予有表嫂小产后,腹痛晕厥,冷汗淋淋,遍身麻木,心怔怔动,左脉绝不应指,虚极故
也
。以当归三钱,川芎一钱五分,人参、荆芥穗灯火烧存性各一钱,益母草、泽兰吐各八分,
甘草五分,水煎饮之。腹痛减,惟怔怔不宁。以四君子汤倍加黄 为君,当归、香附、益母
草为臣,川芎为佐,炮姜为使,两剂而安。
陈士美,孤子也。年弱冠,由梦遗后患头疼发热,时值仲夏,医治不瘳。凡市中有名者
率延
致,转治转热,反加水泻口渴,日夜不得眠者旬日,众视为危。时有俞氏者用参 白术为其
敛汗止泻,而汗泻愈剧,呻吟不间昼夜,勺粒不入口,咳嗽胸痞,躁闷不宁,又四日矣。渠
亲邵琼林交予,因 邵逆予为治。诊其脉左弦长,右洪大俱七至,舌苔焦黄,体若火燎,神
昏气促。予曰∶此仲景伤寒热症也。邪在阳明少阳二经,其危不啻风中烛。胡时师不认症察
脉,徒以梦遗受病,率投补剂,无怪乎转治转剧也。幸予至,设迟一日,大事去矣。用石膏
五钱,柴胡、知母各三钱,炙甘草、白芍药、枳壳、桔梗、黄芩、天花粉各一钱,粳米一撮
,急煎饮之。夜半热稍退,神稍静,脉之仍数甚。继以前剂进,天明乃得睡觉而热退神清,
泻止膈宽。惟口尚渴。再用柴胡一钱五分,白芍药、麦门冬、知母各一钱,石膏三钱,甘草
、五味子各五分,人参七分,服之舌润渴止,余热尽退,粥饮始入,渐向安矣。次日,忽两
足指前一截痛如犬啮不能耐,以野蓼一握入明矾四两,煎汤熏洗,痛势稍缓。又以薏苡仁三
钱,木瓜二钱,黄柏、牛膝各一钱,汉防己三分,一帖而愈。后又干咳嗽尽夜不住口,喉且
疼,胸胀而体略热,此为误服参术太早之过。用马兜铃、百部、御米壳,各用蜜水制过一钱
,五味子、甘草各五分,百合二钱,四帖而愈。
我的表嫂在小产之后,出现腹部疼痛、晕厥,冷汗淋漓不止,全身麻木,心中悸动不安,左侧脉搏微弱到几乎摸不到,这是因为气血极度虚弱所致。
我用当归三钱,川芎一钱五分,人参和荆芥穗(用灯火烧至存性)各一钱,益母草和泽兰叶各八分,甘草五分,加水煎煮后服用。服药后腹痛减轻,但心中仍感到悸动不宁。于是改用四君子汤(由人参、白术、茯苓、甘草组成,具有益气健脾功效),加倍使用黄芪作为主药,当归、香附、益母草作为辅药,川芎作为佐药,炮姜作为使药,服用两剂后病情安定。
陈士美是一个孤儿。年纪刚成年,在梦遗之后患上头痛发热,当时正值仲夏,经过治疗没有痊愈。凡是市面上有名的医生都请来了,越治病情越热,反而出现了水样腹泻和口渴,日夜无法入睡长达十天,大家都认为这是危重病症。当时有一位姓俞的医生用人参和白术为他敛汗止泻,结果出汗和腹泻更加严重,昼夜呻吟不停,连一口水和食物都吃不下,咳嗽胸闷,烦躁闷乱不宁,又过了四天。他的亲戚邵琼林与我交好,便通过邵琼林邀请我为他诊治。我诊察他的脉象,左手脉弦长,右手脉洪大,每呼吸一次脉搏跳动七次(数脉),舌苔焦黄,身体像火烧一样烫,神志昏迷,气息急促。我说:“这是张仲景《伤寒论》中的伤寒热症。”邪气在阳明经和少阳经,其危险程度不亚于风中残烛。那些庸医不辨证候和脉象,仅仅因为患者有梦遗病史,就随意投用补药,难怪病情越来越重。幸好我及时赶到,如果晚一天,大事就完了。我使用石膏五钱,柴胡、知母各三钱,炙甘草、白芍药、枳壳、桔梗、黄芩、天花粉各一钱,粳米一小撮,急火煎煮后服用。半夜时热度稍退,神志稍静,但脉象仍然很快。接着继续服用前面的方剂,天亮时才得以睡觉,随后热退神清,腹泻停止,胸膈宽舒。只是口中尚感口渴。再用柴胡一钱五分,白芍药、麦门冬、知母各一钱,石膏三钱,甘草、五味子各五分,人参七分,服用后舌面湿润,口渴停止,余热全部消退,开始能喝粥进水,逐渐趋向康复。第二天,忽然两个脚趾的前一节疼痛如狗咬般难以忍受,我用一把野蓼草加入四两明矾,煎汤熏洗患处,疼痛稍微缓解。又用薏苡仁三钱,木瓜二钱,黄柏、牛膝各一钱,汉防己三分,一剂药后痊愈。后来又整夜干咳不止,喉咙疼痛,胸部胀满且身体略有发热,这是过早服用参、术等补药的过错。我用马兜铃、百部、御米壳,各用蜜水制过后一钱,五味子、甘草各五分,百合二钱,服用四剂后痊愈。
My cousin's wife, after a miscarriage, suffered from abdominal pain and syncope, with profuse cold sweat, numbness all over the body, palpitations, and a left pulse that was imperceptible due to extreme deficiency.
I prescribed Dang Gui (Radix Angelicae Sinensis) 3 qian, Chuan Xiong (Rhizoma Chuanxiong) 1.5 qian, Ren Shen (Radix Ginseng) and Jing Jie Sui (Flos Schizonepetae, burned to retain its properties) each 1 qian, Yi Mu Cao (Herba Leonuri) and Ze Lan Ye (Herba Lycopi) each 0.8 qian, and Gan Cao (Radix Glycyrrhizae) 0.5 qian. These were decocted in water and administered orally. The abdominal pain subsided, but palpitations persisted. I then used Si Jun Zi Tang (Four Gentlemen Decoction), doubling the amount of Huang Qi (Radix Astragali) as the sovereign herb, Dang Gui and Xiang Fu (Rhizoma Cyperi) and Yi Mu Cao as minister herbs, Chuan Xiong as assistant herb, and Pao Jiang (Rhizoma Zingiberis Preparatum) as guide herb. After two doses, she stabilized.
Chen Shimei was an orphan. In his early adulthood, he developed headache and fever following nocturnal emissions. It was mid-summer, and treatment had failed to cure him. He consulted every famous physician available, but the more he was treated, the hotter his condition became. He subsequently developed watery diarrhea and thirst, unable to sleep day or night for ten days; everyone considered his condition critical. At that time, a physician surnamed Yu used Ren Shen and Bai Zhu (Rhizoma Atractylodis Macrocephalae) to stop sweating and diarrhea, but this exacerbated both symptoms. He groaned continuously day and night, could not take any food or drink, and suffered from cough, chest fullness, and restlessness for another four days. His relative, Shao Qionglin, who was friendly with me, introduced us. Upon examination, his left pulse was wiry and long, and his right pulse was large and flooding, both rapid at seven beats per breath. His tongue coating was scorched yellow, his body felt like burning fire, his spirit was confused, and his breathing was short. I said, "This is a Heat Syndrome of Cold Damage according to Zhang Zhongjing." The pathogen is in the Yangming and Shaoyang meridians; his danger is akin to a candle in the wind. Those contemporary physicians failed to differentiate the syndrome and examine the pulse. Relying solely on the history of nocturnal emission, they indiscriminately administered tonifying agents, which explains why the condition worsened with treatment. Fortunately, I arrived in time; if I had been delayed by one day, it would have been too late. I prescribed Shi Gao (Gypsum Fibrosum) 5 qian, Chai Hu (Radix Bupleuri) and Zhi Mu (Rhizoma Anemarrhenae) each 3 qian, Zhi Gan Cao (Prepared Radix Glycyrrhizae), Bai Shao Yao (Radix Paeoniae Alba), Zhi Ke (Fructus Aurantii), Jie Geng (Radix Platycodi), Huang Qin (Radix Scutellariae), and Tian Hua Fen (Radix Trichosanthis) each 1 qian, and a pinch of Jing Mi (Semen Oryzae Sativum). This was rapidly decocted and administered. By midnight, the fever slightly subsided, and his spirit calmed somewhat, but the pulse remained very rapid. I continued with the same prescription. By dawn, he slept, the fever receded, his spirit cleared, diarrhea stopped, and his chest felt relaxed. However, he still felt thirsty. I then prescribed Chai Hu 1.5 qian, Bai Shao Yao, Mai Men Dong (Tuber Ophiopogonis), and Zhi Mu each 1 qian, Shi Gao 3 qian, Gan Cao and Wu Wei Zi (Fructus Schisandrae) each 0.5 qian, and Ren Shen 0.7 qian. After taking this, his tongue became moist, thirst ceased, residual heat disappeared, and he began to consume porridge and liquids, gradually recovering. The next day, suddenly, the front section of his toes hurt intensely as if bitten by a dog. I used a handful of Ye Liao (Polygonum aviculare) mixed with 4 liang of Ming Fan (Alumen) to decoct a solution for fumigation and washing, which slightly relieved the pain. Then, using Yi Yi Ren (Semen Coicis) 3 qian, Mu Gua (Fructus Chaenomelis) 2 qian, Huang Bo (Cortex Phellodendri), Niu Xi (Radix Achyranthis Bidentatae) each 1 qian, and Han Fang Ji (Radix Stephaniae Tetrandrae) 0.3 fen, he recovered after one dose. Later, he suffered from dry coughing all night with sore throat, chest distension, and slight fever. This was due to the premature administration of Ren Shen and Bai Zhu. I used Ma Dou Ling (Fructus Aristolochiae), Bai Bu (Radix Stemonae), and Yu Mi Ke (Pericarpium Papaveris), each prepared with honey water and dosed at 1 qian, Wu Wei Zi and Gan Cao each 0.5 qian, and Bai He (Bulbus Lilii) 2 qian. He recovered after four doses.