章男 十一个月 六月十三日 泄久伤脾,恐成柔痉,俗所谓慢脾风,议疏补中焦。
茯苓块(三钱) 浓朴(一钱) 煨肉果(一钱) 苡仁(三钱,炒) 扁豆(二钱,炒) 莲子
(三钱,连皮去心) 广皮炭(八分) 芡实(钱半,连皮) 木香(五分)
十四日 仍用通补而进之。
人参(五分) 浓朴(八分) 煨肉果(一钱) 茯苓块(二钱) 广皮炭(八分) 木香(七分)
苡
仁(二钱,炒) 藿梗(八分) 焦神曲(八分) 白扁豆(三钱,炒) 半夏(二钱) 小茴香(一
钱)
十六日 疏补中焦,业已见效,仍不能外此法。
人参(五分) 浓朴(八分) 半夏(二钱) 木香(八分) 茯苓(三钱) 煨肉果(钱半) 苡
仁(三钱,炒) 扁豆(三钱,炒) 藿梗(八分) 广皮炭(八分) 焦于术(一钱)
十七日 神气声音稍健,皮热亦觉平和,大有起色,但积虚旦晚可充。
人参(五钱) 莲子(二钱) 肉果霜(钱半) 茯苓(三钱) 半夏(二钱) 木香(八分) 白
扁豆(二钱,炒) 广皮(钱半) 山药(钱半)
十八日 舌有黄苔,小便色黄,微有积,皆脾虚不运之故,且暂停参药,加宣络法。
茯苓(三钱) 浓朴(一钱) 煨肉果(一钱) 半夏(二钱,炒) 鸡内金(一钱) 白蔻仁(
二钱) 莲子(二钱,去心) 木香(七分) 生苡仁(三钱) 生于术(一钱) 广皮炭(八分)
十九日 大便有不化形,思乳食,为血肉有情,应于疏补之中,加消血肉积者。
鸡内金(一钱,炒) 楂炭(一钱) 广皮炭(一钱) 茯苓块(三钱) 煨肉果(一钱) 范曲
炭(八分) 木香(七分) 川朴(钱半) 白蔻仁(三分) 生苡仁(三钱)
二十日 脾虚火衰,则食物有不化之形,肝肾与冲脉伏寒,怒甚则疝痛。
小茴香(二钱) 生苡米(三钱) 木香(一钱) 黑楂炭(钱半) 煨肉果(钱半) 制茅术(
一钱) 茯苓(一钱) 广皮炭(八分) 白蔻仁(五分) 青皮(六分) 乌药(八分)
二十二日 补下通中。
小茴香(钱半,炒黑) 生苡仁(钱半) 人参(三分) 楂炭(八分) 煨肉果(一钱) 茯苓
(三钱) 制茅术(八分) 白蔻仁(五分) 木香(六分)
张男 八个月 泄泻四五日,暑邪深入下焦,头热如火,手冷如冰,谓之暑厥。羸瘦难
堪,脉迟紧,未必得愈,姑立方以救之。先与紫雪丹五分,三次服。
猪苓(二钱) 制苍术(一钱) 泽泻(一钱) 茯苓(二钱) 桂枝木(一钱) 广皮炭(七分)
白扁豆(一钱) 木香(七分)
略有转机,然终可畏也。
猪苓(二钱) 白扁豆(钱半,炒) 泽泻(钱半) 半夏(钱半) 生苡仁(三钱) 广木香(
八分) 茅术炭(一钱) 浓朴(六分)
广皮炭(五分)
孟 十五岁 八月初八日 伏暑泄泻,加以停食,欲泻腹痛,泻后痛减,防成滞下,与
五苓散加消食,脉细弦而缓。
桂枝(三钱) 云苓皮(五钱) 楂炭(二钱) 苍术炭(三钱) 神曲(四钱,炒) 小枳实(
二钱) 猪苓(三钱) 广皮炭(四钱) 川椒炭(二钱) 泽泻(三钱)
一月后复诊,病已大愈,善后方与调和脾胃。
章姓男童,十一个月大。六月十三日就诊:腹泻日久损伤脾气,担心发展为柔痉(因津液亏损、筋脉失养引起的痉挛),即民间所说的慢脾风,建议采用疏通并补益中焦脾胃的方法。
茯苓块(三钱) 浓朴(一钱) 煨肉果(一钱) 苡仁(三钱,炒制) 扁豆(二钱,炒制) 莲子(三钱,保留外皮并去除芯) 广皮炭(八分) 芡实(一钱半,保留外皮) 木香(五分)
十四日:继续采用通补兼施的方法治疗。
人参(五分) 浓朴(八分) 煨肉果(一钱) 茯苓块(二钱) 广皮炭(八分) 木香(七分) 苡仁(二钱,炒制) 藿梗(八分) 焦神曲(八分) 白扁豆(三钱,炒制) 半夏(二钱) 小茴香(一钱)
十六日:疏通并补益中焦脾胃,已经见到疗效,仍不能脱离此法。
人参(五分) 浓朴(八分) 半夏(二钱) 木香(八分) 茯苓(三钱) 煨肉果(一钱半) 苡仁(三钱,炒制) 扁豆(三钱,炒制) 藿梗(八分) 广皮炭(八分) 焦于术(一钱)
十七日:患儿精神气息和声音稍显强健,皮肤发热感也趋于平和,大有好转迹象,但积滞导致的虚弱早晚可以恢复充实。
人参(五钱) 莲子(二钱) 肉果霜(一钱半) 茯苓(三钱) 半夏(二钱) 木香(八分) 白扁豆(二钱,炒制) 广皮(一钱半) 山药(一钱半)
十八日:舌苔发黄,小便颜色黄,微有积滞,这都是脾虚无法运化的缘故,且暂时停用参类补药,增加宣通经络的方法。
茯苓(三钱) 浓朴(一钱) 煨肉果(一钱) 半夏(二钱,炒制) 鸡内金(一钱) 白蔻仁(二钱) 莲子(二钱,去芯) 木香(七分) 生苡仁(三钱) 生于术(一钱) 广皮炭(八分)
十九日:大便中有未消化的食物残渣,想吃乳食,因为乳食属于血肉有情之品,应当在疏补之中,加入消除肉食积滞的药物。
鸡内金(一钱,炒制) 楂炭(一钱) 广皮炭(一钱) 茯苓块(三钱) 煨肉果(一钱) 范曲炭(八分) 木香(七分) 川朴(一钱半) 白蔻仁(三分) 生苡仁(三钱)
二十日:脾虚火衰,则食物会出现不消化的形态;肝肾与冲脉潜伏寒邪,发怒严重时会导致疝痛。
小茴香(二钱) 生苡米(三钱) 木香(一钱) 黑楂炭(一钱半) 煨肉果(一钱半) 制茅术(一钱) 茯苓(一钱) 广皮炭(八分) 白蔻仁(五分) 青皮(六分) 乌药(八分)
二十二日:补益下焦,疏通中焦。
小茴香(一钱半,炒黑) 生苡仁(一钱半) 人参(三分) 楂炭(八分) 煨肉果(一钱) 茯苓(三钱) 制茅术(八分) 白蔻仁(五分) 木香(六分)
张姓男童,八个月大。腹泻四五天,暑邪深入下焦,头部发热如火,手脚冰冷如冰,这称为暑厥(中暑引起的昏厥)。身体消瘦瘦弱难以忍受,脉象迟而紧,未必能痊愈,暂且开具方剂以急救。先给予紫雪丹五分,分三次服用。
猪苓(二钱) 制苍术(一钱) 泽泻(一钱) 茯苓(二钱) 桂枝木(一钱) 广皮炭(七分) 白扁豆(一钱) 木香(七分)
病情略有转机,但最终结果仍令人担忧。
猪苓(二钱) 白扁豆(一钱半,炒制) 泽泻(一钱半) 半夏(一钱半) 生苡仁(三钱) 广木香(八分) 茅术炭(一钱) 浓朴(六分) 广皮炭(五分)
孟姓患儿,十五岁。八月初八日就诊:伏暑引起的泄泻,加上停食(饮食停滞),想要排便时腹痛,排便后疼痛减轻,防止演变为滞下(痢疾),给予五苓散加消食药,脉象细弦而缓。
桂枝(三钱) 云苓皮(五钱) 楂炭(二钱) 苍术炭(三钱) 神曲(四钱,炒制) 小枳实(二钱) 猪苓(三钱) 广皮炭(四钱) 川椒炭(二钱) 泽泻(三钱)
一个月后复诊,病已大好,善后调理给予调和脾胃的方药。
Zhang, male infant, 11 months old. June 13th: Prolonged diarrhea has injured the Spleen Qi; there is fear of it developing into Rou Jing (Soft Spasm, a type of spasm caused by fluid depletion and malnourishment of sinews), commonly known as Man Pi Feng (Slow Spleen Wind). The proposed treatment is to soothe and tonify the Middle Jiao (Middle Burner).
Poria Block (San Qian) Magnolia Bark (Yi Qian) Baked Myristica Seed (Yi Qian) Coix Seed (San Qian, stir-fried) White Hyacinth Bean (Er Qian, stir-fried) Lotus Seed (San Qian, with skin, heart removed) Charred Tangerine Peel (Ba Fen) Euryale Seed (Qian Ban, with skin) Aucklandia Root (Wu Fen)
June 14th: Continue with the method of unblocking and tonifying while advancing the treatment.
Ginseng Root (Wu Fen) Magnolia Bark (Ba Fen) Baked Myristica Seed (Yi Qian) Poria Block (Er Qian) Charred Tangerine Peel (Ba Fen) Aucklandia Root (Qi Fen) Coix Seed (Er Qian, stir-fried) Agastache Stem (Ba Fen) Scorched Medicated Leaven (Ba Fen) White Hyacinth Bean (San Qian, stir-fried) Pinellia Tuber (Er Qian) Small Fennel Fruit (Yi Qian)
June 16th: Soothing and tonifying the Middle Jiao has already shown efficacy; this method should still not be departed from.
Ginseng Root (Wu Fen) Magnolia Bark (Ba Fen) Pinellia Tuber (Er Qian) Aucklandia Root (Ba Fen) Poria (San Qian) Baked Myristica Seed (Qian Ban) Coix Seed (San Qian, stir-fried) White Hyacinth Bean (San Qian, stir-fried) Agastache Stem (Ba Fen) Charred Tangerine Peel (Ba Fen) Scorched Atractylodes Macrocephala Rhizome (Yi Qian)
June 17th: The spirit, breath, and voice are slightly stronger; the skin heat feels more moderate. There is significant improvement, but the deficiency caused by accumulation can be replenished soon.
Ginseng Root (Wu Qian) Lotus Seed (Er Qian) Myristica Frost (Qian Ban) Poria (San Qian) Pinellia Tuber (Er Qian) Aucklandia Root (Ba Fen) White Hyacinth Bean (Er Qian, stir-fried) Tangerine Peel (Qian Ban) Chinese Yam (Qian Ban)
June 18th: There is yellow coating on the tongue, and urine is yellow. There is slight accumulation, all due to Spleen deficiency failing to transport. Temporarily suspend Ginseng preparations and add methods to promote collateral circulation.
Poria (San Qian) Magnolia Bark (Yi Qian) Baked Myristica Seed (Yi Qian) Pinellia Tuber (Er Qian, stir-fried) Chicken Gizzard Lining (Yi Qian) White Cardamom Seed (Er Qian) Lotus Seed (Er Qian, heart removed) Aucklandia Root (Qi Fen) Raw Coix Seed (San Qian) Raw Atractylodes Macrocephala Rhizome (Yi Qian) Charred Tangerine Peel (Ba Fen)
June 19th: Undigested food shapes in stool indicate desire for milk/food. Since these are "blood and flesh sentient substances" (nutritive foods), one should add herbs that digest meat/animal-based accumulations within the framework of soothing and tonifying.
Chicken Gizzard Lining (Yi Qian, stir-fried) Charred Hawthorn Fruit (Yi Qian) Charred Tangerine Peel (Yi Qian) Poria Block (San Qian) Baked Myristica Seed (Yi Qian) Charred Medicated Leaven (Ba Fen) Aucklandia Root (Qi Fen) Sichuan Magnolia Bark (Qian Ban) White Cardamom Seed (San Fen) Raw Coix Seed (San Qian)
June 20th: Spleen deficiency and fire decline lead to undigested food forms. Latent cold in the Liver, Kidney, and Chong Mai (Penetrating Vessel) causes hernia pain when anger is severe.
Small Fennel Fruit (Er Qian) Raw Coix Seed (San Qian) Aucklandia Root (Yi Qian) Black Charred Hawthorn Fruit (Qian Ban) Baked Myristica Seed (Qian Ban) Processed Atractylodes Rhizome (Yi Qian) Poria (Yi Qian) Charred Tangerine Peel (Ba Fen) White Cardamom Seed (Wu Fen) Green Tangerine Peel (Liu Fen) Lindera Root (Ba Fen)
June 22nd: Tonify the Lower Jiao and unblock the Middle Jiao.
Small Fennel Fruit (Qian Ban, stir-fried black) Raw Coix Seed (Qian Ban) Ginseng Root (San Fen) Charred Hawthorn Fruit (Ba Fen) Baked Myristica Seed (Yi Qian) Poria (San Qian) Processed Atractylodes Rhizome (Ba Fen) White Cardamom Seed (Wu Fen) Aucklandia Root (Liu Fen)
Zhang, male infant, 8 months old. Diarrhea for four to five days. Summer-heat pathogen has penetrated deeply into the Lower Jiao. Head is hot as fire, hands and feet are cold as ice. This is called Shu Jue (Summer-Heat Collapse/Jue Syndrome). The body is emaciated and unbearable. Pulse is slow and tight. Recovery is uncertain. Prescribe a formula to save the condition. First administer Zi Xue Dan (Purple Snow Pill) 5 fen, taken in three doses.
Polyporus (Er Qian) Processed Atractylodes Lancea Rhizome (Yi Qian) Alisma Rhizome (Yi Qian) Poria (Er Qian) Cinnamon Twig Wood (Yi Qian) Charred Tangerine Peel (Qi Fen) White Hyacinth Bean (Yi Qian) Aucklandia Root (Qi Fen)
There is slight turning point, but the outcome remains fearful.
Polyporus (Er Qian) White Hyacinth Bean (Qian Ban, stir-fried) Alisma Rhizome (Qian Ban) Pinellia Tuber (Qian Ban) Raw Coix Seed (San Qian) Guangmu Xiang (Aucklandia Root) (Ba Fen) Charred Atractylodes Rhizome (Yi Qian) Magnolia Bark (Liu Fen) Charred Tangerine Peel (Wu Fen)
Meng, 15 years old. August 8th: Latent summer-heat causing diarrhea, compounded by food stagnation. Abdominal pain before defecation, pain relieved after defecation. Prevent progression to Zhixia (Dysentery). Prescribe Wu Ling San (Five-Ingredient Powder with Poria) plus food-resolving herbs. Pulse is fine, wiry, and slow.
Cinnamon Twig (San Qian) Cloud Poria Skin (Wu Qian) Charred Hawthorn Fruit (Er Qian) Charred Atractylodes Lancea Rhizome (San Qian) Medicated Leaven (Si Qian, stir-fried) Small Immature Bitter Orange (Er Qian) Polyporus (San Qian) Charred Tangerine Peel (Si Qian) Charred Sichuan Pepper (Er Qian) Alisma Rhizome (San Qian)
One month later, follow-up visit: The illness has greatly improved. For convalescence, prescribe formulas to harmonize the Spleen and Stomach.