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Qin (Family Name): Last year, [the patient] suffered from liver wind-induced vertigo. The treatment focused on cooling the blood level (Xue Fen), harmonizing yang to extinguish wind. It did not recur for a year. This year, in the first lunar month, the spring cold was unlike the warm weather that allows pores to open and release. This recurrence of illness must be triggered by labor and anger disturbing the emotions. Regarding the vomiting and reflux, alternating chills and fever, tinnitus, and pharyngeal obstruction gradually occurring between the Chou and Yin hours, and food remaining long in the epigastrium: it is speculated that Shaoyang Wood-Fire flourishes at Yin hour. Since the Gallbladder meridian passes through the ear, the aggressive nature of the rebellious pathogen must ascend to Yangming and affect various orifices. The pulse on the right is choppy and large, indicating stomach qi rebelling and failing to descend. Taste is insipid, and there is chaotic rebellion in the epigastrium with intense steaming heat, consuming Ying-Blood internally so it cannot nourish the Heart. Thus, sleep is restless, the Heart spirit is agitated, presenting an indescribable state of turmoil. Currently, heavy head and epigastric obstruction are entirely due to Wood-Fire ascending in the Upper Jiao, obstructing clear Yang. Previous prescriptions were rich in blood-nourishing herbs for clearing heat, which inevitably failed to produce results. Now, a decoction is proposed using bitter herbs to descend rebellion and pungent herbs to unblock obstruction. However, the dosage of the decoction should be small because of chronic illness and deficiency; given this condition in early spring, it is evident that winter storage was not solid. The pill formula should be Ju Fang Long Hui Wan (Cathartic Pill), taken temporarily for half a month before further discussion. (Wind-fire constrained upward)

Forsythia Fruit (1.5 qian) Black Gardenia Peel (1 qian) Antelope Horn (1 qian) Fresh Chrysanthemum Leaf (3 qian) Aster Root (2 qian) Curcuma Aromatic Tuber (0.8 fen) Large Apricot Kernel (peeled, core removed, not ground, 6 kernels) Trichosanthes Peel (1 qian) Fresh Acorus Rhizome (0.4 fen, avoid iron) Take at noon.

Shen (Female): Abdominal pain has decreased slightly, vomiting and reflux have stopped. There is heat in the Upper Jiao and cold in the Lower Jiao; Liver Yang has not yet harmonized. It is planned to administer the Dang Gui Long Hui method (Danggui Longhui Wan approach).
Angelica Sinensis Root Dragon's Gall Bladder Coptis Chinensis Rhizome Evodia Fruit Fennel

Huang (Family Name): Liver-Gallbladder wind-fire constrained upward, causing twitching and discomfort in the sinews of the clear orifices of the head and face. Treatment focuses on clearing and dispersing.
Antelope Horn Rhinoceros Horn Gardenia Forsythia Fruit Trichosanthes Peel Lotus Leaf Stem Mint Stem Green Chrysanthemum Leaf

Zheng (Family Name): Distending pain at the vertex, mental confusion, meridian twitching pain, distension and fullness with no desire to eat. Menstruation occurs four times a month. This is a disease caused by constraint injuring Qi and Blood. Take Long Hui Wan (Cathartic Pill) 2.5 qian, three doses.

Ye (Family Name): Jue-Yang disturbs the Spirit, menstrual blood is dark, limbs are cold, complexion is green, constipation. Take Long Hui Wan (Cathartic Pill) 1.2 qian, ten doses.

Que (Age 18): While reading or chanting, although the body sits still, the Mind often moves. All movements of the Five Emotions belong to Yang. When Yang overflows without restraint, the clear and spiritual mind becomes obscured. The meaning of Yi Jing states that "Meng" (Ignorance/Enveloped) implies external addition. Describing the onset of illness: the head feels like it needs pinching, the epigastrium feels like it needs rubbing, and bowel/bladder movements are necessarily obstructed. This is blockage of Fu-organ Qi, arising from Liver-Gallbladder Jue-rebellious constraint. It is proposed to treat from the Hand meridians of the Upper Jiao. (Mental labor causes Yang movement, Wood-fire obscures upward)

Antelope Horn Forsythia Heart Scrophularia Root Acorus Rhizome Curcuma Aromatic Tuber Ophiopogon Tuber Bamboo Leaf

Tang (Female): Pulse left choppy, right wiry. Qi-fire fails to descend, dull pain in chest and hypochondrium, epigastric discomfort. Most feared is hemorrhage. (Qi-fire constraint causing epigastric pain)

Fritillaria Bulb Gardenia Moutan Bark Curcuma Juice Uncaria Vine Trichosanthes Peel Poria Citrus Peel

Second visit: Qi-fire constrained upward, obstruction and pain in the epigastrium, vomiting saliva. First, open up the congestion and obstruction.
Fermented Soybean Trichosanthes Peel Gardenia Curcuma Bamboo Shavings Pinellia Paste Apricot Kernel

Ge: Anger and shouting cause Qi-fire to rebel and fly upward, leading to blood obstruction, sore throat, aversion to food, and stabbing pain around the ears, anterior/posterior to shoulders. It is proposed to resolve Shaoyang. (Anger stirs Gallbladder fire)
Prunella Spike Moutan Bark Mulberry Leaf Uncaria Vine Gardenia Groundtree Bark

Zhu (Age 54): Headache and mental restlessness arrive suddenly. Among the Five Elements, none is faster than Wind-Fire. However, etiology involves deficiency/excess and internal/external factors; it is not merely a matter of dispersing or using bitter-cold herbs. If there is a history of Liver disease, eye disease leading to blindness, it indicates long-term injury to Yin constitution. Currently, Jueyin Wind-Wood governs the year, and deep spring releases Yang energy violently. Even discussing exogenous pathogens, it aligns with Nei Jing stating "If one does not store essence in winter, one will suffer from Warm diseases in spring." Nourishing Yin can clear heat; dispersion is strictly contraindicated. Because the root of Yin is long injured, dispersing again injures Yang and robs fluids. Zhang Zhongjing said, "One mistake prolongs the illness, two mistakes hasten death." Previously, I advocated E Jiao Chicken Egg Yolk Decoction, assisted by Rehmannia and Asparagus to strengthen Water, and Paeonia and Licorice to cultivate Earth, urgently harmonizing the violent rebellion of Jue-Yang. Salty flavors enter Yin, sweet flavors relieve urgency, matching the three methods of treating Liver disease in Nei Jing. Now, three days into summer, deficient Yang suddenly ascends, causing irritability and headache. One should greatly nourish Kidney Mother (Kidney Water) to soothe Liver Child (Liver Wood), tonify Stomach Yin to prevent Wood-Fire from invading Spleen/Stomach. Within ten days, relapse may be avoided; after a month, full recovery is expected. (Liver-Kidney Yin deficiency, Wind-Yang rising)
Ginseng Prepared Rehmannia Asparagus Ophiopogon Tortoise Shell Glue Donkey-Hide Gelatin North Schisandra Spirit Polygala

Lu: Bleeding from the left nostril, pain in the left scapula and arm. All indicate excessive movement of Ministerial Fire, imbalance of Ying-Qi heat. Pulse is right deficient, left rapid. First, clear Liver and unblock collaterals. (Collateral Heat)
Moutan Bark Gardenia Antelope Horn Prunella Spike Silkworm Sand Uncaria Vine Forsythia Green Chrysanthemum Leaf

The Liver is the General Officer, housing Ministerial Fire within. It receives nourishment from True Water and control from True Qi, allowing Wood-Fire to maintain its generative mechanism. Originally, there is no name for such symptoms. Generally, emotional dissatisfaction leads to constraint, discordant speech leads to anger, and excessive planning leads to exhaustion. The Liver, as the root of fatigue, transforms into Fire from within. Its aggressive attack is fierce; if ascending without extinguishing, it becomes Wind-Yang; if suppressed without penetrating, it becomes Constraint Qi. Epigastric/hypochondriac distension, sudden vertigo and syncope, vomiting/reflux, stranguria/retention, mania and hematemesis, etc., arise from this. Although ancients distinguished Liver Wind, Liver Qi, and Liver Fire, they share the same source. For severe constraint, pungent and cool methods are appropriate to guide it out顺势; for excessive ascending, softening and descending methods are prioritized to calm the disturbance; for self-exhaustion, it is purely deficiency, requiring tonification of the Mother and Child Zang organs. Various complications involving attacking upward, insulting middle, or overcoming downward are scattered across different categories and can be verified. (Shao Xinpu)