痰阻眩晕(高血压)
李××，女，六十八岁，住某专区。1943年2月。
初诊；患者素体丰腴，喜食腥腻，多痰疾。花甲后，常现面浮、肢体麻木、浮肿。且感胸闷气（目真），痰多泡沫，纳呆，多梦。进而头晕目眩，脑转耳呜，心悸诸症悉增，甚则不能行步。医以归脾养心、朱砂安神，治之不效。再投以八味地黄之类，症候反剧。乃专程至昆，寻余诊治。脉象关上浮大而滑，寸日濡弱，舌质淡胖、苔白腻而滑润。此丹溪所谓“无痰不作眩也。”日常恣食肥甘，伤及脾胃，运化失司，湿聚痰盛。水谷不能化精，肝失所养，风从内生，风痰相助，上扰清空，发为是症。法宜化风宣络，豁痰理气，兼镇逆平肝。处方：
明天麻9克 法半夏9克 自吉力9克 黑芝麻12克 化桔
红6克茯苓神15克 代赭石9克(醋煅) 炒枳壳6克桑
枝15克白檀香4．5克生甘草3克竹茹6克
二诊：上方服三剂，顿觉头目清爽，眩晕得减。咯出风沫痰涎甚多，胸膈舒畅，稍思纳食。仍浮肿、心悸，夜寐不宁。耳呜，神倦，肢体觉麻。脉象滑大较平，风痰渐化。乘势再进下方：
明天麻9克 法半夏9克 生龙齿9克 石决明9克 茯神
木15克 酸枣仁15克 炙远志6克 沙吉力12克 化桔红
4．5克 白檀香4．5克生汁草3克 桑枝木12克荷叶顶2枚
三诊：上方连服五剂，眩晕若失，浮肿消退，痰涎渐少。
行动自如，纳食增加。仍时感肢体麻木，神疲。能眠而梦境尚多。脉缓微滑，舌质淡，苔薄润。此风痰化除，续宜滋血养肝安神之品。处方：
当归身12克 炒杭芍9克 酸枣仁15克 茯苓神15克 明天
麻9克 桑寄生12克 黑芝麻12克 法半夏9克 化桔红
6克 石决明9克 白檀香4．5克 生甘草3克 荷叶顶3枚
嘱服五剂后，配十剂制为丸，早晚各服6克。戒荤腥。
[按]本案紧扣“痰湿”治眩。以祛风豁痰，兼佐柔镇。
风痰既化，再益肾柔肝，养心安神，避辛燥及滋腻。用药从轻灵处下功夫。
血不养肝眩晕
张××，女，四十五岁，干部。1950年。
初诊：生育过多，伤及气血，十多年来，常感头昏眩晕，两眼花雾，耳鸣，食少，夜眠多梦．经候前期，量多，行经则眩晕尤甚，举步欲仆。患者住本市红会医院治疗，并邀余会诊。诊见脉象濡弱沉细，舌质淡红，苔薄润，血压波动在180—140／110—90毫米汞柱之问，血象偏低。此属血不养肝，肝木虚旺，风越于上，发为眩晕，并兼见心脾肾经不足，法宜滋养调理。处方：
白人参9克(另煎汤兑服) 大熟地15克 当归身15克 生杭
芍9克 白茯神15克干果杞15克沙吉力12克黑芝麻12克
明天麻6克 法半夏9克 炙甘草3克 荷叶顶3个 龙眼
肉9克
二诊：上方服三剂，觉头眩耳鸣轻减，食眠渐佳。经行二日，量较前减少。脉弱缓，舌粉润。余无它异，续拟下方：
苏条参12克 明玉竹12克 当归身1 5克 炒杭芍9克 炙首
乌15克 黑芝麻12克沙吉力15克干果杞12克法半夏9克
广陈皮6克 炙甘草3克 黑小豆15克 荷叶顶3个
三诊：上方连服十剂，六脉调和，舌红润有津，眩晕诸症悉平。血压稳定，血象正常。为拟下方，嘱其出院后配服，以资巩固。处方；
苏条参15克 东阿胶15克(烊化兑服) 全当归15克 炒杭
芍9克炙首乌15克沙吉力15克明天麻9克干果杞15克
广陈皮6克茯苓神15克炙甘草3克莲子肉15克龙眼
肉12克 荷叶顶3个
[按]经云：“虚者补之”，此例聿无火邪实热，故能予受纳大剂滋肝补肾、荣养气血之品。
肝肾虚亏眩晕
徐××，男，四十五岁，家住昆明市。1951年。
初诊；深嗜烟酒，劳累过度，四十岁以后，经常头昏眩晕，失眠多梦，耳鸣眼花，腰酸足软。食欲不振，自汗神倦，站立不稳。曾服中西药，效果不明。体质日衰，求诊于余。症见面色苍白，少气懒言，声音低沉。脉濡弱沉细，两尺尤为无力，舌质淡红，苔薄白。此系肝肾虚亏，水火不济，而为眩晕，法宜滋补治之。处方：
红人参9克(另煨兑服) 炙首乌15克 沙吉力12克 女贞
子12克大熟地15克 盐巴戟15克生龙齿12克酸枣仁15克
炙甘草3克 西砂仁6克 盐水烘荷叶顶3个为引
二诊：上方连服五剂，精神渐佳，食眠稍有好转。然余症无明显起色，脉仍濡弱沉细。此水火渐济，下元不足，当填精补肾，双调阴阳。处方：
红人参9克(另煨兑服) 炙首乌15克 大熟地15克 淮山药
12克 大果杞15克 川附片30克(开水先煨透) 西砂仁6克
沙吉力15克 女贞子12克 炙甘草3克 黑小豆24克 荷叶
顶3个
三诊：上方连服十剂，头昏、日花、耳鸣等诸症大为好转，面色渐润。脉细弱，舌红有津。病久体赢，拟方增损，缓图调理，熬制膏剂。处方：
龟鹿胶各15克 红人参9克 炙首乌15克 川附片30克 大
果杞15克 沙吉力15克 怀牛夕9克 西砂仁6克炒枣仁
15克 淮山药15克 炙甘草3克 莲子肉15克 桂元15枚
上方十剂一料。服法：早晚各一匙，开水冲服。
[按]下元既亏，阴阳失衡，水火难济。徒尔安镇何益!经云：“形不足者，温之以气，精不足者，补之以味。”方投参、附、杞、地、首乌、龙齿、酸枣、巴戟等配有情血肉之品，气味俱厚，久服乙癸得养，精液得滋，神形乃复。
脾虚湿痰眩晕
高××，男，五十五岁，干部。1970年7，月。
初诊：患者体形肥胖，湿痰较重，多年来积劳过度。自1952年起，即感头昏眩晕、耳鸣，如乘舟车，夜卧不安，梦多。有时胸闷、痰凝、欲呕、食少。十多年来，血压波动在180／110毫米汞柱上下。经西医诊断为美尼尔氏综合症。服西药并服中药滋补剂，病情不减，近已停止工作，特约余前往会诊。
症见舌苔薄白，微腻，脉象右濡滑，左弦细。余谓此属疲劳过度，心神不宁，又因湿痰凝滞，脾运受损，肝之清阳不升，发为眩晕。法宜淡渗利湿，化痰理气，升清降浊，健脾宁心为治。处方：
法半夏9克 明天麻9克 漂白术9克 白茯苓15克 化桔
红6克淮枣仁15克炙远志6克石菖蒲3克炒枳壳6克
生甘草3克 炒苡仁15克 净秫米15克 荷叶顶2个
二诊：服上方五剂之后，夜卧渐安，血压稍降，头目仍发眩晕，耳鸣腰楚，咯痰较多，二便如常，饮食增加，胸闷已减。左脉稍弦，右仍濡滑。乃脾为湿困，痰凝未涤，清浊升降失司，肝肾不足。嘱须尽量节制肥甘腥腻及动湿生痰之品。续用原方增减：
法半夏9克 明天麻9克漂白术9克 白茯神15克化桔
红6克 光杏仁9克炒苡仁12克生杜仲12克建莲子15克
生甘草3克石决明9克荷叶顶3个
三诊：上方连服十五剂，诸症均有显著减轻，血压降至150／80毫米汞柱。患者已能适当工作，独自行走，饮食增加，二便正常。脉转缓和，舌淡苔润，唯精神尚弱。证属湿痰渐化，心脾功能逐渐恢复，清浊渐分而肝肾未足。可用原方稍佐滋养固脾之品，调理善后。处方：
炙首乌15g 漂白术12克 白茯神15克明天麻9克法半
夏9克 化桔红6克黑小豆15克沙吉力12克生甘草3克
炒苡仁12克荷叶顶3个
[按]脾虚湿痰郁阻引起的眩晕症，临床较多。病的初期，往往辨证不确，或用滋腻，或用强壮，或用温燥，或用寒凉，甚或使用攻下，皆未获效，反致迁绵。固当重视病因病理的特点。此例首用淡渗利湿，化痰理气，升清降浊，以治其标，方中兼以健牌宁心，调达盱肾；继投补益，以固根本。此法可供借鉴。
湿寒泄泻
外宾某，男，四十五岁。1965年6月初诊。自述：腹痛泄泻月余，日三、四行，每痛即有便意，行之不爽，色黄，质稀，检验无异常。食欲渐减，日淡无味，纳谷不香，且食后胸腹饱闷。睡眠欠差，腰酸，耳呜，自汗，下肢浮肿，小便少。服西药，能改善，停药后，症复作。诊见舌质淡，苔白腻，脉沉细而迟缓。此由脾胃之阳受损，而肾命之火不足，温运失司，寒湿水邪浮泛阻遏，以致泄利肿满诸症丛生。诊断为脾肾阳虚、寒湿泄泻。治宜温肾健脾燥湿，并佐分利为法。处方：
炙吴萸2．4克黑固脂9克肉蔻霜6克(去油) 炒苍术9克
法半夏9克 广陈皮6克 西砂仁9克(冲) 白茯苓15克
木猪苓9克炒苡仁12克炒老米12克 生姜2片(烧) 大
枣5枚
上方服三剂，大便日一次，成形。肿满、耳鸣、自汗、饱闷、口淡诸症大减。精神好转，饮食增加。脉缓而有力，苔腻渐退。方药获效，患者极为欣慰。乃嘱照原方续服三剂，调理善后。
[按]湿邪阴浊，最易伤阳，金鉴有言：“命门无火，不能为中宫腐熟水谷之用，肾气不固，谁复司其闭藏之职”。
此证，寒湿久停不化，而脾肾之阳已伤，故取吴萸、固脂、肉蔻之辜温，暖肝、仆脾、温肾，以治阴邪，并用二苓、二陈、术、姜、枣、砂仁、老未，燥湿渗利，分清化浊。方药投症，泄泻遂得速止。
痰阻眩晕（高血压）
李××，女，六十八岁，住某专区。1943年2月。
初诊：患者平时身体丰腴，喜欢吃腥腻食物，多患痰疾。花甲之年（六十岁）后，常出现面部浮肿、肢体麻木、全身浮肿。且感到胸闷气短（原文“目真”疑为笔误，结合语境译为气短），痰多呈泡沫状，食欲不振，多梦。进而头晕目眩，头脑旋转，耳鸣，心悸等症状全部加重，严重时甚至无法行走。医生曾用归脾汤养心、朱砂安神丸治疗，无效。又投以八味地黄丸之类的药物，症状反而加剧。于是专程到昆明，找我诊治。脉象关部浮大而滑，寸部濡弱，舌质淡胖，苔白腻而滑润。这是丹溪所说的“无痰不作眩”。日常恣意食用肥甘厚味，损伤脾胃，运化功能失调，湿气聚集，痰湿盛极。水谷不能化为精微，肝失所养，内风自生，风痰相互助长，上扰清空（头部清明之所），发为此症。治法宜平肝熄风宣通经络，豁痰理气，兼以镇逆平肝。处方：
明天麻9克 法半夏9克 沙吉力9克 黑芝麻12克 化桔红6克 茯神15克 代赭石9克（醋煅） 炒枳壳6克 桑枝15克 白檀香4.5克 生甘草3克 竹茹6克
二诊：上方服用三剂后，顿觉头目清爽，眩晕减轻。咯出大量风沫痰涎，胸膈舒畅，稍微想吃东西了。仍有浮肿、心悸，夜间睡眠不安稳。耳鸣，精神疲倦，肢体感觉麻木。脉象滑大较前平和，风痰逐渐化解。乘势再进下方：
明天麻9克 法半夏9克 生龙齿9克 石决明9克 茯神木15克 酸枣仁15克 炙远志6克 沙吉力12克 化桔红4.5克 白檀香4.5克 生甘草3克 桑枝木12克 荷叶顶2枚
三诊：上方连续服用五剂，眩晕消失，浮肿消退，痰涎逐渐减少。行动自如，食欲增加。仍时常感到肢体麻木，精神疲乏。能入睡但梦境尚多。脉缓微滑，舌质淡，苔薄润。此乃风痰已化除，后续宜用滋血养肝安神的药物。处方：
当归身12克 炒杭芍9克 酸枣仁15克 茯神15克 明天麻9克 桑寄生12克 黑芝麻12克 法半夏9克 化桔红6克 石决明9克 白檀香4.5克 生甘草3克 荷叶顶3枚
嘱咐服用五剂后，配制十剂制成丸药，早晚各服6克。忌食荤腥。
[按]本案紧扣“痰湿”治疗眩晕。以祛风豁痰为主，兼佐柔肝镇静。风痰既已化解，再益肾柔肝，养心安神，避免使用辛燥及滋腻的药物。用药从轻灵处下功夫。
血不养肝眩晕
张××，女，四十五岁，干部。1950年。
初诊：生育过多，损伤气血，十多年来，常感头昏眩晕，两眼视物模糊如雾，耳鸣，食量减少，夜间睡眠多梦。月经周期提前，经量多，行经时眩晕尤其严重，举步欲倒。患者住在本市红十字会医院治疗，并邀请我会诊。诊见脉象濡弱沉细，舌质淡红，苔薄润，血压波动在180—140/110—90毫米汞柱之间，血象偏低。这属于血不养肝，肝木虚旺，风气越于上部，发为眩晕，并兼见心、脾、肾经不足。治法宜滋养调理。处方：
白人参9克（另煎汤兑服） 大熟地15克 当归身15克 生杭芍9克 白茯神15克 干果杞15克 沙吉力12克 黑芝麻12克 明天麻6克 法半夏9克 炙甘草3克 荷叶顶3个 龙眼肉9克
二诊：上方服用三剂，觉得头眩耳鸣减轻，饮食睡眠逐渐好转。经期两天，经量较前减少。脉弱缓，舌粉润。其余无其他异常，继续拟定下方：
苏条参12克 明玉竹12克 当归身15克 炒杭芍9克 炙首乌15克 黑芝麻12克 沙吉力15克 干果杞12克 法半夏9克 广陈皮6克 炙甘草3克 黑小豆15克 荷叶顶3个
三诊：上方连续服用十剂，六脉调和，舌红润有津液，眩晕诸症全部平息。血压稳定，血象正常。为此拟定下方，嘱咐其出院后配药服用，以巩固疗效。处方：
苏条参15克 东阿胶15克（烊化兑服） 全当归15克 炒杭芍9克 炙首乌15克 沙吉力15克 明天麻9克 干果杞15克 广陈皮6克 茯神15克 炙甘草3克 莲子肉15克 龙眼肉12克 荷叶顶3个
[按]《内经》云：“虚者补之”，此例并无火邪实热，故能承受大剂滋肝补肾、荣养气血的药物。
肝肾虚亏眩晕
徐××，男，四十五岁，家住昆明市。1951年。
初诊：深嗜烟酒，劳累过度，四十岁以后，经常头昏眩晕，失眠多梦，耳鸣眼花，腰酸足软。食欲不振，自汗神倦，站立不稳。曾服用中西药，效果不明。体质日渐衰弱，求诊于我。症见面色苍白，少气懒言，声音低沉。脉濡弱沉细，两尺脉尤为无力，舌质淡红，苔薄白。此为肝肾虚亏，水火不济，而为眩晕。治法宜滋补治疗。处方：
红人参9克（另煨兑服） 炙首乌15克 沙吉力12克 女贞子12克 大熟地15克 盐巴戟15克 生龙齿12克 酸枣仁15克 炙甘草3克 西砂仁6克 盐水烘荷叶顶3个为引
二诊：上方连续服用五剂，精神渐佳，饮食睡眠稍有好转。然而其余症状无明显起色，脉仍濡弱沉细。此乃水火渐济，下元不足，当填精补肾，双调阴阳。处方：
红人参9克（另煨兑服） 炙首乌15克 大熟地15克 淮山药12克 大果杞15克 川附片30克（开水先煨透） 西砂仁6克 沙吉力15克 女贞子12克 炙甘草3克 黑小豆24克 荷叶顶3个
三诊：上方连续服用十剂，头昏、眼花、耳鸣等诸症大为好转，面色渐润。脉细弱，舌红有津。病久体赢，拟方增损，缓图调理，熬制膏剂。处方：
龟鹿胶各15克 红人参9克 炙首乌15克 川附片30克 大果杞15克 沙吉力15克 怀牛夕9克 西砂仁6克 炒枣仁15克 淮山药15克 炙甘草3克 莲子肉15克 桂元15枚
上方十剂为一料。服法：早晚各一匙，开水冲服。
[按]下元既已亏损，阴阳失衡，水火难济。徒然安镇有何益处！《内经》云：“形不足者，温之以气，精不足者，补之以味。”方中投入人参、附子、枸杞、地黄、首乌、龙齿、酸枣、巴戟等配有情血肉之品，气味俱厚，久服使乙癸（肝肾）得养，精液得滋，神形乃复。
脾虚湿痰眩晕
高××，男，五十五岁，干部。1970年7月。
初诊：患者体形肥胖，湿痰较重，多年来积劳过度。自1952年起，即感头昏眩晕、耳鸣，如乘舟车之感，夜卧不安，梦多。有时胸闷、痰凝、欲呕、食少。十多年来，血压波动在180/110毫米汞柱上下。经西医诊断为美尼尔氏综合症。服西药并服中药滋补剂，病情不减，近已停止工作，特约我前往会诊。
症见舌苔薄白，微腻，脉象右濡滑，左弦细。我认为此属疲劳过度，心神不宁，又因湿痰凝滞，脾运受损，肝之清阳不升，发为眩晕。治法宜淡渗利湿，化痰理气，升清降浊，健脾宁心为治。处方：
法半夏9克 明天麻9克 漂白术9克 白茯苓15克 化桔红6克 淮枣仁15克 炙远志6克 石菖蒲3克 炒枳壳6克 生甘草3克 炒苡仁15克 净秫米15克 荷叶顶2个
二诊：服用上方五剂之后，夜卧渐安，血压稍降，头目仍发眩晕，耳鸣腰楚，咯痰较多，二便如常，饮食增加，胸闷已减。左脉稍弦，右仍濡滑。乃是脾为湿困，痰凝未涤，清浊升降失司，肝肾不足。嘱咐须尽量节制肥甘腥腻及动湿生痰之品。续用原方增减：
法半夏9克 明天麻9克 漂白术9克 白茯神15克 化桔红6克 光杏仁9克 炒苡仁12克 生杜仲12克 建莲子15克 生甘草3克 石决明9克 荷叶顶3个
三诊：上方连续服用十五剂，诸症均有显著减轻，血压降至150/80毫米汞柱。患者已能适当工作，独自行走，饮食增加，二便正常。脉转缓和，舌淡苔润，唯精神尚弱。证属湿痰渐化，心脾功能逐渐恢复，清浊渐分而肝肾未足。可用原方稍佐滋养固脾之品，调理善后。处方：
炙首乌15克 漂白术12克 白茯神15克 明天麻9克 法半夏9克 化桔红6克 黑小豆15克 沙吉力12克 生甘草3克 炒苡仁12克 荷叶顶3个
[按]脾虚湿痰郁阻引起的眩晕症，临床较多。病的初期，往往辨证不确，或用滋腻，或用强壮，或用温燥，或用寒凉，甚或使用攻下，皆未获效，反致迁延。固当重视病因病理的特点。此例首用淡渗利湿，化痰理气，升清降浊，以治其标，方中兼以健脾宁心，调达肝肾；继投补益，以固根本。此法可供借鉴。
湿寒泄泻
外宾某，男，四十五岁。1965年6月初诊。自述：腹痛泄泻月余，日三、四行，每痛即有便意，行之不爽，色黄，质稀，检验无异常。食欲渐减，口淡无味，纳谷不香，且食后胸腹饱闷。睡眠欠差，腰酸，耳鸣，自汗，下肢浮肿，小便少。服西药，能改善，停药后，症复作。诊见舌质淡，苔白腻，脉沉细而迟缓。此由脾胃之阳受损，而肾命之火不足，温运失司，寒湿水邪浮泛阻遏，以致泄利肿满诸症丛生。诊断为脾肾阳虚、寒湿泄泻。治宜温肾健脾燥湿，并佐分利为法。处方：
炙吴萸2.4克 黑固脂9克 肉蔻霜6克（去油） 炒苍术9克 法半夏9克 广陈皮6克 西砂仁9克（冲） 白茯苓15克 木猪苓9克 炒苡仁12克 炒老米12克 生姜2片（烧） 大枣5枚
上方服用三剂，大便日一次，成形。肿满、耳鸣、自汗、饱闷、口淡诸症大减。精神好转，饮食增加。脉缓而有力，苔腻渐退。方药获效，患者极为欣慰。乃嘱照原方续服三剂，调理善后。
[按]湿邪阴浊，最易伤阳，金鉴有言：“命门无火，不能为中宫腐熟水谷之用，肾气不固，谁复司其闭藏之职”。
此证，寒湿久停不化，而脾肾之阳已伤，故取吴萸、固脂、肉蔻之辛温，暖肝、健脾、温肾，以治阴邪，并用二苓、二陈、术、姜、枣、砂仁、老米，燥湿渗利，分清化浊。方药投症，泄泻遂得速止。
Dizziness Caused by Phlegm Obstruction (Hypertension)
Patient Li XX, female, 68 years old, residing in a certain prefecture. February 1943.
First visit: The patient has always had a robust physique and enjoys eating greasy and fishy foods, often suffering from phlegmatic diseases. After reaching the age of sixty (flower cycle), she frequently presents with facial edema, numbness of limbs, and generalized edema. She also complains of chest tightness and shortness of breath, copious foamy sputum, poor appetite, and frequent dreaming. Subsequently, dizziness and vertigo, sensation of head spinning, tinnitus, and palpitations all intensified, to the extent that she could hardly walk. Physicians previously treated her with Guipi Tang (Spleen-Restoring Decoction) to nourish the heart and Zhusha Anshen Wan (Cinnabar-Calming Spirit Pill) without effect. Subsequent administration of formulas like Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pill) aggravated the symptoms. She then traveled specifically to Kunming to seek my treatment. The pulse was floating, large, and slippery at the Guan position, and soggy and weak at the Cun position. The tongue body was pale and swollen, with a white, greasy, and slippery coating. This corresponds to Danxi’s saying: “Without phlegm, there is no vertigo.” Daily indulgence in rich and sweet foods damaged the Spleen and Stomach, leading to dysfunction of transportation and transformation, accumulation of dampness, and excessive phlegm. Food and fluids failed to transform into essence, causing the Liver to lose nourishment; internal wind arose. Wind and phlegm assisted each other, disturbing the clear orifices above, resulting in this condition. The therapeutic principle should be to extinguish wind and unblock collaterals, resolve phlegm and regulate Qi, combined with subduing rebellious Qi and calming the Liver. Prescription:
Tianmae Rhizoma (Gastrodiae Rhizoma) 9g, Banxia Preparata (Pinelliae Rhizoma Praeparatum) 9g, Shajili (likely Sha Ren or similar aromatic seed, transliterated as Shajili) 9g, Sesami Nigris Semen (Black Sesame Seed) 12g, Juhong Preparata (Citri Reticulatae Pericarpium Rubrum) 6g, Fushen (Poria with Hostwood) 15g, Daizheshi Preparata (Haematitum Praeparatum, calcined with vinegar) 9g, Zhike Chao (Fructus Aurantii Immaturus, stir-fried) 6g, Sangzhi (Ramulus Mori) 15g, Tanxiang Bai (Lignum Santali Albae) 4.5g, Gancao Sheng (Radix Glycyrrhizae Preparata) 3g, Zhuru (Spiraxis Caulis) 6g.
Second visit: After taking three doses of the above prescription, she immediately felt refreshed in the head and eyes, and vertigo decreased. She expectorated a large amount of wind-phlegm saliva, felt comfortable in the chest and diaphragm, and had a slight desire for food. Edema and palpitations persisted, along with restless sleep at night. Tinnitus, mental fatigue, and limb numbness were present. The pulse was slippery and large but more balanced than before, indicating that wind-phlegm was gradually resolving. Taking advantage of this momentum, the following prescription was administered:
Tianmae Rhizoma (Gastrodiae Rhizoma) 9g, Banxia Preparata (Pinelliae Rhizoma Praeparatum) 9g, Longchi Sheng (Os Draconis) 9g, Jieming Shijue (Concha Haliotidis) 9g, Fushenmu (Poria with Hostwood) 15g, Zaoren Suan (Semen Ziziphi Spinosae) 15g, Yuanzhi Zhi (Radix Polygalae Preparata) 6g, Shajili 12g, Juhong Preparata (Citri Reticulatae Pericarpium Rubrum) 4.5g, Tanxiang Bai (Lignum Santali Albae) 4.5g, Gancao Sheng (Radix Glycyrrhizae Preparata) 3g, Sangzhimu (Ramulus Mori) 12g, Heye Ding (Apex Nelumbinis) 2 pieces.
Third visit: After continuously taking five doses of the above prescription, vertigo disappeared, edema subsided, and sputum gradually decreased. Mobility returned to normal, and appetite increased. She still occasionally felt limb numbness and mental fatigue. She could sleep but had many dreams. The pulse was slow and slightly slippery; the tongue body was pale with a thin, moist coating. Since wind-phlegm had been resolved, subsequent treatment should focus on nourishing blood, benefiting the Liver, and calming the spirit. Prescription:
Danggui Shen (Radix Angelicae Sinensis, root part) 12g, Baishao Chao (Radix Paeoniae Albae, stir-fried) 9g, Zaoren Suan (Semen Ziziphi Spinosae) 15g, Fushen (Poria with Hostwood) 15g, Tianmae Rhizoma (Gastrodiae Rhizoma) 9g, Sangjisheng (Ramulus Taxilli) 12g, Sesami Nigris Semen (Black Sesame Seed) 12g, Banxia Preparata (Pinelliae Rhizoma Praeparatum) 9g, Juhong Preparata (Citri Reticulatae Pericarpium Rubrum) 6g, Jieming Shijue (Concha Haliotidis) 9g, Tanxiang Bai (Lignum Santali Albae) 4.5g, Gancao Sheng (Radix Glycyrrhizae Preparata) 3g, Heye Ding (Apex Nelumbinis) 3 pieces.
She was instructed to take five doses, then prepare ten doses as pills, taking 6g morning and evening. Avoid meat and fish.
[Commentary] This case focuses on treating vertigo caused by "phlegm-dampness." It employs methods to dispel wind and resolve phlegm, supplemented by softening the Liver and calming the spirit. Once wind-phlegm is resolved, it benefits the Kidney and softens the Liver, nourishes the Heart, and calms the spirit, avoiding pungent-drying and cloying-nourishing herbs. Medication is applied with a light and agile approach.
Vertigo Due to Blood Failing to Nourish the Liver
Patient Zhang XX, female, 45 years old, cadre. 1950.
First visit: Excessive childbirth damaged Qi and Blood. For over ten years, she has frequently experienced dizziness and vertigo, blurred vision as if through fog, tinnitus, reduced appetite, and frequent dreaming during sleep. Her menstrual cycles occurred early, with heavy flow. Vertigo worsened significantly during menstruation, making her feel as though she would fall when walking. She was being treated at the local Red Cross Hospital, and I was invited to consult. Examination revealed a soggy, weak, deep, and fine pulse; the tongue body was pale red with a thin, moist coating. Blood pressure fluctuated between 180–140/110–90 mmHg, and blood indices were low. This belongs to blood failing to nourish the Liver, causing deficient hyperactivity of Liver Wood, with wind rising upward, resulting in vertigo, accompanied by deficiency in the Heart, Spleen, and Kidney meridians. The therapeutic principle should be nourishment and regulation. Prescription:
Renshen Bai (Ginseng Radix et Rhizoma Albae) 9g (decocted separately and mixed in), Shudi Da (Radix Rehmanniae Preparata) 15g, Danggui Shen (Radix Angelicae Sinensis, root part) 15g, Baishao Sheng (Radix Paeoniae Albae) 9g, Fushen Bai (Poria with Hostwood) 15g, Gouqi Gan (Fructus Lycii) 15g, Shajili 12g, Sesami Nigris Semen (Black Sesame Seed) 12g, Tianmae Rhizoma (Gastrodiae Rhizoma) 6g, Banxia Preparata (Pinelliae Rhizoma Praeparatum) 9g, Gancao Zhi (Radix Glycyrrhizae Preparata) 3g, Heye Ding (Apex Nelumbinis) 3 pieces, Longyanrou (Arillus Longan) 9g.
Second visit: After three doses of the above prescription, dizziness and tinnitus lessened, and appetite and sleep improved. Menstruation lasted two days, with lighter flow than before. The pulse was weak and slow; the tongue was pink and moist. No other abnormalities were found. The following prescription was continued:
Renshen Su (Ginseng Radix et Rhizoma) 12g, Yuzhu Ming (Rhizoma Polygonati Odorati) 12g, Danggui Shen (Radix Angelicae Sinensis, root part) 15g, Baishao Chao (Radix Paeoniae Albae, stir-fried) 9g, Shouwu Zhi (Radix Polygoni Multiflori Preparata) 15g, Sesami Nigris Semen (Black Sesame Seed) 12g, Shajili 15g, Gouqi Gan (Fructus Lycii) 12g, Banxia Preparata (Pinelliae Rhizoma Praeparatum) 9g, Chenpi Guang (Pericarpium Citri Reticulatae) 6g, Gancao Zhi (Radix Glycyrrhizae Preparata) 3g, Dou Hei Xiao (Phaseoli Vulgaris Var. Nigricans) 15g, Heye Ding (Apex Nelumbinis) 3 pieces.
Third visit: After continuously taking ten doses of the above prescription, the six pulses harmonized, the tongue became red and moist, and all vertigo symptoms subsided. Blood pressure stabilized, and blood indices normalized. The following prescription was formulated for her to take after discharge to consolidate the effect. Prescription:
Renshen Su (Ginseng Radix et Rhizoma) 15g, Ejiao Dong (Colla Corii Asini) 15g (melted and mixed in), Dangquan (Radix Angelicae Sinensis) 15g, Baishao Chao (Radix Paeoniae Albae, stir-fried) 9g, Shouwu Zhi (Radix Polygoni Multiflori Preparata) 15g, Shajili 15g, Tianmae Rhizoma (Gastrodiae Rhizoma) 9g, Gouqi Gan (Fructus Lycii) 15g, Chenpi Guang (Pericarpium Citri Reticulatae) 6g, Fushen (Poria with Hostwood) 15g, Gancao Zhi (Radix Glycyrrhizae Preparata) 3g, Lianzi Rou (Semen Nelumbinis) 15g, Longyanrou (Arillus Longan) 12g, Heye Ding (Apex Nelumbinis) 3 pieces.
[Commentary] The *Classic* states: "Deficiency is treated by tonification." This case lacks fire pathogenic factors and excess heat, so it can tolerate large doses of herbs that nourish the Liver and Kidney and enrich Qi and Blood.
Vertigo Due to Deficiency of Liver and Kidney
Patient Xu XX, male, 45 years old, residing in Kunming City. 1951.
First visit: Deeply fond of tobacco and alcohol, and overworked. After the age of forty, he frequently experienced dizziness and vertigo, insomnia with frequent dreaming, tinnitus, blurred vision, sore back, and weak legs. Poor appetite, spontaneous sweating, mental fatigue, and instability when standing. He had taken Chinese and Western medicines with unclear effects. His constitution deteriorated daily, and he sought my consultation. Symptoms included pale complexion, shortness of breath, reluctance to speak, and low voice. The pulse was soggy, weak, deep, and fine, particularly powerless at both Chi positions. The tongue body was pale red with a thin white coating. This is deficiency of the Liver and Kidney, failure of Water and Fire to interact, resulting in vertigo. The therapeutic principle should be tonification and nourishment. Prescription:
Renshen Hong (Ginseng Radix et Rhizoma Rubra) 9g (simmered separately and mixed in), Shouwu Zhi (Radix Polygoni Multiflori Preparata) 15g, Shajili 12g, Zizyphi Fructus (Fructus Ligustri Lucidi) 12g, Shudi Da (Radix Rehmanniae Preparata) 15g, Bajie Yan (Radix Morindae Officinalis, salt-processed) 15g, Longchi Sheng (Os Draconis) 12g, Zaoren Suan (Semen Ziziphi Spinosae) 15g, Gancao Zhi (Radix Glycyrrhizae Preparata) 3g, Sharen Xi (Fructus Amomi Rotundus) 6g, Heye Ding (Apex Nelumbinis, roasted in salt water) 3 pieces as a guide.
Second visit: After continuously taking five doses of the above prescription, spirit improved, and appetite and sleep showed slight improvement. However, other symptoms showed no significant change, and the pulse remained soggy, weak, deep, and fine. This indicates that Water and Fire are gradually interacting, but the Lower Origin is insufficient. Essence should be filled, the Kidney tonified, and Yin and Yang regulated simultaneously. Prescription:
Renshen Hong (Ginseng Radix et Rhizoma Rubra) 9g (simmered separately and mixed in), Shouwu Zhi (Radix Polygoni Multiflori Preparata) 15g, Shudi Da (Radix Rehmanniae Preparata) 15g, Shanyao Huai (Rhizoma Dioscoreae Hypoglaucae) 12g, Gouqi Da (Fructus Lycii) 15g, Fupian Chuan (Radix Aconiti Lateralis Preparata) 30g (pre-simmered thoroughly in boiling water), Sharen Xi (Fructus Amomi Rotundus) 6g, Shajili 15g, Zizyphi Fructus (Fructus Ligustri Lucidi) 12g, Gancao Zhi (Radix Glycyrrhizae Preparata) 3g, Dou Hei Xiao (Phaseoli Vulgaris Var. Nigricans) 24g, Heye Ding (Apex Nelumbinis) 3 pieces.
Third visit: After continuously taking ten doses of the above prescription, dizziness, blurred vision, and tinnitus improved significantly, and the complexion became lustrous. The pulse was fine and weak; the tongue was red and moist. Given the chronic illness and emaciation, the prescription was modified for gradual regulation, prepared as an ointment/paste. Prescription:
Gui Lu Jiao (Colla Cornus Cervi et Testudinis) 15g each, Renshen Hong (Ginseng Radix et Rhizoma Rubra) 9g, Shouwu Zhi (Radix Polygoni Multiflori Preparata) 15g, Fupian Chuan (Radix Aconiti Lateralis Preparata) 30g, Gouqi Da (Fructus Lycii) 15g, Shajili 15g, Niuxi Huai (Radix Achyranthis Bidentatae) 9g, Sharen Xi (Fructus Amomi Rotundus) 6g, Zaoren Chao (Semen Ziziphi Spinosae, stir-fried) 15g, Shanyao Huai (Rhizoma Dioscoreae Hypoglaucae) 15g, Gancao Zhi (Radix Glycyrrhizae Preparata) 3g, Lianzi Rou (Semen Nelumbinis) 15g, Guiyuan (Arillus Longan) 15 pieces.
Ten doses constitute one batch. Dosage: One spoonful morning and evening, taken with boiled water.
[Commentary] When the Lower Origin is depleted, Yin and Yang are imbalanced, and Water and Fire fail to interact. Merely using calming agents is of no benefit! The *Classic* states: "For deficiency of form, warm with Qi; for deficiency of essence, tonify with flavor." The formula includes Ginseng, Aconite, Lycium, Rehmannia, Polygonum, Dragon Bone, Jujube Seed, Morinda, etc., combined with animal-derived substances (flesh and blood products). These have strong flavors and odors. Long-term use nourishes the Liver and Kidney (Yi-Gui), replenishes essence and fluids, and restores spirit and form.
Vertigo Due to Spleen Deficiency and Damp-Phlegm
Patient Gao XX, male, 55 years old, cadre. July 1970.
First visit: The patient had a obese physique and significant damp-phlegm, compounded by years of overwork. Since 1952, he had experienced dizziness and vertigo, tinnitus, a sensation of riding in a boat or car, restless sleep, and frequent dreaming. Sometimes he suffered from chest tightness, phlegm stagnation, nausea, and poor appetite. For over ten years, his blood pressure fluctuated around 180/110 mmHg. Diagnosed with Meniere's Syndrome by Western medicine, he took Western drugs and Chinese tonic preparations without improvement, eventually stopping work. He specially requested my consultation.
Examination showed a thin white, slightly greasy tongue coating; the pulse was soggy and slippery on the right, and wiry and fine on the left. I stated that this belonged to over-fatigue causing unrest of the Heart Spirit, combined with damp-phlegm stagnation damaging Spleen transportation, leading to failure of Liver Clear Yang to ascend, resulting in vertigo. The therapeutic principle should be mild leaching to promote diuresis, resolving phlegm and regulating Qi, ascending Clear and descending Turbid, and strengthening the Spleen to calm the Heart. Prescription:
Banxia Preparata (Pinelliae Rhizoma Praeparatum) 9g, Tianmae Rhizoma (Gastrodiae Rhizoma) 9g, Baizhu Biao (Rhizoma Atractylodis Macrocephalae, bleached) 9g, Fuling Bai (Poria) 15g, Juhong Preparata (Citri Reticulatae Pericarpium Rubrum) 6g, Zaoren Huai (Semen Ziziphi Spinosae) 15g, Yuanzhi Zhi (Radix Polygalae Preparata) 6g, Shichangpu (Rhizoma Acori Tatarinowii) 3g, Zhike Chao (Fructus Aurantii Immaturus, stir-fried) 6g, Gancao Sheng (Radix Glycyrrhizae Preparata) 3g, Yiren Chao (Semen Coicis, stir-fried) 15g, Shumi Jing (Semen Setariae Italicae) 15g, Heye Ding (Apex Nelumbinis) 2 pieces.
Second visit: After five doses of the above prescription, sleep at night improved, and blood pressure dropped slightly. However, dizziness and vertigo persisted, along with tinnitus and sore waist. Sputum production increased, while bowel movements and urination remained normal. Appetite increased, and chest tightness decreased. The left pulse was slightly wiry; the right remained soggy and slippery. This indicated the Spleen was constrained by dampness, phlegm stagnation was not cleared, regulation of ascending Clear and descending Turbid was dysfunctional, and Liver and Kidney were deficient. He was advised to strictly avoid rich, sweet, fishy, and greasy foods that generate dampness and phlegm. The original prescription was continued with modifications:
Banxia Preparata (Pinelliae Rhizoma Praeparatum) 9g, Tianmae Rhizoma (Gastrodiae Rhizoma) 9g, Baizhu Biao (Rhizoma Atractylodis Macrocephalae, bleached) 9g, Fushen Bai (Poria with Hostwood) 15g, Juhong Preparata (Citri Reticulatae Pericarpium Rubrum) 6g, Xingguang (Semen Armeniacae Amarum) 9g, Yiren Chao (Semen Coicis, stir-fried) 12g, Duzhong Sheng (Cortex Eucommiae) 12g, Lianzi Jian (Semen Nelumbinis) 15g, Gancao Sheng (Radix Glycyrrhizae Preparata) 3g, Jieming Shijue (Concha Haliotidis) 9g, Heye Ding (Apex Nelumbinis) 3 pieces.
Third visit: After continuously taking fifteen doses of the above prescription, all symptoms significantly alleviated, and blood pressure dropped to 150/80 mmHg. The patient could work appropriately, walk independently, eat more, and had normal bowel and urinary functions. The pulse became moderate and smooth; the tongue was pale with a moist coating, but spirit was still weak. The syndrome indicated gradual resolution of damp-phlegm, gradual recovery of Heart and Spleen functions, separation of Clear and Turbid, but insufficiency of Liver and Kidney. The original prescription could be used with slight additions of herbs to nourish and secure the Spleen for follow-up regulation. Prescription:
Shouwu Zhi (Radix Polygoni Multiflori Preparata) 15g, Baizhu Biao (Rhizoma Atractylodis Macrocephalae, bleached) 12g, Fushen Bai (Poria with Hostwood) 15g, Tianmae Rhizoma (Gastrodiae Rhizoma) 9g, Banxia Preparata (Pinelliae Rhizoma Praeparatum) 9g, Juhong Preparata (Citri Reticulatae Pericarpium Rubrum) 6g, Dou Hei Xiao (Phaseoli Vulgaris Var. Nigricans) 15g, Shajili 12g, Gancao Sheng (Radix Glycyrrhizae Preparata) 3g, Yiren Chao (Semen Coicis, stir-fried) 12g, Heye Ding (Apex Nelumbinis) 3 pieces.
[Commentary] Vertigo caused by Spleen deficiency and damp-phlegm stagnation is common clinically. In the early stages, differentiation is often inaccurate, leading to the use of cloying tonics, strengthening agents, pungent-drying herbs, cold-cooling herbs, or even purgatives, none of which yield results and instead prolong the disease. It is essential to pay attention to the characteristics of the etiology and pathology. This case first employed mild leaching to promote diuresis, resolving phlegm and regulating Qi, ascending Clear and descending Turbid to treat the branch, while simultaneously strengthening the Spleen and calming the Heart, and regulating the Liver and Kidney in the formula. Subsequently, tonification was administered to secure the root. This method is worthy of reference.
Diarrhea Due to Cold-Dampness
Foreign guest, male, 45 years old. First visit in June 1965. Self-reported: Abdominal pain and diarrhea for over a month, occurring three to four times daily. Pain is followed by the urge to defecate, which is unsatisfactory. Stool color is yellow, consistency is loose. Laboratory tests were normal. Appetite gradually decreased, taste was bland, food lacked flavor, and postprandial chest and abdominal fullness occurred. Sleep was poor, accompanied by sore back, tinnitus, spontaneous sweating, lower limb edema, and oliguria. Western medicine provided temporary improvement, but symptoms recurred upon discontinuation. Examination revealed a pale tongue body with a white, greasy coating; the pulse was deep, fine, and slow. This resulted from damage to Spleen and Stomach Yang, insufficiency of Kidney and Mingmen Fire, failure of warming and transportation, and floating/blocking of cold-damp water pathogens, leading to various symptoms including diarrhea, edema, and fullness. Diagnosis: Spleen-Kidney Yang Deficiency, Cold-Damp Diarrhea. Treatment should warm the Kidney, strengthen the Spleen, dry dampness, and assist with separating pure from turbid. Prescription:
Wuyu Zhi (Fructus Evodiae Preparatus) 2.4g, Gutanzhi Hei (Lithargyri Preparatum) 9g, Roukou Shuang (Semen Myristicae, de-oiled) 6g, Cangzhu Chao (Rhizoma Atractylodis Lanceae, stir-fried) 9g, Banxia Preparata (Pinelliae Rhizoma Praeparatum) 9g, Chenpi Guang (Pericarpium Citri Reticulatae) 6g, Sharen Xi (Fructus Amomi Rotundus) 9g (added just before serving), Fuling Bai (Poria) 15g, Zhuling Mu (Polyporus) 9g, Yiren Chao (Semen Coicis, stir-fried) 12g, Laomi Chao (Oryza Sativa, stir-fried) 12g, Shengjiang (Zingiberis Rhizoma Recens) 2 slices (charred), Dazao (Fructus Jujubae) 5 pieces.
After three doses of the above prescription, bowel movements occurred once daily and formed normally. Edema, tinnitus, spontaneous sweating, fullness, and bland taste greatly decreased. Spirit improved, and appetite increased. The pulse was slow and forceful; the greasy coating gradually receded. The prescription was effective, and the patient was very gratified. He was instructed to continue taking the original prescription for three more doses for follow-up regulation.
[Commentary] Damp pathogens and Yin turbidity easily damage Yang. The *Jinjian* states: "If the Mingmen lacks fire, it cannot rot and cook food and drink for the Middle Palace; if Kidney Qi is insecure, who will manage its closing and storing functions?"
In this case, cold-dampness has lingered for a long time without transforming, and Spleen-Kidney Yang is already injured. Therefore, Wu Yu, Gutanzhi, and Roukou are used for their acrid-warm properties to warm the Liver, Spleen, and Kidney to treat Yin pathogens. Er Ling (Polyporus and Poria), Er Chen (Pinellia and Citrus), Baizhu, Ginger, Jujube, Sharen, and Lao Mi are used to dry dampness and promote leaching, separating pure from turbid. The prescription matches the syndrome, and diarrhea stops quickly.