祖庙巷高太太。年三十余。平素肝阳极旺。而质瘦弱。患痰火气逆。每日吐痰一两碗。喉间咯咯有声。面赤烦躁。
舌苔中心赤陷无苔。脉弦细虚数。乃感受风邪。少阳木火偏旺。风得火而愈横。风火相扇。肺金受制。阳明所生之津
液被火灼而成痰。旋去旋生。是以吐之不尽。痰吐多而肾液立伤。故内热。素问云。大颧发赤者。其热内连肾也。痰
随气以升降。气升痰亦升。治当用釜底抽薪法。先以清火降气为主。火降气降。而痰自瘥矣。方书治心肝之火以
苦寒。治肺肾之火以咸寒。古有成法。方用咸苦寒降法、丹皮、山栀、青黛、竹茹、竹沥、杏仁、黄连、黄芩、羚羊角、
石决明、川贝母、旋复花、海浮石。加指迷茯苓丸三钱。连服三剂。气平热退。痰喘俱瘥。安卧如常。后用清肺降火化
痰之药。如沙参、麦冬、石斛、竹茹、青黛、山栀、牡蛎、鳖甲、阿胶、川贝母、海石、茯苓、仙半夏、橘红、首乌、
雪羹等。出入为方。调理数剂而愈。
宁波西郊陈姓子年十七。患痫症三四载矣。初则数月病作。后乃渐近。甚至一日数发。口角流涎。乃求余治。脉右
三部洪滑流利。左关弦而抟指。左寸上溢鱼际。余谓症属痰火充斥。上蒙胞络。闭塞神明之府。故昏厥卒倒。不省
人事。先以牛黄清心丸用竹沥一杯。入生姜汁二三滴化服。复以鲜石菖蒲、郁金、胆南星、羚羊角、桑叶、钩藤、橘红
等宣络道而清疏之。继则用宁神安魂。佐以金石。堵其痰火复入之路。每清晨以橄榄膏入矾末少许。用开水冲
服四钱。服月余而病不复作矣。
祖庙巷的高太太,三十多岁。平时肝阳极度旺盛,体质瘦弱。患有痰火气逆证,每天吐出一两碗痰,喉咙里咯咯作响,面色发红,烦躁不安。舌苔中心部位红赤凹陷且无苔,脉象弦细、虚弱而数。这是感受了风邪,导致少阳经木火偏旺。风遇到火更加肆虐,风火相互煽动,制约了肺金。阳明经所化生的津液被火热灼烧而成痰,边产生边排出,所以怎么吐也吐不干净。痰吐得多就会立刻损伤肾中阴液,因此出现内热。《素问》说:大颧骨发红的,说明热邪内部连及肾脏。痰随着气的升降而升降,气上升痰也随之上升。治疗应当采用“釜底抽薪”的方法,先以清泻火热、降逆下气为主。火热下降、气机顺降,痰自然痊愈。医书规定治疗心肝之火用苦寒药,治疗肺肾之火用咸寒药,这是古代已有的成法。方剂使用咸苦寒降法,药物包括丹皮、山栀、青黛、竹茹、竹沥、杏仁、黄连、黄芩、羚羊角、石决明、川贝母、旋复花、海浮石。加入指迷茯苓丸三钱。连续服用三剂后,气平热退,痰喘症状全部好转,能像常人一样安稳睡眠。之后改用清肺降火化痰的药物,如沙参、麦冬、石斛、竹茹、青黛、山栀、牡蛎、鳖甲、阿胶、川贝母、海石、茯苓、仙半夏、橘红、首乌、雪羹等,根据情况加减处方。调理服用几剂后痊愈。
宁波西郊陈姓人家的儿子,十七岁。患癫痫症已有三四年了。起初几个月发作一次,后来逐渐频繁,甚至一天发作数次,口角流涎。于是来找我治疗。右手三部脉洪大滑利流畅,左手关部脉弦硬搏指,左手寸部脉上溢至鱼际。我认为此症属于痰火充斥体内,向上蒙蔽心包络,闭塞神明之府,所以导致昏厥突然倒地,不省人事。先用牛黄清心丸,用一杯竹沥和二三滴生姜汁化开服用。接着用鲜石菖蒲、郁金、胆南星、羚羊角、桑叶、钩藤、橘红等药物宣通经络、清疏痰火。随后再用宁神安魂的药物,佐以金石类药物,堵塞痰火再次侵入的路径。每天早上用橄榄膏加入少许白矾末,用开水冲服四钱。服用一个多月后,病症不再发作。
Gao Taitai of Zumiao Alley, over thirty years old. Her Liver Yang was excessively hyperactive in her usual state, and her constitution was emaciated. She suffered from Phlegm-Fire Qi Reversal (Phlegm-Fire causing Qi to rebel upwards), vomiting one or two bowls of phlegm daily, with a rattling sound in the throat, flushed face, and irritability. The center of the tongue coating was red, depressed, and devoid of coating; the pulse was wiry, fine, deficient, and rapid. This resulted from contracting Wind Pathogen (Wind Evil), causing Shaoyang Wood-Fire to be excessively hyperactive. Wind becomes more rampant when meeting Fire; Wind and Fire fan each other, constraining Lung Metal. The fluids generated by the Yangming channel were scorched by Fire into Phlegm, which was continuously produced and expelled, hence it could never be completely cleared. Excessive expectoration immediately injured Kidney Yin, leading to internal heat. As stated in *Suwen* (The Basic Questions): "Redness of the cheekbones indicates heat internally connected to the Kidneys." Phlegm rises and falls with Qi; as Qi ascends, Phlegm ascends. Treatment should employ the method of "removing firewood from under the cauldron" (addressing the root cause). First, focus on clearing Fire and descending Qi. Once Fire descends and Qi flows downward, Phlegm will naturally resolve. Medical texts prescribe bitter-cold herbs for Heart-Liver Fire and salty-cold herbs for Lung-Kidney Fire, an established ancient practice. The formula used is Salty-Bitter-Cold Descending Method, comprising Danpi (Moutan Cortex), Shanzhi (Gardeniae Fructus), Qingdai (Indigo Naturalis), Zhuru (Bambusae Caulis in Taeniam), Zhuli (Bambusae Sap), Xingren (Armeniacae Semen Amarum), Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Lingyangjiao (Saigae Tataricae Cornu), Shijueming (Haliotidis Concha), Chuanbeimu (Fritillariae Cirrhosae Bulbus), Xuanfuhua (Inulae Flos), Haifushi (Pumex). Added Zhimi Fuling Wan (Pinellia and Poria Pill for Resolving Phlegm) 3 qian. After three doses, Qi calmed, heat subsided, and phlegm-panting improved significantly; she slept peacefully as usual. Subsequently, medications for clearing Lung heat, descending Fire, and resolving Phlegm were used, such as Shashen (Glehniae Radix), Maidong (Ophiopogonis Radix), Shihu (Dendrobii Caulis), Zhuru, Qingdai, Shanzhi, Muli (Ostreae Concha), Biejia (Trionycis Carapax), Ejiao (Asini Corii Colla), Chuanbeimu, Haishi (Pumex), Fuling (Poria), Xian Banxia (Pinelliae Rhizoma Praeparatum), Juhong (Citri Reticulatae Pericarpium), Shouwu (Polygoni Multiflori Radix), Xue Geng (Snow Broth decoction), etc., adjusted according to condition. After several doses of regulation, she recovered.
Chen's son from the western suburbs of Ningbo, seventeen years old, had suffered from Epilepsy (Xian Syndrome) for three or four years. Initially, attacks occurred every few months, but gradually became more frequent, even occurring several times a day, with drooling from the mouth corners. He sought my treatment. The right hand's three positions showed a surging, slippery, and smooth pulse; the left Guan position was wiry and hard against the finger; the left Cun position overflowed towards the Yuji point. I determined that the syndrome belonged to Phlegm-Fire filling the interior, ascending to confuse the Pericardium Collateral, and obstructing the Mansion of Spirit (Mind), thus causing sudden fainting and loss of consciousness. First, Niuhuang Qingxin Wan (Calculus Bovis Clearing Heart Pill) was administered, dissolved in one cup of Zhuli and two or three drops of Shengjiang juice (Fresh Ginger Juice). Then, fresh Shichangpu (Acori Tatarinowii Rhizoma), Yujin (Curcumae Radix), Dantanxing (Arisaematis Cum Bile), Lingyangjiao, Sangye (Mori Folium), Gouteng (Uncariae Ramulus cum Uncis), and Juhong were used to unblock collaterals and clear/dredge the pathogen. Subsequently, herbs for calming the Spirit and anchoring the Hun (Ethereal Soul) were used, assisted by mineral substances to block the pathway for Phlegm-Fire re-entry. Every morning, Ganlan Gao (Olive Paste) mixed with a small amount of Fanmo (Alumen) powder was taken with boiling water, 4 qian per dose. After taking it for over a month, the disease did not recur.