生动,冲气平,畏寒止,仍然早服化 回生丹一丸,晚服奇经丸三钱
。
[Background Information]
Book: Wujutong's Medical Cases (Wu Juzhong Yi An)
Author: Wu Juzhong (Wu Ju-tong)
Dynasty: Qing Dynasty
Chapter: Bi Syndrome (Part 2/2)
Category: Medical Discussion
Shigao (Gypsum Fibrosum, 3 liang), Huashi (Talcum, 1 liang).
On the 7th day, add:
Nouhou (Magnoliae Officinalis Cortex, 3 qian), Jiangxia (Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine, 5 qian).
Pill Formula: For Bi syndrome complicated with Phlegm-Fluids and Hernia/Masses, with six pulses being surging and large. Apply the method of "selecting only Taiyin for all Bi syndromes." If the surging and large pulse becomes smaller, this aligns with the *Nan Jing* saying: "When a person is ill but the pulse does not reflect illness, there is hope for survival." However, although the pulse has normalized, the abdominal masses, distension, and Bi pain have not been eliminated. It is proposed to use Wuyao San (Lindera Powder) to retreat the difficult-to-resolve aspects of the masses and Bi, because long-standing diseases reside in the collaterals. Furthermore, use pills to gently unblock the collaterals. If the pulse becomes large again, continue taking the previous prescription for a few doses; stop when it becomes smaller.
Qianglangchong (Scarabaeus Siccus, 1 liang), Guixu (Angelicae Sinensis Radix Caulis, 4 liang), Liangtoujian (Aconiti Kusnezoffii Radix, 2 liang), Chuanshanjia (Manis Squama, 3 liang), Jiangxiangmo (Dalbergiae Odoriferae Lignum, 3 qian), Xiaohuixiang (Foeniculi Fructus, 3 liang, stir-fried), Haitongpi (Saposhnikoviae Radix, 3 liang), Ruxiang (Olibanum, 1 liang), Pianjianghuang (Curcumae Longae Rhizoma, 3 liang), Shexiang (Moschus, 3 qian), Dilong (Pheretima, 1 liang, cleaned), Chuanlianzi (Meliosmae Fructus, 3 liang, stir-fried).
Grind into fine powder, mix with half wine and half water to form pills. Take 2 qian per dose, two to three times daily. Continue taking Qianglang Wan (Scarab Pill) for two months from the start.
On March 24th: Bi syndrome complicated with Phlegm-Fluids. The pulse was originally surging and rapid. Previous use of Acrid-Cool herbs reduced the pulse. Concurrent use of Tongluo San (Collateral-Unblocking Powder) and Jia Wan San (Masses Pill Powder) was also effective. Currently, the middle positions of the six pulses are still surging, but no longer rapid. It is proposed to temporarily use Acrid-Cool herbs to diffuse Lung Qi.
Sheng Shigao (Raw Gypsum Fibrosum, 4 liang), Xiao Zhishi (Immature Bitter Orange Fruit, 4 qian), Guizhi (Cinnamomi Ramulus, 8 qian), Xingren (Armeniacae Semen Amarum, 8 qian), Fangji (Stephaniae Tetrandrae Radix, 6 qian), Guangpi (Citri Reticulatae Pericarpium, 2 qian), Yunlingkuai (Poria Cocos, 1 liang), Quanguui (Whole Angelicae Sinensis Radix, 3 qian), Banxia (Pinelliae Rhizoma, 8 qian), Fei Huashi (Precipitated Talcum, 2 liang), Haitongpi (Saposhnikoviae Radix, 3 qian).
On the 26th day: The right pulse is even larger, and urination is conversely scanty. Use the Bitter-Acid-Dilute method, adding to the previous formula:
Chao Huangbai (Stir-fried Phellodendri Chinensis Cortex, 3 qian).
On April 16th: Bi pain complicated with Phlegm-Fluids.
Sheng Shigao (Raw Gypsum Fibrosum, 8 qian), Yiren (Coicis Semen, 5 qian), Fangji (Stephaniae Tetrandrae Radix, 4 qian), Yunlingpi (Poria Cocos with Bark, 5 qian), Xingren (Armeniacae Semen Amarum, 5 qian), Can Sha (Bombyx Batryticatus, 3 qian), Guizhi (Cinnamomi Ramulus, 5 qian), Baotongcao (Akebiae Caulis, 1.5 qian), Banxia (Pinelliae Rhizoma, 5 qian), Guangpi (Citri Reticulatae Pericarpium, 3 qian).
Boil to make three cups, take in three divided doses.
On the 17th day: Internally, hypochondriac pain; externally, lumbar Bi pain. This is a combined obstruction of Qi and Blood.
Guizhijian (Tip of Cinnamomi Ramulus, 5 qian), Guixu (Angelicae Sinensis Radix Caulis, 2 qian), Baokouren (Amomi Fructus Rotundus, 1.5 qian), Xingren (Armeniacae Semen Amarum, 5 qian), Yunlingpi (Poria Cocos with Bark, 3 qian), Pianjianghuang (Curcumae Longae Rhizoma, 2 qian).
Xuanfuhua (Inulae Flos, 3 qian, wrapped), Fangji (Stephaniae Tetrandrae Radix, 3 qian), Sheng Yiren (Raw Coicis Semen, 3 qian), Xiao Zhishi (Immature Bitter Orange Fruit, 4 qian), Banxia (Pinelliae Rhizoma, 4 qian), Yujin (Curcumae Radix, 2 qian), Guangpi (Citri Reticulatae Pericarpium, 3 qian).
On the 25th day: Phlegm-Fluids occupy the Middle Jiao; Bi pain knots in the Taiyang channel. Qi rushes upward to the chest, and both urination and defecation are obstructed.
Guizhi (Cinnamomi Ramulus, 8 qian), Jiang Banxia (Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine, 5 qian), Tongcao (Akebiae Caulis, 1.5 qian), Yunlingpi (Poria Cocos with Bark, 2 liang 2 qian), Fangji (Stephaniae Tetrandrae Radix, 6 qian), Xingren (Armeniacae Semen Amarum, 8 qian), Zhishi (Aurantii Fructus Immaturus, 6 qian), Guangpi (Citri Reticulatae Pericarpium, 3 qian), Huashi (Talcum, 6 qian).
Boil to make four cups, take in four divided doses.
On May 3rd: Generally, disorders of abdominal distension are attributed either to Taiyin or Jueyin. Since January, treatments opening Taiyang invariably drained Taiyin. Although other symptoms have decreased by half, they are not yet eliminated. There are three reasons: First, the disease originated from Liver Qi Stagnation; Second, the Liver governs free flow and drainage, and mistaken tonification led to congestion; Third, since January, due to the surging and large right pulse, the Bi syndrome was severe. Treatment focused on the Lung Meridian, following the clear instruction in the classics that "for all Bi syndromes, select only Taiyin." Now, the right pulse is normal while the left pulse is large, so we cannot adhere to the previous discussion. Temporarily drain the collaterals of Jueyin, because long-standing diseases reside in the collaterals.
Xuanfuhua (Inulae Flos, 5 qian, wrapped), Huangqin (Scutellariae Radix, 3 qian), Guixu (Angelicae Sinensis Radix Caulis, 3 qian), Lao Chuanpu (Old Magnoliae Officinalis Cortex, 5 qian), Shanpi (Cupressi Ligninum, 3 qian), Banxia (Pinelliae Rhizoma, 5 qian).
Xiao Zhishi (Immature Bitter Orange Fruit, 5 qian), Wan Can Sha (Late Silkworm Droppings, 3 qian), Guangpi (Citri Reticulatae Pericarpium, 3 qian), Yujin (Curcumae Radix, 3 qian), Suzishuang (Pericarpium Sesami Nigris Pulveratum, 3 qian), Jiangxiangmo (Dalbergiae Odoriferae Lignum, 3 qian).
Boil to make three cups, take in three divided doses.
On the 23rd day: Left hypochondriac pain and distension; lying down does not relieve the chest stuffiness and distension; shortness of breath. This is due to the Liver meridian connecting to the chest.
Xinjiansha (New Crimson Gauze, 3 qian), Xiangfu (Cyperi Rhizoma, 4 qian), Banxia (Pinelliae Rhizoma, 5 qian), Xuanfuhua (Inulae Flos, 3 qian, wrapped), Guixu (Angelicae Sinensis Radix Caulis, 3 qian), Xiao Zhishi (Immature Bitter Orange Fruit, 4 qian).
Suzishuang (Pericarpium Sesami Nigris Pulveratum, 3 qian), Jiangxiangmo (Dalbergiae Odoriferae Lignum, 3 qian), Yujin (Curcumae Radix, 3 qian), Guangpi (Citri Reticulatae Pericarpium, 3 qian), Chuanjiaotan (Zanthoxyli Fructus Carbonized, 4 qian), Qingpi (Citri Reticulatae Pericarpium Viride, 3 qian).
Boil to make three large cups, take in three divided doses. Seven doses.
On June 1st: Phlegm-Fluids and Liver Stagnation. Pulse is wiry and thin. Qi rushes upward to the chest.
Xuanfuhua (Inulae Flos, 4 qian), Zhishi (Aurantii Fructus Immaturus, 3 qian), Gong Dingxiang (Caryophylli Flos, 2 qian), Suzishuang (Pericarpium Sesami Nigris Pulveratum, 3 qian), Banxia (Pinelliae Rhizoma, 6 qian), Pianjianghuang (Curcumae Longae Rhizoma, 3 qian), Jiangxiangmo (Dalbergiae Odoriferae Lignum, 3 qian), Yujin (Curcumae Radix, 3 qian), Qingpi (Citri Reticulatae Pericarpium Viride, 3 qian), Guangpi (Citri Reticulatae Pericarpium, 5 qian), Guizhijian (Tip of Cinnamomi Ramulus, 3 qian).
Boil to make three cups, take in three divided doses.
On the 3rd day: Phlegm-Fluids flooding upward, coughing with thin sputum, accompanied by onset of Bi syndrome.
Guizhi (Cinnamomi Ramulus, 6 qian), Fangji (Stephaniae Tetrandrae Radix, 6 qian), Xingren (Armeniacae Semen Amarum, 5 qian), Chuan Wutou (Aconiti Radix, 3 qian), Yunlingpi (Poria Cocos with Bark, 5 qian), Zhishi (Aurantii Fructus Immaturus, 4 qian), Guangpi (Citri Reticulatae Pericarpium, 5 qian), Guixin (Cinnamomi Cortex, 2 qian), Yiren (Coicis Semen, 3 qian), Baotongcao (Akebiae Caulis, 2 qian), Huashi (Talcum, 4 qian), Chao Huangbai (Stir-fried Phellodendri Chinensis Cortex, 3 qian).
Boil to make three cups, take in three divided doses.
On the 6th day: Urination is not smooth, dampness gathers in the Lower Jiao. Add the method of Zishen Wan (Kidney-Nourishing Pill) to the original formula.
On the 11th day: Bi syndrome is not fully eliminated, Phlegm-Fluids are not completely resolved. During the peak of summer heat circulation, dispelling fluids and opening Bi is the way to prevent summerheat.
Yunlingkuai (Poria Cocos, 6 qian), Xiao Zhishi (Immature Bitter Orange Fruit, 2 qian), Banxia (Pinelliae Rhizoma, 6 qian), Fangji (Stephaniae Tetrandrae Radix, 3 qian), Sheng Yiren (Raw Coicis Semen, 6 qian), Xingren (Armeniacae Semen Amarum, 3 qian), Guangpi (Citri Reticulatae Pericarpium, 2 qian), Guizhi (Cinnamomi Ramulus, 3 qian).
Boil to make three cups, take in three divided doses.
On the 13th day: Summerheat diarrhea, abdominal distension, yellow tongue coating. The patient originally had Phlegm-Fluids and Bi syndrome. Propose modified Wuling San (Five-Ingredient Poria Powder).
Guizhi (Cinnamomi Ramulus, 3 qian), Zhuling (Polyporus, 4 qian), Zexie (Alismatis Rhizoma, 4 qian), Yunlingpi (Poria Cocos with Bark, 5 qian), Huashi (Talcum, 6 qian), Chuanpu (Magnoliae Officinalis Cortex, 3 qian), Shanpi (Cupressi Ligninum, 3 qian), Muxiang (Aucklandiae Radix, 1.5 qian), Banxia (Pinelliae Rhizoma, 3 qian), Huogeng (Agastachis Herba, 3 qian), Baokouren (Amomi Fructus Rotundus, 3 qian), Chuanjiaotan (Zanthoxyli Fructus Carbonized, 2 qian), Zhen Shanlian (Gentianae Macrophyllae Radix, 1 qian).
On the 15th day: Pulse is slow, take the previous formula.
On the 16th day: Pulse is very slow, take the previous formula.
On the 21st day: Long-standing disease resides in the collaterals. The root disease will wait for the pill formula to be established. For now, only dispel Phlegm-Fluids, diffuse Qi and resolve dampness, to defend against the seasonal summer-dampness.
Banxia (Pinelliae Rhizoma, 6 qian), Yunlingkuai (Poria Cocos, 5 qian), Sheng Xiangfu (Raw Cyperi Rhizoma, 3 qian), Chuanpu (Magnoliae Officinalis Cortex, 2 qian), Guangpi (Citri Reticulatae Pericarpium, 3 qian), Shanpi (Cupressi Ligninum, 3 qian), Dafupi (Arecae Pericarpium, 3 qian), Xiao Zhishi (Immature Bitter Orange Fruit, 3 qian).
Boil to make three cups, take in three divided doses.
On June 26th: Start taking Huaqi Huisheng Dan (Revitalizing Pill), one pill daily.
On the 27th day: Pulse is floating, soreness and pain in sinews and bones, shortness of breath, five-palm heat. Newly contracted summer-dampness qi. Add Acrid-Cool herbs to benefit the Triple Burner.
Lianqiao (Forsythiae Fructum, 3 qian), Yiren (Coicis Semen, 5 qian), Yinhua (Lonicerae Japonicae Flos, 3 qian), Baokouren (Amomi Fructus Rotundus, 2 qian), Huoxiangye (Agastachis Folium, 3 qian), Xingren (Armeniacae Semen Amarum, 3 qian), Guangpi (Citri Reticulatae Pericarpium, 3 qian), Xiao Zhishi (Immature Bitter Orange Fruit, 3 qian).
Boil to make three cups, take in three divided doses.
On July 2nd: Severe back pain. First, treat the Taiyang Bi obstruction.
Guizhi (Cinnamomi Ramulus, 6 qian), Zhishi (Aurantii Fructus Immaturus, 5 qian, crushed), Fangji (Stephaniae Tetrandrae Radix, 5 qian), Yunlingpi (Poria Cocos with Bark, 8 qian), Banxia (Pinelliae Rhizoma, 5 qian), Xingren (Armeniacae Semen Amarum, 3 qian), Chuanjiaotan (Zanthoxyli Fructus Carbonized, 2 qian).
Boil to make three cups, take in three divided doses, complete by early Hai hour (9-11 PM).
On the 9th day: Recent continuous rainy days, back pain and abdominal distension unchanged, urination and defecation unsatisfactory, belching or hiccups occur. Pulse is smaller than before. Prescribe Diffusing Bi and Opening Depression, combined with removing old stagnation.
Guizhi (Cinnamomi Ramulus, 8 qian), Fuling (Poria Cocos, 8 qian, with bark), Baotongcao (Akebiae Caulis, 1.5 qian), Chuanpu (Magnoliae Officinalis Cortex, 5 qian), Gong Dingxiang (Caryophylli Flos, 3 qian), Fangji (Stephaniae Tetrandrae Radix, 6 qian), Xingren (Armeniacae Semen Amarum, 6 qian), Wan Can Sha (Late Silkworm Droppings, 3 qian), Xiaohuixiang (Foeniculi Fructus, 3 qian), Zhishi (Aurantii Fructus Immaturus, 5 qian), Baokouren (Amomi Fructus Rotundus, 3 qian).
Boil to make four cups, take in four divided doses.
On the 21st day: Cold-Damp causing Bi, pulse very slow, with Phlegm-Fluids inside.
Guizhi (Cinnamomi Ramulus, 6 qian), Fuling (Poria Cocos, 6 qian), Baotongcao (Akebiae Caulis, 1.5 qian), Fangji (Stephaniae Tetrandrae Radix, 5 qian), Yiren (Coicis Semen, 4 qian), Xiebai (Allii Macrostemonis Bulbus, 3 qian), Zhishi (Aurantii Fructus Immaturus, 3 qian), Xingren (Armeniacae Semen Amarum, 4 qian), Shu Fuzi (Prepared Aconiti Lateralis Radix, 2 qian), Chuan Wutou (Aconiti Radix, 2 qian), Guangpi (Citri Reticulatae Pericarpium, 5 qian), Bibing (Dioscoreae Hypoglaucae Rhizoma, 5 qian), Pianjianghuang (Curcumae Longae Rhizoma, 3 qian).
Boil to make three cups, take in three divided doses. Already taken five doses.
On the 28th day: Pulse is wiry and tight. Phlegm-Fluids, Bi syndrome, and Masses flare up due to dryness qi. Zang-Fu organs and collaterals are all obstructed, hence cold limbs and aversion to cold. Strongly apply Unblocking Yang.
Guizhi (Cinnamomi Ramulus, 1 liang), Guangpi (Citri Reticulatae Pericarpium, 6 qian), Guixu (Angelicae Sinensis Radix Caulis, 2 qian), Fangji (Stephaniae Tetrandrae Radix, 5 qian), Xiao Zhishi (Immature Bitter Orange Fruit, 4 qian), Xingren (Armeniacae Semen Amarum, 5 qian), Banxia (Pinelliae Rhizoma, 3 qian), Chuanshanjia (Manis Squama, 1 qian), Zexie (Alismatis Rhizoma, 3 qian), Gong Dingxiang (Caryophylli Flos, 3 qian), Chuanjiaotan (Zanthoxyli Fructus Carbonized, 5 qian, stir-fried), Pianjianghuang (Curcumae Longae Rhizoma, 3 qian).
Boil to make four cups, take in four divided doses.
From June 26th, take one Huaqi Huisheng Dan (Revitalizing Pill) on an empty stomach daily. After July 29th, take Tiantai Wuyao San (Tiantai Lindera Powder) daily, varying between 3 fen, 5 fen, 1 qian, or 2 qian. By October 12th, add 1 fen of Bashuang (Crotonis Semen Extract) to each liang of Wuyao San, take 3-5 fen nightly, occasionally up to 1 qian. After November 1st, take Qijing Wan (Extraordinary Vessel Pill) every night.
On December 10th: Bi pain, fluid-induced cough, pulse wiry and thin.
Guizhi (Cinnamomi Ramulus, 8 qian), Yiren (Coicis Semen, 5 qian), Huashi (Talcum, 4 qian), Chuan Wutou (Aconiti Radix, 3 qian), Yunlingpi (Poria Cocos with Bark, 6 qian), Zhishi (Aurantii Fructus Immaturus, 3 qian), Chuan Bibing (Dioscoreae Hypoglaucae Rhizoma, 5 qian), Xingren (Armeniacae Semen Amarum, 4 qian), Fangji (Stephaniae Tetrandrae Radix, 5 qian), Chuanjiaotan (Zanthoxyli Fructus Carbonized, 3 qian).
On the 12th day: Chong Qi moving upward with aversion to cold, pulse deep and thin. Apply the method of Guizhi Jia Gui Tang (Cinnamon Twig Decoction plus Cinnamon), directly attacking the Chong Qi.
Guizhijian (Tip of Cinnamomi Ramulus, 1 liang 2 qian), Zi Shiyin (Hematitum, 6 qian, ground), Yunlingkuai (Poria Cocos, 3 liang), Guixin (Cinnamomi Cortex, 8 qian), Xiaohuixiang (Foeniculi Fructus, 5 qian).
Boil to make four cups, take in four divided doses.
On the 13th day: At Major Cold solar term, Chong Qi has not stopped, pulse is surprisingly wiry and tight. Add to the original formula:
Danggui (Angelicae Sinensis Radix, 5 qian), Chuanxiong (Ligustici Chuanxiong Rhizoma, 3 qian).
Take two doses. Yang Qi becomes active in the pulse, Chong Qi calms, aversion to cold stops. Continue taking one Huaqi Huisheng Dan (Revitalizing Pill) in the morning and 3 qian of Qijing Wan (Extraordinary Vessel Pill) at night.