于（五五） 郁损心阳。阳坠入阴为淋浊。由情志内伤。即为阴虚致病。见症乱治。最为庸劣。心藏神。神
耗如愦。诸窍失司。非偏寒偏热药治。必得开爽。冀有向安。服药以草木功能。恐不能令其欢
悦。（郁损心阳） 妙香散。
陆（二六） （心脾气结神志不清）
人参 桔梗 乌药 木香 各三分磨汁
又 夜服白金丸。
又 久郁。心脾气结。利窍佐以益气。
人参 石菖蒲 龙骨 枣仁 远志 茯神
胡（四六） 悲泣。乃情怀内起之病。病生于郁。形象渐大。按之坚硬。正在心下。用苦辛泄降。先从气结
治。（心下痞结）
川连 干姜 半夏 姜汁 茯苓 连皮栝蒌
季（六九） 老年情志不适。郁则少火变壮火。知饥。脘中不爽。口舌糜腐。心脾营损。木火劫烁精华。肌
肉日消。惟怡悦开爽。内起郁热可平。但执清火苦寒。非调情志内因郁热矣。（郁损心脾营内热）
金石斛 连翘心 炒丹皮 经霜桑叶 川贝 茯苓
接服养心脾之营。少佐苦降法。
人参 川连 炒丹皮 生白芍 小麦 茯神
某 脘痛已止。味酸。乃肝郁也。（肝郁）
金石斛 黑山栀 丹皮 半夏曲 橘红 枇杷叶
某 初起左边麻木。舌强。筋吊脑后痛。痰阻咽喉。此系肝风上引。必由情怀郁勃所致。
羚羊角 连翘心 鲜生地 元参 石菖蒲 郁金汁
某 气郁不舒。木不条达。嗳则少宽。逍遥散去白术加香附。
某 肝郁成热。加味逍遥去白术加郁金。
某 郁热吞酸。温胆汤加山栀丹皮郁金姜汁炒黄连。
沈（四三） 脉虚涩。情怀失畅。肝脾气血多郁。半载不愈。难任峻剂。议以局方逍遥散。兼服补中益气。
莫以中宫虚塞为泥。（肝脾气血郁）
吴（四十） 劳倦嗔怒致伤。病在肝脾。久有脑泄。髓脂暗损。暂以解郁。继当宣补。
钩藤 生香附 丹皮 桑叶 神曲 白芍 茯苓 广皮
叶（氏） 悒郁动肝致病。久则延及脾胃。中伤不纳。不知味。火风变动。气横为痛为胀。疏泄失职。便
秘忽泻。情志之郁。药难霍然。数年久病。而兼形瘦液枯。若再香燥劫夺。必变格拒中满。与辛
润少佐和阳。
柏子仁（二钱） 归须（二钱） 桃仁（三钱） 生白芍（一钱） 小川连（三分） 川楝子（一钱）
某 恼怒肝郁。思虑脾伤。面黄脉涩。寤不成寐。宗薛氏法治之。
人参 黄 熟于术 茯神 枣仁 桂圆肉 当归 炙草 黑山栀 丹皮 远志
戴（氏） 隐情曲意不伸。是为心疾。此草木攻病。难以见长。乃七情之郁损。以丹溪越鞠方法。
香附 川芎 小川连 茯苓 半夏 橘红 炒楂肉 神曲浆丸
程（妪） 脉弦涩。外寒内热。齿痛舌干。无寐。乃肝脾郁结不舒。
郁金 钩藤 丹皮 夏枯草 生香附 薄荷
广皮 茯苓
吴（四一） 操持过动。肝胆阳升。胃气日减。脉应左搏。从郁热治。（肝胆郁热）
丹皮 黑山栀 薄荷梗 钩藤 广皮 白芍 茯苓 神曲
陆（二四） 郁伤。筋胀心痛。
钩藤 生香附 郁金 白蒺藜 丹皮 薄荷 广皮 茯苓
王（六三） 劳怒伤阳。气逆血郁致痛。痞胀便溏。风木侮土。前方既效。与通补阳明厥阴。
（肝犯胃气逆血郁）
大半夏汤加桃仁柏仁当归姜枣汤法。
朱（三二） 因抑郁悲泣。致肝阳内动。阳气变化火风。有形有声。贯膈冲咽。自觉冷者。非真寒也。内经
以五志过极皆火。但非六气外来。芩连之属。不能制伏。固当柔缓以濡之。合乎肝为刚脏。济
之以柔。亦和法也。（肝郁风火升）
生地 天冬 阿胶 茯神 川斛 牡蛎 小麦 人中白 熬膏
赵（四四） 郁勃日久。五志气火上升。胃气逆则脘闷不饥。肝阳上僭。风火凌窍。必旋晕咽痹。自觉冷
者。非真寒也。皆气痹不通之象。病能篇以诸禁鼓栗属火。丹溪谓上升之气。从肝胆相火。非
无据矣。
生地 阿胶 玄参 丹参 川斛 黑 豆皮
朱（氏） 脉弦右大。乳房刺痛。经阻半年。若遇劳怒。腹痛逆气上冲。此邪郁既久。少火化为壮火。气
钝不循。胞脉遂痹。治以泄少阳补太阴。气血流利。郁热可解。（胆脾气血郁）
人参 柴胡 当归 白术 丹皮 甘草 茯苓
吴（三八） 脉弦涩数。颈项结瘿。咽喉痛肿阻痹。水谷难下。此皆情志郁勃。肝胆相火内风。上循清窍。
虽清热直降。难制情怀之阳。是以频药勿效也。（木火上升喉肿痹）
鲜枇杷叶 射干 牛蒡子 苏子 大杏仁 紫降香
朱 情怀悒郁。五志热蒸。痰聚阻气。脘中窄隘不舒。胀及背部。上焦清阳欲结。治肺以展气化。
务宜怡悦开怀。莫令郁痹绵延。（木火上升肺不肃降）
鲜枇杷叶 杏仁 栝蒌皮 郁金 半夏 茯苓 姜汁 竹沥
又 脉左大弦数。头目如蒙。背俞 胀。都是郁勃热气上升。气有余便是火。治宜清上。
羚羊角 夏枯草 青菊叶 栝蒌皮 杏仁 香附 连翘 山栀
又 苦辛清解郁勃。头目已清。而膈嗳气。颇觉秽浊。此肝胆厥阳。由胃系上冲所致。丹溪谓上
升之气。自肝而出。是其明征矣。
川连 姜汁 半夏 枳实 桔梗 橘红 栝蒌皮
吴（氏） 气血郁痹。久乃化热。女科八脉失调。渐有经阻瘕带诸疾。但先治其上。勿滋腻气机。
（郁热先清上焦）
黑山栀皮 炒黄川贝 枇杷叶 栝蒌皮 杏仁 郁金 橘红
徐（氏） 火升头痛。来去无定期。咽喉垂下心悸。二便不爽。带下不已。固奇经。通补阳明。及养肝熄
风。展转未能却病。病从情志内伤。治法惟宜理偏。议先用滋肾丸三钱。早上淡盐汤送。四服。（阴火上炎）
虞（三四） 脉数。舌白神呆。得之郁怒。（郁热）
犀角 羚羊角 野郁金 炒远志 鲜石菖蒲 炒丹皮 黑山栀 茯神
王（三十） 痰多咽痛。频遭家难。郁伤。心中空洞。呛逆不已。议与胃药。（郁伤胃）金
匮麦门冬汤。
陆（二五） 病起忧虑上损。两年调理。几经反复。今夏心胸右胁之间。常有不舒之象。此气
血内郁少展。支脉中必有痰饮气阻。是宣通流畅脉络。夏季宜进商矣。（郁损脉络痰饮阻气）
天竺黄 茯神 郁金 橘红 远志 石菖蒲 丹参 琥珀 竹沥法丸
赵（六二） 脉左涩。右弦。始觉口鼻中气触腥秽。今则右胁板痛。呼吸不利。卧着不安。此
属有年郁伤。
治当宣通脉络。（血络郁痹右胁痛）
金铃子 延胡 桃仁 归须 郁金 降香
王（女） 阴虚。齿衄肠血。未出阁。郁热为多。与养肝阴方。（郁热伤肝阴）
生地 天冬 阿胶 女贞子 旱莲草 白芍 茯神 乌骨鸡
张（六六） 情志连遭郁勃。脏阴中热内蒸。舌绛赤糜干燥。心动悸。若饥。食不加餐。内伤情怀起病。务
以宽怀解释。热在至阴。咸补苦泄。是为医药。（肝肾郁热）
鸡子黄 清阿胶 生地 知母 川连 黄柏
许 厥阴少阴。脏液干涸。阳升结痹于喉舌。皆心境失畅所致。药无效者。病由情怀中来。草木
凉药。仅能治六气外来之偏耳。（肝肾液涸阳升喉痹）
熟地 女贞 天冬 霍山石斛 柏子仁 茯神
龙（五六） 久郁气血不行。升降皆钝。外凉内热。骨节沉痛。肌肿腹膨。肤腠无汗。用药务在宣通五郁
六郁大旨。（经络气血郁痹）
香附汁 白蒺藜 钩藤 丹皮 山栀 抚芎 泽兰 姜黄 神曲
金 气血久郁成热脘胁痹闷不通。常有风疹腹痛。瘀痹已深。发时宜用通圣一剂。半时以通
调气热之郁。
土栝蒌皮 枇杷叶 黑山栀 郁金 桃仁 杏仁
杨 惊惶忿怒都主肝阳上冒。血沸气滞。瘀浊宜宣通以就下。因误投止塞。旧瘀不清。新血又
瘀络中。匝月屡屡反复。究竟肝胆气血皆。郁仍宜条达宣扬。漏疡在肛。得体中稍健设法。
旋复花 新绛 青葱管 炒桃仁 柏子仁
赵（氏） 瘰 。寒热盗汗。脘中瘕聚。经期不来。大便溏。呛咳减食。春深至冬未痊。此乃郁损成劳。难
治之症。（郁劳）
香附 丹皮 归身 白芍 川贝 茯苓 牡蛎 夏枯草
胡（氏） 头项结核。暮夜寒热盗汗。此乃忧郁不解。气血皆虚。倘若经阻。便难调治。
炒当归 炒白芍 炙草 广皮 茯神 钩藤 南枣
张（氏） 据说丧子悲哀。是情志中起。因郁成劳。知饥不能食。内珠忽陷忽胀。两胁忽若刀刺。经先
期。色变瘀紫。半年来医药无效者。情怀不得解释。草木无能为矣。
人参 当归 生白芍 炙草 肉桂 炒杞子 茯苓 南枣
素问六元正纪大论。言五郁之发。乃因五运之气。有太过不及。遂有胜复之变。由此观
之。天地且有郁。而况于人乎。故六气着人。皆能郁而致病。如伤寒之邪。郁于卫。郁于营。或
在经在腑在脏。如暑湿之蕴结在三焦。瘟疫之邪。客于募原。风寒湿三气杂感而成痹症。总之邪不解散即谓之郁。此外
感六气而成者也。前人论之详矣。今所辑者。七情之郁居
多。如思伤脾。怒伤肝之类是也。其原总由于心。因情志不遂。则郁而成病矣。其症心脾肝
胆为多。案中治法。有清泄上焦郁火。或宣畅少阳。或开降肺气。通补肝胃。泄胆补脾。宣通
脉络。若热郁至阴。则用咸补苦泄。种种治法未能按症分析详论。今举其大纲。皆因郁则
气滞。气滞久则必化热。热郁则津液耗而不流。升降之机失度。初伤气分。久延血分。延及
郁劳沉 。故先生用药大旨。每以苦辛凉润宣通。不投燥热敛涩呆补。此其治疗之大法
也。此外更有当发明者。郁则气滞。其滞或在形躯。或在脏腑。必有不舒之现症。盖气本无
形。郁则气聚。聚则似有形而实无质。如胸膈似阻。心下虚痞胁胀背胀。脘闷不食。气瘕攻
冲。筋脉不舒。医家不察。误认有形之滞。放胆用破气攻削。迨至愈治愈剧。转方又属呆补。
此不死于病。而死于药矣。不知情志之郁。由于隐情曲意不伸。故气之升降开阖枢机不
利。虽内经有泄折达发夺。五郁之治。犹虑难获全功。故疏五过论。有始富后贫。故贵脱势。
总属难治之例。盖郁症全在病者能移情易性。医者构思灵巧。不重在攻补。而在乎用苦
泄热。而不损胃。用辛理气。而不破气用滑润濡燥涩。而不滋腻气机。用宣通而不揠苗助
长。庶几或有幸成。耳。（华岫云）
[Background Information]
Book: *Lin Zheng Zhi Nan Yi An* (Clinical Guide to Medical Cases)
Author: Ye Gui (Ye Tianshi)
Dynasty: Qing
Chapter: Yu (Stagnation/Depression)
Category: Medical Theory
Yu (55) Stagnation damages Heart Yang. When Yang sinks into Yin, it manifests as strangury and turbid urine. Caused by internal emotional injury, this constitutes a disease arising from Yin deficiency. Treating based on symptoms without addressing the root is the most mediocre approach. The Heart houses the Spirit (Shen). When the Spirit is exhausted, it becomes confused; all orifices lose their regulation. Treatment cannot rely solely on drugs that are excessively cold or hot; one must achieve an open and refreshing state, hoping for gradual recovery. Relying merely on the functions of herbs may not bring joy and relief to the patient. (Stagnation damaging Heart Yang) Miao Xiang San.
Lu (26) [Heart and Spleen Qi binding with unclear spirit/mind]
Ren Shen (Ginseng Radix), Jie Geng (Platycodonis Radix), Wu Yao (Linderae Radix), Mu Xiang (Aucklandiae Radix), each 3 fen, ground and mixed with water.
Again, take Bai Jin Wan at night.
Again, for long-standing stagnation causing Heart and Spleen Qi binding, benefit the orifices while assisting Qi.
Ren Shen (Ginseng Radix), Shi Chang Pu (Acori Tatarinowii Rhizoma), Long Gu (Fossilia Ossis Mastodi), Zao Ren (Ziziphi Spinosomi Semen), Yuan Zhi (Polygalae Radix), Fu Shen (Poria Cum Radice).
Hu (46) Weeping is a disease arising from inner emotions. The illness originates from stagnation. The mass gradually enlarges, feels hard upon palpation, and is located exactly below the heart (epigastrium). Use bitter and acrid methods to drain and descend, treating the Qi binding first. (Epigastric fullness/stagnation)
Chuan Lian (Coptidis Rhizoma), Gan Jiang (Zingiberis Rhizoma), Ban Xia (Pinelliae Rhizoma), Jiang Zhi (Zingiberis Juice), Fu Ling (Poria), Gua Lou Pi (Trichosanthis Pericarpium - with skin).
Ji (69) In old age, emotional discomfort causes "Lesser Fire" to transform into "Greater Fire." The patient feels hungry but experiences discomfort in the epigastrium, and suffers from ulceration and rotting of the mouth and tongue. Heart and Spleen Ying (Nutritive) level is damaged. Wood and Fire consume the essence, leading to daily wasting of muscles. Only through joy and openness can the internally generated stagnant heat be calmed. Adhering strictly to bitter-cold fire-clearing methods does not address the internal cause of emotional stagnation. (Stagnation damaging Heart and Spleen Ying, generating internal heat)
Jin Shi Hu (Dendrobii Officinalis Caulis), Lian Qiao Xin (Forsythiae Fructum Cor), Chao Dan Pi (Moutan Cortex), Jing Shuang Sang Ye (Mulbai Folium after frost), Chuan Bei (Fritillariae Cirrhosae Bulbus), Fu Ling (Poria).
Subsequently, administer formulas to nourish Heart and Spleen Ying, with a slight addition of bitter-descending methods.
Ren Shen (Ginseng Radix), Chuan Lian (Coptidis Rhizoma), Chao Dan Pi (Moutan Cortex), Sheng Bai Shao (Paeoniae Radix Alba), Xiao Mai (Tritici Fructus), Fu Shen (Poria Cum Radice).
Certain case: Epigastric pain has stopped. Sour taste indicates Liver Stagnation. (Liver Stagnation)
Jin Shi Hu (Dendrobii Officinalis Caulis), Hei Shan Zhi (Gardeniae Fructum), Dan Pi (Moutan Cortex), Ban Xia Qu (Pinelliae Fermentatum), Ju Hong (Citri Reticulatae Pericarpium), Pi Pa Ye (Eriobotryae Folium).
Certain case: Initially, numbness on the left side, stiff tongue, tendons pulling causing pain at the back of the head, phlegm obstructing the throat. This is Liver Wind rising, necessarily caused by emotional agitation.
Ling Yang Jiao (Capricornis Cornu), Lian Qiao Xin (Forsythiae Fructum Cor), Xian Sheng Di (Rehmanniae Radix Recens), Yuan Shen (Scrophulariae Radix), Shi Chang Pu (Acori Tatarinowii Rhizoma), Yu Jin Zhi (Curcumae Longae Radix Juice).
Certain case: Qi stagnation is uncomfortable, Wood (Liver) fails to spread smoothly. Belching brings slight relief. Remove Bai Zhu from Xiao Yao San, add Xiang Fu.
Certain case: Liver stagnation transforms into heat. Add modified Xiao Yao San, remove Bai Zhu, add Yu Jin.
Certain case: Stagnant heat with acid regurgitation. Wen Dan Tang plus Shan Zhi, Dan Pi, Yu Jin, Jiang Zhi fried Chuan Lian.
Shen (43) Pulse is deficient and choppy. Emotional flow is unsmooth. Liver and Spleen Qi and Blood are largely stagnant. Half a year without cure, difficult to tolerate harsh medicines. Propose Ju Fang Xiao Yao San, combined with Bu Zhong Yi Qi. Do not be stuck on the idea of middle jiao deficiency and blockage. (Liver and Spleen Qi and Blood Stagnation)
Wu (40) Injury caused by fatigue and anger. Disease is in Liver and Spleen. Long-standing cerebral discharge (brain leakage), marrow and fat secretly damaged. Temporarily resolve stagnation, subsequently promote tonification and dissemination.
Gou Teng (Uncariae Ramulus cum Uncis), Sheng Xiang Fu (Cyperi Rhizoma), Dan Pi (Moutan Cortex), Sang Ye (Mori Folium), Shen Qu (Massa Medicata Fermentata), Bai Shao (Paeoniae Radix Alba), Fu Ling (Poria), Guang Pi (Citri Reticulatae Pericarpium).
Ye (Family) Depression moves the Liver, causing disease. Over time, it extends to Spleen and Stomach. Middle jiao is injured, failing to receive food, loss of taste. Fire and Wind change, Qi spreads horizontally causing pain and distension. Dispersing and draining functions fail. Constipation suddenly turns to diarrhea. Emotional stagnation is hard to cure abruptly. Years of chronic illness accompanied by emaciation and fluid depletion. If aromatic-drying and plundering drugs are used again, it will surely lead to rejection and middle jiao fullness. Provide slightly acrid-moistening to harmonize Yang.
Bai Zi Ren (Biota Semen), Gui Xu (Angelicae Sinensis Radix Fibrae), Tao Ren (Persicae Semen), Sheng Bai Shao (Paeoniae Radix Alba), Xiao Chuan Lian (Coptidis Rhizoma), Chuan Li Zi (Toosendan Fructus).
Certain case: Anger causes Liver Stagnation, overthinking injures Spleen. Yellow complexion, choppy pulse, inability to sleep at night. Follow Master Xue's treatment method.
Ren Shen (Ginseng Radix), Huang Qi (Astragali Radix), Shu Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Shen (Poria Cum Radice), Zao Ren (Ziziphi Spinosomi Semen), Gui Yuan Rou (Longan Arillus), Dang Gui (Angelicae Sinensis Radix), Zhi Cao (Glycyrrhizae Radix et Rhizoma Preparata), Hei Shan Zhi (Gardeniae Fructum), Dan Pi (Moutan Cortex), Yuan Zhi (Polygalae Radix).
Dai (Family) Hidden feelings and twisted intentions are not expressed, constituting a Heart disease. Herbal medicine attacking the disease finds it hard to show progress. This is damage from Seven Emotions' stagnation. Use Danxi's Yue Ju Fang method.
Xiang Fu (Cyperi Rhizoma), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Xiao Chuan Lian (Coptidis Rhizoma), Fu Ling (Poria), Ban Xia (Pinelliae Rhizoma), Ju Hong (Citri Reticulatae Pericarpium), Chao Zha Rou (Crataegi Fructus Preparated Flesh), Shen Qu (Massa Medicata Fermentata), made into pills with Shen Qu paste.
Cheng (Elderly woman) Pulse is wiry and choppy. External cold, internal heat. Toothache, dry tongue, insomnia. Liver and Spleen stagnation and knotting, uncomfortable.
Yu Jin (Curcumae Longae Radix), Gou Teng (Uncariae Ramulus cum Uncis), Dan Pi (Moutan Cortex), Xia Ku Cao (Prunellae Spicae), Sheng Xiang Fu (Cyperi Rhizoma), Bo He (Menthae Haplocalycis Herba).
Guang Pi (Citri Reticulatae Pericarpium), Fu Ling (Poria).
Wu (41) Excessive mental exertion and movement. Liver and Gallbladder Yang rises, Stomach Qi decreases daily. Pulse should beat on the left. Treat from Stagnant Heat. (Liver and Gallbladder Stagnant Heat)
Dan Pi (Moutan Cortex), Hei Shan Zhi (Gardeniae Fructum), Bo He Geng (Menthae Haplocalycis Herba Stem), Gou Teng (Uncariae Ramulus cum Uncis), Guang Pi (Citri Reticulatae Pericarpium), Bai Shao (Paeoniae Radix Alba), Fu Ling (Poria), Shen Qu (Massa Medicata Fermentata).
Lu (24) Stagnation injury. Tendons distended, Heart pain.
Gou Teng (Uncariae Ramulus cum Uncis), Sheng Xiang Fu (Cyperi Rhizoma), Yu Jin (Curcumae Longae Radix), Bai Ji Li (Tribuli Fructus), Dan Pi (Moutan Cortex), Bo He (Menthae Haplocalycis Herba), Guang Pi (Citri Reticulatae Pericarpium), Fu Ling (Poria).
Wang (63) Labor and anger injure Yang. Rising Qi and stagnant Blood cause pain. Fullness, loose stools. Wind-Wood insults Earth. Previous formula was effective. Provide Tong Bu (Unblocking and Tonifying) to Yangming and Jueyin. (Liver invading Stomach, Rising Qi, Stagnant Blood)
Da Ban Xia Tang plus Tao Ren, Bai Ren, Dang Gui, Jiang Zao Decoction method.
Zhu (32) Due to depression and weeping, Liver Yang moves internally. Yang Qi transforms into Fire and Wind. With form and sound, penetrating diaphragm and rushing to throat. Feeling cold is not true cold. *Neijing* states excessive Five Emotions all become Fire, but this is not external Six Qi. Coptis and Scutellaria cannot subdue it. Must use soft and slow methods to moisten it. This conforms to "Liver is a rigid organ," supplementing rigidity with softness is also a Harmonizing method. (Liver Stagnation, Wind-Fire Rising)
Sheng Di (Rehmanniae Radix), Tian Dong (Asparagi Radix), E Jiao (Colla Corii Asini), Fu Shen (Poria Cum Radice), Chuan Hu (Dendrobii Caulis), Mu Li (Ostreae Concha), Xiao Mai (Tritici Fructus), Ren Zhong Bai (Urinae Humanis Depuratum), boiled into paste.
Zhao (44) Stagnation agitated for a long time. Qi and Fire of Five Emotions rise. Stomach Qi reverses causing epigastric stuffiness and lack of appetite. Liver Yang usurps upward, Wind-Fire attacks orifices,必定 causing vertigo and throat obstruction. Feeling cold is not true cold. All are signs of Qi obstruction and blockage. *Suwen* Chapter on Diseases states various spasms and shivering belong to Fire. Danxi stated rising Qi comes from Liver-Gallbladder Ministerial Fire, which is well-founded.
Sheng Di (Rehmanniae Radix), E Jiao (Colla Corii Asini), Xuan Shen (Scrophulariae Radix), Dan Shen (Salviae Miltiorrhizae Radix), Chuan Hu (Dendrobii Caulis), Hei Dou Pi (Sojae Semen Nigrum Pericarpium).
Zhu (Family) Pulse wiry, right side large. Piercing breast pain. Menstruation blocked for half a year. If encountering labor or anger, abdominal pain and reverse Qi rush upward. Pathogenic stagnation has been long, Lesser Fire transforms into Greater Fire. Qi becomes dull and does not follow normal paths, Uterine vessels thus become obstructed. Treat by draining Shaoyang and tonifying Taiyin. Qi and Blood flow smoothly, stagnant heat can be resolved. (Gallbladder and Spleen Qi and Blood Stagnation)
Ren Shen (Ginseng Radix), Chai Hu (Bupleuri Radix), Dang Gui (Angelicae Sinensis Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Dan Pi (Moutan Cortex), Gan Cao (Glycyrrhizae Radix et Rhizoma), Fu Ling (Poria).
Wu (38) Pulse wiry, choppy, rapid. Neck and nape have goiters. Throat painful, swollen, obstructed. Food and water difficult to swallow. All due to emotional agitation. Liver-Gallbladder Ministerial Fire and Internal Wind ascend following clear orifices. Although clearing heat and descending directly, it is hard to control the Yang of emotions. Hence frequent medication yields no effect. (Wood-Fire ascending, throat swelling and obstruction)
Xian Pi Pa Ye (Eriobotryae Folium Recens), She Gan (Belamcandae Rhizoma), Niu Bang Zi (Arctii Fructus), Su Zi (Perillae Fructus), Da Xing Ren (Armeniacae Semen Amarum), Zi Jiang Xiang (Aquilariae Lignum Resinatum).
Zhu Emotional depression. Heat steaming from Five Emotions. Phlegm gathers blocking Qi. Epigastrium narrow and uncomfortable, distension extends to back. Upper Jiao Clear Yang wants to knot. Treat Lung to expand Qi transformation. Must maintain joy and open mind, do not let stagnation and obstruction prolong. (Wood-Fire ascending, Lung failing to descend)
Xian Pi Pa Ye (Eriobotryae Folium Recens), Xing Ren (Armeniacae Semen Amarum), Gua Lou Pi (Trichosanthis Pericarpium), Yu Jin (Curcumae Longae Radix), Ban Xia (Pinelliae Rhizoma), Fu Ling (Poria), Jiang Zhi (Zingiberis Juice), Zhu Li (Bambusae Succus).
Again, Left pulse large, wiry, rapid. Head and eyes feel covered. Back Shu points distended. All are stagnant-heat rising. Excess Qi is Fire. Treatment should clear the upper.
Ling Yang Jiao (Capricornis Cornu), Xia Ku Cao (Prunellae Spicae), Qing Ju Ye (Chrysanthemi Indici Folium), Gua Lou Pi (Trichosanthis Pericarpium), Xing Ren (Armeniacae Semen Amarum), Xiang Fu (Cyperi Rhizoma), Lian Qiao (Forsythiae Fructum), Shan Zhi (Gardeniae Fructum).
Again, Bitter-acrid clearing resolving stagnation. Head and eyes are clear, but chest belching smells foul. This is Liver-Gallbladder Jue-Yang rushing up from the Stomach system. Danxi stated rising Qi originates from Liver, which is clear evidence.
Chuan Lian (Coptidis Rhizoma), Jiang Zhi (Zingiberis Juice), Ban Xia (Pinelliae Rhizoma), Zhi Shi (Aurantii Fructus Immaturus), Jie Geng (Platycodonis Radix), Ju Hong (Citri Reticulatae Pericarpium), Gua Lou Pi (Trichosanthis Pericarpium).
Wu (Family) Qi and Blood stagnation and obstruction, long-term transforming into heat. Eight Extraordinary Vessels in gynecology are disordered. Gradually developing menstrual blockage, masses, and leukorrhea. But treat the upper first, do not clog Qi mechanism with greasy substances. (Stagnant Heat, first clear Upper Jiao)
Hei Shan Zhi Pi (Gardeniae Fructum Pericarpium), Chao Huang Chuan Bei (Fritillariae Cirrhosae Bulbus Prepared Yellow), Pi Pa Ye (Eriobotryae Folium), Gua Lou Pi (Trichosanthis Pericarpium), Xing Ren (Armeniacae Semen Amarum), Yu Jin (Curcumae Longae Radix), Ju Hong (Citri Reticulatae Pericarpium).
Xu (Family) Fire rising causing headache, coming and going irregularly. Throat hanging down, palpitations. Urination and defecation uncomfortable. Leukorrhea continuous. Consolidating Chong and Ren, Unblocking and Tonifying Yangming, and Nourishing Liver extinguishing Wind, turning around failed to cure the disease. Disease arises from internal emotional injury. Treatment method should only regulate imbalance. Propose using Zi Shen Wan 3 qian first, taken morning with light salt soup, four doses. (Yin Fire Flaring Up)
Yu (34) Pulse rapid. White tongue, dull spirit. Acquired from stagnation and anger. (Stagnant Heat)
Xi Jiao (Rhinocerotis Cornu), Ling Yang Jiao (Capricornis Cornu), Ye Yu Jin (Curcumae Longae Radix Wild), Chao Yuan Zhi (Polygalae Radix Preparated), Xian Shi Chang Pu (Acori Tatarinowii Rhizoma Recens), Chao Dan Pi (Moutan Cortex Preparated), Hei Shan Zhi (Gardeniae Fructum), Fu Shen (Poria Cum Radice).
Wang (30) Excessive phlegm, sore throat. Frequently suffering family disasters. Stagnation injury. Heart feels empty. Constant choking and reversing. Propose Stomach medicine. *Jin Gui* Mai Men Dong Tang.
Lu (25) Illness started from worry injuring Upper Jiao. Two years of regulation, many relapses. This summer, between chest/right hypochondrium, often uncomfortable sensation. This is internal stagnation of Qi and Blood with little expansion. Branch vessels must have phlegm-fluid and Qi obstruction. Thus, unblock and smooth the meridians. Summer is suitable for advancing Shang (Metal/Lung) strategy. (Stagnation damaging meridians, phlegm-fluid blocking Qi)
Tian Zhu Huang (Calami Tuber), Fu Shen (Poria Cum Radice), Yu Jin (Curcumae Longae Radix), Ju Hong (Citri Reticulatae Pericarpium), Yuan Zhi (Polygalae Radix), Shi Chang Pu (Acori Tatarinowii Rhizoma), Dan Shen (Salviae Miltiorrhizae Radix), Hu Po (Electrum), made into pills with Zhu Li method.
Zhao (62) Left pulse choppy, Right wiry. Initially felt fishy smell in nose and mouth. Now right hypochondrium board-like pain, breathing difficult, uneasy lying down. This belongs to long-standing stagnation injury.
Treatment should unblock meridians. (Blood collaterals stagnant obstruction, right hypochondrium pain)
Jin Ling Zi (Meliae Fructus), Yan Hu (Corydalis Rhizoma), Tao Ren (Persicae Semen), Gui Xu (Angelicae Sinensis Radix Fibrae), Yu Jin (Curcumae Longae Radix), Jiang Xiang (Dalbergiae Odoriferae Lignum).
Wang (Female) Yin deficiency. Gingival bleeding, intestinal blood. Not yet married. Mostly stagnant heat. Provide Liver Yin nourishing formula. (Stagnant Heat injuring Liver Yin)
Sheng Di (Rehmanniae Radix), Tian Dong (Asparagi Radix), E Jiao (Colla Corii Asini), Nu Zhen Zi (Ligustri Lucidi Fructus), Han Lian Cao (Ecliptae Herba), Bai Shao (Paeoniae Radix Alba), Fu Shen (Poria Cum Radice), Wu Gu Ji (Galli Corneum).
Zhang (66) Emotions repeatedly遭受 stagnation. Organ Yin heat steams internally. Tongue crimson, red, ulcerated, dry. Heart palpitations, feeling like hunger, eating does not increase meals. Illness starts from internal emotional injury. Must broaden mind and explain. Heat is in Supreme Yin. Salty tonification and bitter drainage is medical treatment. (Liver-Kidney Stagnant Heat)
Ji Zi Huang (Galli Ovum Album), Qing E Jiao (Colla Corii Asini Clarified), Sheng Di (Rehmanniae Radix), Zhi Mu (Anemarrhenae Rhizoma), Chuan Lian (Coptidis Rhizoma), Huang Bo (Phellodendri Chinensis Cortex).
Xu Jueyin and Shaoyin. Organ fluids dried up. Yang rises, knotting obstruction in throat and tongue. All caused by mental state unsmooth. Medicine ineffective because disease comes from emotions. Cool herbal medicines only treat bias of external Six Qi. (Liver-Kidney Fluid Depletion, Yang Rising, Throat Obstruction)
Shu Di (Rehmanniae Radix Preparata), Nu Zhen (Ligustri Lucidi Fructus), Tian Dong (Asparagi Radix), Huo Shan Shi Hu (Dendrobii Officinalis Caulis), Bai Zi Ren (Biota Semen), Fu Shen (Poria Cum Radice).
Long (56) Long stagnation, Qi and Blood do not move. Ascending and Descending both dull. External cool, internal heat. Bone joints heavy pain. Muscle swelling, abdomen distended. Skin pores no sweat. Medication must focus on unblocking the general principles of Five and Six Stagnations. (Meridian Qi and Blood Stagnation Obstruction)
Xiang Fu Zhi (Cyperi Rhizoma Juice), Bai Ji Li (Tribuli Fructus), Gou Teng (Uncariae Ramulus cum Uncis), Dan Pi (Moutan Cortex), Shan Zhi (Gardeniae Fructum), Fu Xiong (Ligustici Chuanxiong Rhizoma), Ze Lan (Lycopersi Herba), Jiang Huang (Curcumae Longae Rhizoma), Shen Qu (Massa Medicata Fermentata).
Jin Qi and Blood long stagnated becoming heat. Epigastric and hypochondriac obstruction and stuffiness unblocked. Often wind-rash and abdominal pain. Stasis obstruction is deep. At onset, should use Tong Sheng one dose. Half hour later to unblock and regulate Qi-Heat stagnation.
Tu Gua Lou Pi (Trichosanthis Pericarpium), Pi Pa Ye (Eriobotryae Folium), Hei Shan Zhi (Gardeniae Fructum), Yu Jin (Curcumae Longae Radix), Tao Ren (Persicae Semen), Xing Ren (Armeniacae Semen Amarum).
Yang Panic and anger all govern Liver Yang covering upward. Blood boils, Qi stagnates. Stasis and turbidity should be unblocked to descend. Due to mistaken use of stopping and blocking, old stasis not cleared, new blood again stasis in collaterals. Month-long repeated relapses. Ultimately Liver-Gallbladder Qi and Blood are all stagnant, still should be smoothed and promoted. Fistula in anus. Should obtain slight health of Middle Jiao to devise method.
Xuan Fu Hua (Inulae Flos), Xin Jiang (Safrani Stigma), Qing Cong Guan (Allii Fistulosi Caulis), Chao Tao Ren (Persicae Semen Preparated), Bai Zi Ren (Biota Semen).
Zhao (Family) Scrofula. Alternating fever and night sweats. Mass in epigastrium. Menstruation absent. Loose stool. Choking cough, reduced food. From late spring to winter not cured. This is stagnation damage becoming consumption (Lao), difficult to treat. (Stagnation Consumption)
Xiang Fu (Cyperi Rhizoma), Dan Pi (Moutan Cortex), Gui Shen (Angelicae Sinensis Radix Root), Bai Shao (Paeoniae Radix Alba), Chuan Bei (Fritillariae Cirrhosae Bulbus), Fu Ling (Poria), Mu Li (Ostreae Concha), Xia Ku Cao (Prunellae Spicae).
Hu (Family) Neck and nape tubercles. Evening alternating fever and night sweats. This is unresolved melancholy, Qi and Blood both deficient. If menstruation blocks, difficult to regulate.
Chao Dang Gui (Angelicae Sinensis Radix Preparated), Chao Bai Shao (Paeoniae Radix Alba Preparated), Zhi Cao (Glycyrrhizae Radix et Rhizoma Preparata), Guang Pi (Citri Reticulatae Pericarpium), Fu Shen (Poria Cum Radice), Gou Teng (Uncariae Ramulus cum Uncis), Nan Zao (Jujubae Fructus).
Zhang (Family) Said mourning son's death, sorrow arises from emotions. Becomes consumption from stagnation. Knows hunger cannot eat. Inner pearl suddenly sinks or swells. Both hypochondria suddenly feel like knife stabbing. Menstruation early, color changes to purple stasis. Half year medicine ineffective because emotions not resolved. Herbs are powerless.
Ren Shen (Ginseng Radix), Dang Gui (Angelicae Sinensis Radix), Sheng Bai Shao (Paeoniae Radix Alba), Zhi Cao (Glycyrrhizae Radix et Rhizoma Preparata), Rou Gui (Cinnamomi Cortex), Chao Qi Zi (Cannabis Fructus Preparated), Fu Ling (Poria), Nan Zao (Jujubae Fructus).
*Suwen* *Liuyuan Zhengji Dalun* states the outbreak of Five Stagnations is due to Five Movements Qi having excess or deficiency, thus having victory and return changes. From this view, Heaven and Earth even have stagnation, how much more so humans? Thus Six Qi attaching to humans can all stagnate and cause disease. Like Cold Damage pathogen, stagnating in Wei, stagnating in Ying, or in Meridian, Fu, or Zang. Like Summer-Heat-Dampness accumulating in Sanjiao. Plague pathogen lodging in Muyuan. Wind-Cold-Damp three Qi mixed sensing forming Bi syndrome. In short, pathogen not dispersing is called Stagnation. These are formed by external Six Qi. Predecessors discussed in detail. What is compiled now, Seven Emotions' stagnation accounts for most. Like thinking injures Spleen, anger injures Liver, etc. Its origin generally lies in Heart. Because emotions are unsatisfied, then stagnates and becomes disease. Symptoms mostly involve Heart, Spleen, Liver, Gallbladder. Treatment methods in cases include clearing and draining Upper Jiao stagnant fire, or promoting Shaoyang, or opening and descending Lung Qi, unblocking and tonifying Liver-Stomach, draining Gallbladder tonifying Spleen, unblocking meridians. If heat stagnates in Supreme Yin, then use salty tonification and bitter drainage. Various treatments could not analyze detailed discussion according to symptoms. Now listing its outline, all because stagnation leads to Qi stagnation. Qi stagnation long-term must transform into heat. Heat stagnation consumes Jin-Ye (Body Fluids) and they do not flow. Ascending and Descending mechanism loses degree. Initially injuring Qi Fen (Level), long-term extending to Xue Fen (Level), extending to Stagnation Consumption and severe conditions. Thus Mr.'s main principle of medication, usually uses bitter-acrid-cool-moist-unblocking, does not throw dry-hot-astringent-stupid tonification. This is the major law of treatment. Additionally, there are things to be clarified. Stagnation leads to Qi stagnation, the stagnation may be in body shape or in organs, must have uncomfortable presenting symptoms. Basically Qi has no form, stagnation makes Qi gather. Gathering seems to have form but actually lacks substance. Like chest-diaphragm seems blocked, epigastric empty fullness, hypochondriac/back distension, epigastric stuffiness not eating, Qi mass attacking, tendons-vessels uncomfortable. Physicians not observing, mistakenly recognize有形 (form-having) stagnation, boldly use breaking-Qi attacking scraping. Until treated more severely, changing formula again belongs to stupid tonification. This does not die from disease, but dies from medicine. Not knowing emotional stagnation is due to hidden feelings and twisted intentions not expressing. Thus Qi ascending-descending-opening-closing pivot mechanism is unfavorable. Although *Neijing* has Xie, Zhe, Da, Fa, Duo, Five Stagnations' treatments, still worry difficult to achieve complete success. Thus *Shuwugulun* has starting rich ending poor, starting noble losing power, all belong to difficult-to-treat examples. Basically Stagnation Syndrome entirely depends on patient being able to shift emotion and change nature, physician conceiving cleverly. Not focusing on attacking-tonifying, but relying on using bitter to drain heat without damaging Stomach, using acrid to regulate Qi without breaking Qi, using slippery-moist to nourish dryness-astringency without clogging Qi mechanism, using unblocking without pulling seedlings to help growth. Perhaps there might be lucky success. (Hua Xiuyun)