沈阳张姓媪，年过六旬，肠结腹疼，兼心中发热。
病因 素有肝气病，因怒肝气发动，恒至大便不通，必服泻药始
通下。此次旧病复发而呕吐不能受药，是以病久不愈。
证候 胃下脐上似有实积，常常作疼，按之则疼益甚，表里俱觉发热，恶心呕吐。连次
延医服药，下咽须臾即吐出，大便不行已过旬日，水浆不入者七八日矣。脉搏五至，左右脉象皆
弱，独右关重按似有力，舌有黄苔，中心近黑，因问其得病之初
曾发冷否？答云∶旬日前曾发冷两日，至三日即变为热矣。
诊断 即此证脉论之，其阳明胃腑当蕴有外感实热，是以表里俱热，因其肠结不通，胃气不能
下行，遂转而上行与热相并作呕吐。治此证之法，当用镇降之药止其呕，咸润之药开其结，
又当辅以补益之品，俾其呕止、结开，而正气无伤始克有济。
处方 生石膏（一两轧细） 生赭石（一两轧细） 玄参（一两） 潞参（四钱）
芒硝（四钱） 生麦芽（二钱） 茵陈（二钱）
共煎汤一大盅，温服。
效果 煎服一剂，呕止结开，大便通下燥粪若干，表里热皆轻减，可进饮食。诊其脉仍有余热未
净，再为开滋阴清热之方，俾服数剂以善其后。
天津李姓，得头疼证，日久不愈。
病因 其人素羸弱，因商务操劳遇事又多不顺，心肝之火常常妄动，遂致头疼。
证候 头疼不起床者已逾两月，每日头午犹轻，过午则浸加重，夜间疼不能寐，鸡鸣后疼又
渐轻可以少睡，心中时或觉热，饮食懒进。脉搏五至，左部弦长，关脉犹弦而兼硬，右脉则稍和平。
诊断 即此脉象论之，显系肝胆之热上冲脑部作疼也。宜用药清肝火、养肝阴、镇肝逆，且兼用
升清降浊之药理其脑部。
处方 生杭芍（八钱） 柏子仁（六钱） 玄参（六钱） 生龟板（六钱轧细）
龙胆草（三钱） 川芎（钱半） 甘菊花（一钱） 甘草（三钱）
共煎汤一大盅，温服。
效果 服药一剂，病愈十之七八，脉象亦较前和平，遂将龙胆草减去一钱，又服两剂全愈。
或问 川芎为升提气分之品，今其头疼既因肝胆之热上冲，复用川芎以升提之，其热不益上冲乎？
何以服之有效也？答曰∶川芎升清气者也，清气即轻气也。按化学之理，无论何种
气，若在轻气之中必然下降，人之脏腑原有轻气，川芎能升轻气上至脑中，则脑中热浊之气自然
下降，是以其疼可愈也。
【医案一】
沈阳有一位张姓老妇人，年龄超过六十岁，患有肠道闭塞腹痛，同时伴有心胸发热。
病因：她平时就有肝气郁结的病症，因为发怒导致肝气发动，常常引起大便不通，必须服用泻药才能通便。这次旧病复发并且出现呕吐，无法服药，因此病情迁延不愈。
证候：胃脘部至肚脐上方感觉有实邪积聚，经常疼痛，按压时疼痛加剧，身体表里都感觉发热，伴有恶心呕吐。接连请医生服药，药液咽下片刻即被吐出，大便不通已超过十天，连水浆都无法进入已有七八天。脉搏跳动五次（每呼吸一次脉跳五至），左右脉象都虚弱，唯独右关脉重按似乎有力，舌苔发黄，中心近黑色。于是询问她发病之初是否曾怕冷？回答说：十天前曾怕冷两天，到了第三天就变为发热了。
诊断：根据这些症状和脉象分析，她的阳明胃腑应当蕴藏着外感实热，所以表里都发热。因为肠道闭塞不通，胃气不能下行，反而上逆与热邪相搏结，从而引起呕吐。治疗此证的方法，应当使用具有镇降作用的药物来止呕，使用咸味滋润的药物来开通闭塞，同时辅以补益的药物，使得呕吐停止、闭塞开通，且正气不受损伤，这样才能取得疗效。
处方：生石膏（一两，碾细） 生赭石（一两，碾细） 玄参（一两） 潞党参（四钱） 芒硝（四钱） 生麦芽（二钱） 茵陈（二钱）
将上述药材共煎成一大碗汤剂，温服。
效果：服用一剂后，呕吐停止，闭塞开通，排出若干燥结粪便，表里之热均减轻，可以进食。诊察其脉象仍有残余热邪未清，再次开具滋阴清热的方剂，让她服用几剂以巩固疗效。
【医案二】
天津有一位李姓患者，患上头痛证，日久不愈。
病因：此人素体虚弱，因为商务操劳，遇事又多不顺心，心火和肝火常常妄动，从而导致头痛。
证候：因头痛卧床不起已逾两个月，每天上午较轻，午后逐渐加重，夜间疼痛无法入睡，鸡鸣之后疼痛又逐渐减轻，可以稍作睡眠，心中时常觉得发热，饮食懒于进用。脉搏跳动五次，左部脉弦长，关脉仍弦且兼硬，右脉则稍显平和。
诊断：仅从这些脉象分析，明显是肝胆的热邪上冲脑部导致疼痛。适宜用药清泄肝火、滋养肝阴、平抑肝气上逆，并且兼用升清降浊的药物调理脑部。
处方：生杭白芍（八钱） 柏子仁（六钱） 玄参（六钱） 生龟板（六钱，碾细） 龙胆草（三钱） 川芎（一钱半） 甘菊花（一钱） 甘草（三钱）
将上述药材共煎成一大碗汤剂，温服。
效果：服用一剂后，病愈十之七八，脉象也较之前平和，于是将龙胆草减去一钱，又服用两剂后完全痊愈。
有人问：川芎是提升气分的药物，如今他的头痛既是因为肝胆热邪上冲，再使用川芎来提升气机，岂不是让热邪更加上冲吗？为什么服用它有效呢？回答说：川芎提升的是清气，清气就是轻清之气。按照化学原理，无论何种气体，如果在轻清之气中必然下沉。人的脏腑原本就有轻清之气，川芎能将轻清之气提升至脑中，那么脑中热浊之气自然下降，因此疼痛可以痊愈。
[Case 1]
An elderly surnamed Zhang in Shenyang, over sixty years of age, suffered from intestinal obstruction with abdominal pain, accompanied by a sensation of heat in the heart and chest.
Etiology: She had a history of Liver Qi stagnation (Liver Qi disorder). Due to anger triggering the movement of Liver Qi, she frequently experienced constipation, requiring laxatives to relieve it. This time, the old disease recurred with vomiting, preventing medication intake, thus prolonging the illness.
Symptoms: A sensation of solid accumulation between the stomach and above the umbilicus, with frequent pain that worsens upon pressure. Both exterior and interior felt hot, accompanied by nausea and vomiting. Repeated medical consultations and medication resulted in immediate vomiting shortly after swallowing. Constipation had persisted for over ten days, and even water or liquid food could not be retained for seven or eight days. The pulse beat five times per respiration cycle; both left and right pulses were weak, except for the Right Guan position which seemed forceful when pressed heavily. The tongue coating was yellow, turning nearly black at the center. Inquiry revealed whether chills occurred at the onset; the answer was yes, chills lasted two days ten days prior, turning into fever on the third day.
Diagnosis: Based on these symptoms and pulse characteristics, there is likely an accumulation of exogenous excess heat in the Yangming Stomach Fu organ, causing heat in both exterior and interior. Due to intestinal obstruction, Stomach Qi cannot descend but instead rebels upward, combining with heat to cause vomiting. The treatment principle should employ sedating and descending herbs to stop vomiting, salty and moistening herbs to open the obstruction, supplemented by tonifying agents to ensure that once vomiting ceases and obstruction opens, the healthy Qi remains unharmed, thereby achieving therapeutic success.
Prescription: Sheng Shi Gao (Gypsum Fibrosum, 1 liang, finely crushed), Sheng Zhe Shi (Haematitum, 1 liang, finely crushed), Xuan Shen (Scrophulariae Radix, 1 liang), Lu Shen (Codonopsis Radix, 4 qian), Mang Xiao (Natrii Sulfas, 4 qian), Sheng Mai Ya (Hordei Fructus Germinatus, 2 qian), Yin Chen (Artemisiae Scopariae Herba, 2 qian).
Decoct together in a large cup of water, take warm.
Outcome: After one dose, vomiting ceased and obstruction opened, passing several dry feces. Heat in both exterior and interior diminished significantly, allowing for food intake. Pulse examination showed residual heat remained. Another prescription for nourishing Yin and clearing heat was prescribed for several doses to consolidate recovery.
[Case 2]
A patient surnamed Li in Tianjin suffered from headache that persisted for a long time without resolution.
Etiology: The individual was constitutionally weak. Due to business stress and frequent frustrations, Heart Fire and Liver Fire often flared up recklessly, leading to headache.
Symptoms: Bedridden due to headache for over two months. Symptoms were lighter in the forenoon but intensified progressively after noon. Nighttime pain prevented sleep, though pain gradually eased after cockcrow, allowing slight rest. Occasional sensations of heat in the heart, poor appetite. Pulse beat five times per respiration cycle; the Left position was wiry and long, the Guan position was wiry and hard, while the Right position was relatively peaceful.
Diagnosis: Analysis of the pulse indicates clearly that Heat from the Liver and Gallbladder is rushing upward to the head, causing pain. Treatment should clear Liver Fire, nourish Liver Yin, suppress rebellious Liver Qi, and simultaneously use herbs that ascend the clear and descend the turbid to regulate the head.
Prescription: Sheng Hang Shao (Paeoniae Radix Alba, 8 qian), Bai Zi Ren (Biotae Semen, 6 qian), Xuan Shen (Scrophulariae Radix, 6 qian), Sheng Gui Ban (Testudinis Carapax et Plastrum, 6 qian, finely crushed), Long Dan Cao (Gentianae Radix, 3 qian), Chuan Xiong (Ligustici Chuanxiong Rhizoma, 1.5 qian), Gan Ju Hua (Chrysanthemi Flos, 1 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 qian).
Decoct together in a large cup of water, take warm.
Outcome: After one dose, the condition improved by seventy to eighty percent, and the pulse became more peaceful. Long Dan Cao was reduced by one qian, and two additional doses led to complete recovery.
Interrogation: Someone asked, "Chuan Xiong is an herb that ascends and lifts Qi. Since this headache is caused by Liver and Gallbladder Heat rushing upward, does using Chuan Xiong to lift Qi not exacerbate the upward rush of Heat? Why is it effective?" The response was: "Chuan Xiong ascends Clear Qi, which is Light Qi. According to chemical principles, regardless of the type of gas, if present within light air, it naturally descends. The human body's organs inherently possess Light Qi. Chuan Xiong can ascend this Light Qi to the brain, causing the hot and turbid Qi in the brain to naturally descend, thus curing the pain."