遗风王 舌浓黄滑，便泻不化，脉弦濡，小便不利，此属湿热。脘闷，宜和中清利。（
六月初八日。）
藿香梗（二钱） 焦六曲（四钱） 蜜银花（二钱） 猪苓（钱半） 原滑石（四钱） 炒川连（
七分
）扁豆衣（三钱） 通草（钱半） 川朴（一钱） 省头草（三钱） 新会皮（钱半） （引）荷叶（一
角）
二帖。
介按∶湿胜便泻而小便不利，治以清利湿热。又佐消食扶脾，确是双方兼顾之疗法。
安昌夏 舌滑白，脉弦细，便溏，患小便不多，脘闷，气冲欲呕，藉猪苓汤加减。（三
月十三日。）
猪苓（钱半） 广藿香（二钱） 仙半夏（钱半） 大腹皮（三钱） 泽泻（二钱） 滑石（四钱）
左金丸（八分） 玫瑰花（五朵） 茯苓（四钱） 浓朴（一钱） 香附（三钱）
清煎四帖。
又 湿热未清，腹中胀闷，脉涩滞，便泻，仍宜猪苓汤加减。
猪苓（钱半） 藿香梗（二钱） 大腹皮（三钱） 左金丸（八分） 泽泻（三钱） 滑石（四钱）
制香附（三钱） 佛手花（八分） 茯苓（四钱） 浓朴（钱半） 佩兰叶（钱半）
清煎四帖。
介按∶内经曰∶湿胜则濡泄。难经曰∶湿多成五泄。兹以湿胜而脾胃失于健运，不能渗
化，
方从猪苓汤加减，以藿、朴、香附，玫瑰等味，芳香燥湿，二苓、泽泻健脾佐运，半夏、左
金和胃宽胸，腹皮、滑石泄湿利溲。前后二方，大旨相同，即古人所谓利小便即是实大便之
意。
渔庄沈（妇） 便泻腹痛，右脉涩，左弦细，经停四月，腰酸带下。心泛，舌微白，咳呛
。姑宜清气和中。（十月二十日。）
藿香梗（二钱） 诃子肉（钱半） 新会皮（钱半） 桔梗（钱半） 川贝（钱半） 扁豆衣（三
钱） 苏梗（钱半） 生款冬（三钱） 大腹皮（三钱） 广木香（八分） 蔻壳（钱半）
清煎三帖。
介按∶肝肾阴亏，带脉不固，则腰酸带下，肝阳横逆，则腹痛便泻，上乘于肺则咳嗽心
泛。先以清肺扶脾，兼用理气之品，是急则治标之意。
新田郦 据述便泻较减，舌根浓，面浮，宜和胃为主。（六月十三日。）
焦六曲（四钱） 新会皮（钱半） 制香附（三钱） 鸡内金（钱半） 川连（五分） 赤苓（三
钱）
扁豆衣（钱半） 大腹皮（三钱） 仙半夏（钱半） 炒麦芽（三钱） 通草（钱半） 鲜荷叶（一角）
二帖。
介按∶便泻较减，舌浓面浮，此系湿热未净，夹食为患。故治以扶脾渗湿，兼消食滞。
大西庄沈 木克土便泻，气滞经阻，脉右涩左弦，舌心光，胃钝脘闷，腹中有瘕。姑宜
泄木和中。（七月二十九日。）
乌药（二钱） 川楝子（三钱） 炒谷芽（四钱） 左金丸（八分） 茯苓（四钱） 木蝴蝶（四
分） 扁豆衣（三钱） 玫瑰花（五朵） 大腹皮（三钱） 炒白芍（钱半） 佩兰（钱半）
清煎四帖。
介按∶肝阳侮胃，气聚成瘕，阳明隶于冲脉，冲脉即是血海。兹以胃被肝乘，血海亦同
时为病，以致经阻。治以泄肝救胃，方极稳健可法。
某 据述胃纳稍增，便泻稀水，缘水湿并归阳明，宜分利为稳。
茯苓（三钱） 大腹皮（三钱） 原砂仁（七分） 石莲子（三钱） 泽泻（三钱） 猪苓（钱半）
绿萼梅（钱半） 通草（钱半） 江西术（一钱） 新会皮（钱半） 生白芍（钱半）
清煎四帖。
介按∶湿归阳明而为泄泻，治以五苓散加减，洵是对症之妙剂。
遗风庞 舌黄滑，脉弦濡，便利腹痛，此属湿热。宜治防痢。（六月初九日。）
广藿香（二钱） 焦六曲（四钱） 青木香（七分） 大腹皮（三钱） 六一散（三钱） 炒川连
（五分） 炒枳壳（钱半） 新会皮（钱半） 川朴（一钱） 猪苓（钱半） 通草（钱半）
清煎三帖。
介按∶湿热薄于肠胃，阻遏气机，而致太阴失健运，厥阴失疏泄，湿蒸热郁，传导失其
常度，而便利腹痛。清热导气以渗湿，则诸恙自愈。
某 便泻较减，脉虚，气机不和，舌滑，宜固肾止泻，理气和中。（三月十七日。）
熟地（三钱） 骨碎补（三钱） 炒杜仲（三钱） 炒米仁（四钱） 怀药（三钱） 茯苓（四钱）
新会皮（钱半） 玫瑰花（五朵） 芡实（三钱） 原蚕砂（一钱） 甘松（四分）
清煎十帖。
介按∶此是脾肾兼虚为泻，故君以地黄、杜仲、骨碎补，大滋肾阴，填精补髓，臣以芡
实、
山药之健脾，又佐泽泻、米仁以疏水道之滞，使以芳香诸味之理气，适气机转动，则湿走而
肾强脾健矣。
渔庄沈 中虚气馁，水谷酿湿，成痰作泻，左脉虚细，右弦濡，舌微黄，心肾不交，寝
不成寐。宜治脾肾为主。（五月十三日。）
骨碎补（三钱） 夜交藤（三钱） 炒枣仁（三钱） 炒川连（五分） 炒杜仲（三钱） 怀山药
（三
钱） （辰砂拌）茯神（四钱） 粟壳（一钱） 炒江西术（一钱） 阳春砂（一钱） 百药煎（三钱）
清煎五帖。
介按∶雷少逸曰∶昔贤云，脾为生痰之源，肺为贮痰之器。夫痰乃湿气而生，湿由脾弱
而起
。盖为太阳湿土，得湿则健，一被寒湿所侵，遂困顿矣。脾既困顿，焉能掌运用之权衡，则
水谷之精微，悉变为痰。痰气上袭于肺，肺与大肠相为表里，其大肠固者，肺经自病而为痰
嗽，其不固者，则肺病移于大肠而为痰泻矣。雷氏此言，发明痰泻之病源，已无余蕴，深堪
钦佩，惟此症系是脾肾兼虚，以致水泛为痰，因大肠不固，遂移病于大肠而作泻。且以心不
藏神，阳不交阴而不寐，故其治法，于固肾健脾之中，参用安神涩肠之品。
朱墅杨（妇） 木克土便泻腹满，脉沉涩，舌黄，心泛欲呕，癸涩，宜防腹胀。（六月二
十日。）
藿香（二钱） 大腹皮（三钱） 新会皮（钱半） 川楝子（三钱） 左金丸（八分） 茯苓（四
钱） 扁豆衣（三钱） 玫瑰花（五朵） 佩兰（钱半） 通草（钱半） 香附（钱半）
清煎三帖。
介按∶冲隶阳明，厥阴对峙，今因肝病犯胃，则心泛欲呕，乘脾则便泻腹满，冲脉既被
肝逆
犯胃而受影响，则癸水难以应期而至。故治以苦辛泄降，俾肝逆稍平，胃气渐和，则诸恙自
退。
安昌马（妇） 上咳下泻，形肉日削，脉弱细，经闭脘格，属棘手重症。宜法候政之。（
又六月初五日。）
省头草（五钱） 诃子肉（三钱） 炒谷芽（四钱） 绿萼梅（钱半） 川贝（三钱） 扁豆衣（
三钱） 石莲子（三钱） 桑白皮（钱半） 制香附（三钱） 新会皮（钱半） 赤苓（四钱）
清煎二帖。
介按∶经闭脘格，咳泻形削，此是脾弱肝横，生化无权，中气久虚，血液渐涸，虽用扶
脾抑肝之品，究属难愈之症。
某（稚孩） 呕渴已瘥，脉涩滞，舌心浓，腹尚大，胃钝便滑，仍遵前法加减。（二月十
一日）
乌梅（一个） 甘松（四分） 赤苓（三钱） 生香附（钱半） 椒目（四分） 炒谷芽（三钱）
浓朴（一钱） 鸡内金（钱半） 大腹皮（三钱） 通草（钱半） 绿萼梅（一钱）
清煎三帖。
介按∶肝胃湿热久蕴，脾弱而致腹大便滑，当然以扶脾渗湿，兼清肝胃之热。
某（稚孩） 腹形不减，气逆便溏，脉弦细，舌薄滑，身微热，口渴，仍宜和中分消，防
疳。（六月二十四日）
广藿香（二钱） 省头草（钱半） 鸡内金（钱半） 川楝子（钱半） 宣木瓜（钱半） 甘松（
四分） 五谷虫（三钱） 绿萼梅（一钱） 大腹皮（三钱） 通草（钱半） 香附（钱半）
清煎三帖。
介按∶食物不节，脾胃受创，肝阳乘侮，而致腹膨便泻，故治以和肝健脾，清导清热。
渔庄沈 女孩虫气内着，腹痛乍作乍止，脉弦濡，便溏。姑宜安胃和中。（二月十五日
。）
乌梅（一个） 川椒（十四粒） 五谷虫（三钱） 广木香（八分） 川楝子（三钱） 延胡（二
钱） 茯苓（四钱） 茉莉花（八分） 生白芍（钱半） 甘松（四分） 佩兰（三钱）
清煎二帖。
介按∶疳泻治法，不离脾胃，约分数种，如胃滞当消，脾弱宜补，因热则苦寒清火，因
冷则
辛温健脾，有虫则用杀虫之品，因虚则补本脏之母。今此案系是湿热内滞，夹着虫积，以致
腹痛便溏。治宗安胃丸之意，而以健脾驱虫，理气导滞，洵治虫积腹痛而兼便溏之良方。
遗风庞 女孩 后受暑，夹食化泻，脉弦，舌黄，口渴，宜清热和中。
藿香梗（二钱） 炒川连（八分） 百药煎（三钱） 银花（二钱） 六一散（四钱） 扁豆衣（
三钱） 生白芍（钱半） 麦芽（三钱） 佩兰（三钱） 通草（钱半） 新会皮（钱半）
清煎二帖。
又 时 后，便泻腹痛，右脉弦，潮热似疟。宜和中清利。（七月十三号五月二十九日。）
猪苓（三钱） 六一散（四钱） 青蒿子（八分） 炒川连（八分） 泽泻（三钱） 大腹皮（三
钱） 蔻壳（钱半） 新会皮（钱半） 赤苓（四钱） 扁豆衣（三钱） 通草（钱半）
清煎三帖。
又 后便泻化利，腹痛不爽，胃纳较增，舌滑微黄。宜清热、化气、分利。（七月十
七号丁未初四日）
炒川连（八分） 莱菔子（三钱） 大腹皮（三钱） 冬瓜皮（三钱） 生白芍（钱半） 六一散
（四钱） 广皮（钱半） 焦六曲（四钱） 枳壳（钱半） 青木香（八分） 生米仁（四钱）
清煎二帖。
介按∶麻疹又名曰痧，吾绍通称曰 ，江苏总名曰疹。其实皆一病也，无非因地异名
耳。
叶氏治法，分晰四时，最为简明。其言曰∶春令发痧，从风温治，夏季从暑风，暑必兼湿，
秋令从热烁燥气，冬月从风寒。又曰∶疹宜通泄，泄泻为顺。下痢五色者亦不妨。惟二便不
利者，最多凶症，治法大忌止泻。今此案适在夏月，吸受暑热，兼挟湿食化泻，治以清暑，
最属正当。逮日久而湿热内陷，移于大肠，治以导滞而清湿热，大旨近是。
[Background Information]
Book: Shao Lansun's Medical Cases; Author: Shao Lansun; Dynasty: Qing; Chapter: Diarrhea; Category: Medical Discussion
Patient Wang (Yifeng): The tongue coating is thick, greasy, and slippery. Stools are unformed with undigested food. The pulse is wiry and soggy. Urination is difficult. This syndrome belongs to Damp-Heat. There is epigastric stuffiness. It is appropriate to harmonize the middle jiao and clear/drain dampness. (June 8th.)
Agastache Rhizome Stem (2 qian), Scorched Medicated Leaven (4 qian), Honey-fried Honeysuckle Flower (2 qian), Polyporus (1.5 qian), Raw Talcum (4 qian), Stir-fried Coptis Rhizome (0.7 fen), Coix Seed Husk (3 qian), Tongcao (1.5 qian), Magnolia Bark (1 qian), Pogostemon Herb (3 qian), Tangerine Peel (1.5 qian); (Guide) Lotus Leaf (one corner).
Take two doses.
Commentary: When Dampness prevails, diarrhea occurs accompanied by difficulty in urination. Treatment focuses on clearing and draining Damp-Heat. Additionally, assisting digestion and supporting the Spleen constitutes a treatment strategy that addresses both aspects effectively.
Patient Xia (Anchang): The tongue coating is white and slippery. The pulse is wiry and fine. Stools are loose. Urine volume is low. There is epigastric stuffiness. Qi rebels upward causing nausea. Borrowing from Zhu Ling Tang (Polyporus Decoction) for modification. (March 13th.)
Polyporus (1.5 qian), Guang Huo Xiang (Agastache Rhizome) (2 qian), Fairy Pinellia Tuber (1.5 qian), Greater Citron Fruit Pericarp (3 qian), Alisma Rhizome (2 qian), Talcum (4 qian), Zuo Jin Pill (0.8 fen), Rose Flower (5 petals), Poria (4 qian), Magnolia Bark (1 qian), Cyperus Rhizome (3 qian).
Decoct in water, take four doses.
Follow-up: Damp-Heat has not cleared. Abdominal distension and stuffiness persist. The pulse is choppy and sluggish. Diarrhea continues. Zhu Ling Tang (Polyporus Decoction) should still be used for modification.
Polyporus (1.5 qian), Agastache Rhizome Stem (2 qian), Greater Citron Fruit Pericarp (3 qian), Zuo Jin Pill (0.8 fen), Alisma Rhizome (3 qian), Talcum (4 qian), Processed Cyperus Rhizome (3 qian), Bergamot Flower (0.8 fen), Poria (4 qian), Magnolia Bark (1.5 qian), Eupatorium Leaf (1.5 qian).
Decoct in water, take four doses.
Commentary: The *Neijing* states: "When Dampness prevails, it leads to soft diarrhea." The *Nanjing* states: "Excess Dampness results in five types of diarrhea." Here, due to excess Dampness, the Spleen and Stomach lose their healthy transportation function and fail to transform fluids. The formula modifies Zhu Ling Tang (Polyporus Decoction). Huo Xiang, Hou Po, Xiang Fu, and Rose flowers use aromatic properties to dry Dampness. Er Ling (Polyporus and Poria) and Ze Xie strengthen the Spleen and assist transportation. Ban Xia and Zuo Jin Pill harmonize the Stomach and broaden the chest. Da Fu Pi and Shi Gao drain Dampness and promote urination. The gist of both formulas is identical, reflecting the ancient principle that "promoting urination solidifies stools."
Patient Shen (Yuzhuang, Female): Diarrhea accompanied by abdominal pain. Right pulse is choppy; Left pulse is wiry and fine. Menstruation has been absent for four months. Lower back soreness and leukorrhea. Nausea. Tongue coating is slightly white. Cough and wheezing. Temporarily clear Qi and harmonize the middle jiao. (October 20th.)
Agastache Rhizome Stem (2 qian), Chebula Fruit Flesh (1.5 qian), Tangerine Peel (1.5 qian), Platycodon Root (1.5 qian), Fritillaria Bulb (1.5 qian), Coix Seed Husk (3 qian), Perilla Stem (1.5 qian), Raw Coltsfoot Flower (3 qian), Greater Citron Fruit Pericarp (3 qian), Costus Root (0.8 fen), Nutmeg Shell (1.5 qian).
Decoct in water, take three doses.
Commentary: Deficiency of Liver and Kidney Yin causes insecurity of the Dai Mai, leading to lower back soreness and leukorrhea. Rebellion of Liver Yang causes abdominal pain and diarrhea. Rising to affect the Lung causes cough and nausea. Initially clearing the Lung and supporting the Spleen, combined with regulating Qi, follows the principle of treating acute symptoms first.
Patient Li (Xintian): Reports reduced diarrhea. Tongue root coating is thick. Facial edema. Treatment should primarily harmonize the Stomach. (June 13th.)
Scorched Medicated Leaven (4 qian), Tangerine Peel (1.5 qian), Processed Cyperus Rhizome (3 qian), Chicken Gizzard Lining (1.5 qian), Coptis Rhizome (0.5 fen), Red Poria (3 qian), Coix Seed Husk (1.5 qian), Greater Citron Fruit Pericarp (3 qian), Fairy Pinellia Tuber (1.5 qian), Stir-fried Barley Sprout (3 qian), Tongcao (1.5 qian), Fresh Lotus Leaf (one corner).
Take two doses.
Commentary: Reduced diarrhea with thick tongue coating and facial edema indicates residual Damp-Heat complicated by food stagnation. Therefore, treatment supports the Spleen, drains Dampness, and eliminates food stagnation.
Patient Shen (Daxizhuang): Wood overacting on Earth causes diarrhea. Qi stagnation obstructs menstruation. Right pulse is choppy; Left pulse is wiry. Tongue center is peeled. Stomach feels dull with epigastric stuffiness. Masses (Jia) in the abdomen. Temporarily vent Wood and harmonize the middle jiao. (July 29th.)
Lindera Root (2 qian), Toosendan Fruit (3 qian), Stir-fried Rice Sprout (4 qian), Zuo Jin Pill (0.8 fen), Poria (4 qian), Butterfly Tree Seed (0.4 fen), Coix Seed Husk (3 qian), Rose Flower (5 petals), Greater Citron Fruit Pericarp (3 qian), Stir-fried White Peony Root (1.5 qian), Pogostemon Herb (1.5 qian).
Decoct in water, take four doses.
Commentary: Liver Yang insulting the Stomach leads to Qi accumulation forming masses. The Yangming Stomach channel is subordinate to the Chong Mai, which is the Sea of Blood. With the Stomach being overcome by the Liver, the Sea of Blood is also diseased, causing menstrual obstruction. Treatment vents the Liver and saves the Stomach. The formula is very steady and commendable.
Patient [Name Unknown]: Reports slight increase in appetite. Diarrhea of watery stool. Water-Dampness converges on the Yangming. Division and drainage is the stable approach.
Poria (3 qian), Greater Citron Fruit Pericarp (3 qian), Raw Amomum Fruit (0.7 fen), Stone Lotus Seed (3 qian), Alisma Rhizome (3 qian), Polyporus (1.5 qian), Green Calyx Plum (1.5 qian), Tongcao (1.5 qian), Jiangxi Atractylodes Macrocephala Rhizome (1 qian), Tangerine Peel (1.5 qian), Raw White Peony Root (1.5 qian).
Decoct in water, take four doses.
Commentary: Dampness returning to Yangming causes diarrhea. Modifying Wu Ling San (Five-Ingredient Poria Decoction) is indeed an effective prescription for this symptom.
Patient Pang (Yifeng): Tongue coating is yellow and slippery. Pulse is wiry and soggy. Bowel movements are free but painful. This belongs to Damp-Heat. Treat to prevent dysentery. (June 9th.)
Guang Huo Xiang (Agastache Rhizome) (2 qian), Scorched Medicated Leaven (4 qian), Blue Sandalwood Root (0.7 fen), Greater Citron Fruit Pericarp (3 qian), Liu Yi San (Six-to-One Powder) (3 qian), Stir-fried Coptis Rhizome (0.5 fen), Stir-fried Bitter Orange (1.5 qian), Tangerine Peel (1.5 qian), Magnolia Bark (1 qian), Polyporus (1.5 qian), Tongcao (1.5 qian).
Decoct in water, take three doses.
Commentary: Damp-Heat pressing on the Intestines and Stomach obstructs Qi mechanism, causing the Taiyin Spleen to lose healthy transportation and the Jueyin Liver to lose free flow. Damp steaming and Heat depression disrupt normal transmission, resulting in free bowel movements with abdominal pain. Clearing Heat, guiding Qi, and draining Dampness will resolve all ailments.
Patient [Name Unknown]: Diarrhea reduced. Pulse is deficient. Qi mechanism is disharmonious. Tongue coating is slippery. Solidify the Kidney to stop diarrhea, regulate Qi and harmonize the middle jiao. (March 17th.)
Prepared Rehmannia Root (3 qian), Drynaria Rhizome (3 qian), Stir-fried Eucommia Bark (3 qian), Stir-fried Coix Seed (4 qian), Huai Shan Yao (Chinese Yam) (3 qian), Poria (4 qian), Tangerine Peel (1.5 qian), Rose Flower (5 petals), Euryale Seed (3 qian), Original Silkworm Excrement (1 qian), Sweet Flag Rhizome (0.4 fen).
Decoct in water, take ten doses.
Commentary: This is diarrhea due to simultaneous deficiency of Spleen and Kidney. Thus, Shu Di Huang, Du Zhong, and Gu Sui Bu are used as Sovereign herbs to greatly nourish Kidney Yin, fill essence, and supplement marrow. Qian Shi and Shan Yao act as Ministers to strengthen the Spleen. Ze Xie and Yi Yi Ren act as Assistants to unclog water pathways. Fragrant herbs acting as Envoys regulate Qi. Once Qi moves, Dampness leaves, and Kidney and Spleen become strong.
Patient Shen (Yuzhuang): Middle Qi deficiency and Qi collapse. Food and water ferment into Dampness, forming Phlegm and causing diarrhea. Left pulse is deficient and fine. Right pulse is wiry and soggy. Tongue coating is slightly yellow. Heart and Kidney do not interact. Insomnia. Treatment should focus on Spleen and Kidney. (May 13th.)
Drynaria Rhizome (3 qian), Polygonum Vine (3 qian), Stir-fried Ziziphus Seed (3 qian), Stir-fried Coptis Rhizome (0.5 fen), Stir-fried Eucommia Bark (3 qian), Huai Shan Yao (Chinese Yam) (3 qian), Poria with Cinnabar (4 qian), Poppy Shell (1 qian), Stir-fried Jiangxi Atractylodes Macrocephala Rhizome (1 qian), Yangchun Amomum Fruit (1 qian), Bai Yao Jian (3 qian).
Decoct in water, take five doses.
Commentary: Lei Shaoyi said: Ancients stated, "The Spleen is the source of Phlegm production; the Lung is the vessel storing Phlegm." Phlegm arises from Dampness, and Dampness arises from Spleen weakness. The Spleen belongs to Taiyin Damp-Earth; it thrives with moisture but becomes trapped when invaded by Cold-Dampness. If the Spleen is trapped, it cannot control transformation. Essence of food and water turns entirely into Phlegm. Phlegm-Qi attacks the Lung. Lung and Large Intestine are exterior-interior partners. If the Large Intestine is secure, Lung disease manifests as Phlegm-Cough; if insecure, Lung disease transfers to the Large Intestine as Phlegm-Diarrhea. Lei's words elucidate the origin of Phlegm-Diarrhea thoroughly. However, this case involves simultaneous Spleen-Kidney deficiency causing water flooding into Phlegm. Due to Large Intestine insecurity, disease transfers there causing diarrhea. Furthermore, Heart failing to house Spirit and Yang failing to interact Yin causes insomnia. Thus, treatment combines Kidney-solidifying and Spleen-strengthening with Spirit-calming and Intestine-astringing herbs.
Patient Yang (Zhushu, Female): Wood overacting on Earth causes diarrhea and abdominal fullness. Pulse is deep and choppy. Tongue coating is yellow. Nausea and desire to vomit. Menstruation is delayed. Prevent abdominal distension. (June 20th.)
Huo Xiang (Agastache Rhizome) (2 qian), Greater Citron Fruit Pericarp (3 qian), Tangerine Peel (1.5 qian), Toosendan Fruit (3 qian), Zuo Jin Pill (0.8 fen), Poria (4 qian), Coix Seed Husk (3 qian), Rose Flower (5 petals), Pogostemon Herb (1.5 qian), Tongcao (1.5 qian), Cyperus Rhizome (1.5 qian).
Decoct in water, take three doses.
Commentary: The Chong Mai is subordinate to Yangming, opposing Jueyin. Now, Liver disease invading the Stomach causes nausea and vomiting. Overacting on the Spleen causes diarrhea and abdominal fullness. Since the Chong Mai is affected by Liver rebellion invading the Stomach, menstrual blood cannot arrive on time. Treatment uses bitter-pungent descending methods to calm Liver rebellion and harmonize Stomach Qi, resolving all ailments.
Patient Ma (Anchang, Female): Upper cough, lower diarrhea. Flesh wasting daily. Pulse is weak and fine. Amenorrhea and epigastric obstruction. Belongs to difficult severe cases. Follow the method of Hou Zhengzhi. (Also June 5th.)
Pogostemon Herb (5 qian), Chebula Fruit Flesh (3 qian), Stir-fried Rice Sprout (4 qian), Green Calyx Plum (1.5 qian), Fritillaria Bulb (3 qian), Coix Seed Husk (3 qian), Stone Lotus Seed (3 qian), Mulberry Root Bark (1.5 qian), Processed Cyperus Rhizome (3 qian), Tangerine Peel (1.5 qian), Red Poria (4 qian).
Decoct in water, take two doses.
Commentary: Amenorrhea, epigastric obstruction, cough-diarrhea, and emaciation indicate Spleen weakness and Liver rebellion. Transformation and generation lack power. Middle Qi has been deficient for long, and Blood is gradually exhausted. Although using herbs to support Spleen and suppress Liver, it remains a difficult-to-cure condition.
Patient [Child Name Unknown]: Vomiting and thirst have improved. Pulse is choppy and sluggish. Tongue center coating is thick. Abdomen is still large. Stomach feels dull with loose stools. Continue previous method with modifications. (February 11th.)
Mume Fruit (one), Sweet Flag Rhizome (0.4 fen), Red Poria (3 qian), Raw Cyperus Rhizome (1.5 qian), Pepper Seed (0.4 fen), Stir-fried Rice Sprout (3 qian), Magnolia Bark (1 qian), Chicken Gizzard Lining (1.5 qian), Greater Citron Fruit Pericarp (3 qian), Tongcao (1.5 qian), Green Calyx Plum (1 qian).
Decoct in water, take three doses.
Commentary: Long-standing Damp-Heat in Liver and Stomach, combined with Spleen weakness, causes large abdomen and loose stools. Treatment must support Spleen, drain Dampness, and clear Liver-Stomach Heat.
Patient [Child Name Unknown]: Abdominal shape unchanged. Qi rebels with loose stools. Pulse is wiry and fine. Tongue coating is thin and slippery. Slight fever. Thirst. Harmonize middle and divide/drain to prevent malnutrition syndrome (Gan). (June 24th.)
Guang Huo Xiang (Agastache Rhizome) (2 qian), Pogostemon Herb (1.5 qian), Chicken Gizzard Lining (1.5 qian), Toosendan Fruit (1.5 qian),宣木瓜 (Quince Fruit) (1.5 qian), Sweet Flag Rhizome (0.4 fen), Five-Grain Insect (3 qian), Green Calyx Plum (1 qian), Greater Citron Fruit Pericarp (3 qian), Tongcao (1.5 qian), Cyperus Rhizome (1.5 qian).
Decoct in water, take three doses.
Commentary: Irregular diet damages Spleen and Stomach. Liver Yang takes advantage to insult, causing abdominal distension and diarrhea. Treatment harmonizes Liver, strengthens Spleen, clears heat, and guides stagnation.
Patient Shen (Yuzhuang, Girl): Parasite Qi internal attachment. Abdominal pain comes and goes intermittently. Pulse is wiry and soggy. Loose stools. Temporarily calm Stomach and harmonize middle jiao. (February 15th.)
Mume Fruit (one), Sichuan Pepper (14 grains), Five-Grain Insect (3 qian), Costus Root (0.8 fen), Toosendan Fruit (3 qian), Corydalis Rhizome (2 qian), Poria (4 qian), Jasmine Flower (0.8 fen), Raw White Peony Root (1.5 qian), Sweet Flag Rhizome (0.4 fen), Pogostemon Herb (3 qian).
Decoct in water, take two doses.
Commentary: Treatment for Gan-Diarrhea revolves around Spleen and Stomach, roughly categorized: eliminate Stomach stagnation, tonify Spleen weakness, clear fire with bitter-cold if Heat, warm Spleen with pungent-warm if Cold, use vermifuge if parasites exist, tonify the mother organ if deficiency exists. This case involves internal Damp-Heat stagnation with parasite accumulation causing abdominal pain and loose stools. Following the intent of An Wei Wan, strengthening Spleen, expelling parasites, regulating Qi, and guiding stagnation is indeed an excellent formula for parasitic abdominal pain with loose stools.
Patient Pang (Yifeng, Girl): Contracted Summerheat subsequently, complicated by food transforming into diarrhea. Pulse is wiry. Tongue coating is yellow. Thirst. Clear Heat and harmonize middle jiao.
Agastache Rhizome Stem (2 qian), Stir-fried Coptis Rhizome (0.8 fen), Bai Yao Jian (3 qian), Honeysuckle Flower (2 qian), Liu Yi San (Six-to-One Powder) (4 qian), Coix Seed Husk (3 qian), Raw White Peony Root (1.5 qian), Malt (3 qian), Pogostemon Herb (3 qian), Tongcao (1.5 qian), Tangerine Peel (1.5 qian).
Decoct in water, take two doses.
Follow-up: After pathogenic factor, diarrhea and abdominal pain. Right pulse is wiry. Tidal fever resembling malaria. Harmonize middle and clear/drain. (July 13 / May 29).
Polyporus (3 qian), Liu Yi San (Six-to-One Powder) (4 qian), Artemisia Annua Bud (0.8 fen), Stir-fried Coptis Rhizome (0.8 fen), Alisma Rhizome (3 qian), Greater Citron Fruit Pericarp (3 qian), Nutmeg Shell (1.5 qian), Tangerine Peel (1.5 qian), Red Poria (4 qian), Coix Seed Husk (3 qian), Tongcao (1.5 qian).
Decoct in water, take three doses.
Follow-up: Subsequently, diarrhea became purgative-like, abdominal pain uncomfortable. Appetite increased. Tongue coating slippery and slightly yellow. Clear Heat, transform Qi, and divide/drain. (July 17 / Dingwei 4th day)
Stir-fried Coptis Rhizome (0.8 fen), Radish Seed (3 qian), Greater Citron Fruit Pericarp (3 qian), Winter Melon Peel (3 qian), Raw White Peony Root (1.5 qian), Liu Yi San (Six-to-One Powder) (4 qian), Broad Tangerine Peel (1.5 qian), Scorched Medicated Leaven (4 qian), Bitter Orange (1.5 qian), Blue Sandalwood Root (0.8 fen), Raw Coix Seed (4 qian).
Decoct in water, take two doses.
Commentary: Measles is also called Sha. Our local Shaoxing commonly calls it Sha, while Jiangsu generally calls it Zhen. Essentially, they are the same disease, differing only by name due to location.
Ye Tianshi's treatment method distinguishes the four seasons, most concisely. He stated: Spring Sha treated as Wind-Warmth; Summer as Summer-Wind (Summerheat necessarily includes Dampness); Autumn as Heat scorching Dryness; Winter as Wind-Cold. He also said: Rashes should be vented and drained; diarrhea is favorable. Dysentery with five colors is also acceptable. Only when both urine and stool are obstructed are there mostly fatal cases; treatment strictly forbids stopping diarrhea. This case occurred in summer, absorbing Summerheat, complicated by Damp-Food transforming into diarrhea. Treating with clearing Summerheat is most appropriate. As days passed, Damp-Heat sank internally, transferring to the Large Intestine. Treating with guiding stagnation and clearing Damp-Heat aligns closely with the general principle.