阳虚候,时(名也)病得之内,众医皆以为蹶。臣意诊脉以为痹。根在右胁下大如覆杯,
令人喘逆气,不能食。臣意即以火齐粥,且饮六日,气下,即令更服丸药。出入六日,病已。
予治一人腹下坚痞,大如覆杯,不痛肿,惟气逆,病得之暮年纳外家。投以黄 、熟地、
党参,气下痞消即此类也。(樊阿注)
成开方病,得之数饮酒以见大风气,苦沓风三岁,四肢不能自开,使人喑,喑即死。
酒后受大风,渐入于内,发热口燥,至四肢不能用,经络病矣。至于失音,肺气绝矣。
酒有发酵力,最伤脑与肺,观此沓风,当知所戒。(樊阿注)
项处病牡疝,牡疝在膈下,上连肺,病得之内(即上腹下坚痞大如覆杯是也)。臣意谓
之∶“慎毋为劳力事,为劳力事则必呕血死。”处后蹴 ,腰蹶寒,汗出多即呕血死。
牡疝之成,由肾气虚,劳力则汗出,肺气不能制,因呕血。凡成横 者,亦牡疝之类也。
第地位较牡疝又为下耳。戒之在色,人何忽诸。(樊阿注)
文王病喘,头痛,目不明。臣意心论之∶以为非病也,以为肥而蓄精,身体不得摇,骨
肉不相任,故喘。不当医治。脉法曰∶“年二十,脉气当趋;年三十,当疾步;年四十,当
安坐;年五十,当安卧;年六十以上气当大董。”文王年未满二十,方脉气之趋也而徐之。
不应天道四时。后闻医灸之,即笃。此论病之过也。臣意论之∶以为神气争而邪气入,非年
少所能复之也,以故死。所谓气者,当调饮食,择宴日,车步广志,以适筋骨肉血脉,以泻
气。故年二十,是谓“易 。”法不当砭灸,砭灸至气逐。
头痛目不明,湿重可知,阴虚亦可知。湿重之人,大可砭灸,惟阴虚则不可灸,况又病
喘,灸固不宜。若以年龄拘,则世有下胎而灸,婴得不免者,将何说哉?(樊阿注)
阳虚证候,这种病是内伤所致,众医生都认为是厥证。我诊察脉象后认为是痹证。病根在右胁下,肿大如倒扣的杯子,导致人气喘逆气,不能进食。我便用火齐粥治疗,连续服用六日,气机下行,随即令其改服丸药。又经过六日,病就好了。
我曾治疗一人,腹下坚硬痞块,大如倒扣的杯子,不痛不肿,只有气逆症状,此病得之于晚年纳妾纵欲。投以黄耆、熟地黄、党参,气机下行,痞块消散,属于此类情况。(樊阿注)
成开方患病,因多次饮酒并感受大风邪气,患苦沓风三年,四肢不能自主活动,使人失音,失音则死。酒后受大风侵袭,病邪逐渐深入体内,发热口燥,直至四肢无法使用,经络已病。至于失音,说明肺气已绝。酒具有发酵之力,最损伤脑与肺,观察这例沓风病,应当知道戒除酗酒。(樊阿注)
项处患牡疝,牡疝位于膈下,向上连及肺部,此病为内伤所致(即上腹部坚硬痞块大如倒扣的杯子)。我对他说:“务必不要从事劳累体力的工作,如果从事劳累体力工作,必定会呕血而死。”项处后来踢球,腰部受寒,出汗多,随即呕血而死。牡疝的形成,是由于肾气虚弱,劳累则汗出,肺气不能制约,因而呕血。凡是形成横疝的,也属于牡疝之类,只是部位比牡疝更靠下罢了。戒色欲,人们为何忽视呢?(樊阿注)
文王患喘症,头痛,眼睛视物不清。我用心法推演分析:认为这不是疾病,而是因为他身体肥胖且蓄积精气,身体缺乏运动,骨肉不相称任,所以喘息。不应当进行医治。脉法说:“二十岁,脉气应当趋向旺盛;三十岁,应当快步走;四十岁,应当安坐;五十岁,应当安卧;六十岁以上,气应当大盛。”文王年龄未满二十岁,正是脉气趋向旺盛的时候,却行动迟缓。这不顺应天道四时的规律。后来听说医生给他施灸,病情加重。这是论断疾病的错误之处。我进一步分析认为:神气争斗而邪气侵入,不是年轻人所能恢复的,因此死亡。所谓调气,应当调节饮食,选择适宜的日子,扩大车马步行的范围,以舒展筋骨肌肉血脉,以泄泻多余之气。所以二十岁,称为“易壮”。依法不应当使用砭石和艾灸,砭灸会导致气机散乱。
头痛目不明,可知湿气重,阴虚也可知。湿气重的人,大可施用砭石,但阴虚则不可艾灸,况且又患喘症,艾灸本来就不适宜。如果拘泥于年龄,那么世间有给胎儿施灸的,婴儿难免受害,那又作何解释呢?(樊阿注)
Yang deficiency syndrome, this illness originates from internal injury. Most physicians considered it to be Jue syndrome (Cold extremities and collapse). I diagnosed the pulse and determined it was Bi syndrome (Obstruction syndrome). The root of the disease was located under the right hypochondrium, swollen like an inverted cup, causing wheezing and rebellious Qi, and inability to eat. I treated him with Huoqi Zhou (Fire-Heated Porridge), administered for six days, after which the Qi descended. Subsequently, I instructed him to take pill medicine. After another six days, the disease was cured.
I once treated a patient with a hard mass in the lower abdomen, large as an inverted cup, without pain or swelling, only with rebellious Qi. This illness resulted from excessive sexual activity in late life. I prescribed Huangqi (Astragali Radix), Shudi (Rehmanniae Radix Preparata), and Dangshen (Codonopsis Radix). After the Qi descended and the mass dissipated, it fell into this category. (Commentary by Fan A)
Cheng Kaifang suffered from illness due to frequent alcohol consumption followed by exposure to strong wind pathogens. He suffered from Ta Feng (Cumulative Wind) for three years, resulting in limbs that could not move voluntarily and aphonia (loss of voice). Aphonia leads to death. After drinking, he was exposed to strong wind, and the pathogen gradually entered internally, causing fever and dry mouth, until the limbs became unusable, indicating meridian pathology. The loss of voice signifies the exhaustion of Lung Qi. Alcohol has fermentative properties and most damages the brain and lungs. Observing this case of Ta Feng, one should know to exercise caution. (Commentary by Fan A)
Xiang Chu suffered from Mu Shan (Male Hernia). Mu Shan is located below the diaphragm, connecting upward to the Lungs. This illness results from internal injury (specifically, a hard mass in the upper abdomen large as an inverted cup). I told him: "Be careful not to engage in strenuous labor. If you do, you will certainly vomit blood and die." Later, Xiang Chu played football (Cuju), his waist became cold, he sweated profusely, and subsequently vomited blood and died. The formation of Mu Shan is due to Kidney Qi deficiency. Strenuous labor causes sweating, and Lung Qi fails to control it, leading to vomiting of blood. Any condition forming Heng Shan (Horizontal Hernia) belongs to the same category as Mu Shan, merely located lower than Mu Shan. Guard against lust; why do people neglect this? (Commentary by Fan A)
King Wen suffered from asthma (Chuan), headache, and blurred vision. I analyzed this using Heart-mind theory: I believed it was not a pathological disease, but rather due to obesity and accumulated essence. His body lacked movement, and flesh and bone were unbalanced, causing asthma. It did not require medical treatment. The Pulse Method states: "At twenty, Qi should be vigorous; at thirty, one should walk briskly; at forty, one should sit calmly; at fifty, one should lie down comfortably; above sixty, Qi should be abundant." King Wen was under twenty, when Qi should be vigorous, yet he moved slowly. This did not accord with the Heavenly Dao and the four seasons. Later, I heard that doctors applied moxibustion, causing his condition to worsen. This was an error in disease analysis. My further analysis concluded: Shen Qi (Spiritual Qi) contended while evil Qi invaded; this was not recoverable for a young person, hence death. To regulate Qi, one should adjust diet, choose appropriate times, increase walking and carriage travel to benefit sinews, bones, muscles, and blood vessels, thereby draining excess Qi. Thus, at twenty, one is called "Yi Zhuang" (Easily Strong). According to method, Bian stone (Bian shi) and moxibustion should not be used, as they cause Qi to scatter.
Headache and blurred vision indicate heavy Dampness and Yin deficiency. For those with heavy Dampness, Bian stone therapy is suitable, but for Yin deficiency, moxibustion is contraindicated. Moreover, with asthma present, moxibustion is indeed inappropriate. If one strictly adheres to age, there are cases of moxibustion applied to fetuses, harming infants. What would be the explanation then? (Commentary by Fan A)