Library

Charred Caelestial Cypress Leaf (Cacumen Platycladi) 9g, Licorice Root (Gancao) 3g, Roasted Chicken Gizzard Lining (Shao Jijin) 6g, Charred Prepared Ginger Root (Pao Jiangtan) 6g.

Third visit: After taking the above prescription for six doses, dryness in the mouth gradually moistened, distending pain decreased, and appetite increased; dizziness, palpitations, spontaneous sweating, and restless sleep at night all improved. Constipation persisted, stool was dark brown, with a small amount of fresh blood after defecation. The pulse was fine and wiry, and the yellow tongue coating had receded. This indicates that the Yin collaterals have begun to be nourished, and the Spleen and Stomach functions are gradually recovering. Given the long duration of the illness resulting in deficiency of Qi, Blood, Yin, and Yang, we continue with a modified Huangtu Tang (Yellow Earth Decoction):
Dry Rehmannia Root (Di Huang) 15g, Sichuan Aconite Slice (Chuan Fupian) 15g (pre-boiled thoroughly in boiling water), Atractylodes Macrocephala Rhizome (Baizhu) 12g, Dong-E Ejiao (Donkey-hide Gelatin) 15g (melted and mixed into the decoction), Stir-fried Scutellaria Root (Huangqin) 6g, Whole Angelica Sinensis Root (Danggui) 12g, Hearth Soil (Zaoxintu) one piece (approx. 120g, crushed, soaked in water until clarified, the clear liquid boiled, and used to decoct the other herbs).

Fourth visit: After continuously taking the above prescription for ten doses, chest and stomach distending pain resolved from relief to disappearance, stool turned yellow, occurring once daily, and fresh blood stopped. Multiple occult blood tests were negative (-). Appetite increased, sleep was good, complexion was lustrous, muscles were plump, the pulse was harmonious and regulated, and the tongue was pink and moist. All residual symptoms completely resolved.
Upon discharge, we prescribed the following formula, advising the preparation of honey pills for long-term use. Prescription:
Codonopsis Pilosula Root (Sutiaoshen) 30g, Stir-fried Atractylodes Macrocephala Rhizome (Baizhu) 30g, Poria (Fushen) 30g, Angelica Sinensis Root (Danggui) 30g, Stir-fried Hangzhou White Peony Root (Hangshaoyao) 2.4g, Amomum Fruit (Xisharen) 15g, Charred Prepared Rehmannia Root (Shuditan) 2.4g, Cuttlefish Bone (Haipiaoxiao) 2.4g, Honey-fried Aconite Slice (Zhifupian) 30g (pre-boiled thoroughly in boiling water), Honey-fried Licorice Root (Zhigancao) 9g, Stir-fried Scorched Scutellaria Root (Kouqin) 9g.
The above herbs are made into honey pills, each weighing 9g, taken one pill morning and evening, washed down with boiling water.

[Commentary] When Spleen Yang is damaged and Yin collaterals are injured, overly drying medications can damage Body Fluids and Blood; conversely, overly tonifying Yin with cloying substances hinders the Middle Jiao. In the second visit, herbs such as Ginseng, Atractylodes, Angelica, White Peony Root, and Fritillaria were used due to their mild nature and ease of assimilation. Subsequently, a modified Huangtu Tang was used to warm Yang, strengthen transport and transformation, nourish Blood and benefit Yin, regulating both Qi and Blood to treat the root cause. Finally, pills were used for consolidation.

Massive Epistaxis (Nosebleed)
Li XX, Male, 25 years old, worker at a factory in the western suburbs of Kunming. February 1971. First visit: The patient was usually robust with a strong appetite. Due to excessive smoking and alcohol consumption, he developed dry Blood and Lung Heat, with Fire scorching the Heart and Gallbladder. It was spring, the climate was dry, and he consumed spicy and stimulating foods, which stirred up Blood Heat, leading to epistaxis. Initially, it was occasional bleeding from the nose, but soon progressed to massive hemorrhage, filling cups and bowls, uncontrollable. Emergency Western ENT treatment involved acupuncture, medication, and surgical nasal packing with gauze, but the bleeding shifted to oral expulsion and remained uncontrolled. He was transported by car to our outpatient clinic. Due to excessive blood loss, his complexion was sallow, he had no desire to eat, felt dizzy, was mentally fatigued, lips were cracked, mouth was dry, the pulse was surging and slippery, and the tongue coating was yellow. This belongs to excessive epistaxis causing Yin deficiency and dry collaterals, with heavy Heat in the Heart and Lungs.
The treatment principle first employed physical therapy to lower Blood with Heat, curbing its turbulent momentum. A towel soaked in ice water was applied as a cold compress to the occiput and neck (Du Meridian). Then, a basin of hot water was used to soak the patient's feet. The following formula was rapidly decocted and administered:
Rhinoceros Horn (Xijiao) 4.5g, Raw Rehmannia Root (Shengdi) 30g, Moutan Bark (Danpi) 6g, Red Peony Root (Chishao) 9g, Charred Gardenia Fruit (Zhizi Tan) 9g, Charred Lotus Node (Oujie Tan) 9g, Charred Caelestial Cypress Leaf (Cebaiye Tan) 9g, Imperata Rhizome (Baimaogen) 30g, Fritillaria Cirrhosa Bulb (Chuanbeimu) 9g, Calcined Flower Coriaria Stone (Huajiu Cu Huaruishi) 9g.

Second visit: After using physical therapy and taking the above prescription yesterday, epistaxis temporarily stopped, with only a small amount of blood expectorated in phlegm. The surging and slippery pulse decreased, the yellow tongue coating lightened, he could take slight food, and bowel/bladder movements were patent. The following formula was used again:
Rhinoceros Horn (Xijiao) 4.5g, Charred Raw Rehmannia Root (Shengditan) 18g, Jerusalem Artichoke Root (Jingyuanshen) 12g, Ophiopogon Tuber (Maidong) 9g, Red Peony Root (Chishao) 9g, Stir-fried Charred Gardenia Fruit (Zhizitan) 6g, Charred Moutan Bark (Danpitan) 6g, Fritillaria Cirrhosa Bulb (Chuanbeimu) 9g, Loquat Stem (Jieluo) 9g, Clean Loquat Leaf (Jing Pa Ye) 3 leaves, Raw Licorice Root (Shengancao) 3g, Lotus Node (Oujie) 9g, Fresh Bamboo Leaves (Xian Jingzhuye) 50 leaves.

Third visit: After taking the above prescription, epistaxis completely stopped. There was slight cough with condensed phlegm, fatigue, dizziness, and limb heaviness. This indicates the pathogen is retreating, with Yin deficiency and Lung dryness, and lingering residual Heat. The following formula was used, and after more than ten doses, he recovered:
Charred Raw Rehmannia Root (Shengditan) 15g, Jerusalem Artichoke Root (Jingyuanshen) 9g, Ophiopogon Tuber (Maidong) 9g, Raw Hangzhou White Peony Root (Sheng Hangshao) 9g, Chuanbei Mother Powder (Chong Chuanbeimu) 9g, Powdered Moutan Bark (Fendanpi) 4.5g, Poria (Fushen) 12g, Broad Loquat Stem (Guang Jieluo) 6g, Honey-fried Adenophora Root (Zhi Donghua) 9g, Licorice Root (Gancao) 3g, Lotus Nodes (Oujie) 5 pieces.

[Yao's Commentary] Epistaxis is one of the common diseases in clinical practice. If handled improperly or treated late, mild cases result in blood loss damaging Yin, while severe cases involve massive epistaxis leading to Qi collapse following Blood loss. I once saw an elderly rural man who, due to age and alcoholism, suffered massive epistaxis filling basins, and died due to untimely rescue. I also diagnosed a middle-aged woman who, due to trauma, suffered excessive epistaxis with blood flowing like a stream, facing the danger of Qi collapse following Blood loss. Although rescued with large doses of Ginseng and Aconite, she subsequently suffered extreme anemia, weak constitution, and frequent illnesses. Medical predecessors stated: "When Yang collaterals are injured, blood exits via the Du Meridian, termed epistaxis. When Yin collaterals are injured, blood exits via the Chong Meridian, termed hemoptysis." For this case, based on clinical symptoms, I first used physical therapy: cold compress with ice cloth above, and soaking feet in boiling water below, embodying the *Neijing* principle of "drawing down from above." Subsequently, a large dose of Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) was modified to nourish Yin, cool Blood, and moisten dryness, leading to recovery.

Cold-induced Stomach Pain
Foreign Guest, Male, 50 years old. August 1967.
First visit: The patient had a weak constitution and a history of gastric disease. Attacks occurred easily during the rainy seasons of summer and autumn, after overwork, or from dietary indiscretion. One week prior, after contracting cold and fever, Western medicine treatment improved the condition, but the gastric disease relapsed with acid regurgitation, fullness, and dull pain. Stool was loose, four to five times daily, small amount, yellow-green color, with persistent fullness after defecation. Poor appetite, cold limbs, dizziness. The condition was protracted, prompting consultation. Symptoms showed the patient bedridden, mentally exhausted, limbs weak, face thin and pale. Tongue body pale, coating thin white. Pulse was fine and slow on superficial pressure, soggy and weak on deep pressure. This belongs to Cold-Dampness obstruction, failure of Spleen Yang to transport, and disharmony of the Intestines and Stomach. The method should be warming the Middle to dispel Cold, strengthening the Spleen to remove Dampness. Formula proposed:
Red Ginseng Root (Hong Renshen) 6g (decocted separately and mixed in), Cassia Bark (Shang Rougui) 4.5g (mixed with boiling water), Stir-fried Atractylodes Lancea Rhizome (Cangzhu) 9g, Broad-leaved Tangerine Peel (Guang Chenpi) 6g, Amomum Fruit (Xisharen) 9g, Poria (Fuling) 15g, Stir-fried Old Rice (Laomi) 15g, Ginger Slice (Shengjiang) 1 slice (burnt), Small Jujubes (Xiaozao) 11 pieces.
The above prescription was taken for five doses consecutively, decocted three times per dose.

Second visit: Symptoms significantly improved. Pulse was fine, slow, and forceful; tongue turned red and moist. Stool formed, once daily. Acid regurgitation, bloating, dull stomach pain, and cold limbs gradually disappeared. He could get up and walk, desired food, but mental energy was still poor. This indicates Middle Jiao Cold-Dampness is resolving, and Spleen Yang is recovering. Continue with a formula to tonify Qi, strengthen the Spleen, and warm the Stomach:
Red Ginseng Root (Hong Renshen) 6g (decocted separately and mixed in), Cassia Bark (Shang Rougui) 6g (mixed with boiling water), Astragalus Root (Shengkouqi) 15g, Stir-fried Atractylodes Macrocephala Rhizome (Baizhu) 9g, Amomum Fruit (Xisharen) 9g (mixed in), Processed Pinellia Tuber (Fabanxia) 9g, Broad-leaved Tangerine Peel (Guang Chenpi) 6g, Burnt Ginger (Shao Jiang) 2 slices, Stir-fried Old Rice (Laomi) 15g, Small Jujubes (Xiaozao) 11 pieces.

[Commentary] The Middle Jiao Spleen and Stomach possess the functions of receiving, rotting and ripening, steaming and transforming, and transporting and transforming the essence of food and water, producing nutrients such as Body Fluids, Qi, Blood, Ying, and Wei. Traditional Chinese Medicine metaphorically describes this series of physiological processes as "the Middle Jiao is like a fermenting vat" (Zhongjiao Ru Ou). When the Qi transformation of the Middle Jiao fails, Cold-Dampness is produced. Rising upward to the epigastrium causes pain and acid regurgitation; sinking downward into the intestines causes loose stools, even diarrhea with undigested food. This case was treated symptomatically with herbs to warm the Middle, dispel Cold, strengthen the Spleen, remove Dampness, tonify Qi, and enhance Yang function, achieving significant efficacy.

Liver Qi Stagnation with Spleen Dampness
Li XX, Male, 35 years old, government cadre. April 1959.
First visit: Diagnosed with "persistent hepatitis" at a certain hospital. Symptoms included dull pain in the right hypochondrium, acid regurgitation and belching, nausea. Bitter taste in the mouth, poor appetite, short yellow urine. Slight edema of the face and feet, slight jaundice of the eyes, tidal fever, restless sleep. Pulse was fine and wiry on the left, soggy and slow on the right; tongue body red, coating thin and greasy. This is chronic illness causing Yin deficiency, Qi stagnation with Dampness constraint, and Liver-Spleen disharmony. Treatment should resolve stagnation, clear Heat, and transform Dampness. Prescription:
Stir-fried Bupleurum Root (Chaihu) 9g, Stir-fried Hangzhou White Peony Root (Hangshaoyao) 9g, Poria (Fuling) 15g, Processed Pinellia Tuber (Fabanxia) 9g, Broad-leaved Tangerine Peel (Guang Chenpi) 6g, Aucklandia Root (Yunmuxiang) 3g, Amomum Fruit (Xisharen) 9g, Vine-processed Curcuma Tuber (Yu Jin) 6g, Coix Seed (Yiyiren) 15g, Roasted Chicken Gizzard Lining (Shao Jijin) 6g, Cortex Lycii (Digupi) 9g.

Second visit: After five doses of the above prescription, hypochondriac pain and acid regurgitation/belching decreased, urine became lighter, but eyes remained yellow. Other symptoms persisted. This indicates Damp-Heat is gradually resolving, and Liver Qi is somewhat free. Continue modifying the original formula.
Prescription:
Vine-processed Turtle Shell (Biejia) 12g, Stir-fried Bupleurum Root (Chaihu) 6g, Stir-fried Hangzhou White Peony Root (Hangshaoyao) 9g, Poria (Fuling) 15g, Amomum Fruit (Sharen) 9g, Processed Pinellia Tuber (Fabanxia) 9g, Broad-leaved Tangerine Peel (Guang Chenpi) 6g, Clean Bamboo Shavings (Zhuzhu) 6g, Roasted Chicken Gizzard Lining (Shao Jijin) 6g, Cortex Lycii (Digupi) 9g, Aucklandia Root (Yunmuxiang) 3g, Small Red Jujubes (Xiaohongzao) 10 pieces.

Third visit: After five consecutive doses of the above prescription, hypochondriac pain stopped, urine was clear and abundant, and all symptoms decreased. Pulse was harmonious, tongue moist, coating receded. Feeling fatigued, indicating pathogen retreat with Qi deficiency and Liver-Spleen insufficiency. Formula for regulation:
Codonopsis Pilosula Root (Sutiaoshen) 12g, Atractylodes Macrocephala Rhizome (Baizhu) 12g, Poria (Fuling) 15g, Stir-fried Hangzhou White Peony Root (Hangshaoyao) 9g, Angelica Sinensis Root (Danggui) 9g, Processed Pinellia Tuber (Fabanxia) 9g, Stir-fried Ziziphus Seed (Suanzaoren) 12g, Amomum Fruit (Xisharen) 6g, Aucklandia Root (Yunmuxiang) 3g, Coix Seed (Yiyiren) 15g, Small Red Jujubes (Xiaohongzao) 11 pieces.
After one month of taking the above prescription, follow-up examination showed liver function returned to normal.

[Commentary] Wood stagnation leads to Earth congestion; the Spleen is confined by Dampness, losing its ability to disperse and transform, making recovery difficult and Zheng Qi increasingly deficient, hence the term "persistent." At this time, neither clearing nor tonifying is appropriate. Instead, dispersing and regulating is used, reflecting the flexibility of adapting to circumstances.

Liver Qi Stagnation with Damp-Heat Syndrome
Zhao XX, Male, 32 years old, PLA cadre. June 1961.
First visit: Complained of right hypochondriac pain for over half a month, worsened by pressure, chest and diaphragm stuffiness, poor appetite, loose stools two to three times daily, short yellow urine. Dry and bitter mouth, desire to drink, aversion to oily meat. Occasional chills and fever. Diagnosed with acute infectious hepatitis upon examination. Medication effect was insignificant. Symptoms included slightly yellow eyes, dull and lusterless complexion, mental fatigue. Pulse was wiry on the left and stagnant on the right; tongue body red, coating thin yellow and greasy. This belongs to Liver Qi stagnation with internal latent Damp-Heat. The method should soothe the Liver, regulate Qi, clear Heat, warm the Gallbladder, and promote Dampness removal. Prescription:
Stir-fried Bupleurum Root (Chaihu) 6g, Mint (Bohe) 6g, Stir-fried Immature Bitter Orange (Zhishi) 4.5g (mixed in), Stir-fried Hangzhou White Peony Root (Hangshaoyao) 6g, Aucklandia Root (Guangmuxiang) 3g, Amomum Fruit (Xisharen) 6g, Broad-leaved Tangerine Peel (Guang Chenpi) 6g, Citron (Chenfoshou) 9g, Reed Rhizome (Lugen) 15g, Solitary Spurge Herb (Jigucao) 15g, Clean Bamboo Shavings (Zhuzhu) 6g, Roasted Chicken Gizzard Lining (Shao Jijin) 6g.

Second visit: After eight consecutive doses of the above prescription, chills and fever did not recur, spirit gradually revived, appetite returned (though still aversive to grease), chest stuffiness and hypochondriac pain decreased, bitter taste and thirst diminished. Urine was clear and abundant, stool dried. Pulse was fine and wiry, tongue red, greasy coating largely receded. TCM Syndrome Differentiation: Liver Qi is gradually soothing, Damp-Heat is largely resolving, and there is a mechanism for Spleen-Stomach harmony. Continue with the following formula:
Stir-fried Bupleurum Root (Chaihu) 6g, Stir-fried Immature Bitter Orange (Zhishi) 6g (mixed in), Vine-processed Pinellia (Fabanxia) 9g, Broad-leaved Tangerine Peel (Guang Chenpi) 6g, Stir-fried Hangzhou White Peony Root (Hangshaoyao) 9g, Poria (Fuling) 12g, Aucklandia Root (Yunmuxiang) 3g, Amomum Fruit (Xisharen) 6g, Reed Rhizome (Lugen) 12g, Clean Bamboo Shavings (Zhuzhu) 6g, Roasted Chicken Gizzard Lining (Shao Jijin) 6g, Citron (Chenfoshou) 9g.

Third visit: After fifteen consecutive doses of the above prescription, all symptoms disappeared, spirit improved, diet increased, greasy coating completely receded, pulse was harmonious. Lab tests: liver function normalized. Prescribe the following formula for regulation and consolidation:
Stir-fried Bupleurum Root (Chaihu) 6g, Stir-fried Hangzhou White Peony Root (Hangshaoyao) 9g, Poria (Fuling) 15g, Vine-processed Pinellia (Fabanxia) 9g, Stir-fried Immature Bitter Orange Peel (Zhike) 6g, Clean Bamboo Shavings (Zhuzhu) 6g, Aucklandia Root (Yunmuxiang) 3g, Citron (Chenfoshou) 9g, Raw Licorice Root (Shengancao) 3g, Stir-fried Corn and Old Rice (Laomi) 9g each.

[Commentary] The three prescriptions across the three visits consisted of only seventeen clearing and dispersing herbs, with minor additions and subtractions, yet achieved swift efficacy. This was because the pathogenesis was strictly adhered to, allowing "lightness to dispel excess," eliminating Liver Qi stagnation and Damp-Heat, resulting in cure.