吴(六三)肝阳亢为头晕。肾阴虚则耳鸣。此晚年肝肾气馁。下虚上实明甚。但忽惊悸。汗大泄。有时寤不肯寐。
竟有悲伤欲哭之象。明系脏阴少藏。厥阳鼓动。内风上冒。舞于太阴。每有是症。病自情志中生。所以清之攻之。均属
无益。议仲景妇人篇。参脏躁悲伤之旨。用药自有准绳。但王道未能速效。
阿胶(三钱) 牡蛎(三钱) 磁石(二钱) 淮小麦(一钱五分) 炙草(五分) 大枣(三钱) 茯神(二钱)
韩(十一)风温袭于肺卫。身热发痧。痰咳气喘。烦躁少寐。频渴脉大。且议清泄。
牛蒡(三钱) 杏仁(三钱) 桑皮(一钱五分) 羚羊角(一钱) 桔梗(一钱) 连翘(二钱) 薄荷(八分)
象贝母(一钱五分)
又 痧痘巳回。目赤咽痛。余毒未清。宜凉解泄邪。
犀角(一钱) 嫩元参(一钱五分) 银花(一钱) 小生地(三钱) 桔梗(一钱) 霜桑叶(一钱) 连翘(二
钱) 生甘草(三分) 黑山栀(一钱五分)
曹(八岁)头面堆沙回靥。毒瓦斯未尽。口疳龈血。稚年阳亢阴虚。恐有暴脱之虑。
地骨皮(三钱) 犀角(四分) 连翘(一钱五分) 川贝(二钱) 生地炭(三钱) 生草(三分) 银花(一
钱) 丹皮(一钱五分)
穆(四岁)堆沙已经回靥。毒瓦斯未尽。咳痰不寐。稚年阳亢阴虚。最怕慢惊之变。治从和脾胃。利湿方法。
地骨皮(三钱) 川斛(三钱) 苡仁(二钱) 川贝(去心研,二钱) 炒麦冬(二钱) 茯苓(三钱) 银花
(一钱)
吴(六十三岁):肝阳亢盛导致头晕。肾阴不足则出现耳鸣。这是晚年肝肾之气虚弱,下虚上实的症状非常明显。但突然感到惊悸,大汗淋漓,有时清醒着不肯入睡。竟然表现出悲伤想哭的样子。这明显是脏阴不足无法潜藏,厥阳鼓动,内风上扰,在太阴经活动。每当出现这种症状,病多由情志因素引起。所以采用清热或攻下的治法,都无益处。建议参考张仲景《金匮要略·妇人杂病篇》中关于“脏躁”悲伤的旨意,用药自然有准则。但是王道的温和疗法不能迅速见效。
阿胶(三钱) 牡蛎(三钱) 磁石(二钱) 淮小麦(一钱五分) 炙甘草(五分) 大枣(三钱) 茯神(二钱)
韩(十一岁):风温邪气侵袭肺卫。身体发热并出痧疹,痰多咳嗽气喘,烦躁少寐,频繁口渴,脉象洪大。暂议采用清泄法治疗。
牛蒡子(三钱) 杏仁(三钱) 桑白皮(一钱五分) 羚羊角(一钱) 桔梗(一钱) 连翘(二钱) 薄荷(八分) 象贝母(一钱五分)
复诊:痧痘已经消退,眼睛红赤咽喉疼痛,余毒未清。宜用凉解法以泄除邪气。
犀角(一钱) 嫩元参(一钱五分) 金银花(一钱) 小生地(三钱) 桔梗(一钱) 霜桑叶(一钱) 连翘(二钱) 生甘草(三分) 黑山栀(一钱五分)
曹(八岁):头面部痘疮堆积如沙,痘疹回靥(结痂脱落),毒瓦斯未尽。口疳牙龈出血。年幼时期阳气亢盛而阴虚,恐怕有暴脱的危险。
地骨皮(三钱) 犀角(四分) 连翘(一钱五分) 川贝母(二钱) 生地炭(三钱) 生甘草(三分) 金银花(一钱) 牡丹皮(一钱五分)
穆(四岁):痘疮已经回靥,毒瓦斯未尽。咳嗽有痰,睡眠不安。年幼时期阳气亢盛而阴虚,最怕发生慢惊风的变证。治疗从调和脾胃、利湿的方法入手。
Wu (63 years old): Hyperactive Liver Yang (Liver Yang Hyperactivity) causes dizziness. Kidney Yin Deficiency (Kidney Yin Deficiency) results in tinnitus. This indicates a deficiency of Qi and Blood in the Liver and Kidneys in late life, with obvious Lower Deficiency and Upper Excess (Lower Deficiency and Upper Excess). However, sudden palpitations and anxiety occur, accompanied by profuse sweating. Sometimes, when awake, there is an unwillingness to sleep. There is even a manifestation of sadness and a desire to cry. This clearly stems from insufficient Zang Yin failing to anchor, stirring up Jue Yang (Jue Yang), causing internal wind to rise and disturb the Taiyin (Taiyin). Whenever these symptoms appear, the disease originates from emotional factors. Therefore, treatments involving clearing heat or purging are all ineffective. It is proposed to refer to the principles regarding "Zang Zao" (Visceral Agitation) and sadness in Zhang Zhongjing's chapter on women's diseases in the *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet). The choice of herbs will then have a standard. However, the "Kingly Way" (gentle tonic therapy) cannot produce rapid effects.
Donkey-hide gelatin (3 qian) Oyster shell (3 qian) Magnetite (2 qian) Huai wheat (1.5 qian) Honey-fried licorice root (0.5 qian) Jujube (3 qian) Poria with hostwood (2 qian)
Han (11 years old): Wind-warmth pathogens invade the Lung and Wei (Defensive) levels. Fever occurs with sand-rash (sand-rash), phlegm, cough, asthma, irritability, and insomnia. Frequent thirst and a large pulse are present. A strategy of clearing and draining is tentatively proposed.
Burdock fruit (3 qian) Apricot seed (3 qian) Mulberry bark (1.5 qian) Antelope horn (1 qian) Platycodon root (1 qian) Forsythia fruit (2 qian) Mint (0.8 fen) Xiang Fritillaria bulb (1.5 qian)
Revisit: The sand-rash and smallpox have receded. Red eyes and sore throat indicate residual toxins not yet cleared. Cooling and resolving methods should be used to vent the pathogen.
Rhinoceros horn (1 qian) Tender Scrophularia root (1.5 qian) Honeysuckle flower (1 qian) Small Rehmannia root (3 qian) Platycodon root (1 qian) Frost mulberry leaf (1 qian) Forsythia fruit (2 qian) Raw licorice root (0.3 fen) Black Gardenia fruit (1.5 qian)
Cao (8 years old): Head and face show piled-up sand-like lesions; the rash has crusted over, but toxic vapors remain incomplete. Mouth ulcers and bleeding gums occur. In early childhood, Yang is hyperactive and Yin is deficient, raising concern for sudden collapse.
Lycium bark (3 qian) Rhinoceros horn (0.4 qian) Forsythia fruit (1.5 qian) Sichuan Fritillaria bulb (2 qian) Charred Rehmannia root (3 qian) Raw licorice root (0.3 fen) Honeysuckle flower (1 qian) Moutan bark (1.5 qian)
Mu (4 years old): The piled-up sand lesions have already crusted over, but toxic vapors remain incomplete. Cough with phlegm and insomnia occur. In early childhood, Yang is hyperactive and Yin is deficient, making slow convulsion (Slow Convulsion) the most feared complication. Treatment follows the method of harmonizing the Spleen and Stomach and promoting dampness resolution.
Lycium bark (3 qian) Sichuan Dendrobium stem (3 qian) Coix seed (2 qian) Sichuan Fritillaria bulb (decored and ground, 2 qian) Stir-fried Ophiopogon tuber (2 qian) Poria (3 qian) Honeysuckle flower (1 qian)