董妪年四十余。患胸痛呕逆。喉痹带下。头痛。病非一端。诊其脉沉细而涩。余曰脉法云。下手脉沉。便知是气。
病由情怀不畅。郁怒伤肝。木邪犯土。心脾气结。法当疏气平肝。先用归、芍、香附、橘红、郁金、蔻仁、柴胡、丹皮、
鲜橘叶、佛手花、瓦楞子、牡蛎等。以水先煮生铁落。然后煎药服三剂。诸症俱减八九。后以逍遥散加丹、栀、香附、
海螵蛸、牡蛎。服二十余剂而愈。
又徐妪年近五十。患胸痛。月信虽少。而尚未断。体肥脉弦而虚。余谓此属血虚气郁。与丹参饮而愈。此二症虽同
为气郁。而却有肝旺血虚之分别焉。
毛姓妇。患胸痛甚剧。床上乱滚。哀号欲绝。月信愆期。延余诊之。脉沉弦搏滑。指甲与唇俱青。余曰。脉沉滑主
血。弦劲搏指。其血菀结。当是瘀血留于胸膈而作痛也。细询得病之由。忽悟半月前被硬木触胸。其为瘀血无疑矣。与
归尾、赤芍、桃仁、丹参、东洋参、琥珀、乳香、蒲黄、五灵脂一剂而愈。故治病之道。四诊皆当留意。乃能与病切中。
而所投无不效也。
某木匠因触伤。腰胁瘀血留阻于经络。痛甚。呼吸转侧。尤为难忍。恶寒发热。脉弦劲而数。此因瘀留经络。以致
气机不宣也。方用归须、桃仁、苏梗、橘络、丝瓜络、乳香、没药、红花、参三七、穿山甲、牛膝、青葱管等活血通络
逐瘀之品。两剂而愈。
定邑北门陈姓妇。患气郁络阻。左胁肋闪痛。连于期门章门部位。脉沉细涩。以前方去乳香、没药、红花。加香附、
郁金、柴胡、山栀。亦两剂而愈。
董家老妇人,四十多岁。患有胸痛、呕吐逆气、喉痹(咽喉肿痛闭塞)、带下病、头痛等症状。病情复杂,并非单一病症。诊察其脉象沉细而涩。我说:脉法中说,“下手脉沉,便知是气”。
此病由心情不畅、郁怒伤肝所致,肝木邪气侵犯脾土,导致心脾气机结滞。治疗法则应当疏理气机、平抑肝木。先用当归、白芍、香附、橘红、郁金、蔻仁、柴胡、丹皮、鲜橘叶、佛手花、瓦楞子、牡蛎等药物。以水先煎煮生铁落,然后再加入其他药物煎服,服用三剂后,各种症状减轻了八九成。后来改用逍遥散(调和肝脾的基础方)加牡丹皮、山栀、香附、海螵蛸、牡蛎,服用二十多剂后痊愈。
另一位徐家老妇人,年近五十。患有胸痛。月经量虽少,但尚未断绝。身体肥胖,脉象弦而虚。我说这属于血虚兼气郁,给予丹参饮(活血行气止痛方)治疗后痊愈。这两个病例虽然同为气郁所致,却有肝旺与血虚的区别。
毛姓妇女,患剧烈胸痛,在床上翻滚乱动,哀号欲绝。月经延期未至,请我诊治。脉象沉弦搏滑,指甲和嘴唇都发青。我说:脉沉滑主血证,脉弦劲搏指,说明血液郁结停滞,应该是瘀血留滞在胸膈部位引起的疼痛。仔细询问得知病因,忽然想起半个月前被硬物撞击胸部,这无疑是瘀血所致。给予归尾、赤芍、桃仁、丹参、东洋参、琥珀、乳香、蒲黄、五灵脂,一剂药后痊愈。所以治病之道,四诊(望闻问切)都必须留意,才能与病情切合,所开处方没有不有效的。
某位木匠因外伤,腰胁部瘀血阻滞于经络,疼痛剧烈,呼吸和翻身转侧时尤其难以忍受,伴有恶寒发热。脉象弦劲而数。这是因为瘀血留在经络,导致气机不能宣通。方用归须、桃仁、苏梗、橘络、丝瓜络、乳香、没药、红花、参三七、穿山甲、牛膝、青葱管等具有活血通络、逐瘀功效的药物,两剂药后痊愈。
定邑北门陈姓妇女,患气郁络阻,左胁肋部闪痛,牵连到期门、章门穴位部位。脉象沉细涩。用前面的方子去掉乳香、没药、红花,加上香附、郁金、柴胡、山栀,也是两剂药后痊愈。
Old woman Dong, in her forties, suffered from chest pain, vomiting and regurgitation, throat obstruction (soreness and blockage of the throat), leukorrhea, and headache. The condition was complex, not a single disease. Her pulse was deep, fine, and choppy. I said: "The pulse method states, 'If the pulse is deep upon initial palpation, it indicates Qi stagnation.'"
This illness resulted from emotional distress and anger injuring the Liver. Wood pathogen invading Earth led to Qi binding in the Heart and Spleen. The treatment principle should be to soothe Qi and calm the Liver. Initially, use Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Xiangfu (Cyperi Rhizoma), Juhong (Exocarpium Citri Reticulatae Rubrum), Yujin (Curcumae Longae Radix), Kouren (Amomi Fructus Rotundus), Chaihu (Bupleuri Radix), Danpi (Moutan Cortex), fresh Ju Ye (Citri Reticulatae Pericarpium Viride), Foshou Hua (Fortunellae Semen Flos), Walengzi (Arcaea Concha), and Muli (Ostrea Concha). Boil Sheng Tieluo (Ferrum Depressum) in water first, then decoct the other herbs and take orally. After three doses, all symptoms decreased by eight or nine tenths. Subsequently, Xiaoyao San (Free and Easy Wanderer Powder) was modified with Mudanpi (Moutan Cortex), Zhizi (Gardeniae Fructus), Xiangfu (Cyperi Rhizoma), Haipiaoxiao (Sepiae Endoconcha), and Muli (Ostrea Concha). After more than twenty doses, she recovered.
Another old woman, surnamed Xu, near fifty years old, suffered from chest pain. Although her menstrual flow was scant, it had not ceased. She was obese, and her pulse was wiry and deficient. I stated that this belongs to Blood deficiency with Qi stagnation. She was treated with Danshen Yin (Salvia Drink) and recovered. These two cases, although both caused by Qi stagnation, differed in that one involved Liver hyperactivity and the other Blood deficiency.
A woman surnamed Mao suffered from severe chest pain, rolling about on the bed in agony, wailing as if dying. Her menstruation was delayed. Upon examination, her pulse was deep, wiry, forceful, and slippery; her fingernails and lips were cyanotic. I said: "A deep and slippery pulse indicates a Blood disorder. A wiry, stiff, and forceful pulse suggests blood stasis and accumulation. It is likely that blood stasis retained in the chest and diaphragm is causing the pain." Upon detailed inquiry into the cause, I suddenly recalled that she had been struck in the chest by a hard object half a month prior. This was undoubtedly blood stasis. She was prescribed Guiwei (Angelicae Sinensis Radix Caulis), Chishao (Paeoniae Radix Rubra), Taoren (Persicae Semen), Danshen (Salviae Miltiorrhizae Radix et Rhizoma), Dongyangshen (Panax Ginseng Radix et Rhizoma - Japanese origin), Hupo (Succinum), Ruxiang (Olibanum), Puhuang (Typhae Pollen), and Wulingzhi (Trogopterori Faeces). One dose cured her. Therefore, in treating diseases, one must pay attention to all four diagnostic methods (inspection, auscultation-olfaction, inquiry, and palpation) to accurately match the pathology, ensuring that prescriptions are effective.
A carpenter, due to trauma, had blood stasis obstructing the meridians in the waist and hypochondrium, causing severe pain, especially intolerable during breathing and turning over. He experienced aversion to cold and fever. His pulse was wiry, stiff, and rapid. This was due to stasis remaining in the meridians, leading to failure of Qi mechanism to circulate freely. The formula used included Guixu (Angelicae Sinensis Radix Caulis), Taoren (Persicae Semen), Sugeng (Perillae Caulis), Juluo (Citri Reticulatae Pericarpium Retinervum), Sigualuo (Luffae Fructus Retinervus), Ruxiang (Olibanum), Moyao (Myrrha), Honghua (Carthami Flos), Sansanqi (Notoginseng Radix et Rhizoma), Chuanshanjia (Manis Squama), Niuxi (Achyranthis Bidentatae Radix), and Qingcongguan (Allii Fistulosi Bulbus et Caulis), which are substances for invigorating blood, unblocking collaterals, and expelling stasis. Two doses cured him.
A woman surnamed Chen at the North Gate of Dingyi County suffered from Qi stagnation and collateral obstruction, with sudden pain in the left hypochondrium radiating to the Qimen (LR14) and Zhangmen (LR13) acupoints. Her pulse was deep, fine, and choppy. Using the previous formula but removing Ruxiang (Olibanum), Moyao (Myrrha), and Honghua (Carthami Flos), and adding Xiangfu (Cyperi Rhizoma), Yujin (Curcumae Longae Radix), Chaihu (Bupleuri Radix), and Zhizi (Gardeniae Fructus), she also recovered after two doses.