例二余调，男，2.5月，1970年7月31日初诊。家人代诉：患儿系第一孕第一胎，出生后数日开始发黄，日渐加童，至今二月未愈。经某医院检查，诊为新生儿黄疸(病理性），谓非手术治疗不可，未遂。来诊时患儿面目追体黄如橘色，神倦，思睡，不欲饮乳，偶有呕吐，尿量少，色黄赤，大便于结不畅，色淡，唇舌紫红而黯。辨证，脾运不健，湿热之邪蕴蓄于内、不得宣泄而致胎黄。一治法：清热解毒，行气利湿。方药：绵茵陈9克炒栀子6至枳壳3克泽泻9克白花蛇舌草9克小叶凤尾草12克2剂。二诊(8月4日）：药后大便较稀烂，按上方去枳壳加厚朴3克，鸡内金4．5克，云茯苓6．9克，3剂。三诊(8月7日）：药后精神好转，胃纳渐增，舌色稍红，苔薄白，遵前法，稍佐益气之品。处方如下：绵茵陈9克枳壳3至云茯芩9至白花蛇舌草9克小叶凤尾草9克孩儿参6克3剂。四诊(8月15日）：皮肤面目黄染渐退，神情较前活泼。尿量稍多，色较前淡，大便稀烂，每天1至2次：湿热已解大半，继以清热利湿解毒兼益气健脾。处方：孩儿参6克参须4．5克绵茵陈9克小叶凤尾草9克白花蛇舌草9克枳壳3克泽泻9克生苡仁12克岗梅根9克3剂。五诊(8月18日）：前症显著好转，面目皮肤黄色渐退减，尿量增多，大便正常。按：5日方继服3剂，以后依此加减再服10余剂，诸证悉除。随访6年，小儿健康成长。
(《新中医》编辑室：《老中医医案医话选》，罗元恺医案，张玉珍整理。1977年）
例三杜某某，男，6岁，1953年10月出诊。冒雪玩耍，受寒战栗，小便不利，用热熨法暖脐下，小茴香煎汤服之，小便稍利，遂致面目发黄，黄色晦暗，腹胀尿少，食欲不振，便稀色灰，脉浮缓，苔白腻。辨证：寒湿阻遏，脾阳不振，胆液为湿所阻，溢于肌肤。治法：化气利水，温脾燥湿。方药：茵陈9克猪苓6克茯苓6克泽泻6克白木9克桂枝3克于姜3克服1剂，小便利，又服2剂，黄疸皆退，诸证悉愈。
(《窦伯清医案》
【评按】小儿黄疸，明代儿科学家万全认为此病“多因湿热、食积，与大人不同”，或由于脾虚湿滞而发病。但其中有属于新生儿黄疸者，中医称之为“胎黄”。此证多由母体湿热遗于胎儿，亦有因分娩后胎儿感受湿毒所致者。小儿黄疸的治疗，当以清利湿热或扶脾导滞化湿为大法。
例一为母体湿热蕴滞熏蒸于胎，即所谓“胎黄”。儿体湿热盛，兼见肝脾郁滞，治宜疏肝化湿和中为主。方用茵陈五苓散加减，凉血解毒则非所宜。
例二亦属胎黄，但临床辨证有脾运失健、湿热蕴内、不得宣泄之象。治以清热解毒、行气利湿法，方用茵陈蒿汤加减，其中用白花蛇舌草、小叶凤尾草能加强清热解毒利湿之效。此案的另一特点是，前后五诊始终辅以行气药以助运化，有助于健脾法湿消黄。
例三属小儿阴黄，由于寒湿阻遏，脾阳不振，湿困中土，症见面目晦黄，腹胀纳减，便稀色灰。治以化气利水，温脾燥湿法。按茵陈五苓散原治小儿湿热阳黄，此案以本方加辛热之干姜以温中扶阳，使临床适应症有所改变，然究非阴黄常用治法。
(十六）小儿肝昏迷孙××，男，1岁，住院号：101917。患黄疸二十天，十天来加重，精神不好，于1970年7月15日入院。入院印象：急性肝萎缩，早期肝昏迷。入院后神志逐渐不清，时有躁动，今晨神志益昏迷，躁动加甚，不断抽风，周身黄染明显，腹胀，便溏色白。肝胁下0．5厘米，脾未触及。体温38．5℃。舌质红，苔黄腻，脉象滑数。肝功能：谷丙转氨迥320单位，麝浊17．9单位，麝絮(++），直接胆红质13．9毫克％，间接胆红质17．1毫克％，7月17日请中医会诊：辨证：湿热入营，侵入心包。治法：清热开窍，利胆消黄。方药：3号安宫牛黄丸，每日四次，每次半丸。胆郁通，每日四次，每次一丸。服药第二天，躁动略减，继服上药。第三天昏迷好转，热退。第五天神清，但视力障碍，仍服上方。8月7日复诊：饮食、神志、体温均正常，一般情况好。仅视力未恢复，巩膜尚微黄，大使每日一次，在胆郁通方剂基础上加清肝明目法治之。方药：草决明、密蒙花、杭菊花、马尾连各9克胆草3克淡竹叶、广郁金各4．7克茵陈6克甘草3至水煎，4剂。8月11日复诊：视力好转，眼球能随外物活动，于8月6日复查肝功能：谷丙转氨酶：90单位，麝浊8.1，白蛋白3．1克％，球蛋白2．3克％。直接胆红质3．08毫克％，间接胆红质0．7毫克％。原方带药出院，门诊继续治疗。一个月后复查，一般情况好，视力已恢复正常。肝功能基本正常。附注：“胆郁通”为何氏验方，功能清利湿热，利胆消黄。其组成为：茵陈150克，郁金75克，甘草15克。共研细末，蜜丸，丸重1．5克。服法：一日总量，1岁2丸，3岁4丸，6岁6丸。主治急性传染性肝炎，包括黄疸型与非黄疸型，溶血性黄疸，慢性间歇性幼儿黄疸等辨证属于阳黄者，较有效验。
(《何世英儿科医案》
【评按】此例辨证属湿热入营，邪犯心包。故先治以安宫牛黄丸清热解毒，芳香开窍，开其闭以治其标；又以何氏验方“胆郁通”清泄湿热、利胆化郁以治其本。标本兼顾，效验颇著。
(十六）小儿肾炎
例一张××，男，8岁，病历号：565920一天来壮热轻咳，头痛，颈部不适，面目微肿，小溲短赤，大使两日未行。血压110/65毫米汞柱，心、肺、腹未见异常。化验尿蛋白(+++），红细胞(++），管型0～1。血沉第一小时28毫米，第二小时58毫米。舌苔薄黄，脉滑。辨证：邪热郁闭，内伤阴络。治法：清宣泻热化瘀。方药：银花10克连翘10克荆芥10克枯芩6克赤芍10克丹皮6克白茅根15克败酱草12至大青叶10至大黄2．4克炒栀子10克服药3剂，肺气得宣，汗出尿增，诸证大减，病有转机。又继服3剂。面目肿已消，咳嗽壮热俱平。诸症悉无，仅尿化验尚有轻微异常。继以金匮肾气丸调治月余而愈，各项化验均正常。
(《赵心波几科临床经验选编》）
例二。汤某某，男，8岁，病历号：118707。因浮肿6个月，屡治不效，于1963年9月24日入院。患儿半年前开始面部四肢浮肿，尿少色黄，并出现腹水，尿蛋白(+++），诊为肾病综合征。半月前又合并肺炎，曾用多种抗菌素未效。入院后经多种化验检查，西医确诊为，慢性肾炎肾病期(大量胸水、腹水），肺炎。患儿面色萎黄不泽，舌尖赤，舌光无苔，脉沉细弦。证属脾肺俱虚，水湿泛滥，肝阳偏亢，虚火上炎之证。予以扶脾利水平肝之四苓散合龙胆泻肝汤及牡蛎泽泻散等方治之。住院四日，诸症不减，呼吸困难加重，胸水仍多，腹水增加，曾采取西医积极措施，予抽胸水、放腹水，仅肺炎略有好转，诸症仍无明显进步，病情持续恶化，1963年10月8日请王老会诊，辨证认为：病在脾肾，重点在脾。又因治不得法，病势危笃。只能消补同施，温清并用。药用：白茅根60克，煎15分钟，取水二大碗，去渣，以一碗水煎生鸡内金(打烂）15至，白术9至，广陈皮3克，生姜皮9至，煎二次。停用西药及输液。苡米神曲粥：苡米60克，神曲120克，大黄米90克，赤小豆180克，另加猪肝半斤切碎，用砂锅煮成粥，每次饭前服用小半碗。5日后诸症进展不大，改用茅根鸡金汤：鲜茅根60至，先煎15分钟，后入生鸡内金15克，煎法同前。同时用葱熨法：大葱一斤纵切，黄酒60克，炒热装纱布袋内，在腹部按顺时针方向自右下至左下处熨，每日1～2次，每次熨1～3小时。一周后诸症悉减，尿量增加，每日800～1000毫升，大便正常，阴囊水肿减轻。10月26日：患儿外感发烧(39．8℃）脉浮，苔薄黄，证属外有风气，内有积滞，诊为“风水”，治以表里分消：麻黄(先煎去沫）3克滑石9克生甘草1．5克香薷4．5克麸炒枳壳3至川厚朴3克生姜3克大枣1枚炒神曲9克炒山楂9克炒麦芽9克药后微有汗出，当晚体温下降至正常，仍服茅根鸡金汤；另用香薷6克煎水代茶饮，20余剂后症情明显好转。11月9日，脉趋和平，肿胀基本消退，原方酌加清补肺肾之品。鲜茅根60克先煎去渣。再煎下药：生鸡内金(打碎）9至生黄芪9克广陈皮1．2至11月18日停香薷代茶及葱熨，乃予六味地黄汤化裁调理。住院4个半月，症情基本消失，遂以滋益肾水，调和脾胃善后。随访14年，曾反复三次，均获缓解、现已参加工作5年，一般情况良好；未再复发。
(王文鼎治验，靖雨珍整理：小儿童症水肿证治验，《新医药学杂志》6：17，1978）
【评按】肾炎为病，主要当从中医水肿门中探求证治。临床辨证与肺、脾、肾三脏的关系尤为密切。所谓“其标在肺，其本在肾，其制在脾”。急性肾炎有主张治以清宣泻热利水法，或认为此病急性发作多属“风水”，宜用发表法风利水之法，慢性肾炎则多从脾肾论治。
例一为急性肾炎，有一派实热见症。治以清宣泻热化瘀为大法，主治的重点在肺，赵氏以宣肺利尿治其标，后以肾气丸温肾治本，使三焦决渎有权。
例二为慢性肾炎肾病期合并肺炎，中医辨证已从风水发展为正水，患儿腹水胸水明显，病理上脾肺俱虚，水湿泛滥，肝阳偏亢，虚火上炎。故以四苓散合龙胆泻肝汤及牡蛎泽泻散等方加减。在治疗过程中消补兼施，清温并用，还配合食疗及葱熨外治，加强了宣肺健脾、消滞利水等医疗作用。在调理诸脏方面，更多地着眼于脾。此案是在停用西药的情况下取得良效的。
(十八）尿频。戴某，男，8岁初诊
(1976年：月6日）：尿频、尿急半年余、从无尿痛，夜寐不安，睡中起床而走，惊恐哭闹，醒后全忘，寐则盗汗，舌苔薄，脉滑数，病系心肾不足。治与养心宁神，补益肾气，甘麦大枣汤加味。甘草9克淮小麦30至红枣30克珍珠母30克夜交藤30克茯神9克远志9克磁石30克(先煎）五味子6克菟丝子15克7剂。二诊(1月13日）：尿频略有好转，原方续服7剂。三诊(1月24日）：尿频尿急续有好转。守原意加培补脾肾之品，党参12克补骨脂15克珍珠母30克磁石30克(先煎）五味子9克夜交藤30至甘草9克菟丝子15克覆盆子15克10剂。四诊(2月5日）：尿频、尿急、尿短大有好转，纳可，口气秽臭，舌苔薄腻，脉细滑。原法加胡黄连，以苦降清胃中湿热。炙甘草9克淮小麦30克红枣30克五味子6克菟丝子15克远志9克珍珠母30克磁石30至(先煎）、夜交藤30至胡黄连4.5克7剂。五诊(3月13日）：服药以来，症情好转，小便次数明显减少，上课已不解溲，夜寐亦安，盗汗尚多，口气秽臭已消。原有夜游一症已月余未发。再予前法巩固之。炙甘草9克淮小麦30至红枣30克糯稻根30克菟丝子15克远志9克茯苓9克五味子6克(打）北秫米30克7剂。
(《上海老中医经验选编》王玉澜医案）
【评按】此案尿频急而有心肾不足见证，王氏以甘麦大枣汤加远志、茯神、磁石、珍珠母，夜交藤等养心宁神、甘润缓急为主，佐以菟丝子、覆盆子、补骨脂等补益肾气，井于治疗过程中参入扶脾、清胃诸法。全案治法活泼，随证变化而方药精审可取。
(十九）小儿再生障碍性贫血李××，男，8岁，1972年1月1日入院。住院号：109285。患者以再生障碍性贫血入院，当时血色素4．6％，血小板16，000／立方毫米。先后用过强的松、丙酸睾丸酮等治疗九个多月，血象仍无进展。1972年10月7日中医会诊。证见面色苍白，腰酸膝软，疲倦乏力，舌质淡红，脉象细弱。辨证：脾肾两虚。治法：健脾益肾。方药：复血汤(一般用量，见下附方）。经服上药两周，血色素升至10．2至％，一共服药五个月，至1973年6月13日血色素升至16克％，血小板为56，000／立方毫米。又过三个月，至1973年9月8日复诊：一般情况好，血色素多次化验，最低为14．8克％，血小板已增至102，000／立方毫米，好转出院。附方：复血汤：山萸肉、黄精、生黄芪、当归、阿胶、玉竹、生地、熟地各9克，何首乌、旱莲草）生山药各15克。
(《何世英儿科医案》）
【评按】再生障碍性贫血属内伤血虚范畴，中医多从肝、脾、肾论治。此案辨证属肝肾两虚，然结合脉证，肝血亦虚，何氏所用复血汤为其个人验方，主治气血两虚、阴血不足，症见身倦乏力，面色苍白，腰膝酸软，舌质淡红，脉象细弱之再障患者。功能补气生血，补益肝肾。
例二：我诊治的一位患儿，男，2.5个月大，于1970年7月31日初诊。家属代述：患儿为第一胎第一产，出生后数日开始出现黄疸，日渐加重，至今两个月未愈。曾在某医院检查，诊断为新生儿黄疸（病理性），称非手术治疗不可，但家属未同意。来诊时，患儿面目及全身皮肤黄如橘色，精神疲倦，想睡觉，不想吃奶，偶尔呕吐，尿量少且颜色黄赤，大便干结不畅、颜色淡，嘴唇和舌头紫红而暗。辨证为：脾运化功能不健，湿热之邪蕴蓄在体内，不得宣泄而导致胎黄（先天性黄疸）。治法：清热解毒，行气利湿。方药：绵茵陈9克，炒栀子6克，枳壳3克，泽泻9克，白花蛇舌草9克，小叶凤尾草12克，共2剂。
二诊（8月4日）：服药后大便较稀烂，按上方去掉枳壳，加厚朴3克，鸡内金4.5克，云茯苓6.9克，共3剂。
三诊（8月7日）：服药后精神好转，胃纳渐增，舌色稍红，苔薄白，遵照前法，稍加益气之品。处方如下：绵茵陈9克，枳壳3克，云茯苓9克，白花蛇舌草9克，小叶凤尾草9克，孩儿参6克，共3剂。
四诊（8月15日）：皮肤面目黄染逐渐消退，神情较前活泼。尿量稍多，颜色较前淡，大便稀烂，每天1至2次；湿热已解大半，继续以清热利湿解毒兼益气健脾。处方：孩儿参6克，参须4.5克，绵茵陈9克，小叶凤尾草9克，白花蛇舌草9克，枳壳3克，泽泻9克，生苡仁12克，岗梅根9克，共3剂。
五诊（8月18日）：前症显著好转，面目皮肤黄色逐渐退减，尿量增多，大便正常。按语：继服上述方剂3剂，以后依此加减再服10余剂，诸证悉除。随访6年，小儿健康成长。
（《新中医》编辑室：《老中医医案医话选》，罗元恺医案，张玉珍整理。1977年）
例三：杜某某，男，6岁，1953年10月出诊。因冒雪玩耍，受寒战栗，小便不利，用热熨法暖脐下，小茴香煎汤服之，小便稍利，遂致面目发黄，黄色晦暗，腹胀尿少，食欲不振，便稀色灰，脉浮缓，苔白腻。辨证：寒湿阻遏，脾阳不振，胆液为湿所阻，溢于肌肤。治法：化气利水，温脾燥湿。方药：茵陈9克，猪苓6克，茯苓6克，泽泻6克，白术9克，桂枝3克，干姜3克，服1剂，小便利，又服2剂，黄疸皆退，诸证悉愈。
（《窦伯清医案》
【评按】小儿黄疸，明代儿科学家万全认为此病“多因湿热、食积，与大人不同”，或由于脾虚湿滞而发病。但其中有属于新生儿黄疸者，中医称之为“胎黄”。此证多由母体湿热遗于胎儿，亦有因分娩后胎儿感受湿毒所致者。小儿黄疸的治疗，当以清利湿热或扶脾导滞化湿为大法。
例一为母体湿热蕴滞熏蒸于胎，即所谓“胎黄”。儿体湿热盛，兼见肝脾郁滞，治宜疏肝化湿和中为主。方用茵陈五苓散加减，凉血解毒则非所宜。
例二亦属胎黄，但临床辨证有脾运失健、湿热蕴内、不得宣泄之象。治以清热解毒、行气利湿法，方用茵陈蒿汤加减，其中用白花蛇舌草、小叶凤尾草能加强清热解毒利湿之效。此案的另一特点是，前后五诊始终辅以行气药以助运化，有助于健脾法湿消黄。
例三属小儿阴黄，由于寒湿阻遏，脾阳不振，湿困中土，症见面目晦黄，腹胀纳减，便稀色灰。治以化气利水，温脾燥湿法。按茵陈五苓散原治小儿湿热阳黄，此案以本方加辛热之干姜以温中扶阳，使临床适应症有所改变，然究非阴黄常用治法。
(十六）小儿肝昏迷孙××，男，1岁，住院号：101917。患黄疸二十天，十天来加重，精神不好，于1970年7月15日入院。入院印象：急性肝萎缩，早期肝昏迷。入院后神志逐渐不清，时有躁动，今晨神志益昏迷，躁动加甚，不断抽风，周身黄染明显，腹胀，便溏色白。肝胁下0.5厘米，脾未触及。体温38.5℃。舌质红，苔黄腻，脉象滑数。肝功能：谷丙转氨酶320单位，麝浊17.9单位，麝絮(++），直接胆红素13.9毫克％，间接胆红素17.1毫克％，7月17日请中医会诊：辨证：湿热入营，侵入心包。治法：清热开窍，利胆消黄。方药：3号安宫牛黄丸，每日四次，每次半丸。胆郁通，每日四次，每次一丸。服药第二天，躁动略减，继服上药。第三天昏迷好转，热退。第五天神清，但视力障碍，仍服上方。8月7日复诊：饮食、神志、体温均正常，一般情况好。仅视力未恢复，巩膜尚微黄，大便每日一次，在胆郁通方剂基础上加清肝明目法治之。方药：草决明、密蒙花、杭菊花、马尾连各9克，龙胆草3克，淡竹叶、广郁金各4.7克，茵陈6克，甘草3克，水煎，4剂。8月11日复诊：视力好转，眼球能随外物活动，于8月6日复查肝功能：谷丙转氨酶：90单位，麝浊8.1，白蛋白3.1克％，球蛋白2.3克％。直接胆红素3.08毫克％，间接胆红素0.7毫克％。原方带药出院，门诊继续治疗。一个月后复查，一般情况好，视力已恢复正常。肝功能基本正常。附注：“胆郁通”为何氏验方，功能清利湿热，利胆消黄。其组成为：茵陈150克，郁金75克，甘草15克。共研细末，蜜丸，丸重1.5克。服法：一日总量，1岁2丸，3岁4丸，6岁6丸。主治急性传染性肝炎，包括黄疸型与非黄疸型，溶血性黄疸，慢性间歇性幼儿黄疸等辨证属于阳黄者，较有效验。
(《何世英儿科医案》
【评按】此例辨证属湿热入营，邪犯心包。故先治以安宫牛黄丸清热解毒，芳香开窍，开其闭以治其标；又以何氏验方“胆郁通”清泄湿热、利胆化郁以治其本。标本兼顾，效验颇著。
(十六）小儿肾炎
例一张××，男，8岁，病历号：565920。一天来壮热轻咳，头痛，颈部不适，面目微肿，小溲短赤，大便两日未行。血压110/65毫米汞柱，心、肺、腹未见异常。化验尿蛋白(+++），红细胞(++），管型0～1。血沉第一小时28毫米，第二小时58毫米。舌苔薄黄，脉滑。辨证：邪热郁闭，内伤阴络。治法：清宣泻热化瘀。方药：银花10克，连翘10克，荆芥10克，枯芩6克，赤芍10克，丹皮6克，白茅根15克，败酱草12克，大青叶10克，大黄2.4克，炒栀子10克。服药3剂，肺气得宣，汗出尿增，诸证大减，病有转机。又继服3剂。面目肿已消，咳嗽壮热俱平。诸症悉无，仅尿化验尚有轻微异常。继以金匮肾气丸调治月余而愈，各项化验均正常。
（《赵心波儿科临床经验选编》）
例二：汤某某，男，8岁，病历号：118707。因浮肿6个月，屡治不效，于1963年9月24日入院。患儿半年前开始面部四肢浮肿，尿少色黄，并出现腹水，尿蛋白(+++)，诊为肾病综合征。半月前又合并肺炎，曾用多种抗菌素未效。入院后经多种化验检查，西医确诊为：慢性肾炎肾病期(大量胸水、腹水），肺炎。患儿面色萎黄不泽，舌尖赤，舌光无苔，脉沉细弦。证属脾肺俱虚，水湿泛滥，肝阳偏亢，虚火上炎之证。予以扶脾利水平肝之四苓散合龙胆泻肝汤及牡蛎泽泻散等方治之。住院四日，诸症不减，呼吸困难加重，胸水仍多，腹水增加，曾采取西医积极措施，予抽胸水、放腹水，仅肺炎略有好转，诸症仍无明显进步，病情持续恶化，1963年10月8日请王老会诊，辨证认为：病在脾肾，重点在脾。又因治不得法，病势危笃。只能消补同施，温清并用。药用：白茅根60克，煎15分钟，取水二大碗，去渣，以一碗水煎生鸡内金(打烂）15克，白术9克，广陈皮3克，生姜皮9克，煎二次。停用西药及输液。苡米神曲粥：苡米60克，神曲120克，大黄米90克，赤小豆180克，另加猪肝半斤切碎，用砂锅煮成粥，每次饭前服用小半碗。5日后诸症进展不大，改用茅根鸡金汤：鲜茅根60克，先煎15分钟，后入生鸡内金15克，煎法同前。同时用葱熨法：大葱一斤纵切，黄酒60克，炒热装纱布袋内，在腹部按顺时针方向自右下至左下处熨，每日1～2次，每次熨1～3小时。一周后诸症悉减，尿量增加，每日800～1000毫升，大便正常，阴囊水肿减轻。10月26日：患儿外感发烧(39.8℃）脉浮，苔薄黄，证属外有风气，内有积滞，诊为“风水”，治以表里分消：麻黄(先煎去沫）3克，滑石9克，生甘草1.5克，香薷4.5克，麸炒枳壳3克，川厚朴3克，生姜3克，大枣1枚，炒神曲9克，炒山楂9克，炒麦芽9克。药后微有汗出，当晚体温下降至正常，仍服茅根鸡金汤；另用香薷6克煎水代茶饮，20余剂后症情明显好转。11月9日：脉趋和平，肿胀基本消退，原方酌加清补肺肾之品。鲜茅根60克先煎去渣。再煎下药：生鸡内金(打碎）9克，生黄芪9克，广陈皮1.2克。11月18日停香薷代茶及葱熨，乃予六味地黄汤化裁调理。住院4个半月，症情基本消失，遂以滋益肾水，调和脾胃善后。随访14年，曾反复三次，均获缓解、现已参加工作5年，一般情况良好；未再复发。
（王文鼎治验，靖雨珍整理：小儿童症水肿证治验，《新医药学杂志》6：17，1978）
【评按】肾炎为病，主要当从中医水肿门中探求证治。临床辨证与肺、脾、肾三脏的关系尤为密切。所谓“其标在肺，其本在肾，其制在脾”。急性肾炎有主张治以清宣泻热利水法，或认为此病急性发作多属“风水”，宜用发表法风利水之法，慢性肾炎则多从脾肾论治。
例一为急性肾炎，有一派实热见症。治以清宣泻热化瘀为大法，主治的重点在肺，赵氏以宣肺利尿治其标，后以肾气丸温肾治本，使三焦决渎有权。
例二为慢性肾炎肾病期合并肺炎，中医辨证已从风水发展为正水，患儿腹水胸水明显，病理上脾肺俱虚，水湿泛滥，肝阳偏亢，虚火上炎。故以四苓散合龙胆泻肝汤及牡蛎泽泻散等方加减。在治疗过程中消补兼施，清温并用，还配合食疗及葱熨外治，加强了宣肺健脾、消滞利水等医疗作用。在调理诸脏方面，更多地着眼于脾。此案是在停用西药的情况下取得良效的。
(十八）尿频。戴某，男，8岁初诊（1976年1月6日）：尿频、尿急半年余，从无尿痛，夜寐不安，睡中起床而走，惊恐哭闹，醒后全忘，寐则盗汗，舌苔薄，脉滑数，病系心肾不足。治与养心宁神，补益肾气，甘麦大枣汤加味。甘草9克，淮小麦30克，红枣30克，珍珠母30克，夜交藤30克，茯神9克，远志9克，磁石30克(先煎），五味子6克，菟丝子15克，7剂。二诊(1月13日）：尿频略有好转，原方续服7剂。三诊(1月24日）：尿频尿急续有好转。守原意加培补脾肾之品，党参12克，补骨脂15克，珍珠母30克，磁石30克(先煎），五味子9克，夜交藤30克，甘草9克，菟丝子15克，覆盆子15克，10剂。四诊(2月5日）：尿频、尿急、尿短大有好转，纳可，口气秽臭，舌苔薄腻，脉细滑。原法加胡黄连，以苦降清胃中湿热。炙甘草9克，淮小麦30克，红枣30克，五味子6克，菟丝子15克，远志9克，珍珠母30克，磁石30克(先煎），夜交藤30克，胡黄连4.5克，7剂。五诊(3月13日）：服药以来，症情好转，小便次数明显减少，上课已不解溲，夜寐亦安，盗汗尚多，口气秽臭已消。原有夜游一症已月余未发。再予前法巩固之。炙甘草9克，淮小麦30克，红枣30克，糯稻根30克，菟丝子15克，远志9克，茯苓9克，五味子6克(打），北秫米30克，7剂。
（《上海老中医经验选编》王玉澜医案）
【评按】此案尿频急而有心肾不足见证，王氏以甘麦大枣汤加远志、茯神、磁石、珍珠母，夜交藤等养心宁神、甘润缓急为主，佐以菟丝子、覆盆子、补骨脂等补益肾气，并于治疗过程中参入扶脾、清胃诸法。全案治法活泼，随证变化而方药精审可取。
(十九）小儿再生障碍性贫血李××，男，8岁，1972年1月1日入院。住院号：109285。患者以再生障碍性贫血入院，当时血色素4.6％，血小板16,000／立方毫米。先后用过强的松、丙酸睾丸酮等治疗九个多月，血象仍无进展。1972年10月7日中医会诊。证见面色苍白，腰酸膝软，疲倦乏力，舌质淡红，脉象细弱。辨证：脾肾两虚。治法：健脾益肾。方药：复血汤(一般用量，见下附方）。经服上药两周，血色素升至10.2克％，一共服药五个月，至1973年6月13日血色素升至16克％，血小板为56,000／立方毫米。又过三个月，至1973年9月8日复诊：一般情况好，血色素多次化验，最低为14.8克％，血小板已增至102,000／立方毫米，好转出院。附方：复血汤：山萸肉、黄精、生黄芪、当归、阿胶、玉竹、生地、熟地各9克，何首乌、旱莲草、生山药各15克。
（《何世英儿科医案》）
【评按】再生障碍性贫血属内伤血虚范畴，中医多从肝、脾、肾论治。此案辨证属肝肾两虚，然结合脉证，肝血亦虚，何氏所用复血汤为其个人验方，主治气血两虚、阴血不足，症见身倦乏力，面色苍白，腰膝酸软，舌质淡红，脉象细弱之再障患者。功能补气生血，补益肝肾。
Case 2: I treated a pediatric patient, male, 2.5 months old, first seen on July 31, 1970. The family reported: The infant was the first child of the first pregnancy and delivery. Jaundice appeared several days after birth and gradually worsened, persisting for two months without resolution. He had been examined at a certain hospital and diagnosed with Neonatal Jaundice (Pathological), where it was stated that non-surgical treatment was necessary, but the family did not agree. Upon consultation, the infant’s face, eyes, and whole body were yellow like an orange peel. He showed mental fatigue, drowsiness, refused breastfeeding, occasionally vomited, had scanty urine that was dark yellow-red, dry and difficult-to-pass stools that were pale in color, and purple-red, dark lips and tongue. Syndrome differentiation: Spleen transportation and transformation function is impaired; Damp-Heat pathogenic factors are accumulated internally and cannot be vented, leading to Taihuang (Congenital Jaundice). Therapeutic method: Clear heat and detoxify, move Qi and promote diuresis to resolve dampness. Prescription: Yinchen 9g (Mume Fruit), Chao Zhizi 6g (Stir-fried Gardenia Fructus), Zhike 3g (Aurantium Fructus), Zexie 9g (Alisma Rhizome), Baihua She She Cao 9g (Hedyotis Diffusa Herb), Xiaoye Fengwei Cao 12g (Pteris Multifida Herb). Total 2 doses.
Second visit (August 4): After medication, stools became looser. Based on the previous prescription, remove Zhike, add Houpo 3g (Magnolia Bark), Jineijin 4.5g (Gallus Gallus Bladder Lining), Yun Fuling 6.9g (Poria Cocos). Total 3 doses.
Third visit (August 7): Mental state improved, appetite increased slightly, tongue color slightly red, coating thin and white. Follow the previous method, adding slight Qi-tonifying herbs. Prescription: Yinchen 9g, Zhike 3g, Yun Fuling 9g, Baihua She She Cao 9g, Xiaoye Fengwei Cao 9g, Haier Shen 6g (Codonopsis Pilosula Rootlet). Total 3 doses.
Fourth visit (August 15): Skin and facial jaundice gradually receded, spirit more active than before. Urine volume slightly increased, color lighter than before, stools loose, 1-2 times daily; Damp-Heat has resolved by more than half. Continue clearing heat, promoting diuresis to resolve dampness, detoxifying, while tonifying Qi and strengthening the Spleen. Prescription: Haier Shen 6g, Renshu 4.5g (Codonopsis Pilosula Rootlets), Yinchen 9g, Xiaoye Fengwei Cao 9g, Baihua She She Cao 9g, Zhike 3g, Zexie 9g, Sheng Yiren 12g (Coix Seed), Gangmei Gen 9g (Platycodon Grandiflorus Root). Total 3 doses.
Fifth visit (August 18): Previous symptoms significantly improved, facial and skin yellowing gradually faded, urine volume increased, stools normal. Note: Continue taking the above prescription for 3 doses, then adjust based on this formula and take for over 10 more doses until all symptoms disappear. Follow-up for 6 years shows healthy growth of the child.
(Editorial Department of "New Chinese Medicine": *Selection of Old TCM Doctors' Cases and Talks*, Luo Yuankai's Cases, organized by Zhang Yuzhen. 1977)
Case 3: Du Moumou, male, 6 years old, consulted in October 1953. After playing in the snow, he suffered from cold-induced shivering and difficulty urinating. Heat application was used to warm the lower abdomen, and Xiao Hui Xiang (Fennel) decoction was taken orally, which slightly improved urination. Subsequently, facial and eye jaundice developed, with a dull yellow color, abdominal distension, scanty urine, poor appetite, loose gray-colored stools, floating and slow pulse, and white greasy coating. Syndrome differentiation: Cold-Dampness obstruction, failure of Spleen Yang to rise, bile fluid blocked by dampness and overflowing into the skin. Therapeutic method: Transform Qi and promote water metabolism, warm the Spleen and dry dampness. Prescription: Yinchen 9g, Zhu Ling 6g (Polyporus), Fuling 6g (Poria Cocos), Zexie 9g, Baizhu 9g (Atractylodes Macrocephala Rhizome), Guizhi 3g (Cinnamon Twig), Ganjiang 3g (Dried Ginger). Take 1 dose; if urination improves, take another 2 doses. Jaundice disappeared completely, and all symptoms resolved.
(*Dou Boqing Medical Cases*)
[Commentary]: Pediatric jaundice, according to Wan Quan, a Ming Dynasty pediatrician, is "mostly due to Damp-Heat and food stagnation, different from adults," or caused by Spleen deficiency with dampness retention. Among these, some belong to neonatal jaundice, known in TCM as "Taihuang" (Congenital Jaundice). This condition is mostly caused by maternal Damp-Heat transmitted to the fetus, or sometimes due to the fetus contracting damp-toxin after delivery. The treatment of pediatric jaundice should primarily focus on clearing and draining Damp-Heat or supporting the Spleen to guide stagnation and resolve dampness.
Case 1 involves maternal Damp-Heat accumulation steaming the fetus, i.e., "Taihuang." The infant has excessive internal Damp-Heat accompanied by Liver-Spleen Qi stagnation. Treatment should prioritize soothing the Liver, resolving dampness, and harmonizing the middle. Use Yinchen Wuling San (Artemisia Capillaris and Five-Ingredient Poria Decoction) with modifications; cooling blood and detoxifying is not appropriate.
Case 2 also belongs to Taihuang, but clinical differentiation shows signs of impaired Spleen transportation, internal Damp-Heat accumulation, and inability to vent. Treatment uses clearing heat, detoxifying, moving Qi, and promoting diuresis to resolve dampness. Use Yinchen Hao Tang (Artemisia Capillaris, Gardenia, and Rhubarb Decoction) with modifications. The use of Baihua She She Cao and Xiaoye Fengwei Cao enhances the effects of clearing heat, detoxifying, and promoting diuresis. Another feature of this case is the consistent use of Qi-moving herbs throughout the five visits to assist digestion, aiding in strengthening the Spleen, resolving dampness, and eliminating jaundice.
Case 3 belongs to pediatric Yin Huang (Yin-type Jaundice). Due to Cold-Dampness obstruction and failure of Spleen Yang, dampness traps the Middle Jiao, presenting with dull yellow face and eyes, abdominal distension, reduced appetite, and loose gray stools. Treatment uses transforming Qi, promoting water metabolism, warming the Spleen, and drying dampness. Although Yinchen Wuling San originally treats pediatric Yang Huang (Yang-type Jaundice) caused by Damp-Heat, this case adds Xin Re (Acrid-Warm) Ganjiang (Dried Ginger) to warm the middle and support Yang, altering its clinical indications, though it is not the standard treatment for Yin Huang.
(Sixteen) Pediatric Hepatic Coma Sun XX, male, 1 year old, Hospital No.: 101917. Suffered from jaundice for 20 days, worsening over the past 10 days, with poor spirit, admitted on July 15, 1970. Admission impression: Acute liver atrophy, early hepatic coma. After admission, consciousness gradually became unclear, with occasional restlessness. That morning, consciousness worsened into coma, restlessness intensified, continuous convulsions occurred, obvious jaundice covered the body, abdominal distension, and loose white stools. Liver palpable 0.5 cm below the costal margin, spleen not palpable. Temperature 38.5°C. Tongue red, coating yellow and greasy, pulse slippery and rapid. Liver function tests: ALT 320 units, Macroglobulin Turbidity (TTL) 17.9 units, Macroglobulin Flocculation (++), Direct Bilirubin 13.9 mg%, Indirect Bilirubin 17.1 mg%. On July 17, TCM consultation requested: Syndrome differentiation: Damp-Heat enters the Ying (Nutrient) level, invading the Pericardium. Therapeutic method: Clear heat and open orifices, promote bile flow and reduce jaundice. Prescription: An Gong Niu Huang Wan (Calculus Bovis and Bezoar Pill) No. 3, four times daily, half pill each time. Dan Yu Tong (Bile Stagnation Unblock), four times daily, one pill each time. On the second day of medication, restlessness decreased slightly; continue the above medicine. On the third day, coma improved, fever subsided. On the fifth day, consciousness cleared, but visual impairment remained; continue the above prescription. Follow-up on August 7: Diet, consciousness, and temperature were normal, general condition good. Only vision had not recovered, sclera still slightly yellow, stool once daily. Add liver-clearing and vision-improving methods to the Dan Yu Tong prescription. Prescription: Ju Ming Zi 9g (Cassia Seed), Mi Meng Hua 9g (Buddleja Flower), Hang Ju Hua 9g (Chrysanthemum Flower), Ma Wei Lian 9g (Isatis Root), Long Dan Cao 3g (Gentian Root), Dan Zhu Ye 4.7g (Lophatherum Leaf), Guang Yu Jin 4.7g (Curcuma Aromatica Rhizome), Yinchen 6g, Gancao 3g (Licorice Root). Decoct in water, 4 doses. Follow-up on August 11: Vision improved, eyeballs could follow external objects. Liver function re-examined on August 6: ALT 90 units, TTL 8.1, Albumin 3.1 g%, Globulin 2.3 g%. Direct Bilirubin 3.08 mg%, Indirect Bilirubin 0.7 mg%. Discharged with original prescription for outpatient continued treatment. One month later re-examination: General condition good, vision fully recovered. Liver function basically normal. Note: "Dan Yu Tong" is a verified formula by Mr. He, functioning to clear and drain Damp-Heat, promote bile flow, and reduce jaundice. Composition: Yinchen 150g, Yu Jin 75g, Gancao 15g. Grind into fine powder, make honey pills, each weighing 1.5g. Dosage: Daily total, 2 pills for 1-year-old, 4 pills for 3-year-old, 6 pills for 6-year-old. Mainly treats acute infectious hepatitis, including icteric and non-icteric types, hemolytic jaundice, chronic intermittent pediatric jaundice, etc., differentiated as Yang Huang, with effective results.
(He Shiying Pediatric Cases)
[Commentary]: This case is differentiated as Damp-Heat entering the Ying level, pathogens attacking the Pericardium. Therefore, initially treat with An Gong Niu Huang Wan to clear heat, detoxify, and use aromatic herbs to open orifices, addressing the branch/symptoms; simultaneously use Mr. He's verified formula "Dan Yu Tong" to clear and drain Damp-Heat, promote bile flow, and resolve stagnation, addressing the root cause. Addressing both branch and root yielded significant efficacy.
(Sixteen) Pediatric Nephritis
Case 1 Zhang XX, male, 8 years old, Medical Record No.: 565920. For one day, high fever, mild cough, headache, neck discomfort, slight swelling of face and eyes, short and red urine, no bowel movement for two days. Blood pressure 110/65 mmHg, heart, lungs, and abdomen normal. Lab tests: Urine protein (+++), Red Blood Cells (++), Casts 0-1. ESR 1st hour 28mm, 2nd hour 58mm. Tongue coating thin yellow, pulse slippery. Syndrome differentiation: Pathogenic heat constrained and closed, damaging Yin collaterals internally. Therapeutic method: Clear and diffuse, purge heat, resolve stasis. Prescription: Yinhua 10g (Honeysuckle Flower), Lianqiao 10g (Forsythia Fruit), Jingjie 10g (Schizonepeta Spike), Ku Qin 6g (Scutellaria Root), Chishao 10g (Red Peony Root), Danpi 6g (Moutan Cortex), Baimaogen 15g (Imperata Rhizome), Baijiangcao 12g (Patrinia Herb), Da Qing Ye 10g (Isatis Leaf), Dahuang 2.4g (Rhubarb Root), Chao Zhizi 10g (Stir-fried Gardenia Fructus). Take 3 doses; Lung Qi diffuses, sweating occurs, urine increases, major symptoms decrease, disease turns. Continue taking 3 more doses. Facial and eye swelling subsided, cough and high fever ceased. All symptoms disappeared, only slight abnormalities in urine lab tests remain. Continue treating with Jinkui Shenqi Wan (Golden Cabinet Kidney Qi Pill) for over a month until cured; all lab tests normal.
(Zhao Xinbo Pediatric Clinical Experience Selection)
Case 2 Tang Moumou, male, 8 years old, Medical Record No.: 118707. Admitted on September 24, 1963, due to edema for 6 months, unresponsive to repeated treatments. Six months prior, facial and limb edema began, with scanty yellow urine and ascites. Urine protein (+++), diagnosed as Nephrotic Syndrome. Half a month ago, pneumonia complicated the condition; multiple antibiotics were ineffective. After various lab tests upon admission, Western medicine confirmed Chronic Nephritis, Nephrotic Stage (massive pleural effusion, ascites), and Pneumonia. Infant’s complexion was sallow and lusterless, tongue tip red, tongue smooth without coating, pulse deep, fine, and wiry. Syndrome belongs to Spleen and Lung deficiency, flooding of water-dampness, hyperactivity of Liver Yang, and deficiency fire flaming upward. Treat with Si Ling San (Four-Poria Decoction) combined with Longdan Xiegan Tang (Gentian Liver-Draining Decoction) and Muzhou Zexie San (Oyster Shell and Alisma Powder) to support Spleen, promote diuresis, and calm Liver. After four days of hospitalization, symptoms did not subside, breathing difficulty worsened, pleural effusion remained heavy, ascites increased. Western medical measures were taken, including thoracentesis and paracentesis; only pneumonia slightly improved, other symptoms showed no obvious progress, condition continuously deteriorated. Consulted Elder Wang on October 8, 1963. Differentiation: Disease located in Spleen and Kidney, focusing on Spleen. Due to improper treatment, the condition became critical. Must apply simultaneous reduction and supplementation, combining warming and clearing. Medication: Baimaogen 60g, decoct for 15 minutes, collect two large bowls of liquid, remove residue, use one bowl of water to decoct raw Jineijin (crushed) 15g, Baizhu 9g, Guang Chenpi 3g (Aged Tangerine Peel), Shengjiang Pi 9g (Ginger Peel), decoct twice. Stop Western medicines and IV fluids. Coix Seed and Shen Qu Porridge: Yimi 60g (Coix Seed), Shenqu 120g (Medicated Leaven), Dahuangmi 90g (Millet), Chixiaodou 180g (Adzuki Bean), plus half a pound of chopped pork liver, cooked into porridge in a clay pot. Take a small half-bowl before each meal. After 5 days, symptoms progressed little, switch to Maogen Jijin Tang (Imperata and Gallus Bladder Decoction): Fresh Maogen 60g, decoct first for 15 minutes, then add raw Jineijin 15g, decoct as before. Simultaneously use Congyun Method (Green Onion Heat Application): Cut one jin (500g) of green onions longitudinally, mix with 60g of yellow wine, stir-fry hot, place in a gauze bag, apply to the abdomen in a clockwise direction from right lower to left lower quadrant, 1-2 times daily, 1-3 hours each time. After one week, all symptoms decreased, urine volume increased to 800-1000 ml daily, stools normal, scrotal edema reduced. October 26: Infant had external contraction fever (39.8°C), floating pulse, thin yellow coating. Syndrome belongs to external Wind-Qi and internal stagnation, diagnosed as "Fengshui" (Wind Edema). Treat by dispersing exterior and interior simultaneously: Mahuang (decoct first, remove foam) 3g, Huashi 9g (Talcum), Sheng Gancao 1.5g (Raw Licorice), Xiangru 4.5g (Elsholtzia Herb), Fu Chao Zhike 3g (Bran-stirred Aurantium Fructus), Chuan Houpo 3g (Magnolia Bark), Shengjiang 3g (Fresh Ginger), Dazao 1 piece (Jujube), Chao Shenqu 9g, Chao Shanzha 9g (Stir-fried Hawthorn Fruit), Chao Maiya 9g (Stir-fried Sprouted Barley). After medication, slight sweating occurred, temperature dropped to normal that night, continue Maogen Jijin Tang; additionally, decoct Xiangru 6g in water as tea substitute. After over 20 doses, condition significantly improved. November 9: Pulse became peaceful, swelling basically subsided. Add lung- and kidney-nourishing herbs to the original prescription. Fresh Maogen 60g decoct first, remove residue. Then decoct next batch: Raw Jineijin (crushed) 9g, Sheng Huangqi 9g (Raw Astragalus Root), Guang Chenpi 1.2g. November 18: Stop Xiangru tea and Congyun, switch to Liuwei Dihuang Tang (Six-Ingredient Rehmannia Decoction) modified for regulation. Hospitalized for 4.5 months, symptoms basically disappeared, then nourish Kidney Water and harmonize Spleen and Stomach for recovery. Follow-up for 14 years: Relapsed three times, all achieved remission; has worked for 5 years, general condition good; no recurrence.
(Wang Wending Verified Cases, organized by Jing Yuzhen: Treatment Verification of Pediatric Edema, *New Medical Science Magazine* 6:17, 1978)
[Commentary]: Nephritis pathology should mainly seek diagnosis and treatment within the TCM category of Edema. Clinical differentiation is closely related to the Lung, Spleen, and Kidney organs. It is said, "Its branch is in the Lung, its root is in the Kidney, its control is in the Spleen." For acute nephritis, some advocate clearing and diffusing heat, purging heat, and promoting diuresis, or believe acute onset often belongs to "Fengshui" (Wind Edema), suitable for releasing the exterior and promoting diuresis. Chronic nephritis is mostly treated from the perspective of Spleen and Kidney.
Case 1 is acute nephritis with a set of excess-heat symptoms. Treatment prioritizes clearing and diffusing heat, purging heat, and resolving stasis. The main focus is on the Lung. Mr. Zhao treated the branch by diffusing Lung Qi and promoting diuresis, then treated the root by warming the Kidney with Shenqi Wan, enabling the Triple Burner to regulate water passages.
Case 2 is chronic nephritis, nephrotic stage, complicated by pneumonia. TCM differentiation has progressed from Fengshui to Zhengshui (True Edema). The infant has obvious ascites and pleural effusion; pathologically, Spleen and Lung are deficient, water-dampness floods, Liver Yang is hyperactive, and deficiency fire flares upward. Thus, Si Ling San combined with Longdan Xiegan Tang and Muzhou Zexie San were modified. During treatment, reduction and supplementation were applied together, warming and clearing were combined, and dietary therapy and external Congyun application were used to enhance Lung-diffusing, Spleen-strengthening, stagnation-resolving, and diuretic effects. In regulating the organs, more emphasis was placed on the Spleen. This case achieved good results under the condition of stopping Western medicines.
(Eighteen) Frequent Urination. Dai Mou, male, 8 years old, first seen (January 6, 1976): Frequent and urgent urination for over half a year, never painful urination. Restless sleep, walking during sleep, frightened crying, complete amnesia upon waking, night sweats during sleep. Tongue coating thin, pulse slippery and rapid. Disease stems from Heart and Kidney insufficiency. Treatment: Nourish Heart and calm Spirit, tonify Kidney Qi, Ganmai Dazao Tang (Licorice, Wheat, and Jujube Decoction) with modifications. Gancao 9g, Huaixiaomai 30g (Wheat), Hongzao 30g (Jujube), Zhenzhumu 30g (Mother-of-Pearl), Yejiaoteng 30g (Polygonum Vine), Fushen 9g (Poria with Hostwood), Yuanzhi 9g (Polygala Root), Cishi 30g (Magnetite, decoct first), Wuweizi 6g (Schisandra Berry), Tusizi 15g (Cuscuta Seed). 7 doses. Second visit (January 13): Frequent urination slightly improved, continue original prescription for 7 doses. Third visit (January 24): Frequent and urgent urination continued to improve. Maintain original intent, add Spleen-Kidney tonifying herbs: Dangshen 12g (Codonopsis Root), Buguzhi 15g (Psoralea Fruit), Zhenzhumu 30g, Cishi 30g (decoct first), Wuweizi 9g, Yejiaoteng 30g, Gancao 9g, Tusizi 15g, Fupenzi 15g (Rubus Fruit). 10 doses. Fourth visit (February 5): Frequent, urgent, and short urination improved, appetite acceptable, foul breath, thin greasy tongue coating, fine slippery pulse. Original method add Huhuanglian 4.5g (Phellodendron Bark) to bitter-descend and clear Stomach Damp-Heat. Zhigancao 9g, Huaixiaomai 30g, Hongzao 30g, Wuweizi 6g, Tusizi 15g, Yuanzhi 9g, Zhenzhumu 30g, Cishi 30g (decoct first), Yejiaoteng 30g, Huhuanglian 4.5g. 7 doses. Fifth visit (March 13): Since taking medicine, condition improved, urination frequency significantly reduced, no longer wets bed during class, sleep peaceful, night sweats still frequent, foul breath eliminated. Sleepwalking symptom absent for over a month. Continue previous method to consolidate. Zhigancao 9g, Huaixiaomai 30g, Hongzao 30g, Nuodaogen 30g (Saccharum Spontaneum Root), Tusizi 15g, Yuanzhi 9g, Fuling 9g, Wuweizi 6g (crushed), Beishumi 30g (Millet). 7 doses.
(Shanghai Old TCM Doctors' Experience Selection, Dr. Wang Yulan's Cases)
[Commentary]: This case presents frequent and urgent urination with signs of Heart-Kidney insufficiency. Dr. Wang used Ganmai Dazao Tang plus Yuanzhi, Fushen, Cishi, Zhenzhumu, Yejiaoteng, etc., primarily to nourish the Heart, calm the Spirit, and moisten with sweetness to relieve urgency, assisted by Tusizi, Fupenzi, Buguzhi, etc., to tonify Kidney Qi, and incorporated Spleen-supporting and Stomach-clearing methods during treatment. The entire case demonstrates flexible treatment methods and precise prescription adjustments based on syndrome changes, which are worthy of reference.
(Nineteen) Pediatric Aplastic Anemia Li XX, male, 8 years old, admitted January 1, 1972. Hospital No.: 109285. Admitted with aplastic anemia, hemoglobin 4.6%, platelets 16,000/cubic mm. Treated with Prednisone, Testosterone Propionate, etc., for over nine months, with no progress in blood counts. TCM consultation on October 7, 1972. Symptoms: Pale complexion, soreness and weakness of waist and knees, fatigue, pale red tongue, weak and fine pulse. Syndrome differentiation: Spleen and Kidney dual deficiency. Therapeutic method: Strengthen Spleen and benefit Kidney. Prescription: Fuxue Tang (General dosage see attached formula below). After taking the above medicine for two weeks, hemoglobin rose to 10.2 g%. After a total of five months of medication, by June 13, 1973, hemoglobin rose to 16 g%, platelets reached 56,000/cubic mm. Three months later, follow-up on September 8, 1973: General condition good, hemoglobin multiple tests lowest at 14.8 g%, platelets increased to 102,000/cubic mm. Discharged with improvement. Attached Formula: Fuxue Tang: Shanyurou 9g (Cornus Fruit), Huangjing 9g (Polygonatum Rhizome), Sheng Huangqi 9g (Raw Astragalus Root), Danggui 9g (Angelica Sinensis Root), Ejiao 9g (Donkey-hide Gel), Yuzhu 9g (Polygonatum Odoratum Rhizome), Shengdi 9g (Rehmannia Root), Shudi 9g (Prepared Rehmannia Root), Heshouwu 15g (Polygonum Multiflorum Root), Hanliancao 15g (Eclipta Herb), Sheng Shanyao 15g (Raw Dioscorea Rhizome).
(He Shiying Pediatric Cases)
[Commentary]: Aplastic anemia belongs to the category of internal injury blood deficiency. TCM mostly treats it from the perspectives of Liver, Spleen, and Kidney. This case is differentiated as Liver-Kidney dual deficiency, but combined with pulse and symptoms, Liver Blood is also deficient. The Fuxue Tang used by Mr. He is his personal verified formula, mainly treating patients with Qi and Blood dual deficiency, Yin-Blood insufficiency, presenting with fatigue, pale complexion, soreness and weakness of waist and knees, pale red tongue, and weak fine pulse. Its function is to tonify Qi and generate Blood, benefit Liver and Kidney.