《余无言》
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医家小传
余无言(1900～1963年)，原名余愚，字择明(一作”则民”)，别署不平。汉族，江苏省阜宁县人，出生于该县益林镇。祖讳子散，精于医丽通儒。咸丰、同治年间，苏北多次疫病流行，经子舰公施治获痊者甚多。父奉仙公，医术受教于子砚公，在益林镇悬壶十余年。壮年从戎，游幕大江南北，曾掌湘军董军门宝泉幕府者有年，佐治戎机，颇有声誉。四十岁后，复归乡里业医，求治者众，在周围地区有很高的名望。其遗著《医方经验汇编》，以内科医案为主，其中论治之疫病尤多，包括瘟疫、疫疟、疫疹、寒疫渺霍、疫疹、疫斑、疫黄、疫痢、虾摸疫、鹏鹅疫、羊毛疫、蛰刺瘟、葡萄疫、瓜瓤疫、天泡疫、疙瘩瘟、鼠疫、燥疫等。每病均有精要之阐论，并附医案，堪称是近代的”治疫大家”。
由于奉仙公学验俱富，邻县及外省求治者亦众。19世纪末，奉仙公与兴化赵海仙、淮安张子平，并称为”晚清苏北三大名医”。
无言先生幼年以儒学、理学、史学诸典籍奠基(曾于1909～1911年在淮安高等小学插班毕业)，少年时随其父奉仙公习医，悟性高而精勤不倦。他以医学经典名著《内经》、《难经》、《神农本草经》、《伤寒论》、《金匮要略》奠定学术基础，并系统学习内、外、妇、儿各科名著，术业大进。18周岁即应诊于乡里。鉴于当时欧西医学东渐，在沿海城市已逐步形成主流，先生又受当时”医学衷中参西”的影响，于1920年即南下上海学习西医。内科从师于俞凤宾博士，外科受教于德籍名医维都富尔。在此期间，开始对中西医的融会贯通深感兴趣。1923年返回故里继续业医，并在益林镇主办益林小学，自任校长。1927年至1929年冬，曾应聘担任旧国民政府顾祝同军部第二师任军医官，转战皖、豫、鄂、赣诸省，主治以外伤科病证居多。1929年冬，先生辞去军职，去上海业医定居。
1930年，应上海中国医学院院长包识生先生之请，担任该院外科学教授;嗣后，与张赞臣先生合办《世界医报》。
1931年，先生又与张赞臣先生共组联合诊所。1932年，由旧中央国医馆焦易堂馆长聘请先生担任该馆名誉理事。1934年，中央国医馆复增聘先生为该馆编审委员会委员，负责起草”外科病名表式”以颁布全国中医界采用，获得好评。是年，还编写、出版了他所撰著的《实用混合外科学总论》和《实用混合外科学各论》。又以改进中医为素志，发表多篇学术论文，在当时有较为广泛的影响。先生还针对旧国民政府和余云岫等”废止中医药”的举措和主张予以撰文批驳，进行了针锋相对的斗争。
1936年，应章太炎先生之请，担任苏州国医学校外科主任。并应聘为上海中国医学院、新中国医学院教授，主讲《伤寒论》、《金匮要略》、《中医外科学》等课程。
1937年，与张赞臣先生共同主办”上海中医专科学校”，聘请谢观先生担任名誉校长，陈无咎先生任校长，丁福保、张伯熙先生先后任副校长，先生自任教务主任，张赞臣先生任总务主任。学制为三年制，共举办三届。先生除主管校务外，主讲《伤寒论》、《金匮要略》等课程。在五年办校过程中，从未缺课，虽大雨滂沱，身衣淋湿，亦阔步上台讲课，受到同学们的爱戴和尊崇。1938年，曾受聘于中华职业学校之中国医学专修馆担任讲席。1939年，先生所撰著的《伤寒论新义》在中华书局出版。1942年，因不屈于日伪政府的登记、造册，停办了学校。1943～1946年，先后编写、出版了《湿温伤寒病篇》和《斑疹伤寒病篇》。”湿温伤寒”指西医所说的肠伤寒，”斑疹伤寒”为西医病名，这两部著作可谓是温病学早期中西医学术汇通性的编著”1947年，创办上海大同疗养院，自任院长，请丁福保先生担任名誉院长，开办不足二年，因经费不足而停办。
先生长期在上海业医，经治疑难重病和伤寒、温病殊多。由于崇尚经方，伤寒、温病用石膏、大黄者亦多不胜数。在辨证精审的基础上，用量大而效验卓著，不少市民或称之为”石膏、大黄先生”(经治病例请参看余氏医案)。故在民国时期，他是国内著名的”经方派”医家，学术经验俱富。
先生在上海业医，曾深受谢观、陈无咎、丁福保等前辈之教益，而在学术临床方面，又十分推崇”南北二张”“南张”指嘉定张山雷，”北张”系天津张锡纯)。生平治医主张”中医科学化，西医中国化”。对于中西医学，力求贯通融会，故亦有将之列为”汇通派”医家者。
建国后，先生拥护党和政府的中医政策。1952年又编写出版了《金匮要略语译》，完成了他系统整理、研究仲景著作的夙愿，并被认为是上海市研究仲景学说的”三大家”之一(另二家是曹颖甫和陆渊雷)。1954年，先生应邀出席华东及上海市中医代表会议，他在会上即席发言，并向大会秘书处另写有关开展中医工作的四项提案。
1956年春，应卫生部中医研究院之请，由沪来京主持中医研究院编审室(其后数年改为文献研究室)工作，又为卫生部主办之全国第一届西医学习中医研究班讲授部分课程(《金匮要略》等)，还参与审订中医九种教材。1957年，无言先生将其父奉仙公遗著《医方经验汇编》(解放前由中华书局出版)与其个人医案著作《翼经经验录》刊印合订本(未公开发行)，分增有关人员。1958年，奉调至北京中医学院任教，并参加北京中医学院”十大经典医著”的编纂设计。此外，还承担一些中央首长的医疗保健和会诊工作。
1963年9月7日，因高血压、脑溢血在京逝世。
附余氏小传说明:早在1942年，上海名医姜春华先生曾为先父无言公写有一小传，对先父中年以前的经历及学术临床特色多有精要、中肯的表述。现针对先父毕生情况，由本人予以增补、定稿。
(姜春华先生1942年所写《余无言先生传》复印件1页，见文前)专病论伤风伤风转少阳证初秋感冒风邪，恶寒发热，头痛肢酸。继转寒热往来，两胁满痛，时时作呕，口苦咽干，意乱心烦，坐卧不安，口干欲饮，饮则呕更加甚。医以荆芥、防风、豆豉、豆卷治之，症愈加剧。询其大便，前昨均解。急投小柴胡汤，一剂而痊。
患者张石舟，住西藏南路崇善里口。以人力车工会事忙，昼则奔走于烈日之下，夜则纳凉于露台之上。因之恶寒发热，头痛肢酸。自以生姜赤糖汤饮之，次日头痛肢酸己愈。而两胁转痛，往来寒热。寒则被覆而仍战栗，热则赤膊而犹如焚。心烦作呕，口苦异常，渴欲得饮，饮则呕吐加甚。因之坐卧难安，片刻不宁。延医治之，甲医投以荆芥、防风之属，乙医投以豆鼓、豆卷之类，丙医投以藿香正气之方。病更加剧，心烦欲死。
其堂弟世英，与余为友。见状大惊，急来延余。余午餐小饮，尚未释杯，即携余手强之而去。相去不远，始听世英之述症。先后登楼，继察石舟之现状。余即笑而慰之曰：“此柴胡汤证也。乃病在少阳，解之易耳，其毋惊俱。”病者曰：“能不死乎。”余笑曰：“此证而死，则病而死者多矣。
乃时医者流，不肯读《伤寒论》一书耳。”因书小柴胡汤一方，并无加减。令其服药时，先以生姜一二片，置口中嚼之使烂，庶姜汁遍及齿舌，使生辣麻之感。然后高举两手，后坐一人以扶持之，端坐而挺直。另请一人操匙以饮之，则可以不呕。定心静气约一刻钟，再缓卧于沙发上，勿令睡平。
至半小时后，再睡平，任其安平睡去也。病家如余言，照法服之，果然--剂而痊。
小柴胡汤方春柴胡二钱五分生黄芩三钱西党参三钱姜制半夏三钱炙甘草二钱生姜三片大枣十枚*余氏卒于1963年，其时处方尚用旧制。可以一钱约等于3克换算。全书同。
伤风转结胸证妇人年近六旬，体质素丰，重感风邪。寒热甫退，即又伤饮食。因之胸院及腹，均形胀满，两胁亦膨，按之硬而作痛，渐至不能平卧，挺胸伸颈，张口呼吸，此结胸实证也。与以大陷胸汤加枳实方，大挫其势，再以瓜萎葶苈汤，肃清余孽。
有劳工韩小顺者，其姨母许氏，年近六旬，住于克王渡路康定路口之某里。初为重感风邪，经医治后，寒热已退，而里邪尚未清肃，即急于饮食，且过常量。因之胸烷结痛，连及腹部，上则气逆满闷，下则大便不通，小便亦少。复延附近之医生，治之无效，韩乃延余往诊。余既入病者之室，见其倚卧于床栏上，背后垫以卷好之棉被，被上加以重叠之棉枕。病者挺其胸腹，倚于其上，心已知其不能平卧也。询其过去之病情，知为病中多食所致。按其胸腹，则处处作硬而痛，两胁亦然，膈间尤甚。舌苔则湿腻带黄。更觉心烦不安。诊其两脉，则沉而且紧。周身并无热候，手足反觉微凉。询其大便，已数日不解。乃断为结胸重证。但年事已高，不无顾虑，复思脉证均实，不得有所顾虑。即为之处方，以大陷胸汤加积实主之，嘱其如法煎服。
迫服药之后，果得大泻数次。每泻一次，则胸胁脘腹之满痛，即轻减一次。至第三次泻下之后，病者已渐能平卧，即自转转侧，亦觉痛可自忍。及二煎服后，又续下两次，似已病去七分矣。次日复诊。见其效如此之速，余固心喜，而病家亦言谢不置。诊其脉沉亦起，不似以前之实而有力。察其舌苔，则舌尖已退，根上腻黄渐化，而中心亦宣而浮起。诚恐余邪未尽，再有反复，又顾及高年之体质，陷胸方不容再剂。
乃仿傅青主方，以瓜萎为主，合小陷胸汤及葶苈泻肺法。继服两剂，而告痊愈。接服调理脾胃之剂，于是健康恢复矣。
大陷胸汤加积实方锦纹大黄五钱(酒洗)元明粉五钱(分冲)制甘遂二钱五分(为末)炒积实五钱上四味，先煎大黄积实。汤成，纳元明粉之半量，再温烊化，纳甘遂末半量。调匀服之。六小时后，服二煎，如前法。
瓜萎葶苈汤方全瓜萎六钱葶苈子三钱制半夏四钱炒积壳四钱元明粉四钱(分冲)上五味，先煎四味。汤成，纳元明粉半量，再温烊化。
服二煎，如前法。
伤风汗多阳虚证卫气素虚，皮毛不固，动则自汗，忽感风邪，始则恶风恶寒，继则寒热并作，头项强痛，接再酸楚，间以恶心，而自汗颇多。迟延两日，渐至手足微撅，四肢亦微有拘急。技以桂枝加附子汤，一剂而痊。
患者顾芝轩，年42岁，为劳动人民，庸工于菜市路一小茶楼中。其人卫气素虚，动则有汗。皮毛既不固，且与炉灶相亲，热汤相近，其平日自汗之情况，已可想而知。此种体质，即《伤寒论》所谓”病常自汗出者，此营气和，卫不谐，卫气不共营气和谐”之体质。而其所任职业，亦足促使其自汗多也。于1950年3月间，以劳汗当风，忽患伤风之证。始则膏音恶寒，渐渐恶风，但寒不热，约半日许，始渐蠢蠢发热。此乃体质较弱，故发热较迟，不似体质强壮者，其发热与恶寒同时并见也。他如头项强痛，腰特酸楚，间以恶心，而自汗淋漓，较平时为尤甚。
初病之时，以经济关系，未延医调治。至第三日，以病势有增无减，且增四肢拘急，屈伸不和，手足发凉，十指尤冷，此时始就余诊。入诊室之时，余见其面带垢晦，袖手缩足，人扶而进。坐定之时，又见头面颈项均自汗颇多，领围带湿，气息微喘。及诊其脉，则觉手已微凉，手指尤甚。手如此，足亦可知。细询其发病时日，知才三日耳。其表证指历，必由自汗而来。其他症状，已如前述。综其全盘症状，太阳表证及卫虚末厥，必须一鼓而克之，否则顾此失彼，难保元肢厥脉沉之危险也。乃处以桂枝加附子汤，俟汗止热退后，再行调理。
诸生间曰：“此证面带垢晦之色，颇似温病，而今用桂枝，何也?”余曰：“仲景之书，以证候诊断为主。而治疗之法，又以有某证用某药，无某证减某药。今恶寒与发热均在，且与头痛项强、腰臀酸楚并见。全为风邪表证，焉得不用桂枝。不似温病之面垢，但发热而不恶寒也，其认证在此。”诸生又曰：“桂枝附子汤方，原为不应大汗，而大发其汗，遂至漏汗不止之证而用之。今病者三日未治，根本并未发汗，何亦用此，余曰：“汝等读书如此，难以与言医矣。
大发汗之漏，与此自汗之漏，其汗不止，有何异乎?发汗与自汗虽有异，而漏汗不止则同也。既漏汗不止矣，安得不急用附子耶。且已手足微厥，四肢微拘，附子之用，更不可缓矣。”及至次日复诊，果已一药而痊。诸生更大喜而服。为处以调理之剂，令服两帖，以扶正气。
桂枝加附子汤方川桂枝三钱京芍药四钱炙甘草二钱五分熟附片五钱生姜一钱五分大枣十枚伤寒夏令伤寒证(一）时当夏令，妇人恶寒高热。头痛项强，体疼骨疼，周身无汗、脉浮而紧。微有恶心及气急，此真六月伤寒也。询其致病之源，系在电影场中，为冷气所逼。以麻黄汤加葛根、霍香主之。
《余无言》
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医家小传
余无言（1900～1963年），原名余愚，字择明（一作“则民”），别署不平。汉族，江苏省阜宁县人，出生于该县益林镇。祖父余子散，精通医学且通晓儒家经典。咸丰、同治年间，苏北地区多次发生疫病流行，经余子散公施治而痊愈者甚多。父亲余奉仙，医术受教于余子散公，在益林镇行医十余年。壮年时从军，游历大江南北，曾多年掌管湘军董军门宝泉的幕府，辅佐处理军事机务，颇有声誉。四十岁后，回归家乡从事医疗工作，求医者众多，在周围地区享有极高的声望。其遗著《医方经验汇编》，以内科医案为主，其中关于疫病的治疗论述尤多，包括瘟疫、疫疟、疫疹、寒疫霍乱、疫斑、疫黄、疫痢、虾蟆疫、鹅口疫、羊毛疫、蛰刺瘟、葡萄疫、瓜瓤疫、天泡疫、疙瘩瘟、鼠疫、燥疫等。每种疾病均有精要的阐论，并附有医案，堪称近代的“治疫大家”。
由于余奉仙公学识与临床经验俱丰富，邻县及外省前来求治者也很多。19世纪末，余奉仙公与兴化赵海仙、淮安张子平，并称为“晚清苏北三大名医”。
无言先生幼年以儒学、理学、史学等典籍奠定基础（曾于1909～1911年在淮安高等小学插班毕业），少年时随其父余奉仙公学习医学，悟性高且勤奋不懈。他以医学经典名著《内经》、《难经》、《神农本草经》、《伤寒论》、《金匮要略》奠定学术基础，并系统学习内、外、妇、儿各科名著，医术大进。18周岁即开始在乡里应诊。鉴于当时西方医学东渐，在沿海城市已逐步形成主流，先生又受当时“医学衷中参西”思想的影响，于1920年南下上海学习西医。内科师从俞凤宾博士，外科受教于德籍名医维都富尔。在此期间，开始对中西医的融会贯通深感兴趣。1923年返回故里继续行医，并在益林镇主办益林小学，自任校长。1927年至1929年冬，曾应聘担任旧国民政府顾祝同军部第二师军医官，转战皖、豫、鄂、赣诸省，主治以外伤科病证居多。1929年冬，先生辞去军职，去上海行医定居。
1930年，应上海中国医学院院长包识生先生之请，担任该院外科学教授；嗣后，与张赞臣先生合办《世界医报》。
1931年，先生又与张赞臣先生共组联合诊所。1932年，由旧中央国医馆焦易堂馆长聘请先生担任该馆名誉理事。1934年，中央国医馆复增聘先生为该馆编审委员会委员，负责起草“外科病名表式”以颁布全国中医界采用，获得好评。是年，还编写、出版了他所撰著的《实用混合外科学总论》和《实用混合外科学各论》。又以改进中医为素志，发表多篇学术论文，在当时有较为广泛的影响。先生还针对旧国民政府和余云岫等“废止中医药”的举措和主张予以撰文批驳，进行了针锋相对的斗争。
1936年，应章太炎先生之请，担任苏州国医学校外科主任。并应聘为上海中国医学院、新中国医学院教授，主讲《伤寒论》、《金匮要略》、《中医外科学》等课程。
1937年，与张赞臣先生共同主办“上海中医专科学校”，聘请谢观先生担任名誉校长，陈无咎先生任校长，丁福保、张伯熙先生先后任副校长，先生自任教务主任，张赞臣先生任总务主任。学制为三年制，共举办三届。先生除主管校务外，主讲《伤寒论》、《金匮要略》等课程。在五年办校过程中，从未缺课，虽大雨滂沱，身衣淋湿，亦阔步上台讲课，受到同学们的爱戴和尊崇。1938年，曾受聘于中华职业学校之中国医学专修馆担任讲席。1939年，先生所撰著的《伤寒论新义》在中华书局出版。1942年，因不屈于日伪政府的登记、造册，停办了学校。1943～1946年，先后编写、出版了《湿温伤寒病篇》和《斑疹伤寒病篇》。“湿温伤寒”指西医所说的肠伤寒，“斑疹伤寒”为西医病名，这两部著作可谓是温病学早期中西医学术汇通性的编著。1947年，创办上海大同疗养院，自任院长，请丁福保先生担任名誉院长，开办不足二年，因经费不足而停办。
先生长期在上海行医，经治疑难重病和伤寒、温病殊多。由于崇尚经方，伤寒、温病用石膏、大黄者亦多不胜数。在辨证精审的基础上，用量大而效验卓著，不少市民或称之为“石膏、大黄先生”（经治病例请参看余氏医案）。故在民国时期，他是国内著名的“经方派”医家，学术经验俱富。
先生在上海行医，曾深受谢观、陈无咎、丁福保等前辈之教益，而在学术临床方面，又十分推崇“南北二张”（“南张”指嘉定张山雷，“北张”系天津张锡纯）。生平治医主张“中医科学化，西医中国化”。对于中西医学，力求贯通融会，故亦有将之列为“汇通派”医家者。
建国后，先生拥护党和政府的中医政策。1952年又编写出版了《金匮要略语译》，完成了他系统整理、研究仲景著作的夙愿，并被认为是上海市研究仲景学说的“三大家”之一（另二家是曹颖甫和陆渊雷）。1954年，先生应邀出席华东及上海市中医代表会议，他在会上即席发言，并向大会秘书处另写有关开展中医工作的四项提案。
1956年春，应卫生部中医研究院之请，由沪来京主持中医研究院编审室（其后数年改为文献研究室）工作，又为卫生部主办之全国第一届西医学习中医研究班讲授部分课程（《金匮要略》等），还参与审订中医九种教材。1957年，无言先生将其父余奉仙公遗著《医方经验汇编》（解放前由中华书局出版）与其个人医案著作《翼经经验录》刊印合订本（未公开发行），分赠有关人员。1958年，奉调至北京中医学院任教，并参加北京中医学院“十大经典医著”的编纂设计。此外，还承担一些中央首长的医疗保健和会诊工作。
1963年9月7日，因高血压、脑溢血在京逝世。
附余氏小传说明：早在1942年，上海名医姜春华先生曾为先父无言公写有一小传，对先父中年以前的经历及学术临床特色多有精要、中肯的表述。现针对先父毕生情况，由本人予以增补、定稿。
(姜春华先生1942年所写《余无言先生传》复印件1页，见文前)
专病论
初秋感冒风邪，恶寒发热，头痛肢酸。继转寒热往来，两胁满痛，时时作呕，口苦咽干，意乱心烦，坐卧不安，口干欲饮，饮则呕更加甚。医以荆芥、防风、豆豉、豆卷治之，症愈加剧。询其大便，前昨均解。急投小柴胡汤，一剂而痊。
患者张石舟，住西藏南路崇善里口。以人力车工会事忙，昼则奔走于烈日之下，夜则纳凉于露台之上。因之恶寒发热，头痛肢酸。自以生姜赤糖汤饮之，次日头痛肢酸己愈。而两胁转痛，往来寒热。寒则被覆而仍战栗，热则赤膊而犹如焚。心烦作呕，口苦异常，渴欲得饮，饮则呕吐加甚。因之坐卧难安，片刻不宁。延医治之，甲医投以荆芥、防风之属，乙医投以豆鼓、豆卷之类，丙医投以藿香正气之方。病更加剧，心烦欲死。
其堂弟世英，与余为友。见状大惊，急来延余。余午餐小饮，尚未释杯，即携余手强之而去。相去不远，始听世英之述症。先后登楼，继察石舟之现状。余即笑而慰之曰：“此柴胡汤证也。乃病在少阳，解之易耳，其毋惊惧。”病者曰：“能不死乎。”余笑曰：“此证而死，则病而死者多矣。乃时医者流，不肯读《伤寒论》一书耳。”因书小柴胡汤一方，并无加减。令其服药时，先以生姜一二片，置口中嚼之使烂，庶姜汁遍及齿舌，使生辣麻之感。然后高举两手，后坐一人以扶持之，端坐而挺直。另请一人操匙以饮之，则可以不呕。定心静气约一刻钟，再缓卧于沙发上，勿令睡平。至半小时后，再睡平，任其安平睡去也。病家如余言，照法服之，果然--剂而痊。
小柴胡汤方
春柴胡二钱五分 生黄芩三钱 西党参三钱 姜制半夏三钱 炙甘草二钱 生姜三片 大枣十枚
*余氏卒于1963年，其时处方尚用旧制。可以一钱约等于3克换算。全书同。
妇人年近六旬，体质素丰，重感风邪。寒热甫退，即又伤饮食。因之胸院及腹，均形胀满，两胁亦膨，按之硬而作痛，渐至不能平卧，挺胸伸颈，张口呼吸，此结胸实证也。与以大陷胸汤加枳实方，大挫其势，再以瓜萎葶苈汤，肃清余孽。
有劳工韩小顺者，其姨母许氏，年近六旬，住于克王渡路康定路口之某里。初为重感风邪，经医治后，寒热已退，而里邪尚未清肃，即急于饮食，且过常量。因之胸烷结痛，连及腹部，上则气逆满闷，下则大便不通，小便亦少。复延附近之医生，治之无效，韩乃延余往诊。余既入病者之室，见其倚卧于床栏上，背后垫以卷好之棉被，被上加以重叠之棉枕。病者挺其胸腹，倚于其上，心已知其不能平卧也。询其过去之病情，知为病中多食所致。按其胸腹，则处处作硬而痛，两胁亦然，膈间尤甚。舌苔则湿腻带黄。更觉心烦不安。诊其两脉，则沉而且紧。周身并无热候，手足反觉微凉。询其大便，已数日不解。乃断为结胸重证。但年事已高，不无顾虑，复思脉证均实，不得有所顾虑。即为之处方，以大陷胸汤加积实主之，嘱其如法煎服。
迫服药之后，果得大泻数次。每泻一次，则胸胁脘腹之满痛，即轻减一次。至第三次泻下之后，病者已渐能平卧，即自转转侧，亦觉痛可自忍。及二煎服后，又续下两次，似已病去七分矣。次日复诊。见其效如此之速，余固心喜，而病家亦言谢不置。诊其脉沉亦起，不似以前之实而有力。察其舌苔，则舌尖已退，根上腻黄渐化，而中心亦宣而浮起。诚恐余邪未尽，再有反复，又顾及高年之体质，陷胸方不容再剂。
乃仿傅青主方，以瓜萎为主，合小陷胸汤及葶苈泻肺法。继服两剂，而告痊愈。接服调理脾胃之剂，于是健康恢复矣。
大陷胸汤加积实方
锦纹大黄五钱（酒洗） 元明粉五钱（分冲） 制甘遂二钱五分（为末） 炒积实五钱
上四味，先煎大黄积实。汤成，纳元明粉之半量，再温烊化，纳甘遂末半量。调匀服之。六小时后，服二煎，如前法。
瓜萎葶苈汤方
全瓜萎六钱 葶苈子三钱 制半夏四钱 炒积壳四钱 元明粉四钱（分冲）
上五味，先煎四味。汤成，纳元明粉半量，再温烊化。
服二煎，如前法。
卫气素虚，皮毛不固，动则自汗，忽感风邪，始则恶风恶寒，继则寒热并作，头项强痛，接再酸楚，间以恶心，而自汗颇多。迟延两日，渐至手足微撅，四肢亦微有拘急。技以桂枝加附子汤，一剂而痊。
患者顾芝轩，年42岁，为劳动人民，庸工于菜市路一小茶楼中。其人卫气素虚，动则有汗。皮毛既不固，且与炉灶相亲，热汤相近，其平日自汗之情况，已可想而知。此种体质，即《伤寒论》所谓“病常自汗出者，此营气和，卫不谐，卫气不共营气和谐”之体质。而其所任职业，亦足促使其自汗多也。于1950年3月间，以劳汗当风，忽患伤风之证。始则膏音恶寒，渐渐恶风，但寒不热，约半日许，始渐蠢蠢发热。此乃体质较弱，故发热较迟，不似体质强壮者，其发热与恶寒同时并见也。他如头项强痛，腰特酸楚，间以恶心，而自汗淋漓，较平时为尤甚。
初病之时，以经济关系，未延医调治。至第三日，以病势有增无减，且增四肢拘急，屈伸不和，手足发凉，十指尤冷，此时始就余诊。入诊室之时，余见其面带垢晦，袖手缩足，人扶而进。坐定之时，又见头面颈项均自汗颇多，领围带湿，气息微喘。及诊其脉，则觉手已微凉，手指尤甚。手如此，足亦可知。细询其发病时日，知才三日耳。其表证指历，必由自汗而来。其他症状，已如前述。综其全盘症状，太阳表证及卫虚末厥，必须一鼓而克之，否则顾此失彼，难保元肢厥脉沉之危险也。乃处以桂枝加附子汤，俟汗止热退后，再行调理。
诸生间曰：“此证面带垢晦之色，颇似温病，而今用桂枝，何也?”余曰：“仲景之书，以证候诊断为主。而治疗之法，又以有某证用某药，无某证减某药。今恶寒与发热均在，且与头痛项强、腰臀酸楚并见。全为风邪表证，焉得不用桂枝。不似温病之面垢，但发热而不恶寒也，其认证在此。”诸生又曰：“桂枝附子汤方，原为不应大汗，而大发其汗，遂至漏汗不止之证而用之。今病者三日未治，根本并未发汗，何亦用此，余曰：“汝等读书如此，难以与言医矣。大发汗之漏，与此自汗之漏，其汗不止，有何异乎?发汗与自汗虽有异，而漏汗不止则同也。既漏汗不止矣，安得不急用附子耶。且已手足微厥，四肢微拘，附子之用，更不可缓矣。”及至次日复诊，果已一药而痊。诸生更大喜而服。为处以调理之剂，令服两帖，以扶正气。
桂枝加附子汤方
川桂枝三钱 京芍药四钱 炙甘草二钱五分 熟附片五钱 生姜一钱五分 大枣十枚
时当夏令，妇人恶寒高热。头痛项强，体疼骨疼，周身无汗、脉浮而紧。微有恶心及气急，此真六月伤寒也。询其致病之源，系在电影场中，为冷气所逼。以麻黄汤加葛根、霍香主之。
Yu Wu Yan
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Biography of the Physician
Yu Wu Yan (1900–1963), originally named Yu Yu, courtesy name Zhe Ming (also written as "Zemin"), pseudonym Buping. Han ethnicity, from Funing County, Jiangsu Province, born in Yilin Town of that county. His grandfather, Yu Zisan, was proficient in medicine and well-versed in Confucian classics. During the Xianfeng and Tongzhi reigns, epidemics broke out multiple times in northern Jiangsu; many were cured under the treatment of Grandfather Yu Zisan. His father, Yu Fengxian, learned medicine from Yu Zisan and practiced in Yilin Town for over ten years. In his youth, he joined the military and traveled north and south of the Yangtze River. He served for years in the staff office of General Dong Baoquan of the Xiang Army, assisting in military affairs and gaining considerable reputation. After the age of forty, he returned to his hometown to practice medicine. Many sought his treatment, and he enjoyed high prestige in the surrounding areas. His posthumous work, *Compilation of Medical Formulas and Experience*, focuses mainly on internal medicine case records, with numerous discussions on the treatment of epidemics, including plague, epidemic malaria, epidemic rash, cold epidemic cholera, epidemic spots, epidemic jaundice, epidemic dysentery, toad epidemic, goose-mouth epidemic, wool epidemic, sting epidemic, grape epidemic, melon-rind epidemic, blister epidemic, pimple epidemic, rat plague, dry epidemic, etc. Each disease is accompanied by concise theoretical exposition and case records, earning him the title of a "master of treating epidemics" in modern times.
Due to Father Yu Fengxian’s abundant learning and clinical experience, patients also came from neighboring counties and other provinces. At the end of the 19th century, Yu Fengxian, along with Zhao Haixian of Xinghua and Zhang Ziping of Huai'an, was known as one of the "Three Great Physicians of Northern Jiangsu in the Late Qing Dynasty."
Mr. Wu Yan laid a foundation in childhood with classics of Confucianism, Neo-Confucianism, and history (he graduated from Huai'an Higher Primary School via transfer between 1909 and 1911). In his youth, he studied medicine with his father, Yu Fengxian. Possessing high aptitude and tireless diligence, he established his academic foundation through classic medical texts such as *Neijing* (Inner Canon), *Nanjing* (Classic of Difficult Issues), *Shennong Bencao Jing* (Divine Farmer's Materia Medica), *Shanghan Lun* (Treatise on Cold Damage), and *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet). He systematically studied masterpieces of internal, surgical, gynecological, and pediatric specialties, greatly advancing his skills. By age eighteen, he began practicing in his hometown. Recognizing that Western medicine was spreading eastward and becoming mainstream in coastal cities, and influenced by the contemporary idea of "integrating Chinese and Western medicine," he went south to Shanghai in 1920 to study Western medicine. He studied internal medicine under Dr. Yu Fengbin and surgery under the German physician Weidu Fu'er. During this period, he became deeply interested in the integration of Chinese and Western medicine. In 1923, he returned home to continue practicing and founded Yilin Primary School in Yilin Town, serving as its principal. From 1927 to the winter of 1929, he served as a military surgeon in the Second Division of Gu Zhutong’s army under the former National Government, campaigning across Anhui, Henan, Hubei, and Jiangxi provinces, primarily treating traumatic conditions. In the winter of 1929, he resigned from his military post and settled in Shanghai to practice medicine.
In 1930, at the invitation of Mr. Bao Shisheng, Dean of the China Medical College in Shanghai, he served as a professor of surgery. Subsequently, he co-founded *World Medical Journal* with Mr. Zhang Zanchen.
In 1931, he formed a joint clinic with Mr. Zhang Zanchen. In 1932, he was appointed Honorary Director of the Central National Medical Bureau by its director, Jiao Yitang. In 1934, the Bureau further appointed him as a member of the Editorial Review Committee, responsible for drafting the "Standardized Nomenclature for Surgical Diseases" for adoption by the national TCM community, which received praise. That year, he also wrote and published *General Theory of Practical Integrated Surgery* and *Specific Theory of Practical Integrated Surgery*. Committed to improving TCM, he published numerous academic papers, exerting a broad influence at the time. He also wrote articles refuting the measures and proposals of the former National Government and Yu Yunxiu to "abolish traditional Chinese medicine," engaging in direct confrontation.
In 1936, at the request of Mr. Zhang Taiyan, he served as the Director of Surgery at the Suzhou School of Traditional Chinese Medicine. He was also invited to teach at the China Medical College and New China Medical College in Shanghai, lecturing on courses such as *Shanghan Lun*, *Jingui Yaolue*, and *TCM Surgery*.
In 1937, he co-founded the "Shanghai Professional School of Traditional Chinese Medicine" with Mr. Zhang Zanchen. He invited Mr. Xie Guan as Honorary Principal, Mr. Chen Wujiu as Principal, and Mr. Ding Fubao and Mr. Zhang Boxi as Vice Principals in succession. Mr. Wu Yan served as Director of Academic Affairs, and Mr. Zhang Zanchen as Director of General Affairs. The program was three years long, with three cohorts held. Besides managing school affairs, he taught *Shanghan Lun* and *Jingui Yaolue*. Throughout the five-year operation, he never missed a class; even in heavy rain when his clothes were soaked, he walked confidently onto the stage to lecture, earning the love and respect of students. In 1938, he was invited to lecture at the Chinese Medicine Specialized Study Hall of the China Vocational School. In 1939, his book *New Interpretations of Shanghan Lun* was published by Zhonghua Book Company. In 1942, due to his refusal to register with the Japanese puppet government, the school was closed. Between 1943 and 1946, he compiled and published *Chapter on Damp-Warmth Typhoid* and *Chapter on Epidemic Typhus*. "Damp-warmth typhoid" refers to intestinal typhoid in Western medicine, and "epidemic typhus" is a Western medical term; these two works are considered early integrative compilations of warm disease theory and Western medicine. In 1947, he founded the Shanghai Datong Sanatorium, serving as Director and inviting Mr. Ding Fubao as Honorary Director. It operated for less than two years before closing due to insufficient funds.
Having practiced in Shanghai for a long time, he treated many difficult, critical cases of cold damage and warm diseases. Adhering to classical formulas, he frequently used Shi Gao (Gypsum Fibrosum) and Da Huang (Rhei Radix et Rhizoma) for cold damage and warm diseases. Based on precise syndrome differentiation, he used large doses with remarkable efficacy, leading many citizens to call him "Mr. Gypsum and Rhubarb" (see Yu’s case records for treated cases). Thus, during the Republic of China era, he was a famous domestic physician of the "Classical Formula School," rich in both academic knowledge and clinical experience.
While practicing in Shanghai, he benefited greatly from senior figures like Xie Guan, Chen Wujiu, and Ding Fubao. Academically and clinically, he highly revered the "Two Zhangs of North and South" ("Southern Zhang" referring to Zhang Shanlei of Jiading, "Northern Zhang" referring to Zhang Xichun of Tianjin). His lifelong medical philosophy was "Scientization of TCM, Sinicization of Western Medicine." Striving for the integration of both systems, some classify him as a physician of the "Integration School."
After the founding of the People's Republic, he supported the Party and government's policies on TCM. In 1952, he compiled and published *Vernacular Translation of Jingui Yaolue*, fulfilling his long-held wish to systematically organize and research Zhang Zhongjing’s works. He was regarded as one of the "Three Major Scholars of Zhang Zhongjing Studies in Shanghai" (the other two being Cao Yingfu and Lu Yuanlei). In 1954, he attended the East China and Shanghai TCM Representative Conference, where he spoke impromptu and submitted four proposals to the secretariat regarding the development of TCM work.
In the spring of 1956, at the invitation of the Academy of Traditional Chinese Medicine under the Ministry of Health, he moved from Shanghai to Beijing to head the Editorial Review Office (later renamed the Literature Research Office) of the Academy. He also taught part of the curriculum for the First National Western Medicine Learning TCM Training Class hosted by the Ministry of Health (including *Jingui Yaolue*) and participated in reviewing nine TCM textbooks. In 1957, Mr. Wu Yan compiled and printed a combined edition of his father Yu Fengxian’s posthumous work *Compilation of Medical Formulas and Experience* (published by Zhonghua Book Company before liberation) and his own case record book *Records of Wing Jing Experience* (not publicly distributed), distributing them to relevant personnel. In 1958, he was transferred to Beijing University of Chinese Medicine to teach and participated in the compilation design of the "Ten Classic Medical Works" of the university. Additionally, he undertook healthcare and consultation duties for some central leaders.
On September 7, 1963, he passed away in Beijing due to hypertension and cerebral hemorrhage.
Note on the Biography: As early as 1942, the renowned Shanghai physician Mr. Jiang Chunhua wrote a short biography for my father, Mr. Wu Yan, providing concise and pertinent descriptions of his experiences and academic/clinical characteristics before middle age. Now, based on my father’s entire life, I have supplemented and finalized this text.
(Copy of page 1 of *Biography of Mr. Yu Wu Yan* written by Mr. Jiang Chunhua in 1942, see front matter)
Special Disease Discussions
Wind-Cold Transforming into Shaoyang Syndrome
Early autumn wind-cold invasion presents with aversion to cold, fever, headache, and limb soreness. This subsequently transforms into alternating chills and fever, fullness and pain in the hypochondrium, frequent vomiting, bitter taste in the mouth, dry throat, mental confusion, irritability, restlessness, dry mouth with desire to drink, and worsening vomiting upon drinking. The physician treated with Jingjie (Schizonepetae Herba), Fangfeng (Saposhnikoviae Radix), Douchi (Sojae Semen Praeparatum), and Doujuan (Phaseoli Volubilis Caulis et Folium), but symptoms worsened. Inquiry revealed normal bowel movements previously and yesterday. Urgently administered Xiaochaihu Tang (Minor Bupleurum Decoction), cured after one dose.
Patient Zhang Shizhou, residing at Chongshan Li Entrance, Tibet South Road. Busy with labor union affairs, he ran under the scorching sun during the day and cooled off on the terrace at night. Consequently, he developed aversion to cold, fever, headache, and limb soreness. He drank ginger and brown sugar soup himself; the next day, headache and limb soreness resolved. However, pain shifted to the hypochondrium, with alternating chills and fever. When cold, he shivered despite being covered; when hot, he felt burning naked. Irritable, nauseated, extremely bitter taste, thirsty for drinks, vomiting worsened upon drinking. Restless, unable to sit or lie comfortably. Sought treatment: Doctor A prescribed Jingjie and Fangfeng; Doctor B prescribed Douchi and Doujuan; Doctor C prescribed Huoxiang Zhengqi formula. Condition worsened, extreme irritability bordering on despair.
His cousin Shiying, a friend of mine, was shocked seeing this and urgently summoned me. I had just finished lunch and put down my cup when he grabbed my hand and insisted I go. Not far away, I listened to Shiying describe the symptoms. Ascending the stairs, I examined Shizhou’s condition. I smiled and reassured him: "This is a Chaihu Tang syndrome. The pathogen is in Shaoyang; resolving it is easy, do not fear." The patient asked, "Can I avoid death?" I laughed, "If this syndrome leads to death, many would die of illness. It is merely that contemporary physicians refuse to read *Shanghan Lun*." I prescribed Xiaochaihu Tang without modifications. Instructed him to chew one or two slices of fresh ginger until soft before taking the medicine, so ginger juice coats the teeth and tongue, creating a spicy-numbing sensation. Then raise both hands high, have someone support him from behind, sit upright. Ask another person to feed him with a spoon to prevent vomiting. Calm mind and breath for about fifteen minutes, then lie slowly on the sofa, not flat. After half an hour, lie flat and sleep peacefully. The family followed instructions, and indeed, cured after one dose.
Xiaochaihu Tang Formula
Chaihu (Bupleuri Radix) 2.5 qian
Huangqin (Scutellariae Radix) 3 qian
Dangshen (Codonopsis Radix) 3 qian
Banxia (Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine) 3 qian
Gancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle) 2 qian
Shengjiang (Zingiberis Rhizoma Recens) 3 slices
Dazao (Jujubae Fructus) 10 pieces
*Mr. Yu died in 1963; prescriptions used old measurements. One qian approximates 3 grams. Applies throughout the book.
Wind-Cold Transforming into Jie Xiong (Chest Binding) Syndrome
A woman near sixty, constitutionally robust, suffered severe wind-cold invasion. As chills and fever subsided, she indulged in food. Consequently, chest and abdomen became distended and full, hypochondria swollen, hard and painful on pressure, gradually unable to lie flat, protruding chest, extending neck, breathing through mouth. This is excess-type Jie Xiong. Prescribed Daxiexiong Tang (Major Chest-Binding Decoction) with Zhishi (Aurantii Fructus Immaturus) to significantly reduce the pathogenic force, followed by Gualou Tingli Tang (Trichosanthis Fruit and Lepidii Seed Decoction) to clear residual pathogens.
Laborer Han Xiaoshun’s aunt, Ms. Xu, near sixty, lived in an alley near Kangding Road intersection of Kingwangdu Road. Initially severely invaded by wind-cold, after treatment chills and fever subsided, but interior pathogens remained uncleared. She eagerly ate, exceeding normal amounts. Consequently, chest binding pain extended to abdomen, upper Qi rebellion causing fullness/stuffiness, lower constipation, scanty urination. Nearby doctors failed to treat effectively, so Han summoned me. Entering the room, I saw her leaning against bed rails, back cushioned with rolled cotton quilt and stacked pillows. She protruded chest and abdomen, leaning on them, knowing she could not lie flat. Inquiry revealed excessive eating during illness. Palpation showed hardness and pain everywhere in chest/abdomen, especially hypochondria and diaphragm. Tongue coating damp, greasy, yellow. Feeling irritable and uneasy. Pulse deep and tight. No systemic heat, hands and feet slightly cool. Bowel movement absent for several days. Diagnosed as severe Jie Xiong. Age was a concern, but pulse and signs indicated excess, requiring no hesitation. Prescribed Daxiexiong Tang plus Zhishi, instructed proper decoction and administration.
After medication, significant diarrhea occurred several times. Each episode relieved chest/hypochondrium/abdominal fullness/pain. After third evacuation, she could gradually lie flat, turning side-to-side tolerable pain. After second decoction, two more evacuations, approximately 70% recovery. Next day follow-up: rapid effect pleased me; family thanked repeatedly. Pulse deep but rising, less solid/forceful than before. Tongue tip coating receded, root greasy-yellow melting, center lifting. Fearing residual pathogens and recurrence, considering elderly constitution, Xiexiong formula could not be repeated.
Imitating Fu Qingzhu’s method, used Gualou (Trichosanthis Fructus) as main ingredient, combining Xiaoxiexiong Tang (Minor Chest-Binding Decoction) and Tingli fei xie method (Lepidii Seed Lung-Draining Method). Continued for two doses, achieving cure. Followed by spleen-stomach regulating agents, health restored.
Daxiexiong Tang Plus Zhishi Formula
Dahuang (Rhei Radix et Rhizoma) 5 qian (wine washed)
Yuanmingfen (Natrii Sulfas) 5 qian (dissolved separately)
Gansui (Kansui Radix) 2.5 qian (powdered)
Zhishi (Aurantii Fructus Immaturus) 5 qian (stir-fried)
First decoct Dahuang and Zhishi. When liquid is ready, add half amount of Yuanmingfen, warm until dissolved, add half amount of Gansui powder. Mix and take. Six hours later, take second decoction, same method.
Gualou Tingli Tang Formula
Gualou (Trichosanthis Fructus) 6 qian
Tinglizi (Lepidii Semens) 3 qian
Banxia (Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine) 4 qian
Zhike (Aurantii Fructus) 4 qian (stir-fried)
Yuanmingfen (Natrii Sulfas) 4 qian (dissolved separately)
Decoct first four ingredients. When liquid is ready, add half amount of Yuanmingfen, warm until dissolved.
Take second decoction, same method.
Wind-Cold with Excessive Sweating and Yang Deficiency Syndrome
Wei Qi (Defensive Qi) inherently deficient, skin/pores unconsolidated, spontaneous sweating upon movement. Suddenly invaded by wind-cold, initially aversion to wind/cold, then simultaneous chills/fever, stiff neck/head, waist/back soreness, occasional nausea, profuse spontaneous sweating. Delayed two days, hands/feet slightly cold, limbs slightly spasmodic/tight. Prescribed Guizhi Jia Fuzi Tang (Cinnamon Twig Decoction Plus Aconite Root), cured after one dose.
Patient Gu Zhixuan, 42 years old, laborer working in a small teahouse on Caishi Road. His Wei Qi inherently deficient, sweats upon movement. Pores unconsolidated, close proximity to stove/hot water, daily spontaneous sweating situation understandable. This constitution matches *Shanghan Lun* description: "Patients who often sweat spontaneously possess harmonious Ying Qi (Nutritive Qi) but disharmonious Wei Qi; Wei Qi does not harmonize with Ying Qi." His occupation also promotes sweating. In March 1950, exposed to wind while sweating from labor, suddenly contracted wind-cold. Initially severe aversion to cold, gradually aversion to wind, only cold no fever, for about half a day, then gradual low-grade fever. Weak constitution caused delayed fever, unlike strong constitutions where fever and aversion to cold appear simultaneously. Other symptoms: stiff neck/head, waist/back soreness, occasional nausea, profuse sweating worse than usual.
Initially, due to financial reasons, did not seek medical help. By third day, condition worsened, adding limb spasms, difficulty bending/stretching, cold hands/feet, especially fingers. Finally consulted me. Entering consulting room, saw dirty/dull complexion, hands tucked, feet curled, assisted walking. Sitting down, saw profuse sweating on head/face/neck, collar wet, slight panting. Pulse felt slightly cool, fingers colder. Feet similarly cold. Detailed inquiry revealed only three days since onset. Exterior signs must stem from spontaneous sweating. Other symptoms as described. Comprehensive analysis: Taiyang exterior syndrome plus Wei deficiency leading to mild extremity coldness must be resolved decisively, otherwise risking extremity coldness and deep pulse danger. Prescribed Guizhi Jia Fuzi Tang, to regulate afterwards once sweating stops and fever subsides.
Students asked: "This facial dullness resembles Warm Disease, why use Guizhi?" I replied: "Zhongjing’s books focus on syndrome diagnosis. Treatment uses specific herbs for specific syndromes. Here, aversion to cold and fever coexist with headache/stiff neck/waist soreness. All are wind-cold exterior signs, how can we not use Guizhi? Unlike Warm Disease facial dullness with only fever and no aversion to cold, recognition lies here." Students said: "Guizhi Fuzi Tang formula is originally for cases where excessive sweating was induced improperly, leading to continuous leaking sweat. This patient hasn't been treated for three days, never induced sweating, why use this?" I said: "Reading like this makes discussing medicine difficult. Leaking sweat from induced sweating vs. spontaneous leaking sweat, is there difference in continuous leakage? Induced vs. spontaneous sweating differs, but continuous leakage is same. Since leakage continues, how can we not urgently use Fuzi? Moreover, mild extremity coldness and limb spasms make Fuzi use even more urgent." Next day follow-up, indeed cured after one dose. Students greatly pleased and accepted. Prescribed regulating agent, two doses to support healthy Qi.
Guizhi Jia Fuzi Tang Formula
Guizhi (Cinnamomi Ramulus) 3 qian
Shaoyao (Paeoniae Radix Alba) 4 qian
Gancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle) 2.5 qian
Fuzi (Aconiti Lateralis Radix Praeparata) 5 qian
Shengjiang (Zingiberis Rhizoma Recens) 1.5 qian
Dazao (Jujubae Fructus) 10 pieces
Summer Cold Damage Syndrome (Part 1)
During summer, woman presents with aversion to cold, high fever. Headache, stiff neck, body/bone ache, no sweating on body, floating and tight pulse. Mild nausea and shortness of breath. This is true June Cold Damage. Inquiry revealed cause: exposure to cold air in movie theater. Prescribed Mahuang Tang (Ephedra Decoction) plus Gegen (Puerariae Radix) and Huoxiang (Agastaches Herba).