岵翁公祖。自春月论耳鸣后。见昌执理不阿。知为可用。至冬初以脾约便艰。再召诊视。进苁蓉胡麻山
药首乌等。四剂即润。盖缘肠中少血多风。与药适宜。故效敏耳。自是益加信悦。时沐枉驾就问。披衷相示。
冬尽偶因饱食当风。忽然一吐。倾囊而出。胃气大伤。随召诊间。体中微似发热。左关之脉甚大。自
云始先中脘不舒。今觉气反攻左。始用梨汁不投。今用蔗浆稍定。不知此何症也。昌因断曰。此虚风之候也。
以胃中所受之水谷。出尽无留。空虚若谷。而风自内生。兼肠中久蓄之风。乘
机上入。是以胃中不安。然风入于胃。必左投肝木而从其类。是以气反攻左而左脉即为之大且劲。内经云。风
淫于内。治以甘寒。梨汁蔗浆。俱甘寒对症之物。而一效一不效者。又可知胃中气虚已极。不耐梨性之达下。
而喜蔗性之和中也。于是以甘寒一派之药定方。人参竹沥麦门冬生地黄之属。众议除参不用。服后
腹中呱呱有声。呕出黄痰少许。胸中遂快。次早大便亦通。症似向安。然有可怪者。本是胃经受病。而胃脉反
不见其病。只是上下两旁。心肾肝肺之脉。时时另起一头。不安其常。因为剖心争论。谓此非上下两旁之见病
端也。乃中央气弱。不能四迄。如母病而四子失乳。故现饥馁之象耳。观公祖自云。口中之味极淡。
又云。水到喉管。即注住不肯下行。明明是胃中之气不转。宿水留住喉间。不能更吞新水耳。宜急用四君子汤
以理胃气。则中央之枢轴转。而四畔之机关尽利。喉管之水气不逆。而口中之淡味亦除矣。如不见信。速
请明者商之。不便在此羁时误事也。然而言过激烈。反怪为故意惊骇。改召二医。有谓中风者。有谓
伤寒者。见各不同。至于人参之不可用。则同声和之。谓症之轻而易疗。则同力担之。微用发表之药。即汗出
沾濡。又同口赞之。曾罔顾已竭之胃气。追之实难。反开关而纵之去。于是气高神荡。呃逆不休矣。再侥幸
而投黄连一剂。将绝之系。加极苦以速其绝。二医措手不及。复召昌至。则脉已大乱。如沸如羹。频
转频歇。神昏不醒。身强莫移。年寿间一团黑滞。其气出则顺。而入必哕。通计昼夜一万三千五百息。即得
一万三千五百哕矣。二医卸祸。谓昌前所议四君子汤。今始可用。吁嗟。呼吸存亡。尚图雍容樽俎乎。据理答
之曰。气已出而不入。再加参术之腻阻。立断矣。惟有仲景旋复代赭石一方。可收神功于百一。进一
剂而哕势稍减。二剂加代赭石至五钱。哕遂大减。连连进粥。神清色亮。脉复体轻。再用参苓麦冬木瓜甘草。
平调二日。遂康复如初。此盖祖翁少时纯朴不凋。故松柏之姿。老而弥劲。非尽药
之功能也。即论药。亦非参之力。乃代赭坠参下行之力也。祖翁病剧。问昌何为不至。及病间。见昌进药。
即鼓勇欣尝。抑何见知之深耶。而昌亦得藉汤药以行菽水之事。快矣快矣。
胡卣臣先生曰。左氏春秋。无与于兵。而名将以为兵法之至精。见理
不到。则一心之运用不出也。噫。难与俗人言。
岵翁公祖。自春月论耳鸣后。见昌执理不阿。知为可用。至冬初以脾约便艰。再召诊视。进苁蓉胡麻山 药首乌等。四剂即润。盖缘肠中少血多风。与药适宜。故效敏耳。自是益加信悦。时沐枉驾就问。披衷相示。
冬尽偶因饱食当风。忽然一吐。倾囊而出。胃气大伤。随召诊间。体中微似发热。左关之脉甚大。自 云始先中脘不舒。今觉气反攻左。始用梨汁不投。今用蔗浆稍定。不知此何症也。昌因断曰。此虚风之候也。
以胃中所受之水谷。出尽无留。空虚若谷。而风自内生。兼肠中久蓄之风。乘 机上入。是以胃中不安。然风入于胃。必左投肝木而从其类。是以气反攻左而左脉即为之大且劲。内经云。风 淫于内。治以甘寒。梨汁蔗浆。俱甘寒对症之物。而一效一不效者。又可知胃中气虚已极。不耐梨性之达下。 而喜蔗性之和中也。于是以甘寒一派之药定方。人参竹沥麦门冬生地黄之属。众议除参不用。服后 腹中呱呱有声。呕出黄痰少许。胸中遂快。次早大便亦通。症似向安。然有可怪者。本是胃经受病。而胃脉反 不见其病。只是上下两旁。心肾肝肺之脉。时时另起一头。不安其常。因为剖心争论。谓此非上下两旁之见病 端也。乃中央气弱。不能四迄。如母病而四子失乳。故现饥馁之象耳。观公祖自云。口中之味极淡。 又云。水到喉管。即注住不肯下行。明明是胃中之气不转。宿水留住喉间。不能更吞新水耳。宜急用四君子汤 以理胃气。则中央之枢轴转。而四畔之机关尽利。喉管之水气不逆。而口中之淡味亦除矣。如不见信。速 请明者商之。不便在此羁时误事也。然而言过激烈。反怪为故意惊骇。改召二医。有谓中风者。有谓 伤寒者。见各不同。至于人参之不可用。则同声和之。谓症之轻而易疗。则同力担之。微用发表之药。即汗出 沾濡。又同口赞之。曾罔顾已竭之胃气。追之实难。反开关而纵之去。于是气高神荡。呃逆不休矣。再侥幸 而投黄连一剂。将绝之系。加极苦以速其绝。二医措手不及。复召昌至。则脉已大乱。如沸如羹。频 转频歇。神昏不醒。身强莫移。年寿间一团黑滞。其气出则顺。而入必哕。通计昼夜一万三千五百息。即得 一万三千五百哕矣。二医卸祸。谓昌前所议四君子汤。今始可用。吁嗟。呼吸存亡。尚图雍容樽俎乎。据理答 之曰。气已出而不入。再加参术之腻阻。立断矣。惟有仲景旋复代赭石一方。可收神功于百一。进一 剂而哕势稍减。二剂加代赭石至五钱。哕遂大减。连连进粥。神清色亮。脉复体轻。再用参苓麦冬木瓜甘草。 平调二日。遂康复如初。此盖祖翁少时纯朴不凋。故松柏之姿。老而弥劲。非尽药 之功能也。即论药。亦非参之力。乃代赭坠参下行之力也。祖翁病剧。问昌何为不至。及病间。见昌进药。 即鼓勇欣尝。抑何见知之深耶。而昌亦得藉汤药以行菽水之事。快矣快矣。
胡卣臣先生曰。左氏春秋。无与于兵。而名将以为兵法之至精。见理 不到。则一心之运用不出也。噫。难与俗人言。
After discussing tinnitus (tinnitus) in the spring, Ancestor Hu recognized that I, Chang, adhered strictly to principles without flattery, and thus deemed me competent. By early winter, due to Pi Yue syndrome (Spleen Constraint Syndrome, characterized by constipation), he summoned me again for consultation. I administered Cistanche Herba (Rou Cong Rong), Sesame Seed (Hu Ma Zi), Dioscoreae Rhizoma (Shan Yao), and Polygoni Multiflori Radix (Shou Wu). After four doses, his bowels became moistened. This was because there was a deficiency of blood and an excess of wind in the intestines, which matched the properties of the herbs, hence the rapid efficacy. From then on, he trusted and pleased with me even more, often visiting me personally to ask for advice and opening his heart to show his condition.
At the end of winter, accidentally eating too much while exposed to wind, he suddenly vomited, emptying his stomach completely. His Stomach Qi (Stomach's physiological function) was severely damaged. When I was summoned to examine him, he had a slight fever. The pulse at the left Guan position (position corresponding to the Liver/Gallbladder) was very large. He said initially he felt discomfort in the Zhongwan area (epigastrium), but now felt Qi counterattacking to the left. Initially, pear juice did not agree with him; now, cane syrup has slightly stabilized the condition. He asked what this syndrome was. I therefore diagnosed it as a manifestation of Deficient Wind (internal wind generated by deficiency). Because the food and drink received by the Stomach were all expelled with no residue remaining, the interior became hollow like a valley, causing wind to generate internally. Additionally, the wind long accumulated in the intestines took the opportunity to enter upwards, causing unrest in the Stomach. However, when wind enters the Stomach, it must move to the left to attack the Liver Wood (Liver system) and follow its kind. Thus, Qi counterattacks to the left, and the left pulse becomes large and forceful. The *Neijing* states: "When wind dominates internally, treat it with sweet and cold substances." Both pear juice and cane syrup are sweet and cold substances appropriate for the syndrome. The fact that one worked and the other did not further indicates that the Qi deficiency in the Stomach is extreme; it cannot tolerate the descending nature of pear, but prefers the harmonizing nature of cane syrup. Therefore, I formulated a prescription using a category of sweet and cold herbs, including Ginseng Radix et Rhizoma (Ren Shen), Bamboo Sap (Zhu Li), Ophiopogonis Radix (Mai Men Dong), and Rehmanniae Radix (Sheng Di Huang). The consensus was to exclude Ginseng and not use it. After taking the medicine, gurgling sounds were heard in the abdomen, and a small amount of yellow phlegm was vomited, bringing relief to the chest. The next morning, his bowels moved freely, and the symptoms seemed to be improving.
However, there was something strange. Although the disease originated in the Stomach Meridian (Stomach channel), the Stomach pulse did not show signs of illness. Instead, the pulses of the Heart, Kidney, Liver, and Lungs in the upper, lower, and lateral positions frequently presented independently, deviating from their normal state. I explained my reasoning earnestly, arguing that this was not a sign of disease in the upper, lower, or lateral areas, but rather weakness of the Central Qi (Spleen/Stomach Qi) unable to reach the four extremities. It is like a mother who is ill and her four children lose milk, thus showing signs of hunger and deprivation. Observing that the Ancestor himself said his taste in the mouth was extremely bland, and that water reaching the throat stopped and refused to go down, it was clearly due to the failure of Stomach Qi to rotate. Old water remained in the throat, preventing the swallowing of new water. It was urgent to use Si Jun Zi Tang (Four Gentlemen Decoction) to regulate Stomach Qi. Then the pivot of the center would turn, and the mechanisms of the four sides would become smooth. The rebellious Qi of water in the throat would subside, and the bland taste in the mouth would disappear. If you do not believe this, quickly consult a knowledgeable physician. It is inappropriate to delay here and cause mistakes.
However, my words were perceived as overly severe, and they blamed me for intentionally startling them. They changed to summon two other physicians. One diagnosed it as Stroke (Zhong Feng), and the other as Cold Damage (Shang Han); their views differed. Regarding the inadvisability of using Ginseng, they all agreed. Regarding the claim that the syndrome was mild and easy to treat, they all supported it. They lightly used releasing-the-exterior herbs, resulting in profuse sweating, and they all praised this action. They disregarded the already exhausted Stomach Qi, finding it difficult to tonify, so instead they opened the pores and let the pathogen escape. Consequently, Qi rose high, spirit became scattered, and hiccups (E Ni) continued incessantly. As a last resort, they administered a dose of Coptidis Rhizoma (Huang Lian). To a nearly severed life connection, they added extreme bitterness to hasten its end. The two physicians were caught off guard and summoned me again. At this point, the pulse was greatly disordered, boiling like soup, changing frequently and pausing intermittently. The patient was unconscious and comatose, body rigid and immobile. Between the nose and philtrum, there was a patch of dark stagnation. Exhalation was smooth, but inhalation caused hiccups. Counting breaths over day and night, totaling 13,500 breaths, there were exactly 13,500 hiccups. The two physicians shifted blame, saying that the Si Jun Zi Tang (Four Gentlemen Decoction) I had previously discussed could now be used. Alas! With life hanging by a thread of respiration, can one still plan leisurely banquets? Answering based on principle, I said: "Qi has exited and does not return. Adding the cloying obstruction of Ginseng and Atractylodis Rhizoma (Bai Zhu) will lead to immediate death. Only Zhang Zhongjing’s Xuan Fu Dai Zhe Shi Tang (Inula and Hematite Decoction) can achieve miraculous results in one out of a hundred cases." After administering one dose, the severity of hiccups decreased slightly. After two doses, the dosage of Hematite (Dai Zhe Shi) was increased to five qian, and the hiccups decreased significantly. He continuously consumed congee, his spirit cleared, complexion brightened, pulse normalized, and body became light. Using Ginseng, Poria (Fu Ling), Ophiopogon (Mai Dong), Chaenomelis Fructus (Mu Gua), and Licorice Root (Gan Cao) to gently regulate for two days, he recovered as before.
This was partly because the Ancestor was simple and unadorned in his youth, retaining the posture of pine and cypress, becoming stronger with age. This was not solely due to the efficacy of the medicine. Even discussing the medicine, it was not the power of Ginseng alone, but the downward-pushing force of Hematite assisting Ginseng. When the Ancestor was critically ill, he asked why I did not come. When he improved and saw me administer medicine, he gathered courage to appreciate it. How deep was his insight! And I was also able to rely on decoctions to perform the duties of filial care. How delightful!
Mr. Hu Youchen said: The *Zuo Zhuan* (*Commentary of Zuo*) has nothing to do with military affairs, yet great generals consider it the essence of military strategy. If one's understanding of principles is insufficient, the application of the mind cannot extend. Alas! It is difficult to speak with vulgar people.