沈别驾翁,有老仆,头痛,遍身骨节痛,面色黑,发热,口渴,胸膈膨胀,饮食七日不
入,
复感寒,人皆危之。予诊其脉,左弦数,右洪大,以藿香、苍术、防风、葛根、白芷、紫苏
、甘草、陈皮、大腹皮、麦芽、枳实,服后胸膈稍宽,热与痛更甚。改以麻黄、
葛根、柴胡各二钱,石膏、滑石各三钱,紫
苏叶、白芷、苍术各一钱,甘草五分,姜三片,服后大汗出,而热痛皆除,惟口渴。又以白芍药
、当归、石膏、知母、柴胡、黄芩、麦冬、葛根、陈皮,煎服痊愈。别驾翁喜诘予曰∶老仆
病甚重,无不谓其必死,先生三日起之,此何症?而何汤剂饮之使起也?予曰∶此三阳合病,
先为饮食所伤,予故先用藿香正气汤,加消导之剂治其本,又以六神通解散,加助表之药治
其标,病虽重,年虽高,喜其色脉相对,故投以对症之药易愈也。翁曰∶在先生然耳!若他
人轻者且重,况重者乎!吾未见其能起也。
蔡中林文学内人,发热口渴,舌上燥裂,小腹痛,呕吐,药食不能入者七日,诸医之技
殚矣,
皆视为膈食而不可为。吴我峰翁固邀予诊,右寸脉绝不应指,关沉滑有力,左手弦数。予曰
∶此阳明少阳合病,邪热壅于上焦然也,非膈食,法当解散,数剂可愈,无恐。以软柴胡、
石膏各五钱,半夏曲、枳实、黄芩、黄连、葛根、竹茹、人参各二钱,姜三片,煎服,药纳
而不吐,五更下黑粪数块,热痛减半。次日仍与前药,右寸脉至是亦起粥始进。改用小柴胡
加橘红、竹茹、葛根,服三帖而全安。
沈别驾(官职名)家中有一位老仆人,出现头痛、全身骨节疼痛、面色发黑、发热、口渴、胸膈部胀满的症状,连续七天无法进食。后来又感受了寒邪,大家都认为病情危重。我诊察他的脉象,左手脉弦数,右手脉洪大。于是使用藿香、苍术、防风、葛根、白芷、紫苏、甘草、陈皮、大腹皮、麦芽、枳实这些药材组方。服用后胸膈部的胀满感稍微缓解,但发热和疼痛反而加重。
于是改用麻黄、葛根、柴胡各二钱,石膏、滑石各三钱,紫苏叶、白芷、苍术各一钱,甘草五分,生姜三片。服用后大汗出,发热和疼痛全部消除,只剩下口渴症状。接着又用白芍药、当归、石膏、知母、柴胡、黄芩、麦冬、葛根、陈皮煎服,最终痊愈。
沈别驾高兴地质问我道:“老仆人的病非常严重,没有不认为他必死无疑的,先生三天内让他起死回生,这是什么病症?用了什么汤剂让他康复的?”我说:“这是三阳合病(太阳、阳明、少阳三经同时受邪),起初是因为饮食不当受伤,所以我先用藿香正气汤(化湿和中、解表散寒的方剂),加入消食导滞的药物来治疗根本原因;又用六神通解散(解表清热、通利经络的方剂),加入助发表的药物来治疗标症。虽然病重且患者年事已高,但庆幸其面色与脉象相符(色脉相应),所以投以对症的药物容易治愈。”沈别驾说:“只有先生您能做到!如果换作其他人,轻病尚且会加重,何况重病呢!我没见过能救活他的。”
蔡中林(人名)先生的夫人,出现发热、口渴、舌面干燥开裂、小腹痛、呕吐,药物和食物七天都无法进入体内的症状。各位医生的医术都已用尽,都将其视为噎膈(吞咽困难、饮食不下之病)而认为不可治。吴我峰先生坚决邀请我为她诊脉,发现右寸脉微弱几乎摸不到,关脉沉滑有力,左手脉弦数。我说:“这是阳明少阳合病(阳明经与少阳经同时受邪),是邪热壅塞在上焦所致,并非噎膈,治疗方法应当疏散解表,服用几剂药就可以痊愈,不必担心。”于是使用软柴胡、石膏各五钱,半夏曲、枳实、黄芩、黄连、葛根、竹茹、人参各二钱,生姜三片,煎服。服药后药液能够咽下而不呕吐,五更时分排出黑色粪便数块,发热和疼痛减轻了一半。第二天仍然服用前一种药物,右寸脉至此也恢复,开始喝粥。随后改用小柴胡汤(和解少阳的主方),加入橘红、竹茹、葛根,服用三帖后完全康复。
Mr. Shen, a Jieba (official title), had an old servant who suffered from headache, pain throughout the body and joints, dark complexion, fever, thirst, and distension in the chest and diaphragm. He had not taken any food for seven days. Subsequently, he contracted cold pathogens, and everyone considered his condition critical. I examined his pulse: the left side was wiry and rapid, while the right side was large and flooding. I prescribed a formula containing Huoxiang (Agastache Herba), Cangzhu (Atractylodis Rhizoma), Fangfeng (Saposhnikoviae Radix), Gegen (Puerariae Lobatae Radix), Baizhi (Angelicae Dahuricae Radix), Zisu (Perillae Folium), Gancao (Glycyrrhizae Radix et Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Dafupi (Arecae Pericarpium), Maiya (Hordei Fructus Germinatus), and Zhishi (Aurantii Fructus Immaturus). After taking the medicine, the distension in the chest and diaphragm slightly relieved, but the fever and pain intensified.
I then changed the prescription to Mahuang (Ephedrae Herba), Gegen (Puerariae Lobatae Radix), and Chaihu (Bupleuri Radix), each 2 qian; Shigao (Gypsum Fibrosum) and Huashi (Talcum), each 3 qian; Zisuye (Perillae Folium), Baizhi (Angelicae Dahuricae Radix), and Cangzhu (Atractylodis Rhizoma), each 1 qian; Gancao (Glycyrrhizae Radix et Rhizoma) 5 fen; and three slices of Shengjiang (Zingiberis Rhizoma Recens). After ingestion, profuse sweating occurred, and both fever and pain were completely eliminated, leaving only thirst. Subsequently, I prescribed Shaoyao (Paeoniae Radix Alba), Danggui (Angelicae Sinensis Radix), Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma), Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), Maidong (Ophiopogonis Radix), Gegen (Puerariae Lobatae Radix), and Chenpi (Citri Reticulatae Pericarpium) decocted and administered orally, resulting in full recovery.
Mr. Shen happily questioned me, saying, "The old servant's illness was severe; no one believed he would survive. How did you revive him within three days? What syndrome is this, and what decoction cured him?" I replied, "This is Sanyang Hebing (Concurrent disease of the Taiyang, Yangming, and Shaoyang channels). Initially, it was caused by dietary injury. Therefore, I first used Huoxiang Zhengqi Tang (Agastache Powder to Rectify the Qi) combined with digestive aids to treat the root cause, and Liutong Sanjie San (Six-Channel Resolving Decoction) with exterior-assisting herbs to treat the branch symptoms. Although the disease was severe and the patient elderly, fortunately, the complexion and pulse were consistent (color-pulse correspondence), so administering targeted medication led to easy recovery." Mr. Shen said, "Only you, Master, could achieve this! If others treated him, even mild cases would worsen, let alone severe ones. I never expected him to be revived."
Ms. Cai, wife of Scholar Cai Zhonglin, presented with fever, thirst, dry and cracked tongue coating, lower abdominal pain, and vomiting, unable to retain any medicine or food for seven days. All physicians had exhausted their skills and diagnosed her with Ge Shi (Dysphagia/Regurgitation), deeming it incurable. Mr. Wu Wofeng strongly invited me to examine her. Her right Cun (inch) pulse was imperceptible, the Guan (bar) pulse was deep, slippery, and forceful, and the left hand pulse was wiry and rapid. I stated, "This is Yangming Shaoyang Hebing (Concurrent disease of the Yangming and Shaoyang channels), caused by pathogenic heat obstructing the Upper Jiao (Upper Burner). It is not Ge Shi (Dysphagia/Regurgitation). The treatment method should be to disperse and resolve the exterior. A few doses will suffice for recovery; do not worry." I prescribed Ruan Chaihu (Soft Bupleuri Radix) and Shigao (Gypsum Fibrosum), each 5 qian; Banxia Qu (Pinelliae Fermentatum), Zhishi (Aurantii Fructus Immaturus), Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Gegen (Puerariae Lobatae Radix), Zhuru (Bambusae Caulis in Taenia), and Renshen (Ginseng Radix), each 2 qian; along with three slices of Shengjiang (Zingiberis Rhizoma Recens). After decoction and administration, the medicine was retained without vomiting. At dawn (Wugeng time), she passed several pieces of black stool, and the fever and pain reduced by half. The following day, she continued with the same prescription. By then, the right Cun pulse had recovered, and she began consuming congee. I then modified Xiao Chaihu Tang (Minor Bupleurum Decoction) by adding Juhong (Citri Reticulatae Pericarpium Rubrum), Zhuru (Bambusae Caulis in Taenia), and Gegen (Puerariae Lobatae Radix). After three doses, she fully recovered.