褚(四八)痹痛。汗泄甚多。湿邪较风寒二气更胜。拟护阳法。从汗多亡阳例。仍佐驱邪。
生黄 (三钱) 海桐皮(一钱) 粗桂枝(八分) 当归(一钱五分) 片姜黄(一钱) 生于术(二钱) 防
风根(六分) 川独活(五分)
沈(三七)风湿相搏。历节痛。四肢麻木。此属周痹。
粗桂枝(八分) 木防己(一钱五分) 海桐皮(一钱) 羚羊角(一钱) 晚蚕砂(一钱) 片姜黄(一钱) 川
萆(二钱) 酒炒桑枝(一两)
又 风湿麻痹。服苦温方。痛势已缓。所有入暮口干。当兼佐以甘润。
羚羊角(一钱) 甜杏仁(三钱) 苡仁(二钱) 晚蚕砂(二钱) 南花粉(二钱) 木防己(一钱五分) 桂
枝(五分)
吴(廿八)面青汗泄。不寐。诸阳一并为厥之后。寒战肢掣。牵引阳升。便秘。是肝肾内衰之征。往往有骤脱之虞。
此止厥甚难。勉拟经旨肝苦急。急食甘以缓之。甘麦大枣汤加阿胶、牡蛎、枣仁、茯神。
阿胶(二钱) 炙甘草(五分) 牡蛎(三钱) 淮小麦(一钱五分) 南枣(三钱) 枣仁(三钱) 茯神(二
钱)
顾(四六)神识如醉。厥阳上并。志意不乐。有时叫喊。凡动皆阳。诸静为阴。此属热痰阻蔽灵机。经云。重阳者
狂。重阴者癫。议降肝胆相火。
羚羊角(一钱) 化橘红(一钱) 陈胆星(五分) 龙胆草(一钱) 天竺黄(一钱) 石菖蒲(六分) 远志
(七分)
褚某(48岁),患痹痛。出汗非常多。湿邪比风寒二气更为严重。拟定护阳法。参照汗多导致亡阳的病例处理。同时辅助驱除邪气。
生黄芪(三钱) 海桐皮(一钱) 粗桂枝(八分) 当归(一钱五分) 片姜黄(一钱) 炒白术(二钱) 防风根(六分) 川独活(五分)
沈某(37岁),风湿相互搏结。历节疼痛。四肢麻木。这属于周痹。
粗桂枝(八分) 木防己(一钱五分) 海桐皮(一钱) 羚羊角(一钱) 晚蚕砂(一钱) 片姜黄(一钱) 川萆薢(二钱) 酒炒桑枝(一两)
复诊:风湿麻痹,服用苦温方剂后,疼痛程度已经缓解。但傍晚时出现口干症状,应当兼用甘润之法辅助治疗。
羚羊角(一钱) 甜杏仁(三钱) 薏苡仁(二钱) 晚蚕砂(二钱) 南花粉(二钱) 木防己(一钱五分) 桂枝(五分)
吴某(28岁),面色青暗,出汗,失眠。在诸阳之气并逆为厥之后,出现寒战、肢体抽搐。牵引阳气上升,便秘。这是肝肾内部衰败的征象。往往有突然脱绝的危险。
这种厥证很难治愈。勉强依照《内经》旨意“肝苦急,急食甘以缓之”,使用甘麦大枣汤加阿胶、牡蛎、枣仁、茯神。
阿胶(二钱) 炙甘草(五分) 牡蛎(三钱) 淮小麦(一钱五分) 南枣(三钱) 枣仁(三钱) 茯神(二钱)
顾某(46岁),神识恍惚如醉酒状态。厥阳上并。意志不乐。有时叫喊。凡是动的属阳,凡是静的属阴。这属于热痰阻蔽灵机(心神)。《内经》说:“重阳者狂,重阴者癫。”建议降泄肝胆相火。
羚羊角(一钱) 化橘红(一钱) 陈胆星(五分) 龙胆草(一钱) 天竺黄(一钱) 石菖蒲(六分) 远志(七分)
Mr. Chu (48 years old) suffers from Bi pain (painful obstruction syndrome). He sweats profusely. The pathogenic dampness is more severe than wind-cold. A method to protect Yang is proposed, following the pattern of Yang collapse due to excessive sweating, while simultaneously assisting in expelling pathogens.
Raw Huangqi (Astragali Radix, 3 qian) Haitongpi (Tinosporae Caulis, 1 qian) Cui Guizhi (Cinnamomi Ramulus, 0.8 qian) Danggui (Angelicae Sinensis Radix, 1.5 qian) Pian Jianghuang (Curcumae Longae Rhizoma, 1 qian) Sheng Baizhu (Atractylodis Macrocephalae Rhizoma, 2 qian) Fangfenggen (Saposhnikoviae Radix, 0.6 qian) Chuan Duhuo (Angelicae Pubescentis Radix, 0.5 qian)
Mr. Shen (37 years old) presents with wind-dampness intermingling and battling. There is pain in all joints (Lijie pain) and numbness in the four limbs. This belongs to Zhou Bi (generalized painful obstruction).
Cui Guizhi (Cinnamomi Ramulus, 0.8 qian) Mu Fangji (Stephaniae Tetrandrae Radix, 1.5 qian) Haitongpi (Tinosporae Caulis, 1 qian) Lingyangjiao (Saigae Tataricae Cornu, 1 qian) Wan Can Sha (Bombyx Batryticatus, 1 qian) Pian Jianghuang (Curcumae Longae Rhizoma, 1 qian) Chuan Bixie (Dioscoreae Hypoglaucae Rhizoma, 2 qian) Jiu Chao Sangzhi (Mori Ramulus processed with wine, 1 liang)
Follow-up: Wind-dampness paralysis. After taking bitter-warm formulas, the pain has eased. However, dry mouth occurs at dusk. Sweet-moistening methods should be added as adjuvant therapy.
Lingyangjiao (Saigae Tataricae Cornu, 1 qian) Tian Xingren (Armeniacae Semen Amarum, 3 qian) Yiren (Coicis Semen, 2 qian) Wan Can Sha (Bombyx Batryticatus, 2 qian) Nanhuafen (Pseudostellariae Radix, 2 qian) Mu Fangji (Stephaniae Tetrandrae Radix, 1.5 qian) Guizhi (Cinnamomi Ramulus, 0.5 qian)
Mr. Wu (28 years old) has a cyan complexion, sweating, and insomnia. Following the reversal of all Yang qi into Jue (reversal cold), there are chills and limb convulsions. This draws Yang qi upward, accompanied by constipation. These are signs of internal decline of the Liver and Kidney. There is often a danger of sudden collapse.
Treating this type of Jue is very difficult. Tentatively applying the principle from the Classic: "The Liver dislikes tension; urgently feed sweet flavors to relieve it." Ganmai Dazao Tang (Licorice, Wheat, and Jujube Decoction) is modified with Ejiao (Donkey-hide Gelatin), Muli (Ostreae Concha), Zaoren (Ziziphi Spinosomi Semen), and Fushen (Poria with Hostwood).
Ejiao (Donkey-hide Gelatin, 2 qian) Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma, 0.5 qian) Muli (Ostreae Concha, 3 qian) Huai Xiaomai (Tritici Fructus, 1.5 qian) Nanzao (Jujubae Fructus, 3 qian) Zaoren (Ziziphi Spinosomi Semen, 3 qian) Fushen (Poria with Hostwood, 2 qian)
Mr. Gu (46 years old) has a spirit confused as if intoxicated. Reversal Yang merges upward. His will is unhappy. He sometimes shouts. Movement belongs to Yang; stillness belongs to Yin. This belongs to heat-phlegm obstructing the spiritual mechanism (Shen). The Classic states: "Excess Yang leads to Mania (Kuang); excess Yin leads to Epilepsy (Dian)." It is proposed to descend the Minister Fire of the Liver and Gallbladder.
Lingyangjiao (Saigae Tataricae Cornu, 1 qian) Hua Juhong (Citri Reticulatae Pericarpium Rubrum, 1 qian) Chen Dansheng (Arisomatis Cum Bile, aged, 0.5 qian) Longdancao (Gentianae Radix, 1 qian) Tianzhuhuang (Textiliae Rhizoma, 1 qian) Shichangpu (Acori Tatarinowii Rhizoma, 0.6 qian) Yuanzhi (Polygalae Radix, 0.7 qian)