五十八岁 癸酉二月初一日 太阳中风，尚未十厘清解，兼之湿痹髀痛。
桂枝（四钱） 浓朴（二钱） 蚕砂（三钱） 杏仁（三钱） 防己（三钱） 茯苓皮（五钱） 姜
黄（二钱） 炙甘草（钱半） 广皮（钱半）
二帖。
初二日 行经络而和脾胃，则风痹自止。
桂枝（八钱） 白芍（四钱，炒） 半夏（五钱） 防己（六钱） 炙甘草（三钱） 生白术（五
钱） 生姜（五片） 大枣（二个）
水八杯，煮三杯，分三次服，头一次啜稀粥，令微汗佳，二三次，不必食粥。
初五日 左脉沉紧，即于前方加∶
熟附子（五钱）
初六日 脉洪大而数，经络痛虽解而未尽除，痹也；小便白而浊，湿也。
桂枝（三钱） 泽泻（三钱） 黄柏炭（一钱） 通草（三钱） 杏仁（五钱） 滑石（五钱） 苡
仁（五钱） 茯苓皮（五钱） 猪苓（三钱）
初九日 昨服开肺与大肠痹法，湿滞已下，小便亦清，但大便与瘼中微有血迹，证从寒
湿化
热而来，未便即用柔药以清血分。今日且与宣行腑阳，右脉仍见数大，可加苦药。如明日血
分未清，再清血分未迟。
杏仁泥（三钱） 黄柏炭（一钱） 黄芩炭（二钱） 陈皮（钱半） 苡仁（五钱） 半夏（三钱）
滑石（五钱） 浓朴（二钱） 细苏梗（一钱）
头煎两杯，二煎一杯，分三次服。
初八日 舌苔仍有新白，衣被稍薄则畏寒，身热已退，阳虚湿气未尽无疑。
桂枝（三钱） 苡仁（五钱） 白芍（二钱炒） 陈皮（钱半） 半夏（五钱） 生茅术（二钱）
杏仁（三钱） 浓朴（二钱） 全当归（钱半）
煎服均如前法。二帖。
初十日 诸证向安，惟营气与卫不和，寐不实，寐后自觉身凉，以调和营卫为主。
桂枝（三钱） 苡仁（五钱） 大枣（二个） 白芍（三钱） 陈皮（钱半） 炙甘草（二钱） 半
夏（六钱） 生姜（三片） 茯苓（三钱）
六帖。
十六日 营卫已和，即于前方内加∶
胶饴（三钱） 白芍（二钱成五钱）
七帖而安。
唐 氏三十八岁 太阳中风漏汗，桂枝加附子汤主之。
桂枝（六钱） 熟附子（三钱） 炙甘草（三钱） 焦白芍（四钱） 生姜（三片） 大枣（三个）
煮三杯，分三次服。
十七日 中风漏汗，兼之肾水上凌心，心悸腹痛，昨用桂枝加附子汤，诸症悉退。今左
脉沉
缓。右脉滑，表虽清而浊阴未退。议苓桂伐肾邪，归茴温冲脉，吴萸、半夏、生姜两和肝胃
，白芍以收阴气，合桂枝而调营卫，加黄芩以清风化之热。合诸药为苦辛通法，此外感之余
，兼有下焦里证之治法也。
桂枝（四钱） 全当归（三钱） 小茴香（三钱，二味同炒） 半夏（四钱） 吴萸（三钱） 青
皮（钱半） 焦白芍（二钱） 茯苓（五钱） 黄芩炭（一钱） 生姜（三片）
甘澜水煎成三杯，分三次服。
十九日 脉缓浊阴久居，兼有滞物续下，用药仍不外苦辛通法，稍加推荡之品，因其势
而导之。大意通补阳明之阳，正所以驱浊阴之阴。若其人阳明本旺，胃阴自能下降，六腑通
调，
浊阴何以能
聚，再胃旺自能坐镇中州，浊阴何以能
越胃而上攻心下，反复推求，病情自见。
淡吴萸（三钱） 小茴香（三钱，同炒黑） 桂枝尖（四钱） 浓朴（三钱） 川楝子（二钱）
黄芩
炭（一钱） 小枳实（钱半） 乌药（二钱） 青皮（钱半） 广木香（一钱） 焦白芍（二钱） 陈皮
（一钱） 茯苓（三钱）
二十二日 凡痛胀滞下，必用苦辛通法，兼护阳明，固不待言。前法业已见效，细询病
已十
余年，以半产后得之，误用壅补成之。按久病在络再痛胀偏左下至少腹板着，其中必有瘀滞
，非纯用汤药所能成功。盖汤者荡也，条肠胃和通百脉，固其所长。至于细雕密镂，缓行横
络，是其所短，非兼用化症回生丹缓通不可。且阳剂过重，有症散为蛊之虞，不得不思患
预防也。
桂枝尖（一钱） 乌药（钱半） 浓朴（一钱） 全当归（一钱，炒黑） 半夏（五钱） 地榆炭
（一
钱） 小茴香（二钱，炒） 川楝子（二钱） 黄芩炭（一钱） 白芍（二钱，炒） 黄连（八分）
广皮炭（八分） 两头尖（二钱） 广木香（八分） 桃仁（钱半，炒） 红花（七分） 郁金（一钱）
降香末（二钱）
甘澜水煎，前后四杯，日三夜一，分四次服。四帖。
昔李东垣有方用药至三十余味者，张仲圣鳖甲煎丸，亦有三十几味，后人学问不到，妄
生议
论。不知治经治以急，急则用少而分量多。治络治以缓，缓则用多而分量少。治新则用急，
治旧则用缓。治急可用独，治旧必用众。独则无推诿而一力成功，众则分功而互相调剂，此
又用药多寡之权冲也。
兼服化症回生丹一粒。
二十七日 宣络法兼两和肝胃。
全当归（三钱） 制香附（二钱） 小茴香（三钱，炒黑） 半夏（三钱） 川芎（五分） 青皮
（八
分，炒） 丹皮（三钱，炒） 沙苑子（三钱） 白芍（六钱，炒） 二十八日 寐仍不实，于前
方内加∶
半夏（二钱） 生苡仁（六钱）
服三帖。
初二日 案仍前。
全归（三钱） 制香附（钱半） 干姜炭（五分） 小茴香（三钱） 降香末（二钱） 高良姜（
二分） 青皮（八分） 广皮炭（八分） 乌药（二钱） 半夏（五钱） 桃仁泥（钱半）
三帖。
初五日 络瘀多年，腹痛胀攻胃，食后 胀。今搜去络中瘀滞，饥甚则如刀刮竹，络气
虚也，与通补络法。
归身（三钱） 龙眼肉（三钱） 白芍（六钱，炒） 杞子（三钱，炒） 丹皮（三钱） 小茴香
（一钱） 丹参（三钱）
九帖全愈。
吴氏 二十三岁 二月二十一 头项强痛而恶寒，脉缓有汗，太阳中风，主以桂枝汤。
桂枝（三钱） 白芍（二钱） 炙甘草（二钱） 生姜（三钱） 大枣（二个）
水五杯，煮二杯。第一杯服后，即食稀热粥，令微汗佳。有汗二杯，不必食粥，无汗仍
然。
二十四日 不解，于前方内加∶
羌活（五钱）
二十五日 服前方已，脉静身凉，不肯避风，因而复中，脉紧无汗，用麻黄汤法。
麻黄（三钱，去节） 羌活（三钱） 桂枝（三钱） 白芍（三钱） 炙甘草（二钱） 生姜（三
片） 大枣（二个）
煮二杯，分二次服。
二十六日 服前药不知身重疼痛，其人肥而阳气本虚，平素面色淡黄，舌白湿气又重，
非加助阳胜湿之品不可。于前方内加∶
麻黄（五钱成八钱） 桂枝（二钱成五钱） 炙甘草（一钱成三钱） 杏仁（三钱） 白术（五
钱） 熟附子（三钱）
水五碗，先煮麻黄去上沫，入诸药取两碗，分二次服，服一碗而汗出愈。
唐 五十九岁 三月十六日 头痛恶寒，脉紧，言蹇，肢冷，舌色淡，太阳中风，虽系
季春，天气早间阴晦，雨气甚寒，以桂枝二麻黄一法。
麻黄（三钱，去节） 桂枝（六钱） 炙甘草（三钱） 杏仁（五钱） 生姜（六片） 大枣（二
个）
煮三杯，得微汗，止后服，不汗，再服。不汗促役其间。
十八日 原方倍麻黄，减桂枝，加∶
附子（三钱）
二帖。
十八日 原方再服一帖。
十九日 诸证悉减，药当暂停以消息之。
二十日 中风表解后，言蹇减食则汗头行痛，舌白滑，脉微紧，宜桂枝加附子汤，除风
实表护阳。
桂枝（六钱） 白芍（四钱，炒） 炙甘草（二钱） 附子（三钱） 生姜（五片） 大枣（二个）
水五杯，煮二碗，分二次服，渣再煮一碗服。
二十一日 表解后复中，恶寒胸结，舌苔浓而白，脉迟紧里急。
桂枝（六钱） 苍术（三钱） 附子（四钱） 干姜（三钱） 苡仁（五钱） 茯苓（五钱） 浓朴
（三钱） 枳实（二钱） 陈皮（二钱）
日二帖。
二十二日 于前方内加∶
炙甘草（二钱） 生姜（二两） 去茯苓 减苡仁
日二帖。
二十三日 诸证悉衰，当减其制，照前日方，日一帖。
二十四日 中风表解后，余邪入里，舌黄身热胸痞，议泻心汤泻其痞。
干姜（五钱） 生姜（五钱） 黄芩（五钱，炒） 黄连（二钱，炒） 半夏（六钱）
头煎二杯，二煎一杯，分三次服。
先寒后热，胁痛腰痛，少阳证也，议从少阳领邪外出太阳法。
柴胡（六钱） 黄芩（三钱） 党参（三钱） 桂枝（四钱） 半夏（钱半） 炙甘草（三钱） 羌
活（钱半） 生姜（三片）
寒热后，寒退热存，胁胀。
半夏（五钱） 炙甘草（钱半） 陈皮炭（钱半） 生姜（三钱） 黄芩（四钱） 香附（三钱）
郁金（二钱） 大枣（二个）
张 二十五日 今年风木司天，现下寒水客气，故时近初夏，犹有太阳中风之症。按
太阳
中风，系伤寒门中第一关，最忌误下。时人不读唐晋以上之书，故不识症之所由来。仲景谓
太阳至五六日太阳证不罢者，仍从太阳驱出，宜桂枝汤。现下头与身仍微痛，既身热而又仍
恶风寒，的是太阳未罢，理宜用桂枝汤，但其人素有湿热，不喜甘，又有微咳，议于桂枝汤
内去甘药，加辛燥，服如桂枝汤法。
桂枝（六钱） 陈皮（三钱） 白芍（四钱） 半夏（四钱） 杏仁（三钱）
二十六日 太阳中风，误下胸痞，四五日太阳症未罢。昨用太阳证仍在例之桂枝法，今
日恶
寒已罢，头目已清，惟胸痞特甚，不渴舌白而壮热，泄泻稀水频仍。仲景法云病发于阳而误
下成胸痞者，泻心汤主之。今用其法，再经谓脉不动数者为不传经也。昨日已动数太甚，断
无不传之理，可畏在此。
干姜（五钱） 茯苓（五钱，连皮） 半夏（五钱） 生姜（三片） 黄连（三钱）
二十七日 太阳中风误下，前日先与解外，昨日太阳证罢，即泻胸痞。今日胸痞解，惟
自利
不渴，舌灰白，脉沉数。经谓自利不渴者，属太阴也。太阴宜温，但理中之甘草，人参，恐
不合拍，议用其法而不用其方。
干姜（五钱） 半夏（六钱） 苍术炭（四钱） 生姜（四钱） 陈皮炭（二钱） 茯苓（一两，
连皮）
二十八日 太阳中风，先与解外，外解已即与泻误下之胸痞，痞解而现自利不渴之太阴
证。
今日口不渴而利止，是由阴出阳也，脉亦顿小其半。古云脉小则病退。但仍沉数，身犹热而
气粗不寐，陷下之余邪不净。仲景《伤寒论》谓真阴已虚，阳邪尚盛之不寐，用阿胶鸡子黄
汤。按∶此汤重用芩连。议用甘草泻心法。
甘草（三钱） 黄芩（四钱） 半夏（五钱） 黄连（三钱） 生姜（三钱） 大枣（二个） 茯苓
（三钱）
二十九日 脉沉数，阴经热阳经不热，是陷下之余邪在里也。气不伸而哕，哕者伤寒门
中之大忌也，皆误下之故。议少用丁香柿蒂汤法，加芩、连以彻里热，疏逆气。
公丁香（二钱） 黄芩（三钱） 柿蒂（九个） 黄连（一钱） 陈皮（二钱） 姜汁（三匙冲）
初一日 误下成胸痞自利，两用泻心，胸痞自利俱止。但陷下之邪，与受伤之胃气，搏
而成
哕。昨用丁香柿蒂汤去人参加芩连，方虽易，仍不外仲圣苦辛通降之法。病者畏而不服，今
日哕不止而左脉加进，勉与仲圣哕门中之橘皮竹茹汤，其力量降前方数等矣。所以如此用者
，病多一日，则气虚一日，仲圣于小柴胡汤中即用人参，况误下中虚者乎。
陈皮（六钱） 生姜（五钱） 炙甘草（四钱） 竹茹（五钱） 大枣（四枚） 半夏（三钱） 人
参（二钱，如无以洋参代）
十七日 误下中虚，气逆成哕，昨与金匮橘皮竹茹汤，今日哕减过半。古谓效不更方，
仍用前法。但微喘而舌苔白，仲圣谓喘家加浓朴杏子佳，议于前方内。加∶
浓朴（二钱） 杏仁（三钱） 柿蒂（三钱）
十九日 误下之陷证，哕而喘，昨连与橘皮竹茹汤，一面补中，一面宣邪。兹已邪溃诸
恶候
如失，脉亦渐平，但其人中气受伤不浅，议与小建中汤加橘皮、半夏，小小创建中气，调和
营卫，兼宣胃阳，令能进食安眠。
白芍（六钱，炒） 生姜（三片） 半夏（四钱） 桂枝（四钱） 大枣（二枚） 陈皮（一钱）
炙甘草（三钱） 饴糖（一两，去渣后化搅匀再上火二三沸）
煮三杯，三次服。
病解后微有饮咳，议与小建中去饴糖，加∶
半夏 陈皮 茯苓 苡仁 蔻仁 杏仁
初六日 病后两服建中，胃阳已复，脾阳不醒，何以知之？安眠进食，是胃阳起。舌起
白滑
苔，小便短，大便不解，脉乍数，是脾阳未醒，而上蒸于肺也。议与宣利三焦法，以醒脾阳
。
杏仁（五钱） 半夏（五钱） 茯苓（五钱） 陈皮（三钱） 苡仁（五钱） 枳实（三钱） 通草
（一钱） 益智仁（一钱）
初八日 大小便已利，脉仍洪数，舌白滑苔未除，仍宜苦辛淡法，转运脾阳，宣行湿热
。
Patient, male/female, 58 years old. First day of the second month in the Guiyou year: Diagnosis of Taiyang Wind Strike (Taiyang Wind Strike refers to an exterior syndrome caused by wind pathogen invading the Taiyang meridian). The condition has not yet been completely cleared and resolved, accompanied by Bi syndrome (painful obstruction) causing pain in the thigh.
Prescription: Guizhi (Cinnamon Twig, 4 qian), Nongpo (Magnolia Bark, 2 qian), Can Sha (Mulberry Mummified Larva, 3 qian), Xingren (Apricot Seed, 3 qian), Fangji (Stephania Root, 3 qian), Fuling Pi (Poria Peel, 5 qian), Jianghuang (Turmeric Rhizome, 2 qian), Zhi Gancao (Honey-fried Licorice Root, 1.5 qian), Guangpi (Tangerine Peel, 1.5 qian).
Total two doses.
Second day: By unblocking the meridians and harmonizing the Spleen and Stomach, the Wind-Bi will naturally cease.
Prescription: Guizhi (Cinnamon Twig, 8 qian), Baishao (White Peony Root, 4 qian, stir-fried), Banxia (Pinellia Tuber, 5 qian), Fangji (Stephania Root, 6 qian), Zhi Gancao (Honey-fried Licorice Root, 3 qian), Sheng Baizhu (Raw Atractylodes Macrocephala Rhizome, 5 qian), Shengjiang (Fresh Ginger, 5 slices), Dazao (Jujube, 2 pieces).
Boil with eight cups of water until three cups remain. Divide into three doses. After the first dose, drink thin porridge to induce a slight sweat; for the second and third doses, no need to drink porridge.
Fifth day: The left pulse is deep and tight. Add to the previous prescription: Shu Fuzi (Prepared Aconite Root, 5 qian).
Sixth day: The pulse is surging and rapid. Although meridian pain has resolved, it is not completely eliminated, indicating Bi syndrome; urine is white and turbid, indicating Dampness.
Prescription: Guizhi (Cinnamon Twig, 3 qian), Zexie (Alisma Rhizome, 3 qian), Huangbai Tan (Charred Phellodendron Bark, 1 qian), Tongcao (Tetrapanax Pith, 3 qian), Xingren (Apricot Seed, 5 qian), Huashi (Talcum, 5 qian), Yiren (Coix Seed, 5 qian), Fuling Pi (Poria Peel, 5 qian), Zhuling (Polyporus, 3 qian).
Ninth day: Yesterday, the method of opening Lung and Large Intestine Bi was used. Damp stagnation has moved downward, and urine is clear. However, there are still traces of blood in the stool and hemorrhoids. The syndrome arises from Cold-Damp transforming into Heat. It is inappropriate to immediately use soft/moistening herbs to clear the Blood level. Today, we temporarily use the method of promoting Fu-Yang. The right pulse remains rapid and large; bitter herbs can be added. If the Blood level is not cleared tomorrow, clearing it then will not be too late.
Prescription: Xingren Ni (Apricot Seed Paste, 3 qian), Huangbai Tan (Charred Phellodendron Bark, 1 qian), Huangqin Tan (Charred Scutellaria Root, 2 qian), Chenpi (Aged Tangerine Peel, 1.5 qian), Yiren (Coix Seed, 5 qian), Banxia (Pinellia Tuber, 3 qian), Huashi (Talcum, 5 qian), Nongpo (Magnolia Bark, 2 qian), Xi Su Geng (Perilla Stem, 1 qian).
First decoction yields two cups, second decoction yields one cup. Divide into three doses.
Eighth day: The tongue coating still shows new white. When clothing/bedding is slightly thinner, chills are felt. Body heat has subsided; Yang deficiency with incomplete resolution of Dampness is undeniable.
Prescription: Guizhi (Cinnamon Twig, 3 qian), Yiren (Coix Seed, 5 qian), Baishao (White Peony Root, 2 qian, stir-fried), Chenpi (Aged Tangerine Peel, 1.5 qian), Banxia (Pinellia Tuber, 5 qian), Sheng Maozhu (Raw Atractylodes Lancea Rhizome, 2 qian), Xingren (Apricot Seed, 3 qian), Nongpo (Magnolia Bark, 2 qian), Quan Danggui (Whole Angelica Sinensis Root, 1.5 qian).
Decoct and take as before. Two doses.
Tenth day: Various symptoms tend towards peace. Only Ying-Qi (Nutritive Qi) and Wei-Qi (Defensive Qi) are not harmonized; sleep is restless, and upon waking, the body feels cool. The main treatment is to harmonize Ying and Wei.
Prescription: Guizhi (Cinnamon Twig, 3 qian), Yiren (Coix Seed, 5 qian), Dazao (Jujube, 2 pieces), Baishao (White Peony Root, 3 qian), Chenpi (Aged Tangerine Peel, 1.5 qian), Zhi Gancao (Honey-fried Licorice Root, 2 qian), Banxia (Pinellia Tuber, 6 qian), Shengjiang (Fresh Ginger, 3 slices), Fuling (Poria, 3 qian).
Six doses.
Sixteenth day: Ying and Wei are now harmonized. Add to the previous prescription: Jiaoyi (Maltose, 3 qian); increase Baishao (White Peony Root) from 2 qian to 5 qian.
Seven doses lead to recovery.
Ms. Tang, 38 years old. Taiyang Wind Strike with spontaneous sweating (leaking sweat). Main formula: Guizhi Jia Fuzi Tang (Cinnamon Twig Decoction plus Prepared Aconite).
Prescription: Guizhi (Cinnamon Twig, 6 qian), Shu Fuzi (Prepared Aconite Root, 3 qian), Zhi Gancao (Honey-fried Licorice Root, 3 qian), Jiao Baishao (Stir-fried White Peony Root, 4 qian), Shengjiang (Fresh Ginger, 3 slices), Dazao (Jujube, 3 pieces).
Boil to yield three cups. Divide into three doses.
Seventeenth day: Wind strike with leaking sweat, accompanied by Kidney Water flooding over the Heart, causing palpitations and abdominal pain. Yesterday, Guizhi Jia Fuzi Tang was used, and all symptoms retreated. Today, the left pulse is deep and slow; the right pulse is slippery. The exterior is cleared, but Turbid Yin has not receded. Proposal: Use Linggui (Poria and Cinnamon Twig combination) to attack Kidney pathogens, Guihui (Angelica and Fennel) to warm the Chong Mai (Penetrating Vessel), Wuyu (Evodia Fruit), Banxia (Pinellia), and Shengjiang (Fresh Ginger) to harmonize Liver and Stomach, Baishao (White Peony Root) to gather Yin Qi, combined with Guizhi to harmonize Ying and Wei, and add Huangqin (Scutellaria Root) to clear wind-transformed heat. Combining these herbs forms the Bitter-Spicy Unblocking Method. This is the treatment method for residual external contraction complicated by interior syndromes in the Lower Jiao.
Prescription: Guizhi (Cinnamon Twig, 4 qian), Quan Danggui (Whole Angelica Sinensis Root, 3 qian), Xiao Huixiang (Small Fennel Fruit, 3 qian, stir-fried together), Banxia (Pinellia Tuber, 4 qian), Wuyu (Evodia Fruit, 3 qian), Qingpi (Green Tangerine Peel, 1.5 qian), Jiao Baishao (Stir-fried White Peony Root, 2 qian), Fuling (Poria, 5 qian), Huangqin Tan (Charred Scutellaria Root, 1 qian), Shengjiang (Fresh Ginger, 3 slices).
Decoct with Ganlan Water (Agitated Water) to yield three cups. Divide into three doses.
Nineteenth day: The slow pulse indicates long-standing Turbid Yin. Accompanied by continued discharge of stagnant matter, medication still adheres to the Bitter-Spicy Unblocking Method, slightly adding pushing/draining agents to guide along the momentum. The general idea is to tonify Yang of the Yangming (Stomach/Large Intestine), which precisely drives out Turbid Yin. If the person's Yangming is inherently strong, Stomach Yin will descend naturally, Six Fu organs will be smooth, and how could Turbid Yin gather? Furthermore, if Stomach Qi is strong, it sits firmly in the Middle Jiao; how could Turbid Yin surpass the Stomach and attack below the heart? Repeated deduction reveals the pathology.
Prescription: Dan Wuyu (Light Evodia Fruit, 3 qian), Xiao Huixiang (Small Fennel Fruit, 3 qian, stir-fried black), Guizhi Jian (Tip of Cinnamon Twig, 4 qian), Nongpo (Magnolia Bark, 3 qian), Chuan Lianzi (Sichuan Chinaberry Fruit, 2 qian), Huangqin Tan (Charred Scutellaria Root, 1 qian), Xiao Zhishi (Small Immature Bitter Orange, 1.5 qian), Wuyao (Lindera Root, 2 qian), Qingpi (Green Tangerine Peel, 1.5 qian), Guang Muxiang (Costus Root, 1 qian), Jiao Baishao (Stir-fried White Peony Root, 2 qian), Chenpi (Aged Tangerine Peel, 1 qian), Fuling (Poria, 3 qian).
Twenty-second day: For pain, distension, and dysentery-like conditions, the Bitter-Spicy Unblocking Method must be used, protecting Yangming, which goes without saying. The previous method has shown efficacy. Detailed inquiry reveals the illness has lasted over ten years, originating after a miscarriage, caused by mistaken use of cloying tonics. According to "long-standing disease enters collaterals," pain and distension偏向 left lower abdomen extending to the lower abdomen, indicating stasis within. Pure decoctions cannot succeed alone. "Decoction" implies sweeping; while it regulates intestines/stomach and unblocks vessels, its strength lies here. However, for fine, intricate regulation and slow passage through horizontal collaterals, this is its weakness. It is necessary to combine with Huazheng Huisheng Dan (Stasis-Resolving Life-Restoring Pill) for slow unblocking. Moreover, excessive Yang-tonifying agents risk dispersing nodules into "Gu" poisoning; thus, preventive measures are needed.
Prescription: Guizhi Jian (Tip of Cinnamon Twig, 1 qian), Wuyao (Lindera Root, 1.5 qian), Nongpo (Magnolia Bark, 1 qian), Quan Danggui (Whole Angelica Sinensis Root, 1 qian, stir-fried black), Banxia (Pinellia Tuber, 5 qian), Diyu Tan (Sanguisorba Root Charcoal, 1 qian), Xiao Huixiang (Small Fennel Fruit, 2 qian, stir-fried), Chuan Lianzi (Sichuan Chinaberry Fruit, 2 qian), Huangqin Tan (Charred Scutellaria Root, 1 qian), Baishao (White Peony Root, 2 qian, stir-fried), Huanglian (Coptis Rhizome, 8 fen), Guangpi Tan (Charred Tangerine Peel, 8 fen), Liangtoujian (Gardenia Fruit, 2 qian), Guang Muxiang (Costus Root, 8 fen), Taoren (Peach Kernel, 1.5 qian, stir-fried), Honghua (Safflower, 7 fen), Yujin (Curcuma Longa Rhizome, 1 qian), Jiangxiang Mo (Dalbergia Odorifera Wood Sawdust, 2 qian).
Decoct with Ganlan Water to yield four cups total. Take three times during the day and once at night, divided into four doses. Four doses.
In the past, Li Dongyuan had prescriptions with over thirty ingredients; Zhang Zhongjing's Biejia Jian Wan (Turtle Shell Decoction Pill) also had nearly thirty. Later generations, lacking sufficient scholarship, made baseless criticisms. They do not know that treating Jing (Vessels) requires urgency; urgency means fewer ingredients but higher dosage. Treating Luo (Collaterals) requires slowness; slowness means more ingredients but lower dosage. Treating new diseases uses urgent methods; treating old diseases uses slow methods. Urgent treatment can use single herbs; old disease treatment must use multiple herbs. Single herbs avoid buck-passing and achieve success with one force; multiple herbs divide labor and adjust each other. This is the balance of using many or few herbs.
Take one pill of Huazheng Huisheng Dan concurrently.
Twenty-seventh day: Collateral-opening method combined with harmonizing Liver and Stomach.
Prescription: Quan Danggui (Whole Angelica Sinensis Root, 3 qian), Zhi Xiangfu (Processed Cyperus Rhizome, 2 qian), Xiao Huixiang (Small Fennel Fruit, 3 qian, stir-fried black), Banxia (Pinellia Tuber, 3 qian), Chuanxiong (Ligusticum Rhizome, 5 fen), Qingpi (Green Tangerine Peel, 8 fen, stir-fried), Danpi (Moutan Cortex, 3 qian, stir-fried), Shayuanzi (Astragalus Complanatus Seed, 3 qian), Baishao (White Peony Root, 6 qian, stir-fried).
Twenty-eighth day: Sleep remains restless. Add to previous prescription: Banxia (Pinellia Tuber, 2 qian), Sheng Yiren (Raw Coix Seed, 6 qian).
Take three doses.
Second day (next cycle): Case record remains as before.
Prescription: Quan Gui (Whole Angelica Root, 3 qian), Zhi Xiangfu (Processed Cyperus Rhizome, 1.5 qian), Ganjiang Tan (Charred Dried Ginger, 5 fen), Xiao Huixiang (Small Fennel Fruit, 3 qian), Jiangxiang Mo (Dalbergia Odorifera Wood Sawdust, 2 qian), Gaoliangjiang (Galangal Rhizome, 2 fen), Qingpi (Green Tangerine Peel, 8 fen), Guangpi Tan (Charred Tangerine Peel, 8 fen), Wuyao (Lindera Root, 2 qian), Banxia (Pinellia Tuber, 5 qian), Taoren Ni (Peach Kernel Paste, 1.5 qian).
Three doses.
Fifth day: Collateral stasis for many years. Abdominal pain and distension attack the Stomach; bloating after eating. Now searching out collateral stasis, hunger causes sensation like scraping bamboo, indicating deficiency of Luo-Qi. Apply the method of unblocking and tonifying collaterals.
Prescription: Guishen (Root tip of Angelica, 3 qian), Longyan Rou (Longan Aril, 3 qian), Baishao (White Peony Root, 6 qian, stir-fried), Qizi (Goji Berry, 3 qian, stir-fried), Danpi (Moutan Cortex, 3 qian), Xiao Huixiang (Small Fennel Fruit, 1 qian), Danshen (Salvia Root, 3 qian).
Nine doses lead to full recovery.
Mr. Wu, 23 years old. February 21st: Stiffness and pain in head and neck with aversion to cold. Pulse is slow with sweating. Taiyang Wind Strike. Main formula: Guizhi Tang (Cinnamon Twig Decoction).
Prescription: Guizhi (Cinnamon Twig, 3 qian), Baishao (White Peony Root, 2 qian), Zhi Gancao (Honey-fried Licorice Root, 2 qian), Shengjiang (Fresh Ginger, 3 qian), Dazao (Jujube, 2 pieces).
Boil five cups of water to yield two cups. After the first cup, eat hot thin porridge to induce slight sweat. If sweating occurs, take both cups without porridge; if no sweat, continue drinking porridge.
Twenty-fourth day: Condition unresolved. Add to previous prescription: Qianghuo (Notopterygium Rhizome, 5 qian).
Twenty-fifth day: After taking previous prescription, pulse became calm and body cooled, but patient refused to avoid wind, leading to re-infection. Pulse is tight with no sweat. Use Mahuang Tang (Ephedra Decoction) method.
Prescription: Mahuang (Ephedra Herb, 3 qian, remove joints), Qianghuo (Notopterygium Rhizome, 3 qian), Guizhi (Cinnamon Twig, 3 qian), Baishao (White Peony Root, 3 qian), Zhi Gancao (Honey-fried Licorice Root, 2 qian), Shengjiang (Fresh Ginger, 3 slices), Dazao (Jujube, 2 pieces).
Boil to yield two cups. Divide into two doses.
Twenty-sixth day: After taking previous medicine, body heaviness and pain were unknown. The patient is obese with inherent Yang deficiency, pale yellow complexion usually, white tongue coating indicating heavy dampness. Must add herbs to assist Yang and overcome dampness. Add to previous prescription: Mahuang (increase from 5 qian to 8 qian), Guizhi (increase from 2 qian to 5 qian), Zhi Gancao (increase from 1 qian to 3 qian), Xingren (Apricot Seed, 3 qian), Baizhu (Atractylodes Rhizome, 5 qian), Shu Fuzi (Prepared Aconite Root, 3 qian).
Boil five bowls of water. First boil Mahuang to remove surface foam, then add other herbs to yield two bowls. Divide into two doses. Recovery occurs after sweating from one dose.
Mr. Tang, 59 years old. March 16th: Headache, aversion to cold, tight pulse, slurred speech, cold limbs, pale tongue color. Taiyang Wind Strike. Although it is late spring, early morning weather is gloomy and rainy/cold. Use Guizhi Er Mahuang Yi Fa (Two parts Guizhi Tang to one part Mahuang Tang).
Prescription: Mahuang (Ephedra Herb, 3 qian, remove joints), Guizhi (Cinnamon Twig, 6 qian), Zhi Gancao (Honey-fried Licorice Root, 3 qian), Xingren (Apricot Seed, 5 qian), Shengjiang (Fresh Ginger, 6 slices), Dazao (Jujube, 2 pieces).
Boil to yield three cups. Stop subsequent doses after slight sweat; if no sweat, take again; if still no sweat, shorten intervals between doses.
Eighteenth day: Original formula, double Mahuang, reduce Guizhi, add: Fuzi (Aconite Root, 3 qian).
Two doses.
Eighteenth day: Take one more dose of original formula.
Nineteenth day: All symptoms significantly reduced. Pause medication to observe.
Twentieth day: After resolving Taiyang exterior, slurred speech reduced. Eating induces sweating and head pain. Tongue is white and slippery, pulse slightly tight. Use Guizhi Jia Fuzi Tang (Cinnamon Twig Decoction plus Aconite) to dispel wind, secure exterior, and protect Yang.
Prescription: Guizhi (Cinnamon Twig, 6 qian), Baishao (White Peony Root, 4 qian, stir-fried), Zhi Gancao (Honey-fried Licorice Root, 2 qian), Fuzi (Aconite Root, 3 qian), Shengjiang (Fresh Ginger, 5 slices), Dazao (Jujube, 2 pieces).
Boil five cups of water to yield two bowls. Divide into two doses. Boil residue again to yield one bowl and take.
Twenty-first day: Re-infected after exterior resolution. Aversion to cold, chest binding, thick white tongue coating, slow/tight pulse with interior tension.
Prescription: Guizhi (Cinnamon Twig, 6 qian), Cangzhu (Atractylodes Lancea Rhizome, 3 qian), Fuzi (Aconite Root, 4 qian), Ganjiang (Dried Ginger, 3 qian), Yiren (Coix Seed, 5 qian), Fuling (Poria, 5 qian), Nongpo (Magnolia Bark, 3 qian), Zhishi (Immature Bitter Orange, 2 qian), Chenpi (Aged Tangerine Peel, 2 qian).
One dose per day.
Twenty-second day: Add to previous prescription: Zhi Gancao (Honey-fried Licorice Root, 2 qian), Shengjiang (Fresh Ginger, 2 liang). Remove Fuling, reduce Yiren.
One dose per day.
Twenty-third day: All symptoms declined. Reduce dosage. Follow previous day's formula, one dose per day.
Twenty-fourth day: After Taiyang exterior resolution, residual pathogen enters interior. Yellow tongue, body heat, chest stuffiness. Propose Xiexin Tang (Drain the Epigastrium Decoction) to drain stuffiness.
Prescription: Ganjiang (Dried Ginger, 5 qian), Shengjiang (Fresh Ginger, 5 qian), Huangqin (Scutellaria Root, 5 qian, stir-fried), Huanglian (Coptis Rhizome, 2 qian, stir-fried), Banxia (Pinellia Tuber, 6 qian).
First decoction two cups, second decoction one cup. Divide into three doses.
Initial chills followed by fever, hypochondriac and lower back pain: Shaoyang Syndrome. Propose method to lead pathogen out from Shaoyang to Taiyang.
Prescription: Chaihu (Bupleurum Root, 6 qian), Huangqin (Scutellaria Root, 3 qian), Renshen (Ginseng Root, 3 qian - note: text says Dangshen but context implies Tonification, WHO term often maps Renshen/Dangshen based on context, here translated as Ginseng/Panax for standard terminology unless specified otherwise, though Dangshen is Codonopsis. Given "Shaoyang", Chaihu Tang variants usually use Ren Shen. Text says Dangshen. I will translate as Codonopsis Root to be precise to text, but note standard Shaoyang uses Ginseng. Actually, WHO term for Dangshen is Codonopsis Radix. I will use Codonopsis Root.), Guizhi (Cinnamon Twig, 4 qian), Banxia (Pinellia Tuber, 1.5 qian), Zhi Gancao (Honey-fried Licorice Root, 3 qian), Qianghuo (Notopterygium Rhizome, 1.5 qian), Shengjiang (Fresh Ginger, 3 slices).
After chills and fever, chills retreat, heat remains, hypochondriac distension.
Prescription: Banxia (Pinellia Tuber, 5 qian), Zhi Gancao (Honey-fried Licorice Root, 1.5 qian), Chenpi Tan (Charred Tangerine Peel, 1.5 qian), Shengjiang (Fresh Ginger, 3 qian), Huangqin (Scutellaria Root, 4 qian), Xiangfu (Cyperus Rhizome, 3 qian), Yujin (Curcuma Longa Rhizome, 2 qian), Dazao (Jujube, 2 pieces).
Mr. Zhang, 25th day. This year Feng Mu (Wind Wood) governs the Heaven, currently Han Shui (Cold Water) is the guest Qi. Thus, near early summer, there are still Taiyang Wind Strike symptoms. Taiyang Wind Strike is the first barrier in Shanghan (Cold Damage) category, most忌讳 (taboo) is mistaken purgation. Contemporary people do not read books above Tang/Jin dynasties, so they do not recognize the origin of symptoms. Zhongjing stated: If Taiyang syndrome persists after 5-6 days, drive it out from Taiyang, suitable for Guizhi Tang. Currently, head and body still have slight pain, body heat with aversion to wind/cold. This is indeed Taiyang not resolved,理应 (should) use Guizhi Tang. But the person has chronic Damp-Heat, dislikes sweet, and has slight cough. Propose removing sweet herbs from Guizhi Tang, adding pungent/dry herbs, taking as Guizhi Tang method.
Prescription: Guizhi (Cinnamon Twig, 6 qian), Chenpi (Aged Tangerine Peel, 3 qian), Baishao (White Peony Root, 4 qian), Banxia (Pinellia Tuber, 4 qian), Xingren (Apricot Seed, 3 qian).
Twenty-sixth day: Taiyang Wind Strike, mistaken purgation led to chest stuffiness. Taiyang symptoms persisted for 4-5 days. Yesterday used Guizhi method for persistent Taiyang. Today, aversion to cold ceased, head/eyes clear, only chest stuffiness is severe. No thirst, white tongue, high fever, frequent watery diarrhea. Zhongjing's law: Disease starting at Yang level, mistaken purgation causing chest stuffiness, Xiexin Tang is main. Using this method now. Also, classic states: Pulse not moving rapidly means no transmission. Yesterday pulse moved rapidly too much, surely transmission occurred, this is fearful.
Prescription: Ganjiang (Dried Ginger, 5 qian), Fuling (Poria, 5 qian, with peel), Banxia (Pinellia Tuber, 5 qian), Shengjiang (Fresh Ginger, 3 slices), Huanglian (Coptis Rhizome, 3 qian).
Twenty-seventh day: Taiyang Wind Strike mistaken purgation. Day before yesterday, first resolved exterior. Yesterday Taiyang syndrome ceased, then drained chest stuffiness. Today chest stuffiness resolved, only spontaneous diarrhea without thirst, grey-white tongue, deep rapid pulse. Classic states: Spontaneous diarrhea without thirst belongs to Taiyin. Taiyin should be warmed. But Lizhong Tang's Gancao and Renshen may not fit well. Propose using its method but not its formula.
Prescription: Ganjiang (Dried Ginger, 5 qian), Banxia (Pinellia Tuber, 6 qian), Cangzhu Tan (Charred Atractylodes Lancea Rhizome, 4 qian), Shengjiang (Fresh Ginger, 4 qian), Chenpi Tan (Charred Tangerine Peel, 2 qian), Fuling (Poria, 1 liang, with peel).
Twenty-eighth day: Taiyang Wind Strike, first resolved exterior. Once exterior resolved, drained chest stuffiness from mistaken purgation. Stuffiness resolved, presenting Taiyin syndrome of spontaneous diarrhea without thirst. Today, no thirst and diarrhea stopped, emerging from Yin to Yang. Pulse suddenly halved. Ancient saying: Small pulse means disease retreats. Still deep and rapid, body still hot, coarse breathing, insomnia. Residual pathogen from sinking is not clean. Zhongjing's Shanghan Lun states: Insomnia due to True Yin deficiency and abundant Yang pathogen, use Ejiao Jizihuang Tang (Donkey-hide Gel and Chicken Egg Yolk Decoction). Note: This decoction heavily uses Huangqin and Huanglian. Propose using Gancao Xiexin Fa (Licorice Drain the Epigastrium Method).
Prescription: Gancao (Licorice Root, 3 qian), Huangqin (Scutellaria Root, 4 qian), Banxia (Pinellia Tuber, 5 qian), Huanglian (Coptis Rhizome, 3 qian), Shengjiang (Fresh Ginger, 3 qian), Dazao (Jujube, 2 pieces), Fuling (Poria, 3 qian).
Twenty-ninth day: Deep rapid pulse. Yin channel heat, Yang channel no heat. Residual pathogen from sinking is in interior. Qi not stretching leads to hiccups. Hiccups are a major taboo in Shanghan category, all due to mistaken purgation. Propose using small amount of Dingxiang Shidi Tang (Clove and Persimmon Calyx Decoction) method, adding Huangqin and Huanglian to clear interior heat and disperse rebellious Qi.
Prescription: Gong Dingxiang (Clove, 2 qian), Huangqin (Scutellaria Root, 3 qian), Shidi (Persimmon Calyx, 9 pieces), Huanglian (Coptis Rhizome, 1 qian), Chenpi (Aged Tangerine Peel, 2 qian), Jiangzhi (Ginger Juice, 3 spoons mixed in).
First day: Mistaken purgation caused chest stuffiness and spontaneous diarrhea. Used Xiexin twice, both stopped. But residual pathogen from sinking and injured Stomach Qi contend, causing hiccups. Yesterday used Dingxiang Shidi Tang, removed Renshen, added Huangqin/Huanglian. Formula changed, but still follows Zhongsheng's Bitter-Spicy Descending Method. Patient feared and did not take. Today hiccups persist, left pulse advanced. Reluctantly give Zhongsheng's JuPi ZhuRu Tang (Tangerine Peel and Bamboo Shave Decoction) from Hiccups category. Its power is several levels stronger than previous formula. Reason for such use: Each day of illness increases Qi deficiency. Zhongsheng used Renshen in Xiaochaihu Tang, let alone in mistaken purgation with middle deficiency.
Prescription: Chenpi (Aged Tangerine Peel, 6 qian), Shengjiang (Fresh Ginger, 5 qian), Zhi Gancao (Honey-fried Licorice Root, 4 qian), Zhuru (Bamboo Shave, 5 qian), Dazao (Jujube, 4 pieces), Banxia (Pinellia Tuber, 3 qian), Renshen (Ginseng Root, 2 qian; substitute with Yangshen/Codonopsis if unavailable).
Seventeenth day: Mistaken purgation with middle deficiency, rebellious Qi causing hiccups. Yesterday gave Jin Gui JuPi ZhuRu Tang. Today hiccups reduced by more than half. Ancient saying: Efficacy does not change formula. Continue previous method. But slight wheezing and white tongue coating. Zhongsheng states: For wheezers, add Nongpo and Xingzi is good. Propose adding to previous prescription: Nongpo (Magnolia Bark, 2 qian), Xingren (Apricot Seed, 3 qian), Shidi (Persimmon Calyx, 3 qian).
Nineteenth day: Sunken syndrome from mistaken purgation, hiccups with wheezing. Consecutively given JuPi ZhuRu Tang, tonifying middle while venting pathogen. Now pathogen溃 (broken), all bad symptoms lost, pulse gradually calm. But person's Middle Qi injured deeply. Propose giving Xiaojianzhong Tang (Minor Construct the Middle Decoction) plus Chenpi and Banxia, slightly constructing Middle Qi, harmonizing Ying/Wei, venting Stomach Yang, enabling eating and sleeping.
Prescription: Baishao (White Peony Root, 6 qian, stir-fried), Shengjiang (Fresh Ginger, 3 slices), Banxia (Pinellia Tuber, 4 qian), Guizhi (Cinnamon Twig, 4 qian), Dazao (Jujube, 2 pieces), Chenpi (Aged Tangerine Peel, 1 qian), Zhi Gancao (Honey-fried Licorice Root, 3 qian), Yitang (Maltose, 1 liang, dissolve residue, mix evenly, boil 2-3 boils).
Boil three cups. Take three times.
After illness resolution, slight phlegm-cough. Propose Xiaojianzhong Tang minus Yitang, add: Banxia, Chenpi, Fuling, Yiren, Kouren (Cardamom), Xingren.
Sixth day: After illness, two doses of Jianzhong. Stomach Yang recovered, Spleen Yang not awake. How to know? Sound sleep and eating indicate Stomach Yang rising. White slippery tongue coating, short urine, constipation, intermittent rapid pulse indicate Spleen Yang not awake, steaming upward to Lung. Propose Xuanli Sanjiao Fa (Vent and Drain Three Jiao Method) to awaken Spleen Yang.
Prescription: Xingren (Apricot Seed, 5 qian), Banxia (Pinellia Tuber, 5 qian), Fuling (Poria, 5 qian), Chenpi (Aged Tangerine Peel, 3 qian), Yiren (Coix Seed, 5 qian), Zhishi (Immature Bitter Orange, 3 qian), Tongcao (Tetrapanax Pith, 1 qian), Yizhiren (Yi Zhi Ren Fruit, 1 qian).
Eighth day: Urination and defecation smoothed. Pulse still surging and rapid. White slippery tongue coating not removed. Still suitable for Bitter-Spicy-Light Method, transporting Spleen Yang, venting Damp-Heat.