秦（氏） 年前肝风眩晕。主以凉血分。和阳熄风。一年未发。今岁正月春寒。非比天暖开泄。此番病
发。必因劳怒触动情志。至于呕逆。微冷倏热。交丑寅渐作耳鸣咽痹。食纳久留脘中。想少阳
木火盛于寅。胆脉贯耳。犯逆之威。必向阳明而后上凭诸窍。脉右涩大。胃逆不降。食味不甘。
而脘中逆乱。熏蒸日炽。营血内耗。无以养心。斯寤不肯寐。心摇荡漾。有难以鸣状之象。今头
重脘痹。全是上焦为木火升腾。阻遏清阳。前方滋清。血药居多。必不奏功。今议汤剂方。以苦
降其逆。辛通其痹。然汤宜小其制度。以久病体虚。初春若此。冬藏未为坚固可知。其丸剂当
以局方龙荟丸。暂服半月再议。（风火上郁）
连翘（一钱半） 黑栀皮（一钱） 羚羊角（一钱） 鲜菊叶（三钱） 紫菀（二钱） 郁金（八分）
大杏仁（去皮尖勿研六粒） 土栝蒌皮（一钱） 鲜菖蒲根（四分忌铁） 午服。
沈（女） 腹痛少减。呕逆已止。上焦热。下焦冷。肝阳尚未和平。拟进当归龙荟法。
当归 龙胆草 川楝子 芦荟 川连 吴萸 大茴
黄（氏） 肝胆风火上郁。头面清空之筋掣不和。治以清散。
羚羊角 犀角 山栀 连翘 栝蒌皮 荷叶梗 薄荷梗 青菊叶
郑（氏） 巅胀神迷。经脉抽痛。胀闷不欲纳食。一月经期四至。此郁伤气血成病。龙荟丸二钱五
分。三服。
叶（氏） 厥阳扰乱神明。经色已黑。肢冷面青便秘。龙荟丸一钱二分。十服。
阙（十八） 诵读吟咏。身虽静坐。而心神常动。凡五志之动皆阳。阳冒无制。清灵遂蒙。易旨以蒙乃外
加之义。述病发之时。头中欲掐。脘欲抚摩。二便必不自利。此腑气之窒。由乎肝胆厥怫逆起
见矣。议从手经上焦治。（劳心阳动木火上蒙）
羚羊角 连翘心 元参 石菖蒲根 郁金 麦冬 竹叶
唐（女） 脉左涩右弦。气火不降。胸胁隐痛。脘不爽。最虑失血。（气火郁脘痛）
川贝 山栀 丹皮 郁金汁 钩藤 栝蒌皮 茯苓 橘红
又 气火上郁。脘中窒痛。呕涎。先以开通壅遏。
香豉 栝蒌皮 山栀 郁金 竹茹 半夏曲 杏仁
葛 嗔怒喧嚷。气火逆飞。致血痹咽痛。食物厌恶。耳前后绕肩闪刺。议解少阳。（怒动胆火）
夏枯草 丹皮 桑叶 钩藤 山栀 地骨皮
朱（五四） 头痛神烦。忽然而至。五行之速。莫如风火。然有虚实内外之因。非徒发散苦寒为事矣。如
向有肝病。目疾丧明。是阴气久伤体质。今厥阴风木司天。春深发泄。阳气暴张。即外感而论。
正内经冬不藏精。春必病温。育阴可使热清。大忌发散。盖阴根久伤。表之再伤阳劫津液。仲
景谓一逆尚引日。再逆促命期矣。余前主阿胶鸡子黄汤。佐地冬壮水。芍甘培土。亟和其厥
阳冲逆之威。咸味入阴。甘缓其急。与内经肝病三法恰合。今已入夏三日。虚阳倏上。烦躁头
痛。当大滋肾母。以苏肝子。补胃阴以杜木火乘侮。旬日不致反复。经月可望全好。（肝肾阴虚风阳上升）
人参 熟地 天冬 麦冬 龟胶 阿胶 北味 茯神
陆 鼻左窍有血。左肩胛臂痛。皆君相多动。营热气偏。脉得右虚左数。先以清肝通络。（络热）
丹皮 山栀 羚羊角 夏枯草 蚕砂 钩藤 连翘 青菊叶
肝者将军之官。相火内寄。得真水以涵濡。真气以制伏。木火遂生生之机。本无是症之名
也。盖因情志不舒则生郁。言语不投则生嗔。谋虑过度则自竭。斯罢极之本。从中变火。攻
冲激烈。升之不熄为风阳。抑而不透为郁气。脘胁胀闷。眩晕猝厥。呕逆淋闭。狂躁见红等
病。由是来矣。古人虽分肝风肝气肝火之殊。其实是同一源。若过郁者宜辛宜凉。乘势达
之为妥。过升者宜柔宜降。缓其旋扰为先。自竭者全属乎虚。当培其子母之脏。至于犯上
侮中乘下诸累。散见各门。可考。（邵新甫）
秦氏：前年患有肝风眩晕。治疗以凉血分、调和阳气、平息内风为主。一年后未再发作。今年正月正值春寒，不像天气温暖时腠理开泄那样容易发散。此次发病，必定是因为劳累和愤怒触动了情志。至于出现的呕吐逆气、忽冷忽热的症状，在丑时到寅时之间逐渐出现耳鸣、咽喉痹阻感，食物在胃脘中停留很久不消化。推测是因为少阳胆木之火在寅时旺盛，胆经脉络贯串耳部，邪气犯逆的威势，必然向上冲犯阳明经并波及各个清窍。脉象右侧涩而大，说明胃气上逆不能下降。味觉不甘，且胃脘中气机逆乱，熏蒸之势日益炽盛，导致营血在内耗损，无法滋养心脏，因此睡眠不安，心神摇荡，呈现出难以言状的躁动之象。如今头部沉重、胃脘痹阻，完全是因为上焦被木火升腾之气所阻遏，清阳之气不得上升。之前的方剂滋阴清热，但血药居多，必然不会见效。现在议定汤剂方，用苦味药以降其逆气，用辛味药以通其痹阻。然而汤剂的剂量宜小，因为久病体虚，初春时节如此，可知冬季藏精的功能并不坚固。丸剂应当使用局方龙荟丸，暂时服用半个月后再做商议。（风火上郁）
连翘（一钱半） 黑栀皮（一钱） 羚羊角（一钱） 鲜菊叶（三钱） 紫菀（二钱） 郁金（八分） 大杏仁（去皮尖，不要研磨，六粒） 土栝蒌皮（一钱） 鲜菖蒲根（四分，忌铁器） 午时服用。
沈氏（女）：腹痛已减轻，呕吐逆气已停止。上焦有热，下焦寒冷，肝阳尚未平和。拟采用当归龙荟法进行治疗。
当归 龙胆草 川楝子 芦荟 川黄连 吴茱萸 大茴香
黄氏：肝胆风火上郁，头面部清空部位的筋脉抽搐不适。治疗以清散风火为主。
羚羊角 犀角 山栀 连翘 栝蒌皮 荷叶梗 薄荷梗 青菊叶
郑氏：头顶胀痛，神志迷蒙，经脉抽痛，胀闷不想进食。月经一个月来四次。这是郁结损伤气血导致的疾病。服用龙荟丸二钱五分，服三次。
叶氏：厥阳扰乱神明，经血色黑，四肢冰冷，面色青，便秘。服用龙荟丸一钱二分，服十次。
阙某（十八岁）：诵读吟咏时，身体虽然静坐，但心神经常动荡。凡是五志（喜怒忧思恐）的发动都属于阳，阳气冒越没有制约，清灵之心遂被蒙蔽。《易经》旨意认为“蒙”是外加的含义。描述发病时的情况，头部想要掐按，胃脘想要抚摸，大小便必然不通利。这是腑气窒塞，源于肝胆厥逆怫郁之气起于下焦。议定从手经上焦论治。（劳心导致阳动，木火上蒙）
唐氏（女）：脉象左侧涩、右侧弦，气火不降，胸胁隐痛，胃脘不爽。最担心的是失血。（气火郁结导致脘痛）
又诊：气火上郁，胃脘中窒塞疼痛，呕吐涎沫。先以开通壅遏为主。
葛氏：嗔怒喧嚷，气火逆飞，导致血痹咽痛，厌恶食物，耳前后及绕肩部位闪刺痛楚。议定解少阳经邪。（怒动胆火）
朱氏（五四岁）：头痛神烦，突然而至。五行变化之速，没有比风火更快的了。然而病因有虚实内外之分，不能单纯依靠发散和解表苦寒药物治疗。如果向来有肝病、目疾甚至失明，说明阴气长期受损，体质虚弱。如今正值厥阴风木司天，春深时节发泄，阳气暴张。即使从外感角度论述，也符合《内经》所说的“冬不藏精，春必病温”。育阴可以使热清，绝对忌讳发散。因为阴根长期受损，若再用发散之法，会再次损伤阳气，劫夺津液。张仲景曾说：“一逆尚引日，再逆促命期。”我之前主张用阿胶鸡子黄汤，佐以地黄、天冬壮水，芍药、甘草培土，急切地调和厥阳冲逆的威势。咸味入阴，甘味缓急，这与《内经》治疗肝病的三法恰好吻合。现在已经进入夏季三天，虚阳忽然上浮，烦躁头痛，应当大滋肾母（肾水），以舒缓肝子（肝木），补胃阴以防止木火乘侮脾胃。旬日之内不致反复，满月之后可望痊愈。（肝肾阴虚，风阳上升）
陆氏：左侧鼻孔出血，左肩胛及手臂疼痛，都是君相之火多动，营热气偏所致。脉象右虚左数。先以清肝通络为主。（络热）
肝脏是将军之官，相火内寄其中，得到真水的涵濡和真气的制伏，木火才能保持生生之机，本来没有这种病症的名称。大概因为情志不舒畅则产生郁结，言语不合则产生嗔怒，谋虑过度则自身枯竭。作为罢极之本的肝脏，从中变生为火，攻冲激烈，升发而不熄灭成为风阳，抑制而不能透达成为郁气。胃脘胁肋胀闷、眩晕猝然昏厥、呕吐逆气、淋证闭癃、狂躁见红等疾病，由此而来。古人虽然区分肝风、肝气、肝火的不同，其实它们同源。如果郁结过重的，适宜用辛散和凉润的方法，顺势通达为宜；如果升发过盛的，适宜用柔润和降逆的方法，缓和其旋扰为先；如果因自竭导致的，全属虚证，应当培补其子母之脏。至于犯上、侮中、乘下等各种累及，散见于各门类中，可以考证。（邵新甫）
Qin (Family Name): Last year, [the patient] suffered from liver wind-induced vertigo. The treatment focused on cooling the blood level (Xue Fen), harmonizing yang to extinguish wind. It did not recur for a year. This year, in the first lunar month, the spring cold was unlike the warm weather that allows pores to open and release. This recurrence of illness must be triggered by labor and anger disturbing the emotions. Regarding the vomiting and reflux, alternating chills and fever, tinnitus, and pharyngeal obstruction gradually occurring between the Chou and Yin hours, and food remaining long in the epigastrium: it is speculated that Shaoyang Wood-Fire flourishes at Yin hour. Since the Gallbladder meridian passes through the ear, the aggressive nature of the rebellious pathogen must ascend to Yangming and affect various orifices. The pulse on the right is choppy and large, indicating stomach qi rebelling and failing to descend. Taste is insipid, and there is chaotic rebellion in the epigastrium with intense steaming heat, consuming Ying-Blood internally so it cannot nourish the Heart. Thus, sleep is restless, the Heart spirit is agitated, presenting an indescribable state of turmoil. Currently, heavy head and epigastric obstruction are entirely due to Wood-Fire ascending in the Upper Jiao, obstructing clear Yang. Previous prescriptions were rich in blood-nourishing herbs for clearing heat, which inevitably failed to produce results. Now, a decoction is proposed using bitter herbs to descend rebellion and pungent herbs to unblock obstruction. However, the dosage of the decoction should be small because of chronic illness and deficiency; given this condition in early spring, it is evident that winter storage was not solid. The pill formula should be Ju Fang Long Hui Wan (Cathartic Pill), taken temporarily for half a month before further discussion. (Wind-fire constrained upward)
Forsythia Fruit (1.5 qian) Black Gardenia Peel (1 qian) Antelope Horn (1 qian) Fresh Chrysanthemum Leaf (3 qian) Aster Root (2 qian) Curcuma Aromatic Tuber (0.8 fen) Large Apricot Kernel (peeled, core removed, not ground, 6 kernels) Trichosanthes Peel (1 qian) Fresh Acorus Rhizome (0.4 fen, avoid iron) Take at noon.
Shen (Female): Abdominal pain has decreased slightly, vomiting and reflux have stopped. There is heat in the Upper Jiao and cold in the Lower Jiao; Liver Yang has not yet harmonized. It is planned to administer the Dang Gui Long Hui method (Danggui Longhui Wan approach).
Angelica Sinensis Root Dragon's Gall Bladder Coptis Chinensis Rhizome Evodia Fruit Fennel
Huang (Family Name): Liver-Gallbladder wind-fire constrained upward, causing twitching and discomfort in the sinews of the clear orifices of the head and face. Treatment focuses on clearing and dispersing.
Antelope Horn Rhinoceros Horn Gardenia Forsythia Fruit Trichosanthes Peel Lotus Leaf Stem Mint Stem Green Chrysanthemum Leaf
Zheng (Family Name): Distending pain at the vertex, mental confusion, meridian twitching pain, distension and fullness with no desire to eat. Menstruation occurs four times a month. This is a disease caused by constraint injuring Qi and Blood. Take Long Hui Wan (Cathartic Pill) 2.5 qian, three doses.
Ye (Family Name): Jue-Yang disturbs the Spirit, menstrual blood is dark, limbs are cold, complexion is green, constipation. Take Long Hui Wan (Cathartic Pill) 1.2 qian, ten doses.
Que (Age 18): While reading or chanting, although the body sits still, the Mind often moves. All movements of the Five Emotions belong to Yang. When Yang overflows without restraint, the clear and spiritual mind becomes obscured. The meaning of Yi Jing states that "Meng" (Ignorance/Enveloped) implies external addition. Describing the onset of illness: the head feels like it needs pinching, the epigastrium feels like it needs rubbing, and bowel/bladder movements are necessarily obstructed. This is blockage of Fu-organ Qi, arising from Liver-Gallbladder Jue-rebellious constraint. It is proposed to treat from the Hand meridians of the Upper Jiao. (Mental labor causes Yang movement, Wood-fire obscures upward)
Antelope Horn Forsythia Heart Scrophularia Root Acorus Rhizome Curcuma Aromatic Tuber Ophiopogon Tuber Bamboo Leaf
Tang (Female): Pulse left choppy, right wiry. Qi-fire fails to descend, dull pain in chest and hypochondrium, epigastric discomfort. Most feared is hemorrhage. (Qi-fire constraint causing epigastric pain)
Fritillaria Bulb Gardenia Moutan Bark Curcuma Juice Uncaria Vine Trichosanthes Peel Poria Citrus Peel
Second visit: Qi-fire constrained upward, obstruction and pain in the epigastrium, vomiting saliva. First, open up the congestion and obstruction.
Fermented Soybean Trichosanthes Peel Gardenia Curcuma Bamboo Shavings Pinellia Paste Apricot Kernel
Ge: Anger and shouting cause Qi-fire to rebel and fly upward, leading to blood obstruction, sore throat, aversion to food, and stabbing pain around the ears, anterior/posterior to shoulders. It is proposed to resolve Shaoyang. (Anger stirs Gallbladder fire)
Prunella Spike Moutan Bark Mulberry Leaf Uncaria Vine Gardenia Groundtree Bark
Zhu (Age 54): Headache and mental restlessness arrive suddenly. Among the Five Elements, none is faster than Wind-Fire. However, etiology involves deficiency/excess and internal/external factors; it is not merely a matter of dispersing or using bitter-cold herbs. If there is a history of Liver disease, eye disease leading to blindness, it indicates long-term injury to Yin constitution. Currently, Jueyin Wind-Wood governs the year, and deep spring releases Yang energy violently. Even discussing exogenous pathogens, it aligns with Nei Jing stating "If one does not store essence in winter, one will suffer from Warm diseases in spring." Nourishing Yin can clear heat; dispersion is strictly contraindicated. Because the root of Yin is long injured, dispersing again injures Yang and robs fluids. Zhang Zhongjing said, "One mistake prolongs the illness, two mistakes hasten death." Previously, I advocated E Jiao Chicken Egg Yolk Decoction, assisted by Rehmannia and Asparagus to strengthen Water, and Paeonia and Licorice to cultivate Earth, urgently harmonizing the violent rebellion of Jue-Yang. Salty flavors enter Yin, sweet flavors relieve urgency, matching the three methods of treating Liver disease in Nei Jing. Now, three days into summer, deficient Yang suddenly ascends, causing irritability and headache. One should greatly nourish Kidney Mother (Kidney Water) to soothe Liver Child (Liver Wood), tonify Stomach Yin to prevent Wood-Fire from invading Spleen/Stomach. Within ten days, relapse may be avoided; after a month, full recovery is expected. (Liver-Kidney Yin deficiency, Wind-Yang rising)
Ginseng Prepared Rehmannia Asparagus Ophiopogon Tortoise Shell Glue Donkey-Hide Gelatin North Schisandra Spirit Polygala
Lu: Bleeding from the left nostril, pain in the left scapula and arm. All indicate excessive movement of Ministerial Fire, imbalance of Ying-Qi heat. Pulse is right deficient, left rapid. First, clear Liver and unblock collaterals. (Collateral Heat)
Moutan Bark Gardenia Antelope Horn Prunella Spike Silkworm Sand Uncaria Vine Forsythia Green Chrysanthemum Leaf
The Liver is the General Officer, housing Ministerial Fire within. It receives nourishment from True Water and control from True Qi, allowing Wood-Fire to maintain its generative mechanism. Originally, there is no name for such symptoms. Generally, emotional dissatisfaction leads to constraint, discordant speech leads to anger, and excessive planning leads to exhaustion. The Liver, as the root of fatigue, transforms into Fire from within. Its aggressive attack is fierce; if ascending without extinguishing, it becomes Wind-Yang; if suppressed without penetrating, it becomes Constraint Qi. Epigastric/hypochondriac distension, sudden vertigo and syncope, vomiting/reflux, stranguria/retention, mania and hematemesis, etc., arise from this. Although ancients distinguished Liver Wind, Liver Qi, and Liver Fire, they share the same source. For severe constraint, pungent and cool methods are appropriate to guide it out顺势; for excessive ascending, softening and descending methods are prioritized to calm the disturbance; for self-exhaustion, it is purely deficiency, requiring tonification of the Mother and Child Zang organs. Various complications involving attacking upward, insulting middle, or overcoming downward are scattered across different categories and can be verified. (Shao Xinpu)