左 每至大便,辄痔随便出,甚则带红必睡卧良久,方得渐收。湿热压坠大肠。宜清府理湿,以望轻减。
秦艽(一钱五分) 粉丹皮(二钱) 炙 皮(一钱) 防风炭(六分) 当归炭(二钱) 炒槐花(二钱)
白茯苓(三钱) 侧柏炭(三钱) 鲜首乌(五钱) 槐角丸(三钱开水先服)
尹(左) 肛门痔坠,脘痞不舒,食入腹满。此痰湿有余,湿压府气。不易图治也。
焦白术 赤白苓 防风根 猪苓 泽泻 砂仁 制半夏 上广皮 煨葛根 制香附 生熟米仁
二诊 肠痔下坠,肛门作痛。苟非湿热有余,则气坠何致作痛。然卧着之后,肛仍不收,中气亦未必实。
拟汤丸并进,上下分治。
野于术 川黄柏(姜汁炒) 泽泻 赤白苓 生米仁 制半夏 苍术(麻油炒黄) 猪苓 补中益气丸(三钱开水
晚服)
师曰、肛坠有二,一则气虚,一则湿坠,气虚不痛,此则作痛,故曰湿热也。(清儒志)
某 阳络伤则血外溢,血外溢则衄血,阴络伤则血内溢,血内溢则后血,此主便血而言其来于脏腑
者也。便血频年累月,安有复能支持之理。此盖由湿热内郁,结成肠痔,血即由此而来,与所谓远血者有间。
炒于苍术(各一钱五分) 炒防风(一钱) 川连炭(五分) 丹皮炭(二钱) 炒荆芥(一钱五分)
川柏炭(一钱五分) 赤猪苓(各二钱) 炒槐花(二钱) 泽泻(一钱五分) 大红鸡冠花(三钱)
左 痔坠便血身热。风邪在表,湿热在府。
冬桑叶(一钱) 炒槐花(二钱) 川连炭(五分) 秦艽(一钱五分) 防风(一钱) 丹皮炭(二钱)
川柏炭(三钱) 荆芥炭(一钱) 炒枳壳(一钱) 皂荚子(一钱五分蜜炙)
二诊 便血已止,肛门灼热湿热不楚也。
川柏 炒槐角 秦艽 泽泻 地榆炭 黄芩炭 蜜炙皂角子
李(左) 咳嗽渐定,肛门痛胀虚火郁于大肠也。
炒槐花 淡芩 象贝母 冬瓜子 粉丹皮 炒杏仁 甘草 天花粉 枇杷叶膏(三钱)
二诊 肛门痛胀大减,每至清晨,气冲欲咳,日间则干呛无痰,阴分日亏还恐传损。
生地炭(四钱) 粉丹皮(二钱) 象贝母(二钱) 甜杏仁(三钱) 甘草(三分) 炒槐花(二钱)
青蛤散(三钱) 冬瓜子(三钱) 枇杷叶(三钱蜜炙) 都气丸(三钱先服)
郑(左) 肛门胀硬作痛,海底穴筋掣,肾囊牵引,髀关疼痛,大便不畅,肉色不变。此由痰湿结聚,势成外
疡,宜求 门名家商治。
炒小茴(五分) 川萆 (三钱) 制半夏(一钱五分) 泽泻(二钱) 没药(四分去油) 鹿角霜(三钱)
广橘红(一钱) 左秦艽(一钱五分) 云苓(三钱) 桑枝(七钱酒炒)
迟(左) 便血仍然不止,其血滴沥而下。风湿热郁于大肠,肠痔情形。前法再进一筹。
荆芥炭(一钱) 黄柏炭(三钱) 丹皮炭(二钱) 防风炭(一钱) 细生地(四钱) 柏叶炭(三钱)
地榆炭(三钱) 木耳炭(二钱) 炒槐花(二钱) 泽泻(一钱五分) 当归炭(一钱五分) 赤白苓(各二钱)
二诊 加川连炭血余炭二妙丸。
郑(左) 大便之后,血遂注下。湿热结于大肠,肠痔情形也。
苍术(一钱麻油炒黄) 荆芥炭(一钱) 茯苓(三钱) 当归炭(二钱) 炒防风(一钱) 泽泻(一钱五分)
川连炭(五分) 黄芩(一钱五分) 黄柏炭(三钱) 白术(一钱) 陈大红鸡冠花(三钱炙)
二诊 血下稍止。再大苦泄热,使直透肠中。
黄柏炭 秦艽 炒槐花 炒丹皮 台白术 川连炭 泽泻 猪茯苓 防风炭 炒荆芥
右 痔坠便血。肝火湿热下注于肠。不宜急切图功。
黄柏炭(二钱) 炒槐米(二钱) 炒丹皮(二钱) 地榆炭(二钱) 川连炭(三分) 火麻仁(一钱五分)
龟甲心(七钱先煎) 荆芥炭(一钱五分) 润肠丸(一钱五分)
二诊 痔坠下血大减。再凉血宽肠。
白术炭 煨天麻 白蒺藜 钩钩 石决明 茯苓神 丹皮炭 火麻仁 泽泻
邵(左) 肺痈之后,湿热下趋大肠,每至大便,痔坠下血。日来胃钝少纳,中脘不舒。脉象微滑,舌苔粘腻。
似不在阴虚之极、阴络损伤之例。良以湿热伤营,营络不固。非苦温不足以胜湿,非大苦不足以泄热而入肠中也。
泽泻(一钱五分) 丹皮炭(二钱) 炒槐花(二钱) 防风炭(一钱) 于术(土炒钱半) 苍术(八分麻油
炒黄) 黄柏炭(三钱) 白茯苓(三钱) 红鸡冠花(三钱)
二诊 培土燥湿泄热,下血稍减。若是阴虚而阴络不固,断不能如此和平也。前法再进一步。
苍术(一钱二分) 防风炭(一钱) 黄柏炭(三钱) 丹皮炭(二钱) 荆芥炭(一钱) 当归炭(一钱
五分) 土炒于术(二钱) 大红鸡冠花(三钱) 脏连丸(二钱)
三诊 血色渐淡,大肠湿热稍清,而脾阳不能固摄之象也。再温脏清腑。
苍于术(各一钱五分) 丹皮炭(一钱五分) 川连炭(四分) 黄柏炭(三钱) 炮姜炭(六分) 云苓(三钱)
防风炭(一钱) 生薏仁(四钱) 泽泻(一钱五分) 大红鸡冠花(三钱)
四诊 温脏清腑肠红大退。的是大肠湿热有余,而脾土真阳不足。非大苦不足以泄肠中之湿,非大
温不足以复脾藏之阳气也。
川连炭(三分) 黄柏炭(二钱) 焦茅术(一钱五分) 丹皮炭(二钱) 茯苓(三钱) 炮姜炭(五分)
泽泻(一钱五分) 炒于术(一钱五分) 大红鸡冠花(三钱) 黑地黄丸(三钱)
五诊 血已止住。然血去阴伤,诸虚杂出。既节其流,再开其源。
朱茯神(三钱) 女贞子(三钱) 柏子仁(三钱) 当归炭(二钱) 白芍(一钱五分) 旱莲草(二钱)
池菊花(二钱) 黑 豆衣(三钱) 黑地黄丸(三钱)
六诊 肠红之后,气觉上逆。再导湿热下行,而引入膀胱。
冬瓜子 光杏仁 生米仁 通草 滑石 云茯苓 白蒺藜 池菊花 青芦尖
七诊 阳气上逆不平,面色浮黄,筋脉跳跃。此由血去阴伤,不能涵养。再培土养肝。
生于术 白茯苓 白蒺藜 黑豆衣 冬瓜子 生米仁 晚蚕砂 海蛤壳 炒竹茹
八诊 神情稍振,面色浮黄稍退。再培土养肝,仍参理湿。
于术 黑豆衣 女贞子 茯苓 生薏仁 泽泻 蚕砂 海蛤壳 炒竹茹 白蒺藜 生山药
左。每次到大便时,痔疮随即脱出,严重时伴有出血,必须躺卧很久,才能逐渐回纳。这是湿热下注压迫大肠所致。适宜采用清利脏腑、理气化湿的方法,期望病情减轻。
秦艽(一钱五分) 粉丹皮(二钱) 炙皮(一钱) 防风炭(六分) 当归炭(二钱) 炒槐花(二钱)
白茯苓(三钱) 侧柏炭(三钱) 鲜首乌(五钱) 槐角丸(三钱,开水先服)
尹(左)。肛门痔疮下坠,胃脘部痞闷不舒,进食后腹部胀满。这是痰湿有余,湿气压制了腑气。不容易治疗。
焦白术 赤茯苓与白茯苓 防风根 猪苓 泽泻 砂仁 制半夏 上广皮 煨葛根 制香附 生薏苡仁与熟薏苡仁
二诊。肠道痔疮下坠,肛门疼痛。如果不是湿热有余,气机下坠怎么会引起疼痛呢?然而躺卧之后,肛门仍然不能回纳,说明中气也未必充实。
拟用汤剂与丸药并进,上下分治。
野于术 川黄柏(姜汁炒) 泽泻 赤茯苓与白茯苓 生薏苡仁 制半夏 苍术(麻油炒黄) 猪苓 补中益气丸(三钱,开水晚服)
老师说道:肛门下坠有两种情况,一种是气虚,一种是湿邪下坠。气虚则不痛,此症作痛,所以说是湿热。(清儒志)
某。阳络受伤则血液外溢,血液外溢则发生鼻衄;阴络受伤则血液内溢,血液内溢则发生便血,这是主要就便血而言,指出其来源于脏腑。
便血多年累月,哪里还有能够支撑的道理呢?这大概是由湿热内郁,结成肠道痔疮,血液即由此而来,与所谓的“远血”有所不同。
炒苍术与炒白术(各一钱五分) 炒防风(一钱) 川连炭(五分) 丹皮炭(二钱) 炒荆芥(一钱五分)
川柏炭(一钱五分) 赤茯苓与猪苓(各二钱) 炒槐花(二钱) 泽泻(一钱五分) 大红鸡冠花(三钱)
左。痔疮下坠伴便血,身体发热。风邪在表,湿热在腑。
冬桑叶(一钱) 炒槐花(二钱) 川连炭(五分) 秦艽(一钱五分) 防风(一钱) 丹皮炭(二钱)
川柏炭(三钱) 荆芥炭(一钱) 炒枳壳(一钱) 皂荚子(一钱五分,蜜炙)
二诊。便血已经停止,肛门灼热,说明湿热未除。
川柏 炒槐角 秦艽 泽泻 地榆炭 黄芩炭 蜜炙皂角子
李(左)。咳嗽逐渐平息,肛门疼痛胀满,是虚火郁结于大肠所致。
炒槐花 淡黄芩 象贝母 冬瓜子 粉丹皮 炒杏仁 甘草 天花粉 枇杷叶膏(三钱)
二诊。肛门疼痛胀满大减,每到清晨,气冲欲咳,白天则干咳无痰,阴分日渐亏损,还恐怕传变为虚损病。
生地炭(四钱) 粉丹皮(二钱) 象贝母(二钱) 甜杏仁(三钱) 甘草(三分) 炒槐花(二钱)
青蛤散(三钱) 冬瓜子(三钱) 枇杷叶(三钱,蜜炙) 都气丸(三钱,先服)
郑(左)。肛门胀硬作痛,海底穴筋脉抽搐,肾囊牵引疼痛,大腿根部髀关疼痛,大便不畅,皮肤颜色不变。这是由痰湿结聚,势成外疡,宜寻求外科名家商量治疗。
炒小茴(五分) 川萆薢(三钱) 制半夏(一钱五分) 泽泻(二钱) 没药(四分,去油) 鹿角霜(三钱)
广橘红(一钱) 左秦艽(一钱五分) 云茯苓(三钱) 桑枝(七钱,酒炒)
迟(左)。便血仍然不止,血液滴沥而下。风湿热郁结于大肠,属肠痔情形。前方再进一筹。
荆芥炭(一钱) 黄柏炭(三钱) 丹皮炭(二钱) 防风炭(一钱) 细生地(四钱) 柏叶炭(三钱)
地榆炭(三钱) 木耳炭(二钱) 炒槐花(二钱) 泽泻(一钱五分) 当归炭(一钱五分) 赤茯苓与白茯苓(各二钱)
郑(左)。大便之后,血液随之注下。这是湿热结于大肠,属肠痔情形。
苍术(一钱,麻油炒黄) 荆芥炭(一钱) 茯苓(三钱) 当归炭(二钱) 炒防风(一钱) 泽泻(一钱五分)
川连炭(五分) 黄芩(一钱五分) 黄柏炭(三钱) 白术(一钱) 陈大红鸡冠花(三钱,炙)
二诊。下血稍微停止。再用大苦之品泄热,使药力直透肠中。
黄柏炭 秦艽 炒槐花 炒丹皮 台白术 川连炭 泽泻 猪茯苓 防风炭 炒荆芥
右。痔疮下坠伴便血。肝火湿热下注于肠。不宜急切求功。
黄柏炭(二钱) 炒槐米(二钱) 炒丹皮(二钱) 地榆炭(二钱) 川连炭(三分) 火麻仁(一钱五分)
龟甲心(七钱,先煎) 荆芥炭(一钱五分) 润肠丸(一钱五分)
二诊。痔疮下坠下血大减。再凉血宽肠。
白术炭 煨天麻 白蒺藜 钩藤 石决明 茯苓神 丹皮炭 火麻仁 泽泻
邵(左)。肺痈之后,湿热下趋大肠,每次到大便时,痔疮下坠下血。近日胃口迟钝,进食减少,中脘部不舒。脉象微滑,舌苔粘腻。
似乎不属于阴虚至极、阴络损伤的范畴。实在是因为湿热伤及营分,营络不固。非苦温不足以胜湿,非大苦不足以泄热而入肠中。
泽泻(一钱五分) 丹皮炭(二钱) 炒槐花(二钱) 防风炭(一钱) 于术(土炒,一钱半) 苍术(八分,麻油炒黄) 黄柏炭(三钱) 白茯苓(三钱) 红鸡冠花(三钱)
二诊。培土燥湿泄热,下血稍减。如果是阴虚而阴络不固,断然不能如此平和有效。前方再进一步。
苍术(一钱二分) 防风炭(一钱) 黄柏炭(三钱) 丹皮炭(二钱) 荆芥炭(一钱) 当归炭(一钱五分) 土炒于术(二钱) 大红鸡冠花(三钱) 脏连丸(二钱)
三诊。血色渐淡,大肠湿热稍清,但出现脾阳不能固摄的迹象。再温脏清腑。
苍术与于术(各一钱五分) 丹皮炭(一钱五分) 川连炭(四分) 黄柏炭(三钱) 炮姜炭(六分) 云茯苓(三钱)
防风炭(一钱) 生薏苡仁(四钱) 泽泻(一钱五分) 大红鸡冠花(三钱)
四诊。温脏清腑,肠红大退。确是大肠湿热有余,而脾土真阳不足。非大苦不足以泄肠中之湿,非大温不足以恢复脾藏之阳气。
川连炭(三分) 黄柏炭(二钱) 焦茅术(一钱五分) 丹皮炭(二钱) 茯苓(三钱) 炮姜炭(五分)
泽泻(一钱五分) 炒于术(一钱五分) 大红鸡冠花(三钱) 黑地黄丸(三钱)
五诊。血已止住。然而血去则阴伤,各种虚证杂出。既然节流,再开源。
朱茯神(三钱) 女贞子(三钱) 柏子仁(三钱) 当归炭(二钱) 白芍(一钱五分) 旱莲草(二钱)
池菊花(二钱) 黑豆衣(三钱) 黑地黄丸(三钱)
六诊。肠红之后,感觉气机上逆。再导湿热下行,并引入膀胱。
冬瓜子 光杏仁 生薏苡仁 通草 滑石 云茯苓 白蒺藜 池菊花 青芦尖
七诊。阳气上逆不平,面色浮黄,筋脉跳跃。这是由于血去阴伤,不能涵养所致。再培土养肝。
生于术 白茯苓 白蒺藜 黑豆衣 冬瓜子 生薏苡仁 晚蚕砂 海蛤壳 炒竹茹
八诊。神情稍振作,面色浮黄稍退。再培土养肝,仍参入理湿之法。
于术 黑豆衣 女贞子 茯苓 生薏苡仁 泽泻 蚕砂 海蛤壳 炒竹茹 白蒺藜 生山药
Left. Every time defecation occurs, the hemorrhoids prolapse immediately; in severe cases with bleeding, one must lie down for a long time before they can gradually retract. This is caused by damp-heat pressing down on the Large Intestine. It is appropriate to clear the fu-organs and resolve dampness, hoping for alleviation.
Qin Jiao (1.5 qian) Fen Dan Pi (2 qian) Zhi Pi (1 qian) Fang Feng Tan (0.6 fen) Dang Gui Tan (2 qian) Chao Huai Hua (2 qian)
Bai Fu Ling (3 qian) Ce Bai Tan (3 qian) Xian Shou Wu (5 qian) Huai Jiao Wan (3 qian, taken first with boiling water)
Yin (Left). Hemorrhoidal prolapse at the anus, epigastric fullness and discomfort, abdominal distension after eating. This indicates excess phlegm-dampness, where dampness suppresses the qi of the fu-organs. It is difficult to treat.
Jiao Bai Zhu Chi Bai Fu Ling Fang Feng Gen Zhu Ling Ze Xie Sha Ren Zhi Ban Xia Shang Guang Pi Wei Ge Gen Zhi Xiang Fu Sheng Shu Yi Ren
Second visit. Intestinal hemorrhoidal prolapse, pain in the anus. If there were no excess damp-heat, how would qi sinking cause pain? However, after lying down, the anus still does not retract, suggesting that the middle qi may not be solid.
Prescribe decoction and pills together, treating upper and lower separately.
Ye Yu Chu Chuan Huang Bo (stir-fried with ginger juice) Ze Xie Chi Bai Fu Sheng Yi Ren Zhi Ban Xia Cang Zhu (stir-fried with sesame oil) Zhu Ling Bu Zhong Yi Qi Wan (3 qian, taken late at night with boiling water)
The Master said: There are two types of anal prolapse: one is qi deficiency, the other is damp-sinking. Qi deficiency does not cause pain; this case causes pain, hence it is damp-heat. (Qing Ru Zhi)
Certain patient. When yang collaterals are injured, blood overflows externally, resulting in epistaxis; when yin collaterals are injured, blood overflows internally, resulting in hematochezia. This refers primarily to hematochezia originating from the zang-fu organs.
Hematochezia persisting for years, how can the body sustain it? This is likely due to internal stagnation of damp-heat forming intestinal hemorrhoids, from which the blood originates, differing from what is called "distant blood."
Chao Cang Bai Zhu (each 1.5 qian) Chao Fang Feng (1 qian) Chuan Lian Tan (0.5 fen) Dan Pi Tan (2 qian) Chao Jing Jie (1.5 qian)
Chuan Bai Tan (1.5 qian) Chi Zhu Ling (each 2 qian) Chao Huai Hua (2 qian) Ze Xie (1.5 qian) Da Hong Ji Guan Hua (3 qian)
Left. Hemorrhoidal prolapse with hematochezia, fever. Wind pathogen is at the exterior, damp-heat is in the fu-organs.
Dong Sang Ye (1 qian) Chao Huai Hua (2 qian) Chuan Lian Tan (0.5 fen) Qin Jiao (1.5 qian) Fang Feng (1 qian) Dan Pi Tan (2 qian)
Chuan Bai Tan (3 qian) Jing Jie Tan (1 qian) Chao Zhi Ke (1 qian) Zao Jia Zi (1.5 qian, honey-fried)
Second visit. Hematochezia has stopped, but the anus feels burning, indicating damp-heat remains unresolved.
Chuan Bai Chao Huai Jiao Qin Jiao Ze Xie Di Yu Tan Huang Qin Tan Mi Zhi Zao Jia Zi
Li (Left). Cough is gradually subsiding, but the anus feels painful and distended, due to deficient fire郁结 (stagnating) in the Large Intestine.
Chao Huai Hua Dan Qin Xiang Bei Mu Dong Gua Zi Fen Dan Pi Chao Xing Ren Gan Cao Tian Hua Fen Pi Pa Ye Gao (3 qian)
Second visit. Anal pain and distension have greatly decreased. Every morning, qi rushes upward causing urge to cough; during the day, dry hacking cough without sputum. Yin aspect is daily declining, fearing transmission into consumptive disease.
Sheng Di Tan (4 qian) Fen Dan Pi (2 qian) Xiang Bei Mu (2 qian) Tian Xing Ren (3 qian) Gan Cao (0.3 fen) Chao Huai Hua (2 qian)
Qing Ge San (3 qian) Dong Gua Zi (3 qian) Pi Pa Ye (3 qian, honey-fried) Du Qi Wan (3 qian, taken first)
Zheng (Left). Anus swollen, hard, and painful; tendons at Hai Di point twitch; scrotum pulls and hurts; Bi Guan (thigh root) hurts; bowel movement is unsmooth; skin color unchanged. This is due to accumulation of phlegm-dampness, potentially becoming an external abscess. Seek advice from a renowned surgeon.
Chao Xiao Hui (0.5 fen) Chuan Bi Xie (3 qian) Zhi Ban Xia (1.5 qian) Ze Xie (2 qian) Mo Yao (0.4 fen, de-oiled) Lu Jiao Shuang (3 qian)
Guang Ju Hong (1 qian) Zuo Qin Jiao (1.5 qian) Yun Fu Ling (3 qian) Sang Zhi (7 qian, wine-fried)
Chi (Left). Hematochezia still persists, dripping slowly. Wind-damp-heat stagnates in the Large Intestine, presenting as intestinal hemorrhoids. Advance the previous prescription further.
Jing Jie Tan (1 qian) Huang Bai Tan (3 qian) Dan Pi Tan (2 qian) Fang Feng Tan (1 qian) Xi Sheng Di (4 qian) Bai Ye Tan (3 qian)
Di Yu Tan (3 qian) Mu Er Tan (2 qian) Chao Huai Hua (2 qian) Ze Xie (1.5 qian) Dang Gui Tan (1.5 qian) Chi Bai Fu Ling (each 2 qian)
Second visit. Add Chuan Lian Tan, Xue Yu Tan, and Er Miao Wan.
Zheng (Left). After defecation, blood pours down. Damp-heat knots in the Large Intestine, presenting as intestinal hemorrhoids.
Cang Zhu (1 qian, stir-fried with sesame oil until yellow) Jing Jie Tan (1 qian) Fu Ling (3 qian) Dang Gui Tan (2 qian) Chao Fang Feng (1 qian) Ze Xie (1.5 qian)
Chuan Lian Tan (0.5 fen) Huang Qin (1.5 qian) Huang Bai Tan (3 qian) Bai Zhu (1 qian) Chen Da Hong Ji Guan Hua (3 qian, fried)
Second visit. Bleeding has slightly stopped. Use bitter-cold herbs again to drain heat, allowing direct penetration into the intestines.
Huang Bai Tan Qin Jiao Chao Huai Hua Chao Dan Pi Tai Bai Zhu Chuan Lian Tan Ze Xie Zhu Fu Ling Fang Feng Tan Chao Jing Jie
Right. Hemorrhoidal prolapse with hematochezia. Liver fire and damp-heat pour downward into the intestines. Do not seek quick results.
Huang Bai Tan (2 qian) Chao Huai Mi (2 qian) Chao Dan Pi (2 qian) Di Yu Tan (2 qian) Chuan Lian Tan (0.3 fen) Huo Ma Ren (1.5 qian)
Gui Jia Xin (7 qian, decocted first) Jing Jie Tan (1.5 qian) Run Chang Wan (1.5 qian)
Second visit. Hemorrhoidal prolapse and bleeding have greatly reduced. Cool blood and relax the intestines again.
Bai Zhu Tan Wei Tian Ma Bai Ji Li Gou Gou Shi Jue Ming Fu Ling Shen Dan Pi Tan Huo Ma Ren Ze Xie
Shao (Left). After lung abscess, damp-heat descends to the Large Intestine; every time defecating, hemorrhoids prolapse and bleed. Recently, stomach function is dull with poor appetite, epigastrium is uncomfortable. Pulse is slightly slippery, tongue coating is sticky.
This does not seem to fall under extreme yin deficiency or injury to yin collaterals. Rather, damp-heat injures the Ying level, making Ying collaterals insecure. Bitter-warm is insufficient to overcome dampness; only bitter-cold can drain heat and enter the intestines.
Ze Xie (1.5 qian) Dan Pi Tan (2 qian) Chao Huai Hua (2 qian) Fang Feng Tan (1 qian) Yu Zhu (earth-fried, 1.5 qian) Cang Zhu (0.8 fen, stir-fried with sesame oil) Huang Bai Tan (3 qian) Bai Fu Ling (3 qian) Hong Ji Guan Hua (3 qian)
Second visit. Strengthen earth, dry dampness, drain heat; bleeding slightly reduced. If it were yin deficiency with insecure yin collaterals, such mild efficacy would certainly not occur. Advance the previous method further.
Cang Zhu (1.2 qian) Fang Feng Tan (1 qian) Huang Bai Tan (3 qian) Dan Pi Tan (2 qian) Jing Jie Tan (1 qian) Dang Gui Tan (1.5 qian) Tu Chao Yu Zhu (2 qian) Da Hong Ji Guan Hua (3 qian) Zang Lian Wan (2 qian)
Third visit. Blood color fades, damp-heat in Large Intestine slightly clears, but signs appear that Spleen Yang cannot secure and hold. Warm the zang-organs and clear the fu-organs again.
Cang Yu Zhu (each 1.5 qian) Dan Pi Tan (1.5 qian) Chuan Lian Tan (0.4 fen) Huang Bai Tan (3 qian) Pao Jiang Tan (0.6 fen) Yun Fu Ling (3 qian)
Fang Feng Tan (1 qian) Sheng Yi Ren (4 qian) Ze Xie (1.5 qian) Da Hong Ji Guan Hua (3 qian)
Fourth visit. Warming zang and clearing fu significantly reduces intestinal redness. Indeed, there is excess damp-heat in the Large Intestine, while true Yang of Spleen Earth is insufficient. Only bitter-cold can drain dampness in the intestines; only great warmth can restore Yang Qi of the Spleen organ.
Chuan Lian Tan (0.3 fen) Huang Bai Tan (2 qian) Jiao Mao Zhu (1.5 qian) Dan Pi Tan (2 qian) Fu Ling (3 qian) Pao Jiang Tan (0.5 fen)
Ze Xie (1.5 qian) Chao Yu Zhu (1.5 qian) Da Hong Ji Guan Hua (3 qian) Hei Di Huang Wan (3 qian)
Fifth visit. Bleeding has stopped. However, loss of blood injures Yin, leading to mixed deficiency syndromes. Having regulated the flow, now open the source.
Zhu Fu Shen (3 qian) Nu Zhen Zi (3 qian) Bai Zi Ren (3 qian) Dang Gui Tan (2 qian) Bai Shao (1.5 qian) Han Lian Cao (2 qian)
Chi Ju Hua (2 qian) Hei Dou Yi (3 qian) Hei Di Huang Wan (3 qian)
Sixth visit. After intestinal redness, Qi feels rebellious upward. Guide damp-heat downward again, directing it into the Bladder.
Dong Gua Zi Guang Xing Ren Sheng Yi Ren Tong Cao Hua Shi Yun Fu Ling Bai Ji Li Chi Ju Hua Qing Lu Jian
Seventh visit. Yang Qi rebels upward unevenly, complexion is floating yellow, tendons and vessels jump. This is due to blood loss injuring Yin, failing to nourish. Strengthen Earth and nourish Liver again.
Sheng Yu Zhu Bai Fu Ling Bai Ji Li Hei Dou Yi Dong Gua Zi Sheng Yi Ren Wan Can Sha Hai Ge Qiao Chao Zhu Ru
Eighth visit. Spirit slightly revitalized, floating yellow complexion slightly receded. Strengthen Earth and nourish Liver again, still incorporating methods to resolve dampness.
Yu Zhu Hei Dou Yi Nu Zhen Zi Fu Ling Sheng Yi Ren Ze Xie Can Sha Hai Ge Qiao Zhu Ru Bai Ji Li Sheng Shan Yao