便血匝月未发。中气有权摄血矣。血得贮于营。则虚阳不致上越。所以自觉精神行动。颇属安适也。
台人参（一钱五分） 制附子（三分） 炒枣仁（三钱） 左牡蛎（八钱） 黄 （三钱陈皮五分泡汤炙）
煨木香（三分） 炒木瓜（一钱） 炒丹皮（一钱五分） 炒冬术（一钱五分） 春砂仁（五分）
大黑枣（三钱）
尤
临经旬日前。腹痛不已。入夜交寅卯时更觉痛极难堪。肝郁血分也。拟疏其痰气。养其营血。可许得痊。
旋复花（一钱五分） 广郁金（三分） 甘枸子（一钱五分） 白芍（一钱五分） 老苏梗（一钱）
瓦楞子（三钱） 杜仲（三钱） 青皮（五分） 归身（三钱） 枣仁（三钱）
尤（又诊）
叠进养血化痰法。是月月事如期。病势大减。眠食并适。仍守前意。
旋复花（三钱） 老苏梗（一钱） 小茴香（三分） 川断（二钱） 白蒺藜（三钱）
广郁金（五分） 炒丹皮（一钱五分） 真橘络（一钱五分） 归身（三钱） 小青皮（一钱）
尤（又诊）
癸水甫净。养心脾佐调奇脉。
炒枯熟地（三钱） 广郁金（三分） 川贝母（三钱） 归身（一钱五分） 紫石英（三钱）
怀牛膝（一钱五分） 老苏梗（一钱五分） 白芍（一钱五分） 炒枣仁（三钱） 橘白（五分）
尤（又诊）
日来脉情和缓。营卫气血流通。拟培养奇经八脉。佐理肝脾。
熟地炭（二钱砂仁末拌） 川杜仲（三钱） 川贝母（三钱） 云苓（三钱） 白蒺藜（一钱五分）
浮归身（一钱五分） 炒枣仁（三钱） 青皮（七分） 苡仁（三钱） 炙橘白（一钱）
尤（又诊）
气为血帅。气顺则营血循序。叠进和肝运脾。诸恙皆安。仍守前法。冀其临经痛止焉妙。
尤（又诊）
痛经止后。怀麟三月矣。微见呕痰纳少。虽属恶阻余波。即是肝胃不和也。
制首乌 川断 冬术 白芍 浓杜仲 山药 黄芩 生甘草 川贝母 砂仁 枣仁 橘白
加川石斛煎汤泛丸
尤
乳房结 。大小不一。起经四载。屡发酸 。痛楚则更坚大。胸膈梗痛如束。脉弦舌红。一派肝郁。
结于阳明部分也。有关格之根柢。怡养为佳。
制首乌（四钱） 乌药（一钱） 青皮（三分） 归身（一钱五分） 川贝母（三钱）
广郁金（三分） 橘络（一钱五分） 白芍（一钱五分） 栝蒌皮（三钱） 杞子（二钱） 左金丸（五分）
尤（又诊）
乳 痛缓胀松。胸脘亦舒。脉症合参。究系营虚肝郁也。
制首乌（四钱） 川贝母（二钱） 枣仁（三钱） 归身（一钱五分） 元参（一钱五分）
枸杞（三钱） 柿霜（三钱） 东白芍（一钱五分生炒各半） 广郁金（四分）
蔡
历节风痛已缓。四肢尚是麻木。内风未化也。
生 皮（三钱） 明天麻（七分） 姜半夏（一钱五分） 归身（三钱） 白蒺藜（三钱）
广郁金（五分） 钩勾（四钱） 生甘草（五分） 秦艽（三钱） 桑枝（七分） 蔗浆（一杯）
羹
暑风暑热。蕴伏于经。病交四日。昨午壮热无汗。烦躁昏谵。热逼肝胆。气火直升犯胃。呕
吐痰少。频频嗳气。夜半得汗极畅。表热退净。脉尚濡数。舌红苔黄。伏邪未必即化。转疟可虑。
金石斛（三钱） 枳壳（一钱五分） 赤芍（一钱五分） 鲜佛手（一钱五分） 炙鳖甲（三钱）
青蒿（一钱五分） 鲜竹茹（一钱五分） 老枇杷叶（一钱五分）
加白荷花露（一两）
羹（又诊）
暑风郁伏肺卫。暑温热蒸营分。争而为间日疟。寒轻热重。曾发两度。邪犹蕴蓄。治宜先解
卫风。继清营热。非比秋邪入少阳。而用小柴胡和解者也。
带叶藿梗（一钱五分） 苦桔梗（五分） 郁金（五分） 归身（一钱五分） 牛蒡子（一钱五分）
青蒿（一钱五分） 黑栀（一钱五分） 赤芍（一钱五分） 鳖甲（四钱） 秦艽（一钱五分）
丹皮（一钱五分） 鲜佛手（一钱五分）
羹（又诊）
暑疟今交三度。寒势减轻。汗易泄而热退颇早。营阴素虚之质。伏热犹深。非垣途也。
牛蒡子（一钱五分） 广郁金（五分） 丹皮（一钱五分） 赤芍（一钱五分） 香青蒿（二钱）
炙鳖甲（五钱） 黑栀（一钱五分） 鲜佛手（一钱五分） 秦艽（一钱五分） 益元散（三钱）
羹（又诊）
辰刻指尖微清。实时壮热。渴饮如长鲸吸川。神烦谵语。酉刻得汗。汗多如注。小溲频数。此乃
瘅疟明征。经云。阴气孤绝。阳气独发。但热不寒。是为瘅疟。细参其文。既云不寒。即是阳明潮热矣。
此不寒。但身不觉寒。其指尖微清。背觉微寒。皆作但热不寒例看。故云饮以桂枝白虎汤。二进必愈。内
经金匮文辞深奥。非精思参悟。则临症不明其妙也。同议方。以冀应手。
鲜生地（五钱） 肥知母（一钱五分） 桑叶（一钱五分） 小青皮（五分） 生石膏（七钱）
川贝母（三钱） 丹皮（一钱五分） 生甘草（五分） 生鳖甲（五钱） 白粳米（五钱）
羹（又诊）
连进白虎汤。疟来热短且缓。口渴谵语并少。再守前意。益其津气。以化余邪。
鲜霍斛（一两） 肥知母（一钱五分） 淡芩（三钱） 大竹叶（三钱） 青蒿（一钱五分）
川贝母（一钱五分） 丹皮（一钱五分） 鲜芦根（一两） 秦艽（一钱） 益元散（三钱）
羹（又诊）
疟将止。养阴清理为主。
生洋参（一钱五分） 金石斛 肥知母（一钱五分） 鲜竹茹 细生地（七钱） 羚羊角（一钱五分）
天花粉（三钱） 竹卷心（三钱） 鳖甲（四钱） 川贝母（二钱） 青蒿（一钱） 白茆根（一两）
羹（又诊）
疟止热化。胃中痰气未清。治以疏通腑浊。佐理脾元。
生洋参（一钱五分） 生冬术（一钱五分） 枳壳（三分） 川贝（一钱五分） 生鳖甲（四钱）
制半夏（一钱） 栝蒌（二钱） 建曲（三钱） 金石斛（三钱） 广郁金（一钱） 佛手露（一两）
羹（又方）
细生地（五钱） 生冬术（一钱） 川斛（三钱） 建曲（一钱五分） 生洋参（一钱人参须一钱同蒸）
金石斛（三钱） 橘白（五分） 藿梗（一钱五分） 鲜竹茹（一钱五分） 鲜莲子（三钱）
俞
经居三月之余。骤然腹痛。 坠不已。曾经小产。手厥阴经络受伤。脉胎巳至脱根。气从下陷。深
恐血崩之虑。仿东垣法。
人参（三钱） 柴胡（二分） 新会皮（五分） 云苓（二钱） 黄 （二钱） 枣仁（三钱）
春砂仁（五分） 炙草（三分） 冬术（一钱五分）
俞（又诊）
昨进补中益气汤。酸坠之势虽缓。而瘀下如崩。肢冷发痉。幸元气尚属扶住。未知厥脱。
然胎尚未下。须防气陷血脱。浊瘀下泛。
人参须（七分） 老苏梗（一钱五分） 炮姜炭（四分） 陈皮（五分） 炒冬术（一钱五分）
春砂仁（三分） 枣仁（三钱） 茯苓（三钱） 归身（一钱五分） 胎产金丹（半粒）
俞（又诊）
血崩止之后。自觉胎元跃跃如常而动。肝升烦热。寅卯更衣。感冒寒邪。形冷发搐。郁木内扰。
悲从中来。骤然哭泣。面色泛 。神志模糊。脉细无神。此属血去胎伤。又失于调养。胎殒腹中。
浊向上蒙。至危至险候也。
人参须（一钱） 大腹皮（一钱五分） 陈皮（七分） 老苏梗（一钱） 炮姜炭（一钱）
江枳壳（一钱） 砂仁（五分） 赤苓（三钱） 广郁金（五分） 胎产金丹（半粒）
俞（又诊）
药后得寐。神志渐清。面 略转。少腹酸楚。急坠极甚。如欲大便而便闭。盖小产胎殒。重于大产。
或有气衰血热。或因内外感触。损其根柢。漏红之后。本当调养气血。听其自然。但血去已多。
胎涸难于下行。不得已。用平胃法。宜佐保本为要。
人参须（七分） 元武版（五钱） 大腹绒（三钱） 炙陈皮（五分） 炮姜炭（一钱）
元明粉（七分） 江枳壳（一钱五分） 焦白芍（一钱五分） 老苏梗（一钱五分） 归身（一钱五分）
俞（又诊）
昨投平胃散加元明以下瘀浊。佛手散温通气血。刻间腹中 坠异常。秽水下行极多。即觉舒和。因知人立方
之神妙也。但瘀浊尚有未净。胞衣或有留顿。亦宜留意虚阳上冒。慎调至嘱。
熟地炭（四钱） 炮姜（五分） 陈皮（七分） 归身（一钱） 炒于术（二钱） 丹皮（三钱）
云苓（二钱） 白芍（一钱） 炒枣仁（三钱） 青皮（五分） 谷芽（三钱） 益母草（煎汤代水）
俞（又诊）
瘀露下而黑色。停瘀留顿未化。胃纳渐安。寐亦稳贴。神脉皆涉和平。但恐有胎元未化。仍宜留意也。
熟地炭（四钱） 川石斛（三钱） 煨枣仁（三钱） 川贝母（二钱） 生冬术（一钱五分）
白蒺藜（三钱） 浮归身（一钱五分） 粉丹皮（一钱五分） 西琥珀（五分） 陈皮（一钱）
云苓（三钱） 桃仁（七粒）
俞（又诊）
益阴通瘀之下。夜寐得安。脉息稍静。正气渐醒。今晨瘀中虽下茄蒂之象。此即胞胎之根柢也。前日
或指停经。或指崩漏。定可剖析分明而无惑矣。仍守昨法。
熟地炭（四钱） 怀牛膝（一钱五分） 川贝（二钱） 炒冬术（一钱五分） 紫石英（三钱）
枣仁（三钱） 白芍（一钱五分） 旋复花（三钱） 西琥珀（五分） 益母膏（三钱）
俞（又诊）
小产后。肝肾阴虚。虚阳易升。逆胃焉汗泄气急。脉见芤数。阳衰已复。阴血尚难速长。眠食向安。
自可日臻佳境。百日内务宜慎养。
生洋参（一钱五分） 制首乌（四钱） 川贝母（二钱） 归身（一钱五分） 生冬术（一钱五分）
金石斛（三钱） 艽蔚子（三钱） 白芍（一钱五分） 西琥珀（五分） 枣仁（三钱） 茯苓（三钱）
小红枣（三枚）
俞（又诊）
日来色 已转。脉维右寸关尚弦数。由乎盗汗自汗互伤营液。故易于心悸也。今瘀已净。可以补中。
寓以收摄法矣。
党参（三钱） 熟地炭（四钱） 甘枸子（一钱五分） 炒白芍（一钱五分） 炒冬术（一钱五分） 五味子（三
分） 炒枣仁（三钱） 生甘草（三分） 炒竹茹（一钱五分） 菟丝子（三钱） 炒香谷芽（三钱）
蒋
产虚未复。郁怒动肝。肝火上薰肺胃。寅卯时咳呛缠绵。半载未能全止。纳谷勉强。五心烦热。脉细。
左部虚细。右寸关弦数。虑涉损途。急挽可许向吉。
北沙参（三钱） 天花粉（一钱五分） 栝蒌皮（一钱五分） 广郁金（四分） 羚羊角（一钱
五分） 真川贝（三钱） 炙橘白（五分） 生谷芽（三钱） 制首乌（四钱） 怀牛膝（一钱五分）
滁菊瓣（一钱） 扁豆衣（一钱五分）
蒋（又诊）
五更咳呛得缓。癸水先期而至。舌心露质。诊脉左见数象。胁中刺痛。产后营虚肝郁也。
北沙参（四钱） 天花粉（一钱） 栝蒌皮（三钱） 广郁金（五分） 羚羊角（一钱五分）
川贝母（二钱） 青蒿梗（一钱五分） 炙橘白（五分） 制首乌（四钱） 阿胶（二钱）
怀牛膝（一钱五分） 鲜稻叶（五钱） 怀山药（三钱）
蒋（又诊）
前进平肝养阴。寅卯时咳呛渐稀。脉息左部弦数。右尺虚软。经事乍过。毓阴平肝为主。
生西洋参（一钱五分） 川贝母（三钱） 栝蒌皮（一钱五分） 炒白芍（一钱五分） 制首乌（四钱）
元武版（五钱） 广郁金（三分） 怀山药（三钱） 金铃子（一钱） 鲜佛手（一钱）
蒋（又诊）
郁火已化。阴血不致为其所耗矣。脾气尚弱。纳谷不多。大便少调。脾胃之根。在乎金水流行。
水火升降。为佳。
参须（七分） 羚羊角（一钱五分） 炒木瓜（五分） 五味子（三分） 麦冬（二钱）
金石斛（三钱） 杜仲（三钱） 白芍（一钱五分） 怀山药（三钱） 橘白（五分） 生谷芽（三钱） 鲜佛手（一
钱五分）
俞
阴虚之体肝火劫伤胃液痰气凝结于胃下午腹痛。痛甚无寐。头眩便燥患经五月。防痛甚致厥。
瓦楞子（三钱） 姜半夏（一钱五分） 青皮（一钱） 白芍（一钱五分） 金铃子（一钱五分）
枳实（一钱） 乌梅（一钱） 使君子（三钱） 老苏梗（五分） 鲜佛手（一钱五分）
俞（又诊）
前进两和肝胃。脘痛得减。痰血未呕。大便续通未畅。唇色泛紫。瘀痰犹滞络中也。
苏梗（五分） 炙鳖甲（五钱） 枳壳（一钱） 木瓜（五分） 瓦楞子（三钱） 使君子（三钱）
青皮（七分） 单桃仁（三钱） 川楝子（一钱五分） 乌梅（七分） 鲜佛手（一钱）
俞（又诊）
叠进平肝和胃。蛔厥之痛势虽止。阴血已伤。起居宜慎。
制首乌（四钱） 炙鳖甲（五钱） 川楝子（一钱五分） 香苏梗（五分） 炒山药（三钱）
乌梅肉（一钱） 瓦楞子（三钱） 宣木瓜（五分） 川石斛（三钱）
沈
肝阳化火生风。从冲脉逆行乘胃。巅顶胀痛。不能转侧。面部肌肉跳跃。屡发屡止。今春烦劳之下。
Blood in stool has not recurred for a month. This indicates that the Middle Qi (Qi of the Spleen and Stomach) has regained its ability to control blood. Since blood is stored in the Ying (Nutritive) level, floating Yang will not ascend uncontrollably. Therefore, the patient feels energetic and comfortable in movement.
Tai Renshen (Cistanche Ginseng, 1.5 qian) Zhi Fuzi (Prepared Aconite Root, 0.3 qian) Chao Zaoren (Stir-fried Sour Jujube Seed, 3 qian) Zuo Muli (Left-side Oyster Shell, 8 qian) Huangqi (Astragalus Root, 3 qian, stir-fried with decoction of Chenpi)
Wei Muxiang (Baked Aucklandia Root, 0.3 qian) Chao Mugua (Stir-fried Papaya, 1 qian) Chao Danpi (Stir-fried Moutan Cortex, 1.5 qian) Chao Zhushu (Stir-fried Atractylodes Macrocephala Rhizome, 1.5 qian) Chun Sharen (Spring Amomum Fruit, 0.5 qian)
Da Heizao (Large Black Date, 3 qian)
Patient You (Re-examination)
Ten days before the expected menstrual period, abdominal pain persisted. The pain became unbearable during the Yin and Mao hours (3:00 AM - 7:00 AM). This is Liver Qi stagnation affecting the Blood aspect. The proposed treatment is to soothe Phlegm-Qi and nourish Ying-Blood, which should lead to recovery.
Xuanfuhua (Inula Flower, 1.5 qian) Guang Yujin (Curcuma Aromatica Rhizome, 0.3 qian) Gan Gouqi (Sweet Goji Berry, 1.5 qian) Baishao (White Peony Root, 1.5 qian) Lao Sugeng (Old Perilla Stem, 1 qian)
Walengzi (Arca Shell, 3 qian) Duzhong (Eucommia Bark, 3 qian) Qingpi (Green Tangerine Peel, 0.5 qian) Guishen (Angelica Sinensis Root Body, 3 qian) Zaoren (Sour Jujube Seed, 3 qian)
Patient You (Re-examination)
After continuously taking blood-nourishing and phlegm-resolving formulas, menstruation arrived on schedule this month. The disease condition significantly decreased, and sleep and appetite improved. Continue with the previous strategy.
Xuanfuhua (Inula Flower, 3 qian) Lao Sugeng (Old Perilla Stem, 1 qian) Xiaohuixiang (Small Fennel Fruit, 0.3 qian) Chuanduan (Dipsacus Root, 2 qian) Baijili (Japanese Tearweed Fruit, 3 qian)
Guang Yujin (Curcuma Aromatica Rhizome, 0.5 qian) Chao Danpi (Stir-fried Moutan Cortex, 1.5 qian) Zhen Juluo (True Tangerine Mesh, 1.5 qian) Guishen (Angelica Sinensis Root Body, 3 qian) Xiao Qingpi (Small Green Tangerine Peel, 1 qian)
Patient You (Re-examination)
Menstruation has just ended. Nourish Heart and Spleen, assisting in regulating the Eight Extraordinary Vessels.
Chao Kushudi (Stir-fried Prepared Rehmannia Root, 3 qian) Guang Yujin (Curcuma Aromatica Rhizome, 0.3 qian) Chuanbeimu (Fritillaria Cirrhosa Bulb, 3 qian) Guishen (Angelica Sinensis Root Body, 1.5 qian) Zi Shiyin (Purple Quartz, 3 qian)
Huainiuxi (Achyranthus Bidentata Root, 1.5 qian) Lao Sugeng (Old Perilla Stem, 1.5 qian) Baishao (White Peony Root, 1.5 qian) Chao Zaoren (Stir-fried Sour Jujube Seed, 3 qian) Jubai (Tangerine Albedo, 0.5 qian)
Patient You (Re-examination)
The pulse is now harmonious and slow; Ying-Wei and Qi-Blood are circulating smoothly. The plan is to cultivate the Eight Extraordinary Vessels, assisted by regulating Liver and Spleen.
Shuditan (Rehmannia Root Charcoal, 2 qian, mixed with Sandren powder) Chuan Duzhong (Eucommia Bark, 3 qian) Chuan Beimu (Fritillaria Cirrhosa Bulb, 3 qian) Yunling (Poria Cocos, 3 qian) Baijili (Japanese Tearweed Fruit, 1.5 qian)
Fu Guishen (Floating Angelica Sinensis Root Body, 1.5 qian) Chao Zaoren (Stir-fried Sour Jujube Seed, 3 qian) Qingpi (Green Tangerine Peel, 0.7 qian) Yiren (Coix Seed, 3 qian) Zhi Jubai (Stir-fried Tangerine Albedo, 1 qian)
Patient You (Re-examination)
Qi is the commander of Blood; when Qi flows smoothly, Ying-Blood follows order. After continuously administering formulas to harmonize Liver and transport Spleen, all ailments have subsided. Maintain the previous method, hoping for cessation of dysmenorrhea at the next cycle.
Patient You (Re-examination)
After dysmenorrhea ceased, it was discovered that pregnancy had reached three months. There is slight vomiting of phlegm and poor appetite. Although this belongs to the residual waves of Ezu (morning sickness), it indicates Disharmony between Liver and Stomach.
Zhi Shouwu (Prepared Polygonum Multiflorum Root) Chuanduan (Dipsacus Root) Zhushu (Atractylodes Macrocephala Rhizome) Baishao (White Peony Root) Nong Duzhong (Thick Eucommia Bark) Shanyao (Dioscorea Rhizome) Huangqin (Scutellaria Root) Sheng Gancao (Raw Licorice Root) Chuan Beimu (Fritillaria Cirrhosa Bulb) Sharen (Amomum Fruit) Zaoren (Sour Jujube Seed) Jubai (Tangerine Albedo)
Add Chuan Shihu (Dendrobium Officinale Stem) decoction to form pills.
Patient You
Breast nodules of varying sizes appeared four years ago. They frequently cause soreness; upon pain, they become harder and larger. There is a sensation of obstruction and pain in the chest and diaphragm as if bound. The pulse is wiry, tongue red, indicating a pattern of Liver Qi Stagnation.
The nodules are located in the Yangming channel area. This is the root of Guan Ge (obstruction syndrome), best managed with emotional regulation.
Zhi Shouwu (Prepared Polygonum Multiflorum Root, 4 qian) Wuyao (Lindera Root, 1 qian) Qingpi (Green Tangerine Peel, 0.3 qian) Guishen (Angelica Sinensis Root Body, 1.5 qian) Chuan Beimu (Fritillaria Cirrhosa Bulb, 3 qian)
Guang Yujin (Curcuma Aromatica Rhizome, 0.3 qian) Juluo (Tangerine Mesh, 1.5 qian) Baishao (White Peony Root, 1.5 qian) Guloupi (Trichosanthes Peel, 3 qian) Gouqi (Goji Berry, 2 qian) Zuojin Wan (Left Metal Pill, 0.5 qian)
Patient You (Re-examination)
Breast swelling and pain have eased, and the chest/epigastrium feels relaxed. Pulse and symptoms combined indicate Ying deficiency and Liver Qi Stagnation.
Zhi Shouwu (Prepared Polygonum Multiflorum Root, 4 qian) Chuan Beimu (Fritillaria Cirrhosa Bulb, 2 qian) Zaoren (Sour Jujube Seed, 3 qian) Guishen (Angelica Sinensis Root Body, 1.5 qian) Yuan Shen (Scrophularia Root, 1.5 qian)
Gouqi (Goji Berry, 3 qian) Shishuang (Persimmon Frost, 3 qian) Dong Baishao (East White Peony Root, 1.5 qian, half raw half stir-fried) Guang Yujin (Curcuma Aromatica Rhizome, 0.4 qian)
Patient Cai
Lijie Fengtong (painful wandering joint syndrome) has eased, but limbs remain numb. Internal Wind has not yet transformed.
Sheng Pipi (Raw Astragalus Skin, 3 qian) Ming Tianma (Clearing Gastrodia Rhizome, 0.7 qian) Jiang Banxia (Ginger-processed Pinellia Tuber, 1.5 qian) Guishen (Angelica Sinensis Root Body, 3 qian) Baijili (Japanese Tearweed Fruit, 3 qian)
Guang Yujin (Curcuma Aromatica Rhizome, 0.5 qian) Gougou (Uncaria Rhynchophylla, 4 qian) Sheng Gancao (Raw Licorice Root, 0.5 qian) Qin Jiao (Gentiana Macrophylla Root, 3 qian) Sangzhi (Mulberry Twig, 0.7 qian) Zhejiang (Sugarcane Juice, 1 cup)
Patient Geng
Summer-Wind and Summer-Heat are hidden in the meridians. On the fourth day, there was high fever without sweat yesterday noon, irritability, confusion, and delirium. Heat forced into Liver/Gallbladder, causing Qi-Fire to rise and invade Stomach, leading to vomiting of little phlegm and frequent belching. Sweat occurred freely at midnight, clearing exterior heat. However, the pulse remains soft and rapid, tongue red with yellow coating. Hidden pathogens may not resolve immediately; transformation into Malaria is a concern.
Jin Shihu (Gold Dendrobium Stem, 3 qian) Zhike (Bitter Orange Fruit, 1.5 qian) Chi Shao (Red Peony Root, 1.5 qian) Xian Foshou (Fresh Bergamot Fruit, 1.5 qian) Zhi Biejia (Stir-fried Turtle Shell, 3 qian)
Qinghao (Sweet Wormwood Herb, 1.5 qian) Xian Zhuru (Fresh Bamboo Shavings, 1.5 qian) Lao Pipaye (Old Loquat Leaf, 1.5 qian)
Add Bai Hehua Lu (White Lotus Dew, 1 liang)
Patient Geng (Re-examination)
Summer-Wind is hidden in Lung-Wei; Summer-Heat steams in Ying. Their struggle results in Intermittent Malaria (light chills, heavy fever), having occurred twice. Pathogens remain accumulated. Treatment should first release Wei-Wind, then clear Ying-Heat. This differs from Autumn pathogens entering Shaoyang treated with Xiao Chai Hu Tang for harmonization.
Daiye Huogeng (Loosestrife Stem with Leaves, 1.5 qian) Ku Jiegeng (Bitter Platycodon Root, 0.5 qian) Yujin (Curcuma Aromatica Rhizome, 0.5 qian) Guishen (Angelica Sinensis Root Body, 1.5 qian) Niubangzi (Arctium Fruit, 1.5 qian)
Qinghao (Sweet Wormwood Herb, 1.5 qian) Hei Zhi (Black Gardenia Fruit, 1.5 qian) Chi Shao (Red Peony Root, 1.5 qian) Biejia (Turtle Shell, 4 qian) Qin Jiao (Gentiana Macrophylla Root, 1.5 qian)
Danpi (Moutan Cortex, 1.5 qian) Xian Foshou (Fresh Bergamot Fruit, 1.5 qian)
Patient Geng (Re-examination)
Summer-Malaria has now occurred three times. Chills are lighter, sweat comes easily, and fever subsides early. Given the patient's constitution of chronic Ying-Yin deficiency, deep-hidden Heat persists; this is not a standard course.
Niubangzi (Arctium Fruit, 1.5 qian) Guang Yujin (Curcuma Aromatica Rhizome, 0.5 qian) Danpi (Moutan Cortex, 1.5 qian) Chi Shao (Red Peony Root, 1.5 qian) Xiang Qinghao (Fragrant Sweet Wormwood, 2 qian)
Zhi Biejia (Stir-fried Turtle Shell, 5 qian) Hei Zhi (Black Gardenia Fruit, 1.5 qian) Xian Foshou (Fresh Bergamot Fruit, 1.5 qian) Qin Jiao (Gentiana Macrophylla Root, 1.5 qian) Yiyuan San (Benefit Origin Powder, 3 qian)
Patient Geng (Re-examination)
Fingertips were slightly cool at dawn, followed by sudden high fever. Thirst led to drinking heavily like a whale sucking water. Spirit was irritable with delirium. At You hour (5-7 PM), profuse sweating occurred like pouring, with frequent urination. This is a clear sign of Dan Malaria (Malaria with only heat, no chills). The Classic states: "Yin Qi is isolated and exhausted, Yang Qi erupts alone; only heat, no chills, this is Dan Malaria." Carefully analyzing the text, "no chills" implies Yangming tidal fever. The "no chills" here means the body does not feel cold, though fingertips are slightly cool and back feels slightly cold; these are viewed as examples of "only heat, no chills." Thus, Gui Zhi Bai Hu Tang is prescribed; two doses should cure. The texts of Neijing and Jingui are profound; without deep contemplation, clinical application lacks subtlety. Jointly discussing the formula to ensure efficacy.
Xian Shengdi (Fresh Rehmannia Root, 5 qian) Fei Zhimu (Plump Anemarrhena Rhizome, 1.5 qian) Sangye (Mulberry Leaf, 1.5 qian) Xiao Qingpi (Small Green Tangerine Peel, 0.5 qian) Sheng Shigao (Raw Gypsum Fibrosum, 7 qian)
Chuan Beimu (Fritillaria Cirrhosa Bulb, 3 qian) Danpi (Moutan Cortex, 1.5 qian) Sheng Gancao (Raw Licorice Root, 0.5 qian) Sheng Biejia (Raw Turtle Shell, 5 qian) Bai Jingshi (White Glutinous Rice, 5 qian)
Patient Geng (Re-examination)
Continuing Bai Hu Tang, malaria episodes are shorter and milder; thirst and delirium have decreased. Maintain previous intent, benefit Jin (Fluids) and Qi to transform residual pathogens.
Xian Huo Shihu (Fresh Huoshan Dendrobium, 1 liang) Fei Zhimu (Plump Anemarrhena Rhizome, 1.5 qian) Dan Qin (Light Scutellaria Root, 3 qian) Da Zhuye (Large Bamboo Leaf, 3 qian) Qinghao (Sweet Wormwood Herb, 1.5 qian)
Chuan Beimu (Fritillaria Cirrhosa Bulb, 1.5 qian) Danpi (Moutan Cortex, 1.5 qian) Xian Lugen (Fresh Reed Rhizome, 1 liang) Qin Jiao (Gentiana Macrophylla Root, 1 qian) Yiyuan San (Benefit Origin Powder, 3 qian)
Patient Geng (Re-examination)
Malaria is about to cease; focus on nourishing Yin and clearing.
Sheng Yangshen (Raw American Ginseng, 1.5 qian) Jin Shihu (Gold Dendrobium Stem) Fei Zhimu (Plump Anemarrhena Rhizome, 1.5 qian) Xian Zhuru (Fresh Bamboo Shavings) Xi Shengdi (Fine Rehmannia Root, 7 qian) Lingyangjiao (Antelope Horn, 1.5 qian)
Tianhuafen (Trichosanthes Root, 3 qian) Zhu Juanxin (Bamboo Scroll Heart, 3 qian) Biejia (Turtle Shell, 4 qian) Chuan Beimu (Fritillaria Cirrhosa Bulb, 2 qian) Qinghao (Sweet Wormwood Herb, 1 qian) Bai Maogen (Imperata Rhizome, 1 liang)
Patient Geng (Re-examination)
Malaria stopped, heat resolved, but Phlegm-Qi in Stomach remains uncleaned. Treat by unblocking Fu organs and clearing turbidity, assisting Spleen/Yuan Qi.
Sheng Yangshen (Raw American Ginseng, 1.5 qian) Sheng Zhushu (Raw Atractylodes Macrocephala Rhizome, 1.5 qian) Zhike (Bitter Orange Fruit, 0.3 qian) Chuan Bei (Fritillaria Cirrhosa Bulb, 1.5 qian) Sheng Biejia (Raw Turtle Shell, 4 qian)
Zhi Banxia (Processed Pinellia Tuber, 1 qian) Gulou (Trichosanthes Fruit, 2 qian) Jianqu (Medicated Leaven, 3 qian) Jin Shihu (Gold Dendrobium Stem, 3 qian) Guang Yujin (Curcuma Aromatica Rhizome, 1 qian) Foshou Lu (Bergamot Dew, 1 liang)
Patient Geng (Another Formula)
Xi Shengdi (Fine Rehmannia Root, 5 qian) Sheng Zhushu (Raw Atractylodes Macrocephala Rhizome, 1 qian) Chuan Hu (Chuan Dendrobium, 3 qian) Jianqu (Medicated Leaven, 1.5 qian) Sheng Yangshen (Raw American Ginseng, steamed with 1 qian Ren Shen Xu/Ginseng Tendril)
Jin Shihu (Gold Dendrobium Stem, 3 qian) Jubai (Tangerine Albedo, 0.5 qian) Huogeng (Loosestrife Stem, 1.5 qian) Xian Zhuru (Fresh Bamboo Shavings, 1.5 qian) Xian Lianzi (Fresh Lotus Seed, 3 qian)
Patient Yu
After more than three months of amenorrhea, sudden abdominal pain and continuous bearing-down sensation occurred. History of miscarriage suggests injury to Hand-Jueyin (Pericardium) channels. Pulse indicates fetal root detachment; Qi sinks downward. Deep fear of blood flooding (metrorrhagia). Following Dongyuan's method.
Renshen (Ginseng Root, 3 qian) Chaihu (Bupleurum Root, 0.2 qian) Xinhui Pi (New Hail Tangerine Peel, 0.5 qian) Yunling (Poria Cocos, 2 qian) Huangqi (Astragalus Root, 2 qian) Zaoren (Sour Jujube Seed, 3 qian)
Chun Sharen (Spring Amomum Fruit, 0.5 qian) Zhi Cao (Stir-fried Licorice Root, 0.3 qian) Zhushu (Atractylodes Macrocephala Rhizome, 1.5 qian)
Patient Yu (Re-examination)
Yesterday, Bu Zhong Yi Qi Tang was administered. The sour/bearing-down sensation eased, but stasis flowed down like flooding. Limbs were cold with spasms. Fortunately, Yuan Qi held firm, avoiding Jue-Tuo (collapse).
However, the fetus has not yet passed. Must guard against Qi sinking and Blood loss, with turbid stasis flowing downward.
Ren Shen Xu (Ginseng Tendril, 0.7 qian) Lao Sugeng (Old Perilla Stem, 1.5 qian) Pao Jiang Tan (Charred Ginger, 0.4 qian) Chenpi (Tangerine Peel, 0.5 qian) Chao Zhushu (Stir-fried Atractylodes Macrocephala Rhizome, 1.5 qian)
Chun Sharen (Spring Amomum Fruit, 0.3 qian) Zaoren (Sour Jujube Seed, 3 qian) Fuling (Poria Cocos, 3 qian) Guishen (Angelica Sinensis Root Body, 1.5 qian) Taichan Jin Dan (Obstetric Golden Pill, half pill)
Patient Yu (Re-examination)
After bleeding stopped, the fetus felt active as usual. Liver rising caused irritability/heat. Bowel movement at Yin/Mao hours. Cold pathogen invasion caused chilliness and convulsions. Depressed Wood disturbed internally. Sudden sorrow and crying. Face flushed, spirit confused. Pulse fine and spiritless. This is Blood loss injuring the fetus, plus lack of care, leading to fetal death in utero. Turbid Qi ascends to cloud the orifices; a critical/dangerous state.
Ren Shen Xu (Ginseng Tendril, 1 qian) Dafupi (Areca Peel, 1.5 qian) Chenpi (Tangerine Peel, 0.7 qian) Lao Sugeng (Old Perilla Stem, 1 qian) Pao Jiang Tan (Charred Ginger, 1 qian)
Jiang Zhike (Jiangsu Bitter Orange Fruit, 1 qian) Sharen (Amomum Fruit, 0.5 qian) Chi Ling (Red Poria Cocos, 3 qian) Guang Yujin (Curcuma Aromatica Rhizome, 0.5 qian) Taichan Jin Dan (Obstetric Golden Pill, half pill)
Patient Yu (Re-examination)
After medication, sleep was achieved, spirit cleared, complexion improved slightly. Lower abdomen sore and severely bearing down, desire to defecate but constipated. Miscarriage/dead fetus is heavier than full-term birth. Possibly Qi deficiency/Blood heat or external/internal contact damaging roots. After spotting, one should nourish Qi/Blood and let nature take its course. But much blood lost, fetus dried up and hard to descend. Forced to use Pingwei San method, assisting preservation of Ben Yuan (Root Qi) is key.
Ren Shen Xu (Ginseng Tendril, 0.7 qian) Yuan Wu Ban (Tortoise Plastron, 5 qian) Dafurong (Areca Fiber, 3 qian) Zhi Chenpi (Stir-fried Tangerine Peel, 0.5 qian) Pao Jiang Tan (Charred Ginger, 1 qian)
Yuanming Fen (Mirabilite, 0.7 qian) Jiang Zhike (Jiangsu Bitter Orange Fruit, 1.5 qian) Jiao Baishao (Charred White Peony Root, 1.5 qian) Lao Sugeng (Old Perilla Stem, 1.5 qian) Guishen (Angelica Sinensis Root Body, 1.5 qian)
Patient Yu (Re-examination)
Yesterday, Pingwei San plus Yuanming Fen cleared turbid stasis; Foshou San warmed/unblocked Qi/Blood. Abdominal bearing down was intense, much foul fluid discharged, bringing relief. Proves the brilliance of the prescription. But turbid stasis not fully cleared; placenta may remain. Also watch for floating Yang ascending. Careful regulation is urged.
Shuditan (Rehmannia Root Charcoal, 4 qian) Pao Jiang (Charred Ginger, 0.5 qian) Chenpi (Tangerine Peel, 0.7 qian) Guishen (Angelica Sinensis Root Body, 1 qian) Chao Yuzhu (Stir-fried Atractylodes Rhizome, 2 qian) Danpi (Moutan Cortex, 3 qian)
Yunling (Poria Cocos, 2 qian) Baishao (White Peony Root, 1 qian) Chao Zaoren (Stir-fried Sour Jujube Seed, 3 qian) Qingpi (Green Tangerine Peel, 0.5 qian) Guya (Sprouted Millet, 3 qian) Yimucao (Motherwort, decocted as water substitute)
Patient Yu (Re-examination)
Dark black discharge indicates retained stasis not yet transformed. Appetite improving, sleep stable. Spirit and pulse peaceful. Fear untransformed fetal tissue remains; stay vigilant.
Shuditan (Rehmannia Root Charcoal, 4 qian) Chuan Shihu (Chuan Dendrobium, 3 qian) Wei Zaoren (Baked Sour Jujube Seed, 3 qian) Chuan Beimu (Fritillaria Cirrhosa Bulb, 2 qian) Sheng Zhushu (Raw Atractylodes Macrocephala Rhizome, 1.5 qian)
Baijili (Japanese Tearweed Fruit, 3 qian) Fu Guishen (Floating Angelica Sinensis Root Body, 1.5 qian) Fen Danpi (Powdered Moutan Cortex, 1.5 qian) Xi Hupo (Western Amber, 0.5 qian) Chenpi (Tangerine Peel, 1 qian)
Yunling (Poria Cocos, 3 qian) Tao Ren (Peach Kernel, 7 grains)
Patient Yu (Re-examination)
Nourishing Yin and unblocking stasis brought good sleep. Pulse quieted, Zheng Qi awakening. Morning discharge showed tomato-stalk-like shape, the root of the gestational sac. Previous diagnosis of amenorrhea or metrorrhagia can now be clearly distinguished. Maintain yesterday's method.
Shuditan (Rehmannia Root Charcoal, 4 qian) Huainiuxi (Achyranthus Bidentata Root, 1.5 qian) Chuan Bei (Fritillaria Cirrhosa Bulb, 2 qian) Chao Zhushu (Stir-fried Atractylodes Macrocephala Rhizome, 1.5 qian) Zi Shiyin (Purple Quartz, 3 qian)
Zaoren (Sour Jujube Seed, 3 qian) Baishao (White Peony Root, 1.5 qian) Xuanfuhua (Inula Flower, 3 qian) Xi Hupo (Western Amber, 0.5 qian) Yimu Gao (Motherwort Paste, 3 qian)
Patient Yu (Re-examination)
Post-miscarriage, Liver/Kidney Yin deficiency allows floating Yang to rise, invading Stomach causing sweat/Qi urgency. Pulse Kou/Shu. Yang collapse recovered, but Yin/Blood grows slowly. Sleep/appetite good, prognosis improving. Caution required for 100 days.
Sheng Yangshen (Raw American Ginseng, 1.5 qian) Zhi Shouwu (Prepared Polygonum Multiflorum Root, 4 qian) Chuan Beimu (Fritillaria Cirrhosa Bulb, 2 qian) Guishen (Angelica Sinensis Root Body, 1.5 qian) Sheng Zhushu (Raw Atractylodes Macrocephala Rhizome, 1.5 qian)
Jin Shihu (Gold Dendrobium Stem, 3 qian) Jiawei Zi (Chrysosplenium Seed, 3 qian) Baishao (White Peony Root, 1.5 qian) Xi Hupo (Western Amber, 0.5 qian) Zaoren (Sour Jujube Seed, 3 qian) Fuling (Poria Cocos, 3 qian)
Xiao Hongzao (Small Red Date, 3 pieces)
Patient Yu (Re-examination)
Complexion improved. Right Cun/Guan pulse still wiry/rapid due to night sweats/day sweats damaging Ying fluids, causing palpitations. Stasis cleared, ready for tonification with astringent methods.
Dangshen (Codonopsis Root, 3 qian) Shuditan (Rehmannia Root Charcoal, 4 qian) Gan Gouqi (Sweet Goji Berry, 1.5 qian) Chao Baishao (Stir-fried White Peony Root, 1.5 qian) Chao Zhushu (Stir-fried Atractylodes Macrocephala Rhizome, 1.5 qian) Wuweizi (Schisandra Fruit, 0.3 qian) Chao Zaoren (Stir-fried Sour Jujube Seed, 3 qian) Sheng Gancao (Raw Licorice Root, 0.3 qian) Chao Zhuru (Stir-fried Bamboo Shavings, 1.5 qian) Tusizi (Dodder Seed, 3 qian) Chao Xiang Guya (Stir-fried Fragrant Sprouted Millet, 3 qian)
Patient Jiang
Postpartum deficiency unresolved. Depression/Anger moves Liver. Liver Fire harasses Lung/Stomach. Coughing at Yin/Mao hours persists for half a year. Poor appetite, five-palm heat. Pulse fine, Left deficient/fine, Right Cun/Guan wiry/rapid. Concern for Sun Disease (consumption). Urgent rescue may bring auspicious outcome.
Beishashen (North Glehnia Root, 3 qian) Tianhuafen (Trichosanthes Root, 1.5 qian) Guloupi (Trichosanthes Peel, 1.5 qian) Guang Yujin (Curcuma Aromatica Rhizome, 0.4 qian) Lingyangjiao (Antelope Horn, 1.5 qian) Zhen Chuanbei (Authentic Fritillaria Cirrhosa Bulb, 3 qian) Zhi Jubai (Stir-fried Tangerine Albedo, 0.5 qian) Sheng Guya (Sprouted Millet, 3 qian) Zhi Shouwu (Prepared Polygonum Multiflorum Root, 4 qian) Huainiuxi (Achyranthus Bidentata Root, 1.5 qian)
Chu Juban (Chuzhou Chrysanthemum Petal, 1 qian) Bian Dou Yi (Vigna Umbellate Husk, 1.5 qian)
Patient Jiang (Re-examination)
Five-watch cough eased. Menstruation arrived early. Tongue center shows texture. Left pulse rapid. Hypochondriac stabbing pain. Postpartum Ying deficiency/Liver stagnation.
Beishashen (North Glehnia Root, 4 qian) Tianhuafen (Trichosanthes Root, 1 qian) Guloupi (Trichosanthes Peel, 3 qian) Guang Yujin (Curcuma Aromatica Rhizome, 0.5 qian) Lingyangjiao (Antelope Horn, 1.5 qian)
Chuan Beimu (Fritillaria Cirrhosa Bulb, 2 qian) Qinghao Geng (Sweet Wormwood Stem, 1.5 qian) Zhi Jubai (Stir-fried Tangerine Albedo, 0.5 qian) Zhi Shouwu (Prepared Polygonum Multiflorum Root, 4 qian) Ejiao (Donkey-Hide Gelatin, 2 qian)
Huainiuxi (Achyranthus Bidentata Root, 1.5 qian) Xian Daoye (Fresh Rice Leaf, 5 qian) Huai Shanyao (Huai Dioscorea Rhizome, 3 qian)
Patient Jiang (Re-examination)
Previous Liver-soothing/Yin-nourishing herbs reduced cough at Yin/Mao hours. Left pulse wiry/rapid, Right Chi weak. Menstruation just passed. Focus on nurturing Yin and calming Liver.
Sheng Xiyangshen (Raw American Ginseng, 1.5 qian) Chuan Beimu (Fritillaria Cirrhosa Bulb, 3 qian) Guloupi (Trichosanthes Peel, 1.5 qian) Chao Baishao (Stir-fried White Peony Root, 1.5 qian) Zhi Shouwu (Prepared Polygonum Multiflorum Root, 4 qian)
Yuan Wu Ban (Tortoise Plastron, 5 qian) Guang Yujin (Curcuma Aromatica Rhizome, 0.3 qian) Huai Shanyao (Huai Dioscorea Rhizome, 3 qian) Jinlingzi (Evodia Fruit, 1 qian) Xian Foshou (Fresh Bergamot Fruit, 1 qian)
Patient Jiang (Re-examination)
Depressed fire transformed, Yin/Blood preserved. Spleen Qi still weak, poor appetite, irregular bowels. Spleen/Stomach root lies in Metal/Water circulation and Water/Fire ascent/descent.
Shen Xu (Ginseng Tendril, 0.7 qian) Lingyangjiao (Antelope Horn, 1.5 qian) Chao Mugua (Stir-fried Papaya, 0.5 qian) Wuweizi (Schisandra Fruit, 0.3 qian) Maidong (Ophiopogon Tuber, 2 qian)
Jin Shihu (Gold Dendrobium Stem, 3 qian) Duzhong (Eucommia Bark, 3 qian) Baishao (White Peony Root, 1.5 qian) Huai Shanyao (Huai Dioscorea Rhizome, 3 qian) Jubai (Tangerine Albedo, 0.5 qian) Sheng Guya (Sprouted Millet, 3 qian) Xian Foshou (Fresh Bergamot Fruit, 1.5 qian)
Patient Yu
Yin-deficient constitution, Liver Fire damaged Stomach fluids. Phlegm-Qi congealed in Stomach. Afternoon abdominal pain, severe pain prevents sleep, dizziness, dry stool. Ill for five months. Guard against syncope from severe pain.
Walengzi (Arca Shell, 3 qian) Jiang Banxia (Ginger-processed Pinellia Tuber, 1.5 qian) Qingpi (Green Tangerine Peel, 1 qian) Baishao (White Peony Root, 1.5 qian) Jinlingzi (Evodia Fruit, 1.5 qian)
Zhishi (Immature Bitter Orange Fruit, 1 qian) Wumei (Mume Fruit, 1 qian) Shijunzi (Quisqualis Fruit, 3 qian) Lao Sugeng (Old Perilla Stem, 0.5 qian) Xian Foshou (Fresh Bergamot Fruit, 1.5 qian)
Patient Yu (Re-examination)
Liver-Stomach harmonizing herbs reduced epigastric pain. No vomiting of phlegm/blood. Bowels moving but not smooth. Lips purple. Stasis/Phlegm lingering in collaterals.
Sugeng (Perilla Stem, 0.5 qian) Zhi Biejia (Stir-fried Turtle Shell, 5 qian) Zhike (Bitter Orange Fruit, 1 qian) Mugua (Papaya, 0.5 qian) Walengzi (Arca Shell, 3 qian) Shijunzi (Quisqualis Fruit, 3 qian)
Qingpi (Green Tangerine Peel, 0.7 qian) Dan Tao Ren (Single Peach Kernel, 3 qian) Chuan Lianzi (Chuan Evodia Fruit, 1.5 qian) Wumei (Mume Fruit, 0.7 qian) Xian Foshou (Fresh Bergamot Fruit, 1 qian)
Patient Yu (Re-examination)
Continuous Liver-soothing/Stomach-harmonizing stopped Ascaris-colic pain. Yin/Blood injured. Daily life must be cautious.
Zhi Shouwu (Prepared Polygonum Multiflorum Root, 4 qian) Zhi Biejia (Stir-fried Turtle Shell, 5 qian) Chuan Lianzi (Chuan Evodia Fruit, 1.5 qian) Xiang Sugeng (Fragrant Perilla Stem, 0.5 qian) Chao Shanyao (Stir-fried Dioscorea Rhizome, 3 qian)
Wumei Rou (Mume Fruit Flesh, 1 qian) Walengzi (Arca Shell, 3 qian) Xuan Mugua (Xuan Papaya, 0.5 qian) Chuan Shihu (Chuan Dendrobium, 3 qian)
Patient Shen
Liver Yang transforms into Fire generating Wind. Reverses along Chong Mai to attack Stomach. Vertex distending pain, inability to turn head. Facial muscle twitching, recurring. This spring, under fatigue,