钱(四十岁) 情志郁结,是内因生胀,自投攻泻,胀加溺闭,已属痼疾难治。议通下焦
之阳。
生附子
去皮脐切小块,炒极黑色三钱,水一盏,煎至四分,入童便一小杯,猪胆汁一个。
何(南濠) 甘温益气见效,粪后肠血乃营虚。
人参 白术 归身 炮姜 黄 黄精 炙草 白芍
施 阳明之阳已困,胸胀引背,动怒必发,医药无效。
人参 熟半夏 生白蜜 姜汁 茯苓
大半夏汤加味。
吴(江阴,十六岁) 十二年春夏发疮,内因之湿,本乎脾胃,忌口可愈。
生真于术(一斤) 白蒺藜(一斤)
用糯薏苡仁十两煎汁泛丸(方药极精)。
王(三十二岁) 湿去八九,前议运脾安肾,治本既乏人参,双补未合,况屡见黄色,仍
以脾胃之法。
生于术,生杜仲 泽泻 茯苓 米仁 川斛
水泛丸。
陆(陕西,三十八岁) 血脉有热,外冷袭腠,气血不和,凝涩肌隧,遂见瘾疹
。凡痛多属冷闭,痒由热熏,渺小之恙久发,欲除根不易。平时调理,忌食腥浊,发时用凉
膈散,二日愈时,用和血熄风。
连翘 生甘草 炒黑山栀 赤芍 薄荷 桔梗 枯芩 生大黄
接用丸方 黑豆皮汤丸
首乌 胡麻 当归 松节 茯苓 地肤子
戴(枫桥) 咽痹痰咸,是肾虚水泛,下焦少力,浮阳上升,阴不上承,以咸补甘泻实下
(甘守中,咸润下。甘能化咸,土制水也。中宫既培,咸味自当趋下,不上泛矣。)
熟地 远志 苁蓉 茯苓 青盐 骨脂 胡桃
红枣肉丸。
苗(三十六岁) 痛起寒月,胃脘贯及右胁,腹鸣攻至少腹,少腹气还攻胃口,呕吐酸浊
,或食或不食,三年之久。病由胃络逆走入肝,肝木复来乘胃土,主以辛热,佐以苦降。(
土气先走入木中,是为侮其所不胜,故曰逆也。总是胃中寒胜,故引入厥阴。厥阴不受,仍
还乘胃土耳。治法极为周密。)
吴萸 良姜 茯苓 川楝 延胡 莪术
荻(二十四岁) 左搏尺动(脉理深微,)肝肾阴伤,血后干呛,夜汗阴火闪动,阳不内交
,虚怯阴损,壮水固本为要。医但治嗽清肺,必致胃乏减食。
人参 茯神 芡实 山药 熟地 五味 萸肉 湖莲 生龙骨 鲜河车胶丸
朱(木渎,三十岁) 外视伟然,是阳气发越于外,冬乏藏阳,肝肾无藏。上年酸甘见效
,今当佐苦坚阴。
熟地 五味 萸肉 茯神 天冬 黄柏
陆(水关桥,二十三岁) 久嗽入夜气冲,失血肾逆,必开太阳。
钱某(四十岁):情志抑郁结滞,这是内因导致的气胀,自行服用攻下泻下的药物后,腹胀加重并出现小便闭塞,这已经属于顽固难治的疾病。建议通利下焦的阳气。
生附子:去皮和脐,切成小块,炒至极黑色三钱,用水一盏,煎至四分,加入童便一小杯、猪胆汁一个。
何某(南濠):使用甘温益气的方法见效,但大便后肠道出血,这是因为营血虚弱。
人参、白术、当归身、炮姜、黄芪、黄精、炙甘草、白芍。
施某:阳明经的阳气已经困顿,胸部胀满牵引背部,发怒时必定发作,药物治疗无效。
人参、制半夏、生白蜜、姜汁、茯苓。
大半夏汤加味。
吴某(江阴,十六岁):十二年来春夏季节发作疮疡,这是内因之湿,根源在于脾胃,忌口即可痊愈。
生真于术(一斤)、白蒺藜(一斤)。
用糯米薏苡仁十两煎汁泛丸(方药极其精妙)。
王某(三十二岁):湿气已去除八九成,之前建议运脾安肾,治疗根本。既然缺乏人参,双补之法不合宜,况且屡次见到黄色(黄疸或面色萎黄),仍按照调理脾胃的方法治疗。
生于术、生杜仲、泽泻、茯苓、米仁(薏苡仁)、川石斛。
水泛丸。
陆某(陕西,三十八岁):血脉有热,外感冷邪侵袭腠理,气血不和,凝涩阻滞肌腠隧道,于是出现瘾疹(荨麻疹)。凡是疼痛多属于寒邪闭阻,瘙痒由热邪熏蒸所致。这种微小的病症长期发作,想要除根不容易。平时调理需忌食腥浊之物,发作时使用凉膈散,两天痊愈;在症状缓解时,使用和血熄风的方法。
连翘、生甘草、炒黑山栀、赤芍、薄荷、桔梗、枯芩(黄芩)、生大黄。
接续使用的丸方:黑豆皮汤丸。
首乌、胡麻、当归、松节、茯苓、地肤子。
戴某(枫桥):咽部痹阻、痰液味咸,这是肾虚水气泛滥,下焦力量不足,浮阳上升,阴液不能上承。采用咸味补益、甘味泻实以固下(甘味守中,咸味润下。甘能化咸,土能制水。中宫既已培补,咸味自然趋向下行,不再上泛了。)
熟地黄、远志、肉苁蓉、茯苓、青盐、骨脂(补骨脂)、胡桃。
红枣肉丸。
苗某(三十六岁):疼痛始于寒冷月份,胃脘部疼痛放射至右胁,肠鸣攻冲至少腹,少腹之气还攻胃口,呕吐酸浊液体,有时进食有时不进食,长达三年之久。病因为胃络逆乱走入肝经,肝木反过来乘克胃土。主以辛热药物,佐以苦降药物。(土气先走入木中,这是侮其所不胜,所以称为逆。总是因为胃中寒胜,所以引入厥阴经。厥阴经不接受,仍然回来乘克胃土。治法极为周密。)
吴茱萸、良姜、茯苓、川楝子、延胡索、莪术。
荻某(二十四岁):左尺脉搏动异常(脉理深微),肝肾阴伤,血后干咳呛咳,夜间出汗且阴火闪动,阳气不能内交,虚怯阴损,壮水固本是关键。医生只治疗咳嗽清肺,必然导致胃气匮乏减少食欲。
人参、茯神、芡实、山药、熟地黄、五味子、山茱萸、湖莲、生龙骨、鲜河车胶丸。
朱某(木渎,三十岁):外表看起来伟岸,这是阳气发散于外,冬季缺乏藏阳,肝肾无藏。去年使用酸甘之法见效,现在应当佐以苦味坚阴。
熟地黄、五味子、山茱萸、茯神、天冬、黄柏。
Patient Qian (40 years old): Emotional depression and stagnation, which is internal factor-induced abdominal distension. Self-administration of purgatives exacerbated the distension and caused urinary retention; this has become a stubborn disease difficult to treat. Proposal: To unblock the Yang of the Lower Jiao.
Raw Aconite Root (Fuzi): Remove skin and navel, cut into small pieces, stir-fry until extremely black, 3 qian. Decoct with one cup of water until reduced to 1/4 cup. Add one small cup of child's urine and one pig gallbladder juice.
Patient He (Nanhao): Sweet-warm Qi-tonifying method showed efficacy. Rectal bleeding after defecation indicates Ying (Nutritive) deficiency.
Ginseng Root (Renshen), Atractylodes Rhizome (Baizhu), Angelica Sinensis Root (Guishen), Processed Ginger (Paojiang), Astragalus Root (Huangqi), Polygonatum Rhizome (Huangjing), Honey-processed Licorice Root (Zhigancao), White Peony Root (Baishao).
Patient Shi: Yang of the Yangming channel is already constrained. Chest distension radiating to the back, triggered by anger, ineffective with medication.
Ginseng Root (Renshen), Prepared Pinellia Tuber (Banxia), Raw White Honey (Baimi), Ginger Juice (Jiangzhi), Poria (Fuling).
Modified Banxia Tang (Pinellia Decoction).
Patient Wu (Jiangyin, 16 years old): Recurrent sores during spring and summer for twelve years. Internal dampness rooted in Spleen and Stomach; curable by dietary restrictions.
Raw Zhen Atractylodes Rhizome (Yuzhu, 1 jin), Tribulus Fruit (Bijili, 1 jin).
Pill form using decoction of ten liang of glutinous rice Coix Seed (Yiyiren). (The prescription is extremely refined.)
Patient Wang (32 years old): Dampness removed by 80-90%. Previous proposal was to move Spleen and calm Kidney to treat the root. Lacking Ginseng, dual tonification is not suitable. Moreover, yellow discoloration appears frequently; still follow the method of regulating Spleen and Stomach.
Raw Atractylodes Rhizome (Yuzhu), Raw Eucommia Bark (Duzhong), Alisma Rhizome (Zexie), Poria (Fuling), Coix Seed (Miren), Dendrobium Stem (Chuhu).
Water-pill.
Patient Lu (Shaanxi, 38 years old): Heat in blood vessels, external cold invading couli (pores), disharmony of Qi and Blood, coagulation and stagnation in muscle tunnels, resulting in urticaria (Yinzhen). Pain mostly belongs to cold closure; itching arises from heat steaming. This minor ailment recurring for a long time is hard to eradicate. Daily regulation requires avoiding fishy and turbid foods. During outbreaks, use Liangge San (Cooling the Diaphragm Powder); when healing occurs after two days, use methods to harmonize blood and extinguish wind.
Forsythia Fruit (Lianqiao), Raw Licorice Root (Gancao), Stir-fried Black Gardenia Fruit (Zhizi), Red Peony Root (Chishao), Mint Herb (Bohe), Platycodon Root (Jiegeng), Dried Scutellaria Root (Kuming), Raw Rhubarb (Dahuang).
Follow-up Pill Prescription: Black Soybean Skin Soup Pill.
Polygonum Multiflorum Root (Shouwu), Sesame Seed (Huma), Angelica Sinensis Root (Danggui), Pine Joint (Songjie), Poria (Fuling), Kochia Fruit (Difuzi).
Patient Dai (Fengqiao): Pharyngeal obstruction with salty phlegm indicates Kidney deficiency with water overflowing. Lower Jiao lacks strength, floating Yang rises, Yin fails to ascend. Use salty to tonify and sweet to drain, securing the lower (Sweet guards the center, salty moistens downward. Sweet can transform salty; Earth controls Water. Once the Middle Jiao is fortified, salty flavor naturally trends downward without overflowing.)
Prepared Rehmannia Root (Shudi), Polygala Root (Yuanzhi), Cistanche Stem (Congrong), Poria (Fuling), Green Salt (Qingyan), Psoralea Fruit (Guzhi), Walnut Kernel (Hutao).
Red Date Meat Pill.
Patient Miao (36 years old): Pain started in cold months, epigastric pain radiating to the right hypochondrium, borborygmus attacking the lower abdomen, Qi from lower abdomen returning to attack the stomach gate, vomiting sour turbid fluid, intermittent eating for three years. Disease originates from Stomach collaterals reversing into Liver channel; Liver Wood overacts on Stomach Earth. Main treatment with pungent-hot herbs, assisted by bitter-descending herbs. (Earth Qi enters Wood first, insulting what it cannot overcome, hence called 'reverse'. It is always due to excess cold in Stomach, leading to Jueyin. Jueyin rejects it, so it returns to overact on Stomach Earth. The treatment method is extremely meticulous.)
Evodia Fruit (Wuyu), Galangal Rhizome (Liangjiang), Poria (Fuling), Toosendan Fruit (Chuanlian), Corydalis Rhizome (Yanhu), Curcuma Rhizome (Ezhu).
Patient Di (24 years old): Left Chi pulse pulsates abnormally (pulse principle is deep and subtle), Kidney and Liver Yin damaged. Dry cough after blood loss, night sweats with Yin fire flickering, Yang failing to interact internally, deficiency consumption with Yin damage. Strengthening Water to consolidate the root is essential. If doctors only treat cough and clear Lung, it will inevitably lead to Spleen-Stomach weakness and reduced appetite.
Ginseng Root (Renshen), Poria with Hostwood (Fushen), Euryale Seed (Qianshi), Chinese Yam (Shanyao), Prepared Rehmannia Root (Shudi), Schisandra Berry (Wuweizi), Cornus Fruit (Yurou), Lake Lotus Seed (Hulian), Raw Dragon Bone (Longgu), Fresh Placenta Pill (Hexie Jiao Wan).
Patient Zhu (Mudu, 30 years old): Outwardly robust appearance indicates Yang Qi venting outward. Winter lacks stored Yang; Liver and Kidney have no storage. Last year, sour-sweet method showed efficacy; now assist with bitter to firm Yin.
Prepared Rehmannia Root (Shudi), Schisandra Berry (Wuweizi), Cornus Fruit (Yurou), Poria with Hostwood (Fushen), Asparagus Tuber (Tiantong), Phellodendron Bark (Huangbai).
Patient Lu (Shuiguan Bridge, 23 years old): Chronic cough with Qi rushing at night, hemoptysis with Kidney Qi rebellion, must open the Taiyang channel.