消渴3(糖尿痛)
李某某，男，47岁
初诊
糖尿病发现三年余，空腹血糖180～200mg／dl，尿糖+～+++。口服西药优降糖及中药消满丸效果欠佳。自觉口干舌燥，渴欲热饮，一身疲乏无力，形体较胖，脉象湃软且大，舌体胖大苔白而润，腰酸而痛，夜多小便。证属气阴不足肝肾两亏。先用益气养阴，填补下元方法。
生黄芪30克，生熟地各20克，沙参15克，麦门冬15克，五味子10克，金樱子10克，杜仲10克，川续断10克，补骨脂10克，七付
二诊
药后口渴减轻，自觉较前有力，腰痛显著好转。诊脉濡软，舌胖苔润，仍以前法进退。并颁小心控制饮食，不吃甜食。适当多吃蛋白食品。每日运动锻炼乃治疗之本，不可忽视。
生黄芪30克，沙参15克，麦门冬15克，生熟地各20克，五味子10克，金樱子10克，杜仲10克，朴骨脂10克，川续断10克，山萸肉10克，七忖
三诊
患者自述药后精神体力均明显增强，遵医嘱每日清晨驱车到远郊爬山，呼吸新鲜空气，心情十分舒畅。诊脉濡软以滑，舌红苔白而润，再以填补下元方法。坚持锻炼，必有收获。
生黄芪30克，沙参15克，麦门冬15克，五味子10克，生山药15克，花粉15克，生熟地各10克，杜仲10克，川续断10克，补骨脂10克，山萸肉10克，枸杞子10克，七付
四诊
迭进益气养阴填补下元之剂，精神振奋，气力增加，劳作虽多，已不感疲劳，每日徒步登山渐增至两个山头，锻炼与治疗配合，已初见成效。近日化验，血糖已降至正常，尿糖阴性。继用前法，以资巩固；运动锻炼，不可或缺，是为至嘱。
生黄芪30克，沙参15克，麦门冬15克，五味子10克，玉竹10克，花粉10克，生熟地各10克，生山药10克，杜仲10克，金樱子10克，补骨脂10克，巴戟天10克，七付
后以上方加减治疗半年，血糖保持正常，尿糖始终阴性，各种症状消失，体力大为增强。治疗期间，患者每天清晨坚持徒步爬山，风雨无阻，往返30里，已成习惯。困而特别感谢赵师教给了他健身之道。
[按]：本案患者糖尿病已三年余，久治不愈，因其疲乏无力，向以休养为主，体力活动很少。赵师据其形肥、脉濡、舌胖、苔润等脉症，作肝肾不足，投以填补下元之剂，兼以益气养阴，可谓中下兼顾，服之即见救果。然并不单纯依赖药物取胜，而是要求病人自主运动锻炼，并把运动作为配合治疗的第一要求。起初患者将信将疑，以为如此疲乏之体。何以能承受较大运动量的体力活动。及其坚持锻炼～段之后，就尝到了运动锻炼的甜头，越炼越有劲，越炼精力越旺盛，以至于到后来欲罢不能，几乎成了“运动癣”。运动锻炼的最大好处是流通气血，增强脏腑功能。血气者，所以周于性命者也，以奉生身，莫贵于此。人之所以病者，即血气不得流通。无论虚证实证，莫不如此。惟有血气流通，乃能和调于五脏，洒陈于六腑，脏腑功能才能强健旺盛漕贤张子和云：“《内经》一书，唯斟血气流通为贵。”是为至理之言。现代医学之糖尿病，其病理是胰腺中胰岛细胞分泌胰岛案不足，功能低下之病。虽然中医辨证可见虚实寒热之分，然其必有血气不得流通，故尔功能低下，何以令其血气流通，用药调其血气而令条达，此其一也，还必须令患者进行运动锻炼，以促进周身之气血运行。况本案辨为气阴不足，肝肾两亏，治疗顼大剂填补，而补则滞，然则病为虚，又不得不补，如此奈之何?惟以运动疗法，以行气血，以运药力。此本案治疗中运动锻炼之不可少也。另须说明，本案投以大剂填补，服药之法不可不知，当多加水煎药2至3次，合并药液得3～4千毫升，令病人饮之代茶，渴即饮之，不拘时。此治疗本病不同于他病之处，为赵师的用药经验之一。
黑疸(阿狄森氏病)
颜某，男，40岁
初诊
面色黧黑如漆，逐渐加重，颧部炱黑尤甚。病已两年余麓!某大医院检查，确诊为阿狄森氏病。自觉精神疲惫，一身乏力，腰膝酸软，双下肢无力尤甚，恶心欲吐，饮食步进。诊脉沉细无力，按之欲无，舌白苔精。一派阳虚水泛之象。治宜先温肾阳以治其本，所谓益火之源以消阴翳也。
淡附片6克，淡干姜6克，淡吴萸6克，肉桂6克，杜仲10克，川续断10克，补骨脂10克，熟地黄20克，七付
二诊
药后自觉精神好转，乏力减轻，余证如前，继用前法，重剂以进。
淡附片10克，淡干姜10克，淡吴萸10克，肉桂10克，杜仲15克，川续断15克，补骨脂10克，熟地黄20克，七付
三诊
自觉精神转佳，气力有增。仍感恶心欲呕，纳食少进。脉仍沉细，舌白苔润。温补下元，兼运中阳。
淡附片10克，淡干姜10克，淡吴萸10克，肉桂10克，杜仲10克，川续断10克，补骨脂10克，焦白术10克，半夏10克，陈皮10克，白蔻仁6克(后下)，七付
四诊
呕恶虽减而未除。面色黧黑有减退之势，遗进温补下元，肾阳有再振之望，继用前法，补命火以燠中土。
淡附片10克，淡干姜10克，淡吴萸10克，肉桂10克，杜仲10克，川续断10克，补骨脂10克，焦白术10克，仙灵脾10克，山萸肉10克，怀山药15克，枸杞子10克，熟地黄20克，七付
五诊
药后精神大振，纳食有增，面色黧黑续减。然肾阳久衰，非朝夕可以为功，宜用丸药以缓图之。宗前法加味。
淡附片30克，淡干姜30克，淡吴萸30克，肉桂30克，杜仲30克，川续断30克，补骨脂30克，焦白术30克，红人参30克，枸杞子30克，山萸肉30克，仙灵脾30克，熟地黄60克，怀山药60克，陈皮30克，半夏30克，茯苓50克，鹿角胶100克。
制法：上药除鹿角胶外共研细面，将鹿胶烊化后加炼蜜适量，为丸如弹子大，重约10克。每日早晚各服1丸。
患者服上药1料，面色黧黑渐次消退，精神体力均有好转，其余症状大部消失。
[按]：阿狄森氏病，又称慢性肾上腺皮质机能减退症，是由于多种原因引起的肾上腺皮质严重损害时出现的一种综合征，其特征性的临床表现是显著的色素沉着(中医将其描述为面色黧黑)，并伴有恶心、呕吐、纳差、消瘦、疲乏、眩晕等多系统症状。西医给予激素治疗，有一定效果。本病在中医古代文献中尚无确切的对应病种，治疗无成法可依。赵师根据中医理论对本病进行辨析，认为其主症面色黧黑属于元阳衰微，命门火衰，故伴见神疲乏力，腰膝酸软、眩晕耳呜等症，在男子可9己阳痿不举，皆是阳衰之征。故治疗以温肾壮阳为法，以仲景四逆汤为基础，加入淡吴萸，名三淡汤，再酌加肉桂、杜仲、川断、补骨脂、熟地黄等温补下元之品，治疗本病可收到明显效果。
肥胖(高血脂症)
沈某，男，51岁，形伟体丰，体重逾90公斤，体检时发现血脂极高，服西药降脂效果欠佳，于1990年12月前来就诊。
观其面色潮红，油光发亮，舌红苔黄垢厚，脉象弦滑且数，按之有力。血生化检验甘油三脂高达18.86mmol／L。辨为痰湿瘀阻，久之恐有中风之虞，治宜涤痰活血化瘀之法，用三子养亲汤加味。药用苏子10克，莱菔子10克，白芥子6克，冬瓜子10克，皂角子6克，赤勺10克，丹参10克，茜草10克，水煎服。每日1剂，半月后复查，甘油三脂降为12.64mmol/L，患者信心大增，继服前方加柴胡6克，川楝子6克，焦三仙各10克，1月后复查甘油三脂降为7.56mmol/L。嘱其坚持控制饮食，加强锻炼，以善其后。
[按]：高血脂症，古无此名，故中药治疗无成法可嵌。赵师据其形体肥胖、舌滑苔腻，断为痰湿瘀阻，借用治疗痰喘的三子养亲汤，加冬瓜子、皂角子名曰五子涤痰汤，以涤痰消腻。临床应用可随证加减，或配赤芍、丹参、茜草以活血化瘀，或配柴胡、黄芩、川楝子以泻肝热，或配焦三仙、水红花子、夫黄以疏调三焦，对于高血脂症、单纯性肥胖等均有较好的治疗效果。
阳痿1(性功能障碍)
孙某，男，24岁
初诊
患者新婚三个月。婚后即患阳事不举。夫妻关系随之恶化。曾自购补肾壮阳丸药服之无效。两月来心情苦闷异常，每晚独自饮酒解愁，不能自拔。自述半年以来疲乏嗜睡，习渐严重，甚至工作中即可入睡。患者体形肥胖，面色潮红而光亮。诊脉濡软且滑，按之且数，沉取弦急。舌苔黄腻，根部垢厚。合参脉、舌，色、证，此属湿热童盛，阻滞经络，当清化湿热，治在厥阴。
柴胡6克，苏藿梗各10克，独活5克，草豆蔻5克，车前子10克，山栀6克，黄芩10克，龙胆草6克，醋大黄10克(后下)，二剂
二诊
药后大便畅行三次，心中烦热大减，阳萎已起，嗜睡减轻。诊脉弦滑，按之濡数，沉取弦急之象大减，苔垢已化，舌质仍较红。此湿热积滞渐化，三焦气机渐通。然湿热蕴郁日久，非一剂可愈之证，仍氲清化湿热，活血通络方，继清余邪。
柴胡6克，黄苓10克，泽兰叶10克，片姜黄6克，蝉衣6克，钩藤10克，川楝子10克，防风6克，杏仁10克，大黄粉2克，龙胆草4克(后二味研细末装胶囊吞服)，三剂
上疗服后，患者前来告知，阳萎已完全治愈，其他症状也已消失，夫妻和好。遂嘱其停药，并嘱其禁糖，戒酒。忌食蒜、慧、韭、辣椒等辛辣之物。并劝其每日运动锻炼，以为强身健体之计。
[按]：本案患者年轻力壮，虽患阳萎，并非为肾虚，故其自服补药而日渐加重。其形肥，嗜酒，面赤光亮，舌红苔腻，疲乏嗜睡，全是湿热蕴肓1；之象，其脉濡滑弦数，接之愈数，沉取弦急，说明其病本质是肝经湿热下迫，肝郁化火。不可一见阳萎，便投补肝肾温命门之剂。一般说来，凡年轻而体质壮实者，多园恣食厚味，或酗酒不止而患阳萎，皆属湿热蕴郁，三焦气机不畅，所谓“湿热不攘，大筋软短，小筋弛长，软短为拘，弛长为痿，”皆可仿此例而治。
阳痿2(前列腺炎)
李某，男，42岁
1992年4月2曰初诊
患前列腺炎已10余年，近半年来阳事不举，尿中白浊。现体质肥胖，大便不畅，心烦失眠，夜寐梦多，舌红苔白厚腻，脉弦槽数。证属湿热蕴郁，气机阻滞，升降失常。治以清化湿热，疏调气机，升清降浊。
方药；蝉衣、片姜黄、柴胡、黄芩、川楝子、荆芥、防风各6克，僵蚕、大腹皮、槟榔各10克，大黄1克。嘱其忌烟酒辛辣肥甘厚腻，加强体育锻炼。服药7剂后，阳萎好转，仍心烦梦多。
原方去荆芥加钩藤、川草解各10克，枳壳、竹茹各6克，服药2周，阳事复常，余症皆除。
[按]：形肥者多湿，参以苔白厚腻，知其湿盛无疑；心烦梦多，舌红脉数，知其热盛。湿热两盛互阻不化，气机不畅，经脉瘀阻，发为阳萎。故用升降散调气机复升降，柴胡、黄芩、川辣子泄肝热，荆芥、防风宣扬阳气而解肝郁，大腹皮、槟榔疏利三焦。如此则湿热去而阳萎愈矣。若一见阳萎，便谓命门火衰，而投温朴，不惟阳萎不能愈，恐痈肿淋秘便毒之证亦不为远矣。
阳强(前列腺炎)
赵某，男，39岁
1992年元月9日初诊
患者于4个月前因前列腺炎服用阳起石、巴戟天、附子等朴肾强阳方药后，致阳强不倒，已服中药近百剂均无效。现面红目赤，心烦急躁，整夜不能入眠，头晕乏力，会阴及睾丸作痛，大便干结，小便黄赤，舌红起刺，苔白且干，脉弦精且数，皆为肝经郁热之象。治以清泻肝经郁热。
方药：蝉衣、片姜黄、柴胡、黄苓、川楝子，炒山栀各6克，僵蚕、茅芦根、青陈皮、炒槐花各10克，龙胆草2克，大黄1克。服药3剂，阳强好转，能八睡，10剂后症状基本消失。
[按]：患者正值壮年，以腰痛、会阴部时觉刺痛为主诉就医，脉症俱实，何虚之有!奈何前医辨为肾虚，大投温补，致阳强不倒，面目红赤，心烦急躁，夜不能寐，舌红起刺，脉弦滑数，一派肝经郁热之象，故用清泄肝胆方法，用升降散加柴胡、黄芩、川楝子、龙胆草、炒山栀等，大清肝热，服之即愈。此案为误服温补之剂而致肝胆郁热，表现为阳强不倒，上案乃湿热阻滞厥阴经脉而致阳萎不举，证虽相反，其病机则相似，舌脉俱现湿热之象，肝主琉泄，被湿热郁阻，则泄疏不利，气机不能畅行，厥阴经脉郁潞，或勃为阳强，或萎而不举，皆当从肝调治，疏其气机，复其疏泄之职。故皆选用升降散之善调气机复升降者加减取效。
消渴3（糖尿病）
李某某，男，47岁
初诊
发现糖尿病三年多，空腹血糖180～200mg/dl，尿糖+～+++。口服西药优降糖及中药消满丸效果不佳。自觉口干舌燥，想喝热饮，全身疲乏无力，形体较胖，脉象濡软且大，舌体胖大苔白而润，腰酸而痛，夜间小便多。证属气阴不足、肝肾两亏。先用益气养阴，填补下元的方法。
生黄芪30克，生地黄和熟地黄各20克，沙参15克，麦门冬15克，五味子10克，金樱子10克，杜仲10克，川续断10克，补骨脂10克，七付
二诊
服药后口渴减轻，自觉比之前有力，腰痛显著好转。诊脉濡软，舌胖苔润，仍用前法加减。并嘱咐小心控制饮食，不吃甜食。适当多吃蛋白食品。每日运动锻炼乃治疗之本，不可忽视。
生黄芪30克，沙参15克，麦门冬15克，生地黄和熟地黄各20克，五味子10克，金樱子10克，杜仲10克，补骨脂10克，川续断10克，山萸肉10克，七付
三诊
患者自述服药后精神体力均明显增强，遵医嘱每日清晨驱车到远郊爬山，呼吸新鲜空气，心情十分舒畅。诊脉濡软以滑，舌红苔白而润，再以填补下元的方法。坚持锻炼，必有收获。
生黄芪30克，沙参15克，麦门冬15克，五味子10克，生山药15克，花粉15克，生地黄和熟地黄各10克，杜仲10克，川续断10克，补骨脂10克，山萸肉10克，枸杞子10克，七付
四诊
连续服用益气养阴填补下元的药剂，精神振奋，气力增加，劳作虽多，已不感疲劳，每日徒步登山渐增至两个山头，锻炼与治疗配合，已初见成效。近日化验，血糖已降至正常，尿糖阴性。继用前法，以资巩固；运动锻炼，不可或缺，是为至嘱。
生黄芪30克，沙参15克，麦门冬15克，五味子10克，玉竹10克，花粉10克，生地黄和熟地黄各10克，生山药10克，杜仲10克，金樱子10克，补骨脂10克，巴戟天10克，七付
后以上方加减治疗半年，血糖保持正常，尿糖始终阴性，各种症状消失，体力大为增强。治疗期间，患者每天清晨坚持徒步爬山，风雨无阻，往返30里，已成习惯。因而特别感谢赵师教给了他健身之道。
[按]：本案患者糖尿病已三年余，久治不愈，因其疲乏无力，向以休养为主，体力活动很少。赵师据其形肥、脉濡、舌胖、苔润等脉症，作肝肾不足，投以填补下元之剂，兼以益气养阴，可谓中下兼顾，服之即见效果。然并不单纯依赖药物取胜，而是要求病人自主运动锻炼，并把运动作为配合治疗的第一要求。起初患者将信将疑，以为如此疲乏之体，何以能承受较大运动量的体力活动。及其坚持锻炼一段时间之后，就尝到了运动锻炼的甜头，越炼越有劲，越炼精力越旺盛，以至于到后来欲罢不能，几乎成了“运动癖”。运动锻炼的最大好处是流通气血，增强脏腑功能。血气者，所以周于性命者也，以奉生身，莫贵于此。人之所以病者，即血气不得流通。无论虚证实证，莫不如此。惟有血气流通，乃能和调于五脏，洒陈于六腑，脏腑功能才能强健旺盛。张子和云：“《内经》一书，唯珍血气流通为贵。”是为至理之言。现代医学之糖尿病，其病理是胰腺中胰岛细胞分泌胰岛素不足，功能低下之病。虽然中医辨证可见虚实寒热之分，然其必有血气不得流通，故尔功能低下，何以令其血气流通，用药调其血气而令条达，此其一也，还必须令患者进行运动锻炼，以促进周身之气血运行。况本案辨为气阴不足，肝肾两亏，治疗须大剂填补，而补则滞，然则病为虚，又不得不补，如此奈之何?惟以运动疗法，以行气血，以运药力。此本案治疗中运动锻炼之不可少也。另须说明，本案投以大剂填补，服药之法不可不知，当多加水煎药2至3次，合并药液得3～4千毫升，令病人饮之代茶，渴即饮之，不拘时。此治疗本病不同于他病之处，为赵师的用药经验之一。
黑疸（阿狄森氏病）
颜某，男，40岁
初诊
面色黧黑如漆，逐渐加重，颧部黧黑尤甚。病已两年余，经某大医院检查，确诊为阿狄森氏病。自觉精神疲惫，一身乏力，腰膝酸软，双下肢无力尤甚，恶心欲吐，饮食不进。诊脉沉细无力，按之欲无，舌白苔滑。一派阳虚水泛之象。治宜先温肾阳以治其本，所谓益火之源以消阴翳也。
淡附片6克，淡干姜6克，淡吴茱萸6克，肉桂6克，杜仲10克，川续断10克，补骨脂10克，熟地黄20克，七付
二诊
药后自觉精神好转，乏力减轻，余证如前，继用前法，重剂以进。
淡附片10克，淡干姜10克，淡吴茱萸10克，肉桂10克，杜仲15克，川续断15克，补骨脂10克，熟地黄20克，七付
三诊
自觉精神转佳，气力有增。仍感恶心欲呕，纳食少进。脉仍沉细，舌白苔润。温补下元，兼运中阳。
淡附片10克，淡干姜10克，淡吴茱萸10克，肉桂10克，杜仲10克，川续断10克，补骨脂10克，焦白术10克，半夏10克，陈皮10克，白蔻仁6克（后下），七付
四诊
呕恶虽减而未除。面色黧黑有减退之势，拟进温补下元，肾阳有再振之望，继用前法，补命火以燠中土。
淡附片10克，淡干姜10克，淡吴茱萸10克，肉桂10克，杜仲10克，川续断10克，补骨脂10克，焦白术10克，仙灵脾10克，山萸肉10克，怀山药15克，枸杞子10克，熟地黄20克，七付
五诊
药后精神大振，纳食有增，面色黧黑续减。然肾阳久衰，非朝夕可以为功，宜用丸药以缓图之。宗前法加味。
淡附片30克，淡干姜30克，淡吴茱萸30克，肉桂30克，杜仲30克，川续断30克，补骨脂30克，焦白术30克，红人参30克，枸杞子30克，山萸肉30克，仙灵脾30克，熟地黄60克，怀山药60克，陈皮30克，半夏30克，茯苓50克，鹿角胶100克。
制法：上药除鹿角胶外共研细面，将鹿角胶烊化后加炼蜜适量，为丸如弹子大，重约10克。每日早晚各服1丸。
患者服上药1料，面色黧黑渐次消退，精神体力均有好转，其余症状大部消失。
[按]：阿狄森氏病，又称慢性肾上腺皮质机能减退症，是由于多种原因引起的肾上腺皮质严重损害时出现的一种综合征，其特征性的临床表现是显著的色素沉着（中医将其描述为面色黧黑），并伴有恶心、呕吐、纳差、消瘦、疲乏、眩晕等多系统症状。西医给予激素治疗，有一定效果。本病在中医古代文献中尚无确切的对应病种，治疗无成法可依。赵师根据中医理论对本病进行辨析，认为其主症面色黧黑属于元阳衰微，命门火衰，故伴见神疲乏力，腰膝酸软、眩晕耳鸣等症，在男子可伴阳痿不举，皆是阳衰之征。故治疗以温肾壮阳为法，以仲景四逆汤为基础，加入淡吴茱萸，名三淡汤，再酌加肉桂、杜仲、川断、补骨脂、熟地黄等温补下元之品，治疗本病可收到明显效果。
肥胖（高血脂症）
沈某，男，51岁，形伟体丰，体重逾90公斤，体检时发现血脂极高，服西药降脂效果欠佳，于1990年12月前来就诊。
观其面色潮红，油光发亮，舌红苔黄垢厚，脉象弦滑且数，按之有力。血生化检验甘油三酯高达18.86mmol/L。辨为痰湿瘀阻，久之恐有中风之虞，治宜涤痰活血化瘀之法，用三子养亲汤加味。药用苏子10克，莱菔子10克，白芥子6克，冬瓜子10克，皂角子6克，赤芍10克，丹参10克，茜草10克，水煎服。每日1剂，半月后复查，甘油三酯降为12.64mmol/L，患者信心大增，继服前方加柴胡6克，川楝子6克，焦三仙各10克，1月后复查甘油三酯降为7.56mmol/L。嘱其坚持控制饮食，加强锻炼，以善其后。
[按]：高血脂症，古无此名，故中药治疗无成法可寻。赵师据其形体肥胖、舌滑苔腻，断为痰湿瘀阻，借用治疗痰喘的三子养亲汤，加冬瓜子、皂角子名曰五子涤痰汤，以涤痰消腻。临床应用可随证加减，或配赤芍、丹参、茜草以活血化瘀，或配柴胡、黄芩、川楝子以泻肝热，或配焦三仙、水红花子、大黄以疏调三焦，对于高血脂症、单纯性肥胖等均有较好的治疗效果。
阳痿1（性功能障碍）
孙某，男，24岁
初诊
患者新婚三个月。婚后即患阳事不举。夫妻关系随之恶化。曾自购补肾壮阳丸药服之无效。两月来心情苦闷异常，每晚独自饮酒解愁，不能自拔。自述半年以来疲乏嗜睡，日渐严重，甚至工作中即可入睡。患者体形肥胖，面色潮红而光亮。诊脉濡软且滑，按之且数，沉取弦急。舌苔黄腻，根部垢厚。合参脉、舌、色、证，此属湿热壅盛，阻滞经络，当清化湿热，治在厥阴。
柴胡6克，苏梗和藿梗各10克，独活5克，草豆蔻5克，车前子10克，山栀6克，黄芩10克，龙胆草6克，醋大黄10克（后下），二剂
二诊
药后大便畅行三次，心中烦热大减，阳痿已起，嗜睡减轻。诊脉弦滑，按之濡数，沉取弦急之象大减，苔垢已化，舌质仍较红。此湿热积滞渐化，三焦气机渐通。然湿热蕴郁日久，非一剂可愈之证，仍宜清化湿热，活血通络方，继清余邪。
柴胡6克，黄芩10克，泽兰叶10克，片姜黄6克，蝉衣6克，钩藤10克，川楝子10克，防风6克，杏仁10克，大黄粉2克，龙胆草4克（后二味研细末装胶囊吞服），三剂
上方服后，患者前来告知，阳痿已完全治愈，其他症状也已消失，夫妻和好。遂嘱其停药，并嘱其禁糖，戒酒。忌食蒜、薤、韭、辣椒等辛辣之物。并劝其每日运动锻炼，以为强身健体之计。
[按]：本案患者年轻力壮，虽患阳痿，并非为肾虚，故其自服补药而日渐加重。其形肥，嗜酒，面赤光亮，舌红苔腻，疲乏嗜睡，全是湿热蕴郁之象，其脉濡滑弦数，按之愈数，沉取弦急，说明其病本质是肝经湿热下迫，肝郁化火。不可一见阳痿，便投补肝肾温命门之剂。一般说来，凡年轻而体质壮实者，多因恣食厚味，或酗酒不止而患阳痿，皆属湿热蕴郁，三焦气机不畅，所谓“湿热不攘，大筋软短，小筋弛长，软短为拘，弛长为痿”，皆可仿此例而治。
阳痿2（前列腺炎）
李某，男，42岁
1992年4月2日初诊
患前列腺炎已10余年，近半年来阳事不举，尿中白浊。现体质肥胖，大便不畅，心烦失眠，夜寐梦多，舌红苔白厚腻，脉弦滑数。证属湿热蕴郁，气机阻滞，升降失常。治以清化湿热，疏调气机，升清降浊。
方药：蝉衣、片姜黄、柴胡、黄芩、川楝子、荆芥、防风各6克，僵蚕、大腹皮、槟榔各10克，大黄1克。嘱其忌烟酒辛辣肥甘厚腻，加强体育锻炼。服药7剂后，阳痿好转，仍心烦梦多。
原方去荆芥加钩藤、萆薢各10克，枳壳、竹茹各6克，服药2周，阳事复常，余症皆除。
[按]：形肥者多湿，参以苔白厚腻，知其湿盛无疑；心烦梦多，舌红脉数，知其热盛。湿热两盛互阻不化，气机不畅，经脉瘀阻，发为阳痿。故用升降散调气机复升降，柴胡、黄芩、川楝子泄肝热，荆芥、防风宣扬阳气而解肝郁，大腹皮、槟榔疏利三焦。如此则湿热去而阳痿愈矣。若一见阳痿，便谓命门火衰，而投温补，不惟阳痿不能愈，恐痈肿淋秘便毒之证亦不为远矣。
阳强（前列腺炎）
赵某，男，39岁
1992年元月9日初诊
患者于4个月前因前列腺炎服用阳起石、巴戟天、附子等补肾强阳方药后，致阳强不倒，已服中药近百剂均无效。现面红目赤，心烦急躁，整夜不能入眠，头晕乏力，会阴及睾丸作痛，大便干结，小便黄赤，舌红起刺，苔白且干，脉弦滑且数，皆为肝经郁热之象。治以清泻肝经郁热。
方药：蝉衣、片姜黄、柴胡、黄芩、川楝子，炒山栀各6克，僵蚕、茅芦根、青陈皮、炒槐花各10克，龙胆草2克，大黄1克。服药3剂，阳强好转，能入睡，10剂后症状基本消失。
[按]：患者正值壮年，以腰痛、会阴部时觉刺痛为主诉就医，脉症俱实，何虚之有!奈何前医辨为肾虚，大投温补，致阳强不倒，面目红赤，心烦急躁，夜不能寐，舌红起刺，脉弦滑数，一派肝经郁热之象，故用清泄肝胆方法，用升降散加柴胡、黄芩、川楝子、龙胆草、炒山栀等，大清肝热，服之即愈。此案为误服温补之剂而致肝胆郁热，表现为阳强不倒，上案乃湿热阻滞厥阴经脉而致阳痿不举，证虽相反，其病机则相似，舌脉俱现湿热之象，肝主疏泄，被湿热郁阻，则疏泄不利，气机不能畅行，厥阴经脉郁滞，或勃为阳强，或萎而不举，皆当从肝调治，疏其气机，复其疏泄之职。故皆选用升降散之善调气机复升降者加减取效。
Xiao Ke 3 (Diabetes Mellitus)
Patient Li, Male, 47 years old
First Visit
Diabetes mellitus discovered for over three years. Fasting blood glucose: 180-200 mg/dl; Urine sugar: + to +++. Oral administration of Western medicine Glibenclamide and Traditional Chinese Medicine (TCM) Xiaoman Wan yielded poor results. The patient complains of dry mouth and tongue, a desire for hot drinks, general fatigue and weakness, a plump physique, a pulse that is soggy (Ru), soft, and large. The tongue body is enlarged with a white, moist coating. There is soreness and pain in the lower back, and frequent urination at night. The pattern is identified as Qi and Yin deficiency with dual deficiency of the Liver and Kidneys. The initial treatment strategy employs tonifying Qi and nourishing Yin, along with replenishing the Lower Yuan (Lower Burner/Essence).
Raw Astragali Radix (Huangqi) 30g, Raw and Prepared Rehmanniae Radix (Sheng/Di Shudi) 20g each, Glehniae Radix (Shashen) 15g, Ophiopogonis Tuber (Maidong) 15g, Schisandrae Fructus (Wuweizi) 10g, Rosa laevigata Fruit (Jinyingzi) 10g, Eucommiae Cortex (Duzhong) 10g, Dipsaci Radix (Chuanxuduan) 10g, Psoraleae Fructus (Buguzhi) 10g. Seven doses.
Second Visit
After taking the herbs, thirst decreased, energy levels improved compared to before, and lower back pain significantly improved. Pulse is soggy and soft; tongue is plump with a moist coating. Continue the previous method with modifications. Advice: Carefully control diet, avoid sweets. Appropriately increase protein intake. Daily exercise is the foundation of treatment and cannot be ignored.
Raw Astragali Radix (Huangqi) 30g, Glehniae Radix (Shashen) 15g, Ophiopogonis Tuber (Maidong) 15g, Raw and Prepared Rehmanniae Radix (Sheng/Di Shudi) 20g each, Schisandrae Fructus (Wuweizi) 10g, Rosa laevigata Fruit (Jinyingzi) 10g, Eucommiae Cortex (Duzhong) 10g, Psoraleae Fructus (Buguzhi) 10g, Dipsaci Radix (Chuanxuduan) 10g, Corni Fructus (Shanzhuyu) 10g. Seven doses.
Third Visit
The patient reported significant enhancement in spirit and physical strength after medication. Following medical advice, he drove to the suburbs every morning to climb mountains, breathe fresh air, and felt very comfortable. Pulse is soggy, soft, and slippery; tongue is red with a white, moist coating. Continue the method of replenishing the Lower Yuan. Persist in exercise, and there will surely be gains.
Raw Astragali Radix (Huangqi) 30g, Glehniae Radix (Shashen) 15g, Ophiopogonis Tuber (Maidong) 15g, Schisandrae Fructus (Wuweizi) 10g, Raw Dioscoreae Rhizoma (Shanyao) 15g, Paefloris Radix (Huafen) 15g, Raw and Prepared Rehmanniae Radix (Sheng/Di Shudi) 10g each, Eucommiae Cortex (Duzhong) 10g, Dipsaci Radix (Chuanxuduan) 10g, Psoraleae Fructus (Buguzhi) 10g, Corni Fructus (Shanzhuyu) 10g, Lycii Fructus (Gouqizi) 10g. Seven doses.
Fourth Visit
Continuous administration of formulas tonifying Qi, nourishing Yin, and replenishing the Lower Yuan has revitalized the spirit and increased strength. Despite heavy labor, fatigue is no longer felt. Daily hiking has gradually increased to two mountain peaks. The combination of exercise and treatment shows initial effectiveness. Recent lab tests show blood glucose has dropped to normal levels, and urine sugar is negative. Continue the previous method to consolidate results; exercise is indispensable, which is strongly advised.
Raw Astragali Radix (Huangqi) 30g, Glehniae Radix (Shashen) 15g, Ophiopogonis Tuber (Maidong) 15g, Schisandrae Fructus (Wuweizi) 10g, Polygonati Odorati Rhizoma (Yuzhu) 10g, Paefloris Radix (Huafen) 10g, Raw and Prepared Rehmanniae Radix (Sheng/Di Shudi) 10g each, Raw Dioscoreae Rhizoma (Shanyao) 10g, Eucommiae Cortex (Duzhong) 10g, Rosa laevigata Fruit (Jinyingzi) 10g, Psoraleae Fructus (Buguzhi) 10g, Morinda Officinalis Root (Bajitian) 10g. Seven doses.
Subsequently, the formula was modified and administered for half a year. Blood glucose remained normal, urine sugar stayed negative, all symptoms disappeared, and physical strength greatly increased. During treatment, the patient persisted in hiking every morning regardless of weather, covering 30 li round trip, which became a habit. He expressed special gratitude to Master Zhao for teaching him the way of fitness.
[Commentary]: This patient had diabetes for over three years without cure due to fatigue leading to a lifestyle focused on rest with little physical activity. Based on his plump physique, soggy pulse, enlarged tongue, and white moist coating, Master Zhao diagnosed Liver and Kidney insufficiency. He prescribed formulas to replenish the Lower Yuan while tonifying Qi and nourishing Yin, addressing both middle and lower burners, yielding immediate results. However, success did not rely solely on medication but required the patient's autonomous exercise, prioritizing movement as part of the treatment. Initially skeptical, the patient eventually experienced the benefits of exercise, gaining strength and vitality until it became an addiction. The greatest benefit of exercise is promoting the circulation of Qi and Blood and enhancing Zang-Fu organ function. Qi and Blood are essential for sustaining life. Disease arises from the stagnation of Qi and Blood. Whether deficiency or excess patterns, this principle holds. Only through free-flowing Qi and Blood can the Five Zang organs harmonize and the Six Fu organs receive proper distribution, ensuring robust organ function. Zhang Zihe stated, "The Neijing values the free flow of Qi and Blood above all." This is profound truth. Modern medicine attributes diabetes to insufficient insulin secretion by pancreatic islet cells and low function. Although TCM differentiates deficiency/excess and cold/heat, there is invariably stagnation of Qi and Blood leading to dysfunction. To restore flow, one must use herbs to regulate Qi and Blood (first step) and require patients to exercise to promote systemic circulation (second step). In this case, diagnosed as Qi/Yin deficiency and Liver/Kidney depletion, large doses of tonics were needed. Tonics can cause stagnation, yet tonification is necessary for deficiency. How to resolve this? Exercise therapy moves Qi and Blood and facilitates the action of the herbs. Thus, exercise is indispensable. Additionally, for large tonic doses, decoction method matters: add ample water, decoct 2-3 times, combine liquids to obtain 3-4 liters, and have the patient drink it like tea whenever thirsty, without time restrictions. This differs from treating other diseases and is one of Master Zhao's unique experiences.
Hei Dan (Addison's Disease)
Patient Yan, Male, 40 years old
First Visit
Complexion is dark black like lacquer, progressively worsening, especially on the cheekbones. Illness duration: over two years. Examined at a major hospital, confirmed as Addison's disease. Complains of mental exhaustion, general fatigue, soreness and weakness of waist and knees, severe weakness in both lower limbs, nausea with urge to vomit, and poor appetite. Pulse is deep, fine, and weak, barely palpable upon pressure. Tongue is pale with a slippery coating. The presentation indicates Yang deficiency with Water overflowing. Treatment should first warm Kidney Yang to address the root, known as "benefiting the source of Fire to eliminate Yin shadows."
Processed Aconiti Lateralis Radix Praeparata (Fupian) 6g, Processed Zingiberis Rhizoma (Ganjiang) 6g, Processed Evodiae Fructus (Wuzhuyu) 6g, Cinnamomi Cortex (Rougui) 6g, Eucommiae Cortex (Duzhong) 10g, Dipsaci Radix (Chuanxuduan) 10g, Psoraleae Fructus (Buguzhi) 10g, Prepared Rehmanniae Radix (Shudi) 20g. Seven doses.
Second Visit
After medication, spirit improved, fatigue reduced, other symptoms remain. Continue previous method with heavier dosage.
Processed Aconiti Lateralis Radix Praeparata (Fupian) 10g, Processed Zingiberis Rhizoma (Ganjiang) 10g, Processed Evodiae Fructus (Wuzhuyu) 10g, Cinnamomi Cortex (Rougui) 10g, Eucommiae Cortex (Duzhong) 15g, Dipsaci Radix (Chuanxuduan) 15g, Psoraleae Fructus (Buguzhi) 10g, Prepared Rehmanniae Radix (Shudi) 20g. Seven doses.
Third Visit
Spirit further improved, strength increased. Still feels nausea and poor appetite. Pulse remains deep and fine; tongue pale with moist coating. Warm and tonify the Lower Yuan, simultaneously moving Middle Yang.
Processed Aconiti Lateralis Radix Praeparata (Fupian) 10g, Processed Zingiberis Rhizoma (Ganjiang) 10g, Processed Evodiae Fructus (Wuzhuyu) 10g, Cinnamomi Cortex (Rougui) 10g, Eucommiae Cortex (Duzhong) 10g, Dipsaci Radix (Chuanxuduan) 10g, Psoraleae Fructus (Buguzhi) 10g, Fried Atractylodis Macrocephalae Rhizoma (Baizhu) 10g, Pinelliae Tuber (Banxia) 10g, Citri Reticulatae Pericarpium (Chenpi) 10g, Amomi Fructus Rotundus (Bai Kou Ren) 6g (added later). Seven doses.
Fourth Visit
Nausea reduced but not eliminated. Dark complexion shows signs of fading. Plan to advance warming and tonifying the Lower Yuan; hope exists for reviving Kidney Yang. Continue previous method, tonifying Mingmen Fire to warm the Middle Earth.
Processed Aconiti Lateralis Radix Praeparata (Fupian) 10g, Processed Zingiberis Rhizoma (Ganjiang) 10g, Processed Evodiae Fructus (Wuzhuyu) 10g, Cinnamomi Cortex (Rougui) 10g, Eucommiae Cortex (Duzhong) 10g, Dipsaci Radix (Chuanxuduan) 10g, Psoraleae Fructus (Buguzhi) 10g, Fried Atractylodis Macrocephalae Rhizoma (Baizhu) 10g, Epimedii Folium (Xinyianpi) 10g, Corni Fructus (Shanzhuyu) 10g, Huai Dioscoreae Rhizoma (Shanyao) 15g, Lycii Fructus (Gouqizi) 10g, Prepared Rehmanniae Radix (Shudi) 20g. Seven doses.
Fifth Visit
Spirit greatly revived, appetite increased, dark complexion continues to fade. However, long-standing Kidney Yang decline cannot be cured overnight; pills should be used for slow recovery. Follow previous method with additions.
Processed Aconiti Lateralis Radix Praeparata (Fupian) 30g, Processed Zingiberis Rhizoma (Ganjiang) 30g, Processed Evodiae Fructus (Wuzhuyu) 30g, Cinnamomi Cortex (Rougui) 30g, Eucommiae Cortex (Duzhong) 30g, Dipsaci Radix (Chuanxuduan) 30g, Psoraleae Fructus (Buguzhi) 30g, Fried Atractylodis Macrocephalae Rhizoma (Baizhu) 30g, Red Ginseng Radix et Rhizoma (Renshen) 30g, Lycii Fructus (Gouqizi) 30g, Corni Fructus (Shanzhuyu) 30g, Epimedii Folium (Xinyianpi) 30g, Prepared Rehmanniae Radix (Shudi) 60g, Huai Dioscoreae Rhizoma (Shanyao) 60g, Citri Reticulatae Pericarpium (Chenpi) 30g, Pinelliae Tuber (Banxia) 30g, Poria (Fuling) 50g, Cornu Cervi Corneum (Lujiaojiao) 100g.
Preparation: Grind all herbs except Lujiaojiao into fine powder. Melt Lujiaojiao and mix with appropriate amount of refined honey. Form pills the size of marbles, weighing approx. 10g each. Take one pill morning and evening.
After one course of these pills, the dark complexion gradually faded, spirit and physical strength improved, and most other symptoms disappeared.
[Commentary]: Addison's disease, also known as chronic adrenal cortical insufficiency, is a syndrome resulting from severe damage to the adrenal cortex due to various causes. Its characteristic clinical manifestation is significant hyperpigmentation (described in TCM as a dark black complexion), accompanied by multi-system symptoms such as nausea, vomiting, poor appetite, emaciation, fatigue, and dizziness. Western hormone therapy has some effect. Ancient TCM literature lacks an exact corresponding disease name, so there are no established treatment protocols. Master Zhao analyzed this disease based on TCM theory, identifying the main symptom of dark complexion as indicative of衰竭 of Primordial Yang and Mingmen Fire decline. Accompanying symptoms include mental fatigue, weakness, sore waist/knees, dizziness, tinnitus, and potentially impotence in men, all signs of Yang decline. Therefore, treatment focuses on warming the Kidney and strengthening Yang. Based on Zhang Zhongjing's Sini Tang (Four Reversal Decoction), adding Processed Evodiae Fructus creates San Dan Tang. Further additions of Cinnamomi Cortex, Eucommiae Cortex, Dipsaci Radix, Psoraleae Fructus, and Prepared Rehmanniae Radix provide warming and tonifying effects for the Lower Yuan, yielding obvious results for this disease.
Pang Fei (Hyperlipidemia)
Patient Shen, Male, 51 years old, tall and stout, weight over 90 kg. High blood lipids detected during check-up; Western lipid-lowering drugs yielded poor results. Consulted in December 1990.
Observation: Flushed face, oily and shiny skin. Tongue is red with thick, greasy yellow coating. Pulse is wiry, slippery, and rapid, forceful upon pressure. Blood biochemistry test shows Triglycerides as high as 18.86 mmol/L. Pattern differentiation identifies Phlegm-Dampness and Blood Stasis obstruction. Long-term risk of Stroke (Zhong Feng). Treatment requires clearing Phlegm and invigorating Blood to remove stasis. Formula: San Zi Yang Qin Tang (Three Seeds Nourishing Elderly Decoction) modified. Ingredients: Perillae Fructus (Suzi) 10g, Raphani Fructus (Laifuzi) 10g, Mustard Seed (Baijiezi) 6g, Benincasae Semen (Dongguazi) 10g, Gleditsiae Sinensis Spina (Zaojiaoren) 6g, Paefloris Radix (Chishao) 10g, Salviae Miltiorrhizae Radix (Danshen) 10g, Rubiae Cordifoliae Radix et Rhizoma (Qiancao) 10g. Decoct in water. One dose daily. Recheck after half a month: Triglycerides dropped to 12.64 mmol/L. Patient's confidence increased. Continue previous formula adding Bupleuri Radix (Chaihu) 6g, Meliae Semen (Chuanlianzi) 6g, Jiao San Xian (Fried Hawthorn, Medicated Leaven, Barley Sprout) 10g each. Recheck after 1 month: Triglycerides dropped to 7.56 mmol/L. Advised to persist in dietary control and strengthen exercise to conclude treatment.
[Commentary]: Hyperlipidemia has no ancient name, so no fixed herbal protocol exists. Based on obesity, slippery tongue, and greasy coating, Master Zhao diagnosed Phlegm-Dampness and Blood Stasis. Borrowing San Zi Yang Qin Tang (used for Phlegm-Wheeze) and adding Benincasae Semen and Gleditsiae Sinensis Spina, he named it Wu Zi Di Tan Tang (Five Seeds Phlegm-Clearing Decoction) to clear Phlegm and reduce grease. Clinical application allows modifications: add Chishao, Danshen, Qiancao for Blood Stasis; add Chaihu, Huangqin, Chuanlianzi to drain Liver Heat; add Jiao San Xian, Hydrocotylis Herba (Shuihonghua), Dahuang to regulate the Triple Burner. This approach yields good results for hyperlipidemia and simple obesity.
Yang Wei 1 (Sexual Dysfunction)
Patient Sun, Male, 24 years old
First Visit
Married for three months. Developed impotence immediately after marriage. Marital relationship deteriorated. Self-purchased Kidney-tonifying Yang-strengthening pills were ineffective. For two months, felt extremely depressed, drinking alone every night to drown sorrows, unable to extricate himself. Reports fatigue and excessive sleepiness for six months, worsening, even falling asleep at work. Physique is obese, face flushed and shiny. Pulse is soggy, soft, and slippery, rapid upon pressure, wiry and urgent when pressed deeply. Tongue coating is yellow and greasy, thick and dirty at the root. Integrating pulse, tongue, complexion, and symptoms, this belongs to Damp-Heat congestion obstructing meridians. Treatment requires clearing and transforming Damp-Heat, focusing on the Jueyin (Liver/Pericardium) channel.
Bupleuri Radix (Chaihu) 6g, Perillae Caulis (Sugeng) and Agastache Herba (Huogeng) 10g each, Angelicae Pubescentis Radix (Duohuo) 5g, Amomi Fructus (Caodoukou) 5g, Plantaginis Semen (Cheqianzi) 10g, Gardeniae Fructus (Shanzhi) 6g, Scutellariae Radix (Huangqin) 10g, Gentianae Radix (Longdancao) 6g, Vinegar-processed Rheum Palmatum Rhizoma (Dahuang) 10g (added later). Two doses.
Second Visit
After medication, bowel movements occurred freely three times, mental heat significantly reduced, erection returned, sleepiness decreased. Pulse is wiry and slippery, soggy and rapid upon pressure, deep wiry urgency largely diminished. Dirty coating transformed, tongue body still relatively red. Damp-Heat accumulation is gradually resolving, Triple Burner Qi mechanism is opening. However, long-standing Damp-Heat郁stagnation cannot be cured in one dose. Continue clearing Damp-Heat and invigorating Blood to unblock collaterals to clear residual pathogens.
Bupleuri Radix (Chaihu) 6g, Scutellariae Radix (Huangqin) 10g, Lycopodium Herb (Zelan Ye) 10g, Curcumae Radix (Pian Jianghuang) 6g, Bombyx Batryticatus (Chanyi) 6g, Uncariae Ramulus cum Uncis (Gouteng) 10g, Meliae Semen (Chuanlianzi) 10g, Saposhnikoviae Radix (Fangfeng) 6g, Armeniacae Semen Amarum (Xingren) 10g, Rhubarb Powder (Dahuang Fen) 2g, Gentianae Radix (Longdancao) 4g (last two ground fine, encapsulated, swallowed). Three doses.
After taking the above prescription, the patient reported complete cure of impotence, disappearance of other symptoms, and reconciliation with his wife. Advised to stop medication, abstain from sugar and alcohol, and avoid pungent/spicy foods like garlic, Allium macrostemon, leeks, and chili peppers. Encouraged daily exercise for health maintenance.
[Commentary]: This young, strong patient suffered from impotence not due to Kidney deficiency, hence self-administered tonics worsened his condition. His obesity, alcoholism, flushed shiny face, red tongue with greasy coating, fatigue, and sleepiness indicate Damp-Heat郁stagnation. Pulse characteristics (soggy, slippery, wiry, rapid, deep urgency) reveal the essence is Liver Channel Damp-Heat pressing downward and Liver Qi郁stagnation transforming into Fire. One must not see impotence and automatically prescribe Kidney/Liver tonics or Mingmen warming agents. Generally, young, robust men suffering from impotence often do so due to rich food consumption or excessive drinking, leading to Damp-Heat郁stagnation and blocked Triple Burner Qi. As stated, "If Damp-Heat is not cleared, large tendons become short and weak, small tendons become lax; shortness leads to spasm, laxity leads to flaccidity (impotence)." This case illustrates that principle.
Yang Wei 2 (Prostatitis)
Patient Li, Male, 42 years old
First Visit: April 2, 1992
Suffered from prostatitis for over 10 years. For the past six months, impotence and cloudy urine. Currently obese, constipation, irritability, insomnia, vivid dreams. Tongue red with thick white greasy coating. Pulse wiry, slippery, and rapid. Pattern: Damp-Heat郁stagnation, Qi mechanism obstruction, abnormal ascending/descending. Treatment: Clear and transform Damp-Heat, regulate Qi mechanism, ascend Clear and descend Turbid.
Formula: Bombyx Batryticatus (Chanyi), Curcumae Radix (Pian Jianghuang), Bupleuri Radix (Chaihu), Scutellariae Radix (Huangqin), Meliae Semen (Chuanlianzi), Schizonepetae Herba (Jingjie), Saposhnikoviae Radix (Fangfeng) 6g each; Silkworm (Jiangcan), Arecae Pericarpium (Dafupi), Areca Seed (Binglang) 10g each; Rhubarb (Dahuang) 1g. Advised to avoid tobacco, alcohol, spicy/greasy foods, and strengthen exercise. After 7 doses, impotence improved, but irritability and vivid dreams persisted.
Original formula minus Jingjie, added Gouteng and Pi Xie (Bixie) 10g each, Zhi Qiao and Zhu Ru 6g each. After 2 weeks, sexual function normalized, other symptoms resolved.
[Commentary]: Obese individuals often have Dampness; combined with thick white greasy coating, Dampness is confirmed. Irritability, vivid dreams, red tongue, rapid pulse indicate Heat. Excessive Damp-Heat obstructing each other, blocking Qi mechanism and causing meridian stasis leads to impotence. Thus, Sheng Jiang San (Ascending and Descending Powder) regulates Qi and restores ascending/descending. Chaihu, Huangqin, Chuanlianzi drain Liver Heat. Jingjie, Fangfeng promote Yang Qi and resolve Liver郁stagnation. Dafupi, Binglang regulate the Triple Burner. With this, Damp-Heat clears and impotence resolves. If one sees impotence and assumes Mingmen Fire decline, prescribing warming tonics will not only fail to cure impotence but may lead to abscesses, strangury, or toxic sores.
Yang Qiang (Prostatitis)
Patient Zhao, Male, 39 years old
First Visit: January 9, 1992
Four months prior, took Yangqi Shi, Morinda Officinalis Root, Aconite, etc., for kidney-yang strengthening due to prostatitis. Resulted in persistent priapism (Yang Qiang). Nearly 100 doses of TCM ineffective. Currently: red face, red eyes, irritability, insomnia all night, dizziness, fatigue, perineal and testicular pain, dry stool, yellow-red urine. Tongue red with prickles, white and dry coating. Pulse wiry, slippery, and rapid. All indicate Liver Channel郁Heat. Treatment: Clear and purge Liver Channel郁Heat.
Formula: Bombyx Batryticatus (Chanyi), Curcumae Radix (Pian Jianghuang), Bupleuri Radix (Chaihu), Scutellariae Radix (Huangqin), Meliae Semen (Chuanlianzi), Fried Gardeniae Fructus (Chao Shanzhi) 6g each; Silkworm (Jiangcan), Imperatae Rhizoma (Maigen), Ophiopogonis Tuber (Lugen), Tangerine Peel (Qingchenpi), Fried Sophora Flower (Chao Huaihua) 10g each; Gentianae Radix (Longdancao) 2g; Rhubarb (Dahuang) 1g. After 3 doses, priapism improved, able to sleep. After 10 doses, symptoms basically disappeared.
[Commentary]: Patient is in his prime. Chief complaints: lower back pain, stabbing pain in perineum. Pulse and symptoms are excess, where is the deficiency? Previous doctors misdiagnosed Kidney deficiency and heavily prescribed warming tonics, causing persistent priapism, red face/eyes, irritability, insomnia, red prickly tongue, wiry-slippery-rapid pulse—a picture of Liver Channel郁Heat. Thus, clearing and purging Liver/Gallbladder郁Heat using Sheng Jiang San plus Chaihu, Huangqin, Chuanlianzi, Longdancao, Chao Shanzhi effectively cleared Liver Heat, curing the condition. This case resulted from misusing warming tonics causing Liver/Gallbladder郁Heat manifesting as priapism. The previous case (Yang Wei 2) involved Damp-Heat blocking Jueyin meridians causing impotence. Though symptoms are opposite, the pathogenesis is similar: both show Damp-Heat signs on tongue/pulse. The Liver governs free flow (Shuxie). When blocked by Damp-Heat, free flow is impaired, Qi mechanism stalls, Jueyin meridians郁stagnate, leading either to priapism or impotence. Both should be treated from the Liver perspective, regulating Qi mechanism and restoring free flow. Hence, both cases utilized Sheng Jiang San to regulate Qi and restore ascending/descending dynamics.