决明子治便秘乃今人之发明，集中药大成之《本草纲目》亦不载决明子具有通便功能。决明子善通便秘之报道余首先于《本草推陈》：“慢性便秘及卒中后顽固便秘：用决明子一斤炒香研细末，水泛为丸，每日三回，每回一钱，连服三、五天，大便自然通顺，且排出成形粪便而不泄泻。此后继续每日服少量，维持经常便通，并能促进食欲，恢复健康。”用上述方法治疗便秘效果确切，服法亦甚科学，以丸剂缓治更能润肠而不伤正气，但制用不易。故恒常服用可以适量决明子泡茶饮服，每次10g左右，可视大便通畅程度而增损其用量，以适应本身之情况为宜。余于数年前治一晚期腹腔癌患者，大便不通数日，忽觉腹中急迫难忍，但登圊又不能排便，不得已于居室内转展踯躅，直至夜深仍不得通。急电告余，患者自知肠道多为肿瘤侵蚀损坏，恐用力不当致成意外，故不敢过分努责，要求授予速通大便之方。余踌躇再三，回电嘱其家属急购炒决明子60g。此时已近子夜，其妻幸得药店值班人之帮助将药购回。嘱先以30g加水一大碗，煮成浓汁约大半饭碗，吹冷与饮，服后腹中微微躁动鸣响，便仍不下，腹胀如故。一小时后再次来电求助，余嘱将剩余之30g和入首次药渣中，加水再煎再服，服后半小时许，竟得畅解坚硬粟子粪数十枚。腹笥宽转，痛苦尽失。患者于半年后病故，但自服用决明子以后未再便秘。
由此可知决明子之通便也，小病可医，大病亦可治；壮盛者可施，虚衰者亦可投。其性缓而不伤正气，其效速而不致泻痢，诚为医门之上品，通便之良剂也。
中医学将人体之五官九窍、四肢百骸及组织器官，类比归纳，分属五脏，其中骨属于肾。人身以骨为其支架，以脊为之支柱。人无骨则形体不立，脏腑失其维系，肢节无以运动。且骨髓为涵育大脑与经络(尤其督脉)之源，因而骨于人体生命活动中具有至关重要之特殊作用，故《内经》将骨归属于“先天之本”之肾，其理至深。即显示骨与肾脏之精气密切相关。《黄帝内经·素问》曰：“肾藏精、主水”、“肾之合骨也”、“肾生骨髓”、“肾不生则髓不能满”，又曰：“肾气热，则腰背不举，……热舍于肾，肾者水脏也，今水不胜火，则骨枯而髓虚，故足不任身，发为骨痿。”以上经文明确阐明“肾主骨”之生理病理，指出骨髓充盈与否，取决于。肾气之盛衰。中医病因学将致病原因归纳为内因、外因与不内外因，三者皆能侵袭于骨而生骨病。外因如风、寒、暑、湿、燥、火等六淫；内因如气、血、痰、火、湿、食等六郁；不内外因如房室、金刃、劳力负重、外力损伤之类，均可导致骨痹、骨痿、骨疣、骨质伤损等种种骨病，然病因不同，病机自别，治法亦当随之，何以独谓填精益髓以疗骨疾?
盖腰为肾之腑，而腰背又为脊柱所居之地，腰痛每与脊骨有关，故本方引用昔贤腰痛之论以辨骨病与肾精不足、真元虚衰之关系。如张璐玉于《张氏医通》卷五“腰痛”门中曰：“《内经》言太阳腰痛者，外感六气也。言肾经腰痛者，内伤房劳也。假令肾脏真气布护，六气焉能为害、惟肾脏虚伤，膀胱之腑安能独足?又有膏粱之人，久服热剂，醉以人房，损其真气，则肾脏热、腰脊痛，久则髓减骨枯，发为骨痿。此为本病，其有风寒、湿热、闪挫、瘀血、滞气、痰积，皆为标病，而肾虚则其本也。”指出骨病经久，虽有实邪，宦从本治，须以肾虚为其根本，以填精益髓为其主要治法。又如《景岳全书》论腰痛证旧有五辨：“一曰阳气不足，少阴肾衰。二曰风痹风寒，湿着腰痛。三曰劳役伤肾。四曰隧堕损伤。五曰寝卧湿地。”但是，景岳一转笔锋，直捷而言口：“腰痛之虚证十居八、九，但察其既无表邪，又无湿热，而或以年衰，或以劳倦，或以酒色斫丧，或七情忧郁所致者，则悉属真阴虚证。”景岳之见与石顽相同。腰痛骨病虽致病之因有种种不同，而究以肾虚居多，故以填补真阴为治法之根本。
据于上述，可知骨病不异与人体其他诸症，三因均可导致骨病，而骨病与肾虚具有特殊之内在关系，故治疗骨病之根本关键，在于填补精髓以滋养先天，但使肾脏精气充足，骨髓盈满，则骨得所养而骨病自已。
目前临床常见之骨质疏松与骨质增生两症，初看似相径庭，细审病机及治法，仍不越肾主骨生髓之基本原理。
骨质疏松症。此症常见于老年病人，年老之人肾气渐衰，真精亏乏，骨失濡涵滋养，使骨质松脆而致本病。其证常见身材渐渐变矮，俗渭“老缩”。脊柱弯曲畸形，不得已只能伛偻以行，弓背垂腰，仅能策杖缓步。由于重心不正，加之骨质松脆已少承受之力，行走常易跌倒，且易骨折。骨折多见于腕部及髋关节处，仅需轻度外力即可导致骨折发生，脊柱还易发生压缩性骨折。此外骨质疏松症患者平素常有骨酸疼痛等见症。脉细弱，或大而无力，亦可兼见弦脉。舌质多淡或淡胖，苔多薄白。
以上见证都与肾脏虚衰、精亏阳弱有关。纵有外邪、伤损、瘀血、痰涎等因素，终属诱因，即使须用祛邪、消痰、化瘀等治标之法，只宜暂用，不可常服，或与补肾之法同用，标本兼顾。补肾以填精益髓、温肾壮骨为法。余临证每以黄芪、党参、白术、当归、白芍、熟地、杞子、狗脊、川断、杜仲、淮牛膝、苁蓉、制首乌、三七粉等药物选择组方。如阳虚较甚者，益入肉桂、附片，或兼用右归丸。如无明显阳虚之象，以上方合左归丸或健步丸(原为丹溪之虎潜丸)，随证加减，久服自效。
骨质增生症。此症亦为老年人常见之病，故谓之退行性病变。本病与骨质疏松症形成之根本原因基本一致，亦因人至老年，肝肾精血亏损，筋骨渐失所养，而于承重部位，骨之代偿能力甚强，于是骨边缘形成骨质增生。骨质易于增生之部位，常见于颈部、手腕、髋骨、膝部及踝骨关节等处，此处活动度大，负重时易受重力压迫，骨边缘易于摩擦而生骨赘(亦称骨刺)。
骨赘形成之后，易对周围肌肉、神经等组织产生压迫，故其主症为关节疼痛，患处关节可见肿胀、僵硬、活动时亦可闻及摩擦音，听到“喀喀”响声。本病于天气变化或局部关节负重过甚时，可见症状加重。或因骨刺压迫神经，或因肿胀之韧带等软组织压迫神经、可引起臂丛或坐骨神经痛。病久者可致肌肉萎缩。骨质增生发生于颈椎及腰椎者，渭之颈椎增生及腰椎增生，今时此类患者人数极多，故治疗骨质增生症之重点，即在于治疗颈、腰椎病变。
本病与骨质疏松症同属肝肾精血亏损，以致筋骨失养之病，因而其治法及所用方药，亦相近似。但骨质增生症易夹六淫外邪或六郁内伤等因素，常表现为虚中夹实，故用药时常须兼顾。如确系邪实者，亦可先事祛邪以治其标，待病解之后，再拟治本以巩固治疗。余治本症之常用药为：太子参、炒白术、当归、白芍、狗脊、续断、杜仲、淮牛膝、骨碎补、威灵仙、延胡索、木瓜、红花、鸡血藤、葛根、羌活、生地、天冬等品。肾阳虚者．肉桂、附子亦可适当加入，而真阴不足者，又当以调养肝肾精血为先，宜以六味、左归等方为其主体。
余治骨质疏松症，投以前述方药，大多即可见效，惟疗程较长，须有耐心。而所治颈椎病例中，有一特殊病例兼患肺结核及附睾结核，属阴虚内热体质，不能稍参益气及温肾之品，试以天门冬少量煎服，则不仅潮热不作，咳嗽渐减，且颈椎宽展舒适，稍稍益入生地、山药、茯苓等品，效亦佳良。此病之形成，据患者自述，乃因宿疾至市郊一名医处求诊，医投大剂生地、麦冬、女贞子、墨旱莲、磁石、夜交藤、合欢皮、砂仁、沉香等味，服十数帖后渐见手麻，嗣后颈椎及胸椎上段疼痛，痛势甚剧。此时精神萎顿，胃纳极差。见家中有烧就之莲肉红枣，随取少量食用，食后精神胃纳转佳，颈中疼痛大减，颈部转动自如，即每日煮食，及至用莲肉、红枣各1000g时，食后即见头痛内热，遂停食，此时颈胸椎疼痛已消，惟增生处依然如故。余揣此例虽阴亏内热体质，久病阳气亦弱，用大剂养阴镇摄，损其阳气，伤及肝肾，遂至颈椎病变。而后患者稍涉女贞、旱莲、金银花等克伐之品，颈椎立疼，手指立麻，而用参、芪、杞子等品则颈椎舒适，手麻消失。但如用生地、麦冬、天冬、菊花、桑叶等养阴清热而不损阳气之品，颈椎之疼痛与不适同样好转。由是而知骨质增生之病，确与肝肾相关，虽多数偏于阳弱，宜于温养，而阴虚者亦可致病，总由肝肾亏损，阴阳失调而成，温肾、育阴不可一概而论，本篇所述，不过通论而已，具体病例尚须辨证施治，切莫一方遍投．草率从事。
另有一例腰椎增生患者，因骑车过久及感受寒邪等因素，突发腰腿疼痛，致两足痿废不能着地，且原有隐性糖尿病宿疾。患者缘不能行走而恐惧不胜，连连急电促余疏方。余兼顾两病，列于一纸，药用黄芪、熟地、山药、苍术、元参、杜仲、淮牛膝、红花、丹参、当归、炒白芍、威灵仙、地龙、接骨木等，先后三方，服药二十余剂，腰腿疼痛消失，两腿恢复正常功能。至今已两年有余，生活起居一如常人。
某研究所高级工程师林先生，年过知命之后，时感腰脊酸痛，经市一医院检查确诊为腰椎增生肥大，虽服药无虚夕而病情依然发展。渐至不能直立，站必弯腰曲背，走则偻俯以行，腰肢牵强难以转侧，深以为苦。兼见畏寒怯冷、四末不温、阳痿早泄、纳少神疲。余诊其脉左手细而无力，右虽稍大而按之豁然，两尺沉细。舌质淡胖，苔薄白微腻。据其脉证，当属肝肾精血亏损，阴伤及阳，阴阳俱虚而阳虚更甚之证。治宜补益肝肾、滋阴助阳以治本，佐以健脾化湿、祛风通络以治其标。遂选云翔公治肥大性脊柱炎之腰痛方子服。原方未予增损，方为：
炙黄芪6g巴戟天9g淡苁蓉9g金狗脊12g酒川断9g炒杜仲12g甘杞子12g黑芝麻15g桂圆肉9g制附子3g炒苍术4．5g法半夏4．5g云茯苓9g薏苡仁9g炒独活3g陈皮4．5g全鹿丸9g(吞服)
上药每日一剂水煎服。三月后诸证渐退，腰痛减轻，有时可直立伸腰。服至半年，见效更佳，腰痛不作，无论站立或行走。腰脊可自然挺直，余症渐消。以后改汤为丸，又服数月而病尽解。
诈病经治记
诈病，一般医书多不记载，惟《景岳全书》叙述甚详。考其所论证候及治法，符合于现代西医之癔病。余临证间曾遇一例，治法取自景岳：“其治之之法，亦惟借其欺而反欺之，则真情自露而假病自瘥矣。”今记述于后。
1969年秋间，有高姓中年男子，组织上促其交待经济问题。一日，两工作人员陪其外出办事，行走于马路之旁。适一辆卡车迎面疾驰而来，高停步踌躇，陪者觉之。待车驰至身边，高猛然上扑，幸陪者力挽，仅稍稍擦过而缓缓跌地。然高僵卧路边，状若死人。余适在近侧，急速迓余往视，诊得六脉缓软，知为诈病。盖因连日思索不止，精神压力重重，加之欲行自尽时思绪纷杂。跃向汽车霎那之间，神魂飘荡，遂成此病。于是告言无妨，然陪者惊惶不已，拦汽车送往医院。余随车以观究竟，途中余谓陪者曰：此症或以软言慰之，或以厉言激之，皆可使醒。陪者某素来声色俱厉，即于患者耳边曰：“尔欲自杀害人，死亦罪加一等。明明未死，还要装死，本可从轻发落，今则非严加惩办不可。”并大声佯谓司机曰：“汽车转向，直送公安分局。”高闻声即缓缓睁眼而醒，哀求莫去公安局。及至医院，无病可查，亦不用药，后即一如常人。
此症即“癔病性假昏迷”，若不加治疗，经十数分钟或数小时后，亦能自解。今以言激之，不过促其速醒耳。《景岳全书》之治法与现代西医相通，试之实例果然有效。是知古人立言，必有其本，后世之贬景岳者，往往言之过甚，已非平心之论矣。
肿瘤类
“关脉如豆”说癌症
中医临证，贵在四诊合参、而历代名家，于四诊之中，无不倚重脉诊。《内经》曰：“微妙在脉，不可不察”。对于辨证求因，脉之作用至关重要。四言脉决云：“脉乃血派，气血之先。”是谓脉为人体生理病理信息之反应及预兆。余临证三十年间，辨疑似，别真伪，深得力于脉者恒多，而于癌症患者之证治，亦无不借重于三指之禅。就中不乏体会，此处仅以消化道肿瘤患者之关脉，诊见厥厥动摇如豆例，略加报道，以作探讨。
从中医传统之脉诊部位而论，左关属肝胆，右关属脾胃，俱归消化系统。若于此处脉道中或一手，或两手，诊见“动脉”，即指下如小豆一粒，稍硬而突起，厥厥动摇者。脉书多作肝脾不调，气机郁滞论，主于行气开郁法；或作痰浊瘀血盘踞，主于祛瘀消痰；或主阳热亢盛，热毒内燔，治宜泻火解毒。余于消化道癌症患者中，至今见此脉凡三例：一例胃腺癌，一例淋巴癌愈后复发胃转移，一例十二指肠壶腹部癌肿，均已晚期。三者同见此脉，足否此脉为消化道肿瘤患者特异脉象之一种，有待于今后深入探索。但三人脉象之辨证意义，同中有异，然皆不越上述所说病机。
决明子治疗便秘是近代人的发现，《本草纲目》这部集中药学大成的著作中也没有记载决明子具有通便的功能。我最早在《本草推陈》一书中看到关于决明子善于治疗便秘的报道：“慢性便秘及中风后顽固性便秘：用一斤炒香研成细末的决明子，用水泛制成丸剂，每日服用三次，每次一钱（约3-5克），连续服用三到五天，大便自然通畅，且排出成形粪便而不会腹泻。此后继续每天服用少量，以维持经常性的排便通畅，并能促进食欲，恢复健康。”使用上述方法治疗便秘效果确切，服药方式也很科学，以丸剂缓治更能润肠而不损伤正气，但制作起来不容易。因此，长期服用可以适量取决明子泡茶饮用，每次约10克，可根据大便通畅的程度增减用量，以适应自身情况为宜。
几年前，我治疗过一位晚期腹腔癌患者，几天不通大便，突然感到腹部急迫难忍，但去厕所又排不出便，不得已只能在居室内来回踱步，直到深夜仍无法排便。家属紧急电话告知我，患者自知肠道多被肿瘤侵蚀损坏，担心用力不当导致意外，所以不敢过分努责，要求给予迅速通大便的方子。我犹豫再三，回电嘱咐其家属急忙购买炒决明子60克。此时已接近半夜，其妻幸得药店值班人员的帮助将药购回。嘱咐先用30克加水一大碗，煮成浓汁约大半饭碗，吹凉后让患者饮服。服药后腹中微微躁动鸣响，但大便仍未下，腹胀如故。一小时后再次来电求助，我嘱咐将剩余的30克加入首次的药渣中，加水再煎再服。服药后半小时左右，竟然畅解出数十枚坚硬的粟米状粪便。腹部宽松舒适，痛苦完全消失。该患者半年后病故，但自服用决明子以后未再出现便秘。
由此可知，决明子的通便作用，小病可医，大病亦可治；身体强壮者可施用，虚弱衰败者也可投用。其药性缓和而不伤正气，药效迅速而不至于引起泄泻痢疾，诚为医门中的上品，通便的良剂。
中医学将人体的五官九窍、四肢百骸及组织器官进行类比归纳，分属于五脏，其中骨骼归属于肾。人体以骨骼为支架，以脊柱为支柱。人没有骨骼则形体不能站立，脏腑失去维系，肢节无法运动。而且骨髓是涵养大脑与经络（尤其是督脉）的源泉，因此骨骼在人体生命活动中具有至关重要之特殊作用，所以《内经》将骨归属于“先天之本”的肾，其道理非常深远。即显示骨与肾脏的精气密切相关。《黄帝内经·素问》说：“肾藏精、主水”、“肾之合骨也”、“肾生骨髓”、“肾不生则髓不能满”，又说：“肾气热，则腰背不举，……热舍于肾，肾者水脏也，今水不胜火，则骨枯而髓虚，故足不任身，发为骨痿。”以上经文明确阐明了“肾主骨”的生理病理，指出骨髓充盈与否，取决于肾气的盛衰。中医病因学将致病原因归纳为内因、外因与不内外因，三者都能侵袭于骨而生骨病。外因如风、寒、暑、湿、燥、火等六淫；内因如气、血、痰、火、湿、食等六郁；不内外因如房室劳倦、金刃创伤、劳力负重、外力损伤之类，均可导致骨痹、骨痿、骨疣、骨质伤损等种种骨病，然而病因不同，病机自然有别，治法也应当随之改变，为什么唯独说填精益髓来治疗骨疾呢？
大概腰部是肾的腑，而腰背又是脊柱所在之地，腰痛往往与脊骨有关，所以本方引用古代贤人对腰痛的论述来辨析骨病与肾精不足、真元虚衰之间的关系。如张璐玉在《张氏医通》卷五“腰痛”门中说：“《内经》说太阳腰痛，是外感六气所致。说肾经腰痛，是内伤房劳所致。假如肾脏真气布护，六气怎么能成为危害？只有肾脏虚伤，膀胱之腑怎么能独自充足？又有膏粱之人，久服热剂，醉后行房，损害其真气，则肾脏热、腰脊痛，久了则髓减骨枯，发为骨痿。这是本病，那些有风寒、湿热、闪挫、瘀血、滞气、痰积的，都是标病，而肾虚则是根本。”指出了骨病经久，虽有实邪，应从本治，必须以肾虚为其根本，以填精益髓为主要治法。又如《景岳全书》论腰痛证旧有五辨：“一是阳气不足，少阴肾衰。二是风痹风寒，湿着腰痛。三是劳役伤肾。四是坠堕损伤。五是寝卧湿地。”但是，景岳一转笔锋，直截了当地说：“腰痛之虚证十居八九，只要观察其既无表邪，又无湿热，而或因年老体衰，或因劳倦，或因酒色耗损，或因七情忧郁所致的，则都属于真阴虚证。”景岳的观点与石顽相同。腰痛骨病虽然致病之因有种种不同，但究其根本多以肾虚居多，所以以填补真阴为治法的根本。
基于上述，可知骨病不同于人体其他诸症，三因均可导致骨病，而骨病与肾虚具有特殊的内在关系，所以治疗骨病的根本关键，在于填补精髓以滋养先天，只要使肾脏精气充足，骨髓盈满，则骨得到滋养而骨病自愈。
目前临床常见的骨质疏松与骨质增生两症，初看似相径庭，细审病机及治法，仍不超出肾主骨生髓的基本原理。
骨质疏松症。此症常见于老年病人，年老之人肾气渐衰，真精亏乏，骨失濡涵滋养，使骨质松脆而致本病。其证常见身材渐渐变矮，俗谓“老缩”。脊柱弯曲畸形，不得已只能伛偻而行，弓背垂腰，仅能拄杖缓步。由于重心不正，加之骨质松脆已少承受之力，行走常易跌倒，且易骨折。骨折多见于腕部及髋关节处，仅需轻度外力即可导致骨折发生，脊柱还易发生压缩性骨折。此外骨质疏松症患者平素常有骨酸疼痛等见症。脉细弱，或大而无力，亦可兼见弦脉。舌质多淡或淡胖，苔多薄白。
以上见证都与肾脏虚衰、精亏阳弱有关。纵有外邪、伤损、瘀血、痰涎等因素，终属诱因，即使须用祛邪、消痰、化瘀等治标之法，只宜暂用，不可常服，或与补肾之法同用，标本兼顾。补肾以填精益髓、温肾壮骨为法。我临证每以黄芪、党参、白术、当归、白芍、熟地、杞子、狗脊、川断、杜仲、淮牛膝、苁蓉、制首乌、三七粉等药物选择组方。如阳虚较甚者，益入肉桂、附片，或兼用右归丸。如无明显阳虚之象，以上方合左归丸或健步丸（原为丹溪之虎潜丸），随证加减，久服自效。
骨质增生症。此症亦为老年人常见之病，故谓之退行性病变。本病与骨质疏松症形成之根本原因基本一致，亦因人至老年，肝肾精血亏损，筋骨渐失所养，而于承重部位，骨之代偿能力甚强，于是骨边缘形成骨质增生。骨质易于增生之部位，常见于颈部、手腕、髋骨、膝部及踝骨关节等处，此处活动度大，负重时易受重力压迫，骨边缘易于摩擦而生骨赘（亦称骨刺）。
骨赘形成之后，易对周围肌肉、神经等组织产生压迫，故其主症为关节疼痛，患处关节可见肿胀、僵硬、活动时亦可闻及摩擦音，听到“喀喀”响声。本病于天气变化或局部关节负重过甚时，可见症状加重。或因骨刺压迫神经，或因肿胀之韧带等软组织压迫神经，可引起臂丛或坐骨神经痛。病久者可致肌肉萎缩。骨质增生发生于颈椎及腰椎者，谓之颈椎增生及腰椎增生，今时此类患者人数极多，故治疗骨质增生症之重点，即在于治疗颈、腰椎病变。
本病与骨质疏松症同属肝肾精血亏损，以致筋骨失养之病，因而其治法及所用方药，亦相近似。但骨质增生症易夹六淫外邪或六郁内伤等因素，常表现为虚中夹实，故用药时常须兼顾。如确系邪实者，亦可先事祛邪以治其标，待病解之后，再拟治本以巩固治疗。我治本症之常用药为：太子参、炒白术、当归、白芍、狗脊、续断、杜仲、淮牛膝、骨碎补、威灵仙、延胡索、木瓜、红花、鸡血藤、葛根、羌活、生地、天冬等品。肾阳虚者，肉桂、附子亦可适当加入，而真阴不足者，又当以调养肝肾精血为先，宜以六味地黄丸、左归丸等方为其主体。
我治疗骨质疏松症，投以前述方药，大多即可见效，惟疗程较长，须有耐心。而在所治颈椎病例中，有一特殊病例兼患肺结核及附睾结核，属阴虚内热体质，不能稍参益气及温肾之品，试以天门冬少量煎服，则不仅潮热不作，咳嗽渐减，且颈椎宽展舒适，稍稍益入生地、山药、茯苓等品，效亦佳良。此病之形成，据患者自述，乃因宿疾至市郊一名医处求诊，医投大剂生地、麦冬、女贞子、墨旱莲、磁石、夜交藤、合欢皮、砂仁、沉香等味，服十数帖后渐见手麻，嗣后颈椎及胸椎上段疼痛，痛势甚剧。此时精神萎顿，胃纳极差。见家中有烧就之莲肉红枣，随取少量食用，食后精神胃纳转佳，颈中疼痛大减，颈部转动自如，即每日煮食，及至用莲肉、红枣各1000g时，食后即见头痛内热，遂停食，此时颈胸椎疼痛已消，惟增生处依然如故。我揣测此例虽阴亏内热体质，久病阳气亦弱，用大剂养阴镇摄，损其阳气，伤及肝肾，遂至颈椎病变。而后患者稍涉女贞、旱莲、金银花等克伐之品，颈椎立疼，手指立麻，而用参、芪、杞子等品则颈椎舒适，手麻消失。但如用生地、麦冬、天冬、菊花、桑叶等养阴清热而不损阳气之品，颈椎之疼痛与不适同样好转。由是而知骨质增生之病，确与肝肾相关，虽多数偏于阳弱，宜于温养，而阴虚者亦可致病，总由肝肾亏损，阴阳失调而成，温肾、育阴不可一概而论，本篇所述，不过通论而已，具体病例尚须辨证施治，切莫一方遍投，草率从事。
另有一例腰椎增生患者，因骑车过久及感受寒邪等因素，突发腰腿疼痛，致两足痿废不能着地，且原有隐性糖尿病宿疾。患者缘不能行走而恐惧不胜，连连急电促余疏方。我兼顾两病，列于一纸，药用黄芪、熟地、山药、苍术、元参、杜仲、淮牛膝、红花、丹参、当归、炒白芍、威灵仙、地龙、接骨木等，先后三方，服药二十余剂，腰腿疼痛消失，两腿恢复正常功能。至今已两年有余，生活起居一如常人。
某研究所高级工程师林先生，年过知命之后，时感腰脊酸痛，经市一医院检查确诊为腰椎增生肥大，虽服药无数而病情依然发展。渐至不能直立，站必弯腰曲背，走则偻俯以行，腰肢牵强难以转侧，深以为苦。兼见畏寒怯冷、四末不温、阳痿早泄、纳少神疲。我诊其脉左手细而无力，右虽稍大而按之豁然，两尺沉细。舌质淡胖，苔薄白微腻。据其脉证，当属肝肾精血亏损，阴伤及阳，阴阳俱虚而阳虚更甚之证。治宜补益肝肾、滋阴助阳以治本，佐以健脾化湿、祛风通络以治其标。遂选云翔公治肥大性脊柱炎之腰痛方子服。原方未予增损，方为：
炙黄芪6g 巴戟天9g 淡苁蓉9g 金狗脊12g 酒川断9g 炒杜仲12g 甘杞子12g 黑芝麻15g 桂圆肉9g 制附子3g 炒苍术4.5g 法半夏4.5g 云茯苓9g 薏苡仁9g 炒独活3g 陈皮4.5g 全鹿丸9g（吞服）
上药每日一剂水煎服。三月后诸证渐退，腰痛减轻，有时可直立伸腰。服至半年，见效更佳，腰痛不作，无论站立或行走，腰脊可自然挺直，余症渐消。以后改汤为丸，又服数月而病尽解。
诈病经治记
诈病，一般医书多不记载，惟《景岳全书》叙述甚详。考其所论证候及治法，符合于现代西医之癔病。我临证间曾遇一例，治法取自景岳：“其治之之法，亦惟借其欺而反欺之，则真情自露而假病自瘥矣。”今记述于后。
1969年秋间，有高姓中年男子，组织上促其交待经济问题。一日，两工作人员陪其外出办事，行走于马路之旁。适一辆卡车迎面疾驰而来，高停步踌躇，陪者觉之。待车驰至身边，高猛然上扑，幸陪者力挽，仅稍稍擦过而缓缓跌地。然高僵卧路边，状若死人。我适在近侧，急速迓余往视，诊得六脉缓软，知为诈病。盖因连日思索不止，精神压力重重，加之欲行自尽时思绪纷杂。跃向汽车霎那之间，神魂飘荡，遂成此病。于是告言无妨，然陪者惊惶不已，拦汽车送往医院。我随车以观究竟，途中余谓陪者曰：此症或以软言慰之，或以厉言激之，皆可使醒。陪者某素来声色俱厉，即于患者耳边曰：“尔欲自杀害人，死亦罪加一等。明明未死，还要装死，本可从轻发落，今则非严加惩办不可。”并大声佯谓司机曰：“汽车转向，直送公安分局。”高闻声即缓缓睁眼而醒，哀求莫去公安局。及至医院，无病可查，亦不用药，后即一如常人。
此症即“癔病性假昏迷”，若不加治疗，经十数分钟或数小时后，亦能自解。今以言激之，不过促其速醒耳。《景岳全书》之治法与现代西医相通，试之实例果然有效。是知古人立言，必有其本，后世之贬景岳者，往往言之过甚，已非平心之论矣。
肿瘤类
“关脉如豆”说癌症
中医临证，贵在四诊合参、而历代名家，于四诊之中，无不倚重脉诊。《内经》曰：“微妙在脉，不可不察”。对于辨证求因，脉之作用至关重要。四言脉决云：“脉乃血派，气血之先。”是谓脉为人体生理病理信息之反应及预兆。我临证三十年间，辨疑似，别真伪，深得力于脉者恒多，而于癌症患者之证治，亦无不借重于三指之禅。就中不乏体会，此处仅以消化道肿瘤患者之关脉，诊见厥厥动摇如豆例，略加报道，以作探讨。
从中医传统之脉诊部位而论，左关属肝胆，右关属脾胃，俱归消化系统。若于此处脉道中或一手，或两手，诊见“动脉”，即指下如小豆一粒，稍硬而突起，厥厥动摇者。脉书多作肝脾不调，气机郁滞论，主于行气开郁法；或作痰浊瘀血盘踞，主于祛瘀消痰；或主阳热亢盛，热毒内燔，治宜泻火解毒。我于消化道癌症患者中，至今见此脉凡三例：一例胃腺癌，一例淋巴癌愈后复发胃转移，一例十二指肠壶腹部癌肿，均已晚期。三者同见此脉，足否此脉为消化道肿瘤患者特异脉象之一种，有待于今后深入探索。但三人脉象之辨证意义，同中有异，然皆不越上述所说病机。
Cassiae Semen (Jue Ming Zi) for treating constipation is a modern invention; the *Bencao Gangmu* (Compendium of Materia Medica), which gathers the achievements of Chinese materia medica, does not record that Cassiae Semen has a laxative function. I first saw reports on Cassiae Semen's efficacy in treating constipation in the book *Bencao Tuichen*: "For chronic constipation and stubborn post-stroke constipation: Use one jin (approx. 500g) of Cassiae Semen, stir-fried until fragrant and ground into fine powder, made into pills with water. Take three times daily, each time one qian (approx. 3-5g). After continuous use for three to five days, bowel movements will naturally become smooth, and formed stools will be expelled without diarrhea. Thereafter, continue taking small amounts daily to maintain regular bowel movements, promote appetite, and restore health." Using the above method to treat constipation yields definite effects, and the administration method is scientific; using pills for slow treatment can moisten the intestines without damaging healthy Qi (vital energy), but preparation is difficult. Therefore, for long-term use, one can brew an appropriate amount of Cassiae Semen as tea, approximately 10g per time, adjusting the dosage up or down according to the degree of bowel smoothness to suit individual conditions.
A few years ago, I treated a patient with late-stage abdominal cancer who had not had a bowel movement for several days. Suddenly, he felt unbearable urgency in his abdomen but could not defecate even when going to the toilet. He was forced to pace back and forth in his room until late at night, still unable to pass stool. His family urgently called me. The patient knew his intestines were largely eroded and damaged by tumors and feared that straining improperly might cause accidents, so he dared not exert himself excessively. He requested a prescription to rapidly relieve constipation. After much hesitation, I replied by telegram instructing his family to urgently purchase 60g of stir-fried Cassiae Semen. It was close to midnight by then. Fortunately, his wife obtained help from the pharmacy's on-duty staff to buy the medicine. I instructed them to take 30g, add a large bowl of water, boil it into a concentrated decoction of about half a rice bowl, let it cool, and have the patient drink it. After ingestion, there was slight restlessness and rumbling in the abdomen, but no stool passed, and abdominal distension remained unchanged. An hour later, they called again for help. I instructed them to add the remaining 30g to the dregs of the first decoction, add water, boil again, and administer. About half an hour after this second dose, he successfully passed dozens of hard, millet-grain-sized stools. His abdomen felt loose and comfortable, and all pain disappeared. The patient died six months later, but he had no further constipation since taking Cassiae Semen.
From this, we can see that Cassiae Semen's laxative effect can treat minor illnesses and major diseases alike; it can be used for robust individuals and those who are weak and declining. Its nature is mild and does not damage healthy Qi; its effect is rapid without causing diarrhea or dysentery. It is truly a superior herb in medical practice and an excellent agent for relieving constipation.
Tonifying Essence and Nourishing Kidney to Treat Bone Diseases
Traditional Chinese Medicine (TCM) analogizes and categorizes the body's five sense organs, nine orifices, four limbs, hundred bones, tissues, and organs, assigning them to the Five Zang Organs. Among these, bones belong to the Kidney. The human body uses bones as its framework and the spine as its pillar. Without bones, the body cannot stand, organs lose their support, and joints cannot move. Moreover, bone marrow is the source that nourishes the brain and meridians (especially the Du Meridian). Therefore, bones play a crucial and special role in human life activities. Thus, the *Neijing* (Inner Canon) assigns bones to the Kidney, the "Root of Congenital Constitution," a principle of profound significance. This indicates a close relationship between bones and the essence-Qi of the Kidney. The *Huangdi Neijing·Suwen* (Yellow Emperor's Inner Canon: Basic Questions) states: "The Kidney stores essence and governs water," "The Kidney's harmony is with the bones," "The Kidney generates bone marrow," "If the Kidney does not generate, marrow cannot fill." It also says: "If Kidney-Qi is hot, the waist and back cannot lift... If heat resides in the Kidney, and the Kidney, being a Water organ, finds water insufficient to overcome fire, then bones wither and marrow empties, so the feet cannot bear the body, leading to bone flaccidity." These passages clearly elucidate the physiology and pathology of "the Kidney governs bones," pointing out that whether bone marrow is full depends on the prosperity or decline of Kidney-Qi. TCM etiology categorizes pathogenic factors into internal, external, and neither-internal-nor-external causes. All three can invade bones and cause bone diseases. External causes include the Six Excesses (Wind, Cold, Summerheat, Dampness, Dryness, Fire); internal causes include the Six Stagnations (Qi, Blood, Phlegm, Fire, Dampness, Food); neither-internal-nor-external causes include sexual excess, metal/blade injuries, labor/overexertion, and external trauma. These can lead to various bone diseases such as bone Bi (painful obstruction), bone flaccidity, bone warts, and bone damage. However, different causes lead to different pathogenesis, and treatment methods must follow accordingly. Why single out tonifying essence and replenishing marrow to treat bone diseases?
Generally, the waist is the palace of the Kidney, and the lower back is where the spine resides. Lower back pain is often related to the spinal bones. Therefore, this section cites ancient discussions on lower back pain to analyze the relationship between bone diseases and insufficient Kidney Essence and deficient Yuan Qi. For example, Zhang Luyu stated in Volume 5 of *Zhangshi Yitong* under the section "Lower Back Pain": "The *Neijing* mentions Taiyang lower back pain as caused by external contraction of the Six Qi. It mentions Shaoyin (Kidney) lower back pain as caused by internal injury from sexual fatigue. Suppose the True Qi of the Kidney is well-distributed and protected; how can the Six Qi cause harm? Only when the Kidney is injured and deficient can the Bladder, its paired organ, be insufficient? Furthermore, people accustomed to rich food and wine, who frequently take heating agents and engage in sex while intoxicated, damage their True Qi, leading to Kidney Heat and lower back/spine pain. Over time, marrow decreases and bones wither, causing bone flaccidity. This is the root disease. Those with Wind-Cold, Damp-Heat, sprains, blood stasis, stagnant Qi, and phlegm accumulation are branch diseases, while Kidney deficiency is the root." This points out that although long-standing bone diseases may involve excess pathogens, treatment should address the root, identifying Kidney deficiency as fundamental and tonifying essence/replenishing marrow as the main method. Similarly, *Jingyue Quanshu* discusses five types of lower back pain: "1. Insufficient Yang Qi, decline of Shaoyin Kidney. 2. Wind-Bi from Wind-Cold, dampness adhering to lower back pain. 3. Labor injuring the Kidney. 4. Falls and injuries. 5. Sleeping in damp places." However, Jingyue shifts tone and directly states: "Eight or nine out of ten cases of lower back pain are deficiency patterns. If one observes no exterior pathogens and no Damp-Heat, but attributes it to old age, fatigue, depletion from alcohol and sex, or emotional depression, then all belong to True Yin deficiency." Jingyue's view aligns with Shiweng's. Although bone diseases and lower back pain have various causes, Kidney deficiency is predominant. Therefore, tonifying True Yin is the fundamental treatment method.
Based on the above, bone diseases, like other conditions, can be caused by the Three Categories of Etiology, but they have a special internal relationship with Kidney deficiency. Thus, the key to treating bone diseases lies in filling essence and marrow to nourish the congenital foundation. As long as Kidney essence-Qi is sufficient and bone marrow is full, bones receive nourishment, and bone diseases heal themselves.
Currently common clinical conditions, osteoporosis and osteophytosis (bone spurs), seem disparate at first glance, but upon careful examination of their pathogenesis and treatment, they do not exceed the basic principle that "the Kidney governs bones and generates marrow."
Osteoporosis. This condition is common in elderly patients. As people age, Kidney-Qi gradually declines, and true essence becomes deficient. Bones lose moisture and nourishment, becoming brittle and leading to this disease. Symptoms often include gradual shortening of stature, commonly called "shrinking with age." Spinal curvature deformity forces patients to walk stooped, with arched backs and drooping waists, able only to walk slowly with a cane. Due to uneven center of gravity and reduced load-bearing capacity of brittle bones, falls are frequent, and fractures occur easily. Fractures often occur in the wrists and hips, requiring only mild external force. Vertebral compression fractures are also common. Additionally, patients often experience bone soreness and pain. The pulse is fine and weak, or large but forceless, possibly accompanied by a wiry pulse. The tongue body is pale or pale and puffy, with a thin white coating.
These manifestations are related to Kidney deficiency, essence depletion, and Yang weakness. Even if there are external pathogens, injuries, blood stasis, or phlegm-fluids, these are ultimately triggers. Even if symptomatic treatments like dispelling pathogens, resolving phlegm, or invigorating blood are necessary, they should only be used temporarily, not chronically, or combined with Kidney-tonifying methods to address both root and branch. The method for tonifying the Kidney involves replenishing essence and marrow, warming the Kidney, and strengthening bones. In clinical practice, I often select formulas containing Astragali Radix (Huangqi), Codonopsis Radix (Dangshen), Atractylodis Rhizoma (Baizhu), Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Baishao), Rehmanniae Radix Preparata (Shudihuang), Lycii Fructus (Gouqi), Cibotii Rhizome (Gouji), Spatholobi Caulis (Chuanjian), Eucommiae Cortex (Duzhong), Achyranthis Bidentatae Radix (Huainiuxi), Cistanches Herba (Rongrong), Polygoni Multiflori Radix Preparata (Zhihe shouwu), and Panacis Notoginseng Radix et Rhizoma Powder (Sanqi Fen). If Yang deficiency is severe, add Cinnamon Twig (Rougui) and Prepared Aconite Root (Fupian), or combine with Yougui Wan. If there is no obvious sign of Yang deficiency, combine the above formula with Zuogui Wan or Jianbu Wan (originally Danxi's Hujian Wan), modifying according to symptoms; long-term use yields results.
Osteophytosis. This is also a common disease in the elderly, hence called degenerative change. The fundamental cause is basically the same as osteoporosis: as people age, Liver and Kidney essence-blood decline, and tendons and bones gradually lose nourishment. At weight-bearing sites, the bone's compensatory ability is strong, leading to bone hyperplasia at the edges. Sites prone to hyperplasia include the neck, wrists, hip bones, knees, and ankle joints. These areas have high mobility and are easily compressed by gravity when bearing weight, causing friction at bone edges and forming osteophytes (bone spurs).
After osteophyte formation, they easily compress surrounding muscles, nerves, and other tissues. Thus, the main symptom is joint pain. Affected joints may show swelling and stiffness, and friction sounds or "clicking" noises may be heard during movement. Symptoms worsen with weather changes or excessive local joint loading. Compression of nerves by bone spurs, or by swollen ligaments and soft tissues, can cause brachial plexus or sciatic nerve pain. Long-term illness can lead to muscle atrophy. Osteophytosis occurring in the cervical and lumbar vertebrae is called cervical and lumbar hyperplasia, respectively. Currently, the number of such patients is very high, so the focus of treating osteophytosis lies in treating cervical and lumbar lesions.
This disease, like osteoporosis, belongs to Liver-Kidney essence-blood deficiency leading to loss of nourishment for tendons and bones. Therefore, treatment methods and prescriptions are similar. However, osteophytosis often involves external Six Excesses or internal Six Stagnations, manifesting as deficiency mixed with excess. Medication must account for this. If there is definitely excess pathogen, dispel it first to treat the branch; after the pathogen resolves, then treat the root to consolidate therapy. Common herbs I use for this condition include: Codonopsis Radix (Taizishen), Stir-fried Atractylodis Rhizoma (Chaobaizhu), Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Baishao), Cibotii Rhizome (Gouji), Spatholobi Caulis (Xuduan), Eucommiae Cortex (Duzhong), Achyranthis Bidentatae Radix (Huainiuxi), Drynariae Rhizoma (Gusuibu), Salvia Miltiorrhiza Radix et Rhizoma (Weilingxian), Corydalis Rhizoma (Yanhusuo), Chaenomelis Fructus (Mugua), Carthami Flos (Honghua), Spatholobi Caulis (Jixueteng), Puerariae Radix (Gegen), Notopterygii Rhizoma et Radix (Qianghuo), Rehmanniae Radix (Shengdi), and Asparagi Radix (Tiantong). For Kidney Yang deficiency, Cinnamon Twig (Rougui) and Aconiti Lateralis Radix Preparata (Fuzi) can be appropriately added. For True Yin insufficiency, nourishing Liver-Kidney essence-blood comes first, preferably using Liuwei Dihuang Wan or Zuogui Wan as the main formula.
In my treatment of osteoporosis, the aforementioned prescriptions usually show effects quickly, though the course is long and requires patience. Among the cervical cases I treated, there was a special case complicated by pulmonary tuberculosis and epididymal tuberculosis, belonging to a Yin-deficient with internal heat constitution. Tonifying Qi and warming the Kidney were contraindicated. Trying small doses of Asparagi Radix (Tianmendong) decocted and taken orally not only stopped tidal fever and reduced cough but also relieved cervical discomfort. Adding small amounts of Rehmanniae Radix (Shengdi), Dioscoreae Rhizoma (Shanyao), and Poria (Fuling) yielded good results. According to the patient, this condition arose because, seeking treatment for a chronic illness from a famous doctor in the suburbs, the doctor prescribed large doses of Rehmanniae Radix (Shengdi), Ophiopogonis Radix (Maidong), Ligustri Lucidi Fructus (Nüzhenzi), Ecliptae Herba (Mohanlian), Magnetitum (Cishi), Passiflorae Caulis (Yejaoteng), Albiziae Cortex (Hehuanpi), Amomi Fructus Rotundus (Sharen), and Aquilariae Lignum Resinatum (Chenxiang). After taking more than ten doses, hand numbness gradually appeared, followed by severe pain in the cervical and upper thoracic spine. At this time, spirit was listless, and appetite was poor. Seeing roasted lotus seeds and red dates at home, he ate a small amount. Afterwards, spirit and appetite improved, neck pain decreased significantly, and neck rotation became free. He continued eating them daily. When consuming 1000g each of lotus seeds and red dates, he developed headache and internal heat after eating, so he stopped. At this point, neck and thoracic spine pain had disappeared, but the hyperplasia remained. I surmise that although this case had Yin deficiency with internal heat, long-term illness also weakened Yang Qi. Large doses of Yin-nourishing and anchoring agents damaged Yang Qi and injured Liver-Kidney, leading to cervical lesions. Later, when the patient took even small amounts of Ligustri Lucidi Fructus (Nüzhen), Ecliptae Herba (Hanlian), and Chrysanthemi Flos (Jinyinhua) which are clearing/draining, cervical pain and finger numbness immediately returned. However, using Codonopsis Radix (Renshen), Astragali Radix (Huangqi), and Lycii Fructus (Gouqi) relieved cervical discomfort and eliminated finger numbness. But using Rehmanniae Radix (Shengdi), Ophiopogonis Radix (Maidong), Asparagi Radix (Tianmendong), Chrysanthemi Flos (Juhua), and Morus Folium (Sangye)—which nourish Yin and clear heat without damaging Yang Qi—also improved cervical pain and discomfort. From this, we know that osteophytosis is indeed related to the Liver and Kidney. Although most cases lean towards Yang weakness and benefit from warming/nourishing, Yin deficiency can also cause disease. It is always due to Liver-Kidney depletion and Yin-Yang imbalance. Warming the Kidney and nurturing Yin cannot be applied uniformly. What is described here is a general discussion; specific cases require syndrome differentiation and treatment. Do not indiscriminately apply one formula rashly.
Another case involved a patient with lumbar hyperplasia who suddenly suffered lower back and leg pain due to prolonged cycling and exposure to Cold pathogens, resulting in flaccidity of both legs making walking impossible. He also had a history of latent diabetes. Fearful of being unable to walk, he urgently contacted me for a prescription. Considering both diseases, I listed them on one paper, prescribing: Astragali Radix (Huangqi), Rehmanniae Radix Preparata (Shudihuang), Dioscoreae Rhizoma (Shanyao), Atractylodis Rhizoma (Cangzhu), Scrophulariae Radix (Yuanshen), Eucommiae Cortex (Duzhong), Achyranthis Bidentatae Radix (Huainiuxi), Carthami Flos (Honghua), Salviae Miltiorrhizae Radix et Rhizoma (Danshen), Angelicae Sinensis Radix (Danggui), Stir-fried Paeoniae Radix Alba (Chaobaishao), Salviae Miltiorrhizae Radix et Rhizoma (Weilingxian), Long Earthworm (Dilong), and Adenocaulon Caulis (Jieguomu). After three prescriptions and over twenty doses, lower back and leg pain disappeared, and leg function recovered normally. It has been over two years since then, and his daily life is like normal.
Mr. Lin, a senior engineer at a research institute, after age fifty, often felt soreness and pain in the lower back and spine. Diagnosed with lumbar hyperplasia and hypertrophy at a city hospital, his condition progressed despite numerous medications. He gradually became unable to stand upright, bending forward when standing and stooping when walking. His waist was stiff and difficult to turn, causing him great suffering. Accompanying symptoms included aversion to cold, cold extremities, impotence and premature ejaculation, poor appetite, and mental fatigue. My pulse diagnosis revealed: left side fine and forceless; right side slightly large but empty upon pressure; both Chi positions deep and fine. Tongue body pale and puffy, coating thin white and slightly greasy. Based on pulse and symptoms, this belongs to Liver-Kidney essence-blood depletion, Yin injury affecting Yang, with both Yin and Yang deficiency but Yang deficiency being more severe. Treatment should tonify Liver-Kidney, nourish Yin and assist Yang to treat the root, assisted by strengthening Spleen, resolving Dampness, dispelling Wind, and unblocking collaterals to treat the branch. I selected Yun Xianggong's formula for lower back pain in hypertrophic spondylitis. The original formula was not modified:
Roasted Astragali Radix (Zhì Huángqí) 6g, Morinda Officinalis Root (Bājǐtiān) 9g, Cistanches Herba (Dàn Cōngróng) 9g, Cibotii Rhizome (Jīn Gǒujǐ) 12g, Wine-processed Spatholobi Caulis (Jiǔ Chuānduàn) 9g, Stir-fried Eucommiae Cortex (Chǎo Dùzhòng) 12g, Sweet Lycii Fructus (Gān Qǐzǐ) 12g, Black Sesame Seed (Hēi Zhīmā) 15g, Longan Aril (Guìyuán Ròu) 9g, Prepared Aconite Root (Zhì Fùzǐ) 3g, Stir-fried Atractylodis Rhizoma (Chǎo Cāngzhú) 4.5g, Processed Pinellia Tuber (Fǎ Bànxià) 4.5g, Cloud Poria (Yún Fúlín) 9g, Coix Seed (Yìyǐrén) 9g, Stir-fried Notopterygii Rhizoma et Radix (Chǎo Dúhuó) 3g, Tangerine Peel (Chénpí) 4.5g, Whole Deer Pill (Quánlù Wán) 9g (swallowed).
One dose daily, decocted in water and taken orally. After three months, symptoms gradually receded, lower back pain lessened, and sometimes he could stand straight and extend his waist. After six months, effects were better; lower back pain ceased, whether standing or walking. The spine could naturally straighten, and other symptoms gradually disappeared. Later, changing from decoction to pills, he took them for several more months until the disease was completely resolved.
Record of Treating Feigned Illness
Feigned illness is rarely recorded in general medical books, except for detailed descriptions in *Jingyue Quanshu*. Examining the syndromes and treatments discussed, they correspond to modern Western medicine's hysteria. I encountered one such case in clinical practice, adopting Jingyue's method: "The treatment method is merely to borrow his deception and deceive him in return, so that the true condition reveals itself and the fake illness heals." I record it below.
In autumn 1969, a middle-aged man surnamed Gao was urged by the organization to confess economic issues. One day, two staff members accompanied him out for business, walking beside the road. A truck came speeding towards them. Gao stopped, hesitating, which the companions noticed. As the truck approached, Gao suddenly lunged forward. Fortunately, the companions pulled him back, barely grazing him before he fell slowly to the ground. However, Gao lay stiffly by the roadside, appearing dead. I happened to be nearby and was quickly summoned to examine him. I found his six pulses slow and soft, knowing it was feigned illness. Because he had been thinking incessantly for days, under heavy mental stress, and his thoughts were chaotic as he attempted suicide. In the split second of jumping towards the car, his soul wandered, leading to this condition. I told them it was harmless, but the companions were panicked and hailed a car to send him to the hospital. I followed to observe. On the way, I told the companions: "This condition can be awakened either by soothing words or by harsh provocation." One companion, usually stern in voice and manner, leaned close to the patient and said, "You tried to kill yourself and endanger others. Death adds another crime. Clearly you are not dead, yet you pretend to be. Originally, you could have received a lighter sentence, but now strict punishment is inevitable." He loudly pretended to tell the driver, "Turn the car, go straight to the Public Security Bureau." Hearing this, Gao slowly opened his eyes and woke up, begging not to go to the police station. Upon arrival at the hospital, no disease could be found, and no medication was needed. He subsequently acted like a normal person.
This condition is "hysterical pseudo-coma." Without treatment, it resolves spontaneously after ten minutes or a few hours. Provoking him with words merely accelerated his awakening. The treatment method in *Jingyue Quanshu* aligns with modern Western medicine, and practical application proved effective. This shows that ancient sayings have their basis. Those who criticize Jingyue in later generations often speak too severely, which is not a fair judgment.
Tumor Category
"The Guan Pulse Like a Bean" Discussing Cancer
In TCM clinical practice, the integration of the Four Diagnostic Methods is paramount. Throughout history, masters have relied heavily on pulse diagnosis among the four methods. The *Neijing* states: "Subtlety lies in the pulse, it must not be neglected." For syndrome differentiation and seeking the cause, the role of the pulse is crucial. The *Siyan Maijue* (Four-Character Pulse Resolution) says: "The pulse is the pathway of blood, the precursor of Qi and Blood." This means the pulse is a reaction and omen of physiological and pathological information in the human body. During my thirty years of clinical practice, distinguishing between apparent and real, I have benefited greatly from pulse diagnosis. In treating cancer patients, I have also relied heavily on the "Zen of three fingers." There are many insights here. I will briefly report on the Guan pulse of gastrointestinal tumor patients presenting as trembling like a bean, for discussion.
From the perspective of traditional TCM pulse diagnosis locations, the Left Guan belongs to the Liver and Gallbladder, and the Right Guan belongs to the Spleen and Stomach, both part of the digestive system. If at these pulse locations, in one or both hands, an "Moving Pulse" (Dong Mai) is felt—like a small bean grain under the fingers, slightly hard and protruding, trembling vigorously—pulse books mostly attribute this to Liver-Spleen disharmony and Qi mechanism stagnation, advocating Qi-moving and depression-resolving methods; or to turbid Phlegm and Blood Stasis occupying the area, advocating blood-invigorating and phlegm-resolving methods; or to Hyperactive Yang-Heat and internal burning Heat-Toxin, advocating fire-purging and toxin-clearing methods. Among gastrointestinal cancer patients, I have seen this pulse in three cases to date: one case of gastric adenocarcinoma, one case of lymphoma recurrence with gastric metastasis, and one case of ampullary carcinoma of the duodenum, all in late stages. All three presented with this pulse. Whether this pulse is a specific pulse image for gastrointestinal tumor patients awaits further in-depth exploration. However, the diagnostic significance of the pulses in these three cases, while having similarities and differences, does not exceed the pathogenesis mentioned above.