阴虚络燥——紫斑
周××，女，五岁，住昆明市某医院。
初诊：患儿发热潮烧二月不退，已住院月余。咳嗽，口鼻衄血，烦躁思饮。大便稀溏，色黑。发现紫斑，以胸背较多，时叫腹痛，病情日渐严重。1960年8月，医院给予输血补液，并邀余会诊。诊脉虚数无力，舌质红降，苔淡黄少津。此系阴虚络燥，血热妄行，而脾弱肝旺肺燥，正虚邪盛。治宜凉血养阴，清热化燥，调肝健脾，舒络益气。处方：
白元参6克白人参6克(另煨兑服) 沙参6克 广桔络6克
白茅根12克 赤芍6克 侧柏叶6克 紫草茸4．5克 苡
仁9克 甘草3克 莲子9克 棕炭6克 桑叶6克
二诊：上方服三剂后，患儿发热较退，口鼻衄血渐止，腹中疼痛轻减，微烦思饮。咳少，溺赤，大便黄褐。紫斑渐消。舌红绛，苔薄黄，脉细数。此血热较化，阴虚肺燥，络脉瘀滞，肝脾未调，续拟下方：
细生地12克 元参9克 麦冬9克 藏红花2．1克 赤芍6克
丹皮4．5克 白茅根0克 紫草3克 桔络6克 冬桑叶6克
莲子12克 藕节3个
三诊：上方服三剂，腹痛消失，大便转黄，溺清，热退衄止，咳稀、烦渴已除。能进食，自呼身痒，紫斑靥散。此血热清化，络脉瘀滞渐散，肝脾调和。脉细徽弦，舌红润有津。续拟下方：
细生地9克 连召6克生淮药9克赤茯苓9克苡仁9克
广桔络6克 金银花6克 绿豆6克 生甘草3克
四诊：上方连进五剂，诸症全消。脉和舌润，食眠均佳，正气汤复。再以下方巩固数剂，痊愈出院。处方：
生地9克 麦冬9克 淮药9克 苡仁9克 茯苓9克 绿
豆9克(冲) 杭芍9克 桔络6克 生甘草3克 丝瓜
络4．5克杷叶2片
[姚按]本案是阴虚络燥，血热妄行导致的小儿紫斑，我采取一面凉血养阴、清热化燥，一面调肝健脾，舒络益气，兼加止血药如白茅根、紫草茸、侧柏叶、红花及棕炭之搦，使病症逐步由稳定而趋向痊愈。
湿毒窜络——紫斑
张××，男，二十八岁，人民解放军战士。1969年5月。
初诊：周身发现散在性紫斑，膝以下斑点密布，日晡足心潮热，遍体骚痒，夜间烦躁尤甚，头昏体困。行走时两足酸胀疼痛无力，且有轻度浮肿。经治疗无效，渐至需人搀扶。面色萎黄，饮食尚可，便秘，溺赤。脉象沉弦而数，舌质紫红，苔黄。症属脾虚血燥，风热湿毒伤络，血不归经，窜于肌表。法当凉血祛风，除湿通络，清热解毒。处方：
苦参9克 防己6克 秦艽12克 粉丹皮6克 赤芍药9克
川红花4．5克 紫草茸6克 金银花9克 广蛇床e克地
夫子9克生甘草3克
外用绣防风二两煎汤早晚薰洗。
二诊：上方连续服八剂，周身散在性紫斑渐散，但两膝下斑点仍密，骚痒未止，它症如前。续用原方，量加重，
细生地15克 木防己6克 细秦艽12克 桑枝15克 苦参
9克 粉丹皮6克 赤芍药9克 木通9克 金银花9克
广连翘9克 川红花4．5克 紫草茸9克 通草3克 丝瓜
络9克 海风藤9克 浙贝母9克(冲) 牛夕9克
外治法同前。
三诊：上方连服十五剂，紫斑逐渐稀少，骚痒、潮热、疼痛、浮肿亦渐消失。能单独活动，行走数公里不感疲乏，夜可安卧。饮食增加，面色转润。大便畅通，溺色清淡。脉现缓和，舌苔薄润。此内伏风热湿毒渐化，络脉气机疏通。
续为拟凉血清络，化湿解毒之方常服。
细生地12克 淮山药12克 云茯苓12克 粉丹皮6克 川红
花4．5克 金银花6克 紫地丁9克 生苡仁12克 生甘
草3克冲绿豆9克丝瓜络9克
七一年来信，经服上方三十余剂，病症痊愈。
[按]因风热湿毒浸瑶血络，发为紫斑，治用凉血苦寒解毒寓轻淡清通法。
阻塞性脉管炎
赵××，男，五十三岁，工程技术人员。1968年7月。
初诊：患者平素热爱体育锻炼，经常参加球类比赛。发病前因足部外伤，继则双下肢脉管发炎，色紫红，肿胀疼痛，行动困难。西医诊断：阻塞性脉管炎。言须“截肢”始有希望，而患者拒作手术。遂改服中药附片、姜、桂、及注射川乌、红花等药，症状有增无减，体虚乏力，转余诊治。
脉象六部皆涩，舌红、苔薄腻。症属肝脾肾经不足，风湿凝滞，气不行血，瘀血阻络，经脉损伤。处方：
生口芪15克 当归尾12克炒杭芍9克川芎6克茯苓15克 紫丹参15克 怀牛夕9克 川红花3克 忍冬藤12克 伸筋草15克 桑枝木15克生苡仁15克红饭豆15克豨莶草9克
千年健9克 生三七3克(冲细调服)
上方连服数十剂后，症情大减，患者适当加强体育锻炼，后即行动自如，恢复工作。
[按]“脉管炎”相当于祖国医学之“脱疽”，本书共三例。此案赵××为“阻塞性脉管炎”，另二案王××及苏××为“血栓性脉管炎”。 (见下页)姚老医师辨证：王案特．占’是热胜于湿，苏案特点是湿胜于热，本案特点是气不行血。
王案采用清热解毒，活血消瘀，兼化湿邪。苏案采用祛湿舒筋，活血化热。本案采用助气行血，去瘀除湿，强健筋络。
可见“病同症异”，治则及方药，应灵活变化。
血栓性脉管炎(一)
王××，男，三十五岁，解放军。1968年。
初诊：病经数年，双下肢筋脉曲张变形，红肿疼痛，兼弥漫隐疹，行动困难，便秘溺赤。诊断：血栓性脉管炎。后因治疗无效，约余会诊。脉象弦数有力，舌红，尖赤，苔黄。是属血燥阴虚，风热湿毒滞塞，下肢筋脉受损，瘀血不化，热胜于湿。拟用下方：
细生地15克赤芍药9克土茯苓15克金银花9克忍冬
藤12克焦黄柏3克 木通9克 桑枝木15克 当归尾12克 藏红花3克 紫草茸6克生甘草3克芦根15克苡仁15克 生三七3克(冲细调服)
上方嘱患者在病情无其它变化时连续服用。约服二十剂后，脉转调和，舌赤苔黄退净，患处红肿疼痛及隐疹诸症皆消失。
按语见前案。
血栓性脉管炎(二)
苏××，男，约三十岁，某县缝纫工。1970年夏。
初诊：患者病经三年，症见双下肢足面青紫，筋脉肿胀，疼痛不止。每当气候炎热，病情加剧。曾经数医院中西医诊断治疗，及自服草药，也曾注射针水，均无明显效果。
据西医诊断：血栓性脉管炎。脉象细而濡滞，舌红苔腻，中医辨症：此属肝肾失调，下肢湿热不化，湿胜予热，筋脉气血受损。拟用下方：
霜苍术6克怀牛夕9克 焦黄柏4．5克 当归尾12克 云茯苓15克 桑枝木15克 青木香4．5克 稀莶草9克 伸筋草12克 甘草梢3克 生苡仁15克 红饭豆15克(冲) 生
三七3克(冲细词服)
嘱患者每剂服三、四煎后，用药渣熬汤，薰洗双足患部。
上方连服十五剂后，症状明显好转，疼痛肿胀消失。随嘱其保存此方，经常配服，巩固疗效。
阴虚络燥——紫斑
周××，女，五岁，住昆明市某医院。
初诊：患儿发热如潮水般定时发作持续两个月未退，已住院一个多月。咳嗽，口鼻出血，烦躁想喝水。大便稀薄溏泄，颜色发黑。发现紫斑，以胸背部较多，时常呼叫腹痛，病情日渐严重。1960年8月，医院给予输血补液，并邀请我会诊。诊脉象虚数无力，舌质红降（深红），苔淡黄少津液。这是阴虚络脉干燥，血热妄行，而脾弱肝旺肺燥，正气虚弱邪气盛实。治疗宜凉血养阴，清热化燥，调肝健脾，舒络益气。处方：
白元参6克 白人参6克（另炖兑服） 沙参6克 广桔络6克
白茅根12克 赤芍6克 侧柏叶6克 紫草茸4.5克 苡
仁9克 甘草3克 莲子9克 棕炭6克 桑叶6克
二诊：上方服用三剂后，患儿发热较退，口鼻出血逐渐停止，腹部疼痛减轻，微烦想喝水。咳嗽减少，小便色赤，大便黄褐色。紫斑逐渐消退。舌红绛，苔薄黄，脉细数。这是血热较前化解，阴虚肺燥，络脉瘀滞，肝脾未调和，继续拟定下方：
细生地12克 元参9克 麦冬9克 藏红花2.1克 赤芍6克
丹皮4.5克 白茅根0克 紫草3克 桔络6克 冬桑叶6克
莲子12克 藕节3个
三诊：上方服用三剂，腹痛消失，大便转黄，小便清，热退衄止，咳嗽稀少、烦渴已除。能进食，自述身体痒，紫斑结痂消散。这是血热清解，络脉瘀滞逐渐消散，肝脾调和。脉细微弦，舌红润有津液。继续拟定下方：
细生地9克 连召6克（注：应为连翘之误或别名，此处保留原文）生淮药9克 赤茯苓9克 苡仁9克
广桔络6克 金银花6克 绿豆6克 生甘草3克
四诊：上方连续进服五剂，诸症全消。脉象平和舌润，饮食睡眠均佳，正气恢复。再以下方巩固数剂，痊愈出院。处方：
生地9克 麦冬9克 淮药9克 苡仁9克 茯苓9克 绿
豆9克（冲服） 杭芍9克 桔络6克 生甘草3克 丝瓜
络4.5克 杷叶2片
[姚按]本案是阴虚络燥，血热妄行导致的小儿紫斑，我采取一面凉血养阴、清热化燥，一面调肝健脾，舒络益气，兼加止血药如白茅根、紫草茸、侧柏叶、红花及棕炭等搦（按压/收敛之意，此处指药物作用），使病症逐步由稳定而趋向痊愈。
湿毒窜络——紫斑
张××，男，二十八岁，人民解放军战士。1969年5月。
初诊：周身发现散在性紫斑，膝盖以下斑点密布，日晡（下午3-5点）足心潮热，遍体瘙痒，夜间烦躁尤其严重，头昏体困。行走时两足酸胀疼痛无力，且有轻度浮肿。经治疗无效，渐至需人搀扶。面色萎黄，饮食尚可，便秘，小便色赤。脉象沉弦而数，舌质紫红，苔黄。症状属于脾虚血燥，风热湿毒损伤络脉，血不归经，窜于肌表。治法应当凉血祛风，除湿通络，清热解毒。处方：
苦参9克 防己6克 秦艽12克 粉丹皮6克 赤芍药9克
川红花4.5克 紫草茸6克 金银花9克 广蛇床e克（注：疑为蛇床子之误，保留原文）地
夫子9克 生甘草3克
外用绣防风二两煎汤早晚薰洗。
二诊：上方连续服用八剂，周身散在性紫斑逐渐消散，但两膝下斑点仍密，瘙痒未止，其他症状如前。续用原方，剂量加重，
细生地15克 木防己6克 细秦艽12克 桑枝15克 苦参
9克 粉丹皮6克 赤芍药9克 木通9克 金银花9克
广连翘9克 川红花4.5克 紫草茸9克 通草3克 丝瓜
络9克 海风藤9克 浙贝母9克（冲服） 牛夕9克
外治法同前。
三诊：上方连续服用十五剂，紫斑逐渐稀少，瘙痒、潮热、疼痛、浮肿亦逐渐消失。能单独活动，行走数公里不感疲乏，夜间可安卧。饮食增加，面色转润。大便畅通，小便色清淡。脉现缓和，舌苔薄润。这是内伏风热湿毒逐渐化解，络脉气机疏通。
继续拟定凉血清络，化湿解毒之方常服。
细生地12克 淮山药12克 云茯苓12克 粉丹皮6克 川红
花4.5克 金银花6克 紫地丁9克 生苡仁12克 生甘
草3克 冲绿豆9克 丝瓜络9克
七一年来信，经服用上方三十余剂，病症痊愈。
[按]因风热湿毒浸淫血络，发为紫斑，治用凉血苦寒解毒寓轻淡清通法。
阻塞性脉管炎
赵××，男，五十三岁，工程技术人员。1968年7月。
初诊：患者平素热爱体育锻炼，经常参加球类比赛。发病前因足部外伤，继则双下肢脉管发炎，色紫红，肿胀疼痛，行动困难。西医诊断：阻塞性脉管炎。言须“截肢”始有希望，而患者拒绝手术。遂改服中药附片、姜、桂、及注射川乌、红花等药，症状有增无减，体虚乏力，转余诊治。
脉象六部皆涩，舌红、苔薄腻。症状属于肝脾肾经不足，风湿凝滞，气不行血，瘀血阻络，经脉损伤。处方：
生口芪15克（注：应为生黄芪，保留原文） 当归尾12克 炒杭芍9克 川芎6克 茯苓15克 紫丹参15克 怀牛夕9克 川红花3克 忍冬藤12克 伸筋草15克 桑枝木15克 生苡仁15克 红饭豆15克 豨莶草9克
千年健9克 生三七3克（冲细调服）
上方连续服用数十剂后，症情大减，患者适当加强体育锻炼，后即行动自如，恢复工作。
[按]“脉管炎”相当于祖国医学之“脱疽”，本书共三例。此案赵××为“阻塞性脉管炎”，另二案王××及苏××为“血栓性脉管炎”。 (见下页)姚老医师辨证：王案特点是热胜于湿，苏案特点是湿胜于热，本案特点是气不行血。
王案采用清热解毒，活血消瘀，兼化湿邪。苏案采用祛湿舒筋，活血化热。本案采用助气行血，去瘀除湿，强健筋络。
可见“病同症异”，治则及方药，应灵活变化。
血栓性脉管炎(一)
王××，男，三十五岁，解放军。1968年。
初诊：病经数年，双下肢筋脉曲张变形，红肿疼痛，兼弥漫隐疹，行动困难，便秘溺赤。诊断：血栓性脉管炎。后因治疗无效，约余会诊。脉象弦数有力，舌红，尖赤，苔黄。是属血燥阴虚，风热湿毒滞塞，下肢筋脉受损，瘀血不化，热胜于湿。拟用下方：
细生地15克 赤芍药9克 土茯苓15克 金银花9克 忍冬
藤12克 焦黄柏3克 木通9克 桑枝木15克 当归尾12克 藏红花3克 紫草茸6克 生甘草3克 芦根15克 苡仁15克 生三七3克（冲细调服）
上方嘱患者在病情无其它变化时连续服用。约服二十剂后，脉转调和，舌赤苔黄退净，患处红肿疼痛及隐疹诸症皆消失。
按语见前案。
血栓性脉管炎(二)
苏××，男，约三十岁，某县缝纫工。1970年夏。
初诊：患者病经三年，症见双下肢足面青紫，筋脉肿胀，疼痛不止。每当气候炎热，病情加剧。曾经数医院中西医诊断治疗，及自服草药，也曾注射针水，均无明显效果。
据西医诊断：血栓性脉管炎。脉象细而濡滞，舌红苔腻，中医辨症：此属肝肾失调，下肢湿热不化，湿胜予热（注：应为湿胜于热，保留原文），筋脉气血受损。拟用下方：
霜苍术6克 怀牛夕9克 焦黄柏4.5克 当归尾12克 云茯苓15克 桑枝木15克 青木香4.5克 稀莶草9克 伸筋草12克 甘草梢3克 生苡仁15克 红饭豆15克（冲） 生
三七3克（冲细词服）（注：应为调服，保留原文）
嘱患者每剂服三、四煎后，用药渣熬汤，薰洗双足患部。
上方连续服用十五剂后，症状明显好转，疼痛肿胀消失。随嘱其保存此方，经常配服，巩固疗效。
Yin Deficiency with Dry Collaterals — Purpura
Zhou XX, female, five years old, residing at a certain hospital in Kunming City.
First visit: The child had suffered from tidal fever for two months without relief and had been hospitalized for over a month. Symptoms included coughing, bleeding from the mouth and nose, irritability, and thirst. Stools were loose and blackish. Purpuric spots were observed, more numerous on the chest and back, accompanied by intermittent abdominal pain. The condition worsened day by day. In August 1960, the hospital administered blood transfusions and fluid replacement, and invited me for consultation. The pulse was deficient, rapid, and weak; the tongue body was deep red, with a pale yellow coating and scanty fluids. This case is attributed to Yin deficiency causing dryness of the collaterals, reckless movement of blood due to heat in the blood, combined with Spleen deficiency, Liver excess, and Lung dryness, resulting in deficiency of righteous Qi and abundance of pathogenic factors. The treatment principle should be to cool the blood and nourish Yin, clear heat and resolve dryness, regulate the Liver and strengthen the Spleen, soothe the collaterals and benefit Qi. Prescription:
Bai Yuanshen (White Scrophulariae Radix) 6g, Bai Renshen (White Ginseng Radix) 6g (decocted separately and mixed), Shashen (Glehniae Radix) 6g, Guang Jieluo (Citri Reticulatae Pericarpium Viride) 6g,
Baimaogen (Imperatae Rhizoma) 12g, Chishao (Paeoniae Radix Rubra) 6g, Cebeiye (Platycladi Cacumen) 6g, Zicaorong (Arnebiae Radix et Rhizoma) 4.5g, Yiren (Coicis Semen) 9g,
Gancao (Glycyrrhizae Radix et Rhizoma) 3g, Lianzi (Nelumbinis Semen) 9g, Zongtan (Cinnamomi Cortex Carbonisatus? Note: Likely Cinnamomi Cortex processed to stop bleeding) 6g, Sangye (Mori Folium) 6g.
Second visit: After taking three doses of the above prescription, the child's fever subsided somewhat, bleeding from the mouth and nose gradually stopped, abdominal pain decreased, and there was slight irritability and thirst. Cough reduced, urine became reddish, stools turned yellowish-brown. Purpuric spots gradually faded. The tongue was crimson with a thin yellow coating, and the pulse was fine and rapid. This indicates that blood heat has partially resolved, but Yin deficiency and Lung dryness persist, with stasis in the collaterals and imbalance of the Liver and Spleen. Continue with the following prescription:
Xi Shengdi (Prepared Rehmanniae Radix) 12g, Yuanshen (Scrophulariae Radix) 9g, Maidong (Ophiopogonis Radix) 9g, Zanghonghua (Saffron) 2.1g, Chishao (Paeoniae Radix Rubra) 6g,
Danpi (Moutan Cortex) 4.5g, Baimaogen (Imperatae Rhizoma) 0g, Zicao (Arnebiae Radix et Rhizoma) 3g, Jieluo (Citri Reticulatae Pericarpium Viride) 6g, Dong Sangye (Mori Folium) 6g,
Lianzi (Nelumbinis Semen) 12g, Oujie (Nelumbinis Node) 3 pieces.
Third visit: After taking three doses of the above prescription, abdominal pain disappeared, stools turned yellow, urine cleared, fever ceased, bleeding stopped, cough became sparse, and irritability/thirst were eliminated. The patient could eat and reported itching, while purpuric spots scabbed and dispersed. This indicates that blood heat has cleared, collateral stasis is dissipating, and the Liver and Spleen are harmonized. The pulse is fine and slightly wiry; the tongue is red and moist. Continue with the following prescription:
Xi Shengdi (Prepared Rehmanniae Radix) 9g, Lianqiao (Forsythiae Fructus) 6g, Sheng Huaiyao (Dioscoreae Rhizoma) 9g, Chi Fuling (Poria) 9g, Yiren (Coicis Semen) 9g,
Guang Jieluo (Citri Reticulatae Pericarpium Viride) 6g, Jinyinhua (Lonicerae Japonicae Flos) 6g, Lv dou (Phaseoli Radiatus Semen) 6g, Sheng Gancao (Glycyrrhizae Radix et Rhizoma) 3g.
Fourth visit: After taking five consecutive doses of the above prescription, all symptoms vanished. The pulse was harmonious, the tongue moist, and appetite and sleep were excellent. Righteous Qi recovered. Prescribe the following formula for several doses to consolidate the cure, leading to discharge. Prescription:
Sheng Di (Rehmanniae Radix) 9g, Maidong (Ophiopogonis Radix) 9g, Huaiyao (Dioscoreae Rhizoma) 9g, Yiren (Coicis Semen) 9g, Fuling (Poria) 9g,
Lv dou (Phaseoli Radiatus Semen) 9g (mixed in decoction), Hang Shao (Paeoniae Radix Alba) 9g, Jieluo (Citri Reticulatae Pericarpium Viride) 6g, Sheng Gancao (Glycyrrhizae Radix et Rhizoma) 3g, Sigualuo (Luffae Fructus Retinervus) 4.5g, Paye (Eriobotryae Folium) 2 leaves.
[Dr. Yao's Comment]: This case involves pediatric purpura caused by Yin deficiency with dry collaterals and reckless movement of blood due to heat. I adopted a strategy of cooling the blood and nourishing Yin, clearing heat and resolving dryness, while simultaneously regulating the Liver and strengthening the Spleen, soothing the collaterals and benefiting Qi. Hemostatic herbs such as Baimaogen, Zicaorong, Cebeiye, Honghua, and Zongtan were added to stabilize the condition and promote recovery.
Damp-Toxin Invading Collaterals — Purpura
Zhang XX, male, twenty-eight years old, soldier of the People's Liberation Army. May 1969.
First visit: Scattered purpuric spots appeared all over the body, densely concentrated below the knees. There was tidal heat in the soles of the feet during the afternoon (Shi hour), generalized pruritus, and severe irritability at night, along with dizziness and heaviness. Walking caused soreness, swelling, pain, and weakness in both legs, accompanied by mild edema. Treatment was ineffective, and the patient eventually required assistance to walk. The complexion was sallow, diet was acceptable, but constipation and reddish urine were present. The pulse was deep, wiry, and rapid; the tongue body was purple-red with a yellow coating. The syndrome belongs to Spleen deficiency with dry blood, where wind-heat and damp-toxin damage the collaterals, causing blood to leave its vessels and invade the muscle surface. The treatment method should be to cool the blood, dispel wind, remove dampness, unblock collaterals, and clear heat and detoxify. Prescription:
Kushen (Sophorae Flavescentis Radix) 9g, Fangji (Stephaniae Tetrandrae Radix) 6g, Qinjiao (Gentianae Macrophyllae Radix) 12g, Fen Danpi (Moutan Cortex) 6g, Chishao (Paeoniae Radix Rubra) 9g,
Chuan Honghua (Carthami Flos) 4.5g, Zicaorong (Arnebiae Radix et Rhizoma) 6g, Jinyinhua (Lonicerae Japonicae Flos) 9g, Guang Shechuang (Cnidii Fructus) [Note: Text says 'e gram', likely typo], Difuzi (Agrimoniae Herba) 9g, Sheng Gancao (Glycyrrhizae Radix et Rhizoma) 3g.
External use: Decoct 2 liang of Xiu Fangfeng (Saposhnikoviae Radix) in water for morning and evening fumigation and washing.
Second visit: After eight consecutive doses of the above prescription, scattered purpuric spots gradually dissipated, but spots below the knees remained dense, and pruritus persisted. Other symptoms remained unchanged. Continue the original prescription with increased dosages:
Xi Shengdi (Prepared Rehmanniae Radix) 15g, Mu Fangji (Stephaniae Sinensis Rhizoma) 6g, Xi Qinjiao (Gentianae Macrophyllae Radix) 12g, Sangzhi (Mori Ramulus) 15g, Kushen (Sophorae Flavescentis Radix) 9g,
Fen Danpi (Moutan Cortex) 6g, Chishao (Paeoniae Radix Rubra) 9g, Mutong (Akebiae Caulis) 9g, Jinyinhua (Lonicerae Japonicae Flos) 9g,
Guang Lianqiao (Forsythiae Fructus) 9g, Chuan Honghua (Carthami Flos) 4.5g, Zicaorong (Arnebiae Radix et Rhizoma) 9g, Tongcao (Tetrapanacis Medulla) 3g, Sigualuo (Luffae Fructus Retinervus) 9g, Haifengteng (Sargentodoxae Caulis) 9g, Zhe Beimu (Fritillariae Thunbergii Bulbus) 9g (mixed in decoction), Niuxi (Achyranthis Bidentatae Radix) 9g.
External treatment remains the same.
Third visit: After fifteen consecutive doses of the above prescription, purpuric spots became increasingly sparse, and pruritus, tidal heat, pain, and edema gradually disappeared. The patient could move independently, walking several kilometers without fatigue, and slept peacefully at night. Appetite increased, and the complexion became lustrous. Bowel movements were smooth, and urine was light-colored. The pulse became moderate, and the tongue coating was thin and moist. This indicates that internal wind-heat and damp-toxin are gradually resolving, and Qi mechanism in the collaterals is unblocked.
Continue prescribing formulas to cool the blood, clear collaterals, resolve dampness, and detoxify for long-term use.
Xi Shengdi (Prepared Rehmanniae Radix) 12g, Huai Shanyao (Dioscoreae Rhizoma) 12g, Yun Fuling (Poria) 12g, Fen Danpi (Moutan Cortex) 6g, Chuan Honghua (Carthami Flos) 4.5g, Jinyinhua (Lonicerae Japonicae Flos) 6g, Zididing (Violaris Herba) 9g, Sheng Yiren (Coicis Semen) 12g, Sheng Gancao (Glycyrrhizae Radix et Rhizoma) 3g, mixed with Lv dou (Phaseoli Radiatus Semen) 9g, Sigualuo (Luffae Fructus Retinervus) 9g.
In 1971, a letter received stated that after taking over thirty doses of the above prescription, the illness was cured.
[Comment]: Due to wind-heat and damp-toxin invading the blood collaterals, purpura developed. The treatment employed cooling blood, bitter-cold detoxification, combined with light, bland, clearing, and unblocking methods.
Obstructive Vasculitis
Zhao XX, male, fifty-three years old, engineering technician. July 1968.
First visit: The patient usually loved physical exercise and frequently participated in ball games. Before onset, due to foot trauma, vasculitis occurred in both lower limbs, appearing purple-red, swollen, painful, and making movement difficult. Western medical diagnosis: Obstructive Vasculitis. It was stated that "amputation" was necessary for hope, but the patient refused surgery. He then switched to Chinese medicine including Fupian (Aconiti Lateralis Radix Praeparata), Ginger, Cinnamon, and injections of Chuanwu (Aconiti Radix) and Honghua (Carthami Flos). Symptoms increased rather than decreased, with physical weakness and fatigue, leading him to seek my treatment.
The pulse was choppy in all six positions; the tongue was red with a thin greasy coating. The syndrome belongs to deficiency of the Liver, Spleen, and Kidney meridians, stagnation of wind-damp, Qi failing to move blood, blood stasis blocking collaterals, and meridian injury. Prescription:
Sheng Huangqi (Astragali Radix) [Text says 'Sheng Kouqi', likely typo] 15g, Dangguiwei (Angelicae Sinensis Radix) 12g, Chao Hangshao (Paeoniae Radix Alba) 9g, Chuanxiong (Ligustici Chuanxiong Rhizoma) 6g, Fuling (Poria) 15g, Zidan Shen (Salviae Miltiorrhizae Radix et Rhizoma) 15g, Huai Niuxi (Achyranthis Bidentatae Radix) 9g, Chuan Honghua (Carthami Flos) 3g, Rendongteng (Lonicerae Japonicae Caulis) 12g, Shenjincao (Lycopii Herba) 15g, Sangzhimu (Mori Ramulus) 15g, Sheng Yiren (Coicis Semen) 15g, Hongfandou (Phaseoli Vulgaris Semen) 15g, Xixiancao (Siegesbeckiae Herba) 9g,
Qian Nian Jian (Drynariae Rhizoma) 9g, Sanqi (Notoginseng Radix et Rhizoma) 3g (finely ground and mixed).
After taking dozens of doses of the above prescription, symptoms significantly decreased. With appropriate intensification of physical exercise, the patient regained free movement and returned to work.
[Comment]: "Vasculitis" corresponds to "Tuo Ju" (Gangrene) in Traditional Chinese Medicine. There are three cases in this book. Case Zhao XX is "Obstructive Vasculitis," while Cases Wang XX and Su XX are "Thrombotic Vasculitis." (See next page) Dr. Yao's differentiation: Case Wang is characterized by heat exceeding dampness; Case Su is characterized by dampness exceeding heat; this case is characterized by Qi failing to move blood.
Case Wang used clearing heat and detoxifying, invigorating blood and eliminating stasis, combined with resolving dampness. Case Su used removing dampness and relaxing sinews, invigorating blood and transforming heat. This case used assisting Qi to move blood, removing stasis and dampness, and strengthening sinews and collaterals.
This shows that "same disease, different symptoms" requires flexible changes in treatment principles and prescriptions.
Thrombotic Vasculitis (I)
Wang XX, male, thirty-five years old, PLA soldier. 1968.
First visit: The disease had lasted for years. Varicose veins in both lower limbs were deformed, with redness, swelling, and pain, accompanied by diffuse hidden rashes. Movement was difficult, with constipation and reddish urine. Diagnosis: Thrombotic Vasculitis. Due to ineffective treatment, I was consulted. The pulse was wiry, rapid, and forceful; the tongue was red, especially at the tip, with a yellow coating. This belongs to blood dryness and Yin deficiency, with wind-heat and damp-toxin obstruction, damage to lower limb sinews and collaterals, unresolved blood stasis, and heat exceeding dampness. Prescribe the following:
Xi Shengdi (Prepared Rehmanniae Radix) 15g, Chishao (Paeoniae Radix Rubra) 9g, Tufuling (Smilacis Glabrae Rhizoma) 15g, Jinyinhua (Lonicerae Japonicae Flos) 9g, Rendongteng (Lonicerae Japonicae Caulis) 12g, Jiao Huangbai (Phellodendri Cortex) 3g, Mutong (Akebiae Caulis) 9g, Sangzhimu (Mori Ramulus) 15g, Dangguiwei (Angelicae Sinensis Radix) 12g, Zanghonghua (Saffron) 3g, Zicaorong (Arnebiae Radix et Rhizoma) 6g, Sheng Gancao (Glycyrrhizae Radix et Rhizoma) 3g, Lugeng (Phragmitis Rhizoma) 15g, Yiren (Coicis Semen) 15g, Sanqi (Notoginseng Radix et Rhizoma) 3g (finely ground and mixed).
The patient was instructed to take the prescription continuously without other changes in condition. After approximately twenty doses, the pulse became harmonious, the red tongue and yellow coating disappeared completely, and redness, swelling, pain, and rashes at the affected site all vanished.
Comments refer to previous cases.
Thrombotic Vasculitis (II)
Su XX, male, approximately thirty years old, tailor in a certain county. Summer 1970.
First visit: The patient had been ill for three years. Symptoms included cyanosis on the dorsum of both feet, swelling of sinews and collaterals, and unceasing pain. The condition worsened during hot weather. Multiple diagnoses and treatments in various hospitals (both TCM and Western medicine), self-administration of herbal medicines, and injections yielded no significant effect.
Western medical diagnosis: Thrombotic Vasculitis. The pulse was fine and soggy/stagnant; the tongue was red with a greasy coating. TCM differentiation: This belongs to Liver-Kidney imbalance, failure to transform damp-heat in the lower limbs, dampness exceeding heat, and damage to sinew/collateral Qi and blood. Prescribe the following:
Shuang Cangzhu (Atractylodis Rhizoma) 6g, Huai Niuxi (Achyranthis Bidentatae Radix) 9g, Jiao Huangbai (Phellodendri Cortex) 4.5g, Dangguiwei (Angelicae Sinensis Radix) 12g, Yun Fuling (Poria) 15g, Sangzhimu (Mori Ramulus) 15g, Qingmuxiang (Aucklandiae Radix) 4.5g, Xixiancao (Siegesbeckiae Herba) 9g, Shenjincao (Lycopii Herba) 12g, Gancaoshao (Glycyrrhizae Radix et Rhizoma tip) 3g, Sheng Yiren (Coicis Semen) 15g, Hongfandou (Phaseoli Vulgaris Semen) 15g (mixed in decoction), Sanqi (Notoginseng Radix et Rhizoma) 3g (finely ground and mixed).
The patient was instructed to decoct each dose three or four times, then boil the medicinal dregs in water to fumigate and wash the affected parts of both feet.
After fifteen consecutive doses of the above prescription, symptoms improved significantly, and pain and swelling disappeared. The patient was advised to keep this prescription and take it regularly to consolidate the curative effect.