方药：镇肝熄风汤加减：怀牛膝30克，代赭石30克，生龙骨15克，生牡蛎15克，生龟甲15克，生白芍15克，玄参15克，天门冬15克，川棟子6克，生麦芽6克，茵陈6克，甘草4克，桑枝30克。
若脉弦数，舌红，头晕目眩，有时震颤等肝火化风者，天麻钩藤饮加减：天麻9克，钩藤15克，石决明25克，栀子9克，黄芩9克，川牛膝12克，杜仲9克，益母草12克，桑寄牛24克，夜交藤15克，茯苓15克。
病例：赵××，男，成。头重脚轻，站立不稳，头中热痛，烦躁失眠，左上下肢活动不便1年。某院诊为动脉硬化，脑血管痉挛。中、西药治疗8个多月无效。审其面色红赤，尤以额部为甚，舌质红，苔薄白，脉弦大上人鱼际．诊为阴虚阳亢，予镇肝熄风汤加减，]O剂后诸证大减，30剂后走路基本恢复正常，头晕亦随之消失。
六、柔肝熄风法
适应证：真阴亏损，虚风内动，瘛疭瘫痪，神疲乏力，或自汗盗汗，手足心热，舌绛少苔或光剥无苔，脉虚大无根或虚而无力。
方药：大定风珠加减：白芍18克，阿胶9克(烊化)，龟甲12克，生地18克，火麻仁6克，五味子6克，生牡蛎12克，麦冬18克，炙甘草12克，生鳖甲12克。
病例：李××，男，79岁。在开会发言时，突然昏迷偏瘫．急住某院，诊为蛛网膜下腔出血。中、西药治疗2个多月无效。审其意识朦胧，失语，右侧偏瘫，手足心热，并见时时瘛疯，舌质红绛无苔，脉虚大。综其脉证，诊为阴液亏损，虚风内动，筋脉失养，予养阴柔肝熄风，大定风珠加减。一周后神志转清，右上下肢微能活动，又继服2月，上肢能上举至头，手指亦稍能活动，并能在他人搀扶下走30步左右。
七、益气散风法
适应证：气血俱虚，寒湿内蕴，外受风寒，偏瘫身重，心中寒，气短乏力，手足厥冷，舌苔薄白，脉沉细弦。
方药：侯氏黑散加减：菊花40克，白术10克，细辛3克，茯苓3克，牡蛎3克，桔梗8克，防风10克，人参4克，明矾3克，黄芩5克，当归3克，干姜3克，川芎3克，附子5克。共为细末，一日3次，一次1一3克，黄酒少许，冷服。
病例：李翰卿先生治一男性患者，右侧轻度偏瘫1年，四肢沉重，行路困难，有时翻身亦感困难，畏寒怯冷，纳差神疲，舌质淡苔薄白，指厥脉微。予侯氏黑散2月而愈。
八、苦寒泻火法
适应证：肝胆实火，筋脉失养，头晕头痛，烦躁易怒，轻度偏瘫，恶热，尿黄赤，舌质红苔黄或黄白，脉弦数者。
方药：龙胆泻肝汤加减：龙胆草10克，栀子10克，黄芩10克，柴胡10克，生地10克，泽泻10克，车前子10克，木通10克，当归10克，防风10克。
若大便干燥，舌苔黄燥者，去车前子、泽泻、木通，加酒军6—10克。
病例：胡××，男，成。高血压、脑血栓形成3个月来，虽经针灸、中、西药物治疗有效，但仍左半身活动不便，头晕头痛，烦躁易怒。询之，除上症外，并见目赤口苦，便干尿黄，舌苔黄，脉弦数。予龙胆泻肝汤加减20剂而愈。
九、化痰通络法
适应证：气滞痰郁，络脉不通，偏瘫挛急，难于屈伸，疼痛，痴呆，或无故悲哭，舌苔白或黄白，脉沉滑。
方药：癫狂梦醒汤加减：桃仁24克，柴胡9克，香附9克，木通9克，赤芍9克，半夏9克，大腹皮9克，青皮9克，陈皮9克，桑皮9克，川芎9克，苏子30克，甘草15克。
若仅轻微偏瘫，头晕，口干，脉弦滑者，熄风通络汤：钩藤30克，地龙10克，桑枝30克，木瓜10克，枳壳10克，香橼10克，佛手10克，连翘10克，丝瓜络10克。
病例：高××，女，60岁。脑血栓形成4年多来，痴呆妄语，右侧偏瘫，翻身站立等均困难，饮食尚可，舌偏歪，舌质红苔黄，脉沉弦滑。诊为气滞痰郁，脉络瘀滞，予癫狂梦醒汤加减10剂，偏瘫、妄语、痴呆等好转。20剂后翻身自如．并能在他人搀扶下走路。
十、益气养血，化痰通络法
适应证：气血俱衰，痰浊阻滞，痰多或不多，昏迷或失语，或瘫痪缓纵不收，心悸失眠，烦躁易怒，舌苔白或黄白而膩，脉虚大弦滑。
方药：十味温胆汤加减：黄芪15克，当归9克，丹参15克，麦冬9克，人参9克，五味子9克，竹茹9克，枳实9克，半夏9克，陈皮9克，茯苓9克，甘草6克，川芎9克，知母6克。
病例：岳××，男，71岁。脑血栓形成2个多月来昏迷、瘫痪不见改善，审其证除昏迷、瘫痪外，喉中痰声漉漉不止，发热，舌苔黄白厚腻，脉虚大弦滑。诊为气阴俱衰，痰火郁结，络脉瘀滞，心窍被蒙。予十味温胆汤加减10剂神志转清，偏瘫好转，继服1个月后上下肢活动明显改善，但行走仍略感不适，半年后诸症消失而愈。
十一、补气养阴法
适应证：偏瘫数年久久不愈，气短乏力，汗多口干，舌质红，苔黄白，脉虚大。
方药：芪脉地黄汤加减：黄芪15克，当归10克，麦冬]O克，党参10克，五味子10克，苍术10克，生地15克，茯苓10克，泽泻10克，丹皮10克。
病例：徐××，男，69岁。偏瘫9年，翻身困难，虽两人搀扶亦仅能走六七步，气短乏力，疲乏思睡，食欲正常，自汗盗汗，舌质红少苔，脉虚大。诊为气阴两虚。予芪脉地黄汤40剂后能自如的翻身，60剂后能在放下拐杖的情况下走路四五百米左右。
十二、培补肾气法
适应证：肾气虚衰，筋骨失养，瘫痪久久不愈，脉沉细弦或虚大无根者．
方药：地黄饮子加减：熟地30克，肉苁蓉15克，巴戟天10克，山萸肉10克，石斛10克，麦冬10克，茯苓10克，附子10克，肉桂6克，菖蒲10克，远志10克，薄荷1．5克，生姜3片，大枣4个。
脉细数，舌质红或舌尖红赤，尿黄者，虎潜丸加减：酒黄柏6克，炙龟甲30克，知母3克，熟地12克，白芍10克，陈皮10克，锁阳10克，干姜1克。
病例：商××，男，50岁。右侧偏瘫，语涩5年多。审其脉微弱，指趾厥冷。子地黄饮子加减2年，愈。
全身窜痛
《金匮》《伤寒》两书，一书主论杂病，一书主述伤寒热病，《伤寒》辨证多从症状，《金匮》辨证多从脉、色。余宗其意，用于反复不愈之证，多见甚效。例如：患者王××，女，成。七八年来全身窜痛，近一年来疼痛加重。询之，疼痛时作时止，或发在头，或几秒钟后迅速转至两臂，刚刚停止，又在脚、腿、手部发生，疼痛处有时如火灼，有时如冰触，有时麻木疼痛，有时跳痛，有时钝痛，春夏剧，秋冬减，总之，休作不一，难于名状。经北京、天津、太原等数家医院检查，均未确诊。不得已，又请中医治疗，遍用祛风散寒、活血通络、针灸、按摩等治疗，症状反见加重，并见心胸烦乱，难以人寐。审视其色，近于常人，言语、呼吸无异常，舌苔薄白，脉沉弦滑。综其脉证，诊为痰火化风之候，拟用熄风化痰，通络泻火。处方：钩藤30克，地龙10克，枳壳10克，香橼9克，佛手9克，连翘9克，丝瓜络9克，桑枝30克。某医云：“全身窜痛是风吗?为什么用风药治之不效?滑脉是有痰吗?为什么用南星、白芥子无功?疼痛是瘀血吗?为什么用乳香、没药、元胡等无效?”答云：“全身窜痛确属风，但风有外风、内风，有虚而生风，有实而生风。外风宜散，如羌活、防风、独活之属，内风宜熄，如钩藤、地龙、僵蚕、羚羊角之类；虚风宜补，但补应视气血阴阳的不同而去补，如气虚者宜人参、黄芪；血虚者宜当归、白芍、阿胶、生地、熟地；阴虚者宜生地、阿胶、玄参、龟甲、鳖甲；阳虚者宜附子、肉桂、川乌、吴萸。实风者宜泻，但应视痰、热的不同和脏腑的区别而用药，如痰热者，宜竹茹、竹沥、胆星，佐加钩藤、地龙、羚羊角、全蝎、僵蚕；热极生风者，宜分胃、肝而用药，如阳明气分热炽者，用白虎，腑实热盛者，用承气，气营两燔者用清瘟败毒饮等。本证之窜痛，不是外风，故不可用羌活、防风、灵仙之散，散之则伤肝之阴而疼痛反加，钩藤、地龙熄内风，舒筋脉，故用之。至于风痰为什么不用白芥子、南星，因其辛温行散之力较强，而无理气之效，而且本证脉见沉弦而滑，沉为气郁为主，故应以理气为先，此时若过用化痰而略于理气，则气郁之火反而更剧，因此采用理气为主微有化痰作用的香橼、佛手、枳壳、丝瓜络，配以连翘软坚散结清热，丝瓜络化痰通络，这样既可除沉痼之害，又可使正气得复。至于疼痛为什么不用乳香、没药、元胡之属，为什么前医应用此类药物而无效，在于配方之中未分君臣佐使，未分虚实寒热，未分缓急之故耳。”10日后，患者来诊云：“服药8剂，证已消失八九。”余诊后云：“药已合拍，勿事更张”，继服20剂，愈。
缩阳
阴茎回缩，少腹疼痛，甚至缩人少腹，名曰缩阳。医多从肾论治，有有效者，亦有无效者。曾治患者麻××，男，30岁。阴茎回缩7个多月，严重时阴茎完全缩人少腹而疼痛不巳，前医始以八味地黄不效，继以大剂附子、肉桂、巴戟、硫黄、沉香之属而加重。患者因之异常恐惧，常常令其爱人用手牢拉阴茎以防完全缩人。细审其证，除以上诸证之外，并见头晕乏力，胸满心烦，口苦口干，舌苔薄白，脉沉而弦。综合脉证，云：“肾阳虚者，两尺脉必沉弱或弦大，且兼腰痛腰酸、本证脉既不见尺弦大，又不见沉弱，而仅见六脉沉弦，沉脉为气郁，弦脉为肝病，且阴茎为宗筋之属，宗筋隶属于肝，此证乃肝郁气结，上热下寒，宗筋拘急之故耳。治宜疏肝木，理三焦，清上温下。柴胡加龙骨牡蛎汤去铅丹。药进2剂，其证大减，继进4剂而愈。
《素问·厥论篇》说：“厥阴之厥，则少腹肿痛，腹胀泾溲不利……阴缩。”《灵枢·经筋篇》说：“足厥阴之筋……伤于寒则阴缩人。”前以治肾，后以治肝，所以取效与不效者，在于病位之不同耳。
久泻久痢
曾治患者石××，男，50岁。一年多来，腹痛，泄泻。里急后重，日渐消瘦，前以中、西药物治疗无效．细询其证，腹痛尤甚于脐腹，痛则欲便，每日大便约30次左右，大便稀溏兼夹脓血，疲乏无力，但食欲基本正常，舌质淡，舌苔白，脉弦。证脉合参，诊为寒积不化，治以健脾温中导滞。理中大黄汤加味：附子9克，党参9克，白术9克，干姜9克，槟榔9克，甘草6克，大黄3克，焦山楂30克，莱菔子12克。因思病久正虚，攻伐太过则正气不支，嘱其4日1剂。2剂后。腹痛消失，大便减为每日4．5次，粘液脓血明显减少，继按上方服药3剂，治疗20多天，大便减至一日3—4次，粘液脓血便明显减少。此时患者见此方效果卓著，为求速效改为每日1剂，三天后，腹痛、泄泻加剧。再审其证，舌苔薄白而呈水滑状，质淡。因思病久肾气虚衰，改为四神丸加减：补骨脂12克，吴茱萸9克，肉豆蔻9克，五味子9克，山药30克。连服4剂，不但腹痛、腹泻不减，反见里急后重更加严重。口舌生疮。经验教训告诉我，必须重新追问病史，必须反复考虑各种治法的得与失。因询患者家属，云：“某院检查诊断为肛门5厘米处，有一中等硬度，有压痛的6厘米×4厘米×3厘米的菜花状肿瘤，诊为直肠癌，因患者拒绝手术，而求中医治疗。”又说：“某院曾用清热解毒，活血止血，收敛固涩的药物1OO多剂，不但无效，反而腹痛，泄泻更加严重。”因悟：久病正气已伤，虽有寒积，不可大下，又思肾虚之状全无，再与补肾，恐药不达病所，而治无过。故仍以理中大黄汤加味，七日1剂，服药1个月，大便正常，其他诸证亦解。(惟因条件关系，没有进一步检查，实为遗憾。)
又如：患者朱×，男，46岁。慢性痢疾，久治不效4年多：先在某院住院治疗无效，后在某院以芍药汤、香连丸、桃花汤、四神丸等治疗1年仍无功。细审其证，除大便每日3~4次外，并见大便稀溏而兼少量脓血，里急后重，左下腹疼痛，舌苔白，脉弦。综其脉证，诊为寒积不化，中土虚衰。乃拟理中大黄汤加味以温中健脾导滞。处方：附子9克，干姜9克，党参9克，白术9克，甘草9克，木香9克，槟榔9克，大黄4．5克。三日1剂。2剂后，腹痛、泄泻、便利脓血等症均明显好转；继服2剂，脓血消失，大便减至一日2—3次。但左下腹疼痛不减，或时见加重。综合脉证，因思左下腹乃肝经之所络也，此寒积虽除，脾土已衰，木邪犯土，治宜理肝木，助脾土，逍遥散加减：柴胡6克、当归9克、白芍9克、白术9克、茯苓9克、甘草6克、干姜4．5克、防风3克。4剂后，诸证消失而愈。
方药：镇肝熄风汤加减：怀牛膝30克，代赭石30克，生龙骨15克，生牡蛎15克，生龟甲15克，生白芍15克，玄参15克，天门冬15克，川楝子6克，生麦芽6克，茵陈6克，甘草4克，桑枝30克。
若脉象弦数，舌质红，出现头晕目眩、有时震颤等肝火化风的症状，使用天麻钩藤饮加减：天麻9克，钩藤15克，石决明25克，栀子9克，黄芩9克，川牛膝12克，杜仲9克，益母草12克，桑寄生24克，夜交藤15克，茯苓15克。
病例：赵××，男，成年。头重脚轻，站立不稳，头部发热疼痛，烦躁失眠，左侧上下肢活动不便1年。某医院诊断为动脉硬化、脑血管痉挛。经中、西药治疗8个多月无效。诊察其面色红赤，尤其是额头部位尤为明显，舌质红，苔薄白，脉象弦大且上达鱼际。诊断为阴虚阳亢（肾阴不足，肝阳上亢），给予镇肝熄风汤加减，服用10剂后诸症大幅减轻，服用30剂后行走基本恢复正常，头晕也随之消失。
六、柔肝熄风法
适应证：真阴亏损（肾阴严重不足），虚风内动，手足抽搐瘫痪，精神疲倦乏力，或自汗盗汗，手足心发热，舌质绛红少苔或光剥无苔，脉象虚大无根或虚而无力。
方药：大定风珠加减：白芍18克，阿胶9克（烊化），龟甲12克，生地18克，火麻仁6克，五味子6克，生牡蛎12克，麦冬18克，炙甘草12克，生鳖甲12克。
病例：李××，男，79岁。在开会发言时，突然昏迷并偏瘫，急住某医院，诊断为蛛网膜下腔出血。经中、西药治疗2个多月无效。诊察其意识朦胧，失语，右侧偏瘫，手足心发热，并见时时手足抽搐，舌质红绛无苔，脉象虚大。综合其脉证，诊断为阴液亏损，虚风内动，筋脉失养，采用养阴柔肝熄风之法，予大定风珠加减。一周后神志转清，右上下肢微能活动，又继续服用2个月，上肢能上举至头部，手指亦稍能活动，并能在他人搀扶下行走约30步。
七、益气散风法
适应证：气血俱虚，寒湿内蕴，外受风寒，偏瘫身重，心中寒冷，气短乏力，手足厥冷，舌苔薄白，脉象沉细弦。
方药：侯氏黑散加减：菊花40克，白术10克，细辛3克，茯苓3克，牡蛎3克，桔梗8克，防风10克，人参4克，明矾3克，黄芩5克，当归3克，干姜3克，川芎3克，附子5克。共研为细末，一日3次，一次1—3克，用少许黄酒送服，冷服。
病例：李翰卿先生治疗一男性患者，右侧轻度偏瘫1年，四肢沉重，行路困难，有时翻身也感到困难，畏寒怯冷，食欲差精神疲倦，舌质淡苔薄白，指端厥冷脉微。给予侯氏黑散治疗2个月而痊愈。
八、苦寒泻火法
适应证：肝胆实火，筋脉失养，头晕头痛，烦躁易怒，轻度偏瘫，恶热，尿黄赤，舌质红苔黄或黄白，脉象弦数者。
方药：龙胆泻肝汤加减：龙胆草10克，栀子10克，黄芩10克，柴胡10克，生地10克，泽泻10克，车前子10克，木通10克，当归10克，防风10克。
若大便干燥，舌苔黄燥者，去掉车前子、泽泻、木通，加酒大黄6—10克。
病例：胡××，男，成年。高血压、脑血栓形成3个月来，虽经针灸、中、西药物治疗有效，但仍左半身活动不便，头晕头痛，烦躁易怒。询问得知，除上述症状外，并见目赤口苦，便干尿黄，舌苔黄，脉象弦数。给予龙胆泻肝汤加减20剂而痊愈。
九、化痰通络法
适应证：气滞痰郁，络脉不通，偏瘫挛急，难于屈伸，疼痛，痴呆，或无故悲哭，舌苔白或黄白，脉象沉滑。
方药：癫狂梦醒汤加减：桃仁24克，柴胡9克，香附9克，木通9克，赤芍9克，半夏9克，大腹皮9克，青皮9克，陈皮9克，桑白皮9克，川芎9克，苏子30克，甘草15克。
若仅轻微偏瘫，头晕，口干，脉象弦滑者，使用熄风通络汤：钩藤30克，地龙10克，桑枝30克，木瓜10克，枳壳10克，香橼10克，佛手10克，连翘10克，丝瓜络10克。
病例：高××，女，60岁。脑血栓形成4年多来，痴呆妄语，右侧偏瘫，翻身站立等均困难，饮食尚可，舌体偏歪，舌质红苔黄，脉象沉弦滑。诊断为气滞痰郁，脉络瘀滞，给予癫狂梦醒汤加减10剂，偏瘫、妄语、痴呆等症状好转。20剂后翻身自如，并能在他人搀扶下走路。
十、益气养血，化痰通络法
适应证：气血俱衰，痰浊阻滞，痰多或不多，昏迷或失语，或瘫痪缓纵不收，心悸失眠，烦躁易怒，舌苔白或黄白而腻，脉象虚大弦滑。
方药：十味温胆汤加减：黄芪15克，当归9克，丹参15克，麦冬9克，人参9克，五味子9克，竹茹9克，枳实9克，半夏9克，陈皮9克，茯苓9克，甘草6克，川芎9克，知母6克。
病例：岳××，男，71岁。脑血栓形成2个多月来昏迷、瘫痪不见改善，诊察其证除昏迷、瘫痪外，喉中痰声漉漉不止，发热，舌苔黄白厚腻，脉象虚大弦滑。诊断为气阴俱衰，痰火郁结，络脉瘀滞，心窍被蒙。给予十味温胆汤加减10剂神志转清，偏瘫好转，继服1个月后上下肢活动明显改善，但行走仍略感不适，半年后诸症消失而痊愈。
十一、补气养阴法
适应证：偏瘫数年久久不愈，气短乏力，汗多口干，舌质红，苔黄白，脉象虚大。
方药：芪脉地黄汤加减：黄芪15克，当归10克，麦冬10克，党参10克，五味子10克，苍术10克，生地15克，茯苓10克，泽泻10克，丹皮10克。
病例：徐××，男，69岁。偏瘫9年，翻身困难，虽两人搀扶亦仅能走六七步，气短乏力，疲乏思睡，食欲正常，自汗盗汗，舌质红少苔，脉象虚大。诊断为气阴两虚。给予芪脉地黄汤40剂后能自如地翻身，60剂后能在放下拐杖的情况下走路四五百米左右。
十二、培补肾气法
适应证：肾气虚衰，筋骨失养，瘫痪久久不愈，脉象沉细弦或虚大无根者。
方药：地黄饮子加减：熟地30克，肉苁蓉15克，巴戟天10克，山萸肉10克，石斛10克，麦冬10克，茯苓10克，附子10克，肉桂6克，菖蒲10克，远志10克，薄荷1.5克，生姜3片，大枣4个。
脉细数，舌质红或舌尖红赤，尿黄者，使用虎潜丸加减：酒黄柏6克，炙龟甲30克，知母3克，熟地12克，白芍10克，陈皮10克，锁阳10克，干姜1克。
病例：商××，男，50岁。右侧偏瘫，言语涩滞5年多。诊察其脉微弱，指趾厥冷。给予地黄饮子加减治疗2年，痊愈。
全身窜痛
《金匮要略》和《伤寒论》两书，一书主要论述杂病，一书主要阐述伤寒热病，《伤寒论》辨证多从症状入手，《金匮要略》辨证多从脉象、面色入手。我遵循其意旨，用于反复不愈的病症，多见显著疗效。例如：患者王××，女，成年。七八年来全身窜痛，近一年来疼痛加重。询问得知，疼痛时作时止，有时发作在头部，或几秒钟后迅速转至两臂，刚刚停止，又在脚、腿、手部发生，疼痛处有时如火灼烧，有时如冰触碰，有时麻木疼痛，有时跳痛，有时钝痛，春夏季节剧烈，秋冬季节减轻，总之，发作休止不一，难以名状。经北京、天津、太原等数家医院检查，均未确诊。不得已，又请中医治疗，遍用祛风散寒、活血通络、针灸、按摩等治疗，症状反而加重，并见心胸烦乱，难以入睡。审视其面色，接近常人，言语、呼吸无异常，舌苔薄白，脉象沉弦滑。综合其脉证，诊断为痰火化风之候，拟定用熄风化痰，通络泻火之法。处方：钩藤30克，地龙10克，枳壳10克，香橼9克，佛手9克，连翘9克，丝瓜络9克，桑枝30克。某医生说：“全身窜痛是风邪吗？为什么用治风药治疗不效？滑脉是有痰吗？为什么用南星、白芥子无功？疼痛是瘀血吗？为什么用乳香、没药、元胡等无效？”回答说：“全身窜痛确实属于风，但风有外风和内风之分，有因虚而生风，有因实而生风。外风宜疏散，如羌活、防风、独活之类；内风宜平息，如钩藤、地龙、僵蚕、羚羊角之类；虚风宜补益，但补益应视气血阴阳的不同而选用药物，如气虚者宜用人参、黄芪；血虚者宜用当归、白芍、阿胶、生地、熟地；阴虚者宜用地黄、阿胶、玄参、龟甲、鳖甲；阳虚者宜用附子、肉桂、川乌、吴茱萸。实风宜泻，但应视痰、热的不同和脏腑的区别而用药，如痰热者，宜用竹茹、竹沥、胆南星，佐加钩藤、地龙、羚羊角、全蝎、僵蚕；热极生风者，宜分胃、肝而用药，如阳明气分热炽者，用白虎汤，腑实热盛者，用承气汤，气营两燔者用清瘟败毒饮等。本证的窜痛，不是外风，故不可用羌活、防风、威灵仙之疏散，疏散则伤肝之阴而疼痛反而加剧，钩藤、地龙平息内风，舒筋脉，故用之。至于风痰为什么不用白芥子、南星，因其辛温行散之力较强，而无理气之效，而且本证脉见沉弦而滑，沉脉主气郁为主，故应以理气为先，此时若过用化痰而忽略理气，则气郁之火反而更剧，因此采用理气为主微有化痰作用的香橼、佛手、枳壳、丝瓜络，配以连翘软坚散结清热，丝瓜络化痰通络，这样既可除沉痼之害，又可使正气得复。至于疼痛为什么不用乳香、没药、元胡之类，为什么前医应用此类药物而无效，在于配方之中未分君臣佐使，未分虚实寒热，未分缓急之故耳。”10日后，患者来就诊说：“服药8剂，症状已消失八九。”我诊察后说：“药已合拍，不要更改”，继服20剂，痊愈。
缩阳
阴茎回缩，少腹疼痛，甚至缩入少腹，名为缩阳。医生多从肾论治，有有效者，亦有无效者。曾治疗患者麻××，男，30岁。阴茎回缩7个多月，严重时阴茎完全缩入少腹而疼痛不已，前医起初以八味地黄丸治疗不效，继以大剂附子、肉桂、巴戟天、硫黄、沉香之类而加重病情。患者因此异常恐惧，常常令其爱人用手牢牢拉住阴茎以防完全缩入。仔细审察其证，除以上诸证之外，并见头晕乏力，胸满心烦，口苦口干，舌苔薄白，脉象沉而弦。综合脉证，我说：“肾阳虚者，两尺脉必沉弱或弦大，且兼腰痛腰酸，本证脉既不见尺部弦大，又不见沉弱，而仅见六脉沉弦，沉脉为气郁，弦脉为肝病，且阴茎为宗筋所属，宗筋隶属于肝，此证乃肝郁气结，上热下寒，宗筋拘急之故耳。治宜疏肝木，理三焦，清上温下。使用柴胡加龙骨牡蛎汤去铅丹。药进2剂，其证大减，继进4剂而痊愈。
《素问·厥论篇》说：“厥阴之厥，则少腹肿痛，腹胀泾溲不利……阴缩。”《灵枢·经筋篇》说：“足厥阴之筋……伤于寒则阴缩入。”前以治肾，后以治肝，所以取效与不效者，在于病位之不同耳。
久泻久痢
曾治疗患者石××，男，50岁。一年多来，腹痛，泄泻。里急后重，日渐消瘦，前以中、西药物治疗无效。仔细询问其证，腹痛尤甚于脐腹，痛则欲便，每日大便约30次左右，大便稀溏兼夹脓血，疲乏无力，但食欲基本正常，舌质淡，舌苔白，脉象弦。证脉合参，诊断为寒积不化，治以健脾温中导滞。使用理中大黄汤加味：附子9克，党参9克，白术9克，干姜9克，槟榔9克，甘草6克，大黄3克，焦山楂30克，莱菔子12克。因思虑病久正虚，攻伐太过则正气不支，嘱其4日1剂。2剂后，腹痛消失，大便减为每日4-5次，粘液脓血明显减少，继按上方服药3剂，治疗20多天，大便减至一日3-4次，粘液脓血便明显减少。此时患者见此方效果卓著，为求速效改为每日1剂，三天后，腹痛、泄泻加剧。再审其证，舌苔薄白而呈水滑状，质淡。因思虑病久肾气虚衰，改为四神丸加减：补骨脂12克，吴茱萸9克，肉豆蔻9克，五味子9克，山药30克。连服4剂，不但腹痛、腹泻不减，反见里急后重更加严重，口舌生疮。经验教训告诉我，必须重新追问病史，必须反复考虑各种治法的得与失。因询问患者家属，说：“某院检查诊断为肛门5厘米处，有一中等硬度，有压痛的6厘米×4厘米×3厘米的菜花状肿瘤，诊断为直肠癌，因患者拒绝手术，而求中医治疗。”又说：“某院曾用清热解毒，活血止血，收敛固涩的药物100多剂，不但无效，反而腹痛，泄泻更加严重。”因而领悟：久病正气已伤，虽有寒积，不可大下，又思肾虚之状全无，再与补肾，恐药不达病所，而治无过。故仍以理中大黄汤加味，七日1剂，服药1个月，大便正常，其他诸证亦解。（惟因条件关系，没有进一步检查，实为遗憾。）
又如：患者朱×，男，46岁。慢性痢疾，久治不效4年多：先在某院住院治疗无效，后在某院以芍药汤、香连丸、桃花汤、四神丸等治疗1年仍无功。仔细审察其证，除大便每日3-4次外，并见大便稀溏而兼少量脓血，里急后重，左下腹疼痛，舌苔白，脉象弦。综合脉证，诊断为寒积不化，中土虚衰。乃拟理中大黄汤加味以温中健脾导滞。处方：附子9克，干姜9克，党参9克，白术9克，甘草9克，木香9克，槟榔9克，大黄4.5克。三日1剂。2剂后，腹痛、泄泻、便利脓血等症均明显好转；继服2剂，脓血消失，大便减至一日2-3次。但左下腹疼痛不减，或时见加重。综合脉证，因思左下腹乃肝经之所络也，此寒积虽除，脾土已衰，木邪犯土，治宜理肝木，助脾土，逍遥散加减：柴胡6克、当归9克、白芍9克、白术9克、茯苓9克、甘草6克、干姜4.5克、防风3克。4剂后，诸证消失而痊愈。
Prescription: Zhen Gan Xi Feng Tang (Sedate the Liver and Extinguish Wind Decoction) modified: Huai Niuxi (Radix Achyranthis Bidentatae) 30g, Daizheshi (Haematitum) 30g, Sheng Longgu (Os Draconis et Ossis Mammothi) 15g, Sheng Muli (Concha Ostreae) 15g, Sheng Guijia (Carapax et Plastrum Testudinis) 15g, Sheng Baishao (Radix Paeoniae Alba) 15g, Xuanshen (Radix Scrophulariae) 15g, Tianmendong (Herba Asparagi) 15g, Chuanlianzi (Fructus Toosendan) 6g, Sheng Maiya (Fructus Hordei Germinatus) 6g, Yichen (Herba Artemisiae Scopariae) 6g, Gancao (Radix Glycyrrhizae) 4g, Sangzhi (Ramulus Mori) 30g.
If the pulse is wiry and rapid, the tongue is red, and symptoms such as dizziness, vertigo, or occasional tremors occur indicating liver fire transforming into wind, use Tianma Gouteng Yin (Gastrodia and Uncaria Decoction) modified: Tianma (Rhizoma Gastrodiae) 9g, Gouteng (Caulis Uncariae cum Uncis) 15g, Shijueming (Concha Haliotidis) 25g, Zhizi (Fructus Gardeniae) 9g, Huangqin (Radix Scutellariae) 9g, Chuan Niuxi (Radix Achyranthis Bidentatae) 12g, Duzhong (Cortex Eucommiae) 9g, Yimucao (Herba Leonuri) 12g, Sangjisheng (Cacumen Taxilli) 24g, Yejiaoteng (Caulis Polygoni Multiflori) 15g, Fuling (Poria) 15g.
Case: Zhao XX, male, adult. Symptoms included heaviness in the head with lightness in the feet, instability when standing, heat and pain in the head, irritability, insomnia, and difficulty moving the left upper and lower limbs for one year. A certain hospital diagnosed arteriosclerosis and cerebral vasospasm. Treatment with Chinese and Western medicines for over eight months was ineffective. Examination revealed a ruddy complexion, especially on the forehead; the tongue was red with a thin white coating; the pulse was wiry, large, and reached beyond the radial artery to the fish margin. The diagnosis was Yin deficiency with Yang hyperactivity (Kidney Yin insufficiency leading to Liver Yang rising). He was prescribed Zhen Gan Xi Feng Tang (Sedate the Liver and Extinguish Wind Decoction) modified. After taking 10 doses, all symptoms significantly decreased. After 30 doses, walking ability basically returned to normal, and dizziness disappeared.
Six. Softening the Liver and Extinguishing Wind Method
Indications: Deficiency of True Yin (severe Kidney Yin deficiency), internal movement of deficient wind, clonic spasms and paralysis, mental fatigue and weakness, spontaneous sweating or night sweats, heat in the palms and soles, a crimson tongue with little coating or peeled/no coating, and a pulse that is empty, large without root, or weak and powerless.
Prescription: Da Ding Feng Zhu (Great Calming Wind Pearl) modified: Baishao (Radix Paeoniae Alba) 18g, Ejiao (Colla Corii Asini) 9g (melted), Guijia (Carapax et Plastrum Testudinis) 12g, Shengdi (Radix Rehmanniae Preparata) 18g, Huomaren (Semen Cannabis) 6g, Wuweizi (Fructus Schisandrae Chinensis) 6g, Sheng Muli (Concha Ostreae) 12g, Maidong (Radix Ophiopogonis) 18g, Zhigancao (Radix Glycyrrhizae Preparata) 12g, Sheng Biejia (Carapax Trionycis) 12g.
Case: Li XX, male, 79 years old. Suddenly fell into coma with hemiplegia while speaking at a meeting. Emergency admission to a hospital resulted in a diagnosis of subarachnoid hemorrhage. Treatment with Chinese and Western medicines for over two months was ineffective. Examination showed blurred consciousness, aphasia, right-sided hemiplegia, heat in the palms and soles, and frequent clonic spasms. The tongue was crimson red without coating, and the pulse was empty and large. Synthesizing the pulse and symptoms, the diagnosis was loss of Yin fluids, internal movement of deficient wind, and malnutrition of sinews and vessels. Treatment involved nourishing Yin, softening the Liver, and extinguishing wind using Da Ding Feng Zhu (Great Calming Wind Pearl) modified. After one week, consciousness cleared, and slight movement was possible in the right upper and lower limbs. After continuing for another two months, the upper limb could be raised to the head, fingers could move slightly, and he could walk about 30 steps with assistance.
Seven. Tonifying Qi and Dispersing Wind Method
Indications: Deficiency of both Qi and Blood, internal accumulation of cold-dampness, external contraction of wind-cold, hemiplegia with heavy body, cold sensation in the heart, shortness of breath, fatigue, cold extremities, thin white tongue coating, and a deep, fine, wiry pulse.
Prescription: Hou Shi Hei San (Hou's Black Powder) modified: Juhua (Flos Chrysanthemi) 40g, Baizhu (Rhizoma Atractylodis Macrocephalae) 10g, Xixin (Herba Asari) 3g, Fuling (Poria) 3g, Muli (Concha Ostreae) 3g, Jiegeng (Radix Platycodonis) 8g, Fangfeng (Radix Saposhnikoviae) 10g, Renshen (Radix Ginseng) 4g, Mingfan (Alumen) 3g, Huangqin (Radix Scutellariae) 5g, Danggui (Radix Angelicae Sinensis) 3g, Ganjiang (Rhizoma Zingiberis) 3g, Chuanxiong (Rhizoma Chuanxiong) 3g, Fuzi (Radix Aconiti Lateralis Preparata) 5g. Grind into fine powder. Take three times daily, 1–3g each time, with a small amount of yellow wine, taken cold.
Case: Mr. Li Hanqing treated a male patient with mild right-sided hemiplegia for one year. Symptoms included heaviness in the four limbs, difficulty walking, difficulty turning over, aversion to cold and fear of cold, poor appetite, and mental fatigue. The tongue was pale with a thin white coating; fingertips were cold, and the pulse was faint. Treatment with Hou Shi Hei San (Hou's Black Powder) for two months resulted in recovery.
Eight. Bitter-Cold Draining Fire Method
Indications: Excess fire of the Liver and Gallbladder, malnutrition of sinews and vessels, dizziness and headache, irritability and anger, mild hemiplegia, aversion to heat, yellow-red urine, red tongue with yellow or yellow-white coating, and wiry-rapid pulse.
Prescription: Longdan Xiegan Tang (Gentian Liver-Draining Decoction) modified: Longdancao (Radix Gentianae) 10g, Zhizi (Fructus Gardeniae) 10g, Huangqin (Radix Scutellariae) 10g, Chaihu (Radix Bupleuri) 10g, Shengdi (Radix Rehmanniae Preparata) 10g, Zexie (Rhizoma Alismatis) 10g, Cheqianzi (Semen Plantaginis) 10g, Mutong (Caulis Akebiae) 10g, Danggui (Radix Angelicae Sinensis) 10g, Fangfeng (Radix Saposhnikoviae) 10g.
If there is dry stool and a dry yellow tongue coating, remove Cheqianzi (Semen Plantaginis), Zexie (Rhizoma Alismatis), and Mutong (Caulis Akebiae), and add Jiujun (Radix Rhei Preparata) 6–10g.
Case: Hu XX, male, adult. For three months since hypertension and cerebral thrombosis, although acupuncture and Chinese/Western medicines were effective, left-sided hemiplegia persisted with dizziness, headache, irritability, and anger. Inquiry revealed red eyes, bitter taste in the mouth, dry stool, yellow urine, yellow tongue coating, and wiry-rapid pulse. Treatment with Longdan Xiegan Tang (Gentian Liver-Draining Decoction) modified for 20 doses resulted in recovery.
Nine. Resolving Phlegm and Unblocking Collaterals Method
Indications: Qi stagnation with phlegm depression, unblocked collaterals, hemiplegia with spasms, difficulty in flexion and extension, pain, dementia, or unexplained weeping/crying, white or yellow-white tongue coating, and deep-slippery pulse.
Prescription: Diankuang Mengxing Tang (Manic-Depressive Dream-Awakening Decoction) modified: Taoren (Semen Persicae) 24g, Chaihu (Radix Bupleuri) 9g, Xiangfu (Rhizoma Cyperi) 9g, Mutong (Caulis Akebiae) 9g, Chishao (Radix Paeoniae Rubra) 9g, Banxia (Rhizoma Pinelliae Preparata) 9g, Dafupi (Pericarpium Arecae Catechu) 9g, Qingpi (Pericarpium Citri Reticulatae Viride) 9g, Chenpi (Pericarpium Citri Reticulatae) 9g, Sangbai (Cortex Mori Radicis) 9g, Chuanxiong (Rhizoma Chuanxiong) 9g, Suzi (Fructus Perillae) 30g, Gancao (Radix Glycyrrhizae) 15g.
For mild hemiplegia, dizziness, dry mouth, and wiry-slippery pulse, use Xifeng Tongluo Tang (Extinguish Wind and Unblock Collaterals Decoction): Gouteng (Caulis Uncariae cum Uncis) 30g, Dilong (Pheretima) 10g, Sangzhi (Ramulus Mori) 30g, Mugua (Fructus Chaenomelis) 10g, Zhiqiao (Fructus Aurantii) 10g, Xianyuan (Fructus Citri Sarcodactylis) 10g, Foshou (Fructus Citri Sarcodactylis) 10g, Lianqiao (Fructus Forsythiae) 10g, Sigualuo (Fructus Luffae) 10g.
Case: Gao XX, female, 60 years old. For over four years since cerebral thrombosis, she suffered from dementia and delirious speech, right-sided hemiplegia, and difficulty turning over or standing. Diet was acceptable. The tongue deviated to one side, was red with yellow coating, and the pulse was deep-wiry-slippery. Diagnosis: Qi stagnation with phlegm depression, collateral stasis. Prescribed Diankuang Mengxing Tang (Manic-Depressive Dream-Awakening Decoction) modified for 10 doses. Hemiplegia, delirious speech, and dementia improved. After 20 doses, she could turn over freely and walk about with assistance.
Ten. Tonifying Qi and Nourishing Blood, Resolving Phlegm and Unblocking Collaterals Method
Indications: Decline of both Qi and Blood, obstruction by turbid phlegm, excessive or non-excessive phlegm, coma or aphasia, or flaccid paralysis that cannot retract, palpitations, insomnia, irritability, white or yellow-white greasy tongue coating, and empty-large-wiry-slippery pulse.
Prescription: Shiwei Wendan Tang (Ten-Ingredient Warm Gallbladder Decoction) modified: Huangqi (Radix Astragali) 15g, Danggui (Radix Angelicae Sinensis) 9g, Danshen (Radix Salviae Miltiorrhizae) 15g, Maidong (Radix Ophiopogonis) 9g, Renshen (Radix Ginseng) 9g, Wuweizi (Fructus Schisandrae Chinensis) 9g, Zhuru (Spiram Bambusae) 9g, Zhishi (Fructus Aurantii Immaturus) 9g, Banxia (Rhizoma Pinelliae Preparata) 9g, Chenpi (Pericarpium Citri Reticulatae) 9g, Fuling (Poria) 9g, Gancao (Radix Glycyrrhizae) 6g, Chuanxiong (Rhizoma Chuanxiong) 9g, Zhimu (Rhizoma Anemarrhenae) 6g.
Case: Yue XX, male, 71 years old. For over two months since cerebral thrombosis, coma and paralysis did not improve. Examination revealed continuous rattling phlegm sound in the throat, fever, thick greasy yellow-white tongue coating, and empty-large-wiry-slippery pulse. Diagnosis: Decline of both Qi and Yin, stagnation of phlegm-fire, collateral stasis, obscuration of the Heart orifices. Prescribed Shiwei Wendan Tang (Ten-Ingredient Warm Gallbladder Decoction) modified for 10 doses. Consciousness cleared, and hemiplegia improved. After continuing for one month, upper and lower limb activity improved significantly, though walking remained slightly uncomfortable. All symptoms disappeared after six months, resulting in recovery.
Eleven. Tonifying Qi and Nourishing Yin Method
Indications: Hemiplegia persisting for years without cure, shortness of breath, fatigue, excessive sweating, dry mouth, red tongue, yellow-white coating, and empty-large pulse.
Prescription: Qimai Dihuang Tang (Astragalus and Rehmannia Pulse-Decoction) modified: Huangqi (Radix Astragali) 15g, Danggui (Radix Angelicae Sinensis) 10g, Maidong (Radix Ophiopogonis) 10g, Dangshen (Radix Codonopsis) 10g, Wuweizi (Fructus Schisandrae Chinensis) 10g, Cangzhu (Rhizoma Atractylodis) 10g, Shengdi (Radix Rehmanniae Preparata) 15g, Fuling (Poria) 10g, Zexie (Rhizoma Alismatis) 10g, Danpi (Cortex Moutan) 10g.
Case: Xu XX, male, 69 years old. Hemiplegia for nine years, difficulty turning over, able to walk only six or seven steps even with two people assisting. Shortness of breath, fatigue, desire to sleep, normal appetite, spontaneous and night sweats, red tongue with little coating, empty-large pulse. Diagnosis: Dual deficiency of Qi and Yin. Prescribed Qimai Dihuang Tang (Astragalus and Rehmannia Pulse-Decoction). After 40 doses, he could turn over freely. After 60 doses, he could walk 400–500 meters without a cane.
Twelve. Cultivating and Tonifying Kidney Qi Method
Indications: Decline of Kidney Qi, malnutrition of sinews and bones, persistent paralysis, deep-fine-wiry or empty-large-rootless pulse.
Prescription: Dihuang Yinzi (Rehmannia Infusion) modified: Shudi (Radix Rehmanniae Preparata) 30g, Roucongrong (Herba Cynomorii) 15g, Bajitian (Radix Morindae Officinalis) 10g, Shanzhuyu (Fructus Corni) 10g, Shihu (Caulis Dendrobii) 10g, Maidong (Radix Ophiopogonis) 10g, Fuling (Poria) 10g, Fuzi (Radix Aconiti Lateralis Preparata) 10g, Rougui (Cortex Cinnamomi) 6g, Changpu (Rhizoma Acori Tatarinowii) 10g, Yuanzhi (Radix Polygalae) 10g, Bohe (Herba Menthae) 1.5g, Shengjiang (Rhizoma Zingiberis Recens) 3 slices, Dazao (Fructus Jujubae) 4 pieces.
For fine-rapid pulse, red tongue or red tongue tip, and yellow urine, use Huyian Wan (Tiger-Hiding Pill) modified: Jiu Huangbo (Cortex Phellodendri Preparata) 6g, Zhi Guijia (Carapax et Plastrum Testudinis Preparata) 30g, Zhimu (Rhizoma Anemarrhenae) 3g, Shudi (Radix Rehmanniae Preparata) 12g, Baishao (Radix Paeoniae Alba) 10g, Chenpi (Pericarpium Citri Reticulatae) 10g, Suoyang (Herba Cynomorii) 10g, Ganjiang (Rhizoma Zingiberis) 1g.
Case: Shang XX, male, 50 years old. Right-sided hemiplegia and slurred speech for over five years. Examination showed weak pulse and cold fingertips/toes. Treatment with Dihuang Yinzi (Rehmannia Infusion) modified for two years resulted in recovery.
General Wandering Pain
The *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) mainly discusses miscellaneous diseases, while the *Shanghan Lun* (Treatise on Cold Damage) mainly elaborates on cold damage febrile diseases. The *Shanghan Lun* differentiates syndromes mostly from symptoms, whereas the *Jingui Yaolue* differentiates mostly from pulse and complexion. I follow their intent and find it highly effective for persistent, recurring conditions.
Example: Patient Wang XX, female, adult. For seven or eight years, she experienced wandering pain throughout the body, worsening in the past year. The pain came and went, sometimes starting in the head, then rapidly moving to both arms within seconds. Just as it stopped, it appeared in the legs, feet, and hands. The pain felt like burning fire, ice touch, numbness, throbbing, or dull ache. It was severe in spring/summer and mild in autumn/winter. The pattern of onset and cessation varied, making it hard to describe. Several hospitals in Beijing, Tianjin, and Taiyuan failed to diagnose. Seeking TCM treatment, she tried dispersing wind-cold, activating blood, unblocking collaterals, acupuncture, and massage, but symptoms worsened, accompanied by chest/heart vexation and insomnia. Her complexion was near normal, speech and breathing were unremarkable, tongue coating was thin white, and pulse was deep-wiry-slippery. Synthesizing pulse and symptoms, the diagnosis was phlegm-fire transforming into wind. The strategy was to extinguish wind, resolve phlegm, unblock collaterals, and drain fire. Prescription: Gouteng (Caulis Uncariae cum Uncis) 30g, Dilong (Pheretima) 10g, Zhiqiao (Fructus Aurantii) 10g, Xianyuan (Fructus Citri Sarcodactylis) 9g, Foshou (Fructus Citri Sarcodactylis) 9g, Lianqiao (Fructus Forsythiae) 9g, Sigualuo (Fructus Luffae) 9g, Sangzhi (Ramulus Mori) 30g.
Another doctor asked: "Is general wandering pain due to wind? Why didn't wind-dispelling herbs work? Is slippery pulse due to phlegm? Why didn't Nanxing (Rhizoma Arisaematis) and Baijiezi (Semen Sinapis) work? Is pain due to blood stasis? Why didn't Rushxiang (Resina Agallochi), Moyao (Resina Olibani), and Yuanyu (Rhizoma Curcumae) work?"
I replied: "General wandering pain is indeed wind, but wind has exterior and interior types, and can arise from deficiency or excess. Exterior wind should be dispersed (e.g., Qianghuo, Fangfeng, Duhuo). Interior wind should be extinguished (e.g., Gouteng, Dilong, Jiangcan, Lingyangjiao). Deficient wind requires tonification based on Qi/Blood/Yin/Yang deficiency (Qi: Renshen, Huangqi; Blood: Danggui, Baishao, Ejiao, Shengdi, Shudi; Yin: Shengdi, Ejiao, Xuanshen, Guijia, Biejia; Yang: Fuzi, Rougui, Chuanwu, Wuzhuyu). Excess wind requires draining based on phlegm/heat and organ differentiation (Phlegm-heat: Zhuru, Zhulv, Danning, plus Gouteng, Dilong, Lingyangjiao, Quanxie, Jiangcan; Extreme heat generating wind: Baihu Tang for Yangming Qi-level heat; Chengqi Tang for Fu-organ heat; Qingwen Baidu Yin for Qi and Ying simultaneous burning). This case's wandering pain is not exterior wind, so dispersing herbs like Qianghuo, Fangfeng, and Lingxian are contraindicated as they injure Liver Yin and worsen pain. Gouteng and Dilong extinguish interior wind and relax sinews, hence used.
Why not Baijiezi or Nanxing for wind-phlegm? Because their acrid-warm dispersing power is strong, but they lack Qi-regulating effects. The pulse here is deep-wiry-slippery; deep indicates Qi stagnation as the primary issue. Thus, regulating Qi must come first. Overusing phlegm-resolving herbs while neglecting Qi regulation would intensify the fire from Qi stagnation. Therefore, I used Qi-regulating herbs with mild phlegm-resolving effects (Xianyuan, Foshou, Zhiqiao, Sigualuo), combined with Lianqiao to soften hardness, dissipate nodules, and clear heat, and Sigualuo to resolve phlegm and unblock collaterals. This removes chronic pathology and restores healthy Qi.
Why not Rushxiang, Moyao, or Yuanyu for pain? Previous prescriptions failed because they lacked proper hierarchy (Jun-Chen-Zuo-Shi), differentiation of deficiency/excess and cold/heat, and consideration of urgency."
After 10 days, the patient reported: "After 8 doses, 80-90% of symptoms disappeared." I said: "The prescription matches the syndrome; do not change it." She continued for 20 more doses and recovered.
Retraction of the Penis (Suo Yang)
Retraction of the penis, lower abdominal pain, or even retraction into the lower abdomen is named Suo Yang (Penile Retraction). Doctors often treat from the Kidney perspective; some succeed, others fail.
Case: Ma XX, male, 30 years old. Penile retraction for over 7 months. Severe cases involved complete retraction into the lower abdomen with incessant pain. Previous doctors first used Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pill) without effect, then used large doses of Fuzi, Rougui, Bajitian, Liuhuang, and Chenxiang, which worsened the condition. The patient was extremely fearful, often asking his wife to hold the penis firmly to prevent complete retraction. Careful examination revealed, besides the above, dizziness, fatigue, chest fullness, vexation, bitter/dry mouth, thin white tongue coating, and deep-wiry pulse.
I stated: "In Kidney Yang deficiency, the Chi (cun-kou) pulses must be deep-weak or wiry-large, accompanied by lower back/knee soreness. Here, the Chi pulses are neither wiry-large nor deep-weak, but all six pulses are deep-wiry. Deep indicates Qi stagnation; wiry indicates Liver disease. The penis belongs to the Zongjin (general sinews), which are governed by the Liver. This case is due to Liver Qi stagnation and knotting, upper heat and lower cold, causing Zongjin spasm. Treatment should soothe the Liver, regulate the Sanjiao, clear the upper, and warm the lower. Use Chaihu Jia Longgu Muli Tang (Bupleurum Plus Dragon Bone and Oyster Shell Decoction) removing Qian Dan (Lead Carbonate)."
After 2 doses, symptoms greatly reduced. After 4 more doses, he recovered.
The *Suwen: Jue Lun Pian* states: "Jueyin Jue presents with lower abdominal swelling and pain, abdominal distension, and difficult urination... retraction of the genitals." The *Ling Shu: Jing Jin Pian* states: "The Foot Jueyin tendon... if injured by cold, causes genital retraction." Treating the Kidney initially versus treating the Liver later explains the difference in efficacy, depending on the disease location.
Chronic Diarrhea and Dysentery
Case: Shi XX, male, 50 years old. For over a year: abdominal pain, diarrhea, tenesmus, progressive emaciation. Previous Chinese/Western treatments failed. Abdominal pain was worst around the umbilicus; pain triggered defecation. Stool frequency ~30 times/day, loose with pus and blood. Fatigue, but normal appetite. Pale tongue, white coating, wiry pulse. Diagnosis: Cold accumulation not resolving. Treatment: Strengthen Spleen, warm Middle, guide out stagnation. Lizhong Dahuang Tang (Regulate the Middle with Rhubarb Decoction) added: Fuzi 9g, Dangshen 9g, Baizhu 9g, Ganjiang 9g, Binglang 9g, Gancao 6g, Dahuang 3g, Jiaoshanzha 30g, Laifuzi 12g. Considering long-term illness and deficiency, excessive attacking would harm healthy Qi. Instructed to take one dose every 4 days. After 2 doses, abdominal pain disappeared, stool reduced to 4-5 times/day, pus/blood significantly decreased. Continued same formula for 3 doses. After 20+ days, stool reduced to 3-4 times/day, pus/blood significantly decreased. Seeing great effect, patient requested faster results and switched to one dose daily. Three days later, pain and diarrhea worsened. Re-examination: thin white watery-slippery coating, pale tongue. Considering long-term illness led to Kidney Qi decline, switched to Sishen Wan (Four-Spirit Pill) added: Buguzhi 12g, Wuzhuyu 9g, Roudoukou 9g, Wuweizi 9g, Shanyao 30g. After 4 doses, pain/diarrhea did not decrease; tenesmus worsened, mouth/tongue ulcers appeared.
Lesson: Must re-inquire history and evaluate treatments. Family revealed: Hospital diagnosed a cauliflower-shaped tumor (6x4x3 cm) at 5cm from anus, diagnosed as rectal cancer. Patient refused surgery. Another hospital used >100 doses of clearing heat-toxicity, activating blood/stopping bleeding, and astringent herbs, worsening pain/diarrhea.
Realization: Long-term illness damages healthy Qi. Although cold accumulation exists, drastic purging is contraindicated. No signs of Kidney deficiency, so tonifying Kidney might miss the target. Returned to Lizhong Dahuang Tang (Regulate the Middle with Rhubarb Decoction) added, one dose every 7 days. After 1 month, stool normalized, other symptoms resolved. (Regretfully, further examination was not possible due to conditions.)
Another Case: Zhu X, male, 46 years old. Chronic dysentery, untreatable for 4+ years. Hospitalization failed. Then treated for 1 year with Shaoyao Tang, Xianglian Wan, Taohua Tang, Sishen Wan without success. Examination: Stool 3-4 times/day, loose with small amount of pus/blood, tenesmus, left lower quadrant pain, white tongue coating, wiry pulse. Diagnosis: Cold accumulation not resolving, Middle Earth (Spleen) deficiency. Prescribed Lizhong Dahuang Tang (Regulate the Middle with Rhubarb Decoction) added to warm Middle, strengthen Spleen, guide stagnation: Fuzi 9g, Ganjiang 9g, Dangshen 9g, Baizhu 9g, Gancao 9g, Muxiang 9g, Binglang 9g, Dahuang 4.5g. One dose every 3 days. After 2 doses, pain, diarrhea, and pus/blood improved significantly. After 2 more doses, pus/blood disappeared, stool reduced to 2-3 times/day. However, left lower quadrant pain persisted or worsened. Synthesizing pulse/symptoms, noted left lower quadrant is where Liver meridian connects. Although cold accumulation was removed, Spleen Earth was weak, and Wood evil attacked Earth. Treatment should regulate Liver Wood, assist Spleen Earth. Used Xiaoyao San (Free and Easy Wanderer Powder) modified: Chaihu 6g, Danggui 9g, Baishao 9g, Baizhu 9g, Fuling 9g, Gancao 6g, Ganjiang 4.5g, Fangfeng 3g. After 4 doses, all symptoms disappeared and recovered.