肠梗阻
潘××，男，五十五岁，干部。1958年。
初诊：患者平日工作劳累，脾胃较弱。因伤食受寒，而致腹痛，胸闷，呕吐，便秘。服中西药物，症情不减，胸腹胀满更甚。面色青，自汗，呻吟不止。家属即送某医院，诊为急性肠梗阻及肠套叠症。立即施行外科手术。术后，患者仍感腹内胀满疼痛，大便不通，作呕，饮食不下，且有低热。
一周后，病又转剧，院方立刻召集中西医会诊，决定连夜作第二次腹腔手术。虽经二次手术，但病情仍如原状，腹胀胸闷，疼痛不休。面苍白，自汗，大便仍未通，病况危重。中医会诊：症情如上述，脉象沉细而紧，舌质淡，苔白腻。症由脾阳失运，寒湿积滞，气机壅塞，而致腑实。但因正虚，不可峻下攻逐。法当理气温中，和胃宽肠，芳香透达，以资通利。用自拟方七香汤治之。处方：
广藿香6克 伽楠沉香4．5克 广木香6克 真绛香4．5克
白檀香6克 公丁香4．5克 炒小茴香9克 大葱白2寸为引
上方连夜服三煎后，天明，腹中雷鸣，矢气频传。此气机疏通，脾阳已苏，是为佳兆。自觉得矢气后，腹痛减轻，但胀满未除。诊脉沉紧之象稍减而现弦滞，舌白腻，改用下方：
炒枳实6克(冲)炒厚朴9克广藿香6克广木香4．5克伽
楠沉香3克冲白蔻3克炒谷、麦芽各9克 烧鸡金2个
烧生姜2片小枣7个
上方服一剂后，矢气频连。晌午，大便畅下，中有硬结数枚，胸腹胀满顿觉轻舒，疼痛大减，渐思饮食。仍神倦，自汗思睡。脉弱缓，舌淡白有津。此气血双亏，心脾不足。
再用下方调理。嘱慎风寒，节饮食，静养即可康复。处方：
白人参9克(另煨兑服) 当归身12克 炒杭芍9克 白茯神
15克 白术9克枣仁15克(冲) 砂仁9克炙远志6克广
木香2．4克 炙甘草6克 大龙眼104- 莲子肉15克
[按]两番手术，中阳衰惫，无能温煦运化传导，故虽腑实胀满，岂可不虑消夺真元而妄行峻下攻逐!贵在洞察症结，本中医的气化原理着手，因症立法，按法制方，独创“七香汤”，枢转气机，宣通六腑，温暖五脏，旋解壅塞之危。继进朴枳等品，腑实畅下。病后正虚，则随用中西药物调养补益而痊。
痛 痹
梁××，女，四十五岁，住昆明市郊区。1952年7月。
初诊：患者务农数十年，风雨寒暑，常在田问。寒湿之邪侵入，伏于筋络腠理，关节时痛。此次先是沭雨受寒，恶冷发烧，头痛项强，身疼。曾服麻黄桂枝等药得汗，热虽退而周身关节疼痛不止。两足痛，浮肿，屈伸不利，行动困难。
复用中西药及药酒揉擦按摩，经月余，疼痛更甚，浮肿加剧，不能行动，乃由家属肩负前来门诊。
症见形体赢瘦，脚肿如脱。脉沉紧而弦，舌质淡，苔白腻。是属寒湿痹于筋脉关节肌肉之间，遂剧痛，不可屈伸。
所谓寒气胜者真痛痹也。拟宗金匮法：以乌头汤加味治之。
处方：
炙川乌30克(开水先煨透) 细辛4．5克 去节麻黄9克 炒白
芍9克 甘草3克 生黄芪18克 怀牛夕9克 桑枝24克
生姜15克 大枣5枚
加用外治法：用好矾石60克加水1500毫升，煎煮令沸，每日浸泡两足二至三次。
二诊：上方连服五剂，患者两足浮肿显著消退，关节肌肉疼痛轻减。由于久病，体虚足软，尚不能起立行动。诊脉紧象已减，尚弦细，舌淡白有滓，苔腻较退。症势缓解，续拟下方为治：
炙川乌18克 川附片1 8克(上二味开水先煨透) 去节麻黄6克
细辛3克 生黄芪15克 全当归12克 炒白芍9克 桂枝木
6克 桑枝18克 苡仁12克 甘草3克 大枣5枚 生姜
片9克
续用外治法同前。
三诊：上方连服十余剂，兼用外治法，已能柱杖行走前来就诊，两足浮肿将消失，周身疼痛大减。饮食日增，但身体瘦弱，感精神尚差。诊脉转现弱缓调和，舌白淡。此乃气弱血虚，筋络未强。拟宗崔氏八味丸，调理善后。处方：
干地黄90克 山萸肉30克 炒淮药90克 泽泻60克 云茯
苓90克 粉丹皮60克 川附片120克(开水先煨透) 桂枝60克
全当归90克 白芍60克
以上各昧，共为细末，炼蜜为丸，梧桐子大。每服十丸，温酒送服。
[按]沐雨爱寒，邪舍脾肾，重感于寒湿之气而发为痛痹。经云：“痛者，寒气多也，有寒故痛也。”寒湿内伏，性粘滞，加以症重体赢，致病缠绵。方用大剂加味乌头汤，温经散寒，以治其标，再拟加味崔氏八味丸，以固其本。标本先后，内外配合，获取卓效．
风湿、闭经、心悸
孙××，女，十七岁，学生，住昆明市。1960年9月。
初诊：患者幼年感受风湿，每当气候转变，或遇寒饮冷，则关节疼痛，迄未彻底治疗，病情逐渐加重。面目肢体出现浮肿，经候不调，常三、四月始一行，色暗红有块状，腹痛腰楚，胸胁不适，常见头晕神倦，食少乏力， 口干溺黄，阵作心悸，夜烦失眠，梦境纷云。经某医院诊断为“风湿性心脏病”。
诊脉沉细微弦，舌边尖红，苔薄白。此属风湿阻络，气血失调，心神不足之候。治宜驱风除湿，调和气血，舒达肝脾。拟方如下：
炒柴胡9克 炒杭芍9克 全当归15克 川芎片6克 炒苍
术9克 川独活6克桑枝木15克桂枝木9克炙香附6克
粉丹皮4．5克 茯苓神12克 生姜2片 小枣11+
二诊：服上方五剂后，诸症稍减，脉弦涪，仍有风湿阻络血虚气滞。续以调经、舒络、除湿。处方：
全当归15克 川芎6克 炒杭芍9克 紫丹参15克 桑枝
木15克 川独活9克 伸筋草15克 粉丹皮4．5克 焦栀
子3克 茯苓15克 生三七4．5克(研细末分次兑服)
三诊：上方服七剂，经汛遂通，腹痛、腰楚减除，面目浮肿渐消，关节痛减，夜能安卧，心悸较平。饮食略增，小便淡黄。脉细弦，舌淡红。此风湿渐化，气血得舒。续拟养心安神、舒筋活络之剂。处方：
柏子仁12克 白檀香3克 全当归12克 茯神木15克桑寄
生15克 川独活6克炙远志6克紫丹参9克炒苍术9克
竹茹4．5克 炒苡仁15克 桂元11个
上方服七剂后，病愈出院。
[按]风湿痹于筋络，血脉凝泣，汛期停滞，而致心悸。
内经云：“必伏其所主，而先其所因”。若但见动悸，即纯滋补，心使风湿内闭，后患无穷!方以祛风除湿，活血通经，兼调肝脾。风湿化除，经汛得通，再进养益，心神即安。
消 渴(一)
外宾某，男，四十岁。1959年7月。
初诊：患者世居热带，嗜烟酒，喜冷饮，面色黧黑晦暗，体形胖壅，望而知为湿痰内滞之体。自述染患糖尿病已数年，每日需饮水数十杯，小便频数，夜间尤甚，影响睡眠，且溺色黄浊，似油脂浮于其上。但饮食不减，身体愈趋肥胖，化验检查，尿糖血糖均高。多方治疗，效果不显。余往诊时，除见上述病情外，患者且感头眩，身困重，足软无力，口燥思饮，时有痰凝作咳。诊脉弦滑，舌苔干黄。此属消渴日久，脾肾阴虚，胃火内炽，津液不升，湿热痰浊不化。权宜清热化湿，后当“壮水之主”。处方：
粉葛根9克 天花粉9克 白元参9克 麦门冬9克 京半
夏9克川贝母6克(冲) 广桔络9克 生石膏12克(打碎)
淡竹叶6克茯苓12克苡仁12克
二诊：上方服五剂，患者渴饮略少，溺色转淡，次数稍减。舌苔较润，脉仍细弦而滑。时咳嗽，痰凝，夜卧不安。
此消渴渐退，病久阴虚脾弱，湿痰未化，续以上方加减：
白元参9克麦门冬9克 自茯神15克 炒知母6克 粉葛
根9克 天花粉9克鲜芦根18克半夏曲9克广桔络9克
京竹叶30片．净杷叶3片
三诊：上方复进五剂后，患者小便次数尤减，质渐清，色转淡。虽口燥思饮，而量已不多，咳嗽渐稀，尚有痰凝。
夜能入睡，多梦。已能单独下楼散步。自述头眩轻减，肢体较前轻松灵活，壅肿日消。脉弦滑渐平，舌润，苔黄已退。
此消渴症逐渐好转，而脾肾未足，心神不宁。拟方：
枣仁15克(冲) 茯神15克炒知母6克 天花粉9克 粉葛
根9克 金石斛9克广桔络9克炒杭芍9克京半夏9克
鲜芦根15克 净杷叶3片 竹茹6克
四诊：上方续服五剂，饮水大减，已不觉口渴。经化验，尿糖血糖正常。面色由晦暗转现红润。咳少，痰凝渐涤。每夜均能入睡，尚有梦境。舌红润，脉和缓。多年痼疾，一旦减轻，患者心情舒畅，对我国医学深感敬佩。为彻底根治，因拟善后调理之方如下：
干地黄12克淮山药12克茯神15克粉丹皮6克枣皮6克
(炒) 泽泻6克粉葛根9克 天花粉9克 京半夏9克
广桔络9克枣仁15克(冲) 净杷叶3片
某医院赠送该外宾蜜炙六味地黄丸十斤，嘱其每日早晚各服一丸(约9克)。1962年来函，谓病已痊愈，并未复发，特致谢云。
[按]先以清凉甘淡，润燥生津，祛湿化痰，利肺止咳，为其清除体内蕴郁已久之湿热痰浊，使肺、脾、肾之功能改进。因而气机豁达，津液上升，化源资布。继用养心安神，滋益脾肾之法，巩固疗效。
潘××，男性，55岁，干部。1958年就诊。
初诊：患者平时工作劳累，脾胃功能较弱。因饮食不节且受寒邪侵袭，导致腹痛、胸闷、呕吐、便秘。服用中西药物后，症状未减轻，胸腹胀满反而加重。面色发青，自汗出，呻吟不止。家属随即送其至某医院，诊断为急性肠梗阻及肠套叠症。立即施行外科手术。术后，患者仍感觉腹内胀满疼痛，大便不通，作呕，无法进食，并伴有低热。
一周后，病情再次加剧，医院立即召集中西医专家会诊，决定连夜进行第二次腹腔手术。虽然进行了二次手术，但病情仍无改善，腹胀胸闷，疼痛持续不断。面色苍白，自汗出，大便仍未通畅，病势危重。中医会诊意见：症状如上述，脉象沉细而紧，舌质淡，苔白腻。此证由脾阳失于运化，寒湿积滞，气机壅塞，导致腑实（六腑之气闭塞不通）。但因正气虚弱，不可使用峻猛攻下的方法。治法应当理气温中，和胃宽肠，芳香透达，以助通利。使用自拟方“七香汤”治疗。处方如下：
广藿香6克 伽楠沉香4.5克 广木香6克 真绛香4.5克
白檀香6克 公丁香4.5克 炒小茴香9克 大葱白2寸为引药
上方连夜煎服三剂后，天亮时，腹中肠鸣音明显，频繁排气。这是气机疏通，脾阳恢复的迹象，属于佳兆。患者自觉排气后，腹痛减轻，但胀满感未消除。诊脉沉紧之象稍减，转为弦滞，舌苔白腻。改用下方：
炒枳实6克（冲服） 炒厚朴9克 广藿香6克 广木香4.5克 伽楠沉香3克（冲服） 白蔻仁3克 炒谷芽、麦芽各9克 烧鸡内金2个
烧生姜2片 大枣7个
上方服用一剂后，排气连续不断。中午，大便通畅排出，其中有硬结数枚，胸腹胀满顿觉轻松，疼痛大减，开始有食欲。但仍神疲乏力，自汗，想睡觉。脉弱缓，舌淡白而有津液。此为气血双亏，心脾不足。
再用下方调理。嘱咐注意防风寒，节制饮食，静养即可康复。处方如下：
白人参9克（另炖兑服） 当归身12克 炒杭芍9克 白茯神15克 白术9克 枣仁15克（冲服） 砂仁9克 炙远志6克 广木香2.4克 炙甘草6克 大龙眼肉10个 莲子肉15克
[按语]经过两次手术，中焦阳气衰惫，无力温煦、运化和传导，因此虽然存在腑实胀满，岂能不顾虑消耗真元而妄行峻猛攻下！关键在于洞察病症关键，从中医的气化原理着手，因症立法，按法制方，独创“七香汤”，枢转气机，宣通六腑，温暖五脏，解除壅塞之危。继用厚朴、枳实等药物，使腑实通畅排出。病后正气虚弱，则随用中西药物调养补益而痊愈。
梁××，女性，45岁，住昆明市郊区。1952年7月就诊。
初诊：患者务农数十年，风雨寒暑常在田间劳作。寒湿之邪侵入，伏留于筋络腠理，关节时常疼痛。此次先是淋雨受寒，恶冷发烧，头痛项强，身体疼痛。曾服用麻黄、桂枝等药物发汗，热虽退但周身关节疼痛不止。两足疼痛，浮肿，屈伸不利，行动困难。
又复用中西药及药酒揉擦按摩，经一个多月，疼痛更甚，浮肿加剧，不能行动，乃由家属背负前来门诊。
症见形体消瘦，脚肿如脱。脉沉紧而弦，舌质淡，苔白腻。这是寒湿痹阻于筋脉关节肌肉之间，遂致剧痛，不可屈伸。
所谓寒气胜者为真痛痹也。拟遵循《金匮要略》之法：以乌头汤加味治疗。
处方：
炙川乌30克（开水先煨透） 细辛4.5克 去节麻黄9克 炒白芍9克 甘草3克 生黄芪18克 怀牛膝9克 桑枝24克
生姜15克 大枣5枚
加用外治法：用好矾石60克加水1500毫升，煎煮令沸，每日浸泡两足二至三次。
二诊：上方连服五剂，患者两足浮肿显著消退，关节肌肉疼痛减轻。由于久病，体虚足软，尚不能起立行动。诊脉紧象已减，尚弦细，舌淡白有津，苔腻较退。症势缓解，续拟下方为治：
炙川乌18克 川附片18克（上二味开水先煨透） 去节麻黄6克 细辛3克 生黄芪15克 全当归12克 炒白芍9克 桂枝木6克 桑枝18克 苡仁12克 甘草3克 大枣5枚 生姜片9克
续用外治法同前。
三诊：上方连服十余剂，兼用外治法，已能拄杖行走前来就诊，两足浮肿将消失，周身疼痛大减。饮食日增，但身体瘦弱，感精神尚差。诊脉转现弱缓调和，舌白淡。此乃气弱血虚，筋络未强。拟遵循崔氏八味丸之法，调理善后。处方：
干地黄90克 山萸肉30克 炒淮山药90克 泽泻60克 云茯苓90克 粉丹皮60克 川附片120克（开水先煨透） 桂枝60克
全当归90克 白芍60克
以上各味，共为细末，炼蜜为丸，梧桐子大。每服十丸，温酒送服。
[按语]淋雨爱寒，邪气舍于脾肾，重感于寒湿之气而发为痛痹。《内经》云：“痛者，寒气多也，有寒故痛也。”寒湿内伏，性质粘滞，加之症重体弱，致病缠绵难愈。方用大剂加味乌头汤，温经散寒，以治其标；再拟加味崔氏八味丸，以固其本。标本先后，内外配合，获取卓效。
风湿、闭经、心悸
孙××，女性，17岁，学生，住昆明市。1960年9月就诊。
初诊：患者幼年感受风湿，每当气候转变，或遇寒饮冷，则关节疼痛，迄未彻底治疗，病情逐渐加重。面目肢体出现浮肿，月经不调，常三、四月始一行，色暗红有块状，腹痛腰楚，胸胁不适，常见头晕神倦，食少乏力，口干溺黄，阵作心悸，夜烦失眠，梦境纷纭。经某医院诊断为“风湿性心脏病”。
诊脉沉细微弦，舌边尖红，苔薄白。此属风湿阻络，气血失调，心神不足之候。治宜驱风除湿，调和气血，舒达肝脾。拟方如下：
炒柴胡9克 炒杭芍9克 全当归15克 川芎片6克 炒苍术9克 川独活6克 桑枝木15克 桂枝木9克 炙香附6克 粉丹皮4.5克 茯苓神12克 生姜2片 小枣11个
二诊：服上方五剂后，诸症稍减，脉弦滑，仍有风湿阻络血虚气滞。续以调经、舒络、除湿。处方：
全当归15克 川芎6克 炒杭芍9克 紫丹参15克 桑枝木15克 川独活9克 伸筋草15克 粉丹皮4.5克 焦栀子3克 茯苓15克 生三七4.5克（研细末分次兑服）
三诊：上方服七剂，月经遂通，腹痛、腰楚减除，面目浮肿渐消，关节痛减，夜能安卧，心悸较平。饮食略增，小便淡黄。脉细弦，舌淡红。此风湿渐化，气血得舒。续拟养心安神、舒筋活络之剂。处方：
柏子仁12克 白檀香3克 全当归12克 茯神木15克 桑寄生15克 川独活6克 炙远志6克 紫丹参9克 炒苍术9克 竹茹4.5克 炒苡仁15克 桂圆肉11个
上方服七剂后，病愈出院。
[按语]风湿痹阻于筋络，血脉凝涩，经期停滞，而致心悸。《内经》云：“必伏其所主，而先其所因”。若但见动悸，即纯滋补，必使风湿内闭，后患无穷！方以祛风除湿，活血通经，兼调肝脾。风湿化除，经汛得通，再进养益，心神即安。
消渴（一）
外宾某，男性，40岁。1959年7月就诊。
初诊：患者世居热带，嗜烟酒，喜冷饮，面色黧黑晦暗，体形胖壅，望而知为湿痰内滞之体。自述染患糖尿病已数年，每日需饮水数十杯，小便频数，夜间尤甚，影响睡眠，且溺色黄浊，似油脂浮于其上。但饮食不减，身体愈趋肥胖，化验检查，尿糖血糖均高。多方治疗，效果不显。余往诊时，除见上述病情外，患者且感头眩，身困重，足软无力，口燥思饮，时有痰凝作咳。诊脉弦滑，舌苔干黄。此属消渴日久，脾肾阴虚，胃火内炽，津液不升，湿热痰浊不化。权宜清热化湿，后当“壮水之主”（滋阴补肾）。处方：
粉葛根9克 天花粉9克 白元参9克 麦门冬9克 京半夏9克 川贝母6克（冲服） 广桔络9克 生石膏12克（打碎） 淡竹叶6克 茯苓12克 苡仁12克
二诊：上方服五剂，患者渴饮略少，溺色转淡，次数稍减。舌苔较润，脉仍细弦而滑。时咳嗽，痰凝，夜卧不安。
此消渴渐退，病久阴虚脾弱，湿痰未化，续以上方加减：
白元参9克 麦门冬9克 白茯神15克 炒知母6克 粉葛根9克 天花粉9克 鲜芦根18克 半夏曲9克 广桔络9克 京竹叶30片 净杷叶3片
三诊：上方复进五剂后，患者小便次数尤减，质渐清，色转淡。虽口燥思饮，而量已不多，咳嗽渐稀，尚有痰凝。
夜能入睡，多梦。已能单独下楼散步。自述头眩轻减，肢体较前轻松灵活，壅肿日消。脉弦滑渐平，舌润，苔黄已退。
此消渴症逐渐好转，而脾肾未足，心神不宁。拟方：
枣仁15克（冲服） 茯神15克 炒知母6克 天花粉9克 粉葛根9克 金石斛9克 广桔络9克 炒杭芍9克 京半夏9克 鲜芦根15克 净杷叶3片 竹茹6克
四诊：上方续服五剂，饮水大减，已不觉口渴。经化验，尿糖血糖正常。面色由晦暗转现红润。咳少，痰凝渐涤。每夜均能入睡，尚有梦境。舌红润，脉和缓。多年痼疾，一旦减轻，患者心情舒畅，对我国医学深感敬佩。为彻底根治，因拟善后调理之方如下：
干地黄12克 淮山药12克 茯神15克 粉丹皮6克 枣皮6克（炒） 泽泻6克 粉葛根9克 天花粉9克 京半夏9克 广桔络9克 枣仁15克（冲服） 净杷叶3片
某医院赠送该外宾蜜炙六味地黄丸十斤，嘱其每日早晚各服一丸（约9克）。1962年来函，谓病已痊愈，并未复发，特致谢云。
[按语]先以清凉甘淡，润燥生津，祛湿化痰，利肺止咳，为其清除体内蕴郁已久之湿热痰浊，使肺、脾、肾之功能改进。因而气机豁达，津液上升，化源资布。继用养心安神，滋益脾肾之法，巩固疗效。
Intestinal Obstruction
Pan XX, male, 55 years old, cadre. Visited in 1958.
First visit: The patient usually worked hard and had weak Spleen and Stomach functions. Due to dietary injury and cold pathogen invasion, he developed abdominal pain, chest tightness, vomiting, and constipation. After taking Chinese and Western medicines, the symptoms did not subside, and chest and abdominal distension worsened. His complexion was bluish, he sweated spontaneously, and groaned incessantly. His family sent him to a certain hospital immediately, where he was diagnosed with acute intestinal obstruction and intussusception. Emergency surgery was performed. Post-operatively, the patient still felt abdominal distension and pain, could not pass stool, vomited, could not eat, and had low-grade fever.
One week later, the condition deteriorated again. The hospital immediately convened a joint consultation of Chinese and Western medicine doctors and decided to perform a second abdominal surgery overnight. Although two surgeries were performed, the condition remained unchanged: abdominal distension, chest tightness, and continuous pain. His face was pale, he sweated spontaneously, and stool was still not passed. The condition was critical. Chinese medicine consultation opinion: Symptoms as described above; pulse is deep, fine, and tight; tongue body is pale with white greasy coating. This syndrome is caused by the failure of Spleen Yang to transport, accumulation of cold-dampness, stagnation of Qi mechanism, leading to Fu-organ excess (obstruction of Qi in the six Fu organs). However, due to deficiency of healthy Qi, harsh purgative methods should not be used. The treatment method should regulate Qi and warm the middle, harmonize the Stomach and widen the intestines, use aromatic penetrating herbs to facilitate unblocking. A self-formulated prescription "Qi Xiang Tang" (Seven Fragrance Decoction) was used for treatment. Prescription:
Pogostemonis Herba (Guang Huo Xiang) 6g
Aquilariae Lignum Resinatum (Qie Nan Chen Xiang) 4.5g
Aucklandiae Radix (Guang Mu Xiang) 6g
Lignum Aquilariae Resinatum (Zhen Jiang Xiang) 4.5g
Santalum Albumi Lignum (Bai Tan Xiang) 6g
Syzygdii Flos (Gong Ding Xiang) 4.5g
Foeniculi Fructus (Chao Xiao Hui Xiang) 9g
Allii Fistulosi Bulbus (Da Cong Bai) 2 cun as a guide drug
After taking three doses of the above prescription overnight, loud borborygmus occurred at dawn, and frequent flatus was passed. This indicates that the Qi mechanism is unblocked and Spleen Yang has recovered, which is a good omen. The patient felt that abdominal pain decreased after passing flatus, but distension remained. Pulse was slightly less deep and tight, becoming wiry and stagnant; tongue coating was white and greasy. Changed to the following prescription:
Immature Bitter Orange (Chao Zhi Shi) 6g (taken with decoction)
Magnoliae Officinalis Cortex (Chao Hou Po) 9g
Pogostemonis Herba (Guang Huo Xiang) 6g
Aucklandiae Radix (Guang Mu Xiang) 4.5g
Aquilariae Lignum Resinatum (Qie Nan Chen Xiang) 3g (taken with decoction)
Amomi Rotundus Fructus (Bai Kou Ren) 3g
Hordei Fructus Germinatus (Chao Gu Ya) and Setariae Fructus Germinatus (Chao Mai Ya) each 9g
Roasted Gallbladder of Chicken (Shao Ji Jin) 2 pieces
Roasted Ginger (Shao Sheng Jiang) 2 slices
Jujubae Fructus (Da Zao) 7 pieces
After taking one dose of the above prescription, flatus was passed continuously. At noon, stool was smoothly discharged, containing several hard masses. Chest and abdominal distension suddenly relieved, pain greatly reduced, and appetite gradually returned. However, he was still mentally fatigued, sweating spontaneously, and sleepy. Pulse was weak and slow; tongue was pale white with moisture. This indicates dual deficiency of Qi and Blood, and insufficiency of Heart and Spleen.
Used the following prescription for regulation. Advised to avoid wind and cold, control diet, and rest quietly for recovery. Prescription:
Codonopsis Radix (Bai Ren Shen) 9g (simmered separately and mixed in)
Angelicae Sinensis Radix (Dang Gui Shen) 12g
Paeoniae Radix Alba (Chao Hang Shao) 9g
Poria Cum Radix Pini (Bai Fu Shen) 15g
Atractylodis Macrocephalae Rhizoma (Bai Zhu) 9g
Ziziphi Spinosae Semen (Zao Ren) 15g (taken with decoction)
Amomi Fructus (Sha Ren) 9g
Polygalae Radix (Zhi Yuan Zhi) 6g
Aucklandiae Radix (Guang Mu Xiang) 2.4g
Licorice Root (Zhi Gan Cao) 6g
Longan Aril (Da Long Yan Rou) 10 pieces
Lotus Seed (Lian Zi Rou) 15g
[Commentary] After two surgeries, Middle Jiao Yang is exhausted and unable to warm, transport, and conduct. Therefore, although there is Fu-organ excess and distension, one must not recklessly use harsh purgatives that consume true Yuan Qi! The key lies in insight into the crux of the syndrome, starting from the principle of Qi transformation in Chinese medicine, establishing laws based on symptoms, and prescribing according to laws. The独创 "Qi Xiang Tang" pivots the Qi mechanism, promotes the six Fu organs, warms the five Zang organs, and resolves the crisis of stagnation. Subsequently, using Magnoliae Officinalis Cortex and Immature Bitter Orange, the Fu-organ excess was smoothly discharged. Post-illness healthy Qi deficiency was treated with Chinese and Western medicines for nourishment and tonification, leading to recovery.
Bi Pain Syndrome
Liang XX, female, 45 years old, living in the suburbs of Kunming City. Visited in July 1952.
First visit: The patient worked as a farmer for decades, often working in fields regardless of wind, rain, cold, or heat. Cold-damp pathogens invaded and lodged in the sinews, collaterals, and interstices, causing intermittent joint pain. This time, she first caught rain and cold, experiencing aversion to cold, fever, headache, stiff neck, and body pain. She took Ephedrae Herba (Mahuang) and Cinnamomi Ramulus (Guizhi) etc., induced sweating, fever subsided, but joint pain throughout the body persisted. Both feet were painful and edematous, with limited flexion and extension, making movement difficult.
She then used Chinese and Western medicines and medicinal wine for rubbing, massage, etc. After more than a month, pain worsened, edema increased, and she could not move. She was carried by her family to the outpatient clinic.
Symptoms showed emaciated body, swollen feet as if detached. Pulse was deep, tight, and wiry; tongue body was pale with white greasy coating. This belongs to cold-damp Bi syndrome obstructing sinews, collaterals, joints, muscles, and tissues, resulting in severe pain and inability to flex or extend.
It is said that when cold qi prevails, it is true Bi pain. Following the method of *Jin Gui Yao Lue*, treating with Wu Tou Tang modified.
Prescription:
Prepared Aconitum Carmichaelii Radix (Zhi Chuan Wu) 30g (pre-boiled thoroughly in boiling water)
Asari Radix et Rhizoma (Xi Xin) 4.5g
Ephedrae Herba (Qu Jie Mahuang) 9g
Prepared Paeoniae Radix Alba (Chao Bai Shao) 9g
Licorice Root (Gan Cao) 3g
Astragali Membranaceus Radix (Sheng Huang Qi) 18g
Achyranthis Bidentatae Radix (Huai Niu Xi) 9g
Mori Ramulus (Sang Zhi) 24g
Zingiberis Rhizoma Recens (Sheng Jiang) 15g
Jujubae Fructus (Da Zao) 5 pieces
Added external treatment: Use 60g of Alum (Hao Fan Shi) added to 1500ml of water, boil, and soak both feet twice to three times daily.
Second visit: After taking five doses of the above prescription, edema in both feet significantly subsided, and joint and muscle pain decreased. Due to chronic illness, body weakness and leg weakness, she still could not stand or walk. Pulse tightness had decreased, remaining wiry and fine; tongue was pale white with moisture, coating less greasy. Condition alleviated, continuing with the following prescription:
Prepared Aconitum Carmichaelii Radix (Zhi Chuan Wu) 18g
Prepared Aconiti Lateralis Radix Praeparata (Chuan Fu Pian) 18g (Both pre-boiled thoroughly in boiling water)
Ephedrae Herba (Qu Jie Mahuang) 6g
Asari Radix et Rhizoma (Xi Xin) 3g
Astragali Membranaceus Radix (Sheng Huang Qi) 15g
Angelicae Sinensis Radix (Quan Dang Gui) 12g
Prepared Paeoniae Radix Alba (Chao Bai Shao) 9g
Cinnamomi Ramulus (Gui Zhi Mu) 6g
Mori Ramulus (Sang Zhi) 18g
Coix Seed (Yi Yi Ren) 12g
Licorice Root (Gan Cao) 3g
Jujubae Fructus (Da Zao) 5 pieces
Zingiberis Rhizoma (Sheng Jiang Pian) 9g
Continue external treatment as before.
Third visit: After taking more than ten doses of the above prescription combined with external treatment, she could walk with a cane to the clinic. Edema in both feet was about to disappear, and whole-body pain greatly reduced. Food intake increased daily, but body was thin and spirit was poor. Pulse became weak, slow, and harmonious; tongue was pale white. This indicates Qi weakness and Blood deficiency, with sinews and collaterals not yet strong. Following the method of Cui Shi Ba Wei Wan (Dr. Cui's Eight-Ingredient Pill), for regulation and follow-up care. Prescription:
Rehmanniae Radix Preparata (Gan Di Huang) 90g
Corni Fructus (Shan Yu Rou) 30g
Dioscoreae Rhizoma (Chao Huai Yao) 90g
Alismatis Rhizoma (Ze Xie) 60g
Poria (Yun Fu Ling) 90g
Moutan Cortex (Fen Dan Pi) 60g
Prepared Aconiti Lateralis Radix Praeparata (Chuan Fu Pian) 120g (pre-boiled thoroughly in boiling water)
Cinnamomi Ramulus (Gui Zhi) 60g
Angelicae Sinensis Radix (Quan Dang Gui) 90g
Paeoniae Radix Alba (Bai Shao) 60g
All ingredients were ground into fine powder, made into pills with refined honey, size of paulownia seeds. Take 10 pills per dose, washed down with warm wine.
[Commentary] Exposure to rain and cold causes pathogens to lodge in Spleen and Kidney. Heavy exposure to cold-damp qi leads to Bi pain syndrome. *Nei Jing* states: "Pain is caused by excessive cold qi; because there is cold, there is pain." Cold-dampness lodges internally, its nature being sticky and stagnant. Combined with severe symptoms and weak constitution, the disease becomes lingering. Using a large dose of modified Wu Tou Tang to warm meridians and dispel cold treats the branch (symptoms); subsequently using modified Cui Shi Ba Wei Wan consolidates the root (constitution). Treating branch and root sequentially, combining internal and external treatments, achieved excellent results.
Wind-Dampness, Amenorrhea, Palpitations
Sun XX, female, 17 years old, student, living in Kunming City. Visited in September 1960.
First visit: The patient contracted wind-dampness in childhood. Whenever climate changed or she encountered cold drinks/cold food, joint pain occurred. It was never completely treated, and the condition gradually worsened. Edema appeared on face, limbs. Menstruation was irregular, occurring only once every three to four months, dark red with clots, abdominal pain, sore waist, chest and hypochondriac discomfort. Commonly experienced dizziness, mental fatigue, poor appetite, weakness, dry mouth, yellow urine, episodic palpitations, nighttime irritability, insomnia, and vivid dreams. Diagnosed with "Rheumatic Heart Disease" at a certain hospital.
Pulse was deep, fine, slightly wiry; tongue edges and tip were red, coating thin and white. This belongs to wind-dampness obstructing collaterals, Qi and Blood imbalance, and Heart Spirit insufficiency. Treatment should expel wind and remove dampness, harmonize Qi and Blood, soothe Liver and Spleen. Prescribed as follows:
Bupleuri Radix (Chao Chai Hu) 9g
Paeoniae Radix Alba (Chao Hang Shao) 9g
Angelicae Sinensis Radix (Quan Dang Gui) 15g
Ligustici Chuanxiong Rhizoma (Chuan Xiong Pian) 6g
Atractylodis Rhizoma (Chao Cang Zhu) 9g
Angelicae Pubescentis Radix (Chuan Du Huo) 6g
Mori Ramulus (Sang Zhi Mu) 15g
Cinnamomi Ramulus (Gui Zhi Mu) 9g
Cyperi Rhizoma (Zhi Xiang Fu) 6g
Moutan Cortex (Fen Dan Pi) 4.5g
Poria Cum Radice Pini (Fu Ling Shen) 12g
Zingiberis Rhizoma Recens (Sheng Jiang) 2 slices
Jujubae Fructus (Xiao Zao) 11 pieces
Second visit: After taking five doses of the above prescription, symptoms slightly decreased, pulse became wiry and slippery, indicating wind-dampness obstructing collaterals, Blood deficiency, and Qi stagnation. Continued with regulating menstruation, soothing collaterals, removing dampness. Prescription:
Angelicae Sinensis Radix (Quan Dang Gui) 15g
Ligustici Chuanxiong Rhizoma (Chuan Xiong) 6g
Paeoniae Radix Alba (Chao Hang Shao) 9g
Salviae Miltiorrhizae Radix (Zi Dan Shen) 15g
Mori Ramulus (Sang Zhi Mu) 15g
Angelicae Pubescentis Radix (Chuan Du Huo) 9g
Lycopi Herba (Shen Jin Cao) 15g
Moutan Cortex (Fen Dan Pi) 4.5g
Gardeniae Fructus (Jiao Zhi Zi) 3g
Poria (Fu Ling) 15g
Notoginseng Radix et Rhizoma (Sheng San Qi) 4.5g (ground into fine powder, taken in divided doses)
Third visit: After taking seven doses of the above prescription, menstruation flowed, abdominal pain and waist soreness disappeared, facial and limb edema gradually subsided, joint pain decreased, able to sleep peacefully at night, palpitations stabilized. Food intake slightly increased, urine pale yellow. Pulse fine and wiry, tongue pale red. Wind-dampness is gradually resolving, Qi and Blood are smoothing out. Continuing with formulas to nourish Heart, calm Spirit, soothe sinews, and activate collaterals. Prescription:
Platycladi Semen (Bai Zi Ren) 12g
Santalum Albumi Lignum (Bai Tan Xiang) 3g
Angelicae Sinensis Radix (Quan Dang Gui) 12g
Poria Cum Radice Pini (Fu Shen Mu) 15g
Eucommiae Cortex (Sang Ji Sheng) 15g
Angelicae Pubescentis Radix (Chuan Du Huo) 6g
Polygalae Radix (Zhi Yuan Zhi) 6g
Salviae Miltiorrhizae Radix (Zi Dan Shen) 9g
Atractylodis Rhizoma (Chao Cang Zhu) 9g
Bambusae Folium (Zhu Ru) 4.5g
Coix Seed (Chao Yi Yi Ren) 15g
Longan Aril (Gui Yuan) 11 pieces
After taking seven doses of the above prescription, the patient recovered and was discharged.
[Commentary] Wind-dampness bi obstructs sinews and collaterals, blood vessels coagulate and stagnate, menstrual period stops, leading to palpitations. *Nei Jing* states: "Must subdue what dominates, and first address the cause." If one only sees palpitations and uses pure tonification, it will inevitably cause wind-dampness to close internally, leading to endless troubles! The formula expels wind and removes dampness, invigorates Blood and unblocks meridians, while simultaneously regulating Liver and Spleen. Once wind-dampness is resolved and menstruation flows, further nourishment calms the Heart Spirit.
Xiao Ke (Diabetes Mellitus) (Part 1)
Foreign guest XX, male, 40 years old. Visited in July 1959.
First visit: The patient lived in the tropics all his life, indulged in tobacco and alcohol, preferred cold drinks. Complexion was dark and dull, body shape obese and bloated. Visual inspection revealed a constitution with internal stagnation of damp-phlegm. He stated he had suffered from diabetes for several years, needing to drink dozens of cups of water daily. Urination was frequent, especially at night, affecting sleep. Urine color was yellow and turbid, resembling oil floating on top. Food intake did not decrease, body became increasingly obese. Laboratory tests showed high urine sugar and blood sugar. Multiple treatments showed little effect. When I examined him, besides the above conditions, he also complained of dizziness, heavy body, weak legs, dry mouth desiring drink, and occasional phlegm congestion with cough. Pulse was wiry and slippery; tongue coating was dry and yellow. This belongs to long-standing Xiao Ke, Yin deficiency of Spleen and Kidney, blazing Stomach fire, failure of fluids to ascend, and non-transformation of damp-heat and turbid phlegm. Temporarily clear heat and transform dampness; later, "strengthen the master of Water" (nourish Kidney Yin). Prescription:
Puerariae Lobatae Radix (Fen Ge Gen) 9g
Trichosanthis Radix (Tian Hua Fen) 9g
Scrophulariae Radix (Bai Yuan Shen) 9g
Ophiopogonis Radix (Mai Men Dong) 9g
Pinelliae Rhizoma (Jing Ban Xia) 9g
Fritillariae Thunbergii Bulbus (Chuan Bei Mu) 6g (taken with decoction)
Citri Reticulatae Pericarpium Viride (Guang Ju Luo) 9g
Gypsum Fibrosum (Sheng Shi Gao) 12g (crushed)
Lophatheri Herba (Dan Zhu Ye) 6g
Poria (Fu Ling) 12g
Coix Seed (Yi Yi Ren) 12g
Second visit: After taking five doses of the above prescription, thirst and drinking slightly decreased, urine color turned lighter, frequency slightly reduced. Tongue coating became moister, pulse remained fine, wiry, and slippery. Occasional cough, phlegm congestion, restless sleep at night.
This indicates Xiao Ke is gradually receding, but due to long illness, Yin deficiency and Spleen weakness remain, and damp-phlegm has not transformed. Continue with modifications of the above prescription:
Scrophulariae Radix (Bai Yuan Shen) 9g
Ophiopogonis Radix (Mai Men Dong) 9g
Poria Cum Radice Pini (Bai Fu Shen) 15g
Anemarrhenae Rhizoma (Chao Zhi Mu) 6g
Puerariae Lobatae Radix (Fen Ge Gen) 9g
Trichosanthis Radix (Tian Hua Fen) 9g
Phragmitis Rhizoma (Xian Lu Gen) 18g
Curared Pinelliae Rhizoma (Ban Xia Qu) 9g
Citri Reticulatae Pericarpium Viride (Guang Ju Luo) 9g
Lophatheri Herba (Jing Zhu Ye) 30 leaves
Fritillariae Cirrhosae Bulbus (Jing Pa Ye) 3 pieces
Third visit: After taking another five doses of the above prescription, urine frequency further decreased, quality became clearer, color lighter. Although mouth was dry and desired drink, volume was small. Cough gradually稀 (sparse), phlegm congestion remained.
Able to sleep at night, with many dreams. Able to go downstairs alone for walks. Self-reported dizziness lightened, limbs felt lighter and more flexible, bloating subsided daily. Pulse wiry and slippery gradually flattened, tongue moist, yellow coating retreated.
This indicates Xiao Ke is gradually improving, but Spleen and Kidney are insufficient, and Heart Spirit is unsettled. Prescribed:
Ziziphi Spinosae Semen (Zao Ren) 15g (taken with decoction)
Poria Cum Radice Pini (Fu Shen) 15g
Anemarrhenae Rhizoma (Chao Zhi Mu) 6g
Trichosanthis Radix (Tian Hua Fen) 9g
Puerariae Lobatae Radix (Fen Ge Gen) 9g
Dendrobii Caulis (Jin Shi Hu) 9g
Citri Reticulatae Pericarpium Viride (Guang Ju Luo) 9g
Paeoniae Radix Alba (Chao Hang Shao) 9g
Pinelliae Rhizoma (Jing Ban Xia) 9g
Phragmitis Rhizoma (Xian Lu Gen) 15g
Fritillariae Cirrhosae Bulbus (Jing Pa Ye) 3 pieces
Bambusae Folium (Zhu Ru) 6g
Fourth visit: After continuing to take five doses of the above prescription, water intake greatly decreased, no longer feeling thirsty. Laboratory tests showed normal urine sugar and blood sugar. Complexion turned from dull to ruddy. Cough decreased, phlegm congestion gradually cleared. Able to sleep every night, though with dreams. Tongue reddish and moist, pulse harmonious and slow. The chronic disease, once alleviated, put the patient in a good mood, deeply admiring Chinese medicine. To achieve a complete cure, a follow-up regulation prescription was formulated as follows:
Rehmanniae Radix (Gan Di Huang) 12g
Dioscoreae Rhizoma (Huai Shan Yao) 12g
Poria Cum Radice Pini (Fu Shen) 15g
Moutan Cortex (Fen Dan Pi) 6g
Corni Fructus (Zao Pi) 6g (stir-fried)
Alismatis Rhizoma (Ze Xie) 6g
Puerariae Lobatae Radix (Fen Ge Gen) 9g
Trichosanthis Radix (Tian Hua Fen) 9g
Pinelliae Rhizoma (Jing Ban Xia) 9g
Citri Reticulatae Pericarpium Viride (Guang Ju Luo) 9g
Ziziphi Spinosae Semen (Zao Ren) 15g (taken with decoction)
Fritillariae Cirrhosae Bulbus (Jing Pa Ye) 3 pieces
A certain hospital gifted this foreign guest 10 jin of Honey-Fried Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia), instructed to take one pill (approx. 9g) morning and evening. In 1962, he wrote a letter stating the disease was cured and had not relapsed, specifically expressing gratitude.
[Commentary] Initially used cool, sweet, and bland herbs to moisten dryness, generate fluids, remove dampness, transform phlegm, benefit lungs, and stop cough, clearing the long-stagnated damp-heat and turbid phlegm within the body, thereby improving the functions of Lung, Spleen, and Kidney. Thus, Qi mechanism became open, fluids ascended, and sources of transformation were distributed. Subsequently used methods to nourish Heart, calm Spirit, and tonify Spleen and Kidney to consolidate therapeutic effects.