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Doupi (3 qian) Danshen (1 qian) Maidong (1.5 qian) Chuanhu (1.5 qian) Oujiang (1 small cup)
Patient Chen: Stomach deficiency. External pathogenic qi reverses upward causing hiccup and belching. Phlegm carries blood spots. Slight pain in the throat. Tentatively apply the method of calming and anchoring. (Stomach deficiency with qi rebellion)
Renshen Shudihuang Tan Wuweizi Fushen Qingqian
Follow-up: Remove Qingqian from the previous prescription, add Maidong, Chuanhu, and Yuanzhi Tan.
Patient Sun (age 35): Pulse is small and wiry. After blood loss, appetite decreases. Taking Rehmanniae Radix Preparata (Shudihuang), which is soft and cloying, causes a feeling of stagnation. Furthermore, he dislikes rich and sweet foods. Propose harmonizing Liver and Stomach. (Liver-Stomach disharmony)
Suzi Fuling Jinshihu Jiangxiang Gouteng Heishanzhi
Patient Cai (age 39): After a new hot bath, steam causes diarrhea. Collateral blood overflows upward and exits via the anus. Usually has much phlegm, does not desire to drink water, yet stool is quite difficult. This violates the principle that Stomach Qi should descend smoothly. Combined with fatigue, worry, anger, treatment focuses on Liver and Stomach.
Jinshihu Zi Jiangxiang Chao Taoren Juhong Yiren Fuling
Patient Wan: Pulse is rapid, left side is firm. In summer, fourth month, Yang Qi is flourishing. Sudden anger causes Liver Yang to surge violently, collateral blood rushes upward. Although bleeding stopped, there is coughing, counterflow Qi, desire to vomit, and inability to sleep leaning on the left side. This is Liver Yang rising too excessively on the left, Wood failing to be nourished by Water. Yin deficiency generates heat. These are all deviations of original Yin and Yang, not comparable to external pathogenic excess fire that can simply be cleared or descended. It is most suitable to be tranquil and non-action-oriented, maintaining quietness and leisure. If it does not recur for a year, hope exists for gradual return to balance. Relying solely on herbal treatment will further damage Stomach Qi. The Classic says: The manifestation of Stomach Cough is coughing with counterflow Qi and vomiting. Wood invades Stomach Earth, piercing through the diaphragm, reaching the throat and lung. Lung Qi declines, Wood counteracts Metal. Following the Inner Classic's "Gan Huan" (Sweet and Slow) method to restrain urgency...
Mi Chao Maidong Nuodaogenxu Nvzhenzi Fusheng Gancao Nanzaorou
Follow-up: Yi Gui Tong Zhi (Treating Yi and Gui together - Liver and Kidney), benefiting Stomach Qi and nourishing Yin.
Renshen (washed with Qiushi Tang, dried, powdered) Shengdi Huang Shu Di Huang Tiandong Maidong
Use Renshen powder to consolidate.
Certain Patient: Blood loss damages Stomach Qi, should be treated from the middle. Moreover, five years ago illness arose from labor and anger; Liver Wood inevitably overacts on Earth. Physicians aggressively used warm tonification, causing Qi stagnation and distension. At night, throat is dry, unable to sleep, no desire for food, tasteless. Vomiting and coughing occur; this is entirely Stomach Yang rising and reversing. The Classic says: When Stomach is not harmonious, sleep is disturbed. Yang fails to submerge and descend, seemingly due to turbid Qi and congealed phlegm (有形之物) obstructing ascent and descent. Ancients said: "Two deficiencies and one excess, treat the excess first" to open a way forward. I focus on Stomach disease, restrain Liver, rescue the Middle, regulate Qi, clear the膈. This is a flexible treatment for deficiency with excess. Do not treat randomly at this stage.
Renshen Zhishi Banxia Xingren Gancao Zhuru Shengjiang Dazao
Patient Li: Violent anger causes Liver Yang to rise greatly, Stomach collateral blood surges heavily. Already violated the principle of Qi descending as smooth. Zhongchun's Three Essentials for Hematemesis say: Descend Qi, do not necessarily descend Fire. Currently, no hunger, no intake, caused by cold and greasy medicines.
Chao Suzi Jiangxiang Zhi Chao Shanzhi Yujin Fuling Chuanhu Danshen
Certain Patient: Left pulse is fine, firm, and beats against the finger. Liver Yang rebels, blood loss, sweating.
Shudi Wuweizhi Zhigancao Niuxi Baishao Guixin Tongbian (mixed in)
Patient Li (wife): Pulse is fine and small, almost imperceptible. Usually prone to depression and anger. Illness started during menstruation. Winter stomach pain, followed by continuous hemoptysis, chills, red face, palpitations, head shaking. Clearly Liver Yang transforming into Wind, collateral blood boiling up. Four limbs are cold, True Yang is declining. The Inner Classic mentions sudden changes in Liver disease; how can the condition be slight? Propose using Jingyue's Zhenyin Jian method to restrain Yang rebellion, still following the meaning of directing downward.
Shudihuang Tan Niuxi Tan Rougui Fusheng Baishao Tongbian
Follow-up: Menstruation came, blood stopped, Liver disease is certain.
Chao Zharou Danggui Chao Yanhu Zelan Taoren Fuling
Patient Shen (wife): Long-term cough after blood loss, epigastric pain, decreased appetite, amenorrhea, loose stools. Propose dispersing and draining Liver Qi. (Liver Qi stagnation)
Suzi Chao Danpi Taoren Yujin Gouteng Baishao
Patient Cai (age 37): External cold water, internal fear and shock. Yin malaria for three years, followed by hemoptysis, now seven years, no end in sight. Inquiry reveals blood comes as purple clots, still able to taste food and eat peacefully. Investigating malaria and shock injuries, it must be Liver collateral stasis. Triggered by anger and labor. Do not treat as alcohol/sex damage, blindly administering yin-nourishing greasy medicines, fearing Stomach Qi will decrease daily, worsening the disease. (Blood collateral obstruction)
Taoren (3 qian) Biejia (3 qian) Chuan Guizhi (7 fen) Guixu (1 qian) Dahuang (5 fen) Chongweizi (2 qian)
Patient Chai (age 25): Labor injury, uneven cold and warmth. Hypochondriac pain, hemoptysis, food intake unchanged. Should descend Qi and unblock collaterals.
Suzi Fuling Jiangxiang Juhong Jiegeng Yiren Jiubai Zhi
Patient Lu: Five days before Spring Equinox, time when Liver Wood rises vigorously. Massive vomiting of saliva and blood, chest and epigastrium uncomfortable. This is long-standing depression of Qi and Fire scorching heat, Spirit-Mind losing its residence, leading to much fear and panic. Blood in collaterals follows Fire rising and Qi reversing upward. Should first descend Qi, not use cold/bitter drugs to obstruct.
Suzi Jiangxiang Danshen Zharou Taoren Yujin Fuling Hei Zhipi
Patient Wu: Pulse is choppy. Can eat but has hemoptysis.
Jiangxiang Taoren Yujin Suzi Chao Shanzhi Yiren
Jiubai Zhi (mixed in)
Patient Yao (age 45): This is labor injury causing movement and blood loss. Mass in hypochondrium. Bleeding occurs due to severe coughing. First should descend Qi.
Suzi Yiren Fuling Hei Shanzhi Danpi Jiangxiang Jingjie Tan Niuxi Tan Oujiang
Patient Wu (age 34): Form fears cold, alternating chills and fever. Old mass in left hypochondrium. Blood loss and cough. Recently exerted force suddenly. Year-round emaciation, medicine not effective.
Xuanfuhua Xinjiang Guixu Chao Taoren Baiziren Fushen
Patient He (age 37): Beside left breast in hypochondrium, often feels like needle pricking. Sweating. Heart discomfort but can eat. This is Shaoyang collateral, Yang Qi burning. All due to excessive planning/worry causing injury, about to have collateral blood rushing up. Propose clearing collaterals and promoting circulation, do not let stasis remain.
Shengdi Huang Danpi Zelan Ye Taoren Yujin Hupo Mo
Follow-up: After taking collateral-unblocking formula, stasis blood went down, new blood also injured. Heart discomfort and good appetite, Yang hyperactivity burning, Ying Yin cannot protect. Still use method of harmonizing Yang and extinguishing Wind.
Ejiao Jizihuang Shengdi Huang Maidong Sheng Gancao Sheng Baishao
Patient Wang (age 20): After hematemesis, no hunger, chest and back pain.
Suzi Jiegeng Yujin Loupi Zhipi Jiangxiang
Patient Luo (age 18): Due to left pulse being firm and beating, twice administered soft/harmonizing methods to benefit Yang and nourish Yin, blood did not stop, right chest feels like fullness, left hypochondrium stabbing pain. This is where Shaoyang collaterals pass. Gallbladder is a pure and clear organ, Yin-soft nourishment cannot promote circulation in collaterals, so pain and cough persist. Propose pungent-moistening unblocking patent medicine.
Taoren Danpi Guixu Baiziren Zelan Jiangxiang Mo
Follow-up: From previous formula remove Jiangxiang Mo, Zelan, add Hei Zhipi.
Follow-up: Pungent-moistening, pain and cough both reduced. Slightly added bitter-descending, right hypochondrium hurts. Not only collaterals empty, Qi aspect is also weak. Ancients said upper half of body is Yang, originally no need for heavy bitter drugs.
Taoren Baiziren Xian Shengdi Xuan Shen Xian Yinhua
Patient Cheng (age 41): Pulse left wiry, right small and soggy. According to origin, illness started from depression. Depression accumulated long turning to heat, steaming and forcing collaterals, blood overflows upward. Clots formed are stasis staying after leaving collaterals. After blood loss, appetite is same as before, showing Fu-collaterals stored plenty. Moreover, Fu organs function by patency. Blood rebellion Qi also goes up, gurgling sound, all Qi-Fire rotating, not tangible substance. Blood diseases exist in all Zang-Fu, this symptom should clear Yangming collaterals as key. When illness starts, treat the cause, do not stick to routine.
Pipaye Yiren Fuling Suzi Sangye Danpi Chao Taoren Jiangxiang Mo
Certain Patient (age 28): Straining causes hemoptysis, whole chest and back hurt. Should use Zhongchun's method.
Suzi Jiangxiang Zhi Danpi Yiren Dongguaren Chao Taoren Niuxi Chuan Beimu
Certain Patient: Winter overly warm, body Qi cannot submerge. Yin-deficient constitution, blood follows Qi rebellion. Palpated Yangming pulse moving, vomited black stasis. Blood out of position in collaterals remains, cannot just use astringents.
Shengdi Huang Danshen Danpi Jiangxiang Taoren Niuxiu Jiuzhi Tongbian (mixed in)
Certain Patient: Liver rebellion blood loss.
Suzi Yujin Jiangxiang Zhi Danpi Gouteng Chi Shao Danshen Fuling Decoct with Bai Nuomi Tang.
Patient Hou (age 19): Epigastrium center, where Liver meridian crosses, spreads to Lung. Coughing makes stomach side sour, abdominal distension. Collateral Qi rebels. Should fear blood loss. Pulse rapid, can eat, should harmonize collateral Qi.
Shengdi Huang Taoren Sangye Danpi Maidong Fushen
Patient Chen (age 27): Hematemesis eight days, epigastric stuffiness, hypochondriac pain, cold limbs. Collateral injured Qi blocked. First give descending Qi and harmonizing Blood. (Blood collateral obstruction chest/hypochondriac pain)
Suzi Yujin Xingren Fuling Taoren Jiangxiang
Patient Weng (age 22): Asked about reading and sitting quietly, phlegm-blood erupts in summer, continues in winter. Chest/hypochondriac pain radiates to back. Pulse micro/small/choppy. Not desiring to injure Yin-Fire. Pain is collateral disharmony, Qi in collaterals rebels, blood goes up. Follow Zhongchun: Qi is commander of Blood.
Suzi Yiren Fuling Shanzhi Sangye Danpi Jiangxiang Mo Lao Jiubai
Patient Jiang: Palpate pulse rapid, snot has blood, cough phlegm. Cold/heat external factors move Lung. Because usually suffers Liver Bi, left hypochondrium cannot bear lying down. Fear Yang rising blood overflow. Slightly use bitter/pungent draining/descending, not patent medicine.
Hei Shanzhi Sangye Huafen Zhimu Gualou Pi Jiangxiang
Patient Shen: Left hypochondrium swollen/tight, pressing hurts, cough phlegm with blood. Merely collaterals not peaceful. Tentatively advance descending Qi unblocking collateral formula.
Jiangxiang Zhi Suzi Yiren Fuling Juhong Gouteng Baiji Li Jiubai Zhi
Follow-up: Right pulse long, choking blood. Still should descend Qi.
Suzi Yiren Fuling Shanzhi Danpi Gouteng Yujin
Patient Jin (age 29): Hunger/fullness/labor, Qi rebellion blood stasis. Chest pain frequent vomiting. This fluid consumption Yang rising, upward reversal unceasing, blood has no stopping date. First should descend Qi and regulate, do not use cloying/blocking meds.
Suzi Jiangxiang Taoren Danshen Jiubai Zhi Shanzhi Fuling
Certain Patient (age 41): Pulse wiry, blood loss, hypochondriac pain Qi rebellion.
Pipaye (3 qian) Dongguazi (3 qian) Suzi (1 qian) Yiren (3 qian) Chao Danpi (1 qian) Taoren (3 qian) Jiangxiang Zhi (8 fen) Niuxi Tan (1.5 qian)
Patient Fang (age 42): Worry/thoughts depressed, Five Emotions Qi-Fire internally burning. Plus tobacco pungent leaking Lung, wine heat damaging Stomach. Essence/Nutrient fluids turned to foul turbidity by heat steaming. Classic says: Yang collateral injured then blood overflows externally. Stomach collateral injured, Yangming Qi/Blood plentiful, still barely lasts years. Until Yangming collaterals decline day by day, then back first feels cold, right hypochondrium sore/pain, coughing/vomiting unceasing. Stomach Earth more exhausted, Liver Wood more rampant, Jue-Yang more rebellious, foul odor, none not floating up from below. Generally left ascending belongs to Liver, right descending belongs to Lung. Since Middle Jiao Stomach Earth is trapped, resulting in ascending without descending, blocking and pressing, how can lie on left side to sleep, suppress ascending/rebellent might? Also vexing steaming heat scorching, no thirst drinking water sign. Condition entirely in blood collaterals, clearing heat/nourishing Yin treatment power cannot enter collaterals. Now determine clearing/nourishing Stomach Yin as main, additionally advance unblocking collateral meaning. Liver/Gallbladder Jue-Yang slightly harmonized, hope saliva less, hypochondrium unblocked, accumulated deep sickness, regulating not easy.
Sangye Danpi Yiren Suzi Gouteng Yujin Jiangxiang Taoren
Follow-up: Sangye Pipaye Yiren Dashashen Suzi Fuling Yujin Jiangxiang
Follow-up: Take Qiongyu Gao early morning.
Patient Hu (age 67): Elderly, winter storage failed, seems external heat blazing. Pungent dispersing/bitter cold, is excess-solid treatment method. From spring to summer, Great Qi opens/releases, day by day listless/fatigued, breathing throat sounds, hypochondrium stiff/board wanting pain, coughing/spitting purple blood, collaterals not harmonious. Propose pungent-tonifying unblocking/regulating, not causing cold coagulation/dryness. Hope avoid Guan-Ge upper/lower mutual obstruction burden.
Baiziren Xi Shengdi Danggui Xu Taoren Jiangxiang Fushen
Patient Shi (age 34): Previously bone pain/shivering, every ten days, must vomit blood bowl amount. From winter to summer always so. Recently only can lie supine, lying right causes cough/reversal unceasing. Said due to anger/labor causing illness, all Yang Qi over-moving, while Xiao-Khe tongue coating, still eats grain as usual. Tentatively harmonize Jue-Yang/Yangming Yang, not merely treating seeing blood/cough generally. (Anger/Labor blood Bi)
Shigao Shudi Maidong Zhimu Niuxi
Follow-up: Shigao Shengdi Zhimu Danpi Dahuang Taoren Niuxi
Patient Jiang (age 62): Old injury, anger/labor moves Liver, blood overflows purple clots. First descend Qi guide blood.
Suzi Jiangxiang Mo Taoren Hei Shanzhi Jinhu Zhi Dahuang
Follow-up: Tian Di Qi Yuan add Zaoren Fushen.
Certain Patient: Robust form wiry pulse, yellow eyes, cough phlegm sticky/turbid, hematemesis. This Stomach has damp-heat congealed phlegm, due to anger/labor moving Liver, thus left hypochondrium pain, blood rebels upward. Not deficiency consumptive. Should light flavor quiet regulation, forbid anger, hundred days can eliminate.
Suzi Jiangxiang Guangpi Bai Shengjiang Taoren Yujin Jinhu After six doses, continue Hai Fen Wan half jin.
Certain Patient: Previously back pain. Still laboring. Qi rebellion hemoptysis. Is labor injury disease. (Labor injury) Guijian Qu remove Ginger add Fuling.
Certain Patient (age 28): Straining injures collaterals, blood loss yellow face. Mouth sweet taste, epigastrium vexing fullness rushing Qi. Disease in Liver/Stomach. Do not because of blood loss, treat with cloying/nourishing.
Xuanfuhua Daizheshi Banxia Dan Ganjiang Kuai Fuling Nanzaorou
Patient Lv (age 29): Pulse rapid coming up, right hypochondrium upper pain, then phlegm-blood overflows. Must be due to anger/straining/labor causing collateral Qi blockage. Should be peaceful/quietly anchoring, forbid anger/caution labor. Within one year, not likely to erupt, can say disease gone.
Jiangxiang Mo (8 fen mixed) Chao Jiao Taoren (3 qian) Danpi (1 qian) Ye Yujin (1 qian) Fuling (3 qian) Hei Shanzhi (1 qian) Danshen (1 qian) Juhong (1 qian)
Patient Wu (wife): Qi blocked blood loss, cough heart heat, evening chills/fever, no desire to eat. This depression internal damage, Two Yang disease affects Heart/Spleen. If not mood open/refreshed, taking medicine useless. (Depression)
Ejiao Maidong Fushen Baishao Beishashen Nvzhenzi
Patient Li (wife): Emotion long depressed, Qi rebellion phlegm wheezing, summer hemoptysis. All due to Five Emotions Yang rising. Moreover epigastrium has gathered Qi, two years widowhood, hidden grievances not extended. Theoretically treat Liver/Spleen. However not medicine efficacy achieves success.
Jiangxiang Mo Pipaye Suzi Yujin Gualou Pi Hei Zhipi Fuling Yiren
Patient Wu (wife): Depression damage, hemoptysis frequent. When changing solar terms rebellion, vomiting limb cold jue-ni. Manifested all are consumptive late stage. How is good scene. Tentatively prescribe formula.
Sheng Baishao Wumei Zhigan Chao Maidong Fushen Juhong
Patient Zhang (wife): Blood loss, mouth cracks/tongue blisters. Is emotion depressed/internal cause. Ying/Wei not harmonious, chills/fever again blazing. Disease depression prolonged becomes consumptive. Pleasant menstrual flow still arrives. Propose Hand Jueyin Blood aspect main treatment.
Xijiao Jinyinhua Xian Shengdi Xuan Shen Lianqiao Xin Yujin
Hemoptysis symptom, names vary. Here speak of those going up and vomiting. Three Causes' origins should be detailed. If external cause arises, Yang pathogen is many. Those contracting this symptom, Yin division first deficient, easily receives Heaven's Wind-Heat-Dry-Fire. To Yin pathogen harm, only one or two thereof. Treatment method generally takes Hand Three Yin as key. Investigate disease in Heart Ying/Lung Wei how. If internal cause arises, not out of anger/depression stimulating injuring Liver, labor body hard mind consuming Heart/Spleen. And indulging desire destroying Kidney True Yin/True Yang. Also should take Foot Three Yin as key. Again examine their multiplying/rebelling controlling/transformation how. If neither internal nor external cause, is diet preference, straining and falling injuries. Treatment divides Zang-Fu/Collateral differences. Know external cause arising, must have sensation signs first. Internal cause arising, must have internal symptoms basis. These Three Causes root medication, strictly do not confuse. Generally regulating Lung/Wei, use Sweet-Cool肃降. Like Shashen Maidong Sangye Huafen Yuzhu Chuanhu etc categories. Treating Heart Ying, use Light-Clear nourishing. Like Shengdi Xuan Shen Danshen Lianqiao Zhuye Gutou etc categories. Take these two methods as ancestor, follow seasons adding/subtracting. If Wind excessive fluid dry, add Sweet-Cold. Like Lugeng Zheshui Bohe Lingyang items. If Warm excessive fire strong, mix in Bitter-Cold. Like Shanzhi Huangqin Xingren Shigao items. If Summer Heat forces Qi aspect, assist Huashi Xianhe opening/resolving. In Ying with Yinhua Xijiao clearing/fragrant. Autumn season select pure Sweet to clear dryness. Winter time increase Clear-Tonify to help storage. All this is external cause general outline. Said Yin pathogen harming, hard to speak together. Old has Mahuang Renshen Shaoyao Tang, Mr. has Guizhi modification method. As for internal cause damage, methods more complex. If anger moves Liver Yang, blood follows Qi rebellion, use Miao's Qi is Blood Commander method. Like Suzi Yujin Sangye Danpi Jiangxiang Chuan Bei etc. If depression long injuring Liver Yin, Wood/Fire internally burning Yang collateral, use Soft-Liver Nourish-Yin method. Like Ejiao Ji Huang Shengdi Maidong Baishao Gancao etc. If labor/worry ceaseless,偏损 Heart/Spleen, Qi not holding blood, use Sweet-Warm Tonify-Secure method. Like Baoyuan Tang Guipi Tang etc. If indulgence exhausts Kidney True, or Yang hyperactive Yin winning, or Yin injured Yang escaping, have follow Yin/Yang methods. Like Qingqian Liuwei, Rougui Qiwei. Plus Tongbian etc. If essence exhausted sea empty, Qi floats blood surges, Mr. uses Urgently Secure True Origin, Great Tonify Essence/Blood method. Like Renshen Gouqi Wuwei Shudi Heche Zishiyang etc. All this is internal cause general outline. As for neither internal nor external cause, also not one type. Like case said tobacco pungent leaks Lung, wine heat damages Stomach etc. All can aid fire move blood. Have treating Upper/Middle methods. Like Weijing Tang Ganlu Yin Maogen Oujiang etc formulas. Depends on person recognizing and using. Falling injuries, from blood stasis overflowing. Generally first should guide down, later should unblock/tonify. If straining is