太康刘仓使,病大便少而频,日七、八十次,常于两股间悬半枚瓠芦,如此十余
年。戴人见之而笑曰∶病既频而少,欲通而不得通也。何不大下之?此通因通用也。此一
服药之力。乃与药,大下三十余行,顿止。
殷辅之父,年六十余,暑月病泄泻,日五、六十行,自建碓镇来请戴人于陈州。
其父喜饮,二家人辈争止之。戴人曰∶夫暑月年老,津液衰少,岂可禁水?但劝之少饮。比及
用药,先令速归,以绿豆、鸡卵十余枚,同煮,卵熟取出,令豆软,下陈粳米作稀粥,搅令
食鸡卵以下之,一、二顿,病减大半。盖粳米、鸡卵,皆能断痢。然后制抑火流湿之药,调顺而方愈。
萧令腹满,面足皆肿,痰黄而喘急,食减。三年之间,医者皆尽而不验。戴人以瓜
蒂散涌之,出寒痰三、五升;以舟车丸、浚川散下之,青黄涎沫缶平;复以桂苓白术散、
五苓散调之,半月复旧矣。
郾城梁贾人,年六十余,忽晓起梳发,觉左手指麻,斯须半臂麻,又一臂麻,斯须
头一半麻;比及梳毕,从胁至足皆麻,大便二、三日不通。往问他医,皆云风也。或药或针
,皆不解。求治于戴人。戴人曰∶左手三部脉皆伏,比右手小三倍,此枯涩痹也。不可纯归之风
,亦有火燥相兼。乃命一涌一泄一汗,其麻立已。后以辛凉之剂调之,润燥之剂濡之,惟小
指次指尚麻。戴人曰∶病根已去,此余烈也。方可针溪谷。溪谷者,骨空也,一日晴和,往
针之,用《灵枢》中鸡足法,向上卧针,三进三引讫,复卓针起,向下卧针送入指间皆然,
手热如火,其麻全去。昔刘河间作《原病式》,常以麻与涩,同归燥门中,真知病机者也。
太康县的刘仓使,患有大便量少且排便频繁的症状,每天多达七八十次,常常在两腿之间悬挂半个葫芦(用于接住漏出的粪便),这种情况持续了十多年。张从正(字戴人)见到后笑着说:“既然排便频繁却量少,说明肠道想要通畅却无法真正通畅。为什么不采用强力泻下的方法呢?这就是‘通因通用’的治疗原则。”只服用了一服药的效果,就给予药物,导致患者剧烈腹泻三十多次,症状立刻停止。
殷辅的父亲,六十多岁,在暑天患泄泻病,每天腹泻五六十次,家人从自建碓镇到陈州请张从正去诊治。他的父亲喜欢喝酒,两个儿子极力劝阻他不要喝。张从正说:“暑天年老之人,津液已经衰少,怎么能禁止饮水呢?只是劝他少量饮用罢了。”等到用药时,先让他迅速回家,用绿豆和十余枚鸡蛋一起煮,蛋煮熟后取出,让豆子煮软,加入陈年粳米煮成稀粥,搅拌后让他吃鸡蛋并喝粥,一两次之后,病情减轻了一半以上。因为粳米和鸡蛋都能止痢。然后配制清热降火、利湿的药物,调理得当后才痊愈。
萧县令腹部胀满,面部和双脚都浮肿,痰多色黄且呼吸急促,食欲减退。三年间,医生们都用尽了各种方法但都没有见效。张从正用瓜蒂散进行催吐,吐出寒痰三到五升;接着用舟车丸和浚川散进行泻下,排出装满罐子的青黄色涎沫;随后再用桂苓白术散和五苓散进行调理,半个月后身体恢复如初。
郾城的梁姓商人,六十多岁,一天早晨起床梳头时,感觉左手指头发麻,一会儿半边手臂发麻,接着另一只手臂也发麻,不一会儿半个头部也发麻;等到梳完头,从胁部到脚全部发麻,大便两三天不通畅。去找其他医生诊治,都说这是中风。无论是吃药还是针灸,都不能解除病痛。于是来求治于张从正。张从正说:“左手三部脉象都伏匿不起,比右手小三倍,这是枯涩痹阻的证候。不能单纯归结为风邪,也有火燥相兼的因素。”于是命令采用涌吐、泻下、发汗三种疗法,麻木感立刻消除。后来用辛凉的药物调理,用润燥的药物滋养,只有小指和无名指还残留一点麻木。张从正说:“病根已经去除,这只是残余的影响。此时可以针刺溪谷穴。”溪谷就是骨空之处。有一天天气晴朗,前去针刺,使用《灵枢》中的“鸡足法”,向上卧针,进针三次引气三次后,将针直立提起,再向下卧针送入指间都是这样操作,手部发热如火,麻木感完全消失。以前刘河间撰写《原病式》,常将麻木与涩滞一同归入燥门中,真是深知病机的人啊。
Liu Cangshi of Taikang suffered from infrequent small-volume bowel movements, defecating seventy to eighty times a day. For over ten years, he often hung half a gourd between his thighs to catch the leakage. Dai Ren (Zhang Congzheng) saw this and laughed, saying, "Since the defecation is frequent but scanty, it indicates an attempt at unblocking that fails to achieve true patency. Why not use strong purgatives? This applies the principle of 'treating obstruction with unblocking methods' (Tong Yin Tong Yong)." With just one dose, he administered a purgative, causing more than thirty episodes of severe diarrhea, after which the symptoms ceased immediately.
The father of Yin Fu, in his sixties, suffered from summerheat-induced diarrhea, defecating fifty to sixty times a day. His family traveled from Zijun Town to Chenzhou to invite Dai Ren for treatment. The patient enjoyed drinking alcohol, and his two sons strongly advised against it. Dai Ren said, "In summer, for an elderly person whose body fluids are depleted, how can water intake be prohibited? One should only advise moderate consumption." When prescribing medication, he first instructed them to return home quickly. He had them boil green beans and more than ten chicken eggs together; once the eggs were cooked, they were removed, leaving the beans soft. Old japonica rice was added to make a thin porridge, which was stirred and consumed along with the eggs. After one or two meals, the illness reduced by more than half. This is because both japonica rice and chicken eggs can alleviate dysentery. Subsequently, formulas to suppress fire and drain dampness were prepared, and after proper regulation, he recovered.
Magistrate Xiao suffered from abdominal distension, edema of the face and feet, yellow phlegm with rapid breathing, and reduced appetite. Over three years, physicians exhausted their methods without success. Dai Ren used Gou Ti San (Melon Stalk Powder) to induce vomiting, expelling three to five sheng of cold phlegm. Then, using Zhou Che Wan (Boat Cart Pill) and Jun Chuan San (River Clearing Powder), he induced purgation, emptying jars full of green and yellow saliva and foam. Finally, he regulated the condition with Gui Ling Bai Zhu San (Cinnamon Twig, Poria, and Atractylodes Macrocephala Powder) and Wu Ling San (Five-Ingredient Powder with Poria), and within half a month, his health was restored.
Merchant Liang from Yancheng, in his sixties, suddenly felt numbness in his left fingers while combing his hair in the morning. Soon, half of his arm became numb, then the other arm, and shortly after, half of his head. By the time he finished combing, numbness extended from his hypochondrium to his feet, accompanied by constipation for two to three days. Other physicians diagnosed it as wind-stroke. Neither herbal medicine nor acupuncture provided relief. Seeking Dai Ren's treatment, Dai Ren observed that the pulses on the left hand were all hidden (Fu pulse) and smaller than those on the right by three times, indicating dryness and涩 (astringency/obstruction). He stated that this could not be attributed solely to wind but also involved fire and dryness. He prescribed emesis, purgation, and diaphoresis simultaneously, and the numbness disappeared immediately. Later, he used acrid-cooling formulas for regulation and moistening-dryness formulas for nourishment. Only the little finger and ring finger remained slightly numb. Dai Ren said, "The root cause has been eliminated; this is merely residual effect. Now acupuncture at the Xi Gu (valleys/cavities) points is appropriate." Xi Gu refers to bone cavities. On a clear day, he performed acupuncture using the "Chicken Foot Method" from the *Ling Shu*. The needle was inserted horizontally upward, advanced three times and withdrawn three times, then lifted vertically, and re-inserted horizontally downward into the fingertips. The hand became hot like fire, and the numbness completely vanished. Liu Hejian, in his work *Yuan Bing Shi* (Original Treatise on Disease Causes), often categorized numbness and astringency under the category of Dryness. He truly understood the pathogenesis.