辛亥二月。毗陵学官王仲景妹。始伤寒。七八日。 寒。喉中涎响如锯。目瞑不知人。病势
极矣。予诊之。询其未 寒以前证。母在侧曰。初病四五日。夜间谵语。如见鬼状。予曰。得病
之初。正值经候来否。答曰经水方来。因身热病作而自止。予曰。此热入血室也。仲景云妇人中风发热。经水适来。昼
日明了。夜则谵语。发作有时。此为热入血室。医者不晓。例以热药补之。遂致胸膈不利。三焦不通。涎潮上
脘。喘急息高。予曰。病热极矣。先当化其涎。后当除其热。无汗而自解矣。予急以一呷散投之。
两时间。涎定得睡。是日遂省人事。自次日以小柴胡汤加生地黄。三投热除。无汗而解。
乡里市人姓京。鬻绳为业。谓之京绳子。其子年近三十。初得病。身微汗。脉弱。恶风。医
者误以麻黄汤汗之。汗遂不止。发热。心痛。多惊悸。夜间不得眠卧。谵语。不识人。筋惕肉 。
振振动摇。医者以镇心惊风药治之。予视之曰。强汗之过也。仲景云脉微弱。汗出恶风者。不可
服青龙汤。服之则筋惕肉 。此为逆也。惟真武汤可收之。仲景云太阳病发汗。汗出不解。其人
仍发热。心下悸。身 动。振振欲擗地者。真武汤主之。予三投而大病除。次以清心丸竹叶汤解
余毒。数日瘥。
辛亥年二月。毗陵(今江苏常州)的学官王仲景的妹妹。起初患伤寒。到了七八天。出现恶寒。喉咙中痰鸣声像拉锯一样响。眼睛闭合不能视物。神志昏迷不省人事。病情非常危急。我诊治她时。询问她在发冷之前的症状。母亲在旁边说。刚生病四五天夜里。胡言乱语。好像看见鬼怪一样。我说。得病之初。正值月经来潮吗?回答说月经正在来潮。因为身体发热、疾病发作而自行停止。我说。这是热入血室证。张仲景说妇女中风发热。月经适逢来潮。白天神志清楚。夜间则胡言乱语。发作有定时。这就是热入血室证。医生不懂此理。常规用热性药物补益。于是导致胸膈部不适。三焦气机不通畅。痰涎上涌至胃脘。气喘急促、呼吸声高。我说。病势热极。应当先化解痰涎。随后清除热邪。不出汗而自然痊愈。我急忙给了一呷散服用。大约一顿饭工夫。痰涎平息得以入睡。当天就恢复了意识。从第二天起用小柴胡汤加生地黄。服用三次后热退。不出汗而病愈。
同乡有个姓京的市井商人。以卖绳子为业。人称“京绳子”。他的儿子年纪近三十岁。初患病时。身上微微出汗。脉象微弱。怕风。医生误用麻黄汤发汗。汗出遂不止。发热。心痛。多惊悸。夜间无法安睡。胡言乱语。不认识人。肌肉跳动。肢体震颤动摇。医生用镇惊熄风的药物治疗。我看后说。这是强行发汗造成的过失。张仲景说脉象微弱。汗出怕风的人。不可服用大青龙汤。服用了就会肌肉跳动。这是逆治。只有真武汤可以挽回。张仲景说太阳病发汗。汗出后病不解。其人仍然发热。心下悸动。身体颤动。振振动摇欲倒地的样子。应用真武汤主治。我服用三次后大病消除。接着用清心丸和竹叶汤解除余毒。几天后痊愈。
In the second month of the Xinhai year, the younger sister of Wang Zhongjing, an educational official in Bilin (modern Changzhou, Jiangsu), initially contracted Shanghan (Cold Damage). By the seventh or eighth day, she exhibited aversion to cold, a rattling sound in her throat resembling a sawing motion, eyes closed with inability to see, and unconsciousness. The condition was extremely critical. Upon examining her, I inquired about her symptoms prior to the onset of chills. Her mother, present at the side, stated that during the fourth or fifth day of illness, she had delirium at night, appearing as if seeing ghosts. I asked, "At the beginning of the illness, did her menstruation occur?" She replied, "Her menses had just begun, but stopped spontaneously due to fever and the onset of disease." I said, "This is Heat Entering the Blood Chamber (Re Ru Xue Shi)." Zhang Zhongjing stated: "When a woman contracts Wind-Heat (Feng Re) with fever, and her menses happen to arrive, she is clear during the day but delirious at night, with paroxysmal occurrences. This is Heat Entering the Blood Chamber." The physicians did not understand this and routinely administered hot-natured tonifying herbs. Consequently, this led to chest and diaphragm discomfort, obstruction of the Sanjiao (Triple Burner) qi mechanism, flooding of phlegm-saliva rising to the epigastrium, panting, and high-pitched respiration. I said, "The pathological heat is extreme. We must first resolve the phlegm-saliva, then eliminate the heat, and she will recover without sweating." I urgently administered Yiha San (One-Sip Powder). Within the time it takes to eat one meal, the phlegm-saliva settled, and she fell asleep. On that day, she regained consciousness. From the next day, Xiaochaihu Tang (Minor Bupleurum Decoction) combined with Sheng Dihuang (Radix Rehmanniae Recens) was administered. After three doses, the heat subsided, and she recovered without sweating.
A townsman surnamed Jing, who sold ropes for a living and was known as 'Jing Shengzi' (Rope Seller Jing), had a son nearly thirty years old. Initially, he presented with slight sweating, a weak pulse, and aversion to wind. The physician mistakenly administered Mahuang Tang (Ephedra Decoction) to induce sweating. The sweating continued incessantly, accompanied by fever, heart pain, frequent palpitations and fright, inability to sleep at night, delirium, and failure to recognize people. He experienced muscle twitching (Jin Ti Rou Tiao) and tremulous shaking. The physician treated him with herbs for calming the spirit and extinguishing wind. Upon examination, I said, "This is an error caused by forced sweating." Zhang Zhongjing stated: "If the pulse is weak and faint, with sweating and aversion to wind, Qinglong Tang (Green Dragon Decoction/Da Qinglong Tang) should not be taken. Taking it results in muscle twitching. This is a contraindication." Only Zhenwu Tang (True Warrior Decoction) could remedy this. Zhang Zhongjing also stated: "In Taiyang Disease, after inducing sweating, if the condition does not resolve, and the patient still has fever, palpitations in the epigastrium, body tremors, and a trembling desire to fall to the ground, Zhenwu Tang governs." After three doses of my prescription, the major illness was eliminated. Subsequently, Qingxin Wan (Clear Heart Pill) and Zhuye Tang (Bamboo Leaf Decoction) were used to resolve residual toxins. He recovered after several days.