服药12剂，心烦心悸，浮肿均减，面色正常，红斑消失，尿蛋白(+)，红细胞1—3个，白细胞(一)。继服上方1月，诸证消失，尿常规(一)，肝功正常，心电图正常。
某医云：小柴胡汤加减治疗红斑性狼疮的心、肝、肾损害，吾未闻也，请明示之。答曰：《素问》云：微妙在脉，不可不察。察什么?察阴阳，察脏腑，察先后。今脉沉而滑，说明本病乃为痰火在先，故以理气化痰之剂治之。
过敏性紫癜性肾炎
1．胶于解毒，泥于凉血，囿于活血，不审脉，不察兼挟，久治不效
何×，女，10岁。
紫癜消退后，尿中一直保持大量蛋白、红、白细胞半年多。医诊过敏性紫癜性肾炎。先以西药治疗2个多月无效，后又配合清热解毒，活血凉血之剂5个多月亦无功。审其精神、食欲正常，身体呈库欣综合征型，舌苔黄白厚腻，脉虚大弦滑数，尿蛋白(++++)，红细胞15—30个，白细胞20～30个。综合脉证，思之：脉虚大者，气阴两虚也；弦者，寒也；滑数者，痰热也。气阴两虚，湿热蕴久，郁而成痰，中挟寒也。治宜补气养阴，燥湿清热，佐以温化。处方：肾康灵胶囊，1次2粒，1日3次，空心服。
服药1周，查尿常规(一)；继服1周，停药2周，复查尿常规4次，均为阴性。
2．不察虚实，但予祛邪，反复发热，不知其过
温××，男，16岁
过敏性紫癜大片紫斑消退后，持续蛋白尿1年多。医诊过敏性紫癜性肾炎。先以大剂西药治疗7个月不效，继又配合中药解毒活血，活血益气之剂4个多月仍无功。特别是近3个多月来，经常出现发热，咽喉疼痛，且近一周来连续发烧不止，虽用中、西药治疗，症状一直不见好转。细审其证，发热，体温38．5℃，疲乏无力，咽喉干痛，口干舌燥，脉虚大弦数，舌苔黄白。尿常规：蛋白什抖，红细胞满视野，白细胞20～30个。综合脉证，思之：脉虚大弦数者，气阴两虚为本，湿热内蕴，外受风邪为标。治宜补气养阴、燥湿清热，佐以解表。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，生姜3片，大枣5个。服药2剂，发热消失，体温36．7℃。继服上方，加肾康灵胶囊，每日3次，每次4粒，空心服。服药1月，诸证消失，尿(一)。
某医云：紫癜性肾炎难治之疾也，前用激素及中药清热解毒，凉血活血而不愈，今不治此病而反愈者，何也?答曰：仲景云：观其脉证，知犯何逆，随证治之者，云其先见其脉而论病，今此病既不见热毒，又不见血热，又不见瘀血，反大剂用药，此误也。至于用肾康灵胶囊何以治之取效者，乃有其脉证也。
肾盂肾炎
1．胶于炎症，不审辨证，病在少阳，反清热毒，其病不解
独××，女，29岁。
高热不退，恶心欲吐，心烦不安5天。医诊肾盂肾炎。先以西药治疗2天不效，后又配合中药清热解毒剂3天亦无明显效果。审其证见寒热往来，体温39．8℃，头晕乏力，恶心欲吐，纳呆食减，舌苔白，脉弦数。综合脉证，思之证系少阳，反见数脉，为少阳夹有郁热也。治宜和解少阳；佐以泄火。处方：柴胡24克，半夏10克，黄芩10克，党参10克，甘草10克，生姜3片，大枣5个，连翘15克。
服药1剂，寒热，呕吐均大减，体温降至37．8℃，继服l剂，诸证俱失，尿常规(一)，又服3剂，果愈。
2．胶于炎症，固于膀胱，不审气机，肝脾不调，反用寒凉
黎××，女，40岁。
泌尿系感染3个多月。医先用西药治疗1个多月不效，后用西药配合中药利水通淋、清热解毒亦效果不著。细审其证，除尿频尿热尿痛外，并见脘腹胀满，小腹坠痛，里急后重，欲便不能，欲罢不止，心烦不安，头晕乏力，纳呆食减，脉弦紧稍滑。因思脉弦者，肝胆三焦也；紧者，寒也，结也；滑者，积热也。合之于症论之，乃三焦郁热，肝脾不和也。治宜调肝脾，理三焦，散郁热。处方：厚朴10克，草果10克，槟榔10克，黄芩10克，知母10克，菖蒲10克，甘草6克，柴胡10克，紫苏6克，白芷10克。
服药4剂，诸证俱减；继服3剂，小腹坠胀，尿频尿痛消失，尿常规、尿培养均恢复正常；又服15剂，诸证消失，愈。
3．湿热久蕴，损及肾阳，命火不足，反与泻火，损正益邪，久病不愈
赵××，女，35岁。
肾盂肾炎、肾盂积水7～8年。医始用西药治疗有所好转，继而无效，再配用清利湿热、清热解毒之剂，亦是始效，而后又不效。特别是近一年来，尿急尿频尿痛经常反复发作，近4个月来，尿急尿频尿痛特别严重，虽反复应用中、西药物亦不见减，且近3个月来，日渐感到腰困腰痛，疲乏无力，不得已，再求中医治之。审其除上症外，并见舌苔薄白，脉沉细弦涩。思之：脉沉细者，里虚也；弦涩并见者，阳虚寒盛也。合之于症，统而论之，此乃肾阳不足为本，湿热为标耳。拟用培补肾气以培本，利湿清热以治标。处方：熟地24克，山药10克，肉苁蓉12克，土茯苓15克，泽泻10克，丹皮10克，附子10克，肉桂10克，车前子10克(布包)，怀牛膝10克，五味子10克。
服药4剂，尿频尿痛，腰困腰痛大减，继服上药40剂，诸证消失，乃以金匮肾气丸，每次l丸，每日2次，服药3个月，果愈。
某医云：肾盂肾炎、肾盂积水经过抗菌治疗久久不解，有时此种细菌虽已消失，而彼种细菌却突然出现，如此缠绵岁月者何也?今不用抗菌药物却见细菌很快消失，且肾盂积水亦获痊愈，其原因何在?答曰：中医外科将细菌感染的疾病分为阴证、阳证，半阴半阳证，阳证者用清热解毒细菌可以消失，阴证者用补阳益气可以使细菌消失。内科疾病与外科疾病相同，所以采用补肾益阳法可以使本病获得痊愈。
4．肝郁气滞，郁而化火，不解其郁，但泻其火，郁者更郁，火者更火
章××，女，30岁。
尿急尿频尿痛时轻时重，时发时止1年多。医诊肾盂肾炎。前医始予西药治疗半年多，效果一直不够理想，加用中药清热解毒、利水通淋后仍然效果不够显著。细审其证，除尿急尿频尿痛之外，并见小腹坠胀，大便不爽，舌苔白，脉沉。综合脉证，思之：脉沉者，气郁也，合之于症，乃气郁化火之气淋证也。因拟理气通淋。处方：木香10克，香附10克，乌药10克，苏叶6克，槟榔10克，黄芩9克。
服药2剂，腹部坠胀，尿频尿痛大减；继服30剂，诸证消失，尿培养、尿常规均恢复正常，后果愈。
肾、输尿管结石
1．寒热不分，但予通淋，寒凝不化，疼痛更甚
黄××，男，53岁。
脘腹绞痛，痛彻腰胁、少腹，欲尿不出3天。医诊肾、输尿管结石，左肾盂积水。先用西药治之不减，后配合中药排石利水、针灸治之仍不效。审其除脘腹绞痛，痛彻腰胁少腹之外，并见发热，舌苔薄白，脉弦紧数。综合脉证，思之：脉弦紧数者，寒也。正与仲景所述“胁下偏痛，发热，其脉紧弦，此寒也，以温药下之，宜大黄附子汤”相符合。因拟大黄附子汤加减。处方：附子10克，细辛4克，枳实10克，厚朴10克，大黄3克。
昼夜16个小时内连服2剂。并云：服药至4个小时时，腹痛即止，为巩固疗效，又服2剂。1月之后，经x线、超声波探查肾盂积水、结石均消失。
医云：诸家之报道均云利尿排石为治沙石淋之唯一方法，而老师反不用之何也?答曰：本病前医已用过此法而无效，而脉又见弦紧数，弦紧数脉者为寒邪凝滞，只可用温药散之，故不再用利尿排石之剂治之。
2．气滞血瘀，不予理气活血，但予利水通淋，血病治气，故而不愈
庞××，男，40岁。
右肾、输尿管结石5年多。先用西药治疗1年不效，后又配合中药利水通淋排石亦无效。细审证见腹痛频发，发时则尿频尿急尿痛，排尿困难，甚或恶心呕吐，并见有双侧肾盂积水，脉沉弦紧涩，舌质暗，舌苔白。综合脉证，思之：病久不愈，且脉沉弦紧涩，舌质暗，必有瘀血也。因拟理气活血，利水通淋排石。处方：桃仁10克，丹皮10克，赤芍10克，乌药10克，元胡10克，甘草6克，当归10克，川芎10克，灵脂10克，红花10克，枳壳10克，香附10克，萹蓄30克，海金沙30克，瞿麦30克，滑石10克，细辛3克。
服药10剂，疼痛尽失，20天后突然排出如拇指大的结石一块及小的结石数块。1个月后，再次复查，不但结石消失，而且肾盂积水亦痊愈。
再生障碍性贫血
1．但予补益，不知敛潜，虚火炽盛，耗烁阴精
勾××，男，25岁。
3年多来，鼻衄、齿衄、紫斑、发热。医诊再生障碍性贫血。医先予激素、输血、丙酸睾丸酮等治疗不效，后又配合中药滋补肝肾、补气养血之剂亦不效。审其除鼻衄齿衄经常出现外，并见全身有多处大片大片的紫斑，按之平坦而不碍手，亦不退色，持续发热在39℃～39．8℃左右，自汗盗汗，疲乏无力，全身酸痛，纳呆食减，心烦不安，面色皓白无华，舌苔白，脉虚大滑数而时见促。综合脉证，思之：面色皓白，脉虚大滑数而促者，气阴两虚为本，相火妄动，津气不敛为标。治宜补气养阴，泻火敛阳。处方：黄芪15克，当归6克，龟甲60克，鳖甲30克，龙骨15克，牡蛎15克，人参10克，甘草10克，五味子10克，麦冬10克，白芍15克，阿胶10克(烊化)，生地15克。
连续服药26剂后，齿衄、鼻衄、发热、汗出均消失，且精神、食欲明显改善。继服上药60剂，诸证大部消失，血色素由4克增至10克。又服上方60剂，诸证消失，血色素上升至15克。
某医云：前方药物绝大多数均已用过，然其均无效果，其故何也?答曰：补气养阴虽具而敛潜之力不足也。正如吴鞠通所说：“若伤之太甚，阴阳有脱离之象，复脉亦不胜任，则非救逆不可。”救逆者，即于加减复脉内去麻仁，加生龙骨、生牡蛎，脉虚大欲散者加人参也。
2．脾胃虚寒，不益脾胃，反以凉血，伐脾伤胃，统血不能，生血不成
郭××，男，17岁。
鼻衄时发时止，疲乏无力3年多。医诊再生障碍性贫血。先以西药治疗2年无效，后又配合中药清热凉血、滋阴补肾、补气养血等剂近一年多亦无明显效果。审其除鼻衄、紫斑、疲乏无力外，并见面色萎黄，消瘦乏神，纳呆食减，舌质淡白，舌苔白润，脉沉细弦。综合脉证，思之：面色萎黄者，脾病也，血虚也；舌淡苔白润者，气血俱虚，脾胃虚寒也；沉细弦脉者，气血俱虚，脾虚木乘也。综而论之，乃气血俱虚，脾胃虚寒，木邪犯土，脾虚不得生血统血也。治拟益气养血，健脾温中。处方：黄芪7克，肉桂3克，生地6克，川芎3克，当归6克，白芍6克，人参6克，白术6克，茯苓6克，炙草6克，麦冬6克，半夏6克，附子O．1克，肉苁蓉4克，生姜l片，大枣3个。
服药6剂，食欲增加，精神好转。继服20剂后，鼻衄、紫斑均消失，血色素亦由6克增至9克。再服120剂，诸证消失，血色素恢复至15克，愈。
某医云：诸医均以清热凉血、滋阴补肾、补气养血治之，而先生独以十四味建中汤治之，其故何也?答曰：紫斑、出血者以热毒入于营血者为多，故临床医家多以清热凉血治之。这些年来，随着中西医结合的开展，逐步发现再生障碍性贫血肾阴亏损、气血俱虚者不少，故多以滋阴补肾、补气养血之法治之。然而血热妄行、肾阴亏损、气血俱虚者虽多，而并不是所有的再生障碍性贫血都属于此种类型，因此还需要我们认真的分辨疾病的性质。本病不但气血俱虚，而且脾胃虚寒，此时若但予补气养血必然壅脾害胃而血不生，脾不统。因此在治疗时必须在健脾温中的基础上予以补气养血。十四味建中汤者，王海藏《医垒元戎》去肉苁蓉称之谓大建中汤，云：“治内虚里急少气，手足厥逆，少腹挛急，或腹满弦急不能食，起即微汗出，阴缩，或腹中寒痛，不堪劳苦，唇口舌干，精自出，或手足作寒作热，时烦苦酸痛不能，当立此补中益气。”汪昂《汤头歌诀》云其治阴斑劳损，说：“亦有阴症发斑者，淡红隐隐，散见肌表，此寒伏于下，逼其无根之火，熏肺而然，若服寒药立毙。”“又有建中十四味，阴斑劳损起沉疴。”故以十四味建中汤治之。
3．热毒炽盛，不审病情，胶于补益，病势愈剧
郑××，女，28岁。
服用该方药12剂后，心烦、心悸及浮肿症状均减轻，面色恢复正常，红斑消失。尿检显示蛋白(+)，红细胞1—3个/高倍视野，白细胞(-)。继续服用上方1个月，所有症状消失，尿常规检查正常，肝功能正常，心电图正常。
某位医生说：“用小柴胡汤加减治疗红斑性狼疮引起的心、肝、肾损害，我从未听说过，请明示其中的道理。”我回答说：“《素问》说：‘医道的微妙在于脉象，不可不仔细诊察。’诊察什么呢？诊察阴阳、脏腑以及病情的先后缓急。现在患者脉象沉而滑，说明本病是由于痰火内蕴在先，因此使用理气化痰的方剂进行治疗。”
过敏性紫癜性肾炎
1．拘泥于解毒，局限于凉血，固守于活血，不审察脉象，不观察兼夹证候，久治无效
何××，女性，10岁。
紫癜消退后，尿液中持续存在大量蛋白、红细胞和白细胞半年多。医生诊断为过敏性紫癜性肾炎。先用西药治疗2个多月无效，后又配合清热解毒、活血凉血的中药治疗5个多月也毫无功效。诊察其精神状态和食欲正常，身体呈现库欣综合征（皮质醇增多症）体型，舌苔黄白厚腻，脉象虚大弦滑数，尿蛋白(++++)，红细胞15—30个/高倍视野，白细胞20～30个/高倍视野。综合脉象和症状思考：脉象虚大，是气阴两虚；脉弦，主寒；脉滑数，主痰热。这是气阴两虚，湿热蕴结日久，郁结而成痰，中间夹杂寒邪。治疗应当补气养阴，燥湿清热，佐以温化。处方：肾康灵胶囊，每次2粒，每日3次，空腹服用。
服药1周后，复查尿常规正常；继服1周，停药2周，复查尿常规4次，均为阴性。
2．不审察虚实，只给予祛邪治疗，导致反复发热，不知过错所在
温××，男性，16岁。
过敏性紫癜大片紫斑消退后，持续蛋白尿1年多。医生诊断为过敏性紫癜性肾炎。先以大剂量西药治疗7个月无效，继而又配合中药解毒活血、活血益气之剂治疗4个多月仍无功效。特别是近3个多月来，经常出现发热、咽喉疼痛，且近一周来连续发烧不止，虽然使用中、西药治疗，症状一直不见好转。仔细审察其证候：发热，体温38.5℃，疲乏无力，咽喉干痛，口干舌燥，脉象虚大弦数，舌苔黄白。尿常规：蛋白(+)，红细胞满视野，白细胞20～30个/高倍视野。综合脉象和症状思考：脉象虚大弦数，是气阴两虚为本，湿热内蕴，外受风邪为标。治疗应当补气养阴、燥湿清热，佐以解表。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，生姜3片，大枣5个。服药2剂，发热消失，体温降至36.7℃。继服上方，加服肾康灵胶囊，每日3次，每次4粒，空腹服用。服药1个月，所有症状消失，尿检正常。
某位医生说：“紫癜性肾炎是难治之疾，之前用激素及中药清热解毒、凉血活血而未愈，如今不治此病反而痊愈了，为什么呢？”我回答说：“张仲景说：‘观其脉证，知犯何逆，随证治之’，意思是先通过脉象来论断病情。现在这个病既没有看到热毒，也没有看到血热，更没有看到瘀血，反而使用大剂量药物，这是误治。至于使用肾康灵胶囊为何能取效，是因为符合其脉证表现。”
肾盂肾炎
1．拘泥于炎症概念，不审察辨证，病在少阳经，反而使用清热毒法，导致病不解
独××，女性，29岁。
高热不退，恶心欲吐，心烦不安5天。医生诊断为肾盂肾炎。先用西药治疗2天无效，后又配合中药清热解毒剂治疗3天也无明显效果。审察其证见寒热往来，体温39.8℃，头晕乏力，恶心欲吐，食欲不振，舌苔白，脉弦数。综合脉象和症状思考：证系少阳病，反见数脉，为少阳病夹有郁热。治疗应当和解少阳，佐以泄火。处方：柴胡24克，半夏10克，黄芩10克，党参10克，甘草10克，生姜3片，大枣5个，连翘15克。
服药1剂，寒战发热、呕吐均大幅减轻，体温降至37.8℃，继服1剂，所有症状消失，尿常规正常，又服3剂，果然痊愈。
2．拘泥于炎症，固守于膀胱病变，不审察气机运行，肝脾不调，反而使用寒凉药物
黎××，女性，40岁。
泌尿系感染3个多月。医生先用西药治疗1个多月无效，后用西药配合中药利水通淋、清热解毒，效果也不显著。仔细审察其证，除尿频、尿热、尿痛外，并见脘腹胀满，小腹坠痛，里急后重，想排便却排不出，想停止却停不下来，心烦不安，头晕乏力，食欲不振，脉弦紧稍滑。因而思考：脉弦者，涉及肝胆和三焦；脉紧者，主寒、主结聚；脉滑者，主积热。结合症状论述，这是三焦郁热，肝脾不和。治疗应当调肝脾，理三焦，散郁热。处方：厚朴10克，草果10克，槟榔10克，黄芩10克，知母10克，石菖蒲10克，甘草6克，柴胡10克，紫苏6克，白芷10克。
服药4剂，所有症状均减轻；继服3剂，小腹坠胀、尿频尿痛消失，尿常规、尿培养均恢复正常；又服15剂，所有症状消失，痊愈。
3．湿热久蕴，损伤肾阳，命门火不足，反而使用泻火法，损伤正气助长邪气，久病不愈
赵××，女性，35岁。
肾盂肾炎、肾盂积水7～8年。医生起初用西药治疗有所好转，继而无效，再配用清利湿热、清热解毒之剂，也是开始有效，而后又不效。特别是近一年来，尿急、尿频、尿痛经常反复发作，近4个月来，尿急、尿频、尿痛特别严重，虽反复应用中、西药物亦不见减轻，且近3个月来，日渐感到腰部困倦腰痛，疲乏无力，不得已，再次求治中医。审察其除上述症状外，并见舌苔薄白，脉沉细弦涩。思考：脉沉细者，是里虚；弦涩并见者，是阳虚寒盛。结合症状，统而言之，这是肾阳不足为本，湿热为标。拟定用培补肾气以治本，利湿清热以治标。处方：熟地黄24克，山药10克，肉苁蓉12克，土茯苓15克，泽泻10克，牡丹皮10克，附子10克，肉桂10克，车前子10克（布包），怀牛膝10克，五味子10克。
服药4剂，尿频尿痛、腰部困倦腰痛大幅减轻，继服上药40剂，所有症状消失，乃改用金匮肾气丸，每次1丸，每日2次，服药3个月，果然痊愈。
某位医生说：“肾盂肾炎、肾盂积水经过抗菌治疗久久不解，有时此种细菌虽已消失，而彼种细菌却突然出现，如此缠绵岁月者为什么呢？如今不用抗菌药物却见细菌很快消失，且肾盂积水亦获痊愈，其原因何在？”我回答说：“中医外科将细菌感染的疾病分为阴证、阳证、半阴半阳证，阳证者用清热解毒细菌可以消失，阴证者用补阳益气可以使细菌消失。内科疾病与外科疾病相同，所以采用补肾益阳法可以使本病获得痊愈。”
4．肝郁气滞，郁而化火，不解其郁结，只泻其火势，郁者更郁，火者更火
章××，女性，30岁。
尿急、尿频、尿痛时轻时重，时发时止1年多。医生诊断为肾盂肾炎。前医起初予西药治疗半年多，效果一直不够理想，加用中药清热解毒、利水通淋后仍然效果不够显著。仔细审察其证，除尿急、尿频、尿痛之外，并见小腹坠胀，大便不爽，舌苔白，脉沉。综合脉象和症状思考：脉沉者，是气郁，结合症状，乃是气郁化火之气淋证。因而拟定理气通淋。处方：木香10克，香附10克，乌药10克，苏叶6克，槟榔10克，黄芩9克。
服药2剂，腹部坠胀、尿频尿痛大幅减轻；继服30剂，所有症状消失，尿培养、尿常规均恢复正常，后果痊愈。
肾、输尿管结石
1．寒热不分，只给予通淋法，寒凝不化，疼痛更甚
黄××，男性，53岁。
脘腹绞痛，痛彻腰胁、少腹，想排尿却排不出3天。医生诊断为肾、输尿管结石，左肾盂积水。先用西药治疗不减，后配合中药排石利水、针灸治疗仍无效。审察其除脘腹绞痛，痛彻腰胁少腹之外，并见发热，舌苔薄白，脉弦紧数。综合脉象和症状思考：脉弦紧数者，是寒邪所致。正与张仲景所述“胁下偏痛，发热，其脉紧弦，此寒也，以温药下之，宜大黄附子汤”相符合。因而拟定大黄附子汤加减。处方：附子10克，细辛4克，枳实10克，厚朴10克，大黄3克。
昼夜16个小时内连服2剂。并说：服药至4个小时时，腹痛即止，为巩固疗效，又服2剂。1月之后，经X线、超声波探查，肾盂积水、结石均消失。
医生说：“诸家报道均称利尿排石为治疗沙石淋的唯一方法，而老师反而不用，为什么呢？”我回答说：“本病前医已用过此法而无效，而脉又见弦紧数，弦紧数脉者为寒邪凝滞，只可用温药散之，故不再用利尿排石之剂治疗。”
2．气滞血瘀，不予理气活血，只给予利水通淋，血病治气，故而不得痊愈
庞××，男性，40岁。
右肾、输尿管结石5年多。先用西药治疗1年无效，后又配合中药利水通淋排石亦无效。仔细审察证见腹痛频发，发作时则尿频尿急尿痛，排尿困难，甚或恶心呕吐，并见有双侧肾盂积水，脉沉弦紧涩，舌质暗，舌苔白。综合脉象和症状思考：病久不愈，且脉沉弦紧涩，舌质暗，必有瘀血。因而拟定理气活血，利水通淋排石。处方：桃仁10克，牡丹皮10克，赤芍10克，乌药10克，元胡10克，甘草6克，当归10克，川芎10克，五灵脂10克，红花10克，枳壳10克，香附10克，萹蓄30克，海金沙30克，瞿麦30克，滑石10克，细辛3克。
服药10剂，疼痛尽失，20天后突然排出如拇指大的结石一块及小的结石数块。1个月后，再次复查，不但结石消失，而且肾盂积水亦痊愈。
再生障碍性贫血
1．只给予补益，不知收敛潜阳，虚火炽盛，耗烁阴精
勾××，男性，25岁。
3年多来，鼻衄、齿衄、紫斑、发热。医生诊断为再生障碍性贫血。医生先予激素、输血、丙酸睾丸酮等治疗无效，后又配合中药滋补肝肾、补气养血之剂也无效。审察其除鼻衄、齿衄经常出现外，并见全身有多处大片大片的紫斑，按之平坦而不碍手，亦不退色，持续发热在39℃～39.8℃左右，自汗盗汗，疲乏无力，全身酸痛，食欲不振，心烦不安，面色皓白无华，舌苔白，脉虚大滑数而时见促脉。综合脉象和症状思考：面色皓白，脉虚大滑数而促者，是气阴两虚为本，相火妄动，津气不敛为标。治疗应当补气养阴，泻火敛阳。处方：黄芪15克，当归6克，龟甲60克，鳖甲30克，龙骨15克，牡蛎15克，人参10克，甘草10克，五味子10克，麦冬10克，白芍15克，阿胶10克（烊化），生地黄15克。
连续服药26剂后，齿衄、鼻衄、发热、汗出均消失，且精神、食欲明显改善。继服上药60剂，所有症状大部消失，血色素由4克增至10克。又服上方60剂，所有症状消失，血色素上升至15克。
某位医生说：“前方药物绝大多数均已用过，然而均无效果，其原因是什么呢？”我回答说：“补气养阴虽然具备，但收敛潜阳之力不足。正如吴鞠通所说：‘若伤之太甚，阴阳有脱离之象，复脉亦不胜任，则非救逆不可。’救逆者，即在加减复脉汤内去麻仁，加生龙骨、生牡蛎，脉虚大欲散者加人参。”
2．脾胃虚寒，不益脾胃，反而使用凉血法，伐脾伤胃，统血不能，生血不成
郭××，男性，17岁。
鼻衄时发时止，疲乏无力3年多。医生诊断为再生障碍性贫血。先以西药治疗2年无效，后又配合中药清热凉血、滋阴补肾、补气养血等剂近一年多亦无明显效果。审察其除鼻衄、紫斑、疲乏无力外，并见面色萎黄，消瘦乏神，食欲不振，舌质淡白，舌苔白润，脉沉细弦。综合脉象和症状思考：面色萎黄者，是脾病，血虚；舌淡苔白润者，是气血俱虚，脾胃虚寒；沉细弦脉者，是气血俱虚，脾虚肝乘。综而论之，乃是气血俱虚，脾胃虚寒，木邪犯土，脾虚不得生血统血。治疗拟定益气养血，健脾温中。处方：黄芪7克，肉桂3克，生地黄6克，川芎3克，当归6克，白芍6克，人参6克，白术6克，茯苓6克，炙甘草6克，麦冬6克，半夏6克，附子0.1克，肉苁蓉4克，生姜1片，大枣3个。
服药6剂，食欲增加，精神好转。继服20剂后，鼻衄、紫斑均消失，血色素亦由6克增至9克。再服120剂，所有症状消失，血色素恢复至15克，痊愈。
某位医生说：“诸医均以清热凉血、滋阴补肾、补气养血治之，而先生独以十四味建中汤治之，其原因是什么呢？”我回答说：“紫斑、出血者多以热毒入于营血为主，故临床医家多以清热凉血治之。这些年来，随着中西医结合的开展，逐步发现再生障碍性贫血肾阴亏损、气血俱虚者不少，故多以滋阴补肾、补气养血之法治之。然而血热妄行、肾阴亏损、气血俱虚者虽多，而并不是所有的再生障碍性贫血都属于此种类型，因此还需要我们认真的分辨疾病的性质。本病不但气血俱虚，而且脾胃虚寒，此时若只给予补气养血必然壅脾害胃而血不生，脾不统血。因此在治疗时必须在健脾温中的基础上予以补气养血。十四味建中汤者，王海藏《医垒元戎》去肉苁蓉称之谓大建中汤，云：‘治内虚里急少气，手足厥逆，少腹挛急，或腹满弦急不能食，起即微汗出，阴缩，或腹中寒痛，不堪劳苦，唇口舌干，精自出，或手足作寒作热，时烦苦酸痛不能，当立此补中益气。’汪昂《汤头歌诀》云其治阴斑劳损，说：‘亦有阴症发斑者，淡红隐隐，散见肌表，此寒伏于下，逼其无根之火，熏肺而然，若服寒药立毙。’‘又有建中十四味，阴斑劳损起沉疴。’故以十四味建中汤治之。”
3．热毒炽盛，不审病情，拘泥于补益，病势愈剧
郑××，女性，28岁。
After taking the prescription for 12 doses, mental restlessness (Xin Fan), palpitations (Xin Ji), and edema (Fu Zhong) were all reduced; complexion returned to normal, and erythema disappeared. Urine test showed protein (+), red blood cells 1–3/high power field, white blood cells (-). Continuing to take the same prescription for 1 month, all symptoms disappeared, urine routine examination was normal, liver function was normal, and electrocardiogram was normal.
A certain doctor said: "I have never heard of treating cardiac, hepatic, and renal damage caused by systemic lupus erythematosus with modified Xiao Chai Hu Tang (Minor Bupleurum Decoction). Please explain the rationale." I replied: "The *Su Wen* states: 'The subtlety of medicine lies in the pulse, which must not be neglected.' What is examined? Yin and Yang, Zang-Fu organs, and the sequence of pathology. The current pulse is deep and slippery, indicating that phlegm-fire accumulation occurred first in this disease. Therefore, a formula regulating Qi and resolving phlegm was used for treatment."
Henopurpura Nephritis
1. Adhering to detoxification, limited to cooling blood, confined to invigorating blood circulation, failing to examine the pulse, failing to observe concurrent syndromes, resulting in ineffective long-term treatment
He ××, Female, 10 years old.
After the purpura subsided, large amounts of protein, red blood cells, and white blood cells persisted in the urine for over half a year. Diagnosed as Henopurpura Nephritis. Western medicine treatment for over 2 months was ineffective, followed by Chinese medicine for clearing heat and detoxifying, invigorating blood circulation, and cooling blood for over 5 months, also without efficacy. Examination revealed normal spirit and appetite, Cushingoid habitus, yellowish-white thick greasy tongue coating, and a deficiency-large, wiry-slippery-rapid pulse. Urine protein (++++) , red blood cells 15–30/high power field, white blood cells 20–30/high power field. Synthesizing the pulse and symptoms: A deficiency-large pulse indicates Qi and Yin deficiency; a wiry pulse indicates Cold; a slippery-rapid pulse indicates Phlegm-Heat. This is Qi and Yin deficiency, with Damp-Heat accumulating over time, transforming into Phlegm, mixed with Cold. Treatment should tonify Qi and nourish Yin, dry Dampness and clear Heat, assisted by warming transformation. Prescription: Shenkangling Capsules, 2 capsules per dose, 3 times daily, taken on an empty stomach.
After 1 week of medication, urine routine examination was normal; after continuing for another week and stopping for 2 weeks, four re-examinations of urine routine were all negative.
2. Failing to examine deficiency and excess, only providing pathogen-expelling treatment, leading to recurrent fever, unaware of the error
Wen ××, Male, 16 years old.
After the large patches of purpura from Henopurpura subsided, persistent proteinuria lasted for over 1 year. Diagnosed as Henopurpura Nephritis. High-dose Western medicine treatment for 7 months was ineffective, followed by Chinese medicine for clearing heat, detoxifying, invigorating blood, and tonifying Qi for over 4 months, still without efficacy. Especially in the last 3 months, frequent fever and sore throat occurred, and continuous fever persisted for nearly a week. Despite Chinese and Western medicine treatment, symptoms did not improve. Careful examination revealed fever, body temperature 38.5°C, fatigue, dry and painful throat, dry mouth and tongue, deficiency-large, wiry-rapid pulse, and yellowish-white tongue coating. Urine routine: Protein (+), red blood cells full field, white blood cells 20–30/high power field. Synthesizing pulse and symptoms: A deficiency-large, wiry-rapid pulse indicates Qi and Yin deficiency as the root, with internal Damp-Heat accumulation and external Wind pathogen as the branch. Treatment should tonify Qi and nourish Yin, dry Dampness and clear Heat, assisted by releasing the exterior. Prescription: Codonopsis 10g, Licorice 6g, Astragalus 15g, Angelica Sinensis 6g, Ophiopogon 10g, Schisandra 10g, Green Tangerine Peel 10g, Tangerine Peel 10g, Medicated Leaven 10g, Phellodendron 10g, Kudzu Root 15g, Atractylodes Macrocephala 10g, Atractylodes Lancea 10g, Cimicifuga 10g, Alisma 10g, Ginger 3 slices, Jujube 5 pieces. After 2 doses, fever disappeared, body temperature dropped to 36.7°C. Continuing the above prescription, adding Shenkangling Capsules, 3 times daily, 4 capsules per dose, taken on an empty stomach. After 1 month of medication, all symptoms disappeared, urine test normal.
A certain doctor said: "Henopurpura nephritis is a difficult disease to treat. Previous treatments with hormones and Chinese medicine for clearing heat, detoxifying, cooling blood, and invigorating blood failed. Why did it heal now without treating this specific disease?" I replied: "Zhang Zhongjing said: 'Observe the pulse and symptoms, know what deviation has occurred, and treat according to the syndrome.' This means diagnosing based on the pulse first. In this case, there are no signs of Heat-Toxin, Blood-Heat, or Blood Stasis. Using large doses of drugs was an error. As for why Shenkangling Capsules were effective, it is because they matched the patient's pulse and symptoms."
Pyelonephritis
1. Adhering to the concept of inflammation, failing to differentiate syndromes, disease in Shaoyang channel, but using heat-clearing and detoxifying methods, leading to unresolved illness
Du ××, Female, 29 years old.
Persistent high fever, nausea with urge to vomit, mental restlessness for 5 days. Diagnosed as Pyelonephritis. Western medicine treatment for 2 days was ineffective, followed by Chinese medicine for clearing heat and detoxifying for 3 days, also with no obvious effect. Examination revealed alternating chills and fever, body temperature 39.8°C, dizziness and fatigue, nausea with urge to vomit, poor appetite, white tongue coating, and wiry-rapid pulse. Synthesizing pulse and symptoms: The syndrome belongs to Shaoyang, but the rapid pulse indicates Shaoyang syndrome complicated by constrained Heat. Treatment should harmonize Shaoyang, assisted by draining fire. Prescription: Bupleurum 24g, Pinellia 10g, Scutellaria 10g, Codonopsis 10g, Licorice 10g, Ginger 3 slices, Jujube 5 pieces, Forsythia 15g.
After 1 dose, chills, fever, and vomiting were significantly reduced, body temperature dropped to 37.8°C. After another dose, all symptoms disappeared, urine routine normal. After 3 more doses, complete recovery was achieved.
2. Adhering to inflammation, confined to bladder pathology, failing to examine Qi mechanism, Liver-Spleen disharmony, but using cold-natured herbs
Li ××, Female, 40 years old.
Urinary tract infection for over 3 months. Western medicine treatment for over 1 month was ineffective, followed by Western medicine combined with Chinese medicine for promoting urination and relieving strangury, clearing heat and detoxifying, with insignificant results. Careful examination revealed urinary frequency, burning, and pain, accompanied by abdominal distension and fullness, lower abdominal dragging pain, tenesmus (urgent need to defecate but unable to pass stool), inability to stop the urge, mental restlessness, dizziness and fatigue, poor appetite, and a wiry-tight slightly slippery pulse. Reflection: A wiry pulse involves Liver, Gallbladder, and Sanjiao; a tight pulse indicates Cold and binding; a slippery pulse indicates accumulated Heat. Combined with symptoms, this is constrained Heat in Sanjiao and Liver-Spleen disharmony. Treatment should regulate Liver and Spleen, regulate Sanjiao, and dissipate constrained Heat. Prescription: Magnolia Bark 10g, Tsaoko 10g, Areca Seed 10g, Scutellaria 10g, Anemarrhena 10g, Acorus 10g, Licorice 6g, Bupleurum 10g, Perilla Leaf 6g, Angelica Dahurica 10g.
After 4 doses, all symptoms were reduced; after continuing for 3 doses, lower abdominal dragging sensation, urinary frequency, and pain disappeared, urine routine and culture returned to normal; after another 15 doses, all symptoms disappeared, and recovery was achieved.
3. Long-standing Damp-Heat damaging Kidney Yang, insufficient Mingmen Fire, but using fire-draining methods, damaging healthy Qi and aiding pathogenic factors, leading to chronic non-healing
Zhao ××, Female, 35 years old.
Pyelonephritis and hydronephrosis for 7–8 years. Initial Western medicine treatment showed improvement, then became ineffective. Subsequent use of Chinese medicine for clearing Damp-Heat and detoxifying showed initial efficacy but later failed. Especially in the past year, urinary urgency, frequency, and pain recurred frequently. In the past 4 months, these symptoms were particularly severe. Despite repeated use of Chinese and Western medicines, there was no reduction. For the past 3 months, increasing lumbar soreness and weakness, and fatigue led to seeking Traditional Chinese Medicine (TCM) treatment again. Examination revealed thin white tongue coating and deep-fine, wiry-choppy pulse. Reflection: A deep-fine pulse indicates interior deficiency; wiry and choppy pulses together indicate Yang deficiency and abundant Cold. Combined with symptoms, this is Kidney Yang deficiency as the root and Damp-Heat as the branch. The plan is to tonify Kidney Qi to address the root and promote urination and clear Heat to address the branch. Prescription: Prepared Rehmannia 24g, Dioscorea 10g, Cistanche 12g, Smilax Glabra 15g, Alisma 10g, Moutan Cortex 10g, Aconite 10g, Cinnamon Bark 10g, Plantago Seed 10g (wrapped), Achyranthes Bidentata 10g, Schisandra 10g.
After 4 doses, urinary frequency/pain and lumbar soreness/weakness were significantly reduced. After continuing the above medicine for 40 doses, all symptoms disappeared. Jin Gui Shen Qi Wan (Kidney Qi Pill from the Golden Cabinet) was then used, 1 pill per dose, twice daily, for 3 months, resulting in complete recovery.
A certain doctor said: "Pyelonephritis and hydronephrosis often do not resolve after antibiotic treatment. Sometimes one type of bacteria disappears while another suddenly appears, causing prolonged suffering. Why do bacteria disappear quickly and hydronephrosis heal without antibiotics?" I replied: "In TCM Surgery, bacterial infections are classified into Yin Syndrome, Yang Syndrome, and Half-Yin Half-Yang Syndrome. For Yang Syndrome, clearing Heat and detoxifying eliminates bacteria; for Yin Syndrome, tonifying Yang and benefiting Qi eliminates bacteria. Internal medicine diseases are similar to surgical diseases; therefore, the method of tonifying Kidney and benefiting Yang can achieve cure for this disease."
4. Liver Qi stagnation transforming into Fire, failing to resolve stagnation, only draining Fire, leading to increased stagnation and Fire
Zhang ××, Female, 30 years old.
Urinary urgency, frequency, and pain fluctuating in severity and intermittent for over 1 year. Diagnosed as Pyelonephritis. Previous Western medicine treatment for over half a year had unsatisfactory results. Adding Chinese medicine for clearing heat, detoxifying, and promoting urination also yielded insignificant effects. Careful examination revealed lower abdominal dragging sensation, uncomfortable bowel movements, white tongue coating, and deep pulse, in addition to urinary symptoms. Synthesizing pulse and symptoms: A deep pulse indicates Qi stagnation. Combined with symptoms, this is Qi-Stagnation transforming into Fire, constituting Qi Strangury. The plan is to regulate Qi and relieve strangury. Prescription: Aucklandia 10g, Cyperus 10g, Lindera 10g, Perilla Leaf 6g, Areca Seed 10g, Scutellaria 9g.
After 2 doses, abdominal dragging sensation and urinary frequency/pain were significantly reduced. After continuing for 30 doses, all symptoms disappeared, urine culture and routine returned to normal, and recovery was achieved.
Renal and Ureteral Calculi
1. Failure to distinguish Cold and Heat, only providing strangury-relieving methods, Cold coagulation not resolving, pain worsening
Huang ××, Male, 53 years old.
Abdominal colic radiating to waist and hypochondrium, lower abdomen, inability to urinate for 3 days. Diagnosed as Renal and Ureteral Calculi, left hydronephrosis. Western medicine treatment provided no relief. Combination of Chinese medicine for expelling stones and promoting urination, and acupuncture, was also ineffective. Examination revealed fever, thin white tongue coating, and wiry-tight-rapid pulse, in addition to abdominal colic radiating to waist and hypochondrium. Synthesizing pulse and symptoms: A wiry-tight-rapid pulse indicates Cold. This aligns with Zhang Zhongjing's description: "Pain on one side of the hypochondrium, fever, tight-wiry pulse, this is Cold, treat with warm purgatives, Da Huang Fu Zi Tang (Rhubarb and Aconite Decoction) is appropriate." The plan is modified Da Huang Fu Zi Tang. Prescription: Aconite 10g, Asarum 4g, Immature Bitter Orange 10g, Magnolia Bark 10g, Rhubarb 3g.
Two doses were taken continuously within 16 hours day and night. It was reported that abdominal pain stopped at 4 hours after taking the medicine. To consolidate efficacy, 2 more doses were taken. One month later, X-ray and ultrasound examinations showed disappearance of hydronephrosis and calculi.
The doctor said: "All reports state that diuresis and stone expulsion are the only methods for treating Stone Strangury. Why did you not use them?" I replied: "Previous doctors used this method without effect, and the pulse was wiry-tight-rapid, indicating Cold pathogen stagnation. Only warm herbs can disperse it; therefore, diuretic stone-expelling agents were not used again."
2. Qi stagnation and Blood stasis, failing to regulate Qi and invigorate Blood, only providing diuresis and strangury relief, treating Blood disease via Qi, thus failing to heal
Pang ××, Male, 40 years old.
Right renal and ureteral calculi for over 5 years. Western medicine treatment for 1 year was ineffective. Combination of Chinese medicine for diuresis, strangury relief, and stone expulsion was also ineffective. Careful examination revealed frequent abdominal pain, urinary frequency/urgency/pain during attacks, difficulty urinating, sometimes nausea and vomiting, bilateral hydronephrosis, deep-wiry-tight-choppy pulse, dark tongue body, and white tongue coating. Synthesizing pulse and symptoms: Chronic non-healing, deep-wiry-tight-choppy pulse, and dark tongue body indicate Blood Stasis. The plan is to regulate Qi, invigorate Blood, promote urination, relieve strangury, and expel stones. Prescription: Peach Kernel 10g, Moutan Cortex 10g, Red Peony Root 10g, Lindera 10g, Corydalis 10g, Licorice 6g, Angelica Sinensis 10g, Ligusticum 10g, Trogopterus Dung 10g, Safflower 10g, Aurantium 10g, Cyperus 10g, Polygonum Aviculare 30g, Lygodium Spore 30g, Dianthus 30g, Talcum 10g, Asarum 3g.
After 10 doses, pain completely disappeared. Suddenly, after 20 days, a thumb-sized stone and several small stones were passed. One month later, re-examination showed disappearance of calculi and healing of hydronephrosis.
Aplastic Anemia
1. Only providing tonification, failing to know how to astringe and subdue, flourishing deficient Fire consuming Yin Essence
Gou ××, Male, 25 years old.
Epistaxis, gingival bleeding, purpura, and fever for over 3 years. Diagnosed as Aplastic Anemia. Hormones, blood transfusion, and Testosterone Propionate were ineffective. Chinese medicine for tonifying Liver and Kidney, benefiting Qi and nourishing Blood was also ineffective. Examination revealed frequent epistaxis and gingival bleeding, large patches of flat, non-blanching purpura on the body, persistent fever around 39°C–39.8°C, spontaneous and night sweats, fatigue, generalized soreness, poor appetite, mental restlessness, pale lusterless complexion, white tongue coating, and deficiency-large, slippery-rapid pulse with occasional knotted interruptions. Synthesizing pulse and symptoms: Pale complexion and deficiency-large, slippery-rapid, knotted pulse indicate Qi and Yin deficiency as the root, with ministerial Fire moving recklessly and failure to astringe Jin-Qi as the branch. Treatment should tonify Qi and nourish Yin, drain Fire, and astringe Yang. Prescription: Astragalus 15g, Angelica Sinensis 6g, Turtle Shell 60g, Softshell Turtle Shell 30g, Dragon Bone 15g, Oyster Shell 15g, Ginseng 10g, Licorice 10g, Schisandra 10g, Ophiopogon 10g, White Peony Root 15g, Donkey-Hide Gelatin 10g (melted), Rehmannia 15g.
After continuous administration of 26 doses, gingival bleeding, epistaxis, fever, and sweating disappeared, and spirit/appetite improved significantly. After continuing for 60 doses, most symptoms disappeared, hemoglobin increased from 4g to 10g. After another 60 doses of the same prescription, all symptoms disappeared, hemoglobin rose to 15g.
A certain doctor said: "Most drugs in the previous prescription had been used before without effect. Why?" I replied: "While Qi and Yin tonification was present, the power of astringing and subduing was insufficient. As Wu Jutong stated: 'If injury is too severe, with signs of Yin-Yang separation, Fumai Tang cannot suffice, then Jiuni [Rescue from Collapse] is necessary.' Jiuni refers to modifying Fumai Tang by removing Hemp Seed, adding Raw Dragon Bone and Raw Oyster Shell, and adding Ginseng if the pulse is deficiency-large and scattering."
2. Spleen-Stomach deficiency-Cold, failing to benefit Spleen-Stomach, but using blood-cooling methods, damaging Spleen and Stomach, failing to control Blood and generate Blood
Guo ××, Male, 17 years old.
Intermittent epistaxis and fatigue for over 3 years. Diagnosed as Aplastic Anemia. Western medicine treatment for 2 years was ineffective. Chinese medicine for clearing heat, cooling blood, nourishing Yin, tonifying Kidney, benefiting Qi, and nourishing Blood for over a year showed no obvious effect. Examination revealed sallow complexion, emaciation and lack of spirit, poor appetite, pale tongue body, moist white tongue coating, and deep-fine-wiry pulse, in addition to epistaxis, purpura, and fatigue. Synthesizing pulse and symptoms: Sallow complexion indicates Spleen disease and Blood deficiency; pale tongue with moist white coating indicates joint Qi-Blood deficiency and Spleen-Stomach deficiency-Cold; deep-fine-wiry pulse indicates joint Qi-Blood deficiency and Spleen deficiency with Wood encroachment. Overall, this is joint Qi-Blood deficiency, Spleen-Stomach deficiency-Cold, Wood pathogen attacking Earth, and Spleen deficiency failing to generate and control Blood. Treatment plans to benefit Qi and nourish Blood, strengthen Spleen and warm the Middle. Prescription: Astragalus 7g, Cinnamon Bark 3g, Rehmannia 6g, Ligusticum 3g, Angelica Sinensis 6g, White Peony Root 6g, Ginseng 6g, Atractylodes Macrocephala 6g, Poria 6g, Roasted Licorice 6g, Ophiopogon 6g, Pinellia 6g, Aconite 0.1g, Cistanche 4g, Ginger 1 slice, Jujube 3 pieces.
After 6 doses, appetite increased, spirit improved. After continuing for 20 doses, epistaxis and purpura disappeared, hemoglobin increased from 6g to 9g. After another 120 doses, all symptoms disappeared, hemoglobin recovered to 15g, and recovery was achieved.
A certain doctor said: "Other physicians treated with clearing heat, cooling blood, nourishing Yin, tonifying Kidney, benefiting Qi, and nourishing Blood. Why did you uniquely use Shi Si Wei Jian Zhong Tang (Fourteen-Ingredient Building the Middle Decoction)?" I replied: "Purpura and bleeding are mostly due to Heat-Toxin entering Ying and Blood levels, so clinicians often use clearing heat and cooling blood. With the development of integrated Chinese and Western medicine, it has been gradually found that many cases of aplastic anemia involve Kidney Yin deficiency and joint Qi-Blood deficiency, hence the common use of nourishing Yin, tonifying Kidney, benefiting Qi, and nourishing Blood. However, although Blood-Heat reckless movement, Kidney Yin deficiency, and joint Qi-Blood deficiency are common, not all aplastic anemia belongs to this type. Therefore, careful differentiation of disease nature is required. This disease involves not only joint Qi-Blood deficiency but also Spleen-Stomach deficiency-Cold. If only Qi and Blood are tonified, it will obstruct Spleen and harm Stomach, preventing Blood generation and Spleen control. Thus, tonification of Qi and Blood must be based on strengthening Spleen and warming the Middle. Shi Si Wei Jian Zhong Tang, as described in Wang Haizang's *Yi Lei Yuan Rong*, is Da Jian Zhong Tang (Greatly Building the Middle Decoction) minus Cistanche. It states: 'Treats interior deficiency, urgency, shortness of breath, cold extremities, lower abdominal cramping, or abdominal fullness/tightness preventing eating, slight sweating upon rising, penile retraction, or cold pain in abdomen, intolerance to labor, dry lips/mouth/tongue, seminal emission, or alternating cold/heat in extremities, frequent vexation/soreness/pain. Establish this formula to tonify Middle and benefit Qi.' Wang Ang's *Tang Tou Ge Jue* states it treats Yin Purpura and consumptive disease: 'There are also Yin Syndrome cases with purpura, faint red spots scattered on skin surface. This is Cold hidden below forcing rootless Fire to scorch Lungs. Taking cold herbs leads to immediate death.' 'Also, Jian Zhong Fourteen Ingredients treat Yin Purpura and consumptive disease arising from chronic ailments.' Hence, Shi Si Wei Jian Zhong Tang was used."
3. Flourishing Heat-Toxin, failing to assess condition, adhering to tonification, disease severity worsens
Zheng ××, Female, 28 years old.