勾××，男，6岁。两年来，胃脘、脐腹经常疼痛，食纳减少，并时有蛔虫排出，虽多次服用驱虫药物，其效不著。邀某医治之。云：西药不如中药，应改用中药驱虫。处方：使君子10克，槟榔10克，榧子10克，胡黄连10克，大黄10克，苦楝皮10克。服药3剂，腹痛不但不减，反见加重，且未见虫体排出。数日后，再邀余治。察其舌苔薄白，腹满，按之有索条物起伏，脉弦紧涩。因云：脉弦紧涩者寒也。治宜健脾温中。处方：丁香3克，小茴香3克，肉桂3克。服药1剂，腹痛即解，食纳亦增。加吴茱萸1克。1剂后，便出蛔虫10条。后果愈。
2．蛔病驱蛔，不辨虚实，但予劫夺，久治不效
王××，男，成。
腹痛隐隐，时或剧痛20多天。医作蛔虫病论治，先用驱蛔灵治之而诸汪更甚，后又易医以中药乌梅汤加减治之，痛不减。再邀马振岳先生诊治。云：蛔病本当驱蛔，何驱蛔之法不效也?正虚也，正虚当补，不任克伐劫夺，故不愈也。余有妙方，可治之。急处：甘草10克，粳米20粒，蜂蜜30克。
服药4口其痛果缓，服药尽剂，痛止，便蛔十余条，愈。
余思之：乃仲景《金匮》法耳。仲景云：“蛔虫之为病，令人吐涎，心痛发作有时，毒药不止，甘草粉蜜汤主之。”甘草粉蜜汤者，由甘草、粉、蜜三药组成。甘草、蜂蜜两药历代医家均无异议，而粉者为何?铅粉乎?米粉乎?持铅粉之议者，云：铅粉有毒能驱虫，当为铅粉；持米粉之议者，云：当米粉，因其为毒药不止者用之。余读《金匮》久久不知何者为对，今睹此情始解也。自此之后，凡见毒药不止者，恒以甘草、大米、蜂蜜为方治之，均效如桴鼓。
3．脘痛吐蛔，驱蛔不效，脉弦而细知其寒实，温下始瘥
邢××，女，65岁。
胁下腹痛，阵阵而剧，时而吐蛔一个多月。医诊胆道蛔虫病。先用阿托品等止痛，后用驱蛔之剂不效，后又以中药乌梅丸加减止痛，使君、槟榔、苦楝驱蛔均不效。某医欲手术治之，然因患者拒绝而作罢。审其痛始从脐腹，继至胁下攻冲作痛，痛彻肩背、胁腰，脉弦细。思之：仲景曾云：“胁下偏痛，发热，此寒也，以温药下之，宜大黄附子汤。”前方之用乌梅汤不效者，乃未顾及其实耳。服药1剂，果愈。
绦虫病
不辨寒热，但予驱虫，虫体不出，反增呕吐
苏××，男，25岁。3年来，时时腹痛隐隐，疲乏无力，纳呆食减，体重日减，大便稀溏，时有面条样绦虫节片排出。医诊绦虫病。曾服槟榔、南瓜子方10剂，不效。某医云：虫也者，非用大剂泻下药不能排出，前用槟榔、南瓜子无效者，就在于此也。因拟槟榔60克，南瓜子60克，大黄15克，芒硝15克。药后不但虫体未见排出，反增腹痛难止，恶心欲吐，大便一日十余行。不得已，改邀余诊。察其除上症外，并见脉弦紧而数。综合脉证，思之：弦紧而数之脉者，寒邪凝滞也。宦温中散寒。处方：吴茱萸12克，槟榔60克，雷丸10克(研末，冲服)。服药1剂，腹痛稍减，再剂，排出虫体一条，放大镜观察头亦排出，但恶心呕吐仍未全止，乃予柴平汤加减为方，2剂，诸证消失，愈。
上呼吸道感染——感冒
1．以寒作热，不辨环境，徒用辛凉，久延病期
芦××，男，58岁。今年入夏以来，频繁感冒，医始以多种西药治之不效，继又改清中医治之，或丸，或冲剂，或胶囊剂，或辛凉解表汤剂，或养阴益气汤剂，前后治疗一个多月，并输液数次，均不效。余审其除经常喷嚏外，并见头、身酸痛，疲乏无力，微恶风寒，舌苔薄白，脉浮稍紧。综合脉证，思之：此似风寒表证。然风寒表证者多发生于冬季，此发生于暑夏热时，不相合也。勉予苏叶、防风、藿香等为剂予服。次日，其汽车司机开车来邀。余一进汽车顿感甚冷，且亦感全身有酸痛感。乃问：你开此车有多少时间?答曰：约有两月。再问：你开此车后有何感觉?答曰：不知怎么，今年人夏以来，我经常感冒，且服很多药都不顶事。余顿悟：芦氏之病就在于此。至芦家，诊后，乃云：伊之感冒乃空调所致也。除治疗用药外，并应控制空调之量，使室内，室外比较协调，汽车内外比较协调。并处辛温解表之九味羌活汤1剂。果愈。
芦云：医生不但治病，而且应考虑环境，妙也，高也。
2．阳虚表寒，当予补阳益气，反以解表祛邪
李××，男，45岁。
从战争年代始，即发现脘腹冷痛，医诊慢性胃炎、十二指肠球部溃疡、慢性肠炎，虽经中、西药物治疗多年，仍然反复发作。近5年又出现反复感冒。尤其是近3年来，几乎每个月发作一次。每次发病时，除鼻塞喷嚏外，并见头痛，项脊强，恶寒发热，无汗。此时若不治疗即常常拖延一月不愈，若治疗即引起胃痛、腹痛，不能饮食。此次发病已近一个月，仍然头痛，项脊强痛，恶寒发热，喷嚏鼻塞，脘腹冷痛，不能饮食。细察其证，除上述者外，并见疲乏无力，舌苔薄白，脉沉细无力，指趾厥冷。综合脉证，思之：仲景《伤寒论》云：“病人有寒，复发汗，胃中冷，必吐蛔。”“脉浮紧者，法当身疼痛，宜以汗解之。假令尺中迟者，不可发汗，何以知然?以荣气不足，血少故也。”“伤寒二三日，心中悸而烦者，小建中汤主之。”《医宗金鉴》云：“中气素虚，虽有表证亦不可汗之”。上证之所以以解表之法不愈者乃未补其中焦耳。又思本证除胃脘冷痛之外，并见手足厥冷，脉沉细无力之阳气俱损状，若但健中则不可，必脾肾阳气俱补方可。再造散者，既补阳又益气，且微有解表之功，正如童养学《伤寒六书纂要辨疑》所说：“再造散，治头痛发热，项脊强，恶寒无汗，用发汗药二三剂，汗不出者，庸医不论时令，遂以麻黄重药及火劫取汗，误死者，多不知阳虚不能作汗，故有此症，名日无阳症。”因拟再造散加减：黄芪10克，党参10克，桂枝10克，附子10克，细辛1克，甘草3克，生姜3片，防风2克，川芎6克，羌活2克，白芍10克。
服药3剂，诸证均解大半，继服2剂，诸证消失，其后每月服药3剂，共服9剂，愈。
3．三焦郁热，反用补益，火邪烁金，卫气不固
苏××，女，30岁。
3～4年来，感冒反复发作。医诊卫气不固，久用玉屏风散，补中益气丸治之。不但不效，反见加重。开始每月一次，以后逐渐变为每周一次。特别是近一个月来，几乎每天都处于感冒状态之中。细审其证，除一般的感冒症状外，并时时感到口鼻干燥，口苦心烦，头晕胀痛，便干尿赤，脉弦而滑。因思脉证显属三焦郁热，何不用清泻三焦之剂治之。因处：黄连上清丸，一日2次，一次1丸。
服药一月，诸证果愈。
一友问：反复感冒当属气虚，气虚者当益气固表，此历代医家之常用法耳，何此患者用之不效?而你用黄连上清反愈也?答曰：反复感冒为卫气虚乃颠扑不破的真理，但卫气之虚有肺气不足所致者，有荣卫失调所致者，有火邪凌金所致者，此证之虚乃三焦郁火烁金而致，故泻其火而愈也。
4．暑热伤气，气阴俱伤，反用清热，其病不愈
苏××，男，30岁。
一个多月以来，感冒一直不愈。先用抗生素、康泰克、感冒通等不见好转，后又用中药清热解毒、疏风清热等仍不效。细审其证，除发热头晕，疲乏无力外，并见口干，纳呆，多汗，喷嚏，舌苔薄白，脉弦大紧数等证。且病发于夏季暑令之时。因云：此乃暑热外客，气阴俱伤之候。拟用清暑益气，养阴清热。处方：党参10克，甘草6克，黄芪15克，当归10克，麦冬10克，五味子10克，青皮10克，陈皮10克，神曲10克，黄柏jO克，葛根15克，苍术15克，白术10克，升麻10克，泽泻10克。
服药4剂，愈。某医问：《温病条辨》吴鞠通列暑温上焦病有五方。其一为人参白虎，其二为东垣清暑益气，其三为新加香薷饮，其四为生脉散，其五为清络饮。何先生独选东垣清暑益气?答曰：人参白虎者尤善治口渴甚而右脉洪大而数者，因其热甚津气两伤也。生脉散者主用于脉散大汗多，喘喝欲脱者。新加香薷饮者主用于汗不出者。清络饮者主用于但有余邪未尽者。本症既有汗，又见脉弦大紧数之表寒证，乃表里合邪，正虚邪实之证，故宜用东垣清暑益气汤。又问：何不用孟英清暑益气汤?答曰：孟英清暑益气者虽为暑伤津气者设，然其总以阴虚有热为主，而此证脉却见弦大紧数，弦大紧数之脉者气虚多于阴虚，且夹表寒也，故只宜东垣清暑益气汤。再问：何用清热解毒，疏风清热而热不减?答曰：气阴俱虚也。虚者当补，正虚为主而邪气亦在者，尤当重补，不补则邪不除也。
5.但知解表，不审病机，不审标本，徒施药饵
黎××，女，38岁。
七八年来，每次月经将至前一二天即出现头痛身痛，鼻塞流涕，频繁的喷嚏，或见轻微的咳嗽，月经过后两天以上症状自然消失。前后曾用多种西药和中药清热解表、疏风散寒、益气固表等剂进行治疗，但一直不效。特别是近两年来，以上症状更加严重。此次月经来潮前3天即感头晕头痛，鼻塞喷嚏，眼痒流泪，鼻流清涕，全身酸痛，月经来潮之后以上症状更加严重，应用感冒清，感冒冲剂。扑尔敏，去痛片5天，疏风解表剂中药两帖不见好转。细审其证，除上述者外，并见胸满心烦，手心热，舌苔薄白，脉弦细。反复思考：月经者，冲脉所主，冲脉者隶属于肝；肝者，将军之官也；将军之官者，调营卫，御外邪者也。肝郁血虚，郁而化火，则卫气不固，故反复感冒。前方之疏风散寒，益气解表，清热解表者，均非治其病之所在也。宜改予疏肝、养阴、解郁、清热。处方：柴胡10克，当归1O克，白芍10克，白术10克，茯苓10克，甘草IO克，干姜3克，生姜3片，丹皮10克，栀子10克。
服药1剂，诸证好转，继服2剂，诸证尽失。为彻底痊愈汁，每次月经来潮以前，均服药4剂。服药3个周期，共服药12剂，果愈。
6．气郁不畅，卫气不行，不予理气，反予解表，伤卫助郁，病不得解
葛××，男，30岁。
感冒2个多月，先用西药治疗1个多月不效，后又用中药疏风散寒、疏风清热、益气解表治疗20余天仍然不见改善。审其证见头晕头痛，全身酸痛，鼻塞流涕，不断喷嚏，眼微痒，轻微咳嗽，胸胁苦满，食欲不振，舌苔薄白，脉沉微弦。再询其发病原因，云：生气之后，突患感冒，其后即反复治疗，然至今不愈。综合脉证，反复思考：《素问·六节脏象论》云：“凡十一脏取决于胆也。”李杲云：“胆者，少阳春生之气，春气升则万化安，故胆气春升，则余脏从之。”肝胆相表里，肝胆郁则卫气不行，诸脏随之而郁，今其病始因气郁而复受外邪，治当解郁疏表，而反与解表以伤卫，补益以壅气，故其病久久不得而解。法宜调肝理气，佐以解表，其病自解。处方：党参10克，苏叶10克，陈皮10克，枳壳10克，前胡10克，半夏10克，葛根15克，甘草10克，木香6克，桔梗10克，茯苓10克。服药3剂，其病果愈。
7．不知春秋，不知阴阳，不知和调，但予祛邪扶正，其病不愈
荀××，女，40岁。
七八年来，每到春、秋二季即反复感冒，轻时五六天一次，重时二三天即一次。每次发病，虽然立即服药亦得七八天才能缓解，但刚缓解几天即又发病。最近两年多以来，虽然反复采用疏风解表，益气固表，以及胎盘球蛋白等方法治疗，亦无明显改变。细审其证见头晕乏力，时时喷嚏，口苦口干，纳呆食减，心烦易怒，舌苔薄白，脉弦缓。综合脉证，思之：春、秋者，阴阳气交之令也；少阳者，胆也，胆气春升则万化均安，今少阳枢机不利，肝胆气郁，卫气不行，故反复感冒也。前用诸方，或补气以壅邪，或解表以伤正，不宜也。仲景于少阳一篇中，论少阳病有三禁，一禁汗，二禁吐，三禁下。即论其枢机不利者只可和，而不可汗、下也。今处以和解少阳，调营卫之法。处方：柴胡10克，半夏10克，黄芩10克，党参10克，炙甘草10克，生姜3片，大枣7个，桂枝10克，白芍10克。
服药3剂，诸证消失。其后每至春、秋即服药3剂，共服3年，果愈。
8．伏阴伏阳不知，但知解表益气，徒施药铒，终难取效
甄××，男，26岁。
五六年来，每至夏季即反复感冒。先用胎盘球蛋白治疗不效，后以中药玉屏风散、补中益气汤近百余剂无功。审其证见头晕乏力，喷嚏流涕，眼时痒，舌苔白，脉虚弦。综合脉证，思之：夏季者阴盛于里，阳盛于表，阳盛于外者，则气阴反伤，卫气不固，此东垣列补气养阴以治暑邪之意也。今之但用补气而不予养阴，则阴液更伤，卫气不固，故予玉屏风、补中益气不得痊愈也。处方：党参10克，甘草6克，黄芪15克，当归6克，麦冬10克，五味子10克，青皮10克，陈皮10克，神曲10克，黄柏10克，葛根15克，苍术10克，白术10克，升麻10克，泽泻10克。
服药3剂，诸证消失。次年夏季诸证又复出现，但比较轻微，服3剂又愈。其后，又连续两年，在未病前服药4剂，果愈。
9．不求治本，但求治标，终归不愈
栗××，男，30岁。
【背景信息】
书名：中医临证经验与方法 章节：正文(30/94) 类别：方剂
1. 蛔虫病驱虫，不辨虚实，一味攻伐，久治不效
患者勾某某，男性，6岁。两年来，胃脘部及脐腹部经常疼痛，食欲减退，并时常排出蛔虫，虽然多次服用驱虫药物，但效果不明显。邀请某医生诊治。该医生说：西药不如中药，应当改用中药驱虫。处方：使君子10克，槟榔10克，榧子10克，胡黄连10克，大黄10克，苦楝皮10克。服药3剂后，腹痛不仅没有减轻，反而加重，且未见虫体排出。数日后，再次邀请我诊治。观察其舌苔薄白，腹部胀满，按压时有索条状物起伏，脉象弦紧涩。因此我说：脉象弦紧涩属于寒证。治疗应当健脾温中。处方：丁香3克，小茴香3克，肉桂3克。服药1剂后，腹痛立即缓解，食欲也增加。加入吴茱萸1克。再服1剂后，排出蛔虫10条。最终痊愈。
2. 蛔虫病驱虫，不辨虚实，一味攻伐，久治不效
患者王某某，男性，成年。
腹痛隐隐，有时剧烈疼痛20多天。医生诊断为蛔虫病进行治疗，先用驱蛔灵治疗，结果诸症更加严重；后又换医生用中药乌梅汤加减治疗，疼痛未减。再次邀请马振岳先生诊治。先生说：蛔虫病本当驱虫，为何驱虫的方法无效呢？这是正气虚弱。正气虚弱应当补益，不能耐受攻伐劫夺，所以不愈。我有妙方，可以治疗它。紧急处方：甘草10克，粳米20粒，蜂蜜30克。
服药4天，疼痛果然缓解，服药尽剂后，疼痛停止，排出蛔虫十余条，痊愈。
我思考这个问题：这是张仲景《金匮要略》中的方法啊。仲景说：“蛔虫之为病，令人吐涎，心痛发作有时，毒药不止，甘草粉蜜汤主之。”甘草粉蜜汤，由甘草、粉、蜜三味药组成。甘草、蜂蜜两味药历代医家都没有异议，而“粉”是什么？是铅粉吗？还是米粉呢？主张是铅粉的人说：铅粉有毒能驱虫，应当是铅粉；主张是米粉的人说：应当是米粉，因为它是用于“毒药不止”的情况。我读《金匮要略》很久不知道哪个是对的，今天看到这种情况才理解。从此以后，凡是见到用毒药驱虫无效的，恒常使用甘草、大米、蜂蜜为方治疗，都效如桴鼓（像敲鼓一样迅速有效）。
3. 脘痛吐蛔，驱虫无效，脉弦而细知其寒实，温下始瘥
患者邢某某，女性，65岁。
胁下腹痛，阵阵剧痛，时而吐出蛔虫一个多月。医生诊断为胆道蛔虫病。先用阿托品等止痛，后用驱虫药剂无效，后又用中药乌梅丸加减止痛，使君子、槟榔、苦楝驱虫均无效。某医生想手术治疗，但因患者拒绝而作罢。审查其疼痛开始从脐腹，继而向胁下攻冲作痛，疼痛放射至肩背、胁腰，脉象弦细。思考：仲景曾说：“胁下偏痛，发热，此寒也，以温药下之，宜大黄附子汤。”前方使用乌梅汤无效的原因，是没有顾及其实邪的一面。服药1剂，果然痊愈。
绦虫病
不辨寒热，一味驱虫，虫体不出，反增呕吐
患者苏某某，男性，25岁。3年来，时时腹痛隐隐，疲乏无力，食欲不振，体重日渐减轻，大便稀溏，时有面条样绦虫节片排出。医生诊断为绦虫病。曾服用槟榔、南瓜子方10剂，无效。某医生说：虫子这种东西，非用大剂量泻下药不能排出，前用槟榔、南瓜子无效的原因就在于此。于是拟定槟榔60克，南瓜子60克，大黄15克，芒硝15克。服药后不但虫体未见排出，反而增加腹痛难止，恶心欲吐，大便一日十余次。不得已，改邀我诊治。观察除上述症状外，并见脉象弦紧而数。综合脉证，思考：弦紧而数的脉象，是寒邪凝滞的表现。应当温中散寒。处方：吴茱萸12克，槟榔60克，雷丸10克（研末，冲服）。服药1剂，腹痛稍减，再服1剂，排出虫体一条，放大镜观察头也排出了，但恶心呕吐仍未完全停止，于是给予柴平汤加减为方，2剂后，诸证消失，痊愈。
上呼吸道感染——感冒
1. 将寒证当作热证，不辨环境因素，徒用辛凉解表，拖延病程
患者芦某某，男性，58岁。今年入夏以来，频繁感冒，医生起初用多种西药治疗无效，接着又改为中医治疗，或丸剂，或冲剂，或胶囊剂，或辛凉解表汤剂，或养阴益气汤剂，前后治疗一个多月，并输液数次，均无效。我审查其除经常打喷嚏外，并见头、身酸痛，疲乏无力，微恶风寒，舌苔薄白，脉浮稍紧。综合脉证，思考：这似乎是风寒表证。然而风寒表证多发生于冬季，此发生于暑夏热时，不相符合。勉强给予苏叶、防风、藿香等为剂予服。次日，其汽车司机开车来邀请。我一进汽车顿感甚冷，且亦感全身有酸痛感。于是问：你开这辆车有多少时间？回答说：约有两个月。再问：你开这辆车后有何感觉？回答说：不知怎么，今年入夏以来，我经常感冒，且服很多药都不顶事。我突然领悟：芦氏的病就在于此。到芦家，诊后，于是说：他的感冒乃空调所致。除了治疗用药外，还应控制空调的量，使室内、室外比较协调，汽车内外比较协调。并处辛温解表的九味羌活汤1剂。果然痊愈。
芦云：医生不但治病，而且应考虑环境，妙啊，高明啊。
2. 阳虚表寒，应当补阳益气，反而以解表祛邪
患者李某某，男性，45岁。
从战争年代起，就发现胃脘腹部冷痛，医生诊断为慢性胃炎、十二指肠球部溃疡、慢性肠炎，虽经中、西药物治疗多年，仍然反复发作。近5年又出现反复感冒。尤其是近3年来，几乎每个月发作一次。每次发病时，除鼻塞喷嚏外，并见头痛，项脊强直，恶寒发热，无汗。此时若不治疗常常拖延一月不愈，若治疗则引起胃痛、腹痛，不能饮食。此次发病已近一个月，仍然头痛，项脊强痛，恶寒发热，喷嚏鼻塞，胃脘腹部冷痛，不能饮食。仔细察其证候，除上述者外，并见疲乏无力，舌苔薄白，脉沉细无力，指趾厥冷。综合脉证，思考：仲景《伤寒论》说：“病人有寒，复发汗，胃中冷，必吐蛔。”“脉浮紧者，法当身疼痛，宜以汗解之。假令尺中迟者，不可发汗，何以知然？以营气不足，血少故也。”“伤寒二三日，心中悸而烦者，小建中汤主之。”《医宗金鉴》说：“中气素虚，虽有表证亦不可汗之”。上证之所以用解表之法不愈，是因为没有补其中焦。又思考本证除胃脘冷痛之外，并见手足厥冷，脉沉细无力之阳气俱损状，若只健中则不可，必须脾肾阳气俱补方可。再造散，既补阳又益气，且微有解表之功，正如童养学《伤寒六书纂要辨疑》所说：“再造散，治头痛发热，项脊强，恶寒无汗，用发汗药二三剂，汗不出者，庸医不论时令，遂以麻黄重药及火劫取汗，误死者，多不知阳虚不能作汗，故有此症，名曰无阳症。”于是拟定再造散加减：黄芪10克，党参10克，桂枝10克，附子10克，细辛1克，甘草3克，生姜3片，防风2克，川芎6克，羌活2克，白芍10克。
服药3剂，诸证均解大半，继服2剂，诸证消失，其后每月服药3剂，共服9剂，痊愈。
3. 三焦郁热，反而用补益，火邪灼伤肺金，卫气不固
患者苏某某，女性，30岁。
3～4年来，感冒反复发作。医生诊断为卫气不固，久用玉屏风散，补中益气丸治疗。不但不效，反而加重。开始每月一次，以后逐渐变为每周一次。特别是近一个月来，几乎每天都处于感冒状态之中。仔细审查其证候，除一般的感冒症状外，并时时感到口鼻干燥，口苦心烦，头晕胀痛，便干尿赤，脉象弦而滑。因而思考脉证显属三焦郁热，何不用清泻三焦的药剂治疗。于是处方：黄连上清丸，一日2次，一次1丸。
服药一月，诸证果然痊愈。
一朋友问：反复感冒当属气虚，气虚者当益气固表，这是历代医家的常用法耳，为何此患者用之不效？而你用黄连上清反愈也？回答说：反复感冒为卫气虚乃是颠扑不破的真理，但卫气之虚有肺气不足所致者，有营卫失调所致者，有火邪凌金所致者，此证之虚乃三焦郁火灼伤肺金而致，故泻其火而愈也。
4. 暑热伤气，气阴俱伤，反而用清热，其病不愈
患者苏某某，男性，30岁。
一个多月以来，感冒一直不愈。先用抗生素、康泰克、感冒通等不见好转，后又用中药清热解毒、疏风清热等仍无效。仔细审查其证候，除发热头晕，疲乏无力外，并见口干，纳呆，多汗，喷嚏，舌苔薄白，脉弦大紧数等证。且病发于夏季暑令之时。于是说：此乃暑热外客，气阴俱伤之候。拟用清暑益气，养阴清热。处方：党参10克，甘草6克，黄芪15克，当归10克，麦冬10克，五味子10克，青皮10克，陈皮10克，神曲10克，黄柏10克，葛根15克，苍术15克，白术10克，升麻10克，泽泻10克。
服药4剂，痊愈。某医问：《温病条辨》吴鞠通列暑温上焦病有五方。其一为人参白虎汤，其二为东垣清暑益气汤，其三为新加香薷饮，其四为生脉散，其五为清络饮。为何先生独选东垣清暑益气汤？回答说：人参白虎汤尤其善于治疗口渴甚而右脉洪大而数者，因其热甚津气两伤也。生脉散主要用于脉散大汗多，喘喝欲脱者。新加香薷饮主要用于汗不出者。清络饮主要用于但有余邪未尽者。本症既有汗，又见脉弦大紧数之表寒证，乃表里合邪，正虚邪实之证，故宜用东垣清暑益气汤。又问：为何不用孟英清暑益气汤？回答说：孟英清暑益气汤虽是为暑伤津气者设，然其总以阴虚有热为主，而此证脉却见弦大紧数，弦大紧数之脉者气虚多于阴虚，且夹表寒也，故只宜东垣清暑益气汤。再问：为何用清热解毒，疏风清热而热不减？回答说：气阴俱虚也。虚者当补，正虚为主而邪气亦在者，尤当重补，不补则邪不除也。
5. 但知解表，不审病机，不审标本，徒施药饵
患者黎某某，女性，38岁。
七八年来，每次月经将至前一二天即出现头痛身痛，鼻塞流涕，频繁的喷嚏，或见轻微的咳嗽，月经过后两天以上症状自然消失。前后曾用多种西药和中药清热解表、疏风散寒、益气固表等剂进行治疗，但一直无效。特别是近两年来，以上症状更加严重。此次月经来潮前3天即感头晕头痛，鼻塞喷嚏，眼痒流泪，鼻流清涕，全身酸痛，月经来潮之后以上症状更加严重，应用感冒清，感冒冲剂，扑尔敏，去痛片5天，疏风解表剂中药两帖不见好转。仔细审查其证候，除上述者外，并见胸满心烦，手心热，舌苔薄白，脉象弦细。反复思考：月经者，冲脉所主，冲脉者隶属于肝；肝者，将军之官也；将军之官者，调营卫，御外邪者也。肝郁血虚，郁而化火，则卫气不固，故反复感冒。前方之疏风散寒，益气解表，清热解表者，均非治其病之所在也。宜改予疏肝、养阴、解郁、清热。处方：柴胡10克，当归10克，白芍10克，白术10克，茯苓10克，甘草10克，干姜3克，生姜3片，丹皮10克，栀子10克。
服药1剂，诸证好转，继服2剂，诸证尽失。为彻底痊愈计，每次月经来潮以前，均服药4剂。服药3个周期，共服药12剂，果然痊愈。
6. 气郁不畅，卫气不行，不予理气，反而解表，伤卫助郁，病不得解
患者葛某某，男性，30岁。
感冒2个多月，先用西药治疗1个多月无效，后又用中药疏风散寒、疏风清热、益气解表治疗20余天仍然不见改善。审查其证见头晕头痛，全身酸痛，鼻塞流涕，不断喷嚏，眼微痒，轻微咳嗽，胸胁苦满，食欲不振，舌苔薄白，脉象沉微弦。再询问其发病原因，说：生气之后，突患感冒，其后即反复治疗，然至今不愈。综合脉证，反复思考：《素问·六节脏象论》说：“凡十一脏取决于胆也。”李杲说：“胆者，少阳春生之气，春气升则万化安，故胆气春升，则余脏从之。”肝胆相表里，肝胆郁则卫气不行，诸脏随之而郁，今其病始因气郁而复受外邪，治当解郁疏表，而反与解表以伤卫，补益以壅气，故其病久久不得而解。法宜调肝理气，佐以解表，其病自解。处方：党参10克，苏叶10克，陈皮10克，枳壳10克，前胡10克，半夏10克，葛根15克，甘草10克，木香6克，桔梗10克，茯苓10克。服药3剂，其病果然痊愈。
7. 不知春秋，不知阴阳，不知和调，但予祛邪扶正，其病不愈
患者荀某某，女性，40岁。
七八年来，每到春、秋二季即反复感冒，轻时五六天一次，重时二三天即一次。每次发病，虽然立即服药亦得七八天才能缓解，但刚缓解几天即又发病。最近两年多以来，虽然反复采用疏风解表，益气固表，以及胎盘球蛋白等方法治疗，亦无明显改变。仔细审查其证见头晕乏力，时时喷嚏，口苦口干，纳呆食减，心烦易怒，舌苔薄白，脉象弦缓。综合脉证，思考：春、秋者，阴阳气交之令也；少阳者，胆也，胆气春升则万化均安，今少阳枢机不利，肝胆气郁，卫气不行，故反复感冒也。前用诸方，或补气以壅邪，或解表以伤正，不宜也。仲景于少阳一篇中，论少阳病有三禁，一禁汗，二禁吐，三禁下。即论其枢机不利者只可和，而不可汗、下也。今处以和解少阳，调营卫之法。处方：柴胡10克，半夏10克，黄芩10克，党参10克，炙甘草10克，生姜3片，大枣7个，桂枝10克，白芍10克。
服药3剂，诸证消失。其后每至春、秋即服药3剂，共服3年，果然痊愈。
8. 伏阴伏阳不知，但知解表益气，徒施药饵，终难取效
患者甄某某，男性，26岁。
五六年来，每至夏季即反复感冒。先用胎盘球蛋白治疗无效，后以中药玉屏风散、补中益气汤近百余剂无功。审查其证见头晕乏力，喷嚏流涕，眼时痒，舌苔白，脉象虚弦。综合脉证，思考：夏季者阴盛于里，阳盛于表，阳盛于外者，则气阴反伤，卫气不固，此东垣列补气养阴以治暑邪之意也。今之但用补气而不予养阴，则阴液更伤，卫气不固，故予玉屏风、补中益气不得痊愈也。处方：党参10克，甘草6克，黄芪15克，当归6克，麦冬10克，五味子10克，青皮10克，陈皮10克，神曲10克，黄柏10克，葛根15克，苍术10克，白术10克，升麻10克，泽泻10克。
服药3剂，诸证消失。次年夏季诸证又复出现，但比较轻微，服3剂又愈。其后，又连续两年，在未病前服药4剂，果然痊愈。
[Background Information]
Book: Clinical Experience and Methods of Traditional Chinese Medicine Chapter: Main Text (30/94) Category: Formulas
1. Ascariasis: Dredging worms without distinguishing deficiency and excess, using only purgation leads to prolonged ineffectiveness.
Patient Gou XX, male, 6 years old. For two years, he has frequently suffered from pain in the epigastrium and periumbilical abdomen, reduced appetite, and occasionally expels roundworms. Although he has taken deworming drugs multiple times, the effect is not significant. A certain doctor was invited for treatment. He said: Western medicine is inferior to traditional Chinese medicine; deworming should be changed to traditional Chinese medicine. Prescription: *Shijunzi* (Quisqualis Fructus) 10g, *Binglang* (Arecae Semen) 10g, *Feizi* (Torreya Seed) 10g, *Huhuanglian* (Coptidis Rhizoma var. Chinense) 10g, *Dahuang* (Rhei Radix et Rhizoma) 10g, *Kulianpi* (Meliae Cortex) 10g. After taking 3 doses, abdominal pain not only did not decrease but worsened, and no worm bodies were expelled. Several days later, I was invited again. Observing his thin white tongue coating, abdominal fullness, and palpable cord-like structures rising and falling upon pressure, with a wiry-tight-choppy pulse, I said: A wiry-tight-choppy pulse indicates cold. The treatment should invigorate the spleen and warm the middle. Prescription: *Dingxiang* (Caryophylli Flos) 3g, *Xiaohuixiang* (Foeniculi Fructus) 3g, *Rougui* (Cinnamomi Cortex) 3g. After one dose, abdominal pain resolved immediately, and appetite increased. Add *Wuzhuyu* (Evodiae Fructus) 1g. After another dose, 10 roundworms were expelled. Eventually cured.
2. Ascariasis: Dredging worms without distinguishing deficiency and excess, using only purgation leads to prolonged ineffectiveness.
Patient Wang XX, male, adult.
Dull abdominal pain, sometimes severe, for over 20 days. The physician diagnosed ascariasis and treated accordingly. First, *Piperazine* was used, resulting in worsening symptoms. Then, another physician prescribed modified *Wumei Wan* (Mume Pill), but pain persisted. Mr. Ma Zhenyue was invited. He said: Ascariasis should be treated by dredging worms, why is this method ineffective? It is due to righteous qi deficiency. Righteous qi deficiency requires tonification; it cannot withstand harsh purgation or depletion, hence the lack of cure. I have an excellent formula. Emergency prescription: *Gancao* (Glycyrrhizae Radix et Rhizoma) 10g, *Jingmi* (Oryza Sativa Grain) 20 grains, *Fengmi* (Mel) 30g.
After 4 days of medication, pain indeed alleviated. Upon finishing the dose, pain ceased, and over ten roundworms were expelled. Cured.
I pondered: This is the method from Zhang Zhongjing's *Jin Gui Yao Lue*. Zhongjing stated: "In diseases caused by roundworms, patients salivate excessively, experience heart pain that occurs intermittently, and when toxic drugs fail to stop it, *Gancao Fenmi Tang* (Licorice, Powder, and Honey Decoction) should be administered." *Gancao Fenmi Tang* consists of Gancao, Fen (Powder), and Mi (Honey). There is no disagreement among physicians through the ages regarding Gancao and Honey, but what is "Fen"? Is it *Qianfen* (Lead Carbonate)? Or *Mifen* (Rice Flour)? Those advocating Lead Carbonate argue: Lead Carbonate is toxic and can expel worms, so it must be Lead Carbonate. Those advocating Rice Flour argue: It must be Rice Flour, as it is used when "toxic drugs fail." I read *Jin Gui* for a long time without knowing which was correct; seeing this case clarified it. Since then, whenever I encounter cases where toxic drugs fail to expel worms, I consistently use Gancao, rice, and honey, achieving results as swiftly as striking a drum.
3. Epigastric pain with vomiting of worms, deworming ineffective, wiry-thin pulse indicates cold-excess, warming and purging brings recovery.
Patient Xing XX, female, 65 years old.
Paroxysmal severe pain in the hypochondrium and abdomen, occasionally vomiting roundworms for over a month. Diagnosed with biliary ascariasis. First, Atropine was used for pain relief, followed by deworming agents which failed. Then, modified *Wumei Wan* was used for pain relief, and deworming with *Shijunzi*, *Binglang*, and *Kulianpi* also failed. A physician proposed surgery, but the patient refused. Reviewing the pain starting in the periumbilical area and radiating to the hypochondrium, extending to the shoulder, back, and waist, with a wiry-thin pulse. Thinking: Zhongjing once said: "Pain on one side of the hypochondrium, with fever, indicates cold; it should be treated with warming purgatives, such as *Dahuang Fuzi Tang*." The previous failure of *Wumei Wan* was due to neglecting the excess pathogen. One dose resulted in a cure.
Taeniasis
Not distinguishing cold and heat, merely attempting deworming fails to expel the parasite and increases vomiting.
Patient Su XX, male, 25 years old. For 3 years, intermittent dull abdominal pain, fatigue, poor appetite, weight loss, loose stools, and occasional passage of noodle-like tapeworm segments. Diagnosed with taeniasis. Took 10 doses of *Binglang* and *Nanguazi* (Pumpkin Seed) with no effect. A physician stated: Parasites require large doses of purgatives to be expelled; the previous failure of *Binglang* and *Nanguazi* was due to insufficient dosage. Thus, *Binglang* 60g, *Nanguazi* 60g, *Dahuang* 15g, and *Mangxiao* (Natrii Sulfas) 15g were prescribed. After medication, not only was the parasite not expelled, but severe unrelenting abdominal pain, nausea, and frequent diarrhea (over 10 times/day) occurred. Reluctantly, I was consulted. Besides the above symptoms, the pulse was wiry-tight-rapid. Synthesizing pulse and symptoms: A wiry-tight-rapid pulse indicates stagnation of cold pathogens. Warming the middle and dispersing cold is indicated. Prescription: *Wuzhuyu* 12g, *Binglang* 60g, *Leiwang* (Omphaliae Spora) 10g (powdered, taken with water). After one dose, abdominal pain slightly decreased. After another dose, one tapeworm was expelled, and under magnification, the head was also present. However, nausea and vomiting persisted. Therefore, modified *Chai Ping Tang* (Bupleurum and Pinellia Decoction) was prescribed. After 2 doses, all symptoms disappeared. Cured.
Upper Respiratory Tract Infection — Common Cold
1. Mistaking cold for heat, ignoring environmental factors, using only acrid-cool herbs prolongs the illness.
Patient Lu XX, male, 58 years old. Since entering summer this year, he has had frequent colds. Initially treated with various Western medicines without effect, then switched to TCM treatments including pills, granules, capsules, acrid-cool exterior-resolving decoctions, and yin-nourishing qi-tonifying decoctions. Treatment lasted over a month with several IV infusions, all ineffective. Examining him, besides frequent sneezing, he had headache, body ache, fatigue, slight aversion to wind and cold, thin white tongue coating, and floating-slightly-tight pulse. Synthesizing pulse and symptoms: This resembles a wind-cold exterior syndrome. However, wind-cold exterior syndromes typically occur in winter, not in hot summer. Reluctantly, I prescribed *Suye* (Perillae Folium), *Fangfeng* (Saposhnikoviae Radix), and *Huoxiang* (Agastaches Herba). The next day, his taxi driver came to invite me. Upon entering the car, I felt very cold and experienced body aches. I asked: How long have you been driving this car? Answer: About two months. I asked again: How do you feel after driving? Answer: I don't know, since this summer, I've had frequent colds, and many medicines haven't worked. I suddenly realized: Lu's illness lies here. Visiting Lu's home, after diagnosis, I said: His cold is caused by air conditioning. Besides medication, he must control the amount of air conditioning to coordinate indoor/outdoor and car interior/exterior temperatures. Prescribed one dose of *Jiuwei Qianghuo Tang* (Nine-Ingredient Notopterygium Decoction) for acrid-warm exterior resolution. Indeed cured.
Lu said: The doctor not only treats disease but considers the environment. Wonderful, profound!
2. Yang deficiency with exterior cold should be treated by tonifying yang and qi; instead, exterior-resolving methods were used.
Patient Li XX, male, 45 years old.
Since the war era, he has noticed cold pain in the epigastrium and abdomen. Diagnosed with chronic gastritis, duodenal bulb ulcer, and chronic enteritis. Despite years of TCM and Western medicine treatment, relapses persist. For the past 5 years, recurrent colds have appeared. Especially in the last 3 years, almost monthly attacks. Each attack involves nasal congestion, sneezing, headache, stiff neck and spine, aversion to cold, fever, and anhidrosis. Without treatment, it often drags on for a month; with treatment, it triggers stomach/abdominal pain and inability to eat. This episode has lasted nearly a month with persistent headache, stiff neck/spine, aversion to cold, fever, sneezing, nasal congestion, epigastric/abdominal cold pain, and inability to eat. Careful examination reveals, besides the above, fatigue, thin white tongue coating, deep-thin-weak pulse, and cold fingers/toes. Synthesizing pulse and symptoms: Zhongjing's *Shang Han Lun* states: "If a patient has cold and sweating is reapplied, causing cold in the stomach, roundworms will be vomited." "A floating-tight pulse indicates body pain, suitable for sweating. If the chi position is slow, sweating is contraindicated because Ying Qi is deficient and blood is scant." "Two to three days into Shanghan, if there is palpitations and irritability, *Xiao Jianzhong Tang* (Minor Construct the Middle Decoction) should be administered." *Yi Zong Jin Jian* states: "If the middle qi is inherently deficient, even with exterior signs, sweating is contraindicated." The reason the exterior-resolving method failed here is the lack of middle jiao tonification. Furthermore, besides epigastric cold pain, cold extremities and deep-thin-weak pulse indicate damage to both spleen and kidney yang. Merely strengthening the middle is insufficient; spleen and kidney yang must both be tonified. *Zaizao San* (Reconstruction Powder) tonifies yang and qi while mildly resolving the exterior. As Tong Yangxue wrote in *Shanghan Liushu Zuan Yao Bian Yi*: "*Zaizao San* treats headache, fever, stiff neck/spine, aversion to cold, anhidrosis. When sweating herbs fail to induce sweat, ignorant doctors ignore seasons and use heavy Ephedra or fire therapy to force sweat, leading to death. They do not know that yang deficiency prevents sweat production, hence this 'No-Yang Syndrome'." Modified *Zaizao San* was prescribed: *Huangqi* (Astragali Radix) 10g, *Dangshen* (Codonopsis Radix) 10g, *Guizhi* (Cinnamomi Ramulus) 10g, *Fuzi* (Aconiti Lateralis Radix Praeparata) 10g, *Xixin* (Asari Radix et Rhizoma) 1g, *Gancao* 3g, *Shengjiang* (Zingiberis Rhizoma Recens) 3 slices, *Fangfeng* 2g, *Chuanxiong* (Ligustici Chuanxiong Rhizoma) 6g, *Qianghuo* (Notopterygii Rhizoma et Radix) 2g, *Baishao* (Paeoniae Radix Alba) 10g.
After 3 doses, most symptoms resolved. After 2 more doses, all symptoms disappeared. Subsequently, 3 doses were taken monthly, totaling 9 doses. Cured.
3. Stagnant heat in the Triple Burner, mistakenly treated with tonics; fire evil scorches Metal, Wei Qi remains insecure.
Patient Su XX, female, 30 years old.
For 3-4 years, recurrent colds. Diagnosed with insecure Wei Qi, treated long-term with *Yupingfeng San* (Jade Windscreen Powder) and *Buzhong Yiqi Wan* (Tonify the Middle and Augment Qi Pill). Instead of improvement, symptoms worsened. Frequency increased from monthly to weekly. Recently, almost daily colds. Careful examination reveals, besides general cold symptoms, dry mouth/nose, bitter taste, irritability, distending headache, dry stool, red urine, and wiry-slipping pulse. Thinking: Pulse and symptoms clearly indicate stagnant heat in the Triple Burner. Why not use formulas to clear and drain Triple Burner heat? Prescribed *Huanglian Shangqing Wan* (Coptis Upper-Clearing Pill), twice daily, one pill each time.
After one month, all symptoms cured.
A friend asked: Recurrent colds belong to Qi deficiency; Qi deficiency requires tonifying Qi and securing the exterior, a common method of past physicians. Why did this patient fail to respond, yet Huanglian Shangqing Wan succeeded? I answered: Recurrent colds due to Wei Qi deficiency is an irrefutable truth. However, Wei Qi deficiency can stem from Lung Qi insufficiency, Ying-Wei disharmony, or Fire Evil attacking Metal. This case's deficiency is caused by stagnant fire in the Triple Burner scorching Metal. Thus, clearing the fire led to recovery.
4. Summer-heat injuring Qi, damaging both Qi and Yin, mistakenly treated with cooling clears, illness persists.
Patient Su XX, male, 30 years old.
For over a month, colds have persisted. Antibiotics, Contac, Ganmaotong showed no improvement. TCM heat-clearing and detoxifying, wind-dispersing and heat-clearing methods also failed. Careful examination reveals fever, dizziness, fatigue, dry mouth, poor appetite, excessive sweating, sneezing, thin white tongue coating, and wiry-large-tight-rapid pulse. Illness onset coincided with summer heat season. I said: This is external invasion of summer-heat, damaging both Qi and Yin. Plan to clear summer-heat, tonify Qi, nourish Yin, and clear heat. Prescription: *Dangshen* 10g, *Gancao* 6g, *Huangqi* 15g, *Danggui* (Angelicae Sinensis Radix) 10g, *Maidong* (Ophiopogonis Radix) 10g, *Wuweizi* (Schisandrae Fructus) 10g, *Qingpi* (Citri Reticulatae Pericarpium Viride) 10g, *Chenpi* (Citri Reticulatae Pericarpium) 10g, *Shenqu* (Massa Medicata Fermentata) 10g, *Huangbai* (Phellodendri Cortex) 10g, *Gegen* (Puerariae Lobatae Radix) 15g, *Cangzhu* (Atractylodis Rhizoma) 15g, *Baizhu* (Atractylodis Macrocephalae Rhizoma) 10g, *Shengma* (Cimicifugae Rhizoma) 10g, *Zexie* (Alismatis Rhizoma) 10g.
After 4 doses, cured. A physician asked: Wu Jutong's *Wen Bing Tiao Bian* lists five formulas for upper jiao Warm-Heat diseases in summer: Ren Shen Bai Hu Tang, Dongyuan Qing Shu Yi Qi Tang, Xinjia Xiangru Yin, Sheng Mai San, and Qing Luo Yin. Why did you choose Dongyuan's Qing Shu Yi Qi Tang? I answered: Ren Shen Bai Hu Tang is best for extreme thirst with a large-rapid right pulse, indicating severe heat damaging fluids and Qi. Sheng Mai San is for profuse sweating, panting, and impending collapse. Xinjia Xiangru Yin is for anhidrosis. Qing Luo Yin is for lingering residual pathogens. This case has sweating and a wiry-large-tight-rapid pulse indicating exterior cold, representing combined exterior-interior pathogens, righteous deficiency, and pathogenic excess. Thus, Dongyuan's Qing Shu Yi Qi Tang is appropriate. Asked again: Why not Mengying's Qing Shu Yi Qi Tang? I answered: Mengying's formula is designed for summer-heat damaging fluids and Qi, primarily focusing on Yin deficiency with heat. However, this case's wiry-large-tight-rapid pulse indicates Qi deficiency outweighs Yin deficiency, accompanied by exterior cold. Thus, only Dongyuan's formula is suitable. Asked again: Why didn't heat-clearing/detoxifying and wind-dispersing/clearing heat reduce the fever? I answered: Both Qi and Yin are deficient. Deficiency requires tonification. When righteous deficiency is primary and pathogens remain, heavy tonification is crucial; without tonification, pathogens cannot be eliminated.
5. Knowing only to resolve the exterior, failing to examine pathogenesis and root/symptom relationship, merely administering drugs.
Patient Li XX, female, 38 years old.
For 7-8 years, 1-2 days before menstruation, she experiences headache, body pain, nasal congestion, runny nose, frequent sneezing, or mild cough. Symptoms naturally disappear 2+ days after menstruation ends. Treated with various Western and TCM medicines (heat-clearing/exterior-resolving, wind-dispersing/cold-scattering, Qi-tonifying/exterior-securing) with no effect. Symptoms worsened in the last 2 years. This time, 3 days before menstruation, dizziness, headache, nasal congestion, sneezing, itchy eyes, tearing, clear nasal discharge, body ache. Symptoms worsened after menstruation started. Used Ganmao Qing, Ganmao Granules, Chlorpheniramine, Analgin for 5 days, and 2 doses of wind-dispersing/exterior-resolving TCM with no improvement. Careful examination reveals, besides above, chest fullness, irritability, hot palms, thin white tongue coating, and wiry-thin pulse. Repeated thinking: Menstruation is governed by the Chong Mai (Penetrating Vessel), which belongs to the Liver. The Liver is the General; it regulates Ying and Wei and defends against external pathogens. Liver Qi stagnation and Blood deficiency lead to transformation into fire, causing insecure Wei Qi and recurrent colds. Previous formulas for wind-dispersing/cold-scattering, Qi-tonifying/exterior-resolving, and heat-clearing/exterior-resolving did not target the root. Should switch to soothing Liver, nourishing Yin, resolving stagnation, and clearing heat. Prescription: *Chaihu* (Bupleuri Radix) 10g, *Danggui* 10g, *Baishao* 10g, *Baizhu* 10g, *Fuling* (Poria) 10g, *Gancao* 10g, *Ganjiang* (Zingiberis Rhizoma) 3g, *Shengjiang* 3 slices, *Danpi* (Moutan Cortex) 10g, *Zhizi* (Gardeniae Fructus) 10g.
After 1 dose, symptoms improved. After 2 more doses, symptoms vanished. To ensure complete cure, 4 doses were taken before each menstruation. Over 3 cycles, total 12 doses. Indeed cured.
6. Qi stagnation obstructs flow, Wei Qi does not move; failing to regulate Qi and instead resolving the exterior damages Wei and aids stagnation, illness persists.
Patient Ge XX, male, 30 years old.
Cold for over 2 months. Treated with Western medicine for over a month without effect. Then treated with TCM wind-dispersing/cold-scattering, wind-dispersing/heat-clearing, Qi-tonifying/exterior-resolving for over 20 days with no improvement. Examination shows dizziness, headache, body ache, nasal congestion, runny nose, continuous sneezing, itchy eyes, mild cough, chest/hypochondriac fullness, poor appetite, thin white tongue coating, and deep-slightly-wiry pulse. Inquiry reveals onset after anger, followed by recurrent treatment without cure. Synthesizing pulse and symptoms: *Su Wen · Liu Jie Zang Xiang Lun* states: "All eleven organs depend on the Gallbladder." Li Gao said: "The Gallbladder possesses the Spring-raising Qi of Shaoyang. When Spring Qi rises, all transformations are peaceful. Thus, when Gallbladder Qi rises like Spring, other organs follow." Liver and Gallbladder are interior-exterior partners. Liver-Gallbladder stagnation causes Wei Qi stagnation, leading to stagnation in all organs. Here, the illness began with Qi stagnation compounded by external pathogens. Treatment should resolve stagnation and gently release the exterior. Instead, exterior-resolving damaged Wei Qi, and tonification obstructed Qi, preventing cure. Method: Regulate Liver and move Qi, assisted by exterior resolution. Prescription: *Dangshen* 10g, *Suye* (Perillae Folium) 10g, *Chenpi* 10g, *Zhike* (Aurantii Fructus Immaturus) 10g, *Qianhu* (Peucedani Radix) 10g, *Banxia* (Pinelliae Rhizoma) 10g, *Gegen* 15g, *Gancao* 10g, *Muxiang* (Aucklandiae Radix) 6g, *Jiegeng* (Platycodonis Radix) 10g, *Fuling* 10g. After 3 doses, illness cured.
7. Ignoring Spring/Autumn, Yin/Yang, and harmonization; merely dispelling pathogens and supporting righteousness fails.
Patient Xun XX, female, 40 years old.
For 7-8 years, recurrent colds in Spring and Autumn. Mild cases every 5-6 days, severe cases every 2-3 days. Even with immediate medication, relief takes 7-8 days, but recurrence follows quickly. For over 2 years, repeated use of wind-dispersing/exterior-resolving, Qi-tonifying/exterior-securing, and placenta globulin showed no obvious change. Examination shows dizziness, fatigue, frequent sneezing, bitter/dry mouth, poor appetite, reduced food intake, irritability, thin white tongue coating, and wiry-slow pulse. Synthesizing pulse and symptoms: Spring and Autumn are seasons of Yin-Yang Qi intersection. Shaoyang refers to the Gallbladder. When Gallbladder Qi rises like Spring, all transformations are peaceful. Now, Shaoyang pivot mechanism is unfavorable, Liver-Gallbladder Qi is stagnant, Wei Qi does not move, causing recurrent colds. Previous formulas either tonified Qi trapping pathogens or resolved the exterior damaging righteousness, which was inappropriate. Zhongjing's discussion on Shaoyang disease includes three prohibitions: prohibit sweating, vomiting, and purging. For pivot mechanism unfavorable, only harmonization is allowed, not sweating or purging. Now prescribing Shaoyang harmonization and Ying-Wei regulation. Prescription: *Chaihu* 10g, *Banxia* 10g, *Huangqin* (Scutellariae Radix) 10g, *Dangshen* 10g, *Zhi Gancao* (Prepared Licorice) 10g, *Shengjiang* 3 slices, *Dazao* (Jujubae Fructus) 7 pieces, *Guizhi* 10g, *Baishao* 10g.
After 3 doses, symptoms vanished. Subsequently, 3 doses were taken during each Spring and Autumn for 3 years. Indeed cured.
8. Unaware of hidden Yin and Yang; knowing only to resolve the exterior and tonify Qi, merely administering drugs yields no effect.
Patient Zhen XX, male, 26 years old.
For 5-6 years, recurrent colds every summer. Placenta globulin failed. Nearly 100 doses of *Yupingfeng San* and *Buzhong Yiqi Tang* were ineffective. Examination shows dizziness, fatigue, sneezing, runny nose, itchy eyes, white tongue coating, and deficient-wiry pulse. Synthesizing pulse and symptoms: In summer, Yin is abundant internally, Yang is abundant externally. Excessive Yang externally damages Qi and Yin, making Wei Qi insecure. This aligns with Dongyuan's intent to tonify Qi and nourish Yin to treat summer pathogens. Currently, only Qi tonification is used without nourishing Yin, further damaging Yin fluids and insecurity of Wei Qi, hence failure of Yupingfeng and Buzhong Yiqi. Prescription: *Dangshen* 10g, *Gancao* 6g, *Huangqi* 15g, *Danggui* 6g, *Maidong* 10g, *Wuweizi* 10g, *Qingpi* 10g, *Chenpi* 10g, *Shenqu* 10g, *Huangbai* 10g, *Gegen* 15g, *Cangzhu* 10g, *Baizhu* 10g, *Shengma* 10g, *Zexie* 10g.
After 3 doses, symptoms vanished. Next summer, symptoms recurred but mildly; 3 doses cured them. Subsequently, for two consecutive years, 4 doses were taken prophylactically before illness onset. Indeed cured.
9. Seeking only symptom relief, not root cause, ultimately uncured.
Patient Li XX, male, 30 years old.