北沙参(四钱) 阿胶珠(二钱) 大生地(四钱) 西洋参(二钱) 生山药(三钱) 光杏仁(三钱)
川贝母(二钱) 茯苓(四钱) 大麦冬(三钱) 青蛤散(五钱) 白蜜(二钱冲) 白粳米(一撮)
猪肤(五钱煎汤去沫代水煎药)
沈(左) 嗜饮伤肺。屡次见红,久咳不止。脉数微促。金水并亏,症入损门,虽可苟安于目前,难免颓败于日后
也。
南沙参 地骨皮 青蛤散 光杏仁 青芦管 生米仁 川石斛 川贝 冬瓜子 枇杷叶 桑叶
吴(左) 嗜饮湿热蒸腾,损伤肺胃,致吐血之后,咳久音哑。金为水母,未有金损不复而水源独裕者,其
涸也可立而待也。症入损途不能许治。
光杏仁 生薏仁 冬瓜子 青蛤散 青芦管 云茯苓 桔梗 川贝 蝉衣 炒蒌皮 竹茹(水炒)
右 咽痛大减,口渴亦觉稍退,胃纳亦起,药病如桴鼓相投。但频带呛咳,时仍呕吐。肝肾之阴,亏损已
极,以致水不涵木,木火凌金则呛咳,木乘土位则呕吐。舌腐虽退,中心灰黑。时易汗出,还是欲脱之象。
岂草木之功,能与造化争权哉。勉从前意扩充。
台参须(五分) 生白芍(一钱) 川贝(炒黄二钱) 大麦冬(四钱) 女贞子(三钱) 西洋参(三钱)
大生地(四钱) 金石斛(四钱) 牡蛎(四钱 ) 梨汁(一两冲) 豆衣(三钱)
二诊 肝阴肾水,亏损已极,致肝风上翔,冲侮胃土,风翔则浪涌,以致呕吐复作。营液既亏,气分亦耗,
两腋下发出白 。脉虚苔腐。此欲脱之兆也。勉拟补气育阴,亦尽人事而已。
台参须 牡蛎 西洋参 黑豆衣 梨汁 大麦冬 大生地 金石斛 女贞子 生白芍 血燕根(三钱绢包煎汤代
水)
江(左) 咳嗽不减,内热口渴便赤,脉象细数,饮食少思。肺金肾水交亏,将恐不支。
北沙参 川石斛 川贝母 光杏仁 炒蒌皮 海蛤粉 橘红(盐水炒) 云茯苓 款冬花 建泽泻 冬瓜子
二诊 久咳气逆难卧。脉细如丝,舌苔腐烂。肾虚之极,肾火挟浊上浮。危在旦夕,勉方图进。
麦冬(三钱) 西洋参(一钱五分) 真阿胶(三钱) 橘白(盐水炒一钱五分) 海蛤粉(四钱) 北沙参(五
钱) 大生地(四钱) 牛膝炭(三钱) 云茯苓(四钱) 吉林参(另煎冲一钱) 白荷花露(温冲七钱) 竹沥(一
两姜汁少许冲) 上濂珠(四分) 川贝母(五分二味研细末分两次服) 枇杷叶(去毛炙三片)
三诊 气喘大定,痰亦略爽,而糜腐时退时来。脉形虚弦关部独大。饮化为痰,痰化为燥,燥化为火,所
有阴津,尽行劫夺。虽略转机,尚不足恃。
西洋参(三钱) 海蛤粉(四钱) 北沙参(八钱) 海浮石(三钱) 川贝母(三钱) 大麦冬(三钱)
云茯苓(三钱) 竹沥(一两姜汁少许冲) 金石斛(四钱) 陈关蛰(一两) 大荸荠(四枚二味煎汤代水) 上濂
珠(五分) 真川贝(一钱二味研极细末分两次服)
改方 阴由火劫,火由痰化。虽宜以救阴为急,而仍宜顾其痰火,竹油雪羹之类,宜频频兼进。
黄(左) 吐血之后,剧咳多痰,痰皆稀白。脉细沉苔白无华。三焦之气已虚,劳损根深,鞭长莫及。
川桂枝 云茯苓 光杏仁 炙绵 煨生姜 炒苏子 旋复花 炙甘草 新会皮
二诊 创建中气,咳嗽气逆渐松,音哑转亮,胃纳亦起。虽从失血蔓延致损,而叠进甘温,并不见红,足
见久咳而三焦气虚。药既应手,安能坐视,姑从前意扩充,以观造化。
川桂枝 光杏仁 云茯苓 广橘红 牡蛎(盐水炒) 茯神 炙绵 炙甘草 牛膝炭 东白芍 淮小麦 龙齿
某 本是先天不足,肾脏空虚,湿热下注,发为漏疡,理宜培补之不暇矣。乃肺感风邪,邪恋不澈,遂致
咳久不止,咽痒痰多音闪,脉数内热。本虚表实,竟是劳损情形,非学浅才疏者,所敢许治也。勉拟化痰润肺以备商用。
川贝(炒黄二钱) 云茯苓(四钱) 光杏仁(三钱) 荆芥(一钱炒) 橘红(蜜炙一钱) 栝蒌皮(三钱)
海蛤粉(四钱) 肺露(一两冲) 霜桑叶(炙黄研末先调服二钱) 枇杷叶(去毛七片用蜜炙十四片用姜汁炙煎汤代
水)
二诊 肺气稍得下行,咳嗽略减,音声亦较爽利,不可不为起色。但时犹燥热。脉象带数,仍未敛静。阴
液已耗,还恐缠绵不复。
苦桔梗(八分) 麦冬(二钱炒) 茯苓(三钱) 光杏仁(三钱) 橘红(蜜炙一钱) 地骨皮(一钱五分)
制半夏(一钱五分) 桑皮(一钱炙) 女贞子(一钱五分) 丹皮(一钱五分) 竹衣(一分) 枇杷叶(二十片煎
汤代水)
某 天下无倒行之水,故人身无逆上之血,水有时而倒行,风激之也,血无端而逆上,火激之也。体无
端而有火,木所生也,木何以生火,郁则生火也。血阴气阳,吐血之后,阴虚阳旺,必然之道。此时滋助水
源,即是治血治火之正道。盖火有虚火,非若实火可以寒胜,可以凉折也。乃以凉治热,血止热平。而阴
分不复,因耗成损因损成虚,遂致金水不能相生,肾气不能收摄,呼吸之气,渐失其肺出肾纳之常。咳
嗽气逆,内热连绵,液被热蒸,尽成胶浊,痰多盈碗。脉象数,左关细弦,尺部缓急不齐,舌红苔。薄白肺津
肾水,中气脾阳,一齐亏损。金为水母,养肺必先益肾,中气下根于肾,治脾胃亦必先治肾也。拟金水并
调法即请商裁。
北沙参(三钱) 川贝母(二钱) 白茯苓(三钱) 金石斛(三钱) 海蛤粉(三钱) 生地炭(四钱)
煨磁石(三钱) 车前子(一钱五分) 盐水炒牛膝(三钱) 炙款冬花(一钱五分)
杨(右) 产后久咳,复产更甚,吐血时止时来,不能左卧,甚至音声雌喑,左胁漉漉有声,咽痒有时呕吐。
脉细弦数,舌红少苔。阴虚木旺,木叩金鸣。证入损门,不敢言治。
阿胶珠(三钱) 金石斛(四钱) 生扁豆(三钱) 大天冬(二钱) 青蛤散(四钱) 生白芍(一钱五分)
生甘草(四分) 怀牛膝(三钱) 冬虫夏草(二钱) 琼玉膏(二次冲五钱)
周(左) 屡次吐血,渐至久咳不止,内热火升,右颊红赤。脉细弦而数。音闪不扬。阴虚木火凌金,金被火
铄,生化不及,即水源日涸。恐损而难复。
大生地(五钱) 炙桑皮(一钱五分) 冬瓜子(三钱) 青蒿子(三钱) 大天冬(三钱) 地骨皮(二钱)
青蛤散(四钱) 川贝母(二钱) 阿胶珠(三钱) 生甘草(三分) 枇杷叶(四片) 都气丸(三钱晨服)
二诊 音闪渐扬,咳仍不减,内热火升。舌红,苔糙白,脉细弦数。吐血之后,阴虚已甚,冲阳挟龙相上炎。
再金水并调。
大生地(五钱) 川贝母(二钱) 生白芍(一钱五分) 炙款冬(二钱) 大麦冬(三钱) 青蛤散(三钱)
粉丹皮(一钱五分) 牛膝炭(三钱) 冬虫夏草(二钱) 都气丸(三钱)
顾(右) 心悸肢节作痛,皮寒骨热。脉象细弦。营血亏损,遂致营卫失和,营血不能濡养经络。宜养血和营。
全当归(三钱) 炙黑草(五分) 柏子霜(三钱) 甘杞子(三钱) 龙眼肉(五枚) 白芍(酒炒二钱)
茯神(三钱) 枣仁(二钱炒) 阿胶珠(二钱) 大南枣(四枚)
二诊 心悸稍定,胃纳如常。的是营血不足,心阳不能下降。效方扩充。
大生地(四钱) 辰麦冬(三钱) 枣仁(二钱炒) 白归身(一钱五分) 阿胶(二钱) 白芍(酒炒一钱五分)
辰茯神(三钱) 柏子霜(三钱) 龙眼肉(四枚) 天王补心丹(三钱清晨先服)
又膏方 营阴亏损,营血不足,不克与卫俱行,遂致营卫不和,皮寒骨热。血不养经,则肢节作痛。血不
养肝,风阳上旋,则头痛耳鸣心悸。滋水以涵肝木,育阴而和营血,一定之理。
大生地(六两) 池菊花(一两) 杭白芍(酒炒三两) 柏子仁(二两) 川断(二两) 大熟地(四两)
白归身(酒炒三两) 浓杜仲(三两) 奎党参(四两) 茯神(二两) 西洋参(一两) 女贞子(酒蒸二两)
天麦冬(辰砂拌各一两五钱) 黑豆衣(二两) 白薇(二两炒) 生熟甘草(各五钱) 肥玉竹(二两) 泽泻
(一两) 杞子(二两) 怀牛膝(酒炒三两) 青蒿(一两五钱) 枣仁(二两炒) 于术(乳蒸一两) 炒萸肉
(一两) 炒木瓜(一两) 石决明(四两)
阿胶三两,龟胶二两,鹿胶一两,溶化收膏。
韩(左) 抑郁阳升不寐,木火刑金,而致吐血复发。血止之后,营阴亏损,营卫循环失度,倏寒倏热,头晕
火升,口渴。舌红少苔,脉象细弦。皆阴虚不复之象。急为和阴,以冀渐复。
阿胶珠(二钱) 杭白芍(一钱五分) 金石斛(四钱) 茯神(三钱) 生牡蛎(三钱) 天冬(三钱)
生山药(三钱) 龙齿(三钱 ) 川贝(去心一钱五分) 枣仁(炒研二钱)
庄(左) 吐血之后,阴分未复,操劳动作,阳气升腾,头目昏晕,寐中辄轰然而热,有汗出之意。脉形左大。
宜育阴熄肝。
阿胶珠(三钱) 生牡蛎(五钱) 女贞子(三钱) 茯神(三钱) 甘菊花(一钱五分) 生鳖甲(五钱)
生白芍(一钱五分) 粉丹皮(一钱五分) 生地(四钱) 淮麦(三钱)
二诊 头目昏晕稍减,然寐中仍轰热汗出,血吐未复,操劳动阳,阳气不收。再敛阴潜阳。
大生地(四钱) 生牡蛎(七钱) 黑豆衣(三钱) 柏子霜(三钱) 枣仁(二钱炒) 生鳖甲(四钱)
生白芍(三钱) 女贞子(三钱) 茯苓神(各三钱) 淮小麦(五钱) 大红枣(三枚)
三诊 眩晕稍减。寐中轰热汗出略定。的是吐血之后,阴虚阳气不收。再育阴摄阳。
龟板(五钱) 牡蛎(五钱) 枣仁(三钱) 黑豆衣(三钱) 大红枣(三枚) 鳖甲(四钱)
白芍(二钱) 青蒿(三钱) 大生地(四钱) 淮小麦(五钱)
四诊 寐得酣沉,轰热汗出已定,眩晕渐轻,胃纳升序。阳气渐得收摄。但虚而不复,非滋养难收全功也。
生龟板(四钱) 杭白芍(一钱五分) 黑豆衣(三钱) 生牡蛎(四钱) 川贝(二钱) 生鳖甲(四钱)
枣仁(二钱炒) 大生地(四钱) 白茯苓(三钱) 海蛤粉(三钱) 橘红(盐水炒一钱)
北沙参(四钱) 阿胶珠(二钱) 大生地(四钱) 西洋参(二钱) 生山药(三钱) 光杏仁(三钱)
川贝母(二钱) 茯苓(四钱) 大麦冬(三钱) 青蛤散(五钱) 白蜜(二钱,冲服) 白粳米(一撮)
猪肤(五钱,煎汤去沫后代替水来煎药)
沈姓患者(左侧脉象):嗜酒损伤肺脏。屡次咳血,久咳不止。脉搏数而微促。肺金与肾水同时亏损,病症已进入虚损范畴,虽然目前可以勉强维持安稳,但日后难免走向衰败。
南沙参 地骨皮 青蛤散 光杏仁 青芦管 生薏苡仁 川石斛 川贝 冬瓜子 枇杷叶 桑叶
吴姓患者(左侧脉象):嗜酒导致湿热蒸腾,损伤肺胃,致使吐血之后,咳嗽日久声音嘶哑。肺为肾之母,没有肺受损而肾水独自充沛的道理,水源枯竭是立刻就能预见的事。病症进入虚损途径,不能承诺治愈。
光杏仁 生薏苡仁 冬瓜子 青蛤散 青芦管 云茯苓 桔梗 川贝 蝉衣 炒瓜蒌皮 竹茹(用水炒制)
右侧脉象:咽痛大幅减轻,口渴也感觉稍退,胃纳开始恢复,药物与病情如鼓槌击鼓般相应。但频繁伴有呛咳,时常仍有呕吐。肝肾之阴,亏损已到极点,以致水不涵木,肝火犯肺则呛咳,肝气乘脾土则呕吐。舌苔腐腻虽退,但舌中心呈灰黑色。时常容易出汗,这是阳气欲脱的征象。难道草木药物的功效,能与自然造化争权吗?勉强按照前法扩充思路。
台参须(五分) 生白芍(一钱) 川贝(炒黄二钱) 大麦冬(四钱) 女贞子(三钱) 西洋参(三钱)
大生地(四钱) 金石斛(四钱) 牡蛎(四钱) 梨汁(一两,冲服) 豆衣(三钱)
二诊:肝阴肾水,亏损已到极点,导致肝风上翔,冲犯侮逆胃土,风翔则浪涌,以致呕吐再次发作。营液既然亏损,气分也耗伤,两腋下发出白㾦(晶亮小水泡)。脉虚苔腐。这是阳气欲脱的征兆。勉强拟定补气育阴之法,也只是尽力而为罢了。
台参须 牡蛎 西洋参 黑豆衣 梨汁 大麦冬 大生地 金石斛 女贞子 生白芍 血燕根(三钱,用绢包煎汤代替水)
江姓患者(左侧脉象):咳嗽不减,内热口渴小便赤,脉象细数,饮食减少思虑。肺金肾水交相亏损,恐怕难以支撑。
北沙参 川石斛 川贝母 光杏仁 炒瓜蒌皮 海蛤粉 橘红(盐水炒) 云茯苓 款冬花 建泽泻 冬瓜子
二诊:久咳气逆难以平卧。脉细如丝,舌苔腐烂。肾虚到了极点,肾火挟带浊气上浮。危险就在旦夕之间,勉强开方图谋进取。
麦冬(三钱) 西洋参(一钱五分) 真阿胶(三钱) 橘白(盐水炒一钱五分) 海蛤粉(四钱) 北沙参(五钱) 大生地(四钱) 牛膝炭(三钱) 云茯苓(四钱) 吉林参(另煎冲服一钱) 白荷花露(温冲七钱) 竹沥(一两,加少许姜汁冲服) 上濂珠(四分) 川贝母(五分,二味研细末分两次服) 枇杷叶(去毛炙三片)
三诊:气喘大幅平息,痰也略微顺畅,但口腔糜腐时退时发。脉形虚弦,关部独大。饮水化为痰,痰化为燥,燥化为火,所有的阴津,都被劫夺殆尽。虽然略有转机,尚不足以依赖。
西洋参(三钱) 海蛤粉(四钱) 北沙参(八钱) 海浮石(三钱) 川贝母(三钱) 大麦冬(三钱)
云茯苓(三钱) 竹沥(一两,加少许姜汁冲服) 金石斛(四钱) 陈关蛰(一两) 大荸荠(四枚,二味煎汤代替水) 上濂珠(五分) 真川贝(一钱,二味研极细末分两次服)
改方:阴津因火邪劫夺,火邪由痰化生。虽然应以救阴为急务,但仍需顾及其痰火,竹油雪羹之类,宜频频兼进。
黄姓患者(左侧脉象):吐血之后,剧烈咳嗽多痰,痰皆稀白。脉细沉苔白无光泽。三焦之气已虚,劳损根深,鞭长莫及。
川桂枝 云茯苓 光杏仁 炙绵芪 煨生姜 炒苏子 旋复花 炙甘草 新会皮
二诊:建立中气,咳嗽气逆逐渐舒缓,声音嘶哑转亮,胃纳也开始恢复。虽然是从失血蔓延导致虚损,但连续服用甘温药物,并不见出血,足见久咳导致三焦气虚。药物既然见效,怎能坐视不管,暂且按前法扩充,以观察造化变化。
川桂枝 光杏仁 云茯苓 广橘红 牡蛎(盐水炒) 茯神 炙绵芪 炙甘草 牛膝炭 东白芍 淮小麦 龙齿
某患者:本是先天不足,肾脏空虚,湿热下注,发为漏疡,按理应当培补还来不及。乃肺感风邪,邪气留恋未清,遂致咳嗽久不止,咽痒痰多声音闪动,脉数内热。本虚表实,竟是劳损情形,非学识浅薄、才疏学陋者,敢承诺治愈。勉强拟定化痰润肺之法以备使用。
川贝(炒黄二钱) 云茯苓(四钱) 光杏仁(三钱) 荆芥(一钱炒) 橘红(蜜炙一钱) 栝蒌皮(三钱)
海蛤粉(四钱) 肺露(一两冲服) 霜桑叶(炙黄研末先调服二钱) 枇杷叶(去毛七片用蜜炙十四片用姜汁炙煎汤代替水)
二诊:肺气稍得下行,咳嗽略减,音声也较爽利,不可不为起色。但时常仍觉燥热。脉象带数,仍未敛静。阴液已耗,还恐缠绵难愈不复原。
苦桔梗(八分) 麦冬(二钱炒) 茯苓(三钱) 光杏仁(三钱) 橘红(蜜炙一钱) 地骨皮(一钱五分)
制半夏(一钱五分) 桑皮(一钱炙) 女贞子(一钱五分) 丹皮(一钱五分) 竹衣(一分) 枇杷叶(二十片煎汤代替水)
某患者:天下没有倒行之水,所以人身没有逆上之血,水有时而倒行,是因为风激之;血无端而逆上,是因为火激之。体无端而有火,是木所生;木何以生火,郁则生火。血属阴气属阳,吐血之后,阴虚阳旺,是必然之道。此时滋助水源,即是治血治火的正道。盖火有虚火,不像实火可以用寒胜、用凉折。乃以凉治热,血止热平。而阴分不复,因耗成损因损成虚,遂致金水不能相生,肾气不能收摄,呼吸之气,渐失其肺出肾纳之常。咳嗽气逆,内热连绵,液被热蒸,尽成胶浊,痰多盈碗。脉象数,左关细弦,尺部缓急不齐,舌红苔薄白。肺津肾水,中气脾阳,一齐亏损。肺为肾之母,养肺必先益肾,中气下根于肾,治脾胃亦必先治肾也。拟金水并调法即请商裁。
北沙参(三钱) 川贝母(二钱) 白茯苓(三钱) 金石斛(三钱) 海蛤粉(三钱) 生地炭(四钱)
煨磁石(三钱) 车前子(一钱五分) 盐水炒牛膝(三钱) 炙款冬花(一钱五分)
杨姓患者(右侧脉象):产后久咳,复产更甚,吐血时止时来,不能左侧卧,甚至声音雌哑,左胁漉漉有声,咽痒有时呕吐。脉细弦数,舌红少苔。阴虚木旺,木叩金鸣。证入损门,不敢言治。
阿胶珠(三钱) 金石斛(四钱) 生扁豆(三钱) 大天冬(二钱) 青蛤散(四钱) 生白芍(一钱五分)
生甘草(四分) 怀牛膝(三钱) 冬虫夏草(二钱) 琼玉膏(二次冲服五钱)
周姓患者(左侧脉象):屡次吐血,渐至久咳不止,内热火升,右颊红赤。脉细弦而数。音闪不扬。阴虚木火凌金,金被火铄,生化不及,即水源日涸。恐损而难复。
大生地(五钱) 炙桑皮(一钱五分) 冬瓜子(三钱) 青蒿子(三钱) 大天冬(三钱) 地骨皮(二钱)
青蛤散(四钱) 川贝母(二钱) 阿胶珠(三钱) 生甘草(三分) 枇杷叶(四片) 都气丸(三钱晨服)
二诊:音闪渐扬,咳仍不减,内热火升。舌红,苔糙白,脉细弦数。吐血之后,阴虚已甚,冲阳挟龙相上炎。再金水并调。
大生地(五钱) 川贝母(二钱) 生白芍(一钱五分) 炙款冬(二钱) 大麦冬(三钱) 青蛤散(三钱)
粉丹皮(一钱五分) 牛膝炭(三钱) 冬虫夏草(二钱) 都气丸(三钱)
顾姓患者(右侧脉象):心悸肢节作痛,皮寒骨热。脉象细弦。营血亏损,遂致营卫失和,营血不能濡养经络。宜养血和营。
全当归(三钱) 炙黑草(五分) 柏子霜(三钱) 甘杞子(三钱) 龙眼肉(五枚) 白芍(酒炒二钱)
茯神(三钱) 枣仁(二钱炒) 阿胶珠(二钱) 大南枣(四枚)
二诊:心悸稍定,胃纳如常。的是营血不足,心阳不能下降。效方扩充。
大生地(四钱) 辰麦冬(三钱) 枣仁(二钱炒) 白归身(一钱五分) 阿胶(二钱) 白芍(酒炒一钱五分)
辰茯神(三钱) 柏子霜(三钱) 龙眼肉(四枚) 天王补心丹(三钱清晨先服)
又膏方:营阴亏损,营血不足,不克与卫俱行,遂致营卫不和,皮寒骨热。血不养经,则肢节作痛。血不养肝,风阳上旋,则头痛耳鸣心悸。滋水以涵肝木,育阴而和营血,一定之理。
大生地(六两) 池菊花(一两) 杭白芍(酒炒三两) 柏子仁(二两) 川断(二两) 大熟地(四两)
白归身(酒炒三两) 浓杜仲(三两) 奎党参(四两) 茯神(二两) 西洋参(一两) 女贞子(酒蒸二两)
天麦冬(辰砂拌各一两五钱) 黑豆衣(二两) 白薇(二两炒) 生熟甘草(各五钱) 肥玉竹(二两) 泽泻(一两) 杞子(二两) 怀牛膝(酒炒三两) 青蒿(一两五钱) 枣仁(二两炒) 于术(乳蒸一两) 炒萸肉(一两) 炒木瓜(一两) 石决明(四两)
阿胶三两,龟胶二两,鹿胶一两,溶化收膏。
韩姓患者(左侧脉象):抑郁阳升不寐,木火刑金,而致吐血复发。血止之后,营阴亏损,营卫循环失度,倏寒倏热,头晕火升,口渴。舌红少苔,脉象细弦。皆阴虚不复之象。急为和阴,以冀渐复。
阿胶珠(二钱) 杭白芍(一钱五分) 金石斛(四钱) 茯神(三钱) 生牡蛎(三钱) 天冬(三钱)
生山药(三钱) 龙齿(三钱) 川贝(去心一钱五分) 枣仁(炒研二钱)
庄姓患者(左侧脉象):吐血之后,阴分未复,操劳动作,阳气升腾,头目昏晕,寐中辄轰然而热,有汗出之意。脉形左大。宜育阴熄肝。
阿胶珠(三钱) 生牡蛎(五钱) 女贞子(三钱) 茯神(三钱) 甘菊花(一钱五分) 生鳖甲(五钱)
生白芍(一钱五分) 粉丹皮(一钱五分) 生地(四钱) 淮麦(三钱)
二诊:头目昏晕稍减,然寐中仍轰热汗出,血吐未复,操劳动阳,阳气不收。再敛阴潜阳。
大生地(四钱) 生牡蛎(七钱) 黑豆衣(三钱) 柏子霜(三钱) 枣仁(二钱炒) 生鳖甲(四钱)
生白芍(三钱) 女贞子(三钱) 茯苓神(各三钱) 淮小麦(五钱) 大红枣(三枚)
三诊:眩晕稍减。寐中轰热汗出略定。的是吐血之后,阴虚阳气不收。再育阴摄阳。
龟板(五钱) 牡蛎(五钱) 枣仁(三钱) 黑豆衣(三钱) 大红枣(三枚) 鳖甲(四钱)
白芍(二钱) 青蒿(三钱) 大生地(四钱) 淮小麦(五钱)
四诊:寐得酣沉,轰热汗出已定,眩晕渐轻,胃纳升序。阳气渐得收摄。但虚而不复,非滋养难收全功也。
生龟板(四钱) 杭白芍(一钱五分) 黑豆衣(三钱) 生牡蛎(四钱) 川贝(二钱) 生鳖甲(四钱)
枣仁(二钱炒) 大生地(四钱) 白茯苓(三钱) 海蛤粉(三钱) 橘红(盐水炒一钱)
Bei Sha Shen (Glehniae Radix, 4 qian) Ejiao Zhu (Colla Corii Asini Pulverized with Sand, 2 qian) Da Sheng Di (Rehmanniae Radix Recens, 4 qian) Xi Yang Shen (Panacis Quinquefolii Radix, 2 qian) Sheng Shan Yao (Dioscoreae Rhizoma, 3 qian) Guang Xing Ren (Armeniacae Semen Amarum, 3 qian) Chuan Bei Mu (Fritillariae Cirrhosae Bulbus, 2 qian) Fu Ling (Poria, 4 qian) Da Mai Dong (Ophiopogonis Radix, 3 qian) Qing Ge San (Shell of Clam and Turbinella Powder, 5 qian) Bai Mi (White Honey, 2 qian, taken by dissolving in decoction) Bai Jing Mi (White Rice, a pinch) Zhu Fu (Porcine Skin, 5 qian, decocted to remove foam and used as water for decocting other herbs)
Patient Shen (Left pulse): Habitual alcohol consumption injures the Lung. Recurrent hemoptysis and chronic cough persist. The pulse is rapid and slightly hurried. Both Lung Metal and Kidney Water are deficient; the condition has entered the category of Xu Sun (Consumption). Although temporary stability may be maintained, decline is inevitable in the future.
Nan Sha Shen (Adenophorae Radix), Di Gu Pi (Lycii Cortex), Qing Ge San, Guang Xing Ren, Qing Lu Guan (Green Reed Tube), Sheng Yi Ren (Coicis Semen), Chuan Shi Hu (Dendrobii Caulis), Chuan Bei, Dong Gua Zi (Benincasae Semen), Pi Pa Ye (Loquat Leaf), Sang Ye (Mori Folium).
Patient Wu (Left pulse): Alcohol-induced damp-heat steaming injures the Lung and Stomach, leading to chronic cough and hoarseness after hemoptysis. The Lung is the mother of the Kidney; it is impossible for the Lung to be damaged while Kidney Water remains abundant. Depletion of the water source is imminent. The condition has entered the path of Consumption; cure cannot be promised.
Guang Xing Ren, Sheng Yi Ren, Dong Gua Zi, Qing Ge San, Qing Lu Guan, Yun Fu Ling (Poria), Jie Geng (Platycodonis Radix), Chuan Bei, Chan Yi (Cicadae Periostracum), Chao Lou Pi (Trichosanthis Pericarpium Stir-fried), Zhu Ru (Bambusae Caulis in Taeniam, stir-fried with water).
Right pulse: Throat pain has significantly decreased, thirst has slightly receded, and appetite is returning; the medicine acts effectively like a drumstick striking a drum. However, frequent choking coughs and occasional vomiting persist. Yin of the Liver and Kidney is extremely depleted, failing to nourish Wood (Water does not nurture Wood), causing Liver Fire to harass Metal (choking cough) and Liver Qi to invade Earth (vomiting). Although tongue coating erosion has subsided, the center is gray-black. Frequent sweating indicates impending collapse of Yang. Can herbal efficacy compete with natural transformation? Forcing an expansion of the previous formula.
Tai Shen Xu (Ginseng Radix et Rhizoma Filamentous Root, 0.5 qian), Sheng Bai Shao (Paeoniae Radix Alba, 1 qian), Chuan Bei (Stir-fried Yellow, 2 qian), Da Mai Dong (4 qian), Nv Zhen Zi (Ligustri Lucidi Fructus, 3 qian), Xi Yang Shen (3 qian), Da Sheng Di (4 qian), Jin Shi Hu (Dendrobii Caulis, 4 qian), Mu Li (Ostreae Concha, 4 qian), Li Zhi (Pear Juice, 1 liang, dissolved), Dou Yi (Sojae Semen Nigrum Testa, 3 qian).
Second Visit: Liver Yin and Kidney Water are extremely depleted, causing Liver Wind to rise and assault the Stomach Earth. Rising wind creates surging waves, leading to recurrent vomiting. Ying Fluid is depleted, and Qi is also consumed. White miliary eruptions appear on both armpits. The pulse is weak and tongue coating eroded. This is a sign of impending collapse. Tentatively prescribing Qi-tonifying and Yin-nourishing methods, doing one's utmost.
Tai Shen Xu, Mu Li, Xi Yang Shen, Hei Dou Yi, Li Zhi, Da Mai Dong, Da Sheng Di, Jin Shi Hu, Nv Zhen Zi, Sheng Bai Shao, Xue Yan Gen (Blood Swallow Nest Root, 3 qian, decocted in silk bag to replace water).
Patient Jiang (Left pulse): Cough persists without reduction, internal heat and thirst with dark urine, pulse is fine and rapid, appetite is low and thinking is scarce. Lung Metal and Kidney Water are mutually deficient; support seems unlikely.
Bei Sha Shen (Glehniae Radix), Chuan Shi Hu, Chuan Bei Mu, Guang Xing Ren, Chao Lou Pi, Hai Ge Fen (Clam Shell Powder), Ju Hong (Citri Reticulatae Pericarpium, salt-water stir-fried), Yun Fu Ling, Kuan Dong Hua (Farfarae Flos), Jian Ze Xie (Alismatis Rhizoma), Dong Gua Zi.
Second Visit: Chronic cough with rebellious Qi making lying down difficult. Pulse is fine as a thread, tongue coating is eroded. Kidney deficiency is extreme, with Kidney Fire carrying turbidity upward. Danger is imminent; tentatively prescribing a formula to advance treatment.
Mai Dong (3 qian), Xi Yang Shen (1.5 qian), Zhen Ejiao (True Colla Corii Asini, 3 qian), Ju Bai (Citri Reticulatae Albedo, salt-water stir-fried 1.5 qian), Hai Ge Fen (4 qian), Bei Sha Shen (5 qian), Da Sheng Di (4 qian), Niu Xi Tan (Achyranthis Bidentatae Radix Charred, 3 qian), Yun Fu Ling (4 qian), Ji Lin Shen (Jilin Ginseng, separately decocted and taken by dissolving 1 qian), Bai He Hua Lu (White Lotus Flower Dew, warm dissolved 7 qian), Zhu Li (Bambusae Succesio, 1 liang with少许 Ginger Juice), Shang Lian Zhu (Pearl, 0.4 fen), Chuan Bei Mu (0.5 fen, two ingredients ground into fine powder, taken twice). Pi Pa Ye (De-hairied and roasted, 3 slices).
Third Visit: Asthma has largely settled, phlegm is slightly clearer, but oral erosion comes and goes. Pulse is deficient and wiry, particularly large at the Guan position. Drinking transforms into phlegm, phlegm into dryness, dryness into fire; all Yin fluids have been plundered. Although there is slight improvement, it is not yet reliable.
Xi Yang Shen (3 qian), Hai Ge Fen (4 qian), Bei Sha Shen (8 qian), Hai Fu Shi (Pumex, 3 qian), Chuan Bei Mu (3 qian), Da Mai Dong (3 qian), Yun Fu Ling (3 qian), Zhu Li (1 liang with少许 Ginger Juice), Jin Shi Hu (4 qian), Chen Guan Zhe (Chenpi from Guan region, 1 liang), Da Bi Qi (Large Water Chestnut, 4 pieces, decocted to replace water), Shang Lian Zhu (0.5 fen), Zhen Chuan Bei (Real Chuan Bei Mu, 1 qian, two ingredients ground into very fine powder, taken twice).
Modified Formula: Yin is plundered by Fire, Fire is generated from Phlegm. Although saving Yin is urgent, attention must still be paid to Phlegm-Fire. Bamboo Oil and Xue Geng (Winter Melon and Trichosanthes Decoction) should be frequently administered alongside.
Patient Huang (Left pulse): After hemoptysis, severe cough with much phlegm, phlegm is thin and white. Pulse is fine and deep, tongue coating is white and lusterless. Qi of the Triple Burner is deficient, root of Labor Consumption is deep, beyond reach.
Chuan Gui Zhi (Cinnamomi Ramulus), Yun Fu Ling, Guang Xing Ren, Zhi Mian (Astragali Radix Roasted), Wei Sheng Jiang (Gingeris Rhizoma Recens Roasted), Chao Su Zi (Perillae Fructus Stir-fried), Xuan Fu Hua (Inulae Flos), Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Roasted), Xin Hui Pi (Xinhui Citri Reticulatae Pericarpium).
Second Visit: Middle Qi is established, cough and rebellious Qi gradually loosen, hoarseness turns bright, appetite returns. Although damage spread from blood loss, continuous administration of Sweet-Warm herbs did not cause bleeding, proving that chronic cough caused Triple Burner Qi deficiency. Since the medicine works, how can we sit idle? Tentatively expanding the previous idea to observe natural transformation.
Chuan Gui Zhi, Guang Xing Ren, Yun Fu Ling, Guang Ju Hong, Mu Li (Salt-water stir-fried), Fu Shen (Poria with Hostwood), Zhi Mian, Zhi Gan Cao, Niu Xi Tan, Dong Bai Shao (East Paeoniae Radix Alba), Huai Xiao Mai (Triticum Grain), Long Chi (Draconis Os).
Certain Patient: Originally congenital insufficiency, Kidney emptiness, Damp-Heat pouring downward causing fistula/ulcer,理应培补 (should ideally be tonified urgently). Then Lung contracted Wind Evil, evil lingered unresolved, leading to chronic cough, throat itching, much phlegm, voice fluctuation, rapid pulse, internal heat. Root deficiency, Excess exterior, truly resembling Labor Consumption. Not within the capability of shallow learning and sparse talent to promise cure. Tentatively prescribing Phlegm-resolving and Lung-moistening method for reference.
Chuan Bei (Stir-fried Yellow, 2 qian), Yun Fu Ling (4 qian), Guang Xing Ren (3 qian), Jing Jie (Schizonepetae Spica, 1 qian stir-fried), Ju Hong (Honey-roasted 1 qian), Gua Lou Pi (Trichosanthis Pericarpium, 3 qian), Hai Ge Fen (4 qian), Fei Lu (Lung Dew, 1 liang dissolved), Shuang Sang Ye (Frost Mulberry Leaf, roasted yellow ground to powder, taken first 2 qian), Pi Pa Ye (De-hairied 7 slices honey-roasted, 14 slices ginger-juice roasted, decocted to replace water).
Second Visit: Lung Qi descends slightly, cough reduces slightly, voice becomes clearer, which is a positive sign. But still occasionally feels dry-hot. Pulse carries rapidity, not yet gathered and quiet. Yin fluid is consumed, fear lingering non-recovery.
Ku Jie Geng (Bitter Platycodonis Radix, 0.8 fen), Mai Dong (Stir-fried 2 qian), Fu Ling (3 qian), Guang Xing Ren (3 qian), Ju Hong (Honey-roasted 1 qian), Di Gu Pi (1.5 qian), Zhi Ban Xia (Prepared Pinelliae Tuber, 1.5 qian), Sang Pi (Mori Cortex, 1 qian roasted), Nv Zhen Zi (1.5 qian), Dan Pi (Moutan Cortex, 1.5 qian), Zhu Yi (Bamboo Coat, 0.1 fen), Pi Pa Ye (20 slices decocted to replace water).
Certain Patient: There is no backward-flowing water in the world, so there is no upward-rebellious blood in the body. Water flows backward due to Wind agitation; Blood rebels upward due to Fire agitation. Fire arises from Wood; Wood generates Fire through stagnation. Blood is Yin, Qi is Yang; after hemoptysis, Yin deficiency and Yang hyperactivity are inevitable. Nourishing the Water source at this time is the correct way to treat blood and fire. Fire includes Deficient Fire, which cannot be overcome by Cold or cooled by Coolness like Excess Fire. Using Cool to treat Heat stops bleeding and calms heat. But if Yin does not recover, depletion leads to Consumption, Consumption leads to Deficiency, causing Metal and Water unable to generate each other, Kidney Qi unable to grasp, respiration losing its normal pattern of Lung exhalation and Kidney inhalation. Cough and rebellious Qi, continuous internal heat, fluids steamed by heat become sticky turbid, phlegm fills bowls. Pulse is rapid, Left Guan is fine and wiry, Chi position is irregular. Tongue red, coating thin white. Lung Jin, Kidney Water, Middle Qi, Spleen Yang are all deficient. Lung is mother of Kidney; nourishing Lung must first benefit Kidney. Middle Qi roots in Kidney; treating Spleen/Stomach must first treat Kidney. Proposing Metal-Water simultaneous regulation method for discussion.
Bei Sha Shen (3 qian), Chuan Bei Mu (2 qian), Bai Fu Ling (3 qian), Jin Shi Hu (3 qian), Hai Ge Fen (3 qian), Sheng Di Tan (Rehmanniae Radix Recens Charred, 4 qian), Wei Ci Shi (Calcitritum Roasted, 3 qian), Che Qian Zi (Plantaginis Semen, 1.5 qian), Yan Shui Chao Niu Xi (Salt-water stir-fried Achyranthis Bidentatae Radix, 3 qian), Zhi Kuan Dong Hua (Roasted Farfarae Flos, 1.5 qian).
Patient Yang (Right pulse): Postpartum chronic cough, worse after second birth, hemoptysis comes and goes, cannot lie on left side, even voice becomes female-like hoarse, left hypochondrium sounds gurgling, throat itching with occasional vomiting. Pulse fine, wiry, rapid; tongue red, little coating. Yin deficiency, Wood hyperactivity, Wood strikes Metal. Condition enters Consumption door, dare not speak of cure.
Ejiao Zhu (3 qian), Jin Shi Hu (4 qian), Sheng Bian Dou (Phaseoli Radiati Semen, 3 qian), Da Tian Dong (Asparagi Radix, 2 qian), Qing Ge San (4 qian), Sheng Bai Shao (1.5 qian), Sheng Gan Cao (Licorice Root, 0.4 qian), Huai Niu Xi (Achyranthis Bidentatae Radix, 3 qian), Dong Chong Xia Cao (Cordyceps, 2 qian), Qiong Yu Gao (Qiongyu Paste, taken by dissolving twice 5 qian).
Patient Zhou (Left pulse): Repeated hemoptysis, gradually to chronic cough, internal heat rising, right cheek red. Pulse fine, wiry, rapid. Voice fluctuates and is not resonant. Yin deficiency, Wood-Fire harassing Metal, Metal scorched by Fire, generation insufficient, water source dries daily. Fear Consumption difficult to recover.
Da Sheng Di (5 qian), Zhi Sang Pi (Roasted Mori Cortex, 1.5 qian), Dong Gua Zi (3 qian), Qing Hao Zi (Artemisiae Annuae Fructus, 3 qian), Da Tian Dong (3 qian), Di Gu Pi (2 qian), Qing Ge San (4 qian), Chuan Bei Mu (2 qian), Ejiao Zhu (3 qian), Sheng Gan Cao (0.3 qian), Pi Pa Ye (4 slices), Du Qi Wan (Duqi Pill, 3 qian morning dose).
Second Visit: Voice fluctuation gradually improves, cough still unchanged, internal heat rising. Tongue red, coating rough white, pulse fine, wiry, rapid. After hemoptysis, Yin deficiency is severe, Chong Yang carries Dragon Fire upward. Again regulating Metal and Water.
Da Sheng Di (5 qian), Chuan Bei Mu (2 qian), Sheng Bai Shao (1.5 qian), Zhi Kuan Dong (Roasted Farfarae Flos, 2 qian), Da Mai Dong (3 qian), Qing Ge San (3 qian), Fen Dan Pi (Moutan Cortex, 1.5 qian), Niu Xi Tan (Charred Achyranthis Bidentatae Radix, 3 qian), Dong Chong Xia Cao (2 qian), Du Qi Wan (3 qian).
Patient Gu (Right pulse): Palpitations, joint pain, cold skin, hot bones. Pulse fine, wiry. Ying Blood deficient, leading to disharmony of Ying and Wei, Ying Blood unable to nourish meridians. Should nourish Blood and harmonize Ying.
Quan Dang Gui (Angelicae Sinensis Radix, 3 qian), Zhi Hei Cao (Blackened Licorice, 0.5 qian), Bai Zi Shuang (Biota Seed Frost, 3 qian), Gan Qi Zi (Goji Berry, 3 qian), Long Yan Rou (Longan Aril, 5 pieces), Bai Shao (Wine-stir-fried Paeoniae Radix Alba, 2 qian), Fu Shen (3 qian), Zao Ren (Ziziphi Spinosae Semen, 2 qian stir-fried), Ejiao Zhu (2 qian), Da Nan Zao (Large Chinese Jujube, 4 pieces).
Second Visit: Palpitations slightly settled, appetite normal. Indeed Ying Blood insufficient, Heart Yang unable to descend. Effective formula expanded.
Da Sheng Di (4 qian), Chen Mai Dong (Ophiopogonis Radix with Cinnabar, 3 qian), Zao Ren (2 qian stir-fried), Bai Gui Shen (Angelicae Sinensis Radix Body, 1.5 qian), Ejiao (Colla Corii Asini, 2 qian), Bai Shao (Wine-stir-fried, 1.5 qian), Chen Fu Shen (Poria with Hostwood with Cinnabar, 3 qian), Bai Zi Shuang (3 qian), Long Yan Rou (4 pieces), Tian Wang Bu Xin Dan (Emperor of Heaven’s Heart-Nourishing Pill, 3 qian taken early morning).
Another Paste Formula: Ying Yin deficient, Ying Blood insufficient, unable to travel with Wei, leading to disharmony of Ying and Wei, cold skin, hot bones. Blood not nourishing meridians causes joint pain. Blood not nourishing Liver causes Wind-Yang to rotate upward, headache, tinnitus, palpitations. Nourishing Water to contain Liver Wood, nurturing Yin to harmonize Ying Blood is a fixed principle.
Da Sheng Di (6 liang), Chi Ju Hua (Chrysanthemi Flos, 1 liang), Hang Bai Shao (Wine-stir-fried Paeoniae Radix Alba, 3 liang), Bai Zi Ren (Biota Semen, 2 liang), Chuan Duan (Dipsaci Radix, 2 liang), Da Shu Di (Rehmanniae Radix Preparata, 4 liang), Bai Gui Shen (Wine-stir-fried Angelicae Sinensis Radix Body, 3 liang), Nong Du Zhong (Eucommiae Cortex, 3 liang), Kui Dang Shen (Codonopsis Radix, 4 liang), Fu Shen (2 liang), Xi Yang Shen (1 liang), Nv Zhen Zi (Wine-steamed Ligustri Lucidi Fructus, 2 liang), Tian Mai Dong (Ophiopogonis Radix and Liriopes Radix mixed with Cinnabar, 1.5 liang each), Hei Dou Yi (2 liang), Bai Wei (Cynanchi Atrati Radix, 2 liang stir-fried), Sheng Shu Gan Cao (Raw and Prepared Licorice, 5 qian each), Fei Yu Zhu (Polygonati Odorati Rhizoma, 2 liang), Ze Xie (Alismatis Rhizoma, 1 liang), Qi Zi (Goji Berry, 2 liang), Huai Niu Xi (Wine-stir-fried Achyranthis Bidentatae Radix, 3 liang), Qing Hao (Artemisiae Annuae Herba, 1.5 liang), Zao Ren (2 liang stir-fried), Yu Zhu (Atractylodis Rhizoma, milk-steamed 1 liang), Chao Yu Rou (Corni Fructus stir-fried, 1 liang), Chao Mu Gua (Chaenomelis Fructus stir-fried, 1 liang), Shi Jue Ming (Haliotidis Concha, 4 liang).
Ejiao 3 liang, Gui Jiao (Testudinis et Chelydrae Carapax et Plastrum Preparatum) 2 liang, Lu Jiao (Cervi Cornu Degelatinatum) 1 liang, melt and collect paste.
Patient Han (Left pulse): Depression, Yang rising, insomnia, Wood-Fire punishing Metal, causing recurrent hemoptysis. After bleeding stops, Ying Yin deficient, Ying-Wei circulation disordered, sudden chills and fever, dizziness, fire rising, thirst. Tongue red, little coating, pulse fine, wiry. All signs of Yin deficiency non-recovery. Urgently harmonizing Yin, hoping for gradual recovery.
Ejiao Zhu (2 qian), Hang Bai Shao (1.5 qian), Jin Shi Hu (4 qian), Fu Shen (3 qian), Sheng Mu Li (Ostreae Concha, 3 qian), Tian Dong (Asparagi Radix, 3 qian), Sheng Shan Yao (3 qian), Long Chi (3 qian), Chuan Bei (De-heartened Pinelliae/Tibetan Fritillaria, 1.5 qian), Zao Ren (Stir-fried ground, 2 qian).
Patient Zhuang (Left pulse): After hemoptysis, Yin division not recovered, physical labor causes Yang Qi to rise, dizziness, hot flashes during sleep with intention to sweat. Pulse shape large on left. Should nurture Yin and extinguish Liver.
Ejiao Zhu (3 qian), Sheng Mu Li (5 qian), Nv Zhen Zi (3 qian), Fu Shen (3 qian), Gan Ju Hua (Chrysanthemi Flos, 1.5 qian), Sheng Bie Jia (Trionycis Carapax, 5 qian), Sheng Bai Shao (1.5 qian), Fen Dan Pi (1.5 qian), Sheng Di (Rehmanniae Radix Recens, 4 qian), Huai Mai (Triticum aestivum, 3 qian).
Second Visit: Dizziness slightly reduced, but still hot flashes and sweating during sleep, blood not recovered, labor agitates Yang, Yang Qi not grasped. Again gathering Yin and subduing Yang.
Da Sheng Di (4 qian), Sheng Mu Li (7 qian), Hei Dou Yi (3 qian), Bai Zi Shuang (3 qian), Zao Ren (2 qian stir-fried), Sheng Bie Jia (4 qian), Sheng Bai Shao (3 qian), Nv Zhen Zi (3 qian), Fu Ling Shen (Poria and Poria with Hostwood, 3 qian each), Huai Xiao Mai (5 qian), Da Hong Zao (Large Red Date, 3 pieces).
Third Visit: Dizziness slightly reduced. Hot flashes and sweating during sleep slightly settled. Indeed after hemoptysis, Yin deficiency, Yang Qi not grasped. Again nurturing Yin and grasping Yang.
Gui Ban (Testudinis Carapax, 5 qian), Mu Li (5 qian), Zao Ren (3 qian), Hei Dou Yi (3 qian), Da Hong Zao (3 pieces), Bie Jia (Trionycis Carapax, 4 qian), Bai Shao (2 qian), Qing Hao (3 qian), Da Sheng Di (4 qian), Huai Xiao Mai (5 qian).
Fourth Visit: Sleep is deep, hot flashes and sweating settled, dizziness gradually lightens, appetite rises in order. Yang Qi gradually grasped. But deficiency non-recovering, hard to achieve full effect without nourishment.
Sheng Gui Ban (Raw Turtle Shell, 4 qian), Hang Bai Shao (1.5 qian), Hei Dou Yi (3 qian), Sheng Mu Li (4 qian), Chuan Bei (2 qian), Sheng Bie Jia (4 qian), Zao Ren (2 qian stir-fried), Da Sheng Di (4 qian), Bai Fu Ling (3 qian), Hai Ge Fen (3 qian), Ju Hong (Salt-water stir-fried Citri Reticulatae Pericarpium, 1 qian).