(二诊）：腹胀膨大较消，惟脐下少腹尚觉绷硬，气泄则舒，食稍增益，大使较利，带淋未减，脉来弦涩，肠急脾钝，气机不行，子脏亦难免不受压迫，肠覃之患，当预虑也。制川朴4．5克炒青皮4．5克泡吴萸1．8克煨莪术4．5克缩砂仁4．5克瞿麦9克白蔹9克陈枳壳4．5克(炒）台乌药4．5克煨肉果3．6克广木香2.4克茯苓9克续随子霜4．5克三诊、四诊：
(略）。12月28日
(五诊）：膨大较消，胀则时胀时减，脐下少腹坚硬略坎，肠间乍鸣，昨曾作泻；有形症结，消弭甚难。脉弦涩，守原意以治。制川朴4．5克煨草果4．5克制附片6克庶虫4．5克瞿麦9克炙干蟾皮3．6克续随子霜6克煨莪术4。5克海南子6克北细辛1．2克蜣螂虫4．5克泡吴萸2．4克缩砂仁4．5克六诊：(略）。石月17日
(七诊）：症结较软，仍梢膨胀。日来又痛而难过，大便仍溏，日有两起，食下已不胀闷，脉弦。守原意以通调肠胃、化症消结。制川朴4．5克台乌药人5克北细辛1。2克川桂枝4．5克煨莪术4．5克炒黑川芎3克泡吴萸2．4克炒青皮4．5克炒小茴2．4克茯苓9克缩砂仁4．5克佛手柑3克另：真阿魏0．9克，广木香2．4克，同研，饭丸，吞、4月6日
(八诊）：腹肩减轻，溏泻转硬，如厕只一次。舌苔灰黄而腻，已较融化；面容仍稍晦，环脐腹中症结已消。日来又感时行伤风、咳嗽，脉濡滑而弦，治当兼顾。煨肉果4．5克佩兰9克摈榔6克炒五灵脂9克紫苑4．5克杏仁9克沉香曲4.5泡吴萸1.8克炒青皮4．5克煨川楝子4．5克真广皮6克蒸百部2．4克獭肝3．6克
(王蕙娱等整理：王仲奇先生医学经验简介，《上海中医药杂志》5：1，1962）
【评按】
例一西医诊断为子宫肌瘤，中医则属症积。症者，征也。以其成形，坚硬不移，故名。通常治妇女症结多从血滞、气滞入手，钱氏鉴于患者有气阴两虚，痰气郁结，治疗不圃于常法，遂以益气养阴、化痰软坚为主而取效。
例二为卵巢囊肿，左侧卵巢曾已摘除，后右侧又发，辨证属气逆血滞，而症脉则有明显虚象，故治以攻补兼施法。方用桂枝茯苓丸加味，以增强化症法瘀兼以扶正之效：末以补肾活血、调肝理脾法收功，案方脉络较为清楚，
例三为石瘕证，《灵枢经·水胀》明确指出是由于寒气客于子门，子门闭塞，坏血留于胞门所致。以案患者因经期用力太过，兼感严寒而发病。蒲氏结合因证和患者体质状况，用温经破血法为主，选方及掌握治疗的时机，都比较合宜。
例四诊为肠覃证，《灵枢经·水胀》：肠覃者，“寒气客于肠外，与卫气相搏，气不得荣、因有所系，解而内著，恶气乃起，息肉乃生。其始生也，大如鸡卵，稍以益大，至其成如怀子之状，久者离岁，按之则坚、推之则移，月事以时下……”。从述症可能属于内生殖器肿瘤。王氏治重行气逐瘀、化症消积，兼以逐寒暖脏。其立方、选药、配伍均具特色。
(二十三）妇人脏躁
例一李姓妇人，年30余，农民。1954年春，因抑郁寡欢，内心畏怯，渐至不言不笑，畏见光，多呵欠，闻声则惊恐倍增，不时悲伤痛哭，涕泪纵横，询之，病人自谓两三月来身畔常见有一人跟随，终日不离左右，呼之不应，驱之不退，颇以为累。诊得脉沉细而微，舌白，面色黯然，据《金匮要略·妇人脏躁病及五脏风寒积聚篇》谓：“邪哭使魂魄不安者，血气少也，血气少属于心，心气虚者，其人则畏，合目则眠，梦运行而精神离散，魂魄妄行。”因之诊为妇人脏躁，以甘麦大枣为主，方用：生甘草12克小麦30克大枣10枚归身9克柏子仁9克茯神9克远志9克酸枣仁9克(炒）五味子3克赤油桂1.5克煎服3剂而愈。
例二李××，、女，48岁。初诊日期：1975年5月17日。近年来，头痛持续不已，剧烈时引起泛恶，情绪抑郁不乐，急躁易怒，多疑，精神恍惚，耳中时闻语言声，听后更增烦闷，有时悲伤欲哭，睡眠甚差，恶梦引起惊恐，耳鸣头昏，腰酸，”白带甚多，神疲乏力，面色无华。舌苔薄腻，脉细数。、长期服用镇静剂，效果不显。辨证：思虑忧愁过度，耗伤心气，兼有肝郁气滞，风阳上扰。治法：养心安神，疏肝解郁。方药：炙甘草9克淮小麦30克大枣5枚郁金9克菖蒲9克陈胆星9克铁落60(先煎）夜交藤30克蝎蜈片6片(分二次吞服）、7剂。、5月24日
(二诊）：月经来潮，情绪急躁，头痛较以往经期减轻，其余症状基本如前，耳中语声已少。日前小便频急而痛。尿常规白细胞满视野，曾服呋喃坦丁药片，胃中不舒，现已停服，再以原方加减。原方去大枣、菖蒲，加黄芩12克，知母12克，再进7剂。5月31日
(三诊）：近日上午头痛已除，下午头痛较减，睡眠已有进步，中午亦能入睡片刻，烦躁已少，耳中仍有语声，尿频减少。再守原意。炙甘草9克淮小麦30克大枣5枚郁金9克丹参9克知母15克铁落60克(先煎）夜交藤30克蝎蜈片6片(分二次吞服）7剂。6月7日
(四诊）：上午头痛未发，下午仅有轻微疼痛，近日月经来潮，亦未见大发作。晚上安睡：午睡可达一小时，耳中人语声续减，舌苔薄腻，脉细不数。再守原意。炙甘草9克淮小麦30克大枣5枚郁金9克菖蒲9克铁落60克(先煎）丹参9克夜交藤30克7剂。另：都梁片
(白芷研粉制成药片，每片0．3克）100片，每日三次，每次5片，吞服。6月14日
(五诊）：睡眠较好，但有梦，有时感乏力，疲劳则觉疼痛，程度减轻，面白少华，脉细，舌质红。再守原法，前方去菖蒲，加白芍9克。6月21日
(六诊）：一周来仅昨日头痛小发，睡安，日夜可睡9小时以上，心烦及梦均减，有时精神欠佳，平时已无耳语，但在安静时偶有出现，情绪开朗，脉细，苔薄腻，再予前法加入补益之品。炙甘草9克淮小麦30克大枣5枚党参9克白术9克白芍9克丹参9克炙远志4.5克7剂。
(《黄文东医案》
【评按】妇人脏躁，后世多宗仲景治法。
例一以心气虚为主要病理，故以仲景甘麦大枣汤合柏子养心丸方加减，此方具有养心益血安神，兼化郁痰、调和脾胃之功，方药平稳有效。
例二系因情绪抑郁，思虑过度，以致心气亏耗，脏阴不足而致脏躁，方用甘麦大枣汤加味，以小麦养心气，甘草、大枣甘以缓急，夜交藤、胆星、菖蒲、郁金安神宣窍解郁。铁落、蜈蚣平肝熄风止痛，经此方加减月余、缠绵日久之症，日见痊可。
(二十四）妇人缩阴证魏妇，45岁，邮亭圩人。1958年冬，天气严寒，日在田间劳作，汗出解衣，因而受寒。归家即觉不适，晚餐未竟便睡，极畏寒，夜半抖颤不已，双被不温，旋现肢厥，屈伸不利，少腹拘痛，恶心欲呕，约半时许，阴户出现收缩，拘紧内引，小便时出，汗出如洗，自觉阴户空洞，时有冷气冲出，不安之至。清晨，夫来迎诊。切脉细微，舌苔白润，身倦神疲，言食如常，余证若上述。据此辨认，病属虚寒，由肝肾亏损，遽被贼风侵袭，气血寒凝，经络拘急，颇类三阴直中之象，又其证所患部位，与男子缩阴证同，治法谅亦无异。不过俗传妇人缩阴多指乳房缩入，至于阴户抽搐牵引则少见也。其治，当以温经法寒为法，因投以当归四逆加吴茱萸生姜汤，法风寒，温肝肾，经血得养，其病自已。该汤日进三大剂，遂告全安，未另服药。
(赵守真《治验回忆录》）
【评按】妇人缩阴，临床较为罕见。内因多属阳虚、肝肾亏损，复外受风寒侵袭所致，缩阴不论发生于男女，总属下焦阳虚寒甚之证。赵氏宗前贤治法，用当归四逆汤加吴萸、生姜以温经法寒，方证契合，故能效如桴应。
(二十五）阴挺朱××，女，30岁。初诊：去秋曾经难产，达五天始分娩。惟由彼时用力过度，胞络损伤引起本病。尔后劳则经常有下腹重坠之感，子宫有时脱出阴道之外。方用补中益气汤加减。潞党参15克炙升麻3克炙黄芪12克丹参15克白芍15克茯苓12克江枳壳20克柴胡3克陈皮6克炙甘草3克服药7剂后，子宫回升，精神转佳，胃纳正常。二诊：近由月事适临，参加农忙劳动，子宫又复脱垂。阴部肿痛，带下黄水淋漓，小溲热少。伴有头晕腰酸，心悸气逆，舌薄白，脉软弦带数。劳累过度，气虚下陷，兼有湿热下注。拟再升举清阳，补益气血，佐以清热利湿之品。炙升麻2克炙黄芪9克柴胡2克菟丝子15克江枳壳2克金樱子15克覆盆子15克茯苓15克川断肉9克陈皮6克益母草2O克土霍香9克服上方7剂，外用高锰酸钾坐浴后，子宫位置已接近正常，胃纳有增，体力增强，已能恢复劳动。
(《黄一峰医案医话集》）
【评按】阴挺即子宫脱垂，古代又有阴菌(蕈）、阴下脱等病名，多因中气下陷，失于固摄所致。经云：“病在下，取之上”。方用补中益气汤加减正为合拍，此例所加覆盆子、金樱子、菟丝子以补益肝肾，固元益精；方中用较大量江枳壳，据报道，积壳能增强子宫平滑肌收缩使之肌张力增加，较之单纯用补中益气汤，疗效有所提高。
四、儿科病类医菜
(一）小儿伤风顾幼，发热三日，有汗不解，咳呛痰多，夜寐不安，腑气未行，舌白，脉浮滑，风邪客肺，肺气不宣。宜以宣熄，不闭则佳。川桂枝3克竹节白附3克白杏仁12克白芥子4．5克黄郁金9克制南星4．5克姜半夏9克橘红4．5克朱赤苓12克远志3克活磁石30克(先煎）钩藤9克(后下）生姜汁10滴(冲）
(邓嘉成整理：徐小圃儿科医案，《中医杂志》4：26，1965）
【评按】小儿伤风属风寒者多，此案乃风邪客肺，肺气失宣。故治以辛温解表为主。因其有汗不解，故舍麻黄、用桂枝以解肌透热，其他诸药多属辛开豁痰之品，使邪从肺出。小儿外感咳嗽，一般不宜过早投肃肺止咳之剂，此案呛咳痰多，于宣散方中加入白附子，功能涤除顽痰，共奏法风寒、逐痰湿之效。此案在立方遣药方面反映了徐氏独到的经验。
(二）小儿肺炎
例一陈某，男，7岁。病历号：16425。七日来高烧不退，咳嗽胸疼，头痛不食，腹部不适。一日来恶寒高烧，日哺尤甚，口干思饮，大便于，小溲赤。来院时体温39．6℃，重病容。右肺中部有实变征及罗音，心腹正常，胸透为大叶肺炎。自细胞10，200／立方毫米。舌质赤，苔薄黄，脉洪数。辨证：表邪入里，热的太阴。治法：辛凉解表，清肺化痰。方药：银花10克连翘10克桑叶6克菊花6克炒杏仁5克薄荷2．4克生石膏24克桔梗6克黄芩6克浙贝6克鲜生地12克甲壬金散及羚羊粉各0．3克，日服三次。服药1剂，体温下降，两剂后体温正常,两颧尚赤，咳嗽痰浊，粘稠难出，精神食欲均好，舌苔黄厚，脉数有力。表证已罢，里热未清，继予原方加减：银花10克连翘10克菊花6克炒杏仁5克生石膏24克桔梗5克鲜生地12克山栀衣5克大麦冬10克浙贝10克焦军5克紫雪丹1．2克，日服三次。又服两剂，热净身凉，午后咳嗽尚重，余症悉无。舌根尚有厚苔，脉缓，肺热未净，继予清热肃肺之剂；又三日后，肺内炎症大部吸收，仅轻咳有痰，乃出院疗养。附方：甲壬金散：天竺黄10克广橘红10克银花10克麻黄、桃仁各6克杏仁、栀子、川连各10克浙贝15克全蝎10克羌独活各6克锦纹30克赭石10克朱砂30克。上药共研极细未，每30克加羚羊角2．4克，犀角面1．5克，牛黄5克，麝香2．4克，珍珠1．8克，琥珀5克，冰片1克。共研匀备用。
(《赵心波儿科临床经验选编》）
例二冯××，女，6岁，1961年3月14日会诊。腺病毒肺炎住院三周，发热，咳嗽气喘，发憋，面青白，下利，肺部罗音较多。舌淡苔灰黑，脉滑数，属内饮兼感，治宜宣肺。处方：麻黄1．5克干姜0．9克细辛0．9克五味子(打）10枚法半夏3克桂枝1．5克生石膏6克炙草1．5克杏仁10枚白芍1．5克大枣2枚。以水300毫升，分三次温服。3月16日复诊：身微热，面红润，咽间有痰，食纳稍增，大便次数已减少。舌淡、苔灰黑已减，脉滑微数。治宜调和脾胃，理肺化痰。处方：法半夏3克橘红2．4克炙甘草1．5克紫菀2．4克五味子(打）10枚细辛0．9克苏子(炒）3克前胡1．5克生姜2片大枣2枚。3月17日三诊：热退，喘憋减，精神转佳，食纳好。脉缓，舌淡苔减，继服前方而愈。
(《蒲辅周医疗经验》
（二诊）：腹部胀大较前消退，但脐下及小腹部仍感觉绷硬，排气后症状缓解，饮食稍有好转，大便较为通畅，带下和淋证未减轻，脉象弦涩。肠部拘急、脾运迟钝，气机运行不畅，子宫也难免受到压迫，需警惕肠覃的病变。处方：制厚朴4.5克，炒青皮4.5克，泡吴茱萸1.8克，煨莪术4.5克，缩砂仁4.5克，瞿麦9克，白蔹9克，陈枳壳4.5克（炒），台乌药4.5克，煨肉豆蔻3.6克，广木香2.4克，茯苓9克，续随子霜4.5克。三诊、四诊：（略）。12月28日
（五诊）：腹部膨隆较前消退，腹胀时轻时重，脐下少腹坚硬程度略有减轻，肠间偶尔鸣响，昨日曾腹泻；有形的症结，消除非常困难。脉象弦涩，遵循原意继续治疗。处方：制厚朴4.5克，煨草果4.5克，制附片6克，庶虫4.5克，瞿麦9克，炙干蟾皮3.6克，续随子霜6克，煨莪术4.5克，海南子6克，北细辛1.2克，蜣螂虫4.5克，泡吴茱萸2.4克，缩砂仁4.5克。六诊：（略）。石月17日
（七诊）：症结较前变软，仍有轻微膨胀。近日又出现疼痛难忍，大便仍然稀溏，每天两次，进食后已不感到胀闷，脉象弦。遵循原意以通调肠胃、化症消结为主。处方：制厚朴4.5克，台乌药5克，北细辛1.2克，川桂枝4.5克，煨莪术4.5克，炒黑川芎3克，泡吴茱萸2.4克，炒青皮4.5克，炒小茴香2.4克，茯苓9克，缩砂仁4.5克，佛手柑3克。另：真阿魏0.9克，广木香2.4克，同研为末，用饭丸，吞服。4月6日
（八诊）：腹部沉重感减轻，稀便转为成形，如厕仅一次。舌苔灰黄而腻，已较前融化；面容仍稍显晦暗，环脐腹中的症结已消除。近日又感受时行伤风，咳嗽，脉象濡滑而弦，治疗当兼顾外感。处方：煨肉豆蔻4.5克，佩兰9克，槟榔6克，炒五灵脂9克，紫菀4.5克，杏仁9克，沉香曲4.5克，泡吴茱萸1.8克，炒青皮4.5克，煨川楝子4.5克，真广陈皮6克，蒸百部2.4克，獭肝3.6克。
（王蕙娱等整理：王仲奇先生医学经验简介，《上海中医药杂志》5：1，1962）
【评按】
例一西医诊断为子宫肌瘤，中医则属症积。症者，征也。因其成形，坚硬不移，故名。通常治疗妇女症结多从血滞、气滞入手，钱氏鉴于患者有气阴两虚，痰气郁结，治疗不拘泥于常法，遂以益气养阴、化痰软坚为主而取效。
例二为卵巢囊肿，左侧卵巢曾已摘除，后右侧又发，辨证属气逆血滞，而症脉则有明显虚象，故治以攻补兼施法。方用桂枝茯苓丸加味，以增强化瘀法瘀兼以扶正之效：末以补肾活血、调肝理脾法收功，案方脉络较为清楚。
例三为石瘕证，《灵枢经·水胀》明确指出是由于寒气客于子门，子门闭塞，坏血留于胞门所致。以案患者因经期用力太过，兼感严寒而发病。蒲氏结合因证和患者体质状况，用温经破血法为主，选方及掌握治疗的时机，都比较合宜。
例四诊为肠覃证，《灵枢经·水胀》：肠覃者，“寒气客于肠外，与卫气相搏，气不得荣、因有所系，解而内著，恶气乃起，息肉乃生。其始生也，大如鸡卵，稍以益大，至其成如怀子之状，久者离岁，按之则坚、推之则移，月事以时下……”。从述症可能属于内生殖器肿瘤。王氏治重行气逐瘀、化症消积，兼以逐寒暖脏。其立方、选药、配伍均具特色。
(二十三）妇人脏躁
例一李姓妇人，年30余，农民。1954年春，因抑郁寡欢，内心畏怯，渐至不言不笑，畏见光，多呵欠，闻声则惊恐倍增，不时悲伤痛哭，涕泪纵横，询之，病人自谓两三月来身畔常见有一人跟随，终日不离左右，呼之不应，驱之不退，颇以为累。诊得脉沉细而微，舌白，面色黯然，据《金匮要略·妇人脏躁病及五脏风寒积聚篇》谓：“邪哭使魂魄不安者，血气少也，血气少属于心，心气虚者，其人则畏，合目则眠，梦运行而精神离散，魂魄妄行。”因之诊为妇人脏躁，以甘麦大枣汤为主，方用：生甘草12克，小麦30克，大枣10枚，归身9克，柏子仁9克，茯神9克，远志9克，酸枣仁9克（炒），五味子3克，赤油桂1.5克。煎服3剂而愈。
例二李××，女，48岁。初诊日期：1975年5月17日。近年来，头痛持续不已，剧烈时引起泛恶，情绪抑郁不乐，急躁易怒，多疑，精神恍惚，耳中时闻语言声，听后更增烦闷，有时悲伤欲哭，睡眠甚差，恶梦引起惊恐，耳鸣头昏，腰酸，白带甚多，神疲乏力，面色无华。舌苔薄腻，脉细数。长期服用镇静剂，效果不显。辨证：思虑忧愁过度，耗伤心气，兼有肝郁气滞，风阳上扰。治法：养心安神，疏肝解郁。方药：炙甘草9克，淮小麦30克，大枣5枚，郁金9克，菖蒲9克，陈胆星9克，铁落60克（先煎），夜交藤30克，蝎蜈片6片（分二次吞服），7剂。5月24日
（二诊）：月经来潮，情绪急躁，头痛较以往经期减轻，其余症状基本如前，耳中语声已少。日前小便频急而痛。尿常规白细胞满视野，曾服呋喃坦丁药片，胃中不舒，现已停服，再以原方加减。原方去大枣、菖蒲，加黄芩12克，知母12克，再进7剂。5月31日
（三诊）：近日上午头痛已除，下午头痛较减，睡眠已有进步，中午亦能入睡片刻，烦躁已少，耳中仍有语声，尿频减少。再守原意。炙甘草9克，淮小麦30克，大枣5枚，郁金9克，丹参9克，知母15克，铁落60克（先煎），夜交藤30克，蝎蜈片6片（分二次吞服），7剂。6月7日
（四诊）：上午头痛未发，下午仅有轻微疼痛，近日月经来潮，亦未见大发作。晚上安睡，午睡可达一小时，耳中人语声续减，舌苔薄腻，脉细不数。再守原意。炙甘草9克，淮小麦30克，大枣5枚，郁金9克，菖蒲9克，铁落60克（先煎），丹参9克，夜交藤30克，7剂。另：都梁片（白芷研粉制成药片，每片0.3克）100片，每日三次，每次5片，吞服。6月14日
（五诊）：睡眠较好，但有梦，有时感乏力，疲劳则觉疼痛，程度减轻，面白少华，脉细，舌质红。再守原法，前方去菖蒲，加白芍9克。6月21日
（六诊）：一周来仅昨日头痛小发，睡安，日夜可睡9小时以上，心烦及梦均减，有时精神欠佳，平时已无耳语，但在安静时偶有出现，情绪开朗，脉细，苔薄腻，再予前法加入补益之品。炙甘草9克，淮小麦30克，大枣5枚，党参9克，白术9克，白芍9克，丹参9克，炙远志4.5克，7剂。
（《黄文东医案》
【评按】妇人脏躁，后世多宗仲景治法。
例一以心气虚为主要病理，故以仲景甘麦大枣汤合柏子养心丸方加减，此方具有养心益血安神，兼化郁痰、调和脾胃之功，方药平稳有效。
例二系因情绪抑郁，思虑过度，以致心气亏耗，脏阴不足而致脏躁，方用甘麦大枣汤加味，以小麦养心气，甘草、大枣甘以缓急，夜交藤、胆星、菖蒲、郁金安神宣窍解郁。铁落、蜈蚣平肝熄风止痛，经此方加减月余、缠绵日久之症，日见痊可。
(二十四）妇人缩阴证魏妇，45岁，邮亭圩人。1958年冬，天气严寒，日在田间劳作，汗出解衣，因而受寒。归家即觉不适，晚餐未竟便睡，极畏寒，夜半抖颤不已，双被不温，旋现肢厥，屈伸不利，少腹拘痛，恶心欲呕，约半时许，阴户出现收缩，拘紧内引，小便时出，汗出如洗，自觉阴户空洞，时有冷气冲出，不安之至。清晨，夫来迎诊。切脉细微，舌苔白润，身倦神疲，言食如常，余证若上述。据此辨认，病属虚寒，由肝肾亏损，遽被贼风侵袭，气血寒凝，经络拘急，颇类三阴直中之象，又其证所患部位，与男子缩阴证同，治法谅亦无异。不过俗传妇人缩阴多指乳房缩入，至于阴户抽搐牵引则少见也。其治，当以温经散寒为法，因投以当归四逆加吴茱萸生姜汤，祛风寒，温肝肾，经血得养，其病自已。该汤日进三大剂，遂告全安，未另服药。
（赵守真《治验回忆录》）
【评按】妇人缩阴，临床较为罕见。内因多属阳虚、肝肾亏损，复外受风寒侵袭所致，缩阴不论发生于男女，总属下焦阳虚寒甚之证。赵氏宗前贤治法，用当归四逆汤加吴萸、生姜以温经散寒，方证契合，故能效如桴应。
(二十五）阴挺朱××，女，30岁。初诊：去秋曾经难产，达五天始分娩。惟由彼时用力过度，胞络损伤引起本病。尔后劳则经常有下腹重坠之感，子宫有时脱出阴道之外。方用补中益气汤加减。潞党参15克，炙升麻3克，炙黄芪12克，丹参15克，白芍15克，茯苓12克，江枳壳20克，柴胡3克，陈皮6克，炙甘草3克。服药7剂后，子宫回升，精神转佳，胃纳正常。二诊：近由月事适临，参加农忙劳动，子宫又复脱垂。阴部肿痛，带下黄水淋漓，小溲热少。伴有头晕腰酸，心悸气逆，舌薄白，脉软弦带数。劳累过度，气虚下陷，兼有湿热下注。拟再升举清阳，补益气血，佐以清热利湿之品。炙升麻2克，炙黄芪9克，柴胡2克，菟丝子15克，江枳壳2克，金樱子15克，覆盆子15克，茯苓15克，川断肉9克，陈皮6克，益母草20克，土藿香9克。服上方7剂，外用高锰酸钾坐浴后，子宫位置已接近正常，胃纳有增，体力增强，已能恢复劳动。
（《黄一峰医案医话集》）
【评按】阴挺即子宫脱垂，古代又有阴菌（蕈）、阴下脱等病名，多因中气下陷，失于固摄所致。经云：“病在下，取之上”。方用补中益气汤加减正为合拍，此例所加覆盆子、金樱子、菟丝子以补益肝肾，固元益精；方中用较大量江枳壳，据报道，枳壳能增强子宫平滑肌收缩使之肌张力增加，较之单纯用补中益气汤，疗效有所提高。
四、儿科病类医案
(一）小儿伤风顾幼，发热三日，有汗不解，咳呛痰多，夜寐不安，腑气未行，舌白，脉浮滑，风邪客肺，肺气不宣。宜以宣散，不闭则佳。川桂枝3克，竹节白附3克，白杏仁12克，白芥子4.5克，黄郁金9克制南星4.5克，姜半夏9克，橘红4.5克，朱赤苓12克，远志3克，活磁石30克（先煎），钩藤9克（后下），生姜汁10滴（冲）。
（邓嘉成整理：徐小圃儿科医案，《中医杂志》4：26，1965）
【评按】小儿伤风属风寒者多，此案乃风邪客肺，肺气失宣。故治以辛温解表为主。因其有汗不解，故舍麻黄、用桂枝以解肌透热，其他诸药多属辛开豁痰之品，使邪从肺出。小儿外感咳嗽，一般不宜过早投肃肺止咳之剂，此案呛咳痰多，于宣散方中加入白附子，功能涤除顽痰，共奏散风寒、逐痰湿之效。此案在立方遣药方面反映了徐氏独到的经验。
(二）小儿肺炎
例一陈某，男，7岁。病历号：16425。七日来高烧不退，咳嗽胸疼，头痛不食，腹部不适。一日来恶寒高烧，日哺尤甚，口干思饮，大便于，小溲赤。来院时体温39.6℃，重病容。右肺中部有实变征及罗音，心腹正常，胸透为大叶肺炎。白细胞10,200/立方毫米。舌质赤，苔薄黄，脉洪数。辨证：表邪入里，热壅太阴。治法：辛凉解表，清肺化痰。方药：银花10克，连翘10克，桑叶6克，菊花6克，炒杏仁5克，薄荷2.4克，生石膏24克，桔梗6克，黄芩6克，浙贝6克，鲜生地12克，甲壬金散及羚羊粉各0.3克，日服三次。服药1剂，体温下降，两剂后体温正常，两颧尚赤，咳嗽痰浊，粘稠难出，精神食欲均好，舌苔黄厚，脉数有力。表证已罢，里热未清，继予原方加减：银花10克，连翘10克，菊花6克，炒杏仁5克，生石膏24克，桔梗5克，鲜生地12克，山栀衣5克，大麦冬10克，浙贝10克，焦军5克，紫雪丹1.2克，日服三次。又服两剂，热净身凉，午后咳嗽尚重，余症悉无。舌根尚有厚苔，脉缓，肺热未净，继予清热肃肺之剂；又三日后，肺内炎症大部吸收，仅轻咳有痰，乃出院疗养。附方：甲壬金散：天竺黄10克，广橘红10克，银花10克，麻黄、桃仁各6克，杏仁、栀子、川连各10克，浙贝15克，全蝎10克，羌独活各6克，锦纹30克，赭石10克，朱砂30克。上药共研极细末，每30克加羚羊角2.4克，犀角面1.5克，牛黄5克，麝香2.4克，珍珠1.8克，琥珀5克，冰片1克。共研匀备用。
（《赵心波儿科临床经验选编》）
例二冯××，女，6岁，1961年3月14日会诊。腺病毒肺炎住院三周，发热，咳嗽气喘，发憋，面青白，下利，肺部罗音较多。舌淡苔灰黑，脉滑数，属内饮兼感，治宜宣肺。处方：麻黄1.5克，干姜0.9克，细辛0.9克，五味子（打）10枚，法半夏3克，桂枝1.5克，生石膏6克，炙草1.5克，杏仁10枚，白芍1.5克，大枣2枚。以水300毫升，分三次温服。3月16日复诊：身微热，面红润，咽间有痰，食纳稍增，大便次数已减少。舌淡、苔灰黑已减，脉滑微数。治宜调和脾胃，理肺化痰。处方：法半夏3克，橘红2.4克，炙甘草1.5克，紫菀2.4克，五味子（打）10枚，细辛0.9克，苏子（炒）3克，前胡1.5克，生姜2片，大枣2枚。3月17日三诊：热退，喘憋减，精神转佳，食纳好。脉缓，舌淡苔减，继服前方而愈。
（《蒲辅周医疗经验》
(Second visit): Abdominal distension and swelling have subsided compared to before, but the area below the umbilicus and the lower abdomen still feel tense and hard; symptoms relieve after passing gas. Food intake has slightly increased, bowel movements are more unobstructed, but leukorrhea and stranguria remain unchanged. The pulse is wiry and choppy. Intestinal urgency and spleen sluggishness indicate stagnant Qi mechanism. The uterus is inevitably subject to compression, so one must be vigilant about the potential development of *Changqin* (Intestinal Polyp/Tumor). Prescription: Processed Magnolia Bark (*Zhi Chuan Po*) 4.5g, Stir-fried Green Tangerine Peel (*Chao Qing Pi*) 4.5g, Soaked Evodia Fruit (*Pao Wu Zhu Yu*) 1.8g, Gingered Turmeric Tuber (*Wei E Zhu*) 4.5g, Cardamom Seed (*Suo Sha Ren*) 4.5g, Dianthus Flower (*Qu Mai*) 9g, White Peony Root (*Bai Lian*) 9g, Aged Aurantium (*Chen Zhi Ke*) 4.5g (stir-fried), Taizhou Lindera Root (*Tai Wu Yao*) 4.5g, Gingered Nutmeg (*Wei Rou Guo*) 3.6g, Aucklandia Root (*Guang Mu Xiang*) 2.4g, Poria (*Fu Ling*) 9g, Croton Seed Frost (*Xu Sui Zi Shuang*) 4.5g. Third and fourth visits: (Omitted). December 28.
(Fifth visit): Abdominal bulging has subsided; distension fluctuates. Hardness below the umbilicus and in the lower abdomen has slightly decreased. Bowel sounds occur occasionally; diarrhea occurred yesterday. Resolving solid pathological accumulations is very difficult. The pulse is wiry and choppy. Continue treatment following the original principle. Prescription: Processed Magnolia Bark (*Zhi Chuan Po*) 4.5g, Gingered Apple Fruit (*Wei Cao Guo*) 4.5g, Processed Aconite Slice (*Zhi Fu Pian*) 6g, Leech (*Shu Chong*) 4.5g, Dianthus Flower (*Qu Mai*) 9g, Honey-fried Toad Skin (*Zhi Gan Chan Pi*) 3.6g, Croton Seed Frost (*Xu Sui Zi Shuang*) 6g, Gingered Turmeric Tuber (*Wei E Zhu*) 4.5g, Hainan Citrus Seed (*Hai Nan Zi*) 6g, Northern Asarum (*Bei Xi Xin*) 1.2g, Dung Beetle (*Dang Lang Chong*) 4.5g, Soaked Evodia Fruit (*Pao Wu Zhu Yu*) 2.4g, Cardamom Seed (*Suo Sha Ren*) 4.5g. Sixth visit: (Omitted). Shi Month 17th.
(Seventh visit): The accumulation has softened, but slight distension persists. Recently, severe pain has recurred; stools remain loose, occurring twice daily. Eating no longer causes bloating or stuffiness. The pulse is wiry. Continue treatment with the original intent to regulate the intestines and stomach, resolve masses, and dissipate accumulations. Prescription: Processed Magnolia Bark (*Zhi Chuan Po*) 4.5g, Taizhou Lindera Root (*Tai Wu Yao*) 5g, Northern Asarum (*Bei Xi Xin*) 1.2g, Cinnamon Twig (*Chuan Gui Zhi*) 4.5g, Gingered Turmeric Tuber (*Wei E Zhu*) 4.5g, Stir-fried Black Sichuan Lovage Rhizome (*Chao Hei Chuan Xiong*) 3g, Soaked Evodia Fruit (*Pao Wu Zhu Yu*) 2.4g, Stir-fried Green Tangerine Peel (*Chao Qing Pi*) 4.5g, Stir-fried Small Fennel (*Chao Xiao Hui*) 2.4g, Poria (*Fu Ling*) 9g, Cardamom Seed (*Suo Sha Ren*) 4.5g, Bergamot (*Fo Shou Gan*) 3g. Separate prescription: True Asafoetida (*Zhen A Wei*) 0.9g, Aucklandia Root (*Guang Mu Xiang*) 2.4g, ground together, formed into pills with rice paste, taken orally. April 6.
(Eighth visit): Abdominal heaviness has decreased; loose stools have become formed; defecation occurs only once. The tongue coating is grayish-yellow and greasy, but has melted somewhat compared to before; facial complexion remains slightly dull. The accumulation around the umbilicus has resolved. Recently, a seasonal wind-cold invasion occurred with coughing. The pulse is soggy, slippery, and wiry. Treatment should address both conditions. Prescription: Gingered Nutmeg (*Wei Rou Guo*) 4.5g, Eupatorium Leaf (*Pei Lan*) 9g, Betel Nut (*Bing Lang*) 6g, Stir-fried Trogopterus Dung (*Chao Wu Ling Zhi*) 9g, Aster Root (*Zi Wan*) 4.5g, Apricot Seed (*Xing Ren*) 9g, Agarwood Fermented Curd (*Chen Xiang Qu*) 4.5g, Soaked Evodia Fruit (*Pao Wu Zhu Yu*) 1.8g, Stir-fried Green Tangerine Peel (*Chao Qing Pi*) 4.5g, Gingered Chinese Melia Fruit (*Wei Chuan Lian Zi*) 4.5g, True Broadleaf Mandarin Peel (*Zhen Guang Pi*) 6g, Steamed Stemona Root (*Zheng Bai Bu*) 2.4g, Hyrax Liver (*Ta Gan*) 3.6g.
(Wang Huiyu et al. compiled: Brief Introduction to Mr. Wang Zhongqi's Medical Experience, *Shanghai Journal of Traditional Chinese Medicine* 5:1, 1962)
[Commentary]
Case 1: Western medicine diagnosed uterine fibroids; in Traditional Chinese Medicine (TCM), this belongs to *Zheng Ji* (Masses). "Zheng" implies manifestation. Because it takes form, is hard, and does not move, it is named thus. Typically, treating gynecological masses starts from blood stasis and Qi stagnation. Given the patient's Qi and Yin deficiency with Phlegm-Qi constraint, Qian did not adhere to conventional methods but achieved efficacy primarily by tonifying Qi and nourishing Yin, resolving Phlegm, and softening hardness.
Case 2: Ovarian cyst. The left ovary had been removed previously, and the right side recurred. Syndrome differentiation indicated rebellious Qi and blood stasis, with obvious deficiency signs in the mass and pulse. Thus, treatment employed simultaneous attacking and tonifying. The formula used was *Guizhi Fuling Wan* (Cinnamon Twig and Poria Pill) modified to enhance blood-activating and mass-resolving effects while supporting healthy Qi. Finally, kidney-tonifying, blood-activating, liver-regulating, and spleen-strengthening methods were used to conclude treatment. The logic of the case and formulas is clear.
Case 3: *Shi Xia* (Stone Lei) syndrome. *Ling Shu Jing · Shui Zhang* explicitly states this is caused by cold pathogen lodging at the cervical os, causing closure, leading to bad blood remaining in the uterine cavity. This patient developed the condition due to excessive exertion during menstruation combined with exposure to severe cold. Pu combined the cause-syndrome relationship with the patient's constitution, primarily using warming meridians and breaking blood methods. Formula selection and timing of treatment were appropriate.
Case 4: Diagnosed as *Changqin* (Intestinal Polyp/Tumor) syndrome. *Ling Shu Jing · Shui Zhang*: "When cold pathogen lodges outside the intestines, it struggles with Defensive Qi. Qi fails to nourish, becomes bound, penetrates inward, evil Qi arises, and polyps grow. Initially, it is the size of a chicken egg, gradually enlarging until it resembles pregnancy. After many years, it is hard upon pressure but movable upon pushing, and menstruation continues normally..." Based on symptoms, this may belong to internal genital tumors. Wang emphasized moving Qi, expelling blood stasis, resolving masses, and dissipating accumulations, combined with dispelling cold and warming viscera. His formula construction, herb selection, and compatibility are distinctive.
(Twenty-three) Female Visceral Agitation
Case 1: Ms. Li, over 30 years old, farmer. In spring 1954, due to depression and sorrow, inner fear gradually led to silence and lack of laughter, photophobia, frequent yawning, increased terror upon hearing sounds, occasional sad weeping with tears flowing freely. Upon inquiry, the patient reported that for two to three months, she often saw a person following her, never leaving her side, ignoring calls, and unable to drive away, which burdened her greatly. Pulse was deep, fine, and faint; tongue white; complexion dark. According to *Jin Gui Yao Lue · Female Visceral Agitation Disease and Five Zang Wind-Cold Accumulation Chapter*: "Evil crying causing insecurity of soul and spirit indicates insufficient Blood and Qi. Insufficient Blood and Qi relates to the Heart. Those with Heart Qi deficiency fear easily; closing eyes leads to sleep; dreams involve running, spirit scatters, and soul wanders." Thus diagnosed as Female Visceral Agitation, primarily using *Gan Mai Da Zao Tang* (Licorice, Wheat, and Jujube Decoction). Prescription: Raw Licorice (*Sheng Gan Cao*) 12g, Wheat (*Xiao Mai*) 30g, Jujube (*Da Zao*) 10 pieces, Angelica Sinensis Root (*Gui Shen*) 9g, Biota Seed (*Bai Zi Ren*) 9g, Spirit Poria (*Fu Shen*) 9g, Polygala Root (*Yuan Zhi*) 9g, Sour Jujube Seed (*Suan Zao Ren*) 9g (stir-fried), Schisandra Berry (*Wu Wei Zi*) 3g, Red Oil Cinnamon (*Chi You Gui*) 1.5g. Taken decocted, 3 doses resulted in cure.
(Yin Huihe: Yin Huihe Medical Cases, *Chinese Journal of Traditional Chinese Medicine* 9:35, 1959)
Case 2: Li XX, female, 48 years old. First visit date: May 17, 1975. For recent years, persistent headache, severe episodes causing nausea, depressed mood, irritability, suspicion, mental trance, hearing voices in ears increasing irritability upon hearing, occasional sadness and desire to cry, poor sleep, nightmares causing terror, tinnitus, dizziness, sore back, abundant leukorrhea, fatigue, pale complexion. Tongue coating thin and greasy, pulse fine and rapid. Long-term use of sedatives showed little effect. Syndrome differentiation: Excessive worry and sorrow consumed Heart Qi, accompanied by Liver Qi stagnation and stirring Wind-Yang. Treatment method: Nourish Heart and calm Spirit, soothe Liver and resolve depression. Prescription: Honey-fried Licorice (*Zhi Gan Cao*) 9g, Huai Wheat (*Huai Xiao Mai*) 30g, Jujube (*Da Zao*) 5 pieces, Curcuma Tuber (*Yu Jin*) 9g, Acorus Tuber (*Chang Pu*) 9g, Old Pinellia Star (*Chen Dan Xing*) 9g, Iron Filings (*Tie Luo*) 60g (decocted first), Night-crossing Vine (*Ye Jiao Teng*) 30g, Scorpion and Centipede Tablets (*Xie Wu Pian*) 6 tablets (taken in two doses), 7 doses. May 24.
(Second visit): Menstruation arrived, mood irritable, headache less severe than previous periods, other symptoms basically unchanged, ear voices reduced. Recently, frequent urgent painful urination. Urine routine showed full field of white blood cells; took Furantoin tablets, causing gastric discomfort, now stopped. Modify original prescription. Remove Jujube and Acorus from original, add Scutellaria Root (*Huang Qin*) 12g, Anemarrhena Rhizome (*Zhi Mu*) 12g, continue 7 doses. May 31.
(Third visit): Headache in morning resolved, afternoon headache reduced, sleep improved, able to nap at noon, irritability reduced, ear voices persist, urinary frequency decreased. Continue original intent. Honey-fried Licorice (*Zhi Gan Cao*) 9g, Huai Wheat (*Huai Xiao Mai*) 30g, Jujube (*Da Zao*) 5 pieces, Curcuma Tuber (*Yu Jin*) 9g, Salvia Root (*Dan Shen*) 9g, Anemarrhena Rhizome (*Zhi Mu*) 15g, Iron Filings (*Tie Luo*) 60g (decocted first), Night-crossing Vine (*Ye Jiao Teng*) 30g, Scorpion and Centipede Tablets (*Xie Wu Pian*) 6 tablets (taken in two doses), 7 doses. June 7.
(Fourth visit): No headache in morning, slight pain in afternoon. Recent menstruation, no major attacks. Sleeps well at night, nap up to one hour, ear voices continue to decrease. Tongue coating thin and greasy, pulse fine and not rapid. Continue original intent. Honey-fried Licorice (*Zhi Gan Cao*) 9g, Huai Wheat (*Huai Xiao Mai*) 30g, Jujube (*Da Zao*) 5 pieces, Curcuma Tuber (*Yu Jin*) 9g, Acorus Tuber (*Chang Pu*) 9g, Iron Filings (*Tie Luo*) 60g (decocted first), Salvia Root (*Dan Shen*) 9g, Night-crossing Vine (*Ye Jiao Teng*) 30g, 7 doses. Separate: Duliang Tablets (Angelica Dahurica powder made into tablets, 0.3g each) 100 tablets, three times daily, 5 tablets per dose, taken orally. June 14.
(Fifth visit): Better sleep, but with dreams, sometimes feels weak, pain felt when fatigued but reduced in severity, pale face lacking luster, pulse fine, tongue body red. Continue original method, remove Acorus from previous formula, add White Peony Root (*Bai Shao*) 9g. June 21.
(Sixth visit): Only minor headache yesterday for the past week, sleeps peacefully, sleeps over 9 hours day and night, heart vexation and dreams reduced, sometimes poor spirit, no ear whispers usually, but occasionally appears in quiet moments, mood cheerful, pulse fine, coating thin and greasy. Add tonifying herbs to previous method. Honey-fried Licorice (*Zhi Gan Cao*) 9g, Huai Wheat (*Huai Xiao Mai*) 30g, Jujube (*Da Zao*) 5 pieces, Codonopsis Root (*Dang Shen*) 9g, Atractylodes Macrocephala Rhizome (*Bai Zhu*) 9g, White Peony Root (*Bai Shao*) 9g, Salvia Root (*Dan Shen*) 9g, Honey-fried Polygala Root (*Zhi Yuan Zhi*) 4.5g, 7 doses.
(*Huang Wendong Medical Cases*)
[Commentary] For Female Visceral Agitation, later generations mostly follow Zhang Zhongjing's treatment methods.
Case 1: Main pathology is Heart Qi deficiency. Thus, Zhang Zhongjing's *Gan Mai Da Zao Tang* combined with *Baizi Yangxin Wan* (Biota Seed Heart-Nourishing Pill) modified. This formula nourishes Heart, benefits Blood, calms Spirit, resolves Phlegm-Dampness, and harmonizes Spleen and Stomach. The formula is stable and effective.
Case 2: Caused by emotional depression and excessive worry, consuming Heart Qi and depleting Visceral Yin, leading to Visceral Agitation. Used *Gan Mai Da Zao Tang* modified. Wheat nourishes Heart Qi; Licorice and Jujube sweetly relieve urgency. Night-crossing Vine, Pinellia Star, Acorus, and Curcuma calm Spirit, open orifices, and resolve depression. Iron Filings and Centipede pacify Liver, extinguish Wind, and stop pain. After over a month of modification with this formula, the lingering chronic symptoms gradually healed.
(Twenty-four) Female Yin Retraction Syndrome. Mrs. Wei, 45 years old, from You Ting Wei. Winter 1958, severe weather, worked in fields all day, sweated and undressed, thereby catching cold. Returned home feeling unwell, slept before finishing dinner. Extreme aversion to cold, shivering uncontrollably at midnight, double blankets not warm, followed by limb coldness, difficulty bending and extending, lower abdominal cramping pain, nausea and desire to vomit. About half an hour later, vaginal contraction occurred, tight retraction inward, intermittent urination, profuse sweating like washing, feeling of vaginal emptiness, occasional cold air rushing out, extreme unease. Early morning, husband came to summon doctor. Pulse minute and fine, tongue coating white and moist, body tired and spirit fatigued, speech and eating normal, other symptoms as above. Based on this identification, disease belongs to Deficiency-Cold, due to Liver-Kidney depletion, suddenly invaded by thief-wind, Qi-Blood cold coagulation, meridians tense. Very similar to direct attack of Three Yin channels. Also, the affected site is same as Male Yin Retraction Syndrome, so treatment method likely no different. However, folk tradition says Female Yin Retraction mostly refers to breast retraction; vaginal twitching and traction is rare. Treatment should use Warming Meridians and Dispelling Cold method. Therefore, administered *Danggui Sini Jia Wuzhuyu Shengjiang Tang* (Angelica Decoction for Cold Extremities plus Evodia and Ginger Decoction) to dispel wind-cold, warm Liver and Kidney, nourish meridian blood, and the disease would heal itself. Took three large doses of this decoction daily, then fully recovered, took no other medicine.
(Zhao Shouzhen *Memories of Therapeutic Verification*)
[Commentary] Female Yin Retraction is clinically rare. Internal causes mostly belong to Yang deficiency and Liver-Kidney depletion, compounded by external wind-cold invasion. Regardless of gender, Yin Retraction always belongs to Lower Jiao Yang deficiency with severe cold. Zhao followed ancient masters' methods, using *Danggui Sini Tang* plus Evodia and Ginger to warm meridians and dispel cold. Formula matches syndrome, hence efficacy is immediate like striking a drum.
(Twenty-five) Vaginal Prolapse. Zhu XX, female, 30 years old. First visit: Last autumn experienced dystocia, delivering after five days. Due to excessive exertion at that time, damage to uterine collaterals caused this disease. Since then, labor often causes heavy bearing sensation in lower abdomen, uterus sometimes prolapses outside vagina. Formula: *Buzhong Yiqi Tang* (Tonify Middle and Augment Qi Decoction) modified. Codonopsis Root (*Lu Dang Shen*) 15g, Honey-fried Cimicifuga Rhizome (*Zhi Sheng Ma*) 3g, Honey-fried Astragalus Root (*Zhi Huang Qi*) 12g, Salvia Root (*Dan Shen*) 15g, White Peony Root (*Bai Shao*) 15g, Poria (*Fu Ling*) 12g, Jiang Aurantium (*Jiang Zhi Ke*) 20g, Bupleurum Root (*Chai Hu*) 3g, Tangerine Peel (*Chen Pi*) 6g, Honey-fried Licorice (*Zhi Gan Cao*) 3g. After taking 7 doses, uterus rose back, spirit improved, appetite normalized. Second visit: Recently menstruation arrived, participated in farm work, uterus prolapsed again. Vulvar swelling and pain, yellow watery leukorrhea dripping, scant hot urination. Accompanied by dizziness, sore back, palpitations, rebellious Qi. Tongue thin white, pulse soft, wiry, and rapid. Overexertion, Qi deficiency sinking, accompanied by Damp-Heat pouring downward. Plan to again raise Clear Yang, tonify Qi and Blood, assist with clearing heat and promoting diuresis. Honey-fried Cimicifuga Rhizome (*Zhi Sheng Ma*) 2g, Honey-fried Astragalus Root (*Zhi Huang Qi*) 9g, Bupleurum Root (*Chai Hu*) 2g, Dodder Seed (*Tu Si Zi*) 15g, Jiang Aurantium (*Jiang Zhi Ke*) 2g, Cherokee Rose Fruit (*Jin Ying Zi*) 15g, Raspberry (*Fu Pen Zi*) 15g, Poria (*Fu Ling*) 15g, Dogwood Cortex (*Chuan Duan Rou*) 9g, Tangerine Peel (*Chen Pi*) 6g, Motherwort Herb (*Yi Mu Cao*) 20g, Patchouli (*Tu Huo Xiang*) 9g. After taking above 7 doses, external potassium permanganate sitz bath, uterus position near normal, appetite increased, strength enhanced, able to resume labor.
(*Huang Yifeng Medical Cases and Conversations Collection*)
[Commentary] *Yin Ting* is uterine prolapse, also known in ancient times as *Yin Jun* (Mushroom) or *Yin Xia Tuo*. Mostly caused by Middle Qi sinking and loss of containment. Classic says: "Disease below, treat above." Using *Buzhong Yiqi Tang* modified fits perfectly. Added Raspberry, Cherokee Rose Fruit, and Dodder Seed in this case to tonify Liver and Kidney, consolidate origin and benefit essence. Using larger amount of Jiang Aurantium in the formula, reported to enhance uterine smooth muscle contraction and increase muscle tension, improving efficacy compared to using *Buzhong Yiqi Tang* alone.
IV. Pediatric Disease Cases
(One) Pediatric Wind-Cold. Child Gu, fever for three days, sweating without resolution, coughing with wheezing and much phlegm, restless sleep at night, bowel Qi not moving, tongue white, pulse floating and slippery. Wind pathogen lodged in Lung, Lung Qi not diffusing. Should use dispersing method, not obstructing is good. Cinnamon Twig (*Chuan Gui Zhi*) 3g, Bamboo-sectioned White Aconite (*Zhu Jie Bai Fu*) 3g, White Apricot Seed (*Bai Xing Ren*) 12g, White Mustard Seed (*Bai Jie Zi*) 4.5g, Yellow Curcuma (*Huang Yu Jin*) 9g, Processed Arisaema (*Zhi Nan Xing*) 4.5g, Ginger Pinellia (*Jiang Ban Xia*) 9g, Orange Peel (*Ju Hong*) 4.5g, Cinnabar Poria (*Zhu Chi Ling*) 12g, Polygala Root (*Yuan Zhi*) 3g, Living Magnet Stone (*Huo Ci Shi*) 30g (decocted first), Uncaria (*Gou Teng*) 9g (added later), Ginger Juice (*Sheng Jiang Zhi*) 10 drops (mixed in).
(Deng Jiacheng compiled: Xu Xiaopu Pediatric Medical Cases, *Chinese Journal of Traditional Chinese Medicine* 4:26, 1965)
[Commentary] Pediatric wind-cold is mostly wind-cold type. This case is wind pathogen lodged in Lung, Lung Qi failing to diffuse. Thus treated primarily with Acrid-Warm Exterior-Releasing method. Because sweating did not resolve it, Mahuang was abandoned, using Guizhi to release muscle layer and vent heat. Other herbs are mostly Acrid-Opening and Phlegm-Resolving agents, allowing pathogen to exit via Lung. Pediatric exogenous cough generally should not receive early Lung-Sinking and Cough-Stopping agents. This case with harsh cough and much phlegm, adding Baifuzi to dispersing formula functions to wash away stubborn phlegm, jointly achieving Wind-Cold Dispelling and Phlegm-Damp Expelling effects. This case reflects Xu's unique experience in formula construction and herb selection.
(Two) Pediatric Pneumonia
Case 1: Chen XX, male, 7 years old. Medical record number: 16425. High fever unremitting for seven days, coughing chest pain, headache, anorexia, abdominal discomfort. For one day, aversion to cold and high fever, worse at sunset, dry mouth desiring drink, dry stool, red urine. Temperature upon arrival 39.6°C, critical appearance. Right lung middle lobe consolidation signs and rales, heart and abdomen normal, chest fluoroscopy shows lobar pneumonia. White blood cells 10,200/cubic millimeter. Tongue body red, coating thin yellow, pulse surging and rapid. Syndrome differentiation: Exterior pathogen entering interior, Heat congesting Taiyin. Treatment method: Acrid-Cool Exterior-Releasing, Clear Lung and transform Phlegm. Prescription: Honeysuckle Flower (*Yin Hua*) 10g, Forsythia Fruit (*Lian Qiao*) 10g, Mulberry Leaf (*Sang Ye*) 6g, Chrysanthemum Flower (*Ju Hua*) 6g, Stir-fried Apricot Seed (*Chao Xing Ren*) 5g, Mint (*Bo He*) 2.4g, Raw Gypsum (*Sheng Shi Gao*) 24g, Platycodon Root (*Jie Geng*) 6g, Scutellaria Root (*Huang Qin*) 6g, Zhejiang Fritillary Bulb (*Zhe Bei*) 6g, Fresh Rehmannia Root (*Xian Sheng Di*) 12g, Jia Ren Jin San and Antelope Horn Powder 0.3g each, taken three times daily. After 1 dose, temperature dropped; after 2 doses, temperature normal, cheeks still red, coughing turbid phlegm, sticky and hard to expectorate, spirit and appetite good, tongue coating thick yellow, pulse rapid and forceful. Exterior syndrome resolved, interior heat not cleared, continue modifying original prescription: Honeysuckle Flower (*Yin Hua*) 10g, Forsythia Fruit (*Lian Qiao*) 10g, Chrysanthemum Flower (*Ju Hua*) 6g, Stir-fried Apricot Seed (*Chao Xing Ren*) 5g, Raw Gypsum (*Sheng Shi Gao*) 24g, Platycodon Root (*Jie Geng*) 5g, Fresh Rehmannia Root (*Xian Sheng Di*) 12g, Gardenia Husk (*Shan Zhi Yi*) 5g, Large Ophiopogon Tuber (*Da Mai Dong*) 10g, Zhejiang Fritillary Bulb (*Zhe Bei*) 10g, Scorched Rhubarb (*Jiao Jun*) 5g, Zi Xue Dan 1.2g, taken three times daily. After another 2 doses, heat cleared, body cool, afternoon cough still heavy, other symptoms gone. Tongue root still has thick coating, pulse slow, Lung heat not cleared, continue with Clearing Heat and Descending Lung agent; three days later, most lung inflammation absorbed, only light cough with phlegm, discharged for recuperation. Attached Formula: Jia Ren Jin San: Heavenly Bamboo Spatula (*Tian Zhu Huang*) 10g, Broadleaf Mandarin Peel (*Guang Ju Hong*) 10g, Honeysuckle Flower (*Yin Hua*) 10g, Ephedra Herba (*Ma Huang*), Peach Kernel (*Tao Ren*) 6g each, Apricot Seed (*Xing Ren*), Gardenia Fruit (*Zi Zi*), Coptis Rhizome (*Chuan Lian*) 10g each, Zhejiang Fritillary Bulb (*Zhe Bei*) 15g, Whole Scorpion (*Quan Xie*) 10g, Notopterygium Rhizome (*Qiang Huo*), Ligusticum Wallichii Rhizome (*Du Huo*) 6g each, Rheum Palmatum (*Jin Wen*) 30g, Hematite (*Zhe Shi*) 10g, Cinnabar (*Zhu Sha*) 30g. Above herbs ground to extremely fine powder, every 30g add Antelope Horn (*Ling Yang Jiao*) 2.4g, Rhinoceros Horn Powder (*Xi Jiao Mian*) 1.5g, Buffalo Gallstone (*Niu Huang*) 5g, Musk (*She Xiang*) 2.4g, Pearl (*Zhen Zhu*) 1.8g, Amber (*Hu Po*) 5g, Borneol (*Bing Pian*) 1g. Grind uniformly for reserve.
(*Selected Clinical Experience of Zhao Xinbo Pediatrics*)
Case 2: Feng XX, female, 6 years old, consulted March 14, 1961. Adenovirus pneumonia hospitalized three weeks, fever, coughing wheezing, suffocation, cyanotic pale face, diarrhea, many lung rales. Tongue pale, coating gray-black, pulse slippery and rapid. Belongs to internal fluid retention combined with infection, treatment should diffuse Lung. Prescription: Ephedra Herba (*Ma Huang*) 1.5g, Dried Ginger (*Gan Jiang*) 0.9g, Northern Asarum (*Xi Xin*) 0.9g, Schisandra Berry (*Wu Wei Zi*) 10 berries (crushed), Processed Pinellia (*Fa Ban Xia*) 3g, Cinnamon Twig (*Gui Zhi*) 1.5g, Raw Gypsum (*Sheng Shi Gao*) 6g, Honey-fried Licorice (*Zhi Cao*) 1.5g, Apricot Seed (*Xing Ren*) 10 berries, White Peony Root (*Bai Shao*) 1.5g, Jujube (*Da Zao*) 2 pieces. With 300ml water, divide into three warm doses. March 16 second visit: Slight fever, face ruddy, phlegm in throat, appetite slightly increased, bowel movement frequency reduced. Tongue pale, gray-black coating reduced, pulse slippery and slightly rapid. Treatment should harmonize Spleen and Stomach, regulate Lung and transform Phlegm. Prescription: Processed Pinellia (*Fa Ban Xia*) 3g, Orange Peel (*Ju Hong*) 2.4g, Honey-fried Licorice (*Zhi Gan Cao*) 1.5g, Aster Root (*Zi Wan*) 2.4g, Schisandra Berry (*Wu Wei Zi*) 10 berries (crushed), Northern Asarum (*Xi Xin*) 0.9g, Perilla Fruit (*Su Zi*) 3g (stir-fried), Peucedanum Root (*Qian Hu*) 1.5g, Ginger (*Sheng Jiang*) 2 slices, Jujube (*Da Zao*) 2 pieces. March 17 third visit: Fever retreated, wheezing/suffocation reduced, spirit improved, appetite good. Pulse slow, tongue pale coating reduced, continue previous formula and cured.
(*Pu Fuzhou Medical Experience*)