126．心脏病如引起气短、浮肿，兼有畏寒喜温的情况，可酌用真武汤治之。虚者，可加人参。
127．肝炎，用逍遥散时，须用赤芍；肝区疼痛时，可酌用郁金、姜黄、乳香、没药；肝炎初期，不必加补药；食欲不振者，可以调理脾胃为主；憋胀甚者，可以加青皮、枳壳、香附等品；兼见口苦、舌黄、脉弦数者，可加丹皮、栀子、龙胆草等。
128．月经过多服他药而无效者，可用红枣，不拘多少，烧服之，每验。
129．病后虚烦不眠，心中懊（忄农），栀子豉汤吋，如有呕吐者，可加人生姜，少气者，加甘草，腹胀满者，加枳实、厚朴，腹泻者，加干姜，这是栀子豉汤应用的加减法则，本系仲景之意也。
130．疣子，以薏米煮粥食之有效。
131．胃脘压痛，可用枳实，胀满可用厚朴，便秘加大黄，燥用芒硝，兼虚者，辅以参归，兼郁者，加入香附，兼寒者，酌加姜桂。用泻下法必须如此，可触类引申，灵活掌握。
132．根据我的经验，无腹胀满症，虽大便不通，也不用枳朴，有胀满症，即使是泄泻症也可用之。仲景曰： “伤寒吐后，腹胀满者，与调胃承气汤。”(《伤寒论》第249条)我认为凋胃承气汤中(大黄、甘草、芒硝)没有除胀满的药品，本条当是小承气汤(大黄、枳实、厚朴)的适应证。
133．痛痹，若初感寒即痛者，可用桂枝及酒煎熨治，寒化为热禁用。
134．痹证见筋脉拘滞，屈伸不利者，此血虚血燥之证，非养血养气不可。
135．痛风，痛久邪必入络，如木通、刺蒺藜、红花、银花、钩藤之类，最能入络，可随宜加之。
136．痹证不愈，久痛必夹郁，郎而成热，热盛则生痰，如南星、半夏、瓜蒌根、黄柏、郁金、川贝、竹沥、姜汁之类，都能解郁清热化痰，可随宜加入。
137．痛痹，凡用乌附辛桂之药而不效者，宜用葳蕤、麦冬、桑叶、生芪、菊花、蒺藜、阿胶、甘草之类为膏，柔润熄风之法。
138．闪挫扭伤所致腰背肢体疼痛者，可用活血通络之品，酌加麝香效果较好。麝香有活血通络之功，可入丸剂，如入汤剂，可冲服之，用量0．03～0．06克即可。
139．关节炎之急性者，用少量醋柳酸，每次O．2克，1日3次。有热者，加生石膏效果很好，用量不宜多。
140．药物配伍，要注意有机配伍，而不是随意堆砌。如厚朴配人参，用于虚胀；厚朴配枳实、大黄，用于腹胀满而拒按；厚朴配干姜，用于寒胀；厚朴配栀子，用于烦满等。还有一种配伍为复用，可增强其同类作用。如败毒散中的羌活配独活，柴胡配前胡，清肺汤中的麦冬配天冬等，虽然作用有所差异，但大的方面作用还是一致的，互相配合，协同应用，取其力量增强之意。如无机地配合，则没有什么意义，也难以取得较好疗效。
141．白虎汤用治燥热之证，不论舌苔黄黑或绛，只要是干燥者，即可用之。曾治一例因注射606后发热者，午前热盛，午后热渐减，口燥舌干。考虑其为辛苦热毒之剂，给以白虎汤而愈。又治一热病，舌干口渴，但兼腹泻，予白虎汤粳米易薏米加苍术而愈。
142．达原饮治湿盛之湿温证可用，若热偏盛者，下宜用。
143．生脉散为清暑之剂，暑伤元气用之为宜。清暑益气汤宜用于虚多而夹湿之暑证。六一散为清暑之轻剂，白虎加人参汤为清暑之重剂。临证斟酌选用。
144．远血用黄土汤时，方中附子可易为姜炭，量也不宜多用，因此证湿热者多。如便血多者，再加些椿皮为佳。
145．逍遥散为疏肝解郁之剂，其治疗目标为：郁怒伤肝，肝血虚少，寒热如疟，暮热朝凉，五心烦热，鼻咽干燥，头晕眼花，两目干涩，肢体疼痛，嗜卧少食，月水不调，或少腹重坠，水道涩痛，或肿痛出脓，或遍身瘙痒，赤白游片，或瘰疬痰核等。
146．理中汤所主之虚寒证，为吐泻而腹痛者，若无吐泻，甚则便秘，审系虚寒者，小建中汤主之。临床须细心加以区别。
147．炙甘草汤之应用，应以脉结代、心动悸为主症，脉兼细小而数，不任循按，常致心悸不寐，常出虚汗者，本方桂枝可用4．5～7．5克，生地须18克左右，便秘者加火麻仁适量。甚者加入大黄，便溏者，去麻仁，失眠者，加炒枣仁、朱砂，如热者，去桂姜，加白芍，复脉汤之意也。
148．金铃子散治心腹痛之非寒凉性者皆效，张寿甫加入乳香、没药用之亦佳。
149．芍药汤中之肉桂为治湿而设，盖痢兼湿热，纯用苦寒，热去而湿不去，仍不愈，必加肉桂以佐之，庶几湿与热可尽化耳，但须少量为妥。
150．治痰饮用干姜苓术汤为主，干姜之意在于温脾阳，脾阳得复，水饮白化。咳者，干姜细辛五味也，有痰者，属寒者宜之，临床夹杂者多用，量不宜大，必要时口苦伍黄芩，口渴热甚者，伍石膏，随症加减方有效。
151．四逆之与附子理中，一是温法，一是温补法。如大吐泻之后发厥，四逆汤加人参以补之，因虚故也。又从病的日期及平素病人体质来看，如有虚弱情况，都可酌加补药，总之，必须吻合病情病机，才会取效。
152．玉枢丹芳开之力不及苏合香丸，凡中暑秽浊、中湿呕吐、腹泻等均可用之。又可用于夹有疠气之喉痛．
153．桂枝附子汤是治疗阳虚兼风寒湿性身体疼痛之方，症见身体烦疼，不能自转侧，不呕不渴，脉浮虚而涩。此方必须具有不喜冷性饮食的症状，单不渴一症，不能说明没有内热现象。
154．除内湿羌活汤(羌活、防风、柴胡、藁本、苍术、升麻、生姜)是治疗风湿在表的方子，症见一身尽痛，日晡发熱。使用此方必须没有喜冷现象方能合拍，并治兼有大便溏症最效。
155．桔梗汤是治疗咽痛的普通方剂，热轻者用之固佳，有脓欲溃时用之更好，但桔梗必须重用。
156．甘草干姜汤中干姜温中治厥，炮黑变辛为苦，使回阳而不伤阴，倍用甘草更从中以控制之。干姜一药对于此证不用不行，用之又嫌燥热太过，对于咽干烦躁之阴虚现象确实不利，故炮黑使用，方才稳妥．
157．《金匮要略》肾着汤(甘、姜、茯、术)主治寒湿在肾之经络诸证，因此证寒湿不在肾脏，故不宜用桂附。恐伤肾阴。
158．使用桂枝汤吋必须具备汗出、脉浮、不喜冷性饮食三个主症，否则就会出现医疗事故或轻病致重或重病转危。这三个主症当中不喜冷性饮食一症更为重要，临床体会使用桂枝汤不一定都有汗，但不喜冷性饮食一症却是绝对不可缺少的。
]59．桂枝加葛根汤的主症是项背强直，余如桂枝证即太阳有汗之证，没有喜冷现象。桂枝汤是太阳有汗恶风之专方；葛根退热，生滓润燥，是治项背强几几之专药。
160．温经汤加减可治宫寒不孕，月经不调，或前或后，或逾期不止，或一月再行，傍晚发热，手心烦热，唇口干燥，或少腹冷痛诸证。
161．九痛丸乃温中散寒、导滞攻下之方。善治寒实结滞、脘腹剧痛、按之更甚、舌苔薄白、大便秘结之急腹症，如胰腺炎、肠梗阻等。
方证(病)治验
162．湿温初期，须发汗时，以藿香、紫苏为宜，兼见胸痞闷，选用三仁汤加减治之。
163．湿热证，身热、脉洪、口渴、自汗，此属热重之白虎汤证；若兼身重、胸痞，为热中夹湿。湿热夹杂时，如热重湿轻，则白虎汤少加苍术、厚朴即可；如兼腹泻，石膏即不宜用，改为滑石，再加薏仁；如热不减而胸痞，蔻仁可以用，为藿朴夏苓汤之意也。
164．暑伤气分，热甚烦渴，倦怠气短，多汗，食欲不振，有时大便溏泻，清暑益气汤主之。
165．一位经常感冒经久不愈的患者，遍用玉屏风、补中益气等方药数百剂无效。经过认真观察，发现其病多发在夏季，苔黄厚舌质红，脉滑，为三焦郁火熏肺，肺被火灼，卫外失固，予牛黄上清丸而愈。
166．一例头晕患者，久治无效，经诊察症见头晕恶心，食欲不振，心神不宁，失眠，脉缓，予以二陈加天麻、白术、龙骨、牡蛎、石决明。3剂即显著好转。复诊仍照原方略有加减，渐愈。
167．治牙龈出血，全身紫斑，曾用考的松即可，但离不了，停药即复发如初，化验为血小板减少，给以犀角地黄汤而愈。
168．曾遇一证，舌肿满口而硬，不能言语，以针刺廉泉、玉英二穴出血，以生蒲黄细面掺之，内服黄连泻心汤而愈。此心经实火也。
169．治喉证，兼外感者，酌用荆防或银翘散治之；无表证之实火，以三黄汤治之；阴虚者，养阴清肺汤加减治之。
170．一喑哑患者，因素体有火，又加过食生冷，导致寒中包火之喑哑证，仿麻杏石甘汤之法，加薄荷、牛子、连翘、蝉蜕、胖大海，1剂即显著好转。由其他原因致喑哑者，不宜用此方。
171．治一咳嗽患者，平时不咳，每于下午即咳，久不愈，给以麦味地黄丸而愈。
172．曾治一例咳嗽，病已迁延20余天，症见咳嗽，两胁胀满，痰多，易咯，咽干口苦，不喜饮，兼头痛。此属肝气郁结，上热下寒之证，给以贝母、桑皮、柴胡、香附、橘红、半夏、茯苓、干姜、黄芩等剂，以清肺化痰解郁，平调其寒热，一剂即见好转，3剂而愈。此证关键点在于寒热夹杂，用药特点也在于寒温并用．
173．肺气肿如审其属虚寒者，薯蓣丸很好。如兼肾虚者。方中可加入紫河车。原方以分计量，每分折为二钱半。用此药时，应注意起火。
174．曾治一喘者，病势已危，患者喘不得卧，呼吸促迫，脉数无力，微有热，苔白，脘腹拒按，即以真武汤为主，加人人参，另少加麻黄1．5克以祛其表热，莱菔子以去其脘腹痛，一剂即好转。说明用药须灵活掌握，才能收到良效，死搬硬套不行，无的放矢也不行。
175．呃逆，有一种因阴虚大逆而发者，其声长，患者自觉有气由脐下上冲咽喉，町用知柏地黄丸治之。
176．腹中气痛上冲，俗称肾气，即痃癖、奔豚等证。临床上大体可分为三类：一属寒者，宜桂枝加桂汤加减：二属热者，宜奔豚汤加减；三属寒热夹杂者，宜黄连汤加减。具体应用仍须辨别虚实情况和兼证而定。又，奔豚汤从药味分析，主药芍药、甘草以止痛，归芍以养血，姜夏止呕，芩葛李根白皮分解内外之热，是以奔豚证，兼血虚内外有热，上冲又兼呕逆者用之为宜。寒热夹杂者，黄连汤或乌梅丸均可随证选用。
177．曾治一初期肝硬化患者，以逍遥散为主，柴胡少量用之，疼痛加入乳香、没药、郁金、姜黄，偏胀又加厚朴、青皮、香附，如肝区热痛，加元胡、川棟子，如发热有块者，加鳖甲、丹皮。治疗中时时应注意。
178．痹证寒湿胜，手臂、肩肿痛，用散风除湿之行痹方，不效者，用草乌、苍术、白术、当归、乳香、没药。
]79．痹证风胜者，治当行散，宜败毒散、乌药顺气散之类治之。兼火者，大秦艽汤或九味羌活汤主之。
]80．痹证寒胜，察其表里俱无热证者，宜五积散或小续命汤、甘草附子汤主之。
181．痹证湿胜，疼痛重着，小续命汤倍防己主之，增损五痹汤亦主之．
182．一例腰椎结核患者，前医以阳和汤治之不效．余审其面色姚白，脉滑数，诊为气血俱虚，热毒壅滞，予黄芪15克，当归9克，赤芍6克，银花9克，连翘9克。40剂获愈。
183．水肿一证，用五皮饮是一般方剂，必须辨证加减，始为恰当。如上肿，宜汗，酌加麻桂；下肿，则酌加渗利之品；实者，酌加消导之品；虚者，酌加参术；寒者，酌加桂附；热者，酌加滑石、木通之品。必须如是用之。又，茯苓导水汤为实证相宜，虚者不宜用。
184．痢证兼发热，葛根、连翘等可酌用之。如屆热痢，葛根芩连汤主之．
185．一慢性痢疾久治不愈的患者，曾用补法、泻法及攻补兼施，但3年多疗效不显，余审其症见里急后重，便痢脓血，脘腹胀痛，按之更甚，脉弦而细，子附子1．5克，木香4．5克，焦山楂10克，山药]5克，大黄3克，1周1剂，仅服4剂便愈，其效甚佳。关键在于祛邪不伤正，谨候其气之来复，病自愈。
186．大便不利，属于肝气不舒的，芍药、香附即可治愈。
187．一老年男性，患肠梗阻腹痛不止，用复方大承气汤治之而腹痛加重，余审其腹胀尚濡软，脉微而肢厥，神倦欲寐，舌质淡苔白，诊为中气大衰，先宜枢利，予厚朴生姜半夏甘草人参汤一剂而愈。
188．痿证，在我区以湿热者居多，好发于夏秋之季，清燥汤治之较好。见症必须有口粘腻、胸满闷、午后身热等湿热症状。用时尚需随症加减。
189．治狂证，用防风通圣为主，加用镇静之品，有良效。
190。休克。病血压降低，脉微欲绝，似应属虚，然临床听见非尽属虚，至其治法亦应虚实有分，寒热有别，经络必分。若大实者虽承气亦不可缺，若阳虚者虽四逆亦不可少，至如气脱者莫若人参，阴脱者生脉可为佳方，肾脱者可考虑山茱萸，血脱者可考虑当归补血等。
191．努伤证，胸中刺痛，憋胀，有吋夹痰，常用旋覆花、茜草伍以灵脂、郁金、瓜蒌、半夏、葱白，效果很好。此即旋覆花汤、失笑散之意。
126. If heart disease causes shortness of breath and edema, accompanied by aversion to cold and a preference for warmth, Zhenwu Tang (True Warrior Decoction) may be used酌情ly. For deficiency patterns, Ren Shen (Ginseng Radix) can be added.
127. When treating hepatitis with Xiaoyao San (Free and Easy Wanderer Powder), Chi Shao (Red Peony Root) must be used. For pain in the liver area, Yu Jin (Turmeric Tuber), Jiang Huang (Curcuma Longa Rhizome), Ru Xiang (Frankincense), and Mo Yao (Myrrh) may be added酌情ly. In the early stage of hepatitis, tonifying herbs are not necessary. For loss of appetite, regulation of the Spleen and Stomach should be the primary focus. For severe distension, Qing Pi (Green Tangerine Peel), Zhi Ke (Aurantium Fructus), and Xiang Fu (Cyperus Rhizome) can be added. If accompanied by bitter taste in the mouth, yellow tongue coating, and wiry-rapid pulse, Mu Dan Pi (Moutan Cortex), Zhi Zi (Gardeniae Fructus), and Long Dan Cao (Gentianae Radix et Rhizoma) can be added.
128. For menorrhagia unresponsive to other medications, Red Dates (Jujubae Fructus) can be used in any quantity, charred and taken orally; this method has proven effective each time.
129. For post-illness restlessness, insomnia, and mental agitation (Ao Nong), Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) is applicable. If vomiting occurs, add Sheng Jiang (Zingiberis Rhizoma Recens); if there is shortness of breath, add Gan Cao (Licorice Root); if abdominal fullness occurs, add Zhi Shi (Immature Bitter Orange) and Hou Po (Magnolia Bark); if diarrhea occurs, add Gan Jiang (Dried Ginger). These are the modification rules for Zhizi Chi Tang, originating from Zhang Zhongjing's intent.
130. For warts, cooking porridge with Yi Mi (Coix Seed) and eating it is effective.
131. For tenderness in the epigastrium, Zhi Shi (Immature Bitter Orange) can be used; for distension, Hou Po (Magnolia Bark) can be used; for constipation, add Da Huang (Rhubarb Root and Rhizome); for dryness, use Mang Xiao (Mirabilite); for accompanying deficiency, supplement with Ren Shen (Ginseng Radix) and Dang Gui (Angelica Sinensis Radix); for accompanying stagnation, add Xiang Fu (Cyperus Rhizome); for accompanying cold,酌情ly add Gan Jiang (Dried Ginger) and Gui Zhi (Cinnamon Twig). This approach must be followed when using purgative methods; one should apply this principle flexibly to similar situations.
132. Based on my experience, if there is no abdominal fullness, even if stool is difficult to pass, Zhi Shi (Immature Bitter Orange) and Hou Po (Magnolia Bark) should not be used. If there is abdominal fullness, they can be used even in cases of diarrhea. Zhang Zhongjing stated: "After vomiting in Shaoyang syndrome, if there is abdominal fullness, give Tiaowei Chengqi Tang (Regulate the Stomach and Order the Qi Decoction)." (Shanghan Lun, Clause 249). I believe that Tiaowei Chengqi Tang (Da Huang, Gan Cao, Mang Xiao) lacks herbs to eliminate fullness; this clause should be an indication for Xiao Chengqi Tang (Da Huang, Zhi Shi, Hou Po).
133. For painful Bi syndrome, if pain occurs immediately upon initial cold invasion, Gui Zhi (Cinnamon Twig) and wine-compressed heat therapy can be used. It is contraindicated if the cold transforms into heat.
134. In Bi syndrome, if tendons and vessels are constrained and movement is difficult, this is a pattern of Blood deficiency and dryness; nourishing Blood and Qi is essential.
135. In gout, prolonged pain implies pathogenic factors have entered the collaterals. Herbs such as Mu Tong (Akebia Caulis), Ci Ji Li (Tribulus Fruit), Hong Hua (Carthamus Flower), Yin Hua (Chrysanthemi Flos), and Gou Teng (Uncaria Ramulus cum Uncis) are best at entering the collaterals and can be added as appropriate.
136. If Bi syndrome persists and chronic pain inevitably involves stagnation, which eventually generates heat, and excessive heat produces phlegm, herbs such as Nan Xing (Arisaematis Rhizoma Preparatum), Ban Xia (Pinelliae Rhizoma), Gua Lou Gen (Trichosanthis Radix), Huang Bo (Phellodendri Cortex), Yu Jin (Curcumae Radix), Chuan Bei (Fritillariae Bulbus), Zhu Li (Bambusa Sap), and Jiang Zhi (Zingiberis Juice) can resolve stagnation, clear heat, and transform phlegm. They can be added as appropriate.
137. For painful Bi syndrome, if Wu Tou (Aconiti Radix), Fu Zi (Aconiti Lateralis Radix Preparata), Xin Yi (Xanthii Fructus), and Gui Zhi (Cinnamon Twig) are ineffective, it is advisable to use Wei Yu (Polygonati Reticulati Rhizoma), Mai Dong (Ophiopogonis Radix), Sang Ye (Mori Folium), Sheng Qi Huang (Astragali Radix), Ju Hua (Chrysanthemi Flos), Ji Li (Tribuli Fructus), E Jiao (Asini Corii Colla), and Gan Cao (Licorice Root) to make a paste, employing the method of softening, moistening, and extinguishing wind.
138. For back, limb, and body pain caused by sprains or strains, blood-invigorating and collateral-unblocking herbs can be used; adding She Xiang (Moschus)酌情ly yields better results. She Xiang has the function of invigorating blood and unblocking collaterals; it can be used in pills. If used in decoctions, it should be taken with the decoction, in a dose of 0.03–0.06 g.
139. For acute arthritis, a small amount of salicylic acid vinegar can be used, 0.2 g per dose, three times daily. If there is heat, adding Sheng Shi Gao (Gypsum Fibrosum) is very effective, but the dosage should not be large.
140. Drug compatibility requires organic combination, not arbitrary stacking. For example, Hou Po (Magnolia Bark) combined with Ren Shen (Ginseng Radix) is used for deficiency-type distension; Hou Po combined with Zhi Shi (Immature Bitter Orange) and Da Huang (Rhubarb Root and Rhizome) is used for abdominal fullness with resistance to pressure; Hou Po combined with Gan Jiang (Dried Ginger) is used for cold-type distension; Hou Po combined with Zhi Zi (Gardeniae Fructus) is used for vexation and fullness. Another type of compatibility is duplication, which enhances similar effects. For instance, Qiang Huo (Notopterygii Rhizoma et Radix) combined with Du Huo (Angelicae Pubescentis Radix) in Baidu San (Detoxicate Powder), Chai Hu (Bupleuri Radix) combined with Qian Hu (Peucedani Radix), and Mai Dong (Ophiopogonis Radix) combined with Tian Dong (Asparagi Radix) in Qingfei Tang (Clear Lung Decoction). Although their specific actions differ, their general effects are consistent. Mutual cooperation and synergistic application aim to enhance efficacy. Inorganic combination is meaningless and unlikely to yield good therapeutic results.
141. Baihu Tang (White Tiger Decoction) is used for dry-heat patterns. Regardless of whether the tongue coating is yellow, black, or crimson, as long as it is dry, it can be used. I once treated a patient who developed fever after injection of "606" (Salvarsan). The fever was severe in the morning and subsided in the afternoon, with dry mouth and tongue. Considering it was a bitter, pungent, and hot-toxic agent, I prescribed Baihu Tang, and the patient recovered. I also treated a heat disease patient with a dry tongue and thirst, but accompanied by diarrhea. I modified Baihu Tang by replacing Jing Mi (Coicis Semen) with Yi Yi Ren (Coix Seed) and adding Cang Zhu (Atractylodis Rhizoma), resulting in recovery.
142. Dayin Yin (Reach the Origin Drink) can be used for damp-warmth syndromes with predominant dampness. If heat is predominant, the following prescription is not suitable.
143. Shengmai San (Generate the Pulse Powder) is a summerheat-clearing formula, suitable for summerheat damaging Yuan Qi. Qing Shu Yi Qi Tang (Clear Summerheat and Benefit Qi Decoction) is suitable for summerheat syndromes with significant deficiency and accompanying dampness. Liu Yi San (Six-to-One Powder) is a mild summerheat-clearing formula, while Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng) is a heavy summerheat-clearing formula. Choose appropriately based on clinical presentation.
144. For distal bleeding (hematochezia), when using Huangtu Tang (Yellow Earth Decoction), Fu Zi (Aconiti Lateralis Radix Preparata) can be replaced with Jiang Tan (Charred Dried Ginger), and the dosage should not be high, as these patterns often involve damp-heat. If bleeding is profuse, adding Chun Pi (Toosendan Cortex) is advisable.
145. Xiaoyao San (Free and Easy Wanderer Powder) is a formula for soothing the Liver and resolving stagnation. Its indications include: anger injuring the Liver, Liver Blood deficiency, alternating chills and fever like malaria, evening heat and morning coolness, five-palm heat, dry nose and throat, dizziness, blurred vision, dry eyes, body pain, lethargy, poor appetite, irregular menstruation, heaviness in the lower abdomen, painful urination, swelling and pus discharge, generalized itching, red and white patches, or scrofula and phlegm nodules.
146. The deficiency-cold pattern treated by Lizhong Tang (Regulate the Middle Decoction) involves vomiting, diarrhea, and abdominal pain. If there is no vomiting or diarrhea, or even constipation, and it is confirmed to be deficiency-cold, Xiaojianzhong Tang (Minor Construct the Middle Decoction) should be used. Careful differentiation is required in clinical practice.
147. The application of Zhigancao Tang (Honey-Processed Licorice Decoction) should focus on knotted or intermittent pulse and palpitations. If the pulse is also fine, small, and rapid, difficult to palpate, often causing palpitations and insomnia, and accompanied by spontaneous sweating, Gui Zhi (Cinnamon Twig) in this formula can be used in doses of 4.5–7.5 g, and Sheng Di Huang (Rehmanniae Radix) should be around 18 g. For constipation, add适量的 Huo Ma Ren (Cannabis Seed). For severe cases, add Da Huang (Rhubarb Root and Rhizome); for loose stools, remove Huo Ma Ren; for insomnia, add Chao Suan Zao Ren (Ziziphus Seed Prepared) and Zhu Sha (Cinnabar); if there is heat, remove Gui Zhi (Cinnamon Twig) and Gan Jiang (Dried Ginger) and add Bai Shao (White Peony Root), reflecting the intent of Fumai Tang (Restore the Pulse Decoction).
148. Jinlingzi San (Melia Dispenser Powder) is effective for heart and abdominal pain that is not due to cold-cool nature. Zhang Shoufu added Ru Xiang (Frankincense) and Mo Yao (Myrrh) to it, which is also excellent.
149. Rou Gui (Cinnamon Bark) in Shaoyao Tang (Peony Decoction) is set to treat dampness. Dysentery often involves damp-heat; purely using bitter-cold herbs clears heat but leaves dampness, so the condition does not resolve. Rou Gui must be added to assist, allowing dampness and heat to be fully transformed, but a small dose is appropriate.
150. Ganjiang Lingzhu Tang (Dried Ginger, Poria, and Atractylodes Decoction) is the main formula for treating Phlegm-Fluid retention. The intent of Gan Jiang (Dried Ginger) is to warm the Spleen Yang; once Spleen Yang is restored, Phlegm-Fluids transform spontaneously. For cough, Gan Jiang (Dried Ginger), Xi Xin (Asari Radix et Rhizoma), and Wu Wei Zi (Schisandrae Fructus) are used. For patients with phlegm, this is suitable for cold patterns and is commonly used in mixed clinical cases; the dosage should not be large. If there is a bitter taste, combine with Huang Qin (Scutellariae Radix); if there is thirst and severe heat, combine with Shi Gao (Gypsum Fibrosum). Modifications based on symptoms are effective.
151. Sini Tang (Reverse-Recovery Decoction) and Fuzi Lizhong Tang (Aconite Regulate-the-Middle Decoction): one is a warming method, the other is a warming-tonifying method. After severe vomiting and diarrhea leading to cold extremities, Sini Tang plus Ren Shen (Ginseng Radix) is used to tonify, due to deficiency. From the perspective of disease duration and the patient's usual constitution, if there is weakness, tonifying herbs can be added酌情ly. In summary, treatment must align with the disease condition and pathogenesis to be effective.
152. Yushu Dan (Jade Pivot Pellet) has less aromatic opening power than Suhexiang Wan (Styrax Pill). It can be used for heatstroke with turbid pathogens, dampness-induced vomiting, and diarrhea. It can also be used for sore throat complicated by epidemic toxic pathogens.
153. Guizhi Fuzi Tang (Cinnamon Twig and Aconite Decoction) is a formula for treating body pain due to Yang deficiency combined with Wind-Cold-Dampness. Symptoms include bodily discomfort and pain, inability to turn over independently, no vomiting, no thirst, and a floating, deficient, and choppy pulse. This formula must be used only if the patient has a symptom of disliking cold foods/drinks. The absence of thirst alone does not indicate the absence of internal heat.
154. Chu Neishi Qianghuo Tang (Remove Internal Dampness and Notopterygium Decoction: Qiang Huo, Fang Feng, Chai Hu, Gao Ben, Cang Zhu, Sheng Ma, Sheng Jiang) is a formula for treating Wind-Dampness at the exterior. Symptoms include whole-body pain and fever in the late afternoon. This formula must be used only if there is no preference for cold, and it is most effective for accompanying loose stools.
155. Jiegeng Tang (Platycodon Decoction) is a common formula for treating sore throat. It is good for mild heat, and even better when pus is about to rupture, but Jie Geng (Platycodon Root) must be used in a heavy dose.
156. In Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction), Gan Jiang (Dried Ginger) warms the middle and treats cold extremities. Charred, it changes from pungent to bitter, restoring Yang without damaging Yin. Doubling the amount of Gan Cao (Licorice Root) further controls this from the middle. Gan Jiang is indispensable for this pattern, but its dryness and heat are too strong, which is detrimental to Yin deficiency phenomena like dry throat and irritability. Therefore, it must be charred before use to be safe.
157. Shen Zhuo Tang (Kidney Fixation Decoction: Gan Cao, Gan Jiang, Fu Ling, Bai Zhu) from *Jingui Yaolue* treats various patterns of Cold-Dampness in the meridians of the Kidney. Since the Cold-Dampness is not in the Kidney organ itself, Gui Zhi (Cinnamon Twig) and Fu Zi (Aconite) should not be used, to avoid damaging Kidney Yin.
158. Using Guizhi Tang (Cinnamon Twig Decoction) requires the presence of three main symptoms: sweating, floating pulse, and dislike of cold foods/drinks. Otherwise, medical errors may occur, turning mild illness severe or severe illness critical. Among these three, disliking cold foods/drinks is more important. Clinical experience shows that while not all Guizhi Tang cases have sweating, disliking cold foods/drinks is absolutely indispensable.
159. The main symptom of Guizhi Jia Gegen Tang (Cinnamon Twig Decoction plus Platycodon) is stiffness and tension in the neck and back. Other symptoms are those of Guizhi syndrome, i.e., Taiyang syndrome with sweating, and no preference for cold. Guizhi Tang is the specialized formula for Taiyang syndrome with sweating and aversion to wind. Gegen (Platycodon Root) reduces fever and generates fluids to moisten dryness; it is the specialized herb for treating neck and back stiffness.
160. Modified Wenjing Tang (Warm the Menses Decoction) can treat infertility due to uterine cold, irregular menstruation (early, late, prolonged, or twice a month), evening fever, palm heat, dry lips and mouth, or cold pain in the lower abdomen.
161. Jiutong Wan (Nine Pain Pill) is a formula for warming the middle, dispersing cold, guiding out stagnation, and purging. It is good for acute abdominal conditions such as pancreatitis and intestinal obstruction, characterized by cold-excess accumulation, severe epigastric/abdominal pain worsened by pressure, thin white tongue coating, and constipation.
Case Studies of Formula-Syndrome Match
162. In the early stage of damp-warmth, when sweating is required, Huo Xiang (Patchouli Herb) and Zi Su Ye (Perilla Leaf) are suitable. If accompanied by chest stuffiness, Sanren Tang (Three Seeds Decoction) modified can be used.
163. For damp-heat syndrome with fever, surging pulse, thirst, and spontaneous sweating, this is a Baihu Tang (White Tiger Decoction) pattern with predominant heat. If accompanied by heaviness and chest stuffiness, it is heat mixed with dampness. When damp-heat is mixed, if heat is heavy and damp is light, add a small amount of Cang Zhu (Atractylodis Rhizoma) and Hou Po (Magnolia Bark) to Baihu Tang. If accompanied by diarrhea, Shi Gao (Gypsum Fibrosum) should not be used; replace it with Hua Shi (Halloysitum Rubrum) and add Yi Yi Ren (Coix Seed). If heat persists and chest stuffiness remains, Kou Ren (Cardamomi Fructus) can be used, reflecting the intent of Huopo Xialing Tang (Magnolia, Amomum, Pinellia, and Poria Decoction).
164. For summerheat damaging Qi level, with severe heat, vexation, thirst, fatigue, shortness of breath, profuse sweating, poor appetite, and occasional loose stools, Qingshu Yiqi Tang (Clear Summerheat and Benefit Qi Decoction) is the main formula.
165. A patient with frequent colds that persisted despite treatment tried hundreds of doses of Yupingfeng San (Jade Windscreen Powder) and Buzhong Yiqi Tang (Tonify the Middle and Benefit Qi Decoction) without effect. Upon careful observation, I found the illness mostly occurred in summer, with a thick yellow tongue coating, red tongue body, and slippery pulse. This indicated depression fire of the Triple Burner steaming the Lungs, burning the Lungs, and failing to secure the Exterior. I prescribed Niuhuang Shangqing Wan (Calculus Bovis Upper-Clearing Pill), and the patient recovered.
166. A patient with dizziness had been treated unsuccessfully for a long time. Examination revealed dizziness, nausea, poor appetite, restlessness, insomnia, and a slow pulse. I prescribed Erchen Tang (Two-Aged Decoction) plus Tian Ma (Gastrodiae Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Long Gu (Fossilia Ossis Mastodi), Mu Li (Concha Ostreae), and Shi Jue Ming (Concha Haliotidis). Significant improvement occurred after three doses. On follow-up, slight modifications were made to the original formula, leading to gradual recovery.
167. For gingival bleeding and generalized purpura, Cortisone was previously used but could not be discontinued without relapse. Laboratory tests showed thrombocytopenia. I prescribed Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction), and the patient recovered.
168. I encountered a case where the tongue was swollen, filling the mouth and hard, making speech impossible. I punctured the Lianquan (Confluence of Yin) and Yuying (Jade Ying) acupoints to bleed them, applied raw Pu Huang (Typhae Pollen) powder topically, and administered internally Huanglian Xiexin Tang (Coptis Drain the Epigastrium Decoction). The patient recovered. This was excess fire of the Heart Meridian.
169. For throat disorders, if accompanied by external contraction, Jing Fang (Schizonepeta and Saposhnikovia) or Yinqiao San (Honeysuckle and Forsythia Powder) can be used酌情ly. For excess fire without exterior signs, Sanhuang Tang (Three Yellow Decoction) is used. For Yin deficiency, Yangyin Qingfei Tang (Nourish Yin and Clear Lung Decoction) modified is used.
170. A hoarse patient, constitutionally prone to fire, exacerbated by excessive consumption of cold/raw food, developed hoarseness due to cold enveloping fire. Following the method of Maxing Shigan Tang (Ephedra, Apricot Kernel, Gypsum, and Licorice Decoction), I added Bo He (Menthae Haplocalycis Herba), Niu Bang Zi (Arctii Fructus), Lian Qiao (Forsythiae Fructus), Chan Tui (Cicada Slough), and Pang Da Hai (Sterculiae Lychnophorae Semen). Significant improvement occurred after one dose. This formula is not suitable for hoarseness caused by other reasons.
171. Treating a cough patient who did not cough normally but coughed every afternoon, persisting for a long time, Maiwei Dihuang Wan (Lily and Schisandra Rehmannia Pill) cured him.
172. I treated a cough case that had persisted for over 20 days. Symptoms included cough, distension in both hypochondria, abundant sputum easy to expectorate, dry throat, bitter taste, lack of desire to drink, and headache. This belonged to Liver Qi stagnation with upper heat and lower cold. I prescribed Bei Mu (Fritillariae Bulbus), Sang Bai Pi (Mori Cortex), Chai Hu (Bupleuri Radix), Xiang Fu (Cyperus Rhizoma), Ju Hong (Citri Reticulatae Pericarpium Rubrum), Ban Xia (Pinelliae Rhizoma), Fu Ling (Poria), Gan Jiang (Dried Ginger), and Huang Qin (Scutellariae Radix) to clear the Lungs, transform phlegm, resolve stagnation, and harmonize cold and heat. Improvement was seen after one dose, and recovery after three doses. The key to this pattern was the mixture of cold and heat, and the medication characteristic was the simultaneous use of cold and warm herbs.
173. For pulmonary emphysema confirmed as deficiency-cold, Shuyu Wan (Dioscorea Pill) is very good. If accompanied by Kidney deficiency, Zi He Che (Human Placenta) can be added to the formula. The original formula is measured in fen; each fen equals 2.5 qian. When using this medicine, attention should be paid to the fire control during preparation.
174. I treated a wheezing patient in critical condition. The patient could not lie down due to wheezing, breathing was rapid and weak, pulse was rapid and forceless, slight fever, white tongue coating, and epigastric/abdominal resistance to pressure. I primarily used Zhenwu Tang (True Warrior Decoction), added Ren Shen (Ginseng Radix), and separately added a small amount of Ma Huang (Ephedrae Herba) 1.5 g to dispel exterior heat, and Lai Fu Zi (Radish Seed) to relieve epigastric/abdominal pain. Improvement occurred after one dose. This illustrates that flexible application of medication is necessary for good results; rigid adherence fails, as does shooting blindly without a target.
175. Hiccups can sometimes arise from severe Yin deficiency reversal. The sound is long, and the patient feels Qi rushing up from below the navel to the throat. Zhibai Dihuang Wan (Anemarrhena, Phellodendron, and Rehmannia Pill) can be used to treat this.
176. Abdominal Qi pain rushing upward, commonly known as "Kidney Qi," refers to patterns like Xuanpi (Flank Mass) and Bentun (Rushing Bull). Clinically, it can be roughly divided into three categories: one belonging to cold, suitable for Guizhi Jia Guixin Tang (Cinnamon Twig Decoction plus Cinnamon) modified; one belonging to heat, suitable for Bentun Tang (Rushing Bull Decoction) modified; and one belonging to mixed cold and heat, suitable for Huanglian Tang (Coptis Decoction) modified. Specific application still depends on distinguishing deficiency/excess and accompanying patterns. Furthermore, analyzing Bentun Tang, the main herbs Shao Yao (Peony Root) and Gan Cao (Licorice Root) stop pain, Gui/Shao nourish Blood, Jiang/Xia stop vomiting, and Qin/Ge/Ligen Baipi (Phellodendri Cortex, Platycodon Root, and Pyri Radix) resolve internal and external heat. Thus, Bentun Tang is suitable for Bentun syndrome accompanied by Blood deficiency, internal and external heat, and upward rushing with vomiting. For mixed cold and heat, Huanglian Tang or Wumei Wan (Mume Pill) can be selected according to the pattern.
177. I treated a patient with early-stage liver cirrhosis, primarily using Xiaoyao San (Free and Easy Wanderer Powder), with a small dose of Chai Hu (Bupleuri Radix). For pain, I added Ru Xiang (Frankincense), Mo Yao (Myrrh), Yu Jin (Curcumae Radix), and Jiang Huang (Curcuma Longa Rhizome). For distension, I added Hou Po (Magnolia Bark), Qing Pi (Green Tangerine Peel), and Xiang Fu (Cyperus Rhizome). For heat pain in the liver area, I added Yuan Hu (Corydalis Rhizome) and Chuan Lian Zi (Meliae Fructus). For fever with masses, I added Bie Jia (Carapax Trionycis) and Mu Dan Pi (Moutan Cortex). Attention should be paid throughout the treatment.
178. For Bi syndrome with predominant Cold-Dampness, causing swelling and pain in arms and shoulders, if Wind-dispersing and Damp-draining formulas for Moving Bi fail, use Cao Wu (Aconiti Radix), Cang Zhu (Atractylodis Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Dang Gui (Angelicae Sinensis Radix), Ru Xiang (Frankincense), and Mo Yao (Myrrh).
179. For Bi syndrome with predominant Wind, treatment should involve dispersing and moving. Baidu San (Detoxicate Powder) or Wuyao Shunqi San (Aucklandia Regulate-Qi Powder) can be used. If accompanied by Fire, Da Qin Jiao Tang (Large Gentian Decoction) or Jiuwei Qianghuo Tang (Nine-Ingredient Notopterygium Decoction) are the main formulas.
180. For Bi syndrome with predominant Cold, if there are no heat signs in both interior and exterior, Wuji San (Five Accumulations Powder), Xiao Xuming Tang (Minor Rescue Life Decoction), or Gancao Fuzi Tang (Licorice and Aconite Decoction) are the main formulas.
181. For Bi syndrome with predominant Dampness, with heavy and fixed pain, Xiao Xuming Tang (Minor Rescue Life Decoction) with doubled Fang Ji (Stephaniae Tetrandrae Radix) is the main formula. Zengsun Wubi Tang (Modified Five-Bi Decoction) is also used.
182. A patient with lumbar vertebral tuberculosis was treated with Yanghe Tang (Yang-Nourishing Decoction) by previous physicians without effect. I examined her pale complexion, slippery and rapid pulse, and diagnosed Qi and Blood deficiency with Heat-Toxin stagnation. I prescribed Huang Qi (Astragali Radix) 15 g, Dang Gui (Angelicae Sinensis Radix) 9 g, Chi Shao (Paeoniae Radix Rubra) 6 g, Yin Hua (Chrysanthemi Flos) 9 g, and Lian Qiao (Forsythiae Fructus) 9 g. Recovery was achieved after 40 doses.
183. Edema is generally treated with Wupi Yin (Five-Bark Drink), but it must be differentiated and modified to be appropriate. For upper edema, sweating is indicated;酌情ly add Ma Huang (Ephedrae Herba) and Gui Zhi (Cinnamon Twig). For lower edema,酌情ly add diuretic herbs. For excess patterns,酌情ly add digestion-promoting herbs. For deficiency patterns,酌情ly add Ren Shen (Ginseng Radix) and Bai Zhu (Atractylodis Macrocephalae Rhizoma). For cold patterns,酌情ly add Gui Zhi (Cinnamon Twig) and Fu Zi (Aconiti Lateralis Radix Preparata). For heat patterns,酌情ly add Hua Shi (Halloysitum Rubrum) and Mu Tong (Akebiae Caulis). It must be used in this manner. Also, Fuling Daoshui Tang (Poria Guiding-Water Decoction) is suitable for excess patterns and not for deficiency.
184. For dysentery accompanied by fever, Ge Gen (Puerariae Lobatae Radix) and Lian Qiao (Forsythiae Fructus) can be used酌情ly. If it is heat-dysentery, Gegen Qinlian Tang (Kudzu, Coptis, and Scutellaria Decoction) is the main formula.
185. A patient with chronic dysentery unresponsive to treatment for over three years, having tried tonification, purgation, and combined attack-and-tonification methods, presented with tenesmus, bloody/purulent stool, epigastric/abdominal pain worse on pressure, and a wiry, fine pulse. I prescribed Fu Zi (Aconiti Lateralis Radix Preparata) 1.5 g, Mu Xiang (Aucklandiae Radix) 4.5 g, Jiao Shan Zha (Charred Crataegi Fructus) 10 g, Shan Yao (Dioscoreae Rhizoma) 15 g, and Da Huang (Rhubarbi Radix et Rhizoma) 3 g, one dose per week. Only four doses were needed for recovery, with excellent efficacy. The key lies in expelling pathogens without damaging healthy Qi, carefully awaiting the return of Qi, leading to self-healing.
186. For difficulty in defecation due to Liver Qi stagnation, Shao Yao (Peony Root) and Xiang Fu (Cyperus Rhizome) can cure it.
187. An elderly male patient suffered from continuous abdominal pain due to intestinal obstruction. Treatment with Fufang Dachengqi Tang (Compound Major Order the Qi Decoction) worsened the pain. I examined his abdomen, which was still soft, pulse was faint with cold extremities, spirit was fatigued with desire to sleep, tongue was pale with white coating, and diagnosed severe collapse of Middle Qi. First, I promoted circulation, prescribing Houpo Shengjiang Banxia Gancao Renshen Tang (Magnolia Bark, Fresh Ginger, Pinellia, Licorice, and Ginseng Decoction). One dose resulted in recovery.
188. Atrophy syndrome in our region is mostly due to damp-heat, occurring frequently in summer and autumn. Qingzao Tang (Clear Dryness Decoction) is better for treatment. Symptoms must include sticky mouth, chest fullness, and afternoon fever, indicating damp-heat. Modifications should be made based on symptoms.
189. For mania, Fangfeng Tongsheng San (Saposhnikovia Unblocking and Releasing Powder) as the main formula, combined with sedatives, has good effects.
190. Shock. With lowered blood pressure and faint pulse nearly imperceptible, it seems to belong to deficiency. However, clinically, it is not entirely deficiency. Treatment methods should distinguish between deficiency and excess, cold and heat, and meridians. If there is great excess, even Chengqi formulas cannot be omitted. If there is Yang deficiency, Sini Tang (Reverse-Recovery Decoction) cannot be spared. For Qi collapse, Ren Shen (Ginseng Radix) is best. For Yin collapse, Shengmai San (Generate the Pulse Powder) is an excellent formula. For Kidney collapse, Shan Zhu Yu (Corni Fructus) can be considered. For Blood collapse, Danggui Buxue Tang (Angelica Tonify-Blood Decoction) can be considered.
191. For strain injuries, with stabbing pain in the chest, distension, and sometimes phlegm, Xuan Fu Hua (Inulae Flos), Qian Cao (Rubiae Radix et Rhizoma) combined with Ling Zhi (Trogopterori Faeces), Yu Jin (Curcumae Radix), Gua Lou (Trichosanthis Fructus), Ban Xia (Pinelliae Rhizoma), and Cong Bai (Allii Fistulosi Bulbus) are commonly used with good effects. This reflects the intent of Xuanfu Hua Tang (Inula Decoction) and Shixiao San (Excellent Payment Powder).