1979年7月追访，患者说： “我第一次服这样重的热药，很怕上火，小心试着服，结果几剂药后，反觉得比较舒服，喉部就不堵了，从此，三年来未再发病”。
(按语]《素问·阴阳别论篇》云： “一阴一阳结谓之喉痹”。结者，气结痰凝；痹者，闭也。既然如此，辨证施治之症结，在于如何辨其阴阳，突破其闭阻。一般治疗此类喉证，多以属阳、属热，药用甘寒之品。而干姜之燥，附子之热，则视为大忌。
范老针对此类病证常说： “口内少实火”。临床所见，凡虚火上炎，郁结于喉；尤以正气不足，证属少阴者，概用寒凉之剂，则邪聚益甚。而投以辛温，则其郁反通。不仅郁结于咽嗌之客寒，温之能散；且怫郁于咽喉之客热，散之即通。此即“微者逆之，甚者从之” (《素问·至真要大论篇》)之意也。
少阴证喉痹
(慢性咽炎)
李××，男，36岁。四川三台县某厂干部。
(病史]1971年5月，咽部有异物感，吞咽不利，并伴有项强、胸满、肩酸、背痛等证。××医院诊为“慢性咽炎”，服用炎得平、六神丸、四环素类，并外用冰硼散治疗，病势不减。后续服清咽利膈、泄热解毒中药约半年，咽喉疾患益重，并出现恶寒身痛，胸憋气短，胃腹胀痛，完谷不化等证，自疑“癌”变，思想包袱沉重。于1972年2月22日来蓉求治。
[初诊]咽痛，吞咽如有阻塞，胸满，纳呆，便溏，头痛，咳痰，四肢清冷。舌质偏淡，苔微黄滑，脉弱无力。此病乃过服凉药，以致阳气虚微，复因旅途劳累，受风寒侵袭。本少阴喉痹，今又兼太阳外邪。以麻黄附子甘草汤加细辛、生姜，扶阳解表，通达内外。
处方：
麻黄10克制附片60克(久煎) 甘草20克细辛3克生姜30克四剂
(二诊]头痛，胸满，咳痰俱减，余证无明显变化，原方再服四剂。
[三诊]身疼减，饮食增，便溏止，咽痛痹阻稍有好转。因肾阳虚衰，阴气上腾，痰湿上干清道，日久凝聚较深，致喉痹难愈。以大剂四逆汤， 壮阳驱阴，加上肉桂温营血，助气化，益火消阴，散寒止痛。
处方：
制附片120克(久煎) 干姜60克炙甘草30克上肉桂12克(冲服)
三剂
[四诊]咽痛痹阻之证基本消失，精神大振。久病气血皆亏，应培补脾肾，以理中丸加阴阳平补之品，嘱其缓服。
处方：
党参30克 白术30克 干姜30克制附片60克上肉桂15克紫河车30克冬虫夏草30克菟丝子30克炙甘草20克共研细末，水打丸。日服三次，每次10克月余后，其友来告，患者已病愈上班。
1979年8月3日追访，至今良好。
[按语]本例喉痹，曾服大量清凉退热之品，病势不减而反增；参之舌、脉诸证，显然与风热、燥热等邪实上犯之喉痛，有原则区别。
喉痹之证，须分阴阳。由于少阴经脉循于咽喉，故咽喉疼痛与痹阻，属少阴病者屡见不鲜。 《伤寒论》中，少阴咽痛证，大致有虚热咽痛，客热咽痛，痰热闭阻咽痛及客寒咽痛几种。考此例属客寒咽痛，因喉痹日久，邪聚益甚，且少阴寒化之证突出；而初诊时，太阳伤寒之兼证又比较明显。故首以太阳少阴两经同治，寓解表于壮阳。再峻投四逆汤加昧，以补命门，散寒滞。最后，培补脾肾以收功。
少阴证舌强
王××，男，60岁。内蒙古某厂干部。
[病史]1970年末，在架设变压器时，被钢丝绳撞击头部，当即昏迷约8分钟，急送当地×x医院，诊为“急性脑震荡”。约一月内均处于意识模糊，吐字不清，口角流涎状态。其后仍觉头晕、头胀、恶心、呕吐、畏声音刺激。经治疗两月，上述诸症有好转，但严重失眠，且似睡非睡之状，持续7年余。头左侧偶有闪电般剧痛，发作后则全身汗出。1976年5月开始觉舌干、舌强，说话不灵，下肢沉重，后逐渐发展至左上肢厥冷麻木。到1979年2月，出现神志恍惚，气短，动则尤甚，纳呆，病情加重。同年11月内蒙××医院诊断为“脑震荡后遗症”，转北京治疗，于1980年1月3日来诊。
[初诊]舌强，舌干，难以转动已三年余。尤其晨起为甚，须温水饮漱之后，才能说话，舌苔干厚，刮之有声。纳差，畏寒，左上肢麻木，活动不灵，下肢沉重无力，左肢较甚。七年来双足反觉热，卧时不能覆盖，否则心烦不安。步履艰难，扶杖可以勉强缓行数十米，动则喘息不已。小便清长频数。面色黄滞晦暗，眼睑浮肿，精神萎靡。舌质暗淡，少津，伸出向左偏斜，苔灰白腻，脉沉。此为少阴阳衰阴盛证，以四逆汤主之。
处方：
制附片60克(久煎)干姜30克炙甘草30克二剂
(辨证]此例脑外伤，酿成后遗之证多年。来诊时，神靡，恶寒，内寒外热，四肢沉重， 舌淡，脉沉，一派少阴阳衰阴盛之候。陆渊雷云： “少阴病者，心力不振，全身机能衰减之病也。”患者头部受重物撞击，长期失眠，纳呆，甚则神志恍惚，肢体麻木，迁延过久，必致全身机能衰减，心肾阳气俱伤。盖头为诸阳之会，舌为心之苗。心力不振， 肾阳衰微，津液不能上达，可引起舌强难言。证属少阴寒化，阳衰阴盛，即投以四逆汤为治。
[二诊]11月7口。主诉：服完一剂，半夜醒来，自觉舌有津液，已能转动，遂情不自禁，唤醒陪伴说：舌头好多啦，我能说话了!起床后，下肢沉重感亦减轻。服完两剂，舌强、舌干、转动困难之症显著减轻。守原方再进五剂。
[三诊]1月14日。舌强、舌干进一步好转。左上肢麻木、畏寒减轻。舌根部尚有强硬感，仍稍觉气一短，眼睑浮肿，食少寐差，舌淡苔白。少阴寒化已深，又累及太阴脾阳衰惫，以四逆、理中合方加减为治。
处方：
制附片60克(久煎)干姜30克炙甘草20克白术30克茯苓30克桂枝lO克五剂
[四诊]1月21日。舌强、舌干已愈大半。可离杖行动，独自登上四楼，左上肢凉麻消失，摆动有力。双足已无发热感，夜卧覆被如常，寐安，食欲增加。以上方加上肉桂10克，增强益阳消阴，峻补命火之效，再进五剂。
(五诊]1月28日。患者精神振奋，诸症显著好转，要求回家过春节。为巩固疗效，嘱其原方续服十剂。
(按语]此例虽属外伤，但其主证，已不在外而在里，属少阴寒化。外伤可循经入里，伤科亦能从内而治。《伤寒论翼》云： “仲景治法，悉本内经。按歧伯日：调治之方，必别阴阳：阳病治阴， 阴病治阳。定其中外，各守其乡”。又云： “仲景约法，能合百病”。范老在临证中，对于某些外科疾病，亦遵仲景六经学术思想，扩展加以运用。抓住六经主证及其变化，内外相参，立法处方，外伤每随之迎刃而解；或配合外治之法，常获捷效。
少阴证心悸
(植物神经功能紊乱)
于××，女，40岁。北京市某商店职工。
[病史]1973年初，自觉眩晕。至1976年病情加重，心悸，手麻，上肢震颤。××医院诊断为： “植物神经功能紊乱”。长期服中药调补，疗效不显。
[初诊]1978年10月13日。心悸，气短，胸闷，眩晕，纳呆，夜卧不宁，背畏寒，膝关节疼痛，肩臂肌肉时有颤抖。月经提前一周，色暗，有淤块。面浮肿，舌淡，苔白滑，脉沉细。病情虽错综复杂，主证乃少阴心肾阳衰，法宜温通心阳，益火之源，以桂枝甘草汤加味主之。
处方：
桂枝10克炙甘草20克 制附片30克(久煎)
生姜30克四剂
[二诊]10月17日。服上方后，心悸头晕减，余证如前。原方再进四剂。
[三诊]10月23日。心悸．头晕、失眠、乏力，均明显好转。但仍面浮、背凉，关节痛，肌肉震颤。上方加麻黄lO克，辽细辛3克，以散经络之寒湿。服三剂。
[四诊]10月28日。自觉胸中宽舒，关节痛减。守原法，加炮姜、血余炭各30克，再进五剂，以温经逐淤而生新。
[五诊]11月17日。心悸、头晕基本消失，余证 均已好转。令再服五剂。
1979年5月10日随访，病未复发。
[按语]本例心悸诸证，病情交织错杂。但其主证乃手足少阴心肾虚衰之病变。正如《伤寒明理论1)>所说： “其气虚者，由阳气虚弱，心下空虚，内动而为悸也”。其病根又在于肾阳不振，不能升腾上济于心所致。始终以补肾气、通心阳为治。故投桂枝甘草汤加味，以桂枝为君，入心助阳；甘草佐之，以补中气；二者相得，辛甘合化，则有温通心阳之功。真气之根既藏于肾，故加附子，大补命门火种，配生姜开提散郁，逐阴行阳之意也。因兼有经络之寒郁，故少佐麻黄、辽细辛。肾气旺而气血和，诸证即可迎刃而解。
少阴证虚损
陈××，男，28岁。解放军某部医生。
[病史]1971年，到西藏某地执行任务，长期风餐露宿而致病。开始自觉指尖、手掌、下肢关节咯咯作响，继而面肿，心悸，腰痛，彻夜不眠。某部医院曾按“肾炎”治疗一段时问。后又改服清热解毒之品，包括犀角、羚角等。逐渐行走乏力，神疲纳呆。其后按“肝肾虚损，气血亏耗”论治，服滋补之剂。曾出现脑内如鸣，头顶发脱，心悸加重，动则气喘，身出冷汗，肢体皆痛，四肢麻木等证。至1977年1月3日，自觉口内从左侧冒出一股凉气，频吐白泡沫痰涎，胸中如有水荡漾，左耳不断渗出黄水，听力减退，走路摇摆不定。血压70／50毫米汞柱。同年5月22日，突然昏倒。急入××医院，住院治疗三月，未查明病因。面部及双下肢浮肿加重，头昏胀难忍，转送××医院会诊。左半身痛、温觉明显减退，左上肢难举，提睾反射消失，悬雍垂向左弯曲，舌向左偏。结论为： “左半身麻木，感痛觉障碍，左上肢无力，水肿待诊。”数年来，服中药千余剂。1977年9月，转来就诊。
[初诊]面部与双下肢肿胀，左半身及手足麻木，四肢厥冷，脑呜，头摇，神疲，心悸，失眠，记忆力及听力减退，身痛，胁痛。口中频频冒冷气，吐大量泡沫痰涎，纳呆，大便稀薄，小便失禁。舌质暗淡、胖嫩，边缘齿痕明显，苔白滑厚腻而紧密，脉沉细。此为少阴寒化，迁延日久，阴盛阳微， 气血亏损，已成坏病。法宜回阳救逆，化气行水。以四逆汤、真武汤加减主之。
处方：
制附片120克(久煎)干姜60克生姜120克炙甘草30克 茯苓30克 白术30克桂枝lO克辽细辛6克[二诊]上方服二十剂，脑鸣消失，心悸好转，面部及下肢浮肿显著消退，小便失禁转为余沥。多年痼疾初见成效，守原方续服。
制附片120克(久煎)干姜60克炙甘草60克桂枝10克生姜皮60克辽细辛3克 茯苓30克[三诊]服十剂后，口中已不冒凉气，神疲、肢冷、纳呆。便溏均有好转，但仍不断吐白沫，余证尚无明显改善。少阴阳衰日久，沉寒痼冷已深，积重难返。法宜益火消阴，温补肾阳，以四逆汤加上肉桂，嘱其坚持服用。可连服四、五剂后，停药两天再服，直至身体自觉温暖为止。并配服自制坎离丹。
处方：
制附片60克(久煎) 干姜30克炙甘草30克 上肉桂10克(冲服)
上方连服半年，全身肿胀消退，摇头基本控制，身痛和手足麻木显著减轻，心悸明显消失，吐白沫：欠减，二便正常。血压回升到120／80毫米汞柱，身体逐渐恢复正常。
1979年11月20日随访：于1978年下半年病基本痊愈，重新走上工作岗位。
[按语]本例患者，病情较重，迁延日久，加以误补误治，日益恶化。初诊时已明显可见三阴俱病，五脏虚损：心悸失眠，神疲肢冷，舌淡胖嫩，为手少阴心阳虚弱；头摇。脑鸣、发脱、胁痛，为足厥阴肝血亏损；浮肿、纳呆、便溏，为足太阴脾土虚甚；口中频冒冷气，吐大量泡沫痰涎，为手太阴肺气内伤；四肢厥逆，小便失禁，精神萎靡，记忆力和听力减退，为足少阴肾阳衰微。身痛、左半身及手足麻木，为风寒湿长期留滞肌肉经络，逐渐深入筋骨，正气日虚，精血耗损。可见，患者全身性之里虚寒证，十分明显。病情虽复杂，其症结实属少阴寒化，心肾阳微，尤以肾阳衰败为甚。所谓“五脏之伤，穷必及肾”。故抓住根本，坚持回阳救逆，益火消阴，大补命门真火，峻逐脏腑沉寒，守四逆辈，连服半载，多年痼疾始得突破。
少阴证偏枯
(脑血管意外)
陈××，女，65岁。成都市某公司职工家属。
[病史]平素身体尚好，未患过大病。1963年10月间，正从事家务劳动，忽觉头似重物压顶，旋即昏仆，不省人事。急邀某中医来诊，用温针刺百会穴，约十五分钟，苏醒。左侧上下肢已偏瘫，口歪斜，流清泫涎不止，成都××中医院诊为： “中风”。××医院确诊为： “脑血管意外”。其后，由中医诊治，病未发展。每年秋冬开始卧床，直到次年春，天暖后可扶床缓慢移步。1971年冬，病势沉重，患者一再告之家人：今冬难以熬过，命备后事。遂来求诊。
[初诊]入冬以来，畏寒踡卧，重被覆盖，左侧手足仍厥冷。头部发木，如盛盒内。左侧偏枯，骨瘦如柴。脸面浮肿，面色苍白。舌质淡，苔白腻。半身不遂多年，阳气日衰，属少阴寒化，阴寒内盛，阳虚水泛已极。急须回阳救逆，化气行水，以四逆汤并真武汤加减主之。
1979年7月随访，患者说：“我第一次服用如此大剂量的温热药物，非常担心会上火（出现热性症状），于是小心翼翼地尝试服用，结果服药几剂后，反而觉得比较舒适，喉部的堵塞感消失了。从此以后，三年间没有再复发。”
[按语]《素问·阴阳别论篇》中说：“一阴一阳结，谓之喉痹。”所谓“结”，是指气机郁结、痰湿凝聚；所谓“痹”，是指闭塞不通。既然如此，辨证施治的关键，在于如何辨别其属于阴证还是阳证，从而突破其闭阻状态。一般治疗此类咽喉病症，多认为属于阳证、热证，用药多用甘寒性质的药物。而干姜的燥烈、附子的温热，则被视为大忌。
范中林老针对此类病证常说：“口内少实火”（口腔内很少存在真正的实热之火）。临床所见，凡是虚火上炎，郁结于咽喉；尤其是正气不足，证属少阴经者，如果一概使用寒凉药物，则邪气聚集会更加严重。而如果投用辛温药物，则郁结反而得以疏通。这不仅是因为郁结于咽部的客寒之邪，用温法可以消散；而且怫郁于咽喉的客热之邪，用散法也能通畅。这就是《素问·至真要大论篇》中“微者逆之，甚者从之”的意思。
李××，男，36岁。四川三台县某厂干部。
[病史] 1971年5月，咽部有异物感，吞咽不利，并伴有项部僵硬、胸部胀满、肩酸、背痛等症状。××医院诊断为“慢性咽炎”，服用炎得平、六神丸、四环素类药物，并外用冰硼散治疗，病情未见减轻。后续又服用清咽利膈、泄热解毒的中药约半年，咽喉疾患更加严重，并出现恶寒身痛、胸闷气短、胃腹胀痛、完谷不化（大便中含有未消化的食物）等症状，自己怀疑是“癌症”病变，思想包袱沉重。于1972年2月22日来成都求治。
[初诊] 咽痛，吞咽时有阻塞感，胸满，食欲不振，大便溏薄，头痛，咳痰，四肢清冷。舌质偏淡，苔微黄滑，脉弱无力。此病乃因过服凉药，导致阳气虚弱微小，又因旅途劳累，受风寒侵袭所致。本为少阴喉痹，如今又兼有太阳经外邪。以麻黄附子甘草汤加细辛、生姜，扶助阳气，解除表邪，通达内外。
处方：
麻黄10克，制附片60克（久煎），甘草20克，细辛3克，生姜30克。四剂。
[二诊] 头痛、胸满、咳痰均减轻，其余症状无明显变化，原方再服四剂。
[三诊] 身体疼痛减轻，饮食增加，大便溏止，咽痛痹阻稍有好转。因肾阳虚衰，阴气上腾，痰湿上犯清窍，日久凝聚较深，导致喉痹难愈。以大剂量四逆汤，壮阳驱阴，加上肉桂温养营血，助气化，益火消阴，散寒止痛。
处方：
制附片120克（久煎），干姜60克，炙甘草30克，上肉桂12克（冲服）。三剂。
[四诊] 咽痛痹阻之证基本消失，精神大振。久病气血皆亏，应培补脾肾，以理中丸加阴阳平补之品，嘱其缓慢服用。
处方：
党参30克，白术30克，干姜30克，制附片60克，上肉桂15克，紫河车30克，冬虫夏草30克，菟丝子30克，炙甘草20克。共研细末，水泛为丸。日服三次，每次10克。月余后，其友来告，患者已病愈上班。
1979年8月3日随访，至今良好。
[按语] 本例喉痹，曾服用大量清凉退热之品，病势不减反而加重；参合舌象、脉象及其他症状，显然与风热、燥热等邪实上犯之喉痛，有原则区别。
喉痹之证，须分阴阳。由于少阴经脉循行于咽喉，故咽喉疼痛与痹阻，属少阴病者屡见不鲜。《伤寒论》中，少阴咽痛证，大致有虚热咽痛、客热咽痛、痰热闭阻咽痛及客寒咽痛几种。考证此例属于客寒咽痛，因喉痹日久，邪气聚集更加严重，且少阴寒化之证突出；而初诊时，太阳伤寒之兼证又比较明显。故首以太阳、少阴两经同治，寓解表于壮阳之中。再峻投四逆汤加减，以补命门之火，散寒滞。最后，培补脾肾以收功。
王××，男，60岁。内蒙古某厂干部。
[病史] 1970年末，在架设变压器时，被钢丝绳撞击头部，当即昏迷约8分钟，急送当地××医院，诊为“急性脑震荡”。约一月内均处于意识模糊、吐字不清、口角流涎状态。其后仍觉头晕、头胀、恶心、呕吐、畏声音刺激。经治疗两月，上述诸症有好转，但严重失眠，且似睡非睡之状，持续7年余。头左侧偶有闪电般剧痛，发作后则全身汗出。1976年5月开始觉舌干、舌强，说话不灵，下肢沉重，后逐渐发展至左上肢厥冷麻木。到1979年2月，出现神志恍惚，气短，动则尤甚，纳呆，病情加重。同年11月内蒙××医院诊断为“脑震荡后遗症”，转北京治疗，于1980年1月3日来诊。
[初诊] 舌强，舌干，难以转动已三年余。尤其晨起为甚，须温水饮漱之后，才能说话，舌苔干厚，刮之有声。纳差，畏寒，左上肢麻木，活动不灵，下肢沉重无力，左肢较甚。七年来双足反觉热，卧时不能覆盖，否则心烦不安。步履艰难，扶杖可以勉强缓行数十米，动则喘息不已。小便清长频数。面色黄滞晦暗，眼睑浮肿，精神萎靡。舌质暗淡，少津，伸出向左偏斜，苔灰白腻，脉沉。此为少阴阳衰阴盛证，以四逆汤主之。
处方：
制附片60克（久煎），干姜30克，炙甘草30克。二剂。
[辨证] 此例脑外伤，酿成后遗之证多年。来诊时，神靡，恶寒，内寒外热，四肢沉重，舌淡，脉沉，一派少阴阳衰阴盛之候。陆渊雷云：“少阴病者，心力不振，全身机能衰减之病也。”患者头部受重物撞击，长期失眠，纳呆，甚则神志恍惚，肢体麻木，迁延过久，必致全身机能衰减，心肾阳气俱伤。盖头为诸阳之会，舌为心之苗。心力不振，肾阳衰微，津液不能上达，可引起舌强难言。证属少阴寒化，阳衰阴盛，即投以四逆汤为治。
[二诊] 11月7日。主诉：服完一剂，半夜醒来，自觉舌有津液，已能转动，遂情不自禁，唤醒陪伴说：舌头好多啦，我能说话了！起床后，下肢沉重感亦减轻。服完两剂，舌强、舌干、转动困难之症显著减轻。守原方再进五剂。
[三诊] 1月14日。舌强、舌干进一步好转。左上肢麻木、畏寒减轻。舌根部尚有强硬感，仍稍觉气短，眼睑浮肿，食少寐差，舌淡苔白。少阴寒化已深，又累及太阴脾阳衰惫，以四逆、理中合方加减为治。
处方：
制附片60克（久煎），干姜30克，炙甘草20克，白术30克，茯苓30克，桂枝10克。五剂。
[四诊] 1月21日。舌强、舌干已愈大半。可离杖行动，独自登上四楼，左上肢凉麻消失，摆动有力。双足已无发热感，夜卧覆被如常，寐安，食欲增加。以上方加上肉桂10克，增强益阳消阴，峻补命火之效，再进五剂。
[五诊] 1月28日。患者精神振奋，诸症显著好转，要求回家过春节。为巩固疗效，嘱其原方续服十剂。
[按语] 此例虽属外伤，但其主证，已不在外而在里，属少阴寒化。外伤可循经入里，伤科亦能从内而治。《伤寒论翼》云：“仲景治法，悉本内经。按歧伯曰：调治之方，必别阴阳：阳病治阴，阴病治阳。定其中外，各守其乡”。又云：“仲景约法，能合百病”。范老在临证中，对于某些外科疾病，亦遵仲景六经学术思想，扩展加以运用。抓住六经主证及其变化，内外相参，立法处方，外伤每随之迎刃而解；或配合外治之法，常获捷效。
于××，女，40岁。北京市某商店职工。
[病史] 1973年初，自觉眩晕。至1976年病情加重，心悸，手麻，上肢震颤。××医院诊断为：“植物神经功能紊乱”。长期服中药调补，疗效不显。
[初诊] 1978年10月13日。心悸，气短，胸闷，眩晕，纳呆，夜卧不宁，背畏寒，膝关节疼痛，肩臂肌肉时有颤抖。月经提前一周，色暗，有淤块。面浮肿，舌淡，苔白滑，脉沉细。病情虽错综复杂，主证乃少阴心肾阳衰，法宜温通心阳，益火之源，以桂枝甘草汤加味主之。
处方：
桂枝10克，炙甘草20克，制附片30克（久煎），生姜30克。四剂。
[二诊] 10月17日。服上方后，心悸头晕减，余证如前。原方再进四剂。
[三诊] 10月23日。心悸、头晕、失眠、乏力，均明显好转。但仍面浮、背凉，关节痛，肌肉震颤。上方加麻黄10克，辽细辛3克，以散经络之寒湿。服三剂。
[四诊] 10月28日。自觉胸中宽舒，关节痛减。守原法，加炮姜、血余炭各30克，再进五剂，以温经逐淤而生新。
[五诊] 11月17日。心悸、头晕基本消失，余证均已好转。令再服五剂。
1979年5月10日随访，病未复发。
[按语] 本例心悸诸证，病情交织错杂。但其主证乃手足少阴心肾虚衰之病变。正如《伤寒明理论》所说：“其气虚者，由阳气虚弱，心下空虚，内动而为悸也”。其病根又在于肾阳不振，不能升腾上济于心所致。始终以补肾气、通心阳为治。故投桂枝甘草汤加味，以桂枝为君，入心助阳；甘草佐之，以补中气；二者相得，辛甘合化，则有温通心阳之功。真气之根既藏于肾，故加附子，大补命门火种，配生姜开提散郁，逐阴行阳之意也。因兼有经络之寒郁，故少佐麻黄、辽细辛。肾气旺而气血和，诸证即可迎刃而解。
**少阴证虚损**
陈××，男，28岁。解放军某部医生。
[病史] 1971年，到西藏某地执行任务，长期风餐露宿而致病。开始自觉指尖、手掌、下肢关节咯咯作响，继而面肿，心悸，腰痛，彻夜不眠。某部医院曾按“肾炎”治疗一段时间。后又改服清热解毒之品，包括犀角、羚角等。逐渐行走乏力，神疲纳呆。其后按“肝肾虚损，气血亏耗”论治，服滋补之剂。曾出现脑内如鸣，头顶发脱，心悸加重，动则气喘，身出冷汗，肢体皆痛，四肢麻木等证。至1977年1月3日，自觉口内从左侧冒出一股凉气，频吐白泡沫痰涎，胸中如有水荡漾，左耳不断渗出黄水，听力减退，走路摇摆不定。血压70／50毫米汞柱。同年5月22日，突然昏倒。急入××医院，住院治疗三月，未查明病因。面部及双下肢浮肿加重，头昏胀难忍，转送××医院会诊。左半身痛、温觉明显减退，左上肢难举，提睾反射消失，悬雍垂向左弯曲，舌向左偏。结论为：“左半身麻木，感痛觉障碍，左上肢无力，水肿待诊。”数年来，服中药千余剂。1977年9月，转来就诊。
[初诊] 面部与双下肢肿胀，左半身及手足麻木，四肢厥冷，脑鸣，头摇，神疲，心悸，失眠，记忆力及听力减退，身痛，胁痛。口中频频冒冷气，吐大量泡沫痰涎，纳呆，大便稀薄，小便失禁。舌质暗淡、胖嫩，边缘齿痕明显，苔白滑厚腻而紧密，脉沉细。此为少阴寒化，迁延日久，阴盛阳微，气血亏损，已成坏病。法宜回阳救逆，化气行水。以四逆汤、真武汤加减主之。
处方：
制附片120克（久煎），干姜60克，生姜120克，炙甘草30克，茯苓30克，白术30克，桂枝10克，辽细辛6克。
[二诊] 上方服二十剂，脑鸣消失，心悸好转，面部及下肢浮肿显著消退，小便失禁转为余沥。多年痼疾初见成效，守原方续服。
制附片120克（久煎），干姜60克，炙甘草60克，桂枝10克，生姜皮60克，辽细辛3克，茯苓30克。
[三诊] 服十剂后，口中已不冒凉气，神疲、肢冷、纳呆、便溏均有好转，但仍不断吐白沫，余证尚无明显改善。少阴阳衰日久，沉寒痼冷已深，积重难返。法宜益火消阴，温补肾阳，以四逆汤加上肉桂，嘱其坚持服用。可连服四、五剂后，停药两天再服，直至身体自觉温暖为止。并配服自制坎离丹。
处方：
制附片60克（久煎），干姜30克，炙甘草30克，上肉桂10克（冲服）。
上方连服半年，全身肿胀消退，摇头基本控制，身痛和手足麻木显著减轻，心悸明显消失，吐白沫减少，二便正常。血压回升到120／80毫米汞柱，身体逐渐恢复正常。
1979年11月20日随访：于1978年下半年病基本痊愈，重新走上工作岗位。
[按语] 本例患者，病情较重，迁延日久，加以误补误治，日益恶化。初诊时已明显可见三阴俱病，五脏虚损：心悸失眠，神疲肢冷，舌淡胖嫩，为手少阴心阳虚弱；头摇、脑鸣、发脱、胁痛，为足厥阴肝血亏损；浮肿、纳呆、便溏，为足太阴脾土虚甚；口中频冒冷气，吐大量泡沫痰涎，为手太阴肺气内伤；四肢厥逆，小便失禁，精神萎靡，记忆力和听力减退，为足少阴肾阳衰微。身痛、左半身及手足麻木，为风寒湿长期留滞肌肉经络，逐渐深入筋骨，正气日虚，精血耗损。可见，患者全身性之里虚寒证，十分明显。病情虽复杂，其症结实属少阴寒化，心肾阳微，尤以肾阳衰败为甚。所谓“五脏之伤，穷必及肾”。故抓住根本，坚持回阳救逆，益火消阴，大补命门真火，峻逐脏腑沉寒，守四逆辈，连服半载，多年痼疾始得突破。
陈××，女，65岁。成都市某公司职工家属。
[病史] 平素身体尚好，未患过大病。1963年10月间，正从事家务劳动，忽觉头似重物压顶，旋即昏仆，不省人事。急邀某中医来诊，用温针刺百会穴，约十五分钟，苏醒。左侧上下肢已偏瘫，口歪斜，流清泫涎不止，成都××中医院诊为：“中风”。××医院确诊为：“脑血管意外”。其后，由中医诊治，病未发展。每年秋冬开始卧床，直到次年春，天暖后可扶床缓慢移步。1971年冬，病势沉重，患者一再告之家人：今冬难以熬过，命备后事。遂来求诊。
[初诊] 入冬以来，畏寒踡卧，重被覆盖，左侧手足仍厥冷。头部发木，如盛盒内。左侧偏枯，骨瘦如柴。脸面浮肿，面色苍白。舌质淡，苔白腻。半身不遂多年，阳气日衰，属少阴寒化，阴寒内盛，阳虚水泛已极。急须回阳救逆，化气行水，以四逆汤并真武汤加减主之。
In July 1979, during follow-up, the patient stated: "When I first took such a heavy dose of hot (warming) medicine, I was very afraid of 'shanghuo' (developing heat symptoms), so I cautiously tried taking it. As a result, after taking a few doses, I felt relatively comfortable, and the blockage in my throat disappeared. Since then, I have not had a recurrence for three years."
[Commentary] The *Suwen* (Basic Questions), Chapter on Differentiations of Yin and Yang, states: "The binding of one Yin and one Yang is called Hou Bi (throat obstruction)." "Jie" (binding) refers to Qi stagnation and phlegm condensation; "Bi" (obstruction) refers to closure. Given this, the crux of syndrome differentiation and treatment lies in how to differentiate between Yin and Yang syndromes to break through the obstruction. Generally, when treating such throat conditions, they are often considered as Yang or Heat syndromes, and medicines used are mostly sweet and cold in nature. The dryness of Ganjiang (Dried Ginger) and the heat of Fuzi (Prepared Aconite Root) are regarded as major taboos.
Old Man Fan often said regarding such diseases: "There is little true Fire in the mouth." In clinical practice, whenever deficiency Fire flares upward and knots in the throat; especially in cases where Zhengqi (Upright Qi) is insufficient and the syndrome belongs to Shaoyin, if one uniformly uses cold and cool agents, the pathogenic factors will gather even more severely. However, if pungent-warm agents are administered, the stagnation will instead be unblocked. This is not only because the external Cold lodged in the pharynx can be scattered by warming methods; but also because the external Heat stifled in the throat can be unblocked by dispersing methods. This embodies the meaning of "For minor [pathogens], treat contrary to them; for severe [pathogens], treat following them" from the *Suwen*, Chapter on the Most Essential and Important Treatments.
**Shaoyin Syndrome Hou Bi**
(Chronic Pharyngitis)
Li XX, Male, 36 years old. Cadre at a factory in Santai County, Sichuan.
[Medical History] In May 1971, he felt a foreign body sensation in his throat and difficulty swallowing, accompanied by stiffness in the neck, chest fullness, shoulder soreness, and back pain. Diagnosed with "chronic pharyngitis" at XX Hospital, he took Yandeping, Liushen Wan, and tetracyclines, and used Bingpeng San externally. The condition did not improve. Subsequently, he took Chinese herbal medicines for clearing the throat, benefiting the diaphragm, draining heat, and detoxifying for about half a year. His throat disease worsened, and he developed aversion to cold with body pain, chest oppression with shortness of breath, abdominal distension and pain, and undigested food in stool. He suspected cancer and carried a heavy psychological burden. He came to Chengdu for treatment on February 22, 1972.
[First Visit] Throat pain, feeling of obstruction when swallowing, chest fullness, poor appetite, loose stools, headache, cough with sputum, and cold limbs. Tongue body pale, coating slightly yellow and slippery, pulse weak and powerless. This illness resulted from excessive intake of cooling medicines, leading to extremely deficient and minute Yang Qi, compounded by travel fatigue and invasion of Wind-Cold. It is originally Shaoyin Hou Bi, now complicated by Taiyang exterior pathogens. Use Mahuang Fuzi Gancao Tang plus Xixin and Shengjiang to support Yang, release the exterior, and unblock interior and exterior.
Prescription:
Mahuang 10g, Zhi Fupian 60g (decocted for a long time), Gancao 20g, Xixin 3g, Shengjiang 30g. Four doses.
[Second Visit] Headache, chest fullness, and cough with sputum all decreased; other symptoms showed no significant change. Continue the original prescription for four more doses.
[Third Visit] Body pain decreased, appetite increased, loose stools stopped, and throat pain/obstruction improved slightly. Due to Kidney Yang deficiency and decline, Yin Qi ascends, and phlegm-dampness invades the clear orifices. Long-standing condensation makes Hou Bi difficult to cure. Use a large dose of Sini Tang to strengthen Yang and drive out Yin, adding Rougui to warm Ying-Blood, assist Qi transformation, benefit Fire to eliminate Yin, scatter Cold, and stop pain.
Prescription:
Zhi Fupian 120g (decocted for a long time), Ganjiang 60g, Zhi Gancao 30g, Shang Rougui 12g (dissolved). Three doses.
[Fourth Visit] Symptoms of throat pain and obstruction basically disappeared; spirit greatly revitalized. Chronic illness has depleted both Qi and Blood; Spleen and Kidney should be nourished. Use Lizhong Wan plus Yin-Yang balancing herbs, advised to take slowly.
Prescription:
Renshen (Dangshen) 30g, Baizhu 30g, Ganjiang 30g, Zhi Fupian 60g, Shang Rougui 15g, Ziheche 30g, Dongchongxiacao 30g, Tusizi 30g, Zhi Gancao 20g. Grind into fine powder, make pills with water. Take three times daily, 10g each time. Over a month later, his friend reported that the patient had recovered and returned to work.
Follow-up on August 3, 1979: Condition remains good.
[Commentary] This case of Hou Bi involved taking large amounts of cooling and heat-clearing substances, yet the condition did not subside but worsened; combined with tongue and pulse signs, it clearly differs in principle from throat pain caused by excess pathogens like Wind-Heat or Dry-Heat attacking upwards.
Hou Bi must be differentiated by Yin and Yang. Since the Shaoyin meridian circulates around the throat, throat pain and obstruction belonging to Shaoyin disease are common. In the *Shanghan Lun*, Shaoyin throat pain syndromes roughly include deficiency-heat throat pain, external-heat throat pain, phlegm-heat obstructed throat pain, and external-cold throat pain. This case belongs to external-cold throat pain. Because Hou Bi has persisted for a long time, pathogenic factors have gathered severely, and the Shaoyin cold-transformation syndrome is prominent; additionally, at the first visit, the complication of Taiyang Cold-Stagnation was quite obvious. Therefore, initially treat both Taiyang and Shaoyin meridians simultaneously, embedding exterior-releasing within Yang-strengthening. Then administer Sini Tang heavily with modifications to tonify Mingmen and scatter Cold stagnation. Finally, nourish Spleen and Kidney to conclude treatment.
**Shaoyin Syndrome Tongue Stiffness**
Wang XX, Male, 60 years old. Cadre at a factory in Inner Mongolia.
[Medical History] At the end of 1970, while installing transformers, he was struck on the head by a steel wire rope, falling unconscious for about 8 minutes. Rushed to local XX Hospital, diagnosed with "acute concussion." For about a month, he remained in a state of confusion, slurred speech, and drooling. Later, he still felt dizzy, head distension, nausea, vomiting, and fear of sound stimulation. After two months of treatment, these symptoms improved, but severe insomnia persisted, characterized by a dreamless sleep state, lasting over 7 years. Occasionally, sharp lightning-like pain occurred on the left side of the head, followed by whole-body sweating. Starting in May 1976, he felt dry and stiff tongue, unclear speech, and heavy lower limbs, which gradually developed into cold numbness in the left upper limb. By February 1979, he appeared confused, short of breath (worse with movement), poor appetite, and the condition worsened. In November of the same year, XX Hospital in Inner Mongolia diagnosed "post-concussion syndrome," and he transferred to Beijing for treatment, coming for consultation on January 3, 1980.
[First Visit] Tongue stiffness and dryness, difficult to move for over three years. Especially severe upon waking in the morning; requires rinsing with warm water before speaking. Tongue coating dry and thick, making a sound when scraped. Poor appetite, aversion to cold, numbness in left upper limb with limited mobility, heavy and weak lower limbs (left worse than right). For seven years, feet felt hot; could not cover them while sleeping, otherwise feeling restless and irritable. Walking is difficult; leaning on a cane allows勉强 walking dozens of meters; moving causes panting. Urine is clear, long, and frequent. Complexion is yellowish, dull, and dark; eyelids edematous; spirit listless. Tongue body dark and pale, lacking fluids, deviating to the left when extended; coating gray-white and greasy; pulse deep. This is a Shaoyin syndrome of Yang decline and Yin abundance. Treat primarily with Sini Tang.
Prescription:
Zhi Fupian 60g (decocted for a long time), Ganjiang 30g, Zhi Gancao 30g. Two doses.
[Syndrome Differentiation] This case of brain trauma led to sequelae for many years. At consultation, spirit was listless, aversion to cold present, internal cold with external heat, heavy limbs, pale tongue, and deep pulse—a picture of Shaoyin Yang decline and Yin abundance. Lu Yuanlei said: "Shaoyin disease is a condition of declining heart power and attenuated whole-body function." The patient suffered heavy head trauma, long-term insomnia, poor appetite, even mental confusion and limb numbness. Prolonged duration inevitably leads to attenuation of whole-body function and injury to Heart and Kidney Yang. The head is the meeting place of all Yang meridians; the tongue is the sprout of the Heart. Declining heart power and declining Kidney Yang prevent Jinye (Body Fluids) from reaching upwards, causing tongue stiffness and difficulty speaking. The syndrome belongs to Shaoyin cold-transformation, Yang decline and Yin abundance; thus, administer Sini Tang.
[Second Visit] November 7. Chief complaint: After finishing one dose, woke up in the middle of the night, felt saliva in the tongue, able to move it, involuntarily woke companion saying: "Tongue feels much better, I can speak!" After getting up, heaviness in lower limbs also reduced. After finishing two doses, symptoms of tongue stiffness, dryness, and difficulty moving significantly decreased. Continue original prescription for five more doses.
[Third Visit] January 14. Tongue stiffness and dryness further improved. Left upper limb numbness and aversion to cold reduced. Still feel stiffness at root of tongue, slight shortness of breath, eyelid edema, poor appetite and sleep, pale tongue with white coating. Shaoyin cold-transformation has gone deep, affecting Taiyin Spleen Yang decline. Treat with modified combination of Sini Tang and Lizhong Tang.
Prescription:
Zhi Fupian 60g (decocted for a long time), Ganjiang 30g, Zhi Gancao 20g, Baizhu 30g, Fuling 30g, Guizhi 10g. Five doses.
[Fourth Visit] January 21. Tongue stiffness and dryness largely cured. Can walk without cane, climb four floors alone, left upper limb coldness and numbness disappeared, movement strong. Feet no longer feel hot, cover with quilt normally at night, sleep peaceful, appetite increased. Add Shang Rougui 10g to the above prescription to enhance benefiting Yang, eliminating Yin, and strongly tonifying Mingmen Fire. Continue for five more doses.
[Fifth Visit] January 28. Patient's spirit is revitalized, all symptoms significantly improved, requested to go home for Spring Festival. To consolidate efficacy, advise continuing original prescription for ten more doses.
[Commentary] Although this case originated from trauma, its main syndrome is no longer exterior but interior, belonging to Shaoyin cold-transformation. Trauma can enter the interior via meridians; orthopedics can also treat from the inside. *Shanghan Lun Yi* states: "Zhongjing's treatments are all based on Neijing. As Qibo said: Formulas for regulation must distinguish Yin and Yang: Treat Yin diseases by addressing Yang, treat Yang diseases by addressing Yin. Determine interior and exterior, each keeping to their domain." It also says: "Zhongjing's general principles can integrate hundred diseases." In clinical practice, Old Man Fan, for certain surgical diseases, also follows Zhongjing's Six Meridian academic thought, expanding its application. Grasping the main syndromes of the Six Meridians and their changes, referencing interior and exterior, establishing laws and prescriptions, traumatic injuries often resolve readily; or combined with external treatments, frequently achieving rapid effects.
**Shaoyin Syndrome Palpitations**
(Autonomic Nervous System Dysfunction)
Yu XX, Female, 40 years old. Employee at a store in Beijing.
[Medical History] In early 1973, felt dizzy. By 1976, condition worsened with palpitations, hand numbness, and upper limb tremors. Diagnosed with "autonomic nervous system dysfunction" at XX Hospital. Long-term use of Chinese herbal medicines for regulation and tonification showed little effect.
[First Visit] October 13, 1978. Palpitations, shortness of breath, chest tightness, dizziness, poor appetite, restless sleep, aversion to cold on back, knee joint pain, occasional trembling of shoulder and arm muscles. Menstruation advanced by one week, dark color with clots. Facial edema, pale tongue, white slippery coating, deep and fine pulse. Although the condition is complex, the main syndrome is Shaoyin Heart-Kidney Yang decline. The method should be to warm and unblock Heart Yang, benefit the source of Fire. Primarily use Guizhi Gancao Tang with modifications.
Prescription:
Guizhi 10g, Zhi Gancao 20g, Zhi Fupian 30g (decocted for a long time), Shengjiang 30g. Four doses.
[Second Visit] October 17. After taking the above prescription, palpitations and dizziness decreased; other symptoms remained as before. Continue original prescription for four more doses.
[Third Visit] October 23. Palpitations, dizziness, insomnia, and fatigue all significantly improved. But still facial edema, cold back, joint pain, muscle tremors. Add Mahuang 10g and Liaoxixin 3g to the above prescription to scatter Cold-Dampness in collaterals. Take three doses.
[Fourth Visit] October 28. Feels chest comfort, joint pain reduced. Maintain original method, add Paogjiang and Xuyutan 30g each, continue for five more doses to warm meridians, expel stasis, and generate new blood.
[Fifth Visit] November 17. Palpitations and dizziness basically disappeared; other symptoms all improved. Order to take five more doses.
Follow-up on May 10, 1979: No recurrence.
[Commentary] The various symptoms of palpitations in this case are intertwined and complex. However, the main syndrome is the decline of Hand and Foot Shaoyin Heart-Kidney. As stated in *Shanghan Mingli Lun*: "Those with Qi deficiency, due to weakness of Yang Qi, emptiness below the heart, internal movement causes palpitations." The root of the disease lies in the failure of Kidney Yang to rise and nourish the Heart. Always treat by tonifying Kidney Qi and unblocking Heart Yang. Thus, administer Guizhi Gancao Tang with modifications. Guizhi is the sovereign herb, entering the Heart to assist Yang; Gancao assists, tonifying Middle Qi. Together, pungent and sweet combine to transform, possessing the function of warming and unblocking Heart Yang. Since the root of True Qi resides in the Kidney, add Fuzi to strongly tonify Mingmen Fire seed; pair with Shengjiang to lift and scatter depression, meaning to drive out Yin and promote Yang. Because there is also Cold stagnation in collaterals, add small amounts of Mahuang and Liaoxixin. When Kidney Qi is vigorous and Qi-Blood harmonious, all symptoms can be resolved easily.
**Shaoyin Syndrome Deficiency Damage**
Chen XX, Male, 28 years old. Doctor in a PLA unit.
[Medical History] In 1971, went to Tibet to perform tasks, suffering illness from long-term exposure to wind and dew. Initially felt clicking sounds in fingertips, palms, and lower limb joints, followed by facial edema, palpitations, lower back pain, and sleeplessness all night. A unit hospital treated him for "nephritis" for a period. Later switched to heat-clearing and detoxifying substances, including Xijiao (Rhinoceros Horn) and Lingjiao (Antelope Horn). Gradually became weak in walking, fatigued, and poor appetite. Subsequently treated according to "Liver-Kidney deficiency damage, Qi-Blood depletion," taking tonifying agents. Experienced buzzing in head, hair loss on crown, worsened palpitations, panting on exertion, cold sweat, body pain, and limb numbness. By January 3, 1977, felt a stream of cold air rising from the left side of the mouth, frequently spitting white foamy sputum, feeling of water sloshing in chest, continuous yellow fluid oozing from left ear, hearing loss, unsteady gait. Blood pressure 70/50 mmHg. On May 22 of the same year, suddenly fainted. Rushed to XX Hospital, hospitalized for three months, cause not identified. Facial and bilateral lower limb edema worsened, unbearable head dizziness/distension, transferred to XX Hospital for consultation. Left half-body pain and temperature sensation significantly reduced, left upper limb difficult to raise, cremasteric reflex disappeared, uvula bent to the left, tongue deviated to the left. Conclusion: "Left half-body numbness, sensory pain disturbance, left upper limb weakness, edema pending diagnosis." Over several years, took over a thousand doses of Chinese medicine. Transferred for consultation in September 1977.
[First Visit] Facial and bilateral lower limb swelling, numbness of left half-body and hands/feet, cold limbs, head buzzing, head shaking, fatigue, palpitations, insomnia, memory and hearing loss, body pain, hypochondriac pain. Frequently emitting cold air from mouth, spitting large amounts of foamy sputum, poor appetite, loose stools, urinary incontinence. Tongue body dark and pale, puffy and tender, distinct teeth marks on edges, coating white, slippery, thick, greasy, and tight, pulse deep and fine. This is Shaoyin cold-transformation, persisting for a long time, Yin abundance and Yang minuteness, Qi-Blood depletion, becoming a damaged disease. The method should be to restore Yang and rescue from collapse, transform Qi and move Water. Primarily use Sini Tang and Zhenwu Tang with modifications.
Prescription:
Zhi Fupian 120g (decocted for a long time), Ganjiang 60g, Shengjiang 120g, Zhi Gancao 30g, Fuling 30g, Baizhu 30g, Guizhi 10g, Liaoxixin 6g.
[Second Visit] After taking the above prescription for twenty doses, head buzzing disappeared, palpitations improved, facial and lower limb edema significantly subsided, urinary incontinence turned to dribbling. First effectiveness seen in chronic disease; maintain original prescription and continue.
Zhi Fupian 120g (decocted for a long time), Ganjiang 60g, Zhi Gancao 60g, Guizhi 10g, Shengjiangpi 60g, Liaoxixin 3g, Fuling 30g.
[Third Visit] After taking ten doses, no longer emitting cold air from mouth, fatigue, cold limbs, poor appetite, and loose stools all improved, but still continuously spitting white foam, other symptoms showing no significant improvement. Shaoyin Yang decline for a long time, deep-seated Cold and stubborn Cold already profound, accumulation heavy and hard to reverse. Method should be to benefit Fire and eliminate Yin, warm and tonify Kidney Yang. Use Sini Tang plus Shang Rougui, advise persistent use. Can take four or five doses consecutively, then stop for two days and resume, until body feels warm. Also co-administer self-made Kanli Dan.
Prescription:
Zhi Fupian 60g (decocted for a long time), Ganjiang 30g, Zhi Gancao 30g, Shang Rougui 10g (dissolved).
Continuing the above prescription for half a year, whole-body swelling subsided, head shaking basically controlled, body pain and hand/foot numbness significantly reduced, palpitations obviously disappeared, spitting of white foam reduced, urination and defecation normal. Blood pressure rose to 120/80 mmHg, body gradually returned to normal.
Follow-up on November 20, 1979: Basically recovered in the second half of 1978, returned to work.
[Commentary] This patient's condition was severe, persisting for a long time, worsened by incorrect tonification and treatment. At the first visit, it was clearly visible that all Three Yin were diseased, and Five Viscera were damaged: Palpitations, insomnia, fatigue, cold limbs, pale puffy tender tongue indicate Hand Shaoyin Heart Yang deficiency; head shaking, head buzzing, hair loss, hypochondriac pain indicate Foot Jueyin Liver Blood depletion; edema, poor appetite, loose stools indicate Foot Taiyin Spleen Earth extreme deficiency; frequently emitting cold air from mouth, spitting large amounts of foamy sputum indicate Hand Taiyin Lung Qi internal injury; cold limbs, urinary incontinence, listless spirit, memory and hearing loss indicate Foot Shaoyin Kidney Yang decline. Body pain, left half-body and hand/foot numbness indicate Wind-Cold-Dampness staying long in muscles and collaterals, gradually penetrating into sinews and bones, Zhengqi daily weakening, Essence-Blood depleting. Evidently, the patient's systemic interior deficiency-Cold syndrome is very obvious. Although the condition is complex, the core syndrome truly belongs to Shaoyin cold-transformation, Heart-Kidney Yang minuteness, especially severe Kidney Yang collapse. As the saying goes, "Damage to the Five Viscera, ultimately reaches the Kidney." Thus, grasping the root, persisting in restoring Yang and rescuing from collapse, benefiting Fire to eliminate Yin, strongly tonifying Mingmen True Fire, fiercely driving out deep Cold of viscera, adhering to Sini lineage, taking continuously for half a year, allowed the breakthrough of this chronic disease.
**Shaoyin Syndrome Hemiplegia**
(Cerebrovascular Accident)
Chen XX, Female, 65 years old. Family member of an employee at a company in Chengdu.
[Medical History] Generally healthy, never suffered major illness. In October 1963, while doing housework, suddenly felt head as if pressed by heavy object, immediately fell unconscious. Urgently invited a TCM doctor who used warm needle at Baihui point; after about fifteen minutes, regained consciousness. Left upper and lower limbs were hemiplegic, mouth deviated, continuous flow of clear saliva. Chengdu XX TCM Hospital diagnosed "Stroke"; XX Hospital confirmed "Cerebrovascular Accident". Thereafter, treated by TCM, condition did not develop. Every autumn and winter, bedridden until next spring, when weather warmed, could slowly step holding bed. In winter 1971, condition became heavy; patient repeatedly told family: "Cannot survive this winter, prepare funeral affairs." Thus came for consultation.
[First Visit] Since entering winter, aversion to cold, curled up lying, covered with heavy quilts, left hand and foot still cold. Head feels numb, like inside a box. Left hemiplegia, emaciated. Facial edema, pale complexion. Tongue body pale, white greasy coating. Hemiplegia for many years, Yang Qi daily declining, belonging to Shaoyin cold-transformation, Yin-Cold interior abundance, Yang deficiency with Water flooding extreme. Urgently need to restore Yang and rescue from collapse, transform Qi and move Water. Primarily use Sini Tang combined with Zhenwu Tang with modifications.