高氏 四十五岁 乙丑十一月十一日 肝阳上窜，因怒即发，十余年矣。经云∶久病在
络，
岂经药可效？再肝厥之症，亦有寒热之不同。此症脉沉而弦细，其为寒也无疑。大凡寒厥必
死，今不死者，以其为腑厥而非脏厥也，现下胁下有块有声，经色紫黑。拟先用温通络脉法
。
新绛纱（三钱） 旋复花（三钱） 川椒（二钱，炒黑） 降香末（三钱） 归须（二钱） 制半
夏（五钱） 桂枝尖（三钱） 生香附（三钱） 桃仁炭（三钱）
煮二杯，二次服。
三兄夫人 二十二岁 除夕日亥时 先是产后受寒痹痛，医用桂附等极刚热之品，
服之
大效；医见其效也，以为此人非此不可，用之一年有余。不知温燥与温养不同，可以治病，
不可以养生，以致少阳津液被劫无余，厥阴头痛，单巅顶一点，痛不可忍，畏明，至于窗
间有豆大微光，即大叫，必室如黑漆而后少安，一日厥去四五次。脉弦细数，按之无力，危
急已极，勉与定风珠潜阳育阴，以熄肝风。
真大生地（八钱） 麻仁（四钱） 生白芍（四钱） 麦冬（四钱，带心） 海参（二条） 生阿
胶（
四钱） 生龟板（六钱） 炙甘草（五钱） 生牡蛎（六钱） 生鳖甲（六钱） 鸡子黄（二枚，去渣
后化入搅匀）
煮成八杯，去渣，上火煎成四杯，不时频服。
正月初一日 微见小效，加∶
鲍鱼片（一两）
煮成十杯，去渣，煎至五杯，频服。
初四日 腰以上发热，腰以下冰凉，上下浑如两截；身左半有汗，身右半无汗，左右浑
如两
畔。自古方书未见是症，窃思古人云∶琴瑟不调，必改弦而更张之，此症当令其复厥，厥后
再安则愈。照前方定风珠减半，加∶
青蒿（八分） 当夜即厥二三次。
初五日 照前方定风珠原分量一帖，服后厥止神安。
初七日 仍照前方。
初八日 方皆如前，渐不畏明，至正月二十日外，彻去帏帐，汤药服至二月春分后，与
专翕大生膏一料痊愈。
杨 室女 四十九岁 甲申十二月初二日 初因肝郁胁痛，继而肝厥犯胃，医者不识病
名肝
着，与络痛治法，无非滋阴补虚，或用凉药，以致十年之久，不能吃饭，饮粥汤止一二口，
食炒米粉止一酒杯，稍闻声响即痉厥，终夜抽搐，二三日方渐平，六脉弦紧而长，经闭二年
，周身疼痛，痰饮咳嗽，终年无已，骨瘦如柴，奄奄一息。此症内犯阳明，故不食；木克脾
土，故饮聚；阳明空虚，故无主，闻声而惊；外犯太阳，故身痛而痉；本脏致病，故厥。经
谓治病必求其本，仍从肝络论治。
新绛纱 归须 川椒炭 桂枝 郁金 旋复花 青皮 苏子霜 半夏 降香末
十四日 服前方七帖，胁痛虽轻，痰饮特甚，喘咳频仍，夜卧不安，暂停络药，专与和
胃蠲饮。
半夏（八钱） 广陈皮（四钱） 生苡仁（五钱） 茯苓（六钱） 枳实（三钱） 淡干姜（三钱）
桂枝（三钱）
十七日 胃稍开，能食稀粥半碗，胁仍痛，仍服前活络方去川椒，加广陈皮。
十二月初四日十一日 胁痛平，咳嗽未除，又服前蠲饮方。
十一日 因余有由绍兴之行，令其常服和胃方，胁痛发时，暂服新绛旋复花汤，此时已
能食烂饭半碗矣。
乙酉二月二十八日 脉稍和平，虽弦而有胃气，干饭能吃一碗有半，经亦复通，仍间服
前二
方。夜间偶感燥症，欲起不得起，欲坐不得坐，欲卧不得卧，烦躁无奈不可当，约二时，服
霹雳散三两许始安。次日仍与和胃。
十八日 能食干饭两小碗矣，六脉又和一等，仍间服前二方。
四月初三日 余复由淮至绍，初八日至苏州，不放心此病，作书一封，令其调适性情。
五月
间又作书一封，痛以大道理开导之。十月间始得回书，据云竟以余书作座右铭，每日讽诵一
过，饮食又进，精神大长，阖家欢乐。
高氏，四十五岁。乙丑年十一月十一日就诊。肝阳上窜（肝阳亢逆上行），因愤怒而诱发，病程已十余年。《内经》云：“久病在络”（长期患病，病邪深入络脉），难道仅靠常规经方药物就能见效吗？再者，肝厥（由肝气逆乱引起的厥证）这一病症，也有寒证和热证的不同。此患者脉象沉而弦细，属于寒证无疑。大凡寒厥（阴寒内盛导致的四肢厥冷）多预后不良，今未致死，是因为此为腑厥（病位在六腑或经络之厥）而非脏厥（病位在五脏之厥）。目前胁下有肿块且按之有声，面色呈紫黑色。拟先用温通络脉法治疗。
新绛纱（三钱） 旋复花（三钱） 川椒（二钱，炒黑） 降香末（三钱） 归须（二钱） 制半夏（五钱） 桂枝尖（三钱） 生香附（三钱） 桃仁炭（三钱）
煎煮成两杯药液，分两次服用。
三兄夫人，二十二岁。除夕夜亥时就诊。起初产后受寒痹痛，医生使用桂枝、附子等极刚热的药物，服用后效果显著；医生见其有效，认为此人非用此不可，连续使用了一年多。不知温燥（温散燥烈）与温养（温和滋养）不同，前者可以治病，但不适合养生，导致少阳津液被劫夺殆尽，引发厥阴头痛，疼痛部位仅在头顶一点，痛不可忍，畏光，以至于窗间有豆大的微光，就会大叫，必须房间漆黑如漆才能稍得安宁，一天发作厥逆四五次。脉象弦细数，重按无力，病情危急至极，勉强给予定风珠（滋阴潜阳熄风方剂）以潜阳育阴，平息肝风。
真大生地（八钱） 麻仁（四钱） 生白芍（四钱） 麦冬（四钱，带心） 海参（二条） 生阿胶（四钱） 生龟板（六钱） 炙甘草（五钱） 生牡蛎（六钱） 生鳖甲（六钱） 鸡子黄（二枚，去渣后化入搅匀）
煎煮成八杯药液，去渣，上火再煎至四杯，不时频繁服用。
正月初一日，症状略有缓解，加味：
鲍鱼片（一两）
煎煮成十杯药液，去渣，煎至五杯，频繁服用。
初四日，腰部以上发热，腰部以下冰凉，上下仿佛分为两截；身体左半侧出汗，右半侧无汗，左右仿佛分为两畔。自古以来的医书中未见此症，私下思考古人云：“琴瑟不调，必改弦而更张之”，此症应当让其再次发作厥逆，厥逆过后若能安定则痊愈。照前方定风珠减半，加味：
青蒿（八分） 当夜即发作厥逆二三次。
初五日，照前方定风珠原剂量服用一帖，服药后厥逆停止，神志安宁。
初七日，仍照前方。
初八日，方药皆同前，逐渐不畏光，直到正月二十日以后，撤去帷帐，汤药服用至二月春分之后，给予专翕大生膏一料，痊愈。
杨姓室女，四十九岁。甲申年十二月初二日就诊。起初因肝郁胁痛，继而肝厥犯胃，医者不识“肝着”（肝脏气血郁滞，着而不行）这一病名，按照络痛治法，无非是滋阴补虚，或使用凉药，导致十年之久不能进食，喝粥汤只进一二口，吃炒米粉只进一杯酒量，稍闻声响即发生痉厥，整夜抽搐，两三天才逐渐平静，六脉弦紧而长，闭经两年，周身疼痛，痰饮咳嗽，终年不止，骨瘦如柴，奄奄一息。此症内犯阳明（胃与大肠），故不食；木克脾土（肝木克制脾土），故水饮停聚；阳明空虚，故无主见，闻声而惊；外犯太阳（膀胱与小肠经），故身痛而痉；本脏致病，故发厥。《内经》谓治病必求其本，仍从肝络论治。
新绛纱 归须 川椒炭 桂枝 郁金 旋复花 青皮 苏子霜 半夏 降香末
十四日，服用前方七帖，胁痛虽减轻，但痰饮特别严重，喘咳频繁，夜间卧不安稳，暂停络药，专门给予和胃蠲饮（消除体内停积水饮）之法。
半夏（八钱） 广陈皮（四钱） 生苡仁（五钱） 茯苓（六钱） 枳实（三钱） 淡干姜（三钱） 桂枝（三钱）
十七日，胃气稍开，能吃稀粥半碗，胁痛仍在，仍服前活络方，去掉川椒，加广陈皮。
十二月初四日至十一日，胁痛平复，咳嗽未除，又服前蠲饮方。
十一日，因我即将前往绍兴，令其常服和胃方，胁痛发作时，暂服新绛旋复花汤，此时已能吃烂饭半碗了。
乙酉年二月二十八日，脉象稍和平，虽弦但有胃气，能吃干饭一碗半，月经也恢复通畅，仍间歇服用前两方。夜间偶感燥症，想起身起不了，想坐坐不下，想躺躺不平，烦躁无奈难以承受，约两个小时，服用霹雳散三两许才安定。次日仍给予和胃之法。
十八日，能吃干饭两小碗了，六脉又调和一等，仍间歇服用前两方。
四月初三日，我又从淮安到绍兴，初八日到苏州，不放心此病，写了一封信，令其调适性情。五月间又写了一封信，痛陈大道理开导她。十月间才收到回信，据信中说竟把我的信作为座右铭，每日诵读一遍，饮食又增加，精神大长，阖家欢乐。
Gao, female, 45 years old. Visited on the 11th day of the 11th lunar month in the Yichou year. Liver Yang (Liver Yang) is surging upward, triggered by anger, for over ten years. The *Classic of Internal Medicine* states: "Chronic diseases reside in the collaterals" (Long-standing illness, pathogenic factors penetrate into the collateral vessels). Can ordinary Jingfang (classical formulas from the classics) be effective? Furthermore, Gan Jue (Liver Jue syndrome, a type of cold extremity syndrome caused by liver qi rebellion) presents with both cold and heat patterns. This patient's pulse is deep, wiry, and thin, undoubtedly indicating a cold pattern. Generally, Han Jue (Cold Jue syndrome, characterized by cold extremities due to severe internal cold) has a poor prognosis; the fact that she did not die indicates this is Fu Jue (Jue syndrome involving the fu organs or meridians) rather than Zang Jue (Jue syndrome involving the zang organs). Currently, there is a mass under the hypochondrium that makes sounds upon palpation, and the complexion is purple-black. It is proposed to first use the method of warming and unblocking the collaterals.
Xinjiang Sha (New Crimson Gauze, 3 qian), Xuanfu Hua (Inula Flower, 3 qian), Chuanjiao (Sichuan Pepper, 2 qian, stir-fried until black), Jiangxiang Mo (Aquilaria Wood Powder, 3 qian), Guixu (Angelica Sinensis Root Tips, 2 qian), Zhibanxia (Prepared Pinellia Tuber, 5 qian), Guizhi Jian (Cinnamon Twig Tip, 3 qian), Sheng Xiangfu (Raw Cyperus Rhizome, 3 qian), Taoren Tan (Charred Peach Kernel, 3 qian).
Decoct with water to yield two cups of decoction, take in two divided doses.
Madam of the Third Brother, female, 22 years old. Visited at Hai hour (9-11 PM) on New Year's Eve. Initially, postpartum cold-bi pain occurred. Physicians used extremely hot and acrid drugs such as Guizhi Tang (Cinnamon Twig Decoction) and Fuzi (Aconite Root). The effect was significant; seeing this efficacy, the physicians believed this patient required these drugs exclusively, using them for over a year. They failed to realize that Wenzao (Warming and drying methods) differs from Wenyang (Warming and nourishing methods); the former can treat disease but is unsuitable for health preservation. Consequently, Shaoyang body fluids were depleted, leading to Jueyin headache (headache associated with the Jueyin liver channel), localized only at the vertex, unbearable in intensity, photophobia. Even a bean-sized glimmer of light from a window would cause screaming; only complete darkness provided slight relief. She experienced Jue episodes four to five times daily. The pulse was wiry, thin, rapid, and powerless upon deep pressure. The condition was extremely critical. Reluctantly, Dingfeng Zhu (Wind-Calming Pearl, a formula for subduing liver wind) was prescribed to subdue Yang, nourish Yin, and extinguish Liver Wind (internal wind generated by liver pathology).
Zhen Dadihuang (True Rehmannia Root, 8 qian), Maren (Kern Fructus Cannabis, 4 qian), Sheng Baishao (Raw White Peony Root, 4 qian), Maidong (Ophiopogon Tuber, 4 qian, with heart), Haishen (Sea Cucumber, 2 pieces), Sheng Ejiao (Donkey-Hide Gelatin, 4 qian), Sheng Guiban (Tartar Testudo Carapace, 6 qian), Zhigancao (Honey-fried Licorice Root, 5 qian), Sheng Muli (Oyster Shell, 6 qian), Sheng Biejia (Softshell Turtle Plastron, 6 qian), Jizihuang (Chicken Egg Yolk, 2 pieces, melted into the strained decoction after removing dregs).
Decoct to yield eight cups, strain, return to fire to reduce to four cups, take frequently in small amounts.
On the 1st day of the 1st lunar month, slight improvement was observed. Add:
Baoyu Pian (Abalone Slices, 1 liang).
Decoct to yield ten cups, strain, reduce to five cups, take frequently.
On the 4th day, fever above the waist, ice-cold below the waist, as if divided into two sections; sweating on the left half of the body, no sweating on the right half, as if divided into two sides. No such case has been recorded in ancient medical texts. Reflecting on the saying, "If the lute and zither are out of tune, one must change the strings and adjust the pegs," this case requires inducing Jue again; if stability follows the Jue episode, recovery will ensue. Use the previous Dingfeng Zhu formula at half dose, add:
Qinghao (Artemisia Annua Herb, 8 fen). That night, Jue episodes occurred two to three times.
On the 5th day, one dose of the original Dingfeng Zhu formula was taken. After ingestion, Jue ceased, and spirit calmed.
On the 7th day, continue with the previous prescription.
On the 8th day, prescriptions remained the same. Gradually, photophobia decreased. By the 20th day of the 1st lunar month, curtains were removed. Herbal decoctions continued until after the Spring Equinox in February. Then, Zhuxi Dasheng Gao (Special Nourishing Large Life Paste) was administered for one course, resulting in cure.
Ms. Yang, unmarried female, 49 years old. Visited on the 2nd day of the 12th lunar month in the Jiashen year. Initially suffered from liver depression causing hypochondriac pain, which progressed to Gan Jue invading the Stomach. Physicians failed to recognize the disease name "Ganzhe" (Liver Fixation, stagnation of liver qi and blood), treating it instead as collateral pain. Treatments consisted mainly of nourishing yin and tonifying deficiency, or using cooling herbs. For ten years, she could not eat; consuming only one or two mouthfuls of porridge soup, or a cup of fried rice flour. Any sound triggered spasmodic Jue, with all-night convulsions, taking two to three days to gradually subside. The six pulses were wiry, tight, and long. Amenorrhea for two years. Whole-body pain, phlegm-fluid retention coughing, incessant throughout the year. Emaciated, barely alive. This case involves internal invasion of Yangming (Stomach and Large Intestine channels), hence anorexia; Wood overacting on Spleen Earth, hence fluid accumulation; Yangming emptiness, hence lack of mastery, startled by sound; external invasion of Taiyang (Bladder and Small Intestine channels), hence body pain and spasms; pathology of the primary organ, hence Jue. The Classic states: "In treating disease, one must seek the root." Treatment should still focus on the Liver collaterals.
Xinjiang Sha, Guixu, Chuanjiao Tan (Charred Sichuan Pepper), Guizhi, Yujin (Curcuma Longa Rhizome), Xuanfu Hua, Qingpi (Aurantium Peel), Suzi Shuang (Perilla Seed Frost), Banxia, Jiangxiang Mo.
On the 14th day, after seven doses of the previous prescription, hypochondriac pain lightened, but phlegm-fluid retention became severe, with frequent wheezing and coughing, and restless sleep. Pause collateral-unblocking drugs; specifically apply He Wei Juan Yin (Harmonize Stomach and Eliminate Fluids) method.
Banxia (Pinellia Tuber, 8 qian), Guang Chenpi (Citrus Reticulata Peel, 4 qian), Sheng Yiren (Coix Seed, 5 qian), Fuling (Poria, 6 qian), Zhishi (Immature Bitter Orange, 3 qian), Dangangjiang (Mild Dried Ginger, 3 qian), Guizhi (Cinnamon Twig, 3 qian).
On the 17th day, stomach function slightly improved, able to eat half a bowl of thin porridge. Hypochondriac pain persists. Continue the previous Huoluo (unblocking collaterals) formula, remove Chuanjiao, add Guang Chenpi.
From the 4th to the 11th day of the 12th lunar month, hypochondriac pain subsided, cough persisted. Resume the previous Juan Yin formula.
On the 11th day, due to my upcoming trip to Shaoxing, instructed her to regularly take the He Wei formula. When hypochondriac pain flared, temporarily take Xinjiang Xuanfu Hua Tang (New Crimson Gauze and Inula Flower Decoction). At this time, she could already eat half a bowl of soft rice.
On the 28th day of the 2nd lunar month in the Yiyu year, pulse slightly harmonized; though wiry, it possessed Stomach Qi. Able to eat one and a half bowls of dry rice. Menstruation resumed. Still intermittently taking the previous two formulas. Nighttime, accidentally contracted a dryness syndrome. Unable to rise, sit, or lie down comfortably. Extreme restlessness and helplessness lasted about two hours. Took approximately three liang of Pilei San (Thunderbolt Powder) before calming. The next day, resume He Wei treatment.
On the 18th day, able to eat two small bowls of dry rice. Six pulses further harmonized. Still intermittently taking the previous two formulas.
On the 3rd day of the 4th lunar month, I traveled from Huai'an to Shaoxing, arriving in Suzhou on the 8th. Concerned about this case, wrote a letter instructing emotional regulation. In May, wrote another letter, earnestly explaining profound principles to guide her. Received a reply in October, stating she took my letter as a motto, reciting it daily. Diet improved significantly, spirits greatly elevated, family rejoiced.