张道南先生内人,以饮食忤于气,因腹痛不饮食五日矣。逆予诊之。两寸关弦,尺滑。
予曰
∶此上焦气虚,下有郁滞也。以姜黄、青皮为君,山楂、槟榔、当归、杏仁、乌药、枳壳为
臣,柴胡、木香为佐,吴茱萸为使。服后气稍顺。然后用葱二斤,前汤浴洗腰腹,即将熟葱
擦
摩腰腹,使气通透,洗毕即安卧少顷。其夜大便通,先下皆黑硬结块,后皆水,此积滞行而
正气虚也。以建中汤加山楂、茯苓、泽泻、柴胡、香附、姜连调摄之而痊。
张道南先生尊堂老妇人,以劳倦致早晨膈上有痰痞而恶心。每食热物,目中即出泪,脉
右寸
关皆滑,左寸短弱,此心血不足,而肺胃有痰也。以六君子汤加麦芽、白豆仁、旋复花治之
而愈。
马迪庵先生内人,原以饮食过伤,又为风寒外袭,以内伤外感治之后,复至五更发热,
唇燥
,胸中冲跳不已,手足皆冷,脉两寸俱滑数。予谓此奇痰症也。以小陷胸汤加白芍药、萝卜
子、前胡、酒芩二帖,次早大便行,下蛔虫八条,胸中即不冲跳,但觉力怯。再诊之,两寸
减半,尺脉稍起。以二陈汤加白术、白芍药、酒芩调理,后四帖加当归而痊愈。
大宗伯董浔老夫人,常眩晕,手指及肢节作胀。脉右寸软弱,关滑,左脉弦长,直上鱼际,
两尺皆弱,此亢而不下之脉。《难经》所谓木行乘金之候也。总由未生育而肝经之血未破尔
。《内经》云∶诸风掉眩,皆属肝木。兼有痰火,治当养金平木,培土化痰。以白术半夏天
麻汤,正与此对。服两帖而眩晕平。再与六君子汤加天麻、白僵蚕以治其晕,加白芍药以泻
肝,麦门冬、人参以补肺金,麦芽、枳实、神曲、苍术以健脾,使宿痰去而新痰不生。少用
黄柏二分为使,引热下行,令不再发。
张道南先生的妻子,因为饮食与气机相逆,导致腹痛且五天无法进食。我去为她诊脉。两手寸部和关部脉象弦,尺部脉象滑。
我说:这是上焦气虚,下焦有郁结阻滞。用姜黄、青皮作为君药,山楂、槟榔、当归、杏仁、乌药、枳壳作为臣药,柴胡、木香作为佐药,吴茱萸作为使药。服药后气机稍微顺畅。然后用葱二斤,以前方煎汤洗浴腰腹部,随即用熟葱擦拭按摩腰腹部,使气机通透,洗完澡后即安静躺卧片刻。当晚大便通畅,先排出的是黑色硬结块,后来排出的是水样物,这是积滞下行而正气虚弱所致。用建中汤加山楂、茯苓、泽泻、柴胡、香附、姜连进行调摄治疗而痊愈。
张道南先生的母亲老妇人,因为劳累疲倦导致早晨膈上有痰痞塞感并恶心。每次吃热食,眼中就会流泪,脉象右寸和关部皆滑,左寸短弱,这是心血不足,而肺胃有痰。用六君子汤加麦芽、白豆仁、旋复花治疗而痊愈。
马迪庵先生的妻子,原本因为饮食过度损伤,又受到风寒外袭,在以内伤和外感治疗后,再次出现五更时分发热,嘴唇干燥,胸中冲跳不止,手脚都冷,两手寸部脉象皆滑数。我说这是奇痰症。用小陷胸汤加白芍药、萝卜子、前胡、酒芩(酒制黄芩)两帖,第二天早上大便通行,排出蛔虫八条,胸中就不再冲跳,只是觉得力气怯弱。再诊脉时,两手寸部脉象减半,尺脉稍起。用二陈汤加白术、白芍药、酒芩调理,后面四帖加入当归而痊愈。
大宗伯董浔老夫人,经常眩晕,手指及肢体关节发胀。脉象右寸软弱,关部滑,左脉弦长,直上鱼际部位,两尺部皆弱,这是阳气亢盛而不能下潜的脉象。《难经》所说的木行乘金的表现。总归是因为未曾生育,肝经之血未破的缘故。《内经》说:各种风病引起的掉眩,都属于肝木。兼有痰火,治疗应当养金平木,培土化痰。用白术半夏天麻汤,正与此证相对。服用两帖后眩晕平息。再给予六君子汤加天麻、白僵蚕以治其晕,加白芍药以泻肝,麦门冬、人参以补肺金,麦芽、枳实、神曲、苍术以健脾,使宿痰去除而新痰不生。少用黄柏二分作为使药,引热下行,令不再发作。
Mr. Zhang Daonan's wife suffered from abdominal pain and inability to eat for five days due to dietary factors conflicting with qi mechanism. I examined her pulse. The cun (inch) and guan (bar) positions on both hands were xian (wiry), while the chi (cubit) position was hua (slippery).
I stated: This indicates deficiency of qi in the upper jiao (upper burner) and stagnation in the lower jiao. I used Jianghuang (Curcumae Radix, 姜黄) and Qingpi (Citri Reticulatae Pericarpium Viride, 青皮) as Jun (Sovereign) herbs; Shan Zha (Crataegi Fructus, 山楂), Bing Lang (Arecae Semen, 槟榔), Dang Gui (Angelicae Sinensis Radix, 当归), Xing Ren (Armeniacae Semen Amarum, 杏仁), Wu Yao (Linderae Radix, 乌药), and Zhi Qiao (Aurantii Fructus, 枳壳) as Chen (Minister) herbs; Chai Hu (Bupleuri Radix, 柴胡) and Mu Xiang (Aucklandiae Radix, 木香) as Zuo (Assistant) herbs; and Wu Zhu Yu (Evodiae Fructus, 吴茱萸) as Shi (Envoy) herb. After taking the medicine, the qi flow became slightly smooth. Subsequently, two jin (approx. 1 kg) of scallions were boiled to make a decoction for bathing the waist and abdomen. The warm scallions were then rubbed and massaged over the waist and abdomen to promote qi penetration. She rested quietly for a short time after washing. That night, her bowels moved. Initially, black hard lumps were passed, followed by watery stool, indicating that the accumulation had moved but the healthy qi was deficient. Jianzhong Tang (Cinnamon Twig Decoction) was administered with additions of Shan Zha, Fu Ling (Poria, 茯苓), Ze Xie (Alismatis Rhizoma, 泽泻), Chai Hu, Xiang Fu (Cyperi Rhizoma, 香附), and Jiang Lian (Ginger-processed Coptidis Rhizoma, 姜连) for regulation, leading to recovery.
The elderly mother of Mr. Zhang Daonan suffered from morning phlegm obstruction in the diaphragm area accompanied by nausea due to fatigue and overexertion. Whenever she consumed hot food, tears flowed from her eyes. Her pulse was hua (slippery) at the right cun and guan positions, and duan ruo (short and weak) at the left cun position. This indicated insufficiency of heart blood and the presence of phlegm in the lungs and stomach. Liujunzi Tang (Six Gentlemen Decoction) was prescribed with additions of Mai Ya (Hordei Fructus Germinatus, 麦芽), Bai Dou Ren (Vigna Radiata Seed, 白豆仁), and Xuan Fu Hua (Inulae Flos, 旋复花), resulting in a cure.
Mr. Ma Di'an's wife originally suffered from excessive dietary injury compounded by external wind-cold invasion. After treatment for internal injury and external contraction, she developed fever at dawn (wugeng hour), dry lips, incessant palpitations/churning in the chest, and cold hands and feet. Both cun pulses were hua shuo (slippery and rapid). I diagnosed this as a rare phlegm syndrome. Xiaoxianxiong Tang (Small Trap in the Chest Decoction) was given with additions of Bai Shao Yao (Paeoniae Radix Alba, 白芍药), Luo Bo Zi (Brassicae Semens, 萝卜子), Qian Hu (Peucedani Radix, 前胡), and Jiu Qin (Scutellariae Radix processed with wine, 酒芩) for two doses. The next morning, bowel movement occurred, and eight roundworms were expelled. The chest churning ceased, though she felt weak. Upon re-examination, the cun pulses had halved, and the chi pulse slightly rose. Erchen Tang (Two Aged Herbs Decoction) was used for regulation with additions of Bai Zhu (Atractylodis Macrocephalae Rhizoma, 白术), Bai Shao Yao, and Jiu Qin. In the subsequent four doses, Dang Gui was added, leading to full recovery.
Dong Xun, the Elderly Lady of the Grand Secretary, frequently suffered from dizziness and distension in the fingers and limb joints. The right cun pulse was ruan ruo (soft and weak), the guan was hua (slippery); the left pulse was xian chang (wiry and long), extending straight up to the yuji (fish border) area, and both chi pulses were weak. This is a pulse pattern of hyperactivity without descent, described in the Nan Jing (Classic of Difficult Issues) as Wood overcoming Metal. It is attributed to her never having given birth, meaning the liver channel blood had not been broken/released. The Nei Jing (Inner Canon) states: "All wind diseases causing tremors and dizziness belong to Liver Wood." Accompanied by phlegm-fire, the treatment should nourish Metal to calm Wood and strengthen Earth to resolve phlegm. Baizhu Banxia Tianma Tang (Atractylodes, Pinellia, and Gastrodia Decoction) was appropriate for this condition. After two doses, the dizziness subsided. Liujunzi Tang was then given with additions of Tian Ma (Gastrodiae Rhizoma, 天麻) and Bai Jiang Can (Bombyx Batryticatus, 白僵蚕) to treat dizziness, Bai Shao Yao to drain Liver fire, Mai Men Dong (Ophiopogonis Tuber, 麦门冬) and Ren Shen (Ginseng Radix, 人参) to tonify Lung Metal, Mai Ya, Zhi Shi (Aurantii Fructus Immaturus, 枳实), Shen Qu (Massa Medicata Fermentata, 神曲), and Cang Zhu (Atractylodis Rhizoma, 苍术) to strengthen the Spleen, ensuring old phlegm is removed and new phlegm does not form. A small amount of Huang Bo (Phellodendri Cortex, 黄柏), two fen, was used as an envoy to guide heat downward and prevent recurrence.