麻黄10克杏仁12克法夏12克甘草10克上方连服六剂,复视消失,视觉恢复正常。
1978年12月28日,至患者家中追访。他高兴地说:六年前,吃了六付药,眼睛便完全恢复,每付药才九分钱。自那时起,我不仅照常算账看书,还经常书写蝇头小楷,作国画,描绘山水、花鸟、人物等,一如常人。
[辨证]此证无明显之既往病史,患病之始,仅自觉劳累如感冒后之不适,主证即现复视。《灵枢·大惑论篇》云: “五脏六腑之精气,皆上注于目……精散则视歧,视歧见两物。”通常认为,精散多由肝肾虚损。但此例患者,从病情及全身情况辨析,并无肝肾两虚之征。再者,前医曾用补肝血、益肾气之中西药品,亦未奏效。我们认为,本例之“精散”,当属邪伤手太阴肺经。究其病因,主要在以下几个方面:
其一, 《审视瑶函》曾说:目“中有神膏”,此神膏实为肺阴所聚;前人或称为阴精所生之魄。即《素问·宣明五气篇》所谓: “肺藏魄”; 《灵枢·本神篇》云: “并而精出入者谓之魄”。张景岳注:“魄之为用,能动能作,痛痒由之而觉也” (《类经·脏象类》卷三)。人体一些知觉与动作,皆与“魄”正常作用相关。很显然,此例之视歧,乃邪伤手太阴之精膏所致。
其二,患者视物常现白色、白影。《医宗金鉴》曾指出: “浅绿如白肺经发”。同时,患者在白睛中现淡红血丝。白睛属肺,肺主治节,且为娇脏,五哐六腑之华盖也。外感寒湿之邪入侵,每先犯肺,使治节失调,致令气血阻滞于目,逐渐凝聚,必损及手太阴之精膏;久之,遂发为视歧。
再参之舌象:舌质淡红而润;苔白滑而腻,兼淡黄色,标志寒湿较重,邪渐入里。再望舌苔紧密,更说明寒湿凝聚较深。寒湿之邪入侵人体,太阳经首当其冲。同时足太阳膀胱之脉,起目内眦,上额,交巅,.下脑后;外邪循经上目逐渐凝聚,终于截散瞳神之精膏,以致视物分歧。
总之,此证之病因病机,为外伤寒湿之邪,循太阳之经入侵,内伤手太阴之精膏,凝结而成。故用太阳伤寒之主方,随证加减,以散肺金之寒湿,通经脉之凝滞,从根本入手施治。
[按语]前人对麻黄汤之运用,总其要不外太阳伤寒。正如柯琴所说:太阳主一身之表,主筋所生之病,为诸阳主气,太阳为开,立麻黄汤以开之,诸证悉除矣。但,多年来范老临证对麻黄汤应用的范围,已大大超过上述诸证。不仅已突破外感伤寒之局限,同时在许多内伤杂病之运用上,亦常获效。为何此例与麻黄八证无关而用麻黄汤,须从本方之配伍具体分析。
麻黄,味微苦,性温,不仅为发汗之主药,而且“于全身之腑脏经络,莫不透达”,故前贤赞其“开诸闭”; “谓其破症瘕积聚者,以其能透出皮肤毛孔之外,又能深入积痰凝血之中,而消坚化淤之药,可偕之以奏效也”。今用麻黄入手太阴,以逐寒搜风开闭散淤,透邪外出,而去病根。
杏仁,性愠,味甘苦,可升可降,气薄味厚,亦为入手太阴之剂。《本草求真》谓: “杏仁,既有发散风寒之能,复有下气除喘之力”。本例用杏仁配麻黄,开毛窍,利气机,使久郁之寒邪得有出路。不仅如此,杏仁还能散结滞,故此证用之,不在于降气平喘,而在于散太阴之寒邪,通经脉之凝滞。
去桂枝,不使增强发汗之力;加半夏,取其燥脾湿,散郁结之功;使以甘草,不仅甘平缓中,为麻杏之匡助,而且能表能里,可升可降,通经脉,利血气。
前人云,用药如用兵。 “运用之妙,存乎一心”。推之经方之应用,这个“妙”字,盖为“师其法而不泥其方”欤!
太阴证痰咳
(慢性支气管炎)
李×,男,5岁。北京某所干部之子。
[病史]初生不久,即患支气管炎。一至四岁时,曾先后在北京××中医院住院治疗。因缠绵不愈,身体益弱,经常感冒发烧,咳嗽反复加重。1978年7月来诊,按太阴证痰饮咳嗽论治,两诊痊愈。
[初诊]患儿咳嗽已一年多,频频发作。痰清稀,睡时可闻痰鸣声。食纳不佳,面萎黄,体瘦。舌质偏淡,苔自滑腻。触双手,肌肤微冷,此为手足太阴两脏同病,水饮久留不去,上干于肺,致常年痰咳不止。法宜温化水饮,降逆止咳。以小半夏加茯苓汤加味主之。
处方:
法夏10克生姜10克茯苓12克紫菀6克冬花3克 甘草3克二剂
[二诊]服上方两剂,咳嗽减,痰鸣消;但仍吐清稀痰,上方损益再服。
处方:
法夏10克干姜6克茯苓12克甘草6克1979年5月24日追访,患儿家长说:经范老治愈,去冬今春再未复发。
[辨证]患儿面黄、体瘦、食少、肢冷,舌质偏淡,皆脾为湿困,失其健运,化源衰少之证。而咳痰稀薄,苔白滑厚腻,又为痰湿内蕴,上干于肺之象。加以卧则痰鸣,显系寒饮上泛喉间,呼吸之气激发使然。正如仲景所云: “水在肺,吐涎沫”, “水在脾,少气身重”。可见,此例病根,首责于手足太阴皆为水湿所困,并互相连累,致使痰饮咳嗽更加胶着难愈。本例痰饮,投以小半夏加茯苓汤,为振奋阳气,治病务求其本之意。原方《金匮要略》用以主治痰饮咳嗽。方中半夏、生姜化饮降逆;加茯苓以去水安神。加甘草者,以助脾气,并配干姜以温中;加紫菀、冬花者,更增消痰下气之效。且小儿脏腑娇嫩,生机蓬勃,一旦病邪衰退,即不宜频频用药,故嘱其着重调理后天,扶正以驱余邪。
[按语)后世不少《伤寒论》注述认为,六经仅三阳与少阴有咳。其理由为《伤寒论》中,太阳、阳明、少阳病咳记载较多;而少阴病咳,属少阴阳虚,或属少阴热化,但亦非必然见证;何况太阴、厥阴篇并无病咳之记载。而本例痰咳,何以按太阴证论治?
第一, “五脏六腑,皆令人咳”,非独肺也(《素问·咳论篇》);但五脏六腑之咳,又必皆表现于肺。他脏之病,必须起于肺,或累及于肺,方能出现咳嗽。故张景岳说: “咳证虽多,无非肺病”,喻嘉言亦认为: “咳者,肺之本病也”。
第二,本例患者之痰咳,不仅脾为湿困,且为水气袭肺所致。显然为足太阴脾与手太阴肺同病。
第三,或问,伤寒六经传足不传手,足太阴脾湿何能上干手太阴肺?其实,后世不少注家对此已有阐述。如《伤寒六经辨证治法》云: “人之充满一身,无非气血所养,昼夜循环,运行不已,岂有止行足而不行手乎……?设或不传,气逆作满,何经而来?如谓不然,仲景设有桂枝麻黄,乃肺经药也, 岂虚言哉!”
第四,即使“伤寒论》中仅三阳与少阴有咳,正如近世学者认为: “《伤寒论》是仲景书的总论”(《伤寒论证治类诠》)。很明显,我们焉能苛求,仲景在“总论”中,必须将六经诸咳罗列无遗!
太阴证寒呃
(胃神经官能症)
罗x×,男,25岁。四川新津县某乡,农民。
[病史]1969年冬,时感胃脘隐痛,按之似包块。便秘而腹不满,未予治疗。翌年,胃脘持续疼痛,嗳气吞酸,呃逆气阻,暧出始舒。曾按“胃炎”治疗数年,后转成都××医院诊为“胃神经官能症”,后改由中医按“肝胃不和”等论治,时痛时缓,迁延至1973年冬,病情加剧。1974年4月初来诊。
[初诊]形体消瘦,面色不荣,阵阵呃逆,胃脘疼痛,遇寒加剧。数月来,只能食稀粥流质,饮入频频发呕,泛吐清涎。大便先结后溏,数日一次。舌质偏淡,苔白滑,脉沉。此为足太阴脾虚寒呃,法宜温中健脾,行气化浊,以理中汤加味主之。
处方:
党参20克干姜15克 白术15克炙甘草6克茯苓20克砂仁12克 白蔻10克法夏15克三剂
[二诊]呃气减少,腹痛缓解,继上方加公丁香、吴茱萸,暖肝行气止痛,再服五剂。
(三诊]呃逆止,食欲增,大便畅,精神好转。嘱忌生冷。再将上方服十余剂。月余后患者来告,饮食如常,已参加农业劳动。
1979年7月20日追访:患者说, “现在身体健康,体力超过一般劳动力。”
[按语]呃逆一证, 《素问·宣明五气篇》云:“胃为气逆、为哕”。《素问·宝命全形论篇》云: “病深者,其声哕”。《金匮要略》将此证分寒呃,虚热、实热。此例寒呃,证属足太阴。乃中阳不振,寒湿内聚,阴寒与胃气相搏于中脘,以致上逆而呃。故不宜见气逆即投降逆平冲之品。今用理中以温中行气,除湿化浊而获效。
太阴证胃脘痛
周××,男,61岁。四川郫县某乡,农民。
[病史]胃脘痛二十余年,时吐酸,呃逆。开始几年,服药后可缓解;后十年渐重,饥则时疼。1970年4月,病情进行性加剧,持续疼痛,纳呆, 体虚,便黑。急送××医院治疗,诊为“胃溃疡”、 “胃癌待查”。建议手术,但考虑血色素仅4.5克,年老体衰,商定改由中医保守治疗。遂来成都就诊。
(初诊]患者按腹弯腰,呻吟不已;呕吐酸水,时时呃逆,食不下,恶寒肢冷;舌淡、苔白腻浊。证属太阴虚寒邪盛。法宜温中散寒,消淤止痛,以四逆汤加味主之。
处方一:
炙甘草30克 炮姜30克 制附片30克(久煎)
上肉桂10克公丁香6克处方二:
回生丹,日服二次,每次三粒,痛止停服。
(二诊]一周后来诊,疼痛大减,便血止, 泛酸、呃逆明显减轻。以甘草干姜汤加味缓服。
处方:
炙甘草30克炮姜30克 上肉桂10克 砂仁lO克白蔻10克茯苓20克 白术20克服药调养月余,疼痛消失,饮食正常。
1979年7月20日追访:数年来,曾轻度复发一次,服甘草干姜汤加味后愈,未再复发。现已七旬,尚可做一些轻活。
[按语)《素问·金匮真言论篇》云: “人身之阴阳,则背为阳,腹为阴”。腹部之病,按其部位,分属太、少,厥阴。太阴为三阴之里,其脉从足入腹,属脾络胃。脾为湿土,阴中之至阴,凡伤于寒湿,则脾先受之。且与阳明胃相表里,脾虚胃亦虚,即所谓胃家不实,便是太阴病。此证显系属太阴虚寒邪盛。始终抓住太阴主证;而太阴温里宜四逆辈,故首投四逆汤加味,兼以行气通络,散滞化淤为治,而病获愈。
太阴证水肿
于××,男,4l岁。北京某机关干部。
(病史]全身浮肿十年,近一年加重。出国工作期间,曾患疟疾,服奎宁半年而愈。回国后,1969年到西南山区,在潮润闷热之坑道内工作一年多。逐渐感到全身乏力,肢体沉重,食欲减退,面与下肢开始浮肿。1978年初,病情发展,上肢麻木不能写字,下肢关节冷痛,全身浮肿明显加重。口干,欲大量热饮。小便短少。时而点滴难下,体重由140斤增至174斤。北京××医院诊为“前列腺炎”。但水肿原因始终未查明。
[初诊]1978年8月4日。因一周前参加夏收后,浮肿加剧。面部与四肢尤甚,按之凹陷。神疲,纳呆,腹满,喜热饮,腰痛,阳痿,小便短少。面暗黑无华,舌淡,苔白滑腻。此为太阴脾虚湿郁所致。初因湿热内困,后伤及脾阳,故水液内停;而太阴之伤,又累及足少阴肾,法宜温肾健脾,燥湿利水,以理中汤加减主之。
处方:
制附片30克(久煎) 白术15克 干姜15克炙甘草12克茯苓12克上肉桂6克(冲服)
[二诊]8月18日。上方服十剂, 浮肿减轻,头昏、乏力好转。原方再服二十剂。
[三诊]9月18日。 全身浮肿消退大半,纳增,小便较前通畅。上方加桂枝10克,生姜皮60克,以增化气行水之力。续服十五剂。
(四诊]lO月8日。浮肿基本消退, 诸证均明显好转。为巩固疗效,以理中丸加味缓缓服之。
处方:
党参30克 炒白术60克 干姜60克 炙甘草30克制附片120克 茯苓60克上肉桂lO克十剂
共为细末,水打为丸。日服2次,每次10克。
1979年5月15日追访:服丸药四个多月,病痊愈,体重由170余斤降至140余斤。
[按语]《素问·至真要大论篇》云: “诸湿肿满,皆属于脾”。脾乃至阴之脏,少阴又为太阴之母。故肾不主五液,脾不行水,则肿满生焉。本例先后以理中汤加附子等,温补太、少二阴,阳气升,阴霾散,气化行,水湿消,故病获愈。
太阴证泄泻
(慢性肠炎)
刘××,女,26岁。北京某机关干部。
[病史]从幼儿起,常年腹泻,已迁延二十余载,北京××医院诊断为慢性肠炎。经中西医长期治疗未愈。1978年8月初来诊,按太阴虚寒证泄泻论治,三诊病愈。
麻黄10克,杏仁12克,法半夏12克,甘草10克。上方连续服用六剂后,复视症状消失,视觉恢复正常。
1978年12月28日,医生前往患者家中进行随访。患者高兴地说:“六年前,吃了六副药,眼睛便完全恢复了,每副药才九分钱。自那时起,我不仅照常算账、看书,还经常书写蝇头小楷,创作国画,描绘山水、花鸟、人物等,和正常人一样。”
[辨证] 此病例没有明显的既往病史。患病初期,仅自觉劳累,感觉像感冒后的不适,主要症状随即出现复视(视物重影)。《灵枢·大惑论篇》说:“五脏六腑的精气,都上注于眼睛……精气涣散则视物重影,视物重影就会看到两个物体。”通常认为,精气涣散多由肝肾虚损引起。但本例患者,从病情及全身情况分析,并没有肝肾两虚的迹象。此外,前医曾使用补肝血、益肾气的中西药物,也未见效。我们认为,本例的“精气涣散”,属于邪气损伤手太阴肺经所致。究其病因,主要在以下几个方面:
其一,《审视瑶函》曾说,眼中“有神膏”,这个神膏实际上是肺阴所聚;前人有时称之为阴精所生的“魄”。即《素问·宣明五气篇》所谓:“肺藏魄”;《灵枢·本神篇》说:“并而精出入者谓之魄”。张景岳注释:“魄的作用,在于能动能作,痛痒的感觉由此产生”(《类经·脏象类》卷三)。人体的一些知觉与动作,都与“魄”的正常作用相关。很明显,本例的视物重影,是邪气损伤了手太阴肺经的神膏所致。
其二,患者视物时常出现白色或白影。《医宗金鉴》曾指出:“浅绿如白肺经发”。同时,患者在白睛(眼白)中出现淡红血丝。白睛属肺,肺主治节,且为娇脏,是五脏六腑的华盖。外感寒湿之邪入侵,往往先侵犯肺脏,导致治节失调,致使气血在眼部阻滞,逐渐凝聚,必然损害手太阴肺经的神膏;久而久之,便发展为视物重影。
再参考舌象:舌质淡红而湿润;苔白滑而腻,兼有淡黄色,标志寒湿较重,邪气渐入体内深处。再看舌苔紧密,更说明寒湿凝聚较深。寒湿之邪入侵人体,太阳经首当其冲。同时足太阳膀胱经,起始于目内眦,上行至额部,交会于头顶,下行脑后;外邪循经上行至眼部逐渐凝聚,最终截断散瞳神之精膏,以致视物分歧。
总之,此病的病因病机,是外伤寒湿之邪,循太阳经入侵,内伤手太阴肺经的精膏,凝结而成。因此使用治疗太阳伤寒的主方,随证加减,以疏散肺金的寒湿,疏通经脉的凝滞,从根本入手施治。
[按语] 前人对麻黄汤的运用,总结其主要不外乎治疗太阳伤寒。正如柯琴所说:太阳主一身之表,主筋所生之病,为诸阳主气,太阳为开,设立麻黄汤以开启腠理,诸证悉除矣。但是,多年来范中林老医师临证对麻黄汤应用的范围,已大大超过上述诸证。不仅突破了外感伤寒的局限,同时在许多内伤杂病的治疗上,也常获效。为何此例与麻黄汤八证无关却用麻黄汤,须从本方的配伍具体分析。
麻黄,味微苦,性温,不仅是发汗的主药,而且“于全身之脏腑经络,莫不透达”,故前贤赞其“开诸闭”;“谓其破症瘕积聚者,以其能透出皮肤毛孔之外,又能深入积痰凝血之中,而消坚化淤之药,可偕之以奏效也”。今用麻黄入手太阴肺经,以驱逐寒邪、搜风、开闭、散瘀,透邪外出,以去病根。
杏仁,性微温,味甘苦,可升可降,气薄味厚,亦为入手太阴肺经之剂。《本草求真》谓:“杏仁,既有发散风寒之能,复有下气除喘之力”。本例用杏仁配麻黄,开发毛窍,利通气机,使久郁之寒邪得有出路。不仅如此,杏仁还能散结滞,故此证用之,不在于降气平喘,而在于散太阴之寒邪,通经脉之凝滞。
去掉桂枝,不使其增强发汗之力;加入半夏,取其燥脾湿、散郁结之功;使用甘草,不仅甘平缓中,作为麻黄、杏仁的辅助,而且能表能里,可升可降,通经脉,利血气。
前人云,用药如用兵。“运用之妙,存乎一心”。推之经方的应用,这个“妙”字,大概在于“师其法而不泥其方”吧!
太阴证痰咳
(慢性支气管炎)
李×,男,5岁。北京某单位干部之子。
[病史] 出生不久,即患支气管炎。一至四岁时,曾先后在北京××中医院住院治疗。因缠绵不愈,身体日益虚弱,经常感冒发烧,咳嗽反复加重。1978年7月来诊,按太阴证痰饮咳嗽论治,两诊痊愈。
[初诊] 患儿咳嗽已一年多,频频发作。痰清稀,睡时可闻痰鸣声。食纳不佳,面色萎黄,身体瘦弱。舌质偏淡,苔白滑腻。触双手,肌肤微冷,此为手足太阴两脏同病,水饮久留不去,上干于肺,致常年痰咳不止。治法宜温化水饮,降逆止咳。以小半夏加茯苓汤加味为主方。
处方:
法半夏10克,生姜10克,茯苓12克,紫菀6克,款冬花3克,甘草3克。二剂。
[二诊] 服上方两剂,咳嗽减轻,痰鸣消失;但仍吐清稀痰,上方损益再服。
1979年5月24日追访,患儿家长说:经范老治愈,去冬今春再未复发。
[辨证] 患儿面黄、体瘦、食少、肢冷,舌质偏淡,皆是脾为湿困,失其健运,化源衰少的证候。而咳痰稀薄,苔白滑厚腻,又是痰湿内蕴,上干于肺的表现。加上卧则痰鸣,显系寒饮上泛喉间,呼吸之气激发使然。正如仲景所言:“水在肺,吐涎沫”,“水在脾,少气身重”。可见,此例病根,首先责于手足太阴皆为水湿所困,并互相连累,致使痰饮咳嗽更加胶着难愈。本例痰饮,投以小半夏加茯苓汤,旨在振奋阳气,治病务求其本之意。原方出自《金匮要略》,用以主治痰饮咳嗽。方中半夏、生姜化饮降逆;加茯苓以去水安神。加甘草者,以助脾气,并配干姜以温中;加紫菀、款冬花者,更增消痰下气之效。且小儿脏腑娇嫩,生机蓬勃,一旦病邪衰退,即不宜频频用药,故嘱其着重调理后天脾胃,扶正以驱余邪。
[按语] 后世不少《伤寒论》注述认为,六经仅三阳与少阴有咳。其理由为《伤寒论》中,太阳、阳明、少阳病咳记载较多;而少阴病咳,属少阴阳虚,或属少阴热化,但亦非必然见证;何况太阴、厥阴篇并无病咳之记载。而本例痰咳,何以按太阴证论治?
第一,“五脏六腑,皆令人咳”,非独肺也(《素问·咳论篇》);但五脏六腑之咳,又必皆表现于肺。他脏之病,必须起于肺,或累及于肺,方能出现咳嗽。故张景岳说:“咳证虽多,无非肺病”,喻嘉言亦认为:“咳者,肺之本病也”。
第二,本例患者之痰咳,不仅脾为湿困,且为水气袭肺所致。显然为足太阴脾与手太阴肺同病。
第三,或问,伤寒六经传足不传手,足太阴脾湿何能上干手太阴肺?其实,后世不少注家对此已有阐述。如《伤寒六经辨证治法》云:“人之充满一身,无非气血所养,昼夜循环,运行不已,岂有止行足而不行手乎……?设或不传,气逆作满,何经而来?如谓不然,仲景设有桂枝麻黄,乃肺经药也,岂虚言哉!”
第四,即使《伤寒论》中仅三阳与少阴有咳,正如近世学者认为:“《伤寒论》是仲景书的总论”(《伤寒论证治类诠》)。很明显,我们焉能苛求,仲景在“总论”中,必须将六经诸咳罗列无遗!
太阴证寒呃
(胃神经官能症)
罗××,男,25岁。四川新津县某乡农民。
[病史] 1969年冬,时感胃脘隐痛,按之似包块。便秘而腹不满,未予治疗。翌年,胃脘持续疼痛,嗳气吞酸,呃逆气阻,嗳出始舒。曾按“胃炎”治疗数年,后转成都××医院诊为“胃神经官能症”,后改由中医按“肝胃不和”等论治,时痛时缓,迁延至1973年冬,病情加剧。1974年4月初来诊。
[初诊] 形体消瘦,面色不荣,阵阵呃逆,胃脘疼痛,遇寒加剧。数月来,只能食稀粥流质,饮入频频发呕,泛吐清涎。大便先结后溏,数日一次。舌质偏淡,苔白滑,脉沉。此为足太阴脾虚寒呃,治法宜温中健脾,行气化浊,以理中汤加味为主方。
处方:
党参20克,干姜15克,白术15克,炙甘草6克,茯苓20克,砂仁12克,白蔻10克,法半夏15克。三剂。
[二诊] 呃气减少,腹痛缓解,继上方加公丁香、吴茱萸,暖肝行气止痛,再服五剂。
[三诊] 呃逆止,食欲增,大便畅,精神好转。嘱忌生冷。再将上方服十余剂。月余后患者来告,饮食如常,已参加农业劳动。
1979年7月20日追访:患者说,“现在身体健康,体力超过一般劳动力。”
[按语] 呃逆一证,《素问·宣明五气篇》云:“胃为气逆、为哕”。《素问·宝命全形论篇》云:“病深者,其声哕”。《金匮要略》将此证分寒呃、虚热、实热。此例寒呃,证属足太阴。乃中阳不振,寒湿内聚,阴寒与胃气相搏于中脘,以致上逆而呃。故不宜见气逆即投降逆平冲之品。今用理中汤以温中行气,除湿化浊而获效。
[病史] 胃脘痛二十余年,时吐酸,呃逆。开始几年,服药后可缓解;后十年渐重,饥则时疼。1970年4月,病情进行性加剧,持续疼痛,纳呆,体虚,便黑。急送××医院治疗,诊为“胃溃疡”、“胃癌待查”。建议手术,但考虑血色素仅4.5克,年老体衰,商定改由中医保守治疗。遂来成都就诊。
[初诊] 患者按腹弯腰,呻吟不已;呕吐酸水,时时呃逆,食不下,恶寒肢冷;舌淡、苔白腻浊。证属太阴虚寒邪盛。治法宜温中散寒,消瘀止痛,以四逆汤加味为主方。
处方一:
炙甘草30克,炮姜30克,制附片30克(久煎),上肉桂10克,公丁香6克。
处方二:
回生丹,日服二次,每次三粒,痛止停服。
[二诊] 一周后来诊,疼痛大减,便血止,泛酸、呃逆明显减轻。以甘草干姜汤加味缓服。
处方:
炙甘草30克,炮姜30克,上肉桂10克,砂仁10克,白蔻10克,茯苓20克,白术20克。
服药调养月余,疼痛消失,饮食正常。
1979年7月20日追访:数年来,曾轻度复发一次,服甘草干姜汤加味后愈,未再复发。现已七旬,尚可做一些轻活。
[按语] 《素问·金匮真言论篇》云:“人身之阴阳,则背为阳,腹为阴”。腹部之病,按其部位,分属太、少、厥阴。太阴为三阴之里,其脉从足入腹,属脾络胃。脾为湿土,阴中之至阴,凡伤于寒湿,则脾先受之。且与阳明胃相表里,脾虚胃亦虚,即所谓胃家不实,便是太阴病。此证显系属太阴虚寒邪盛。始终抓住太阴主证;而太阴温里宜四逆辈,故首投四逆汤加味,兼以行气通络,散滞化瘀为治,而病获愈。
太阴证水肿
于××,男,41岁。北京某机关干部。
[病史] 全身浮肿十年,近一年加重。出国工作期间,曾患疟疾,服奎宁半年而愈。回国后,1969年到西南山区,在潮润闷热之坑道内工作一年多。逐渐感到全身乏力,肢体沉重,食欲减退,面与下肢开始浮肿。1978年初,病情发展,上肢麻木不能写字,下肢关节冷痛,全身浮肿明显加重。口干,欲大量热饮。小便短少。时而点滴难下,体重由140斤增至174斤。北京××医院诊为“前列腺炎”。但水肿原因始终未查明。
[初诊] 1978年8月4日。因一周前参加夏收后,浮肿加剧。面部与四肢尤甚,按之凹陷。神疲,纳呆,腹满,喜热饮,腰痛,阳痿,小便短少。面暗黑无华,舌淡,苔白滑腻。此为太阴脾虚湿郁所致。初因湿热内困,后伤及脾阳,故水液内停;而太阴之伤,又累及足少阴肾,治法宜温肾健脾,燥湿利水,以理中汤加减为主方。
处方:
制附片30克(久煎),白术15克,干姜15克,炙甘草12克,茯苓12克,上肉桂6克(冲服)。
[二诊] 8月18日。上方服十剂,浮肿减轻,头昏、乏力好转。原方再服二十剂。
[三诊] 9月18日。全身浮肿消退大半,纳增,小便较前通畅。上方加桂枝10克,生姜皮60克,以增化气行水之力。续服十五剂。
[四诊] 10月8日。浮肿基本消退,诸证均明显好转。为巩固疗效,以理中丸加味缓缓服之。
处方:
党参30克,炒白术60克,干姜60克,炙甘草30克,制附片120克,茯苓60克,上肉桂10克。十剂。
共为细末,水打为丸。日服2次,每次10克。
1979年5月15日追访:服丸药四个多月,病痊愈,体重由170余斤降至140余斤。
[按语] 《素问·至真要大论篇》云:“诸湿肿满,皆属于脾”。脾乃至阴之脏,少阴又为太阴之母。故肾不主五液,脾不行水,则肿满生焉。本例先后以理中汤加附子等,温补太、少二阴,阳气升,阴霾散,气化行,水湿消,故病获愈。
[病史] 从幼儿起,常年腹泻,已迁延二十余载,北京××医院诊断为慢性肠炎。经中西医长期治疗未愈。1978年8月初来诊,按太阴虚寒证泄泻论治,三诊病愈。
Mahuang (Ephedrae Herba) 10g, Xingren (Armeniacae Semen Amarum) 12g, Banxia (Pinelliae Rhizoma Preparatum) 12g, Gancao (Glycyrrhizae Radix et Rhizoma) 10g. After taking the above prescription continuously for six doses, the symptom of diplopia disappeared, and vision returned to normal.
On December 28, 1978, the physician visited the patient's home for follow-up. The patient said happily: "Six years ago, after taking six doses of medicine, my eyes recovered completely; each dose cost only nine cents. Since then, I have been able to calculate and read books as usual, and often write small regular script, create traditional Chinese paintings depicting landscapes, flowers and birds, figures, etc., just like a normal person."
[Differentiation] This case had no obvious medical history. At the onset of the illness, the patient only felt fatigued, with discomfort similar to that after a cold; the main symptom, diplopia (double vision), appeared immediately. *Ling Shu · Da Huo Lun* states: "The essence and qi of the five zang organs and six fu organs all ascend to the eyes... When the essence scatters, vision becomes double, and one sees two objects." It is generally believed that scattered essence is mostly caused by deficiency and damage of the Liver and Kidney. However, in this case, based on the condition and overall situation, there were no signs of Liver and Kidney deficiency. Furthermore, previous physicians had used Chinese and Western medicines to nourish Liver blood and benefit Kidney qi, without effect. We believe that the "scattered essence" in this case belongs to pathogenic factors damaging the Hand Taiyin Lung Meridian. Investigating the etiology, it is mainly due to the following aspects:
Firstly, *Shen Shi Yao Han* stated that there is "divine paste" in the eye; this divine paste is actually gathered from Lung Yin; predecessors sometimes called it the "Po" generated by yin essence. That is, what *Su Wen · Xuan Ming Wu Qi Pian* says: "The Lung stores Po"; *Ling Shu · Ben Shen Pian* says: "What enters and exits together with essence is called Po". Zhang Jingyue annotated: "The function of Po lies in movement and action; sensations of pain and itching arise from it" (*Lei Jing · Zang Xiang Lei*, Vol. 3). Some human perceptions and movements are related to the normal function of "Po". Obviously, the diplopia in this case was caused by pathogenic factors damaging the divine paste of the Hand Taiyin Lung Meridian.
Secondly, the patient often saw white objects or white shadows when looking at things. *Yi Zong Jin Jian* pointed out: "Light green resembling white indicates Lung Meridian involvement." Meanwhile, pale red blood vessels appeared in the Baijing (white part of the eye). The Baijing belongs to the Lung; the Lung governs regulation and is a delicate organ, the canopy of the five zang and six fu organs. Exogenous cold-damp pathogens invade, usually attacking the Lung first, causing disorder in regulation, leading to stagnation of qi and blood in the eyes, gradually condensing, which inevitably damages the divine paste of the Hand Taiyin Lung Meridian; over time, it develops into diplopia.
Referring to the tongue manifestation: the tongue body is pale red and moist; the coating is white, slippery, and greasy, with a light yellow tint, indicating heavy cold-dampness and pathogens gradually entering the interior. Observing the tightness of the tongue coating further explains deep condensation of cold-dampness. When cold-damp pathogens invade the human body, the Taiyang Meridian bears the brunt. Meanwhile, the Foot Taiyang Bladder Meridian originates at the inner canthus of the eye, ascends to the forehead, intersects at the vertex, and descends behind the head; exogenous pathogens ascend along the meridian to the eyes, gradually condensing, finally obstructing the divine paste of the pupil spirit, resulting in divided vision.
In summary, the etiology and pathogenesis of this case are external injury by cold-damp pathogens, invading via the Taiyang Meridian, internally injuring the divine paste of the Hand Taiyin Lung Meridian, forming condensation. Therefore, the main formula for treating Taiyang Cold Damage was used, modified according to symptoms, to dissipate cold-dampness of Lung Metal, unblock stagnation of meridians, and treat from the root.
[Commentary] Predecessors' application of Mahuang Tang mainly focused on Taiyang Cold Damage. As Ke Qin said: Taiyang governs the exterior of the whole body, diseases generated by tendons, is the master qi of all yang meridians, Taiyang is opening, establishing Mahuang Tang to open it, and all symptoms were eliminated. However, over the years, Master Fan Zhonglin's clinical application of Mahuang Tang has greatly exceeded these conditions. Not only has it broken through the limitations of exogenous cold damage, but it has also often achieved efficacy in many internal miscellaneous diseases. Why use Mahuang Tang for this case unrelated to the eight indications of Mahuang Tang? This requires specific analysis of the formula's compatibility.
Mahuang, slightly bitter in taste and warm in nature, is not only the main herb for inducing sweating, but also "penetrates all viscera, meridians, and collaterals of the whole body," hence praised by predecessors as "opening all blockages"; "regarding its ability to break masses and accumulations, because it can penetrate outside the skin pores and deeply into accumulated phlegm and coagulated blood, herbs that eliminate hardness and resolve stasis can achieve efficacy with its assistance." Now using Mahuang to enter the Hand Taiyin Meridian to drive out cold, search for wind, open blockages, dissipate stasis, expel pathogens outward, and remove the root of disease.
Xingren, slightly warm in nature, sweet and bitter in taste, capable of ascending and descending, thin in qi and thick in flavor, is also an agent entering the Hand Taiyin Meridian. *Ben Cao Qiu Zhi* states: "Xingren has the ability to disperse wind-cold and the power to direct qi downward and relieve asthma." In this case, Xingren is combined with Mahuang to open hair follicles, facilitate qi mechanism, providing an outlet for long-stagnated cold pathogens. Moreover, Xingren can also dissipate nodules and stagnation; thus, its use in this case is not for directing qi downward and relieving asthma, but for dispersing cold pathogens of Taiyin and unblocking stagnation of meridians.
Removing Guizhi prevents enhancing the sweating effect; adding Banxia utilizes its functions of drying Spleen dampness and dissipating stagnation; using Gancao not only gently moderates the middle and assists Mahuang and Xingren, but also acts on both exterior and interior, capable of ascending and descending, unblocking meridians, and benefiting qi and blood.
Predecessors said, using medicine is like using soldiers. "The subtlety of application lies in the mind." Extending this to the application of classical formulas, this "subtlety" probably lies in "learning their methods without being bound by their formulas"!
Taiyin Syndrome Phlegm-Cough
(Chronic Bronchitis)
Li ×, Male, 5 years old. Son of a cadre in Beijing.
[Medical History] Shortly after birth, he suffered from bronchitis. From ages one to four, he was hospitalized for treatment at Beijing XX Traditional Chinese Medicine Hospital successively. Due to lingering non-healing, his body became increasingly weak, frequently catching colds and fevers, with cough worsening repeatedly. He consulted in July 1978. Treated according to Taiyin Syndrome Phlegm-Fluid Cough, cured after two consultations.
[Initial Consultation] The child had been coughing for over a year, with frequent attacks. Sputum was clear and thin; rattling sounds could be heard during sleep. Poor appetite, sallow complexion, emaciated body. Tongue body slightly pale, coating white, slippery, and greasy. Touching both hands, skin was slightly cold. This indicates simultaneous disease of Hand and Foot Taiyin organs, with fluid retention lingering for a long time, affecting the Lung upward, causing chronic cough with phlegm. The treatment principle should be warming and transforming fluids, directing rebellious qi downward, and stopping cough. Using Xiao Ban Xia Jia Fu Ling Tang modified as the main prescription.
Prescription:
Banxia (Pinelliae Rhizoma Preparatum) 10g, Shengjiang (Zingiberis Rhizoma Recens) 10g, Fuling (Poria) 12g, Ziwan (Asteris Radix) 6g, Donghua (Adenophorae Radix) 3g, Gancao (Glycyrrhizae Radix et Rhizoma) 3g. Two doses.
[Second Consultation] After taking two doses of the above prescription, cough decreased, rattling disappeared; however, clear thin sputum was still expectorated. Modify and continue taking the above prescription.
Prescription:
Banxia (Pinelliae Rhizoma Preparatum) 10g, Ganjiang (Zingiberis Rhizoma) 6g, Fuling (Poria) 12g, Gancao (Glycyrrhizae Radix et Rhizoma) 6g.
Follow-up on May 24, 1979: The child's parents said: Cured by Master Fan, there was no recurrence last winter and this spring.
[Differentiation] The child's sallow face, emaciation, poor appetite, cold limbs, and slightly pale tongue body are all signs of Spleen constrained by dampness, loss of healthy transportation, and decline in source transformation. Clear thin sputum, thick white slippery coating are manifestations of internal accumulation of phlegm-dampness affecting the Lung upward. Plus rattling when lying down, clearly indicating cold-fluid refluxing to the throat, stimulated by respiration. As Zhongjing said: "Water in the Lung, expectorates saliva foam," "Water in the Spleen, shortness of breath and heavy body." Thus, the root of this case lies primarily in Hand and Foot Taiyin being trapped by water-dampness, mutually involving each other, making phlegm-fluid cough more stubborn and difficult to cure. For this phlegm-fluid, administering Xiao Ban Xia Jia Fu Ling Tang aims to invigorate yang qi, seeking the root in treating disease. The original formula from *Jin Gui Yao Lue* is used to treat phlegm-fluid cough. Banxia and Shengjiang transform fluid and direct rebellious qi downward; adding Fuling removes water and calms the spirit. Adding Gancao helps Spleen qi, paired with Ganjiang to warm the middle; adding Ziwan and Donghua enhances the effect of eliminating phlegm and directing qi downward. Furthermore, children's viscera are delicate, and vitality is vigorous; once pathogens recede, frequent medication is inappropriate. Hence, instructed to focus on regulating the acquired constitution (Spleen/Stomach), supporting righteous qi to drive away residual pathogens.
[Commentary] Many later commentaries on *Shang Han Lun* believe that among the Six Channels, only the Three Yang and Shaoyin have cough. The reason is that *Shang Han Lun* records more cases of cough in Taiyang, Yangming, and Shaoyang diseases; Shaoyin cough belongs to Shaoyin Yang deficiency or Shaoyin heat transformation, but is not necessarily a manifest sign; moreover, there are no records of cough in the Taiyin and Jueyin chapters. So why treat this phlegm-cough according to Taiyin Syndrome?
First, "The five zang and six fu organs all cause cough," not just the Lung (*Su Wen · Ke Lun Pian*); but cough from the five zang and six fu organs must manifest in the Lung. Diseases of other organs must originate from the Lung or involve the Lung before cough appears. Hence Zhang Jingyue said: "Although cough syndromes are numerous, they are none other than Lung diseases," and Yu Jiayan also believed: "Cough is the fundamental disease of the Lung."
Second, the phlegm-cough in this case is not only constrained by Spleen dampness but also caused by water qi attacking the Lung. Clearly, this is simultaneous disease of Foot Taiyin Spleen and Hand Taiyin Lung.
Third, one might ask, does Shanghan transmission affect the feet but not the hands? How can Foot Taiyin Spleen dampness affect Hand Taiyin Lung? Actually, many later commentators have elaborated on this. For example, *Shang Han Liu Jing Bian Zheng Zhi Fa* states: "The human body is full of qi and blood nourishment, circulating day and night without ceasing, how could it only travel through the feet and not the hands...? If it does not transmit, where does the rebellious qi causing fullness come from? If you say otherwise, Zhongjing provided Guizhi and Mahuang, which are Lung Meridian herbs, is this empty talk!"
Fourth, even if *Shang Han Lun* only mentions cough in the Three Yang and Shaoyin, as modern scholars believe: "*Shang Han Lun* is the general discussion of Zhongjing's works" (*Shang Han Lun Zheng Zhi Lei Quan*). Obviously, how can we demand that Zhongjing must list all Six Channel coughs exhaustively in the "general discussion"!
Taiyin Syndrome Cold-Hiccups
(Gastric Neurosis)
Luo ××, Male, 25 years old. Farmer from a township in Xinjin County, Sichuan.
[Medical History] In winter 1969, he occasionally felt dull pain in the epigastrium, feeling like a mass upon pressing. Constipation without abdominal distension, untreated. The following year, persistent epigastric pain, belching with acid regurgitation, hiccups with qi obstruction, relieved only after belching. Treated as "gastritis" for several years, later diagnosed as "gastric neurosis" at Chengdu XX Hospital, then treated by TCM as "Liver-Stomach Disharmony," with intermittent pain and relief, lingering until winter 1973 when the condition worsened. He consulted in early April 1974.
[Initial Consultation] Emaciated body, lackluster complexion, paroxysmal hiccups, epigastric pain, aggravated by cold. For months, could only eat thin porridge and liquids, vomiting frequently after drinking, spitting clear saliva. Stool initially hard then loose, once every few days. Tongue body slightly pale, coating white and slippery, pulse deep. This is Foot Taiyin Spleen deficiency-cold hiccups. Treatment principle: warm the middle, strengthen the Spleen, move qi, and transform turbidity. Using Lizhong Tang modified as the main prescription.
Prescription:
Dangshen (Codonopsis Radix) 20g, Ganjiang (Zingiberis Rhizoma) 15g, Baizhu (Atractylodis Macrocephalae Rhizoma) 15g, Zhi Gancao (Glycyrrhizae Radix et Rhizoma Preparata) 6g, Fuling (Poria) 20g, Sharen (Amomi Fructus) 12g, Baokou (Amomi Rotundus Fructus) 10g, Banxia (Pinelliae Rhizoma Preparatum) 15g. Three doses.
[Second Consultation] Hiccups decreased, abdominal pain relieved. Continue the above prescription, adding Gong Dingxiang (Caryophylli Flos) and Wuzhuyu (Evodiae Fructus) to warm the Liver, move qi, and stop pain. Take another five doses.
[Third Consultation] Hiccups stopped, appetite increased, stool smooth, spirit improved. Advised to avoid raw and cold foods. Continue taking the above prescription for more than ten doses. Over a month later, the patient reported normal diet and participation in agricultural labor.
Follow-up on July 20, 1979: The patient said, "Now my health is good, physical strength exceeds average laborers."
[Commentary] Regarding hiccups, *Su Wen · Xuan Ming Wu Qi Pian* states: "The Stomach is for rebellious qi and hiccups." *Su Wen · Bao Ming Quan Xing Lun Pian* states: "When disease is deep, the sound is hiccup." *Jin Gui Yao Lue* divides this syndrome into cold hiccups, deficiency-heat, and excess-heat. This case of cold hiccups belongs to Foot Taiyin. It is due to failure of Middle Yang to rise, internal accumulation of cold-dampness, yin-cold fighting with Stomach qi in the Zhongwan, leading to upward rebellion and hiccups. Therefore, one should not simply administer anti-rebellious and descending agents upon seeing rebellious qi. Now using Lizhong Tang to warm the middle, move qi, remove dampness, and transform turbidity, achieving efficacy.
Taiyin Syndrome Epigastric Pain
Zhou ××, Male, 61 years old. Farmer from a township in Pixian County, Sichuan.
[Medical History] Epigastric pain for over twenty years, occasional acid regurgitation and hiccups. In the first few years, medication could relieve it; in the subsequent ten years, it gradually worsened, hurting when hungry. In April 1970, the condition progressively worsened, with continuous pain, poor appetite, weakness, and black stools. Urgently sent to XX Hospital for treatment, diagnosed as "gastric ulcer" and "suspected gastric cancer." Surgery was suggested, but considering hemoglobin was only 4.5 g, advanced age, and frailty, it was decided to change to conservative TCM treatment. He came to Chengdu for consultation.
[Initial Consultation] The patient bent over pressing his abdomen, groaning incessantly; vomiting sour water, frequent hiccups, unable to eat, aversion to cold and cold limbs; pale tongue, white greasy turbid coating. Syndrome belongs to Taiyin deficiency-cold with abundant pathogens. Treatment principle: warm the middle, dispel cold, eliminate stasis, and stop pain. Using Sini Tang modified as the main prescription.
Prescription One:
Zhi Gancao (Glycyrrhizae Radix et Rhizoma Preparata) 30g, Pao Jiang (Zingiberis Rhizoma Preparatum) 30g, Zhi Fupian (Aconiti Lateralis Radix Preparata) 30g (decocted for a long time), Rougui (Cinnamomi Cortex) 10g, Gong Dingxiang (Caryophylli Flos) 6g.
Prescription Two:
Huisheng Dan, taken twice daily, three pills each time, stop when pain ceases.
[Second Consultation] Visited one week later, pain significantly reduced, bleeding stopped, acid regurgitation and hiccups obviously alleviated. Slowly take Gancao Ganjiang Tang modified.
Prescription:
Zhi Gancao (Glycyrrhizae Radix et Rhizoma Preparata) 30g, Pao Jiang (Zingiberis Rhizoma Preparatum) 30g, Rougui (Cinnamomi Cortex) 10g, Sharen (Amomi Fructus) 10g, Baokou (Amomi Rotundus Fructus) 10g, Fuling (Poria) 20g, Baizhu (Atractylodis Macrocephalae Rhizoma) 20g.
After taking medicine and recuperating for over a month, pain disappeared, diet normalized.
Follow-up on July 20, 1979: Over the past few years, there was one mild recurrence, cured after taking Gancao Ganjiang Tang modified, with no further recurrence. Now in his seventies, still able to do some light work.
[Commentary] *Su Wen · Jin Gui Zhen Yan Lun Pian* states: "Regarding yin and yang of the human body, the back is yang, the abdomen is yin." Diseases of the abdomen, classified by location, belong to Taiyin, Shaoyin, and Jueyin. Taiyin is the interior of the Three Yin, its meridian enters the abdomen from the foot, belonging to the Spleen and connecting to the Stomach. Spleen is damp-earth, extreme yin within yin; whenever injured by cold-dampness, the Spleen is affected first. And it is exterior-interior paired with the Yangming Stomach; Spleen deficiency leads to Stomach deficiency, meaning what is called "Stomach family not solid" is Taiyin disease. This case clearly belongs to Taiyin deficiency-cold with abundant pathogens. Always grasping the main symptoms of Taiyin; for warming the interior of Taiyin, Sini Tang category is suitable, so initially administered Sini Tang modified, combined with moving qi, unblocking collaterals, dissipating stagnation, and resolving stasis for treatment, and the disease was cured.
Taiyin Syndrome Edema
Yu ××, Male, 41 years old. Cadre in Beijing.
[Medical History] Generalized edema for ten years, worsening in the recent year. During working abroad, he suffered from malaria, cured after taking Quinine for half a year. After returning, in 1969, he worked in humid and muggy tunnels in the southwest mountains for over a year. Gradually felt whole-body fatigue, heavy limbs, decreased appetite, and swelling began in the face and lower limbs. In early 1978, the condition developed; upper limbs numb and unable to write, lower limb joints cold and painful, generalized edema significantly worsened. Dry mouth, desire for large amounts of hot drinks. Scanty urination. Sometimes difficult to pass drops, weight increased from 140 jin to 174 jin. Diagnosed as "prostatitis" at Beijing XX Hospital. But the cause of edema remained unexplained.
[Initial Consultation] August 4, 1978. Due to participating in summer harvest a week prior, edema worsened. Especially severe in face and limbs, pitting upon pressure. Fatigue, poor appetite, abdominal fullness, preference for hot drinks, lower back pain, impotence, scanty urination. Dark, lusterless face, pale tongue, white slippery greasy coating. This is caused by Taiyin Spleen deficiency and dampness stagnation. Initially due to internal constraint of damp-heat, later injuring Spleen Yang, thus fluid retention; and injury to Taiyin further affected Foot Shaoyin Kidney. Treatment principle: warm Kidney, strengthen Spleen, dry dampness, and promote diuresis. Using Lizhong Tang modified as the main prescription.
Prescription:
Zhi Fupian (Aconiti Lateralis Radix Preparata) 30g (decocted for a long time), Baizhu (Atractylodis Macrocephalae Rhizoma) 15g, Ganjiang (Zingiberis Rhizoma) 15g, Zhi Gancao (Glycyrrhizae Radix et Rhizoma Preparata) 12g, Fuling (Poria) 12g, Rougui (Cinnamomi Cortex) 6g (dissolved in decoction).
[Second Consultation] August 18. After taking ten doses of the above prescription, edema reduced, dizziness and fatigue improved. Continue taking the original prescription for twenty doses.
[Third Consultation] September 18. Most of the generalized edema subsided, appetite increased, urination smoother than before. Add Guizhi (Cinnamomi Ramulus) 10g and Shengjiang Pi (Zingiberis Pericarpium) 60g to the above prescription to enhance qi transformation and water-moving power. Continue taking fifteen doses.
[Fourth Consultation] October 8. Edema basically subsided, all symptoms obviously improved. To consolidate curative effect, slowly take Lizhong Wan modified.
Prescription:
Dangshen (Codonopsis Radix) 30g, Chao Baizhu (Atractylodis Macrocephalae Rhizoma Stir-fried) 60g, Ganjiang (Zingiberis Rhizoma) 60g, Zhi Gancao (Glycyrrhizae Radix et Rhizoma Preparata) 30g, Zhi Fupian (Aconiti Lateralis Radix Preparata) 120g, Fuling (Poria) 60g, Rougui (Cinnamomi Cortex) 10g. Ten doses.
Grind into fine powder, make pills with water. Take twice daily, 10g each time.
Follow-up on May 15, 1979: After taking pill medicine for over four months, the disease was cured, weight dropped from over 170 jin to over 140 jin.
[Commentary] *Su Wen · Zhi Zhen Yao Da Lun Pian* states: "All dampness, swelling, and fullness belong to the Spleen." Spleen is the organ of extreme yin, and Shaoyin is the mother of Taiyin. Thus, if Kidney does not govern the five fluids, and Spleen does not transport water, swelling and fullness arise. This case successively used Lizhong Tang plus Fuzi, etc., to warm and tonify Taiyin and Shaoyin; yang qi rose, yin mist dispersed, qi transformation proceeded, water-dampness dissipated, thus the disease was cured.
Taiyin Syndrome Diarrhea
(Chronic Enteritis)
Liu ××, Female, 26 years old. Cadre in Beijing.
[Medical History] Since childhood, chronic diarrhea, lingering for over twenty years, diagnosed as chronic enteritis at Beijing XX Hospital. Long-term treatment with Chinese and Western medicines failed to cure. He consulted in early August 1978. Treated according to Taiyin deficiency-cold syndrome diarrhea, cured after three consultations.