俞(左) 寒饮停聚胃中,胃阳闭塞。中脘作痛,甚至有形,按之漉漉。不入虎穴焉得虎子。
薤白头 大腹皮 公丁香 白茯苓 川朴 制半夏
老生姜 白蔻仁(研后入) 黑丑(三分) 交趾桂(一分) 上沉香(一分后三味研细末先调服)
二诊 温通胃阳,兼逐停饮,中脘作痛大退。的是寒饮停于胃府。从此切忌寒冷水果,勿再自贻伊芳戚。
制半夏(一钱五分) 木猪苓(一钱五分) 大腹皮(一钱五分) 泽泻(一钱五分) 公丁香(三分)
制香附(二钱) 白茯苓(三钱) 川朴(一钱) 高良姜(四分) 橘皮(一钱) 生姜(二片)
某 中脘有形漉漉,攻撑作痛。厥气郁于胃中也。
杭白芍(一钱五分淡吴萸四分同炒) 酒炒延胡索(一钱五分) 炒枳壳(一钱) 广玉金(一钱五分)
台乌药(一钱五分) 香橼皮(一钱五分) 沉香片(四分后入) 金铃子(切一钱五分) 砂仁(七分后入)
制香附(研一钱五分)
某 脉象沉弦。中脘有形作痛,此中阳不足,寒浊阻于胃府也。
薤白头(三钱) 广皮(一钱) 茯苓(三钱) 高良姜(四分) 沉香曲(二钱) 干佛手(一钱) 半
夏(一钱五分) 制香附(二钱) 瓦楞子(五钱打) 丁香(一钱五分) 蔻仁(一钱二分二味研细末每服五分盐汤
下)
沈(右) 中脘有形,食入痞阻。苔白罩霉,脉沉弦细。此痰气郁结胃中。当为宣通。
广郁金(一钱五分) 建泽泻(一钱五分) 沉香曲(二钱炒) 川桂枝(三分) 制半夏(一钱五分)
薤白头(三钱)
栝蒌仁(三钱) 茯苓(三钱) 广皮(一钱) 制香附(二钱)
二诊 苔霉全化,中脘渐舒。然脉象尚带沉弦。宜肝胃两和,疏通痰气。
制半夏(一钱五分) 炒沉香曲(二钱) 白蒺藜(去刺炒三钱) 枳实(一钱) 制香附(二钱) 广
玉金(一钱五分) 香橼皮(一钱) 整砂仁(四粒入煎) 上广皮(一钱)
左 胃痛虽减,然左关颇觉弦硬,得食则痛稍定。良以因寒致郁,因郁生火。以连理汤出入。
雅连(五分吴萸三分同炒) 奎党参(二钱) 淡干姜(五分) 延胡索(一钱五分) 金铃子(一钱五
分) 炒冬术(二钱) 制香附(二钱) 香橼皮(一钱五分) 缩砂仁(五分)
许(右) 温通而痛仍不定。谅以节令之交,阴阳转换之时,气机难于畅达,勿以为药之罔效,而变计焉。
薤白头 半夏 香附 乌药 砂仁 青皮 瓦楞子 陈皮 上安桂(三分去粗皮研后入)
二诊 吃面食果,气寒肝横。防厥。
吴萸 青皮 金铃子 白芍 砂仁 香附 枳壳 沉香片 陈皮
三诊 中脘作痛,得温即定,此中阳为湿寒所阻。经云、温则消而去之。
高良姜 广皮 郁金 陈香橼皮 乌药 半夏 香附 公丁香 白蔻仁(二味研细末先送下)
杨(左) 中脘作痛,每至呕吐,寒热交作。脉象关滑,而沉候濡缓。此饮停于内,遂致土滞木郁。难杜根株。
川桂枝 炙甘草 茯苓 广皮 香附 淡干姜 制半夏 枳壳 姜汁炒竹茹
某 脉形细弱背 作胀,中脘作痛不纳不饥。此由先天不足,气弱失运,运迟则生湿,气弱则生寒,寒
湿交阻,宜乎其脘痛不纳矣。急则治标,宗此立方。
制香附 九虫香 瓦楞子 广皮 白蔻仁 香橼皮 公丁香
洪(左) 中脘作胀,而且剧痛,呕吐涎水。脉象沉弦。此寒饮停阻胃中。恐致痛厥。
上安桂(七分后入) 荜茇(六分) 赤白苓(各一钱) 香附(三钱) 公丁香(三分) 制半夏(三钱)
广皮(一钱五分) 香附(三钱) 薤白头(三钱) 上沉香(三分) 黑丑(一分后二味研细末先调服)
二诊 剧痛欲厥,业已大定,出险履夷,幸矣幸矣。前法再进一步。
上安桂 半夏 广皮 薤白头 老生姜 瓦楞子 香附 乌药 香橼皮 茯苓
徐(左) 中脘作痛,腹满气撑,便阻不爽。脉两关俱弦。厥气挟痰,阻于胃府,久则成膈。
薤白头(三钱) 栝蒌仁(四钱) 酒炒延胡索(一钱五分) 青皮(一钱) 瓦楞子(五钱)
制香附(二钱) 淡吴萸(五分) 枳壳(一钱) 沉香(二分) 公丁香(三分) 黑丑(三分)
湘军(四分后四味研细先服)
二诊 脘痛微减。然稍有拂逆,痛即渐至。还是肝胃不和。再为疏泄。
赤芍(吴萸四分同炒) 制半夏 香附 乌药 薤白头 陈香橼皮 砂仁 青皮 延胡 瓦楞子
席(右) 中脘作痛。脉形弦滑,独尺部濡细而沉。此由命火衰微,在下之蒸变无力,在上之痰气停留。
遍体作酸,以胃病则不能束筋骨而利机关也。宜辛以通之。
枳实 赤白苓 半夏 广皮 香橼皮 香附
瓦楞 薤白头 姜汁炒蒌仁
虞(右) 木郁土中,中脘作痛,胃脘之间,时有烘热之象。脉细关弦。肝经之气,火冲侮胃土。急宜开展襟
怀,使木气条达。
醋炒柴胡 杭白芍 金铃子 广郁金 当归身 制香附 青陈皮 麸炒枳壳 粉丹皮 姜汁炒山栀
二诊 中脘烙热较退,痛亦略松。然每晨面肿,头晕耳鸣。无非火气生风蔓延所致。
金铃子 制香附 川雅连(淡吴萸同炒) 麸炒枳壳 白蒺藜 东白芍 蜜水炒小青皮 十大功劳叶 桑叶
三诊 气注作痛渐轻,而咽中仍然如阻,时仍潮热。还是气火之郁。
磨苏梗 朱茯神 生香附 炒枳壳 磨郁金 炒枣仁 龙齿 白蒺藜 粉丹皮 钩钩 逍遥丸
沈(左) 辛通气分,中脘痞阻较定,痛呕泄泻。的是木乘土位。经云、寒则湿不能流,温则消而去之。
白芍(一钱五分吴萸四分同炒) 沉香曲(二钱) 茯苓(三钱) 枳壳(一钱) 砂仁(七分)
香橼皮(一钱五分) 上徭桂(三分饭丸先服)
左 胸阳旋转而痛止,浊痰留恋而未清。欲使其气分宣通,当问其谁为阻我气分者。
炒潜于术(一钱五分) 公丁香(三钱) 炮姜炭(四分) 橘红(一钱) 制半夏(一钱五分)
白蔻仁(七分) 炒枳实(一钱) 香橼皮(一钱五分) 川桂枝(五分) 云茯苓(三钱)
照方十帖,研末为丸,每服三钱。
某 痛势大减。然气冲至脘,则痛仍剧,大便不行。肝胃不和,气浊内阻。再为疏通。
青皮 金铃子 郁金 整砂仁 木香 槟榔 白蒺藜 制香附 川雅连(淡吴萸同打)
二诊 大便已行,并呕涎水,痛势降序,而仍未止。再辛通胃阳。
薤白头 制香附 沉香片 砂仁 上徭桂 制半夏 青陈皮 栝蒌仁 茯苓
某 胃脘作痛,痛久气血凝滞,中脘坚硬。恐结聚不散,而变外疡。
延胡索 瓦楞子 蓬莪术 当归尾 南楂炭 制香附
川郁金 台乌药 青陈皮 磨沉香 旋复花 青葱管
尤(右) 脘痛气撑腹满,肢体震动大便不解。厥气纵横,恐致发厥。
川楝子(切一钱五分) 制香附(三钱) 白蒺藜(三钱) 炒白芍(一钱五分) 淡吴萸(五分) 郁金(
一钱五分) 醋炒青皮(一钱) 陈香橼皮(一钱五分) 磨沉香(四分) 煨天麻(一钱五分) 川雅连
(四分吴萸同炒入煎) 砂仁(七分)
左 中脘有形作痛,痛引背脊。痰气交阻阳明,势难杜截根株。
薤白头(三钱) 栝蒌仁(三钱) 制半夏(一钱五分) 乌药(一钱) 瓦楞子(四钱) 制香附(二钱)
延胡索(酒炒一钱五分) 砂仁(七分) 淡吴萸(四分赤芍一钱五分同炒) 香橼皮(一钱五分)
范(右) 中脘不时作痛,痛则牵引背肋,甚至呕吐痰涎,肤肿面浮,往来寒热。肝胃不和,夹饮内阻。拟辛
润通降法。
薤白头(三钱) 制半夏(一钱五分) 白蒺藜(三钱) 白僵蚕(三钱) 橘红(一钱) 栝蒌霜(四钱)
白茯苓(三钱) 煨天麻(一钱) 紫丹参(二钱)
二诊 脘痛已止,胸闷呕吐亦减。两关脉弦。还是肝阳犯胃未平也。
制半夏(一钱五分) 代赭石(三钱) 旋复花(包一钱五分) 白蒺藜(三钱) 炒竹茹(一钱) 白茯
苓(三钱)
橘皮(一钱) 川雅连(二分淡干姜二分同炒)
俞先生(左侧脉象):寒饮停滞积聚在胃中,导致胃阳被闭塞。中脘部位疼痛,甚至能摸到有形之物,按压时听到漉漉的水声。不深入病机核心怎能解决问题?
薤白头、大腹皮、公丁香、白茯苓、川朴、制半夏、老生姜、白蔻仁(研碎后加入)、黑丑(三分)、交趾桂(一分)、上沉香(一分,后三味药研成细末,先调服)。
二诊:温通胃阳,兼以驱逐停聚的饮邪,中脘疼痛大幅减轻。确证是寒饮停留在胃府。从此务必忌讳寒冷和水果,不要再自己招致病痛。
制半夏(一钱五分)、木猪苓(一钱五分)、大腹皮(一钱五分)、泽泻(一钱五分)、公丁香(三分)、制香附(二钱)、白茯苓(三钱)、川朴(一钱)、高良姜(四分)、橘皮(一钱)、生姜(两片)。
某患者:中脘部位有有形之物,漉漉作响,攻撑作痛。这是厥逆之气郁结在胃中。
杭白芍(一钱五分,与淡吴茱萸四分同炒)、酒炒延胡索(一钱五分)、炒枳壳(一钱)、广玉金(一钱五分)、台乌药(一钱五分)、香橼皮(一钱五分)、沉香片(四分,后下)、金铃子(切片一钱五分)、砂仁(七分,后下)、制香附(研末一钱五分)。
某患者:脉象沉弦。中脘部位有有形之物且作痛,这是中焦阳气不足,寒浊阻滞于胃府。
薤白头(三钱)、广皮(一钱)、茯苓(三钱)、高良姜(四分)、沉香曲(二钱)、干佛手(一钱)、半夏(一钱五分)、制香附(二钱)、瓦楞子(五钱,打碎)、丁香(一钱五分)、蔻仁(一钱二分,这两味研成细末,每次服用五分,用盐汤送下)。
沈先生(右侧脉象):中脘部位有有形之物,进食后痞塞阻碍。舌苔白且罩有霉色,脉象沉弦细。这是痰气郁结在胃中。应当予以宣通。
广郁金(一钱五分)、建泽泻(一钱五分)、沉香曲(二钱,炒)、川桂枝(三分)、制半夏(一钱五分)、薤白头(三钱)、栝蒌仁(三钱)、茯苓(三钱)、广皮(一钱)、制香附(二钱)。
二诊:舌苔上的霉色完全消退,中脘逐渐舒缓。然而脉象仍带沉弦。宜调和肝胃,疏通痰气。
制半夏(一钱五分)、炒沉香曲(二钱)、白蒺藜(去刺炒三钱)、枳实(一钱)、制香附(二钱)、广玉金(一钱五分)、香橼皮(一钱)、整砂仁(四粒,入煎)、上广皮(一钱)。
左侧脉象:胃痛虽然减轻,但左关脉颇觉弦硬,进食后疼痛稍定。这是因为因寒导致气郁,因郁而生火。使用连理汤加减。
雅连(五分,与吴茱萸三分同炒)、奎党参(二钱)、淡干姜(五分)、延胡索(一钱五分)、金铃子(一钱五分)、炒冬术(二钱)、制香附(二钱)、香橼皮(一钱五分)、缩砂仁(五分)。
许先生(右侧脉象):经过温通治疗,疼痛仍不稳定。推测是因为节气交替,阴阳转换之时,气机难以畅达,不要认为药物无效而改变治疗方案。
薤白头、半夏、香附、乌药、砂仁、青皮、瓦楞子、陈皮、上安桂(三分,去粗皮研碎后加入)。
二诊:吃面食和水果后,寒气引发肝气横逆。防止发生厥逆。
吴茱萸、青皮、金铃子、白芍、砂仁、香附、枳壳、沉香片、陈皮。
三诊:中脘作痛,得温则缓解,这是中阳被湿寒所阻。《内经》说:“温则消而去之。”
高良姜、广皮、郁金、陈香橼皮、乌药、半夏、香附、公丁香、白蔻仁(这两味研成细末,先送服)。
杨先生(左侧脉象):中脘作痛,经常呕吐,寒热交替发作。脉象关部滑,沉取濡缓。这是饮邪停聚在内,导致土滞木郁。很难杜绝病根。
川桂枝、炙甘草、茯苓、广皮、香附、淡干姜、制半夏、枳壳、姜汁炒竹茹。
某患者:脉形细弱,背部胀满,中脘作痛,不想进食也不觉得饥饿。这是由于先天不足,气弱失去运化功能,运化迟缓则生湿,气弱则生寒,寒湿相互阻滞,所以出现脘痛和不思饮食。急则治其标,依据此原则立方。
制香附、九虫香、瓦楞子、广皮、白蔻仁、香橼皮、公丁香。
洪先生(左侧脉象):中脘胀满,而且剧烈疼痛,呕吐涎水。脉象沉弦。这是寒饮停聚阻滞在胃中。恐怕会导致痛厥。
上安桂(七分,后下)、荜茇(六分)、赤白茯苓(各一钱)、香附(三钱)、公丁香(三分)、制半夏(三钱)、广皮(一钱五分)、香附(三钱)、薤白头(三钱)、上沉香(三分)、黑丑(一分,后两味研成细末,先调服)。
二诊:剧痛欲厥的情况已经大大安定,脱离危险,真是幸运。前面的方法再进一步。
上安桂、半夏、广皮、薤白头、老生姜、瓦楞子、香附、乌药、香橼皮、茯苓。
徐先生(左侧脉象):中脘作痛,腹部胀满气撑,大便不通畅。左右关脉都弦。厥气挟带痰浊,阻滞于胃府,日久可能形成膈证。
薤白头(三钱)、栝蒌仁(四钱)、酒炒延胡索(一钱五分)、青皮(一钱)、瓦楞子(五钱)、制香附(二钱)、淡吴茱萸(五分)、枳壳(一钱)、沉香(二分)、公丁香(三分)、黑丑(三分)、湘军(四分,后四味研碎先服)。
二诊:脘痛轻微减轻。然而稍有情绪不顺,疼痛就逐渐加剧。还是肝胃不和。再次进行疏泄。
赤芍(与吴茱萸四分同炒)、制半夏、香附、乌药、薤白头、陈香橼皮、砂仁、青皮、延胡索、瓦楞子。
席先生(右侧脉象):中脘作痛。脉形弦滑,唯独尺部濡细而沉。这是由于命门之火衰微,在下焦的蒸腾气化无力,在上焦的痰气停留。全身酸痛,因为胃病导致不能约束筋骨和利关节。宜用辛味药来通散。
枳实、赤白茯苓、半夏、广皮、香橼皮、香附、瓦楞子、薤白头、姜汁炒栝楼仁。
虞先生(右侧脉象):肝木郁结于脾土之中,中脘作痛,胃脘之间,时常有烘热的感觉。脉细关弦。肝经之气,火热冲逆侮犯胃土。急切宜舒展胸怀,使木气条达。
醋炒柴胡、杭白芍、金铃子、广郁金、当归身、制香附、青陈皮、麸炒枳壳、粉丹皮、姜汁炒山栀。
二诊:中脘烙热较退,疼痛也略微松弛。然而每天早晨面部浮肿,头晕耳鸣。无非是火气生风蔓延所致。
金铃子、制香附、川雅连(与淡吴茱萸同炒)、麸炒枳壳、白蒺藜、东白芍、蜜水炒小青皮、十大功劳叶、桑叶。
三诊:气注作痛逐渐减轻,但咽喉中仍然感觉如有物阻塞,时常仍有潮热。还是气火郁结。
磨苏梗、朱茯神、生香附、炒枳壳、磨郁金、炒枣仁、龙齿、白蒺藜、粉丹皮、钩藤、逍遥丸。
沈先生(左侧脉象):辛通气分后,中脘痞塞阻碍较定,但仍痛呕泄泻。确证是木乘土位(肝木克伐脾土)。《内经》说:“寒则湿不能流,温则消而去之。”
白芍(一钱五分,与吴茱萸四分同炒)、沉香曲(二钱)、茯苓(三钱)、枳壳(一钱)、砂仁(七分)、香橼皮(一钱五分)、上徭桂(三分,饭丸先服)。
左侧脉象:胸阳旋转而疼痛停止,但浊痰留恋未清。想要使气分宣通,当问是谁阻碍了我的气分。
炒潜于术(一钱五分)、公丁香(三钱)、炮姜炭(四分)、橘红(一钱)、制半夏(一钱五分)、白蔻仁(七分)、炒枳实(一钱)、香橼皮(一钱五分)、川桂枝(五分)、云茯苓(三钱)。
照原方十帖,研末制成丸药,每次服用三钱。
某患者:疼痛大势已减。然而气冲至脘部,则疼痛依然剧烈,大便不通。肝胃不和,气浊内阻。再次进行疏通。
青皮、金铃子、郁金、整砂仁、木香、槟榔、白蒺藜、制香附、川雅连(与淡吴茱萸同捣)。
二诊:大便已行,并呕吐涎水,疼痛程度下降,但仍未停止。再次辛通胃阳。
薤白头、制香附、沉香片、砂仁、上徭桂、制半夏、青陈皮、栝蒌仁、茯苓。
某患者:胃脘作痛,疼痛日久气血凝滞,中脘坚硬。恐怕结聚不散,而变成外疡。
延胡索、瓦楞子、蓬莪术、当归尾、南楂炭、制香附、川郁金、台乌药、青陈皮、磨沉香、旋复花、青葱管。
尤先生(右侧脉象):脘痛气撑腹满,肢体震动,大便不解。厥气纵横,恐怕导致发厥。
川楝子(切片一钱五分)、制香附(三钱)、白蒺藜(三钱)、炒白芍(一钱五分)、淡吴茱萸(五分)、郁金(一钱五分)、醋炒青皮(一钱)、陈香橼皮(一钱五分)、磨沉香(四分)、煨天麻(一钱五分)、川雅连(四分,与吴茱萸同炒入煎)、砂仁(七分)。
左侧脉象:中脘有形作痛,疼痛牵引背脊。痰气交阻于阳明经,势难杜绝病根。
薤白头(三钱)、栝蒌仁(三钱)、制半夏(一钱五分)、乌药(一钱)、瓦楞子(四钱)、制香附(二钱)、延胡索(酒炒一钱五分)、砂仁(七分)、淡吴茱萸(四分,与赤芍一钱五分同炒)、香橼皮(一钱五分)。
范先生(右侧脉象):中脘不时作痛,痛则牵引背肋,甚至呕吐痰涎,皮肤肿胀面部浮肿,往来寒热。肝胃不和,夹饮内阻。拟用辛润通降法。
薤白头(三钱)、制半夏(一钱五分)、白蒺藜(三钱)、白僵蚕(三钱)、橘红(一钱)、栝蒌霜(四钱)、白茯苓(三钱)、煨天麻(一钱)、紫丹参(二钱)。
二诊:脘痛已止,胸闷呕吐也减轻。左右关脉弦。还是肝阳犯胃未平复。
制半夏(一钱五分)、代赭石(三钱)、旋复花(包煎一钱五分)、白蒺藜(三钱)、炒竹茹(一钱)、白茯苓(三钱)、橘皮(一钱)、川雅连(二分,与淡干姜二分同炒)。
Mr. Yu (Left pulse): Cold-fluid retention stagnates and accumulates in the Stomach, blocking Stomach-Yang. Pain occurs at Zhongwan (CV12), sometimes with a palpable mass; pressing it produces a gurgling sound. One must enter the tiger's den to get the tiger's cub (i.e., address the root cause directly).
Allii Macrostemonis Bulbus, Tugestibulbi Fructus, Caryophylli Flos, Poria, Magnoliae Cortex, Pinelliae Rhizoma Preparatum, Zingiberis Rhizoma Recens, Amomi Fructus Rotundus (crushed and added later), Strychni Semen (3 fen), Cinnamomi Ramulus (Jiaozhi) (1 fen), Aquilariae Lignum Resinatum (Superior grade) (1 fen, the latter three herbs are ground into fine powder and taken first mixed with water).
Second visit: Warming and unblocking Stomach-Yang, while simultaneously driving out retained fluid, significantly reduces pain at Zhongwan. It is indeed confirmed that cold-fluid retention resides in the Stomach-Fu. From now on, strictly avoid cold foods and fruits, do not bring suffering upon yourself.
Pinelliae Rhizoma Preparatum (1 qian 5 fen), Polyporus cum Pini Mycelium (1 qian 5 fen), Tugestibulbi Fructus (1 qian 5 fen), Alismatis Rhizoma (1 qian 5 fen), Caryophylli Flos (3 fen), Cyperi Rhizoma Preparatum (2 qian), Poria (3 qian), Magnoliae Cortex (1 qian), Galangal Fruit (4 fen), Citri Reticulatae Pericarpium (1 qian), Zingiberis Rhizoma Recens (2 slices).
Certain patient: A palpable mass with gurgling sounds at Zhongwan, causing distending pain. This is Jue-Qi (rebellious Qi of the Liver/Gallbladder) stagnating in the Stomach.
Paeoniae Radix Alba (Hang) (1 qian 5 fen, stir-fried with Evodiae Fructus Dan (4 fen)), Corydalis Rhizoma (wine-fried) (1 qian 5 fen), Aurantii Fructus Immaturus (stir-fried) (1 qian), Curcumae Radix (Guang) (1 qian 5 fen), Linderae Radix (Tai) (1 qian 5 fen), Eriobotryae Folium (1 qian 5 fen), Aquilariae Lignum Resinatum slice (4 fen, added later), Meliae Fructus (cut, 1 qian 5 fen), Amomi Fructus (7 fen, added later), Cyperi Rhizoma Preparatum (crushed, 1 qian 5 fen).
Certain patient: Pulse is deep and wiry. There is a palpable mass and pain at Zhongwan. This indicates deficiency of Middle-Jiao Yang, with cold-turbidity obstructing the Stomach-Fu.
Allii Macrostemonis Bulbus (3 qian), Citri Reticulatae Pericarpium (Guang) (1 qian), Poria (3 qian), Galangal Fruit (4 fen), Aquilariae Lignum Resinatum Qu (2 qian), Dry Bergamot (1 qian), Pinelliae Rhizoma (1 qian 5 fen), Cyperi Rhizoma Preparatum (2 qian), Arcae Concha (5 qian, crushed), Caryophylli Flos (1 qian 5 fen), Amomi Fructus (1 qian 2 fen, these two are ground into fine powder, take 5 fen per dose with salt water).
Mr. Shen (Right pulse): A palpable mass at Zhongwan, food intake causes obstruction and fullness. Tongue coating is white with a moldy appearance, pulse is deep, wiry, and thin. This is Phlegm-Qi stagnation in the Stomach. Treatment should focus on dispersing and unblocking.
Curcumae Radix (Guang) (1 qian 5 fen), Alismatis Rhizoma (Jian) (1 qian 5 fen), Aquilariae Lignum Resinatum Qu (2 qian, stir-fried), Cinnamomi Ramulus (Chuan) (3 fen), Pinelliae Rhizoma Preparatum (1 qian 5 fen), Allii Macrostemonis Bulbus (3 qian), Trichosanthis Semen (3 qian), Poria (3 qian), Citri Reticulatae Pericarpium (Guang) (1 qian), Cyperi Rhizoma Preparatum (2 qian).
Second visit: The moldy tongue coating has completely resolved, and Zhongwan feels gradually relaxed. However, the pulse still carries a deep-wiry quality. It is appropriate to harmonize Liver and Stomach, and dredge Phlegm-Qi.
Pinelliae Rhizoma Preparatum (1 qian 5 fen), Stir-fried Aquilariae Lignum Resinatum Qu (2 qian), Tribuli Fructus (de-thorned, stir-fried, 3 qian), Zedoary Rhizoma (1 qian), Cyperi Rhizoma Preparatum (2 qian), Curcumae Radix (Guang) (1 qian 5 fen), Eriobotryae Folium (1 qian), Whole Amomi Fructus (4 grains, added to decoction), Superior Grade Citri Reticulatae Pericarpium (1 qian).
Left pulse: Although stomach pain has decreased, the Left Guan position feels quite wiry and hard; pain settles slightly after eating. This is due to Qi stagnation caused by Cold, and Fire generated from stagnation. Modify Lianli Tang.
Coptidis Rhizoma (Ya) (5 fen, stir-fried with Evodiae Fructus Dan (3 fen)), Codonopsis Radix (Kui) (2 qian), Dried Ginger (Dan) (5 fen), Corydalis Rhizoma (1 qian 5 fen), Meliae Fructus (1 qian 5 fen), Atractylodis Rhizoma (Dong) (stir-fried, 2 qian), Cyperi Rhizoma Preparatum (2 qian), Eriobotryae Folium (1 qian 5 fen), Amomi Fructus (Suo) (5 fen).
Mr. Xu (Right pulse): After warming and unblocking, pain remains unstable. Presumably, during the transition of solar terms when Yin and Yang shift, Qi mechanism is difficult to flow smoothly. Do not consider the medicine ineffective and change the plan.
Allii Macrostemonis Bulbus, Pinelliae Rhizoma, Cyperi Rhizoma, Linderae Radix, Amomi Fructus, Tangerine Peel (Qingpi), Arcae Concha, Chenpi (Tangerine Peel), An Gui (Cinnamon Bark, Superior grade) (3 fen, remove coarse bark, grind and add).
Second visit: Eating wheat noodles and fruits causes Cold Qi and Liver Qi to flare horizontally. Prevent Jue (syncope/cold extremities).
Evodiae Fructus, Tangerine Peel (Qingpi), Meliae Fructus, Paeoniae Radix Alba, Amomi Fructus, Cyperi Rhizoma, Aurantii Fructus Immaturus, Aquilariae Lignum Resinatum slice, Chenpi.
Third visit: Pain at Zhongwan resolves with warmth; this is Middle-Yang obstructed by Damp-Cold. As the Classics say: "Warmth dissolves and removes it."
Galangal Fruit, Citri Reticulatae Pericarpium (Guang), Curcumae Radix, Old Eriobotryae Folium, Linderae Radix, Pinelliae Rhizoma, Cyperi Rhizoma, Caryophylli Flos, Amomi Fructus Rotundus (these two are ground into fine powder and taken first).
Mr. Yang (Left pulse): Pain at Zhongwan, frequent vomiting, alternating chills and fever. Pulse at Guan is slippery, and deep pressure reveals soft and slow qualities. Fluid retention inside leads to Earth stagnation and Wood depression. It is difficult to eradicate the root.
Cinnamomi Ramulus (Chuan), Glycyrrhizae Radix et Rhizoma (roasted), Poria, Citri Reticulatae Pericarpium (Guang), Cyperi Rhizoma, Dried Ginger (Dan), Pinelliae Rhizoma Preparatum, Aurantii Fructus Immaturus, Bamboo Shavings (fried with ginger juice).
Certain patient: Pulse shape is fine and weak, back feels distended, pain at Zhongwan, no appetite and no hunger. This stems from congenital insufficiency, Qi weakness leading to loss of transportation function. Slow transportation generates Dampness; Qi weakness generates Cold. Cold and Dampness mutually obstruct, hence the epigastric pain and anorexia. Treat the branch urgently, base the prescription on this principle.
Cyperi Rhizoma Preparatum, Jiuchongxiang, Arcae Concha, Citri Reticulatae Pericarpium (Guang), Amomi Fructus Rotundus, Eriobotryae Folium, Caryophylli Flos.
Mr. Hong (Left pulse): Distension and severe pain at Zhongwan, vomiting saliva. Pulse is deep and wiry. Cold-fluid retention obstructs the Stomach. Fear of pain-induced syncope.
An Gui (Cinnamon Bark, Superior grade) (7 fen, added later), Long Pepper Fruit (6 fen), Red and White Poria (each 1 qian), Cyperi Rhizoma (3 qian), Caryophylli Flos (3 fen), Pinelliae Rhizoma Preparatum (3 qian), Citri Reticulatae Pericarpium (Guang) (1 qian 5 fen), Cyperi Rhizoma (3 qian), Allii Macrostemonis Bulbus (3 qian), Aquilariae Lignum Resinatum (Superior grade) (3 fen), Strychni Semen (1 fen, the latter two are ground into fine powder and taken first mixed with water).
Second visit: Severe pain and impending syncope have largely stabilized, escaping danger safely, how fortunate. Advance the previous method further.
An Gui (Cinnamon Bark), Pinelliae Rhizoma, Citri Reticulatae Pericarpium (Guang), Allii Macrostemonis Bulbus, Zingiberis Rhizoma Recens (Old), Arcae Concha, Cyperi Rhizoma, Linderae Radix, Eriobotryae Folium, Poria.
Mr. Xu (Left pulse): Pain at Zhongwan, abdominal fullness and distension, bowel obstruction and discomfort. Both Guan pulses are wiry. Jue-Qi carrying Phlegm obstructs the Stomach-Fu; over time, it may become Ge Syndrome (obstruction/dysphagia).
Allii Macrostemonis Bulbus (3 qian), Trichosanthis Semen (4 qian), Corydalis Rhizoma (wine-fried) (1 qian 5 fen), Tangerine Peel (Qingpi) (1 qian), Arcae Concha (5 qian), Cyperi Rhizoma Preparatum (2 qian), Evodiae Fructus Dan (5 fen), Aurantii Fructus Immaturus (1 qian), Aquilariae Lignum Resinatum (2 fen), Caryophylli Flos (3 fen), Strychni Semen (3 fen), Xiangjun (4 fen, the latter four are ground and taken first).
Second visit: Epigastric pain slightly reduced. However, any slight irritation causes pain to gradually return. Still Liver-Stomach disharmony. Continue to dredge and drain.
Paeoniae Radix Rubra (stir-fried with Evodiae Fructus 4 fen), Pinelliae Rhizoma Preparatum, Cyperi Rhizoma, Linderae Radix, Allii Macrostemonis Bulbus, Old Eriobotryae Folium, Amomi Fructus, Tangerine Peel (Qingpi), Corydalis Rhizoma, Arcae Concha.
Mr. Xi (Right pulse): Pain at Zhongwan. Pulse is wiry and slippery, but the Chi position alone is soft, fine, and deep. This is due to decline of Mingmen Fire, inability to steam and transform from below, leading to Phlegm-Qi stagnation above. Whole body soreness, because Stomach disease fails to bind sinews and bones and facilitate joints. Use Acrid substances to unblock.
Zedoary Rhizoma, Red and White Poria, Pinelliae Rhizoma, Citri Reticulatae Pericarpium (Guang), Eriobotryae Folium, Cyperi Rhizoma, Arcae Concha, Allii Macrostemonis Bulbus, Trichosanthis Semen (fried with ginger juice).
Mr. Yu (Right pulse): Wood depression within Earth, pain at Zhongwan, occasional feeling of baking heat between the epigastrium. Pulse is fine, Guan is wiry. Qi of the Liver Channel, Fire rushing up to insult Stomach Earth. Urgently expand one's mindset to allow Wood Qi to flow freely.
Bupleuri Radix (vinegar-fried), Paeoniae Radix Alba (Hang), Meliae Fructus, Curcumae Radix (Guang), Angelicae Sinensis Radix (Shen), Cyperi Rhizoma Preparatum, Tangerine Peel (Qing/Chen), Aurantii Fructus Immaturus (bran-fried), Moutan Cortex, Gardeniae Fructus (fried with ginger juice).
Second visit: Baking heat at Zhongwan has receded somewhat, pain is also slightly relieved. However, morning facial edema, dizziness, and tinnitus occur. This is merely Wind generated by Fire spreading.
Meliae Fructus, Cyperi Rhizoma Preparatum, Coptidis Rhizoma (Ya) (stir-fried with Evodiae Fructus Dan), Aurantii Fructus Immaturus (bran-fried), Tribuli Fructus, Paeoniae Radix Alba (East), Tangerine Peel (Qing) (honey-water fried), Mahoniae Leaf, Mori Folium.
Third visit: Pain from Qi injection has gradually lightened, but throat still feels obstructed, tidal fever persists. Still Qi-Fire depression.
Perilla Stem (ground), Polygalae Radix (with Zhu Sha), Cyperi Rhizoma (raw), Aurantii Fructus Immaturus (stir-fried), Curcumae Radix (ground), Ziziphi Spinosae Semen (stir-fried), Dragon Bone, Tribuli Fructus, Moutan Cortex, Uncaria Ramulus cum Uncis, Xiaoyao Wan.
Mr. Shen (Left pulse): After Acrid substances moving Qi mechanism, Zhongwan obstruction has settled somewhat, but pain, vomiting, and diarrhea persist. Indeed Wood encroaching on Earth position. As the Classics say: "Cold prevents Dampness from flowing; Warmth dissolves and removes it."
Paeoniae Radix Alba (1 qian 5 fen, stir-fried with Evodiae Fructus 4 fen), Aquilariae Lignum Resinatum Qu (2 qian), Poria (3 qian), Aurantii Fructus Immaturus (1 qian), Amomi Fructus (7 fen), Eriobotryae Folium (1 qian 5 fen), Yao Gui (Cinnamon Bark, Superior grade) (3 fen, rice pill, taken first).
Left pulse: Chest-Yang rotates and pain stops, but turbid Phlegm lingers and is not cleared. To make Qi mechanism unblocked, ask who is obstructing my Qi mechanism.
Atractylodis Rhizoma (stir-fried, Qian) (1 qian 5 fen), Caryophylli Flos (3 qian), Ginger Char (Pao Jiang Tan) (4 fen), Citri Reticulatae Pericarpium (Hong) (1 qian), Pinelliae Rhizoma Preparatum (1 qian 5 fen), Amomi Fructus Rotundus (7 fen), Aurantii Fructus Immaturus (stir-fried, 1 qian), Eriobotryae Folium (1 qian 5 fen), Cinnamomi Ramulus (Chuan) (5 fen), Yun Poria (3 qian).
Ten doses according to the formula, ground into powder for pills, take 3 qian each time.
Certain patient: Pain intensity greatly reduced. However, when Qi rushes to the epigastrium, pain becomes severe again, bowels do not move. Liver-Stomach disharmony, turbid Qi internally obstructed. Continue to dredge and unblock.
Tangerine Peel (Qingpi), Meliae Fructus, Curcumae Radix, Whole Amomi Fructus, Aucklandiae Radix, Arecae Semen, Tribuli Fructus, Cyperi Rhizoma Preparatum, Coptidis Rhizoma (Ya) (beaten with Evodiae Fructus Dan).
Second visit: Bowels have moved, spitting saliva, pain intensity has descended but has not stopped. Again, Acridly unblock Stomach-Yang.
Allii Macrostemonis Bulbus, Cyperi Rhizoma Preparatum, Aquilariae Lignum Resinatum slice, Amomi Fructus, Yao Gui (Cinnamon Bark, Superior grade), Pinelliae Rhizoma Preparatum, Qingpi and Chenpi, Trichosanthis Semen, Poria.
Certain patient: Epigastric pain, long-standing pain causes Qi and Blood stasis, Zhongwan is hard. Fear of aggregation not dispersing, turning into external abscess.
Corydalis Rhizoma, Arcae Concha, Curcuma Longa Rhizoma, Angelicae Sinensis Radix (Wei), Southern Hawthorn Char, Cyperi Rhizoma Preparatum, Curcumae Radix (Yu), Linderae Radix (Tai), Qingpi and Chenpi, Ground Aquilariae Lignum Resinatum, Inulae Flos, Green Onion Tube.
Mr. You (Right pulse): Epigastric pain with distension and abdominal fullness, limb tremors, bowel movement unresolved. Jue-Qi crisscrosses, fear of developing syncope.
Meliae Fructus (cut, 1 qian 5 fen), Cyperi Rhizoma Preparatum (3 qian), Tribuli Fructus (3 qian), Paeoniae Radix Alba (stir-fried, 1 qian 5 fen), Evodiae Fructus Dan (5 fen), Curcumae Radix (1 qian 5 fen), Tangerine Peel (Qingpi) (vinegar-fried, 1 qian), Old Eriobotryae Folium (1 qian 5 fen), Ground Aquilariae Lignum Resinatum (4 fen), Gastrodiae Rhizoma (roasted, 1 qian 5 fen), Coptidis Rhizoma (Ya) (4 fen, stir-fried with Evodiae Fructus and decocted), Amomi Fructus (7 fen).
Left pulse: Palpable mass and pain at Zhongwan, pain radiating to the spine. Phlegm and Qi inter-block the Yangming channels, difficult to cut off the root.
Allii Macrostemonis Bulbus (3 qian), Trichosanthis Semen (3 qian), Pinelliae Rhizoma Preparatum (1 qian 5 fen), Linderae Radix (1 qian), Arcae Concha (4 qian), Cyperi Rhizoma Preparatum (2 qian), Corydalis Rhizoma (wine-fried, 1 qian 5 fen), Amomi Fructus (7 fen), Evodiae Fructus Dan (4 fen, stir-fried with Paeoniae Radix Rubra 1 qian 5 fen), Eriobotryae Folium (1 qian 5 fen).
Mr. Fan (Right pulse): Intermittent pain at Zhongwan, pain radiating to back and ribs, even vomiting phlegm-saliva, skin swelling and facial edema, alternating chills and fever. Liver-Stomach disharmony, accompanied by internal fluid retention. Propose Acrid-Moistening Descending method.
Allii Macrostemonis Bulbus (3 qian), Pinelliae Rhizoma Preparatum (1 qian 5 fen), Tribuli Fructus (3 qian), Bombyx Batryticatus (3 qian), Citri Reticulatae Pericarpium (Hong) (1 qian), Trichosanthis Powder (4 qian), Poria (3 qian), Gastrodiae Rhizoma (roasted, 1 qian), Salviae Miltiorrhizae Radix (Zi) (2 qian).
Second visit: Epigastric pain has stopped, chest tightness and vomiting also reduced. Both Guan pulses are wiry. Still Liver-Yang offending Stomach is not pacified.
Pinelliae Rhizoma Preparatum (1 qian 5 fen), Haematitum (3 qian), Inulae Flos (wrapped, 1 qian 5 fen), Tribuli Fructus (3 qian), Bamboo Shavings (stir-fried, 1 qian), Poria (3 qian), Citri Reticulatae Pericarpium (1 qian), Coptidis Rhizoma (Ya) (2 fen, stir-fried with Dried Ginger Dan 2 fen).