干苁蓉(一两五钱) 盐水炒菟丝子(三两) 白茯苓(三两) 炒萸肉(一两) 泽泻(一两) 盐水炒潼沙苑(三
两) 粉丹皮(二两) 川石斛(四两) 浓杜仲(三两) 西洋参(二两) 黑豆衣(二两) 奎党参(三两) 黑
玄参肉(一两五钱) 肥知母(二两) 玉竹(一两五钱) 炒木瓜(一两)
加清阿胶三两,龟板胶二两,鹿角胶二两,溶化收膏。
陈(左) 熄风养血,臂痛稍轻,脉缓微弦,重按少力。从前法兼补阳明。
炙熟地 阿胶珠 于术 归身 云茯神 甘杞子 炙绵 白芍 玉竹 夜合花
二诊 脉渐柔软,臂痛略轻。仍守调补气血,气血一充,则调理自和。
大生地(四钱) 炙绵 (三钱) 奎党参(三钱) 杭白芍(酒炒一钱五分) 阿胶珠(三钱)
甘杞子(三钱) 生于术(二钱) 白归身(酒炒二钱) 干苁蓉(一钱五分) 川断肉(三钱) 肥玉竹(三钱)
高(左) 髀关作痛,以天晴霾为加减,湿也。
二妙丸(独活寄生二陈两汤煎汤送下)
某 尻痛。
二妙丸(用二陈汤送下)
叶(右) 向有偏左头痛。兹则背脊恶寒,遍身作痛。营血不足,风阳乘虚入络。暂为宣通。
川桂枝(二分) 左秦艽(一钱五分) 桑寄生(酒炒三钱) 酒炒防己(一钱) 全当归(二钱) 白蒺
藜(去刺炒三钱)
嫩桑枝(酒炒三钱) 橘皮络(各一钱) 丝瓜络(酒炒一钱五分)
二诊 身痛稍减,偏左头疼渐止。再和营血而熄肝阳。
粉全归(酒炒二钱) 炙黑草(四分) 桑叶(一钱) 元参(三钱) 杭白芍(酒炒一钱五分) 池菊花(一钱
五分) 丹皮(二钱) 南枣(三枚) 白蒺藜(去刺炒三钱) 黑豆衣(三钱)
顾(右) 遍身酸痛稍减,而腿股仍觉恶寒,前法参以辛温。
桂枝(三分) 川萆 (二钱) 左秦艽(一钱五分) 茯苓(三钱) 炒桑枝(四钱) 防己(一钱五分)
桑寄生(三钱) 煨天麻(一钱五分) 薏仁(三钱)
二诊 遍身酸痛大退。然仍肝阳上升, 杂气冲,经脉抽掣,四肢厥逆。良以阳明脉络空虚,肝阳乘袭。
再通补阳明,参以熄肝。
奎党参(三钱) 制半夏(一钱五分) 炙黑草(四分) 归身(二钱) 淮小麦(五钱) 麦冬(三钱)
白芍(土炒一钱五分) 炒杞子(三钱) 茯神(三钱) 龙眼肉(四枚) 大南枣(四枚)
程(左) 苦温辛烈,燥胃强脾,口中津液转滋。盖湿流气化,则清津方能上供。惟足肿身痛未松。良以风
湿相搏,不能遽化。再作日就月将之计。
苍术(八分麻油炒黄) 连皮苓(三钱) 五加皮(三钱) 生薏仁(四钱) 猪苓(二钱) 泽泻(一钱五分)
汉防己(五钱) 川独活(一钱) 牡蛎泽泻散(三钱开水先服)
干苁蓉(一两五钱) 盐水炒菟丝子(三两) 白茯苓(三两) 炒山茱萸肉(一两) 泽泻(一两) 盐水炒潼蒺藜/沙苑子(三两) 粉丹皮(二两) 川石斛(四两) 浓杜仲(三两) 西洋参(二两) 黑豆衣(二两) 奎党参(三两) 黑玄参肉(一两五钱) 肥知母(二两) 玉竹(一两五钱) 炒木瓜(一两)
加入清阿胶三两,龟板胶二两,鹿角胶二两,烊化后收膏。
陈姓患者(左侧症状):采用熄风养血法,手臂疼痛稍减轻,脉象缓而微弦,重按力度不足。沿用前法,兼补阳明经。
处方:炙熟地黄、阿胶珠、于术、当归身、云茯神、甘枸杞子、炙黄芪、白芍、玉竹、夜合花。
二诊:脉象逐渐柔软,手臂疼痛略微减轻。仍守调补气血之法,气血充盈,则身体调理自然和谐。
处方:大生地(四钱)、炙黄芪(三钱)、奎党参(三钱)、杭白芍(酒炒一钱五分)、阿胶珠(三钱)、甘枸杞子(三钱)、生于术(二钱)、白归身(酒炒二钱)、干苁蓉(一钱五分)、川断肉(三钱)、肥玉竹(三钱)。
高姓患者(左侧症状):髀关穴处疼痛,随天气晴朗或阴霾而变化,此为湿邪所致。
处方:二妙丸(用独活寄生汤与二陈汤的煎剂送服)。
叶姓患者(右侧症状):向来有偏左头痛的病史。此次出现背部恶寒,全身疼痛。营血不足,风阳乘虚侵入络脉。暂时采用宣通之法。
处方:川桂枝(二分)、左秦艽(一钱五分)、桑寄生(酒炒三钱)、酒炒防己(一钱)、全当归(二钱)、白蒺藜(去刺炒三钱)、嫩桑枝(酒炒三钱)、橘皮络(各一钱)、丝瓜络(酒炒一钱五分)。
二诊:身体疼痛稍减,偏左头痛逐渐停止。再调和营血并平息肝阳。
处方:粉全归(酒炒二钱)、炙黑甘草(四分)、桑叶(一钱)、元参(三钱)、杭白芍(酒炒一钱五分)、池菊花(一钱五分)、丹皮(二钱)、南枣(三枚)、白蒺藜(去刺炒三钱)、黑豆衣(三钱)。
顾姓患者(右侧症状):全身酸痛稍减,但腿股部仍觉恶寒,前方药物中参入辛温之品。
处方:桂枝(三分)、川萆薢(二钱)、左秦艽(一钱五分)、茯苓(三钱)、炒桑枝(四钱)、防己(一钱五分)、桑寄生(三钱)、煨天麻(一钱五分)、薏仁(三钱)。
二诊:全身酸痛大幅消退。然而仍有肝阳上升,杂气冲逆,经脉抽掣,四肢厥冷。这是因为阳明脉络空虚,肝阳乘袭所致。
再次通补阳明,参以平息肝阳。
处方:奎党参(三钱)、制半夏(一钱五分)、炙黑甘草(四分)、归身(二钱)、淮小麦(五钱)、麦冬(三钱)、白芍(土炒一钱五分)、炒杞子(三钱)、茯神(三钱)、龙眼肉(四枚)、大南枣(四枚)。
程姓患者(左侧症状):苦温辛烈之药能燥胃强脾,口中津液得以滋润。因为湿气流动气化,清津才能上供。只是足肿和身体疼痛仍未缓解。这是因为风湿相搏,不能迅速化解。再制定循序渐进的治疗计划。
处方:苍术(八分麻油炒黄)、连皮茯苓(三钱)、五加皮(三钱)、生薏仁(四钱)、猪苓(二钱)、泽泻(一钱五分)、汉防己(五钱)、川独活(一钱)、牡蛎泽泻散(三钱开水先服)。
Dried Cistanche Herba (Liuqian Wuqian) Salt-processed Dodder Seed (Sanliang) White Poria (Sanliang) Stir-fried Cornus Fruit (Yiliang) Alisma Rhizome (Yiliang) Salt-processed Astragalus Complanatus Seed (Sanliang) Powdered Moutan Cortex (Erliang) Dendrobium Caulis (Siliang) Thick Eucommia Bark (Sanliang) American Ginseng (Erliang) Black Soybean Coat (Erliang) Kui Dangshen (Sanliang) Black Scrophularia Root Flesh (Liuqian Wuqian) Plump Anemarrhena Rhizome (Erliang) Polygonatum Odoratum Rhizome (Yiliang) Stir-fried Papaya (Yiliang)
Add Clear Donkey-hide Gelatin (Sanliang), Tortoise Shell Gelatin (Erliang), and Deer Antler Gelatin (Erliang), dissolve and collect as paste.
Patient Chen (Left side): To extinguish wind and nourish blood, arm pain is slightly relieved. The pulse is slow and slightly wiry, with less force upon deep pressure. Continue the previous method while supplementing the Yangming channel.
Prescription: Roasted Rehmannia Root, Prepared Donkey-hide Gelatin Pearl, Atractylodes Macrocephala Rhizome, Angelica Sinensis Root Tip, Cloud Poria Spirit, Sweet Lycium Fruit, Roasted Astragalus Membranaceus Root, White Peony Root, Polygonatum Odoratum Rhizome, Albizia Flower.
Second visit: The pulse gradually becomes soft, arm pain slightly lightens. Still adhere to regulating and tonifying qi and blood; once qi and blood are abundant, regulation will naturally harmonize.
Prescription: Large Fresh Rehmannia Root (Siqian), Roasted Astragalus Membranaceus Root (Sanqian), Kui Codonopsis Pilosula Root (Sanqian), Hang White Peony Root (Jiu Chao Yiqian Wufen), Prepared Donkey-hide Gelatin Pearl (Sanqian), Sweet Lycium Fruit (Sanqian), Raw Atractylodes Macrocephala Rhizome (Erqian), White Angelica Sinensis Root Tip (Jiu Chao Erqian), Dried Cistanche Herba (Yiqian Wufen), Dipsacus Asper Root (Sanqian), Plump Polygonatum Odoratum Rhizome (Sanqian).
Patient Gao (Left side): Pain at the Bituan acupoint, varying with clear or overcast weather, indicating dampness.
Prescription: Ermiao Wan (administered with decoction of Duhuo Jisheng Tang and Erchen Tang).
Certain patient: Pain in the Ka region.
Prescription: Ermiao Wan (administered with Erchen Tang).
Patient Ye (Right side): Previously suffered from left-sided headache. Now experiencing aversion to cold in the back and generalized body pain. Deficiency of Ying blood allows Wind-Yang to enter the collaterals vacantly. Temporarily employ dispersing and unblocking methods.
Prescription: Cinnamon Twig (Er fen), Left Gentian Root (Yiqian Wufen), Mulberry Root Bark (Jiu Chao Sanqian), Wine-processed Stephania Tetrandra Root (Yiqian), Whole Angelica Sinensis Root (Erqian), Tribulus Terrestris Fruit (Qu Ci Chao Sanqian), Tender Mulberry Twig (Jiu Chao Sanqian), Tangerine Peel and Network (Ge Yiqian), Luffa Sponge Fiber (Jiu Chao Yiqian Wufen).
Second visit: Body pain slightly reduced, left-sided headache gradually stopped. Again harmonize Ying blood and extinguish Liver Yang.
Prescription: Powder Whole Angelica Sinensis Root (Jiu Chao Erqian), Roasted Black Licorice Root (Sifen), Mulberry Leaf (Yiqian), Yuan Shen (Sanqian), Hang White Peony Root (Jiu Chao Yiqian Wufen), Chi Chrysanthemum Flower (Yiqian Wufen), Moutan Cortex (Erqian), Southern Date (San mei), Tribulus Terrestris Fruit (Qu Ci Chao Sanqian), Black Soybean Coat (Sanqian).
Patient Gu (Right side): Generalized soreness and pain slightly reduced, but thighs and legs still feel aversion to cold. Modify previous method by adding acrid-warm herbs.
Prescription: Cinnamon Twig (San fen), Chinese Dioscorea Hypoglauca Rhizome (Erqian), Left Gentian Root (Yiqian Wufen), Poria (Sanqian), Stir-fried Mulberry Twig (Siqian), Stephania Tetrandra Root (Yiqian Wufen), Mulberry Root Bark (Sanqian), Calc Gastrodia Elata Tuber (Yiqian Wufen), Coix Seed (Sanqian).
Second visit: Generalized soreness and pain greatly retreated. However, Liver Yang still rises, miscellaneous Qi rushes upward, meridians twitch, and limbs are cold. This is due to emptiness of Yangming meridians, allowing Liver Yang to invade.
Again unblock and tonify Yangming, combined with extinguishing Liver Yang.
Prescription: Kui Codonopsis Pilosula Root (Sanqian), Processed Pinellia Tuber (Yiqian Wufen), Roasted Black Licorice Root (Sifen), Angelica Sinensis Root Tip (Erqian), Huai Wheat (Wuqian), Ophiopogon Japonicus Root (Sanqian), White Peony Root (Tu Chao Yiqian Wufen), Stir-fried Lycium Fruit (Sanqian), Poria Spirit (Sanqian), Longan Aril (Si mei), Large Southern Date (Si mei).
Patient Cheng (Left side): Bitter-warm and acrid-hot herbs dry the stomach and strengthen the spleen, causing saliva to moisten the mouth. Because dampness flows and transforms into Qi, clear fluids can then ascend. Only foot swelling and body pain remain unresolved. This is because wind and dampness struggle against each other and cannot be quickly resolved. Continue with a plan for gradual progress.
Prescription: Atractylodes Rhizome (Bafen, fried yellow in sesame oil), Poria with Skin (Sanqian), Five-finger Peach Bark (Sanqian), Raw Coix Seed (Siqian), Polyporus (Erqian), Alisma Rhizome (Yiqian Wufen), Han Stephania Tetrandra Root (Wuqian), Ligusticum Wallichii Rhizome (Yiqian), Muli Zexie San (Sanqian, taken first with boiling water).