一产妇腰痛。腹胀善噫。诸药皆呕。立斋以为脾虚血弱。用白术一味炒黄。每剂一两。
米泔煎。时饮匙许。四剂后渐安。百余剂而愈。
震按腰痛而用白术。以所兼之证为腹胀善噫。诸药皆呕。则补肾不若补脾矣。时饮匙许
虑其呕耳。每剂一两。用至百剂。惟见得到。斯守得定。叶案每用米泔煎药本于此。他如
失血过多腰痛者。用归 汤、十全大补汤。瘀血腰痛者。桃仁汤、五香连翘汤。风湿腰痛者
五积散、寄生防风汤。
郭茂恂嫂金华君。产七日。不食。始言头痛。头痛已。又心痛作。既而目睛痛。如割如
刺。更作更止。相去无瞬息间。每头痛甚。欲取大石压。良久渐定。心痛作。则以十指抓
臂。血流满掌。痛定目复痛。又以两手自剜取之。如是十日不已。众医无计。进黑龙丹半粒
疾少间。中夜再服。乃瞑目寝如平时。至清晨下一行。约三升许。如蝗虫子。三夜减半。
已刻又行如前。则顿愈矣。
武叔卿曰。此虫咬痛。不如用杀虫药。更神效。
震按此证情形。定当作瘀血治。亦有因痰而痛者。不如是之剧。因虫则自此案始。
立斋治一产后中风。口眼 斜。四肢逆冷。自汗泄泻。肠鸣腹痛。用六君子加姜、附各
五钱。不应。以参、附各一两。始应。良久不服。仍肠鸣腹痛。复灸关元穴百余壮。及服十
全大补方效。
震按此种治法。惟薛公能之。若今人用参、附至四五钱不应。惟束手待毙耳。但不载脉
象若何。想诸虚寒证毕现。其脉之大小迟数不足计耶。
一位产妇出现腰痛。伴有腹胀、容易嗳气，服用各种药物都引发呕吐。薛立斋认为这是脾虚血弱所致，只用白术一味药，炒至微黄，每剂用量为一两。用米泔水煎煮，每次只让患者少量啜饮（约一汤匙）。服用四剂后症状逐渐缓解，服完百余剂后痊愈。
俞震按语：治疗腰痛却使用白术，是因为患者兼有腹胀、容易嗳气、服药即吐的症状，所以补肾不如补脾重要。每次只喝一小勺是担心引起呕吐。每剂用量一两，甚至用到百余剂，只有见识独到，才能坚守方药不变。叶天士医案中常用米泔水煎药，其本意就是源于此。其他如失血过多导致的腰痛，可用归芎汤、十全大补汤；瘀血导致的腰痛，可用桃仁汤、五香连翘汤；风湿导致的腰痛，可用五积散、寄生防风汤。
郭茂恂的嫂子金华君，产后七天，不能进食，起初说头痛。头痛停止后，又发作心痛。不久眼睛疼痛，感觉像刀割针刺一样，痛一阵停一阵，间隔极短没有片刻安宁。每当头痛剧烈时，想要找块大石头压住头部，过了很久才逐渐平静。心痛发作时，就用十指抓挠手臂，直到血流满手掌。痛止后眼睛又开始痛，又用双手挖抓自己的眼睛。这样持续了十天不见好转，众医生没有办法。喂服半粒黑龙丹，病情稍见缓和，半夜再服一次，这才闭上眼睛像平时一样入睡。到了清晨排出一行粪便，大约三升左右，形状像蝗虫卵。连续三天减半，刚过一刻钟又排出与前次相同的粪便，于是顿时痊愈了。
武叔卿说：这是虫子咬噬引起的疼痛，不如使用杀虫药，效果会更神奇。
俞震按语：这种病症的情形，应当作为瘀血来治疗。也有因痰饮致痛的，但没有如此剧烈。因为虫致痛是从这个医案开始的。
薛立斋治疗一位产后中风的病人，出现口眼歪斜，四肢逆冷，自汗出并伴有腹泻，肠鸣腹痛。使用六君子汤加干姜、附子各五钱，无效。改用人参、附子各一两，才开始见效。但过了一会儿不服药，又出现肠鸣腹痛。于是又灸关元穴一百多壮，随后服用十全大补汤才见效。
俞震按语：这种治疗方法，只有薛立斋能做到。如果现在的人用人参、附子用到四五钱无效，就只好束手待毙了。只是这里没有记载脉象如何，猜想应该是诸虚寒证全部显现，那么脉象的大小迟数就不值得计较了吗？
A postpartum woman suffered from lower back pain. She experienced abdominal distension and frequent belching, and vomited after taking various medicines. Xue Lizhai considered this to be due to Spleen deficiency and Blood weakness. He used only one herb, Atractylodis Rhizoma (Baizhu), stir-fried until slightly yellow, with each dose weighing one liang. It was decocted in rice washing water, and the patient was allowed to sip small amounts (about one spoonful) at a time. After four doses, symptoms gradually stabilized, and she recovered after more than a hundred doses.
Yu Zhen’s commentary: Treating lower back pain with Atractylodis Rhizoma is justified by the accompanying symptoms of abdominal distension, frequent belching, and vomiting upon medication intake; thus, tonifying the Spleen is preferable to tonifying the Kidney. The small sips were intended to prevent vomiting. Using one liang per dose, up to a hundred doses, requires both profound insight and steadfast adherence to the prescription. Ye Tianshi’s medical cases often use rice washing water for decoction, originating from this principle. For other cases, lower back pain caused by excessive blood loss can be treated with Danggui Dihuang Tang or Shiquan Dabu Decoction; lower back pain due to Blood stasis can be treated with Taoren Tang or Wuxiang Lianqiao Tang; and lower back pain due to Wind-Dampness can be treated with Wuji San or Jisheng Fangfeng Tang.
Guo Maoxun’s sister-in-law, Lady Jinhua, on the seventh day postpartum, could not eat. Initially, she complained of headache. After the headache subsided, heart pain ensued. Subsequently, her eyes became painful, feeling as if cut or pierced. The pain came and went repeatedly with very short intervals. When the headache was severe, she wished for a large stone to press down on her head; it took a long time for it to subside. When heart pain occurred, she scratched her arms with ten fingers until blood filled her palms. After the pain ceased, eye pain resumed, and she dug at her own eyes with both hands. This continued for ten days without improvement, and no physician had a solution. Administering half a pill of Heilong Dan alleviated the condition slightly. A second dose at midnight allowed her to close her eyes and sleep as usual. By early morning, she passed a stool, approximately three sheng in volume, resembling locust eggs. Over three nights, the amount decreased by half. Just after a quarter-hour interval, she passed stool again similar to before, and then she was suddenly cured.
Wu Shuqing stated: This pain is caused by worm bites. Using vermifuge herbs would be even more effective.
Yu Zhen’s commentary: Given the nature of this case, it should be treated as Blood stasis. There are also cases of pain due to Phlegm, but they are not as severe. Cases of pain caused by worms begin with this record.
Xue Lizhai treated a postpartum woman suffering from stroke, presenting with deviation of the mouth and eyes, cold extremities, spontaneous sweating, diarrhea, borborygmus, and abdominal pain. He prescribed Liujunzi Tang plus Ganjiang (Dried Ginger) and Fuzi (Prepared Aconite Root), each five qian, but there was no response. He then increased Ginseng Radix et Rhizoma (Renshen) and Prepared Aconite Root (Fuzi) to one liang each, which finally produced a response. However, when she stopped taking the medicine for a while, borborygmus and abdominal pain returned. Consequently, he moxa-burned the Guanyuan (CV4) acupoint over a hundred moxa cones, followed by the administration of Shiquan Dabu Decoction, which proved effective.
Yu Zhen’s commentary: Such treatment methods could only be employed by Dr. Xue. If modern physicians use Ginseng and Prepared Aconite Root up to four or five qian without effect, they would simply wait helplessly for death. However, since the pulse condition is not recorded, it is presumed that all signs of deficiency-cold were manifest, making the details of the pulse’s size, slowness, or rapidity negligible.