邑中王××之女,年十五岁,于仲春得温病久不愈。
病因 仲春上旬,感受风温,医者延医失宜,迁延旬余,病益增剧,医者诿为不治,始延愚为诊视。
证候 心下胀满甚剧,喘不能卧,自言心中干甚,似难支持。其舌苔白而微黄。小便赤少,大便
从前滑泻,此时虽不滑泻,然仍每日下行。脉搏一息五至强,左部弦而有力,右部似大而有力,
然皆不任重按。
诊断 此其温病之热,本不甚剧。因病久真阴亏损致小便不利,所饮之水停于肠胃则胀满,迫
于心下则作喘。其心中自觉干甚,固系温病之热未清,亦足征其真阴亏损阴精不能上奉也
(《内经》谓阴精上奉,其人寿)。当滋其真阴,利其小便,真阴足则以水济火,而心中自然不干;
小便利则水从下消,而胀满喘促自愈。至于些些温病之余热,亦可皆随小便泻出而不治自愈矣。
处方 鲜白茅根去净皮及节间细根(六两锉碎),用水三大碗,煎一沸,俟半点钟,视其茅根
若不沉水底,再煎一沸,至茅根皆沉水底其汤即成。去渣当茶,徐徐温饮之。
效果 如法煎饮茅根两日,其病霍然全愈。盖白茅根凉润滋阴,
又善治肝肾有热,小便不利,且具有发表之性,能透温病之热外出。一药而三善备,故单用之而
能立建奇功也。然必剖取鲜者用之,且复如此煎法(过煎则无效)方能有效。
凡药之性,能利水者多不
能滋阴,能下降者多不能上升,能清里者多不能达表。惟茅根既善滋阴,又善利水,既善引
水气下行,又善助肾阴上升。且内清脏腑之热,外托肌表之邪,而尤善清肺利痰定其喘逆。
我县王先生的女儿,十五岁,在仲春时节患上温病,久治不愈。
病因:仲春上旬,感受风温之邪,医生诊治不当,拖延了十几天,病情日益加重,医生推诿说无法治疗,这才请我诊治。
证候:心下(胃脘部)胀满非常严重,气喘不能平卧,自述心中极度干燥,似乎难以支撑。舌苔白而微黄。小便短赤量少,大便从前滑泻,此时虽然不再滑泻,但每天仍有排便。脉搏一息五至以上,左脉弦而有力,右脉似大且有力,但都不耐重按。
诊断:这是温病的热邪本来并不剧烈。因为患病日久导致真阴亏损,致使小便不利,所饮入的水液停滞在肠胃中则引起胀满,压迫于心下则引发气喘。其心中自觉极度干燥,固然是温病的热邪未清,也足以证明真阴亏损,阴精不能上奉于口舌(《内经》说阴精上奉,人就能长寿)。应当滋补真阴,通利小便,真阴充足则以水济火,心中自然就不会干燥;小便利则水湿从下焦消退,胀满和喘促自然痊愈。至于那些微弱的温病余热,也可以随着小便排出而不治自愈。
处方:鲜白茅根去除干净外皮及节间的细根(六两切碎),用三大碗水,煎煮一沸,等待半小时,观察茅根若不沉入水底,再煎煮一沸,直到茅根全部沉入水底,汤剂即成。去渣当作茶,慢慢温热饮用。
效果:按照方法煎煮饮用白茅根两天,病霍然全愈。因为白茅根凉润滋阴,又善于治疗肝肾有热、小便不利,且具有发表的性质,能透发温病的热邪外出。一药具备三种优点,所以单用此药就能建立奇功。然而必须剖开取用新鲜的,并且采用这种煎法(煎煮过度则无效)才能有效。凡是药物的性质,能利水的多不能滋阴,能下降的多不能上升,能清里的多不能达表。只有白茅根既善于滋阴,又善于利水,既善于引导水气下行,又善于帮助肾阴上升。而且内清脏腑的热邪,外托肌表的邪气,尤其善于清肺利痰以定喘逆。
The daughter of Mr. Wang in my county, aged fifteen, contracted a warm disease (Wen Bing) in mid-spring that failed to resolve after a long period.
Etiology: In the early days of mid-spring, she was affected by wind-warmth (Feng Wen). The attending physicians provided inappropriate treatment, allowing the condition to linger for over ten days, during which it worsened significantly. The doctors declared it incurable and referred her to me.
Symptoms: Severe distension and fullness in the epigastrium (Xin Xia), accompanied by panting so severe that she could not lie flat. She reported extreme dryness in the heart region, feeling as though she could barely sustain herself. Her tongue coating was white with a slight yellow tint. Urine was scanty and dark red. Previously, she had suffered from slippery diarrhea; although this had ceased, she still passed stool daily. The pulse beat five times per respiration or more. The left pulse was wiry and forceful, while the right pulse appeared large and forceful, yet neither could withstand heavy pressure.
Diagnosis: The heat pathogen of the warm disease was originally not severe. However, due to prolonged illness causing depletion of True Yin (Zhen Yin), urination became difficult. The ingested water stagnated in the intestines and stomach, causing distension, and pressed upon the epigastrium, inducing panting. The sensation of extreme dryness in the heart region is indeed due to residual heat from the warm disease, but it also evidences the depletion of True Yin, where Yin essence fails to ascend (as stated in the *Nei Jing*, when Yin essence ascends, longevity is achieved). The treatment should focus on nourishing True Yin and promoting diuresis. When True Yin is sufficient, Water will control Fire, and the heart dryness will naturally resolve; when urination becomes free, water dampness will dissipate downward, and distension and panting will heal spontaneously. Any remaining mild heat from the warm disease can be expelled through urine and resolve without further specific treatment.
Prescription: Fresh Rhizoma Imperatae (Ba Mao Gen), peeled and cleaned of fine roots at the nodes (six liang, chopped), boiled in three large bowls of water until boiling once. Let stand for half an hour. If the rhizome does not sink to the bottom, boil again until all pieces sink. The decoction is then ready. Strain and drink as tea, slowly and warm.
Outcome: Following this method for two days, she recovered completely. Rhizoma Imperatae is cool, moistening, and nourishes Yin; it is effective for heat in the Liver and Kidney with difficult urination, and possesses dispersing properties that allow it to vent warm disease heat outward. This single herb combines three beneficial actions, thus achieving remarkable results when used alone. It must be fresh and prepared specifically as described (over-boiling renders it ineffective). Generally, herbs that promote diuresis often fail to nourish Yin; those that descend rarely ascend; those that clear interior heat rarely reach the exterior. Only Rhizoma Imperatae both nourishes Yin and promotes diuresis, guides water Qi downward, and assists Kidney Yin upward. Furthermore, it clears internal organ heat externally while expelling exterior pathogens, and is particularly effective in clearing Lung heat, resolving phlegm, and arresting panting.