阴疽出阳
张××，女，四十二岁，农民。1970年秋。
初诊：右殷胫部疼痛，卧床已三、四月，难转侧，不能行立。余适因秋收义务劳动住其家，询之，家属告日：曾经送往昆市各医院诊查治疗，中、西、草药尽皆服用，并兼针灸、穴位注射及外科敷药，毫无效果。外科因诊断不明，拒绝手术，病遂拖延至今。饮食、体力日减。患部牵连腰部，天候阴雨，疼痛尤剧，呻吟不休。诊脉沉细而紧，舌淡苔白。触诊患部，一片冰凉，肌肉坚硬，无红肿、痈脓。患者二便尚通，经期不调，数月一行。面黄肌瘦，表情痛楚，颜容憔悴。
余思虑再三，认为：此属痹症。经云“风寒湿三邪杂至，合而为痹。”由于局部筋络兼有损伤，气血不通，与邪相结，日久不散，阳气虚弱，邪不得出，转为“阴疽”昆明俗呼“附骨疽”是也。症属难治，且有内陷之机，势不可延，当为速拟固气回阳、散寒活血之阳合汤加减，托毒外出。处方：
生麻黄9克熟地黄15克 京白芥子9克鹿角胶15克(烊化
兑服) 当归15克 上肉桂6克(兑服) 川芎6克 桑寄
生15克 生甘草梢3克
二诊：余因秋收劳动完毕返昆，临行时嘱将上方多服数剂。一月后，患者家属用车推患者至医院复诊，言上方已服八剂，症情有所好转，患部冰凉转温，疼痛轻减，由人扶持已能站立，并可慢步行动。诊脉弦数有力，舌亦转红。饮食增加，心情喜悦。此属气血渐增，寒湿较化，筋络渐舒，症有由阴出阳之势。续宗原意，滋养气血，调和阴阳，舒筋活络，托毒散寒。处方：
生麻黄9克熟地黄15克北细辛3克桂枝木6克鹿角
胶12克京白芥6克(冲) 当归15克川芎6克生口芪30克
川附片18克(开水先煨透) 甘草3克
三诊：上方服六剂，已能单独柱杖慢步行走，并能蹲下、立起，食增眠安。患部转呈灼热，发红且肿，肿处有核桃大小一枚凸起，按之疼痛，牵及腰部亦痛。脉弦数，舌红润。此阴疽出阳之势明显，不足虑矣。续宜扶正除邪。处方：
生口芪30克 当归15克川芎6克川独活6克桑寄生15克
吴白芷12克 北细辛3克 川附片18克(开水先煨透) 忍冬
藤15克透骨草12克生甘草3克
四诊：上方连服十剂后，疼痛日减，能单独行走。但患部红肿日加，灼热愈甚。脉弦滑数，舌红、苔薄黄。食眠及二二便正常。此症已由阴出阳，化脓将溃，宜由外科诊治处理，因嘱服下方五剂后，可往外科手术。处方：
生口芪24克 全当归15克 川独活6克 桑寄生15克 吴白
芷9克 忍冬藤12克 透骨草9克 生甘草3克
二、三月后，患者家属来告．经外科最后透视检查，确定为腿部脓肿，施行手术，过程良好。患者已能参加适当生产劳动。
[按]阳气虚弱，阴疽内陷，实堪深虑!治本“寒者热之”，“陷者举之”大法，投“阳和”配伍芪、附、归、芎等峻剂，鼓邪外出、化险为夷。
胃病合并脂瘤
白××，男，五十四岁，干部。1970年5月。
初诊：患者病经十余年，曾由某医院诊断为十二指肠球部溃疡。因症状加重而住我院治疗。症见体困、神倦，饮食日减，面黄肌瘦，眠差。脘腹经常隐痛、胀闷，大便溏，有时色褐黑、带粘液。诊脉沉细而弦，舌质淡，苔白厚腻。此嚆寒湿凝滞，日久不化，脾阳失运，胃络不疏，治以温中散寒、除湿理气。处方：
川附片18克(开水先煨透) 上党参12克 炒白术12克 白茯
苓12克西砂仁6克(冲) 广陈皮6克 肉桂心3克(开水兑
服) 法半夏9克 生甘草3克 烧姜2片 大枣3枚
二诊：上方服十剂之后，脘腹胀闷日渐好转，食纳增加，便溏转干，粘液亦减，色仍褐。两手臂间原有脂瘤数颗，日来突然增多，自掌后至上臂皆布满，形如苡米，约百数粒，扪之楞手，皮色淡红，两臂极感酸胀不适，患者惊恐。因告之曰：此脂瘤也。医宗金鉴——六瘤之一，乃脾运不及，湿邪凝滞皮肉筋脉之间，经络气血不疏而成。诊脉沉细且濇，舌苔白腻。亟宜疏通络脉，理气活血，健脾祛湿之剂。处方：
当归15克川芎6克藏红花3克桑寄生15克紫丹参15克
青木香4．5克炒白术9克茯苓12克 西砂仁6克(冲)
炒苡仁12克 甘草梢3克 生三七粉4．5克(分次词服)
除服上方外，用食盐拌入茴香、木香少许同炒热，淬清酒，用纱布包好，以之热熨两手患部，每日数次。
三诊：服上方又十剂，兼外用热熨法，内外配合，两臂脂瘤大者变小，小者渐散，扪之已不楞手，皮肤光华泽润，脘腹胀痛轻减。纳增，眠佳，大便转黄，粘液亦止。脉细缓，舌苔淡红。再拟方调理：
上党参15克 炒白术12克 当归身12克 西砂仁6克 茯
苓12克 广木香2．4克 紫丹参6克 桑寄生12克 红饭
豆12克 炒苡仁12克 烧生姜2片 大红枣3枚
上方服十五剂，并续外用热熨法，脂瘤消失，胃病痊愈出院。嘱日后常服理中丸、归脾丸。三月后钡餐复查，溃疡未见波动。1973年相逢，身体健康病未复发。
[按]病本在脾。寒湿凝结，阳气不宣，气血郁滞，络脉不畅，故里则脘腹疼痛，运化失司，肠胃不调，表则肌肤筋咏不利，发为脂瘤。治疗始终以健运脾阳，祛化寒湿为主，又灵活巧妙地配合活血、行气、疏通筋脉之法，内外并治，使病得痊。
胆结石
鲁××，男，七十六岁，中医师。1955年7月。
初诊：平时喜啖辛辣厚味及烟酒等物，身体肥胖，湿盛痰多。月前，感精神倦怠，午后寒热往来，胁下痞痛拒按，不思饮食，面目苍黄浮肿，痰凝，胸闷，腹胀，口苦咽干，头眩欲呕。小便短赤，大便秘结。夜间烦躁，难于入睡。时当夏令暑热，自服香薷饮、六合汤及大、小柴胡等方无效，遂住院治疗。诊断：胆道结石并感染，拟予手术治疗，又恐年老引起它变。
会诊时，症见脉弦数而滑，两关部尤硬劲挺指，舌红，苔黄厚而腻。系属暑热夹湿，邪滞三焦，胆胃失调，气机不利。拟方如下：
茵陈15克 藿香6克 炒枳实9克 陈皮6克 焦山查9克
炒谷芽9克 炒麦芽9克 醋法夏9克 滑石12克 佩兰
叶9克 炒黄连3克 竹茹9克 烧鸡金6克 金钱草18克
瓜蒌1枚
二诊：上方三剂后，寒热渐退，口苦咽干、头眩呕逆等状减轻。唯胸胁痞痛，腹胀未除，纳呆，痰凝，溺短便秘。
脉弦滑带数，两关仍硬，舌黄白相兼，厚腻未退。此暑热较化，阳明燥结、痰湿仍重。法当攻逐邪实，否则养痈贻累，后患无穷。处方。
茵陈15克 炒枳实9克(冲) 金钱草24克 元明粉9克
滑石12克 冲郁金9克 广木香3克 炒黄连3克 烧鸡
金6克 青礞石15克 通草3克 瓜蒌1枚(打)
三诊：患者因见方内有礞石，乃又自加服礞石滚痰丸一包。至夜半，腹中雷鸣，大便畅通，兼下云豆大褐色结石一枚。翌日会诊，察观结石，皆惊奇!自便通石下后，胸胁痞痛顿觉轻松，寒热退，腹胀消。续用下方调养清理。处方：
沙参0克 寸冬9克 金石斛9克 茯神15克 法夏9克
广陈皮6克 苡仁12克冲波蔻6克生扁豆9克甘草3克
烧鸡金6克
上方服三剂后，改用香砂六君汤调理而病愈出院。
[按]惠者虽年高症重邪实，乃取“留者攻之”遂“通”而痊愈。
放射病
杨××，男，四十二岁，某专区职工医院工作人员。
1970年4月。
初诊：患者在我省某专区职工医院任放射科工作十六年，平日体力强健，虽常在暗室中工作，而食眠均佳，未患过任何重病。自去冬以来，常感头眩神昏，夜寐不宁，失眠多梦，渐至胸闷气短，痰凝呕逆，面目及四肢皆现浮肿，两足尤甚。眼皮及手指有时发抖，溺短便溏，体重减轻。至今春已不能支持工作，经医院检查，血压偏低，兼有贫血现象，白血球低至2800——3000，血红球300Z——320万，血小板7万，血色素8克。曾用过大量维生素葡萄糖溶液和氯化钙等西药治疗，症状未见改善。至今夏浮肿胸闷加剧，起床则头眩，呕吐痰延，食欲不振．夜卧烦躁，乃专程来昆进住我院治疗。脉象濡滑沉细，舌白腻，苔润滑。此乃心阳不足，脾肾两虚，湿滞中焦，痰凝胸痹。
治法拟分三步，先宣胸豁痰，理肺止呕；继可温脾健运，消肿利尿，最后养心固肾，益气补血。拟方如下：
全瓜萎1枚 薤白9克 法半夏9克 桂枝木9克 广陈
皮6克茯苓12克细枳实9克 净秫米12克 生姜3片
大枣5枚
二诊：上方服五剂后，患者胸膈渐感宽畅，气短痰凝有所减轻。夜卧未宁，起床仍感头眩欲呕，眼睑四肢尚有轻度浮肿，手指及双目不时颤抖。便溏薄，溺短。饮食不思，精神倦怠，行动迟缓。此胸痹较舒，痰凝渐化，湿滞中焦日久脾失健运，水湿有泛滥之虞，脉濡滑而缓，唇白舌润，苔淡薄。拟采第二步疗法，，以温脾健运利水消肿。处方：
川附片30克(开水先煨透) 炒白术1 2克茯苓24克砂仁6克
(冲) 法半夏9克 桂枝木9克 猪苓9克 泽泻6克
川干姜9克 大枣5枚
三诊：患者连服上方六剂后，小便渐利，大便溏薄已少，面部浮肿有明显消退，能进少量饮食。可以起床缓步行走，虽数百步亦不觉头眩。呕逆已止，只夜间睡卧多梦。脉濡缓，舌白润。此病久心肾阳虚，心神不宁，续用下方调理：
川附片30克(开水先煨透) 白术12克 茯神15克 枣仁16克
(炒) 炙远志6克 法夏9克 砂仁6克(冲) 甘草3克
川干姜9克 莲子lsE(去心) 大枣3枚
四诊：患者住院月余，又将上方连服十余剂，病情日趋好转，面目四肢浮肿消退。小便清长，大便微溏，日一行。
食量增加，夜梦已少，能静卧。肤色转红润，体力精神渐好，虽日行数里亦不觉头目昏眩。咏调和，舌红润。拟用第三步疗法，养心固肾，益气补血。处方；
上党参18克 川附片30克(开水先煨透) 茯神15克 当归
身15克 白术12克 果杞15克 西砂仁6克 生黄芪15克
炙甘草3克 莲子15克(去心) 生姜2片 大枣3枚 桂圆
10枚(去壳)
上方服二十余剂，病愈出院。
[姚按]放射病是现代医学科学中的一种职业病，祖国医学文献，没有这种记载。余在诊治时，只依据患者之临床体征如脉、舌、色等证状。由于患者在暗室中工作多年，阳虚体弱，肺气不宣，有胸痹证状，兼之脾弱胃寒、湿邪凝滞，故常呕吐头眩。日久未愈，食少眠差，引起面目浮肿，精神萎顿。根据辨证施冶，给予对证治疗，取得初步疗效，还不能肯定对本病有确切疗效，观提出来，仅供参考。
Yin Abscess Transforming into Yang
Patient Zhang XX, female, 42 years old, farmer. Date of consultation: Autumn 1970.
First Visit: Pain in the right thigh (specifically the medial aspect and lower leg), bedridden for three to four months, unable to turn over or walk. I happened to be staying at her home due to autumn harvest volunteer labor. Upon inquiry, the family reported that she had been sent to various hospitals in Kunming for examination and treatment. She had taken Chinese medicine, Western medicine, and herbal remedies, and received acupuncture, acupoint injection, and external surgical dressings, but with no effect. Due to an unclear diagnosis by the surgery department, surgery was refused, leading to the prolongation of the illness until now. Her diet and physical strength have daily decreased. The affected area involves the waist; on rainy days, the pain is particularly severe, accompanied by constant moaning. The pulse is deep, fine, and tight; the tongue is pale with a white coating. Palpation of the affected area reveals it is ice-cold, with hard muscles, no redness, swelling, or abscess formation. The patient’s urination and defecation are still patent, but menstruation is irregular, occurring once every few months. The complexion is sallow, the body is emaciated, the expression is painful, and the face looks haggard.
After careful consideration, I concluded: This belongs to Bi Syndrome (a condition caused by the invasion of wind, cold, and dampness pathogens affecting the meridians, leading to pain and numbness). The *Classic of Internal Medicine* states: "When wind, cold, and dampness pathogens mix together, they combine to form Bi." Due to local damage to the sinews and collaterals, Qi and Blood circulation is blocked, binding with the pathogens. Over time, without dispersal, Yang Qi becomes deficient, and the pathogens cannot be expelled, transforming into a "Yin Abscess" (a yin-type ulcer originating in the bones and muscles), locally known in Kunming as "Gu-attached Abscess" (Fugu Ju). This condition is difficult to treat and carries the risk of internal sinking (pathogens penetrating deeply into the zang-fu organs). It cannot be delayed; we must quickly prescribe a modified Yang He Tang (Cordyceps Decoction) to consolidate Qi, restore Yang, dispel cold, invigorate Blood, and expel toxins outward. Prescription:
Sheng Mahuang (Ephedrae Herba) 9g, Shu Dihuang (Rehmanniae Radix Preparata) 15g, Jing Baijiezi (Brassicae Semen Album) 9g, Lujiao Jiao (Colla Cornus Cervi) 15g (melted and mixed in), Danggui (Angelicae Sinensis Radix) 15g, Shang Rougui (Cinnamomi Cortex) 6g (mixed in), Chuanxiong (Ligustici Chuanxiong Rhizoma) 6g, Sangjisheng (Taxilli Caulis) 15g, Sheng Gancao Gao (Glycyrrhizae Radix et Rhizoma) 3g.
Second Visit: After returning to Kunming following the completion of autumn harvest labor, I instructed the family to take several more doses of the previous prescription. One month later, the patient was pushed to the hospital by family members for follow-up. They reported that eight doses had been taken, symptoms improved, the affected area turned from cold to warm, pain decreased, and with assistance, standing and slow walking were possible. The pulse is wiry, rapid, and forceful; the tongue has turned red. Diet has increased, and mood is joyful. This indicates gradual increase in Qi and Blood, transformation of cold-dampness, relaxation of sinews and collaterals, and a trend of the condition transforming from Yin to Yang. Continuing with the original intent: nourish Qi and Blood, harmonize Yin and Yang, relax sinews and activate collaterals, expel toxins and dispel cold. Prescription:
Sheng Mahuang (Ephedrae Herba) 9g, Shu Dihuang (Rehmanniae Radix Preparata) 15g, Bei Xixin (Asari Radix et Rhizoma) 3g, Guizhi Mu (Ramulus Cinnamomi) 6g, Lujiao Jiao (Colla Cornus Cervi) 12g, Jing Baijiezi (Brassicae Semen Album) 6g (taken with water), Danggui (Angelicae Sinensis Radix) 15g, Chuanxiong (Ligustici Chuanxiong Rhizoma) 6g, Sheng Huangqi (Astragali Radix) 30g, Chuan Fupian (Aconiti Lateralis Radix Preparata) 18g (simmered thoroughly in boiling water first), Gancao (Glycyrrhizae Radix et Rhizoma) 3g.
Third Visit: After taking six doses of the previous prescription, the patient could walk slowly with a cane alone, squat down, and stand up. Appetite increased, and sleep was peaceful. The affected area became hot, red, and swollen, with a walnut-sized protrusion that was tender to pressure, radiating pain to the waist. The pulse is wiry and rapid; the tongue is red and moist. The trend of the Yin Abscess transforming into Yang is obvious and not a cause for concern. Continue to support the healthy Qi and eliminate pathogens. Prescription:
Sheng Huangqi (Astragali Radix) 30g, Danggui (Angelicae Sinensis Radix) 15g, Chuanxiong (Ligustici Chuanxiong Rhizoma) 6g, Chuan Duhuo (Angelicae Pubescentis Radix) 6g, Sangjisheng (Taxilli Caulis) 15g, Wu Baizhi (Angelicae Dahuricae Radix) 12g, Bei Xixin (Asari Radix et Rhizoma) 3g, Chuan Fupian (Aconiti Lateralis Radix Preparata) 18g (simmered thoroughly in boiling water first), Rendongteng (Lonicerae Japonicae Caulis) 15g, Tougucao (Herba Epimedii? Note: Usually refers to specific herbs like Ligusticum wallichii or others depending on region, here kept as Tougucao) 12g, Sheng Gancao Gao (Glycyrrhizae Radix et Rhizoma) 3g.
Fourth Visit: After ten consecutive doses of the previous prescription, pain decreased daily, and the patient could walk alone. However, redness and swelling of the affected area increased, and heat intensified. The pulse is wiry, slippery, and rapid; the tongue is red with a thin yellow coating. Diet, sleep, and excretion are normal. The condition has transformed from Yin to Yang, pus is forming and about to rupture. It should be managed by the surgery department. Therefore, instruct to take the following prescription for five doses before undergoing surgery. Prescription:
Sheng Huangqi (Astragali Radix) 24g, Quan Danggui (Angelicae Sinensis Radix) 15g, Chuan Duhuo (Angelicae Pubescentis Radix) 6g, Sangjisheng (Taxilli Caulis) 15g, Wu Baizhi (Angelicae Dahuricae Radix) 9g, Rendongteng (Lonicerae Japonicae Caulis) 12g, Tougucao (Herba Epimedii?) 9g, Sheng Gancao Gao (Glycyrrhizae Radix et Rhizoma) 3g.
Two to three months later, the family reported that after final fluoroscopic examination by surgery, it was confirmed as a leg abscess. Surgery was performed successfully. The patient can now participate in appropriate productive labor.
[Commentary] When Yang Qi is deficient and Yin Abscess sinks internally, it is indeed a matter of deep concern! Treatment should follow the great principles of "treating cold with heat" and "lifting sunken conditions." Using Yang He Tang (Cordyceps Decoction) combined with potent agents like Huangqi (Astragali Radix), Fuzi (Aconiti Radix Preparata), Danggui (Angelicae Sinensis Radix), and Chuanxiong (Ligustici Chuanxiong Rhizoma) helps drive pathogens out and turns danger into safety.
Stomach Disease Complicated by Lipoma
Patient Bai XX, male, 54 years old, cadre. Date of consultation: May 1970.
First Visit: The patient has been ill for over ten years and was previously diagnosed with duodenal bulb ulcer at another hospital. Due to worsening symptoms, he was admitted to our hospital. Symptoms include bodily heaviness, mental fatigue, decreasing appetite, sallow complexion, emaciation, and poor sleep. There is frequent dull pain and distension in the epigastrium and abdomen, loose stools, sometimes dark brown with mucus. The pulse is deep, fine, and wiry; the tongue is pale with a thick, greasy white coating. This is Cold-Dampness stagnation, unresolved for a long time, leading to failure of Spleen Yang to transport and Stomach collaterals to unblock. Treatment aims to warm the middle, dispel cold, remove dampness, and regulate Qi. Prescription:
Chuan Fupian (Aconiti Lateralis Radix Preparata) 18g (simmered thoroughly in boiling water first), Shang Dangshen (Codonopsis Radix) 12g, Chao Baizhu (Atractylodis Macrocephalae Rhizoma) 12g, Bai Fuling (Poria) 12g, Xi Sha Ren (Amomi Fructus Rotundus) 6g (taken with water), Guang Chenpi (Citri Reticulatae Pericarpium) 6g, Rougui Xin (Cinnamomi Cortex Medulla) 3g (mixed in boiling water), Fa Banxia (Pinelliae Rhizoma Preparatum) 9g, Sheng Gancao (Glycyrrhizae Radix et Rhizoma) 3g, Shao Jiang (Zingiberis Rhizoma Recens) 2 slices, Da Zao (Jujubae Fructus) 3 pieces.
Second Visit: After ten doses of the previous prescription, epigastric and abdominal distension improved daily, appetite increased, stools became formed, and mucus decreased (though color remained brown). Several lipomas (fatty tumors) originally present between the arms suddenly multiplied, spreading from the palms to the upper arms, resembling coix seeds, numbering about a hundred. They felt rough to touch, with pale red skin, causing extreme soreness and discomfort in both arms, frightening the patient. I informed him: These are lipomas. Listed as one of the six types of tumors in *Medical Master's Mirror* (Yi Zong Jin Jian), they result from insufficient Spleen transportation, where Dampness pathogens stagnate between skin, flesh, sinews, and collaterals, blocking Qi and Blood flow. The pulse is deep, fine, and choppy; the tongue coating is white and greasy. Urgent treatment requires formulas to unblock collaterals, regulate Qi, invigorate Blood, strengthen the Spleen, and expel Dampness. Prescription:
Danggui (Angelicae Sinensis Radix) 15g, Chuanxiong (Ligustici Chuanxiong Rhizoma) 6g, Zang Honghua (Carthami Flos) 3g, Sangjisheng (Taxilli Caulis) 15g, Zi Danshen (Salviae Miltiorrhizae Radix) 15g, Qingmuxiang (Aucklandiae Radix) 4.5g, Chao Baizhu (Atractylodis Macrocephalae Rhizoma) 9g, Fuling (Poria) 12g, Xi Sha Ren (Amomi Fructus Rotundus) 6g (taken with water), Chao Yiren (Coicis Semen) 12g, Gancao Gao (Glycyrrhizae Radix et Rhizoma) 3g, Sheng Sanqi Fen (Notoginseng Radix Powder) 4.5g (taken in divided doses mixed with water).
In addition to the oral prescription, mix salt with a small amount of Huixiang (Foeniculi Fructus) and Muxiang (Aucklandiae Radix), stir-fry until hot, quench in clear wine, wrap in gauze, and apply hot compress to the affected areas of both hands several times daily.
Third Visit: After another ten doses of the prescription combined with external hot compress therapy, the larger lipomas on both arms shrank, smaller ones dispersed, and they no longer felt rough to touch. Skin became smooth and lustrous. Epigastric pain and distension lightened. Appetite increased, sleep improved, stools turned yellow, and mucus stopped. The pulse is fine and slow; the tongue coating is pale red. Prescribe another formula for regulation:
Shang Dangshen (Codonopsis Radix) 15g, Chao Baizhu (Atractylodis Macrocephalae Rhizoma) 12g, Danggui Shen (Angelicae Sinensis Radix) 12g, Xi Sha Ren (Amomi Fructus Rotundus) 6g, Fuling (Poria) 12g, Guang Muxiang (Aucklandiae Radix) 2.4g, Zi Danshen (Salviae Miltiorrhizae Radix) 6g, Sangjisheng (Taxilli Caulis) 12g, Hong Fan Dou (Phaseoli Semen Rubrum) 12g, Chao Yiren (Coicis Semen) 12g, Shao Jiang (Zingiberis Rhizoma Recens) 2 slices, Da Hong Zao (Jujubae Fructus) 3 pieces.
After fifteen doses of this prescription and continued external hot compress therapy, the lipomas disappeared, and the stomach disease was cured upon discharge. Instructed to regularly take Lizhong Wan (Regulate the Middle Pill) and Guipi Wan (Restore the Spleen Pill) thereafter. Follow-up barium meal examination three months later showed no fluctuation in the ulcer. Meeting again in 1973, the patient was healthy with no recurrence.
[Commentary] The root of the disease lies in the Spleen. Cold-Dampness condenses, Yang Qi does not circulate, Qi and Blood stagnate, and collaterals are obstructed. Internally, this causes epigastric/abdominal pain, failure of transportation and transformation, and gastrointestinal disharmony. Externally, it causes dysfunction of skin and sinews, resulting in lipomas. Treatment always focused on strengthening Spleen Yang and resolving Cold-Dampness, flexibly combining methods to invigorate Blood, move Qi, and unblock sinews. Internal and external treatments together led to recovery.
Gallstones
Patient Lu XX, male, 76 years old, Traditional Chinese Medicine practitioner. Date of consultation: July 1955.
First Visit: Normally enjoys spicy, rich foods, alcohol, and tobacco. The body is obese, with abundant Dampness and Phlegm. A month ago, felt mental fatigue, alternating chills and fever in the afternoon, fullness and pain under the ribs that rejects pressure, loss of appetite, sallow and puffy face and eyes, phlegm accumulation, chest oppression, abdominal distension, bitter taste in the mouth, dry throat, dizziness, and urge to vomit. Urine is short and red, stool is constipated. Restless at night, difficulty sleeping. During the summer heat, self-medicated with Xiangru Yin (Elsholtzia Decoction), Liuhe Tang (Six Harmonies Decoction), and Xiao/Chaihu San (Minor/Major Bupleurum Powders) without effect, so hospitalized. Diagnosis: Biliary tract stones with infection, planned for surgery, but feared complications due to advanced age.
During consultation, symptoms included a wiry, rapid, and slippery pulse, especially hard and stiff at the Guan positions (representing Liver/Gallbladder and Spleen/Stomach); tongue red with thick, greasy yellow coating. This belongs to Summer-Heat夹杂着 Dampness, pathogens stagnating in the Triple Burner, disharmony between Gallbladder and Stomach, and impaired Qi mechanism. Proposed prescription:
Yinchen (Artemisiae Scopariae Herba) 15g, Huoxiang (Agastaches Herba) 6g, Chao Zhishi (Aurantii Fructus Immaturus) 9g, Chenpi (Citri Reticulatae Pericarpium) 6g, Jiao Shanzha (Crataegi Fructus) 9g, Chao Guya (Hordei Fructus Germinatus) 9g, Chao Maiya (Sacchari Stylum Germinatum) 9g, Cu Banxia (Pinelliae Rhizoma Preparatum) 9g, Huashi (Talcum) 12g, Peilan Ye (Eupatorii Herba) 9g, Chao Huanglian (Coptidis Rhizoma) 3g, Zhuru (Bambusae Caulis in Taenia) 9g, Shao Jijin (Galli Gigerii Endothelium Corneum) 6g, Jinqiancao (Lysimachiae Herba) 18g, Gualou (Trichosanthis Fructus) 1 piece.
Second Visit: After three doses, chills and fever gradually subsided, and symptoms like bitter taste, dry throat, dizziness, and vomiting reduced. Only chest/hypochondriac fullness/pain and abdominal distension remain, along with poor appetite, phlegm accumulation, short urine, and constipation.
The pulse is wiry, slippery, and slightly rapid; the Guan positions remain hard. The tongue shows mixed yellow and white, thick and greasy coating unchanged. Summer-Heat has largely resolved, but Yangming Dryness Accumulation and Phlegm-Dampness remain heavy. The method should be to attack and purge pathogenic excess; otherwise, nurturing the carbuncle will lead to endless future troubles. Prescription:
Yinchen (Artemisiae Scopariae Herba) 15g, Chao Zhishi (Aurantii Fructus Immaturus) 9g (taken with water), Jinqiancao (Lysimachiae Herba) 24g, Yuan Ming Fen (Natrii Sulfas) 9g, Huashi (Talcum) 12g, Chong Yujin (Curcumae Radix) 9g, Guang Muxiang (Aucklandiae Radix) 3g, Chao Huanglian (Coptidis Rhizoma) 3g, Shao Jijin (Galli Gigerii Endothelium Corneum) 6g, Qing Mengshi (Calcareum Micae) 15g, Tongcao (Tetrapanacis Medulla) 3g, Gualou (Trichosanthis Fructus) 1 piece (crushed).
Third Visit: Seeing Mengshi in the prescription, the patient additionally took a packet of Mengshi Gun Tan Wan (Mengshi Phlegm-Rolling Pill) himself. By midnight, borborygmus occurred, bowels moved smoothly, and a bean-sized brown stone was passed. Next day, during consultation, everyone was amazed by the stone! Since bowel movement and stone passage, chest/hypochondriac fullness/pain instantly relieved, chills/fever subsided, abdominal distension resolved. Continue with the following prescription for conditioning and clearing:
Shashen (Glehniae Radix) 0g (Note: Original text says 0g, likely an error or specific context, translated as written), Cun Dong (Ophiopogonis Radix) 9g, Jin Shi Hu (Dendrobii Caulis) 9g, Fushen (Poria cum Pinodia) 15g, Fa Banxia (Pinelliae Rhizoma Preparatum) 9g, Guang Chenpi (Citri Reticulatae Pericarpium) 6g, Yiren (Coicis Semen) 12g, Chong Bo Kou (Amomi Fructus Rotundus) 6g, Sheng Bian Dou (Phaseoli Cordifolii Semen) 9g, Gancao (Glycyrrhizae Radix et Rhizoma) 3g, Shao Jijin (Galli Gigerii Endothelium Corneum) 6g.
After three doses of this prescription, switched to Xiangsha Liujun Tang (Costus and Amomi Six Gentlemen Decoction) for regulation, and the patient recovered and was discharged.
[Commentary] Although the patient was elderly with severe symptoms and excess pathogens, the principle of "attacking those that remain" and achieving "patency" led to recovery.
Radiation Sickness
Patient Yang XX, male, 42 years old, staff member of a prefectural worker's hospital. Date of consultation: April 1970.
First Visit: The patient worked in the Radiology Department of a prefectural worker's hospital in our province for sixteen years. Previously physically strong, working often in darkrooms, with good diet and sleep, and no history of serious illness. Since last winter, frequently experienced dizziness and mental confusion, restless sleep, insomnia with many dreams, gradually progressing to chest oppression, shortness of breath, phlegm accumulation, vomiting, edema of the face and limbs (especially feet). Eyelids and fingers sometimes trembled, urine was short, stools loose, weight decreased. By spring, unable to continue work. Hospital checks showed low blood pressure, anemia, white blood cells as low as 2800–3000, red blood cells 3.0–3.2 million, platelets 70,000, hemoglobin 8g. Treated with large amounts of vitamin glucose solution and calcium chloride etc., but symptoms did not improve. By summer, edema and chest oppression worsened; getting up caused dizziness, vomiting of phlegm/saliva, loss of appetite, restlessness at night. Came specifically to Kunming to be admitted to our hospital. Pulse is soggy, slippery, deep, and fine; tongue white and greasy, coating moist. This is Heart Yang deficiency, Spleen and Kidney dual deficiency, Dampness stagnating in the Middle Burner, and Phlegm condensing in Chest Bi (obstruction).
Treatment plan divided into three steps: First, ventilate the chest, resolve Phlegm, regulate Lung, stop vomiting; second, warm the Spleen, strengthen transportation, reduce edema, promote diuresis; finally, nourish the Heart, secure the Kidney, tonify Qi, and benefit Blood. Proposed prescription:
Quan Gualou (Trichosanthis Fructus) 1 piece, Xiebai (Allii Macrostemonis Bulbus) 9g, Fa Banxia (Pinelliae Rhizoma Preparatum) 9g, Guizhi Mu (Ramulus Cinnamomi) 9g, Guang Chenpi (Citri Reticulatae Pericarpium) 6g, Fuling (Poria) 12g, Xi Zhishi (Aurantii Fructus Immaturus) 9g, Jing Shumi (Sorghei Semen) 12g, Shengjiang (Zingiberis Rhizoma Recens) 3 slices, Da Zao (Jujubae Fructus) 5 pieces.
Second Visit: After five doses, the patient felt chest diaphragm gradually relaxed, shortness of breath and phlegm reduced. Sleep still restless, getting up still causes dizziness and urge to vomit. Mild edema remains in eyelids and limbs; fingers and eyes occasionally tremble. Stools loose, urine short. No desire for food, mental fatigue, slow movement. Chest Bi is relatively relieved, Phlegm gradually resolving, but long-term Dampness stagnation in Middle Burner has caused Spleen failure in transportation, with risk of water flooding. Pulse is soggy, slippery, and slow; lips white, tongue moist, coating thin. Adopt the second step therapy: warm Spleen, strengthen transportation, promote diuresis, reduce edema. Prescription:
Chuan Fupian (Aconiti Lateralis Radix Preparata) 30g (simmered thoroughly in boiling water first), Chao Baizhu (Atractylodis Macrocephalae Rhizoma) 12g, Fuling (Poria) 24g, Sha Ren (Amomi Fructus Rotundus) 6g (taken with water), Fa Banxia (Pinelliae Rhizoma Preparatum) 9g, Guizhi Mu (Ramulus Cinnamomi) 9g, Zhuling (Polyporus) 9g, Zexie (Alismatis Rhizoma) 6g, Chuan Ganjiang (Zingiberis Rhizoma) 9g, Da Zao (Jujubae Fructus) 5 pieces.
Third Visit: After six consecutive doses, urination gradually increased, loose stools decreased significantly, facial edema noticeably subsided, able to eat small amounts. Can get up and walk slowly; even hundreds of steps do not cause dizziness. Vomiting stopped, only dreaming at night. Pulse soggy and slow, tongue white and moist. Long-standing illness has led to Heart and Kidney Yang deficiency, disturbing the Spirit. Continue with the following prescription for regulation:
Chuan Fupian (Aconiti Lateralis Radix Preparata) 30g (simmered thoroughly in boiling water first), Baizhu (Atractylodis Macrocephalae Rhizoma) 12g, Fushen (Poria cum Pinodia) 15g, Zaoren (Ziziphi Spinosae Semen) 16g (stir-fried), Zhi Yuanzhi (Polygalae Radix) 6g, Fa Banxia (Pinelliae Rhizoma Preparatum) 9g, Sha Ren (Amomi Fructus Rotundus) 6g (taken with water), Gancao (Glycyrrhizae Radix et Rhizoma) 3g, Chuan Ganjiang (Zingiberis Rhizoma) 9g, Lianzi (Nelumbinis Semen) 15g (heart removed), Da Zao (Jujubae Fructus) 3 pieces.
Fourth Visit: After staying in hospital for over a month and taking the previous prescription for more than ten doses, condition gradually improved, edema of face and limbs subsided. Urine clear and abundant, stools slightly loose, once daily. Appetite increased, fewer dreams, able to lie quietly. Skin tone turned ruddy, physical strength and spirit gradually improved; walking miles daily does not cause dizziness. Pulse harmonious, tongue red and moist. Adopt the third step therapy: nourish Heart, secure Kidney, tonify Qi, benefit Blood. Prescription:
Shang Dangshen (Codonopsis Radix) 18g, Chuan Fupian (Aconiti Lateralis Radix Preparata) 30g (simmered thoroughly in boiling water first), Fushen (Poria cum Pinodia) 15g, Danggui Shen (Angelicae Sinensis Radix) 15g, Baizhu (Atractylodis Macrocephalae Rhizoma) 12g, Gouqi (Lycii Fructus) 15g, Xi Sha Ren (Amomi Fructus Rotundus) 6g, Sheng Huangqi (Astragali Radix) 15g, Zhi Gancao (Glycyrrhizae Radix et Rhizoma) 3g, Lianzi (Nelumbinis Semen) 15g (heart removed), Shengjiang (Zingiberis Rhizoma Recens) 2 slices, Da Zao (Jujubae Fructus) 3 pieces, Guiyuan (Longan Arillus) 10 pieces (shell removed).
After taking more than twenty doses of this prescription, the patient recovered and was discharged.
[Dr. Yao's Commentary] Radiation sickness is an occupational disease in modern medical science; there is no such record in traditional Chinese medical literature. During diagnosis and treatment, I relied only on clinical signs such as pulse, tongue, and complexion. Because the patient worked in a darkroom for many years, he had Yang deficiency and weak constitution, Lung Qi not venting, presenting with Chest Bi symptoms, combined with weak Spleen and cold Stomach, Dampness stagnation, hence frequent vomiting and dizziness. Untreated for a long time, poor diet and sleep led to facial edema and mental depression. Based on syndrome differentiation and treatment, symptomatic treatment yielded preliminary results. I cannot confirm exact efficacy for this disease, but present it for reference only.