董左 少腹为厥阴之界，新寒外束，厥气失于疏泄，宿滞互阻，阳明通降失司，少腹作痛拒按，胸闷泛
恶，临晚形寒身热，小溲短赤不利，舌苔腻黄，脉象弦紧而数。厥阴内寄相火，与少阳为表里，是内有热而外反
寒之征。寒热夹杂，表里并病，延今两候，病势有进无退。急拟和解少阳，以泄厥阴，流畅气机，而通阳明。
软柴胡（八分） 黑山栀（一钱五分） 清水豆卷（八分） 京赤芍（一钱五分） 金铃子（二钱）
延胡索（一钱） 枳实炭（一钱五分） 炒竹茹（一钱五分） 陈橘核（四钱） 福泽泻（一钱五分）
路路通（一钱五分） 甘露消毒丹（包煎，五钱）
复诊 前投疏泄厥少通畅阳明，已服两剂。临晚寒热较轻，少腹作痛亦减，惟胸闷不思纳谷，腑气不行，
小溲短赤，溺时管痛，苔薄腻黄，脉弦紧较和。肝失疏泄，胃失降和，气化不及州都，膀胱之湿热壅塞溺窍也。
前法颇合病机，仍从原意扩充。
柴胡梢（八分） 清水豆卷（八分） 黑山栀（二钱） 陈橘核（四钱） 金铃子（二钱） 延胡索（一钱）
路路通（一钱五分）
方通草（八分） 福泽泻（一钱五分） 枳实炭（一钱） 炒竹茹（一钱五分） 荸荠梗（一钱五分）
滋肾通关丸（包煎，三钱）
钮右 经行忽阻，少腹痛拒按，痛引腰胯，腰腹屈而难伸，小溲不利，苔薄腻，脉弦涩，良由蓄瘀积于下
焦，肝脾气滞，不通则痛。急拟疏气通瘀，可望通则不痛。
全当归（二钱） 紫丹参（二钱） 茺蔚子（三钱） 抚芎（八分） 川楝子（二钱） 延胡索（一钱）
制香附（一钱五分） 大砂仁（研，八分） 生蒲黄（包，三钱） 五灵脂（一钱五分） 两头尖（酒浸、包，
一钱五分） 琥珀屑（冲服，八分）
温右 病本湿温，适值经行，寒凉郁遏，湿浊阻于中宫，旧瘀积于下焦，以致少腹作痛，小溲淋沥不利，
胸痞泛恶，不能纳谷，舌苔灰腻，脉左弦涩，右濡缓，病
情夹杂，最难着手。急拟通气去瘀，苦降淡渗。
藿香梗（一钱五分） 仙半夏（二钱） 姜川连（五分） 两头尖（一钱五分） 淡吴萸（三钱）
赤茯苓（三钱） 枳实炭（一钱） 延胡索（一钱） 生蒲黄（包，三钱） 藏红花（八分） 五灵脂（一钱五分）
福泽泻（一钱五分） 荸荠梗（一钱五分） 滋肾通关丸（包煎，三钱）
吉左 风冷由脐而入，引动寒疝，脐腹攻痛，有形积块如拳，形寒怯冷，肠鸣，不能饮食，舌苔白腻，脉象
弦紧。阳不营运，浊阴凝聚，急拟温通阳气，而散寒邪。
桂枝心（各三分） 炒白芍（一钱五分） 金铃子（二钱） 延胡索（一钱） 熟附块（一钱五分） 小茴香（八
分） 大砂仁（研，一钱） 台乌药（一钱五分） 云茯苓（三钱） 细青皮（一钱） 陈橘核（四钱） 淡吴萸（四
分） 枸橘（打，一枚）
Dong Zuo: The lower abdomen is the boundary of the Jueyin (Liver) channel. New cold pathogens have constrained the exterior, causing the Jueqi (Jueyin Qi) to lose its dispersing and draining function. Old stagnations mutually obstruct, and the descending and diffusing function of the Yangming (Stomach/Intestines) fails. This results in pain in the lower abdomen that refuses pressure, chest tightness, nausea, aversion to cold and fever in the evening, short and dark urine with difficult urination, a greasy yellow tongue coating, and a wiry, tight, and rapid pulse. The Jueyin internally harbors Ministerial Fire and is exterior-interior related to Shaoyang (Gallbladder). This is a sign of internal heat but external cold. Cold and heat are mixed, and both exterior and interior are affected. After two five-day periods (ten days), the disease has progressed rather than receded. Urgently prescribe harmonizing Shaoyang to vent Jueyin, unblock the Qi mechanism, and unblock Yangming. Prescription: Ruan Chaihu (Bupleuri Radix) 8 fen, Hei Shanzhi (Gardeniae Fructus) 1.5 qian, Qingshui Doujuan (Sojae Semen Praeparatum) 8 fen, Jing Chishao (Paeoniae Radix Rubra) 1.5 qian, Jinlingzi (Meliosmae Fructus) 2 qian, Yanhusuo (Corydalis Rhizoma) 1 qian, Zhishi Tan (Immature Bitter Orange Charcoal) 1.5 qian, Chao Zhuru (Bamboo Shavings Stir-fried) 1.5 qian, Chen Juhe (Citri Reticulatae Pericarpium Viride) 4 qian, Fu Zexie (Alismatis Rhizoma) 1.5 qian, Lulutong (Liquidambaris Fructus) 1.5 qian, Ganlu Xiaodu Dan (Sweet Dew Detoxication Powder) 5 qian (wrapped and decocted).
Second visit: The previous prescription for dispersing Jueyin and Shaoyang and unblocking Yangming was taken for two doses. Evening chills and fever are milder, and lower abdominal pain is reduced. However, there is still chest tightness, loss of appetite, unsmooth bowel Qi, short dark urine, and dysuria with urethral pain. The tongue coating is thin, greasy, and yellow; the pulse is wiry and tight but more relaxed. Liver failure to disperse and drain, stomach failure to descend and harmonize, Qi transformation failing to reach the Zhou Du (Bladder), leading to damp-heat congestion in the bladder orifice obstructing the urinary passage. The previous method fits the pathogenesis well; expand upon the original intent. Prescription: Chaihu Shao (Bupleuri Radix Tip) 8 fen, Qingshui Doujuan (Sojae Semen Praeparatum) 8 fen, Hei Shanzhi (Gardeniae Fructus) 2 qian, Chen Juhe (Citri Reticulatae Pericarpium Viride) 4 qian, Jinlingzi (Meliosmae Fructus) 2 qian, Yanhusuo (Corydalis Rhizoma) 1 qian, Lulutong (Liquidambaris Fructus) 1.5 qian, Fang Tongcao (Tetrapanacis Medulla) 8 fen, Fu Zexie (Alismatis Rhizoma) 1.5 qian, Zhishi Tan (Immature Bitter Orange Charcoal) 1 qian, Chao Zhuru (Bamboo Shavings Stir-fried) 1.5 qian, Biqi Geng (Dioscoreae Bulbiferae Caulis) 1.5 qian, Zishen Tongguan Wan (Nourish Kidney Unblock Passage Pill) 3 qian (wrapped and decocted).
Niu You: Menstruation suddenly stopped, lower abdominal pain refusing pressure, pain radiating to the waist and hips, inability to extend the waist and abdomen due to flexion, difficult urination, thin greasy tongue coating, wiry and choppy pulse. This is caused by accumulated blood stasis in the Lower Jiao (Lower Burner), with Liver and Spleen Qi stagnation, resulting in pain due to obstruction. Urgently prescribe regulating Qi and unblocking blood stasis, hoping to achieve "unobstructed means no pain." Prescription: Quan Danggui (Angelicae Sinensis Radix) 2 qian, Zi Danshen (Salviae Miltiorrhizae Radix et Rhizoma) 2 qian, Chongweizi (Leonuri Fructus) 3 qian, Fu Xiong (Ligustici Chuanxiong Rhizoma) 8 fen, Chuanlianzi (Meliae Fructus) 2 qian, Yanhusuo (Corydalis Rhizoma) 1 qian, Zhi Xiangfu (Cyperi Rhizoma Processed) 1.5 qian, Da Sharen (Amomi Fructus Rotundus) ground 8 fen, Sheng Puhuang (Typhae Pollen Raw) 3 qian (wrapped), Wulingzhi (Trogopterori Faeces) 1.5 qian, Liangtoujian (Aconiti Kusnezoffii Radix) 1.5 qian (soaked in wine, wrapped), Hupo Xie (Succinum Pulverized) 8 fen (taken with decoction).
Wen You: The root disease is Damp-Warmth (Shiwen). Coinciding with menstruation, cold constriction suppressed the condition, damp-turbidity obstructed the Middle Jiao (Middle Burner), and old blood stasis accumulated in the Lower Jiao. This led to lower abdominal pain, dribbling and difficult urination, chest fullness, nausea, inability to eat, gray greasy tongue coating, wiry-choppy left pulse, and soggy-slow right pulse. The complex condition is difficult to treat. Urgently prescribe promoting Qi movement and removing blood stasis, using bitter descent and bland leaching. Prescription: Huoxiang Geng (Agastaches Rhizoma et Caulis) 1.5 qian, Xian Banxia (Pinelliae Tuber Processed) 2 qian, Jiang Chuanlian (Coptidis Rhizoma Ginger-processed) 5 fen, Liangtoujian (Aconiti Kusnezoffii Radix) 1.5 qian, Dan Wuyu (Evodiae Fructus) 3 qian, Chi Fuling (Poria Cocos with Red Mycelium) 3 qian, Zhishi Tan (Immature Bitter Orange Charcoal) 1 qian, Yanhusuo (Corydalis Rhizoma) 1 qian, Sheng Puhuang (Typhae Pollen Raw) 3 qian (wrapped), Zang Honghua (Carthami Flos) 8 fen, Wulingzhi (Trogopterori Faeces) 1.5 qian, Fu Zexie (Alismatis Rhizoma) 1.5 qian, Biqi Geng (Dioscoreae Bulbiferae Caulis) 1.5 qian, Zishen Tongguan Wan (Nourish Kidney Unblock Passage Pill) 3 qian (wrapped and decocted).
Ji Zuo: Wind-cold entered through the umbilicus, triggering Han Shan (Cold Hernia). There is attacking pain in the umbilical and abdominal regions, a tangible mass like a fist, aversion to cold and fear of chill, borborygmus, inability to eat, white greasy tongue coating, and wiry-tight pulse. Yang Qi fails to circulate, turbid Yin condenses. Urgently prescribe warming and unblocking Yang Qi to dissipate cold pathogens. Prescription: Guizhi Xin (Cinnamomi Ramulus Heart) 3 fen each, Chao Baishao (Paeoniae Radix Alba Stir-fried) 1.5 qian, Jinlingzi (Meliosmae Fructus) 2 qian, Yanhusuo (Corydalis Rhizoma) 1 qian, Shu Fuku (Aconiti Lateralis Radix Preparata) 1.5 qian, Xiao Huixiang (Foeniculi Fructus) 8 fen, Da Sharen (Amomi Fructus Rotundus) ground 1 qian, Tai Wuyao (Linderae Radix) 1.5 qian, Yun Fuling (Poria Cocos) 3 qian, Xi Qingpi (Citri Reticulatae Pericarpium Viride Aromaticum) 1 qian, Chen Juhe (Citri Reticulatae Pericarpium Viride) 4 qian, Dan Wuyu (Evodiae Fructus) 4 fen, Gouju (Ponciri Fructus) one piece (beaten).