寻衣撮空,许叔微谓之肝热。夫肝主筋,筋脉血枯,而风引之,故手指为之撮敛也,宜确服
六味地黄丸,间有回生之功。钱仲阳用泻青丸,此治肝经实热,盖寻衣撮空,皆病后之败症
耳
神,脉弦浮而虚,血脱内躁热之极也,气粗鼻干,此为难治,用生地黄连汤主之。
治验
王少参孙女年十二岁,脾胃素弱,后成疳症,发热,小腹膨胀坚直,大便溏泻,气喘咳嗽,
彻夜烦躁不睡,鼻塞眼暗谵语,其脉大而无根,用人参一两、附子三分,腹胀渐减,脉渐敛
。然犹寻衣撮空,鼻孔出血,用六味地黄丸料二服,如脱乃昼服独参姜附汤,及服六味地黄
丸料,脉渐有根,诸症渐愈,又用六君子、补中益气汤而痊。(详见发热)
一小儿停食,夜惊腹痛,服消食丸,泻数次,寻衣撮空,面青黄或色白,此脾土受伤,肺金
休囚,肝火旺而然耳,先用异功散加升麻以补脾土;用六味地黄丸料以滋肝血,稍定,各二
剂渐愈,却用补中益气汤、六味地黄丸,间以异功散而痊。
一小儿受惊骇,恪服镇惊化痰等药,忽患前症,眼上面痿黄,或兼青赤,此肝经阴血虚,阴
气旺而生风耳,当滋肝肾益脾肺,遂用异功散而痊。
一小儿面痿黄患瘰 ,忽发面色青赤,此脾气虚,木火相搏而为患也,用补中益气汤,佐以
柴胡山栀散二剂,加味逍遥散三服,诸症渐退,又以地黄丸而遂痊。
一小儿流注,出脓甚多,患前症,此元气虚弱,内热而变耳。用八珍汤、异功散各数剂,方
稍缓,又数剂而安,又补中益气汤而愈。
一小儿膝痈,误触其膝,出血甚多,患前症,恶寒面白,此阳随阴散而虚寒,用十全大补汤
加附子三分,四剂未应,用人参一两,附子五分,姜枣煎服稍退,又二剂顿退。乃朝用异功
散,夕用八珍汤而安。
一小儿伤风表汗后,患前症,恶风面白,手足冷,用补中益气汤加五味子,汗顿止而诸症渐
退;又用四剂而安,乃十全大补汤而愈。
生地黄连汤 治血脱,寻衣撮空,摇头妄语。
川芎 生地黄 当归(各七钱) 赤芍药 栀子 黄芩 黄连(各三钱) 防风(一钱五分)
上每服三钱,水煎服。
加味逍遥散
异功散
六君子汤(三方见内钓)
地黄丸(方见肾脏)
补中益气汤(方见虚羸)
柴胡栀子散(方见发热)
泻青丸(方见肝脏)
八珍汤
十全大补汤(二方见自汗)
寻衣撮空,许叔微认为这是肝热所致。肝脏主管筋脉,若筋脉中的血液枯竭,风邪引动内风,就会导致手指出现撮弄收敛的动作,适宜确服用六味地黄丸,偶尔有起死回生的功效。钱仲阳使用泻青丸,这是治疗肝经实热的方法;然而寻衣撮空,都是疾病后期出现的败坏症状。
如果神志昏乱,脉象弦浮而虚弱,这是血脱导致内部躁热至极的表现;如果呼吸粗重、鼻干,这属于难治之症,宜用生地黄连汤为主进行治疗。
治疗案例:
王少参的孙女十二岁,脾胃向来虚弱,后来发展成疳症,伴有发热,小腹部膨胀且坚硬挺直,大便溏泻,气喘咳嗽,整夜烦躁无法入睡,鼻塞、视力模糊、胡言乱语,其脉象大而无根。医生用人参一两、附子三分,服药后腹胀逐渐减轻,脉象逐渐收敛。但是仍然出现寻衣撮空、鼻孔出血的症状,于是服用两剂六味地黄丸的药料,病情如脱体般危重时,白天服用独参姜附汤,同时服用六味地黄丸药料,脉象逐渐有了根基,各种症状逐渐痊愈,后来又用六君子汤、补中益气汤而完全康复。(详见发热章节)
另一个小儿因停食(饮食积滞),夜间惊悸腹痛,服用消食丸后腹泻数次,随后出现寻衣撮空,面色青黄或苍白,这是脾土受伤,肺金休囚(功能减弱),肝火旺盛所致。先用异功散加升麻以补益脾土;用六味地黄丸药料以滋养肝血,稍见安定,各服两剂后逐渐好转,接着用补中益气汤、六味地黄丸,间杂服用异功散而康复。
另一个小儿受惊吓,严格服用了镇惊化痰等药物,忽然患上前述病症,眼上面部萎黄,或者兼带青红色,这是肝经阴血虚,阴气旺盛而生风所致,应当滋肝肾、益脾肺,于是用异功散而康复。
另一个小儿面部萎黄患有瘰疬,忽然发作时面色青赤,这是脾气虚,木火相搏而产生的病变,用补中益气汤,佐以柴胡山栀散两剂,加味逍遥散三服,各种症状逐渐消退,又以地黄丸而最终康复。
另一个小儿患流注(一种漫肿无头、皮色不变的化脓性疾病),出脓很多,患上前述病症,这是元气虚弱,内热变化所致。用八珍汤、异功散各数剂,方子才稍微缓和,又服数剂而安宁,再用补中益气汤而痊愈。
另一个小儿患膝痈,误触膝盖,出血很多,患上前述病症,恶寒面白,这是阳气随着阴血消散而导致的虚寒,用十全大补汤加附子三分,四剂未见效,改用人参一两,附子五分,加生姜大枣煎服,症状稍退,又服两剂后迅速消退。于是早晨服用异功散,晚上服用八珍汤而安宁。
另一个小儿伤风发汗后,患上前述病症,恶风面白,手足冰冷,用补中益气汤加五味子,汗立刻停止而各种症状逐渐消退;又服四剂而安宁,最后用十全大补汤而痊愈。
生地黄连汤:治疗血脱,寻衣撮空,摇头胡言乱语。
川芎、生地黄、当归(各七钱)、赤芍药、栀子、黄芩、黄连(各三钱)、防风(一钱五分)。
以上药材每次服用三钱,水煎服。
加味逍遥散
异功散
六君子汤(三方见内钓章节)
地黄丸(方见肾脏章节)
补中益气汤(方见虚羸章节)
柴胡栀子散(方见发热章节)
泻青丸(方见肝脏章节)
八珍汤
十全大补汤(二方见自汗章节)
"Seeking clothes and picking at empty air" (Xun Yi Cuo Kong), Xu Shuwei attributed it to Liver Heat. The Liver governs the sinews; when the blood in the sinews is depleted, wind pathogens draw upon internal wind, causing the fingers to clench and gather. It is appropriate to strictly administer Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill), which occasionally has the power to revive the dying. Qian Zhongyang used Xieqing Wan (Drain Green Pill) to treat excess heat in the Liver channel. However, "seeking clothes and picking at empty air" are generally signs of collapse after severe illness.
If there is mental confusion, with a string-like, floating, and deficient pulse, this indicates extreme internal restlessness due to blood depletion. If breathing is coarse and the nose is dry, this is difficult to treat; Shengdi Huanglian Tang (Rehmannia and Coptis Decoction) should be used as the primary treatment.
Case Record:
The granddaughter of Vice Minister Wang, aged twelve, had always had weak Spleen and Stomach, later developing into Infantile Malnutrition (Gan Syndrome). She presented with fever, distension and hardness of the lower abdomen, loose stools, wheezing and coughing, restlessness throughout the night preventing sleep, nasal congestion, blurred vision, and delirious speech. Her pulse was large but rootless. The physician administered Ren Shen (Ginseng Root) 1 liang and Fu Zi (Aconite Lateral Root) 3 fen. After administration, abdominal distension gradually decreased, and the pulse gradually became restrained. However, she still exhibited "seeking clothes and picking at empty air" and epistaxis. Two doses of the ingredients for Liuwei Dihuang Wan were given. When her condition appeared critical ("like falling off"), she took Dushen Jiangfu Tang (Single Ginseng Ginger-Aconite Decoction) during the day, along with the ingredients for Liuwei Dihuang Wan. Her pulse gradually gained a root, and various symptoms improved. Subsequently, Liujunzi Tang (Six-Gentlemen Decoction) and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) were used until she fully recovered. (See also Fever).
Another child suffered from food stagnation, experiencing night terrors and abdominal pain. After taking Xiaoshi Wan (Digestive Pills), he had several episodes of diarrhea, followed by "seeking clothes and picking at empty air," with a complexion that was greenish-yellow or pale. This indicated injury to Spleen Earth, weakening of Lung Metal, and flourishing Liver Fire. Initially, Yigong San (Yi-Gong Powder) plus Shengma (Cimicifugae Rhizoma) was used to tonify Spleen Earth; the ingredients for Liuwei Dihuang Wan were used to nourish Liver Blood. After slight stabilization, two doses of each led to gradual improvement. Later, Buzhong Yiqi Tang and Liuwei Dihuang Wan were used, interspersed with Yigong San, until recovery.
Another child, frightened, had strictly taken drugs for calming fright and resolving phlegm, then suddenly developed the aforementioned symptoms. His face above the eyes was sallow, sometimes mixed with greenish-red. This indicated deficiency of Yin-blood in the Liver channel, with excessive Yin-Qi generating wind. Treatment should nourish Liver and Kidney, benefit Spleen and Lung. He recovered using Yigong San.
Another child had a sallow face and suffered from Scrofula (Luo Li). Suddenly, his face turned greenish-red. This indicated Spleen Qi deficiency, with Wood and Fire battling each other. He was treated with Buzhong Yiqi Tang, assisted by Chaihu Shanzhi San (Bupleurum and Gardenia Powder) for two doses, and Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) for three doses. Symptoms gradually receded, and he finally recovered using Dihuang Wan (Rehmannia Pill).
Another child suffered from Liuzhu (Flowing Abscesses), losing much pus, and developed the aforementioned symptoms. This indicated deficiency of Yuan-Qi (Original Qi) and transformation due to internal heat. Bazhen Tang (Eight-Treasure Decoction) and Yigong San were administered for several doses each, leading to slight relief. After more doses, he stabilized, and finally recovered with Buzhong Yiqi Tang.
Another child had a Carbuncle on the knee. Accidental contact caused significant bleeding, leading to the aforementioned symptoms, aversion to cold, and a pale face. This indicated Yang dissipating with Yin, resulting in deficiency-cold. Shiquan Dabu Tang (Ten-Tonifying Decoction) plus 3 fen of Fu Zi was used for four doses without effect. Then, Ren Shen 1 liang and Fu Zi 5 fen, decocted with Ginger and Jujube, were used. Symptoms subsided slightly, and after two more doses, they rapidly disappeared. Thereafter, Yigong San was taken in the morning and Bazhen Tang in the evening until stability.
Another child, after sweating for Wind-Cold exterior syndrome, developed the aforementioned symptoms: aversion to wind, pale face, and cold hands and feet. Buzhong Yiqi Tang plus Wuweizi (Schisandrae Fructus) was used. Sweating stopped immediately, and symptoms gradually receded. After four more doses, he stabilized, and finally recovered with Shiquan Dabu Tang.
Shengdi Huanglian Tang: Treats blood depletion, "seeking clothes and picking at empty air," head shaking, and delirious speech.
Chuanxiong Radix Ligustici (Chuanxiong), Shengdi Huang (Rehmanniae Radix Preparata), Dang Gui (Angelicae Sinensis Radix) (each 7 qian); Chi Shaoyao (Paeoniae Radix Rubra), Zhizi (Gardeniae Fructus), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma) (each 3 qian); Fangfeng (Saposhnikoviae Radix) (1.5 qian).
Take 3 qian per dose, decoct in water, and drink.
Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder)
Yigong San (Yi-Gong Powder)
Liujunzi Tang (Six-Gentlemen Decoction) (See Internal Hook chapter)
Dihuang Wan (Rehmannia Pill) (See Kidney chapter)
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) (See Emaciation chapter)
Chaihu Shanzhi San (Bupleurum and Gardenia Powder) (See Fever chapter)
Xieqing Wan (Drain Green Pill) (See Liver chapter)
Bazhen Tang (Eight-Treasure Decoction)
Shiquan Dabu Tang (Ten-Tonifying Decoction) (Two formulas see Spontaneous Sweating chapter)