某（左）便解带溏，湿热虽得外泄，然遍体作痛，至暮发热。是痰湿内郁，络隧不宣，肿病之先声也。
独活 威灵仙 秦艽 丹皮 炒白薇 防己 桑寄生 萆 泽泻 生薏仁
孙（右） 体丰多湿，湿郁经络，体时酸痛。湿土化风，头作眩晕。拟祛湿和络。
白蒺藜 木猪苓 广皮 独活 制半夏 生薏仁 左秦艽 通草 白术 桑白皮 建泽泻 川萆
某（右） 身半以上，痛虽渐减，身半以下，痛未蠲除，肌肤赤疹，时起时伏。风湿留恋不解。前法再进一步。
苍术（一钱） 秦艽（一钱五分） 酒炒当归（二钱） 酒炒稀 草（三钱） 萆 （二钱）
独活（一钱） 汉防己（三钱） 粉丹皮（二钱） 海桐皮（四钱） 赤白苓（各二钱）
某（左） 节骱虽仍作痛，咯吐之痰，较前稍多，痰湿有泄越之机。
独活 威灵仙 秦艽 制半夏 指迷茯苓丸 广皮 桑寄生 萆 白僵蚕 云茯苓
（附吞酸 吐蛔）
陶（左） 胃有停饮，不时呕吐。水为阴类，非阳气旋运，不能消化。拟半夏茯苓汤苓桂术甘汤两方出入。
制半夏（三钱） 上广皮（一钱） 川桂枝（四分） 公丁香（三分） 广藿香（三钱） 淡
干姜（四分） 白蔻仁（七分后入） 白茯苓（五钱）
右 身热气冲呕吐。木不条达也。
冬桑叶 粉丹皮 金铃子 制半夏 生薏仁 新会红 制香附 赤白苓 白蔻仁 砂仁
沈（右） 脾虚木旺，木侮胃土。中脘作痛，甚则呕吐，大便时泻时止。脉左关弦。木郁土中，久恐延膈。
上徭桂（四分饭丸先服） 缩砂仁 茯苓 白蒺藜 枳壳 上广皮 制半夏 煨天麻 香橼皮
左 和胃中阴阳，呕吐仍来。苔灰舌白。从苦辛进退之。
制半夏（一钱五分） 川桂枝（四分） 炙黑草（二分） 人参须（七分） 枳实（八分） 淡干姜（五分）
川雅连（五分） 白茯苓（三钱） 生姜汁（一匙）
左 镇逆平肝，诸恙暂退。而日来气复上冲，甚则呃忒，间有呕吐。风木上干。再壮水以涵风木。
熟地（四钱炒松） 牡蛎（五钱） 土炒白芍（一钱五分） 茯神（三钱） 橘白（一钱） 大麦冬（三钱）
磁石（三钱） 半夏曲（一钱五分盐水炒） 白蒺藜（三钱）
陈（左） 食入辄作呕吐。脉两关俱弦。肝阳冲侮胃土，久恐成膈。拟苦辛通降法。
制半夏（一钱五分） 淡干姜（三分） 茯苓（三钱） 土炒白芍（一钱五分） 川雅连（五分） 代赭石（三钱）
橘红（一钱） 旋复花（一钱五分绢包） 枳实（一钱） 炒竹茹（一钱五分）
二诊 脉弦稍平，呕吐略减。的属肝阳逆犯胃土。再和中镇逆，苦降辛开。
制半夏（一钱五分） 白蒺藜（去刺炒三钱） 代赭石（四钱） 土炒白芍（一钱五分） 沉香曲（一钱五分炒）
旋复花（二钱包） 淡吴萸（一分五厘） 川雅连（五分同吴萸炒） 炒竹茹（一钱五分）
三诊 呕吐虽减，仍未能止。木克胃土，以致清浊混淆。不入虎穴，焉得虎子。
制香附（一钱五分） 枳实（一钱） 炒香甜杏仁（三钱） 沉香曲（一钱五分炒） 炒竹茹（二钱）
橘皮（一钱） 白蒺藜（三钱） 来复丹（八分开水另下）
四诊 大便通调，三日未经呕吐。胃中之清浊，渐得分化。药既应手，再守前意。
川雅连（五分） 炙黑草（二分） 广皮（一钱） 淡干姜（四分） 制半夏（一钱五分） 川桂枝（四分）
白茯苓（三钱） 枳实（一钱） 炒竹茹（一钱） 来复丹（六分先服）
五诊 苦降辛开，分化清浊，胃中之阴阳渐和，呕吐渐定。药既应手，未便更章，但猛剂不宜久投耳。
制半夏（一钱五分） 炙黑草（四分） 川雅连（四分） 枳实（七分） 川桂枝（四分） 白茯苓（三钱）
淡干姜（三分） 竹茹（一钱水炒） 白芍（一钱五分土炒） 来复丹（六分先服）
另拟一方备服。
制半夏（一钱五分） 川雅连（四分） 炙甘草（三分） 茯苓（三钱） 橘皮（一钱） 杭白芍（一钱五
分） 淡干姜（四分） 吉林参（另煎冲七分） 焦麦芽（二钱）
右 呕吐大减，涌涎亦定。的是高年五液皆涸，三阳并结也。前方踵进。
南沙参 川贝母 生扁豆 藕汁 活水芦根 川石斛 天花粉 甜杏仁 梨汁
二诊 交节又复呕吐。三阳并结，既入重地，不易履夷也。
川石斛 白蒺藜 北沙参 半夏曲 单桃仁 扁豆衣 梨汁 藕汁 姜
汁韭汁 牛乳 盐水炒竹茹
右 浮游之火渐平，而食入辄作反逆。此胆胃不主下降，肝阳从而浊升。再降胆胃。
制半夏 炒枳实 甜杏仁 白蒺藜 陈胆星 茯苓神 上广皮 竹茹 山
栀（姜汁炒） 陈关蛰 大荸荠
左 中阳不足，阳气不旋。呕吐复作。再辛温以助阳气，而运浊邪。
制半夏（三钱） 橘皮（一钱） 鲜生姜（二钱打） 川桂枝（四分） 淡吴萸（四分） 茯苓（
四钱） 炒于术（一钱五分） 炒枳实（一钱） 竹茹（一钱五分） 伏龙肝（八钱煎汤代水）
二诊 攻下之后，中阳不复，痰水渐次复聚。间数日仍作呕吐。只宜缓以图之。
于术炭（二钱） 茯苓（五钱） 竹茹（一钱） 制半夏（一钱五分） 橘皮（一钱） 淡吴萸（四分）
猪苓（二钱） 盐煨姜（二钱） 来复丹（一钱药汤送下）
左 中脘作痛，甚则呕吐。脉象沉弦。此水饮停聚胃府。当缓以攻之。
二陈去甘草 制香附 延胡索 白蒺藜 高良姜 瓦楞子（醋炒）
红芽大戟（八分） 白蔻仁（一钱三分） 公丁香（一钱） 黑白丑（各一钱五味研末为丸）
右 体丰多湿，湿盛生痰，痰阻胃府，中州窒痹。呕吐痰涎。宜苦辛通降。
川雅连（姜汁炒三分） 制半夏（三钱） 淡干姜（六分） 云茯苓（五钱） 广陈皮（一钱） 薤白头（三钱）
炒枳实（一钱） 竹二青（一钱生姜汁炒） 上湘军（四分） 公丁香（三分） 黑白丑（各二分）
白蔻仁（四分五味研末分二次服）
二诊 呕吐不止，中脘板滞。脉象沉弦。还是痰阻胃府，不能通降。再拟苦辛开降，参以芳香化浊。
川朴（一钱） 川雅连（四分） 炒竹茹（一钱） 白蔻仁（七分） 茯苓（五钱） 橘皮（一钱）
制半夏（三钱） 淡干姜（五分） 生姜汁（一匙） 太乙丹（三分磨冲）
左 胃有停痰，胃阳不展。至暮辄作呕吐。脉象沉弦。恐延反胃之证。
制半夏 淡吴萸 白蔻仁 云茯苓 猪苓 广陈皮 鲜生姜（二钱打） 太乙丹（三分磨冲） 伏龙肝（煎代水）
缪（左） 呕吐止而复作。胸中之阳气不克转旋。再进辛温。
川桂枝（五分） 制半夏（三钱醋炒） 茯苓（七钱） 白蔻仁（七分） 公丁香（三分） 广藿香（三钱）
淡干姜（五分炒） 橘皮（一钱） 猪苓（二钱） 伏龙肝（一两煎代水）
缪（左） 呕吐时作时止。舌苔薄白，并不浓腻。大便数日方行。脾得阳始运，胃得阴乃和，高年液亏胃阴
不足，所以宜通宜降者，转滞而转逆矣。
人参须（一钱五分） 白茯苓（三钱） 炒香甜杏仁（三钱） 白檀香（一钱） 制半夏（一钱五分）
白蒺藜（三钱） 竹二青（盐水炒五分） 白蜜（二钱）
右 食入片刻，即吐出酸水，面现青色。询系失恃后悲苦所致。肝火郁极，故作酸也。
桑叶 丹皮 郁金 制香附 山栀（姜汁炒） 左金丸
张（左） 脉证相安。至暮腹满，酸水上涌。营滞不行，土郁湿困。不能急切图功。
制半夏 白蒺藜 台白术 公丁香 茯苓皮 广皮 淡吴萸 晚蚕砂 炒蒌皮 建泽泻 禹余粮丸（
一钱五分开水先服）
吴（媪） 风阳较平，眩晕大减，而余威未靖，吞酸涌涎，时止而仍时作。再养肝熄肝，参苦辛以制心火，而
佐金气以平肝木。
阿胶珠 杭白芍 黑豆衣 池菊 茯神 炒杞子
女贞子 潼沙苑 左金丸
李（左） 经云、心为汗肺为涕，脾为涎，肝为泪肾为唾，是为五液。今起居如常，而时吐涎沫，胃
纳不旺。显属脾胃两虚，不能约束津液，以丸药缓调。
炙绵 （三两） 炙黑草（五钱） 缩砂仁（四钱） 煨益智（七钱） 广陈皮（七钱） 奎党参（四两）
浓杜仲（三两） 炒于术（二两） 炒山药（三两） 炒杞子（三两） 制半夏（一两五钱） 炒淡姜渣（四钱）
炒范志曲（一两） 广藿梗（一两五钱） 泽泻（一两五钱） 白茯苓（三两） 焦麦芽（二两） 炒扁
豆（二两） 炒萸肉（一两五钱）
上药研为细末水泛为丸每服三钱。
姚（右） 头痛眩晕，甚则呕吐涎水，腰胁酸楚。脉濡左滑。此肝阳挟痰上冲胃土也。
制半夏 天麻 甘菊 白蒺藜 丹皮 钩钩 广皮 炒枣仁 茯苓神 石决明 水炒竹茹
虞（右） 头痛较退，而呕吐之后，涎沫上涌，长沙所谓肝病吐涎沫者是也。风翔浪涌，都缘肝阳上升，胃
土被克，致胃中不能约束津液。再和肝胃。
金石斛 杞子 代赭石 白蒺藜 炒半夏曲 茯苓 钩钩 桑叶 丹皮 盐水炒竹茹
涎清因肝阳者用代赭，与胃寒涌涎者异。若肝气呕吐，又必痛也。（清儒附志）
某 口吐涎沫，胃气虚不能约束津液也。吐沫而仍口渴，胃阴虚而求救于水也。舌萎苔黄，胃气不治
而虚浊反行攒聚也。气阴益亏，又复夹浊，用药顾此失彼，且恐动辄得咎，惟仲景大半夏汤取人参以
补胃气，白蜜以和胃阴，半夏以通胃阳，试进之以觇动静。
人参（一钱） 白蜜（五钱） 半夏（三钱）
廉（左） 呕吐数日，至昨忽然偏右胀满，上则中脘，下则少腹，尽行板硬，一时之间，气从上逆。幸未几即
平。然食入仍呕，并吐出蛔虫，口渴频饮。舌苔糙白，脉象虚弦。肝木横逆之余，胃土有升无降，阳明之液
暗亏。恐呃忒致厥。
川连（五分） 炒乌梅（五分） 炒川椒（二分） 金石斛（五钱） 金铃子（一钱五分） 吴萸（二分）
杭白芍（二钱酒炒） 制半夏（三钱） 白蒺藜（三钱） 红石榴子（百粒） 枇杷叶（二片去毛） 鲜竹茹（盐
水炒一钱）
Patient (Left pulse): Stool is loose and watery. Although damp-heat has been discharged externally via the lower jiao, pain pervades the whole body, with fever occurring in the evening. This indicates phlegm-dampness stagnating internally and collaterals being obstructed, which is a precursor to edema.
Prescription: Du Huo, Wei Ling Xian, Qin Jiao, Dan Pi, Chao Bai Wei, Fang Ji, Sang Ji Sheng, Bi Xie, Ze Xie, Sheng Yi Ren.
Patient Sun (Right pulse): The constitution is obese and prone to dampness. Dampness stagnates in the meridians, causing occasional body soreness and pain. Damp-earth transforms into wind, leading to dizziness. The proposed treatment is to dispel dampness and harmonize the collaterals.
Prescription: Bai Ji Li, Mu Zhu Ling, Guang Pi, Du Huo, Zhi Ban Xia, Sheng Yi Ren, Zuo Qin Jiao, Tong Cao, Bai Zhu, Sang Bai Pi, Jian Ze Xie, Chuan Bi Xie.
Patient (Right pulse): Pain in the upper half of the body has gradually decreased, but pain in the lower half remains unrelieved. Red rashes appear on the skin, rising and subsiding intermittently. Wind-dampness lingers unresolved. The previous method should be advanced further.
Prescription: Cang Zhu (1 qian), Qin Jiao (1.5 qian), Jiu Chao Dang Gui (2 qian), Jiu Chao Xi Xian Cao (3 qian), Bi Xie (2 qian), Du Huo (1 qian), Han Fang Ji (3 qian), Fen Dan Pi (2 qian), Hai Tong Pi (4 qian), Chi Fu Ling & Bai Fu Ling (2 qian each).
Patient (Left pulse): Joint pain persists, but the amount of sputum coughed up has increased slightly compared to before, indicating a tendency for phlegm-dampness to vent outward.
Prescription: Du Huo, Wei Ling Xian, Qin Jiao, Zhi Ban Xia, Zhi Mi Fu Ling Wan, Guang Pi, Sang Ji Sheng, Bi Xie, Bai Jiang Can, Yun Fu Ling.
(Attached: Acid Regurgitation and Expelling Roundworms)
Patient Tao (Left pulse): Fluid retention in the stomach causes intermittent vomiting. Water belongs to Yin; without the rotation and transformation of Yang Qi, it cannot be digested. The prescription modifies a combination of Ban Xia Fu Ling Tang and Ling Gui Zhu Gan Tang.
Prescription: Zhi Ban Xia (3 qian), Shang Guang Pi (1 qian), Chuan Gui Zhi (4 fen), Gong Ding Xiang (3 fen), Guang Huo Xiang (3 qian), Dan Gan Jiang (4 fen), Bai Kou Ren (7 fen, added later), Bai Fu Ling (5 qian).
Right pulse: Body heat rushes upward accompanied by vomiting. This is due to the failure of Liver Wood Qi to flow freely.
Prescription: Dong Sang Ye, Fen Dan Pi, Jin Ling Zi, Zhi Ban Xia, Sheng Yi Ren, Xin Hui Hong, Zhi Xiang Fu, Chi Bai Fu Ling, Bai Kou Ren, Sha Ren.
Patient Shen (Right pulse): Spleen deficiency with hyperactive Liver Wood; Wood insults Earth (Stomach). Pain in the epigastrium, severe cases involve vomiting, and bowel movements alternate between diarrhea and constipation. The left Guan pulse is wiry. Liver Qi stagnation in the middle jiao may eventually develop into Ge Syndrome (dysphagia).
Prescription: Shang Yao Gui (4 fen, taken first as rice pill), Suo Sha Ren, Fu Ling, Bai Ji Li, Zhi Ke, Shang Guang Pi, Zhi Ban Xia, Wei Tian Ma, Xiang Yuan Pi.
Left pulse: After harmonizing Yin and Yang in the Stomach, vomiting recurs. The tongue coating is gray and white. Treatment proceeds with bitter and pungent methods, advancing and retreating as needed.
Prescription: Zhi Ban Xia (1.5 qian), Chuan Gui Zhi (4 fen), Zhi Hei Cao (2 fen), Ren Shen Xu (7 fen), Zhi Shi (8 fen), Dan Gan Jiang (5 fen), Chuan Ya Lian (5 fen), Bai Fu Ling (3 qian), Sheng Jiang Zhi (1 spoon).
Left pulse: With sedation of rebellious Qi and pacification of the Liver, symptoms temporarily receded. However, Qi has rushed upward again recently, causing severe hiccups and occasional vomiting. Wind-Wood attacks upwards. The treatment again focuses on nourishing Water to contain Wind-Wood.
Prescription: Shu Di (4 qian, roasted until loose), Mu Li (5 qian), Tu Chao Bai Shao (1.5 qian), Fu Shen (3 qian), Ju Bai (1 qian), Da Mai Dong (3 qian), Ci Shi (3 qian), Ban Xia Qu (1.5 qian, salt-water fried), Bai Ji Li (3 qian).
Patient Chen (Left pulse): Vomiting occurs immediately after eating. Both Guan pulses are wiry. Liver Yang rebels against and insults Stomach Earth; prolonged cases may lead to Ge Syndrome. The proposed method is Bitter-Pungent Descending and Unblocking.
Prescription: Zhi Ban Xia (1.5 qian), Dan Gan Jiang (3 fen), Fu Ling (3 qian), Tu Chao Bai Shao (1.5 qian), Chuan Ya Lian (5 fen), Dai Zhe Shi (3 qian), Ju Hong (1 qian), Xuan Fu Hua (1.5 qian, wrapped in silk), Zhi Shi (1 qian), Chao Zhu Ru (1.5 qian).
Second Visit: The wiry quality of the pulse has slightly flattened, and vomiting has slightly decreased. It indeed belongs to Liver Yang rebelling against Stomach Earth. Continue to harmonize the middle and sedate rebellion, using Bitter Descending and Pungent Opening.
Prescription: Zhi Ban Xia (1.5 qian), Bai Ji Li (de-thorned, roasted, 3 qian), Dai Zhe Shi (4 qian), Tu Chao Bai Shao (1.5 qian), Chen Xiang Qu (1.5 qian, roasted), Xuan Fu Hua (2 qian, wrapped), Dan Wu Zhu Yu (1.5 li), Chuan Ya Lian (5 fen, stir-fried with Wu Zhu Yu), Chao Zhu Ru (1.5 qian).
Third Visit: Although vomiting has decreased, it has not stopped completely. Wood overacts on Stomach Earth, causing confusion of Clear and Turbid Qi. "If one does not enter the tiger's den, how can one get the tiger's cub?" (Bold action is required).
Prescription: Zhi Xiang Fu (1.5 qian), Zhi Shi (1 qian), Chao Xiang Tian Xing Ren (3 qian), Chen Xiang Qu (1.5 qian, roasted), Chao Zhu Ru (2 qian), Ju Pi (1 qian), Bai Ji Li (3 qian), Lai Fu Dan (8 fen, dissolved separately in boiling water).
Fourth Visit: Bowels are unobstructed; no vomiting for three days. The Clear and Turbid in the Stomach are gradually differentiating. Since the medicine is effective, continue with the previous intent.
Prescription: Chuan Ya Lian (5 fen), Zhi Hei Cao (2 fen), Guang Pi (1 qian), Dan Gan Jiang (4 fen), Zhi Ban Xia (1.5 qian), Chuan Gui Zhi (4 fen), Bai Fu Ling (3 qian), Zhi Shi (1 qian), Chao Zhu Ru (1 qian), Lai Fu Dan (6 fen, taken first).
Fifth Visit: Bitter Descending and Pungent Opening differentiate Clear and Turbid; Yin and Yang in the Stomach gradually harmonize, and vomiting stabilizes. Since the medicine works, there is no need to change the prescription, but strong agents should not be used for long.
Prescription: Zhi Ban Xia (1.5 qian), Zhi Hei Cao (4 fen), Chuan Ya Lian (4 fen), Zhi Shi (7 fen), Chuan Gui Zhi (4 fen), Bai Fu Ling (3 qian), Dan Gan Jiang (3 fen), Zhu Ru (1 qian, water-fried), Bai Shao (1.5 qian, earth-fried), Lai Fu Dan (6 fen, taken first).
Another formula prepared for backup use.
Prescription: Zhi Ban Xia (1.5 qian), Chuan Ya Lian (4 fen), Zhi Gan Cao (3 fen), Fu Ling (3 qian), Ju Pi (1 qian), Hang Bai Shao (1.5 qian), Dan Gan Jiang (4 fen), Ji Lin Shen (decocted separately, 7 fen mixed in), Jiao Mai Ya (2 qian).
Right pulse: Vomiting has significantly reduced, and salivation has settled. This is indeed due to the exhaustion of the Five Fluids in an elderly person and the binding of the Three Yang channels. The previous formula continues to be effective.
Prescription: Nan Sha Shen, Chuan Bei Mu, Sheng Bian Dou, Ou Zhi, Huo Shui Lu Gen, Chuan Shi Hu, Tian Hua Fen, Tian Xing Ren, Li Zhi.
Second Visit: Vomiting recurs at the change of solar terms. The binding of the Three Yang has entered deep territory; it is not easy to return to smooth health.
Prescription: Chuan Shi Hu, Bai Ji Li, Bei Sha Shen, Ban Xia Qu, Dan Tao Ren, Bian Dou Yi, Li Zhi, Ou Zhi, Jiang Zhi, Jiu Zhi, Niu Nai, Yan Shui Chao Zhu Ru.
Right pulse: Floating fire has gradually calmed, but regurgitation occurs immediately after eating. The Gallbladder and Stomach fail to descend; Liver Yang rises with turbid Qi. Again, descend Gallbladder and Stomach Qi.
Prescription: Zhi Ban Xia, Chao Zhi Shi, Tian Xing Ren, Bai Ji Li, Chen Dan Xing, Fu Ling Shen, Shang Guang Pi, Zhu Ru, Shan Zhi (Jiang Zhi fried), Chen Guan Zhe, Da Bi Qi.
Left pulse: Middle Yang is insufficient, and Yang Qi fails to rotate. Vomiting recurs. Again, use Pungent-Warm methods to assist Yang Qi and transform turbid pathogens.
Prescription: Zhi Ban Xia (3 qian), Ju Pi (1 qian), Xian Sheng Jiang (2 qian, crushed), Chuan Gui Zhi (4 fen), Dan Wu Zhu Yu (4 fen), Fu Ling (4 qian), Chao Yu Zhu (1.5 qian), Chao Zhi Shi (1 qian), Zhu Ru (1.5 qian), Fu Long Gan (8 qian, decocted as water substitute).
Second Visit: After purgation, Middle Yang has not recovered; phlegm and fluid gradually re-accumulate. Vomiting occurs every few days. Only slow management is suitable.
Prescription: Yu Zhu Tan (2 qian), Fu Ling (5 qian), Zhu Ru (1 qian), Zhi Ban Xia (1.5 qian), Ju Pi (1 qian), Dan Wu Zhu Yu (4 fen), Zhu Ling (2 qian), Yan Wei Jiang (2 qian), Lai Fu Dan (1 qian, delivered with medicinal soup).
Left pulse: Epigastric pain, severe cases involve vomiting. Pulse is deep and wiry. This is fluid retention in the Stomach organ. Attack it slowly.
Prescription: Er Chen Tang minus Gan Cao, Zhi Xiang Fu, Yan Hu Suo, Bai Ji Li, Gao Liang Jiang, Wa Leng Zi (Cu Chao), Hong Da Ji (8 fen), Bai Kou Ren (1.3 qian), Gong Ding Xiang (1 qian), Hei Bai Chou (1 qian each, ground with Wu Wei Zi into pills).
Right pulse: Obese and prone to dampness; excessive dampness generates phlegm. Phlegm obstructs the Stomach organ, causing blockage in the Middle Jiao. Vomiting of phlegm-saliva. Use Bitter-Pungent Descending and Unblocking.
Prescription: Chuan Ya Lian (Jiang Zhi fried, 3 fen), Zhi Ban Xia (3 qian), Dan Gan Jiang (6 fen), Yun Fu Ling (5 qian), Guang Chen Pi (1 qian), Xie Bai Tou (3 qian), Chao Zhi Shi (1 qian), Zhu Er Qing (1 qian, Jiang Zhi fried), Shang Jun Jun (4 fen, i.e., Da Huang), Gong Ding Xiang (3 fen), Hei Bai Chou (2 fen each), Bai Kou Ren (4 fen, ground with Wu Wei Zi, taken in two doses).
Second Visit: Vomiting persists, epigastrium feels stiff. Pulse is deep and wiry. Still phlegm obstructing the Stomach, failing to descend. Re-prescribe Bitter-Pungent Opening and Descending, assisted by Aromatic Transformation of Turbidity.
Prescription: Chuan Pu (1 qian), Chuan Ya Lian (4 fen), Chao Zhu Ru (1 qian), Bai Kou Ren (7 fen), Fu Ling (5 qian), Ju Pi (1 qian), Zhi Ban Xia (3 qian), Dan Gan Jiang (5 fen), Sheng Jiang Zhi (1 spoon), Tai Yi Dan (3 fen, ground and mixed).
Left pulse: Phlegm retention in the Stomach, Stomach Yang fails to expand. Vomiting occurs in the evening. Pulse is deep and wiry. Fear it will progress to Fan Wei (reverse stomach/retrograde vomiting).
Prescription: Zhi Ban Xia, Dan Wu Zhu Yu, Bai Kou Ren, Yun Fu Ling, Zhu Ling, Guang Chen Pi, Xian Sheng Jiang (2 qian, crushed), Tai Yi Dan (3 fen, ground and mixed), Fu Long Gan (decocted as water substitute).
Patient Miao (Left pulse): Vomiting stopped but recurred. Yang Qi in the chest fails to rotate. Advance Pungent-Warm treatments again.
Prescription: Chuan Gui Zhi (5 fen), Zhi Ban Xia (3 qian, Cu Chao), Fu Ling (7 qian), Bai Kou Ren (7 fen), Gong Ding Xiang (3 fen), Guang Huo Xiang (3 qian), Dan Gan Jiang (5 fen, roasted), Ju Pi (1 qian), Zhu Ling (2 qian), Fu Long Gan (1 liang, decocted as water substitute).
Patient Miao (Left pulse): Vomiting comes and goes. Tongue coating is thin and white, not thick or greasy. Bowel movement occurs only after several days. Spleen requires Yang to transport; Stomach requires Yin to harmonize. In old age, fluids are deficient, and Stomach Yin is insufficient. Therefore, what should promote unblocking and descending instead causes stagnation and rebellion.
Prescription: Ren Shen Xu (1.5 qian), Bai Fu Ling (3 qian), Chao Xiang Tian Xing Ren (3 qian), Bai Tan Xiang (1 qian), Zhi Ban Xia (1.5 qian), Bai Ji Li (3 qian), Zhu Er Qing (5 fen, Yan Shui Chao), Bai Mi (2 qian).
Right pulse: Shortly after eating, sour water is vomited, and the face appears cyan. Inquiry reveals this resulted from grief after losing one's mother. Liver Fire is extremely constrained, thus producing acidity.
Prescription: Sang Ye, Dan Pi, Yu Jin, Zhi Xiang Fu, Shan Zhi (Jiang Zhi fried), Zuo Jin Wan.
Patient Zhang (Left pulse): Pulse and symptoms are stable. Abdominal fullness occurs in the evening, with sour water surging upward. Ying (Nutrient) Qi stagnates and fails to circulate; Earth Qi is constrained by dampness. Cannot seek quick success.
Prescription: Zhi Ban Xia, Bai Ji Li, Tai Bai Zhu, Gong Ding Xiang, Fu Ling Pi, Guang Pi, Dan Wu Zhu Yu, Wan Can Sha, Chao Lou Pi, Jian Ze Xie, Yu Yu Liang Wan (1.5 qian, dissolved in boiling water, taken first).
Elderly Woman Wu: Wind-Yang is relatively calm, dizziness greatly reduced, but residual effects remain. Acid regurgitation and salivation occur intermittently. Again, nourish and extinguish Liver, assisted by Bitter-Pungent to control Heart Fire, and aided by Metal Qi to level Liver Wood.
Prescription: E Jiao Zhu, Hang Bai Shao, Hei Dou Yi, Chi Ju, Fu Shen, Chao Qi Zi, Nu Zhen Zi, Tong Sha Yuan, Zuo Jin Wan.
Patient Li (Left pulse): The Classic states: Heart produces sweat, Lungs produce mucus, Spleen produces saliva, Liver produces tears, Kidneys produce spittle; these are the Five Fluids. Now, daily life is normal, but saliva is frequently spat out, and appetite is poor. This clearly indicates deficiency of both Spleen and Stomach, failing to constrain body fluids. Slow regulation with pills is proposed.
Prescription: Zhi Mian Huang (3 liang), Zhi Hei Cao (5 qian), Suo Sha Ren (4 qian), Wei Yi Zhi (7 qian), Guang Chen Pi (7 qian), Kui Dang Shen (4 liang), Nong Du Zhong (3 liang), Chao Yu Zhu (2 liang), Chao Shan Yao (3 liang), Chao Qi Zi (3 liang), Zhi Ban Xia (1.5 liang), Chao Dan Jiang Zha (4 qian), Chao Fan Zhi Qu (1 liang), Guang Huo Geng (1.5 liang), Ze Xie (1.5 liang), Bai Fu Ling (3 liang), Jiao Mai Ya (2 liang), Chao Bian Dou (2 liang), Chao Yu Rou (1.5 liang).
Grind the above medicines into fine powder, form pills with water. Take 3 qian per dose.
Patient Yao (Right pulse): Headache and dizziness, severe cases involve vomiting of saliva, soreness in waist and flanks. Pulse is soggy, Left is slippery. This is Liver Yang carrying phlegm rushing upward to insult Stomach Earth.
Prescription: Zhi Ban Xia, Tian Ma, Gan Ju, Bai Ji Li, Dan Pi, Gou Gou (Gou Teng), Guang Pi, Chao Zao Ren, Fu Ling Shen, Shi Jue Ming, Shui Chao Zhu Ru.
Patient Yu (Right pulse): Headache has receded somewhat, but after vomiting, saliva surges upward. This is what Changsha (Zhang Zhongjing) referred to as Liver disease causing saliva vomiting. Wind soaring and waves surging all stem from Liver Yang rising, insulting Stomach Earth, causing the Stomach to fail to constrain fluids. Again, harmonize Liver and Stomach.
Prescription: Jin Shi Hu, Qi Zi, Dai Zhe Shi, Bai Ji Li, Chao Ban Xia Qu, Fu Ling, Gou Gou, Sang Ye, Dan Pi, Yan Shui Chao Zhu Ru.
For saliva caused by Liver Yang, Dai Zhe Shi is used; this differs from saliva surging due to Stomach Cold. If vomiting is caused by Liver Qi, pain must also be present. (Recorded by Qing Dynasty Confucian Physician)
Patient: Spitting saliva indicates Stomach Qi deficiency failing to constrain fluids. Spitting saliva yet remaining thirsty indicates Stomach Yin deficiency seeking relief from water. Withered tongue with yellow coating indicates Stomach Qi failing to govern, allowing empty turbidity to accumulate. Qi and Yin are increasingly depleted, complicated by turbidity. Medications often address one aspect while neglecting another, and mistakes are easily made. Only Zhang Zhongjing's Da Ban Xia Tang, using Ren Shen to tonify Stomach Qi, Bai Mi to harmonize Stomach Yin, and Ban Xia to unblock Stomach Yang, is tried to observe the reaction.
Prescription: Ren Shen (1 qian), Bai Mi (5 qian), Ban Xia (3 qian).
Patient Lian (Left pulse): Vomiting for several days; suddenly yesterday, swelling occurred on the right side, extending from the epigastrium to the lower abdomen, becoming hard. Qi rushed upward momentarily. Fortunately, it subsided quickly. However, eating still causes vomiting, roundworms are expelled, thirst is frequent with drinking. Tongue coating is rough and white, pulse is deficient and wiry. After the horizontal rebellion of Liver Wood, Stomach Earth rises but does not descend, and Yangming fluids are secretly depleted. Fear hiccups leading to syncope.
Prescription: Chuan Lian (5 fen), Chao Wu Mei (5 fen), Chuan Chuan Jiao (2 fen), Jin Shi Hu (5 qian), Jin Ling Zi (1.5 qian), Wu Zhu Yu (2 fen), Hang Bai Shao (2 qian, Jiu Chao), Zhi Ban Xia (3 qian), Bai Ji Li (3 qian), Hong Shi Liu Zi (100 grains), Pi Pa Ye (2 slices, de-hairy), Xian Zhu Ru (1 qian, Yan Shui Chao).