痰 厥
袁× ×，男，四十六岁。1948年9月。
初诊：咳嗽多日，夜间尤甚。曾服“清燥救肺”“百合固金”等方，反痰凝不爽，质稠牯，色黄白，不易咯出。继而胸闷喘促，睡卧不宁，时有神迷，肢冷，汗出。口唇夹肯，肌肤消瘦，便秘溺赤。脉象沉而细滑，舌质红，苔黄白厚腻。此脾湿痰聚，胆肺伏热，气机壅滞，发为痰厥。治宜豁痰理气，清胆祛湿。处方：
光杏仁9克 陈皮6克 胆炒半夏9克 生苡仁12克甜桔
梗4．5克炒枳壳6克甜葶苈子9克冬瓜仁12克(冲) 竹
茹6克 生甘草3克 全瓜蒌1枚(打碎)
二诊：上方服二剂，咳嗽稍减，痰凝未涤。便秘，溺短赤。仍时作惊厥，脉弦滑而数，舌苔黄厚且腻。此湿痰尚重，气机不利，肺失肃降，胆火熏灼。续拟下方；
胆炒半夏9克 化桔红6克 炒知母9克 光杏仁9克 醋
煅青礞石12克 自苏子9克(冲) 甘草3克 甜葶苈子6克
金瓜蒌1枝(打碎) 竹沥二匙(兑服)
三诊：上方服三剂，大便畅下，夹粘液风沫甚多。咳嗽轻减，痰凝渐化。患者自感气爽神清。此多日蕴结之痰湿郁热，已得豁达疏通。脉弦、滑均减，舌苔退薄，病趋向愈。
再拟下方，赓续清理：
胆炒半夏9克 广陈皮6克 瓜蒌壳9克 光杏仁9克 白
茯苓12克 炙桑皮9克 炒枳壳9克 生苡仁12克净竹茹
6克生甘草3克冬瓜仁9克(冲) 净杷叶2片
[按]湿痰甚重，胆火郁热，误于阴寒收敛，遂致气机壅塞而为厥。治本内经：“结者散之”“留者攻之”的精神，投方获效。
咳嗽痰厥昏睡症
郭××，男，四十八岁，干部。1970年]2月。
初诊：患者素体肥胖，且嗜厚味肥甘，数年来体重日增。
痰浊甚多，稍有感冒，即语音重浊，痰凝、呼吸不畅。据述此次始病受寒，咳嗽，胸闷气逆，神昏思睡，不进饮食。诊其脉浮弦且滑，舌苔薄白。症属表寒袭肺，引动湿痰，阻滞气机作咳。当辛温散寒，利气祛痰。处方：
麻茸4．5克 桂枝木6克 光杏仁9克 法半夏9克 陈
皮6克 白茯神15克 前胡片6克 炒枳壳6克 甘草3克
生姜2片 大枣3枚
二诊：上方服二剂，咳嗽减而痰凝未豁，胸膈痞鞭不舒，嗳气、干呕时作，但无食臭。终日冲昏嗜睡，呼叫亦不易醒，饮食不思，大便不畅，小便短赤。此新寒解后，脾胃两虚，内伏痰浊壅滞，气机受阻，心虚神弱，故昏睡不醒。脉浮象减，舌黄腻。续与豁痰降逆之方；
空沙参9克 旋复花9克 代赭石15克 法半夏9克 化桔
红6克 白茯神15克生甘草3克生姜2片大枣2枚 竹
沥2匙(凋兑)
三诊：上方连服三剂，咯出大量痰浊，暖气、干呕顿减，咳嗽稀少，胸膈爽利，稍思饮食，但仍嗜睡。大便畅通，小便短黄。舌尖红，苔腻退，脉转细滑。此痰凝渐涤，湿邪化燥而心胆有热。改拟清心温胆，除湿化痰之方：
冲生枣仁15克 炒知母6克 白茯神15克 炒冲枳实6克
广陈皮6克 法半夏9克 煅代赭石9克 净竹茹6克生
甘草3克 生姜2片 小枣11枚
上方嘱服十剂，并禁忌肥甘厚味之物，二、三月后，痰化神清，体重减轻，病遂全愈。
[按]痰为病本，新寒为标，故先散寒解表，次降逆豁痰，再清心温胆。
阳虚中风
徐× ×，女，七十五岁，昆明市人。1945年8月。
初诊：湿痰素盛之体，常感头眩、耳呜、肢麻。晨起突然跌仆，不省人事，面白唇青，其孙急延余往诊。患者脉弦大而滑，两尺细弱，四肢逆冷，牙关紧闭。鼻息有鼾，痰声漉漉，口眼歪斜。症属高年阳虚，寒湿内滞，痰厥生风。速用牙皂、细辛、研末吹鼻取嚏，及拟三生饮加味救治。处方：
生附片30克 生川乌15克生南星15克(以上三味同先煨二小时)
法半夏15克广陈皮6克云木香3克
上药浓煎后，每服兑生姜汁一匙为引，灌服。
二诊；上方服后，有倾，吐出风沫痰涎，鼾声痰声减少，神识稍苏，四肢厥逆转温。原方加石菖蒲4．5克、代赭石9克再服。
三诊：上方服后，神智渐清，痰涎已少，略能张口。但言謇舌强，左侧肢体偏瘫。舌苔白腻，脉虚弦而滑。是心胞痰凝渐豁，经络风邪未化，气机不利。再拟下方：
川附片30克(先用开水煨透) 姜南星6克 法半夏9克 朱
茯神18克 嫩桑枝30克 双勾藤9克 石菖蒲4．5克 代赭
石9克云木香4．5克甘草梢3克生姜片15克 大枣3枚
四诊：上方服两剂，神识全苏，痰涎大减，稍能进食，口眼微斜。偶作咳，左侧偏瘫不用。舌如前，脉细弦而滑，两尺较前有力。续用下方温阳化痰祛风，养血舒络，赓连调治。
炙附片30克(用开水先煨透) 姜南星15克法半夏9克 嫩桑
枝15克 茯苓神15克淮牛夕9克炙首乌15克全当归15克
黑芝麻15克云木香9克 广地龙4．5克 稀莶草9克 广
陈皮6克 生甘草3克 生姜片9克 生三七末4．5克 大
枣7枚分次调服。
五诊；上方服十余剂后，渐能扶持缓步，食、眠及二便正常。但左半身仍麻痹不灵，乃属高年血虚，络脉失调，此一时不易全瘥。嘱用上方加倍制为丸剂，每日早晚常服。
[按]老年阳虚，湿寒内伏，痰厥生风，卒然昏仆， 矛
关紧闭，四肢厥逆，病势垂危。先用牙皂，细辛取嚏开闭，
宣通关窍，后以回阳祛风、化痰舒络之大剂三生饮加味化
裁，病莲缓解。而左半身偏瘫，步履迟缓等，是由中风后
阳虚筋络不舒，气血不足所致。此症得转险为夷，实属难
能。
阴虚中风
赵××，男，六十五岁，工人。1970年。
初诊：患者因腰部外伤，住院治疗，尚未全愈。复因牙疼头痛，服止痛剂未减。某晨，突然中风，神识昏蒙，两目直视，呼之不应，喉中痰声漉漉，手足抽搐，口角喁斜。骨科约余会诊。
脉象弦大而滑，牙关紧闭，用竹筷撬开，见舌尖红，苔燥，有龟裂。此老年肝肾不足，外伤后，血弱阴虚中风，气滞痰凝，邪闭心胞，络脉失调，症属危重。治宜化风宣络，芳香开窍，涤痰顺气，镇心安神。先用安官牛黄丸二丸用水化调匀，分次用鼻饲法内服。
午后复诊．症无显著变化，仅喉间痰声稍减，神识仍昏，抽搐时作。小便失禁，大便秘结。牙关微开， 目能闭合。脉象弦大略减，舌苔仍燥，有龟裂。风势未平，痰凝气滞，邪闭心胞，仍属危重。拟用下方；
羚羊角4．5克(磨水兑服)桑枝2．4克代赭石15克 云茯神18寞
全蝎1对 蜈蚣3条 石菖蒲4．5克 冲郁金9克 勾藤6克
甘草梢3克蛇胆陈皮2支宝丹1丸 (上二药分次调入)
三诊：服上方后，神识渐清，呼之能应。目能开闭，口角喁斜较正。喉中痰声已稀，略能饮水下咽。但言蹇舌强，抽搐阵作，肢体强直，难为转侧。微咳，龈肿。小便失禁较减，大便未通。脉象弦滑，舌红，苔黄而燥。此神明渐苏，风邪未化，筋络不舒，气滞痰凝。宜清化疏调。处方：
羚羊角3克(磨水兑服) 桑枝24克 云茯神15克 秦艽9克
勾藤6克 杭菊花6克 全蝎1对 薄荷6克 夏枯草6克
甘草3克 竹茹6克 青木香4．5克蛇胆陈皮2支(调服)
四诊：上方服二剂，神识已清，抽搐渐止。大便通，小便色黄能禁。时咳痰凝。仍言蹇舌强，肢体转动不灵。脉弦滑，舌淡黄有津。此风象渐平，络脉未舒，肝肺燥热。续用下方祛风化痰，舒筋宣络。处方：
秦艽12克桑枝24克青木香4．5克菊花6克 勾藤9克
天竺黄6克甘草3克 蜂房6克 白吉力9克 姜蚕9克
竹茹6克
五诊：上方服二剂，腰痛牙疼减轻，抽搐已停，渐能言语，口眼杅斜消除，肢体较能活动。大便畅通，小便淡黄。
咳嗽痰凝，神倦思睡，肢软无力。脉弦滑均减，舌淡红、苔薄黄而润。此风势已平，阴虚肺燥，络脉未调，心神不足之候。续用下方，养阴舒络，化痰缓调。处方：
白元参9克大寸冬9克怀牛夕9克 青木香4．5克 桑
枝15克 川续断12克杜仲12克 甘草3克京半夏9克(冲)
伸筋草9克
六诊：服上方近十剂，已能起床由家属搀扶慢步行走。
饮食增加，夜卧较宁。腰痛牙疼全止，咳痰稀少，二便正常。唯肢体软弱，头昏乏力。脉转弱缓调匀，舌红润有津。
此病退阴虚，肝肾络脉不强，气血心神未足，宜滋血益阴，安神、舒络，养肝熄风。处方：
炙首乌15克 大熟地15克 淮山药15克 云茯神15克金石
斛9克怀牛夕9克黑芝麻15克粉丹皮6克酸枣皮6克
炒泽泻6克黑小豆15克桑寄生12克甘草梢3克
服数剂后，渐能单独行动，食眠均佳，就出院。嘱可常服上方调理善后。七、八年随访，情况良好，能自行料理生活，并作轻微事务。
[按]老年气血失荣，肝肾阴亏，至为风火湿痰骤袭，急用凉开，祛邪启闭。继投清疏宣化缓调，随后滋益固本。
阴 黄
李××，男，三十一岁，教师，住昆明市。1931年夏来诊。患者自述病经二、三月，因周身黄疸，曾服柴胡平胃、及茵陈蒿汤多剂，效不显。症见面目全身晦黄不荣，肌肤浮肿，四肢冷，自汗淋淋衣被尽染黄色。胸膈痞闷，食少神疲，大便稀溏，小便黄短。脉象濡滞，舌质淡、苔白腻。此属久病，过服苦寒，脾肾之阳受损，运化失司，邪从寒化，呈现阴黄之候。法当温运渗利，兼理气和胃。处方：
炙附片30克(开水先煨透) 茵陈蒿12克 桂枝木9克 云茯
苓30克 西砂仁9克(冲) 广陈皮6克 川干姜9克 炒苡
仁12克 小红枣11枚
二诊：上方服二剂，患者面目全身黄疸、浮肿、自汗均减，肢冷转温，胸膈舒畅，小便清长，大便渐干。脉象濡缓，舌白腻退。此阳气渐回，脾运复苏。寒湿未尽，续宜温运渗化。处方：
炙附片30克(开水先煨透) 茵陈蒿12克 云茯苓30克 猪苓
片9克 桂枝木9克炒泽泻9克川干姜9克大红枣5枚
三诊：上方连服四剂，黄疸、浮肿、自汗诸症消失。脉弱缓，舌粉红而润。饮食增加，二便正常。病后体虚，脾肾未强。再拟下方调补，数剂而安。
炙附片30克(开水先煨透) 潞党参15克 漂白术12克 茯苓
神15克 西砂仁6克(冲) 广陈皮6克 炒苡仁12克 生甘
草3克 川干姜6克 大红枣3枚
[按]阴黄之侯，立温运渗化，脉象由濡滞而渐缓和，诸症迅退，可以知其为正法。
阳 黄
王××，女，二十八岁，干部。1959年7月。
痰厥
袁××，男性，四十六岁。1948年9月就诊。
初诊：咳嗽多日，夜间尤为严重。曾服用“清燥救肺汤”、“百合固金汤”等方剂，反而导致痰液凝结不畅，质地粘稠成块，颜色黄白相间，难以咳出。继而出现胸闷、气喘急促，睡眠不安稳，时常神志昏迷，四肢发冷，出汗。口唇青紫，肌肤消瘦，便秘，小便短赤。脉象沉而细滑，舌质红，苔黄白厚腻。此为脾虚湿盛聚痰，胆腑与肺脏伏有热邪，气机壅滞，发为痰厥（因痰浊阻滞气机导致的突然昏倒或肢体厥冷）。治疗宜豁痰理气，清胆祛湿。处方：
光杏仁9克 陈皮6克 胆炒半夏9克 生苡仁12克 甜桔梗4.5克 炒枳壳6克 甜葶苈子9克 冬瓜仁12克（冲服） 竹茹6克 生甘草3克 全瓜蒌1枚（打碎）
二诊：上方服用两剂后，咳嗽稍减，但痰凝未除。便秘，小便短赤。仍不时发生惊厥，脉弦滑而数，舌苔黄厚且腻。此为湿痰依然沉重，气机不利，肺失肃降功能，胆火熏灼。继续拟定下方：
胆炒半夏9克 化桔红6克 炒知母9克 光杏仁9克 醋煅青礞石12克 自苏子9克（冲服） 甘草3克 甜葶苈子6克 金瓜蒌1枝（打碎） 竹沥二匙（兑服）
三诊：上方服用三剂后，大便通畅排出，夹杂大量粘液风沫。咳嗽减轻，痰凝逐渐化解。患者自觉气息顺畅，神志清醒。此多日蕴结的痰湿郁热，已得到豁达疏通。脉象弦、滑均减轻，舌苔退去变薄，病情趋向痊愈。
再拟定下方，继续清理余邪：
胆炒半夏9克 广陈皮6克 瓜蒌壳9克 光杏仁9克 白茯苓12克 炙桑皮9克 炒枳壳9克 生苡仁12克 净竹茹6克 生甘草3克 冬瓜仁9克（冲服） 净杷叶2片
[按语]湿痰非常重，胆火郁热，误用阴寒收敛药物，遂导致气机壅塞而发生厥证。治疗遵循《内经》：“结者散之”、“留者攻之”的精神，投药获效。
咳嗽痰厥昏睡症
郭××，男性，四十八岁，干部。1970年12月就诊。
初诊：患者平时体质肥胖，且嗜好厚味肥甘食物，多年来体重日益增加。
痰浊非常多，稍有感冒，即声音重浊，痰凝、呼吸不畅。据述此次发病受寒，咳嗽，胸闷气逆，神志昏迷思睡，不进饮食。诊其脉浮弦且滑，舌苔薄白。症状属于表寒袭肺，引动湿痰，阻滞气机引发咳嗽。应当辛温散寒，利气祛痰。处方：
麻茸4.5克 桂枝木6克 光杏仁9克 法半夏9克 陈皮6克 白茯神15克 前胡片6克 炒枳壳6克 甘草3克 生姜2片 大枣3枚
二诊：上方服用两剂后，咳嗽减少但痰凝未豁除，胸膈痞硬不舒，嗳气、干呕时作，但没有食臭。终日冲昏嗜睡，呼叫也不易醒，不想饮食，大便不畅，小便短赤。此为新感寒邪解除后，脾胃两虚，内伏痰浊壅滞，气机受阻，心虚神弱，所以昏睡不醒。脉浮象减轻，舌苔黄腻。继续给予豁痰降逆的方剂：
空沙参9克 旋复花9克 代赭石15克 法半夏9克 化桔红6克 白茯神15克 生甘草3克 生姜2片 大枣2枚 竹沥2匙（调兑）
三诊：上方连续服用三剂，咯出大量痰浊，嗳气、干呕顿减，咳嗽稀少，胸膈爽利，稍微想吃东西，但仍嗜睡。大便畅通，小便短黄。舌尖红，苔腻退去，脉转细滑。此痰凝逐渐涤除，湿邪化燥而心胆有热。改拟清心温胆，除湿化痰的方剂：
冲生枣仁15克 炒知母6克 白茯神15克 炒冲枳实6克 广陈皮6克 法半夏9克 煅代赭石9克 净竹茹6克 生甘草3克 生姜2片 小枣11枚
上方嘱咐服用十剂，并禁忌肥甘厚味之物，二、三月后，痰化神清，体重减轻，病遂全愈。
[按语]痰为病之本，新感寒邪为标，故先散寒解表，次降逆豁痰，再清心温胆。
阳虚中风
徐××，女性，七十五岁，昆明市人。1945年8月就诊。
初诊：湿痰素来旺盛的体质，常感到头晕、耳鸣、肢体麻木。晨起突然跌倒，不省人事，面色白嘴唇青紫，其孙子急忙请我前往诊治。患者脉弦大而滑，两尺脉细弱，四肢逆冷，牙关紧闭。鼻息有鼾声，痰声漉漉，口眼歪斜。症状属于高龄阳虚，寒湿内滞，痰厥生风。速用牙皂、细辛，研末吹鼻取嚏，并拟定三生饮加味救治。处方：
生附片30克 生川乌15克 生南星15克（以上三味同先煨二小时）
法半夏15克 广陈皮6克 云木香3克
上药浓煎后，每服兑生姜汁一匙为引，灌服。
二诊：上方服用后，有呕吐，吐出风沫痰涎，鼾声痰声减少，神识稍苏，四肢厥逆转温。原方加石菖蒲4.5克、代赭石9克再服。
三诊：上方服用后，神智渐清，痰涎已少，略能张口。但言语謇涩舌体僵硬，左侧肢体偏瘫。舌苔白腻，脉虚弦而滑。这是心包痰凝逐渐豁除，经络风邪未化，气机不利。再拟定下方：
川附片30克（先用开水煨透） 姜南星6克 法半夏9克 朱茯神18克 嫩桑枝30克 双勾藤9克 石菖蒲4.5克 代赭石9克 云木香4.5克 甘草梢3克 生姜片15克 大枣3枚
四诊：上方服用两剂，神识全苏，痰涎大减，稍能进食，口眼微斜。偶作咳，左侧偏瘫不用。舌如前，脉细弦而滑，两尺较前有力。续用下方温阳化痰祛风，养血舒络，继续调治。
炙附片30克（用开水先煨透） 姜南星15克 法半夏9克 嫩桑枝15克 茯苓神15克 淮牛夕9克 炙首乌15克 全当归15克 黑芝麻15克 云木香9克 广地龙4.5克 稀莶草9克 广陈皮6克 生甘草3克 生姜片9克 生三七末4.5克 大枣7枚分次调服。
五诊：上方服用十余剂后，渐能扶持缓步，食、眠及二便正常。但左半身仍麻痹不灵，乃属高龄血虚，络脉失调，此时不易全愈。嘱咐用上方加倍制为丸剂，每日早晚常服。
[按语]老年阳虚，湿寒内伏，痰厥生风，卒然昏仆，牙关紧闭，四肢厥逆，病势垂危。先用牙皂、细辛取嚏开闭，宣通关窍，后以回阳祛风、化痰舒络的大剂三生饮加味化裁，病情缓解。而左半身偏瘫，步履迟缓等，是由中风后阳虚筋络不舒，气血不足所致。此症得转险为夷，实属难能。
阴虚中风
赵××，男性，六十五岁，工人。1970年就诊。
初诊：患者因腰部外伤，住院治疗，尚未全愈。复因牙疼头痛，服止痛剂未减。某晨，突然中风，神识昏蒙，两目直视，呼之不应，喉中痰声漉漉，手足抽搐，口角喁斜。骨科约我会诊。
脉象弦大而滑，牙关紧闭，用竹筷撬开，见舌尖红，苔燥，有龟裂。此为老年肝肾不足，外伤后，血弱阴虚中风，气滞痰凝，邪闭心包，络脉失调，症状属危重。治疗宜化风宣络，芳香开窍，涤痰顺气，镇心安神。先用安宫牛黄丸二丸用水化调匀，分次用鼻饲法内服。
午后复诊：症无显著变化，仅喉间痰声稍减，神识仍昏，抽搐时作。小便失禁，大便秘结。牙关微开，目能闭合。脉象弦大略减，舌苔仍燥，有龟裂。风势未平，痰凝气滞，邪闭心包，仍属危重。拟定用下方：
羚羊角4.5克（磨水兑服） 桑枝2.4克 代赭石15克 云茯神18克 全蝎1对 蜈蚣3条 石菖蒲4.5克 冲郁金9克 勾藤6克 甘草梢3克 蛇胆陈皮2支 宝丹1丸（上二药分次调入）
三诊：服上方后，神识渐清，呼之能应。目能开闭，口角喁斜较正。喉中痰声已稀，略能饮水下咽。但言语蹇涩舌体僵硬，抽搐阵作，肢体强直，难为转侧。微咳，龈肿。小便失禁较减，大便未通。脉象弦滑，舌红，苔黄而燥。此神明渐苏，风邪未化，筋络不舒，气滞痰凝。宜清化疏调。处方：
羚羊角3克（磨水兑服） 桑枝24克 云茯神15克 秦艽9克 勾藤6克 杭菊花6克 全蝎1对 薄荷6克 夏枯草6克 甘草3克 竹茹6克 青木香4.5克 蛇胆陈皮2支（调服）
四诊：上方服用两剂，神识已清，抽搐渐止。大便通，小便色黄能禁。时咳痰凝。仍言语蹇涩舌体僵硬，肢体转动不灵。脉弦滑，舌淡黄有津。此风象渐平，络脉未舒，肝肺燥热。续用下方祛风化痰，舒筋宣络。处方：
秦艽12克 桑枝24克 青木香4.5克 菊花6克 勾藤9克 天竺黄6克 甘草3克 蜂房6克 白吉力9克 姜蚕9克 竹茹6克
五诊：上方服用两剂，腰痛牙疼减轻，抽搐已停，渐能言语，口眼歪斜消除，肢体较能活动。大便畅通，小便淡黄。
咳嗽痰凝，神倦思睡，肢软无力。脉弦滑均减，舌淡红、苔薄黄而润。此风势已平，阴虚肺燥，络脉未调，心神不足之候。续用下方，养阴舒络，化痰缓调。处方：
白元参9克 大寸冬9克 怀牛夕9克 青木香4.5克 桑枝15克 川续断12克 杜仲12克 甘草3克 京半夏9克（冲服） 伸筋草9克
六诊：服上方近十剂，已能起床由家属搀扶慢步行走。
饮食增加，夜卧较宁。腰痛牙疼全止，咳痰稀少，二便正常。唯肢体软弱，头昏乏力。脉转弱缓调匀，舌红润有津。
此病退阴虚，肝肾络脉不强，气血心神未足，宜滋血益阴，安神、舒络，养肝熄风。处方：
炙首乌15克 大熟地15克 淮山药15克 云茯神15克 金石斛9克 怀牛夕9克 黑芝麻15克 粉丹皮6克 酸枣皮6克 炒泽泻6克 黑小豆15克 桑寄生12克 甘草梢3克
服数剂后，渐能单独行动，食眠均佳，就出院。嘱可常服上方调理善后。七、八年随访，情况良好，能自行料理生活，并作轻微事务。
[按语]老年气血失荣，肝肾阴亏，至为风火湿痰骤袭，急用凉开，祛邪启闭。继投清疏宣化缓调，随后滋益固本。
阴黄
李××，男性，三十一岁，教师，住昆明市。1931年夏来诊。患者自述病经二、三月，因周身黄疸，曾服柴胡平胃散、及茵陈蒿汤多剂，效不显。症状见面目全身晦黄不荣，肌肤浮肿，四肢冷，自汗淋淋衣被尽染黄色。胸膈痞闷，食少神疲，大便稀溏，小便黄短。脉象濡滞，舌质淡、苔白腻。此属久病，过服苦寒，脾肾之阳受损，运化失司，邪从寒化，呈现阴黄之候。法当温运渗利，兼理气和胃。处方：
炙附片30克（开水先煨透） 茵陈蒿12克 桂枝木9克 云茯苓30克 西砂仁9克（冲服） 广陈皮6克 川干姜9克 炒苡仁12克 小红枣11枚
二诊：上方服用两剂，患者面目全身黄疸、浮肿、自汗均减，肢冷转温，胸膈舒畅，小便清长，大便渐干。脉象濡缓，舌白腻退。此阳气渐回，脾运复苏。寒湿未尽，续宜温运渗化。处方：
炙附片30克（开水先煨透） 茵陈蒿12克 云茯苓30克 猪苓片9克 桂枝木9克 炒泽泻9克 川干姜9克 大红枣5枚
三诊：上方连续服用四剂，黄疸、浮肿、自汗诸症消失。脉弱缓，舌粉红而润。饮食增加，二便正常。病后体虚，脾肾未强。再拟定下方调补，数剂而安。
炙附片30克（开水先煨透） 潞党参15克 漂白术12克 茯苓神15克 西砂仁6克（冲服） 广陈皮6克 炒苡仁12克 生甘草3克 川干姜6克 大红枣3枚
[按语]阴黄之候，立温运渗化，脉象由濡滞而渐缓和，诸症迅退，可以知其为正法。
阳黄
王××，女性，二十八岁，干部。1959年7月就诊。
Phlegm-Jue (Sudden Collapse due to Phlegm)
Yuan XX, Male, 46 years old. September 1948.
First Visit: Cough for many days, worse at night. Previously took "Qingzao Jiufei Tang" (Clear Dryness and Rescue the Lung Decoction) and "Baihe Gujin Tang" (Lily Tonic for Metal Decoction), etc., but phlegm became condensed and difficult to expectorate, with a thick, sticky consistency, yellowish-white color. Subsequently developed chest tightness, panting, restless sleep, occasional loss of consciousness, cold limbs, and sweating. Lips were cyanotic, body emaciated, constipation, and scanty dark urine. Pulse was deep, fine, and slippery; tongue body red, coating yellow-white and thick/greasy. This is Spleen-dampness condensing into phlegm, latent heat in Gallbladder and Lung, Qi mechanism obstruction, manifesting as Phlegm-Jue. Treatment should focus on resolving phlegm and regulating Qi, clearing Gallbladder heat and dispelling dampness. Prescription:
Guang Xingren (Apricot Seed) 9g Chenpi (Aged Tangerine Peel) 6g Dan Chao Banxia (Gallbladder-fried Pinellia Rhizome) 9g Sheng Yiren (Raw Coix Seed) 12g Tian Jiegeng (Sweet Platycodon Root) 4.5g Chao Zhike (Stir-fried Aurantium Fruit) 6g Tinglizi (Descurainia Seed) 9g Dongguaren (Winter Melon Seed) 12g (taken with decoction) Zhuru (Bamboo Shavings) 6g Sheng Gancao (Raw Licorice Root) 3g Quangualou (Whole Trichosanthes Fruit) 1 piece (crushed)
Second Visit: After taking two doses of the above prescription, cough slightly decreased, but phlegm condensation remained. Constipation, scanty dark urine. Still experiencing occasional convulsions. Pulse wiry, slippery, and rapid; tongue coating yellow, thick, and greasy. Damp-phlegm is still heavy, Qi mechanism is unsmooth, Lung fails to descend, Gallbladder fire is scorching. Continue with the following prescription:
Dan Chao Banxia (Gallbladder-fried Pinellia Rhizome) 9g Hua Juhong (Transformed Tangerine Pulp) 6g Chao Zhimu (Stir-fried Anemarrhena Rhizome) 9g Guang Xingren (Apricot Seed) 9g Cu Duan Qingmengshi (Vinegar-processed Calcined Qingmeng Stone) 12g Zi Su Zi (Perilla Fruit) 9g (taken with decoction) Gancao (Licorice Root) 3g Tinglizi (Descurainia Seed) 6g Jin Gualou (Golden Trichosanthes Fruit) 1 branch (crushed) Zhuli (Bamboo Juice) 2 spoons (mixed in)
Third Visit: After taking three doses of the above prescription, stool passed smoothly, containing much mucus and frothy substance. Cough lightened, phlegm condensation gradually dissolved. Patient felt breath was clear and spirit was bright. The long-standing accumulated damp-phlegm and stagnant heat have been cleared and unblocked. Pulse wiry and slippery both reduced; tongue coating thinned. Disease trend towards recovery.
Further prescribe to continue clearing residual pathogens:
Dan Chao Banxia (Gallbladder-fried Pinellia Rhizome) 9g Guang Chenpi (Broad Aged Tangerine Peel) 6g Gualou Qiao (Trichosanthes Fruit Rind) 9g Guang Xingren (Apricot Seed) 9g Bai Fuling (White Poria) 12g Zhi Sangpi (Honey-fried Mulberry Bark) 9g Chao Zhike (Stir-fried Aurantium Fruit) 9g Sheng Yiren (Raw Coix Seed) 12g Jing Zhuru (Pure Bamboo Shavings) 6g Sheng Gancao (Raw Licorice Root) 3g Dongguaren (Winter Melon Seed) 9g (taken with decoction) Jing Paye (Pure Loquat Leaf) 2 leaves
[Commentary] Damp-phlegm is very heavy, Gallbladder fire is stagnant. Misuse of Yin-cold astringent agents led to Qi mechanism blockage resulting in Jue. Treatment follows the spirit of *Neijing*: "Disperse what is knotted," "Attack what remains." Efficacy was achieved.
Cough, Phlegm-Jue, and Somnolence Syndrome
Guo XX, Male, 48 years old, Cadre. December 1970.
First Visit: Patient constitutionally obese, fond of rich and sweet foods, weight increased daily over years.
Profuse turbid phlegm; slight cold causes hoarse voice, phlegm condensation, and breathing difficulty. Reported onset due to cold exposure, cough, chest tightness, rebellious Qi, coma/somnolence, anorexia. Pulse floating, wiry, and slippery; tongue coating thin white. Symptoms belong to Exterior Cold attacking Lung, stirring up Damp-Phlegm, obstructing Qi mechanism causing cough. Should use Acrid-Warm to scatter Cold, promote Qi movement and resolve phlegm. Prescription:
Mahuang (Ephedra Stem) 4.5g Guizhi Mu (Cinnamon Twig Wood) 6g Guang Xingren (Apricot Seed) 9g Fa Banxia (Processed Pinellia Rhizome) 9g Chenpi (Aged Tangerine Peel) 6g Bai Fushen (White Poria with Hostwood) 15g Qianhu Pian (Peucedani Radix Slice) 6g Chao Zhike (Stir-fried Aurantium Fruit) 6g Gancao (Licorice Root) 3g Shengjiang (Fresh Ginger) 2 slices Dazao (Jujube) 3 pieces
Second Visit: After two doses, cough reduced but phlegm not resolved. Chest/diaphragm fullness and hardness, belching, dry retching without food odor. Constant drowsiness/coma, difficult to wake, no appetite, poor bowel movement, scanty dark urine. New Cold has resolved, but Spleen/Stomach deficiency exists, internal turbid phlegm stagnates, Qi mechanism blocked, Heart deficiency leads to weak spirit, hence somnolence. Floating pulse aspect reduced, tongue yellow/greasy. Continue with prescription to resolve phlegm and direct rebellious Qi downward:
Kong Shashen (Empty Glehnia Root) 9g Xuanfuhua (Inula Flower) 9g Daizheshi (Hematite) 15g Fa Banxia (Processed Pinellia Rhizome) 9g Hua Juhong (Transformed Tangerine Pulp) 6g Bai Fushen (White Poria with Hostwood) 15g Sheng Gancao (Raw Licorice Root) 3g Shengjiang (Fresh Ginger) 2 slices Dazao (Jujube) 2 pieces Zhuli (Bamboo Juice) 2 spoons (mixed in)
Third Visit: After three consecutive doses, large amount of turbid phlegm expectorated, belching/retching significantly reduced, cough rare, chest/diaphragm clear, slight appetite returned, but still somnolent. Bowel movement smooth, urine short/yellow. Tongue tip red, greasy coating receded, pulse turned fine/slippery. Phlegm condensation gradually cleared, Dampness transformed into Dryness, Heart/Gallbladder heat present. Change to Clear Heart, Warm Gallbladder, Dispel Dampness, Resolve Phlegm prescription:
Chong Sheng Zaoren (Flushed Raw Sour Jujube Seed) 15g Chao Zhimu (Stir-fried Anemarrhena Rhizome) 6g Bai Fushen (White Poria with Hostwood) 15g Chong Chong Zhishi (Flushed Stir-fried Aurantium Immature Fruit) 6g Guang Chenpi (Broad Aged Tangerine Peel) 6g Fa Banxia (Processed Pinellia Rhizome) 9g Duan Daizheshi (Calcined Hematite) 9g Jing Zhuru (Pure Bamboo Shavings) 6g Sheng Gancao (Raw Licorice Root) 3g Shengjiang (Fresh Ginger) 2 slices Xiaozao (Small Jujube) 11 pieces
Prescribed ten doses, forbid rich/sweet foods. After 2-3 months, phlegm cleared, spirit bright, weight reduced, disease fully cured.
[Commentary] Phlegm is the root cause, new Cold is the branch. First scatter Cold and release Exterior, then direct rebellious Qi downward and resolve phlegm, finally Clear Heart and Warm Gallbladder.
Yang-Deficiency Stroke
Xu XX, Female, 75 years old, Kunming resident. August 1945.
First Visit: Constitution with abundant damp-phlegm, often feels dizzy, tinnitus, limb numbness. Suddenly fell upon waking, unconscious, pale face, cyanotic lips. Grandson urgently summoned me. Pulse wiry, large, slippery; Chi positions fine/weak; four limbs cold/reversed, jaw locked. Snoring respiration, gurgling phlegm sound, facial deviation. Symptoms belong to elderly Yang-deficiency, Internal Cold-Damp stagnation, Phlegm-Jue generating Wind. Immediately use YaZao (Gleditsia Sinensis Fruit) and Xixin (Asarum), powder blown into nose to induce sneezing, and prescribe Sansheng Yin (Three Living Decoction) modified. Prescription:
Sheng Fupian (Raw Prepared Aconite Lateral Root) 30g Sheng Chuanwu (Raw Sichuan Aconite Root) 15g Sheng Nanxing (Raw Arisaema Rhizome) 15g (These three simmered first for 2 hours)
Fa Banxia (Processed Pinellia Rhizome) 15g Guang Chenpi (Broad Aged Tangerine Peel) 6g Yun Muxiang (Aucklandia Root) 3g
Decoct strongly, add one spoon of Shengjiang juice per dose as guide, administer by force-feeding.
Second Visit: After taking prescription, vomited frothy phlegm-saliva, snoring/phlegm sounds reduced, spirit slightly recovered, four limbs reversed cold turned warm. Original prescription plus Shichangpu (Acorus Rhizome) 4.5g, Daizheshi (Hematite) 9g, take again.
Third Visit: Spirit gradually clear, phlegm-saliva less, can open mouth slightly. But speech slurred, tongue stiff, left hemiplegia. Tongue coating white/greasy, pulse deficient/wiry/slippery. Pericardium phlegm condensation gradually resolved, Meridian Wind pathogen not transformed, Qi mechanism unsmooth. Further prescribe:
Chuan Fupian (Sichuan Prepared Aconite Lateral Root) 30g (simmered thoroughly in boiling water first) Jiang Nanxing (Ginger-processed Arisaema Rhizome) 6g Fa Banxia (Processed Pinellia Rhizome) 9g Zhu Fushen (Cinnabar-coated Poria with Hostwood) 18g Nen Sangzhi (Tender Mulberry Twig) 30g Gouteng (Uncaria Ramulus cum Uncis) 9g Shichangpu (Acorus Rhizome) 4.5g Daizheshi (Hematite) 9g Yun Muxiang (Aucklandia Root) 4.5g Gancao Shao (Licorice Tip) 3g Shengjiang Pian (Fresh Ginger Slice) 15g Dazao (Jujube) 3 pieces
Fourth Visit: After two doses, spirit fully recovered, phlegm-saliva greatly reduced, can eat slightly, facial deviation slight. Occasional cough, left hemiplegia useless. Tongue same, pulse fine/wiry/slippery, Chi positions stronger than before. Continue prescription to Warm Yang, Resolve Phlegm, Dispel Wind, Nourish Blood, Soothe Meridians, continue treatment.
Zhi Fupian (Honey-fried Prepared Aconite Lateral Root) 30g (simmered thoroughly in boiling water first) Jiang Nanxing (Ginger-processed Arisaema Rhizome) 15g Fa Banxia (Processed Pinellia Rhizome) 9g Nen Sangzhi (Tender Mulberry Twig) 15g Fuling Shen (Poria with Hostwood) 15g Huai Niuxi (Achyranthes Bidentata Root) 9g Zhi Shouwu (Honey-fried Polygonum Multiflorum Root) 15g Quan Danggui (Whole Angelica Sinensis Root) 15g Hei Zhima (Black Sesame Seed) 15g Yun Muxiang (Aucklandia Root) 9g Guang Dilong (Broad Earthworm) 4.5g Xixian Cao (Siegesbeckia Herb) 9g Guang Chenpi (Broad Aged Tangerine Peel) 6g Sheng Gancao (Raw Licorice Root) 3g Shengjiang Pian (Fresh Ginger Slice) 9g Sheng Sanqi Mo (Raw Notoginseng Powder) 4.5g Dazao (Jujube) 7 pieces (mixed in portions)
Fifth Visit: After more than ten doses, can walk slowly with support, eating/sleeping/bowel/bladder normal. Left half-body still paralyzed/unresponsive, belonging to elderly Blood deficiency, Meridian disharmony, difficult to fully recover at this time. Prescribe original prescription doubled, made into pills, taken morning/evening regularly.
[Commentary] Elderly Yang-deficiency, Cold-Damp internal storage, Phlegm-Jue generating wind, sudden collapse, jaw locked, four limbs cold/reversed, critical condition. First use YaZao, Xixin to induce sneezing, open orifices, unblock passages. Then use large dose of Sansheng Yin modified to Return Yang, Dispel Wind, Resolve Phlegm, Soothe Meridians. Condition alleviated. Left hemiplegia, slow walking due to post-stroke Yang-deficiency, meridian stiffness, insufficient Qi/Blood. Turning danger to safety is truly remarkable.
Yin-Deficiency Stroke
Zhao XX, Male, 65 years old, Worker. 1970.
First Visit: Hospitalized for lumbar trauma, not fully healed. Recurrent toothache/headache, painkillers ineffective. One morning, sudden stroke, spirit confused, eyes staring straight, unresponsive to call, gurgling phlegm sound in throat, hand/foot convulsions, mouth corner deviation. Orthopedics consulted me.
Pulse wiry, large, slippery, jaw locked, pried open with bamboo chopstick, tongue tip red, coating dry, cracked. Elderly Liver/Kidney insufficiency, post-trauma Blood weakness/Yin deficiency stroke, Qi stagnation/Phlegm condensation, Pathogen closing Pericardium, Meridian disharmony, critical symptoms. Treatment: Transform Wind, Unblock Meridians, Aromatic Open Orifices, Scour Phlegm, Regulate Qi, Calm Heart, Pacify Spirit. First use Angong Niuhuang Wan (Calico Bull's Gallstone Pill) 2 pills, mixed with water, administered via nasogastric tube in portions.
Afternoon Second Visit: No significant change, only throat phlegm sound slightly reduced, spirit still confused, convulsions occurring. Urinary incontinence, fecal impaction. Jaw slightly open, eyes can close. Pulse wiry/large slightly reduced, tongue coating still dry/cracked. Wind势头 not calm, Phlegm condensation/Qi stagnation, Pathogen closing Pericardium, still critical. Prescribe:
Lingyangjiao (Antelope Horn) 4.5g (ground water mixed in) Sangzhi (Mulberry Twig) 2.4g Daizheshi (Hematite) 15g Yun Fushen (Cloud Poria with Hostwood) 18g Quanxie (Whole Scorpion) 1 pair Wugong (Centipede) 3 strips Shichangpu (Acorus Rhizome) 4.5g Chong Yujin (Curcuma Aromatica Rhizome) 9g Gouteng (Uncaria Ramulus cum Uncis) 6g Gancao Shao (Licorice Tip) 3g Shedan Chenpi (Snake-Gall Tangerine Peel) 2 tubes Baodan (Precious Pill) 1 pill (These two medicines mixed in portions)
Third Visit: After taking prescription, spirit gradually clear, responds to call. Eyes open/close, mouth deviation corrected. Throat phlegm sound sparse, can drink/swallow slightly. Speech slurred, tongue stiff, intermittent convulsions, limb rigidity, difficult to turn. Mild cough, gum swelling. Urinary incontinence reduced, stool not passed. Pulse wiry/slippery, tongue red, coating yellow/dry. Spirit gradually recovering, Wind pathogen not transformed, sinews/meridians unsoothed, Qi stagnation/Phlegm condensation. Suitable for Clearing/Transforming/Dredging. Prescription:
Lingyangjiao (Antelope Horn) 3g (ground water mixed in) Sangzhi (Mulberry Twig) 24g Yun Fushen (Cloud Poria with Hostwood) 15g Qinjiao (Gentiana Macrophylla Root) 9g Gouteng (Uncaria Ramulus cum Uncis) 6g Hang Juhua (Hangzhou Chrysanthemum Flower) 6g Quanxie (Whole Scorpion) 1 pair Bohe (Mint) 6g Xiakucao (Prunella Vulgaris Spike) 6g Gancao (Licorice Root) 3g Zhuru (Bamboo Shavings) 6g Qingmuxiang (Illicium Anisatum Fruit) 4.5g Shedan Chenpi (Snake-Gall Tangerine Peel) 2 tubes (mixed in)
Fourth Visit: After two doses, spirit clear, convulsions stopped. Stool passed, urine yellow/controllable. Occasional cough/phlegm. Still speech slurred/tongue stiff, limb movement unresponsive. Pulse wiry/slippery, tongue pale yellow/moist. Wind signs calming, meridians unsoothed, Liver/Lung Dryness-Heat. Continue prescription to Dispel Wind, Resolve Phlegm, Soothe Sinews, Unblock Meridians. Prescription:
Qinjiao (Gentiana Macrophylla Root) 12g Sangzhi (Mulberry Twig) 24g Qingmuxiang (Illicium Anisatum Fruit) 4.5g Juhua (Chrysanthemum Flower) 6g Gouteng (Uncaria Ramulus cum Uncis) 9g Tianzhuhuang (Calamus Rhizome) 6g Gancao (Licorice Root) 3g Fengfang (Honeycomb) 6g Baijili (White Centipede - likely typo for Baiji or similar, kept as transliteration) 9g Jiangcan (Silkworm) 9g Zhuru (Bamboo Shavings) 6g
Fifth Visit: After two doses, waist/tooth pain reduced, convulsions stopped, can speak gradually, facial deviation eliminated, limb activity improved. Stool smooth, urine pale yellow.
Cough/phlegm condensation, spirit fatigue/somnolence, limb soft/weak. Pulse wiry/slippery reduced, tongue pale red/coating thin yellow/moist. Wind势头 calmed, Yin deficiency/Lung dryness, meridians unregulated, Heart spirit insufficient. Continue prescription to Nourish Yin, Soothe Meridians, Resolve Phlegm, Slow Regulation. Prescription:
Bai Yuanshen (White Scrophularia Root) 9g Da Mudong (Large Ophiopogon Tuber) 9g Huai Niuxi (Achyranthes Bidentata Root) 9g Qingmuxiang (Illicium Anisatum Fruit) 4.5g Sangzhi (Mulberry Twig) 15g Chuan Xuduan (Teasel Root) 12g Duzhong (Eucommia Bark) 12g Gancao (Licorice Root) 3g Jing Banxia (Capital Pinellia Rhizome) 9g (taken with decoction) Shenjincao (Lycopodium Clubmoss Herb) 9g
Sixth Visit: After nearly ten doses, can get up, walk slowly supported by family.
Diet increased, night sleep quieter. Waist/tooth pain stopped, cough/phlegm rare, bowel/bladder normal. Only limb weakness, dizziness/fatigue. Pulse weak/slow/regular, tongue red/moist.
Disease retreated, Yin deficiency, Liver/Kidney meridians weak, Qi/Blood/Heart spirit insufficient. Suitable to Nourish Blood, Benefit Yin, Calm Spirit, Soothe Meridians, Nourish Liver, Extinguish Wind. Prescription:
Zhi Shouwu (Honey-fried Polygonum Multiflorum Root) 15g Da Shudi (Large Prepared Rehmannia Root) 15g Huai Shanyao (Huai Chinese Yam) 15g Yun Fushen (Cloud Poria with Hostwood) 15g Jinshihu (Dendrobium Stem) 9g Huai Niuxi (Achyranthes Bidentata Root) 9g Hei Zhima (Black Sesame Seed) 15g Fen Danpi (Powdered Moutan Cortex) 6g Suanzaoren Pi (Sour Jujube Seed Skin) 6g Chao Zexie (Stir-fried Alisma Rhizome) 6g Hei Xiaodou (Black Soybean) 15g Sangjisheng (Taxillus Branch) 12g Gancao Shao (Licorice Tip) 3g
After several doses, can walk alone, eating/sleeping good, discharged. Advised to take prescription regularly for recovery. 7-8 years follow-up, condition good, can manage life independently, do minor tasks.
[Commentary] Elderly Qi/Blood lack nourishment, Liver/Kidney Yin deficiency, suddenly attacked by Wind/Fire/Damp/Phlegm. Urgently use Cool Opening to Expel Pathogen and Open Blockage. Then Clear/Dredge/Transform/Regulate slowly, finally Nourish/Consolidate Root.
Yin Jaundice
Li XX, Male, 31 years old, Teacher, Kunming resident. Summer 1931. Patient reported illness for 2-3 months, whole body jaundice, took Chaihu Pingwei San and Yinchen Hao Tang multiple doses, efficacy不明显. Symptoms: dull yellow complexion/body, edema, cold limbs, profuse sweating staining clothes/quilt yellow. Chest/diaphragm fullness, poor appetite/fatigue, loose stool, scanty yellow urine. Pulse soggy/stagnant, tongue pale/coating white/greasy. Long-term illness, excessive bitter-cold herbs damaged Spleen/Kidney Yang, transportation failed, pathogen transformed from Cold, presenting Yin Jaundice. Method: Warm Transport, Leach/Promote Diuresis, regulate Qi harmonize Stomach. Prescription:
Zhi Fupian (Honey-fried Prepared Aconite Lateral Root) 30g (simmered in boiling water first) Yinchen Hao (Artemisia Capillaris Herb) 12g Guizhi Mu (Cinnamon Twig Wood) 9g Yun Fuling (Cloud Poria) 30g Xi Sharen (Amomum Villosum Fruit) 9g (taken with decoction) Guang Chenpi (Broad Aged Tangerine Peel) 6g Chuan Ganjiang (Sichuan Dried Ginger) 9g Chao Yiren (Stir-fried Coix Seed) 12g Xiao Hongzao (Small Red Jujube) 11 pieces
Second Visit: After two doses, jaundice/edema/sweating reduced, limbs warm, chest/diaphragm comfortable, urine clear/long, stool drying. Pulse soggy/slow, white/greasy coating receded. Yang energy gradually returning, Spleen transport reviving. Cold-Damp not exhausted, continue Warm Transport/Leach/Transform. Prescription:
Zhi Fupian (Honey-fried Prepared Aconite Lateral Root) 30g (simmered in boiling water first) Yinchen Hao (Artemisia Capillaris Herb) 12g Yun Fuling (Cloud Poria) 30g Zhuling Pian (Polyporus Slice) 9g Guizhi Mu (Cinnamon Twig Wood) 9g Chao Zexie (Stir-fried Alisma Rhizome) 9g Chuan Ganjiang (Sichuan Dried Ginger) 9g Da Hongzao (Large Red Jujube) 5 pieces
Third Visit: After four consecutive doses, jaundice/edema/sweating disappeared. Pulse weak/slow, tongue pink/moist. Diet increased, bowel/bladder normal. Post-illness weakness, Spleen/Kidney not strong. Further prescribe for tonification, stable after several doses.
Zhi Fupian (Honey-fried Prepared Aconite Lateral Root) 30g (simmered in boiling water first) Luodangshen (Luodong Codonopsis Root) 15g Biaobai Zhu (Bleached White Atractylodes Rhizome) 12g Fuling Shen (Poria with Hostwood) 15g Xi Sharen (Amomum Villosum Fruit) 6g (taken with decoction) Guang Chenpi (Broad Aged Tangerine Peel) 6g Chao Yiren (Stir-fried Coix Seed) 12g Sheng Gancao (Raw Licorice Root) 3g Chuan Ganjiang (Sichuan Dried Ginger) 6g Da Hongzao (Large Red Jujube) 3 pieces
[Commentary] Yin Jaundice syndrome, establish Warm Transport/Leach/Transform. Pulse changed from soggy/stagnant to gradual relaxation, symptoms rapidly receded, confirming correct method.
Yang Jaundice
Wang XX, Female, 28 years old, Cadre. July 1959.