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心悸健忘 · 邵兰荪医案 · 医典·华经

邵兰荪医案

心悸健忘15 / 30

邵兰荪医案 · 心悸健忘 · 清

古文

遗风徐血后阴耗，脉濡数，舌黄滑，湿火未清，心悸健忘，仍遵前法再进。
生地（四钱）焦山栀（三钱）黄草石斛（三钱）夜交藤（三钱）麦冬（三钱）茯神（四
钱）远志肉（八分）白薇（钱半）丹参（三钱）元参（钱半）炒条芩（钱半）淡竹叶（钱半）
（七支）
四帖。
介按∶阳明湿热未清，再以劳神动肝，以致咳血而暗吸肾阴，肾液既虚，未能上承于心
，则心悸健忘，滋液清热，安神养胃。治法极为周到。
某咳嗽盗汗悉瘥，左脉虚细，右劲，舌滑白，心虚悸惕。宜补心丹加减治之（三月念
九日。）
苏丹参（三钱）归身（钱半）甜杏仁（三钱）炙甘草（七分）茯神（四钱）炒枣仁（三
钱）远志（八分）炒杜仲（三钱）老东参（钱半）生牡蛎（四钱）龙齿（钱半）
清煎八帖。
介按∶肃肺分之余热，潜未靖之浮阳，借以补益心神，则悸惕自瘳。
白马山李肝逆乘中，脘痛气冲，脉弦，语蹙心悸，姑宜泄降化痰。（四月二号癸卯望
日。）
栝蒌皮（三钱）川楝子（三钱）生石决明（六钱）仙半夏（钱半）薤白（钱半）延胡（
二钱）
光杏仁（三钱）沉香（五分）橘红（一钱）抱木茯神（四钱）远志肉（八分，炒）（引）
灯心（七支）
四帖。
又冲气未平，脉弦细，舌白，心无所主，语蹙。宜镇肝逆，凝心神。（四月六号癸卯
十九日。）
西琥珀（八分）丹参（三钱）仙半夏（钱半）合欢皮（三钱）沉香（五分）龙齿（钱
半）
新会皮（钱半）炒枣仁（三钱）抱木茯神（四钱）石决明（五钱）远志肉（八分，炒）石菖
蒲（五分）（引）灯心（七支）
四帖。
介按∶肝升太过，胃降无权，湿酿成痰，阻碍气机，平肝清肺，治法甚佳。次以肝风浮
越，语蹙依然，因其冲气未平，再进镇冲凝神之品，秩序井然。
安昌徐水亏木旺，脉细劲，音低，心悸，寝寐恍惚，舌心微黄。姑宜滋水涵木，佐以
凝神。（三月十四日。）
生地（四钱）阿胶珠（钱半）桑叶（三钱）远志肉（八分）茯神（四钱）石决明（六钱）
淮
山药（三钱）预知子（三钱，即八月札）夜交藤（三钱）炒枣仁（三钱）黄草石斛（三钱）
（引）鸡子壳（一枚）
介按∶少阴之脉，循喉咙，挟舌本。今以肾液未能上承，而致音低心悸，此方宗阿胶鸡
子黄汤加减，俾心肾交合，阳和阴充，则少阴之火各归其部，而诸恙自除。

白话

【背景信息】
书名：邵兰荪医案作者：邵兰荪朝代：清章节：心悸健忘类别：医论

【待处理原文】
遗风徐血后阴耗，脉濡数，舌黄滑，湿火未清，心悸健忘，仍遵前法再进。
生地（四钱）焦山栀（三钱）黄草石斛（三钱）夜交藤（三钱）麦冬（三钱）茯神（四
钱）远志肉（八分）白薇（钱半）丹参（三钱）元参（钱半）炒条芩（钱半）淡竹叶（钱半）
（七支）
四帖。
介按∶阳明湿热未清，再以劳神动肝，以致咳血而暗吸肾阴，肾液既虚，未能上承于心
，则心悸健忘，滋液清热，安神养胃。治法极为周到。
某咳嗽盗汗悉瘥，左脉虚细，右劲，舌滑白，心虚悸惕。宜补心丹加减治之（三月念
九日。）
苏丹参（三钱）归身（钱半）甜杏仁（三钱）炙甘草（七分）茯神（四钱）炒枣仁（三
钱）远志（八分）炒杜仲（三钱）老东参（钱半）生牡蛎（四钱）龙齿（钱半）
清煎八帖。
介按∶肃肺分之余热，潜未靖之浮阳，借以补益心神，则悸惕自瘳。
白马山李肝逆乘中，脘痛气冲，脉弦，语蹙心悸，姑宜泄降化痰。（四月二号癸卯望
日。）
栝蒌皮（三钱）川楝子（三钱）生石决明（六钱）仙半夏（钱半）薤白（钱半）延胡（
二钱）
光杏仁（三钱）沉香（五分）橘红（一钱）抱木茯神（四钱）远志肉（八分，炒）（引）
灯心（七支）
四帖。
又冲气未平，脉弦细，舌白，心无所主，语蹙。宜镇肝逆，凝心神。（四月六号癸卯
十九日。）
西琥珀（八分）丹参（三钱）仙半夏（钱半）合欢皮（三钱）沉香（五分）龙齿（钱
半）
新会皮（钱半）炒枣仁（三钱）抱木茯神（四钱）石决明（五钱）远志肉（八分，炒）石菖
蒲（五分）（引）灯心（七支）
四帖。
介按∶肝升太过，胃降无权，湿酿成痰，阻碍气机，平肝清肺，治法甚佳。次以肝风浮
越，语蹙依然，因其冲气未平，再进镇冲凝神之品，秩序井然。
安昌徐水亏木旺，脉细劲，音低，心悸，寝寐恍惚，舌心微黄。姑宜滋水涵木，佐以
凝神。（三月十四日。）
生地（四钱）阿胶珠（钱半）桑叶（三钱）远志肉（八分）茯神（四钱）石决明（六钱）
淮
山药（三钱）预知子（三钱，即八月札）夜交藤（三钱）炒枣仁（三钱）黄草石斛（三钱）
（引）鸡子壳（一枚）
介按∶少阴之脉，循喉咙，挟舌本。今以肾液未能上承，而致音低心悸，此方宗阿胶鸡
子黄汤加减，俾心肾交合，阳和阴充，则少阴之火各归其部，而诸恙自除。

英文

[Background Information]
Book: Shao Lansun's Medical Cases; Author: Shao Lansun; Dynasty: Qing; Chapter: Palpitations and Forgetfulness; Category: Medical Discussion

[Original Text to Process]
Patient Xu from Yifeng. After blood loss, Yin is depleted. The pulse is soft and rapid (Ru Shu), the tongue coating is yellow and slippery, indicating that damp-heat and fire have not yet been cleared. There are palpitations and forgetfulness. Continue with the previous method.
Rehmanniae Radix Preparata (4 qian), Scoriarum Fructus Carbonized (3 qian), Dendrobii Caulis Flavus (3 qian), Polygoni Multiflori Caulis (3 qian), Ophiopogonis Radix (3 qian), Poria Cum Radix Xylodi (4 qian), Polygalae Semen (0.8 fen), Cynanchi Atrati Radix (1.5 qian), Salviae Miltiorrhizae Radix et Rhizoma (3 qian), Scrophulariae Radix (1.5 qian), Scutellariae Radix Stir-fried (1.5 qian), Lophatheri Herba (1.5 qian) (7 stalks).
Four doses.

Commentary by Jie: The damp-heat in the Yangming channel has not been cleared. Furthermore, mental exertion stirs up the Liver, leading to hemoptysis which secretly consumes Kidney Yin. Since the Kidney fluids are deficient and unable to ascend to nourish the Heart, palpitations and forgetfulness occur. The treatment method of nourishing fluids, clearing heat, calming the Spirit, and benefiting the Stomach is extremely thorough.

Patient Mou. Coughing and night sweats have completely ceased. The left pulse is deficient and fine, the right pulse is taut. The tongue is slippery and white. There is Heart deficiency with palpitations and timidity. It is appropriate to treat with Suanzaoren Tang modified (March 29th).
Codonopsis Pilosula (3 qian), Angelicae Sinensis Radix (1.5 qian), Pruni Armeniaci Semen Dulce (3 qian), Glycyrrhizae Radix et Rhizoma Honey-fried (0.7 fen), Poria Cum Radix Xylodi (4 qian), Ziziphi Spinosae Semen Stir-fried (3 qian), Polygalae Semen (0.8 fen), Eucommiae Cortex Stir-fried (3 qian), Codonopsis Pilosula Old Type (1.5 qian), Ostreae Shell Raw (4 qian), Draconis Os (1.5 qian).
Decocted clearly, eight doses.

Commentary by Jie: Clear the residual heat in the Lung sector, subdue the floating Yang that has not yet settled, thereby supplementing and benefiting the Heart Spirit, so that palpitations and timidity will heal naturally.

Patient Li from Baimashan. Liver Qi rebellion attacks the Middle Jiao. There is epigastric pain with Qi rushing upward, the pulse is wiry, speech is hurried due to anxiety, and there are palpitations. For now, it is suitable to drain downward and resolve phlegm. (April 2nd, Gui Mao day, full moon).
Trichosanthis Pericarpium (3 qian), Toosendan Fructus (3 qian), Halloysitum Rubrum Raw (6 qian), Pinelliae Tuber Prepared (1.5 qian), Allii Macrostemonis Bulbus (1.5 qian), Cyperi Rhizoma (2 qian), Pruni Armeniaci Semen Light-colored (3 qian), Aquilariae Lignum Resinatum (0.5 fen), Citri Reticulatae Pericarpium (1 qian), Poria Cum Radix Xylodi Held Wood (4 qian), Polygalae Semen Flesh (0.8 fen, stir-fried) (guide), Junci Medulla (7 stalks).
Four doses.

Again. The rushing Qi has not stabilized. The pulse is wiry and fine, the tongue is white, the Heart lacks mastery, and speech is hurried. It is suitable to suppress Liver rebellion and consolidate the Heart Spirit. (April 6th, Gui Mao day, 19th day).
Electrum Occidentale (0.8 fen), Salviae Miltiorrhizae Radix et Rhizoma (3 qian), Pinelliae Tuber Prepared (1.5 qian), Albiziae Cortex (3 qian), Aquilariae Lignum Resinatum (0.5 fen), Draconis Os (1.5 qian), Citri Reticulatae Pericarpium Xin Hui (1.5 qian), Ziziphi Spinosae Semen Stir-fried (3 qian), Poria Cum Radix Xylodi Held Wood (4 qian), Halloysitum Rubrum (5 qian), Polygalae Semen Flesh (0.8 fen, stir-fried), Acori Tatarinowii Rhizoma (0.5 fen) (guide), Junci Medulla (7 stalks).
Four doses.

Commentary by Jie: Liver ascending is excessive, Stomach descending lacks authority. Dampness brews into phlegm, obstructing Qi mechanism. Calming the Liver and clearing the Lung is a very good treatment method. Subsequently, because Liver Wind floats and overflows, and speech remains hurried, since the rushing Qi has not stabilized, further administration of substances to calm rushing Qi and consolidate Spirit follows an orderly sequence.

Patient Xu from Anchang. Water deficiency and Wood hyperactivity. The pulse is fine and taut, voice is low, there are palpitations, sleep is dream-disturbed and vague, and the center of the tongue is slightly yellow. For now, it is suitable to nourish Water to contain Wood, assisted by consolidating the Spirit. (March 14th).
Rehmanniae Radix Preparata (4 qian), Euphorbiae Pekinensis Seed Ball (1.5 qian), Mori Folium (3 qian), Polygalae Semen Flesh (0.8 fen), Poria Cum Radix Xylodi (4 qian), Halloysitum Rubrum (6 qian), Dioscoreae Hypoglauca Rhizoma (3 qian), Decaisnaea Fructus (3 qian, i.e., August Zha), Polygoni Multiflori Caulis (3 qian), Ziziphi Spinosae Semen Stir-fried (3 qian), Dendrobii Caulis Flavus (3 qian) (guide), Gallus Galli Shell (one piece).

Commentary by Jie: The Shaoyin meridian runs along the throat and flanks the root of the tongue. Now, because Kidney fluids fail to ascend, low voice and palpitations result. This formula is based on Ejiao Jizi Huang Tang modified, aiming for Heart-Kidney interaction, harmonizing Yang and filling Yin, so that the Fire of Shaoyin returns to its respective sector, and all ailments are eliminated naturally.