苏(五一)肝肾久衰。内风袭络。脉象缓大。肢体麻木。舌强言謇。此属痱中之象。阴气不主上承。当重培其下。
兼佐熄风。
熟地(四钱) 淡苁蓉(三钱) 沙蒺藜(二钱) 清阿胶(二钱) 杞子(二钱) 黄甘菊(一钱) 茯神(二
钱)
鲍(五四)眩晕仆中。口 眼斜。舌强言謇。脉形浮散。此属晚年肝肾气衰。内风袭络。阴液无以上供。拟滋阴熄
风方。
制首乌(四钱) 白蒺藜(二钱) 淮牛膝(二钱) 归身(一钱五分) 黄甘菊(一钱炒) 枸杞子(二钱) 明
天麻(二钱煨)
苏(六三)夏令阳升。目昏头晕。复遭嗔怒。肝气大作。所以黎明跌仆。遂致神昏。脉形短数。舌苔黄浓。姑议滋
清。
羚羊角(一钱) 炒焦半曲(一钱五分) 郁金(一钱) 小生地(三钱) 橘红(一钱) 石菖蒲根(三钱) 连
翘心(一钱五分) 川贝母(二钱)
苏(六三)前议滋清方。服至两剂。神识稍清。肝阳郁勃已解。脏阴虚损未复。今幸纳谷加餐。腑阳无恙。高年明
是肝肾气馁。阴虚而阳无所附。阳神失守。致有目中妄见之象。非脱阳见鬼也。大忌祈祷。扰动阳神。恐阳愈偏而不返。
再拟镇阳法。以冀回春。
人参(一钱) 清阿胶(二钱) 生左牡蛎(三钱) 五味子(五分) 龙骨(三钱) 茯神(二钱) 生白芍(一
钱五分)
苏某(51岁),肝肾长期虚弱。内风侵袭经络。脉象缓大而无力,肢体麻木,舌体僵硬、言语不清。这属于痱病(一种以肢体废用、神志障碍为特征的疾病)的征象。阴气不能正常上承滋养头目,治疗应当重在培补下焦(肝肾)。
同时兼用熄风(平息内风)的方法。
熟地黄(四钱)、肉苁蓉(三钱)、沙苑子(二钱)、清阿胶(二钱)、枸杞子(二钱)、黄甘菊(一钱)、茯神(二钱)。
鲍某(54岁),因眩晕而突然跌倒昏迷。口眼歪斜,舌体僵硬、言语不清。脉象浮散无根。这属于晚年肝肾之气衰退,内风侵袭经络,阴液无法向上供养所致。拟定滋阴熄风的方剂。
制何首乌(四钱)、白蒺藜(二钱)、怀牛膝(二钱)、当归身(一钱五分)、黄甘菊(一钱,炒)、枸杞子(二钱)、明天麻(二钱,煨)。
苏某(63岁),夏季阳气升发,出现视物昏花、头晕。又遭遇愤怒情绪,导致肝气亢盛发作。因此在黎明时分跌倒昏迷,随即导致神志昏迷。脉象短促而数,舌苔黄厚浓腻。暂议采用滋阴凉清的方法。
羚羊角(一钱)、炒焦六神曲(一钱五分)、郁金(一钱)、小生地(三钱)、橘红(一钱)、石菖蒲根(三钱)、连翘心(一钱五分)、川贝母(二钱)。
苏某(63岁),前次商议的滋清方,服用两剂后,神识稍微清醒,肝阳郁结亢盛的情况已解除。但脏腑阴虚亏损尚未恢复。如今幸得食欲增加,腑阳(脾胃之阳)尚且无恙。高龄之人,显然是肝肾气馁,阴虚导致阳气无所依附,阳神失守,从而导致眼前出现幻觉妄见。这不是脱阳见鬼的症状。绝对忌讳祈祷,以免扰动阳神,恐怕阳气更加偏亢而不能回归。再次拟定镇潜阳气的方法,以期恢复健康。
人参(一钱)、清阿胶(二钱)、生左牡蛎(三钱)、五味子(五分)、龙骨(三钱)、茯神(二钱)、生白芍(一钱五分)。
Su (51 years old) has long-standing deficiency of the Liver and Kidneys. Internal wind invades the collaterals. The pulse is slow and large [deficient]. There is numbness in the limbs, stiffness of the tongue, and dysarthria. This presents as Fei disease (a condition characterized by limb paralysis and mental disorder). Yin Qi fails to ascend and nourish properly; treatment should focus on strongly tonifying the Lower Jiao (Liver and Kidneys), assisted by methods to extinguish wind.
Shu Di Huang (Rehmanniae Radix Preparata, 4 qian), Rou Cong Rong (Cistanche Herba, 3 qian), Sha Ji Li (Astragali Complanati Semen, 2 qian), Qing E Jiao (Donkey-hide Gelatin, 2 qian), Qi Zi (Lycii Fructus, 2 qian), Huang Gan Ju (Chrysanthemi Flos, 1 qian), Fu Shen (Poria with Hostwood, 2 qian).
Bao (54 years old) suffered sudden collapse and coma due to vertigo. There is deviation of the mouth and eye, stiffness of the tongue, and dysarthria. The pulse form is floating and scattered. This belongs to the decline of Liver and Kidney Qi in late life, where internal wind invades the collaterals and Yin fluids fail to supply upwards. A formula for nourishing Yin and extinguishing wind is proposed.
Zhi Shou Wu (Polygoni Multiflori Radix Preparata, 4 qian), Bai Ji Li (Tribuli Fructus, 2 qian), Huai Niu Xi (Achyranthis Bidentatae Radix, 2 qian), Gui Shen (Angelicae Sinensis Radix, 1.5 qian), Huang Gan Ju (Chrysanthemi Flos, 1 qian, stir-fried), Gou Qi Zi (Lycii Fructus, 2 qian), Ming Tian Ma (Gastrodiae Rhizoma, 2 qian, baked).
Su (63 years old): In summer, Yang Qi ascends, causing blurred vision and dizziness. Subsequently encountering anger, Liver Qi becomes hyperactive. Consequently, he fell and collapsed at dawn, leading to loss of consciousness. The pulse is short and rapid, and the tongue coating is thick, yellow, and greasy. Tentatively propose a method of nourishing Yin and clearing heat.
Ling Yang Jiao (Saiga Tataricae Cornu, 1 qian), Chao Jiao Ban Qu (Medicated Leaven Stir-fried, 1.5 qian), Yu Jin (Curcumae Radix, 1 qian), Xiao Sheng Di (Rehmanniae Radix, 3 qian), Ju Hong (Citri Reticulatae Pericarpium Rubrum, 1 qian), Shi Chang Pu Gen (Acori Tatarinowii Rhizoma, 3 qian), Lian Qiao Xin (Jasminis Flos Stamen, 1.5 qian), Chuan Bei Mu (Fritillariae Cirrhosae Bulbus, 2 qian).
Su (63 years old): Regarding the previous proposal of the nourishing-yin and clearing-heat formula, after taking two doses, mental clarity slightly improved, and the stagnation and hyperactivity of Liver Yang have resolved. However, the deficiency of Yin in the Zang organs has not yet recovered. Fortunately, appetite has increased, and the Yang of the Fu organs remains intact. In advanced age, it is evident that Liver and Kidney Qi are weak; Yin deficiency causes Yang to have no foundation, and the Spirit of Yang loses its residence, resulting in visual hallucinations. This is not "seeing ghosts" due to Yang collapse. Prayer is strictly contraindicated to avoid disturbing the Yang Spirit; otherwise, Yang may become even more deviated and fail to return. Again, a method to calm and anchor Yang is proposed to hope for recovery.
Ren Shen (Ginseng Radix et Rhizoma, 1 qian), Qing E Jiao (Donkey-hide Gelatin, 2 qian), Sheng Zuo Mu Li (Ostreae Concha, raw, 3 qian), Wu Wei Zi (Schisandrae Chinensis Fructus, 0.5 qian), Long Gu (Dinosaur Bone, 3 qian), Fu Shen (Poria with Hostwood, 2 qian), Sheng Bai Shao (Paeoniae Radix Alba, raw, 1.5 qian).