佩兰钱半,丝瓜络二钱,橘络钱半,茵陈二钱,银花二钱,赤芍钱半,连翘钱半,生地钱半,薏苡仁三钱,地肤子钱半,白藓皮一钱,丹皮一钱二分,荷梗一尺五寸,香豉二十粒,服两剂,渐愈。此孩体弱多病,发病与人不同。至于以手牵阴,仍有此象,且闻尚偷食门斗灰和茶叶,此必系疳积症之反应。
(32)睾丸肿大
25岁
左边睾丸肿痛,正午及夜间痛愈甚,时有呕吐,两眼发花,为其诊脉,伊言别无他病,毋须把脉。余见其粗暴不讲理,姑以
山甲珠三钱,小茴香二钱研末,分三次酒调下,一日服完。另日再来,云痛一半,但阴囊发烧。改以:
煅牡蛎三钱,高良姜三钱研末,以自己口津调药敷上,若有火射出时,则抹去不敷,其病从此告愈。
(34)水蓄膀胱
男,30岁
整日车水,迄晚十时回家休息。是夜小便胀痛,身直不能俯仰,腰挺目晕,坐卧不安,喊叫欲绝。脉浮大,小腹下高耸喜按,我断其忍尿入房,致水蓄膀胱。处方:
云苓四钱,泽泻三钱,木通二钱,猪苓二钱,白术三钱,前仁二钱,桂枝五钱。嘱服一剂。
并嘱其妻口吸丹田穴五分钟,停吸时,用双手在小腹两旁往上推(左边九下,右边六下),未几患者叫腹胀较好些。后又用白葱捣烂,和灰而拌匀炕热,乘热作饼敷丹田穴。
当日傍晚服药,约到十时,自觉病好一半,翌日复诊,于原方去桂枝,加上安桂(研末)二钱,随药兑服。第三日,腰不挺,丹田穴不高耸,但畏寒。我断其必转皮寒,乃用芳香透络法,果得战汗而愈。
佩兰叶二钱,毕澄茄二钱,丝瓜络二钱,秦艽二钱,茵陈三钱,扁豆花二钱,香豉四十粒。
女,30岁
小便胀痛,日夜不安。欲求速效,竟日更三医。余察其面色青,舌淡红,脉浮数互见。前医有投利尿剂者,亦有作转胞论治,而用升提者。当时患者透大气,求水喝,以手擦少腹。此必因决渎之官失职,致令水蓄膀胱,盖由忍尿行房而起。处方五苓散加味:
云苓三钱,泽泻三钱,猪苓二钱,川通钱半,前仁二钱,白术二钱,桂枝二钱。嘱服二剂。
外用食盐炒热,以袋装之,方脐下。当晚脐下暖甚,欲呕不呕,冷汗淋漓,欲睡。至天明,病势减轻,然口渴不止,服药二剂,安然无事。
(35)血蓄膀胱
男,32岁
乘凉噉瓜果,身热,汗不出者三日。目珠黄赤,身黄如橘,口渴不多饮,透大气,脉洪数,断为血蓄膀胱,用桃仁承气汤,连服四剂,汗出热解,目珠黄赤减轻。改服龙胆泻肝汤二剂,目黄赤全退,惟身黄未减,乃以纸抹其身,黄色随纸而脱。嘱用鸡蛋去白搅匀,以老黄酒冲服,黄色虽退,浑身有汗。我查其血虚,令取妇人头发一团,置猪油内煎至发烊为度,将其油和黄酒冲服,遂告全愈。
至于抵当汤证,乃下焦瘀血积蓄所致,其症身黄脉沉结,少腹硬,小便自利,其人如狂者。
(36)孤阳外越
男,年未详
嫖赌无度。忽发热,精神极度衰竭,某医用生地、黄芩等养阴剂,病益严重,乃邀予往诊。脉寸尺浮滑而两关沉伏,头面色红无光,剂颈而还,自汗神疲,舌绛无苔,四肢不厥,二便正常,目畏灯光。断为孤阳外越,处以四逆汤。服一剂,情况无变,乃令其自摸龟头,是冷抑热?其问曰:“何故摸之?”余曰:“龟头热者不治,若冷,犹可挽救。”其告曰:“冷也。”复令乃妻摸其臀部,试冷热,云亦冷。
余以龟头臀部皆冷,虽为孤阳外越,而阴尚内守,因于原方加肉桂。服后面红已退,诸恙减轻,断其必得战汗而解,遂投芳香透络剂,果验。
男,48岁
体弱多病,经常服药。某年痰喘大作,烧热不退,蜷卧不言,满面红光,剂颈而还,脉无伦次,舌黄,满布唾涎,声音低微,时常以手牵阴茎。如此情况,无望闻问切之可循。余素知其挥霍成性,早有五劳七伤之根,故未发表意见,坚不开方。乃兄问我延梅医参酌如何?我仅允侍诊。梅医至。问我有何见解?我以今日侍诊,未便发言。梅迳自诊脉,旋即书方青蒿鳖甲汤加参附,嘱服一剂后再诊。另日,梅医见情况无变,于前方加重附桂,再服一剂,患者叫口干。三诊去附桂,加熟地,前后诊治十一次,皆未离青蒿鳖甲。迄十二日头汗淋漓,喉间疼痛。改延胡医,投清燥救肺汤加参附。胡诊四次无效。
第五日汗收,满脸红已转暗,目光放大,以手牵阴茎。乃兄召我至,我预晚十二时必修文地下矣,是夜果如余言。
此证我认为脉无伦次,胃津已竭,满面红光,剂颈而还者,乃孤阳外越也。其生平挥霍,当有物丧殆尽之虞。又见其以手牵阴,精管定然作痛。似此险象迭见,余前后未写一字,亦未发一言。
(37)亡阴亡阳
男,35岁
大汗不止,日夜烦躁,遇事骂人,致无人敢于亲近。余入室,即高声叫要看脉,并怒目曰:“我吃了好多药,今日你须斟酌,给你四块钱,好好给我看看。”余闻其言语反常,终非吉兆。未及诊毕,即大叫“算了。”察其舌如镜面,唇色暗红。断其大汗不止是亡阳,舌光如镜是亡阴。阴阳俱亡,岂有生理?遂决意不开方,亦不取诊金。病家质问为何不开方?扬言不开方是有意卸责,非请人谈判理论不可。当日下午,果向我起交涉,我以不知此系何病,故不敢开方。余愿受不开方之法律处分,不愿受开方误治致死之处分。何况我一未开方,二未受钱,量无重大过失。如须交涉,可俟患者好了再谈。该患者是夜起倒不定,大汗淋漓,循衣摸床,抽大烟则打掉灯,喝茶则茶壶落地,时拉胡琴,时唱歌曲,无一人敢近其身。未几,又将裤子脱下,往床上一倒,顿时痰声漉漉,仆卧不动。家人近前视之,其人已遽然长逝矣。
余以为似此阴阳两亡,若开方吃药,当有“庸医杀人”之嫌也。
男,50岁
痰喘气逼,大汗淋漓,曾以亡阳论治,服过大剂参附。六脉俱沉有力,余向其分析亡阳亡阴之脉症云,亡阳者脉多洪,汗多冷,手足冷,口不渴,不欲食,不欲寐。亡阴汗多温,手足温,能食能寐,口微渴,脉沉中有紧。亡阴亡阳,有轻重悬殊之分。其是亡阴,不是亡阳。此汗乃阳遏于外,宜收其汗,用:
小麦一升,红枣二十枚水煎浓汁饮之。俟汗收,再用敛阳清痰降火之品,作方阴阳两顾:
女贞子、龙骨、牡蛎、玉竹、熟地炭、沙参、郁金、川柏(盐水炒)、海浮石、麦冬、知母(盐水炒)、瓜蒌仁各二钱,五味钱半,竹叶钱半,粳米一撮
服一剂,当夜汗少,不需更衣,但腹响如雷,旋即小便,尿量大增,汗止,酣睡至天明,精神觉软。再服一剂,至下午连续打屁,身感觉热,遂跃然而起,散步于外,并食土瓜一边,顿觉凉爽舒适,一觉甚安。
复诊脉无太过不及,第关部起伏不定,知胃气未复,阴津被灼,改方:
玉竹、南沙参、扁豆、麦冬、女贞子、毕澄茄、鲜生地、瓜蒌仁、东波叩各二钱,金钗石斛三钱,五味子钱半,煅石膏三钱,薏苡仁三钱,冬瓜仁三钱
嘱服四剂,并批明亡阳宜热解,亡阴宜凉解,切忌温补,谨防生疮疖。此后不免发疟(阴阳相维系,当先有战汗也)。后果如余言。
(38)畏寒
男,年未详
六月须穿棉衣,曾服附子、熟地、参茸等达五六十剂均罔效,问我方术。我叫其吃狗肉,多吃有效。其连吃三只狗,果验,后晤面,其问狗肉何故有效?我以其恙乃卫气弱,无阴阳偏胜之虑,盖非脏寒,乃腑症也。狗性纯阳,逢冷■地,以口鼻伏肚下,善吸土气,不怕风寒,取其有抵抗力。
黄某,男,53岁
心怀郁郁,时有潮热,或五心烦热,有时咳嗽,伏天需穿棉衣,服药鲜效,且日见沉重。一日其妾吵离婚,并索离婚费,黄某一气,晕倒在地,从此病更猖獗,不能多食,夜不安寐时进时出,时起时坐,不欲与人说话,如是年余。曾写信要我往诊,我因未便抽身,乃以“脱营”二字见告,黄恍然悟之。其后翻书,见百合病与他相合,遂每日食百合粉及百合炒肉,后逐渐好转。
(39)劳伤气脱
男,20岁
父丧,办丧事六七日,未得休息。出殡时,大哭一顿,遂跌仆在地。家人怆惶失措,认为父死犯了“重丧”。适有道士在旁,张口大叫:“今日戊申已酉,恰是重丧日,何敢用此日下葬?”大肆哗然,骂堪舆先生不是。当时有人以为重丧事以后再谈。现在救人要紧。遂急延余往诊。其人四肢厥冷,大汗满身,目闭神倦,唇舌均呈淡白色,恶闻人声,脉象浮数无根,尚能应指,摸其胸部,气温尚存,心跳而不急,腿夹微汗粘手,肾囊扩大下垂,知阴阳尚未离开,嘱用独参汤,以济燃眉。
熬参服下两句钟,患者汗收一半,肢厥如前,至四句钟,取回阳返本法,用
黑锡丹一钱,参汤送下。至八句钟再服。
次日复诊,汗止肢温,但患者一手牵裤裆,问以故,患者难于出口,余揭视之,乃遗下之白精,疑之,身旁有同学云其有淋病。综合前症,劳伤虚脱已明。服药后脱症虽解,而淋病复发,仍是阳虚阴凑危候,殊堪棘手。处方:
龙骨、牡蛎、复盆子、菟丝子、枸杞、当归、淮山、鱼鳔、桑螵蛸各二钱,熟地三钱
服四剂,病机若失,一日至我家道谢,言及追究“重丧”事,我告其病好即是福,何故再找祸耶?万一无谓劳伤,谁人再来挽救?乃劝其保重身体,行听外人唆使。
男,30岁
母丧开弔,大闹三日。其兄弟于开弔后分用灵轴,未得均匀,大起纠纷,患者从此得病,神志失守,茫然无知,脉四散无根,面青神青,鼻色如煤,目光放大,满盘危候,我不敢开方。其岳欲抬至其家住宿,我不负责任,乡人皆以为凶多吉少,遂抬家中,傍晚告困。
李某,男,48岁
挑垾半月,颇受寒湿,突患泄泻,自服药四、五剂罔效,遂归。甫至家,即倒卧床上,摸其身不冷,视其裤裆,有水与屎,其妻颇怀疑,问且喝茶否?答要热茶,及与之,呷一口即异之。翌日想肉吃,待依其意烧好,吃一口即倾出,颇不自安。第四日来江桥诊所,见其目陷神昏,满面垢色,鼻孔两眼如深洞,六脉无根,舌呈褐色,口张唇缩,阴茎引痛,畏寒,心烦意乱,曲立不稳。此脾肾不济,已达极点,危症显明。断其劳伤过分,且有劳复变相。将至气脱,危在旦夕。余辞之,不开方。万一要吃药,可购黑锡丹一瓶,回家吞服。其欲留宿诊所,余坚辞之。李怒目视我,乃忿忿叫如抬归。是夜十句钟,大汗淋漓,寂寂无闻而逝。
余以为李自知医,素喜用附桂参茸,此证已吃附子不少,因而斲丧元阳,且其中尚有房劳也。其以手牵阴茎,不无感受阴阳易中之阴易。如此真阳一动,气绝须臾矣。录此作研究伤寒论阴阳易和女劳复之参考。
男,50岁
精神疲惫,若有所失。某医拟方,令服四十剂,其服至二十余剂,未见动静,自觉食欲减少,丢药不吃。数度更医,自认不合病情,悉弃之。迳自找我求治,并自带伙食行李,拟住诊十余日。余见其形色憔悴,语言在腹中转,诊脉两手均不及四至,察反关,亦无动际。问其饮食如何?曰食不多,不知味,便带黑色,目视阳光及灯光均为黄色,舌知心异隐黄,额上、两腋、胸部有黄汗。断为脱营症,五脏俱伤,万无生理,碍难处方。然又未敢造次,遽尔拒绝。及薄暮,力促开方,我借其旅途劳顿推脱之。是夜踌躇良久,似此病无生机,倘妄投药饵,当引认症不清之咎,遂拟参麦汤,以脉无动际为依据,若生脉有望,再作办法。为免浪费,以玉竹代洋参。
另日煎服一剂,当夜屙出两节炭色粪便,再诊与前无异,且鼻色如煤,断其五脏皆绝,为难挽救,乃向其子建议从速回家。患者无奈何,潸然泪下,令我叫个病名,俾回家翻书。我以“脱营”二字告之。并对其子言明十日内必有凶险。回家后七日,气脱而终。
按脱营者,即先贵后贱,营血与卫气不相济。此证直达肝肾,实非遗精、多梦、头晕、目眩等可治之症相比拟。
(40)阴阳易
男,35岁
回乡探亲,在家与新纳妇共宿三晚。复因其戚葬坟,在外露宿一夜。回省途中,遇倾盆大雨,衣服湿透,顿觉寒湿难当,比夜寒热交作。其人卧床,目光放大,目陷形焦,声音低微,呼吸不相接续,面色晦暗,脉无伦次,说话半句,转身不语,颈项红色隐隐,将有浮阳外见之虑,不敢开方。其同事以为我是乡下医,颇不介意。改延某医,投防风通圣散,服后烦躁大作,其妻要我开方,我复辞之。又更医,投大承气汤,病益剧,第四日送南昌医院。有人问我何故不开方?我以阴阳易告之,此证不过七日死。其起病之第七日,果卒要院。
女,年未详
佩兰钱半,丝瓜络二钱,橘络钱半,茵陈二钱,银花二钱,赤芍钱半,连翘钱半,生地钱半,薏苡仁三钱,地肤子钱半,白藓皮一钱,丹皮一钱二分,荷梗一尺五寸,香豉二十粒。服用两剂后,病情逐渐好转。这个孩子体质虚弱且多病,发病情况与常人不同。至于他用手拉扯阴部,仍有此现象,而且听说他还偷吃门斗灰混合茶叶,这必定是疳积症(小儿因脾胃虚弱、饮食不节导致的慢性营养障碍性疾病)的反应。
(32)睾丸肿大
患者25岁。
左侧睾丸肿痛,正午及夜间疼痛加剧,时常呕吐,双眼视物模糊。为他诊脉时,他说没有其他疾病,不需要把脉。我看他态度粗暴不讲理,暂且开具:
山甲珠三钱,小茴香二钱研成粉末,分三次用酒调服,一天服完。次日再来复诊,说疼痛减轻了一半,但阴囊发热。改为:
煅牡蛎三钱,高良姜三钱研成粉末,用自己的唾液调和药粉敷在患处,如果有如火射出的感觉时,则抹去不再敷,从此病愈。
(34)水蓄膀胱
男,30岁。
整天车水(灌溉农田),直到晚上十点回家休息。当晚小便胀痛,身体僵硬不能俯仰,腰部挺直眼睛晕眩,坐卧不安,喊叫欲绝。脉象浮大,小腹下方高耸且喜欢按压,我判断他是忍尿行房,导致水液蓄积在膀胱。处方:
云苓四钱,泽泻三钱,木通二钱,猪苓二钱,白术三钱,前仁二钱,桂枝五钱。嘱咐服用一剂。
并嘱咐其妻子口吸丹田穴五分钟,停吸时,用双手在小腹两旁往上推(左边九下,右边六下),不久患者叫腹胀有所缓解。后又用白葱捣烂,和灰拌匀炕热,趁热做成饼敷在丹田穴。
当天傍晚服药,大约到十点钟,自觉病好了一半,第二天复诊,在原方中去掉桂枝,加上安桂(研末)二钱,随药兑服。第三天,腰不挺了,丹田穴不高耸了,但怕冷。我判断他必定转为皮寒(皮肤寒冷),于是用芳香透络法,果然通过战汗而痊愈。
佩兰叶二钱,毕澄茄二钱,丝瓜络二钱,秦艽二钱,茵陈三钱,扁豆花二钱,香豉四十粒。
女,30岁。
小便胀痛,日夜不安。想求速效,整天换了三个医生。我观察她面色青,舌淡红,脉浮数互见。前医有投利尿剂的,也有作转胞论治,而用升提法的。当时患者透大气(深呼吸),求水喝,以手擦少腹。这必定是因为决渎之官(三焦)失职,导致水蓄膀胱,大概是由忍尿行房引起的。处方五苓散加味:
云苓三钱,泽泻三钱,猪苓二钱,川通钱半,前仁二钱,白术二钱,桂枝二钱。嘱咐服用两剂。
外用食盐炒热,装在袋子里,放在脐下。当晚脐下很暖,想吐又没吐出来,冷汗淋漓,想睡觉。到了天亮,病势减轻,然而口渴不止,服药两剂后,安然无事。
(35)血蓄膀胱
男,32岁。
乘凉吃瓜果,身热,三天不出汗。眼珠黄赤,全身黄如橘子色,口渴但不多饮,深呼吸,脉洪数,判断为血蓄膀胱,用桃仁承气汤,连续服用四剂,出汗热解,眼珠黄赤减轻。改服龙胆泻肝汤两剂,目黄赤全退,只是身体黄未减,于是用纸擦拭其身,黄色随纸而脱。嘱咐用鸡蛋去白搅匀,用老黄酒冲服,黄色虽退,浑身有汗。我检查其血虚,令取妇人头发一团,置猪油内煎至发烊为止,将其油和黄酒冲服,于是宣告痊愈。
至于抵当汤证,乃下焦瘀血积蓄所致,其症状身黄脉沉结,少腹硬,小便自利,其人如狂者。
(36)孤阳外越
男,年龄不详。
嫖赌无度。忽然发热,精神极度衰竭,某医用生地、黄芩等养阴剂,病情更加严重,于是邀请我去诊治。脉寸尺浮滑而两关沉伏,头面色红无光,仅到颈部为止,自汗神疲,舌绛无苔,四肢不厥,二便正常,目畏灯光。判断为孤阳外越,处以四逆汤。服用一剂,情况无变化,于是让他自己摸龟头,问是冷还是热?他问:“为什么摸那里?”我说:“如果龟头热则不治,若冷,还可以挽救。”他回答说:“冷的。”又让他妻子摸他的臀部,试冷热,也说冷。
我认为龟头臀部皆冷,虽然为孤阳外越,而阴尚内守,因此在原方中加入肉桂。服后面红已退,诸恙减轻,判断他必定得战汗而解,于是投芳香透络剂,果然见效。
男,48岁。
体质虚弱多病,经常服药。某年痰喘大作,烧热不退,蜷卧不言,满面红光,仅到颈部为止,脉无伦次,舌黄,满布唾涎,声音低微,时常以手牵阴茎。如此情况,无法遵循望闻问切来诊断。我素知他挥霍成性,早有五劳七伤之根,故未发表意见,坚决不开方。于是他哥哥问我是否请梅医参酌如何?我只答应侍诊。梅医到来,问我有何见解?我以今日侍诊,不便发言为由。梅医径直诊脉,随即书写处方青蒿鳖甲汤加参附,嘱咐服用一剂后再诊。另一天,梅医见情况无变化,于前方加重附桂,再服一剂,患者叫口干。第三次诊治去掉附桂,加熟地,前后诊治十一次,皆未离开青蒿鳖甲。直到第十二日头汗淋漓,喉间疼痛。改延胡医,投清燥救肺汤加参附。胡医诊治四次无效。
第五天汗收,满脸红已转暗,目光放大,以手牵阴茎。于是他哥哥召我至,我预言晚十二时必须入土矣,那夜果然如我所言。
此证我认为脉无伦次,胃津已竭,满面红光,仅到颈部为止者,乃是孤阳外越也。他生平挥霍,应当有物丧殆尽的担忧。又见他以手牵阴,精管定然作痛。像这样险象迭见,我前后未写一字,亦未发一言。
(37)亡阴亡阳
男,35岁。
大汗不止,日夜烦躁,遇事骂人,致无人敢于亲近。我进入房间,他即高声叫要看脉,并怒目曰:“我吃了好多药,今天你必须斟酌,给你四块钱,好好给我看看。”我听到他言语反常,终非吉兆。未及诊毕,即大叫“算了。”察其舌如镜面,唇色暗红。判断他大汗不止是亡阳,舌光如镜是亡阴。阴阳俱亡,岂有生理?遂决意不开方,也不取诊金。病家质问为何不开方?扬言不开方是有意卸责,非请人谈判理论不可。当日下午,果然向我起交涉,我以不知此系何病,故不敢开方。我愿受不开方的法律处分,不愿受开方误治致死之处分。何况我一未开方,二未受钱,量无重大过失。如须交涉,可等患者好了再谈。该患者那夜起倒不定,大汗淋漓,循衣摸床,抽大烟则打掉灯,喝茶则茶壶落地,时而拉胡琴,时而唱歌曲,无一人敢近其身。不久,又将裤子脱下,往床上一倒,顿时痰声漉漉,仆卧不动。家人近前视之,其人已经遽然长逝矣。
我认为像这样阴阳两亡,若开方吃药,当有“庸医杀人”的嫌疑也。
男,50岁。
痰喘气逼,大汗淋漓,曾以亡阳论治,服过大剂参附。六脉俱沉有力,我向他分析亡阳亡阴的脉症云,亡阳者脉多洪,汗多冷,手足冷,口不渴,不欲食,不欲寐。亡阴汗多温,手足温,能食能寐,口微渴,脉沉中有紧。亡阴亡阳,有轻重悬殊之分。这是亡阴,不是亡阳。此汗乃阳遏于外,宜收其汗,用:
小麦一升,红枣二十枚水煎浓汁饮之。待汗收,再用敛阳清痰降火之品,作方阴阳两顾:
女贞子、龙骨、牡蛎、玉竹、熟地炭、沙参、郁金、川柏(盐水炒)、海浮石、麦冬、知母(盐水炒)、瓜蒌仁各二钱,五味子钱半,竹叶钱半,粳米一撮。
服用一剂,当夜汗少,不需更衣,但腹响如雷,旋即小便,尿量大增,汗止,酣睡至天明,精神觉软。再服一剂,至下午连续打屁,身感觉热,遂跃然而起,散步于外,并吃土瓜一边,顿觉凉爽舒适,一觉甚安。
复诊脉无太过不及,唯关部起伏不定,知胃气未复,阴津被灼,改方:
玉竹、南沙参、扁豆、麦冬、女贞子、毕澄茄、鲜生地、瓜蒌仁、东波叩各二钱,金钗石斛三钱,五味子钱半,煅石膏三钱,薏苡仁三钱,冬瓜仁三钱。
嘱咐服用四剂,并批明亡阳宜热解,亡阴宜凉解,切忌温补,谨防生疮疖。此后不免发疟疾(阴阳相维系,当先有战汗也)。后果如我所言。
(38)畏寒
男,年龄不详。
六月须穿棉衣,曾服附子、熟地、参茸等达五六十剂均无效,问我方术。我叫其吃狗肉,多吃有效。他连吃三只狗,果然见效,后来见面,他问狗肉何故有效?我解释他的病乃是卫气弱,无阴阳偏胜之虑,盖非脏寒,乃腑症也。狗性纯阳,逢冷即钻入地下,以口鼻伏肚下,善吸土气,不怕风寒,取其有抵抗力。
黄某,男,53岁。
心怀郁郁,时有潮热,或五心烦热,有时咳嗽,伏天需穿棉衣,服药鲜效,且日见沉重。一日其妾吵离婚,并索离婚费,黄某一气,晕倒在地,从此病更猖獗,不能多食,夜不安寐时进时出,时起时坐,不欲与人说话,如是年余。曾写信要我往诊,我因未便抽身,乃以“脱营”二字告知,黄某恍然悟之。其后翻书,见百合病与他相合,遂每日食百合粉及百合炒肉,后逐渐好转。
(39)劳伤气脱
男,20岁。
父亲去世,办丧事六七日,未得休息。出殡时,大哭一顿,遂跌仆在地。家人惊慌失措,认为父死犯了“重丧”。适有道士在旁,张口大叫:“今日戊申已酉,恰是重丧日,何敢用此日下葬?”大肆哗然,骂堪舆先生不对。当时有人以为重丧事以后再谈。现在救人要紧。遂急邀我去诊治。其人四肢厥冷,大汗满身,目闭神倦,唇舌均呈淡白色,恶闻人声,脉象浮数无根,尚能应指,摸其胸部,气温尚存,心跳而不急,腿夹微汗粘手,肾囊扩大下垂,知阴阳尚未离开,嘱咐用独参汤,以济燃眉之急。
熬参服下两小时后,患者汗收一半,肢厥如前,至四小时,取回阳返本法,用
黑锡丹一钱,参汤送下。至八小时再服。
次日复诊,汗止肢温,但患者一手牵裤裆,问其原因,患者难于出口,我揭开查看,乃是遗下之白精,怀疑他有淋病,身旁同学说他确有淋病。综合前症,劳伤虚脱已明。服药后脱症虽解,而淋病复发,仍是阳虚阴凑危候,殊堪棘手。处方:
龙骨、牡蛎、复盆子、菟丝子、枸杞、当归、淮山、鱼鳔、桑螵蛸各二钱,熟地三钱。
服用四剂,病机若失,一天到我家里道谢,言及追究“重丧”事,我告诉他病好即是福,何故再找祸耶?万一无谓劳伤,谁人再来挽救?于是劝其保重身体,勿听外人唆使。
男,30岁。
母亲去世开吊,大闹三日。其兄弟于开吊后分用灵轴,未得均匀,大起纠纷,患者从此得病,神志失守,茫然无知,脉四散无根,面青神青,鼻色如煤,目光放大,满盘危候,我不敢开方。其岳欲抬至其家住宿,我不负责任,乡人皆以为凶多吉少,遂抬回家中,傍晚告困。
李某,男,48岁。
挑垾半月,颇受寒湿,突患泄泻,自服药四、五剂无效,遂归。甫到家,即倒卧床上,摸其身不冷,视其裤裆,有水与屎,其妻颇怀疑,问且喝茶否?答要热茶,及与之,呷一口即异之。翌日想吃肉,待依其意烧好,吃一口即倾出,颇不自安。第四日来江桥诊所,见其目陷神昏,满面垢色,鼻孔两眼如深洞,六脉无根,舌呈褐色,口张唇缩,阴茎引痛,畏寒,心烦意乱,曲立不稳。此脾肾不济,已达极点,危症显明。断其劳伤过分,且有劳复变相。将至气脱,危在旦夕。我辞之,不开方。万一要吃药,可购黑锡丹一瓶,回家吞服。其欲留宿诊所,我坚决拒绝。李怒目视我,乃忿忿叫如抬归。那夜十点钟,大汗淋漓,寂寂无闻而逝。
我认为李自知医,素喜用附桂参茸,此证已吃附子不少,因而斲丧元阳,且其中尚有房劳也。他以手牵阴茎,不无感受阴阳易中之阴易。如此真阳一动,气绝须臾矣。录此作研究伤寒论阴阳易和女劳复之参考。
男,50岁。
精神疲惫,若有所失。某医拟方,令服四十剂,其服至二十余剂,未见动静,自觉食欲减少,丢药不吃。数度更医,自认不合病情,悉弃之。径自找我求治,并自带伙食行李,拟住诊十余日。我见其形色憔悴,语言在腹中转,诊脉两手均不及四至,察反关,亦无动际。问其饮食如何?曰食不多,不知味,便带黑色,目视阳光及灯光均为黄色,舌知心异隐黄,额上、两腋、胸部有黄汗。判断为脱营症,五脏俱伤,万无生理,碍难处方。然又未敢造次,遽尔拒绝。及薄暮,力促开方,我借其旅途劳顿推脱之。那夜踌躇良久,似此病无生机,倘妄投药饵,当引认症不清之咎,遂拟参麦汤,以脉无动际为依据,若生脉有望,再作办法。为免浪费,以玉竹代洋参。
另一天煎服一剂,当晚屙出两节炭色粪便,再诊与前无异,且鼻色如煤,判断其五脏皆绝,为难挽救,乃向其子建议从速回家。患者无可奈何,潸然泪下,令我叫个病名,以便回家翻书。我以“脱营”二字告知。并对其子言明十日内必有凶险。回家后七日,气脱而终。
按脱营者,即先贵后贱,营血与卫气不相济。此证直达肝肾,实非遗精、多梦、头晕、目眩等可治之症相比拟。
(40)阴阳易
男,35岁。
回乡探亲,在家与新纳妇共宿三晚。复因其戚葬坟,在外露宿一夜。回省途中,遇倾盆大雨,衣服湿透,顿觉寒湿难当,比夜寒热交作。其人卧床,目光放大,目陷形焦,声音低微,呼吸不相接续,面色晦暗,脉无伦次,说话半句,转身不语,颈项红色隐隐,将有浮阳外见之虑,不敢开方。其同事以为我是乡下医,颇不介意。改延某医,投防风通圣散,服后烦躁大作,其妻要我开方,我复辞之。又更医,投大承气汤,病益剧,第四日送南昌医院。有人问我何故不开方?我以阴阳易告之,此证不过七日死。其起病之第七日,果卒于医院。
女,年龄不详
Peilan (Eupatorii Herba) 0.5 qian, Sigualuo (Luffae Fructus Retinervus) 2 qian, Jueluo (Citri Reticulatae Pericarpium Retinervum) 0.5 qian, Yichen (Artemisiae Scopariae Herba) 2 qian, Yinhua (Lonicerae Japonicae Flos) 2 qian, Chishao (Paeoniae Radix Rubra) 0.5 qian, Lianqiao (Forsythiae Fructus) 0.5 qian, Shengdi (Rehmanniae Radix Preparata) 0.5 qian, Yiyiren (Coicis Semen) 3 qian, Difuzi (Kochiae Scopariae Herba) 0.5 qian, Baixianpi (Dictamni Cortex) 1 qian, Danpi (Moutan Cortex) 1.2 qian, Hegeng (Nelumbinis Nodus) 1.5 chi, Xiangchi (Fermented Soybean) 20 grains. After taking two doses, the condition gradually improved. This child has a weak constitution and suffers from frequent illnesses; his onset of disease differs from others. Regarding his habit of pulling at his genitals with his hand, this phenomenon persists, and it is also heard that he secretly eats a mixture of door-step dust and tea leaves. This must be a reaction to Ganji syndrome (a chronic nutritional disorder in children caused by spleen-stomach weakness and improper diet).
(32) Testicular Swelling
Patient, male, 25 years old.
Swelling and pain in the left testicle, worsening at noon and at night, accompanied by occasional vomiting and blurred vision. When I attempted to take his pulse, he stated he had no other ailments and refused the examination. Observing his rude and unreasonable demeanor, I temporarily prescribed:
Shanjiazhu (Oryctolagi Cuniculi Os) 3 qian, Xiaohuixiang (Foeniculi Fructus) 2 qian, ground into powder, divided into three doses, taken with wine, consumed within one day. He returned the next day, reporting half the pain relief but heat in the scrotum. The prescription was changed to:
Duanshimu (Concha Ostreae) 3 qian, Gaoliangjiang (Alpiniae Officinarum Rhizoma) 3 qian, ground into powder, mixed with the patient's own saliva, and applied topically to the affected area. If a sensation like fire shooting out occurs, wipe it off and stop application. The illness was cured thereafter.
(34) Water Accumulation in the Bladder
Male, 30 years old.
He spent the whole day irrigating fields with a water wheel and returned home to rest at 10 PM. That night, he experienced painful and distending urination, stiffness preventing flexion or extension, erect waist, dizziness, restlessness, and desperate screaming. The pulse was floating and large; the lower abdomen was prominent below and preferred pressure. I diagnosed that holding urine during intercourse led to water accumulation in the bladder. Prescription:
Yunling (Poria) 4 qian, Zexie (Alismatis Rhizoma) 3 qian, Mutong (Akebiae Caulis) 2 qian, Zhuling (Polyporus) 2 qian, Baizhu (Atractylodis Macrocephalae Rhizoma) 3 qian, Qianren (Plantaginis Semen) 2 qian, Guizhi (Cinnamomi Ramulus) 5 qian. Instructed to take one dose.
I also instructed his wife to inhale Qi into the Dantian acupoint for five minutes. During breath retention, she should push upwards on both sides of the lower abdomen (nine times on the left, six times on the right). Soon, the patient reported some relief from abdominal distension. Subsequently, white scallions were mashed, mixed with ash, heated on a kiln, formed into a hot cake, and applied to the Dantian acupoint.
The medicine was taken in the evening of that day. By around 10 PM, he felt half recovered. On the second day's follow-up, Guizhi was removed from the original formula, and Angui (ground cinnamon bark) 2 qian was added to be taken with the decoction. On the third day, his waist straightened, the Dantian area was no longer prominent, but he felt cold. I judged that the condition had shifted to "skin cold" (cutaneous coldness) and employed an aromatic meridian-penetrating method. Indeed, he recovered through chills and sweating (Zhanhan).
Peilan Ye (Eupatorii Folium) 2 qian, Bichengqie (Bergamii Fructus) 2 qian, Sigualuo (Luffae Fructus Retinervus) 2 qian, Qinjiao (Gentianae Macrophyllae Radix) 2 qian, Yichen (Artemisiae Scopariae Herba) 3 qian, Biandouhua (Dolichoris Flors) 2 qian, Xiangchi (Fermented Soybean) 40 grains.
Female, 30 years old.
Painful and distending urination, restless day and night. Seeking rapid effect, she consulted three different doctors in one day. I observed her complexion was bluish, tongue pale red, and pulse showed alternating floating and rapid qualities. Previous doctors had used diuretics or treated it as "Zhuanbao" (bladder dysfunction) with lifting methods. At that time, the patient took deep breaths, asked for water, and rubbed her lower abdomen with her hand. This was likely due to the failure of the "Official of Uncultivated Land" (Sanjiao/Triple Burner), causing water accumulation in the bladder, probably triggered by holding urine during intercourse. Prescription: Modified Wuling San (Five-Ingredient Powder with Poria):
Yunling (Poria) 3 qian, Zexie (Alismatis Rhizoma) 3 qian, Zhuling (Polyporus) 2 qian, Chuantong (Akebiae Caulis) 0.5 qian, Qianren (Plantaginis Semen) 2 qian, Baizhu (Atractylodis Macrocephalae Rhizoma) 2 qian, Guizhi (Cinnamomi Ramulus) 2 qian. Instructed to take two doses.
Externally, salt was stir-fried until hot, placed in a bag, and applied below the umbilicus. That night, the area below the umbilicus felt very warm. She felt nauseous but did not vomit, sweated cold profusely, and wanted to sleep. By dawn, the condition alleviated, but thirst persisted. After two doses of medicine, she rested peacefully.
(35) Blood Accumulation in the Bladder
Male, 32 years old.
After cooling off and eating melons/fruits, he had body heat and no sweat for three days. His eyeballs were yellow and red, his entire body yellow like an orange peel, thirsty but drinking little, taking deep breaths, pulse flooding and rapid. I diagnosed blood accumulation in the bladder and prescribed Tao Ren Cheng Qi Tang (Peach Kernel Decoction to Order the Qi). After four doses, he sweated, the heat resolved, and the yellow-red eyes improved. He then took Longdan Xiegan Tang (Gentian Liver-Draining Decoction) for two doses, completely clearing the eye yellow/redness, though body yellow remained. I wiped his body with paper, and the yellow color transferred to the paper. I instructed him to mix beaten egg whites with aged yellow rice wine to drink. Although the yellow faded, he sweated all over. Checking for blood deficiency, I instructed him to take a clump of women's hair, fry it in lard until melted, and drink the oil mixed with yellow rice wine. He was fully cured.
Regarding Didang Tang syndrome, it is caused by the accumulation of blood stasis in the lower jiao. Symptoms include body yellow, sinking and knotted pulse, hard lower abdomen, free urination, and a manic-like state.
(36) Solitary Yang Floating Outward
Male, age unspecified.
Excessive indulgence in prostitution and gambling. Suddenly developed fever and extreme mental exhaustion. A certain doctor used Yin-nourishing agents like Shengdi (Rehmanniae Radix Preparata) and Huangqin (Scutellariae Radix), making the condition worse. I was invited to diagnose. Pulse: floating and slippery at Cun and Chi positions, sunken and hidden at Guan positions. Face and head red but dull, redness only up to the neck. Spontaneous sweating, mental fatigue, crimson tongue without coating, limbs not cold, bowel and bladder functions normal, aversion to light. Diagnosed as Solitary Yang Floating Outward. Prescribed Sini Tang (Four-Reverse Decoction). After one dose, no change. I instructed him to touch his glans penis to check if it was cold or hot. He asked why. I said, "If hot, it is incurable; if cold, it can still be saved." He replied, "Cold." I then had his wife touch his buttocks to check temperature; she also said cold.
Since both the glans and buttocks were cold, although it was Solitary Yang Floating Outward, Yin was still retained internally. I added Rougui (Cinnamomi Cortex) to the original formula. After taking it, facial redness receded, and symptoms alleviated. I predicted recovery through chills and sweating, so I administered an aromatic meridian-penetrating agent, which proved effective.
Male, 48 years old.
Weak constitution, frequently ill, often taking medicine. One year, severe phlegm-wheezing occurred, persistent high fever, curled up lying down, silent, face flushed red only up to the neck, pulse chaotic, yellow tongue coated with saliva, low voice, frequently pulling at his penis. Such a condition defied standard observation, listening, inquiry, and palpation diagnosis. Knowing his profligacy and root of Five Exhaustions and Seven Injuries, I offered no opinion and firmly refused to prescribe. His brother asked if we should consult Dr. Mei. I agreed only to observe. Dr. Mei arrived, asked for my view, and I declined to speak while observing. Dr. Mei palpated the pulse and immediately prescribed Qinghao Biejia Tang (Artemisiae Annuae and Turtle Shell Decoction) plus Renshen (Ginseng Radix) and Fuzi (Aconiti Lateralis Radix Preparata), instructing one dose before follow-up. Another day, seeing no change, Dr. Mei increased Fuzi and Guizhi (Cinnamomi Ramulus) in the previous formula for another dose. The patient complained of dry mouth. Third visit: remove Fuzi and Guizhi, add Shudi (Rehmanniae Radix Preparata). Over eleven visits, the prescription never deviated from Qinghao Biejia Tang. On the twelfth day, head sweating profusely, throat pain. Consulted Dr. Hu, who prescribed Qingzao Jiufei Tang (Dryness-Nourishing Lung-Rescuing Decoction) plus Renshen and Fuzi. Dr. Hu treated four times with no effect.
On the fifth day, sweating stopped, facial redness turned dark, pupils dilated, hand pulling at penis. Brother summoned me. I predicted death by midnight, which came true that night.
In my opinion, the chaotic pulse, exhausted stomach fluids, and flushed face only up to the neck indicate Solitary Yang Floating Outward. His profligacy suggests depletion of essence. Pulling at the penis indicates pain in the spermatic duct. With such dangerous signs appearing repeatedly, I wrote nothing and said nothing throughout.
(37) Collapse of Yin and Yang
Male, 35 years old.
Profuse continuous sweating, day and night irritability, cursing people, causing isolation. Upon entering the room, he loudly demanded pulse-taking, glaring and saying, "I've taken many medicines. You must consider carefully today. Here are four yuan, examine me well." Hearing his abnormal speech, I sensed bad omens. Before finishing the diagnosis, he shouted, "Forget it." Tongue mirror-like, lips dark red. I diagnosed profuse sweating as Yang Collapse, and mirror-like tongue as Yin Collapse. With both Yin and Yang collapsing, survival was impossible. I decided not to prescribe and refused payment. The family questioned why, threatening legal action for shirking responsibility. That afternoon, they confronted me. I stated I dared not prescribe without knowing the disease. I accepted legal punishment for not prescribing rather than for killing via misprescription. Moreover, I neither prescribed nor took money, implying no major negligence. Negotiation could wait until recovery. That night, the patient tossed about, sweated profusely, traced clothes and bed with hands, knocked over lamps when smoking, dropped teapots when drinking tea, played erhu, sang songs, keeping everyone away. Soon, he removed his pants, fell on the bed, produced loud rattling phlegm sounds, and lay motionless. Family checked, and he had suddenly passed away.
I believe that in such cases of dual Yin-Yang collapse, prescribing medicine would invite suspicion of "quackery killing."
Male, 50 years old.
Phlegm-wheezing, breath compression, profuse sweating. Previously treated as Yang Collapse with large doses of Shenfu (Ginseng and Aconite). Six pulses were all sunken and forceful. I analyzed the pulse and symptoms of Yin vs. Yang collapse: Yang Collapse features flooding pulse, cold sweat, cold limbs, no thirst, anorexia, insomnia. Yin Collapse features warm sweat, warm limbs, ability to eat/sleep, slight thirst, sunken pulse with tight quality. There is a significant difference in severity between Yin and Yang collapse. This case was Yin Collapse, not Yang Collapse. The sweat was due to Yang being constrained externally; thus, sweating should be收敛 (consolidated/stopped). Prescription:
Xiaomai (Tritici Fructus) 1 sheng, Hongzao (Jujubae Fructus) 20 pieces, boiled in water to make concentrated juice to drink. Once sweating stopped, use herbs to consolidate Yang, clear phlegm, and descend fire, balancing Yin and Yang:
Nvzhenzi (Ligustri Lucidi Fructus), Longgu (Os Draconis), Muli (Concha Ostreae), Yuzhu (Polygonati Odorati Rhizoma), Shuditan (Rehmanniae Radix Preparata Carbonized), Shashen (Glehniae Radix), Yujin (Curcumae Radix), Chuanbai (Phellodendri Chinensis Cortex, salt-fried), Haifushi (Lithotrix), Maidong (Ophiopogonis Radix), Zhimu (Anemarrhenae Rhizoma, salt-fried), Gualouren (Trichosanthis Semen) each 2 qian, Wuweizi (Schisandrae Fructus) 0.5 qian, Zhuye (Bambusae Folium) 0.5 qian, Jingmi (Oryzae Semen) a pinch.
One dose: sweating decreased that night, no need to change clothes, but abdomen rumbled like thunder, followed by urination with large volume. Sweating stopped, slept soundly until dawn, feeling weak. Second dose: continuous flatulence in the afternoon, body felt hot, jumped up, walked outside, ate a wild melon, felt cool and comfortable, slept well.
Follow-up: Pulse neither excessive nor deficient, but Guan position fluctuated, indicating Stomach Qi not restored and Yin fluids scorched. Changed prescription:
Yuzhu (Polygonati Odorati Rhizoma), Nanshashen (Glehniae Radix), Biandou (Dolichi Lablabis Semen), Maidong (Ophiopogonis Radix), Nvzhenzi (Ligustri Lucidi Fructus), Bichengqie (Bergamii Fructus), Xianshengdi (Rehmanniae Radix Fresh), Gualouren (Trichosanthis Semen), Dongboku (Amomi Fructus Rotundus) each 2 qian, Jinchai Shihu (Dendrobii Nobile Caulis) 3 qian, Wuweizi (Schisandrae Fructus) 0.5 qian, Duanshigao (Gypsum Fibrosum Calcined) 3 qian, Yiyiren (Coicis Semen) 3 qian, Dongguaren (Benincasae Semen) 3 qian.
Instructed to take four doses. Noted: Yang Collapse requires warming resolution, Yin Collapse requires cooling resolution. Avoid warm tonification. Beware of sores and boils. Malaria may occur later (Yin-Yang connection requires prior chills and sweating). Outcome matched prediction.
(38) Aversion to Cold
Male, age unspecified.
Wearing cotton clothes in June. Took Fuzi (Aconiti Lateralis Radix Preparata), Shudi (Rehmanniae Radix Preparata), Renshen (Ginseng Radix), and Rong (Antler) for 50-60 doses with no effect. Asked for advice. I told him to eat dog meat; more is better. He ate three dogs, and it worked. Later, he asked why. I explained his condition was Wei Qi (Defensive Qi) weakness, without Yin-Yang imbalance, not Zang cold but Fu syndrome. Dog meat is purely Yang; dogs dig underground when cold, burying nose/mouth under belly, absorbing Earth Qi, resisting wind-cold. It possesses strong resistance.
Huang Mou, Male, 53 years old.
Depressed mood, tidal fever, or five-palm heat, occasional cough, wearing cotton in summer, little effect from medicine, worsening daily. One day, concubine demanded divorce and fees. Huang fainted from anger. Illness worsened: poor appetite, restless sleep, pacing, sitting/standing, avoiding conversation. Lasted over a year. Sent letter requesting consultation. I couldn't visit, so I sent the term "Tuoying" (Depletion of Ying). Huang understood. Later, he found it matched Baihe Bing (Lily Disease). He ate Lily powder and stir-fried lily daily, gradually improving.
(39) Labor Injury and Qi Collapse
Male, 20 years old.
Father died. Funeral preparations lasted 6-7 days without rest. During procession, cried bitterly, then collapsed. Family panicked, fearing "Double Mourning" omen. A Daoist priest shouted, "Today is Wushen/Yiyou, a Double Mourning day! How dare you bury?" Chaos ensued, blaming the Fengshui master. Someone suggested postponing ritual concerns to save life. Urgently summoned me. Patient: cold limbs, profuse sweating, eyes closed, mental fatigue, pale lips/tongue, aversion to sound, floating-rapid rootless pulse (still palpable), chest warm, heart beating slowly, damp sticky sweat in leg crotch, scrotum enlarged and drooping. Yin and Yang not yet separated. Prescribed Dushen Tang (Single Ginseng Decoction) to relieve emergency.
After two hours of ginseng decoction, sweating halved, limbs still cold. At four hours, used Huayang Fanben Fa (Restore Yang Return Method):
Heixi Dan (Black Tin Pill) 1 qian, delivered with ginseng soup. Taken again at eight hours.
Next day follow-up: sweating stopped, limbs warm. Patient held his crotch. Reluctantly revealed seminal emission. Suspected Gonorrhea; classmate confirmed history. Combined with previous symptoms, labor injury and collapse were clear. Collapse resolved after medicine, but Gonorrhea relapsed, indicating critical Yang deficiency with Yin encroachment. Prescription:
Longgu (Os Draconis), Muli (Concha Ostreae), Fupenzi (Rubigenae Fructus), Tusizi (Cuscutae Semen), Gouqi (Lycii Fructus), Danggui (Angelicae Sinensis Radix), Huaishan (Dioscoreae Rhizoma), Yubiao (Blennorrhagis Membrana), Sangpiaoxiao (Mantis Oötheca) each 2 qian, Shudi (Rehmanniae Radix Preparata) 3 qian.
Four doses: condition stabilized. Visited next day to thank me, mentioning pursuing the "Double Mourning" issue. I advised that health is blessing; seeking trouble causes unnecessary injury. Advised self-care and ignoring outsiders.
Male, 30 years old.
Mother died. Open coffin mourning lasted three days of chaos. Brothers disputed distribution of spirit axes. Patient became ill: lost spirit, confusion, scattered rootless pulse, blue face/spirit, coal-black nose, dilated pupils, critical signs everywhere. I dared not prescribe. Father-in-law wanted to move him home; I declined responsibility. Villagers thought it fatal. Moved home, exhausted by evening.
Li Mou, Male, 48 years old.
Carried earth for half a month, exposed to cold-damp. Sudden diarrhea. Self-medicated 4-5 doses ineffective. Returned home, collapsed on bed. Body not cold. Pants wet with water and stool. Wife suspicious, asked if he wanted tea. Requested hot tea. Tasted one sip, spat it out, uneasy. Next day craved meat. Cooked per request. Ate one bite, spat out, uneasy. Fourth day at Jiangqiao Clinic: sunken eyes, coma, dirty face, deep nostrils/eyes, rootless six pulses, brown tongue, open mouth/pursed lips, penile pain, aversion to cold, mental turmoil, unable to stand straight. Spleen-Kidney disconnect, extreme crisis. Diagnosed excessive labor injury with relapse transformation. Approaching Qi collapse, imminent death. Refused to prescribe. Advised buying Heixi Dan (Black Tin Pill) if medicine insisted. Refused hospitalization. Li glared, angrily ordered to be carried home. That night at 10 PM, profuse sweating, died silently.
I believe Li knew medicine, liked using Fuzi/Guizhi/Renshen/Rong. This case consumed much Fuzi, damaging Yuan Yang, compounded by sexual excess. Pulling penis suggests Yin Yi (Yin Transmission). With True Yang moving, Qi seizes instantly. Recorded for study of Shanghan Lun Yin-Yang transmission and female relapse.
Male, 50 years old.
Mental fatigue, loss. Doctor prescribed 40 doses. Took 20+ doses, no effect, appetite decreased, discarded medicine. Changed doctors multiple times, discarded all. Came to me directly, brought luggage, planned 10-day stay. Appearance haggard, mumbling, pulse <4 beats per breath, radial artery reversal inactive. Diet: little intake, tasteless, black stool. Vision yellow for sun/light. Tongue center yellow-hidden. Yellow sweat on forehead, armpits, chest. Diagnosed Tuoying Syndrome (Depletion of Ying), five Zang organs injured, no hope, difficult to prescribe. Hesitated to refuse abruptly. Evening, pressured to prescribe. Excused based on travel fatigue. Night: deliberated long. No vitality; random medication invites blame for misdiagnosis. Drafted Shenmai Tang (Ginseng and Ophiopogon Decoction), based on inactive pulse. If Shengmai (Generate Pulse) possible, proceed later. To save cost, replaced American Ginseng with Yuzhu (Polygonati Odorati Rhizoma).
Next day, one dose taken. Night: passed two segments of charcoal-colored stool. Follow-up unchanged, nose coal-black. Diagnosed five Zang organs extinct, hard to save. Advised son to return home quickly. Patient wept, asked for diagnosis name to check books. I said "Tuoying". Warned son of danger within ten days. Died of Qi collapse seven days after returning.
Note: Tuoying refers to former nobility now fallen, Ying Blood and Wei Qi failing to support each other. This case reaches Liver/Kidney, incomparable to treatable symptoms like seminal emission, dreams, dizziness, vertigo.
(40) Yin-Yang Transmission
Male, 35 years old.
Returned home for visit, cohabited with new wife for three nights. Attended relative's funeral, slept outdoors one night. On way back to province, caught heavy rain, clothes soaked. Felt unbearable cold-damp. That night, alternating chills and fever. Bedridden, dilated pupils, sunken eyes, emaciated, low voice, discontinuous breathing, dark complexion, chaotic pulse, spoke half sentence then silent, faint redness on neck, risk of floating Yang showing outward. Dared not prescribe. Colleagues dismissed me as country doctor. Consulted another doctor, prescribed Fangfeng Tongsheng San (Saposhnikovia Unblocking-Harmonizing Powder). Agitation worsened after taking. Wife asked me to prescribe; I refused. Another doctor prescribed Dachengqi Tang (Major Order the Qi Decoction). Condition worsened. Day 4: sent to Nanchang Hospital. Asked why I didn't prescribe. I said Yin-Yang Transmission, death within seven days. On seventh day, indeed died in hospital.
(41) Latent Summerheat, Heatstroke
Female, age unspecified