王（右） 向有痰饮，兹则心悸不宁，遍身筋脉动跃，背脊寒冷，渐即汗出。脉象弦滑，舌胖苔腻。此肝阴不
足，脾胃湿痰悉随肝阳鼓舞，君火为水气所干，以致摇撼震动。无性命之忧，有频年之累。
茯苓神 石菖蒲 制半夏 广橘红 真武丸 远志肉 块辰砂 煨天麻 指迷茯苓丸
高（右） 两和肝胃之阴，肃肺以通肠痹，肺与大肠本相表里，清肃之令一行，府气自然通降，所以药进
之后，如鼓应桴，大便即解。甘以养胃，阳土得和，风木之气，不能动辄摇撼，所以烦 之状已定，身热退
清，面红赤转淡。脉弦大转柔，舌苔浮腐顿化。惟不易酣寐，而易汗出，还是阳不藏敛之兆。其为伏邪之
后，肝胃阴伤，可谓毫发不爽矣。若踵余邪蕴湿论治，则阴愈伤而热愈甚，热愈甚则邪愈不敢撤，真有
不堪设想者。今药既平响应验，无庸再事更章。方草正之。
金钗石斛 鲜竹茹 炒杞子 茯神 火麻仁 淮小麦（煎汤代水）
半夏曲 地骨皮 钩钩 白蒺藜 龙齿
张（左） 外风已解，内风暗动，睡卧心神昏乱稍定，而时易汗出。阳气不收。再和阴摄阳。
金石斛（四钱） 炒枣仁（二钱） 牡蛎（四钱） 川贝母（二钱） 茯神（三钱） 地骨皮（二钱）
生甘草（三分） 海蛤粉（三钱） 淮小麦（五钱） 糯稻根（四钱）
二诊 心神渐清，汗出亦止。然肢体无力，口渴欲饮，胃呆少纳。再和肝胃之阴。
金石斛（四钱） 白蒺藜（三钱） 黑豆衣（三钱） 茯苓（三钱） 池菊（一钱五分） 半夏曲（二钱炒）
橘白（一钱） 生甘草（三分） 生熟谷芽（各一钱）
李（左） 头晕而四肢厥逆，欲吐不吐，欲泻不泻，半月之中，连发两次。厥逆既回，而头晕汗出不定。此由
肝风上旋，与时行之病不同。拟熄肝和阳。
炒枣仁 龙骨 茯神 白芍 地骨皮（桂枝二分同炒） 黑豆衣 白蒺藜 牡蛎 池菊花 淮小麦
王（左） 心胸灼热既退，寐亦稍安，而时仍眩晕。痰热化火，上旋头巅，肺胃交通之路，为痰所阻，阳出而
阴不得入，所以动辄气逆也。
光杏仁 青盐半夏 蜜炙橘红 白蒺藜 炒川贝 海蛤粉 天麻 薤白头 栝蒌仁 泽泻 云苓
胡（左） 用龙牡救逆法，肌肤甲错大退，四肢厥冷，筋惕肉 俱减，而仍悸晕耳鸣。还是阳气少藏，恐尚周折。
白蒺藜 龙骨 朱茯苓 豆衣 钩钩 煨天麻 炒枣仁 牡蛎 淮小麦 金器
服此方诸症皆减，惟眩晕耳鸣异常，以苔腻为胃有浊痰，用胆星白金丸，寐安，余不应。曰、少阳胆火不泄，用桑
皮丹栀夏枯决明加磁朱丸。乃应。耳仍不聪，加用龟甲。耳渐聪，又增带下。曰、亦是阳不上升，用盐水炒柴胡青
葙子炒椿根皮萆 白芍牡蛎伏龙肝，乃定。可谓怪证也。（正蒙附志）
杨（左） 向有肝阳，迩来神气不能自持，言语错杂，健忘善悲。脉弦虚大，右部歇止。此心肾交亏，水火不
能交接。八秩大年，何敢言治。
龟甲心 生地炭 远志肉 盐水炒牡蛎 朱茯神 辰麦冬 九节菖蒲 砂仁 上濂珠 西血珀（二味研细先服）
蒋（右） 左腹向有积聚，每至一阳将复，辄心悸耳鸣，四肢烙热，一阴来复，诸病渐安。今咳逆虽止，四肢
烙热如昨，食不馨增。肢体困乏。脉象沉涩，右关独弦。此由肝气失疏，肝阳逆犯阳气未能遽敛。拟和中
醒胃，兼养肝阴，阴生则阳自长也。
制首乌 黑豆衣 青葙子 川石斛 朱茯神 女贞子 制半夏 白蒺藜 白芍 竹茹（盐水炒）
浮小麦（一两煎汤代水）
左 偏枯三载，饮食如常。五六日前大拇指忽发疔疮，阳明湿热之盛，略见一斑。前晚恶热，欲去衣被，
昨晨复食面包，胃气壅实，甲木之气，不能下降，遂致肝风挟痰上升，清窍为之蒙闭，神昏不语，喉有痰
声，脘腹饱满，头汗溱溱，而汗有秽气。脉象弦滑，舌红苔黄，中心霉黑。唇口蠕动。痰火蒙闭于内，湿热熏
蒸于上。恐蒙闭不开，风阳震动，而致厥脱，勉拟清泄痰火，芳开蒙闭。请商。
乌犀角（五分磨冲） 天竺黄（二钱） 白蒺藜（三钱） 粉丹皮（二钱） 胆星（八分） 钩钩（三钱）
菖蒲根（三钱） 栝蒌皮（三钱） 竹半夏（一钱五分） 至宝丹（一丸菖蒲汤化服）
胡（右） 肝木纵横，腹中胀满。络隧气阻，肩臂作痛。再疏肝之用，养肝之体，而以养血和络兼之。
川断肉 金铃子 柏子仁 桑椹子 白芍 川玉金 木防己 橘皮络 香橼皮 砂仁 香附 当归
另常服史国公药酒
右 营阴不足，肝火风上旋。由头痛而至口眼 斜，舌强言謇。脉细弦数。此风火蒸痰，袭入少阳阳明
之络。拟化痰平肝泄热。
冬桑叶（一钱） 远志肉（三分） 白僵蚕（三钱） 池菊花（一钱五分） 粉丹皮（一钱五分） 黑山
栀（三钱） 石菖蒲（三分） 煨天麻（一钱五分） 钩钩（三钱） 松罗茶（一钱） 青果（三枚）
王（左） 向有肝阳，一阳来复之时，加以情怀怫郁，以致甲木不降，乙木勃升，心悸不寐，肉 筋惕，肢震
头摇。脉细而沉取弦搏，苔浊浓腻。此由肝火风震撼，津液凝痰，痰转化热，遂与风火彼此相煽，而有莫
御之势矣。拟化痰熄风，参以宁神镇肝。
胆星（六分） 天麻（一钱五分） 钩钩（三钱） 豆衣（四钱） 茯苓神（各二钱） 竺黄（三钱）
半夏（一钱五分） 橘红（一钱） 珍珠母（五钱） 大淡菜（二只） 金器（一件悬煎） 童便（半杯每日另服）
二诊 化痰熄肝，脉证相安。然仍筋惕肉 ，悸眩不寐。脉象弦滑，舌苔腻浊。痰火风鼓旋不熄。再化痰熄肝。
制半夏（二钱） 橘红（一钱） 茯苓神（各二钱） 胆星（三钱） 磁石（三钱） 龙齿（三钱）
牡蛎（五钱） 珍珠母（一两） 天麻（一钱五分） 块辰砂（三钱） 大淡菜（二只） 鸡子黄（一枚）
任（左） 咳嗽大退，火从上冲亦平。足见痰 贯珠，皆少阳胆火挟痰流窜，木叩金鸣也。
粉丹皮（二钱） 羚羊片（一钱先煎） 菟丝子（四钱） 川贝母（一钱） 天花粉（二钱） 黑山栀（三钱）
青蛤散（五钱） 杏仁泥（二钱） 郁金（一钱五分） 桑叶（一钱） 枇杷叶（三片去毛）
某 向有肝气，不时胀满。兹则头眩旋晕，心悸火升不寐，痰多 杂。脉细而沉取带滑。此气弱生痰，胆
胃不降，肝木独升。欲平其肝，当降其胆，欲降其胆，当降其胃，欲降其胃，当化其痰。
制半夏（一钱五分） 天竺黄（二钱） 桑叶（八分） 橘红（一钱） 珍珠母（三钱） 海蛤粉（三钱包）
黑山栀（一钱五分） 丹皮（一钱五分） 胆星（四分） 栝蒌霜（三钱） 制香附（二钱研） 陈关蛰（洗淡一两）
马（右） 疏肝化痰，脘胁痛胀未止，竟至神识迷乱，两手引动，频转矢气，大便不行。良由气滞不宣，浊痰
因而弥漫，神机被阻，胆阳上逆，风阳勃动，有昏痉喘厥之虞。疏府涤痰，势不容缓。脉象弦滑而濡。病实
正虚，恐成必败之局，然人力不能不尽，非敢孟浪，聊竭割股之忱。录方备商，立候荫棠先生正是。（首案未录）
制半夏 薄橘红 茯苓 白蒺藜 陈胆星 石菖蒲 煨天麻 白僵蚕 礞石滚痰丸（二钱开水先服） 濂珠粉
（三分另服）
三诊 投剂之后，呕出粘痰，继以畅解，皆属胶粘稠腻之物，其为痰积下达，确然可征。蒙阻由此得开，
神识迷乱大退，脘胁胀痛亦松。但时多倦寐遍身作痛，背 尤甚。脉象弦滑舌苔满布白腻，渴不欲饮，
还是浊痰弥漫之象。年及古稀，正虚病实，虽得转机，恐不足恃。再拟化痰而宣泄气火之郁，以防化燥
生风。方备商裁，并候荫棠兄正是。
制半夏（三钱） 陈胆星（一钱五分） 石菖蒲（五分） 枳实（一钱） 生姜汁（一分冲） 栝蒌仁（四钱）
玉金（一钱五分） 光杏仁（三钱） 煨天麻（一钱五分） 鲜枇杷叶（去毛四片） 白金丸（一钱吞服） 濂珠粉
（三分另服）
四诊 疏气之滞，泄火之郁，而开浊痰，神情清爽，迷睡较退，痰吐爽利大便续解，脘胁胀痛全定。右脉
稍觉有力，舌苔大化，皆转机之象。但火时上升，升则两颧红赤，遍身作痛，有时恶心。良由痰积虽达，而
胃土少降，阳明脉络失和，胆阳从而上逆。再降胆胃而化痰浊。
陈胆星（八分） 广皮（一钱五分） 枳实（一钱） 桑叶（一钱） 杏仁（去尖打三钱） 制半夏（三钱）
茯苓（四钱） 炒竹茹（二钱） 丹皮（二钱） 炒蒌皮（三钱） 鲜枇杷叶（四片去毛）
五诊 神情慧爽，火升较平，恶心亦止。然时带呛咳，咳则胸膺背肋牵掣作痛，头旋眩晕，目不能开，胸
中似有冷物搏聚。脉象弦滑，舌苔前半已化，根尚浓腻。还是痰邪未清，甲木少降，肝风上旋，络气阻痹。
再拟化痰熄肝宣络。
制半夏（三钱） 旋复花（二钱） 局猩绛（五分） 茯苓（三钱） 橘红络（各一钱） 白蒺藜（三钱）
煨天麻（一钱五分） 钩钩（三钱） 冬瓜子（三钱） 炒竹茹（三钱） 青葱管（寸许两茎）
六诊 遍身掣痛已定，眩晕大减，渐能安谷。惟胸中时仍窒闷，呛咳痰多。脉象弦滑。胆胃之气下降，则
风阳自平，痰气之郁渐开，则脉络自和。然肺胃之间，痰饮不能遽澈，所以咳逆痰多。再和中降气化痰。
制半夏（一钱五分） 炒苏子（三钱） 旋复花（一钱五分） 橘红（一钱） 茯苓（三钱） 煨天麻（一
钱五分） 白蒺藜（三钱鸡子黄拌炒） 砂仁（四分） 生熟谷芽（各一钱） 玫瑰花（二朵）
郭（右） 清化痰热，育阴和阳，神渐守舍，怔悸大减， 杂亦定。虚里仍然动跃。脉弦滑而软。阳明脉络空
虚，厥阳上扰未熄。前法出入。
炙黄 （三钱） 杏仁泥（三钱） 粉丹皮（一钱五分） 炒苏子（三钱） 黑山栀（三钱） 法半夏（二钱）
枳实（一钱） 茯苓（五钱） 盐水炒竹茹（一钱五分） 枇杷叶（四片）
严（右） 腹时 痛，眩晕头昏，心中跳荡，带下舌光，脉象虚弦。此液虚不能涵养，致阳气升腾不熄。拟平
肝而熄风木。
杭白芍（一钱五分酒炒） 醋炒香附（二钱） 磁石（三钱） 阿胶珠（三钱） 川楝子（一钱五分） 炒川雅
连（三分） 石决明（四钱） 朱茯苓（三钱） 潼白蒺藜（盐水炒各一钱五分）
二诊 腹痛已止，眩晕亦减。然心中时仍跳荡荡，则神觉昏糊。还是肝阳撼扰。再宁神和阳养肝。
阿胶珠（二钱） 杭白芍（一钱五分） 茯神（三钱） 龙骨（三钱） 大生地（四钱） 炒枣仁（二钱研）
生牡蛎（五钱） 块辰砂（三钱） 钩钩（后入三钱） 金器（一件悬煎）
孙（左） 忿怒抑郁，肝火风内炽。肩臂头项面颊自觉热气注射，甚则舌麻肢厥。宜化痰泄热。
制半夏（一钱五分） 白蒺藜（三钱） 栝蒌皮（三钱炒） 黑山栀（三钱） 陈胆星（五分） 广橘红（一钱）
粉丹皮（二钱） 光杏仁（三钱） 淡黄芩（一钱五分酒炒） 白茯苓（三钱）
龚（右） 热气随处攻注，经脉跳动，脘胁皮肤板滞。木旺阳升气滞。再和阴以涵肝木，兼化热痰。
阿胶珠（三钱） 牡蛎（五钱） 木瓜皮（一钱） 炒枣仁（二钱） 淮小麦（五钱） 大生地（四钱）
白芍（二钱酒炒） 炙黑草（三分） 大南枣（三枚） 糯稻根（五钱）
陈（幼） 案遗失。
陈胆星 竹沥半夏 郁金 菖蒲 竹茹 枳实 云茯苓 川石斛 礞石滚痰丸（一钱化服）
二诊 大便解出粘痰，烦扰顿然宁静，恶心口渴亦止。乃日晡又复烦渴，吮乳口中虽热，却不甚盛，涕
泪俱无，头摇不定，面有青色。舌光无苔，脉象细软。胸中之结痰稍开，而脾气胃阴并虚，肝风因而震动。
慢惊情形，仍在险境。姑养肺胃之阴，而培脾土以熄肝木。
西洋参 生于术 云茯苓 土炒白芍 钩钩 大麦冬 生甘草 川石斛 生山药 回春丹
三诊 舌燥转润，热势渐退，而四肢搐动，甚则手足拘挛，头摇反张，便泄腥酸。自夏徂冬，不时身热。童
真不足，阴分未病先虚。兹以风温外薄，痰气结聚，散邪达痰，病邪虽退，元气愈加亏损，以致真水不能
涵濡，真气不能伏制，肝风鸱张，经所谓曲直动摇，风之象也。慢惊重症，恐难图治。拟理中地黄汤大意。
台参须（一钱） 土炒白芍（三钱） 炮姜（五分） 生牡蛎（一两） 熟地炭（四钱） 炙甘杞（二钱）
大麦冬（三钱） 五味子（三分） 怀山药（三钱） 炙绵 （三钱）
四诊 补气养肝，安土熄风，便泄大减，然仍肢搐风动，涕泪俱无肝风鸱张，窍络闭阻，深入重地。勉拟
标本并治法。
台参须（五分） 生牡蛎（六钱） 炒怀药（三钱） 煨天麻（一钱五分） 天竺黄（二钱） 金石斛（三钱）
土炒白芍（一钱五分） 阿胶珠（三钱） 石菖蒲（五分） 全蝎（去毒炙二分） 牛黄清心丸（一丸分两次化服）
Wang (Right): Having a history of phlegm-fluid retention, he now presents with palpitations and restlessness, jumping movements of tendons and vessels throughout the body, coldness in the back, and gradual sweating. The pulse is wiry and slippery; the tongue is puffy with a greasy coating. This indicates insufficient Liver Yin, where damp-phlegm from the Spleen and Stomach is stirred up by hyperactive Liver Yang. The Ministerial Fire is disturbed by fluid accumulation, leading to shaking and trembling. Although there is no immediate threat to life, it will cause chronic distress for years.
Fuling Shen (Poria with Hostwood), Shichangpu (Acori Rhizoma), Zhi Banxia (Prepared Pinellia), Guang Juhong (Broadleaf Kumquat Peel), Zhenwu Wan (True Warrior Pill), Yuanzhi Rou (Polygalae Radix Flesh), Kuai Chensha (Cinnabar Block), Wei Tianma (Baked Gastrodia), Zhimi Fuling Wan (Pointing to Confusion Poria Pill).
Gao (Right): Harmonize the Yin of the Liver and Stomach, and descend Lung Qi to unblock intestinal obstruction. The Lung and Large Intestine are exterior-interior related; once the clear-descending function operates, the Fu-organ Qi naturally descends. Thus, after taking the medicine, the response was swift like a drumstick striking a drum, and stool was passed immediately. Sweet flavors nourish the Stomach; when Yang Earth is harmonized, Wind-Wood Qi cannot shake it at will. Consequently, the irritability has stabilized, body heat has cleared, and facial redness has faded. The pulse has changed from wiry and large to soft; the floating and rotten tongue coating has suddenly transformed. However, difficulty in deep sleep and easy sweating remain, indicating that Yang is not storing properly. This follows latent pathogenic factors damaging Liver and Stomach Yin, which is accurate to the finest detail. If treated according to residual pathogens and accumulated dampness, Yin would be further damaged and heat intensified, making pathogen clearance impossible, with dire consequences. Since the current prescription is effective, there is no need to change the strategy. Drafted for correction.
Jincha Shihu (Dendrobium Nobile Stem), Xian Zhuru (Fresh Bamboo Shavings), Chao Qizi (Stir-fried Lycium Fruit), Fushen (Poria with Hostwood), Huomaren (Hemp Seed), Huaixiaomai (Huai Wheat decocted as water substitute), Banxia Qu (Pinellia Fermented Curd), Digupi (Lycii Cortex), Gougou (Uncaria Rhynchophylla), Baijili (Tribulus Fruit).
Zhang (Left): External wind has resolved, but internal wind moves secretly. Mental confusion during sleep has slightly stabilized, yet sweating occurs frequently. Yang Qi fails to consolidate. Further harmonize Yin to secure Yang.
Jinshihu (Dendrobium Officinale Stem, 4 qian), Chao Zaoren (Stir-fried Ziziphus Seed, 2 qian), Muli (Oyster Shell, 4 qian), Chuan Beimu (Fritillaria Cirrhosa Bulb, 2 qian), Fushen (Poria with Hostwood, 3 qian), Digupi (Lycii Cortex, 2 qian), Sheng Gancao (Raw Licorice Root, 3 fen), Haigefen (Clam Shell Powder, 3 qian), Huaixiaomai (Huai Wheat, 5 qian), Nuodaogen (Saccharum Spontaneum Root, 4 qian).
Second Visit: Mental clarity gradually returns, sweating stops. However, limbs feel weak, thirst with desire to drink, poor appetite due to Stomach stagnation. Re-harmonize Liver and Stomach Yin.
Jinshihu (4 qian), Baijili (3 qian), Heidouyi (Black Soybean Coat, 3 qian), Fuling (Poria, 3 qian), Chiju (Chrysanthemum Morifolium, 1.5 qian), Banxia Qu (2 qian stir-fried), Ju Bai (Orange Albedo, 1 qian), Sheng Gancao (3 fen), Sheng Shu Guya (Raw and Stir-fried Barley Sprouts, 1 qian each).
Li (Left): Dizziness with cold extremities, urge to vomit without success, urge to defecate without success, occurring twice within half a month. After reversal of cold extremities subsides, dizziness and irregular sweating persist. This is due to Liver Wind rotating upward, different from seasonal epidemics. Prescribe extinguishing Liver Wind and harmonizing Yang.
Chao Zaoren, Longgu (Dragon Bone), Fushen, Baishao (White Peony Root), Digupi (stir-fried with 2 fen Guizhi), Heidouyi, Baijili, Muli, Chi Juhua (Chrysanthemum), Huaixiaomai.
Wang (Left): Burning sensation in chest and heart has subsided, sleep slightly improved, but dizziness persists. Phlegm-heat transforms into fire, rotating upward to the vertex. The pathway between Lung and Stomach is blocked by phlegm; Yang exits but Yin cannot enter, causing frequent Qi rebellion.
Guang Xingren (Apricot Seed), Qingyan Banxia (Qingyan Pinellia), Mi Zhi Juhong (Honey-fried Broadleaf Kumquat Peel), Baijili, Chuan Bei (Stir-fried Fritillaria), Haigefen, Tianma (Gastrodia), Xie Baitou (Allium Macrostemon Bulb), Gualou Ren (Trichosanthes Seed), Zexie (Alisma), Yunling (Poria).
Hu (Left): Using Longmu Jiuni Method (Dragon and Oyster Rescue Method), skin roughness significantly reduced, cold extremities and muscle twitching decreased, but palpitations, dizziness, and tinnitus persist. Yang Qi still lacks storage; complications may arise.
Baijili, Longgu, Zhu Fuling (Cinnabar-coated Poria), Douyi (Bean Coat), Gougou, Wei Tianma, Chao Zaoren, Muli, Huaixiaomai, Jinqi (Gold Artifact).
Symptoms improved with this formula, except severe dizziness and tinnitus. Greasy coating indicates turbid phlegm in Stomach; used Dansheng Baijin Wan. Sleep improved, other symptoms did not respond. Diagnosis: Shaoyang Gallbladder Fire not draining. Used Sangpi, Danpi, Zhizi, Xiakucao, Jue Ming Zi plus Cizhu Wan. Response achieved. Tinnitus persisted; added Guijia. Hearing improved, but leukorrhea increased. Diagnosis: Yang failing to ascend. Used Yanshui Chao Chaihu, Qingxiangzi, Chao Chun Gen Pi, Bibai, Baishao, Muli, Fulonggan. Condition stabilized. Considered a strange case. (Recorded by Zhengmeng)
Yang (Left): History of hyperactive Liver Yang. Recently, spirit cannot maintain itself, speech is disordered, memory loss, prone to sadness. Pulse is wiry, deficient, and large; right side has intermittent pauses. Heart and Kidney interaction is deficient; Water and Fire fail to connect. At eighty years old, treatment is risky.
Guijia Xin (Turtle Plastron Center), Shengdi Tan (Charred Rehmannia), Yuanzhi Rou (Polygalae Radix Flesh), Yanshui Chao Muli (Salt-water stir-fried Oyster Shell), Zhu Fushen (Cinnabar-coated Poria with Hostwood), Chen Maidong (Cinnabar-coated Ophiopogon), Jiejie Changpu (Nine-section Acorus), Sharen (Amomum Cardamomum), Shang Lianzhu (Top-quality Pearl), Xixuepo (Western Blood Amber - two powders taken first).
Jiang (Right): Accumulation in left abdomen since long ago. When Yang Qi begins to recover, palpitations and tinnitus occur, limbs burn hot; when Yin Qi returns, symptoms ease. Now coughing has stopped, but limbs burn hot as before, appetite not increased, limbs heavy. Pulse is deep and choppy, right Guan position only wiry. Liver Qi failed to disperse, Liver Yang rebels, Yang Qi fails to gather. Strategy: Harmonize middle, awaken Stomach, nourish Liver Yin. As Yin generates, Yang naturally grows.
Zhi Shouwu (Prepared Polygonum Multiflorum), Heidouyi, Qingxiangzi, Chuan Shihu, Zhu Fushen, Nvzhenzi (Ligustrum Fruit), Zhi Banxia, Baijili, Baishao, Zhuru (Salt-water stir-fried Bamboo Shavings), Fuxiaomai (1 liang decocted as water substitute).
Zuo (Left): Hemiplegia for three years, normal diet. Five or six days ago, sudden carbuncle on thumb, indicating excess Damp-Heat in Yangming. Previous night aversion to heat, wanting to remove covers; next morning ate bread, causing Stomach Qi stagnation. Jia Wood (Liver) Qi failed to descend, leading to Liver Wind carrying Phlegm upward, clouding clear orifices. Unconscious, mute, phlegm sound in throat, full epigastrium/abdomen, profuse head sweat with foul odor. Pulse wiry-slippery, tongue red with yellow coating, center moldy-black. Lip/mouth twitching. Phlegm-fire clouds inside, Damp-Heat steams above. Fear clouding remains unresolved, Wind-Yang shakes, leading to collapse. Tentatively prescribe clearing Phlegm-Fire and aromatic opening. Please consult.
Wuxijiao (Rhinoceros Horn - substitute with Buffalo Horn clinically, 5 fen ground mixed), Tianzhuhuang (Calamus/Taro Tuber - actually Bambusa Textilis Sap or similar, here likely referring to a specific phlegm-resolving agent, often interpreted as Calamus or similar in context, but strictly Tianzhuhuang is Hyacinth Bean), Baijili (3 qian), Fen Danpi (Moutan Bark, 2 qian), Dansheng (Arisaema with Bile, 8 fen), Gougou (3 qian), Changpu Gen (Acorus Root, 3 qian), Gualou Pi (Trichosanthes Peel, 3 qian), Zhu Banxia (Pinellia, 1.5 qian), Zhibao Dan (Treasure Treasure Pill, 1 pill dissolved in Acorus soup).
Hu (Right): Liver Wood spreads horizontally, abdominal distension. Collateral pathways obstructed, shoulder/arm pain. Disperse Liver function, nourish Liver substance, combined with nourishing blood and harmonizing collaterals.
Chuanduan Rou (Dipsacus Root), Jinlingzi (Melia Toosendan), Baiziren (Biota Seed), Sangshenzi (Mulberry Fruit), Baishao, Chuan Yujin (Curcuma), Mugufeng (Stephania Tetrandra), Jupi Luo (Tangerine Peel Network), Xiangyuan Pi (Citron Peel), Sharen, Xiangfu (Cyperus), Danggui (Angelica Sinensis).
Also take Shiguogong Medicinal Wine regularly.
Right (Right): Ying-Nutrient Yin insufficient, Liver Fire/Wind rotates upward. From headache to facial paralysis, stiff tongue, slurred speech. Pulse fine, wiry, rapid. Wind-fire steams phlegm, invading Shaoyang/Yangming collaterals. Prescribe resolving phlegm, calming Liver, clearing heat.
Dongsangye (Mulberry Leaf, 1 qian), Yuanzhi Rou (3 fen), Baijiangcan (Bombyx Batryticatus, 3 qian), Chiju (1.5 qian), Fen Danpi (1.5 qian), Heishanzhi (Gardenia, 3 qian), Shichangpu (3 fen), Wei Tianma (1.5 qian), Gougou (3 qian), Songluo Cha (Songluo Tea, 1 qian), Qingguo (Betel Nut, 3 pieces).
Wang (Left): History of Liver Yang. During recovery of Yang Qi, compounded by emotional depression, Jia Wood fails to descend, Yi Wood rises vigorously. Palpitations, insomnia, muscle twitching, limb tremors, head shaking. Pulse fine, deep-wiry and forceful, thick greasy coating. Liver Fire/Wind shakes, fluids condense into phlegm, phlegm transforms to heat, fanning Wind-Fire uncontrollably. Prescribe resolving phlegm, extinguishing wind, calming spirit, anchoring Liver.
Dansheng (6 fen), Tianma (1.5 qian), Gougou (3 qian), Douyi (4 qian), Fuling Shen (Poria & Hostwood, 2 qian each), Zhuhuang (Hyacinth Bean, 3 qian), Banxia (1.5 qian), Juhong (1 qian), Zhenzhumu (Pearl Mother-of-Pearl, 5 qian), Da Dancai (Large Mussel, 2 pieces), Jinqi (Gold artifact suspended in decoction), Tongbian (Infant Urine, half cup taken separately daily).
Second Visit: Resolved phlegm, calmed Liver, pulse/symptoms stable. Yet muscle twitching, palpitations/dizziness, insomnia persist. Wiry-slippery pulse, greasy turbid coating. Phlegm-fire/wind rotation continues. Re-prescribe resolving phlegm, calming Liver.
Zhi Banxia (2 qian), Juhong (1 qian), Fuling Shen (2 qian each), Dansheng (3 qian), Cishi (Magnetite, 3 qian), Longchi (Dragon Tooth, 3 qian), Muli (5 qian), Zhenzhumu (1 liang), Tianma (1.5 qian), Kuai Chensha (Cinnabar, 3 qian), Da Dancai (2 pieces), Ji Huang (Egg Yolk, 1 piece).
Ren (Left): Cough greatly reduced, rising fire flattened. Phlegm-fluid beads indicate Shaoyang Gallbladder Fire carrying phlegm wandering, Wood striking Metal.
Fen Danpi (2 qian), Lingyang Pian (Antelope Horn slice, 1 qian decocted first), Tusizi (Dodder Seed, 4 qian), Chuan Beimu (1 qian), Tianhuafen (Trichosanthes Root, 2 qian), Heishanzhi (3 qian), Qingge San (Green Clam Powder, 5 qian), Xingren Ni (Apricot Paste, 2 qian), Yujin (Curcuma, 1.5 qian), Sangye (Mulberry Leaf, 1 qian), Pipaye (Loquat Leaf, 3 pieces de-haired).
Certain Patient (Left): History of Liver Qi stagnation, occasional distension. Now dizziness, palpitations, rising fire, insomnia, excessive mixed phlegm. Pulse fine, deep-wiry-slippery. Qi deficiency generates phlegm, Gallbladder/Stomach fail to descend, Liver Wood rises alone. To calm Liver, descend Gallbladder; to descend Gallbladder, descend Stomach; to descend Stomach, resolve phlegm.
Zhi Banxia (1.5 qian), Tianzhuhuang (2 qian), Sangye (8 fen), Juhong (1 qian), Zhenzhumu (3 qian), Haigefen (3 qian wrapped), Heishanzhi (1.5 qian), Danpi (1.5 qian), Dansheng (4 fen), Gualou Shuang (Trichosanthes Frost, 3 qian), Zhi Xiangfu (2 qian powdered), Chenguanzhe (Marine Leech, washed/light 1 liang).
Ma (Right): Dispersed Liver, resolved phlegm, but epigastric/hypochondriac pain/distension persisted, leading to mental confusion, hand convulsions, frequent flatulence, constipation. Due to Qi stagnation not venting, turbid phlegm diffused, Spirit mechanism blocked, Gallbladder Yang reversed, Wind-Yang agitated. Risk of coma, spasm, asthma, collapse. Purging Fu-organs and washing out phlegm is urgent. Pulse wiry-slippery-choppy. Excess disease with deficiency of healthy Qi, likely fatal, but effort must be made. Recorded for consultation. (First case not recorded)
Zhi Banxia, Bo Juhong (Thin Tangerine Peel), Fuling, Baijili, Chen Dansheng (Aged Arisaema with Bile), Shichangpu, Wei Tianma, Baijiangcan, Mengshi Gun Tan Wan (Magnesia Rolling Phlegm Pill, 2 qian taken first with boiling water), Lianzhu Fen (Pearl Powder, 3 fen taken separately).
Third Visit: After medication, vomited sticky phlegm, then passed copious sticky/greasy stool, confirming downward movement of phlegm accumulation. Clouding opened, mental confusion greatly reduced, pain eased. But frequent sleepiness, body pain (worse in back). Wiry-slippery pulse, white greasy coating all over, thirst without desire to drink, still turbid phlegm diffusion. Elderly, deficiency/excess mix. Though turning point reached, unreliable. Prescribe resolving phlegm, venting Qi/Fire depression, preventing dryness generating wind.
Zhi Banxia (3 qian), Chen Dansheng (1.5 qian), Shichangpu (5 fen), Zhishi (Immature Bitter Orange, 1 qian), Shengjiang Zhi (Ginger Juice, 1 fen mixed), Gualou Ren (4 qian), Yujin (1.5 qian), Guang Xingren (3 qian), Wei Tianma (1.5 qian), Xian Pipaye (De-haired Loquat Leaf, 4 pieces), Baijin Wan (Platinum Pill, 1 qian swallowed), Lianzhu Fen (3 fen taken separately).
Fourth Visit: Ventilated Qi stagnation, cleared Fire depression, opened turbid phlegm. Spirit clear, drowsiness reduced, phlegm expectoration smooth, stool passed, pain resolved. Right pulse slightly stronger, coating largely transformed, signs of recovery. But Fire occasionally rises, causing malar flush, body pain, nausea. Phlegm moved down, but Stomach Earth fails to descend, Yangming collaterals disharmonious, Gallbladder Yang rebels. Descend Gallbladder/Stomach, resolve turbid phlegm.
Chen Dansheng (8 fen), Guangpi (Tangerine Peel, 1.5 qian), Zhishi (1 qian), Sangye (1 qian), Xingren (Apricot Seed, de-tip pounded 3 qian), Zhi Banxia (3 qian), Fuling (4 qian), Chao Zhuru (Stir-fried Bamboo Shavings, 2 qian), Danpi (2 qian), Chao Lou Pi (Stir-fried Trichosanthes Peel, 3 qian), Xian Pipaye (4 pieces de-haired).
Fifth Visit: Spirit bright, fire rise flatter, nausea stopped. Occasional choking cough, pulling pain in chest/back/ribs when coughing, dizziness, eyes unable to open, cold mass gathering in chest. Wiry-slippery pulse, anterior coating transformed, root thick greasy. Phlegm pathogen not cleared, Jia Wood fails to descend, Liver Wind rotates upward, collateral Qi obstructed. Prescribe resolving phlegm, calming Liver, unblocking collaterals.
Zhi Banxia (3 qian), Xuanfuhua (Inula Flower, 2 qian), Juxingjiang (Red Silk, 5 fen), Fuling (3 qian), Juhong Luo (Tangerine Peel Network, 1 qian each), Baijili (3 qian), Wei Tianma (1.5 qian), Gougou (3 qian), Dongguazi (Winter Melon Seed, 3 qian), Chao Zhuru (3 qian), Qingcong Guan (Green Onion Tube, 2 stems approx. cun).
Sixth Visit: Body twitching pain stabilized, dizziness greatly reduced, able to eat grains. Chest stuffiness, choking cough, excessive phlegm persist. Wiry-slippery pulse. Gallbladder/Stomach Qi descending calms Wind-Yang; Phlegm-Qi depression opening harmonizes collaterals. Phlegm-fluid in Lung/Stomach not fully cleared, hence cough/phlegm. Harmonize middle, descend Qi, resolve phlegm.
Zhi Banxia (1.5 qian), Chao Suzi (Perilla Seed, 3 qian), Xuanfuhua (1.5 qian), Juhong (1 qian), Fuling (3 qian), Wei Tianma (1.5 qian), Baijili (3 qian stir-fried with egg yolk), Sharen (4 fen), Sheng Shu Guya (Sprouts, 1 qian each), Meiguihua (Rose Bud, 2 flowers).
Guo (Right): Cleared Phlegm-Heat, nurtured Yin, harmonized Yang. Spirit settling, palpitations reduced, mixed symptoms settled. Xu Li (Heart region) still jumping. Wiry-slippery-soft pulse. Yangming collaterals empty, Jue Yang disturbing not extinguished. Modify previous method.
Zhi Huangqi (Astragalus, 3 qian), Xingren Ni (Apricot Paste, 3 qian), Fen Danpi (1.5 qian), Chao Suzi (3 qian), Heishanzhi (3 qian), Fa Banxia (Processed Pinellia, 2 qian), Zhishi (1 qian), Fuling (5 qian), Yanshui Chao Zhuru (Salt-water stir-fried Bamboo Shavings, 1.5 qian), Pipaye (4 leaves).
Yan (Right): Abdominal pain, dizziness, palpitations, leukorrhea, peeled tongue, deficient-wiry pulse. Fluid deficiency fails to nourish, Yang rises unceasingly. Calm Liver, extinguish Wind-Wood.
Hang Baishao (White Peony, 1.5 qian wine-fried), Cu Chao Xiangfu (Vinegar stir-fried Cyperus, 2 qian), Cishi (3 qian), Ejiao Zhu (Gelatin Pellet, 3 qian), Chuanlianzi (Melia Seed, 1.5 qian), Chao Chuan Yalian (Stir-fried Coptis, 3 fen), Shijueming (Haliotidis Shell, 4 qian), Zhu Fuling (3 qian), Tong/Bai Jili (Tribulus, salt-water stir-fried 1.5 qian each).
Second Visit: Abdominal pain stopped, dizziness reduced. Heart palpitations persist, mental fuzziness. Liver Yang disturbing. Calm spirit, harmonize Yang, nourish Liver.
Ejiao Zhu (2 qian), Hang Baishao (1.5 qian), Fushen (3 qian), Longgu (3 qian), Da Shengdi (Rehmannia, 4 qian), Chao Zaoren (Ziziphus Seed, 2 qian powdered), Sheng Muli (Raw Oyster Shell, 5 qian), Kuai Chensha (Cinnabar, 3 qian), Gougou (Uncaria, add later 3 qian), Jinqi (Gold artifact suspended).
Sun (Left): Anger/depression, Liver Fire/Wind blazing internally. Heat injection in shoulders/arms/head/face, severe tongue numbness/cold limbs. Resolve phlegm, clear heat.
Zhi Banxia (1.5 qian), Baijili (3 qian), Gualou Pi (Trichosanthes Peel, 3 qian stir-fried), Heishanzhi (3 qian), Chen Dansheng (5 fen), Guang Juhong (1 qian), Fen Danpi (2 qian), Guang Xingren (3 qian), Dan Huangqin (Scutellaria, 1.5 qian wine-fried), Bai Fuling (Poria, 3 qian).
Gong (Right): Heat attacking everywhere, meridians jumping, epigastric/hypochondriac skin stiffness. Wood excess, Yang rising, Qi stagnation. Harmonize Yin to nourish Liver Wood, resolve heat-phlegm.
Ejiao Zhu (3 qian), Muli (5 qian), Mugua Pi (Papaya Peel, 1 qian), Chao Zaoren (2 qian), Huaixiaomai (5 qian), Da Shengdi (4 qian), Baishao (2 qian wine-fried), Zhi Hei Cao (Charred Licorice, 3 fen), Da Nanzao (Jujube, 3 pieces), Nuodaogen (5 qian).
Chen (Child): Case lost.
Chen Dansheng, Zhuli Banxia (Bamboo Juice Pinellia), Yujin, Changpu, Zhuru, Zhishi, Yun Fuling, Chuan Shihu, Mengshi Gun Tan Wan (1 qian dissolved).
Second Visit: Sticky phlegm passed in stool, restlessness quieted, nausea/thirst stopped. Late afternoon recurrence of restlessness/thirst, mouth hot while nursing but not severe, no tears/runny nose, head shaking, greenish face. Peeled tongue no coating, fine-soft pulse. Chest phlegm slightly opened, but Spleen Qi/Stomach Yin deficient, Liver Wind shaken. Slow Convulsion condition, still dangerous. Temporarily nourish Lung/Stomach Yin, cultivate Spleen Earth to extinguish Liver Wood.
Xiyangshen (American Ginseng), Sheng Baizhu (Atractylodes), Yun Fuling, Tu Chao Baishao (Earth-stir-fried White Peony), Gougou, Da Maidong (Ophiopogon), Sheng Gancao, Chuan Shihu, Sheng Shanyao (Yam), Huichun Dan (Revival Pill).
Third Visit: Tongue dry turned moist, heat receding. Limb spasms, severe hand/foot contracture, head shaking/opisthotonos, foul diarrhea. Intermittent fever from summer to winter. Child's essence insufficient, Yin deficient before illness. Wind-Warmth external attack, Qi/Phlegm knotting. Dispersing pathogen/reaching phlegm, pathogen retreated but Yuan Qi further depleted. True Water fails to nourish, True Qi fails to control, Liver Wind rampant. Classic says: bending/straightening/shaking is image of Wind. Severe Slow Convulsion, hard to treat. Prescribe Lizhong Dihuang Tang gist.
Taishenxu (Ginseng Thread, 1 qian), Tu Chao Baishao (3 qian), Pao Jiang (Roasted Ginger, 5 fen), Sheng Muli (Raw Oyster Shell, 1 liang), Shudi Tan (Charred Rehmannia, 4 qian), Zhi Gengqi (Goji Berry, 2 qian), Da Maidong (3 qian), Wuweizi (Schisandra, 3 fen), Huai Shanyao (3 qian), Zhi Mianhuangqi (Astragalus, 3 qian).
Fourth Visit: Tonify Qi, nourish Liver, stabilize Earth, extinguish wind. Diarrhea greatly reduced, yet limb spasms/wind movement persist, no tears, Liver Wind rampant, orifices/collaterals blocked, deeply entrenched. Tentatively treat root and branch simultaneously.
Taishenxu (5 fen), Sheng Muli (6 qian), Chao Huaiyao (Stir-fried Yam, 3 qian), Wei Tianma (1.5 qian), Tianzhuhuang (2 qian), Jinshihu (3 qian), Tu Chao Baishao (1.5 qian), Ejiao Zhu (3 qian), Shichangpu (5 fen), Quanxie (Scorpion, detoxified roasted 2 fen), Niuhuang Qingxin Wan (Cow-bezoar Clear Heart Pill, 1 pill divided twice dissolved).