石膏(一味,细末如面,每夕新汲水服方寸匕,取身无热为度。)
热劳,附骨蒸热,四肢微瘦,有汗脉长者,此方主之。
热劳之证,岂曰尽属阴虚,亦有阳邪外袭,传入于骨,不能泄越,内作骨蒸,令人先寒
后热,久久渐成羸瘦。有汗者,胃家实也。脉长者,阳邪证也。石膏寒而清肃者也,可以疗
里热。以故《外台》集之,处州吴医用之,睦州郑迪功之妻验之,《名医录》载之,所以开
蒙后学也至矣。或问∶东垣言血虚身热,证象白虎,误服白虎者必死,非石膏之谓乎?余曰∶
若
劳瘵脉数,燥渴日瘦者,宜服之。盖天一生水,所以养万物者也,若火盛而水灭,令人
五液干枯,则甘梨浆可以急救之。此物匪惟可以救急,曾有回生起死者。师云∶生用之可以
凉五火,熟用之可以滋五脏。
咳血者,以童便一物主之。
咳血是肺中有窍。肺是清虚之脏,纤芥不容,一有其窍,则血渗入肺矣。愈渗愈咳,愈
咳愈渗,此为难治。褚澄云∶以寒凉治之,百不一生。以溲溺治之,百不一死。故特表而出
之。又曰∶血虽阴类,运之者其和阳乎!所以示人者深矣。
割股之事,古昔有之。盖贤妇急于舅姑夫子之疾,而祈一念以格天尔。至唐开元间,陈
藏器撰《本草拾遗》云∶人肉治瘵疾。自是闾阎益多割股,至有假名干誉而为之者。呜呼!
同类固不可食,亏体岂曰事亲?且俞、扁、淳、华,上世神良之医也,未闻用人肉以治疾,
而闵损、曾参之孝,亦未尝割股,所以来要名之行者,藏器其作之矣。
石膏(单味药,研成细粉如面粉状,每晚用刚打来的井水送服一方寸匕的量,以身体不再发热为停止用药的标准。)
热劳病,表现为附骨蒸热、四肢略微消瘦、有汗且脉象长,此方主治。
热劳这种病症,难道说完全属于阴虚吗?也有阳邪从外部侵袭,传入骨骼,无法宣泄发散,在体内形成骨蒸热,使人先感到寒冷随后发热,久而久之逐渐变得消瘦羸弱。有汗出的,是胃家实热的表现。脉象长的,是阳邪证的特征。石膏性寒凉而具有清肃作用,可以治疗里热证。因此,《外台秘要》收录了此方,处州的吴医生使用它有效,睦州的郑迪功的妻子验证过它的疗效,《名医录》也记载了它,这用来启发蒙昧的后学弟子,意义深远了。有人问:李东垣曾说血虚导致的身热,症状像白虎汤证,误服白虎汤的人必定死亡,说的不是石膏吗?我回答说:如果是劳瘵病,脉象数急,口干燥渴,日渐消瘦的患者,适宜服用石膏。盖因天一生水,水是滋养万物的物质,如果火气旺盛而水被熄灭,使人五脏津液干枯,那么甘甜的梨汁浆可以急救这种情况。石膏不仅可用于急救,曾有起死回生的案例。老师说:生用石膏可以清除五脏之火,熟用石膏可以滋养五脏。
咳血是因为肺中有孔隙。肺是清虚的脏器,连细微的尘埃都不能容纳,一旦有了孔隙,血液就会渗入肺中。渗得越多咳嗽越厉害,咳嗽越厉害渗出越多,这是难以治疗的病症。褚澄说:用寒凉药物治疗,一百个病人没有一个能活;用尿液治疗,一百个病人没有一个会死。所以特意提出并阐明这一点。又说:血虽然属于阴类,但推动运行血的应该是调和的阳气啊!这其中的深意在于以此警示人们。
割取大腿肉这件事,古代就有。大概是贤惠的妻子急于救治公婆和丈夫的疾病,希望通过一念之诚来感动上天。到了唐代开元年间,陈藏器撰写《本草拾遗》说:人肉可以治疗劳瘵病。从此民间割股疗亲的行为越来越多,甚至有人假借名义追求名誉而这样做。唉!同类之肉固然不可食用,损害身体怎么能说是侍奉双亲呢?况且俞跗、扁鹊、淳于意、华佗,都是上古时期神奇良善的医生,没听说过用人肉来治病;闵损、曾参的孝行,也从未有过割股的行为。那些以此来博取名声的行为,是陈藏器开创的风气。
Shigao (Gypsum Fibrosum) [1] (Single herb, ground into a fine powder like flour. Each evening, take one *cunfang bi* [2] with freshly drawn well water. Stop when the body temperature returns to normal.)
For *Rela* [3] presenting as deep-seated steaming bone fever, slight emaciation of the four limbs, sweating, and a long pulse, this formula is indicated.
Regarding the syndrome of *Rela*, can it be said that it entirely belongs to Yin deficiency? There are also cases where Yang pathogenic factors invade from the exterior, penetrate into the bones, fail to vent and disperse, and internally generate steaming bone fever, causing the patient to first feel cold and then hot. Over time, this gradually leads to emaciation. The presence of sweating indicates excess heat in the Stomach organ system [4]. A long pulse indicates a Yang pathogenic factor syndrome. Shigao (Gypsum Fibrosum) is cold and possesses clearing and purifying properties; it can treat interior heat syndromes. Therefore, *Waitai Mi Yao* [5] collected this formula. It was used effectively by physicians in Chuzhou, verified by the wife of Zheng Digong in Mozhou, and recorded in *Mingyi Lu* [6]. This serves to enlighten later students of medicine profoundly. One might ask: Li Dongyuan stated that body heat due to Blood deficiency resembles the Baihu Tang [7] syndrome, and those who mistakenly take Baihu Tang will surely die; does this not refer to Shigao? I reply: If the patient suffers from *Laozai* [8], with a rapid pulse, dryness, thirst, and daily emaciation, they are suitable for taking Shigao. As "Heaven generates Water at One," Water nourishes all things. If Fire is excessive and extinguishes Water, causing the fluids of the Five Zang organs to dry up, sweet pear juice can serve as an emergency rescue. This substance is not only useful for emergencies but has also been known to restore life from death. The Master said: Using it raw can cool the Five Fires; using it cooked can nourish the Five Zang organs.
Hemoptysis [9] is treated primarily with Tongbian [10] (Child's urine).
Hemoptysis occurs because there are openings in the Lung. The Lung is a clear and empty organ that tolerates no impurities whatsoever. Once such openings exist, blood seeps into the Lung. The more it seeps, the more the coughing; the more the coughing, the more it seeps. This is difficult to treat. Chu Cheng stated: "If treated with cold and cooling herbs, fewer than one in a hundred survives. If treated with urine, fewer than one in a hundred dies." Thus, I specifically highlight and elucidate this point. Furthermore, he said: Although Blood belongs to the Yin category, what moves it must be harmonious Yang Qi! The implication here is profound.
The act of cutting flesh from the thigh exists since ancient times. It stems from virtuous wives being anxious about the illnesses of their parents-in-law and husband, hoping that a single sincere thought could move Heaven. During the Kaiyuan era of the Tang Dynasty, Chen Cangqi compiled *Bencao Shiyi* [11], stating: "Human flesh treats *Zhaiji* [12]." Since then, the practice of cutting thigh flesh among the common people increased significantly, with some even doing so under false pretenses to seek fame. Alas! Flesh of the same kind should certainly not be eaten; how can damaging one's body be considered serving one's parents? Moreover, Yu Fu, Bian Que, Chunyu Yi, and Hua Tuo were divine and excellent physicians of antiquity; it is unheard of that they used human flesh to treat diseases. Similarly, the filial piety of Min Sun and Zeng Shen did not involve cutting flesh. Those who perform such acts to solicit reputation, Chen Cangqi initiated this trend.
[1] Shigao (Gypsum Fibrosum): A mineral drug used to clear heat and purge fire.
[2] *Cunfang bi*: An ancient measuring spoon, roughly equivalent to a tablespoon.
[3] *Rela*: A chronic wasting disease characterized by fever, often associated with tuberculosis or severe chronic infections.
[4] Stomach organ system: Refers to the Stomach channel and its functional system in TCM.
[5] *Waitai Mi Yao*: "Essential Prescriptions Worth a Thousand Gold for Emergencies," a famous medical compendium by Wang Tao.
[6] *Mingyi Lu*: "Records of Famous Physicians," a historical text on medical practitioners.
[7] Baihu Tang (White Tiger Decoction): A classic formula for clearing intense heat.
[8] *Laozai*: Tuberculosis or chronic consumptive disease.
[9] Hemoptysis: Coughing up blood.
[10] Tongbian: Urine from a healthy prepubertal boy, used in traditional medicine for cooling blood and stopping bleeding.
[11] *Bencao Shiyi*: "Supplement to Materia Medica" by Chen Cangqi.
[12] *Zhaiji*: Another term for *Laozai* or tuberculosis.