鸿胪苏龙溪,咳嗽气喘,鼻塞流涕,余用参苏饮一剂,以散寒邪,更用补中益气,以实胰理而愈。后因
劳怒仍作,自用前药益甚,加黄连、枳实,腹胀不食,小便短少,服二陈、四苓,前证愈剧,小便不通。余曰∶腹
胀不食,脾胃虚也;小便短少,肺肾虚也,悉因攻伐所致。投以六君加黄 、炮姜、五味,二剂,诸证悉退。
再用补中益气加炮姜、五味、数剂全愈。
地官李北川,每患咳嗽,余用补中益气即愈。一日复作,用参苏饮益甚,更服人参败毒散,项强口噤,
腰背反张。余曰∶此误汗亡津液而变痉矣,仍以前汤加附子一钱,四剂而痊。感冒咳嗽,若误行发汗过多,
喘促呼吸不利,吐痰不止,必患肺痈矣。
司厅陈国华,素阴虚,患咳嗽,以自知医,用发表化痰
之剂,不应,因清热化痰等药,其症愈甚。余曰∶此脾肺虚也。不信,用牛黄清心丸,更加心腹作胀,
饮食少思,足三阴虚症悉具。朝用六君、桔梗、升麻、麦冬、五味,补脾以生肺金;夕用八味丸,补命门以
生脾土,诸症渐愈。经云∶不能治其虚,安问其余?此脾土虚不能生肺金而金病,复用前药反泻其火,吾
不得而知也。
儒者张克明,咳嗽,用二陈、芩、连、枳壳,胸满气喘,清晨吐痰;加苏子、杏仁,口出痰涎,口干作渴。
余曰∶清晨吐痰,脾虚不能消化;饮食胸满气喘,脾虚不能生肺金;涎沫自出,脾虚不能收摄;口干作渴,
脾虚不能生津液。遂用六君加炮姜、肉果温补脾胃,更用八味丸以补土母而愈。
鸿胪寺官员苏龙溪,出现咳嗽、气喘、鼻塞、流涕的症状。我使用参苏饮一剂,以疏散寒邪;随后改用补中益气汤,以充实脾胃(注:原文“胰”通“脾”,指脾胃)之气,病情痊愈。后来因为劳累和发怒导致旧病复发,他自行服用之前的药物反而加重了病情,又加入黄连、枳实,导致腹胀、无法进食,小便短少。他又服用二陈汤、四苓散,之前的症状更加剧烈,甚至出现小便不通。我说:“腹胀不食,是脾胃虚弱;小便短少,是肺肾虚弱,这都是因为过度攻伐(使用泻下、清热等苦寒药物)所致。”于是投予六君子汤加黄芪、炮姜、五味子,两剂后,所有症状全部消退。再使用补中益气汤加炮姜、五味子,服用数剂后完全康复。
地官李北川,经常患咳嗽,我使用补中益气汤即可治愈。有一天病情复发,他使用参苏饮反而加重,又服用人参败毒散,出现颈部僵硬、牙关紧闭、腰背向后反张(角弓反张)。我说:“这是误用发汗法导致津液耗竭而转变为痉病(抽搐痉挛),仍然用前一种方剂(指补中益气类或针对虚证的方剂,此处语境暗示需温阳固本,结合后文加附子,实为温补阳气以救逆)加入一钱附子,服用四剂后痊愈。感冒咳嗽,如果误行发汗过多,导致喘促、呼吸不利、吐痰不止,一定会患上肺痈(肺部化脓性感染)。”
司厅官员陈国华,平素阴虚,患有咳嗽,因为他自认为懂医,使用发表化痰的药物,没有效果,于是改用清热化痰等药物,症状更加严重。我说:“这是脾肺虚弱。”他不相信,使用了牛黄清心丸,更加导致心腹部胀满,饮食减少且缺乏食欲,足三阴经(肝、脾、肾)的虚证症状全部具备。早晨使用六君子汤、桔梗、升麻、麦冬、五味子,通过补益脾胃来滋生肺金(土生金);晚上使用八味丸(即金匮肾气丸/桂附地黄丸),通过补益命门之火来滋生脾土(火生土),各种症状逐渐痊愈。《内经》说:“如果不能治疗其虚损,怎么能去问其他的实证呢?”这是因为脾土虚弱不能滋生肺金而导致肺病,又复用前面的寒凉药物反而泻伤了阳气(火),我真是不理解他的做法。
儒者张克明,患有咳嗽,使用二陈汤加上黄芩、黄连、枳壳,导致胸中胀满、气喘,清晨吐痰;又加入苏子、杏仁,导致口出痰涎、口干作渴。我说:“清晨吐痰,是脾虚不能消化水谷;饮食后胸满气喘,是脾虚不能滋生肺金;涎沫自行流出,是脾虚不能收摄津液;口干作渴,是脾虚不能生津液。”于是使用六君子汤加炮姜、肉豆蔻温补脾胃,再使用八味丸以补益脾土之母(肾阳),最终痊愈。
Su Longxi, an official of the Honglu Temple (Court of State Ceremonial), suffered from cough, asthma, nasal congestion, and runny nose. I administered one dose of Shensu Yin (Ginseng and Perilla Decoction) to disperse cold pathogens, followed by Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to strengthen the Spleen-Stomach Qi, resulting in a cure. Later, due to fatigue and anger, the condition relapsed. He self-medicated with the previous prescription, which exacerbated his symptoms. He added Huanglian (Coptidis Rhizoma) and Zhishi (Immature Bitter Orange Fruit), leading to abdominal distension, anorexia, and scanty urination. He then took Erchen Tang (Two-Cured Decoction) and Siling San (Four-Ingredient Powder), causing the prior symptoms to worsen significantly, culminating in urinary retention. I stated: "Abdominal distension and inability to eat indicate Spleen-Stomach deficiency; scanty urination indicates Lung and Kidney deficiency. All these are caused by excessive attacking and purging methods." I prescribed Liujunzi Tang (Six-Gentlemen Decoction) supplemented with Huangqi (Astragali Radix), Paojiang (Prepared Ginger), and Wuweizi (Schisandrae Fructus). After two doses, all symptoms subsided. Subsequently, using Buzhong Yiqi Tang with added Paojiang and Wuweizi for several doses led to complete recovery.
Li Beichuan, an official of the Diguan Bureau, frequently suffered from cough, which was cured each time I used Buzhong Yiqi Tang. One day, the condition recurred. He used Shensu Yin, which made it worse, and then took Renshen Baidu San (Ginseng and Detoxification Powder), resulting in neck stiffness, trismus (lockjaw), and opisthotonos (backward arching of the back). I said: "This is a transformation into Jing disease (spasm) due to erroneous sweating that depleted body fluids." I still used the previous decoction type, adding one qian of Fuzi (Aconiti Lateralis Radix Praeparata), and he recovered after four doses. Regarding colds and coughs, if excessive sweating is erroneously induced, leading to panting, difficult breathing, and incessant expectoration, it will inevitably lead to Fei Yong (Lung Abscess).
Chen Guohua, an official of the Siting Office, had a constitution of Yin deficiency and suffered from cough. Believing himself knowledgeable in medicine, he used exterior-releasing and phlegm-resolving agents without effect. He then switched to heat-clearing and phlegm-resolving drugs, which aggravated his condition. I stated: "This is Spleen-Lung deficiency." He did not believe me and used Niuhuang Qingxin Wan (Calculus Bovis Heart-Clearing Pill), which further caused epigastric and abdominal distension, reduced appetite, and manifested all symptoms of Foot Three Yin Meridian (Liver, Spleen, Kidney) deficiency. In the morning, I prescribed Liujunzi Tang with Jiegeng (Platycodonis Radix), Shengma (Cimicifugae Rhizoma), Maidong (Ophiopogonis Radix), and Wuweizi to tonify the Spleen to generate Lung Metal (Earth generates Metal); in the evening, I prescribed Bawei Wan (Eight-Ingredient Pill) to tonify the Mingmen (Gate of Life) to generate Spleen Earth (Fire generates Earth). His various symptoms gradually improved. The Classic states: "If one cannot treat the deficiency, how can one address the rest?" This is because Spleen Earth deficiency failed to generate Lung Metal, causing Lung pathology, and yet he reused the previous [cold/bitter] drugs, thereby draining the Fire. I could not comprehend his actions.
Zhang Keming, a scholar, suffered from cough. He used Erchen Tang combined with Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), and Zhike (Aurantii Fructus), leading to chest fullness, asthma, and morning expectoration. He then added Suzi (Perillae Fructus) and Xingren (Armeniace Semen), resulting in salivary froth discharge, dry mouth, and thirst. I stated: "Morning expectoration indicates Spleen deficiency failing to digest food; post-prandial chest fullness and asthma indicate Spleen deficiency failing to generate Lung Metal; spontaneous saliva flow indicates Spleen deficiency failing to control fluids; dry mouth and thirst indicate Spleen deficiency failing to generate body fluids." Consequently, I used Liujunzi Tang with Paojiang (Prepared Ginger) and Rouguou (Myristicae Semen) to warm and tonify the Spleen and Stomach, and subsequently used Bawei Wan (Eight-Ingredient Pill) to tonify the mother of Spleen Earth (Kidney Yang), leading to a cure.