杜右 腹部结块，按之略痛，或左或右，内热神疲，脉沉弦，苔薄腻。病属脏，着而不移，瘕病属腑，移而
不着。中阳不足，脾胃素伤，血不养肝，肝气瘀凝，脉症参合，病非轻浅。若仅用攻破，恐中阳不足，脾胃素伤，
而致有膨满之患，辗转思维，殊属棘手。姑拟香砂六君加味，扶养脾胃，冀其消散。
炒潞党参（三钱） 制香附（一钱五分） 大枣（五枚） 云茯苓（三钱） 春砂壳（五分） 炙甘草（八分）
炒白术（二钱） 陈广皮（一钱）
复诊∶前方服二十剂后，神疲内热均减。瘕块不疼略消，纳谷渐香。中阳有来复之象，脾胃得生化之机。
再拟前方进步。
炒潞党参（三钱） 炙甘草（八分） 陈广皮（一钱） 云茯苓（三钱） 制香附（一钱五分） 大腹皮（三钱）
炒白术（二钱） 春砂壳（五分） 炒谷芽（三钱） 大红枣（五枚） 桂圆肉（五粒）
孙右 肝之积，名为肥气。肝气横逆，有升无降，胁部作痛，按之有块，泛泛作恶，头内眩晕，纳谷衰少。
多愁善郁，症属七情，非易图治，若能怡情悦性，更以药石扶助，或可消散于无形。
软柴胡（五分） 金铃子（一钱五分） 制香附（一钱五分） 全当归（二钱） 延胡索（五分） 春砂
壳（八分） 炒白芍（三钱） 细青皮（八分） 广木香（五分） 失笑散（包煎，一钱五分）
二诊 泛泛作恶略止，胁部气块亦觉略消。头内眩晕，纳谷衰少，肝气横逆，上升则呕恶，下郁则痞块作
痛。再与平肝理气，和胃畅中。
金铃子（一钱五分） 制香附（一钱五分） 仙半夏（一钱五分） 延胡索（五分） 春砂壳（五分） 陈广皮（一
钱五分） 炒白芍（一钱五分） 大腹皮（三钱） 制小朴（八分） 失笑散（包煎，一钱五分）
姜右 经停四月，忽然崩漏，状如小产，腹内作痛，泛泛呕吐，形瘦骨立，纳谷衰少，脉象弦细而数，苔薄腻
而灰。前医疑是妊孕，叠投安胎之剂。参合脉症，肝脾两虚，寒瘀停凝。夫肝藏血，脾统血，藏统失司，气血不能
循经而行，偶受寒气，停于腹内，状如怀孕，经所谓瘕病是也。症势沉重，非易图治，急与培补气阴，温通寒瘀。
炒潞党（二钱） 熟附块（二钱） 单桃仁（一钱五分） 炙黄 （三钱） 炮姜炭（一钱） 杜红花（八分）
炒白术（二钱） 淡吴萸（一钱） 泽兰（一钱五分） 大红枣（五枚） 广木香（五分）
此药服三剂，崩漏腹痛均止，仍以前方去淡吴萸、桃仁、红花、泽兰，加杞子、杜仲、川断，共服十剂而愈。
王右 心下结块，痛则呕吐，嗳气不舒，纳谷不多。素体气阴两亏，肝木用事，肝气挟痰瘀阻于心下，
经书所谓伏梁，即此候也。治宜开清阳而化浊阴，平肝气而化痰瘀。
金铃子（一钱五分） 云苓（三钱） 全当归（三钱） 延胡索（五分） 姜川连（三分） 炒白芍（二钱）
淡吴萸（五分） 白蔻壳（四分） 瓦楞（三钱） 佛手柑（八分）
Mr. Du presented with an abdominal mass, slight pain upon pressure, located alternatively on the left or right. Accompanied by internal heat and mental fatigue, the pulse is deep and wiry (Chen Xian), and the tongue coating is thin and greasy. The disease resides in the Zang organs; masses that adhere and do not move are classified as Ju (accumulation). The Jia (mass) disease resides in the Fu organs; masses that move and do not adhere. With insufficient Middle Jiao Yang and a constitutionally damaged Spleen and Stomach, blood fails to nourish the Liver, leading to Qi stagnation and coagulation in the Liver. Integrating pulse and symptoms, this is not a superficial disease. If only attacking and breaking methods are used, fearing the insufficiency of Middle Yang and the pre-existing damage to the Spleen and Stomach may lead to distension and fullness. After repeated consideration, it is indeed tricky. Tentatively prescribing Xiang Sha Liu Jun Zi Tang (Aromatic Sandalwood Six Gentlemen Decoction) with modifications, to support and nourish the Spleen and Stomach, hoping for the resolution of the mass.
Stir-fried Lu Dang Shen (Codonopsis Radix) (3 qian), Processed Xiang Fu (Cyperi Rhizoma) (1.5 qian), Da Zao (Jujubae Fructus) (5 pieces), Yun Fu Ling (Poria) (3 qian), Chun Sha Ke (Amomi Fructus Rotundus Pericarpium) (0.5 qian), Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Preparata) (0.8 qian), Stir-fried Bai Zhu (Atractylodis Macrocephalae Rhizoma) (2 qian), Chen Guang Pi (Citri Reticulatae Pericarpium) (1 qian).
Follow-up: After taking the previous prescription for twenty doses, mental fatigue and internal heat have decreased. The Jia mass no longer hurts and has slightly reduced; appetite is gradually improving. There are signs of the recovery of Middle Yang, and the Spleen and Stomach have regained their mechanism of transformation and production. Re-prescribing the previous formula with progressive adjustments.
Stir-fried Lu Dang Shen (Codonopsis Radix) (3 qian), Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Preparata) (0.8 qian), Chen Guang Pi (Citri Reticulatae Pericarpium) (1 qian), Yun Fu Ling (Poria) (3 qian), Processed Xiang Fu (Cyperi Rhizoma) (1.5 qian), Da Fu Pi (Arecae Pericarpium) (3 qian), Stir-fried Bai Zhu (Atractylodis Macrocephalae Rhizoma) (2 qian), Chun Sha Ke (Amomi Fructus Rotundus Pericarpium) (0.5 qian), Stir-fried Gu Ya (Setariae Fructus Germinatus) (3 qian), Da Hong Zao (Jujubae Fructus) (5 pieces), Gui Yuan Rou (Longan Arillus) (5 grains).
Ms. Sun, the accumulation in the Liver is named Fei Qi (Liver Accumulation). Liver Qi rebels horizontally, rising without descending, causing pain in the hypochondrium, a palpable mass upon pressure, nausea, dizziness inside the head, and poor appetite. Prone to worry and depression, the syndrome belongs to the Seven Emotions, which is not easy to treat. If one can cultivate joy and regulate emotions, assisted by herbal medicine, the mass might dissipate invisibly.
Soft Chai Hu (Bupleuri Radix) (0.5 qian), Jin Ling Zi (Meliae Toosendan Fructus) (1.5 qian), Processed Xiang Fu (Cyperi Rhizoma) (1.5 qian), Quan Dang Gui (Angelicae Sinensis Radix) (2 qian), Yan Hu Suo (Corydalis Rhizoma) (0.5 qian), Chun Sha Ke (Amomi Fructus Rotundus Pericarpium) (0.8 qian), Stir-fried Bai Shao (Paeoniae Radix Alba Preparata) (3 qian), Xi Qing Pi (Citri Reticulatae Pericarpium Viride) (0.8 qian), Guang Mu Xiang (Agastaches Rhizoma) (0.5 qian), Shi Xiao San (Seven Stars Powder) (wrapped and decocted, 1.5 qian).
Second visit: Nausea has slightly stopped, and the Qi mass in the hypochondrium feels slightly reduced. Dizziness inside the head and poor appetite persist. Liver Qi rebels horizontally; ascending causes vomiting and nausea, while descending stagnation causes pain from the痞 (fullness) mass. Again, employing soothing the Liver, regulating Qi, harmonizing the Stomach, and unblocking the Middle Jiao.
Jin Ling Zi (Meliae Toosendan Fructus) (1.5 qian), Processed Xiang Fu (Cyperi Rhizoma) (1.5 qian), Xian Ban Xia (Pinelliae Rhizoma Preparatum) (1.5 qian), Yan Hu Suo (Corydalis Rhizoma) (0.5 qian), Chun Sha Ke (Amomi Fructus Rotundus Pericarpium) (0.5 qian), Chen Guang Pi (Citri Reticulatae Pericarpium) (1.5 qian), Stir-fried Bai Shao (Paeoniae Radix Alba Preparata) (1.5 qian), Da Fu Pi (Arecae Pericarpium) (3 qian), Zhi Xiao Po (Zingiberis Rhizoma Preparatum) (0.8 qian), Shi Xiao San (Seven Stars Powder) (wrapped and decocted, 1.5 qian).
Ms. Jiang, menstruation ceased for four months, suddenly followed by Beng Lou (metrorrhagia and metrostaxis), resembling a miscarriage, with abdominal pain, nausea and vomiting, emaciation, poor appetite, a wiry, fine, and rapid pulse, and a thin, greasy, gray tongue coating. Previous physicians suspected pregnancy and repeatedly administered fetal-calming agents. Integrating pulse and symptoms, it is deficiency of both Liver and Spleen, with cold and blood stasis stagnating. The Liver stores blood, and the Spleen controls blood. When storage and control fail, Qi and Blood cannot follow the meridians. Occasionally affected by cold qi, it stagnates in the abdomen, resembling pregnancy, which is what the classics call Jia disease. The condition is severe and difficult to treat. Urgently tonifying Qi and Yin, and warming to unblock cold and stasis.
Stir-fried Lu Dang Shen (Codonopsis Radix) (2 qian), Shu Fu Kuai (Aconiti Lateralis Radix Preparata) (2 qian), Dan Tao Ren (Persicae Semen) (1.5 qian), Zhi Huang Qi (Astragali Radix Preparata) (3 qian), Pao Jiang Tan (Zingiberis Rhizoma Carbonisatum) (1 qian), Du Hong Hua (Carthami Flos) (0.8 qian), Stir-fried Bai Zhu (Atractylodis Macrocephalae Rhizoma) (2 qian), Dan Wu Zhu Yu (Evodiae Fructus) (1 qian), Ze Lan (Lycopus Herba) (1.5 qian), Da Hong Zao (Jujubae Fructus) (5 pieces), Guang Mu Xiang (Agastaches Rhizoma) (0.5 qian).
After taking this medicine for three doses, Beng Lou and abdominal pain stopped. The previous formula was continued, removing Dan Wu Zhu Yu, Tao Ren, Hong Hua, and Ze Lan, adding Gou Qi Zi (Lycii Fructus), Du Zhong (Eucommiae Cortex), and Chuan Duan (Dipsaci Radix). Taking a total of ten doses resulted in a cure.
Ms. Wang, a mass in the epigastrium, vomiting when painful, uncomfortable belching, and poor appetite. Constitutionally deficient in both Qi and Yin, with Liver Wood overacting. Liver Qi carries Phlegm and Stasis to obstruct the epigastrium, known in classics as Fu Liang (Hidden Beam), which is this presentation. Treatment should open Clear Yang and transform Turbid Yin, soothe Liver Qi and resolve Phlegm and Stasis.
Jin Ling Zi (Meliae Toosendan Fructus) (1.5 qian), Yun Fu Ling (Poria) (3 qian), Quan Dang Gui (Angelicae Sinensis Radix) (3 qian), Yan Hu Suo (Corydalis Rhizoma) (0.5 qian), Jiang Chuan Lian (Coptidis Rhizoma Ginger-processed) (0.3 qian), Stir-fried Bai Shao (Paeoniae Radix Alba Preparata) (2 qian), Dan Wu Zhu Yu (Evodiae Fructus) (0.5 qian), Bai Kou Ke (Amomi Fructus Rotundus Pericarpium) (0.4 qian), Wa Leng (Arcae Concha) (3 qian), Fo Shou Gan (Citri Sarcodactylis Fructus) (0.8 qian).