徐 老年上盛下虚,呛咳上气,声哑嗌干,咳则起坐,卧不安枕,溺黄便硬。此由温邪化燥、渐传入腑,
脉虚涩,两寸俱大。治仍清上。用生地、麦冬、竹叶、沙参、贝母、玉竹、山栀、甘草、枇杷膏,数服遂平。
朱邑尊 疟瘳复感秋燥,虚阳上冒,则为头眩耳鸣,津不上供,则为舌干咽燥。加以公事劳心,渴饮脘
闷不饥,左寸关脉大于右,是秋令亢阳致病。后液涸,最忌燥药劫津。用钗斛、丹皮、沙参、麦冬、鲜生地、
栝蒌霜、洋参、茯神,二剂霍然。
王女 秋感风燥,头晕热烦,咳连胸胁震痛,吸气有音。治
宜清肃上焦,勿令气痹。豆豉、杏仁、贝母、橘红、蒌皮、桑皮蜜炙、桔梗、嫩桑叶,枇杷膏和服。
三剂而平。
董氏 经闭忽通,下损佳兆。近逢秋燥,寒热渴烦,脉数唇干,嗽多寐少,症由阴液不足,肺脾感燥而成,
治在滋养营液。用局方甘露饮∶生熟地黄、麦冬、石斛、甘草、茯神、枇杷叶,加五味、杞子、甜杏仁、梨肉。
四服症退,数脉顿改。但着左卧则咳而胁痛,去五味、梨肉,加桑皮(蜜炙)、白芍。四服更适,饮食亦加,
调理渐愈。
岳 老年因怒失血,渴烦羸瘦,延秋燥气加临,舌紫黑,干薄无津,溺涩痛,右尺偏旺。肺肾液涸,
心胃火燔,恐延痉厥。用犀角地黄汤加麦冬、石斛、鲜藕。再服舌润苔浮,但呃逆颔动,肉 筋惕,乃风火
成痉。急宜滋液熄风,复脉汤去姜、桂、麻仁,加竹茹、钩藤乃定。
汤氏 衰年食少病羸,胃阴虚弱,冬感风燥,疮疥搔痒,时或寒热谵烦,口渴舌焦,额汗冰指,脉左
虚大,右疾数。此阴阳交损,兼风燥劫津,治先甘润除烦。鲜地黄、玉竹、沙参、石斛(各二钱)、麦冬、
当归(各钱半)、黄 (八分)、霜桑叶(二钱)、蔗汁(半杯)冲服。热退舌润。随用潞参、黄 、茯神、
枣仁、当归、白芍、玉竹、莲、枣。平补阴阳,症愈。
徐先生:年事已高,呈现上实下虚之证。呛咳气逆,声音嘶哑,咽喉干燥,咳嗽剧烈时需起身坐立,卧床时枕头也难以安枕,小便黄赤,大便干硬。此病由温邪化燥、逐渐传入腑脏所致。脉象虚涩,两手寸脉均大。治疗仍宜清解上焦。用药为生地黄、麦冬、竹叶、沙参、贝母、玉竹、山栀、甘草、枇杷膏,服用数剂后病情平复。
朱邑尊(对朱大人的尊称):疟疾痊愈后又感受秋燥,虚阳上浮冒犯头部,导致头晕目眩、耳鸣;津液不能上承滋润,导致舌干咽燥。加之处理公务劳心费力,出现口渴饮水、胃脘闷胀、食欲不振等症状。左手寸关脉大于右手,这是秋季亢盛之阳致病。后期若阴液枯竭,最忌使用燥烈药物劫伤津液。用药用石斛、丹皮、沙参、麦冬、鲜生地、栝蒌霜、西洋参、茯神,服用两剂后霍然痊愈。
王小姐:秋季感受风燥,出现头晕、烦热,咳嗽牵连胸胁震痛,吸气时有声响。治疗宜清肃上焦,防止气机痹阻。用药用豆豉、杏仁、贝母、橘红、瓜蒌皮、蜜炙桑白皮、桔梗、嫩桑叶,配合枇杷膏和服。三剂后病情平复。
董氏女士:月经闭止突然通畅,是下元亏损好转的佳兆。近期恰逢秋燥,出现寒热交替、口渴烦躁,脉数唇干,咳嗽多而睡眠少。病症由阴液不足,肺脾感受燥邪而成,治疗重在滋养营血津液。使用局方甘露饮:生熟地黄、麦冬、石斛、甘草、茯神、枇杷叶,加入五味子、枸杞子、甜杏仁、梨肉。服用四剂后症状消退,数脉顿时改变。但若向左侧卧则咳嗽且胁肋疼痛,故去掉五味子和梨肉,加入蜜炙桑白皮、白芍。再服四剂更加适宜,饮食增加,调理渐愈。
岳先生:老年人因发怒导致失血,口渴烦躁,身体消瘦,延至秋季燥气加临,舌色紫黑,干枯薄腻无津液,小便涩痛,右尺脉偏旺。肺肾津液枯竭,心胃火邪炽盛,恐怕蔓延引发痉厥。用药用犀角地黄汤加麦冬、石斛、鲜藕。再服后舌面润泽、苔浮起,但出现呃逆、下巴颤动、肌肉跳动、筋脉抽搐,这是风火相煽形成痉证。急宜滋阴增液、熄风止痉,使用复脉汤去掉生姜、肉桂、火麻仁,加入竹茹、钩藤,病情才安定。
汤氏女士:年老体衰,饮食减少,因病体弱,胃阴虚弱,冬季感受风燥,出现疮疥瘙痒,时而寒热、谵语烦躁,口渴舌焦,额头出汗、手指冰凉,脉象左手虚大,右手疾数。此为阴阳俱损,兼受风燥劫伤津液,治疗先以甘润之法除烦。用药用鲜地黄、玉竹、沙参、石斛(各二钱)、麦冬、当归(各一钱半)、黄芪(八分)、霜桑叶(二钱),冲服蔗汁(半杯)。热退舌润后。随后使用党参、黄芪、茯神、酸枣仁、当归、白芍、玉竹、莲子、大枣。平和补益阴阳,病症痊愈。
Mr. Xu: In his advanced years, presenting with excess in the upper jiao and deficiency in the lower jiao. Choking cough with rebellious Qi, hoarseness, and dry throat; severe coughing necessitates sitting up, unable to rest peacefully on a pillow. Urine is yellow, stool is hard. This arises from warm pathogenic factors transforming into dryness and gradually transmitting to the fu organs. The pulse is deficient and choppy, with both cun positions enlarged. Treatment remains focused on clearing the upper jiao. Prescribed are Sheng Di Huang (Rehmanniae Radix), Mai Dong (Ophiopogonis Tuber), Zhu Ye (Bambusae Folium), Sha Shen (Glehniae Radix or Adenophorae Radix), Bei Mu (Fritillariae Bulbus), Yu Zhu (Polygonati Odorati Rhizoma), Shan Zhi (Gardeniae Fructus), Gan Cao (Glycyrrhizae Radix et Rhizoma), and Pi Pa Gao (Loquat Syrup). After several doses, the condition stabilized.
President Zhu: After malaria subsided, he contracted autumn dryness again. Deficient Yang floated upward, causing dizziness and tinnitus; fluids failed to ascend for nourishment, resulting in a dry tongue and parched throat. Compounded by mental exertion from official duties, he experienced thirst despite drinking, epigastric fullness, and lack of appetite. The left cun and guan pulses were larger than the right, indicating disease caused by hyperactive Yang of autumn. Later, if fluids become depleted, it is most contraindicated to use drying herbs that rob fluids. Prescribed are Dui Shi (Dendrobii Caulis), Dan Pi (Moutan Cortex), Sha Shen (Glehniae Radix or Adenophorae Radix), Mai Dong (Ophiopogonis Tuber), Xian Sheng Di Huang (Fresh Rehmanniae Radix), Gua Lou Shuang (Trichosanthis Semen Pulveratum), Yang Shen (Panacis Quinquefolii Radix), and Fu Shen (Poria Cum Radix Pini). After two doses, he recovered abruptly.
Miss Wang: Contracted wind-dryness in autumn, presenting with dizziness, heat, and irritability; continuous cough radiating pain to chest and hypochondrium, with audible sound upon inspiration. Treatment should clear and purify the upper jiao, preventing Qi obstruction. Prescribed are Dou Chi (Sojae Semens Praeparatum), Xing Ren (Armeniacae Semen Amarum), Bei Mu (Fritillariae Bulbus), Ju Hong (Citri Reticulatae Pericarpium), Lou Pi (Trichosanthis Pericarpium), Sang Bai Pi (Mori Cortex) honey-fried, Jie Geng (Platycodonis Radix), and Nong Sang Ye (Mori Folium). Taken with Pi Pa Gao (Loquat Syrup). Stabilized after three doses.
Ms. Dong: Menstrual amenorrhea suddenly ceased, a favorable sign of improving lower jiao deficiency. Recently encountering autumn dryness, she presented with alternating chills and fever, thirst, irritability, rapid pulse, and dry lips. Frequent coughing and little sleep. The syndrome results from insufficient Yin fluids, with Lung and Spleen affected by dryness. Treatment focuses on nourishing Ying fluids. Used Ju Fang Gan Lu Yin (Official Formula Sweet Dew Decoction): Sheng Di Huang (Rehmanniae Radix), Shu Di Huang (Prepared Rehmanniae Radix), Mai Dong (Ophiopogonis Tuber), Shi Hu (Dendrobii Caulis), Gan Cao (Glycyrrhizae Radix et Rhizoma), Fu Shen (Poria Cum Radix Pini), Pi Pa Ye (Loquat Leaf), added Wu Wei Zi (Schisandrae Fructus), Qi Zi (Lycii Fructus), Tian Xing Ren (Sweet Armeniacae Semen), and Li Rou (Pyrus Flesh). After four doses, symptoms receded, and the rapid pulse changed immediately. However, lying on the left side induced cough and hypochondriac pain, so Wu Wei Zi and Li Rou were removed, adding Sang Bai Pi (Mori Cortex) honey-fried and Bai Shao (Paeoniae Radix Alba). After another four doses, she felt more comfortable, appetite increased, and gradual recovery ensued through regulation.
Mr. Yue: An elderly man suffered bleeding due to anger, presenting with thirst, irritability, emaciation. As autumn dryness arrived, his tongue became purple-black, dry, thin, and devoid of fluids; urination was difficult and painful. The right chi position was hyperactive. Lung and Kidney fluids were exhausted, Heart and Stomach fire was blazing, fearing progression to spasm and convulsion. Prescribed Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction) added Mai Dong (Ophiopogonis Tuber), Shi Hu (Dendrobii Caulis), and Xian Ou (Fresh Nelumbinis Rhizoma). After further doses, the tongue became moist with floating coating, but hiccups, chin tremors, muscle twitching, and tendon spasms appeared, indicating spasm formed by wind-fire. Urgently needed to nourish fluids and extinguish wind. Used Mai Mai Teng Tang (Ligusticum and Uncaria Decoction - *Note: Context implies Gui Pi Tang or similar modification, but text says "Fu Mai Tang" which usually refers to Mai Men Dong Tang or similar fluid-nourishing formulas in this context, often interpreted as a variation of Si Ni Tang or Mai Mai Tang depending on school, here translated as Pulse-Recovering Decoction*) removing Jiang (Zingiberis Rhizoma), Gui (Cinnamomi Ramulum), and Ma Ren (Semen Cannabis), adding Zhu Ru (Bambusae Caulis in Taenia) and Gou Teng (Uncariae Ramulus cum Uncis). Condition settled.
Ms. Tang: In her declining years, poor appetite and illness-induced weakness, with weak Stomach Yin. Contracted wind-dryness in winter, presenting with sores, itching, occasional chills/fever, delirium, irritability, thirst, scorched tongue, cold sweat on forehead, and cold fingers. Pulse: left deficient and large, right rapid and frequent. This is mutual damage of Yin and Yang, compounded by wind-dryness robbing fluids. Treatment first uses sweet-moistening methods to remove irritability. Prescribed Xian Di Huang (Fresh Rehmanniae Radix), Yu Zhu (Polygonati Odorati Rhizoma), Sha Shen (Glehniae Radix or Adenophorae Radix), Shi Hu (Dendrobii Caulis) [each 2 qian], Mai Dong (Ophiopogonis Tuber), Dang Gui (Angelicae Sinensis Radix) [each 1.5 qian], Huang Qi (Astragali Radix) [8 fen], Shuang Sang Ye (Frost-covered Mori Folium) [2 qian], taken with Zhe Zhi (Saccharum Japonicum Juice) [half cup]. Heat subsided, tongue moistened. Subsequently used Lu Shen (Codonopsis Radix), Huang Qi (Astragali Radix), Fu Shen (Poria Cum Radix Pini), Zao Ren (Ziziphi Spinosae Semen), Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba), Yu Zhu (Polygonati Odorati Rhizoma), Lian Zi (Nelumbinis Semen), and Da Zao (Jujubae Fructus). Peacefully tonifying Yin and Yang, the condition healed.