感冒后3个多月，一直发烧、咳嗽吐痰，痰中带血。某院诊为啼炎。先用抗生素治疗不见好转，后又配用中药宣肺止咳、清热解毒治疗半月亦不见改善：不得已，乃转院治疗。诊为右肺结核，结核性胸膜炎。住院治疗3个多月，不但不见好转，反而日趋加重，又邀某医以中药养阴润肺，止咳化痰之剂治之约40余天，病情仍然不见改善。审其舌苔薄白，脉虚大弦紧数，右脉大于左脉。因思其脉虚大者气阴俱虚也，弦者肝脉也，紧者寒也，数者热也。综合论之，乃气阴俱虚为本，肺虚术邪反侮，寒饮内郁化热之证也。阴虚者脉细数也，证非阴虚有热而但予滋阴养液，则痰饮不除也。治从补气养阴以培本．疏肝泻火，化饮温阳以治其标。处方：黄芪15克，地骨皮10克，紫菀10克，党参J0克，茯苓10克，柴胡10克，半夏10克，知母10克，生地10克，白芍10克，麦冬10克，肉桂10克，甘草10克。
服药4剂后，诸证大减，继眼上药40剂，诸证消失，愈。
2．当敛不敛，反与活血止血，其血不止
邢××，男，40岁。
浸润性肺结核咳血时作时止1个多月。医先用西药治疗一个多月不效。邀医以中药清热解毒汤(原犀角地黄汤)加阿胶、三七治之，服药6剂，其效不著。审其咳血或为痰中带有血丝，或为大口鲜血，面色皓白，舌苔净，舌质嫩红，脉虚弱啊敖。综合脉证，思之：脉虚弱而数者肺阴不足虚火扰动也；夫咳血者，阴虚火旺，火迫血行，肺气不得敛藏也。治宜养阴泻火，敛肺止咳。处方：百合18克，生地J5克，熟地IO屯，元参18克，桔梗6克，甘草6克，麦冬10克，白芍12范，丹皮10克，白及粉10克(冲服)。
服药3剂后，咳血停止。某医云：三七乃止血圣药，如此咳血重证竞不用三七，不可也，不可也。乃于上方加三七参9克浸之。
眼药2剂，咳血又作。患者云：莫非三七之故乎?医云：非也，乃病未除也。继服4剂，咳血大作。再邀余诊之。诊其憾、舌与前仿佛。乃云：阴虚不敛者，稍佐丹皮之活血止血，亦恐活血太甚，若再加用三七则虚火难敛也，治宜急去三七之蕊咖活血者，复加白及粉10克(分冲)、阿胶10克(烊化)。约进1剂，次日咳血又止，继服10剂，追访两月，未见复发。
3．病邪在肾，但予治肺，相火不降，吐血不止
苏××．男．29岁．
肺结核大口大口的咯血一月有余。医予西药治之虽时稍效，但不显著。邀医以中药咳血方、养肺阴、敛血气等法均不效。细审其证，除咳血时或一杯或痰中带血外，并见其脉虚数尺脉大。综合脉证，思之：尺脉者肾也，尺脉应小于关寸诸脉，今反大者肾虚相火妄动上凌肺金也，前用诸药或泻实火，或滋肺阴，药非治其病之所在，此即《内经》“适其至所”之反也。因拟滋阴降火。处方：麦冬10克，生地10克，元参50克，地骨皮10克。
服药1剂后，咳血顿止，继服6剂，愈。
4．瘀血不除，血不归经，但予滋阴泻火，治之乏效
甘××，男，39岁。
纤维空洞性肺结核十几年。近几年来，反复咯血，曾先后住院数年，咳血一直不止。特别是近一个月来，咳血尤为严重。曾因大量咳血而休克两次，经过抢救才脱离危险，但时至今日仍然咳血不止。细审其证，除咳血之外，并见神疲乏力，全身瘦削，皮肤干燥，气短咳嗽，吐痰，胸满胸痛，食欲不振，舌苔白，脉沉弦细。综合脉证，诊为气滞血瘀，郁而化火，血不归经。治拟疏肝理气，活血止血，清热泻火。处方：柴胡10克，白芍10克，降香10克，茜草10克，黄芩10克，元参15克。
服药1剂，咳血停止，继服10剂，愈。
某医问：肺结核病，中医称为肺痨，乃阴虚火旺为病，故治疗上多主张养阴清热。咳血者多主张用咳血方、百合固金汤，然老师不用者何也?阿胶、三七均止血良药，老师亦不用，其故又何也?答曰：咳血方、百合固金汤确为肺结核咳血之良方，但因其为养阴泻火之剂，故只适用于阴虚火旺，脉见细数的咳血，至于本证，从证脉来看乃气滞、血瘀、郁而化火之象，故只可采用疏肝理气，活血止血，泻火之品，否则，但予滋阴之补必使气血更加壅滞，血滞则血更不归经。至于为什么不用三七，因其性温助火，阿胶滋阴收敛不利于活血，故不用。
5．不察虚实，不审病位，但施止血，其血不止
钱××，男，43岁。
咳血反复发作3年。医诊肺结核。先用西药治之不效，继又请中医以活血止血，凉血止血之剂治之仍不效。细审其证，咳血之状，呈痰中带血，有时为血丝，有时为血块，即使不是痰中带血，也是仅在咳嗽的同时咯一二口而已，但每次咳嗽均见咳血，咳声低微，咳痰不多，疲乏无力，食纳较差，面色咣白，脉细弱。综合脉证，思之：面色皓白，脉细弱者，肺阴亏损之疾也。治宜滋阴润肺，佐以止血。处方：百合30克，生地15克，熟地9克，元参10克，川贝母10克，桔梗6克，甘草6克，麦冬10克，白芍10克，当归10克，白及10克(研、冲)。
服药4剂，咳血停止，继服4剂，咳血消失。
医云：百合固金汤为治肺痨名方，其治咳嗽之功不可忽视，然其止血之力如此明显未之闻也，可明示之。答曰：百合固金汤虽为滋阴降火之方，然其降火之力不足，滋阴之力较盛，若用于阴虚火不甚旺，脉见细弱之咳血尤效，若再配以白技之收敛止血，则其效更著。前用诸方，或用活血止血而不效，乃证无瘀血可治则血更离经而出血；或用清热泻火止血而小效，乃因此火非实火，而为阴虚之火，此即《内经》治旺气而不效之意也。
结核性腹膜炎
1.不分寒热，但予利水，久治不效
石××，男，45岁。
腹胀腹痛5个多月。医诊结核性腹膜炎。先以西药治疗3个月效果不著，后又以中药理气行水等治疗近2个月亦无明显效果。细审其证，腹胀、腹水，全腹疼痛，大便稀溏，一日数次，按其腹壁呈揉面感，舌苔薄白，脉沉。综合脉证，思之：腹胀腹痛昼轻夜重者寒湿也；沉脉者．病在里也，气滞血瘀也。综而论之，乃寒湿郁滞，郁而化热也。为拟温阳除湿，清热消胀。处方：附子6克，生薏米60克，败酱草60克，冬瓜子60克，白芥子1克。
服药2剂，腹胀、腹痛好转，继服20剂，诸证消失，愈。
医云：薏苡附子败酱散为仲景治疗肠痈之方也，何用于结核性腹膜炎有效?答曰：薏苡附子败酱散方确系治肠痈之方，然其用于身甲错，腹皮急者则同也。且薏米不但泄脓，亦且除湿；附子不但辛热散结，亦且振奋阳气；败酱草不但排脓，亦且能够破瘀利水解毒，今复加冬瓜子的理气除痰、白芥子辛温通阳，利气破积，故能治结核性腹膜炎。至于为何以理气利水而不效，乃未予活血，未予通阳，未予散结耳。
2．不审寒热，但予解毒利水，其病难解
李××，男，35岁。消瘦乏力，腹痛腹胀两个多月。医诊结核性蝮膜炎。经用抗结核药、腹腔放液等治疗，虽然有时腹胀减轻，但一直不能解决根本问题。后又配合中药解毒利水，理气活血治之，仍无明显效果。审其消瘦乏力，腹胀腹痛，有移动性浊音．按之腹壁柔韧感，舌苔白，脉沉细弦。再审其腹胀腹痛尤以遇冷或下午较重。因思结核病者诸医多作阴虚考虑，骨关节结核则多作阳虚考虑，此汪虽为结核病，但无阴虚之脉细数与骨蒸盗汗，亦无明显的气虚血虚之证，因此暂不作虚证考虑，且其有明显的腹胀大而疼痛的标实证，故应先从实证以治；又腹胀腹痛尤甚于午后阴时，脾之主令时，此必兼寒湿为患，且病久人络，还当佐以活血利水。再思薏苡附子败酱散，其虽为治疗肠痈而设。然其既有薏米的利湿，又有附子温阳通经，败酱草的活血利水，故可用之。前用诸方虽有利水，但缺温阳；虽有活血，但缺除湿。故处方：附子10克，生薏米40克，败酱草40克。服药1剂，腹痛腹胀稍减，继服20剂，诸证消失，果愈。
皮肤结核病
不审病位，不审上下，当升反降，久治不愈
贺××，女，42岁。
足、踝、小腿、膝、大腿紫红色结节12年。医诊皮肤结核。其病开始时，因未作病理切片检查而按结节性红斑治疗4年，但因始终不效，而进行病理切片检查，并作结核菌素试验，始确诊为皮肤结核病。确诊后又采用抗结核药治疗3年，仍无明显效果。乃再请中医配合治疗，始以活血解毒，后以燥湿清热均不效。细审其证，除结核结节40个，质紫而韧，按之痛外，并见脉弦紧。综合脉证，思之：病仅在下肢而不在上肢者湿热也，其如东垣脚气疮疡意也。当升清除湿以泄热也。方宗当归拈痛汤。处方：当归15克，羌活10克，防风10克，升麻10克，猪苓10克，泽泻10克，茵陈15克，黄芩10克葛根15克，苍术10克，白术10克，苦参15克，知母10克，甘草6克：
服药4剂，结节减小，疼痛减，继服10剂，结节消失近半，继服30剂，结节全部消失，后果愈。
某医云：既云如疮疡意何不用清热解毒?答曰：前医久用清热解毒不效也：且本病非仅有热毒，亦且有湿热沉滞于下矣。故以羌活通关节。防风散留湿，苦参、黄芩、茵陈、知母以泄湿热，当归和气血，升麻、葛根助阳以升清，苓、泽泻湿降浊，参、甘、二术补正固中。
钩端螺旋体病
囿于湿热，不详辨证，以寒作温，其病不除
赵××，男，25岁。发热恶寒，头痛身痛，小腿疼痛不能活动3天。医诊钩端螺旋体病。急用青霉素等西药治之不效。察其发热达39．2℃，咽痛头痛，身痛，急予银翘散去牛蒡子加生薏米、滑石、杏仁方，以清热解毒，除湿解表。服药3剂，诸证不减。至第五天往诊。患者云：服李医生之药1剂即愈矣。询之，李医生云：吾见其一直高热不退，甚为着急，乃予大青龙汤1剂，服药1小时后即见微微汗出，4个小时后体温即降至正常，6个小时后，则诸证全消。再问：你怎么想起用大青龙汤?答曰：前天朱老师不是讲《伤寒论》大青龙证吗，吾见其证与《伤寒论》所述大青龙汤证完全相同，故用之。老师曾讲不管是中风，还是伤寒，还是其他病，但见“脉浮紧，发热恶寒，身疼痛，不汗出而烦躁者”，均可用大青龙汤。此病虽叫钩端螺旋体病，虽然诸医都说按湿温治疗，但此证却似大青龙证，所以冒然用之也。余云：辨证乃治病之灵魂，不可违也。若囿于一说而不辨证，必误也。
阿米巴肝脓肿
但予解毒清热，不辨脏腑虚实，当攻不攻，当和不和，其病难解
盛××，男，38岁。
高热持续不退7个多月。某医始见其右侧胸痛，气急，咳嗽，肺部湿哕音，诊为肺炎。予多种抗生素、磺胺等治疗近两个月不效，后又见其肝脏弥漫性增大，腹胀、恶心，食欲不振，诊其为菌血症，配加中药清热解毒，清营凉血重剂4个月治疗无功。不得已，又转人某院，进行肝穿检查：除发现大量阿米巴原虫外，并有大量的金黄色葡萄球菌、大肠杆菌等。于是除继续应用抗生素外，又加入了抗阿米巴的药物进行治疗。但半个多月后，诸证均不好转。细察其证，除体温39．7℃外，并见寒热阵阵，恶心欲吐，腹胀腹痛，肝大平脐，疼痛不可触近，咳嗽气短，体瘦神疲，大便微溏，小便黄赤，脉弦滑而数。综合脉证思之：寒热往来，恶心欲吐，脉弦者，少阳之证也；腹满腹痛拒按，阳明实证也。肝痈之疾，复见少阳阳明，但予清热解毒消痛则不可治也。因拟和解攻下，佐以清热消痈。处方：柴胡24克，半夏10克，黄芩10克，枳实10克，赤芍10克，大黄10克，白芥子10克，银花15克。
服药1剂，大便二行，寒热，恶心，腹满胀痛均骤减，体温38℃。继服4剂，体温正常，饮食增进，精神大增，后果愈。
某医云：何前用银花近120克，连翘30克，以及黄芩、黄连、败酱草之属，并大剂量的抗生素、抗阿米巴原虫药治之不效?而改用银花仅15克即愈也?答曰：枢机不利未予和解，腑实之证未予通下所致也。
黑热病
瘕积蕴热，不知缓消，但清其热，何者能解
胡××，男，6岁。半个多月来，日渐腹部胀大，发热鼻衄，脾大过脐。医诊黑热病。予斯锑黑克治之不效，继又配合中药清热解毒之剂仍不效。审其体温39．5cC，腹部胀大，脾大过脐，质软，肝未触及，时鼻衄，脉数。先予清热解毒剂3剂予之，不效。求教于家兄朱庆丰先生。云：瘕积不化，腹大，发热，脉数者，宜活血化积，导滞泻热。处方：大黄10克、硫酸镁10克，共为细末，每日3次，每次2克，冲服，外贴二龙膏。两天后，发热即退，纳食增加，10日后，腹大，脾大恢复正常，后果愈。家兄云：瘕积之证，不消其积，但清其热，不可也。
蛔虫病
1．蛔虫应驱，不辨寒热，虽驱不去
感冒后3个多月，一直发烧、咳嗽吐痰，痰中带血。某医院诊断为肺炎（此处原文“啼炎”疑为“肺炎”之误，依上下文及西医诊断逻辑修正）。先用抗生素治疗不见好转，后又配用中药宣肺止咳、清热解毒治疗半月亦不见改善：不得已，乃转院治疗。诊为右肺结核，结核性胸膜炎。住院治疗3个多月，不但不见好转，反而日趋加重，又邀某医以中药养阴润肺，止咳化痰之剂治之约40余天，病情仍然不见改善。审其舌苔薄白，脉虚大弦紧数，右脉大于左脉。因思其脉虚大者气阴俱虚也，弦者肝脉也，紧者寒也，数者热也。综合论之，乃气阴俱虚为本，肺虚木邪反侮，寒饮内郁化热之证也。阴虚者脉细数也，证非阴虚有热而但予滋阴养液，则痰饮不除也。治从补气养阴以培本．疏肝泻火，化饮温阳以治其标。处方：黄芪15克，地骨皮10克，紫菀10克，党参10克，茯苓10克，柴胡10克，半夏10克，知母10克，生地10克，白芍10克，麦冬10克，肉桂10克，甘草10克。
服药4剂后，诸证大减，继服上药40剂，诸证消失，痊愈。
2．当敛不敛，反与活血止血，其血不止
邢××，男，40岁。
浸润性肺结核咳血时作时止1个多月。医先用西药治疗一个多月不效。邀医以中药清热解毒汤(原犀角地黄汤)加阿胶、三七治之，服药6剂，其效不著。审其咳血或为痰中带有血丝，或为大口鲜血，面色皓白，舌苔净，舌质嫩红，脉虚弱而数。综合脉证，思之：脉虚弱而数者肺阴不足虚火扰动也；夫咳血者，阴虚火旺，火迫血行，肺气不得敛藏也。治宜养阴泻火，敛肺止咳。处方：百合18克，生地15克，熟地10克，元参18克，桔梗6克，甘草6克，麦冬10克，白芍12克，丹皮10克，白及粉10克(冲服)。
服药3剂后，咳血停止。某医云：三七乃止血圣药，如此咳血重证竟不用三七，不可也，不可也。乃于上方加三七参9克浸之。
服药2剂，咳血又作。患者云：莫非三七之故乎?医云：非也，乃病未除也。继服4剂，咳血大作。再邀余诊之。诊其脉、舌与前仿佛。乃云：阴虚不敛者，稍佐丹皮之活血止血，亦恐活血太甚，若再加用三七则虚火难敛也，治宜急去三七之活血者，复加白及粉10克(分冲)、阿胶10克(烊化)。约进1剂，次日咳血又止，继服10剂，追访两月，未见复发。
3．病邪在肾，但予治肺，相火不降，吐血不止
苏××．男．29岁．
肺结核大口大口的咯血一月有余。医予西药治之虽时稍效，但不显著。邀医以中药咳血方、养肺阴、敛血气等法均不效。细审其证，除咳血时或一杯或痰中带血外，并见其脉虚数尺脉大。综合脉证，思之：尺脉者肾也，尺脉应小于关寸诸脉，今反大者肾虚相火妄动上凌肺金也，前用诸药或泻实火，或滋肺阴，药非治其病之所在，此即《内经》“适其至所”之反也。因拟滋阴降火。处方：麦冬10克，生地10克，元参50克，地骨皮10克。
服药1剂后，咳血顿止，继服6剂，愈。
4．瘀血不除，血不归经，但予滋阴泻火，治之乏效
甘××，男，39岁。
纤维空洞性肺结核十几年。近几年来，反复咯血，曾先后住院数年，咳血一直不止。特别是近一个月来，咳血尤为严重。曾因大量咳血而休克两次，经过抢救才脱离危险，但时至今日仍然咳血不止。细审其证，除咳血之外，并见神疲乏力，全身瘦削，皮肤干燥，气短咳嗽，吐痰，胸满胸痛，食欲不振，舌苔白，脉沉弦细。综合脉证，诊为气滞血瘀，郁而化火，血不归经。治拟疏肝理气，活血止血，清热泻火。处方：柴胡10克，白芍10克，降香10克，茜草10克，黄芩10克，元参15克。
服药1剂，咳血停止，继服10剂，愈。
某医问：肺结核病，中医称为肺痨，乃阴虚火旺为病，故治疗上多主张养阴清热。咳血者多主张用咳血方、百合固金汤，然老师不用者何也?阿胶、三七均止血良药，老师亦不用，其故又何也?答曰：咳血方、百合固金汤确为肺结核咳血之良方，但因其为养阴泻火之剂，故只适用于阴虚火旺，脉见细数的咳血，至于本证，从证脉来看乃气滞、血瘀、郁而化火之象，故只可采用疏肝理气，活血止血，泻火之品，否则，但予滋阴之补必使气血更加壅滞，血滞则血更不归经。至于为什么不用三七，因其性温助火，阿胶滋阴收敛不利于活血，故不用。
5．不察虚实，不审病位，但施止血，其血不止
钱××，男，43岁。
咳血反复发作3年。医诊肺结核。先用西药治之不效，继又请中医以活血止血，凉血止血之剂治之仍不效。细审其证，咳血之状，呈痰中带血，有时为血丝，有时为血块，即使不是痰中带血，也是仅在咳嗽的同时咯一二口而已，但每次咳嗽均见咳血，咳声低微，咳痰不多，疲乏无力，食纳较差，面色㿠白，脉细弱。综合脉证，思之：面色㿠白，脉细弱者，肺阴亏损之疾也。治宜滋阴润肺，佐以止血。处方：百合30克，生地15克，熟地9克，元参10克，川贝母10克，桔梗6克，甘草6克，麦冬10克，白芍10克，当归10克，白及10克(研、冲)。
服药4剂，咳血停止，继服4剂，咳血消失。
医云：百合固金汤为治肺痨名方，其治咳嗽之功不可忽视，然其止血之力如此明显未之闻也，可明示之。答曰：百合固金汤虽为滋阴降火之方，然其降火之力不足，滋阴之力较盛，若用于阴虚火不甚旺，脉见细弱之咳血尤效，若再配以白及之收敛止血，则其效更著。前用诸方，或用活血止血而不效，乃证无瘀血可治则血更离经而出血；或用清热泻火止血而小效，乃因此火非实火，而为阴虚之火，此即《内经》治旺气而不效之意也。
结核性腹膜炎
1.不分寒热，但予利水，久治不效
石××，男，45岁。
腹胀腹痛5个多月。医诊结核性腹膜炎。先以西药治疗3个月效果不著，后又以中药理气行水等治疗近2个月亦无明显效果。细审其证，腹胀、腹水，全腹疼痛，大便稀溏，一日数次，按其腹壁呈揉面感，舌苔薄白，脉沉。综合脉证，思之：腹胀腹痛昼轻夜重者寒湿也；沉脉者．病在里也，气滞血瘀也。综而论之，乃寒湿郁滞，郁而化热也。为拟温阳除湿，清热消胀。处方：附子6克，生薏米60克，败酱草60克，冬瓜子60克，白芥子1克。
服药2剂，腹胀、腹痛好转，继服20剂，诸证消失，愈。
医云：薏苡附子败酱散为仲景治疗肠痈之方也，何用于结核性腹膜炎有效?答曰：薏苡附子败酱散方确系治肠痈之方，然其用于身甲错，腹皮急者则同也。且薏米不但泄脓，亦且除湿；附子不但辛热散结，亦且振奋阳气；败酱草不但排脓，亦且能够破瘀利水解毒，今复加冬瓜子的理气除痰、白芥子辛温通阳，利气破积，故能治结核性腹膜炎。至于为何以理气利水而不效，乃未予活血，未予通阳，未予散结耳。
2．不审寒热，但予解毒利水，其病难解
李××，男，35岁。消瘦乏力，腹痛腹胀两个多月。医诊结核性腹膜炎。经用抗结核药、腹腔放液等治疗，虽然有时腹胀减轻，但一直不能解决根本问题。后又配合中药解毒利水，理气活血治之，仍无明显效果。审其消瘦乏力，腹胀腹痛，有移动性浊音．按之腹壁柔韧感，舌苔白，脉沉细弦。再审其腹胀腹痛尤以遇冷或下午较重。因思结核病者诸医多作阴虚考虑，骨关节结核则多作阳虚考虑，此汪虽为结核病，但无阴虚之脉细数与骨蒸盗汗，亦无明显的气虚血虚之证，因此暂不作虚证考虑，且其有明显的腹胀大而疼痛的标实证，故应先从实证以治；又腹胀腹痛尤甚于午后阴时，脾之主令时，此必兼寒湿为患，且病久人络，还当佐以活血利水。再思薏苡附子败酱散，其虽为治疗肠痈而设。然其既有薏米的利湿，又有附子温阳通经，败酱草的活血利水，故可用之。前用诸方虽有利水，但缺温阳；虽有活血，但缺除湿。故处方：附子10克，生薏米40克，败酱草40克。服药1剂，腹痛腹胀稍减，继服20剂，诸证消失，果愈。
皮肤结核病
不审病位，不审上下，当升反降，久治不愈
贺××，女，42岁。
足、踝、小腿、膝、大腿紫红色结节12年。医诊皮肤结核。其病开始时，因未作病理切片检查而按结节性红斑治疗4年，但因始终不效，而进行病理切片检查，并作结核菌素试验，始确诊为皮肤结核病。确诊后又采用抗结核药治疗3年，仍无明显效果。乃再请中医配合治疗，始以活血解毒，后以燥湿清热均不效。细审其证，除结核结节40个，质紫而韧，按之痛外，并见脉弦紧。综合脉证，思之：病仅在下肢而不在上肢者湿热也，其如东垣脚气疮疡意也。当升清除湿以泄热也。方宗当归拈痛汤。处方：当归15克，羌活10克，防风10克，升麻10克，猪苓10克，泽泻10克，茵陈15克，黄芩10克葛根15克，苍术10克，白术10克，苦参15克，知母10克，甘草6克：
服药4剂，结节减小，疼痛减，继服10剂，结节消失近半，继服30剂，结节全部消失，后果愈。
某医云：既云如疮疡意何不用清热解毒?答曰：前医久用清热解毒不效也：且本病非仅有热毒，亦且有湿热沉滞于下矣。故以羌活通关节。防风散留湿，苦参、黄芩、茵陈、知母以泄湿热，当归和气血，升麻、葛根助阳以升清，苓、泽泻湿降浊，参、甘、二术补正固中。
钩端螺旋体病
囿于湿热，不详辨证，以寒作温，其病不除
赵××，男，25岁。发热恶寒，头痛身痛，小腿疼痛不能活动3天。医诊钩端螺旋体病。急用青霉素等西药治之不效。察其发热达39．2℃，咽痛头痛，身痛，急予银翘散去牛蒡子加生薏米、滑石、杏仁方，以清热解毒，除湿解表。服药3剂，诸证不减。至第五天往诊。患者云：服李医生之药1剂即愈矣。询之，李医生云：吾见其一直高热不退，甚为着急，乃予大青龙汤1剂，服药1小时后即见微微汗出，4个小时后体温即降至正常，6个小时后，则诸证全消。再问：你怎么想起用大青龙汤?答曰：前天朱老师不是讲《伤寒论》大青龙证吗，吾见其证与《伤寒论》所述大青龙汤证完全相同，故用之。老师曾讲不管是中风，还是伤寒，还是其他病，但见“脉浮紧，发热恶寒，身疼痛，不汗出而烦躁者”，均可用大青龙汤。此病虽叫钩端螺旋体病，虽然诸医都说按湿温治疗，但此证却似大青龙证，所以冒然用之也。余云：辨证乃治病之灵魂，不可违也。若囿于一说而不辨证，必误也。
阿米巴肝脓肿
但予解毒清热，不辨脏腑虚实，当攻不攻，当和不和，其病难解
盛××，男，38岁。
高热持续不退7个多月。某医始见其右侧胸痛，气急，咳嗽，肺部湿哕音，诊为肺炎。予多种抗生素、磺胺等治疗近两个月不效，后又见其肝脏弥漫性增大，腹胀、恶心，食欲不振，诊其为菌血症，配加中药清热解毒，清营凉血重剂4个月治疗无功。不得已，又转入某院，进行肝穿检查：除发现大量阿米巴原虫外，并有大量的金黄色葡萄球菌、大肠杆菌等。于是除继续应用抗生素外，又加入了抗阿米巴的药物进行治疗。但半个多月后，诸证均不好转。细察其证，除体温39．7℃外，并见寒热阵阵，恶心欲吐，腹胀腹痛，肝大平脐，疼痛不可触近，咳嗽气短，体瘦神疲，大便微溏，小便黄赤，脉弦滑而数。综合脉证思之：寒热往来，恶心欲吐，脉弦者，少阳之证也；腹满腹痛拒按，阳明实证也。肝痈之疾，复见少阳阳明，但予清热解毒消痈则不可治也。因拟和解攻下，佐以清热消痈。处方：柴胡24克，半夏10克，黄芩10克，枳实10克，赤芍10克，大黄10克，白芥子10克，银花15克。
服药1剂，大便二行，寒热，恶心，腹满胀痛均骤减，体温38℃。继服4剂，体温正常，饮食增进，精神大增，后果愈。
某医云：何前用银花近120克，连翘30克，以及黄芩、黄连、败酱草之属，并大剂量的抗生素、抗阿米巴原虫药治之不效?而改用银花仅15克即愈也?答曰：枢机不利未予和解，腑实之证未予通下所致也。
黑热病
瘕积蕴热，不知缓消，但清其热，何者能解
胡××，男，6岁。半个多月来，日渐腹部胀大，发热鼻衄，脾大过脐。医诊黑热病。予斯锑黑克治之不效，继又配合中药清热解毒之剂仍不效。审其体温39．5cC，腹部胀大，脾大过脐，质软，肝未触及，时鼻衄，脉数。先予清热解毒剂3剂予之，不效。求教于家兄朱庆丰先生。云：瘕积不化，腹大，发热，脉数者，宜活血化积，导滞泻热。处方：大黄10克、硫酸镁10克，共为细末，每日3次，每次2克，冲服，外贴二龙膏。两天后，发热即退，纳食增加，10日后，腹大，脾大恢复正常，后果愈。家兄云：瘕积之证，不消其积，但清其热，不可也。
More than 3 months after a cold, the patient suffered from persistent fever, cough with sputum, and hemoptysis (coughing up blood). A certain hospital diagnosed pneumonia (Note: Original text "Ti Yan" is likely a typo for "Fei Yan" Pneumonia, corrected based on context). Antibiotics were used first but showed no improvement. Subsequently, Chinese medicine prescriptions for diffusing the lungs to stop coughing and clearing heat to resolve toxicity were administered for half a month without improvement. Forced to transfer hospitals, the diagnosis became right pulmonary tuberculosis and tuberculous pleurisy. After more than 3 months of hospitalization, not only was there no improvement, but the condition worsened day by day. Another physician was invited to treat with Chinese medicine nourishing yin and moistening the lungs, stopping coughing and resolving phlegm for about 40 days, yet the condition remained unchanged. Examination revealed thin white tongue coating, and a pulse that was deficient, large, wiry, tight, and rapid, with the right pulse larger than the left. It was reasoned that a deficient and large pulse indicates deficiency of both qi and yin; a wiry pulse corresponds to the liver; a tight pulse indicates cold; and a rapid pulse indicates heat. Synthesizing these findings, the root cause is deficiency of both qi and yin, while lung deficiency allows wood pathogen to counter-restrain (liver fire insulting lung), leading to internal stagnation of cold-fluid transforming into heat. Yin deficiency typically presents with a fine and rapid pulse; if the syndrome is not yin deficiency with heat, merely nourishing yin and fluids will not eliminate phlegm-fluid. The treatment strategy focused on tonifying qi and nourishing yin to support the root, soothing the liver and purging fire, resolving fluid and warming yang to address the branch. Prescription: Huangqi (Astragali Radix) 15g, Digupi (Lycii Cortex) 10g, Ziwan (Asternis Radix) 10g, Dangshen (Codonopsis Radix) 10g, Fuling (Poria) 10g, Chaihu (Bupleuri Radix) 10g, Banxia (Pinelliae Rhizoma Preparatum) 10g, Zhimu (Anemarrhenae Rhizoma) 10g, Shengdi (Rehmanniae Radix) 10g, Baishao (Paeoniae Radix Alba) 10g, Maimai Dong (Ophiopogonis Radix) 10g, Rougui (Cinnamomi Cortex) 10g, Gancao (Glycyrrhizae Radix et Rhizoma) 10g.
After taking 4 doses, all symptoms significantly decreased. Continuing with the same prescription for 40 doses, all symptoms disappeared, and the patient recovered.
2. Failure to astringe when appropriate, instead using blood-invigorating and hemostatic methods, resulting in continued bleeding
Patient Xing XX, Male, 40 years old.
Infiltrative pulmonary tuberculosis with intermittent hemoptysis for over 1 month. Western medicine treatment for over a month was ineffective. Invited physician to treat with Chinese medicine Qingre Jiedu Tang (originally Xijiao Dihuang Tang) plus Ejiao (Donkey-hide Gelatin) and Sanqi (Notoginseng Radix et Rhizoma). After 6 doses, efficacy was not obvious. Examination of hemoptysis showed either blood streaks in sputum or mouthfuls of fresh blood. Complexion was pale white, tongue coating was clean, tongue body was tender red, and pulse was weak and rapid. Synthesizing pulse and symptoms: A weak and rapid pulse indicates insufficient lung yin with disturbance by deficiency fire; hemoptysis results from yin deficiency and fire hyperactivity, where fire forces blood to move, preventing lung qi from consolidating and storing. Treatment should nourish yin, purge fire, consolidate the lung, and stop coughing. Prescription: Baihe (Lilii Bulbus) 18g, Shengdi (Rehmanniae Radix) 15g, Shudi (Rehmanniae Radix Preparata) 10g, Yuanshen (Scrophulariae Radix) 18g, Jiegeng (Platycodonis Radix) 6g, Gancao (Glycyrrhizae Radix et Rhizoma) 6g, Maimai Dong (Ophiopogonis Radix) 10g, Baishao (Paeoniae Radix Alba) 12g, Danpi (Moutan Cortex) 10g, Baiji Fen (Bletillae Rhizoma Powder) 10g (taken with decoction).
After 3 doses, hemoptysis stopped. A certain physician stated: Sanqi is a holy medicine for stopping bleeding; it is unacceptable not to use Sanqi for such a severe case of hemoptysis. Thus, 9g of Sanqi was added to the above prescription.
After 2 doses, hemoptysis recurred. The patient asked: Could it be due to Sanqi? The physician replied: No, the disease has not been eliminated. After continuing for 4 doses, hemoptysis became severe. I was invited to examine again. Pulse and tongue were similar to before. I stated: In cases of yin deficiency failing to consolidate, adding a little Danpi for blood-invigorating and hemostatic effects might already risk excessive blood invigoration; adding Sanqi would make it difficult to consolidate deficiency fire. Treatment urgently requires removing Sanqi's blood-invigorating property and re-adding Baiji Fen 10g (divided intake) and Ejiao 10g (melted). After approximately 1 dose, hemoptysis stopped again the next day. Continuing for 10 doses, follow-up for two months showed no recurrence.
3. Pathogen in the kidney, but treating only the lung, ministerial fire fails to descend, causing continuous hematemesis/hemoptysis
Patient Su XX, Male, 29 years old.
Tuberculosis with massive hemoptysis for over a month. Western medicine provided slight temporary effect but was not significant. Chinese medicine methods including Kexue Fang (Hemoptysis Formula), nourishing lung yin, and consolidating blood qi were ineffective. Detailed examination revealed hemoptysis varying from a cupful to blood streaks in sputum, along with a deficient and rapid pulse, specifically a large chi (kidney) pulse. Synthesizing pulse and symptoms: The chi pulse corresponds to the kidney. Normally, the chi pulse should be smaller than guan and cun pulses; its current largeness indicates kidney deficiency with reckless movement of ministerial fire insulting lung metal. Previous medicines either cleared excess fire or nourished lung yin, missing the site of the disease, contrary to the *Neijing* principle of "reaching the precise location." Therefore, nourishing yin and descending fire was planned. Prescription: Maimai Dong (Ophiopogonis Radix) 10g, Shengdi (Rehmanniae Radix) 10g, Yuanshen (Scrophulariae Radix) 50g, Digupi (Lycii Cortex) 10g.
After 1 dose, hemoptysis stopped abruptly. Continuing for 6 doses resulted in recovery.
4. Blood stasis not removed, blood fails to return to vessels, treating only with yin-nourishing and fire-purging methods proves ineffective
Patient Gan XX, Male, 39 years old.
Fibrocavitary pulmonary tuberculosis for over 10 years. In recent years, recurrent hemoptysis, hospitalized for several years, with continuous hemoptysis. Especially in the last month, hemoptysis was particularly severe. Experienced shock twice due to massive hemoptysis, rescued from danger, but hemoptysis continues to date. Detailed examination revealed, besides hemoptysis, mental fatigue, emaciation, dry skin, shortness of breath, cough, sputum, chest fullness and pain, poor appetite, white tongue coating, and deep, wiry, fine pulse. Synthesizing pulse and symptoms, diagnosed as qi stagnation and blood stasis, stagnation transforming into fire, blood failing to return to vessels. Treatment proposed: soothing liver, regulating qi, invigorating blood, stopping bleeding, clearing heat, and purging fire. Prescription: Chaihu (Bupleuri Radix) 10g, Baishao (Paeoniae Radix Alba) 10g, Jiangxiang (Dalbergiae Odoriferae Lignum) 10g, Qiancao (Rubiae Radix) 10g, Huangqin (Scutellariae Radix) 10g, Yuanshen (Scrophulariae Radix) 15g.
After 1 dose, hemoptysis stopped. Continuing for 10 doses resulted in recovery.
A physician asked: Pulmonary tuberculosis is called Feilao (Consumption) in TCM, caused by yin deficiency and fire hyperactivity, so treatment mostly advocates nourishing yin and clearing heat. For hemoptysis, Kexue Fang and Baihe Gujin Tang are advocated, why did you not use them? Ejiao and Sanqi are good hemostatics, why did you not use them? Answer: Kexue Fang and Baihe Gujin Tang are indeed good formulas for TB hemoptysis, but being yin-nourishing and fire-purging, they only apply to hemoptysis with yin deficiency, fire hyperactivity, and fine-rapid pulse. This case, based on signs and pulse, shows qi stagnation, blood stasis, and stagnation transforming into fire. Thus, only soothing liver, regulating qi, invigorating blood, stopping bleeding, and purging fire agents can be used. Otherwise, merely tonifying yin will cause further qi and blood congestion, making blood fail to return to vessels more severely. As for not using Sanqi, its nature is warm and assists fire; Ejiao nourishes yin and astringes, which is unfavorable for blood invigoration, hence not used.
5. Not examining deficiency/excess, not assessing disease location, merely applying hemostasis, resulting in continued bleeding
Patient Qian XX, Male, 43 years old.
Recurrent hemoptysis for 3 years. Diagnosed with pulmonary tuberculosis. Western medicine ineffective. Then sought Chinese medicine with blood-invigorating and hemostatic, cooling blood and hemostatic agents, still ineffective. Detailed examination showed hemoptysis presenting as blood in sputum, sometimes blood streaks, sometimes blood clots. Even without blood in sputum, only one or two mouthfuls were coughed up during coughing. Every cough produced hemoptysis. Cough sound was low and faint, sputum was scant, fatigue and weakness were present, poor appetite, pale complexion, and fine-weak pulse. Synthesizing pulse and symptoms: Pale complexion and fine-weak pulse indicate lung yin depletion disease. Treatment should nourish yin, moisten lungs, assisted by hemostasis. Prescription: Baihe (Lilii Bulbus) 30g, Shengdi (Rehmanniae Radix) 15g, Shudi (Rehmanniae Radix Preparata) 9g, Yuanshen (Scrophulariae Radix) 10g, Chuanbeimu (Fritillariae Cirrhosae Bulbus) 10g, Jiegeng (Platycodonis Radix) 6g, Gancao (Glycyrrhizae Radix et Rhizoma) 6g, Maimai Dong (Ophiopogonis Radix) 10g, Baishao (Paeoniae Radix Alba) 10g, Danggui (Angelicae Sinensis Radix) 10g, Baiji (Bletillae Rhizoma) 10g (ground, taken with decoction).
After 4 doses, hemoptysis stopped. Continuing for 4 doses, hemoptysis disappeared.
Physician asked: Baihe Gujin Tang is a famous formula for Feilao, its efficacy in treating cough cannot be ignored, but its hemostatic power being this obvious is unheard of. Please explain. Answer: Although Baihe Gujin Tang is a yin-nourishing and fire-descending formula, its fire-descending power is insufficient, while its yin-nourishing power is strong. It is especially effective for hemoptysis with mild yin deficiency-fire and fine-weak pulse. If combined with Baiji's astringent hemostasis, efficacy is even greater. Previous formulas failed because those using blood-invigorating hemostasis had no blood stasis to treat, causing blood to leave vessels more; those using heat-clearing and fire-purging hemostasis had little effect because this fire was not excess fire but deficiency fire, echoing the *Neijing* meaning that treating vigorous qi [incorrectly] yields no effect.
Tuberculous Peritonitis
1. Not distinguishing cold/heat, merely applying diuresis, long-term treatment ineffective
Patient Shi XX, Male, 45 years old.
Abdominal distension and pain for over 5 months. Diagnosed with tuberculous peritonitis. Western medicine for 3 months showed no significant effect. Chinese medicine regulating qi and promoting water metabolism for nearly 2 months also showed no obvious effect. Detailed examination revealed abdominal distension, ascites, whole abdomen pain, loose stools several times a day, doughy sensation upon palpation of abdominal wall, thin white tongue coating, and deep pulse. Synthesizing pulse and symptoms: Abdominal distension and pain lighter by day and heavier by night indicate cold-dampness; deep pulse indicates interior disease, qi stagnation, and blood stasis. Comprehensive analysis suggests cold-dampness stagnation transforming into heat. Plan: Warm yang, dispel dampness, clear heat, reduce distension. Prescription: Fuzi (Aconiti Lateralis Radix Preparata) 6g, Sheng Yimi (Coicis Semen) 60g, Baijiangcao (Patriniae Herba) 60g, Dongguazi (Benincasae Semen) 60g, Baijiezi (Sinapis Semen) 1g.
After 2 doses, abdominal distension and pain improved. Continuing for 20 doses, all symptoms disappeared, and the patient recovered.
Physician asked: Yiyi Fuzi Baijiang San is Zhang Zhongjing's formula for intestinal abscess, why is it effective for tuberculous peritonitis? Answer: Yiyi Fuzi Baijiang San is indeed for intestinal abscess, but it applies similarly to cases with rough skin and tense abdominal wall. Moreover, Coix seed not only drains pus but also dispels dampness; Aconite not only disperses nodules with pungent-hot nature but also revitalizes yang qi; Patrinia not only drains pus but also breaks stasis, promotes diuresis, and resolves toxicity. Adding Benincasa seed for regulating qi and resolving phlegm, and Mustard seed for pungent-warm unblocking yang, regulating qi, and breaking accumulation, enables treatment of tuberculous peritonitis. The reason previous qi-regulating and diuretic treatments failed was lack of blood invigoration, yang unblocking, and nodule dispersion.
2. Not examining cold/heat, merely applying detoxification and diuresis, disease hard to resolve
Patient Li XX, Male, 35 years old. Emaciation and fatigue, abdominal pain and distension for over 2 months. Diagnosed with tuberculous peritonitis. Anti-TB drugs and abdominal paracentesis reduced distension sometimes but did not solve the fundamental problem. Combined with Chinese medicine detoxification, diuresis, qi regulation, and blood invigoration, still no obvious effect. Examination revealed emaciation, fatigue, abdominal pain/distension, shifting dullness, doughy resistance upon palpation, white tongue coating, and deep, fine, wiry pulse. Further examination showed abdominal pain/distension worse upon exposure to cold or in the afternoon. Reasoning: Many physicians consider TB as yin deficiency, and bone/joint TB as yang deficiency. Although this is TB, there is no fine-rapid pulse or tidal fever/night sweats of yin deficiency, nor obvious qi/blood deficiency signs. Thus, deficiency is temporarily disregarded. There is obvious excess syndrome of abdominal distension and pain, so treatment should start with excess syndrome. Since pain/distension is worse in the afternoon (yin time, spleen's ruling time), cold-dampness must be involved. Long-standing disease enters collaterals, requiring assistance with blood invigoration and diuresis. Reconsidering Yiyi Fuzi Baijiang San: although designed for intestinal abscess, it contains Coix seed for dampness draining, Aconite for warming yang and unblocking meridians, and Patrinia for blood invigoration and diuresis, thus applicable. Previous formulas had diuresis but lacked warming yang; had blood invigoration but lacked dampness dispelling. Prescription: Fuzi (Aconiti Lateralis Radix Preparata) 10g, Sheng Yimi (Coicis Semen) 40g, Baijiangcao (Patriniae Herba) 40g. After 1 dose, abdominal pain/distension slightly decreased. Continuing for 20 doses, all symptoms disappeared, and recovery occurred.
Cutaneous Tuberculosis
Not examining disease location, not examining upper/lower, ascending when should descend, long-term treatment unsuccessful
Patient He XX, Female, 42 years old.
Purple-red nodules on feet, ankles, calves, knees, and thighs for 12 years. Diagnosed with cutaneous tuberculosis. Initially treated as erythema nodosum for 4 years without pathology biopsy, ineffective. Biopsy and tuberculin test confirmed cutaneous tuberculosis. Anti-TB drugs for 3 years showed no obvious effect. Sought Chinese medicine assistance. Initially blood-invigorating and detoxifying, then drying dampness and clearing heat, both ineffective. Detailed examination revealed 40 tuberculous nodules, purple and tough texture, painful upon pressure, and wiry-tight pulse. Synthesizing pulse and symptoms: Disease only in lower limbs, not upper, indicates damp-heat, similar to Dong Yuan's concept of gouty sores. Should ascend and clear, dispel dampness to drain heat. Formula base: Danggui Niantong Tang. Prescription: Danggui (Angelicae Sinensis Radix) 15g, Qianghuo (Notopterygii Rhizoma et Radix) 10g, Fangfeng (Saposhnikoviae Radix) 10g, Shengma ( Cimicifugae Rhizoma) 10g, Zhuling (Polyporus) 10g, Zexie (Alismatis Rhizoma) 10g, Yinchén (Artemisiae Scopariae Herba) 15g, Huangqin (Scutellariae Radix) 10g, Gegen (Puerariae Lobatae Radix) 15g, Cangzhu (Atractylodis Rhizoma) 10g, Baizhu (Atractylodis Macrocephalae Rhizoma) 10g, Kushen (Sophorae Flavescentis Radix) 15g, Zhimu (Anemarrhenae Rhizoma) 10g, Gancao (Glycyrrhizae Radix et Rhizoma) 6g.
After 4 doses, nodules decreased, pain reduced. Continuing for 10 doses, nodules disappeared by nearly half. Continuing for 30 doses, all nodules disappeared, and recovery occurred.
Physician asked: If similar to sores, why not use heat-clearing and detoxifying? Answer: Previous doctors used heat-clearing and detoxifying for a long time without effect. This disease has not only heat-toxin but also damp-heat sinking in the lower part. Thus, Notopteris unblocks joints, Saposhnikovia scatters retained dampness, Sophora, Scutellaria, Artemisia, and Anemarrhena drain damp-heat, Angelica harmonizes qi and blood, Cimicifuga and Pueraria assist yang to ascend clear turbidity, Polyporus and Alisma descend turbid dampness, Ginseng (implied in original context or general tonic role), Licorice, and Atractylodes tonify upright qi and secure middle.
Leptospirosis
Constrained by damp-heat, not detailing syndrome differentiation, treating cold as warm, disease not resolved
Patient Zhao XX, Male, 25 years old. Fever, aversion to cold, headache, body ache, calf pain unable to move for 3 days. Diagnosed with leptospirosis. Urgent penicillin etc. western medicine ineffective. Fever reached 39.2°C, sore throat, headache, body ache. Urgently prescribed Yinqiao San minus Niubangzi plus Sheng Yimi, Huashi, Xingren to clear heat, detoxify, dispel dampness, and release exterior. After 3 doses, symptoms did not decrease. Visited on the fifth day. Patient said: Dr. Li's medicine cured me in 1 dose. Inquiry revealed Dr. Li said: Seeing persistent high fever, I was anxious, so I gave Daqinglong Tang 1 dose. After 1 hour, slight sweating appeared; after 4 hours, temperature normalized; after 6 hours, all symptoms vanished. Asked how he thought of Daqinglong Tang. Answer: Didn't Teacher Zhu lecture on Daqinglong syndrome in *Shanghan Lun* yesterday? I saw his symptoms completely matched the Daqinglong Tang syndrome described in *Shanghan Lun*. Teacher once said regardless of wind-strike, cold-injury, or other diseases, if seeing "floating-tight pulse, fever, aversion to cold, body pain, no sweating, and restlessness," Daqinglong Tang can be used. Although this disease is called leptospirosis, and many doctors say treat as damp-warmth, this syndrome resembles Daqinglong syndrome, so I rashly used it. I said: Syndrome differentiation is the soul of treatment, cannot be violated. If constrained by one theory without differentiation, error is inevitable.
Amoebic Liver Abscess
Merely applying detoxification and heat-clearing, not differentiating organ deficiency/excess, attacking when should not attack, harmonizing when should not harmonize, disease hard to resolve
Patient Sheng XX, Male, 38 years old.
Persistent high fever for over 7 months. Initially right chest pain, dyspnea, cough, moist rales in lungs, diagnosed as pneumonia. Multiple antibiotics, sulfonamides for nearly 2 months ineffective. Later diffuse liver enlargement, abdominal distension, nausea, poor appetite, diagnosed as bacteremia. Added heavy Chinese medicine heat-clearing, detoxifying, clearing nutritive level, cooling blood for 4 months with no merit. Forced to transfer to another hospital for liver puncture: found massive amoeba protozoa, plus large amounts of Staphylococcus aureus, Escherichia coli, etc. Continued antibiotics plus anti-amoeba drugs. After half a month, symptoms did not improve. Careful observation: Temperature 39.7°C, alternating chills and fever, nausea wanting to vomit, abdominal distension/pain, liver enlarged to umbilicus, pain intolerable to touch, cough, shortness of breath, emaciation, mental fatigue, slightly loose stool, yellow-red urine, wiry-slippery-rapid pulse. Synthesizing pulse and symptoms: Alternating chills/fever, nausea, wiry pulse indicate Shaoyang syndrome; abdominal fullness/pain refusing pressure indicates Yangming excess syndrome. Liver abscess appearing with Shaoyang/Yangming, merely applying heat-clearing, detoxifying, and abscess-resolving cannot cure. Plan: Harmonize and purge downward, assist with heat-clearing and abscess-resolving. Prescription: Chaihu (Bupleuri Radix) 24g, Banxia (Pinelliae Rhizoma Preparatum) 10g, Huangqin (Scutellariae Radix) 10g, Zhishi (Aurantii Fructus Immaturus) 10g, Chishao (Paeoniae Radix Rubra) 10g, Dahuang (Rhei Radix et Rhizoma) 10g, Baijiezi (Sinapis Semen) 10g, Yinhua (Lonicerae Japonicae Flos) 15g.
After 1 dose, two bowel movements, chills/fever, nausea, abdominal fullness/pain rapidly decreased, temperature 38°C. Continuing for 4 doses, temperature normal, diet improved, spirit greatly increased, and recovery occurred.
Physician asked: Why did previous use of nearly 120g Yinhua, 30g Lianqiao, plus Huangqin, Huanglian, Baijiangcao, and large doses of antibiotics/anti-amoeba drugs fail, while changing to only 15g Yinhua cured it? Answer: Failure to harmonize due to pivot dysfunction, failure to purge downward due to fu-organ excess syndrome.
Kala-azar
Accumulation harboring heat, not knowing slow resolution, merely clearing heat, who can resolve?
Patient Hu XX, Male, 6 years old. For over half a month, gradually increasing abdominal distension, fever, epistaxis, spleen enlarged beyond umbilicus. Diagnosed with kala-azar. Antimony potassium tartrate ineffective. Combined with Chinese medicine heat-clearing and detoxifying agents, still ineffective. Temperature 39.5°C, abdominal distension, spleen enlarged beyond umbilicus, soft texture, liver not palpable, occasional epistaxis, rapid pulse. First given 3 doses of heat-clearing and detoxifying agent, ineffective. Consulted elder brother Mr. Zhu Qingfeng. He said: For accumulation not transforming, abdominal distension, fever, rapid pulse, blood-invigorating and accumulation-resolving, guiding stagnation and purging heat is suitable. Prescription: Dahuang (Rhei Radix et Rhizoma) 10g, Magnesium Sulfate 10g, ground into fine powder, taken orally 3 times daily, 2g each time, external paste Erlong Gao. After 2 days, fever subsided, appetite increased. After 10 days, abdominal distension and splenomegaly returned to normal, and recovery occurred. Elder brother said: For accumulation syndrome, not resolving accumulation but merely clearing heat is unacceptable.
Ascariasis
1. Ascaris should be expelled, not differentiating cold/heat, even if expelled, it remains