一、治重脏腑精于辨证临床辨治疾病，李氏最为重视脏腑。认为人体是以脏腑为核心的有机整体。一脏一腑各有功能，脏与脏，腑与脏，腑与腑之间，以其相生相制的关系相互联系，而维持人体生理功能的协调和平衡。人体受到这样或那样的病因影响，则会以病因的属性影响脏腑功能，一病有一病的发展趋势，一证有一证的发展规律，明辨各种疾病的发展趋势和规律，根据其临床证候的各种表现，就能制定出合理的治法与方药。如胸痹（冠心病），李氏认为其多由阴阳、气血失调及寒凝、热结、痰、阻、气滞、血瘀等因素引起，观察其发病规律，一般初起多有胸阳不振，心脉痹阻，则治宜通阳宣痹；病情发展，气郁日久，血行瘀滞，则治宜活血化瘀；胸痹后期，气阴耗损，运血无力，气血受阻，则治宜益气养阴，行气活血；病势深入，气血俱虚，阳虚阴盛，则治宜温通心痹，回阳救逆等等。即使疾病变化万端，亦可在主法运用的前提下随证加减。冠心病如此，他病亦然。
审病问疾，处方用药，善于辨证论治，辨出疾病的表现为何“证”然后根据辨出的“证”确定采用何种治法，再根据所订治法的要求，选用方药，随证变化，进行治疗。辨证论治的具体体现是理法方药，方药的灵活运用在辨证论治中尤为重要，一证有一证之专方，一病又有一病之专药，如《伤寒论》太阳病中风表证有桂枝汤，伤寒表实证有麻黄汤，《金匮要略》阴阳毒有升麻鳖甲汤，肠痈者有大黄牡丹皮汤，而茵陈、常山、白头翁分别是治疗黄疸、疟疾、下痢的专药等，此即所谓“有是病者用是药，有是证者用是方”。但专方专药的应用，要注意专病的本质、特征及其阶段性，根据疾病进退缓急灵活变化，切不能只知套主方专药而忽视辨证论治，而应在辨证前提下选择方药，或创造新的用方。如曾治严某，男，４７岁，珠海某公司干部。１９９３年６月因患胸腺瘤在武汉某医院做胸瘤摘除术，术后不久，出现眼皮下垂，四肢无力，曾在省、市多所大型医院诊治，经反复检查，均诊断为“重症肌无力”。服用中药益气之品脘腹胀气，服用升提之剂则烦冤不解；用西药溴化新斯的明或地塞米松又心胸不适。转延李氏治，刻诊所见：上睑下垂，四肢无力，吞咽不利，口流涎水，胸脘闷胀，不知饥饿，嗳气频频，睡不安寐，大便带血（有痔疮史），小便短黄，舌尖红，苔黄腻，脉细而略数。李氏诊之曰：此中医痿证也。《内经》谓本病发生，与“肺热叶焦”有关，肺热则燥，精血不能输于五脏，遂见痿也，提出“治痿独取阳明”之说（见《素问·痿论》）。故后世医书多以肺热伤津、脾胃虚弱或肝肾阴亏立论，或清热润燥，或益气健脾，或补益肝肾，见仁见智。而本案例，证属胸阳受损，痰热内阻，阴津伤耗，则治当通阳宣痹、清热化痰为主，佐以清热生津、健脾益气之法。药用：炒瓜蒌皮１０克，薤白１０克，炒竹茹１０克，枇杷叶１５克，陈皮１０克，炒枳壳１０克，茯神１５克，法夏１０克，炒川连１０克，夏枯草１５克，炒二芽１５克，香橼皮１０克，芦根２０克。此方前后加减共服１５剂，精神大振，心胸舒畅，纳食增进，二便通利，上睑下垂症消失。继以通阳散结、清热化痰、健脾和胃之品调理而愈。随访半年，未见复发。细详此案，是胸腺瘤术后，病发“重症肌无力”，世医套用成法，或健脾，或益第三卷１９８气、或妄用升提，而效罔然。究其因也，病在胸阳损伤，气机郁滞，痰热内阻，热邪耗津，胸阳不能振奋，气机不能宣通，痰热不能清除，病焉可自愈哉？李氏不为成见所拘，从痰热立论，法从证出，方随法成，以瓜蒌薤白半夏汤合黄连温胆汤为主，结合证情变化，灵活化裁用药，而取得良好效果。
二、善用经方药取平稳李氏行医迄今有６０余年，临床治病，善用经方，然师古不泥，化裁灵活，运用自如。如曾治程某，男，４５岁，以种田兼缝纫为业，素嗜烟，并有咳喘宿疾。某年秋，因外感发热，咳嗽加剧，痰中见脓，有腥臭味。服中药清热解毒、宣肺化痰排脓之品，热势虽退，而他证未除。再延西医诊治，考虑为“肺脓疡”，注射青、链霉素等抗炎针剂，咳唾脓之症时而小愈，时而增剧，困卧床第，已将一年。患者为病势折磨，意志消沉，几欲自寻短见。其家属偕来恳求一速效良方处治。
细询其证，胸闷异常，左胸部并有痛感，时唾浊痰腥臭，咽干不渴，苔黄脉数，是与《金匮》所云之肺痈相符。又阅前服中药处方，如苇茎汤、泻白散、排脓散、犀黄丸及鱼腥草、忍冬藤、葶苈大枣泻肺汤等均已服过，而未彻底收效。细审此证，虽旷日持久，元气已损，然脉来有神，似尚未至竭绝程度。惟肺部浊痰败脓，病久似已结成窠囊，必得攻坚拨积峻药，捣其病之症结处，背城一战，以冀转危为安。遂用三物白散方，以桔梗、川贝母各１０克，巴豆（去壳，炒黑存性）３克，共研细末，以白开水调下，作数次服。初服未见动静，约１小时后，再服２次，服后须臾，胸痛不舒，唾出顽痰败脓半升许，急令止药勿服，以米粥调养，和其胃气。此后胸膈见快。唾出浊脓亦稀。改用扶土生金法，仿参苓白术散加化痰解毒药调理而愈。
又如１９９２年初，２０岁的国家划艇运动员宁某某反复呕吐，胃痛３年，并伴偏头痛史，近日加剧，进食则吐，饮水呕吐更甚，胃脘疼痛如针刺，舌红苔白脉细弦。服用西药雷尼替丁、灭吐灵、胃舒平等罔效，严重影响体育训练，其教练员偕来诊治。李氏断为训练过度，脾胃气伤，升降失职，气机不畅。治用和胃降浊，理气行滞之法，遂以旋复代赭汤化裁，用旋复花、代赭石、党参、厚朴、橘红、炒枳壳、茯苓、砂仁、苏梗、焦三仙、炙甘草等味，服药５剂，呕逆即止，未再复发。
后宁某某１９９２年５月１０日在波兰划艇联合杯比赛中，一举为国家夺得女双５００米等两项冠军。
李氏用药一贯轻灵平稳，此主要受张仲景、叶天士、吴鞠通及恽铁樵、曹颖甫等医家的影响，而较前人有新的发展。如其治温热黄疸，在仲景治法的基础上，提出三焦论治：温热侵犯上焦，肺卫宣发失常，治用宣上，辛香宣透，芳化湿浊，常用藿香叶、杏仁、佩兰、枇杷叶、蔻衣之类；湿热郁滞中焦，肝胃失和，治用宽中，清热燥湿，疏肝和胃，常用枳实、枳壳、陈皮、砂仁、建曲、谷麦芽、鸡内金、薏苡仁、藿香梗、蔻仁类；湿热蕴于下焦，或在大肠，或在膀胱，治用导下，导滞通腑，或泄热利尿，常用大黄、枳实、槟榔、厚朴、赤茯苓、滑石、通草、茅根、车前子之类。药量一般在６～１５克之间，非大病重病不用大剂重剂，而且不轻易使用辛燥太过之品，以防燥热燃起，同时亦反对重剂使用大黄等苦寒类药，虑其有伤脾败胃之弊；至于滋阴补气之药，如黄芪、党参等亦要慎用，以免滋腻助湿生满，加重病情。有人谓李氏以用药量小著称，李氏谓：“治方有大小，病势有缓急，药量有轻重。古人谓病大药大，病毒药毒，为人医者，岂能以滥投虎狼之剂而称道耶？”他赞赏近代名医施今墨、冉雪峰等人用药特点，以为药量不大，方不见奇，而有良效。感叹第三卷１９９当今之士，处方用药，动辄三五十克，或以为胆大，殊不知误人之迹甚多，且造成中药的浪费匮乏。因此他在临床时，无问大小缓急之剂，当用则用，不畏其峻，不当用则不用，而不以轻剂为敷衍藏拙。
李氏长用经方，亦惯用时方，在运用的同时且能根据自己数十年的临床经验，创制出一些新的病方，如治疗头部疼痛的清上定痛汤，治疗食道病变的清化解郁汤等等。
三、冠心病的辨治经验冠心病，又称缺血性心脏病，包括因冠状动脉粥样硬化使之狭窄或阻塞、或其功能性改变，如痉挛所致的心肌缺血性疾病。常以心绞痛、心肌梗塞、心力衰竭、心律失常等为临床特点。
李氏认为，冠心病属中医学的胸痹范畴，多由阴阳气血失调及寒凝、热结、痰阻、气滞、血瘀等因素引起，临床采用辨证论治或辨证与辨病相结合的方法治疗。
（一）通阳宣痹素体阳虚，胸阳不振或心气不足，复因寒邪侵袭，阻碍胸阳，心脉痹阻，易致冠心病发作。
《素问·调经论》曰：“寒气积于胸中，不泻则温气去，寒邪留则自凝泣，凝则不通。”故患者常易在气候突变，特别是受寒时卒然发生心痛。若暑热太过，伤及心气，亦可血脉不畅而发心痛。振奋心阳，宣痹通络始终是治疗冠心病的一个重要措施。
证见胸闷心痛，遇寒则发或加剧，甚者形寒肢冷，心悸短气，心痛彻背，背痛彻心舌质暗红，苔薄白，化热则苔黄而腻，脉紧或弦紧，病久则脉来细涩或细弦。此证多见于冠心病心绞痛等。治宜宣痹通阳，散寒活血。药用瓜蒌皮、薤白、法夏、桂枝、甘草、当归、桃仁、丹参、赤芍、香附等。若痰浊较甚者，加枳实、厚朴、浙贝各１０克；夹有瘀血胸痛甚者，加红花１０克，制乳没各６克，以化瘀止痛；胸闷气寒者，加玄胡、橘皮、橘络、苏梗各１０克，以理气宽胸；心气虚者，加太子参、麦冬、五味子各１０克，以益气养心；食欲不振者，加炒山楂１５克，炒二芽１５克，以醒脾和胃；寒邪化热者，去桂枝等辛温之品，加竹茹１０克，黄连６克，银花３０克，以清热化痰；大便秘结者，加火麻仁５克，制大黄６克，以润肠通便。对于胸阳闭阻或心阳不足之证，李氏一般不主张滥用桂枝、附子等辛燥之品，即便用之亦不过３～５日，用后即停；或于温阳药中参入益阴之品，以调节阴阳，阴中求阳，阳中求阴，防止病人有阴阳互损之变。
案例：邱某，女，６４岁，武汉电厂退休工人。１９９４年３月２５日初诊。阵发性胸闷心痛，心悸伴畏寒４月。１９９３年１２月因天气变化，患者病发胸闷，甚则心痛，心悸畏寒。当时在厂医务室服用地奥心血康、复方丹参片等，稍有缓解，但移时又发。１９９４年２月病又发作加重，即往同济医院住院诊治，经心脏摄片、心电图、静息心肌显象等检查，诊断为“冠心病，心功能不全”，用强心、扩管、对症等治疗，病无显效，自请出院转中医诊治，或温通心阳，或活血化瘀，或养心益气，亦无明显效果。现症：家属护送来诊，胸闷心痛，心悸短气，发作欲死，夜间尤甚，一日发作数次，身体怕冷，阳春三月，竟着冬装，肢体乏力，纳食减退，大便干燥，小便不利，咽喉疼痛，舌质暗红，边有瘀点，舌苔黄而略腻，脉来细弦。既往有过敏性哮喘、慢性肾盂肾炎、慢性咽炎等病，时有发作。审视从前所用方药，大多为桂枝、熟附之类。此乃胸阳阻遏，气血不畅，心脾亦虚，迭用温药，而有化热之象矣。治拟宣痹通阳，行气活血，健运脾胃，佐以清热解毒之法。
第三卷２００处方：炒蒌皮１５克，薤白１０克，丹参３０克，赤芍３０克，桃仁０克，玄胡１５克，制香附１０克，太子参１５克，茯神３０克，火麻仁１５克，陈皮１２克，银花３０克，白茅根１８克，炒山楂１５克，炒二芽１５克。
二诊：服上方剂，胸闷心痛明显好转，精神振奋，纳食增进，大便通畅，已着春装，步行来诊。
惟咽部稍感干燥，舌质暗红苔薄黄、脉细弦。当予宣痹通阳、行气和血、健运脾胃，方中参入清利咽喉之品。处方：炒蒌皮１５克，薤白１０克，丹皮３０克，赤芍３０克，桃仁１０克，太子参１５克，茯神３０克，芦根１５克，陈皮１０克，制香附１０克，炒山楂１５克，炒二芽１５克，青果１０克。
连服１２剂，胸闷、心痛、心悸等症消失，惟夜间有时易醒，后以宣痹通阳、养心安神之品调治而愈。
（二）活血化瘀若素体阳虚，阴乘阳位；或过食肥甘厚味痰湿内蕴，上犯胸位，气机失畅；或情态失调，气郁日久，血行滞阻；或劳伤元气，气虚不能运血，血气瘀滞；或受寒邪，寒主凝滞，痹阻心脉等，均可导致气血瘀滞而为病。临床采用活血化瘀、宽胸理气为主，实验证明，其具有改善冠脉循环和微循环，保护心肌缺血，缩小梗塞面积，减轻病变程度，保护心肌结构，促进修复，增强纤溶酶活性，防治动脉硬化，增强耐缺氧能力和体力，以及调节免疫机能等多方面的作用，是治疗冠心病、心绞痛、心肌梗塞的重要方法。
一、治疗重视脏腑，精通辨证
在临床辨治疾病时，李氏最为重视脏腑。他认为人体是以脏腑为核心的有机整体。每一脏和每一腑各有其功能，脏与脏之间、腑与脏之间、腑与腑之间，通过相生相克的相互关系彼此联系，从而维持人体生理功能的协调与平衡。当人体受到各种病因的影响时，病因的属性会干扰脏腑的功能。每种疾病都有其特定的发展趋势，每个证候都有其发展规律。若能明辨各种疾病的发展趋势和规律，根据其临床表现出的各种证候，就能制定出合理的治疗方法和方药。例如胸痹（冠心病），李氏认为其多由阴阳失调、气血失调以及寒凝、热结、痰阻、气滞、血瘀等因素引起。观察其发病规律，一般初起时多有胸阳不振、心脉痹阻的情况，则治疗宜采用通阳宣痹法；病情发展后，若气郁日久导致血行瘀滞，则治疗宜采用活血化瘀法；到了胸痹后期，气阴耗损，运血无力，气血受阻，则治疗宜采用益气养阴、行气活血法；若病势深入，出现气血俱虚、阳虚阴盛的情况，则治疗宜采用温通心痹、回阳救逆法。即使疾病变化万千，也可以在确立主法的前提下随证加减。冠心病如此，其他疾病也是如此。
审察病情、询问疾苦、处方用药，都善于进行辨证论治。辨出疾病的表现属于何种“证”，然后根据辨出的“证”确定采用何种治法，再根据所定治法的要求，选用方药，随证变化，进行治疗。辨证论治的具体体现是理、法、方、药，其中方药的灵活运用在辨证论治中尤为重要。一个证有一个证的专方，一种病有一种病的专药。例如《伤寒论》中太阳病中风表证有桂枝汤，伤寒表实证有麻黄汤；《金匮要略》中阴阳毒有升麻鳖甲汤，肠痈有大黄牡丹皮汤；而茵陈、常山、白头翁分别是治疗黄疸、疟疾、痢疾的专药等。这就是所谓的“有是病者用是药，有是证者用是方”。但应用专方专药时，要注意专病的本质、特征及其阶段性，根据疾病的进退缓急灵活变化，绝不能只知道套用主方专药而忽视辨证论治，而应在辨证的前提下选择方药，或创造新的用法。
例如曾治疗严某，男，47岁，珠海某公司干部。1993年6月因患胸腺瘤在武汉某医院做了胸腺瘤摘除术，术后不久，出现眼皮下垂、四肢无力。曾在省、市多所大型医院诊治，经反复检查，均诊断为“重症肌无力”。服用中药益气之品后感到脘腹胀气，服用升提之剂则烦闷不解；使用西药溴化新斯的明或地塞米松又感到心胸不适。转延请李氏治疗，刻诊所见：上睑下垂，四肢无力，吞咽不利，口流涎水，胸脘闷胀，不知饥饿，嗳气频频，睡不安稳，大便带血（有痔疮史），小便短黄，舌尖红，苔黄腻，脉细而略数。李氏诊察后说：这是中医的痿证。《内经》认为本病的发生与“肺热叶焦”有关，肺热则燥，精血不能输布于五脏，遂见痿弱不用，提出了“治痿独取阳明”的说法（见《素问·痿论》）。因此后世医书多以肺热伤津、脾胃虚弱或肝肾阴亏立论，或清热润燥，或益气健脾，或补益肝肾，各持己见。而本案例，证属胸阳受损，痰热内阻，阴津伤耗，则治疗应当以通阳宣痹、清热化痰为主，佐以清热生津、健脾益气之法。药用：炒瓜蒌皮10克，薤白10克，炒竹茹10克，枇杷叶15克，陈皮10克，炒枳壳10克，茯神15克，法半夏10克，炒川连10克，夏枯草15克，炒二芽15克，香橼皮10克，芦根20克。此方前后加减共服15剂，精神大振，心胸舒畅，食欲增进，二便通利，上睑下垂症状消失。继以通阳散结、清热化痰、健脾和胃之品调理而痊愈。随访半年，未见复发。仔细详查此案，是胸腺瘤术后，病发“重症肌无力”，世医套用成法，或健脾，或益气，或妄用升提，而效果毫无。究其原因，病在胸阳损伤，气机郁滞，痰热内阻，热邪耗津，胸阳不能振奋，气机不能宣通，痰热不能清除，病怎么能自愈呢？李氏不为成见所拘束，从痰热立论，法从证出，方随法成，以瓜蒌薤白半夏汤合黄连温胆汤为主，结合证情变化，灵活化裁用药，而取得良好效果。
二、善用经方，用药平稳
李氏行医迄今已有60余年，临床治病，善用经方，然而师法古人而不拘泥，化裁灵活，运用自如。例如曾治疗程某，男，45岁，以种田兼缝纫为业，平时嗜好吸烟，并有咳喘宿疾。某年秋天，因外感发热，咳嗽加剧，痰中带脓，有腥臭味。服用中药清热解毒、宣肺化痰排脓之品，热势虽退，而其他症状未除。再延请西医诊治，考虑为“肺脓肿”，注射青霉素、链霉素等抗炎针剂，咳唾脓血的症候时而小愈，时而增剧，困卧床第，已将一年。患者被病势折磨，意志消沉，几乎想要自寻短见。其家属偕来恳求一个速效良方处治。
仔细询问其证候，胸闷异常，左胸部并有痛感，时常吐出浊痰且腥臭，咽干但不渴，苔黄脉数，这与《金匮要略》所说的肺痈相符。又查阅前服中药处方，如苇茎汤、泻白散、排脓散、犀黄丸及鱼腥草、忍冬藤、葶苈大枣泻肺汤等均已服过，但未彻底收效。仔细审视此证，虽然旷日持久，元气已损，然脉来有神，似乎尚未至竭绝程度。只是肺部浊痰败脓，病久似已结成窠囊，必须得到攻坚破积的峻药，捣毁疾病的症结之处，背城一战，以冀转危为安。于是使用三物白散方，以桔梗、川贝母各10克，巴豆（去壳，炒黑存性）3克，共研细末，以白开水调下，分数次服用。初服未见动静，约1小时后，再服2次，服后须臾，胸痛不舒，吐出顽痰败脓半升许，急令停药勿服，以米粥调养，调和胃气。此后胸膈感觉畅快，吐出的浊脓也变稀。改用扶土生金法，仿参苓白术散加化痰解毒药调理而痊愈。
又如1992年初，20岁的国家划艇运动员宁某某反复呕吐，胃痛3年，并伴有偏头痛史，近日加剧，进食则吐，饮水呕吐更甚，胃脘疼痛如针刺，舌红苔白脉细弦。服用西药雷尼替丁、灭吐灵、胃舒平等无效，严重影响体育训练，其教练员偕来诊治。李氏断定为训练过度，脾胃气伤，升降失职，气机不畅。治疗用和胃降浊，理气行滞之法，遂以旋复代赭汤化裁，用旋复花、代赭石、党参、厚朴、橘红、炒枳壳、茯苓、砂仁、苏梗、焦三仙、炙甘草等味，服药5剂，呕逆即止，未再复发。
后来宁某某在1992年5月10日的波兰划艇联合杯比赛中，一举为国家夺得女双500米等两项冠军。
李氏用药一贯轻灵平稳，这主要受张仲景、叶天士、吴鞠通及恽铁樵、曹颖甫等医家的影响，而较前人有新的发展。如其治疗温热黄疸，在仲景治法的基础上，提出三焦论治：温热侵犯上焦，肺卫宣发失常，治疗用宣上法，辛香宣透，芳化湿浊，常用藿香叶、杏仁、佩兰、枇杷叶、蔻衣之类；湿热郁滞中焦，肝胃失和，治疗用宽中法，清热燥湿，疏肝和胃，常用枳实、枳壳、陈皮、砂仁、建曲、谷麦芽、鸡内金、薏苡仁、藿香梗、蔻仁类；湿热蕴于下焦，或在大肠，或在膀胱，治疗用导下法，导滞通腑，或泄热利尿，常用大黄、枳实、槟榔、厚朴、赤茯苓、滑石、通草、茅根、车前子之类。药量一般在6～15克之间，非大病重病不用大剂重剂，而且不轻易使用辛燥太过之品，以防燥热燃起，同时亦反对重剂使用大黄等苦寒类药，虑其有伤脾败胃之弊；至于滋阴补气之药，如黄芪、党参等亦要慎用，以免滋腻助湿生满，加重病情。有人谓李氏以用药量小著称，李氏说：“治方有大小，病势有缓急，药量有轻重。古人谓病大药大，病毒药毒，为人医者，岂能以滥投虎狼之剂而称道耶？”他赞赏近代名医施今墨、冉雪峰等人用药特点，以为药量不大，方不见奇，而有良效。感叹当今之士，处方用药，动辄三五十克，或以为胆大，殊不知误人之迹甚多，且造成中药的浪费匮乏。因此他在临床时，无问大小缓急之剂，当用则用，不畏其峻，不当用则不用，而不以轻剂为敷衍藏拙。
李氏长用经方，亦惯用时方，在运用的同时且能根据自己数十年的临床经验，创制出一些新的病方，如治疗头部疼痛的清上定痛汤，治疗食道病变的清化解郁汤等等。
三、冠心病的辨治经验
冠心病，又称缺血性心脏病，包括因冠状动脉粥样硬化使之狭窄或阻塞、或其功能性改变，如痉挛所致的心肌缺血性疾病。常以心绞痛、心肌梗死、心力衰竭、心律失常等为临床特点。
李氏认为，冠心病属中医学的胸痹范畴，多由阴阳气血失调及寒凝、热结、痰阻、气滞、血瘀等因素引起，临床采用辨证论治或辨证与辨病相结合的方法治疗。
（一）通阳宣痹
素体阳虚，胸阳不振或心气不足，复因寒邪侵袭，阻碍胸阳，心脉痹阻，易致冠心病发作。
《素问·调经论》曰：“寒气积于胸中，不泻则温气去，寒邪留则自凝泣，凝则不通。”故患者常易在气候突变，特别是受寒时卒然发生心痛。若暑热太过，伤及心气，亦可血脉不畅而发心痛。振奋心阳，宣痹通络始终是治疗冠心病的一个重要措施。
证见胸闷心痛，遇寒则发或加剧，甚者形寒肢冷，心悸短气，心痛彻背，背痛彻心，舌质暗红，苔薄白，化热则苔黄而腻，脉紧或弦紧，病久则脉来细涩或细弦。此证多见于冠心病心绞痛等。治宜宣痹通阳，散寒活血。药用瓜蒌皮、薤白、法半夏、桂枝、甘草、当归、桃仁、丹参、赤芍、香附等。若痰浊较甚者，加枳实、厚朴、浙贝各10克；夹有瘀血胸痛甚者，加红花10克，制乳没各6克，以化瘀止痛；胸闷气寒者，加玄胡、橘皮、橘络、苏梗各10克，以理气宽胸；心气虚者，加太子参、麦冬、五味子各10克，以益气养心；食欲不振者，加炒山楂15克，炒二芽15克，以醒脾和胃；寒邪化热者，去桂枝等辛温之品，加竹茹10克，黄连6克，银花30克，以清热化痰；大便秘结者，加火麻仁5克，制大黄6克，以润肠通便。对于胸阳闭阻或心阳不足之证，李氏一般不主张滥用桂枝、附子等辛燥之品，即便用之亦不过3～5日，用后即停；或于温阳药中参入益阴之品，以调节阴阳，阴中求阳，阳中求阴，防止病人有阴阳互损之变。
案例：邱某，女，64岁，武汉电厂退休工人。1994年3月25日初诊。阵发性胸闷心痛，心悸伴畏寒4月。1993年12月因天气变化，患者病发胸闷，甚则心痛，心悸畏寒。当时在厂医务室服用地奥心血康、复方丹参片等，稍有缓解，但移时又发。1994年2月病又发作加重，即往同济医院住院诊治，经心脏摄片、心电图、静息心肌显象等检查，诊断为“冠心病，心功能不全”，用强心、扩管、对症等治疗，病无显效，自请出院转中医诊治，或温通心阳，或活血化瘀，或养心益气，亦无明显效果。现症：家属护送来诊，胸闷心痛，心悸短气，发作欲死，夜间尤甚，一日发作数次，身体怕冷，阳春三月，竟着冬装，肢体乏力，纳食减退，大便干燥，小便不利，咽喉疼痛，舌质暗红，边有瘀点，舌苔黄而略腻，脉来细弦。既往有过敏性哮喘、慢性肾盂肾炎、慢性咽炎等病，时有发作。审视从前所用方药，大多为桂枝、熟附之类。此乃胸阳阻遏，气血不畅，心脾亦虚，迭用温药，而有化热之象矣。治拟宣痹通阳，行气活血，健运脾胃，佐以清热解毒之法。
处方：炒蒌皮15克，薤白10克，丹参30克，赤芍30克，桃仁10克，玄胡15克，制香附10克，太子参15克，茯神30克，火麻仁15克，陈皮12克，银花30克，白茅根18克，炒山楂15克，炒二芽15克。
二诊：服上方剂，胸闷心痛明显好转，精神振奋，纳食增进，大便通畅，已着春装，步行来诊。惟咽部稍感干燥，舌质暗红苔薄黄、脉细弦。当予宣痹通阳、行气和血、健运脾胃，方中参入清利咽喉之品。处方：炒蒌皮15克，薤白10克，丹皮30克，赤芍30克，桃仁10克，太子参15克，茯神30克，芦根15克，陈皮10克，制香附10克，炒山楂15克，炒二芽15克，青果10克。
连服12剂，胸闷、心痛、心悸等症消失，惟夜间有时易醒，后以宣痹通阳、养心安神之品调治而愈。
（二）活血化瘀
若素体阳虚，阴乘阳位；或过食肥甘厚味痰湿内蕴，上犯胸位，气机失畅；或情态失调，气郁日久，血行滞阻；或劳伤元气，气虚不能运血，血气瘀滞；或受寒邪，寒主凝滞，痹阻心脉等，均可导致气血瘀滞而为病。临床采用活血化瘀、宽胸理气为主，实验证明，其具有改善冠脉循环和微循环，保护心肌缺血，缩小梗塞面积，减轻病变程度，保护心肌结构，促进修复，增强纤溶酶活性，防治动脉硬化，增强耐缺氧能力和体力，以及调节免疫机能等多方面的作用，是治疗冠心病、心绞痛、心肌梗死的重要方法。
I. Emphasis on Zang-Fu Organs and Proficiency in Syndrome Differentiation
In clinical diagnosis and treatment, Li places the greatest emphasis on the Zang-Fu organs. He believes that the human body is an organic whole centered around the Zang-Fu organs. Each Zang and each Fu organ has its own functions. The Zang organs are interconnected with one another, the Fu organs with the Zang organs, and the Fu organs with one another through relationships of mutual generation and restriction (Sheng-Zhi), thereby maintaining the coordination and balance of physiological functions in the human body. When the human body is affected by various pathogenic factors, the attributes of these pathogens will influence the functions of the Zang-Fu organs. Each disease has its own development trend, and each syndrome has its own developmental law. By clearly distinguishing the development trends and laws of various diseases, and based on the various manifestations of clinical syndromes, reasonable treatment methods and prescriptions can be formulated. For example, regarding Xiongbi (Chest Bi / Coronary Heart Disease), Li believes it is mostly caused by imbalances of Yin and Yang, Qi and Blood, as well as factors such as Cold coagulation, Heat binding, Phlegm obstruction, Qi stagnation, and Blood stasis. Observing its pattern of onset, generally at the beginning there is often failure of Chest Yang to rise and obstruction of the Heart vessels, so the treatment should prioritize promoting Yang and dispersing Bi (Tong Yang Xuan Bi); as the condition develops, if Qi stagnation persists for a long time leading to stagnant Blood circulation, the treatment should prioritize invigorating Blood and resolving stasis (Huo Xue Hua Yu); in the late stage of Xiongbi, when Qi and Yin are depleted and the power to move Blood is weak, causing obstruction of Qi and Blood, the treatment should prioritize tonifying Qi and nourishing Yin while moving Qi and invigorating Blood (Yi Qi Yang Yin, Xing Qi Huo Xue); if the disease progresses deeply resulting in deficiency of both Qi and Blood, with Yang deficiency and excess of Yin, the treatment should prioritize warming and unblocking the Heart Bi and rescuing Yang from collapse (Wen Tong Xin Bi, Hui Yang Jiu Ni). Even if the disease changes in myriad ways, modifications can be made according to the syndrome under the premise of applying the principal method. This applies to Coronary Heart Disease, and similarly to other diseases.
When examining the illness, asking about symptoms, prescribing, and administering medication, [Li] excels in syndrome differentiation and treatment. One identifies what "syndrome" (Zheng) the disease manifestations belong to, then determines which treatment method to adopt based on the differentiated syndrome, and subsequently selects prescriptions and herbs according to the requirements of the established treatment method, adjusting with the changing syndrome for therapy. The concrete manifestation of syndrome differentiation and treatment lies in Principle, Method, Prescription, and Herb. The flexible application of prescriptions and herbs is particularly important in syndrome differentiation and treatment. There is a specific prescription for each syndrome, and a specific herb for each disease. For instance, in *Shanghan Lun* (Treatise on Cold Pathogenic Diseases), Guizhi Tang (Cinnamon Twig Decoction) is used for Taiyang disease Wind-strike exterior syndrome, and Mahuang Tang (Ephedra Decoction) is used for Taiyang disease Cold-excess exterior syndrome; in *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet), Shengma Biejia Tang (Immature Yellowhorn Turtle Shell Decoction) is used for Yin-Yang Toxicity, and Dahuang Mudanpi Tang (Rhubarb and Moutan Decoction) is used for Intestinal Abscess; meanwhile, Yinchen (Artemisiae Scopariae Herba), Changshan (Dichroae Radix), and Baitouweng (Pulsatillae Radix) are specific herbs for treating Jaundice, Malaria, and Dysentery respectively. This is what is referred to as "Use the appropriate medicine for the disease, use the appropriate prescription for the syndrome." However, when applying specific prescriptions and herbs, attention must be paid to the essence, characteristics, and stages of the specific disease, and changes must be made flexibly according to the progression and urgency of the disease. One must not simply套用 (apply mechanically) the main prescription and specific herbs while ignoring syndrome differentiation; rather, prescriptions and herbs should be selected under the premise of syndrome differentiation, or new applications created.
For example, Yan, male, 47 years old, a cadre of a company in Zhuhai. In June 1993, he underwent thymectomy for a thymoma at a hospital in Wuhan. Shortly after surgery, he developed ptosis (drooping eyelids) and weakness in all four limbs. He was treated in many large hospitals in the province and city, and after repeated examinations, he was diagnosed with "Myasthenia Gravis." Taking Chinese herbal medicines for tonifying Qi caused abdominal distension; taking ascending agents resulted in unresolved irritability; using Western medicines such as Neostigmine Bromide or Dexamethasone caused chest discomfort. He was then referred to Li. At the time of consultation: upper eyelid ptosis, weakness in all four limbs, dysphagia, drooling, chest and epigastric fullness/distension, lack of appetite, frequent belching, restless sleep, blood in stool (history of hemorrhoids), scanty yellow urine, red tongue tip, yellow greasy coating, fine and slightly rapid pulse. Li diagnosed this as Wei Syndrome (Flaccidity Syndrome) in Traditional Chinese Medicine. *Neijing* states that the occurrence of this disease is related to "Lung Heat scorching the leaves"; Lung Heat causes dryness, preventing Essence and Blood from being distributed to the Five Zang organs, thus leading to flaccidity. It proposes the theory of "Treating Flaccidity by exclusively focusing on the Yangming" (see *Suwen: Treatise on Flaccidity*). Therefore, later medical books mostly base their theories on Lung Heat damaging fluids, Spleen-Stomach deficiency, or Liver-Kidney Yin deficiency, employing methods such as clearing Heat and moistening dryness, tonifying Qi and strengthening the Spleen, or tonifying the Liver and Kidneys, each holding their own views. In this case, however, the syndrome belongs to damage of Chest Yang, internal obstruction by Phlegm-Heat, and consumption of Yin fluids. Thus, the treatment should prioritize promoting Yang and dispersing Bi, clearing Heat and resolving Phlegm, assisted by clearing Heat, generating fluids, strengthening the Spleen, and tonifying Qi. Medicines used: Chao Gualou Pi (Fried Trichosanthes Peel) 10g, Xiebai (Allii Macrostemonis Bulbus) 10g, Chao Zhuru (Fried Bamboo Shavings) 10g, Pipa Ye (Loquat Leaf) 15g, Chenpi (Citrus Reticulata Peel) 10g, Chao Zhike (Fried Aurantium Fructus) 10g, Fushen (Poria with Hostwood) 15g, Fa Xia (Prepared Pinellia Rhizome) 10g, Chao Chuanlian (Fried Coptis Rhizome) 10g, Xiakucao (Prunella Vulgaris) 15g, Chao Erya (Fried Sprouted Grains) 15g, Xiangyuan Pi (Citron Rind) 10g, Lugeng (Reed Rhizome) 20g. After adding and subtracting ingredients, this formula was taken for a total of 15 doses. Spirit greatly improved, chest felt comfortable, appetite increased, urination and defecation became smooth, and ptosis disappeared. Subsequently, regulation with formulas promoting Yang dispersion, clearing Heat resolving Phlegm, and strengthening Spleen harmonizing Stomach led to recovery. Follow-up for half a year showed no recurrence. Carefully analyzing this case, post-thymectomy Myasthenia Gravis was treated by worldly physicians who mechanically applied established methods, either strengthening the Spleen, tonifying Qi, or recklessly using ascending agents, yielding no effect. The reason lies in damage to Chest Yang, Qi mechanism stagnation, internal obstruction by Phlegm-Heat, and fluid consumption by Heat pathogens. Since Chest Yang cannot be revitalized, Qi mechanism cannot be unblocked, and Phlegm-Heat cannot be cleared, how could the disease heal itself? Li was not constrained by preconceived notions, basing his approach on Phlegm-Heat. The method emerged from the syndrome, and the prescription followed the method. Using Gualou Xiebai Banxia Tang (Trichosanthes, Allium, and Pinellia Decoction) combined with Huanglian Wendan Tang (Coptis and Gallbladder-Calming Decoction) as the main basis, and flexibly modifying medications according to changes in the syndrome, good results were achieved.
II. Skillful Use of Classic Formulas and Steady Medication
Li has been practicing medicine for over 60 years. In clinical treatment, he skillfully uses Jingfang (Classic Formulas), yet he follows the ancients without being bound by them, modifying flexibly and applying freely. For example, Cheng, male, 45 years old, engaged in farming and sewing, had a habit of smoking and a chronic history of cough and asthma. One autumn, due to external contraction with fever, cough worsened, sputum contained pus, and had a foul odor. After taking Chinese herbal medicines for clearing Heat detoxifying, diffusing Lung, resolving Phlegm, and expelling pus, the fever subsided, but other symptoms remained. Seeking Western medical treatment again, "Lung Abscess" was considered, and anti-inflammatory injections such as Penicillin and Streptomycin were administered. The symptom of coughing up pus fluctuated between slight improvement and exacerbation, confining him to bed for nearly a year. Tormented by the disease, his will was depressed, and he almost sought suicide. His family came pleading for a fast-acting effective prescription.
Upon detailed inquiry into the syndrome: extreme chest tightness, pain in the left chest, frequent expectoration of turbid foul-smelling sputum, dry throat but no thirst, yellow coating, rapid pulse. This matches the description of Feiyong (Lung Abscess) in *Jingui*. Reviewing previous Chinese herbal prescriptions, weijingsheng Tang (Euphrasia Seed Decoction), Xiebai San (Drain White Powder), Paion San (Pus-Expelling Powder), Xihuang Wan (Rhino Horn Pill), Yuxingcao (Houttuynia Cordata), Rendongteng (Lonicera Japonica Stem), Tingli Dazao Xiefei Tang (Descurainia Seed and Jujube Decoction Draining Lung) had all been taken without complete efficacy. Carefully examining this syndrome, although prolonged and Yuan Qi damaged, the pulse still has spirit, suggesting it has not reached exhaustion. However, the turbid phlegm and rotten pus in the lungs, persisting for a long time, seem to have formed a nest/cyst. Only potent drugs capable of breaking hard accumulations can attack the crux of the disease, fighting a last stand to hope for turning danger into safety. Thus, Sanwu Baisan (Three-Ingredient White Powder) was used: Jiegeng (Platycodon Root) and Chuanbeimu (Fritillaria Cirrhosa Bulb) 10g each, Badou (Croton Seed, shelled, fried black retaining nature) 3g, ground into fine powder, taken with boiled water in divided doses. Initially no reaction was seen. After about 1 hour, 2 more doses were taken. Shortly after, chest pain and discomfort occurred, and approximately half a sheng of stubborn phlegm and rotten pus was expelled. Medication was immediately stopped, and the patient was nourished with rice gruel to harmonize Stomach Qi. Afterwards, the chest and diaphragm felt relieved, and the expectorated turbid pus became thinner. The method of "Supporting Earth to Generate Metal" was adopted, imitating Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) plus Phlegm-resolving and detoxifying herbs for regulation until recovery.
Again, in early 1992, Ning, a 20-year-old national rowing athlete, suffered from recurrent vomiting and stomach pain for 3 years, accompanied by a history of migraines, which recently worsened. Vomiting occurred upon eating, and drinking water exacerbated vomiting. Epigastric pain was like needle pricking, red tongue, white coating, fine and wiry pulse. Western medicines Ranitidine, Metoclopramide, and Weishuping were ineffective, severely affecting sports training. His coach brought him for treatment. Li diagnosed excessive training damaging Spleen and Stomach Qi, loss of ascending and descending functions, and stagnant Qi mechanism. The treatment used harmonizing Stomach and descending turbidity, regulating Qi and moving stagnation. Suozi Daihe Tang (Inula and Hematite Decoction) was modified, using Suozi Hua (Inula Flower), Daiheshi (Hematite), Dangshen (Codonopsis Radix), Houpo (Magnolia Bark), Juhong (Tangerine Red Peel), Chao Zhike (Fried Aurantium Fructus), Fuling (Poria), Sharen (Amomum Fruit), Sugeng (Perilla Stem), Jiao Sanxian (Fried Three Immortals - Hawthorn, Malt, Medicated Leaven), and Zhi Gancao (Honey-fried Licorice Root). After 5 doses, vomiting ceased and did not recur.
Later, Ning won two gold medals for China in the Women's Double 500m event at the Polish Rowing Joint Cup competition on May 10, 1992.
Li’s medication is consistently light, agile, and steady. This is mainly influenced by Zhang Zhongjing, Ye Tianshi, Wu Jutong, Yun Tieqiao, Cao Yingfu, and other physicians, representing new developments compared to predecessors. For instance, in treating Warm-Heat Jaundice, based on Zhongjing’s methods, he proposed treatment according to the Triple Burner (Sanjiao): When Warm-Heat invades the Upper Burner, impairing Lung and Wei defensive dissemination, the treatment uses "Dispersing Upward," pungent-aromatic diffusion, and aromatic transformation of damp-turbidity, commonly using Huoxiang Ye (Agastache Leaf), Xingren (Apricot Seed), Peilan (Patchouli), Pipa Ye (Loquat Leaf), Kouyi (Cardamom Peel), etc.; When Damp-Heat stagnates in the Middle Burner, disrupting Liver and Stomach harmony, the treatment uses "Broadening the Middle," clearing Heat drying Dampness, soothing Liver and harmonizing Stomach, commonly using Zhishi (Immature Bitter Orange), Zhike (Aurantium Fructus), Chenpi (Citrus Peel), Sharen (Amomum Fruit), Jianqu (Medicated Leaven), Guyamaiya (Barley and Malt Sprouts), Jinneijin (Chicken Gizzard Lining), Yiyiren (Coix Seed), Huoxiang Geng (Patchouli Stem), Kourou (Cardamom Seed), etc.; When Damp-Heat accumulates in the Lower Burner, whether in Large Intestine or Bladder, the treatment uses "Guiding Downward," guiding stagnation and unblocking bowels, or draining Heat and promoting urination, commonly using Dahuang (Rhubarb Root), Zhishi (Immature Bitter Orange), Binglang (Areca Seed), Houpo (Magnolia Bark), Chi Fuling (Red Poria), Huashi (Talcum), Tongcao (Tetrapanax Pith), Maogen (Imperata Rhizome), Cheqianzi (Plantago Seed), etc. Dosages are generally between 6–15 grams. Large heavy doses are not used for non-severe/non-critical illnesses, nor are excessively pungent-drying substances used lightly to prevent igniting dryness-heat. Simultaneously, he opposes heavy doses of bitter-cold drugs like Dahuang, fearing damage to Spleen and Stomach. As for Yin-nourishing and Qi-tonifying drugs like Huangqi (Astragalus Root) and Dangshen (Codonopsis Radix), they must also be used cautiously to avoid cloying nature aiding Dampness and causing fullness, worsening the condition. Some say Li is famous for small dosages. Li said: "Prescriptions have sizes, disease trends have urgency, and drug dosages have heaviness. The ancients said 'big disease requires big medicine, toxic virus requires toxic medicine.' How can a physician claim merit by indiscriminately throwing tiger-wolf (potent/toxic) agents?" He admired the medication characteristics of modern famous doctors Shi Jinmo and Ran Xuefeng, believing that small dosages do not appear extraordinary but yield good effects. He lamented that contemporary practitioners prescribe 30–50 grams casually, thinking it bold, unaware that it causes much harm and waste of Chinese materia medica. Therefore, in clinical practice, regardless of whether the prescription is large or small, urgent or slow, if indicated, it is used without fear of being harsh; if not indicated, it is not used. He does not use light doses perfunctorily to hide deficiencies.
Li frequently uses Jingfang (Classic Formulas) and is also accustomed to using Shifang (Contemporary Formulas). While applying them, based on decades of clinical experience, he has created new prescriptions for specific diseases, such as Qing Shang Ding Tong Tang (Clear Upper Pain-Settling Decoction) for headache and Qing Jie Hua Yu Tang (Clear Resolve Stagnation Decoction) for esophageal lesions.
III. Experience in Differentiating and Treating Coronary Heart Disease
Coronary Heart Disease (CHD), also known as Ischemic Heart Disease, includes myocardial ischemic diseases caused by narrowing or occlusion of coronary arteries due to atherosclerosis, or functional changes such as spasms. Clinical features often include angina pectoris, myocardial infarction, heart failure, and arrhythmias.
Li believes CHD belongs to the category of Xiongbi (Chest Bi) in Traditional Chinese Medicine, mostly caused by imbalances of Yin-Yang, Qi-Blood, and factors such as Cold coagulation, Heat binding, Phlegm obstruction, Qi stagnation, and Blood stasis. Clinically, it is treated using syndrome differentiation or a combination of syndrome differentiation and disease differentiation.
(1) Promoting Yang and Dispersing Bi
Constitutional Yang deficiency, failure of Chest Yang to rise, or Heart Qi deficiency, compounded by Cold pathogen invasion obstructing Chest Yang and blocking Heart vessels, easily triggers CHD attacks.
*Suwen: Treatise on Regulating Jing-Luo* states: "Cold Qi accumulates in the chest. If not discharged, warm Qi departs; if Cold pathogen remains, it congeals and stagnates; congestion leads to blockage." Therefore, patients often suddenly develop chest pain during sudden climate changes, especially when exposed to Cold. If Summer-Heat is excessive, damaging Heart Qi, it can also cause poor blood vessel flow leading to chest pain. Revitalizing Heart Yang and dispersing Bi unblocking collaterals remains an important measure in treating CHD.
Syndromes manifest as chest tightness and pain, triggered or aggravated by Cold, severe cases showing aversion to cold and cold limbs, palpitations, shortness of breath, pain piercing through to the back and back pain piercing through to the chest, dark red tongue body, thin white coating, yellow greasy coating if transforming into Heat, tight or wiry-tight pulse, fine-choppy or fine-wiry pulse if chronic. This syndrome is common in CHD angina pectoris, etc. Treatment should prioritize dispersing Bi promoting Yang and scattering Cold invigorating Blood. Medicines used: Gualou Pi (Trichosanthes Peel), Xiebai (Allii Macrostemonis Bulbus), Fa Xia (Prepared Pinellia Rhizome), Guizhi (Cinnamon Twig), Gancao (Licorice Root), Danggui (Angelica Sinensis Radix), Taoren (Peach Kernel), Danshen (Salvia Miltiorrhiza Radix), Chishao (Red Peony Root), Xiangfu (Cyperus Rhizome), etc. If Phlegm-Turbidity is severe, add Zhishi (Immature Bitter Orange), Houpo (Magnolia Bark), Zhebei (Zhejiang Fritillaria Bulb) 10g each; if accompanied by severe Blood stasis chest pain, add Honghua (Safflower) 10g, Zhi Rumu (Prepared Frankincense and Myrrh) 6g each, to resolve stasis stop pain; if chest tightness and Cold Qi exist, add Xuanyan (Corydalis Rhizome), Jupi (Tangerine Peel), Jieluo (Tangerine Network), Sugeng (Perilla Stem) 10g each, to regulate Qi broaden chest; if Heart Qi is deficient, add Taizishen (Pseudostellaria Radix), Maidong (Ophiopogon Tuber), Wuweizi (Schisandra Berry) 10g each, to tonify Qi nourish Heart; if poor appetite, add Chao Shanzha (Fried Hawthorn Fruit) 15g, Chao Erya (Fried Sprouted Grains) 15g, to awaken Spleen harmonize Stomach; if Cold transforms into Heat, remove pungent-warm items like Guizhi, add Zhuru (Bamboo Shavings) 10g, Huanglian (Coptis Rhizome) 6g, Yinhua (Honeysuckle Flower) 30g, to clear Heat resolve Phlegm; if constipation, add Huomaren (Hemp Seed) 5g, Zhi Dahuang (Prepared Rhubarb Root) 6g, to moisten intestines unblock bowels. For syndromes of Chest Yang closure or Heart Yang deficiency, Li generally does not advocate abusing pungent-drying drugs like Guizhi and Fuzi (Aconite Lateral Root). Even if used, it is for no more than 3–5 days, stopping thereafter; or Yin-nourishing substances are added to Yang-warming drugs to regulate Yin-Yang, seeking Yang within Yin and Yin within Yang, preventing mutual damage of Yin and Yang.
Case: Qiu, female, 64 years old, retired worker from Wuhan Power Plant. First visit March 25, 1994. Paroxysmal chest tightness and pain, palpitations with aversion to cold for 4 months. In December 1993, due to weather changes, she developed chest tightness, severe pain, palpitations, and aversion to cold. She took Di’ao Xinxuekang and Compound Danshen Tablets at the factory clinic, with slight relief, but symptoms recurred later. In February 1994, the condition worsened, and she was hospitalized at Tongji Hospital. Diagnosed with "Coronary Heart Disease, Cardiac Insufficiency" via cardiac angiography, ECG, and resting myocardial imaging. Treated with cardiotonics, vasodilators, and symptomatic treatment, with no significant effect. She requested discharge and transferred to TCM treatment. Whether warming unblocking Heart Yang, invigorating Blood resolving stasis, or nourishing Heart tonifying Qi yielded no obvious effect. Current symptoms: Brought by family, chest tightness and pain, palpitations, shortness of breath, attacks feeling like death, worse at night, occurring several times a day. Body feels cold, wearing winter clothes in spring, limb fatigue, decreased appetite, dry stool, difficult urination, sore throat, dark red tongue body with ecchymotic spots on edges, yellow slightly greasy coating, fine wiry pulse. History of allergic asthma, chronic pyelonephritis, chronic pharyngitis, with occasional attacks. Examining previous prescriptions, mostly containing Guizhi and Shufu (Prepared Aconite). This indicates Chest Yang suppression, poor Qi-Blood flow, Spleen-Heart deficiency, and repeated use of warm drugs leading to Heat transformation. Treatment plan: Disperse Bi promote Yang, regulate Qi invigorate Blood, strengthen Spleen transport, assist with clearing Heat detoxifying.
Prescription: Chao Lou Pi (Fried Trichosanthes Peel) 15g, Xiebai (Allii Macrostemonis Bulbus) 10g, Danshen (Salvia Miltiorrhiza Radix) 30g, Chishao (Red Peony Root) 30g, Taoren (Peach Kernel) 10g, Xuanyan (Corydalis Rhizome) 15g, Zhi Xiangfu (Processed Cyperus Rhizome) 10g, Taizishen (Pseudostellaria Radix) 15g, Fushen (Poria with Hostwood) 30g, Huomaren (Hemp Seed) 15g, Chenpi (Citrus Reticulata Peel) 12g, Yinhua (Honeysuckle Flower) 30g, Baimaogen (Imperata Rhizome) 18g, Chao Shanzha (Fried Hawthorn Fruit) 15g, Chao Erya (Fried Sprouted Grains) 15g.
Second Visit: After taking the above prescription, chest tightness and pain significantly improved, spirit lifted, appetite increased, bowel movements smooth, wearing spring clothes, walking to clinic. Only slight dryness in throat, dark red tongue body, thin yellow coating, fine wiry pulse. Should disperse Bi promote Yang, regulate Qi harmonize Blood, strengthen Spleen transport, adding herbs to clear and benefit the throat. Prescription: Chao Lou Pi (Fried Trichosanthes Peel) 15g, Xiebai (Allii Macrostemonis Bulbus) 10g, Danpi (Moutan Cortex) 30g, Chishao (Red Peony Root) 30g, Taoren (Peach Kernel) 10g, Taizishen (Pseudostellaria Radix) 15g, Fushen (Poria with Hostwood) 30g, Lugeng (Reed Rhizome) 15g, Chenpi (Citrus Reticulata Peel) 10g, Zhi Xiangfu (Processed Cyperus Rhizome) 10g, Chao Shanzha (Fried Hawthorn Fruit) 15g, Chao Erya (Fried Sprouted Grains) 15g, Qingguo (Canarium Album Fruit) 10g.
Taken continuously for 12 doses, symptoms of chest tightness, pain, and palpitations disappeared. Occasionally waking at night. Later regulated with formulas dispersing Bi promoting Yang and nourishing Heart calming Spirit until recovery.
(2) Invigorating Blood and Resolving Stasis
If constitutional Yang deficiency allows Yin to invade Yang positions; or excessive consumption of rich/greasy foods leads to internal accumulation of Phlegm-Dampness attacking the chest position, causing Qi mechanism dysfunction; or emotional imbalance leads to long-term Qi stagnation and stagnant Blood circulation; or labor damages Yuan Qi, Qi deficiency fails to move Blood, causing Qi-Blood stasis; or Cold pathogen invasion, where Cold governs coagulation/stagnation blocking Heart vessels, etc., all can lead to Qi-Blood stasis and disease. Clinically, the primary method is invigorating Blood resolving stasis and broadening chest regulating Qi. Experiments prove this method improves coronary circulation and microcirculation, protects against myocardial ischemia, reduces infarct area, alleviates lesion severity, protects myocardial structure, promotes repair, enhances fibrinolytic enzyme activity, prevents arteriosclerosis, increases hypoxia tolerance and physical strength, and regulates immune function. It is an important method for treating CHD, angina pectoris, and myocardial infarction.