诸(新开河桥,十六岁) 形瘦色黄,交阴身热,冲年夏热,真阴不生,秋燥加嗽,最有
损怯之累。
今人触冒秽气,动辄刮痧,苏合香丸远胜他药,但屡开则盛耳。
程(四十七岁) 肌色淡白,脉右弦左缓弱,大便久溏,嗳噫哕声不已。日前谓吐蛔起见
,以
酸苦和胃理肝,病患述用药不饥脘闷,乃中宫阳微,味多酸浊。酸苦属阴,不中病矣。议运
行中焦之阳气,辛可以胜酸(用药不知转换变通,必先伤脾胃之阳,此事须极灵活人方能入
道。)
人参 茯苓 益智仁 生姜 葫芦巴 浓朴
李(茜泾,二十一岁) 务农劳力,周身脉络皆动,暑天负重,两次失血,况已先有泻血
,血聚
在络,络系脏腑外郛。盖静养血宁,必一年可以坚固(血聚络而不用宣通药者,以上下皆溢
,不可再用行血药,补则自达。)
熟地 归身 杞子 沙苑 茯苓 山药 杜仲 巴戟 川斛
徐(十八岁) 有梦乃遗,是心动神驰精散,用交心肾法。
水煮熟地 萸肉 远志肉 生龙骨 茯神 石菖蒲 芡实 湘莲子肉
用药渊微。
顾(二十三岁) 三日疟是入阴经而发,延及数月乃罢。其疟热在里,劫损肝血肾精,长
夏一阴
不复,遂加寒热汗出。此病伤成痨,淹淹肉消形软,必绝欲生出精血,有充复之理,草木无
情无用(疟邪不可强截,截则寒热虽罢,而伏邪留着,逼烁精血,自有不适苦况,久之邪既
不得外达,精血日就销亡,日深一日,势必延成痨损也。)
人参 河车胶 茯神 萸肉 五味 芡实 山药 建莲
有陈岐山亦因此丧身,确切之论。
曹(二十一岁) 声出于肺,全赖元海之气旺,俾阳中之阴,承载于上,而声音自扬。据
吃柿饼
遂呕,考其性甘寒而清肺热,欠嗽气散不受,参、 甘温,亦有见效者。若五旬男子,下元
日亏,金水同出一源,形色黄萎少泽,全是下虚上实。所幸纳谷,不致骤凶,经年累月,焉
有速功。
阿胶 天冬 黑豆皮 鸡子黄 大生地
二十剂后,服六味加五味、川斛。
汪(五十岁) 脏真系于目珠,不独肝窍,中年五液不充,阳挟内风,侵及清窍,光明为
阳蒙
蔽,非六气致伤。法当酸收甘缓补法,但六味汤究属是三阴三阳平剂,不切(实者当升清降
浊,虚者应酸收甘补。治羞明昏蒙之大法也。)
炒焦枸杞 菊花炭 萸肉 五味 人参 炙草
羞明目病,虽系内伤,其故亦非一端可尽。有初感时邪,风火搅扰而羞明者,有阳挟内
风,光明为浊阳侵扰而羞明。有下焦浊阴上泛,不敢与阳光敌而羞明者。
孙(北濠,二十六岁) 气郁滞则血不行,当理血中之气。
南查 生香附
另煎四物汤收入,烘炒磨末(制方极巧妙。)
益母膏丸,四物阴浊而滞,得查、附以流通,查、附气燥味辛,得四物以滋润。气血兼
理,燥湿协和。再得益母以行血,血中之气宣顺矣。即有痰滞血凝者,亦可服也。
徐(二十四岁) 初诊谓下焦跗踵浮肿,以收摄肝肾病者,用过颇安。但胸脘不舒展,改
进开
泄血中之气,服之又不安,且面少华色,痞闷又如饥,当以虚论,未有骤功(层次转换。)
人参 桂心 茯苓 炒当归 煨姜 炙甘草
吴(三十四岁) 操家烦冗,兼有嗔怒,肝脾不和, 胀由胁至脘,木犯中土,必妨食不
饥。理气舒郁,和其中宫(开郁总不离越鞠法。)
南查 生香附 神曲 茯苓 钩藤 橘红
赵(三十三岁) 脘痛映脊,甚则四肢逆冷,问当年产后瘕泄,今滞漏脊椎酸垂。内经云
∶阴
维脉病苦心痛,医不和维脉,阴阳异治,谓痛以破气降气,何见识浅陋乃尔(凡女人脘痛久
不愈者,必是奇经中来。曾用过鹿角胶一斤治十四年,脘痛不止者。)
鹿茸 角霜 当归 小茴 枸杞 白蒺藜 茯苓 苁蓉
沈(三十二岁) 壮年,望色夺肉瘦,脉左细右空,此男子精损,真气不主收纳。自述少
腹筑
筑动气而痛,病形脉症,已在下焦。治肺嗽大谬,杂治日延劳怯(少腹动气是关元气海极虚
,命蒂真气已离散,不可收拾,由下窜上,法在不治。)
薛氏八味丸(三钱)
金(六十五岁) 热伤气分,水谷不化之湿,留着胃络,已入秋凉,衰年气弱,夏令伏邪
未去。
议东垣清暑益气,减去滞药(从来气旺之体即感时令偏气,有本体元气以转旋时令偏气
,即为之默化,衰年气弱,客气为主矣。)
人参 茯苓 神曲 升麻 葛根 泽泻 广皮 木瓜 川连
赵(二十三岁) 当年厥症,用填精固摄乃愈。知少壮情念内萌,阴火突起,乱其神明。
今夏热
食减厥,发继而淋浊,热入伤阴,苟不绝欲,未必见效(伤阴热入而伤胃阴也,勿被瞒过。)
人参 茯苓 扁豆 炙草 炒麦冬 川石斛
阴火最能冲乱神明,试观灯檠煤头,带火坠下,火焰冲起,盏上之火即摇动不宁,非明
证欤。
刘(三十七岁) 操持用心,心阳扰动,暗耗脂液,上则悸怔气怯,下则肠枯便难,视色
苍肉
瘦,温补不受,先仿徐之才滑可去涩(裁缝尚能相体剪裁,操司命之责者,可不因人施治乎
此色苍肉瘦,不用温补之所以为高也。)
柏子仁 松子仁 郁李仁 冬葵子 杜苏子 麻仁
用诸仁既可悦心,更滋肠液,切当清真,金针暗度。
诸(十六岁) 夜热不止,舌绛形干,前议伏暑伤阴,用竹叶地黄汤不应,是先天禀薄,
夏至一阴不生,阴虚生热,成痨之象(寒之不寒是无水也。)
三才加丹皮骨皮
赵(五十七岁) 头晕心嘈二十年,向老年岁,血耗阳化内热,近来减食,不必偏寒偏热
,以甘
柔缓热熄风,无燥热戕胃之累(好好阳气,一经血耗,便化内热,即阴虚生内热之变文也。
新极。)
桂元 枸杞 天冬 生地 茯神 柏子仁
甘柔药味平和,可以缓热熄风。盖甘能生液,柔则养阴,老年人调摄要着,盖老人久病
,全要调扶胃气,一切庞杂驳劣之药,概不可投,以其戕贼胃气也。
陶(二十九岁) 暑着必阻游行之气,但热无寒,疮痍不尽,其邪骨节痛,肢末肿,从仲
景湿温例,用苍术白虎汤。
杨(二十六岁) 脉虚数,久嗽呛血,劳则寒热。
虎潜丸(四钱)
顾(二十二岁) 少壮,冬不藏精,仲春内热召风,谓风温,咳嗽内伤,略兼外邪。治邪
必兼
养正(风雅宜人。)昔人有温邪忌汗下者,谓阴阳二气,不可再伤也。一逆再逆,病日深矣。
视面色黄白少泽,按脉形致虚,下垂入尺(望色切脉细密极矣。)问咳频气不舒展,必有
呕恶
之状,显然肾虚少纳,肝阳阴火冲起,犯胃为呕,熏肺喉痒,其不致骤凶,赖水谷未减安受
。考血必聚络,气攻热灼,络血上涌,精血有形
损伤,草木无情不能生续。血脱益气,乃急固其暴。治法以潜心宁静,必情念不萌,绝欲肾
安,斯精血生聚。若频发不已,虽安养不能却病(风温虽缘外感,然必肝肾内虚,冬不藏精
,相火上游,有以召致外邪而温邪内陷,牵引龙雷,伏于内则灼津耗液,冲于上则咳嗽失血
纯见内伤恶状矣。)
人参 熟地 川斛 五味 女贞子 茯神 漂淡天冬 紫衣胡桃肉。
三才加以摄纳,佐以填阴。
陈(十六岁) 秋燥咳嗽。
桑叶 川贝母 南沙参 南花粉 玉竹
萧(二十一岁) 伏暑上郁。
连翘 飞滑石 大竹叶 白杏仁 象贝
方药俱精妙。
张(葑门,六十九岁) 老年下虚痰多,入夜冲气(即是阳不内归,)起坐新凉内侵,肾水
泛,气不收纳,常服肾气丸。
【背景信息】
书名:徐批叶天士晚年方案真本 作者:叶天士 朝代:清 章节:人参建中汤 / 竹叶地黄汤 / 苏合香丸 类别:方剂
【待处理原文】
诸(新开河桥,十六岁) 形瘦色黄,交阴身热,冲年夏热,真阴不生,秋燥加嗽,最有
损怯之累。
今人触冒秽气,动辄刮痧,苏合香丸远胜他药,但屡开则盛耳。
程(四十七岁) 肌色淡白,脉右弦左缓弱,大便久溏,嗳噫哕声不已。日前谓吐蛔起见
,以
酸苦和胃理肝,病患述用药不饥脘闷,乃中宫阳微,味多酸浊。酸苦属阴,不中病矣。议运
行中焦之阳气,辛可以胜酸(用药不知转换变通,必先伤脾胃之阳,此事须极灵活人方能入
道。)
人参 茯苓 益智仁 生姜 葫芦巴 浓朴
李(茜泾,二十一岁) 务农劳力,周身脉络皆动,暑天负重,两次失血,况已先有泻血
,血聚
在络,络系脏腑外郛。盖静养血宁,必一年可以坚固(血聚络而不用宣通药者,以上下皆溢
,不可再用行血药,补则自达。)
熟地 归身 杞子 沙苑 茯苓 山药 杜仲 巴戟 川斛
徐(十八岁) 有梦乃遗,是心动神驰精散,用交心肾法。
水煮熟地 萸肉 远志肉 生龙骨 茯神 石菖蒲 芡实 湘莲子肉
用药渊微。
顾(二十三岁) 三日疟是入阴经而发,延及数月乃罢。其疟热在里,劫损肝血肾精,长
夏一阴
不复,遂加寒热汗出。此病伤成痨,淹淹肉消形软,必绝欲生出精血,有充复之理,草木无
情无用(疟邪不可强截,截则寒热虽罢,而伏邪留着,逼烁精血,自有不适苦况,久之邪既
不得外达,精血日就销亡,日深一日,势必延成痨损也。)
人参 河车胶 茯神 萸肉 五味 芡实 山药 建莲
有陈岐山亦因此丧身,确切之论。
曹(二十一岁) 声出于肺,全赖元海之气旺,俾阳中之阴,承载于上,而声音自扬。据
吃柿饼
遂呕,考其性甘寒而清肺热,欠嗽气散不受,参、 甘温,亦有见效者。若五旬男子,下元
日亏,金水同出一源,形色黄萎少泽,全是下虚上实。所幸纳谷,不致骤凶,经年累月,焉
有速功。
阿胶 天冬 黑豆皮 鸡子黄 大生地
二十剂后,服六味加五味、川斛。
汪(五十岁) 脏真系于目珠,不独肝窍,中年五液不充,阳挟内风,侵及清窍,光明为
阳蒙
蔽,非六气致伤。法当酸收甘缓补法,但六味汤究属是三阴三阳平剂,不切(实者当升清降
浊,虚者应酸收甘补。治羞明昏蒙之大法也。)
炒焦枸杞 菊花炭 萸肉 五味 人参 炙草
羞明目病,虽系内伤,其故亦非一端可尽。有初感时邪,风火搅扰而羞明者,有阳挟内
风,光明为浊阳侵扰而羞明。有下焦浊阴上泛,不敢与阳光敌而羞明者。
孙(北濠,二十六岁) 气郁滞则血不行,当理血中之气。
南查 生香附
另煎四物汤收入,烘炒磨末(制方极巧妙。)
益母膏丸,四物阴浊而滞,得查、附以流通,查、附气燥味辛,得四物以滋润。气血兼
理,燥湿协和。再得益母以行血,血中之气宣顺矣。即有痰滞血凝者,亦可服也。
徐(二十四岁) 初诊谓下焦跗踵浮肿,以收摄肝肾病者,用过颇安。但胸脘不舒展,改
进开
泄血中之气,服之又不安,且面少华色,痞闷又如饥,当以虚论,未有骤功(层次转换。)
人参 桂心 茯苓 炒当归 煨姜 炙甘草
吴(三十四岁) 操家烦冗,兼有嗔怒,肝脾不和, 胀由胁至脘,木犯中土,必妨食不
饥。理气舒郁,和其中宫(开郁总不离越鞠法。)
南查 生香附 神曲 茯苓 钩藤 橘红
赵(三十三岁) 脘痛映脊,甚则四肢逆冷,问当年产后瘕泄,今滞漏脊椎酸垂。内经云
∶阴
维脉病苦心痛,医不和维脉,阴阳异治,谓痛以破气降气,何见识浅陋乃尔(凡女人脘痛久
不愈者,必是奇经中来。曾用过鹿角胶一斤治十四年,脘痛不止者。)
鹿茸 角霜 当归 小茴 枸杞 白蒺藜 茯苓 苁蓉
沈(三十二岁) 壮年,望色夺肉瘦,脉左细右空,此男子精损,真气不主收纳。自述少
腹筑
筑动气而痛,病形脉症,已在下焦。治肺嗽大谬,杂治日延劳怯(少腹动气是关元气海极虚
,命蒂真气已离散,不可收拾,由下窜上,法在不治。)
薛氏八味丸(三钱)
金(六十五岁) 热伤气分,水谷不化之湿,留着胃络,已入秋凉,衰年气弱,夏令伏邪
未去。
议东垣清暑益气,减去滞药(从来气旺之体即感时令偏气,有本体元气以转旋时令偏气
,即为之默化,衰年气弱,客气为主矣。)
人参 茯苓 神曲 升麻 葛根 泽泻 广皮 木瓜 川连
赵(二十三岁) 当年厥症,用填精固摄乃愈。知少壮情念内萌,阴火突起,乱其神明。
今夏热
食减厥,发继而淋浊,热入伤阴,苟不绝欲,未必见效(伤阴热入而伤胃阴也,勿被瞒过。)
人参 茯苓 扁豆 炙草 炒麦冬 川石斛
阴火最能冲乱神明,试观灯檠煤头,带火坠下,火焰冲起,盏上之火即摇动不宁,非明
证欤。
刘(三十七岁) 操持用心,心阳扰动,暗耗脂液,上则悸怔气怯,下则肠枯便难,视色
苍肉
瘦,温补不受,先仿徐之才滑可去涩(裁缝尚能相体剪裁,操司命之责者,可不因人施治乎
此色苍肉瘦,不用温补之所以为高也。)
柏子仁 松子仁 郁李仁 冬葵子 杜苏子 麻仁
用诸仁既可悦心,更滋肠液,切当清真,金针暗度。
诸(十六岁) 夜热不止,舌绛形干,前议伏暑伤阴,用竹叶地黄汤不应,是先天禀薄,
夏至一阴不生,阴虚生热,成痨之象(寒之不寒是无水也。)
三才加丹皮骨皮
赵(五十七岁) 头晕心嘈二十年,向老年岁,血耗阳化内热,近来减食,不必偏寒偏热
,以甘
柔缓热熄风,无燥热戕胃之累(好好阳气,一经血耗,便化内热,即阴虚生内热之变文也。
新极。)
桂元 枸杞 天冬 生地 茯神 柏子仁
甘柔药味平和,可以缓热熄风。盖甘能生液,柔则养阴,老年人调摄要着,盖老人久病
,全要调扶胃气,一切庞杂驳劣之药,概不可投,以其戕贼胃气也。
陶(二十九岁) 暑着必阻游行之气,但热无寒,疮痍不尽,其邪骨节痛,肢末肿,从仲
景湿温例,用苍术白虎汤。
杨(二十六岁) 脉虚数,久嗽呛血,劳则寒热。
虎潜丸(四钱)
顾(二十二岁) 少壮,冬不藏精,仲春内热召风,谓风温,咳嗽内伤,略兼外邪。治邪
必兼
养正(风雅宜人。)昔人有温邪忌汗下者,谓阴阳二气,不可再伤也。一逆再逆,病日深矣。
视面色黄白少泽,按脉形致虚,下垂入尺(望色切脉细密极矣。)问咳频气不舒展,必有
呕恶
之状,显然肾虚少纳,肝阳阴火冲起,犯胃为呕,熏肺喉痒,其不致骤凶,赖水谷未减安受
。考血必聚络,气攻热灼,络血上涌,精血有形
损伤,草木无情不能生续。血脱益气,乃急固其暴。治法以潜心宁静,必情念不萌,绝欲肾
安,斯精血生聚。若频发不已,虽安养不能却病(风温虽缘外感,然必肝肾内虚,冬不藏精
,相火上游,有以召致外邪而温邪内陷,牵引龙雷,伏于内则灼津耗液,冲于上则咳嗽失血
纯见内伤恶状矣。)
人参 熟地 川斛 五味 女贞子 茯神 漂淡天冬 紫衣胡桃肉。
三才加以摄纳,佐以填阴。
陈(十六岁) 秋燥咳嗽。
桑叶 川贝母 南沙参 南花粉 玉竹
萧(二十一岁) 伏暑上郁。
连翘 飞滑石 大竹叶 白杏仁 象贝
方药俱精妙。
张(葑门,六十九岁) 老年下虚痰多,入夜冲气(即是阳不内归,)起坐新凉内侵,肾水
泛,气不收纳,常服肾气丸。
[Background Information]
Book: *Xu's Commentary on Ye Tianshi's Late-Life Prescriptions (Authentic Edition)*
Author: Ye Tianshi
Dynasty: Qing
Chapter: Renshen Jianzhong Tang / Zhuye Dihuang Tang / Suhexiang Wan
Category: Formulas
[Original Text Translation]
Zhu (Xinkaihe Bridge, 16 years old): The body is emaciated and the complexion sallow. Fever arises during Yin hours. In his prime, summer heat prevailed; True Yin failed to generate. Autumn dryness aggravated coughing. This condition is most prone to cause consumptive debility.
Li (36 years old): Turbid filth is knotted in the middle jiao. Thirst with drinking leads to vomiting.
Currently, when people are exposed to turbid miasma, they often resort to *Gua Sha* (scraping). *Suhexiang Wan* (Styrax Pills) far surpasses other medicines, but frequent use makes it overly potent/heavy.
Cheng (47 years old): Muscle color is pale white. Pulse is wiry on the right and slow/weak on the left. Stool has been loose for a long time. Belching and hiccups cease not. Previously, due to vomiting roundworms, sour and bitter herbs were used to harmonize the stomach and regulate the liver. The patient reported that after taking the medicine, he had no appetite and felt fullness/stuffiness in the epigastrium. This indicates weak Yang of the Middle Palace (Spleen/Stomach), and the taste was too sour and turbid. Sour and bitter belong to Yin, so they did not target the disease. It is proposed to move the Yang Qi of the Middle Jiao. Pungent flavors can overcome sourness. (Commentary: If one does not know how to transform and adapt medications, one will inevitably damage the Yang of the Spleen and Stomach first. Only a very flexible practitioner can enter the Dao [of medicine].)
Renshen (Codonopsis Ginseng Radix et Rhizoma), Fuling (Poria), Yizhiren (Alpinia Oxyphylla Fructus), Shengjiang (Fresh Ginger Rhizome), Huluba (Trigonella Foenum-graecum Seed), Houpo (Magnolia Officinalis Bark).
Li (Qianjing, 21 years old): Engaged in farming labor, all meridians and collaterals throughout the body were active. Carrying heavy loads in summer led to blood loss twice. Moreover, there was prior bloody diarrhea. Blood gathered in the collaterals; collaterals are the outer shields of the Zang-Fu organs. Stillness nourishes blood and calms it; it must take one year to consolidate. (Commentary: Blood gathers in collaterals, so circulating drugs are not used because bleeding occurs above and below; using blood-moving drugs again is inadvisable. Tonification will achieve its effect naturally.)
Shudi (Prepared Rehmannia Root), Guishen (Angelica Sinensis Root Body), Qizi (Lycium Barbarum Fruit), Shayuanzi (Astragalus Complanatus Seed), Fuling (Poria), Shanyao (Dioscorea Opposita Rhizome), Duzhong (Eucommia Ulmoides Bark), Bajitian (Morinda Officinalis Root), Chuanhu (Dendrobium Nobile Stem).
Xu (18 years old): Emission occurs with dreams. This is Heart movement causing Spirit to wander and Essence to scatter. Use the method of communicating Heart and Kidney.
Shudi (Prepared Rehmannia Root) boiled in water, Yurou (Cornus Officinalis Fruit), Yuanzhi (Polygala Tenuifolia Root), Sheng Longgu (Fossilized Mammal Bones), Fushen (Poria with Hostwood), Shichangpu (Acorus Tatarinowii Rhizome), Qianshi (Euryale Ferox Seed), Xianglianrou (Lotus Seed Embryo).
Medication is profound and subtle.
Gu (23 years old): Every-third-day malaria (*Sanri Nue*) erupts by entering the Yin meridians, lasting several months before subsiding. The malaria heat is interior, robbing and damaging Liver Blood and Kidney Essence. During the late summer, the generation of Yin did not recover, leading to added chills, fever, and sweating. This disease injures and becomes consumption (*Lao*). Flesh wastes away, form becomes soft. One must abstain from sexual desire to generate Essence and Blood, which has the principle of replenishment. Herbs and grasses are emotionless and useless here. (Commentary: Malaria pathogens cannot be forcibly arrested. Arresting them stops chills and fever temporarily, but latent pathogens remain, forcing and burning Essence and Blood, leading to inevitable discomfort. Over time, pathogens cannot reach the exterior, Essence and Blood daily diminish, day by day deepening, inevitably extending into consumptive injury.)
Renshen (Codonopsis Ginseng Radix et Rhizoma), Hechejiao (Placenta Gelatin), Fushen (Poria with Hostwood), Yurou (Cornus Officinalis Fruit), Wuwei Zi (Schisandra Chinensis Fruit), Qianshi (Euryale Ferox Seed), Shanyao (Dioscorea Opposita Rhizome), Jianlian (Lotus Seed).
Chen Qishan also died from this; an exact argument.
Cao (21 years old): Voice originates from the Lung, relying entirely on the vigor of Yuan Sea (Kidney) Qi, allowing Yin within Yang to bear upwards, so voice naturally resonates. After eating persimmon cakes, vomiting ensued. Examining their nature: sweet and cold, clearing Lung heat. However, deficient cough and scattered Qi do not accept it. Renshen and Gancao are sweet and warm, and have shown efficacy. For a man in his fifties, Lower Yuan declines daily. Metal and Water share the same source. Complexion is sallow, withered, lacking luster. It is entirely Lower Deficiency and Upper Excess. Fortunately, food intake continues, preventing sudden catastrophe. Over years and months, how can there be quick success?
Ejiao (Donkey-Hide Gelatin), Tiandong (Asparagus Cochinchinensis Root), Heidoupi (Black Soybean Skin), Jizihuang (Chicken Egg Yolk), Dashengdi (Rehmannia Glutinosa Root).
After twenty doses, take Liuwei Dihuang Wan plus Wuwei Zi and Chuanhu.
Wang (50 years old): Visceral Truth is connected to the eyeballs, not just the Liver orifice. Middle age: Five Fluids are insufficient. Yang carries internal Wind, invading clear orifices. Brightness is obscured by Yang turbidity, not caused by Six Qi pathogenic factors. Method should be sour-astringent and sweet-slow tonification. However, Liuwei Dihuang Decoction is ultimately a balanced formula for Three Yin and Three Yang, not fitting precisely. (Commentary: Excess requires ascending Clear and descending Turbid; Deficiency requires sour-astringent and sweet-tonifying. This is the major method for treating photophobia and dim vision.)
Chaoji Gouqi (Charred Lycium Barbarum Fruit), Juhua Tan (Chrysanthemum Charcoal), Yurou (Cornus Officinalis Fruit), Wuwei Zi (Schisandra Chinensis Fruit), Renshen (Codonopsis Ginseng Radix et Rhizoma), Zhigancao (Honey-fried Licorice Root).
Photophobia eye disease, though related to internal injury, has causes that cannot be exhausted in one aspect. Some initially contract seasonal pathogens, wind-fire disturbs, causing photophobia. Some have Yang carrying internal wind, brightness disturbed by turbid Yang, causing photophobia. Some have turbid Yin from Lower Jiao floating upward, daring not oppose sunlight, causing photophobia.
Sun (Beihao, 26 years old): Qi stagnation prevents Blood flow; must regulate Qi within Blood.
Nanzha (Southern Hawthorn Fruit), Sheng Xiangfu (Raw Cyperus Rotundus Rhizome).
Separately decoct Siwu Tang, incorporate into it, bake, fry, and grind into powder. (Commentary: Formula formulation is extremely ingenious.)
Yimuao Wan (Motherwort Paste Pills). Siwu Tang is Yin, turbid, and stagnant; obtaining Zha and Xiangfu allows circulation. Zha and Xiangfu are Qi-dry and pungent; obtaining Siwu Tang provides moistening. Both Qi and Blood are regulated; dryness and dampness harmonize. Further benefiting from Motherwort to move Blood, Qi within Blood becomes smooth. Even with Phlegm stagnation and Blood coagulation, it can be taken.
Xu (24 years old): Initial diagnosis noted edema of the lower jiao ankles and heels. Using methods to secure/restrain Liver and Kidney diseases provided relief. But chest and epigastrium were not comfortable. Changing to open and drain Qi in Blood caused discomfort again. Face lacked luster, stuffiness felt like hunger. Should be discussed as Deficiency. No quick success. (Commentary: Shift in hierarchical approach.)
Renshen (Codonopsis Ginseng Radix et Rhizoma), Guixin (Cinnamon Twig), Fuling (Poria), Chao Danggui (Fried Angelica Sinensis Root), Weijiang (Baked Ginger), Zhigancao (Honey-fried Licorice Root).
Wu (34 years old): Managing household complexities, accompanied by anger. Liver and Spleen disharmony. Distension extends from hypochondrium to epigastrium. Wood invades Central Earth, hindering appetite and causing lack of hunger. Regulate Qi, soothe depression, harmonize the Middle Palace. (Commentary: Resolving depression always involves Yueju method.)
Nanzha (Southern Hawthorn Fruit), Sheng Xiangfu (Raw Cyperus Rotundus Rhizome), Shenqu (Medicated Leaven), Fuling (Poria), Gouteng (Uncaria Rhynchophylla Hook), Juhong (Citrus Reticulata Pericarpium Rubrum).
Zhao (33 years old): Epigastric pain radiating to the spine, even extremities become cold. Asked about postpartum mass and diarrhea in the past, now stagnation and leakage with spinal soreness and heaviness. *Neijing* states: Yin Wei Mai disease suffers from heart pain. Physicians do not harmonize the Wei Mai, treating Yin and Yang differently. To treat pain by breaking and descending Qi, how shallow is such insight! (Commentary: For women with chronic epigastric pain, it must originate from the Extraordinary Vessels. Once used one jin of Lurongjiao [Deer Antler Gelatin] to treat fourteen years of unceasing epigastric pain.)
Lurong (Deer Antler without Bone), Jiaoshuang (Deer Antler Frost), Danggui (Angelica Sinensis Root), Xiaohui (Fennel Fruit), Gouqi (Lycium Barbarum Fruit), Baijili (Tribulus Terrestris Fruit), Fuling (Poria), Congrong (Cistanche Deserticola Stem).
Shen (32 years old): In prime of life, complexion shows flesh wasting. Pulse fine on left, empty on right. This is Essence damage in men, True Qi failing to govern reception and storage. Self-reported pounding Qi sensation and pain in lower abdomen. Disease form, pulse, and symptoms are already in the Lower Jiao. Treating Lung cough is a great error. Miscellaneous treatments prolong consumptive debility daily. (Commentary: Pounding Qi in lower abdomen indicates extreme deficiency of Guan Yuan and Qi Hai; Ming Di True Qi has dispersed, irretrievable,窜ming upwards from below. Method is untreatable.)
Xueshi Bawei Wan (Xue’s Eight-Ingredient Pill) (3 qian).
Jin (65 years old): Heat injures Qi level. Dampness from undigested water and grain remains in Stomach collaterals. Autumn coolness has arrived. Declining years, Qi is weak. Summer latent pathogens have not gone.
Propose Dongyuan’s Qing Shu Yi Qi (Clear Summerheat and Benefit Qi), removing cloying drugs. (Commentary: Always, those with vigorous constitution contracting seasonal biased Qi have original Qi to rotate the seasonal biased Qi, silently transforming it. In declining years with weak Qi, external pathogens dominate.)
Renshen (Codonopsis Ginseng Radix et Rhizoma), Fuling (Poria), Shenqu (Medicated Leaven), Shengma (Cimicifuga Racemosa Rhizome), Gegen (Pueraria Lobata Root), Zexie (Alisma Orientale Rhizome), Guangpi (Citrus Reticulata Pericarpium), Mugua (Chaenomelis Fructus), Chuanlian (Coptis Chinensis Rhizome).
Zhao (23 years old): In youth, Jue syndrome was cured by filling Essence and securing retention. Knowing that in youth/prime, emotional thoughts arise internally, Yin Fire erupts, disturbing Spirit/Mind. This summer, heat reduced appetite, Jue occurred, followed by turbid urine. Heat entered injuring Yin. If not abstaining from desire, efficacy is unlikely. (Commentary: Injuring Yin, heat enters and damages Stomach Yin. Do not be deceived.)
Renshen (Codonopsis Ginseng Radix et Rhizoma), Fuling (Poria), Bian Dou (Lablab Album Seed), Zhigancao (Honey-fried Licorice Root), Chao Maidong (Fried Ophiopogon Japonicus Root), Chuan Shihu (Dendrobium Nobile Stem).
Yin Fire best disturbs Spirit/Mind. Observe lamp wick coal head: falling with fire, flame rushes up, fire on cup shakes restlessly. Is this not a clear proof?
Liu (37 years old): Mental exertion disturbs Heart Yang, secretly consuming fat/fluids. Above: palpitations, fright, Qi timidity. Below: intestines dry, difficult stool. Complexion dark, flesh thin. Warm tonification not accepted. First imitate Xu Zhicai’s “Slippery can remove astringency.” (Tailors cut according to body; those holding responsibility for life, should they not treat according to person? This dark complexion and thin flesh, why not using warm tonification is high.)
Baiziren (Biota Seed Songtan), Songziren (Pine Nut), Yuliren (Apricot Kernel Prunus Armeniaca), Dongkuizi (Malva Verticillata Seed), Dusuzi (Perilla Fructus), Mahren (Hemp Seed).
Using these seeds pleases Heart, further nourishes Intestine fluids. Precise and pure, passing the golden needle secretly.
Zhu (16 years old): Night fever persists. Tongue crimson, body dry. Previous discussion: Latent Summerheat injuring Yin. Used Zhuye Dihuang Tang without response. This is congenital thin endowment. At Summer Solstice, Yin does not generate. Yin Deficiency generates Heat, forming signs of Consumption. (Commentary: Cooling without cooling means no Water.)
Sancai Tang plus Danpi (Moutan Cortex) and Guipi (Phellodendron Bark).
Zhao (57 years old): Dizziness and heart palpitations for twenty years. Approaching old age, Blood consumed, Yang transforms into Internal Heat. Recently reduced food intake. Do not lean towards cold or hot. Use sweet-soft to slow heat and extinguish wind, avoiding dry-heat damaging Stomach. (Commentary: Good Yang Qi, once Blood is consumed, transforms into Internal Heat. This is a variation of Yin Deficiency generating Internal Heat. Very new.)
Guiyuan (Longan Aril), Gouqi (Lycium Barbarum Fruit), Tiandong (Asparagus Cochinchinensis Root), Shengdi (Rehmannia Glutinosa Root), Fushen (Poria with Hostwood), Baiziren (Biota Seed Songtan).
Sweet-soft medicinal flavors are mild, can slow heat and extinguish wind. Sweet generates fluids, Soft nourishes Yin. Key regulation for elderly. Elderly with chronic illness must fully support Stomach Qi. All miscellaneous inferior medicines must not be administered, as they damage Stomach Qi.
Tao (29 years old): Summerheat adhering blocks wandering Qi. Only heat, no chills. Sores not healed. Pathogen causes joint pain, limb swelling. Follow Zhongjing’s Wet-Warm example. Use Cangzhu Baihu Tang.
Yang (26 years old): Pulse void and rapid. Chronic cough with spurting blood. Labor induces chills and fever.
Hujian Wan (Tiger Crouching Pill) (4 qian).
Gu (22 years old): Young and strong. Winter did not store Essence. Mid-Spring internal heat summons Wind. Called Wind-Warm. Cough internal injury, slightly combined with external pathogen. Treating pathogen must combine nourishing Righteousness. (Commentary: Elegant and suitable.) Ancients said Warm Pathogens forbid sweating and purging, meaning Yin and Yang Qi cannot be injured again. One reversal, then another, disease deepens daily. Complexion yellow-white lacking luster. Pulse shape extremely void, sinking to Chi position. (Observation of color and cutting pulse is extremely detailed.) Asking: Frequent cough, Qi not舒展 (comfortable), must have nausea/vomiting. Obviously Kidney Deficiency, poor intake. Liver Yang and Yin Fire rush up, invading Stomach causing vomiting, steaming Lung causing throat itch. Not causing sudden catastrophe relies on water/grain not decreasing, safely received. Examining: Blood must gather in collaterals. Qi attacks, heat burns, collateral blood surges upward. Essence and Blood tangible damage. Herbs/grasses emotionless cannot regenerate. Blood loss benefits Qi, urgently consolidating the acute. Treatment method: Calm mind, quiet spirit. Must emotional thoughts not arise, abstain from desire, Kidney safe, thus Essence and Blood generate/gather. If frequent and unceasing, even peaceful nourishment cannot expel disease. (Commentary: Wind-Warm although due to external contraction, necessarily Liver/Kidney internal deficiency. Winter not storing Essence, Minister Fire flows upstream, summoning external pathogens, Warm pathogens sink interior, dragging Dragon/Thunder. Latent interior burns fluids/juices. Rushing upward causes cough and blood loss. Purely seeing internal injury evil signs.)
Renshen (Codonopsis Ginseng Radix et Rhizoma), Shudi (Prepared Rehmannia Root), Chuanhu (Dendrobium Nobile Stem), Wuwei Zi (Schisandra Chinensis Fruit), Nvzhenzi (Ligustrum Lucidum Fruit), Fushen (Poria with Hostwood), Piaotan Tian Dong (Float-washed Asparagus Root), Ziyi Hutao Rou (Purple-skin Walnut Kernel).
Sancai Tang plus receiving/gathering, assisting with filling Yin.
Chen (16 years old): Autumn Dryness Cough.
Sangye (Mulberry Leaf), Chuanbeimu (Fritillaria Cirrhosa Bulb), Nanshashen (Adenophora Stricta Root), Nan Huafen (Trichosanthes Kirilowii Root Powder), Yuzhu (Polygonatum Odoratum Rhizome).
Xiao (21 years old): Latent Summerheat constrained upward.
Lianqiao (Forsythia Fruit), Fei Huashi (Flying Talc), Da Zhuye (Large Bamboo Leaf), Bai Xingren (White Apricot Kernel), Xiangbei (Fritillaria Thunbergii Bulb).
Formulas and medicines are all exquisite and subtle.
Zhang (Fengmen, 69 years old): Elderly, Lower Deficiency, much Phlegm. Entering night, Chong Qi rises (This is Yang not returning inward). Rising/sitting, new coolness invades internally. Kidney Water floods, Qi not received/stored. Often takes Shenqi Wan.