舌色白晦,脉得右大,来去不整,左部小促,耳聋,身热不寐,语言謇涩,非是少阳伤
寒,良由小产。阴气不复,惕气上冒,恐有牵搐暴厥之忧,勿以轻浅视之。
生地 阿胶 丹皮 麦冬 白芍 蔗浆
再诊
前方去白芍,加元参、羚羊角。
遗由精窍,淋由溺窍。异出同门,最宜分别。久遗不愈,是精关不摄为虚,但点滴痛痒
,少腹
,膀胱撑满,遂致坚满耳。五苓散主治。
秋暑失血,初春再发,脉右大能纳食。金匮云∶男子脉大为劳,极虚亦为劳。要知脉大
为劳,是烦劳伤气,脉虚为劳,是情欲致损,安静一年可愈。
黄 北沙参 南枣 白芨 炙草 薏苡仁
咳嗽从肺治者,以外邪必由皮毛而入,内合乎肺。然六气皆令火化散之,未解清之润之
即愈。若内因之嗽,由别经干连及肺,当明其因,徒治肺无益。夫肾为先天,坎中真阳,内藏而
主,封蛰奇经,得司其间,冲阳由前直起。且少阴脉循喉咙,挟舌本,阴乏上承,阳独自灼
,故阴上阳下则寿,反则死。八味丸阴中之阳,似乎有理,然肉消形瘦,桂、附仍属刚
燥,宜
以青盐引入下元,斯为合法。
鹿角胶 鹿角霜 熟地 菟饼 白茯苓 青盐 补骨脂 柏子仁
住居临海,风瘴疠气,侵入脑髓骨骱,气血不和,壅遏内蒸,头面清阳痹阻,久则邪正
混处其间,草木不能见效,当以虫蚁疏通逐邪。
蜣螂 蜂房 川芎 威灵仙
火酒飞面为丸。
由夏季目黄神倦,渐至中焦胀满,延至霜降,上吐瘀血,下便污浊。按脉弱细不调,视
色神采不振,兼以呼吸带喘,素有寒疾气逆,其宿饮之畜,已非一日,当夏三月脾胃主令,天气
热,地气升,人身气泄,加以饥饱劳役,而遂减食胀满,是皆病于中绵延上下矣。夫六府以
通
以宣通为法,而有阴阳之殊,后之攻劫宣通如神佑舟车禹功等方,值此久病淹淹,何敢轻试
?议以专通三焦之阳气,驱其锢蔽之浊阴,温补兼进,若不阳气渐苏,难以拟投。引用忡景
去须葱白(四枚) 干姜(切片,盐水泡二十余次,去辣味,三钱) 猪胆汁(十匙) 淡附
子(去皮脐,再用包火煨,一钱)
再诊 脉神如昨,胸满胀更急,不思纳食,鼻尖冷甚,热汗出,自吐瘀便垢,至今神衰
。古人谓上下交征,当理其中,但阳微浊僭,格拒不通,理中守剂,不能理烦治剧,此护阳
通阳,仍参苦寒,俾浊阴泄得一分,其阳复得一分,安谷之理在焉,不及缕述。
前方去葱白,加人参三钱。
前用生津养阴,已得咳停热退,可以渐入佳境,不虞发热较甚,三昼夜不减,口渴不饥
。盖体弱肌疏,邪易侵袭,郁遏不宣,蒸燎如焚,质系金虚火旺。今遇炎威酷烈,相火风煽,暑
热外侵,交相烁液,必致煎熬枯涸,欲进苦寒,奈虚火不堪直折,且虑徒伤胃气,议用海藏
神术法,上解三阳,下安太阴。
白术 梨汁 防风 麦冬 甘草
酒客淋浊,必系湿热之邪,着于气分,故五苓八正,俱用通利。病数年不愈,必由情欲
致伤败精血阻于内窍,溺与精异路同门。茎中因精腐阻居多,必通败精,一定之理。
杜牛膝一两五钱。捣汁冲入麝香三分。
痰饮留伏而发最详。《金匮》、《玉函》、仲景,必分内外。以内饮治肾,外饮治脾。
更出
都气丸,加坎 、胡桃。
经来渐迟,色淡而少,当期必暮夜,腹痛 胀,腰髀酸楚,经络牵掣少舒,脉数,右小
左大
溢,用药须择入奇经者为宜。血海固阳明隶属奇经肝肾为多,议两和气血宣通奇脉方。
当归 茺蔚子 生香附 小茴香 焦麦芽 大黑豆皮
调入西琥珀末一钱。
面肿气喘,咳呛不止,音渐哑,酒客久蓄之湿热,必上熏及肺,为肿为喘,声音闭塞
。按《内经》湿淫于内,治以淡渗,佐以苦温。
芦根 薏苡仁 滑石 赤苓 杏仁 浓朴
寒入厥阴之脉,结为气疝,痛则胀升气消,绝无踪迹。老年下元已亏,不可破气攻疝,
尿管痛或阻溺,温养下元,佐以通窍。
鹿茸 麝香 韭菜子 蛇床子 茴香 归身 青盐 覆盆子
肝肾精血交亏,阳气不肯潜伏,阳升面赤戴阳,阳坠精关不固,时令冬失潜藏,阳生阳
动病加,静处山林,勿预家务。迎夏至一阴来复,必有好音,倘然却药,心境操持,与身病无益
水制熟地 琐阳 元武板 茯苓 线鱼胶 远志炭
宿瘕在胁下,亦与肥气相类,自述因嗔怒,盖肝之积也。久郁气血不通,肝藏内寄相火
,时当夏令泛潮苦雨,脾胃受湿,自必困倦,肝木横克脾土,胀势百满,所受湿邪,漫无出路,
蒸于肠胃,粘脓积滞,利不肯爽。中焦不和,寤不得逸,症属难治,且议分消。
白术 浓朴 茯苓 猪苓 茵陈 通草
胎孕而患疟,古人先保胎,佐以治病。兹诊齿燥舌白,呕闷自利,乃夏令伏邪,至深秋
而发,非柴、枳之属可止。呕吐黑水,腹痛,胎气不动,邪陷入里,蒸迫脏腑,是大危之象。
黄芩 黄连 黄柏 秦皮 川贝母
再诊 寒少热多,即先后厥之谓。热甚胎攻冲心痛,盖胎在冲,疟邪从四末渐归胃,冲
阳明胃脉管辖,上呕青黑涎沫,胎受邪迫,上攻冲心,总是邪热无由发泄,内陷不已,势必
坠胎。且协热自利,外邪从里而出,有不死不休之戒。方书保胎必固阴益气,今热炽壅塞,
人参胶地反为热邪树帜,前以纯苦气寒急取,固上焦阳明胃、厥阴肝两治,今则用酸苦辛泄
两经之热邪,外以井泥护胎。
川连 草决明 乌梅肉 石莲肉 黄芩 白芍 炒川椒
三诊 苦辛酸清,泄阳明厥阴邪热,兼外护胎法,病减十之二。视苔色芒刺,舌心干板,而
心中痛不已,此皆热邪内迫,阳津阴液告穷。两日前虑其陷伏闭寒,今又怕其昏痉,最难调
治。夫护胎存阴,清邪去邪,俱不可少。
阿胶 鲜生地 川连 鸡子黄 知母
雨淋冲阳受伤,热水洗浴,迫其冷湿深入,与水谷之气互蒸,而肌肉发黄,陈无择云∶
谷疸
生谷芽 半夏 广皮白 柴胡 黄芩 川连 人参 枳实 姜汁
经云∶谋虑在肝,决断在胆,操持思虑,五志阳气,有升无降,肝脉循环,绕乎阴器,气逆
拂乱,不可疏泄之权,似疝如淋病象。其实内系肝脏,但治淋、治疝,不越子和辛香流气,
即从丹溪分消泄热。今形脉已衰当以虚论,肝病三法,曰辛,曰酸、曰甘缓。经云∶
食酸令人癃,小便不爽,大忌酸味。
当归 茴香 穿山甲 枸杞子 沙蒺藜
凡当脐动气,脐腹结瘕,肌肉濡动,眩晕羞明。昔贤都主下焦精血之损,二气不得摄纳
,则变乱火风,如混蒙之象,泄气温燥攻病,是虚其虚也。温养有情之属为宜。
紫河车 肉苁蓉 当归 青盐 茯芩 胡桃 黄柏 小茴香 柏子仁 紫石英
暑风入肺为瘅疟,金匮为阳气独发。嘉言云∶体中阴液素虚,所伏热气,日久混入血分
,阴虚阳冒,上焦清气皆蒙,胃阳失和,不纳易痞,究竟伏邪未去。凡苦辛疏泄,皆属禁例。夫
上实下虚,有客邪留着,镇降不应,仿徐之才轻可去实之例,分别气血,以宣之,以逐之。
犀角 连翘 元参 通草 竹叶 荷叶
十年前小产血崩,损伤未复,家政操持,形神俱不能清静,上年交秋,带下淋浊,不特
脂液告竭,奇经与诸络亦无血存留。气冲犯胃,脘膈刺痛,胁肋高突,更兼下焦寒冷,腰围如
带拘束,两足麻木,践地痿软,二便窒塞不爽。五液枯涸,至阳不交阴,见痛用沉香大谬。
凡血液枯槁,大忌香燥,姑以血肉参和人参。若春和温煦,草木借以滋生。
人参 甘枸杞 归身 肉苁蓉 小茴香 沙蒺藜 黑芝麻 羊内肾
诊脉尺垂,据述冲气上冲,肝脉必搏大无偏,视面色赤亮,肌肉瘦削,乃肾精肝血内耗,阴
不和阳,致冲任不主把持,固摄壮水,正谓助阴抑阳。然久损不复,当与味浓质静,或血肉
有情,填实精隧。考古海藏与可久辈,咸遵是制。内损精血,务宜绝欲静养,使其加餐壮胃
,所谓精生于谷也。且肝肾久伤,累及八脉,阴伤渐干及阳,岂一法网罗者。
闺中室女,忽然神志时惑,遂月事不来,正《内经》谓二阳之病发心脾也。盖气逆血菀,经
纬紊乱,日加郁痹,焉得聪明。清旷情怀,致病草木药饵,都属无情,所以不易奏功。议以
上清心窍以通神,下调奇脉以通经。
琥珀末(五钱) 丹参(一两)
鲜石菖蒲捣汁法丸,辰砂为衣。
回生丹为小丸,早服一钱。另以大黑豆一两,炒赤,置竹篮盖内,以无灰酒淋热豆,取
天癸从未至,肉瘦色悴,咳呛着枕更甚,暮夜内外皆热,天明汗出势减,痰或粘或稀,咽中
总不爽利,此先天最薄,真阴不旺,弗勤针指,务要安闲怡悦,俾经来热除。不然,俗云干血劳。
复脉汤去姜、桂。
男子结疝,在《内经》则曰冲任为病。子和统论疏肝,今疝未愈,脐右复高突硬起,乃
由疝渐至瘕聚肠覃之属。夫肠覃者,寒气客于大肠,与胃气相搏,大肠与肺表里,传送肺气,寒
则气凝不行,清气散而浊气结为瘕。迁延日久,如怀胎妊,按之坚,推之移,气病而血不病
穿山甲 椒目 桂枝 川楝子 小茴香 茯苓 麝香 白芥子
冒暑远行,热气由口鼻吸入,先犯上中,分走营卫,故为寒热疟疾。当淡泊饮食滋味,清疏
胃气,投剂或以凉解芳香,或以甘寒生津,皆可疗治。奈何发散不效。复肆行滋补,致肺气
壅闭,胃中凝滞,自上及下,一身气机不通,变成肿胀,矫其非而欲与攻逐。无如病久形消
,又虑正气之垂寂,不得已用保和丸,缓疏中焦,渐渐升降得宣,六腑转达,腑气先通,经脉之气无有不通者矣。
Tongue color is white and dull, pulse is large on the right side, irregular in onset and termination, small and rapid on the left side. Accompanied by deafness, fever, insomnia, and slurred speech. This is not Shaoyang Cold Damage (Shaoyang syndrome caused by cold pathogen), but indeed due to miscarriage. Yin Qi cannot recover, empty Qi rises and冒 (assaults) the head, there is fear of convulsions and sudden syncope. Do not regard it as a mild condition.
Sheng Di Huang (Rehmanniae Radix Preparata) | E Jiao (Colla Corii Asini) | Dan Pi (Moutan Cortex) | Mai Dong (Ophiopogonis Radix) | Bai Shao (Paeoniae Radix Alba) | Zhe Jiang (Saccharum Japonicum Juice)
Second visit
Remove Bai Shao from the previous prescription, add Yuan Shen (Scrophulariae Radix) and Ling Yang Jiao (Capricornu Saigae Tataricae).
Spermatorrhea exits via the spermatic orifice, strangury exits via the urinary orifice. They emerge from the same gate but follow different paths; they must be distinguished carefully. Long-term spermatorrhea that does not heal indicates deficiency due to failure of the essence gate to secure. If there is only slight pain and itching, with fullness and distension in the lower abdomen and bladder, leading to hardness and fullness, this is the indication for Wu Ling San (Five-Ingredient Powder with Poria).
Summer heat caused bleeding in autumn, recurring in early spring. The pulse is large on the right, yet food intake is maintained. The *Jin Gui Yao Lue* states: "In men, a large pulse indicates Lao (exhaustion/chronic depletion); an extremely deficient pulse also indicates Lao." One must understand that a large pulse as Lao is due to fatigue injuring Qi; a deficient pulse as Lao is due to sexual excess causing damage. Quiet rest for one year can lead to recovery.
Huang Qi (Astragali Radix) | Bei Sha Shen (Glehniae Radix) | Nan Zao (Ziziphi Jujubae Fructus) | Bai Ji (Bletillae Rhizoma) | Zhi Cao Cao (Glycyrrhizae Radix et Rhizoma Preparata) | Yi Yi Ren (Coicis Semen)
Cough is treated from the Lung because external pathogens enter via the skin and hair and internally connect with the Lung. However, the Six Evils all transform into Fire; after dispersing, if unresolved, clearing and moistening will bring cure. If the cough is due to internal causes, involving other meridians affecting the Lung, the root cause must be identified; treating only the Lung is of no benefit. The Kidney is the root of pre-heaven, containing the True Yang of Kan, which is stored internally and governs, sealing and storing the Extraordinary Vessels. Chong Yang rises straight from here. Moreover, the Shaoyin meridian circulates along the throat and flanks the base of the tongue. If Yin fluids fail to ascend, Yang burns alone. Thus, Yin ascending and Yang descending leads to longevity; the reverse leads to death. Ba Wei Wan (Eight-Ingredient Pill) represents Yang within Yin, which seems reasonable. However, if flesh wastes and the form emaciates, Gui Zhi (Cinnamomi Ramulus) and Fu Zi (Aconiti Lateralis Radix Preparata) are still too acrid and drying. It is appropriate to use Qing Yan (Halitum) to guide the medicine to the Lower Yuan (Lower Origin); this is the correct method.
Lu Jiao Jiao (Colla Cornus Cervi) | Lu Jiao Shuang (Cornu Cervi Degelatinatum) | Shu Di Huang (Rehmanniae Radix Preparata) | Tu Si Zi (Cuscutae Semen) | Bai Fu Ling (Poria) | Qing Yan (Halitum) | Bu Gu Zhi (Psoraleae Fructus) | Bai Zi Ren (Biota Semen)
Living near the sea, wind, miasma, and pestilential Qi invade the brain marrow and bone joints. Qi and Blood are disharmonious, obstructed and steaming internally. Clear Yang of the head and face is bi-blocked. Over time, pathogenic factors and healthy Qi mix together, and herbal medicines cannot take effect. Insect and ant species should be used to unblock and expel pathogens.
Qiang Lang (Scarabaeus) | Feng Fang (Vespa Nidus) | Chuan Xiong (Ligustici Chuanxiong Rhizoma) | Wei Ling Xian (Clematidis Radix et Rhizoma)
Made into pills using rice wine and flour.
From yellow eyes and mental fatigue in summer, gradually progressing to middle Jiao distension, extending until Frost's Descent, vomiting blood clots upwards, and passing turbid matter downwards. The pulse is weak, fine, and irregular. The complexion lacks luster. Breathing is accompanied by wheezing. There is a history of cold disease and Qi rebellion. The accumulation of retained fluid has been present for a long time. During the three months of summer, when the Spleen and Stomach govern, the weather is hot, earth Qi ascends, and human Qi leaks out. Added to irregular eating and labor, this leads to reduced appetite and distension. All these diseases originate in the middle and spread up and down. The Six Fu organs function through unblocking; promoting circulation is their method, but there are differences between Yin and Yang. Later methods of attacking and purging, such as Shen You, Zhou Che, and Yu Gong formulas, dare not be lightly tried in such prolonged and lingering illness. We propose specifically unblocking the Yang Qi of the Triple Burner to drive out the entrenched turbid Yin. Warming and tonifying are advanced together. Unless Yang Qi gradually revives, it is difficult to prescribe medication. Referencing Zhang Zhongjing's method, add Cong Bai (Allii Fistulosi Bulbus, 4 pieces), Gan Jiang (Zingiberis Rhizoma, sliced, soaked in salt water over twenty times to remove pungency, 3 qian), Zhu Dan Ye (Porci Bile, 10 spoons), and Dan Fu Zi (Aconiti Lateralis Radix Preparata, peeled and de-navelled, wrapped and fire-roasted, 1 qian).
Second visit. Pulse and spirit remain as yesterday. Chest fullness and distension are more urgent. No desire to eat. Nose tip is very cold. Hot sweat flows. Self-vomiting of blood clots and filth. Spirit is now exhausted. Ancients said: when upper and lower mutually drain, regulate the middle. But with Yang deficiency and turbid rebellion, blocking and failing to communicate, Li Zhong Wan (Regulate the Middle Pill) as a standing formula cannot manage complex and severe conditions. This approach protects Yang and unblocks Yang, still incorporating bitter-cold herbs, so that for every point of turbid Yin discharged, one point of Yang is restored. The principle of nourishing the stomach lies herein; details are omitted.
Remove Cong Bai from the previous prescription, add Ren Shen (Panax Ginseng Radix et Rhizoma) 3 qian.
Previous use of generating fluids and nourishing Yin has stopped the cough and reduced fever, allowing gradual improvement. Unexpectedly, fever became more severe, lasting three days and nights without abatement. Thirsty with no appetite. Likely due to weak constitution and loose muscle texture, pathogens easily invade. Depressed and unvented, steaming like burning fire. The constitution is Metal Deficiency with Fire Prosperity. Now encountering intense heat, Ministerial Fire fans the wind, summer heat invades externally, mutually scorching fluids, inevitably leading to boiling and desiccation. Wanting to use bitter-cold herbs, but the deficient fire cannot bear direct suppression, and there is concern about damaging Stomach Qi. We propose using Hai Zang Shen Shu Fa (Hai Zang's Divine Skill Method), resolving the Three Yang above, calming the Taiyin below.
Bai Zhu (Atractylodis Macrocephalae Rhizoma) | Li Zhi (Pyrus Sinensis Fruit Juice) | Fang Feng (Saposhnikoviae Radix) | Mai Dong (Ophiopogonis Radix) | Gan Cao (Glycyrrhizae Radix et Rhizoma)
Wine drinkers suffering from strangury and turbidity must have damp-heat pathogens attaching to the Qi level. Therefore, Wu Ling San and Ba Zheng San both use draining and promoting methods. Illness persisting for years without healing must be due to sexual excess causing ruined essence and blood obstruction in the inner orifices. Urine and semen follow different paths from the same gate. Obstruction in the penis is mostly due to rotten essence. Unblocking ruined essence is an absolute principle.
Tu Niu Xi (Achyranthis Bidentatae Radix) 1.5 liang. Crushed for juice, mixed with She Xiang (Moschus) 3 fen.
The retention and eruption of Phlegm-Fluids are detailed extensively. *Jin Gui* and *Yu Han*, Zhang Zhongjing, definitely distinguish internal and external. Internal fluids are treated via the Kidney; external fluids are treated via the Spleen.
Alternatively, Du Qi Wan (Nine-Ingredient Pill) is added with Kan Qi (Umbilical Cord) and Hu Tao (Juglans Regia Seed).
Menstruation comes gradually later, color is pale and scanty. During the period, it must be at night. Abdominal pain and distension. Waist and thighs are sore. Meridions pulling relieve slightly. Pulse is rapid. Right is small, Left is large and overflowing. Medication must select those entering the Extraordinary Vessels. The Sea of Blood belongs to the Yangming, subordinate to the Extraordinary Vessels, Liver and Kidney are predominant. We propose a formula to harmonize Qi and Blood and unblock the Extraordinary Meridians.
Dang Gui (Angelicae Sinensis Radix) | Chong Wei Zi (Leonuri Fructus) | Sheng Xiang Fu (Cyperi Rhizoma) | Xiao Hui Xiang (Foeniculi Fructus) | Jiao Mai Ya (Hordei Fructus Germinatus Carbonized) | Da Hei Dou Pi (Sojae Semen Rubrum Pericarpium)
Mix in Xi Hu Po (Electrum) powder 1 qian.
Facial swelling and asthma, incessant coughing and wheezing. Voice gradually hoarse. Damp-heat accumulated long-term by wine drinkers must steam upwards to the Lung, causing swelling and asthma, blocking the voice. According to *Nei Jing*: "When dampness dominates internally, treat with bland leaching, assist with bitter-warm."
Lu Gen (Phragmitis Rhizoma) | Yi Yi Ren (Coicis Semen) | Hua Shi (Talcum) | Chi Fu Ling (Poria cum Rubro) | Xing Ren (Armeniacae Semen Amarum) | Hou Po (Magnoliae Officinalis Cortex)
Cold enters the Jueyin meridian, knotting into Qi Hernia. Pain causes swelling to rise and Qi to dissipate, leaving no trace. The Lower Yuan of the elderly is already deficient. Breaking Qi to attack hernia is contraindicated. If urethral pain or urinary obstruction occurs, warm and nourish the Lower Yuan, assisting with unblocking orifices.
Lu Rong (Cervi Cornu Pantotrichum) | She Xiang (Moschus) | Jiu Cai Zi (Allii Tuberosi Semen) | She Chuang Zi (Cnidii Fructus) | Hui Xiang (Foeniculi Fructus) | Gui Shen (Angelicae Sinensis Radix) | Qing Yan (Halitum) | Fu Pen Zi (Rubiae Fructus)
Liver and Kidney Essence and Blood are jointly deficient. Yang Qi refuses to hide. Yang rises causing facial redness (Floating Yang), Yang sinks causing insecure essence gate. Seasonally, winter fails to store. Yang generation and movement worsen the disease. Stay quietly in the mountains, do not engage in household affairs. Welcome the return of Yin at Summer Solstice; there will surely be good news. If refusing medicine and managing emotions, it is of no benefit to the body's illness.
Water-processed Shu Di Huang (Rehmanniae Radix Preparata) | Suo Yang (Cynomorii Herba) | Yuan Wu Ban (Testudinis Carapax et Plastrum) | Fu Ling (Poria) | Xian Yu Jiao (Hydrophilus Colla) | Yuan Zhi Tan (Polygalae Radix Carbonized)
Old masses in the hypochondrium are similar to Fei Qi (Fat Qi). Self-reported due to anger, covering Liver accumulation. Long-term depression of Qi and Blood leads to blockage. The Liver stores Ministerial Fire. When summer season brings humid rain, the Spleen and Stomach receive dampness, inevitably becoming fatigued. Liver Wood overacts on Spleen Earth. Distension is extreme. The received damp pathogen has no outlet, steaming into the intestines and stomach, causing sticky pus and stagnation. Bowel movements are not smooth. Middle Jiao is disharmonious, unable to rest even when awake. The condition is difficult to treat. We propose separating and eliminating.
Bai Zhu (Atractylodis Macrocephalae Rhizoma) | Hou Po (Magnoliae Officinalis Cortex) | Fu Ling (Poria) | Zhu Ling (Polyporus) | Yin Chen (Artemisiae Scopariae Herba) | Tong Cao (Tetrapanacis Medulla)
During pregnancy, malaria occurs. Ancients first protect the fetus, assisting with treating the disease. Current diagnosis shows dry teeth and white tongue, vomiting, stuffiness, and spontaneous diarrhea. This is latent pathogen from summer heat, erupting in late autumn. It cannot be stopped by Chai Hu (Bupleuri Radix) or Zhi Ke (Aurantii Fructus). Vomiting black water, abdominal pain, fetal movement is absent. Pathogen has sunk inward, steaming and forcing the Zang-Fu. This is a critical danger sign.
Huang Qin (Scutellariae Radix) | Huang Lian (Coptidis Rhizoma) | Huang Bo (Phellodendri Chinensis Cortex) | Qin Pi (Fraxini Cortex) | Chuan Bei Mu (Fritillariae Cirrhosae Bulbus)
Second visit. Less chills, more fever, which refers to alternating cold and heat. Severe heat attacks the fetus, causing heart pain. The fetus is in the Chong Mai (Penetrating Vessel). Malaria pathogen moves from the extremities towards the Stomach. The Chong Mai and Yangming Stomach meridian govern. Upward vomiting of green-black saliva. The fetus is forced by pathogen, attacking upwards to the heart. Always, pathogenic heat has no way to vent, sinking inward endlessly, inevitably leading to abortion. Furthermore, heat-collateral spontaneous diarrhea, external pathogen exits from inside. There is a warning of "not dying until exhaustion." Formulas for protecting the fetus must solidify Yin and boost Qi. Now, with blazing heat and congestion, Ren Shen (Panax Ginseng Radix et Rhizoma) and Ejiao (Colla Corii Asini) instead provide a banner for the heat pathogen. Previously, pure bitter-cold was used urgently to secure the Upper Jiao Yangming Stomach and Jueyin Liver. Now, sour-bitter-acrid methods are used to drain heat from both meridians. Externally, well mud is used to protect the fetus.
Chuan Lian (Coptidis Rhizoma) | Jue Ming Zi (Cassiae Semen) | Wu Mei Rou (Mume Fructus) | Shi Lian Rou (Nelumbinis Plumula) | Huang Qin (Scutellariae Radix) | Bai Shao (Paeoniae Radix Alba) | Chuan Chuan Jiao (Zanthoxyli Pericarpium Stir-fried)
Third visit. Bitter, sour, acrid, and clear methods drain Yangming and Jueyin pathogenic heat, combined with external fetal protection. Disease reduced by two-tenths. Tongue coating shows thorns, center is dry and stiff, heart pain persists. All this is due to heat pathogen pressing inward, Yang fluids and Yin liquids are exhausted. Two days ago, feared sinking and closure by cold. Today, fear coma and convulsions. Hardest to treat. Protecting the fetus and preserving Yin, clearing and removing pathogen, both are indispensable.
E Jiao (Colla Corii Asini) | Xian Sheng Di (Rehmanniae Radix Recens) | Chuan Lian (Coptidis Rhizoma) | Ji Zi Huang (Galli Ovi Yolk) | Zhi Mu (Anemarrhenae Rhizoma)
Rain soaking injures Chong Yang. Hot bath forces cold-damp deep inside. Steaming with grain and water Qi, muscles turn yellow. Chen Wuzhe says: Gu Dan (Grice Jaundice).
Sheng Gu Ya (Hordei Fructus Germinatus) | Ban Xia (Pinelliae Rhizoma) | Guang Pi Bai (Citri Reticulatae Pericarpium Album) | Chai Hu (Bupleuri Radix) | Huang Qin (Scutellariae Radix) | Chuan Lian (Coptidis Rhizoma) | Ren Shen (Panax Ginseng Radix et Rhizoma) | Zhi Shi (Aurantii Fructus Immaturus) | Jiang Zhi (Zingiberis Rhizoma Recens Juice)
Classic says: Planning lies in the Liver, decision-making in the Gallbladder. Managing thoughts and worries, the Yang Qi of the Five Emotions rises but does not descend. The Liver meridian circulates, surrounding the genitalia. Qi rebels and disrupts. Cannot control the power of dispersion and drainage. Symptoms resemble hernia and strangury. Actually, it internally relates to the Liver. Treating strangury and hernia does not exceed He Zi's acrid-aromatic Qi-moving, nor Dan Xi's separating and eliminating heat. Now, form and pulse are already depleted, discuss as deficiency. Three methods for Liver disease: Acrid, Sour, and Sweet-Slowing. Classic says: Eating sour causes strangury (urinary difficulty). Urine is not smooth. Greatly avoid sour flavors.
Dang Gui (Angelicae Sinensis Radix) | Hui Xiang (Foeniculi Fructus) | Chuan Shan Jia (Manis Squama) | Gou Qi Zi (Lycii Fructus) | Sha Ji Li (Tribuli Fructus)
Whenever there is moving Qi at the navel, nodules in the umbilical abdomen, muscle twitching, dizziness, and photophobia. Ancient sages all attribute it to deficiency of Essence and Blood in the Lower Jiao. If the two Qi cannot be grasped and accepted, Fire and Wind become chaotic, resembling confusion. Draining Qi with warm-dry attacking disease is making deficiency more deficient. Warming and nourishing sentient substances is appropriate.
Zi He Che (Placenta Humana) | Rou Cong Rong (Cistanches Herba) | Dang Gui (Angelicae Sinensis Radix) | Qing Yan (Halitum) | Fu Ling (Poria) | Hu Tao (Juglans Regia Seed) | Huang Bo (Phellodendri Chinensis Cortex) | Xiao Hui Xiang (Foeniculi Fructus) | Bai Zi Ren (Biota Semen) | Zi Shi Ying (Hematitum)
Summer wind entering the Lung causes Dan Malaria (Febrile Malaria). *Jin Gui* calls it independent emission of Yang Qi. Jia Yan says: Body's Yin fluids are originally deficient. The latent heat, mixed into the Blood level over a long time. Yin deficiency, Yang floating. Clear Qi of the Upper Jiao is all covered. Stomach Yang loses harmony, easy to become stagnant if not accepting food. Ultimately, latent pathogen is not gone. Bitter-acrid dispersion and drainage are all prohibited. Upper excess and Lower deficiency, with guest pathogen lingering. Sedation and descent do not respond. Imitating Xu Zhi Cai's example that "light can remove excess," differentiate Qi and Blood, disperse them, drive them away.
Xi Jiao (Rhinocerotis Cornu - Note: Substitute with Niuxi Horn or Water Buffalo Horn in modern practice, here translated literally as per text) | Lian Qiao (Forsythiae Fructus) | Yuan Shen (Scrophulariae Radix) | Tong Cao (Tetrapanacis Medulla) | Zhu Ye (Bambusae Folium) | He Ye (Nelumbinis Folium)
Ten years ago, miscarriage and blood collapse, injury not recovered. Managing household affairs, form and spirit could not be quiet. Last year entering Autumn, leukorrhea and strangury/turbidity. Not only Lipid fluids exhausted, but Extraordinary Vessels and collaterals also have no blood remaining. Qi rushes invading Stomach, epigastric and diaphragm stabbing pain. Hypochondrium protrudes high. Plus Lower Jiao cold, waist feels bound like a belt. Both feet numb, weak when stepping on ground. Urination and defecation blocked and unsmooth. Five fluids dried up. Extreme Yang does not connect with Yin. Seeing pain and using Chen Xiang (Aquilariae Lignum Resinatum) is a major error. Whenever Blood is withered, strongly avoid acrid-dry. Temporarily use fleshy substances combined with Ren Shen (Panax Ginseng Radix et Rhizoma). If Spring warmth arrives, herbs borrow it to grow.
Ren Shen (Panax Ginseng Radix et Rhizoma) | Gan Gou Qi (Lycii Fructus) | Gui Shen (Angelicae Sinensis Radix) | Rou Cong Rong (Cistanches Herba) | Xiao Hui Xiang (Foeniculi Fructus) | Sha Ji Li (Tribuli Fructus) | Hei Ma Zi (Sesami Semenis Nigrum) | Yang Nei Shen (Ovis Testis)
Diagnosing pulse, Chi position hangs low. Reported Chong Qi rushing upward. Liver pulse must be large and pulsating without deviation. Looking at face color bright red, muscles emaciated. This is Kidney Essence and Liver Blood internally consumed. Yin does not harmonize with Yang. Chong and Ren vessels fail to hold and secure. Solidifying and promoting Water (Kidney Yin) is precisely aiding Yin to suppress Yang. However, long-term damage not recovering, should give thick-flavored, static-substance, or fleshy sentient substances to fill the Essence tunnels. Studying ancient Hai Zang and Ke Jiu generations, all followed this system. Internal damage to Essence and Blood must abstain from desire and rest quietly, allowing increased meals to strengthen Stomach. This is called "Essence is born from Grain." Moreover, long-term Liver and Kidney injury involves the Eight Extraordinary Vessels. Yin injury gradually dries and affects Yang. How can a single net capture it?
A maiden suddenly experiences confused spirit and mind, then menstruation stops. This is exactly what *Nei Jing* says: "Diseases of Er Yang (Stomach and Large Intestine) arise from Heart and Spleen." Because Qi rebels and Blood stasis, meridians and collaterals become chaotic. Day by day adding depression and blockage, how can one be wise? Clear and open feelings. Pathogenic herbs and medicines are all insentient, so they are not easy to achieve success. Propose clearing Heart orifices above to unblock Spirit, regulating Extraordinary Vessels below to unblock menstruation.
Hu Po Mo (Electrum Powder, 5 qian) | Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma, 1 liang)
Fresh Shi Chang Pu (Acori Tatarinowii Rhizoma) crushed for juice to make pills, coated with Chen Sha (Cinnabar).
Hui Sheng Dan (Life-Returning Pill) made into small pills, take 1 qian in the morning. Additionally, take 1 liang of large black beans, stir-fried red, placed in bamboo basket lid, poured with non-grain alcohol to soak hot beans, extract Tian Mi (Heavenly Dew/Menstrual Fluid). Meat is thin, color is haggard. Coughing and wheezing worse when lying on pillow. Nighttime internal and external heat. Dawn sweating reduces intensity. Phlegm is either sticky or thin. Throat never feels smooth. This is thinnest congenital foundation, True Yin not prosperous. Do not frequently use acupuncture and moxibustion. Must be peaceful and joyful, so that when menstruation comes, heat removes. Otherwise, commonly known as Dry Blood Labor (Gan Xue Lao).
Mai Mai Tang (Decoctio Pulsus) remove Jiang (Zingiberis Rhizoma) and Gui (Cinnamomi Ramulus).
Men's hernia, in *Nei Jing* is called Chong and Ren disease. He Zi generally discusses soothing Liver. Now hernia not healed, right of navel protrudes hard again. From hernia gradually to mass accumulation and Chang Dan (Intestinal Polyp/Tumor). Chang Dan is cold qi lodging in Large Intestine, fighting with Stomach Qi. Large Intestine and Lung are exterior-interior, transmitting Lung Qi. Cold causes Qi coagulation and non-movement. Clear Qi scatters, turbid Qi knots into mass. Protracted long time, like carrying pregnancy. Press firm, push moves. Qi disease, not Blood disease.
Chuan Shan Jia (Manis Squama) | Jiao Mu (Phyllolithus) | Gui Zhi (Cinnamomi Ramulus) | Chuan Li Zi (Toosendan Fructus) | Xiao Hui Xiang (Foeniculi Fructus) | Fu Ling (Poria) | She Xiang (Moschus) | Bai Jie Zi (Sinapis Semen)
Exposing to summer heat while traveling far. Heat Qi inhaled via mouth and nose, first attacking Upper and Middle, dividing into Ying and Wei levels. Thus becoming cold-heat malaria. Should eat bland diet, clear and disperse Stomach Qi. Prescriptions can be cool-resolving aromatic, or sweet-cold generating fluids, all can treat. Alas, dispersing did not work. Repeatedly indulged in tonification, causing Lung Qi congestion and closure, Stomach stagnation. From top to bottom, whole body Qi mechanism blocked, turning into swelling. Correcting the wrong and wanting to attack and purge. Unfortunately, illness long, form wasted. Also fear righteous Qi nearing silence. Reluctantly use Bao He Wan (Preserve Harmony Pill), slowly disperse Middle Jiao. Gradually rising and descending get vented. Six Fu organs transmit. Fu Qi first unblocked, then meridian Qi has no unblocked ones.