章（左） 向有肠红，兹则每晨便泄之后，仍见干粪胃气日行困顿。脉左虚弦，右濡滑，关部三十余至一
动。此由肝阴不足，脾气虚损，肝不足则血不收藏，脾亏损则鼓旋乏力。由是而水湿之气，不能分泄，混
入肠中，所以每至黎明，阳气发动之时，水湿之气，傍流而下。脾与胃以膜相连，脾虚则胃弱，理固然也。
拟连理汤出入。
野于术（土炒二钱） 上广皮（土炒一钱） 云茯苓（四钱） 川雅连（姜汁炒二分） 防风根（一钱炒） 炒
薏仁（四钱） 炮姜（五分） 滑石块（三钱） 泽泻（一钱五分） 荷叶边（二钱）
二诊 温脏清腑，注泄已止。右脉濡滑较退。的是中气虚而脾土之阳气不足，肝阴亏而大肠之湿热
有余。刻下大便溏燥不调。脾气未复耳。前法参入分消，盖祛湿即所以崇土也。
野于术（土炒） 炒薏仁（四钱） 整砂仁（四粒） 真建曲（二钱） 防风根（一钱炒） 云茯苓（五钱）
木猪苓（二钱） 泽泻（一钱五分） 炮姜（三分川连一分五厘炖冲入）
三诊 右脉滑象渐退，溲亦渐利。湿热有外泄之机。特胃纳不醒，当和中芳运。
炒于术 制半夏 真建曲 生熟薏仁 炒谷芽 云茯苓 上广皮 广藿梗 省头草 泽泻
乔（左） 停饮日久，清浊升降不行，胃中窒塞，向有呕吐，兹则便泄，色必深酱。是水饮之气，郁而化热，在
胃上则兼辛金之化，其水兼寒，在胃下则兼丙火之化，其湿兼热，亦定理也。降阳和阴，冀其升降清浊，
各循常度。是否即请裁用。
制半夏 云茯苓 淡干姜 瓦楞子 川雅连 生熟草 人参须 川桂枝
某 迷睡已退，然大便溏泄，此痰泄是也。
制半夏 南楂炭 炮姜 木猪苓 熟附片（二分） 上广皮 范志曲 泽泻 焦白术
又 少阴气至但欲寐。进理中加附，大便亦渐坚实。前法再参补气。
西党参 炮姜炭 猪茯苓 熟附片 泽泻 野于术 炙黑草 玫瑰花 生熟谷芽
某 便泄气撑，以泄为快。脾弱则木旺，土衰则木贼。恐非草木可以为功。
吴萸 金铃子 南楂炭 广皮 郁金 砂仁 杭白芍 白蒺藜 广木香 香橼皮 青皮（醋炒）
左 外寒束缚里热，挟积不化。由头痛发热，而至腹痛水泻，每在清晨。至今泻虽暂定，而腹痛未止，浊
积必然未化。脉细关弦。拟调气运中以磨化之。
制川朴 上广皮 云茯苓 范志曲 砂仁末 制半夏 枳实炭 广木香 焦白术 香薷 川连 炮姜
右 久泻不止，足胫带肿，舌心光剥无苔，寐则干咳，心悸健忘。心脾两虚，旋运无权，致传化失职。恐成肿胀。
西党参（三钱） 扁豆衣（三钱） 白茯苓（三钱） 炮姜（三分） 炙黑草（三分） 野于术（二钱）
益智仁（八分） 炒薏仁（四钱） 猪苓（二钱）
左 头痛身热便泄。邪郁而气机下陷也。
煨木香（五分） 泽泻（一钱五分） 川芎（一钱） 羌独活（各一钱） 茯苓（三钱） 上陈皮（一钱）
砂仁（后下七分） 桔梗（一钱） 前胡（一钱五分） 柴胡（五分）
二诊 头痛已止，身热便泄未定。再调气泄湿。
川朴（一钱） 蔻仁（七分） 藿香（三钱） 猪茯苓（各二钱） 生熟薏仁（各二钱） 广皮（一钱）
通草（一钱） 滑石（四钱） 枳实炭（一钱） 木香（一钱） 泽泻（一钱五分）
三诊 身热已退，便泄亦减。再为疏通。
制川朴 范志曲 南楂炭 台乌药 茯苓 青陈皮 枳实炭 煨木香 炒薏仁
某 嗜饮多湿，湿困脾阳。大便泻利。脉象濡软，舌苔淡白。宜理脾温中。
于术（土炒二钱） 范志曲（一钱） 茯苓（三钱） 泽泻（一钱五分） 炒黄干姜（四分） 葛花（一钱五
分） 白蔻仁（三粒） 砂仁（三粒） 煨木香（五分）
右 脉滑便泄如前，小溲欲解不爽。湿郁腑中，水液渗入大肠。再参分利。
葛花（一钱五分） 于术（二钱） 羌活（一钱） 广皮（一钱） 滑石（三钱） 煨木香（五分）
泽泻（一钱五分） 通草（一钱） 云苓（四钱） 防风（一钱） 猪苓（二钱） 生熟薏仁（各二钱）
二诊 便泄稍减，小溲亦畅，腰府作酸。湿犹未清，而脾胃之气，久已暗损。再为兼顾。
野于术（一钱五分） 破故纸（盐水炒三钱） 云茯苓（四钱） 羌活（一钱） 煨肉蔻（五分研） 菟丝
子（盐水炒三钱） 泽泻（一钱五分） 猪苓（二钱） 生熟薏仁（各二钱） 防风（一钱）
右 上则嗳噫下则便泄。厥气不和，克制脾土。协和肝脾，即所以固其胎息也。
砂仁 制香附 淡吴萸 苏梗 茯苓 杭白芍 防风（炒） 香橼皮 木香 广皮
某 每至阴分，则肠鸣便泻。此脾虚而湿郁气滞。恐变胀病。
大腹皮 生熟薏仁 川朴 木香 泽泻 煨姜 炒椒目 广皮 草果仁 炒冬瓜皮 猪茯苓
某 胃主盛纳，脾司运化，脾虚湿热内蕴，失健运之权。合夜腹满，清晨得泄方适。湿热无彻底之日，则
脾土无再复之期，可虞也。
白术炭 整砂仁 泽泻 范志曲 生熟薏仁 白茯苓 木猪苓 广皮 川雅连（姜汁炒）
某 木郁不克条达，气分攻撑不平。土被木克，运化无权，寅卯之交，依然便泄内热。脉细弦数。营液日
耗，恐入损途。
制香附 土炒白芍 沉香片 上广皮 砂仁 白蒺藜 生熟木香 淡吴萸 川雅连（吴萸同炒）
杨（童） 便泄不止，时带红腻，临圊不爽。脾虚湿热郁阻肠胃。再苦辛通降。
生于术（一钱） 淡黄芩（酒炒一钱） 酒炒白芍（一钱） 六一散（三钱包） 白茯苓（三钱） 生熟草（各
二钱） 土炒陈皮（一钱） 香连丸（四分入煎） 广木香（四分） 炒枳壳（七分）
汪（幼） 久泻不止，阳气不运，以致四肢逆冷，神迷如寐，呕吐切牙。脉形沉细。土虚木旺，将成慢惊，切勿
轻视。方请儿科先生商政。
台参须（另煎冲五分） 橘红（八分） 炙黑草（二分） 煨天麻（一钱） 炒于术（一钱五分） 熟
附片（四分） 炮姜炭（四分） 白茯苓（三钱）
屠（右） 腹痛甚则便泄，泄甚热。气有余，便是火，洵哉。
金铃子 香附 辰茯神 钩钩 炒酸枣仁 白蒺藜 天麻 炒白芍 砂仁 沉香片
金（右） 暑湿浸淫脾土，土不运旋，气湿不能分化。水泻口渴，舌淡白而喜热饮，中脘不舒。宜调气分化。
川朴（一钱） 六一散（三钱包） 缩砂仁（五分） 藿香（三钱） 白茯苓（三钱） 广皮（一钱）
鲜佛手（一钱五分） 煨木香（六分） 猪苓（二钱）
二诊 调气分化，水泻已止，口渴亦减。再调气以通津液。
六一散（三钱包） 生于术（一钱） 猪苓（一钱五分） 沉香曲（一钱五分） 建泽泻（一钱五分） 薄官桂
（三分） 鲜佛手（一钱） 鲜荷梗（去刺尺许） 茯苓（三钱） 砂仁（盐水炒研后入四分）
聂（左） 素体湿甚，兹则由胀满而致便泄，色如败酱，得泄转松，然中脘有形，气冲嗳噫，胃呆少纳，时易
汗出。脉象濡软而滑，苔白质腻，口味带甜。此由湿热内蕴，脾土不能转旋，水谷不能分化，尽注于肠，肝
木从而暗动。恐致呃忒。拟和中运脾，兼泄府浊。
六一散（三钱包） 省头草（二钱） 炒红曲（一钱） 土炒陈皮（一钱） 生熟薏仁（各二钱） 白茯苓（三钱）
广木香（四分） 小温中丸（三钱） 川雅连（四分吴萸二分煎汁拌炒）
二诊 投剂之后，解出极为秽臭，府中之浊，得从外泄，而自利仍不稀疏。昨尚和平，今又腹中胀满，甚
致有形上冲，直抵中脘，则恶心嗳噫，最为难堪，抚之摩之，其形方能降下。口甜干腻，苔白转黄，脉象转
滑，关部独弦。湿热内蕴，清浊之气，不司升降，土气既滞，木气遂郁，致横暴之气，肆逆莫制。望六之年，恐
正不胜病。金匮厥阴篇中每用苦辛酸，即遵其旨。
川雅连（六分） 生甘草（三分） 淡子芩（酒炒一钱五分） 车前子（一钱五分） 杭白芍（三钱） 白茯
苓（三钱） 生熟木香（各二分） 土炒广皮（二钱） 淡干姜（三分） 省头草（二钱）
许（右） 脘痞嗳噫已退。大便带泄，气坠于下也。
广木香（五分） 砂仁（后入七分） 泽泻（二钱） 郁金（一钱五分） 香橼皮（一钱五分） 广陈皮（一
钱） 白芍（一钱五分） 吴萸（三分白芍同炒） 茯苓（四钱） 枳壳（一钱）
二诊 中州已舒。腹痛便利。再理气分消。
砂仁（后入七分） 木香（五分） 茯苓（四钱） 生熟薏仁（各二钱） 泽泻（一钱五分） 乌药（一钱五
分） 广皮（一钱） 吴萸（五分） 鲜佛手（一钱五分） 范志曲（二钱） 川朴（一钱） 猪苓（二钱）
王（右） 少腹胀满，腹中不和，痛泄止而复作，面色微浮，足跗带肿。肝强土弱，木乘土位。拟柔肝培土，以
御肝木。
于潜术（一钱五分木香三分煎汁炒） 炒木瓜皮（一钱五分） 炒黑当归（二钱） 土炒白芍（一钱五分） 炒防
风（七分） 炙黑草（五分） 菟丝子（盐水炒三钱） 上徭桂（去粗皮研后入三分）
二诊 面浮已退，色稍华泽，腹中痛胀略松，而便泄不止，泄时气甚酸秽。肝为刚藏，在五行为木，在五
味为酸，木旺土衰，即此可见。再培土抑木。脾弱则生痰，以化痰参之。
奎党参（三钱） 炙甘草（四分） 广陈皮（一钱） 炮姜（五分） 炒于术（二钱） 淡吴萸（四分）
云茯苓（三钱） 制半夏（三钱） 杭白芍（三钱与吴萸同炒） 伏龙肝（七钱煎汤代水）
林少筠太守 肾泄又名晨泄，每至黎明，辄暴迫而注者是也。然肝病亦有至晨而泄者，以寅卯属木，
木气旺时，辄乘土位也。疑似之症，将何以辨之哉。盖肾泄是命火衰微，而无抑郁之气，故暴注而不痛。
肝病而木旺克土，则木气抑郁，多痛而不暴注。以此为辨，可了然矣。诊见脉象右尺细弱，左尺小涩，两
关右弱左弦，两寸右微左部略搏。是水亏木旺，心肺阴液不足之象。数载以来，常带晨泄，泄必作痛。今
泄止而至寅卯木旺时，犹尚作痛。此以近时借烟性提挈，肝木虽不致克土，而气虚不克鼓舞，故肝木
升发之令，未复其原，仍是一屈曲抑郁之局。人身法天地，水火阴阳升降而已。阴中无阳，是谓独阴。阳
中无阴，是谓独阳。独阴不生，独阳不长，所以脏阴而腑阳，脏升而腑降。肝、藏也，阴也体阴者其用阳，故
其气宜升。脾、藏也，亦阴也惟肝升而脾藏之气得与俱升。肝藏之气上升，则与少阳胆木交合，而心血
以生。脾藏之气上升，则与阳明胃土交合，而胃液以长。于是胆府之气，下交于厥阴肝脏，而相火以化。
胃府之气，下交于太阴脾土，而脾阳以资。今木克脾土，日以郁陷，升生之令不行，其气不能上交于少
阳，而反抑伏于太阳，太阳膀胱为寒水之府，水中有木，其屈曲郁勃之气，与寒水之气相激，宜为痛矣。
然木不升发而抑伏太阳，似不当有头晕耳鸣目昏肝阳上升之候。曰、不然。肝木之气，不能上升，而与
胆交，则胆不降矣。胆为甲木，甲木逆，亦化风也。总之，木不升发，则心血不生，脾不能为胃行其津液，胆
不能下化相火，胃不能下降而资盛纳。心血亏，胃液薄，脾阳虚，相火微，能无于腹痛而外，诸病百出哉。
调治之计，必使水中之木遂其升发，上与少阳交合，于是脏腑之介降，皆复其常，而生生之机不息。拟
以青皮引至厥阴之分，而以柴胡升发木郁，使肝经之气条达上行。而又恐升动胆木，故以白芍酸收
之品，摄入肝经。青皮引之入其地，白芍摄之不使出其地，自与胆无涉矣。青皮破气柴胡散气，故以人
参坐镇，制其破性散性。第取青皮之引入厥阴，柴胡之升发木气，俾之扶疏条达，而无偏胜之弊。当否
正之。
柴胡 青皮 人参 白芍
Mr. Zhang (Left pulse): Previously suffered from intestinal bleeding (hematochezia), now presents with loose stools every morning followed by dry feces, and the stomach Qi feels sluggish daily. The pulse is deficient and wiry on the left, soggy and slippery on the right, with over thirty beats per breath and intermittent arrests at the Guan position. This is due to insufficient Liver Yin and damaged Spleen Qi. Insufficient Liver Yin fails to store blood properly, while Spleen deficiency weakens its motility and transformation functions. Consequently, dampness and turbidity cannot be separated and excreted properly, mixing into the intestines. Thus, at dawn when Yang Qi arises, dampness flows downward. The Spleen and Stomach are connected by membranes; Spleen deficiency leads to Stomach weakness, which is natural. Prescribe Lianli Tang (Coptis and Ginseng Decoction) with modifications.
Atractylodis Macrocephalae Rhizoma (Earth-fried, 2 qian), Tangerine Peel (Earth-fried, 1 qian), Poria (4 qian), Coptidis Rhizoma (Ginger juice fried, 0.2 fen), Saposhnikoviae Radix (Fried, 1 qian), Coicis Semen (Fried, 4 qian), Zingiberis Rhizoma Preparatum (0.5 fen), Talcum (3 qian), Alismatis Rhizoma (1.5 qian), Lotus Leaf Margin (2 qian).
Second visit: Warming the Zang organs and clearing the Fu organs has stopped the profuse diarrhea. The soggy and slippery quality of the right pulse has receded. It is indeed a case of Middle Qi deficiency and insufficient Spleen Yang, combined with Liver Yin deficiency and excess Damp-Heat in the Large Intestine. Currently, bowel movements are alternating between loose and dry, indicating that Spleen Qi has not yet recovered. The previous method is modified to include separation and elimination, as removing dampness fortifies the Earth.
Atractylodis Macrocephalae Rhizoma (Earth-fried), Coicis Semen (Fried, 4 qian), Amomi Fructus (4 grains), Medicated Leaven (2 qian), Saposhnikoviae Radix (Fried, 1 qian), Poria (5 qian), Polyporus (2 qian), Alismatis Rhizoma (1.5 qian), Zingiberis Rhizoma Preparatum (0.3 fen, mixed with Coptidis Rhizoma 0.15 fen and stewed for infusion).
Third visit: The slippery aspect of the right pulse is gradually receding, and urination is becoming smoother. Damp-Heat has a tendency to dissipate externally. However, appetite remains poor; harmonize the middle and promote transportation with aromatic herbs.
Atractylodis Rhizoma (Fried), Pinelliae Rhizoma Preparatum, Medicated Leaven, Coicis Semen (Raw and Fried), Setariae Fructum (Fried), Poria, Tangerine Peel, Pogostemonis Herba, Artemisiae Scopariae Herba, Alismatis Rhizoma.
Mr. Qiao (Left pulse): Fluid retention has persisted for a long time, impairing the ascending and descending of Clear and Turbid substances, causing obstruction in the Stomach. Previously suffered from vomiting, now presenting with diarrhea, likely with dark soy-sauce colored stool. This indicates that fluid-dampness stagnates and transforms into Heat. In the upper Stomach, it combines with Metal (Lung) transformation, making the water cold; in the lower Stomach, it combines with Fire (Small Intestine/Pericardium) transformation, making the dampness hot. This is the principle. Lower Yang and harmonize Yin, hoping to restore normal ascending and descending of Clear and Turbid. Please advise if this approach is suitable.
Pinelliae Rhizoma Preparatum, Poria, Dried Ginger (Light), Arcae Concha, Coptidis Rhizoma, Licorice Root (Raw and Prepared), Ginseng Radicula, Cinnamomi Ramulus.
Patient [Name Unknown]: Comatose sleepiness has subsided, but loose stools persist; this is Phlegm-induced diarrhea.
Pinelliae Rhizoma Preparatum, Crataegi Fructus Carbonized, Zingiberis Rhizoma Preparatum, Polyporus, Aconiti Lateralis Radix Preparata (0.2 fen), Tangerine Peel, Medicinal Leaven, Alismatis Rhizoma, Atractylodis Rhizoma (Charred).
Another visit: Shaoyin Qi arrival manifests as drowsiness. After administering Lizhong Tang (Ginseng and Ginger Decoction) plus Aconite, stools have become firmer. Add Qi-tonifying herbs to the previous method.
Codonopsis Radix, Zingiberis Rhizoma Carbonized, Polyporus & Poria, Aconiti Lateralis Radix Preparata, Alismatis Rhizoma, Atractylodis Macrocephalae Rhizoma, Glycyrrhizae Radix et Rhizoma (Charred), Rosa Rugosa, Setariae Fructum (Raw and Fried).
Patient [Name Unknown]: Diarrhea accompanied by bloating, feeling relief after evacuation. Spleen weakness leads to Liver Wood hyperactivity; Earth decline allows Wood to invade. Herbal medicine may not suffice.
Evodiae Fructus, Chrysanthemi Indici Flos, Crataegi Fructus Carbonized, Tangerine Peel, Curcumae Radix, Amomi Fructus, Paeoniae Radix Alba, Tribuli Fructus, Aucklandiae Radix, Eriocauli Fructus, Citri Reticulatae Pericarpium Viride (Vinegar-fried).
Mr. Left: External Cold constrains internal Heat, carrying undigested accumulation. Progressing from headache and fever to abdominal pain and watery diarrhea, mostly in the early morning. Although diarrhea has temporarily ceased, abdominal pain persists, indicating turbid accumulation remains unresolved. Pulse is fine and wiry at the Guan. Regulate Qi and transport to grind down the accumulation.
Magnoliae Officinalis Cortex Preparated, Tangerine Peel, Poria, Medicinal Leaven, Amomi Fructus Powder, Pinelliae Rhizoma Preparated, Ziziphi Spinosae Semen Carbonized, Aucklandiae Radix, Atractylodis Rhizoma (Charred), Elsholtziae Herba, Coptidis Rhizoma, Zingiberis Rhizoma Preparatum.
Mr. Right: Chronic diarrhea unceasing, swelling in calves and shins, peeled tongue coating without moss, dry cough during sleep, palpitations and forgetfulness. Heart and Spleen dual deficiency, failure of rotation and movement, leading to dysfunction of transmission and transformation. Fear of developing edema.
Codonopsis Radix (3 qian), Dolichoris Semen (3 qian), Poria (3 qian), Zingiberis Rhizoma Preparatum (0.3 fen), Glycyrrhizae Radix et Rhizoma (Charred, 0.3 fen), Atractylodis Macrocephalae Rhizoma (2 qian), Alpiniae Oxyphyllae Fructus (0.8 fen), Coicis Semen (Fried, 4 qian), Polyporus (2 qian).
Mr. Left: Headache, body heat, and diarrhea. Pathogenic factor stagnation causing Qi mechanism to sink.
Aucklandiae Radix (Baked, 0.5 fen), Alismatis Rhizoma (1.5 fen), Ligustici Chuanxiong Rhizoma (1 qian), Notopterygii Rhizoma et Radix & Saposhnikoviae Radix (1 qian each), Poria (3 qian), Citri Reticulatae Pericarpium (1 qian), Amomi Fructus (Add later, 0.7 fen), Platycodonis Radix (1 qian), Peucedani Radix (1.5 fen), Bupleuri Radix (0.5 fen).
Second visit: Headache stopped, body heat and diarrhea unresolved. Again regulate Qi and drain Dampness.
Magnoliae Officinalis Cortex (1 qian), Cardamomi Fructus (0.7 fen), Agastaches Herba (3 qian), Polyporus & Poria (2 qian each), Coicis Semen (Raw and Fried, 2 qian each), Tangerine Peel (1 qian), Tinosporae Caulis (1 qian), Talcum (4 qian), Ziziphi Spinosae Semen Carbonized (1 qian), Aucklandiae Radix (1 qian), Alismatis Rhizoma (1.5 fen).
Third visit: Body heat subsided, diarrhea reduced. Continue to dredge and unblock.
Magnoliae Officinalis Cortex Preparated, Medicinal Leaven, Crataegi Fructus Carbonized, Linderae Fructus, Poria, Citri Reticulatae Pericarpium & Citri Reticulatae Pericarpium Viride, Ziziphi Spinosae Semen Carbonized, Aucklandiae Radix (Baked), Coicis Semen (Fried).
Patient [Name Unknown]: Habitual drinking causes excessive Dampness, trapping Spleen Yang. Loose stools. Pulse is soggy and soft, tongue coating pale white. Regulate Spleen and warm the Middle.
Atractylodis Rhizoma (Earth-fried, 2 qian), Medicinal Leaven (1 qian), Poria (3 qian), Alismatis Rhizoma (1.5 fen), Zingiberis Rhizoma (Fried yellow, 0.4 fen), Puerariae Flos (1.5 fen), Cardamomi Fructus (3 grains), Amomi Fructus (3 grains), Aucklandiae Radix (Baked, 0.5 fen).
Mr. Right: Slippery pulse, diarrhea as before, difficult urination. Dampness stagnates in the Fu organs, fluids seep into the Large Intestine. Add separating and draining methods.
Puerariae Flos (1.5 fen), Atractylodis Rhizoma (2 qian), Notopterygii Rhizoma et Radix (1 qian), Tangerine Peel (1 qian), Talcum (3 qian), Aucklandiae Radix (Baked, 0.5 fen), Alismatis Rhizoma (1.5 fen), Tinosporae Caulis (1 qian), Poria (4 qian), Saposhnikoviae Radix (1 qian), Polyporus (2 qian), Coicis Semen (Raw and Fried, 2 qian each).
Second visit: Diarrhea slightly reduced, urination smooth, soreness in waist. Dampness not yet cleared, Spleen and Stomach Qi secretly damaged for a long time. Address both.
Atractylodis Macrocephalae Rhizoma (1.5 fen), Psoraleae Fructus (Salt-water fried, 3 qian), Poria (4 qian), Notopterygii Rhizoma et Radix (1 qian), Myristicae Semen (Baked, 0.5 fen ground), Cuscutae Semen (Salt-water fried, 3 qian), Alismatis Rhizoma (1.5 fen), Polyporus (2 qian), Coicis Semen (Raw and Fried, 2 qian each), Saposhnikoviae Radix (1 qian).
Mr. Right: Belching above, diarrhea below. Jueyin Qi disharmony, attacking Spleen Earth. Harmonizing Liver and Spleen secures the foundation.
Amomi Fructus, Cyperi Rhizoma Preparated, Evodiae Fructus (Light), Perillae Caulis, Poria, Paeoniae Radix Alba, Saposhnikoviae Radix (Fried), Eriocauli Fructus, Aucklandiae Radix, Tangerine Peel.
Patient [Name Unknown]: At Yin times, borborygmus and diarrhea occur. Spleen deficiency with Damp-stagnation and Qi blockage. Fear of developing distension.
Arecae Pericarpium, Coicis Semen (Raw and Fried), Magnoliae Officinalis Cortex, Aucklandiae Radix, Alismatis Rhizoma, Zingiberis Rhizoma (Baked), Piperis Fructus (Fried), Tangerine Peel, Tsaoko Fructus, Benincasae Exocarpium (Fried), Polyporus & Poria.
Patient [Name Unknown]: Stomach governs reception, Spleen governs transformation. Spleen deficiency with internal Damp-Heat accumulation, losing transport authority. Abdominal fullness at night, relief only after morning evacuation. If Damp-Heat is not彻底 eliminated, Spleen Earth will not recover, which is concerning.
Atractylodis Rhizoma Carbonized, Amomi Fructus, Alismatis Rhizoma, Medicinal Leaven, Coicis Semen (Raw and Fried), Poria, Polyporus, Tangerine Peel, Coptidis Rhizoma (Ginger juice fried).
Patient [Name Unknown]: Wood stagnation fails to flourish, Qi attacks unevenly. Earth is controlled by Wood, losing transformation power. During Yin-Mao hours (5-9 AM), still experiencing diarrhea and internal heat. Pulse is fine, wiry, and rapid. Ying fluids deplete daily, fear entering consumption stage.
Cyperi Rhizoma Preparated, Paeoniae Radix Alba (Earth-fried), Aquilariae Lignum Resinatum, Tangerine Peel, Amomi Fructus, Tribuli Fructus, Aucklandiae Radix (Raw and Fried), Evodiae Fructus (Light), Coptidis Rhizoma (Stir-fried with Evodiae Fructus).
Child Yang: Unceasing diarrhea, sometimes with red turbid matter, discomfort during defecation. Spleen deficiency with Damp-Heat obstructing intestines. Use bitter and acrid to descend.
Atractylodis Rhizoma (Raw, 1 qian), Scutellariae Radix (Light, Wine-fried, 1 qian), Paeoniae Radix Alba (Wine-fried, 1 qian), Liu Yi San (Six-to-One Powder, wrapped 3 qian), Poria (3 qian), Licorice Root (Raw and Prepared, 2 qian each), Citri Reticulatae Pericarpium (Earth-fried, 1 qian), Xianglian Wan (Xianglian Pill, 0.4 fen added to decoction), Aucklandiae Radix (0.4 fen), Aurantii Fructus (Fried, 0.7 fen).
Child Wang: Chronic diarrhea unceasing, Yang Qi failing to move, leading to cold limbs, coma-like state, vomiting and teeth grinding. Pulse is deep and fine. Earth deficiency and Wood hyperactivity, impending slow convulsion. Do not underestimate. Consult pediatrician for prescription.
Codonopsis Radicula (Separately decocted, 0.5 fen), Exocarpium Citri Reticulatae (0.8 fen), Glycyrrhizae Radix et Rhizoma (Charred, 0.2 fen), Gastrodiae Rhizoma (Baked, 1 qian), Atractylodis Rhizoma (Fried, 1.5 fen), Aconiti Lateralis Radix Preparata (0.4 fen), Zingiberis Rhizoma Carbonized (0.4 fen), Poria (3 qian).
Mr. Tu (Right pulse): Severe abdominal pain leads to diarrhea, diarrhea brings heat. Excess Qi becomes Fire, truly so.
Chrysanthemi Indici Flos, Cyperi Rhizoma, Poria (Chen), Uncariae Ramulus cum Uncis, Ziziphi Spinosae Semen (Fried), Tribuli Fructus, Gastrodiae Rhizoma, Paeoniae Radix Alba (Fried), Amomi Fructus, Aquilariae Lignum Resinatum.
Mr. Jin (Right pulse): Summer-Dampness invades Spleen Earth, Earth fails to rotate, Qi and Dampness fail to separate. Watery diarrhea with thirst, pale white tongue preferring hot drinks, epigastric discomfort. Regulate Qi to separate Dampness.
Magnoliae Officinalis Cortex (1 qian), Liu Yi San (Six-to-One Powder, wrapped 3 qian), Amomi Fructus (0.5 fen), Agastaches Herba (3 qian), Poria (3 qian), Tangerine Peel (1 qian), Bergamot Fruit (Fresh, 1.5 fen), Aucklandiae Radix (Baked, 0.6 fen), Polyporus (2 qian).
Second visit: Regulating Qi and separating Dampness stopped watery diarrhea and reduced thirst. Again regulate Qi to unblock fluids.
Liu Yi San (Six-to-One Powder, wrapped 3 qian), Atractylodis Rhizoma (Raw, 1 qian), Polyporus (1.5 fen), Aquilariae Lignum Resinatum Leaven (1.5 fen), Alismatis Rhizoma (Jian, 1.5 fen), Cinnamomi Cortex (Thin, 0.3 fen), Bergamot Fruit (Fresh, 1 qian), Nelumbinis Nodus (Fresh, remove thorns, approx. 1 chi), Poria (3 qian), Amomi Fructus (Salt-water fried, ground, add later, 0.4 fen).
Mr. Nie (Left pulse): Constitutionally prone to Dampness, now progressing from distension to diarrhea, stool color like spoiled sauce, relief after evacuation, but epigastric mass present, Qi rushing up with belching, poor appetite, spontaneous sweating. Pulse is soggy, soft, and slippery, tongue coating white and greasy, sweet taste. Internal Damp-Heat accumulation, Spleen Earth unable to rotate, food and fluids fail to separate, pouring into intestines, stirring latent Liver Wood. Fear of hiccups. Harmonize middle, transport Spleen, drain Fu turbidity.
Liu Yi San (Six-to-One Powder, wrapped 3 qian), Artemisiae Scopariae Herba (2 qian), Red Yeast Rice (Fried, 1 qian), Citri Reticulatae Pericarpium (Earth-fried, 1 qian), Coicis Semen (Raw and Fried, 2 qian each), Poria (3 qian), Aucklandiae Radix (0.4 fen), Xiao Wen Zhong Wan (Small Warm Middle Pill, 3 qian), Coptidis Rhizoma (0.4 fen stir-fried with Evodiae Fructus 0.2 fen decoction).
Second visit: After medication, discharge was extremely foul, Fu turbidity expelled externally, but spontaneous diarrhea remains frequent. Yesterday peaceful, today abdominal distension again, even rising mass reaching epigastrium, causing nausea and belching, very distressing, requiring massage to subside. Sweet, dry, greasy mouth, white coating turning yellow, pulse slippery, particularly wiry at Guan. Internal Damp-Heat, Clear and Turbid failing to ascend/descend, Earth Qi stagnant, Wood Qi depressed, leading to violent rebellious Qi uncontrollable. Approaching sixty years old, fear righteous Qi cannot overcome disease. Jingui Jueyin chapter often uses bitter, sour, and acrid; follow this principle.
Coptidis Rhizoma (0.6 fen), Glycyrrhizae Radix et Rhizoma (Raw, 0.3 fen), Scutellariae Radix (Light, Wine-fried, 1.5 fen), Plantaginis Semen (1.5 fen), Paeoniae Radix Alba (3 qian), Poria (3 qian), Aucklandiae Radix (Raw and Fried, 0.2 fen each), Citri Reticulatae Pericarpium (Earth-fried, 2 qian), Dried Ginger (Light, 0.3 fen), Artemisiae Scopariae Herba (2 qian).
Mr. Xu (Right pulse): Epigastric stuffiness and belching subsided. Loose stools, Qi sinking downward.
Aucklandiae Radix (0.5 fen), Amomi Fructus (Add later, 0.7 fen), Alismatis Rhizoma (2 qian), Curcumae Radix (1.5 fen), Eriocauli Fructus (1.5 fen), Tangerine Peel (1 qian), Paeoniae Radix Alba (1.5 fen), Evodiae Fructus (0.3 fen stir-fried with Paeoniae Radix Alba), Poria (4 qian), Aurantii Fructus (1 qian).
Second visit: Middle Jiao comfortable. Abdominal pain relieved, bowel movement smooth. Regulate Qi and eliminate Dampness.
Amomi Fructus (Add later, 0.7 fen), Aucklandiae Radix (0.5 fen), Poria (4 qian), Coicis Semen (Raw and Fried, 2 qian each), Alismatis Rhizoma (1.5 fen), Linderae Radix (1.5 fen), Tangerine Peel (1 qian), Evodiae Fructus (0.5 fen), Bergamot Fruit (Fresh, 1.5 fen), Medicinal Leaven (2 qian), Magnoliae Officinalis Cortex (1 qian), Polyporus (2 qian).
Mr. Wang (Right pulse): Lower abdominal distension, discomfort, painful diarrhea stopping and recurring, slight facial edema, foot swelling. Liver strong, Earth weak, Wood invading Earth. Soften Liver and tonify Earth to resist Liver Wood.
Atractylodis Rhizoma (Qianqian, 1.5 qian stir-fried with Aucklandiae Radix 0.3 fen decoction), Chaenomelis Fructus (Fried, 1.5 fen), Angelicae Sinensis Radix (Charred, 2 qian), Paeoniae Radix Alba (Earth-fried, 1.5 fen), Saposhnikoviae Radix (Fried, 0.7 fen), Glycyrrhizae Radix et Rhizoma (Charred, 0.5 fen), Cuscutae Semen (Salt-water fried, 3 qian), Cinnamomi Cortex (Shanyao, remove bark, ground, add later, 0.3 fen).
Second visit: Facial edema subsided, complexion lustrous, abdominal pain/distension slightly relaxed, but diarrhea continues, acidic and foul odor upon evacuation. Liver is a solid organ, corresponds to Wood, flavor Sour. Wood hyperactivity and Earth decline evident here. Tonify Earth and suppress Wood. Spleen weakness generates Phlegm, add Phlegm-resolving herbs.
Codonopsis Radix (Kui, 3 qian), Glycyrrhizae Radix et Rhizoma (Prepared, 0.4 fen), Tangerine Peel (1 qian), Zingiberis Rhizoma Preparatum (0.5 fen), Atractylodis Rhizoma (Fried, 2 qian), Evodiae Fructus (Light, 0.4 fen), Poria (3 qian), Pinelliae Rhizoma Preparatum (3 qian), Paeoniae Radix Alba (3 qian stir-fried with Evodiae Fructus), Longum Dragon Bone (Seven qian decocted as water substitute).
Prefect Lin Shaoyun: Kidney diarrhea, also called Morning Diarrhea, characterized by sudden urgent expulsion at dawn. However, Liver disease can also cause morning diarrhea, as Yin-Mao hours belong to Wood, and when Wood Qi is strong, it invades Earth. How to distinguish similar symptoms? Kidney diarrhea is due to declining Mingmen Fire without depression, hence sudden expulsion without pain. Liver disease with Wood hyperactivity controlling Earth involves Wood depression, hence pain without sudden expulsion. This distinction clarifies it. Diagnosis shows Right Chi fine and weak, Left Chi small and choppy, both Guan Right weak Left wiry, both Cun Right faint Left slightly pulsating. This indicates Water deficiency and Wood hyperactivity, insufficient Yin fluids of Heart and Lung. For years, accompanied by morning diarrhea with pain. Now diarrhea stopped, but pain persists during Yin-Mao Wood-strong hours. Recently using tobacco to lift Qi, Liver Wood does not control Earth, but Qi deficiency fails to inspire, so Liver Wood ascending command has not restored, remaining in a bent and depressed state. Human body follows Heaven and Earth, Water and Fire, Yin and Yang ascending and descending. Yin without Yang is called Solitary Yin. Yang without Yin is called Solitary Yang. Solitary Yin does not generate, Solitary Yang does not grow. Hence Zang are Yin and Fu are Yang, Zang ascend and Fu descend. Liver is a Zang, Yin, substance Yin but function Yang, so its Qi should ascend. Spleen is a Zang, also Yin, only when Liver ascends can Spleen Qi ascend with it. When Liver Qi ascends, it combines with Shaoyang Gallbladder Wood, generating Heart Blood. When Spleen Qi ascends, it combines with Yangming Stomach Earth, growing Stomach fluids. Then Gallbladder Qi descends to Jueyin Liver, transforming Ministerial Fire. Stomach Qi descends to Taiyin Spleen Earth, nourishing Spleen Yang. Now Wood controls Spleen Earth, depressing daily, ascending command fails, Qi cannot ascend to Shaoyang, instead suppressed in Taiyang. Taiyang Bladder is Cold Water Fu, containing Wood within Water. Its bent and depressed Qi clashes with Cold Water Qi, causing pain. However, if Wood fails to ascend and suppresses Taiyang, one might not expect dizziness, tinnitus, blurred vision, or Liver Yang rising. Answer: Not so. If Liver Wood Qi cannot ascend and combine with Gallbladder, Gallbladder will not descend. Gallbladder is Jia Wood, Jia Wood rebellion also transforms Wind. In short, if Wood fails to ascend, Heart Blood is not generated, Spleen cannot distribute fluids for Stomach, Gallbladder cannot descend to transform Ministerial Fire, Stomach cannot descend to aid reception. Heart Blood deficit, Stomach fluid thin, Spleen Yang deficiency, Ministerial Fire weak, how can there be no abdominal pain and myriad diseases? Treatment plan must ensure Wood in Water ascends, combining with Shaoyang above, then Fu/Zang mediation returns to normal, life mechanism uninterrupted. Prescribe Qingpi (Green Tangerine Peel) to guide to Jueyin, Chaihu (Bupleurum) to ascend Wood depression, allowing Liver channel Qi to flow smoothly upward. But fearing moving Gallbladder Wood, use Baishao (White Peony) sour astringent to gather into Liver channel. Qingpi guides in, Baishao gathers preventing exit, thus unrelated to Gallbladder. Qingpi breaks Qi, Chaihu scatters Qi, so use Renshen (Ginseng) to anchor, restraining breaking/scattering nature. Only take Qingpi guiding to Jueyin, Chaihu ascending Wood Qi, enabling support and flourishing without excess. Is this correct?
Bupleuri Radix, Citri Reticulatae Pericarpium Viride, Ginseng Radix, Paeoniae Radix Alba