赵 血不养心，则心悸少寐。胃有寒饮，则呕吐清水。虚火
燥金，则咽痛。肝木乘中，则腹胀。此时调剂，最难熨贴。盖补
养心血之药，多嫌其滞；清降虚火之药，又恐其滋。欲除胃寒，
虑其温燥劫液；欲平肝木，恐其克伐耗气。今仿胡洽居士法，专
治其胃。以胃为气血之乡，土为万物之母，一举而三善备焉。请试服之。
党参 冬术 茯苓 半夏 枣仁 扁豆 陈皮 怀山药 秫米
渊按∶土虚木燥，积饮内生。原木之所以燥，由脾不运化精微而生营血以养肝木耳。治胃一言最扼要。
复 阴虚则阳不藏，水亏则木自旺。金衰不能制木，脾弱更
受木刑。久病不复，便谓之损。调补之外，何法敢施。
党参 茯神 枣仁 熟地 冬术 当归 陈皮 川贝 神曲 五味子 龙眼肉
又 阳明为阳盛之经，虚则寒栗。少阴为相火之宅，虚则火
升，咽喉燥痛，耳鸣颧赤所由来也。至于腹中撑胀，虽为肝旺，
亦属脾衰。心跳少寐，咳嗽短气，心营肺卫俱虚矣。虚者补之，是为大法。虚不受补，谓之逆候。古有明训，后人莫得
异议。
党参 怀山药 神曲 元参 白芍 茯神 大生地 枣仁 陈皮
侯 病已两月，外皮不热，而脉微数急，是里有热也。里热
属阴虚，非关表邪，并无头痛恶寒。愈散其邪，愈虚其表，故反
增咳嗽也。若谓湿热，亦似是而非。夫湿热蕴于中焦，必有胸痞
恶心见症。此证无之，其非湿热明矣。近来数日腹中不和，大便溏。且以和中为主，兼理其脾肺，再商治本可耳。
党参 茯苓 木香 广皮 砂仁 冬术 神曲 川贝 款冬花
又 和补相投，诸恙俱减。惟脉数未静，究属元气真阴亏
损。但前之补在肺脾，再参入肾药，兼养其阴，以观动静。
党参 冬术 白芍 豆皮 莲肉 首乌 归身 茯苓 沙苑子 谷芽
丁 营阴虚则风阳易逆，脾胃弱则肝木易横。心嘈、头眩、
耳鸣，液涸阳升之兆；腹胀、脘痞、厌食，脾虚气滞之愆。今吐泻之余，实系肝强脾弱。宗越人肝病缓中论治。
人参 茯苓 冬术 竹茹 麦冬 半夏 陈皮 橘叶 刺蒺藜（鸡子黄拌炒）
薛 阴亏营损，风木之脏失涵；木胜风淫，仓廪之官受制。
是以头痛肢麻，腹满嗳气，心跳少寐，掌热腰酸等症见也。所虑
水土俱弱，肝木独强。强者难于骤服，弱者宜急扶持。今再益营
阴以抚绥之，实仓廪以堵御之，佐金气以制治之，亦剿抚兼行之法也。
大生地 归身 白芍 谷芽 怀山药 潞党参 神曲 茯神 陈皮 刺蒺藜 红枣 川连（吴萸炒）
张 气虚则脾弱，肝强侮其所胜，食即饱胀，腹中气冲作泄也。扶土泄木，一定法程。
炙甘草 防风根 砂仁 陈皮 冬术（川朴五分，煎汁拌炒） 焦神
曲茯苓 炮姜 白芍（吴萸三分，煎汁拌炒）
薛 便泄半载，脾肾两亏；脉沉细涩，阴阳并弱。阳萎不
举，精伤特甚；面白无华，气虚已极。足跗浮肿，阳虚湿注于
下；纳食嗳气，胃虚气逆于中。调治之方，自宜脾肾双补，阴阳
并顾。然刚热补阳，恐劫其阴；滋腻补阴，恐妨其胃。刻下节届
清明，木旺土衰之候。脾者，土也。肾属坎水，一阳藏于二阴之中。当于补土中兼顾肾脏阴阳为是。
怀山药 炮姜 炙甘草 党参 五味子 菟丝子 砂仁 茯苓 冬术 鹿角霜
如不效，党参换人参，鹿角霜换鹿茸。
复 脾肾双补，略见小效。今腹中鸣响，气向下坠，属脾虚
气陷。舌心光红，脉沉细数，为肾脏阴伤。用补中升阳法。
高丽参 怀山药 冬术 炙甘草 肉果 五味子 陈皮 菟丝子 沙苑子 川断 鹿角霜 白芍
丁 养心营以济肾阴，清肝热以安相火。
生地 茯神 丹皮 黑山栀 豆衣 枣仁 麦冬 北沙参 五味子
吴 气血两虚，心跳头眩。肝郁不舒，胸中痞胀。用景岳逍遥饮参入丹溪左金丸。
大熟地 香附 当归 陈皮 白芍 茯神 枣仁 砂仁 白术 吴萸炒川连
渊按∶熟地恐碍膈。头眩属痰阻中脘最多。
冯 夜凉昼热，热在上午，此东垣所谓劳倦伤脾也。上午热属气虚，用补中益气汤补气升阳。
补中益气汤加神曲、茯苓。
李 病将半载，寒热淹缠。前方补营，兼以疏郁，心悸腹胀
仍然。兹更便溏足肿，是脾气虚弱也。脉缓无力，当补其脾，进归脾加减法。
防风根 党参 黄 冬术 茯苓 大腹皮 归身 白芍 枣仁 木香 荷叶蒂
渊按∶可参与桂枝、姜、枣。
赵 心肾虚而不交，脾肝虚而不调。内风上扰，头眩心跳；
中土式微，不寐纳少。交济坎离，须借戊己以为媒；欲平肝风，亦宜培土。
党参 归身 白芍 冬术 茯神 远志 枣仁 神曲 沙苑
子
钱 心脾营阴内亏，肝胆风火上逆。内热头眩，项间结核。脉虚形弱，治以养营。然病由内生，不易速效。
大生地 洋参 元参 归身 白芍 石决明 茯神 嫩钩钩 豆衣 香附 广皮 川贝 十大功劳
汪 肾水不足，君火上炎，相火下炽。心中如燔，舌光如
柿，阳事易举，阴精易泄。拟清君以制相，益肾以潜阳。所虑酷暑炎蒸，亢阳为害耳。
川连 淡芩 黄柏 阿胶 甘草 大生地 鸡子黄（一枚，搅和冲服）
另∶鸡子一个，破头，纳大黄三分，蒸熟。每日服一个。
又 投咸苦坚阴降火，以制亢阳，心中之燔灼，舌色之光
红，已减三分之一。然上午之身热如燎者未退，幸纳食颇增，苦寒可进，再望转机为吉。
川连 大生地 淡芩 元参 蛤壳 阿胶 元精石 甘草 鸡子黄（一枚，冲服）
又 舌干红，知饥善食。水亏阳亢，土燥于中。咸苦坚阴之
剂，虽衰其燔亢之势，未能尽除其焰。犹畏炎暑，湿热相火蒸腾。复入清中固下，仍不出咸苦之例。
洋参 甘草 川连 生石膏 蛤壳 知母 麦冬 阿胶 大生地
黄柏末，猪胆汁丸三钱。每朝开水送下一钱。
渊按∶胃气未败，可任苦寒咸润，直折其炎上之火，然亦须防胃败。虚损之所以难治者，大都如此。
金 骨胳瘦小，先天元气不足。夏秋寒热，至今不已。脉细
数弱，气血两亏。头不痛而但身疼，或口沃清水，此胃气虚寒也。当商温补，仿东垣法。
党参 茯苓 陈皮 桂枝 柴胡 黄 半夏 神曲 当归
干姜 砂仁
渊按∶中气虚寒，少阳胆木之气抑遏，故寒热纠缠。升阳益胃汤恰合，尤妙在加干姜。
又 补中益胃，温卫气，开腠理，诸恙皆减，仍从前法。
前方去神曲、干姜，加白术、白芍。
张 劳碌内伤脾，倦怠而无力。凛凛畏寒频，淅淅盗汗出。
咳多痰带红，食少身无热。土衰金不生，卫虚营不摄。延来半载余，劳损难调适。
炙甘草 当归 白芍 冬术 党参 怀山药 黄 麦冬 茯神 五味子 红枣
渊按∶此非劳倦伤中，乃劳损伤精也。所因不同，见证亦异，勿得混治。
又 益元气，补脾土。土旺而金自生，气足而力自足。
前方去甘草，加陈皮、生熟谷芽。
陈 先后天俱不足。痰多鼻血，阴亏阳亢之征；纳少腹疼，
土衰木横之兆。是以年将弱冠，犹然幼稚之形；面白无华，具见精神之乏。治先天当求精血之属，培后天须参谷食之方。
党参 茯苓 冬术 陈皮 黑芝麻 怀山药 白扁豆 炙甘草 砂仁 建莲肉 粳米
上药为末，米饮汤调服，加白糖少许。枣汤调服亦可。
附丸方 精不足者，补之以味，当求精血之属，治其肾也。
熟地 菟丝子 牛膝 白芍 鹿角霜 山药 五味子 归身 川柏 杜仲 茯苓 甘杞子
泽泻 天冬 龟板 丹皮 山萸肉
上为末，用鲜紫河车一具，洗净，煮烂，将上药末杵和，为丸如梧子大。每朝盐花汤送下三钱。
温 卫气虚则洒洒恶寒，营气虚则蒸蒸发热。营卫并出中
焦，总以脾胃为主。补脾胃则金有所恃，不必治肝而肝自驯
矣。
党参 冬术 当归 川贝 玫瑰花 黄 茯苓 白芍 陈皮
某 咳嗽发热日久，前投补益脾胃之药六、七剂，谷食加
增，起居略健。但热势每交寅卯而盛，乃少阳旺时也。少阳属
胆，与肝相为表里。肝胆有郁热，戕伐生生之气，肺金失其清
肃，脾胃失其转输，相火日益炽，阴津日益涸，燎原之势，不至
涸竭不止也。其脉弦数者，肝胆郁热之候也。刻下初交夏令，趁
其胃旺加餐，拟进酸苦益阴和阳，清彻肝胆之郁热。考古有柴前梅连散，颇有深意。
柴胡（猪胆汁浸炒） 白芍 乌梅 党参 炙甘草 淡秋石 前胡 麦冬 川连 薤白头
徐 肺脾两虚，心营亏损。咳嗽气塞，骨蒸夜热，脉形软数，面白无华。劳损根深，夏至防剧。
怀山药 茯苓 枣仁 川贝 党参 五味子 扁豆 苡仁 款冬花 橘饼
又 脉软数为气虚，骨蒸心跳为血虚，咳嗽头眩，面色萎黄，脾肺两虚之候也。
党参 扁豆 陈皮 五味子 款冬花 茯苓 枣仁 川贝 炙甘草 红枣
奚 阳虚生外寒，阴虚生内热。热气熏于肺则咳嗽，咳久则
音哑，肺遗热于大肠，则肛门结疡，皆阴虚之为病也。至于阳虚
之说，一则卫外之阳，一则胃中之阳。惟胃中阳虚，呕酸水痰涎。症成劳损。今当扶土生金。
党参 五味子 川贝 半夏 金石斛 茯苓 麦冬 扁豆 陈皮 炮姜 地骨皮 十大功劳
又 投扶土生金法，谷食反减，夜热增重，乃胃阴失降，虚阳外浮也。夫脾宜升则健，胃宜降则和，胃
为阳土生肺金。今诊
左脉数疾，为心肝阳亢之象。肝火戕胃，心火烁金。宜其食减热增，夏令防剧。
金石斛 党参 谷芽 陈皮 川贝 石决明 川连 麦冬 半夏 沙参 五味子 茯苓
又 前方退心肝之火，养肺胃之阴，其热稍减而咳未平。然
此为肺虚而咳，本非易治之症。再从前法加减。
党参 川贝 桑白皮 五味子 沙参 麦冬 炙甘草 地骨皮 石决明 粳米
又 咳嗽内热俱减，惟脉之细数不退，仍为可虑。
党参 地骨皮 茯苓 白芍 川贝 麦冬 五味子 沙参 炙甘草
每晨服八仙长寿丸三钱，开水送。
张 左寸关搏指，心肝之阳亢；右关小紧，脾胃虚寒，是以
腹中常痛，大便不实。病延四月，身有微热，是属虚阳外浮。近
增口舌碎痛，亦属虚火上炎，津液消灼，劳损何疑。当以温中为主，稍佐清上，俾土浓则火敛，金旺则水生。
党参 炮姜 麦冬 茯苓 炙甘草 白术 五味子 灯心
渊按∶坤土不能坐镇中宫，虚阳因而上浮，未可以口舌碎痛辄进清降。腹痛便溏，脾土虚寒已着，不得不温矣。
王 病后胃气不醒，脘腹饱胀，近增寒热恶心，痰升气逆，
咳呛口干，阻塞咽嗌，大便艰难，小便短涩，左胁有块，大如覆
杯，撑攻作痛。此因脾胃不足，肝木亢逆，清气不升，浊气不
降，攻消克伐，元气愈伤，纳谷大减，津液日枯，虚火内炽，戕
及肺胃，渐见火升颧赤、脉数内热之象，当成劳损。宜以扶土为
主，升清降浊，佐以泻火清金，俾得中气安和，自然饱胀渐解。
党参 升麻 川连 怀山药 延胡 茯苓 柴胡 白芍 杏
仁枳壳 通草 陈皮 半夏 川楝子 苏梗 蔷薇露 枇杷叶
渊按∶痰升气逆咳呛，虽有寒热，升、柴不可用。因攻克而
元伤胃减，仍以连、楝苦寒，延、枳破气，元乃矛盾，欲望中气
安和，其可得乎！法虽从东垣得来，但东垣不是如此用法。用古人方，须会其意，若徒袭其貌，适为所误耳。
杨 先咳嗽而四肢无力，肺脾两虚。加以怒动肝木侮脾，土
益受戕，脘腹胸胁撑攻。曾经吐血，乃心火乘胃，胃中瘀血上
溢。大便溏薄，每月必发寒热数次。姑拟扶土生金，佐以平木。
异功散加白芍、川贝、麦冬、神曲、川连（吴萸炒）、川朴、沉香、五味子。
渊按∶乃土虚木横而胀也。川连、川朴益其胀耳。
又 就脉数内热，咳嗽，脘胁仍痛而论，乃阴虚肝郁成热，肺失清肃，仍防吐血。
北沙参 陈皮 川贝 延胡 白芍 金铃子 茯苓 丹皮 橘饼 麦冬 藕汁（冲服）
朱 阴虚肝郁，郁火刑金。咳嗽痰中带血，乳房颈间皆结
痰，心空嘈杂，头眩目花，腰酸腿软，劳损之根。治主养阴，佐以化痰。
大生地 归身 白芍 阿胶 茯神 豆衣 玉竹 香附 枣仁 沙参 石决明 丹皮 紫
菀川贝 钩钩 女贞子 藕节 橘叶 红枣
王 脾虚气陷，肛门先发外疡。疡溃之后，大便作泻，迄今
一月有余。自云下部畏冷，而两脉弦硬不柔，此谓牢脉，症属阴虚。法以温中扶土，升阳化湿。
党参 防风根 炮姜 陈皮 冬术 川芎 补故纸 砂仁 神曲
四神丸一两，资生丸二两，和服。日三钱，开水送。
渊按∶虽从阴虚而起，目前脾虚阳弱，不得不先治之。
冯 病延半载，骨蒸不已，鼻血时流，周身骨痛。营阴大
亏，虚火内亢。脉沉搏数，口燥渴饮。劳损根深，入夏防剧。拟
滋少阴，清阳明。
赵先生：血液不能滋养心脏，就会出现心悸和睡眠减少。胃中有寒湿停饮，就会呕吐清水。虚火灼伤肺金（肺属金），就会导致咽喉疼痛。肝木克制脾土（脾属土），就会导致腹部胀满。此时进行调理，最难做到周全。因为补养心血的药物，大多担心其滋腻碍胃；清降虚火的药物，又恐怕其过于滋润。想要去除胃寒，顾虑药物温燥会劫夺津液；想要平抑肝木，担心药物克伐会耗损正气。现在模仿胡洽居士的方法，专门治疗胃。因为胃是气血生化之源，脾土是万物的根本，一举而三善具备。请尝试服用。
党参、白术、茯苓、半夏、酸枣仁、扁豆、陈皮、怀山药、秫米。
渊按：脾土虚弱导致肝木干燥，积饮内生。原本肝木之所以干燥，是因为脾不运化精微物质来生成营血以滋养肝木。治疗胃这一句话最切中要害。
复诊：阴虚则阳气不能潜藏，肾水亏虚则肝木自然亢旺。肺金衰弱不能制约肝木，脾土虚弱更受肝木克制。久病不愈，就称为“损”。除了调补之外，还有什么方法敢用呢？
党参、茯神、酸枣仁、熟地黄、白术、当归、陈皮、川贝母、神曲、五味子、龙眼肉。
又诊：阳明经是阳气旺盛的经脉，虚弱时会出现畏寒战栗。少阴经是相火居住的宅舍，虚弱时火气上升，这就是咽喉干燥疼痛、耳鸣、颧骨发红的原因。至于腹中撑胀，虽然属于肝气旺盛，但也属于脾脏衰败。心跳、睡眠少、咳嗽、气短，说明心的营气和肺的卫气都虚弱了。虚证就要用补法，这是大法。如果虚不受补，就称为逆证。古人有明确的训诫，后人不应有异议。
党参、怀山药、神曲、玄参、白芍、茯神、大生地、酸枣仁、陈皮。
侯先生：患病已经两个月，体表皮肤不热，但脉象微数且急，这是里有热邪。里热属于阴虚，与表邪无关，并没有头痛恶寒的症状。越是发散表邪，越会使体表虚弱，所以反而增加了咳嗽。如果说这是湿热，也似是而非。湿热蕴结在中焦，一定有胸脘痞闷、恶心等症状。这个证候没有这些表现，显然不是湿热。最近几天腹中不和，大便溏薄。暂且以调和脾胃为主，兼理脾肺，再商量治本的方法。
党参、茯苓、木香、广陈皮、砂仁、白术、神曲、川贝母、款冬花。
又诊：调和与补益的药物配合使用，各种病症都减轻了。只有脉数没有平静下来，终究属于元气和真阴亏损。但是之前的补益侧重于肺脾，现在参入补肾的药物，兼养阴液，以观察病情变化。
党参、白术、白芍、豆衣、莲子肉、何首乌、当归身、茯苓、沙苑子、谷芽。
丁先生：营阴不足则风阳容易上逆，脾胃虚弱则肝木容易横逆。心中嘈杂、头晕、耳鸣，是津液枯竭、阳气升腾的征兆；腹胀、胃脘痞闷、厌食，是脾虚气滞的过失。现在在吐泻之后，实际上是肝强脾弱。遵循越人关于肝病宜缓中的理论进行治疗。
人参、茯苓、白术、竹茹、麦冬、半夏、陈皮、橘叶、刺蒺藜（用鸡蛋黄拌炒）。
薛先生：阴亏营损，主疏泄的风木之脏（肝）失去涵养；肝木过胜风邪淫溢，主运化的仓廪之官（脾胃）受到制约。所以出现头痛、肢体麻木、腹部胀满、嗳气、心跳、睡眠少、手掌发热、腰酸等症状。所担忧的是水土俱弱，唯独肝木强盛。强者难以突然压制，弱者应当急于扶持。现在再次益养营阴以安抚它，充实仓廪以防御它，辅助金气以制约它，这也是剿抚兼行的方法。
大生地、当归身、白芍、谷芽、怀山药、潞党参、神曲、茯神、陈皮、刺蒺藜、红枣、川黄连（用吴茱萸炒）。
张先生：气虚则脾弱，肝强侮其所胜（脾），进食后即感饱胀，腹中气冲作泻。扶土泄木，是一定的法则。
炙甘草、防风根、砂仁、陈皮、白术（用厚朴五分煎汁拌炒）、焦神曲、茯苓、炮姜、白芍（用吴茱萸三分煎汁拌炒）。
薛先生：便泄半年，脾肾两亏；脉象沉细涩，阴阳并弱。阳痿不举，精伤特别严重；面色苍白无华，气虚已极。足背浮肿，是阳虚湿气下注；纳食嗳气，是胃虚气逆于中。调治的方剂，自然应当脾肾双补，阴阳并顾。然而刚热补阳，恐怕劫夺阴液；滋腻补阴，恐怕妨碍胃气。此刻正值清明节气，是木旺土衰的时候。脾属土。肾属坎水，一阳藏于二阴之中。应当在补土的同时兼顾肾脏的阴阳为是。
怀山药、炮姜、炙甘草、党参、五味子、菟丝子、砂仁、茯苓、白术、鹿角霜。
如果不见效，党参换为人参，鹿角霜换成鹿茸。
复诊：脾肾双补，略微见到小效。现在腹中鸣响，气向下坠，属于脾虚气陷。舌中心光红，脉沉细数，为肾脏阴伤。用补中升阳法。
高丽参、怀山药、白术、炙甘草、肉豆蔻、五味子、陈皮、菟丝子、沙苑子、川断、鹿角霜、白芍。
丁先生：养心营以济助肾阴，清肝热以安顿相火。
生地黄、茯神、牡丹皮、黑山栀、豆衣、酸枣仁、麦冬、北沙参、五味子。
吴先生：气血两虚，心跳头晕。肝郁不舒，胸中痞胀。用张景岳的逍遥饮参入朱丹溪的左金丸。
大熟地、香附、当归、陈皮、白芍、茯神、酸枣仁、砂仁、白术、吴茱萸炒川黄连。
冯先生：夜间凉白天热，热在上午，这是李东垣所说的劳倦伤脾。上午的热属于气虚，用补中益气汤补气升阳。
补中益气汤加神曲、茯苓。
李先生：患病将近半年，寒热缠绵。前方补养营血，兼以疏解郁结，心悸腹胀仍然没有好转。现在更加大便溏薄、足部浮肿，这是脾气虚弱。脉缓无力，应当补脾，进用归脾汤加减法。
防风根、党参、黄芪、白术、茯苓、大腹皮、当归身、白芍、酸枣仁、木香、荷叶蒂。
赵先生：心肾虚而不相交，脾肝虚而不协调。内风上扰，头晕心跳；中土式微，失眠纳少。交通心肾（坎离），必须借助脾胃（戊己）作为媒介；想要平抑肝风，也应当培补脾土。
党参、当归身、白芍、白术、茯神、远志、酸枣仁、神曲、沙苑子。
钱先生：心脾营阴内亏，肝胆风火上逆。内热头晕，颈部结核。脉虚形弱，治疗以养营为主。然而病由内生，不容易快速见效。
大生地、西洋参、玄参、当归身、白芍、石决明、茯神、嫩钩藤、豆衣、香附、广陈皮、川贝母、十大功劳。
汪先生：肾水不足，君火上炎，相火下炽。心中如火烧，舌头光亮如柿子，阳事易举，阴精易泄。拟清君火以制相火，益肾以潜阳。所虑酷暑炎热，亢阳为害罢了。
川黄连、淡黄芩、黄柏、阿胶、甘草、大生地、鸡子黄（一枚，搅和冲服）。
另：鸡蛋一个，打破头，纳入大黄三分，蒸熟。每日服一个。
又诊：投用咸苦坚阴降火的药物，以制约亢阳，心中的烧灼感，舌色的光红，已经减轻三分之一。然而上午的身热如燎原之势未退，幸好食欲颇增，苦寒药可进，再望转机为吉。
川黄连、大生地、淡黄芩、玄参、蛤壳、阿胶、元精石、甘草、鸡子黄（一枚，冲服）。
又诊：舌干红，知饥善食。水亏阳亢，土燥于中。咸苦坚阴的药剂，虽然衰减了其燔亢的势头，未能尽除其火焰。依然畏惧炎热，湿热相火蒸腾。重新加入清中固下的药物，仍不出咸苦的范畴。
西洋参、甘草、川黄连、生石膏、蛤壳、知母、麦冬、阿胶、大生地。
黄柏末，猪胆汁丸三钱。每晨开水送下一钱。
渊按：胃气未败，可任苦寒咸润，直折其炎上之火，但也须防止胃气败坏。虚损之所以难治，大都是这样。
金先生：骨骼瘦小，先天元气不足。夏秋季节寒热，至今未止。脉细数弱，气血两亏。头不痛只是身体疼，或者口吐清水，这是胃气虚寒。应当商量温补，模仿李东垣的方法。
党参、茯苓、陈皮、桂枝、柴胡、黄芪、半夏、神曲、当归、干姜、砂仁。
渊按：中气虚寒，少阳胆木之气被抑制，所以寒热纠缠。升阳益胃汤恰好合适，尤其妙在加入干姜。
又诊：补中益胃，温卫气，开腠理，各种病症都减轻，仍从前的方法。
前方去掉神曲、干姜，加入白术、白芍。
张先生：劳碌内伤脾，倦怠无力。凛凛畏寒频繁，淅淅盗汗出。咳嗽多痰带红，食少身无热。土衰金不生，卫虚营不摄。拖延半年多，劳损难调适。
炙甘草、当归、白芍、白术、党参、怀山药、黄芪、麦冬、茯神、五味子、红枣。
渊按：这不是劳倦伤中，而是劳损伤精。原因不同，见证也不同，不得混淆治疗。
又诊：益元气，补脾土。土旺而金自生，气足而力自足。
前方去掉甘草，加入陈皮、生熟谷芽。
陈先生：先后天俱不足。痰多鼻血，是阴亏阳亢的征象；纳少腹痛，是土衰木横的兆头。所以年纪刚成年，还是幼稚的形体；面色苍白无华，具见精神匮乏。治先天应当求精血类的药物，培后天须参谷食类的方剂。
党参、茯苓、白术、陈皮、黑芝麻、怀山药、白扁豆、炙甘草、砂仁、建莲肉、粳米。
上药研为末，米饮汤调服，加白糖少许。枣汤调服也可以。
附丸方：精不足的，用味厚的药物补益，应当求精血类的药物，治疗肾脏。
熟地黄、菟丝子、牛膝、白芍、鹿角霜、山药、五味子、当归身、川柏、杜仲、茯苓、甘杞子、泽泻、天冬、龟板、牡丹皮、山萸肉。
上药研为末，用鲜紫河车一具，洗净，煮烂，将上药末杵和，做成梧桐子大的丸药。每晨盐花汤送下三钱。
温先生：卫气虚则洒洒恶寒，营气虚则蒸蒸发热。营卫都出自中焦，总以脾胃为主。补脾胃则肺金有所依恃，不必治肝而肝自然驯服。
党参、白术、当归、川贝母、玫瑰花、黄芪、茯苓、白芍、陈皮。
某先生：咳嗽发热日久，前投补益脾胃的药物六、七剂，谷食增加，起居略健。但热势每交寅卯时（凌晨3-7点）而盛，这是少阳旺的时候。少阳属胆，与肝相为表里。肝胆有郁热，戕伐生生之气，肺金失其清肃，脾胃失其转输，相火日益炽盛，阴津日益枯竭，燎原之势，不到枯竭不止。其脉弦数的，是肝胆郁热的证候。此刻初交夏令，趁其胃旺加餐，拟进酸苦益阴和阳，清彻肝胆的郁热。考古有柴前梅连散，颇有深意。
柴胡（猪胆汁浸炒）、白芍、乌梅、党参、炙甘草、淡秋石、前胡、麦冬、川黄连、薤白头。
徐先生：肺脾两虚，心营亏损。咳嗽气塞，骨蒸夜热，脉形软数，面白无华。劳损根深，夏至防剧。
怀山药、茯苓、酸枣仁、川贝母、党参、五味子、扁豆、苡仁、款冬花、橘饼。
又诊：脉软数为气虚，骨蒸心跳为血虚，咳嗽头晕，面色萎黄，是脾肺两虚的证候。
党参、扁豆、陈皮、五味子、款冬花、茯苓、酸枣仁、川贝母、炙甘草、红枣。
奚先生：阳虚生外寒，阴虚生内热。热气熏于肺则咳嗽，咳久则音哑，肺遗热于大肠，则肛门结疡，都是阴虚造成的疾病。至于阳虚的说法，一则卫外之阳，二则胃中之阳。惟独胃中阳虚，呕酸水痰涎。症成劳损。现在应当扶土生金。
党参、五味子、川贝母、半夏、金石斛、茯苓、麦冬、扁豆、陈皮、炮姜、地骨皮、十大功劳。
又诊：投用扶土生金法，谷食反而减少，夜热增重，这是胃阴失降，虚阳外浮。脾宜升则健，胃宜降则和，胃为阳土生肺金。现在诊左脉数疾，是心肝阳亢的象。肝火戕胃，心火烁金。应当食减热增，夏令防剧。
金石斛、党参、谷芽、陈皮、川贝母、石决明、川黄连、麦冬、半夏、沙参、五味子、茯苓。
又诊：前方退心肝之火，养肺胃之阴，其热稍减而咳未平。然而此为肺虚而咳，本来不是容易治疗的症。再从前法加减。
党参、川贝母、桑白皮、五味子、沙参、麦冬、炙甘草、地骨皮、石决明、粳米。
又诊：咳嗽内热俱减，惟独脉之细数不退，仍为可虑。
党参、地骨皮、茯苓、白芍、川贝母、麦冬、五味子、沙参、炙甘草。
每晨服八仙长寿丸三钱，开水送。
张先生：左寸关搏指，心肝之阳亢；右关小紧，脾胃虚寒，所以腹中常痛，大便不实。病延四月，身有微热，是属虚阳外浮。近增口舌碎痛，也属虚火上炎，津液消灼，劳损何疑。当以温中为主，稍佐清上，使土浓则火敛，金旺则水生。
党参、炮姜、麦冬、茯苓、炙甘草、白术、五味子、灯心。
渊按：坤土不能坐镇中宫，虚阳因而上浮，不可以口舌碎痛就进清降药。腹痛便溏，脾土虚寒已明显，不得不温了。
王先生：病后胃气不醒，脘腹饱胀，近增寒热恶心，痰升气逆，咳呛口干，阻塞咽嗌，大便艰难，小便短涩，左胁有块，大如覆杯，撑攻作痛。这是因为脾胃不足，肝木亢逆，清气不升，浊气不降，攻消克伐，元气愈伤，纳谷大减，津液日枯，虚火内炽，戕及肺胃，渐见火升颧赤、脉数内热之象，当成劳损。宜以扶土为主，升清降浊，佐以泻火清金，使得中气安和，自然饱胀渐解。
党参、升麻、川黄连、怀山药、延胡索、茯苓、柴胡、白芍、杏仁、枳壳、通草、陈皮、半夏、川楝子、苏梗、蔷薇露、枇杷叶。
渊按：痰升气逆咳呛，虽有寒热，升麻、柴胡不可用。因为攻克而元伤胃减，仍以黄连、川楝苦寒，延胡索、枳壳破气，元气乃矛盾，欲望中气安和，怎么可能！法虽从李东垣得来，但李东垣不是如此用法。用古人方，须会其意，若徒袭其貌，适为所误耳。
杨先生：先咳嗽而四肢无力，肺脾两虚。加以怒动肝木侮脾，土益受戕，脘腹胸胁撑攻。曾经吐血，是心火乘胃，胃中瘀血上溢。大便溏薄，每月必发寒热数次。姑拟扶土生金，佐以平木。
异功散加白芍、川贝母、麦冬、神曲、川黄连（吴茱萸炒）、厚朴、沉香、五味子。
又诊：就脉数内热，咳嗽，脘胁仍痛而论，是阴虚肝郁成热，肺失清肃，仍防吐血。
北沙参、陈皮、川贝母、延胡索、白芍、金铃子、茯苓、牡丹皮、橘饼、麦冬、藕汁（冲服）。
朱先生：阴虚肝郁，郁火刑金。咳嗽痰中带血，乳房颈间皆结痰，心空嘈杂，头晕眼花，腰酸腿软，劳损之根。治主养阴，佐以化痰。
大生地、当归身、白芍、阿胶、茯神、豆衣、玉竹、香附、酸枣仁、沙参、石决明、牡丹皮、紫菀、川贝母、钩藤、女贞子、藕节、橘叶、红枣。
王先生：脾虚气陷，肛门先发外疡。疡溃之后，大便作泻，迄今一月有余。自云下部畏冷，而两脉弦硬不柔，此谓牢脉，症属阴虚。法以温中扶土，升阳化湿。
党参、防风根、炮姜、陈皮、白术、川芎、补骨脂、砂仁、神曲。
四神丸一两，资生丸二两，和服。日三钱，开水送。
冯先生：病延半载，骨蒸不已，鼻血时流，周身骨痛。营阴大亏，虚火内亢。脉沉搏数，口燥渴饮。劳损根深，入夏防剧。拟滋少阴，清阳明。
Mr. Zhao: Blood fails to nourish the Heart, resulting in palpitations and insomnia. Cold-fluid retention in the Stomach leads to vomiting of clear fluid. Deficient fire scorches Metal (Lung), causing sore throat. Liver Wood overacts on Spleen Earth, leading to abdominal distension. At this time, regulation is most difficult to achieve harmoniously. Medicines that tonify Heart blood are often feared for being cloying; medicines that clear deficient fire are feared for being too moistening. To remove Stomach cold, one worries about warming-drying herbs depleting fluids; to calm Liver Wood, one fears astringent or purgative methods consuming Qi. Now imitating the method of Scholar Hu Qia, we focus solely on treating the Stomach. For the Stomach is the home of Qi and Blood, and Spleen Earth is the mother of all things; thus, one action achieves three benefits. Please try taking it.
Codonopsis Radix (Dangshen), Atractylodis Macrocephalae Rhizoma (Baizhu), Poria (Fuling), Pinelliae Tuber (Banxia), Ziziphi Spinosae Semen (Suanzaoren), Dolichos Lablab Seed (Bian Dou), Citri Reticulatae Pericarpium (Chenpi), Dioscoreae Hypoglaucae Rhizoma (Huai Shanyao), Sorghum Vulgare Seed (Shumi).
Note by Yuan: When Spleen Earth is deficient, Liver Wood becomes dry, and accumulated fluids arise internally. The reason Liver Wood is dry is due to the Spleen's failure to transform and transport refined essences to generate Ying-Blood to nourish the Liver. Focusing on the Stomach hits the key point.
Second visit: Yin deficiency allows Yang to float unanchored; Kidney Water depletion causes Liver Wood to flourish naturally. Lung Metal weakness fails to control Liver Wood, and Spleen Earth weakness suffers further from Liver Wood oppression. Chronic illness without recovery is termed "Damage" (Sun). Besides regulation and tonification, what other methods dare to be used?
Codonopsis Radix (Dangshen), Poria with Hostwood (Fushen), Ziziphi Spinosae Semen (Suanzaoren), Rehmanniae Radix Preparata (Shu Di Huang), Atractylodis Macrocephalae Rhizoma (Baizhu), Angelicae Sinensis Radix (Danggui), Citri Reticulatae Pericarpium (Chenpi), Fritillariae Thunbergii Bulbus (Chuanbei), Medicated Leaven (Shenqu), Schisandrae Fructus (Wuweizi), Longan Aril (Longyan Rou).
Third visit: The Yangming Channel is a channel of abundant Yang; when deficient, it presents with chills. The Shaoyin Channel is the residence of Ministerial Fire; when deficient, fire rises, which explains dry/sore throat, tinnitus, and malar flush. As for abdominal distension, although it belongs to Liver excess, it also indicates Spleen decline. Palpitations, insomnia, cough, and shortness of breath indicate deficiency of both Heart Ying and Lung Wei. For deficiency, tonification is the great principle. If deficiency cannot tolerate tonification, it is called an adverse sign. Ancient teachings are clear; later generations should not dissent.
Codonopsis Radix (Dangshen), Dioscoreae Hypoglaucae Rhizoma (Huai Shanyao), Medicated Leaven (Shenqu), Scrophulariae Radix (Xuanshen), Paeoniae Radix Alba (Baishao), Poria with Hostwood (Fushen), Rehmanniae Radix (Sheng Dihuang), Ziziphi Spinosae Semen (Suanzaoren), Citri Reticulatae Pericarpium (Chenpi).
Mr. Hou: Ill for two months, skin surface is not hot, but pulse is slightly rapid and urgent, indicating internal heat. Internal heat belongs to Yin deficiency, unrelated to exterior pathogens, and there is no headache or aversion to cold. Dispersing pathogens further weakens the exterior, hence increasing cough. If considered damp-heat, it is plausible yet incorrect. Damp-heat accumulating in the Middle Jiao must present with chest fullness and nausea. This case lacks these signs, clearly not damp-heat. Recently, abdominal discomfort and loose stools occur. Temporarily focus on harmonizing the Middle, assisting Spleen and Lung, then discuss treating the root.
Codonopsis Radix (Dangshen), Poria (Fuling), Aucklandiae Radix (Muxiang), Citri Reticulatae Pericarpium (Guangpi), Amomi Fructus (Sharen), Atractylodis Macrocephalae Rhizoma (Baizhu), Medicated Leaven (Shenqu), Fritillariae Thunbergii Bulbus (Chuanbei), Kolkwitziae Herba (Kuandonghua).
Fourth visit: Harmonizing and tonifying agents have reduced symptoms. However, the rapid pulse remains unsettled, ultimately indicating deficiency of Original Qi and True Yin. Previous tonification focused on Lung and Spleen; now incorporate Kidney tonics to nourish Yin, observing changes.
Codonopsis Radix (Dangshen), Atractylodis Macrocephalae Rhizoma (Baizhu), Paeoniae Radix Alba (Baishao), Sojae Semen Praeparatum (Dou Pi), Nelumbinis Semen (Lianrou), Polygoni Multiflori Caulis (Shouwu), Angelicae Sinensis Radix (Guishen), Poria (Fuling), Astragali Complanati Semen (Shayuanzi), Hordeum Vulgare Sprout (Guya).
Mr. Ding: Ying-Yin deficiency allows Wind-Yang to rebel easily; Spleen-Stomach weakness allows Liver Wood to invade horizontally. Heart burning, dizziness, tinnitus are signs of fluid exhaustion and Yang rising; abdominal distension, epigastric fullness, anorexia are faults of Spleen deficiency and Qi stagnation. Post-emesis and diarrhea, this is essentially Liver strength and Spleen weakness. Follow Yue Ren’s theory of treating Liver disease by moderating the center.
Ginseng Radix (Renshen), Poria (Fuling), Atractylodis Macrocephalae Rhizoma (Baizhu), Bambusae Folium (Zhuru), Ophiopogonis Radix (Maidong), Pinelliae Tuber (Banxia), Citri Reticulatae Pericarpium (Chenpi), Citri Reticulatae Blade (Juye), Tribuli Fructus (Cijili) stir-fried with egg yolk.
Mr. Xue: Yin deficiency and Ying damage cause the Wind-Wood organ (Liver) to lose nourishment; excessive Wood and Wind pathogen oppress the Granary Official (Spleen-Stomach). Thus, headache, limb numbness, abdominal fullness, belching, palpitations, insomnia, palm heat, and lumbar soreness appear. The concern is dual weakness of Water and Earth, with only Liver Wood strong. The strong are hard to subdue suddenly; the weak need urgent support. Now again nourish Ying-Yin to pacify, strengthen Granary to defend, assist Metal to control; this is a combined suppression and appeasement method.
Rehmanniae Radix (Sheng Dihuang), Angelicae Sinensis Radix (Guishen), Paeoniae Radix Alba (Baishao), Hordeum Vulgare Sprout (Guya), Dioscoreae Hypoglaucae Rhizoma (Huai Shanyao), Codonopsis Radix (Lu Dangshen), Medicated Leaven (Shenqu), Poria with Hostwood (Fushen), Citri Reticulatae Pericarpium (Chenpi), Tribuli Fructus (Cijili), Jujubae Fructus (Hongzao), Coptidis Rhizoma (Chuanlian) stir-fried with Evodiae Fructus (Wuzhuyu).
Mr. Zhang: Qi deficiency leads to Spleen weakness; Liver excess insults its conquered element (Spleen), causing postprandial fullness and Qi rushing downward causing diarrhea. Strengthen Earth and drain Wood is the fixed protocol.
Glycyrrhizae Radix et Rhizoma Preparata (Zhi Gancao), Saposhnikoviae Radix (Fangfeng Gen), Amomi Fructus (Sharen), Citri Reticulatae Pericarpium (Chenpi), Atractylodis Macrocephalae Rhizoma (Baizhu) stir-fried with decoction of Magnoliae Officinalis Cortex (Houpo 5 fen), Scoriated Medicated Leaven (Jiao Shenqu), Poria (Fuling), Zingiberis Rhizoma Preparata (Paojiang), Paeoniae Radix Alba (Baishao) stir-fried with decoction of Evodiae Fructus (Wuzhuyu 3 fen).
Mr. Xue: Loose stools for half a year, Spleen-Kidney dual deficiency; pulse deep, fine, and choppy, Yin-Yang both weak. Impotence indicates severe Essence injury; pale complexion indicates extreme Qi deficiency. Foot edema indicates Yang deficiency with dampness sinking; belching after eating indicates Stomach deficiency with rebellious Qi. Treatment should tonify Spleen and Kidney, attending to both Yin and Yang. However, warm-hot Yang tonics may deplete Yin; cloying Yin tonics may hinder Stomach. Currently at Qingming solar term, Wood is strong and Earth weak. Spleen is Earth. Kidney is Kan Water, with one Yang hidden between two Yins. Tonify Earth while attending to Kidney Yin-Yang is appropriate.
Dioscoreae Hypoglaucae Rhizoma (Huai Shanyao), Zingiberis Rhizoma Preparata (Paojiang), Glycyrrhizae Radix et Rhizoma Preparata (Zhi Gancao), Codonopsis Radix (Dangshen), Schisandrae Fructus (Wuweizi), Cuscutae Semen (Tusizi), Amomi Fructus (Sharen), Poria (Fuling), Atractylodis Macrocephalae Rhizoma (Baizhu), Cornus Officinalis Bark (Lujiaoshuang - *Correction: Lujiaoshuang is Deer Antler Glue/Calcined*). Note: Text says Lujiaoshuang.
If ineffective, replace Codonopsis with Ginseng, and Lujiaoshuang with Deer Antler Velvet (Lurong).
Second visit: Dual tonification of Spleen-Kidney shows slight effect. Abdominal borborygmus and Qi sinking downward indicate Spleen deficiency with Qi collapse. Red glossy tongue center and deep-fine-rapid pulse indicate Kidney Yin injury. Use Bu Zhong Yi Qi method (Tonify Middle and Augment Qi).
Korean Ginseng (Gaoliren), Dioscoreae Hypoglaucae Rhizoma (Huai Shanyao), Atractylodis Macrocephalae Rhizoma (Baizhu), Glycyrrhizae Radix et Rhizoma Preparata (Zhi Gancao), Myristicae Semen (Rouguo), Schisandrae Fructus (Wuweizi), Citri Reticulatae Pericarpium (Chenpi), Cuscutae Semen (Tusizi), Astragali Complanati Semen (Shayuanzi), Drynariae Rhizoma (Chuanduan), Deer Antler Glue (Lujiaoshuang), Paeoniae Radix Alba (Baishao).
Mr. Ding: Nourish Heart Ying to aid Kidney Yin; clear Liver Heat to calm Ministerial Fire.
Rehmanniae Radix (Shengdi), Poria with Hostwood (Fushen), Moutan Cortex (Danpi), Gardeniae Fructus (Heishanzhi), Sojae Semen Praeparatum (Douyi), Ziziphi Spinosae Semen (Suanzaoren), Ophiopogonis Radix (Maidong), Glehniae Radix (Beishashen), Schisandrae Fructus (Wuweizi).
Mr. Wu: Dual deficiency of Qi and Blood, palpitations and dizziness. Liver depression with disharmony, chest fullness. Use Jingyue Xiaoyao Yin combined with Danxi Zuojin Wan.
Prepared Rehmanniae Radix (Shudi), Cyperi Rhizoma (Xiangfu), Angelicae Sinensis Radix (Danggui), Citri Reticulatae Pericarpium (Chenpi), Paeoniae Radix Alba (Baishao), Poria with Hostwood (Fushen), Ziziphi Spinosae Semen (Suanzaoren), Amomi Fructus (Sharen), Atractylodis Rhizoma (Baizhu), Evodiae Fructus stir-fried Coptidis Rhizoma (Wuzhuyu Chao Chuanlian).
Note by Yuan: Prepared Rehmannia may obstruct the diaphragm. Dizziness is mostly due to Phlegm obstructing the Middle Jiao.
Mr. Feng: Night coolness and daytime heat, heat in the morning, as Dongyuan said, labor fatigue damages Spleen. Morning heat belongs to Qi deficiency; use Buzhong Yiqi Tang to tonify Qi and raise Yang.
Buzhong Yiqi Tang plus Medicated Leaven (Shenqu) and Poria (Fuling).
Mr. Li: Ill for nearly half a year, alternating cold and heat lingering. Previous formula tonified Ying and dispersed depression, but palpitations and abdominal distension persist. Now with loose stools and foot swelling, this is Spleen Qi deficiency. Pulse slow and powerless, must tonify Spleen, advance Guipi Tang modified.
Saposhnikoviae Radix (Fangfeng Gen), Codonopsis Radix (Dangshen), Astragali Radix (Huangqi), Atractylodis Macrocephalae Rhizoma (Baizhu), Poria (Fuling), Arecae Pericarpium (Dafupi), Angelicae Sinensis Radix (Guishen), Paeoniae Radix Alba (Baishao), Ziziphi Spinosae Semen (Suanzaoren), Aucklandiae Radix (Muxiang), Nelumbinis Petalum (Heyetidi).
Note by Yuan: Can add Cinnamomi Ramulus (Guizhi), Zingiberis Rhizoma (Jiang), and Jujubae Fructus (Zao).
Mr. Zhao: Heart and Kidney fail to interact; Spleen and Liver fail to coordinate. Internal wind disturbs upward, causing dizziness and palpitations; Middle Earth declines, causing insomnia and poor appetite. To connect Kan and Li (Kidney and Heart), one must borrow Wuji (Stomach) and Jiyi (Spleen) as mediators; to calm Liver wind, one must cultivate Earth.
Codonopsis Radix (Dangshen), Angelicae Sinensis Radix (Guishen), Paeoniae Radix Alba (Baishao), Atractylodis Macrocephalae Rhizoma (Baizhu), Poria with Hostwood (Fushen), Polygalae Radix (Yuanzhi), Ziziphi Spinosae Semen (Suanzaoren), Medicated Leaven (Shenqu), Astragali Complanati Semen (Shayuanzi).
Mr. Qian: Heart-Spleen Ying-Yin internally deficient; Liver-Gallbladder Wind-Fire rebels upward. Internal heat and dizziness, neck lymphadenopathy. Pulse weak, body emaciated, treatment focuses on nourishing Ying. However, disease arises internally, not easy to cure quickly.
Rehmanniae Radix (Sheng Dihuang), Panax Notoginseng (Yangshen - *Text says Yangshen, likely American Ginseng/Xiyangshen*), Scrophulariae Radix (Xuanshen), Angelicae Sinensis Radix (Guishen), Paeoniae Radix Alba (Baishao), Margarita Concha (Shijueming), Poria with Hostwood (Fushen), Uncariae Ramulus cum Uncis (Nenggou gou), Sojae Semen Praeparatum (Douyi), Cyperi Rhizoma (Xiangfu), Citri Reticulatae Pericarpium (Guangpi), Fritillariae Thunbergii Bulbus (Chuanbei), Mahoniae Leaf (Shida Gonglao).
Mr. Wang: Kidney Water insufficient, Sovereign Fire flares upward, Ministerial Fire blazes below. Heart feels like burning, tongue smooth like persimmon, erections frequent, Essence leaks easily. Plan to clear Sovereign Fire to control Ministerial Fire, benefit Kidney to submerge Yang. Worried about intense summer heat harming hyperactive Yang.
Coptidis Rhizoma (Chuanlian), Scutellariae Radix (Dan Qin), Phellodendri Cortex (Huangbai), Corii Asini Colla (Ejiao), Glycyrrhizae Radix et Rhizoma (Gancao), Rehmanniae Radix (Sheng Dihuang), Gallus Gallus Domesticus Brain (Jizihuang - *Text says Ji Zi Huang, Egg Yolk*) one piece, mixed and taken with decoction.
Separate: One chicken egg, break top, insert 3 fen Rhubarb (Dahuang), steam until cooked. Take one daily.
Second visit: Salty-bitter Yin-firming and fire-lowering agents have controlled hyperactive Yang; heart burning and red tongue have decreased by one-third. However, morning fever like blazing has not receded. Fortunately, appetite has increased, bitter-cold drugs can be advanced, hoping for a turn for the better.
Coptidis Rhizoma (Chuanlian), Rehmanniae Radix (Sheng Dihuang), Scutellariae Radix (Dan Qin), Scrophulariae Radix (Xuanshen), Tridacna Shell (Geqiao), Corii Asini Colla (Ejiao), Yuanjing Stone (Yuanjingshi), Glycyrrhizae Radix et Rhizoma (Gancao), Gallus Gallus Domesticus Brain (Jizihuang) one piece, taken with decoction.
Third visit: Tongue dry and red, hungry and eats well. Water deficiency and Yang hyperactivity, Earth dry in the middle. Salty-bitter Yin-firming agents have attenuated the blazing trend but not extinguished the flame. Still fear heat; damp-heat and Ministerial Fire steaming. Re-enter clearing Middle and securing Lower methods, still within salty-bitter category.
Panax Quinquefolius Radix (Yangshen), Glycyrrhizae Radix et Rhizoma (Gancao), Coptidis Rhizoma (Chuanlian), Gypsum Fibrosum (Sheng Shigao), Tridacna Shell (Geqiao), Anemarrhenae Rhizoma (Zhimu), Ophiopogonis Radix (Maidong), Corii Asini Colla (Ejiao), Rehmanniae Radix (Sheng Dihuang).
Phellodendri Cortex powder, pig bile pills, 3 qian. Take 1 qian with boiled water every morning.
Note by Yuan: Stomach Qi not defeated, can bear bitter-cold and salty-moist, directly cutting down flaming fire, but must prevent Stomach defeat. Difficulty in treating consumptive diseases is largely like this.
Mr. Jin: Bones small, congenital Yuan Qi insufficient. Summer-autumn cold and heat, not ceased till now. Pulse fine, rapid, weak, dual deficiency of Qi and Blood. Head does not hurt but body aches, or mouth produces clear fluid, this is Stomach Qi deficiency and cold. Should discuss warm tonification, imitating Dongyuan’s method.
Codonopsis Radix (Dangshen), Poria (Fuling), Citri Reticulatae Pericarpium (Chenpi), Cinnamomi Ramulus (Guizhi), Bupleuri Radix (Chaihu), Astragali Radix (Huangqi), Pinelliae Tuber (Banxia), Medicated Leaven (Shenqu), Angelicae Sinensis Radix (Danggui), Zingiberis Rhizoma (Ganjiang), Amomi Fructus (Sharen).
Note by Yuan: Middle Qi deficiency and cold, Shaoyang Gallbladder Wood Qi suppressed, hence cold and heat entangled. Shengyang Yiewei Tang fits perfectly, especially with added Ganjiang.
Second visit: Tonify Middle and benefit Stomach, warm Wei Qi, open cou li, all symptoms reduced, continue previous method.
Previous formula minus Medicated Leaven and Ganjiang, add Baizhu and Baishao.
Mr. Zhang: Labor injuries Spleen internally, fatigue and weakness. Chills frequent, night sweats profuse. Cough with bloody sputum, little food intake, no body heat. Earth weak, Metal not born; Wei deficient, Ying not secured. Dragging for half a year, consumptive damage hard to regulate.
Glycyrrhizae Radix et Rhizoma Preparata (Zhi Gancao), Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Baishao), Atractylodis Macrocephalae Rhizoma (Baizhu), Codonopsis Radix (Dangshen), Dioscoreae Hypoglaucae Rhizoma (Huai Shanyao), Astragali Radix (Huangqi), Ophiopogonis Radix (Maidong), Poria with Hostwood (Fushen), Schisandrae Fructus (Wuweizi), Jujubae Fructus (Hongzao).
Note by Yuan: This is not labor-fatigue damaging the center, but labor damaging Essence. Causes differ, manifestations differ, do not treat confusedly.
Second visit: Benefit Yuan Qi, tonify Spleen Earth. Earth strong, Metal self-born; Qi sufficient, strength self-sufficient.
Previous formula minus Gancao, add Chenpi and raw/cooked Hordeum Sprouts (Guya).
Mr. Chen: Congenital and acquired sources both insufficient. Phlegm and epistaxis, signs of Yin deficiency and Yang hyperactivity; poor appetite and abdominal pain, signs of Earth weakness and Wood invasion. Hence young adult, still childish form; pale face, spirit lacking. Treat congenital with essence-blood tonics; cultivate acquired with grain-food formulas.
Codonopsis Radix (Dangshen), Poria (Fuling), Atractylodis Macrocephalae Rhizoma (Baizhu), Citri Reticulatae Pericarpium (Chenpi), Sesamum Indicum Seed (Heizhima), Dioscoreae Hypoglaucae Rhizoma (Huai Shanyao), Dolichos Lablab Seed (Bai Biandou), Glycyrrhizae Radix et Rhizoma Preparata (Zhi Gancao), Amomi Fructus (Sharen), Nelumbinis Semen (Jian Lianrou), Oryza Sativa (Jingmi).
Powder above, mix with rice soup, add little white sugar. Jujube soup mixing is also acceptable.
Attached Pill Formula: Essence deficiency, tonify with flavor, seek essence-blood substances, treat Kidney.
Prepared Rehmanniae Radix (Shudi), Cuscutae Semen (Tusizi), Achyranthis Bidentatae Radix (Niuxi), Paeoniae Radix Alba (Baishao), Deer Antler Glue (Lujiaoshuang), Dioscoreae Rhizoma (Shanyao), Schisandrae Fructus (Wuweizi), Angelicae Sinensis Radix (Guishen), Phellodendri Cortex (Chuanbai), Eucommiae Cortex (Duzhong), Poria (Fuling), Lycii Fructus (Ganqizi), Alismatis Rhizoma (Zexie), Asparagi Radix (Tiantong), Testudinis Carapax et Plastrum (Guiban), Moutan Cortex (Danpi), Cornus Officinalis Fruit (Shanzhuyu).
Powder above, use fresh Human Placenta (Ziheche) one piece, wash clean, boil soft, mix with powder, make pills like wu zi size. Take 3 qian with salt water every morning.
Mr. Wen: Wei Qi deficiency causes chilliness; Ying Qi deficiency causes steaming fever. Ying and Wei both emerge from Middle Jiao, primarily governed by Spleen-Stomach. Tonify Spleen-Stomach, then Lung Metal has support, no need to treat Liver, Liver will tame itself.
Codonopsis Radix (Dangshen), Atractylodis Macrocephalae Rhizoma (Baizhu), Angelicae Sinensis Radix (Danggui), Fritillariae Thunbergii Bulbus (Chuanbei), Rosae Rugosae Flos (Meiguifei), Astragali Radix (Huangqi), Poria (Fuling), Paeoniae Radix Alba (Baishao), Citri Reticulatae Pericarpium (Chenpi).
Mr. X: Chronic cough and fever, previous tonifying Spleen-Stomach meds for 6-7 doses, food intake increased,起居 slightly healthier. But fever peaks at Yin-Mao hours (3-7 AM), when Shaoyang is prosperous. Shaoyang belongs to Gallbladder, interior-exterior related to Liver. Liver-Gallbladder depressed heat destroys vital Qi, Lung Metal loses clarity and descending, Spleen-Stomach lose transformation, Ministerial Fire increases, Yin fluids decrease, prairie fire spreads until exhaustion. Stringent-rapid pulse indicates Liver-Gallbladder depressed heat. Early summer, take advantage of strong Stomach appetite, plan sour-bitter Yin-nourishing and Yang-harmonizing, clear Liver-Gallbladder depressed heat. Ancient Chaiqian Meilian San has deep meaning.
Bupleuri Radix (Chaihu) stir-fried with pig bile, Paeoniae Radix Alba (Baishao), Mume Fructus (Wumei), Codonopsis Radix (Dangshen), Glycyrrhizae Radix et Rhizoma Preparata (Zhi Gancao), Halotitum (Dan Qiushi), Peucedani Radix (Qianhu), Ophiopogonis Radix (Maidong), Coptidis Rhizoma (Chuanlian), Allii Macrostemonis Bulbus (Xie baitou).
Mr. Xu: Lung-Spleen dual deficiency, Heart Ying loss. Cough and air blockage, bone-steaming night fever, pulse soft and rapid, pale face. Consumptive damage root deep, fear worsening at Summer Solstice.
Dioscoreae Hypoglaucae Rhizoma (Huai Shanyao), Poria (Fuling), Ziziphi Spinosae Semen (Suanzaoren), Fritillariae Thunbergii Bulbus (Chuanbei), Codonopsis Radix (Dangshen), Schisandrae Fructus (Wuweizi), Dolichos Lablab Seed (Biandou), Coicis Semen (Yiren), Kolkwitziae Herba (Kuandonghua), Citrus reticulata 'Chachi' (Jubing).
Second visit: Soft-rapid pulse indicates Qi deficiency; bone-steaming and palpitations indicate Blood deficiency; cough and dizziness, sallow complexion, Lung-Spleen dual deficiency.
Codonopsis Radix (Dangshen), Dolichos Lablab Seed (Biandou), Citri Reticulatae Pericarpium (Chenpi), Schisandrae Fructus (Wuweizi), Kolkwitziae Herba (Kuandonghua), Poria (Fuling), Ziziphi Spinosae Semen (Suanzaoren), Fritillariae Thunbergii Bulbus (Chuanbei), Glycyrrhizae Radix et Rhizoma Preparata (Zhi Gancao), Jujubae Fructus (Hongzao).
Mr. Xi: Yang deficiency generates external cold; Yin deficiency generates internal heat. Heat steams Lung causing cough; long cough hoarses voice; Lung transmits heat to Large Intestine causing anal ulcer, all Yin deficiency diseases. Regarding Yang deficiency: one is defensive Yang, one is Stomach Yang. Only Stomach Yang deficiency causes vomiting acid/phlegm. Disease becomes consumptive. Now should fortify Earth to generate Metal.
Codonopsis Radix (Dangshen), Schisandrae Fructus (Wuweizi), Fritillariae Thunbergii Bulbus (Chuanbei), Pinelliae Tuber (Banxia), Dendrobii Caulis (Jinshihu), Poria (Fuling), Ophiopogonis Radix (Maidong), Dolichos Lablab Seed (Biandou), Citri Reticulatae Pericarpium (Chenpi), Zingiberis Rhizoma Preparata (Paojiang), Cortex Lycii (Digupi), Mahoniae Leaf (Shida Gonglao).
Second visit: Fortify Earth generate Metal method, food intake decreased, night fever increased, this is Stomach Yin failing to descend, deficient Yang floating externally. Spleen prefers ascending to be healthy; Stomach prefers descending to be harmonious. Stomach is Yang Earth generating Lung Metal. Left pulse rapid and frantic, Heart-Liver Yang hyperaction. Liver fire damages Stomach, Heart fire scorches Metal. Food decreases, heat increases, fear worsening in summer.
Dendrobii Caulis (Jinshihu), Codonopsis Radix (Dangshen), Hordeum Vulgare Sprout (Guya), Citri Reticulatae Pericarpium (Chenpi), Fritillariae Thunbergii Bulbus (Chuanbei), Margarita Concha (Shijueming), Coptidis Rhizoma (Chuanlian), Ophiopogonis Radix (Maidong), Pinelliae Tuber (Banxia), Glehniae Radix (Shashen), Schisandrae Fructus (Wuweizi), Poria (Fuling).
Third visit: Previous formula cleared Heart-Liver fire, nourished Lung-Stomach Yin, heat slightly reduced but cough not flat. This is Lung deficiency cough, inherently hard to treat. Modify previous method.
Codonopsis Radix (Dangshen), Fritillariae Thunbergii Bulbus (Chuanbei), Morus Alba Root Bark (Sangbaipi), Schisandrae Fructus (Wuweizi), Glehniae Radix (Shashen), Ophiopogonis Radix (Maidong), Glycyrrhizae Radix et Rhizoma Preparata (Zhi Gancao), Cortex Lycii (Digupi), Margarita Concha (Shijueming), Oryza Sativa (Jingmi).
Fourth visit: Cough and internal heat reduced, but fine-rapid pulse persists, still concerning.
Codonopsis Radix (Dangshen), Cortex Lycii (Digupi), Poria (Fuling), Paeoniae Radix Alba (Baishao), Fritillariae Thunbergii Bulbus (Chuanbei), Ophiopogonis Radix (Maidong), Schisandrae Fructus (Wuweizi), Glehniae Radix (Shashen), Glycyrrhizae Radix et Rhizoma Preparata (Zhi Gancao).
Take Baxian Changshou Wan 3 qian every morning with boiled water.
Mr. Zhang: Left Cun-Guan pulse beats against finger, Heart-Liver Yang hyperactive; Right Guan pulse slightly tight, Spleen-Stomach deficiency-cold, hence constant abdominal pain and loose stools. Ill for four months, slight body heat, deficient Yang floating externally. Recently increased oral ulcers, deficient fire flaming upward, fluids consumed, consumptive damage suspected. Focus on warming Middle, slightly assist clearing Upper, so Earth thickens fire contains, Metal strong Water generates.
Codonopsis Radix (Dangshen), Zingiberis Rhizoma Preparata (Paojiang), Ophiopogonis Radix (Maidong), Poria (Fuling), Glycyrrhizae Radix et Rhizoma Preparata (Zhi Gancao), Atractylodis Rhizoma (Baizhu), Schisandrae Fructus (Wuweizi), Junci Medulla (Dengxin).
Note by Yuan: Kun Earth fails to anchor Center Palace, deficient Yang floats up. Do not use clearing-descending drugs just for oral ulcers. Abdominal pain and loose stools indicate obvious Spleen-Earth deficiency-cold, must warm.
Mr. Wang: Post-illness Stomach Qi not revived, epigastric-abdominal fullness, recent cold-heat nausea, phlegm rising Qi rebellion, coughing dry mouth, throat obstruction, difficult stool, scanty urine, left hypochondriac mass like inverted cup, distending pain. Due to Spleen-Stomach insufficiency, Liver Wood hyper-rebellion, Clear Qi not ascending, Turbid Qi not descending, attacking/purging harms Yuan Qi more, food intake greatly reduced, fluids daily dried, deficient fire internal blazing, damaging Lung-Stomach, gradually showing fire rising malar flush, rapid pulse internal heat, becoming consumptive. Focus on fortifying Earth, ascending Clear descending Turbid, assist draining fire clearing Metal, so Middle Qi harmonizes, fullness resolves.
Codonopsis Radix (Dangshen), Cimicifugae Rhizoma (Shengma), Coptidis Rhizoma (Chuanlian), Dioscoreae Hypoglaucae Rhizoma (Huai Shanyao), Corydalis Rhizoma (Yanhusu), Poria (Fuling), Bupleuri Radix (Chaihu), Paeoniae Radix Alba (Baishao), Armeniacae Semen Amarum (Xingren), Aurantii Fructus (Zhike), Tectona Grandis Stem (Tongcao), Citri Reticulatae Pericarpium (Chenpi), Pinelliae Tuber (Banxia), Meliae Fructus (Chuanlianzi), Perillae Caulis (Sugeng), Rosa Rosae Centifoliae Aqua (Qiangweilu), Eriobotryae Folium (Pipaye).
Note by Yuan: Phlegm rising Qi rebellion coughing, despite cold-heat, Shengma and Chaihu cannot be used. Because purging damaged Yuan and reduced Stomach, using Chuanlian and Chuanlianzi bitter-cold, Yanhu and Zhike breaking Qi, Yuan is contradictory. Desiring Middle Qi harmony, how possible! Method derived from Dongyuan, but Dongyuan did not use it this way. Using ancient formulas, must grasp intent, if merely copying appearance, misled.
Mr. Yang: First cough then limb weakness, Lung-Spleen dual deficiency. Anger moves Liver Wood insulting Spleen, Earth further damaged, epigastric-abdominal-chest-hypochondriac distending pain. History of hematemesis, Heart fire invading Stomach, Stomach blood stasis overflowing. Loose stools, monthly cold-heat episodes. Tentatively fortify Earth generate Metal, assist calming Wood.
Yigong San plus Baishao, Chuanbei, Maidong, Shenqu, Chuanlian (Wuzhuyu fried), Houpo, Chenxiang, Wuweizi.
Note by Yuan: Earth deficiency Wood invasion causing distension. Chuanlian and Houpo increase distension.
Second visit: Rapid pulse internal heat, cough, epigastric-hypochondriac pain remain, Yin deficiency Liver depression generating heat, Lung loses clarity, fear hematemesis.
Glehniae Radix (Beishashen), Citri Reticulatae Pericarpium (Chenpi), Fritillariae Thunbergii Bulbus (Chuanbei), Corydalis Rhizoma (Yanhusu), Paeoniae Radix Alba (Baishao), Sydenhamia Fructus (Jinlingzi), Poria (Fuling), Moutan Cortex (Danpi), Citrus reticulata 'Chachi' (Jubing), Ophiopogonis Radix (Maidong), Nelumbinis Plumula (Ouzhi) taken with decoction.
Mr. Zhu: Yin deficiency Liver depression, depressed fire punishing Metal. Cough with bloody sputum, breast-neck phlegm nodules, heart empty burning, dizziness blurred vision, lumbar sore leg weakness, consumptive root. Treatment main nourish Yin, assist resolving Phlegm.
Rehmanniae Radix (Sheng Dihuang), Angelicae Sinensis Radix (Guishen), Paeoniae Radix Alba (Baishao), Corii Asini Colla (Ejiao), Poria with Hostwood (Fushen), Sojae Semen Praeparatum (Douyi), Polygonati Odorati Rhizoma (Yuzhu), Cyperi Rhizoma (Xiangfu), Ziziphi Spinosae Semen (Suanzaoren), Glehniae Radix (Shashen), Margarita Concha (Shijueming), Moutan Cortex (Danpi), Asteris Radix (Ziwan), Fritillariae Thunbergii Bulbus (Chuanbei), Uncariae Ramulus (Gou gou), Ligustri Lucidi Fructus (Nvzhenzi), Nelumbinis Rhizomatis Node (Oujie), Citri Reticulatae Blade (Juye), Jujubae Fructus (Hongzao).
Mr. Wang: Spleen deficiency Qi collapse, anus first external ulcer. After ulcer rupture, loose stools for over a month. Claims lower body cold, pulses string-tense hard unyielding, called firm pulse, syndrome belongs to Yin deficiency. Method warm Middle fortify Earth, raise Yang transform damp.
Codonopsis Radix (Dangshen), Saposhnikoviae Radix (Fangfeng Gen), Zingiberis Rhizoma Preparata (Paojiang), Citri Reticulatae Pericarpium (Chenpi), Atractylodis Macrocephalae Rhizoma (Baizhu), Ligustici Chuanxiong Rhizoma (Chuanxiong), Psoraleae Fructus (Buguzhi), Amomi Fructus (Sharen), Medicated Leaven (Shenqu).
Sishen Wan 1 liang, Zisheng Wan 2 liang, mixed and taken. 3 qian daily with boiled water.
Note by Yuan: Although starting from Yin deficiency, currently Spleen deficiency Yang weak, must treat first.
Mr. Feng: Ill half year, bone-steaming unceasing, intermittent epistaxis, whole body bone pain. Ying-Yin greatly depleted, deficient fire internal hyperactive. Pulse deep beating rapid, mouth dry thirst drinking. Consumptive damage root deep, fear worsening entering summer. Plan nourish Shaoyin, clear Yangming.