倪二南先生内人,小水不禁,一日二十余起。脉右寸洪而有力,左寸虚,右尺沉微。此
心肾不交之症也。以当归、远志、丹参、牡丹皮、桑螵蛸、人参、山茱萸、益智仁、黄柏
、知母
为丸,服之,五日为安。后凡遇辛苦则发,以此服之立效。
柱史严印老长媳,少司空沈镜老女也。患腹痛有小块累累然,腹觉冷甚,两寸关皆滑数
,两尺皆沉微,此脾气弱而饮食不消。又当秋令湿淫之候,不利亦泻,宜预防。与白术、苍
术、茯苓、甘草、白豆仁、木香、半夏、陈皮、泽泻煎服。其夜果泻一度。次早又泻一度。
小腹仍疼不少减,且里急后重。盖其禀赋素虚,当补中兼消兼利。白芍药三钱,桂心一钱,
甘草、人参、茯苓、泽泻、陈皮、白术各八分,升麻、葛根各六分。服后脉皆软弱不滑,累
块亦消。改以人参、黄 、白术、白芍药各二钱,炙甘草、陈皮、泽泻、葛根、柴胡、茯苓
各一钱,调理而痊。
新市陈鹿塘先生,原有肠风脏毒之症,大便燥结,数日不能一行,痛苦殊甚。此胃寒肠
热之
症,其脉两寸皆数,两关皆弦而无力,两尺洪滑而左尤甚。诊毕,渠告予曰∶病数年,百医
不效,望生难矣。闻公治多奇中,冀一奇而生之,实再造之恩也。予怜其苦,而俯想久之。
因思李东垣有云∶大肠喜清而恶热,脾胃喜温而恶寒,以胃属土,而大肠属金也。今治肠胃
相兼之疾,必寒非凄凄,热非灼灼始可。乃详酌一方,专以肠风脏毒之药为君主,外以养血
之剂裹之,使不伤胃气。盖药先入胃,而后传入大肠,入胃时裹药未化,及入大肠则裹药化
,而君药始见,庶几两不相妨,亦假道灭虢之策也。因以大黄酒浸九蒸九晒者二两,槐花三
两,木耳二两,郁李仁、皂角子、象牙屑、条芩各一两,血余灰、升麻、荆芥穗各五钱为末
,炼蜜为丸,赤豆大,外以四物汤加蒲黄各一两为衣,米汤送下,空必及下午各服二钱。服
此果然血止,而大便不燥,饮食日加。鹿塘大喜曰∶古称用药如用兵,奇正相生,鲜有不克
敌者,其公之谓乎。
倪二南先生的夫人,小便失禁,一天要起夜二十多次。脉象右寸部洪大且有力,左寸部虚弱,右尺部沉细微弱。这是心肾不交的病证。用当归、远志、丹参、牡丹皮、桑螵蛸、人参、山茱萸、益智仁、黄柏、知母制成丸药,服用后,五天病情安定。后来凡是遇到劳累辛苦就会发作,服用此药立刻见效。
柱史严印老的长媳,是少司空沈镜老的女儿。患有腹痛,腹部有累累成串的小肿块,腹部感觉非常寒冷,两手寸关部脉象滑数,两尺部脉象沉微,这是脾气虚弱导致饮食不消化。又正值秋季湿气盛行的时候,即使不利也会腹泻,应当预防。给予白术、苍术、茯苓、甘草、白豆仁、木香、半夏、陈皮、泽泻煎服。当天夜里果然腹泻了一次。第二天早上又腹泻了一次。小腹仍然疼痛没有减少,并且出现里急后重(想排便但排不出或排不尽的感觉)。大概是因为她体质素来虚弱,治疗应当补益中气兼以消导兼以利湿。用白芍药三钱,桂心一钱,甘草、人参、茯苓、泽泻、陈皮、白术各八分,升麻、葛根各六分。服用后脉象都变得软弱而不滑,腹中肿块也消散了。改为用人参、黄芪、白术、白芍药各二钱,炙甘草、陈皮、泽泻、葛根、柴胡、茯苓各一钱,调理而痊愈。
新市的陈鹿塘先生,原本患有肠风和脏毒的病证,大便干燥结硬,几天不能解一次,痛苦非常严重。这是胃寒肠热的病证,他的脉象两寸部都数,两关部都弦而无力,两尺部洪滑且左侧尤其明显。诊脉完毕,他告诉我道:患病多年,众多医生治疗无效,希望生存很难了。听说您治疗多有奇效,希望能有一次奇迹让我活下来,这真是再造之恩啊。我怜悯他的痛苦,沉思良久。于是想到李东垣说过:大肠喜欢清凉而厌恶燥热,脾胃喜欢温暖而厌恶寒冷,因为胃属土,而大肠属金。现在治疗肠胃相兼的疾病,必须达到寒不凄冷、热不灼热的程度才可以。于是仔细斟酌一方,专门以治疗肠风脏毒的药物为主药,外面用养血药剂包裹,使其不伤胃气。因为药物先进入胃,然后传入大肠,进入胃时包裹的药尚未化开,等到进入大肠则包裹的药化开,主药才显现出来,这样两者互不妨碍,也是借用道路消灭虢国的策略。于是用大黄(酒浸,九蒸九晒)二两,槐花三两,木耳二两,郁李仁、皂角子、象牙屑、条芩各一两,血余灰、升麻、荆芥穗各五钱研为细末,炼蜜为丸,大小如赤豆,外面用四物汤加蒲黄各一两作为包衣,米汤送下,空腹和下午各服二钱。服用此药果然血止住了,大便不再干燥,饮食日渐增加。鹿塘大喜道:古人称用药如用兵,奇正相生,很少有不能克敌制胜的,这说的就是您吧。
Mr. Ni E'nan's wife suffered from urinary incontinence, urinating more than twenty times a day. The pulse at the right Cun position was surging and forceful, while the left Cun position was deficient; the right Chi position was deep and faint. This is a syndrome of Heart-Kidney non-interaction (Xin Shen Bu Jiao). Pills were prepared using Dang Gui (Angelica Sinensis), Yuan Zhi (Polygalae Radix), Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma), Mu Dan Pi (Moutan Cortex), Sang Piao Xiao (Mantis Egg Case), Ren Shen (Ginseng Radix), Shan Zhu Yu (Corni Fructus), Yi Zhi Ren (Alpiniae Oxyphyllae Fructus), Huang Bo (Phellodendri Cortex), and Zhi Mu (Anemarrhenae Rhizoma). After taking them, she stabilized within five days. Later, whenever she encountered fatigue or hard work, the symptoms would recur, but taking this prescription brought immediate relief.
The eldest daughter-in-law of Yan Yinlao, a Zhushi (Historian/Archivist), was the daughter of Shen Jinglao, a Shaokong (Vice Minister of Works). She suffered from abdominal pain with multiple small lumps palpable in the abdomen, and her abdomen felt extremely cold. The pulses at both Cun and Guan positions on the hands were slippery and rapid, while those at both Chi positions were deep and faint. This indicated Spleen Qi deficiency leading to indigestion. Furthermore, it was the season of autumn when dampness prevails; even if not currently diarrhea, it might occur, so prevention was advised. A decoction was prescribed containing Bai Zhu (Atractylodis Macrocephalae Rhizoma), Cang Zhu (Atractylodis Rhizoma), Fu Ling (Poria), Gan Cao (Glycyrrhizae Radix et Rhizoma), Bai Dou Ren (Arecae Semen), Mu Xiang (Aucklandiae Radix), Ban Xia (Pinelliae Tuber), Chen Pi (Citri Reticulatae Pericarpium), and Ze Xie (Alismatis Rhizoma). That night, she indeed had one episode of diarrhea. The next morning, another episode occurred. However, the lower abdominal pain did not decrease significantly, accompanied by tenesmus (Li Ji Hou Zhong). Given her constitution was inherently deficient, the treatment should tonify the middle jiao while simultaneously resolving stagnation and promoting diuresis. The prescription included Bai Shao Yao (Paeoniae Radix Alba) 3 qian, Gui Xin (Cinnamomi Ramulus) 1 qian, Gan Cao, Ren Shen, Fu Ling, Ze Xie, Chen Pi, and Bai Zhu each 8 fen, and Sheng Ma (Cimicifugae Rhizoma) and Ge Gen (Puerariae Lobatae Radix) each 6 fen. After administration, the pulses became weak and soft without slipperiness, and the lumps dissipated. The formula was then modified to include Ren Shen, Huang Qi (Astragali Radix), Bai Zhu, and Bai Shao Yao each 2 qian, and Zhi Gan Cao (Honey-fried Glycyrrhizae Radix et Rhizoma), Chen Pi, Ze Xie, Ge Gen, Chai Hu (Bupleuri Radix), and Fu Ling each 1 qian. She recovered after further regulation.
Mr. Chen Lutang from Xinshi originally suffered from Chang Feng (Intestinal Wind) and Zang Du (Visceral Toxin), characterized by dry and constipated stools, unable to defecate for several days, causing severe suffering. This is a syndrome of Cold Stomach and Heat Intestine. His pulses at both Cun positions were rapid, both Guan positions were wiry and deficient, and both Chi positions were surging and slippery, especially on the left side. After diagnosis, he told me: "I have been ill for years, and many doctors failed to cure me. Hope for survival is slim. I heard your treatments are often miraculous; I hope for one miracle to save my life, which would be a grace of re-creation." Sympathizing with his suffering, I pondered deeply. I recalled Li Dongyuan's saying: "The Large Intestine prefers coolness and dislikes heat; the Spleen and Stomach prefer warmth and dislike cold, because the Stomach belongs to Earth, while the Large Intestine belongs to Metal." When treating diseases involving both stomach and intestines, the condition must reach a state where it is neither chillingly cold nor scorchingly hot. Therefore, I carefully devised a formula, using herbs specifically for Chang Feng and Zang Du as the sovereign drugs, wrapped in blood-nourishing agents to prevent injury to Stomach Qi. Since the medicine enters the Stomach first before reaching the Large Intestine, the wrapping agent remains intact in the Stomach and dissolves only upon entering the Large Intestine, allowing the sovereign drugs to act there, thus avoiding mutual interference. This strategy is akin to "borrowing a path to destroy Guo." The prescription consisted of Da Huang (Rhei Radix et Rhizoma, soaked in wine, steamed and dried nine times) 2 liang, Huai Hua (Sophorae Flos) 3 liang, Mu Er (Auriculariae Auricula-Judae) 2 liang, Yu Li Ren (Pruni Semen), Zao Jiao Zi (Gleditsiae Spina), Xiang Ya Xie (Elephantis Dentis Fragmentum), and Tiao Qin (Scutellariae Radix) each 1 liang, plus Xue Yu Hui (Sanguinis Humanis Cinis), Sheng Ma, and Jing Jie Sui (Schizonepetae Spica) each 5 qian, ground into powder and formed into pills with refined honey, sized like red beans. These were coated with Si Wu Tang (Four Substances Decoction) plus Pu Huang (Typhae Pollen) each 1 liang, taken with rice soup, 2 qian each time on an empty stomach and in the afternoon. Indeed, after taking this, the bleeding stopped, stools were no longer dry, and appetite improved daily. Lutang rejoiced and said: "Ancients say that using medicine is like using troops; combining orthodox and unorthodox strategies rarely fails to defeat the enemy. This describes you perfectly."