陶 三十岁 乙酉六月初二日 风淫末疾,两手发软,不能持物,脚亦有时而软,脉弦
数,治以辛凉。
薄荷(钱半) 桑叶(三钱) 全归(钱半) 连翘(三钱) 麦冬(三钱,连心) 丹皮(三钱)
银花(三钱) 菊花(三钱) 细生地(四钱)
服八帖。
周 四十岁 壬戌八月二十五日 内而暑湿,外而新凉,内外相搏,痰饮斯发。
杏仁粉(三钱) 白通草(三钱) 广皮(二钱) 生苡仁(五钱) 飞滑石(三钱) 小枳实(
二钱) 半夏(五钱) 川朴(三钱) 生姜(三片) 桂枝木(三钱) 茯苓皮(三钱)
二十八日 支饮射肺,眩冒,小青龙去麻辛。
桂枝(四钱) 白芍(三钱,炒) 焦于术(三钱) 干姜(二钱) 制五味(一钱) 生姜(三
片) 半夏(六钱) 杏仁粉(五钱) 小枳实(二钱) 生苡仁(五钱) 炙甘草(二钱)
初一日 渴为痰饮欲去,不寐为胃仍未和,故以枳实橘皮汤逐不尽之痰饮,以半夏汤和
胃令得寐。
半夏(一两) 杏仁粉(三钱) 广皮(三钱) 桂枝(三钱) 生姜(三片) 生苡仁(五钱)
枳实(二钱) 秫米(一合)
得寐再诊。
初六日 服半夏汤,既得寐矣,而反咳痰多,议桂枝干姜五味茯苓汤,合葶苈大枣泄肺
汤逐饮。
桂枝(五钱) 茯苓块(六钱) 苦葶苈(三钱) 半夏(二钱) 肥大枣(四钱,去核) 干姜
(五钱) 五味子(三钱)
甘澜水五碗,煮取二碗,分二次服。再煮一碗服。
初八日 先以葶苈大枣泄肺汤,行业已攻动之饮,令其速去。
苦葶苈(四钱) 肥大枣(五枚)
服葶苈汤后,即以半夏汤和胃。
半夏(一两) 生姜(五大片) 小枳实(四钱) 洋参(二钱,生姜块同捣炒老黄)
水八杯,煮取三杯,三次服。
九月初十日 逐去水后,用《外台》茯苓饮,消痰气,令能食。
茯苓块(六钱) 半夏(三钱) 小枳实(四钱) 洋参(二钱,姜汁制黄色) 生姜(八钱)
广皮(三钱) 于术(六钱,炒)
十五日 饮居胁下则肝病,肝病则肝气愈衰,故得后与气则愈。先与行胁下之饮,泄肝即所
以舒脾,俟胁痛止,再议补脾。
生香附(三钱) 广皮(二钱) 旋复花(三钱,包) 青皮(钱半) 苏子霜(三钱) 降香末
(三钱) 半夏(四钱) 枳实(钱半)
二十日 行胁络之饮,业已见效,尚有不尽,仍用前法。
生香附(三钱) 归须(一钱) 半夏(三钱) 广皮(一钱) 苏子霜(钱半) 降香末(钱半)
郁金(二钱) 小枳实(一钱) 旋复花(三钱,包)
二帖。
二十二日 通补中阳,兼行胁下不尽之饮。
代赭石(五钱) 焦术(三钱) 旋复花(三钱,包) 桂枝(三钱) 炙甘草(三钱) 茯苓(
五钱) 生姜(三片) 半夏(五钱)
四帖。
十月初二日 通降胁下之痰饮,兼与两和肝胃。
旋复花(三钱) 小枳实(二钱,杵) 干姜(钱半) 苏子霜(三钱) 桂枝尖(二钱) 广皮
(二钱) 生姜(三片) 半夏(六钱)
金氏 二十六岁 癸亥二月初十日 风寒挟痰饮为病,自汗恶寒,喘满短气,渴不多饮
,饮则呕,夜咳甚,倚息不得卧,小青龙去麻、杏,加枳实、广皮,行饮而降逆气。
桂枝(六钱) 制五味(钱半) 炙甘草(三钱) 干姜(三钱) 白术(四钱,炒) 半夏(六
钱) 小枳实(二钱) 广皮(二钱) 生姜(三片) 茯苓(六钱)
甘澜水八杯,煮成三杯,三次服。
十一日 昨用小青龙,咳虽稍减,仍不得卧,今用葶苈大枣合法。
桂枝(八钱) 广皮(三钱) 干姜(五钱) 五味子(二钱) 半夏(六钱) 炙甘草(三钱)
白芍(四钱,炒) 小枳实(二钱) 大枣(去核,五枚) 苦葶苈(二钱,炒香研细)
水八杯,煮取三杯,三次服,渣再煮一杯服。
十二日 用小青龙逐饮,兼利小便,使水有出路。
桂枝(五钱) 小枳实(二钱) 干姜(二钱) 白通草(钱半) 杏泥(五钱) 制五味(钱半)
炙甘草(一钱) 白芍(二钱,炒) 生苡仁(五钱) 半夏(五钱) 生姜(三片)
煮成两杯,分二次服,渣再煮一杯服。
十三日 脉稍平,病起本渴,大服姜桂,渴反止者。饮居心下,格拒心火之渴也,仍以
蠲饮为主。微恶寒,兼和营卫。
桂枝(六钱) 茯苓(三钱) 杏泥(四钱) 半夏(六钱) 干姜(三钱) 白芍(三钱,炒)
炙甘
草(钱半) 广皮(一钱) 生姜(三片) 小枳实(钱半) 制五味(钱半) 大枣(二钱,去核)
煎法如前。
十四日 咳则胁痛,不惟支饮射肺,且有悬饮内痛之虞,兼逐胁下悬饮。
桂枝(六钱) 青皮(二钱) 干姜(四钱) 广皮(二钱) 杏仁泥(四钱) 郁金(三钱) 生
香附
(三钱) 制五味(钱半) 旋复花(三钱,包) 小枳实(钱半) 半夏(八钱) 苏子霜(二钱)
生姜(五钱)
三碗,三次服,渣再煎一碗服。
十五日 咳止大半,惟胁痛攻胸,肝胃不和之故。切戒恼怒,用通肝络法。
半夏 苏子(三钱,去油) 干姜(三钱) 桂枝尖(三钱) 降香末 归须(二钱) 青皮(
二钱) 旋复花(三钱) 郁金 生香附
头煎二杯,二煎一杯,分三次服。
谢氏 二十五岁 癸亥二月二十二日 痰饮哮喘,咳嗽声重,有汗,六脉弦细,有七月
之孕,与小青龙去麻辛主之。
桂枝(五钱) 半夏(五钱) 干姜(三钱) 白芍(三钱) 小枳实(二钱) 炙甘草(一钱)
五味(一钱) 广皮(钱半)
甘澜水五杯,煮成两杯,二次服,渣再煮一杯服。
二十二日 其人本渴,服桂姜热药当更渴,今渴反止者,饮也。恶寒未罢,仍用小青龙
法,胸痹痛加薤白。按∶饮为阴邪,以误服苦寒坚阴,不能速愈。
桂枝(八钱) 小枳实(二钱) 薤白(三钱) 干姜(五钱) 制五味(一钱) 川朴(三钱)
半夏(六钱) 焦白芍(四钱) 广皮(二钱) 炙甘草(二钱)
甘澜水五杯,煮成两杯,分二次服,渣再煮二杯服。
二十三日 胃不和则卧不安,亥子属水,故更重。胀也,痛也,皆阴病也,无非受苦寒
药之累。
桂枝(八钱) 半夏(八钱) 炙甘草(一钱) 白芍(三钱,炒) 干姜(五钱) 薤白(三钱)
生苡仁(五钱) 川朴(三钱) 杏泥(三钱) 苦桔梗(三钱) 五味子(钱半) 茯苓块(五钱)
甘澜水八杯,煮三杯,分三次服,渣再煮一杯服。
二十四日 寒饮误服苦寒坚阴,大用辛温三帖,今日甫能转热,右脉始大,左脉仍弦细
,咳嗽反重者,是温药启其封固也。再用温药兼滑痰,痰出自然松快。
桂枝(五钱) 生苡仁(五钱) 薤白(三钱) 杏泥(三钱) 干姜(三钱) 茯苓(五钱) 栝
蒌(二钱) 小枳实(二钱) 半夏(八钱) 白芍(三钱,炒) 川朴(三钱) 制五味(钱半)
甘澜水八杯,煮取三杯,三次服,渣再煮一杯服。
二十五日 右脉已退,病势少减,但寒热汗多胸痹,恐成漏汗,则阳愈虚,饮更难愈。
议桂枝加附子,去甘草,以肋胀故也。合栝蒌薤白汤意,通中上之清阳,护表阳为急。
桂枝(六钱) 大枣(二枚,去核) 川朴(三钱) 焦白芍(四钱) 熟附子(二钱) 小枳实
(钱半) 生姜(三片) 薤白(三钱)
甘澜水五杯,煮取两杯,渣再煮一杯,三次服,其第一次即啜稀热粥半碗,令微汗佳,
第二三次不必啜粥。
二十六日 昨日用桂枝汤加附子,再加薤白法,漏汗已止,表之寒热已和,但咳甚,议
与逐饮。
桂枝(六钱) 大枣(五枚,去核) 半夏(五钱) 茯苓块(六钱) 生苡仁(五钱) 葶苈子
(二钱,炒研细)
甘澜水八杯,取三杯,分三次服。
僧 四十二岁 脉双弦而紧,寒也;不欲饮水,寒饮也;喉中痒,病从外感来也;痰清
不粘
,寒饮也;咳而呕,胃阳衰而寒饮乘之,谓之胃咳也。背恶寒时欲浓衣向火,卫外之阳虚,
而寒乘太阳经也。面色淡黄微青,唇色淡白,亦寒也。法当温中阳而护表阳,未便以吐血之
后,而用柔润寒凉,小青龙去麻杏,加枳实、广皮、杏仁、生姜汤主之。服此方十数帖而愈
。
徐 二十六岁 二月初十日 酒客脉弦细而沉,喘满短气,胁连腰痛,有汗,舌白滑而
浓,恶风寒,倚息不得卧,此系内水招外风为病,小青龙去麻辛证也。
桂枝(六钱) 干姜(三钱) 杏泥(五钱) 白芍(四钱,炒) 生姜(五片) 半夏(六钱)
炙甘草(一钱) 制五味(钱半) 旋复花(三钱,包)
邵 四十三岁 癸亥七月二十三日 右关单弦饮癖,少阴独盛,水脏盛而土气衰也。至
吞酸饭后吐痰不止,治在胃肾两关。不能戒酒,不必服药,真武法。
熟附子(五钱) 茯苓块(六钱) 生苡仁(六钱) 细辛(钱半) 生姜(五片) 真山连(钱
半,同吴萸浸炒) 吴萸(三钱)
水八杯,煮成三杯,分三次服。四帖。
二十八日 内饮用温水脏法,已见大效,但药太阳刚,不可再用,所谓一张一弛,文武
之道。且议理阳明,以为过峡文本。
半夏(六钱) 广皮(一钱) 小枳实(钱半) 茯苓块(六钱) 生苡仁(六钱) 白豆蔻(一
钱) 生姜(六钱)
四帖。
八月初三日 用理阳明,亦复见效,惟吐酸仍然未止。按∶吞酸究属肝病,议肝胃同治
法。
半夏(六钱) 桂枝(三钱) 吴萸(三钱) 茯苓块(六钱) 青皮(六钱) 生姜(三片) 苡
仁(五钱) 山连(钱半,姜炒)
四帖。
某氏 内饮招外风为病,既喘且咳,议小青龙法。
桂枝(三钱) 麻黄(一钱,蜜炒) 制五味(一钱) 白芍(钱半) 细辛(八分) 半夏(三
钱) 炙甘草(钱半) 茯苓块(三钱) 干姜(三钱) 生苡仁(五钱)
痰饮喘咳,前用小青龙汤,业已见效,但非常服之品,脉迟缓,议外治脾法。
桂枝(五钱) 炙甘草(二钱) 生于术(三钱) 制茅术(四钱) 茯苓(六钱) 生苡仁(五
钱) 益智仁(钱半) 半夏(六钱) 生姜(五片)
四帖。
皮氏 四十八岁 甲子十月二十八日 痰饮喘咳,左脉浮弦沉紧,自汗,势甚凶危,议
小青龙加杏仁、浓朴,去麻、辛。
桂枝(六钱) 白芍(四钱) 半夏(六钱) 炙甘草(三钱) 干姜(五钱) 浓朴(三钱) 制
五味(二钱) 杏仁霜(五钱)
甘澜水八杯,煮成三杯,分三次服。
二十九日 于前方内加∶
云苓块(五钱) 半夏(五钱)
三十日 服青龙已效,然其水尚洋溢,未能一时平复。
桂枝(八钱) 炙甘草(三钱) 五味子(三钱) 杏仁霜(五钱) 半夏(一两二钱) 干姜(
五钱) 云苓(八钱) 白芍(五钱,炒) 生姜(五大片) 广皮(三钱)
四帖。
甘澜水八碗,煮取三碗,渣再煮一碗,日三夜一,分四次服。
初二日 以眩冒甚,于前方内加∶
于术(六钱)
初四日 脉现单弦,喘止咳喊,眩冒未宁,再太阴属土,既重且缓,万不能一时速愈。
且痰饮五年,岂三五日可了。
于术(六钱) 半夏(一两) 杏仁霜(五钱) 桂枝(五钱) 干姜(三钱) 云苓(六钱) 炙
甘草(三钱) 五味子(六钱)
甘澜水八碗,煮三碗,分三次服。
福 三十二岁 乙丑二月初三日 痰饮胸痹,兼有胁下悬饮。
杏泥(三钱) 薤白(三钱) 栝蒌(二钱) 桂枝(三钱) 广皮(钱半) 川朴(二钱) 小枳
实(三钱) 旋复花(三钱) 生香附(三钱) 半夏(五钱)
水八杯,煮取三杯,三次服。三帖。
初七日 胸痹悬饮已愈,惟肠痹食不甘味,议和肝胃,兼开肠痹。
半夏(三钱) 广皮(二钱) 小枳实(二钱) 白通草(二钱) 杏仁(八钱) 生苡仁(五钱)
姜汁(三匙冲)
水五杯,煮取二杯,渣再煮一杯,分三次服。
邵 三十八岁 十一月十一日 脉弦细而沉,咳嗽,倚息不得卧,胸满口渴,小青龙去
麻辛法。
桂枝(六钱) 白芍(四钱) 炙甘草(三钱) 干姜(五钱) 半夏(一两五钱) 五味子(二
钱) 茯苓(一两) 小枳实(七钱) 广皮(三钱)
四次服。
十三日 服小青龙已效,但喉哑知渴,脉见微数,为痰饮欲去,转用辛凉,开提肺气法
。
麻黄(三钱,蜜汁) 杏仁(五钱) 石膏(八钱) 生甘草(三钱) 苦桔梗(三钱) 半夏(
三钱) 广皮(一钱)
焕氏 三十八岁 丙寅正月 痰饮法当恶水,反喜水者,饮在肺也。喜水法当甘润,今
反用
温燥者,以其为饮也。既喜水,曷以知其为饮?以得水不行,心悸短气,喘满眩冒,咳嗽多
陶某,三十岁。乙酉年六月初二日就诊。因风邪侵袭导致肢体末端病变,双手发软,无法持物,双脚有时也感到软弱无力,脉象弦而数,治疗采用辛凉之法。
薄荷(一钱半) 桑叶(三钱) 全当归(一钱半) 连翘(三钱) 麦冬(三钱,保留心部) 牡丹皮(三钱) 金银花(三钱) 菊花(三钱) 细生地(四钱)
服用八剂。
周某,四十岁。壬戌年八月二十五日就诊。体内有暑湿,体表受新感凉邪,内外邪气相互搏结,导致痰饮发作。
杏仁粉(三钱) 白通草(三钱) 广陈皮(二钱) 生薏苡仁(五钱) 飞滑石(三钱) 小枳实(二钱) 半夏(五钱) 川厚朴(三钱) 生姜(三片) 桂枝木(三钱) 茯苓皮(三钱)
二十八日,支饮射肺,出现眩晕昏冒症状,使用小青龙汤去掉麻黄、细辛。
桂枝(四钱) 白芍(三钱,炒制) 焦白术(三钱) 干姜(二钱) 制五味子(一钱) 生姜(三片) 半夏(六钱) 杏仁粉(五钱) 小枳实(二钱) 生薏苡仁(五钱) 炙甘草(二钱)
初一日,口渴是因为痰饮欲去,失眠是因为胃气仍未调和,因此用枳实橘皮汤祛除未尽的痰饮,用半夏汤调和胃气以助睡眠。
半夏(一两) 杏仁粉(三钱) 广陈皮(三钱) 桂枝(三钱) 生姜(三片) 生薏苡仁(五钱) 枳实(二钱) 秫米(一合)
若能入睡,则进行复诊。
初六日,服用半夏汤后,虽然能入睡了,但反而咳嗽痰多,商议使用桂枝干姜五味茯苓汤,配合葶苈大枣泻肺汤来逐除饮邪。
桂枝(五钱) 茯苓块(六钱) 苦葶苈(三钱) 半夏(二钱) 肥大枣(四枚,去核) 干姜(五钱) 五味子(三钱)
用甘澜水五碗,煮取两碗,分两次服用。再煎一碗服用。
初八日,先用葶苈大枣泻肺汤,攻动已经松动的饮邪,使其迅速排出。
苦葶苈(四钱) 肥大枣(五枚)
服用葶苈汤后,立即用半夏汤调和胃气。
半夏(一两) 生姜(五大片) 小枳实(四钱) 西洋参(二钱,与生姜块同捣炒至老黄色)
用水八杯,煮取三杯,分三次服用。
九月初十日,逐去水邪后,使用《外台秘要》中的茯苓饮,消除痰气,使患者能够进食。
茯苓块(六钱) 半夏(三钱) 小枳实(四钱) 西洋参(二钱,姜汁制呈黄色) 生姜(八钱) 广陈皮(三钱) 于术(六钱,炒制)
十五日,饮邪停留在胁下则影响肝脏,肝病则肝气更加衰弱,所以大便通畅、气机调畅后即可痊愈。先给予疏通胁下饮邪的药物,疏泄肝气即所以舒缓脾气,等到胁痛停止,再商议补脾。
生香附(三钱) 广陈皮(二钱) 旋复花(三钱,包煎) 青皮(一钱半) 苏子霜(三钱) 降香末(三钱) 半夏(四钱) 枳实(一钱半)
二十日,疏通胁络之饮,已经见效,但仍有残留,仍用前法。
生香附(三钱) 归须(一钱) 半夏(三钱) 广陈皮(一钱) 苏子霜(一钱半) 降香末(一钱半) 郁金(二钱) 小枳实(一钱) 旋复花(三钱,包煎)
服用两剂。
二十二日,通补中阳,兼行胁下未尽之饮。
代赭石(五钱) 焦白术(三钱) 旋复花(三钱,包煎) 桂枝(三钱) 炙甘草(三钱) 茯苓(五钱) 生姜(三片) 半夏(五钱)
服用四剂。
十月初二日,通降胁下之痰饮,兼以调和肝胃。
旋复花(三钱) 小枳实(二钱,捣碎) 干姜(一钱半) 苏子霜(三钱) 桂枝尖(二钱) 广陈皮(二钱) 生姜(三片) 半夏(六钱)
金氏,二十六岁。癸亥年二月初十日就诊。风寒挟带痰饮致病,自汗恶寒,气喘胸闷短气,口渴但不想多喝水,饮水则呕吐,夜间咳嗽加重,倚靠呼吸不能平卧,用小青龙汤去掉麻黄、杏仁,加入枳实、广陈皮,以行饮降逆气。
桂枝(六钱) 制五味子(一钱半) 炙甘草(三钱) 干姜(三钱) 白术(四钱,炒制) 半夏(六钱) 小枳实(二钱) 广陈皮(二钱) 生姜(三片) 茯苓(六钱)
用甘澜水八杯,煮成三杯,分三次服用。
十一日,昨天用了小青龙汤,咳嗽虽稍减,但仍不能平卧,今天用葶苈大枣汤合方治疗。
桂枝(八钱) 广陈皮(三钱) 干姜(五钱) 五味子(二钱) 半夏(六钱) 炙甘草(三钱) 白芍(四钱,炒制) 小枳实(二钱) 大枣(去核,五枚) 苦葶苈(二钱,炒香研细)
用水八杯,煮取三杯,分三次服用,药渣再煮一杯服用。
十二日,用小青龙汤逐除饮邪,兼利小便,使水邪有出路。
桂枝(五钱) 小枳实(二钱) 干姜(二钱) 白通草(一钱半) 杏泥(五钱) 制五味子(一钱半) 炙甘草(一钱) 白芍(二钱,炒制) 生薏苡仁(五钱) 半夏(五钱) 生姜(三片)
煮成两杯,分二次服用,药渣再煮一杯服用。
十三日,脉象稍平,病起时本口渴,大量服用姜桂等热药后,口渴反而停止。这是因为饮邪停聚在心下,格拒心火导致的假性口渴,仍以蠲除饮邪为主。微恶寒,兼以调和营卫。
桂枝(六钱) 茯苓(三钱) 杏泥(四钱) 半夏(六钱) 干姜(三钱) 白芍(三钱,炒制) 炙甘草(一钱半) 广陈皮(一钱) 生姜(三片) 小枳实(一钱半) 制五味子(一钱半) 大枣(二钱,去核)
煎法如前。
十四日,咳嗽则胁痛,不仅支饮射肺,且有悬饮内痛的担忧,兼以逐除胁下悬饮。
桂枝(六钱) 青皮(二钱) 干姜(四钱) 广陈皮(二钱) 杏仁泥(四钱) 郁金(三钱) 生香附(三钱) 制五味子(一钱半) 旋复花(三钱,包煎) 小枳实(一钱半) 半夏(八钱) 苏子霜(二钱) 生姜(五钱)
煮成三碗,分三次服用,药渣再煎一碗服用。
十五日,咳嗽止了大半,只是胁痛攻及胸部,这是肝胃不和的缘故。切忌恼怒,用通肝络的方法。
半夏 苏子(三钱,去油) 干姜(三钱) 桂枝尖(三钱) 降香末 归须(二钱) 青皮(二钱) 旋复花(三钱) 郁金 生香附
头煎取两杯,二煎取一杯,分三次服用。
谢氏,二十五岁。癸亥年二月二十二日就诊。痰饮哮喘,咳嗽声重,有汗,六脉弦细,怀孕七月,用小青龙汤去掉麻黄、细辛主治。
桂枝(五钱) 半夏(五钱) 干姜(三钱) 白芍(三钱) 小枳实(二钱) 炙甘草(一钱) 五味子(一钱) 广陈皮(一钱半)
用甘澜水五杯,煮成两杯,分二次服用,药渣再煮一杯服用。
二十二日,其人本来口渴,服用桂枝、干姜等热药后应当更渴,现在口渴反而停止,这是因为有饮邪。恶寒未罢,仍用小青龙法,胸痹痛加薤白。按:饮为阴邪,若误服苦寒药坚敛阴气,不能速愈。
桂枝(八钱) 小枳实(二钱) 薤白(三钱) 干姜(五钱) 制五味子(一钱) 川厚朴(三钱) 半夏(六钱) 焦白芍(四钱) 广陈皮(二钱) 炙甘草(二钱)
用甘澜水五杯,煮成两杯,分二次服用,药渣再煮二杯服用。
二十三日,胃不和则卧不安,亥子时属水,故病情更重。胀和痛,都是阴病,无非是受苦寒药物拖累所致。
桂枝(八钱) 半夏(八钱) 炙甘草(一钱) 白芍(三钱,炒制) 干姜(五钱) 薤白(三钱) 生薏苡仁(五钱) 川厚朴(三钱) 杏泥(三钱) 苦桔梗(三钱) 五味子(一钱半) 茯苓块(五钱)
用甘澜水八杯,煮三杯,分三次服用,药渣再煮一杯服用。
二十四日,寒饮误服苦寒药坚敛阴气,大用辛温药三帖,今日才转为热象,右脉始大,左脉仍弦细,咳嗽反而加重,这是温药启发了其封固之气。再用温药兼以滑利痰浊,痰出自然松快。
桂枝(五钱) 生薏苡仁(五钱) 薤白(三钱) 杏泥(三钱) 干姜(三钱) 茯苓(五钱) 栝蒌(二钱) 小枳实(二钱) 半夏(八钱) 白芍(三钱,炒制) 川厚朴(三钱) 制五味子(一钱半)
用甘澜水八杯,煮取三杯,分三次服用,药渣再煮一杯服用。
二十五日,右脉已退,病势稍减,但寒热汗多胸痹,恐怕形成漏汗证,则阳气更虚,饮邪更难治愈。
商议使用桂枝加附子汤,去掉甘草,因为肋胀的缘故。合用栝蒌薤白汤之意,通调中上部的清阳,保护表阳为急务。
桂枝(六钱) 大枣(二枚,去核) 川厚朴(三钱) 焦白芍(四钱) 熟附子(二钱) 小枳实(一钱半) 生姜(三片) 薤白(三钱)
用甘澜水五杯,煮取两杯,药渣再煮一杯,分三次服用,第一次即喝稀热粥半碗,令微汗为佳,第二三次不必喝粥。
二十六日,昨天用了桂枝汤加附子,再加薤白的方法,漏汗已止,体表的寒热已调和,但咳嗽严重,商议用逐饮之法。
桂枝(六钱) 大枣(五枚,去核) 半夏(五钱) 茯苓块(六钱) 生薏苡仁(五钱) 葶苈子(二钱,炒研细)
用甘澜水八杯,取三杯,分三次服用。
僧人,四十二岁。脉象双弦而紧,这是寒;不想喝水,是寒饮;喉中痒,病从外感而来;痰清不粘,是寒饮;咳嗽且呕吐,是胃阳衰败而寒饮乘虚而入,称为胃咳。背部恶寒时常想穿厚衣靠近火源,是卫外阳气虚弱,而寒邪乘袭太阳经。面色淡黄微青,唇色淡白,也是寒象。治法当温中阳而护表阳,不便在吐血之后使用柔润寒凉之品,用小青龙汤去掉麻黄、杏仁,加入枳实、广陈皮、杏仁、生姜汤主治。服用此方十数剂而愈。
徐某,二十六岁。二月初十日就诊。嗜酒之人脉弦细而沉,气喘胸闷短气,胁部牵连腰痛,有汗,舌苔白滑而厚,恶风寒,倚靠呼吸不能平卧,这是内在水饮招致外风致病,属于小青龙汤去掉麻黄、细辛的证候。
桂枝(六钱) 干姜(三钱) 杏泥(五钱) 白芍(四钱,炒制) 生姜(五片) 半夏(六钱) 炙甘草(一钱) 制五味子(一钱半) 旋复花(三钱,包煎)
邵某,四十三岁。癸亥年七月二十三日就诊。右关脉单弦主饮癖,少阴脉独盛,是水脏盛而土气衰。到饭后吞酸吐痰不止,治疗在胃肾两关。不能戒酒,不必服药,用真武汤法。
熟附子(五钱) 茯苓块(六钱) 生薏苡仁(六钱) 细辛(一钱半) 生姜(五片) 真山黄连(一钱半,同吴茱萸浸炒) 吴茱萸(三钱)
用水八杯,煮成三杯,分三次服用。四剂。
二十八日,内饮用温水脏法,已见大效,但药性过于刚燥,不可再用,所谓一张一弛,文武之道。且议理阳明,作为过渡阶段的文本。
半夏(六钱) 广陈皮(一钱) 小枳实(一钱半) 茯苓块(六钱) 生薏苡仁(六钱) 白豆蔻(一钱) 生姜(六钱)
四剂。
八月初三日,用理阳明法,亦复见效,惟吞酸仍然未止。按:吞酸究属肝病,议肝胃同治法。
半夏(六钱) 桂枝(三钱) 吴茱萸(三钱) 茯苓块(六钱) 青皮(六钱) 生姜(三片) 薏苡仁(五钱) 山黄连(一钱半,姜炒)
四剂。
某氏,内饮招致外风致病,既喘且咳,议用小青龙法。
桂枝(三钱) 麻黄(一钱,蜜炒) 制五味子(一钱) 白芍(一钱半) 细辛(八分) 半夏(三钱) 炙甘草(一钱半) 茯苓块(三钱) 干姜(三钱) 生薏苡仁(五钱)
痰饮喘咳,前用小青龙汤,业已见效,但非常服之品,脉迟缓,议外治脾法(此处指调理脾胃)。
桂枝(五钱) 炙甘草(二钱) 生于术(三钱) 制茅术(四钱) 茯苓(六钱) 生薏苡仁(五钱) 益智仁(一钱半) 半夏(六钱) 生姜(五片)
四剂。
皮氏,四十八岁。甲子年十月二十八日就诊。痰饮喘咳,左脉浮弦沉紧,自汗,病势甚凶危,议用小青龙加杏仁、浓朴,去麻黄、细辛。
桂枝(六钱) 白芍(四钱) 半夏(六钱) 炙甘草(三钱) 干姜(五钱) 浓朴(三钱) 制五味子(二钱) 杏仁霜(五钱)
用甘澜水八杯,煮成三杯,分三次服用。
二十九日,于前方内加:
云茯苓块(五钱) 半夏(五钱)
三十日,服用青龙汤已有效,然其水邪尚洋溢,未能一时平复。
桂枝(八钱) 炙甘草(三钱) 五味子(三钱) 杏仁霜(五钱) 半夏(一两二钱) 干姜(五钱) 云茯苓(八钱) 白芍(五钱,炒制) 生姜(五大片) 广陈皮(三钱)
四剂。
用甘澜水八碗,煮取三碗,药渣再煮一碗,白天三次夜间一次,分四次服用。
初二日,因眩晕昏冒严重,于前方内加:
于术(六钱)
初四日,脉现单弦,喘止咳喊,眩晕昏冒未宁,再太阴属土,既重且缓,万不能一时速愈。且痰饮五年,岂三五日可了。
于术(六钱) 半夏(一两) 杏仁霜(五钱) 桂枝(五钱) 干姜(三钱) 云茯苓(六钱) 炙甘草(三钱) 五味子(六钱)
用甘澜水八碗,煮三碗,分三次服用。
福某,三十二岁。乙丑年二月初三日就诊。痰饮胸痹,兼有胁下悬饮。
杏仁泥(三钱) 薤白(三钱) 栝蒌(二钱) 桂枝(三钱) 广陈皮(一钱半) 川厚朴(二钱) 小枳实(三钱) 旋复花(三钱) 生香附(三钱) 半夏(五钱)
用水八杯,煮取三杯,分三次服用。三剂。
初七日,胸痹悬饮已愈,惟肠痹食不甘味,议调和肝胃,兼开肠痹。
半夏(三钱) 广陈皮(二钱) 小枳实(二钱) 白通草(二钱) 杏仁(八钱) 生薏苡仁(五钱) 姜汁(三匙冲服)
用水五杯,煮取二杯,药渣再煮一杯,分三次服用。
邵某,三十八岁。十一月十一日就诊。脉弦细而沉,咳嗽,倚靠呼吸不能平卧,胸满口渴,用小青龙汤去掉麻黄、细辛法。
桂枝(六钱) 白芍(四钱) 炙甘草(三钱) 干姜(五钱) 半夏(一两五钱) 五味子(二钱) 茯苓(一两) 小枳实(七钱) 广陈皮(三钱)
分四次服用。
十三日,服用小青龙汤已有效,但喉哑知渴,脉见微数,为痰饮欲去,转用辛凉,开提肺气法。
麻黄(三钱,蜜汁) 杏仁(五钱) 石膏(八钱) 生甘草(三钱) 苦桔梗(三钱) 半夏(三钱) 广陈皮(一钱)
焕氏,三十八岁。丙寅年正月就诊。痰饮法当恶水,反喜水者,饮在肺也。喜水法当甘润,今反用温燥者,以其为饮也。既喜水,曷以知其为饮?以得水不行,心悸短气,喘满眩冒,咳嗽多
Tao, aged 30. On the second day of the sixth month in the Yiyu year. Due to wind pathogen invading leading to extremity disorders (Feng Yin Mo Ji), both hands are weak and unable to hold objects; feet are sometimes also weak. The pulse is wiry (Xian) and rapid (Shu). Treatment employs acrid-cool methods.
Bohe (Menthae Haplocalycis Herba, 1.5 qian) Sangye (Bombycis Batryticoli Folium, 3 qian) Quanguidanggui (Angelicae Sinensis Radix, 1.5 qian) Lianqiao (Forsythiae Fructum, 3 qian) Maidong (Ophiopogonis Radix, 3 qian, retaining the heart) Danpi (Moutan Cortex, 3 qian) Yinhua (Lonicerae Japonicae Flos, 3 qian) Juhua (Chrysanthemi Flos, 3 qian) Xishengdi (Rehmanniae Radix Preparata, 4 qian)
Take eight doses.
Zhou, aged 40. On the twenty-fifth day of the eighth month in the Renxu year. Internally there is summer-heat-dampness; externally there is new cold. Internal and external pathogens struggle against each other, causing Phlegm-Fluids (Tan Yin) to arise.
Xingrenfen (Armeniacae Semen Amarum Pulvis, 3 qian) Baitongcao (Akebiae Caulis, 3 qian) Guangpi (Citri Reticulatae Pericarpium, 2 qian) Shengyiren (Coicis Semen, 5 qian) Feihuashi (Talcum, 3 qian) Xiao Zhishi (Aurantii Fructus Immaturus, 2 qian) Banxia (Pinelliae Rhizoma, 5 qian) Chuanpu (Magnoliae Officinalis Cortex, 3 qian) Shengjiang (Zingiberis Rhizoma Recens, 3 slices) Guizhimu (Cinnamomi Ramulus, 3 qian) Fulingpi (Poria Cum Risu Cortex, 3 qian)
On the twenty-eighth day, Branch Fluids (Zhi Yin) shoot into the Lung, causing dizziness and vertigo. Use Xiao Qing Long Tang (Minor Blue Dragon Decoction) removing Mahuang (Ephedrae Herba) and Xixin (Asari Radix).
Guizhi (Cinnamomi Ramulus, 4 qian) Baishao (Paeoniae Radix Alba, 3 qian, stir-fried) Jiaoyuzhu (Atractylodis Macrocephalae Rhizoma, 3 qian) Ganjiang (Zingiberis Rhizoma, 2 qian) Zhi Wuwei (Schisandrae Fructus, 1 qian) Shengjiang (Zingiberis Rhizoma Recens, 3 slices) Banxia (Pinelliae Rhizoma, 6 qian) Xingrenfen (Armeniacae Semen Amarum Pulvis, 5 qian) Xiao Zhishi (Aurantii Fructus Immaturus, 2 qian) Shengyiren (Coicis Semen, 5 qian) Zhigancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle, 2 qian)
On the first day: Thirst indicates Phlegm-Fluids are about to disperse; insomnia indicates the Stomach Qi is not yet harmonized. Therefore, use Zhishi Ju Pi Tang (Zhishi and Tangerine Peel Decoction) to eliminate remaining Phlegm-Fluids, and Ban Xia Tang (Pinellia Decoction) to harmonize the Stomach to enable sleep.
Banxia (Pinelliae Rhizoma, 1 liang) Xingrenfen (Armeniacae Semen Amarum Pulvis, 3 qian) Guangpi (Citri Reticulatae Pericarpium, 3 qian) Guizhi (Cinnamomi Ramulus, 3 qian) Shengjiang (Zingiberis Rhizoma Recens, 3 slices) Shengyiren (Coicis Semen, 5 qian) Zhishi (Aurantii Fructus Immaturus, 2 qian) Shumi (Milii Indici Fructus, 1 he)
If sleep is achieved, follow up.
On the sixth day: After taking Ban Xia Tang, sleep was achieved, but cough with profuse sputum returned. It is proposed to use Guizhi Ganjiang Wuwei Fuling Tang (Cinnamon Twig, Dried Ginger, Schisandra, and Poria Decoction) combined with Tingli Dazao Xie Fei Tang (Descurainia Seed and Jujube Decoction to Drain the Lung) to expel fluids.
Guizhi (Cinnamomi Ramulus, 5 qian) Fulingkuai (Poria, 6 qian) Ku Tingli (Descurainiae Semen Lepidii et Lepidii Semen, 3 qian) Banxia (Pinelliae Rhizoma, 2 qian) Fei Dazao (Jujubae Fructus, 4 pieces, pitted) Ganjiang (Zingiberis Rhizoma, 5 qian) Wuweizi (Schisandrae Fructus, 3 qian)
Decoct five bowls of Ganlan Shui (Ganshui/Gliding Water) to obtain two bowls, take in two doses. Decoct again for one bowl.
On the eighth day: First use Tingli Dazao Xie Fei Tang to attack the moved fluids, causing them to leave quickly.
Ku Tingli (Descurainiae Semen Lepidii et Lepidii Semen, 4 qian) Fei Dazao (Jujubae Fructus, 5 pieces)
After taking Tingli Tang, immediately use Ban Xia Tang to harmonize the Stomach.
Banxia (Pinelliae Rhizoma, 1 liang) Shengjiang (Zingiberis Rhizoma Recens, 5 large slices) Xiao Zhishi (Aurantii Fructus Immaturus, 4 qian) Yangshen (Panacis Quinquefolii Radix, 2 qian, pounded fried with ginger chunks until dark yellow)
Use eight cups of water, decoct to obtain three cups, take in three doses.
On the tenth day of the ninth month: After expelling water, use Fuling Yin from Wai Tai Mi Yao (Prescriptions Kept Behind the Yellow Emperor's Sleeve) to dissipate phlegm-qi and restore appetite.
Fulingkuai (Poria, 6 qian) Banxia (Pinelliae Rhizoma, 3 qian) Xiao Zhishi (Aurantii Fructus Immaturus, 4 qian) Yangshen (Panacis Quinquefolii Radix, 2 qian, processed with ginger juice to yellow) Shengjiang (Zingiberis Rhizoma Recens, 8 qian) Guangpi (Citri Reticulatae Pericarpium, 3 qian) Yushu (Atractylodis Macrocephalae Rhizoma, 6 qian, stir-fried)
On the fifteenth day: When fluids reside under the hypochondrium, it affects the Liver; Liver disease causes Liver Qi to decline further. Thus, relief comes after bowel movement and qi regulation. First, administer herbs to move fluids under the hypochondrium; draining the Liver soothes the Spleen. Wait for hypochondriac pain to cease before discussing Spleen tonification.
Sheng Xiangfu (Cyperi Rhizoma, 3 qian) Guangpi (Citri Reticulatae Pericarpium, 2 qian) Xuanfuhua (Inulae Flos, 3 qian, wrapped) Qingpi (Citri Reticulatae Pericarpium Viride, 1.5 qian) Suzishuang (Perillae Fructus Frost, 3 qian) Jiangxiangmo (Dalbergiae Odoriferae Lignum, 3 qian) Banxia (Pinelliae Rhizoma, 4 qian) Zhishi (Aurantii Fructus Immaturus, 1.5 qian)
On the twentieth day: Moving fluids in the hypochondriac collaterals has shown effect, but some remain. Continue previous method.
Sheng Xiangfu (Cyperi Rhizoma, 3 qian) Guixu (Angelicae Sinensis Radix Caulis, 1 qian) Banxia (Pinelliae Rhizoma, 3 qian) Guangpi (Citri Reticulatae Pericarpium, 1 qian) Suzishuang (Perillae Fructus Frost, 1.5 qian) Jiangxiangmo (Dalbergiae Odoriferae Lignum, 1.5 qian) Yujin (Curcumae Radix, 2 qian) Xiao Zhishi (Aurantii Fructus Immaturus, 1 qian) Xuanfuhua (Inulae Flos, 3 qian, wrapped)
Take two doses.
On the twenty-second day: Unblock and tonify Middle Yang, while moving remaining fluids under the hypochondrium.
Daizheshi (Haematitum, 5 qian) Jiaozhu (Atractylodis Macrocephalae Rhizoma, 3 qian) Xuanfuhua (Inulae Flos, 3 qian, wrapped) Guizhi (Cinnamomi Ramulus, 3 qian) Zhigancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle, 3 qian) Fuling (Poria, 5 qian) Shengjiang (Zingiberis Rhizoma Recens, 3 slices) Banxia (Pinelliae Rhizoma, 5 qian)
Take four doses.
On the second day of the tenth month: Descend Phlegm-Fluids under the hypochondrium, simultaneously harmonizing Liver and Stomach.
Xuanfuhua (Inulae Flos, 3 qian) Xiao Zhishi (Aurantii Fructus Immaturus, 2 qian, pounded) Ganjiang (Zingiberis Rhizoma, 1.5 qian) Suzishuang (Perillae Fructus Frost, 3 qian) Guizhijian (Cinnamomi Ramulus Tip, 2 qian) Guangpi (Citri Reticulatae Pericarpium, 2 qian) Shengjiang (Zingiberis Rhizoma Recens, 3 slices) Banxia (Pinelliae Rhizoma, 6 qian)
Jin, aged 26. On the tenth day of the second month in the Guihai year. Wind-cold carrying Phlegm-Fluids causes disease: spontaneous sweating, aversion to cold, asthma, chest fullness, shortness of breath, thirst with little desire to drink, vomiting after drinking, worse night cough, orthopnea (unable to lie flat). Use Xiao Qing Long Tang (Minor Blue Dragon Decoction) removing Mahuang (Ephedrae Herba) and Xingren (Armeniacae Semen Amarum), adding Zhishi (Aurantii Fructus Immaturus) and Guangpi (Citri Reticulatae Pericarpium) to move fluids and descend rebellious Qi.
Guizhi (Cinnamomi Ramulus, 6 qian) Zhi Wuwei (Schisandrae Fructus, 1.5 qian) Zhigancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle, 3 qian) Ganjiang (Zingiberis Rhizoma, 3 qian) Baizhu (Atractylodis Macrocephalae Rhizoma, 4 qian, stir-fried) Banxia (Pinelliae Rhizoma, 6 qian) Xiao Zhishi (Aurantii Fructus Immaturus, 2 qian) Guangpi (Citri Reticulatae Pericarpium, 2 qian) Shengjiang (Zingiberis Rhizoma Recens, 3 slices) Fuling (Poria, 6 qian)
Decoct eight cups of Ganlan Shui (Gliding Water) to three cups, take in three doses.
On the eleventh day: Yesterday using Xiao Qing Long Tang, cough slightly reduced but still unable to lie flat. Today use Tingli Dazao Tang (Descurainia Seed and Jujube Decoction) combined method.
Guizhi (Cinnamomi Ramulus, 8 qian) Guangpi (Citri Reticulatae Pericarpium, 3 qian) Ganjiang (Zingiberis Rhizoma, 5 qian) Wuweizi (Schisandrae Fructus, 2 qian) Banxia (Pinelliae Rhizoma, 6 qian) Zhigancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle, 3 qian) Baishao (Paeoniae Radix Alba, 4 qian, stir-fried) Xiao Zhishi (Aurantii Fructus Immaturus, 2 qian) Dazao (Jujubae Fructus, 5 pieces, pitted) Ku Tingli (Descurainiae Semen Lepidii et Lepidii Semen, 2 qian, stir-fried fragrant and ground fine)
Use eight cups of water, decoct to obtain three cups, take in three doses, decoct residue for one cup.
On the twelfth day: Use Xiao Qing Long Tang to expel fluids, simultaneously promoting urination to provide an exit for water.
Guizhi (Cinnamomi Ramulus, 5 qian) Xiao Zhishi (Aurantii Fructus Immaturus, 2 qian) Ganjiang (Zingiberis Rhizoma, 2 qian) Baitongcao (Akebiae Caulis, 1.5 qian) Xingni (Armeniacae Semen Amarum Paste, 5 qian) Zhi Wuwei (Schisandrae Fructus, 1.5 qian) Zhigancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle, 1 qian) Baishao (Paeoniae Radix Alba, 2 qian, stir-fried) Shengyiren (Coicis Semen, 5 qian) Banxia (Pinelliae Rhizoma, 5 qian) Shengjiang (Zingiberis Rhizoma Recens, 3 slices)
Decoct to two cups, take in two doses, decoct residue for one cup.
On the thirteenth day: Pulse slightly normalized. Illness began with thirst; after large doses of Ganjiang (Dried Ginger) and Guizhi (Cinnamon Twig), thirst stopped. This is because fluids reside in the Heart region (Xia), rejecting Heart Fire thirst. Still focus on eliminating fluids. Mild aversion to cold, simultaneously harmonize Ying and Wei.
Guizhi (Cinnamomi Ramulus, 6 qian) Fuling (Poria, 3 qian) Xingni (Armeniacae Semen Amarum Paste, 4 qian) Banxia (Pinelliae Rhizoma, 6 qian) Ganjiang (Zingiberis Rhizoma, 3 qian) Baishao (Paeoniae Radix Alba, 3 qian, stir-fried) Zhigancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle, 1.5 qian) Guangpi (Citri Reticulatae Pericarpium, 1 qian) Shengjiang (Zingiberis Rhizoma Recens, 3 slices) Xiao Zhishi (Aurantii Fructus Immaturus, 1.5 qian) Zhi Wuwei (Schisandrae Fructus, 1.5 qian) Dazao (Jujubae Fructus, 2 qian, pitted)
Decoct as before.
On the fourteenth day: Cough causes hypochondriac pain. Not only Branch Fluids shooting into the Lung, but also risk of Hanging Fluids (Xuan Yin) internal pain. Simultaneously expel Hanging Fluids under the hypochondrium.
Guizhi (Cinnamomi Ramulus, 6 qian) Qingpi (Citri Reticulatae Pericarpium Viride, 2 qian) Ganjiang (Zingiberis Rhizoma, 4 qian) Guangpi (Citri Reticulatae Pericarpium, 2 qian) Xingrenni (Armeniacae Semen Amarum Paste, 4 qian) Yujin (Curcumae Radix, 3 qian) Sheng Xiangfu (Cyperi Rhizoma, 3 qian) Zhi Wuwei (Schisandrae Fructus, 1.5 qian) Xuanfuhua (Inulae Flos, 3 qian, wrapped) Xiao Zhishi (Aurantii Fructus Immaturus, 1.5 qian) Banxia (Pinelliae Rhizoma, 8 qian) Suzishuang (Perillae Fructus Frost, 2 qian) Shengjiang (Zingiberis Rhizoma Recens, 5 qian)
Decoct to three bowls, take in three doses, decoct residue for one bowl.
On the fifteenth day: Cough stopped by more than half, only hypochondriac pain attacking the chest, due to Liver-Stomach disharmony. Strictly avoid anger. Use method to unblock Liver collaterals.
Banxia (Pinelliae Rhizoma) Suzi (Perillae Fructus, 3 qian, oil removed) Ganjiang (Zingiberis Rhizoma, 3 qian) Guizhijian (Cinnamomi Ramulus Tip, 3 qian) Jiangxiangmo (Dalbergiae Odoriferae Lignum) Guixu (Angelicae Sinensis Radix Caulis, 2 qian) Qingpi (Citri Reticulatae Pericarpium Viride, 2 qian) Xuanfuhua (Inulae Flos, 3 qian) Yujin (Curcumae Radix) Sheng Xiangfu (Cyperi Rhizoma)
First decoction two cups, second decoction one cup, take in three doses.
Xie, aged 25. On the twenty-second day of the second month in the Guihai year. Phlegm-Fluids asthma, heavy cough sound, sweating, six pulses wiry and thin, seven months pregnant. Treat with Xiao Qing Long Tang (Minor Blue Dragon Decoction) removing Mahuang (Ephedrae Herba) and Xixin (Asari Radix).
Guizhi (Cinnamomi Ramulus, 5 qian) Banxia (Pinelliae Rhizoma, 5 qian) Ganjiang (Zingiberis Rhizoma, 3 qian) Baishao (Paeoniae Radix Alba, 3 qian) Xiao Zhishi (Aurantii Fructus Immaturus, 2 qian) Zhigancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle, 1 qian) Wuwei (Schisandrae Fructus, 1 qian) Guangpi (Citri Reticulatae Pericarpium, 1.5 qian)
Decoct five cups of Ganlan Shui (Gliding Water) to two cups, take in two doses, decoct residue for one cup.
On the twenty-second day: The person originally had thirst; after taking Guizhi (Cinnamon Twig) and Ganjiang (Dried Ginger) hot medicines, should be thirstier, but now thirst stops. This is due to fluids. Aversion to cold has not ceased. Still use Xiao Qing Long method; add Xiebai (Allii Macrostemonis Bulbus) for Chest Bi pain. Note: Fluids are Yin pathogens; mistakenly taking bitter-cold medicines consolidates Yin, preventing quick recovery.
Guizhi (Cinnamomi Ramulus, 8 qian) Xiao Zhishi (Aurantii Fructus Immaturus, 2 qian) Xiebai (Allii Macrostemonis Bulbus, 3 qian) Ganjiang (Zingiberis Rhizoma, 5 qian) Zhi Wuwei (Schisandrae Fructus, 1 qian) Chuanpu (Magnoliae Officinalis Cortex, 3 qian) Banxia (Pinelliae Rhizoma, 6 qian) Jiao Baishao (Paeoniae Radix Alba, 4 qian, stir-fried) Guangpi (Citri Reticulatae Pericarpium, 2 qian) Zhigancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle, 2 qian)
Decoct five cups of Ganlan Shui (Gliding Water) to two cups, take in two doses, decoct residue for two cups.
On the twenty-third day: Disharmony of Stomach leads to restless sleep; Hai-Zi hours belong to Water, so condition worsens. Distension and pain are Yin diseases, all suffering from bitter-cold medicines.
Guizhi (Cinnamomi Ramulus, 8 qian) Banxia (Pinelliae Rhizoma, 8 qian) Zhigancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle, 1 qian) Baishao (Paeoniae Radix Alba, 3 qian, stir-fried) Ganjiang (Zingiberis Rhizoma, 5 qian) Xiebai (Allii Macrostemonis Bulbus, 3 qian) Shengyiren (Coicis Semen, 5 qian) Chuanpu (Magnoliae Officinalis Cortex, 3 qian) Xingni (Armeniacae Semen Amarum Paste, 3 qian) Ku Jiegeng (Platycodonis Radix, 3 qian) Wuweizi (Schisandrae Fructus, 1.5 qian) Fulingkuai (Poria, 5 qian)
Decoct eight cups of Ganlan Shui (Gliding Water) to three cups, take in three doses, decoct residue for one cup.
On the twenty-fourth day: Cold-fluids mistakenly treated with bitter-cold consolidating Yin. Large use of acrid-warm medicines for three doses; today heat finally emerges. Right pulse becomes large, left pulse remains wiry-thin. Cough worsens because warm medicines opened their sealed state. Use warm medicines again combined with slippery-phlegm herbs; when phlegm exits, naturally feels relaxed.
Guizhi (Cinnamomi Ramulus, 5 qian) Shengyiren (Coicis Semen, 5 qian) Xiebai (Allii Macrostemonis Bulbus, 3 qian) Xingni (Armeniacae Semen Amarum Paste, 3 qian) Ganjiang (Zingiberis Rhizoma, 3 qian) Fuling (Poria, 5 qian) Gualou (Trichosanthis Fructus, 2 qian) Xiao Zhishi (Aurantii Fructus Immaturus, 2 qian) Banxia (Pinelliae Rhizoma, 8 qian) Baishao (Paeoniae Radix Alba, 3 qian, stir-fried) Chuanpu (Magnoliae Officinalis Cortex, 3 qian) Zhi Wuwei (Schisandrae Fructus, 1.5 qian)
Decoct eight cups of Ganlan Shui (Gliding Water) to three cups, take in three doses, decoct residue for one cup.
On the twenty-fifth day: Right pulse has receded, disease trend slightly reduced. But cold-heat, profuse sweating, and Chest Bi suggest fear of Lou Han (Leaking Sweat), making Yang more deficient and fluids harder to cure.
Propose Guizhi Jia Fuzi Tang (Cinnamon Twig Decoction plus Aconite Root), removing Gancao (Licorice Root) due to rib distension. Combine intent of Gualou Xiebai Tang (Trichosanthes and Macrostemon Allium Decoction) to unblock clear Yang in Middle/Upper Jiao, protecting Exterior Yang is urgent.
Guizhi (Cinnamomi Ramulus, 6 qian) Dazao (Jujubae Fructus, 2 pieces, pitted) Chuanpu (Magnoliae Officinalis Cortex, 3 qian) Jiao Baishao (Paeoniae Radix Alba, 4 qian, stir-fried) Shu Fuzi (Aconiti Lateralis Radix Praeparata, 2 qian) Xiao Zhishi (Aurantii Fructus Immaturus, 1.5 qian) Shengjiang (Zingiberis Rhizoma Recens, 3 slices) Xiebai (Allii Macrostemonis Bulbus, 3 qian)
Decoct five cups of Ganlan Shui (Gliding Water) to two cups, decoct residue for one cup, take in three doses. First dose drink half bowl of hot thin porridge to induce slight sweat, best result. Second and third doses need not drink porridge.
On the twenty-sixth day: Yesterday used Guizhi Tang (Cinnamon Twig Decoction) plus Fuzi (Aconite Root), plus Xiebai (Macrostemon Allium) method. Leaking sweat stopped, exterior cold-heat harmonized. But cough severe. Propose expelling fluids.
Guizhi (Cinnamomi Ramulus, 6 qian) Dazao (Jujubae Fructus, 5 pieces, pitted) Banxia (Pinelliae Rhizoma, 5 qian) Fulingkuai (Poria, 6 qian) Shengyiren (Coicis Semen, 5 qian) Tinglizhi (Descurainiae Semen Lepidii et Lepidii Semen, 2 qian, stir-fried ground fine)
Decoct eight cups of Ganlan Shui (Gliding Water) to three cups, take in three doses.
Monk, aged 42. Pulses double wiry and tight, indicating Cold; no desire to drink, indicating Cold-Fluids; throat itch, disease from external contraction; sputum clear and non-sticky, indicating Cold-Fluids; cough and vomiting, Stomach Yang decline with Cold-Fluids invading, called Wei Ke (Stomach Cough). Back aversion to cold, desiring thick clothes near fire, indicates Wei (Defensive) Exterior Yang deficiency, Cold invading Taiyang Meridian. Complexion pale yellow slightly green, lips pale white, also Cold. Method should warm Middle Yang and protect Exterior Yang. Inappropriate to use soft-moist cold-cool herbs after hemoptysis. Use Xiao Qing Long Tang (Minor Blue Dragon Decoction) removing Mahuang (Ephedrae Herba) and Xingren (Armeniacae Semen Amarum), adding Zhishi (Aurantii Fructus Immaturus), Guangpi (Citri Reticulatae Pericarpium), Xingren (Armeniacae Semen Amarum), Shengjiang (Fresh Ginger) Decoction as main treatment. Take this prescription for over ten doses to recover.
Xu, aged 26. On the tenth day of the second month. Wine-drinker, pulse wiry-thin and deep, asthma, chest fullness, shortness of breath, hypochondriac pain radiating to lower back, sweating, tongue coating white-slippery and thick, aversion to wind-cold, orthopnea. This is internal water attracting external wind. Pattern of Xiao Qing Long Tang (Minor Blue Dragon Decoction) removing Mahuang (Ephedrae Herba) and Xixin (Asari Radix).
Guizhi (Cinnamomi Ramulus, 6 qian) Ganjiang (Zingiberis Rhizoma, 3 qian) Xingni (Armeniacae Semen Amarum Paste, 5 qian) Baishao (Paeoniae Radix Alba, 4 qian, stir-fried) Shengjiang (Zingiberis Rhizoma Recens, 5 slices) Banxia (Pinelliae Rhizoma, 6 qian) Zhigancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle, 1 qian) Zhi Wuwei (Schisandrae Fructus, 1.5 qian) Xuanfuhua (Inulae Flos, 3 qian, wrapped)
Shao, aged 43. On the twenty-third day of the seventh month in the Guihai year. Right Guan position single wiry indicates fluid retention (Yin Pi); Shaoyin pulse alone excessive indicates Water Organ excess and Earth Qi deficiency. Post-meal acid regurgitation and continuous phlegm vomiting. Treatment focuses on Stomach and Kidney Guan positions. Cannot quit alcohol, no need for medicine. Use Zhen Wu Tang (True Warrior Decoction) method.
Shu Fuzi (Aconiti Lateralis Radix Praeparata, 5 qian) Fulingkuai (Poria, 6 qian) Shengyiren (Coicis Semen, 6 qian) Xixin (Asari Radix, 1.5 qian) Shengjiang (Zingiberis Rhizoma Recens, 5 slices) Zhen Shanlian (Coptidis Rhizoma, 1.5 qian, soaked and stir-fried with Wuyu) Wuyu (Evodiae Fructus, 3 qian)
Use eight cups of water, decoct to three cups, take in three doses. Four doses.
On the twenty-eighth day: Internal fluids treated with warming Water Organ method, showing great effect. But medicine is too Sun-gang (excessively hot/drying), cannot continue. As the saying goes, tension and relaxation are the way of Wen and Wu. Discuss regulating Yangming as a transition text.
Banxia (Pinelliae Rhizoma, 6 qian) Guangpi (Citri Reticulatae Pericarpium, 1 qian) Xiao Zhishi (Aurantii Fructus Immaturus, 1.5 qian) Fulingkuai (Poria, 6 qian) Shengyiren (Coicis Semen, 6 qian) Bai Doukou (Amomi Fructus Rotundus, 1 qian) Shengjiang (Zingiberis Rhizoma Recens, 6 qian)
Four doses.
On the third day of the eighth month: Regulating Yangming shows effect, but acid regurgitation continues. Note: Acid regurgitation ultimately belongs to Liver disease. Propose Liver-Stomach simultaneous treatment.
Banxia (Pinelliae Rhizoma, 6 qian) Guizhi (Cinnamomi Ramulus, 3 qian) Wuyu (Evodiae Fructus, 3 qian) Fulingkuai (Poria, 6 qian) Qingpi (Citri Reticulatae Pericarpium Viride, 6 qian) Shengjiang (Zingiberis Rhizoma Recens, 3 slices) Yiren (Coicis Semen, 5 qian) Shanlian (Coptidis Rhizoma, 1.5 qian, ginger stir-fried)
Four doses.
Certain Person: Internal fluids attract external wind causing disease, both asthma and cough. Propose Xiao Qing Long Tang (Minor Blue Dragon Decoction) method.
Guizhi (Cinnamomi Ramulus, 3 qian) Mahuang (Ephedrae Herba, 1 qian, honey stir-fried) Zhi Wuwei (Schisandrae Fructus, 1 qian) Baishao (Paeoniae Radix Alba, 1.5 qian) Xixin (Asari Radix, 8 fen) Banxia (Pinelliae Rhizoma, 3 qian) Zhigancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle, 1.5 qian) Fulingkuai (Poria, 3 qian) Ganjiang (Zingiberis Rhizoma, 3 qian) Shengyiren (Coicis Semen, 5 qian)
Phlegm-fluids asthma/cough, previously used Xiao Qing Long Tang (Minor Blue Dragon Decoction), already effective, but not for long-term use. Pulse slow-rapid. Propose treating Spleen externally (regulating Spleen/Stomach).
Guizhi (Cinnamomi Ramulus, 5 qian) Zhigancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle, 2 qian) Sheng Yushu (Atractylodis Macrocephalae Rhizoma, 3 qian) Zhi Maoshu (Atractylodis Rhizoma, 4 qian) Fuling (Poria, 6 qian) Shengyiren (Coicis Semen, 5 qian) Yizhiren (Alpiniae Oxyphyllae Fructus, 1.5 qian) Banxia (Pinelliae Rhizoma, 6 qian) Shengjiang (Zingiberis Rhizoma Recens, 5 slices)
Four doses.
Pi, aged 48. On the twenty-eighth day of the tenth month in the Jiazi year. Phlegm-fluids asthma/cough, Left pulse floating-wiry-deep-tight, spontaneous sweating, condition critical. Propose Xiao Qing Long Tang (Minor Blue Dragon Decoction) plus Xingren (Armeniacae Semen Amarum) and Nongpu (Magnoliae Officinalis Cortex), removing Mahuang (Ephedrae Herba) and Xixin (Asari Radix).
Guizhi (Cinnamomi Ramulus, 6 qian) Baishao (Paeoniae Radix Alba, 4 qian) Banxia (Pinelliae Rhizoma, 6 qian) Zhigancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle, 3 qian) Ganjiang (Zingiberis Rhizoma, 5 qian) Nongpu (Magnoliae Officinalis Cortex, 3 qian) Zhi Wuwei (Schisandrae Fructus, 2 qian) Xingrenshuang (Armeniacae Semen Amarum Frost, 5 qian)
Decoct eight cups of Ganlan Shui (Gliding Water) to three cups, take in three doses.
On the twenty-ninth day: Add to previous formula:
Yunlingkuai (Poria, 5 qian) Banxia (Pinelliae Rhizoma, 5 qian)
On the thirtieth day: Taking Qinglong Tang effective, but water still overflowing, cannot settle instantly.
Guizhi (Cinnamomi Ramulus, 8 qian) Zhigancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle, 3 qian) Wuweizi (Schisandrae Fructus, 3 qian) Xingrenshuang (Armeniacae Semen Amarum Frost, 5 qian) Banxia (Pinelliae Rhizoma, 1 liang 2 qian) Ganjiang (Zingiberis Rhizoma, 5 qian) Yunling (Poria, 8 qian) Baishao (Paeoniae Radix Alba, 5 qian, stir-fried) Shengjiang (Zingiberis Rhizoma Recens, 5 large slices) Guangpi (Citri Reticulatae Pericarpium, 3 qian)
Four doses.
Decoct eight bowls of Ganlan Shui (Gliding Water) to three bowls, decoct residue for one bowl. Day three times, night once, take in four doses.
On the second day: Due to severe dizziness, add to previous formula:
Yushu (Atractylodis Macrocephalae Rhizoma, 6 qian)
On the fourth day: Pulse shows single wiry, asthma stops but cough persists, dizziness unsettled. Tainyin belongs to Earth, heavy and slow, cannot recover quickly in one moment. Phlegm-fluids for five years, how can it end in three-five days?
Yushu (Atractylodis Macrocephalae Rhizoma, 6 qian) Banxia (Pinelliae Rhizoma, 1 liang) Xingrenshuang (Armeniacae Semen Amarum Frost, 5 qian) Guizhi (Cinnamomi Ramulus, 5 qian) Ganjiang (Zingiberis Rhizoma, 3 qian) Yunling (Poria, 6 qian) Zhigancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle, 3 qian) Wuweizi (Schisandrae Fructus, 6 qian)
Decoct eight bowls of Ganlan Shui (Gliding Water) to three bowls, take in three doses.
Fu, aged 32. On the third day of the second month in the Yichou year. Phlegm-fluids Chest Bi, combined with Hanging Fluids under hypochondrium.
Xingni (Armeniacae Semen Amarum Paste, 3 qian) Xiebai (Allii Macrostemonis Bulbus, 3 qian) Gualou (Trichosanthis Fructus, 2 qian) Guizhi (Cinnamomi Ramulus, 3 qian) Guangpi (Citri Reticulatae Pericarpium, 1.5 qian) Chuanpu (Magnoliae Officinalis Cortex, 2 qian) Xiao Zhishi (Aurantii Fructus Immaturus, 3 qian) Xuanfuhua (Inulae Flos, 3 qian) Sheng Xiangfu (Cyperi Rhizoma, 3 qian) Banxia (Pinelliae Rhizoma, 5 qian)
Use eight cups of water, decoct to three cups, take in three doses. Three doses.
On the seventh day: Chest Bi and Hanging Fluids cured. Only Intestinal Bi with loss of taste. Propose harmonizing Liver-Stomach, opening Intestinal Bi.
Banxia (Pinelliae Rhizoma, 3 qian) Guangpi (Citri Reticulatae Pericarpium, 2 qian) Xiao Zhishi (Aurantii Fructus Immaturus, 2 qian) Baitongcao (Akebiae Caulis, 2 qian) Xingren (Armeniacae Semen Amarum, 8 qian) Shengyiren (Coicis Semen, 5 qian) Jiangzhi (Zingiberis Rhizoma Recens Juice, 3 spoons mixed)
Use five cups of water, decoct to two cups, decoct residue for one cup, take in three doses.
Shao, aged 38. On the eleventh day of November. Pulse wiry-thin-deep, cough, orthopnea, chest fullness, thirst. Use Xiao Qing Long Tang (Minor Blue Dragon Decoction) removing Mahuang (Ephedrae Herba) and Xixin (Asari Radix) method.
Guizhi (Cinnamomi Ramulus, 6 qian) Baishao (Paeoniae Radix Alba, 4 qian) Zhigancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle, 3 qian) Ganjiang (Zingiberis Rhizoma, 5 qian) Banxia (Pinelliae Rhizoma, 1 liang 5 qian) Wuweizi (Schisandrae Fructus, 2 qian) Fuling (Poria, 1 liang) Xiao Zhishi (Aurantii Fructus Immaturus, 7 qian) Guangpi (Citri Reticulatae Pericarpium, 3 qian)
Take in four doses.
On the thirteenth day: Taking Xiao Qing Long Tang effective, but hoarse throat knowing thirst, pulse slightly rapid. Indicates Phlegm-Fluids about to disperse. Switch to acrid-cool, lifting Lung Qi method.
Mahuang (Ephedrae Herba, 3 qian, honey juice) Xingren (Armeniacae Semen Amarum, 5 qian) Shigao (Gypsum Fibrosum, 8 qian) Sheng Gancao (Glycyrrhizae Radix et Rhizoma, 3 qian) Ku Jiegeng (Platycodonis Radix, 3 qian) Banxia (Pinelliae Rhizoma, 3 qian) Guangpi (Citri Reticulatae Pericarpium, 1 qian)
Huan, aged 38. In Zhengyue of Bingyin year. Phlegm-Fluids pattern usually dislikes water; if preferring water, Fluids are in the Lung. Preferring water usually calls for sweet-moist; now using warm-dry because it is Fluids. Since preferring water, how to know it is Fluids? Because water intake does not move, palpitations, shortness of breath, asthma-fullness, dizziness, cough many...