赵 左胁痛,脉洪耳鸣,时呕胀腹痛。皆肝火 腾,浊瘀不肯泄降,宜戒怒节饮可愈。仿栀萸汤,
山栀(姜汁炒)、黄连(吴茱萸汁炒)、白芍、牡蛎(生杵)、丹皮、金橘皮。服效。
本 寐醒舌干辣,华池津不上朝,头眩耳鸣,肢麻胁痛,肝风内震,腹满肠鸣,晨泻不爽,木气直犯中
宫矣。左关浮弦,右浮滑,痰嗽不利,太阴受戕,有年,须防类中。晨服方,运脾阳以利湿。生白术、茯苓、
半夏(青盐制)、炙草、薏米(炒)、砂仁、益智仁(煨)、山药(炒)、小麦。晚服方,养肝阴以熄风。阿
胶(水化)、杞子、茯神、麦冬、石斛、白芍、桑枝、甘菊(炒)、黑芝麻、牡蛎粉。寐后,用柿霜(二匙)
含舌下,以生廉泉之津。服效。
沈氏 当夏郁怒不寐,五更起坐,倏然头摇手战,目闭耳鸣,晕绝身冷。此怒动肝阳,内风挟痰火上冒也。
急煎淡青盐汤以降风火,一啜即醒。用牡蛎、钩藤、山枝、桑叶、白芍、茯神、菊花(炒),二服神志已清。
转方用熟地黄(炒)、杞子(焙)、石斛、枣仁(炒)、龟板(炙)、牡蛎粉、磁石,镇补肝阴而安。
沃 烦劳伤阳,阳气化风上巅,两太阳刺痛,耳鸣口干,寒热不寐,自汗便泻,下元疲乏,脉模糊。
治先熄风镇阳。甘菊(炒)、荷叶、磁石、牡蛎粉、茯神、甘杞子(焙)、熟地炭、白芍、五味(炒)。
数服诸症向安。惟不嗜味微嗽,加甜杏仁、潞参、莲、枣,以补脾肺,原方去前四味,嗣用丸方牡蛎粉、淡菜、
首乌、熟地、杞子、牛膝(酒蒸)、五味(焙)、阿胶(水化),和炼蜜丸,以滋填下元,匝月而愈。
赵姓患者左胁部疼痛,脉象洪大且伴有耳鸣,时常出现呕吐、腹胀及腹痛。这些症状皆因肝火亢盛,导致浊邪与瘀血停滞而不能下行消散,应当戒除愤怒、节制饮酒方可痊愈。仿照栀萸汤的方义进行加减:山栀(用姜汁炒制)、黄连(用吴茱萸汁炒制)、白芍、牡蛎(生捣碎)、丹皮、金橘皮。服用后见效。
本姓患者睡醒后舌干且有辣感,口中津液不能上承滋润口腔,头部眩晕、耳鸣,四肢麻木、胁痛,这是肝风在体内扰动,腹部胀满、肠鸣,早晨腹泻排出不畅,这是肝木之气直接侵犯中焦脾胃所致。左手关脉浮而弦,右手脉浮滑,伴有痰嗽不畅,说明太阴脾肺已受损伤多年,必须防止发生中风类疾病。早晨服用的方剂,旨在运化脾阳以利湿邪:生白术、茯苓、半夏(用青盐炮制)、炙甘草、薏米(炒制)、砂仁、益智仁(煨制)、山药(炒制)、小麦。晚上服用的方剂,旨在滋养肝阴以平息内风:阿胶(用水烊化)、枸杞子、茯神、麦冬、石斛、白芍、桑枝、甘菊(炒制)、黑芝麻、牡蛎粉。睡眠时,含服柿霜(两匙)于舌下,以生津液于廉泉穴处。服用后见效。
沈氏患者在夏季因郁结愤怒而失眠,五更时分起床静坐,突然头部摇动、手部颤抖,眼睛闭合、耳鸣,晕厥且身体发冷。这是因为愤怒引动了肝阳,内风挟带痰火上冲头部所致。急煎淡青盐水汤以降伏风火,喝一口后即苏醒。随后使用牡蛎、钩藤、山栀、桑叶、白芍、茯神、菊花(炒制),服用两剂后神志已清醒。转换方药使用熟地黄(炒制)、枸杞子(焙干)、石斛、枣仁(炒制)、龟板(炙制)、牡蛎粉、磁石,以镇摄并补益肝阴从而安定心神。
沃姓患者因烦劳损伤阳气,阳气化为风邪上扰至头顶,两侧太阳穴刺痛,耳鸣口干,寒热交替且失眠,自汗出、大便泄泻,下元肾气疲乏,脉象模糊不清。治疗先以平息风邪、镇潜阳气为主:甘菊(炒制)、荷叶、磁石、牡蛎粉、茯神、甘枸杞子(焙干)、熟地炭、白芍、五味子(炒制)。服用数剂后诸症趋向安宁。只是食欲不佳且轻微咳嗽,加入甜杏仁、党参、莲子、红枣,以补益脾肺,原方去掉前四味药,后续改用丸方:牡蛎粉、淡菜、首乌、熟地、枸杞子、牛膝(酒蒸制)、五味子(焙干)、阿胶(用水烊化),调和炼蜜制成丸药,以滋填下元,一个月后痊愈。
Zhao: The patient suffered from pain in the left hypochondrium, a flooding pulse (Hong Mai), and tinnitus. There was occasional vomiting, abdominal distension, and pain. These symptoms were all due to the soaring of Liver Fire (Gan Huo), causing turbid pathogens and blood stasis to stagnate without descending. It is advisable to abstain from anger and moderate alcohol intake for recovery. Following the principle of Zhizhu Tang (Gardenia and Evodia Decoction): Gardeniae Fructus (Zhi Zi) stir-fried with ginger juice; Coptidis Rhizoma (Huang Lian) stir-fried with Evodiae Fructus juice; Paeoniae Radix Alba (Bai Shao); Ostrea Concha (Mu Li) raw and pounded; Moutan Cortex (Dan Pi); Citri Reticulatae Pericarpium (Jin Ju Pi). Effective after administration.
Ben: Upon waking from sleep, the tongue was dry and felt spicy; saliva failed to ascend to moisten the mouth (Hua Chi Jin Bu Shang Chao). Symptoms included dizziness, tinnitus, numbness of limbs, and hypochondriac pain, indicating internal shaking of Liver Wind (Gan Feng). Abdominal fullness and borborygmus were present, along with morning diarrhea that was unsatisfactory. This signifies Wood Qi directly invading the Middle Palace (Spleen/Stomach). The left Guan position pulse was floating and wiry; the right pulse was floating and slippery. There was phlegm-cough with difficulty in expectoration, indicating damage to the Taiyin (Spleen/Lung) system over many years. One must guard against stroke-like conditions (Lei Zhong). Morning formula: to move Spleen Yang to promote dampness resolution. Atractylodis Macrocephalae Rhizoma (Sheng Bai Zhu); Poria (Fu Ling); Pinelliae Rhizoma (Ban Xia) prepared with green salt; Glycyrrhizae Radix et Rhizoma Preparata (Zhi Cao Yi); Coicis Semen (Yi Mi) stir-fried; Amomi Fructus (Sha Ren); Alpiniae Oxyphyllae Fructus (Yi Zhi Ren) roasted; Dioscoreae Rhizoma (Shan Yao) stir-fried; Triticum Aestivum (Xiao Mai). Evening formula: to nourish Liver Yin to extinguish wind. Epimedii Herba? No, Ejiao (E Jiao) dissolved in water; Lycii Fructus (Qi Zi); Poria with Hostwood (Fu Shen); Ophiopogonis Radix (Mai Dong); Dendrobii Caulis (Shi Hu); Paeoniae Radix Alba (Bai Shao); Mori Ramulus (Sang Zhi); Chrysanthemi Flos (Gan Ju) stir-fried; Sesami Nigris Semen (Hei Zhi Ma); Ostreae Concha Pulvis (Mu Li Fen). After falling asleep, hold two spoonfuls of Persimmon Frost (Shi Shuang) under the tongue to generate fluids at the Lianquan acupoint. Effective after administration.
Shen: During summer, depression and anger caused insomnia. Waking at the fifth watch (5-7 AM), sitting up, there was sudden head shaking and hand tremors, eyes closed, tinnitus, fainting, and cold body. This was anger stirring Liver Yang, with internal wind carrying phlegm-fire rushing upward. Immediately decocted light green salt water to subdue wind and fire; one sip led to immediate awakening. Used Ostreae Concha, Uncariae Ramulus cum Uncis (Gou Teng), Gardeniae Fructus (Shan Zhi), Mori Folium (Sang Ye), Paeoniae Radix Alba, Poria with Hostwood, Chrysanthemi Flos (stir-fried). After two doses, mental clarity returned. Changed formula to Rehmanniae Radix Preparata (Chao Shu Di), Lycii Fructus (roasted), Dendrobii Caulis, Ziziphi Spinosae Semen (Chao Zao Ren), Testudinis Carapax et Plastrum (Zhi Gui Ban), Ostreae Concha Pulvis, Magnetitum (Ci Shi), to settle and tonify Liver Yin for tranquility.
Wo: Fatigue injured Yang; Yang transformed into wind ascending to the vertex. Throbbing pain in both temples, tinnitus, dry mouth, alternating chills and fever, insomnia, spontaneous sweating, and diarrhea. Lower Yuan (Kidney/Essence) was exhausted; pulse was vague. Treatment first focused on extinguishing wind and anchoring Yang. Chrysanthemi Flos (stir-fried), Nelumbinis Folium (He Ye), Magnetitum, Ostreae Concha Pulvis, Poria with Hostwood, Lycii Fructus (roasted), Rehmanniae Radix Carbonisata (Shu Di Tan), Paeoniae Radix Alba, Schisandrae Fructus (Chao Wu Wei Zi). After several doses, symptoms stabilized. However, lack of appetite and slight cough persisted. Added Sweet Almond Seed (Tian Xing Ren), Codonopsis Radix (Lu Shen), Nelumbinis Semen (Lian Zi), Jujubae Fructus (Zao), to tonify Spleen and Lung. Removed the first four ingredients from the original formula. Subsequently used a pill formula: Ostreae Concha Pulvis, Mytilus Edulis (Dan Cai), Polygoni Multiflori Radix (Shou Wu), Rehmanniae Radix Preparata, Lycii Fructus, Achyranthis Bidentatae Radix (Niu Xi) steamed with wine, Schisandrae Fructus (roasted), Epimedii Herba? No, Ejiao (dissolved in water). Mixed with refined honey to form pills, to nourish and fill the Lower Yuan. Recovered after one month.