服药6剂，神情呆痴之状明显好转，能分清部分朋友、同事及家属，且能自动去厕所大小便，饥饿时已知索要食物，继服40剂，诸证消失。
某医问：何不用安宫牛黄、至宝丹?答曰：其一实践证明不效者一也，其二舌苔黄白厚腻者，二也。其所以舌苔黄白厚腻不过用安宫牛黄者，因其过凉不利于化痰开窍而有碍开窍也，故减寒凉而增化痰之力，以助开窍也。
3．谨察其脉，审其病因，随证加减，病始得治黑××，男，50岁。在昼夜连续开会3天，并煤气中毒以后，突然精神失常7个多月。医诊一氧化碳中毒性精神病。先用西药治疗4个多月不效。后又用中药安宫牛黄丸、至宝丹、针灸相配合治疗3个多月，亦无明显效果。细审其证，两眼瞪目直视，不断的自言自语，问其所苦时概不回答，若予饮水则饮之不止，不予水喝从不索要，与其饭吃即一直张口，不与饭吃从不索要，有时主动要求去厕所大小便而却不便，有时拒绝大小便而却经常排便于衣被之中，舌苔黄白，脉沉弦滑数。综合脉证，思之：病发于开会激烈争论之后，脉且见沉弦，沉脉者，郁证也；弦者，肝脉也；滑脉者，痰热也，且病已人血分。因拟活血化瘀，理气疏肝，化痰泻火。处方：南星10克，防己10克，桃仁10克，红花10克，龙胆草10克，青皮10克，郁金10克，丹参15克。
服药6剂，精神、智力均明显改善，已知饥渴二便，且能辨认出妻子儿女及部分亲友。继服上方58剂，智力、精神基本恢复，并开始处理工作中的部分问题。
某医云：先生治疗一氧化碳中毒性精神病，有重用活血泻火开窍者；有重用活血化痰除湿泻火者；有重用活血化痰，理气泻火者；其治如何鉴别?答曰：重点在审其脉、舌耳。若脉弦者必理肝，脉滑者必化痰，脉数者必泻火，舌红者必凉血，苔腻者必除湿，脉沉者必理气，不可本末倒置，乱施药物。
老年性和早老性痴呆
谨遵脉舌，不从症论，处方用药，坚持一贯
周××，男，59岁。
性格改变，健忘失眠，烦躁易怒2年。医诊脑动脉硬化，老年性痴呆。先予西药治疗1年多不效，继又配合中药益气补肾宁心之剂1年多仍无效。细审其证，两眼有时凝视如呆痴状，有时无神，性格异常，常因一些小事而勃然大怒，与人吵闹不已，夜不能眠，昼则嗜睡，记忆力极差，常常前说后忘，丢东忘西，有时没有吃饭而偏说已经吃过，有时已经吃饭而反说没有进食，有时称其妻为姐姐，有时称其儿子为爸爸，当别人纠正其言语差误时即大笑不已，有时又勃然大怒。舌苔黄白而腻，脉弦滑。推拉其上、下肢时均僵硬不变。综合脉证，思之：舌苔黄白而腻者，湿热蕴郁也。四肢僵硬者，瘀血阻滞脉络也。脉弦滑者，痰热蕴结也。合而论之，乃痰热、瘀血相结于心肝二经也。治宜化痰除湿，活血开窍。处方：黄柏10克，苍术10克，南星10克，桂枝10克，防己10克，威灵仙3克，桃仁10克，红花10克，龙胆草10克，白芷3克，郁金10克，桑枝30克。服药4剂，两眼凝视，对周围事物反应的能力较前好转，记忆力亦稍见恢复。继服上药近2个月，诸证明显好转，至服药5个月时，诸证基本恢复正常，但握笔写字仍有点不太灵活。
某医云：《实用内科学》云：“中药益气补肾宁心的方剂，如六味地黄丸、附桂八味丸等，或能有所裨益。”然本例久用此类方剂无效者何也?答曰：中医治病的主要原则是“观其脉证，知犯何逆，随证治之。”今脉证既然表现为痰热与瘀血相结，那么自当给予化痰除湿，活血开窍进行治疗。至于此证为什么用益气补肾宁心之剂无效，恐亦在于此耳。
精神分裂症
审其脉沉，知其为郁，予疏肝理气，化痰泻火始安
阎××，女，25岁。
婚姻破裂后突然精神失常2个多月。医诊精神分裂症。先以西药治疗狂躁不安之状似有好转，但痴呆不语之状反见增加，后又以中药安宫牛黄丸与泻下逐痰之剂治疗1个月，亦无明显改善。细审其证，行为被动，不言不动，不吃不喝，不眠不便，对任何外界事物均缺乏反应，但有时自言自语，口唇周围大量疱疹，舌苔白，脉沉。综合脉证，思之：脉沉者，肝郁也。心神呆痴者，痰火蒙蔽心窍也。治宜疏肝理气，化痰开窍，醒神。处方：柴胡10克，枳实10克，白芍10克，甘草10克，郁金10克，桔梗10克，杏仁10克，瓜蒌15克，菖蒲10克，苏叶6克，栀子10克。
针：中脘。
服药2剂，针中脘2次，精神、食欲均好转，并能回答医生所提出的问题，继服20剂，诸证消失愈。
神经官能症
1．谨遵其脉，勿胶于方，坚持下去，自然效宏
彭××，女，35岁
易惊易恐1年多，医诊焦虑症。先以西药治之半年多不效，后又配合中药疏肝理气、安神镇静等治之亦无功。细审其证，有时突然感到马上要死亡，有时突然感到发生了什么事情。有时心悸气短，有时胸满胸痛，头晕手麻，有时突然昏厥而人事不知，舌苔薄白，脉濡缓。综合脉证，思之：病久而脉濡缓者，气阴俱虚，痰气郁结之证也。治宜补气养阴以扶正，理气化痰以除邪。处方：黄芪15克，当归6克，党参10克，麦冬10克，五味子10克，竹茹10克，枳实10克，半夏10克，陈皮10克，茯苓10克，甘草10克，菖蒲10克，远志10克，生地10克。
服药4剂，1周内易惊易恐之状未作，心悸气短，胸满胸痛好转。继服4剂，易惊易恐40多天未作，其他诸证消失。又服12剂，诸证消失，愈。
某医云：既见脉濡缓，何不用归脾汤治之？答曰：易惊易恐之症为胆之病，自应以温胆汤，而不可主治心脾也。归脾汤者，心脾药也，故不与之。
2.脉变药变，随证用药，病始得愈
商××，女，35岁。
恐惧不安，如将被捕之状3年多。医诊焦虑症。先以西药治疗1年无甚效果，继又配合中药养心安神之剂亦无明显改善。细询其证，整日惊恐不安，如人将捕之，心悸频作，每日3～5次不等，头昏失眠，疲乏无力，阵阵烦热上冲，一谈工作即心烦意乱，舌苔白，脉濡缓。综合脉证，思之：此气阴俱虚，痰郁气结之症耳。治宜补气养阴，理气化痰。处方：黄芪15克，当归6克，党参10克，麦冬10克，五味子10克，竹茹10克，枳实10克，半夏10克，陈皮10克，茯苓10克，甘草10克，菖蒲10克，远志10克，生地10克。
服药6剂，诸证突然全部消失。为巩固疗效，又服40剂，但服至40剂时，上证又突然发作，但较服药之始症状要轻。舌苔白，脉弦紧而数。综合脉证，思之：此病乃肝胆之证，非补气养阴之剂所能治，宜疏肝理气，化饮降冲。处方：柴胡10克，半夏10克，黄芩10克，党参10克，生姜3片，大枣5个，甘草6克，桂枝10克，茯苓15克，熟军3克，龙骨15克，牡蛎15克。
服药1剂，诸证全失，继服20剂，观察2年，愈。
某医云：何转方而治之?答曰：《伤寒论》云：“观其脉证，知犯何逆，随证治之。”今脉已变，故治法亦应改变也。
3．证情繁杂，尤宜和调，调其肝胆，理其枢机
席××，女，29岁。人工流产后，心情慌恐7个多月。医诊神经官能症。先以西药治疗4个多月不效，继又配合中药养血安神、安神镇惊之剂3个多月亦无功。细审其证，心悸不安，腹中空虚，脘腹悸动灼热，逆气上冲，冲则寒热往来，时或抽搐，四肢厥冷，易惊易恐，舌苔白，脉弦紧。综合脉证，思之：弦紧之脉者，少阳枢机不利，寒饮内郁，郁而化风也。治宜和解少阳，化饮熄风。处方：柴胡10克，半夏10克，黄芩10克，党参10克，甘草6克，生姜4片，大枣5枚，桂枝15克，茯苓15克，酒军2克，龙骨15克，牡蛎15克。
服药4剂，寒热搐搦，心悸，易惊易恐，逆气上冲大减，继服10剂，诸证消失。
某医云：如此复杂之疾，竟得柴胡加龙骨牡蛎汤数剂而愈，其故何也?答曰：《内经》论治病，一者攻邪，一者调和，并称调和之法为促进阴平阳密之最神圣之法。而调和之法，在于调气，在于调气之升降，今本病诸证俱见，非调之不得以除诸疾，非调之不得以助气之升降，而促病得愈也。
4．胶于成方，泥于镇静，不审脉证，久治不效
苏××，女，50岁。
阵发性连续昼夜哭泣20多年。医诊癔证。先以西药治疗十几年不效，后又配合中药甘麦大枣汤加减数年亦不效。细审其证，自从22岁分娩一女婴时，因心情不愉快而发本病以来，每至冬季即必发生本病，轻则连续昼夜哭泣十几天，重则1个多月，有时因哭泣不止而连续昏厥，至夏则全然不作，此次发病既重且长，已连续哭泣75天未止，并曾哭泣昏厥4次，每次少则3秒，多则10分钟才清醒，舌苔薄白，脉弦涩不调。综合脉证；思之：涩脉者，寒也，滞也，瘀也。冬季发而夏季瘥者，阳气闭郁于外也。喜悲而不喜笑者，肺强而心弱也，痰浊内郁也。治宜清化热痰，通阳散结。处方：竹茹20克，生石膏20克，桂枝10克，甘草20克，白薇10克。
服药6剂，悲伤哭泣之状顿止。继服20剂，追访6年．未见复发。
某医云：本病前后住院达6年，除中、西药外，还遍请巫者以神灵法治之，然均无效，而老师仅用竹皮大丸法数十剂而愈，其故何也?答曰：竹皮大丸者，《金匮要略》之方也。其原为“妇人乳中虚，烦乱呕逆”而设，因其有“安中益气，，之效耳。今本病虚者有之，热者有之，寒者有之，急需安中益气，故以此方治之。今本方有石膏之清肺热，桂枝、甘草之养心阳，竹茹、甘草、白薇之和肝胆。故以此方治之而获效如神也。
5.不审病因，不察其脉，胶于验方，久治延宕
贺××，男，成。
生气后完全失语3个多月。医诊癔病。先以针灸治疗3天病情一度好转，但其后又完全说话不能，又以西药、理疗治疗2个月，中药养阴开窍之剂治疗1月，至今仍然不见改善。细审其证，除完全不能说话外，并见其面色呈忧郁状，舌苔白，脉沉滑。综合脉证，思之：脉沉者，郁证也；脉滑者，痰热也。合而论之，乃肝肺气郁，痰热不化之证也。治宜疏肝理气，宣肺化痰。处方：柴胡10克，枳壳10克，白芍10克，桔梗10克，杏仁10克，苏叶10克，郁金10克，陈皮10克，薄荷6克，黄芩10克，元参10克。
服药2剂，说话增多，继服10剂，说话完全恢复。
阮××，女，成。
生气后失语2个多月。医诊癔病。先以针灸，西药、中药金嗓丸、清音丸等治疗不效。细审其证，完全不能说话，咽喉窒塞不适，舌苔黄白而腻，脉沉弦滑。综合脉证，诊为肝郁气结，湿滞不化。治拟疏肝理气，化湿祛痰。处方：柴胡10克，枳壳10克，白芍10克，甘草6克，香橼10克，佛手10克，玫瑰花10克，代代花10克，黄芩4克，元参6克。
服药2剂，咽喉窒塞感减轻，并开始能说一些简短的语言，继服20剂，诸证消失，愈。
某医云：同病而异方，其治均愈者何也?答曰：两病均为气滞所为，故均取理气疏肝法治之，然贺姓者脉见沉滑，滑者，痰热也，故重于化痰；阮姓者脉见沉弦滑，苔且见腻，乃湿为甚，故重在化湿，故用方不同也。
干燥综合征
但宗养阴，不求病因，实以虚治，津反不生
邹×，男，50岁。
口、鼻、眼、咽喉干燥疼痛3年多，口鼻眼咽关节肿痛干燥1年多。医诊口眼干燥，关节炎综合征。先以西药治疗近2年不效，继又配合中药养阴生津泻火之剂近1年亦无功。细察其证，除口、鼻、咽干燥外，并见两眼干痛微红，全身关节肿痛，手指关节发僵，胸满心烦，胃脘满胀，舌苔白，脉虚弦滑。综合脉证，诊为气阴两虚为本，气滞血瘀，湿郁不化为标。治拟补气养阴以培本，理气活血，燥湿化痰以治标。处方：党参30克，麦冬15克，生地30克，苍术15克，白术10克，陈皮10克，青皮10克，柴胡10克，郁金10克，姜黄10克，薄荷3克，夜交藤30克。
服药6剂，眼、口、鼻、咽喉干燥，胸满心烦，关节肿痛均减，继服20剂，诸证竟失，后果愈。
某医云：本证既为阴虚，为何养阴之剂反不效?答曰：干燥之证本为津虚，故治疗者尤重养阴生津。然局部津虚有阴津亏损所致者，有瘀血阻滞所致者，有痰湿不化所致者，其若痰湿不化者，必须燥湿除湿，若但予养阴生津，非但津不得生，亦且助其痰湿耳。今本证既有气虚，阴虚，又有痰、瘀阻滞，故但予养阴生津则不效，今所以用加味一贯煎取效者，就在于其既能补气养阴，又能燥湿，活血耳。又问：本方本无治关节肿痛之药，为何关节肿痛反愈?答曰：关节者，诸筋之会也；筋者，肝之所主也。今用加味一贯煎理肝木，养肝阴，故关节肿痛得愈。
脂膜炎
1．仅遵经训，以脉论证，处方论治，始获奇效
雷××，女，38岁。
After taking 6 doses of the medicine, the condition of mental dullness and stupidity improved significantly; the patient could distinguish some friends, colleagues, and family members, and could go to the toilet independently for urination and defecation. When hungry, the patient knew how to ask for food. After continuing to take 40 more doses, all symptoms disappeared.
A certain doctor asked: "Why not use An Gong Niu Huang Wan (Calculus Bovis Pill) and Zhi Bao Dan (Treasure Pill)?" The reply was: "First, practical experience proves them ineffective in this case; second, the tongue coating is yellow, white, thick, and greasy. The reason for not excessively using An Gong Niu Huang Wan when the tongue coating is yellow, white, thick, and greasy is that its cold nature is unfavorable for resolving phlegm and opening orifices, thereby hindering the process of opening orifices. Therefore, we reduce the cold-natured herbs and increase the strength of resolving phlegm to assist in opening the orifices."
3. Carefully observe the pulse, examine the etiology, and modify the prescription according to the syndrome pattern before the disease can be cured.
He XX, male, 50 years old. Sudden onset of mental disorder for over 7 months after attending continuous meetings for 3 days and suffering from coal gas poisoning. Diagnosed by the hospital as carbon monoxide poisoning psychosis. Treated with Western medicine for over 4 months without effect. Subsequently treated with Chinese herbal medicines An Gong Niu Huang Wan and Zhi Bao Dan combined with acupuncture for over 3 months, also without obvious effect. Detailed examination of symptoms: eyes staring wide open, constant self-talk, no response when asked about suffering; if given water, drinks continuously, never asks for water if not offered; if given food, keeps mouth open, never asks for food if not offered; sometimes actively requests to go to the toilet but cannot excrete, sometimes refuses to excrete but frequently soils clothes and bedding. Tongue coating is yellow and white; pulse is deep, wiry, slippery, and rapid. Synthesizing the pulse and symptoms: The illness started after intense arguments during meetings, and the pulse shows deep and wiry qualities. A deep pulse indicates stagnation; a wiry pulse belongs to the Liver meridian; a slippery pulse indicates phlegm-heat, and the pathogen has entered the blood level. Thus, the treatment principle was formulated as invigorating blood and resolving stasis, regulating Qi and soothing the Liver, and resolving phlegm and purging fire. Prescription: Arisaema Cum Bile (Nan Xing) 10g, Stephania Tetrandra (Fang Ji) 10g, Persicae Semen (Tao Ren) 10g, Carthami Flos (Hong Hua) 10g, Gentianae Radix (Long Dan Cao) 10g, Aurantii Fructus Viridis (Qing Pi) 10g, Curcumae Radix (Yu Jin) 10g, Salviae Miltiorrhizae Radix et Rhizoma (Dan Shen) 15g.
After taking 6 doses, mental state and intelligence improved significantly; the patient knew feelings of hunger, thirst, and needs for urination/defecation, and could recognize wife, children, and some relatives/friends. Continuing to take the above prescription for 58 doses, intelligence and mental state basically recovered, and the patient began handling some work issues.
A certain doctor said: "In treating carbon monoxide poisoning psychosis, you have cases emphasizing invigorating blood, purging fire, and opening orifices; cases emphasizing invigorating blood, resolving phlegm, removing dampness, and purging fire; and cases emphasizing invigorating blood, resolving phlegm, regulating Qi, and purging fire. How do you differentiate these treatments?" The reply was: "The key lies in examining the pulse and tongue. If the pulse is wiry, one must regulate the Liver; if slippery, resolve phlegm; if rapid, purge fire; if the tongue is red, cool the blood; if the coating is greasy, remove dampness; if the pulse is deep, regulate Qi. One must not reverse the root and branch or administer drugs indiscriminately."
Senile and Presenile Dementia
Strictly follow pulse and tongue signs, do not treat based solely on symptoms, maintain consistent prescribing principles.
Zhou XX, male, 59 years old.
Personality changes, forgetfulness, insomnia, irritability for 2 years. Diagnosed by the hospital as cerebral arteriosclerosis and senile dementia. Treated with Western medicine for over 1 year without effect, then combined with Chinese herbal medicines for tonifying Qi, nourishing Kidney, and calming the Heart for over 1 year, still ineffective. Detailed examination of symptoms: Eyes sometimes stare blankly like stupor, sometimes spiritless; abnormal personality; often flies into a rage over trivial matters, arguing endlessly with others; unable to sleep at night, sleepy during the day; extremely poor memory, forgetting what was just said, losing things frequently; sometimes claims to have eaten when having not, sometimes claims not to have eaten when having done so; sometimes calls wife 'sister', sometimes calls son 'father'; laughs uncontrollably when others correct speech errors, or sometimes flies into a rage. Tongue coating is yellow, white, and greasy; pulse is wiry and slippery. Limbs are stiff and unyielding when pushed or pulled. Synthesizing pulse and symptoms: Yellow, white, and greasy tongue coating indicates accumulation and stagnation of damp-heat. Stiff limbs indicate blood stasis blocking the collaterals. Wiry and slippery pulse indicates accumulation of phlegm-heat. In summary, phlegm-heat and blood stasis are intertwined in the Heart and Liver meridians. Treatment should focus on resolving phlegm and removing dampness, invigorating blood and opening orifices. Prescription: Phellodendri Cortex (Huang Bo) 10g, Atractylodis Rhizoma (Cang Zhu) 10g, Arisaema Cum Bile (Nan Xing) 10g, Cinnamomi Ramulus (Gui Zhi) 10g, Stephania Tetrandra (Fang Ji) 10g, Syneilesis Rhizoma (Wei Ling Xian) 3g, Persicae Semen (Tao Ren) 10g, Carthami Flos (Hong Hua) 10g, Gentianae Radix (Long Dan Cao) 10g, Angelicae Dahuricae Radix (Bai Zhi) 3g, Curcumae Radix (Yu Jin) 10g, Mori Ramulus (Sang Zhi) 30g.
After taking 4 doses, eye staring and reaction to surroundings improved, and memory slightly recovered. Continuing to take the above medicine for nearly 2 months, all symptoms significantly improved. By the 5th month of medication, all symptoms basically returned to normal, although writing with a pen remained somewhat inflexible.
A certain doctor said: "Practical Internal Medicine states: 'Chinese herbal formulas for tonifying Qi, nourishing Kidney, and calming the Heart, such as Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) and Fu Gui Ba Wei Wan (Eight-Ingredient Pill with Cinnamon and Phoenix Tree Bark), may offer some benefit.' However, why were such formulas ineffective in this long-term case?" The reply was: "The main principle of TCM treatment is 'Observe the pulse and symptoms, identify the deviation, and treat according to the syndrome pattern.' Since the current pulse and symptoms manifest as an intertwining of phlegm-heat and blood stasis, the appropriate treatment is naturally to resolve phlegm, remove dampness, invigorate blood, and open orifices. As for why formulas for tonifying Qi, nourishing Kidney, and calming the Heart were ineffective, it is likely due to this mismatch."
Schizophrenia
Observing a deep pulse indicates stagnation; treating with soothing Liver, regulating Qi, resolving phlegm, and purging fire leads to peace.
Yan XX, female, 25 years old.
Sudden onset of mental disorder for over 2 months after marital breakdown. Diagnosed by the hospital as schizophrenia. Initial Western medicine treatment seemed to improve manic restlessness, but dumb stupeness increased. Subsequent treatment with An Gong Niu Huang Wan and downward-draining phlegm-resolving agents for 1 month showed no obvious improvement. Detailed examination of symptoms: Passive behavior, no speaking or moving, no eating or drinking, no sleeping or excreting, lack of response to external stimuli, yet occasionally talks to oneself; numerous herpes lesions around lips; tongue coating white; pulse deep. Synthesizing pulse and symptoms: A deep pulse indicates Liver stagnation. Mental stupor indicates phlegm-fire obscuring the Heart orifices. Treatment should focus on soothing the Liver, regulating Qi, resolving phlegm, opening orifices, and awakening the spirit. Prescription: Bupleuri Radix (Chai Hu) 10g, Aurantii Fructus Immaturus (Zhi Shi) 10g, Paeoniae Radix Alba (Bai Shao) 10g, Glycyrrhizae Radix et Rhizoma (Gan Cao) 10g, Curcumae Radix (Yu Jin) 10g, Platycodonis Radix (Jie Geng) 10g, Armeniacae Semen Amarum (Xing Ren) 10g, Trichosanthis Fructus (Gua Lou) 15g, Acori Tatarinowii Rhizoma (Shi Chang Pu) 10g, Perillae Folium (Su Ye) 6g, Gardeniae Fructus (Zhi Zi) 10g.
Acupuncture: Zhongwan (CV12).
After taking 2 doses and receiving 2 acupuncture sessions at Zhongwan, mental state and appetite improved, and the patient could answer doctors' questions. Continuing to take 20 doses, all symptoms disappeared, leading to recovery.
Neurosis
1. Strictly follow the pulse, do not rigidly adhere to fixed formulas, persist in treatment, and natural efficacy will be significant.
Peng XX, female, 35 years old.
Susceptibility to fright and fear for over 1 year. Diagnosed by the hospital as anxiety disorder. Treated with Western medicine for over half a year without effect, then combined with Chinese herbal medicines for soothing Liver, regulating Qi, calming mind, and sedating spirit, also without merit. Detailed examination of symptoms: Sometimes suddenly feels imminent death, sometimes feels something bad is happening. Sometimes palpitations and shortness of breath, sometimes chest fullness and pain, dizziness and hand numbness, sometimes sudden syncope with loss of consciousness. Tongue coating thin white; pulse soggy and slow. Synthesizing pulse and symptoms: Chronic illness with soggy and slow pulse indicates deficiency of both Qi and Yin, and stagnation of phlegm-Qi. Treatment should focus on tonifying Qi and nourishing Yin to support healthy Qi, and regulating Qi and resolving phlegm to eliminate pathogenic factors. Prescription: Astragali Radix (Huang Qi) 15g, Angelicae Sinensis Radix (Dang Gui) 6g, Codonopsis Radix (Dang Shen) 10g, Ophiopogonis Radix (Mai Dong) 10g, Schisandrae Fructus (Wu Wei Zi) 10g, Bambusae Mesocarpus (Zhu Ru) 10g, Aurantii Fructus Immaturus (Zhi Shi) 10g, Pinelliae Rhizoma Preparatum (Ban Xia) 10g, Citri Reticulatae Pericarpium (Chen Pi) 10g, Poria (Fu Ling) 10g, Glycyrrhizae Radix et Rhizoma (Gan Cao) 10g, Acori Tatarinowii Rhizoma (Shi Chang Pu) 10g, Polygalae Radix (Yuan Zhi) 10g, Rehmanniae Radix (Sheng Di) 10g.
After taking 4 doses, susceptibility to fright and fear did not occur within 1 week, and palpitations, shortness of breath, chest fullness, and pain improved. Continuing to take 4 doses, susceptibility to fright and fear did not occur for over 40 days, and other symptoms disappeared. Taking another 12 doses, all symptoms disappeared, leading to recovery.
A certain doctor said: "Since the pulse is soggy and slow, why not use Gui Pi Tang (Restore the Spleen Decoction)?" The reply was: "Susceptibility to fright and fear is a Gallbladder disorder; thus, Wen Dan Tang (Warm the Gallbladder Decoction) should be used, rather than targeting the Heart and Spleen. Gui Pi Tang targets the Heart and Spleen, hence it is not used here."
2. Pulse changes dictate drug changes; treat according to the syndrome pattern for cure.
Shang XX, female, 35 years old.
Fear and uneasiness, feeling as if being hunted, for over 3 years. Diagnosed by the hospital as anxiety disorder. Treated with Western medicine for 1 year with little effect, then combined with Chinese herbal medicines for nourishing Heart and calming spirit, also without obvious improvement. Detailed inquiry into symptoms: All-day fearful and uneasy, feeling as if someone is hunting; frequent palpitations, 3-5 times daily; dizziness, insomnia, fatigue, waves of heat rushing upward; mental turmoil when discussing work. Tongue coating white; pulse soggy and slow. Synthesizing pulse and symptoms: This is a condition of deficiency of both Qi and Yin, with stagnation of phlegm and Qi. Treatment should focus on tonifying Qi and nourishing Yin, regulating Qi and resolving phlegm. Prescription: Astragali Radix (Huang Qi) 15g, Angelicae Sinensis Radix (Dang Gui) 6g, Codonopsis Radix (Dang Shen) 10g, Ophiopogonis Radix (Mai Dong) 10g, Schisandrae Fructus (Wu Wei Zi) 10g, Bambusae Mesocarpus (Zhu Ru) 10g, Aurantii Fructus Immaturus (Zhi Shi) 10g, Pinelliae Rhizoma Preparatum (Ban Xia) 10g, Citri Reticulatae Pericarpium (Chen Pi) 10g, Poria (Fu Ling) 10g, Glycyrrhizae Radix et Rhizoma (Gan Cao) 10g, Acori Tatarinowii Rhizoma (Shi Chang Pu) 10g, Polygalae Radix (Yuan Zhi) 10g, Rehmanniae Radix (Sheng Di) 10g.
After taking 6 doses, all symptoms suddenly disappeared. To consolidate efficacy, another 40 doses were taken. However, upon completing 40 doses, the aforementioned symptoms suddenly recurred, though milder than at the start. Tongue coating white; pulse wiry, tight, and rapid. Synthesizing pulse and symptoms: This disease belongs to the Liver and Gallbladder, and cannot be treated by formulas for tonifying Qi and nourishing Yin. Treatment should focus on soothing the Liver, regulating Qi, resolving fluid retention, and descending rebellious Qi. Prescription: Bupleuri Radix (Chai Hu) 10g, Pinelliae Rhizoma Preparatum (Ban Xia) 10g, Scutellariae Radix (Huang Qin) 10g, Codonopsis Radix (Dang Shen) 10g, Zingiberis Rhizoma Recens (Sheng Jiang) 3 slices, Jujubae Fructus (Da Zao) 5 pieces, Glycyrrhizae Radix et Rhizoma (Gan Cao) 6g, Cinnamomi Ramulus (Gui Zhi) 10g, Poria (Fu Ling) 15g, Prepared Rheum Palmatum Root and Rhizome (Shu Jun) 3g, Dragon Bone (Long Gu) 15g, Oyster Shell (Mu Li) 15g.
After taking 1 dose, all symptoms vanished. Continuing to take 20 doses, observed for 2 years, leading to recovery.
A certain doctor said: "Why change the formula for treatment?" The reply was: "The Shang Han Lun states: 'Observe the pulse and symptoms, identify the deviation, and treat according to the syndrome pattern.' Since the pulse has changed, the treatment method must also change."
3. Complex syndromes require harmonization; regulate Liver and Gallbladder, and manage the pivot mechanism.
Xi XX, female, 29 years old. Panic and fear for over 7 months following induced abortion. Diagnosed by the hospital as neurosis. Treated with Western medicine for over 4 months without effect, then combined with Chinese herbal medicines for nourishing blood, calming spirit, and settling fright for over 3 months, also without merit. Detailed examination of symptoms: Palpitations and uneasiness, emptiness in abdomen, palpitations and burning sensation in epigastrium/abdomen, rebellious Qi rushing upward, alternating chills and fever upon rushing, occasional convulsions, cold extremities, susceptibility to fright and fear. Tongue coating white; pulse wiry and tight. Synthesizing pulse and symptoms: Wiry and tight pulse indicates dysfunction of the Shaoyang pivot, internal stagnation of cold-fluid, which transforms into wind due to stagnation. Treatment should focus on harmonizing Shaoyang, resolving fluid retention, and extinguishing wind. Prescription: Bupleuri Radix (Chai Hu) 10g, Pinelliae Rhizoma Preparatum (Ban Xia) 10g, Scutellariae Radix (Huang Qin) 10g, Codonopsis Radix (Dang Shen) 10g, Glycyrrhizae Radix et Rhizoma (Gan Cao) 6g, Zingiberis Rhizoma Recens (Sheng Jiang) 4 slices, Jujubae Fructus (Da Zao) 5 pieces, Cinnamomi Ramulus (Gui Zhi) 15g, Poria (Fu Ling) 15g, Wine-processed Rheum Palmatum Root and Rhizome (Jiu Jun) 2g, Dragon Bone (Long Gu) 15g, Oyster Shell (Mu Li) 15g.
After taking 4 doses, alternating chills and fever, convulsions, palpitations, susceptibility to fright and fear, and rebellious Qi rushing upward were greatly reduced. Continuing to take 10 doses, all symptoms disappeared.
A certain doctor said: "Such a complex disease was cured by just a few doses of Chai Hu Jia Long Gu Mu Li Tang (Bupleurum Plus Dragon Bone and Oyster Shell Decoction). What is the reason?" The reply was: "The Nei Jing discusses treatment as either attacking pathogens or harmonizing. Harmonization is praised as the most sacred method for promoting balance between Yin and Yang. Harmonization lies in regulating Qi, specifically the ascending and descending of Qi. Since this disease presents with various symptoms, only harmonization can eliminate the diseases and assist the ascending/descending of Qi to promote recovery."
4. Rigid adherence to fixed formulas, reliance on sedation, failure to examine pulse and symptoms leads to prolonged ineffectiveness.
Su XX, female, 50 years old.
Paroxysmal continuous crying day and night for over 20 years. Diagnosed by the hospital as hysteria. Treated with Western medicine for over 10 years without effect, then combined with modified Gan Mai Da Zao Tang (Licorice, Wheat, and Jujube Decoction) for several years, also ineffective. Detailed examination of symptoms: Since giving birth to a daughter at age 22, triggered by unhappy mood, the illness occurs every winter. Mild cases involve continuous crying for over 10 days; severe cases last over 1 month. Sometimes continuous crying leads to consecutive syncope; completely absent in summer. This episode was severe and long-lasting, with continuous crying for 75 days without stopping, and 4 episodes of crying-induced syncope, lasting from 3 seconds to 10 minutes each. Tongue coating thin white; pulse wiry, choppy, and irregular. Synthesizing pulse and symptoms: Choppy pulse indicates cold, stagnation, and stasis. Occurring in winter and improving in summer indicates Yang Qi closed and stagnant externally. Preferring sadness over laughter indicates strong Lung and weak Heart, with internal stagnation of turbid phlegm. Treatment should focus on clearing and resolving heat-phlegm, unblocking Yang, and dissipating nodulation. Prescription: Bambusae Mesocarpus (Zhu Ru) 20g, Gypsum Fibrosum (Sheng Shi Gao) 20g, Cinnamomi Ramulus (Gui Zhi) 10g, Glycyrrhizae Radix et Rhizoma (Gan Cao) 20g, Anemarrhenae Rhizoma (Bai Wei) 10g.
After taking 6 doses, sadness and crying stopped abruptly. Continuing to take 20 doses, followed up for 6 years with no recurrence.
A certain doctor said: "This patient was hospitalized for 6 years. Besides Chinese and Western medicines, sorcerers were consulted for spiritual healing, all without effect. Yet the teacher cured it with dozens of doses of Zhu Pi Da Wan (Large Bamboo Peel Pill). Why?" The reply was: "Zhu Pi Da Wan is a formula from the Jin Gui Yao Lue. It was originally designed for 'postpartum deficiency in nursing women, causing vexation, chaos, vomiting, and reflux,' due to its effect of 'calming the middle and tonifying Qi.' Now, this patient has deficiency, heat, and cold, urgently needing to calm the middle and tonify Qi, hence this formula is used. The formula contains Gypsum to clear Lung heat, Cinnamon Twig and Licorice to nourish Heart Yang, and Bamboo Sheath, Licorice, and Anemarrhena to harmonize Liver and Gallbladder. Thus, it yields miraculous results."
5. Failure to examine etiology and pulse, rigid adherence to effective formulas leads to prolonged delay in cure.
He XX, male, adult.
Complete aphasia for over 3 months after anger. Diagnosed by the hospital as hysteria. Acupuncture treatment improved condition temporarily for 3 days, but then complete inability to speak returned. Treated with Western medicine and physiotherapy for 2 months, and Chinese herbal medicines for nourishing Yin and opening orifices for 1 month, still no improvement. Detailed examination of symptoms: Besides complete aphasia, facial expression is depressed; tongue coating white; pulse deep and slippery. Synthesizing pulse and symptoms: Deep pulse indicates stagnation; slippery pulse indicates phlegm-heat. In summary, this is a condition of Liver-Lung Qi stagnation and unresolved phlegm-heat. Treatment should focus on soothing the Liver, regulating Qi, diffusing the Lung, and resolving phlegm. Prescription: Bupleuri Radix (Chai Hu) 10g, Aurantii Fructus (Zhi Ke) 10g, Paeoniae Radix Alba (Bai Shao) 10g, Platycodonis Radix (Jie Geng) 10g, Armeniacae Semen Amarum (Xing Ren) 10g, Perillae Folium (Su Ye) 10g, Curcumae Radix (Yu Jin) 10g, Citri Reticulatae Pericarpium (Chen Pi) 10g, Menthae Haplocalycis Herba (Bo He) 6g, Scutellariae Radix (Huang Qin) 10g, Scrophulariae Radix (Yuan Shen) 10g.
After taking 2 doses, speech increased. Continuing to take 10 doses, speech fully recovered.
Ruan XX, female, adult.
Aphasia for over 2 months after anger. Diagnosed by the hospital as hysteria. Treated with acupuncture, Western medicine, and Chinese herbal medicines Jin Sang Wan and Qing Yin Wan without effect. Detailed examination of symptoms: Complete inability to speak, sensation of obstruction and discomfort in throat; tongue coating yellow, white, and greasy; pulse deep, wiry, and slippery. Synthesizing pulse and symptoms, diagnosed as Liver Qi stagnation and unresolved damp-stagnation. Treatment plan: Soothe the Liver, regulate Qi, resolve dampness, and dispel phlegm. Prescription: Bupleuri Radix (Chai Hu) 10g, Aurantii Fructus (Zhi Ke) 10g, Paeoniae Radix Alba (Bai Shao) 10g, Glycyrrhizae Radix et Rhizoma (Gan Cao) 6g, Erythrochlamys Fructus (Xiang Yuan) 10g, Bergamia Fruit (Fo Shou) 10g, Rosa Rugosa Flos (Mei Gui Hua) 10g, Carrion Flower (Dai Dai Hua) 10g, Scutellariae Radix (Huang Qin) 4g, Scrophulariae Radix (Yuan Shen) 6g.
After taking 2 doses, throat obstruction sensation decreased, and ability to speak short sentences began. Continuing to take 20 doses, all symptoms disappeared, leading to recovery.
A certain doctor said: "Same disease, different formulas, both cured. Why?" The reply was: "Both diseases are caused by Qi stagnation, so both were treated with methods to regulate Qi and soothe the Liver. However, He's pulse was deep and slippery; slippery indicates phlegm-heat, so emphasis was placed on resolving phlegm. Ruan's pulse was deep, wiry, and slippery, with greasy coating, indicating severe dampness, so emphasis was placed on resolving dampness. Hence, different formulas were used."
Sjögren's Syndrome
Merely adhering to Yin-nourishing, ignoring etiology, treating deficiency as deficiency, fluids fail to generate.
Zou XX, male, 50 years old.
Dryness and pain in mouth, nose, eyes, and throat for over 3 years; swelling, pain, dryness in mouth, nose, eyes, throat, and joints for over 1 year. Diagnosed by the hospital as Sjögren's syndrome/arthritis syndrome. Treated with Western medicine for nearly 2 years without effect, then combined with Chinese herbal medicines for nourishing Yin, generating fluids, and purging fire for nearly 1 year, also without merit. Detailed observation of symptoms: Besides dryness in mouth, nose, and throat, eyes are dry, painful, and slightly red; whole-body joint swelling and pain; finger joints stiff; chest fullness and vexation; epigastric fullness/distension. Tongue coating white; pulse deficient, wiry, and slippery. Synthesizing pulse and symptoms, diagnosed as deficiency of both Qi and Yin as the root, and Qi stagnation, blood stasis, and damp-stagnation as the branch. Treatment plan: Tonify Qi and nourish Yin to cultivate the root, regulate Qi, invigorate blood, dry dampness, and resolve phlegm to treat the branch. Prescription: Codonopsis Radix (Dang Shen) 30g, Ophiopogonis Radix (Mai Dong) 15g, Rehmanniae Radix (Sheng Di) 30g, Atractylodis Rhizoma (Cang Zhu) 15g, Atractylodis Macrocephalae Rhizoma (Bai Zhu) 10g, Citri Reticulatae Pericarpium (Chen Pi) 10g, Aurantii Fructus Viridis (Qing Pi) 10g, Bupleuri Radix (Chai Hu) 10g, Curcumae Radix (Yu Jin) 10g, Curcumae Longae Rhizoma (Jiang Huang) 10g, Menthae Haplocalycis Herba (Bo He) 3g, Polygoni Multiflori Caulis (Ye Jiao Teng) 30g.
After taking 6 doses, dryness in eyes, mouth, nose, throat, chest fullness, vexation, and joint swelling/pain were reduced. Continuing to take 20 doses, all symptoms disappeared, leading to subsequent recovery.
A certain doctor said: "If this syndrome is Yin deficiency, why did Yin-nourishing agents fail?" The reply was: "Dryness syndromes are fundamentally fluid deficiency, so treatment emphasizes nourishing Yin and generating fluids. However, local fluid deficiency can be caused by Yin-fluid depletion, blood stasis blockage, or unresolved phlegm-dampness. If caused by unresolved phlegm-dampness, one must dry dampness and remove dampness. Merely nourishing Yin and generating fluids not only fails to generate fluids but also aids phlegm-dampness. This case involves Qi deficiency, Yin deficiency, and blockage by phlegm and stasis; thus, merely nourishing Yin and generating fluids is ineffective. The reason Jia Wei Yi Guan Jian (Modified One-Way Decoction) succeeded is that it can tonify Qi and nourish Yin while drying dampness and invigorating blood." Asked again: "This formula lacks herbs for treating joint swelling and pain, yet the joints healed. Why?" The reply was: "Joints are the gathering point of sinews; sinews are governed by the Liver. By using Jia Wei Yi Guan Jian to regulate Liver Wood and nourish Liver Yin, the joint swelling and pain were resolved."
Panniculitis
1. Solely following classic teachings, using pulse to diagnose, prescribing and treating accordingly, achieves miraculous effects.
Lei XX, female, 38 years old.