天津骆××，年四十九岁，得脑充血兼痰厥证。
病因 平素常患头晕，间有疼时，久则精神渐似短少，言语渐形
謇涩，一日外出会友，饮食过度，归家因事有拂意，怒动肝火，陡然昏厥。
证候 闭目昏昏，呼之不应，喉间痰涎杜塞，气息微通。诊其脉左右皆弦硬而长，重
按有力，知其证不但痰厥实素有脑充血病也。
诊断 其平素头晕作疼，即脑充血之现证也。其司知觉之神经为脑充血所伤，是以精神短少。其
司运动之神经为脑充血所伤，是以言语謇涩。又凡脑充血之人，其脏腑之气多上逆，胃气逆则
饮食停积不能下行，肝气逆则痰火相并易于上干，此所以因饱食动怒而陡成痰厥也。此其危险即
在目前，取药无及当先以手术治之。
手术 治痰厥之手术，当以手指点其天突穴处（详见“治痰点天突穴法”），近八分钟许，即
咳嗽呕吐。约吐出痰涎饮食三碗许，豁然顿醒，自言心中发热，头目胀疼，此当继治其脑部充血以求全
愈。拟用建瓴汤方治之，因病脉之所宜而略为加减。
处方 生赭石（一两轧细） 怀牛膝（一两） 生怀地黄（一两） 天花粉（六钱）
生杭芍（六钱） 生龙骨（五钱捣碎） 生牡蛎（五钱捣碎） 生麦芽（三钱）
茵陈（钱半） 甘草（钱半）
磨取生铁锈浓水，以之煎药，煎汤一盅，温服下。
复诊 将药服三剂，心中已不发热，头疼目胀皆愈，惟步履之时觉头重足轻，脚底如踏棉絮。
其脉象较前和缓似有上盛下虚之象，爰即原方略为加减，再添滋补之品。
处方 生赭石（一两轧细） 怀牛膝（一两） 生怀地黄（一两） 大甘枸杞（八钱）
生杭芍（六钱） 净萸肉（六钱） 生龙骨（五钱捣碎） 生牡蛎（五钱捣碎）
柏子仁（五钱炒捣） 茵陈（钱半） 甘草（钱半）
磨取生铁锈浓水以之煎药，煎汤一大盅，温服。
效果 将药连服五剂，病遂脱然全愈。将赭石、牛膝、地黄皆改用八钱，俾多服数剂以善其后。
Tianjin resident Luo XX, aged forty-nine, suffered from cerebral congestion complicated by phlegm syncope.
Etiology He had been suffering from dizziness for a long time, with occasional pain. Over time, his spirit gradually became deficient, and his speech became increasingly slurred. One day, after visiting friends and overeating, he returned home where an unpleasant incident provoked anger and stirred up liver fire, causing him to suddenly faint.
Symptoms His eyes were closed in a stuporous state, and he did not respond when called. Phlegm and saliva obstructed his throat, and his breathing was faint but patent. Palpation of his pulse revealed that both left and right pulses were wiry, hard, and long, with strength upon heavy pressure. This indicated that the condition was not merely phlegm syncope, but rather that he had a pre-existing history of cerebral congestion.
Diagnosis His chronic dizziness and pain are manifestations of cerebral congestion. The nerves responsible for perception have been damaged by cerebral congestion, leading to mental deficiency. The nerves responsible for motor function have also been damaged, resulting in slurred speech. Furthermore, in cases of cerebral congestion, the qi of the zang-fu organs tends to rebel upward. When stomach qi rebels, food and drink stagnate and fail to descend; when liver qi rebels, phlegm and fire combine and easily ascend to disturb the head. This explains why sudden phlegm syncope occurred following overeating and anger. The danger is imminent, and obtaining herbs would take too long; therefore, surgical intervention should be employed first.
Surgical Intervention To treat phlegm syncope, one should use fingers to press the Tiantu (CV22) acupoint (see "Method for Treating Phlegm by Pressing Tiantu Acupoint") for approximately eight minutes, which induces coughing and vomiting. Approximately three bowls of phlegm, saliva, and food were vomited out, and he suddenly regained consciousness. He reported feeling heat in the chest and distending pain in the head and eyes. Subsequent treatment should target cerebral congestion to achieve a complete cure. It is proposed to use Jianling Decoction (Jianling Tang), slightly modified according to the indications of the disease and pulse.
Prescription Raw Hematitum (Shi Zhé Shí, 1 liang, finely crushed)
Raw Huai Dioscorea Rhizome / Radix Achyranthis Bidentata (Huái Niú Xī, 1 liang) [Note: Context implies Achyranthes]
Raw Raw Rehmannia Root (Shēng Huái Dì Huáng, 1 liang)
Trichosanthes Root (Tiān Huā Fěn, 6 qian)
Raw Hang Peony Root (Shēng Háng Sháo, 6 qian)
Raw Dragon Bone (Shēng Lóng Gǔ, 5 qian, crushed)
Raw Oyster Shell (Shēng Mǔ Lì, 5 qian, crushed)
Raw Barley Sprout (Shēng Mài Yá, 3 qian)
Artemisia Capillaris (Yīn Chén, 1.5 qian)
Licorice Root (Gān Cǎo, 1.5 qian)
Decoct the herbs using concentrated water from rust scraped from raw iron. Boil until one cup remains, and administer warm.
Follow-up Visit After taking three doses, the heat in the chest subsided, and the headache and eye distension resolved. However, while walking, he felt heaviness in the head and lightness in the feet, as if stepping on cotton. The pulse was more moderate than before, suggesting an excess in the upper jiao and deficiency in the lower jiao. Therefore, the original formula was slightly modified, and tonifying herbs were added.
Prescription Raw Hematitum (Shi Zhé Shí, 1 liang, finely crushed)
Raw Huai Dioscorea Rhizome / Radix Achyranthis Bidentata (Huái Niú Xī, 1 liang)
Raw Raw Rehmannia Root (Shēng Huái Dì Huáng, 1 liang)
Large Sweet Goji Berry (Dà Gān Gǒu Qǐ, 8 qian)
Raw Hang Peony Root (Shēng Háng Sháo, 6 qian)
Clean Cornus Fruit (Jìng Yú Ròu, 6 qian)
Raw Dragon Bone (Shēng Lóng Gǔ, 5 qian, crushed)
Raw Oyster Shell (Shēng Mǔ Lì, 5 qian, crushed)
Biota Seed (Bǎi Zǐ Rén, 5 qian, stir-fried and crushed)
Artemisia Capillaris (Yīn Chén, 1.5 qian)
Licorice Root (Gān Cǎo, 1.5 qian)
Decoct the herbs using concentrated water from rust scraped from raw iron. Boil until one large cup remains, and administer warm.
Outcome After continuously taking five doses, the illness was completely cured. The dosages of Hematitum, Achyranthes, and Rehmannia were reduced to 8 qian each, allowing for several additional doses to consolidate the recovery.