大宗伯董浔老,年六十七,有脾胃疾,翁以过啖瓜果而胸膈胀痛,时当处暑也。延予治。诊其脉,寸关弦
紧,观其色,神
藏气固。翁门下蒋虹桥、沈乐闲者,多艺人也,翁素亲信二公,诘余曰∶症脉何如?予曰∶
症脉虽胸腹胀痛,然易瘳也。二公曰∶翁生平不能素食,食辍泻。今不茹荤者半月,燕居好
弈,好看书,好作诗文,即盛暑亦手一编不言倦,日永亦不瞌,今不亲笔砚者月余,不栉沐
者
七日,它一切无所事事,倦极矣。诸名家如沈竹亭、沈春宇、金樗丘者,剂备尝之无益也。
而公何言易?予曰∶诸公不过用二陈平胃,加山楂、麦芽等消导剂耳,与症何涉。盖翁伤于
瓜果,而为寒湿淫胜。经云∶寒淫所胜,治以辛温。然瓜果非麝香、肉桂
不能消,此诸公所以不能愈翁疾也。予以高良姜、香附各一两为君,肉桂五钱为臣,麝香一
钱为佐,每服二钱,酒调下之。药入腹,胸次便宽,再而知饿,三服而巾栉,交接宾客如
未病者。翁语沈、蒋曰∶孙君所见所养,度越诸人若是。往闻治张氏子,气绝两日而能活之
,今于活吾病益信,诚临淄虢国之遗,特书一轴以彰其高,因以纪一时之良遇云。
大宗伯郎君董龙山公夫人,为宪副茅鹿门公女,年三十五而病便血,日二三下,腹不疼
,诸医延医者三年不效。予诊之,左脉沉涩,右脉漏出关外,诊不应病。予窃谓,血既久下
,且当益其气而升提之,以探其症。乃用补中益气汤,加阿胶、地榆、侧柏叶,服八剂,血
不下者半月。彼自喜病愈矣。偶因劳而血复下,因索前药。予语龙山公曰∶夫人之病,必
有瘀血积于经隧,前药因右脉漏关难凭,故以升提兼补兼涩者,以探虚实耳。今得病情,法
当下而除其根也。龙山公曰∶三年间便血,虽一日二三下,而月汛之期不爽,每行且五日,如此尚
有瘀血停蓄耶?
予曰∶此予因其日下月至而知其必有瘀血停蓄也。
经云∶不塞不流,不行不止。今之瘀,实由塞之行也,不可再涩。古人治
痢,必先下之,亦此意也。公曰∶明日试卜之。予曰∶卜以决疑,不疑何卜?公随以语夫人
,
夫人曰∶孙先生非误人者,识见往往出寻常,宜惟命。盖夫人读书能文,聪明谋断,不啻丈
夫,故言下便能了悟。即用桃仁承气汤,加丹参、五灵脂、荷叶蒂,水煎,夜服之,五更下
黑瘀血半桶,其日血竟不来,复令人索下药。予曰∶姑以理脾药养之,病根已动,俟五
日而再下未晚也。至期复用下剂,又下黑血如前者半,继用补中益气汤、参苓白术散,调理
痊愈。
大宗伯董浔阳老先生,六十七岁,患有脾胃疾病。老人因为过量食用瓜果,导致胸膈部胀痛,当时正值处暑节气。他请我诊治。诊察他的脉象,寸部和关部的脉弦而紧;观察他的面色,神气内藏,元气稳固。老人的门客蒋虹桥、沈乐闲都是多才多艺的人,老人一向亲近信任这两位先生,便问我:“病症和脉象如何?”我说:“虽然症状表现为胸腹胀痛,但容易治愈。”两位先生说:“老人生平不能素食,一停荤食就会腹泻。现在不吃荤腥已经半个月了,闲暇时喜欢下棋,喜欢看书,喜欢写诗作文,即使在盛夏也手持书卷不觉得疲倦,白天长也不打瞌睡。现在一个多月不碰笔墨,七天不梳洗,其他一切无所事事,极度疲倦。各位名医如沈竹亭、沈春宇、金樗丘等人,药方试遍了都没有效果。您为什么说容易治愈?”我说:“各位医生不过是用二陈汤(燥湿化痰、理气和中)和平胃散(燥湿运脾、行气和胃),加上山楂、麦芽等消食导滞的药物罢了,这与病情不相干。这是因为老人被瓜果所伤,寒湿之气过盛。《内经》说:‘寒邪过盛,用辛温药物治疗。’然而瓜果非麝香、肉桂不能消化,这就是各位医生不能治好老人疾病的原因。”我用高良姜、香附各一两作为君药,肉桂五钱作为臣药,麝香一钱作为佐药,每次服用二钱,用酒调服。药入腹中,胸膈立刻感到宽舒,第二天知道饿了,第三天就梳洗打扮,接待宾客像没生病一样。老人对沈、蒋二位说:“孙医生的见解和调养方法,超越众人如此之多。以前听说他治张家的儿子,气绝两天都能救活,现在对我病情的救治更加让我相信,这真是古代虢国神医扁鹊的遗风,特意写一幅字来彰显他的医术高超,以此记录这次美好的相遇。”
大宗伯的儿子董龙山公的夫人,是宪副茅鹿门公的女儿,三十五岁时患便血病,每天大便两三次带血,腹部不疼痛,延请多位医生治疗三年无效。我诊察她的脉象,左脉沉涩,右脉漏出关外,脉象与病情似乎不相符。我心里暗自思忖,既然出血日久,应当补益气血并升提举陷,以试探病情的虚实。于是使用补中益气汤(补中益气、升阳举陷),加入阿胶、地榆、侧柏叶,服用八剂后,出血停止半个月。她自以为病好了。偶然因为劳累,血又再次流出,于是索要之前的药方。我对龙山公说:“夫人的病,必定有瘀血积聚在经络隧道中,之前因为右脉漏出关外难以凭据,所以用升提兼补兼涩的方法,来试探虚实罢了。现在摸清了病情,法度上应该用攻下法去除病根。”龙山公说:“三年间便血,虽然每天两三次,但每月的月经周期没有差错,每次来潮且持续五天,这样还有瘀血停滞蓄积吗?”我说:“这是因为我根据她每日出血直到月底的情况,推断出必然有瘀血停滞蓄积。《内经》说:‘不通则塞,不塞则流不行;不流通则不止。’现在的瘀血,确实是因为堵塞而导致运行不畅,不能再使用收敛止涩的药物。古人治疗痢疾,必须先通下,也是这个意思。”龙山公说:“明天试着占卜一下。”我说:“占卜是为了决断疑惑,没有疑惑何必占卜?”龙山公随即把这话告诉夫人,夫人说:“孙先生不是误人的医生,见识往往超出常人,应该听从他的命令。”大概因为夫人读书能文,聪明且有谋略决断能力,不亚于丈夫,所以听后立即领悟。于是立即使用桃仁承气汤(逐瘀泻热),加入丹参、五灵脂、荷叶蒂,水煎,晚上服用,五更时分排出黑色瘀血半桶,当天血竟然不再来了,又让人索要攻下药。我说:“暂且用调理脾胃的药物来养护它,病根已经触动,等到五天后再攻下也不迟。”到了日期再次使用攻下药,又排出黑色瘀血像之前的一半,随后使用补中益气汤、参苓白术散(健脾益气、渗湿止泻),调理痊愈。
Grand Secretary Dong Xunyang, aged sixty-seven, suffered from a spleen and stomach disorder. Due to excessive consumption of fruits and melons, he experienced distension and pain in the chest and diaphragm; this occurred during the Chushu (End of Heat) solar term. He invited me for treatment. Upon palpating his pulse, the Cun (inch) and Guan (bar) positions were wiry and tight. Observing his complexion, his Shen (Spirit) was contained, and his Yuan Qi (Original Qi) was solid. Two of his disciples, Jiang Hongqiao and Shen Lexian, were men of many talents whom he trusted and favored. They asked me, "What are the symptoms and pulse like?" I replied, "Although the symptoms involve chest and abdominal distension and pain, it is easy to cure." The two gentlemen said, "My master has never been able to eat a vegetarian diet; if he stops eating meat, he suffers diarrhea. For half a month now, he has abstained from meat. In his leisure, he enjoys playing chess, reading books, and composing poetry and prose. Even in the height of summer, he holds a book without tiring, and long days do not make him drowsy. For over a month, he has not touched pen and ink, and for seven days, he has not combed his hair or bathed. He does nothing else and is extremely fatigued. Renowned physicians such as Shen Zhuting, Shen Chunyu, and Jin Chuqiu have tried various prescriptions with no effect. Why do you say it is easy to cure?" I said, "Those doctors merely used Er Chen Tang (Two-Aged Decoction) and Ping Wei San (Calm the Stomach Powder), adding Hawthorn Fruit and Malt as digestive aids. This has little relevance to the actual condition. The master's injury stems from fruits and melons, leading to an excess of Cold-Dampness. The Classic states: 'When Cold is in excess, treat with Pungent-Warm herbs.' However, fruits and melons cannot be digested without Moschus (Musk) and Cinnamon Twig. This is why those doctors could not cure my master." I prescribed Galangal Rhizome and Cyperus Rhizome, each one liang, as the Sovereign herb; Cinnamon Twig, five qian, as the Minister herb; and Moschus, one qian, as the Assistant herb. Each dose was two qian, taken with wine mixed in. After taking the medicine, his chest felt immediately relieved. By the second day, he felt hungry. After three doses, he combed his hair and received guests as if he had never been ill. The master told Shen and Jiang, "Dr. Sun's insight and nurturing methods surpass others so greatly. I once heard he revived Zhang's son who had been clinically dead for two days. Now, seeing him cure my illness, I truly believe this is the legacy of Bian Que, the divine physician of Guo State. I have written a scroll to honor his high medical skill, recording this fortunate encounter."
The wife of Dong Longshan, Grand Secretary's son, was the daughter of Vice Commissioner Mao Lumen. At thirty-five, she suffered from hematochezia (blood in stool), passing blood two or three times daily, without abdominal pain. Various physicians treated her for three years without success. I palpated her pulse: the Left pulse was deep and choppy, and the Right pulse leaked beyond the Guan position, appearing inconsistent with the disease. I secretly reasoned that since bleeding had persisted for a long time, I should tonify Qi and lift Yang to probe the nature of the syndrome. Thus, I used Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), added Donkey-Hide Gelatin, Sanguisorba Root, and Biota Leaf, and administered eight doses. The bleeding stopped for half a month. She rejoiced, believing herself cured. Accidentally, due to exertion, the bleeding recurred, and she requested the previous prescription. I told Mr. Longshan, "Madam's illness must involve stagnant Blood accumulated in the meridians. Previously, because the Right pulse leaking beyond the Guan made diagnosis difficult, I used lifting, tonifying, and astringing methods to probe the deficiency and excess. Now that I understand the pathology, the method requires purging to remove the root cause." Mr. Longshan said, "For three years she has had bloody stools, though only two or three times a day, her menstrual cycle has been regular, lasting five days each time. How can there still be stagnant Blood?" I said, "I deduced the presence of stagnant Blood based on her daily bleeding until the end of the month. The Classic states: 'If blocked, flow ceases; if not flowing, it will not stop.' The current stasis is indeed caused by blockage preventing flow; we must not use further astringents. Ancient practitioners treating dysentery would first purge, which reflects this same principle." Mr. Longshan said, "Let us consult divination tomorrow." I said, "Divination resolves doubt; if there is no doubt, why divinate?" Mr. Longshan conveyed this to Madam. She said, "Mr. Sun is not one who harms people; his insights often exceed the ordinary. We should obey his command." Since Madam was literate, intelligent, and decisive, comparable to her husband, she understood immediately upon hearing this. I immediately prescribed Tao Ren Cheng Qi Tang (Peach Kernel Draining the Yin Decoction), added Salvia Root, Trogopterus Dung, and Lotus Seed Pod Peduncle, decocted in water, and administered at night. At dawn (Wugeng), she passed half a bucket of black, stagnant Blood. On that day, no more blood appeared, and she requested further purgatives. I said, "Temporarily use spleen-regulating herbs to nourish the body. The root of the disease has been stirred; it is not too late to purge again after five days." When the time came, another purgative was used, resulting in half the amount of black blood as before. Subsequently, Bu Zhong Yi Qi Tang and Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) were used for regulation, leading to a complete recovery.