脉缓弱，脘中痛胀，呕涌清涎，是脾胃阳微。得之积劳，午后病甚，阳不用事也。大凡
脾阳宜通则运，温补极是。而守中乃腻滞，皆非通府，勿佐用之。
人参 半夏 淡干姜 生益智 茯苓 生姜汁
大便不通，间服半硫丸五分。
痔血久下，肌肉萎黄，乃血脱气馁，渐加喘促浮肿，再延腹胀，二便不通。此症藏阴有
寒，府阳有热。详于《金匮》谷疸篇中，极难调治。
人参 白术 茯苓 智仁 菟丝 木瓜 广皮
经营不遂，情怀拂郁，少火化为壮火，风木挟阳上巅，眩晕不寐，是阳不入阴，非阴虚
症也。如果纯虚，岂有由春及秋，仍能纳食驱驰。今忽然中脘噎阻，由药伤胃口，致胃阳上逆使
然。温胆汤加减之。
陈皮 茯苓 丹皮 栀皮 半夏 枳实 桑叶 竹茹
湿温长夏最多，湿热郁蒸之气，由口鼻而入，上焦先病，渐布中下，河间所谓三焦病也
与风寒食积迥异。仲景云∶湿家不可发汗，汗之则痉。湿本阴邪，其中人也则伤阳，汗则阳
易泄越，而邪留不解。湿蒸热郁，发现为黄，熏蒸气坠之间，正如罨曲之比。斯时病全在气
分，连翘赤小豆汤可以奏效。今经一月，邪弥三焦，自耳前后左肿及右，痈疡大发。夫痈者
壅也，不惟气滞，血亦阻塞，蒸而为脓，谷食不思，陡然肉消殆尽，胃气索然矣。商治之法
，补则助壅，清则垂脱，前辈成法，一无可遵，因思湿热秽浊结于头面清窍，议轻可去实之法
，选芳香气味，使胃无所苦，或者壅遏得宜，少进浆粥，便是进步。经云∶从上病者治其上
。《灵枢》云∶上焦如雾，非轻扬芳香之气，何以开之?
青菊叶 荷叶边 金银花 象贝母 绿豆皮 马兜铃 连翘 射干
煎好，露一宿，临服加金汁一小杯。
身腴，体质适值过劳，阳气受伤，呕吐食物，身热而无头痛。已非外感风寒。间日烦躁渴饮
，唇焦舌黑。是内伏热气。由募原以流布三焦，亦如疟邪之分争营卫者然。然积劳既久，伏
邪客病，脉来小缓，按之不鼓，可为征验。且两便颇通，略能纳谷，焉有停聚积滞?仲景以
单热无寒之症，不出方药，但以饮食消息之。后贤参拟甘寒滋养胃阴，其热自解。
竹叶 花粉 麦冬 连翘 生地 杏仁 蔗浆
寅卯少阳内动，络中血溢，寒热呕逆，骤然泄泻，不能左卧。盖阳木必犯阴土，胆汁无
藏，少寐多寤，土藏被克，食减无味。宜补土疏木。
人参 山药 炙草 白术 扁豆 丹皮
虚损泄泻，用异功理中，乃补脾胃以煦其阳气方法。无如失血遗精，金水久亏，阴乏上承，
咽痛失音，而泻仍不已。长夏吸受暑湿之气，与身中浮越之气，互为郁蒸，遂起疳蚀。气阻
则妨食，是劳损为本，而杂以暑湿，纯补决不应病，与轻淡气薄之剂，先清上焦，后议补益。
芦根 马兜铃 通草 米仁 滑石 西瓜翠衣
瘦人阴虚，热邪易入于阴，病后遗精，皆阴弱不主固摄也。泄泻在夏秋间，是暑湿内侵
，其
者
。近代名贤，讹传阴症，伤人比比。总之遗泄阴亏，与利后阴伤，均非刚剂所宜，当拟柔刚以
人参 山药 川斛 芡实 茯苓 生地炭
七年沉痼，心惕热迷，切牙嚼舌，阴火失守，阳乃鸱张。前方理厥阴阳明，以和阳主治
，继方以咸味纯阴，填水源以生木。病究竟未能却，自述每每遗泄，其病随发。春夏
两时
三合。精遗则肾液少，操劳则胆汁亏，欲望春阳不动，安可得耶?
熟地 肉苁蓉 五味子 龙骨 茯苓 左牡蛎 石菖蒲 远志 川斛 山萸肉
脉弦数右大，舌绛色，面微浮，咳呕上逆，心中热，腹中气撑，卧侧着右，暮夜内外皆
热。自五月起病，百日不晓饥饱，病因忧愁嗔怒而起。诸气交逆。少火化为壮火，烦热不熄 ，
液皆涸，内风煽动，亦属阳化。见症肝病，十之八九。秋金主候，木尚不和，日潮加剧，病
属郁劳，难以久延。议咸苦清养厥阴之阴以和阳。
阿胶 川连 生地 糯米 白芍，鸡子黄
再诊，脉百至，右弦数，左细数。寒热无汗，渴饮呕逆，病中咯血，经水反多。邪热入
迫血妄行。平日奇经多病，已属内虚，故邪乘虚陷，竟属厥阴之热炽以犯阳明。故为呕为闷
，不食，目胞紫暗羞明，咽中窒塞头痛。四厥阴热邪通胃贯膈，上及面目诸窍，先寒后热，
饥不能食，消渴，气上冲心，呕哕。仲景皆例厥阴篇中，此伏邪在至阴之中，必熬至枯涸
而后已。表之则伤阳，攻之则劫阴，惟咸味直走阴分，参入苦寒，以清伏热。清邪之中，仍
护阴气，俾邪退一分，便存得一分之阴，望其少苏。
阿胶 鸡子黄 生地 白芍 黄连 黄柏
右脉平和，左寸关弦动甚锐，面色带赤，体质清 ，得木火之形，禀多动之性，加以操
持烦虑，五志之阳，无有不炽，宜乎寤多寐少，内风不熄，眩晕自生。经云∶阳气下入阴中，阴
满乃得寐。谋虑不决，则火动阴伤，肝阳独行，乏阴和协而魂不藏，则寐不安。总以益阴和
阳为主治，议加味补心丹，兼和肝阳。
人参 生地 元参 桔梗 川连 茯神 天冬 丹参 枣仁 远志 羚羊角 琥珀 麦
冬白芍 柏仁 石菖蒲
炼蜜丸
五日前胀满已在脘间，兼中下寒冷不暖，议参、附、川乌驱阴寒之气凝结，非补虚方也
。十
主通阳极妙。若得阳气通调，何患水湿不去。
人参 熟川附子 大茴香 生淡干姜 茯苓 川楝子 川椒
和入童便杯许。
脉弦数，腹膨便泄，目自泪出，经来身体掣痛，今秋冬两月不至。据说两年患病，医药
不效
干
血偏滞，非徒补可以治病。议厥阴阳明同治，酸苦泄热为先，和补胃气为佐。
吴茱萸 川连 胡连 川楝子 乌梅 人参 白芍 延胡索 云苓 香附 南枣
益母草膏同乌梅肉捣丸。
痰饮乃浊阴所化，阻遏阳气，不入于阴，阴跷空，夜不熟寐，《灵枢经》用半夏秫米汤
，谓通阳交阴，饮邪不聚，天王补心丹一派寒凉阴药，与浊阴树帜。中年必以护阳为要，即《金匮
》所云必以温药和之也。
半夏 秫术 茯苓
少年面色青黄，脉小无神，自幼频有呕吐之症，明是饮食寒暄不调，以致中气不足，咳
嗽非外感，不宜疏泄，小建中汤主之。
脉象缓弱，胃脘部疼痛且胀满，呕吐清稀涎沫，这是脾胃阳气微弱的表现。这是由于长期劳累所致，午后病情加重，是因为阳气不能正常发挥作用。一般来说，脾阳宜通畅才能运化，温补是非常必要的。但守中（固守中焦）的药物往往滋腻滞涩，都不属于通利腑气的药物，不要辅助使用。
痔疮出血日久不止，肌肉萎黄，这是血脱气衰的表现，逐渐出现气喘急促、浮肿，再拖延下去会出现腹胀，大小便不通。这种病症是脏阴有寒，腑阳有热。详细情况在《金匮要略》的谷疸篇中有记载，极难调治。
经营事业不顺，心情抑郁，少火转化为壮火，风木挟带阳气上冲头顶，导致眩晕失眠，这是阳不入阴，不是阴虚症。如果是纯虚证，怎么会有从春天到秋天，仍能进食和奔波劳碌的情况？现在突然感到中脘噎阻，是因为药物损伤了胃口，导致胃阳上逆所致。用温胆汤加减治疗。
湿温病在长夏季节最多见，湿热郁蒸之气，从口鼻而入，上焦先发病，逐渐蔓延到中下焦，这就是河间所说的三焦病。这与风寒食积截然不同。仲景说：患湿病的人不可发汗，发汗就会导致痉病。湿本是阴邪，它侵入人体就会损伤阳气，发汗则阳气容易外泄散失，而邪气留滞不解。湿气蒸腾，热气郁结，表现为发黄，熏蒸之气下沉之间，正像发酵酒曲的情形。此时病全在气分，连翘赤小豆汤可以奏效。现在已经过了一个月，邪气弥漫三焦，从耳前后左侧肿胀波及右侧，痈疡大发。所谓“痈”，就是壅塞，不仅气机阻滞，血液也阻塞，蒸酿而成脓液，谷物食物不想吃，突然之间肌肉消瘦殆尽，胃气索然无存了。商讨治疗方法，补益则会助长壅滞，清热则会导致虚脱，前辈的成法，没有一条可遵循的，于是想到湿热秽浊结聚于头面清窍，建议采用轻扬去实的方法，选择芳香气味的药物，使胃不受苦，或许壅遏得以疏通，稍微进些浆粥，就是进步。经书说：从上部的病，治疗上部。《灵枢》说：上焦如雾，如果不是轻扬芳香之气，怎么能开通它呢？
煎好后，露天放置一夜，临服时加入金汁一小杯。
身体肥胖，体质正值过度劳累，阳气受伤，呕吐食物，身体发热但没有头痛。已经不是外感风寒。隔日烦躁口渴饮水，嘴唇焦黑舌苔黑。这是内伏的热气。由募原流布到三焦，也像疟邪分别争扰营卫那样。然而积劳已久，伏邪客居生病，脉来小缓，按之无力，可以作为验证。而且大小便颇通，略微能进食，哪里有停聚积滞？仲景对于单热无寒的症状，不出方药，只以饮食调养。后贤参考拟定甘寒滋养胃阴，其热自然解除。
寅卯时（凌晨3-7点）少阳内动，络中血液溢出，寒热呕逆，骤然泄泻，不能向左卧。大概阳木必然侵犯阴土，胆汁无法藏纳，睡眠少而觉醒多，土脏被克制，食欲减退无味。应当补土疏木。
虚损泄泻，使用异功散合理中汤，这是补益脾胃以温暖其阳气的方法。无奈失血遗精，金水久已亏损，阴液缺乏上承，咽痛失音，而腹泻仍然不止。长夏吸入暑湿之气，与体内浮越之气，互相郁蒸，遂起疳蚀。气机阻滞则妨碍进食，这是劳损为本，而夹杂暑湿，纯用补益决不应验，先用轻淡气薄的药剂，先清上焦，然后再议补益。
瘦人阴虚，热邪容易进入阴分，病后遗精，都是阴弱不能固摄的缘故。泄泻发生在夏秋间，是暑湿内侵，其……（原文此处有缺漏或断句问题，结合上下文推测意为暑湿致病）。近代名医贤者，讹传阴症，伤人比比皆是。总之遗泄阴亏，与利小便后阴伤，均非刚燥剂所适宜，应当拟制柔刚并用的方剂。
七年沉疴，心中惊惕热迷，咬牙嚼舌，阴火失守，阳气乃鸱张（猖獗）。前方调理厥阴阳明，以调和阳气为主治，继方用咸味纯阴，填补水源以生木。病终究未能去除，自述每每遗泄，病随之发作。春夏两季……（原文此处有缺漏）。精遗则肾液少，操劳则胆汁亏，想要春阳不动，怎么可能呢？
熟地黄 肉苁蓉 五味子 龙骨 茯苓 左牡蛎 石菖蒲 远志 川石斛 山萸肉
脉弦数，右脉大，舌绛色，面部微浮，咳嗽呕吐上逆，心中热，腹中气撑，侧卧偏向右侧，夜晚内外皆热。从五月起病，百日不知饥饱，病因忧愁嗔怒而起。诸气交逆。少火转化为壮火，烦热不熄，津液皆枯竭，内风煽动，也属于阳化。见症属肝病，十之八九。秋金主令之时，木尚不和，每日潮热加剧，病属郁劳，难以长久延续。建议用咸苦清养厥阴之阴以调和阳气。
再诊，脉百至（脉搏极快），右脉弦数，左脉细数。寒热无汗，渴饮呕逆，病中咯血，月经反而增多。邪热入里迫血妄行。平日奇经多病，已属内虚，故邪乘虚陷，竟属厥阴之热炽盛以犯阳明。所以呕吐闷胀，不食，眼睑紫暗羞明，咽喉窒塞头痛。厥阴热邪通胃贯膈，上及面目诸窍，先寒后热，饥不能食，消渴，气上冲心，呕哕。仲景都在厥阴篇中举例，此伏邪在至阴之中，必熬至枯涸而后已。表之则伤阳，攻之则劫阴，只有咸味直走阴分，参入苦寒，以清伏热。在清邪之中，仍护阴气，使邪退一分，便存得一分之阴，希望其稍苏醒。
右脉平和，左寸关弦动甚锐，面色带赤，体质清瘦，得木火之形，禀赋多动之性，加上操持烦虑，五志之阳，无不炽盛，理应醒多睡少，内风不熄，眩晕自生。经书说：阳气下入阴中，阴满乃得寐。谋虑不决，则火动阴伤，肝阳独行，缺乏阴和协而魂不藏，则睡眠不安。总以益阴和阳为主治，建议加味补心丹，兼和肝阳。
人参 生地 玄参 桔梗 川黄连 茯神 天冬 丹参 枣仁 远志 羚羊角 琥珀 麦冬 白芍 柏子仁 石菖蒲
炼蜜为丸
五日前胀满已在胃脘间，兼中下部寒冷不暖，建议用人参、附子、川乌驱散阴寒之气凝结，这不是补虚的方子。十分……（原文此处有缺漏或断句问题，结合上下文推测意为十分关键/主要在于）主通阳极妙。若得阳气通调，何患水湿不去。
调入童便一杯许。
脉弦数，腹部膨隆便泄，眼睛自然流泪，经期身体掣痛，今秋冬两月月经不至。据说两年患病，医药不效……（原文此处有缺漏）。干血偏滞，不仅仅靠补就可以治病。建议厥阴阳明同治，酸苦泄热为先，和补胃气为佐。
吴茱萸 川黄连 胡黄连 川楝子 乌梅 人参 白芍 延胡索 云苓 香附 南枣
痰饮乃浊阴所化，阻遏阳气，不入于阴，阴跷空虚，夜间不能熟睡，《灵枢经》用半夏秫米汤，谓通阳交阴，饮邪不聚，天王补心丹一派寒凉阴药，与浊阴树帜（同类相求/助纣为虐）。中年必须把护阳作为要点，即《金匮要略》所说的必须用温药调和它。
Pulse is slow and weak, pain and distension in the epigastrium, vomiting of clear saliva, indicating Spleen-Yang deficiency (Spleen-Yang deficiency). This results from chronic overwork; symptoms worsen in the afternoon because Yang Qi fails to function properly. Generally, Spleen-Yang requires unobstructed flow to facilitate transportation and transformation; warming and tonifying are essential. However, herbs that strictly "guard the middle" tend to be cloying and stagnating, and do not belong to the category of unblocking the Fu organs; they should not be used as adjuvants.
Ren Shen (Ginseng Radix), Ban Xia (Pinelliae Rhizoma), Dan Gan Jiang (Dried Ginger), Sheng Yi Zhi (Raw Alpinia Officinarum Rhizome), Fu Ling (Poria), Sheng Jiang Zhi (Fresh Ginger Juice)
For constipation, take Ban Liu Wan (Half-Sulfur Pill) intermittently, 5 fen.
Chronic hemorrhoidal bleeding with emaciated, yellowish muscles indicates blood loss leading to Qi exhaustion. Progressively, panting, edema, abdominal distension, and obstruction of both urine and stool may occur. This condition involves Cold in the Zang organs and Heat in the Fu organs. Detailed descriptions can be found in the *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet) under the chapter on Grain Jaundice; it is extremely difficult to treat.
Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling (Poria), Zhi Ren (Alpinia Officinarum Seed), Tu Si Zi (Cuscutae Semen), Mu Gua (Chaenomelis Fructus), Guang Pi (Tangerine Peel)
Unsuccessful business endeavors and emotional depression transform the "Lesser Fire" into "Greater Fire." Wind-Wood carries Yang Qi upward to the vertex, causing dizziness and insomnia. This is due to Yang failing to enter Yin, not a Yin deficiency syndrome. If it were pure deficiency, how could one still eat and travel from spring to autumn? The sudden blockage in the epigastrium is caused by medication damaging the stomach appetite, leading to rebellious Stomach-Yang. Treat with modified Wen Dan Tang (Warm the Gallbladder Decoction).
Chen Pi (Tangerine Peel), Fu Ling (Poria), Dan Pi (Moutan Cortex), Zhi Pi (Gardeniae Pericarpium), Ban Xia (Pinelliae Rhizoma), Zhi Shi (Aurantii Fructus Immaturus), Sang Ye (Mulberry Leaf), Zhu Ru (Bambusae Caulis in Taenia)
Damp-Warmth diseases are most common in late summer. The qi of dampness and heat, stagnant and steaming, enters through the mouth and nose, affecting the Upper Jiao first, then gradually spreading to the Middle and Lower Jiao. This is what He Jian referred to as San Jiao disease. It is completely different from Wind-Cold or food stagnation. Zhong Jing stated: "Patients with Dampness must not be induced to sweat; sweating leads to spasms." Dampness is essentially a Yin pathogen; when it invades, it damages Yang. Sweating causes Yang to leak and scatter, while pathogens remain unresolved. Steaming dampness and stagnant heat manifest as jaundice; the steaming qi sinks, resembling the fermentation of yeast starter. At this stage, the pathology is entirely in the Qi level; Lian Qiao Chi Xiao Dou Tang (Forsythia and Adzuki Bean Decoction) can be effective. After one month, the pathogen has permeated the San Jiao, swelling starting from the left side around the ears and spreading to the right, with severe carbuncles and sores erupting. "Carbuncle" implies congestion; not only is Qi stagnant, but Blood is also blocked, steaming into pus. Loss of appetite and rapid muscle wasting indicate depleted Stomach Qi. Discussing treatment: Tonification aids congestion; clearing Heat risks collapse. None of the predecessors' established methods are applicable. Considering damp-heat and turbid pathogens congealing in the clear orifices of the head and face, I propose using light agents to dispel excess. Select aromatic herbs to avoid burdening the Stomach; if congestion is relieved and some gruel can be taken, progress is made. The Classics state: "Diseases originating from above should be treated from above." The *Ling Shu* states: "The Upper Jiao is like mist"; without light, ascending, and aromatic qi, how can it be opened?
Qing Ju Ye (Green Chrysanthemum Leaf), He Ye Bian (Lotus Leaf Margin), Jin Yin Hua (Lonicerae Japonicae Flos), Xiang Bei Mu (Fritillariae Thunbergii Bulbus), Lv Dou Pi (Vigna Radiata Testa), Ma Dou Ling (Aristolochiae Manshuriensis Radix), Lian Qiao (Forsythiae Fructus), She Ye (Belamcandae Rhizoma)
Decoct, leave exposed overnight, and add a small cup of Jin Zhi (Golden Juice) before administration.
The patient is obese, constitution compromised by excessive labor, injuring Yang Qi. Symptoms include vomiting food, fever without headache, indicating this is no longer external Wind-Cold. Intermittent irritability, thirst, dry lips, and black tongue coating suggest internal latent Heat. This Heat spreads from the Mu Yuan (Sea of Origin) to the San Jiao, similar to Malaria pathogens contesting Ying and Wei levels. However, given chronic overwork and latent pathogens, the pulse is small and slow, non-resilient upon pressure, confirming this diagnosis. Bowels and bladder are relatively open, and slight food intake is possible; thus, there is no stagnation. Zhong Jing provided no formula for single-Heat without Cold cases, advising dietary management instead. Later scholars proposed sweet-cold herbs to nourish Stomach Yin, which naturally resolves the Heat.
Zhu Ye (Bambusae Folium), Hua Fen (Trichosanthis Radix), Mai Dong (Ophiopogonis Tuber), Lian Qiao (Forsythiae Fructus), Sheng Di Huang (Rehmanniae Radix), Xing Ren (Armeniacae Semen Amarum), Zhe Jiang (Sugarcane Juice)
During Yin-Mao hours (3-7 AM), Shaoyang moves internally, bleeding occurs in collaterals, accompanied by alternating chills and fever, vomiting, sudden diarrhea, and inability to lie on the left side. Wood (Liver) inevitably attacks Earth (Spleen/Stomach); Gallbladder bile cannot store properly, leading to scant sleep and frequent waking. Earth organs are suppressed, reducing appetite and taste. Treatment should tonify Earth and soothe Wood.
Ren Shen (Ginseng Radix), Shan Yao (Dioscoreae Rhizoma), Zhi Cao (Prepared Licorice Root), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Bian Dou (Lablab Semen Album), Dan Pi (Moutan Cortex)
For deficiency-type diarrhea, Yi Gong San (Benefiting the Work Powder) combined with Li Zhong Wan (Regulate the Middle Pill) warms Yang by tonifying Spleen and Stomach. However, in cases of blood loss and spermatorrhea with long-term depletion of Metal and Water, Yin lacks upper ascent, causing sore throat and aphonia, while diarrhea persists. Summer-heat and dampness absorbed in late summer interact with floating internal Qi, causing malnutrition ulcers. Qi obstruction hinders eating; this is root deficiency complicated by summer-heat and dampness. Pure tonification will fail. Use light, thin-qi formulas to clear the Upper Jiao first, then consider tonification.
Lu Gen (Phragmitis Rhizoma), Ma Dou Ling (Aristolochiae Manshuriensis Radix), Tong Cao (Tetrapanacis Medulla), Yi Yi Ren (Coicis Semen), Hua Shi (Talcum), Xi Gua Cui Yi (Watermelon Rind)
Thin individuals have Yin deficiency, making them susceptible to Heat entering Yin. Post-illness spermatorrhea results from weak Yin failing to secure. Diarrhea in summer-autumn is due to internal invasion of summer-heat and dampness... [Text fragment missing]. Modern famous physicians erroneously transmit concepts of Yin syndromes, harming many. In summary, spermatorrhea with Yin deficiency and post-diuretic Yin injury are not suitable for harsh, acrid-warm agents. A soft-yang/hard-yin approach should be devised.
Ren Shen (Ginseng Radix), Shan Yao (Dioscoreae Rhizoma), Chuan Hu (Dendrobii Nodule), Qian Shi (Euryales Semen), Fu Ling (Poria), Sheng Di Tan (Charred Rehmanniae Radix)
Seven-year chronic illness, heart palpitations with heat confusion, teeth grinding, tongue biting, Yin fire losing control, Yang flaring wildly. Previous formulas regulated Jueyin and Yangming harmonizing Yang; subsequent formulas used salty-pure Yin to fill the water source to generate Wood. The disease persists. Self-reported frequent spermatorrhea triggers relapse. Spring and summer seasons... [Text fragment missing]. Spermatorrhea depletes Kidney fluids; labor depletes Gallbladder bile. Can one expect Spring Yang to remain undisturbed? Impossible.
Shu Di Huang (Prepared Rehmanniae Radix), Rou Cong Rong (Cistanche Deserticolae Herba), Wu Wei Zi (Schisandrae Chinensis Fructus), Long Gu (Fossilia Ossis Mastodi et Scapulae), Fu Ling (Poria), Zuo Mu Li (Left Oyster Shell), Shi Chang Pu (Acori Tatarinowii Rhizoma), Yuan Zhi (Polygalae Radix), Chuan Hu (Dendrobii Nodule), Shan Yu Rou (Corni Fructus)
Pulse is wiry and rapid, right side large; tongue is crimson; face slightly swollen; cough, vomiting, rebellious Qi, heart heat, abdominal distension, preference for lying on the right side, internal and external heat at night. Illness began in May, lasting 100 days with ignorance of hunger/fullness, caused by worry and anger. All Qi mechanisms reverse. Lesser Fire transforms into Greater Fire; vexing heat persists, fluids dry up, internal wind stirs, all belonging to Yang transformation. Symptoms largely indicate Liver disease. In Autumn, when Metal rules, Wood remains disordered; daily tidal fever worsens. Disease is constrained勞 (consumptive fatigue), difficult to prolong. Propose salty-bitter clearing and nourishing Jueyin Yin to harmonize Yang.
E Jiao (Donkey-Hide Gelatin), Chuan Lian (Coptidis Rhizoma), Sheng Di Huang (Rehmanniae Radix), Nuomi (Glutinous Rice), Bai Shao (Paeoniae Radix Alba), Ji Zi Huang (Chicken Egg Yolk)
Second visit: Pulse reaches 100 beats per minute, right wiry-rapid, left fine-rapid. Alternating chills and fever, anhidrosis, thirst, vomiting, hemoptysis during illness, menorrhagia. Pathogenic Heat forces reckless blood movement. Chronic disorders of the Extraordinary Vessels indicate internal deficiency; thus, pathogens sink into deficiency, becoming intense Jueyin Heat invading Yangming. Symptoms include vomiting, oppression, anorexia, dark purple eyelids, photophobia, throat obstruction, headache. Jueyin Heat pathogens connect Stomach and penetrate Diaphragm, ascending to facial orifices. Preceded by chills then fever, hunger without desire to eat, thirst, Qi rushing to heart, belching. These examples are in Zhong Jing's Jueyin Chapter. Latent pathogens in Supreme Yin must burn until exhausted. Exteriorizing harms Yang; purging robs Yin. Only salty flavors go directly to Yin levels; combine with bitter-cold to clear latent Heat. While clearing pathogens, protect Yin. For every point of pathogen retreat, preserve a point of Yin, hoping for slight recovery.
E Jiao (Donkey-Hide Gelatin), Ji Zi Huang (Chicken Egg Yolk), Sheng Di Huang (Rehmanniae Radix), Bai Shao (Paeoniae Radix Alba), Huang Lian (Coptidis Rhizoma), Huang Bo (Phellodendri Cortex)
Right pulse is peaceful; left Cun-Guan pulses are wiry and sharp. Face is reddish. Constitution is slender, possessing Wood-Fire characteristics, prone to activity. Added to mental stress and worry, the Five Zang Yangs are blazing. Naturally, wakefulness exceeds sleep, internal wind does not extinguish, dizziness arises spontaneously. Classics state: "Yang Qi enters Yin; when Yin is full, sleep occurs." Indecision causes Fire to move and Yin to injure; Liver Yang acts alone, lacking Yin harmony, Hun (Ethereal Soul) does not store, causing restless sleep. Main treatment is tonifying Yin and harmonizing Yang. Propose modified Bu Xin Dan (Tonify the Heart Pill), simultaneously harmonizing Liver Yang.
Ren Shen (Ginseng Radix), Sheng Di Huang (Rehmanniae Radix), Yuan Shen (Scrophulariae Radix), Jie Geng (Platycodonis Radix), Chuan Lian (Coptidis Rhizoma), Fu Shen (Poria with Hostwood), Tian Dong (Asparagi Tuber), Dan Shen (Salviae Miltiorrhizae Radix), Zao Ren (Ziziphi Spinosae Semen), Yuan Zhi (Polygalae Radix), Ling Yang Jiao (Saiga Tataricae Cornu), Hu Po (Amber), Mai Dong (Ophiopogonis Tuber), Bai Shao (Paeoniae Radix Alba), Bai Ren (Biotae Semen), Shi Chang Pu (Acori Tatarinowii Rhizoma)
Prepare pills with refined honey.
Five days ago, distension was in the epigastrium, accompanied by coldness in the middle and lower abdomen. Proposed using Ren Shen, Fu Zi, Chuan Wu to drive out congealed Yin-Cold; this is not a deficiency-tonifying formula. [Fragment missing] promoting Yang unblocking is excellent. If Yang Qi flows smoothly, why worry about water-dampness not departing?
Ren Shen (Ginseng Radix), Shu Chuan Fu Zi (Prepared Aconiti Lateralis Radix), Da Hui Xiang (Foeniculi Fructus), Sheng Dan Gan Jiang (Raw Dried Ginger), Fu Ling (Poria), Chuan Li Zi (Toosendan Fructus), Chuan Jiao (Zanthoxyli Pericarpium)
Mix with a cup of Tong Bian (Child's Urine).
Pulse wiry-rapid, abdominal distension with diarrhea, spontaneous tearing, body cramping pain during menstruation, amenorrhea in autumn-winter. Two years of illness, ineffective treatments... [Fragment missing]. Dry Blood stagnation cannot be cured by tonification alone. Propose simultaneous treatment of Jueyin and Yangming, sour-bitter clearing Heat first, harmonizing and tonifying Stomach Qi as adjuvant.
Wu Zhu Yu (Evodiae Fructus), Chuan Lian (Coptidis Rhizoma), Hu Lian (Coptidis Rhizoma var.), Chuan Li Zi (Toosendan Fructus), Wu Mei (Mume Fructus), Ren Shen (Ginseng Radix), Bai Shao (Paeoniae Radix Alba), Yan Hu Suo (Corydalis Rhizoma), Yun Ling (Poria), Xiang Fu (Cyperi Rhizoma), Nan Zao (Chinese Date)
Pills made with Yi Mu Cao Gao (Leonurus Herbaceous Extract) and Wu Mei Rou (Mume Fruit Pulp).
Phlegm-Fluids are transformed from turbid Yin, obstructing Yang, preventing entry into Yin. Empty Yin Qiao vessel causes poor night sleep. *Ling Shu* uses Ban Xia Shu Mi Tang (Pinellia and Millet Decoction) to unblock Yang and connect Yin, preventing fluid accumulation. Tian Wang Bu Xin Dan consists of cold-cool Yin herbs, aligning with Turbid Yin. For middle-aged patients, protecting Yang is crucial, as stated in *Jin Gui*: "Must use warm herbs to harmonize."
Ban Xia (Pinelliae Rhizoma), Shu Mi (Millet), Fu Ling (Poria)
Youthful patient with green-yellow complexion, small pulse lacking spirit. Frequent vomiting since childhood clearly indicates disharmony of diet and temperature, leading to Middle Qi deficiency. Cough is not external contraction; dispersing is inappropriate. Treat with Xiao Jian Zhong Tang (Minor Construct the Middle Decoction).