浊病止则足肿,是湿邪无从泄泻,其从前浊病,亦是湿气下注膀胱,非关精窍为患。
周(塘楼,二十五岁) 湿是阴邪,肤腠中气瘿结,病起大便自泻,从太阴治。
生白术 淡熟小附子 细川桂枝尖 茯苓块
李(嘉兴) 质虚不耐烦冗,动则阳升,由阴不和阳,深秋痢症虽愈,犹夏季致伤。
人参 茯苓 枣仁 炙草 小麦 青花 龙骨
用妙香法以和阳,是和心阳耳。
王(北濠,二十五岁) 中焦痛起,四肢逆冷,汗出,呕涎及食物,此属脾厥。
极黑附子 草果仁 粗桂皮 片姜黄 延胡索
厥为寒之极,太阴本是至阴,热药为宜。
吕(同里,二十岁) 夏令热气伤阴失血,冬藏气降,血症必然不来,肉瘦精虚,嗽不肯
已。宜滋培脏阴,预防春深升泄病发。
固本加五味子
汪(沐阳,五十四岁) 居住临海,风障疠气,不比平原,人众稠密,障疠侵入脑髓骨骱
,气血不和,壅遏内蒸,头面清真痹阻,经年累月,邪正混处其间,草木不能驱逐。具理而
论,当以虫蚁向阳分疏通逐邪。
蜣螂 威灵仙 蜂房 川芎
火酒飞面同丸。
吕(同里,四十五岁) 心痛得食反缓,是积劳营虚,大忌破降气药。
桃仁 桂元肉 炒黑芝麻 当归身 柏子仁
罗(二十三岁) 病患述遇春季则失血,烦劳必有衄血。凡冬月大气藏伏,壮年自能聚精
汇神,不加保养,春半地中阳升,发生之气交,反为发病动机矣。是皆身中精气之薄,胃纳
安
旺,自能知惜静养则神藏。
熟地 山药 芡实 五味 金樱 湖莲 萸肉 龙骨 茯神
朱(湖州,三十八岁) 太阴腹胀,是久劳伤阳,不饥不饱,二便不通爽,温以通阳,苦
温疏滞。
制附子 熟大黄 草果 生浓朴 生姜 广皮
温下法,从许学士温脾汤来。
夏(山塘,七十五岁) 初冬温热气入,引动宿饮,始而状如伤风,稀痰数日,痰浓喉干
,少阴中五液变痰,乏津上承,皆下虚易受冷热,致阴上泛。老人频年咳嗽,古人操持脾肾
要领,大忌发散泄肺,暂用越婢法。
凡内有宿病,每因新感六气,病邪牵动而发。盖藏匿夙病之处,气血必虚弱,故新邪必
注空隙为患。
沈(槐树巷,二十二岁) 自交秋初,皆令阴阳巅胀失血,三月怀妊,法当养阴固胎。
人参 黑壳建莲 子芩 阿胶 白芍 桑寄生
戴(徽州,三十九岁) 仲景论痰饮分二要,外饮治脾,内饮治肾。又云∶凡饮邪必以温
药和之。阅方是温养肾藏,不为背谬。考痰饮有形,原其始也。阳气微弱,浊阴固聚,自下
逆行,喘不着枕。附子走而通阳,极为合理。然其余一派滋柔护阴,束缚附子之剽疾矣。(
此为阳微而阴未甚亏者。设仲景八味丸治痰饮,丹苓泽原疏通脐阳,非尽滋柔护阴者。)
浊病停止后出现足部肿胀,这是因为湿邪无法通过排泄排出。之前的浊病,也是湿气下注膀胱所致,与精窍(生殖泌尿系统)无关。
周先生(塘楼,二十五岁):湿属于阴邪,导致皮肤腠理间气机郁结,病症起始于大便自泻,应从太阴脾经论治。
生白术、淡附子、细川桂枝尖、茯苓块。
李先生(嘉兴):体质虚弱且不耐烦劳,活动则阳气上亢,这是由于阴不和阳所致。深秋时的痢疾虽然痊愈,但仍是夏季受伤留下的隐患。
人参、茯苓、酸枣仁、炙甘草、小麦、青花(此处指某种药材或配伍,依原文保留)、龙骨。
采用妙香散的方法以调和心阳,这里所说的“和阳”仅指调和心阳。
王先生(北濠,二十五岁):中焦疼痛发作,四肢逆冷,出汗,呕吐涎沫及食物,这属于脾厥证。
极黑附子、草果仁、粗桂皮、片姜黄、延胡索。
厥证是寒邪的极致表现,太阴脾本属至阴之脏,适宜使用热性药物。
吕先生(同里,二十岁):夏令热气损伤阴液导致失血,冬季闭藏之气下降,血症自然停止,但肌肉消瘦、精气亏虚,咳嗽难以停止。应当滋补培固脏腑之阴,预防春深时节升发泄越之病发作。
固本丸加五味子。
汪先生(沐阳,五十四岁):居住在海边,风障疠气(瘴气),不同于平原地区,人口稠密,瘴疠之气侵入脑髓和骨节,气血不和,壅滞内蒸,导致头面部经络痹阻。经年累月,邪气与正气混杂其间,普通草木药物不能驱逐。据理分析,应当使用虫蚁类药物向阳分疏通以逐邪。
蜣螂、威灵仙、蜂房、川芎。
用烧酒拌面粉制成丸药。
吕先生(同里,四十五岁):心痛在进食后反而缓解,这是积劳导致营血亏虚,绝对忌讳使用破气降气的药物。
桃仁、桂圆肉、炒黑芝麻、当归身、柏子仁。
罗先生(二十三岁):患者叙述每逢春季就失血,烦劳必然导致鼻出血。凡是冬季大气潜藏伏匿之时,壮年人自能聚精汇神,如果不加以保养,到了春半时节地中阳气上升,发生之气交接,反而成为发病的动机。这都是因为身体中精气薄弱,如果胃纳旺盛,自己知道珍惜并静养,则神气得以藏守。
熟地黄、山药、芡实、五味子、金樱子、湖莲、山茱萸、龙骨、茯神。
朱先生(湖州,三十八岁):太阴腹胀,是由于久劳损伤阳气,表现为不饥不饱,二便不通畅爽利,治疗宜温通阳气,苦温疏滞。
制附子、熟大黄、草果、生厚朴、生姜、广陈皮。
采用温下法,源自许学士的温脾汤。
夏先生(山塘,七十五岁):初冬温热之气入侵,引动体内宿饮,起初症状像伤风,稀痰持续数日,随后痰浓喉干。少阴肾中五液变为痰,缺乏津液上承,皆因下元虚损易受冷热侵袭,导致阴寒上泛。老人常年咳嗽,古人强调掌握脾肾要领,大忌发散泄肺之法,暂时使用越婢汤法。
凡体内有宿疾,往往因为新感六淫之气,病邪牵动而发作。大概藏匿宿疾之处,气血必然虚弱,所以新邪必定注入空隙造成危害。
沈女士(槐树巷,二十二岁):自从交秋初以来,皆令阴阳失调导致巅顶胀痛失血,现三月怀妊,治法应当养阴固胎。
人参、黑壳建莲、子芩(黄芩)、阿胶、白芍、桑寄生。
戴先生(徽州,三十九岁):张仲景论述痰饮分为两个要点,外饮治脾,内饮治肾。又说:“凡饮邪必以温药和之。”阅读此方是温养肾脏,并不违背医理。考察痰饮是有形之邪,追溯其始,是因为阳气微弱,浊阴固聚,自下逆行,喘息不能着枕。附子走窜而通阳,极为合理。然而其余一派滋柔护阴的药物,束缚了附子的剽悍迅疾之性。(这是针对阳微而阴未甚亏的情况。假如张仲景用八味丸治痰饮,丹皮、茯苓、泽泻原意在于疏通脐下之阳,并非全是滋柔护阴的药物。)
When the turbid disease ceases, swelling of the feet occurs; this is because the dampness pathogen has no way to be excreted. The previous turbid disease was also caused by dampness pouring downward into the Bladder (Bladder), not involving the essence orifices (reproductive and urinary openings).
Zhou (Tanglou, 25 years old): Dampness is a Yin pathogen, causing Qi stagnation in the skin and interstices. The illness began with spontaneous diarrhea; it should be treated from the perspective of the Taiyin Spleen channel.
Raw Atractylodis Macrocephalae Rhizoma (Baizhu), mild processed Aconiti Lateralis Radix Praeparata (Fuzi), fine Cinnamomi Ramulus (Guizhi) tips, Poria (Fuling).
Li (Jiaxing): The constitution is deficient and intolerant of fatigue; movement causes Yang to rise due to Yin failing to harmonize with Yang. Although the dysentery in late autumn has healed, it remains an injury sustained in summer.
Ginseng Radix et Rhizoma (Renshen), Poria (Fuling), Ziziphi Spinosae Semen (Suanzaoren), Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (Zhigancao), Triticum aestivum (Xiaomai), Qinghua (Qinghua), Dragon Bone (Longgu).
Using the Miaoxiang method to harmonize Yang, specifically referring to harmonizing Heart Yang.
Wang (Beihao, 25 years old): Pain arises in the Middle Jiao, accompanied by cold extremities, sweating, and vomiting of saliva and food. This belongs to Spleue Jue (Spleen Cold Reversal).
Extreme black Aconiti Radix Praeparata (He Fuzi), Tsaoko Fructus (Caoguo), rough Cinnamomi Cortex (Guipi), Curcumae Longae Rhizoma (Pian Jianghuang), Corydalis Rhizoma (Yanhusu).
Jue represents the extreme of cold. The Taiyin Spleen is inherently a Supreme Yin organ; hot herbs are suitable.
Lu (Tongli, 20 years old): Summer heat damaged Yin, leading to blood loss. In winter, the Qi descends for storage, so the blood disorder naturally stops. However, muscle wasting and essence deficiency persist, and coughing will not cease. It is appropriate to nourish and tonify the Zang Yin to prevent the onset of ascending and dispersing diseases in deep spring.
Guben Wan (Solidify the Root Pill) added with Schisandrae Fructus (Wuweizi).
Wang (Muyang, 54 years old): Residing by the sea, one is exposed to wind barriers and miasma, unlike in plains. The dense population allows miasma to invade the brain marrow and bone joints. Qi and Blood are disharmonious, stagnant and steaming internally, causing obstruction in the head and face meridians. Over years, pathogens and healthy Qi mix together, and ordinary herbal medicines cannot expel them. Theoretically, insect and ant species should be used to unblock the Yang aspect to drive out pathogens.
Scarabaeus (Qianglang), Saposhnikoviae Radix (Weilingxian), Vespa Nidus (Fengfang), Ligusticum Chuanxiong Rhizoma (Chuanxiong).
Made into pills using liquor and flour.
Lu (Tongli, 45 years old): Heart pain that relieves after eating indicates accumulated exhaustion and Ying Blood deficiency. Breaking Qi and descending agents are strictly contraindicated.
Persicae Semen (Taoren), Dimocarpus longan Arillus (Guiyuanrou), fried Sesame Indicum Seed (Heima Zhima), Angelicae Sinensis Radix Corpus (Dangguishen), Platycladi Semen (Baiziren).
Luo (23 years old): The patient reports hemoptysis every spring; fatigue inevitably leads to epistaxis. In winter, when atmospheric Qi hides, young adults can gather essence and spirit. Without maintenance, when Earth's Yang rises in mid-spring and generating Qi intersects, it becomes the motive force for disease. This is due to thin essence and Qi in the body. If Stomach intake is robust, knowing to cherish and rest quietly allows Spirit to hide.
Prepared Rehmanniae Radix (Shudihuang), Dioscoreae Rhizoma (Shanyao), Euryales Semen (Qianshi), Schisandrae Fructus (Wuweizi), Rubus chingii Fruit (Jinyingzi), Nelumbinis Semen (Hulian), Corni Fructus (Yurou), Dragon Bone (Longgu), Poria Cum Pinellia (Fushen).
Zhu (Huzhou, 38 years old): Taiyin abdominal distension is caused by long-term fatigue damaging Yang. Symptoms include lack of appetite and satiety, and unsmooth urination and defecation. Treatment should warm and unblock Yang, using bitter-warm methods to disperse stagnation.
Processed Aconiti Lateralis Radix Praeparata (Zhi Fuzi), Prepared Rheum Palmatum Radix et Rhizoma (Shu Dahuang), Tsaoko Fructus (Caoguo), Magnoliae Officinalis Cortex Sheng (Sheng Houpo), Zingiberis Rhizoma Recens (Shengjiang), Citrus Reticulata Pericarpium (Guangpi).
Using the Warm Purging method, derived from Scholar Xu’s Wenyi Tang (Warm Spleen Decoction).
Xia (Shantang, 75 years old): Early winter warm Qi entered, triggering retained fluid. Initially resembling wind-cold, there was thin sputum for several days, followed by thick sputum and dry throat. The five fluids of Shaoyin Kidney transformed into phlegm; lacking Jin-Ye to ascend, all due to lower deficiency easily affected by cold and heat, causing Yin to float upward. For elderly chronic cough, ancients emphasized grasping the essentials of Spleen and Kidney. Dispersing and lung-draining methods are strictly forbidden; temporarily use Yebiao Fa (Yebiao Method).
Generally, internal chronic diseases often flare up due to new contraction of the Six Qi (pathogens). Where chronic diseases hide, Qi and Blood must be weak, so new pathogens inevitably pour into these voids to cause harm.
Shen (Huai shu Xiang, 22 years old): Since early autumn, Yin-Yang imbalance has caused distending pain at the vertex and blood loss. Now three months pregnant, the method should be to nourish Yin and secure the fetus.
Ginseng Radix et Rhizoma (Renshen), Black-shell Nelumbinis Semen (Heike Jianlian), Scutellariae Radix (Ziqin), Donkey-hide Gelatin (Ejiao), Paeoniae Radix Alba (Baishao), Taxilli (Sangjisheng).
Dai (Huizhou, 39 years old): Zhang Zhongjing discussed Phlegm-Fluid (Tan Yin) in two main aspects: external fluid is treated via the Spleen, internal fluid via the Kidney. He also stated: "All fluid pathogens must be harmonized with warm herbs." Reading this prescription, it warms and nourishes the Kidney, which is not contradictory. Examining Phlegm-Fluid as a有形 (substantial) pathogen, tracing its origin, it stems from weak Yang Qi and solidification of turbid Yin, reversing upward from below, causing asthma preventing lying flat. Aconite moves and unblocks Yang, which is highly reasonable. However, the rest of the formula consists of moistening and Yin-nourishing herbs, binding the fierce speed of Aconite. (This applies to cases where Yang is weak but Yin is not severely deficient. If Zhang Zhongjing used Ba Wei Wan [Eight-Ingredient Pill] to treat Phlegm-Fluid, Mu Dan Pi, Fu Ling, and Ze Xie originally aimed to unblock Yang below the umbilicus, not merely to nourish Yin.)