康（右） 木郁生火，肝火散越。内热日久不退，咽中热冲，头目昏晕。脉弦大而数，舌红无苔，满布裂纹。肝
火灼烁，阴津日耗，水源有必尽之势。草木无情，恐难回情志之病。拟黄连阿胶汤以救厥少二阴之阴，
而泻厥少二阴之火。
清阿胶（溶化冲二钱） 川连（五分鸡子黄拌炒） 生白芍（三钱） 地骨皮（二钱） 大生地（五钱） 丹皮（
二钱） 女贞子（三钱酒蒸） 川石斛（四钱） 萱花（三钱）
二诊 内热稍轻，而咽喉胸膈仍觉干燥难忍。舌红无苔，裂纹满布。心火劫烁，阴津消耗。惟有涵育阴
津为抵御之计。
大生地（四钱） 阿胶（三钱） 煨石膏（三钱） 石决明（五钱） 黑豆衣（三钱） 大麦冬（三钱）
花粉（二钱） 炒知母（二钱） 双钩钩（三钱）
三诊 内热大减，而仍头目昏晕，舌燥咽干。气火内烁，阴津消耗。再和阴泄热。
大生地（五钱） 生甘草（五分） 粉丹皮（二钱） 阿胶（三钱） 大麦冬（三钱） 生白芍（三钱）
地骨皮（二钱） 钩钩（三钱） 石决明（五钱） 川雅连（三分鸡子黄拌炒）
四诊 咽喉胸膈燥痛稍减，神情稍振。然仍口渴无津。厥少二阴之火。劫烁胃阴。再救阴泄热。
西洋参（二钱） 青盐半夏（一钱五分） 生甘草（五分） 花粉（二钱） 大麦冬（三钱） 煨石膏
（五钱） 黑豆衣（三钱） 池菊（一钱五分） 川石斛（四钱） 女贞子（三钱酒蒸）
五诊 咽喉胸膈燥痛大减。然耳窍闭塞，眼目昏花，大便不行。少阳郁勃之火，上升不靖。甘养之中。再参清泄。
西洋参（一钱五分） 花粉（二钱） 丹皮（二钱） 黑山栀（三钱） 黑豆衣（三钱） 大麦冬（三钱）
桑叶（一钱五分） 池菊（二钱） 更衣丸（一钱开水先送下）
六诊 胸膈燥痛降序。目昏耳闭，还是郁勃之升。再泄少阳而和胃阴。
西洋参 麦冬 黑山栀 黑豆衣 桑叶 南花粉 淡芩 川石斛 池菊花 丹皮
七诊 肝木偏亢，上升则为风为火，下行则为郁为气，所以舌红俱淡，燥渴俱减，而胀满气逆也。疏其
有余之气，养其不足之阴。
金铃子（二钱） 沉香（二分乳汁磨冲） 白芍（三钱） 川石斛（三钱） 大天冬（三钱） 香附（蜜水炒二钱）
干橘叶（一钱五分） 煨磁石（三钱） 阿胶珠（二钱）
胡（右） 诸恙较前稍轻，而阳气化风，鼓动不熄，唇口蠕动，即颊车牵掣，舌强难言。左脉弦大，右脉濡细。
夫脾胃开窍于口，唇为脾之华，阳明之脉，环口而交于人中。今肝风所犯部位，皆脾胃两经所辖之区。
经云、邪之所凑，其气必虚。苟非脾胃气虚，何致肝阳浊趋其地。拟归芍六君，以补脾胃而御肝木，仍参
介类以滋水潜阳。
吉林参（一钱） 白茯苓（三钱） 朱茯神（三钱） 杭白芍（三钱） 阿胶珠（二钱） 白归身（一钱五分）
生于术（二钱） 炒枣仁（二钱） 生鳖甲（五钱） 生牡蛎（八钱） 龙齿（三钱） 上濂珠（三分）
上西黄（三厘二味研细分两次蜜水调服）
钟（左） 少腹居中为冲脉，两旁属肝。少腹胀满，按之坚硬，大便旬日方得一解，坚燥异常。每至午后，先
厥后热，气从上冲，冲则痰涎上涌，头痛苦厥，刻许方苏。脉细弦而数，舌红苔白少津，寐醒则口燥咽干。
此由气质薄弱，水不涵木，冲气从而上逆，气火升动，则液炼成痰，所以痰升苦厥。恐螈 发痉。拟养肝
之阴，柔肝之体，以平冲气。
生鳖甲（六钱） 杭白芍（三钱） 火麻仁（二钱） 粉丹皮（二钱） 白归身（二钱） 阿胶珠（二钱）
甘杞子（三钱） 大元参（三钱） 金铃子（一钱五分） 更衣丸（三钱先服）
二诊 大便通行，然冲气时仍上逆，气冲则中脘聚形，恶心痰涌，头痛发厥，厥则肢强不语，心中仍然
明事，良久方苏，腹中烙热，饮食不思。脉形弦数，苔黄质红。冲气逆上，皆化为火，气火上升，煎熬津液，悉
化为痰，所谓痰即有形之火也。拟直清气火，以望厥定胃开，再商调理。
川连（六分吴萸一分同炒） 生芍（一钱五分） 玳瑁片（三钱） 川楝子（三钱） 淡芩（一钱五分） 丹皮
（二钱） 大元参（三钱） 栝蒌皮（五钱） 蛤粉（三钱） 川贝（二钱） 水炒竹茹（一钱五分） 陈关蛰（一
两） 濂珠（三分） 青黛（一分） 川贝母（三分） 真金箔（一张四味研末另服）
贾（左） 气喘不止，厥气尽从上逆，无形之火亦随之而上，火冲之时，懊 欲去衣被。金无制木之权。姑
清金平木。
栝蒌霜（四钱） 杏仁泥（三钱） 川贝母（二钱） 郁金（一钱五分） 海浮石（三钱） 风化硝（七分）
黑山栀（二钱） 蛤粉（四钱） 粉丹皮（一钱四分） 竹茹（盐水炒一钱） 枇杷叶（六片）
二诊 大便未行，灼热依然不退，寅卯之交，体作振痉，而脉并不数。无非肝胆之火内炽，不得不暂排其势。
杏仁泥（三钱） 羚羊片（一钱五分） 郁金（一钱五分） 丹皮（二钱） 竹茹（一钱） 栝蒌仁
（五钱） 法半夏（一钱五分） 川贝母（二钱） 青黛（五分包）
三诊 火热之势稍平，略近衣被，不至如昨之发躁，咽喉气结稍舒。的属痰滞阻气，气郁生火。再展气
化而清熄肝胆。
栝蒌霜 夏枯草 羚羊片 郁金 川贝 橘红 鲜菊叶 松罗茶 黑山栀 杏仁 枳实
四诊 火热渐平，然两胁胀满气逆，甚至发厥。良由气郁化火内炽，火既得熄，仍还于气。再平肺肝之
逆而开郁化痰。
郁金 杏仁 竹茹 山栀 丹皮 蒺藜 橘红 枳壳 枇杷叶 皂荚子（一钱五分重蜜涂炙研末每服分许蜜水调）
五诊 中脘不舒，两胁下胀满，妨碍饮食，不能馨进，气逆不平。脉象沉弦。此肝藏之气，挟痰阻胃，胃气
不降，则肺气不能独向下行，所以气逆而如喘也。
整砂仁 广皮 杏仁 旋复花 制半夏 炒枳壳 香附 苏子 徭桂（二分研末饭丸）
六诊 中脘渐松，两胁胀满亦减，气逆火升略定。的是寒痰蔽阻，胃气欲降不得，肺气欲降无由，一遇
辛温，阴霾渐扫，所以诸恙起色也。再从前法进步。
桂枝 制半夏 瓦楞子 茯苓 薤白头 枳实 广玉金 栝蒌仁 橘皮 干姜
蒋（右） 肝火痰热未平，开合失度，又作寒热，热则阳气挟痰，浮游上扰，神明为之不治。清化痰热，参以
熄肝，自当徐愈也。
郁金（一钱五分） 陈胆星（四分） 黑山栀（二钱） 西血珀（五分蜜水先调服） 炒远志（五分） 天竺
黄（三钱） 丹皮（一钱） 桑叶（一钱） 九节石菖蒲（五分）
左 病后自汗，咽中牵腻，有时火从上升，则肌肤灼热。脉数软滑。此由甲木与戊土不降，而乙木独升。
恐损久不复。
制半夏（一钱五分） 广皮（一钱五分） 地骨皮（三钱桂枝四分煎汁收入） 栝蒌皮（一钱五分） 蛤粉（三
钱包） 竹茹（一钱五分姜汁炒） 茯苓（四钱） 建泽泻（一钱五分） 枇杷叶（四分去毛） 淮小麦（一两煎
汤代水）
费统帅 肾虚则生火，木燥则生风，水亏木旺，肝风鸱张，风乃阳化，故主上旋。阳明胃土，适当其冲，所
以中脘不时作痛。木侮不已，胃土日虚，而风阳震撼，所以左乳下虚里穴动跃不平。肝风上旋至巅，所
以头昏目重，一身如坐舟中。肝为藏血之海，肝脏既病，则荣血不和，遍体肌肤作麻。吾人脏腑阴阳，一
升必配一降。肝、脏也，本主左升。胆腑也，本主右降。升者太过，则化火化风，降者太过，则生沦陷诸疾，必
得升降控制，而后可以和平。今肝升太过，则胆降不及，胆木漂拔，所以决断无权，多疑妄恐，面色并不
虚浮，而自觉面肿，阳气壅重于上故也。舌苔白腻，冷气从咽中出，以肝胆内寄相火，阳气升腾，龙相上
逆，寒湿阴气，随风泛动。倘实以寒湿盛极，而致咽中冷气直冲，断无能食如平人之理。丹溪谓上升之
气，自肝而出，中挟相火。夫邪火不能杀谷，而胃虚必求助于食，可知胃虚乃胃之阴液空虚，非胃之气
虚也。脉象细弦而带微数，亦属阴虚阳亢之征，为今之计，惟有静药以滋水养肝，甘以补中，重以镇摄。
阳气得潜，则阴气自收，盗汗亦自止也。特内因之症，不能急切图功耳。
玄武板（六钱炙） 龙骨（三钱） 块辰砂（三钱） 大生地（四钱） 生牡蛎（六钱） 白芍（二钱）
天冬（二钱） 茯神（三钱） 生熟草（各三分） 洋青铅（六钱） 淮小麦（六钱） 南枣（四枚）
赵（左） 命火向来不足，火不生土，土弱生痰，原属痰饮之类，虽有咳嗽，亦无足异。乃于去夏偶感风邪，
邪与痰合，咳愈不止。猝受惊恐，震动胆木，胆为肝之外府，附于肝叶之内，此响彼应，肝火上犯，致咳剧
而吐秽痰。斯时当作痰治，导肝火湿热下行。乃漫进参 壅补，肝火痰热，阻肺不出，如油入面，莫之能
泄。咳热痰秽，经年以来，日就沉困，脐上有形动跃。夫脐上为太阴脾土部位，此时肺金久损，金水无由
相生，炎上之火日炽，似非壮水滋其化源，不足以制其燎原之势。然水邪干犯土位，脐上如此悸动，稠
腻之药，势难尝试。脉右寸小涩，关部带滑，尺部细沉，而左寸关俱弦，尺部微弱。病属肝火挟痰蒸肺，蔓
延而至气阴皆虚，滋肾益肺，则碍于脾土，理湿化痰，则碍于肝木。勉拟益水之上源，而兼泄热化痰。请正。
南北沙参 炒麦冬 海蛤粉 炒蒌皮 冬瓜子 海浮石 云茯苓 鲜竹茹 枇杷叶 肺露
陈子岩 向有肝阳，时发时止。兹则少腹胀硬，大腹胀满，中脘胀痛，势不可忍，恶心泛呕，其味甚酸，心
胸杂，大便不行。脉象细弦而数，苔黄质腻。骨热皮寒，气逆短促。少腹居中为冲脉。两旁属肝。考冲脉
部位，起于气街，夹脐上行，至胸中而散，足见下则少腹，上则胸脘，皆冲脉所辖之区。今冲气逆行，冲阳
逆上，胃为中枢，适受其侮，所以为痛为 杂为恶心，诸恙俱作矣。胆为肝之外府，为阴阳开合之枢纽，
肝病则少阳甲木开合失常，为寒为热，似与外感不同。所虑者气冲不已，致肾气亦动，转成奔豚之候。
兹议两和肝胃，参以镇逆。方备商裁。
川雅连（五分） 淡干姜（四分） 川桂枝（四分） 制半夏（二钱） 代赭石（四钱） 旋复花（二钱）
金铃子（二钱） 延胡索（一钱五分） 陈皮（一钱） 土炒白芍（一钱五分） 姜汁炒竹茹（一钱）
二诊 两和肝胃，参以镇逆，中脘胀痛已止，恶心 杂吞酸亦定。然大便未行，痰气欲降无由，遂致气
窜入络，两季胁异常作痛，牵引腰膂背肋，不能转侧。更加烟体失瘾，气不营运，其势益甚，竟至发厥。幸
吐出稠痰数口，方得稍定。脉象细弦，重按带滑。络气痹阻，恐其复厥。勉与荫棠先生同议逐痰通府宣
络。非敢率尔，实逼处此也。方备商裁。
薤白头（三钱） 栝蒌仁（三钱） 竹沥半夏（一钱五分） 旋复花（二钱） 猩绛（六分） 橘皮络（各
一钱） 冬瓜子（三钱） 茯苓（三钱） 青葱管（三茎） 控涎丹（五分橘络汤先送下）
三诊 投剂后季胁腰膂痛止，大便一次甚畅，日前之所谓痛胀阻隔，快然若失，不可不为转机。惟气
时上逆，甚至如喘，胸闷酸涎上泛，头昏眩晕，虽频频吐痰。自觉欲出未出者尚多。脉象弦滑而数，重按
少力。络气之滞，虽得宣通，而木火不平，与浊痰相合，蒸腾于上，消烁阴津，所以舌苔黄 干毛，恐起糜
腐。拟清泄木火，化痰救津。留候荫棠兄裁夺。
黑山栀（三钱） 炒黄川贝（二钱） 光杏仁（去尖三钱） 大麦冬（三钱） 栝蒌皮（三钱） 海蛤粉（三钱）
霍石斛（四钱） 鲜竹茹（二钱） 鲜枇杷叶（一两） 左金丸（八分包煎） 白金丸（五分先吞服）
四诊 清泄木火，化痰救津，颇能安寐。舌苔边尖较化，干毛转润，脉数较缓，神情略为振卓，但时带呛
咳，咳则气从上升。两季胁吊痛，略闻食臭，辄增 杂头晕。丹溪云、上升之气，自肝而出。经云、诸逆冲上，
皆属于火。良由厥气纵横之余，余威尚盛遂至气化为火，逆犯肺金，消烁津液，其水源之不能涵养肝
木，略见一斑。若肝胆之火，挟龙雷上逆，便是喘汗之局。兹与荫棠先生同议滋水养肝，兼泄气火。前人
谓痰即有形之火，火即无形之痰，冀其火降，痰亦自化，然非易事也。
陈阿胶珠（二钱） 大麦冬（三钱） 霍石斛（四钱） 粉丹皮（二钱） 生白芍（一钱五分） 黑山栀（一钱五
分） 炒栝蒌皮（三钱） 炒黄川贝（三钱） 海蛤粉（三钱） 秋石（一钱） 磁石（三钱）
五诊 舌黄大化，润泽有津，口渴自减，渐能安谷。但气火不平，挟痰上逆，肺为华盖，适当其冲，频频呛
咳，痰虽欲出，碍于两胁之痛，不能用力推送，致喘呼不宁，欲寐不得，神情烦懊。脉象细弦。咽中燥痛，一
【患者康，右侧脉象】肝气郁结化火，肝火向外发散。体内发热日久不退，咽喉有热感上冲，头部和眼睛昏沉眩晕。脉象弦大而数，舌质红而无苔，布满裂纹。肝火灼烧消耗，阴津日渐耗损，肾水（水源）有枯竭的趋势。草木药物无情，恐怕难以治愈情志引起的疾病。拟用黄连阿胶汤来救足厥阴肝经和足少阴肾经的阴液，同时清泻这两条经络的火邪。
处方：清阿胶（烊化兑服二钱）、川黄连（五分，用鸡蛋黄拌炒）、生白芍（三钱）、地骨皮（二钱）、大生地（五钱）、丹皮（二钱）、女贞子（三钱，酒蒸）、川石斛（四钱）、萱花（三钱）。
二诊：内热稍减，但咽喉和胸膈仍感觉干燥难忍。舌质红无苔，裂纹遍布。心火劫烁，阴津消耗。只有涵养育护阴津作为抵御之策。
处方：大生地（四钱）、阿胶（三钱）、煨石膏（三钱）、石决明（五钱）、黑豆衣（三钱）、大麦冬（三钱）、花粉（二钱）、炒知母（二钱）、双钩钩（即钩藤，三钱）。
三诊：内热大减，但仍头目昏晕，舌燥咽干。气火在内灼烧，阴津消耗。再行滋阴泄热之法。
处方：大生地（五钱）、生甘草（五分）、粉丹皮（二钱）、阿胶（三钱）、大麦冬（三钱）、生白芍（三钱）、地骨皮（二钱）、钩钩（即钩藤，三钱）、石决明（五钱）、川雅连（三分，用鸡蛋黄拌炒）。
四诊：咽喉胸膈燥痛稍减，神情稍见振奋。然而仍然口渴无津。这是厥阴、少阴之火劫烁胃阴。再行救阴泄热之法。
处方：西洋参（二钱）、青盐半夏（一钱五分）、生甘草（五分）、花粉（二钱）、大麦冬（三钱）、煨石膏（五钱）、黑豆衣（三钱）、池菊（即杭菊花，一钱五分）、川石斛（四钱）、女贞子（三钱，酒蒸）。
五诊：咽喉胸膈燥痛大减。但耳窍闭塞，眼目昏花，大便不通。这是少阳郁勃之火，上升而不安宁。在甘润养阴之中，再参入清泄之法。
处方：西洋参（一钱五分）、花粉（二钱）、丹皮（二钱）、黑山栀（三钱）、黑豆衣（三钱）、大麦冬（三钱）、桑叶（一钱五分）、池菊（二钱）、更衣丸（一钱，开水先送服）。
六诊：胸膈燥痛按顺序减轻。目昏耳闭，仍是郁勃之气上升。再泄少阳之火而调和胃阴。
处方：西洋参、麦冬、黑山栀、黑豆衣、桑叶、南花粉、淡芩（即淡黄芩）、川石斛、池菊花、丹皮。
七诊：肝木偏亢，上升则为风为火，下行则为郁为气，所以舌红变淡，燥渴减轻，而出现胀满气逆。疏解其有余之气，滋养其不足之阴。
处方：金铃子（即川楝子，二钱）、沉香（二分，乳汁磨汁冲服）、白芍（三钱）、川石斛（三钱）、大天冬（三钱）、香附（蜜水炒二钱）、干橘叶（一钱五分）、煨磁石（三钱）、阿胶珠（二钱）。
【患者胡，右侧脉象】各种病症较前稍轻，但阳气化为风邪，鼓动不息，嘴唇口角蠕动，甚至颊车穴部位牵掣，舌体僵硬难以言语。左脉弦大，右脉濡细。
中医认为脾胃开窍于口，唇为脾之外华，阳明经脉环绕口唇交于人中的位置。如今肝风所侵犯的部位，都是脾胃两经所辖的区域。
《内经》说：邪气聚集的地方，正气必定虚弱。如果不是脾胃气虚，怎么会致使肝阳浊气趋向于此地呢？拟用归芍六君子汤，以补益脾胃而抵御肝木，并参入介类药物以滋水潜阳。
处方：吉林参（一钱）、白茯苓（三钱）、朱茯神（三钱）、杭白芍（三钱）、阿胶珠（二钱）、白归身（一钱五分）、生于术（即白术，二钱）、炒枣仁（二钱）、生鳖甲（五钱）、生牡蛎（八钱）、龙齿（三钱）、上濂珠（即珍珠，三分）、上西黄（即牛黄，三厘，以上两味研细分两次，蜜水调服）。
【患者钟，左侧脉象】少腹居中为冲脉所在，两旁属肝经。少腹胀满，按压坚硬，大便十天才能解一次，坚燥异常。每到午后，先出现四肢厥冷后发热，气从下向上冲，气冲则痰涎上涌，头痛且发生昏厥，片刻后才苏醒。脉象细弦而数，舌红苔白少津，睡醒后口燥咽干。
这是由于体质薄弱，肾水不能涵敛肝木，冲气随之上逆，气火升动，煎熬津液成痰，所以痰升导致苦闷昏厥。恐怕会发生抽搐痉挛。拟用滋养肝阴，柔润肝体，以平抑冲气。
处方：生鳖甲（六钱）、杭白芍（三钱）、火麻仁（二钱）、粉丹皮（二钱）、白归身（二钱）、阿胶珠（二钱）、甘杞子（即枸杞子，三钱）、大元参（即玄参，三钱）、金铃子（即川楝子，一钱五分）、更衣丸（三钱，先服）。
二诊：大便通行，但冲气时常仍上逆，气冲则中脘部聚成形块，恶心痰涌，头痛发厥，厥时肢体强直不语，心中虽然明白事理，良久才苏醒，腹中烙热，不想饮食。脉形弦数，苔黄质红。冲气逆上，都化为火，气火上升，煎熬津液，全部化为痰，所谓痰就是“有形之火”。拟直接清清气火，希望厥定胃开，再商量调理。
处方：川黄连（六分，与吴茱萸一分同炒）、生芍（一钱五分）、玳瑁片（三钱）、川楝子（三钱）、淡芩（一钱五分）、丹皮（二钱）、大元参（三钱）、栝蒌皮（五钱）、蛤粉（三钱）、川贝（二钱）、水炒竹茹（一钱五分）、陈关蛰（即海螵蛸，一两）、濂珠（即珍珠，三分）、青黛（一分）、川贝母（三分）、真金箔（一张，以上四味研末另服）。
【患者贾，左侧脉象】气喘不止，厥逆之气尽从上逆，无形的火也随之而上，火冲之时，心中烦闷懊恼想要脱去衣被。肺金无法制约肝木。姑且清肺金以平肝木。
处方：栝蒌霜（四钱）、杏仁泥（三钱）、川贝母（二钱）、郁金（一钱五分）、海浮石（三钱）、风化硝（七分）、黑山栀（二钱）、蛤粉（四钱）、粉丹皮（一钱四分）、竹茹（盐水炒一钱）、枇杷叶（六片）。
二诊：大便未行，灼热依然不退，寅卯之交（凌晨3-7点），身体出现震颤痉挛，但脉象并不数急。无非是肝胆之火内炽，不得不暂时排解其势。
处方：杏仁泥（三钱）、羚羊片（一钱五分）、郁金（一钱五分）、丹皮（二钱）、竹茹（一钱）、栝蒌仁（五钱）、法半夏（一钱五分）、川贝母（二钱）、青黛（五分包煎）。
三诊：火热之势稍平，稍微靠近衣被，不至于像昨天那样烦躁，咽喉气结稍舒。确实属于痰滞阻气，气郁生火。再舒展气化而清熄肝胆之火。
处方：栝蒌霜、夏枯草、羚羊片、郁金、川贝、橘红、鲜菊叶、松罗茶、黑山栀、杏仁、枳实。
四诊：火热渐平，但两胁胀满气逆，甚至发生昏厥。良由气郁化火内炽，火既得熄，病机仍还在于气。再平降肺肝之逆气而开郁化痰。
处方：郁金、杏仁、竹茹、山栀、丹皮、蒺藜、橘红、枳壳、枇杷叶、皂荚子（一钱五分重，蜜涂炙后研末，每服分许，蜜水调服）。
五诊：中脘不舒，两胁下胀满，妨碍饮食，不能进食，气逆不平。脉象沉弦。这是肝藏之气，挟痰阻滞胃腑，胃气不降，则肺气不能独向下行，所以气逆而像喘一样。
处方：整砂仁、广皮、杏仁、旋复花、制半夏、炒枳壳、香附、苏子、徭桂（即肉桂，二分研末，饭丸）。
六诊：中脘渐松，两胁胀满亦减，气逆火升略定。确实是寒痰蔽阻，胃气欲降不得，肺气欲降无由，一遇辛温药，阴霾渐扫，所以诸症起色。再从前法进步。
处方：桂枝、制半夏、瓦楞子、茯苓、薤白头、枳实、广玉金（即郁金）、栝蒌仁、橘皮、干姜。
【患者蒋，右侧脉象】肝火痰热未平，开合失度，又发作寒热。热时阳气挟痰，浮游上扰，神明为之不治。清化痰热，参入熄肝之法，自然应当慢慢痊愈。
处方：郁金（一钱五分）、陈胆星（四分）、黑山栀（二钱）、西血珀（即琥珀，五分，蜜水先调服）、炒远志（五分）、天竺黄（三钱）、丹皮（一钱）、桑叶（一钱）、九节石菖蒲（五分）。
【左侧脉象患者】病后自汗，咽喉中有牵拉腻感，有时火从上升，则肌肤灼热。脉数软滑。这是由于甲木（胆）与戊土（胃）不降，而乙木（肝）独升。恐怕损伤长久不能恢复。
处方：制半夏（一钱五分）、广皮（一钱五分）、地骨皮（三钱，用桂枝四分煎汁收入）、栝蒌皮（一钱五分）、蛤粉（三钱包）、竹茹（一钱五分，姜汁炒）、茯苓（四钱）、建泽泻（一钱五分）、枇杷叶（四分，去毛）、淮小麦（一两，煎汤代水）。
【费统帅】肾虚则生火，木燥则生风，水亏木旺，肝风鸱张，风乃阳化，故主上旋。阳明胃土，正当其冲，所以中脘不时作痛。木侮不已，胃土日虚，而风阳震撼，所以左乳下虚里穴动跃不平。肝风上旋至巅顶，所以头昏目重，一身如坐舟中。肝为藏血之海，肝脏既病，则营血不和，遍体肌肤作麻。吾人脏腑阴阳，一升必配一降。肝为脏，本主左升；胆为腑，本主右降。升者太过，则化火化风；降者太过，则生沦陷诸疾。必须得到升降控制，而后才可以和平。今肝升太过，则胆降不及，胆木漂拔，所以决断无权，多疑妄恐。面色并不虚浮，而自觉面肿，是阳气壅重于上故也。舌苔白腻，冷气从咽中出，以肝胆内寄相火，阳气升腾，龙雷上逆，寒湿阴气，随风泛动。倘若真是寒湿盛极，而致咽中冷气直冲，断然没有能食如常人的道理。丹溪谓上升之气，自肝而出，中挟相火。夫邪火不能杀谷（消化食物），而胃虚必求助于食，可知胃虚乃胃之阴液空虚，非胃之气虚也。脉象细弦而带微数，亦属阴虚阳亢之征。为今之计，惟有静药以滋水养肝，甘以补中，重以镇摄。阳气得潜，则阴气自收，盗汗亦自止也。特内因之症，不能急切图功耳。
处方：玄武板（即龟板，六钱，炙）、龙骨（三钱）、块辰砂（即朱砂，三钱）、大生地（四钱）、生牡蛎（六钱）、白芍（二钱）、天冬（二钱）、茯神（三钱）、生熟草（即生甘草、熟地黄，各三分）、洋青铅（六钱）、淮小麦（六钱）、南枣（四枚）。
【患者赵，左侧脉象】命门之火向来不足，火不生土，土弱生痰，原属痰饮之类，虽有咳嗽，亦无足异。乃于去夏偶感风邪，邪与痰合，咳愈不止。猝受惊恐，震动胆木，胆为肝之外府，附于肝叶之内，此响彼应，肝火上犯，致咳剧而吐秽痰。斯时当作痰治，导肝火湿热下行。乃漫进人参等壅补之品，肝火痰热，阻肺不出，如油入面，莫之能泄。咳热痰秽，经年以来，日就沉困，脐上有形动跃。夫脐上为太阴脾土部位，此时肺金久损，金水无由相生，炎上之火日炽，似非壮水滋其化源，不足以制其燎原之势。然水邪干犯土位，脐上如此悸动，稠腻之药，势难尝试。脉右寸小涩，关部带滑，尺部细沉，而左寸关俱弦，尺部微弱。病属肝火挟痰蒸肺，蔓延而至气阴皆虚，滋肾益肺，则碍于脾土，理湿化痰，则碍于肝木。勉拟益水之上源，而兼泄热化痰。请正。
处方：南北沙参、炒麦冬、海蛤粉、炒蒌皮、冬瓜子、海浮石、云茯苓、鲜竹茹、枇杷叶、肺露。
【陈子岩】向有肝阳，时发时止。兹则少腹胀硬，大腹胀满，中脘胀痛，势不可忍，恶心泛呕，其味甚酸，心胸嘈杂，大便不行。脉象细弦而数，苔黄质腻。骨热皮寒，气逆短促。少腹居中为冲脉。两旁属肝。考冲脉部位，起于气街，夹脐上行，至胸中而散，足见下则少腹，上则胸脘，皆冲脉所辖之区。今冲气逆行，冲阳逆上，胃为中枢，适受其侮，所以为痛为嘈杂为恶心，诸恙俱作矣。胆为肝之外府，为阴阳开合之枢纽，肝病则少阳甲木开合失常，为寒为热，似与外感不同。所虑者气冲不已，致肾气亦动，转成奔豚之候。兹议两和肝胃，参以镇逆。方备商裁。
处方：川雅连（五分）、淡干姜（四分）、川桂枝（四分）、制半夏（二钱）、代赭石（四钱）、旋复花（二钱）、金铃子（二钱）、延胡索（一钱五分）、陈皮（一钱）、土炒白芍（一钱五分）、姜汁炒竹茹（一钱）。
二诊：两和肝胃，参以镇逆，中脘胀痛已止，恶心嘈杂吞酸亦定。然大便未行，痰气欲降无由，遂致气窜入络，两季胁异常作痛，牵引腰膂背肋，不能转侧。更加烟体失瘾（戒烟反应），气不营运，其势益甚，竟至发厥。幸吐出稠痰数口，方得稍定。脉象细弦，重按带滑。络气痹阻，恐其复厥。勉与荫棠先生同议逐痰通腑宣络。非敢率尔，实逼处此也。方备商裁。
处方：薤白头（三钱）、栝蒌仁（三钱）、竹沥半夏（一钱五分）、旋复花（二钱）、猩绛（即紫草或茜草类，六分）、橘皮络（各一钱）、冬瓜子（三钱）、茯苓（三钱）、青葱管（三茎）、控涎丹（五分，橘络汤先送下）。
三诊：投剂后季胁腰膂痛止，大便一次甚畅，日前之所谓痛胀阻隔，快然若失，不可不为转机。惟气时上逆，甚至如喘，胸闷酸涎上泛，头昏眩晕，虽频频吐痰。自觉欲出未出者尚多。脉象弦滑而数，重按少力。络气之滞，虽得宣通，而木火不平，与浊痰相合，蒸腾于上，消烁阴津，所以舌苔黄干毛，恐起糜腐。拟清泄木火，化痰救津。留候荫棠兄裁夺。
处方：黑山栀（三钱）、炒黄川贝（二钱）、光杏仁（去尖三钱）、大麦冬（三钱）、栝蒌皮（三钱）、海蛤粉（三钱）、霍石斛（四钱）、鲜竹茹（二钱）、鲜枇杷叶（一两）、左金丸（八分包煎）、白金丸（五分先吞服）。
四诊：清泄木火，化痰救津，颇能安寐。舌苔边尖较化，干毛转润，脉数较缓，神情略为振卓，但时带呛咳，咳则气从上升。两季胁吊痛，略闻食臭，辄增嘈杂头晕。丹溪云：上升之气，自肝而出。经云：诸逆冲上，皆属于火。良由厥气纵横之余，余威尚盛遂至气化为火，逆犯肺金，消烁津液，其水源之不能涵养肝木，略见一斑。若肝胆之火，挟龙雷上逆，便是喘汗之局。兹与荫棠先生同议滋水养肝，兼泄气火。前人谓痰即有形之火，火即无形之痰，冀其火降，痰亦自化，然非易事也。
处方：陈阿胶珠（二钱）、大麦冬（三钱）、霍石斛（四钱）、粉丹皮（二钱）、生白芍（一钱五分）、黑山栀（一钱五分）、炒栝蒌皮（三钱）、炒黄川贝（三钱）、海蛤粉（三钱）、秋石（一钱）、磁石（三钱）。
五诊：舌黄大化，润泽有津，口渴自减，渐能安谷。但气火不平，挟痰上逆，肺为华盖，适当其冲，频频呛咳，痰虽欲出，碍于两胁之痛，不能用力推送，致喘呼不宁，欲寐不得，神情烦懊。脉象细弦。咽中燥痛，一
[Patient Kang, Right Pulse] Liver Qi stagnation generates fire, and Liver Fire scatters outward. Internal heat persists for a long time without receding, with a sensation of heat rushing up in the throat, dizziness and vertigo of the head and eyes. The pulse is wiry, large, and rapid; the tongue is red without coating, covered with cracks. Liver Fire scorches and consumes, Yin fluids are depleted day by day, and Kidney Water (the source) faces the trend of exhaustion. Herbal medicines are lifeless and may struggle to cure diseases caused by emotional factors. It is proposed to use Huanglian Ejiao Tang to rescue the Yin of the Foot Jueyin Liver Meridian and Foot Shaoyin Kidney Meridian, while draining the fire of these two meridians.
Prescription: Qing Ejiao (melted and added, 2 qian), Chuan Lian (5 fen, stir-fried with chicken egg yolk), Sheng Bai Shao (3 qian), Di Gu Pi (2 qian), Da Sheng Di (5 qian), Dan Pi (2 qian), Nv Zhen Zi (3 qian, wine-steamed), Chuan Shi Hu (4 qian), Xuan Hua (3 qian).
Second Visit: Internal heat has slightly decreased, but the throat and chest/diaphragm still feel unbearably dry. The tongue is red without coating, covered with cracks. Heart Fire is scorching, and Yin fluids are consumed. The only strategy is to nourish and protect Yin fluids as a defense.
Prescription: Da Sheng Di (4 qian), Ejiao (3 qian), Wei Shi Gao (calcined gypsum, 3 qian), Shi Jue Ming (5 qian), Hei Dou Yi (black soybean coat, 3 qian), Da Mai Dong (3 qian), Hua Fen (trichosanthes root powder, 2 qian), Chao Zhi Mu (stir-fried anemarrhena, 2 qian), Shuang Gou Gou (uncaria rhynchophylla, 3 qian).
Third Visit: Internal heat has greatly decreased, but there is still dizziness and vertigo of the head and eyes, dry tongue, and dry throat. Qi and Fire scorch internally, consuming Yin fluids. Continue with nourishing Yin and draining heat.
Prescription: Da Sheng Di (5 qian), Sheng Gan Cao (raw licorice, 5 fen), Fen Dan Pi (white peony bark, 2 qian), Ejiao (3 qian), Da Mai Dong (3 qian), Sheng Bai Shao (raw white peony, 3 qian), Di Gu Pi (2 qian), Gou Gou (uncaria rhynchophylla, 3 qian), Shi Jue Ming (5 qian), Chuan Ya Lian (Chuanlian huanglian, 3 fen, stir-fried with chicken egg yolk).
Fourth Visit: Dryness and pain in the throat and chest/diaphragm have slightly decreased, and mental spirit has slightly revived. However, thirst remains without saliva. This is due to the Fire of Jueyin and Shaoyin meridians scorching Stomach Yin. Continue with rescuing Yin and draining heat.
Prescription: Xi Yang Shen (American ginseng, 2 qian), Qing Yan Ban Xia (green salt-processed pinellia, 1.5 qian), Sheng Gan Cao (raw licorice, 5 fen), Hua Fen (trichosanthes root powder, 2 qian), Da Mai Dong (3 qian), Wei Shi Gao (calcined gypsum, 5 qian), Hei Dou Yi (black soybean coat, 3 qian), Chi Ju (Hangzhou chrysanthemum, 1.5 qian), Chuan Shi Hu (dendrobium, 4 qian), Nv Zhen Zi (ligustrum lucidum, 3 qian, wine-steamed).
Fifth Visit: Dryness and pain in the throat and chest/diaphragm have greatly decreased. However, ear orifices are blocked, vision is blurred, and bowels are unobstructed. This is due to the pent-up and vigorous Fire of Shaoyang rising unrestfully. Within the sweet-nourishing method, add clearing and draining techniques.
Prescription: Xi Yang Shen (American ginseng, 1.5 qian), Hua Fen (trichosanthes root powder, 2 qian), Dan Pi (moutan bark, 2 qian), Hei Shan Zhi (gardenia, 3 qian), Hei Dou Yi (black soybean coat, 3 qian), Da Mai Dong (3 qian), Sang Ye (mulberry leaf, 1.5 qian), Chi Ju (chrysanthemum, 2 qian), Geng Yi Wan (Gengyi Pill, 1 qian, taken first with boiling water).
Sixth Visit: Chest/diaphragm dryness and pain decrease sequentially. Blurred vision and deafness persist, indicating rising pent-up Qi. Again, drain Shaoyang and harmonize Stomach Yin.
Prescription: Xi Yang Shen (American ginseng), Mai Dong (ophiopogon), Hei Shan Zhi (gardenia), Hei Dou Yi (black soybean coat), Sang Ye (mulberry leaf), Nan Hua Fen (trichosanthes root powder), Dan Qin (scutellaria baicalensis), Chuan Shi Hu (dendrobium), Chi Ju Hua (chrysanthemum flower), Dan Pi (moutan bark).
Seventh Visit: Liver Wood is hyperactive; when rising, it becomes Wind and Fire; when descending, it becomes stagnation and Qi. Thus, the red tongue turns pale, dryness and thirst decrease, but distension and rebellious Qi appear. Disperse the excess Qi and nourish the deficient Yin.
Prescription: Jin Ling Zi (szechwan chinaberry fruit, 2 qian), Chen Xiang (aquilaria wood, 2 fen, ground in milk and mixed), Bai Shao (white peony, 3 qian), Chuan Shi Hu (dendrobium, 3 qian), Da Tian Dong (asparagus tuber, 3 qian), Xiang Fu (cyperus rotundus, stir-fried with honey water, 2 qian), Gan Ju Ye (dried tangerine leaf, 1.5 qian), Wei Ci Shi (calcined magnetite, 3 qian), Ejiao Zhu (gelatin pearls, 2 qian).
[Patient Hu, Right Pulse] Various ailments are slightly lighter than before, but Yang Qi transforms into Wind, drumming incessantly. Lips and mouth twitch, jaw muscles spasm, tongue is stiff and difficult to speak. Left pulse is wiry and large; right pulse is soft and fine.
The Spleen and Stomach open into the mouth; lips are the bloom of the Spleen; the Yangming meridian circles the mouth and intersects at the philtrum. The areas invaded by Liver Wind now belong to the territories of the Spleen and Stomach meridians.
The Classics state: Where evil gathers, Qi must be deficient. If Spleen and Stomach Qi were not deficient, how could Liver Yang turbidity rush to this area? It is proposed to use Guixie Liujun Tang to tonify Spleen and Stomach to resist Liver Wood, and incorporate shell-type minerals to nourish Water and submerge Yang.
Prescription: Ji Lin Shen (Jilin ginseng, 1 qian), Bai Fu Ling (poria, 3 qian), Zhu Fu Shen (poria with cinnabar, 3 qian), Hang Bai Shao (Hangzhou white peony, 3 qian), Ejiao Zhu (gelatin pearls, 2 qian), Bai Gui Shen (angelica sinensis root, 1.5 qian), Sheng Yu Zhu (atractylodes macrocephala, 2 qian), Chao Zao Ren (ziziphus seed, 2 qian), Sheng Bie Jia (softshell turtle shell, 5 qian), Sheng Mu Li (oyster shell, 8 qian), Long Chi (dragon teeth, 3 qian), Shang Lian Zhu (pearl, 3 fen), Shang Xi Huang (bezoar, 3 li, the latter two ground finely, divided into two doses, mixed with honey water).
[Patient Zhong, Left Pulse] The lower abdomen center belongs to the Chong Mai (Penetrating Vessel); the sides belong to the Liver. Lower abdominal distension and fullness, hard upon pressure; bowel movement occurs only once every ten days, extremely hard and dry. Every afternoon, cold limbs precede fever; Qi rushes upward from below, causing phlegm-saliva to surge, headache, and fainting, recovering after a moment. Pulse is fine, wiry, and rapid; tongue is red with scanty white coating, lacking moisture; mouth and throat are dry upon waking.
This results from weak constitution, where Water fails to nurture Wood, causing Chong Qi to rebel upward. Qi and Fire rise, refining fluids into phlegm, leading to phlegm surging and bitter fainting. There is fear of convulsions and spasms. It is proposed to nourish Liver Yin, soften Liver substance, and calm Chong Qi.
Prescription: Sheng Bie Jia (softshell turtle shell, 6 qian), Hang Bai Shao (Hangzhou white peony, 3 qian), Huo Ma Ren (hemp seed, 2 qian), Fen Dan Pi (moutan bark, 2 qian), Bai Gui Shen (angelica sinensis root, 2 qian), Ejiao Zhu (gelatin pearls, 2 qian), Gan Qi Zi (goji berry, 3 qian), Da Yuan Shen (scrophularia root, 3 qian), Jin Ling Zi (szechwan chinaberry fruit, 1.5 qian), Geng Yi Wan (Gengyi Pill, 3 qian, taken first).
Second Visit: Bowel movement is patent, but Chong Qi still rebels upward intermittently. Qi rushing causes formation in the middle jiao, nausea, phlegm surging, headache, and fainting; during fainting, limbs are rigid and speechless, though mind remains clear, recovering after a long time. Abdomen feels burning hot, no desire for food. Pulse is wiry and rapid; coating is yellow, body red. Chong Qi rebelling upward transforms into Fire; Qi and Fire rise, frying fluids into phlegm. Phlegm is termed "solidified Fire." It is proposed to directly clear Qi and Fire, hoping for cessation of fainting and opening of Stomach, then discuss regulation.
Prescription: Chuan Lian (goldthread, 6 fen, stir-fried with Wu Zhu Yu 1 fen), Sheng Shao (white peony, 1.5 qian), Dai Mao Pian (alectryon slice, 3 qian), Chuan Liu Zi (szechwan chinaberry fruit, 3 qian), Dan Qin (scutellaria baicalensis, 1.5 qian), Dan Pi (moutan bark, 2 qian), Da Yuan Shen (scrophularia root, 3 qian), Gua Lou Pi (trichosanthes peel, 5 qian), Ge Fen (tridacna powder, 3 qian), Chuan Bei (fritillaria, 2 qian), Shui Chao Zhu Ru (bamboo shavings, water-stir-fried, 1.5 qian), Chen Guan Zhe (cuttlebone, 1 liang), Lian Zhu (pearl, 3 fen), Qing Dai (indigo naturalis, 1 fen), Chuan Bei Mu (fritillaria, 3 fen), Zhen Jin Bo (real gold foil, 1 sheet; last four ground together for separate administration).
[Patient Jia, Left Pulse] Unremitting asthma; rebellious Qi rises entirely from below; formless Fire follows upward. During Fire surges, there is restlessness and desire to remove clothing. Metal fails to control Wood. Tentatively clear Metal to level Wood.
Prescription: Gua Lou Shuang (trichosanthes powder, 4 qian), Xing Ren Ni (apricot kernel paste, 3 qian), Chuan Bei Mu (fritillaria, 2 qian), Yu Jin (curcuma, 1.5 qian), Hai Fu Shi (pyrite, 3 qian), Feng Hua Xiao (weathered saltpeter, 7 fen), Hei Shan Zhi (gardenia, 2 qian), Ge Fen (tridacna powder, 4 qian), Fen Dan Pi (moutan bark, 1.4 qian), Zhu Ru (bamboo shavings, salt-water stir-fried, 1 qian), Pi Pa Ye (loquat leaf, 6 pieces).
Second Visit: Bowels unobstructed, burning heat persists. At Yin-Mao hours (3-7 AM), body trembles and spasms, yet pulse is not rapid. This is merely internal blazing of Liver-Gallbladder Fire; must temporarily drain its momentum.
Prescription: Xing Ren Ni (apricot kernel paste, 3 qian), Ling Yang Pian (antelope horn slice, 1.5 qian), Yu Jin (curcuma, 1.5 qian), Dan Pi (moutan bark, 2 qian), Zhu Ru (bamboo shavings, 1 qian), Gua Lou Ren (trichosanthes seed, 5 qian), Fa Ban Xia (pinellia, 1.5 qian), Chuan Bei Mu (fritillaria, 2 qian), Qing Dai (indigo naturalis, 5 qian, wrapped).
Third Visit: Fire momentum slightly calmed; can tolerate clothing slightly, not as irritable as yesterday; throat Qi obstruction slightly relieved. Indeed, phlegm stagnation obstructs Qi, Qi stagnation generates Fire. Again, expand Qi transformation and clear/extinguish Liver-Gallbladder.
Prescription: Gua Lou Shuang (trichosanthes powder), Xia Ku Cao (prunella spike), Ling Yang Pian (antelope horn slice), Yu Jin (curcuma), Chuan Bei (fritillaria), Ju Hong (tangerine red pith), Xian Ju Ye (fresh chrysanthemum leaf), Song Luo Cha (pine-rope tea), Hei Shan Zhi (gardenia), Xing Ren (apricot kernel), Zhi Shi (immature bitter orange).
Fourth Visit: Fire gradually calms, but bilateral hypochondriac distension and rebellious Qi occur, even leading to fainting. Caused by Qi stagnation transforming into internal blazing Fire. Once Fire is extinguished, pathology returns to Qi. Again, level Lung-Liver rebellion and resolve stagnation/transform phlegm.
Prescription: Yu Jin (curcuma), Xing Ren (apricot kernel), Zhu Ru (bamboo shavings), Shan Zhi (gardenia), Dan Pi (moutan bark), Ji Li (tribulus), Ju Hong (tangerine red pith), Zhi Qiao (immature bitter orange), Pi Pa Ye (loquat leaf), Zao Jia Zi (gleditsia spine, 1.5 qian heavy, honey-coated roasted, ground, dose approx. 1 fen, mixed with honey water).
Fifth Visit: Epigastric discomfort, bilateral hypochondriac distension, hindering diet, unable to eat well, Qi rebellious and uneven. Pulse is deep and wiry. This is Liver Qi, carrying phlegm, obstructing Stomach; Stomach Qi fails to descend, so Lung Qi cannot descend alone, causing Qi rebellion resembling asthma.
Prescription: Zheng Sha Ren (amomum fruit), Guang Pi (tangerine peel), Xing Ren (apricot kernel), Xuan Fu Hua (inula flower), Zhi Ban Xia (pinellia), Chao Zhi Qiao (immature bitter orange), Xiang Fu (cyperus rotundus), Su Zi (perilla seed), Yao Gui (cinnamon bark, 2 fen ground, rice pill).
Sixth Visit: Epigastrium gradually loosens, hypochondriac distension decreases, Qi rebellion and Fire rise slightly settle. Indeed, Cold-Phlegm obstruction prevents Stomach Qi from descending and Lung Qi from finding a way down. Upon encountering acrid-warm herbs, Yin-Evil gradually sweeps away, hence improvement. Advance with previous method.
Prescription: Gui Zhi (cinnamon twig), Zhi Ban Xia (pinellia), Wa Leng Zi (corbicula shell), Fu Ling (poria), Xie Bai (macrostemon bulb), Zhi Shi (immature bitter orange), Guang Yu Jin (curcuma), Gua Lou Ren (trichosanthes seed), Ju Pi (tangerine peel), Gan Jiang (dried ginger).
[Patient Jiang, Right Pulse] Liver Fire and Phlegm-Heat not yet settled, opening/closing imbalance, alternating chills and fever again. When hot, Yang Qi carries Phlegm, floating upward disturbing Spirit. Clear/transform Phlegm-Heat, incorporate calming Liver, will slowly heal.
Prescription: Yu Jin (curcuma, 1.5 qian), Chen Dan Xing (aged arisaema with bile, 4 fen), Hei Shan Zhi (gardenia, 2 qian), Xi Xue Po (amber, 5 fen, mixed with honey water first), Chao Yuan Zhi (polygala, 5 fen), Tian Zhu Huang (bamboo resin, 3 qian), Dan Pi (moutan bark, 1 qian), Sang Ye (mulberry leaf, 1 qian), Jiu Jie Shi Chang Pu (nine-joint calamus, 5 fen).
[Left Pulse Patient] Post-illness spontaneous sweating, pulling greasiness in throat, sometimes Fire rises causing skin burning. Pulse is rapid, soft, slippery. This is because Jia Wood (Gallbladder) and Wu Earth (Stomach) fail to descend, while Yi Wood (Liver) rises alone. Fear damage will not recover long-term.
Prescription: Zhi Ban Xia (pinellia, 1.5 qian), Guang Pi (tangerine peel, 1.5 qian), Di Gu Pi (lycium bark, 3 qian, decocted with Gui Zhi 0.4 qian juice incorporated), Gua Lou Pi (trichosanthes peel, 1.5 qian), Ge Fen (tridacna powder, 3 qian wrapped), Zhu Ru (bamboo shavings, 1.5 qian, ginger juice stir-fried), Fu Ling (poria, 4 qian), Jian Ze Xie (alisma, 1.5 qian), Pi Pa Ye (loquat leaf, 4 fen, de-hairy), Huai Xiao Mai (wheat, 1 liang, decocted as water substitute).
[Commander Fei] Kidney deficiency generates Fire; Wood dryness generates Wind; Water deficit, Wood hyperactivity, Liver Wind rampant. Wind is Yang-transformed, thus governing upward rotation. Yangming Stomach Earth bears the impact, hence epigastric pain occurs intermittently. Wood insulting endlessly, Stomach Earth daily weakens, Wind-Yang shakes, hence pulsation at Xu Li point under left breast is uneven. Liver Wind rotates upward to vertex, hence dizziness, heavy eyes, body feels like sitting in a boat. Liver is the sea of storing Blood; once Liver disease, Ying-Blood discordant, whole body skin feels numb. Human Zang-Fu Yin-Yang: one ascending must match one descending. Liver is Zang, originally governs left ascent; Gallbladder is Fu, originally governs right descent. Ascending too much transforms into Fire/Wind; descending too much generates sinking diseases. Must achieve ascension-descent control for harmony. Now Liver ascends too much, Gallbladder descends insufficiently, Gallbladder Wood floats, hence decision-making lacks power, prone to suspicion/fear. Face not visibly puffy, yet feels swollen, due to Yang Qi congestion above. Tongue coating white-greasy, cold air exits throat; Liver/Gallbladder house Ministerial Fire internally, Yang Qi rises, Dragon-Leopard Fire rebels upward, Cold-Damp Yin Qi moves with Wind. If truly Cold-Damp extreme causing cold air rushing throat, surely cannot eat like normal person. Danxi said: Ascending Qi originates from Liver, carrying Ministerial Fire. Evil Fire cannot digest grain; Stomach deficiency seeks food aid,可知 Stomach deficiency is Stomach Yin fluid emptiness, not Stomach Qi deficiency. Pulse fine, wiry, slightly rapid, also sign of Yin deficiency Yang hyperactivity. Current plan: quiet herbs to nourish Water/Liver, sweet to tonify Middle, heavy to suppress. Once Yang sinks, Yin collects, night sweats stop. Specifically, internal cause diseases cannot seek quick success.
Prescription: Xuan Wu Ban (turtle plastron, 6 qian calcined), Long Gu (dragon bone, 3 qian), Kuai Chen Sha (cinnabar, 3 qian), Da Sheng Di (rehmannia, 4 qian), Sheng Mu Li (oyster shell, 6 qian), Bai Shao (white peony, 2 qian), Tian Dong (asparagus tuber, 2 qian), Fu Shen (poria with hostwood, 3 qian), Sheng Shu Cao (raw licorice/roasted rehmannia, 3 fen each), Yang Qing Qian (lead, 6 qian), Huai Xiao Mai (wheat, 6 qian), Nan Zao (jujube, 4 pieces).
[Patient Zhao, Left Pulse] Mingmen Fire historically insufficient, Fire fails to generate Earth, Earth weak generates Phlegm, originally belonging to Phlegm-Fluid category. Cough exists, nothing strange. Last summer accidentally caught Wind Evil, Evil combines with Phlegm, cough worsens uncontrollably. Suddenly frightened, shaking Gallbladder Wood. Gallbladder is exterior mansion of Liver, attached inside Liver lobe, resonance occurs, Liver Fire invades, causing severe cough and vomiting foul phlegm. At that time should treat Phlegm, guide Liver Fire/Damp-Heat downward. Instead blindly administered Ginseng/stagnant tonics, Liver Fire/Phlegm-Heat obstruct Lung, cannot exit, like oil entering flour, impossible to drain. Cough/Heat/Foul Phlegm, year after year, daily worsening, palpable pulsation above navel. Above navel is Taiyin Spleen Earth territory. Now Lung Metal long damaged, Metal-Water cannot generate each other, flaming Fire daily intensifies, seems unless strengthening Water to nourish source, insufficient to control prairie fire. However, Water Evil invading Earth territory, such pulsation above navel, thick/greasy herbs difficult to try. Pulse Right Cun small/choppy, Guan slippery, Chi fine/deep; Left Cun/Guan all wiry, Chi weak/faint. Disease belongs to Liver Fire carrying Phlegm steaming Lung, spreading to Qi/Yin both deficient. Tonify Kidney/Nourish Lung hinders Spleen Earth; resolve Damp/Transform Phlegm hinders Liver Wood. Tentatively benefit upper source of Water, simultaneously drain Heat/Transform Phlegm. Please correct.
Prescription: Nan Bei Sha Shen (glehnia/adhatoda roots), Chao Mai Dong (ophiopogon), Hai Ge Fen (clam powder), Chao Lou Pi (trichosanthes peel), Dong Gua Zi (winter melon seed), Hai Fu Shi (pyrite), Yun Fu Ling (poria), Xian Zhu Ru (fresh bamboo shavings), Pi Pa Ye (loquat leaf), Fei Lu (lung dew).
[Chen Ziyan] Historically had Liver Yang, intermittent onset/cessation. Now lower abdomen hard/full, great abdomen distended, epigastric painful distension, unbearable, nausea/vomiting, taste very sour, chest/mind chaotic, bowels unobstructed. Pulse fine/wiry/rapid, coating yellow/body greasy. Bone heat/skin cold, Qi rebellious/short breath. Lower abdomen center is Chong Mai; sides belong to Liver. Examining Chong Mai location, starts at Qi Street, runs alongside navel upward, disperses in chest; thus lower is lower abdomen, upper is chest/epigastrium, all Chong Mai territory. Now Chong Qi rebels, Chong Yang rebels upward, Stomach is hub,恰受其侮 (just insulted), hence pain, chaos, nausea, all ailments arise. Gallbladder is exterior mansion of Liver, pivot of Yin-Yang opening/closing; Liver disease causes Shaoyang Jia Wood opening/closing abnormal, chills/fever, different from external contraction. Worry is Qi rushing endlessly, causing Kidney Qi to move, turning into Ben Tun (running piglet) syndrome. Now propose harmonizing Liver/Stomach, incorporating suppressing/rebelling. Formula prepared for discussion.
Prescription: Chuan Ya Lian (goldthread, 5 fen), Dan Gan Jiang (light dried ginger, 4 fen), Chuan Gui Zhi (cinnamon twig, 4 fen), Zhi Ban Xia (pinellia, 2 qian), Dai Zhe Shi (hematite, 4 qian), Xuan Fu Hua (inula flower, 2 qian), Jin Ling Zi (szechwan chinaberry fruit, 2 qian), Yan Hu Suo (corydalis, 1.5 qian), Chen Pi (tangerine peel, 1 qian), Tu Chao Bai Shao (earth-stir-fried white peony, 1.5 qian), Jiang Zhi Chao Zhu Ru (ginger-juice stir-fried bamboo shavings, 1 qian).
Second Visit: Harmonizing Liver/Stomach, incorporating suppressing/rebelling, epigastric painful distension stopped, nausea/chaos/acid regurgitation settled. But bowels unobstructed, Phlegm-Qi wants to descend but no way, thus Qi窜入络 (intrudes into collaterals), bilateral hypochondriac exceptionally painful, radiating to waist/back/ribs, unable to turn. Plus smoking withdrawal, Qi not circulating, momentum worse, even fainting. Fortunately vomited thick phlegm several mouthfuls, slightly settled. Pulse fine/wiry, heavy press slippery. Collateral Qi blocked, fear recurrence of fainting. Tentatively discussed with Mr. Yintang expelling Phlegm/unblocking Fu/collaterals. Not daring to act rashly, actually forced here. Formula prepared for discussion.
Prescription: Xie Bai (macrostemon bulb, 3 qian), Gua Lou Ren (trichosanthes seed, 3 qian), Zhu Li Ban Xia (pinellia with bamboo juice, 1.5 qian), Xuan Fu Hua (inula flower, 2 qian), Xing Jiang (zicao/qiancao, 6 fen), Ju Pi Luo (tangerine peel network, 1 qian each), Dong Gua Zi (winter melon seed, 3 qian), Fu Ling (poria, 3 qian), Qing Cong Guan (green onion tube, 3 stems), Kong Xian Dan (Kongxian Pill, 5 fen, sent down first with tangerine network decoction).
Third Visit: After dosing, hypochondriac/waist pain stopped, bowel movement once very smooth, previous pain/distension/blockage suddenly lost, cannot not be a turning point. Only Qi occasionally rebels upward, even like asthma, chest tightness/sour saliva surging, dizziness/vertigo, although frequently spitting phlegm. Self-feels much more wanting to come out but hasn't. Pulse wiry/slippiy/rapid, heavy press less force. Collateral Qi stagnation, although unblocked, Wood/Fire uneven, combined with turbid Phlegm, steaming upward, consuming Yin fluids, hence tongue coating yellow/dry/hairy, fear starting ulceration. Propose clearing/draining Wood/Fire, transforming Phlegm/rescuing Jin. Wait for Brother Yintang's decision.
Prescription: Hei Shan Zhi (gardenia, 3 qian), Chao Huang Chuan Bei (fried yellow fritillaria, 2 qian), Guang Xing Ren (apricot kernel, de-hilum 3 qian), Da Mai Dong (ophiopogon, 3 qian), Gua Lou Pi (trichosanthes peel, 3 qian), Hai Ge Fen (clam powder, 3 qian), Huo Shi Hu (huoshan dendrobium, 4 qian), Xian Zhu Ru (fresh bamboo shavings, 2 qian), Xian Pi Pa Ye (fresh loquat leaf, 1 liang), Zuo Jin Wan (Zuojin Pill, 8 fen wrapped decoction), Bai Jin Wan (Baijin Pill, 5 fen swallowed first).
Fourth Visit: Clearing/draining Wood/Fire, transforming Phlegm/rescuing Jin, able to sleep well. Tongue coating edges/tips partially resolved, dry/hairy turned moist, pulse rate slower, spirit slightly revived, but occasional choking cough, coughing causes Qi rising. Bilateral hypochondriac hanging pain, slight smell of food increases chaos/dizziness. Danxi said: Ascending Qi originates from Liver. Classics said: All rebellious rushing upward belong to Fire. Indeed, after rebellious Qi runs wild, residual power still strong, thus Qi transforms into Fire, rebelling against Lung Metal, consuming Jin fluids, inability of Water source to nourish Liver Wood seen briefly. If Liver/Gallbladder Fire carries Dragon-Leopard upward rebellion, it is panting/sweating situation. Now discussed with Mr. Yintang nourishing Water/nourishing Liver, simultaneously draining Qi/Fire. Predecessors said: Phlegm is solidified Fire, Fire is formless Phlegm, hope Fire descends, Phlegm self-transforms, however not easy.
Prescription: Chen Ejiao Zhu (gelatin pearls, 2 qian), Da Mai Dong (ophiopogon, 3 qian), Huo Shi Hu (huoshan dendrobium, 4 qian), Fen Dan Pi (moutan bark, 2 qian), Sheng Bai Shao (raw white peony, 1.5 qian), Hei Shan Zhi (gardenia, 1.5 qian), Chao Gua Lou Pi (fried trichosanthes peel, 3 qian), Chao Huang Chuan Bei (fried yellow fritillaria, 3 qian), Hai Ge Fen (clam powder, 3 qian), Qiu Shi (autumn stone, 1 qian), Ci Shi (magnetite, 3 qian).
Fifth Visit: Tongue yellow largely resolved, moist with fluids, thirst self-decreased, gradually able to eat grains. But Qi/Fire uneven, carrying Phlegm upward rebellion, Lung is canopy, bearing impact, frequent choking cough, Phlegm wants to come out, hindered by bilateral hypochondriac pain, unable to exert force to push, causing panting/restlessness, wanting sleep but cannot, spirit vexed/restless. Pulse fine/wiry. Throat dry/painful, one