[病史]十余年前，患慢性支气管炎，后发展为哮喘，经常发作，每冬必重，常须住院治疗。经安徽省××医院确诊为“支气管哮喘”、 “肺气肿”，久治未愈。1978年7月4日来诊，按少阴证论治。前后八诊，已一年未再复发。
[初诊]气紧，心累，乏力，偶有咳嗽，痰少，清稀色白。体稍胖，两颧赤暗，唇乌，舌淡白，苔灰白厚腻。时值伏天，哮喘虽未大作，但病根犹存，此证属少阴。法宜扶先天之元阳，镇纳浊阴之气，以四逆加味主之。
处方：
制附片60克(久煎) 干姜片60克炙甘草18克上肉桂15克生白术30克[二诊]上方加减服二十余剂，渚证皆减。活动后还觉气紧、心累。舌质仍淡，苔腻稍退。阳衰阴盛，日久难复，守原法再进。
(三诊]上方加减又服二十余剂，气紧、心累明显减轻。双颧暗赤色稍退，舌质微现淡红，苔厚腻减。为扶正驱邪，巩固疗效，拟四逆、理中合方加味，配成丸药，坚持服用两月。
处方：
制附片150克干姜片150克炙甘草60克红参30克炒白术120克上肉桂60克宁枸杞120克菟丝子120克紫河车120克共研细末，加红糖为丸，如枣大，每日2次，每次2丸。
1978年冬季，在中央党校学习时，经服药后，与往年冬季截然不同：在严寒之晨，可在室外坚持打太极拳和跑步约1小时，咳喘未再发作。
1979年4月，患者从安徽来京，特来看望范老，介绍自去冬以来，至今良好。过去走一、二里路，上二、三层楼，皆觉困难，经常住院。现在，一直坚持工作和体育锻炼，身体日益康复。
[按语]患者于1979年1月，向有关研究部门反映，着重提出两个问题：
(一)据说川附片超过四钱，就要中毒，多服干姜有害于肾。但范老所处药方，每剂药附片用到二两以上，干姜用量亦不少，四个月内，附片累计服用二十余斤，不仅没有中毒和其他反应，而且疗效显著，究竟是何缘故?
(二)我在京服汤药，是从1978年7月12日开始，至9月20日。时值伏天，每天一剂，早中晚三次分服。有的医生，对盛暑服用如此大量热药很担心。象类似陈规，范老为什么敢于突破?建议一并作为专门课题研究总结。
我们认为，病人提出的这些问题十分中肯。如能采取现代科学手段，加以认真研究，是有现实意义的。
少阴证哮喘
(支气管哮喘)
曹××，女，40岁。成都某厂工人。
[病史]十余岁开始患支气管哮喘。每年冬季发作。1960年以后，病情日趋严重，发作频繁。屡至××医院急诊，输氧抢救。1965年4月来诊。
[初诊]咳嗽，气紧，心累，痰多不易咳出，呈泡沫状。喘则张口抬肩，哮鸣不已，出多入少，动则尤甚。又身恶寒，经常头晕眩，曾诊断为“美尼尔氏综合症”。食欲不振，形体消瘦。月经量多，色乌暗，挟紫黑色淤血，某院妇科诊断为“功能性子宫出血”。查血色素仅有5克。面色萎白无华，眼胞及双颧浮肿，唇乌，舌质淡而紫暗，苔灰白黄、浊腻、根部厚。此为少阴寒化证，兼太阳表证未解。须表里同治，法宜散外寒，涤内饮，以小青龙汤加减主之。
处方：
麻黄10克 干姜15克 甘草15克桂枝10克法夏18克辽细辛5克炮姜20克生姜20克四剂
[二诊]服四剂，咳嗽减轻，气喘稍减，痰易咳出。此病积之已久，脾肾阳气日衰，喘时呼多吸少，肾不纳气之虚象甚显。故不宜过表，须峻补脾肾之阳，固肺气之根，扶正以涤饮驱邪。以四逆加味主之。
处方：
制附片120克(久煎) 干姜60克炙甘草45克茯苓20克上肉桂10克(冲服)
[三诊]上方随证加减，服十余剂。咳喘， 畏寒，眩晕等证，皆显著好转。宜扶阳益气，培补二天，损益续服。
处方：
制附片60克(久煎)炮干姜30克炙甘草25克炒白术30克 茯苓20克菟丝子20克宁枸杞20克北沙参20克砂仁10克上方出入增减，服两月余。咳喘皆平， 月事正常，体质逐渐恢复。1979年7月，在成都偶遇范老，特来家致谢，谈及十余年前患哮喘重证，经治愈后，仅去年有轻度发作，一周后即愈。表示不胜感激之意。
[按语]刘、曹二例，分属北京、成都南北两 地，均系少阴证哮喘。其年龄、病情、西医诊断，以及理法方药皆大体相似，故一并选于此，以资参照。
有人认为，中医诊籍，所选若干病例，其疗效是否可以重复?颇值得怀疑。其实，祖国临床医学，正是千百年来医疗实践的结晶，反过来又指导临床实践。有是证，有是病，则用是方是药，哪有不能重复之理?以《伤寒论》为例，从问世以来，迄今近两千年，其理法方药，临床治验，经重复疗效之检验，则难以数计。若不能重复，焉能历代一脉相承，且扬之海外。时至今日，仍为中医之典籍?!
但所谓重复，亦必须有正确理解。仍以刘、曹二例而言，现代医学辨病大体相似。祖国医学不仅辨证，也要辨病：少阴属证，可谓辨证之分类与纲要，而哮喘才是病名。证属少阴，又有热化寒化之分，证同气异之别。深入分析，证中有证；合而言之，纲目分明。论其辨病，依然如此。所以，我们所理解的重复，并非同一病名，即可搬用同一方药的机械重复；而是病证合参，具体病证具体分析、辨证施治的重复。这正是祖国医学的精华所在。张仲景曾针对自己的著作，满育抱负地说过： “为《伤寒杂病论》，合十六卷，虽未能尽愈诸病，庶可以见病知源”。此乃这一巨著，千百年来强大生命力之所在。
少阴证虚喘
(支气管哮喘)
罗x×，男，26岁。四川双流县某乡，农民。
[病史]1962年4月，因风寒咳嗽，痰多，气紧，不能平卧，××医院诊断为“支气管哮喘”，经治疗，病情好转。1963年冬季，咳嗽加剧，心累气紧，动则尤甚，致卧床不起。治疗一段时间，基本缓解。1964年春，旧病复发，遂来求诊。
(初诊]喉间痰声漉漉，张口抬肩，气不接续，喘时汗出，痰多清稀，精神萎靡，恶寒肢冷，面肿。舌质淡暗，苔白滑腻。此为少阴阳衰阴盛，气不归元，寒饮上逆而致。法宜壮阳驱阴，纳气归肾，以四逆汤加味主之。 处方： 制附片30克(久煎) 生姜30克炙甘草15克 上肉桂10克(冲服) 砂仁12克 白术12克四剂
[二诊]服上方后哮喘减。原方加茯苓，以增强利水、渗湿、化痰之效。续服五剂。
[三诊]哮喘明显减轻。其后又继续服上方月余，以巩固疗效。
1979年6月追访：患者病愈后，次年即由农村调某厂工作，患者始终坚持全日工作，十四年来病未复发。
(按语]本例气急喘促，不能续接，张口抬肩，得长引一息为快，应属元气不足之虚证。这与气促壅塞，不能布息，得呼出余气为快之实证不同。
虚喘之证，无非气虚。气藏于肺而根于肾。此证虚喘，喘则汗出，动则尤甚，恶寒肢冷，面浮神疲，痰涎稀薄，舌淡苔白，一派少阴虚喘之象。故自始至终，坚持壮阳驱阴，补肾纳气之法。阳旺邪消，哮喘自平。
少阴证咳嗽
(慢性支气管炎)
安××，女，54岁。北京某部队家属。
[病史]1966年因受风寒，咳嗽迁延十二年。每年入秋则发，冬季加剧，甚则不能平卧。××医院诊断为慢性支气管炎。发作时服药虽可暂时缓解，但经常反复，日益加重。1978年8月来诊，按少阴证水寒内结论治，三个月基本治愈。
[初诊]每日阵发性剧咳，痰清稀，量多，头晕心累，气短，昼夜不能平卧。畏寒恶风，面足浮肿，脸色萎黄。舌质淡暗有淤斑，舌体畔嫩而边缘多齿痕，苔白滑，根部厚腻。此为少阴阳虚水泛，寒痰阻肺咳嗽。法宜温阳化气行水，以真武汤加减主之。
处方：
茯苓24克生姜30克白术20克制附片60克(久煎) 桂枝10克六剂
[辨证]患者每年秋冬外感，咳必复发，神疲身倦，恶寒肢冷，气短倚息难卧，面色晦滞，舌质暗淡无华，皆肾阳衰微之明证。因肾为水脏，肾中真阳衰微不能化气，则水饮内停。水寒之气上泛，则头眩、心累。水气停于胸肺，则咳嗽不已，痰涎清稀量多，气短难卧。水气溢于肌表，故面足浮肿沉重。舌质胖嫩，兼有齿印与淤斑，舌苔白而厚腻，皆为水泛寒凝之象。同时年逾半百，阳虚益甚。多年前，初感寒邪病咳，正气未衰，逐风寒之邪从外而解，或可速愈；今则迥然不同，断不可舍本求标。综上所述，此属少阴肾阳衰微，水寒射肺，故投以温阳散寒、化气行水之真武汤为宜。
上方真武汤加减，以附子之辛热，壮肾之元阳，则水有所主；白术之苦燥，建立中土，则水有所制；兼生姜之辛散，佐附子以补阳；茯苓之淡渗，佐白术以燠土，并寓散水渗湿之意；以芍药易桂枝者，加速温经敞寒，化气行水之功。
[二诊]原方连服六剂，咳嗽明显好转，痰亦减少过半，呼吸较前通畅，渐能平卧。面已不觉肿，舌质稍转红润，厚腻苔减。多年之患，已获初效。宜守原法，以干姜易生姜，加强温中补脾之效。
[三诊]上方续服六剂，诸证显著减轻。尚有轻微咳嗽，清痰少许。舌质转为淡红，乌暗淤斑与白腻苔渐退，舌边齿痕已不明显。有时尚觉气短，心累。病有从阴出阳之势。须适应转机，通阳和中，燥湿涤饮。以苓桂术甘汤加味，缓缓服之。
处方：
茯苓20克桂枝10克 白术20克法夏15克生姜20克 甘草3克十二剂
服十二剂后，诸证基本痊愈。入冬以来，再未重犯。1979年5月4日至患者家中追访，自觉始终良好。
[按语]咳嗽一证，有从外而入者，有从内而出者。不论其外入或内出，皆可按六经辨证。本例咳嗽，应属少阴阳虚，水泛成痰，水寒袭肺，肾阳虚而累及于肺。既有水气，又系少阴寒化。故投以真武汤，壮元阳以消阴翳，逐寒痰以清水源。不攻肺而肺之病自愈，不止咳而咳嗽自平。
少阴证喉痹
(慢性喉炎、瘜肉)
黄××，女，44岁。四川郫县团结乡，农民。
[病史]1975年4月，因兄病故，目睹火化现场，不胜悲戚。次日，自觉喉部不适，似有物梗塞。继而发展至呼吸不畅，甚至憋气，心悸，身麻。××医院五官科检查，诊为“喉炎”、 “瘜肉”，治疗无效。又转几处医院医治，其效不显，病情日益加重。1976年5月来诊。
[初诊]患者觉喉部明显堵塞，轻微疼痛。向左侧躺卧，气憋心慌，全身发麻。头昏，体痛，乏力，咳嗽吐泡沫痰甚多，自觉周身血管常有轻微颤动，精神倦怠，食欲不振，每进一餐，皆须休息几次，胃脘常隐痛，喜热敷，形体消瘦，步履艰难。前医均以清热解毒，养阴散结为治，服药百余剂，仅夏枯草一味，自采煎服共两萝筐之多。医治年余，越清火，自觉火益上炎，舌上沾少许温水均觉灼痛，满口牙齿松动，疼痛。唇乌，舌质偏淡微暗，少苔不润，脉沉细。此忧思郁结而成梅核气，并因正气不足，过服凉药，转为少阴证喉痹。先以半夏厚朴汤加味，调气散郁为治。
处方：
法夏15克 厚朴12克茯苓12克生姜15克苏叶10克 干姜12克甘草10克四剂
[二诊]上方服四剂，觉喉部较前舒畅，憋气感消失，吞咽自如。仍咳嗽、头昏、身痛，为太阳表证未解；法宜温通少阴经脉，兼解太阳之表，以麻黄附子甘草汤加味主之。
处方：
麻黄10克制附片120克(久煎) 炙甘草60克干姜60克辽细辛6克六剂
[三诊]服六剂，咳嗽，头昏、体痛基本消失，痰涎减少，心悸好转。惟喉间瘛肉未全消，左侧躺卧仍有不适。尚觉神疲，牙疼松动，舌触温水仍有痛感。此为少阴虚火上腾，宜壮阳温肾，引火归原，以四逆汤加味主之。
处方：
制附片120克(久煎) 干姜片60克炙甘草45克 上肉桂12克(研末、冲服)
辽细辛6克[辨证]此病得于七情，忧思郁气，致痰涎滞：于：咽中，如同有物梗塞，咯之不出，咽之不下，显系梅核气。正如《金匮要略》所说： “妇人咽中如有炙脔，半夏厚朴汤主之”。但是，从患者全身证状，参之舌脉来看，神疲、乏力、心悸、舌淡、脉沉细，乃阴盛阳郁，少阴寒化之象。少阴之经脉循行于咽喉，心肾阳衰，正气不固，阴气上腾，与郁气凝涎相结，使咽喉堵塞，疼痛，甚则聚而生变，不仅“如有炙脔”，而且凝结为有形之瘛肉。进一步阻滞经脉，影响气机，故梗塞，憋气，心悸，身麻等诸症接踵而生。
病情虽较复杂，但纵观全局：病根在于少阴心肾阳虚，无根之火上扰；主证在于喉部气血痹阻，病属虚火喉痹；诱因为忧伤太过，致痰气郁结而上逆；兼证为太阳风寒之表。治宜先开痹阻，利气化痰，然后表里同治，再集中优势兵力，引火归原，关键得以突破。
[四诊]上方连进四剂后，上述诸证皆显著减轻。过服凉药，元气亏损，魁伐太过，短期难奏全功，宜培补脾肾，助阳益气，以理中汤加味再服。
处方：
潞党参15克 干姜片20克炒白术15克炙甘草12克制附片30克(久煎) 上肉桂10克嘱其继服十余剂，忌食生冷，戒忧虑， 注意调养。
【病史】十多年前，患有慢性支气管炎，后来发展为哮喘，经常发作，每年冬天必定加重，常常需要住院治疗。经安徽省某医院确诊为“支气管哮喘”、“肺气肿”，久治不愈。1978年7月4日来就诊，按照少阴证（少阴经受邪，心肾阳虚为主的病证）进行论治。前后八次诊疗，已经一年没有再复发。
【初诊】气短急促，心慌劳累，乏力，偶尔有咳嗽，痰少，质地清稀、颜色白。身体稍胖，两颧部颜色赤暗，嘴唇发黑，舌质淡白，苔灰白且厚腻。正值伏天，哮喘虽然未剧烈发作，但病根依然存在，此证属于少阴证。治法应当扶持先天之元阳，镇纳浊阴之气，以四逆汤加味为主方。
处方：
制附片60克（久煎） 干姜片60克 炙甘草18克 上肉桂15克 生白术30克
【二诊】上方加减服用二十余剂后，诸症皆减轻。活动后仍感觉气紧、心慌劳累。舌质仍然淡，苔腻稍退。阳气衰微、阴寒内盛，日久难以恢复，坚守原法继续进药。
【三诊】上方加减又服用二十余剂，气紧、心慌明显减轻。双颧暗红色稍退，舌质微现淡红，苔厚腻减少。为了扶正驱邪，巩固疗效，拟定四逆汤与理中汤合方加味，配制成丸药，坚持服用两个月。
处方：
制附片150克 干姜片150克 炙甘草60克 红参30克 炒白术120克 上肉桂60克 宁枸杞120克 菟丝子120克 紫河车120克
共研细末，加红糖做成丸药，如枣大小，每日2次，每次2丸。
1978年冬季，在中央党校学习期间，经过服药后，与往年冬季截然不同：在严寒的早晨，可以在室外坚持打太极拳和跑步约1小时，咳喘未再发作。
1979年4月，患者从安徽来到北京，特意来看望范老，介绍自去年冬天以来，至今身体状况良好。过去走一、二里路，上二、三层楼，都觉得困难，经常住院。现在，一直坚持工作和体育锻炼，身体日益康复。
【按语】患者于1979年1月，向有关研究部门反映，着重提出两个问题：
（一）据说川附片超过四钱，就要中毒，多服干姜有害于肾。但范老所开的药方，每剂药附片用到二两以上，干姜用量也不少，四个月内，附片累计服用二十余斤，不仅没有中毒和其他反应，而且疗效显著，究竟是何缘故？
（二）我在北京服汤药，是从1978年7月12日开始，至9月20日。时值伏天，每天一剂，早中晚三次分服。有的医生，对盛暑服用如此大量热药很担心。像类似陈规，范老为什么敢于突破？建议一并作为专门课题研究总结。
我们认为，病人提出的这些问题十分中肯。如能采取现代科学手段，加以认真研究，是有现实意义的。
【病史】十多岁开始患支气管哮喘。每年冬季发作。1960年以后，病情日趋严重，发作频繁。屡次到某医院急诊，输氧抢救。1965年4月来就诊。
【初诊】咳嗽，气短急促，心慌劳累，痰多不易咳出，呈泡沫状。喘息时张口抬肩，哮鸣声不停，呼气多吸气少，活动后尤其严重。又伴有身恶寒，经常头晕眩，曾诊断为“美尼尔氏综合症”。食欲不振，形体消瘦。月经量多，颜色乌暗，夹杂紫黑色淤血，某院妇科诊断为“功能性子宫出血”。查血色素仅有5克。面色萎黄无光泽，眼胞及双颧浮肿，嘴唇发黑，舌质淡而紫暗，苔灰白黄、浊腻、根部厚。此为少阴寒化证（少阴病表现为虚寒性质的证候），兼太阳表证（太阳经受邪，表现为恶寒发热等表证）未解。须表里同治，治法宜散外寒，涤除内饮，以小青龙汤加减为主方。
处方：
麻黄10克 干姜15克 甘草15克 桂枝10克 法半夏18克 辽细辛5克 炮姜20克 生姜20克
四剂
【二诊】服用四剂后，咳嗽减轻，气喘稍减，痰易咳出。此病积之久远，脾肾阳气日渐衰微，喘息时呼多吸少，肾不纳气（肾脏不能摄纳肺气）的虚象非常明显。故不宜过度发散表邪，须峻补脾肾之阳，固护肺气之根，扶正以涤除饮邪、驱除病邪。以四逆汤加味为主方。
处方：
制附片120克（久煎） 干姜60克 炙甘草45克 茯苓20克 上肉桂10克（冲服）
【三诊】上方随证加减，服用十余剂。咳喘、畏寒、眩晕等症状，皆显著好转。宜扶阳益气，培补先天之本（肾）与后天之本（脾），损益续服。
处方：
制附片60克（久煎） 炮干姜30克 炙甘草25克 炒白术30克 茯苓20克 菟丝子20克 宁枸杞20克 北沙参20克 砂仁10克
上方出入增减，服用两月余。咳喘皆平，月经正常，体质逐渐恢复。1979年7月，在成都偶遇范老，特意来家致谢，谈及十余年前患哮喘重证，经治愈后，仅去年有轻度发作，一周后即愈。表示不胜感激之意。
【按语】刘、曹二例，分属北京、成都南北两地，均系少阴证哮喘。其年龄、病情、西医诊断，以及理法方药皆大体相似，故一并选于此，以资参照。
有人认为，中医诊籍，所选若干病例，其疗效是否可以重复？颇值得怀疑。其实，祖国临床医学，正是千百年来医疗实践的结晶，反过来又指导临床实践。有是证，有是病，则用是方是药，哪有不能重复之理？以《伤寒论》为例，从问世以来，迄今近两千年，其理法方药，临床治验，经重复疗效之检验，则难以数计。若不能重复，焉能历代一脉相承，且扬之海外。时至今日，仍为中医之典籍？！
但所谓重复，亦必须有正确理解。仍以刘、曹二例而言，现代医学辨病大体相似。祖国医学不仅辨证，也要辨病：少阴属证，可谓辨证之分类与纲要，而哮喘才是病名。证属少阴，又有热化寒化之分，证同气异之别。深入分析，证中有证；合而言之，纲目分明。论其辨病，依然如此。所以，我们所理解的重复，并非同一病名，即可搬用同一方药的机械重复；而是病证合参，具体病证具体分析、辨证施治的重复。这正是祖国医学的精华所在。张仲景曾针对自己的著作，满怀抱负地说过：“为《伤寒杂病论》，合十六卷，虽未能尽愈诸病，庶可以见病知源”。此乃这一巨著，千百年来强大生命力之所在。
少阴证虚喘
（支气管哮喘）
罗x×，男，26岁。四川双流县某乡，农民。
【病史】1962年4月，因风寒咳嗽，痰多，气紧，不能平卧，某医院诊断为“支气管哮喘”，经治疗，病情好转。1963年冬季，咳嗽加剧，心累气紧，动则尤甚，致卧床不起。治疗一段时间，基本缓解。1964年春，旧病复发，遂来求诊。
【初诊】喉间痰声漉漉，张口抬肩，气不接续，喘息时汗出，痰多清稀，精神萎靡，恶寒肢冷，面肿。舌质淡暗，苔白滑腻。此为少阴阳衰阴盛，气不归元，寒饮上逆而致。治法宜壮阳驱阴，纳气归肾，以四逆汤加味为主方。
处方：
制附片30克（久煎） 生姜30克 炙甘草15克 上肉桂10克（冲服） 砂仁12克 白术12克
四剂
【二诊】服用上方后哮喘减轻。原方加茯苓，以增强利水、渗湿、化痰之效。续服五剂。
【三诊】哮喘明显减轻。其后又继续服用上方月余，以巩固疗效。
1979年6月追访：患者病愈后，次年即由农村调某厂工作，患者始终坚持全日工作，十四年来病未复发。
【按语】本例气急喘促，不能续接，张口抬肩，得长引一息为快，应属元气不足之虚证。这与气促壅塞，不能布息，得呼出余气为快之实证不同。
虚喘之证，无非气虚。气藏于肺而根于肾。此证虚喘，喘则汗出，动则尤甚，恶寒肢冷，面浮神疲，痰涎稀薄，舌淡苔白，一派少阴虚喘之象。故自始至终，坚持壮阳驱阴，补肾纳气之法。阳旺邪消，哮喘自平。
少阴证咳嗽
（慢性支气管炎）
安××，女，54岁。北京某部队家属。
【病史】1966年因受风寒，咳嗽迁延十二年。每年入秋则发，冬季加剧，甚则不能平卧。某医院诊断为慢性支气管炎。发作时服药虽可暂时缓解，但经常反复，日益加重。1978年8月来就诊，按少阴证水寒内结（少阴阳虚，水饮寒邪内停）论治，三个月基本治愈。
【初诊】每日阵发性剧咳，痰清稀，量多，头晕心慌劳累，气短，昼夜不能平卧。畏寒恶风，面足浮肿，脸色萎黄。舌质淡暗有淤斑，舌体胖嫩而边缘多齿痕，苔白滑，根部厚腻。此为少阴阳虚水泛，寒痰阻肺咳嗽。治法宜温阳化气行水，以真武汤加减为主方。
处方：
茯苓24克 生姜30克 白术20克 制附片60克（久煎） 桂枝10克
六剂
【辨证】患者每年秋冬外感，咳必复发，神疲身倦，恶寒肢冷，气短倚息难卧，面色晦滞，舌质暗淡无华，皆肾阳衰微之明证。因肾为水脏，肾中真阳衰微不能化气，则水饮内停。水寒之气上泛，则头眩、心慌劳累。水气停于胸肺，则咳嗽不已，痰涎清稀量多，气短难卧。水气溢于肌表，故面足浮肿沉重。舌质胖嫩，兼有齿印与淤斑，舌苔白而厚腻，皆为水泛寒凝之象。同时年逾半百，阳虚益甚。多年前，初感寒邪病咳，正气未衰，逐风寒之邪从外而解，或可速愈；今则迥然不同，断不可舍本求标。综上所述，此属少阴肾阳衰微，水寒射肺，故投以温阳散寒、化气行水之真武汤为宜。
上方真武汤加减，以附子之辛热，壮肾之元阳，则水有所主；白术之苦燥，建立中土（脾胃），则水有所制；兼生姜之辛散，佐附子以补阳；茯苓之淡渗，佐白术以燠土（温暖脾土），并寓散水渗湿之意；以芍药易桂枝者，加速温经散寒，化气行水之功。
【二诊】原方连服六剂，咳嗽明显好转，痰亦减少过半，呼吸较前通畅，渐能平卧。面已不觉肿，舌质稍转红润，厚腻苔减。多年之患，已获初效。宜守原法，以干姜易生姜，加强温中补脾之效。
【三诊】上方续服六剂，诸证显著减轻。尚有轻微咳嗽，清痰少许。舌质转为淡红，乌暗淤斑与白腻苔渐退，舌边齿痕已不明显。有时尚觉气短，心慌劳累。病有从阴出阳之势。须适应转机，通阳和中，燥湿涤饮。以苓桂术甘汤加味，缓缓服之。
处方：
茯苓20克 桂枝10克 白术20克 法半夏15克 生姜20克 甘草3克
十二剂
服十二剂后，诸证基本痊愈。入冬以来，再未重犯。1979年5月4日至患者家中追访，自觉始终良好。
【按语】咳嗽一证，有从外而入者，有从内而出者。不论其外入或内出，皆可按六经辨证。本例咳嗽，应属少阴阳虚，水泛成痰，水寒袭肺，肾阳虚而累及于肺。既有水气，又系少阴寒化。故投以真武汤，壮元阳以消阴翳，逐寒痰以清水源。不攻肺而肺之病自愈，不止咳而咳嗽自平。
少阴证喉痹
（慢性喉炎、息肉）
黄××，女，44岁。四川郫县团结乡，农民。
【病史】1975年4月，因兄病故，目睹火化现场，不胜悲戚。次日，自觉喉部不适，似有物梗塞。继而发展至呼吸不畅，甚至憋气，心悸，身麻。某医院五官科检查，诊为“喉炎”、“息肉”，治疗无效。又转几处医院医治，其效不显，病情日益加重。1976年5月来就诊。
【初诊】患者觉喉部明显堵塞，轻微疼痛。向左侧躺卧，气憋心慌，全身发麻。头昏，体痛，乏力，咳嗽吐泡沫痰甚多，自觉周身血管常有轻微颤动，精神倦怠，食欲不振，每进一餐，皆须休息几次，胃脘常隐痛，喜热敷，形体消瘦，步履艰难。前医均以清热解毒，养阴散结为治，服药百余剂，仅夏枯草一味，自采煎服共两萝筐之多。医治年余，越清火，自觉火益上炎，舌上沾少许温水均觉灼痛，满口牙齿松动，疼痛。唇乌，舌质偏淡微暗，少苔不润，脉沉细。此忧思郁结而成梅核气（指咽喉中有异物感，咯之不出，咽之不下的一种病症），并因正气不足，过服凉药，转为少阴证喉痹（少阴经脉循行于咽喉，因阳虚寒凝导致的咽喉闭塞疼痛）。先以半夏厚朴汤加味，调气散郁为治。
处方：
法半夏15克 厚朴12克 茯苓12克 生姜15克 苏叶10克 干姜12克 甘草10克
四剂
【二诊】上方服四剂，觉喉部较前舒畅，憋气感消失，吞咽自如。仍咳嗽、头昏、身痛，为太阳表证未解；治法宜温通少阴经脉，兼解太阳之表，以麻黄附子甘草汤加味为主方。
处方：
麻黄10克 制附片120克（久煎） 炙甘草60克 干姜60克 辽细辛6克
六剂
【三诊】服六剂，咳嗽，头昏、体痛基本消失，痰涎减少，心悸好转。惟喉间息肉未全消，左侧躺卧仍有不适。尚觉神疲，牙疼松动，舌触温水仍有痛感。此为少阴虚火上腾，宜壮阳温肾，引火归原，以四逆汤加味为主方。
处方：
制附片120克（久煎） 干姜片60克 炙甘草45克 上肉桂12克（研末、冲服）
辽细辛6克
【辨证】此病得于七情，忧思郁气，致痰涎滞于咽中，如同有物梗塞，咯之不出，咽之不下，显系梅核气。正如《金匮要略》所说：“妇人咽中如有炙脔，半夏厚朴汤主之”。但是，从患者全身证状，参之舌脉来看，神疲、乏力、心悸、舌淡、脉沉细，乃阴盛阳郁，少阴寒化之象。少阴之经脉循行于咽喉，心肾阳衰，正气不固，阴气上腾，与郁气凝涎相结，使咽喉堵塞，疼痛，甚则聚而生变，不仅“如有炙脔”，而且凝结为有形之息肉。进一步阻滞经脉，影响气机，故梗塞，憋气，心悸，身麻等诸症接踵而生。
病情虽较复杂，但纵观全局：病根在于少阴心肾阳虚，无根之火上扰；主证在于喉部气血痹阻，病属虚火喉痹；诱因为忧伤太过，致痰气郁结而上逆；兼证为太阳风寒之表。治宜先开痹阻，利气化痰，然后表里同治，再集中优势兵力，引火归原，关键得以突破。
【四诊】上方连进四剂后，上述诸证皆显著减轻。过服凉药，元气亏损，魁伐太过，短期难奏全功，宜培补脾肾，助阳益气，以理中汤加味再服。
处方：
潞党参15克 干姜片20克 炒白术15克 炙甘草12克 制附片30克（久煎） 上肉桂10克
嘱其继服十余剂，忌食生冷，戒忧虑，注意调养。
[Medical History] More than ten years ago, the patient suffered from chronic bronchitis, which later developed into asthma. The condition occurred frequently and worsened every winter, often requiring hospitalization. Diagnosed as "bronchial asthma" and "emphysema" by a certain hospital in Anhui Province, it remained incurable after long-term treatment. On July 4, 1978, the patient sought consultation and was treated according to Shaoyin Syndrome (a syndrome characterized by deficiency-cold of the Heart and Kidney meridians). After eight consultations over one year, there was no recurrence.
[First Visit] Symptoms included shortness of breath, palpitations, fatigue, occasional cough with scanty, clear, white sputum. The body was slightly obese, with malar flush that was dark-red, blackish lips, pale tongue, and thick, greasy, grey-white coating. Although the asthma did not flare up severely during the dog days of summer, the root cause remained. This syndrome belongs to Shaoyin. The therapeutic method should be to support the primordial Yang of the congenital foundation and suppress/anchor turbid Yin Qi. The main prescription was Sini Tang (Four Reversal Decoction) with modifications.
Prescription:
Zhi Fupian (Prepared Aconiti Lateralis Radix) 60g (decocted for a long time), Ganjiang Pian (Dried Zingiberis Rhizoma) 60g, Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) 18g, Shang Rougui (Cinnamomi Cortex) 15g, Sheng Baizhu (Raw Atractylodis Macrocephalae Rhizoma) 30g.
[Second Visit] After taking the modified prescription for more than twenty doses, all symptoms subsided. However, shortness of breath and palpitations persisted after activity. The tongue quality remained pale, and the greasy coating had slightly receded. Due to Yang deficiency and Yin excess, recovery is difficult over a long period. Adhere to the original method and continue medication.
[Third Visit] After taking the modified prescription for another twenty doses, shortness of breath and palpitations were significantly alleviated. The dark-red color on both cheeks faded slightly, the tongue showed a faint pale red hue, and the thick greasy coating decreased. To support healthy Qi and expel pathogenic factors, consolidate efficacy, the combined formula of Sini Tang (Four Reversal Decoction) and Lizhong Tang (Regulate the Middle Decoction) with modifications was prescribed as pills, to be taken continuously for two months.
Prescription:
Zhi Fupian (Prepared Aconiti Lateralis Radix) 150g, Ganjiang Pian (Dried Zingiberis Rhizoma) 150g, Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) 60g, Hongshen (Red Ginseng Radix et Rhizoma) 30g, Chao Baizhu (Stir-fried Atractylodis Macrocephalae Rhizoma) 120g, Shang Rougui (Cinnamomi Cortex) 60g, Ning Gouqi (Lycii Fructus) 120g, Tuszizi (Cuscutae Semen) 120g, Ziheche (Placenta Humana) 120g.
Grind into fine powder, add brown sugar to form pills the size of dates. Take twice daily, two pills each time.
During the winter of 1978, while studying at the Central Party School, after taking the medicine, the condition was completely different from previous winters: In the cold morning, he could persist in practicing Tai Chi and running outdoors for about one hour without any recurrence of cough or asthma.
In April 1979, the patient came to Beijing from Anhui specifically to visit Master Fan, reporting that since last winter, his health has been good. Previously, walking one or two li or climbing two or three flights of stairs was difficult, and hospitalization was frequent. Now, he persists in work and physical exercise, and his body is recovering day by day.
[Commentary] In January 1979, the patient reported to relevant research departments, emphasizing two questions:
(1) It is said that if Sichuan Fupian exceeds four qian, it causes poisoning, and excessive dried ginger harms the kidneys. However, in the prescriptions by Master Fan, each dose contains more than two liang of Fupian, and the dosage of dried ginger is also considerable. Within four months, the cumulative intake of Fupian exceeded twenty jin. Not only was there no poisoning or other reactions, but the curative effect was significant. What is the reason?
(2) I took decoctions in Beijing from July 12, 1978, to September 20. During the dog days, I took one dose daily, divided into three times. Some doctors were worried about taking such large amounts of hot medicines in midsummer. Regarding such conventions, why did Master Fan dare to break through? It is suggested to summarize this as a special research topic.
We believe that the problems raised by the patient are very pertinent. If modern scientific methods can be adopted for serious study, it has practical significance.
Shaoyin Syndrome Asthma
(Bronchial Asthma)
Cao XX, Female, 40 years old. Worker at a factory in Chengdu.
[Medical History] She began suffering from bronchial asthma in her teens. Attacks occurred every winter. After 1960, the condition became increasingly severe with frequent attacks. She repeatedly went to the emergency room of a certain hospital for oxygen therapy and rescue. She consulted on April 1965.
[First Visit] Cough, shortness of breath, palpitations, profuse sputum difficult to expectorate, foamy in nature. During panting, she opened her mouth and lifted her shoulders, with continuous wheezing, more exhalation than inhalation, worsening with movement. She also had aversion to cold, frequent dizziness and vertigo, previously diagnosed as "Meniere's Syndrome". Poor appetite, emaciation. Menstrual flow was heavy, dark purple-black in color, mixed with purple-black blood stasis; diagnosed as "functional uterine bleeding" by the gynecology department of a certain hospital. Hemoglobin was only 5 grams. The complexion was sallow and lusterless, eyelids and malar bones were edematous, lips were blackish, tongue was pale and purple-dark, coating was grey-white-yellow, turbid, greasy, and thick at the root. This is Shaoyin Cold Transformation Syndrome (a syndrome manifesting deficiency-cold in Shaoyin disease), complicated by unresolved Taiyang Exterior Syndrome (exterior syndrome caused by pathogenic factors invading the Taiyang meridian). Treatment requires addressing both interior and exterior simultaneously. The method should be to disperse external cold and wash away internal fluid retention, using Xiao Qinglong Tang (Minor Blue Dragon Decoction) with modifications as the main prescription.
Prescription:
Mahuang (Ephedrae Herba) 10g, Ganjiang (Dried Zingiberis Rhizoma) 15g, Gancao (Glycyrrhizae Radix et Rhizoma) 15g, Guizhi (Cinnamomi Ramulus) 10g, Faxia (Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine) 18g, Liao Xixin (Asari Radix et Rhizoma) 5g, Paojiang (Prepared Zingiberis Rhizoma) 20g, Shengjiang (Fresh Zingiberis Rhizoma) 20g.
Four doses.
[Second Visit] After four doses, cough reduced, panting slightly alleviated, sputum easier to expectorate. This disease has accumulated for a long time, with Spleen and Kidney Yang declining day by day. During panting, exhalation is more than inhalation, showing obvious deficiency signs of Kidney failing to grasp Qi. Therefore, excessive exterior-dispersing is inappropriate. One must vigorously tonify Spleen and Kidney Yang, secure the root of Lung Qi, support healthy Qi to wash away fluid retention and expel pathogens. Use Sini Tang (Four Reversal Decoction) with modifications as the main prescription.
Prescription:
Zhi Fupian (Prepared Aconiti Lateralis Radix) 120g (decocted for a long time), Ganjiang (Dried Zingiberis Rhizoma) 60g, Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) 45g, Fuling (Poria) 20g, Shang Rougui (Cinnamomi Cortex) 10g (dissolved in the decoction).
[Third Visit] With modifications based on symptoms, taken for over ten doses. Cough, panting, aversion to cold, and dizziness improved significantly. The method should be to tonify Yang and benefit Qi, cultivate the Two Foundations (Kidney and Spleen), and continue taking with adjustments.
Prescription:
Zhi Fupian (Prepared Aconiti Lateralis Radix) 60g (decocted for a long time), Paoganjiang (Prepared Dried Zingiberis Rhizoma) 30g, Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) 25g, Chao Baizhu (Stir-fried Atractylodis Macrocephalae Rhizoma) 30g, Fuling (Poria) 20g, Tuszizi (Cuscutae Semen) 20g, Ning Gouqi (Lycii Fructus) 20g, Beishashen (Glehniae Radix) 20g, Sharen (Amomi Fructus Rotundus) 10g.
With adjustments, taken for over two months. Cough and panting ceased, menstruation normalized, constitution gradually recovered. In July 1979, she met Master Fan in Chengdu and visited him to express gratitude, mentioning that after being cured of severe asthma more than ten years ago, she only had a mild attack last year, which resolved within a week. She expressed deep gratitude.
[Commentary] Cases Liu and Cao, located in Beijing and Chengdu respectively, both suffer from Shaoyin Syndrome Asthma. Their age, condition, Western medical diagnosis, and principles, methods, formulas, and herbs are largely similar, so they are selected together here for reference.
Some people doubt whether the curative effects of selected cases in Traditional Chinese Medicine (TCM) records can be repeated. Actually, TCM clinical medicine is the crystallization of thousands of years of medical practice and guides clinical practice in return. Where there is a specific syndrome and disease, use the corresponding formula and herbs; how could it not be repeatable? Taking *Shanghan Lun* (Treatise on Cold Pathogenic Diseases) as an example, since its publication nearly two thousand years ago, its theories, methods, formulas, and herbs, along with clinical experiences, have been tested by repeated curative effects countless times. If they could not be repeated, how could they have been passed down generation after generation and spread overseas? Why are they still considered classics of TCM today?!
However, the so-called repetition must be understood correctly. Taking cases Liu and Cao as examples, modern medical disease differentiation is roughly similar. TCM not only differentiates syndromes but also identifies diseases: Shaoyin is a syndrome category, serving as a classification and outline for syndrome differentiation, while asthma is the disease name. Syndromes belonging to Shaoyin have heat transformation and cold transformation distinctions, and differences in Qi despite similar syndromes. Deep analysis reveals syndromes within syndromes; collectively, the outline and details are clear. Disease differentiation remains the same. Therefore, our understanding of repetition is not a mechanical repetition of using the same formula and herbs simply because the disease name is the same; rather, it is the repetition of combining disease and syndrome differentiation, analyzing specific conditions specifically, and treating based on syndrome differentiation. This is the essence of TCM. Zhang Zhongjing once said with confidence regarding his work: "I wrote *Shanghan Zabing Lun*, compiled into sixteen volumes. Although it may not cure all diseases, it allows one to see the disease and know its source." This is where the powerful vitality of this masterpiece lies for thousands of years.
Shaoyin Syndrome Deficiency Panting
(Bronchial Asthma)
Luo XX, Male, 26 years old. Farmer from a township in Shuangliu County, Sichuan.
[Medical History] In April 1962, due to wind-cold cough, profuse sputum, shortness of breath, and inability to lie flat, he was diagnosed with "bronchial asthma" at a certain hospital. After treatment, the condition improved. In the winter of 1963, cough intensified, palpitations and shortness of breath worsened, especially with movement, leading to bedridden status. After a period of treatment, it basically remitted. In spring 1964, the old disease relapsed, so he sought consultation.
[First Visit] Rattling phlegm sound in the throat, opening mouth and lifting shoulders, gasping for air, sweating during panting, profuse clear thin sputum, listless spirit, aversion to cold, cold limbs, facial swelling. Tongue was pale-dark, coating white, slippery, and greasy. This is caused by Shaoyin Yang deficiency and Yin excess, Qi failing to return to its origin, and cold-fluid retching upward. The method should be to strengthen Yang and drive out Yin, grasp Qi and return it to the Kidney, using Sini Tang (Four Reversal Decoction) with modifications as the main prescription.
Prescription:
Zhi Fupian (Prepared Aconiti Lateralis Radix) 30g (decocted for a long time), Shengjiang (Fresh Zingiberis Rhizoma) 30g, Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) 15g, Shang Rougui (Cinnamomi Cortex) 10g (dissolved in the decoction), Sharen (Amomi Fructus Rotundus) 12g, Baizhu (Atractylodis Macrocephalae Rhizoma) 12g.
Four doses.
[Second Visit] After taking the above prescription, asthma reduced. Add Fuling (Poria) to the original formula to enhance diuresis, dampness-draining, and phlegm-resolving effects. Continue taking for five doses.
[Third Visit] Asthma significantly reduced. Subsequently continued taking the above prescription for over a month to consolidate efficacy.
Follow-up in June 1979: After recovery, the next year he was transferred from rural areas to work in a factory. He persisted in full-time work, and the disease did not recur for fourteen years.
[Commentary] This case features urgent panting unable to continue, opening mouth and lifting shoulders, finding relief only after a long breath, indicating a deficiency syndrome due to insufficient Yuan Qi. This differs from excess syndromes where panting is obstructed, unable to distribute breath, finding relief only after exhaling residual air.
Deficiency panting is nothing but Qi deficiency. Qi resides in the Lung and roots in the Kidney. This deficiency panting presents with sweating during panting, worsening with movement, aversion to cold, cold limbs, facial edema, mental fatigue, thin sputum, pale tongue, and white coating, presenting a picture of Shaoyin deficiency panting. Therefore, throughout the treatment, the method of strengthening Yang, driving out Yin, tonifying Kidney, and grasping Qi was adhered to. When Yang is vigorous and pathogens eliminated, asthma naturally calms.
Shaoyin Syndrome Cough
(Chronic Bronchitis)
An XX, Female, 54 years old. Family member of military personnel in Beijing.
[Medical History] In 1966, due to wind-cold exposure, cough persisted for twelve years. It occurred every autumn and worsened in winter, sometimes making lying flat impossible. Diagnosed as chronic bronchitis at a certain hospital. Although medication could temporarily relieve attacks, they frequently recurred and worsened. She consulted in August 1978 and was treated according to Shaoyin Syndrome Water-Cold Internal Accumulation, achieving basic cure in three months.
[First Visit] Daily paroxysmal severe cough, clear thin sputum, profuse amount, dizziness, palpitations, shortness of breath, unable to lie flat day or night. Aversion to cold and wind, facial and foot edema, sallow complexion. Tongue was pale-dark with blood stasis spots, tongue body fat and tender with many teeth marks on edges, coating white and slippery, thick and greasy at the root. This is Shaoyin Yang deficiency with water overflowing, cold-phlegm obstructing the Lung causing cough. The method should be to warm Yang, transform Qi, and promote water metabolism, using Zhenwu Tang (True Warrior Decoction) with modifications as the main prescription.
Prescription:
Fuling (Poria) 24g, Shengjiang (Fresh Zingiberis Rhizoma) 30g, Baizhu (Atractylodis Macrocephalae Rhizoma) 20g, Zhi Fupian (Prepared Aconiti Lateralis Radix) 60g (decocted for a long time), Guizhi (Cinnamomi Ramulus) 10g.
Six doses.
[Syndrome Differentiation] The patient suffers annual autumn-winter external infections, triggering cough recurrence, mental fatigue, body weariness, aversion to cold, cold limbs, shortness of breath leaning on something for breathing difficulty, dull complexion, and pale-dark lusterless tongue, all clear signs of Kidney Yang decline. Since the Kidney is the Water Organ, if the True Yang in the Kidney declines and cannot transform Qi, water-fluid retention occurs internally. Water-cold Qi rising upward causes dizziness and palpitations. Water-Qi stopping in the chest and lungs causes incessant cough, profuse clear thin sputum, shortness of breath, and difficulty lying flat. Water-Qi overflowing into the muscle surface causes facial and foot edema and heaviness. Fat and tender tongue with teeth marks and blood stasis spots, white and thick greasy coating, are all images of water overflowing and cold coagulation. Moreover, being over fifty, Yang deficiency is even more severe. Many years ago, when initially contracting cold pathogen causing cough, healthy Qi was not deficient, allowing wind-cold pathogens to be resolved externally, possibly leading to a quick cure; now it is completely different. One must absolutely not abandon the root to seek the branch. In summary, this belongs to Shaoyin Kidney Yang decline, water-cold shooting into the Lung, so administering Zhenwu Tang (True Warrior Decoction) to warm Yang, scatter cold, transform Qi, and promote water metabolism is appropriate.
The modified Zhenwu Tang uses the acrid-hot nature of Fuzi to strengthen the primordial Yang of the Kidney, thus governing water; the bitter-dry nature of Baizhu establishes the Middle Earth (Spleen/Stomach), thus controlling water; combined with the acrid-dispersing nature of Shengjiang assisting Fuzi to tonify Yang; the light-permeating nature of Fuling assisting Baizhu to warm Earth, implying dispersing water and draining dampness; replacing Guizhi with Shaoyao accelerates warming meridians, scattering cold, transforming Qi, and promoting water metabolism.
[Second Visit] Taking the original formula continuously for six doses, cough significantly improved, sputum reduced by more than half, breathing smoother, gradually able to lie flat. Face no longer swollen, tongue slightly turned reddish, thick greasy coating decreased. The chronic ailment has achieved initial efficacy. Adhere to the original method, replace Shengjiang with Ganjiang to strengthen warming the middle and tonifying Spleen effects.
[Third Visit] Continuing the above prescription for six doses, all symptoms significantly reduced. Still slight cough, small amount of clear sputum. Tongue turned pale red, dark blood stasis spots and white greasy coating gradually receded, teeth marks on tongue edges no longer obvious. Occasionally feels shortness of breath and palpitations. The disease shows a trend of emerging from Yin to Yang. Must adapt to the turning point, unblock Yang, harmonize the middle, dry dampness, and wash away fluid retention. Use Linggui Zhugan Tang (Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction) with modifications, taken slowly.
Prescription:
Fuling (Poria) 20g, Guizhi (Cinnamomi Ramulus) 10g, Baizhu (Atractylodis Macrocephalae Rhizoma) 20g, Faxia (Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine) 15g, Shengjiang (Fresh Zingiberis Rhizoma) 20g, Gancao (Glycyrrhizae Radix et Rhizoma) 3g.
Twelve doses.
After taking twelve doses, all symptoms basically recovered. Since entering winter, no severe recurrence. Follow-up visit to patient's home on May 4, 1979, felt consistently good.
[Commentary] Cough syndromes can enter from the exterior or emerge from the interior. Regardless of whether external or internal, they can be differentiated according to the Six Meridians. This case of cough belongs to Shaoyin Yang deficiency, water overflowing forming phlegm, water-cold attacking the Lung, Kidney Yang deficiency affecting the Lung. There is water-Qi, and it is Shaoyin Cold Transformation. Therefore, administering Zhenwu Tang (True Warrior Decoction) strengthens primordial Yang to eliminate Yin shadows, drives out cold-phlegm to clear the water source. Without directly attacking the Lung, the Lung disease heals itself; without directly stopping cough, the cough calms down.
Shaoyin Syndrome Throat Bi
(Chronic Laryngitis, Polyps)
Huang XX, Female, 44 years old. Farmer from Tuanjie Township, Pixian County, Sichuan.
[Medical History] In April 1975, due to the death of her brother, witnessing the cremation scene, she was overwhelmed with grief. The next day, she felt discomfort in the throat, as if something was blocking it. This developed into breathing difficulties, even suffocation, palpitations, and body numbness. Examination by the ENT department of a certain hospital diagnosed "laryngitis" and "polyps", but treatment was ineffective. Transferred to several other hospitals, efficacy was poor, and the condition worsened. She consulted in May 1976.
[First Visit] Patient felt obvious blockage in the throat, slight pain. Lying on the left side caused breathlessness, palpitations, and whole-body numbness. Dizziness, body pain, fatigue, coughing up profuse foamy sputum, feeling slight trembling of blood vessels throughout the body, mental exhaustion, poor appetite, needing rest several times per meal, dull pain in the epigastrium preferring warm compresses, emaciation, difficult walking. Previous doctors treated with clearing heat and detoxifying, nourishing Yin and dissipating nodules. Took over a hundred doses, mainly self-harvested and decocted Xiakucao (Prunellae Spica), totaling two baskets. After more than a year of treatment, the more heat was cleared, the more fire seemed to flare upwards. Touching the tongue with a little warm water felt burning, teeth loosened and hurt. Lips blackish, tongue pale-dark, scanty coating not moist, pulse deep and fine. This resulted from sorrow and worry causing stagnation, forming Plum Pit Qi (a sensation of a foreign body in the throat), and due to insufficient healthy Qi and excessive intake of cooling medicines, transformed into Shaoyin Syndrome Throat Bi (throat obstruction due to Shaoyin deficiency-cold). First, use Banxia Houpo Tang (Pinellia and Magnolia Bark Decoction) with modifications to regulate Qi and dissipate stagnation.
Prescription:
Faxia (Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine) 15g, Houpo (Magnoliae Officinalis Cortex) 12g, Fuling (Poria) 12g, Shengjiang (Fresh Zingiberis Rhizoma) 15g, Ziyè (Perillae Folium) 10g, Ganjiang (Dried Zingiberis Rhizoma) 12g, Gancao (Glycyrrhizae Radix et Rhizoma) 10g.
Four doses.
[Second Visit] After four doses of the above prescription, throat felt more comfortable, breathlessness disappeared, swallowing normal. Still coughing, dizzy, body pain, indicating unresolved Taiyang Exterior Syndrome. The method should be to warm and unblock Shaoyin meridians, and simultaneously resolve the Taiyang exterior, using Mahuang Fuzi Gancao Tang (Ephedra, Aconite, and Licorice Decoction) with modifications as the main prescription.
Prescription:
Mahuang (Ephedrae Herba) 10g, Zhi Fupian (Prepared Aconiti Lateralis Radix) 120g (decocted for a long time), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) 60g, Ganjiang (Dried Zingiberis Rhizoma) 60g, Liao Xixin (Asari Radix et Rhizoma) 6g.
Six doses.
[Third Visit] After six doses, cough, dizziness, and body pain basically disappeared, sputum reduced, palpitations improved. Only polyps in the throat not fully dissolved, discomfort when lying on the left side. Still feels mental fatigue, toothache and loosening, tongue hurts when touching warm water. This is Shaoyin deficiency fire floating upward. The method should be to strengthen Yang and warm the Kidney, guide fire back to its source, using Sini Tang (Four Reversal Decoction) with modifications as the main prescription.
Prescription:
Zhi Fupian (Prepared Aconiti Lateralis Radix) 120g (decocted for a long time), Ganjiang Pian (Dried Zingiberis Rhizoma) 60g, Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) 45g, Shang Rougui (Cinnamomi Cortex) 12g (ground into powder, dissolved in the decoction), Liao Xixin (Asari Radix et Rhizoma) 6g.
[Syndrome Differentiation] This disease originated from Seven Emotions, sorrow and worry causing Qi stagnation, leading to phlegm-saliva stagnating in the throat, feeling like something is blocking it, unable to spit out or swallow, clearly Plum Pit Qi. As stated in *Jingui Yaolue*: "If a woman feels as if there is a piece of roasted meat in her throat, Banxia Houpo Tang governs it." However, considering the patient's systemic symptoms and referring to tongue and pulse, mental fatigue, weakness, palpitations, pale tongue, and deep-fine pulse indicate Yin excess and Yang depression, a Shaoyin Cold Transformation image. The Shaoyin meridian runs through the throat. Heart and Kidney Yang decline, healthy Qi is insecure, Yin Qi floats upward, combining with stagnant Qi and congealed saliva, causing throat blockage and pain. Even gathering and transforming, not only "feeling like roasted meat," but condensing into tangible polyps. Further blocking meridians and affecting Qi mechanism, thus blockage, breathlessness, palpitations, and body numbness arise successively.
Although the condition is complex, viewing the overall situation: the root lies in Shaoyin Heart-Kidney Yang deficiency, rootless fire disturbing upwards; the main symptom lies in Blood-Qi obstruction in the throat, belonging to deficiency-fire Throat Bi; the inducement is excessive sorrow causing Phlegm-Qi stagnation and counterflow; the accompanying symptom is Taiyang Wind-Cold exterior. Treatment should first open obstruction, benefit Qi, resolve phlegm, then address interior and exterior simultaneously, then concentrate superior forces to guide fire back to its source, breaking through the key point.
[Fourth Visit] After taking the above prescription continuously for four doses, all aforementioned symptoms significantly reduced. Excessive intake of cooling medicines depleted Yuan Qi, overwhelming too much, difficult to achieve full results in a short term. Should cultivate and tonify Spleen and Kidney, assist Yang and benefit Qi, using Lizhong Tang (Regulate the Middle Decoction) with modifications again.
Prescription:
Ludangshen (Codonopsis Radix) 15g, Ganjiang Pian (Dried Zingiberis Rhizoma) 20g, Chao Baizhu (Stir-fried Atractylodis Macrocephalae Rhizoma) 15g, Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) 12g, Zhi Fupian (Prepared Aconiti Lateralis Radix) 30g (decocted for a long time), Shang Rougui (Cinnamomi Cortex) 10g.
Instruct to continue taking for over ten doses, avoid raw/cold foods, refrain from worry, pay attention to regulation and care.