朱(三三)咳痰见血。肺胃久虚。
桑叶(一钱) 杏仁(三钱) 川斛(三钱) 大沙参(二钱) 象贝(一钱五分) 茯苓(二钱) 玉竹(二钱)
蒋(三六)吐血已止。脉象弦数。胃纳不减。咳嗽气冲。少阴久虚之象。防血复来。
大淡菜(一两) 牛膝炭(一钱五分) 白扁豆(五钱) 川斛(三钱) 参三七(五分) 糯稻根须(五钱) 白
茯苓(三钱)
徐(三二)嗔怒肝阳上升。胃络血涌。诸气皆以下行为顺。拟降气法。
苏子(炒研一钱) 郁金(一钱) 南楂肉(二钱) 桃仁(炒,一钱) 丹皮(炒,一钱五分) 黑山栀(一钱
五分) 降香末(冲入五分)
魏(四八)心肾精血不充。痰中带血。胃纳颇佳。后天生气甚好。不致损怯之虞。
熟地(四两) 远志(五钱) 山药(二两) 萸肉(二两) 五味子(一两) 茯苓(三两) 芡实(二两) 建
莲(三两)
雷(五四)脉左坚。肝肾阴伤失血。
生地炭(三钱) 川斛(三钱) 山药(二钱) 清阿胶(二钱) 麦冬(二钱) 茯苓(二钱) 左牡蛎(三钱)
五味子(一钱五分)
陆(五三)吐血已止。咳痰晡甚。暮热气喘。肺胃阴虚所致。兼以养阴和阳。
川斛(四钱) 白扁豆(五钱) 炙草(四分) 生地炭(三钱) 麦冬(二钱) 茯神(二钱) 清阿胶(二钱)
又 昨进养阴和阳。痰咳已缓。暮热盗汗。寐醒即止。再当镇摄可安。
生左牡蛎(三钱) 五味子(一钱五分) 炙草(四分) 清阿胶(三钱) 麦冬(二钱) 云茯神(二钱) 熟
地炭(四钱) 远志(八分)
戴 少阴久亏。阳不潜藏。肝肾之血。亦随气升。冲胃犯肺。震动络脉。溢于其上。以致咯出。左关脉渐平。右关
濡软略旺。瘀行未尽。略有咳逆。前议熟地。又取壮水。乃阴旺阳乃复辟之意。即经旨所谓阳在外。阴之使也。拟方候
裁。
熟地(四钱) 拣麦冬(二钱) 淮牛膝炭(一钱五分) 陈阿胶(另烊冲,二钱) 川贝母(去心研,一钱五分)
左牡蛎( 研三钱) 云茯神(二钱) 北沙参(一钱五分) 苡仁(二钱)
又
熟地(四钱) 白蒺藜(一钱五分) 云茯神(二钱) 拣麦冬(二钱) 霞天曲(炒,三钱) 制女贞(一钱五
分) 北沙参(三钱) 川贝(去心研,二钱)
朱某(33岁)咳嗽咳痰带血。肺脏和胃腑长期虚弱。
桑叶(一钱) 杏仁(三钱) 川石斛(三钱) 北沙参(二钱) 象贝母(一钱五分) 茯苓(二钱) 玉竹(二钱)
蒋某(36岁)吐血症状已经停止。脉象弦而数。胃纳食量未减少。咳嗽且气机上冲。这是少阴经长期虚弱的征象。防止血液再次溢出。
大淡菜(一两) 牛膝炭(一钱五分) 白扁豆(五钱) 川石斛(三钱) 三七粉(五分) 糯稻根须(五钱) 白茯苓(三钱)
徐某(32岁)因愤怒导致肝阳上升。胃络中的血液涌出。各种气机都以下行为顺。拟定降气的方法。
紫苏子(炒研一钱) 郁金(一钱) 南山楂肉(二钱) 桃仁(炒,一钱) 牡丹皮(炒,一钱五分) 黑山栀子(一钱五分) 降香末(冲服五分)
魏某(48岁)心肾精血不足。痰中带血。胃纳食量很好。后天脾胃之气甚好。没有发展为虚损劳怯的担忧。
熟地黄(四两) 远志(五钱) 山药(二两) 山茱萸肉(二两) 五味子(一两) 茯苓(三两) 芡实(二两) 建莲肉(三两)
雷某(54岁)左脉坚硬。肝肾阴伤导致失血。
生地黄炭(三钱) 川石斛(三钱) 山药(二钱) 清阿胶(二钱) 麦冬(二钱) 茯苓(二钱) 左牡蛎(三钱) 五味子(一钱五分)
陆某(53岁)吐血已经停止。咳嗽咳痰在傍晚加重。夜间发热气喘。这是肺胃阴虚所致。兼用养阴和阳的方法。
川石斛(四钱) 白扁豆(五钱) 炙甘草(四分) 生地黄炭(三钱) 麦冬(二钱) 茯神(二钱) 清阿胶(二钱)
复诊:昨日服用养阴和阳方剂后,痰咳已缓解。夜间发热盗汗,睡眠醒来后即止。应当再用镇摄之法以求安宁。
生左牡蛎(三钱) 五味子(一钱五分) 炙甘草(四分) 清阿胶(三钱) 麦冬(二钱) 云茯神(二钱) 熟地黄炭(四钱) 远志(八分)
戴某:少阴经长期亏损。阳气不能潜藏。肝肾之血,也随着气机上逆。冲犯胃部和肺部。震动脉络。血液溢出于上部。以致咯出。左关脉逐渐平和。右关脉濡软略旺。瘀血未尽行散。略有咳嗽气逆。前议使用熟地黄,又是取“壮水之主,以制阳光”之意。即《内经》旨意所说的“阳在外,阴之使也”。拟定方剂候裁。
熟地黄(四钱) 拣选麦冬(二钱) 淮牛膝炭(一钱五分) 陈阿胶(另烊化冲服,二钱) 川贝母(去心研,一钱五分) 左牡蛎(研,三钱) 云茯神(二钱) 北沙参(一钱五分) 薏苡仁(二钱)
复诊:
熟地黄(四钱) 白蒺藜(一钱五分) 云茯神(二钱) 拣选麦冬(二钱) 霞天曲(炒,三钱) 制女贞子(一钱五分) 北沙参(三钱) 川贝母(去心研,二钱)
Zhu (33 years old) coughs up phlegm with blood. The Lung and Stomach have been deficient for a long time.
Folium Mori (Sangye, 1 qian) Semen Armeniacae Amarum (Xingren, 3 qian) Radix Dendrobii Nodosi (Chuanhu, 3 qian) Radix Glehniae (Dashashen, 2 qian) Bulbus Fritillariae Thunbergii (Xiangbei, 1.5 qian) Poria (Fuling, 2 qian) Rhizoma Polygonati Odorati (Yuzhu, 2 qian)
Jiang (36 years old) hematemesis has stopped. The pulse is wiry and rapid. Appetite remains unchanged. Cough with rebellious Qi. This presents as chronic deficiency of the Shaoyin channel. Prevention of recurrent bleeding is advised.
Mytilus edulis (Datancai, 1 liang) Radix Achyranthis Bidentatae Carbonisata (Niuxitantan, 1.5 qian) Semen Dolichoris Albis (Baibian dou, 5 qian) Radix Dendrobii Nodosi (Chuanhu, 3 qian) Radix Notoginseng (Shansanqi, 0.5 qian) Radix Oryzae Sativae Cum Glutine (Nuodaogenxu, 5 qian) Poria (Bai Fuling, 3 qian)
Xu (32 years old) anger causes Liver Yang to ascend. Blood surges from the Stomach collaterals. All Qi should descend smoothly. A method to direct Qi downward is proposed.
Fructus Sojae Preparatus (Su Zi, stir-fried and ground, 1 qian) Radix Curcumae Longae (Yujin, 1 qian) Fructus Crataegi (Nanzha rou, 2 qian) Semen Persicae (Taoren, stir-fried, 1 qian) Cortex Moutan (Danpi, stir-fried, 1.5 qian) Fructus Gardeniae (Heishanzhi, 1.5 qian) Lignum Dalbergiae Odoriferae (Xiangmu, powder, taken with decoction, 0.5 qian)
Wei (48 years old) Essence and Blood of the Heart and Kidney are insufficient. Blood in phlegm. Appetite is good. Post-heaven Qi is strong. There is no risk of developing consumptive disease.
Radix Rehmanniae Preparata (Shudi, 4 liang) Radix Polygalae (Yuanzhi, 5 qian) Rhizoma Dioscoreae (Shanyao, 2 liang) Fructus Corni (Yurou, 2 liang) Fructus Schisandrae (Wuweizi, 1 liang) Poria (Fuling, 3 liang) Semen Euryales (Qianshi, 2 liang) Semen Nelumbinis (Jianlian, 3 liang)
Lei (54 years old) Left pulse is firm. Loss of blood due to Yin injury of the Liver and Kidney.
Radix Rehmanniae Carbonisata (Shengditan, 3 qian) Radix Dendrobii Nodosi (Chuanhu, 3 qian) Rhizoma Dioscoreae (Shanyao, 2 qian) Colla Corii Asini (Qingejiao, 2 qian) Radix Ophiopogonis (Maidong, 2 qian) Poria (Fuling, 2 qian) Concha Ostreae (Zuomuli, 3 qian) Fructus Schisandrae (Wuweizi, 1.5 qian)
Lu (53 years old) Hematemesis has stopped. Cough and sputum worsen in the late afternoon. Evening fever and asthma. Caused by Yin deficiency of the Lung and Stomach. Combined with nourishing Yin and harmonizing Yang.
Radix Dendrobii Nodosi (Chuanhu, 4 qian) Semen Dolichoris Albis (Baibian dou, 5 qian) Radix Glycyrrhizae Preparata (Zhigancao, 0.4 qian) Radix Rehmanniae Carbonisata (Shengditan, 3 qian) Radix Ophiopogonis (Maidong, 2 qian) Poria Cum Radix Pinelliae (Fushen, 2 qian) Colla Corii Asini (Qingejiao, 2 qian)
Follow-up: Yesterday, after taking the formula to nourish Yin and harmonize Yang, cough and sputum have eased. Evening fever and night sweats stop upon waking from sleep. Further sedation and anchoring are needed for peace.
Concha Ostreae (Sheng Zuomuli, 3 qian) Fructus Schisandrae (Wuweizi, 1.5 qian) Radix Glycyrrhizae Preparata (Zhigancao, 0.4 qian) Colla Corii Asini (Qingejiao, 3 qian) Radix Ophiopogonis (Maidong, 2 qian) Poria Cum Radix Pinelliae (Yun Fushen, 2 qian) Radix Rehmanniae Preparata Carbonisata (Shuditan, 4 qian) Radix Polygalae (Yuanzhi, 0.8 fen)
Dai: Chronic deficiency of the Shaoyin channel. Yang fails to anchor. Blood of the Liver and Kidney rises with Qi. It assaults the Stomach and Lung. It shakes the collaterals. Blood overflows upwards. Resulting in expectoration. The left Guan pulse is gradually level. The right Guan pulse is soggy and slightly vigorous. Stasis has not fully resolved. Slight cough and rebellious Qi remain. Previously, Shudi was discussed, again invoking the principle of "strengthening water to control fire." This aligns with the Classic saying: "Yang outside is the servant of Yin." A formula is proposed for review.
Radix Rehmanniae Preparata (Shudi, 4 qian) Radix Ophiopogonis (Jian Maidong, 2 qian) Radix Achyranthis Bidentatae Carbonisata (Huainiuxitantan, 1.5 qian) Colla Corii Asini (Chen Ejiao, melted separately and mixed, 2 qian) Bulbus Fritillariae Thunbergii (Chuanbeimu, heart removed and ground, 1.5 qian) Concha Ostreae (Zuomuli, ground, 3 qian) Poria Cum Radix Pinelliae (Yun Fushen, 2 qian) Radix Glehniae (Beishashen, 1.5 qian) Semen Coicis (Yiren, 2 qian)
Follow-up:
Radix Rehmanniae Preparata (Shudi, 4 qian) Fructus Tribuli (Bajili, 1.5 qian) Poria Cum Radix Pinelliae (Yun Fushen, 2 qian) Radix Ophiopogonis (Jian Maidong, 2 qian) Massa Medicata Fermentata Chinensis (Xiatianqu, stir-fried, 3 qian) Fructus Ligustri Lucidi (Zhi Nvzhen, 1.5 qian) Radix Glehniae (Beishashen, 3 qian) Bulbus Fritillariae Thunbergii (Chuanbei, heart removed and ground, 2 qian)