“Medical Records” Mr. Guo, female, 48 years old, missing medical record number.
First visit on February 19, 1962: abdominal distention and pain since January Chest tightness, not wanting to eat, shortness of breath, abdominal distension, poor stool, yellow turbid urine. Western medicine examination showed that the heart and lungs were normal, and there was no disease in gynecology. Pain when pressed on the abdomen, dry and bitter mouth, yellow and greasy base of the tongue, and stringy pulse. Evidence that the heat is in the house and the food is served.
Buihu four money, Scutellaria three money, ginger three money, Pinellia three money, Zhigancao two money , three jujubes, three peony root, three citrus fruits, two rhubarb, three magnolia, and two ruoyu. Second payment.
February 21st follow-up: all symptoms subsided, still spitting up, dry mouth, no desire to eat, afternoon Abdominal distention, pain immediately after distention, less stool, less yellow urine, restless sleep at night, dry mouth and bitterness, yellow moss and greasy roots, fast pulse.
Three coins of Pinellia, eight coins of orange peel, two coins of Paojiang, three coins of Poria, and three coins of Atractylodes , Suzi three money, Houpu three money, Guizhi three money, Zhuling three money, Alisma three money, Zhigancao two money. Three payments.
Third consultation on February 24: abdominal distension was relieved, no distention in the morning, fullness and discomfort in the afternoon, saliva It has been reduced, and the phlegm is slightly trapped, but still does not want to eat, does not like sweet things, and the urine is less red and yellow. On the top, go to Guizhi and Baizhu, add 5 coins of talc, 2 coins of Ejiao, and 6 coins of fried Coix seed, and pay three times.
Analysis< /span>
The patient’s pulse and symptoms at the first consultation: abdominal distention and pain, frequent vomiting, chest tightness, anorexia, Shortness of breath, poor stool, yellow turbid urine, dry and bitter mouth, yellow and greasy tongue base, fast pulse.
1, chest tightness, shortness of breath, dry mouth and bitterness, abdominal distention and pain, poor appetite, poor stool, yellow urine Turbidity, yellow and greasy coating, stringy pulse—Shaoyang-Yangming syndrome, consider using Dachaihu decoction;
< span>2. Vomiting and salivation – water poisoning, coupled with the previous Shaoyang Yangming problem, this disease should not be a typical cold symptom, and it is not sticky or obvious heat, so choose Pinellia sinensis plus Poria Soup is more appropriate.
In general, choose Dachaihu Decoction and Xiaobanxia and Fuling Decoction, and the actual medicine is Dachaihu Decoction and Poria.
He chose Da Chai Hu Tang Jia Hou Pu and Evodia. The use of Magnolia may be due to abdominal distension to eliminate bloating and fullness; the choice of Evodia may be due to the lack of saliva, but the patient is a positive disease as a whole, and there will be no such serious problem of cold and cold.
Illness at the second visit The symptoms of pulse syndrome: spit saliva, dry mouth, not wanting to eat, abdominal distention in the afternoon, even pain when distended, less stool, less yellow urine, restless sleep at night, dry mouth, greasy moss, yellow root, stringy pulse.
1, dry mouth, bitter taste, poor appetite, abdominal distention, less stool, less sputum, yellow moss, Pulse string – or Shaoyang-Yangming disease, consider Dachaihu decoction treatment;
2, but less The yang condition is relieved, the yang-ming fu-organs are obviously full, and there is restlessness at night, so the dose of rhubarb in Dachaihu decoction is increased;
3, spit saliva – is still water poisoning.
Da Chai Hu Tang combined with Xiao Ban Xia and Fu Ling Tang is still used for treatment.
What Mr. Hu chose at this time was Pinellia Houpu Decoction, Wuling Powder and Tangerine Peel Decoction. Fire ginger, add licorice. The whole is to remove dampness and phlegm, promote qi, and target water poisoning and Taiyin disease. However, the patient as a whole is a positive disease, and the reason for Hu Lao’s treatment is unknown.
In addition, at this time, Mr. Hu chose Baizhu. In his twenty-year lecture, Mr. Hu clearly stated that Clinical use of Atractylodes macrocephala does not require Baizhu, it can be seen that Hu is constantly exploring and advancing, constantly overthrowing himself, and making continuous progress.
Illness at three visits Pulse syndrome manifestations of the family: abdominal distension, spit foam, poor appetite, less mellow yellow.
These symptoms alone may be caused by Taiyin disease with mild fever, and the description of pulse syndrome in the whole body is few, so it cannot be accurately analyzed .
What Mr. Hu chose at this time was Banxia Houpu Tang combined with Zhuling Tang and Tangerine Peel Tang. It is very suitable to choose Pinellia Magnolia soup, and the use of pork ling soup may be due to abnormal urination. I don’t understand Hu Lao’s thinking as a whole.
No re-diagnosis, unknown outcome.
usual doses of the drug And decoction method:
Small Pinellia plus Poria soup: 18 grams of Pinellia 24 grams of ginger, 12 grams of Poria, Soak seven bowls of water for 40 minutes, fry to 1.5 bowls, and serve warm in two batches.
Pinellia Magnolia Soup: 12-18 grams of Pinellia, 9 grams of Magnolia, 12 grams of Poria, 6 grams of Suzi, and 15 grams of ginger, soak in seven bowls of water for 40 minutes, fry until three bowls, and serve warm three times.
Orange peel soup: 12 grams of orange peel, 24 grams of ginger, soak in seven bowls of water for 40 minutes, fry until three Bowl, warm service in three times.