郭 三十二岁 六月初二日 太阴中湿,病势沉闷,最难速功,非极刚以变脾胃两伤不
可。
生茅术(四钱) 半夏(六钱) 川朴(四钱) 生草果(三钱) 椒目(三钱) 桂枝(五钱)
小枳实(三钱) 生苡仁(五钱) 广皮(三钱) 茯苓皮(五钱) 生姜(一两)
煮三碗,分三次服。
十七帖。
二十九日 寒湿为病,误用硝黄,致浊阴蟠踞,坚凝如石,苟非重刚,何以直透重围。
安边桂(二钱) 熟附子(五钱) 生草果(二钱) 川朴(四钱) 黑川椒(四钱,炒) 茯苓
皮
(五钱) 猪苓(三钱) 泽泻(三钱) 通草(二钱) 生苡仁(五钱) 广皮(三钱) 干姜(四钱)
小茴香(三钱)
煮四碗,四次服。共服十三帖而后脉转。
昆氏 二十六岁 风湿相搏,一身尽痛,既以误汗伤表,又以误下伤里,渴思凉饮,面
赤
舌绛,得饮反停,胁胀胸痛,皆不知病因而妄治之累瘁也。议木防己汤,两开表里之痹。
桂枝(六钱) 防己(四钱) 生石膏(一两) 炙甘草(三钱) 杏仁(四钱) 苍术(五钱)
生香附(三钱)
四次服。
十二日 胁胀止而胸痛未愈,于前方加薤白广皮,以通补胸上之清阳。
薤白(三钱) 广皮(三钱)
十四日 痹症愈后,胃不和,土恶湿也。
半夏(一两) 茯苓(五钱) 广皮(三钱) 秫米(二合) 生姜(三钱)
水五碗,煮两碗,渣再煮一碗,三次服。
十六日 痹后清阳不伸,右胁瘕痛。
半夏(六钱) 广皮(二钱) 青皮(钱半) 乌药(二钱) 薤白(三钱) 桂枝(二钱) 吴萸
(一钱) 郁金(二钱)
煮两杯,渣再煮一杯,三次服。
吴 十一岁 行痹。
防己(二钱) 桂枝(三钱) 炙甘草(一钱) 杏泥(三钱) 茯苓皮(二钱) 生石膏(五钱)
片姜黄(钱半) 海桐皮(钱半) 牛膝(钱半) 生苡仁(三钱)
张 二十五岁 十一月十五日 风湿。
羌活(三钱) 桂枝(二钱) 杏仁(三钱) 炙甘草(一钱) 苦桔梗(三钱) 生姜(三片)
陈皮(二钱) 半夏(二钱) 苏叶(三钱)
十六日 风湿相搏,一身尽痛,汗之不解,用麻黄加术法。
麻黄(去节) 杏仁(五钱) 苍术(五钱) 桂枝(三钱) 羌活(钱半) 炙甘草(三钱) 生
姜(三片)
又 于前方内加∶
熟附子(三钱)
半帖而愈。
胡 十八岁 四月十九日 跗肿,右脉洪数,痰多咳嗽,口渴,茎中痛,与凉利小便法
。
生石膏(八钱) 甘草梢(钱半) 半夏(三钱) 滑石(六钱) 生仁(五钱) 云苓皮(五钱)
海金沙(五钱)
四帖。
五月初六日 脉之洪数者减,去石膏二钱,加∶
广皮(三钱) 杏仁(三钱)
十一日 湿热伤气,气伤则小便短,汗多必渴,湿聚则跗踵。与猪苓汤去阿胶,加银花
以化湿热,湿热化则诸证皆愈。
猪苓(四钱) 云苓皮(五钱) 银花(三钱) 泽泻(三钱) 滑石(六钱)
二十日 湿热不攘,下注腿肿,小便不利,茎中痛。
萆 (五钱) 猪苓(三钱) 甘草梢(钱半) 云苓皮(五钱) 泽泻(三钱) 飞滑石(六钱)
苡仁(三钱) 木通(二钱) 晚蚕砂(三钱)
服至小便畅为度。
二十四日 脉洪数,小便反黄,加黄柏、滑石,茎痛止,去甘草。
七月初四日 小便已长,肿未全消,脉弦滑,咳嗽多痰。
半夏(六钱) 生苡仁(五钱) 广皮(四钱) 云苓皮(五钱) 猪苓(三钱) 萆 (五钱)
泽泻(三钱)
张 二十岁 七月十九日 身热头痛,腰痛,肢痛,无汗,六脉弦细,两目不明,食少
,寒湿痹也。
熟附子(三钱) 川乌头(二钱) 羌活(二钱) 桂枝(五钱) 泽泻(三钱) 苡仁(五钱)
广皮(三钱) 防己(三钱) 云苓皮(五钱) 杏仁(五钱)
二帖。
五月初三日 服前方二帖,头痛止。旋即误服他人补阴之品,便溏腹胀。今日复诊,因
头痛愈,用原方去羌活,治药逆,加∶
浓朴(三钱)
已服三帖。
初八日 痹症已愈,颇能健步,便溏泄泻皆止,目已复明,胃口较前加餐。因服一帖,
脉稍数,寒湿有化热之象,当与平药,逐其化热之余邪而已。
云苓皮(五钱) 防己(二钱) 滑石(六钱) 桑枝(五钱) 泽泻(三钱) 晚蚕砂(三钱)
苡仁(五钱) 杏仁(二钱)
六月十八日 又感受暑湿,泄泻,脉弦,腹胀,与五苓法。
桂枝(五钱) 泽泻(三钱) 云苓皮(五钱) 苍术(三钱炒) 大腹皮(三钱) 广木香(二
钱) 猪苓(四钱) 广皮(三钱) 苡仁(五钱)
煮三杯,三次服。
赵氏 四十七岁 六月二十日 太阳寒痹,脉弦,背心板着而痛。
桂枝(五钱) 云苓皮(五钱) 防己(三钱) 川椒炭(三钱) 川乌头(三钱) 白通草(一
钱) 生苡仁(五钱)
二十五日 服前药已效,而背痛难除,加∶
附子(二钱)
七月初二日 脉已回阳,痛未止,每日服半帖,六日三帖。加∶
木通(三钱) 晚蚕砂(四钱)
初九日 脉仍小,阳未回,背仍痛,再服三帖,分六帖。
赵 三十六岁 五月初六日 痹症夹伏湿胀痛,且有肥气,湿已化热,故六脉洪滑,本
寒标热,先治其标,本当缓治。
生石膏(四两) 防己(四钱) 半夏(五钱) 杏仁(六钱) 桂枝(六钱) 川朴(五钱) 广
皮(四钱)
初十日 尺脉洪数更甚,加∶
黄柏(三钱) 木通(三钱) 云苓皮(六钱)
十二日 尺脉仍洪,腹痛欲便,便后肛门热痛,原方再服二帖。
十六日 水停心下,漉漉有声,暂与逐水,无暇治痹。
广皮(五钱) 半夏(六钱) 枳实(六钱) 生姜(五钱)
甘澜水八茶杯,煮成三水杯,三次服。
十九日 水响退,腹胀甚,仍服前方去黄柏,加大腹皮。
二十三日 痹少减,胃不开,其人本有肥气,肥气成于肝郁,暂与两和肝胃。
半夏(六钱) 降香末(三钱) 广皮(三钱) 益智仁(二钱) 青皮(二钱) 川朴(三钱)
香附(三钱) 云苓块(五钱)
六月初三日 右脉大而数,加黄芩二钱,去川朴。
初五日 诸症向安,脉亦调适,胃口亦开,以调理脾胃立法。
云苓块(五钱) 白蔻仁(钱半) 苡仁(五钱) 黄芩炭(二钱) 广皮(二钱) 半夏(五钱)
二十日 误服西瓜寒冷,未有不发停饮者。
公丁香(八分) 半夏(五钱) 益智仁(钱半) 干姜(三钱) 白蔻仁(一钱) 广皮(三钱)
云苓(五钱) 小枳实(三钱)
钱 三十四岁 五月二十九日 寒痹,脉弦短涩而紧,由腿上连少腹,痛不可忍,甚至
欲厥,兼有痰饮胃痛。
桂枝(六钱) 广皮(三钱) 防己(四钱) 川乌头(三钱) 川椒炭(三钱) 小茴香(三钱
,炒) 云苓皮(五钱) 片姜黄(三钱) 生苡仁(五钱) 海桐皮(三钱)
六月初一日 左脉稍长,仍然紧甚,再服二帖。
丸方 寒湿为病。
萆 (四两) 小茴香(四两,炒) 川椒炭(三两) 苡仁(八两) 苍术(六两,炒) 云苓
皮(八两) 川楝子(三两) 熟附子(二两) 木通(四两)
共为细末,神曲糊丸,小梧子大,每服三钱,姜汤下。
杨氏 二十六岁 乙酉正月初七日 前曾崩带 后得痿痹,病者自疑虚损。询病情寒时
轻热
时重,正所谓经热则痹,络热则痰者也。再行经有紫有黑,经来时不惟腰腿大痛,少腹亦痛
,
经亦不调,或多或寡,日数亦然。此不但湿热,且有瘀血。治湿热用汤药,治瘀血用丸药,
(左脉浮取弦,沉取宽泛。右脉浮取弦,沉取洪。)汤药用诸痹汤取太阴法,丸药用化 回生
丹。
生石膏(二两) 桂枝(四钱) 通草(一钱) 杏泥(五钱) 云苓皮(五钱) 片姜黄(三钱)
防己(四钱) 晚蚕砂(三钱) 海桐皮(三钱) 苡仁(五钱)
煮三杯,三次服。
岳 四十六岁 暑湿痹症,误以熟地等柔药滑脾,致令泄泻,卧床不起,两足蜷曲不伸
,饮
食少进,兼之疝痛。先以五苓散,加川椒、广皮、木香止其泄;继以半夏、广皮、良姜、益
智、白蔻开其胃;复以丁香、川椒、吴萸、云苓、苡仁、姜黄平其疝;又以防己、杏仁、桂
枝、乌头、苓皮、川椒等伸其痹末。惟引痛风在筋也,重用地龙、桂枝,引痛亦止,后补脾
胃而愈。
王 四十六岁 寒湿为痹,背痛不能转侧,昼夜不寐,二十余日。两腿拘挛,手不能握
,口
眼歪斜,烦躁不宁,畏风自汗,脉弦,舌苔白滑,面色昏暗且黄,睛黄,大便闭。先以桂枝
、杏仁、苡仁、羌活、广皮、半夏、茯苓、防己、川椒、滑石令得寐;继以前方去川椒、羌
活,加白通草、蚕砂、萆 ,得大便。一连七八日均如黑蛋子,服至二十余剂,身半以上稍
轻,背足痛甚,于前方去半夏,加附子、片姜黄、地龙、海桐皮。又服十数帖,痛渐止;又
去附子、地龙,又服十数帖,足渐伸。后用二妙丸,加云苓、苡仁、萆 、白术等药收功。
何 二十六岁 手足拘挛,误服桂、附、人参、熟地等补阳,以致面赤,脉洪数,小便
闭,
身重不能转侧,手不能上至鬓,足蜷曲,丝毫不能移动。细询病情,因大饮酒食肉而然。所
谓湿热不攘,大筋软短,小筋弛长,软短为拘,弛长为痿者也。与极苦通小肠,淡渗利膀胱
法。
龙胆草(四钱) 芦荟(三钱) 胡黄连(三钱) 生石膏(八两) 地龙(三钱) 白通草(二
钱)
茯苓皮(六钱) 飞滑石(一两) 穿山甲(三钱) 桑枝(五钱) 杏仁(三钱) 晚蚕砂(四钱)
防己(五钱)
前方服至七日后,小便红黑而浊,臭不可当。半月后手渐动、足渐伸,一月后下床扶桌
椅能
行,四十日后走至檐前,不能下阶,又半月始下阶,三月后能行四十里。后因痰饮,用理脾
收功。此症始于三月二十三日,至八月二十二日停药。
周 四十二岁 两腿紫绛而肿,上起细疮如痱,已三年矣。两腿足酸痛不能立,六脉弦
细而紧,窦氏《扁鹊新书》,谓之苏木腿,盖寒湿着痹也。
附子(八钱) 乌头(六钱) 苡仁(一两) 桂枝(一两) 云苓皮(一两)
煮四杯,分四次服,服三十余帖则始策杖能行,后去乌附,用通经活络渗湿而愈。
成 五十四岁 腰间酸软,两腿无力,不能跪拜,间有腰痛,六脉洪大而滑。前医无非
补阴,故日重一日。此湿热痿也,与诸痿独取阳明法。
生石膏(四钱) 海桐皮(二钱) 晚蚕砂(三钱) 白通草(二钱) 生苡仁(八钱) 云苓
皮(五钱) 防己(四钱) 杏仁(四钱) 桑枝(五钱) 萆 (五钱) 飞滑石(一两)
前后共服九十余帖。病重时自加石膏一倍,后用二妙丸收功。
赵 四十五岁 乙酉正月十五日 肝郁挟痰饮,肾水上凌心,心悸短气,腹胀胸痹,
六脉反沉洪,水极而似火也,与蠲痰饮伐邪,兼降肝逆法。
姜夏(八钱) 降香末(三钱) 小枳实(五钱) 桂枝(五钱) 茯苓块(一两) 苏子霜(
三钱) 广皮(四钱) 川椒炭(三钱) 生姜汁(每杯三匙) 旋复花(三钱)
甘澜水煮四杯,分早中晚夜四次服,戒生冷猪肉咸菜。
四帖。
二十日 痰饮夹痹,肾水上凌,心惊悸短气,腰脊痹痛,皆太阳所过之地,小便短而腹
胀,
肚脐突出,是内而脏腑,外而经络,无不痹者。且开太阳之痹,脉洪大,与大青龙合木防己
汤法。
桂枝(五钱) 半夏(五钱) 云苓皮(六钱) 生石膏(四两) 苡仁(五钱) 川朴(三钱)
防己(四钱) 广皮(三钱) 枳实(五钱) 杏仁(四钱) 滑石(六钱) 白通草(钱半)
煮四杯,三次服。
二十一日 于前方内加∶
晚蚕砂(三钱) 飞滑石(四钱)
二十三日 外而经络之痹,内而脏腑之痹,行痰开痹,俱不甚应,现下脉洪数,少腹胀
,小便短浊而臭。先与开支河,使湿热有出路,再商后法。
川萆 (三钱) 飞滑石(钱半) 海金砂(五钱) 云苓皮(五钱) 猪苓(四钱) 小茴香(
三钱) 白通草(钱半) 泽泻(三钱)
二帖。
二十五日 加去陈 法。
两头尖(三钱) 半夏(五钱)
二帖。
二十九日 痹症夹痰饮,六脉洪大,湿已化热,屡利小便不应,非重用石膏宣肺热不可
。诸痹独取太阴也。
生石膏(四两) 云苓皮(五钱) 白通草(一钱) 杏仁(五钱) 桂枝(五钱) 滑石(二两)
羌活(一钱) 黄柏(四钱) 防己(五钱) 苡仁(五钱) 晚蚕砂(三钱)
四帖。
二月初四日 痹症十年,误补三年,以致层层固结,开之非易,石膏用至二斤有余,脉
象方
郭某,三十二岁。六月初二日就诊:太阴脾经受湿邪侵袭,病情表现为沉重闷滞,难以迅速见效,必须使用极刚燥的药物来改变脾胃两伤的局面。
生苍术(四钱) 半夏(六钱) 厚朴(四钱) 生草果(三钱) 椒目(三钱) 桂枝(五钱)
小枳实(三钱) 生薏苡仁(五钱) 广陈皮(三钱) 茯苓皮(五钱) 生姜(一两)
加水煎煮成三碗药汤,分三次服用。
共服用十七帖。
六月二十九日:寒湿致病,误用了硝石、大黄等寒凉攻下药物,导致浊阴之气盘踞体内,凝结坚硬如石头,如果不是用重剂刚猛之药,怎么能直接穿透重重阻碍。
安边肉桂(二钱) 熟附子(五钱) 生草果(二钱) 厚朴(四钱) 黑川花椒(四钱,炒制) 茯苓皮(五钱) 猪苓(三钱) 泽泻(三钱) 通草(二钱) 生薏苡仁(五钱) 广陈皮(三钱) 干姜(四钱) 小茴香(三钱)
加水煎煮成四碗药汤,分四次服用。共服用十三帖后脉象才转变。
昆氏,二十六岁:风湿相互搏结,全身疼痛,已经因为误用发汗法损伤了表气,又因误用攻下法损伤了里气,口渴想喝冷饮,面色发红,舌质深红,喝了水反而停滞不化,胁肋胀满胸痛,这都是不知道病因而胡乱治疗的祸害。建议用木防己汤,同时开通表和里的痹阻。
桂枝(六钱) 防己(四钱) 生石膏(一两) 炙甘草(三钱) 杏仁(四钱) 苍术(五钱) 生香附(三钱)
分四次服用。
六月十二日:胁肋胀满停止但胸痛未愈,在前方基础上加薤白、广陈皮,以通补胸中清阳之气。
薤白(三钱) 广陈皮(三钱)
六月十四日:痹症痊愈后,胃不和,这是因为土(脾)厌恶湿气。
半夏(一两) 茯苓(五钱) 广陈皮(三钱) 秫米(二合) 生姜(三钱)
用水五碗,煮取两碗,药渣再煮一碗,分三次服用。
六月十六日:痹症之后清阳之气不能伸展,右胁下有瘕聚疼痛。
半夏(六钱) 广陈皮(二钱) 青皮(一钱半) 乌药(二钱) 薤白(三钱) 桂枝(二钱) 吴茱萸(一钱) 郁金(二钱)
煎煮两杯,药渣再煮一杯,分三次服用。
吴某,十一岁:行痹(风邪偏盛的痹症)。
防己(二钱) 桂枝(三钱) 炙甘草(一钱) 杏仁泥(三钱) 茯苓皮(二钱) 生石膏(五钱) 片姜黄(一钱半) 海桐皮(一钱半) 牛膝(一钱半) 生薏苡仁(三钱)
张某,二十五岁。十一月十五日:风湿病。
羌活(三钱) 桂枝(二钱) 杏仁(三钱) 炙甘草(一钱) 苦桔梗(三钱) 生姜(三片) 陈皮(二钱) 半夏(二钱) 苏叶(三钱)
十一月十六日:风湿相互搏结,全身疼痛,发汗后不解,采用麻黄加术汤的方法。
麻黄(去节) 杏仁(五钱) 苍术(五钱) 桂枝(三钱) 羌活(一钱半) 炙甘草(三钱) 生姜(三片)
另外,在前方中加入:
熟附子(三钱)
服用半帖即愈。
胡某,十八岁。四月十九日:足背浮肿,右脉洪数,痰多咳嗽,口渴,尿道疼痛,给予清凉利小便的方法。
生石膏(八钱) 甘草梢(一钱半) 半夏(三钱) 滑石(六钱) 生薏苡仁(五钱) 云茯苓皮(五钱) 海金沙(五钱)
服用四帖。
五月初六日:脉象的洪数减轻,去掉石膏二钱,加入:
广陈皮(三钱) 杏仁(三钱)
五月十一日:湿热损伤正气,气伤则小便短少,汗多必口渴,湿聚则足背脚踝肿胀。给予猪苓汤去掉阿胶,加入金银花以化解湿热,湿热化解则诸证皆愈。
猪苓(四钱) 云茯苓皮(五钱) 金银花(三钱) 泽泻(三钱) 滑石(六钱)
五月二十日:湿热不去除,向下流注导致腿肿,小便不利,尿道疼痛。
萆薢(五钱) 猪苓(三钱) 甘草梢(一钱半) 云茯苓皮(五钱) 泽泻(三钱) 飞滑石(六钱) 薏苡仁(三钱) 木通(二钱) 晚蚕砂(三钱)
服用至小便通畅为止。
五月二十四日:脉象洪数,小便反而发黄,加入黄柏、滑石,尿道痛止,去掉甘草。
七月初四日:小便已长(正常),肿胀未全消,脉弦滑,咳嗽多痰。
半夏(六钱) 生薏苡仁(五钱) 广陈皮(四钱) 云茯苓皮(五钱) 猪苓(三钱) 萆薢(五钱) 泽泻(三钱)
张某,二十岁。七月十九日:身热头痛,腰痛,肢体疼痛,无汗,六脉弦细,两眼视物不明,食量减少,这是寒湿痹症。
熟附子(三钱) 川乌头(二钱) 羌活(二钱) 桂枝(五钱) 泽泻(三钱) 薏苡仁(五钱) 广陈皮(三钱) 防己(三钱) 云茯苓皮(五钱) 杏仁(五钱)
服用两帖。
五月初三日(注:原文此处时间可能有误或为复诊记录回溯,依原文翻译):服用前方两帖,头痛停止。随即误服他人补阴的药物,导致便溏腹胀。今日复诊,因为头痛已愈,用原方去掉羌活,治疗药物引起的逆乱,加入:
浓朴(三钱)
已服用三帖。
初八日:痹症已愈,颇能健步,便溏泄泻都停止了,眼睛已复明,胃口比以前增加进食。因为服用了一帖药,脉稍快,寒湿有化热的迹象,应当用平和的药,清除其化热后的余邪而已。
云茯苓皮(五钱) 防己(二钱) 滑石(六钱) 桑枝(五钱) 泽泻(三钱) 晚蚕砂(三钱) 薏苡仁(五钱) 杏仁(二钱)
六月十八日:又感受暑湿,腹泻,脉弦,腹胀,给予五苓散的方法。
桂枝(五钱) 泽泻(三钱) 云茯苓皮(五钱) 苍术(三钱,炒) 大腹皮(三钱) 广木香(二钱) 猪苓(四钱) 广陈皮(三钱) 薏苡仁(五钱)
煎煮三杯,分三次服用。
赵氏,四十七岁。六月二十日:太阳寒痹,脉弦,背心僵硬疼痛。
桂枝(五钱) 云茯苓皮(五钱) 防己(三钱) 川椒炭(三钱) 川乌头(三钱) 白通草(一钱) 生薏苡仁(五钱)
六月二十五日:服用前药已有效,但背痛难除,加入:
附子(二钱)
七月初二日:脉象已回阳,但疼痛未止,每日服用半帖,六天共三帖。加入:
木通(三钱) 晚蚕砂(四钱)
初九日:脉仍细小,阳气未回,背部仍痛,再服三帖,分六帖服用。
赵某,三十六岁。五月初六日:痹症夹伏湿胀痛,且有肥气(肝积),湿已化热,所以六脉洪滑,本为寒证标为热证,先治其标,本当缓治。
生石膏(四两) 防己(四钱) 半夏(五钱) 杏仁(六钱) 桂枝(六钱) 厚朴(五钱) 广陈皮(四钱)
十月初十日:尺脉洪数更甚,加入:
黄柏(三钱) 木通(三钱) 云茯苓皮(六钱)
十二月十二日:尺脉仍洪,腹痛想大便,便后肛门热痛,原方再服两帖。
十二月十六日:水停在心下,漉漉有声,暂时给予逐水之法,无暇治疗痹症。
广陈皮(五钱) 半夏(六钱) 枳实(六钱) 生姜(五钱)
甘澜水八茶杯,煮成三杯水,分三次服用。
十二月十九日:水响声退去,腹胀严重,仍服前方去掉黄柏,加大腹皮。
十二月二十三日:痹症稍减,胃不开,其人本来有肥气,肥气形成于肝郁,暂时给予调和肝胃的方法。
半夏(六钱) 降香末(三钱) 广陈皮(三钱) 益智仁(二钱) 青皮(二钱) 厚朴(三钱) 香附(三钱) 云茯苓块(五钱)
六月初三日:右脉大而数,加入黄芩二钱,去掉厚朴。
六月初五日:诸症趋向安宁,脉象也调适,胃口也开了,以调理脾胃为立法原则。
云茯苓块(五钱) 白蔻仁(一钱半) 薏苡仁(五钱) 黄芩炭(二钱) 广陈皮(二钱) 半夏(五钱)
六月二十日:误服西瓜寒冷之物,没有不发停饮病的。
公丁香(八分) 半夏(五钱) 益智仁(一钱半) 干姜(三钱) 白蔻仁(一钱) 广陈皮(三钱) 云茯苓(五钱) 小枳实(三钱)
钱某,三十四岁。五月二十九日:寒痹,脉弦短涩而紧,从腿部连及少腹,痛不可忍,甚至欲昏厥,兼有痰饮胃痛。
桂枝(六钱) 广陈皮(三钱) 防己(四钱) 川乌头(三钱) 川椒炭(三钱) 小茴香(三钱,炒) 云茯苓皮(五钱) 片姜黄(三钱) 生薏苡仁(五钱) 海桐皮(三钱)
丸方:寒湿为病。
萆薢(四两) 小茴香(四两,炒) 川椒炭(三两) 薏苡仁(八两) 苍术(六两,炒) 云茯苓皮(八两) 川楝子(三两) 熟附子(二两) 木通(四两)
共研为细末,神曲糊丸,梧桐子大小,每次服用三钱,姜汤送下。
杨氏,二十六岁。乙酉年正月初七日:先前曾崩漏带下,后来得痿痹,病人自己怀疑是虚损。询问病情,寒时轻热时重,正所谓经热则痹,络热则痰。再次行经时有紫有黑,经来时不但腰腿大痛,少腹也痛,月经也不调,或多或少,天数也是如此。这不仅是湿热,还有瘀血。治湿热用汤药,治瘀血用丸药。(左脉浮取弦,沉取宽泛。右脉浮取弦,沉取洪。)汤药用诸痹汤取太阴法,丸药用化回生丹。
生石膏(二两) 桂枝(四钱) 通草(一钱) 杏仁泥(五钱) 云茯苓皮(五钱) 片姜黄(三钱) 防己(四钱) 晚蚕砂(三钱) 海桐皮(三钱) 薏苡仁(五钱)
煎煮三杯,分三次服用。
岳某,四十六岁:暑湿痹症,误用熟地等柔润药物滑腻碍脾,导致泄泻,卧床不起,两足蜷曲不能伸直,饮食少进,兼之疝痛。先用五苓散,加川椒、广陈皮、木香止住泄泻;继用半夏、广陈皮、良姜、益智、白蔻开其胃气;再用丁香、川椒、吴茱萸、云苓、薏苡仁、姜黄平其疝痛;最后以防己、杏仁、桂枝、乌头、苓皮、川椒等舒展其痹阻。只有引痛风在筋,重用用地龙、桂枝,引痛也止,后补脾胃而愈。
王某,四十六岁:寒湿为痹,背痛不能转侧,昼夜不寐,二十余日。两腿拘挛,手不能握,口眼歪斜,烦躁不宁,畏风自汗,脉弦,舌苔白滑,面色昏暗且黄,睛黄,大便闭。先用桂枝、杏仁、薏苡仁、羌活、广陈皮、半夏、茯苓、防己、川椒、滑石令其得睡;继用前方去掉川椒、羌活,加白通草、蚕砂、萆薢,得大便。一连七八日均如黑蛋子样,服用至二十余剂,身体上半部稍轻,背足痛甚,于前方去掉半夏,加附子、片姜黄、地龙、海桐皮。又服十余帖,痛渐止;又去掉附子、地龙,又服十余帖,足渐伸。后用二妙丸,加云苓、薏苡仁、萆薢、白术等药收功。
何某,二十六岁:手足拘挛,误服桂枝、附子、人参、熟地等补阳药,以致面赤,脉洪数,小便闭,身重不能转侧,手不能上至鬓角,足蜷曲,丝毫不能移动。细询病情,因大量饮酒食肉所致。所谓湿热不去除,大筋软短,小筋弛长,软短为拘,弛长为痿。给予极苦通小肠,淡渗利膀胱的方法。
龙胆草(四钱) 芦荟(三钱) 胡黄连(三钱) 生石膏(八两) 地龙(三钱) 白通草(二钱) 茯苓皮(六钱) 飞滑石(一两) 穿山甲(三钱) 桑枝(五钱) 杏仁(三钱) 晚蚕砂(四钱) 防己(五钱)
前方服用七日后,小便红黑而浊,臭不可当。半月后手渐动、足渐伸,一月后下床扶桌椅能行,四十日后走至檐前,不能下阶,又半月始下阶,三月后能行四十里。后因痰饮,用理脾收功。此症始于三月二十三日,至八月二十二日停药。
周某,四十二岁:两腿紫绛而肿,上起细疮如痱子,已三年矣。两腿足酸痛不能立,六脉弦细而紧,窦氏《扁鹊新书》,谓之苏木腿,盖寒湿着痹也。
附子(八钱) 乌头(六钱) 薏苡仁(一两) 桂枝(一两) 云茯苓皮(一两)
煎煮四杯,分四次服用,服用三十余帖才开始拄杖能行,后去掉乌附,用通经活络渗湿而愈。
成某,五十四岁:腰间酸软,两腿无力,不能跪拜,间有腰痛,六脉洪大而滑。前医无非补阴,故日重一日。这是湿热痿症,与诸痿独取阳明法。
生石膏(四钱) 海桐皮(二钱) 晚蚕砂(三钱) 白通草(二钱) 生薏苡仁(八钱) 云茯苓皮(五钱) 防己(四钱) 杏仁(四钱) 桑枝(五钱) 萆薢(五钱) 飞滑石(一两)
前后共服用九十余帖。病重时自行加倍石膏用量,后用二妙丸收功。
赵某,四十五岁。乙酉年正月十五日:肝郁挟痰饮,肾水上凌心,心悸短气,腹胀胸痹,六脉反沉洪,水极而似火也,给予蠲痰饮伐邪,兼降肝逆法。
姜半夏(八钱) 降香末(三钱) 小枳实(五钱) 桂枝(五钱) 茯苓块(一两) 苏子霜(三钱) 广陈皮(四钱) 川椒炭(三钱) 生姜汁(每杯三匙) 旋复花(三钱)
甘澜水煮四杯,分早中晚夜四次服用,戒生冷猪肉咸菜。
服用四帖。
正月二十日:痰饮夹痹,肾水上凌,心惊悸短气,腰脊痹痛,都是太阳经所过之地,小便短而腹胀,肚脐突出,是内而脏腑,外而经络,无不痹者。且开太阳之痹,脉洪大,与大青龙合木防己汤法。
桂枝(五钱) 半夏(五钱) 云茯苓皮(六钱) 生石膏(四两) 薏苡仁(五钱) 厚朴(三钱) 防己(四钱) 广陈皮(三钱) 枳实(五钱) 杏仁(四钱) 滑石(六钱) 白通草(一钱半)
煎煮四杯,分三次服用。
正月二十三日:外而经络之痹,内而脏腑之痹,行痰开痹,俱不甚应,现下脉洪数,少腹胀,小便短浊而臭。先与开支河,使湿热有出路,再商后法。
川萆薢(三钱) 飞滑石(一钱半) 海金砂(五钱) 云茯苓皮(五钱) 猪苓(四钱) 小茴香(三钱) 白通草(一钱半) 泽泻(三钱)
服用两帖。
正月二十五日:加去陈法。
两头尖(三钱) 半夏(五钱)
服用两帖。
正月二十九日:痹症夹痰饮,六脉洪大,湿已化热,屡利小便不应,非重用石膏宣肺热不可。诸痹独取太阴也。
生石膏(四两) 云茯苓皮(五钱) 白通草(一钱) 杏仁(五钱) 桂枝(五钱) 滑石(二两) 羌活(一钱) 黄柏(四钱) 防己(五钱) 薏苡仁(五钱) 晚蚕砂(三钱)
服用四帖。
Mr. Guo, aged 32. June 2nd: Taiyin (Spleen channel) affected by dampness, the condition presents as heavy and stifling, difficult to achieve rapid results; it is necessary to use extremely acrid-dry herbs to alter the dual injury of the Spleen and Stomach.
Raw Atractylodis Rhizoma (4 qian) Pinelliae Rhizoma Preparatum (6 qian) Magnoliae Officinalis Cortex (4 qian) Raw Tsaoko Fructus (3 qian) Sesami Semen (3 qian) Cinnamomi Ramulus (5 qian) Small Zhi Shi (3 qian) Raw Coicis Semen (5 qian) Tangerini Reticulata Pericarpium (3 qian) Poria Cum Radix Pini (5 qian) Zingiberis Recens Rhizoma (1 liang)
Boil with water to obtain three bowls of decoction, take in three doses.
Total 17 prescriptions taken.
June 29th: Cold-dampness disease, mistakenly treated with Nux (Mirabilite) and Rhei Radix et Rhizoma (Rhubarb), causing turbid Yin qi to stagnate and condense hard like stone. If not using heavy, rigid (yang-warming) medicines, how can one penetrate the siege?
Anbian Cinnamomi Cortex (2 qian) Prepared Aconiti Lateralis Radix (5 qian) Raw Tsaoko Fructus (2 qian) Magnoliae Officinalis Cortex (4 qian) Black Sichuan Pepper (4 qian, stir-fried) Poria Cum Radix Pini (5 qian) Polyporus (3 qan) Alismatis Rhizoma (3 qian) Tetsu Stem (2 qian) Raw Coicis Semen (5 qian) Tangerini Reticulata Pericarpium (3 qian) Zingiberis Rhizoma (4 qian) Foeniculi Fructus (3 qian)
Boil with water to obtain four bowls of decoction, take in four doses. After taking a total of 13 prescriptions, the pulse changed.
Ms. Kun, aged 26: Wind-dampness combusting together, causing pain throughout the body. The exterior was injured by mistaken sweating, and the interior was injured by mistaken purgation. Thirsty for cool drinks, face red, tongue crimson. Drinking causes fluid retention. Hypochondriac distension and chest pain are all due to ignorant treatment without knowing the cause. Propose Mufangji Tang (Wooden Fangji Decoction) to simultaneously open the Bi obstruction of both exterior and interior.
Cinnamomi Ramulus (6 qian) Stephaniae Tetrandrae Radix (4 qian) Gypsum Fibrosum (1 liang) Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (3 qian) Armeniacae Semen Amarum (4 qian) Atractylodis Rhizoma (5 qian) Cyperi Rhizoma (3 qian)
Take in four doses.
June 12th: Hypochondriac distension stopped but chest pain remains. Add Allii Macrostemonis Bulbus and Tangerini Reticulata Pericarpium to the previous formula to unblock and tonify the clear Yang of the upper Jiao.
Allii Macrostemonis Bulbus (3 qian) Tangerini Reticulata Pericarpium (3 qian)
June 14th: After Bi syndrome healed, the Stomach is disharmonious because Earth (Spleen) dislikes dampness.
Pinelliae Rhizoma Preparatum (1 liang) Poria (5 qian) Tangerini Reticulata Pericarpium (3 qian) Sorghum Indicum (2 he) Zingiberis Recens Rhizoma (3 qian)
Boil five bowls of water to two bowls, boil the dregs to one bowl, take in three doses.
June 16th: After Bi syndrome, clear Yang cannot extend, causing mass pain in the right hypochondrium.
Pinelliae Rhizoma Preparatum (6 qian) Tangerini Reticulata Pericarpium (2 qian) Citri Reticulatae Pericarpium Viride (1.5 qian) Linderae Radix (2 qian) Allii Macrostemonis Bulbus (3 qian) Cinnamomi Ramulus (2 qian) Evodiae Fructus (1 qian) Curcumae Aromatica Rhizoma (2 qian)
Boil two cups, boil dregs to one cup, take in three doses.
Mr. Wu, aged 11: Xing Bi (Wandering Bi).
Stephaniae Tetrandrae Radix (2 qian) Cinnamomi Ramulus (3 qian) Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (1 qian) Armeniacae Semen Amarum Paste (3 qian) Poria Cum Radix Pini (2 qian) Gypsum Fibrosum (5 qian) Curcumae Longae Rhizoma (1.5 qian) Cryptoteparei Cortex (1.5 qian) Achyranthis Bidentatae Radix (1.5 qian) Raw Coicis Semen (3 qian)
Mr. Zhang, aged 25. November 15th: Wind-dampness.
Notopterygii Rhizoma et Radix (3 qian) Cinnamomi Ramulus (2 qian) Armeniacae Semen Amarum (3 qian) Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (1 qian) Platycodonis Radix (3 qian) Zingiberis Recens Rhizoma (3 slices) Tangerini Reticulata Pericarpium (2 qian) Pinelliae Rhizoma Preparatum (2 qian) Perillae Folium (3 qian)
November 16th: Wind-dampness combusting together, pain throughout the body, not resolved by sweating. Use the method of Mahuang Jia Zhu Tang (Ephedra plus Atractylodes Decoction).
Ephedrae Herba (devoid of nodes) Armeniacae Semen Amarum (5 qian) Atractylodis Rhizoma (5 qian) Cinnamomi Ramulus (3 qian) Notopterygii Rhizoma et Radix (1.5 qian) Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (3 qian) Zingiberis Recens Rhizoma (3 slices)
Additionally, add to the previous formula:
Prepared Aconiti Lateralis Radix (3 qian)
Healed after half a prescription.
Mr. Hu, aged 18. April 19th: Dorsum pedis edema, right pulse surging and rapid, profuse phlegm and cough, thirst, pain in the urethra. Prescribe cooling and promoting urination method.
Gypsum Fibrosum (8 qian) Glycyrrhizae Radix et Rhizoma (tip) (1.5 qian) Pinelliae Rhizoma Preparatum (3 qian) Talcum (6 qian) Raw Coicis Semen (5 qian) Cloud Poria Skin (5 qian) Chrysosplenii Herba (5 qian)
Four prescriptions.
May 6th: The surging and rapid pulse has decreased. Remove Gypsum Fibrosum by 2 qian, add:
Tangerini Reticulata Pericarpium (3 qian) Armeniacae Semen Amarum (3 qian)
May 11th: Damp-heat injures Qi; Qi injury leads to short urine; excessive sweating causes thirst; dampness accumulation leads to edema of the dorsum pedis and ankle. Prescribe Zhuling Tang (Polyporus Decoction) removing Donkey-hide Gelatin, adding Lonicerae Japonicae Flos to resolve damp-heat. Once damp-heat resolves, all symptoms will heal.
Polyporus (4 qian) Cloud Poria Skin (5 qian) Lonicerae Japonicae Flos (3 qian) Alismatis Rhizoma (3 qian) Talcum (6 qian)
May 20th: Damp-heat not removed, sinking downward causing leg swelling, difficulty in urination, pain in the urethra.
Dioscoreae Hypoglaucae Rhizoma (5 qian) Polyporus (3 qian) Glycyrrhizae Radix et Rhizoma (tip) (1.5 qian) Cloud Poria Skin (5 qian) Alismatis Rhizoma (3 qian) Calcined Talcum (6 qian) Coicis Semen (3 qian) Akebiae Caulis (2 qian) Bombyx Batryticatus (3 qian)
Take until urination is smooth.
May 24th: Pulse surging and rapid, urine turns yellow again. Add Phellodendri Cortex and Talcum. Urethral pain stops, remove Glycyrrhizae Radix et Rhizoma.
July 4th: Urination lengthened, swelling not fully resolved, pulse wiry and slippery, cough with profuse phlegm.
Pinelliae Rhizoma Preparatum (6 qian) Raw Coicis Semen (5 qian) Tangerini Reticulata Pericarpium (4 qian) Cloud Poria Skin (5 qian) Polyporus (3 qian) Dioscoreae Hypoglaucae Rhizoma (5 qian) Alismatis Rhizoma (3 qian)
Mr. Zhang, aged 20. July 19th: Fever, headache, lower back pain, limb pain, no sweat, six pulses wiry and thin, eyes unclear, poor appetite. This is cold-damp Bi syndrome.
Prepared Aconiti Lateralis Radix (3 qian) Sichuan Aconitum Root (2 qian) Notopterygii Rhizoma et Radix (2 qian) Cinnamomi Ramulus (5 qian) Alismatis Rhizoma (3 qian) Coicis Semen (5 qian) Tangerini Reticulata Pericarpium (3 qian) Stephaniae Tetrandrae Radix (3 qian) Cloud Poria Skin (5 qian) Armeniacae Semen Amarum (5 qian)
Two prescriptions.
May 3rd (Note: Date discrepancy in original text): After taking two prescriptions of the previous formula, headache stopped. Immediately afterwards, mistakenly took others' yin-tonifying medicines, resulting in loose stools and abdominal distension. Today's follow-up: since headache is cured, use original formula removing Notopterygii Rhizoma et Radix, treat medicine-induced rebellion, add:
Magnoliae Officinalis Cortex (3 qian)
Has taken three prescriptions.
8th day: Bi syndrome healed, able to walk well, loose stools and diarrhea stopped, eyes recovered vision, appetite increased. Because one prescription was taken, pulse slightly rapid, cold-damp has signs of transforming into heat. Should use mild medicines to eliminate residual heat pathogens.
Cloud Poria Skin (5 qian) Stephaniae Tetrandrae Radix (2 qian) Talcum (6 qian) Mori Ramulus (5 qian) Alismatis Rhizoma (3 qian) Bombyx Batryticatus (3 qian) Coicis Semen (5 qian) Armeniacae Semen Amarum (2 qian)
June 18th: Contracted summerheat-dampness again, diarrhea, wiry pulse, abdominal distension. Use Wuling San (Five-Ingredient Powder with Poria) method.
Cinnamomi Ramulus (5 qian) Alismatis Rhizoma (3 qian) Cloud Poria Skin (5 qian) Atractylodis Rhizoma (3 qian, stir-fried) Arecae Pericarpium (3 qian) Aquilariae Lignum Resinatum (2 qian) Polyporus (4 qian) Tangerini Reticulata Pericarpium (3 qian) Coicis Semen (5 qian)
Boil three cups, take in three doses.
Mrs. Zhao, aged 47. June 20th: Taiyang cold Bi, wiry pulse, stiff and painful back.
Cinnamomi Ramulus (5 qian) Cloud Poria Skin (5 qian) Stephaniae Tetrandrae Radix (3 qian) Charred Sichuan Pepper (3 qian) Sichuan Aconitum Root (3 qian) White Tetsu Stem (1 qian) Raw Coicis Semen (5 qian)
June 25th: Previous medicine effective, but back pain difficult to remove. Add:
Aconiti Lateralis Radix Preparata (2 qian)
July 2nd: Pulse returned to Yang, pain not stopped. Take half prescription daily, three prescriptions over six days. Add:
Akebiae Caulis (3 qian) Bombyx Batryticatus (4 qian)
9th day: Pulse still small, Yang not returned, back still painful. Take three more prescriptions, divided into six doses.
Mr. Zhao, aged 36. May 6th: Bi syndrome with latent dampness causing distending pain, also has Fei Qi (Liver mass). Dampness has transformed into heat, so six pulses are surging and slippery. Root is cold, branch is heat. Treat branch first, should be slow treatment.
Gypsum Fibrosum (4 liang) Stephaniae Tetrandrae Radix (4 qian) Pinelliae Rhizoma Preparatum (5 qian) Armeniacae Semen Amarum (6 qian) Cinnamomi Ramulus (6 qian) Magnoliae Officinalis Cortex (5 qian) Tangerini Reticulata Pericarpium (4 qian)
10th day: Chi (Cun-Kuan-Guan-Chi) pulse surging and rapid even more. Add:
Phellodendri Cortex (3 qian) Akebiae Caulis (3 qian) Cloud Poria Skin (6 qian)
12th day: Chi pulse still surging, abdominal pain wanting stool. After stool, anus hot and painful. Take original formula for two more prescriptions.
16th day: Water retained under Heart, gurgling sound. Temporarily use water-draining method, no time to treat Bi.
Tangerini Reticulata Pericarpium (5 qian) Pinelliae Rhizoma Preparatum (6 qian) Zhi Shi (6 qian) Zingiberis Recens Rhizoma (5 qian)
Ganlan Shui (Agitated Water) eight tea cups, boil to three water cups, take in three doses.
19th day: Water sound receded, severe abdominal distension. Still take previous formula removing Phellodendri Cortex, add Arecae Pericarpium.
23rd day: Bi slightly reduced, Stomach not opening. Person originally had Fei Qi, formed from Liver Qi stagnation. Temporarily harmonize Liver and Stomach.
Pinelliae Rhizoma Preparatum (6 qian) Dalbergiae Odoriferae Lignum (3 qian) Tangerini Reticulata Pericarpium (3 qian) Alpiniae Oxyphyllae Fructus (2 qian) Citri Reticulatae Pericarpium Viride (2 qian) Magnoliae Officinalis Cortex (3 qian) Cyperi Rhizoma (3 qian) Cloud Poria Block (5 qian)
June 3rd: Right pulse large and rapid. Add Scutellariae Radix 2 qian, remove Magnoliae Officinalis Cortex.
5th day: All symptoms calming, pulse regulated, appetite opened. Legislate regulating Spleen and Stomach.
Cloud Poria Block (5 qian) Amomi Fructus Rotundus (1.5 qian) Coicis Semen (5 qian) Charred Scutellariae Radix (2 qian) Tangerini Reticulata Pericarpium (2 qian) Pinelliae Rhizoma Preparatum (5 qian)
20th day: Mistakenly eating cold watermelon inevitably causes fluid retention.
Elettaria Cardamomum Seed (8 fen) Pinelliae Rhizoma Preparatum (5 qian) Alpiniae Oxyphyllae Fructus (1.5 qian) Zingiberis Rhizoma (3 qian) Amomi Fructus Rotundus (1 qian) Tangerini Reticulata Pericarpium (3 qian) Poria (5 qian) Small Zhi Shi (3 qian)
Mr. Qian, aged 34. May 29th: Cold Bi, pulse wiry, short, choppy and tight. Pain extends from legs to lower abdomen, unbearable, even fainting. Accompanied by phlegm-fluid and stomach pain.
Cinnamomi Ramulus (6 qian) Tangerini Reticulata Pericarpium (3 qian) Stephaniae Tetrandrae Radix (4 qian) Sichuan Aconitum Root (3 qian) Charred Sichuan Pepper (3 qian) Foeniculi Fructus (3 qian, stir-fried) Cloud Poria Skin (5 qian) Curcumae Longae Rhizoma (3 qian) Raw Coicis Semen (5 qian) Cryptoteparei Cortex (3 qian)
June 1st: Left pulse slightly longer, still very tight. Take two more prescriptions.
Pill Formula: For cold-dampness disease.
Dioscoreae Hypoglaucae Rhizoma (4 liang) Foeniculi Fructus (4 liang, stir-fried) Charred Sichuan Pepper (3 liang) Coicis Semen (8 liang) Atractylodis Rhizoma (6 liang, stir-fried) Cloud Poria Skin (8 liang) Toosendan Fructus (3 liang) Prepared Aconiti Lateralis Radix (2 liang) Akebiae Caulis (4 liang)
Grind into fine powder, paste with Medicated Leaven pill, size of small wu zi (loquat seed). Take 3 qian each time, down with Ginger Decoction.
Ms. Yang, aged 26. January 7th, Yihai Year: Previously had metrorrhagia and leukorrhea, later got Wei Bi (Atrophy-Bi). Patient suspected deficiency. Inquiry reveals light when cold, heavy when hot. Precisely "Heat in meridians causes Bi, Heat in collaterals causes Phlegm." Menstrual blood purple and black. During menstruation, severe lower back and leg pain, lower abdomen pain, irregular menstruation, varying quantity and days. This is not only damp-heat, but also Blood stasis. Treat damp-heat with Tang medicine, treat Blood stasis with Pill medicine. (Left pulse floating wiry, deep loose. Right pulse floating wiry, deep surging.) Tang medicine uses Zhu Bi Tang (Various Bi Decoction) adopting Taiyin method. Pill medicine uses Hua Sheng Dan (Life-Restoring Pill).
Gypsum Fibrosum (2 liang) Cinnamomi Ramulus (4 qian) Tetsu Stem (1 qian) Armeniacae Semen Amarum Paste (5 qian) Cloud Poria Skin (5 qian) Curcumae Longae Rhizoma (3 qian) Stephaniae Tetrandrae Radix (4 qian) Bombyx Batryticatus (3 qian) Cryptoteparei Cortex (3 qian) Coicis Semen (5 qian)
Boil three cups, take in three doses.
Mr. Yue, aged 46: Summerheat-damp Bi syndrome, mistakenly used Rehmanniae Radix Preparata and other soft/slippery medicines damaging Spleen, causing diarrhea, bedridden, legs curled and unable to extend, poor intake, accompanied by Hernia pain. First use Wuling San (Five-Ingredient Powder with Poria), add Sichuan Pepper, Tangerini Reticulata Pericarpium, Aquilariae Lignum Resinatum to stop diarrhea; then Banxia, Tangerini Reticulata Pericarpium, Alpiniae Officinarum Rhizoma, Alpiniae Oxyphyllae Fructus, Amomi Fructus Rotundus to open Stomach; then Clove, Sichuan Pepper, Evodiae Fructus, Poria, Coicis Semen, Curcumae Longae Rhizoma to calm Hernia; finally Stephaniae Tetrandrae Radix, Armeniacae Semen Amarum, Cinnamomi Ramulus, Aconitum, Poria Skin, Sichuan Pepper to extend Bi. Only wind-pain in sinews, heavily use Earthworm and Cinnamomi Ramulus, pain stops. Later tonify Spleen and Stomach to heal.
Mr. Wang, aged 46: Cold-damp Bi, back pain unable to turn, insomnia day and night for 20+ days. Leg spasms, hand unable to grip, facial paralysis, restlessness, aversion to wind, spontaneous sweating, wiry pulse, white slippery tongue coating, dark yellow complexion, yellow sclera, constipation. First use Cinnamomi Ramulus, Armeniacae Semen Amarum, Coicis Semen, Notopterygii Rhizoma et Radix, Tangerini Reticulata Pericarpium, Pinelliae Rhizoma Preparatum, Poria, Stephaniae Tetrandrae Radix, Sichuan Pepper, Talcum to induce sleep; then previous formula removing Sichuan Pepper, Notopterygii Rhizoma et Radix, add White Tetsu Stem, Bombyx Batryticatus, Dioscoreae Hypoglaucae Rhizoma to achieve bowel movement. For 7-8 days, stools like black eggs. After 20+ prescriptions, upper body slightly lighter, severe back and foot pain. Remove Pinelliae Rhizoma Preparatum from previous formula, add Aconiti Lateralis Radix Preparata, Curcumae Longae Rhizoma, Earthworm, Cryptoteparei Cortex. Take 10+ prescriptions, pain gradually stops; remove Aconiti Lateralis Radix Preparata, Earthworm, take 10+ prescriptions, feet gradually extend. Finally use Ermiao Wan (Two Marvels Pill), add Poria, Coicis Semen, Dioscoreae Hypoglaucae Rhizoma, Atractylodis Macrocephalae Rhizoma to conclude.
Mr. He, aged 26: Limb spasms, mistakenly took Cinnamomi Ramulus, Aconiti Lateralis Radix Preparata, Ginseng Radix, Rehmanniae Radix Preparata and other Yang-tonics, resulting in red face, surging rapid pulse, urinary retention, heavy body unable to turn, hands unable to reach temples, legs curled immobile. Detailed inquiry reveals caused by heavy drinking and meat eating. "If damp-heat is not removed, large sinews become soft and short, small sinews become lax and long. Soft and short is spasm, lax and long is atrophy." Prescribe extremely bitter to unblock Small Intestine, bland to promote Bladder urination.
Gentianae Radix (4 qian) Aloe (3 qian) Picrorhizae Rhizoma (3 qian) Gypsum Fibrosum (8 liang) Earthworm (3 qian) White Tetsu Stem (2 qian) Poria Skin (6 qian) Calcined Talcum (1 liang) Manis Squama (3 qian) Mori Ramulus (5 qian) Armeniacae Semen Amarum (3 qian) Bombyx Batryticatus (4 qian) Stephaniae Tetrandrae Radix (5 qian)
After taking previous formula for 7 days, urine red-black and turbid, foul odor. After half month, hands move, legs extend. After one month, get out of bed, hold table/chair to walk. After 40 days, walk to eaves, unable to go down steps. Another half month to go down steps. After three months, walk 40 li. Later due to phlegm-fluid, use Spleen-regulating to conclude. This case started March 23rd, stopped medication August 22nd.
Mr. Zhou, aged 42: Legs purple-red and swollen, small boils like prickly heat appeared, for three years. Legs and feet sore and painful, unable to stand, six pulses wiry, thin and tight. Dou's "Bianque Xin Shu" calls this Sumu Tui (Sappanwood Leg), which is Han Shi Zhuo Bi (Cold-Damp Fixed Bi).
Aconiti Lateralis Radix Preparata (8 qian) Aconitum Carmichaelii Radix (6 qian) Coicis Semen (1 liang) Cinnamomi Ramulus (1 liang) Cloud Poria Skin (1 liang)
Boil four cups, take in four doses. After 30+ prescriptions, able to walk with cane. Then remove Aconitum and Aconite, use Tong Jing Huo Luo Shen Shi (Unblock Meridians Activate Collaterals Drain Dampness) to heal.
Mr. Cheng, aged 54: Waist sore and weak, legs powerless, unable to kneel and bow, occasional lower back pain, six pulses surging large and slippery. Previous doctors only tonified Yin, so worsened day by day. This is Shi Re Wei (Damp-Heat Atrophy). Use Zhu Wei Du Qu Yang Ming (For All Atrophies, Exclusively Select Yangming) method.
Gypsum Fibrosum (4 qian) Cryptoteparei Cortex (2 qian) Bombyx Batryticatus (3 qian) White Tetsu Stem (2 qian) Raw Coicis Semen (8 qian) Cloud Poria Skin (5 qian) Stephaniae Tetrandrae Radix (4 qian) Armeniacae Semen Amarum (4 qian) Mori Ramulus (5 qian) Dioscoreae Hypoglaucae Rhizoma (5 qian) Calcined Talcum (1 liang)
Took over 90 prescriptions in total. When severe, doubled Gypsum Fibrosum dosage. Finally used Ermiao Wan (Two Marvels Pill) to conclude.
Mr. Zhao, aged 45. January 15th, Yihai Year: Liver Qi stagnation with phlegm-fluid, Kidney Water flooding Heart, palpitations, shortness of breath, abdominal distension, chest Bi. Six pulses surprisingly sunken and surging. Water extreme resembling Fire. Prescribe Juan Tan Yin Fa Xie (Eliminate Phlegm-Fluid Drive Pathogens), concurrently descend Liver rebellion.
Ginger Pinelliae Rhizoma (8 qian) Dalbergiae Odoriferae Lignum (3 qian) Small Zhi Shi (5 qian) Cinnamomi Ramulus (5 qian) Poria Block (1 liang) Perillae Fructus Frost (3 qian) Tangerini Reticulata Pericarpium (4 qian) Charred Sichuan Pepper (3 qian) Zingiberis Recens Rhizoma Juice (3 spoons per cup) Inulae Flos (3 qian)
Boil Ganlan Shui (Agitated Water) to four cups, take morning, noon, evening, night four times. Avoid raw/cold, pork, pickles.
Four prescriptions.
20th day: Phlegm-fluid with Bi, Kidney Water flooding, heart fright palpitations, shortness of breath, waist/spine Bi pain. All areas passed by Taiyang channel. Short urine, abdominal distension, umbilicus protruding. Internal organs and external meridians all Bi. Open Taiyang Bi, pulse surging large. Combine Da Qing Long Tang (Major Green Dragon Decoction) with Mufangji Tang (Wooden Fangji Decoction) method.
Cinnamomi Ramulus (5 qian) Pinelliae Rhizoma Preparatum (5 qian) Cloud Poria Skin (6 qian) Gypsum Fibrosum (4 liang) Coicis Semen (5 qian) Magnoliae Officinalis Cortex (3 qian) Stephaniae Tetrandrae Radix (4 qian) Tangerini Reticulata Pericarpium (3 qian) Zhi Shi (5 qian) Armeniacae Semen Amarum (4 qian) Talcum (6 qian) White Tetsu Stem (1.5 qian)
Boil four cups, take in three doses.
21st day: Add to previous formula:
Bombyx Batryticatus (3 qian) Calcined Talcum (4 qian)
23rd day: External meridian Bi and internal organ Bi, resolving phlegm and opening Bi, not very effective. Now pulse surging rapid, lower abdominal distension, short turbid foul urine. First open side channels to give damp-heat an exit, then discuss next method.
Chuan Dioscoreae Hypoglaucae Rhizoma (3 qian) Calcined Talcum (1.5 qian) Chrysosplenii Herba (5 qian) Cloud Poria Skin (5 qian) Polyporus (4 qian) Foeniculi Fructus (3 qian) White Tetsu Stem (1.5 qian) Alismatis Rhizoma (3 qian)
Two prescriptions.
25th day: Add Qu Chen (Remove Old/Stale) method.
Liang Tou Jian (Two Ends Sharp) (3 qian) Pinelliae Rhizoma Preparatum (5 qian)
Two prescriptions.
29th day: Bi with phlegm-fluid, six pulses surging large, dampness transformed into heat. Repeatedly promoting urination ineffective. Must heavily use Gypsum Fibrosum to ventilate Lung heat. For all Bi, exclusively select Taiyin.
Gypsum Fibrosum (4 liang) Cloud Poria Skin (5 qian) White Tetsu Stem (1 qian) Armeniacae Semen Amarum (5 qian) Cinnamomi Ramulus (5 qian) Talcum (2 liang) Notopterygii Rhizoma et Radix (1 qian) Phellodendri Cortex (4 qian) Stephaniae Tetrandrae Radix (5 qian) Coicis Semen (5 qian) Bombyx Batryticatus (3 qian)
Four prescriptions.
February 4th: Bi for ten years, mistakenly tonified for three years, causing layered consolidation. Opening is not easy. Used over two jin of Gypsum Fibrosum, pulse image just...