袁(同里)经年累月宿恙,全是郁勃,内因五志中之阳气有升无降,故得泄泻反爽,背椎
必捶摩而胀减。盖脏阴之热鼓动,经腑中气皆逆行上巅。春间经漏,议进滋清补方,亦从权
随时令也。暑伏已过,肃降未至,以顺天之气,应乎人身推求。
川黄连 广藿香 生麦芽 茯苓皮 莪术汁 胡黄连 泽泻 南查 丹皮
马(常熟,三十二岁) 寡居无欢悦之意,肝胆中郁勃气火,直上直下,莫能制伏,失其
所泄之用,小溲成淋,谓肝脉环绕阴窍,用龙胆泻肝汤(直捷痛快,但不留余地耳。)
唐(常熟,二十七岁) 疟母瘕聚有形,治必宣通气血,所述病减,已是产虚,八脉受损
,不敢攻瘕。
朱(吴江,十六岁) 天癸从未至,肉瘦色悴,呛嗽着枕更甚,暮夜内外皆热,天明汗出
热减,痰中或稠或稀,咽中总不爽利,此先天所禀最薄(便是主见。)既长真阴不旺,阴虚生
内热,怡悦勿攻针黹,必要经来可得热除,即世俗所谓干血劳怯。
复脉汤去麻仁
恐其滑肠而阴药不得停留滋补也。老手胜人处在此。
王(无锡) 冲脉为病,男子成疝,女子带下瘕聚,经水仍来,是气攻入络脉为有形矣。
况产后又十六年不育,冲任病显然。
小茴香 川楝子 橘核 桂枝 茯苓 南查
凡食入脘中即痛,必是肝火上逆阻滞。若食入胃中而痛,则积滞为患居多。
方(长 ,三十岁) 络脉少血,气聚形象,升降而动,起居如惊(肾主恐,下元虚乏显
然。)跗踵乏力登高,久已未育,乃下焦肝肾虚损,累及八脉(可谓峻补。)
紫石英 巴戟肉 归身 鹿角胶 白石英 淡苁蓉 枸杞子 杜仲
袁某(来自同里)多年陈年旧疾,完全是由于气机郁结勃发所致。内在原因是五脏情志中的阳气只有上升而没有下降,所以出现泄泻反而感觉舒畅,背部脊柱必须通过捶打按摩才能使胀满感减轻。这是因为脏阴之热鼓动,导致经络和腑中的气机全部逆行向上冲至头顶。春季期间月经淋漓不尽,建议服用滋阴清热的补益方剂,这也是权宜之计以顺应时令变化。
暑邪潜伏已过,肃降之气尚未到来,应当顺应天地之气,结合人体情况推求病机。
川黄连 广藿香 生麦芽 茯苓皮 莪术汁 胡黄连 泽泻 南查 丹皮
马某(来自常熟,三十二岁)寡居生活没有欢悦的心情,肝胆中郁结的气火直上直下,无法制约伏藏,失去了其疏泄的作用,小便变成淋证。因为肝脉环绕阴窍,使用龙胆泻肝汤(此法直捷痛快,但不留余地。)
唐某(来自常熟,二十七岁)疟母瘕聚形成有形肿块,治疗必须宣通气血。所述病情减轻,已经是产后体虚,八脉受损,不敢攻伐瘕块。
朱某(来自吴江,十六岁)天癸从未到来,肌肉消瘦面色憔悴,呛咳在躺下时更严重,夜晚内外都发热,天亮出汗后热势减退,痰液有时稠有时稀,咽喉中总是不爽利,这是先天禀赋最薄弱(这就是主要见解)。既然真阴生长而不旺盛,阴虚产生内热,心情愉悦不要从事针线女红,一定要等到月经来潮才可以热除,即世俗所谓的干血劳怯。
复脉汤去掉麻仁
担心其滑肠而阴药不得停留滋补也。老手胜人处在此。
王某(无锡)冲脉为病,男子成疝,女子带下瘕聚,经水仍来,是气攻入络脉为有形矣。况产后又十六年不育,冲任病显然。
小茴香 川楝子 橘核 桂枝 茯苓 南查
凡食入脘中即痛,必是肝火上逆阻滞。若食入胃中而痛,则积滞为患居多。
方某(长 ,三十岁)络脉少血,气聚形象,升降而动,起居如惊(肾主恐,下元虚乏显然而。)跗踵乏力登高,久已未育,乃下焦肝肾虚损,累及八脉(可谓峻补。)
紫石英 巴戟肉 归身 鹿角胶 白石英 淡苁蓉 枸杞子 杜仲
Mr. Yuan (from Tongli) has suffered from chronic ailments for years, entirely due to qi stagnation and exuberance. The internal cause is that the yang qi within the five zang emotions rises but does not descend; thus, diarrhea brings relief, and the back spine must be beaten or massaged to reduce distension. This is because the heat of zang yin stirs, causing the qi in the meridians and fu organs to reverse and ascend to the vertex. During spring, menstrual leakage occurred, so it was proposed to administer a nourishing and clearing tonic formula, which is also a temporary measure to adapt to the seasonal changes.
The summer latent pathogen has passed, but the descending qi has not yet arrived. One should seek the pathology by aligning with the qi of heaven and responding to the human body.
Chuan Lian Zi (Szechwan Chinaberry Fruit), Guang Huo Xiang (Patchouli Herb), Sheng Mai Ya (Sprouted Barley Seed), Fu Ling Pi (Poria Peel), E Zhu Zhi (Curcuma Rhizome Juice), Hu Huang Lian (Picrorhiza Root), Ze Xie (Alisma Rhizome), Nan Zha (Southern Prickly Ash Bark), Dan Pi (Moutan Cortex).
Mr. Ma (from Changshu, 32 years old) lives as a widow without joy. The stagnant qi and fire in the liver and gallbladder rise and fall directly, unable to be restrained, losing its function of drainage. Urine becomes strangury. Since the liver meridian surrounds the yin orifices, Long Dan Xie Gan Tang (Gentiana Liver-Draining Decoction) is used (direct and effective, but leaves no room for error.)
Mr. Tang (from Changshu, 27 years old) has malaria mother and mass accumulation forming tangible lumps. Treatment must promote the circulation of qi and blood. The described reduction in symptoms indicates postpartum deficiency, with damage to the eight extraordinary vessels. It is inadvisable to attack the masses aggressively.
Ms. Zhu (from Wujiang, 16 years old) has never experienced menarche (Tian Gui). She is emaciated with sallow complexion. Choking cough worsens when lying down. Internal and external heat persist at night, reducing after sweating at dawn. Phlegm varies between thick and thin. The throat is always uncomfortable. This indicates the thinnest congenital endowment (this is the main insight). Since true yin grows but is not vigorous, yin deficiency generates internal heat. Joyful mood and avoiding needlework are advised. Menstruation must arrive to eliminate heat, known in secular terms as dry blood consumption and weakness.
Mai Mai Re Xin Tang (Decoction to Restore the Pulse) minus Ma Ren (Cannabis Seed).
Worried about slippery intestines preventing yin tonics from staying and nourishing. This is where the expert excels.
Mr. Wang (Wuxi) Chong Mai disease: men develop hernia, women have leukorrhea and mass accumulation. Menstruation still occurs. Qi attacks the collaterals forming tangible structures. Furthermore, infertility for sixteen years postpartum clearly indicates Chong and Ren vessel disease.
Xiao Hui Xiang (Fennel Fruit), Chuan Lian Zi (Szechwan Chinaberry Fruit), Ju He (Tangerine Seed), Gui Zhi (Cinnamon Twig), Fu Ling (Poria), Nan Zha (Southern Prickly Ash Bark).
If pain occurs immediately upon food entering the epigastrium, it must be liver fire reversing upward and obstructing. If pain occurs when food enters the stomach, it is mostly due to food stagnation.
Mr. Fang (Chang, 30 years old) Collateral vessels lack blood, qi gathers forming shapes, ascending and descending move, daily life like fear (Kidney governs fear, lower yuan deficiency is obvious). Weakness in ankles and heels, difficulty climbing high, long-term infertility, indicating lower jiao liver and kidney deficiency affecting the eight extraordinary vessels (can be considered strong tonification).
Zi Shi Ying (Hematite), Ba Ji Rou (Morinda Officinalis Flesh), Gui Shen (Angelica Sinensis Root Body), Lu Jiao Jiao (Deer Antler Glue), Bai Shi Ying (Quartz), Dan Cong Rong (Cistanche Deserticola), Gou Qi Zi (Goji Berry), Du Zhong (Eucommia Bark).