寄西华县庠山东颜先生,有积
二十年。目视物不真,细字不睹,当心如顽石,每
发痛不可忍,食减肉消,黑 满面,腰不能直。因遇戴
人。令涌寒痰一大盆,如片粉;夜以舟车丸、通经散,下烂鱼肠、葵菜汁七、八行,病十去
三、四;以热浆粥投之,复去痰一盆,次日又以舟车丸、通经散,前后约百余行,略无少困
。不五、六日,面红 去,食进目明,心中空旷,遂失顽石所在,旬日外来谢。
修弓杜匠,其子妇年三十,有孕已岁半矣。每发痛则召侍媪待之,以为将产也。
一、二日复故,凡数次。乃问戴人。戴人诊其脉涩而小,断之曰∶块病也,非孕也。《脉诀
》所谓涩脉如刀刮竹形,主丈夫伤精,女人败血。治之之法
,有病当泻之。先以舟车丸百余粒;后以调胃承气汤加当归、桃仁,用河水煎,乘热投之
;三、两日,又以舟车丸、桃仁承气汤泻,青黄脓血,杂然而下,每更衣,以手向下推之揉
之则出;后三、二日,又用舟车丸,以猪肾散佐之;一、二日,又以舟车丸,通经如前,数
服,病十去九;俟晴明,当未食时,以针泻三阴交穴。不再旬,块已没矣。此与隔腹视五脏者,复何异哉?
胡王之妻,病脐下积块,呕食面黄,肌瘦而不月。或谓之干血气,治之无效。
戴人见之曰∶孕也。其人不信,再三求治于戴人。与之平药以应其意,终不肯下毒药。
后月到,果胎也。人问何以别之?戴人曰∶尺脉洪大也。《素问·阴阳别论》所谓阴搏阳别
寄居在西华县学校里的山东颜先生,患有积证已经二十年了。看东西模糊不清,小字完全看不见,心口部位感觉像有一块顽石堵塞,每次发作时疼痛难以忍受,食欲减退,身体消瘦,脸上布满黑斑,腰部僵硬无法挺直。后来遇到戴人(张从正的号),让他涌吐出一大盆寒痰,状如片粉;夜间服用舟车丸、通经散,排出烂鱼肠状及葵菜汁样的大便七八次,病情去除了三四成;随后用热米汤调养,再次吐出痰液一盆,第二天又服用舟车丸、通经散,前后共排便百余次,身体却几乎没有感到困倦。不到五六天,面部的黑斑消退,食欲恢复,视力清晰,心中空旷不再感觉有顽石阻塞,十天后前来道谢。
修弓的杜匠,他的儿媳三十岁,怀孕已一年半了。每次发作腹痛就召来老妇人侍奉,以为快要分娩了。一两天后疼痛停止,恢复原状,这种情况发生了数次。于是向戴人请教。戴人诊察她的脉象涩而细小,判断说:“这是块状病证,不是怀孕。”《脉诀》中说涩脉像刀刮竹子一样,主要主男子伤精,女子败血。治疗的方法是,有病应当泻下。先用舟车丸一百多粒;后用调胃承气汤加入当归、桃仁,用河水煎煮,趁热服下;两三天后,又用舟车丸、桃仁承气汤泻下,排出青黄脓血混杂的大便,每次上厕所,用手向下推揉才能排出;后又过两三天,再用舟车丸,配合猪肾散辅助;一两天后,又用舟车丸、通经散,像之前一样多次服用,病情去除了九成;等到天气晴朗,在未进食时,用针刺泻三阴交穴。不到十天,肿块已经消失。这与隔着腹部就能看清五脏的情况,又有什么不同呢?
胡王的妻子,患有脐下积块,呕吐食物,面色发黄,肌肉消瘦且闭经。有人说是干血气,治疗无效。戴人见到她说:“是怀孕。”那人不相信,再三请求戴人治疗。戴人给她平和的药物以顺从她的心意,但她始终不肯服用毒药。后来月经如期而至,果然是胎儿出生。别人问如何辨别?戴人说:“尺脉洪大。”正如《素问·阴阳别论》中所说的“阴搏阳别”
Mr. Yan from Shandong, residing in the county school of Xihua, had suffered from an accumulation disorder for twenty years. His vision was blurred; he could not see small characters. He felt as if a stubborn stone were blocking his heart region, and each episode brought unbearable pain. His appetite decreased, his flesh wasted away, his face became covered with dark spots, and his waist was stiff so that he could not straighten it. Later, he met Dairen (Zhang Congzheng's courtesy name). Dairen induced him to vomit a large basin of cold phlegm, which resembled sliced powder. At night, he administered Zhouche Wan (Boat Cart Pill) and Tongjing San (Unblocking Meridian Powder), resulting in the passage of seven or eight stools resembling rotten fish intestines and okra juice. The disease improved by three or four tenths. He then nourished himself with hot rice gruel, vomited another basin of phlegm, and on the following day took Zhouche Wan and Tongjing San again. In total, he passed stool more than one hundred times, yet felt no fatigue at all. Within five or six days, the dark spots on his face disappeared, his appetite returned, his vision cleared, and his chest felt empty, as if the stubborn stone had vanished. Ten days later, he came to express his gratitude.
The son-in-law of Du, an archer craftsman, was thirty years old and had been pregnant for a year and a half. Whenever abdominal pain occurred, she summoned an old maid to attend to her, believing that labor was imminent. After one or two days, the pain ceased and she returned to normal. This happened several times. She then consulted Dairen. Dairen palpated her pulse, finding it choppy (Se, 涩) and fine (Xiao, 小), and diagnosed: "This is a mass disorder, not pregnancy." The *Mai Jue* (Pulse Classic) states that a choppy pulse resembles a knife scraping bamboo, indicating essence injury in men and ruined blood in women. The treatment principle is to purge when there is pathogenic excess. First, he administered over one hundred pills of Zhouche Wan (Boat Cart Pill). Then, he prescribed Tiaowei Chengqi Tang (Stomach-Regulating Decoction to Direct Downward) added with Danggui (Angelicae Sinensis Radix) and Taoren (Persicae Semen), decocted in river water, and administered while hot. Two or three days later, he again used Zhouche Wan and Tao Ren Chengqi Tang (Peach Kernel Decoction to Direct Downward) to purge, expelling green, yellow, purulent, and bloody matter mixed together. Each time she visited the toilet, she had to push and rub downwards with her hand to facilitate the passage. A few days later, he used Zhouche Wan again, assisted by Zhushen San (Pig Kidney Powder). One or two days later, he used Zhouche Wan and Tongjing San (Unblocking Meridian Powder) as before. After several doses, the disease improved by nine tenths. When the weather cleared, before meals, he needled and reduced the Sanyinjiao (SP6, Three Yin Intersection) acupoint. Within ten days, the mass had disappeared. What difference is there between this case and viewing the five zang organs through the abdomen?
The wife of Hu Wang suffered from a mass below the navel, vomiting food, sallow complexion, emaciation, and amenorrhea. Some diagnosed it as dry blood qi (Ganxue Qi, 干血气), but treatment was ineffective. Dairen saw her and said, "It is pregnancy." The woman did not believe him and repeatedly sought treatment from Dairen. He gave her mild medicines to appease her intent, but she refused to take harsh purgatives. Later, her menstrual period arrived, and indeed, a fetus was born. People asked how he distinguished it. Dairen replied, "The chi (尺) pulse was surging (Hong, 洪)." As stated in the *Suwen: Yin Yang Bie Lun* chapter of the *Huangdi Neijing*: "Yin pulses surge, distinct from Yang..."