陈 十五岁 乙丑六月二十五日 病久阴伤已极,骨瘦如柴,又加卒然中暑,中热气,
舌绛芒
刺,唇干液涸,无怪乎痉厥神昏,十指蠕动,危险之至。以脉尚浮弦而芤,勉与一面大队填
阴,兼咸以止厥法。先与紫雪丹二钱,凉水和服,共服六钱。
白芍(五钱) 细生地(三钱) 犀角(五钱) 羚角(三钱) 麻仁(二钱) 炙甘草(二钱)
阿胶(三钱) 生鳖甲(五钱) 牡蛎(五钱)
浓煎,缓缓服。
二十八日 神识未清,间有谵语。
炙甘草(六钱) 麦冬(八钱,连心) 真大生地(八钱) 生鳖甲(五钱) 阿胶(三钱) 麻
仁(三钱) 犀角(五钱) 生白芍(五钱)
七月初一日 邪少虚多,用复脉已当,但舌上黑苔未化,宿粪未见,兼加润法。
生白芍(六钱) 炙甘草(四钱) 麦冬(六钱) 真大生地(八钱) 阿胶(三钱) 麻仁(五
钱) 犀角(五钱) 生鳖甲(六钱) 元参(二两)
煮成三杯,分三次服。
初五日 服前药五帖,见宿粪碗许,黑苔已化,但神识尚未十厘清楚,用三加复脉加犀
角,即于三甲复脉汤内,加∶
犀角(四钱)
初八日 神识仍未清楚,汤药照前,间服牛黄丸三丸。
陈 三岁 九月十六日 燥气化火,壮热,舌黄,脉数,螈 而厥,法宜清凉解肌,切
忌发表。
薄荷(二钱) 羚角(三钱) 杏泥(四钱) 连翘(六钱,连心) 银花(八钱) 丹皮(三钱)
生甘草(二钱) 牛蒡子(三钱) 苦桔梗(六钱) 黄芩(二钱)
共为粗末,分五包,一时许服一包。芦根汤煎,去渣服。
十七日 燥气化火,身壮热,渴甚,于前方内加 石膏、炒知母、麦冬,去牛蒡、薄荷
、丹皮、羚羊。
石膏(五钱) 炒知母(钱半) 麦冬(二钱,连心) 细生地(二钱) 银花(二钱) 连翘
(二钱,连心) 苦桔梗(一钱) 生甘草(八分) 杏仁(一钱) 黄芩(一钱)
岳 八个月 六月二十八日 未及岁之儿,瘟毒头肿,螈 而厥,壮热气促,脉及数大
。恐
真阴不胜阳邪,先以普济消毒饮宣毒外出,必去升麻、柴胡之直升少阳阳明者,加犀角、羚
羊、泻心胆之热。
连翘(六钱) 大力子(六钱) 薄荷(二钱) 人中黄(二钱) 苦桔梗(三钱) 芥穗(二钱)
元
参(五钱) 马勃(三钱) 天虫(三钱) 银花(六钱) 鲜荷叶(一张) 鲜芦根(一两,煎汤代
水)
共为细末,分八包,一时许服一包。
犀角(四钱) 羚羊角(四钱,另包不必研)
于前药每包加五分同煎。
吴 三岁 六月初九日 辰刻以跌扑惊后螈 ,至戌正始醒,醒后身大热,口渴,脉数
,舌无苔,用复脉汤六帖。热退脉静,又服二帖而安。
尹 十五岁 卒中暑风螈 口歪,四肢抽掣,头微痛,与清少阳胆络法。
羚角 连翘 生甘草 桑叶 薄荷 苦桔梗 茶菊 银花 钩藤 丹皮
五帖全愈。
百 五岁 痘后余邪,入少阳阳明二络,但唇口与眼皮螈 ,致饮食不能收合,每从口
张时随落出,四肢不掣,与清二经之络法。
苦桔梗 丹皮 连翘(连心) 生甘草 细生地 银花 桑叶 麦冬(不去心) 钩藤 刺
蒺藜 茶菊
先服汤药数帖,后以三十帖作散,每日早晚中三次,各服二钱,服至半年方愈。
陈姓患者,十五岁。乙丑年六月二十五日就诊。患病日久,阴液损伤已至极点,身体消瘦如柴,又突然遭遇中暑,感受暑热邪气。舌质深红且生芒刺,嘴唇干燥、津液枯竭,出现痉挛抽搐、昏厥、神志昏迷、十指蠕动等症状,情况极其危险。因脉象尚见浮弦而中空(芤脉),勉强给予一方大队滋阴填精的药物,兼用咸寒药物以制止厥逆。先服用紫雪丹二钱,用凉开水送服,累计共服用六钱。
处方:白芍五钱,细生地三钱,犀角五钱,羚羊角三钱,火麻仁二钱,炙甘草二钱,阿胶三钱,生鳖甲五钱,牡蛎五钱。
浓煎药汁,缓缓服用。
二十八日,神志仍未清醒,偶尔有胡言乱语。
处方:炙甘草六钱,麦冬八钱(保留心部),真大生地八钱,生鳖甲五钱,阿胶三钱,火麻仁三钱,犀角五钱,生白芍五钱。
七月初一日,邪气减少而正气虚弱为主,使用复脉汤法已经恰当,但舌上黑苔未退,宿便未见排出,兼用润下之法。
处方:生白芍六钱,炙甘草四钱,麦冬六钱,真大生地八钱,阿胶三钱,火麻仁五钱,犀角五钱,生鳖甲六钱,玄参二两。
煮取药汁三杯,分三次服用。
初五日,服用前方五剂后,排出约一碗量的宿便,黑苔已化,但神志尚未完全清楚,使用三加复脉汤加犀角,即在三甲复脉汤基础上加入:
犀角四钱。
初八日,神志仍然不清楚,汤药照前法服用,间服牛黄丸三丸。
陈姓患儿,三岁。九月十六日就诊。燥气化火,高热,舌苔黄,脉数,出现抽搐(瘛疭)并伴有四肢厥冷,治法宜清凉解肌,切忌使用发汗解表法。
处方:薄荷二钱,羚羊角三钱,杏仁泥四钱,连翘六钱(保留心部),金银花八钱,牡丹皮三钱,生甘草二钱,牛蒡子三钱,苦桔梗六钱,黄芩二钱。
共研为粗末,分五包,约一小时服用一包。用芦根汤煎煮,去渣服用。
十七日,燥气化火,身体高热,口渴严重,在前方中加入石膏、炒知母、麦冬,去掉牛蒡子、薄荷、牡丹皮、羚羊角。
处方:石膏五钱,炒知母一两半,麦冬二钱(保留心部),细生地二钱,金银花二钱,连翘二钱(保留心部),苦桔梗一钱,生甘草八分,杏仁一钱,黄芩一钱。
岳姓患儿,八个月。六月二十八日就诊。未满周岁的婴儿,瘟毒导致头部肿胀,出现抽搐(瘛疭)并四肢厥冷,高热气促,脉象数而盛大。担心真阴不能胜阳邪,先用普济消毒饮宣散毒邪外出,必须去掉升麻、柴胡这些直接升提少阳阳明经气的药物,加入犀角、羚羊角以清泻心胆之热。
处方:连翘六钱,牛蒡子六钱,薄荷二钱,人中黄二钱,苦桔梗三钱,芥穗二钱,玄参五钱,马勃三钱,僵蚕三钱,金银花六钱,鲜荷叶一张,鲜芦根一两(煎汤代水)。
共研为细末,分八包,约一小时服用一包。
另备:犀角四钱,羚羊角四钱(单独包装,不必研磨)。
在前述每包药中加入五分(上述犀角、羚羊角粉末)同煎。
吴姓患儿,三岁。六月初九日就诊。早晨因跌打受惊后出现抽搐(瘛疭),直到晚上戌时正刻才苏醒,醒后身体高热,口渴,脉数,舌面无苔,使用复脉汤六剂。热退脉静,又服用两剂而安定。
尹姓患者,十五岁。突然中暑风,出现抽搐(瘛疭)、口眼歪斜,四肢抽掣,头部微痛,采用清泄少阳胆络的方法治疗。
处方:羚羊角,连翘,生甘草,桑叶,薄荷,苦桔梗,茶菊,金银花,钩藤,牡丹皮。
五剂痊愈。
百姓患儿,五岁。痘疹后余邪未尽,侵入少阳、阳明二经之络脉,仅表现为唇口与眼皮抽搐(瘛疭),导致饮食无法入口闭合,每次张口时食物随之下落,四肢不抽掣,采用清泄这两条经络之络脉的方法治疗。
处方:苦桔梗,牡丹皮,连翘(保留心部),生甘草,细生地,金银花,桑叶,麦冬(不去心),钩藤,刺蒺藜,茶菊。
先服用汤药数剂,后将三十剂的药量制成散剂,每日早晚各服三次,每次服用二钱,服用半年方愈。
Patient Chen, aged 15. On the 25th day of the 6th lunar month in the Yichou year. The illness has persisted for a long time, causing extreme depletion of Yin fluids; the body is emaciated like firewood. Additionally, he suddenly contracted Summerheat (Shu), suffering from Qi and Heat invasion. The tongue is crimson with prickles, lips are dry, and bodily fluids are exhausted. It is no wonder that he presents with convulsions (Chi Song), syncope, coma, and wriggling of the ten fingers; the condition is extremely critical. Since the pulse remains floating, wiry, and hollow (Kou), I tentatively prescribed a large dose of formula to tonify and fill the Yin, combined with salty-cold methods to arrest syncope. First, administer Zi Xue Dan (Purple Snow Pill) 2 qian, taken with cool boiled water, totaling 6 qian.
Prescription: Bai Shao (White Peony Root) 5 qian, Xi Sheng Di (Small Rehmannia Root) 3 qian, Xi Jiao (Rhinoceros Horn) 5 qian, Ling Yang Jiao (Antelope Horn) 3 qian, Ma Ren (Hemp Seed) 2 qian, Zhi Gan Cao (Prepared Licorice Root) 2 qian, E Jiao (Donkey-Hide Gelatin) 3 qian, Sheng Bie Jia (Fresh Turtle Shell) 5 qian, Mu Li (Oyster Shell) 5 qian.
Decoct strongly with ample water, and take slowly.
On the 28th, mental clarity has not returned, with occasional delirious speech.
Prescription: Zhi Gan Cao (Prepared Licorice Root) 6 qian, Mai Dong (Ophiopogon Tuber) 8 qian (retain heart), Zhen Da Sheng Di (True Large Fresh Rehmannia Root) 8 qian, Sheng Bie Jia (Fresh Turtle Shell) 5 qian, E Jiao (Donkey-Hide Gelatin) 3 qian, Ma Ren (Hemp Seed) 3 qian, Xi Jiao (Rhinoceros Horn) 5 qian, Sheng Bai Shao (Fresh White Peony Root) 5 qian.
On the 1st day of the 7th lunar month, pathogenic factors are few while deficiency is predominant. Using Fu Mai Tang (Restore the Pulse Decoction) was appropriate, but the black coating on the tongue has not resolved, and old feces have not been passed. Add moistening methods.
Prescription: Sheng Bai Shao (Fresh White Peony Root) 6 qian, Zhi Gan Cao (Prepared Licorice Root) 4 qian, Mai Dong (Ophiopogon Tuber) 6 qian, Zhen Da Sheng Di (True Large Fresh Rehmannia Root) 8 qian, E Jiao (Donkey-Hide Gelatin) 3 qian, Ma Ren (Hemp Seed) 5 qian, Xi Jiao (Rhinoceros Horn) 5 qian, Sheng Bie Jia (Fresh Turtle Shell) 6 qian, Yuan Shen (Scrophularia Root) 2 liang.
Decoct until three cups remain, divide into three doses.
On the 5th, after taking five doses of the previous prescription, approximately one bowl of old feces was passed, and the black tongue coating has transformed. However, mental clarity is still not fully restored. Use San Jia Fu Mai Tang (Three-Shell Restore the Pulse Decoction) added with Xi Jiao (Rhinoceros Horn). That is, add to San Jia Fu Mai Tang:
Xi Jiao (Rhinoceros Horn) 4 qian.
On the 8th, mental clarity remains unclear. Continue the decoction as before, and intermittently administer Niu Huang Wan (Calculus Bovis Pill) 3 pills.
Patient Chen, aged 3. On the 16th day of the 9th lunar month. Dryness transforms into Fire, presenting with high fever, yellow tongue coating, and rapid pulse. Convulsions (Chi Song) with cold extremities occur. The method should be cooling and releasing the muscle layer; strictly avoid diaphoretic (sweat-inducing) methods.
Prescription: Bo He (Mint) 2 qian, Ling Yang Jiao (Antelope Horn) 3 qian, Xing Ni (Almond Paste) 4 qian, Lian Qiao (Forsythia Fruit) 6 qian (retain heart), Yin Hua (Honeysuckle Flower) 8 qian, Dan Pi (Moutan Cortex) 3 qian, Sheng Gan Cao (Raw Licorice Root) 2 qian, Niu Bang Zi (Arctium Fruit) 3 qian, Ku Jie Geng (Bitter Platycodon Root) 6 qian, Huang Qin (Scutellaria Root) 2 qian.
Grind into coarse powder, divide into five packets. Take one packet every hour or so. Decoct with Lu Gen Tang (Reed Rhizome Decoction), strain, and take.
On the 17th, Dryness transforms into Fire, body has high fever, severe thirst. Add Shi Gao (Gypsum), Chao Zhi Mu (Stir-fried Anemarrhena Rhizome), and Mai Dong (Ophiopogon Tuber) to the previous formula; remove Niu Bang Zi (Arctium Fruit), Bo He (Mint), Dan Pi (Moutan Cortex), and Ling Yang Jiao (Antelope Horn).
Prescription: Shi Gao (Gypsum) 5 qian, Chao Zhi Mu (Stir-fried Anemarrhena Rhizome) 1.5 qian, Mai Dong (Ophiopogon Tuber) 2 qian (retain heart), Xi Sheng Di (Small Rehmannia Root) 2 qian, Yin Hua (Honeysuckle Flower) 2 qian, Lian Qiao (Forsythia Fruit) 2 qian (retain heart), Ku Jie Geng (Bitter Platycodon Root) 1 qian, Sheng Gan Cao (Raw Licorice Root) 0.8 fen, Xing Ren (Apricot Kernel) 1 qian, Huang Qin (Scutellaria Root) 1 qian.
Patient Yue, aged 8 months. On the 28th day of the 6th lunar month. An infant under one year old suffers from Plague Toxin causing head swelling, convulsions (Chi Song) with cold extremities, high fever, shortness of breath, and a rapid, large pulse. Fearing that True Yin cannot overcome Yang Pathogens, first use Pu Ji Xiao Du Yin (Universal Benefit Decoction to Eliminate Toxins) to vent toxins outward. Must remove Sheng Ma (Cimicifuga Rhizome) and Chai Hu (Bupleurum Root), which directly ascend Shaoyang and Yangming channels, and add Xi Jiao (Rhinoceros Horn) and Ling Yang Jiao (Antelope Horn) to clear heat from the Heart and Gallbladder.
Prescription: Lian Qiao (Forsythia Fruit) 6 qian, Da Li Zi (Arctium Fruit) 6 qian, Bo He (Mint) 2 qian, Ren Zhong Huang (Human Waste Yellow) 2 qian, Ku Jie Geng (Bitter Platycodon Root) 3 qian, Jie Sui (Schizonepeta Spike) 2 qian, Yuan Shen (Scrophularia Root) 5 qian, Ma Bo (Pleurotus Mushroom) 3 qian, Tian Chong (Bombyx Batryticatus) 3 qian, Yin Hua (Honeysuckle Flower) 6 qian, Xian He Ye (Fresh Lotus Leaf) 1 piece, Xian Lu Gen (Fresh Reed Rhizome) 1 liang (decoct water substitute).
Grind into fine powder, divide into eight packets. Take one packet every hour or so.
Separately: Xi Jiao (Rhinoceros Horn) 4 qian, Ling Yang Jiao (Antelope Horn) 4 qian (pack separately, do not grind).
Add 0.5 qian of the above (Xi Jiao/Ling Yang Jiao powder) to each packet of the previous medicine for decoction.
Patient Wu, aged 3. On the 9th day of the 6th lunar month. In the morning, following a fall and fright, convulsions (Chi Song) occurred; did not wake until Xu Zheng (7-9 PM). After waking, high fever, thirst, rapid pulse, and tongue without coating appeared. Used Fu Mai Tang (Restore the Pulse Decoction) for six doses. Fever subsided, pulse became calm, took two more doses to stabilize.
Patient Yin, aged 15. Suddenly contracted Summerwind, presenting with convulsions (Chi Song), facial paralysis (deviation of mouth and eyes), limb spasms, and slight headache. Treated with the method of clearing Shaoyang Gallbladder collaterals.
Prescription: Ling Yang Jiao (Antelope Horn), Lian Qiao (Forsythia Fruit), Sheng Gan Cao (Raw Licorice Root), Sang Ye (Mulberry Leaf), Bo He (Mint), Ku Jie Geng (Bitter Platycodon Root), Cha Ju (Chrysanthemum Indicum), Yin Hua (Honeysuckle Flower), Gou Teng (Uncaria Ramulus cum Uncis), Dan Pi (Moutan Cortex).
Five doses resulted in complete recovery.
Patient Bai, aged 5. Residual pathogens after smallpox entered the collaterals of Shaoyang and Yangming. Only the lips, mouth, and eyelids show convulsions (Chi Song), causing inability to keep food in the mouth; food falls out whenever the mouth opens. Limbs do not spasm. Treated with the method of clearing the collaterals of these two meridians.
Prescription: Ku Jie Geng (Bitter Platycodon Root), Dan Pi (Moutan Cortex), Lian Qiao (Forsythia Fruit) (retain heart), Sheng Gan Cao (Raw Licorice Root), Xi Sheng Di (Small Rehmannia Root), Yin Hua (Honeysuckle Flower), Sang Ye (Mulberry Leaf), Mai Dong (Ophiopogon Tuber) (do not remove heart), Gou Teng (Uncaria Ramulus cum Uncis), Ci Ji Li (Tribulus Fruit), Cha Ju (Chrysanthemum Indicum).
First take several doses of decoction. Then, prepare thirty doses as a powder. Take twice daily (morning and evening), three times a day total, 2 qian each time. Treatment lasted half a year for cure.