3．不审病因，徒施消炎，见其阴虚，不审兼证，不思君臣，乱于方寸
吴××，男，32岁。
吞咽困难，食管疼痛2年多。医诊反流性食管炎。先以西药治疗半年不效，后又配合中药清热解毒、养阴清热等剂治疗1年多仍不效。特别是近3个月来，疼痛尤为严重，不吃东西时仅仅隐隐作痛，吃东西时则灼痛难忍，有时咽唾液亦感疼痛。细审其证，除上证外，并见面色皓白无华，呈痛苦忧郁状，失眠心烦，头晕头痛，胸及食管均痛，夜间口干，舌苔白，脉虚弦滑。综合脉证，思之：面色皓白，口干夜甚者，气阴俱虚也；胸满心烦，头晕头痛者，肝气郁滞也；久痛不止者，瘀血也；脉弦滑者，痰湿不化也。合而论之，乃气阴俱虚为本，气滞血瘀，痰湿不化为标。治宜补气养阴以培本，疏肝理气，活血化痰以治标。处方：党参30克，麦冬15克，生地30克，苍术15克，白术10克，青皮10克，陈皮10克，柴胡10克，三棱10克，莪术10克，薄荷3克，夜交藤30克。
服药4剂，食管及胸骨疼痛明显好转，其他诸证亦有所改善。继用上方1个月，诸证消失。
某医云：前用养阴而不效者何也?答曰：气虚未补，瘀血未活，气滞未疏所致也。
食管贲门失弛缓症
1．不辨其脉，但凭证分，乱施药饵，久延病期
孙××，女，50岁。
1个多月前，在吃饭的过程中偶而发现吞咽困难。急至某院作消化道造影，，诊断为食管癌。某医建议手术治疗，但因患者及家属均拒绝而作罢。某医以中药启膈、通幽等治疗l周不效。又改用抗癌药物治疗，2周后，病情加重。细审其证，滴水难进，时时呕吐粘涎，心烦不安，昼夜不得入睡。先予旋覆代赭汤4剂不效，后又与大半夏汤加减3剂仍无功。再审其证，除上症外，并见其极端消瘦(体重3l千克)。气短乏力，烦躁不安，舌苔薄白，脉沉缓稍滑。因思沉脉者郁证也，缓者湿痰郁滞也，滑者痰也。综合脉证，乃肝郁气结，痰滞血瘀也。治拟理气活血，化痰散血。处方：桃仁10克，香附10克，青皮10克，柴胡10克，半夏10克，木通10克，赤芍10克，大腹皮10克，川芎10克，桑皮10克，茯苓10克，苏子20克，甘草20克。
服药之始，每咽一口药汁即绝大部分呕吐而出，至服完一煎药时，药汁即可以大部分吞咽入于胃，至服完第7剂时，不但可以顺利的吞下药汁，而且可以进食牛乳、稀面条、挂面等；服药至1个月时，食欲大增，每日可吃350。400克食物，并可以吃馒头、烙饼等；2个月后，诸证消失，并上班工作。
某医云：旋覆代赭、启膈、通幽诸汤均为治疗噎膈之方，大半夏汤为洽反胃之方，而本例却用之不效，癫狂梦醒汤不是治噎膈方却用于此证有效，其故何也?答曰：旋覆代赭汤本为仲景《伤寒论》方，原方主用于“心下痞硬，噫气不除者”，后人见其具有降气化痰、益气和胃之功，常用于胃气虚弱，痰浊内阻，气逆不降所致的心下痞硬，噫气不除，反胃呕吐。吐涎沫，脉弦而虚者。个人经验用于寸脉尤甚者更佳。启膈散本为程国彭《医学心悟》方，原方为“通噎膈开火之剂”，后人主用于痰气交阻，吞咽梗阻，胸膈痞闷，情志舒畅时可稍减轻，口干咽燥，舌质偏红，苔薄腻，脉弦滑者．且程国彭主张夹郁者则用逍遥散主之。本患者脉尤见沉，沉说明气郁尤甚，故尤当行气，癫狂梦醒汤具有较强的解郁化痰之功，所以采用癫狂梦醒汤。癫狂梦醒汤是王清任著《医林改错》方，主用于“癫狂一症，哭笑不休，詈骂歌唱，不避亲疏，许多恶态，乃气血凝滞脑气，与脏腑不接，如同作梦一样。”余据其药物组成，既有柴胡、香附、赤芍、青皮、大腹皮的理气，又有半夏、青皮、桑皮、苏子的化痰，且佐以桃仁、赤芍、木通的活血，故用于气滞、血瘀、痰郁共有之证奇效。
2．寒饮蕴胃，反与理气启膈，降逆止呕，饮邪壅阻，吞咽不下
钱××，男，38岁。
吞咽难下，甚或食后即吐5年多。医诊食管痉挛。先用西药治疗曾一度好转，但不久即再无效，为此又配合中药降逆止呕、理气启膈、活血化瘀等药治之3年多，仍是开始有效，其后再不见效。细审其证，吞咽食物每到食管下段时即感噎塞难下，偶而也出现食后即吐，吐物为食物，无酸臭味，舌苔薄白，脉弦紧稍数。因思：弦紧而数者寒饮中阻也。世俗虽有数脉主热之论，然数脉不全主热，特别是紧数之脉相兼者更不全主热也，如《伤寒论》126条云：“病人脉数，数为热，当消谷引食，而反吐者，此以发汗，令阳气微，膈气虚，脉乃数也。数为客热，不能消谷，以胃中虚冷，故吐也。”此病之吐虽非发汗之后引起者，然其久病过用克伐之品以伤胃气其理亦相似耳。再审其证，患者亦有遇冷或吃冷食加重的情况。综合脉证，此必胃气大衰，寒水阻滞所致。因拟温中健脾，利水化饮。处方：附子10克，肉桂10克，党参10克，白术10克，干姜10克，甘草10克，泽泻10克，猪苓10克，茯苓10克。
冷服4剂后，吞咽时较前明显顺利，且在1周内没有出现呕吐现象。又继服10剂，噎膈之状竟全部消失，果愈。
某医云：噎膈之治诸医都云：启膈、通幽、旋覆代赭等汤为治疗之要方，而本证却用之不效，其故何也?答曰：从脉来看：一无气郁，二无血瘀，三无阴虚，四无肝胃冲逆，而仅有脾胃虚寒，寒饮蕴结，故理气不应，活血不成，降逆无功，而采用附桂理中健脾，五苓散化饮利水，复佐冷服以解格拒，故治之得愈。
3．脾虚胃燥，不腐水谷，反以温燥以伤其胃
张××，女，29岁。
吞咽困难，时轻时重2年多。医诊食管贲门失弛缓症。先用西药曾一度见效，一周后又复如初，又配合中药苦辛通降、降逆止呕、理气启膈等治疗1年多，病证不减。特别是近3～4个月来病情更加严重，几乎每次吃饭、饮水都噎塞难下，并呕吐而出。细审其证，除上述者外，并见纳呆食减，疲乏无力，舌苔薄白，脉虚大。因思脉虚大者气阴两虚也。合之于症，乃气阴俱衰，脾虚胃燥，熟腐水谷不能之症。治宜半夏开结降逆，人参、白蜜补虚润燥。又思前用诸方之反剧者恐乃辛以耗气，苦以损阳，未顾正气之故。因处大半夏汤加减。人参10克，半夏10克，蜂蜜30克。
服药1剂，不但未见吐药，而且呕吐食物、吞咽困难亦减；继服10剂，竟愈。
某医云：大半夏汤乃仲景为反胃之证所设之方，仲景《金匮》云：“胃反呕吐者，大半夏汤主之。”而先生反用于噎膈者何也?答曰：辨证论治的主要精神乃辨一理耳。本病理者为何?气阴两虚也。大半夏汤乃补气养阴之品，故治之得愈也。
食管裂孔疝
1．不审虚实，不察寒热，久施调脾，佐以理气，其病不减
汪××，男，38岁。
剑突下灼痛，食后加重4年多。医诊食管裂孑L疝。先以西药治之不效，后又配合中药调理脾胃，疏肝和胃，活血化瘀等剂治之效亦不著。细审其证，胸骨后、剑突下、两胁均灼痛难忍，尤以食后更加严重，且时见心烦易怒，头晕头痛，胸胁窜痛，烧心泛酸，夜间口干，舌苔白，脉虚弦紧稍滑。综合脉证，思之：胸胁满痛，心烦易怒者，肝郁也；久痛不止者，瘀血也；灼痛而夜间口干者，阴虚也；食后即痛者，实也；脉虚弦滑者，气阴两虚，痰热阻郁也。合而论之，乃气阴两虚为本，气滞血瘀，痰积不化为标。治宜补气养阴以培本，理气活血，化痰消积以治标。处方：党参30克，麦冬10克，生地30克，苍术15克，白术10克，青皮10克，陈皮10克，柴胡10克，三棱10克，莪术10克，薄荷3克，莱菔子10克，砂仁10克，夜交藤30克。
服药2剂，灼痛，胸满心烦，头痛等证减；继服60剂，疼痛消失，诸证均解。
某医云：前用理气疏肝、活血化瘀而不效者何也?答曰：未予扶正、未予消导，未予养阴之故也。
2．久施克伐，正虚邪实，补正壅邪，消导正伤，难施药饵
郝××，男，78岁。
胃脘灼痛数十年。医诊食管裂孔疝。始以西药治之不效，继又配合中药疏肝和胃，活血化瘀、调理脾胃、消食导滞等亦不效。细审其证，剑突下疼痛，食后更甚，嗳气呃逆，口苦而干，舌苔黄白，脉沉紧而滑。综合脉证，思之：食后即痛者，实积也。当以消食导滞。然年高气血阴阳俱不足，过消其积则正气必伤，消导重剂不可为也。宜宗仲景缓中补虚法。处方：山楂化滞丸，1次半丸，1日3次。上方连续服药2个月，诸证消失，饮食增加。
急性胃肠炎
1．汤、丸有异，缓速不同，尤应区别
章××．男，40岁。
2年多来，胃脘疼痛，询之，正当心下疼痛，按之更甚，察其脉浮滑，乃予小陷胸汤。4剂后，痛减七八，乃嘱其继服3剂。不料，次日，突然吐泻不止，发热汗出。其子稍知中医，乃云：此伤暑吐泻霍乱也。乃急购藿香正气丸一盒，不想，服药4丸寸效不见。再急邀余前往诊治。审其除吐泻并作，身热乏力之外，并见其汗出遍身，头汗如雨，舌苔白，脉浮紧数。思之：病发暑季，其势急骤，且脉浮紧而数，必外感风寒，内伤暑湿，内外合邪之证。乃云：此乃伤暑之寒者，急宜解表和中，理气化浊，藿香正气散加减。刚予开方，患者之子曰：先生之论非也，此病既如先生之所言，当服藿香正气取效，然其不效者何也?此病实乃先生用陷胸之误造成，请不要推卸责任。回曰：先生之言差矣!假若如先生所言为陷胸所误，那么为什么你母之病开始用陷胸汤不但有效，而且效果甚佳，且在上次门诊时要求再服上方，事实胜于雄辩，请先生思之。至于为什么服藿香正气丸4丸无效，我认为丸者缓也，汤者荡也，即藿香正气丸不但药少力微，而且缓缓有功，因此服用藿香正气丸已3个小时不见效，而如改用汤剂，服药入胃即可荡涤病邪，而不久可愈也。患者及其家属始信余言之有理。急处：藿香10克，大腹皮10克，紫苏10克，甘草6克，桔梗10克，陈皮10克，茯苓10克，白术10克，厚朴10克，半夏10克，神曲10克，白芷10克，生姜3片，大枣5个。
煎药20分钟时，即开始一匙一匙的服下，至服药30分钟时，呕吐停止，40分钟时吐泻止，至2小时时诸证均大减，至8小时时，病愈。又服1剂，善后。
2．湿浊犯脾，邪结少阳，不审脉证，但与藿香正气，其效不见
文××，男，66岁。
慢性胃炎30多年，糖尿病十几年，阵发性室上性心动过速5年。近2个多月以来，又发现吐泻并作，心悸气短，头晕头痛。急至某院住院治疗。诊为急性胃肠炎、心房纤颤、糖尿病酮症酸中毒。先用西药治疗1个多月不见好转，继又配合中药藿香正气胶囊、养心安神、养阴益气之汤剂8天，病情仍然不见改善。细审其证见精神疲惫，恶心呕吐，时而泄泻，心烦心悸，胸满胸痛，头晕头胀，口苦咽干，舌苔薄白，脉弦紧而涩。因思：脉弦者少阳之脉也，紧涩并见者寒湿犯脾也。综合脉证论之：乃少阳枢机不利，寒湿秽浊犯于脾胃。治宜和解少阳，燥湿温中化浊。处方：柴胡10克，半夏10克，人参10克，黄芩10克，干姜3克，甘草6克，大枣5个，苍术10克，厚朴10克，陈皮10克，茯苓15克，桂枝10克。
处方刚毕，某医云：患者系糖尿病酮症酸中毒，为何反用大枣，而不用生地、元参、花粉、麦冬?答曰：中医学的灵魂在于按照中医的理论去辨证论治。本病虽为糖尿病酮症酸中毒但无中医认为的阴虚证，故不可用生地之类，又从证来看本病乃湿寒客脾，若再加养阴之味必助寒湿而为害，此病之所大忌也。
服药2剂，恶心呕吐停止，饮食稍进，心悸心烦，头晕脑胀亦减。继服6剂，诸证大部消失。
10天后，又来复诊。云：2天来，脘腹胀痛，口苦咽干，疲乏无力，并于昨夜突然发生心动过速，急压眼球才停止。上午又急去某院诊治。诊为慢性胃炎、糖尿病、阵发性室上性心动过速。审其脉弦大紧数，舌苔薄白。因思脉弦大紧数者气阴两虚，湿热蕴结，清升浊降之势失职耳。为拟补气养阴，燥湿清热，升清降浊。处方：人参10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10克，苍术10克，白术10克，升麻10克，泽泻10克。
服药2剂，诸证稍减。为了准确的观察药物疗效，嘱其停用其他任何药物。服药10剂后，诸证果然消减80％以上；又服1月，诸证消失。
3．秽积于胃，反与止吐，浊邪不解，其病难除
安××，男，10岁
脘腹疼痛，频繁呕吐10天。医诊急性胃炎。先予西药治之不效，继又配用中药疏肝和胃、藿香正气治之仍无功。细审其证，呕吐频频，胃脘胀痛，拒按，闻油腻味则更甚，食纳全废，舌苔白厚腻，脉弦紧滑数。综合脉证，思之：此饮食不洁，秽浊犯胃，积滞不化所致。治宜化浊导滞。处方：神曲10克，苏叶10克。
针：中脘、又足三里、内关。
服药1剂，并配合针刺后，疼痛、呕吐已减八九，继服2剂，愈。
3. 不审病因，徒施消炎，见其阴虚，不审兼证，不思君臣，乱于方寸
吴××，男，32岁。
吞咽困难，食管疼痛2年多。医生诊断为反流性食管炎。先用西药治疗半年无效，后又配合中药清热解毒、养阴清热等剂治疗1年多仍无效。特别是近3个月来，疼痛尤为严重，不吃东西时仅仅隐隐作痛，吃东西时则灼痛难忍，有时咽唾液亦感疼痛。仔细审查其证候，除上述症状外，并见面色苍白无光泽，呈痛苦忧郁状，失眠心烦，头晕头痛，胸及食管均痛，夜间口干，舌苔白，脉虚弦滑。综合脉象和证候，思考：面色苍白，夜间口干甚者，是气阴两虚；胸满心烦，头晕头痛者，是肝气郁滞；久痛不止者，是瘀血；脉弦滑者，是痰湿不化。综合论述，乃是气阴两虚为本，气滞血瘀，痰湿不化为标。治宜补气养阴以培本，疏肝理气，活血化痰以治标。处方：党参30克，麦冬15克，生地30克，苍术15克，白术10克，青皮10克，陈皮10克，柴胡10克，三棱10克，莪术10克，薄荷3克，夜交藤30克。
服药4剂，食管及胸骨疼痛明显好转，其他诸证亦有所改善。继用上方1个月，诸证消失。
某医云：前用养阴而不效者何也？答曰：气虚未补，瘀血未活，气滞未疏所致也。
1. 不辨其脉，但凭证分，乱施药饵，久延病期
孙××，女，50岁。
1个多月前，在吃饭的过程中偶尔发现吞咽困难。急至某院作消化道造影，诊断为食管癌。某医建议手术治疗，但因患者及家属均拒绝而作罢。某医以中药启膈散、通幽汤等治疗1周无效。又改用抗癌药物治疗，2周后，病情加重。仔细审查其证候，滴水难进，时时呕吐粘涎，心烦不安，昼夜不得入睡。先予旋覆代赭汤4剂无效，后又与大半夏汤加减3剂仍无功。再审其证候，除上述症状外，并见其极端消瘦（体重31千克）。气短乏力，烦躁不安，舌苔薄白，脉沉缓稍滑。因思沉脉者属郁证，缓者属湿痰郁滞，滑者属痰。综合脉证，乃是肝郁气结，痰滞血瘀。治拟理气活血，化痰散血。处方：桃仁10克，香附10克，青皮10克，柴胡10克，半夏10克，木通10克，赤芍10克，大腹皮10克，川芎10克，桑皮10克，茯苓10克，苏子20克，甘草20克。
服药之初，每咽一口药汁即绝大部分呕吐而出，至服完一煎药时，药汁即可以大部分吞咽入于胃，至服完第7剂时，不但可以顺利吞下药汁，而且可以进食牛乳、稀面条、挂面等；服药至1个月时，食欲大增，每日可吃350-400克食物，并可以吃馒头、烙饼等；2个月后，诸证消失，并上班工作。
某医云：旋覆代赭汤、启膈散、通幽汤均为治疗噎膈之方，大半夏汤为治疗反胃之方，而本例却用之不效，癫狂梦醒汤不是治噎膈方却用于此证有效，其故何也？答曰：旋覆代赭汤本为仲景《伤寒论》方，原方主用于“心下痞硬，噫气不除者”，后人见其具有降气化痰、益气和胃之功，常用于胃气虚弱，痰浊内阻，气逆不降所致的心下痞硬，噫气不除，反胃呕吐，吐涎沫，脉弦而虚者。个人经验用于寸脉尤甚者更佳。启膈散本为程国彭《医学心悟》方，原方为“通噎膈开火之剂”，后人主用于痰气交阻，吞咽梗阻，胸膈痞闷，情志舒畅时可稍减轻，口干咽燥，舌质偏红，苔薄腻，脉弦滑者。且程国彭主张夹郁者则用逍遥散主之。本患者脉尤见沉，沉说明气郁尤甚，故尤当行气，癫狂梦醒汤具有较强的解郁化痰之功，所以采用癫狂梦醒汤。癫狂梦醒汤是王清任著《医林改错》方，主用于“癫狂一症，哭笑不休，詈骂歌唱，不避亲疏，许多恶态，乃气血凝滞脑气，与脏腑不接，如同做梦一样。”余据其药物组成，既有柴胡、香附、赤芍、青皮、大腹皮的理气，又有半夏、青皮、桑皮、苏子的化痰，且佐以桃仁、赤芍、木通的活血，故用于气滞、血瘀、痰郁共有之证奇效。
钱××，男，38岁。
吞咽难下，甚或食后即吐5年多。医生诊断食管痉挛。先用西药治疗曾一度好转，但不久即再无效，为此又配合中药降逆止呕、理气启膈、活血化瘀等药治之3年多，仍是开始有效，其后再不见效。仔细审查其证候，吞咽食物每到食管下段时即感噎塞难下，偶尔也出现食后即吐，吐物为食物，无酸臭味，舌苔薄白，脉弦紧稍数。因思：弦紧而数者寒饮中阻也。世俗虽有数脉主热之论，然数脉不全主热，特别是紧数之脉相兼者更不全主热也，如《伤寒论》126条云：“病人脉数，数为热，当消谷引食，而反吐者，此以发汗，令阳气微，膈气虚，脉乃数也。数为客热，不能消谷，以胃中虚冷，故吐也。”此病之吐虽非发汗之后引起者，然其久病过用克伐之品以伤胃气其理亦相似耳。再审其证候，患者亦有遇冷或吃冷食加重的情况。综合脉证，此必胃气大衰，寒水阻滞所致。因拟温中健脾，利水化饮。处方：附子10克，肉桂10克，党参10克，白术10克，干姜10克，甘草10克，泽泻10克，猪苓10克，茯苓10克。
冷服4剂后，吞咽时较前明显顺利，且在1周内没有出现呕吐现象。又继服10剂，噎膈之状竟全部消失，果愈。
某医云：噎膈之治诸医都云：启膈散、通幽汤、旋覆代赭汤等汤为治疗之要方，而本证却用之不效，其故何也？答曰：从脉来看：一无气郁，二无血瘀，三无阴虚，四无肝胃冲逆，而仅有脾胃虚寒，寒饮蕴结，故理气不应，活血不成，降逆无功，而采用附桂理中健脾，五苓散化饮利水，复佐冷服以解格拒，故治之得愈。
张××，女，29岁。
吞咽困难，时轻时重2年多。医生诊断食管贲门失弛缓症。先用西药曾一度见效，一周后又复如初，又配合中药苦辛通降、降逆止呕、理气启膈等治疗1年多，病证不减。特别是近3～4个月来病情更加严重，几乎每次吃饭、饮水都噎塞难下，并呕吐而出。仔细审查其证候，除上述者外，并见纳呆食减，疲乏无力，舌苔薄白，脉虚大。因思脉虚大者气阴两虚也。合之于症，乃气阴俱衰，脾虚胃燥，熟腐水谷不能之症。治宜半夏开结降逆，人参、白蜜补虚润燥。又思前用诸方之反剧者恐乃辛以耗气，苦以损阳，未顾正气之故。因处大半夏汤加减。人参10克，半夏10克，蜂蜜30克。
服药1剂，不但未见吐药，而且呕吐食物、吞咽困难亦减；继服10剂，竟愈。
某医云：大半夏汤乃仲景为反胃之证所设之方，仲景《金匮》云：“胃反呕吐者，大半夏汤主之。”而先生反用于噎膈者何也？答曰：辨证论治的主要精神乃辨一理耳。本病理者为何？气阴两虚也。大半夏汤乃补气养阴之品，故治之得愈也。
汪××，男，38岁。
剑突下灼痛，食后加重4年多。医生诊断食管裂孔疝。先以西药治之不效，后又配合中药调理脾胃，疏肝和胃，活血化瘀等剂治之效亦不著。仔细审查其证候，胸骨后、剑突下、两胁均灼痛难忍，尤以食后更加严重，且时见心烦易怒，头晕头痛，胸胁窜痛，烧心泛酸，夜间口干，舌苔白，脉虚弦紧稍滑。综合脉证，思之：胸胁满痛，心烦易怒者，肝郁也；久痛不止者，瘀血也；灼痛而夜间口干者，阴虚也；食后即痛者，实也；脉虚弦滑者，气阴两虚，痰热阻郁也。合而论之，乃气阴两虚为本，气滞血瘀，痰积不化为标。治宜补气养阴以培本，理气活血，化痰消积以治标。处方：党参30克，麦冬10克，生地30克，苍术15克，白术10克，青皮10克，陈皮10克，柴胡10克，三棱10克，莪术10克，薄荷3克，莱菔子10克，砂仁10克，夜交藤30克。
服药2剂，灼痛，胸满心烦，头痛等证减；继服60剂，疼痛消失，诸证均解。
某医云：前用理气疏肝、活血化瘀而不效者何也？答曰：未予扶正、未予消导，未予养阴之故也。
2. 久施克伐，正虚邪实，补正壅邪，消导正伤，难施药饵
郝××，男，78岁。
胃脘灼痛数十年。医生诊断食管裂孔疝。始以西药治之不效，继又配合中药疏肝和胃，活血化瘀、调理脾胃、消食导滞等亦不效。仔细审查其证候，剑突下疼痛，食后更甚，嗳气呃逆，口苦而干，舌苔黄白，脉沉紧而滑。综合脉证，思之：食后即痛者，实积也。当以消食导滞。然年高气血阴阳俱不足，过消其积则正气必伤，消导重剂不可为也。宜宗仲景缓中补虚法。处方：山楂化滞丸，1次半丸，1日3次。上方连续服药2个月，诸证消失，饮食增加。
1. 汤、丸有异，缓速不同，尤应区别
章××，男，40岁。
2年多来，胃脘疼痛，询之，正当心下疼痛，按之更甚，察其脉浮滑，乃予小陷胸汤。4剂后，痛减七八，乃嘱其继服3剂。不料，次日，突然吐泻不止，发热汗出。其子稍知中医，乃云：此伤暑吐泻霍乱也。乃急购藿香正气丸一盒，不想，服药4丸寸效不见。再急邀余前往诊治。审其除吐泻并作，身热乏力之外，并见其汗出遍身，头汗如雨，舌苔白，脉浮紧数。思之：病发暑季，其势急骤，且脉浮紧而数，必外感风寒，内伤暑湿，内外合邪之证。乃云：此乃伤暑之寒者，急宜解表和中，理气化浊，藿香正气散加减。刚予开方，患者之子曰：先生之论非也，此病既如先生之所言，当服藿香正气取效，然其不效者何也？此病实乃先生用陷胸之误造成，请不要推卸责任。回曰：先生之言差矣！假若如先生所言为陷胸所误，那么为什么你母之病开始用陷胸汤不但有效，而且效果甚佳，且在上次门诊时要求再服上方，事实胜于雄辩，请先生思之。至于为什么服藿香正气丸4丸无效，我认为丸者缓也，汤者荡也，即藿香正气丸不但药少力微，而且缓缓有功，因此服用藿香正气丸已3个小时不见效，而如改用汤剂，服药入胃即可荡涤病邪，而不久可愈也。患者及其家属始信余言之有理。急处：藿香10克，大腹皮10克，紫苏10克，甘草6克，桔梗10克，陈皮10克，茯苓10克，白术10克，厚朴10克，半夏10克，神曲10克，白芷10克，生姜3片，大枣5个。
煎药20分钟时，即开始一匙一匙的服下，至服药30分钟时，呕吐停止，40分钟时吐泻止，至2小时时诸证均大减，至8小时时，病愈。又服1剂，善后。
文××，男，66岁。
慢性胃炎30多年，糖尿病十几年，阵发性室上性心动过速5年。近2个多月以来，又发现吐泻并作，心悸气短，头晕头痛。急至某院住院治疗。诊为急性胃肠炎、心房纤颤、糖尿病酮症酸中毒。先用西药治疗1个多月不见好转，继又配合中药藿香正气胶囊、养心安神、养阴益气之汤剂8天，病情仍然不见改善。仔细审查其证候见精神疲惫，恶心呕吐，时而泄泻，心烦心悸，胸满胸痛，头晕头胀，口苦咽干，舌苔薄白，脉弦紧而涩。因思：脉弦者少阳之脉也，紧涩并见者寒湿犯脾也。综合脉证论之：乃少阳枢机不利，寒湿秽浊犯于脾胃。治宜和解少阳，燥湿温中化浊。处方：柴胡10克，半夏10克，人参10克，黄芩10克，干姜3克，甘草6克，大枣5个，苍术10克，厚朴10克，陈皮10克，茯苓15克，桂枝10克。
处方刚毕，某医云：患者系糖尿病酮症酸中毒，为何反用大枣，而不用生地、元参、花粉、麦冬？答曰：中医学的灵魂在于按照中医的理论去辨证论治。本病虽为糖尿病酮症酸中毒但无中医认为的阴虚证，故不可用生地之类，又从证来看本病乃湿寒客脾，若再加养阴之味必助寒湿而为害，此病之所大忌也。
服药2剂，恶心呕吐停止，饮食稍进，心悸心烦，头晕脑胀亦减。继服6剂，诸证大部消失。
10天后，又来复诊。云：2天来，脘腹胀痛，口苦咽干，疲乏无力，并于昨夜突然发生心动过速，急压眼球才停止。上午又急去某院诊治。诊为慢性胃炎、糖尿病、阵发性室上性心动过速。审其脉弦大紧数，舌苔薄白。因思脉弦大紧数者气阴两虚，湿热蕴结，清升浊降之势失职耳。为拟补气养阴，燥湿清热，升清降浊。处方：人参10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10克，苍术10克，白术10克，升麻10克，泽泻10克。
服药2剂，诸证稍减。为了准确的观察药物疗效，嘱其停用其他任何药物。服药10剂后，诸证果然消减80％以上；又服1月，诸证消失。
3. 秽积于胃，反与止吐，浊邪不解，其病难除
安××，男，10岁
脘腹疼痛，频繁呕吐10天。医生诊断急性胃炎。先予西药治之不效，继又配用中药疏肝和胃、藿香正气治之仍无功。仔细审查其证候，呕吐频频，胃脘胀痛，拒按，闻油腻味则更甚，食纳全废，舌苔白厚腻，脉弦紧滑数。综合脉证，思之：此饮食不洁，秽浊犯胃，积滞不化所致。治宜化浊导滞。处方：神曲10克，苏叶10克。
针：中脘、足三里、内关。
服药1剂，并配合针刺后，疼痛、呕吐已减八九，继服2剂，愈。
3. Failure to investigate the etiology, merely administering anti-inflammatory drugs; observing Yin deficiency without examining accompanying syndromes, neglecting the principles of sovereign, minister, assistant, and envoy, leading to chaotic prescription.
Wu XX, male, 32 years old.
Dysphagia (difficulty in swallowing) and esophageal pain for over 2 years. Diagnosed with reflux esophagitis by physicians. Treated with Western medicine for half a year with no effect, followed by Chinese herbal medicine for clearing heat and detoxifying, nourishing Yin and clearing heat for over one year, still ineffective. Especially in the last 3 months, the pain was particularly severe: dull pain when not eating, unbearable burning pain when eating, and even pain when swallowing saliva. Careful examination of the syndrome revealed, besides the above symptoms, a pale and lusterless complexion, a painful and depressed demeanor, insomnia with vexation, dizziness and headache, pain in the chest and esophagus, dry mouth at night, white tongue coating, and a deficient, wiry, and slippery pulse. Synthesizing the pulse and syndrome: pale complexion and severe night-time dry mouth indicate Qi and Yin deficiency; chest fullness, vexation, dizziness, and headache indicate Liver Qi stagnation; chronic unceasing pain indicates Blood stasis; wiry and slippery pulse indicates Phlegm-dampness retention. In summary, the root is Qi and Yin deficiency, while the branch is Qi stagnation, Blood stasis, and Phlegm-dampness retention. The treatment should tonify Qi and nourish Yin to support the root, soothe the Liver and regulate Qi, invigorate Blood and resolve Phlegm to treat the branch. Prescription: Dangshen 30g, Maidong 15g, Shengdi 30g, Cangzhu 15g, Baizhu 10g, Qingpi 10g, Chenpi 10g, Chaihu 10g, Sanleng 10g, Ezhu 10g, Bohe 3g, Yejiaoteng 30g.
After taking 4 doses, esophageal and sternum pain improved significantly, and other symptoms also ameliorated. Continuing the same prescription for 1 month, all symptoms disappeared.
A certain physician asked: Why did previous treatments using Yin-nourishing herbs fail? Answer: This was due to untonified Qi, unresolved Blood stasis, and unsoothed Qi stagnation.
Achalasia of the Esophagus and Cardia
1. Failure to differentiate the pulse, relying solely on symptoms, indiscriminate medication, prolonging the disease course.
Sun XX, female, 50 years old.
Occasional dysphagia discovered during meals more than 1 month ago. Urgently underwent gastrointestinal contrast radiography at a hospital, diagnosed with esophageal cancer. A physician suggested surgical treatment, but it was abandoned due to refusal by the patient and family. Treated with Chinese herbal medicines Qige San (Qi-Opening Powder) and Tongyou Tang (Unblocking the幽 Decoction) for 1 week with no effect. Switched to anti-cancer drugs, condition worsened after 2 weeks. Careful examination revealed inability to swallow even water, frequent vomiting of sticky saliva, mental restlessness, and inability to sleep day or night. Initially given Xuanfu Daizhe Tang (Inula and Hematite Decoction) for 4 doses with no effect, then Banxiaxitang (Pinellia Decoction) modified for 3 doses, still ineffective. Re-examination showed extreme emaciation (weight 31 kg), shortness of breath, fatigue, irritability, thin white tongue coating, and a deep, slow, slightly slippery pulse. Thinking: Deep pulse indicates constraint syndrome; slow pulse indicates damp-phlegm constraint; slippery pulse indicates phlegm. Synthesizing pulse and syndrome, it is Liver depression with Qi knotting, Phlegm retention, and Blood stasis. Treatment plan: Regulate Qi and invigorate Blood, resolve Phlegm and dissipate Blood stasis. Prescription: Tao Ren 10g, Xiangfu 10g, Qingpi 10g, Chaihu 10g, Banxia 10g, Mutong 10g, Chishao 10g, Dafupi 10g, Chuanxiong 10g, Sangbai 10g, Fuling 10g, Suzi 20g, Gancao 20g.
At the beginning of treatment, most of the decoction was vomited out after each sip. By the time one decoction was finished, most could be swallowed into the stomach. After finishing the 7th dose, not only could the decoction be swallowed smoothly, but milk, thin noodles, and dried noodles could also be eaten. After 1 month of treatment, appetite increased greatly, consuming 350-400g of food daily, including steamed buns and pan-fried cakes. After 2 months, all symptoms disappeared, and she returned to work.
A certain physician asked: Xuanfu Daizhe Tang, Qige San, and Tongyou Tang are all formulas for treating Yige (dysphagia), and Banxiaxitang is for Fanwei (vomiting regurgitation), yet they were ineffective in this case. Diankuang Mengxing Tang is not a formula for Yige, yet it was effective here. Why? Answer: Xuanfu Daizhe Tang originates from Zhang Zhongjing's "Shanghan Lun" (Treatise on Cold Damage), originally indicated for "epigastric hardness and persistent belching." Later generations used it for epigastric hardness, belching, regurgitant vomiting, spitting saliva, wiry and deficient pulse caused by weak Stomach Qi, internal obstruction of turbid Phlegm, and rebellious Qi failing to descend. My personal experience suggests it is better for cases with especially prominent Cun (inch) pulse. Qige San originates from Cheng Guopeng's "Yixue Xinwu" (New Insights into Medicine), originally a formula to open Yige and clear fire, later used for Phlegm-Qi interblockage causing swallowing obstruction, chest diaphragm stuffiness, slight relief with emotional comfort, dry mouth and throat, reddish tongue body, thin greasy coating, and wiry-slippery pulse. Cheng Guopeng advocated using Xiaoyao San for cases with constraint. This patient's pulse was notably deep, indicating severe Qi constraint, thus requiring strong Qi-regulating action. Diankuang Mengxing Tang has strong power to relieve constraint and resolve Phlegm, hence its adoption. Diankuang Mengxing Tang is from Wang Qingren's "Yilin Gaicuo" (Correction of Errors in Medical Works), primarily used for "mania and epilepsy, laughing and crying incessantly, cursing and singing, ignoring relatives and strangers, many bizarre behaviors, caused by Qi and Blood stagnation affecting Brain Qi, disconnecting from Zang-Fu organs, like dreaming." Based on its composition, it contains Chaihu, Xiangfu, Chishao, Qingpi, Dafupi for regulating Qi; Banxia, Qingpi, Sangbai, Suzi for resolving Phlegm; and Tao Ren, Chishao, Mutong for invigorating Blood. Thus, it is remarkably effective for syndromes involving Qi stagnation, Blood stasis, and Phlegm constraint.
2. Cold-fluid accumulation in the Stomach, contrary administration of Qi-regulating, opening-diaphragm, descending-rebellious, and stopping-vomiting methods; fluid pathogen obstruction leads to inability to swallow.
Qian XX, male, 38 years old.
Difficulty swallowing, sometimes vomiting immediately after eating for over 5 years. Diagnosed with esophageal spasm. Initial Western medicine treatment provided temporary improvement, but soon became ineffective. Combined with Chinese herbal medicine for descending rebellious Qi, stopping vomiting, regulating Qi, opening the diaphragm, and invigorating Blood for over 3 years. Initially effective, then ineffective. Careful examination revealed sensation of blockage in the lower esophagus when swallowing food, occasional postprandial vomiting of undigested food without sour odor, thin white tongue coating, and wiry-tight, slightly rapid pulse. Thinking: Wiry-tight and rapid pulse indicates obstruction by cold-fluid in the middle Jiao. Although popular theory holds that rapid pulse indicates Heat, rapid pulse does not always indicate Heat, especially when combined with tight pulse. As stated in Article 126 of "Shanghan Lun": "If the patient's pulse is rapid, rapid indicates Heat, and digestion should be accelerated... but if vomiting occurs instead, this is because sweating depleted Yang Qi, making Diaphragm Qi deficient, resulting in a rapid pulse. Rapid here indicates transient Heat, unable to digest food, due to cold deficiency in the Stomach, hence vomiting." Although this patient's vomiting was not caused by sweating, the principle of long-term illness and excessive use of draining herbs damaging Stomach Qi is similar. Further examination showed worsening with cold exposure or cold food. Synthesizing pulse and syndrome, this must be severe decline of Stomach Qi and obstruction by cold-water. Plan: Warm the Middle, strengthen Spleen, promote urination, and transform fluid. Prescription: Fuzi 10g, Rougui 10g, Dangshen 10g, Baizhu 10g, Jiangtang 10g, Gancao 10g, Zexie 10g, Zhuling 10g, Fuling 10g.
Taken cold, after 4 doses, swallowing was significantly smoother, and no vomiting occurred within 1 week. Continued for another 10 doses, all signs of Yige disappeared, and recovery was achieved.
A certain physician asked: All physicians claim Qige San, Tongyou Tang, and Xuanfu Daizhe Tang are key formulas for treating Yige, yet they were ineffective here. Why? Answer: From the pulse perspective: there is no Qi constraint, no Blood stasis, no Yin deficiency, no Liver-Stomach rebellious Qi, only Spleen-Stomach deficiency-cold and cold-fluid accumulation. Therefore, Qi-regulation failed, Blood-invigoration failed, descending-rebellious failed. Using Fuzi and Rougui to warm and strengthen Spleen, Wuling San to transform fluid and promote urination, combined with cold administration to overcome rejection, led to cure.
3. Spleen deficiency and Stomach dryness, failure to rot and cook food, contrary use of warming-drying herbs damages the Stomach.
Zhang XX, female, 29 years old.
Dysphagia, fluctuating in severity for over 2 years. Diagnosed with achalasia of the esophagus and cardia. Initial Western medicine worked temporarily, but relapsed after a week. Combined with Chinese herbal medicine for bitter-pungent descending, stopping vomiting, regulating Qi, and opening the diaphragm for over 1 year, with no reduction in symptoms. Particularly in the last 3-4 months, the condition worsened severely; almost every meal and drink caused blockage and vomiting. Careful examination revealed poor appetite, reduced food intake, fatigue, thin white tongue coating, and large-deficient pulse. Thinking: Large-deficient pulse indicates dual deficiency of Qi and Yin. Combined with symptoms, this is dual deficiency of Qi and Yin, Spleen deficiency and Stomach dryness, inability to properly digest food. Treatment should use Banxia to open knots and descend rebellious Qi, Renshen and Bai Mi (white honey) to tonify deficiency and moisten dryness. Reflecting on why previous formulas aggravated the condition, it may be due to pungent herbs depleting Qi and bitter herbs damaging Yang, neglecting healthy Qi. Prescribed Banxiaxitang modified: Renshen 10g, Banxia 10g, Fengmi 30g.
After 1 dose, not only was there no vomiting of medicine, but vomiting of food and dysphagia decreased. After continuing for 10 doses, complete recovery occurred.
A certain physician asked: Banxiaxitang is a formula set by Zhang Zhongjing for Fanwei (vomiting regurgitation). Zhang Zhongjing's "Jingui Yaolue" states: "For gastric reversal vomiting, Banxiaxitang governs it." Why did you apply it to Yige? Answer: The main spirit of syndrome differentiation and treatment lies in identifying the underlying principle. What is the principle here? Dual deficiency of Qi and Yin. Banxiaxitang tonifies Qi and nourishes Yin, hence it cured the condition.
Hiatal Hernia
1. Failure to examine deficiency and excess, cold and heat; prolonged use of Spleen-regulating methods assisted by Qi-regulation, disease does not diminish.
Wang XX, male, 38 years old.
Burning pain below the xiphoid process, aggravated after eating for over 4 years. Diagnosed with hiatal hernia. Western medicine was ineffective. Combined with Chinese herbal medicine for regulating Spleen and Stomach, soothing Liver and harmonizing Stomach, and invigorating Blood for removing stasis, efficacy was also insignificant. Careful examination revealed unbearable burning pain behind the sternum, below the xiphoid, and in both hypochondria, worse after eating, accompanied by irritability, dizziness, headache, wandering pain in chest and hypochondria, heartburn and acid regurgitation, night-time dry mouth, white tongue coating, and deficient-wiry-tight, slightly slippery pulse. Synthesizing pulse and syndrome: Chest and hypochondriac fullness/pain, irritability indicate Liver constraint; chronic unceasing pain indicates Blood stasis; burning pain with night-time dry mouth indicates Yin deficiency; pain immediately after eating indicates Excess; deficient-wiry-slippery pulse indicates dual deficiency of Qi and Yin, and Phlegm-Heat obstruction. In summary, root is dual deficiency of Qi and Yin, branch is Qi stagnation, Blood stasis, and Phlegm accumulation. Treatment: Tonify Qi and nourish Yin to support root, regulate Qi and invigorate Blood, resolve Phlegm and dissipate accumulation to treat branch. Prescription: Dangshen 30g, Maidong 10g, Shengdi 30g, Cangzhu 15g, Baizhu 10g, Qingpi 10g, Chenpi 10g, Chaihu 10g, Sanleng 10g, Ezhu 10g, Bohe 3g, Laifuzi 10g, Sharen 10g, Yejiaoteng 30g.
After 2 doses, burning pain, chest fullness/vexation, and headache decreased. After continuing for 60 doses, pain disappeared, and all symptoms resolved.
A certain physician asked: Why did previous Qi-regulating, Liver-soothing, and Blood-invigorating treatments fail? Answer: Due to lack of supporting healthy Qi, lack of promoting digestion, and lack of nourishing Yin.
2. Prolonged use of draining methods, healthy Qi deficient and pathogenic factor excess; tonifying healthy Qi obstructs pathogen, promoting digestion injures healthy Qi, difficult to administer medication.
Hao XX, male, 78 years old.
Burning pain in the epigastrium for decades. Diagnosed with hiatal hernia. Initial Western medicine ineffective. Subsequent combination with Chinese herbal medicine for soothing Liver, harmonizing Stomach, invigorating Blood, regulating Spleen/Stomach, and promoting digestion also ineffective. Careful examination revealed pain below xiphoid, worse after eating, belching and hiccups, bitter and dry mouth, yellow-white tongue coating, and deep-tight-slippery pulse. Synthesizing pulse and syndrome: Pain immediately after eating indicates solid accumulation. Should use digestion-promoting methods. However, advanced age implies insufficiency of Qi, Blood, Yin, and Yang. Over-draining accumulation will inevitably injure healthy Qi; heavy digestion-promoting agents cannot be used. Should follow Zhang Zhongjing's method of gently tonifying deficiency. Prescription: Shan Zha Huazhi Wan (Hawthorn Pill for Resolving Stagnation), half pill per dose, 3 times daily. Continuous use for 2 months resulted in disappearance of all symptoms and increased diet.
Acute Gastroenteritis
1. Decoctions and pills differ, speed varies, distinction is crucial.
Zhang XX, male, 40 years old.
Epigastric pain for over 2 years. Upon inquiry, pain was exactly in the epigastrium, worse upon pressure. Pulse was floating and slippery. Prescribed Xiaoxiantang (Small Trap Decoction). After 4 doses, pain reduced by 70-80%, instructed to continue for 3 doses. Unexpectedly, next day, sudden continuous vomiting and diarrhea, fever, and sweating. His son, knowing some TCM, said: This is summerheat-induced vomiting/diarrhea cholera. Urgently bought a box of Huoxiang Zhengqi Wan (Patchouli Correcting Qi Pills). Taking 4 pills yielded no effect. Urgently invited me for diagnosis. Examination revealed vomiting and diarrhea together, fever, fatigue, profuse sweating all over body, head sweating like rain, white tongue coating, and floating-tight-rapid pulse. Thinking: Disease onset in summer season, rapid progression, floating-tight-rapid pulse indicates external contraction of Wind-Cold and internal injury of Summerheat-Dampness, internal and external combined pathogen. Said: This is Cold-type Summerheat injury, urgently needs exterior-resolving and interior-harmonizing, regulating Qi and transforming turbidity, Huoxiang Zhengqi San modified. Just as prescription was written, patient's son said: Your theory is wrong. If this disease is as you say, Huoxiang Zhengqi should have been effective. Why did it fail? This disease was actually caused by your error in using Trap Decoction, please do not shirk responsibility. I replied: Your words are mistaken! If it were indeed an error from Trap Decoction, why did your mother's initial use of Trap Decoction show good effect, and why did she request to continue the same prescription at the last outpatient visit? Facts speak louder than arguments, please consider. Regarding why 4 pills of Huoxiang Zhengqi Wan were ineffective, I believe pills act slowly, decoctions act vigorously. Huoxiang Zhengqi Wan has fewer ingredients and weaker force, acting gradually. Hence, no effect after 3 hours. If switched to decoction, entering the stomach, it can sweep away pathogens, and recovery will occur soon. Patient and family finally believed my reasoning. Urgently prescribed: Huoxiang 10g, Dafupi 10g, Zisu 10g, Gancao 6g, Jiegeng 10g, Chenpi 10g, Fuling 10g, Baizhu 10g, Houpo 10g, Banxia 10g, Shenqu 10g, Baizhi 10g, Shengjiang 3 slices, Dazao 5 pieces.
Decoction boiled for 20 minutes, taken spoon by spoon. Vomiting stopped at 30 minutes, vomiting/diarrhea stopped at 40 minutes, symptoms largely reduced at 2 hours, cured at 8 hours. One more dose for consolidation.
2. Damp-turbidity invading Spleen, pathogen binding Shaoyang; failure to examine pulse/syndrome, merely giving Huoxiang Zhengqi, efficacy not seen.
Wen XX, male, 66 years old.
Chronic gastritis for over 30 years, diabetes for over 10 years, paroxysmal supraventricular tachycardia for 5 years. For over 2 months, vomiting and diarrhea together, palpitations, shortness of breath, dizziness, headache. Urgently hospitalized. Diagnosed with acute gastroenteritis, atrial fibrillation, diabetic ketoacidosis. Western medicine for over 1 month showed no improvement. Combined with Huoxiang Zhengqi Capsules, Heart-nourishing/Spirit-calming, and Yin-nourishing/Qi-tonifying decoctions for 8 days, condition still not improving. Careful examination revealed mental exhaustion, nausea/vomiting, intermittent diarrhea, mental restlessness/palpitations, chest fullness/pain, dizziness/head distension, bitter taste and dry throat, thin white tongue coating, and wiry-tight-choppy pulse. Thinking: Wiry pulse is Shaoyang pulse; tight and choppy together indicate Cold-Damp invading Spleen. Synthesizing pulse and syndrome: Shaoyang pivot mechanism dysfunction, Cold-Damp turbidity invading Spleen and Stomach. Treatment: Harmonize Shaoyang, dry Dampness, warm Middle, transform turbidity. Prescription: Chaihu 10g, Banxia 10g, Renshen 10g, Huangqin 10g, Jiangtang 3g, Gancao 6g, Dazao 5 pieces, Cangzhu 10g, Houpo 10g, Chenpi 10g, Fuling 15g, Guizhi 10g.
Just as prescription was finished, a physician asked: Patient has diabetic ketoacidosis, why use Dazao (Jujube) instead of Shengdi, Yuanshen, Huafen, Maidong? Answer: The soul of TCM lies in syndrome differentiation according to TCM theory. Although this disease is diabetic ketoacidosis, there is no Yin deficiency syndrome recognized by TCM, so Shengdi-like herbs cannot be used. From the syndrome perspective, this is Cold-Damp lodging in Spleen; adding Yin-nourishing flavors would aid Cold-Damp and cause harm, which is the greatest taboo for this disease.
After 2 doses, nausea/vomiting stopped, diet slightly improved, palpitations/vexation, dizziness/head distension decreased. After continuing for 6 doses, most symptoms disappeared.
10 days later, returned for follow-up. Reported: For 2 days, abdominal distension/pain, bitter taste/dry throat, fatigue. Last night, sudden tachycardia, stopped only by urgent eye pressure. Urgently visited hospital again. Diagnosed with chronic gastritis, diabetes, paroxysmal supraventricular tachycardia. Pulse was wiry-large-tight-rapid, tongue coating thin white. Thinking: Wiry-large-tight-rapid pulse indicates dual deficiency of Qi and Yin, Damp-Heat accumulation, failure of Clear ascending and Turbid descending functions. Plan: Tonify Qi and nourish Yin, dry Dampness and clear Heat, ascend Clear and descend Turbid. Prescription: Renshen 10g, Gancao 6g, Huangqi 15g, Danggui 6g, Maidong 10g, Wuweizi 10g, Qingpi 10g, Chenpi 10g, Shenqu 10g, Huangbo 10g, Gegen 10g, Cangzhu 10g, Baizhu 10g, Shengma 10g, Zexie 10g.
After 2 doses, symptoms slightly reduced. To accurately observe drug efficacy, instructed to stop all other medications. After 10 doses, symptoms indeed reduced by over 80%; after another month, all symptoms disappeared.
3. Filth accumulating in Stomach, contrary use of anti-emetics; Turbid pathogen not resolved, disease difficult to eliminate.
An XX, male, 10 years old.
Abdominal pain, frequent vomiting for 10 days. Diagnosed with acute gastritis. Western medicine ineffective. Combined with Chinese herbal medicine for soothing Liver, harmonizing Stomach, and Huoxiang Zhengqi, still ineffective. Careful examination revealed frequent vomiting, epigastric distension/pain, refusal to press, worsening upon smelling greasy odors, total loss of appetite, thick greasy white tongue coating, and wiry-tight-slippery-rapid pulse. Synthesizing pulse and syndrome: This is caused by unclean diet, filth-turbidity invading Stomach, accumulation and stagnation failing to transform. Treatment: Transform turbidity and guide out stagnation. Prescription: Shenqu 10g, Ziyeh 10g.
Acupuncture: Zhongwan, Zusanli, Neiguan.
After 1 dose of medicine combined with acupuncture, pain and vomiting reduced by 80-90%. After continuing for 2 doses, cured.