许 四十七岁 癸亥二月二十日 脉弦而紧，弦则木旺，紧则为寒，木旺则土衰，中寒
则阳
不运，土衰而阳不运。故吞酸嗳气，不寐不食，不饥不便，九窍不和，皆属胃病。浊阴蟠踞
中焦，格拒心火，不得下达，则心热如火，议苦辛通法。
小枳实（三钱） 淡吴萸（三钱） 半夏（一两） 真云连（二钱，炒） 生苡仁（五钱） 广皮
（二钱） 浓朴（三钱） 生姜（六大片）
甘澜水八碗，煎成三碗，分三次服，渣再煎一碗服。
二十四日 六脉阳微，浊阴蟠踞，不食，不饥，不便，用和阳明兼驱浊阴法。今腹大痛
，已
归下焦，十余日不大便，肝病不能疏泄，用驱浊阴通阴络法。又苦辛通法，兼以浊攻浊法。
淡吴萸（三钱） 小枳实（二钱） 川楝子（三钱） 小茴香（三钱） 雄鼠粪（三钱） 广皮（
钱半） 乌药（一钱） 良姜（二钱，炒） 川朴（三钱） 槟榔（二钱）
以得通大便为度。
二十七日 服以浊攻浊法，大便已通，但欲便先痛，便后痛减，责之络中宿积未能通清
。
脐上且有动气，又非汤药所能速攻，攻急恐有瘕散为蛊之余。议化 回生丹，缓攻为妙。
某 脉沉紧为里寒，木旺土衰，浊阴上攻，腹拘急时痛，胁胀，腰痛，宜苦辛通法，兼
醒脾阳。
白蔻仁（一钱） 官桂（一钱） 川朴（二钱） 半夏（三钱） 生苡仁（三钱） 荜茇（一钱）
藿梗（三钱） 木香（八分） 生香附（三钱） 广皮（钱半） 郁金（二钱） 乌药（二钱）
某 脉弦细而紧，浊阴上攻，胸痛，用辛香流气法。
淡吴萸（三钱） 小枳实（二钱） 木香（一钱） 川朴（二钱） 川楝子（三钱） 广皮（二钱）
槟榔（钱半） 荜茇（二钱） 乌药（二钱） 良姜（三钱）
三帖。
初八日 补火生土，兼泄浊阴。
淡干姜（二钱） 半夏（三钱） 淡吴萸（二钱） 乌药（二钱） 茯苓块（三钱） 生苡仁（三
钱） 广皮（钱半） 益智仁（钱半，煨）
四帖。
李 十三岁 五月十四日 六脉俱弦，不浮，不沉，不数，舌苔白滑，不食，不饥，不
便，
不寐，九窍不和，皆属胃病。卧时自觉气上阻咽，致令卧不着席，此肝气之逆也。额角上有
虫斑，神气若昏，目闭不欲开，视不远，医云有虫，亦复有理。与两和肝胃，如再不应，再
议治虫。
半夏（一两） 旋复花（五钱，包） 秫米（一合）
二十日 六腑不通，九窍不和。医者不知六腑为阳，以通为补，每见其二便闭也，则以
大黄
、蒌仁寒药下之。以后非下不通，屡下屡伤遂致神气若昏，目闭不开，脉弦缓而九窍愈不通
矣。已成坏症，勉与通阳。
广皮（三钱） 川朴（三钱） 白蔻仁（二钱） 半夏（三钱） 大腹皮（三钱） 鸡内金（二钱
，炒） 云苓皮（三钱） 益智仁（二钱）
二十三日 六腑闭塞不通，有若否卦之象。按∶否之得名，以坤阴长阳消之候，将来必
致上
下皆坤而后已。坤为腹，故腹大无外。坤为纯阴，初爻变震为复。然则欲复其阳，非性烈如
震者不可，岂大黄等阴寒药所可用哉。
天台乌药散二钱，加巴豆霜二分，和匀分三分，先服一分，候五时不便，再服第二分，
得快便，即止。
二十四日 服一次于五时得快便，宿物下者甚多，目闭已开，神气亦清，稍食粥饮，知
顽笑矣。
二十五日 六腑不通，温下后大便虽通，而小便仍然未解，心下窒塞，不肌不食，六腑
弦迟，急急通阳为要，与开太阳阖阳明法。
川椒炭（三钱） 泽泻（三钱） 公丁香（一钱） 半夏（五钱） 广皮（三钱） 猪苓（三钱）
云苓皮（五钱） 良姜（二钱） 安南桂（一钱）
六月初一日 大便已能自解，胃能进食，是阳关已阖。惟小便不通，是太阳不开，与专
开太阳。
桂枝（三钱） 云苓皮（五钱） 猪苓（三钱） 安边桂（钱半） 泽泻（三钱） 滑石（三钱）
苍术炭（二钱） 蚕砂（三钱）
煮三杯，分三次服，以小便通为度。若小便已通，而尚混浊者，再服一帖，以小便清为
度。
初六日 服前方二帖，小便暂通。连日大小便复闭，大便闭已七日，自觉胃中痞塞，脸
上虫
斑未退。议用前配成之乌药散，再服四分。如二便俱通，即停药，统俟初八日清晨再商。如
大便通一次，而小便不通，或竟不通，明日再服三分。若大便二三次，而小便仍不通者，即
勿服。
初八日 服乌药散四分，内巴霜四厘，已得快便，今早且能自行小便，六腑俱通矣。只
与和胃，今能进食，可以收功。盖十二经皆取决于胆，皆秉气于胃也。
半夏（三钱） 云苓块（四钱） 益智仁（一钱，煨） 广皮炭（二钱） 生苡仁（五钱） 生姜
（五钱）
庆宝 女 十六岁 不食十余日 诸医不效，面赤脉洪，与五汁饮，降胃清阴法，兼服
牛乳，三日而大食矣。
梨汁 藕汁 蔗汁 芦根汁 荸荠汁
邱 十八岁 温热愈后，午后微热不除，脉弦数，面赤，五汁饮三日，热退进食，七日
全愈。
Xu, aged 47. On the 20th day of the second month in the Guihai year, the pulse was wiry (Xian) and tight (Jin). A wiry pulse indicates hyperactive Liver Wood; a tight pulse indicates Cold. Hyperactive Liver Wood weakens Spleen Earth; Middle Jiao Cold causes Yang Qi to fail to circulate. With weakened Spleen Earth and non-circulating Yang, symptoms such as acid regurgitation, belching, insomnia, anorexia, lack of hunger, constipation, and disharmony of the nine orifices occur, all belonging to Stomach disease. Turbid Yin stagnates in the Middle Jiao, blocking Heart Fire from descending, resulting in Heart heat like fire. It is proposed to use the Bitter-Spicy Unblocking Method (Ku Xin Tong Fa).
Prescription: Small Zhi Shi (Fructus Aurantii Immaturus, 3 qian), Dan Wu Zhu Yu (Evodiae Fructus, 3 qian), Ban Xia (Pinelliae Rhizoma, 1 liang), Zhen Yun Lian (Coptidis Rhizoma, 2 qian, stir-fried), Sheng Yi Yi Ren (Coicis Semen, 5 qian), Guang Pi (Citri Reticulatae Pericarpium, 2 qian), Nong Po (Magnoliae Officinalis Cortex, 3 qian), Sheng Jiang (Zingiberis Rhizoma Recens, 6 large slices).
Boil with Gan Lan Water (Ganlan water, prepared by stirring boiling water vigorously) 8 bowls down to 3 bowls, divide into three doses. Decoction residue boiled again to yield 1 bowl for administration.
On the 24th day, the Yang positions of the six pulses were faint. Turbid Yin stagnated; there was no eating, no hunger, and no bowel movement. The method of harmonizing Yangming and driving out turbid Yin was used. Now abdominal severe pain has shifted to the Lower Jiao. Having not had a bowel movement for over ten days due to Liver failure in dredging and draining, the method of driving out turbid Yin and unblocking the Yin collaterals is employed. This combines the Bitter-Spicy Unblocking Method with the "Attacking Turbid with Turbid" method.
Prescription: Dan Wu Zhu Yu (Evodiae Fructus, 3 qian), Xiao Zhi Shi (Fructus Aurantii Immaturus, 2 qian), Chuan Li Zi (Toosendan Fructus, 3 qian), Xiao Hui Xiang (Foeniculi Fructus, 3 qian), Xiong Shu Fen (Stercor Mus Marris, 3 qian), Guang Pi (Citri Reticulatae Pericarpium, 1.5 qian), Wu Yao (Linderae Radix, 1 qian), Liang Jiang (Galangal Rhizome, 2 qian, stir-fried), Chuan Po (Magnoliae Officinalis Cortex, 3 qian), Bing Lang (Arecae Semen, 2 qian).
Stop when bowel movement is achieved.
On the 27th day, after taking the "Attacking Turbid with Turbid" method, bowel movement was achieved, but pain preceded defecation and decreased after defecation. This is attributed to old accumulation in the collaterals not being cleared. There is also moving Qi above the navel, which cannot be rapidly attacked by decoctions. Rapid attack might cause masses to scatter and transform into Gu poison remnants. It is proposed to use Hua Huisheng Dan (Hua Huisheng Pill) for slow attack, which is advisable.
Another patient: Pulse deep and tight indicates Interior Cold. Liver Wood is hyperactive and Spleen Earth is weak. Turbid Yin attacks upward, causing abdominal tension and intermittent pain, hypochondriac distension, and lower back pain. The Bitter-Spicy Unblocking Method is suitable, combined with awakening Spleen Yang.
Prescription: Bai Kou Ren (Amomi Fructus Rotundus, 1 qian), Guan Gui (Cinnamomi Cortex, 1 qian), Chuan Po (Magnoliae Officinalis Cortex, 2 qian), Ban Xia (Pinelliae Rhizoma, 3 qian), Sheng Yi Yi Ren (Coicis Semen, 3 qian), Bi Bo (Piperis Kadsurae Fructus, 1 qian), Huo Geng (Agastachis Herba, 3 qian), Mu Xiang (Aucklandiae Radix, 8 fen), Sheng Xiang Fu (Cyperi Rhizoma, 3 qian), Guang Pi (Citri Reticulatae Pericarpium, 1.5 qian), Yu Jin (Curcumae Longae Radix, 2 qian), Wu Yao (Linderae Radix, 2 qian).
Another patient: Pulse wiry, fine, and tight. Turbid Yin attacks upward, causing chest pain. The Pungent-Aromatic Qi-Flowing Method is used.
Prescription: Dan Wu Zhu Yu (Evodiae Fructus, 3 qian), Xiao Zhi Shi (Fructus Aurantii Immaturus, 2 qian), Mu Xiang (Aucklandiae Radix, 1 qian), Chuan Po (Magnoliae Officinalis Cortex, 2 qian), Chuan Li Zi (Toosendan Fructus, 3 qian), Guang Pi (Citri Reticulatae Pericarpium, 2 qian), Bing Lang (Arecae Semen, 1.5 qian), Bi Bo (Piperis Kadsurae Fructus, 2 qian), Wu Yao (Linderae Radix, 2 qian), Liang Jiang (Galangal Rhizome, 3 qian).
Three doses.
On the 8th day, Supplement Fire to Generate Earth, combined with draining Turbid Yin.
Prescription: Dan Gan Jiang (Zingiberis Rhizoma, 2 qian), Ban Xia (Pinelliae Rhizoma, 3 qian), Dan Wu Zhu Yu (Evodiae Fructus, 2 qian), Wu Yao (Linderae Radix, 2 qian), Fu Ling Kuai (Poria, 3 qian), Sheng Yi Yi Ren (Coicis Semen, 3 qian), Guang Pi (Citri Reticulatae Pericarpium, 1.5 qian), Yi Zhi Ren (Alpiniae Oxyphyllae Fructus, 1.5 qian, baked).
Four doses.
Li, aged 13. On May 14th, all six pulses were wiry, neither floating, sinking, nor rapid. Tongue coating was white and slippery. Symptoms included anorexia, lack of hunger, constipation, insomnia, and disharmony of the nine orifices, all belonging to Stomach disease. While lying down, he felt Qi obstructing the throat, preventing him from lying flat. This is counterflow of Liver Qi. There were worm spots on the forehead corners, spirit seemed dull, eyes closed unwilling to open, and distant vision was impaired. The physician diagnosed worms, which is reasonable. First, harmonize Liver and Stomach. If there is no response, discuss treating worms again.
Prescription: Ban Xia (Pinelliae Rhizoma, 1 liang), Xuan Fu Hua (Inulae Flos, 5 qian, wrapped), Shu Mi (Sorghum Vulgare, 1 he).
On the 20th day, the Six Fu organs are blocked, leading to disharmony of the nine orifices. Physicians do not understand that the Six Fu organs belong to Yang and benefit from unblocking. Whenever they see closure of stool and urine, they use cold purgatives like Da Huang (Rhei Radix et Rhizoma) and Lou Ren (Trichosanthis Semen) to purge. Subsequently, without purging, there is no passage; repeated purging repeatedly injures the body, leading to dull spirit, closed eyes, wiry-slow pulse, and worsening blockage of the nine orifices. It has become a ruined condition. Tentatively, unblock Yang.
Prescription: Guang Pi (Citri Reticulatae Pericarpium, 3 qian), Chuan Po (Magnoliae Officinalis Cortex, 3 qian), Bai Kou Ren (Amomi Fructus Rotundus, 2 qian), Ban Xia (Pinelliae Rhizoma, 3 qian), Da Fu Pi (Arecae Pericarpium, 3 qian), Ji Nei Jin (Galli Gigerii Endothelium Corneum, 2 qian, stir-fried), Yun Ling Pi (Poria Cortice, 3 qian), Yi Zhi Ren (Alpiniae Oxyphyllae Fructus, 2 qian).
On the 23rd day, the Six Fu organs are blocked, resembling the hexagram Pi (Standstill). Note: Pi gets its name from the phase where Kun Yin grows and Yang declines, eventually leading to pure Kun (Yin) above and below. Kun represents the abdomen, hence the abdomen is huge. Kun is pure Yin; if the first line changes to Zhen, it becomes Fu (Return). Thus, to restore Yang, one must use something fierce like Zhen. How can cold Yin herbs like Da Huang be used?
Tian Tai Wu Yao San (Tian Tai Lindera Powder) 2 qian, mixed with Ba Dou Shuang (Crotonis Semen Frost, 2 fen), evenly divided into three parts. Take one part first. If no bowel movement after five shichen (10 hours), take the second part. Stop once free stool is passed.
On the 24th day, after one dose, free stool was passed within five shichen. Much accumulated matter was discharged. Eyes opened, spirit cleared, slightly consumed porridge, and knew how to play.
On the 25th day, Six Fu organs blocked. After warm purging, although bowel movement occurred, urination remained unresolved. Epigastric stuffiness, emaciation, anorexia, and Six Fu wiry-slow pulse indicate urgent need to unblock Yang. Use the method of Opening Taiyang and Closing Yangming.
Prescription: Chuan Jiao Tan (Zanthoxyli Pericarpium Carbonized, 3 qian), Ze Xie (Alismatis Rhizoma, 3 qian), Gong Ding Xiang (Syzygii Aromatisati Flos, 1 qian), Ban Xia (Pinelliae Rhizoma, 5 qian), Guang Pi (Citri Reticulatae Pericarpium, 3 qian), Zhu Ling (Polyporus, 3 qian), Yun Ling Pi (Poria Cortice, 5 qian), Liang Jiang (Galangal Rhizome, 2 qian), An Nan Gui (Cinnamomi Ramulus, 1 qian).
On June 1st, bowel movement could resolve spontaneously, and stomach could accept food, indicating the Yang gate is closed. Only urination is blocked, indicating Taiyang is not opening. Prescribe specifically to open Taiyang.
Prescription: Gui Zhi (Cinnamomi Ramulus, 3 qian), Yun Ling Pi (Poria Cortice, 5 qian), Zhu Ling (Polyporus, 3 qian), An Bian Gui (Cinnamomi Ramulus, 1.5 qian), Ze Xie (Alismatis Rhizoma, 3 qian), Hua Shi (Talcum, 3 qian), Cang Zhu Tan (Atractylodis Rhizoma Carbonized, 2 qian), Can Sha (Bombyx Batryticatus, 3 qian).
Boil to three cups, divide into three doses. Stop when urination is clear. If urination is clear but still turbid, take another dose until urine is clear.
On the 6th day, after two doses of the previous prescription, urination temporarily cleared. For consecutive days, both stool and urine became blocked again. Stool blocked for seven days, feeling epigastric stuffiness, worm spots on face not faded. Propose using the previously compounded Wu Yao San, take another 4 fen. If both stool and urine pass, stop medication, wait until early morning of the 8th day to consult further. If stool passes once but urine does not, or completely fails to pass, take 3 fen tomorrow. If stool passes two or three times but urine still does not, do not take.
On the 8th day, took 4 fen of Wu Yao San, containing 4 li of Ba Dou Shuang. Obtained free stool. This morning, could urinate independently. All Six Fu organs are now open. Only give Harmonize Stomach medicine. Now able to eat, treatment can conclude. All twelve meridians depend on Gallbladder and derive Qi from Stomach.
Prescription: Ban Xia (Pinelliae Rhizoma, 3 qian), Yun Ling Kuai (Poria, 4 qian), Yi Zhi Ren (Alpiniae Oxyphyllae Fructus, 1 qian, baked), Guang Pi Tan (Citri Reticulatae Pericarpium Carbonized, 2 qian), Sheng Yi Yi Ren (Coicis Semen, 5 qian), Sheng Jiang (Zingiberis Rhizoma Recens, 5 qian).
Qingbao, Female, 16 years old. Not eating for over ten days. Various physicians ineffective. Face red, pulse surging. Given Wu Zhi Yin (Five Juices Drink), using Descend Stomach and Clear Yin method, combined with cow milk. After three days, ate heavily.
Prescription: Li Zhi (Pyri Fructus Juice), Ou Zhi (Nelumbinis Rhizomatis Juice), Zhe Zhi (Sacchari Sinarum Juice), Lu Gen Zhi (Phragmitis Rhizomatis Juice), Bi Qi Zhi (Dioscoreae Hypoglaucae Juice).
Qiu, 18 years old. After recovery from Warm Heat disease, slight afternoon fever persisted. Pulse wiry and rapid, face red. Took Wu Zhi Yin for three days. Fever subsided, appetite returned, fully recovered in seven days.