老师：暴吐暴泻发生虚脱，在有条件的地方，必须首先采取输液抢救。可是在没有条件的情况下，主要是指在边远山区，交通不方便，医药条件差的情况下，应当发挥和依靠中医中药的救治作用。只要救治得法，完全可以取得速效，上述病案便是实例。从本病的救治而言，应当抓住三个关键问题：第一，暴吐暴泻，必须先治其吐。夫"呕吐者，胃气上逆而不下也"。呕吐严重则饮食不能进，汤药不能入。凡呕吐不能纳药食者，最难治疗。因为药水入咽即吐，不能停留胃中，药既不能入胃，又安能奏效?因此必须先治其吐。俟吐势稍缓，使药能入胃，再去治泻，如此方能取效。余在数十年临证中，每遇此种情况，必当辨别寒热，先治其呕吐。若患者表现口苦、呕恶、舌苔黄，属热证者，用乌梅30g，配以黄连10g，竹茹15g，酸苦并用，止呕作用很强。若患者表现呕吐清水、口不甚渴、舌苔白，属寒证者，用乌梅30g，干姜10g，白豆蔻10g，酸辛并用，止呕之效亦速。方中乌梅，其味极酸，其性收敛，取其酸收以制胃气之上逆，且乌梅生津，对于呕吐而失津者，用之最宜，用大剂量乌梅止呕，临床屡试屡验。本案患者正是频频呕吐，药难下咽，故先取乌梅、干姜，酸温并用以降寒浊，止呕逆，冀其通关开噤，使药能入咽，然后图以正法。这里还需说明，凡治剧烈呕吐，其服药方法十分重要，需将药物浓煎之后，待其冷热适中，每次只能服用l汤匙(小儿酌减)。服后不可随即饮水或进食。服药后或即呕吐者，过15分钟可再进药1汤匙，连服3-5次，吐势就会逐渐控制。俟其吐止能纳，然后才能加大服药量。或有不知此者，明见病人吐药而不能纳，却仍以大杯整碗汤药强灌之，或者药刚下咽即饮水、吃水果者，每致倾囊吐出，愈服愈吐，终不济事。第二，吐泻暴脱，首当拯救阳气。大吐大泻，直接损耗津液，《红炉点雪}曾把泄泻一证作为"亡阴脱液之肇端"。然气能生津，气能化津，气能摄津。在病理上，气虚可致津亏，津亏可致气耗，凡大汗、大吐、大泻而失津者，每见"气随津脱"之证。《扁鹊心书》指出，"暴注之病"可以"损其脾气，泄脱元气"。临床所见，大吐大泻之证不仅损津，而且耗气，容易出现津气两夺之危侯。救治之法，应当先拯阳气，后补阴液，使之固气而后生津。本案患者表现津气俱脱之侯，而其中尤以汗出、肢冷、脉微之阳气虚衰为最紧要，故用大剂参附汤急拯阳气以固其脱，而后用生脉散益气生津，俟气固津回，然后用参苓白术散缓补脾胃。临证之际，自应分清先后缓急，切不可错乱无序。第三，抢险救脱，用药必须量大力专。大吐大泻发生虚脱，其生命危在顷刻。医者不仅要准确辨证，而且要果断用药。如果胆小怕事，仅仅用药试探，定会贻误病机，误人性命。杯水难救车薪，取效贵乎神速。似本案例之气随津脱，表现亡阳之征侯者，必以参附大剂，或可力挽垂危。方中人参用量宜大，非30g不可，更不可用党参替代。凡抢险救脱，用参附汤、独参汤之类，人参俱当重用，并需浓煎频服。附子性虽辛热，而回阳救脱之功甚著，故用量需大。此时此刻，用药宜精，切忌杂乱，否则药力不专，反而无益。孙思邈曾谓医者曰，"行欲方而智欲圆，心欲小而胆欲大"。所谓心小胆大，一要谨慎辨证，二要果断用药，二者缺一不可。
风火痰虚说眩晕
四川省乐山市人民医院中医研究室主任余国俊
徐X，女28岁，干部，1986年2月17日初诊。患者8岁时因不慎落水，着凉受惊，卧病月余，体质渐差。11岁即患眩晕，发时头昏目眩，耳鸣，呕恶，每年发作五六次。迁延至20岁时，一游医令服铅粉18g(1日吞服6g)治疗眩晕，导致急性铅中毒。经华西医大附院排铅治疗4个月，铅中毒的主要症状消失，但眩晕明显加重。患者经常头昏目眩，甚至感觉天旋地转，不敢睁眼，眼球胀痛，视物有飘动感，耳鸣耳闭塞，手足振颤，干口区心烦。西医诊断：内耳眩晕病。曾经省市多家医院中、西医治疗。中药曾用过乎肝潜阳，熄风止痉，滋养肝肾，健脾化痰，虫类搜剔通络等，服药达数百剂，均无显效，经常无法坚持工作。刻诊：症如上述，舌红苔薄白，脉沉细。借鉴江尔逊老中医论治眩晕的独到经验，拟诊为脾肾亏虚，风火痰上扰，试投"柴陈泽泻汤"加味：柴胡10g，黄芩6g，法夏10g，党参15g，茯苓12g，陈皮10g，甘草3g，白术10g，泽泻30g，钩藤12g(后下)，菊花10g，天麻10g(轧细吞服)，生姜10g，白芍12g，生牡蛎30g。效果：服3剂，头昏目眩、眼球胀痛、干呕、心烦明显减轻；守服25剂，诸症基本消失。曾随访2年，惟诉情怀不畅时感觉头昏，或轻微眩晕，而照服本方二三剂，便可息止。
学员甲本例眩晕缠绵17年，又曾受铅粉毒害，身体一直较差，堪称顽固性眩晕，故屡经中、西医治疗未获显效。
老师接诊后，虽未收迅速息止之功，但能守法守方，服至25剂终于基本息止，疗效还是较满意的。据我所知，江老自拟的柴陈泽泻汤，已经临床验证数百例，一般服2-4剂便能迅速息止眩晕，不失为一首高效验方，值得推广使用。
进修生甲：但一般的眩晕病使用西药也能迅速缓解，有的甚至可以自行缓解。
老师：确有自行缓解的，但临床所见较少。至于眩晕急重症，屡用西药如镇静、安定、止吐及抗胆碱能药物，却收效甚微，而转诊于中医者，却不少见。
老师：何谓眩晕?眩者眼目昏花，晕者头脑晕转。但细检中医古书及现代教材，竟有将头昏、头重足轻而无旋转感觉亦赅于其中者，这只能叫做广义的眩晕。而西医的眩晕，则分为"真性眩晕"与"假性眩晕"两大类，堪称泾渭分明。其真性眩晕，亦称"旋转性眩晕"，由前庭神经或内耳迷路病变所致，临床表现为头晕目眩，并感觉自身旋转，或周围景物旋转，伴恶心、呕吐、耳鸣、耳聋、眼球震颤、头痛、共济失调等，此为真性眩晕的特征。有鉴于此，江老认为，宜将头昏、头重足轻而无旋转感觉者排除出眩晕范畴之外，这样名正自然言顺，辨证才有准的。可见江老常说"他山之石，可以攻玉"，即借鉴西医，为我所用，不是一句套话。
进修生丙江老为眩晕正名，令人耳目一新。但怎样运用中医学理论来辨识真性眩晕呢?
老师：首先要参验历代医家关于眩晕的论说，但参验时应子具体分析，含英咀华，切忌信手拈来，生吞活剥。如"无风不作眩"、"无火不作眩"、"无痰不作眩"、"无虚不作眩"等论说，虽各具至理，但未免失之偏颇；且均以眩晕的广义立论，若移来阐释真性眩晕的病因病机，就难免失之笼统和抽象。江老认为，值得重视的倒是张仲景论眩，多从少阳相火上炎，痰饮上逆立论，主用小柴胡汤、苓桂术甘汤、泽泻汤、小半夏加茯苓汤等，颇与真性眩晕的某些特征相契合。
进修生丙这就有点费解了。第一，"少阳相火上炎，痰饮上逆"与"无痰不作眩"有什么本质差别呢?第二，若系痰饮为患，就必有相应的舌脉--舌苔腻，脉弦或滑。但本例却是舌红苔薄白，脉沉细。
老师："少阳相火上炎，痰饮上逆"一语，可以推衍出真性眩晕的综合病因病机--风、火、痰、虚。此与"无痰不作眩"的一隅之见岂可同日而语!而据临床观察，少阳火升，痰饮上逆的真性眩晕，其舌脉均无定体。舌苔腻，固为痰饮之征，而不腻或竟无苔者，未必不是痰饮。江老曾治不少眩晕患者，舌淡红苔薄白或无苔，补气血无效，滋阴潜阳亦不效，改用涤痰逐饮，驱风清火反收捷效。其脉无定体，更无需赘说。不过此中机理尚待进一步探索。
学员乙：老师刚才说"少阳相火上炎，痰饮上逆"一语可以推衍出风、火、痰、虚宋，真是闻所未闻，究竟是怎样推衍出来的?
老师：少阳相火与厥阴风木为表里，风助火势，火助风威，总是相因为患；而痰饮上逆多缘于脾肾亏虚。你看，这不是推卫出风、火、痰、虚四个字来了吗?而历代深谙此理者当首推陈修园。不过，陈修园论眩晕，乃是以风为中心，而以火、虚、痰串解之，颇能阐幽发微，切中肯綮。他说，"风非外来之风，指厥阴风木而言"，木旺则生风；且因厥阴风木"与少阳相火同居，厥阴气逆，则风生而火发"；虚者，"风生必挟木势而克土"，又"肾为肝母，肾主藏精，精虚则脑海空而头重"，即子盗母气；痰者，"土病则聚液成痰"。这就是说，风火痰为眩晕之标，脾肾虚为眩晕之本。所以陈修园总结说，"其言虚者，言其病根；其言实者，言其病象：理本--贯"。((医学从众录·眩晕))江老认为，陈修园的论说十分超妙，若移来阐释真性眩晕的病因病机，比较准确。但江老强调指出，眩晕的发作，并非风、火、痰、虚四者各自单独为患，而是综合为患。所以他对张景岳所谓"眩晕一证，虚者居其八九，而兼火兼痰者，不过十中一二耳"的说法颇不以为然。就临床所见，眩晕发作时，无不呈现一派风火痰上扰之象，难道都能用"虚"来解释吗?
进修生丙但总不能否认"虚"的重要性吧?
老师：当然不能否认，因为否认了。也就很难圆满地解释风火痰上扰的标象。不过，陈修园说虚是眩晕的病根，我们可否理解为"潜在病因"或"体质病因"?但不论如何理解，眩晕总是风火痰虚综合为患，属于本虚标实之证，治疗就宜标本兼顾。
学员丙这是不言而喻的，不过古今医家在遵循"标本同治"这一治则时，在具体治法上却是异彩纷呈，各领风骚，令人无所适从。老师能否点评一二?
老师：一言难尽!陈修园曾评道，"河间诸公，一于清火驱风豁痰，犹未知风火痰之所由作也"。又说，"余少读景岳之书，专主补虚一说，遵之不效，再搜求古训，然后知景岳于虚实二字，认得死煞，即于风火二字，不能洞悉其所以然也"。((医学从众录·眩晕))但修园治疗眩晕，或遵丹溪之法，单用大黄泻火；或运用鹿茸酒、加味左归饮、六味、八味丸补肾；或运用补中益气汤补脾，亦未尝标本同治。程钟龄、叶天士倡言标本同治，如健脾益气合化痰降逆，滋养肝肾合平肝潜阳，平正通达，看似良法。但若移来平息眩晕的发作，犹嫌缓不济急，难求速效。近世论治眩晕，或偏重于治标，如从痰挟肝气上逆施治而用旋复代赭石汤，从"支饮眩冒"施治而用泽泻汤等；或倡言发作期治标用温胆汤，缓解期治本用参芪二陈汤等，均各有千秋，可资参验。
进修生丙江老取法的是哪一家呢?
老师：江老治此证有异于古今诸贤之处，在于其发作期即主张标本同治，而融驱风清火豁痰补脾之药于一炉，庶其迅速息止之。待眩晕息止之后，再缓治其本。
进修生甲：前面追究本虚时，是包括了脾和肾的，为什么标本同治时只补脾而不补肾呢?
老师：江老认为，眩晕发作时，痰饮上逆的标象十分昭著，而直接补肾之药，不但缓不济急，且有滋腻之弊，反而掣肘，难求速效。故必待眩晕息止之后，再议补肾。江老临床曾屡见有迭用六味、八味、左归、右归等以期息止眩晕，结果收效甚微，甚至分毫无效。此非方药力微，实为用之不得其时之故。所以江老治本，首重于脾。而所谓补脾，不是呆补，实为运脾和胃。因为运脾可化痰饮，和胃能止呕逆；脾运能御肝之乘，风木才不得横恣；风木静，相火宁。这样，风火痰上扰的标象就可很快消除。可见这是直接治本而间接治标，一举两得。
实习生我想知道柴陈泽泻汤的药物组成、常用剂量、方解及使用范围。
老师：柴陈泽泻汤即小柴胡、二陈、泽泻汤合方，另加天麻、钩藤、菊花。药用：柴胡10g，黄芩6～10g，法夏10g，党参12～15g，甘草3～5g，大枣10～12g，生姜6～10g，陈皮10g，茯苓15g，白术10～15g，泽泻10～15g，天麻10g(轧细吞服)，钩藤12g(后下)，菊花10g。其中小柴胡汤旋转少阳枢机，透达郁火，升清降浊；二陈汤化痰降逆；泽泻汤涤饮利水。方中尚寓有小半夏加茯苓汤，亦可降逆化痰，涤饮止呕；又寓有六君子汤，运脾和胃以治本。加天麻、钩藤、菊花者，旨在柔润以熄肝风。'根据"异病同治"的原则，可以扩大本方的使用范围。如高血压或脑动脉供血不足所致的眩晕，只要具有真性眩晕的特征性症侯，投以奉方，亦可收迅速息止功。此外，我近来治疗颈椎病所致的眩晕，则去陈皮、茯苓、甘草、钩藤、菊花，而重加葛根30～60g引领津液上过头项，以舒筋缓痉；再重加川芎30～45g活血化瘀，通络止痛。已观察10余例，其近期疗效尚满意。
咳嗽3个月
四川省乐山市人民医院中医研究室主任余国俊
老师：暴吐暴泻导致虚脱，在有条件的地方，必须首先采取输液抢救。可是在没有条件的情况下，主要是指在边远山区，交通不方便，医药条件差的情况下，应当发挥和依靠中医中药的救治作用。只要救治得法，完全可以取得速效，上述病案便是实例。从本病的救治而言，应当抓住三个关键问题：第一，暴吐暴泻，必须先治其吐。夫"呕吐者，胃气上逆而不下也"。呕吐严重则饮食不能进，汤药不能入。凡呕吐不能纳药食者，最难治疗。因为药水入咽即吐，不能停留胃中，药既不能入胃，又安能奏效?因此必须先治其吐。俟吐势稍缓，使药能入胃，再去治泻，如此方能取效。余在数十年临证中，每遇此种情况，必当辨别寒热，先治其呕吐。若患者表现口苦、呕恶、舌苔黄，属热证者，用乌梅30g，配以黄连10g，竹茹15g，酸苦并用，止呕作用很强。若患者表现呕吐清水、口不甚渴、舌苔白，属寒证者，用乌梅30g，干姜10g，白豆蔻10g，酸辛并用，止呕之效亦速。方中乌梅，其味极酸，其性收敛，取其酸收以制胃气之上逆，且乌梅生津，对于呕吐而失津者，用之最宜，用大剂量乌梅止呕，临床屡试屡验。本案患者正是频频呕吐，药难下咽，故先取乌梅、干姜，酸温并用以降寒浊，止呕逆，冀其通关开噤，使药能入咽，然后图以正法。这里还需说明，凡治剧烈呕吐，其服药方法十分重要，需将药物浓煎之后，待其冷热适中，每次只能服用l汤匙(小儿酌减)。服后不可随即饮水或进食。服药后或即呕吐者，过15分钟可再进药1汤匙，连服3-5次，吐势就会逐渐控制。俟其吐止能纳，然后才能加大服药量。或有不知此者，明见病人吐药而不能纳，却仍以大杯整碗汤药强灌之，或者药刚下咽即饮水、吃水果者，每致倾囊吐出，愈服愈吐，终不济事。第二，吐泻暴脱，首当拯救阳气。大吐大泻，直接损耗津液，《红炉点雪》曾把泄泻一证作为"亡阴脱液之肇端"。然气能生津，气能化津，气能摄津。在病理上，气虚可致津亏，津亏可致气耗，凡大汗、大吐、大泻而失津者，每见"气随津脱"之证。《扁鹊心书》指出，"暴注之病"可以"损其脾气，泄脱元气"。临床所见，大吐大泻之证不仅损津，而且耗气，容易出现津气两夺之危侯。救治之法，应当先拯阳气，后补阴液，使之固气而后生津。本案患者表现津气俱脱之侯，而其中尤以汗出、肢冷、脉微之阳气虚衰为最紧要，故用大剂参附汤急拯阳气以固其脱，而后用生脉散益气生津，俟气固津回，然后用参苓白术散缓补脾胃。临证之际，自应分清先后缓急，切不可错乱无序。第三，抢险救脱，用药必须量大力专。大吐大泻发生虚脱，其生命危在顷刻。医者不仅要准确辨证，而且要果断用药。如果胆小怕事，仅仅用药试探，定会贻误病机，误人性命。杯水难救车薪，取效贵乎神速。似本案例之气随津脱，表现亡阳之征侯者，必以参附大剂，或可力挽垂危。方中人参用量宜大，非30g不可，更不可用党参替代。凡抢险救脱，用参附汤、独参汤之类，人参俱当重用，并需浓煎频服。附子性虽辛热，而回阳救脱之功甚著，故用量需大。此时此刻，用药宜精，切忌杂乱，否则药力不专，反而无益。孙思邈曾谓医者曰，"行欲方而智欲圆，心欲小而胆欲大"。所谓心小胆大，一要谨慎辨证，二要果断用药，二者缺一不可。
风火痰虚说眩晕
四川省乐山市人民医院中医研究室主任余国俊
徐X，女28岁，干部，1986年2月17日初诊。患者8岁时因不慎落水，着凉受惊，卧病月余，体质渐差。11岁即患眩晕，发时头昏目眩，耳鸣，呕恶，每年发作五六次。迁延至20岁时，一游医令服铅粉18g(1日吞服6g)治疗眩晕，导致急性铅中毒。经华西医大附院排铅治疗4个月，铅中毒的主要症状消失，但眩晕明显加重。患者经常头昏目眩，甚至感觉天旋地转，不敢睁眼，眼球胀痛，视物有飘动感，耳鸣耳闭塞，手足振颤，干口区心烦。西医诊断：内耳眩晕病。曾经省市多家医院中、西医治疗。中药曾用过平肝潜阳，熄风止痉，滋养肝肾，健脾化痰，虫类搜剔通络等，服药达数百剂，均无显效，经常无法坚持工作。刻诊：症如上述，舌红苔薄白，脉沉细。借鉴江尔逊老中医论治眩晕的独到经验，拟诊为脾肾亏虚，风火痰上扰，试投"柴陈泽泻汤"加味：柴胡10g，黄芩6g，法夏10g，党参15g，茯苓12g，陈皮10g，甘草3g，白术10g，泽泻30g，钩藤12g(后下)，菊花10g，天麻10g(轧细吞服)，生姜10g，白芍12g，生牡蛎30g。效果：服3剂，头昏目眩、眼球胀痛、干呕、心烦明显减轻；守服25剂，诸症基本消失。曾随访2年，惟诉情怀不畅时感觉头昏，或轻微眩晕，而照服本方二三剂，便可息止。
学员甲本例眩晕缠绵17年，又曾受铅粉毒害，身体一直较差，堪称顽固性眩晕，故屡经中、西医治疗未获显效。
老师接诊后，虽未收迅速息止之功，但能守法守方，服至25剂终于基本息止，疗效还是较满意的。据我所知，江老自拟的柴陈泽泻汤，已经临床验证数百例，一般服2-4剂便能迅速息止眩晕，不失为一首高效验方，值得推广使用。
进修生甲：但一般的眩晕病使用西药也能迅速缓解，有的甚至可以自行缓解。
老师：确有自行缓解的，但临床所见较少。至于眩晕急重症，屡用西药如镇静、安定、止吐及抗胆碱能药物，却收效甚微，而转诊于中医者，却不少见。
老师：何谓眩晕?眩者眼目昏花，晕者头脑晕转。但细检中医古书及现代教材，竟有将头昏、头重足轻而无旋转感觉亦赅于其中者，这只能叫做广义的眩晕。而西医的眩晕，则分为"真性眩晕"与"假性眩晕"两大类，堪称泾渭分明。其真性眩晕，亦称"旋转性眩晕"，由前庭神经或内耳迷路病变所致，临床表现为头晕目眩，并感觉自身旋转，或周围景物旋转，伴恶心、呕吐、耳鸣、耳聋、眼球震颤、头痛、共济失调等，此为真性眩晕的特征。有鉴于此，江老认为，宜将头昏、头重足轻而无旋转感觉者排除出眩晕范畴之外，这样名正自然言顺，辨证才有准的。可见江老常说"他山之石，可以攻玉"，即借鉴西医，为我所用，不是一句套话。
进修生丙江老为眩晕正名，令人耳目一新。但怎样运用中医学理论来辨识真性眩晕呢?
老师：首先要参验历代医家关于眩晕的论说，但参验时应子具体分析，含英咀华，切忌信手拈来，生吞活剥。如"无风不作眩"、"无火不作眩"、"无痰不作眩"、"无虚不作眩"等论说，虽各具至理，但未免失之偏颇；且均以眩晕的广义立论，若移来阐释真性眩晕的病因病机，就难免失之笼统和抽象。江老认为，值得重视的倒是张仲景论眩，多从少阳相火上炎，痰饮上逆立论，主用小柴胡汤、苓桂术甘汤、泽泻汤、小半夏加茯苓汤等，颇与真性眩晕的某些特征相契合。
进修生丙这就有点费解了。第一，"少阳相火上炎，痰饮上逆"与"无痰不作眩"有什么本质差别呢?第二，若系痰饮为患，就必有相应的舌脉--舌苔腻，脉弦或滑。但本例却是舌红苔薄白，脉沉细。
老师："少阳相火上炎，痰饮上逆"一语，可以推衍出真性眩晕的综合病因病机--风、火、痰、虚。此与"无痰不作眩"的一隅之见岂可同日而语!而据临床观察，少阳火升，痰饮上逆的真性眩晕，其舌脉均无定体。舌苔腻，固为痰饮之征，而不腻或竟无苔者，未必不是痰饮。江老曾治不少眩晕患者，舌淡红苔薄白或无苔，补气血无效，滋阴潜阳亦不效，改用涤痰逐饮，驱风清火反收捷效。其脉无定体，更无需赘说。不过此中机理尚待进一步探索。
学员乙：老师刚才说"少阳相火上炎，痰饮上逆"一语可以推衍出风、火、痰、虚宋，真是闻所未闻，究竟是怎样推衍出来的?
老师：少阳相火与厥阴风木为表里，风助火势，火助风威，总是相因为患；而痰饮上逆多缘于脾肾亏虚。你看，这不是推卫出风、火、痰、虚四个字来了吗?而历代深谙此理者当首推陈修园。不过，陈修园论眩晕，乃是以风为中心，而以火、虚、痰串解之，颇能阐幽发微，切中肯綮。他说，"风非外来之风，指厥阴风木而言"，木旺则生风；且因厥阴风木"与少阳相火同居，厥阴气逆，则风生而火发"；虚者，"风生必挟木势而克土"，又"肾为肝母，肾主藏精，精虚则脑海空而头重"，即子盗母气；痰者，"土病则聚液成痰"。这就是说，风火痰为眩晕之标，脾肾虚为眩晕之本。所以陈修园总结说，"其言虚者，言其病根；其言实者，言其病象：理本--贯"。((医学从众录·眩晕))江老认为，陈修园的论说十分超妙，若移来阐释真性眩晕的病因病机，比较准确。但江老强调指出，眩晕的发作，并非风、火、痰、虚四者各自单独为患，而是综合为患。所以他对张景岳所谓"眩晕一证，虚者居其八九，而兼火兼痰者，不过十中一二耳"的说法颇不以为然。就临床所见，眩晕发作时，无不呈现一派风火痰上扰之象，难道都能用"虚"来解释吗?
进修生丙但总不能否认"虚"的重要性吧?
老师：当然不能否认，因为否认了。也就很难圆满地解释风火痰上扰的标象。不过，陈修园说虚是眩晕的病根，我们可否理解为"潜在病因"或"体质病因"?但不论如何理解，眩晕总是风火痰虚综合为患，属于本虚标实之证，治疗就宜标本兼顾。
学员丙这是不言而喻的，不过古今医家在遵循"标本同治"这一治则时，在具体治法上却是异彩纷呈，各领风骚，令人无所适从。老师能否点评一二?
老师：一言难尽!陈修园曾评道，"河间诸公，一于清火驱风豁痰，犹未知风火痰之所由作也"。又说，"余少读景岳之书，专主补虚一说，遵之不效，再搜求古训，然后知景岳于虚实二字，认得死煞，即于风火二字，不能洞悉其所以然也"。((医学从众录·眩晕))但修园治疗眩晕，或遵丹溪之法，单用大黄泻火；或运用鹿茸酒、加味左归饮、六味、八味丸补肾；或运用补中益气汤补脾，亦未尝标本同治。程钟龄、叶天士倡言标本同治，如健脾益气合化痰降逆，滋养肝肾合平肝潜阳，平正通达，看似良法。但若移来平息眩晕的发作，犹嫌缓不济急，难求速效。近世论治眩晕，或偏重于治标，如从痰挟肝气上逆施治而用旋复代赭石汤，从"支饮眩冒"施治而用泽泻汤等；或倡言发作期治标用温胆汤，缓解期治本用参芪二陈汤等，均各有千秋，可资参验。
进修生丙江老取法的是哪一家呢?
老师：江老治此证有异于古今诸贤之处，在于其发作期即主张标本同治，而融驱风清火豁痰补脾之药于一炉，庶其迅速息止之。待眩晕息止之后，再缓治其本。
进修生甲：前面追究本虚时，是包括了脾和肾的，为什么标本同治时只补脾而不补肾呢?
老师：江老认为，眩晕发作时，痰饮上逆的标象十分昭著，而直接补肾之药，不但缓不济急，且有滋腻之弊，反而掣肘，难求速效。故必待眩晕息止之后，再议补肾。江老临床曾屡见有迭用六味、八味、左归、右归等以期息止眩晕，结果收效甚微，甚至分毫无效。此非方药力微，实为用之不得其时之故。所以江老治本，首重于脾。而所谓补脾，不是呆补，实为运脾和胃。因为运脾可化痰饮，和胃能止呕逆；脾运能御肝之乘，风木才不得横恣；风木静，相火宁。这样，风火痰上扰的标象就可很快消除。可见这是直接治本而间接治标，一举两得。
实习生我想知道柴陈泽泻汤的药物组成、常用剂量、方解及使用范围。
老师：柴陈泽泻汤即小柴胡、二陈、泽泻汤合方，另加天麻、钩藤、菊花。药用：柴胡10g，黄芩6～10g，法夏10g，党参12～15g，甘草3～5g，大枣10～12g，生姜6～10g，陈皮10g，茯苓15g，白术10～15g，泽泻10～15g，天麻10g(轧细吞服)，钩藤12g(后下)，菊花10g。其中小柴胡汤旋转少阳枢机，透达郁火，升清降浊；二陈汤化痰降逆；泽泻汤涤饮利水。方中尚寓有小半夏加茯苓汤，亦可降逆化痰，涤饮止呕；又寓有六君子汤，运脾和胃以治本。加天麻、钩藤、菊花者，旨在柔润以熄肝风。'根据"异病同治"的原则，可以扩大本方的使用范围。如高血压或脑动脉供血不足所致的眩晕，只要具有真性眩晕的特征性症侯，投以奉方，亦可收迅速息止功。此外，我近来治疗颈椎病所致的眩晕，则去陈皮、茯苓、甘草、钩藤、菊花，而重加葛根30～60g引领津液上过头项，以舒筋缓痉；再重加川芎30～45g活血化瘀，通络止痛。已观察10余例，其近期疗效尚满意。
咳嗽3个月
四川省乐山市人民医院中医研究室主任余国俊
Teacher: In cases of sudden vomiting and diarrhea leading to collapse, intravenous fluid resuscitation must be the first priority where conditions permit. However, in settings lacking such resources—primarily remote mountainous areas with poor transportation and inadequate medical facilities—the therapeutic role of Traditional Chinese Medicine (TCM) and herbal medicine should be leveraged and relied upon. With appropriate treatment methods, rapid efficacy can certainly be achieved; the aforementioned case records serve as examples. Regarding the rescue of this disease, three key issues must be grasped:
First, in sudden vomiting and diarrhea, vomiting must be treated first. As stated, "Vomiting is caused by the rebellious upward movement of Stomach Qi instead of its downward flow." Severe vomiting prevents the intake of food and decoctions. Cases where patients cannot retain medicines or food due to vomiting are the most difficult to treat. Because the liquid medicine is vomited immediately upon swallowing and cannot stay in the Stomach, how can it take effect if it does not enter the Stomach? Therefore, vomiting must be treated first. Once the vomiting subsides slightly, allowing medicine to enter the Stomach, then diarrhea can be treated, which is the only way to achieve efficacy. In my decades of clinical practice, whenever I encounter such situations, I always differentiate between Cold and Heat patterns and treat vomiting first. If the patient presents with bitter taste in the mouth, nausea, and a yellow tongue coating, indicating a Heat pattern, I use 30g of Wu Mei (Fructus Mume), combined with 10g of Huang Lian (Rhizoma Coptidis) and 15g of Zhu Ru (Caulis Bambusae in Taeniam), employing both sour and bitter flavors for a strong anti-emetic effect. If the patient presents with vomiting clear water, little thirst, and a white tongue coating, indicating a Cold pattern, I use 30g of Wu Mei (Fructus Mume), 10g of Gan Jiang (Rhizoma Zingiberis Recens), and 10g of Bai Dou Kou (Fructus Cardamomi Rotundus), employing both sour and acrid flavors for rapid anti-emetic efficacy. In this formula, Wu Mei (Fructus Mume) is extremely sour and has astringent properties; its sourness restrains the rebellious upward movement of Stomach Qi. Moreover, Wu Mei (Fructus Mume) generates fluids, making it most suitable for patients who have lost fluids due to vomiting. The use of large doses of Wu Mei (Fructus Mume) to stop vomiting has been repeatedly verified in clinical practice. The patient in this case was vomiting frequently, making it difficult to swallow medicine. Therefore, Wu Mei (Fructus Mume) and Gan Jiang (Rhizoma Zingiberis Recens) were used first, combining sour and warm properties to descend cold turbidity and stop vomiting, hoping to open the throat and allow medicine to enter, after which standard treatment could proceed. It is also necessary to explain that when treating severe vomiting, the method of administration is crucial. The medicine should be decocted strongly, allowed to reach a moderate temperature, and taken one tablespoon at a time (dose reduced for children). After taking the medicine, one should not drink water or eat immediately. If vomiting occurs after taking the medicine, another tablespoon can be taken after 15 minutes. Taking it 3-5 times consecutively will gradually control the vomiting. Only after vomiting stops and retention is possible can the dosage be increased. Some people, unaware of this, seeing that the patient vomits the medicine and cannot retain it, still force-feed them large cups or bowls of decoction, or have them drink water or eat fruit immediately after swallowing the medicine. This often results in everything being vomited out, increasing vomiting with each dose, ultimately achieving nothing.
Second, in sudden collapse from vomiting and diarrhea, saving Yang Qi is the primary goal. Massive vomiting and diarrhea directly deplete Body Fluids. *Honglu Dianxue* once described diarrhea as the "beginning of Yin depletion and fluid loss." However, Qi can generate fluids, transform fluids, and secure fluids. Pathologically, Qi deficiency can lead to fluid deficiency, and fluid deficiency can lead to Qi consumption. In cases of massive sweating, vomiting, or diarrhea resulting in fluid loss, signs of "Qi following fluid depletion" are often seen. *Bianque Xinshu* points out that "acute watery diarrhea" can "damage Spleen Qi and leak Yuan Qi." Clinically, massive vomiting and diarrhea not only damage fluids but also consume Qi, easily leading to the critical condition of simultaneous depletion of fluids and Qi. The rescue method should prioritize rescuing Yang Qi and later tonifying Yin fluids, thereby securing Qi before generating fluids. The patient in this case presented with simultaneous depletion of fluids and Qi, among which the decline of Yang Qi manifested most critically as sweating, cold limbs, and a faint pulse. Therefore, a large dose of Shen Fu Tang (Ginseng and Aconite Decoction) was used to urgently rescue Yang Qi and secure against collapse, followed by Sheng Mai San (Generate the Pulse Powder) to benefit Qi and generate fluids. Once Qi was secured and fluids returned, Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) was used to gently tonify the Spleen and Stomach. In clinical practice, one must clearly distinguish priorities and urgency, never acting in disorder.
Third, in emergency rescue, medication must be potent and focused. When massive vomiting and diarrhea cause collapse, life is in imminent danger. Physicians must not only differentiate syndromes accurately but also prescribe decisively. If timid and hesitant, merely testing medications will surely delay the optimal timing and cost lives. A cup of water cannot save a burning cartload of firewood; efficacy depends on speed. In cases like this one, where Qi follows fluid depletion and signs of Yang collapse appear, a large dose of Shen Fu Tang (Ginseng and Aconite Decoction) may be required to turn the tide. The dosage of Ren Shen (Radix Ginseng) in the formula should be large, no less than 30g, and Dang Shen (Radix Codonopsis) cannot be used as a substitute. For emergency rescue using formulas like Shen Fu Tang (Ginseng and Aconite Decoction) or Du Shen Tang (Single Ginseng Decoction), Ren Shen (Radix Ginseng) must be heavily used and decocted strongly for frequent administration. Although Fu Zi (Radix Aconiti Lateralis Preparata) is acrid and hot, its merit in restoring Yang and rescuing from collapse is significant, so the dosage needs to be large. At this moment, medication should be precise; avoid complexity, otherwise the medicinal power will not be focused, doing more harm than good. Sun Simiao once said to physicians, "Actions should be principled, wisdom should be comprehensive, the heart should be cautious, and courage should be great." Being cautious yet courageous means two things: careful differentiation of syndromes and decisive prescribing; neither can be missing.
On Dizziness Caused by Wind, Fire, Phlegm, and Deficiency
Yu Guojun, Director of the TCM Research Office, People's Hospital of Leshan City, Sichuan Province
Xu X, Female, 28 years old, cadre. First consultation on February 17, 1986. When the patient was 8 years old, she accidentally fell into water, caught a chill, and was frightened, remaining bedridden for over a month, causing her physical constitution to gradually deteriorate. At age 11, she developed dizziness. During attacks, she experienced dizziness, tinnitus, and nausea, occurring five or six times a year. By age 20, a traveling physician prescribed 18g of lead powder (6g swallowed daily) to treat dizziness, leading to acute lead poisoning. After four months of lead elimination treatment at the Affiliated Hospital of West China University of Medical Sciences, the main symptoms of lead poisoning disappeared, but dizziness worsened significantly. The patient frequently experienced dizziness, even feeling as if the sky and earth were spinning, daring not to open her eyes. She suffered from distending pain in the eyeballs, a floating sensation in vision, tinnitus, ear blockage, tremors in hands and feet, dry mouth, and irritability. Western medical diagnosis: Meniere's disease. She had received TCM and Western medical treatments at multiple hospitals in the province and city. TCM treatments previously included calming Liver Yang and subduing Yang, extinguishing wind and stopping spasms, nourishing Liver and Kidney, strengthening Spleen and resolving phlegm, and using insect drugs to search for and unblock collaterals. She took hundreds of doses with no obvious effect, often unable to persist in work. Current examination: Symptoms as above, red tongue with thin white coating, deep and fine pulse. Drawing on the unique experience of Old TCM Physician Jiang Erxun in treating dizziness, the diagnosis was deficiency of Spleen and Kidney with upward disturbance of Wind, Fire, and Phlegm. A modified Chai Chen Ze Xie Tang (Bupleurum, Pinellia, and Alisma Decoction) was tentatively prescribed: Chai Hu 10g, Huang Qin 6g, Fa Xia 10g, Dang Shen 15g, Fu Ling 12g, Chen Pi 10g, Gan Cao 3g, Bai Zhu 10g, Ze Xie 30g, Gou Teng 12g (added later), Ju Hua 10g, Tian Ma 10g (crushed and swallowed), Sheng Jiang 10g, Bai Shao 12g, Sheng Mu Li 30g. Effect: After 3 doses, dizziness, distending pain in eyeballs, dry retching, and irritability were significantly relieved; after continuing for 25 doses, all symptoms basically disappeared. Follow-up for 2 years showed that only when emotions were unsatisfactory did she feel slight dizziness or mild vertigo, which could be stopped by taking two or three doses of this formula.
Student Jia: This case of dizziness persisted for 17 years, and the patient suffered from lead powder toxicity, with generally poor health, qualifying as refractory dizziness. Thus, repeated TCM and Western medical treatments failed to show obvious effects.
Teacher: After receiving treatment, although there was no immediate cessation, adhering to the same method and formula for 25 doses finally resulted in basic cessation of symptoms. The efficacy is quite satisfactory. As far as I know, Jiang Lao's self-formulated Chai Chen Ze Xie Tang (Bupleurum, Pinellia, and Alisma Decoction) has been clinically verified in hundreds of cases. Generally, taking 2-4 doses can rapidly stop dizziness. It is indeed a highly effective and reliable formula worth promoting.
Trainee Jia: But general dizziness diseases can also be rapidly relieved with Western medicine, some even resolving spontaneously.
Teacher: There are indeed cases of spontaneous resolution, but they are rare in clinical observation. As for acute and severe dizziness, repeated use of Western medicines such as sedatives, tranquilizers, antiemetics, and anticholinergic drugs often yields minimal effect, while referrals to TCM are quite common.
Trainee Yi: But TCM's concept of dizziness cannot be equated with Western medicine's dizziness disease.
Teacher: What is dizziness? "Xuan" refers to blurred vision, and "Yun" refers to a spinning sensation in the head. However, checking ancient TCM books and modern textbooks, some include dizziness and heaviness of the head with lightness of the feet without a spinning sensation within this category; this can only be called broad-sense dizziness. Western medicine divides dizziness into two major categories: "true vertigo" and "false vertigo," which are clearly distinct. True vertigo, also called "rotational vertigo," is caused by lesions of the vestibular nerve or inner ear labyrinth. Clinically, it manifests as dizziness with a sensation of self-rotation or surrounding scenery rotation, accompanied by nausea, vomiting, tinnitus, deafness, nystagmus, headache, ataxia, etc. These are the characteristics of true vertigo. In view of this, Lao Jiang believes that those with dizziness and heaviness of the head with lightness of the feet but no spinning sensation should be excluded from the category of dizziness. This makes the terminology accurate and logical, ensuring precise differentiation. Thus, Lao Jiang often says, "Stones from other hills may serve to polish the jade," meaning borrowing from Western medicine for our own use is not just a cliché.
Trainee Bing: Lao Jiang's clarification of the name of dizziness is refreshing. But how to use TCM theory to identify true vertigo?
Teacher: First, one must consult the discussions on dizziness by physicians of past dynasties. However, when consulting, specific analysis is required, extracting the essence, avoiding arbitrary selection and mechanical application. Statements like "No wind, no dizziness," "No fire, no dizziness," "No phlegm, no dizziness," and "No deficiency, no dizziness," although containing truth, are somewhat biased; moreover, they are based on the broad sense of dizziness. If applied to explain the etiology and pathogenesis of true vertigo, they tend to be too general and abstract. Lao Jiang believes that what deserves attention is Zhang Zhongjing's discussion on dizziness, which mostly establishes theories from the perspective of Shaoyang Ministerial Fire flaming upward and Phlegm-Fluids rebelling upward. He mainly uses Xiao Chai Hu Tang (Minor Bupleurum Decoction), Ling Gui Zhu Gan Tang (Poria, Cinnamon Twig, Atractylodes Macrocephala, and Licorice Decoction), Ze Xie Tang (Alisma Decoction), and Xiao Ban Xia Jia Fu Ling Tang (Minor Pinellia Decoction plus Poria), which align well with certain characteristics of true vertigo.
Trainee Bing: This is somewhat puzzling. First, what is the essential difference between "Shaoyang Ministerial Fire flaming upward and Phlegm-Fluids rebelling upward" and "No phlegm, no dizziness"? Second, if Phlegm-Fluids are the cause, there must be corresponding tongue and pulse signs—greasy tongue coating, wiry or slippery pulse. But this case presents a red tongue with thin white coating and a deep, fine pulse.
Teacher: The phrase "Shaoyang Ministerial Fire flaming upward and Phlegm-Fluids rebelling upward" can deduce the comprehensive etiology and pathogenesis of true vertigo: Wind, Fire, Phlegm, and Deficiency. How can this be compared to the partial view of "No phlegm, no dizziness"! According to clinical observation, true vertigo caused by Shaoyang Fire rising and Phlegm-Fluids rebelling upward has no fixed tongue and pulse manifestations. A greasy tongue coating is indeed a sign of Phlegm-Fluids, but a non-greasy or even absent coating does not necessarily mean absence of Phlegm-Fluids. Lao Jiang has treated many dizziness patients with pale red tongues, thin white or absent coatings. Tonifying Qi and Blood was ineffective, and nourishing Yin and subduing Yang was also ineffective. Switching to clearing Phlegm and expelling Fluids, driving out Wind and clearing Fire yielded rapid effects. Their pulses have no fixed form, which needs no further elaboration. However, the mechanism here requires further exploration.
Student Yi: Teacher, you just said that "Shaoyang Ministerial Fire flaming upward and Phlegm-Fluids rebelling upward" can deduce Wind, Fire, Phlegm, and Deficiency. This is unheard of. How exactly is it deduced?
Teacher: Shaoyang Ministerial Fire and Jueyin Wind Wood are interior-exteriorly related. Wind assists Fire's intensity, and Fire assists Wind's might; they always occur together. Phlegm-Fluids rebelling upward mostly stem from Spleen and Kidney deficiency. You see, doesn't this deduce the four characters: Wind, Fire, Phlegm, and Deficiency? Among those who deeply understood this principle throughout history, Chen Xiuyuan ranks first. However, Chen Xiuyuan's discussion on dizziness centers on Wind, explaining Fire, Deficiency, and Phlegm around it, revealing profound truths and hitting the nail on the head. He said, "Wind is not external Wind, but refers to Jueyin Wind Wood." When Wood is excessive, Wind generates. Furthermore, because Jueyin Wind Wood "dwells with Shaoyang Ministerial Fire, when Jueyin Qi rebels, Wind generates and Fire ignites." Deficiency: "When Wind generates, it inevitably carries Wood's momentum to overcome Earth." Also, "Kidney is the mother of Liver; Kidney stores Essence. When Essence is deficient, the Sea of Brain becomes empty and the head feels heavy," which is the child stealing from the mother. Phlegm: "When Earth is diseased, fluids gather to form Phlegm." This means Wind, Fire, and Phlegm are the branch (manifestation) of dizziness, while Spleen and Kidney deficiency is the root (cause). So Chen Xiuyuan summarized, "When speaking of deficiency, he speaks of the disease root; when speaking of excess, he speaks of the disease image; the principle is consistent." (*Yixue Congzhong Lu · Dizziness*). Lao Jiang considers Chen Xiuyuan's discussion very profound and accurate if applied to explain the etiology and pathogenesis of true vertigo. But Lao Jiang emphasizes that the onset of dizziness is not caused by Wind, Fire, Phlegm, and Deficiency acting separately, but comprehensively. Therefore, he disagrees with Zhang Jingyue's statement that "In the syndrome of dizziness, deficiency accounts for eight or nine parts, while combined Fire and Phlegm account for only one or two parts." From clinical observation, during dizziness attacks, there is invariably a picture of Wind, Fire, and Phlegm disturbing upward. Can all this be explained by "deficiency"?
Trainee Bing: But one cannot deny the importance of "deficiency," right?
Teacher: Of course, one cannot deny it, because denying it makes it difficult to perfectly explain the branch manifestations of Wind, Fire, and Phlegm disturbing upward. However, since Chen Xiuyuan said deficiency is the disease root of dizziness, can we understand it as "latent etiology" or "constitutional etiology"? Regardless of how it is understood, dizziness is always caused by the comprehensive interaction of Wind, Fire, Phlegm, and Deficiency, belonging to a syndrome of root deficiency and branch excess. Treatment should therefore address both root and branch.
Student Bing: This goes without saying. However, when ancient and modern physicians follow the treatment principle of "treating root and branch simultaneously," their specific methods vary greatly, each showing its own style, leaving one at a loss. Could the teacher comment on this?
Teacher: It is hard to say in one word! Chen Xiuyuan once commented, "The gentlemen of Hejian focused solely on clearing Fire, driving out Wind, and resolving Phlegm, yet did not know the origin of Wind, Fire, and Phlegm." He also said, "In my youth, I read Jingyue's books, specifically focusing on tonifying deficiency. Following this was ineffective. Later, searching ancient teachings, I realized Jingyue understood 'excess' and 'deficiency' rigidly, and thus could not thoroughly comprehend the reasons behind 'Wind' and 'Fire'." (*Yixue Congzhong Lu · Dizziness*). But Chen Xiuyuan's treatment of dizziness either followed Danxi's method, using only Da Huang (Radix et Rhizoma Rhei) to purge Fire; or used Luzhong Jiu (Deer Antler Wine), Jia Wei Zuo Gui Yin (Modified Left Restoring Drink), Liu Wei Wan (Six-Ingredient Pill), or Ba Wei Wan (Eight-Ingredient Pill) to tonify Kidney; or used Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) to tonify Spleen. He never treated root and branch simultaneously. Cheng Zhongling and Ye Tianshi advocated treating root and branch simultaneously, such as strengthening Spleen and benefiting Qi combined with resolving Phlegm and descending rebellion, or nourishing Liver and Kidney combined with calming Liver and subduing Yang. These are upright, thorough, and seem like good methods. But if applied to calm dizziness attacks, they are still considered too slow to meet urgent needs, making rapid efficacy difficult to achieve. In recent times, discussions on treating dizziness either focus on treating the branch, such as treating Phlegm combined with rebellious Liver Qi using Xuan Fu Dai Zhe Shi Tang (Inula, Hematite, and Magnetite Decoction), or treating "Branch-Fluids causing dizziness" using Ze Xie Tang (Alisma Decoction); or advocate treating the branch during the attack phase with Wen Dan Tang (Warm the Gallbladder Decoction) and treating the root during the remission phase with Shen Qi Er Chen Tang (Ginseng, Astragalus, and Two-Chen Decoction). All have their merits and can be referenced.
Trainee Bing: Which school did Lao Jiang adopt?
Teacher: Lao Jiang's treatment of this syndrome differs from ancient and modern sages in that he advocates treating root and branch simultaneously during the attack phase, integrating drugs that drive out Wind, clear Fire, resolve Phlegm, and tonify Spleen into one furnace, so as to achieve rapid cessation. After dizziness ceases, he then slowly treats the root.
Trainee Jia: Earlier, when investigating root deficiency, it included both Spleen and Kidney. Why, when treating root and branch simultaneously, only Spleen is tonified and not Kidney?
Teacher: Lao Jiang believes that during dizziness attacks, the branch manifestation of Phlegm-Fluids rebelling upward is very prominent. Directly tonifying Kidney drugs not only fail to meet urgent needs but also have the drawback of being cloying and sticky, causing obstruction and making rapid efficacy difficult to achieve. Therefore, one must wait until dizziness ceases before discussing Kidney tonification. Lao Jiang has clinically seen many cases where repeated use of Liu Wei Wan (Six-Ingredient Pill), Ba Wei Wan (Eight-Ingredient Pill), Zuo Gui Wan (Left Restoring Pill), or You Gui Wan (Right Restoring Pill) aimed to stop dizziness, but results were minimal or even zero. This is not because the prescription lacks power, but because it was used at the wrong time. Therefore, Lao Jiang prioritizes the Spleen when treating the root. And so-called Spleen tonification is not static tonification, but actually moving Spleen and harmonizing Stomach. Because moving Spleen can resolve Phlegm-Fluids, and harmonizing Stomach can stop vomiting; Spleen movement can resist Liver invasion, preventing Wind Wood from rampant growth; when Wind Wood is quiet, Ministerial Fire is peaceful. In this way, the branch manifestation of Wind, Fire, and Phlegm disturbing upward can be eliminated quickly. This shows that this is directly treating the root and indirectly treating the branch, killing two birds with one stone.
Intern: I want to know the drug composition, common dosage, formula explanation, and scope of use of Chai Chen Ze Xie Tang (Bupleurum, Pinellia, and Alisma Decoction).
Teacher: Chai Chen Ze Xie Tang (Bupleurum, Pinellia, and Alisma Decoction) is a combination of Xiao Chai Hu Tang (Minor Bupleurum Decoction), Er Chen Tang (Two-Chen Decoction), and Ze Xie Tang (Alisma Decoction), plus Tian Ma (Rhizoma Gastrodiae), Gou Teng (Uncariae Ramulus cum Uncis), and Ju Hua (Flos Chrysanthemi). Medicines used: Chai Hu 10g, Huang Qin 6-10g, Fa Xia 10g, Dang Shen 12-15g, Gan Cao 3-5g, Da Zao 10-12g, Sheng Jiang 6-10g, Chen Pi 10g, Fu Ling 15g, Bai Zhu 10-15g, Ze Xie 10-15g, Tian Ma 10g (crushed and swallowed), Gou Teng 12g (added later), Ju Hua 10g. Among them, Xiao Chai Hu Tang (Minor Bupleurum Decoction) rotates the Shaoyang pivot, penetrates stagnant Fire, raises Clear and descends Turbid; Er Chen Tang (Two-Chen Decoction) resolves Phlegm and descends rebellion; Ze Xie Tang (Alisma Decoction) clears Phlegm-Fluids and promotes urination. The formula also contains Xiao Ban Xia Jia Fu Ling Tang (Minor Pinellia Decoction plus Poria), which can also descend rebellion, resolve Phlegm, clear Phlegm-Fluids, and stop vomiting; it also contains Liu Jun Zi Tang (Six-Gentlemen Decoction), which moves Spleen and harmonizes Stomach to treat the root. Adding Tian Ma (Rhizoma Gastrodiae), Gou Teng (Uncariae Ramulus cum Uncis), and Ju Hua (Flos Chrysanthemi) aims to soften and moisten to extinguish Liver Wind. According to the principle of "treating different diseases with the same method," the scope of use of this formula can be expanded. For example, for dizziness caused by hypertension or insufficient blood supply to cerebral arteries, as long as characteristic symptoms of true vertigo are present, administering this formula can also achieve rapid cessation. Additionally, recently when treating dizziness caused by cervical spondylosis, I remove Chen Pi (Pericarpium Citri Reticulatae), Fu Ling (Poria), Gan Cao (Radix Glycyrrhizae), Gou Teng (Uncariae Ramulus cum Uncis), and Ju Hua (Flos Chrysanthemi), and heavily add Ge Gen (Puerariae Radix) 30-60g to guide Body Fluids up to the head and neck to relax sinews and relieve spasms; then heavily add Chuan Xiong (Ligustici Chuanxiong Rhizoma) 30-45g to invigorate Blood and resolve stasis, unblock collaterals, and stop pain. Having observed over 10 cases, the short-term efficacy is satisfactory.
Cough for 3 Months
Yu Guojun, Director of the TCM Research Office, People's Hospital of Leshan City, Sichuan Province