张姓妇。盛夏生产半月。患暑热症。口渴目赤。头面身体。暑疡栉比。几无孔隙。召余诊之。脉一息七八至。浮沉
皆洪
滑。为立竹叶石膏汤。妇翁村学究也。执产后宜温之说。见余。方用石膏一两。以为孟浪。余知其意。以金匮用竹皮
大丸之法。曲为详解。并以石膏质重而气清。最能清热。乃彼格不能入。另延他医。迎合疏方。三日而毕命。闻死后
有鲜血从口鼻出。不终朝而皮肉腐矣。
宁波石 周子章先生室人吴氏。仲秋患湿热症。迁延月余。每日晡时必先微寒。旋即发热。至天明而热始退。胸
闷不食。前医固执小柴胡汤出入加减。愈治愈剧。乃延余诊。诊毕告曰。疟脉自弦。今脉不弦而濡小。其为脾胃虚
弱湿邪阻遏募原。而发此潮热。当从太阴阳明两经主治。且令阃体肥痰盛之质。外盛中空。中者阴所守也。中虚
即是阴虚。是以治法又与寻常湿热不同。若用风药胜湿。虚火易于上僭。淡渗利水。阴津易于脱亡。专于燥湿。必
致真阴耗竭。纯用滋阴。反助痰湿上壅。必须润燥合宜。刚柔相济。始克有效。乃以沙参、石斛、麦冬、芡实、牡蛎、
仙半夏、竹茹、陈皮、薏仁、黄芩、等调理数剂。潮热除而胃渐开。余因上郡。彼就邻近之医治之。方中仍用柴胡。服
一剂而寒热又作。复来邀余。仍仿前法。以桑叶、川贝、苓、泽、谷芽等。互相出入调理而愈。叶天士云。柴胡动肝阴。
非正疟不可用之观此益信。
张姓妇女。在盛夏时节生产半个月后。患上暑热症。出现口渴、眼睛发红。头部、面部和身体上。暑热引发的疮疡密密麻麻。几乎没有空隙。请我诊治。脉搏一息跳动七八次。无论轻取还是重按。脉象都呈现洪大且滑利的特征。我为她制定了竹叶石膏汤（清热生津，益气和胃的方剂）。她的公公是村里的私塾先生。坚持认为产后应该用温补的说法。见到我开的方子中用了石膏一两。认为这是鲁莽之举。我知道他的意图。便引用《金匮要略》中使用竹皮大丸的方法。详细地解释说明。并且指出石膏质地沉重而气性清透。最能清除热邪。然而他固执己见不能接受。另外聘请其他医生。迎合其心意开方。三天后病人就去世了。听说死后有鲜血从口鼻流出。不到半天时间皮肤和肌肉就腐烂了。
宁波石浦人周子章先生的妻子吴氏。在仲秋时节患上湿热症。拖延了一个多月。每天傍晚时分必定先感到轻微怕冷。随即发热。直到天亮热势才退去。胸闷不想进食。之前的医生固执于小柴胡汤（和解少阳的代表方剂）进行加减变化。越治病情越严重。于是延请我诊治。诊脉完毕后告诉他说。疟疾的脉象自然应该是弦脉。现在脉象不弦而是濡小（软而细弱）。这是脾胃虚弱，湿邪阻遏募原（半表半里之膜原），从而引发这种潮热（定时发热）。应当从太阴脾经和阳明胃经两条经络来主治。并且告知患者体质肥胖痰多。外表盛实内部中空。体内是阴气所守之处。体内虚就是阴虚。因此治疗方法又与寻常的湿热症不同。如果用风药胜湿。虚火容易向上僭越。用淡味渗利药物利水。阴津容易脱失。专门使用燥湿药。必然导致真阴耗竭。纯用滋阴药。反而助长痰湿上壅。必须润燥配合适宜。刚柔相互济助。才能见效。于是用沙参、石斛、麦冬、芡实、牡蛎、仙半夏、竹茹、陈皮、薏仁、黄芩等药物调理数剂。潮热消除胃口逐渐打开。我因事前往上郡。她就在邻近地方找医生治疗。方子中仍然使用柴胡。服用一剂后寒热症状再次发作。再次来邀请我。仍然仿照前法。用桑叶、川贝母、茯苓、泽泻、谷芽等药物。互相出入调整调理而痊愈。叶天士说。柴胡会扰动肝阴。如果不是正疟不可使用。看到这种情况更加相信这一点。
A woman surnamed Zhang. Half a month after giving birth in midsummer. She suffered from Summerheat-Heat syndrome. With symptoms of thirst and red eyes. Her head, face, and body were covered with summerheat-induced sores. Dense as if combed through. Leaving almost no gaps. I was summoned to examine her. The pulse beat seven or eight times per breath. Whether superficial or deep. The pulse quality was both surging (Hong) and slippery (Hua). I prescribed Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction). Her father-in-law was a village schoolmaster. He adhered to the theory that postpartum conditions should be treated with warming methods. Upon seeing my prescription containing one liang of Shigao (Gypsum Fibrosum). He considered it reckless. Knowing his intent. I cited the method of using Zhipi Dawan (Bamboo Peel Great Pill) from Jin Gui Yao Lue (Essential Prescriptions from the Golden Cabinet). And explained it in detail. Furthermore, I pointed out that Shigao is heavy in texture but clear in qi. Making it most effective at clearing heat. However, he remained obstinate and refused to accept it. He hired another physician who catered to his views. Three days later, the patient died. It was reported that fresh blood flowed from her mouth and nose after death. Within half a day, her skin and flesh had rotted.
Mrs. Wu, wife of Mr. Zhou Zizhang from Shipu, Ningbo. Suffered from Damp-Heat syndrome in early autumn. The condition persisted for over a month. Every day at dusk, she would first feel slight chills. Followed immediately by fever. The fever subsided only at dawn. She experienced chest stuffiness and loss of appetite. Previous physicians stubbornly used modified versions of Xiaochaihu Tang (Minor Bupleurum Decoction). The more they treated, the worse the condition became. Thus, they invited me to examine her. After diagnosis, I told them: The pulse of Malaria (Nüe) is naturally wiry (Xian). Now the pulse is not wiry but soft and small (Ru Xiao). This indicates Spleen-Stomach deficiency with Dampness obstructing the Mou Yuan (Membrane Source). Causing this tidal fever (Chao Re). Treatment should focus on the Taiyin Spleen and Yangming Stomach meridians. Additionally, the patient’s constitution is obese with abundant phlegm. Externally full but internally hollow. The interior is where Yin resides. Internal deficiency implies Yin deficiency. Therefore, the treatment method differs from ordinary Damp-Heat cases. Using acrid-warm wind herbs to overcome dampness may cause deficient fire to flare upward. Using bland-draining diuretics may lead to the loss of Yin fluids. Exclusively using drying-dampness herbs will inevitably deplete True Yin. Purely using yin-nourishing herbs will instead assist phlegm-dampness to congest upwards. One must balance moistening and drying appropriately. Combining rigid and gentle methods harmoniously. Only then can effectiveness be achieved. Thus, I used Shashen (Glehniae Radix), Shihu (Dendrobii Caulis), Maidong (Ophiopogonis Radix), Qianshi (Euryales Semen), Muli (Concha Ostreae), Xian Banxia (Pinelliae Rhizoma Praeparatum), Zhuru (Bambusae Caulis in Taeniam), Chenpi (Citri Reticulatae Pericarpium), Yiren (Coicis Semen), Huangqin (Scutellariae Radix), etc., to regulate for several doses. The tidal fever ceased and stomach function gradually recovered. Due to travel to Shangjun. She sought medical treatment from a nearby doctor. The prescription still included Chaihu (Bupleuri Radix). After one dose, the chills and fever returned. They invited me again. I still followed the previous method. Using Sangye (Mori Folium), Chuanbei (Fritillariae Thunbergii Bulbus), Ling (Poria), Ze (Alismatis Rhizoma), Guya (Hordei Fructus Germinatus), etc. Adjusting the formula interactively until she recovered. Ye Tianshi said: Chaihu disturbs Liver Yin. It should not be used unless it is true Malaria. Seeing this case confirms this statement even more.