(301医院）初诊日期：1959年6月20日。患者孕2产1，产后十天来，排尿非常困难，但无尿痛及残尿感，舌苔淡黄，脉象细数、尺弱。辨证：肾阴不足，膀胱气化不利。治法：补益肾阴，通利膀眈。方药：熟地12克山药9克茯苓9克泽泻9克小茴香3克牛膝6克车前子12克(包）丹皮6克木香6克木通3克2剂。另：肉桂未1．2克、琥珀末1．8克，二味相和，分二次服。6月24日二诊：药后小便已能自解，尚觉通畅，舌苔白腻，脉左细弦、右细弱，治以补气养阴。方药：黄芪15克党参9克山药6克白术6克茯苓9克熟地12克桑寄生12克杜仲12克橘皮6克5剂。
(《钱伯煊妇科医案》
【评按】此例癃闭系因肾阴虚，膀胱气化不利所致，故治宜补益肾阴，通利膀眺。初用济生肾气丸加减，并配合验方以加强膀胱气化，标本兼治：终以补气养阴法善后而愈。治疗的步骤，先驱邪、后扶正，方治的层次比较清楚。
(二十一）不孕
例一张××，女，成人，已婚。初诊日期：1971年6月23日。结婚四年未孕，月经后期，40～50天一次，平素腰腹寒痛，经前乳房作胀，本月月经6月2日宋潮，舌苔淡黄腻、中剥，脉象沉细，病由肝郁肾虚，寒气凝滞所致。洽以疏肝益喑，温经散寒。当归12克茯苓12克青橘皮各6克制香附6克旋覆花9克艾叶6克狗脊12克桑寄生12克牛膝9克益母草12克8剂。另：艾附暖宫丸20丸，早晚加服各1丸。7月5日二诊：头晕腰痛，泛恶纳差，舌苔淡黄腻、尖刺，脉沉细滑。此属肾虚肝旺，脾胃不和，治以疏肝益肾，健脾和胃，佐以活血调经。党参12克茯神12克青橘皮各6克旋覆花9克(包）山药12克川断12克桑寄生12克灯芯3克白芍9克16剂。另：益红片200片，每日3次，每次10片(本院自制，附方于后）。12月31日三诊：月经于7月28日和9月16日来潮两次，末次月经11月16日，量中等，腹痛乳胀，泛恶纳差，舌苔薄黄、尖红，脉象细滑，肝胃不和，肾阴又虚。拟以疏肝和胃，佐以益肾。柴胡6克制香附6克橘皮6克姜竹茹6克黄芩9克桑寄生15克生地12克菟丝子9克3剂。1972年：月3日四诊：月经月余未至，口淡无味，喜酸厌油，乳房作胀，活苔薄黄，脉滑。尿妊娠试验阳性，现已怀孕。治再理气和胃，佐以益肾。生地12克黄芩6克桑寄生15克苧麻根12克姜竹茹9克橘皮6克川断12克苏梗6克旋覆花6克(包）3剂。以后继续调理，于1972年8月正常分娩。附：益红片方：益母草240克牛膝90克茜草60克泽兰120克红花60克川芎60克。上药共为未，制成片剂，每次服10片，每日早晚各服一次。
(《钱伯渲妇科医案》
例二王某某，女，32岁，医生，初诊日期：1976年4月5日。患者结婚四年多未孕，一向月经不调，均属后期，周期35～50天不等，量或多或少，经期少腹胀痛及腰酸，未经5月10日。妇检：外阴发育正常，未产式，阴毛较粗而密，阴道可容二指，宫颈光滑，子宫大小正常，平位，左侧可扪及卵巢增大如荔枝样。左乳晕有一黑毛长约4厘米，足毛较多。舌嫩红少苔，脉沉细。诊断：(1）经北京、广州西医院诊断为多囊性卵巢综合征。(2）中医诊断：月经不调、不孕症。治疗：遵西医嘱服用克罗米芬。中药用补肾养血、行气调经。方药：菟丝子30克熟地20克当归15克川芎10克党参15克枳壳12克淮牛膝15克淫羊霍川克肉苁蓉15克杞子15克，嘱每次月经净后配服，两天一剂，留渣再煎，连服10剂。以上方为基础，选用乌药、香附、首乌、川楝子、白芍等适当加减化裁。经过半年的治疗，月经周期已基本恢复正常，约30～35天一周期，经量中等，持续5～6天。仍嘱继续服药调治，按上方以桑椹、金樱子、黄精、女贞子等出入其间，至1977年2月怀孕，孕后两个月，因房事曾引起少量阴道流血的先兆流产症状，经治疗后胎元得以巩固，至年底安然产下一女婴，母女健康，今已两岁多。《罗元恺医著选》）
例三吴××，女，已婚，27岁。门诊号：80～73087。初诊日期：198Q年5月15日。结婚三年未受孕，经本市××医院做子官输卵管造影，诊为两侧输卵管不通。经期正常，唯有经量少、经前乳胀等症，自婚后起则加临经腹痛。脉弦细，舌苔薄黄质红。妇科检查：宫颈轻度炎症，宫体后位偏右，后壁有小结节、质偏硬，活动度差。辨证：肝气郁结，瘀热阻滞胞宫。治法：理气活血，清热通瘀。方药：柴胡5克当归9克郁金9克丹皮9克赤白芍各9克枳壳9克黄芩9克红藤30克路路通9克王不留行9克全栝蒌9克败酱草30克以上方为主，随证加减；如见乳胀、下腹痛则加小茴香6克，菖蒲9克，元胡15克。10月28日诊：经治五个月，经行腹痛大减，乳胀亦轻，基础体温有双相，但稳步升温，似有黄体不足之象，口干欲饮。脉细，舌苔薄、质红。肝气渐舒，肝阴不足，继以滋阴清热，养血调经治之。生地12克丹皮12克当归9克赤白芍各9克川芎9克牛膝9克元胡15克制香附12克泽兰9克益母草15克4剂。上方服完后，待经净，始服以下丸药：乌鸡白凤丸10粒，每日一粒，分二次吞服，连服十天。河车大造丸140克，每日二次，每次5克，连服14天。11月27日诊：11月25日月经来潮，量中等，此次行经无乳胀，但感腹胀，血块下后腹胀缓，脉弦细，舌苔薄、质红。气血失调，治宜养血理气和营。当归9克白芍9克川芎9克生熟地各9克制香附9克枸杞子9克丹皮9克川断9克仙灵脾9克石楠叶15克苁蓉9克14剂。1981年1月8日诊：末次月经1980年11月25日，停经44天，基础体温上升至37．2℃，自觉胃中不适，脉细滑，舌苔薄、尖红。1月10日诊：尿雄蟾蜍试验
(十），诊断：早孕。
(沈丽君整理：庞泮他治疗不孕症的经验，《中医杂志》9：16，1980
【评按】女子不孕的原因，祖国医学大致归纳为冲任不足、肾气虚寒，或风寒袭于子宫，或脂膜闭塞子宫；或冲任伏热、真阴不足；或阴虚火旺不能摄养精血，或属血虚，或属积血，或属肝郁：或属痰湿……。现代医学多从子宫发育不良，位置偏倾，及输卵管闭塞、卵巢排卵功能障碍等方面分析病因。
例一不孕系肝郁、肾虚寒凝所致。肝郁则气滞，气滞而血亦滞；患者复有肾气虚而命火衰，不能温养冲任，以致寒凝胞宫。治当疏肝益肾，温经散寒。附加艾附暖宫丸，功能温宫调经，益红片为钱氏经验方，有活血化瘀之效。此案贯彻始终的治法是调肝肾，通气血，温胞宫，使经调而受孕。
例二西医诊断为多囊性卵巢综合症，中医辨证以月经不调，肾亏血虚气滞为主。罗氏治以补肾养血调经，佐以行气疏肝等法，效验确切。
例三为肝肾不足，肝郁。瘀热阻滞胞宫。治宜攻补兼施，初则疏化，继则疏补结合，补肝肾而不碍邪，疏肝化瘀而不伤正。初诊方重用红藤、败酱草以清热活血散瘀，在立法和选药方面，也颇具特色。
(二十二）症瘕积聚
例一苏某，女，51岁，已婚。病历号：183579。初诊日期1971年8月24日。患子宫肌瘤十余年，月经先期，15天一次，5～6天净，量多。近一年来，月经周期紊乱，先期15天，或后期50～90天，3～4天净，量多。末次月经8月2日来潮，3天净，头晕口苦，失眠便秘，舌苔薄黄腻，边有齿痕，脉细滑数。妇科检查：子宫肌瘤如孕八周大小。辨证：气阴两虚，痰气郁结。治法：益气养阴，化痰软坚。方药：生脉散加减。北沙参12克麦冬9克五味子6克茯苓12克夜交藤12克女贞子12克昆布12克海藻12克生牡蛎15克土贝母12克莲肉12克以上法治疗十四个月后，已绝经，宫体亦萎缩，肌瘤相应缩小，基本上获得痊愈。
(《钱伯值妇科医案》）
例二杨某，女，33岁，已婚。病历号65937。初诊日期：1961年10月6日。患者述曾患两侧卵巢囊肿，剥除右侧囊肿(留下部分卵巢）。近二个月来，右侧卵巢又发现囊肿。经××医院检查证明：右侧卵巢襄肿3．5x3．5厘米。因不愿再做手术，特来就诊。一患者平素月经赶前错后不定，色量正常，惟觉体倦神疲。平日白带不多，近感右胁及脘腹有时疼痛，睡眠不好。脉弦弱兼滑，96次／分，右寸力微，音淡苔白，语声轻微，精神不振。根据脉证，此系气逆血留壅滞，结为症瘕。但精神不振语声低微，右寸脉无力，却属精气亏损之征；右胁脘腹时痛，睡眠不佳，又为肝胃失谐之象，此邪实正虚明显可知(由于ｘｘ医院检查证明，本院未做内诊）。拟攻补兼施之法。方药：萹蓄草12克，刘寄奴、茯苓各9克煅云母、军炭、丹皮、赤白芍、炙甘草各6克桂枝、桃仁泥、醋三棱各4．5克别直参3克连服3剂。10月10日二诊：右胁及脘腹疼痛减轻，睡眠好转，腹泻日二、三次，无腹痛。昨晚月经来潮，量正常，色较褐，周身乏力，脉弦滑，右手较细，舌苔薄白。患者说：“已决定去南方，请酌拟汤药、丸药各一方，以便常服”。方药：刘寄奴、煅云母、醋炒大黄炭、茯苓、赤白芍各9克萹蓄草15克桂枝、桃仁泥、醋三棱各4．5克丹皮、生甘草各6克鸡内金12克(炒）别直参3克水煎服(此方可常服）。丸药方：茯苓、桂枝、桃仁泥各30克丹皮36克赤白芍各18克真红曲15克上药共为细末，蜜为丸，每丸重3克，每日早晚各服一丸。1962年3月8日三诊：服汤药50余剂，丸药仍在续服，月经自去年12月28日来潮后，至今年2月28日方行。3月5日月经又来，量少色黑，夹有烂肉样物，现少腹左侧有时隐痛，精神困倦，食眠尚好。脉弦滑，84次／分，右寸仍少力；舌边有齿痕，苔薄白。瘀结已通，精力犹弱，宜补气健脾，调和冲任。方药：桑寄生18克续断12克焦白术、生地各9克生白芍、焦六曲各15克桂枝4．5克白寇别直参(二次分冲）各3克炙甘草6克鲜姜3片水煎服，3剂。3月13日四诊：月经于10日已净，少腹右侧偶有隐痛，乘车颠簸时痛较甚，精神有时较差，饮食、睡眠好，小便正常，大便较溏。脉略弦滑，右较细：苔白腻，舌边缘有齿痕。方药：桑寄生30克续断、鸡血藤各12克焦白术、鸡内金、生橘核、焦山楂各9克桂枝、川楝子各4．5克炙甘草6克鲜姜3片服3剂。4月7日五诊：患者述经××医院检查，右侧卵巢囊肿已消失。
(马龙伯：“卵巢囊肿医案三则，《新医药学杂志》10：43．1975）
例三陈某，女，23岁，某年春三月求诊。自诉月经3月多未来潮，渐渐腹胀疼痛，小腹硬，手不能近，连日流血，时多时少，坠胀难受，食欲减少，某医院诊为妊娠，而患者自知非孕。观其颜青，舌色紫，扪其腹，拒按，大如箕，脉象沉弦涩，末次月经是去年12月中旬，正在经期随夫运货，拉车于旅途之中，自此月经停止。此实非孕，腹大如箕，非三月孕形；腹胀痛而小腹坠甚：拒按而坚，亦非孕象；且连日流血而腰不痛，又不似胎漏，此必经期用力大过，兼之途中感受冬候严寒所致，病名石瘕，以女体素健壮，主以当归饮，血竭散合剂：当归6克川芎6克醋制鳖甲15克吴萸4．5克桃仁、赤芍各6克肉桂3克槟榔3克青皮3克木香、莪术、三棱、大黄各3克延胡索6克血竭3克。浓煎温服。此方温通破坚，服一剂，下掌大黑血一片，痛稍减，坠胀不减，脉仍如故，乃以其妹来告：“服药一时许，患者突然昏倒，不知人事，手足亦冷，见下衣皆湿，宽衣视之，皆为血块，大如碗者一枚，余如卵者数枚，色多瘀黑，不一会，手足自温，神志渐清。今日有恶心，不思食。……患者自觉小腹胀痛俱减，但觉尚有似茄子硬块未去。蒲老以“大积大聚，衰其半而止……，况血海骤空，胃虚不纳，宜急扶胃气。”原方止后服。易以异功散加味，嘱服二剂。越三日，其妹来告：“患者服药后，胃口已好，睡眠亦安，已不流血，惟连泻豆渣状物，今晨复下卵大硬块，色白，坚如石，弃之厕中”。再以十全大补，连服三剂，诸证皆除，惟全身浮肿，此虚肿也。仍以十全大补，肉桂易桂枝又进三剂，身肿消失，精神渐复，停药，以饮食调理，又一月恢复健康，月经应期而至。
(《蒲辅周医案》）
例四程右。於12月10日初诊。环脐少腹绷胀膨大，状如怀子。时或胀痛，食难消受；大便不利，带下频仍，脉弦滞。似胀满而非胀满，恐肠覃之属，姑拟一方，未识如何。制川朴4．5克炒青皮4．5克泽兰9克红花2．4克缩砂仁4．5克杏仁9克陈枳壳4．5克(炒）茯苓9克煨莪术4。5克广木香2．4克泡吴萸1．8克白蔹9克12月14日
（301医院）初诊日期：1959年6月20日。患者怀孕2次，生产1次，产后十天来，排尿非常困难，但没有尿痛及排尿不尽感，舌苔淡黄，脉象细数、尺部弱。辨证：肾阴不足，膀胱气化不利。治法：补益肾阴，通利膀胱。方药：熟地黄12克，山药9克，茯苓9克，泽泻9克，小茴香3克，牛膝6克，车前子12克（包煎），牡丹皮6克，木香6克，木通3克，共2剂。另：肉桂末1.2克、琥珀末1.8克，两味混合，分两次服用。6月24日二诊：服药后小便已能自行排出，尚觉通畅，舌苔白腻，脉左细弦、右细弱，治以补气养阴。方药：黄芪15克，党参9克，山药6克，白术6克，茯苓9克，熟地黄12克，桑寄生12克，杜仲12克，橘皮6克，共5剂。
（《钱伯煊妇科医案》
【评按】此例癃闭（排尿困难或闭塞不通）系因肾阴虚，膀胱气化不利所致，故治宜补益肾阴，通利膀胱。初用济生肾气丸加减，并配合验方以加强膀胱气化，标本兼治；终以补气养阴法善后而愈。治疗的步骤，先驱邪、后扶正，方治的层次比较清楚。
(二十一）不孕症
例一张××，女，成人，已婚。初诊日期：1971年6月23日。结婚四年未孕，月经后期，40～50天一次，平素腰腹寒痛，经前乳房作胀，本月月经6月2日未来潮，舌苔淡黄腻、中剥，脉象沉细，病由肝郁肾虚，寒气凝滞所致。治以疏肝益肾，温经散寒。当归12克，茯苓12克，青橘皮各6克，制香附6克，旋覆花9克，艾叶6克，狗脊12克，桑寄生12克，牛膝9克，益母草12克，共8剂。另：艾附暖宫丸20丸，早晚加服各1丸。7月5日二诊：头晕腰痛，泛恶纳差，舌苔淡黄腻、尖刺，脉沉细滑。此属肾虚肝旺，脾胃不和，治以疏肝益肾，健脾和胃，佐以活血调经。党参12克，茯神12克，青橘皮各6克，旋覆花9克（包煎），山药12克，川断12克，桑寄生12克，灯芯3克，白芍9克，共16剂。另：益红片200片，每日3次，每次10片（本院自制，附方于后）。12月31日三诊：月经于7月28日和9月16日来潮两次，末次月经11月16日，量中等，腹痛乳胀，泛恶纳差，舌苔薄黄、尖红，脉象细滑，肝胃不和，肾阴又虚。拟以疏肝和胃，佐以益肾。柴胡6克，制香附6克，橘皮6克，姜竹茹6克，黄芩9克，桑寄生15克，生地12克，菟丝子9克，共3剂。1972年1月3日四诊：月经月余未至，口淡无味，喜酸厌油，乳房作胀，舌苔薄黄，脉滑。尿妊娠试验阳性，现已怀孕。治再理气和胃，佐以益肾。生地12克，黄芩6克，桑寄生15克，苎麻根12克，姜竹茹9克，橘皮6克，川断12克，苏梗6克，旋覆花6克（包煎），共3剂。以后继续调理，于1972年8月正常分娩。附：益红片方：益母草240克，牛膝90克，茜草60克，泽兰120克，红花60克，川芎60克。上药共为末，制成片剂，每次服10片，每日早晚各服一次。
（《钱伯煊妇科医案》
例二王某某，女，32岁，医生，初诊日期：1976年4月5日。患者结婚四年多未孕，一向月经不调，均属后期，周期35～50天不等，量或多或少，经期少腹胀痛及腰酸，末次月经5月10日。妇检：外阴发育正常，未产式，阴毛较粗而密，阴道可容二指，宫颈光滑，子宫大小正常，平位，左侧可扪及卵巢增大如荔枝样。左乳晕有一黑毛长约4厘米，足毛较多。舌嫩红少苔，脉沉细。诊断：(1) 经北京、广州西医院诊断为多囊性卵巢综合征。(2) 中医诊断：月经不调、不孕症。治疗：遵西医嘱服用克罗米芬。中药用补肾养血、行气调经。方药：菟丝子30克，熟地20克，当归15克，川芎10克，党参15克，枳壳12克，淮牛膝15克，淫羊藿9克，肉苁蓉15克，杞子15克，嘱每次月经净后配服，两天一剂，留渣再煎，连服10剂。以上方为基础，选用乌药、香附、首乌、川楝子、白芍等适当加减化裁。经过半年的治疗，月经周期已基本恢复正常，约30～35天一周期，经量中等，持续5～6天。仍嘱继续服药调治，按上方以桑椹、金樱子、黄精、女贞子等出入其间，至1977年2月怀孕，孕后两个月，因房事曾引起少量阴道流血的先兆流产症状，经治疗后胎元得以巩固，至年底安然产下一女婴，母女健康，今已两岁多。（《罗元恺医著选》）
例三吴××，女，已婚，27岁。门诊号：80～73087。初诊日期：1980年5月15日。结婚三年未受孕，经本市××医院做子宫输卵管造影，诊为两侧输卵管不通。经期正常，唯有经量少、经前乳胀等症，自婚后起则加重经腹痛。脉弦细，舌苔薄黄质红。妇科检查：宫颈轻度炎症，宫体后位偏右，后壁有小结节、质偏硬，活动度差。辨证：肝气郁结，瘀热阻滞胞宫。治法：理气活血，清热通瘀。方药：柴胡5克，当归9克，郁金9克，丹皮9克，赤白芍各9克，枳壳9克，黄芩9克，红藤30克，路路通9克，王不留行9克，全栝蒌9克，败酱草30克。以上方为主，随证加减；如见乳胀、下腹痛则加小茴香6克，石菖蒲9克，元胡15克。10月28日诊：经治五个月，经行腹痛大减，乳胀亦轻，基础体温有双相，但稳步升温，似有黄体不足之象，口干欲饮。脉细，舌苔薄、质红。肝气渐舒，肝阴不足，继以滋阴清热，养血调经治之。生地12克，丹皮12克，当归9克，赤白芍各9克，川芎9克，牛膝9克，元胡15克，制香附12克，泽兰9克，益母草15克，共4剂。上方服完后，待经净，始服以下丸药：乌鸡白凤丸10粒，每日一粒，分二次吞服，连服十天。河车大造丸140克，每日二次，每次5克，连服14天。11月27日诊：11月25日月经来潮，量中等，此次行经无乳胀，但感腹胀，血块下后腹胀缓，脉弦细，舌苔薄、质红。气血失调，治宜养血理气和营。当归9克，白芍9克，川芎9克，生熟地各9克，制香附9克，枸杞子9克，丹皮9克，川断9克，仙灵脾9克，石楠叶15克，肉苁蓉9克，共14剂。1981年1月8日诊：末次月经1980年11月25日，停经44天，基础体温上升至37.2℃，自觉胃中不适，脉细滑，舌苔薄、尖红。1月10日诊：尿雄蟾蜍试验阳性，诊断：早孕。
（沈丽君整理：庞泮池治疗不孕症的经验，《中医杂志》9：16，1980
【评按】女子不孕的原因，祖国医学大致归纳为冲任不足、肾气虚寒，或风寒袭于子宫，或脂膜闭塞子宫；或冲任伏热、真阴不足；或阴虚火旺不能摄养精血，或属血虚，或属积血，或属肝郁；或属痰湿……。现代医学多从子宫发育不良，位置偏倾，及输卵管闭塞、卵巢排卵功能障碍等方面分析病因。
例一不孕系肝郁、肾虚寒凝所致。肝郁则气滞，气滞而血亦滞；患者复有肾气虚而命门火衰，不能温养冲任，以致寒凝胞宫。治当疏肝益肾，温经散寒。附加艾附暖宫丸，功能温宫调经，益红片为钱氏经验方，有活血化瘀之效。此案贯彻始终的治法是调肝肾，通气血，温胞宫，使经调而受孕。
例二西医诊断为多囊性卵巢综合症，中医辨证以月经不调，肾亏血虚气滞为主。罗氏治以补肾养血调经，佐以行气疏肝等法，效验确切。
例三为肝肾不足，肝郁。瘀热阻滞胞宫。治宜攻补兼施，初则疏化，继则疏补结合，补肝肾而不碍邪，疏肝化瘀而不伤正。初诊方重用红藤、败酱草以清热活血散瘀，在立法和选药方面，也颇具特色。
(二十二）症瘕积聚
例一苏某，女，51岁，已婚。病历号：183579。初诊日期1971年8月24日。患子宫肌瘤十余年，月经先期，15天一次，5～6天净，量多。近一年来，月经周期紊乱，先期15天，或后期50～90天，3～4天净，量多。末次月经8月2日来潮，3天净，头晕口苦，失眠便秘，舌苔薄黄腻，边有齿痕，脉细滑数。妇科检查：子宫肌瘤如孕八周大小。辨证：气阴两虚，痰气郁结。治法：益气养阴，化痰软坚。方药：生脉散加减。北沙参12克，麦冬9克，五味子6克，茯苓12克，夜交藤12克，女贞子12克，昆布12克，海藻12克，生牡蛎15克，土贝母12克，莲肉12克。以上法治疗十四个月后，已绝经，宫体亦萎缩，肌瘤相应缩小，基本上获得痊愈。
（《钱伯煊妇科医案》）
例二杨某，女，33岁，已婚。病历号65937。初诊日期：1961年10月6日。患者述曾患两侧卵巢囊肿，剥除右侧囊肿（留下部分卵巢）。近二个月来，右侧卵巢又发现囊肿。经××医院检查证明：右侧卵巢囊肿3.5x3.5厘米。因不愿再做手术，特来就诊。患者平素月经赶前错后不定，色量正常，惟觉体倦神疲。平日白带不多，近感右胁及脘腹有时疼痛，睡眠不好。脉弦弱兼滑，96次／分，右寸力微，音淡苔白，语声轻微，精神不振。根据脉证，此系气逆血留壅滞，结为症瘕。但精神不振语声低微，右寸脉无力，却属精气亏损之征；右胁脘腹时痛，睡眠不佳，又为肝胃失谐之象，此邪实正虚明显可知（由于××医院检查证明，本院未做内诊）。拟攻补兼施之法。方药：萹蓄草12克，刘寄奴、茯苓各9克，煅云母、军炭、丹皮、赤白芍、炙甘草各6克，桂枝、桃仁泥、醋三棱各4.5克，别直参3克，连服3剂。10月10日二诊：右胁及脘腹疼痛减轻，睡眠好转，腹泻日二、三次，无腹痛。昨晚月经来潮，量正常，色较褐，周身乏力，脉弦滑，右手较细，舌苔薄白。患者说：“已决定去南方，请酌拟汤药、丸药各一方，以便常服”。方药：刘寄奴、煅云母、醋炒大黄炭、茯苓、赤白芍各9克，萹蓄草15克，桂枝、桃仁泥、醋三棱各4.5克，丹皮、生甘草各6克，鸡内金12克（炒），别直参3克，水煎服（此方可常服）。丸药方：茯苓、桂枝、桃仁泥各30克，丹皮36克，赤白芍各18克，真红曲15克。上药共为细末，蜜为丸，每丸重3克，每日早晚各服一丸。1962年3月8日三诊：服汤药50余剂，丸药仍在续服，月经自去年12月28日来潮后，至今年2月28日方行。3月5日月经又来，量少色黑，夹有烂肉样物，现少腹左侧有时隐痛，精神困倦，食眠尚好。脉弦滑，84次／分，右寸仍少力；舌边有齿痕，苔薄白。瘀结已通，精力犹弱，宜补气健脾，调和冲任。方药：桑寄生18克，续断12克，焦白术、生地各9克，生白芍、焦六曲各15克，桂枝4.5克，白寇、别直参（二次分冲）各3克，炙甘草6克，鲜姜3片，水煎服，3剂。3月13日四诊：月经于10日已净，少腹右侧偶有隐痛，乘车颠簸时痛较甚，精神有时较差，饮食、睡眠好，小便正常，大便较溏。脉略弦滑，右较细；苔白腻，舌边缘有齿痕。方药：桑寄生30克，续断、鸡血藤各12克，焦白术、鸡内金、生橘核、焦山楂各9克，桂枝、川楝子各4.5克，炙甘草6克，鲜姜3片，服3剂。4月7日五诊：患者述经××医院检查，右侧卵巢囊肿已消失。
（马龙伯：“卵巢囊肿医案三则，《新医药学杂志》10：43．1975）
例三陈某，女，23岁，某年春三月求诊。自诉月经3月多未来潮，渐渐腹胀疼痛，小腹硬，手不能近，连日流血，时多时少，坠胀难受，食欲减少，某医院诊为妊娠，而患者自知非孕。观其颜青，舌色紫，扪其腹，拒按，大如箕，脉象沉弦涩，末次月经是去年12月中旬，正在经期随夫运货，拉车于旅途之中，自此月经停止。此实非孕，腹大如箕，非三月孕形；腹胀痛而小腹坠甚；拒按而坚，亦非孕象；且连日流血而腰不痛，又不似胎漏，此必经期用力大过，兼之途中感受冬候严寒所致，病名石瘕，以女体素健壮，主以当归饮，血竭散合剂：当归6克，川芎6克，醋制鳖甲15克，吴萸4.5克，桃仁、赤芍各6克，肉桂3克，槟榔3克，青皮3克，木香、莪术、三棱、大黄各3克，延胡索6克，血竭3克。浓煎温服。此方温通破坚，服一剂，下掌大黑血一片，痛稍减，坠胀不减，脉仍如故，乃以其妹来告：“服药一时许，患者突然昏倒，不知人事，手足亦冷，见下衣皆湿，宽衣视之，皆为血块，大如碗者一枚，余如卵者数枚，色多瘀黑，不一会，手足自温，神志渐清。今日有恶心，不思食。……患者自觉小腹胀痛俱减，但觉尚有似茄子硬块未去。蒲老以“大积大聚，衰其半而止……”，况血海骤空，胃虚不纳，宜急扶胃气。”原方止后服。易以异功散加味，嘱服二剂。越三日，其妹来告：“患者服药后，胃口已好，睡眠亦安，已不流血，惟连泻豆渣状物，今晨复下卵大硬块，色白，坚如石，弃之厕中”。再以十全大补，连服三剂，诸证皆除，惟全身浮肿，此虚肿也。仍以十全大补，肉桂易桂枝又进三剂，身肿消失，精神渐复，停药，以饮食调理，又一月恢复健康，月经应期而至。
（《蒲辅周医案》）
例四程右。於12月10日初诊。环脐少腹绷胀膨大，状如怀子。时或胀痛，食难消受；大便不利，带下频仍，脉弦滞。似胀满而非胀满，恐肠覃之属，姑拟一方，未识如何。制川朴4.5克，炒青皮4.5克，泽兰9克，红花2.4克，缩砂仁4.5克，杏仁9克，陈枳壳4.5克（炒），茯苓9克，煨莪术4.5克，广木香2.4克，泡吴萸1.8克，白蔹9克。12月14日
(301 Hospital) Initial visit date: June 20, 1959. The patient had two pregnancies and one birth. For ten days postpartum, she experienced severe difficulty in urination, but without dysuria or a sensation of residual urine. The tongue coating was pale yellow, and the pulse was fine-rapid (Xi Shu) with weakness at the Chi position. Syndrome differentiation: Kidney Yin deficiency with impaired Qi transformation of the Bladder. Treatment method: Tonify Kidney Yin, promote free flow of Qi and unblock the Bladder. Prescription: Prepared Rehmannia Root (Shu Di Huang) 12g, Chinese Yam (Shan Yao) 9g, Poria (Fu Ling) 9g, Alisma Rhizome (Ze Xie) 9g, Fennel Fruit (Xiao Hui Xiang) 3g, Achyranthes Root (Niu Xi) 6g, Plantago Seed (Che Qian Zi) 12g (wrapped), Moutan Bark (Dan Pi) 6g, Aucklandia Root (Mu Xiang) 6g, Akebia Stem (Mu Tong) 3g, for 2 doses. Additionally: Cinnamon Twig powder (Rou Gui Mo) 1.2g and Amber powder (Hu Po Mo) 1.8g, mixed together, taken in two divided doses. Second visit on June 24: After taking the medicine, urination could be initiated voluntarily and felt smooth. The tongue coating was white and greasy; the pulse was fine-wiry on the left and fine-weak on the right. Treatment: Tonify Qi and nourish Yin. Prescription: Astragalus Root (Huang Qi) 15g, Codonopsis Root (Dang Shen) 9g, Chinese Yam (Shan Yao) 6g, Atractylodes Macrocephala Rhizome (Bai Zhu) 6g, Poria (Fu Ling) 9g, Prepared Rehmannia Root (Shu Di Huang) 12g, Eucommia Bark (Sang Ji Sheng) 12g, Eucommia Bark (Du Zhong) 12g, Tangerine Peel (Ju Pi) 6g, for 5 doses.
(Qian Boxuan's Gynecological Medical Cases)
[Commentary] This case of strangury (Long Bi - difficulty or obstruction of urination) was caused by Kidney Yin deficiency and impaired Qi transformation of the Bladder. Therefore, the treatment should tonify Kidney Yin and unblock the Bladder. Initially, Jisheng Shenqi Wan was modified, combined with an empirical formula to strengthen the Qi transformation of the Bladder, treating both root and branch. Finally, the treatment concluded with tonifying Qi and nourishing Yin, resulting in recovery. The treatment steps were clear: first expelling pathogenic factors, then supporting healthy Qi.
(21) Infertility
Case 1: Zhang XX, female, adult, married. Initial visit date: June 23, 1971. Married for four years without pregnancy. Menstruation was delayed, occurring once every 40–50 days. Usually suffered from cold pain in the lower back and abdomen, and breast distension before menstruation. Menstruation for this month had not arrived by June 2. The tongue coating was pale yellow and greasy with peeling in the center; the pulse was deep-fine. The disease was caused by Liver Qi stagnation, Kidney deficiency, and cold qi congealing and obstructing. Treatment: Soothe the Liver and benefit the Kidney, warm the meridians and dissipate cold. Prescription: Angelica Sinensis Root (Dang Gui) 12g, Poria (Fu Ling) 12g, Green Tangerine Peel (Qing Ju Pi) 6g each, Processed Cyperus Rhizome (Zhi Xiang Fu) 6g, Inula Flower (Xuan Fu Hua) 9g, Moxa Leaf (Ai Ye) 6g, Dogspine (Gou Ji) 12g, Eucommia Bark (Sang Ji Sheng) 12g, Achyranthes Root (Niu Xi) 9g, Motherwort Herb (Yi Mu Cao) 12g, for 8 doses. Additionally: Aifu Nuangong Wan (Cinnamon Twig and Cyperus Pill for Warming the Uterus) 20 pills, take one pill morning and evening in addition to regular meals. Second visit on July 5: Dizziness, lower back pain, nausea, and poor appetite. Tongue coating was pale yellow and greasy with prickles at the tip; pulse was deep-fine-slippery. This belongs to Kidney deficiency with Liver hyperactivity, and disharmony of the Spleen and Stomach. Treatment: Soothe the Liver and benefit the Kidney, invigorate the Spleen and harmonize the Stomach, assisted by activating blood and regulating menstruation. Prescription: Codonopsis Root (Dang Shen) 12g, Poria with Hostwood (Fu Shen) 12g, Green Tangerine Peel (Qing Ju Pi) 6g each, Inula Flower (Xuan Fu Hua) 9g (wrapped), Chinese Yam (Shan Yao) 12g, Drynaria Rhizome (Chuan Duan) 12g, Eucommia Bark (Sang Ji Sheng) 12g, Centipede Grass (Deng Xin) 3g, White Peony Root (Bai Shao) 9g, for 16 doses. Additionally: Yihong Tablets 200 tablets, three times daily, 10 tablets each time (self-made by our hospital, prescription attached below). Third visit on December 31: Menstruation occurred twice, on July 28 and September 16. Last menstrual period was November 16, moderate volume, abdominal pain and breast distension, nausea and poor appetite. Tongue coating was thin yellow with redness at the tip; pulse was fine-slippery. Disharmony of Liver and Stomach, and further deficiency of Kidney Yin. Plan: Soothe the Liver and harmonize the Stomach, assisted by benefiting the Kidney. Prescription: Bupleurum Root (Chai Hu) 6g, Processed Cyperus Rhizome (Zhi Xiang Fu) 6g, Tangerine Peel (Ju Pi) 6g, Ginger-processed Bamboo Shavings (Jiang Zhu Ru) 6g, Scutellaria Root (Huang Qin) 9g, Eucommia Bark (Sang Ji Sheng) 15g, Rehmannia Root (Sheng Di) 12g, Dodder Seed (Tu Si Zi) 9g, for 3 doses. Fourth visit on January 3, 1972: Menstruation had not arrived for over a month. Tasteless mouth, preference for sour taste, aversion to oil, breast distension. Tongue coating was thin yellow; pulse was slippery. Urine pregnancy test positive; now pregnant. Treatment: Continue to regulate Qi and harmonize the Stomach, assisted by benefiting the Kidney. Prescription: Rehmannia Root (Sheng Di) 12g, Scutellaria Root (Huang Qin) 6g, Eucommia Bark (Sang Ji Sheng) 15g, Ramie Root (Zhu Ma Gen) 12g, Ginger-processed Bamboo Shavings (Jiang Zhu Ru) 9g, Tangerine Peel (Ju Pi) 6g, Drynaria Rhizome (Chuan Duan) 12g, Perilla Stem (Su Geng) 6g, Inula Flower (Xuan Fu Hua) 6g (wrapped), for 3 doses. Continued regulation thereafter, and delivered normally in August 1972. Appendix: Yihong Tablet Prescription: Motherwort Herb (Yi Mu Cao) 240g, Achyranthes Root (Niu Xi) 90g, Rubia Root (Qian Cao) 60g, Lycopodium Herb (Ze Lan) 120g, Safflower (Hong Hua) 60g, Ligusticum Rhizome (Chuan Xiong) 60g. Grind all herbs into powder, make into tablets. Take 10 tablets each time, morning and evening.
(Qian Boxuan's Gynecological Medical Cases)
Case 2: Wang XX, female, 32 years old, doctor. Initial visit date: April 5, 1976. Married for over four years without pregnancy. Always had irregular menstruation, mostly delayed, cycles varying from 35 to 50 days. Volume varied. Lower abdominal distending pain and lower back soreness during menstruation. Last menstrual period was May 10. Gynecological examination: Vulva development normal, nulliparous type, pubic hair coarse and dense, vagina accommodates two fingers, cervix smooth, uterus size normal, anteverted, left ovary palpable enlarged like a lychee. One black hair about 4 cm long on the left areola,较多 foot hair. Tongue tender red with little coating, pulse deep-fine. Diagnosis: (1) Diagnosed as Polycystic Ovary Syndrome by Western hospitals in Beijing and Guangzhou. (2) TCM Diagnosis: Irregular menstruation, Infertility. Treatment: Follow Western medical advice to take Clomiphene. TCM treatment: Tonify Kidney and nourish Blood, move Qi and regulate menstruation. Prescription: Cuscuta Seed (Tu Si Zi) 30g, Prepared Rehmannia Root (Shu Di) 20g, Angelica Sinensis Root (Dang Gui) 15g, Ligusticum Rhizome (Chuan Xiong) 10g, Codonopsis Root (Dang Shen) 15g, Aurantium Fruit (Zhi Ke) 12g, Huai Niu Xi 15g, Epimedium Herb (Yin Yang Huo) 9g, Cistanche Stem (Rou Cong Rong) 15g, Goji Berry (Qi Zi) 15g. Instructed to take after menstruation ends, one dose every two days, decoct again with residue, take continuously for 10 doses. Based on the above prescription, appropriately modify with Adder's Tongue Fern Rhizome (Wu Yao), Cyperus Rhizome (Xiang Fu), Polygonum Multiflorum Stem (Shou Wu), Sichuan Chinaberry Seed (Chuan Liu Zi), White Peony Root (Bai Shao), etc. After half a year of treatment, the menstrual cycle basically returned to normal, approximately 30–35 days per cycle, moderate volume, lasting 5–6 days. Still instructed to continue medication for regulation, using Mulberry Fruit (Sang Shen), Cherokee Rose Fruit (Jin Ying Zi), Polygonatum Rhizome (Huang Jing), Glossy Privet Fruit (Nu Zhen Zi) etc. among others. Became pregnant in February 1977. Two months into pregnancy, slight vaginal bleeding due to sexual intercourse threatened miscarriage. After treatment, the fetus was consolidated, and safely delivered a baby girl at the end of the year. Mother and daughter healthy, now over two years old. (Selected Works of Luo Yuankai)
Case 3: Wu XX, female, married, 27 years old. Outpatient No.: 80-73087. Initial visit date: May 15, 1980. Married for three years without conception. Hysterosalpingography at a local hospital diagnosed bilateral fallopian tube blockage. Menstrual cycle normal, only scanty flow and premenstrual breast distension. Since marriage, dysmenorrhea worsened. Pulse wiry-fine, tongue coating thin yellow, body red. Gynecological examination: Mild cervical inflammation, uterine body retroverted to the right, small nodule on posterior wall, hard texture, poor mobility. Syndrome differentiation: Liver Qi stagnation, stasis-heat obstructing the Uterus. Treatment method: Regulate Qi and activate blood, clear heat and unblock stasis. Prescription: Bupleurum Root (Chai Hu) 5g, Angelica Sinensis Root (Dang Gui) 9g, Curcuma Aromatica Rhizome (Yu Jin) 9g, Moutan Cortex (Dan Pi) 9g, Red and White Peony Roots (Chi Bai Shao) 9g each, Aurantium Fruit (Zhi Ke) 9g, Scutellaria Root (Huang Qin) 9g, Patrinia Herb (Hong Teng) 30g, Liquidambar Fructus (Lu Lu Tong) 9g, Immortelle Flower (Wang Bu Liu Xing) 9g, Trichosanthes Fruit (Quan Gua Lou) 9g, Patrinia Herb (Bai Jiang Cao) 30g. Mainly based on this prescription, modify according to symptoms; if breast distension or lower abdominal pain occurs, add Fennel Fruit (Xiao Hui Xiang) 6g, Acorus Rhizome (Shi Chang Pu) 9g, Corydalis Rhizome (Yan Hu Suo) 15g. Visit on October 28: After five months of treatment, dysmenorrhea significantly reduced, breast distension also light. Basal body temperature showed biphasic pattern, but steady rise suggested luteal insufficiency. Dry mouth desire to drink. Pulse fine, tongue coating thin, body red. Liver Qi gradually soothing, Liver Yin insufficient. Continue with nourishing Yin, clearing heat, nourishing blood and regulating menstruation. Prescription: Rehmannia Root (Sheng Di) 12g, Moutan Cortex (Dan Pi) 12g, Angelica Sinensis Root (Dang Gui) 9g, Red and White Peony Roots (Chi Bai Shao) 9g each, Ligusticum Rhizome (Chuan Xiong) 9g, Achyranthes Root (Niu Xi) 9g, Corydalis Rhizome (Yan Hu Suo) 15g, Processed Cyperus Rhizome (Zhi Xiang Fu) 12g, Lycopodium Herb (Ze Lan) 9g, Motherwort Herb (Yi Mu Cao) 15g, for 4 doses. After finishing the above prescription, wait until menstruation ends, then take the following pills: Wuji Baifeng Wan 10 pills, one pill daily, swallowed in two divided doses, for 10 consecutive days. Heche Dazao Wan 140g, twice daily, 5g each time, for 14 consecutive days. Visit on November 27: Menstruation started on November 25, moderate volume. No breast distension this time, but abdominal distension. Abdominal distension eased after passing blood clots. Pulse wiry-fine, tongue coating thin, body red. Qi and Blood disharmony. Treatment: Nourish blood, regulate Qi and harmonize Ying. Prescription: Angelica Sinensis Root (Dang Gui) 9g, White Peony Root (Bai Shao) 9g, Ligusticum Rhizome (Chuan Xiong) 9g, Raw and Prepared Rehmannia Roots (Sheng Shu Di) 9g each, Processed Cyperus Rhizome (Zhi Xiang Fu) 9g, Goji Berry (Gou Qi Zi) 9g, Moutan Cortex (Dan Pi) 9g, Drynaria Rhizome (Chuan Duan) 9g, Epimedium Herb (Xian Ling Pi) 9g, Lithospermum Root (Shi Nan Ye) 15g, Cistanche Stem (Rou Cong Rong) 9g, for 14 doses. Visit on January 8, 1981: Last menstrual period November 25, 1980. Amenorrhea for 44 days. Basal body temperature rose to 37.2°C. Self-reported gastric discomfort. Pulse fine-slippery, tongue coating thin, tip red. Visit on January 10: Urine Toad Test Positive. Diagnosis: Early pregnancy.
(Sorted by Shen Lijun: Experience of Pang Panchi in treating infertility, *Journal of Traditional Chinese Medicine* 9:16, 1980)
[Commentary] The causes of female infertility in TCM are roughly summarized as insufficiency of Chong and Ren meridians, deficiency-cold of Kidney Qi, wind-cold attacking the uterus, or phlegm-damp blocking the uterus; or latent heat in Chong and Ren, deficiency of True Yin; or Yin deficiency with fire hyperactivity unable to nouressence and blood; or belonging to Blood deficiency, or accumulated blood, or Liver stagnation; or belonging to Phlegm-damp... Modern medicine mostly analyzes etiology from aspects such as uterine hypoplasia, positional deviation, fallopian tube blockage, and ovarian ovulation dysfunction.
Case 1 infertility is caused by Liver stagnation and Kidney deficiency with cold coagulation. Liver stagnation leads to Qi stagnation, and Qi stagnation leads to Blood stagnation; the patient also has Kidney Qi deficiency and Mingmen Fire decline, unable to warm and nourish Chong and Ren, leading to cold coagulation in the Uterus. Treatment should soothe the Liver and benefit the Kidney, warm the meridians and dissipate cold. Adding Aifu Nuangong Wan, which functions to warm the uterus and regulate menstruation; Yihong Tablet is Qian's empirical formula, with effects of activating blood and resolving stasis. The treatment method贯穿 throughout this case is regulating Liver and Kidney, unblocking Qi and Blood, warming the Uterus, making menstruation regular to achieve conception.
Case 2 Western diagnosis is Polycystic Ovary Syndrome, TCM syndrome differentiation focuses on irregular menstruation, Kidney deficiency, Blood deficiency, and Qi stagnation. Dr. Luo treated with tonifying Kidney, nourishing Blood, regulating menstruation, assisted by moving Qi and soothing Liver methods, with definite efficacy.
Case 3 is Liver and Kidney insufficiency, Liver stagnation. Stasis-heat obstructs the Uterus. Treatment should combine attack and tonification. Initially resolve and transform, subsequently combine soothing and tonifying, tonifying Liver and Kidney without hindering pathogens, soothing Liver and resolving stasis without damaging healthy Qi. The initial prescription heavily uses Patrinia Herb (Hong Teng) and Patrinia Herb (Bai Jiang Cao) to clear heat, activate blood, and resolve stasis, which is quite distinctive in principle formulation and herb selection.
(22) Masses and Accumulations
Case 1: Su XX, female, 51 years old, married. Medical Record No.: 183579. Initial visit date: August 24, 1971. Suffered from uterine fibroids for over ten years. Menstruation came early, once every 15 days, lasting 5–6 days, heavy volume. In the past year, menstrual cycle became disordered, coming early by 15 days, or late by 50–90 days, lasting 3–4 days, heavy volume. Last menstrual period started on August 2, lasted 3 days. Dizziness, bitter taste in mouth, insomnia, constipation. Tongue coating thin yellow greasy, teeth marks on edges, pulse fine-slippery-rapid. Gynecological examination: Uterine fibroid size equivalent to 8 weeks pregnancy. Syndrome differentiation: Qi and Yin dual deficiency, Phlegm-Qi stagnation. Treatment method: Benefit Qi and nourish Yin, resolve phlegm and soften hardness. Prescription: Modified Shengmai San. Glehnia Root (Bei Sha Shen) 12g, Ophiopogon Tuber (Mai Dong) 9g, Schisandra Fruit (Wu Wei Zi) 6g, Poria (Fu Ling) 12g, Night-blooming Jasmine Vine (Ye Jiao Teng) 12g, Ligustrum Fruit (Nu Zhen Zi) 12g, Kelp (Kun Bu) 12g, Seaweed (Zao Hai) 12g, Raw Oyster Shell (Sheng Mu Li) 15g, Fritillaria Thunbergii Bulb (Tu Bei Mu) 12g, Lotus Seed Meat (Lian Rou) 12g. After fourteen months of treatment with the above method, menopause was reached, uterine body also atrophied, fibroids correspondingly shrank, basically achieving cure.
(Qian Boxuan's Gynecological Medical Cases)
Case 2: Yang XX, female, 33 years old, married. Medical Record No. 65937. Initial visit date: October 6, 1961. Patient stated she previously suffered from bilateral ovarian cysts, right cyst removed (leaving part of ovary). In the past two months, a cyst was found again in the right ovary. Checked by XX Hospital proving: Right ovarian cyst 3.5x3.5 cm. Reluctant to undergo surgery again, specially came for consultation. Patient usually had irregular menstruation, sometimes early, sometimes late, color and volume normal, only felt fatigue and spirit lassitude. Daily leukorrhea not much, recently felt occasional pain in right hypochondrium and epigastrium/abdomen, poor sleep. Pulse wiry-weak with slippery quality, 96 beats/min, Right Cun force weak, voice faint, tongue white, speech quiet, spirit listless. According to pulse and symptoms, this is Qi reversal and Blood stasis congestion, knotting into masses. But listless spirit, low voice, weak Right Cun pulse indicates essence and Qi depletion; occasional pain in right hypochondrium/epigastrium/abdomen, poor sleep indicates Liver-Stomach disharmony. This clearly shows excess pathogen and deficient healthy Qi (Due to XX Hospital examination proof, our hospital did not perform internal examination). Plan attack and tonification combined. Prescription: Polygonum Aviculare Herb (Bian Xu Cao) 12g, Viscum Leptostachyum Herb (Liu Ji Nu) and Poria (Fu Ling) 9g each, Calcined Cloud Mother (Duan Yun Mu), Charred Rheum (Jun Tan), Moutan Cortex (Dan Pi), Red and White Peony Roots (Chi Bai Shao), Honey-fried Licorice Root (Zhi Gan Cao) 6g each, Cinnamon Twig (Gui Zhi), Peach Kernel Paste (Tao Ren Ni), Vinegar-processed Burreed Tuber (Cu San Leng) 4.5g each, Siberian Ginseng Root (Bie Zhi Shen) 3g, take continuously for 3 doses. Second visit on October 10: Right hypochondrium and epigastric/abdominal pain reduced, sleep improved, diarrhea two to three times daily, no abdominal pain. Menstruation came last night, normal volume, darker brown color, whole body fatigue, pulse wiry-slippery, right hand finer, tongue coating thin white. Patient said: "Decided to go south, please prescribe decoction and pill formulas for regular use." Prescription: Viscum Leptostachyum Herb (Liu Ji Nu), Calcined Cloud Mother (Duan Yun Mu), Vinegar-processed Charred Rhubarb (Cu Chao Da Huang Tan), Poria (Fu Ling), Red and White Peony Roots (Chi Bai Shao) 9g each, Polygonum Aviculare Herb (Bian Xu Cao) 15g, Cinnamon Twig (Gui Zhi), Peach Kernel Paste (Tao Ren Ni), Vinegar-processed Burreed Tuber (Cu San Leng) 4.5g each, Moutan Cortex (Dan Pi), Raw Licorice Root (Sheng Gan Cao) 6g each, Chicken Gizzard Membrane (Ji Nei Jin) 12g (stir-fried), Siberian Ginseng Root (Bie Zhi Shen) 3g, decoct in water (this formula can be taken regularly). Pill formula: Poria (Fu Ling), Cinnamon Twig (Gui Zhi), Peach Kernel Paste (Tao Ren Ni) 30g each, Moutan Cortex (Dan Pi) 36g, Red and White Peony Roots (Chi Bai Shao) 18g each, True Red Yeast Rice (Zhen Hong Qu) 15g. Grind all herbs into fine powder, honey for pills, each pill weighs 3g, take one pill morning and evening. Third visit on March 8, 1962: Took over 50 doses of decoction, pills still continuing. Menstruation since December 28 last year did not arrive until February 28 this year. Menstruation came again on March 5, scanty volume, dark black color, mixed with rotten meat-like matter. Occasional dull pain in left lower abdomen, mental fatigue, eating and sleeping okay. Pulse wiry-slippery, 84 beats/min, Right Cun still lacks force; teeth marks on tongue edge, coating thin white. Stasis knots have passed, energy still weak. Suitable to tonify Qi and invigorate Spleen, harmonize Chong and Ren. Prescription: Eucommia Bark (Sang Ji Sheng) 18g, Dipsacus Root (Xu Duan) 12g, Stir-fried Atractylodes Macrocephala Rhizome (Jiao Bai Zhu), Rehmannia Root (Sheng Di) 9g each, Raw White Peony Root (Sheng Bai Shao), Stir-fried Medicated Leaven (Jiao Liu Qu) 15g each, Cinnamon Twig (Gui Zhi) 4.5g, White Cardamom (Bai Kou), Siberian Ginseng Root (Bie Zhi Shen) (taken separately in two portions) 3g each, Honey-fried Licorice Root (Zhi Gan Cao) 6g, Fresh Ginger 3 slices, decoct in water, 3 doses. Fourth visit on March 13: Menstruation ended on the 10th. Occasional dull pain in right lower abdomen, more severe when riding bumpy vehicles. Spirit sometimes poor, diet and sleep good, urination normal, stool loose. Pulse slightly wiry-slippery, right side finer; coating white greasy, teeth marks on tongue edges. Prescription: Eucommia Bark (Sang Ji Sheng) 30g, Dipsacus Root (Xu Duan), Spatholobus Stem (Ji Xue Teng) 12g each, Stir-fried Atractylodes Macrocephala Rhizome (Jiao Bai Zhu), Chicken Gizzard Membrane (Ji Nei Jin), Raw Citrus Aurantium Fruit (Sheng Ju He), Stir-fried Hawthorn Fruit (Jiao Shan Zha) 9g each, Cinnamon Twig (Gui Zhi), Sichuan Chinaberry Seed (Chuan Lian Zi) 4.5g each, Honey-fried Licorice Root (Zhi Gan Cao) 6g, Fresh Ginger 3 slices, take 3 doses. Fifth visit on April 7: Patient stated checked by XX Hospital, right ovarian cyst has disappeared.
(Ma Longbo: "Three Cases of Ovarian Cysts," *New Medical Science Journal* 10:43, 1975)
Case 3: Chen XX, female, 23 years old, sought treatment in March of a certain spring year. Reported menstruation had not arrived for over 3 months, gradually developing abdominal distension and pain, lower abdomen hard, cannot be touched, continuous bleeding for days, volume varying, bearing-down discomfort, decreased appetite. A certain hospital diagnosed pregnancy, but patient knew herself not pregnant. Observed bluish complexion, purple tongue color, palpated abdomen, refused pressure, large like a basket, pulse deep-wiry-choppy. Last menstrual period was mid-December last year, while on her period accompanying husband to transport goods, pulling cart on journey, since then menstruation stopped. This is truly not pregnancy; abdomen large like a basket, not shape of 3-month pregnancy; abdominal distension-pain with severe lower abdomen bearing-down; refusing pressure and hard, also not pregnancy signs; moreover continuous bleeding without lower back pain, unlike fetal leakage. This must be excessive effort during menstruation, combined with contracting winter cold during journey. Disease name: Shi Jia (Stone Leiomyoma/Fibroid). Since the woman's body was originally robust, main treatment with Dang Gui Yin and Xue Jie San combined: Angelica Sinensis Root (Dang Gui) 6g, Ligusticum Rhizome (Chuan Xiong) 6g, Vinegar-processed Softshell Turtle Shell (Cu Zhi Bie Jia) 15g, Evodia Fruit (Wu Yu) 4.5g, Peach Kernel (Tao Ren), Red Peony Root (Chi Shao) 6g each, Cinnamon Bark (Rou Gui) 3g, Areca Seed (Bing Lang) 3g, Green Tangerine Peel (Qing Pi) 3g, Aucklandia Root (Mu Xiang), Curcuma Rhizome (E Zhu), Burreed Tuber (San Leng), Rhubarb (Da Huang) 3g each, Corydalis Rhizome (Yan Hu Suo) 6g, Dragon's Blood (Xue Jie) 3g. Decoct thick and take warm. This formula warms, unblocks, and breaks hardness. After one dose, passed palm-sized black blood clot, pain slightly reduced, bearing-down unchanged, pulse remained same. Then sister came to report: "About an hour after taking medicine, patient suddenly fainted, unconscious, hands and feet cold. Saw underwear all wet, opened clothes to see, all blood clots, one as big as a bowl, several others like eggs, mostly dark purple-black. After a while, hands and feet warmed, consciousness gradually cleared. Today has nausea, no desire to eat... Patient feels lower abdominal distension-pain both reduced, but feels there is still a hard mass like an eggplant remaining. Old Pu said 'For large accumulations, stop when half is resolved...' Moreover, Blood Sea suddenly emptied, Stomach deficiency unable to accept, should urgently support Stomach Qi." Stop original prescription. Change to Yi Gong San with modifications, instructed to take 2 doses. Three days later, sister came to report: "After taking medicine, appetite good, sleep peaceful, no longer bleeding, only continuous passage of bean dregs-like matter. This morning passed another egg-sized hard mass, white color, hard as stone, discarded in toilet." Again use Shi Quan Da Bu Tang, take continuously for 3 doses, all symptoms removed, only whole body edema, this is deficiency edema. Still use Shi Quan Da Bu Tang, replace Cinnamon Bark (Rou Gui) with Cinnamon Twig (Gui Zhi), take another 3 doses, body swelling disappeared, spirit gradually recovered. Stop medication, regulate with diet, recovered health after another month, menstruation arrived on schedule.
(Pu Fuzhou's Medical Cases)
Case 4: Cheng, Right Side. Initial visit on December 10. Around umbilicus and lower abdomen tense, distended and enlarged, resembling pregnancy. Occasionally distending pain, food difficult to digest; bowel movement inconvenient, frequent leukorrhea, pulse wiry-stagnant. Seems full but not truly full, fear it belongs to Chang Dan (Intestinal Tumor), tentatively prescribe one formula, do not know how it will work. Processed Magnolia Bark (Zhi Chuan Po) 4.5g, Stir-fried Green Tangerine Peel (Chao Qing Pi) 4.5g, Lunarweed Herb (Ze Lan) 9g, Safflower (Hong Hua) 2.4g, Amomum Fruit (Suo Sha Ren) 4.5g, Apricot Seed (Xing Ren) 9g, Aged Aurantium Fruit (Chen Zhi Ke) 4.5g (stir-fried), Poria (Fu Ling) 9g, Roasted Curcuma Rhizome (Wei E Zhu) 4.5g, Litsea Root (Guang Mu Xiang) 2.4g, Steamed Evodia Fruit (Pao Wu Yu) 1.8g, Ampelopsis Rhizome (Bai Lian) 9g. December 14