朱(左) 肾气不足,暮夜溲多,脾胃气虚,纳少胃钝。脉濡,苔白少华。宜补气益肾。
台参须(一钱) 炒于术(二钱) 煨益智仁(八分) 菟丝子(盐水炒三钱) 白茯苓(三钱) 炒山药(三钱)
土炒广皮(一钱) 潼沙苑(盐水炒三钱) 生熟米仁(各二钱) 玫瑰花(二朵)
邱(左) 小溲频数而不作痛。脉滑,苔黄质腻。此痰湿有余,膀胱之气,为湿所压。证已年余,驾轻走熟,恐
难一蹴而几。
川萆 益智仁(盐水炒) 赤白苓 广皮 猪苓 石菖蒲(盐水炒) 制半夏 白蒺藜 泽泻 天麻 大淡菜
某 大便仅下坚黑一粒,小便多而不爽,是名频数。皆由湿热蕴阻。宜用分利。
木猪苓 蓄 制半夏 木通 泽泻 生米仁 广皮 甘草梢 滋肾通关丸
庄(左) 命门相火,为生身之本,真阳亏损则火衰,湿痰郁遏,火不用事,则火亦衰。脉滑而大。痰多阳痿,
火之式微,湿之有余也。取舍之间,自有明辨。
冬术炭(二钱) 制半夏(一钱五分) 生米仁(四钱) 炒蒌皮(三钱) 广皮(一钱) 泽泻(一钱五分)
赤白苓(各二钱) 川萆 (二钱) 杏仁泥(三钱) 姜汁炒竹茹(一钱)
二诊 流化湿邪,相火得展,而腹笥膨满。还是湿郁气滞。再调气泄湿。
冬术炭 大腹皮 生薏仁 枳实炭 制香附 赤猪苓 泽泻 广皮 木香 砂仁 焦麦芽
左 体丰多湿,加以大病之后,余蕴未清,以致湿邪流行入络,髀关及左腿膝作酸,麻木不仁,艰于步
履,腰背作痛,卧着尤甚。湿邪久困,则相火为之郁遏,阳道不举。脉象濡滑,苔白微黄,质腻。皆由络隧之
中,为湿所阻,则无形之气,有形之血,不能宣畅流布。而历来所服之药,皆是补滞之品,未免为敌树帜,
名曰中湿,非久药不为功。
川萆 (三钱) 汉防己(一钱五分酒炒) 左秦艽(一钱五分) 上广皮(一钱) 制半夏(二钱) 威灵仙(一
钱五分酒炒) 焦苍术(一钱五分) 川桂枝(五分) 生米仁(五钱) 川独活(一钱五分) 泽泻(一钱五分)
桑枝(酒炒一两五钱煎汤代水)
二诊 祛湿和络,脉象稍觉流畅,相火有燃动之机,足见湿邪抑遏,虽有真阳,无从发露。药既应手,再扩充以进。
焦苍术(一钱五分) 川萆 (二钱) 汉防己(一钱五分酒炒) 威灵仙(一钱五分) 赤白苓(各二钱) 制
半夏(二钱) 泽泻(一钱五分) 独活(一钱) 木猪苓(二钱) 新会皮(一钱) 川桂枝(五分) 白僵蚕(一
钱五分) 生薏仁(四钱) 红花(三分酒炒)
潘(左) 前年二次眩晕,几至发厥。兹则腿股作酸,阳道痿顿。脉形濡滑,舌苔白腻。湿酸郁遏,致命火不
能用事。欲助命阳,当先去其遏我命阳者。
姜半夏 猪赤白苓 广皮 炒枳实 制南星 生熟薏仁 泽泻 炒竹茹
朱(左)肾气不足,夜间小便次数增多;脾胃气虚,食欲减退且胃脘部感觉迟钝。脉象濡软,舌苔白而缺乏光泽。宜采用补气益肾的方法治疗。
党参须(一钱) 炒白术(二钱) 煨益智仁(八分) 菟丝子(盐水炒三钱) 白茯苓(三钱) 炒山药(三钱)
土炒陈皮(一钱) 潼蒺藜(盐水炒三钱) 生薏苡仁和熟薏苡仁(各二钱) 玫瑰花(两朵)
邱(左)小便频数但无疼痛感。脉象滑利,舌苔黄且质地腻浊。此为痰湿有余,膀胱之气机被湿气所压制。病程已有一年多,病情已成惯性,恐怕难以一下子见效。
川萆薢 益智仁(盐水炒) 赤茯苓和白茯苓 陈皮 猪苓 石菖蒲(盐水炒) 制半夏 白蒺藜 泽泻 天麻 淡菜
某患者大便仅排出一粒坚硬黑色的粪便,小便多但不通畅,这称为尿频。皆由湿热蕴结阻滞所致。宜采用分消利湿的方法治疗。
木猪苓 蓄草 制半夏 木通 泽泻 生薏苡仁 陈皮 甘草梢 滋肾通关丸
庄(左)命门相火是生命的根本,真阳亏损则火势衰微,若湿痰郁结遏制,相火不能发挥作用,则火势也会衰微。脉象滑而大。痰多导致阳痿,这是阳气式微、湿气有余的表现。在取舍之间,自有明确的辨别。
冬术炭(二钱) 制半夏(一钱五分) 生薏苡仁(四钱) 炒瓜蒌皮(三钱) 陈皮(一钱) 泽泻(一钱五分)
赤茯苓和白茯苓(各二钱) 川萆薢(二钱) 杏仁泥(三钱) 姜汁炒竹茹(一钱)
二诊 流化湿邪后,相火得以舒展,但腹部依然胀满。仍是湿郁气滞所致。再调理气机以泄除湿邪。
冬术炭 大腹皮 生薏苡仁 枳实炭 制香附 赤茯苓和猪苓 泽泻 陈皮 木香 砂仁 焦麦芽
左姓患者体型丰腴多湿,加之大病之后,余留的病邪未清,导致湿邪流行进入络脉,髀关穴及左腿膝盖感到酸楚,麻木不仁,行走困难,腰背部疼痛,躺下时尤为严重。湿邪久困体内,则相火被郁结遏制,导致阳道不举。脉象濡滑,舌苔白微黄,质地腻浊。皆因络脉隧道之中被湿气阻塞,导致无形之气和有形之血不能宣畅流布。而历来所服用的药物,都是补益且滋腻碍胃之品,未免成为敌人的旗帜(指助长病邪),名为中湿证,非长期用药不能奏效。
川萆薢(三钱) 汉防己(一钱五分酒炒) 左秦艽(一钱五分) 上广陈皮(一钱) 制半夏(二钱) 威灵仙(一钱五分酒炒) 焦苍术(一钱五分) 川桂枝(五分) 生薏苡仁(五钱) 川独活(一钱五分) 泽泻(一钱五分)
桑枝(酒炒一两五钱煎汤代水)
二诊 祛湿和络后,脉象稍觉流畅,相火有燃动之机,足见湿邪抑制遏制了阳气,虽有真阳,也无从显露。药既有效,再扩充方剂继续进服。
焦苍术(一钱五分) 川萆薢(二钱) 汉防己(一钱五分酒炒) 威灵仙(一钱五分) 赤茯苓和白茯苓(各二钱) 制半夏(二钱) 泽泻(一钱五分) 独活(一钱) 木猪苓(二钱) 新会陈皮(一钱) 川桂枝(五分) 白僵蚕(一钱五分) 生薏苡仁(四钱) 红花(三分酒炒)
潘(左)前年曾两次眩晕,几乎昏厥。现在大腿股部酸楚,阳道痿顿。脉象濡滑,舌苔白腻。湿邪郁结遏制,致使命门之火不能发挥作用。想要补助命门之阳,应当先去除那些遏制我命门之阳的因素。
姜半夏 猪苓、赤茯苓和白茯苓 陈皮 炒枳实 制南星 生熟薏苡仁 泽泻 炒竹茹
Zhu (Left) Insufficiency of Kidney Qi (Kidney Qi Deficiency), frequent urination at night; Spleen and Stomach Qi deficiency, poor appetite and dull sensation in the stomach. The pulse is soft (Ru), and the tongue coating is white with lusterlessness. It is appropriate to tonify Qi and benefit the Kidney.
Ginseng Radicula (Shen Xu) - 1 qian; Stir-fried Atractylodis Rhizoma (Yu Zhu) - 2 qian; Calcined Alpiniae Oxyphyllae Fructus (Yi Zhi Ren) - 8 fen; Cuscutae Semen (Tu Si Zi) stir-fried in salt water - 3 qian; Poria (Fu Ling) - 3 qian; Dioscoreae Rhizoma (Shan Yao) stir-fried - 3 qian;
Atractylodis Rhizoma stir-fried in earth (Guang Pi/Chen Pi processed with soil) - 1 qian; Astragali Semen (Tong Sha Yuan) stir-fried in salt water - 3 qian; Coix Seed (Sheng Mi Yi Ren) and roasted Coix Seed (Shu Mi Yi Ren) - 2 qian each; Rosa Rugosa (Mei Gui Hua) - 2 flowers.
Qiu (Left) Frequent urination without pain. The pulse is slippery (Hua), and the tongue coating is yellow and greasy. This indicates excess phlegm-dampness, where the Qi of the Bladder is suppressed by dampness. The condition has persisted for over a year, becoming habitual, so it is feared that quick results are unlikely.
Dioscoreae Hypoglaucae Rhizoma (Chuan Bi Xie); Alpiniae Oxyphyllae Fructus (Yi Zhi Ren) stir-fried in salt water; Red and White Poria (Chi Bai Ling); Citri Reticulatae Pericarpium (Guang Pi); Polyporus (Zhu Ling); Acori Tatarinowii Rhizoma (Shi Chang Pu) stir-fried in salt water; Pinelliae Rhizoma Preparatum (Zhi Ban Xia); Tribuli Fructus (Bai Ji Li); Alismatis Rhizoma (Ze Xie); Gastrodiae Rhizoma (Tian Ma); Mytilus Edulis (Da Dan Cai).
Certain Patient: Only one hard, black stool passed; frequent but unsatisfactory urination, termed frequency. All caused by accumulation and obstruction of Damp-Heat. It is appropriate to use separation and drainage methods.
Polyporus (Mu Zhu Ling); Polygoni Avicularis Herba (Xu Zhong); Pinelliae Rhizoma Preparatum (Zhi Ban Xia); Akebiae Caulis (Mu Tong); Alismatis Rhizoma (Ze Xie); Coix Seed (Sheng Mi Yi Ren); Citri Reticulatae Pericarpium (Guang Pi); Glycyrrhizae Radix et Rhizoma tip (Gan Cao Shao); Zishen Tongguan Wan.
Zhuang (Left): Mingmen Ministerial Fire (Mingmen Xiang Huo) is the root of life. Loss of True Yang leads to weak fire. If Damp-Phlegm stagnates and suppresses, and Ministerial Fire cannot function, then the fire also becomes weak. The pulse is slippery and large. Excess phlegm leads to impotence; this is a decline of Fire and excess of Dampness. Between selection and rejection, there is clear discernment.
Winter Atractylodis Rhizoma Charred (Dong Zhu Tan) - 2 qian; Pinelliae Rhizoma Preparatum (Zhi Ban Xia) - 1.5 qian; Coix Seed (Sheng Mi Yi Ren) - 4 qian; Trichosanthis Pericarpium (Lou Pi) stir-fried - 3 qian; Citri Reticulatae Pericarpium (Guang Pi) - 1 qian; Alismatis Rhizoma (Ze Xie) - 1.5 qian;
Red and White Poria (Chi Bai Ling) - 2 qian each; Dioscoreae Hypoglaucae Rhizoma (Chuan Bi Xie) - 2 qian; Armeniacae Semen Amarum Paste (Xing Ren Ni) - 3 qian; Bambusae Folium (Zhu Ru) stir-fried with ginger juice - 1 qian.
Second Visit: After draining and transforming Dampness, Ministerial Fire expands, yet abdominal distension persists. This remains Damp-stagnation and Qi-stasis. Regulate Qi again to drain Dampness.
Winter Atractylodis Rhizoma Charred (Dong Zhu Tan); Arecae Pericarpium (Da Fu Pi); Coix Seed (Sheng Yi Ren); Ziziphus Fructus Charred (Zhi Shi Tan); Cyperi Rhizoma Preparatum (Zhi Xiang Fu); Red and Brown Polyporus (Chi Zhu Ling); Alismatis Rhizoma (Ze Xie); Citri Reticulatae Pericarpium (Guang Pi); Aucklandiae Radix (Mu Xiang); Amomi Fructus (Sha Ren); Scorched Malto (Jiao Mai Ya).
Patient Zuo: The constitution is robust with much Dampness. Added to this, after a severe illness, residual pathogens remain unclear, causing Dampness to flow into the collaterals. The Bituan acupoint and left knee/thigh feel sour, numb and insensible, making walking difficult. Lower back and waist ache, especially when lying down. Long-standing Dampness suppresses Ministerial Fire, leading to non-elevation of the Yang pathway. The pulse is soft and slippery, tongue coating white slightly yellow, texture greasy. All due to obstruction in the collaterals and tunnels, preventing the smooth circulation of formless Qi and formed Blood. The medicines taken previously were all tonifying and cloying, inadvertently supporting the pathogen. Named as "Zhong Shi" (Dampness Invasion), it requires long-term medication to achieve efficacy.
Dioscoreae Hypoglaucae Rhizoma (Chuan Bi Xie) - 3 qian; Stephaniae Tetrandrae Radix (Han Fang Ji) stir-fried in wine - 1.5 qian; Gentianae Macrophyllae Radix (Zuo Qin Jiao) - 1.5 qian; Top Citri Reticulatae Pericarpium (Shang Guang Pi) - 1 qian; Pinelliae Rhizoma Preparatum (Zhi Ban Xia) - 2 qian; Syneilesidis Rhizoma (Wei Ling Xian) stir-fried in wine - 1.5 qian; Atractylodis Rhizoma Scorched (Jiao Cang Zhu) - 1.5 qian; Cinnamomi Ramulus (Chuan Gui Zhi) - 0.5 qian; Coix Seed (Sheng Mi Yi Ren) - 5 qian; Angelicae Pubescentis Radix (Chuan Du Huo) - 1.5 qian; Alismatis Rhizoma (Ze Xie) - 1.5 qian;
Branches of Morus Alba Sang (Sang Zhi) stir-fried in wine, 1.5 liang decocted to replace water.
Second Visit: After dispelling Dampness and harmonizing collaterals, the pulse feels slightly smoother, and Ministerial Fire shows signs of ignition. This confirms that Dampness was suppressing the Fire; although True Yang exists, it could not manifest. Since the medicine is effective, expand the prescription to continue treatment.
Scorched Atractylodis Rhizoma (Jiao Cang Zhu) - 1.5 qian; Dioscoreae Hypoglaucae Rhizoma (Chuan Bi Xie) - 2 qian; Stephaniae Tetrandrae Radix (Han Fang Ji) stir-fried in wine - 1.5 qian; Syneilesidis Rhizoma (Wei Ling Xian) - 1.5 qian; Red and White Poria (Chi Bai Ling) - 2 qian each; Pinelliae Rhizoma Preparatum (Zhi Ban Xia) - 2 qian; Alismatis Rhizoma (Ze Xie) - 1.5 qian; Angelicae Pubescentis Radix (Du Huo) - 1 qian; Polyporus (Mu Zhu Ling) - 2 qian; Xin Hui Citri Reticulatae Pericarpium (Xin Hui Pi) - 1 qian; Cinnamomi Ramulus (Chuan Gui Zhi) - 0.5 qian; Bombyx Batryticatus (Bai Jiang Can) - 1.5 qian; Coix Seed (Sheng Yi Ren) - 4 qian; Carthami Flos (Hong Hua) stir-fried in wine - 0.3 qian.
Pan (Left): Two years ago, experienced dizziness twice, nearly fainting. Now, thigh and leg soreness, and impotence. The pulse is soft and slippery, tongue coating white and greasy. Dampness stagnation suppresses, preventing Mingmen Fire from functioning. To assist Mingyang, one must first remove what suppresses Mingyang.
Ginger-processed Pinellia (Jiang Ban Xia); Polyporus, Red Poria, and White Poria (Zhu Chi Bai Ling); Citri Reticulatae Pericarpium (Guang Pi); Stir-fried Aurantii Fructus (Chao Zhi Shi); Prepared Arisaematis Rhizoma (Zhi Nan Xing); Raw and Cooked Coix Seed (Sheng Shu Yi Ren); Alismatis Rhizoma (Ze Xie); Stir-fried Bambusae Folium (Chao Zhu Ru).