何谓乎医案也。断病与处方而已。盖医案汗牛充栋。大都统治男妇杂症为居多。而专治妇科则甚少。吾吴顾 云女
士。妇科名医也。道咸间吴下士大夫皆争延诊而钦仰之。曾着有花韵楼医案一卷。惜乎未刊行世。知医者偶一道及。有
欲求不得之憾。余向藏有顾女士医案钞本。其论治透彻。立方平善。洵是经验之作。方之现今女医中实罕有与匹。余屡
欲镌刊以供海内诸君子之研究。然深惭力棉。未能如志公诸同好。意诚怏怏也。爰是函商绍与医药学报社裘君吉生。谋
付剞劂以广流传。幸承允可。自兹以往。风行寰宇。则顾女士济世利人之婆心。既可不致湮没。裘君之赞扬功宏。亦并
垂不朽云。
民国纪元十年辛酉季冬吴县张元瑞玉田氏序于吴趋青选书屋。
汪（医案）
小产之后。血崩月余。音低气怯。寐少咽干。面目浮肿。干呛阵作。良由血去过多。一派虚
象集矣。古人以血崩为之崩中。中者。即脾胃也。前方纯用滋纳固涩。久服不效。何以尚不悟其
理耶。盖肝主藏血。脾主摄血。脾失统血之司。血从内渗不已。由于滋之涩之。凝滞络中。所以
时或淋漓若净。忽又瘀块如掌大者络绎而下。自觉心神无根据。肢冷泄汗。经云。阴阳互根。如环无
端。阴从下渗。阳从上冒。其中枢纽。能无虑其不续耶。急进归脾法以为砥柱中流之计。
大有党参（三钱） 九制于术（一钱） 新会皮（七分） 丹皮炭（一钱五分） 大有黄 （二钱）
大熟地炭（五钱） 地榆炭（三钱） 元眼肉（三钱） 归身（一钱） 白芍（一钱五分） 枣仁
（三钱） 用藕肉（二两） 湘莲肉（五钱） 煎汤代水
汪（又诊）
前进血脱益气法。兼清营分。虚火崩决之阵顿止。胸脘乃觉舒和。略思纳谷。可知从前谬执黄
闭气之误。然肝肾空乏。八脉交虚。最虑腹膨漏带。干呛寒热。此四者崩后极易见之。不可不为
预防。
人参须（一钱五分） 大有 （一钱五分） 陈阿胶（二钱） 地榆皮（三钱） 西党参（三钱）
制于术（一钱五分） 炒丹皮（一钱五分） 枣仁（三钱） 白芍（一钱五分） 云苓（三钱） 元眼
肉（三钱） 湘莲肉（四钱）
汪（又诊）
崩止三日。神脉皆振。头晕轰热。时仍有之。必得营阴恢复。风阳游行之象。方可全熄耳。
人参（一钱） 制冬术（一钱五分） 陈阿胶（二钱） 牡蛎（五钱） 枣仁（三钱） 黄
（二钱） 西党参（三钱） 熟地炭（四钱） 川贝（三钱） 白芍（一钱五分） 加鲜藕肉（一两）
汪（又诊）
肝风渐定。诸症较平。夜寐渐安。惟面色指爪 白不堪。胃气虽醒。脾少健运。知饥不任油腻。
须得屏除烦劳。静养百日。气血充复可期也。
人参须（一钱五分） 制于术（一钱五分） 甘枸子（三钱） 炒枣仁（三钱） 绵黄 （三钱）
炙甘草（四分） 陈阿胶（二钱） 炙陈皮（七分） 元眼肉（三钱） 大黑枣（二枚） 加建莲（三钱）
汪（又诊）
日来精神大胜于前。唇渐转红。眠食颇佳。阳明血液日长矣。
党参（三钱） 炒枣仁（三钱） 炒米仁（三钱） 九制于术（一钱五分） 黄 （二钱） 炒白芍（一
钱五分） 炙陈皮（五分） 炙黑甘草（三分） 陈阿胶（二钱蛤粉炒） 元眼肉（三钱） 大
黑枣（两枚）
张（医案）
脾肾阳衰。早食暮吐。完谷不化。是无火也。并非火热暴迫之完谷下趋耳。舌质淡而苔白。脉细
带。温中以理气分。
上肉桂 淡吴萸 白茯苓 老苏梗 益智仁 煨肉果 炒白芍 新会皮 戈半夏
张（又诊）
水谷入胃。易生痰湿者。多由脾虚土衰。今且肝木来侮。上则嗳腐吐食。下则便泄腹胀。升
降皆属格碍。专理中宫之阳为的当也。
淡干姜 益智仁 云苓 新会皮 淡吴萸 甘草炭 炒白芍 姜半夏 干玫瑰花
张（又诊）
温煦脾胃。中焦气机已得旋晕。果然阴复迟而阳复速也。
制附子 煨肉果 炒白芍 苡仁 制浓朴 淡吴萸 橘白 建曲 云苓
张（又诊）
反胃已止。当扶脾胃之气。佐以养肝之血。
人参条 云苓 新会皮 净归身 生冬术 炙草炭 姜半夏 炒白芍 炒苡仁 香谷芽
停药剂后以香砂六君丸（三钱） 每朝炒黄米泡汤送下。
谢（医案）
思虑伤脾。郁怒伤肝。血崩之下。气营大虚。彻夜不寐。神不自持。触事惊疑。此乃怔忡疑虑之症。并非癫痫类也。
脉症合参。脾藏气血大伤。脾为营之源。虽云心主生血。然血不自生。须得脾气运液。中焦取汁。变化而成。心虚
而不知补脾。绝其生血之源矣。且大便亦溏。胆怯异常。显属不足之症。切勿执定痰火有余也。
大生地 炒白芍 炒枣仁 云苓 制冬术 广郁金 元眼肉 麦冬 莲肉 川贝
谢（又诊）
脉象细而带弦。微见虚数。血崩本属气虚下陷。血去阴液亦亏。心中悸惕。惊疑无主。寻源求本之
计。宜补立中
气为先。倘专清痰火。必有延成痼疾者也。
党参 制冬术 大麦冬 归身 黄 炙黑草 血余炭 白芍 云苓
枣仁 川贝母 加龙眼肉 大黑枣
谢（又诊）
日来脉象。颇形起色。元气渐振。故恐惧忧疑之象。已可支持。肝郁日畅。寡有恼怒。诚佳
机也。心脾血液未充。尚须怡养为佳。
制洋参 云茯神 五味子 川贝 制冬术 左牡蛎 元眼肉 苡仁 枣仁 生甘草
加金橘饼 野蔷薇露 临卧服白金丸（三分）
谢（又诊）
不寐阳升。脾气下陷。风阳游行无定。肾志少液。当引阳潜藏之法。
党参 大熟地 左牡蛎 白芍 黄 制附子 池菊瓣 枣仁 橘白 炙草 川石斛 元眼肉
加鸡子黄
谢（又诊）
大便得实。肾液藏而脾气运矣。神情渐复。惟或感心事。肝阳犹易扰及包络。亦由心营血气未能充足耳。
党参 元参心 远志炭 炒枣仁 黄 川贝母 大熟地 柏子仁 山药 炙甘草 龙眼肉
谢（又诊）
行动步履有力。眠食亦均匀适中。中气虽复。血虚犹少营养。血不养肝。肝经郁火。欲达未达。
现值暑令。当于补剂之中。参入清畅之品。秋凉肃降时。可冀无恙。仿许学士法加减。
大生地 党参 赤芍 川贝 乌犀尖 云苓 玳瑁 山药 麦冬 橘白 加囫囵鸡子黄 白荷花露
张（医案）
新产两朝。瘀不下行。发热神蒙。肢麻汗多。脉芤舌红。酷暑外迫。阴气郁冒。血随气逆。时有昏晕。
变险可危。急扶产母端坐椅中。敞轩 以湘帘护风。切勿听信妪辈。胶执吃热苦草汤也。急嘱。急嘱。
细生地 广郁金 怀牛膝 归身 川贝母 白蒺藜 西琥珀 赤芍 丹皮 白薇 鲜藕肉 童便
张（又诊）
热退神清。气火平降。瘀亦下行。两臂尚麻。少腹 楚。仍从养血通瘀。即是治风先治血之意也。
细生地 净归身 茺蔚子 赤芍 炒山药 白蒺藜 怀牛膝 丹皮 白薇 楂炭 琥珀
汤（医案）
郁火越冒。冲心为厥。厥后心悸不寐。惊恐疑惧。劫肺而为痰血。不时形凛轰热。经行如崩。月
行二次。盛暑而浓衣。稀粥不敢下咽。以脉症参之。非真寒。实由疑虑过深所致也。金先生指为劳损
不起之症。窃恐未确。当放胆啖饭。不必避风。以怡畅襟怀。佐以药力。可许向痊者。
乌犀尖 小川连 云苓 麦冬 大生地 广郁金 白芍 橘白 枣仁 川贝 加建莲子
汤（又诊）
病患深信所嘱。肝胆舒畅。寒热未作。人咸异之。即俗名疑心病也。信能坚决。何疑之有。所谓
智能剑斩烦恼魔。须药饵外求之者。仍须清畅郁火。补养心脾。方无反复。
细生地 乌犀尖 小川连 麦冬 生于术 羚羊角 川贝母 枣仁 米仁 红枣
汤（又诊）
谷食如常。神情安适。心悸咳血皆止。鼻流腥水如注。此乃郁火从心包而畅于肺经也。养阴佐以
清和肺肝。
制首乌 元参心 川贝母 白芍 羚羊角 蔓荆子 淮山药 生甘草 薄荷叶
汤（又诊）
鼻渊虽止。其郁火未净。心脾气血未复。诸恙和平。癸水尚易骖前。仍从前法减轻为治。
细生地 羚羊角 川楝子 左牡蛎 生冬术 川贝母 元参心 大麦冬 云苓 小红枣
张（医案）
冬温乍发。月事适行。阴气先虚。邪从内传。一候之前。失于开泄肺经。今病交十三日。曾服小
柴胡汤微微得汗。惟邪转充斥肺胃。兼入营分矣。昼夜烦躁。神魂飞越。脉涩弦数。舌绛苔浓。痰
滞并阻。大便溏泄。深恐痉厥。必多风波变险。
淡豆豉 牛蒡子 丹皮 川贝母 细生地 淡黄芩 楂炭 广郁金 苦桔梗 秦艽 赤苓
张（辰刻又诊）
病交两候。癸水淋漓未净。色带紫黑。营热炽甚。通宵不寐。寅卯时肝风内动。指痉发厥。目
窜痰涌。遍体汗泄而定。顷诊右脉洪数。舌苔根浓。色转灰黄。大便连泄。自觉火热下注。温邪欲陷。
昏闭可虑。但营分渗泄于下。肺邪壅遏于上。断不能执煞热入血室之古法也。
细生地 淡黄芩 丹皮 薄荷 小川连 广郁金 赤芍 生甘草 天花粉 生麦芽 白茆根
张（酉刻又诊）
温邪自口鼻吸入。肺先受之。逆传心包。入暮病剧。脉较晨间数甚。再与清解。勿致昏闭为妙。
鲜生地 玉卷心 丹皮 川贝 淡黄芩 元参心 麦冬 桔梗 天花粉 生甘草
张（又诊）
昨宵烦躁阵作。风痉略缓。子后稍稍得寐。寐醒痰火上升。欲厥未厥。便泄溲短。阴伤热恋。
热化庶无变幻。
乌犀角 天竺黄 元参 赤芍 细生地 竹卷心 麦冬 花粉 知母 淡芩
张（又诊）
温邪自肺传入手厥阴经。烦躁谵语。痰潮昏涌。叠进清滋化热。内保心阴。虽然不致内闭。其
邪欲达未达。包络
清虚之所。邪火烁津凝痰蒙闭。非芳香宣窍莫解。
陈金汁（二两） 化服至宝丹（四分）
张（又诊）
昨诊脉后。狂躁厥逆。即以至宝丹服下。神志渐定。吐咳浓痰颇畅。黎明时得寐。寐醒尚觉气逆。
便泄已止。口苦咽关疳点密布。冬温化毒。乃外泄之机。
乌犀尖 鲜霍斛 苦桔梗 甘中黄 鲜生地 元参心 天竺黄 土贝 黄芩 赤芍 加陈金
汁野蔷薇露
张（酉刻又诊）
胸膈肌肤热势大减。额上解而不了了。脉息左含静意。右寸关尚见滑数。舌绛苔少。疳点起腐痛甚。
心中烦扰。月水将净。清化上焦痰热为主。
羚羊角 淡芩 海浮石 土贝 鲜霍斛 元参 白杏仁 甘中黄 天花粉 广郁金 枇杷叶 鲜芦根
张（又诊）
冬温失治于前。病涉三候。温邪化燥。几至内陷。幸得邪从疳化。热退转机。经水乍止。营阴亏乏。
肺胃余热尚炽。须防液涸。
乌犀尖 鲜霍斛 元参 知母 鲜生地 淡黄芩 麦冬 土贝 飞青黛 甘中黄 陈金汁 银花露
张（又诊）
舌苔焦黄已化。脉数颇缓。汗多如注。疳势蔓延亦定。白腐渐退。音闪渴饮。痰多黄浓。口中腻涎若涌。
外邪将净。脾虚血热。湿火内生以玉女煎合甘露饮加减。
大生地 生洋参 知母 川贝 生石羔 生冬术 川连 甘中黄 鲜霍斛 鲜竹茹 白粳米 鲜芦根
张（又诊）
汗尚多。热退极净。大便三日未行。邪滞已得归并胃腑。可免传变之虑。口腻渴饮均减。小便渐利。阳
明余烬未熄。仍恐复燃。
生洋参 细生地 甘中黄 鲜竹茹 鲜霍斛 生石羔 川贝母 生枳壳 肥知母 全栝蒌 鲜芦根
枇杷叶露
张（又诊）
疳痛大缓。谷食可进。寐醒之后。溲急欲遗。数而且多。是余热宿垢蕴结阳明。迫其膀胱津液下行也。
汗泄又多胃津更伤。大肠愈燥。燥火更易伤阴。纳谷未多。能勿虑其液涸乎。伤寒论有可下不可下。并急下
存阴等法。两者俱是回生要关。但须用之的当。今见口竭引饮。舌苔老黄干裂。根尤浓浊。脉象数实。按腹
微痛。如斯确据。诚乃急下存阴时候矣。每见邪未归府。误下致逆。不可胜数。
生西参 元明粉 全栝蒌 生白芍 鲜霍斛 火麻仁 莱菔子 生甘草 大麦冬 白粳米
张（又诊）
矢气频转。而便未行。舌苔化动。纳谷较多。仍守昨法。
西洋参 鲜首乌 火麻仁 生甘草 鲜霍斛 元明粉 生白芍 白粳米 大麦冬 甜梨汁
张（又诊）
昨晚大便后。夜卧极安。胃思纳谷。神脉安静。小便合度。肠胃宿垢已彻。余邪下注肛侧。结
有小瘰。且痉厥时擦伤皮肤。滋水频滋。两相蔓延。颇形痛楚。虽属微末。犹恐妨碍眠食。亦属节
外生枝之累也。
西洋参 鲜首乌 生白芍 川柏 鲜霍斛 火麻仁 生甘草 肥知母 橘白 加大黑豆（五钱）
绿豆（五钱）
张（又诊）
大便续通。自觉脘腹舒畅。安寐安谷。腑邪化净。疡痛亦缓。偶触恼怒。心悸耳鸣。胃阴初长。不
胜木火之煽烁也。温邪病后。调养失慎。三复可虑。重言以申明之。
西洋参 鲜霍斛 生白芍 生甘草 细生地 淡天冬 天花粉 甜梨汁 濂珠粉 燕窝屑
张（又诊）
神怡。气阴渐复。饮食寒暖。慎调是嘱。
【序言】
什么是医案呢？不过是诊断病情和开具处方罢了。医学著作汗牛充栋，大多以治疗男女各种杂病为主，而专门治疗妇科疾病的却很少。我们吴地的顾云女士，是著名的妇科医生。在道光、咸丰年间，吴地（苏州一带）的士大夫们都争相邀请她诊治并钦佩仰慕她。她曾著有《花韵楼医案》一卷，可惜未能刊印流传于世。懂医术的人偶尔提及此事，总有一种想求而不得的遗憾。我向来收藏有顾女士医案的抄本，其中论治透彻，处方平和妥善，确实是经验之作，与当今的女医生相比，实在少有能与之匹敌的。我多次想要刻印出版，以供天下各位君子研究，然而深感自己力量微薄，未能像志公等诸位同好那样实现愿望，心中常常感到怏怏不乐。于是写信咨询医药学报社的裘吉生先生，谋求将其付梓印刷以广泛流传。幸好承蒙应允，从此以后，此书将风行寰宇，那么顾女士济世救人的慈悲之心，便不至于被埋没，裘先生弘扬功德的壮举，也将一同流传不朽。
民国十年辛酉年冬季，吴县张元瑞玉田氏作序于吴趋青选书屋。
汪姓患者（初诊医案）
小产之后，阴道出血不止月余，声音低微，气息虚弱，睡眠少且咽干，面目浮肿，干咳阵发性发作。这主要是由于失血过多，呈现出一派虚象。古人将这种严重的崩漏称为“崩中”，其中的“中”指的是脾胃。之前的方子纯粹使用滋阴、收敛固涩的药物，长期服用无效，为什么还不明白其中的道理呢？大概是因为肝主藏血，脾主统摄血液。脾失去统摄血液的功能，血液从内部渗漏不止。由于使用了滋腻和收敛的药物，导致气血凝滞于经络之中，所以有时淋漓似净，忽而又排出如手掌大的瘀块，接连不断。自觉心神无依，四肢发冷，出冷汗。《内经》说：阴阳互根，如环无端。阴血从下渗漏，阳气从上冒越。其中的枢纽，能不让人担心其断绝吗？急需采用归脾法作为中流砥柱之计。
方药：大党参三钱，九制白术一钱，新会陈皮七分，丹皮炭一钱五分，大黄芪二钱，大熟地黄炭五钱，地榆炭三钱，桂圆肉三钱，当归身一钱，白芍一钱五分，酸枣仁三钱。用藕肉二两、湘莲肉五钱煎汤代水。
汪姓患者（复诊）
前面采用血脱益气法，兼清营分热邪，虚火导致的崩漏阵发性停止，胸脘部感觉舒和，稍微想吃东西了。可知从前固执于黄柏、黄连等苦寒闭气药物的错误。但是肝肾空虚，奇经八脉交相亏虚，最担心出现腹部膨隆、带下漏下、干咳、寒热往来这四种症状，这四者在崩漏后极易出现，不可不为预防。
方药：人参须一钱五分，大黄芪一钱五分，陈阿胶二钱，地榆皮三钱，西党参三钱，制白术一钱五分，炒丹皮一钱五分，酸枣仁三钱，白芍一钱五分，云茯苓三钱，桂圆肉三钱，湘莲肉四钱。
汪姓患者（复诊）
崩漏停止三天，神气和脉象都振作起来，但头晕轰热感仍时有出现。必须等到营阴恢复，风阳游走的征象才能完全熄灭。
方药：人参一钱，制冬术一钱五分，陈阿胶二钱，牡蛎五钱，酸枣仁三钱，黄芪二钱，西党参三钱，熟地黄炭四钱，川贝母三钱，白芍一钱五分。加鲜藕肉一两。
汪姓患者（复诊）
肝风逐渐平息，各种症状比较平稳，夜间睡眠逐渐安稳，只是面色和指甲苍白得厉害。胃气虽然苏醒，但脾脏运化功能稍弱，知道饥饿但不能承受油腻食物。必须排除烦劳，静养百日，气血充盈恢复是可以期待的。
方药：人参须一钱五分，制白术一钱五分，甘枸杞三钱，炒酸枣仁三钱，绵黄芪三钱，炙甘草四分，陈阿胶二钱，炙陈皮七分，桂圆肉三钱，大黑枣两枚。加建莲肉三钱。
汪姓患者（复诊）
连日来精神比之前大大好转，嘴唇逐渐转红，睡眠饮食颇佳，阳明经的血液日渐增长了。
方药：党参三钱，炒酸枣仁三钱，炒薏苡仁三钱，九制白术一钱五分，黄芪二钱，炒白芍一钱五分，炙陈皮五分，炙黑甘草三分，陈阿胶二钱（蛤粉炒），桂圆肉三钱，大黑枣两枚。
张姓患者（初诊医案）
脾肾阳气衰微，早上吃晚上吐，完谷不化，这是没有火（命门火衰）的表现，并不是火热暴迫导致的完谷下趋。舌质淡苔白，脉细缓。温补中焦以调理气机。
方药：上肉桂，淡吴茱萸，白茯苓，老苏梗，益智仁，煨肉豆蔻，炒白芍，新会陈皮，戈半夏。
张姓患者（复诊）
水谷进入胃部，容易生痰湿，多由脾虚土衰引起。现在又有肝木来克制脾土，上则嗳腐吐食，下则便泄腹胀，升降都有阻碍。专门调理中宫（脾胃）的阳气才是恰当的。
方药：淡干姜，益智仁，云茯苓，新会陈皮，淡吴茱萸，甘草炭，炒白芍，姜半夏，干玫瑰花。
张姓患者（复诊）
温煦脾胃，中焦气机已经得到旋转运行。果然阴液恢复迟缓而阳气恢复迅速。
方药：制附子，煨肉豆蔻，炒白芍，薏苡仁，制厚朴，淡吴茱萸，橘白，建曲，云茯苓。
张姓患者（复诊）
反胃已经停止，应当扶持脾胃之气，佐以滋养肝脏之血。
方药：人参条，云茯苓，新会陈皮，净当归身，生白术，炙甘草炭，姜半夏，炒白芍，炒薏苡仁，香谷芽。
停药后服用香砂六君丸三钱，每天早晨用炒黄米泡汤送服。
谢姓患者（初诊医案）
思虑损伤脾脏，郁怒损伤肝脏。在血崩之后，气营大虚，彻夜不眠，神志不能自主，遇事惊疑。这是怔忡疑虑的症状，并不是癫痫之类的疾病。
脉症合参，脾脏藏的血气大伤。脾是营血的源头，虽然说心主生血，但血不能自己生成，必须依靠脾气运化津液，在中焦取汁，变化而成。如果心虚却不知道补脾，就断绝了生血的源头。而且大便也溏薄，胆怯异常，明显属于不足的病症。千万不要固执地认为是痰火有余。
方药：大生地，炒白芍，炒酸枣仁，云茯苓，制冬术，广郁金，桂圆肉，麦冬，莲肉，川贝母。
谢姓患者（复诊）
脉象细而带弦，微见虚数。血崩本来属于气虚下陷，血去则阴液也亏损，心中悸动惕惧，惊疑无主。寻源求本的办法，应该以建立中气为先。如果专门清除痰火，必定会拖延成为痼疾。
方药：党参，制冬术，大麦冬，当归身，黄芪，炙黑甘草，血余炭，白芍，云茯苓，酸枣仁，川贝母。加龙眼肉，大黑枣。
谢姓患者（复诊）
连日来脉象颇有起色，元气逐渐振作，所以恐惧忧疑的现象，已经可以支持。肝郁日渐舒畅，很少有恼怒，真是好的转机。心脾血液尚未充盈，还需要怡情调养为佳。
方药：制西洋参，云茯神，五味子，川贝母，制冬术，左牡蛎，桂圆肉，薏苡仁，酸枣仁，生甘草。加金橘饼，野蔷薇露，临睡前服用白金丸三分。
谢姓患者（复诊）
不寐是由于阳气上升，脾气下陷，风阳游走不定，肾志缺乏津液。应当采用引阳潜藏的方法。
方药：党参，大熟地黄，左牡蛎，白芍，黄芪，制附子，池菊瓣，酸枣仁，橘白，炙甘草，川石斛，桂圆肉。加鸡子黄。
谢姓患者（复诊）
大便变得结实，肾液封藏而脾气运化了。神情逐渐恢复，只是偶尔遇到心事，肝阳仍然容易扰动包络，这也是因为心营血气未能充足的原因。
方药：党参，元参心，远志炭，炒酸枣仁，黄芪，川贝母，大熟地黄，柏子仁，山药，炙甘草，龙眼肉。
谢姓患者（复诊）
行动步履有力，睡眠饮食也均匀适中。中气虽然恢复，但血虚仍然缺少营养。血不养肝，肝经有郁火，想要发散却未完全发散。现值暑令，应当在补剂之中，参入清畅的药物。等到秋凉肃降的时候，可以期望无恙。仿照许学士的方法加减。
方药：大生地，党参，赤芍，川贝母，乌犀尖，云茯苓，玳瑁，山药，麦冬，橘白。加囫囵鸡子黄，白荷花露。
张姓患者（初诊医案）
新产两天，恶露不下行，发热神志昏蒙，肢体麻木，出汗多，脉芤舌红。酷暑外迫，阴气郁冒，血随气逆，时有昏晕。病情危险可危。急忙扶产妇端坐在椅子上，敞开窗户用湘帘遮挡风，切勿听信老妇人们胶执地吃热苦草汤。急忙嘱咐，急忙嘱咐。
方药：细生地，广郁金，怀牛膝，当归身，川贝母，白蒺藜，西琥珀，赤芍，丹皮，白薇，鲜藕肉，童便。
张姓患者（复诊）
热退神清，气火平降，瘀血也下行，但两臂仍然麻木，少腹疼痛。仍然从养血通瘀入手，这就是治风先治血的意思。
方药：细生地，净当归身，茺蔚子，赤芍，炒山药，白蒺藜，怀牛膝，丹皮，白薇，楂炭，琥珀。
汤姓患者（初诊医案）
郁火越冒，冲心导致厥逆。厥逆后心悸不寐，惊恐疑惧，劫肺而为痰血，不时身体凛冽轰热，月经来潮如崩，一个月行经两次，盛暑却穿厚衣，稀粥不敢下咽。以脉症参合来看，不是真寒，实际上是由疑虑过深所致。金先生指为劳损不起的病症，我恐怕不准确。应当放胆吃饭，不必避风，以怡畅襟怀，佐以药力，可以允许向痊愈发展。
方药：乌犀尖，小川连，云茯苓，麦冬，大生地，广郁金，白芍，橘白，酸枣仁，川贝母。加建莲子。
汤姓患者（复诊）
病患深信所嘱，肝胆舒畅，寒热未发作，大家都觉得奇怪，这就是俗名疑心病。信念能坚决，还有什么可怀疑的呢。所谓智能剑斩烦恼魔，必须在外求药饵帮助。仍然需要清畅郁火，补养心脾，方才没有反复。
方药：细生地，乌犀尖，小川连，麦冬，生于术，羚羊角，川贝母，酸枣仁，米仁，红枣。
汤姓患者（复诊）
谷食如常，神情安适，心悸咳血都停止了，鼻流腥水如注。这是郁火从心包而畅达于肺经的表现。养阴佐以清和肺肝。
方药：制首乌，元参心，川贝母，白芍，羚羊角，蔓荆子，淮山药，生甘草，薄荷叶。
汤姓患者（复诊）
鼻渊虽然停止，但其郁火未净，心脾气血未恢复，各种症状和平，月经尚易提前。仍然从前法减轻剂量治疗。
方药：细生地，羚羊角，川楝子，左牡蛎，生白术，川贝母，元参心，大麦冬，云茯苓，小红枣。
张姓患者（初诊医案）
冬温突然发作，月经正好来潮，阴气先虚，邪气从内传变。一个候期之前，失于开泄肺经，现在病交十三日，曾服用小柴胡汤微微得汗，但邪气反而充斥肺胃，兼入营分了。昼夜烦躁，神魂飞越，脉涩弦数，舌绛苔浓，痰滞并阻，大便溏泄，深恐发生痉厥，必多风波变险。
方药：淡豆豉，牛蒡子，丹皮，川贝母，细生地，淡黄芩，楂炭，广郁金，苦桔梗，秦艽，赤苓。
张姓患者（辰刻复诊）
病交两个候期，月经淋漓未净，颜色带紫黑，营热炽盛，通宵不寐，寅卯时肝风内动，手指痉挛发厥，目窜痰涌，遍体汗泄后平静。刚才诊察右脉洪数，舌苔根部浓，颜色转灰黄，大便连续泄泻，自觉火热下注，温邪欲陷入，昏闭令人担忧。但是营分渗泄于下，肺邪壅遏于上，绝对不能执着于古法治疗热入血室。
方药：细生地，淡黄芩，丹皮，薄荷，小川连，广郁金，赤芍，生甘草，天花粉，生麦芽，白茅根。
张姓患者（酉刻复诊）
温邪从口鼻吸入，肺先受之，逆传心包，入暮病情加剧，脉象比早晨更快。再给予清解，不要导致昏闭才好。
方药：鲜生地，玉卷心，丹皮，川贝，淡黄芩，元参心，麦冬，桔梗，天花粉，生甘草。
张姓患者（复诊）
昨夜烦躁阵作，风痉略缓，子后稍稍入睡，睡醒后痰火上升，欲厥未厥，便泄尿短，阴伤热恋。热化则庶几没有变幻。
方药：乌犀角，天竺黄，元参，赤芍，细生地，竹卷心，麦冬，花粉，知母，淡芩。
张姓患者（复诊）
温邪从肺传入手厥阴经，烦躁谵语，痰潮昏涌。叠进清滋化热，内保心阴。虽然不至于内闭，但邪气欲达未达，包络是清虚之所，邪火灼烧津液凝结成痰蒙闭，非芳香宣窍不能解开。
方药：陈金汁二两，化服至宝丹四分。
张姓患者（复诊）
昨天诊脉后，狂躁厥逆，立即以至宝丹服下，神志逐渐安定，吐咳浓痰颇通畅，黎明时入睡，睡醒后尚觉气逆，便泄已止，口苦咽关疳点密布。冬温化毒，乃是外泄的时机。
方药：乌犀尖，鲜霍斛，苦桔梗，甘中黄，鲜生地，元参心，天竺黄，土贝母，黄芩，赤芍。加陈金汁，野蔷薇露。
张姓患者（酉刻复诊）
胸膈肌肤热势大减，额头解除了不适但仍感不清爽。脉息左边含静意，右寸关尚见滑数。舌绛苔少，疳点起腐痛甚，心中烦扰，月经将净。以清化上焦痰热为主。
方药：羚羊角，淡芩，海浮石，土贝母，鲜霍斛，元参，白杏仁，甘中黄，天花粉，广郁金，枇杷叶，鲜芦根。
张姓患者（复诊）
冬温在前失治，病涉三个候期，温邪化燥，几乎至内陷。幸得邪从疳化，热退转机，经水乍止，营阴亏乏，肺胃余热尚炽。须防液涸。
方药：乌犀尖，鲜霍斛，元参，知母，鲜生地，淡黄芩，麦冬，土贝母，飞青黛，甘中黄，陈金汁，银花露。
张姓患者（复诊）
舌苔焦黄已化，脉数颇缓，汗多如注，疳势蔓延亦定，白腐渐退，音闪渴饮，痰多黄浓，口中腻涎若涌。外邪将净，脾虚血热，湿火内生。以玉女煎合甘露饮加减。
方药：大生地，生洋参，知母，川贝，生石膏，生白术，川连，甘中黄，鲜霍斛，鲜竹茹，白粳米，鲜芦根。
张姓患者（复诊）
汗尚多，热退极净，大便三日未行，邪滞已得归并胃腑，可免传变之虑。口腻渴饮均减，小便渐利，阳明余烬未熄，仍恐复燃。
方药：生洋参，细生地，甘中黄，鲜竹茹，鲜霍斛，生石膏，川贝母，生枳壳，肥知母，全瓜蒌，鲜芦根，枇杷叶露。
张姓患者（复诊）
疳痛大缓，谷食可进，睡醒之后，尿急欲遗，次数多而且量多，是余热宿垢蕴结阳明，迫使其膀胱津液下行。汗泄又多胃津更伤，大肠愈燥，燥火更易伤阴，纳谷未多，能不忧虑其液涸吗？《伤寒论》有可下不可下，并急下存阴等法，两者都是回生要关，但须用得恰当。现在见到口渴引饮，舌苔老黄干裂，根部尤其浓浊，脉象数实，按腹微痛，如此确据，诚然是急下存阴的时候了。常见邪未归府，误下致逆，不可胜数。
方药：生西洋参，元明粉，全瓜蒌，生白芍，鲜霍斛，火麻仁，莱菔子，生甘草，大麦冬，白粳米。
张姓患者（复诊）
矢气频转，而便未行，舌苔化动，纳谷较多，仍守昨日之法。
方药：西洋参，鲜首乌，火麻仁，生甘草，鲜霍斛，元明粉，生白芍，白粳米，大麦冬，甜梨汁。
张姓患者（复诊）
昨晚大便后，夜卧极安，胃思纳谷，神脉安静，小便合度，肠胃宿垢已彻底清除。余邪下注肛侧，结有小瘰，且痉厥时擦伤皮肤，滋水频滋，两相蔓延，颇形痛楚。虽属微末，犹恐妨碍眠食，也是节外生枝的累赘。
方药：西洋参，鲜首乌，生白芍，川柏，鲜霍斛，火麻仁，生甘草，肥知母，橘白。加大黑豆五钱，绿豆五钱。
张姓患者（复诊）
大便续通，自觉脘腹舒畅，安寐安谷，腑邪化净，疡痛亦缓。偶触恼怒，心悸耳鸣，胃阴初长，不胜木火之煽烁。温邪病后，调养失慎，三复可虑。重言以申明之。
方药：西洋参，鲜霍斛，生白芍，生甘草，细生地，淡天冬，天花粉，甜梨汁，濂珠粉，燕窝屑。
张姓患者（复诊）
神怡，气阴渐复，饮食寒暖，慎调是嘱。
[Preface]
What is a medical case record? It is merely the diagnosis of illness and the prescription of medicine. Medical literature is voluminous, mostly dealing with miscellaneous diseases of men and women, while those specializing in gynecology are rare. Ms. Gu Yun from our Wu region was a renowned gynecologist. During the Daoguang and Xianfeng reigns, scholars and officials in Wu (Suzhou area) competed to invite her for consultations and held her in high esteem. She authored one volume of "Huayunlou Medical Cases," unfortunately unpublished. Those knowledgeable in medicine occasionally mention it, regretting their inability to obtain it. I have long possessed a manuscript copy of Ms. Gu's cases. Her discussions on treatment are thorough, and her prescriptions are balanced and sound, truly works of experience. Compared to female doctors today, few can match her. I have often wished to print and publish them for the study of gentlemen everywhere, but deeply feel my limited strength has prevented me from fulfilling this wish like Mr. Zhigong and other enthusiasts, leaving me often disheartened. Therefore, I corresponded with Mr. Qi Jisheng of the *Zhongyi Yaoxue Bao* Society, seeking to have it printed to spread its influence. Fortunately, he agreed. From now on, this book will circulate widely throughout the world. Thus, Ms. Gu's compassionate heart for saving lives and benefiting people will not be forgotten, and Mr. Qi's great merit in promoting it will also be immortalized.
Preface by Zhang Yuanrui, courtesy name Yutian, of Wu County, at Qingxuan Study House, Wuchu, in the late winter of the 10th year of the Republic of China (Xinyou).
Case of Patient Wang (Initial Consultation)
After a miscarriage, vaginal bleeding persisted for over a month. The voice was low, breath weak, sleep scanty with dry throat, face and eyes swollen, and paroxysmal dry coughing occurred. This is primarily due to excessive blood loss, presenting a picture of deficiency. The ancients called severe metrorrhagia "Bengzhong" (Central Collapse), where "Zhong" refers to the Spleen and Stomach. Previous prescriptions used purely nourishing and astringent herbs, which were ineffective after long-term use. Why is the principle still not understood? The Liver stores blood, and the Spleen controls blood. When the Spleen loses its function of controlling blood, blood leaks internally continuously. Due to the use of cloying and astringent herbs, stagnation occurs in the collaterals. Hence, sometimes bleeding seems clear, then suddenly large clots like a palm appear successively. The patient feels the mind and spirit have no foundation, limbs are cold, and sweat pours out. The *Classic* states: Yin and Yang are mutually rooted, forming a cycle without end. If Yin seeps downward, Yang floats upward. Can we not worry about the interruption of this pivot? Urgently employ the Guipi Method (Restore the Spleen Decoction approach) as a pillar of support.
Prescription: Codonopsis Root (Dangshen) 3 qian, Processed Atractylodes Rhizome (Baizhu) 1 qian, Tangerine Peel (Chenpi) 0.7 qian, Moutan Cortex Charcoal (Danpitan) 1.5 qian, Astragalus Root (Huangqi) 2 qian, Rehmannia Root Charcoal (Shudihuantan) 5 qian, Sanguisorba Root Charcoal (Yutan) 3 qian, Longan Aril (Guiyuanrou) 3 qian, Angelica Sinensis Root (Guishen) 1 qian, White Peony Root (Baishao) 1.5 qian, Ziziphus Seed (Suanzaoren) 3 qian. Decoct with Lotus Root Flesh (Ourou) 2 liang and Hunan Lotus Seed Meat (Xianglianrou) 5 qian as water substitute.
Case of Patient Wang (Follow-up)
The previous method of replenishing Qi for blood loss, combined with clearing the Ying (Nutritive) level, stopped the paroxysmal metrorrhagia caused by deficient fire. The chest and epigastrium feel comfortable, and there is slight appetite. This shows the error of previously adhering strictly to bitter-cold herbs that close Qi. However, the Liver and Kidney are empty, and the Eight Extraordinary Vessels are jointly deficient. One must fear abdominal distension, leukorrhea leakage, dry cough, and alternating chills and fever. These four symptoms easily appear after metrorrhagia and should be prevented.
Prescription: Ginseng Radicula (Renshenxu) 1.5 qian, Astragalus Root (Huangqi) 1.5 qian, Donkey-hide Gelatin (Ejiao) 2 qian, Sanguisorba Bark (Yutupi) 3 qian, Codonopsis Root (Dangshen) 3 qian, Processed Atractylodes Rhizome (Baizhu) 1.5 qian, Fried Moutan Cortex (Danpi) 1.5 qian, Ziziphus Seed (Suanzaoren) 3 qian, White Peony Root (Baishao) 1.5 qian, Poria (Fuling) 3 qian, Longan Aril (Guiyuanrou) 3 qian, Hunan Lotus Seed Meat (Xianglianrou) 4 qian.
Case of Patient Wang (Follow-up)
Metrorrhagia stopped for three days; spirit and pulse have revived. Dizziness and heat flashes still occur occasionally. Only when Ying-Yin recovers can the wandering pattern of Wind-Yang completely subside.
Prescription: Ginseng Radix (Renshen) 1 qian, Processed Winter Atractylodes (Dongzhu) 1.5 qian, Donkey-hide Gelatin (Ejiao) 2 qian, Oyster Shell (Muli) 5 qian, Ziziphus Seed (Suanzaoren) 3 qian, Astragalus Root (Huangqi) 2 qian, Codonopsis Root (Dangshen) 3 qian, Rehmannia Root Charcoal (Shudihuantan) 4 qian, Fritillaria Bulb (Beimu) 3 qian, White Peony Root (Baishao) 1.5 qian. Add Fresh Lotus Root Flesh 1 liang.
Case of Patient Wang (Follow-up)
Liver-Wind gradually settles, symptoms stabilize, night sleep improves. However, complexion and fingernails are extremely pale. Stomach Qi has awakened, but Spleen transportation is weak; hunger is felt but greasy food cannot be tolerated. Distraction from mental labor and quiet rest for 100 days are needed; recovery of Qi and Blood can be expected.
Prescription: Ginseng Radicula (Renshenxu) 1.5 qian, Processed Atractylodes Rhizome (Baizhu) 1.5 qian, Goji Berry (Gouqizi) 3 qian, Fried Ziziphus Seed (Zaosuanzaoren) 3 qian, Milkvetch Root (Huangqi) 3 qian, Honey-fried Licorice Root (Gancao) 0.4 qian, Donkey-hide Gelatin (Ejiao) 2 qian, Honey-fried Tangerine Peel (Chenpi) 0.7 qian, Longan Aril (Guiyuanrou) 3 qian, Large Black Dates (Heizao) 2 pieces. Add Jian Lotus Seeds 3 qian.
Case of Patient Wang (Follow-up)
Spirit has greatly improved compared to before, lips turning red, sleep and diet are good. Yangming Blood is daily increasing.
Prescription: Codonopsis Root (Dangshen) 3 qian, Fried Ziziphus Seed (Zaosuanzaoren) 3 qian, Fried Coix Seed (Yiyiren) 3 qian, Processed Atractylodes Rhizome (Baizhu) 1.5 qian, Astragalus Root (Huangqi) 2 qian, Fried White Peony Root (Baishao) 1.5 qian, Honey-fried Tangerine Peel (Chenpi) 0.5 qian, Honey-fried Black Licorice Root (Gancao) 0.3 qian, Donkey-hide Gelatin (Ejiao) 2 qian (fried with clam powder), Longan Aril (Guiyuanrou) 3 qian, Large Black Dates (Heizao) 2 pieces.
Case of Patient Zhang (Initial Consultation)
Spleen and Kidney Yang decline; morning intake leads to evening vomiting, undigested food passes through. This indicates lack of Fire (Mingmen Fire Deficiency), not rapid expulsion due to Heat-Fire. Tongue is pale with white coating, pulse is fine and slow. Warm the Middle and regulate Qi mechanism.
Prescription: Cinnamon Bark (Rougui), Evodia Fruit (Wuyu), Poria (Fuling), Perilla Stem (Sugeng), Alpinia Oxyphylla Fruit (Yizhiren), Gingered Myristica Seed (Ruguo), Fried White Peony Root (Baishao), Tangerine Peel (Chenpi), Pinellia Tuber (Banxia).
Case of Patient Zhang (Follow-up)
Food and water entering the stomach easily generate Phlegm-Dampness, mostly due to Spleen deficiency and Earth decline. Now Liver Wood insults Spleen Earth; above, belching and vomiting of fermented food; below, diarrhea, abdominal distension. Ascending and descending are obstructed. Specifically regulating the Yang of the Central Palace (Spleen/Stomach) is appropriate.
Prescription: Dried Ginger (Ganjiang), Alpinia Oxyphylla Fruit (Yizhiren), Poria (Fuling), Tangerine Peel (Chenpi), Evodia Fruit (Wuyu), Licorice Root Charcoal (Gancaotan), Fried White Peony Root (Baishao), Ginger-processed Pinellia (Banxia), Dried Rose Flower (Meiguihua).
Case of Patient Zhang (Follow-up)
Warming and moistening the Spleen and Stomach, the Qi mechanism of the Middle Jiao has rotated. Indeed, Yin recovery is slow, while Yang recovery is fast.
Prescription: Processed Aconite Root (Fuzi), Gingered Myristica Seed (Ruguo), Fried White Peony Root (Baishao), Coix Seed (Yiyiren), Processed Magnolia Bark (Houpo), Evodia Fruit (Wuyu), Tangerine Pith (Jubai), Medicated Leaven (Qu), Poria (Fuling).
Case of Patient Zhang (Follow-up)
Regurgitation has stopped. Support Spleen and Stomach Qi, assisted by nourishing Liver Blood.
Prescription: Ginseng Strip (Renshentiao), Poria (Fuling), Tangerine Peel (Chenpi), Clean Angelica Sinensis Root (Guishen), Raw Atractylodes Rhizome (Baizhu), Honey-fried Licorice Root Charcoal (Gancaotan), Ginger-processed Pinellia (Banxia), Fried White Peony Root (Baishao), Fried Coix Seed (Yiyiren), Rice Sprout (Guya).
After stopping the decoction, take Xiangsha Liujun Wan (Three Qian), taken every morning with soup made from fried yellow rice.
Case of Patient Xie (Initial Consultation)
Overthinking injures the Spleen; depression and anger injure the Liver. After metrorrhagia, Qi and Ying are severely deficient. Sleeplessness all night, spirit unable to control itself, startling and doubting everything. This is palpitations and anxiety, not epilepsy.
Combining pulse and symptoms, Spleen-stored Qi and Blood are severely injured. The Spleen is the source of Ying. Although the Heart governs blood generation, blood does not generate itself; it requires Spleen Qi to transport fluids, extract essence from the Middle Jiao, and transform into blood. If Heart deficiency is treated without tonifying the Spleen, the source of blood generation is cut off. Also, stool is loose, gallbladder courage is abnormally low, clearly indicating deficiency. Do not stubbornly adhere to the idea of excess Phlegm-Fire.
Prescription: Large Rehmannia Root (Dishengdi), Fried White Peony Root (Baishao), Fried Ziziphus Seed (Zaosuanzaoren), Poria (Fuling), Processed Winter Atractylodes (Dongzhu), Curcuma Root (Yujin), Longan Aril (Guiyuanrou), Ophiopogon Tuber ( Maidong), Lotus Seed Meat (Lianrou), Fritillaria Bulb (Beimu).
Case of Patient Xie (Follow-up)
Pulse is fine and wiry, slightly rapid. Metrorrhagia belongs to Qi deficiency sinking; blood loss leads to Yin fluid deficit. Palpitations and fear, doubt without mastery. Seeking the root, establishing Middle Qi should be prioritized. If only clearing Phlegm-Fire is done, it will surely become a chronic disease.
Prescription: Codonopsis Root (Dangshen), Processed Winter Atractylodes (Dongzhu), Large Ophiopogon Tuber ( Maidong), Angelica Sinensis Root (Guishen), Astragalus Root (Huangqi), Honey-fried Black Licorice Root (Gancao), Hairy Human Excrement Charcoal (Xuyutan), White Peony Root (Baishao), Poria (Fuling), Ziziphus Seed (Suanzaoren), Fritillaria Bulb (Beimu). Add Longan Aril, Large Black Dates.
Case of Patient Xie (Follow-up)
Pulse shows improvement, Yuan Qi gradually revives. Fear and doubt are manageable. Liver depression is smoothing, anger is rare. This is a good sign. Heart and Spleen Blood are not yet full; emotional nurturing is best.
Prescription: Processed American Ginseng (Yangshen), Poria Spirit (Fushen), Schisandra Berry (Wuweizi), Fritillaria Bulb (Beimu), Processed Winter Atractylodes (Dongzhu), Left Oyster Shell (Muli), Longan Aril (Guiyuanrou), Coix Seed (Yiyiren), Ziziphus Seed (Suanzaoren), Raw Licorice Root (Gancao). Add Kumquat Cake, Wild Rose Dew, take Baijin Wan (3 fen) before bed.
Case of Patient Xie (Follow-up)
Insomnia due to Yang rising, Spleen Qi sinking, Wind-Yang wandering不定. Kidney Essence lacks fluid. Use the method of guiding Yang to submerge and store.
Prescription: Codonopsis Root (Dangshen), Large Rehmannia Root (Shudi), Left Oyster Shell (Muli), White Peony Root (Baishao), Astragalus Root (Huangqi), Processed Aconite Root (Fuzi), Chrysanthemum Petal (Juban), Ziziphus Seed (Suanzaoren), Tangerine Pith (Jubai), Honey-fried Licorice Root (Gancao), Dendrobium Stem (Shihu), Longan Aril (Guiyuanrou). Add Egg Yolk (Jizihuang).
Case of Patient Xie (Follow-up)
Stool is solid, Kidney Essence is stored, Spleen Qi transports. Spirit gradually recovers. Occasionally encountering worries, Liver Yang easily disturbs the Pericardium, also because Heart Ying Blood and Qi are insufficient.
Prescription: Codonopsis Root (Dangshen), Scrophularia Root Heart (Yuanshenxin), Polygala Root Charcoal (Yuanzhi), Fried Ziziphus Seed (Zaosuanzaoren), Astragalus Root (Huangqi), Fritillaria Bulb (Beimu), Large Rehmannia Root (Shudi), Biota Seed (Baiziren), Yam (Shanyao), Honey-fried Licorice Root (Gancao), Longan Aril (Longyanrou).
Case of Patient Xie (Follow-up)
Walking is strong, sleep and diet are moderate. Middle Qi has recovered, but Blood deficiency still lacks nutrition. Blood not nourishing the Liver, Liver channel has stagnant Fire, wanting to vent but not fully. In summer heat, add clearing and unblocking agents to tonics. By autumn coolness, health can be hoped for. Modify according to Scholar Xu's method.
Prescription: Large Rehmannia Root (Dishengdi), Codonopsis Root (Dangshen), Red Peony Root (Chishao), Fritillaria Bulb (Beimu), Rhino Horn Tip (Wuxijian), Poria (Fuling), Trionyx Carapace (Daimao), Yam (Shanyao), Ophiopogon Tuber ( Maidong), Tangerine Pith (Jubai). Add Whole Egg Yolk, White Lotus Dew.
Case of Patient Zhang (Initial Consultation)
Two days postpartum, lochia not descending, fever with mental confusion, limb numbness, profuse sweating, pulse Kou, tongue red. Summer heat forces externally, Yin Qi depressed and covered, blood follows Qi rebellion, occasional fainting. Condition is dangerous. Urgently help the mother sit upright in a chair, open the window with bamboo blinds to protect from wind. Do not listen to old women insisting on hot bitter herb soups. Urgent advice.
Prescription: Small Rehmannia Root (Xishengdi), Amomum Fruit (Yujin), Achyranthes Root (Niuxi), Angelica Sinensis Root (Guishen), Fritillaria Bulb (Beimu), Tribulus Fruit (Jili), Western Amber (Hupo), Red Peony Root (Chishao), Moutan Cortex (Danpi), Anemone Root (Baiwei), Fresh Lotus Root Flesh, Child's Urine (Tongbian).
Case of Patient Zhang (Follow-up)
Heat subsided, spirit clear, Qi and Fire leveled, stasis descended. Arms still numb, lower abdomen painful. Continue nourishing Blood and unblocking stasis, which is the meaning of treating Blood first when treating Wind.
Prescription: Small Rehmannia Root (Xishengdi), Clean Angelica Sinensis Root (Guishen), Chaste Tree Fruit (Chongweizi), Red Peony Root (Chishao), Fried Yam (Shanyao), Tribulus Fruit (Jili), Achyranthes Root (Niuxi), Moutan Cortex (Danpi), Anemone Root (Baiwei), Hawthorn Charcoal (Zhatan), Amber.
Case of Patient Tang (Initial Consultation)
Stagnant Fire surges, attacking the Heart causing Jue. After Jue, palpitations and insomnia, fear and suspicion, damaging the Lung leading to Phlegm-Blood. Occasional chills and heat flashes, menstruation like flooding, twice a month. Wearing thick clothes in summer, dare not swallow thin porridge. Pulse and symptoms indicate not true Cold, but deep suspicion. Mr. Jin diagnosed it as incurable consumption. I fear this is incorrect. Eat boldly, do not avoid wind, relax the mind, assist with medicine, recovery is possible.
Prescription: Rhino Horn Tip (Wuxijian), Small Coptis Rhizome (Xiaochuanlian), Poria (Fuling), Ophiopogon Tuber ( Maidong), Large Rehmannia Root (Dashengdi), Amomum Fruit (Yujin), White Peony Root (Baishao), Tangerine Pith (Jubai), Ziziphus Seed (Suanzaoren), Fritillaria Bulb (Beimu). Add Jian Lotus Seeds.
Case of Patient Tang (Follow-up)
Patient believed the advice, Liver and Gallbladder smoothed, chills and heat did not occur. People find this strange; this is commonly known as psychosomatic disease. Firm belief removes doubt. As the saying goes, the sword of wisdom cuts the demon of sorrow. External medicine is still needed. Clear stagnant Fire, tonify Heart and Spleen to prevent recurrence.
Prescription: Small Rehmannia Root (Xishengdi), Rhino Horn Tip (Wuxijian), Small Coptis Rhizome (Xiaochuanlian), Ophiopogon Tuber ( Maidong), Raw Atractylodes Rhizome (Baizhu), Antelope Horn (Lingyangjiao), Fritillaria Bulb (Beimu), Ziziphus Seed (Suanzaoren), Coix Seed (Yiren), Red Dates (Hongzao).
Case of Patient Tang (Follow-up)
Diet normal, spirit calm, palpitations and hemoptysis stopped. Nose runs bloody water like a stream. This is stagnant Fire flowing from Pericardium to Lung channel. Nourish Yin, assist with clearing and harmonizing Lung and Liver.
Prescription: Processed Polygonum Multiflorum Root (Shouwu), Scrophularia Root Heart (Yuanshenxin), Fritillaria Bulb (Beimu), White Peony Root (Baishao), Antelope Horn (Lingyangjiao), Vitex Fruit (Manjingzi), Chinese Yam (Huai Shanyao), Raw Licorice Root (Gancao), Mint Leaf (Bohoye).
Case of Patient Tang (Follow-up)
Rhinitis stopped, but stagnant Fire not cleared, Heart and Spleen Qi/Blood not restored. Symptoms peaceful, menstruation likely early. Reduce dosage of previous method.
Prescription: Small Rehmannia Root (Xishengdi), Antelope Horn (Lingyangjiao), Chinaberry Seed (Chuanlianzi), Left Oyster Shell (Muli), Raw Atractylodes Rhizome (Baizhu), Fritillaria Bulb (Beimu), Scrophularia Root Heart (Yuanshenxin), Large Ophiopogon Tuber ( Maidong), Poria (Fuling), Small Red Dates (Xiaohongzao).
Case of Patient Zhang (Initial Consultation)
Winter Warmth suddenly appeared, menstruation just started. Yin Qi deficient first, pathogen transmits internally. Before one period, failed to ventilate Lung channel. Now illness day 13, took Xiao Chai Hu Tang, slight sweat, but pathogen fills Lung and Stomach, entering Ying level. Day and night irritability, spirit flying, pulse choppy/wiry/rapid, tongue crimson with thick coating, Phlegm obstruction, loose stool. Fear of convulsions/Jue, many changes possible.
Prescription: Light Fermented Soybean (Douchi), Bullard Fruit (Niubangzi), Moutan Cortex (Danpi), Fritillaria Bulb (Beimu), Small Rehmannia Root (Xishengdi), Light Scutellaria Root (Huangqin), Hawthorn Charcoal (Zhatan), Amomum Fruit (Yujin), Bitter Platycodon Root (Jiegeng), Gentian Root (Qinjiao), Red Poria (Chiling).
Case of Patient Zhang (Chen Hour Follow-up)
Illness two periods, menstruation dripping, purple-black color, Ying Heat blazing, insomnia all night. Yin-Mao hours, Liver-Wind moves internally, finger spasms/Jue, eye rolling, phlegm rushing, sweating stops. Right pulse洪/rapid, tongue root thick, color gray-yellow, continuous diarrhea, feeling heat sinking, Warm pathogen sinking, coma feared. Ying leaking below, Lung pathogen obstructed above, cannot stick to ancient methods for Heat entering Blood Chamber.
Prescription: Small Rehmannia Root (Xishengdi), Light Scutellaria Root (Huangqin), Moutan Cortex (Danpi), Mint (Bohe), Small Coptis Rhizome (Xiaochuanlian), Amomum Fruit (Yujin), Red Peony Root (Chishao), Raw Licorice Root (Gancao), Trichosanthes Root (Tianguafen), Raw Barley Sprout (Sheng Maiya), White Imperata Root (Baimaogen).
Case of Patient Zhang (You Hour Follow-up)
Warm pathogen enters via mouth/nose, Lung affected first, reverses to Pericardium. Worse at night, pulse faster than morning. Give clearing/resolving again, avoid coma.
Prescription: Fresh Rehmannia Root (Xianshengdi), Jade Scroll Heart (Yujuanxin), Moutan Cortex (Danpi), Fritillaria Bulb (Beimu), Light Scutellaria Root (Huangqin), Scrophularia Root Heart (Yuanshenxin), Ophiopogon Tuber ( Maidong), Platycodon Root (Jiegeng), Trichosanthes Root (Tianguafen), Raw Licorice Root (Gancao).
Case of Patient Zhang (Follow-up)
Last night paroxysmal irritability, Wind-spasm slightly eased, slept slightly after Zi hour. Waking, Phlegm-Fire rises, near Jue, diarrhea, short urine, Yin injury, Heat lingering. Heat transformation avoids changes.
Prescription: Rhino Horn (Xijiao), Hyacinth Bean Powder (Tianzhuhuang), Scrophularia Root (Yuanshen), Red Peony Root (Chishao), Small Rehmannia Root (Xishengdi), Bamboo Scroll Heart (Zhujianxin), Ophiopogon Tuber ( Maidong), Trichosanthes Root (Huafen), Anemarrhena Rhizome (Zhimu), Light Scutellaria Root (Qin).
Case of Patient Zhang (Follow-up)
Warm pathogen transmitted from Lung to Hand-Jueyin channel. Irritability, delirium, phlegm rush, coma. Repeatedly using clearing/nourishing to resolve heat, protecting Heart Yin internally. Although no internal closure, pathogen wants to vent but fails. Pericardium is clear/vacuous, pathogen fire burns fluid condensing phlegm blocking. Only aromatic opening can resolve.
Prescription: Old Gold Juice (Chen Jinzhi) 2 liang, dissolve and take Zhibao Dan (4 fen).
Case of Patient Zhang (Follow-up)
After yesterday's pulse, mania/Jue occurred, immediately took Zhibao Dan. Spirit settled, thick phlegm expectorated freely, slept at dawn. Waking, Qi rebellious, diarrhea stopped, bitter mouth, ulcers in throat/mouth dense. Winter Warmth transforming toxin, external venting opportunity.
Prescription: Rhino Horn Tip (Wuxijian), Fresh Dendrobium (Huohu), Bitter Platycodon Root (Jiegeng), Sweet Yellow (Ganzhonghuang), Fresh Rehmannia Root (Xianshengdi), Scrophularia Root Heart (Yuanshenxin), Hyacinth Bean Powder (Tianzhuhuang), Tulip Bulb (Tu Bei), Scutellaria Root (Huangqin), Red Peony Root (Chishao). Add Old Gold Juice, Wild Rose Dew.
Case of Patient Zhang (You Hour Follow-up)
Chest/diaphragm/skin heat greatly reduced, forehead discomfort persists. Left pulse quiet, right Cun/Guan slippery/rapid. Crimson tongue, little coating, ulcers rotting/painful, heart irritable, menstruation ending. Mainly clear/transform Upper Jiao Phlegm-Heat.
Prescription: Antelope Horn (Lingyangjiao), Light Scutellaria Root (Qin), Floating Stone (Haifushi), Tulip Bulb (Tu Bei), Fresh Dendrobium (Huohu), Scrophularia Root (Yuanshen), White Apricot Seed (Baxingren), Sweet Yellow (Ganzhonghuang), Trichosanthes Root (Tianguafen), Amomum Fruit (Yujin), Loquat Leaf (Pipaye), Fresh Reed Rhizome (Xian Lugen).
Case of Patient Zhang (Follow-up)
Winter Warmth mistreated initially, illness three periods, Warm pathogen drying, nearly sinking. Fortunately pathogen vents via ulcers, heat retreats, menstruation stops, Ying Yin deficient, Lung/Stomach residual Heat blazing. Prevent fluid exhaustion.
Prescription: Rhino Horn Tip (Wuxijian), Fresh Dendrobium (Huohu), Scrophularia Root (Yuanshen), Anemarrhena Rhizome (Zhimu), Fresh Rehmannia Root (Xianshengdi), Light Scutellaria Root (Huangqin), Ophiopogon Tuber ( Maidong), Tulip Bulb (Tu Bei), Fly Blue Green Pigment (Fei Qingdai), Sweet Yellow (Ganzhonghuang), Old Gold Juice (Chen Jinzhi), Silver Flower Dew (Yinhualu).
Case of Patient Zhang (Follow-up)
Tongue coating yellow/black transformed, pulse rapid/slows, sweat pouring, ulcer spreading stabilizes, white rot recedes, hoarse thirst, thick yellow phlegm, sticky saliva surging. External pathogen nearly clean, Spleen deficiency/Blood heat, internal Damp-Fire. Yu Nu Jian combined with Gan Lu Yin modified.
Prescription: Large Rehmannia Root (Dishengdi), Raw American Ginseng (Yangshen), Anemarrhena Rhizome (Zhimu), Fritillaria Bulb (Chuanbei), Raw Gypsum (Shigao), Raw Atractylodes Rhizome (Baizhu), Coptis Rhizome (Chuanlian), Sweet Yellow (Ganzhonghuang), Fresh Dendrobium (Huohu), Fresh Bamboo Shavings (Zhuru), White Japonica Rice (Bajngmi), Fresh Reed Rhizome (Xian Lugen).
Case of Patient Zhang (Follow-up)
Sweat still much, heat completely gone, no stool for 3 days, pathogen/stagnation merged in Stomach Fu, avoiding transmission. Mouth sticky/thirst reduced, urination improving, Yangming embers not out, fear relapse.
Prescription: Raw American Ginseng (Yangshen), Small Rehmannia Root (Xishengdi), Sweet Yellow (Ganzhonghuang), Fresh Bamboo Shavings (Zhuru), Fresh Dendrobium (Huohu), Raw Gypsum (Shigao), Fritillaria Bulb (Beimu), Raw Immature Bitter Orange (Zhike), Fat Anemarrhena Rhizome (Zhimu), Whole Trichosanthes Fruit (Gualou), Fresh Reed Rhizome (Xian Lugen), Loquat Leaf Dew (Pipayelu).
Case of Patient Zhang (Follow-up)
Ulcer pain greatly eased, food intake possible. After waking, urgent frequent urination, residual heat/stagnation in Yangming forcing Bladder fluid down. Sweat more, Stomach fluid injured, Large Intestine drier, Dry-Fire injuring Yin. Food intake low, fear fluid exhaustion. *Shanghan Lun* has purge/non-purge, Ji Xia Cun Yin methods. Both are vital, must use appropriately. Thirst, old yellow/cracked tongue root, rapid/solid pulse, abdominal tenderness. Truly time for Ji Xia Cun Yin. Many errors purging before pathogen enters Fu.
Prescription: Raw American Ginseng (Xishen), Sodium Sulfate (Yuanmingfen), Whole Trichosanthes Fruit (Gualou), Raw White Peony Root (Baishao), Fresh Dendrobium (Huohu), Hemp Seed (Huomaren), Radish Seed (Laifuzi), Raw Licorice Root (Gancao), Large Ophiopogon Tuber ( Maidong), White Japonica Rice (Bajngmi).
Case of Patient Zhang (Follow-up)
Frequent flatus, no stool, tongue coating moving, food intake increased. Keep yesterday's method.
Prescription: American Ginseng (Xiyangshen), Fresh Polygonum Multiflorum Root (Xian Shouwu), Hemp Seed (Huomaren), Raw Licorice Root (Gancao), Fresh Dendrobium (Huohu), Sodium Sulfate (Yuanmingfen), Raw White Peony Root (Baishao), White Japonica Rice (Bajngmi), Large Ophiopogon Tuber ( Maidong), Sweet Pear Juice (Tian Lizhi).
Case of Patient Zhang (Follow-up)
After last night's stool, deep sleep, stomach wants food, spirit/pulse calm, urination normal, gut stagnation cleared. Residual pathogen sinks to anus, small nodes formed, skin scraped during spasms, moisture spreads, painful. Minor issue, fear affecting sleep/eating, branch complication.
Prescription: American Ginseng (Xiyangshen), Fresh Polygonum Multiflorum Root (Xian Shouwu), Raw White Peony Root (Baishao), Phellodendron Bark (Chuanbai), Fresh Dendrobium (Huohu), Hemp Seed (Huomaren), Raw Licorice Root (Gancao), Fat Anemarrhena Rhizome (Zhimu), Tangerine Pith (Jubai). Add Black Soybean (5 qian), Mung Bean (5 qian).
Case of Patient Zhang (Follow-up)
Stool continues, epigastric/abdominal comfortable, sleep/eat well, Fu pathogen cleared, ulcer pain eased. Anger triggers palpitations/tinnitus, Stomach Yin growing, cannot withstand Wood-Fire flaming. Post-Warm pathogen, careless nursing, relapse feared. Emphasize again.
Prescription: American Ginseng (Xiyangshen), Fresh Dendrobium (Huohu), Raw White Peony Root (Baishao), Raw Licorice Root (Gancao), Small Rehmannia Root (Xishengdi), Light Asparagus Tuber (Tandong), Trichosanthes Root (Tianguafen), Sweet Pear Juice (Tian Lizhi), Pearl Powder (Lianzhufen), Bird's Nest Fragments (Yanxi).
Case of Patient Zhang (Follow-up)
Spirit joyful, Qi/Yin recovering. Carefully adjust diet/clothing.