带 下
李××，女，三十五岁，干部。1969年6月。
初诊：自云生育二胎，近年来患带下，经候常过期，经前七、八日，带下淋漓，每月如是，带色青白如涕状，量多如注。经行则腰酸腹痛，肛门下坠，食欲不振，面色青白，精神疲乏，形体日趋肥胖，服止带丸及单方均无效。舌淡，苔白腻，脉细弦滑。证属脾虚气弱，肝肾带脉不足，水湿不化，下注为带。治则：调摄肝肾，健脾化湿。处方：
炒柴胡9克 生口芪15克 白术12克 炒苍术9克 炙升
麻3克上党参15克 当归15克 西砂仁6克 煅龙骨12克
诃子肉12克炒淮药12克莲须9克臭椿皮9克烧姜2片
小枣11枚
上方连服十五剂，诸症痊愈，嘱用补中益气丸巩固。
[按]方取补中益气、君、完带、秘元，复方化裁．具升阳、健脾、化湿、固摄性能。针对病机，博而不杂。
妊娠恶阻
王××，女，二十六岁，机关干部。1952年6月。
初诊：婚后年余，尚未生育，素有气短、头晕及月经后期(十至十五日)等症。适当暑夏，下乡支农，返家后，即感头昏晕，发热，微恶寒。恶心，吞酸，作呕，不思饮食。
夜卧不宁，时出自汗，腰酸，便秘，经汛二月未潮。诊脉两寸浮滑，左关弦细，两尺弱。舌质淡红、苔白腻。此虽暑症，但寸脉浮中带滑，又兼停经二月，乃妊娠之兆。法宜先清暑邪，调和肝胃，忌克伐升散之品。处方：
霍香梗4．5克 佩兰叶3克 法半夏9克 广陈皮6克 净
秫米15克 茯苓12克 生甘草2．4克 竹茹6克 生姜2片
炒老米12克 小枣11枚
二诊：上方服二剂，暑邪已解，但呃逆仍频，嗳气，食入即吐。腰楚，诊脉两寸尤动甚，恶阻也。续宜调肝和胃，降逆止呕。处方：
霍香梗6克 法半夏9克 广陈皮6克 西砂仁6克 白
术9克 茯苓12克 净秫米15克 桑寄生12克 云黄连2．4克
生姜汁(炒) 竹茹4．5克小枣1l枚 (嘱少量缓服)
三诊：上方服三剂，胃脘渐舒，恶阻大减，可进稀粥，尚感腰楚肢软。脉滑绥，舌淡润。拟用调和肝脾，兼养气血。处方：
当归身9克 苏条参12克 法半夏9克 炒白术9克 西砂
仁6克广陈皮6克桑寄生12克白茯苓12克炒老米15克
秫米15克烧生姜2片小红枣11枚
[按]妊娠恶阻，又兼伤暑，疑似之间，委而能断。此虽妇科常病，但因素禀各异，兼症颇多，临诊尤须审慎。
子 嗽
苏××，女，三十五岁，住昆明郊区。1945年8月。
初诊：生育六胎，又怀孕七月，因冒雨受寒，头疼身痛，咳嗽发烧。服表里双解剂，外邪得汗已解，但咳嗽不止，胎动不安，腰酸腹坠。逾廿日，昼夜均感小便频数，不能制约。已服润肺化痰，理气清热多剂，渐至面足浮肿，寝食不安。脉象滑数，重取无力，舌淡红。细参症情，此子嗽也。乃因气血两虚，冲任不足，肺风不化所致。亟宜滋血固气养胎，化风益肺宁嗽。处方：
肥沙参9克 当归身15克炒杭芍9克淮山药12克化桔
红6克 菟丝子12克桑螵蛸9克黑芝麻12克炙冬花9克
生白术9克 生甘草3克 蜜炙桑叶9克
次诊；上方服二剂，咳嗽减，吐出风沫痰涎，胎动渐安，小便频数渐能控制。尚有轻度面足浮肿，仍腰酸腹坠。
脉滑，舌红苔润。是肺风较化，气血尚虚，冲任未足。续用原方化裁。处方：
龟鹿胶18克(烊化兑服) 阿胶珠12克 肥沙参9克 当归
身15克 炒杭芍9克 菟丝子15克 甜光杏仁9克 炙冬
花6克 桑螵蛸9克 炒芡实12克 炙甘草3克 白果15克
(烧去壳) 小枣12枚
三诊：上方连服七剂，咳嗽渐平，小便正常，浮肿消退，饮食增加，睡眠安定。脉转滑缓调和，舌苔红润，是气血冲任均得调养，胎元亦渐安固。再为拟下方常服，至足月顺产，咳嗽全愈，此后未发。处方：
沙参12克 当归身15克 炒杭芍9克 白术12克 茯神15克
甜光杏仁9克淮山药12克 炙冬花9克 黑小豆15克化
桔红4．5克 炙甘草3克 莲子肉15克 白果15克(烧去壳)
[按]妊娠血虚受寒，表解后，即当本“散者收之”之意，以免犯虚虚实实之戒。若单纯一味治咳，仅以润肺、化痰、清热而不顾本体虚实，则后患无穷。
本案法重培元安胎，化风益肺，标本同治。正体现了内经“五脏六腑皆令人咳，非独肺也”之辨证观点。
子 痫
王××，女，廿五岁，干部。时间：1969年。
初诊：怀孕八月余，常感头晕目弦，心悸气短，面色潮红，肢体浮肿，手足麻木。经某医院检查为妊娠高血压症。
近数日来，自觉头昏眼花更重，耳鸣，夜卧不安。日前卒然倒扑，不省人事，双目直视，牙关紧闭，颈项强直，口流白沫，手足抽搐，自汗不止。即送某医院抢救后，稍有转机，而抽搐频发不停，神智仍模糊不清，延余前往会诊。脉象弦大而滑，舌苔浮薄微干。证属平素肝肾不足，阴虚阳亢，精不养神，血不荣筋，以致血燥生风，手足抽搐，阳气不潜，上浮而为眩晕昏厥，逆为妊娠子痫重证。治则：宜祛风宣络，养血育阴，潜阳镇逆。方用羚羊勾藤汤加昧：
羚羊角3克(磨水兑服) 双勾藤9克当归15克桑寄生15克
广木香4．5克 细生地12克 炒杭芍9克 茯神15克 云母
石9克(煅) 生石决明12克 生龙骨12克 生甘草3克 竹
茹6克蛇胆陈皮末2支(分次调入)
二诊：上方连服二剂后，神识稍苏，抽搐渐减，口干思饮，自汗时出。时常悲伤叹息，胸闷暖气。有时烦燥不安，不思食，小便少，大便秘。脉象弦大渐平，舌苔淡黄、微润。此风势渐平，血不养肝，阴虚脏燥之象。除用原方续服外，再拟金匮“甘麦大枣汤”频频灌服。处方：
生甘草15克浮小麦30克大枣5牧
三诊：上二方续服三剂后，神志完全苏醒，抽搐已止。
自觉精神倦怠，身软无力。二便已通，稍能静卧，能进少量饮食。仍有头昏耳鸣、心悸、自汗、胎动等症状。脉息细弦带滑，舌苔薄黄有津。此病退气弱，血衰而不养胎，心神不足之候，续用下方调理：
干地黄15克 当归身15克 炒杭芍12克 炒枣仁15克 茯
神15克 沙吉力15克黑芝麻15克桑寄生12克菟丝子15克
浮小麦18克小红枣12枚广陈皮6克生甘草3克
上方服五剂后，子痫证已不再发，产后痊愈出院。
[姚按]“子痫”在妇科症中病例不多。治疗一面要养血驱风，一面要镇静通络。古代医家云：“治风先治血，血行风自灭。”余治疗此一病例，就是本此治则，而收显效。
带下病
李××，女性，三十五岁，干部。就诊时间为1969年6月。
初诊：自述生育二胎后，近年来患带下病（阴道分泌物异常增多），月经经常推迟。经前七、八日，白带淋漓不断，每月如此。白带颜色青白如鼻涕状，量多如注。行经时腰酸腹痛，肛门有下坠感，食欲不振，面色青白，精神疲乏，身体日渐肥胖。曾服用止带丸及单方均无效。舌质淡，苔白腻，脉细弦滑。证属脾虚气弱，肝肾及带脉不足，水湿不化，下注而成带下。治则：调摄肝肾，健脾化湿。处方：
炒柴胡9克 生黄芪15克 白术12克 炒苍术9克 炒升麻3克 上党参15克 当归15克 西砂仁6克 煅龙骨12克 诃子肉12克 炒淮山药12克 莲须9克 臭椿皮9克 烧姜2片 小枣11枚
上方连续服用十五剂，诸症痊愈，嘱咐服用补中益气丸以巩固疗效。
[按语]本方取补中益气汤、完带方、秘元煎之意，复方化裁而成。具有升阳、健脾、化湿、固摄的功效。针对病机，博采众长而不杂乱。
妊娠恶阻
王××，女性，二十六岁，机关干部。就诊时间为1952年6月。
初诊：婚后一年多，尚未生育，素有气短、头晕及月经后期（十至十五日一行）等症状。适逢盛夏，下乡支农，回家后，即感到头昏晕，发热，微恶寒。恶心，吞酸，作呕，不思饮食。夜间睡眠不安，时常自汗，腰酸，便秘，月经两个月未来潮。诊脉两寸浮滑，左关弦细，两尺弱。舌质淡红，苔白腻。此虽为暑症，但寸脉浮中带滑，又兼停经二月，乃是妊娠之兆。法宜先清暑邪，调和肝胃，忌用攻伐升散之品。处方：
藿香梗4.5克 佩兰叶3克 法半夏9克 广陈皮6克 净秫米15克 茯苓12克 生甘草2.4克 竹茹6克 生姜2片 炒老米12克 小枣11枚
二诊：上方服用两剂后，暑邪已解，但呃逆仍频繁，嗳气，食入即吐。腰部酸痛，诊脉两寸搏动尤为明显，确认为恶阻（妊娠呕吐）。续宜调肝和胃，降逆止呕。处方：
藿香梗6克 法半夏9克 广陈皮6克 西砂仁6克 白术9克 茯苓12克 净秫米15克 桑寄生12克 云黄连2.4克 生姜汁(炒) 竹茹4.5克 小枣11枚 (嘱少量缓服)
三诊：上方服用三剂后，胃脘渐舒，恶阻大减，可进稀粥，尚感腰部酸痛、肢体软弱。脉滑缓，舌淡润。拟用调和肝脾，兼养气血。处方：
当归身9克 苏条参12克 法半夏9克 炒白术9克 西砂仁6克 广陈皮6克 桑寄生12克 白茯苓12克 炒老米15克 秫米15克 烧生姜2片 小红枣11枚
[按语]妊娠恶阻，又兼伤暑，在疑似之间，能够准确判断。此虽为妇科常病，但因个体禀赋各异，兼症颇多，临诊尤须审慎。
子嗽（妊娠期咳嗽）
苏××，女性，三十五岁，住昆明郊区。就诊时间为1945年8月。
初诊：生育六胎，现怀孕七月，因冒雨受寒，头疼身痛，咳嗽发烧。服用表里双解剂后，外邪得汗已解，但咳嗽不止，胎动不安，腰酸腹坠。逾二十日，昼夜均感小便频数，不能制约。已服润肺化痰，理气清热多剂，渐至面足浮肿，寝食不安。脉象滑数，重取无力，舌淡红。细参症情，此为子嗽。乃因气血两虚，冲任不足，肺风不化所致。亟宜滋血固气养胎，化风益肺宁嗽。处方：
肥沙参9克 当归身15克 炒杭芍9克 淮山药12克 化桔红6克 菟丝子12克 桑螵蛸9克 黑芝麻12克 炙冬花9克 生白术9克 生甘草3克 蜜炙桑叶9克
次诊：上方服用两剂后，咳嗽减轻，吐出风沫痰涎，胎动渐安，小便频数渐能控制。尚有轻度面足浮肿，仍腰酸腹坠。脉滑，舌红苔润。是肺风较化，气血尚虚，冲任未足。续用原方化裁。处方：
龟鹿胶18克(烊化兑服) 阿胶珠12克 肥沙参9克 当归身15克 炒杭芍9克 菟丝子15克 甜光杏仁9克 炙冬花6克 桑螵蛸9克 炒芡实12克 炙甘草3克 白果15克(烧去壳) 小枣12枚
三诊：上方连续服用七剂后，咳嗽渐平，小便正常，浮肿消退，饮食增加，睡眠安定。脉转滑缓调和，舌苔红润，是气血冲任均得调养，胎元亦渐安固。再为拟下方常服，至足月顺产，咳嗽全愈，此后未发。处方：
沙参12克 当归身15克 炒杭芍9克 白术12克 茯神15克 甜光杏仁9克 淮山药12克 炙冬花9克 黑小豆15克 化桔红4.5克 炙甘草3克 莲子肉15克 白果15克(烧去壳)
[按语]妊娠血虚受寒，表解后，即当本“散者收之”之意，以免犯虚虚实实之戒。若单纯一味治咳，仅以润肺、化痰、清热而不顾本体虚实，则后患无穷。
本案法重培元安胎，化风益肺，标本同治。正体现了内经“五脏六腑皆令人咳，非独肺也”之辨证观点。
子痫（妊娠痫证）
王××，女性，二十五岁，干部。时间：1969年。
初诊：怀孕八月余，常感头晕目眩，心悸气短，面色潮红，肢体浮肿，手足麻木。经某医院检查为妊娠高血压症。
近数日来，自觉头昏眼花更重，耳鸣，夜卧不安。日前卒然倒扑，不省人事，双目直视，牙关紧闭，颈项强直，口流白沫，手足抽搐，自汗不止。即送某医院抢救后，稍有转机，而抽搐频发不停，神智仍模糊不清，延余前往会诊。脉象弦大而滑，舌苔浮薄微干。证属平素肝肾不足，阴虚阳亢，精不养神，血不荣筋，以致血燥生风，手足抽搐，阳气不潜，上浮而为眩晕昏厥，逆为妊娠子痫重证。治则：宜祛风宣络，养血育阴，潜阳镇逆。方用羚羊钩藤汤加味：
羚羊角3克(磨水兑服) 双勾藤9克 当归15克 桑寄生15克 广木香4.5克 细生地12克 炒杭芍9克 茯神15克 云母石9克(煅) 生石决明12克 生龙骨12克 生甘草3克 竹茹6克 蛇胆陈皮末2支(分次调入)
二诊：上方连续服用两剂后，神识稍苏，抽搐渐减，口干思饮，自汗时出。时常悲伤叹息，胸闷暖气。有时烦躁不安，不思食，小便少，大便秘。脉象弦大渐平，舌苔淡黄、微润。此风势渐平，血不养肝，阴虚脏燥之象。除用原方续服外，再拟金匮“甘麦大枣汤”频频灌服。处方：
生甘草15克 浮小麦30克 大枣5枚
三诊：上二方续服三剂后，神志完全苏醒，抽搐已止。
自觉精神倦怠，身软无力。二便已通，稍能静卧，能进少量饮食。仍有头昏耳鸣、心悸、自汗、胎动等症状。脉息细弦带滑，舌苔薄黄有津。此病退气弱，血衰而不养胎，心神不足之候，续用下方调理：
干地黄15克 当归身15克 炒杭芍12克 炒枣仁15克 茯神15克 沙吉力15克 黑芝麻15克 桑寄生12克 菟丝子15克 浮小麦18克 小红枣12枚 广陈皮6克 生甘草3克
上方服用五剂后，子痫证已不再发，产后痊愈出院。
[姚按语]“子痫”在妇科症中病例不多。治疗一面要养血驱风，一面要镇静通络。古代医家云：“治风先治血，血行风自灭。”余治疗此一病例，就是本此治则，而收显效。
Leukorrhea
Li XX, female, 35 years old, cadre. Consultation date: June 1969.
First visit: She reported that after giving birth to her second child, she had suffered from leukorrhea (abnormal increase in vaginal discharge) in recent years, with menstruation often delayed. Seven or eight days before menstruation, the leukorrhea would drip continuously, occurring every month. The leukorrhea was blue-white and mucous-like, with a large volume like a gush. During menstruation, she experienced soreness and pain in the lower back, a bearing-down sensation in the anus, loss of appetite, a bluish-white complexion, mental fatigue, and progressive obesity. She had taken Zhidai Wan (Stop Leukorrhea Pill) and various single-herb prescriptions without effect. The tongue was pale with a white greasy coating, and the pulse was fine, wiry, and slippery. The syndrome belongs to Spleen deficiency and Qi weakness, insufficiency of the Liver, Kidney, and Dai Mai (Girdle Vessel), failure to transform water-dampness, which sinks downward to form leukorrhea. Treatment principle: Regulate the Liver and Kidney, strengthen the Spleen and resolve dampness. Prescription:
Chao Chai Hu (Stir-fried Bupleuri Radix) 9g, Sheng Huang Qi (Raw Astragali Radix) 15g, Bai Zhu (Atractylodis Rhizoma) 12g, Chao Cang Zhu (Stir-fried Atractylodis Rhizoma) 9g, Chao Sheng Ma (Stir-fried Cimicifugae Rhizoma) 3g, Shang Dang Shen (Codonopsis Pilosula from Shangdang) 15g, Dang Gui (Angelicae Sinensis Radix) 15g, Xi Sha Ren (Amomi Fructus) 6g, Duan Long Gu (Calcined Os Draconis) 12g, He Zi Rou (Terminalia Chebula Retocarp) 12g, Chao Huai Yao (Stir-fried Dioscoreae Rhizoma) 12g, Lian Xu (Nelumbinis Plumula) 9g, Chou Chun Pi (Toosendan Cortex) 9g, Shao Jiang (Charred Fresh Zingiberis Rhizoma) 2 slices, Xiao Zao (Small Jujubae Fructus) 11 pieces.
After taking the above prescription for fifteen doses, all symptoms were cured. She was advised to take Buzhong Yiqi Wan (Tonify the Middle and Augment the Qi Pill) to consolidate the efficacy.
[Commentary] This formula is modified from Buzhong Yiqi Tang, Wandai Fang, and Miyuan Jian. It has the effects of raising Yang, strengthening the Spleen, resolving dampness, and securing/astringing. It targets the pathogenesis comprehensively without being chaotic.
Morning Sickness during Pregnancy
Wang XX, female, 26 years old, government organ cadre. Consultation date: June 1952.
First visit: Married for over a year, she had not yet conceived. She had a history of shortness of breath, dizziness, and late menstruation (every ten to fifteen days). During the hot summer, while working in the countryside supporting agriculture, upon returning home, she felt dizzy, feverish, and slightly aversive to cold. She experienced nausea, acid regurgitation, vomiting, and loss of appetite. She slept restlessly at night, sweated spontaneously, had soreness in the lower back, and constipation. Her menstruation had been absent for two months. Pulse: both Cun positions floating and slippery, left Guan position wiry and fine, both Chi positions weak. Tongue: pale red body, white greasy coating. Although this appears to be a Summerheat syndrome, the floating and slippery pulse at the Cun positions, combined with two months of amenorrhea, indicates pregnancy. The method should first clear Summerheat pathogens and harmonize the Liver and Stomach, avoiding harsh draining and ascending/dispersing agents. Prescription:
Huo Xiang Geng (Agastaches Rhizoma et Caulis) 4.5g, Pei Lan Ye (Eupatorii Folium) 3g, Fa Ban Xia (Prepared Pinelliae Tuber) 9g, Guang Chen Pi (Citri Reticulatae Pericarpium) 6g, Jing Shu Mi (Milii Semen) 15g, Fu Ling (Poria) 12g, Sheng Gan Cao (Raw Glycyrrhizae Radix et Rhizoma) 2.4g, Zhu Ru (Bambusae Caulis in Taenia) 6g, Sheng Jiang (Fresh Zingiberis Rhizoma) 2 slices, Chao Lao Mi (Stir-fried Oryzae Fructus) 12g, Xiao Zao (Small Jujubae Fructus) 11 pieces.
Second visit: After taking two doses of the above prescription, the Summerheat pathogen was resolved, but hiccups remained frequent, belching occurred, and food was vomited immediately after ingestion. There was soreness in the waist. The pulse at both Cun positions was particularly active, confirming Morning Sickness (Emesis Gravidarum). Continue to regulate the Liver and harmonize the Stomach, descend rebellious Qi and stop vomiting. Prescription:
Huo Xiang Geng (Agastaches Rhizoma et Caulis) 6g, Fa Ban Xia (Prepared Pinelliae Tuber) 9g, Guang Chen Pi (Citri Reticulatae Pericarpium) 6g, Xi Sha Ren (Amomi Fructus) 6g, Bai Zhu (Atractylodis Rhizoma) 9g, Fu Ling (Poria) 12g, Jing Shu Mi (Milii Semen) 15g, Sang Ji Sheng (Taxilli Caulis et Folium) 12g, Yun Huang Lian (Coptidis Rhizoma) 2.4g, Sheng Jiang Zhi (Zingiberis Rhizoma Recens Juice, stir-fried), Zhu Ru (Bambusae Caulis in Taenia) 4.5g, Xiao Zao (Small Jujubae Fructus) 11 pieces (Take small amounts slowly).
Third visit: After taking three doses of the above prescription, the epigastrium felt comfortable, morning sickness decreased significantly, and she could eat thin porridge. She still felt soreness in the waist and weakness in the limbs. The pulse was slippery and slow, and the tongue was pale and moist. Plan to harmonize the Liver and Spleen, and nourish Qi and Blood. Prescription:
Dang Gui Shen (Angelicae Sinensis Radix) 9g, Su Tiao Shen (Codonopsis Pilosula) 12g, Fa Ban Xia (Prepared Pinelliae Tuber) 9g, Chao Bai Zhu (Stir-fried Atractylodis Rhizoma) 9g, Xi Sha Ren (Amomi Fructus) 6g, Guang Chen Pi (Citri Reticulatae Pericarpium) 6g, Sang Ji Sheng (Taxilli Caulis et Folium) 12g, Bai Fu Ling (Poria) 12g, Chao Lao Mi (Stir-fried Oryzae Fructus) 15g, Shu Mi (Milii Semen) 15g, Shao Jiang (Charred Fresh Zingiberis Rhizoma) 2 slices, Xiao Hong Zao (Small Red Jujubae Fructus) 11 pieces.
[Commentary] Morning sickness during pregnancy, complicated by Summerheat injury, requires careful differentiation between similar presentations. Although this is a common gynecological disease, individual constitutions vary, and there are many accompanying symptoms; thus, clinical diagnosis must be especially prudent.
Fetal Cough (Cough during Pregnancy)
Su XX, female, 35 years old, living in the suburbs of Kunming. Consultation date: August 1945.
First visit: Having given birth to six children, she was now seven months pregnant. Due to exposure to rain and cold, she suffered from headache, body pain, cough, and fever. After taking a formula to release both exterior and interior, the external pathogen was resolved through sweating, but the cough persisted, fetal movement was restless, and she had soreness in the lower back and a bearing-down sensation in the abdomen. For over twenty days, she felt frequent urination day and night, unable to control it. She had taken multiple doses of formulas to moisten the Lungs, resolve phlegm, regulate Qi, and clear heat, leading to edema of the face and feet, and disturbed sleep and appetite. The pulse was slippery and rapid, weak upon heavy pressure, and the tongue was pale red. Carefully analyzing the symptoms, this is Fetal Cough. It is caused by deficiency of both Qi and Blood, insufficiency of the Chong and Ren vessels, and failure to transform Wind in the Lungs. Urgent treatment should nourish Blood, secure Qi, tonify the fetus, transform Wind, benefit the Lungs, and calm the cough. Prescription:
Fei Sha Shen (Glehniae Radix) 9g, Dang Gui Shen (Angelicae Sinensis Radix) 15g, Chao Hang Shao (Stir-fried Paeoniae Radix Alba) 9g, Huai Shan Yao (Dioscoreae Rhizoma) 12g, Hua Ju Hong (Citri Reticulatae Pericarpium Rubrum) 6g, Tu Si Zi (Cuscutae Semen) 12g, Sang Piao Xiao (Mantis Oötheca) 9g, Hei Ba Zhi Ma (Sesami Nigris Semen) 12g, Zhi Dong Hua (Adenophorae Radix) 9g, Sheng Bai Zhu (Raw Atractylodis Rhizoma) 9g, Sheng Gan Cao (Raw Glycyrrhizae Radix et Rhizoma) 3g, Mi Zhi Sang Ye (Honey-fried Mori Folium) 9g.
Second visit: After taking two doses of the above prescription, the cough decreased, and she expectorated wind-phlegm saliva. Fetal movement gradually stabilized, and urinary frequency became controllable. There was still mild edema of the face and feet, and persistent soreness in the lower back and bearing-down sensation in the abdomen. The pulse was slippery, and the tongue was red with a moist coating. This indicates that Lung Wind is transforming, but Qi and Blood are still deficient, and the Chong and Ren vessels are insufficient. Continue with the original formula modified. Prescription:
Gui Lu Jiao (Glutinis Corii Testudinis et Cornu Cervi) 18g (melted and mixed), E Jiao Zhu (Asini Corii Colla Bead) 12g, Fei Sha Shen (Glehniae Radix) 9g, Dang Gui Shen (Angelicae Sinensis Radix) 15g, Chao Hang Shao (Stir-fried Paeoniae Radix Alba) 9g, Tu Si Zi (Cuscutae Semen) 15g, Tian Guang Xing Ren (Pruni Semen Dulce) 9g, Zhi Dong Hua (Adenophorae Radix) 6g, Sang Piao Xiao (Mantis Oötheca) 9g, Chao Qian Shi (Euryales Semen) 12g, Zhi Gan Cao (Honey-fried Glycyrrhizae Radix et Rhizoma) 3g, Bai Guo (Ginkgonis Semen) 15g (roasted and shelled), Xiao Zao (Small Jujubae Fructus) 12 pieces.
Third visit: After continuously taking the above prescription for seven doses, the cough gradually subsided, urination normalized, edema receded, diet increased, and sleep stabilized. The pulse turned slippery, slow, and harmonious, and the tongue coating was red and moist. This indicates that Qi, Blood, Chong, and Ren vessels have been regulated, and the fetal origin is gradually secured. Prescribe the following formula for regular use until full-term delivery. The cough was completely cured and did not recur afterwards. Prescription:
Sha Shen (Glehniae Radix) 12g, Dang Gui Shen (Angelicae Sinensis Radix) 15g, Chao Hang Shao (Stir-fried Paeoniae Radix Alba) 9g, Bai Zhu (Atractylodis Rhizoma) 12g, Fu Shen (Poria with Hostwood) 15g, Tian Guang Xing Ren (Pruni Semen Dulce) 9g, Huai Shan Yao (Dioscoreae Rhizoma) 12g, Zhi Dong Hua (Adenophorae Radix) 9g, Hei Xiao Dou (Phaseoli Semen Nigrum) 15g, Hua Ju Hong (Citri Reticulatae Pericarpium Rubrum) 4.5g, Zhi Gan Cao (Honey-fried Glycyrrhizae Radix et Rhizoma) 3g, Lian Zi Rou (Nelumbinis Semen) 15g, Bai Guo (Ginkgonis Semen) 15g (roasted and shelled).
[Commentary] In cases of pregnancy with Blood deficiency and cold invasion, after the exterior is resolved, one should follow the principle of "astringing what is scattered" to avoid the mistake of treating deficiency as excess. If one simply treats the cough by only moistening the Lungs, resolving phlegm, and clearing heat without considering the constitution's deficiency or excess, endless troubles will follow.
This case emphasizes tonifying the Origin and calming the fetus, transforming Wind and benefiting the Lungs, treating both root and branch simultaneously. This embodies the dialectical viewpoint from the Neijing: "All the five Zang organs and six Fu organs can cause cough, not just the Lung."
Eclampsia (Convulsions during Pregnancy)
Wang XX, female, 25 years old, cadre. Date: 1969.
First visit: Over eight months pregnant, she often felt dizzy and vertigo, palpitations, shortness of breath, flushed complexion, limb edema, and numbness in hands and feet. Examination at a certain hospital diagnosed pregnancy-induced hypertension.
In recent days, she felt worsened dizziness and blurred vision, tinnitus, and restless sleep. Recently, she suddenly collapsed, lost consciousness, stared straight ahead, had clenched teeth, stiff neck, foaming at the mouth, convulsions of hands and feet, and continuous spontaneous sweating. She was sent to a certain hospital for emergency rescue, showing slight improvement, but convulsions continued frequently, and her consciousness remained unclear. I was invited for consultation. The pulse was wiry, large, and slippery, and the tongue coating was floating, thin, and slightly dry. The syndrome belongs to chronic insufficiency of the Liver and Kidney, Yin deficiency with Yang hyperactivity, essence failing to nourish the Spirit, and Blood failing to nourish the sinews, leading to Blood dryness generating Wind, causing convulsions of hands and feet. Yang Qi fails to submerge, floats upward causing dizziness, vertigo, and syncope, reversing into severe Eclampsia. Treatment principle: Dispel Wind and unblock collaterals, nourish Blood and nurture Yin, anchor Yang and suppress rebellion. Formula: Ling Yang Gou Teng Tang (Antelope Horn and Uncaria Decoction) modified:
Ling Yang Jiao (Saigae Tataricae Cornu) 3g (ground in water and mixed), Shuang Gou Teng (Uncariae Ramulus cum Uncis) 9g, Dang Gui (Angelicae Sinensis Radix) 15g, Sang Ji Sheng (Taxilli Caulis et Folium) 15g, Guang Mu Xiang (Aucklandiae Radix) 4.5g, Xi Sheng Di (Rehmanniae Radix Preparata) 12g, Chao Hang Shao (Stir-fried Paeoniae Radix Alba) 9g, Fu Shen (Poria with Hostwood) 15g, Yun Mu Shi (Yunmu) 9g (calcined), Sheng Shi Jue Ming (Haliotidis Concha) 12g, Sheng Long Gu (Os Draconis) 12g, Sheng Gan Cao (Raw Glycyrrhizae Radix et Rhizoma) 3g, Zhu Ru (Bambusae Caulis in Taenia) 6g, She Dan Chen Pi Mo (Powder of Citri Reticulatae Pericarpium with Snake Gallbladder) 2 tubes (mixed in portions).
Second visit: After continuously taking the above prescription for two doses, consciousness slightly recovered, convulsions gradually decreased, mouth was dry with desire to drink, and spontaneous sweating occurred occasionally. She often sighed sadly, felt chest tightness and belching. Sometimes she felt irritable and restless, had no appetite, scanty urination, and constipation. The pulse was wiry and large but gradually flattened, and the tongue coating was pale yellow and slightly moist. This indicates that the Wind pathogen is subsiding, Blood fails to nourish the Liver, and there are signs of Yin deficiency and visceral dryness. In addition to continuing the original prescription, prescribe Gan Mai Da Zao Tang (Licorice, Wheat, and Jujube Decoction) from Jin Gui Yao Lue for frequent administration. Prescription:
Sheng Gan Cao (Raw Glycyrrhizae Radix et Rhizoma) 15g, Fu Xiao Mai (Tritici Fructus Levissimus) 30g, Da Zao (Jujubae Fructus) 5 pieces.
Third visit: After continuously taking the above two prescriptions for three doses, consciousness completely recovered, and convulsions stopped.
She felt mentally fatigued and physically weak. Urination and defecation were normal, she could lie quietly, and could consume small amounts of food. Symptoms such as dizziness, tinnitus, palpitations, spontaneous sweating, and fetal movement remained. The pulse was fine, wiry, and slightly slippery, and the tongue coating was thin, yellow, and moist. This indicates that after the disease recedes, Qi is weak, Blood is depleted and fails to nourish the fetus, and the Heart Spirit is insufficient. Continue with the following prescription for regulation:
Gan Di Huang (Rehmanniae Radix Preparata) 15g, Dang Gui Shen (Angelicae Sinensis Radix) 15g, Chao Hang Shao (Stir-fried Paeoniae Radix Alba) 12g, Chao Zao Ren (Stir-fried Ziziphi Spinosae Semen) 15g, Fu Shen (Poria with Hostwood) 15g, Sha Ji Li (Xanthocermatis Semen) 15g, Hei Ba Zhi Ma (Sesami Nigris Semen) 15g, Sang Ji Sheng (Taxilli Caulis et Folium) 12g, Tu Si Zi (Cuscutae Semen) 15g, Fu Xiao Mai (Tritici Fructus Levissimus) 18g, Xiao Hong Zao (Small Red Jujubae Fructus) 12 pieces, Guang Chen Pi (Citri Reticulatae Pericarpium) 6g, Sheng Gan Cao (Raw Glycyrrhizae Radix et Rhizoma) 3g.
After taking the above prescription for five doses, eclampsia did not recur again, and she was discharged cured after childbirth.
[Dr. Yao's Commentary] Cases of "Eclampsia" are not numerous in gynecology. Treatment requires nourishing Blood and dispelling Wind on one hand, and sedating and unblocking collaterals on the other. Ancient physicians said: "To treat Wind, first treat the Blood; when Blood moves, Wind extinguishes itself." My treatment of this case followed this principle and achieved remarkable results.