至于遗精临床有梦遗、滑精之分：有梦而遗精者谓之“梦遗”，无梦而自遗，甚则清醒时亦有精液外出者为“滑精”。两者之异同，《景岳全书》“遗精”篇曰：“梦遗滑精，总皆失精之病，虽其症不同，而所致之本则一。”俞震于《古今医案按》中言之最切：“向来医书咸云有梦而遗者责之心火，无梦而遗者责之肾虚，二语诚为括要。以予验之，有梦无梦皆虚也，不虚则肾坚精固，交媾犹能久战，岂有一梦即遗之理。”景岳与俞震之论极为精要，本例因营养不良，后天严重失调，体质更见虚弱，加之遗滑不禁则虚而又虚矣。故案中以养血安神、健脾益肝为法。方中用黄柏者，《重庆堂随笔》曰：“精滑自遗，每成劳损．男女皆有之。”“阴虚火动者为虚，湿热下注者为实。不论虚实，皆宜佐以黄柏，苦能坚阴固肾，寒能清热胜湿也。”
瘀血发热二例
瘀血发热一证，临床时有所见，但《黄帝内经》对于此证未见明文论述。推测其发病机理，当与痈疽发热有所近似。《灵枢·痈疽篇》曰：“营卫稽留于经脉之中，则血泣而不行，不行则卫气从之而不通，壅遏不得行，故热。”瘀血滞于经络隧道之中，致气血郁而不通，遂致发热。至其治法，下述两例均选用王清任《医林改错》之“血府逐瘀汤”合曹仁伯“瘀热汤”化裁，俱皆药到病除，可谓复杯即安矣。然血府逐瘀汤原书指征仅言“晚发一阵热”；“每晚内热，兼皮肤热一时，此方一付可愈，重者两付。”今以之治瘀血发热，竟得效验彰彰，已是推广其用矣。
例一
马氏子，1979年时仅五岁，6月26日于幼儿园中被顽童群殴，跌仆抢地口唇青紫肿甚。归家后精神萎顿，当夜发热恶寒，体温38．2℃。连夜送往某医院儿科治疗，诊断为“感冒”，服西药两日无效。改去另一医院就诊，诊断意见与前医院相同，加用银黄注射液，肌注后热退至37．3℃，时而略升，时而略降，终不能退至正常。最后一针注射后，患儿呼叫腿痛，经施以按摩痛渐减。及至晚饭间腿痛又作，不可屈伸，且愈痛愈剧，半小时间至呼号不绝。体温骤升至38℃以上。是日乃7月1日，发热已六日矣。余诊之反复推敲思维：此病发热已数日，天天有微汗津润而热不退，且无恶寒流涕等象，非感寒可知。又无咳嗽、咽痛、头痛诸证，亦无温热之征。且纳食不减，嬉戏如常，定非外感之病。患儿发热前有跌仆瘀肿过程，虑为瘀血发热。遂以王清任之血府逐瘀汤，参合曹仁伯瘀热汤意，疏为一方：
桔梗2g甘草1g鲜芦根20g鲜生地12g柴胡12g当归6g桃仁6g红花3g炒枳壳3g赤芍6g川芎2g川牛膝4g
连夜撮得一帖，急煎予服。九时许服下头煎，随即见患儿口中乱言，喃喃不休，所言又不甚可辨。呼之唤之，均不理会。以手稍触其体，每蓦然坐起，高声乱叫，叫已又卧。闻其时太息，时抱怨，时叫詈，时愤恨。强与对话，则暴跳之余亦能忿忿而答，所答却一毫不错，可见既非错语，亦非谵言。至次晨二时后，渐见平静而睡。翌晨醒来，神识全清，体温降至37．2℃。腿仅微痛，步履亦不妨。又将前药煎二汁与服，至中午体温正常，腿痛消失而愈。今已大学毕业，参加工作，此病未见后遗现象。
例二
豫儿于1986年9月11日晨起自觉不适，坚持去校上课。至中午体温上升自服感冒冲剂。及傍晚，体温升达38．6℃，并见汗出、乏力，略无他症。按其脉弦而迟涩。余一时未明其理，勉予服银翘散煎方一帖，药甫下咽，即觉浑身发热，旋即畏寒、面赤、目中火热，体温升至39．6℃。遂去某医院急诊，诊断为“病毒性感冒”，针药并用。二十四小时后(12日)，体温仍39．4℃。再往复诊，改用青霉素。首次注射后，随即风疹遍体，瘙痒难忍。两膝疹块融合成片，连及上下足胫尽肿。不得已停用所有西药。13日改用午时茶冲剂，服两次后体温降至38℃，但腹泻阵作，一日五、六次，停药则泻止，服药则泻作。临晚服板蓝根冲剂一包，即咽痛、畏寒、体温反升至39．3℃，扁桃体由正常而变为Ⅱ°肿胀。医院复诊断为“急性扁桃体炎。”予对症处理。15日晨热仍39．3℃。余反复谛思此证发热五日，诸药不应，且对症之药，用之病加甚，是辨证不明，识症不真也。据脉弦细迟涩，按之应指无不足之象，是经络瘀阻，血行不畅而然，当足瘀血发热证。遂投血府逐瘀汤加减方：
生地9g当归6g桃仁9g红花3g生甘草lg炒枳壳6g赤芍9g柴胡3g川芎3g银花9g芦根15g丹参9g桔梗3g
服两帖，热即退净，诸症随消，后即全安。
按：首例药后，症见胡言乱语，乃服药后瘀血欲行，流动之际扰及神明所致，瘀净则神明复矣。
例二为瘀血阻滞于经络而发热，非关感冒外邪，故中西解表，消炎诸药，不惟无益，反致引动瘀血，使病加甚。最终之诊断，侧重脉象。日人丹波元简于《脉学辑要》中曰：“今验有癥瘕痃气，壅遏隧道，而见迟脉者，是杂病亦不可以迟概为寒也。”瘀血发热虽非癥瘕痃气，而其机理，犹如前述痈疽，与瘀热一证恰有互通之处。
惊恐重症赖补养
惊者惊骇也。或见非常之物，或闻异常之声，或履险临危。感受于外，卒然人心，而生惊骇，其症自外而入。恐者畏惧也。恐恐然，惕惕然，怖畏不能自持，其病自内而生。惊之与恐，既可独立成病，亦可相因而成；惊可致恐，恐则易惊。
惊恐虽均属七情之病．而于五脏之中，惊病与心肝两脏关系最切。《医学心悟》曰：“《内经》云：东方色青，人通乎肝，其病发惊骇。惊虽属肝，然心有主持则不惊矣。”恐病多发自心肾，《医学心悟》又曰：“恐为肾志，亦多由心虚而得。《经》云：心怵惕思虑则神伤，神伤则恐惧自失。”
惊恐之治法，因惊症多由“气郁生涎，涎与气搏，变生诸证。”故治惊多以清心化痰安神镇静为主，方用温胆汤、朱砂安神丸、安神定志丸之类，多从治心人手。至于恐症则常从虚治，以补肾定志，宁心安神、益气养血为法。《医学心悟》主以十全大补汤或八味丸加鹿茸，重在培补真元，实从经验而来。
对于惊恐重症，必须持之以恒，坚持用药方始有效。程钟龄曾曰：“予尝治惊悸恐惧之症，有用大补数十剂，或百余剂而后愈者，毋谓七情之病而忽视之也。”程氏此语，若非历练有素而深入轩岐堂奥者，莫能道也，余复闻斯语而感慨系之。余于两年前治一惊恐重症患者，经治年余始见大效，异常之病态才基本好转，情志及思惟方趋正常。今述其治疗过程于下：
陆氏，女，三十九岁，为市郊某单位干部。1995年2月23日余处初诊。患者于1990年出差东北某地，偶于夜间独自散步于外，突遇一疯人蓬首垢面，踯躅道侧，见陆独身漫步，则直趋擒陆。陆见状惊惧不胜，拼力逃遁。疯人随后追赶，久之方始逃脱．及至宾馆已魂飞魄散，瘫软不能自主矣。回沪后神情萎顿，呆若木鸡，不惟生活不能自理，且一日三餐均须其母喂食。每日五更两手痉挛、口唇抽动，同时口中呜呜鸣叫不已。及至天明，痉止叫息。须由家人喂以流质食物始渐能醒，然后须由父母给予穿戴盥洗。至1991年12月经市某医院CT检查，确诊为“双侧小脑萎缩”。并经市有关专家多次会诊，有“小中风”及“癫痫”两种意见，最终之结论为“癫痫”，嘱须终身服药。
当时见证如上述症状外，见其兀然呆坐，面对电视机，双目定睛少瞬，表情严肃，语言蹇涩，对答勉强，但所答内容大多正确，少数为答非所问。由于两髋关节处牵强，故步履时常直脚行走，略似中风后遗症，且走路时左手能自由摆动，而右手紧贴身侧，不能摆动。同时只能往前：卣行，头部不能左右顾盼。饮食及二便尚属正常，经汛如期。至余诊时病已五年，加上其夫屡欲与之离异，弃之不问，父母无奈，领回照料，患者内心又增一层精神之创伤与压力，对于治疗徒增孽障。其脉初按时弦滑数而有力，过五分钟后复诊之，则变弦小数软，不任寻按。舌质呈淡姜黄色，中心略瘪。苔则微黄粗糙而干。余思陆氏所患为惊恐重症，惊则心乱神伤，肝胆气逆，痰浊骤生，经络阻滞，遂生诸症。至于定时手脚抽动，口中呜叫，乃因子丑为肝胆经气生旺之时，痰浊随两经之气升逆无制，至寅时肺金用事，欲制肝逆而不能，肝气逆上侮肺，则木叩金鸣而见口中呜叫。肝气不受金制，横溢四肢则抽搐。治拟养气血，安心神，疏肝胆，化痰涎，潜虚阳，熄内风。投柴胡加龙骨牡蛎汤增入益气、化痰、清心、安神诸品，服药两周，四肢抽动及口中呜叫大减。适经汛来临，诸证又见加甚，脉现沉小涩，改拟补阳还五汤加补益肝肾，祛风通络之物，诸证大好，遂以此方续服三月，然证虽减而终不见根本之转机，病体亦不见恢复。余反复分析推敲，认定此证当从虚治。遂采用程钟龄法，以十全大补汤合《张氏医通》之远志丸(人参、龙齿、菖蒲、茯苓神、朱砂、五味子、山药、萸肉、枣仁、黄芪)加减为方。其药用：
党参30g黄芪30g焦白术10g茯苓神各10g甘草3g生熟地各30g当归9g炒白芍9g陈皮9g炙远志9g石菖蒲6g五昧子3g磁石30g先煎生枣仁30g苦参9g
另以蜈蚣、全蝎等量研末，即古方止痉散也。每日服二次，每次1．5g，以止其四肢抽搐。
上方中减去十全大补汤中之肉桂。盖患者心肝痰热较重，稍用热药即不适。后于方中去苦参，加入炙龟板30g天门冬30g见效益佳，定为基本方，随证加减予服。后又添入朱砂安神丸加强清心安神之效。以上方为基础共进退服用一年六个月，每月仅停药休息一、二日，药后神志清晰，记忆及情态基本恢复，可与人正常交谈，能复述所观电视节目。清晨抽搐虽未全除，而已甚微，鸣声亦然。能自行穿衣用餐，行走时四肢协调自然，能协助母亲粗理家务。患者之舌质已由淡姜黄色转为正常人之淡红色，糙黄苔已成薄黄润泽苔。此为其内在正复邪退，病体向安之征兆。然其停药为时未久，其疗效尚须时间考验也。
赭石立治脑震荡
脑震荡与脑挫裂伤，为头部直接受暴力所致。或由外物击伤，或与硬物相撞。亦有因于臀、足受力，外力由脊传头而震伤颅脑者。脑震荡为病较轻，其症每于伤后短暂失却知觉，伴呕吐、头痛及近事遗忘。脑挫裂伤为病较重，患者常可昏迷数小时至数星期。症见明显头痛、呕吐、烦躁不安，严重者可见瞳孔散大，呼吸不匀，甚至持续高热而呈危象。
脑震荡与脑挫伤之治疗，素无特效疗法，中医多主平肝化痰、潜阳熄风，笔者以钩藤、石决、姜夏、茯神、天麻、龙牡、磁石、竹茹、白蒺藜等治疗数例，鲜获速效。后读曹惕寅先生之《诊暇录稿》，得以单味代赭石重投缓服，以治脑震荡之法，用于临床，其效应若桴鼓，捷如影响。先后四、五例，投剂辄应。先录典型病例一则于下：
陶某，男，四十八岁，某粮管所副所长。1979年10月5日上午，与邻居因事争执，被木棍击伤头颅、腰背及眼部，当即晕仆。急送某区中心医院急诊。
在该院留观十二日，诊断为“脑挫伤”。出院时腰背及眼外伤渐愈。血压由入院时220／130(mmHg)下降为130／90(mmHg)。其时主症为头晕泛恶剧烈。于出院当日邀余往诊。自诉：击伤伊始，即晕不可支，旬余以来，虽针药迭进，而症无少减，只能静卧，不能稍动躯体，稍稍动作，即觉天旋地转而眩晕欲仆，随即泛恶频频，但不呕吐。一日三餐及饮水服药，均由家属喂饲。余诊得脉象弦滑，舌质舌苔无异常。迳予：
代赭石100g，加水两大碗，煎至一大碗，待温后，以汤匙缓缓喂饮，约四小时左右饮尽。
当日下午开始服药，至傍晚，甫尽药汁之半，已可自行翻身。于是续服前药而尽其剂，及夜半，独自下床登厕矣。然步履蹒跚，时欲以手扶物。翌日又服一剂，即恢复正常。直至1989年以它病逝世，生前未见任何脑震荡后遗症。
按：此案眩晕甚而无呕吐，《诊暇录稿》之案，则为呕吐剧烈，神识不清。该书原刊于1927年，以后未见再版，渐成凤毛麟角矣。今照录原文，以资读者印证：
“粤东范君之女，年五龄。自楼窗跌仆下坠，狂妄躁语。与饮饮吐，得食食吐。不能辨识父母，目不交睫。或云肝阳挟痰，或谓温邪痰滞。历五日夜，医药罔效。后经其友绍余往诊，切其脉错乱无定。外既不伤于风寒，内亦无病于痰滞，筋骨肌肉，亦无重伤，实以身躯颠倒重震，浊气反上，清气下陷，姑宗镇胃降浊法治之。
Regarding nocturnal emission, clinically it is divided into two types: dream emission and spontaneous emission. Emission accompanied by dreams is called "dream emission" (Meng Yi), while spontaneous emission without dreams, or even leakage of semen while awake, is called "spontaneous emission" (Hua Jing). Regarding the similarities and differences between the two, *Jing Yue Quan Shu* (Complete Works of Zhang Jingyue) in the chapter on "Nocturnal Emission" states: "Dream emission and spontaneous emission are both diseases of losing essence; although their symptoms differ, the root cause leading to them is the same." Yu Zhen, in *Gu Jin Yi An An* (Analysis of Ancient and Modern Medical Cases), stated most accurately: "Previous medical books all say that dream emission should be attributed to Heart Fire, while spontaneous emission should be attributed to Kidney Deficiency. These two statements indeed summarize the essentials. Based on my verification, whether with or without dreams, the nature is deficiency; if not deficient, then the Kidney Qi is firm and essence is secured, allowing for endurance during intercourse. How could there be a principle where one dream leads directly to emission?" The discussions of Zhang Jingyue and Yu Zhen are extremely concise. In this case, due to malnutrition and severe dysfunction of the acquired constitution (Spleen/Stomach), the physical constitution became weaker. Coupled with uncontrollable emission and sliding, the deficiency became compounded. Therefore, the treatment principle for this case was to nourish blood and calm the spirit, strengthen the Spleen and benefit the Liver. The reason for using Huang Bo (Phellodendron Bark) in the formula is explained in *Chong Qing Tang Sui Bi*: "Slippage and spontaneous emission of essence often develop into consumptive disease, affecting both men and women." "Those caused by Yin deficiency with fire hyperactivity belong to deficiency patterns, while those caused by damp-heat pouring downward belong to excess patterns. Regardless of deficiency or excess, it is appropriate to assist with Huang Bo, as bitterness can solidify Yin and secure the Kidney, and coldness can clear heat and overcome dampness."
Two Cases of Fever Due to Blood Stasis
The syndrome of fever due to blood stasis is occasionally seen in clinical practice, but the *Huang Di Nei Jing* (Yellow Emperor's Inner Canon) does not contain explicit discussion on this syndrome. Speculating on its pathogenesis, it should be somewhat similar to fever caused by carbuncles and sores (Yong Ju - purulent infections). The *Ling Shu: Yong Ju Pian* (Spiritual Pivot: Chapter on Carbuncles and Sores) states: "When Ying Qi and Wei Qi stagnate within the meridians, blood becomes viscous and fails to circulate. When blood fails to circulate, Wei Qi follows it but becomes blocked, causing congestion and obstruction, thus generating heat." When blood stasis stagnates within the collaterals and tunnels, it causes Qi and blood to become郁结 (stagnant) and unobstructed, thereby leading to fever. As for the treatment method, the following two cases both selected Xue Fu Zhu Yu Tang (Blood Mansion Stasis-Removing Decoction) from Wang Qingren's *Yi Lin Gai Cuo* (Correction of Errors in Medical Forest) combined with Cao Renbo's Yu Re Tang (Stasis-Heat Decoction) for modification. Both achieved success with precise medication, bringing relief almost immediately after drinking. However, the original indications for Xue Fu Zhu Yu Tang only mention "a burst of heat in the evening" and "internal heat every night, accompanied by skin heat for a moment; one dose of this formula can cure it, two doses for severe cases." Now, using it to treat fever due to blood stasis has yielded significant efficacy, which is an extension of its application.
Case 1
Mr. Ma's son was only five years old in 1979. On June 26, he was beaten up by mischievous children at kindergarten, fell and hit the ground, resulting in severe cyanosis and swelling of the lips. After returning home, he was listless. That night, he developed fever and aversion to cold, with a body temperature of 38.2°C. He was sent to the pediatric department of a certain hospital overnight for treatment and diagnosed with "common cold." Taking Western medicine for two days yielded no effect. He went to another hospital for consultation, where the diagnosis was the same as the previous one. Silver-Huang Injection was added, and after intramuscular injection, his temperature dropped to 37.3°C, fluctuating slightly up and down, but never returning to normal. After the last injection, the child cried out about leg pain. Massage gradually reduced the pain. However, when dinner time arrived, the leg pain recurred, making flexion and extension impossible, and the pain intensified. For half an hour, he cried incessantly. His body temperature suddenly rose above 38°C. This day was July 1st, and he had been feverish for six days. Upon examination, I pondered repeatedly: This illness has been feverish for several days, with slight sweating moistening the skin daily, yet the fever does not subside, and there are no signs of aversion to cold or runny nose, indicating it is not caused by cold invasion. There are also no symptoms such as cough, sore throat, or headache, nor any signs of warm diseases. Moreover, his appetite was unchanged, and he played normally, definitely ruling out an external contraction. Given the history of falling and bruising before the fever, I considered it fever due to blood stasis. Thus, I used Wang Qingren's Xue Fu Zhu Yu Tang, incorporating the intent of Cao Renbo's Yu Re Tang, and prescribed the following formula:
Jie Geng (Platycodon Root) 2g, Gan Cao (Licorice Root) 1g, Xian Lu Gen (Fresh Reed Rhizome) 20g, Xian Sheng Di (Fresh Rehmannia Root) 12g, Chai Hu (Bupleurum Root) 12g, Dang Gui (Angelica Sinensis) 6g, Tao Ren (Peach Seed) 6g, Hong Hua (Carthamus Flower) 3g, Chao Zhi Ke (Stir-fried Aurantium Fruit) 3g, Chi Shao (Red Peony Root) 6g, Chuan Xiong (Ligusticum Rhizome) 2g, Chuan Niu Xi (Cyathula Root) 4g.
I obtained one dose overnight and prepared it urgently for administration. Around 9 PM, after taking the first decoction, the child began speaking nonsense, muttering incessantly, though the words were indistinct. Calling him elicited no response. Touching his body slightly caused him to suddenly sit up and shout loudly, then lie back down. He sighed occasionally, complained, cursed, and showed anger. Forced conversation revealed that despite his agitation, his answers were accurate, indicating neither confused speech nor delirium. By 2 AM the next morning, he gradually calmed and slept. Waking up the next morning, his consciousness was completely clear, and his temperature dropped to 37.2°C. His legs hurt slightly, and walking was unaffected. I prepared the second and third decoctions of the same prescription for him. By noon, his temperature normalized, leg pain disappeared, and he recovered. He has since graduated from university and started working, with no sequelae from this illness.
Case 2
Yu Er felt unwell upon waking on the morning of September 11, 1986, but insisted on attending school. By noon, his temperature rose, and he self-administered cold granules. By evening, his temperature reached 38.6°C, accompanied by sweating and fatigue, with no other obvious symptoms. His pulse was wiry, slow, and choppy. I did not immediately understand the rationale and reluctantly prescribed one dose of Yin Qiao San (Honeysuckle and Forsythia Powder). As soon as the medicine was swallowed, he felt intense whole-body heat, followed by aversion to cold, facial flushing, and burning sensation in the eyes. His temperature rose to 39.6°C. He went to the emergency room of a certain hospital and was diagnosed with "viral感冒 (cold)." Acupuncture and medication were used. Twenty-four hours later (the 12th), his temperature remained at 39.4°C. Upon follow-up visit, Penicillin was switched to. Immediately after the first injection, hives broke out all over his body, causing unbearable itching. The rash on both knees merged into patches, extending to the lower legs, causing complete swelling. All Western medicines were stopped out of necessity. On the 13th, Wu Shi Cha Granules (Noon Tea Granules) were used. After two doses, the temperature dropped to 38°C, but paroxysmal diarrhea occurred, five to six times a day. Diarrhea stopped when medication was stopped and resumed when taken. In the evening, one packet of Ban Lan Gen Granules (Isatis Root Granules) was taken, resulting in sore throat, aversion to cold, and a rebound temperature rise to 39.3°C. The tonsils swelled from normal to Grade II. The hospital re-diagnosed "acute tonsillitis" and provided symptomatic treatment. On the morning of the 15th, the fever persisted at 39.3°C. I reflected deeply: This fever has lasted five days, responding to no medications, and symptomatic treatments worsened the condition. This indicates unclear differentiation and inaccurate identification of symptoms. Based on the wiry, fine, slow, and choppy pulse, which feels adequate upon pressing, this is due to meridian obstruction and poor blood circulation, constituting fever due to blood stasis. I prescribed a modified Xue Fu Zhu Yu Tang:
Sheng Di (Rehmannia Root) 9g, Dang Gui (Angelica Sinensis) 6g, Tao Ren (Peach Seed) 9g, Hong Hua (Carthamus Flower) 3g, Sheng Gan Cao (Raw Licorice Root) 1g, Chao Zhi Ke (Stir-fried Aurantium Fruit) 6g, Chi Shao (Red Peony Root) 9g, Chai Hu (Bupleurum Root) 3g, Chuan Xiong (Ligusticum Rhizome) 3g, Yin Hua (Honeysuckle Flower) 9g, Lu Gen (Reed Rhizome) 15g, Dan Shen (Salvia Root) 9g, Jie Geng (Platycodon Root) 3g.
After two doses, the fever subsided completely, all symptoms disappeared, and he recovered fully.
Commentary: In the first case, the post-medication symptom of talking nonsense was caused by the movement of blood stasis disturbing the Spirit (Shen) as the stasis began to resolve. Once the stasis was cleared, the Spirit returned to clarity.
Case 2 involved fever due to blood stasis blocking the meridians, unrelated to external wind-cold pathogens. Therefore, Western and Chinese exterior-releasing and anti-inflammatory drugs were not only ineffective but also agitated the blood stasis, worsening the condition. The final diagnosis relied heavily on the pulse. Danbo Yuanjian, a Japanese scholar, stated in *Mai Xue Ji Yao* (Essentials of Pulse Learning): "Current verification shows that in cases of masses (Zheng Jia) or abdominal cord-like sensations (Xuan Qi) obstructing the tunnels, presenting with a slow pulse, it cannot be generalized that all slow pulses in miscellaneous diseases indicate cold." Although fever due to blood stasis is not a mass or cord-like sensation, its mechanism is similar to the aforementioned carbuncles and shares commonalities with the stasis-heat syndrome.
Severe Fear and Panic Relies on Tonification
Fear (Jing) refers to shock or alarm. It arises from seeing unusual objects, hearing abnormal sounds, or facing danger. Caused by external factors entering the heart suddenly, the pathology enters from the outside. Terror (Kong) refers to dread. Feeling fearful and apprehensive, unable to control oneself, the pathology originates from within. Fear and terror can exist independently or influence each other; fear can lead to terror, and terror makes one prone to fear.
Although both fear and terror belong to diseases of the Seven Emotions, among the Five Viscera, fear is most closely related to the Heart and Liver. *Yi Xue Xin Wu* (New Insights into Medicine) states: "The *Inner Canon* says: The East corresponds to the color green, connects with the Liver, and its disease manifests as fright. Although fright belongs to the Liver, if the Heart has mastery, one will not be frightened." Terror often originates from the Heart and Kidney. *Yi Xue Xin Wu* further states: "Terror is the emotion of the Kidney, but often results from Heart deficiency. The Classics say: If the Heart is startled and overthinking occurs, the Spirit is damaged; if the Spirit is damaged, fear and loss of confidence arise."
The treatment for fear syndromes, often caused by "Qi stagnation generating phlegm-fluids, which contend with Qi, transforming into various symptoms," primarily focuses on clearing the Heart, resolving phlegm, calming the spirit, and sedating. Formulas like Wen Dan Tang (Warm the Gallbladder Decoction), Zhu Sha An Shen Wan (Cinnabar Calming the Spirit Pill), and An Shen Ding Zhi Wan (Calming the Spirit and Stabilizing Will Pill) are commonly used, starting with treating the Heart. For terror syndromes, treatment often addresses deficiency, using methods to tonify the Kidney, stabilize the will, calm the Heart and spirit, and benefit Qi and nourish blood. *Yi Xue Xin Wu* advocates using Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) or Ba Wei Wan (Eight-Ingredient Pill) plus Deer Antler, focusing on cultivating true Yuan Qi, based on experience.
For severe fear and panic cases, persistence in medication is essential for efficacy. Cheng Zhongling once said: "I have treated patients with palpitations, fear, and panic, curing them after dozens or even hundreds of doses of major tonics. Do not neglect these conditions simply because they stem from the emotions." Such words from Mr. Cheng could only be spoken by someone with extensive experience and deep understanding of traditional medicine. Hearing this, I was deeply moved. Two years ago, I treated a patient with severe fear and panic. After more than a year of treatment, significant improvement was seen, abnormal behavioral states largely resolved, and emotional and cognitive functions returned to normal. I describe the treatment process below:
Ms. Lu, female, 39 years old, a cadre at a suburban unit. She visited me for the first time on February 23, 1995. In 1990, while on a business trip in Northeast China, she was walking alone at night when she encountered a disheveled madman lurking by the road. Seeing her alone, he rushed to grab her. Overcome with fear, she struggled to escape. The madman chased her for a long time before she finally got away. Arriving at the hotel, she was terrified and paralyzed, unable to control herself. After returning to Shanghai, she was listless and dazed, unable to care for herself, requiring her mother to feed her three meals a day. Every dawn, she experienced spasms in both hands and twitching of the lips, accompanied by continuous moaning. By morning, the spasms stopped, and the moaning ceased. She needed liquid food fed by family members to wake up gradually, then required parents to help dress and wash. In December 1991, a CT scan at a municipal hospital confirmed "bilateral cerebellar atrophy." Multiple expert consultations suggested either "minor stroke" or "epilepsy," with the final conclusion being "epilepsy," recommending lifelong medication.
In addition to the above symptoms, she sat motionlessly facing the TV, staring fixedly with few blinks, expression serious, speech slurred, responses hesitant but mostly correct, though occasionally irrelevant. Due to stiffness in the hip joints, she walked with straight legs, resembling sequelae of a stroke. Her left arm swung freely while walking, but her right arm stayed rigidly by her side. She could only walk forward, unable to turn her head left or right. Diet and bowel/bladder functions were normal, and menstruation was regular. At the time of my consultation, the illness had lasted five years. Compounded by her husband's repeated attempts at divorce and abandonment, and her parents' helpless care, she suffered additional psychological trauma and pressure, hindering treatment. Initially, her pulse was wiry, slippery, rapid, and forceful. Five minutes later, upon re-examination, it became wiry, fine, slow, soft, and difficult to press. The tongue body was pale ginger-yellow, slightly depressed in the center. The coating was slightly yellow, rough, and dry. I reasoned that Ms. Lu suffered from severe fear and panic. Fear disturbs the Heart and damages the Spirit, causing Liver and Gallbladder Qi to rebel, sudden generation of turbid phlegm, meridian obstruction, and subsequent symptoms. The timed hand and foot convulsions and moaning occur because Zi and Chou hours are when Liver and Gallbladder Qi is vigorous. Turbid phlegm rises uncontrollably with this Qi. By Yin hour, Lung Metal acts to restrain Liver rebellion but fails. Liver Qi rebels upward insulting Lung, causing Wood striking Metal, manifesting as moaning. Unrestrained by Metal, Liver Qi overflows into the limbs, causing convulsions. The treatment plan was to nourish Qi and blood, calm the Spirit, soothe Liver and Gallbladder, resolve phlegm-fluids, anchor deficient Yang, and extinguish internal wind. I prescribed Chai Hu Jia Long Gu Mu Li Tang (Bupleurum Plus Dragon Bone and Oyster Shell Decoction) augmented with herbs to benefit Qi, resolve phlegm, clear Heart heat, and calm the Spirit. After two weeks, limb convulsions and moaning decreased significantly. Coinciding with menstruation, symptoms worsened, and the pulse became deep, small, and choppy. I changed to Bu Yang Huan Wu Tang (Tonify Yang to Restore Five Tenths Decoction) augmented with herbs to tonify Liver and Kidney, dispel wind, and unblock collaterals. Symptoms improved greatly, and I continued this formula for three months. However, although symptoms lessened, there was no fundamental turnaround, and the body did not recover. After repeated analysis, I determined this case should be treated as a deficiency pattern. Adopting Cheng Zhongling's method, I combined Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) with Yuan Zhi Wan (Polygala Pill) from *Zhang Shi Yi Tong* (Medical Secrets of Master Zhang) [Ren Shen (Ginseng), Long Chi (Dragon Teeth), Chang Pu (Acorus), Fu Ling Shen (Poria with Hostwood), Zhu Sha (Cinnabar), Wu Wei Zi (Schisandra), Shan Yao (Dioscorea), Yu Rou (Cornus), Suan Zao Ren (Ziziphus Seed), Huang Qi (Astragalus)] for modification. The prescription was:
Dang Shen (Codonopsis) 30g, Huang Qi (Astragalus) 30g, Jiao Bai Zhu (Charred Atractylodes Macrocephala) 10g, Fu Ling Shen (Poria with Hostwood) 10g each, Gan Cao (Licorice Root) 3g, Sheng Shu Di (Raw and Prepared Rehmannia) 30g each, Dang Gui (Angelica Sinensis) 9g, Chao Bai Shao (Stir-fried White Peony Root) 9g, Chen Pi (Tangerine Peel) 9g, Zhi Yuan Zhi (Processed Polygala Root) 9g, Shi Chang Pu (Acorus) 6g, Wu Wei Zi (Schisandra) 3g, Ci Shi (Magnetite) 30g (decocted first), Sheng Suan Zao Ren (Raw Ziziphus Seed) 30g, Ku Shen (Sophora Root) 9g.
Additionally, Wu Gong (Centipede) and Quan Xie (Scorpion) were ground equally into powder, forming the ancient formula Zhi Jing San (Stop Spasms Powder). Taken twice daily, 1.5g each time, to stop limb convulsions.
Cinnamon (Rou Gui) was removed from Shi Quan Da Bu Tang in the above formula because the patient had significant Heart and Liver phlegm-heat, and even slight heat-inducing herbs caused discomfort. Later, Ku Shen was removed, and Zhi Gui Ban (Prepared Turtle Shell) 30g and Tian Dong (Asparagus Root) 30g were added, yielding excellent results. This became the basic formula, modified according to symptoms. Later, Zhu Sha An Shen Wan (Cinnabar Calming the Spirit Pill) was added to enhance clearing Heart heat and calming the Spirit. Using this base formula, she took medication continuously for one year and six months, resting only one or two days per month. Post-medication, her consciousness was clear, memory and demeanor basically recovered, she could converse normally, and recall TV programs watched. Morning convulsions were not entirely eliminated but were very mild, as were the moans. She could dress and eat independently, walk with coordinated limbs, and assist her mother with household chores. Her tongue body color changed from pale ginger-yellow to normal light red, and the rough yellow coating became thin, yellow, and moist. This indicated the recovery of righteous Qi and retreat of pathogenic factors, signaling health restoration. However, the duration of drug-free intervals was short, and the efficacy still requires time testing.
Ochre Stone Instantly Treats Concussion
Concussion and cerebral contusion/laceration are caused by direct violence to the head. This may result from being struck by an object or colliding with a hard surface. It can also occur when force applied to the buttocks or feet transmits through the spine to shake the cranial brain. Concussion is a milder condition, typically involving brief loss of consciousness after injury, accompanied by vomiting, headache, and anterograde amnesia. Cerebral contusion/laceration is more severe, often causing coma for hours to weeks. Symptoms include severe headache, vomiting, restlessness, and in serious cases, dilated pupils, irregular breathing, and even persistent high fever indicating critical condition.
There is no specific effective therapy for concussion and cerebral contusion. Traditional Chinese Medicine generally advocates soothing the Liver, resolving phlegm, anchoring Yang, and extinguishing wind. I treated several cases with Gou Teng (Uncaria Ramulus), Shi Jue Ming (Abalone Shell), Jiang Xia (Ginger-processed Pinellia), Fu Shen (Poria with Pine Root), Tian Ma (Gastrodia Rhizome), Long Gu & Mu Li (Dragon Bone & Oyster Shell), Ci Shi (Magnetite), Zhu Ru (Bamboo Shavings), and Bai Ji Li (Tribulus Fruit), rarely achieving rapid effects. Later, reading Mr. Cao Tiyin's *Zhen Xia Lu Gao* (Manuscripts from Leisure Time Diagnosis), I learned the method of using single-dose heavy Ochre Stone (Dai Zhe Shi) administered slowly to treat concussion. Applying this clinically, the effect was immediate, like a drumbeat or echo. Out of four or five cases, every dose worked. I record one typical case below:
Mr. Tao, male, 48 years old, deputy director of a grain management office. On the morning of October 5, 1979, during an argument with a neighbor, he was struck on the head, back, and eye with a wooden stick, causing immediate fainting. He was rushed to the emergency room of a district central hospital.
He was observed in the hospital for twelve days and diagnosed with "cerebral contusion." Upon discharge, injuries to the back and eye had gradually healed. Blood pressure dropped from admission levels of 220/130 mmHg to 130/90 mmHg. His main symptom at that time was severe dizziness and nausea. Invited to consult on the day of discharge, he reported: From the moment of injury, he was overwhelmingly dizzy. For over ten days, despite repeated acupuncture and medication, symptoms did not lessen. He could only lie still; any slight movement caused vertigo and a feeling of falling, followed by frequent nausea without vomiting. Meals, water, and medication were all fed to him by family members. My examination revealed a wiry and slippery pulse, with normal tongue body and coating. I directly prescribed:
Dai Zhe Shi (Hematitum/Ochre Stone) 100g, added with two large bowls of water, decocted until one bowl remained. After cooling, administer slowly with a spoon, finishing within approximately four hours.
Medication started in the afternoon. By evening, having consumed only half the decoction, he could turn over independently. He continued the remaining medicine. By midnight, he got out of bed and went to the toilet alone. However, his gait was unsteady, and he occasionally needed to hold onto objects. The next day, after one more dose, he returned to normal. Until his death from another illness in 1989, he showed no sequelae of concussion.
Commentary: In this case, dizziness was severe without vomiting. In the case from *Zhen Xia Lu Gao*, vomiting was severe with clouded consciousness. The book was originally published in 1927 and has not been reprinted since, becoming rare. I reproduce the original text here for readers' verification:
"The daughter of Mr. Fan from Eastern Guangdong, aged five, fell from a window. She spoke wildly and restlessly. Drinking caused vomiting, eating caused vomiting. She could not recognize her parents and kept her eyes open without blinking. Some said it was Liver Yang carrying phlegm; others claimed it was warm pathogen with phlegm stagnation. After five days and nights, medicine was ineffective. Later, introduced by a friend, I examined her. Her pulse was chaotic and unpredictable. Externally, no injury from wind-cold; internally, no disease from phlegm stagnation; bones, muscles, and tendons were not severely injured. Truly, due to the body being shaken violently upside down, turbid Qi reversed upward, and clear Qi sank downward. I tentatively adopted the method of settling the Stomach and descending turbidity.
Using only calcined Dai Zhe Shi (Hematitum) five taels, decocted in three large bowls of water. Administer five or six spoonfuls every ten minutes with a small spoon. Before consuming half, her consciousness cleared completely, vomiting stopped, she drank a bowl of porridge, lay down peacefully, and recovered."