方中元肉为滋养要药，功能养心安神，治血虚怔忡，劳神健忘，枣仁为宁心敛汗要药，善治虚烦不眠，枸杞为滋肾养肝，生精润肺要药，有坚筋骨、补精气、治虚劳、明目之功，桔络通络行滞，配入滋养药中，可使滋而不腻，补而不．滞；竹茹清热化痰，宁神开郁，灯芯清心经浮热，可治心烦失眠。
另以食物疗法配合，嘱用：猪排骨一斤炖熟，加芹菜三两，豆腐适量，一月服二至三次。
猪排骨和豆腐均为营养之品，芹菜一物，王孟英谓其“甘凉清热，涤胃祛风，利口齿咽喉头目。白嫩者良，煎勿太熟”。昆明市民间称芹菜为“瞌睡菜”，系指服之易于安眠。余每用本品捣汁服用之，治肝阳上亢之高血压颇效。
患者服二剂，即觉睡眠改善。接服十余剂，并佐以食物疗法，睡眠较前安稳，余症亦随之好转，并停服安眠药。后用治其它类似之患者亦效。
痰闭心窍
李××，男，二十余岁。因用脑过度，兼受刺激，情志．不遂，发为昏厥。会诊时已昏迷两日不醒，察其脉滑而虚大，两尺无力，舌润。症属痰浊内蒙，心窍不宣。有别于～般“痰热实火”之症。当以祛痰、解郁、开窍、交阴阳、通心肾治之。方用二陈汤合交泰丸加减。
方中肉桂、黄连一热一寒，名交泰丸。肉桂温肾阳，补命门相火之不足，黄连苦燥泄心火之有余，相反相成，故能交阴阳，通心肾。其余诸药皆为祛痰、舒郁、散结、开窍之品。
二诊：服一剂，即渐甦醒。连服三剂，神志恢复如初。惟感头昏、口苦，胸闷烦躁，眠少梦多。此痰郁酿热，心神不宁。治宜清热化痰，安神宁心。用温胆汤加减。处方：
连服五剂而诸症消失，迄未再发。
邵××，男，四十余岁。体质素健，曾患痔疮，经数次开刀割治未愈。于1949年春再次复发，下血不止，入昆明惠滇医院再次手术割治。术后数月，体质尚未恢复，随即并发“尿路感染”，小便不通，胸腹胀痛，每天均须导尿。病者痛苦不堪。然邵某早年曾留学德国，素不信中医。时患者已卧床不起，面垢发热，自汗，懒言，身重而痛。小便不通，脉象濡细，苔白腻。病属癃闭，系由暑湿内蕴，膀胱气化不利所致。治当清暑利湿。暑湿解，其小便自然通利。方用平胃散合六一散加扁豆。处方：
方中六一散利湿泻热，平胃散燥湿健脾、理气除满，加扁豆清暑利湿。全方解暑利湿，通利小便。
二诊：上方服一剂，发热退其半，身痛全止，面垢渐退，腻苔渐消，小便略通。再踵前意，加通阳化气之品。易方用大橘皮汤加减。处方：
大橘皮汤原方，由二苓、泽泻、白术，桂枝、陈皮、木香、槟榔、滑石、甘草等组成，系六一散合五苓散加昧。五苓散化气利尿，六一散利湿泻热，槟榔为坠下之品，叉能滑胀利水，陈皮、木香利气，余加扁豆解暑利湿。尤妙在干姜配桂枝，用以温阳化气，促使小便通利。《素问·灵兰秘典论》曰：“膀胱者，州都之官，津液藏焉，气化则能出矣。”方中用姜、桂两味者即本此义也。
三诊；服上方后，发热全退，小便较昨畅通，患者乃以悦快之声调告余曰：“小便经化验，菌已减少十之二矣!”惟因病久体弱，精神疲倦，饮食欠佳，脉弱无力，舌苔薄白。应益气健脾，增强机体抵抗力。方用《局方》六君子汤。处方：
本方培元固本，使气足脾运，则诸脏受荫，不仅膀胱功能可望恢复，体力亦可因之增强。方中条参补益元气， 白术、茯苓健脾燥湿而利水，陈皮利气，法夏燥湿降逆，炙草甘温益气，和胃补中，姜枣补益元气。
四诊：精神大佳，小便稍长，已不必再导尿，脉已有力。今虽气足脾运，但尿中尚有细菌。系余邪未尽，还应正本清源，三焦并治，以根治其癃闭。方用《局方》清心莲子饮和《类证治裁》萆薢分清饮合方化裁。处方：
方中黄柏坚肾益阴，最能祛湿，且能利小便之涩结。橘核行肝气，菖蒲化浊通窍。萆薢、茯苓、草梢、车前、灯芯、竹叶清热和尿。妙在加口芪、升麻益气升举，助以白术、莲子健脾运湿。全方合用，以增强三焦气化。《素问·灵兰秘典论》曰：“三焦者，决渎之官，水道出焉。”上焦不宣，则下焦不通，开其上则下自通，此治癃闭之关键所在。本方主治在下而兼及中上，使三焦气化畅行而水道自通也。
五诊和六诊均依上法加减，惟白术一味，自12克加至30克，因扶脾大有助于利水也。如是施治，小便中所含细菌，由七万减至四万。服本方第二剂后，即降至二千，服三剂后竟减至二百。至是小便全通，毫无痛苦，诸症告愈。患者欣喜异常，握手言谢，深悔昔日鄙视中医药之咎也。
不日出院，嘱以桂附八味丸调理。复查验尿，细菌全无，且已精神焕发，体健如常矣!
[按]：癃闭一证，有虚有实，其要不外水道气机阻滞。本例由暑湿内蕴，膀胱气化不利引起。初期亦实证也。《素问·至真要大论》曰：“必伏其所主，而先其所因。”审证求因，病既由暑湿引起，则解暑亦可治癃闭，扶正亦可驱邪外出。最后专治下焦，但加重白术以健中，用升麻、黄芪以举上，其要义已在第四诊中说明。中医视人体为上下联系、内外相通的统一整体，最忌头痛医头、脚痛医脚之形而上学观点。
脏寒癃胀
李××，男，四十岁。患腰痛，小便急胀，夜睡不安，经封闭、理疗等，久治未愈，延余诊治。诊其脉沉而弦，舌青滑。此症腰痛，且兼小便急胀，显系肾阳大虚，肝气下陷所致。以肝主疏泄，肾主闭藏。今肾阳大虚，水寒不能生木，肝气下陷而不能生心火。火者，阳也。心火不足，心阳即虚。心阳通于肾阳，心阳虚，肾阳亦虚，故见上述诸症。治法应大温心阳，暖肾温肝。方用肉桂生姜汤。处方：
上肉桂9克 生姜30克
上方肉桂一味，黄坤载谓：“味甘辛，气香，性温，入足厥阴肝经，温肝暖血，破瘀消症，逐腰腿湿寒，驱腹胁疼痛。”张锡纯谓肉桂“性能下达，暖丹田，壮元阳，补相火。其色紫赤，又善补助君火，温通血脉，治周身血脉因寒而痹，故治关节腰肢疼痛……”。因此，余临证，每用肉桂强心，更用肉桂暖肾温肝而升肝木之下陷。以肝木得温始升，肝升才能恢复其正常的疏泄功能。生姜辛温，黄氏谓本品“入肺胃而驱浊，走肝脾而行滞”，“调和脏腑，宣达荣卫”。二药配伍，不仅温扶心阳，更能暖肾温肝。
患者服上方一剂，即感腰痛减轻，小便急胀亦减，睡眠亦较安适。宜进一步强心温肾，以交阴阳。方用白通汤加昧。处方：
方中自通汤以交阴阳，加肉桂、茯苓以升肝木下陷，附子得肉桂又能强心温肾。心肾为先天之本，乃全身阳气之主。嘱服三剂，诸症好转大半。继用扶阳祛寒，补肾强腰之剂，用四逆汤与刘河间金刚丸加味。处方：
上方以四逆汤扶元阳，其余诸药，补肝肾，强腰膝，治腰痛。金刚丸系治腰痛骨痿之效方。连服十余剂，症状消失。
[整理者按]：本例初诊症状虽较简略，然从舌脉也可知为阳虚、寒湿阻滞。此与肝经湿热所致小便急胀又有不同。阳虚之小便急胀，当有面色皓白，或面色青暗，身重畏寒，目瞑嗜卧，少气懒言，手足逆冷，舌白滑或青滑，脉象沉细或沉弱或沉弦等症。治宜温阳散寒，故可用肉桂生姜汤。属肝经湿热者，多见口苦咽干，胁痛烦躁易怒，小便虽急胀，其色必黄赤，舌苔黄腻，脉象弦数。治宜清肝经湿热，可用龙胆泻肝汤之类。辨证不同，治法迥异。
肉桂生姜汤系戴老医师习用的强心方剂，药简义深，凡心肺疾患，出现心肺阳虚或心阳不振，症见唇舌青暗、心胸闷痈、喘息憋气、寒痰上泛者，俱可用此方治之。本方又治心肺阳虚所致鼻流清涕不止等症。
卢××，男，四十岁。患阳痿达十余年，久治不愈，婚后多年而无子女，曾经某医院检查，发现精虫不活跃，始来我所求治。察其脉，两尺沉弱，面色皓白。记忆力减退，经常头昏腰痛，目眩、耳鸣，疲乏无力。证属肾精不足，元阳虚衰，治宜生精补髓峻扶元阳之剂。处方：
上方十味，共研细末，日服三次，每次9克，用淡盐开水送服。
张景岳谓：“善补阳者，必于阴中求阳，则阳得阴助而生化无穷。”故方中用肉桂、鹿茸于大队补肾药中，温元阳，暖肾水，静中有动，鼓舞阳气化生精液，且鹿茸为血肉有情之品，具生发之机，大补精髓，温壮元阳，补益气血，既补督脉之损，又补冲脉之虚。正如徐灵胎所说：“冲督盛，而肾气强，则诸效自臻矣。”野台参大补元气，木棉花子补肾强腰，治肾虚腰痛、足膝无力，功胜韭菜子。如此配合，使达添精补髓，强壮生殖机能之目的，故用治阳痿不举，精虫无活跃力者有效。但本患者病程已历十余年之久，今始求治，非短期所能见效。嘱以一剂为一料，连服十剂左右。患者遵嘱服用，一年后，不但本症获愈，且喜举一子。
[按]：本方曾用治多例阳痿及男子不育症，均见效果，敬予介绍。
口眼歪斜二例
例一：
李××，女，三十三岁，患左侧口眼歪斜，发病五日来诊。症见：右眼睑不能闭合，右侧面肌松弛，人中平满，面颊口唇歪向右侧，左侧颜面不自主跳动。诊脉弦濇，舌质正常，苔薄白，咳嗽，口不渴，别无所苦。此由肝虚生风，肺有郁热，再兼外邪而诱发，内外交感，因而骤发。其施治之法，着重在清降肺经郁热及温阳解表。用《金匮要略》所载《古今录验》续命汤加法半夏：
方中麻黄、杏仁、石膏、甘草即麻杏石甘汤，可散表邪，宣肺气，清郁热。党参补气扶正，桂枝温经通阳，干姜温中通脉，芎、归活血舒筋，加法半夏降逆化痰。全方协力，能宣能通，可降可散，有舒有缓，实是标本兼顾治法。除内服本方外，另加外治，其方如下：
牙皂30克(略捣碎，醋煮取汁)，每日洗左侧面部三至五次。牙皂为通窍、搜风要药，最搜肝风，《本经》“主风痹死肌，邪气”。煎之以醋，义取引药入肝。肝主筋，肝经风邪得以外散，则筋脉之拘急自可缓懈。既授两方，又复告以兼做针灸以期辅助。患者如法施治，㖞斜之状，得以复常。从发病到治愈，不过二十余日。
例二：
张××，男，二十一岁。因劳累后受寒，第二日早晨漱口时发现口角漏水，始知左侧口眼歪斜，左眼睑不能闭合，流泪，目珠略红，不能皱眉，急来就诊。除上述症状外，诉发热、身痛，咳嗽痰少。脉浮数，舌质淡红，苔白腻少津。症属肝虚肺燥，复感外邪。治宜解表清肺，养肝润燥。用续命汤加减：
方中用麻杏石甘汤散表邪，宣肺气，清郁热。麦冬润燥生津，归、芍补血养肝，桂枝温经通阳，合芍药调和营卫。
二诊：上方服二剂，发热身痛全退，咳稍减，但口眼歪斜如故。宜内外兼治。内服以活血、祛风、解痉为主。处方如下：
生姜汁(每次5滴兑服)
方中天麻、钩藤平肝祛风解痉，桑叶、菊花平肝熄风，当归活血，本“治风先治血，血行风自灭”之义而施。桂枝、杭芍调和营卫，麻绒开腠理，全蝎、僵蚕、姜汁祛风、开窍、化痰。此方功用专在平肝祛风以正歪斜。
外治法：用鳝鱼血加麝香少许涂擦于右侧(左歪涂右，右歪涂左)，正即停用。鳝鱼血通血脉，逐风邪，专治口眼歪斜。麝香通诸窍，开经络，透肌骨，与鳝鱼血同用，则走窜开通之力愈大，用治口眼歪斜愈佳。
方剂中的元肉（龙眼肉）是滋养的重要药物，具有养心安神的功能，用于治疗血虚引起的心悸怔忡、用脑过度导致的健忘；酸枣仁是宁心敛汗的重要药物，善于治疗因虚烦引起的失眠；枸杞子是滋肾养肝、生精润肺的重要药物，具有强健筋骨、补益精气、治疗虚劳、明目的功效；桔络能疏通经络、行气导滞，配伍在滋养药中，可以使滋补而不腻膈，补益而不滞气；竹茹能清热化痰、宁神解郁；灯芯草能清泄心经的浮热，可治疗心烦失眠。
另外配合食疗，嘱咐使用：猪排骨一斤炖熟，加入芹菜三两，适量豆腐，每月服用二至三次。
猪排骨和豆腐都是营养食品，芹菜这一味药，王孟英说它“味甘性凉能清热，涤除胃中邪气祛除风邪，通利口齿咽喉头目。以白嫩者为佳，煎煮不要过熟”。昆明市民间称芹菜为“瞌睡菜”，是指服用后容易安眠。我每次用本品捣汁服用，治疗肝阳上亢型的高血压非常有效。
患者服用两剂后，即感觉睡眠改善。接着服用十余剂，并配合食物疗法，睡眠比以前安稳，其他症状也随之好转，并且停服了安眠药。后来治疗其他类似患者也有效。
李××，男，二十多岁。因为用脑过度，又受到精神刺激，情志不畅，导致昏厥。会诊时已经昏迷两天不醒，诊察其脉象滑而虚大，两尺脉无力，舌苔润泽。症状属于痰浊内蒙蔽心窍，心窍不通宣。这与一般的“痰热实火”病症不同。应当采用祛痰、解郁、开窍、交通阴阳、沟通心肾的方法治疗。方剂选用二陈汤合交泰丸加减。
方中的肉桂和黄连，一热一寒，名为交泰丸。肉桂温补肾阳，补益命门相火的不足；黄连苦燥，清泄心火的有余，两者相反相成，所以能交通阴阳，沟通心肾。其余各种药物都是祛痰、舒解郁结、散结开窍的药物。
二诊：服用一剂后，逐渐苏醒。连续服用三剂，神志恢复如初。只是感到头晕、口苦，胸闷烦躁，睡眠少且多梦。这是痰郁化热，心神不宁。治疗宜清热化痰，安神宁心。使用温胆汤加减。处方：
连续服用五剂后所有症状消失，此后未再复发。
邵××，男，四十多岁。体质素来健壮，曾患痔疮，经过几次手术割治未愈。1949年春再次复发，下血不止，进入昆明惠滇医院再次手术割治。术后几个月，体质尚未恢复，随即并发“尿路感染”，小便不通，胸腹胀痛，每天都需要导尿。病人痛苦不堪。然而邵某早年曾留学德国，一向不信中医。当时患者已卧床不起，面色垢秽发热，自汗，懒言，身体沉重疼痛。小便不通，脉象濡细，舌苔白腻。病属癃闭，是由暑湿内蕴，膀胱气化功能不利所致。治疗应当清解暑湿。暑湿解除，小便自然通利。方剂选用平胃散合六一散加扁豆。处方：
方中的六一散利湿泻热，平胃散燥湿健脾、理气除满，加扁豆清暑利湿。全方解暑利湿，通利小便。
二诊：上方服用一剂，发热退去一半，身痛完全停止，面色垢秽渐退，腻苔渐消，小便略通。继续遵循前意，加入通阳化气的药物。更换方剂为大橘皮汤加减。处方：
大橘皮汤原方，由二苓（猪苓、茯苓）、泽泻、白术、桂枝、陈皮、木香、槟榔、滑石、甘草等组成，系六一散合五苓散加味。五苓散化气利尿，六一散利湿泻热，槟榔是下行坠积的药物，又能消除胀满利水，陈皮、木香理气，另外加入扁豆解暑利湿。尤其妙在用干姜配伍桂枝，用以温阳化气，促使小便通利。《素问·灵兰秘典论》说：“膀胱者，州都之官，津液藏焉，气化则能出矣。”方中使用姜、桂两味药就是基于这个原理。
三诊：服用上方后，发热全部消退，小便比昨天畅通，患者乃以喜悦的声音语调告诉我：“小便化验显示，细菌减少了十分之二！”只是因为病久体弱，精神疲倦，饮食不佳，脉弱无力，舌苔薄白。应当益气健脾，增强机体抵抗力。方剂选用《局方》六君子汤。处方：
本方培补元气固护根本，使气足脾运正常，则各脏腑受其荫庇，不仅膀胱功能有望恢复，体力也可因此增强。方中条参补益元气，白术、茯苓健脾燥湿而利水，陈皮理气，法半夏燥湿降逆，炙甘草甘温益气，和胃补中，姜枣补益元气。
四诊：精神大好，小便稍长，已不必再导尿，脉已有力。现在虽然气足脾运正常，但尿中尚有细菌。这是余邪未尽，还应正本清源，三焦并治，以根治其癃闭。方剂选用《局方》清心莲子饮和《类证治裁》萆薢分清饮合方化裁。处方：
方中的黄柏坚固肾阴，最能祛湿，且能通利小便的涩结。橘核疏理肝气，菖蒲化浊通窍。萆薢、茯苓、甘草梢、车前子、灯芯、竹叶清热利尿。妙在加入黄芪、升麻益气升举，辅助以白术、莲子健脾运湿。全方合用，以增强三焦的气化功能。《素问·灵兰秘典论》说：“三焦者，决渎之官，水道出焉。”上焦不通宣，则下焦不通畅，开通上焦则下焦自然通畅，这是治疗癃闭的关键所在。本方主治在下焦而兼及中上焦，使三焦气化畅行而水道自然通利。
五诊和六诊均依上述方法加减，只是白术一味，从12克加至30克，因为扶脾大有助于利水。如此施治，小便中所含细菌，由七万减至四万。服用本方第二剂后，即降至二千，服用三剂后竟减至二百。至此小便完全通畅，毫无痛苦，诸症告愈。患者欣喜异常，握手致谢，深深后悔昔日鄙视中医药的错误。
不久出院，嘱咐服用桂附八味丸调理。复查验尿，细菌全无，且已精神焕发，体健如常！
[按语]：癃闭这一证候，有虚证有实证，关键不外乎水道气机阻滞。本例由暑湿内蕴，膀胱气化不利引起。初期也是实证。《素问·至真要大论》说：“必伏其所主，而先其所因。”审证求因，病既然由暑湿引起，那么解暑也可以治疗癃闭，扶正也可以驱邪外出。最后专门治疗下焦，但加重白术以健脾胃，用升麻、黄芪以升举阳气，其要义已在第四诊中说明。中医视人体为上下联系、内外相通的统一整体，最忌讳头痛医头、脚痛医脚的形而上学观点。
脏寒导致的癃胀
李××，男，四十岁。患腰痛，小便急胀，夜间睡眠不安，经过封闭、理疗等治疗，久治未愈，延请我诊治。诊察其脉沉而弦，舌质青滑。此症腰痛，且兼小便急胀，显然是肾阳大虚，肝气下陷所致。以肝主疏泄，肾主闭藏。现在肾阳大虚，水寒不能生木（肝），肝气下陷而不能生心火。火者，阳也。心火不足，心阳即虚。心阳通于肾阳，心阳虚，肾阳亦虚，故见上述诸症。治法应大温心阳，暖肾温肝。方剂选用肉桂生姜汤。处方：
上肉桂9克 生姜30克
上方中肉桂一味药，黄坤载说：“味甘辛，气香，性温，入足厥阴肝经，温肝暖血，破瘀消症，逐腰腿湿寒，驱腹胁疼痛。”张锡纯说肉桂“性能下达，暖丹田，壮元阳，补相火。其色紫赤，又善补助君火，温通血脉，治周身血脉因寒而痹，故治关节腰肢疼痛……”。因此，我在临证时，每用肉桂强心，更用肉桂暖肾温肝以升提肝木之下陷。以肝木得温始升，肝升才能恢复其正常的疏泄功能。生姜辛温，黄氏说本品“入肺胃而驱浊，走肝脾而行滞”，“调和脏腑，宣达荣卫”。两药配伍，不仅温扶心阳，更能暖肾温肝。
患者服用上方一剂，即感腰痛减轻，小便急胀亦减，睡眠也较安适。宜进一步强心温肾，以交通阴阳。方剂选用白通汤加味。处方：
方中的白通汤以交通阴阳，加肉桂、茯苓以升提肝木下陷，附子得肉桂又能强心温肾。心肾为先天之本，乃全身阳气之主。嘱咐服用三剂，诸症好转大半。继用扶阳祛寒，补肾强腰的药剂，选用四逆汤与刘河间金刚丸加味。处方：
上方以四逆汤扶助元阳，其余各种药物，补肝肾，强腰膝，治腰痛。金刚丸是治疗腰痛骨痿的有效方剂。连续服用十余剂，症状消失。
[整理者按语]：本例初诊症状虽较简略，但从舌脉也可知为阳虚、寒湿阻滞。这与肝经湿热所致的小便急胀又有不同。阳虚的小便急胀，当有面色皓白，或面色青暗，身重畏寒，目瞑嗜卧，少气懒言，手足逆冷，舌白滑或青滑，脉象沉细或沉弱或沉弦等症状。治宜温阳散寒，故可用肉桂生姜汤。属肝经湿热者，多见口苦咽干，胁痛烦躁易怒，小便虽急胀，其色必黄赤，舌苔黄腻，脉象弦数。治宜清肝经湿热，可用龙胆泻肝汤之类。辨证不同，治法迥异。
肉桂生姜汤是戴老医师习用的强心方剂，药简义深，凡心肺疾患，出现心肺阳虚或心阳不振，症见唇舌青暗、心胸闷痛、喘息憋气、寒痰上泛者，均可用此方治疗。本方又治心肺阳虚所致鼻流清涕不止等症。
卢××，男，四十岁。患阳痿达十余年，久治不愈，婚后多年而无子女，曾经某医院检查，发现精子不活跃，始来我所求治。诊察其脉，两尺脉沉弱，面色皓白。记忆力减退，经常头昏腰痛，目眩、耳鸣，疲乏无力。证属肾精不足，元阳虚衰，治宜生精补髓峻扶元阳的药剂。处方：
上方十味药，共研细末，日服三次，每次9克，用淡盐开水送服。
张景岳说：“善补阳者，必于阴中求阳，则阳得阴助而生化无穷。”故方中用肉桂、鹿茸于大队补肾药中，温元阳，暖肾水，静中有动，鼓舞阳气化生精液，且鹿茸为血肉有情之品，具生发之机，大补精髓，温壮元阳，补益气血，既补督脉之损，又补冲脉之虚。正如徐灵胎所说：“冲督盛，而肾气强，则诸效自臻矣。”野台参大补元气，木棉花子补肾强腰，治肾虚腰痛、足膝无力，功效胜过韭菜子。如此配合，使达到添精补髓，强壮生殖机能的目的，故用治阳痿不举，精子无活跃力者有效。但该患者病程已历十余年之久，现在才求治，非短期所能见效。嘱咐以一剂为一料，连续服用十剂左右。患者遵嘱服用，一年后，不但本症获愈，且喜举一子。
[按语]：本方曾用治多例阳痿及男子不育症，均见效果，敬予介绍。
口眼歪斜二例
例一：
李××，女，三十三岁，患左侧口眼歪斜，发病五日来诊。症状见：右眼睑不能闭合，右侧面肌松弛，人中平满，面颊口唇歪向右侧，左侧颜面不自主跳动。诊脉弦涩，舌质正常，苔薄白，咳嗽，口不渴，别无所苦。此由肝虚生风，肺有郁热，再兼外邪而诱发，内外交感，因而骤发。其施治之法，着重在清降肺经郁热及温阳解表。使用《金匮要略》所载《古今录验》续命汤加法半夏：
方中的麻黄、杏仁、石膏、甘草即麻杏石甘汤，可散表邪，宣肺气，清郁热。党参补气扶正，桂枝温经通阳，干姜温中通脉，川芎、当归活血舒筋，加法半夏降逆化痰。全方协力，能宣能通，可降可散，有舒有缓，实是标本兼顾的治法。除内服本方外，另加外治，其方如下：
牙皂30克（略捣碎，醋煮取汁），每日洗左侧面部三至五次。牙皂为通窍、搜风的重要药物，最擅长搜剔肝风，《本经》记载其“主风痹死肌，邪气”。煎之以醋，意在引药入肝。肝主筋，肝经风邪得以外散，则筋脉之拘急自可缓解。既授两方，又复告以兼做针灸以期辅助。患者如法施治，歪斜之状，得以恢复正常。从发病到治愈，不过二十余日。
例二：
张××，男，二十一岁。因劳累后受寒，第二天早晨漱口时发现口角漏水，始知左侧口眼歪斜，左眼睑不能闭合，流泪，目珠略红，不能皱眉，急来就诊。除上述症状外，诉发热、身痛，咳嗽痰少。脉浮数，舌质淡红，苔白腻少津。症状属肝虚肺燥，复感外邪。治宜解表清肺，养肝润燥。使用续命汤加减：
方中用麻杏石甘汤散表邪，宣肺气，清郁热。麦冬润燥生津，归、芍补血养肝，桂枝温经通阳，合芍药调和营卫。
二诊：上方服用二剂，发热身痛全退，咳稍减，但口眼歪斜如故。宜内外兼治。内服以活血、祛风、解痉为主。处方如下：
生姜汁（每次5滴兑服）
方中天麻、钩藤平肝祛风解痉，桑叶、菊花平肝熄风，当归活血，本着“治风先治血，血行风自灭”的道理而施治。桂枝、杭芍调和营卫，麻绒开腠理，全蝎、僵蚕、姜汁祛风、开窍、化痰。此方功用专在平肝祛风以纠正歪斜。
外治法：用鳝鱼血加麝香少许涂擦于右侧（左歪涂右，右歪涂左），正即停用。鳝鱼血通血脉，逐风邪，专治口眼歪斜。麝香通诸窍，开经络，透肌骨，与鳝鱼血同用，则走窜开通之力愈大，用治口眼歪斜愈佳。
In the prescription, Yuanrou (Longan Aril) is a key nourishing herb with the function of nourishing the heart and calming the spirit, used to treat palpitations due to blood deficiency and forgetfulness caused by mental overexertion; Suanzaoren (Ziziphi Spinosae Semen) is an important herb for calming the heart and consolidating sweat, effective for insomnia caused by deficient heat and restlessness; Gouqizi (Lycii Fructus) is a vital herb for nourishing the kidney and liver, generating fluids, and moistening the lungs, possessing effects of strengthening bones and tendons, tonifying essence and qi, treating consumptive disease, and improving vision; Jieluo (Citri Reticulatae Pericarpium Viride reticulum) unblocks collaterals and moves stagnation; when combined with nourishing herbs, it prevents cloying and stagnation from tonification; Zhuru (Bambusae Caulis in Taeniam) clears heat and resolves phlegm, calms the spirit and relieves depression; Dengxincao (Junci Medulla) clears floating heat from the Heart meridian, treating irritability and insomnia.
Additionally, dietary therapy is prescribed: stew one jin (approx. 500g) of pork ribs until cooked, add three liang (approx. 150g) of celery and an appropriate amount of tofu, to be taken two to three times a month.
Pork ribs and tofu are nutritious foods. Regarding celery, Wang Mengying stated that it is "sweet and cool, clearing heat, purging the stomach, dispelling wind, and benefiting the teeth, gums, throat, eyes, and head. The whiter and more tender varieties are superior; do not cook them too thoroughly." In Kunming folk tradition, celery is called "Sleepy Vegetable," referring to its ability to promote sleep. I frequently use the juice extracted from this herb to treat hypertension caused by Liver Yang rising, with excellent results.
After taking two doses, the patient felt an improvement in sleep. Following ten additional doses, combined with dietary therapy, sleep became more stable than before, and other symptoms improved accordingly, allowing the discontinuation of sleeping pills. Subsequent treatment of similar patients also yielded positive results.
Phlegm Obstructing the Heart Orifices
Li XX, male, twenties. Due to excessive mental exertion and emotional stimulation, leading to constrained emotions, he suffered syncope. At the time of consultation, he had been comatose for two days. His pulse was slippery and empty-large, with weak pulses at both Chi positions, and a moist tongue coating. The syndrome belongs to turbid phlegm internally obscuring the Heart orifices, preventing their opening. This differs from typical "phlegm-heat excess fire" syndromes. Treatment should focus on resolving phlegm, relieving constraint, opening orifices, communicating Yin and Yang, and connecting the Heart and Kidney. The formula selected is Erchen Tang combined with Jiaotai Wan with modifications.
Chenpi (Citri Reticulatae Pericarpium) 6g, Banxia (Pinelliae Rhizoma Preparatum) 9g, Yuanzhi (Polygalae Radix) 15g, Fuling (Poria) 15g, Rougui (Cinnamomi Cortex) 9g; Huanglian (Coptidis Rhizoma) 3g, Yujin (Curcumae Longae Radix) 9g, Changpu (Acori Tatarinowii Rhizoma) 4.5g.
Rougui (Cinnamon Twig) and Huanglian (Coptis Rhizome), one hot and one cold, constitute Jiaotai Wan (Cinnamon and Coptis Decoction). Rougui warms Kidney Yang and supplements the insufficiency of Mingmen Fire; Huanglian is bitter and drying, draining excess Heart Fire. Their opposing actions complement each other, thereby communicating Yin and Yang and connecting the Heart and Kidney. The remaining herbs resolve phlegm, relieve constraint, dissipate nodules, and open orifices.
Second Visit: After one dose, he gradually regained consciousness. After three consecutive doses, his mental state returned to normal. However, he complained of dizziness, bitter taste in the mouth, chest tightness, irritability, scanty sleep, and frequent dreams. This indicates phlegm-constraint transforming into heat, disturbing the Heart spirit. Treatment should clear heat, resolve phlegm, calm the spirit, and soothe the Heart. Wendan Tang (Warm the Gallbladder Decoction) was prescribed with modifications.
Banxia (Pinelliae Rhizoma Preparatum) 9g, Fuling (Poria) 15g, Chenpi (Citri Reticulatae Pericarpium) 6g, Zhishi (Aurantii Fructus Immaturus) 6g, Juluo (Citri Reticulatae Pericarpium Viride reticulum) 6g; Suanzaoren (Ziziphi Spinosae Semen) 15g, Yuanzhi (Polygalae Radix) 6g, Shichangpu (Acori Tatarinowii Rhizoma) 6g, Zhuru (Bambusae Caulis in Taeniam) 6g.
After five consecutive doses, all symptoms disappeared, and there was no recurrence.
Lung-Closed Syndrome Due to Summer-Heat and Dampness
Shao XX, male, forties. He had a robust constitution but suffered from hemorrhoids, which did not heal after several surgical excisions. In spring 1949, it recurred with continuous bleeding, requiring surgery at Huidian Hospital in Kunming. Months post-surgery, his constitution remained unrecovered, and he subsequently developed a "urinary tract infection" with urinary retention, abdominal distension and pain, requiring daily catheterization. The patient suffered greatly. Having studied in Germany, Mr. Shao traditionally distrusted Traditional Chinese Medicine (TCM). At the time, he was bedridden, with a greasy complexion, fever, spontaneous sweating, reluctance to speak, heavy and painful body. Urine was retained, pulse was soggy and fine, and tongue coating was white and greasy. The disease is Lung-Closed Syndrome (urinary retention), caused by internal accumulation of summer-heat and dampness, leading to impaired Qi transformation in the Bladder. Treatment requires clearing summer-heat and promoting diuresis. Once summer-heat and dampness are resolved, urination will naturally flow freely. The formula selected is Pingwei San combined with Liuyi San plus Douli (Dolichos Lablab Seed).
Chao Cangzhu (Atractylodis Rhizoma) 9g, Chao Houpo (Magnoliae Officinalis Cortex) 9g, Guang Chenpi (Citri Reticulatae Pericarpium) 6g, Liuyi San (Six-to-One Powder) 9g (wrapped in cloth and decocted); Douli (Dolichos Lablab Seed) 9g, Gancao Shao (Glycyrrhizae Radix et Rhizoma tip) 4.5g.
Liuyi San promotes diuresis and drains heat; Pingwei San dries dampness, strengthens the Spleen, regulates Qi, and removes fullness; Douli clears summer-heat and promotes diuresis. The entire formula resolves summer-heat, dries dampness, and facilitates urination.
Second Visit: After one dose of the above formula, fever subsided by half, body pain ceased completely, facial greasiness receded, and greasy coating diminished slightly, with urine passing somewhat. Continuing the previous approach, herbs that unblock Yang and transform Qi were added. The formula was changed to Da Jupi Tang (Great Tangerine Peel Decoction) with modifications.
Liuyi San (Six-to-One Powder) 9g, Chao Zexie (Alismatis Rhizoma) 9g, Chao Baizhu (Atractylodis Macrocephalae Rhizoma) 9g, Fuling (Poria) 15g; Zhuling (Polyporus) 9g, Guizhi (Cinnamomi Ramulus) 9g, Ganjiang (Zingiberis Rhizoma) 9g, Guang Muxiang (Aucklandiae Radix) 3g, Guang Chenpi (Citri Reticulatae Pericarpium) 6g; Douli (Dolichos Lablab Seed) 9g, Binglang (Arecae Semen) 6g.
The original Da Jupi Tang consists of Zhuling and Fuling, Zexie, Baizhu, Guizhi, Chenpi, Muxiang, Binglang, Huashi (Talcum), and Gancao, essentially Liuyi San combined with Wuling San (Five-Ling Powder) with additions. Wuling San transforms Qi and promotes diuresis; Liuyi San drains dampness and heat; Binglang is a descending agent that reduces distension and promotes water passage; Chenpi and Muxiang regulate Qi; Douli clears summer-heat and dries dampness. Particularly ingenious is the combination of Ganjiang (Dried Ginger) and Guizhi (Cinnamon Twig) to warm Yang and transform Qi, facilitating urination. *Suwen: Linglan Midian Lun* states: "The Bladder is the official of the capital region, storing fluids; only through Qi transformation can they exit." The use of Ginger and Cinnamon in this formula is based on this principle.
Third Visit: After taking the formula, fever completely subsided, and urination was smoother than the previous day. The patient joyfully reported: "Urine analysis shows bacteria have decreased by twenty percent!" However, due to prolonged illness and weakness, he experienced mental fatigue, poor appetite, weak and powerless pulse, and thin white tongue coating. Treatment should tonify Qi, strengthen the Spleen, and enhance immunity. The formula selected is Liu Junzi Tang (Six-Gentlemen Decoction) from *Ju Fang*.
Tai Shen (Codonopsis Radix) 15g, Chao Baizhu (Atractylodis Macrocephalae Rhizoma) 12g, Banxia (Pinelliae Rhizoma Preparatum) 9g, Zhi Gancao (Glycyrrhizae Radix et Rhizoma Preparatum) 6g; Chenpi (Citri Reticulatae Pericarpium) 6g, Shao Jiangsheng (Roasted Fresh Ginger) 3 slices, Dazao (Jujubae Fructus) 3 pieces, Fuling (Poria) 15g.
This formula cultivates the source and consolidates the root, ensuring sufficient Qi and normal Spleen transport, thereby benefiting all Zang-Fu organs. Not only is Bladder function expected to recover, but physical strength will also increase. Tai Shen tonifies primordial Qi; Baizhu and Fuling strengthen the Spleen, dry dampness, and promote diuresis; Chenpi regulates Qi; Banxia dries dampness and directs rebellious Qi downward; Zhi Gancao is sweet and warm, tonifying Qi, harmonizing the Stomach, and supplementing the Middle; Ginger and Jujube tonify primordial Qi.
Fourth Visit: Spirit greatly improved, urination volume increased slightly, catheterization no longer needed, and pulse became forceful. Although Qi is sufficient and Spleen transport is normal, bacteria remain in the urine. This indicates residual pathogens have not been fully cleared. Treatment should address the root cause, treating the Triple Burner simultaneously to cure the urinary retention permanently. The formula selected combines Qingxin Lianzi Yin (Heart-Clearing Lotus Seed Decoction) from *Ju Fang* and Bixie Fenqing Yin (Dioscorea Hypoglauca Decoction for Clearing Turbidity) from *Leizheng Zaichui*, with modifications.
Huangqi (Astragali Radix) 15g, Baizhu (Atractylodis Macrocephalae Rhizoma) 12g, Shengma (Cimicifugae Rhizoma) 6g, Jiao Huangbai (Phellodendri Cortex) 6g, Bixie (Dioscoreae Hypoglaucae Rhizoma) 9g; Juhe (Citri Grandis Semen) 6g, Fuling (Poria) 15g, Lianzi (Nelumbinis Semen) 9g, Shichangpu (Acori Tatarinowii Rhizoma) 3g, Cheqianzi (Plantaginis Semen) 9g; Gancao Shao (Glycyrrhizae Radix et Rhizoma tip) 4.5g, Danyezhu (Lophatheri Herba) 9g, Dengxin (Junci Medulla) 1 bundle.
Huangbai (Phellodendron Bark) strengthens Kidney Yin, effectively resolves dampness, and facilitates urination. Juhe regulates Liver Qi; Changpu resolves turbidity and opens orifices. Bixie, Fuling, Gancao Shao, Cheqianzi, Dengxin, and Danyezhu clear heat and harmonize urination. Ingeniously, Huangqi (Astragalus Root) and Shengma (Cimicifuga Rhizome) are added to tonify Qi and lift Yang, assisted by Baizhu and Lianzi to strengthen the Spleen and transport dampness. The combined formula enhances Qi transformation in the Triple Burner. *Suwen: Linglan Midian Lun* states: "The Triple Burner is the official of irrigation, through which water passages emerge." If the Upper Burner is not ventilated, the Lower Burner cannot flow; opening the upper allows the lower to clear spontaneously. This is the key to treating urinary retention. This formula treats the Lower Burner while addressing the Middle and Upper, ensuring smooth Qi transformation in the Triple Burner so water passages flow freely.
Fifth and Sixth Visits followed the same method with modifications, except Baizhu was increased from 12g to 30g, as strengthening the Spleen greatly aids diuresis. With this treatment, bacterial count in urine dropped from 70,000 to 40,000. After the second dose, it fell to 2,000; after three doses, it dropped to 200. Urination became completely free of obstruction and pain, and all symptoms resolved. The patient was extremely delighted, shook hands in gratitude, and deeply regretted his past disdain for TCM.
He was discharged shortly thereafter and instructed to take Gui Fu Ba Wei Wan (Cinnamon and Aconite Eight-Ingredient Pill) for regulation. Follow-up urinalysis showed no bacteria, and his spirit was refreshed, returning to normal health.
[Commentary]: Lung-Closed Syndrome (urinary retention) can be excess or deficiency, fundamentally involving obstruction of water pathway Qi mechanism. This case was caused by internal accumulation of summer-heat and dampness impairing Bladder Qi transformation. Initially, it was an excess syndrome. *Suwen: Zhi Zhen Yao Da Lun* states: "One must subdue the dominant pathogen by first addressing its cause." Investigating the syndrome to find the cause, since the disease arises from summer-heat and dampness, resolving summer-heat can treat urinary retention, and supporting righteousness can expel pathogens. Finally, focusing on the Lower Burner, Baizhu was increased to strengthen the Middle, and Shengma and Huangqi were used to lift Yang. The rationale was explained in the Fourth Visit. TCM views the human body as a unified whole with interconnected upper/lower and internal/external aspects, strongly opposing the metaphysical view of "treating the head when the head hurts, treating the foot when the foot hurts."
Cold Viscera Causing Distension and Retention
Li XX, male, forty. He suffered from lower back pain, urgent bladder distension, and restless sleep. Despite block therapy and physiotherapy, it persisted without cure. Upon consultation, his pulse was deep and wiry, and his tongue was cyan and slippery. The lower back pain combined with urgent bladder distension clearly indicates severe Kidney Yang deficiency and sinking of Liver Qi. The Liver governs dispersion and drainage; the Kidney governs closure and storage. Now, with severe Kidney Yang deficiency, cold water fails to generate Wood (Liver), causing Liver Qi to sink and fail to generate Heart Fire. Fire represents Yang. Insufficient Heart Fire means deficient Heart Yang. Heart Yang connects to Kidney Yang; thus, Heart Yang deficiency leads to Kidney Yang deficiency, resulting in the aforementioned symptoms. Treatment should strongly warm Heart Yang, warm the Kidney, and warm the Liver. The formula selected is Rougui Shengjiang Tang (Cinnamon and Ginger Decoction).
Shang Rougui (Cinnamon Bark) 9g, Shengjiang (Fresh Ginger) 30g.
Regarding Rougui (Cinnamon Bark), Huang Kunzai stated: "Sweet and pungent, fragrant aroma, warm nature, enters the Foot Jueyin Liver Meridian, warms the Liver and nourishes blood, breaks stasis and dissipates masses, expels damp-cold from waist and legs, and drives away abdominal and hypochondriac pain." Zhang Xichun stated that Rougui's "nature descends, warms the Dantian, strengthens Primordial Yang, and supplements Ministerial Fire. Its purple-red color also assists Lord Fire, warms and unblocks blood vessels, treating bi-syndrome of blood vessels throughout the body due to cold, thus treating joint and limb pain..." Therefore, in clinical practice, I often use Rougui to strengthen the Heart, and further use it to warm the Kidney and Liver to lift sinking Liver Wood. Only when Liver Wood is warmed does it ascend; only upon ascending can it restore its normal dispersion and drainage function. Shengjiang is acrid and warm. Huang stated this herb "enters the Lung and Stomach to drive out turbidity, travels through the Liver and Spleen to move stagnation," and "harmonizes Zang-Fu organs, disseminates Ying and Wei." The combination of these two herbs not only warms and supports Heart Yang but also warms the Kidney and Liver.
After one dose, the patient felt reduced lower back pain, lessened urgent bladder distension, and improved sleep. Further treatment should strengthen the Heart and warm the Kidney to communicate Yin and Yang. Baitong Tang (White Ginger and Scallion Decoction) with modifications was prescribed.
Hei Fupian (Aconiti Lateralis Radix Praeparata) 60g, Ganjiang (Zingiberis Rhizoma) 15g, Congbai (Allii Fistulosii Bulbus) 3 stalks, Shang Rougui (Cinnamon Bark) 9g, Fuling (Poria) 15g.
Baitong Tang communicates Yin and Yang; adding Rougui and Fuling lifts sinking Liver Wood; Fuzi (Prepared Aconite Root) combined with Rougui strengthens the Heart and warms the Kidney. Heart and Kidney are the foundation of congenital constitution and masters of systemic Yang. Instructed to take three doses, symptoms improved significantly. Subsequently, formulas to support Yang, dispel cold, tonify the Kidney, and strengthen the waist were used: Sixni Tang (Four-Reversal Decoction) combined with Liu Hejian Jingang Wan (Liu Hejian's Diamond Pill) with modifications.
Hei Fupian (Aconiti Lateralis Radix Praeparata) 60g, Ganjiang (Zingiberis Rhizoma) 9g, Zhi Gancao (Glycyrrhizae Radix et Rhizoma Preparatum) 6g, Chao Duzhong (Eucommiae Cortex) 15g; Chao Xuduan (Dipsaci Radix) 9g, Dan Dayun (Cynomachii Herba) 9g, Tusizi (Cuscutae Semen) 9g, Bixie (Dioscoreae Hypoglaucae Rhizoma) 9g.
Sixni Tang supports Primordial Yang; the remaining herbs tonify Liver and Kidney, strengthen waist and knees, and treat lower back pain. Jingang Wan is an effective formula for lower back pain and bone萎 (atrophy/withering). After ten consecutive doses, symptoms disappeared.
[Editor's Commentary]: Although initial symptoms were brief, the tongue and pulse indicate Yang deficiency and cold-damp obstruction. This differs from urgent bladder distension caused by Liver Meridian Damp-Heat. Urgent distension due to Yang deficiency presents with pale or cyan-dark complexion, heaviness and aversion to cold, desire to close eyes and lie down, shortness of breath and reluctance to speak, cold extremities, white-slippery or cyan-slippery tongue, and deep-fine, deep-weak, or deep-wiry pulse. Treatment should warm Yang and dispel cold, hence Rougui Shengjiang Tang is suitable. For Liver Meridian Damp-Heat, symptoms include bitter taste, dry throat, hypochondriac pain, irritability, yellow-red urine despite urgency, yellow-greasy tongue coating, and wiry-rapid pulse. Treatment should clear Liver Damp-Heat, using formulas like Longdan Xiegan Tang (Gentiana Liver-Draining Decoction). Different differentiation yields different treatments.
Rougui Shengjiang Tang is a commonly used heart-strengthening formula by Elder Dai. It is simple yet profound. For cardiopulmonary diseases presenting with Yang deficiency or depressed Heart Yang, manifesting as cyan lips/tongue, chest oppression/pain, wheezing/dyspnea, and upward flooding of cold phlegm, this formula is applicable. It also treats persistent clear nasal discharge due to Cardiopulmonary Yang deficiency.
Impotence and Infertility
Lu XX, male, forty. Suffering from impotence for over ten years without cure, he had no children after many years of marriage. Examination at a certain hospital revealed inactive spermatozoa, prompting him to seek treatment at our institute. Pulse was deep and weak at both Chi positions; complexion was pale. Memory declined, accompanied by frequent dizziness, lower back pain, vertigo, tinnitus, and fatigue. The syndrome belongs to insufficient Kidney Essence and declining Primordial Yang. Treatment requires herbs that generate essence, supplement marrow, and strongly support Primordial Yang. Prescription:
Ye Taishen (Wild Codonopsis Radix) 30g, Poguzhi (Psoraleae Fructus) 15g, Gan Guoqi (Wolfberry Fruit) 15g, Tusizi (Cuscutae Semen) 15g; Guang Suoyang (Cynomachii Herba) 15g, Bai Fuling (Poria) 15g, Huai Maotiao (Polygonati Rhizoma) 15g, Mumian Huazi (Bombacis Seed) 15g; Shang Rougui (Cinnamon Bark) 15g, Lurong (Cornu Cervi Pantotrichum) 30g (or Lu Jiao Jiao 90g may be used).
The ten herbs above are ground into fine powder, taken three times daily, 9g per dose, swallowed with light salt water.
Zhang Jingyue stated: "Those skilled in tonifying Yang must seek Yang within Yin, so that Yang receives assistance from Yin and generation becomes infinite." Thus, Rougui and Lurong are used among a large group of Kidney-tonifying herbs to warm Primordial Yang and warm Kidney Water. Static containing movement, they inspire Yang Qi to generate semen. Lurong is a substance with life energy, possessing generative potential, greatly supplementing essence and marrow, warming and strengthening Primordial Yang, tonifying Qi and Blood, repairing Du Mai damage, and supplementing Chong Mai deficiency. As Xu Lingtai said: "When Chong and Du are abundant and Kidney Qi is strong, all effects will naturally arrive." Ye Taishen greatly tonifies Primordial Qi; Mumian Huazi tonifies the Kidney and strengthens the waist, treating Kidney-deficiency lower back pain and weak knees/shins, surpassing Jiuzi (Tribulus Seed). Such cooperation achieves the goal of adding essence, supplementing marrow, and strengthening reproductive function, making it effective for impotence and inactive sperm. However, this patient's course lasted over ten years; seeking treatment now means results cannot be expected quickly. Instructed to take one dose as one batch, continuing for about ten batches. The patient followed instructions. One year later, not only was the condition cured, but he also happily fathered a son.
[Commentary]: This formula has been used successfully for multiple cases of impotence and male infertility. It is respectfully introduced here.
Facial Paralysis (Deviation of Mouth and Eye) - Two Cases
Case 1:
Li XX, female, thirty-three. Suffering from left-sided facial paralysis, consulted five days after onset. Symptoms: right eyelid unable to close, right facial muscle flaccidity, philtrum flat/full, face and lips deviated to the right, involuntary twitching of the left face. Pulse was wiry and choppy; tongue quality normal, coating thin white; cough present, no thirst, no other discomfort. This was triggered by Liver deficiency generating wind, stagnant heat in the Lung, compounded by external pathogens, leading to internal-external interaction and sudden onset. Treatment focused on clearing descending Lung stagnant heat and warming Yang to release the exterior. Xuming Tang (Continuing Life Decoction) from *Jin Gui Yao Lue* citing *Gu Jin Lu Yan*, with Fa Banxia added, was used.
Mahuang Rong (Ephedrae Herba fuzz) 6g, Xingren (Armeniacae Semen Amarum) 9g, Sheng Shigao (Gypsum Fibrosum) 15g, Gancao (Glycyrrhizae Radix et Rhizoma) 6g, Ludangshen (Codonopsis Radix) 15g; Chuanxiong (Ligustici Chuanxiong Rhizoma) 6g, Danggui (Angelicae Sinensis Radix) 15g, Guizhi (Cinnamomi Ramulus) 9g, Ganjiang (Zingiberis Rhizoma) 9g, Fa Banxia (Pinelliae Rhizoma Preparatum) 9g.
Mahuang, Xingren, Shigao, and Gancao constitute Maxing Shigan Tang (Ephedra, Apricot Kernel, Gypsum, and Licorice Decoction), which disperses exterior pathogens, diffuses Lung Qi, and clears stagnant heat. Dangshen tonifies Qi and supports righteousness; Guizhi warms meridians and unblocks Yang; Ganjiang warms the Middle and unblocks vessels; Chuanxiong and Danggui invigorate blood and relax sinews; Fa Banxia directs rebellious Qi downward and resolves phlegm. The formula works synergistically to diffuse, unblock, descend, disperse, relax, and缓和 (soothe), addressing both root and branch. Besides oral medication, external treatment was prescribed:
Yazao (Gleditsiae Sinensis Spina) 30g (lightly crushed, boiled in vinegar to extract juice), wash the left side of the face three to five times daily. Yazao is a key herb for opening orifices and searching out wind, particularly effective for Liver wind. *Ben Jing* states it treats "wind-bi, dead flesh, and evil qi." Boiling with vinegar aims to guide the herb into the Liver. The Liver governs sinews; once Liver wind pathogens are dispersed externally, sinus tension naturally relaxes. Both formulas were provided, along with acupuncture advice for auxiliary effect. The patient treated according to instructions, and deviation normalized. From onset to cure took just over twenty days.
Case 2:
Zhang XX, male, twenty-one. After catching cold following fatigue, he discovered water leaking from the corner of his mouth while rinsing his mouth the next morning, realizing left-sided facial paralysis. Left eyelid could not close, tearing occurred, eyeballs slightly red, unable to furrow brow. Urgent consultation. Besides above symptoms, he reported fever, body pain, and scanty cough with sputum. Pulse was floating and rapid; tongue light red, coating white-greasy and scanty in fluid. Syndrome belongs to Liver deficiency and Lung dryness, complicated by external pathogens. Treatment should release exterior, clear Lung, nourish Liver, and moisten dryness. Xuming Tang with modifications was used.
Mahuang (Ephedrae Herba) 6g, Xingren (Armeniacae Semen Amarum) 9g, Sheng Shigao (Gypsum Fibrosum) 15g, Maidong (Ophiopogonis Radix) 9g, Danggui (Angelicae Sinensis Radix) 9g; Guizhi (Cinnamomi Ramulus) 9g, Chao Hangshao (Paeoniae Radix Alba Preparatum) 9g, Gancao (Glycyrrhizae Radix et Rhizoma) 6g.
Maxing Shigan Tang disperses exterior pathogens, diffuses Lung Qi, and clears stagnant heat. Maidong moistens dryness and generates fluids; Danggui and Shaohao nourish blood and tonify Liver; Guizhi warms meridians and unblocks Yang; combined with Shaoyao, it harmonizes Ying and Wei.
Second Visit: After two doses, fever and body pain completely resolved, cough slightly reduced, but facial deviation remained unchanged. Internal and external treatment combined. Internal treatment focuses on invigorating blood, dispelling wind, and relieving spasms. Prescription:
Tianma (Gastrodiae Rhizoma) 9g, Guizhi (Cinnamomi Ramulus) 9g, Gouteng (Uncariae Ramulus cum Uncis) 9g, Sangye (Mori Folium) 9g, Juhua (Chrysanthemi Flos) 9g; Danggui (Angelicae Sinensis Radix) 15g, Chao Hangshao (Paeoniae Radix Alba Preparatum) 9g, Mahuang Rong (Ephedrae Herba fuzz) 6g, Quanxie (Scorpio) 6g, Jiangcan (Bombyx Batryticatus) 6g; Shengjiang Zhi (Fresh Ginger Juice) 5 drops mixed per dose.
Tianma and Gouteng calm Liver, dispel wind, and relieve spasms; Sangye and Juhua calm Liver and extinguish wind; Danggui invigorates blood, following the principle "to treat wind, first treat blood; when blood flows, wind self-extinguishes." Guizhi and Hangshao harmonize Ying and Wei; Mahuang Rong opens pores; Quanxie, Jiangcan, and Ginger juice dispel wind, open orifices, and resolve phlegm. This formula specifically calms Liver and dispels wind to correct deviation.
External Treatment: Apply Leech blood (actually Eel blood, Shan Yu Xue) mixed with a small amount of Shexiang (Moschus) to the right side (apply to right if deviated left, apply to left if deviated right). Stop when corrected. Eel blood unblocks blood vessels and expels wind pathogens, specifically treating facial paralysis. Shexiang opens all orifices, unblocks collaterals, penetrates muscle and bone. Combined with eel blood, its penetrating and opening power increases, making it highly effective for facial paralysis.