五诊 补气养阴,以涵肝木,惊搐之象渐轻,面青较退,便泄已止。涕泪虽无,而干燥颇渐转润。的属阴
虚木旺。从效方再望转机。
台参须(五分) 炙生地(三钱) 杭白芍(一钱五分) 炒怀药(三钱) 大麦冬(二钱) 西洋参(一钱)
阿胶珠(二钱) 生牡蛎(五钱) 煨天麻(二钱) 白蒺藜(三钱) 抱龙丸(半丸化服)
六诊 惊搐已定,面青色续退,然犹涕泪不下。舌上转润,而上下唇犹然干燥。脉象细数。其为阴虚气
弱,木旺生风,显然可见。既略转机,自宜从效方扩充。
台参须(五分) 阿胶珠(三钱) 土炒白芍(一钱五分) 生牡蛎(五钱) 煨天麻(一钱) 西洋参(
一钱) 金石斛(三钱) 川贝母(一钱五分) 炒怀药(三钱) 白茯苓(三钱) 盐水炙橘红(五分)
七诊 惊搐之象已定,啼哭渐有涕泪,便泄亦止,惟面色带浮。还是脾虚木旺之象,所谓面肿曰风也。
再拟培养气阴。
五诊:采用补气养阴的方法,以涵养肝木(指通过滋养肝阴来制约肝阳/肝风),惊厥抽搐的症状逐渐减轻,面色发青的情况有所消退,腹泻已经停止。虽然鼻涕和眼泪尚未恢复,但口鼻干燥的状况已逐渐转为滋润。这确实属于阴虚而肝木偏旺的证候。既然方药有效,继续观察病情转机。
处方:台参须(五分)、炙生地(三钱)、杭白芍(一钱五分)、炒怀药(三钱)、大麦冬(二钱)、西洋参(一钱)、阿胶珠(二钱)、生牡蛎(五钱)、煨天麻(二钱)、白蒺藜(三钱)、抱龙丸(半丸化开服用)。
六诊:惊厥抽搐症状已经稳定,面色青色继续消退,然而仍然没有鼻涕和眼泪流出。舌面转为滋润,但上下嘴唇依然干燥。脉象细数。这是阴虚气弱、肝木偏旺而生风的明显征象。既然病情略有转机,自然应当基于有效的方剂进行扩充调整。
处方:台参须(五分)、阿胶珠(三钱)、土炒白芍(一钱五分)、生牡蛎(五钱)、煨天麻(一钱)、西洋参(一钱)、金石斛(三钱)、川贝母(一钱五分)、炒怀药(三钱)、白茯苓(三钱)、盐水炙橘红(五分)。
七诊:惊厥抽搐的症状已经稳定,啼哭时逐渐有鼻涕和眼泪流出,腹泻也已停止,只是面色略带浮肿。这仍然是脾虚而肝木偏旺的表现,即所谓“面部浮肿称为风”。再次拟定培养气和阴液的方案。
Fifth Consultation: Employed the method of tonifying Qi and nourishing Yin to nurture Liver Wood (referring to restraining Liver Yang/Wind by nourishing Liver Yin). The manifestations of fright and convulsions gradually lightened, the bluish complexion receded somewhat, and diarrhea ceased. Although nasal discharge and tears were absent, the dryness had gradually turned moist. This indeed belongs to the pattern of Yin deficiency with exuberant Liver Wood. Since the formula was effective, we await further turning points in the condition.
Prescription: Taishen Xu (Ginseng Radicula, 5 fen), Zhi Shengdi (Prepared Rehmanniae Radix, 3 qian), Hang Baishao (Paeoniae Radix Alba, 1.5 qian), Chao Huaiyao (Dioscoreae Rhizoma, 3 qian), Da Maidong (Ophiopogonis Radix, 2 qian), Xiyangshen (Panacis Quinquefolii Radix, 1 qian), Ejiao Zhu (Colla Corii Asini Beads, 2 qian), Sheng Muli (Concha Ostreae, 5 qian), Wei Tianma (Gastrodiae Rhizoma, 2 qian), Bai Jili (Tribuli Fructus, 3 qian), Baolong Wan (Baolong Pill, half a pill dissolved for administration).
Sixth Consultation: The fright and convulsions have stabilized, and the bluish complexion continues to recede; however, there is still no nasal discharge or tears. The tongue surface has turned moist, but the upper and lower lips remain dry. The pulse is fine and rapid. It is evident that this is a case of Yin deficiency and Qi weakness, with exuberant Liver Wood generating Wind. Since there is a slight turning point, it is appropriate to expand upon the effective formula.
Prescription: Taishen Xu (Ginseng Radicula, 5 fen), Ejiao Zhu (Colla Corii Asini Beads, 3 qian), Tu Chao Baishao (Soil-fried Paeoniae Radix Alba, 1.5 qian), Sheng Muli (Concha Ostreae, 5 qian), Wei Tianma (Gastrodiae Rhizoma, 1 qian), Xiyangshen (Panacis Quinquefolii Radix, 1 qian), Jin Shihu (Dendrobii Caulis, 3 qian), Chuan Beimu (Fritillariae Thunbergii Bulbus, 1.5 qian), Chao Huaiyao (Dioscoreae Rhizoma, 3 qian), Bai Fuling (Poria, 3 qian), Yan Shui Zhi Juhong (Salt-water processed Citri Reticulatae Pericarpium Rubrum, 5 fen).
Seventh Consultation: The manifestations of fright and convulsions have stabilized, crying is now accompanied by gradual production of nasal discharge and tears, and diarrhea has ceased. Only the facial complexion shows slight puffiness. This remains a manifestation of Spleen deficiency with exuberant Liver Wood, as stated: "Facial edema is called Wind." We again propose a plan to cultivate Qi and Yin.