上方服一剂后，疼痛缓解。再剂，则阴囊松缓，睾丸回复。面目、唇舌青色俱退。手足回温，诸痛皆愈。唯阳神尚虚，照原方去川椒，加砂仁9克，连服二剂，精神、饮食均恢复正常。
寒 闭(误服蚕砂酒引发危证)
1924年2月，曾治一奇证，颇险。有姚姓之女，年十八岁，因上年患白喉证服寒凉药过多．以致信期不调，三、五月一至，时时“发痧”。此系阳虚血寒已极无疑。该女因天癸数月不至，用蚕砂二两泡酒服之，冀使通达，殊料服两小盏后，经亦未通，骤发危象。始延某医诊视，断言无救，未拟方而去。随即延余诊视之，六脉俱绝，唇爪俱黑，面目全身皆发青，牙关紧闭，用物拨开，见口舌亦青黑，四肢厥逆，不省人事，气喘欲脱。缘由体素虚寒，且服过量蚕砂酒，亦系寒凉之物，致成纯阴无阳之候，病情险恶。余始疑无救，然口中气息尚存，不忍坐视而归。若用他药，恐为时不及，急以上肉桂泡水灌之，偶咽下一、二口，觉气稍平。又速频频灌喂，喘息渐定，稍识人事，目珠偶动，呼之乃应。
继而复诊，脉仍不见应指。余思寻之，暴病无脉系闭，久病无脉乃绝。此乃暴病所致，肉桂强心温暖血分之寒，服之气机稍回，必有生机。约两小时方过，病者始能言语，言其周身麻木，腹中扭痛，忽而大泻酱黑稀便。再诊，脉隐隐欲现，色象稍转，气微喘，扶之以卧，试其舌，青黑冰指，乃以大剂回阳饮治之。
黄附片60克干姜20克上肉桂20克(研_束，泡水兑入)甘草10克
次日诊视，六脉俱回，轻取弦紧重按无力而空。唇舌青黑悉退，唯面部仍稍带青绿色，党头晕，体痛，腹中冷痛，喜滚饮。此阳气尚虚，里寒未净，宜击鼓直追，方能定夺。
继以上方加味治之，连服数剂，厥疾遂瘳。
天雄片60克 干姜12克 黑姜12克 上肉桂心1 0克(研末，泡水
兑入)桂尖12克炒吴萸6克半夏12克茯苓15克甘草6克经 闭
宋××，女，二十七岁，河南人，住昆明郊区呈贡飞机场。患者禀赋素弱，婚后多年未孕。初始月经参差不调，每月均需用中西药物调治，方能应期而潮。但每次行经，量少而黑，少腹坠胀冷痛。如是两三年后，经血渐少以至闭结。
76后又继用中、西药物治疗，并行人工周期法以诱导之，前后内服中药百余剂，均未获效，迄今已经闭六年之久。患者予1959年7月到云南中医学院附设门诊部就诊。证见患者面色萎黄不泽，神情倦怠，少气懒言，毛发稀疏而焦黄。自月经闭止以来，常感头昏耳鸣，心中烦闷。日间困倦思睡，入夜又不能安眠。口淡无味，不思饮食。腰膂酸痛，腿膝酸软无力，手足厥逆，少腹亦感冰冷不适。脉象沉瀒，舌质淡嫩，色黯夹瘀，苔薄自而润。此系元阳不足，冲任俱虚，血寒气滞，胞宫寒冷所致。阳虚生寒，气虚易滞，血寒则凝。血寒气虚，瘀滞难行，百脉不荣，经血无源，故而闭止，亦不孕育。故当温扶下元，温经活血，散寒暖宫。自拟验方益元暖官汤治之。
附片100克 当归15克 丹参15克 桂枝12克 吴萸9克 炙
香附12克 细辛6克．赤芍9克 炒艾叶12克 干姜15克
甘草9克
服上方三剂后复诊，腹部疼痛减去七、八，少腹冰冷感觉减轻，尚有坠胀感。食思增进，手足四肢回温，心中已不烦闷，夜已能熟寐。脉仍沉瀒，舌质淡，瘀黯稍减，苔薄白。
继上方温化之剂加红花5克以助温经活血之功，并嘱服药时滴酒少许为引，以促其温行血脉之效。告知患者，如服药后诸证均见好转，惟腰及少腹又复酸胀痛者，为月经欲潮之兆，幸勿疑误。
上方连服八剂，果如余言。于原方中去赤芍加川芎9克，阿胶15克(烊化兑服)药炉不辍连服五剂，经水即潮，先行者为黑色血块，继则渐红。次日，腰腹疼痛随之缓解，行经五日而净。继以八珍汤加香附、益母、炒艾等调补气血。
连服十余剂后，面色毛发润泽，精神眠食转佳。其后经信通调，应时而潮，一年后顺产一子．经行血崩
杨××，女，四十一岁，住昆明市正义南路教子巷。
1953年秋，适值月经来潮，因抬重物用力过猛，骤然下血如崩。先后经二医诊治，皆云血热妄行，服用清热，凉血、止血之剂，血未能止，迁延十余日，以致卧床不起，延余诊治。
患者面色蜡黄、精神疲倦，气短而懒言，不思饮食，手足不温。经血仍淋漓不断，时而如潮涌出，皆清淡血水兼夹紫黑血块，腰及小腹酸胀坠痛。舌质淡，苔薄白少津，脉沉瀒。
此乃阳气内虚，冲任不守，气不纳血，血海不固，致成崩漏之证。方用回阳饮加人参扶阳固气。
附片120克吉林红参9克炮黑姜9克上肉桂9克(研末，
泡水兑入) 甘草9克
服二剂后，流血减少其半，血色淡红，瘀块减少，呼吸已转平和，四肢回温。饮食稍增，能进藕粉少许。照原方加炒艾15克，阿胶24克(烊化分次兑服)，炒白术9克，侧柏炭9克。连服三剂后，流血大减，仅为少量淡红血水，精神饮食增加，面色已转润泽，舌质显红润，苔薄白，脉缓弱，已能起床。阳气回复，气血渐充，欲求巩固，仍须与甘温之剂调补之。以四逆当归补血汤加味气血两补。
附片90克口芪60克当归30克干姜15克上肉桂12克(研末，
泡水兑入) 炒艾15克 阿胶12克(烊化，分次兑服) 甘草9克
连服五剂，流血全止，精神、饮食基本恢复，颜面唇舌已转红润，脉象和缓，已能下床活动。惟气血未足，阳神尚虚，走动稍感头昏、腿软，继服四逆当归补血汤加上肉桂、砂仁，服二十余剂，气血恢复，诸证获愈，恢复健康。
经行血崩及口鼻出血不止
过××之妻，年三十五岁，湖南籍，住昆明市东庄九十九号，素患经痛不调，经某医诊治，拟方以破气行瘀之法，方中配伍桃仁、红花、三棱、文术、川芎、当归等，并嘱可作常服，冀使经信通调。如是方药已服十年有余，攻破太过，致气血大伤。1961年6月下旬，因打骂小孩动气生怒，忽然经行血崩不止，急往某医院就诊，经治数日，子宫仍出血未止，又复鼻衄频仍及牙龈出血，身发紫斑，病势日重。
7月1日，家属主动抬出医院改请某中医诊治。医者立案为“血不归经之侯”，拟方二帖：内服以酒炒生地50克，酥炒侧柏叶30克，艾叶30克，炒杭芍30克，浙寸冬30克，姜炭30克，藕节二个，生草20克，点童便少许并加发灰为引，嘱服二剂。
外治用附子面100克，酒炒，包足心涌泉穴。殊料服药一次，上、下出血更甚，呻吟不已，气短欲脱，举家惶恐万状。7月2日清晨来舍促余急诊，见患者面色淡黄晦黯无华，唇舌亦淡白，苔白滑，唇、舌、口腔内两颊粘膜均有大小不匀之紫黑血泡，舌心血泡一枚，约拇指头大，鼻及牙龈仍见出血，色黯红不鲜，用物填塞鼻孔，则血块阻于咽喉，渐从口中咳吐而出，亦为紫黑血块及血水。四肢及胸背皮肤起青紫血斑，神情淡漠、声低息短，呻吟不已，但觉心中慌跳，气虚难接。日不思食，夜不能寐，唯少喜热饮一、二日。六脉芤虚，重按若无。缘由攻破太过，气血两亏，气虚无力摄血，阳不守阴，血虚则气无所依，阴不恋阳，以致血不归经，游溢妄行，气随血耗，散漫无羁。如继续流血不止，恐血尽气亡，阴阳俱脱。盖气血两亏失血之证，当以治气为先，气足则血自能止，血止之后，方能言补益之法。当此证候，余主以扶阳收纳，固气止血，方用：
黑天雄150克炮黑姜30克 黑荆芥6克上肉桂15克(研末，泡
水兑入) 茯神20克桂尖30克 甘草6克 大枣2被(烧黑存性)
7月3日复诊。服上方后已见效，出血减少。然气血太亏，一时难以尽复，口鼻及下部仍流出淡黑血水，心泛呕逆，仍不思饮食，神志尚弱。由于气血所亏，原患寒湿痹痛旧疾又复发，左手肩臂疼痛。照上方佐以温经散寒之剂治之。
附片200克 炮黑姜10克干姜10克上肉桂15克(研末，泡水兑
入)西砂仁10克桂尖20克北细辛6克吴萸5克甘草10克
7月4日三诊。脉象较有神根，各部出血减少十之八、九，唇舌转红润，口舌血泡已瘪，昨夜得熟寐。小便转长，喜热饮，稍能进食。惟头部昏重作痛，左肩臂筋肉仍痛，然病势已见大减，渐可转危为安。处方：
附片200克 炮黑姜10克 干姜15克 上肉桂15克(研末，泡水
兑入) 桂尖30克 北细辛7克 法夏15克 公丁5克 甘
草10克 麻黄根10克
7月6日四诊。上方连进二付，口鼻出血已止，口舌紫黑血泡全退。舌质红润，苔尚薄白，下部仍稍流黑血，极腥臭。此系已离经败坏之血，得阳药温化而下行，非新出之血液也。腑气已通，数日以来始有大便，色黑而干。精神、食量均较佳，脉已和缓较有神，惟左臂仍稍掣痛，延及左侧头项，再以扶阳温化通经散寒治之。
附片200克干姜50克 北细辛10克 桂尖50兑 羌活5克
独活6克 苡仁15克 麻黄5克 上肉桂15克(研末，泡水兑入)
甘草15克
7月8日五诊。病状大减，头疼止，肩臂痛已大为减轻，遂照原方去麻黄，服二剂后，诸证已愈。再以四逆汤加口芪、当归、白术、苡仁数剂调理而善后。
妊娠胎漏
(先兆流产)
范××之妻，年二十八岁，四州省会理县人。身孕六月，某日因家务不慎，忽而跌仆，遂漏下渐如崩状，腰及少腹坠痛难忍，卧床不起。因其夫公务未归，无资以疗，延至六、七日，仍漏欲堕。余往诊之，气血大伤，胎恐难保，惟幸孕脉尚在，以大补气血，扶阳益气引血归经为治，纵虽胎堕，可保产母无损矣。拟方四逆当归补血汤加昧治之。
附片100克 北口芪60克 当归身24克 阿胶12克(烊化兑入)
炙艾叶6克 炙甘草10克 大枣5枚(烧黑存性)
服一剂，漏止其半，再剂则全止，三剂霍然，胎亦保住，至足月而举一子，母子均安。
按：附子补坎中一阳，助少火而生气，阳气上升，胎气始固。芪术补中土之气，脾气健运，则能统摄血液以归其经，入当归、阿胶以资既伤之血。艾、附相伍，能温暖下元以止腰腹之疼痛。姜、枣烧黑、取其温经止血，且烧黑变苦，得甘草之甘以济之，苦甘化阴，阴血得生。阳气温升，阴血能朴，则胎不堕矣。
《内经》云：“治病必求其本。”本固而标自立矣，若只以止血为主，而不急固其气，则气散不能速回，其血何由而止？1半产 血 崩
(流产失血)
方××夫人，年三十五岁，罗平县人，住云南省昆明市红栅子十号，素患半产。1923年5月12日，孕五月又堕。初起腰腹坠痛，继则见红胎堕，血崩盈盆成块，小腹扭痛，心慌目眩，气喘欲脱，脉芤虚无力，两寸且短。唇淡红，舌苔 白滑，舌质夹青乌。据其夫云，是晚曾昏绝二次。由于素患半产，肾气大亏，气虚下陷，无力摄血，阳气有随血下脱之势。以气生予肾，统于肺，今肺肾之气不相接，故气喘欲一脱。拟四逆当归补血汤加枣艾治之。方中四逆汤扶阳收纳，启坎阳上升，佐以口芪、当归，补中益气而生过伤之血，干姜、艾、枣制黑，能温血分之寒，引血归经。
黑附片160克 炮黑姜50克 炙甘草24克 北口苠60克 当
归26克 蕲艾6克(炒黑存性) 大枣5枚(烧黑存性)
13日服一剂后，血崩止，气喘平，病状已去六、七，精神稍增。仍守原方，14日次剂服完，证遂全瘳。
产后失血
苏××，女，三十五岁，住昆明某医院妇产科。分娩第三胎，产后子宫收缩无力，遂致流血不止。经医院施以针药及输血治疗，出血仍不见终止。病已三日，病势日趋危重，于1952年某日邀余前往会诊。患者卧床，已人事不省，面色苍白，目眶凹陷，形容憔悴，呼吸微弱，唇干色淡。掰开口唇，见齿枯舌淡而少津，脉细弱沉伏欲绝，手足冰冷。阴道流血仍未止，色淡而清，浸透垫褥。此系阳弱气虚，气不摄血，血不归经所致。患者失血过多，气血两亏，病势沉重，危在旦夕。若继续出廊，恐有气随血脱之虑。补血及输血之法，固属必要，然已虚之阳无力摄血，无力生血，血亦不能归经循行。此证急当扶阳益气，方能止血固脱。拟大剂回阳饮加味主之。
附片120克 炮黑姜15克 上肉桂15克(研末，泡水兑入) 口
芪30克 当归15克 炒艾9克 炙甘草9克
因病情较重，嘱早晚各煎服一剂，多次徐徐喂之。
次日复诊。昨日方药浓煎频频喂服，服后，今日流血已减其半，神识恢复，能饮葡萄糖水二、三口，呼吸稍觉平稳，手足开始回温。唇、舌仍淡，脉沉细弱，已不似昨日欲绝之状。此阳气已回，有望生机。继上方加阿胶珠9克，炒白术9克连服五剂，流血已止，神识清明、面色渐润，并能背靠床头坐卧，进牛奶及半流汁饮食。惟气血尚虚，阳神尚弱，久坐则感头昏无力，夜寐多梦，气短心慌，声低懒言。舌质已稍现红润色，脉沉细而缓，两尺较弱。拟四逆汤加味治之。
附片90克 干姜12克 砂仁9克 口芪24克 白术15克 茯
苓15克补骨脂12克甘草3克
After taking one dose of the above prescription, the pain was relieved. After another dose, the scrotum became loose and relaxed, and the testes returned to their normal position. The bluish discoloration of the face, eyes, lips, and tongue completely subsided. The hands and feet warmed up, and all pains were cured. Only the Yang spirit remained deficient. Following the original formula, Sichuan Pepper (Chuanjiao) was removed, and Amomum Fruit (Sharen) 9g was added. After taking two consecutive doses, both spirit and diet returned to normal.
Cold Obstruction (Critical condition caused by mistakenly consuming Silkworm Sand Wine)
In February 1924, I treated a rare and dangerous case. An eighteen-year-old woman surnamed Yao had suffered from excessive intake of cold-natured medicines for laryngeal diphtheria the previous year. This resulted in irregular menstruation, occurring only once every three to five months, accompanied by frequent episodes of "Sha syndrome" (a condition characterized by sudden onset of symptoms like abdominal pain, vomiting, or fainting due to pathogenic factors). This was undoubtedly an extreme case of Yang deficiency and Blood cold. Because her menses had been absent for several months, she consumed two taels of Silkworm Sand (Cansha) soaked in wine, hoping to promote circulation. Unexpectedly, after drinking two small cups, her menstruation did not start, but instead, she suddenly developed critical symptoms. Initially, another physician examined her, declared her incurable, left without prescribing any medicine, and departed. I was then consulted. Her six pulses were imperceptible, lips and nails were black, and her entire body, including face and eyes, was blue-green. Her jaw was tightly clenched; when pried open with an object, her mouth and tongue were also seen to be blue-black. Her limbs were cold and inverted (Jue), and she was unconscious, panting as if about to collapse. The cause was her constitutionally deficient and cold nature, compounded by the excessive intake of Silkworm Sand wine, which is also a cold-natured substance, leading to a state of pure Yin without Yang. The condition was perilous. I initially doubted she could be saved, but since breath still lingered, I could not bear to leave her to die. Using other medicines might have been too slow. Urgently, I prepared Cinnamon Twig (Rougui) soaked in water and administered it. She managed to swallow one or two mouthfuls, and her breathing slightly stabilized. I rapidly and frequently continued administering it. Her panting gradually settled, she regained slight consciousness, her eyeballs occasionally moved, and she responded to calls.
Upon follow-up examination, the pulse remained imperceptible. I pondered: in acute diseases, absence of pulse indicates obstruction; in chronic diseases, it indicates exhaustion. This was an acute condition. Cinnamon Twig strengthens the heart and warms the cold in the Blood aspect. Since Qi mechanism had slightly recovered after ingestion, there must be vitality. About two hours later, the patient began to speak, complaining of numbness throughout the body and twisting pain in the abdomen, followed by sudden passage of dark brown, watery diarrhea. Upon re-examination, the pulse was faintly appearing, complexion slightly improved, breathing was slightly short. Supporting her to lie down, I tested her tongue; it was blue-black and ice-cold to the touch. Therefore, I prescribed a large dose of Huayang Yin (Return Yang Decoction).
Radix Aconiti Lateralis Preparata (Huang Fupian) 60g, Rhizoma Zingiberis (Ganjiang) 20g, Cortex Cinnamomi Cassiae (Shang Rougui) 20g (powdered, soaked in water and mixed in), Radix Glycyrrhizae (Gancao) 10g.
The next day, all six pulses had returned. Light pressure revealed wiry and tight qualities, while heavy pressure felt weak and empty. The blue-black discoloration of lips and tongue had completely faded, except for a slight greenish hue on the face. She complained of dizziness, body pain, and cold pain in the abdomen, preferring hot drinks. This indicated that Yang Qi was still deficient and interior cold had not been fully cleared. It was necessary to press the advantage to achieve a decisive cure.
Continuing with the modified formula, after several doses, the stubborn disease was cured.
Radix Aconiti Lateralis Preparata (Tianxiong Pian) 60g, Rhizoma Zingiberis (Ganjiang) 12g, Rhizoma Zingiberis Preparatum (Hei Jiang) 12g, Cortex Cinnamomi Cassiae Cordis (Shang Rouguixin) 10g (powdered, soaked in water and mixed in), Apex Ramuli Cinnamomi (Guijian) 12g, Fructus Evodiae Preparatus (Chao Wuyu) 6g, Rhizoma Pinelliae (Banxia) 12g, Poria (Fuling) 15g, Radix Glycyrrhizae (Gancao) 6g.
Amenorrhea
Ms. Song XX, female, 27 years old, from Henan Province, residing near the Chenggong Airport in Kunming suburbs. The patient had a constitutionally weak endowment and had been infertile for many years after marriage. Initially, menstruation was irregular, requiring Chinese and Western medications monthly to induce flow. However, each period was scanty, dark, and accompanied by bearing-down cold pain in the lower abdomen. After two or three years, menstrual blood decreased until amenorrhea occurred.
Subsequent treatments with Chinese and Western medicines, including artificial cycle therapy, failed over more than a hundred doses of Chinese herbal medicine. Amenorrhea persisted for six years. In July 1959, she visited the outpatient department affiliated with Yunnan College of Traditional Chinese Medicine. Signs included sallow and lusterless complexion, fatigue, shortness of breath and reluctance to speak, sparse and brittle yellow hair. Since amenorrhea, she experienced dizziness, tinnitus, and mental restlessness. Daytime sleepiness contrasted with nighttime insomnia. Taste was bland, appetite poor. Soreness and pain in the lower back, weakness in knees and legs, cold extremities, and cold discomfort in the lower abdomen. Pulse was deep and choppy (Chen Se); tongue was pale and tender, dark with stasis signs, coated with thin white moist coating. This was due to insufficiency of Primordial Yang, deficiency of Chong and Ren meridians, Cold stagnation in Blood, and cold uterus. Yang deficiency generates cold; Qi deficiency leads to stagnation; Blood cold causes coagulation. With Cold-Blood and Qi-deficiency, stasis is difficult to move, vessels are un-nourished, source of menstrual blood is lacking, hence amenorrhea and infertility. Treatment should warm and support the Lower Yuan, warm meridians and invigorate Blood, dispel cold and warm the uterus. I formulated my own verified prescription, Yiyuan Nuangong Tang (Benefit Primordial Warm Uterus Decoction).
Radix Aconiti Lateralis Preparata (Fupian) 100g, Radix Angelicae Sinensis (Danggui) 15g, Salvia Miltiorrhiza Root (Danshen) 15g, Ramulus Cinnamomi (Guizhi) 12g, Fructus Evodiae (Wuyu) 9g, Prepared Rhizoma Cyperi (Zhixiangfu) 12g, Radix Asari (Xixin) 6g, Radix Paeoniae Rubra (Chishao) 9g, Folium Artemisiae Argyi Preparatum (Chao Aiye) 12g, Rhizoma Zingiberis (Ganjiang) 15g, Radix Glycyrrhizae (Gancao) 9g.
After three doses, abdominal pain reduced by 70-80%, cold sensation in lower abdomen lessened, though bearing-down feeling remained. Appetite increased, extremities warmed, mental restlessness ceased, and night sleep improved. Pulse remained deep and choppy; tongue pale, stasis signs slightly reduced, coating thin white.
Continuing the warming and transforming formula, adding Carthamus Flower (Honghua) 5g to assist warming meridians and invigorating Blood. Patients were instructed to add a few drops of wine during administration to promote warming and moving effects of Blood vessels. I informed the patient that if symptoms improved but soreness/pain returned in waist and lower abdomen, it would indicate impending menstruation, and she should not doubt this sign.
After eight doses, as predicted. Red Peony Root (Chishao) was removed from the original formula, and Ligusticum Rhizome (Chuanxiong) 9g and Donkey-Hide Gelatin (Ejiao) 15g (melted and mixed in) were added. Continuous decoction for five doses led to menstruation onset. Initial discharge was dark blood clots, gradually turning red. Next day, waist and abdominal pain alleviated, lasting five days. Subsequently, Bazhen Tang (Eight Treasures Decoction) plus Cyperi Rhizome (Xiangfu), Motherwort Herb (Yimucao), and Prepared Mugwort Leaf (Chao Ai) were used to tonify Qi and Blood.
After ten-plus doses, complexion and hair became lustrous, spirit, sleep, and diet improved. Menstruation became regular and timely. One year later, she gave birth to a healthy son via normal delivery.
Menstrual Hemorrhage (Metrorrhagia)
Ms. Yang XX, female, 41 years old, residing at Jiaozixiang, Zhengyi South Road, Kunming City.
In Autumn 1953, during menstruation, heavy lifting caused sudden severe bleeding (metrorrhagia). Two physicians diagnosed "Blood Heat forcing reckless movement," prescribing heat-clearing, blood-cooling, and hemostatic agents. Bleeding did not stop, persisting for over ten days, leaving her bedridden. I was consulted.
Patient presented with waxy yellow complexion, fatigue, shortness of breath, reluctance to speak, poor appetite, and cold extremities. Vaginal bleeding continued intermittently, sometimes gushing like a tide, consisting of clear bloody fluid mixed with purple-black clots. Soreness, distension, and pain in waist and lower abdomen. Tongue pale, coating thin white with little moisture. Pulse deep and choppy.
This was internal Yang deficiency, failure of Chong and Ren to secure, Qi failing to contain Blood, and instability of the Sea of Blood, resulting in metrorrhagia. Formula: Huayang Yin (Return Yang Decoction) plus Ginseng to support Yang and consolidate Qi.
Radix Aconiti Lateralis Preparata (Fupian) 120g, Radix Panax Ginseng (Jilin Hongshen) 9g, Prepared Rhizoma Zingiberis (Pao Hei Jiang) 9g, Cortex Cinnamomi Cassiae (Shang Rougui) 9g (powdered, soaked in water and mixed in), Radix Glycyrrhizae (Gancao) 9g.
After two doses, bleeding reduced by half, color turned light red, clots decreased, breathing normalized, extremities warmed. Diet slightly increased, able to consume some lotus root starch. Original formula modified with Prepared Mugwort Leaf (Chao Ai) 15g, Donkey-Hide Gelatin (Ejiao) 24g (melted and mixed in portions), Prepared Atractylodes Macrocephala Rhizome (Chao Baizhu) 9g, and Carbonized Platycladi Seed (Ce Bai Tan) 9g. After three doses, bleeding significantly reduced to small amounts of light red bloody fluid. Spirit and diet improved, complexion lustrous, tongue reddish, coating thin white, pulse moderate and weak. Able to get out of bed. Yang recovered, Qi and Blood gradually replenished. For consolidation, sweet-warm tonifying agents were needed. Si Ni Dang Gui Bu Xue Tang (Si Ni Decoction plus Danggui Bu Xue Decoction) modified for dual tonification of Qi and Blood.
Radix Aconiti Lateralis Preparata (Fupian) 90g, Radix Astragali (Huangqi) 60g, Radix Angelicae Sinensis (Danggui) 30g, Rhizoma Zingiberis (Ganjiang) 15g, Cortex Cinnamomi Cassiae (Shang Rougui) 12g (powdered, soaked in water and mixed in), Prepared Mugwort Leaf (Chao Ai) 15g, Donkey-Hide Gelatin (Ejiao) 12g (melted and mixed in portions), Radix Glycyrrhizae (Gancao) 9g.
After five doses, bleeding stopped completely. Spirit and diet basically recovered, face/lips/tongue reddish, pulse harmonious. Able to walk. Qi and Blood still insufficient, Yang spirit still weak, causing dizziness and leg weakness upon walking. Continued Si Ni Dang Gui Bu Xue Tang plus Cinnamon Twig (Rougui) and Amomum Fruit (Sharen). After twenty-plus doses, Qi and Blood restored, all symptoms resolved, health recovered.
Menstrual Hemorrhage and Unceasing Oral/Nasal Bleeding
Wife of Mr. Guo XX, 35 years old, from Hunan, residing at No. 99 Dongzhuang, Kunming. Suffered from painful irregular menstruation. Treated by another doctor who prescribed Qi-breaking and Blood-invigorating methods containing Peach Kernel (Taoren), Carthamus Flower (Honghua), Rhizoma Sparganii (Sanleng), Rhizoma Curcumae (Ezhu), Ligusticum Rhizome (Chuanxiong), and Radix Angelicae Sinensis (Danggui), advised for long-term use to regulate menstruation. Taken for over ten years, excessive breaking and reducing severely damaged Qi and Blood. Late June 1961, anger from scolding children triggered sudden severe menstrual hemorrhage. Hospital treatment for several days failed to stop uterine bleeding. Frequent epistaxis and gingival bleeding ensued, with purple spots on body. Condition worsened daily.
On July 1, family discharged her from hospital and sought another TCM practitioner. Diagnosed as "Blood failing to return to its vessels." Prescribed two doses internally: Wine-fried Rehmannia Root (Jiu Chao Shengdi) 50g, Butter-fried Platycladi Leaf (Su Chao Ce Bai Ye) 30g, Mugwort Leaf (Ai Ye) 30g, Fried White Peony Root (Chao Hangshao) 30g, Zhejiang Ophiopogon Tuber (Zhe Cun Dong) 30g, Charred Ginger (Jiang Tan) 30g, Two Lotus Node Stems (Ou Jie), Raw Licorice Root (Sheng Cao) 20g, a few drops of fresh human urine (Tong Bian) and Hair Ash (Fa Hui) as guides. Externally, Aconite Powder (Fuzi Mian) 100g, wine-fried, applied to Yongquan (KI1) on soles. After one dose, upper and lower bleeding worsened, groaning incessantly, shortness of breath approaching collapse. Family panicked. Early morning July 2, they urged emergency consultation. Patient had dull yellow-dark complexion, pale lips/tongue, white slippery coating. Uneven purple-black blood blisters on lips, tongue, and buccal mucosa. One large blood blister on sublingual vein, thumb-sized. Epistaxis and gingival bleeding continued, dark red. Nasal packing blocked throat with blood clots, coughed up as purple-black clots and bloody fluid. Purple-blue blood spots on limbs, chest, back. Expression indifferent, voice low, short breath, groaning. Palpitations, Qi deficiency unable to connect. Poor appetite, insomnia, preference for hot drinks. Six pulses were hollow (Kou) and deficient, vanishing under heavy pressure. Cause: excessive breaking/reducing over years led to severe Qi/Blood deficiency. Qi deficiency unable to control Blood; Yang fails to guard Yin; Blood deficiency leaves Qi unsupported; Yin fails to retain Yang. Thus, Blood fails to return to vessels, flows recklessly, Qi dissipates with Blood loss. If bleeding continues, fear of Blood exhaustion and Qi death, simultaneous collapse of Yin and Yang. In cases of Qi/Blood deficiency with hemorrhage, treating Qi is priority. Sufficient Qi stops Blood naturally; only after stopping can tonification be discussed. At this stage, I prioritized supporting Yang, gathering, consolidating Qi, and stopping bleeding. Formula:
Black Tianxiong (Hei Tianxiong) 150g, Prepared Black Ginger (Pao Hei Jiang) 30g, Black Schizonepeta Spike (Hei Jingjie) 6g, Cortex Cinnamomi Cassiae (Shang Rougui) 15g (powdered, soaked in water and mixed in), Spirit of Poria (Fushen) 20g, Apex Ramuli Cinnamomi (Guijian) 30g, Radix Glycyrrhizae (Gancao) 6g, Two Dates (Dazao) 2 pieces (charred retaining nature).
July 3 Follow-up. Effective after first dose, bleeding reduced. However, Qi/Blood too deficient for quick recovery. Pale black bloody fluid still flowing from mouth/nose/lower body. Nausea, no appetite, weak consciousness. Due to Qi/Blood deficiency, old rheumatic pain from Cold-Damp recurred, causing left shoulder/arm pain. Modified formula with warming meridians and dispelling cold agents.
Radix Aconiti Lateralis Preparata (Fupian) 200g, Prepared Black Ginger (Pao Hei Jiang) 10g, Rhizoma Zingiberis (Ganjiang) 10g, Cortex Cinnamomi Cassiae (Shang Rougui) 15g (powdered, soaked in water and mixed in), Western Amomum Fruit (Xi Sharen) 10g, Apex Ramuli Cinnamomi (Guijian) 20g, Northern Asari Root (Bei Xixin) 6g, Fructus Evodiae (Wuyu) 5g, Radix Glycyrrhizae (Gancao) 10g.
July 4 Third visit. Pulse showed better root and spirit. Bleeding from various sites reduced by 80-90%. Lips/tongue reddish, oral blisters collapsed. Slept well last night. Urination increased, preferred hot drinks, slight food intake. Head heavy/painful, left shoulder/arm muscle pain persisted, but condition greatly reduced, turning from critical to stable. Prescription:
Radix Aconiti Lateralis Preparata (Fupian) 200g, Prepared Black Ginger (Pao Hei Jiang) 10g, Rhizoma Zingiberis (Ganjiang) 15g, Cortex Cinnamomi Cassiae (Shang Rougui) 15g (powdered, soaked in water and mixed in), Apex Ramuli Cinnamomi (Guijian) 30g, Northern Asari Root (Bei Xixin) 7g, Processed Pinellia Tuber (Faxia) 15g, Clove (Gongding) 5g, Radix Glycyrrhizae (Gancao) 10g, Ephedra Root (Mahuanggen) 10g.
July 6 Fourth visit. Two doses taken. Oral/nasal bleeding stopped, oral purple-black blisters resolved. Tongue reddish, coating thin white. Lower body still slightly discharging black blood, extremely foul-smelling. This is off-vessel degraded Blood, warmed and transformed by Yang herbs to exit downward, not new bleeding. Bowel function restored, first bowel movement in days, black and dry. Spirit/appetite good, pulse harmonious/spirited. Left arm still slightly twitching pain radiating to left head/neck. Continue supporting Yang, warming, transforming, unblocking meridians, dispelling cold.
Radix Aconiti Lateralis Preparata (Fupian) 200g, Rhizoma Zingiberis (Ganjiang) 50g, Northern Asari Root (Bei Xixin) 10g, Apex Ramuli Cinnamomi (Guijian) 50g, Notopterygium Rhizome (Qianghuo) 5g, Angelica Pubescens Root (Duhuo) 6g, Coix Seed (Yiren) 15g, Ephedra Herb (Mahuang) 5g, Cortex Cinnamomi Cassiae (Shang Rougui) 15g (powdered, soaked in water and mixed in), Radix Glycyrrhizae (Gancao) 15g.
July 8 Fifth visit. Symptoms greatly reduced, headache stopped, shoulder/arm pain significantly alleviated. Removed Ephedra (Mahuang) from original formula, took two doses, all symptoms cured. Followed up with Si Ni Tang plus Astragalus (Huangqi), Angelica (Danggui), Atractylodes (Baizhu), Coix Seed (Yiren) for several doses to consolidate.
Pregnancy Fetal Leakage (Threatened Abortion)
Wife of Mr. Fan XX, 28 years old, from Lilí County, Sichuan Provincial Capital. Pregnant six months. Accidental fall during housework caused gradual leakage resembling metrorrhagia, unbearable bearing-down pain in waist and lower abdomen, bedridden. Husband away on business, lack of funds delayed treatment for 6-7 days. Still leaking, threatened miscarriage. I consulted. Qi/Blood severely damaged, fetus likely lost. Fortunately, pregnancy pulse remained. Treatment: Greatly tonify Qi/Blood, support Yang, boost Qi, guide Blood back to vessels. Even if miscarriage occurs, mother will be safe. Formula: Si Ni Dang Gui Bu Xue Tang modified.
Radix Aconiti Lateralis Preparata (Fupian) 100g, Northern Astragalus Root (Bei Huangqi) 60g, Radix Angelicae Sinensis Body (Danggui Shen) 24g, Donkey-Hide Gelatin (Ejiao) 12g (melted and mixed in), Prepared Mugwort Leaf (Zhi Aiye) 6g, Prepared Licorice Root (Zhi Gancao) 10g, Five Dates (Dazao) 5 pieces (charred retaining nature).
One dose: leakage reduced by half. Second dose: stopped completely. Third dose: rapid recovery, fetus preserved. Delivered full-term healthy son, mother and child safe.
Note: Aconite tonifies the single Yang within Kan (Kidney), assists Minor Fire to generate Qi. Rising Yang Qi stabilizes fetal Qi. Astragalus and Atractylodes tonify Middle Earth Qi. Healthy Spleen Qi controls Blood returning to vessels. Angelica and Donkey-Hide Gelatin nourish damaged Blood. Mugwort and Aconite together warm Lower Yuan, stopping waist/abdominal pain. Charred Ginger and Dates warm meridians and stop bleeding; charring turns them bitter. Combined with Licorice's sweetness, Bitter-Sweet transforms into Yin, generating Yin Blood. Rising Yang warmth allows Yin Blood to anchor, preventing miscarriage.
*Neijing* states: "Treating disease must seek its root." When root is solid, branch resolves. If only focusing on stopping bleeding without urgently consolidating Qi, Qi disperses and cannot return quickly, how can Blood stop?
Half-Abortion Hemorrhage (Miscarriage Hemorrhage)
Mrs. Fang XX, 35 years old, from Luoping County, residing at No. 10 Hongzhazi, Kunming, Yunnan. History of habitual abortion (half-abortion). On May 12, 1923, miscarried at five months pregnancy. Initially waist/abdominal bearing-down pain, then red discharge, fetus expelled, hemorrhage filling basin with clots, twisting lower abdominal pain, palpitations, dizziness, panting approaching collapse. Pulse hollow, deficient, weak, short at both Cun positions. Lips light red, coating white slippery, tongue body dark blue-purple. Husband reported two fainting episodes that night. Due to history of habitual abortion, Kidney Qi severely depleted. Qi deficiency sinking, unable to control Blood. Yang Qi has tendency to collapse downward with Blood. Qi originates in Kidney, governed by Lung. Now Lung-Kidney Qi disconnected, hence panting approaching collapse. Formula: Si Ni Dang Gui Bu Xue Tang plus Jujube and Mugwort. Si Ni Tang supports Yang and gathers, raising Kan Yang. Assisted by Astragalus and Angelica to tonify Middle, boost Qi, and generate severely damaged Blood. Charred Ginger, Mugwort, and Jujube warm Blood aspect, guiding Blood back to vessels.
Black Prepared Aconite Slice (Hei Fupian) 160g, Prepared Black Ginger (Pao Hei Jiang) 50g, Prepared Licorice Root (Zhi Gancao) 24g, Northern Astragalus Root (Bei Huangqi) 60g, Radix Angelicae Sinensis (Danggui) 26g, Qichuan Mugwort (Qi Ai) 6g (stir-fried black retaining nature), Five Dates (Dazao) 5 pieces (charred retaining nature).
13th: After one dose, hemorrhage stopped, panting calmed, symptoms resolved 60-70%, spirit slightly improved. Maintained original formula. 14th: After second dose, condition completely cured.
Postpartum Hemorrhage
Ms. Su XX, female, 35 years old, residing at Obstetrics/Gynecology Dept, Kunming Hospital. Third delivery. Postpartum uterine inertia caused unceasing bleeding. Hospital needle/drug therapy and blood transfusion failed to stop bleeding. Ill for three days, condition critically worsening. Invited me to consult on a certain day in 1952. Patient bedridden, unconscious, pale complexion, sunken eye sockets, emaciated, weak respiration, dry pale lips. Opening lips revealed withered teeth, pale tongue with little moisture. Pulse fine, weak, deep, hidden, approaching extinction. Cold extremities. Vaginal bleeding continued, pale and clear, soaking bedding. This was weak Yang and Qi deficiency, Qi unable to control Blood, Blood failing to return to vessels. Massive blood loss led to Qi/Blood dual deficiency, critical condition, imminent danger. Continued bleeding risks Qi collapsing with Blood. While blood tonification/transfusion is necessary, deficient Yang lacks power to control/generate Blood, so Blood cannot circulate properly. Urgent treatment requires supporting Yang and boosting Qi to stop bleeding and prevent collapse. Large dose Huayang Yin (Return Yang Decoction) modified.
Radix Aconiti Lateralis Preparata (Fupian) 120g, Prepared Black Ginger (Pao Hei Jiang) 15g, Cortex Cinnamomi Cassiae (Shang Rougui) 15g (powdered, soaked in water and mixed in), Astragalus Root (Huangqi) 30g, Radix Angelicae Sinensis (Danggui) 15g, Stir-fried Mugwort Leaf (Chao Ai) 9g, Prepared Licorice Root (Zhi Gancao) 9g.
Due to severity, instructed to decoct and administer one dose morning and evening, feeding slowly multiple times.
Next day follow-up. Strong decoction fed frequently. Bleeding reduced by half today. Consciousness recovered, able to drink 2-3 mouthfuls glucose water. Breathing slightly stable, extremities warming. Lips/tongue still pale, pulse deep/fine/weak, no longer approaching extinction as yesterday. Yang has returned, hope for vitality. Added Fried Atractylodes Macrocephala Rhizome (Chao Baizhu) 9g and Fried Donkey-Hide Gelatin Bead (Ejiao Zhu) 9g to original formula. Five doses continuous. Bleeding stopped, consciousness clear, complexion moist. Able to sit propped against headboard, consuming milk and semi-liquid diet. Qi/Blood still deficient, Yang spirit weak. Dizziness/weakness after prolonged sitting, vivid dreams, shortness of breath, palpitations, low voice/reluctance to speak. Tongue slightly reddish, pulse deep/fine/moderate, Chi positions weaker. Formula: Si Ni Tang modified.
Radix Aconiti Lateralis Preparata (Fupian) 90g, Rhizoma Zingiberis (Ganjiang) 12g, Amomum Fruit (Sharen) 9g, Astragalus Root (Huangqi) 24g, Atractylodes Macrocephala Rhizome (Baizhu) 15g, Poria (Fuling) 15g, Psoralea Fruit (Buguzhi) 12g, Radix Glycyrrhizae (Gancao) 3g.