某 素有痰喘旧证，前以辛温开饮，极着成效。又以劳 感邪，于九日前忽先寒后热，继但热不寒，刻
今热势虽衰，而淋淋汗出，欲寐未寐之际， 如梦语，肢搐引动，咽中作痛，喉关偏右白糜星布。脉数濡
滑，舌绛赤，苔黄罩灰。此由邪湿内蒸，所有浊痰，悉化为火，致肺胃之阴津消灼。阴分愈亏，则火热愈炽，
有虚脱之虞。勉拟泄热和阴一法。谋事在人，成事在天。
金石斛（四钱） 朱茯神（三钱） 北沙参（五钱） 大元参（三钱） 光杏仁（三钱） 冬瓜子（三钱）
煨石膏（三钱） 制半夏（一钱五分） 炒黄川贝（一钱五分） 枇杷叶（四片） 青芦管（八钱） 竹沥（四钱）
濂珠（三分） 川贝（五分） 犀黄（三厘三味研末吹喉） 枇杷叶并鲜竹茹代茶。
二诊 泄热和阴，而清肺胃，咽痛糜腐大退。的属痰热化火烁阴。药既应手，姑宗前法扩充。
北沙参（五钱） 大麦冬（三钱） 煨石膏（三钱） 川贝母（二钱） 生薏仁（三钱） 炒蒌皮（三钱）
光杏仁（三钱） 冬瓜子（四钱） 青芦管（八钱） 竹沥（四钱）
雷（左） 脾肾两亏，饮食生痰，痰阻为喘者久。兹值春升之际，痰凭木火之势而化为热，以致竟夜不能
交睫。脉左尺不藏，苔黄舌红。龙相亦动。拟潜阳和阴，参以苦泄。
川雅连（四分酸枣仁三钱同炒） 肥知母（三钱） 炒枳壳（七分） 制半夏（一钱五分盐水炒） 鲜竹茹（一
钱五分） 茯苓神（各二钱） 上濂珠（三分） 真川贝（五分二味研细末调服）
左 平素痰多，交夏君火行令，火与痰合，遂致弥漫心窍，言语不能自如。今神识虽清，而健忘胃钝，左
关脉滑。此痰阻于中，心肾不相交通。欲交心肾，当祛浊痰。
参须（一钱） 制半夏（一钱五分） 陈胆星（五分） 橘红（一钱） 栝蒌仁（三钱炒） 远志（八分）
茯苓神（各二钱） 九节菖蒲（五分） 枳实（一钱） 姜竹茹（一钱） 竹沥（六钱滴入姜汁少许）
某 中虚挟痰，痰热化风，撼扰神舍。心中跳动，则火从上升。脉象虚弦。填补其下，以涵濡肝木，碍于在
上之痰热，而利不胜弊。惟介类以潜之。
生牡蛎 决明 白蒺藜 块辰砂 法半夏 朱茯神 磁石 钩钩 橘红 鸡子黄 大淡菜
王（左） 眩晕足麻，甚至昏仆。肝阳挟痰上逆，恐成痫厥。
制半夏 枳实 天麻 白僵蚕 独活 茯苓 薄橘红 竹茹 钩钩 炒菊花 秦艽
某 素有痰火，一二年一发，发则詈人掷物，自以为痫也。曰、非痫也。夫痫者，发则暴仆，不知人事，口吐
涎沫，声如猪羊鸣也。
制南星（六分） 辰茯神 煨天麻 橘红 盐炒竹茹 天竺黄 白蒺藜 九节菖蒲 郁金 镇心丸（一丸化服）
盛（右） 凡虚里之穴，其动应衣，宗气泄越之征。中流无砥柱之权，肝阳从而撼扰，神舍因而不宁。拟补
中气以御肝木。
盐水炙绵 吉林参 云茯苓 阿胶珠 土炒白芍 远志肉 块辰砂 左牡蛎 龙齿 金器
又 补中以御木，育阴以柔肝，神呆如昨，时多恐怖，心中自觉窒而不开。脉左寸沉滞，关部细弦，尺中
小涩，右寸滑而濡软，关部滑而带弦，尺脉较劲。皆中气脏阴有亏，挟痰内蔽之象。夫既亏矣，何复生痰。
盖肝禀将军之性，其刚柔之用，正施之则主一身之生发，逆施之则为火风之厉阶。今当产后未满百
日，血虚气弱，肝木偏亢，遂为虚里跳动。厥阳上旋，则清津浊液，悉为阳气所炼，凝结成痰。心为离火，火
本下降，与水相交者也。今阳气且从上旋，心火何能独降，心胸清旷之区，转为阳火燔蒸之地，窒闷之
由实在于此。譬如酷暑之时，独居斗室，虽旷达之士，亦且闷不能堪，所谓闷者，皆阳之闷也。夫至阳闷
于中，灼液成痰，神明为痰火所扰，便是不能自主之局。所最难者，阳可以熄，火可以降，痰可以豁，而三
者之药，无不戕贼元气。今以水亏不能涵濡，气虚不能制伏，然后有肝阳之升，痰热之蔽。消之降之，前
者未定，后者又来。若补之涵之，则远水不能济急也。大药之似乎虚设者为此。兹从补养之中，参入治
痰之品，标本并顾。未识勃然欲发之阳，能得渐平否。备正。
吉林参（一钱） 龙齿（五钱） 九节菖蒲（五分） 块辰砂（三钱） 茯苓神（各二钱） 清阿胶（二钱）
焦远志（八分） 辰砂拌麦冬（三钱） 川贝（二钱） 炒松生地（四钱） 马宝（先化服一分）
又 每至动作，虚里辄大跳动，内经谓其动应衣，宗气泄也。病之着眼处，当在于此，所以前诊脉细弦
而并不洪大，与病相应，直认其为中气虚而不能制木，致魂不安谧，神不守舍。欲遵经训，似非补其中
气，交其心神不可也。乃投之罔效，其中必有曲折。此次偶服攻劫之方，大吐大下。今诊右部之脉转滑
微大，寸脉依然细滞。因思肝用在左在于 胁，肝郁之极，气结不行，由 胁而蔓及虚里，气郁则痰滞，
滞则机窍不宣，是神机不运，在乎痰之多寡，痰踞机窍之要地，是以阻神明、乱魂魄。然而吐下之后，神
志而未灵爽者，盖肠胃直行之道，积痰虽一扫而空，至窍络纡回之处，非郁开气行，痰不得动也。今才
经吐下，理应休息数日，乘此以四七汤开其郁结，参入芳香以宣窍络。旬日之后，再用攻法。即请裁夺行之。
上川朴（一钱二分） 磨苏梗（一钱） 广玉金（三钱） 制半夏（三钱） 茯苓（四钱） 九节菖蒲（七分）
姜（二片） 枣（二枚）
又 心虚胆怯，神不自持，多疑寡断，痰火之药，无一不进，迄无应效。即心肾不济一层，亦经小试，未见
寸功，几成棘手难明之局。深究其理，虚里之跳动，究系病起之根，若非宗气之泄，即是肝气之郁，可不
待言。吾人肝主左升，胆主右降，肝升则化为心血，胆降则化为相火。今肝经之气，郁而不舒，则左升失
其常度，而心血无以生长，当升不升，肝木愈郁而愈实。肝为藏魂之地，又为藏血之海，经行血降，郁塞
稍开，神魂稍定。而木气之升泄，仍难合度，心血日少，所以心虚若怯。无理处求理，如以上所述，似与病
情不能为谬。拟升泄肝木，使上化心血，而心虚或能渐复，木升则郁解，而肝实或可渐疏。苟心神可以
自持，魂能安宅，便是佳境也。
柴胡（七分） 生甘草（三分） 杭白芍（二钱） 茯苓神（各二钱） 酒炒当归（二钱） 野于术（二钱）
抚川芎（一钱） 丹参（二钱） 煨姜（二片） 西血珀（五分） 上沉香（二分） 上湘军
（六分三味研细用炒茺蔚子四钱煎汤调服）
方（左） 头胀眩晕火升，频带燥渴，痰多脉滑此痰湿化火生风，与阴虚阳亢者有间也。
栝蒌仁（三钱） 煨天麻 甘菊花 白蒺藜 枳实 石决明 茯苓神 姜汁 竹沥（五钱） 白金丸（四分）
徐（左） 阅病单皆痰火为患。痰一日不去，则火一日不宁，即神色一日不楚。邵筱 龙虎丸，内有信石
之猛，询诸其弟，云服之虽解似痰非痰之物，痰即下行，神识理宜立楚，而犹呆钝如昨。此必因痰浊入
于心胞络中，猛攻之药，不能屈曲搜剔故也。拟方如下。
上濂珠（一钱） 陈胆星（四分） 明玳瑁（四分） 西血珀（七分） 明雄黄（四分） 巴霜（六厘去净油）
研为细末，每服四分空心服。
左 昨进化痰护神，多言呼唱，较昨稍定，然犹未能寐，腹中气满不舒。脉两关弦滑。良以肝火挟痰内
扰，肝经之气，亦散漫不平，心神为之摇撼。既得应手，再守前意出入。
朱茯神 陈胆星 香附 橘红 真珠母 川楝子 制半夏 龙齿 当归龙荟丸（一钱） 礞石滚痰丸（二钱二
丸和合先服） 上濂珠（二分） 西血珀（二分） 辰砂（七厘三味研末临卧服）
复诊 便解神清得寐。前方去二丸，加块辰砂竹茹。
左 清化痰热，心胸烙热稍平，胃纳略起，头晕亦减，然行动气仍上逆。痰火内踞，本虚标实，治愈不易，
聊作缓兵之计而已。
炒玉竹 海蛤粉 炒蒌皮 桔梗 茯苓 川贝母
光杏仁 炒竹茹 广橘红（一钱五分） 生姜（五分二味用蜜水一杯同煎至干微炒入煎）
某 痰火交炽，曾经糊乱。今神识虽清，而左脉弦大。肝胆之火，尚未宁静。
朱茯神（三钱） 竺黄（三钱） 制半夏（一钱五分） 陈胆星（三分） 杏仁泥（三钱） 郁金（一钱五分）
炒枣仁（一钱五分） 钩钩（三钱后入） 煨决明（四钱） 橘红（一钱） 粉丹皮（一钱五分） 远志肉（五分）
顾（左） 向有痰饮，兹感风温，先发咽痛，风化为火，与痰相合，以致痰火交炽，肺肾之气不能相通。气喘
难卧，痰声漉漉，心胸烦闷异常，常欲露胸泄闷，两颧红赤。而脉象濡细，舌苔浮红罩霉。气阴已亏，而痰
火独盛，恐难以草木为功。勉拟育阴化痰，以通肺肾。即请商裁。
阿胶珠（三钱） 天冬（三钱） 灵磁石（四钱 ） 川贝（一钱五分） 茯神（三钱） 生地炭（四钱）
秋石（五分） 海蛤粉（四钱） 陈海蛰（一两） 珠粉（三分） 川贝（三分二味研末先调服）
李（右） 痰火时升时降。再开展气化，良以气有余即是火也。
光杏仁（三钱打） 郁金（一钱五分） 丹皮（二钱） 枳壳（一钱） 山栀（三钱姜汁炒黑） 栝蒌（二钱）
泽泻（一钱五分） 桔梗（一钱） 炒竹茹（一钱） 车前子（三钱） 枇杷叶（一两去毛）
张（左） 中脘渐舒，痰多脉滑。由湿生痰，由痰生火，由火生风，以知痰为火之本，风为火之媒。治病必求
其本。
制半夏（一钱五分） 煨天麻（一钱五分） 广皮（一钱） 猪苓（二钱） 蚕砂（三钱包）
陈胆星（五分） 白茯苓（三钱） 白术（二钱） 泽泻（二钱） 清气化痰丸（三钱）
吴（左） 惊动胆木，木火蒸痰，窒碍灵府。怔忡不宁，神情呆钝。化痰宣窍，参以镇坠。
制半夏（一钱五分） 广橘红（一钱） 广玉金（一钱五分） 块辰砂（三钱包） 陈胆星（五
分） 白茯苓（三钱） 远志肉（五分） 炒枣仁（二钱打） 九节菖蒲（二分） 金器（一件悬煎）
某 神情昏愦，言语无伦，唇朱兼紫。脉滑而弦。此痰火肝阳交炽。拟泄热化痰。
羚羊片（二钱） 菖蒲（五分） 橘红（一钱） 当归（一钱五分） 陈胆星（五分） 远志（五分）
枳实（一钱） 天麻（一钱五分） 天竺黄（三钱） 丹皮（一钱） 竹沥（一钱冲） 龙荟丸（四钱）
江（右） 怒火如狂，六脉弦数。肝火扰攘，心神为之不宁。拟护神化痰熄肝。
竺黄 决明 丹皮 块辰砂 川贝 山栀
胆星 茯神 生铁落 金器 濂珠（三分） 玳瑁（一分五厘二味研末先服）
Patient with a history of phlegm-wheezing previously treated with acrid-warm herbs to resolve fluid retention, showing significant efficacy. Subsequently, due to fatigue and pathogenic invasion, nine days ago he suddenly experienced chills followed by fever, which then progressed to fever without chills. Although the heat intensity has subsided, profuse sweating persists. In the state between sleep and wakefulness, he exhibits somniloquy (sleep-talking), limb twitching and pulling, throat pain, and white miliary erosions scattered on the right side of the glottis. The pulse is rapid, soggy, and slippery; the tongue body is crimson red, coated with yellow moss overlaid with grey. This is caused by internal steaming of pathogenic dampness, transforming all turbid phlegm into fire, thereby consuming the yin fluids of the Lung and Stomach. As the yin deficiency worsens, the fire becomes more intense, posing a risk of collapse. Tentatively prescribing a method to drain heat and harmonize yin. Human effort is involved in planning, but success depends on heaven.
Dendrobii Caulis (Jin Shi Hu) (4 qian)
Polyporus cum Mycelio (Zhu Fu Shen) (3 qian)
Glehniae Radix (Bei Sha Shen) (5 qian)
Scrophulariae Radix (Da Yuan Shen) (3 qian)
Armeniacae Semen Amarum (Guang Xing Ren) (3 qian)
Benincasae Fructus (Dong Gua Zi) (3 qian)
Prepared Gypsum Fibrosum (Wei Shi Gao) (3 qian)
Prepared Pinelliae Tuber (Zhi Ban Xia) (1.5 qian)
Stir-fried Huang Chuan Bei Mu (Chao Huang Chuan Bei) (1.5 qian)
Loquat Leaf (Pi Pa Ye) (4 slices)
Qing Lu Guan (8 qian)
Bamboo Sap (Zhu Li) (4 qian)
Pearl Powder (Lian Zhu) (0.3 fen)
Chuan Bei Mu (0.5 fen)
Calculus Bovis (Xi Huang) (0.03 li, three ingredients ground into powder for throat insufflation)
Loquat leaf and fresh Bamboo Shavings (Zhu Ru) as tea substitute.
Second visit: Draining heat and harmonizing yin, while clearing the Lung and Stomach, throat pain and erosion have significantly receded. Indeed, it belongs to phlegm-heat transforming into fire and scorching yin. Since the medicine is effective, temporarily expanding upon the previous method.
Glehniae Radix (Bei Sha Shen) (5 qian)
Ophiopogonis Tuber (Da Mai Dong) (3 qian)
Prepared Gypsum Fibrosum (Wei Shi Gao) (3 qian)
Pinelliae Tuber (Chuan Bei Mu) (2 qian)
Coix Seed (Sheng Yi Ren) (3 qian)
Stir-fried Trichosanthis Pericarpium (Chao Lou Pi) (3 qian)
Armeniacae Semen Amarum (Guang Xing Ren) (3 qian)
Benincasae Fructus (Dong Gua Zi) (4 qian)
Qing Lu Guan (8 qian)
Bamboo Sap (Zhu Li) (4 qian)
Lei (Left): Spleen and Kidney both deficient, food stagnation generates phlegm, phlegm obstruction causes wheezing for a long time. Now that spring rising energy is present, phlegm relies on the Wood-Fire momentum to transform into heat, causing inability to sleep all night. The left Chi pulse is not stored, coating is yellow, tongue is red. Dragon Fire is also moving. Prescribing subduing Yang and harmonizing yin, supplemented with bitter draining.
Coptidis Rhizoma (Chuan Ya Lian) (0.4 fen, stir-fried together with Ziziphi Spinosae Semen 3 qian)
Anemarrhenae Rhizoma (Fei Zhi Mu) (3 qian)
Stir-fried Aurantii Fructus (Chao Zhi Ke) (0.7 fen)
Prepared Pinelliae Tuber (Zhi Ban Xia) (1.5 qian, stir-fried with salt water)
Fresh Bamboo Shavings (Xian Zhu Ru) (1.5 qian)
Poria Cum Mycelium (Fu Ling Shen) (2 qian each)
Pearl Powder (Shang Lian Zhu) (0.3 fen)
True Chuan Bei Mu (Zhen Chuan Bei) (0.5 fen, two ingredients ground fine for mixing and taking).
Left: Usually abundant phlegm. When Summer君主Fire rules, fire combines with phlegm, thus diffusing into the Heart orifice, making speech involuntary. Although consciousness is clear now, there is forgetfulness and dull stomach qi, left Guan pulse is slippery. This is phlegm obstructing the middle, Heart and Kidney not communicating. To communicate Heart and Kidney, one must remove turbid phlegm.
Ginseng Radix Rubra (Shen Xu) (1 qian)
Prepared Pinelliae Tuber (Zhi Ban Xia) (1.5 qian)
Arisaema Cum Bile (Chen Dan Xing) (0.5 fen)
Tangerine Peel (Ju Hong) (1 qian)
Trichosanthis Semen (Gua Lou Ren) (3 qian, stir-fried)
Polygalae Radix (Yuan Zhi) (0.8 fen)
Poria Cum Mycelium (Fu Ling Shen) (2 qian each)
Acori Tatarinowii Rhizoma (Jiu Jie Chang Pu) (0.5 fen)
Immature Bitter Orange (Zhi Shi) (1 qian)
Ginger-processed Bamboo Shavings (Jiang Zhu Ru) (1 qian)
Bamboo Sap (Zhu Li) (6 qian, add a little Ginger Juice).
Patient: Middle deficiency carrying phlegm, phlegm-heat transforms into wind, disturbing the Spirit residence. Palpitations cause fire to rise. Pulse is deficient and wiry. Tonifying below to nourish Liver Wood, but hindered by upper phlegm-heat, benefits do not outweigh harms. Only shellfish-type minerals can subdue it.
Oyster Shell (Sheng Mu Li)
Cassiae Semen (Jue Ming)
Tribuli Fructus (Bai Ji Li)
Cinnabar (Kuai Chen Sha)
Prepared Pinelliae Tuber (Fa Ban Xia)
Polyporus cum Mycelio (Zhu Fu Shen)
Magnetitum (Ci Shi)
Uncaria Ramulus cum Uncis (Gou Gou)
Tangerine Peel (Ju Hong)
Chicken Egg Yolk (Ji Zi Huang)
Edible Fish Maw (Da Dan Cai)
Wang (Left): Dizziness and numbness in feet, even fainting and falling. Liver Yang carrying phlegm rebels upward, fearing formation of epilepsy or convulsion.
Prepared Pinelliae Tuber (Zhi Ban Xia)
Immature Bitter Orange (Zhi Shi)
Gastrodia Rhizome (Tian Ma)
Bombyx Batryticatus (Bai Jiang Can)
Angelicae Pubescentis Radix (Du Huo)
Poria (Fu Ling)
Thin Tangerine Peel (Bo Ju Hong)
Bamboo Shavings (Zhu Ru)
Uncaria Ramulus cum Uncis (Gou Gou)
Stir-fried Chrysanthemi Flos (Chao Ju Hua)
Gentianae Macrophytae Radix (Qin Jiao)
Patient: Has chronic phlegm-fire, occurring once every one to two years. During attacks, cursing and throwing objects, believing himself to have epilepsy. I say: It is not epilepsy. Epilepsy involves sudden falling, loss of consciousness, foaming at the mouth, and sounds like pigs or sheep.
Arisaema Cum Bile (Zhi Nan Xing) (0.6 fen)
Polyporus cum Mycelio (Chen Fu Shen)
Roasted Gastrodia Rhizome (Wei Tian Ma)
Tangerine Peel (Ju Hong)
Salt-stir-fried Bamboo Shavings (Yan Chao Zhu Ru)
Hyriopsis Schlegelii Concha (Tian Zhu Huang)
Tribuli Fructus (Bai Ji Li)
Acori Tatarinowii Rhizoma (Jiu Jie Chang Pu)
Curcumae Radix (Yu Jin)
Zhen Xin Wan (one pill dissolved and taken).
Sheng (Right): Wherever the Xu Li point is, its movement corresponds to clothing, a sign of Zong Qi leakage. Without a pillar in the middle stream, Liver Yang shakes and disturbs, so the Spirit residence is unsettled. Prescribing tonifying Middle Qi to resist Liver Wood.
Salt-baked Astragali Membranaceus Radix (Shui Yan Zhi Mian Huang Qi)
Jilin Ginseng (Ji Lin Shen)
Cloud Poria (Yun Fu Ling)
Ejiao Pearl (E Jiao Zhu)
Earth-stir-fried Paeoniae Radix Alba (Tu Chao Bai Shao)
Polygalae Radix Meat (Yuan Zhi Rou)
Cinnabar (Kuai Chen Sha)
Left Oyster Shell (Zuo Mu Li)
Dragon Teeth (Long Chi)
Gold Utensil (Jin Qi)
Again: Tonifying middle to resist Wood, nourishing yin to soften Liver, spirit remains dull as yesterday, often feeling terrified, heart feels blocked and unrelieved. Left Cun pulse is deep and stagnant, Guan is fine and wiry, Chi is slightly choppy; Right Cun is slippery and soggy soft, Guan is slippery and wiry, Chi pulse is relatively tense. All indicate deficiency of Middle Qi and Zang Yin, with phlegm blocking internally. Since it is deficient, why does phlegm generate again?
Liver possesses the nature of a general; its use of rigidity and flexibility, when applied correctly, governs the generation of the whole body; when misapplied, it becomes the precipice of fire and wind. Now, postpartum less than 100 days, blood is deficient and qi is weak, Liver Wood is hyperactive, leading to Xu Li palpitations. Jue Yang rotates upward, so clear fluids and turbid liquids are all refined by Yang Qi, condensing into phlegm. Heart is Li Fire, fire naturally descends to interact with Water. Now Yang Qi rotates upward, how can Heart Fire descend alone? The clear and vast area of the chest and heart turns into a place of blazing Yang fire; the reason for blockage lies here. Like staying alone in a small room during severe summer heat, even an open-minded person cannot bear the stuffiness; what is called stuffiness is the stuffiness of Yang. When extreme Yang is stifled in the middle, burning fluids into phlegm, and Spirit is disturbed by Phlegm-Fire, it becomes a situation of losing autonomy. The most difficult part is that Yang can be extinguished, Fire can be descended, Phlegm can be resolved, but drugs for these three all damage Yuan Qi. Now because Water deficiency cannot nourish, and Qi deficiency cannot control, only then does Liver Yang rise and Phlegm-Heat obscure. Eliminating or descending them, if the former is not settled, the latter returns. If tonifying or nourishing, distant water cannot save urgent needs. This is why great medicines seem useless. Here, from within tonification, adding phlegm-resolving agents, attending to both root and branch. Whether the abruptly rising Yang can gradually calm remains to be seen. Prepared for correction.
Jilin Ginseng (1 qian)
Dragon Teeth (5 qian)
Acori Tatarinowii Rhizoma (0.5 fen)
Cinnabar (3 qian)
Poria Cum Mycelium (2 qian each)
Clear Ejiao (2 qian)
Charred Polygalae Radix (0.8 fen)
Cinnabar-mixed Ophiopogonis Tuber (3 qian)
Chuan Bei Mu (2 qian)
Stir-fried Song Di Huang (4 qian)
Hippocamelus Sinensis Calculus (Ma Bao) (dissolve first 0.1 fen).
Again: Whenever moving, Xu Li beats strongly. Nei Jing says its movement corresponds to clothing, Zong Qi leaks. The focus of the disease should be here, so previous diagnosis showed fine and wiry pulse, not surging, corresponding to the disease, directly recognizing it as Middle Qi deficiency unable to control Wood, causing Hun to be unsettled and Shen not guarding the residence. To follow the classic teaching, seems non-tonifying Middle Qi and connecting Heart-Shen is impossible. Yet administration was ineffective, there must be twists. This time accidentally took attacking/purgative formula, severe vomiting and purging. Now diagnosing Right section pulse turned slippery and slightly large, Cun pulse still fine and stagnant. Thinking Liver function is on the left at hypochondrium, extreme Liver depression, Qi knotting and not moving, spreading from hypochondrium to Xu Li, Qi depression leads to Phlegm stagnation, stagnation leads to orifice blockage, Spirit mechanism does not move, depending on amount of phlegm. Phlegm occupying key orifices blocks Spirit and confuses Hun and Po. However after vomiting and purging, spirit is not yet sharp, probably because straight channels of intestines and stomach, accumulated phlegm swept empty, but at winding orifice collaterals, unless depression opens and Qi moves, phlegm cannot move. Just underwent vomiting and purging, should rest for several days, using Si Qi Tang to open depression, adding aromatic herbs to vent orifices. After ten days, use attacking method again. Please decide and execute.
Magnolia Bark (Shang Chuan Pu) (1.2 qian)
Ground Piperis Longi Fructus (Mo Su Geng) (1 qian)
Broad Curcumae Radix (Guang Yu Jin) (3 qian)
Prepared Pinelliae Tuber (Zhi Ban Xia) (3 qian)
Poria (Fu Ling) (4 qian)
Acori Tatarinowii Rhizoma (0.7 fen)
Ginger (2 slices)
Jujube (2 pieces)
Again: Heart deficiency and Gallbladder timidity, Spirit cannot hold itself, suspicious and indecisive. Phlegm-Fire drugs, none were not entered, until no effect. Even Heart-Kidney non-interaction layer, tried slightly, saw no merit, nearly becoming a thorny and unclear situation. Deeply investigating the principle, Xu Li palpitation is ultimately the root of the disease, whether Zong Qi leakage or Liver Qi depression, need not be said. Our Liver governs left ascending, Gallbladder governs right descending, Liver ascending transforms into Heart Blood, Gallbladder descending transforms into Ministerial Fire. Now Liver channel Qi, depressed and not soothing, left ascending loses normal degree, Heart Blood has no way to grow, should ascend but does not ascend, Liver Wood becomes more depressed and solid. Liver is place storing Hun, also sea storing Blood, menstruation flows blood down, depression slightly opens, Hun and Shen slightly settle. But Wood Qi ascending and leaking still hard to meet degree, Heart Blood daily decreases, so Heart deficiency like timidity. Seeking reason in unreasonable places, as described above, seems not erroneous regarding condition. Prescribing ascending and leaking Liver Wood, making upper transform Heart Blood, Heart deficiency may gradually recover, Wood ascending then depression resolves, Liver solidity may gradually disperse. If Heart-Shen can hold itself, Hun can settle home, it is a good state.
Bupleuri Radix (Chai Hu) (0.7 fen)
Raw Glycyrrhizae Radix et Rhizoma (Sheng Gan Cao) (0.3 fen)
Hang Paeoniae Radix Alba (Hang Bai Shao) (2 qian)
Poria Cum Mycelium (2 qian each)
Wine-stir-fried Angelicae Sinensis Radix (Jiu Chao Dang Gui) (2 qian)
Wild Atractylodis Macrocephalae Rhizoma (Ye Yu Zhu) (2 qian)
Fu Chuan Xiong (1 qian)
Salviae Miltiorrhizae Radix (Dan Shen) (2 qian)
Roasted Ginger (Wei Jiang) (2 slices)
Western Blood Amber (Xi Xue Po) (0.5 fen)
Top Agarwood (Shang Chen Xiang) (0.2 fen)
Top Army (Shang Xiang Jun)
(0.6 fen, three ingredients ground fine, mixed with decoction of stir-fried Vitex Fruit 4 qian).
Fang (Left): Head distension and dizziness, fire rising, frequent dry thirst, abundant phlegm, slippery pulse. This is Phlegm-Damp transforming into Fire generating Wind, different from Yin deficiency and Yang hyperactivity.
Trichosanthis Semen (Gua Lou Ren) (3 qian)
Roasted Gastrodia Rhizome (Wei Tian Ma)
Sweet Chrysanthemum Flower (Gan Ju Hua)
Tribuli Fructus (Bai Ji Li)
Immature Bitter Orange (Zhi Shi)
Concha Arcae (Shi Jue Ming)
Poria Cum Mycelium (Fu Ling Shen)
Ginger Juice
Bamboo Sap (Zhu Li) (5 qian)
Bai Jin Wan (0.4 fen)
Xu (Left): Reading medical records, all are Phlegm-Fire disasters. As long as Phlegm is not gone one day, Fire is not peaceful one day, i.e., Spirit and color are not clear one day. Shao Xiao Long Hu Wan contains fierce Realgar, asked his brother, said taking it dissolves substance resembling phlegm but not phlegm, Phlegm goes down, Spirit should immediately clear, yet still dull as yesterday. This must be because turbid Phlegm entered Pericardium Collateral, fierce attacking drugs cannot curve and search out. Prescribing formula as follows.
Pearl Powder (Shang Lian Zhu) (1 qian)
Old Arisaema Cum Bile (Chen Dan Xing) (0.4 fen)
Clear Eretmochelys Carapax (Ming Dai Mao) (0.4 fen)
Western Blood Amber (Xi Xue Po) (0.7 fen)
Realgar (Ming Xiong Huang) (0.4 fen)
Crotonis Fructus Purged (Ba Shuang) (0.06 li, oil removed completely)
Grind into fine powder, take 0.4 fen each time on empty stomach.
Left: Yesterday advanced Phlegm-resolving and Spirit-protecting, talking loudly and singing, slightly calmer than yesterday, however still unable to sleep, abdomen full and uncomfortable. Both Guan pulses wiry and slippery. Good because Liver Fire carries Phlegm disturbing internally, Liver channel Qi also scattered and uneven, Heart-Shen shaken by it. Since effective, keep previous intent with modifications.
Polyporus cum Mycelio (Zhu Fu Shen)
Old Arisaema Cum Bile (Chen Dan Xing)
Cyperi Rhizoma (Xiang Fu)
Tangerine Peel (Ju Hong)
Mother of Pearl (Zhen Zhu Mu)
Fructus Toosendan (Chuan Liu Zi)
Prepared Pinelliae Tuber (Zhi Ban Xia)
Dragon Teeth (Long Chi)
Danggui Longhui Wan (1 qian)
Mengshi Guntan Wan (2 qian, two pills combined, take first)
Pearl Powder (Shang Lian Zhu) (0.2 fen)
Western Blood Amber (Xi Xue Po) (0.2 fen)
Cinnabar (0.07 li, three ingredients ground fine, take before bed).
Follow-up: Bowel movement cleared, spirit clear, able to sleep. Previous formula remove two pills, add Kuai Chen Sha and Zhu Ru.
Left: Clearing and resolving Phlegm-Heat, chest burning heat slightly平和, stomach appetite slightly rises, dizziness also reduces, however movement Qi still rebels upward. Phlegm-Fire occupies internally, root deficiency branch excess, cure not easy, merely a delaying tactic.
Stir-fried Polygonati Odorati Rhizoma (Chao Yu Zhu)
Clam Shell Powder (Hai Ge Fen)
Stir-fried Trichosanthis Pericarpium (Chao Lou Pi)
Platycodonis Radix (Jie Geng)
Poria (Fu Ling)
Pinelliae Tuber (Chuan Bei Mu)
Armeniacae Semen Amarum (Guang Xing Ren)
Stir-fried Bamboo Shavings (Chao Zhu Ru)
Broad Tangerine Peel (Guang Ju Hong) (1.5 qian)
Ginger (0.5 fen, two ingredients decocted in one cup honey water until dry, lightly stir-fried and added to decoction).
Patient: Phlegm and Fire fiercely competing, previously chaotic. Now spirit clear, but left pulse wiry and large. Liver and Gallbladder Fire not yet peaceful.
Polyporus cum Mycelio (Zhu Fu Shen) (3 qian)
Hyriopsis Schlegelii Concha (Zhu Huang) (3 qian)
Prepared Pinelliae Tuber (Zhi Ban Xia) (1.5 qian)
Old Arisaema Cum Bile (Chen Dan Xing) (0.3 fen)
Almond Paste (Xing Ren Ni) (3 qian)
Curcumae Radix (Yu Jin) (1.5 qian)
Stir-fried Ziziphi Spinosae Semen (Chao Zao Ren) (1.5 qian)
Uncaria Ramulus cum Uncis (Gou Gou) (3 qian, add later)
Roasted Cassiae Semen (Wei Jue Ming) (4 qian)
Tangerine Peel (Ju Hong) (1 qian)
Moutan Cortex (Fen Dan Pi) (1.5 qian)
Polygalae Radix Meat (Yuan Zhi Rou) (0.5 fen)
Gu (Left): Previously had Phlegm-Fluid, now contracted Wind-Warmth, first throat pain, Wind transforms into Fire, combines with Phlegm, causing Phlegm-Fire fiercely competing, Lung and Kidney Qi cannot communicate. Wheezing difficult to lie down, phlegm sound gurgling, chest and heart extremely vexed, often wanting to expose chest to relieve stuffiness, malar region red. Pulse soggy and fine, tongue coating floating red covered with mold. Qi and Yin already deficient, but Phlegm-Fire alone excessive, fear difficult to achieve merit with herbal medicine. Tentatively prescribing nourishing Yin and resolving Phlegm to connect Lung and Kidney. Please discuss and decide.
Ejiao Pearl (E Jiao Zhu) (3 qian)
Asparagi Tuber (Tian Dong) (3 qian)
Spirit Magnetite (Ling Ci Shi) (4 qian)
Chuan Bei Mu (1.5 qian)
Fushen (Fu Shen) (3 qian)
Charred Rehmanniae Radix (Sheng Di Tan) (4 qian)
Autumn Stone (Qiu Shi) (0.5 fen)
Clam Shell Powder (Hai Ge Fen) (4 qian)
Old Man-of-the-Sea (Chen Hai Zhe) (1 liang)
Pearl Powder (Zhu Fen) (0.3 fen)
Chuan Bei Mu (0.3 fen, two ingredients ground fine, mix and take first).
Li (Right): Phlegm-Fire rises and falls intermittently. Again develop Qi transformation, good because excess Qi is Fire.
Armeniacae Semen Amarum (Guang Xing Ren) (3 qian, crushed)
Curcumae Radix (Yu Jin) (1.5 qian)
Moutan Cortex (Dan Pi) (2 qian)
Aurantii Fructus (Zhi Ke) (1 qian)
Gardenia Fruit (Shan Zhi) (3 qian, stir-fried black with Ginger Juice)
Trichosanthis Fruit (Gua Lou) (2 qian)
Alisma Rhizoma (Ze Xie) (1.5 qian)
Platycodonis Radix (Jie Geng) (1 qian)
Stir-fried Bamboo Shavings (Chao Zhu Ru) (1 qian)
Plantaginis Semen (Che Qian Zi) (3 qian)
Loquat Leaf (Pi Pa Ye) (1 liang, remove hairs)
Zhang (Left): Zhong Wan gradually comfortable, abundant phlegm, slippery pulse. From Damp generates Phlegm, from Phlegm generates Fire, from Fire generates Wind, knowing Phlegm is root of Fire, Wind is medium of Fire. Treating disease must seek its root.
Prepared Pinelliae Tuber (Zhi Ban Xia) (1.5 qian)
Roasted Gastrodia Rhizome (Wei Tian Ma) (1.5 qian)
Broad Tangerine Peel (Guang Pi) (1 qian)
Polyporus (Zhu Ling) (2 qian)
Bombyx Batryticatus (Can Sha) (3 qian, wrapped)
Old Arisaema Cum Bile (Chen Dan Xing) (0.5 fen)
White Poria (Bai Fu Ling) (3 qian)
Atractylodis Macrocephalae Rhizoma (Bai Zhu) (2 qian)
Alisma Rhizoma (Ze Xie) (2 qian)
Qing Qi Hua Tan Wan (3 qian)
Wu (Left): Startle disturbs Gallbladder Wood, Wood-Fire steams Phlegm, obstructs Spiritual Mansion. Palpitations restless, spirit dull. Resolve Phlegm and vent orifices, supplement with sedation.
Prepared Pinelliae Tuber (Zhi Ban Xia) (1.5 qian)
Broad Tangerine Peel (Guang Ju Hong) (1 qian)
Broad Curcumae Radix (Guang Yu Jin) (1.5 qian)
Cinnabar (Kuai Chen Sha) (3 qian, wrapped)
Old Arisaema Cum Bile (Chen Dan Xing) (0.5 fen)
White Poria (Bai Fu Ling) (3 qian)
Polygalae Radix Meat (Yuan Zhi Rou) (0.5 fen)
Stir-fried Ziziphi Spinosae Semen (Chao Zao Ren) (2 qian, crushed)
Acori Tatarinowii Rhizoma (Jiu Jie Chang Pu) (0.2 fen)
Gold Utensil (Jin Qi) (one piece suspended in decoction).
Patient: Spirit confused, speech incoherent, lips red and purple. Pulse slippery and wiry. This is Phlegm-Fire and Liver Yang fiercely competing. Prescribing draining heat and resolving Phlegm.
Antelope Horn Slice (Ling Yang Pian) (2 qian)
Acorus (Chang Pu) (0.5 fen)
Tangerine Peel (Ju Hong) (1 qian)
Angelicae Sinensis Radix (Dang Gui) (1.5 qian)
Old Arisaema Cum Bile (Chen Dan Xing) (0.5 fen)
Polygalae Radix (Yuan Zhi) (0.5 fen)
Immature Bitter Orange (Zhi Shi) (1 qian)
Gastrodia Rhizome (Tian Ma) (1.5 qian)
Hyriopsis Schlegelii Concha (Tian Zhu Huang) (3 qian)
Moutan Cortex (Dan Pi) (1 qian)
Bamboo Sap (Zhu Li) (1 qian, flush)
Long Hui Wan (4 qian)
Jiang (Right): Anger like madness, six pulses wiry and rapid. Liver Fire disturbances, Heart-Shen unsettled. Prescribing protecting Spirit, resolving Phlegm, extinguishing Liver.
Hyriopsis Schlegelii Concha (Zhu Huang)
Cassiae Semen (Jue Ming)
Moutan Cortex (Dan Pi)
Cinnabar (Kuai Chen Sha)
Pinelliae Tuber (Chuan Bei)
Gardenia Fruit (Shan Zhi)
Arisaema Cum Bile (Dan Xing)
Fushen (Fu Shen)
Raw Iron Filings (Sheng Tie Luo)
Gold Utensil (Jin Qi)
Pearl Powder (Lian Zhu) (0.3 fen)
Eretmochelys Carapax (Dai Mao) (0.15 li, two ingredients ground fine, take first).