192．升阳散火之证，以发热较著、不恶寒、无汗、无舌苔、脉沉数为特征。究其原因，为阳郁于脾，由于过食辛凉所致也。其邪热用辛凉、寒凉均不能退，可予升阳散火汤，效果很好。
193．一西医诊断为脉管炎患者，症见右下肢膝以下自觉发憋发凉，无浮肿疼痛，其他无明显征象。给以活络效灵丹加牛膝、肉桂、麝香，外用葱熨法而愈。
194．曾治一妇人寒热如疟，一日二三度发，病已半年之久，诸药不效。余诊其脉虚而数，舌色如常，用补中益气汤去升麻、陈皮，加白芍、熟地，气血双补而愈。这也可说是少阳类似证之一。
195．曾治一梅核气患者，过去经医用半夏厚朴汤无效，透视检查亦未见实质性病变。诊之属痰热郁结之证，给以王节斋化痰丸而愈。
196。一例功能性子宫出血久久不愈的患者，输血、中药、刮宫等措施均效果不著，视其症除面色胱白、息短语微、两脉沉细外，并见舌苔黄燥，腹满硬痛，便秘溲赤。脉证相参，诊为内有实热之证，方用生地10克，白芍10克，丹皮7．5克，焦栀子10克，大黄10克。1剂崩血止，6剂即愈。
197．月经过多一证，原因很多。如属虚证者，每以归脾汤加入鸡冠花治之，效果很好。若虚甚者，原方党参易人参。
198．温经汤，为妇科常用而有效之方，其着眼点为寒热夹杂证的情况，用之为宜，而非单纯的寒证。
199．带证，清带汤最宜，可以作为治带证之基础方。寒者加桂、姜，热者加黄柏或苦参，气虚者加黄芪，血虚者加归芍，肝气不舒者加香附、柴胡，有瘀滞者加桃仁。临证须活用之。
200．妊娠因负重伤胎而胀痛者，保生无忧散效果较好，如下血者，酌加阿胶。
201．九痛丸(附子、狼牙、巴豆、人参、干姜、吴茱萸)对胃痛拒按、不喜冷性饮食者有效，为温开之法。曾用治宫外孕患者，胃痛拒按，脉沉而似有力，无表证，无热象者，取效甚验。方中人参应用高丽参，狼牙可改用狼毒，剂量仍以原方比例为准。应预制备用。
202．升降散有升清降浊之功，曾用于大头瘟，效果很好。《寒温条辨》的15个方剂都很好。曾用其中增损大柴胡汤、增损三黄石膏汤等方剂分别治疗乙型脑炎、重症肺炎等，都收到了出奇的效果。
203．大柴胡汤为阳明少阳合并之证，柴胡加芒硝为误下之后，柴胡证仍在而有便燥，为虚中夹实之疾。用时须加以区别。
204．当归四逆汤是治寒邪直中厥阴之方(麻黄附子细辛为寒邪直中少阴之方)。曾治一证，由于冬季早晨室外劳动，突然发现下腹部疝痛，抽掣睾丸痛，四肢发凉，脉沉细，给以当归四逆加吴茱萸生姜汤即愈。 日人用此方治冻疮，有效。如单纯内寒之证，不可用，恐阳气被散而虚脱也；阳气被郁之四肢厥逆，不可用(宜宣达阳气)。方中通草，陈氏意见，应改为木通。本方即桂枝汤之变方，凡桂枝证兼血分闭塞者，可以用之，为温中散寒、宣通血络之法也。冻疮之红肿痒痛，予本方四五剂即效。
205．白通汤和通脉四逆汤之用葱白，对格阳证来说，是不适当的，因为葱白总是散的药品，以不用为妥，如系寒邪直中，可以酌用。至于加猪胆汁，有认为系从治法，对格阳证可用；有认为阴阳两虚，胆汁系治阴虚的一面，也不妥。阴阳两虚，系用四逆加人参，猪胆汁有通便的作用，对通脉四逆证也不相宜。如系因格拒，用量不必多。
206．玉女煎，治因牙痛而牵引头痛者，有效。患者自觉有气自颊车上冲头部而痛，不冲则头不痛，上证用之有效。但要注意，本方是适用于表里气血皆热之清热滋阴剂，用时必须体会到这一点。，
207．三甲复脉、大定风珠之类方剂，为滋刚熄风之剂，温病后期，肾水亏不能涵养肝木，致肝风内动者宜之。临床必兼舌红、口干之象，根据临床经验，应加人参为佳．
208．增液汤所治之便秘，为无水停舟，腹痛尤压痛，如兼拒按，则属增液承气之适应证。
209．九种心痛丸，有止痛攻积、除寒杀虫补虚的作用， 虽治几种心痛，但主要治胃部拒按，属寒属实之心痛，主治中恶腹胀，口不能言，连年积冷流注，心胸痛，冷气攻冲，落马坠车，血疾等。
210．桂枝芍药知母汤所主力历节，游走性关节剧痛。曹颖甫曰：“历节证起于风寒外感，汗出不畅，湿流关节，脉迟而滑，属寒湿。轻者宜本方，剧者宜乌头汤。”可作参考。又受风邪，于某一处疼痛，麻杏薏甘汤很好，但游走而遇阴雨风冷反复发作，久延不愈者，服桂枝芍药知母汤，效果很好。
治学方法
211．读古人之书，尤其是医书，不可拘于章句，应分别地加以选择，进行归类分析，然后根据实践加以条理化。古人的东两，应该经过我们的再实践加以验证，有效的加以肯定，无效的给以否定，未经验证过的，不能否定，留待今后实践之。既不可教条地迷信古人，也不可无原则地一笔抹煞，因为社会是发展的。一切事情都不能割断历史，都是从古至今逐渐地发展起来的，我们今天的各种总结，也是为后人奠定基础的．
212．学习古典医学，要重点记忆，全面理解，融汇贯通，并通过临床实践加以验证．以便取其精华，去其糟粕，推陈出新，补充完善．
213．作为一个医生，必须具备辨证的基本功。例如望神，什么是神，如何体现，正常人喜怒忧思，表情各有不同，可以从望而知之。这就是基本功，没见过濒死状态的人，病已垂危而不自知，这就是基本功的问题。所以，平时对各方面要多加留意，久之自然通达，这就是经验，这是书本上找不到的，
214．要想做到方药丝丝入扣，必须熟记数千方，数百药，否则是难以达到这一要求的
215．研究处方，以胃苓汤为例，要注意它的配伍应用。方中之厚朴有人认为足通阳，那么要问：通阳为什么要用厚朴?用其他药行不行?根掘经验，厚朴的主要作用是除胀满，问题在于厚朴有降的作用，对泄泻不宜，故用量宜小。假如腹胀拒按，则不妨多用，甚则枳实、大黄亦可加入。如虚的方面显著。则白术须多用，甚则还须加人参。寒的方面较著，则桂枝可多用，甚则还须加干姜。这样研究，处处结合实际，一通八达，又易理解，又易记忆，而且实用。
216．学习方剂，不但要从其正面、反面体会，而且要注意区別同类方的细微差别．举承气为例，研究大承气时，必须把小承气、调胃承气的应用一同加以区别，更须把备急、温脾的区别弄清楚，进一步再弄清黄龙汤、增液承气汤的不同用法，然后才能应用自如，取效如响。
217．研究药物，应从它的实际性能作用上入手，从它与其他药物的配伍上深究。这也是临床应用的关键。如人参配当归以补血，配黄芪以补气，配石膏、知母治热盛伤津，配干姜、附子治气虚亡阳，配厚朴治虚胀等等。只要把这种精神掌握住，临床应用还有什么问题呢?
218．下利一症，有需利尿法治之，有需消导疏通法，有需开提法。究竟什么情况下应使用哪种方法，这就要从正确的诊断上，从药物的选择上分析之。如因表证失于表散而有内陷之机引致的下泄，必须用升提之法；如腹痛拒按，有积滞者，必须兼用疏通之法。余者类推，可于临床上体会其精神。阅书时，亦须处处以临床应用的观点去体会之。
219．认真地作科学检查对于诊断是最正确的一种方法，对于治疗也有很大的帮助，不然的话，治好了病也拿不出成绩来。
220．继承老中医的经验，不仅是要记住老中医几个秘方、验方，更重要的是要学习老中医的治学方法与诊疗思路，临床上如何辨证，如何分析病情，如何处方用药，甚至于在用药的剂暈上、服用方法上，都应细心留意，才能达到真正继承其学术经验的目的。因为宝贵的经验并不在几个所谓的秘方、验方上面。后记
192．升阳散火证，以发热明显、不怕冷、无汗、舌面无苔、脉象沉而数为主要特征。其病因是阳气郁结在脾脏，由于过度食用辛辣寒凉食物所致。这种邪热用辛凉或寒凉药物均不能退去，可使用升阳散火汤，效果很好。
193．曾有一位被西医诊断为脉管炎的患者，症状表现为右下肢膝盖以下自觉憋闷发凉，没有浮肿和疼痛，其他方面无明显体征。给予活络效灵丹加牛膝、肉桂、麝香，并配合外用葱熨法治疗而痊愈。
194．曾诊治一位妇女，寒热往来如疟疾发作，一天发作两三次，病程已达半年之久，服用各种药物无效。我诊察其脉象虚而数，舌色正常，使用补中益气汤去掉升麻、陈皮，加入白芍、熟地黄，通过气血双补而痊愈。这也可以说是少阳病的类似证之一。
195．曾诊治一位梅核气患者，过去经医生使用半夏厚朴汤治疗无效，透视检查也未发现实质性病变。诊察认为属于痰热郁结之证，给予王节斋化痰丸治疗而痊愈。
196．一例功能性子宫出血久治不愈的患者，输血、中药、刮宫等措施效果均不显著。观察其症状，除面色苍白、气息短促声音微弱、两脉沉细外，还见舌苔黄燥，腹部胀满硬痛，便秘尿赤。脉证合参，诊断为内有实热之证，处方用地黄10克，白芍10克，牡丹皮7.5克，焦栀子10克，大黄10克。服用1剂后崩血停止，服用6剂即痊愈。
197．月经过多这一病症，原因很多。如果属于虚证，常用归脾汤加入鸡冠花治疗，效果很好。如果虚损严重，原方中将党参换为人参。
198．温经汤是妇科常用且有效的方剂，其着眼点在于寒热夹杂证的情况，适用此方为宜，而非单纯的寒证。
199．带下病，清带汤最为适宜，可作为治疗带下病的基础方。寒者加桂枝、干姜，热者加黄柏或苦参，气虚者加黄芪，血虚者加当归、白芍，肝气不舒者加香附、柴胡，有瘀滞者加桃仁。临证时必须灵活运用。
200．妊娠期间因负重导致伤胎而出现胀痛者，保生无忧散效果较好；如果有下血症状，酌情加入阿胶。
201．九痛丸（由附子、狼牙、巴豆、人参、干姜、吴茱萸组成）对胃痛拒按、不喜欢冷性饮食者有效，属于温通开窍之法。曾用此方治疗宫外孕患者，症见胃痛拒按，脉沉而似有力，无表证，无热象者，取效非常显著。方中人参应用高丽参，狼牙可改用狼毒，剂量仍以原方比例为准。应预先制备备用。
202．升降散具有升清降浊的功效，曾用于治疗大头瘟，效果很好。《寒温条辨》中的15个方剂都很好。曾用其中的增损大柴胡汤、增损三黄石膏汤等方剂分别治疗乙型脑炎、重症肺炎等，都收到了出奇的效果。
203．大柴胡汤用于阳明少阳合并之证；柴胡加芒硝汤用于误下之后，柴胡证仍在而有大便干燥，属于虚中夹实的疾病。使用时须加以区别。
204．当归四逆汤是治疗寒邪直中厥阴经的方剂（麻黄附子细辛汤为寒邪直中少阴经的方剂）。曾诊治一证，由于冬季早晨在室外劳动，突然发现下腹部疝痛，牵引睾丸痛，四肢发凉，脉象沉细，给予当归四逆加吴茱萸生姜汤即痊愈。日本人用此方治疗冻疮，有效。如果是单纯的内寒证，不可用，恐怕阳气被发散而导致虚脱；如果是阳气被郁结导致的四肢厥逆，不可用（宜宣达阳气）。方中通草，陈氏意见认为应改为木通。本方即桂枝汤的变方，凡是桂枝证兼有血分闭塞者，可以用之，这是温中散寒、宣通血络的方法。冻疮的红肿痒痛，给予本方四五剂即见效。
205．白通汤和通脉四逆汤中使用葱白，对于格阳证来说是不适当的，因为葱白总是发散的药物，以不用为妥；如果是寒邪直中，可以酌情使用。至于加猪胆汁，有人认为属于从治法，对格阳证可用；有人认为阴阳两虚，胆汁是治疗阴虚的一面，也不妥当。阴阳两虚，应用四逆加人参汤，猪胆汁有通便的作用，对通脉四逆证也不相宜。如果是因格拒所致，用量不必多。
206．玉女煎，治疗因牙痛而牵引头痛者，有效。患者自觉有气从颊车穴上冲头部而痛，不冲则头不痛，上述症状用之有效。但要注意，本方适用于表里气血皆热的清热滋阴剂，使用时必须体会到这一点。
207．三甲复脉汤、大定风珠之类方剂，是滋刚熄风的方剂，温病后期，肾水亏虚不能涵养肝木，导致肝风内动者适宜使用。临床必兼见舌红、口干之象，根据临床经验，应加入人参为佳。
208．增液汤所治疗的便秘，属于无水停舟（津液枯竭导致肠道失润），腹痛且有压痛，如果兼见拒按，则属于增液承气汤的适应证。
209．九种心痛丸，有止痛攻积、除寒杀虫补虚的作用，虽然治疗几种心痛，但主要治疗胃部拒按，属寒属实的心痛，主治中恶腹胀，口不能言，连年积冷流注，心胸痛，冷气攻冲，落马坠车，血疾等。
210．桂枝芍药知母汤主要治疗历节病，表现为游走性关节剧痛。曹颖甫说：“历节证起于风寒外感，汗出不畅，湿流关节，脉迟而滑，属寒湿。轻者宜本方，剧者宜乌头汤。”可作参考。又如因受风邪，在某一处疼痛，麻杏薏甘汤很好，但如果游走不定且遇阴雨风冷反复发作，久延不愈者，服用桂枝芍药知母汤，效果很好。
【治学方法】
211．读古人的书，尤其是医书，不可拘泥于章句，应分别地加以选择，进行归类分析，然后根据实践加以条理化。古人的东西，应该经过我们的再实践加以验证，有效的加以肯定，无效的给以否定，未经验证过的，不能否定，留待今后实践。既不可教条地迷信古人，也不可无原则地一笔抹煞，因为社会是发展的。一切事情都不能割断历史，都是从古至今逐渐地发展起来的，我们今天的各种总结，也是为后人奠定基础的。
212．学习古典医学，要重点记忆，全面理解，融汇贯通，并通过临床实践加以验证。以便取其精华，去其糟粕，推陈出新，补充完善。
213．作为一个医生，必须具备辨证的基本功。例如望神，什么是神，如何体现，正常人喜怒忧思，表情各有不同，可以从望而知之。这就是基本功，没见过濒死状态的人，病已垂危而不自知，这就是基本功的问题。所以，平时对各方面要多加留意，久之自然通达，这就是经验，这是书本上找不到的。
214．要想做到方药丝丝入扣，必须熟记数千方，数百药，否则是难以达到这一要求的。
215．研究处方，以胃苓汤为例，要注意它的配伍应用。方中之厚朴有人认为足通阳，那么要问：通阳为什么要用厚朴？用其他药行不行？根据经验，厚朴的主要作用是除胀满，问题在于厚朴有降的作用，对泄泻不宜，故用量宜小。假如腹胀拒按，则不妨多用，甚则枳实、大黄亦可加入。如虚的方面显著，则白术须多用，甚则还须加人参。寒的方面较著，则桂枝可多用，甚则还须加干姜。这样研究，处处结合实际，一通八达，又易理解，又易记忆，而且实用。
216．学习方剂，不但要从其正面、反面体会，而且要注意区别同类方的细微差别。举承气汤为例，研究大承气汤时，必须把小承气汤、调胃承气汤的应用一同加以区别，更须把备急、温脾的区别弄清楚，进一步再弄清黄龙汤、增液承气汤的不同用法，然后才能应用自如，取效如响。
217．研究药物，应从它的实际性能作用上入手，从它与其他药物的配伍上深究。这也是临床应用的关键。如人参配当归以补血，配黄芪以补气，配石膏、知母治热盛伤津，配干姜、附子治气虚亡阳，配厚朴治虚胀等等。只要把这种精神掌握住，临床应用还有什么问题呢？
218．下利一症，有需利尿法治之，有需消导疏通法，有需开提法。究竟什么情况下应使用哪种方法，这就要从正确的诊断上，从药物的选择上分析之。如因表证失于表散而有内陷之机引致的下泄，必须用升提之法；如腹痛拒按，有积滞者，必须兼用疏通之法。余者类推，可于临床上体会其精神。阅书时，亦须处处以临床应用的观点去体会之。
219．认真地作科学检查对于诊断是最正确的一种方法，对于治疗也有很大的帮助，不然的话，治好了病也拿不出成绩来。
220．继承老中医的经验，不仅是要记住老中医几个秘方、验方，更重要的是要学习老中医的治学方法与诊疗思路，临床上如何辨证，如何分析病情，如何处方用药，甚至于在用药的剂量上、服用方法上，都应细心留意，才能达到真正继承其学术经验的目的。因为宝贵的经验并不在几个所谓的秘方、验方上面。后记
192. The syndrome of Shengyang Sanhuo (Raising Yang and Dispersing Fire) is characterized by prominent fever, absence of aversion to cold, anhidrosis (absence of sweating), a tongue without coating, and a deep and rapid pulse. The etiology involves the stagnation of Yang Qi in the Spleen due to excessive consumption of pungent and cold foods. Since this pathogenic heat cannot be resolved with either pungent-cool or cold medicines, Shengyang Sanhuo Tang (Decoction for Raising Yang and Dispersing Fire) should be administered, yielding excellent results.
193. A patient diagnosed with vasculitis by Western medicine presented with sensations of stuffiness and coldness below the right knee, without edema or pain, and no other obvious signs. He was treated with Huoluo Xiaoling Dan (Pain-Relieving Decoction for Unblocking Collaterals) supplemented with Achyranthis Bidentatae Radix (Niuxi, 牛膝), Cinnamomi Cortex (Rougui, 肉桂), and Moschus (Shexiang, 麝香), along with external application of Scallion Moxibustion (Congyi Fa, 葱熨法), resulting in a cure.
194. I once treated a woman suffering from alternating chills and fever resembling malaria, occurring two to three times daily, persisting for half a year despite various medications. Her pulse was deficient and rapid, and her tongue color was normal. I prescribed Buzhong Yiqi Tang (Decoction for Supplementing the Middle and Augmenting Qi) with the removal of Bupleuri Radix (Chaihu, 柴胡 - *Note: Text says Shengma/ Cimicifugae Rhizoma, corrected to match text*) Shengma (Cimicifugae Rhizoma, 升麻) and Citri Reticulatae Pericarpium (Chenpi, 陈皮), adding Paeoniae Radix Alba (Baishao, 白芍) and Rehmanniae Radix Praeparata (Shudi, 熟地). The condition was cured through dual supplementation of Qi and Blood. This can also be considered one of the similar syndromes of Shaoyang disease.
195. I once treated a patient with Meiheqi (Plum-pit Qi, a sensation of a foreign body in the throat). Previous treatment with Banxia Houpo Tang (Decoction of Pinellia and Magnolia Bark) had been ineffective, and fluoroscopy revealed no organic lesions. Diagnosis indicated a syndrome of Phlegm-Heat stagnation. The patient was cured using Wang Jiezhi's Huatan Wan (Phlegm-Resolving Pill).
196. A patient with persistent dysfunctional uterine bleeding showed poor response to blood transfusion, Chinese herbal medicine, and curettage. Examination revealed pale complexion, shortness of breath with weak voice, deep and fine pulses, yellow and dry tongue coating, abdominal fullness with hardness and pain, constipation, and dark urine. Correlating pulse and symptoms, the diagnosis was internal Excess Heat. The prescription consisted of Shengdi Huang (Rehmanniae Radix, 10g), Baishao (White Peony Root, 10g), Mudan Pi (Moutan Cortex, 7.5g), Jiao Zhizi (Charred Gardenia Fruit, 10g), and Dahuang (Rhubarb Root, 10g). Bleeding stopped after one dose, and the patient recovered after six doses.
197. Menorrhagia has many causes. If it belongs to a Deficiency syndrome, Guipi Tang (Decoction for Tonifying the Spleen) added with Celosiae Cristatae Flos (Jiguanhua, 鸡冠花) is effective. In cases of severe deficiency, Dangshen (Codonopsis Root) in the original formula should be replaced with Renshen (Ginseng Root).
198. Wenjing Tang (Decoction for Warming the Menses) is a commonly used and effective formula in gynecology. Its focus is on mixed Cold and Heat syndromes; it is suitable for such conditions rather than pure Cold syndromes.
199. For leukorrhea (Dai Zheng), Qingdai Tang (Clear Leukorrhea Decoction) is most appropriate and can serve as a base formula. Add Guizhi (Cinnamon Twig) and Ganjiang (Dried Ginger) for Cold; add Huangbai (Phellodendron Bark) or Kushen (Sophora Root) for Heat; add Huangqi (Astragalus Root) for Qi Deficiency; add Danggui (Angelica Sinensis) and Baishao (White Peony Root) for Blood Deficiency; add Xiangfu (Cyperus Rhizome) and Chaihu (Bupleurum Root) for Liver Qi Stagnation; add Taoren (Peach Kernel) for Blood Stasis. Clinical application requires flexibility.
200. For pregnancy complicated by heavy lifting causing fetal injury with distension and pain, Baosheng Wuyou San (Powder for Protecting Life and Ensuring Safety) is effective. If vaginal bleeding occurs, Ejiao (Donkey-Hide Gelatin) should be added according to circumstances.
201. Jiutong Wan (Nine-Pain Pill), composed of Fuzi (Prepared Aconite Root), Langya (Wolf Tooth/Bark), Badou (Croton Seed), Renshen (Ginseng Root), Ganjiang (Dried Ginger), and Wuzhuyu (Evodia Fruit), is effective for stomach pain that refuses pressure and aversion to cold foods. It represents a method of warming and unblocking. It has been successfully used to treat ectopic pregnancy presenting with stomach pain refusing pressure, deep pulse seemingly forceful, no exterior syndrome, and no heat signs. Korean Ginseng (Gaorishen) should be used for Renshen; Langya can be substituted with Langdu (Stellera Root); dosages should follow the original formula proportions. It should be prepared in advance.
202. Shengjiang San (Ascending and Descending Powder) has the function of ascending Clear Yang and descending Turbid Yin. It yielded good results when used for Datouwen (Big Head Plague). The fifteen formulas in Hanwen Tiaobian (Differentiation of Cold and Warm Diseases) are all excellent. Zengsun Dachaihu Tang (Modified Major Bupleurum Decoction) and Zengsun Sanhuang Shigao Tang (Modified Three-Yellow and Gypsum Decoction) were used respectively to treat Japanese Encephalitis Type B and severe pneumonia, achieving remarkable effects.
203. Dachaihu Tang (Major Bupleurum Decoction) is used for combined Yangming and Shaoyang syndromes. Chaihu Jia Mangxiao Tang (Bupleurum Decoction with Mirabilite) is used after erroneous purgation, where Chaihu syndrome persists accompanied by dry stool, representing a deficiency-interior excess condition. Distinction must be made during use.
204. Danggui Sini Tang (Angelica Decoction for Reversing Cold) treats Cold Evil directly invading the Jueyin channel (Mahuang Fuzi Xixin Tang is for direct invasion of Shaoyin). I once treated a case where sudden lower abdominal hernia pain radiating to the testicles and cold limbs occurred after outdoor labor on a winter morning. The pulse was deep and fine. The patient was cured with Danggui Sini Jia Wuzhuyu Shengjiang Tang (Angelica Decoction for Reversing Cold plus Evodia and Fresh Ginger). Japanese physicians use this formula for chilblains with effectiveness. However, it should not be used for pure interior Cold, as it may scatter Yang Qi leading to collapse; nor for cold extremities caused by constrained Yang Qi (where dispersing Yang Qi is preferred). Chen’s opinion suggests replacing Tongcao (Tetrapanacis Medulla) with Mutong (Akebia Stem). This formula is a variation of Guizhi Tang (Cinnamon Twig Decoction); it can be used for Guizhi syndrome accompanied by Blood level obstruction, serving as a method to warm the middle, dispel Cold, and unblock collaterals. Four to five doses are effective for red, swollen, itchy, and painful chilblains.
205. The use of Congbai (Scallion White) in Baitong Tang (White Concoction Decoction) and Tongmai Sini Tang (Pulse-Unblocking Reversing Cold Decoction) is inappropriate for Ge Yang syndrome (Floating Yang), because Congbai is always a dispersing agent; it is better not to use it. It may be used酌情 (discretionarily) if Cold Evil directly invades. Regarding the addition of Zhu Danzhi (Pig Bile), some consider it a "following treatment" method suitable for Ge Yang; others argue that in Yin-Yang dual deficiency, bile only treats the Yin deficiency aspect, which is inadequate. For Yin-Yang dual deficiency, Si Ni Jia Renshen Tang (Reversing Cold Decoction plus Ginseng) should be used; Zhu Danzhi has a laxative effect and is unsuitable for Tongmai Sini syndrome. If due to rejection (Geju), the dosage need not be large.
206. Yunnv Jian (Jade Woman Decoction) is effective for headaches radiating from toothache. Patients feel Qi rushing from the Jiache acupoint to the head causing pain; without this rush, there is no headache. The above symptoms respond well to this formula. Note: This formula is a clearing-heat and nourishing-yin agent applicable to Heat in both Exterior and Interior, and Qi and Blood. This point must be understood during use.
207. Sanjia Fumai Tang (Three-Shells Pulse-Recovering Decoction) and Dadong Fengzhu (Great Wind-Extinguishing Pearl) are nourishing and wind-extinguishing agents. They are suitable for late-stage warm diseases where Kidney Water deficiency fails to nourish Liver Wood, leading to internal stirring of Liver Wind. Clinically, red tongue and dry mouth must be present. Based on clinical experience, adding Renshen (Ginseng Root) is recommended.
208. The constipation treated by Zengye Tang (Fluid-Increasing Decoction) is due to "waterless boat stopping" (fluid exhaustion). Abdominal pain with tenderness is present. If refusal to press is added, it becomes an indication for Zengye Chengqi Tang (Fluid-Increasing Purging Decoction).
209. Jiuzhong Xintong Wan (Nine Kinds of Heart Pain Pill) has functions of relieving pain, attacking accumulation, dispelling Cold, killing parasites, and tonifying deficiency. Although treating several types of heart pain, it mainly treats stomach pain refusing pressure belonging to Cold and Excess. It treats main symptoms like sudden evil causing abdominal distension, inability to speak, chronic accumulated Cold flowing into collaterals, chest-heart pain, Cold Qi attacking upward, injuries from falling off horses or carts, and blood disorders.
210. Guizhi Shaoyao Zhimu Tang (Cinnamon Twig, Peony, and Anemarrhena Decoction) primarily treats Lijie (Joint Bi) with migratory severe joint pain. Cao Yingfu stated: "Lijie syndrome originates from Wind-Cold exterior contraction, incomplete sweating, and Dampness flowing into joints; the pulse is slow and slippery, indicating Cold-Damp. Mild cases suit this formula; severe cases suit Wutou Tang." This serves as reference. For pain in one area due to Wind Evil, Maxing Yigan Tang (Ephedra, Apricot Kernel, Coix Seed, and Licorice Decoction) is good. However, for migratory pain recurring with rainy/windy/cold weather and persisting long-term, Guizhi Shaoyao Zhimu Tang yields excellent results.
[Methods of Study]
211. When reading ancient books, especially medical texts, one should not be bound by sentences and phrases. One should select, categorize, and analyze them separately, then systematize them based on practice. Ancient knowledge should be verified through our own practice: affirm what is effective, negate what is ineffective, and withhold judgment on unverified content until future practice. One should neither dogmatically worship ancients nor indiscriminately dismiss them, as society develops. All matters cannot sever history; they develop gradually from antiquity to the present. Our current summaries lay the foundation for future generations.
212. Studying classical medicine requires focused memorization, comprehensive understanding, integration, and verification through clinical practice. This allows us to extract the essence, discard the dross, innovate, and perfect the knowledge.
213. A physician must possess basic skills in differentiation of syndromes. For example, observing Shen (Spirit): What is Spirit? How is it manifested? Normal people have different expressions for joy, anger, sorrow, and thought, which can be known through observation. This is a basic skill. Not having seen a person in a dying state who is unaware of their critical condition highlights the importance of these basic skills. Therefore, one must pay attention to various aspects in daily life; over time, natural comprehension arises. This is experience, which cannot be found in books.
214. To achieve precise matching of formulas and herbs, one must memorize thousands of formulas and hundreds of herbs; otherwise, this requirement is difficult to meet.
215. Studying prescriptions, taking Weiling Tang (Stomach-Ling Decoction) as an example, one must note its compatibility applications. Houpo (Magnolia Bark) is considered by some to unblock Yang. Question: Why use Houpo to unblock Yang? Can other herbs do it? Experience shows Houpo’s main role is removing fullness. The issue is Houpo has a descending action, making it unsuitable for diarrhea, so the dosage should be small. If abdominal fullness refuses pressure, a larger dose is acceptable, even adding Zhishi (Immature Bitter Orange) and Dahuang (Rhubarb). If deficiency is prominent, Baizhu (Atractylodes Macrocephala Rhizome) should be used in larger amounts, possibly adding Renshen (Ginseng). If Cold is significant, Guizhi (Cinnamon Twig) can be increased, possibly adding Ganjiang (Dried Ginger). Such study integrates theory with practice, facilitating understanding, memory, and practical utility.
216. Studying formulas requires appreciating both positive and negative aspects and distinguishing subtle differences among similar formulas. Taking Chengqi Tangs as an example, studying Dachengqi Tang (Major Purging Decoction) requires distinguishing the applications of Xiaochengqi Tang (Minor Purging Decoction) and Tiaoweichengqi Tang (Regulating Stomach Purging Decoction). One must clarify the differences between Beiji San (Emergency Aid Powder) and Wenpi Tang (Warming Spleen Decoction), and further understand the different uses of Huanglong Tang (Yellow Dragon Decoction) and Zengye Chengqi Tang. Only then can one apply them freely and achieve prompt results.
217. Studying herbs should start from their actual properties and actions, delving deeper into their compatibility with other herbs. This is key to clinical application. For instance, Renshen (Ginseng Root) paired with Danggui (Angelica Sinensis) tonifies Blood; paired with Huangqi (Astragalus Root) tonifies Qi; paired with Shigao (Gypsum) and Zhimu (Anemarrhena Rhizome) treats Heat damaging fluids; paired with Ganjiang (Dried Ginger) and Fuzi (Prepared Aconite Root) treats Qi deficiency with Yang collapse; paired with Houpo (Magnolia Bark) treats deficiency bloating. Mastering this spirit resolves clinical issues.
218. Diarrhea (Xiali) may require diuretic therapy, digestive/unblocking therapy, or lifting therapy. Determining which method to use depends on correct diagnosis and herb selection. If diarrhea results from failure to resolve an exterior syndrome leading to interior sinking, lifting therapy is mandatory. If abdominal pain refuses pressure with stagnation, unblocking therapy must be combined. Other cases follow this logic and should be appreciated clinically. When reading books, one must always view content through the lens of clinical application.
219. Rigorous scientific examination is the most accurate method for diagnosis and greatly aids treatment; otherwise, curing the disease yields no demonstrable achievement.
220. Inheriting the experience of senior TCM practitioners involves more than memorizing secret or proven formulas; it is crucial to learn their methods of study and diagnostic thinking—how to differentiate syndromes, analyze conditions, prescribe, and determine dosages and administration methods. Careful attention to these details achieves true inheritance of academic experience, as valuable experience lies not merely in specific formulas but in the underlying principles. Postscript