郑 夏至后。湿热内蒸。肠风复来。议酸苦法。（湿热）
川连 黄芩 乌梅肉 生白芍 广皮 浓朴 荆芥炭 菊花炭 又驻车丸二钱
某 脉右数。形色苍黑。体质多热。复受长夏湿热内蒸。水谷气壅。血从便下。法以苦寒。佐以辛
温。薄味经月。可冀病愈。
茅术 川连 黄芩 浓朴 地榆 槐米
程 年前痰饮哮喘。不得安卧。以辛温通阳劫饮而愈。知脾阳内弱。运动失职。水谷气蒸。饮邪
由湿而成。湿属阴。久郁化热。热入络。血必自下。但体质仍属阳虚。凡肠红成方。每多苦寒。若
脏连之类。于体未合。毋欲速也。
生于术 茯苓 泽泻 地榆炭 桑叶 丹皮
俞阳虚。肠红洞泻。议劫胃水。（阳虚寒湿）理中换生茅术生浓朴附子炭炮姜。
程（十七） 脉沉粪后下血。少年淳朴得此。乃食物不和。肠络空隙所渗。与升降法。
茅术 浓朴 广皮 炮姜 炙草 升麻 柴胡 地榆
又 脉缓濡弱。阳气不足。过饮湿胜。大便溏滑。似乎不禁。便后血色红紫。兼有成块而下。论
理是少阴肾脏失司固摄。而阳明胃脉。但开无合矣。从来治腑。以通为补。与治脏补法迥异。
先拟暖胃通阳一法。
生茅术 人参 茯苓 新会皮 浓朴 炮附子 炮姜炭 地榆炭
程（三一） 食入不化。饮酒浓味即泻。而肠血未已。盖阳微健运失职。酒食气蒸。湿聚阳郁。脾伤清
阳日陷矣。议用东垣升阳法。（湿遏脾阳）
人参 茅术 广皮 炙草 生益智 防风 炒升麻
某 阳虚体质。食入不化。饮酒浓味即泻。而肠血未止。盖阳微健运失职。酒食气蒸湿聚。脾
阳清阳日陷矣。当从谦甫先生法。（中虚湿下陷）
人参（二钱半） 干姜（二钱半煨） 附子（三钱） 茅术（五钱） 升麻（三钱） 白术（二钱半）
浓朴（二钱半） 茯神（二钱半） 广皮（二钱半） 炙草（二钱半） 归身（一钱半） 白芍（一钱半）
葛根（二钱半） 益智（一钱半） 地榆（三钱半） 神曲（一钱半）
上药各制。姜枣汤丸。
温 湿胜中虚。便红。
焦术 炒当归 炒白芍 炙草 防风根 煨葛根 干荷叶
刘（六一） 郁怒。肠红复来。木火乘腑络。腹中微痛。议与和阴。（郁怒木火犯土）
冬桑叶 丹皮 生白芍 黑山栀 广皮 干荷叶边 生谷芽
张 二年前冲气入脘。有形痛呕。粪前后有血。此属厥阳扰络。风动内烁。头巅皆眩痛。每日用
龙荟丸。
叶 嗔怒动肝。络血乃下。按之痛减为虚。夫肝木上升。必犯胃口。遂胀欲呕。清阳下陷。门户失
藏。致里急便血。参术炮姜。辛甘温暖。乃太阴脾药。焉能和及肝胃。丹溪云。上升之气。自肝而
出。自觉冷者。非真冷也。驻车丸二钱。
程（四六） 少阳络病。必犯太阴。脾阳衰微。中焦痞结。色痿如瘁。便后有血。论脾乃柔脏。非刚不能
苏阳。然郁勃致病。温燥难投。议补土泄木方法。
人参 当归 枳实汁 炒半夏 桑叶 丹皮
参归。养脾之营。枳半通阳明之滞。桑丹泄少阳之郁。
某 凡有痔疾。最多下血。今因嗔怒。先腹满。随泻血。向来粪前。近日便后。是风木郁于土中。气
滞为膨。气走为泻。议理中阳。泄木佐之。（木郁土中）
人参 附子 炮姜 茅术 浓朴 地榆 升麻（醋炒） 柴胡（醋炒）
某 便红脉数。（大肠血热）
生地（三钱） 银花（三钱） 黄芩（一钱） 白芍（一钱半） 槐花（一钱）
程（二三） 脉数。能食肠红。阴自下泄。肠腑热炽所致。非温补之症。
细生地 丹参 黄柏 黑 豆皮 地榆炭 柿饼灰 槐花 金石斛
某（三七） 内热。肠红发痔。当清阴分之热。
生地 炒丹皮 酒炒黄芩 炒黑槐花 柿饼灰 元参 银花 黑山栀
汪 嗽血已止。粪中见红。中焦之热下移。肠胃属腑。止血亦属易事。花甲以外年岁。热移入下。
到底下元衰矣。
细生地 川石斛 柿饼灰 天冬
赵（三六） 劳倦。便后血。
炒黑樗根皮（一两） 炒黑地榆（三钱） 炒黑丹皮（一钱） 五加皮（三钱） 炒焦银花（一钱半）
苍术（一钱） 茯苓（二钱） 炒泽泻（一钱）
钱（十八） 阴虚内热。肠红不止。
炒黑樗根皮（一两） 炒生地（三钱） 炒银花（一钱半） 炒黑地榆（二钱） 归身（一钱半）
生白芍（一钱半） 炒丹皮（一钱） 茯苓（一钱半）
蔡（三八） 脉濡小。食少气衰。春季便血。大便时结时溏。思春夏阳升。阴弱少摄。东垣益气之属升阳。
恐阴液更损。议以甘酸固涩。阖阳明为法。（阳明不阖）
人参 炒粳米 禹粮石 赤石脂 木瓜 炒乌梅
某 能食。肠血。脉细色痿。肛痔下坠。议酸苦熄风坚阴。
萸肉炭 五味炭 黄柏炭 地榆炭 禹粮石 赤石脂
吴（二八） 中满过于消克。便血。食入易滞。是脾胃病。血统于脾。脾健自能统摄。归脾汤嫌其守。疏腑
养脏相宜。（脾胃气滞）
九蒸白术 南山楂 茯苓 广皮 谷芽 麦芽 姜枣汤法
某（二三） 便血如注。面黄。脉小。已经三载。当益胃法。（脾胃阳虚）
人参（一钱） 焦术（三钱） 茯苓（三钱） 炙草（五分） 木瓜（一钱） 炮姜（五分）
李（三十） 上年夏季。络伤下血。是操持损营。治在心脾。（心脾营损） 归脾饴糖丸。
朱 入暮腹痛鸣响。睾丸久已偏坠。春正下血经月。颜色鲜明。此痛决非伤瘀积聚。乃营损寒
乘。木来侮土。致十四载之缠绵。调营培土。以甘泄木。散郁宜辛。节口戒欲。百天可效。
人参 炒当归 炒白芍 肉桂 炮姜 茯苓 炙草 南枣
又 细推病情。不但营气不振。而清阳亦伤。洞泄不已。而辛润宜减。甘温宜加。从桂枝加桂汤
立法。
人参 桂枝 茯苓 生白芍 炙草 肉桂 煨姜 南枣
又 仍议理营。
人参 于术 茯苓 炮姜 桂心 白芍 真武丸（二钱）
某（十八） 便后下血。此远血也。（脾不统血）
焦术（一钱半） 炒白芍（一钱半） 炮姜（一钱） 炙草（五分） 木瓜（一钱）
炒荷叶边（二钱）
方 脉小左数。便实下血。乃肝络热腾。血不自宁。医投参 归桂甘辛温暖。昧于相火寄藏肝
胆。火焰风翔。上蒙清空。鼻塞头晕。呛咳不已。一误再误。遗患中厥。夫下虚则上实。阴伤阳
浮冒。乃一定至理。（血去阴伤虚阳上冒）
连翘心 竹叶心 鲜生地 元参 丹皮 川斛
又 下血阴伤走泄。虚阳上升。头目清窍。参 术桂辛甘助上。致鼻塞耳聋。用清上五六日。右
脉已小。左仍细数。乃阴亏本象。下愈虚则上愈实。议以滋水制火之方。
生地 元参 天冬 川斛 茯神 炒牛膝
又 脉左数。耳聋胁痛。木失水涵养。以致上泛用补阴丸。
补阴丸五钱 又虎潜丸羊肉胶丸。
某 肠红粘滞。四年不痊。阴气致伤。肛坠刺痛。大便不爽。药难骤功。当以润剂通腑。（阴虚血涩）
生地 豆皮 楂肉 麻仁 冬葵子 归须
姚 劳伤下血。络脉空乏为痛。营卫不主循序流行。而为偏寒偏热。诊脉右空大。左小促。通补
阳明。使开合有序。（劳伤营卫） 归 建中汤。
唐（四七） 内经以阴络伤。则血内溢。盖烧酒气雄。扰动脏络聚血之所。虽得小愈。而神采爪甲不荣。
犹是血脱之色。肛坠便甚。治在脾肾。以脾为摄血之司。肾主摄纳之柄故也。（脾肾虚）
晚归脾去木香 早六味去丹泽加五味芡实莲肉阿胶丸。
沈（五五） 酒湿污血。皆脾肾柔腻主病。当与刚药。黑地黄丸。
凡脾肾为柔脏。可受刚药。心肝为刚脏。可受柔药。不可不知。谦甫治此症。立法以平胃散
作主。加桂附干姜归芍。重加炒地榆以收下湿。用之神效。即此意也。
吴（四二） 腹痛下血。食荸荠豆浆而愈。乃泄肺导湿之药。既愈以来。复有筋骨痿 寒热。夜卧口
干。乃湿去气泄。阳明脉乏。不主用事。营卫失度。津液不升之象。天真丸主之。去人参。
支（五六） 痔血久下。肌肉痿黄。乃血脱气馁。渐加喘促浮肿。再延腹胀。便不可为。此症脏阴有寒。腑
阳有热。详于金匮谷疸篇中。极难调治。
人参 焦术 茯苓 炒菟丝子 广皮 生益智 木瓜
杨（四八） 中年形劳气馁。阴中之阳不足。且便血已多。以温养固下。男子有年。下先虚也。（肾阳虚）
人参 茯苓 归身 淡苁蓉 补骨脂 巴戟 炒远志
生精羊肉熬膏丸。服五钱。
田（三八） 久矣晨泄腹痛。近日有红积。此属肾虚。
补骨脂 大茴香 五味 茯苓 生菟丝
陈（三七） 脉左虚涩。右缓大。尾闾痛连脊骨。便后有血。自觉惶惶欲晕。兼之纳谷最少。明是中下交
损。八脉全亏。早进青囊斑龙丸。峻补玉堂关元。暮服归脾膏。涵养营阴。守之经年。形体自固。
鹿茸（生切薄另研） 鹿角霜（另研） 鹿角胶（盐汤化） 柏子仁（去油烘干） 熟地（九蒸） 韭子
（盐水浸炒） 菟丝子（另磨） 赤白茯苓（蒸） 补骨脂（胡桃肉捣烂蒸一日揩净炒香）
上溶膏炼蜜为丸。每服五钱。淡盐汤送。
鹿茸壮督脉之阳。鹿霜通督脉之气。鹿胶补肾脉之血。骨脂独入命门。以收散越阳气。
柏子凉心以益肾。熟地味浓以填肾。韭子菟丝就少阴以升气固精。重用茯苓淡渗。本草
以阳明本药。能引诸药。入于至阴之界耳。不用萸味之酸。以酸能柔阴。且不能入脉耳。
胡（十八） 上下失血。先泻血。后便泻。逾月。阴伤液耗。胃纳颇安。且无操家之劳。安养闲坐百日。所谓
静则阴充。（肾阴虚）
熟地 萸肉 茯神 山药 五味 龙骨
汪 肾虚。当春阳升动咳嗽。嗽止声音未震。粪有血。阴难充复。不肯上承。用阴药固摄。
熟地 白芍 茯神 黑 豆皮 炒焦乌梅肉
陈（三十） 肾阴虚络中热。肝风动。肠红三载不已。左胁及腹不爽。少阳亦逆。多以补中调摄。故未见
奏功。姑用疏补。为益脏通腑。
熟地炭 炒当归 炒楂肉 炒地榆 炒丹皮 冬桑叶
又 益阴泄阳。四剂血止。但腰酸脘中痹。咽燥喜凉饮。肛热若火烙。阳不和平。仍是阴精失涵。
用虎潜法。
熟地炭 白芍 当归 地榆炭 龟胶 知母 黄柏 猪脊髓丸
某 沫血鲜红凝块紫黑。阴络伤损。治在下焦。况少腹疝瘕。肝肾见症。前此精浊日久。亦令阴
伤于下。
人参 茯神 熟地炭 炒黑杞子 五味 炒地榆 生杜仲
又 左脉小数坚。肛坠胀。
人参 茯神 湖莲肉 芡实 熟地炭 五味
陈（氏） 脉小。泻血有二十年。经云。阴络伤。血内溢。自病起十六载。不得孕育。述心中痛坠。血下
不论粪前粪后。问脊椎腰尻酸楚。而经水仍至。跗膝常冷。而骨髓热灼。由阴液损伤。伤及阳
不固密。阅频年服药。归 杂入凉肝。焉是遵古治病。议从奇经升固一法。（奇脉伤）
鹿茸 鹿角霜 枸杞子 归身 紫石英 沙苑 生杜仲 炒大茴 补骨脂 禹余粮石 蒸饼浆丸。
张（三九） 劳力见血。胸背胁肋诸脉络牵掣不和。治在营络。（劳力伤络）
人参 归身 白芍 茯苓 炙草 肉桂
计（五三） 瘀血必结在络。络反肠胃而后乃下。此一定之理。平昔劳形奔弛。寒暄饥饱致伤。苟能安
逸身心。瘀不复聚。不然年余再瘀。不治。（血瘀在络）
旋复花 新绛 青葱 桃仁 当归须 柏子仁
宋（氏） 当年肠红。继衄血喉痛。已见阳气乘络。络为气乘。渐若怀孕者。然气攻则动如梭。与胎动
迥异。倘加劳怒。必有污浊暴下。推理当如是观。
柏子仁 泽兰 卷柏 黑大豆皮 茯苓 大腹皮
便血一症。古有肠风脏毒脉痔之分。其见不外乎风淫肠胃。湿热伤脾二义。不若内经谓
阴络受伤。及结阴之旨为精切。仲景之先便后血。先血后便之文。尤简括也。阴络即脏腑
隶下之络。结阴是阴不随阳之征。以先后分别其血之远近。就远近可决其脏腑之性情。
庶不致气失统摄。血无所归。如漏卮不已耳。肺病致燥涩。宜润宜降。如桑麻丸。及天冬地
黄银花柿饼之类是也。心病则火燃血沸。宜清宜化。如竹叶地黄汤及补心丹之类是也。
脾病必湿滑。宜燥宜升。如茅术理中汤。及东垣益气汤之类是也。肝病有风阳痛迫。宜柔
宜泄。如驻车丸。及甘酸和缓之剂是也。肾病见形消腰折。宜补宜填。如虎潜丸及理阴煎
之类是也。至胆经为枢机。逆则木火煽营。有桑叶山栀柏子丹皮之清养。大肠为燥腑。每
多湿热风淫。如辛凉苦燥之治。胃为水谷之海。多气多血之乡。脏病腑病。无不兼之。宜补
宜和。应寒应热。难以拘执而言。若努力损伤者。通补为主。膏粱蕴积者。清疏为宜。痔疮则
滋燥兼投。中毒须知寒热。余如黑地黄丸。以治脾湿肾燥。天真丸。以大补真气真精。平胃
地榆之升降脾胃。归脾之守补心脾。斑龙以温煦奇督。建中之复生阳。枳术之疏补中土。
Mr. Zheng: After the Summer Solstice, damp-heat steams internally, and Intestinal Wind (bleeding due to wind pathogen) recurs. It is proposed to use the Sour-Bitter method. (Pathogenesis: Damp-Heat)
Coptidis Rhizoma (Huanglian), Scutellariae Radix (Huangqin), Semen Pruni Mume (Wumei Rou), Raw Paeoniae Radix Alba (Sheng Baishao), Tangerine Peel (Guangpi), Magnoliae Officinalis Cortex (Noupu), Bistort Root Charcoal (Jingjie Tan), Chrysanthemi Flos Charcoal (Juhua Tan). Also take Zhuche Wan (Two Qian).
Someone: The pulse is rapid on the right side; complexion is dark and black; constitution is prone to heat. Having been affected by the internal steaming of damp-heat in late summer, the Qi of water and grain is congested, and blood flows out from the bowels. The treatment method employs Bitter-Cold herbs, assisted by Acrid-Warm ones. A bland diet for a month may lead to recovery.
Atractylodis Rhizoma (Maoyu), Coptidis Rhizoma (Chuanlian), Scutellariae Radix (Huangqin), Magnoliae Officinalis Cortex (Noupu), Sanguisorbae Radix (Diyu), Sophorae Flavescentis Flos (Huaimi).
Mr. Cheng: Previously suffered from phlegm-fluid asthma, unable to lie flat, cured by Acrid-Warm methods to unblock Yang and purge fluid. This indicates weak Spleen Yang internally, with failure of movement and transformation. Steaming of water and grain leads to fluid pathogens formed from dampness. Dampness belongs to Yin; long-standing stagnation transforms into heat. Heat enters the collaterals, causing blood to flow down. However, the constitution remains Yang-deficient. Most established formulas for intestinal redness (hematochezia) are Bitter-Cold, such as Zanglian Wan, which does not match this constitution. Do not seek quick results.
Atractylodis Rhizoma (Baizhu), Poria (Fuling), Alismatis Rhizoma (Zexie), Sanguisorbae Radix Charcoal (Diyu Tan), Mori Folium (Sangye), Moutan Cortex (Danpi).
Mr. Yu: Yang deficiency, intestinal redness with watery diarrhea. It is proposed to seize stomach fluids. (Pathogenesis: Yang Deficiency with Cold-Damp) Lizhong Tang modified with Raw Atractylodis Rhizoma (Maoyu), Raw Magnoliae Officinalis Cortex (Noupu), Prepared Aconiti Lateralis Radix Praeparata Charcoal (Fuzi Tan), Prepared Zingiberis Rhizoma (Paojiang).
Mr. Cheng (17 years old): Pulse is deep; bleeding occurs after defecation. Obtained by a simple youth, this is due to improper food intake and seepage from gaps in intestinal collaterals. Treatment involves regulating ascending and descending mechanisms.
Atractylodis Rhizoma (Maoyu), Magnoliae Officinalis Cortex (Noupu), Tangerine Peel (Guangpi), Prepared Zingiberis Rhizoma (Paojiang), Glycyrrhizae Radix et Rhizoma Praeparata (Zhigancao), Cimicifugae Rhizoma (Shengma), Bupleuri Radix (Chaihu), Sanguisorbae Radix (Diyu).
Re-examination: Pulse is slow, soggy, and weak; Yang Qi is insufficient. Excessive drinking leads to dampness excess, loose and slippery stools, seemingly uncontrollable. Blood color after defecation is red-purple, mixed with clots. Theoretically, this is loss of control by the Shaoyin Kidney, while the Yangming Stomach meridian opens but does not close. Historically, treating Fu organs emphasizes "unblocking as tonification," which differs significantly from tonifying Zang organs.
First, propose a method to warm the Stomach and unblock Yang.
Raw Atractylodis Rhizoma (Maoyu), Ginseng Radix et Rhizoma (Renshen), Poria (Fuling), New Hui Peel (Xinhui Pi), Magnoliae Officinalis Cortex (Noupu), Prepared Aconiti Lateralis Radix Praeparata (Paofuzi), Prepared Zingiberis Rhizoma Charcoal (Paojiang Tan), Sanguisorbae Radix Charcoal (Diyu Tan).
Mr. Cheng (31 years old): Food is not digested; diarrhea occurs immediately after alcohol or rich flavors, while intestinal bleeding persists. This is because Yang is weak, transport and transformation fail, alcohol and food steam, dampness gathers, Yang is depressed, Spleen injury causes Clear Yang to sink daily. It is proposed to use Dongyuan's method of raising Yang. (Pathogenesis: Dampness suppressing Spleen Yang)
Ginseng Radix et Rhizoma (Renshen), Atractylodis Rhizoma (Maoyu), Tangerine Peel (Guangpi), Glycyrrhizae Radix et Rhizoma Praeparata (Zhigancao), Raw Alpiniae Oxyphyllae Fructus (Sheng Yizhi), Saposhnikoviae Radix (Fangfeng), Fried Cimicifugae Rhizoma (Chao Shengma).
Someone: Yang-deficient constitution, food not digested, diarrhea after alcohol or rich flavors, intestinal bleeding persists. This is because Yang is weak, transport and transformation fail, alcohol and food steam dampness gathering, Spleen Yang and Clear Yang sink daily. Should follow Mr. Qianfu's method. (Pathogenesis: Middle Deficiency with Dampness Sinking)
Ginseng Radix et Rhizoma (2.5 Qian), Dried Ginger (2.5 Qian, baked), Prepared Aconiti Lateralis Radix Praeparata (3 Qian), Atractylodis Rhizoma (5 Qian), Cimicifugae Rhizoma (3 Qian), Atractylodis Macrocephala Rhizoma (2.5 Qian), Magnoliae Officinalis Cortex (2.5 Qian), Poria with Hostwood (2.5 Qian), Tangerine Peel (2.5 Qian), Glycyrrhizae Radix et Rhizoma Praeparata (2.5 Qian), Angelicae Sinensis Radix (1.5 Qian), Paeoniae Radix Alba (1.5 Qian), Puerariae Radix (2.5 Qian), Alpiniae Oxyphyllae Fructus (1.5 Qian), Sanguisorbae Radix (3.5 Qian), Medicated Leaven (1.5 Qian).
Process each herb separately. Make pills with Ginger and Jujube decoction.
Mr. Wen: Dampness excess, Middle Deficiency, red stool.
Fried Atractylodis Rhizoma (Jiaozhu), Fried Angelicae Sinensis Radix (Chao Danggui), Fried Paeoniae Radix Alba (Chao Baishao), Glycyrrhizae Radix et Rhizoma Praeparata (Zhigancao), Saposhnikoviae Radix Root (Fangfeng Gen), Baked Puerariae Radix (Wei Gegen), Dry Lotus Leaf (Gan Heye).
Mr. Liu (61 years old): Depression and anger cause recurrence of intestinal redness. Wood-Fire invades Fu collaterals, slight abdominal pain. Proposed to harmonize Yin. (Pathogenesis: Depression/Anger, Wood-Fire attacking Earth)
Mulberry Leaf (Dongsangye), Moutan Cortex (Danpi), Raw Paeoniae Radix Alba (Sheng Baishao), Gardeniae Fructus Charcoal (Heishanzhi), Tangerine Peel (Guangpi), Dry Lotus Leaf Edge (Gan Heyebian), Raw Hordeum Vulgare Sprout (Sheng Guya).
Mr. Zhang: Two years ago, rebellious Qi entered the epigastrium, causing painful vomiting, blood before and after stool. This belongs to Jueyang disturbing collaterals, wind moving and internal scorching, dizziness and pain at the vertex. Take Longhui Wan daily.
Mr. Ye: Anger moves Liver, collateral blood flows down. Pain relieved by pressure indicates deficiency. Liver Wood ascends, must invade Stomach opening, causing distension and vomiting. Clear Yang sinks, gates lose storage, leading to tenesmus and hematochezia. Ginseng, Atractylodes, Prepared Ginger are Acrid-Sweet and Warm, medicines of Taiyin Spleen, how can they harmonize Liver and Stomach? Danxi said: Ascending Qi comes from Liver; feeling cold is not true cold. Take Zhuche Wan (2 Qian).
Mr. Cheng (46 years old): Shaoyin collateral disease must invade Taiyin. Spleen Yang is declining, middle jiao is obstructed, complexion is sallow and withered, blood after stool. Discussing Spleen as a soft organ, non-rigid cannot revive Yang. However, disease caused by depression/stagnation makes Warm-Dry difficult to apply. Proposed method: Tonify Earth, Drain Wood.
Ginseng Radix et Rhizoma (Renshen), Angelicae Sinensis Radix (Danggui), Juice of Aurantii Fructus Immaturus (Zhishi Zhi), Fried Pinelliae Rhizoma (Chao Banxia), Mori Folium (Sangye), Moutan Cortex (Danpi).
Ginseng and Angelica nourish Spleen Ying; Zhishi and Banxia unblock Yangming stagnation; Sangye and Danpi drain Shaoyin depression.
Someone: Hemorrhoids often cause heavy bleeding. Now due to anger, first abdominal fullness, then bloody diarrhea. Usually bleeding before stool, recently after stool. This is Wind-Wood depressed in Earth, Qi stagnation causes bloating, Qi movement causes diarrhea. Proposed to regulate Middle Yang, assist with draining Wood. (Pathogenesis: Wood Depression in Earth)
Ginseng Radix et Rhizoma (Renshen), Prepared Aconiti Lateralis Radix Praeparata (Fuzi), Prepared Zingiberis Rhizoma (Paojiang), Atractylodis Rhizoma (Maoyu), Magnoliae Officinalis Cortex (Noupu), Sanguisorbae Radix (Diyu), Cimicifugae Rhizoma Vinegar-fried (Shengma Cu Chao), Bupleuri Radix Vinegar-fried (Chaihu Cu Chao).
Someone: Red stool, rapid pulse. (Pathogenesis: Large Intestine Blood Heat)
Rehmanniae Radix (3 Qian), Lonicerae Japonicae Flos (3 Qian), Scutellariae Radix (1 Qian), Paeoniae Radix Alba (1.5 Qian), Sophorae Flavescentis Flos (1 Qian).
Mr. Cheng (23 years old): Rapid pulse, good appetite, intestinal redness. Yin leaks from below, caused by intense heat in intestinal fu organs. Not a condition for Warm-Tonification.
Fine Rehmanniae Radix (Xishengdi), Salviae Miltiorrhizae Radix (Danshen), Phellodendri Cortex (Huangbai), Black Soybean Skin (Heidoupi), Sanguisorbae Radix Charcoal (Diyu Tan), Persimmon Cake Ash (Shibinghui), Sophorae Flavescentis Flos (Huaima), Dendrobii Caulis (Jinshihu).
Someone (37 years old): Internal heat, intestinal redness with hemorrhoids. Should clear heat from Yin aspect.
Rehmanniae Radix (Shengdi), Fried Moutan Cortex (Chao Danpi), Wine-fried Scutellariae Radix (Jiu Chao Huangqin), Fried Black Sophorae Flavescentis Flos (Chaohei Huaima), Persimmon Cake Ash (Shibinghui), Scrophulariae Radix (Yuanshen), Lonicerae Japonicae Flos (Yinhua), Gardeniae Fructus Charcoal (Heishanzhi).
Mr. Wang: Hematemesis has stopped, red in stool. Heat from Middle Jiao shifts downward. Intestines and Stomach are Fu organs, stopping bleeding is easy. Over sixty years old, heat shifts downward, ultimately Yuan Qi is deficient.
Fine Rehmanniae Radix (Xishengdi), Dendrobii Caulis (Chuan Shihu), Persimmon Cake Ash (Shibinghui), Asparagi Radix (Tiantong).
Mr. Zhao (36 years old): Fatigue, blood after stool.
Fried Black Celastrus Cornus Bark (Chaoheichupgenpi - 1 Liang), Fried Black Sanguisorbae Radix (Chaohei Diyu - 3 Qian), Fried Black Moutan Cortex (Chaohei Danpi - 1 Qian), Eucommiae Cortex (Wujiapi), Fried Black Lonicerae Japonicae Flos (Chaojiao Yinhua - 1.5 Qian), Atractylodis Rhizoma (1 Qian), Poria (2 Qian), Fried Alismatis Rhizoma (Chao Zexie - 1 Qian).
Mr. Qian (18 years old): Yin deficiency with internal heat, intestinal redness persists.
Fried Black Celastrus Cornus Bark (Chaoheichupgenpi - 1 Liang), Fried Rehmanniae Radix (Chao Shengdi - 3 Qian), Fried Lonicerae Japonicae Flos (Chao Yinhua - 1.5 Qian), Fried Black Sanguisorbae Radix (Chaohei Diyu - 2 Qian), Angelicae Sinensis Radix (1.5 Qian), Raw Paeoniae Radix Alba (1.5 Qian), Fried Moutan Cortex (Chao Danpi - 1 Qian), Poria (1.5 Qian).
Mr. Cai (38 years old): Pulse is soggy and small, poor appetite, Qi deficiency. Spring hematochezia, stool alternates hard and loose. Considering spring/summer Yang rising, Yin is weak and lacks control. Dongyuan's Qi-tonifying methods raise Yang, fearing further Yin fluid damage. Proposed method: Sweet-Sour astringency, closing Yangming. (Pathogenesis: Yangming not Closing)
Ginseng Radix et Rhizoma (Renshen), Fried Rice Grain (Chao Jingmi), Kaolinite (Yuliangshi), Red Halloysite (Chishizhi), Papaveris Fructus (Mugua), Fried Semen Pruni Mume (Chao Wumei).
Someone: Good appetite, intestinal bleeding, fine pulse, sallow complexion, anal hemorrhoid prolapse. Proposed Sour-Bitter method to extinguish wind and solidify Yin.
Cornus Fructus Charcoal (Yurou Tan), Schisandrae Fructus Charcoal (Wuweitan), Phellodendri Cortex Charcoal (Huangbai Tan), Sanguisorbae Radix Charcoal (Diyu Tan), Kaolinite (Yuliangshi), Red Halloysite (Chishizhi).
Mr. Wu (28 years old): Middle fullness from excessive purging, hematochezia. Food easily stagnates, indicating Spleen-Stomach disease. Blood is governed by Spleen; strong Spleen controls it naturally. Guipi Tang is too static; unblocking Fu and nourishing Zang is suitable. (Pathogenesis: Spleen-Stomach Qi Stagnation)
Nine-steamed Atractylodis Macrocephala Rhizoma (Jiuzheng Baizhu), Southern Hawthorn Fruit (Nanshan Zha), Poria (Fuling), Tangerine Peel (Guangpi), Barley Sprout (Guya), Malt (Maiya), Ginger-Jujube Decoction method.
Someone (23 years old): Hematochezia like a gush, sallow face, small pulse, lasting three years. Should benefit Stomach. (Pathogenesis: Spleen-Stomach Yang Deficiency)
Ginseng Radix et Rhizoma (1 Qian), Fried Atractylodis Rhizoma (Jiaozhu - 3 Qian), Poria (3 Qian), Glycyrrhizae Radix et Rhizoma Praeparata (Zhigancao - 0.5 Qian), Papaveris Fructus (Mugua - 1 Qian), Prepared Zingiberis Rhizoma (Paojiang - 0.5 Qian).
Mr. Li (30 years old): Last summer, collateral injury caused bleeding, due to overwork damaging Ying. Treatment focuses on Heart and Spleen. (Pathogenesis: Heart-Spleen Ying Damage) Guipi Tang with Maltose Pills.
Mr. Zhu: Abdominal pain and borborygmus at dusk, testicular hernia for a long time. Bleeding for a month in early spring, bright color. This pain is definitely not blood stasis accumulation, but Ying damage with Cold invasion, Wood insulting Earth, causing fourteen years of lingering illness. Regulate Ying and cultivate Earth, use Sweet to drain Wood, Acrid to dissipate depression. Diet control and sexual abstinence, effective in 100 days.
Ginseng Radix et Rhizoma (Renshen), Fried Angelicae Sinensis Radix (Chao Danggui), Fried Paeoniae Radix Alba (Chao Baishao), Cinnamon Twig (Rougui), Prepared Zingiberis Rhizoma (Paojiang), Poria (Fuling), Glycyrrhizae Radix et Rhizoma Praeparata (Zhigancao), Southern Jujube (Nanzao).
Re-examination: Carefully analyzing the condition, not only is Ying Qi weak, but Clear Yang is also injured. Watery diarrhea persists, Acrid-Moist should be reduced, Sweet-Warm should be increased. Base prescription on Guizhi Jia Gu Tang.
Ginseng Radix et Rhizoma (Renshen), Cinnamon Twig (Guizhi), Poria (Fuling), Raw Paeoniae Radix Alba (Sheng Baishao), Glycyrrhizae Radix et Rhizoma Praeparata (Zhigancao), Cinnamon Twig (Rougui), Baked Ginger (Weijiang), Southern Jujube (Nanzao).
Re-examination: Still discuss regulating Ying.
Ginseng Radix et Rhizoma (Renshen), Atractylodis Macrocephala Rhizoma (Yushu), Poria (Fuling), Prepared Zingiberis Rhizoma (Paojiang), Cinnamon Heart (Guixin), Paeoniae Radix Alba (Baishao), Zhenwu Wan (2 Qian).
Someone (18 years old): Bleeding after stool, this is distant blood. (Pathogenesis: Spleen failing to control blood)
Fried Atractylodis Rhizoma (Jiaozhu - 1.5 Qian), Fried Paeoniae Radix Alba (Chao Baishao - 1.5 Qian), Prepared Zingiberis Rhizoma (Paojiang - 1 Qian), Glycyrrhizae Radix et Rhizoma Praeparata (Zhigancao - 0.5 Qian), Papaveris Fructus (Mugua - 1 Qian), Fried Lotus Leaf Edge (Chao Heyebian - 2 Qian).
Mr. Fang: Pulse small, left rapid, firm stool with bleeding, Liver collateral heat surging, blood restless. Doctor used Ginseng, Angelica, Cinnamon, Licorice (Acrid-Sweet-Warm), ignorant that Minister Fire resides in Liver/Gallbladder, flame and wind soar, covering clear orifices, nasal congestion, dizziness, coughing. One error after another, leaving Middle Jue complication. Lower deficiency leads to Upper excess, Yin injury leads to floating Yang, this is a fixed principle. (Pathogenesis: Blood loss Yin injury, Floating Yang)
Loniceræ Flos Cord (Lianqiao Xin), Bambusae Folium (Zhuye Xin), Fresh Rehmanniae Radix (Xianshengdi), Scrophulariae Radix (Yuanshen), Moutan Cortex (Danpi), Dendrobii Caulis (Chuanhu).
Re-examination: Bleeding Yin injury leaking, floating Yang rises, head/eye orifices, Ginseng/Atractylodes/Cinnamon/Acrid-Sweet help upward, causing nasal congestion/deafness. Used clearing upper for 5-6 days, right pulse small, left still fine-rapid, indicating Yin deficiency root, lower more deficient leads to upper more excess. Proposed Water-nourishing Fire-suppressing formula.
Rehmanniae Radix (Shengdi), Scrophulariae Radix (Yuanshen), Asparagi Radix (Tiantong), Dendrobii Caulis (Chuanhu), Poria with Hostwood (Fushen), Fried Achyranthis Bidentatae Radix (Chao Niuxi).
Re-examination: Left pulse rapid, deafness, hypochondriac pain, Wood loses Water nourishment, thus floating up. Use Buyin Wan.
Buyin Wan (5 Qian). Also Huyang Wan with Lamb Gelatin Pills.
Someone: Intestinal redness sticky, four years unresolved, Yin Qi injured, anal prolapse stabbing pain, bowel movement unsatisfactory, medicine hard to achieve quick effect. Should use Moistening agents to unblock Fu. (Pathogenesis: Yin Deficiency with Blood Stickiness)
Rehmanniae Radix (Shengdi), Bean Skin (Doupi), Hawthorn Fruit Flesh (Zharou), Sesame Seed (Maren), Malva Verticillata Seed (Dongkuizi), Angelicae Sinensis Radix Tail (Guixu).
Mr. Yao: Labor injury bleeding, collaterals empty causing pain, Ying-Wei do not circulate sequentially, causing alternating cold/heat. Pulse right empty-large, left small-hesitant. Unblock and tonify Yangming, make opening/closing orderly. (Pathogenesis: Labor Injury Ying-Wei) Guijianzhong Tang.
Mr. Tang (47 years old): Neijing states Yin collateral injury causes internal blood overflow. Strong liquor disturbs visceral collaterals where blood gathers. Though slightly better, spirit/nails lack luster, still blood loss color. Anal prolapse severe bleeding, treatment in Spleen/Kidney, as Spleen governs blood control, Kidney governs grasping. (Pathogenesis: Spleen-Kidney Deficiency)
Evening: Guipi Tang minus Xiangru. Morning: Liuwei Dihuang Wan minus Mudanpi/Zezhen plus Wuweizi/Qianshi/Lianrou/Ejiao pills.
Mr. Shen (55 years old): Alcohol-damp dirty blood, all Spleen/Kidney soft/greasy diseases, should give rigid medicine. Heidi Huang Wan.
Generally Spleen/Kidney are soft organs, accept rigid medicine. Heart/Liver are rigid organs, accept soft medicine. Must know this. Qianfu treated this with Pingwei San as main, added Rongui/Fuzi/Ganjiang/Danggui/Baishao, heavily added fried Diyu to receive lower damp, effective. This is the meaning.
Mr. Wu (42 years old): Abdominal pain bleeding, cured by eating water chestnut/soy milk, these are Lung-draining damp-guiding medicines. Since cure, recurrent limb flaccidity/chills-fever, night dry mouth, damp gone Qi leaked, Yangming pulse lacking, not functioning, Ying-Wei imbalance, Jin-Ye not rising sign. Tianzhen Wan main, remove Renshen.
Mr. Zhi (56 years old): Hemorrhoid bleeding long-term, muscle flaccid yellow, blood loss Qi exhaustion, gradually shortness of breath/edema, then abdominal distension, untreatable. This condition Zang Yin has cold, Fu Yang has heat, detailed in Jingui Gudany chapter, very hard to treat.
Ginseng Radix et Rhizoma (Renshen), Fried Atractylodis Rhizoma (Jiaozhu), Poria (Fuling), Fried Cuscutae Semen (Chao Tusizi), Tangerine Peel (Guangpi), Raw Alpiniae Oxyphyllae Fructus (Sheng Yizhi), Papaveris Fructus (Mugua).
Mr. Yang (48 years old): Middle age labor Qi exhaustion, insufficiency of Yang within Yin, and much bleeding, use Warm-Nourish and secure lower. Men of age, lower first deficient. (Pathogenesis: Kidney Yang Deficiency)
Ginseng Radix et Rhizoma (Renshen), Poria (Fuling), Angelicae Sinensis Radix (Danggui), Cistanche Stem (Dancou Rong), Psoraleae Fructus (Buguzhi), Morinda Officinalis Root (Baji), Fried Polygala Radix (Chao Yuanzhi).
Shengjing Lamb Paste Pills, take 5 Qian.
Mr. Tian (38 years old): Long morning diarrhea abdominal pain, recently red accumulation, belongs to Kidney deficiency.
Psoraleae Fructus (Buguzhi), Star Anise (Da Huixiang), Schisandrae Fructus (Wuwei), Poria (Fuling), Raw Cuscutae Semen (Sheng Tusizi).
Mr. Chen (37 years old): Left pulse deficient-choppy, right slow-large, tailbone pain connecting spine, blood after stool, feeling dizzy/fearful, least appetite, clearly Middle-Lower mutual damage, Eight Vessels all deficient. Morning Qingnang Banlong Wan, severely tonify Yutang/Guan Yuan. Evening Guipi Gao, nourish Ying Yin, persist year-round, body self-solidifies.
Deer Antler Velvet (Raw thin slice separate grind), Deer Antler Glue Residue (Separate grind), Deer Antler Glue (Salt water melt), Biota Seed (Oil removed dry bake), Prepared Rehmanniae Radix (Nine steam), Garlic Chive Seed (Salt water soak fry), Cuscutae Semen (Separate grind), Red/White Poria (Steam), Psoraleae Fructus (Walnut meat mash steam one day wipe clean fry fragrant).
Melt paste refine honey make pills, take 5 Qian each, light salt water send down.
Deer Antler strengthens Du Mai Yang, Deer Residue connects Du Mai Qi, Deer Glue tonifies Kidney Mai Blood, Buguzhi enters Mingmen alone, gathers scattered Yang Qi. Biota cools Heart benefits Kidney, Shudi thick flavor fills Kidney, Jiuzi/Tusizi enter Shaoyin to raise Qi solidify Essence. Heavy use Fuling light leaching, Bencao says Yangming original medicine, can guide other drugs into Supreme Yin realm. Do not use Cornus/Schisandra sour, as sour softens Yin and cannot enter vessels.
Mr. Hu (18 years old): Upper/lower bleeding, first bloody diarrhea, then stool diarrhea, over a month, Yin injury fluid consumption, Stomach appetite quite safe, no family labor, rest sit 100 days, so-called quiet then Yin fills. (Pathogenesis: Kidney Yin Deficiency)
Prepared Rehmanniae Radix (Shudi), Cornus Fructus (Yurou), Poria with Hostwood (Fushen), Dioscoreae Rhizoma (Shanyao), Schisandrae Fructus (Wuwei), Dragon Bone (Longgu).
Mr. Wang: Kidney deficiency, when Spring Yang rises coughs, cough stops voice not resonant, stool has blood, Yin hard to fill/recover, unwilling to ascend up, use Yin medicine to secure.
Prepared Rehmanniae Radix (Shudi), Paeoniae Radix Alba (Baishao), Poria with Hostwood (Fushen), Black Soybean Skin (Heidoupi), Fried Black Semen Pruni Mume (Chaojiu Wumei Rou).
Mr. Chen (30 years old): Kidney Yin deficiency collateral heat, Liver wind moves, intestinal redness three years unceasing, left hypochondrium/abdomen uncomfortable, Shaoyin also rebellious, mostly Bu Zhong Tiao She, so no effect seen. Temporarily use Shu Bu, for benefiting Zang unblocking Fu.
Charred Prepared Rehmanniae Radix (Shuditan), Fried Angelicae Sinensis Radix (Chao Danggui), Fried Hawthorn Fruit (Chao Zharou), Fried Sanguisorbae Radix (Chao Diyu), Fried Moutan Cortex (Chao Danpi), Mulberry Leaf (Dongsangye).
Re-examination: Benefit Yin drain Yang, four doses blood stops, but waist sore epigastric obstruction, throat dry likes cool drink, anal hot如火烙, Yang not peaceful, still Yin essence lost nourishment. Use Huyang method.
Charred Prepared Rehmanniae Radix (Shuditan), Paeoniae Radix Alba (Baishao), Angelicae Sinensis Radix (Danggui), Sanguisorbae Radix Charcoal (Diyutan), Turtle Shell (Guijiao), Anemarrhenae Rhizoma (Zhimu), Phellodendri Cortex (Huangbai), Pig Spinal Cord Pills.
Someone: Foam blood fresh red clots purple-black, Yin collateral injury damage, treat in Lower Jiao, moreover lower abdomen hernia masses, Liver/Kidney signs, previous essence turbidity long time, also causes Yin injury below.
Ginseng Radix et Rhizoma (Renshen), Poria with Hostwood (Fushen), Charred Prepared Rehmanniae Radix (Shuditan), Fried Black Lycii Fructus (Chaohei Qizi), Schisandrae Fructus (Wuwei), Fried Sanguisorbae Radix (Chao Diyu), Raw Eucommiae Cortex (Sheng Duzhong).
Re-examination: Left pulse small-rapid firm, anal prolapse distension.
Ginseng Radix et Rhizoma (Renshen), Poria with Hostwood (Fushen), Lake Lotus Seed Meat (Hulianrou), Euryale Seed (Qianshi), Charred Prepared Rehmanniae Radix (Shuditan), Schisandrae Fructus (Wuwei).
Ms. Chen: Pulse small, bloody diarrhea twenty years, Jing says Yin collateral injury, blood internal overflow, since disease start sixteen years, cannot conceive, describes heart pain prolapse, blood down regardless stool before/after, ask spine/lower back soreness, yet menstruation still arrives, foot/knee always cold, yet marrow heat burning, by Yin liquid injury, injury affects Yang not solid, read frequent years medicine, Danggui mixed enter Cool Liver, how is following ancient treating disease. Propose from Extraordinary Vessels lift-solidify one method. (Pathogenesis: Extraordinary Vessel Injury)
Deer Antler Velvet (Lurong), Deer Antler Glue Residue (Lujiaoshuang), Lycii Fructus (Gouqizi), Angelicae Sinensis Radix (Guishen), Purple Quartz (Zhi Shiying), Astragali Complanati Semen (Shayuan), Raw Eucommiae Cortex (Sheng Duzhong), Fried Star Anise (Chao Da Hui), Psoraleae Fructus (Buguzhi), Halloysitum Rubrum (Yuyuliangshi), Steamed Dough Pill Slurry Pills.
Mr. Zhang (39 years old): Labor effort sees blood, chest/back/hypochondrium collaterals pulling discomfort, treat in Ying collaterals. (Pathogenesis: Labor Effort Collateral Injury)
Ginseng Radix et Rhizoma (Renshen), Angelicae Sinensis Radix (Guishen), Paeoniae Radix Alba (Baishao), Poria (Fuling), Glycyrrhizae Radix et Rhizoma Praeparata (Zhigancao), Cinnamon Twig (Rougui).
Mr. Ji (53 years old): Blood stasis must knot in collaterals, collaterals reverse intestines/stomach then down, this fixed principle. Usually labor form run relax, cold/warm hunger/fullness cause injury, if can rest body mind, stasis not gather again, otherwise year half re-stasis, untreatable. (Pathogenesis: Blood Stasis in Collaterals)
Inula Flower (Xuanfuhua), New Crimson (Xinjiang), Green Onion (Qingcong), Peach Kernel (Taoren), Angelicae Sinensis Radix Tail (Dangguixu), Biota Seed (Baizi Ren).
Ms. Song: That year intestinal redness, followed by epistaxis/sore throat, already saw Yang Qi riding collaterals, collaterals ridden by Qi, gradually like pregnancy, however Qi attack moves like shuttle, distinct from fetal movement, if add labor/anger, must have dirty turbid sudden down, reasoning should view thus.
Biota Seed (Baizi Ren), Lygodii Spora (Zelan), Selaginellae Herba (Juanbai), Black Soybean Skin (Heida Doupi), Poria (Fuling), Arecae Pericarpium (Dafupi).
Hematochezia symptom, ancient has Intestinal Wind Zang Du Mai Hemorrhoids distinction, its manifestation not outside Wind invading intestines/stomach, Damp-Heat injuring Spleen two meanings, not like Neijing says Yin collateral injury, and Jie Yin purpose is precise, Zhang Zhongjing says first stool then blood, first blood then stool text, especially concise. Yin collateral is Zang/Fu subordinate collaterals, Jie Yin is Yin not following Yang sign, by sequence distinguish blood distance, by distance decide Zang/Fu nature, thus not let Qi lose control, blood nowhere return, like leak vessel unceasing. Lung disease causes dryness/astringency, should moisten descend, like Sangma Wan, and Tiandong Dihuang Yinhua Shibing etc. Heart disease fire burns blood boils, should clear transform, like Zhuye Dihuang Tang and Buxin Dan etc. Spleen disease must damp slippery, should dry rise, like Maoyu Lizhong Tang and Dongyuan Yiqi Tang etc. Liver disease has Wind Yang pain pressure, should soften drain, like Zhuche Wan, and Sweet-Sour mild agents etc. Kidney disease sees shape waste waist break, should tonify fill, like Huyang Wan and Liyin Jian etc. To Gallbladder meridian pivot mechanism, rebel then Wood Fire fans Ying, has Sangye Shanzhi Baizi Danpi clear nourish. Large Intestine dry Fu, often many Damp-Heat Wind invading, like Acrid-Cool Bitter-Dry treatment. Stomach water/grain sea, many Qi many Blood place, Zang disease Fu disease, none not combined, should tonify harmonize, should cold should heat, hard to stick say. If effort injury, Tongbu main, rich food accumulation, Qing Shu suitable. Hemorrhoids then moist/dry combine, poison known cold/heat. Rest like Heidi Huang Wan, treat Spleen damp Kidney dry, Tianzhen Wan, greatly tonify True Qi True Essence, Pingwei Diyu lift/lower Spleen/Stomach, Guipi guard tonify Heart/Spleen, Banlong warm煦 Extraordinary Du, Jianzhong restore generate Yang, Zhizhu疏补 Middle Earth.