三诊：经上述内治外涂后，口眼歪斜即正。惟干咳不止，有少许稠痰，舌转红，苔转黄，脉转细数。此肺经郁热未清，肝火灼肺所致。治宜泻肺清肝，润燥止咳，用泻白散合二母宁嗽汤加减：
甘草6克
方中桑白皮、地骨皮泄肺中伏火，降气止咳，合瓜蒌、贝母以增强清肺化痰之功。知母滋肾清肺，粳米清肺益胃，麦冬、陈皮、赤芍、桔梗滋阴润燥，疏利气机。
服二剂，咳嗽即止，诸症告愈。
[整理者按]：口眼歪斜一症，西医有周围性和中枢性之分，前者预后良好，后者则较差。这里介绍的两例，均属于周围性面神经瘫痪，只要治疗及时，用药洽当，一般恢复皆较理想。 《内经》云：“邪之所凑，其气必虚。”从临床看，患者，多有正气先亏，或肝虚肺燥，或脉络空乏等内因，复加六淫外邪，与诱发。发病后则或寒或热因人而异。《灵枢·经筋篇》谓：“足阳明之筋，其病卒口僻急者目不合，热则筋弛纵缓不胜收，故僻(僻即歪斜)。”《金匮》所载《古今录验》续命汤，宣肺泄热，通阳温中，补益气血，寒温并用，寒热平调，内外兼顾，确为对症良方。原义“治中风痱，身体不能自收持，口不能言，冒味不知痛处，或拘急不得转侧。”戴老医师常用于此症，化裁灵活，用后症情即减，或配合外治，收效更佳。若属风痰偏盛而无表里证者，每用牵正散(小白附子、全蝎、僵蚕)治之，其效亦佳。 “牙宣” (齿衄)
左× ×，男，三十余岁。患牙龈出血不止，已月余。曾用西药治疗未效，来我所就诊。诊其脉，芤大而空，舌紫红，面色皓白。此病中医称为“牙宣”，或名“齿衄”。从脉证分析，齿乃骨之余，在脏属肾。由于肝肾阴亏，肾失潜纳，阴火上腾，故现齿龈出血不止。宜用“水中置介”潜阻之法治之。处以下方：
方中以石决明柔肝，并缓齿龈出血之急迫，合以牡蛎、龟板育阴潜阳。阳得潜，阴火即不上腾，则出血自止。配以阿胶、麦冬、杭芍养肝而滋木，白洋参益气生津，玄参滋肾水并清浮越之火，蒲黄、茜草理血疏肝，藕节通气，牛膝引药下行，故能达潜阳的目的。余平日治各种出血，除黄连泻心汤症外，凡血逆上溢之症，均应顾护胃气，若专投苦寒则不免伤胃，且苦能化燥，胃伤则中阳衰败，更增病端。
上方服一剂，血遂止其半。再服三剂则全止。继以封髓丹(焦黄柏9克、砂仁6克、甘草6克)善后而告愈。
[按]：此症病机，在于肝肾阴亏，肾失潜纳，故不用六味地黄丸之类滋肾柔肝，因六味丸只有育阴之力，而乏潜纳之功。今患者由于阴亏，以致相火浮越，血不归经。故必须育阴潜阳并举(育肝肾已亏之阴，潜上浮之相火)，庶可使血能归经而收自止之效。
口
臭
陈××，女，三十二岁。口气臭秽已数月，服药无效，转余诊治。症见口臭，唇口干燥，舌质润，苔薄黄腻，脉微细数。二便正常，虽思水但所饮不多。断为脾胃伏火(虽属阳热但热势不甚)，治宜升清降浊，佐以清胃热之剂。处方：
生石膏30克 升麻10克 细辛4克 焦黄柏10克 杭芍12克
方中石膏辛甘大寒，清胃热，泻胃火，细辛辛温，为肾家本药，其性散而升。经云“火郁发之”，故配石膏能散胃经伏火。升麻升阳明胃经之清阳，又有解毒之功，杭芍平肝益脾阴，焦柏清热燥湿。诸药配合能升清降浊，使清气上升，浊阴下降，则口臭可除。
外用方：吴萸6克，黄连6克。此方为左金丸，有疏肝、清火、和胃之功。将二药研细末，醋炒，包两足心涌泉穴，有上病下取引热下行之义。
二诊：服上方三剂后，自诉：口臭已大为减少。脉转细，仍口唇干燥。此乃胃经伏火虽除，但肺胃津液仍伤。拟方以滋津润燥调治。处方：
服五剂后，口臭全消，口唇转润而痊愈。
[按]：口臭一证，多属胃热与肺胃郁热所致，方书多用写黄散与清胃散，郁热较甚者，可用三黄石膏汤等方，此属阳热之证。亦有阴证口臭者。多由于元气不能收纳，元阳外越所致。阴证除口臭外兼见脉沉细，舌质青滑，苔薄白，二便自调，不思水饮等虚寒证情，曾治二例，用潜阳汤与四逆汤二方交替服用而愈。
便
血
林××，男，三十余岁。患肠风下血多年，曾用凉血祛风之剂无效。每年发作数次，每发纯下鲜血，不杂大便，无里急后重，肛门无红肿，微感疲倦食少，舌质淡，苔薄白，脉细弱。此寒湿郁遏阳明、脾失统摄所致。法当养血温经，健脾燥湿而止血。方用自拟经验方肠风止血汤。处方：
方中归、芍补血养肝，白术、茯苓健脾燥湿，黄连燥湿健胃，少用为苦味健胃药，合荆芥炭、地榆炭祛风止血；炒艾叶、阿胶温经止血，烧乌梅酸涩、温肝止血；香附调气舒肝，炮姜、甘草苦甘化阴，入血分而止血。
复诊；上方服二剂后，下血即止，继用《金匮要略》黄土汤加味调理善后，以资巩固。处方：
无可用赤石脂30克代之)
方中灶心土温燥入脾而止血，附片温肾阳，暖脾阳，合白术以复中焦健运，而加强脾统血的功能。炒生地、阿胶、甘草以益阴固血，黄芩苦寒反佐以坚阴，并制术、附燥热之性。加干姜以温中，和术、附以温补脾肾。更重要者在加桂枝以温阳通络而平肝，兼能调和升降，与诸药协同，其止下部出血之效益佳，其意义与本书治“经漏尿血”案中加入本品者相同，此又打破“血家禁桂”之戒。
此方连服三剂血遂止，嘱再服三剂以巩固疗效。追踪观察一年未见复发。
[整理者按]：肠风下血一症，症状特点是纯下清血，不杂大便，肛门无肿痛。此症有属于阳明热毒壅滞者，有火热之邪下注于大肠者，有寒湿郁遏阳明气机所致者，亦有饮食劳倦无节而伤及中焦者。本证的发病机理，据《灵枢·百病始生篇》谓：“阴络伤则血内溢，血内溢则后血。”上述各种因素均可造成阴络伤损而后血。本案所用之方，专为寒湿证设，凡用清热泻火，凉血祛风而不愈者，或病久症转寒湿者，只要辨证精确，用之则效。
又：黄土汤一方，乃治中焦虚寒出血效方。仲景及历代．一些医家多用于出血之时，但戴老医师认为此方脾肾并重，寒温平调，气血两顾，不仅用于出血之时，尤可作为血证后期调理巩固之用。
1960年，昆明市某厂，因饮食不慎，吃腐败猪肉，有部分职工发生中毒。症见呕吐，泻泄，烦闷，倦怠，头昏，或有欲吐不吐，欲泄不泄，胸腹满闷不爽等症状。予经验方藿香桂枝汤，煮大锅药，每人服100毫升，服药一至三次，均获痊愈。处方：
上方以十剂为一料煎大锅药。
[按]；此方乃临床多年使用之有效方剂，系藿香正气散与桂枝汤合方化裁而出，以芳香化浊立法，用治外感风寒，内伤饮食，出现寒热、胸闷、吐泻等症，无不应验。全方能升降气机，交通上下，蠲除肠中瘀滞，开郁、消痰食积滞而不伤正，化瘀而不伤血，畅通气血使邪从外散。凡食物中毒而出现前述症状者均可使用。
崩漏六例
例一。
戴××，女，四十九岁。月经紊乱，每次经来淋沥不净。一日，忽血崩不止，头晕眼花，冷汗如洗，卒然倒地，昏迷不省人事，其势甚危，急来求诊。症见。舌淡无华，两尺脉芤，面色苍白，手足逆冷。此冲任之气暴虚．不能统摄阴血，血遂妄行。当务之急，宜速补血中之气。所谓“有形之血不能速生，无形之气所当急固"，嘱急取高丽参30克，浓煎服之。服后元气渐复，神智甦醒，流血减少。续予扶阳之剂，以恢复气血阴阳的平衡。此即《内经》“阴平阳秘，精神乃治”，以及“阴阳互根”之理。拟方用四逆汤，干姜易炮姜。处方：
此方温扶元阳而固真阴，为治本之剂。
二诊：上方服一剂，肢厥回，冷汗收，流血止。仍感头晕、神倦，面色尚淡白。此乃肾精亏耗，阴阳俱虚，宜补阴回阳，阴阳并治。方用：
龟龄集二瓶，每次服五分。
三诊：上药服后，头晕及精神好转。改以温中摄血，加固堤防之剂。方用归芍理中汤加炮姜。处方：
当归15克 炒杭芍9克 潞党参15克 白术12克 炮姜15克
炙甘草6克
四诊：连服三剂，症状消失，面色红润，惟觉神倦。继用人参养荣丸调理而安。
此案初诊因病势危急，本“血脱益气”之旨，故用人参大补元气，挽救虚脱。病危重者，当以救元阴元阳为急务。此症恐气随血脱，故急用人参补气固脱，继用四逆汤回阳固阴以治本，庶乎阳得其升而阴有所守，故迅获止崩之效。然崩后肾精亏耗，阴阳俱虚，故以龟龄集补肾助阳，随接以归芍理中加强脾统血之机能，最后用人参养荣丸气血双补以善后。如此标本兼顾，既可迅速恢复体功，更可巩固已获之成效。
例二：
纳××，女，三十岁。患漏症，持续出血，淋漓不止，已四十余日，屡治未效，转我所求诊。症见：脉涩，舌红，下腹胀痛拒按，血行不畅，色黑有块，心烦。脉症合参，断为冲任瘀滞，气机不畅，兼有郁热。治法应化瘀、舒肝为主，兼以清热，使冲任血脉调畅，新血归经，则漏血可止。用失笑散与金铃子散合方加味。处方：
此方本《内经》：“通因通用”之旨而立。五灵脂为行血止痛要药，蒲黄生、炒并用，生能化瘀，醋炒则止血，川楝子舒肝解郁，导热下行。玄胡索调血中滞气，当归养血活血，桃仁、乳香、没药祛瘀理血，宣通脏腑经络。诸药协同则化瘀、舒肝、清热，通畅冲任血脉，而收止漏之效。
服一剂，漏血减少，再剂血全止。后用四物汤加香附、炒黄芩调理，病即告愈。
例三：
李××，女，三十岁。因经漏作刮宫手术后，血仍淋漓不止，已二月余，迭服止血药未效。诊脉细弱，面色不华，神疲倦怠，小腹隐痛喜按。此冲任虚损，气血俱亏，阴血不能内守所致。宜调摄冲任，补益气血治之。方用胶艾四物汤合炮姜甘草汤加减。处方：
上方四物汤去川芎，补血、调血，炙艾、阿胶温经止血，数味合用则有调理冲任，补血益气之效。尤妙在炮姜、甘草二味，苦甘化阴，且能引血归经而止血。
服上方一剂，血渐止。守原方服六剂，病渐痊愈。
例四：
汪××，女，二十六岁。施刮宫术后，经漏不止，已一月余，兼见盗汗，心烦、头昏。余仍用上例之胶艾四物汤合炮姜甘草汤加减，服五剂，漏血全止。仍盗汗，心烦，头昏。证属肾阴不足，肝阳上亢。治以滋阴潜阳法。处方：
玄参9克
方中山药甘平，补脾胃、益肺肾，补而不滞，不燥不热，张锡纯称其有“滋润血脉，固摄气化”及“强志育神"之功。山萸肉酸涩微温，补益肝肾，收敛元气，善止虚汗。龙骨、牡蛎镇肝潜阳，配以萸肉，最能敛汗。玄参苦成寒，补水滋阴，凉血润燥。诸药合用，补益肝肾，滋阴潜阳而安神。
此案所用之方系由张锡纯“阴虚劳热”诸方体验化裁而出。凡肝肾不足，阴虚阳亢所致之心烦、失眠、头昏、口于、盗汗等症，均可使用。
例五：
高××，女，三十五岁。经漏四十余日，近旬加剧，血色淡红，且现面浮、耳鸣、气短、自汗、心悸、神倦等症。脉细弱，舌淡润。此系冲任虚损，气不固摄所致。治宜滋养冲任，补气摄血。用胶艾四物汤加味。处方：
Third visit: After the aforementioned internal treatment and external application, the deviation of the mouth and eye has been corrected. However, there is persistent dry cough with a small amount of thick sputum, the tongue has turned red, the coating yellow, and the pulse fine and rapid (Xisu). This is due to unresolved stagnant heat in the Lung meridian and Liver fire scorching the Lungs. The treatment should focus on purging Lung heat and clearing Liver fire, moistening dryness and stopping cough, using Xie Bai San (Draining White Powder) combined with Er Mu Ning Sou Tang (Two Mother Cough-Calming Decoction) with modifications:
* *Bai Sang Pi* (Morus Cortex) 9g
* *Di Gu Pi* (Lycium Bark) 9g
* *Jing Mi* (Rice) 15g
* *Zhi Mu* (Anemarrhena Rhizome) 9g
* *Chuan Bei Mu* (Fritillaria Cirrhosa Bulb) 9g
* *Quan Gua Lou* (Trichosanthes Fruit) 12g
* *Mai Dong* (Ophiopogon Tuber) 9g
* *Chen Pi* (Citrus Reticulata Peel) 6g
* *Chi Shao* (Red Peony Root) 9g
* *Jie Geng* (Platycodon Root) 9g
* *Gan Cao* (Licorice Root) 6g
In this formula, *Bai Sang Pi* and *Di Gu Pi* drain latent fire from the Lungs and descend Qi to stop cough, working together with *Gua Lou* and *Bei Mu* to enhance the effects of clearing Lung heat and resolving phlegm. *Zhi Mu* nourishes the Kidney and clears the Lungs; *Jing Mi* clears the Lungs and benefits the Stomach; *Mai Dong*, *Chen Pi*, *Chi Shao*, and *Jie Geng* nourish Yin, moisten dryness, and regulate the flow of Qi.
After taking two doses, the cough stopped immediately, and all symptoms resolved.
[Editor's Note]: The symptom of deviation of the mouth and eye is divided into peripheral and central types in Western medicine; the former has a good prognosis, while the latter is poorer. The two cases introduced here both belong to peripheral facial nerve paralysis. As long as treatment is timely and medication is appropriate, recovery is generally satisfactory. *Huang Di Nei Jing* (The Yellow Emperor’s Inner Canon) states: "Where pathogenic factors gather, Zheng Qi (Upright Qi) must be deficient." Clinically, patients often have prior deficiency of Zheng Qi, or Liver deficiency and Lung dryness, or emptiness in the collaterals as internal factors, compounded by invasion of the Six Excesses (external pathogens), which trigger the disease. After onset, it may manifest as cold or heat depending on the individual. *Ling Shu: Jing Jin Chapter* says: "Disease of the sinews of Foot Yangming manifests as sudden deviation of the mouth and inability to close the eyes; if heat is present, the sinews become flaccid and relaxed, unable to contract, thus causing deviation (Pian refers to deviation)." The Xu Ming Tang (Continuing Life Decoction) recorded in *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet) from *Gu Jin Lu Yan* ventilates the Lungs and drains heat, unblocks Yang and warms the middle, tonifies Qi and Blood, combines cold and warm properties, balances cold and heat, and addresses both interior and exterior. It is indeed an effective prescription for this condition. Its original indication is "treating stroke apoplexy where the body cannot control itself, speech is impaired, consciousness is clouded and pain location is unknown, or stiffness prevents turning over." Dr. Dai frequently uses this prescription for this condition with flexible modifications; symptoms improve quickly after use, and efficacy is better when combined with external treatments. If wind-phlegm is predominant without exterior-interior syndromes, Qian Zheng San (Stabilize Face Powder) (Xiao Bai Fu Zi, Quan Xie, Jiang Can) is often used with good results. "Ya Xuan" (Gum Recession/Tooth Bleeding)
Patient Left XX, Male, 30s. Suffering from continuous gum bleeding for over a month. Western medicine treatment was ineffective. He came to our clinic for consultation. His pulse was large, hollow, and cun-kou (Kou) type (Kou Mai); his tongue was purple-red, and his complexion was pale. In Traditional Chinese Medicine (TCM), this disease is called "Ya Xuan" or "Chi Nu" (Tooth Bleeding). Analyzing the pulse and symptoms, teeth are considered the surplus of bone and belong to the Kidneys in Zang-Fu theory. Due to deficiency of Liver and Kidney Yin, the Kidneys fail to anchor and store, allowing Yin fire to flare upward, resulting in continuous gum bleeding. The treatment should employ the method of "placing shellfish in water" to anchor and suppress. The following prescription was given:
* *Shi Jue Ming* (Abalone Shell) 9g
* *Qian Cao* (Madder Root) 6g
* *E Jiao* (Donkey-Hide Gelatin) 9g
* *Zhi Gui Ban* (Prepared Tortoise Shell) 15g
* *Mu Li* (Oyster Shell) 24g
* *Pu Huang* (Typha Pollen, vinegar-fried) 6g
* *Xuan Shen* (Scrophularia Root) 15g
* *Mai Dong* (Ophiopogon Tuber) 9g
* *Chao Hang Shao* (Fried White Peony Root) 9g
* *Zhi Gan Cao* (Honey-fried Licorice Root) 6g
* *Ou Jie* (Lotus Node) 6g
* *Huai Niu Xi* (Achyranthes Root) 6g
* *Bai Yang Shen* (American Ginseng) 6g (decocted separately and mixed in)
In this formula, *Shi Jue Ming* softens the Liver and alleviates the urgency of gum bleeding, combined with *Mu Li* and *Gui Ban* to nourish Yin and anchor Yang. When Yang is anchored, Yin fire does not flare upward, and bleeding stops spontaneously. *E Jiao*, *Mai Dong*, and *Hang Shao* nourish the Liver and moisten Wood; *Bai Yang Shen* tonifies Qi and generates fluids; *Xuan Shen* nourishes Kidney Water and clears floating fire; *Pu Huang* and *Qian Cao* regulate blood and soothe the Liver; *Ou Jie* promotes Qi circulation; and *Niu Xi* guides the herbs downward. Thus, the goal of anchoring Yang is achieved. In my daily practice treating various bleeding disorders, except for conditions indicated by Huang Lian Xie Xin Tang (Coptis Decoction to Drain the Heart), for any symptom where blood rebels and flows upward, I always protect Stomach Qi. Using only bitter-cold herbs inevitably damages the Stomach; bitterness can transform into dryness, and Stomach damage leads to failure of Middle Yang, exacerbating the disease.
After one dose of the above prescription, bleeding stopped by half. After three more doses, it stopped completely. Subsequently, Feng Sui Dan (Seal Marrow Pill) (Jiao Huang Bo, Sha Ren, Gan Cao) was used for consolidation, leading to recovery.
[Note]: The pathogenesis of this condition lies in deficiency of Liver and Kidney Yin and the Kidney's failure to anchor. Therefore, Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) is not used for nourishing the Kidney and softening the Liver, because Liu Wei Wan only has the power to nourish Yin but lacks the function of anchoring. Due to Yin deficiency, Ministerial Fire floats upward, and blood fails to return to its vessels. Therefore, it is necessary to combine nourishing Yin and anchoring Yang (nourishing the deficient Yin of Liver and Kidney, and anchoring the floating Ministerial Fire) so that blood can return to its vessels and achieve spontaneous cessation.
Bad Breath
Patient Chen XX, Female, 32 years old. Bad breath for several months, ineffective with previous medication. Consulted me. Symptoms: bad breath, dry lips and mouth, moist tongue texture, thin yellow greasy coating, fine and slightly rapid pulse. Bowel and urinary functions are normal; although desiring water, intake is low. Diagnosed as latent fire in the Spleen and Stomach (Yang-heat nature but mild intensity). Treatment: raise clear Yang and descend turbid Yin, assisted by herbs that clear Stomach heat. Prescription:
* *Sheng Shi Gao* (Raw Gypsum Fibrosum) 30g
* *Sheng Ma* (Cimicifuga Rhizome) 10g
* *Xi Xin* (Asarum Root) 4g
* *Jiao Huang Bo* (Charred Phellodendron Bark) 10g
* *Hang Shao* (White Peony Root) 12g
In this formula, *Shi Gao* is pungent, sweet, and greatly cold, clearing Stomach heat and draining Stomach fire. *Xi Xin* is pungent and warm, a primary herb for the Kidney, with dispersing and ascending properties. The Classics state, "For constrained fire, disperse it." Therefore, combined with *Shi Gao*, it disperses latent fire in the Stomach meridian. *Sheng Ma* raises the clear Yang of the Yangming Stomach meridian and has detoxifying properties; *Hang Shao* calms the Liver and benefits Spleen Yin; *Jiao Bai* clears heat and dries dampness. The combination of these herbs raises clear Yang and descends turbid Yin, allowing clear Qi to ascend and turbid Yin to descend, thereby eliminating bad breath.
External prescription: *Wu Zhu Yu* (Evodia Fruit) 6g, *Huang Lian* (Coptis Rhizome) 6g. This is Zuo Jin Wan (Left Metal Pill), which soothes the Liver, clears fire, and harmonizes the Stomach. Grind the two herbs into fine powder, stir-fry with vinegar, and apply to the Yongquan acupoints (KI1) on both soles of the feet. This follows the principle of treating upper disorders by targeting lower points, guiding heat downward.
Second visit: After three doses, the patient reported significant reduction in bad breath. Pulse became fine, lips remained dry. This indicates that although latent fire in the Stomach meridian is cleared, fluids in the Lungs and Stomach are still damaged. The new prescription aims to nourish fluids and moisten dryness:
* *Hei Dou* (Black Soybean) 10g
* *Lu Dou* (Mung Bean) 10g
* *Sang Ye* (Mulberry Leaf) 10g
* *Shi Hu* (Dendrobium Stem) 10g
* *Hang Shao* (White Peony Root) 10g
* *Sha Shen* (Glehnia Root) 15g
* *Yuan Shen* (Scrophularia Root) 10g
* *Mai Dong* (Ophiopogon Tuber) 15g
After five doses, bad breath disappeared completely, lips became moist, and the patient recovered.
[Note]: Bad breath is mostly caused by Stomach heat or stagnant heat in the Lungs and Stomach. Medical texts often use Xie Huang San (Drain Yellow Powder) and Qing Wei San (Clear Stomach Powder). For severe stagnant heat, San Huang Shi Gao Tang (Three Yellows and Gypsum Decoction) may be used; these belong to Yang-heat syndromes. There are also Yin-type bad breath cases, caused by Yuan Qi failing to be retained and Yuan Yang escaping outward. Yin-type bad breath is accompanied by deep and fine pulse, bluish-slippery tongue texture, thin white coating, normal bowel/urinary functions, and lack of desire for water/drinks—symptoms of deficiency-cold. I treated two such cases successfully by alternating Qian Yang Tang (Anchor Yang Decoction) and Si Ni Tang (Four Counterflow Decoction).
(Qian Yang Tang: Chuan Fu Pian 60g, Gui Ban 15g, Sha Ren 6g, Zhi Gan Cao 6g)
Blood in Stool
Patient Lin XX, Male, 30s. Suffering from Chang Feng Xia Xue (Intestinal Wind Lower Bleeding) for years. Previous cooling-blood and dispelling-wind prescriptions were ineffective. Attacks occur several times a year, presenting as pure bright red blood without feces, no tenesmus, no anal redness/swelling, slight fatigue, poor appetite, pale tongue, thin white coating, and fine-weak pulse. This is caused by Cold-Damp constraining the Yangming and Spleen failing to control blood. The treatment should nourish blood and warm the meridians, strengthen the Spleen, dry dampness, and stop bleeding. Using my empirical prescription Chang Feng Zhi Xue Tang (Intestinal Wind Hemostatic Decoction):
* *Dang Gui* (Angelica Sinensis) 15g
* *Chao Hang Shao* (Fried White Peony Root) 9g
* *Chuan Huang Lian* (Coptis Rhizome) 2g
* *Bai Zhu* (Atractylodes Macrocephala Rhizome) 9g
* *Zhi Xiang Fu* (Cyperi Rhizoma) 9g
* *Di Yu Tan* (Carbonized Sanguisorba Root) 9g
* *Fu Ling* (Poria) 9g
* *Jing Jie Tan* (Carbonized Schizonepeta Spike) 9g
* *Chao Ai Ye* (Fried Mugwort Leaf) 6g
* *E Jiao* (Donkey-Hide Gelatin) 9g
* *Shao Wu Mei* (Roasted Mume Fruit) 9g
* *Pao Jiang* (Prepared Ginger) 9g
* *Gan Cao* (Licorice Root) 6g
In this formula, *Dang Gui* and *Shao Yao* nourish blood and support the Liver; *Bai Zhu* and *Fu Ling* strengthen the Spleen and dry dampness; *Huang Lian* dries dampness and strengthens the Stomach (used in small amounts as a bitter stomachic); combined with *Jing Jie Tan* and *Di Yu Tan* to dispel wind and stop bleeding; *Chao Ai Ye* and *E Jiao* warm the meridians and stop bleeding; *Shao Wu Mei* is sour/astringent and warms the Liver to stop bleeding; *Xiang Fu* regulates Qi and soothes the Liver; *Pao Jiang* and *Gan Cao* transform bitter and sweet into Yin, entering the Blood level to stop bleeding.
Follow-up: After two doses, bleeding stopped. Continued with modified Huang Tu Tang (Yellow Earth Decoction) from *Jin Gui Yao Lue* for consolidation. Prescription:
* *Hei Fu Pian* (Black Prepared Aconite) 30g
* *Bai Zhu* (Atractylodes Macrocephala Rhizome) 9g
* *Jiu Chao Sheng Di* (Wine-fried Raw Rehmannia) 15g
* *E Jiao* (Donkey-Hide Gelatin) 9g
* *Huang Qin* (Scutellaria Root) 9g
* *Gui Zhi* (Cinnamon Twig) 9g
* *Gan Jiang* (Dried Ginger) 9g
* *Gan Cao* (Licorice Root) 6g
* *Zao Xin Tu* (Caolin/Hearth Soil) 30g (If unavailable, substitute with Chi Shi Zhi 30g)
In this formula, *Zao Xin Tu* is warm and drying, enters the Spleen, and stops bleeding; *Fu Pian* warms Kidney Yang and warms Spleen Yang; combined with *Bai Zhu* to restore Middle Jiao transportation and strengthen the Spleen's function of controlling blood. *Chao Sheng Di*, *E Jiao*, and *Gan Cao* benefit Yin and consolidate blood; *Huang Qin* is bitter-cold and used as a counter-agent to solidify Yin and restrain the drying-hot nature of *Bai Zhu* and *Fu Pian*. *Gan Jiang* warms the Middle; combined with *Bai Zhu* and *Fu Pian* to warm and tonify Spleen and Kidney. Crucially, adding *Gui Zhi* warms Yang, unblocks collaterals, calms the Liver, and harmonizes ascending and descending movements. Synergizing with other herbs, it effectively stops lower bleeding. This significance is similar to adding *Gui Zhi* in the case of "Menorrhagia and Hematuria" in this book, breaking the taboo of "avoiding Cinnamon Twig in blood disorders."
After three consecutive doses, bleeding stopped. Advised to take three more doses to consolidate efficacy. One-year follow-up showed no recurrence.
[Editor's Note]: Chang Feng Xia Xue (Intestinal Wind Lower Bleeding) is characterized by pure fresh blood without feces and no anal swelling/pain. Causes include Yangming heat-toxin stagnation, heat-fire pathogens sinking to the Large Intestine, Cold-Damp constraining Yangming Qi mechanism, or injury to the Middle Jiao due to irregular diet and overwork. According to *Ling Shu: Bai Bing Shi Sheng Pian* (Spiritual Pivot: Hundred Diseases Originate Chapter), "When Yin collaterals are injured, blood overflows internally; internal overflow results in post-anal bleeding." All the above factors can cause Yin collateral damage leading to bleeding. The prescription used in this case is specifically designed for Cold-Damp syndromes. For those who do not respond to clearing heat, draining fire, cooling blood, and dispelling wind, or whose chronic condition turns to Cold-Damp, precise differentiation ensures efficacy.
Additionally: Huang Tu Tang is an effective formula for bleeding due to Middle Jiao deficiency-cold. Zhang Zhongjing and many past physicians used it during active bleeding. However, Dr. Dai believes this formula emphasizes both Spleen and Kidney, balances cold and warm, and attends to both Qi and Blood. It is not only used during bleeding but especially suitable for late-stage regulation and consolidation of blood disorders.
Food Poisoning
In 1960, at a factory in Kunming City, some employees suffered poisoning after eating spoiled pork due to dietary indiscretion. Symptoms included vomiting, diarrhea, restlessness, fatigue, dizziness, sensation of wanting to vomit but unable to, wanting to defecate but unable to, and chest/abdominal fullness and discomfort. Given my empirical prescription Huo Xiang Gui Zhi Tang (Agastache and Cinnamon Twig Decoction), boiled in large pots, each person took 100ml. After one to three doses, all recovered. Prescription:
* *Huo Xiang* (Patchouli Herb) 10g
* *Shen Qu* (Medicated Leaven) 20g
* *Wu Zhu Yu* (Evodia Fruit) 10g
* *Zhi Ke* (Aurantii Fructus) 10g
* *Fa Xia* (Processed Pinellia Tuber) 10g
* *Fu Ling* (Poria) 15g
* *Jiao Zha* (Charred Hawthorn Fruit) 20g
* *Su Ye* (Perilla Leaf) 6g
* *Fang Feng* (Saposhnikovia Root) 10g
* *Gui Zhi* (Cinnamon Twig) 10g
* *Hang Shao* (White Peony Root) 10g
* *Gan Cao* (Licorice Root) 6g
* *Sheng Jiang* (Fresh Ginger) 3 slices
* *Da Zao* (Jujube) 3 pieces
* *Chen Pi* (Citrus Reticulata Peel) 10g
Ten doses constitute one batch for boiling large-pot medicine.
[Note]: This is an effective clinical prescription used for many years, derived from combining and modifying Huo Xiang Zheng Qi San (Agastache Powder to Rectify the Qi) and Gui Zhi Tang (Cinnamon Twig Decoction). Based on the principle of aromatic transformation of turbidity, it treats exterior Cold-Wind and interior food injury presenting with cold/heat, chest tightness, vomiting, and diarrhea. It works reliably. The entire formula regulates Qi mechanism, communicates upper and lower, eliminates intestinal stasis, opens depression, resolves phlegm and food stagnation without damaging healthy Qi, transforms stasis without damaging blood, and unblocks Qi and Blood to allow pathogens to scatter externally. It can be used for any food poisoning presenting with the aforementioned symptoms.
Six Cases of Metrorrhagia and Metrostaxis
Case 1.
Patient Dai XX, Female, 49 years old. Menstrual irregularity, dripping continuously after each period. One day, sudden severe uterine bleeding (Beng), dizziness, blurred vision, cold sweat profuse like washing, sudden collapse, unconsciousness. Condition critical, urgent consultation sought. Symptoms: Pale tongue lacking luster, Cun-Kou pulse at both Chi positions is hollow (Kou Mai), pale complexion, cold hands and feet. This is sudden deficiency of Chong and Ren Qi, failing to control Yin blood, causing reckless bleeding. Priority is to rapidly tonify Qi within Blood. As stated, "Substantial Blood cannot be generated quickly, but Intangible Qi must be urgently secured." Urgently prescribed 30g Korean Ginseng (Gao Li Shen), decocted strongly and taken. After administration, Yuan Qi gradually recovered, consciousness returned, bleeding decreased. Followed by Yang-supporting agents to restore balance of Qi, Blood, Yin, and Yang. This aligns with *Nei Jing* principles: "When Yin is balanced and Yang is secreted, Spirit is governed," and "Yin and Yang are mutually rooted." Prescription: Si Ni Tang (Four Counterflow Decoction), substituting Gan Jiang with Pao Jiang.
* *Fu Pian* (Prepared Aconite) 90g
* *Pao Jiang* (Prepared Ginger) 30g
* *Zhi Gan Cao* (Honey-fried Licorice Root) 9g
This formula warms and supports Yuan Yang and secures True Yin, addressing the root.
Second visit: After one dose, limb coldness reversed, cold sweat stopped, bleeding ceased. Still dizzy and fatigued, complexion still pale. This indicates Kidney Essence depletion and dual deficiency of Yin and Yang. Treatment: Tonify Yin and restore Yang, treating both simultaneously. Prescription:
* *Gui Ling Ji* (Turtle Age Collection) 2 bottles, 0.5 fen per dose.
Third visit: Dizziness and spirit improved after taking the above medicine. Changed to warming the Middle and securing blood, reinforcing the dike. Prescription: Gui Shao Li Zhong Tang (Angelica and Peony Regulate Middle Decoction) plus Pao Jiang.
* *Dang Gui* (Angelica Sinensis) 15g
* *Chao Hang Shao* (Fried White Peony Root) 9g
* *Lu Dang Shen* (Codonopsis Root) 15g
* *Bai Zhu* (Atractylodes Macrocephala Rhizome) 12g
* *Pao Jiang* (Prepared Ginger) 15g
* *Zhi Gan Cao* (Honey-fried Licorice Root) 6g
Fourth visit: After three consecutive doses, symptoms disappeared, complexion ruddy, only feeling fatigued. Continued with Ren Shen Yang Rong Wan (Ginseng Nourishing Glory Pill) for regulation and stability.
In the first visit, due to critical condition, following the principle of "Tonifying Qi in Blood Depletion," Ginseng was used to massively tonify Yuan Qi and rescue collapse. In critical illness, saving Yuan Yin and Yuan Yang is urgent. Fearing Qi collapsing with Blood, Ginseng was urgently used to tonify Qi and secure collapse, followed by Si Ni Tang to restore Yang and secure Yin to treat the root. Thus, Yang ascends properly and Yin is retained, achieving rapid cessation of metrorrhagia. However, after bleeding, Kidney Essence is depleted, and Yin/Yang are dual-deficient. Therefore, Gui Ling Ji was used to tonify Kidney and assist Yang, followed by Gui Shao Li Zhong to strengthen Spleen's blood-controlling function, and finally Ren Shen Yang Rong Wan for dual Qi-Blood tonification for consolidation. Addressing both root and branch allows rapid functional recovery and consolidates achieved results.
Case 2:
Patient Na XX, Female, 30 years old. Suffering from leakage syndrome, continuous dripping bleeding for over 40 days, multiple treatments failed. Consulted us. Symptoms: Choppy pulse, red tongue, lower abdominal distension/pain refusing pressure, poor blood flow, dark color with clots, irritability. Combining pulse and symptoms, diagnosed as Chong/Ren stasis, Qi mechanism obstruction, with stagnant heat. Treatment: Primarily resolve stasis and soothe Liver, secondarily clear heat, to smooth Chong/Ren vessels, return new blood to vessels, and stop leakage. Prescription: Shi Xiao San (Laughing Until Death Powder) combined with Jin Ling Zi San (Melia Toosendan Powder) with additions.
* *Wu Ling Zhi* (Trogopterus Dung) 9g
* *Pu Huang* (Typha Pollen) 9g (Half raw, half fried)
* *Chuan Lian Zi* (Melia Toosendan Fruit) 9g
* *Yan Hu Suo* (Corydalis Rhizome) 9g
* *Dang Gui* (Angelica Sinensis) 9g
* *Tao Ren* (Peach Seed) 6g
* *Ru Xiang* (Frankincense) 6g
* *Mo Yao* (Myrrh) 6g
This formula is based on the *Nei Jing* principle: "Treating obstruction with unblocking methods." *Wu Ling Zhi* is a key herb for moving blood and stopping pain. *Pu Huang* used raw and fried: raw resolves stasis, vinegar-fried stops bleeding. *Chuan Lian Zi* soothes Liver and resolves depression, guides heat downward. *Yan Hu Suo* regulates stagnant Qi in blood; *Dang Gui* nourishes and moves blood; *Tao Ren*, *Ru Xiang*, *Mo Yao* remove stasis and regulate blood, unblocking Zang-Fu and collaterals. Synergy achieves resolution of stasis, soothing of Liver, clearing of heat, smoothing of Chong/Ren vessels, and cessation of leakage.
After one dose, leakage reduced; after another dose, bleeding stopped completely. Subsequently regulated with Si Wu Tang (Four Substance Decoction) plus Xiang Fu and Chao Huang Qin, leading to cure.
Case 3:
Patient Li XX, Female, 30 years old. After dilation and curettage for metrorrhagia, dripping bleeding continued for over two months, hemostatics ineffective. Pulse fine-weak, complexion dull, spirit fatigued, lower abdominal dull pain preferring pressure. This is Chong/Ren deficiency, dual deficiency of Qi and Blood, Yin blood failing to remain inside. Treatment: Regulate Chong/Ren, tonify Qi and Blood. Prescription: Jiao Ai Si Wu Tang (Gelatin and Mugwort Four Substance Decoction) combined with Pao Jiang Gan Cao Tang (Prepared Ginger and Licorice Decoction) with modifications.
* *Sheng Di* (Raw Rehmannia) 15g
* *Dang Gui* (Angelica Sinensis) 15g
* *Hang Shao* (White Peony Root) 9g
* *Lu Dang Shen* (Codonopsis Root) 15g
* *Zhi Ai Ye* (Prepared Mugwort Leaf) 6g
* *E Jiao* (Donkey-Hide Gelatin) 30g
* *Pao Jiang* (Prepared Ginger) 15g
* *Zhi Gan Cao* (Honey-fried Licorice Root) 6g
* *Shao Wu Mei* (Roasted Mume Fruit) 9g
The Si Wu Tang above removes Chuan Xiong to nourish and regulate blood. *Zhi Ai* and *E Jiao* warm meridians and stop bleeding. Combined, they regulate Chong/Ren, nourish blood, and tonify Qi. Particularly ingenious are *Pao Jiang* and *Gan Cao*: bitter and sweet transform into Yin, guiding blood back to vessels to stop bleeding.
After one dose, bleeding gradually stopped. Continuing original formula for six doses, illness gradually cured.
Case 4:
Patient Wang XX, Female, 26 years old. After dilation and curettage, metrorrhagia continued for over a month, accompanied by night sweats, irritability, dizziness. Used the same modification of Jiao Ai Si Wu Tang combined with Pao Jiang Gan Cao Tang as Case 3. After five doses, leakage stopped completely. Night sweats, irritability, and dizziness persisted. Syndrome belongs to Kidney Yin insufficiency and Liver Yang hyperactivity. Treatment: Nourish Yin and anchor Yang. Prescription:
* *Huai Shan Yao* (Chinese Yam) 15g
* *Shan Yu Rou* (Cornus Fruit) 9g
* *Sheng Long Gu* (Dragon Bone) 15g
* *Sheng Mu Li* (Oyster Shell) 15g
* *Xuan Shen* (Scrophularia Root) 9g
In this formula, *Shan Yao* is sweet and neutral, tonifies Spleen/Stomach, benefits Lungs/Kidneys, tonifies without stagnation, non-drying/non-hot. Zhang Xichun praised it for "moistening blood vessels, securing Qi transformation" and "strengthening will and nurturing spirit." *Shan Yu Rou* is sour, astringent, slightly warm, tonifies Liver/Kidney, consolidates Yuan Qi, and stops deficiency sweating well. *Long Gu* and *Mu Li* calm Liver and anchor Yang; combined with *Yu Rou*, best for stopping sweating. *Xuan Shen* is bitter, salty, and cold, supplements water, nourishes Yin, cools blood, and moistens dryness. Combination tonifies Liver/Kidney, nourishes Yin, anchors Yang, and calms spirit.
Patient took five consecutive doses; night sweats stopped completely, irritability and dizziness improved.
This formula is derived from modifications of Zhang Xichun's formulas for "Yin Deficiency Labor Heat." It can be used for irritability, insomnia, dizziness, dry mouth, night sweats caused by Liver/Kidney insufficiency, Yin deficiency, and Yang hyperactivity.
Case 5:
Patient Gao XX, Female, 35 years old. Metrorrhagia for over 40 days, worsening in recent ten days, pale red blood color, accompanied by facial edema, tinnitus, shortness of breath, spontaneous sweating, palpitations, fatigue. Pulse fine-weak, tongue pale and moist. This is Chong/Ren deficiency, Qi failing to secure and control. Treatment: Nourish Chong/Ren, tonify Qi and secure blood. Using modified Jiao Ai Si Wu Tang. Prescription:
* *Sheng Di* (Raw Rehmannia) 15g
* *Dang Gui* (Angelica Sinensis) 15g
* *Lu Dang Shen* (Codonopsis Root) 15g
* *Hang Shao* (White Peony Root) 9g
* *Zhi Ai Ye* (Prepared Mugwort Leaf) 6g
* *Bei Qi* (Astragalus Root) 15g
* *E Jiao* (Donkey-Hide Gelatin) 30g
* *Shan Yu Rou* (Cornus Fruit) 9g
* *Wu Mei* (Mume Fruit) 9g
* *Pao Jiang* (Prepared Ginger) 15g
* *Zhi Gan Cao* (Honey-fried Licorice Root) 6g
* *Yuan Rou* (Longan Aril) 15g