赵氏 五十五岁 乙丑三月十八日 六脉弦而迟，沉部有，浮部无，巅顶痛甚，下连太
阳，阳虚内风眩动之故。
桂枝（六钱） 白芍（三钱） 生 （六钱） 炙甘草（三钱） 川芎（一钱） 全当归（二钱）
生姜（五钱） 大枣（三八，去核） 胶饴（五钱，化入）
辛甘为阳，一法也；辛甘化风，二法也；兼补肝经之正，三法也。服二帖。
初十日 阳虚头痛，愈后用 建中。
白芍（六钱） 桂枝（四钱） 生姜（三片） 生 （五钱） 炙甘草（三钱） 大枣（二枚，去
核） 胶饴（五钱，化入）
李 少阳头痛，本有损一目之弊。无奈盲医不识，混用辛温，反助少阳之火，甚至有用
附子
雄烈者，无奈乎医者盲，致令病者亦盲矣。况此病由于伏暑发疟，疟久不愈，抑郁而起肝之
郁勃难伸，肝愈郁而胆愈热矣。现下仍然少阳头痛未罢，议仍从少阳胆络论治。
桑叶（三钱） 茶菊（三钱） 羚角（三钱） 青葙子（二钱） 钩藤（二钱） 丹皮（三钱） 麦
冬
（五钱，连心） 麻仁（三钱） 桔梗（三钱） 生甘草（钱半） 刺蒺藜（五钱） 苦丁茶（一钱）
陈 三十五岁 乙丑十月二十二日 少阳风动，又袭外风为病，头偏左痛，左脉浮弦而
数，大于右脉一倍，最有损一目之弊。议急清胆络之热，用辛甘化风方法。
羚角（三钱） 茶菊（三钱） 桑叶（三钱） 苦桔梗（三钱） 生甘草（一钱） 丹皮（五钱）
青葙子（二钱） 薄荷（二钱） 刺蒺藜（二钱） 钩藤（二钱）
水五杯，煮取两杯，分二次服，渣再煎一杯服，日二帖。
二十五日 于前方内加∶
木贼（钱半） 蕤仁（三钱） 减薄荷（钱四分） 头痛眼蒙甚。
日三帖，少轻日二帖。
十一月初八日 于前方内加∶
蕤仁 麦冬 白茅根
章 四十三岁 衄血之因，由于热行清道，法当以清轻之品，清清道之热。无奈所用皆
重药
，至头偏左痛，乃少阳胆络之热，最有损一目之患，岂熟地桂附鹿茸所可用。悖谬极矣，无
怪乎深痼难拔也。勉与清少阳胆络法，当用羚羊角散，以无羚羊，故不用。
苦桔梗（一两） 苦丁茶（三钱） 连翘（八钱，连心） 甘草（四钱） 钩藤（六钱） 银花（
八钱） 桑叶（一两） 丹皮（八钱） 薄荷（二钱） 茶菊（五两） 白蒺藜（一钱）
共为细末，每服二钱，日三次，每服白扁豆花汤调，外以豆浆一担，熬至碗许，摊贴马
刀患处，以化净为度，必须盐卤点之，做豆腐水，并非可吃之豆腐浆。
附∶有一人素有肝郁痰火，项间致成马刀，外用蒲黄夏布贴患处，内服元参、贝母、牡
蛎为丸，百日收功。
二十七日 复诊症小效，脉尚仍旧，照前清少阳胆络方，再服二三帖，俟大效后再议。
五月初二日 此时无扁豆花为引，改用鲜荷叶边煎汤为引亦可。少阳络热，误用峻补阳
气，以致头目左半麻木发痒，耳后痈肿，发为马刀。现下六脉沉洪而数，头目中风火相扇，
前用羚羊角散法，虽见小效，而不能大愈。议加一煎方，暂清脑户之风热，其散方仍用勿停
。
苦桔梗 侧柏叶炭 荷叶边（一枚，鲜） 辛夷 生苓 黑山栀（五钱，大便溏去之） 苍
耳子（炒） 桑叶 连翘（连心） 茶菊
六月初三日 细阅病状，由少阳移于阳明，加∶
生石膏（一两） 知母（三钱） 葛根（三分）
十二日 偏头痛系少阳胆络病，医者误认为虚，而用鹿茸等峻补其阳，以致将少阳之热
，移
于阳明部分，项肿牙痛，半边头脸肿痛，目白睛血赤，且闭不得开，如温毒状，舌苔红黄，
六脉沉数有力。议与代赈普济散，急急两清少阳阳明之热毒。
代赈普济散十包，每包五钱。用鲜芦根煎汤，水二杯，煮成一杯。去渣先服半杯，其下
半杯噙化，得稀涎即吐之。一时许再煎一包，服如上法。
十六日 舌黄更甚，脉犹数，肿未全消，目白睛赤缕，自下而上，其名曰倒垂帘，治在
阳明，不比自上而下者，治在太阳也。
代赈普济散，每日服五包，咽下大半，漱吐小半。每包生石膏三钱，煎成一小碗，服二
日。外以不去心麦冬一两，分二次煎代茶。
十八日 今日偏头痛甚，且清少阳之络，其消肿之普济散加石膏，午前服一包，余时服
此方，三次三杯。
羚羊角（一钱） 丹皮（一钱） 银花（一钱） 犀角（八分） 茶菊（一钱） 刺蒺藜（六分）
凌霄花（一钱） 钩藤（六分） 苦桔梗（八分） 桑叶（一钱） 连翘（一钱） 生甘草（四分）
两杯半水，煎一杯，顿服之，日三帖。
二十日 大便结，加元参二钱，溏则去之。
二十三日 经谓脉有独大独小，独浮独沉，斯病之所在也。兹左关独大独浮，胆阳太旺
，清
胆络之药，已服过数十帖之多，而胆脉尚如是之旺。络药清轻上浮，服至何日是了？议胆无
出路，借小肠以为出路，小肠火腑，非苦不通，暂与极苦下夺法。然此等药可暂而不可久，
恐化燥也。
洋芦荟（二钱） 龙胆草（三钱） 胡黄连（二钱） 真雅连（二钱） 麦冬（五钱，不去心）
丹皮（五钱） 秋石（一钱）
二十六日 前方服二帖，左关独大独浮之脉已平。续服羚羊角散一天，代赈普济散一天
，目之赤缕大退，其耳后之马刀，坚硬未消。仍服代赈普济散，日四五次。
七月初一日 脉沉数，马刀之坚结未消，少阳阳明经脉受毒之处，犹然牵拉板滞。议外
面改用水仙膏敷患处，每日早服羚羊角散一帖，已午后服代赈普济散四包。
初九日 服前药喉咙较前清亮，舌苔之黄浊，去其大半，脉渐小仍数，里症日轻，是大
佳处
。外症以水仙膏拔出黄疮少许，毒瓦斯仍未化透，仍须急急再敷，务斯拔尽方妙。至于见功迟
缓，乃前此误用峻补之累，速速解此重围，非旦晚可了。只好宁耐性情，宽限令其自化，太
紧恐致过刚则折之虞。前羚角散，每日午前服一帖，午后服代赈散四包，分四次，再以二三
包煎汤漱口，以护牙齿。
十七日 数日大便不爽，左脉关部复浮，疮口痛甚，再用极苦以泻小肠，加芳香活络定
痛。
洋芦荟（二钱） 乳香（三钱） 生大黄（三钱，酒炒黑） 真川连（二钱） 没药（二钱） 归
尾（三钱） 龙胆草（三钱） 秋石（三钱） 胡黄连（三钱） 银花（五钱）
煮三小杯，分三次服，得快大便，一次即止。
十八日 马刀虽溃，少阳阳明之热毒未除，两手关脉独浮，气大旺，于清少阳阳明络热
之中，兼疏肝郁，软坚化核。
苦桔梗（三钱） 桑叶（三钱） 海藻（二钱） 银花（三钱） 丹皮（五钱） 凌霄花（三钱）
连翘（三钱） 生香附（三钱） 夏枯草（三钱） 茶菊（三钱）
二十五日 马刀以误补太重而成，为日已久，一时未能化净，以畏疼停止水仙膏之故。
舌上舌苔。浮面微黄，其毒尚重，现下胃口稍减，木来克土之故，于前方加宣肝郁。
苦桔梗（二钱） 桑叶（三钱） 香附（二钱） 银花（三钱） 丹皮炭（三钱） 连翘（三钱）
郁金（二钱） 茶菊（三钱）
仍以代赈普济散，漱口勿咽。
二十八日 肝郁误补，结成马刀，目几坏。现下马刀已平其半，目亦渐愈，脉之数者已
平。
惟左关独浮，其性甚急，肝郁总未能降，胃不甚开，胸中饭后觉痞，舌白滑微黄，皆木旺克
土之故。败毒清热之凉剂，临时停止，且与两和肝胃。
新绛纱（三钱） 姜半夏（三钱） 归须（二钱） 旋复花（三钱，包） 广皮炭（二钱） 降香
末（钱半） 苏子霜（钱半） 丹皮（三钱） 郁金（二钱）
八月初九日 少阳相火，误补成马刀，原应用凉络，奈连日白苔太重，胃不和，暂与和
胃，现下舌苔虽化，纳食不旺而呕，未可用凉，恐伤胃也。于前方减其治。
新绛纱（三钱） 丹皮（三钱） 生姜汁（三匙） 旋复花（三钱，包） 郁金（二钱） 黄芩炭
（二钱） 半夏（五钱）
仍用普济散漱口。
初六日 于前方内，去黄芩，加∶
香附（三钱） 广皮炭（二钱）
初八日 胆移热于脑下，为鼻渊，则鼻塞不通，甚则衄血。议清脑户之热，以开鼻塞，
兼宣少阳络气，外有马刀故也。
苍耳子（四钱，炒） 连翘（二钱） 桑叶（三钱） 辛夷（四钱，炒去毛） 银花（二钱） 茶
菊（三钱）
十二日 加旋复花（三钱） 郁金（二钱） 疏肝郁。加 姜半夏（二钱）止呕。
十六日 马刀已出大脓，左胁肝郁作痛，痛则大便，日下六七次，其色间黄间黑，时欲
呕，有大瘕泄之象，与两和肝胃。
旋复花（三钱，包） 姜半夏（四钱） 姜汁（三匙） 绛纱（三钱） 真降香末（三钱） 香附
（三钱） 归须（二钱） 黄芩（二钱，炒） 郁金（二钱） 焦白芍（三钱） 广皮炭（三钱）
十九日 外症未除，内又受伏暑成痢，舌白苔黄滑，小便不畅，大便五七次，有黑有白
，便
又不多，非积滞而何。不惟此也，时而呕水与痰，胃又不和，内外夹攻，何以克当。勉与四
苓合芩芍法。
猪苓（三钱） 广皮（三钱，炒） 木香（二钱） 泽泻（三钱） 白芍（三钱，炒） 降香末（
二钱）
云苓皮（五钱） 黄芩（二钱，炒） 红曲（二钱） 姜半夏（五钱） 真雅连（钱半，姜汁炒）
二十四日 病由胆而入肝，客邪已退，所见皆肝胆病，外而经络，内而脏腑，无所不病
。初
诊时即云深痼难拔，皆误用大热纯阳之累，所谓虽有善者，亦无如之何矣。再勉与泻小肠以
泻胆火法。
真雅连（钱半） 连翘（三钱） 乌梅（三钱，去核） 龙胆草（三钱） 黄芩（三钱，炒） 半
夏（三钱） 桑叶（三钱） 竹茹（三钱） 茶菊（三钱）
二十六日 脉少大而数，加∶
苦桔梗（三钱） 云苓皮（三钱） 银花（三钱）
二十九日 脉仍数，肝胆俱病，不能纯治一边。
连翘（三钱） 麦冬（五钱，连心） 雅连（五钱） 银花（三钱） 黄芩（六分） 乌梅（三钱）
桑叶（三钱） 半夏（三钱） 云苓（三钱） 茶菊（三钱）
九月十二日 前方服十一帖，胃口大开，舌苔化尽，肝气亦渐和。惟马刀核未消尽，鼻
犹塞
，唇犹强，变衄为鼽。脉弦数，大便黑，又于原方内去护土之刚药，加入脑户之络药。盖由
风热蟠聚于脑户，故鼻塞而衄或鼽，误补而邪不得出也。
苦桔梗（三钱） 苍耳子（三钱，炒） 乌梅（三钱） 人中黄（钱半） 辛夷（三钱） 茶菊（
三钱）
连翘心（三钱） 黄芩（二钱） 麦冬（五钱） 银花（三钱） 真雅连（一钱） 桑叶（三钱） 龙
胆草（一钱）
十九日 阅来札前方服七帖，肺胃之火太甚。议于原方加生石膏一两，杏仁二钱，开天
气以
通鼻窍，清阳明以定牙痛。如二三帖不效，酌加石膏，渐至二两，再敷水仙膏以消核之未尽
。
二十八日 右脉洪大而数，渴欲饮水，牙床肿甚，阳明热也。于前方内加石膏一两，共
二两，银花五钱，共八钱，桑叶二钱，共五钱。如服三五帖后，肿不消，加石膏至四两。
富氏 二十五岁 巅顶一点痛，畏灯光日光如虎，脉弦细微数，此厥阴头痛也，与定风
珠三剂而愈。
何氏 四十岁 阳虚头痛，背恶寒，脉弦紧甚，与黄 建中，加附子三帖而痛减，脉稍
和。又每日服半帖，四日而愈。
Zhao, male, 55 years old. On the 18th day of the third month in the Yichou year, the six pulses were wiry and slow; palpable at the deep level but imperceptible at the superficial level. There was severe pain at the vertex, radiating downward to connect with the Taiyang channel. This is due to Yang deficiency causing internal wind and dizziness.
Guizhi Tang (Cinnamon Twig Decoction): Guizhi (Cinnamomi Ramulus) 6 qian, Baishao (Paeoniae Radix Alba) 3 qian, Shengjiang (Zingiberis Rhizoma Recens) 6 qian, Zhigancao (Glycyrrhizae Radix et Rhizoma Preparatum) 3 qian, Chuanxiong (Ligustici Chuanxiong Rhizoma) 1 qian, Quandonggui (Angelicae Sinensis Radix) 2 qian, Shengjiang (Zingiberis Rhizoma Recens) 5 qian, Dazao (Jujubae Fructus) 30 pieces, pitted, Jiaoyi (Maltose) 5 qian, dissolved before adding.
Combining pungent and sweet flavors aids Yang; this is one method. Pungent and sweet together transform into wind energy; this is a second method. Simultaneously supplementing the righteous Qi of the Liver channel; this is a third method. Take two doses.
On the 10th day, after the headache caused by Yang deficiency healed, Jianzhong Tang (Middle-Building Decoction) was used for subsequent regulation.
Baishao (Paeoniae Radix Alba) 6 qian, Guizhi (Cinnamomi Ramulus) 4 qian, Shengjiang (Zingiberis Rhizoma Recens) 3 slices, Shengjiang (Zingiberis Rhizoma Recens) 5 qian, Zhigancao (Glycyrrhizae Radix et Rhizoma Preparatum) 3 qian, Dazao (Jujubae Fructus) 2 pieces, pitted, Jiaoyi (Maltose) 5 qian, dissolved before adding.
Li suffered from Shaoyang headache, originally having a predisposition to damage one eye. Unfortunately, ignorant physicians indiscriminately used pungent-warm drugs, which instead exacerbated the fire of Shaoyang. Some even used Aconitum (Fuzi), a drug with fierce properties. Due to the blindness of the physician, the patient also became blind. Moreover, this disease originated from latent summerheat triggering malaria. The prolonged malaria led to depression, causing Liver Qi stagnation that was difficult to extend. The more stagnant the Liver Qi, the hotter the Gallbladder fire. Currently, the Shaoyang headache persists. It is proposed to continue treating from the perspective of the Shaoyang Gallbladder collaterals.
Sangye (Mori Folium) 3 qian, Chaju (Chrysanthemi Flos) 3 qian, Lingyangjiao (Saigae Tataricae Cornu) 3 qian, Qingxiangzi (Celosiae Semen) 2 qian, Gouteng (Uncariae Ramulus cum Uncis) 2 qian, Danpi (Moutan Cortex) 3 qian, Maidong (Ophiopogonis Radix) 5 qian, retaining the heart, Huren (Canavaliae Semen) 3 qian, Jiegeng (Platycodonis Radix) 3 qian, Shenggancao (Glycyrrhizae Radix et Rhizoma) 1.5 qian, Cijili (Tribuli Fructus) 5 qian, Kudingcha (Ilicis Kudingcha Folium) 1 qian.
Chen, male, 35 years old. On the 22nd day of the tenth month in the Yichou year, Shaoyang wind movement occurred, compounded by external wind pathogen invasion. Pain was on the left side of the head. The left pulse was floating, wiry, and rapid, being twice as large as the right pulse. There was a high risk of damaging one eye. It is advised to urgently clear the heat from the Gallbladder collateral using the method of transforming wind with pungent and sweet flavors.
Lingyangjiao (Saigae Tataricae Cornu) 3 qian, Chaju (Chrysanthemi Flos) 3 qian, Sangye (Mori Folium) 3 qian, Ku Jiegeng (Platycodonis Radix) 3 qian, Shenggancao (Glycyrrhizae Radix et Rhizoma) 1 qian, Danpi (Moutan Cortex) 5 qian, Qingxiangzi (Celosiae Semen) 2 qian, Bohe (Menthae Haplocalycis Herba) 2 qian, Cijili (Tribuli Fructus) 2 qian, Gouteng (Uncariae Ramulus cum Uncis) 2 qian.
Boil five cups of water to obtain two cups. Divide into two doses. Decoction residue boiled again to obtain one cup. Two doses per day.
On the 25th day, added to the previous formula:
Muzei (Equiseti Herba) 1.5 qian, Ruiren (Buckwheat Fruit) 3 qian. Reduced Bohe (Menthae Haplocalycis Herba) to 0.4 qian. Headache and visual obscuration were severe.
Take three times daily; reduce to twice daily when symptoms slightly improve.
On the 8th day of the eleventh month, added to the previous formula:
Ruiren (Buckwheat Fruit), Maidong (Ophiopogonis Radix), Baimaogen (Imperatae Rhizoma).
Zhang, male, 43 years old. The cause of epistaxis is heat traveling through the clear pathways (upper respiratory tract and head/face meridians). The treatment principle should be to use light and clearing agents to clear the heat in the clear pathways. Unfortunately, heavy and cloying medicines were used, leading to left-sided headache, which indicates heat in the Shaoyang Gallbladder collateral. This poses a significant risk of damaging one eye. How could Shudi (Rehmanniae Radix Preparata), Rougui (Cinnamomi Cortex), Fuzi (Aconiti Lateralis Radix Preparata), and Lurong (Cervi Cornu Degelatinatum) be appropriate? This is extremely absurd. No wonder the condition is deep-rooted and difficult to eradicate. I reluctantly prescribed a method to clear the Shaoyang Gallbladder collateral. Lingyangjiao San (Antelope Horn Powder) should have been used, but since Antelope Horn was unavailable, it was not used.
Ku Jiegeng (Platycodonis Radix) 1 liang, Kudingcha (Ilicis Kudingcha Folium) 3 qian, Lianqiao (Forsythiae Fructus) 8 qian, retaining the heart, Gancao (Glycyrrhizae Radix et Rhizoma) 4 qian, Gouteng (Uncariae Ramulus cum Uncis) 6 qian, Yinhua (Lonicerae Japonicae Flos) 8 qian, Sangye (Mori Folium) 1 liang, Danpi (Moutan Cortex) 8 qian, Bohe (Menthae Haplocalycis Herba) 2 qian, Chaju (Chrysanthemi Flos) 5 liang, Baijili (Tribuli Fructus) 1 qian.
Grind into fine powder. Take 2 qian each time, three times daily, mixed with decoction of White Bean Flower (Vigna radiata var. angularis flos). Externally, apply soy milk prepared by boiling one dan (approx. 60kg) until reduced to about one bowl. Spread on the affected area of "Ma Dao" (scrofula/cervical lymphadenitis) until resolved. Must be coagulated with brine (tofu water), not edible tofu slurry.
Note: One person had chronic Liver stagnation and phlegm-fire, resulting in Ma Dao on the neck. Externally applied Puhuang (Lygodii Spora) on hemp cloth to the affected area. Internally took Yuan Shen (Scrophulariae Radix), Bei Mu (Fritillariae Thunbergii Bulbus), and Muli (Concha Ostreae) made into pills. Recovered in 100 days.
On the 27th day, follow-up showed slight improvement in symptoms, but the pulse remained unchanged. Continue with the previous formula to clear Shaoyang Gallbladder collateral heat for 2-3 doses. Re-evaluate after significant improvement.
On May 2nd, White Bean Flower was unavailable as an guiding agent. Fresh Lotus Leaf Edge (Nelumbinis Nelumbofolium) decoction can be used instead. Shaoyang collateral heat was mistakenly treated with strong Yang tonics, causing numbness and itching on the left half of the head and eyes, post-auricular abscess, developing into Ma Dao. Currently, the six pulses are deep, full, and rapid. Wind and fire are stirring in the head and eyes. Although Lingyangjiao San showed slight effect, it cannot achieve a major cure. It is proposed to add a decoction to temporarily clear wind-heat from Naohu (vertex/back of head). The powder formula should still be used continuously.
Ku Jiegeng (Platycodonis Radix), Cebaiye Tan (Platycladi Cacumen Carbonized), He Ye Bian (Fresh Lotus Leaf Edge) 1 piece, Xinyi (Magnoliae Flos) 4 qian, Shengling (Poria) 3 qian, Heishanzhi (Gardeniae Fructus Charred) 5 qian (remove if loose stools), Cang'erzi (Xanthii Fructus, stir-fried), Sangye (Mori Folium), Lianqiao (Forsythiae Fructus, retaining the heart), Chaju (Chrysanthemi Flos).
On June 3rd, reviewing the condition closely, the pathogen has moved from Shaoyang to Yangming. Added:
Sheng Shigao (Gypsum Fibrosum) 1 liang, Zhimu (Anemarrhenae Rhizoma) 3 qian, Gegen (Puerariae Lobatae Radix) 3 fen.
On the 12th day, lateral headache belongs to Shaoyang Gallbladder collateral disease. Physicians mistakenly diagnosed deficiency and used strong Yang tonics like Lurong (Cervi Cornu Degelatinatum), transferring Shaoyang heat to the Yangming portion. Symptoms included neck swelling, toothache, swelling and pain on half of the face and head, redness of the sclera, inability to open eyes, resembling warm-toxin syndrome. Tongue coating was red and yellow. Six pulses were deep, rapid, and forceful. It is proposed to use Daizhen Puji San (Emergency Relief Universal Health Powder) to urgently clear heat-toxin from both Shaoyang and Yangming.
Daizhen Puji San: 10 packets, 5 qian each. Decoct fresh Luzhu Gen (Phragmitis Rhizoma) in 2 cups of water to yield 1 cup. Strain. Drink half cup first. Hold the remaining half cup in the mouth and swallow slowly. When thin saliva forms, spit it out. After one hour, decoct another packet and administer similarly.
On the 16th day, tongue coating is yellower, pulse remains rapid, swelling has not fully subsided. Red streaks in the sclera rising from bottom to top are named "Dao Chui Lian" (Inverted Curtain). Treatment focuses on Yangming, unlike cases descending from top to bottom which focus on Taiyang.
Daizhen Puji San: Take 5 packets daily. Swallow most, gargle and spit out the rest. Each packet contains 3 qian Sheng Shigao (Gypsum Fibrosum). Decoct into a small bowl. Take for 2 days. Externally, use Maidong (Ophiopogonis Radix, retaining the heart) 1 liang, decocted in two parts as tea substitute.
On the 18th day, severe lateral headache today. Clear Shaoyang collaterals. For the swelling-reducing Puji San with added Shigao, take one packet in the morning. Take this formula at other times, three times totaling three cups.
Lingyangjiao (Saigae Tataricae Cornu) 1 qian, Danpi (Moutan Cortex) 1 qian, Yinhua (Lonicerae Japonicae Flos) 1 qian, Xijiao (Rhinocerotis Cornu - note: substitute usually used now) 0.8 qian, Chaju (Chrysanthemi Flos) 1 qian, Cijili (Tribuli Fructus) 0.6 qian, Lingxiaohua (Campsis Grandiflorae Flos) 1 qian, Gouteng (Uncariae Ramulus cum Uncis) 0.6 qian, Ku Jiegeng (Platycodonis Radix) 0.8 qian, Sangye (Mori Folium) 1 qian, Lianqiao (Forsythiae Fructus) 1 qian, Shenggancao (Glycyrrhizae Radix et Rhizoma) 0.4 qian.
Decoct in 2.5 cups of water to yield 1 cup. Take in one dose, three times daily.
On the 20th day, constipation. Add Yuanshen (Scrophulariae Radix) 2 qian. Remove if loose stools occur.
On the 23rd day, The Classic states that pulses being uniquely large/small or floating/sinking indicate the location of disease. Now the left Guan position is uniquely large and floating, indicating excessive Gallbladder Yang. Medicines clearing Gallbladder collaterals have been taken for dozens of doses, yet the Gallbladder pulse remains vigorous. Collateral-clearing medicines are light and float upward. When will this end? Since the Gallbladder has no exit, borrow the Small Intestine as an exit. The Small Intestine is a Fire Fu organ; bitterness is required to unblock it. Temporarily use extremely bitter purgative methods. However, such medicines should only be used temporarily, not long-term, to avoid drying out fluids.
Yang Luhui (Aloe) 2 qian, Longdancao (Gentianae Radix) 3 qian, Hu Huanglian (Picrorhizae Rhizoma) 2 qian, Zhen Yalian (Coptidis Rhizoma) 2 qian, Maidong (Ophiopogonis Radix) 5 qian, retaining the heart, Danpi (Moutan Cortex) 5 qian, Qiushi (Urinal Calculus) 1 qian.
On the 26th day, after taking two doses of the previous formula, the uniquely large and floating pulse at the left Guan position has flattened. Continue alternating Lingyangjiao San and Daizhen Puji San for one day each. Red streaks in the eyes have significantly receded. The Ma Dao behind the ear remains hard. Continue taking Daizhen Puji San, 4-5 times daily.
On July 1st, pulse is deep and rapid. The hardness of the Ma Dao has not dissipated. The areas where Shaoyang and Yangming meridians received toxins remain stiff and pulling. Externally change to applying Shuixian Gao (Narcissus Paste) to the affected area. Take Lingyangjiao San once in the morning, and Daizhen Puji San four packets in the afternoon.
On the 9th day, throat feels clearer than before after taking previous medicines. Yellow and turbid tongue coating has reduced by more than half. Pulse is smaller but still rapid. Interior symptoms are improving daily, which is excellent. Externally, Shuixian Gao extracted some yellow pus, but toxins are not fully resolved. Apply again urgently until completely removed. Delayed efficacy is due to previous misuse of strong tonics. Breaking this siege quickly is not possible overnight. Be patient and allow natural resolution. Being too aggressive risks breaking rigidity. Lingyangjiao San: one packet in the morning. Daizhen San: four packets in the afternoon, divided into four doses. Use 2-3 packets decocted for gargling to protect teeth.
On the 17th day, bowel movements have been unsatisfactory for several days. Left Guan pulse is floating again. Wound is very painful. Use extremely bitter herbs to drain the Small Intestine, adding aromatic collaterals-activating pain-relievers.
Yang Luhui (Aloe) 2 qian, Ruxiang (Olibanum) 3 qian, Sheng Dahuang (Rhei Radix et Rhizoma) 3 qian, wine-fried black, Zhen Chuanlian (Coptidis Rhizoma) 2 qian, Moyao (Myrrha) 2 qian, Guiwei (Angelicae Sinensis Radix Tail) 3 qian, Longdancao (Gentianae Radix) 3 qian, Qiushi (Urinal Calculus) 3 qian, Hu Huanglian (Picrorhizae Rhizoma) 3 qian, Yinhua (Lonicerae Japonicae Flos) 5 qian.
Decoct into three small cups. Divide into three doses. Stop after achieving free bowel movement.
On the 18th day, although Ma Dao has ulcerated, heat-toxin of Shaoyang and Yangming is not cleared. Both Guan pulses are uniquely floating, Qi is very vigorous. While clearing Shaoyang and Yangming collateral heat, simultaneously soothe Liver stagnation and soften hardness/nodules.
Ku Jiegeng (Platycodonis Radix) 3 qian, Sangye (Mori Folium) 3 qian, Haizao (Sargassum) 2 qian, Yinhua (Lonicerae Japonicae Flos) 3 qian, Danpi (Moutan Cortex) 5 qian, Lingxiaohua (Campsis Grandiflorae Flos) 3 qian, Lianqiao (Forsythiae Fructus) 3 qian, Sheng Xiangfu (Cyperi Rhizoma) 3 qian, Xiakucao (Prunellae Spica) 3 qian, Chaju (Chrysanthemi Flos) 3 qian.
On the 25th day, Ma Dao resulted from excessive mistaken tonification. Having existed for a long time, it cannot resolve quickly. Stopped using Shuixian Gao due to fear of pain. Tongue coating is slightly yellow on the surface; toxin is still heavy. Appetite has decreased slightly due to Wood overacting on Earth. Add herbs to vent Liver stagnation to the previous formula.
Ku Jiegeng (Platycodonis Radix) 2 qian, Sangye (Mori Folium) 3 qian, Xiangfu (Cyperi Rhizoma) 2 qian, Yinhua (Lonicerae Japonicae Flos) 3 qian, Danpi Tan (Moutan Cortex Carbonized) 3 qian, Lianqiao (Forsythiae Fructus) 3 qian, Yujin (Curcumae Radix) 2 qian, Chaju (Chrysanthemi Flos) 3 qian.
Still use Daizhen Puji San for gargling, do not swallow.
On the 28th day, Liver stagnation mistook for tonification, forming Ma Dao. Eyes nearly damaged. Ma Dao has reduced by half, eyes are healing, rapid pulse has normalized.
However, left Guan is uniquely floating, nature is urgent. Liver stagnation has not descended. Stomach is not opening well. Chest feels stuffed after meals. Tongue is white, slippery, slightly yellow. All due to Wood excess overacting on Earth. Cooling agents for detoxification and clearing heat are temporarily stopped. Instead, harmonize Liver and Stomach.
Xinjiang Sha (New Crimson Gauze) 3 qian, Jiang Banxia (Pinelliae Rhizoma Preparatum) 3 qian, Xu Guiwei (Angelicae Sinensis Radix Tail) 2 qian, Xuanfuhua (Inulae Flos) 3 qian, wrapped, Guangpi Tan (Citri Reticulatae Pericarpium Carbonized) 2 qian, Jiangxiang Mo (Dalbergiae Odoriferae Lignum) powder 1.5 qian, Suzi Shuang (Perillae Fructus Frost) 1.5 qian, Danpi (Moutan Cortex) 3 qian, Yujin (Curcumae Radix) 2 qian.
On August 9th, Shaoyang Ministerial Fire, mistook for tonification, formed Ma Dao. Originally should have used cooling collaterals. Unfortunately, thick white coating persisted for days, Stomach disharmony. Temporarily harmonize Stomach. Although tongue coating has transformed, appetite is poor with vomiting. Cooling is contraindicated to avoid damaging Stomach. Reduce treatment intensity in previous formula.
Xinjiang Sha (New Crimson Gauze) 3 qian, Danpi (Moutan Cortex) 3 qian, Shengjiang Zhi (Zingiberis Rhizoma Recens Juice) 3 spoons, Xuanfuhua (Inulae Flos) 3 qian, wrapped, Yujin (Curcumae Radix) 2 qian, Huangqin Tan (Scutellariae Radix Carbonized) 2 qian, Banxia (Pinelliae Rhizoma) 5 qian.
Still use Puji San for gargling.
On the 6th day, remove Huangqin from previous formula, add:
Xiangfu (Cyperi Rhizoma) 3 qian, Guangpi Tan (Citri Reticulatae Pericarpium Carbonized) 2 qian.
On the 8th day, Gallbladder transferring heat to below the brain causes Bi Yuan (sinusitis), leading to nasal congestion, severe cases epistaxis. Clear heat from Naohu (vertex/back of head) to open nasal passages, simultaneously vent Shaoyang collateral Qi, given external Ma Dao.
Cangerzi (Xanthii Fructus, stir-fried) 4 qian, Lianqiao (Forsythiae Fructus) 2 qian, Sangye (Mori Folium) 3 qian, Xinyi (Magnoliae Flos, stir-fried, remove hairs) 4 qian, Yinhua (Lonicerae Japonicae Flos) 2 qian, Chaju (Chrysanthemi Flos) 3 qian.
On the 12th day, add Xuanfuhua (Inulae Flos) 3 qian, Yujin (Curcumae Radix) 2 qian to soothe Liver stagnation. Add Jiang Banxia (Pinelliae Rhizoma Preparatum) 2 qian to stop vomiting.
On the 16th day, Ma Dao discharged large amount of pus. Left hypochondrium pain due to Liver stagnation. Pain triggers bowel movement, 6-7 times daily. Stool color alternates yellow and black. Occasional vomiting. Resembles Da Xia Xie (severe diarrhea/dysentery). Harmonize Liver and Stomach.
Xuanfuhua (Inulae Flos) 3 qian, wrapped, Jiang Banxia (Pinelliae Rhizoma Preparatum) 4 qian, Jiang Zhi (Zingiberis Rhizoma Recens Juice) 3 spoons, Jiang Sha (Crimson Gauze) 3 qian, Zhen Jiangxiang Mo (Dalbergiae Odoriferae Lignum) powder 3 qian, Xiangfu (Cyperi Rhizoma) 3 qian, Xu Guiwei (Angelicae Sinensis Radix Tail) 2 qian, Huangqin (Scutellariae Radix, stir-fried) 2 qian, Yujin (Curcumae Radix) 2 qian, Jiao Baishao (Paeoniae Radix Alba, charred) 3 qian, Guangpi Tan (Citri Reticulatae Pericarpium Carbonized) 3 qian.
On the 19th day, exterior symptoms not resolved. Internally, latent summerheat caused dysentery. Tongue white coating, yellow and slippery. Urination difficult. Bowel movement 5-7 times daily, black and white, small volume. Is this not accumulation/stagnation? Furthermore, occasional vomiting of water and phlegm. Stomach disharmony. Internal and external attack combined, how to withstand? Reluctantly prescribe Siling San (Four Porias Powder) combined with Qin-Shao method (Scutellaria and Paeonia).
Zhuling (Polyporus) 3 qian, Guangpi (Citri Reticulatae Pericarpium, stir-fried) 3 qian, Muxiang (Aucklandiae Radix) 2 qian, Zexie (Alismatis Rhizoma) 3 qian, Baishao (Paeoniae Radix Alba, stir-fried) 3 qian, Jiangxiang Mo (Dalbergiae Odoriferae Lignum) powder 2 qian.
Yunling Pi (Poria Peel) 5 qian, Huangqin (Scutellariae Radix, stir-fried) 2 qian, Hongqu (Red Yeast Rice) 2 qian, Jiang Banxia (Pinelliae Rhizoma Preparatum) 5 qian, Zhen Yalian (Coptidis Rhizoma) 1.5 qian, ginger juice fried.
On the 24th day, Disease entered Liver from Gallbladder. External pathogens retreated. What is seen are all Liver-Gallbladder diseases, affecting both exterior meridians and interior organs. At initial diagnosis, it was stated as deep-rooted and difficult to extract, due to misuse of large hot pure-Yang tonics. As the saying goes, even if skilled, there is nothing to be done. Again, reluctantly prescribe draining Small Intestine to drain Gallbladder fire.
Zhen Yalian (Coptidis Rhizoma) 1.5 qian, Lianqiao (Forsythiae Fructus) 3 qian, Wumei (Mume Fructus) 3 qian, pitted, Longdancao (Gentianae Radix) 3 qian, Huangqin (Scutellariae Radix, stir-fried) 3 qian, Banxia (Pinelliae Rhizoma) 3 qian, Sangye (Mori Folium) 3 qian, Zhuru (Bambusae Caulis in Taenia) 3 qian, Chaju (Chrysanthemi Flos) 3 qian.
On the 26th day, pulse slightly large and rapid. Add:
Ku Jiegeng (Platycodonis Radix) 3 qian, Yunling Pi (Poria Peel) 3 qian, Yinhua (Lonicerae Japonicae Flos) 3 qian.
On the 29th day, pulse still rapid. Both Liver and Gallbladder diseased. Cannot treat only one side purely.
Lianqiao (Forsythiae Fructus) 3 qian, Maidong (Ophiopogonis Radix) 5 qian, retaining the heart, Yalian (Coptidis Rhizoma) 5 qian, Yinhua (Lonicerae Japonicae Flos) 3 qian, Huangqin (Scutellariae Radix) 0.6 qian, Wumei (Mume Fructus) 3 qian, Sangye (Mori Folium) 3 qian, Banxia (Pinelliae Rhizoma) 3 qian, Yunling (Poria) 3 qian, Chaju (Chrysanthemi Flos) 3 qian.
On September 12th, took 11 doses of previous formula. Appetite opened up, tongue coating completely transformed, Liver Qi gradually harmonized. Only Ma Dao nodules not fully resolved. Nose still congested, lips stiff. Epistaxis changed to rhinorrhea. Pulse wiry and rapid. Black stool. Removed earth-protecting rigid herbs from original formula, added collaterals herbs for Naohu (vertex/back of head). Because wind-heat gathered at Naohu, causing nasal congestion and epistaxis/rhinorrhea. Mistaken tonification prevented pathogen exit.
Ku Jiegeng (Platycodonis Radix) 3 qian, Cangerzi (Xanthii Fructus, stir-fried) 3 qian, Wumei (Mume Fructus) 3 qian, Renzhonghuang (Human Excremental Soil) 1.5 qian, Xinyi (Magnoliae Flos) 3 qian, Chaju (Chrysanthemi Flos) 3 qian.
Lianqiao Xin (Forsythiae Fructus Heart) 3 qian, Huangqin (Scutellariae Radix) 2 qian, Maidong (Ophiopogonis Radix) 5 qian, Yinhua (Lonicerae Japonicae Flos) 3 qian, Zhen Yalian (Coptidis Rhizoma) 1 qian, Sangye (Mori Folium) 3 qian, Longdancao (Gentianae Radix) 1 qian.
On the 19th day, reviewed letter: previous formula taken for 7 doses. Lung and Stomach fire too severe. Proposed adding Sheng Shigao (Gypsum Fibrosum) 1 liang, Xingren (Armeniacae Semen Amarum) 2 qian to original formula. Open heavenly Qi to unblock nasal orifices, clear Yangming to settle toothache. If ineffective after 2-3 doses,酌情 increase Shigao gradually to 2 liang. Then apply Shuixian Gao (Narcissus Paste) to dissolve remaining nodules.
On the 28th day, Right pulse is full, large, and rapid. Thirsty for drinking water. Gum swelling severe. Yangming heat. Add Shigao 1 liang to previous formula, total 2 liang. Yinhua 5 qian, total 8 qian. Sangye 2 qian, total 5 qian. If swelling does not subside after 3-5 doses, increase Shigao to 4 liang.
Fu, male, 25 years old. Point pain at vertex. Fear of light and sunlight like a tiger. Pulse wiry, fine, subtle, and rapid. This is Jueyin headache. Prescribed Dingfeng Zhu (Wind-Stabilizing Pill) for three doses, cured.
He, male, 40 years old. Yang deficiency headache, aversion to cold on back. Pulse wiry and tight, severe. Prescribed Huangqi Jianzhong Tang (Astragalus Middle-Building Decoction), added Fuzi (Aconiti Lateralis Radix Preparata) for three doses. Pain reduced, pulse slightly harmonized. Continued taking half dose daily, cured in four days.