（三两酒炒） 海蛤粉（三两包） 生山药（一两） 甜广皮（一两） 川贝母（一两） 生鳖甲（十两） 枣仁（炒
研一两） 鸡头子（一两） 龙齿（二两） 生牡蛎（八两） 奎党参（三两） 炒于术（二两） 女贞子（一两
酒炒） 甘杞子（二两）
以清阿胶三两，龟板胶六两，酒化收膏。
黄（左） 头目昏蒙，恶心胃钝。连宵不寐阳升不平，胃土失和。治以和胃熄肝。
制半夏（一钱五分） 上广皮（一钱） 炒秫米（二钱包） 茯苓神（各二钱） 炒竹茹（一钱） 龙齿（三钱）
白蒺藜（三钱） 炒枣仁（二钱） 夜交藤（四钱）
又 寤不成寐，头目昏蒙。皆由真水不足，水不济火。前法再扩充之。
炒枣仁 辰茯神 杞子 柏子霜 辰麦冬 珍珠母 辰灯心
又 寐得稍安，而水火不易交接。再参升降水火法。
朱茯神（三钱） 夜交藤（四钱） 川雅连（三分） 焦秫米（二钱） 辰灯心（三分） 炒枣仁（二钱）
龙齿（三钱） 上徭桂（去粗皮研后入一分五厘） 制半夏（一钱五分）
李（左） 向有肝阳，兹以情志拂逆，更兼一阳来复，肝阳上升，连宵不寐。症属内因，急宜开展襟怀，以遂
其肝木条达之性。
枣仁（炒研二钱） 龙齿（一钱） 白芍（一钱五分） 石决明（四钱） 夜交藤（四钱） 朱茯神（三钱）
甘草（三分） 柏子仁（三钱去油） 朱砂安神丸（三钱开水先下）
二诊 上升之阳渐平，寤得成寐。然肝体已虚，再从下柔养。
龟板 白芍 生熟草 黑豆衣 夜交藤 生地 茯神 女贞子 粉丹皮 谷芽
朱（左） 咸寒育阴，苦泄降火，连宵得寐，遗泄未来。药既应手，宜再扩充。
枣仁（胆汁炒二钱） 龙齿（四钱） 龟甲心（炙先煎六钱） 珍珠母（醋 ） 半夏（胆汁炒二钱）
生牡蛎（四钱） 丹皮（二钱） 桑叶（七分） 百合心（辰砂拌四钱） 朱砂安神丸（二钱开水先下）
王（右） 隔宿之事，尚能记忆，神不昏也。神既不昏，而终日酣眠，呼之不应，断无如此睡状也。面青，脉左
大，舌无华。此中气无权，阳气尽从上冒，则肾阴不能上交，阳气浮而少阴病矣。金匮惟少阴有但欲寐
之条，兹用桂枝汤以和阳，参介类潜伏，但阴不与阳交，阳不与阴接，再进一层，即是阴阳脱离之局，可忧者在此。
桂枝（七分） 杭白芍（三钱炙甘草三分煎汁拌炒） 龙齿（三钱） 左牡蛎（七钱） 制半夏（二钱）
老生姜（二片） 大枣（二枚）
二诊 蒙昧稍清，面青较退，左脉稍敛，而仍神迷如睡，时带错语。阳气上冒未平，炼液成痰，神机愈蔽。
拟潜阳之中，参开郁化痰，必得绩效，方能许治。
桂枝（三分白芍一钱五分同炒） 左牡蛎（一两） 郁金（五分磨冲） 香附（研一钱五分） 炒范志曲（一
钱五分） 茯苓（五钱） 龙骨（三钱） 炒枳实（一钱） 橘红（一钱） 淮小麦（七钱）
三诊 阳气稍潜，上则耳鸣大减，下则大便通行，坎离稍济，蒙昧略清，面色青晦稍退，舌稍华泽。惟中
脘尚觉作痛，右关脉稍觉沉实。中虚宿垢未清，阴阳稍通，坎离仍未互抱。拟从阳引阴，从阴引阳，仍参
磨滞之品，合于胃府以通为降之旨。
人参须（另煎冲四分） 橘红（一钱） 郁金（五分磨冲） 炒范志曲（一钱五分） 枳实（五分磨冲） 生
香附（一钱五分研） 牡蛎（一两） 茯苓（三钱） 制半夏（二钱） 龙骨（三钱） 孔圣枕中丹（三钱先服）
四诊 蒙混迷睡大退，目光渐觉灵动，面色青晦亦渐转华。其为阳气上冒，不能下交于阴，致少阴之
气不能上承，确然可见。中脘拒按已化，虽属积滞下行，未始非土中之木得泄而然也。惟遍身作痛，良
由营血失于涵养，肝风入于筋络。再用参归桂枝汤出入，仍参介类潜阳。
人参须（另煎冲八分） 川桂枝（三分） 橘络（红花汤拌炒一钱） 龙齿（三钱） 左秦艽（一钱五分）
白芍（一钱五分） 牡蛎（八钱） 桑寄生（三钱炒） 当归（二钱炒） 孔圣枕中丹（三钱开水送下先服）
五诊 蒙昧已退，胃亦略起。然言语间有错杂，心中懊烦。当属阳气撼扰，再参宁神。
云茯神（三钱） 辰砂（三钱包） 白蒺藜（去刺炒三钱） 枣仁（炒打二钱） 制香附（二钱） 缩砂仁（研
后入七分） 石决明（四钱） 龙骨（炒打三钱） 白芍（一钱五分与桂枝三分同炒） 人参须（五分） 龙眼肉（
四个） 左牡蛎（五钱）
六诊 神气渐得如常，胃亦渐醒，浮冒之阳既得下潜，所以大便不攻自下者屡矣。但遍体
作痛，是血虚风行入络。宜养血和络，所谓治风先治血也。
川桂枝（四分） 白芍（一钱五分炙甘草三分煎汁拌炒） 白蒺藜（去刺炒三钱） 人参须（另煎冲七分） 桑
寄生（三钱酒炒） 川断肉（三钱） 炒秦艽（一钱五分） 橘红（一钱红花汤炒） 全当归（三钱酒炒） 桑枝（
七钱酒炒） 丝瓜络（二钱酒炒）
七诊 大便甚艰，究之不攻而能畅解，肝火得以下行，面色已转神渐灵慧。惟腹中作痛，遍体酸疼。络
中为风所阻，肝气亦未疏和。再养其体，勿疏其用。
白归身（三钱） 炒杞子（三钱） 香附（二钱醋炒） 潼沙苑（三钱） 火麻仁（二钱） 金铃子（一钱五分）
整砂仁（七分后入） 杭白芍（二钱酒炒） 青皮（一钱醋炒） 桑寄生（三钱）
服二帖后去青皮归身，加枣仁二钱，辰茯神三钱， 龙齿四钱，夜交藤四钱。
(San liang, stir-fried with wine) Haige Fen (Triaereen Shell Powder, San liang, decocted in a bag) Sheng Shanyao (Dioscoreae Rhizoma, Yi liang) Tian Guangpi (Citri Reticulatae Pericarpium, Yi liang) Chuan Beimu (Fritillariae Thunbergii Bulbus, Yi liang) Sheng Biejia (Trionycis Carapax, Shi liang) Zao Ren (Semen Ziziphi Spinosae, stir-fried and crushed, Yi liang) Jitouzi (Nuculus Nelumbinis Semen, Yi liang) Longchi (Dent Draconis, Er liang) Sheng Muli (Ostreae Concha, Ba liang) Kui Dangshen (Codonopsis Radix, San liang) Chao Yuzhu (Atractylodis Macrocephalae Rhizoma, stir-fried, Er liang) Nüzhenzi (Ligustri Lucidi Fructus, Yi liang, stir-fried with wine) Gan Qizi (Lycii Fructus, Er liang)
Combine the above herbs with Qing Ejiao (Colla Corii Asini, San liang) and Guiban Jiao (Colla Testudinis, Liu liang), melt with wine, and collect as an ointment.
Patient Huang (Left pulse): Dizziness and heaviness of the head and eyes, nausea, and a dull sensation in the stomach. Insomnia throughout the night due to unbalanced rising of Yang Qi, resulting in disharmony of Stomach Earth. Treatment aims to harmonize the Stomach and extinguish Liver wind.
Zhi Banxia (Pinelliae Rhizoma Preparatum, Yi qian wu fen) Shang Guangpi (Citri Reticulatae Pericarpium, Yi qian) Chao Shumi (Milii Glutinosi Semen, stir-fried, Er liang, decocted in a bag) Fushen (Poria with Hostwood, each Er qian) Chao Zhuru (Bambusae Caulis Preparatus, Yi qian) Longchi (Dent Draconis, San qian) Baijili (Tribuli Fructus, San qian) Chao Zao Ren (Semen Ziziphi Spinosae, stir-fried, Er qian) Yejiaoteng (Caulis Polygoni Multiflori, Si qian)
Follow-up: Awakening without ability to sleep again, accompanied by dizziness and heaviness of the head and eyes. This is caused by insufficiency of True Yin, where Water fails to assist Fire. Expand upon the previous method.
Chao Zao Ren (Semen Ziziphi Spinosae, stir-fried) Chen Fushen (Poria with Hostwood processed with Cinnabar) Qizi (Lycii Fructus) Baizi Shuang (Platycladi Semen Frost) Chen Maidong (Ophiopogonis Radix processed with Cinnabar) Zhenzhumu (Margaritifera Ostreum) Chen Dengxin (Junci Medulla processed with Cinnabar)
Another visit: Sleep has slightly stabilized, but the interaction between Water and Fire remains difficult. Further refer to methods for regulating the ascending and descending of Water and Fire.
Zhu Fushen (Poria with Hostwood processed with Cinnabar, San qian) Yejiaoteng (Caulis Polygoni Multiflori, Si qian) Chuan Yalian (Coptidis Rhizoma, San fen) Jiao Shumi (Milii Glutinosi Semen, scorched, Er qian) Chen Dengxin (Junci Medulla processed with Cinnabar, San fen) Chao Zao Ren (Semen Ziziphi Spinosae, stir-fried, Er qian)
Longchi (Dent Draconis, San qian) Shang Yao Gui (Cinnamomi Ramulus, coarse bark removed, powdered, add Yi qian wu li) Zhi Banxia (Pinelliae Rhizoma Preparatum, Yi qian wu fen)
Patient Li (Left pulse): Previously prone to hyperactive Liver Yang. Due to emotional frustration and depression, combined with the renewal of "One Yang" (initial generation of Yang Qi after Winter Solstice), Liver Yang rises, causing insomnia throughout the night. The condition belongs to internal causes; urgently need to broaden one's mindset to comply with the free-flowing nature of Liver Wood.
Zao Ren (Semen Ziziphi Spinosae, stir-fried and crushed, Er qian) Longchi (Dent Draconis, Yi qian) Baishao (Paeoniae Radix Alba, Yi qian wu fen) Shijueming (Haliotidis Concha, Si qian) Yejiaoteng (Caulis Polygoni Multiflori, Si qian) Zhu Fushen (Poria with Hostwood processed with Cinnabar, San qian)
Gancao (Glycyrrhizae Radix et Rhizoma, San fen) Baiziren (Semen Platycladi, San qian, oil removed) Zhusha Anshen Wan (Cinnabar Calming the Spirit Pill, San qian, dissolve first in boiling water)
Second visit: Rising Yang has gradually flattened, and sleep is possible after waking. However, the substance of the Liver is now deficient; treat from the perspective of nourishing and softening.
Guiban (Testudinis Carapax et Plastrum) Baishao (Paeoniae Radix Alba) Sheng Shu Cao (Radix Glycyrrhizae Preparata) Heidouyi (Seed Coat of Glycine Max) Yejiaoteng (Caulis Polygoni Multiflori) Shengdi (Rehmanniae Radix) Fushen (Poria with Hostwood) Nüzhenzi (Ligustri Lucidi Fructus) Fen Danpi (Moutan Cortex) Guya (Hordei Fructus Germinatus)
Patient Zhu (Left pulse): Using salty-cold herbs to nourish Yin, and bitter-draining herbs to descend Fire. Slept well throughout the night, and seminal emission did not occur. Since the medicine is effective, expand the prescription further.
Zao Ren (Semen Ziziphi Spinosae, stir-fried with bile, Er qian) Longchi (Dent Draconis, Si qian) Guixin (Cardia Testudinis, roasted, decoct first, Liu qian) Zhenzhumu (Margaritifera Ostreum, vinegar-processed) Banxia (Pinelliae Rhizoma, stir-fried with bile, Er qian)
Sheng Muli (Ostreae Concha, Si qian) Danpi (Moutan Cortex, Er qian) Sangye (Mori Folium, Qi fen) Baihexin (Lilii Bulbus, mixed with Cinnabar, Si qian) Zhusha Anshen Wan (Cinnabar Calming the Spirit Pill, Er qian, dissolve first in boiling water)
Patient Wang (Right pulse): Can still remember events from the previous night, indicating that Shen (Spirit) is not confused. If Shen is not confused, yet sleeps soundly all day and cannot be awakened, such a state of sleep is impossible. Face is green, Left pulse is large, tongue lacks luster. This indicates weak Middle Qi, with all Yang Qi rushing upward, preventing Kidney Yin from ascending. Yang Qi floats, leading to Shaoyin disease. In the *Jin Gui Yao Lue*, only Shaoyin disease mentions "drowsiness" (Dan Yu Mei). Here, use Guizhi Tang (Cinnamon Twig Decoction) to harmonize Yang, referencing bivalve shells to subdue Yang. If Yin does not interact with Yang, and Yang does not connect with Yin, progressing further leads to a separation of Yin and Yang, which is the cause for concern.
Guizhi (Cinnamomi Ramulus, Qi fen) Hang Baishao (Paeoniae Radix Alba, San qian, stir-fried with juice of Zhi Gancao San fen) Longchi (Dent Draconis, San qian) Zuo Muli (Ostreae Concha, Qi qian) Zhi Banxia (Pinelliae Rhizoma Preparatum, Er qian)
Lao Shengjiang (Zingiberis Rhizoma Recens, two slices) Dazao (Jujubae Fructus, two pieces)
Second visit: Confusion has slightly cleared, green color of the face has faded somewhat, Left pulse has contracted slightly, but Shen remains confused as if asleep, occasionally accompanied by incoherent speech. Upward rushing of Yang has not subsided, refining body fluids into phlegm, further obscuring the Shen mechanism.
Plan to incorporate methods for opening stagnation and resolving phlegm within the strategy of subduing Yang. Only upon achieving efficacy can a cure be promised.
Guizhi (Cinnamomi Ramulus, San fen, stir-fried together with Baishao Yi qian wu fen) Zuo Muli (Ostreae Concha, Yi liang) Yujin (Curcumae Radix, Wu fen, ground and taken as slurry) Xiangfu (Cyperi Rhizoma, powdered, Yi qian wu fen) Chao Fan Zhi Qu (Medicated Leaven, stir-fried, Yi qian wu fen) Fuling (Poria, Wu qian) Longgu (Draconis Os, San qian) Chao Zhishi (Aurantii Fructus Immaturus, stir-fried, Yi qian) Juhong (Citri Reticulatae Pericarpium Rubrum, Yi qian) Huai Xiaomai (Tritici Fructus, Qi qian)
Third visit: Yang has slightly submerged. Tinnitus at the top has significantly decreased, bowel movements are smooth below, Kan and Li (Heart and Kidney) are slightly assisting each other, confusion has slightly cleared, green-dull complexion has faded somewhat, tongue shows slight luster. However, pain persists in the Zhongwan area, and the Right Guan pulse feels slightly deep and solid. Middle deficiency and old accumulation remain uncleaned; although Yin and Yang have slightly connected, Kan and Li do not yet embrace each other. Plan to guide Yin from Yang and Yang from Yin, still incorporating herbs that grind down stagnation, aligning with the principle that the Stomach Fu organ promotes descent through unblocking.
Renshen Xu (Ginseng Radicula, separately decocted and taken as slurry, Si fen) Juhong (Citri Reticulatae Pericarpium Rubrum, Yi qian) Yujin (Curcumae Radix, Wu fen, ground and taken as slurry) Chao Fan Zhi Qu (Medicated Leaven, stir-fried, Yi qian wu fen) Zhishi (Aurantii Fructus Immaturus, Wu fen, ground and taken as slurry) Sheng Xiangfu (Cyperi Rhizoma, Yi qian wu fen, powdered) Muli (Ostreae Concha, Yi liang) Fuling (Poria, San qian) Zhi Banxia (Pinelliae Rhizoma Preparatum, Er qian) Longgu (Draconis Os, San qian) Kongsheng Zhenzhong Dan (Confucius' Pillow Treasure Pill, San qian, take first)
Fourth visit: Confusion and drowsiness have largely receded, eyes show increasing agility, and the green-dull complexion is gradually turning rosy. It is evident that this was caused by Yang Qi rushing upward, failing to descend and interact with Yin, resulting in Shaoyin Qi failing to ascend. Rejection tenderness at Zhongwan has resolved; although this belongs to the downward movement of accumulation, it may also be due to the release of Liver Wood within Spleen Earth. However, generalized body pain is likely due to Ying and Blood failing to nourish, with Liver Wind entering the sinews. Use Shen Gui Guizhi Tang (Ginseng, Angelica, and Cinnamon Twig Decoction) with modifications, still incorporating bivalve shells to subdue Yang.
Renshen Xu (Ginseng Radicula, separately decocted and taken as slurry, Ba fen) Chuan Guizhi (Cinnamomi Ramulus, San fen) Juluo (Citri Reticulatae Pericarpium Fibra, stir-fried with Honghua Tang, Yi qian) Longchi (Dent Draconis, San qian) Zuo Qinjiao (Gentianae Macrophyllae Radix, Yi qian wu fen)
Baishao (Paeoniae Radix Alba, Yi qian wu fen) Muli (Ostreae Concha, Ba qian) Sangjisheng (Taxilli Caulis, San qian, stir-fried) Danggui (Angelicae Sinensis Radix, Er qian, stir-fried) Kongsheng Zhenzhong Dan (Confucius' Pillow Treasure Pill, San qian, take first with boiling water)
Fifth visit: Confusion has receded, and Stomach Qi has slightly recovered. However, speech is occasionally disordered, and there is inner restlessness and irritability. This should be attributed to Yang Qi disturbing the Shen; further incorporate calming the Spirit methods.
Yun Fushen (Poria with Hostwood, San qian) Zhusha (Cinnabar, San qian, wrapped) Baijili (Tribuli Fructus, thorns removed, stir-fried, San qian) Zao Ren (Semen Ziziphi Spinosae, stir-fried and pounded, Er qian) Zhi Xiangfu (Cyperi Rhizoma, Er qian) Suoren (Amomi Fructus Rotundus, powdered and added later, Qi fen) Shijueming (Haliotidis Concha, Si qian) Longgu (Draconis Os, stir-fried and pounded, San qian) Baishao (Paeoniae Radix Alba, Yi qian wu fen, stir-fried together with Guizhi San fen) Renshen Xu (Ginseng Radicula, Wu fen) Longyanrou (Longan Arillus, four pieces) Zuo Muli (Ostreae Concha, Wu qian)
Sixth visit: Shen Qi is gradually returning to normal, Stomach Qi is awakening. Since the floating and rushing Yang has been able to subside downward, bowel movements have frequently passed spontaneously without purgatives. However, generalized body pain indicates blood deficiency with wind pathogen entering the collaterals. Should nourish Blood and harmonize collaterals, as the saying goes, "To treat wind, first treat the Blood."
Chuan Guizhi (Cinnamomi Ramulus, Si fen) Baishao (Paeoniae Radix Alba, Yi qian wu fen, stir-fried with juice of Zhi Gancao San fen) Baijili (Tribuli Fructus, thorns removed, stir-fried, San qian) Renshen Xu (Ginseng Radicula, separately decocted and taken as slurry, Qi fen) Sang
Jisheng (Taxilli Caulis, San qian, wine-stir-fried) Chuandourou (Dipsaci Radix, San qian) Chao Qinjiao (Gentianae Macrophyllae Radix, stir-fried, Yi qian wu fen) Juhong (Citri Reticulatae Pericarpium Rubrum, Yi qian, stir-fried with Honghua Tang) Quan Danggui (Angelicae Sinensis Radix, San qian, wine-stir-fried) Sangzhi (Caulis Mori, Qi qian, wine-stir-fried) Sigualuo (Luffae Fructus Rete, Er qian, wine-stir-fried)
Seventh visit: Bowel movements were very difficult, but ultimately passed smoothly without purgation. Liver Fire has descended, complexion has turned rosy, and Shen has become more agile. However, abdominal pain and generalized soreness persist. Wind pathogens are blocking the collaterals, and Liver Qi is not yet smooth and harmonious. Continue to nourish the Liver substance, without dispersing its function.
Bai Guishen (Angelicae Sinensis Radix, San qian) Chao Qizi (Lycii Fructus, stir-fried, San qian) Xiangfu (Cyperi Rhizoma, Er qian, vinegar-stir-fried) Tong Shayuan (Astroci Semen, San qian) Huomaren (Cannabis Fructus, Er qian) Jinlingzi (Meliae Fructus, Yi qian wu fen)
Zheng Sharen (Amomi Fructus Rotundus, Qi fen, added later) Hang Baishao (Paeoniae Radix Alba, Er qian, wine-stir-fried) Qingpi (Citri Reticulatae Pericarpium Viride, Yi qian, vinegar-stir-fried) Sangjisheng (Taxilli Caulis, San qian)
After taking two doses, remove Qingpi and Guishen, add Zao Ren Er qian, Chen Fushen San qian, Longchi Si qian, and Yejiaoteng Si qian.