大致相当于中医之水疝，很多杂志报道用小茴育有效。曾治一例，男性，13岁。阴囊肿胀，皮色光亮如水晶，不热不红，内有聚水，予茴香橘核丸30袋而愈。该患者之父又介绍一患者，男性，28岁。鞘膜积液一年多，余又嘱以前方，患者连续服用60袋无效。诊其脉尺大而弦，审其证腰酸腰困，下肢冷。处以八味地黄丸加减：熟地24克，山药12克，肉苁蓉15克，茯苓9克，泽泻9克，丹皮9克，附子9克，肉桂9克，车前子9克(布包)，五味子9克，怀牛膝9克。7剂证大减，20剂诸证全消而愈。宗筋虽属肝，但亦属肾，因此治疗时必须辨明肝肾之哪个为主，否则仅去治肝，不知变化，常常不会获得很好效果。
第二节 外科、皮科
肠梗阻
肠梗阻，目前中西医结合治疗取得了较好成绩。其中因热、结、滞、瘀者多，寒虚者少，因此往往被人所忽略。曾治一男性患者，15岁。突然腹部剧痛，急诊住院。某院外科诊为肠梗阻。予大剂萝贝芒硝汤、复方大承气汤两天，腹痛不减。邀余诊视，察其脉弦紧，舌苔白润。予云：寒凝气滞，腑气不行所致，宜温中散寒，理气导滞。处方：木香、肉桂、陈皮、香附、小茴香、槟榔各9克。一剂竟痛胀减而矢气，两剂痛止便通而愈。某医问：前予大剂理气通便不效，而你却小剂而愈者何也?余曰：寒热不同所致也。舌苔白，脉弦紧者，为寒实；舌苔黄厚，脉滑或实者，为热实。热实者，非苦寒咸寒大便不能通。寒实者，非辛温理气大便不能解，所以用萝贝芒硝汤、大承气汤不效者，在于寒热不明所致也。实热者，非泻其热，则气不行；寒实者，非温其阳，则寒不能散，所以寒者必须用温通，实热者，必须用苦咸寒不能解。否则热者以温，必使实者更实，寒者以寒必使凝者更凝，因此必须寒者温之，热者寒之。又治患者高××，男，77岁。小肠疝气数十年，每次发病用手托回平卧一个多小时即可回纳。近二三年来发作次数逐渐增多。7天前，发病后某外科医生用手托回后，疼痛呕吐一直不见改善。急予大承气汤、黑豆油及肥皂水灌肠等治疗5天，大便不但不通，反而腹胀加重。昨日下午突然精神萎靡，血压下降至60／50mmHg，内服药物完全吐出，急予抢救休克措施一天不效。邀余诊视。察其精神萎靡，又值年高，问其所苦，迟迟不答，腹部膨隆但按之尚柔软，前额、耳壳、四肢欠温，舌质淡，苔薄白，脉沉而弱。乃云：此年高气衰，阳气不能转运，屡用苦寒攻下又复败伤中气所致也。经云：大气一转，其气乃散。故应以人参大补元气，复佐甘草、生姜以助．脾阳，厚朴理气消壅，半夏降逆。又半夏、厚朴、生姜均辛温行气之品，故以厚朴半夏甘草人参汤补正祛邪为法。厚朴25克，人参10克，半夏15克，炙甘草9克，生姜10克。1剂后，次日即大便行，呕吐止，腹胀大减，精神倍增，食纳少进，血压亦上升至100／80mmHg。2剂而愈。医云：攻下不便，理气不行者何也?答曰：虚实不同耳。经云：虚则补之，实则泻之。若虚采用泻，实采用补，则成虚虚、实实也，他病如此，肠梗阻亦如是也。
腹痈
1948年得见先父治一人，腹痛腹胀，寒热，脉数，以银花四两、白芥子三钱、甘草二钱治之。从脐中排出大量奇臭脓汁而愈。后经学习西医外科始知此证乃腹膜炎也。1968年遇一人，患腹膜炎，腹痛难忍，腹板硬而拒按，寒热，脉数，先予西药治疗2天不效，后因患者惧怕手术改请中医治疗。急予银花120克、白芥子10克、甘草10克。1剂痛减，6剂诸证消失而愈。
肝痈
曾治一人，女，38岁。寒热往来，纳呆食减，胁痛拒按，月十肋下5指，某院诊为阿米巴肝脓肿，合并葡萄球菌感染。先于西药治疗2周无效，后又配合中药清热解毒之剂3天仍无功。审之，除肝大5指外，并有明显压痛，腹满胀痛，寒热往来，口苦纳呆，舌苔黄白，脉弦滑数。综合脉证，诊为少阳阳明之证，予大柴胡汤加减。处方：柴胡24克，赤芍12克，枳实15克，半夏12克，大黄9克，黄芩10克，白芥子6克。药进1剂，寒热往来，腹满腹痛大减，体温由39．5℃降至37．8℃，继进4剂，症状消失大半，加生姜3片、甘草6克，服10剂，症状大部消失。
肠痈
《金匮要略》列排脓散方，药有枳实十六枚、芍药六分、桔梗二分、鸡子黄一枚。尤在泾注释云：“枳实，苦寒除热破滞为君，得芍药则通血，得桔梗则利气，而尤赖鸡子黄之甘润，以为排脓化毒之本也。”余始见其药并无清热解毒者，疑信参半。1958年偶遇一人，患阑尾炎，腹痛不止，腹满胀。欲手术治疗，但因患者要求服中药。前医以大黄牡丹皮汤不效，余审其脉沉，与桔梗30克，枳实60克，白芍30克。半小时后，得矢气，腹痛止，次日愈。始信《金匮要略》排脓之意不谬也。
胆囊炎
胆囊炎但从肝胆论治者甚多，并取得了一定疗效。然胆囊炎亦有从肝胆论治而久久不效者，思其所在为右胁，右胁属肺，宜从宣肺理气论治。例如：张××，女，55岁。右胁疼痛，满闷，食欲不振2个多月。超声波探查诊为胆囊炎。久用中、西药物不效。近又发现左胸部闷痛气短，心电图显示sT段下降，T波倒置，诊为冠心病，心绞痛。细察其证，除以上诸证外，并见胸满心烦，口苦咽干，舌苔黄白腻，脉弦滑。询其前医所用之方，大都为疏肝除湿，清热利胆之品。综合脉证，云：痰热阻郁，治宜化痰理气，右胁疼痛方。处方：钩藤10克，葛根10克，前胡10克，桔梗10克，枳实10克，焦楂10克，枸杞子10克，生地10克。服药4剂，疼痛大减；再服10剂，疼痛消失；继服10剂，超声波复查正常。
丹毒
丹毒，因其色赤如涂丹状，故名丹毒。历代医家认为初起者多因心火妄动，三焦风热，或肝火内动，或脾胃湿热，或风邪外袭。恩师李翰卿认为以风热之毒侵及血分者为多，故初起之治宜清热解毒，外疏风邪为主，若头部者宜升降散、普济消毒饮，下肢者宜连翘败毒饮。一般之证忌用辛温散风之品，至若病程较久，痒重痛轻者，非辛温之品不能解，故羌活、防风、白芷不可缺，若皮肤粗硬，病已入于血分，非苏木、刘寄奴不能软。余宗其意，试治于反复发作者，常效。例如：李××，女，54岁。两小腿丹毒反复发作3年多，前5次发作时，用抗生素和硫酸镁湿敷治疗后均很快痊愈。此次发作虽采用上法治疗20多天一直不效，不得已，转请中医以清热解毒剂内服，如意金黄散外敷，前后治疗1周，仍不显效。邀余诊治．．审其体胖神佳，左小腿前缘(约20厘米×8厘米)紫红肿胀，热痛，舌质红，苔黄白，脉沉而弦数。综其脉证，诊为气滞血瘀所致。予柴胡15克，赤芍10克，枳壳10克，山甲珠10克，桃仁10克，红花10克，大黄10克，甘草6克，连翘15克，白芥子1克。服药6剂，肿胀消失七八。某医云：丹毒乃热毒所致，诸医多以清热解毒之剂治之，然其用之却无效，何也?答曰：叶天士曾云：久病人络，此病久久不愈，血络瘀滞，但予寒凉，其血更结，故以活血而愈，寒凉更甚也。又眼6剂，效果全无，并见局部奇痒难忍。思之，宇泰曾云：痒为风。此风邪未去所致也。又思其病久过用寒凉，非佐以温而不解，故治宜连翘败毒散加味：连翘10克，山栀9克，羌活6克，元参30克，薄荷9克，防风9克，柴胡9克，桔梗9克，升麻9克，川芎9克，当归9克，黄芩9克，赤芍9克，牛蒡子9克，苏木9克。药进6剂，诸证消失而愈。至若反复发作，久久难愈，气血俱衰者，非佐补益之品不效。例如：王××，男，70岁。两小腿丹毒反复发作15年，冠心病3年。近半年来胸满气短，夜间阵发性呼吸困难，不能平卧。两月来两腿丹毒又见加重，先用多种抗生素、地塞米松、血管扩张剂，硫酸镁湿敷，中药瓜蒌薤白汤、普济消毒饮治疗不效。近半月来，又因脚癣感染，小腿、足部痒痛更加严重，不能走路。邀余诊治。审其神疲短气，言语时断时续，面浮腿足浮肿，并见两小腿、足均紫暗，皮肤粗厚而硬，趾间、足部湿烂，发热，舌苔厚腻而黄，舌质暗，脉虚而弦滑。综其脉证，云：年高体衰，正虚邪实，气阴不足，痰滞血瘀，郁而生火，祛邪补正，均难措手。乃予十味温胆汤试治之：黄芪15克，当归10克，麦冬10克，党参10克，五味子10克，半夏10克，陈皮10克，茯苓10克，甘草10克，竹茹10克，枳壳10克，远志10克，菖蒲10克，川芎10克，苏木9克，知母9克。药进6剂后，胸满、气短、浮肿、足部湿烂等均大减，食欲睡眠增加，继予上方1个月，诸证消失七八。
曾治患者李××，女，成。两足无名趾、小趾突然红肿热痛。某院诊为丹毒。急予青霉素、中药清热解毒治之。是夜患者为求其速效。急以热毛巾熨之，2小时内前后予热水约6暖瓶，此时疼痛非但不减，反见肿痛延及小腿。然患者仍不断以热毛巾熨之不止，其肿迅速延及腹股沟部，且疼痛难忍，寒热。邀余诊视。审其脉证之后，云：热毒之证岂能以热熨之法治之，若再以火助火，火毒攻心则难治。嘱其速以冷水毛巾熨洗之。约6小时，家属来告云：自从以冷水毛巾频频熨之之后，小腿、大腿肿痛已基本消退，足部肿痛亦大部消散。
因思亡兄曾告诫说：凡见火毒炽盛之痈肿，疔毒，均宜用冷水熨洗，不宜用热毛巾、热水袋熨洗，否则火毒更甚，而病难愈。
疖
本家外孙刘××，男，19岁。20多天来，项部反复出现疖肿，此起彼伏，疼痛难忍，其大者如枣，小者如杏核、黄豆。频用中西药物治疗不效。因思先父曾以放血法治疔毒疮疡，某医曾以放血法治瘰疬。乃据经取穴，以三棱针刺委中疏散磅胱经之热毒，岂知放血5分钟后，疼痛即减，次日疼痛全失，3日后即完全消退而愈。次年，上症又复发，但较前明显减少，又以上法，一次即愈。
脱疽
脉管炎的治疗，近年来有很多报道。有用温阳取效者，有用活血逐瘀取效者，有用养阴解毒取效者，但由于拘于一法或数法，不去辨别脏腑经络，致使轻浅者愈，复杂者不治。例如：赵××，男，成。右足脉管炎一年多，诸医用温阳通经活血法治疗不效。于三月间发生右足无名趾、小趾坏死，手术截趾后二个月新的肉芽一直不见生长，小腿和右足疼痛，前医遍用养阴解毒、温阳活血等方均不见效。视其神色，颜面呈抑郁之色，时时叹气；审其病位处于少阳胆经，脉见沉弦。乃拟逍遥散加减：柴胡、当归、白芍、白术、茯苓、生姜、青皮各10克，干姜3克，薄荷3克。连服1周，腿、足疼痛竟然好转，新的肉芽开始生长，20剂后而愈。医云：诸书未列逍遥散能治脉管炎，而你用之反效者，何也?余曰：喻嘉言说：“凡治病不明脏腑经络，开口动手便错。”逍遥散者，肝胆经药也，所以取效者，在于经络之用药恰当尔。又如：康××，男：左下肢脉管炎，拇趾，小趾坏死变黑，疼痛昼夜不止，尤以夜间为甚9个多月。审其大趾从甲根到趾尖均变黑色，小趾甲沟外侧大部变黑。眼中药数百剂不效，某院建议手术切除，因其惧怕术后丧失劳动能力而不得已来太原治疗。细审其脉虚大滑数，面色皓白无华，神疲乏力，食纳全废，舌苔白腻。诊为气阴俱虚。拟芪脉地黄汤：黄芪15克，当归10克，党参10克，麦冬10克，五味子10克，生地15克，苍术15克，丹皮10克，肉苁蓉15克，茯苓10克，泽泻10克。服药15剂后，疼痛大减，拇趾、小趾坏死明显改善。继服15剂，坏死部位已恢复正常，疼痛消失。为促使其更快恢复，加刘寄奴12克，继服15剂后，小趾外侧又发现约黄豆大部位变为黑紫色，疼痛隐隐而作，乃去刘寄奴，20剂后诸证消失。医云：刘寄奴乃活血逐瘀之剂，加之则病剧，去之则病减何也?答云：脉证俱虚当予补益，此证久用克伐，正气不支，虽刘寄奴之微予祛邪，亦可使病情加重耳。
肠粘连
阑尾炎术后肠粘连，古代医著中没有这一名称。通过中西医结合治疗的开展，才逐步被广大中医同道所认识。
从许多临床报道来看，一般都认为是瘀血所引起，但是由于不注意脏腑经络和寒热的多少，又往往事倍功半。例如：姜××，女，成。阑尾术后右少腹经常疼痛，走路或跑步，跳跃时疼痛加重。某院诊为肠粘连。经用胎盘组织液，中药祛瘀活血之剂不减。余拘于活血逐瘀之见，复与活血之剂，疼痛更甚。仔细追问，少腹疼痛而冷，乃予少腹逐瘀汤原方递人，2剂后疼痛不但未减，反而出现心悸心烦，头晕失眠，易怒喜哭。复察其脉沉而弦，痛在少腹右侧，乃改予逍遥散加味：柴胡、当归、白芍、白术、茯苓各9克，丹参15克，栀子9克，干姜4克，甘草6克，薄荷3克。4剂诸证俱减，疼痛消失；又进7剂，虽跑、跳等剧烈活动，疼痛亦不发作。
寒热夹杂者，必须注意寒热多少的比例关系和脏腑、经络，否则往往不能取得应有的效果。
血栓性静脉炎
大致相当于中医的水疝，许多医学期刊报道使用小茴香有效。我曾治疗一名13岁男性患者。其阴囊肿胀，皮肤颜色光亮如水晶，不热不红，内有积水聚集，给予茴香橘核丸30袋后痊愈。该患者的父亲又介绍了一名28岁的男性患者。鞘膜积液已一年多，我再次嘱咐服用前方（茴香橘核丸），患者连续服用60袋却无效。诊察其脉象尺部大而弦，审视其证候为腰酸、腰部困重、下肢发冷。于是处以八味地黄丸加减：熟地黄24克，山药12克，肉苁蓉15克，茯苓9克，泽泻9克，牡丹皮9克，附子9克，肉桂9克，车前子9克（布包），五味子9克，怀牛膝9克。服用7剂后症状大幅减轻，服用20剂后所有症状完全消失而痊愈。宗筋虽然归属于肝，但也归属于肾，因此在治疗时必须辨明是肝还是肾为主因，否则仅仅治疗肝脏，不知变通，常常无法获得很好的疗效。
第二节 外科、皮肤科
肠梗阻
目前，中西医结合治疗肠梗阻取得了较好的成绩。其中因热、结、滞、瘀所致者居多，因寒、虚所致者较少，因此往往被人所忽略。曾治疗一名15岁男性患者。突然腹部剧烈疼痛，急诊住院。某医院外科诊断为肠梗阻。给予大剂量萝贝芒硝汤、复方大承气汤两天，腹痛未减。邀请我诊治，观察其脉象弦紧，舌苔白润。我说：这是寒凝气滞，腑气不通所致，适宜温中散寒，理气导滞。处方：木香、肉桂、陈皮、香附、小茴香、槟榔各9克。服用一剂后，疼痛和胀感减轻并排气；服用两剂后，疼痛停止，大便通畅而痊愈。某医生问：之前给予大剂量理气通便药物无效，而你用小剂量却治愈了，为什么呢？我说：这是因为寒热性质不同所致。舌苔白，脉弦紧的，属于寒实证；舌苔黄厚，脉滑或实的，属于热实证。热实证，非用苦寒咸寒之品不能通大便。寒实证，非用辛温理气之品不能解大便。所以之前用萝贝芒硝汤、大承气汤无效，在于没有辨明寒热所致。实热证，不泻其热，则气机不行；寒实证，不温其阳气，则寒气不能消散。所以寒证必须用温通法，实热证，必须用苦咸寒之法才能解除。否则，热证用温药，必使实证更实；寒证用寒药，必使凝滞更甚。因此必须寒者温之，热者寒之。又治疗患者高某某，男，77岁。小肠疝气数十年，每次发病用手托回平卧一个多小时即可回纳。近两三年发作次数逐渐增多。7天前，发病后某外科医生用手托回后，疼痛呕吐一直未见改善。紧急给予大承气汤、黑豆油及肥皂水灌肠等治疗5天，大便不仅不通，反而腹胀加重。昨日下午突然精神萎靡，血压下降至60/50mmHg，内服药物完全吐出，紧急给予抢救休克措施一天无效。邀请我诊治。观察其精神萎靡，又值年事已高，询问其痛苦所在，迟迟不答，腹部膨隆但按之尚柔软，前额、耳壳、四肢欠温，舌质淡，苔薄白，脉沉而弱。我说：这是年高气衰，阳气不能转运，屡用苦寒攻下药物又复败伤中气所致。《内经》说：大气一转，其气乃散。所以应以人参大补元气，再佐以甘草、生姜以助脾阳，厚朴理气消壅，半夏降逆。又因为半夏、厚朴、生姜均属于辛温行气之品，故以厚朴半夏甘草人参汤补正祛邪为治法。厚朴25克，人参10克，半夏15克，炙甘草9克，生姜10克。服药1剂后，次日即大便行，呕吐止，腹胀大减，精神倍增，食欲稍进，血压也上升至100/80mmHg。服用2剂后痊愈。医生问：攻下不便，理气不行的原因是什么呢？回答是：虚实不同罢了。《内经》说：虚则补之，实则泻之。若虚证采用泻法，实证采用补法，就会造成虚虚、实实的错误。其他疾病如此，肠梗阻也是如此。
腹痈
1948年见到先父治疗一人，腹痛腹胀，寒热往来，脉数，用银花四两、白芥子三钱、甘草二钱治疗。从脐中排出大量奇臭脓汁而痊愈。后来学习西医外科才知道此证乃是腹膜炎。1968年遇到一人，患腹膜炎，腹痛难忍，腹部板硬且拒按，寒热往来，脉数，先给予西药治疗2天无效，后因患者惧怕手术改请中医治疗。紧急给予银花120克、白芥子10克、甘草10克。服用1剂疼痛减轻，服用6剂后所有症状消失而痊愈。
肝痈
曾治疗一人，女，38岁。寒热往来，食欲不振，胁痛拒按，肋下肿大5指宽，某医院诊断为阿米巴肝脓肿，合并葡萄球菌感染。先用西药治疗2周无效，后又配合中药清热解毒之剂3天仍无功效。审视其证，除肝大5指外，并有明显压痛，腹满胀痛，寒热往来，口苦纳呆，舌苔黄白，脉弦滑数。综合脉证，诊断为少阳阳明合病，给予大柴胡汤加减。处方：柴胡24克，赤芍12克，枳实15克，半夏12克，大黄9克，黄芩10克，白芥子6克。服药1剂后，寒热往来，腹满腹痛大幅减轻，体温由39.5℃降至37.8℃，继续服用4剂，症状消失大半，加入生姜3片、甘草6克，再服用10剂，症状大部消失。
肠痈
《金匮要略》列有排脓散方，药物有枳实十六枚、芍药六分、桔梗二分、鸡子黄一枚。尤在泾注释说：“枳实，苦寒除热破滞为君药，得芍药则通血，得桔梗则利气，而尤其依赖鸡子黄的甘润，作为排脓化毒的根本。”我开始见到这个方药并没有清热解毒的药物，半信半疑。1958年偶然遇到一人，患阑尾炎，腹痛不止，腹部胀满。想要手术治疗，但因患者要求服用中药。前医使用大黄牡丹皮汤无效，我审视其脉沉，给予桔梗30克，枳实60克，白芍30克。半小时后，得到排气，腹痛停止，次日痊愈。始相信《金匮要略》排脓之意没有错误。
胆囊炎
胆囊炎大多从肝胆论治，并取得了一定疗效。然而胆囊炎也有从肝胆论治而久久无效的，思考其病位在右胁，右胁属肺，适宜从宣肺理气论治。例如：张某某，女，55岁。右胁疼痛，满闷，食欲不振2个多月。超声波探查诊断为胆囊炎。久用中西药物无效。最近又发现左胸部闷痛气短，心电图显示ST段下降，T波倒置，诊断为冠心病，心绞痛。仔细察其证，除以上诸证外，并见胸满心烦，口苦咽干，舌苔黄白腻，脉弦滑。询问前医所用之方，大都为疏肝除湿，清热利胆之品。综合脉证，说：痰热阻郁，治宜化痰理气，右胁疼痛方。处方：钩藤10克，葛根10克，前胡10克，桔梗10克，枳实10克，焦山楂10克，枸杞子10克，生地10克。服药4剂，疼痛大幅减轻；再服10剂，疼痛消失；继服10剂，超声波复查正常。
丹毒
丹毒，因其色赤如涂丹状，故名丹毒。历代医家认为初起者多因心火妄动，三焦风热，或肝火内动，或脾胃湿热，或风邪外袭。恩师李翰卿认为以风热之毒侵及血分者为多，故初起之治宜清热解毒，外疏风邪为主，若头部者宜升降散、普济消毒饮，下肢者宜连翘败毒饮。一般之证忌用辛温散风之品，至于病程较久，痒重痛轻者，非辛温之品不能解，故羌活、防风、白芷不可缺，若皮肤粗硬，病已入于血分，非苏木、刘寄奴不能软坚。我遵循其意，试治于反复发作的患者，常有效。例如：李某某，女，54岁。两小腿丹毒反复发作3年多，前5次发作时，用抗生素和硫酸镁湿敷治疗后均很快痊愈。此次发作虽采用上法治疗20多天一直无效，不得已，转请中医以清热解毒剂内服，如意金黄散外敷，前后治疗1周，仍不显效。邀请我诊治。审视其体胖神佳，左小腿前缘（约20厘米×8厘米）紫红肿胀，热痛，舌质红，苔黄白，脉沉而弦数。综合其脉证，诊断为气滞血瘀所致。给予柴胡15克，赤芍10克，枳壳10克，山甲珠10克，桃仁10克，红花10克，大黄10克，甘草6克，连翘15克，白芥子1克。服药6剂，肿胀消失七八。某医生说：丹毒乃热毒所致，诸医多以清热解毒之剂治之，然其用之却无效，为什么呢？回答说：叶天士曾说：久病人络，此病久久不愈，血络瘀滞，但予寒凉，其血更结，故以活血而愈，寒凉更甚也。又服用6剂，效果全无，并见局部奇痒难忍。思之，宇泰曾说：痒为风。此风邪未去所致也。又思其病久过用寒凉，非佐以温而不解，故治宜连翘败毒散加味：连翘10克，山栀9克，羌活6克，元参30克，薄荷9克，防风9克，柴胡9克，桔梗9克，升麻9克，川芎9克，当归9克，黄芩9克，赤芍9克，牛蒡子9克，苏木9克。药进6剂，诸证消失而痊愈。至于反复发作，久久难愈，气血俱衰者，非佐补益之品不效。例如：王某某，男，70岁。两小腿丹毒反复发作15年，冠心病3年。近半年来胸满气短，夜间阵发性呼吸困难，不能平卧。两月来两腿丹毒又见加重，先用多种抗生素、地塞米松、血管扩张剂，硫酸镁湿敷，中药瓜蒌薤白汤、普济消毒饮治疗无效。近半月来，又因脚癣感染，小腿、足部痒痛更加严重，不能走路。邀请我诊治。审视其神疲短气，言语时断时续，面浮腿足浮肿，并见两小腿、足均紫暗，皮肤粗厚而硬，趾间、足部湿烂，发热，舌苔厚腻而黄，舌质暗，脉虚而弦滑。综合脉证，说：年高体衰，正虚邪实，气阴不足，痰滞血瘀，郁而生火，祛邪补正，均难措手。于是给予十味温胆汤试治之：黄芪15克，当归10克，麦冬10克，党参10克，五味子10克，半夏10克，陈皮10克，茯苓10克，甘草10克，竹茹10克，枳壳10克，远志10克，菖蒲10克，川芎10克，苏木9克，知母9克。药进6剂后，胸满、气短、浮肿、足部湿烂等均大幅减轻，食欲睡眠增加，继予上方1个月，诸证消失七八。
曾治疗患者李某某，女，成年。两足无名趾、小趾突然红肿热痛。某医院诊断为丹毒。紧急给予青霉素、中药清热解毒治疗。是夜患者为求其速效，急以热毛巾熨之，2小时内前后给予热水约6暖瓶，此时疼痛非但不减，反见肿痛延及小腿。然而患者仍不断以热毛巾熨之不止，其肿迅速延及腹股沟部，且疼痛难忍，寒热往来。邀请我诊治。审视其脉证之后，说：热毒之证岂能以热熨之法治之，若再以火助火，火毒攻心则难治。嘱其速以冷水毛巾熨洗之。约6小时，家属来告说：自从以冷水毛巾频频熨之之后，小腿、大腿肿痛已基本消退，足部肿痛亦大部消散。
因而想到亡兄曾告诫说：凡见火毒炽盛之痈肿，疔毒，均宜用冷水熨洗，不宜用热毛巾、热水袋熨洗，否则火毒更甚，而病难愈。
疖
本家外孙刘某某，男，19岁。20多天来，项部反复出现疖肿，此起彼伏，疼痛难忍，其大者如枣，小者如杏核、黄豆。频用中西药物治疗无效。因而想到先父曾以放血法治疗毒疮疡，某医曾以放血法治瘰疬。于是依据经络取穴，以三棱针刺委中疏散膀胱经之热毒，岂知放血5分钟后，疼痛即减，次日疼痛全失，3日后即完全消退而痊愈。次年，上述症状又复发，但较前明显减少，又以上法，一次即愈。
脱疽
脉管炎的治疗，近年来有很多报道。有用温阳取效者，有用活血逐瘀取效者，有用养阴解毒取效者，但由于拘于一法或数法，不去辨别脏腑经络，致使轻浅者愈，复杂者不治。例如：赵某某，男，成年。右足脉管炎一年多，诸医用温阳通经活血法治疗无效。于三月间发生右足无名趾、小趾坏死，手术截趾后二个月新的肉芽一直不见生长，小腿和右足疼痛，前医遍用养阴解毒、温阳活血等方均不见效。视其神色，颜面呈抑郁之色，时时叹气；审视其病位处于少阳胆经，脉见沉弦。于是拟定逍遥散加减：柴胡、当归、白芍、白术、茯苓、生姜、青皮各10克，干姜3克，薄荷3克。连服1周，腿、足疼痛竟然好转，新的肉芽开始生长，20剂后痊愈。医生问：诸书未列逍遥散能治脉管炎，而你用之反效，为什么呢？我说：喻嘉言说：“凡治病不明脏腑经络，开口动手便错。”逍遥散者，肝胆经药也，所以取效者，在于经络之用药恰当尔。又如：康某某，男：左下肢脉管炎，拇趾，小趾坏死变黑，疼痛昼夜不止，尤以夜间为甚9个多月。审视其大趾从甲根到趾尖均变黑色，小趾甲沟外侧大部变黑。服用中药数百剂无效，某医院建议手术切除，因其惧怕术后丧失劳动能力而不得已来太原治疗。细审其脉虚大滑数，面色皓白无华，神疲乏力，食纳全废，舌苔白腻。诊断为气阴俱虚。拟定芪脉地黄汤：黄芪15克，当归10克，党参10克，麦冬10克，五味子10克，生地15克，苍术15克，丹皮10克，肉苁蓉15克，茯苓10克，泽泻10克。服药15剂后，疼痛大幅减轻，拇趾、小趾坏死明显改善。继服15剂，坏死部位已恢复正常，疼痛消失。为促使其更快恢复，加刘寄奴12克，继服15剂后，小趾外侧又发现约黄豆大部位变为黑紫色，疼痛隐隐而作，于是去掉刘寄奴，20剂后诸证消失。医生问：刘寄奴乃活血逐瘀之剂，加之则病剧，去之则病减，为什么呢？回答说：脉证俱虚当予补益，此证久用克伐，正气不支，虽刘寄奴之微予祛邪，亦可使病情加重耳。
肠粘连
阑尾炎术后肠粘连，古代医著中没有这一名称。通过中西医结合治疗的开展，才逐步被广大中医同道所认识。
从许多临床报道来看，一般都认为是瘀血所引起，但是由于不注意脏腑经络和寒热的多少，又往往事倍功半。例如：姜某某，女，成年。阑尾术后右少腹经常疼痛，走路或跑步，跳跃时疼痛加重。某医院诊断为肠粘连。经用胎盘组织液，中药祛瘀活血之剂不减。我拘泥于活血逐瘀之见，复与活血之剂，疼痛更甚。仔细追问，少腹疼痛而冷，于是给予少腹逐瘀汤原方递人，2剂后疼痛不但未减，反而出现心悸心烦，头晕失眠，易怒喜哭。复察其脉沉而弦，痛在少腹右侧，于是改予逍遥散加味：柴胡、当归、白芍、白术、茯苓各9克，丹参15克，栀子9克，干姜4克，甘草6克，薄荷3克。4剂诸证俱减，疼痛消失；又进7剂，虽跑、跳等剧烈活动，疼痛亦不发作。
Roughly equivalent to Shui Han (Water Hernia) in Traditional Chinese Medicine, many medical journals have reported the effectiveness of Xiaohuixiang (Fennel Fruit). I once treated a 13-year-old male patient. His scrotum was swollen, with skin that was bright and translucent like crystal, without heat or redness, containing accumulated fluid. He was cured after taking 30 bags of Huixiang Juhe Wan (Fennel and Citrus Akebia Pill). The father of this patient introduced another patient, a 28-year-old male, who had suffered from hydrocele for over a year. I again instructed him to take the previous prescription (Huixiang Juhe Wan), but he took 60 bags continuously without effect. Upon examining his pulse, it was large and wiry at the Chi position (Cun-Kou pulse diagnosis method, corresponding to the Kidney and Lower Jiao). Observing his symptoms, he complained of soreness and heaviness in the lower back, and coldness in the lower limbs. Therefore, I prescribed Bawei Dihuang Wan (Eight-Ingredient Rehmannia Root Pill) with modifications: Shudi Huang (Prepared Rehmanniae Radix) 24g, Shanyao (Dioscoreae Rhizoma) 12g, Roucongrong (Cynomorphi Herba) 15g, Fuling (Poria) 9g, Zexie (Alismatis Rhizoma) 9g, Danpi (Moutan Cortex) 9g, Fuzi (Aconiti Lateralis Radix Praeparata) 9g, Rougui (Cinnamomi Cortex) 9g, Cheqianzi (Plantaginis Semen) 9g (wrapped in cloth), Wuweizi (Schisandrae Fructus) 9g, Huainiu Xi (Achyranthis Bidentatae Radix) 9g. After 7 doses, symptoms were significantly reduced; after 20 doses, all symptoms disappeared, and he was cured. Although the Zongjin (Confluence of Sinews, referring to the external genitalia) belongs to the Liver, it also belongs to the Kidney. Therefore, treatment must distinguish whether the Liver or the Kidney is the primary cause. Otherwise, treating only the Liver without flexibility often fails to yield good results.
Section 2: Surgery and Dermatology
Intestinal Obstruction
Currently, integrated traditional Chinese and Western medicine has achieved good results in treating intestinal obstruction. Most cases are caused by Heat, Knotting, Stagnation, and Blood Stasis, while few are caused by Cold and Deficiency, so they are often overlooked. I once treated a 15-year-old male patient who suddenly suffered severe abdominal pain and was admitted to the emergency room. A surgical department at a certain hospital diagnosed intestinal obstruction. He was given large doses of Luobei Mangxiao Tang (Radix Glehniae and Mirabilite Decoction) and Fufang Dachengqi Tang (Compound Major Order the Qi Decoction) for two days, but the abdominal pain did not subside. I was invited to consult. Observing his pulse as Wiry-Tight and tongue coating as White-Moist, I said: This is caused by Cold coagulation and Qi stagnation, leading to the failure of Fu organ Qi to descend. It is suitable to Warm the Middle and Disperse Cold, regulate Qi and guide out stagnation. Prescription: Muxiang (Aucklandiae Radix), Rougui (Cinnamomi Cortex), Chenpi (Citri Reticulatae Pericarpium), Xiangfu (Cyperi Rhizoma), Xiaohuixiang (Foeniculi Fructus), and Binglang (Arecae Semen) each 9g. After one dose, pain and distension decreased, and flatus was passed; after two doses, pain stopped, stool became unobstructed, and he was cured. A doctor asked: Why did the previous large doses of Qi-regulating and bowel-unblocking medicines fail, while your small dose succeeded? I replied: It is due to the difference between Cold and Heat. White tongue coating and Wiry-Tight pulse indicate Cold Excess; Yellow-thick tongue coating and Slippery or Excess pulse indicate Heat Excess. For Heat Excess, only Bitter-Cold and Salty-Cold herbs can unblock the bowels. For Cold Excess, only Pungent-Warm Qi-regulating herbs can resolve the bowels. Therefore, the previous use of Luobei Mangxiao Tang and Dachengqi Tang failed because the Cold and Heat were not distinguished. In Heat Excess, if Heat is not purged, Qi cannot move; in Cold Excess, if Yang is not warmed, Cold cannot be dispersed. Thus, Cold patterns must be treated with Warming-Unblocking methods, and Heat Excess patterns must be treated with Bitter-Salty-Cold methods. Otherwise, using Warm herbs for Heat will make Excess more Excess, and using Cold herbs for Cold will make Stagnation more stagnant. Therefore, Cold must be Warmed, and Heat must be Cooled.
I also treated a patient, Gao XX, male, 77 years old. He had suffered from inguinal hernia for decades, usually reducing it manually and lying down for over an hour. In the past two or three years, the frequency of attacks increased. Seven days ago, after a surgeon manually reduced the hernia, pain and vomiting persisted. Emergency treatment with Dachengqi Tang, black bean oil, and soap water enema for five days failed to produce stool, and abdominal distension worsened. Yesterday afternoon, he suddenly became listless, with blood pressure dropping to 60/50 mmHg, and vomited all oral medications. Emergency anti-shock measures for one day were ineffective. I was invited to consult. He appeared listless, and being elderly, he hesitated to answer questions about his suffering. His abdomen was distended but soft upon palpation. His forehead, earlobes, and limbs were cool. Tongue was pale with thin white coating, and pulse was Deep and Weak. I said: This is due to Qi deficiency and decline in old age, where Yang Qi cannot transform and transport. Repeated use of Bitter-Cold purgatives has further damaged Middle Qi. As stated in the Classic: "When the Great Qi turns, the pathogenic Qi disperses." Therefore, Ren Shen (Ginseng Radix et Rhizoma) should be used to greatly tonify Yuan Qi, assisted by Gancao (Licorice Radix et Rhizoma) and Shengjiang (Zingiberis Rhizoma Recens) to aid Spleen Yang, Houpo (Magnoliae Officinalis Cortex) to regulate Qi and dissipate fullness, and Banxia (Pinelliae Rhizoma) to direct rebellious Qi downward. Since Banxia, Houpo, and Shengjiang are all Pungent-Warm Qi-moving herbs, the formula Houpo Banxia Gancao Renshen Tang (Magnolia Bark, Pinellia, Licorice, and Ginseng Decoction) is used to tonify the healthy Qi and expel pathogens. Houpo 25g, Renshen 10g, Banxia 15g, Zhigancao (Honey-fried Licorice Radix et Rhizoma) 9g, Shengjiang 10g. After one dose, stool passed the next day, vomiting stopped, abdominal distension greatly reduced, spirit improved, appetite slightly returned, and blood pressure rose to 100/80 mmHg. He was cured after two doses. The doctor asked: Why did purging fail to relieve constipation and Qi regulation fail to work? I answered: Because of the difference between Deficiency and Excess. The Classic states: "Tonify Deficiency, Purge Excess." If Deficiency is treated with Purging, and Excess with Tonifying, it leads to "making Deficiency more Deficient" and "making Excess more Excessive." This applies to other diseases as well as intestinal obstruction.
Abdominal Abscess
In 1948, I saw my late father treat a patient with abdominal pain and distension, alternating chills and fever, and rapid pulse. He used Yinhua (Lonicerae Japonicae Flos) 4 liang, Baijiezi (Sinapis Semen) 3 qian, and Gancao (Licorice Radix et Rhizoma) 2 qian. Large amounts of foul-smelling pus were discharged from the umbilicus, and the patient recovered. Later, after studying Western surgery, I learned this condition was peritonitis. In 1968, I encountered another patient with peritonitis, unbearable abdominal pain, board-like rigidity of the abdomen with tenderness, alternating chills and fever, and rapid pulse. Western medicine treatment for two days was ineffective. Due to fear of surgery, the patient sought TCM treatment. I urgently prescribed Yinhua 120g, Baijiezi 10g, and Gancao 10g. Pain decreased after one dose, and all symptoms disappeared after six doses, resulting in recovery.
Liver Abscess
I once treated a 38-year-old female patient with alternating chills and fever, poor appetite, hypochondriac pain with tenderness, and liver enlargement extending 5 finger-widths below the costal margin. A certain hospital diagnosed amebic liver abscess complicated by staphylococcal infection. Western medicine treatment for two weeks was ineffective, and adding TCM Clearing Heat and Detoxifying herbs for three days yielded no results. Examining the case, besides liver enlargement, there was obvious tenderness, abdominal fullness and distension, alternating chills and fever, bitter taste in the mouth, poor appetite, yellow-white tongue coating, and Wiry-Slippery-Rapid pulse. Synthesizing pulse and symptoms, I diagnosed Shaoyang-Yangming syndrome and prescribed Da Chaihu Tang (Major Bupleurum Decoction) with modifications: Chaihu (Bupleuri Radix) 24g, Chishao (Paeoniae Radix Rubra) 12g, Zhishi (Aurantii Fructus Immaturus) 15g, Banxia (Pinelliae Rhizoma) 12g, Dahuang (Rhei Radix et Rhizoma) 9g, Huangqin (Scutellariae Radix) 10g, Baijiezi (Sinapis Semen) 6g. After one dose, alternating chills and fever, abdominal fullness and pain greatly decreased, and body temperature dropped from 39.5°C to 37.8°C. Continuing for four doses, most symptoms disappeared. Ginger slices 3 and Gancao 6g were added, and after ten doses, most symptoms vanished.
Intestinal Abscess (Appendicitis)
Jinkui Yaolue lists Paion San (Drain Pus Powder), containing Zhishi (Aurantii Fructus Immaturus) 16 pieces, Shaoyao (Paeoniae Radix) 6 fen, Jiegeng (Platycodonis Radix) 2 fen, and Jizihuang (Egg Yolk) 1. You Zaijing commented: "Zhishi, Bitter-Cold, clears Heat and breaks stagnation as the sovereign herb; with Shaoyao it unblocks blood; with Jiegeng it benefits Qi; and it relies especially on the Sweet-Moist nature of Jizihuang as the root for draining pus and resolving toxicity." Initially, seeing no Clearing Heat and Detoxifying herbs, I was half-believing and half-doubting. In 1958, I accidentally treated a patient with appendicitis, continuous abdominal pain, and abdominal distension. Surgery was desired, but the patient requested TCM. Previous doctors used Dahuang Mudan Pi Tang (Rhubarb and Moutan Decoction) without effect. I examined his pulse as Deep and prescribed Jiegeng 30g, Zhishi 60g, and Baishao (Paeoniae Radix Alba) 30g. Half an hour later, he passed flatus, abdominal pain ceased, and he was cured the next day. I then believed the intent of Paion San in Jinkui Yaolue was not erroneous.
Cholecystitis
Many cases of cholecystitis are treated from the perspective of the Liver and Gallbladder, achieving certain efficacy. However, some cases treated from the Liver-Gallbladder perspective remain ineffective for a long time. Considering the location is the right hypochondrium, which belongs to the Lung, it is appropriate to treat from the perspective of Diffusing the Lung and Regulating Qi. For example, Zhang XX, female, 55 years old. Right hypochondriac pain, fullness, and loss of appetite for over two months. Ultrasound diagnosed cholecystitis. Long-term use of Chinese and Western medicines was ineffective. Recently, left chest tightness, pain, and shortness of breath were discovered. ECG showed ST-segment depression and T-wave inversion, diagnosing coronary heart disease and angina pectoris. Careful examination revealed, besides the above symptoms, chest fullness, irritability, bitter taste, dry throat, yellow-white greasy tongue coating, and Wiry-Slippery pulse. Asking about previous prescriptions, they were mostly Liver-soothing, damp-draining, Heat-clearing, and gallbladder-benefiting herbs. Synthesizing pulse and symptoms, I said: Phlegm-Heat obstruction and stagnation. Treatment should focus on Resolving Phlegm and Regulating Qi. Prescription for Right Hypochondriac Pain: Gouteng (Uncariae Ramulus cum Uncis) 10g, Gegen (Puerariae Lobatae Radix) 10g, Qianhu (Peucedani Radix) 10g, Jiegeng (Platycodonis Radix) 10g, Zhishi (Aurantii Fructus Immaturus) 10g, Jiaozha (Stir-fried Crataegi Fructus) 10g, Gouqizi (Lycii Fructus) 10g, Shengdi (Rehmanniae Radix) 10g. After four doses, pain greatly decreased; after ten more doses, pain disappeared; after another ten doses, ultrasound was normal.
Erysipelas
Erysipelas is named so because its color is red like painted cinnabar. Physicians of past dynasties believed early onset is mostly due to reckless Heart Fire, Wind-Heat in the Triple Burner, internal Liver Fire, Damp-Heat in the Spleen and Stomach, or external invasion of Wind Pathogen. My respected teacher Li Hanqing believed that Wind-Heat toxin invading the Blood level is most common. Thus, early treatment should prioritize Clearing Heat and Detoxifying, and externally dispersing Wind Pathogen. For head cases, Shengjiang San (Ascending and Descending Powder) and Puji Xiaodu Yin (Universal Benefit Detoxification Decoction) are suitable; for lower limb cases, Lianqiao Baidu Yin (Forsythia Antipyretic Decoction) is suitable. General cases should avoid Pungent-Warm Wind-dispersing herbs. However, in prolonged courses with severe itching and mild pain, only Pungent-Warm herbs can resolve it, so Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), and Baizhi (Angelicae Dahuricae Radix) are indispensable. If the skin is rough and hard, indicating the disease has entered the Blood level, only Sumu (Sappan Lignum) and Liuju Nu (Phyllanthi Niruri Herba) can soften hardness. Following his intent, I tried treating recurrent cases with frequent success. For example, Li XX, female, 54 years old. Recurrent erysipelas on both lower legs for over three years. The first five episodes healed quickly with antibiotics and magnesium sulfate wet compresses. This episode, despite 20+ days of the same treatment, was ineffective. Reluctantly, she sought TCM with internal Clearing Heat and Detoxifying herbs and external Yijin Jinhuang San (Golden Shield Powder). After one week, there was still no significant effect. I was invited to consult. She was obese with good spirit. The anterior edge of the left lower leg (approx. 20cm x 8cm) was purple-red, swollen, hot, and painful. Tongue was red with yellow-white coating, and pulse was Deep-Wiry-Rapid. Synthesizing pulse and symptoms, I diagnosed Qi Stagnation and Blood Stasis. Prescription: Chaihu (Bupleuri Radix) 15g, Chishao (Paeoniae Radix Rubra) 10g, Zhike (Aurantii Fructus) 10g, Shan Jiazhu (Manis Squama) 10g, Taoren (Persicae Semen) 10g, Honghua (Carthami Flos) 10g, Dahuang (Rhei Radix et Rhizoma) 10g, Gancao (Licorice Radix et Rhizoma) 6g, Lianqiao (Forsythiae Fructus) 15g, Baijiezi (Sinapis Semen) 1g. After six doses, swelling disappeared by 70-80%. A doctor asked: Erysipelas is caused by Heat-Toxin, and most doctors use Clearing Heat and Detoxifying herbs, yet they are ineffective here. Why? I answered: Ye Tianshi once said: "Long-standing diseases enter the collaterals." This disease has persisted for a long time, causing blood collateral stasis. Using only Cold herbs makes the blood congeal further. Thus, activating Blood led to recovery, whereas Cold herbs would worsen it. After another six doses, there was no effect, and local severe itching appeared. Thinking about it, Yu Tai once said: "Itching is Wind." This indicates Wind Pathogen has not been expelled. Also, considering the long duration and overuse of Cold herbs, warming herbs are needed to resolve it. Thus, the treatment should be Lianqiao Baidu Yin (Forsythia Antipyretic Decoction) with modifications: Lianqiao 10g, Shanzhi (Gardeniae Fructus) 9g, Qianghuo (Notopterygii Rhizoma et Radix) 6g, Xuanshen (Scrophulariae Radix) 30g, Bohe (Menthae Haplocalycis Herba) 9g, Fangfeng (Saposhnikoviae Radix) 9g, Chaihu (Bupleuri Radix) 9g, Jiegeng (Platycodonis Radix) 9g, Shengma ( Cimicifugae Rhizoma) 9g, Chuanxiong (Ligustici Chuanxiong Rhizoma) 9g, Danggui (Angelicae Sinensis Radix) 9g, Huangqin (Scutellariae Radix) 9g, Chishao (Paeoniae Radix Rubra) 9g, Niubangzi (Arctii Fructus) 9g, Sumu (Sappan Lignum) 9g. After six doses, all symptoms disappeared, and he was cured. For recurrent cases that are difficult to cure due to Qi and Blood exhaustion, tonifying herbs are necessary. For example, Wang XX, male, 70 years old. Recurrent erysipelas on both lower legs for 15 years, coronary heart disease for 3 years. For the past six months, chest fullness, shortness of breath, paroxysmal nocturnal dyspnea, and inability to lie flat. Over the past two months, erysipelas on both legs worsened. Multiple antibiotics, dexamethasone, vasodilators, magnesium sulfate wet compresses, Gualou Xiebai Tang (Trichosanthis Radix and Macrostemonis Rhizoma Decoction), and Puji Xiaodu Yin were ineffective. For the past half month, due to tinea pedis infection, itching and pain in calves and feet worsened, making walking impossible. I was invited to consult. He appeared fatigued with shortness of breath, speech intermittent, facial and leg/foot edema. Both calves and feet were purple-dark, skin thick and hard, interdigital and foot areas macerated, fever present. Tongue coating was thick-greasy-yellow, tongue body dark, pulse Deficient-Wiry-Slippery. Synthesizing pulse and symptoms, I said: Elderly and physically weak, Zheng (Healthy Qi) Deficient and Pathogen Excess, Qi and Yin insufficient, Phlegm Stagnation and Blood Stasis,郁 (Stagnation) generating Fire. Expelling Pathogen and Tonifying Zheng are both difficult. Thus, I tried Shiwei Wendan Tang (Ten-Ingredient Warm Gallbladder Decoction): Huangqi (Astragali Radix) 15g, Danggui (Angelicae Sinensis Radix) 10g, Maidong (Ophiopogonis Radix) 10g, Dangshen (Codonopsis Radix) 10g, Wuweizi (Schisandrae Fructus) 10g, Banxia (Pinelliae Rhizoma) 10g, Chenpi (Citri Reticulatae Pericarpium) 10g, Fuling (Poria) 10g, Gancao (Licorice Radix et Rhizoma) 10g, Zhuru (Bambusae Caulis in Taenia) 10g, Zhike (Aurantii Fructus) 10g, Yuanzhi (Polygalae Radix) 10g, Changpu (Acori Tatarinowii Rhizoma) 10g, Chuanxiong (Ligustici Chuanxiong Rhizoma) 10g, Sumu (Sappan Lignum) 9g, Zhimu (Anemarrhenae Rhizoma) 9g. After six doses, chest fullness, shortness of breath, edema, and foot maceration greatly reduced, appetite and sleep increased. Continuing the above formula for one month, 70-80% of symptoms disappeared.
I once treated patient Li XX, female, adult. Sudden redness, swelling, heat, and pain in the ring and little toes of both feet. A certain hospital diagnosed erysipelas. Penicillin and TCM Clearing Heat and Detoxifying herbs were urgently administered. That night, seeking quick relief, the patient urgently applied hot towels. Within two hours, approximately six thermoses of hot water were used. Instead of reducing pain, swelling and pain extended to the calves. The patient continued applying hot towels incessantly. Swelling rapidly extended to the groin, with unbearable pain and alternating chills and fever. I was invited to consult. After examining pulse and symptoms, I said: How can Heat-Toxin conditions be treated with Hot Compress therapy? If Fire aids Fire, Fire-Toxin attacking the Heart will be difficult to treat. I instructed her to immediately wash with cold towel compresses. About six hours later, family reported that since using cold towel compresses frequently, swelling and pain in calves and thighs had basically subsided, and foot swelling and pain largely dissipated.
Thinking of my late brother's warning: Whenever seeing carbuncles or ding toxins with blazing Fire-Toxin, cold water compresses should be used, not hot towels or hot water bottles. Otherwise, Fire-Toxin will intensify, and the disease will be difficult to cure.
Furuncle
My nephew Liu XX, male, 19 years old. For over 20 days, furuncles repeatedly appeared on the neck, rising and falling, with unbearable pain. The largest were date-sized, the smallest apricot kernel or soybean sized. Frequent use of Chinese and Western medicines was ineffective. Remembering my late father used bloodletting to treat ding toxins and sores, and a certain doctor used bloodletting for scrofula, I selected acupoints according to meridians. I pricked Weizhong (BL-40) with a three-edged needle to disperse Heat-Toxin in the Bladder Meridian. Unexpectedly, after 5 minutes of bloodletting, pain decreased. The next day, pain completely disappeared, and it fully resolved after 3 days. The following year, symptoms recurred but were significantly less severe. Using the same method, it healed in one session.
Gangrene (Thromboangiitis Obliterans)
Treatment for thromboangiitis obliterans has been widely reported in recent years. Some achieve efficacy with Warming Yang, some with Invigorating Blood and Dispelling Stasis, and some with Nourishing Yin and Detoxifying. However, sticking to one or several methods without distinguishing Zang-Fu organs and meridians results in curing mild cases but failing in complex ones. For example, Zhao XX, male, adult. Right foot thromboangiitis for over a year. Various doctors used Warming Yang, Unblocking Collaterals, and Invigorating Blood methods without effect. In March, necrosis occurred in the ring and little toes of the right foot. Two months after toe amputation, new granulation tissue did not grow, and pain persisted in the calf and right foot. Previous doctors used various formulas for Nourishing Yin and Detoxifying, Warming Yang and Invigorating Blood, all without effect. Observing his expression, his face was depressed, sighing frequently. Examining the disease location, it was in the Shaoyang Gallbladder Meridian, with a Deep-Wiry pulse. I prescribed Xiaoyao San (Free and Easy Wanderer Powder) with modifications: Chaihu (Bupleuri Radix), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Shengjiang (Zingiberis Rhizoma Recens), Qingpi (Citri Reticulatae Pericarpium Viride) each 10g, Ganjiang (Zingiberis Rhizoma) 3g, Bohe (Menthae Haplocalycis Herba) 3g. After one week of continuous use, leg and foot pain surprisingly improved, and new granulation tissue began to grow. He was cured after 20 doses. The doctor asked: Texts do not list Xiaoyao San for treating thromboangiitis, yet you succeeded. Why? I said: Yu Jiayan stated: "In treating diseases, if one does not understand Zang-Fu organs and meridians, every action is wrong." Xiaoyao San acts on the Liver and Gallbladder meridians. Its efficacy lies in the appropriate medication for the affected meridian. Another example: Kang XX, male. Left lower limb thromboangiitis, big toe and little toe necrosis turning black, pain day and night, worse at night for over 9 months. Examining the big toe, it turned black from nail root to tip; the lateral side of the little toe nail groove was mostly black. Hundreds of doses of Chinese medicine were ineffective. A certain hospital suggested surgical amputation, but due to fear of losing labor capacity, he came to Taiyuan for treatment. Carefully examining his pulse, it was Deficient-Large-Slippery-Rapid. Complexion was pale and lusterless, spirit fatigued, appetite completely lost, tongue coating white-greasy. Diagnosed as Qi and Yin Dual Deficiency. Prescribed Qimai Dihuang Tang: Huangqi (Astragali Radix) 15g, Danggui (Angelicae Sinensis Radix) 10g, Dangshen (Codonopsis Radix) 10g, Maidong (Ophiopogonis Radix) 10g, Wuweizi (Schisandrae Fructus) 10g, Shengdi (Rehmanniae Radix) 15g, Cangzhu (Atractylodis Rhizoma) 15g, Danpi (Moutan Cortex) 10g, Roucongrong (Cynomorphi Herba) 15g, Fuling (Poria) 10g, Zexie (Alismatis Rhizoma) 10g. After 15 doses, pain greatly decreased, and necrosis of big and little toes significantly improved. Continuing for 15 doses, necrotic areas returned to normal, and pain disappeared. To promote faster recovery, Liuju Nu (Phyllanthi Niruri Herba) 12g was added. After 15 doses, a soybean-sized area on the lateral side of the little toe turned black-purple, with dull pain. Liuju Nu was removed. After 20 doses, all symptoms disappeared. The doctor asked: Liuju Nu is an herb for Invigorating Blood and Dispelling Stasis. Why does adding it worsen the disease, and removing it alleviate it? I answered: When pulse and symptoms indicate Deficiency, Tonification should be given. This case has used attacking herbs for a long time, and Healthy Qi cannot support itself. Even the mild pathogen-expelling effect of Liuju Nu can aggravate the condition.
Intestinal Adhesion
Post-appendectomy intestinal adhesion is a term not found in ancient medical texts. Through the development of integrated traditional Chinese and Western medicine, it has gradually been recognized by TCM practitioners.
From many clinical reports, it is generally considered to be caused by Blood Stasis. However, neglecting Zang-Fu organs, meridians, and the balance of Cold and Heat often leads to inefficient results. For example, Jiang XX, female, adult. Frequent right lower quadrant pain after appendectomy, worsening with walking, running, or jumping. A certain hospital diagnosed intestinal adhesion. Treatment with placental tissue fluid and TCM Blood-invigorating and Stasis-resolving herbs did not reduce pain. Constrained by the view of Invigorating Blood and Dispelling Stasis, I prescribed Blood-invigorating herbs again, but pain intensified. Careful inquiry revealed cold pain in the lower abdomen. Thus, I prescribed Shaofu Zhuyu Tang (Lower Abdomen Blood-Stasis Resolving Decoction) original formula. After 2 doses, pain did not decrease but instead palpitations, irritability, dizziness, insomnia, anger, and weeping appeared. Re-examining the pulse, it was Deep-Wiry, with pain in the right lower abdomen. I changed to Xiaoyao San (Free and Easy Wanderer Powder) with modifications: Chaihu (Bupleuri Radix), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria) each 9g, Danshen (Salviae Miltiorrhizae Radix et Rhizoma) 15g, Zhizi (Gardeniae Fructus) 9g, Ganjiang (Zingiberis Rhizoma) 4g, Gancao (Licorice Radix et Rhizoma) 6g, Bohe (Menthae Haplocalycis Herba) 3g. After 4 doses, all symptoms decreased, and pain disappeared. After another 7 doses, even vigorous activities like running and jumping did not trigger pain.
For mixed Cold and Heat patterns, attention must be paid to the proportion of Cold and Heat, as well as Zang-Fu organs and meridians. Otherwise, expected results are often not achieved.
Thrombophlebitis