杨 弱冠成损，嗽血喘促，身热汗泄，食减便溏，脉弱数。此上损及中，补土生金，自不易定法。四君
子汤加熟地砂仁末炒、山药、茯神、五味、白芍、莲子、小麦煎汤，数服血止，喘热亦定。然一阳初生，必交节不
至加重，乃得转危为安。
胡氏女 寒热咳嗽，经断食少，肌削口干无寐，脉虚数，损象已具。经云∶二阳之病发心脾，有不得隐曲，
在女子为不月，二阳足阳明胃也。胃虚则受谷少而血无由生，故症见心脾。心主血，脾统血，情志不遂，
日为忧思烦扰以耗竭之，故月水枯也，宜滋化源。仿立斋先生法，朝用归脾汤加柏子仁，夕用都气丸加杞子、
白芍、枣仁、贝母。两月诸症悉退，后经自通而病霍然。
狄氏 月闭劳热，医用通经之品，喘 气促，怔忡自汗。又用寒凉退热，食减肌削，乍寒乍热，诊其脉
弱数而促，此下损及中也。急用潞参、茯神、黄 、炙草、白芍、当归、五味、枣仁、银柴胡，四剂诸症渐减，
加山药、熟地炭、莲、枣。补心脾兼调肺肾，热嗽悉除，能进食矣。逾月后，忽腰腹痛，下胎形三寸许，儿
头已半损烂。予深自咎临诊未审其母舌青黑与否，然计其经闭后已六阅月，乃知胞宫血涸，胎形不长，干黑
累月，必反枯 深隐。通经破血药数十剂不能令堕，俟气血通调，瘀腐之膈膜者，乃去而不复留也。况血枯
经闭，漫与三棱、莪术、牛膝、桃仁，不速之毙乎，志此为榨干汁者鉴。
李 肩挑伤力，咳嗽胸痛，其损在肺。用黄 、潞参、茯神、百合、贝母、杏仁、当归、白芍、甘草、红
枣，二服即应。此从安肺汤加减，经所谓损其肺者益其气也。
眭 肝肾阴虚，损久不复，冬至后痰咳粉红，嗽声子夜特甚。想虚阳失藏，龙火不伏，交子时阳气一动，
炎灼上凌，浸至娇脏受戕，身热喘促。近又食减无味，午后颊红，时觉懔懔憎寒，是阴伤及阳，非萸地酸腻可
效。必用甘药培元，佐以介属潜阳，冀其封固蛰藏，至立春前后，地气上腾，症不加重为幸。潞参、山药、
百合、甘草、五味、白芍、牡蛎、淡菜、阿胶，数服渐平。
堂弟 呛嗽气急，脉弦数，适逢秋令，予谓此火刑金象也，当滋化源。以自知医，杂用梨膏止嗽，予
谓非法。入冬寒热间作，厥气冲逆，灰痰带红，良由阳亢阴亏，龙雷并扰，冬藏不密。今近立春，地气上升，
内气应之，喘嗽势必加重，拟方阿胶烊化、山药炒，各二钱。洋参、熟地（炒）、茯神、藕节（各三钱）、
川贝母（炒研，一钱）、甜杏仁（炒研，钱半）、枣仁（炒研，八分）、五味（五分）。数服颇效。又五更服
燕窝汤，晚服秋石汤，降虚火而喘定。
堂弟 肺主出气，肾主纳气。今肾少摄钠，时交惊蛰，阳气大升，两关尺通滑兼弦，气由冲脉逆冲而上，
子夜阳动，喘嗽汗泄，必起坐不能安卧，皆真元不纳之咎。屡用参 保固，肺脾既属不济，即用知柏，名为滋
肾，岂能骤安。仿叶氏镇摄法，青铅（三钱）、牡蛎（ 研，钱半）、茯神（三钱）、五味（八分）、炮姜（四分）。
远志（炒炭，钱半）、故纸（盐水炒，一钱）。三服气平喘止，饮食大进，弦脉顿减，后用峻补膏方得痊。
王 劳力伤精，右尺偏旺，是火水未济之象，日晡寒热，嗽血神疲，大宜小心调摄，否则火燃金燥，吐
红嗽喘，行将日甚矣。五味（三分）、熟地、山药、茯苓、杞子、丹皮（各二钱）、潞参（三钱）、白芍、
川贝（各一钱半）、远志（钱八分）、莲子（十粒）。十数服诸症俱平。
妹 积年羸怯，经当断不断，热从腿膝上蒸。今岁厥阴风木司天，又值温候，地气湿蒸，连朝寒热烦渴，
寤不成寐，悸咳善惊，总由阴亏心火燔灼，兼乘木火司令，气泄不主内守，阳维奇脉，不振纲维。越人云∶
阳维为病苦寒热。今藩卫欲空，足寒骨热，所固然已。先培元气，退寒热，待津液上潮，冀烦渴渐平。用潞参、
茯神、麦冬、白芍、丹皮、龟板、熟地、柏子仁、红枣、蔗汁。三服寒热大减，烦渴渐止，但觉寒起足胫。
原方去麦冬、龟板，加首乌、杞子、牛膝（炒炭），壮其奇脉，二服不寒但热，原方又去首乌、杞子、柏子仁，
加莲子、龙眼肉。数十服遂安。
贡 弱冠未室，劳力伤阳，寒热痰红，咳则气促呕沫，头眩食减，色悴肌羸，半载不复，脉来虚数，
右部尤少神，乃肺气受伤，脾元亦惫。理阳兼泄浊为宜。用六君子汤加山药、莲子、南枣、淡姜煎服。四剂寒热
止，浊逆平，去半夏，加贝母、茯神、
五味，嗽稀而食进，数脉较减，又如薏米、芡实、黄 、归、芍，煎丸兼服而瘳。 后因自服地黄滋腻丸剂，
食减便溏，饵牛肚，泻痢不止，又迫于完姻，虚嗽声哑，午余寒热，旦夕利数行，脉益虚数。思食减脾损，痢
久肾伤，阴阳告残，乃求挽救，用药颇难，且终罔济，姑与扶肺脾以摄肾。潞参、茯苓、炙草、白芍、山药、
益智、诃子、五味、莲、枣，数服甚平。但气下陷则痢，迫体懔寒，手足口热，寐必口干，此阳虚生寒，
阴虚生热，而津不上潮也。朝用补中汤去柴、归，加益智、茯神，晚用熟地炭、五味、枣仁、白芍、贝母、
薏米、麦冬（俱炒），蔗汁冲服。寒热轻，痢如故，与桃花汤加参、苓、五味、乌梅。温摄下焦，痢仍不减，
由肠液滑泄已久，气虚不受温摄，而喉痛声嘶，咳吐白沫，因春分节后气温升泄故也。转方仍用参、苓、莲、
药补脾，五味、白芍敛肺，沙参、桔梗清咽，熟地炭、钗斛育阴，诃子、牡蛎（醋淬，）涩下。
谢氏 崩带后蒸热，头晕齿痛，食后嗳腐痞恶，不时便泻。始由冲任经伤，阴虚生火，医用青铅镇摄，
虚火愈炎，中气愈陷，反使发际汗多如水，下部泄气如风，不知症缘阴亏，肝阳失制，上则为眩晕，下则为
蒸泻，中则为风翔浪掀，食入漾漾欲呕。治宜和阳熄风，佐以运脾，否则补虚添胀，滋肾碍脾，势必食减
肌削，延成下损及中之咎。杞子炭、甘菊炭、牡蛎粉、白芍、山栀、神曲（俱炒）、半夏（青盐炒）、茯神、
丹皮、嫩桑叶、浮小麦（煎汤）。三服诸症渐平。原方去栀、曲，加鳖甲、山药、熟地炭，蒸热渐愈。
族弟 嗜饮伤中，湿热内蕴，咳嗽潮热，腹痛呕泻，脉沉小数，左尤涩。不戒饮则成酒劳。生术、茯苓、
薏米、橘红、茴香、制半夏、枳 子、砂仁、湘莲（炒）。数服诸症稍定，乃用葛花解酲汤去青皮、干姜，
加制半夏，数十服全愈。
沈 少年羸怯，晡热呛嗽，头眩食减，频呕苦酸浊沫，大便忽溏忽秘，脉弦数，右尺搏指。由相火太强，
疏泄失司，痰浊不
降，必梦泄足心如烙。先驱湿热以熄龙雷，黄柏（酒炒，六分）、半夏（青盐制，钱半）、茯苓、薏米（各三钱）、
吴萸（盐汤泡，五分）、远志、山栀、泽泻（各八分）、橘红（一钱）。六服痰火降，遗泄止，去吴萸、山栀，
加生白术（钱半）、五味（三分）、牡蛎粉（二钱），诸症俱减，调理得平。
服侄 诵读神疲，晡寒宵热，汗嗽食减，脉虚，右尺弦大，此为童损。由心脾肺兼及肾阴，仿立斋先生治
法，朝用补中益气汤去升麻，加茯苓、枣仁、小麦；晚用六味汤去山萸，加白芍、鳖甲、五味。十数剂寒热止
而精神复。
杨姓患者，二十岁左右即患虚损病，出现咳嗽咯血、气喘急促、身体发热、出汗、食欲减退、大便稀溏，脉象虚弱而数。这是上焦的虚损波及中焦脾胃，采用补益脾胃以生肺金的方法，本来就没有固定的成法。用四君子汤加入用熟地黄和砂仁末拌炒的山药、茯神、五味子、白芍、莲子、小麦煎汤服用，服几剂后出血停止，气喘和发热也平息了。然而，人体阳气初生之时，如果遇到节气交替时病情没有加重，才能转危为安。
胡家女儿，寒热往来、咳嗽，月经停止、食欲少，肌肉消瘦、口干、失眠，脉象虚数，虚损的征象已经具备。医经说：“二阳（指阳明胃和大肠）的病发于心脾，有难以言说的隐情，在女子表现为闭经。”二阳中的足阳明胃，胃气虚弱则受纳谷物减少，血液无从生成，所以症状表现在心脾。心主血，脾统血，情志不畅，每日忧愁思虑烦扰从而耗竭气血，所以月经枯竭，应当滋生化之源。仿照薛立斋先生的方法，早晨服用归脾汤加柏子仁，晚上服用都气丸加枸杞子、白芍、酸枣仁、贝母。两个月后所有症状全部消退，月经自然通畅，病痊愈。
狄氏，闭经伴劳热，医生使用通经的药物，导致气喘、气促、心悸、自汗。又用寒凉药物退热，导致食欲减退、肌肉消瘦，忽冷忽热，诊其脉象弱、数且急促，这是下焦的虚损波及中焦。急用党参、茯神、黄芪、炙甘草、白芍、当归、五味子、酸枣仁、银柴胡，服四剂后各种症状逐渐减轻，加入山药、熟地黄炭、莲子、大枣。补益心脾兼调肺肾，热咳全部消除，能够进食了。过一个月后，突然腰腹痛，排出约三寸长的胎儿，胎儿头部已半损坏腐烂。我深深自责临诊时未仔细审视母亲舌苔是否青黑，但考虑到她闭经后已过六个月，才知道胞宫血液枯竭，胎儿无法生长，干枯变黑数月，必然枯萎深隐于内。用数十剂通经破血的药不能使其堕胎，等待气血通调，瘀腐的膈膜脱落，才会排出不再留存。何况血枯经闭，随意使用三棱、莪术、牛膝、桃仁等药，会导致迅速死亡吗？记下此事作为那些榨干汁液般滥用攻伐药的警示。
李姓患者，因肩挑重物损伤体力，咳嗽胸痛，其虚损在肺。用黄芪、党参、茯神、百合、贝母、杏仁、当归、白芍、甘草、红枣，服两剂即见效。这是从安肺汤加减而来，正如医经所说“损其肺者益其气”。
眭姓患者，肝肾阴虚，虚损日久不恢复，冬至后痰多咳嗽带粉红色，夜间子时咳嗽特别严重。想是虚阳失于潜藏，龙火不安伏，交子时阳气一动，炎灼向上凌犯，浸渍至娇嫩的肺脏受伤害，身体发热气喘急促。近来又食欲减退无味，午后脸颊发红，时常觉得凛凛怕冷，这是阴伤及阳，不是山茱萸、熟地等酸腻药物可以奏效的。必须用甘味药物培补元气，佐以介壳类药材潜降阳气，希望其封固蛰藏，到立春前后，地气上升，症状不加重便是幸运。用党参、山药、百合、甘草、五味子、白芍、牡蛎、淡菜、阿胶，服几剂后逐渐平稳。
堂弟，呛咳气急，脉弦数，适逢秋季，我认为这是火克金的征象，应当滋生化之源。因为他自己懂点医，杂乱使用梨膏止咳，我认为不合法规。入冬后寒热交替发作，厥逆之气冲逆，灰痰带红，良由阳气亢盛阴液亏虚，龙雷之火并扰，冬季闭藏不严密。现在临近立春，地气上升，体内之气相应，喘咳势必加重，拟定方剂：阿胶烊化、山药炒，各二钱；西洋参、熟地黄（炒）、茯神、藕节（各三钱）；川贝母（炒研，一钱）；甜杏仁（炒研，钱半）；酸枣仁（炒研，八分）；五味子（五分）。服几剂颇有效。又在五更时分服燕窝汤，晚上服秋石汤，降低虚火使喘定。
堂弟，肺主呼气，肾主纳气。现在肾气摄纳不足，正值惊蛰时节，阳气大升，两手关部和尺部脉象通滑兼弦，气由冲脉逆冲而上，子夜阳气发动，喘咳出汗，必定坐起不能安卧，这都是真元不能摄纳的过错。屡次用人参保固，既然肺脾已经不济，即使使用知母、黄柏，名为滋肾，怎么能骤然安宁。仿照叶天士的镇摄法，用青铅（三钱）、牡蛎（研细，钱半）、茯神（三钱）、五味子（八分）、炮姜（四分）、远志（炒炭，钱半）、补骨脂（盐水炒，一钱）。服三剂后气平喘止，饮食大增，弦脉顿减，后用峻补膏方得以痊愈。
王姓患者，劳力伤精，右尺脉偏旺，这是水火不济的征象，下午申酉时寒热往来，咳血神疲，非常需要小心调养摄护，否则火燃金燥，吐血咳喘，将会日益严重。用五味子（三分）、熟地黄、山药、茯苓、枸杞子、牡丹皮（各二钱）、党参（三钱）、白芍、川贝母（各一钱半）、远志（八分）、莲子（十粒）。服十数剂后各种症状都平息。
妹妹，多年瘦弱怯症，月经该断不断，热气从腿膝上蒸腾。今年厥阴风木司天，又值温候，地气湿蒸，连续几天寒热烦渴，睡觉不能成寐，心悸咳嗽容易惊恐，总由阴亏心火燔灼，兼乘木火司令，气泄不能主内守，阳维脉异常，不振纲维。越人（扁鹊）说：“阳维为病苦寒热。”现在藩卫欲空，脚冷骨热，是理所当然的。先培补元气，退寒热，待津液上潮，希望烦渴逐渐平息。用党参、茯神、麦冬、白芍、牡丹皮、龟板、熟地黄、柏子仁、红枣、蔗汁。服三剂后寒热大减，烦渴渐止，只觉寒气从足胫升起。原方去掉麦冬、龟板，加何首乌、枸杞子、牛膝（炒炭），壮其奇经八脉，服两剂后不寒但热，原方又去掉何首乌、枸杞子、柏子仁，加莲子、龙眼肉。服数十剂后遂安。
贡姓患者，二十岁未婚，劳力伤阳，寒热痰中带血，咳则气促呕沫，头晕食欲减退，面色憔悴肌肉消瘦，半年不恢复，脉来虚数，右部尤其少神，这是肺气受伤，脾元也疲惫。理阳兼泄浊为宜。用六君子汤加山药、莲子、南枣、淡生姜煎服。四剂后寒热止，浊逆平，去掉半夏，加贝母、茯神、五味子，咳嗽稀少而进食增加，数脉较减，又如薏苡仁、芡实、黄芪、当归、白芍，煎丸兼服而痊愈。后来因自服地黄滋腻丸剂，食欲减退大便稀溏，吃牛肚，泻痢不止，又迫于完婚，虚嗽声哑，午后寒热，早晚腹泻数次，脉更虚数。思考食欲减退脾受损，痢久肾伤，阴阳告罄，乃求挽救，用药颇难，且最终无济于事，姑且给予扶肺脾以摄肾。用党参、茯苓、炙甘草、白芍、山药、益智仁、诃子、五味子、莲子、大枣，服几剂甚平稳。但气下陷则痢，逼迫身体凛凛怕冷，手足口热，睡觉必口干，这是阳虚生寒，阴虚生热，而津液不上潮。早晨用补中益气汤去掉柴胡、当归，加益智仁、茯神，晚上用熟地黄炭、五味子、酸枣仁、白芍、贝母、薏苡仁、麦冬（均炒），蔗汁冲服。寒热轻，痢如故，给桃花汤加人参、茯苓、五味子、乌梅。温摄下焦，痢仍不减，由于肠液滑泄已久，气虚不受温摄，而喉痛声嘶，咳吐白沫，因为春分节后气温升泄的缘故。转方仍用人参、茯苓、莲子、山药补脾，五味子、白芍敛肺，沙参、桔梗清咽，熟地黄炭、石斛育阴，诃子、牡蛎（醋淬）涩下。
谢氏，崩漏带下后蒸热，头晕齿痛，食后嗳腐痞恶，不时便泻。始由冲任经脉受伤，阴虚生火，医生用青铅镇摄，虚火愈炎，中气愈陷，反而使发际汗多如水，下部泄气如风，不知病症缘于阴亏，肝阳失制，上则为眩晕，下则为蒸泻，中则为风翔浪掀，食入漾漾欲呕。治疗宜和阳熄风，佐以运脾，否则补虚添胀，滋肾碍脾，势必食减肌削，延成下损及中的过错。用枸杞子炭、甘菊炭、牡蛎粉、白芍、山栀、神曲（均炒）、半夏（青盐炒）、茯神、牡丹皮、嫩桑叶、浮小麦（煎汤）。服三剂后诸症渐平。原方去掉山栀、神曲，加鳖甲、山药、熟地黄炭，蒸热渐愈。
族弟，嗜酒伤中，湿热内蕴，咳嗽潮热，腹痛呕泻，脉沉小数，左脉尤其涩。不戒酒则成酒劳。用生白术、茯苓、薏苡仁、橘红、茴香、制半夏、枳棋子、砂仁、湘莲（炒）。服几剂后诸症稍定，于是用葛花解酲汤去掉青皮、干姜，加制半夏，服数十剂全愈。
沈姓患者，少年瘦弱怯症，下午发热呛咳，头晕食欲减退，频繁呕吐苦酸浊沫，大便忽溏忽秘，脉弦数，右尺脉搏指有力。由相火太强，疏泄失司，痰浊不降，必定梦遗足心如烙。先驱除湿热以熄龙雷，用黄柏（酒炒，六分）、半夏（青盐制，钱半）、茯苓、薏苡仁（各三钱）、吴茱萸（盐汤泡，五分）、远志、山栀、泽泻（各八分）、橘红（一钱）。服六剂后痰火降，遗泄止，去掉吴茱萸、山栀，加生白术（钱半）、五味子（三分）、牡蛎粉（二钱），诸症俱减，调理得平。
服侄，诵读神疲，下午寒夜晚间热，汗出咳嗽食欲减退，脉虚，右尺脉弦大，此为童损。由心脾肺兼及肾阴，仿照薛立斋先生的治法，早晨用补中益气汤去掉升麻，加茯苓、酸枣仁、小麦；晚上用六味地黄汤去掉山茱萸，加白芍、鳖甲、五味子。服十数剂后寒热止而精神恢复。
Yang, at the age of twenty, developed consumptive disease (Xu Sun), presenting with coughing and hemoptysis, panting and shortness of breath, fever, sweating, reduced appetite, and loose stools. The pulse was weak and rapid. This indicates damage in the upper jiao affecting the middle jiao (Spleen/Stomach). Tonifying Earth to generate Metal is the approach, though there are no fixed formulas. Si Jun Zi Tang (Four Gentlemen Decoction) was modified with Shan Yao (Dioscoreae Rhizoma) stir-fried with Shu Di Huang (Rehmanniae Radix Preparata) and Sha Ren (Amomi Fructus), Fu Shen (Poria Cum Radix), Wu Wei Zi (Schisandrae Fructus), Bai Shao (Paeoniae Radix Alba), Lian Zi (Nelumbinis Semen), and Xiao Mai (Tritici Fructus). After several doses, bleeding stopped, and panting and fever subsided. However, when the Yang Qi first begins to grow, if the condition does not worsen during solar term transitions, recovery can be expected.
The daughter of the Hu family presented with alternating chills and fever, cough, amenorrhea, poor appetite, emaciation, dry mouth, and insomnia. The pulse was deficient and rapid, indicating established consumptive signs. The Classics state: "Diseases of the Two Yangs originate from the Heart and Spleen; having unspoken grievances leads to amenorrhea in women." The Two Yangs refer to the Foot-Yangming Stomach. When Stomach Qi is deficient, grain intake is low, and blood generation fails, thus symptoms manifest in the Heart and Spleen. The Heart governs Blood, and the Spleen controls Blood. Emotional distress and daily worry consume Qi and Blood, leading to menstrual depletion. The treatment should nourish the source of transformation. Following Mr. Li Zai's method, Gui Pi Tang (Restore the Spleen Decoction) with Bai Zi Ren (Biota Seed) was administered in the morning, and Du Qi Wan (All-Qi Pill) with Gou Qi Zi (Lycii Fructus), Bai Shao, Suan Zao Ren (Ziziphi Spinosae Semen), and Bei Mu (Fritillariae Bulbus) in the evening. After two months, all symptoms resolved, menstruation resumed, and the patient recovered completely.
Mrs. Di had amenorrhea with labor-heat. The physician used blood-invigorating and menstruation-promoting herbs, resulting in panting, shortness of breath, palpitations, and spontaneous sweating. Cold-natured herbs were then used to clear heat, causing loss of appetite and emaciation, with alternating chills and fever. The pulse was weak, rapid, and hurried. This indicates damage in the lower jiao affecting the middle jiao. Urgently, Lu Shen (Codonopsis Radix), Fu Shen, Huang Qi (Astragali Radix), Zhi Gan Cao (Prepared Licorice Root), Bai Shao, Dang Gui (Angelicae Sinensis Radix), Wu Wei Zi, Suan Zao Ren, and Yin Chai Hu (Stellariae Radix) were prescribed. After four doses, symptoms gradually decreased. Shan Yao, Shu Di Huang Tan (Charred Rehmannia), Lian Zi, and Da Zao (Jujube) were added. This formula tonifies the Heart and Spleen while regulating the Lungs and Kidneys. Heat and cough ceased, and appetite returned. A month later, sudden lower abdominal pain occurred, and a fetus about three cun long was expelled, with half its head damaged and necrotic. I deeply blamed myself for not carefully examining whether the mother's tongue coating was green-black. Considering she had been amenorrheic for six months, it was known that the uterine blood was exhausted, preventing fetal growth. The fetus had been dry and black for months, likely embedded deeply due to severe wasting. Dozens of doses of blood-breaking and menstruation-promoting herbs failed to induce abortion. Waiting for Qi and Blood to regulate allows the necrotic membrane to detach and pass naturally. Otherwise, using San Leng (Curcumae Rhizoma), E Zhu (Curcumae Rhizoma), Niu Xi (Achyranthis Bidentatae Radix), and Tao Ren (Persicae Semen) on blood-depletion amenorrhea would lead to rapid death. This case serves as a warning against excessive purgation.
Mr. Li suffered physical strain from carrying loads, presenting with cough, chest pain, and lung damage. Huang Qi, Lu Shen, Fu Shen, Bai He (Lilii Bulbus), Bei Mu, Xing Ren (Armeniacae Semen), Dang Gui, Bai Shao, Gan Cao (Licorice Root), and Hong Zao (Red Jujube) were used. Improvement was seen after two doses. This is a modification of An Fei Tang (Peace the Lung Decoction), following the principle: "For lung damage, benefit the Qi."
Mr. Sui had Liver and Kidney Yin deficiency with chronic consumptive disease. After Winter Solstice, he had phlegm-cough with pink sputum, worsening significantly at midnight. This suggests floating Yang failing to anchor and Dragon Fire not subduing. At midnight, Yang moves, causing heat to flare upward, damaging the delicate Lung organ, leading to fever and panting. Recently, appetite decreased, cheeks flushed in the afternoon, and chills were felt. This indicates Yin damage affecting Yang, which cannot be treated with sour/astringent herbs like Yu Zhu and Shu Di Huang alone. Sweet herbs must tonify Yuan Qi, assisted by shell-type minerals to anchor Yang, hoping for storage and consolidation until Spring Equinox. Lu Shen, Shan Yao, Bai He, Gan Cao, Wu Wei Zi, Bai Shao, Mu Li (Ostreae Concha), Dan Cai (Mussel Meat), and E Jiao (Donkey-Hide Gelatin) were given. Symptoms stabilized after several doses.
Cousin presented with harsh cough and急促 breathing, pulse wiry and rapid. In autumn, this is interpreted as Fire insulting Metal, requiring nourishment of the source. Self-medication with Pear Paste was incorrect. In winter, alternating chills/fever, rebellious Qi, gray-red sputum indicated hyperactive Yang and deficient Yin, with Dragon/Thunder fire disturbing and poor winter storage. Approaching Spring Equinox, rising Earth Qi aggravates internal Qi, worsening cough/panting. Formula: E Jiao (melted), Shan Yao (stir-fried), each 2 qian; Yang Shen (American Ginseng), Shu Di Huang (stir-fried), Fu Shen, Ou Jie (Lotus Rhizome Node), each 3 qian; Chuan Bei Mu (stir-fried/powdered), 1 qian; Tian Xing Ren (stir-fried/powdered), 1.5 qian; Suan Zao Ren (stir-fried/powdered), 8 fen; Wu Wei Zi, 5 fen. Several doses were effective. Swallow nest soup was taken at dawn, Qiu Shi (Autumn Stone) soup at night to descend deficient fire and calm panting.
Cousin: The Lung governs exhalation, the Kidney governs inhalation. Kidney grasping Qi is deficient. At Jingzhe (Awakening of Insects), Yang Qi rises greatly. Guan and Chi pulses are slippery and wiry. Qi rebels via the Chong Mai (Penetrating Vessel). At midnight, Yang moves, causing panting, cough, sweating, and inability to lie down. This is failure of True Yuan to grasp. Repeated use of Ren Shen (Ginseng) for protection failed because Lung/Spleen were insufficient. Using Zhi Mu (Anemarrhenae Rhizoma) and Bai Guo Pi (Phellodendri Cortex), named "nourishing Kidney," cannot bring immediate peace. Following Ye Tianshi's anchoring method: Qing Qian (Lead), Mu Li (powdered), Fu Shen, Wu Wei Zi, Pao Jiang (Prepared Ginger), Yuan Zhi (Polygalae Radix, charred), Gu Zhi Bu (Psoraleae Fructus, salt-stir-fried). Three doses stopped panting and calmed Qi, improving appetite and reducing wiry pulse. Strong tonic paste completed the cure.
Mr. Wang suffered essence depletion from labor. Right Chi pulse was vigorous, indicating Water-Fire non-interaction. Afternoon chills/fever, hemoptysis, and fatigue required careful regulation. Otherwise, Fire burning Metal would cause worsening hemoptysis and panting. Wu Wei Zi, Shu Di Huang, Shan Yao, Fu Ling (Poria), Gou Qi Zi, Dan Pi (Moutan Cortex), Lu Shen, Bai Shao, Chuan Bei Mu, Yuan Zhi, Lian Zi were prescribed. Numerous doses resolved symptoms.
Sister: Chronic weakness, irregular menses, heat steaming from legs/knees. With Jueyin Wind-Wood governing the year and warm weather, dampness rose. Days of chills/fever, thirst, insomnia, palpitations, cough, and fright indicate Yin deficiency with blazing Heart Fire, compounded by Wood/Fire dominance. Qi leaks, failing to guard internally. Yang Wei Mai is abnormal, failing to support the framework. Bian Que said: "Yang Wei disease suffers chills and fever." Now defensive Qi is empty, feet cold, bones hot. First tonify Yuan Qi, resolve chills/fever, await fluid return to stop thirst. Lu Shen, Fu Shen, Mai Dong (Ophiopogonis Radix), Bai Shao, Dan Pi, Gui Ban (Testudinis Carapax et Plastrum), Shu Di Huang, Bai Zi Ren, Hong Zao, Zhe Zhi (Sugarcane Juice) were used. Three doses reduced chills/fever and thirst. Cold sensation in calves remained. Mai Dong and Gui Ban were removed; Shou Wu (Polygoni Multiflori Radix), Gou Qi Zi, Niu Xi (charred) added to strengthen extraordinary vessels. Two doses changed cold/fever pattern. Shou Wu, Gou Qi Zi, Bai Zi Ren removed; Lian Zi, Long Yan Rou (Longan Aril) added. Dozens of doses brought stability.
Mr. Gong: Young unmarried man, Yang damaged by labor. Chills/fever, bloody phlegm, cough with shortness of breath/vomiting foam, dizziness, poor appetite, emaciation, no recovery in half a year. Pulse deficient/rapid, right side lacking spirit. Lung Qi injured, Spleen Yuan exhausted. Regulate Yang and drain turbidity. Liu Jun Zi Tang (Six Gentlemen Decoction) with Shan Yao, Lian Zi, Nan Zao (Southern Jujube), Dan Jiang (Light Ginger) was used. Four doses stopped chills/fever and turbidity. Ban Xia (Pinelliae Rhizoma) removed; Bei Mu, Fu Shen, Wu Wei Zi added. Cough decreased, appetite improved, rapid pulse slowed. Yi Mi (Coicis Semen), Qian Shi (Euryales Semen), Huang Qi, Dang Gui, Bai Shao decocted and made into pills. Later, self-administered rich/cloying Shu Di Huang pills caused poor appetite/loose stools. Eating beef tripe caused persistent diarrhea/dysentery. Pressure to marry led to hoarse voice, afternoon chills/fever, frequent stools. Pulse more deficient/rapid. Spleen damage from poor appetite, Kidney damage from dysentery. Yin/Yang depleted. Rescue difficult. Tentatively tonify Lung/Spleen to secure Kidney. Lu Shen, Fu Ling, Zhi Gan Cao, Bai Shao, Shan Yao, Yi Zhi Ren (Alpiniae Oxyphyllae Fructus), He Zi (Terminalia Chebulae Fructus), Wu Wei Zi, Lian Zi, Da Zao. Symptoms stabilized. Qi sinking causes dysentery; body feels cold; hands/feet/mouth hot; dry mouth upon waking. This is Yang deficiency generating cold, Yin deficiency generating heat, fluids not ascending. Morning: Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) minus Chai Hu (Bupleuri Radix) and Dang Gui, plus Yi Zhi Ren, Fu Shen. Evening: Shu Di Huang Tan, Wu Wei Zi, Suan Zao Ren, Bai Shao, Bei Mu, Yi Mi, Mai Dong (all stir-fried), mixed with Zhe Zhi. Chills/fever lightened, dysentery persisted. Tao Hua Tang (Peach Blossom Decoction) plus Ren Shen, Fu Ling, Wu Wei Zi, Wu Mei (Mume Fructus) given. Warmly secure Lower Jiao, but dysentery continued due to prolonged intestinal lubricity loss and Qi deficiency unable to accept warming/astringents. Throat pain, hoarseness, white foam expectoration occurred due to post-Spring Equinox temperature rise. Formula adjusted: Ren Shen, Fu Ling, Lian Zi, Shan Yao tonify Spleen; Wu Wei Zi, Bai Shao astringe Lung; Sha Shen (Glehniae Radix), Jie Geng (Platycodonis Radix) clear throat; Shu Di Huang Tan, Shi Hu (Dendrobii Caulis) nourish Yin; He Zi, Mu Li (vinegar-treated) astringe lower orifice.
Mrs. Xie: Post-metrorrhagia and leukorrhea, steaming heat, dizziness, toothache, belching with food stagnation, frequent diarrhea. Initially Chong/Ren meridians injured, Yin deficiency generating fire. Physician used Qing Qian (Lead) to anchor, exacerbating deficient fire and sinking Middle Qi. Sweat poured from hairline; gas escaped from lower body. Ignoring Yin deficiency and unrestrained Liver Yang, symptoms manifested as dizziness above, steaming diarrhea below, and vomiting in the middle. Treatment: Harmonize Yang, extinguish wind, assist Spleen transport. Otherwise, tonification causes bloating, Kidney nourishment hinders Spleen, leading to emaciation and lower-to-middle damage. Gou Qi Zi Tan, Gan Ju (Chrysanthemi Flos), Mu Li Fen, Bai Shao, Shan Zhi (Gardeniae Fructus), Shen Qu (Medicated Leaven) (all stir-fried), Ban Xia (green salt-stir-fried), Fu Shen, Dan Pi, Nen Sang Ye (Mulberry Leaf), Fu Xiao Mai (Triticum Fructus) decocted. Three doses stabilized symptoms. Shan Zhi, Shen Qu removed; Bie Jia (Trionycis Carapax), Shan Yao, Shu Di Huang Tan added. Steaming heat resolved.
Cousin: Alcohol injury to Middle, damp-heat accumulation. Cough, tidal fever, abdominal pain, vomiting/diarrhea. Pulse deep/slight-rapid, left particularly choppy. Continued drinking leads to alcohol consumption. Sheng Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling, Yi Mi, Ju Hong (Citri Reticulatae Pericarpium), Hui Xiang (Foeniculi Fructus), Zhi Ban Xia, Zhi Li Zi (Ardisiae Fructus), Sha Ren, Xiang Lian (Lotus Seed) (stir-fried). Several doses stabilized symptoms. Ge Hua Jie Cheng Tang (Kudzu Flower Decoction to Resolve Intoxication) minus Qing Pi (Citri Reticulatae Pericarpium Viride), Gan Jiang (Zingiberis Rhizoma), plus Zhi Ban Xia. Dozens of doses cured.
Mr. Shen: Young, weak, afternoon fever, harsh cough, dizziness, poor appetite, frequent vomiting of bitter/sour turbid foam, alternating loose/constipated stools. Pulse wiry/rapid, Right Chi forceful. Hyperactive Ministerial Fire, failure of dispersion/assimilation, turbid phlegm descending, dream emission with burning soles. First drain damp-heat to extinguish Dragon/Thunder. Huang Bo (Phellodendri Cortex, wine-stir-fried), Ban Xia (green salt-prepared), Fu Ling, Yi Mi, Wu Yu (Evodiae Fructus, salt-soaked), Yuan Zhi, Shan Zhi, Ze Xie (Alismatis Rhizoma), Ju Hong. Six doses lowered phlegm-fire, stopped emissions. Wu Yu, Shan Zhi removed; Sheng Bai Zhu, Wu Wei Zi, Mu Li Fen added. Symptoms reduced, regulation achieved.
Nephew: Mental fatigue from reading, afternoon chills/night heat, sweating/cough/poor appetite. Pulse deficient, Right Chi wiry/large. Childhood consumption. Heart/Spleen/Lung affected, involving Kidney Yin. Following Li Zai's method: Morning, Bu Zhong Yi Qi Tang minus Sheng Ma (Cyathulae Radix), plus Fu Ling, Suan Zao Ren, Xiao Mai. Evening, Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) minus Shan Zhu Yu (Corni Fructus), plus Bai Shao, Bie Jia, Wu Wei Zi. Ten-plus doses stopped chills/fever and restored spirit.