Original Case by: Ye Tian-Shi (叶天士)

(Clumping of Heart and Spleen qi, unclear spirit mind)

A 26 year-old patient named Lu was given:

Ginseng Radix (rén shën))
Platycodi Radix (jié gêng)
Linderae Radix (wü yào)
Aucklandiae Radix (mù xiäng)

Each Ingredient had a dose of three fen and was wet ground into a juice.

In addition, Alum and Curcuma Pill (bai jin wan) was given to take at night.

Note: Alum and Curcuma Pill (bai jin wan) is composed of Alumen (bái fán) and Curcumae Radix (yù jïn) (equal parts ground into a fine powder)‚ Its functions are to dislodge phlegm, scatter clumping, unblock the orifices, clear the heart, and quite the spirit.

In addition [at the next visit], there was enduring depression with clumping of Heart and Spleen qi. The treatment was to facilitate the orifices while assisting by augmenting the qi.

Ginseng Radix (r (rén shën)
Acori tatarinowii Rhizoma (sh(shí chäng pû)
Fossilia Ossis Mastodi (l (lóng gû)
Ziziphi spinosae Semen (suän zâo rén)
Polygalae Radix (yuân zhì)
Poriae Sclerotium pararadicis (fú shén)

Translated by: Jason Blalack

Original Chinese: 陆(二六) (心脾气结神志不清)人参 桔梗 乌药 木香 各三分磨汁. 又 夜服白金丸。又 久郁。心脾气结。利窍佐以益气。人参 石菖蒲 龙骨 枣仁 远志 茯神.

Source: From the Constraint Chapter of Case Records as a Guide to Clinical Practice (Lín zhèng zhî nán yï àn) 《临证指南医案》.

Commentary: If anyone has further insight in translating this “又”, please let me know.

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Showing 6 comments
  • Eran Even

    Hi Jason,

    Great case. My guess is that the second 又 is used to emphasize the (negative) enduring depression. Is this the one you mean?


  • Eran Even

    looking at it again I think you’re right in that the 又 is introducing simultaneous actions (ie. taking Bai Jin Wan at night ALONG with the original formula and not at the next visit). But at the end of the day these are just our interpretations and who knows what Master Ye really meant 🙂 I find this to be both a problem and half the battle when attempting to translate classical literature in that what we may think makes sense from a theoretical or grammatical perspective may be so far removed from what the original writer was trying to convey. This is probably what makes it so much fun.

  • Jason Blalack

    Actually the first one, to me, seems more questionable. For example, maybe the bai jin wan was taken *with* the first formula (not following at the next visit)…? Thoughts?

  • Steve Clavey

    Hi guys,

    Actually the 又 simply means ‘next visit’ ie ‘its this patient again’ instead of a different patient.

    In my edition, where the lines run up and down, it is more clear, as the 又 heads the line in place of a name.

    I didn’t know Bai Jin Wan off-hand, but looked it up at the back of my edition, and it is simply Bai Fan and Yu Jin. (You may have included this information elsewhere, if so, sorry).

    From the context I would guess YTS meant to take this at night as well as the decoction.

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