姚贞白老中医师，是姚氏行医的第五代，幼承家学，在父荫轩老医师教育下，勤奋熟读经典。既长，游学大江南北，观摩各家流派，丰富自己的医疗科学知识，并不断以理论和实践相印证，重视治病因地、因人、因病制宜。他行医五十余年，医风朴素，态度和蔼，在医理上有创新，临证疗效显著。
姚老中医是昆明市中医院院长，热爱中医事业。为继承、发扬祖国医学，他曾指导着子女和门人，撰成“巽园医话”及“临床治验录”初稿。但是，由于“四人帮”的干扰破坏，原稿散失。1973年～1977年8月，当他数次中风昏迷，在各级党委的关怀下，经抢救治疗好转后，他仍以坚强的毅力，用回忆口述的方式，由子姚承祖、姚承济执笔，通过长期的努力，完成了这部《医案》初稿。稿成，曾经由昆明医学院姚蓬心同志提供了宝贵的意见。
1978年4月，在省、市卫生局和市中医院的直接领导下，正式成立“姚贞白诊疗经验整理小组”。小组由中医师张浩然、葛鸿源、苏藩及姚老医师子女姚克敏、姚承济、姚承祖医师等六人组成。整理时，对每一案例，认真核实、讨论病情，分析医理，酌句修辞，力求体现姚老中医的学术风格。
姚贞白老中医的学术思想，源于内、难、长沙、金元诸子、温热病学以及历代各大家。如“虚痨发热”数案，他本内经阴阳离合论：“少阳为枢”之机理，从枢转少阳，以平谧脏腑阴阳为总旨，取伤寒论之柴胡、白虎等方经义，又灵活融化温病学之养阴生津、清热化燥及历代治虚痨法，更加重视患者之体质及妇、儿特点。故能拟就一系列程序井然之治则及方药，收到显著的疗效。
类上情况，他的辨证观点颇为明晰。他确认“病同证异”的客观病理现实。如对“眩晕”、“脉管炎”、“紫斑”、“黄疸”、“中风”、“霍乱”、“蛔厥与厥阴伤寒”等病之不同案例，从不同的角度着手，析理精透，法有常变。同时，他强调标、本、缓、急在每症中的规律性，重视初、中及后期治则和方义的机转权变。在各诊次之间，认为要有一定的衔接性和连贯性，这就必须紧紧地把握着症候机理内在的线索。
他既重治标，更重治本，而又不忘调理善后。以治标为先导，意在清理层次，剖露本质，为治本创造条件，如“咳喘”、“咳嗽痰厥昏睡症”、“烧咳伤阴闭经”等案皆为显例。调理善后，则为固本要着。
他早年善治时病，晚年更精于内科及妇科诸疾。对于逆、难大症，不拘陈法，善作决断。如治李××之“少阴热化证”案，鲁××之“胆结石”案、潘××之“肠梗阻”案、常××之“黄疸臌张(肝硬化)”案、王××之“子痫”、周××之“经闭四年”案等，均化险为夷，获取良效。
本书共收内、妇、儿科九十九例，目录原拟按年代顺序，以便反映姚老医师医疗风格的变化和学术思想的发展。但为了读者阅读方便，目录改为按病症分类，另在书后附一按年代的目录索引，供读者参考。这九十九个案例，是姚老中医治验的重要部分，其他诊疗经验俟后出版。每例之后所附之按语大部分是整理小组撰写的，部分按语标明“姚按”，是姚老中医心得体会。医案和按语，简述治疗经验，反映姚老医师的学术思想，公开了一些有效验方，供广大同道参考、借鉴。由于我们水平所限，错漏之处，请读者指正。
《姚贞白诊疗经验整理小组》
1979午5月1日
自 序
我的这部医案是历来治验心得。早在解放前，就想把先辈在长期临证中所医治过的典型病例编撰成一个集子和广大同道交流研究。但在旧社会，祖国医学受尽摧残，整个中医事业处于即将灭亡之境，此愿望迄未实现!
解放后，党和毛主席挽救了中医，党的中医政策，空前提高了中医的社会地位和积极性。1964年我和其他科技工作者光荣地出席了第三届全国人民代表大会。
同年，敬爱的周恩来总理出国访问，在昆期间，曾鼓励我要很好地发掘提高祖国医学遗产，并指示要重视祖国西南边疆地区的医药特点，重视来往昆明的国际友人的保健工作，并嘱咐我，要把自己平生和家传的学术经验整理出来，贡献给人民，这就更坚定了我著书的愿望。
近几年来，我们国家经历了巨大的变化，身边的手稿和记录散失殆尽，自己也因各种原因数次中风，全身瘫痪，深感党的关怀挽救，不然已失去了生命。
1978年，省、市卫生局党委为我成立了《姚贞白诊疗经验整理小组》，从各方面关心我的学术经验整理工作。现经过整理小组同志们的长期努力，第一部分“医案”已经定稿，就要和广大群众见面了。
在收集、回忆、写作的过程中，深深感到自己的学识不足，远未达到客观要求，并且书中难免有错误缺点，敬希同志们批评指正．
一九七九年元月姚贞白于病中
伤 寒
太阳阳明证
陈××，男，成人，干部。1964年12月。
初诊：患者出访归国，途经昆明，忽卧病，邀余往诊。
自云因在国外，寒温失宜，至昆又感风寒。症见头疼身困，恶冷发烧，胸闷，脘腹作痛，小便短黄，便稀不爽，日二、三行。诊脉浮紧，两关兼滞，舌红苔黄腻。证属太阳阳明合病，表里不清，食积胃滞。治宜葛根汤加减：
粉葛根12克藿香梗6克烧神曲9克法半夏9克广陈
皮6克 白茯苓12克 炒谷、麦芽备9克 焦山查9克 冲
波蔻4．5克 净竹茹6克 生姜2片 小枣7枚 烧鸡金2个
复诊：服药得汗，寒热已罢，便爽溺黄，胸腹较舒。头眩身困，饮食尚差。脉缓微弦，舌腻退薄。此太阳阳明证罢，表里渐和，但脾胃未调。续拟下方：
藿香梗4．5克 西砂仁6克(冲) 陈皮6克 法半夏9克 茯
苓神12克猪苓片9克炒谷、麦芽各9克甘草3克 净竹
茹6克 烧鸡金1个 小枣7枚
三诊：各症消除，脉和，舌润，唯神倦乏力，消化尚弱。续拟调脾健胃，和中益气，病遂全愈。处方。
苏条参12克 漂白术9克 广木香2．4克 冲砂仁6克 茯
苓神15克 广陈皮6克 甘草3克 竹茹4．5克 荷项2个
小枣7枚
[按]此例取伤寒法，而用药活变，非畏麻桂辛燥，实因人、地之异使然也。
大青龙汤证辨误
何××，男，四十九岁，昆明市人。1939年3月。
初诊：患者年近五旬，初病喘咳痰凝，早晚恶寒。服桂枝加厚朴杏子汤病不减，夜间烦躁尤甚。一周后，卧床不起，扶送来诊。症见头痛身疼，恶冷，午后热势较甚，无汗。大便秘，小便黄。烦躁不安，脘闷食少。脉象浮紧滑数，舌红，苔黄燥。此系表寒闭束，肺胃伏热不清，治拟大青龙汤加味。处方：
生麻黄6克 桂枝木6克 光杏仁9克 生石膏9克粉
葛根9克 生甘草3克 炒枳壳6克 生姜1片 大枣3枚
二诊：上方服后得汗，头疼身痛顿减。恶寒已罢，热势退大半。但咳喘，痰凝带血，鼻衄。唇焦口燥，思冷饮，夜烦。大便不畅，小便短黄。脉弦滑，舌红苔黄。此表寒已解，伏热外现，肺燥，胃火熏灼。续拟清热、润燥、除烦，方用竹叶石膏汤加减：
鲜京竹叶50片生石膏24克生麻茸3克光杏仁9克麦
门冬9克天花粉9克炒黄芩6克焦栀子3克淡豆豉
2．4克 白茅根15克净枇杷叶3片鸡金2个(烧) 谷麦芽
各9克(炒)
三诊：上方服二剂，脉转和缓，舌红润。痰血及鼻衄已止，仅有微咳，其余诸症平息。此属病后气弱阴虚，肺胃余热不净，心神不足。宜续养阴润肺，化痰止咳。处方：
白元参9克大寸冬9克炒知母6克天花粉9克炒杭
芍9克净杷叶3片炙冬花9克炙紫菀9克生甘草
3克竹茹6克粳米16克广枯络9克
[按]病本太阳伤寒，兼有里热，投桂枝厚朴杏子汤，致表寒未除，引动里热化燥。乃转用大青龙汤治之，表寒解，肺胃伏热外观，再以竹叶石膏汤加栀豉、元麦等方药，清热养阴，使肺胃热除而病瘳。
伤寒痞逆
周××，女，五十二岁，昆明市人。1954年6月。
初诊：病已半月，症见头疼身痛，恶寒发热，胸满胁痛，饮食不思。曾服发表、消导、攻里药，病不解，反结心下。烦躁，干呕频作，便秘溺黄，腹胀且鸣，昼夜呻吟叫号。
诊脉弦滑而数，舌苔薄黄。余谓此属伤寒太阳证，下之过早，而为痞逆。本仲景半夏泻心汤主之。处方：
法半夏12克 党参15克 川干姜9克 云黄连3克(炒冲) 炒
黄芩6克 甘草3克 大枣5枚
二诊：药后，呕逆减轻，发热渐退，夜能安卧。尚感胸闷暖气，腹中作鸣，便秘未通，溺短黄。脉细弦带滑，舌苔薄黄。此胸痞渐散，湿邪郁热不清，续用原方加减：
法半夏9克 川干姜6克 黄连3克(炒冲) 炒黄芩3克
党参3克 波蔻6克(冲) 烧鸡金6克 生姜6克 小枣10枚
瓜萎仁9克(冲)
三诊：上方服二剂，呕逆腹鸣已止，胸中痞闷减轻，烧热全退，大便已通，小便清长。能进食，脉转缓和，舌淡润。此痞积散，热清湿化，改拟下方调治：
苏条参12克 法半夏9克 广陈皮6克 金石斛9克 云茯
苓12克冲波蔻6克生苡仁12克 生甘草3克 烧鸡金6克
生姜2片 小枣10枚
[姚按]半夏能和胃止呕，以千姜之辛温开之，芩连之苦寒泄之，参、枣，甘草、甘缓以和之，则痞逆消而胃气复。
妊娠伤寒
李××，女，三十岁，家庭妇女，住本市大兴街。1932年春。
初诊：结婚十年不孕，经余调治，已妊八月。近因感寒，头疼发热，身痛恶冷。服双解散、桂枝汤，恶寒稍减，而现壮热，口苦思饮，便秘、溺赤。胎动不安，入夜烦躁谵语，病情转急重。证见颜面潮红，口唇干燥，前板齿焦，咳嗽痰浓带血，谵妄烦躁不安时。脉象浮、洪、滑、数，重按有力。
舌苔干黄，尖红少津。
此属妊娠伤寒，太阳未罢，转传阳明，肺胃两燔，气津受灼，病情严重，宜防热极风动，痉厥早产。法当清热泻火，兼解肌表，养胃益阴，以护胎元。方宜仲景自虎汤加味治之：
生石膏30克炒知母6克粉葛根9克炒黄芩6克焦栀
子6克 淡豆豉6克 生甘草3克烧鸡金2个白粳米15克
净竹茹6克
三日后复诊：上方已服二剂，脉转弦数而滑。舌苔较退，略布津液。壮热减，神识渐苏，烦躁谵语渐平。咳嗽痰浓仍带血，二便虽通不畅。胎动不安。此太阳症罢，阳明热邪逼胎，阴虚肺燥。续宜清热润肺，益气生津。原方化裁。
白元参9克 大寸冬9克生石膏15克 炒知母6克炒黄
芩6克炒杭芍9克 云茯神15克生甘草3克净竹茹6克
冬桑叶9克 白粳米15克
三诊：上方服二剂，烧热全退，神识已清，咳嗽轻减，痰血已止，二便通畅。能进少量稀粥，自觉精神倦怠。胎动未安，腰酸，时出自汗。脉细弦而滑，舌苔转润。法当养血滋阴、固气安胎。处方：
白人参6克(另煨兑服) 净杷叶3片 麦门冬9克 当归身12克
炒杭芍9克 菟丝子12克 炒黄芩6克 广桔络9克 桑寄
生12克 生甘草3克 浮小麦15克 小枣10枚
连服五剂，病遂痊愈。足月顺产一子，母子均安。
[按]“有故无殒”虽经有明训，然而临此险证，能明断病机，直驱其邪，实属难能。况邪去正虚，复以养血滋阴，固气安胎。可见，承先启后，策乃万全。
少阴中寒
张××，女，四十岁，四川省人。1939年冬。
初诊：患者系卖饼小商贩，平素操劳过度，身体虚弱。
时值冬令严寒，又兼雨雪，因外出营业受寒。上午发病，下午即不能行动，由家属背来就诊。
症见脉象沉细而紧，舌质淡，苔薄白。恶寒发热，神倦纳呆，头疼身痛，四肢厥冷，咳嗽不宣。此属寒入少阴，兼肺胃不清，治宜温经散寒，和胃化痰。拟麻辛附子汤加味治之：
川附片30克(开水先煎透) 麻茸6克 细辛2．4克 法半夏6克
广皮6克 炒厚朴9克 生甘草3克 生姜2片 小枣9枚
鸡内金1枚(烧)
二诊：上方服后，夜得微汗，身痛顿减，四肢温暖，烧热恶寒已罢。天明时能进稀粥，咳嗽有痰，咳时胸胁牵痛。
自汗，头眩。脉转缓滑稍弦，舌淡苔白。此少阴寒邪散后，营卫未和，肝，肺气滞，伏风未净，脾胃不足。拟方：
川附片30克(，开水先煎透) 法夏9克 广皮6克 桂枝木6克
茯神12克 炒杭芍9克 炙麻根4．5克 甘草3克 烧姜2片
大枣3枚
三诊：诸症渐愈，脉缓和，舌粉润。饮食增加，惟感睡眠欠安，神疲。乃阳虚脾弱，心神不足之候，以下方调理；
川附片30克(开水先煎透) 白术12克 炒杭芍9克 茯苓12克
法半夏9克 广皮6克炙远志6克炙甘草3克烧姜2片
大枣3枚
[按]少阴中寒，麻辛附子汤疗效甚捷。此案兼见肺胃不清，故加和中化痰之品，标本相须，是使用经方灵活化裁突出之点。
少阴中寒伏湿化热(急性肾炎)
丁××，男，二十一岁，高温操作工。1957年6月。
初诊：患者因劳累过度，大汗淋漓，适天气炎热，骤行冷水淋浴，当晚即感身疼，恶冷发烧。次日腰痛尤甚，无汗咳嗽，面足浮，溺短黄。脉沉细而紧，苔白腻。症属汗出水激，邪中少阴，寒湿相搏，玄府郁闭，膀胱气化失司。拟麻黄附子细辛汤加味治之。处方：
Old Chinese Medicine Physician Yao Zhenbai was the fifth generation of the Yao family medical lineage. He inherited his family's learning from childhood and, under the education of his father, Old Physician Yin Xuan, diligently studied classical texts. Upon reaching adulthood, he traveled extensively north and south of the Yangtze River, observing various schools of thought to enrich his medical scientific knowledge. He constantly verified theory with practice, emphasizing treatment tailored to local conditions, individual constitution, and specific diseases. With over fifty years of clinical experience, he maintained a simple medical style, a gentle attitude, innovations in medical theory, and significant clinical efficacy.
Old Physician Yao served as the Director of Kunming Hospital of Traditional Chinese Medicine (TCM) and was passionate about the TCM cause. To inherit and promote national medicine, he guided his children and disciples in drafting "Xun Yuan Yi Hua" (Medical Conversations from Xun Garden) and the preliminary draft of "Lin Chuang Zhi Yan Lu" (Records of Clinical Cures). However, due to the interference and sabotage by the "Gang of Four," the original manuscripts were lost. Between 1973 and August 1977, after suffering several strokes leading to coma and recovering under the care of Party committees at various levels, he persisted with strong will. Through recollection and dictation, with his sons Yao Chengzu and Yao Chengji acting as scribes, and through long-term effort, he completed the preliminary draft of this "Medical Case Record." After completion, Comrade Yao Pengxin of Kunming Medical College provided valuable opinions.
In April 1978, under the direct leadership of the Provincial and Municipal Health Bureaus and the City TCM Hospital, the "Yao Zhenbai Diagnosis and Treatment Experience Organization Group" was officially established. The group consisted of six members: TCM physicians Zhang Haoran, Ge Hongyuan, Su Fan, and Yao's children, Physicians Yao Kemin, Yao Chengji, and Yao Chengzu. During the organization process, each case was carefully verified and discussed, medical principles analyzed, and wording polished to strive for embodying Old Physician Yao's academic style.
The academic thought of Old Physician Yao Zhenbai originated from the *Neijing* (Inner Canon), *Nanjing* (Classic of Difficult Issues), *Shanghan Lun* (Treatise on Cold Damage, also known as Changsha), the scholars of the Jin and Yuan dynasties, Warm Disease Theory, and masters of past generations. For instance, in several cases of "Xu Lao Fa Re" (Febrile Disease due to Deficiency Consumption), he based his approach on the mechanism of "Shaoyang serves as the pivot" from the *Neijing*'s Treatise on Yin-Yang Separation and Combination. His general principle was to regulate the pivot to Shaoyang and calm the Yin-Yang of the Zang-Fu organs. He drew upon the principles of formulas like Chaihu Tang (Bupleurum Decoction) and Baihu Tang (White Tiger Decoction) from the *Shanghan Lun*, flexibly integrated the Yin-nourishing and fluid-generating, heat-clearing and dryness-resolving methods of Warm Disease Theory, and the historical treatments for deficiency consumption. He placed greater emphasis on patients' constitutions and the characteristics of women and children. Thus, he formulated a series of orderly treatment principles and prescriptions, achieving significant efficacy.
In similar situations, his diagnostic differentiation views were quite clear. He acknowledged the objective pathological reality that "the same disease presents different syndromes." For different cases of diseases such as "Xuan Yun" (Vertigo/Dizziness), "Mai Guan Yan" (Vasculitis), "Zi Ban" (Purpura), "Huang Dan" (Jaundice), "Zhong Feng" (Stroke), "Huo Luan" (Cholera-like disorder), "Hui Jue" (Roundworm Convulsion), and "Jueyin Shanghan" (Cold Damage to the Jueyin Meridian), he approached them from different angles, analyzing principles thoroughly and adapting methods flexibly. Simultaneously, he emphasized the regularity of branch/root and urgent/non-urgent aspects in every symptom, valuing the dynamic changes in treatment principles and prescription meanings during the early, middle, and late stages. Between consultations, he believed there must be continuity and coherence, requiring a firm grasp of the internal clues within the symptomatic mechanisms.
He valued treating both the branch (symptoms) and the root (cause), without neglecting post-treatment regulation. Using branch treatment as a guide aimed to clarify layers and reveal the essence, creating conditions for root treatment; cases such as "Ke Chuan" (Cough and Asthma), "Ke Sou Tan Jue Hun Shui Zheng" (Cough with Phlegm, Syncope, and Drowsiness Syndrome), and "Shao Ke Shang Yin Bi Jing" (Burn-induced Cough Damaging Yin and Amenorrhea) are clear examples. Post-treatment regulation was crucial for consolidating the root.
In his early years, he was skilled in treating seasonal epidemics (Shi Bing); in his later years, he became even more proficient in internal medicine and gynecology. For difficult and critical cases, he did not adhere rigidly to old methods but made decisive judgments. For example, in treating Patient Li XX's "Shaoyin Heat Transformation Syndrome," Patient Lu XX's "Gallbladder Calculus," Patient Pan XX's "Intestinal Obstruction," Patient Chang XX's "Jaundice and Distension (Liver Cirrhosis)," Patient Wang XX's "Eclampsia," and Patient Zhou XX's "Four-Year Amenorrhea," he turned danger into safety and achieved good results.
This book collects ninety-nine cases from internal medicine, gynecology, and pediatrics. The table of contents was originally planned to be arranged chronologically to reflect changes in Old Physician Yao's medical style and the development of his academic thought. However, for readers' convenience, it was changed to be classified by disease/syndrome, with a chronological index attached at the end for reference. These ninety-nine cases constitute an important part of Old Physician Yao's curative experiences; other diagnostic and treatment experiences will be published later. The annotations following each case were mostly written by the organization group, while those marked "Yao An" represent Old Physician Yao's personal insights. The medical cases and annotations briefly describe treatment experiences, reflect the physician's academic thought, and disclose some effective empirical prescriptions for peers to reference and learn from. Due to our limited level, errors and omissions may exist; we ask readers to point them out.
"Organization Group for Compiling Yao Zhenbai's Diagnosis and Treatment Experiences"
May 1, 1979
Preface
This medical case record is a compilation of my lifelong curative experiences. Even before liberation, I wished to compile typical cases treated by my ancestors during their long clinical practice into a collection for exchange and research with peers. However, in the old society, national medicine suffered severe devastation, and the entire TCM cause faced imminent extinction; this wish remained unfulfilled!
After liberation, the Party and Chairman Mao saved TCM. The Party's TCM policy unprecedentedly raised the social status and enthusiasm of TCM practitioners. In 1964, I had the honor of attending the Third National People's Congress along with other scientific and technological workers.
That same year, when Premier Zhou Enlai visited abroad and stayed in Kunming, he encouraged me to well excavate and improve the heritage of national medicine. He instructed that attention should be paid to the medicinal characteristics of China's southwestern border regions, the health care of international friends visiting Kunming, and urged me to organize my life-long and family-inherited academic experiences to contribute to the people. This further solidified my desire to write this book.
In recent years, our country has undergone tremendous changes. Manuscripts and records around me have been completely lost. I myself suffered several strokes due to various reasons, resulting in total paralysis. I deeply feel grateful for the Party's care and salvation; otherwise, I would have lost my life.
In 1978, the Party Committee of the Provincial and Municipal Health Bureaus established the "Yao Zhenbai Diagnosis and Treatment Experience Organization Group" for me, caring for the organization of my academic experiences from all aspects. Now, after the long-term efforts of the comrades in the organization group, the first part, "Medical Cases," has been finalized and is about to be presented to the masses.
During the process of collection, recollection, and writing, I deeply felt my insufficient knowledge, far from meeting objective requirements. Moreover, errors and shortcomings are inevitable in the book. I respectfully hope comrades will criticize and correct them.
January 1979, Yao Zhenbai, while ill
Cold Damage
Taiyang and Yangming Syndrome
Patient Chen XX, Male, Adult, Cadre. December 1964.
First Visit: The patient returned from a foreign visit, passing through Kunming, suddenly fell ill, and invited me to diagnose.
He stated that due to improper adaptation to cold and warmth abroad, and contracting wind-cold upon arriving in Kunming, he presented with headache, body heaviness, aversion to cold, fever, chest tightness, epigastric and abdominal pain, short yellow urine, loose stools with incomplete evacuation, occurring two to three times daily. Pulse was floating and tight, with stagnation at both Guan positions; tongue was red with yellow greasy coating. The syndrome belongs to combined Taiyang and Yangming disease, unclear exterior and interior, with food accumulation and stomach stagnation. Treatment should utilize modified Gegen Tang (Kudzu Root Decoction):
Ge Gen (Puerariae Radix) 12g, Huo Xiang (Agastaches Herba) 6g, Shen Qu (Medicated Leaven) 9g, Ban Xia (Pinelliae Rhizoma Preparatum) 9g, Chen Pi (Citri Reticulatae Pericarpium) 6g, Fu Ling (Poria) 12g, Gu Ya (Hordei Fructus Germinatus) and Mai Ya (Sacchari Stachydis Germinatus) stir-fried, each 9g, Shan Zha (Crataegi Fructus) charred 9g, Bo Dou Kou (Amomi Fructus) 4.5g, Zhu Ru (Bambusae Caulis in Taenia) 6g, Sheng Jiang (Zingiberis Rhizoma Recens) 2 slices, Xiao Zao (Jujubae Fructus) 7 pieces, Ji Jin (Galli Gigerii Endothelium Corneum) charred 2 pieces.
Second Visit: After taking the medicine, sweating occurred, chills and fever ceased, stool was smooth, urine yellow, chest and abdomen relatively comfortable. Dizziness, body heaviness, and poor appetite remained. Pulse was slow and slightly wiry; tongue coating thinned. The Taiyang-Yangming syndrome has resolved, exterior and interior are gradually harmonizing, but spleen and stomach are not yet regulated. Continue with the following prescription:
Huo Xiang (Agastaches Herba) 4.5g, Sha Ren (Amomi Fructus) 6g (added just before serving), Chen Pi (Citri Reticulatae Pericarpium) 6g, Ban Xia (Pinelliae Rhizoma Preparatum) 9g, Fu Ling Shen (Poria with Hostwood) 12g, Zhu Ling (Polyporus) 9g, Gu Ya (Hordei Fructus Germinatus) and Mai Ya (Sacchari Stachydis Germinatus) stir-fried, each 9g, Gan Cao (Glycyrrhizae Radix et Rhizoma) 3g, Zhu Ru (Bambusae Caulis in Taenia) 6g, Ji Jin (Galli Gigerii Endothelium Corneum) charred 1 piece, Xiao Zao (Jujubae Fructus) 7 pieces.
Third Visit: All symptoms eliminated, pulse harmonious, tongue moist. Only mental fatigue and weakness remain, digestion still weak. Continue to regulate spleen, strengthen stomach, harmonize middle, and boost Qi. The illness was completely cured. Prescription:
Dang Shen (Codonopsis Radix) 12g, Bai Zhu (Atractylodis Macrocephalae Rhizoma) 9g, Mu Xiang (Aucklandiae Radix) 2.4g, Sha Ren (Amomi Fructus) 6g (added just before serving), Fu Ling Shen (Poria with Hostwood) 15g, Chen Pi (Citri Reticulatae Pericarpium) 6g, Gan Cao (Glycyrrhizae Radix et Rhizoma) 3g, Zhu Ru (Bambusae Caulis in Taenia) 4.5g, He Geng (Lotus Stem) 2 pieces, Xiao Zao (Jujubae Fructus) 7 pieces.
[Note] This case adopts Shanghan method, but medication is flexible. It is not due to fear of the pungent-drying nature of Ma Huang (Ephedrae Herba) and Gui Zhi (Cinnamomi Ramulus), but rather due to differences in person and location.
Misdiagnosis of Da Qing Long Tang Syndrome
Patient He XX, Male, 49 years old, Resident of Kunming City. March 1939.
First Visit: The patient, nearing fifty, initially suffered from wheezing, coughing, and phlegm congestion, with aversion to cold in the morning and evening. After taking Guizhi Jia Houpo Xingzi Tang (Cinnamon Twig Decoction plus Magnolia Bark and Apricot Kernel), the illness did not subside, and nighttime irritability was especially severe. A week later, he was bedridden and brought for diagnosis. Symptoms included headache and body pain, aversion to cold, worse afternoon fever, no sweating, constipation, and yellow urine. Restlessness, epigastric fullness, and poor appetite. Pulse was floating, tight, slippery, and rapid; tongue red with dry yellow coating. This is exterior cold constriction with latent heat in Lung and Stomach not cleared. Treatment proposes modified Da Qing Long Tang (Major Blue Green Dragon Decoction). Prescription:
Ma Huang (Ephedrae Herba) raw 6g, Gui Zhi (Cinnamomi Ramulus) 6g, Xing Ren (Armeniacae Semen Amarum) 9g, Shi Gao (Gypsum Fibrosum) raw 9g, Ge Gen (Puerariae Radix) 9g, Gan Cao (Glycyrrhizae Radix et Rhizoma) raw 3g, Zhi Ke (Aurantii Fructus Immaturus) stir-fried 6g, Sheng Jiang (Zingiberis Rhizoma Recens) 1 slice, Da Zao (Jujubae Fructus) 3 pieces.
Second Visit: After taking the above prescription, sweating occurred, headache and body pain decreased instantly. Aversion to cold ceased, fever reduced by more than half. However, wheezing, coughing, phlegm congestion with blood, and epistaxis (nosebleed) persisted. Lips scorched, mouth dry, craving cold drinks, nighttime irritability. Bowel movement unsatisfactory, urine short and yellow. Pulse wiry and slippery; tongue red with yellow coating. Exterior cold has resolved, latent heat appears externally, Lung dryness, Stomach fire scorching. Continue to clear heat, moisten dryness, and relieve irritability, using modified Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction). Prescription:
Jian Zhu Ye (Bambusae Folium) fresh 50 leaves, Shi Gao (Gypsum Fibrosum) raw 24g, Ma Huang (Ephedrae Herba) raw 3g, Xing Ren (Armeniacae Semen Amarum) 9g, Mai Dong (Ophiopogonis Radix) 9g, Tian Hua Fen (Trichosanthis Radix) 9g, Huang Qin (Scutellariae Radix) stir-fried 6g, Zhi Zi (Gardeniae Fructus) charred 3g, Chi Xiao Dou (Sojae Semen Praeparatum) 2.4g, Bai Mao Gen (Imperatae Rhizoma) 15g, Pi Ye (Eriobotryae Folium) clean 3 pieces, Ji Jin (Galli Gigerii Endothelium Corneum) charred 2 pieces, Gu Ya (Hordei Fructus Germinatus) and Mai Ya (Sacchari Stachydis Germinatus) stir-fried, each 9g.
Third Visit: After taking two doses of the above prescription, pulse became harmonious and slow, tongue reddish and moist. Hemoptysis and epistaxis stopped, only slight cough remains, other symptoms subsided. This belongs to post-illness Qi deficiency and Yin deficiency, residual heat in Lung and Stomach not cleared, Heart Spirit insufficiency. Should continue to nourish Yin, moisten Lung, resolve phlegm, and stop cough. Prescription:
Shan Yu Bei Mu (Fritillariae Thunbergii Bulbus) 9g, Mai Dong (Ophiopogonis Radix) 9g, Zhi Mu (Anemarrhenae Rhizoma) stir-fried 6g, Tian Hua Fen (Trichosanthis Radix) 9g, Bai Shao (Paeoniae Radix Alba) stir-fried 9g, Pi Ye (Eriobotryae Folium) clean 3 pieces, Ju Hua (Periplocae Radix) honey-fried 9g, Zi Wan (Asteris Radix) honey-fried 9g, Gan Cao (Glycyrrhizae Radix et Rhizoma) raw 3g, Zhu Ru (Bambusae Caulis in Taenia) 6g, Jing Mi (Oryzae Fructus) 16g, Ku Luo (Dangshen/Caulis Trichosanthis? Note: Likely Dang Gui or similar, text says Guang Ku Luo which might refer to a specific vine or typo for another herb, keeping literal translation contextually as 'Ku Luo') 9g.
[Note] The disease was originally Taiyang Cold Damage with interior heat. Administering Guizhi Houpo Xingzi Tang failed to remove exterior cold, triggering interior heat to transform into dryness. Then switched to Da Qing Long Tang to treat it. Once exterior cold resolved and latent heat in Lung/Stomach appeared externally, Zhuye Shigao Tang plus Zhi Zi/Chi Xiao Dou and Shan Yu Bei Mai was used to clear heat and nourish Yin, removing Lung/Stomach heat and curing the illness.
Shanghan Pi Ni (Glomus and Regurgitation)
Patient Zhou XX, Female, 52 years old, Resident of Kunming City. June 1954.
First Visit: Ill for half a month, presenting with headache and body pain, aversion to cold and fever, chest fullness and hypochondriac pain, loss of appetite. Had taken exterior-releasing, digestive-promoting, and purgative medicines, but illness did not resolve; instead, glomus formed in the epigastrium. Irritability, frequent dry retching, constipation, yellow urine, abdominal distension with borborygmus, groaning and calling day and night.
Pulse wiry, slippery, and rapid; tongue coating thin yellow. I stated this belongs to Shanghan Taiyang syndrome, where purgatives were used too early, resulting in Pi Ni (Glomus and Regurgitation). Based on Zhang Zhongjing's Banxia Xiexin Tang (Pinellia Decoction for Draining the Epigastrium) as the main treatment. Prescription:
Ban Xia (Pinelliae Rhizoma Preparatum) 12g, Dang Shen (Codonopsis Radix) 15g, Gan Jiang (Zingiberis Rhizoma) 9g, Huang Lian (Coptidis Rhizoma) 3g (stir-fried and added just before serving), Huang Qin (Scutellariae Radix) stir-fried 6g, Gan Cao (Glycyrrhizae Radix et Rhizoma) 3g, Da Zao (Jujubae Fructus) 5 pieces.
Second Visit: After medication, vomiting and regurgitation decreased, fever gradually subsided, able to sleep peacefully at night. Still feels chest stuffiness and belching, borborygmus in abdomen, constipation not resolved, urine short and yellow. Pulse fine, wiry with slipperiness; tongue coating thin yellow. Chest glomus gradually dispersing, dampness and stagnant heat not cleared. Continue with modified original prescription:
Ban Xia (Pinelliae Rhizoma Preparatum) 9g, Gan Jiang (Zingiberis Rhizoma) 6g, Huang Lian (Coptidis Rhizoma) 3g (stir-fried and added just before serving), Huang Qin (Scutellariae Radix) stir-fried 3g, Dang Shen (Codonopsis Radix) 3g, Bo Dou Kou (Amomi Fructus) 6g (added just before serving), Ji Jin (Galli Gigerii Endothelium Corneum) charred 6g, Sheng Jiang (Zingiberis Rhizoma Recens) 6g, Xiao Zao (Jujubae Fructus) 10 pieces, Gua Lou Ren (Trichosanthis Semen) 9g (added just before serving).
Third Visit: After taking two doses of the above prescription, vomiting, regurgitation, and borborygmus stopped, chest glomus discomfort reduced, fever completely subsided, bowel movement resolved, urine clear and abundant. Able to eat, pulse became harmonious and slow, tongue pale and moist. Glomus accumulated dispersed, heat cleared, dampness transformed. Change to the following prescription for regulation:
Dang Shen (Codonopsis Radix) 12g, Ban Xia (Pinelliae Rhizoma Preparatum) 9g, Chen Pi (Citri Reticulatae Pericarpium) 6g, Shi Hu (Dendrobii Caulis) 9g, Fu Ling (Poria) 12g, Bo Dou Kou (Amomi Fructus) 6g (added just before serving), Yi Yi Ren (Coicis Semen) raw 12g, Gan Cao (Glycyrrhizae Radix et Rhizoma) raw 3g, Ji Jin (Galli Gigerii Endothelium Corneum) charred 6g, Sheng Jiang (Zingiberis Rhizoma Recens) 2 slices, Xiao Zao (Jujubae Fructus) 10 pieces.
[Yao Note] Ban Xia can harmonize the Stomach and stop vomiting. With the pungent-warm nature of Gan Jiang to open it, the bitter-cold nature of Huang Qin and Huang Lian to drain it, and Dang Shen, Da Zao, and Gan Cao's sweet-slow nature to harmonize it, the glomus and regurgitation will dissipate, and Stomach Qi will recover.
Pregnancy Cold Damage
Patient Li XX, Female, 30 years old, Housewife, residing at Daxing Street, this city. Spring 1932.
First Visit: Married for ten years without conception, after my regulation, she was eight months pregnant. Recently contracted cold, presenting with headache, fever, body pain, and aversion to cold. Took Shuang Jie San (Double Resolution Powder) and Guizhi Tang (Cinnamon Twig Decoction); aversion to cold slightly reduced, but high fever appeared, bitter taste in mouth, craving drink, constipation, dark urine. Fetal movement uneasy, nighttime irritability and delirious speech, condition became urgent and severe. Signs include flushed face, dry lips, scorched front teeth, cough with thick bloody sputum, delirious restlessness. Pulse floating, surging, slippery, rapid, forceful on deep pressure. Tongue coating dry yellow, tip red with little fluid.
This belongs to Pregnancy Cold Damage, Taiyang not yet resolved, transmitting to Yangming, simultaneous burning of Lung and Stomach, Qi and Fluids scorched, serious condition. Must prevent extreme heat stirring wind, convulsions, syncope, and premature birth. Method should clear heat and purge fire, simultaneously release muscle layer, nourish Stomach and benefit Yin to protect fetal origin. Formula should use modified Zhongjing's Baihu Tang (White Tiger Decoction):
Shi Gao (Gypsum Fibrosum) raw 30g, Zhi Mu (Anemarrhenae Rhizoma) stir-fried 6g, Ge Gen (Puerariae Radix) 9g, Huang Qin (Scutellariae Radix) stir-fried 6g, Zhi Zi (Gardeniae Fructus) charred 6g, Chi Xiao Dou (Sojae Semen Praeparatum) 6g, Gan Cao (Glycyrrhizae Radix et Rhizoma) raw 3g, Ji Jin (Galli Gigerii Endothelium Corneum) charred 2 pieces, Jing Mi (Oryzae Fructus) white 15g, Zhu Ru (Bambusae Caulis in Taenia) 6g.
Three Days Later Second Visit: Two doses of the above prescription taken, pulse became wiry, rapid, and slippery. Tongue coating retreated slightly, fluids appearing. High fever reduced, consciousness gradually recovering, irritability and delirious speech calming. Cough with thick bloody sputum persists, bowel and bladder movements pass but unsatisfactorily. Fetal movement uneasy. Taiyang syndrome resolved, Yangming heat pathogen pressing on fetus, Yin deficiency and Lung dryness. Continue to clear heat, moisten Lung, boost Qi, and generate fluids. Modify original prescription.
Shan Yu Bei Mu (Fritillariae Thunbergii Bulbus) 9g, Mai Dong (Ophiopogonis Radix) 9g, Shi Gao (Gypsum Fibrosum) raw 15g, Zhi Mu (Anemarrhenae Rhizoma) stir-fried 6g, Huang Qin (Scutellariae Radix) stir-fried 6g, Bai Shao (Paeoniae Radix Alba) stir-fried 9g, Fu Ling Shen (Poria with Hostwood) 15g, Gan Cao (Glycyrrhizae Radix et Rhizoma) raw 3g, Zhu Ru (Bambusae Caulis in Taenia) 6g, Sang Ye (Mori Folium) winter 9g, Jing Mi (Oryzae Fructus) white 15g.
Third Visit: Two doses of the above prescription taken, fever completely subsided, consciousness clear, cough lightened, hemoptysis stopped, bowel and bladder movements smooth. Able to consume small amount of thin porridge, feeling mental fatigue. Fetal movement still uneasy, lower back soreness, spontaneous sweating occasionally. Pulse fine, wiry, and slippery; tongue coating turning moist. Method should nourish Blood, yin-nourish, consolidate Qi, and calm fetus. Prescription:
Ren Shen (Ginseng Radix) white 6g (simmered separately and mixed in), Pi Ye (Eriobotryae Folium) clean 3 pieces, Mai Dong (Ophiopogonis Radix) 9g, Dang Gui (Angelicae Sinensis Radix) body 12g, Bai Shao (Paeoniae Radix Alba) stir-fried 9g, Tu Si Zi (Cuscutae Semen) 12g, Huang Qin (Scutellariae Radix) stir-fried 6g, Ju Luo (Citri Reticulatae Pericarpium Viride) 9g, Sang Ji Sheng (Taxilli Caulis et Folium) 12g, Gan Cao (Glycyrrhizae Radix et Rhizoma) raw 3g, Fu Xiao Mai (Tritici Fructus Levissimus) 15g, Xiao Zao (Jujubae Fructus) 10 pieces.
Taken continuously for five doses, illness completely healed. Delivered a healthy baby at full term, mother and child both safe.
[Note] Although "Having pathology means no injury" is clearly taught, facing such dangerous syndromes, being able to clearly judge the disease mechanism and directly expel the pathogen is truly rare. Moreover, after pathogen removal and righteous Qi deficiency, returning to nourish Blood and Yin, consolidate Qi, and calm the fetus shows that inheriting the past and initiating the future makes the strategy perfect.
Shaoyin Zhong Han (Cold Strike in Shaoyin)
Patient Zhang XX, Female, 40 years old, Native of Sichuan Province. Winter 1939.
First Visit: Patient is a small vendor selling pancakes, usually overworked, physically weak.
At the time of severe winter cold, accompanied by rain and snow, she caught cold while working outside. Onset in the morning, unable to move by afternoon, carried by family for diagnosis.
Symptoms include pulse sinking, fine, and tight; tongue pale, coating thin white. Aversion to cold and fever, mental fatigue, poor appetite, headache and body pain, cold limbs, cough not clearing. This belongs to cold entering Shaoyin, combined with unclear Lung and Stomach. Treatment should warm meridians, scatter cold, harmonize Stomach, and resolve phlegm. Propose modified Muxing Fuzi Tang (Ephedra, Asarum, and Aconite Decoction). Prescription:
Fu Pian (Aconiti Lateralis Radix Preparata) 30g (boil thoroughly in water first), Ma Huang (Ephedrae Herba) 6g, Xi Xin (Asari Radix et Rhizoma) 2.4g, Ban Xia (Pinelliae Rhizoma Preparatum) 6g, Chen Pi (Citri Reticulatae Pericarpium) 6g, Hou Po (Magnoliae Officinalis Cortex) stir-fried 9g, Gan Cao (Glycyrrhizae Radix et Rhizoma) raw 3g, Sheng Jiang (Zingiberis Rhizoma Recens) 2 slices, Xiao Zao (Jujubae Fructus) 9 pieces, Ji Nei Jin (Galli Gigerii Endothelium Corneum) charred 1 piece.
Second Visit: After taking the above prescription, slight sweating at night, body pain instantly reduced, limbs warm, fever and aversion to cold ceased. At dawn, able to eat thin porridge, cough with phlegm, chest and hypochondriac pulling pain when coughing. Spontaneous sweating, dizziness. Pulse turning slow, slippery, slightly wiry; tongue pale, coating white. After Shaoyin cold pathogen disperses, Ying and Wei not harmonized, Liver and Lung Qi stagnation, latent wind not cleared, Spleen and Stomach insufficient. Prescribe:
Fu Pian (Aconiti Lateralis Radix Preparata) 30g (boil thoroughly in water first), Ban Xia (Pinelliae Rhizoma Preparatum) 9g, Chen Pi (Citri Reticulatae Pericarpium) 6g, Gui Zhi (Cinnamomi Ramulus) 6g, Fu Shen (Poria with Hostwood) 12g, Bai Shao (Paeoniae Radix Alba) stir-fried 9g, Ma Gen (Polygoni Multiflori Caulis) honey-fried 4.5g, Gan Cao (Glycyrrhizae Radix et Rhizoma) 3g, Sheng Jiang (Zingiberis Rhizoma Recens) charred 2 slices, Da Zao (Jujubae Fructus) 3 pieces.
Third Visit: Various symptoms gradually healing, pulse harmonious and slow, tongue pink and moist. Diet increased, only feeling poor sleep and mental fatigue. This is Yang deficiency, Spleen weakness, Heart Spirit insufficiency. Use the following prescription for regulation:
Fu Pian (Aconiti Lateralis Radix Preparata) 30g (boil thoroughly in water first), Bai Zhu (Atractylodis Macrocephalae Rhizoma) 12g, Bai Shao (Paeoniae Radix Alba) stir-fried 9g, Fu Ling (Poria) 12g, Ban Xia (Pinelliae Rhizoma Preparatum) 9g, Chen Pi (Citri Reticulatae Pericarpium) 6g, Yuan Zhi (Polygalae Radix) honey-fried 6g, Gan Cao (Glycyrrhizae Radix et Rhizoma) honey-fried 3g, Sheng Jiang (Zingiberis Rhizoma Recens) charred 2 slices, Da Zao (Jujubae Fructus) 3 pieces.
[Note] For Shaoyin Zhong Han, Muxing Fuzi Tang has very rapid efficacy. This case also presents unclear Lung and Stomach, so adding herbs to harmonize middle and resolve phlegm addresses both root and branch, highlighting the flexible modification of classic formulas.
Shaoyin Zhong Han Fu Shi Hua Re (Acute Nephritis) (Cold Strike in Shaoyin with Latent Dampness Transforming into Heat)
Patient Ding XX, Male, 21 years old, High-temperature Operator. June 1957.
First Visit: Patient due to overwork, profuse sweating, suitable hot weather, suddenly took a cold shower. That night felt body pain, aversion to cold, fever. Next day lower back pain especially severe, no sweating, cough, facial and foot edema, short yellow urine. Pulse sinking, fine, and tight; coating white greasy. Symptoms belong to sweat-water stimulation, pathogen striking Shaoyin, cold-damp struggling, pores closed, Bladder Qi transformation failing. Propose modified Mahuang Fuzi Xixin Tang (Ephedra, Aconite, and Asarum Decoction). Prescription: