右 阳明脉络空虚，风阳窜络。背痛不止，偏右头痛。去年咯吐见红。亦属木火亢甚。平肝泄热勿望一蹴而几也。
粉丹皮 黑山栀 白蒺藜 甘菊花 炒香玉竹 细子芩 乌贼骨 当归炭 地榆炭
右 脘痛已止，腰背不舒。
旋复花汤加 橘皮络 郁金 丝瓜络 香附 炒枳壳
白蒺藜 缩砂仁 土炒白芍 川断肉 浓杜仲
二诊 腰背作痛。其为痰湿热入络，确然可见。
制半夏 赤白苓 炒枳实 川萆 建泽泻 上广皮 生熟薏仁 水炒竹茹 酒炒桑枝 丝瓜络
胡（左） 背脊作痛，牵引腰膂不舒，不时寒热。此肝肾不足，络隧失和。
川桂枝 炙绵 生于术 酒炒桑枝 左秦艽 木防己 全当归 泽泻
孔（左） 背 牵掣不舒，不时眩晕。脉象细弦，舌红苔白而渴。阳明络虚，风阳上僭。宜通补阳明，参以熄肝。
炙绵 （二钱） 酒炒当归（一钱五分） 白蒺藜（三钱） 滁菊花（一钱五分） 石决明（四钱） 川石斛
（四钱） 生甘草（五分） 酒炒女贞子（三钱） 钩钩（三钱） 黑豆衣（三钱）
王（左） 膺肋作痛已止，然肩臂又复痛楚。络隧尚未宣和。再拟宣通，参以和络。
川桂枝 秦艽 旋复花 桑寄生 酒炒桑枝 川萆 独活 真猩绛 丝瓜络 青葱管
恽（左） 肝气偏旺，湿痰复盛，以致肝气挟痰入络，左肩臂酸痛。脉象弦滑。宜化痰以宣络隧。
制半夏（二钱） 川桂枝（三分） 白僵蚕（一钱五分） 左秦艽（一钱五分） 白蒺藜（三钱） 橘红络（
各一钱） 茯苓（三钱） 酒炒木防己（一钱五分） 指迷茯苓丸（五钱分二次服）
二诊 宣通络隧，搜逐湿痰，浊气下行，大便畅解，右肩臂酸痛大退。脉弦稍柔。药既应手，宜再扩充。
炒于术（二钱） 海风藤（三钱） 白茯苓（三钱） 川独活（一钱） 秦艽（一钱五分） 橘红络（各一钱）
制半夏（一钱五分） 木防己（一钱五分） 白僵蚕（一钱五分） 片姜黄（四分酒炒） 指迷茯苓丸（五钱分二次服）
三诊 肩臂作痛渐定，而湿痰不能悉化，肺气为痰所阻，行动气觉短促。脉象沉弦。痰饮内盛，不流于
彼，即聚于此，其病虽殊，其源则一。
制半夏（一钱五分） 川桂枝（五分） 煨石膏（二钱） 炒于潜术（一钱五分） 广橘红（一钱） 白茯苓（
三钱） 甜葶苈（四分） 淡干姜（四分） 桑寄生（三钱） 指迷茯苓丸（三钱先服）
四诊 辛温寒以开饮降肺，肺肾之气，已得交通，肩臂作痛亦觉稍退。然肌肉有时跳动，内经谓风胜
则动。河间谓曲直动摇，风之象也。丹溪谓治风先治血，血行风自灭。血本流行，所以不行者，痰阻之也。
故治风必当治血，治血仍当化痰。
制半夏（二钱） 广橘红（一钱） 桑寄生（三钱） 白茯苓（三钱） 炒于术（二钱） 白僵蚕（一钱五分）
左秦艽（一钱五分） 川桂枝（三分） 酒炒桑枝（四钱） 指迷茯苓丸（三钱先服）
程（左） 摄纳其下，行动仍然气逆痰多，左肩臂痛。肾水空虚于下，肾阴不收，痰气凭凌于上，流窜经络。
摄下之中，参以化痰。
制半夏 归身 茯苓 淮牛膝 都气丸 大生地 橘红 苏子 车前子
二诊 肾脏封固失职，冬令收藏，气不收摄，遂至痰饮凭凌于上，肾气不收于下，络隧为痰所阻，肩臂
为之作痛。再标本并顾。
制半夏（一钱五分） 苏子（三钱） 海蛤粉（三钱） 盐水炒车前子（三钱） 橘红（一钱）
茯苓（三钱） 猩绛（五分） 盐水炒牛膝（三钱） 旋复花（三钱） 青葱管（三茎） 都气丸（四钱分二次服）
三诊 气逆咳嗽，尚属和平，左肩臂作痛未止。下虚上实，痰饮流入络中。仍标本并治。
竹沥半夏（一钱五分） 白茯苓（三钱） 紫蛤壳（五钱） 炒萸肉（一钱五分） 盐水炒橘红（一钱）
炒苏子（三钱） 酒炒牛膝（三钱） 巴戟肉（三钱） 盐水炒车前子（二钱） 都气丸（三钱空
心服） 指迷茯苓丸（三钱下午服）
四诊 向有肠红，此次兼肛门热痛。历投和阴泄热，肠红肛痛虽止，而天气骤寒，封藏不固，气不收藏，
咳嗽气喘复发。肾阴不足于下，而痰气则有余于上，左肩臂作痛。上实下虚。宜虚实兼顾。
奎党参（三两） 制半夏（一两） 炙生地（十两） 酒炒桑寄生（一两五钱） 于术（二两炒）
紫蛤壳（五两） 炙甘草（四钱） 牛膝（盐水炒三两） 白茯苓（二两） 浓杜仲（三两） 萸肉（三两炒）
全当归（酒炒一两） 制首乌（四两） 甘杞子（三两） 川贝母（一两） 东白芍（酒炒二两） 生山药（三两）
苏子（二两炒） 海风藤（二两） 丝瓜络（酒炒七钱） 车前子（盐水炒二两） 橘红（八钱） 杏仁泥（一两
五钱） 玉竹（一两五钱） 缩砂仁（七钱另煎汤收膏时冲入）
加阿胶三两，龟板胶二两，鹿角胶二两，收膏。
[Right side] The meridians of the Yangming channel are deficient and empty, allowing Wind-Yang to invade the collaterals. The back pain persists, accompanied by headache on the right side. Last year, there was hemoptysis (coughing up blood). This also belongs to excessive Wood-Fire hyperactivity. Calming the Liver and draining heat cannot be expected to yield immediate results.
Radix Paeoniae Rubra (Fen Dan Pi), Fructus Gardeniae Jasminoidis (Hei Shan Zhi), Semen Tribuli (Bai Ji Li), Flos Chrysanthemi Indici (Gan Ju Hua), Rhizoma Polygonati Odorati (Chao Xiang Yu Zhu), Radix Scutellariae (Xi Zi Qin), Endoconcha Sepiae (Wu Mei Gu), Radix Angelicae Sinensis Carbonized (Dang Gui Tan), Herba Sanguisorbae (Di Yu Tan)
[Right side] Epigastric pain has ceased, but the lower back feels uncomfortable.
Xuan Fu Dai Zhe Tang (Inula and Hematite Decoction) plus Pericarpium Citri Reticulatae Viride (Ju Pi Luo), Radix Curcumae Longae (Yu Jin), Fructus Luffae (Si Gua Luo), Rhizoma Cyperi (Xiang Fu), Fructus Aurantii Immaturus (Chao Zhi Ke)
Semen Tribuli (Bai Ji Li), Fructus Amomi Rotundus (Suo Sha Ren), Radix Paeoniae Alba Earth-fried (Tu Chao Bai Shao), Cortex Eucommiae Ulmoidis (Chuan Duan Rou), Cortex Eucommiae Ulmoidis Nong (Nong Du Zhong)
Second visit: Lower back pain. It is evident that Phlegm-Damp-Heat has invaded the collaterals.
Rhizoma Pinelliae Preparatum (Zhi Ban Xia), Radix et Rhizoma Paeoniae Alba et Rubra (Chi Bai Ling), Fructus Aurantii Immaturus (Chao Zhi Shi), Rhizoma Dioscoreae Hypoglaucae (Chuan Bi), Rhizoma Alismatis (Jian Ze Xie), Pericarpium Citri Reticulatae (Shang Guang Pi), Semen Coicis (Sheng Shu Yi Yi Ren), Caulis Bambusae in Taenia Water-fried (Shui Chao Zhu Ru), Ramulus Mori Wine-fried (Jiu Chao Sang Zhi), Fructus Luffae (Si Gua Luo)
Mr. Hu (Left side): Spinal pain radiating to the waist and spine causing discomfort, with intermittent chills and fever. This is due to deficiency of the Liver and Kidney, and disharmony of the collaterals.
Cortex Cinnamomi (Chuan Gui Zhi), Herba Epimedii (Zhi Mian), Rhizoma Atractylodis Macrocephalae (Sheng Yu Zhu), Ramulus Mori Wine-fried (Jiu Chao Sang Zhi), Radix Gentianae Macrophyllae (Zuo Qin Jiao), Radix Et Rhizoma Ephedrae (Mu Fang Ji), Radix Angelicae Sinensis (Quan Dang Gui), Rhizoma Alismatis (Ze Xie)
Mr. Kong (Left side): Back pulling sensation causing discomfort, with intermittent dizziness. The pulse is fine and wiry; the tongue is red with white coating and thirst. The Yangming collaterals are deficient, and Wind-Yang is usurping upwards. It is appropriate to tonify and unblock the Yangming, while extinguishing Liver wind.
Herba Epimedii (Zhi Mian) (2 qian), Radix Angelicae Sinensis Wine-fried (Jiu Chao Dang Gui) (1.5 qian), Semen Tribuli (Bai Ji Li) (3 qian), Flos Chrysanthemi Morifolii (Chu Ju Hua) (1.5 qian), Concha Arcae (Shi Jue Ming) (4 qian), Radix Dendrobii (Chuan Shi Hu)
(4 qian), Radix Glycyrrhizae uralensis (Sheng Gan Cao) (0.5 qian), Fructus Ligustri Lucidi Wine-fried (Jiu Chao Nu Zhen Zi) (3 qian), Uncaria rhynchophylla (Gou Gou) (3 qian), Testa Phaseoli Vulgaris (Hei Dou Yi) (3 qian)
Mr. Wang (Left side): Chest and hypochondriac pain has ceased, but shoulder and arm pain has recurred. The collaterals have not yet been unblocked and harmonized. Again, propose unblocking methods, combined with harmonizing the collaterals.
Cortex Cinnamomi (Chuan Gui Zhi), Radix Gentianae Macrophyllae (Qin Jiao), Flos Inulae (Xuan Fu Hua), Ramulus Taxilli (Sang Ji Sheng), Ramulus Mori Wine-fried (Jiu Chao Sang Zhi), Rhizoma Dioscoreae Hypoglaucae (Chuan Bi), Radix Angelicae Pubescentis (Du Huo), Corallium Rubrum (Zhen Xing Jiang), Fructus Luffae (Si Gua Luo), Caulis Allii Fistulosi (Qing Cong Guan)
Mr. Yun (Left side): Liver Qi is excessively vigorous, and Damp-Phlegm is abundant again, causing Liver Qi to carry Phlegm into the collaterals, resulting in soreness and pain in the left shoulder and arm. The pulse is wiry and slippery. It is appropriate to resolve Phlegm to unblock the collaterals.
Rhizoma Pinelliae Preparatum (Zhi Ban Xia) (2 qian), Cortex Cinnamomi (Chuan Gui Zhi) (3 fen), Sarcotheca Botryospermatis (Bai Jiang Can) (1.5 qian), Radix Gentianae Macrophyllae (Zuo Qin Jiao) (1.5 qian), Semen Tribuli (Bai Ji Li) (3 qian), Pericarpium Citri Reticulatae Viride (Ju Hong Luo) (each 1 qian), Poria (Fu Ling) (3 qian), Radix Et Rhizoma Ephedrae Wine-fried (Jiu Chao Mu Fang Ji) (1.5 qian), Zhi Mi Fu Ling Wan (Poria Pill for Confusing Phlegm) (5 qian, taken in two doses)
Second visit: Unblocking the collaterals, searching out and expelling Damp-Phlegm, turbid Qi descends, bowel movement is smooth, and soreness and pain in the right shoulder and arm have significantly subsided. The pulse is slightly softer. Since the medicine is effective, it is appropriate to expand the prescription further.
Rhizoma Atractylodis Macrocephalae (Chao Yu Zhu) (2 qian), Caulis Sinomenii (Hai Feng Teng) (3 qian), Poria (Bai Fu Ling) (3 qian), Radix Angelicae Pubescentis (Chuan Du Huo) (1 qian), Radix Gentianae Macrophyllae (Qin Jiao) (1.5 qian), Pericarpium Citri Reticulatae Viride (Ju Hong Luo) (each 1 qian)
Rhizoma Pinelliae Preparatum (Zhi Ban Xia) (1.5 qian), Radix Et Rhizoma Ephedrae (Mu Fang Ji) (1.5 qian), Sarcotheca Botryospermatis (Bai Jiang Can) (1.5 qian), Rhizoma Curcumae Longae Pian (Pian Jiang Huang) (4 fen, wine-fried), Zhi Mi Fu Ling Wan (Poria Pill for Confusing Phlegm) (5 qian, taken in two doses)
Third visit: Shoulder and arm pain is gradually stabilizing, but Damp-Phlegm cannot be completely resolved. Lung Qi is obstructed by Phlegm, causing shortness of breath upon movement. The pulse is deep and wiry. Internal accumulation of Phlegm-Fluids, flowing here or gathering there; although the manifestations differ, the root source is one.
Rhizoma Pinelliae Preparatum (Zhi Ban Xia) (1.5 qian), Cortex Cinnamomi (Chuan Gui Zhi) (5 fen), Gypsum Fibrosum Calcined (Wei Shi Gao) (2 qian), Rhizoma Atractylodis Macrocephalae (Chao Yu Qian Zhu) (1.5 qian), Pericarpium Citri Reticulatae (Guang Ju Hong) (1 qian), Poria (Bai Fu Ling) (3 qian), Fructus Lepidii (Tian Ting Li) (4 fen), Radix Zingiberis Recens (Dan Gan Jiang) (4 fen), Ramulus Taxilli (Sang Ji Sheng) (3 qian), Zhi Mi Fu Ling Wan (Poria Pill for Confusing Phlegm) (3 qian, taken first)
Fourth visit: Using acrid-warm and cold-cooling herbs to open fluid retention and descend Lung Qi, the Qi of the Lung and Kidney has achieved communication, and shoulder and arm pain has slightly receded. However, muscles sometimes twitch. The *Neijing* states "Excess Wind causes movement." Hejian (Liu Wansu) stated "Twisting and shaking are images of Wind." Danxi (Zhu Zhenheng) stated "To treat Wind, first treat Blood; when Blood flows, Wind extinguishes itself." Blood naturally circulates; the reason it does not flow is obstruction by Phlegm. Therefore, treating Wind requires treating Blood, and treating Blood still requires resolving Phlegm.
Rhizoma Pinelliae Preparatum (Zhi Ban Xia) (2 qian), Pericarpium Citri Reticulatae (Guang Ju Hong) (1 qian), Ramulus Taxilli (Sang Ji Sheng) (3 qian), Poria (Bai Fu Ling) (3 qian), Rhizoma Atractylodis Macrocephalae (Chao Yu Zhu) (2 qian), Sarcotheca Botryospermatis (Bai Jiang Can) (1.5 qian)
Radix Gentianae Macrophyllae (Zuo Qin Jiao) (1.5 qian), Cortex Cinnamomi (Chuan Gui Zhi) (3 fen), Ramulus Mori Wine-fried (Jiu Chao Sang Zhi) (4 qian), Zhi Mi Fu Ling Wan (Poria Pill for Confusing Phlegm) (3 qian, taken first)
Mr. Cheng (Left side): Grasping and securing the lower jiao, yet movement still causes rebellious Qi, excessive Phlegm, and left shoulder-arm pain. Kidney Water is deficient in the lower jiao, Kidney Yin fails to secure, Phlegm-Qi rebels upwards, and flows into the collaterals. While securing the lower, combine with resolving Phlegm.
Rhizoma Pinelliae Preparatum (Zhi Ban Xia), Radix Angelicae Sinensis (Gui Shen), Poria (Fu Ling), Radix Achyranthis Bidentatae (Huai Niu Xi), Du Qi Wan (Duqi Pill), Radix Rehmanniae Glutinosa (Da Sheng Di), Pericarpium Citri Reticulatae (Ju Hong), Fructus Viticis Negundo (Su Zi), Semen Plantaginis (Che Qian Zi)
Second visit: Failure of the Kidney to seal and store properly; during winter storage, Qi fails to secure, leading to Phlegm-Fluids rebelling upwards, Kidney Qi failing to secure downwards, collaterals obstructed by Phlegm, causing shoulder-arm pain. Attend to both root and branch.
Rhizoma Pinelliae Preparatum (Zhi Ban Xia) (1.5 qian), Fructus Viticis Negundo (Su Zi) (3 qian), Concha Meretricis et Cyclinae (Hai Ge Fen), Semen Plantaginis Salt-fried (Yan Shui Chao Che Qian Zi) (3 qian), Pericarpium Citri Reticulatae (Ju Hong) (1 qian)
Poria (Fu Ling) (3 qian), Corallium Rubrum (Xing Jiang) (5 fen), Radix Achyranthis Bidentatae Salt-fried (Yan Shui Chao Niu Xi) (3 qian), Flos Inulae (Xuan Fu Hua) (3 qian), Caulis Allii Fistulosi (Qing Cong Guan) (3 stems), Du Qi Wan (Duqi Pill) (4 qian, taken in two doses)
Third visit: Rebellious Qi and cough are relatively peaceful, but left shoulder-arm pain persists. Deficiency below and excess above, Phlegm-Fluids flowing into the collaterals. Continue treating both root and branch.
Rhizoma Pinelliae Preparatum with Bamboo Sap (Zhu Li Ban Xia) (1.5 qian), Poria (Bai Fu Ling) (3 qian), Concha Tridacnidae (Zi Ge Ke), Fructus Corni Officinalis (Chao Yu Rou) (1.5 qian), Pericarpium Citri Reticulatae Salt-fried (Yan Shui Chao Ju Hong) (1 qian)
Fructus Viticis Negundo (Chao Su Zi) (3 qian), Radix Achyranthis Bidentatae Wine-fried (Jiu Chao Niu Xi) (3 qian), Radix Morindae Officinalis (Ba Ji Rou) (3 qian), Semen Plantaginis Salt-fried (Yan Shui Chao Che Qian Zi) (2 qian), Du Qi Wan (Duqi Pill) (3 qian, taken on an empty stomach), Zhi Mi Fu Ling Wan (Poria Pill for Confusing Phlegm) (3 qian, taken in the afternoon)
Fourth visit: Previously suffered from rectal bleeding (Chang Hong); this time accompanied by hot and painful anus. After repeated administration of Yin-nourishing and heat-draining formulas, rectal bleeding and anal pain stopped, but due to sudden cold weather, sealing and storing failed, Qi did not gather, and cough and asthma recurred. Kidney Yin is deficient below, while Phlegm-Qi is excessive above, causing left shoulder-arm pain. Excess above and deficiency below. Balance deficiency and excess.
Codonopsis Pilosula (Kui Dang Shen) (3 liang), Rhizoma Pinelliae Preparatum (Zhi Ban Xia) (1 liang), Radix Rehmanniae Glutinosa Honey-fried (Zhi Sheng Di) (10 liang), Ramulus Taxilli Wine-fried (Jiu Chao Sang Ji Sheng) (1.5 liang), Rhizoma Atractylodis Macrocephalae (Yu Zhu) (2 liang, fried)
Concha Tridacnidae (Zi Ge Ke) (5 liang), Radix Glycyrrhizae uralensis Honey-fried (Zhi Gan Cao) (4 qian), Radix Achyranthis Bidentatae Salt-fried (Yan Shui Chao Niu Xi) (3 liang), Poria (Bai Fu Ling) (2 liang), Cortex Eucommiae Ulmoidis Nong (Nong Du Zhong) (3 liang), Fructus Corni Officinalis (Yu Rou) (3 liang, fried)
Radix Angelicae Sinensis (Quan Dang Gui) (1 liang, wine-fried), Radix Polygoni Multiflori Preparated (Zhi Shou Wu), Fructus Lycii Chinensis (Gan Qi Zi) (3 liang), Bulbus fritillariae Cirrhosae (Chuan Bei Mu) (1 liang), Radix Paeoniae Alba (Dong Bai Shao) (2 liang, wine-fried), Rhizoma Dioscoreae Oppositae (Sheng Shan Yao) (3 liang)
Fructus Viticis Negundo (Su Zi) (2 liang, fried), Caulis Sinomenii (Hai Feng Teng) (2 liang), Fructus Luffae (Si Gua Luo) (7 qian, wine-fried), Semen Plantaginis (Che Qian Zi) (2 liang, salt-fried), Pericarpium Citri Reticulatae (Ju Hong) (8 qian), Semen Pruni Armeniacae Paste (Xing Ren Ni) (1.5 liang), Rhizoma Polygonati Odorati (Yu Zhu) (1.5 liang), Fructus Amomi Rotundus (Suo Sha Ren) (7 qian, decocted separately and added to the paste when collected)
Add Colla Corii Asini (E Jiao) 3 liang, Colla Testudinis et Carapax Pelletae (Gui Ban Jiao) 2 liang, Collum Cervi (Lu Jiao Jiao) 2 liang, to collect the paste.