川王病,得之沐发未干而卧,蹶上为重,头痛身热,使人烦懑。臣意即以寒水拊其头,
刺足阳明脉,左右各三所,痛渐已。
寒水有反激力足以使热从上出。针刺有温泻力,足以使风从下泄。下泄则心懑除,上出
则头痛止,不用汤药,盖亦可治病也。(樊阿注)
宋建弄石不能起,即复置之,暮腰脊痛,不得溺。臣意见其色,太阳色干,肾部上及腰
以下,枯四分所,故以往四五日,知其发也。臣意即为柔汤服之,十八日所而痛愈。又曰∶
不亟治,痛即入濡肾,及其未舍(居也)五脏,急治之。病方今客濡肾(即肾外膜濡湿处也),
此所谓肾痹也。
柔汤即阳和汤,流畅血脉,化滞去瘀,此汤肆中人皆知,何经十八日始愈?因阳数止于
九,九九相生,则阳复矣。吾谓吾师有胆,仓公有识。(樊阿注)
济北王侍者韩女病,腰背痛寒热。众医皆以为寒热也,诊其脉时切之肾脉也,涩而不属,
故
吾师有四物女宛丸,专治女病。意药当不外此。可笑众医以此症为寒热,吾不知其用常
山、柴胡、草果仁乎?抑同鳖甲、龟胶乎?(樊阿注)
临 汜里女子薄吾,病蛲瘕。蛲瘕为病,腹大,上肤黄粗,循之戚戚然(动貌)。臣意
饮以芫花一撮,即出蛲可数升,病已,三十日如故。病蛲得之于寒湿,寒湿气宛笃不发。化
为虫,其色泽者,中脏无邪气及重病也。
凡寒湿虽居阴,亦喜外出。蛲成于寒湿,其性亦然。故遇芫花引吐而大出,众医以此病
为寒热笃,当死不治,可笑也夫。(樊阿注)
齐王患病,是因为洗头后头发未干就躺下睡觉所致。病势上逆且严重,出现头痛、身体发热,使人心中烦闷不安。我(淳于意)随即用冷水拍打他的头部,针刺足阳明胃经的穴位,左右各三处,疼痛逐渐缓解。
冷水具有反激之力,足以使热邪从上部排出。针刺具有温通泻实之力,足以使风邪从下部泄出。风邪从下部泄出则心胸烦闷消除,热邪从上部排出则头痛停止。不使用汤药,大概也可以治愈疾病。(樊阿注)
宋建举石用力过猛未能举起,随即放下石头,傍晚时腰脊疼痛,小便不通畅。我观察他的面色,太阳经部位色泽干枯,肾部上方及腰部以下,枯槁程度约为四分之一,因此推断这是过去四五天内发作的疾病。我为他服用柔汤,十八天后疼痛痊愈。又说:如果不迅速治疗,疼痛就会深入濡养肾脏的部位,趁其尚未留驻于五脏,应紧急治疗。此时病邪正客居于濡肾(即肾脏外部濡湿之处),这被称为肾痹。
柔汤即阳和汤,能流畅血脉,化解停滞、去除瘀血,这种汤剂在四市中的人都知道,为何要十八天才痊愈?因为阳数止于九,九九相生,阳气便恢复了。我认为我的老师有胆识,仓公有见识。(樊阿注)
济北王的侍者韩女患病,表现为腰痛、背痛、怕冷和发热。众医生都认为是寒热病,诊察她的脉象时,切到的肾脉涩滞且不连贯,所以我老师有四物女宛丸,专门治疗女性疾病。我想用药应当不外乎此。可笑众医生将此症当作寒热病,我不知道他们是用常山、柴胡、草果仁呢?还是用鳖甲、龟胶呢?(樊阿注)
临淄汜里的女子薄吾,患有蛲瘕病。蛲瘕这种病,腹部胀大,皮肤发黄粗糙,用手抚摸时有震动感(动貌)。我让她服下一撮芫花,随即排出蛲虫可达数升,病就好了,三十天后恢复如常。蛲瘕病是由于寒湿引起的,寒湿气郁结深重而不发,化为虫。其色泽正常者,说明内脏无邪气及重病。
凡是寒湿虽然居于阴位,但也喜欢向外发散。蛲虫生于寒湿,其性质也是如此。所以遇到芫花引吐而大量排出,众医生认为此病是严重的寒热病,将会死亡无法治愈,真是可笑啊!(樊阿注)
King of Qi fell ill because he lay down to sleep with wet hair after washing it. The pathological qi ascended severely, causing headache and body heat, making the patient feel vexed and depressed. I (Chunyu Yi) immediately applied cold water to his head, acupunctured the Foot-Yangming Meridian at three points on each side, and the pain gradually subsided.
Cold water has a counter-irritant force sufficient to expel heat from the upper part. Acupuncture has a warming and draining force sufficient to vent wind from the lower part. When vented from below, chest oppression is relieved; when expelled from above, headache ceases. Without using herbal decoctions, it is possible to cure the disease. (Commentary by Fan A)
Song Jian exerted himself lifting a stone but failed to raise it, then put it down. In the evening, he suffered from lower back and spine pain and urinary retention. I observed his complexion: the Taiyang area was dry and dull, and the area above the Kidney region extending down to the waist showed signs of withering, approximately one-quarter in degree. Therefore, I deduced that the disease had originated four or five days prior. I administered Rou Tang (Softening Decoction) to him, and the pain healed after eighteen days. Furthermore, if not treated promptly, the pain would penetrate into the Ru-Shen (Moistening-Kidney area). While it has not yet settled in the Five Zang Organs, urgent treatment is required. Currently, the pathogenic factor resides in the Ru-Shen (the moist area outside the Kidney), which is referred to as Kidney Bi (Kidney Obstruction Syndrome).
Rou Tang is also known as Yanghe Tang (Yang-Nourishing Decoction), which promotes blood circulation, resolves stagnation, and removes blood stasis. This decoction is well-known among people in the marketplaces. Why did it take eighteen days to heal? Because the number of Yang terminates at nine; nine times nine generates mutual generation, thus restoring Yang. I believe my teacher possessed courage, and Cang Gong possessed insight. (Commentary by Fan A)
Han Nu, a female attendant of the King of Jibei, suffered from lower back pain, back pain, chills, and fever. Most physicians diagnosed it as a Chaine-Recurrent Fever pattern. Upon palpating her pulse, the Kidney pulse was choppy and discontinuous. My teacher possesses Siwu Nüwan Wan (Four-Ingredient Pill for Women's Diseases), specifically treating female ailments. I surmise the medication should fall within this category. It is laughable that these physicians diagnosed this syndrome as Chaine-Recurrent Fever; I wonder if they used Changshan (Radix Dichroae), Chaihu (Radix Bupleuri), and Caoguoren (Semen Tsaoko)? Or perhaps they used Biejia (Carapax Trionycis) and Guijiao (Colla Corii Asini)? (Commentary by Fan A)
Bo Wu, a woman from Sili in Linzi, suffered from Sao Jia (Ascaris Mass). Sao Jia presents with abdominal distension, yellowish and rough skin on the abdomen, and a trembling sensation upon palpation. I administered Yuanhua (Flos Genkwa) in a dose of one tuocuo (approx. 2-3 grams), resulting in the expulsion of several sheng (volume unit) of ascarides. The disease was cured, and she recovered fully after thirty days. Sao Jia arises from Cold-Dampness. When Cold-Damp qi accumulates deeply without manifesting externally, it transforms into parasites. If the complexion remains lustrous, it indicates no evil qi or severe disease within the Zang Organs.
Although Cold-Dampness resides in Yin positions, it tends to favor outward dispersal. Ascarides born of Cold-Damp share this nature. Thus, encountering Yuanhua induces vomiting and massive expulsion. Other physicians believed this disease was a severe Chaine-Recurrent Fever pattern destined for death and incurability, which is truly ridiculous. (Commentary by Fan A)