胸痛2(冠心病)
李某，男，56岁
于1992年12月2日初诊
自今年8月开始，胸前区憋闷疼痛经常发作。西医以其心图有改变诊断为心肌梗塞。中药、西药，从未中断，闻赵老之名+特来求治。现仍胸闷疼痛不舒，心悸气短，头晕体倦，心烦急躁，梦多失眠，面色无华，舌红步苔，脉濡缓。血压180／l20毫米汞柱。证属气机不畅，心血瘀阻。治宜疏调气机，活血通络方法。藿香10克，佩兰10克，蝉衣6克，僵蚕10克，片姜黄6克，大黄1克，竹茹6克，炒枳壳6克，赤芍10克，丹参10克，川楝子6克。服药7剂，胸闷渐舒，头晕见轻，余症好转，血压120／90毫米汞柱。但见口干而渴，心悸气短。改用益气养阴，活血通络方法。药用：蝉衣6克，僵蚕10克，片姜黄6克，沙参10克，麦冬10克，五味子10克，炙甘草10克，丹参10克，赤芍10克，杏仁10克，焦三仙各10克，香附10克。服药20余剂，精神转佳，心情舒畅，胸痛未作，血压稳定，心电图复查：大致正常心电固。又以此方加减服药月余，未再复发。
[按]；冠心病之心绞痛或心肌梗塞，属于祖国医“胸痹”、“真心痛”的范畴。其病多因思虑过度，劳伤心脾；饮食不节，疲饮内生}情志不畅，肝郁阴伤等所致。但其根本病机为气机不畅，心血瘀阻所为。在治疗上赵师非常强调药物治疗同时，配合体育锻炼，节制饮食与精神调摄等综合调理，才能使病人早是康复。此病例以疏调气机为先导，活血通络、益气养阴为基本治法，疗效满意。
嗜 睡
吕某，男，45岁，1992年7月13日初诊
自述春节期间酗酒后嗜睡，现每日昏昏欲睡，时有低热，反应迟钝，面色暗浊，大便不畅，舌红苔白而腻，脉{；Ii}数。证属湿阻热郁，气机不畅。治以芳香宣化，宣展气机。方药：蝉衣、片姜黄、炒山栀、前胡、苏叶各6克，僵蚕、淡豆豉、藿香、佩兰、大腹皮、槟榔各10克，大黄1克，服药7剂后，嗜睡减轻，发热未作，再以上方去藿香、前胡，加防风6克，白蔻仁4克，服药20余剂，嗜睡愈，精神爽，饮食二便如常。
[按]，酗酒后出现嗜睡，必与嗜酒相关。酒乃谷物酿造而成，其性湿热大盛。凡嗜酒之人多湿热壅盛，湿热蒙闭，气机不畅，神明失聪，故昏昏欲睡安。今面浊，舌红苔白腻，脉濡数，皆是湿热之征。治用升降散疏调气机，加前胡、苏叶宣展肺气，气化则湿邪亦化；藿香、佩兰芳香化湿，大腹皮、槟榔、淡豆豉发越陈腐，疏利三焦。服之气机展，三焦畅，湿热去，则热退神清矣。
又接，上案为嗜睡，此案为失眠，证似相反，而皆以升降散加减取效，以其二证虽异，然气机郁滞则一，故皆用疏调气机，复其升降之法，随证加减，自可获效。
失眠1(神经衰弱)
佟某，男，46岁
1992年7月6日初诊
患失眠症20余年，每晚需服安眠药方能入睡。现面色发青，头晕目眩，心烦急躁，夜寐梦多，纳食不香，舌红苔白且干，脉弦滑且数。证属肝胆郁热，气机阻滞，热扰心神。治以泄肝热，调气机以求寐安。方药：蝉衣、片姜黄、柴胡、黄芩、川楝子、枳壳、竹茹各6克，僵蚕、焦三仙、水红花子各10克，大黄1克。服药3剂失眠好转，服10剂后，不服安眠药亦能入睡。又以原方加减调治30余剂，睡眠基本正常。
[按]：失眠一症，方书多责之于心，习用枣、柏仁、合欢、夜交藤等药，养心安神以济安寐。此案患者失眠20余年，诸法尽试，不能奏效，是治未对症也。其失眠伴心烦急躁、夜寐梦多，是肝经郁热之象，其面青、眩晕亦为肝之病状，脉弦滑且数，更是肝热之征，何以舍肝而他求耶?故治以泄肝热，调气机求其寐安。用升降散加柴胡、黄芩、川楝子泄其肝热，加焦三仙、水红花子疏调胃肠，再加竹茹、枳壳，即合入温胆汤意，故能三剂即效，一月痊愈。失眠一症，先生多从肝调治，用升降散加减，每每奏效甚捷。其辨证眼目，在于心烦急躁、夜寐梦多、脉象弦数，舌质红绛，凡见此脉症，俱作肝经郁热，治无不验。
失眠2(神经衰弱)
徐某某，女，42岁
初诊
患者做财会工作20余年如一日，恪尽职守，颇得好评，近破格晋升中级职称。因领导委以重任，致有人不满，散布流言。心中因此郁闷。加之工作压力颇重，遂致夜不能寐，病已月余，以致不能坚持正常工作。形容憔瘁，疲惫不堪。心烦急躁，时欲发怒，又时欲悲泣。诊脉弦细滑数，重按有力，舌红苔白浮黄，大便干结小溲色黄。此肝胆郁火不得发越，内扰心神，魂魄俱不安宁。治宣疏调气机，宣泄木火之郁。用升降散加减。
蝉衣6克，僵蚕10克，片姜黄6克，太黄3克，柴胡6克，黄芩10克，川楝子10克，菖蒲10克，钩藤10克(后下)，七付
二诊
药后大便畅行，心烦易怒俱减，夜晚已能安睡3至4小时。患者精神状态较前判若两人。诊脉仍弦滑数，舌红苔白，郁热尚未全清，继用升降散方法。
蝉衣6克，僵蚕10克，片姜黄6克，大黄3克，柴胡6克，黄芩10克，川楝子10克，枳壳6克，焦三仙各10克，七付
三诊
患者心情显著好转，入夜已能安然入睡，食欲较前大增，面色已显润泽。意欲上班，恢复工作。但思之仍不免心有余悸，唯恐上班后再导致失眠症发生。诊脉弦滑且数，舌红苔薄白。仍宜前法进退，并嘱其每日坚持散步锻炼，饮食当忌辛辣厚味。并注意思想开朗，勿以小事为意。
柴胡6克，黄芩10克，川楝子10克，丹参10克，茜草10克，赤白芍各10克，蝉衣6克，僵蚕10克，片姜黄6克，焦三仙各10克，七付
[按]：此例患者由于工作压力不堪重负，致精神高度紧张，夜不能寐，属精神情志因素所为，故责之于肝经郁热不得宣散，术旺则火生，而成木火同盛，神魂不安。故选用杨栗山升降散之善能疏调气机解郁散结者，合疏肝泄热之品组方，以治其病本。药对其症，故能七剂而获显效。真不亚于西药之镇静剂也。按失眠一症，多从心神不安，心肾不交辨之，动辄堆砌大队安神之品，如酸枣仁、茯神木、远志，合欢皮、珍珠母之类。此所谓对症下药，非辨证施治也。先生此案，不用一味安神之药，而收安神定志之教，中医辨证论治之特色，于斯见矣。
失眠3(神经衰弱)
孙某某，女，76岁
初诊
因职业关系，用脑过度，年轻时即患神经衰弱，经常失眠。年老之后，渐渐严重。经常心慌怔忡，彻夜不眠，心烦不安，每晚必服镇静剂方能入睡。大便干结，常服麻仁丸始通。舌体瘦小，舌质红绛且干，脉象弦细小滑。此因思虑太过，耗伤心脾，年老之后，脏阴又亏，郁热内蕴。值此阴亏火旺之时，先用黄连阿胶鸡子黄汤，滋阴降火，泄南补北，交通心肾。
生熟地各20克，川黄连3克，阿胶12克分两次烊化兑入，旱莲草12克，女贞子10克，鸡子黄2枚，打碎搅匀用煎成之药液乘热兑入搅匀温服。七付
二诊
药后心烦渐减，夜间已能入睡片刻，易醒心惊，神疲乏力，头晕健忘，纳食欠佳。舌缂已减，质红少苔，脉仍弦细且数。老年脏亏已久，阴阳俱衰，气血两亏，难求速效，宜用膏滋调养，为求本之法。为拟补心安神膏治之。
黄芪60克，党参30克，沙参60克，生地60克，当归60克，赤芍60克，白芍60克，阿胶30克，黄芩20克，川黄连10克，女贞子30克，旱莲草60克，金樱子60克，五味子60克，远志肉30克，生牡蛎80克，珍珠母80克，焦麦芽60克，鸡内金60克，桑椹60克，鲜葡萄2500克，鲜苹果400克(切片)，蜂蜜150克，冰糖60克。
制法：上药除阿胶、葡萄、苹果、蜂蜜、冰糖外，余药水煎二次，每次约2小时，将两次所煎得药蔽混合后加入鲜葡萄、鲜苹果，再煎至葡萄、苹果熔化，滤去核渣，将药液置文火上浓缩，同时加入蜂蜜、冰糖，并将阿胶另捣烊化后兑入，徐徐收膏，贮于瓶中。每日早晚各服2匙，开水冲服。
患者依法制药服用后，身体日渐好转，精力渐增，纳食增加，二便已调，心慌怔忡皆愈，多年的顽固失眠也显著好转，去掉了赖以安眠的镇静药。
[按]：患者年高体衰，久患失眠，并见诸般虚弱症候，乃脏阴久亏，无以滋荣。初诊用泻南补北方法，虽获小敏，终非治本方法，必用膏滋荣养，滋其化源，为高年脏腑虚损之调养妙法。本方配伍全面，适用于劳倦思虑太过而致心脾两虚的失眠症；或伴见脾虚食滞者，可见心悸健忘，肢倦神疲，纳食欠佳，面色少华，大便秘结，舌红或淡，脉细弱等症。方中黄芪、党参健脾益气；女贞于、旱莲草、金樱子、桑椹子、五味子滋补肝肾之阴，水足则心火不亢而下交于肾水，则成水火既济}当归、赤白芍、川芎、阿胶养血即所以养心；生牡蛎，珍珠母重镇安神；沙参、生地、鲜葡萄、鲜苹果、蜂蜜生津增液，濡润大肠，对老年血虚便秘之人，尤为适宜。“胃不和则卧不安。”方中又在大量滋补药中加入焦麦芽、鸡内金、远志、黄连、黄芩，一则可防补药滋腻碍胃，二则可消胃中积滞，疏理肠腑，垒方有健脾安神，养血宁心之功，临床对用脑过度，失眠，食欲不佳，大便秘结的患者颇有效验。
耳聋1(神经性耳聋)
陈某，男，45岁，于1992年11月29日初诊。患者自3个月前因情志变化突然耳聋，经多方医治不效，并有加重趋势，特请赵老诊治。现耳聋耳鸣，头眩晕，心烦急躁，夜寐不安，大便偏干，舌红苔黄，脉弦滑且数，血压180／l20毫米汞柱。证属肝胆郁热上蒸，升降失常，治拟清泻肝胆郁热，疏调升降方法。
药用；蝉衣6克，僵蚕10克，片姜黄6克，旋复花10克，代赭石10克，珍珠母30克，生牡蛎30克，青陈皮各10克，炒山栀6克，大黄1克，杏仁10克。
二诊：12月5日
服药7剂，睡眠好转，头晕见轻，心烦急躁缓解，大便偏稀，血压降至130／90毫米汞柱，仍耳聋。仍以前法进退。药用：柴胡6克，川楝子6克，蝉衣6克，僵蚕10克，片姜黄16克，晚蚕砂10克，旋复花10克，代赭石10克，珍珠母30克，大黄O.5克，菖蒲10克，郁金10克。
三诊：12月12日
服药7剂，耳聋见轻，大便正常，头晕心烦急消失，精神好转，舌红苔白，脉濡滑且数，改用填补下元方法。药用，生熟地各10克，山萸肉10克，山药10克，郁金10克，菖蒲10克，珍珠母30克，丹参10克，川楝子6克，赤芍10克，焦三仙各10
克，旋复花10克，炒枳壳6克。
四诊：1 2月17日
服药7剂，耳聋大减，又服10余剂，听力恢复正常，耳鸣消失。
[按]此病案患者因情志刺激突然耳聋，曾服多种中药，均无效。后请赵老诊治，赵师根据患者临床症状辨为肝胆郁热上蒸，上扰清窍，气机升降失常。其治先用清泻肝胆郁热，疏调升降方法，后用填补下元方法，使耳聋病除。
耳聋2(神经性耳聋)
沈某，男，53岁
1991年8月25日初诊
自本月初去旅游，天气炎热，汗出较多，从第三天开始自觉发冷发热，两耳不聪，头目不清，曾服用“藿香正气水”无效，继而耳聋失听，西医诊断为病毒感染后遗症，神经性耳聋。刻诊时除耳聋外，伴有低热不退，头目眩晕，身重乏力，口干渴，不甚饮水，心烦急躁，舌质红，苔黄滑，脉滑数。证属暑湿郁热未尽，气机不畅。先以宣畅气机，清化湿热为法。药用藿香10克(后下)，佩兰10克(后下)，杏仁10克(后下)，枇杷叶10克，竹茹6克，炒枳壳6克，晚蚕砂10克，菖蒲10克，郁金10克，茅芦根各10克，焦三仙各10克。服药7剂，热退，耳聋见轻。后以此方加炒山栀6克，又服7剂，耳聋大减，头晕乏力消失，唯口干欲饮，舌红苔少，改用益气养阴方法。药用沙参10克，麦冬10克，黄芪20克，五味子10克，菖蒲10克，郁金10克，生牡蛎30克，生石决明30克，竹茹6克，炒枳壳6克，焦三仙各10克。服药7剂，精神焕发，心情舒畅，饮食二便正常，耳聋消失，无其他不适。又以上方服药10余剂而告痊愈。
[按]：此病案乃暑湿郁热所致耳聋。暑为火热之邪，人受之，最易伤阴伤气。湿乃重浊之邪，暑热挟湿，气机被困，热蒸湿动。秽浊之气上泛，阻遏清阳，清窍不利，轻则头目眩晕，重则神昏耳聋。赵师先宣开肺气，宣畅气机，暑湿郁热去。邪气去再议益气养阴，切不可过早投朴，否则可致闭门留寇之弊。
毒 痫
高某，男。7岁
1988年11月1日初诊
2年前因脑震荡愈后遗癫痫症，每周发作2至3次，发作时两目上吊，口吐涎沫，四肢抽搐，有时发出尖叫声，即而昏迷不知人事，待3至5分钟后自醒，醒后如常人。经多方治疗，疗效不明显。2年来一直靠服西药维持。诊见形体消瘦，面色发青，心烦急躁，夜寐不安，大便干结如球状。舌红苔黄且干，脉弦滑数。
辨证：肝经郁热，脉络受阻。
治法：活血化瘀，清泻肝热。
胸痛2（冠心病）
李某，男，56岁
于1992年12月2日初诊
从今年8月开始，胸前区憋闷疼痛经常发作。西医以其心电图有改变诊断为心肌梗死。中药、西药，从未中断，听闻赵老的名声，特意前来求治。现仍胸闷疼痛不舒，心悸气短，头晕体倦，心烦急躁，多梦失眠，面色无光泽，舌红少苔，脉濡缓。血压180/120毫米汞柱。证属气机不畅，心血瘀阻。治宜疏调气机，活血通络方法。藿香10克，佩兰10克，蝉衣6克，僵蚕10克，片姜黄6克，大黄1克，竹茹6克，炒枳壳6克，赤芍10克，丹参10克，川楝子6克。服药7剂，胸闷渐舒，头晕见轻，余症好转，血压120/90毫米汞柱。但见口干而渴，心悸气短。改用益气养阴，活血通络方法。药用：蝉衣6克，僵蚕10克，片姜黄6克，沙参10克，麦冬10克，五味子10克，炙甘草10克，丹参10克，赤芍10克，杏仁10克，焦三仙各10克，香附10克。服药20余剂，精神转佳，心情舒畅，胸痛未作，血压稳定，心电图复查：大致正常心电固。又以此方加减服药月余，未再复发。
[按]：冠心病之心绞痛或心肌梗死，属于祖国医“胸痹”、“真心痛”的范畴。其病多因思虑过度，劳伤心脾；饮食不节，痰饮内生；情志不畅，肝郁阴伤等所致。但其根本病机为气机不畅，心血瘀阻所为。在治疗上赵师非常强调药物治疗同时，配合体育锻炼，节制饮食与精神调摄等综合调理，才能使病人早日康复。此病例以疏调气机为先导，活血通络、益气养阴为基本治法，疗效满意。
嗜 睡
吕某，男，45岁，1992年7月13日初诊
自述春节期间酗酒后嗜睡，现每日昏昏欲睡，时有低热，反应迟钝，面色暗浊，大便不畅，舌红苔白而腻，脉濡数。证属湿阻热郁，气机不畅。治以芳香宣化，宣展气机。方药：蝉衣、片姜黄、炒山栀、前胡、苏叶各6克，僵蚕、淡豆豉、藿香、佩兰、大腹皮、槟榔各10克，大黄1克，服药7剂后，嗜睡减轻，发热未作，再以上方去藿香、前胡，加防风6克，白蔻仁4克，服药20余剂，嗜睡愈，精神爽，饮食二便如常。
[按]：酗酒后出现嗜睡，必与嗜酒相关。酒乃谷物酿造而成，其性湿热大盛。凡嗜酒之人多湿热壅盛，湿热蒙闭，气机不畅，神明失聪，故昏昏欲睡安。今面浊，舌红苔白腻，脉濡数，皆是湿热之征。治用升降散疏调气机，加前胡、苏叶宣展肺气，气化则湿邪亦化；藿香、佩兰芳香化湿，大腹皮、槟榔、淡豆豉发越陈腐，疏利三焦。服之气机展，三焦畅，湿热去，则热退神清矣。
又接，上案为嗜睡，此案为失眠，证似相反，而皆以升降散加减取效，以其二证虽异，然气机郁滞则一，故皆用疏调气机，复其升降之法，随证加减，自可获效。
失眠1（神经衰弱）
佟某，男，46岁
1992年7月6日初诊
患失眠症20余年，每晚需服安眠药方能入睡。现面色发青，头晕目眩，心烦急躁，夜寐梦多，纳食不香，舌红苔白且干，脉弦滑且数。证属肝胆郁热，气机阻滞，热扰心神。治以泄肝热，调气机以求寐安。方药：蝉衣、片姜黄、柴胡、黄芩、川楝子、枳壳、竹茹各6克，僵蚕、焦三仙、水红花子各10克，大黄1克。服药3剂失眠好转，服10剂后，不服安眠药亦能入睡。又以原方加减调治30余剂，睡眠基本正常。
[按]：失眠一症，方书多责之于心，习用枣仁、柏子仁、合欢、夜交藤等药，养心安神以济安寐。此案患者失眠20余年，诸法尽试，不能奏效，是治未对症也。其失眠伴心烦急躁、夜寐梦多，是肝经郁热之象，其面青、眩晕亦为肝之病状，脉弦滑且数，更是肝热之征，何以舍肝而他求耶？故治以泄肝热，调气机求其寐安。用升降散加柴胡、黄芩、川楝子泄其肝热，加焦三仙、水红花子疏调胃肠，再加竹茹、枳壳，即合入温胆汤意，故能三剂即效，一月痊愈。失眠一症，先生多从肝调治，用升降散加减，每每奏效甚捷。其辨证眼目，在于心烦急躁、夜寐梦多、脉象弦数，舌质红绛，凡见此脉症，俱作肝经郁热，治无不验。
失眠2（神经衰弱）
徐某某，女，42岁
初诊
患者做财会工作20余年如一日，恪尽职守，颇得好评，近破格晋升中级职称。因领导委以重任，致有人不满，散布流言。心中因此郁闷。加之工作压力颇重，遂致夜不能寐，病已月余，以致不能坚持正常工作。形容憔悴，疲惫不堪。心烦急躁，时欲发怒，又时欲悲泣。诊脉弦细滑数，重按有力，舌红苔白浮黄，大便干结小溲色黄。此肝胆郁火不得发越，内扰心神，魂魄俱不安宁。治宜疏调气机，宣泄木火之郁。用升降散加减。
蝉衣6克，僵蚕10克，片姜黄6克，大黄3克，柴胡6克，黄芩10克，川楝子10克，菖蒲10克，钩藤10克（后下），七付
二诊
药后大便畅行，心烦易怒俱减，夜晚已能安睡3至4小时。患者精神状态较前判若两人。诊脉仍弦滑数，舌红苔白，郁热尚未全清，继用升降散方法。
蝉衣6克，僵蚕10克，片姜黄6克，大黄3克，柴胡6克，黄芩10克，川楝子10克，枳壳6克，焦三仙各10克，七付
三诊
患者心情显著好转，入夜已能安然入睡，食欲较前大增，面色已显润泽。意欲上班，恢复工作。但思之仍不免心有余悸，唯恐上班后再导致失眠症发生。诊脉弦滑且数，舌红苔薄白。仍宜前法进退，并嘱其每日坚持散步锻炼，饮食当忌辛辣厚味。并注意思想开朗，勿以小事为意。
柴胡6克，黄芩10克，川楝子10克，丹参10克，茜草10克，赤白芍各10克，蝉衣6克，僵蚕10克，片姜黄6克，焦三仙各10克，七付
[按]：此例患者由于工作压力不堪重负，致精神高度紧张，夜不能寐，属精神情志因素所为，故责之于肝经郁热不得宣散，木旺则火生，而成木火同盛，神魂不安。故选用杨栗山升降散之善能疏调气机解郁散结者，合疏肝泄热之品组方，以治其病本。药对其症，故能七剂而获显效。真不亚于西药之镇静剂也。按失眠一症，多从心神不安，心肾不交辨之，动辄堆砌大队安神之品，如酸枣仁、茯神木、远志，合欢皮、珍珠母之类。此所谓对症下药，非辨证施治也。先生此案，不用一味安神之药，而收安神定志之效，中医辨证论治之特色，于斯见矣。
失眠3（神经衰弱）
孙某某，女，76岁
初诊
因职业关系，用脑过度，年轻时即患神经衰弱，经常失眠。年老之后，渐渐严重。经常心慌怔忡，彻夜不眠，心烦不安，每晚必服镇静剂方能入睡。大便干结，常服麻仁丸始通。舌体瘦小，舌质红绛且干，脉象弦细小滑。此因思虑太过，耗伤心脾，年老之后，脏阴又亏，郁热内蕴。值此阴亏火旺之时，先用黄连阿胶鸡子黄汤，滋阴降火，泄南补北，交通心肾。
生熟地各20克，川黄连3克，阿胶12克分两次烊化兑入，旱莲草12克，女贞子10克，鸡子黄2枚，打碎搅匀用煎成之药液乘热兑入搅匀温服。七付
二诊
药后心烦渐减，夜间已能入睡片刻，易醒心惊，神疲乏力，头晕健忘，纳食欠佳。舌苔已减，质红少苔，脉仍弦细且数。老年脏亏已久，阴阳俱衰，气血两亏，难求速效，宜用膏滋调养，为求本之法。为拟补心安神膏治之。
黄芪60克，党参30克，沙参60克，生地60克，当归60克，赤芍60克，白芍60克，阿胶30克，黄芩20克，川黄连10克，女贞子30克，旱莲草60克，金樱子60克，五味子60克，远志肉30克，生牡蛎80克，珍珠母80克，焦麦芽60克，鸡内金60克，桑椹60克，鲜葡萄2500克，鲜苹果400克（切片），蜂蜜150克，冰糖60克。
制法：上药除阿胶、葡萄、苹果、蜂蜜、冰糖外，余药水煎二次，每次约2小时，将两次所煎得药液混合后加入鲜葡萄、鲜苹果，再煎至葡萄、苹果熔化，滤去核渣，将药液置文火上浓缩，同时加入蜂蜜、冰糖，并将阿胶另捣烊化后兑入，徐徐收膏，贮于瓶中。每日早晚各服2匙，开水冲服。
患者依法制药服用后，身体日渐好转，精力渐增，纳食增加，二便已调，心慌怔忡皆愈，多年的顽固失眠也显著好转，去掉了赖以安眠的镇静药。
[按]：患者年高体衰，久患失眠，并见诸般虚弱症候，乃脏阴久亏，无以滋荣。初诊用泻南补北方法，虽获小效，终非治本方法，必用膏滋荣养，滋其化源，为高年脏腑虚损之调养妙法。本方配伍全面，适用于劳倦思虑太过而致心脾两虚的失眠症；或伴见脾虚食滞者，可见心悸健忘，肢倦神疲，纳食欠佳，面色少华，大便秘结，舌红或淡，脉细弱等症。方中黄芪、党参健脾益气；女贞子、旱莲草、金樱子、桑椹子、五味子滋补肝肾之阴，水足则心火不亢而下交于肾水，则成水火既济；当归、赤白芍、川芎、阿胶养血即所以养心；生牡蛎，珍珠母重镇安神；沙参、生地、鲜葡萄、鲜苹果、蜂蜜生津增液，濡润大肠，对老年血虚便秘之人，尤为适宜。“胃不和则卧不安。”方中又在大量滋补药中加入焦麦芽、鸡内金、远志、黄连、黄芩，一则可防补药滋腻碍胃，二则可消胃中积滞，疏理肠腑，全方有健脾安神，养血宁心之功，临床对用脑过度，失眠，食欲不佳，大便秘结的患者颇有效验。
耳聋1（神经性耳聋）
陈某，男，45岁，于1992年11月29日初诊。患者自3个月前因情志变化突然耳聋，经多方医治不效，并有加重趋势，特请赵老诊治。现耳聋耳鸣，头眩晕，心烦急躁，夜寐不安，大便偏干，舌红苔黄，脉弦滑且数，血压180/120毫米汞柱。证属肝胆郁热上蒸，升降失常，治拟清泻肝胆郁热，疏调升降方法。
药用：蝉衣6克，僵蚕10克，片姜黄6克，旋复花10克，代赭石10克，珍珠母30克，生牡蛎30克，青陈皮各10克，炒山栀6克，大黄1克，杏仁10克。
二诊：12月5日
服药7剂，睡眠好转，头晕见轻，心烦急躁缓解，大便偏稀，血压降至130/90毫米汞柱，仍耳聋。仍以前法进退。药用：柴胡6克，川楝子6克，蝉衣6克，僵蚕10克，片姜黄10克，晚蚕砂10克，旋复花10克，代赭石10克，珍珠母30克，大黄0.5克，菖蒲10克，郁金10克。
三诊：12月12日
服药7剂，耳聋见轻，大便正常，头晕心烦急消失，精神好转，舌红苔白，脉濡滑且数，改用填补下元方法。药用：生熟地各10克，山萸肉10克，山药10克，郁金10克，菖蒲10克，珍珠母30克，丹参10克，川楝子6克，赤芍10克，焦三仙各10克，旋复花10克，炒枳壳6克。
四诊：12月17日
服药7剂，耳聋大减，又服10余剂，听力恢复正常，耳鸣消失。
[按]此病案患者因情志刺激突然耳聋，曾服多种中药，均无效。后请赵老诊治，赵师根据患者临床症状辨为肝胆郁热上蒸，上扰清窍，气机升降失常。其治先用清泻肝胆郁热，疏调升降方法，后用填补下元方法，使耳聋病除。
耳聋2（神经性耳聋）
沈某，男，53岁
1991年8月25日初诊
自本月初去旅游，天气炎热，汗出较多，从第三天开始自觉发冷发热，两耳不聪，头目不清，曾服用“藿香正气水”无效，继而耳聋失听，西医诊断为病毒感染后遗症，神经性耳聋。刻诊时除耳聋外，伴有低热不退，头目眩晕，身重乏力，口干渴，不甚饮水，心烦急躁，舌质红，苔黄滑，脉滑数。证属暑湿郁热未尽，气机不畅。先以宣畅气机，清化湿热为法。药用藿香10克（后下），佩兰10克（后下），杏仁10克（后下），枇杷叶10克，竹茹6克，炒枳壳6克，晚蚕砂10克，菖蒲10克，郁金10克，茅芦根各10克，焦三仙各10克。服药7剂，热退，耳聋见轻。后以此方加炒山栀6克，又服7剂，耳聋大减，头晕乏力消失，唯口干欲饮，舌红苔少，改用益气养阴方法。药用沙参10克，麦冬10克，黄芪20克，五味子10克，菖蒲10克，郁金10克，生牡蛎30克，生石决明30克，竹茹6克，炒枳壳6克，焦三仙各10克。服药7剂，精神焕发，心情舒畅，饮食二便正常，耳聋消失，无其他不适。又以上方服药10余剂而告痊愈。
[按]：此病案乃暑湿郁热所致耳聋。暑为火热之邪，人受之，最易伤阴伤气。湿乃重浊之邪，暑热挟湿，气机被困，热蒸湿动。秽浊之气上泛，阻遏清阳，清窍不利，轻则头目眩晕，重则神昏耳聋。赵师先宣开肺气，宣畅气机，暑湿郁热去。邪气去再议益气养阴，切不可过早投补，否则可致闭门留寇之弊。
毒 痫
高某，男。7岁
1988年11月1日初诊
2年前因脑震荡愈后遗癫痫症，每周发作2至3次，发作时两目上吊，口吐涎沫，四肢抽搐，有时发出尖叫声，即而昏迷不知人事，待3至5分钟后自醒，醒后如常人。经多方治疗，疗效不明显。2年来一直靠服西药维持。诊见形体消瘦，面色发青，心烦急躁，夜寐不安，大便干结如球状。舌红苔黄且干，脉弦滑数。
辨证：肝经郁热，脉络受阻。
治法：活血化瘀，清泻肝热。
Chest Pain 2 (Coronary Heart Disease)
Patient Li, Male, 56 years old
First consultation on December 2, 1992
Since August of this year, frequent episodes of oppression and pain in the precordial region have occurred. Western medicine diagnosed myocardial infarction based on changes in the electrocardiogram. Neither Chinese nor Western medicines were ever interrupted. Hearing of Master Zhao's reputation, he specifically came to seek treatment. Currently, there is still chest tightness and painful discomfort, palpitations, shortness of breath, dizziness, fatigue, irritability, excessive dreaming, insomnia, and a sallow complexion. The tongue is red with little coating, and the pulse is soft and slow. Blood pressure is 180/120 mmHg. The syndrome belongs to stagnation of Qi mechanism and blood stasis obstructing the heart vessels. The treatment should focus on regulating the Qi mechanism and promoting blood circulation to unblock collaterals. Huoxiang (Agastache Herba) 10g, Peilan (Eupatorium Herba) 10g, Chan Yi (Cicada Slough) 6g, Jiang Can (Bombyx Batryticatus) 10g, Pian Jiang Huang (Curcuma Longae Rhizoma) 6g, Da Huang (Rhei Radix et Rhizoma) 1g, Zhu Ru (Bambusae Caulis in Taeniam) 6g, Chao Zhi Qiao (Aurantii Fructus Preparatus) 6g, Chi Shao (Paeoniae Radix Rubra) 10g, Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma) 10g, Chuan Lian Zi (Meliae Fructus) 6g. After taking 7 doses, chest tightness gradually relieved, dizziness lightened, and other symptoms improved; blood pressure dropped to 120/90 mmHg. However, dry mouth with thirst and palpitations with shortness of breath remained. The method was changed to tonifying Qi and nourishing Yin, while promoting blood circulation to unblock collaterals. Medicines used: Chan Yi (Cicada Slough) 6g, Jiang Can (Bombyx Batryticatus) 10g, Pian Jiang Huang (Curcuma Longae Rhizoma) 6g, Sha Shen (Glehniae Radix or Adenophorae Radix) 10g, Mai Dong (Ophiopogonis Tuber) 10g, Wu Wei Zi (Schisandrae Chinensis Fructus) 10g, Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Preparata) 10g, Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma) 10g, Chi Shao (Paeoniae Radix Rubra) 10g, Xing Ren (Armeniacae Semen Amarum) 10g, Jiao San Xian (Charred Fructus Crataegi, Charred Fructus Chaenomelis, Charred Semen Ziziphi Spinosae) 10g each, Xiang Fu (Cyperi Rhizoma) 10g. After taking more than 20 doses, spirit improved, mood became pleasant, chest pain did not recur, blood pressure stabilized, and follow-up electrocardiogram showed roughly normal electrical patterns. Taking this formula with modifications for over a month, no recurrence occurred.
[Commentary]: Angina pectoris or myocardial infarction of coronary heart disease belongs to the category of "Xiong Bi" (Chest Bi) and "Zhen Xin Tong" (True Heart Pain) in Traditional Chinese Medicine. The disease is mostly caused by excessive thinking, exhausting Heart and Spleen; irregular diet, generating Phlegm-Fluid retention; emotional depression, causing Liver Stagnation and Yin injury. However, its fundamental pathogenesis is stagnation of Qi mechanism and blood stasis obstructing the heart vessels. In treatment, Master Zhao emphasizes that while using medication, it must be combined with physical exercise, dietary restraint, and mental regulation as comprehensive conditioning, so that patients can recover early. This case uses regulating Qi mechanism as the guide, with promoting blood circulation to unblock collaterals and tonifying Qi and nourishing Yin as basic treatment methods, yielding satisfactory results.
Somnolence
Patient Lv, Male, 45 years old, First consultation on July 13, 1992
He reported somnolence after binge drinking during the Spring Festival. Currently, he feels sleepy every day, has occasional low-grade fever, slow reaction, dark and turbid complexion, and unsmooth bowel movements. The tongue is red with white and greasy coating, and the pulse is soft and rapid. The syndrome belongs to Dampness obstruction and Heat depression, with stagnation of Qi mechanism. Treatment aims at aromatic transformation and ventilating/dispersing Qi mechanism. Prescription: Chan Yi (Cicada Slough), Pian Jiang Huang (Curcuma Longae Rhizoma), Chao Shan Zhi (Gardeniae Fructus Preparatus), Qian Hu (Peucedani Radix), Su Ye (Perillae Folium) 6g each; Jiang Can (Bombyx Batryticatus), Dan Dou Chi (Sojae Semen Preparatum), Huo Xiang (Agastaches Rhizoma), Pei Lan (Eupatorii Herba), Da Fu Pi (Arecae Pericarpium), Bing Lang (Arecae Semen) 10g each; Da Huang (Rhei Radix et Rhizoma) 1g. After 7 doses, somnolence decreased, fever did not occur. The above formula was continued, removing Huo Xiang and Qian Hu, adding Fang Feng (Saposhnikoviae Radix) 6g and Bai Kou Ren (Amomi Fructus Rotundus) 4g. After more than 20 doses, somnolence cured, spirit refreshed, diet and bowel/bladder functions normalized.
[Commentary]: Somnolence appearing after binge drinking must be related to alcohol consumption. Wine is brewed from grains, possessing strong Damp-Heat nature. People who love drinking often have abundant Damp-Heat accumulation. When Damp-Heat covers and closes, Qi mechanism stagnates, and the Spirit loses clarity, hence the desire to sleep. Now, the turbid face, red tongue with white greasy coating, and soft-rapid pulse are all signs of Damp-Heat. Treatment uses Sheng Jiang San (Ascending and Descending Powder) to regulate Qi mechanism, adding Qian Hu (Peucedani Radix) and Su Ye (Perillae Folium) to ventilate Lung Qi; when Qi transforms, Dampness also transforms; Huo Xiang (Agastaches Rhizoma) and Pei Lan (Eupatorii Herba) transform Dampness with aroma; Da Fu Pi (Arecae Pericarpium), Bing Lang (Arecae Semen), and Dan Dou Chi (Sojae Semen Preparatum) expel stale corruption and smooth the Triple Burner. After taking, Qi mechanism expands, Triple Burner flows freely, Damp-Heat leaves, then heat retreats and spirit clears.
Furthermore, the previous case was somnolence, this case is insomnia; the syndromes seem opposite, yet both responded to modifications of Sheng Jiang San. Although the two syndromes differ, both involve Qi mechanism stagnation. Thus, both use regulating Qi mechanism to restore ascending and descending functions, modifying according to syndrome, naturally achieving efficacy.
Insomnia 1 (Neurasthenia)
Patient Tong, Male, 46 years old
First consultation on July 6, 1992
Suffering from insomnia for over 20 years, requiring sleeping pills every night to fall asleep. Currently, complexion is bluish-green, dizzy and vertiginous, irritable, excessive dreaming at night, poor appetite. Tongue is red with white and dry coating, pulse is wiry, slippery, and rapid. Syndrome belongs to Liver-Gallbladder Depressed Heat, Qi mechanism obstruction, Heat disturbing Heart Spirit. Treatment aims at draining Liver Heat and regulating Qi mechanism to achieve peaceful sleep. Prescription: Chan Yi (Cicada Slough), Pian Jiang Huang (Curcuma Longae Rhizoma), Chai Hu (Bupleuri Radix), Huang Qin (Scutellariae Radix), Chuan Lian Zi (Meliae Fructus), Zhi Qiao (Aurantii Fructus), Zhu Ru (Bambusae Caulis in Taeniam) 6g each; Jiang Can (Bombyx Batryticatus), Jiao San Xian (Charred Fructus Crataegi, Charred Fructus Chaenomelis, Charred Semen Ziziphi Spinosae), Shui Hong Hua Zi (Alternantherae Radix) 10g each; Da Huang (Rhei Radix et Rhizoma) 1g. After 3 doses, insomnia improved; after 10 doses, could fall asleep without sleeping pills. Continuing original formula with modifications for more than 30 doses, sleep basically normalized.
[Commentary]: Regarding insomnia, medical books often attribute it to the Heart, habitually using Suan Zao Ren (Ziziphi Spinosae Semen), Bai Zi Ren (Platycladi Semen), He Huan (Albiziae Cortex), Ye Jiao Teng (Polygoni Multiflori Caulis) etc., to nourish Heart and calm Spirit to aid sleep. This patient suffered insomnia for 20 years, tried all methods without effect, meaning the treatment was not targeted. His insomnia accompanied by irritability and excessive dreaming indicates Liver Meridian Depressed Heat; his green complexion and vertigo are also Liver pathology signs; wiry-slippery-rapid pulse is even more a sign of Liver Heat. Why abandon the Liver to seek elsewhere? Therefore, treat by draining Liver Heat and regulating Qi mechanism to achieve sleep. Using Sheng Jiang San (Ascending and Descending Powder) plus Chai Hu (Bupleuri Radix), Huang Qin (Scutellariae Radix), Chuan Lian Zi (Meliae Fructus) to drain Liver Heat; adding Jiao San Xian (Charred Fructus Crataegi, Charred Fructus Chaenomelis, Charred Semen Ziziphi Spinosae) and Shui Hong Hua Zi (Alternantherae Radix) to regulate Stomach and Intestines; further adding Zhu Ru (Bambusae Caulis in Taeniam) and Zhi Qiao (Aurantii Fructus), combining the intent of Wen Dan Tang (Warm Gallbladder Decoction). Hence effective in 3 doses, cured in one month. For insomnia, Master often treats from the Liver, using modified Sheng Jiang San (Ascending and Descending Powder), often achieving very quick results. The key to differentiation lies in irritability, excessive dreaming at night, wiry-rapid pulse, and crimson-red tongue body. Seeing these pulse and symptoms, all are treated as Liver Meridian Depressed Heat, treatment invariably verifies.
Insomnia 2 (Neurasthenia)
Patient Xu, Female, 42 years old
First consultation
The patient worked in finance for over 20 years diligently, receiving high praise, recently promoted to intermediate title. Because leaders entrusted heavy responsibilities, causing dissatisfaction among some, spreading rumors. She felt depressed because of this. Coupled with heavy work pressure, leading to inability to sleep at night. The illness had lasted over a month, making her unable to persist in normal work. Appearance haggard, exhausted. Irritable, sometimes wanting to anger, sometimes wanting to weep. Pulse is wiry, fine, slippery, and rapid, forceful upon deep pressing. Tongue is red with white floating yellow coating, stool dry, urine yellow. This is Liver-Gallbladder Depressed Fire unable to vent, internally disturbing Heart Spirit, Hun and Po both uneasy. Treatment should regulate Qi mechanism, vent Wood-Fire depression. Use modified Sheng Jiang San (Ascending and Descending Powder).
Chan Yi (Cicada Slough) 6g, Jiang Can (Bombyx Batryticatus) 10g, Pian Jiang Huang (Curcuma Longae Rhizoma) 6g, Da Huang (Rhei Radix et Rhizoma) 3g, Chai Hu (Bupleuri Radix) 6g, Huang Qin (Scutellariae Radix) 10g, Chuan Lian Zi (Meliae Fructus) 10g, Shi Chang Pu (Acori Tatarinowii Rhizoma) 10g, Gou Teng (Uncariae Ramulus cum Uncis) 10g (added later), 7 doses.
Second consultation
After medicine, bowel movement smooth, irritability and anger reduced, able to sleep peacefully 3-4 hours at night. Patient's mental state is like a different person compared to before. Pulse still wiry-slippery-rapid, tongue red with white coating, Depressed Heat not fully cleared. Continue Sheng Jiang San (Ascending and Descending Powder) method.
Chan Yi (Cicada Slough) 6g, Jiang Can (Bombyx Batryticatus) 10g, Pian Jiang Huang (Curcuma Longae Rhizoma) 6g, Da Huang (Rhei Radix et Rhizoma) 3g, Chai Hu (Bupleuri Radix) 6g, Huang Qin (Scutellariae Radix) 10g, Chuan Lian Zi (Meliae Fructus) 10g, Zhi Qiao (Aurantii Fructus) 6g, Jiao San Xian (Charred Fructus Crataegi, Charred Fructus Chaenomelis, Charred Semen Ziziphi Spinosae) 10g each, 7 doses.
Third consultation
Patient's mood significantly improved, able to fall asleep peacefully at night, appetite greatly increased compared to before, complexion appears lustrous. Wants to go to work, resume work. But thinking of it still causes lingering fear, only fearing that going back to work will cause insomnia again. Pulse wiry-slippery-rapid, tongue red with thin white coating. Still suitable to advance/retreat previous method, and instructed to insist on walking exercise daily, diet should avoid spicy and rich flavors. Also pay attention to open-mindedness, do not take small matters to heart.
Chai Hu (Bupleuri Radix) 6g, Huang Qin (Scutellariae Radix) 10g, Chuan Lian Zi (Meliae Fructus) 10g, Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma) 10g, Qian Cao (Rubiae Cordifoliae Radix et Rhizoma) 10g, Chi Shao (Paeoniae Radix Rubra) and Bai Shao (Paeoniae Radix Alba) 10g each, Chan Yi (Cicada Slough) 6g, Jiang Can (Bombyx Batryticatus) 10g, Pian Jiang Huang (Curcuma Longae Rhizoma) 6g, Jiao San Xian (Charred Fructus Crataegi, Charred Fructus Chaenomelis, Charred Semen Ziziphi Spinosae) 10g each, 7 doses.
[Commentary]: This patient, due to unbearable work pressure, led to high mental tension, inability to sleep at night, belonging to mental-emotional factors, thus attributed to Liver Meridian Depressed Heat unable to disperse. Wood flourishing generates Fire, becoming Wood-Fire simultaneous excess, Hun and Shen uneasy. Thus selected Yang Lisshan's Sheng Jiang San (Ascending and Descending Powder), which excels at regulating Qi mechanism, resolving depression and dissipating knots, combined with herbs soothing Liver and draining Heat to form prescription, treating the root of the disease. Medicine matching symptoms, thus obtaining obvious effect in 7 doses. Truly not inferior to Western sedatives. Regarding insomnia, it is mostly differentiated from unsettled Heart Spirit and non-interaction between Heart and Kidney, often piling up large amounts of calming herbs such as Suan Zao Ren (Ziziphi Spinosae Semen), Fu Shen (Poria with Hostwood), Yuan Zhi (Polygalae Radix), He Huan Pi (Albiziae Cortex), Zhen Zhu Mu (Margarita). This is called targeting symptoms, not syndrome differentiation and treatment. In this case, Master used not a single herb for calming Spirit, yet achieved the effect of calming Spirit and stabilizing Will. The characteristic of TCM syndrome differentiation and treatment is seen here.
Insomnia 3 (Neurasthenia)
Patient Sun, Female, 76 years old
First consultation
Due to occupational reasons, excessive brain use, suffered neurasthenia since youth, frequently insomniac. After aging, gradually worsened. Frequently palpitations and fright, sleepless all night, restless, must take sedatives every night to fall asleep. Stool dry, usually takes Ma Ren Wan (Hemp Seed Pill) to pass. Tongue body thin and small, tongue body crimson and dry, pulse wiry, fine, small, and slippery. This is due to excessive thinking, consuming Heart and Spleen; after aging, Zang Yin also deficient, Depressed Heat internally accumulated. At this time of Yin deficiency and Fire hyperactivity, first use Huang Lian E Jiao Ji Zi Huang Tang (Coptis, Donkey-Hide Gelatin, and Egg Yolk Decoction) to nourish Yin and descend Fire, drain South and tonify North, connect Heart and Kidney.
Sheng Di Huang (Rehmanniae Radix) and Shu Di Huang (Rehmanniae Radix Preparata) 20g each, Chuan Huang Lian (Coptidis Rhizoma) 3g, E Jiao (Colla Corii Asini) 12g divided into two times, melted and mixed in; Han Lian Cao (Ecliptae Herba) 12g, Nv Zhen Zi (Ligustri Lucidi Fructus) 10g, Ji Zi Huang (Ovi Galli Vitellus) 2 pieces, broken and stirred evenly, mix with hot decoction and take warm. 7 doses.
Second consultation
After medicine, irritability gradually reduced, able to fall asleep briefly at night, easily awakened with fright, spirit fatigue and weakness, dizziness and forgetfulness, poor appetite. Tongue coating reduced, body red with little coating, pulse still wiry-fine and rapid. Elderly Zang deficiency long-standing, Yin and Yang both declining, Qi and Blood both deficient, difficult to seek quick effect. Suitable to use paste for conditioning, as a method of seeking the root. Prescribed Bu Xin An Shen Gao (Tonify Heart Calm Spirit Paste) to treat.
Huang Qi (Astragali Radix) 60g, Dang Shen (Codonopsis Radix) 30g, Sha Shen (Glehniae Radix or Adenophorae Radix) 60g, Sheng Di Huang (Rehmanniae Radix) 60g, Dang Gui (Angelicae Sinensis Radix) 60g, Chi Shao (Paeoniae Radix Rubra) 60g, Bai Shao (Paeoniae Radix Alba) 60g, E Jiao (Colla Corii Asini) 30g, Huang Qin (Scutellariae Radix) 20g, Chuan Huang Lian (Coptidis Rhizoma) 10g, Nv Zhen Zi (Ligustri Lucidi Fructus) 30g, Han Lian Cao (Ecliptae Herba) 60g, Jin Ying Zi (Chrysanthemi Fructus) 60g, Wu Wei Zi (Schisandrae Chinensis Fructus) 60g, Yuan Zhi Rou (Polygalae Radix) 30g, Sheng Mu Li (Concha Ostreae) 80g, Zhen Zhu Mu (Margarita) 80g, Jiao Mai Ya (Hordei Fructus Germinatus Preparatus) 60g, Ji Nei Jin (Gavis Periostracum) 60g, Sang Shen (Mori Fructus) 60g, Fresh Grapes 2500g, Fresh Apples 400g (sliced), Honey 150g, Rock Sugar 60g.
Preparation: Except for E Jiao (Colla Corii Asini), grapes, apples, honey, and rock sugar, the remaining herbs are decocted twice with water, about 2 hours each time. Mix the decoctions obtained from the two times, add fresh grapes and apples, decoct until grapes and apples melt, filter out cores and dregs, place the liquid on gentle fire to concentrate, simultaneously add honey and rock sugar, and separately pound and melt E Jiao (Colla Corii Asini) to mix in, slowly collect paste, store in bottle. Take 2 spoons morning and evening, dissolve in boiling water.
After the patient prepared and took the medicine according to the method, body condition gradually improved, energy increased, appetite increased, bowel and bladder functions adjusted, palpitations and fright all cured, chronic stubborn insomnia significantly improved, removed the sedatives relied upon for sleep.
[Commentary]: The patient is elderly and frail, suffering from long-term insomnia, showing various weak symptoms, due to long-term Zang Yin deficiency, unable to nourish. First consultation used Drain South Tonify North method, although obtaining slight effect, ultimately not a root-treating method. Must use paste to nourish, tonify its source, which is a wonderful method for conditioning visceral deficiency in the elderly. This formula has comprehensive compatibility, suitable for insomnia caused by labor fatigue and excessive thinking leading to Heart-Spleen Dual Deficiency; or accompanied by Spleen deficiency and food stagnation, visible palpitations, forgetfulness, limb fatigue, spirit tiredness, poor appetite, sallow complexion, constipation, red or pale tongue, fine-weak pulse etc. In the formula, Huang Qi (Astragali Radix) and Dang Shen (Codonopsis Radix) strengthen Spleen and benefit Qi; Nv Zhen Zi (Ligustri Lucidi Fructus), Han Lian Cao (Ecliptae Herba), Jin Ying Zi (Chrysanthemi Fructus), Sang Shen (Mori Fructus), Wu Wei Zi (Schisandrae Chinensis Fructus) nourish Liver-Kidney Yin; when Water is sufficient, Heart Fire does not hyperact and descends to interact with Kidney Water, forming Water-Fire interaction; Dang Gui (Angelicae Sinensis Radix), Chi Shao (Paeoniae Radix Rubra), Bai Shao (Paeoniae Radix Alba), Chuan Xiong (Ligustici Chuanxiong Rhizoma), E Jiao (Colla Corii Asini) nourish Blood, which is to nourish Heart; Sheng Mu Li (Concha Ostreae) and Zhen Zhu Mu (Margarita) heavily settle and calm Spirit; Sha Shen (Glehniae Radix or Adenophorae Radix), Sheng Di Huang (Rehmanniae Radix), fresh grapes, fresh apples, Honey generate fluids and increase liquids, moisten Large Intestine, especially suitable for elderly people with Blood deficiency and constipation. "When Stomach is not harmonious, sleep is not peaceful." In the formula, besides large amounts of tonifying herbs, Jiao Mai Ya (Hordei Fructus Germinatus Preparatus), Ji Nei Jin (Gavis Periostracum), Yuan Zhi (Polygalae Radix), Huang Lian (Coptidis Rhizoma), Huang Qin (Scutellariae Radix) are added, firstly to prevent tonifying herbs from being cloying and hindering Stomach, secondly to eliminate Stomach stagnation, smooth Intestines. The whole formula has effects of strengthening Spleen and calming Spirit, nourishing Blood and pacifying Heart. Clinically, it is quite effective for patients with excessive brain use, insomnia, poor appetite, and constipation.
Deafness 1 (Nerve Deafness)
Patient Chen, Male, 45 years old, First consultation on November 29, 1992. The patient suddenly became deaf 3 months ago due to emotional changes. After multiple treatments with no effect, and worsening trend, specifically asked Master Zhao for diagnosis. Currently deaf and tinnitus, dizzy, irritable, restless at night, stool slightly dry, tongue red with yellow coating, pulse wiry-slippery-rapid, blood pressure 180/120 mmHg. Syndrome belongs to Liver-Gallbladder Depressed Heat steaming upward, abnormal ascending and descending. Treatment plans to clear and drain Liver-Gallbladder Depressed Heat, regulate ascending and descending.
Medicines used: Chan Yi (Cicada Slough) 6g, Jiang Can (Bombyx Batryticatus) 10g, Pian Jiang Huang (Curcuma Longae Rhizoma) 6g, Xuan Fu Hua (Inulae Flos) 10g, Dai Zhe Shi (Haematitum) 10g, Zhen Zhu Mu (Margarita) 30g, Sheng Mu Li (Concha Ostreae) 30g, Qing Chen Pi (Citri Reticulatae Pericarpium and Citri Reticulatae Pericarpium Viride) 10g each, Chao Shan Zhi (Gardeniae Fructus Preparatus) 6g, Da Huang (Rhei Radix et Rhizoma) 1g, Xing Ren (Armeniacae Semen Amarum) 10g.
Second consultation: December 5
Taking 7 doses, sleep improved, dizziness lightened, irritability relieved, stool slightly loose, blood pressure dropped to 130/90 mmHg, still deaf. Still adjust previous method. Medicines used: Chai Hu (Bupleuri Radix) 6g, Chuan Lian Zi (Meliae Fructus) 6g, Chan Yi (Cicada Slough) 6g, Jiang Can (Bombyx Batryticatus) 10g, Pian Jiang Huang (Curcuma Longae Rhizoma) 10g, Wan Can Sha (Bombyx Batryticatus Excrement) 10g, Xuan Fu Hua (Inulae Flos) 10g, Dai Zhe Shi (Haematitum) 10g, Zhen Zhu Mu (Margarita) 30g, Da Huang (Rhei Radix et Rhizoma) 0.5g, Shi Chang Pu (Acori Tatarinowii Rhizoma) 10g, Yu Jin (Curcumae Radix) 10g.
Third consultation: December 12
Taking 7 doses, deafness lightened, stool normal, dizziness and irritability disappeared, spirit improved, tongue red with white coating, pulse soft-slippery-rapid. Changed to tonifying Lower Origin method. Medicines used: Sheng Di Huang (Rehmanniae Radix) and Shu Di Huang (Rehmanniae Radix Preparata) 10g each, Shan Yu Rou (Corni Fructus) 10g, Shan Yao (Dioscoreae Rhizoma) 10g, Yu Jin (Curcumae Radix) 10g, Shi Chang Pu (Acori Tatarinowii Rhizoma) 10g, Zhen Zhu Mu (Margarita) 30g, Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma) 10g, Chuan Lian Zi (Meliae Fructus) 6g, Chi Shao (Paeoniae Radix Rubra) 10g, Jiao San Xian (Charred Fructus Crataegi, Charred Fructus Chaenomelis, Charred Semen Ziziphi Spinosae) 10g each, Xuan Fu Hua (Inulae Flos) 10g, Chao Zhi Qiao (Aurantii Fructus Preparatus) 6g.
Fourth consultation: December 17
Taking 7 doses, deafness greatly reduced, taking another 10+ doses, hearing returned to normal, tinnitus disappeared.
[Commentary]: This case patient suddenly became deaf due to emotional stimulation, took many Chinese medicines with no effect. Later asked Master Zhao for diagnosis. Master Zhao differentiated based on clinical symptoms as Liver-Gallbladder Depressed Heat steaming upward, disturbing clear orifices, abnormal Qi mechanism ascending and descending. Treatment first used clearing and draining Liver-Gallbladder Depressed Heat, regulating ascending and descending method, then used tonifying Lower Origin method, eliminating deafness.
Deafness 2 (Nerve Deafness)
Patient Shen, Male, 53 years old
First consultation on August 25, 1991
Went traveling at the beginning of this month, weather hot, sweating much. From the third day, felt cold and fever, ears not clear, head and eyes unclear. Took Huo Xiang Zheng Qi Shui (Agastache Rectifying Qi Water) with no effect, subsequently deaf and lost hearing. Western medicine diagnosed as post-viral infection sequelae, nerve deafness. At present examination, besides deafness, accompanied by persistent low-grade fever, dizziness and vertigo, heavy body and fatigue, dry mouth and thirst, drinking little, irritable, tongue body red, coating yellow and slippery, pulse slippery-rapid. Syndrome belongs to Summerheat-Dampness Depressed Heat not fully resolved, Qi mechanism unsmooth. First use ventilating and smoothing Qi mechanism, clearing and transforming Damp-Heat method. Medicines used: Huo Xiang (Agastaches Rhizoma) 10g (added later), Pei Lan (Eupatorii Herba) 10g (added later), Xing Ren (Armeniacae Semen Amarum) 10g (added later), Pi Pa Ye (Loquat Folium) 10g, Zhu Ru (Bambusae Caulis in Taeniam) 6g, Chao Zhi Qiao (Aurantii Fructus Preparatus) 6g, Wan Can Sha (Bombyx Batryticatus Excrement) 10g, Shi Chang Pu (Acori Tatarinowii Rhizoma) 10g, Yu Jin (Curcumae Radix) 10g, Mao Gen (Imperatae Rhizoma) and Lu Gen (Phragmitis Rhizoma) 10g each, Jiao San Xian (Charred Fructus Crataegi, Charred Fructus Chaenomelis, Charred Semen Ziziphi Spinosae) 10g each. Taking 7 doses, heat retreated, deafness lightened. Then added Chao Shan Zhi (Gardeniae Fructus Preparatus) 6g to this formula, took another 7 doses, deafness greatly reduced, dizziness and fatigue disappeared, only dry mouth wanting to drink, tongue red with little coating. Changed to tonifying Qi and nourishing Yin method. Medicines used: Sha Shen (Glehniae Radix or Adenophorae Radix) 10g, Mai Dong (Ophiopogonis Tuber) 10g, Huang Qi (Astragali Radix) 20g, Wu Wei Zi (Schisandrae Chinensis Fructus) 10g, Shi Chang Pu (Acori Tatarinowii Rhizoma) 10g, Yu Jin (Curcumae Radix) 10g, Sheng Mu Li (Concha Ostreae) 30g, Sheng Jue Ming Zi (Semene Lepidii seu Descurainiae) 30g, Zhu Ru (Bambusae Caulis in Taeniam) 6g, Chao Zhi Qiao (Aurantii Fructus Preparatus) 6g, Jiao San Xian (Charred Fructus Crataegi, Charred Fructus Chaenomelis, Charred Semen Ziziphi Spinosae) 10g each. Taking 7 doses, spirit refreshed, mood pleasant, diet and bowel/bladder normal, deafness disappeared, no other discomfort. Took the above formula for another 10+ doses and declared cured.
[Commentary]: This case is deafness caused by Summerheat-Dampness Depressed Heat. Summerheat is Fire-Heat pathogen, humans contracting it easily injure Yin and Qi. Dampness is heavy and turbid pathogen, Summerheat-Dampness entangles, Qi mechanism trapped, Heat steams Dampness moving. Turbid Qi floats upward, obstructing Clear Yang, clear orifices unfavorable, mild cases dizziness and vertigo, severe cases coma and deafness. Master Zhao first ventilates Lung Qi, smooths Qi mechanism, Summerheat-Dampness Depressed Heat leaves. After pathogen leaves, then discuss tonifying Qi and nourishing Yin. Do not tonify too early, otherwise causing "locking the thief inside the house" drawback.
Toxic Epilepsy
Patient Gao, Male, 7 years old
First consultation on November 1, 1988
2 years ago, after concussion healed, left epilepsy sequelae, occurring 2-3 times a week. During attacks, eyes roll up, foaming at mouth, four limbs convulsing, sometimes emitting sharp screams, then unconscious. Wakes up spontaneously after 3-5 minutes, like normal person after waking. Multiple treatments, effect not obvious. For 2 years, maintained by taking Western medicine. Examination shows emaciated body, bluish-green complexion, irritable, restless at night, stool dry like balls. Tongue red with yellow and dry coating, pulse wiry-slippery-rapid.
Differentiation: Liver Meridian Depressed Heat, collaterals obstructed.
Treatment: Invigorate Blood and resolve stasis, clear and drain Liver Heat.