《伤寒论》云：“伤寒，脉结代，心动悸，炙甘草汤主之。”《千金翼》云：“治虚劳不足，汗出而闷，脉结悸，行动如常，不出百日，危急者十一日死。”近人见其脉结用炙甘草汤，故大多把炙甘草汤作为治疗期前收缩的方剂。余始亦认为炙甘草汤是治疗本证的惟一方剂，然久而久之，见效者少，不效者多，不得已而求教于同道，很多同道亦有同感。细思此方养阴者多，益阳者少，又且缺少除邪之品，故虚实夹杂，阳虚寒滞，气滞血虚，痰凝气滞者多不效。曾治患者潘××，男，38岁。头晕心悸，麻木，时轻时重一年多。一个月来日渐加剧。某院诊为窦性心动过缓，多发性室性期前收缩。反复应用西药及中药炙甘草汤不效。细审其证，头晕恶心，气短心悸，心前区刺痛，呼气时胸中有空虚感，疲乏无力，失眠，舌质暗，舌苔薄白，脉弦滑而结。综其脉证，诊为心阳不足，痰郁气结。拟温通心阳，化痰散结。枳实薤白桂枝汤加减：枳壳9克，薤白9克，半夏9克，陈皮9克，厚朴9克，瓜蒌15克，桂枝12克，白芍12克。服药6剂后，心前区疼痛、心悸等消失，头晕、气短、麻木好转，心电图检查正常。查其脉缓，诊为中气不足，胸阳不振，痰郁气结。拟黄芪建中汤加减：黄芪15克，桂枝9克，白芍18克，生姜9克，甘草6克，大枣10枚，瓜蒌15克，薤白9克。连服10剂，诸证消失而愈。又如：于××，女，38岁。胸满胸痛心悸3年。某院诊为冠心病。先予冠心二号方及西药治疗半年多不效，医查其脉结代，予炙甘草汤治疗一年多仍不见好转，邀治于余。审其证见，头晕胸满，心悸心烦，口苦，舌苔薄白，脉弦滑而结。予小柴胡汤加味：柴胡10克，半夏10克，黄芩10克，党参10克，生姜10克，甘草10克，大枣10枚，瓜蒌15克。药后数日来诊云：服药2剂后诸证好转，脉象已无结状，又服6剂，诸证消失三分之二。但此时忽然一学生问：为什么不用炙甘草汤?余因受他人之影响而又改为炙甘草汤治之。一周后，患者来诊，云：症状加剧，心电图数次检查正常以后，近三天来又不正常。并云：可否再服小柴胡汤?答云：小柴胡汤虽在方书中未见治脉结者，然脉学诸书皆云结脉为气滞血瘀所致，且前用该方其效佳，乃理气化痰之法相合拍耳，当续服之。服药30剂后，云：一个多月反复查心电图均正常，且症状亦全部消失。又如似××，男，45岁。感冒后突然发现心悸，查数次心电图呈期前收缩，或呈心房纤颤，或有二联律、三联律出现。医诊心肌炎。住院治疗7个多月，除西药外，并服用中药炙甘草汤加减达200剂，但始终未效。审其证见头晕心烦，胸满胸痛，心悸失眠，舌苔薄白，脉弦而结。综其脉证，诊为血虚肝郁。治以养血疏肝。逍遥散加味：柴胡10克，当归10克，白芍10克，白术10克，茯苓10克，甘草10克，生姜3片，薄荷1克，丹参15克。服药4剂诸证好转，服药30剂后诸证消失，心电图恢复正常。
癫狂
癫狂一证，诸书多从痰、从火论治，如《杂病源流犀烛》说：“狂由心家邪热……狂属脏，痰聚心主，故发而不止。”《证治汇补》说：“二症之因，或大怒而动肝火，或大惊而动心火，或痰为火升，升而不降，壅塞心窍，神明不得出入，主宰失其号令，心反为痰火所役，一时发越，逾垣上屋，持刀杀人，裸体骂詈，不避亲属，飞奔疾走，涉水如陆，此肝气火旺，木来乘心，名之曰狂。”而多忽略蓄血。余宗仲景意，用治蓄血发狂之旨常获奇效。例如：患者薛××，男，22岁。精神失常半个多月，先用西药治疗不效，继用中药安宫牛黄丸治之亦不效。诊时见其两目怒视，大便燥结数日不行，少腹硬满而痛，舌苔黄燥，脉沉滑数。追问其狂发之状，每至夜间其证尤剧。思之，正蓄血发狂之证也，拟大陷胸、抵当汤合方：甘遂6克，水蛭6克，虻虫4．5克，大黄6克，芒硝3克，桃仁6克。患者家属欲求速效，4剂合为1剂，顿服之，药后泻下8次，色黑褐，是夜即睡眠约8个小时，次日夜又连续睡眠达20小时左右。3个月后来诊，精神恢复正常。
癫证，诸书多论其虚，然验之临床纯虚者甚少，若勉予补益之剂治之，大多久延时日而不愈。曾治患者范××，女，50岁。因家庭变故，突然痴呆不语，不食不饮，不睡，有时突至街中乱走，或自语无罪，曾前后住精神病院数年而不效。不得已，改请中医治疗。医或云痰火扰心而予安宫牛黄丸，或云肝郁气结，郁而化火，而予疏肝泻火，或云气血俱虚而于归脾、养心诸汤，然始终不效。审视再三，不得其故，再查色脉，面白而呆痴，不语，脉虚弦滑，舌苔白。乃悟：气血俱虚，痰郁气结之故尔。拟十味温胆汤加减：黄芪15克，当归10克，麦冬10克，五味子10克，党参10克，竹茹10克，枳实10克，半夏10克，陈皮10克，茯苓10克，甘草6克，菖蒲10克，远志10克。药进10剂，精神、食欲均正常。家属、患者均欢喜异常。至若癫证之猝起者，多实，多郁，不可言其为虚。例如：患者石××，女，21岁。因受坏人调戏而精神失常半个多月。先在某院以西药及安宫牛黄丸等治疗不效。审其证见痴呆不语，不食不饮，独坐哭泣流泪，昼夜不眠，面孔呈呆痴状，问其所苦，不与回答，舌苔白，脉沉弦滑。证脉合参，诊为痰气郁结。为拟理气化痰。癫狂梦醒汤加减：桃仁12克．香附9克，青皮9克，柴胡6克，半夏9克，茯苓9克，赤芍12克，桑皮9克，腹皮9克，苏子15克，甘草30克，木通9克，枳壳9克，川芎9克。处方完毕，一实习学生问：安宫牛黄丸为治精神病之有效药物，何故不效?又何故用癫狂梦醒汤?不用顺气化痰汤?答曰：安宫牛黄丸重在泻火开窍，此病则重在气郁痰结，气郁者当顺气为先。至于为什么用癫狂梦醒汤，不用顺气化痰汤，因其脉见沉，沉为气郁为主，故用癲狂梦醒汤以解郁为先之方，又本证发于月经期间，故加调血之品，而不单纯理气。癲狂梦醒汤虽理气化痰为主，而稍佐活血，故而用之。4剂后，诸证均减，已不对隅而哭，食欲增加。问其所苦，云：胸满心烦，失眠，并微有寒热往来，乃处丹栀逍遥散：柴胡10克，当归10克，白芍10克，白术10克茯苓10克，甘草6克，薄荷6克，生姜3片，栀子10克．丹皮10克，生龙骨10克，生牡蛎10克。服药6剂，诸证消失而愈。
汗证
汗出一证，多因气虚卫气不固，故补敛之法尤为多用。至若肝郁气滞、肝热上冲等而致卫气不固者，不疏其肝，则火邪更炽，肺金被伐，气虚不敛，汗出更甚。例如：患者金××，女．49岁。十几年来，一遇见风吹即感头痛，胸满心烦，五心烦热。近四五年来，经常阵发性汗出，每日数次，发作之前，先感心中烦热，热气上冲，冲至胸、头即全身猝然汗出，继而身凉汗止。前医曾应用各种止汗剂100余剂无效。审其舌苔薄黄，脉弦而滑。综合脉证，诊为血虚肝郁，郁而化火。拟疏肝养血，泻火。丹栀逍遥散加味：柴胡6克，当归9克，白芍15克，白术9克，茯苓9克，甘草6克，薄荷4．5克，生姜3片，龙胆草9克，玄参15克，丹皮9克，栀子9克，黄芩9克．药进2剂，未见寸效。再思其脉见滑，滑主痰热，此方疏肝泻火有余，化痰不足，故加瓜蒌15克、丝瓜络9克以化痰。服药4剂，果然心烦汗出大减，继服6剂而愈。
半脸汗出或半身汗出，多为肝木之失达，营卫之失调所致，若徒用止汗非但汗出不止，反见烦躁拘急不适，治宜疏肝木，调三焦，致荣卫调，汗出即解。如：患者康××，男，成。半月来阵发性烦热上冲，半身汗出，时轻时重。前医予益气敛汗之剂10剂不效。审其脉见弦涩不调，舌苔薄白。诊为肝郁气滞，三焦不通，水饮上冲。为拟柴胡加龙骨牡蛎汤加减：柴胡9克，半夏9克，党参9克，黄芩9克，生姜3片，大枣5枚，桂枝9克，茯苓15克，甘草6克，龙骨15克，牡蛎15克。药进4剂汗出大减，继服6剂，诸证消失而愈。又如：患者康××，男，成。左半脸汗多一年余，有时左脸汗出如珠，右脸全然无汗。前医以敛汗止汗之剂，不但汗出不减。反见全身拘急不适。审其脉弦，苔白。诊为肝郁气滞，三焦不通，升降失常，疏泄失职。为拟柴胡加龙骨牡蛎汤加减：柴胡9克，半夏9克，黄芩9克，党参9克，桂枝9克，茯苓9克，熟军3克，生姜3片，大枣5枚，白芍9克，龙骨15克，牡蛎15克，甘草6克。药进10剂，汗出即止。
偏枯
在20世纪50年代随先父，亡兄初学中医时，常见其用续命汤取效，但亦有不效者。及至1956年人北京中医学院学习。并听了一些老师讲课和深研了《中风斟铨》《医学衷中参西录》后，始知其不效者，多因阴虚阳亢，虚风内动所致耳，然临床用之亦有有效和不效者。及毕业实习时，方鸣谦老师，大倡补气乃本病治疗之要着，补阳还五汤乃本病之效方，但临床试用之，亦有有效和不效者。1962年在山西省中医研究所，得见李翰卿老师治一半身不遂患者，久治无功，诊其脉沉，予逍遥散加活血之品而取效。后李翰卿老师突然患半身不遂，前医予熄风化痰之法无效，余诊其脉大而虚，舌质嫩红无苔，予大定风珠加减而取效，然用之临床亦有有效和无效者。1977年一患者昏迷、偏瘫一个多月，医予中、西药治之不效，审其舌苔黄厚腻，脉虚大而滑，与十味温胆汤加减而痊愈，然亦有有效和无效者。综合30余年之经历乃知辨证论治之准确无误是首要方法耳。为了总结经验特将偏瘫总结为十二法。
一、疏散风寒法
适应证：年高气衰，冬季感受风寒后(多在由暖处猝至冷处或汗出受风寒时发生)，猝然偏瘫，舌苔薄白，脉浮紧者。
方药：续命汤加减：麻黄10克，石膏10克，桂枝10克，当归10克，人参(或党参)10克，干姜10克，甘草10克，川芎5克，杏仁10克，千年健10克，威灵仙10克，老鹳草10克。
病例：刘×，男，65岁，农民。雪夜披衣开门时，突然左侧偏瘫摔倒在地，前医以补阳还五汤治疗10日无效。邀家兄前往。审其脉浮紧，舌苔薄白，神识清楚。诊为风寒客于半身之腧。以续命汤加减1剂证减，10剂诸证消失而愈。
二、益气活络法
适应证：气血俱虚，络脉瘀滞，偏瘫不用，脉患侧弦大，健侧弦缓或沉弦。
方药：补阳还五汤加味：黄芪30一60克，当归10克，地龙10克，川芎10克，赤芍10克，桃仁10克，红花10克，木瓜10克。
若头目眩晕，疲乏无力，脉迟弱者，加味补血汤。黄芪30克，当归15克，龙眼肉15克，鹿角胶9克，丹参10克，乳香6克，没药6克，甘松6克。
病例：赵××，女，68岁。一个月前睡眠过程中突发偏瘫。先在某院治疗效果不明显。审其除左上下肢不能活动外，神志清楚，伸舌偏歪，苔薄白，脉左弦大，右缓。诊为气血俱虚，络脉瘀滞。拟补阳还五汤加味方。4剂后好转，40剂后诸证消失。
三、理气疏肝法
适应证：肝郁气滞，枢机不利，阳气不能外达，头晕头痛，胸满心烦，心悸失眠，轻度偏瘫，口苦咽干，舌苔薄白或薄黄而润，脉沉弦涩或结或弦紧者。
方药：柴胡加龙骨牡蛎汤加减：柴胡10克，半夏10克，黄芩10克，党参10克，桂枝10克，生姜10克，茯苓15克，大黄3克，甘草6克，大枣5枚，龙骨15克，牡蛎15克。病例：耿××，男，68岁。冠心病，室性期前收缩3年，脑血栓形成后遗症2年。曾用中、西药治疗效果不明显。细审前医所用诸方多为平肝熄风，养阴清热，益气活血之剂。察其证见头晕头痛，胸满心烦，心悸阵作，左侧偏瘫，活动不便，舌苔薄白，脉沉弦而结。诊为肝郁气结，阳气不能外达一证。予柴胡加龙骨牡蛎汤4剂，诸证俱减，60剂后诸证消失而愈。
四、理气活血法
适应证：气滞血瘀，筋脉失养，瘫痪拘挛，疼痛难伸，胸胁苦满，心烦易怒，头晕头痛，舌质暗，苔薄白，或有瘀斑，脉沉或沉涩。
方药：逍遥散加减：柴胡10克，当归10克，赤芍10克，郁金10克，青皮10克，桃仁10克，红花10克，丝瓜络10克，连翘10克，木瓜10克。
病例：高××，女，60岁。右侧偏瘫3年多，前医以补阳还五汤、天麻钩藤饮及针灸、西药治疗，不但无效，反见日渐疼痛拘挛，难于伸展，头晕头痛，心烦失眠。转邀李翰卿先生诊治。云：两脉沉弦而涩，舌质稍暗，头晕头痛，心烦易怒，此气滞血瘀，筋脉失养所致也，宜逍遥散加减治之。一周后疼痛拘挛果见好转，继服一月疼痛、拘挛、瘫痪均消失大半，又服一月诸证俱失而愈。
五、平肝潜阳法
适应证：阴虚阳亢，头目眩晕，目胀耳鸣，头中热痛，偏瘫麻木，面赤如醉或仅印堂穴附近红赤，舌苔白舌质红，脉弦长有力或寸脉大，甚或上人鱼际。
《伤寒论》中说：“患伤寒病，脉搏出现结代（脉律不齐，时有间歇），心中悸动不安，应当用炙甘草汤主治。”《千金翼方》中说：“治疗虚劳导致的身体亏虚，出汗且胸闷，脉搏结悸，虽然行动如常人，但不出百日就会死亡，病情危急的十一日就会死亡。”近代医生见到脉搏结代就用炙甘草汤，因此大多把炙甘草汤作为治疗期前收缩（心脏过早搏动）的方剂。我起初也认为炙甘草汤是治疗本证唯一的方剂，然而久而久之，见效的少，无效的却多，不得已向同行请教，很多同行也有同样的感受。仔细思考此方滋养阴液的药物多，补益阳气的药物少，而且缺少祛除病邪的药物，所以对于虚实夹杂、阳虚寒凝、气滞血虚、痰凝气滞的患者大多无效。
曾治疗患者潘某某，男性，38岁。头晕心悸，肢体麻木，时轻时重一年多。一个月来日渐加剧。某医院诊断为窦性心动过缓，多发性室性期前收缩。反复应用西药及中药炙甘草汤均无效。仔细审查其症状，头晕恶心，气短心悸，心前区刺痛，呼气时胸中有空虚感，疲乏无力，失眠，舌质暗，舌苔薄白，脉弦滑而结。综合其脉象和症状，诊断为心阳不足，痰郁气结。拟定温通心阳，化痰散结的方法。使用枳实薤白桂枝汤加减：枳壳9克，薤白9克，半夏9克，陈皮9克，厚朴9克，瓜蒌15克，桂枝12克，白芍12克。服药6剂后，心前区疼痛、心悸等症状消失，头晕、气短、麻木好转，心电图检查正常。再诊察其脉象缓和，诊断为中气不足，胸阳不振，痰郁气结。拟定黄芪建中汤加减：黄芪15克，桂枝9克，白芍18克，生姜9克，甘草6克，大枣10枚，瓜蒌15克，薤白9克。连续服用10剂，所有症状消失而痊愈。
又如：于某某，女性，38岁。胸满胸痛心悸3年。某医院诊断为冠心病。先给予冠心二号方及西药治疗半年多无效，医生查其脉结代，给予炙甘草汤治疗一年多仍不见好转，邀请我诊治。审查其症状，头晕胸满，心悸心烦，口苦，舌苔薄白，脉弦滑而结。给予小柴胡汤加味：柴胡10克，半夏10克，黄芩10克，党参10克，生姜10克，甘草10克，大枣10枚，瓜蒌15克。服药后数日来诊说：服药2剂后诸症好转，脉象已无结状，又服6剂，诸症消失三分之二。但此时忽然有一个学生问：为什么不用炙甘草汤？我因受他人影响又改为炙甘草汤治疗。一周后，患者来诊，说：症状加剧，心电图数次检查正常以后，近三天来又不正常。并说：可否再服小柴胡汤？回答说：小柴胡汤虽然在方书中未见治疗脉结者，然而脉学诸书都说结脉是由气滞血瘀所致，况且前用该方效果很好，乃是理气化痰之法相契合，应当继续服用。服药30剂后，说：一个多月反复查心电图均正常，且症状亦全部消失。
又如似某某，男性，45岁。感冒后突然发现心悸，查数次心电图呈期前收缩，或呈心房纤颤，或有二联律、三联律出现。医生诊断为心肌炎。住院治疗7个多月，除西药外，并服用中药炙甘草汤加减达200剂，但始终未效。审查其症状见头晕心烦，胸满胸痛，心悸失眠，舌苔薄白，脉弦而结。综合其脉证，诊断为血虚肝郁。治以养血疏肝。逍遥散加味：柴胡10克，当归10克，白芍10克，白术10克，茯苓10克，甘草10克，生姜3片，薄荷1克，丹参15克。服药4剂诸症好转，服药30剂后诸症消失，心电图恢复正常。
癫狂
癫狂这一病症，各书多从痰、从火论治，如《杂病源流犀烛》说：“狂由心家邪热……狂属脏，痰聚心主，故发而不止。”《证治汇补》说：“二症之因，或大怒而动肝火，或大惊而动心火，或痰为火升，升而不降，壅塞心窍，神明不得出入，主宰失其号令，心反为痰火所役，一时发越，逾垣上屋，持刀杀人，裸体骂詈，不避亲属，飞奔疾走，涉水如陆，此肝气火旺，木来乘心，名之曰狂。”而多忽略蓄血（瘀血停滞）。我遵循张仲景的意思，用治疗蓄血发狂的宗旨，常常获得奇效。例如：患者薛某某，男性，22岁。精神失常半个多月，先用西药治疗无效，继用中药安宫牛黄丸治疗也不效。诊时见其两目怒视，大便燥结数日不行，少腹硬满而痛，舌苔黄燥，脉沉滑数。追问其狂发之状，每至夜间其证尤剧。思之，正是蓄血发狂之证也，拟定大陷胸汤、抵当汤合方：甘遂6克，水蛭6克，虻虫4.5克，大黄6克，芒硝3克，桃仁6克。患者家属欲求速效，4剂合为1剂，顿服之，药后泻下8次，色黑褐，是夜即睡眠约8个小时，次日夜又连续睡眠达20小时左右。3个月后来诊，精神恢复正常。
癫证，各书多论其虚，然而验之临床纯虚者甚少，若勉强给予补益之剂治疗，大多久延时日而不愈。曾治疗患者范某某，女性，50岁。因家庭变故，突然痴呆不语，不食不饮，不睡，有时突至街中乱走，或自语无罪，曾前后住精神病院数年而不效。不得已，改请中医治疗。医生有的说是痰火扰心而给予安宫牛黄丸，有的说是肝郁气结，郁而化火，而给予疏肝泻火，有的说是气血俱虚而给予归脾、养心诸汤，然而始终不效。审视再三，不得其故，再查色脉，面白而呆痴，不语，脉虚弦滑，舌苔白。乃悟：气血俱虚，痰郁气结之故尔。拟定十味温胆汤加减：黄芪15克，当归10克，麦冬10克，五味子10克，党参10克，竹茹10克，枳实10克，半夏10克，陈皮10克，茯苓10克，甘草6克，菖蒲10克，远志10克。药进10剂，精神、食欲均正常。家属、患者均欢喜异常。至于癫证之猝起者，多实，多郁，不可言其为虚。例如：患者石某某，女性，21岁。因受坏人调戏而精神失常半个多月。先在某院以西药及安宫牛黄丸等治疗无效。审查其症状见痴呆不语，不食不饮，独坐哭泣流泪，昼夜不眠，面孔呈呆痴状，问其所苦，不与回答，舌苔白，脉沉弦滑。证脉合参，诊断为痰气郁结。为其拟定理气化痰法。癫狂梦醒汤加减：桃仁12克，香附9克，青皮9克，柴胡6克，半夏9克，茯苓9克，赤芍12克，桑皮9克，腹皮9克，苏子15克，甘草30克，木通9克，枳壳9克，川芎9克。处方完毕，一个实习学生问：安宫牛黄丸为治精神病之有效药物，何故不效？又何故用癫狂梦醒汤？不用顺气化痰汤？回答说：安宫牛黄丸重在泻火开窍，此病则重在气郁痰结，气郁者当顺气为先。至于为什么用癫狂梦醒汤，不用顺气化痰汤，因其脉见沉，沉为气郁为主，故用癫狂梦醒汤以解郁为先之方，又本证发于月经期间，故加调血之品，而不单纯理气。癫狂梦醒汤虽理气化痰为主，而稍佐活血，故而用之。4剂后，诸症均减，已不对隅而哭，食欲增加。问其所苦，说：胸满心烦，失眠，并微有寒热往来，于是处丹栀逍遥散：柴胡10克，当归10克，白芍10克，白术10克茯苓10克，甘草6克，薄荷6克，生姜3片，栀子10克，丹皮10克，生龙骨10克，生牡蛎10克。服药6剂，诸症消失而痊愈。
汗证
汗出一症，多因气虚卫气不固，故补敛之法尤为多用。至于若肝郁气滞、肝热上冲等而致卫气不固者，不疏其肝，则火邪更炽，肺金被伐，气虚不敛，汗出更甚。例如：患者金某某，女性，49岁。十几年来，一遇见风吹即感头痛，胸满心烦，五心烦热。近四五年来，经常阵发性汗出，每日数次，发作之前，先感心中烦热，热气上冲，冲至胸、头即全身猝然汗出，继而身凉汗止。前医曾应用各种止汗剂100余剂无效。审查其舌苔薄黄，脉弦而滑。综合脉证，诊断为血虚肝郁，郁而化火。拟定疏肝养血，泻火。丹栀逍遥散加味：柴胡6克，当归9克，白芍15克，白术9克，茯苓9克，甘草6克，薄荷4.5克，生姜3片，龙胆草9克，玄参15克，丹皮9克，栀子9克，黄芩9克。药进2剂，未见寸效。再思其脉见滑，滑主痰热，此方疏肝泻火有余，化痰不足，故加瓜蒌15克、丝瓜络9克以化痰。服药4剂，果然心烦汗出大减，继服6剂而痊愈。
半脸汗出或半身汗出，多为肝木之失达，营卫之失调所致，若徒用止汗非但汗出不止，反见烦躁拘急不适，治宜疏肝木，调三焦，致荣卫调，汗出即解。如：患者康某某，男性，成（此处原文可能有误，推测为年龄或名字缺失，按原文保留）。半月来阵发性烦热上冲，半身汗出，时轻时重。前医予益气敛汗之剂10剂不效。审查其脉见弦涩不调，舌苔薄白。诊断为肝郁气滞，三焦不通，水饮上冲。为其拟定柴胡加龙骨牡蛎汤加减：柴胡9克，半夏9克，党参9克，黄芩9克，生姜3片，大枣5枚，桂枝9克，茯苓15克，甘草6克，龙骨15克，牡蛎15克。药进4剂汗出大减，继服6剂，诸症消失而痊愈。又如：患者康某某，男性，成。左半脸汗多一年余，有时左脸汗出如珠，右脸全然无汗。前医以敛汗止汗之剂，不但汗出不减，反见全身拘急不适。审查其脉弦，苔白。诊断为肝郁气滞，三焦不通，升降失常，疏泄失职。为其拟定柴胡加龙骨牡蛎汤加减：柴胡9克，半夏9克，黄芩9克，党参9克，桂枝9克，茯苓9克，熟军3克，生姜3片，大枣5枚，白芍9克，龙骨15克，牡蛎15克，甘草6克。药进10剂，汗出即止。
偏枯
在20世纪50年代随先父，亡兄初学中医时，常见其用续命汤取效，但亦有不效者。及至1956年人北京中医学院学习，并听了一些老师讲课和深研了《中风斟铨》《医学衷中参西录》后，始知其不效者，多因阴虚阳亢，虚风内动所致耳，然临床用之亦有有效和不效者。及毕业实习时，方鸣谦老师，大倡补气乃本病治疗之要着，补阳还五汤乃本病之效方，但临床试用之，亦有有效和不效者。1962年在山西省中医研究所，得见李翰卿老师治一半身不遂患者，久治无功，诊其脉沉，予逍遥散加活血之品而取效。后李翰卿老师突然患半身不遂，前医予熄风化痰之法无效，余诊其脉大而虚，舌质嫩红无苔，予大定风珠加减而取效，然用之临床亦有有效和无效者。1977年一患者昏迷、偏瘫一个多月，医予中、西药治之不效，审其舌苔黄厚腻，脉虚大而滑，与十味温胆汤加减而痊愈，然亦有有效和无效者。综合30余年之经历乃知辨证论治之准确无误是首要方法耳。为了总结经验特将偏瘫总结为十二法。
一、疏散风寒法
适应证：年高气衰，冬季感受风寒后（多在由暖处猝至冷处或汗出受风寒时发生），猝然偏瘫，舌苔薄白，脉浮紧者。
方药：续命汤加减：麻黄10克，石膏10克，桂枝10克，当归10克，人参（或党参）10克，干姜10克，甘草10克，川芎5克，杏仁10克，千年健10克，威灵仙10克，老鹳草10克。
病例：刘×，男，65岁，农民。雪夜披衣开门时，突然左侧偏瘫摔倒在地，前医以补阳还五汤治疗10日无效。邀家兄前往。审查其脉浮紧，舌苔薄白，神识清楚。诊断为风寒客于半身之腧。以续命汤加减1剂证减，10剂诸症消失而痊愈。
二、益气活络法
适应证：气血俱虚，络脉瘀滞，偏瘫不用，脉患侧弦大，健侧弦缓或沉弦。
方药：补阳还五汤加味：黄芪30一60克，当归10克，地龙10克，川芎10克，赤芍10克，桃仁10克，红花10克，木瓜10克。
若头目眩晕，疲乏无力，脉迟弱者，加味补血汤。黄芪30克，当归15克，龙眼肉15克，鹿角胶9克，丹参10克，乳香6克，没药6克，甘松6克。
病例：赵××，女，68岁。一个月前睡眠过程中突发偏瘫。先在某院治疗效果不明显。审查其除左上下肢不能活动外，神志清楚，伸舌偏歪，苔薄白，脉左弦大，右缓。诊断为气血俱虚，络脉瘀滞。拟定补阳还五汤加味方。4剂后好转，40剂后诸症消失。
三、理气疏肝法
适应证：肝郁气滞，枢机不利，阳气不能外达，头晕头痛，胸满心烦，心悸失眠，轻度偏瘫，口苦咽干，舌苔薄白或薄黄而润，脉沉弦涩或结或弦紧者。
方药：柴胡加龙骨牡蛎汤加减：柴胡10克，半夏10克，黄芩10克，党参10克，桂枝10克，生姜10克，茯苓15克，大黄3克，甘草6克，大枣5枚，龙骨15克，牡蛎15克。
病例：耿××，男，68岁。冠心病，室性期前收缩3年，脑血栓形成后遗症2年。曾用中、西药治疗效果不明显。细审前医所用诸方多为平肝熄风，养阴清热，益气活血之剂。察其证见头晕头痛，胸满心烦，心悸阵作，左侧偏瘫，活动不便，舌苔薄白，脉沉弦而结。诊断为肝郁气结，阳气不能外达一证。予柴胡加龙骨牡蛎汤4剂，诸症俱减，60剂后诸症消失而痊愈。
四、理气活血法
适应证：气滞血瘀，筋脉失养，瘫痪拘挛，疼痛难伸，胸胁苦满，心烦易怒，头晕头痛，舌质暗，苔薄白，或有瘀斑，脉沉或沉涩。
方药：逍遥散加减：柴胡10克，当归10克，赤芍10克，郁金10克，青皮10克，桃仁10克，红花10克，丝瓜络10克，连翘10克，木瓜10克。
病例：高××，女，60岁。右侧偏瘫3年多，前医以补阳还五汤、天麻钩藤饮及针灸、西药治疗，不但无效，反见日渐疼痛拘挛，难于伸展，头晕头痛，心烦失眠。转邀李翰卿先生诊治。云：两脉沉弦而涩，舌质稍暗，头晕头痛，心烦易怒，此气滞血瘀，筋脉失养所致也，宜逍遥散加减治之。一周后疼痛拘挛果见好转，继服一月疼痛、拘挛、瘫痪均消失大半，又服一月诸症俱失而痊愈。
五、平肝潜阳法
适应证：阴虚阳亢，头目眩晕，目胀耳鸣，头中热痛，偏瘫麻木，面赤如醉或仅印堂穴附近红赤，舌苔白舌质红，脉弦长有力或寸脉大，甚或上人鱼际。
As stated in the *Shanghan Lun* (Treatise on Cold Pathogenic Diseases): "In cases of cold damage, if the pulse is knotted and intermittent (Jie Dai Mai, indicating irregular rhythm with pauses), accompanied by palpitations (Xin Dong Ji), Zhi Gancao Tang (Honey-Fried Licorice Decoction) should be used." The *Qianjin Yi Fang* (Supplement to the Thousand Golden Formulas) states: "For treating deficiency labor (Xu Lao, chronic debility due to exhaustion) with insufficient vital energy, sweating with chest stuffiness, and a knotted, palpitating pulse; although movement appears normal, death will occur within one hundred days, or within eleven days if critical." Modern physicians often use Zhi Gancao Tang for knotted pulses, thus largely regarding it as the formula for treating premature beats (Premature Ventricular Contractions). I initially also believed that Zhi Gancao Tang was the sole formula for this syndrome. However, over time, few cases showed efficacy, while many did not. Reluctantly, I sought advice from colleagues, many of whom shared the same experience. Upon careful reflection, this formula contains more yin-nourishing herbs and fewer yang-tonifying ones, and lacks herbs to expel pathogens. Therefore, it is often ineffective for patients with mixed deficiency and excess, yang deficiency with cold stagnation, qi stagnation with blood deficiency, or phlegm coagulation with qi stagnation.
I once treated a patient, Mr. Pan XX, male, 38 years old. He suffered from dizziness, palpitations, and numbness, fluctuating in severity for over a year. Symptoms had intensified over the past month. A hospital diagnosed sinus bradycardia and multiple ventricular premature beats. Repeated application of Western medicines and Zhi Gancao Tang was ineffective. Careful examination revealed dizziness, nausea, shortness of breath, palpitations, stabbing pain in the precordial region, a sensation of emptiness in the chest during exhalation, fatigue, insomnia, a dark tongue body, thin white coating, and a wiry, slippery, and knotted pulse. Synthesizing these signs and symptoms, the diagnosis was insufficiency of heart yang with phlegm stagnation and qi binding. The treatment principle was to warm and unblock heart yang, and resolve phlegm and dissipate nodules. A modified Zhishi Xiebai Guizhi Tang (Aucklandiae and Macrostemonis Decoction) was prescribed: Zhike (Bitter Orange Fruit) 9g, Xiebai (Allium Macrostemon Bulb) 9g, Banxia (Pinellia Tuber) 9g, Chenpi (Citrus Peel) 9g, Houpo (Magnolia Bark) 9g, Gualou (Trichosanthes Fruit) 15g, Guizhi (Cinnamon Twig) 12g, Baishao (White Peony Root) 12g. After 6 doses, precordial pain and palpitations disappeared, and dizziness, shortness of breath, and numbness improved. Electrocardiogram (ECG) results returned to normal. Subsequent examination showed a moderate pulse, leading to a diagnosis of middle jiao qi insufficiency, depression of chest yang, and phlegm stagnation with qi binding. A modified Huangqi Jianzhong Tang (Astragalus Decoction for Building the Middle) was prescribed: Huangqi (Astragalus Root) 15g, Guizhi (Cinnamon Twig) 9g, Baishao (White Peony Root) 18g, Shengjiang (Fresh Ginger) 9g, Gancao (Licorice Root) 6g, Dazao (Jujube Fruit) 10 pieces, Gualou (Trichosanthes Fruit) 15g, Xiebai (Allium Macrostemon Bulb) 9g. After taking 10 consecutive doses, all symptoms disappeared, and he recovered.
Another case: Ms. Yu XX, female, 38 years old. She experienced chest fullness, pain, and palpitations for 3 years. A hospital diagnosed coronary heart disease. Treatment with Guanxin Erhao Fang (Coronary No. 2 Formula) and Western medicines for over half a year was ineffective. Physicians noted her knotted-intermittent pulse and prescribed Zhi Gancao Tang for over a year without improvement. I was invited to treat her. Examination revealed dizziness, chest fullness, palpitations, irritability, bitter taste in the mouth, thin white tongue coating, and a wiry, slippery, knotted pulse. Xiaochaihu Tang (Minor Bupleurum Decoction) with modifications was prescribed: Chaihu (Bupleurum Root) 10g, Banxia (Pinellia Tuber) 10g, Huangqin (Scutellaria Root) 10g, Dangshen (Codonopsis Root) 10g, Shengjiang (Fresh Ginger) 10g, Gancao (Licorice Root) 10g, Dazao (Jujube Fruit) 10 pieces, Gualou (Trichosanthes Fruit) 15g. She reported improvement after 2 doses, with the pulse no longer knotted. After another 6 doses, two-thirds of the symptoms disappeared. However, a student asked why Zhi Gancao Tang was not used. Influenced by others, I switched back to Zhi Gancao Tang. One week later, she returned with aggravated symptoms; ECGs had been normal but became abnormal again in the last three days. She asked if she could resume Xiaochuanhu Tang. I replied: Although Xiaochaihu Tang is not explicitly listed for treating knotted pulses in standard formularies, pulseology texts state that a knotted pulse is caused by qi stagnation and blood stasis. Moreover, the previous use of this formula was highly effective, as its method of regulating qi and resolving phlegm matched the pathology. It should be continued. After 30 doses, repeated ECGs were normal for over a month, and all symptoms disappeared.
Another case: Mr. Si XX, male, 45 years old. Sudden palpitations appeared after a cold. Multiple ECGs showed premature beats, atrial fibrillation, bigeminy, or trigeminy. Doctors diagnosed myocarditis. Hospitalized for over 7 months, receiving Western medicines and modified Zhi Gancao Tang (200 doses), yet remained ineffective. Symptoms included dizziness, irritability, chest fullness and pain, palpitations, insomnia, thin white tongue coating, and a wiry, knotted pulse. Diagnosis: Blood deficiency with liver qi stagnation. Treatment: Nourish blood and soothe the liver. Xiaoyao San (Free and Easy Wanderer Powder) with modifications: Chaihu (Bupleurum Root) 10g, Danggui (Angelica Sinensis Root) 10g, Baishao (White Peony Root) 10g, Baizhu (Atractylodes Rhizome) 10g, Fuling (Poria) 10g, Gancao (Licorice Root) 10g, Shengjiang (Fresh Ginger) 3 slices, Bohe (Mint) 1g, Danshen (Salvia Miltiorrhiza Root) 15g. Symptoms improved after 4 doses and disappeared after 30 doses, with ECG normalization.
Dian Kuang (Manic-Depressive Psychosis)
Most texts treat Dian Kuang based on phlegm and fire. For example, *Zabing Yuanliu Xizhu* (Source and Flow of Miscellaneous Diseases) states: "Mania arises from pathogenic heat in the heart... Mania belongs to the zang organs; phlegm gathers at the heart master, hence it recurs endlessly." *Zhengzhi Huibu* (Compilation of Syndrome Treatments) states: "The causes of these two syndromes include anger stirring liver fire, shock stirring heart fire, or phlegm rising with fire, obstructing the heart orifices, preventing the spirit from entering and exiting, causing loss of command. The heart becomes enslaved by phlegm-fire, leading to sudden outbursts: climbing walls, holding knives to kill, cursing nakedly, ignoring relatives, running wildly, walking on water as if on land. This is liver qi and fire flourishing, wood overacting on heart, named Mania." These texts often ignore blood stasis (accumulated blood). Following Zhang Zhongjing's intent, using principles for treating mania due to blood stasis often yields miraculous effects.
Example: Patient Xue XX, male, 22 years old. Mental disorder for over half a month. Western medicines failed; Angong Niuhuang Wan (Calos Cow-bezoar Pill) also failed. Signs included glaring eyes, dry constipation for several days, hardness, fullness, and pain in the lower abdomen, yellow dry tongue coating, and deep, slippery, rapid pulse. Inquiry revealed symptoms worsened at night. This is clearly mania due to blood stasis. A combined formula of Daxiexiong Tang (Major Thorax-Piercing Decoction) and Didang Tang (Definitely Defecating Decoction) was prescribed: Gansui (Kansui Root) 6g, Shuizhi (Leech) 6g, Mengchong (Blue Bottle Fly Larva) 4.5g, Dahuang (Rhubarb Root) 6g, Mangxiao (Mirabilite) 3g, Taoren (Peach Kernel) 6g. The family wanted quick results, combining 4 doses into one large dose taken at once. The patient defecated 8 times, with dark brown stool. That night, he slept about 8 hours; the next night, continuous sleep lasted about 20 hours. Three months later, his mental state had normalized.
For Dian syndrome (depressive psychosis), texts often discuss deficiency. However, clinical experience shows pure deficiency is rare. Forcing tonifying formulas usually prolongs illness without cure. Example: Patient Fan XX, female, 50 years old. Sudden dementia, mutism, refusal to eat/drink/sleep, wandering streets, talking to herself claiming innocence, after family trauma. Years in psychiatric hospitals were ineffective. Traditional Chinese Medicine (TCM) was consulted. Some doctors attributed it to phlegm-fire harassing the heart (prescribed Angong Niuhuang Wan), some to liver qi stagnation transforming into fire (prescribed soothing liver and purging fire), some to dual qi and blood deficiency (prescribed Guipi Tang or Yangxin Tang). None worked. After careful review of color and pulse—pale face, dull expression, mutism, deficient-wiry-slippery pulse, white coating—I realized it was dual qi-blood deficiency with phlegm stagnation and qi binding. Shiwei Wendan Tang (Ten-Ingredient Warm Gallbladder Decoction) with modifications was prescribed: Huangqi (Astragalus Root) 15g, Danggui (Angelica Sinensis Root) 10g, Maidong (Ophiopogon Tuber) 10g, Wuweizi (Schisandra Berry) 10g, Dangshen (Codonopsis Root) 10g, Zhuru (Bamboo Shavings) 10g, Zhishi (Immature Bitter Orange) 10g, Banxia (Pinellia Tuber) 10g, Chenpi (Citrus Peel) 10g, Fuling (Poria) 10g, Gancao (Licorice Root) 6g, Changpu (Acorus Rhizome) 10g, Yuanzhi (Polygala Root) 10g. After 10 doses, mental state and appetite normalized. Family and patient were extremely happy. Acute onset Dian syndrome is often excess and stagnation, not deficiency.
Example: Patient Shi XX, female, 21 years old. Mental disorder for half a month after harassment. Previous treatment with Western medicines and Angong Niuhuang Wan failed. Signs: dementia, mutism, refusal to eat/drink, sitting alone crying, insomnia, dull face, unresponsive to questions, white tongue coating, deep-wiry-slippery pulse. Diagnosis: Phlegm-qii stagnation. Treatment: Regulate qi and resolve phlegm. Diankuang Mengxing Tang (Manic-Kaum Dream-Awakening Decoction) with modifications: Taoren (Peach Kernel) 12g, Xiangfu (Cyperus Rhizome) 9g, Qingpi (Green Citrus Peel) 9g, Chaihu (Bupleurum Root) 6g, Banxia (Pinellia Tuber) 9g, Fuling (Poria) 9g, Chishao (Red Peony Root) 12g, Sangpi (Mulberry Bark) 9g, Fupi (Mandarin Orange Peel) 9g, Suzi (Perilla Seed) 15g, Gancao (Licorice Root) 30g, Mutong (Akebia Stem) 9g, Zhike (Bitter Orange Fruit) 9g, Chuanxiong (Ligusticum Rhizome) 9g. An intern asked why Angong Niuhuang Wan was not used, or Shunqi Huatan Tang. I replied: Angong Niuhuang Wan focuses on purging fire and opening orifices; this case focuses on qi stagnation and phlegm binding. Qi stagnation requires regulating qi first. Diankuang Mengxing Tang is chosen because the deep pulse indicates primary qi stagnation, requiring resolution of stagnation first. Also, since onset occurred during menstruation, blood-regulating herbs were added, not just qi-regulating ones. Although primarily for regulating qi and resolving phlegm, it slightly assists blood circulation. After 4 doses, symptoms decreased; she stopped crying in corners, appetite increased. She reported chest fullness, irritability, insomnia, and slight alternating chills and fever. Danzhi Xiaoyao San (Moutan and Gardenia Free and Easy Wanderer Powder) was prescribed: Chaihu (Bupleurum Root) 10g, Danggui (Angelica Sinensis Root) 10g, Baishao (White Peony Root) 10g, Baizhu (Atractylodes Rhizome) 10g, Fuling (Poria) 10g, Gancao (Licorice Root) 6g, Bohe (Mint) 6g, Shengjiang (Fresh Ginger) 3 slices, Zhizi (Gardenia Fruit) 10g, Danpi (Moutan Bark) 10g, Sheng Longgu (Fossilized Bone) 10g, Sheng Muli (Oyster Shell) 10g. After 6 doses, all symptoms disappeared, and she recovered.
Han Zheng (Sweating Disorders)
Sweating is often due to qi deficiency and insecure defensive qi (Wei Qi), so tonifying and astringing methods are commonly used. However, if sweating is caused by liver qi stagnation or liver heat rushing upward leading to insecure Wei Qi, failing to soothe the liver allows fire pathogens to intensify, damaging Lung Metal, leading to qi deficiency and failure to consolidate, resulting in worse sweating.
Example: Patient Jin XX, female, 49 years old. For over ten years, wind exposure caused headache, chest fullness, irritability, and five-palm heat. For the past 4-5 years, paroxysmal sweating occurred several times daily. Before attacks, internal heat rushed upward to the chest and head, causing sudden whole-body sweating, followed by cooling and cessation. Over 100 doses of various antiperspirants failed. Tongue coating was thin yellow; pulse was wiry and slippery. Diagnosis: Blood deficiency with liver qi stagnation, transforming into fire. Treatment: Soothe liver, nourish blood, purge fire. Danzhi Xiaoyao San with modifications: Chaihu (Bupleurum Root) 6g, Danggui (Angelica Sinensis Root) 9g, Baishao (White Peony Root) 15g, Baizhu (Atractylodes Rhizome) 9g, Fuling (Poria) 9g, Gancao (Licorice Root) 6g, Bohe (Mint) 4.5g, Shengjiang (Fresh Ginger) 3 slices, Longdancao (Gentiana Root) 9g, Xuanshen (Scrophularia Root) 15g, Danpi (Moutan Bark) 9g, Zhizi (Gardenia Fruit) 9g, Huangqin (Scutellaria Root) 9g. Two doses yielded no effect. Re-evaluating the slippery pulse (indicating phlegm-heat), the formula lacked sufficient phlegm-resolving power. Gualou (Trichosanthes Fruit) 15g and Sigualuo (Luffa Fiber) 9g were added. After 4 doses, irritability and sweating greatly reduced; 6 more doses led to recovery.
Half-face or hemibody sweating is often due to liver wood failing to disperse and disharmony of Ying and Wei (nutritive and defensive qi). Merely using antiperspirants fails to stop sweating and may cause irritability and spasms. Treatment should soothe liver wood, regulate the Triple Burner (San Jiao), harmonize Ying and Wei, and sweating will cease.
Example: Patient Kang XX, male. Paroxysmal hot flashes rushing upward and hemibody sweating for half a month, fluctuating in severity. Ten doses of qi-tonifying and astringent formulas failed. Pulse was wiry, choppy, and irregular; tongue coating thin white. Diagnosis: Liver qi stagnation, Triple Burner obstruction, fluid retention rushing upward. Chaihu Jia Longgu Muli Tang (Bupleurum Plus Dragon Bone and Oyster Shell Decoction) with modifications: Chaihu (Bupleurum Root) 9g, Banxia (Pinellia Tuber) 9g, Dangshen (Codonopsis Root) 9g, Huangqin (Scutellaria Root) 9g, Shengjiang (Fresh Ginger) 3 slices, Dazao (Jujube Fruit) 5 pieces, Guizhi (Cinnamon Twig) 9g, Fuling (Poria) 15g, Gancao (Licorice Root) 6g, Longgu (Fossilized Bone) 15g, Muli (Oyster Shell) 15g. Four doses greatly reduced sweating; 6 more doses led to recovery.
Another case: Patient Kang XX, male. Excessive sweating on the left side of the face for over a year, sometimes like pearls, with no sweating on the right. Previous astringent formulas failed and caused whole-body spasms. Pulse wiry, coating white. Diagnosis: Liver qi stagnation, Triple Burner obstruction, dysfunction of ascending/descending and dispersing/attenuating. Chaihu Jia Longgu Muli Tang with modifications: Chaihu (Bupleurum Root) 9g, Banxia (Pinellia Tuber) 9g, Huangqin (Scutellaria Root) 9g, Dangshen (Codonopsis Root) 9g, Guizhi (Cinnamon Twig) 9g, Fuling (Poria) 9g, Shu Jun (Prepared Rhubarb) 3g, Shengjiang (Fresh Ginger) 3 slices, Dazao (Jujube Fruit) 5 pieces, Baishao (White Peony Root) 9g, Longgu (Fossilized Bone) 15g, Muli (Oyster Shell) 15g, Gancao (Licorice Root) 6g. Ten doses stopped sweating.
Pian Ku (Hemiplegia)
In the 1950s, accompanying my father and late brother who were learning TCM, I often saw them achieve success with Xuming Tang (Life-Sustaining Decoction), though some cases failed. By 1956, studying at Beijing College of Traditional Chinese Medicine and researching *Zhongfeng Zhenquan* and *Yixue Zhongzhong Canxi Lu*, I learned that failures were often due to yin deficiency with yang hyperactivity and internal stirring of deficient wind. However, clinical use still yielded variable results. During internship, Teacher Fang Mingqian emphasized that tonifying qi is key, and Buyang Huanwu Tang is effective, yet clinical trials showed mixed results. In 1962, at Shanxi Institute of TCM, I observed Teacher Li Hanqing treating a hemiplegic patient who had failed long-term treatment. His pulse was deep; Li prescribed Xiaoyao San with blood-invigorating herbs, achieving success. Later, Teacher Li himself suffered sudden hemiplegia. Previous treatments using wind-extinguishing and phlegm-resolving methods failed. I diagnosed a large, deficient pulse and tender red tongue without coating, prescribing Dadingsheng Zhu (Great Calming Wind Pearl) with modifications, which succeeded. Yet, clinical results remain variable. In 1977, a comatose, hemiplegic patient failed Western and Chinese medicine. Tongue coating was thick greasy yellow; pulse was large, deficient, and slippery. Shiyi Wendan Tang with modifications cured him. Again, results vary. Synthesizing over 30 years of experience, accurate syndrome differentiation and treatment are paramount. To summarize experience, hemiplegia is categorized into twelve methods.
1. Dispersing Wind-Cold Method
Indications: Elderly with declining qi, contracting wind-cold in winter (often moving suddenly from warm to cold areas or sweating then exposed to wind/cold), sudden hemiplegia, thin white tongue coating, floating-tight pulse.
Formula: Xuming Tang with modifications: Mahuang (Ephedra Herb) 10g, Shigao (Gypsum Fibrosum) 10g, Guizhi (Cinnamon Twig) 10g, Danggui (Angelica Sinensis Root) 10g, Renshen (Ginseng Root) or Dangshen (Codonopsis Root) 10g, Jiangtang (Dried Ginger) 10g, Gancao (Licorice Root) 10g, Chuanxiong (Ligusticum Rhizome) 5g, Xingren (Apricot Seed) 10g, Qiannianjian (Drynaria Rhizome) 10g, Weilingxian (Syneilesis Aconitifolia Herb) 10g, Laoguancao (Old Crows Grass) 10g.
Case: Liu X, male, 65, farmer. Sudden left hemiplegia while opening door in snow at night. Buyang Huanwu Tang for 10 days failed. My brother examined him: floating-tight pulse, thin white coating, clear consciousness. Diagnosis: Wind-cold invading half-body acupoints. Xuming Tang modified: 1 dose reduced symptoms, 10 doses cured.
2. Tonifying Qi and Unblocking Collaterals Method
Indications: Dual qi-blood deficiency, collateral stasis, hemiplegia with paralysis, wiry-large pulse on affected side, wiry-slow or deep-wiry pulse on healthy side.
Formula: Buyang Huanwu Tang (Tonify Yang and Restore Five Decoction) with additions: Huangqi (Astragalus Root) 30-60g, Danggui (Angelica Sinensis Root) 10g, Dilong (Earthworm) 10g, Chuanxiong (Ligusticum Rhizome) 10g, Chishao (Red Peony Root) 10g, Taoren (Peach Kernel) 10g, Honghua (Carthamus Flower) 10g, Mugua (Chaenomeles Fruit) 10g.
If dizziness, fatigue, and slow-weak pulse occur, add Bu Xue Tang (Blood-Tonifying Decoction): Huangqi (Astragalus Root) 30g, Danggui (Angelica Sinensis Root) 15g, Longyanrou (Longan Aril) 15g, Lujiaojiao (Donkey-Hide Gelatin) 9g, Danshen (Salvia Miltiorrhiza Root) 10g, Ruxiang (Frankincense) 6g, Moyao (Myrrh) 6g, Gansong (Nardostachys Root) 6g.
Case: Zhao XX, female, 68. Sudden hemiplegia during sleep one month ago. Hospital treatment ineffective. Left limbs paralyzed, conscious, deviated tongue, thin white coating, left wiry-large pulse, right slow pulse. Diagnosis: Dual qi-blood deficiency, collateral stasis. Modified Buyang Huanwu Tang: Improved after 4 doses, cured after 40 doses.
3. Regulating Qi and Soothing Liver Method
Indications: Liver qi stagnation, pivot dysfunction, yang unable to reach exterior, dizziness/headache, chest fullness/irritability, palpitations/insomnia, mild hemiplegia, bitter taste/dry throat, thin white or moist thin yellow coating, deep-wiry-choppy or knotted/tight pulse.
Formula: Chaihu Jia Longgu Muli Tang with modifications: Chaihu (Bupleurum Root) 10g, Banxia (Pinellia Tuber) 10g, Huangqin (Scutellaria Root) 10g, Dangshen (Codonopsis Root) 10g, Guizhi (Cinnamon Twig) 10g, Shengjiang (Fresh Ginger) 10g, Fuling (Poria) 15g, Dahuang (Rhubarb Root) 3g, Gancao (Licorice Root) 6g, Dazao (Jujube Fruit) 5 pieces, Longgu (Fossilized Bone) 15g, Muli (Oyster Shell) 15g.
Case: Geng XX, male, 68. Coronary heart disease, ventricular premature beats for 3 years, sequelae of cerebral thrombosis for 2 years. Previous treatments ineffective. Previous formulas focused on calming liver/extinguishing wind, nourishing yin/clearing heat, tonifying qi/investigating blood. Signs: dizziness/headache, chest fullness/irritability, paroxysmal palpitations, left hemiplegia, difficulty moving, thin white coating, deep-wiry-knotted pulse. Diagnosis: Liver qi binding, yang unable to reach exterior. Chaihu Jia Longgu Muli Tang: Reduced symptoms after 4 doses, cured after 60 doses.
4. Regulating Qi and Invigorating Blood Method
Indications: Qi stagnation and blood stasis, tendons/muscles lacking nourishment, paralysis/spasms, severe pain difficult to extend, chest/hypochondriac fullness, irritability, dizziness/headache, dark tongue body, thin white coating or ecchymosis, deep or deep-choppy pulse.
Formula: Xiaoyao San with modifications: Chaihu (Bupleurum Root) 10g, Danggui (Angelica Sinensis Root) 10g, Chishao (Red Peony Root) 10g, Yujin (Curcuma Tuber) 10g, Qingpi (Green Citrus Peel) 10g, Taoren (Peach Kernel) 10g, Honghua (Carthamus Flower) 10g, Sigualuo (Luffa Fiber) 10g, Lianqiao (Forsythia Fruit) 10g, Mugua (Chaenomeles Fruit) 10g.
Case: Gao XX, female, 60. Right hemiplegia for over 3 years. Previous treatments (Buyang Huanwu Tang, Tianma Gouteng Yin, acupuncture, Western meds) failed, worsening pain/spasms, difficulty extending, dizziness/headache, irritability/insomnia. Consulted Mr. Li Hanqing. Pulse deep-wiry-choppy, tongue slightly dark, dizziness/headache, irritability. Diagnosis: Qi stagnation and blood stasis, tendons/muscles lacking nourishment. Xiaoyao San modified: Pain/spasms improved after one week; after one month, most pain/spasms/paralysis resolved; after another month, fully cured.
5. Calming Liver and Subduing Yang Method
Indications: Yin deficiency with yang hyperactivity, dizziness/vertigo, distended eyes/tinnitus, heat/pain in head, hemiplegia/numbness, flushed face like drunkenness or only redness near Yintang acupoint, white tongue coating with red tongue body, wiry-long-forceful pulse or large cun pulse, even reaching fish-mouth area.