某 风邪入络。
小续命汤。
此症病后一日数次不能言语。只要自己捏肩背，即可渐渐而言也。
某 久虚不能统血，并不能转运其气，是以便血时作，而又腹微满也。吐出之痰结硬，此为老痰，乃湿
热所结，法当兼理。
四物汤去川芎，加党参、冬术、怀山药、陈皮、龟板、蛤壳、荸荠、海蜇。
渊按∶不统血，不转运其气，腹微满，皆脾虚也。
某 久病之躯，去冬常患火升。交春木旺，肝胆升，阳无制，倏忽寒热，头面红肿，延及四肢， 热痒痛，
殆即所谓游火、游风之类欤！匝月以来，肿势大减。四五日前偶然裸体伤
风，遂增咳嗽，音哑痰多，口干舌白，续发寒热，胃气从此不醒，元气愈觉难支。风火交煽，痰浊复甚；阴
津消涸，阳不潜藏。清火养阴，计非不善，抑恐滋则碍脾；化痰扶正，势所必
需，又恐燥则伤液。法取轻灵，立方但求无过。
北沙参 知母 鲜生地 蛤壳 蝉衣 海浮石 豆卷 青果 海蛰 地栗 百合
另珠粉，朝晨用燕窝汤下三分。
上方《金匮》百合知母地黄汤合《本事》神效雪羹，取其清火化痰，不伤脾胃；生津养液，不碍痰湿。
酌古参今，归于平正。
袁 疡脓之后，气血必虚。奔走烈日之中，汗出招风，风与热毒舍于皮肤脉络之间。至秋凉气外束，
热郁于皮中，遂觉遍体瘙痒，几及两月。近来面色带黑而浮，少腹略满。据云奇痒之时，唇舌俱麻，是外风引
动内风也。经云∶面肿曰风。夫风行必燥，木胜克土，此症现为风癞，久防腹满，理势所必然也。
羚羊角 秦艽 地骨皮 陈皮 通草 北沙参 丹皮 苡仁 黄 防风
又洗方∶
紫背浮萍 杜牛膝 侧柏叶 巴豆壳
煎汤洗。
渊按∶面黑腹满，乃脾肾两虚见症。
又 古有风癞一症，周身瘙痒。拟用《千金》法。
生石膏 防风 麻黄 茯苓 生甘草 白术 鲜生地 百部
沈 肾为欠，胃虚亦欠。欠之一症，属肾胃二经。大抵阳气欲升，阴气欲降。肾虚则阳欲升而迟，胃
虚则阴欲降而缓。故《内经》曰∶阴阳相引，故数欠。此兼胸背多汗，足跟时胀。气血两亏，法当兼顾。
西党参 归身 黄 冬术 茯神 大熟地 枸杞子 麦冬 川石斛 蛤壳
胡 脉软无力属气虚，便溏食少属脾虚，干咳无痰属肺虚，时觉口苦属心热移脾也。宜十补一清。
四君子汤加川连、防风、怀山药、陈皮，泽泻、六神曲、
砂仁。
潘 年近六旬，天癸久去而反频来，是谓脱营。脱营者，元气极虚不能固摄，血从外脱也。又名下竭，
故腰痛如折。下竭者必上厥，故面赤、火升、发热也。血属阴，阴虚则阳亢，故脉弦
硬无情。其脉愈数，其阴愈虚。夏令一交，阳亢无制，恐致水涸龙飞，难为力矣。
阿胶（赤石脂拌炒） 牡蛎 海参 线鱼胶（米粉炒） 元精石 沙苑子
贡菜（洗淡） 猪腰子（酒洗） 茯神 龟板胶（余粮石拌炒） 生洋参（元米炒）
朝服震灵丹二钱，暮服威喜丸二钱。
渊按∶吴鞠通法也。妙以咸降有情之物补下焦精血。
舒 乳房属胃，乳汁血之所化。无孩子而乳房膨胀，亦下乳汁，非血之有余，乃不循其道为月水，反随肝
气上入乳房，变为乳汁，非细故矣。夫血，犹水也；气，犹风也。血随气行，如水得风而作波澜也。然则顺其
气而使下行，如风回波转，不必参堵截之法，涩其源而止其流。噫！可与知者道，难为俗人言也。
元精石 赤石脂 紫石英 牡蛎 乌药 寒水石 郁李仁 大生地 白芍 茯神 归身 焦麦芽
某 茹素精枯液涸，更兼便血伤阴。去冬骨骱疼酸，今又心悬如坠，时或口不能言，心中恐怖，必大声
惊叫而后醒。此风阳内扰，震动君主，火溢冲激也。病出于肝，关于心，乘于脾，故
又腹胀也。拟养阴柔肝而熄风阳，佐安神和中。久病宜缓调，又宜常服膏滋方。
大生地（八两） 茯神（三两） 陈皮（一两五钱） 炙甘草（一两） 归身（二两，
炒） 天冬（二两，去心） 柏子仁（三两，炒研） 沙苑子（三两） 龙齿（三两， ）
枣仁（三两，炒研） 洋参（三两） 枸杞子（三两） 石决明（六两， ） 焦六曲（三两）
红枣（四两） 桂圆肉（四两） 五味子（一两五钱，炒，研） 牡蛎（三两， ）
上药煎浓汁，用川贝末二两，莲心粉二两，白密四两，收膏。朝暮开水冲服一羹杓。
渊按∶精血两枯，肝燥火动，故见证如是。
某 《易》曰∶男女媾精，万物化生。《内经》曰∶两精相搏为之神，两神相搏合而成形是为精。是知男女
媾精，必神气交而后生育也。若精神不足之体，或临事而兴已阑，或对垒而戈忽
倒。虽有蓝田实难种玉。滋阴补阳各造其偏，揠苗助长日就枯耗。然则如何而后可？曰天地无心而成化，得春
气者多生，得冬气者多寂。欲补其精，先养其神。欲养其神，先补其气。而必兼壮其胆，胆为甲木春生之气也。
神为阳光，气为阳气。阴津者，犹甘露也。阳和气至，甘露滋之，草木欣欣向荣，生意源源不
息。人身一小天地也，岂犹子嗣为然哉？若徒切切于子嗣，百忧
感其心，万事劳其形。有动乎中，必摇其精，念谁为之戕贼，亦何恨乎药之不灵？
西党参 冬术 茯神 炙甘草 桔梗 酸枣仁 黄 远志 苦参 牡蛎 怀山药
猪胆汁为丸，每日开水送下三钱。
渊按，抵得一篇求子论。惟胆汁恐苦寒伤胃太甚。
[Background Information]
Book: Wang Xugao's Clinical Medical Cases
Author: Wang Xugao
Dynasty: Qing
Chapter: Miscellaneous Diseases Section
Category: Medical Discussion
Case 1
A certain patient: Wind pathogen has entered the collaterals.
Prescription: Xiaoxuting Decoction (Small Continuation Life Decoction).
This case presents as inability to speak several times a day one day after onset. If the patient pinches and rubs their own shoulders and back, speech can gradually recover.
Case 2
A certain patient: Due to prolonged deficiency, the body fails to control blood and cannot transport Qi, resulting in intermittent hematochezia and slight abdominal fullness. The expectorated phlegm forms hard clumps; this is "Old Phlegm" (Lao Tan), formed by damp-heat accumulation. The treatment method should address both aspects.
Prescription: Siwu Tang (Four Substance Decoction) minus Chuanxiong Rhizome (Chuanxiong), plus Codonopsis Root (Dangshen), Atractylodes Lancea Rhizome (Dongzhu), Chinese Yam Rhizome (Huai Shanyao), Tangerine Peel (Chenpi), Turtle Shell (Guiban), Clam Shell (Geke), Water Chestnut (Biqi), and Jellyfish (Hai Zhe).
Note by Yuan: Failure to control blood, failure to transport Qi, and slight abdominal fullness are all manifestations of Spleen Deficiency.
Case 3
A certain patient: In a state of chronic illness, they frequently experienced "Rising Fire" (Huo Sheng) last winter. Upon entering spring, Wood energy becomes vigorous, causing Liver and Gallbladder Qi to ascend. Yang lacks restraint, leading to alternating chills and fever, redness and swelling of the head and face extending to the limbs, accompanied by heat, itching, and pain. This is likely what is referred to as "Wandering Fire" (You Huo) or "Wandering Wind" (You Feng)! Over the past month, the swelling has significantly subsided. However, four or five days ago, exposure to wind while naked led to increased coughing, hoarseness, excessive phlegm, dry mouth, and white tongue coating, followed by new onset of chills and fever. Stomach Qi has since failed to revive, and Yuan Qi feels increasingly difficult to sustain. Wind and Fire fan each other, making turbid phlegm even more severe; Yin fluids are exhausted, and Yang fails to anchor. Clearing fire and nourishing Yin seems sound, but there is fear that cloying nature will hinder the Spleen; resolving phlegm and supporting righteousness is necessary, yet there is fear that drying nature will damage fluids. The method adopts lightness and agility, aiming only to avoid error in prescription.
Ingredients: Glehnia Root (Beishashen), Anemarrhena Rhizome (Zhimu), Fresh Rehmannia Root (Xianshengdi), Clam Shell (Geke), Cicada Slough (Chanyi), Pumice (Haifushi), Soybean Sprouts (Doujuan), Green Olive (Qingguo), Jellyfish (Haizhe), and Water Chestnut (Dili).
Separately, Pearl Powder (Zhufen), taken in 3 fen doses with Bird's Nest Soup in the morning.
The above formula combines Baihe Zhimu Dihuang Tang from *Jingui Yaolue* with Shenxiao Xuegang Tang from *Ben Shi Fang*, taking advantage of clearing fire and resolving phlegm without damaging the Spleen and Stomach; generating fluids and nourishing Yin without obstructing phlegm-dampness. Balancing ancient and modern approaches, it returns to balance and correctness.
Case 4
Patient surnamed Yuan: After pus discharge from sores, Qi and Blood must be deficient. Running in the scorching sun caused sweating and wind exposure; Wind and Heat-Toxin lodged between the skin and collaterals. When autumn coolness bound externally, Heat stagnated within the skin, causing generalized pruritus lasting nearly two months. Recently, the complexion appears dark and puffy, with slight lower abdominal fullness. It is reported that during episodes of intense itching, the lips and tongue become numb, indicating External Wind triggering Internal Wind (Nei Feng). The Classics state: "Facial swelling is termed Wind." Wind movement inevitably causes dryness; Wood excess overacts on Earth. This condition currently presents as "Wind Leprosy" (Feng Lai); long-term concern for abdominal fullness is logically inevitable.
Ingredients: Antelope Horn (Lingyangjiao), Gentian Stem (Qinjiao), Cortex Lycii (Digupi), Tangerine Peel (Chenpi), Tongcao, Glehnia Root (Beishashen), Moutan Bark (Danpi), Coix Seed (Yiren), Astragalus Root (Huangqi), Saposhnikovia Root (Fangfeng).
External Wash Prescription:
Purple-backed Floating Duckweed (Zibei Fuping), Achyranthes Root (Du Niuxi), Biota Leaf (Cebaiye), and Castor Bean Husk (Baduke).
Decoct and wash.
Note by Yuan: Dark face and abdominal fullness are symptoms of dual deficiency of Spleen and Kidney.
Another Case
Ancient texts mention a condition called "Wind Leprosy" (Feng Lai) with generalized pruritus. Proposing the method from *Qianjin Fang*.
Ingredients: Gypsum Fibrosum (Sheng Shigao), Saposhnikovia Root (Fangfeng), Ephedra Stem (Mahuang), Poria (Fuling), Raw Licorice Root (Sheng Gancao), Atractylodes Macrocephala Rhizome (Baizhu), Fresh Rehmannia Root (Xianshengdi), Stemona Root (Baibu).
Case 5
Patient surnamed Shen: Yawning (Qian) relates to the Kidney; Stomach deficiency also causes yawning. This symptom belongs to the Kidney and Stomach meridians. Generally, Yang Qi desires to ascend, and Yin Qi desires to descend. Kidney deficiency causes Yang desire to ascend but delays; Stomach deficiency causes Yin desire to descend but slows. Thus, the *Neijing* states: "When Yin and Yang attract each other, frequent yawning occurs." This case is complicated by excessive sweating on the chest and back, and occasional distension of the heels. Both Qi and Blood are deficient; the treatment method must address both.
Ingredients: Codonopsis Root (Xidangshen), Angelica Sinensis Root (Guishen), Astragalus Root (Huangqi), Atractylodes Lancea Rhizome (Dongzhu), Poria with Hostwood (Fushen), Prepared Rehmannia Root (Dashudi), Goji Berry (Gouqizi), Ophiopogon Tuber (Maidong), Dendrobium Stem (Chuanshihu), Clam Shell (Geke).
Case 6
Patient surnamed Hu: Soft and powerless pulse indicates Qi Deficiency; loose stools and poor appetite indicate Spleen Deficiency; dry cough without phlegm indicates Lung Deficiency; occasional bitter taste indicates Heart Heat transferring to the Spleen. The method should employ "Ten Parts Tonification, One Part Clearing."
Prescription: Sijunzi Tang (Four Gentlemen Decoction) plus Coptis Rhizome (Chuanlian), Saposhnikovia Root (Fangfeng), Chinese Yam Rhizome (Huai Shanyao), Tangerine Peel (Chenpi), Alisma Rhizome (Zexie), Medicated Leaven (Liushenqu), and Amomum Fruit (Sharen).
Case 7
Patient surnamed Pan: Approaching sixty years of age, Tian Gui (menstrual essence) had ceased long ago but now returns frequently; this is called Tuo Ying (Depletion of Ying Qi). Tuo Ying means Yuan Qi is extremely deficient and unable to secure, causing blood to escape externally. Also known as Lower Exhaustion (Xia Jie), hence waist pain like breaking. Lower exhaustion inevitably leads to Upper Reversal (Shang Jue), hence red face, rising fire, and fever. Blood belongs to Yin; Yin deficiency leads to Yang hyperactivity, hence the pulse is wiry, stiff, and unyielding. The faster the pulse, the more deficient the Yin. Once summer arrives, unrestrained Yang hyperactivity may lead to "Water Drying and Dragon Flying" (metaphor for severe Yin deficiency with hyperactive Yang), which would be difficult to remedy.
Ingredients: Donkey-hide Gelatin (Ejiao, stir-fried with Red Kaolin), Oyster Shell (Muli), Sea Cucumber (Haishen), Fish Maw (Xianyujiao, stir-fried with rice flour), Yuanjing Stone, Astragalus Complanatus Seed (Shayuanzi), Tribute Vegetable (Gongcai, washed to remove salt), Pig Kidney (Zhu Yaozi, washed with wine), Poria with Hostwood (Fushen), Tortoise Plastron Gelatin (Gui Ban Jiao, stir-fried with Kao Lin), American Ginseng (Sheng Yangshen, stir-fried with millet).
Morning dose: Zhenling Dan (Two Qian); Evening dose: Weixi Wan (Two Qian).
Note by Yuan: This follows Wu Jutong's method. Its brilliance lies in using salty, descending, sentient substances to tonify the Essence and Blood of the Lower Jiao.
Case 8
Patient surnamed Shu: The breast belongs to the Stomach; milk is transformed from Blood. Breast engorgement and lactation in a woman without children do not indicate Blood excess, but rather Blood failing to follow its proper course to become menstruation, instead ascending with Liver Qi into the breasts to transform into milk. This is no minor matter. Blood is like water; Qi is like wind. Blood follows Qi, just as water creates waves when wind blows. Therefore, guiding Qi downward smoothly, like wind receding and waves calming, avoids the need for blocking methods that seal the source and stop the flow. Alas! This can be discussed with those who understand, but is hard to explain to the vulgar.
Ingredients: Yuanjing Stone, Red Kaolin (Chishizhi), Purple Fluorspar (Zishiying), Oyster Shell (Muli), Lindera Root (Wuyao), Aragonite (Han Shuishishi), Prunus Seed (Yuliren), Large Rehmannia Root (Dashengdi), White Peony Root (Baishao), Poria with Hostwood (Fushen), Angelica Sinensis Root (Guishen), Scorched Malt (Jiao Maiya).
Case 9
A certain patient: Vegetarianism led to exhaustion of Essence and fluids, compounded by hematochezia injuring Yin. Last winter, bone joints ached and hurt; now there is a sensation of heart hanging and dropping, occasional inability to speak, mental terror, requiring loud screaming to awaken. This is Internal disturbance by Wind-Yang, shaking the Sovereign Mind (Heart), with overflowing Fire impacting. The disease originates in the Liver, involves the Heart, and overacts on the Spleen, hence abdominal distension. The plan is to nourish Yin, soften the Liver, extinguish Wind-Yang, assisted by calming the Spirit and harmonizing the Middle. Chronic illness requires slow regulation and regular use of paste prescriptions.
Ingredients: Large Rehmannia Root (8 Liang), Poria with Hostwood (3 Liang), Tangerine Peel (1.5 Liang), Honey-fried Licorice Root (1 Liang), Angelica Sinensis Root (2 Liang, stir-fried), Asparagus Tuber (2 Liang, heart removed), Biota Seed (3 Liang, stir-fried and crushed), Astragalus Complanatus Seed (3 Liang), Dragon Teeth (3 Liang, calcined), Ziziphus Seed (3 Liang, stir-fried and crushed), American Ginseng (3 Liang), Goji Berry (3 Liang), Hemizygia Shell (6 Liang, calcined), Scorched Medicated Leaven (3 Liang), Red Date (4 Liang), Longan Aril (4 Liang), Schisandra Berry (1.5 Liang, stir-fried and crushed), Oyster Shell (3 Liang, calcined).
Decoct these herbs to a thick juice, add Fritillaria Bulb Powder (2 Liang), Lotus Plumule Powder (2 Liang), and White Honey (4 Liang) to form a paste. Take one spoonful dissolved in boiling water morning and evening.
Note by Yuan: Dual exhaustion of Essence and Blood, Liver dryness with Fire agitation, thus presenting such symptoms.
Case 10
A certain patient: The *I Ching* says: "Male and female unite their essence, and all things are transformed." The *Neijing* says: "Two essences interacting create Spirit; two Spirits interacting combine to form shape, which is Essence." Thus, conception requires the interaction of Spirit and Qi for reproduction. If the constitution lacks sufficient Spirit and Qi, sexual excitement may fade before intercourse, or potency may fail suddenly. Even with fertile land, jade cannot be planted. Excessive Yin-nourishing or Yang-tonifying creates imbalance; forcing growth accelerates decline. So how to proceed? It is said: Heaven and Earth accomplish transformation without intent; those receiving Spring Qi survive more, those receiving Winter Qi remain silent. To tonify Essence, first nourish Spirit. To nourish Spirit, first tonify Qi. And necessarily strengthen the Gallbladder, which possesses the Qi of Jia-Wood and Spring generation. Spirit is like sunlight; Qi is like warm Yang. Yin fluids are like sweet dew. When warm Yang Qi arrives, sweet dew nourishes, and grasses and trees flourish with endless vitality. The human body is a small heaven and earth; why should offspring be any different? If one obsesses solely over offspring, hundred worries affect the heart, and ten thousand tasks exhaust the form. Movement within inevitably shakes the Essence. Reflecting on who is harming oneself, why blame the medicine for ineffectiveness?
Ingredients: Codonopsis Root (Xidangshen), Atractylodes Lancea Rhizome (Dongzhu), Poria with Hostwood (Fushen), Honey-fried Licorice Root (Zhigancao), Platycodon Root (Jiegeng), Ziziphus Seed (Suanzaoren), Astragalus Root (Huangqi), Polygala Root (Yuanzhi), Sophora Root (Kushen), Oyster Shell (Muli), Chinese Yam Rhizome (Huai Shanyao).
Pill form with Pig Bile, taken daily with three Qian delivered by boiling water.
Note by Yuan: This reads like an essay on seeking offspring. Only the bile might be too bitter and cold, excessively damaging the Stomach.