范(无锡,二十九岁) 织梭身体皆动,过劳气血,偏倚左胁痛,失血呕血,肝络伤瘀,
久发则重。
炒桃仁 延胡 新绛屑 降香末 炒丹皮 钩藤
沈(湖州,二十九岁) 病伤不复元,壮失保养,延为劳嗽,胃气颇好,可与填精固下。
都气法去丹泽,加水陆二仙(金樱芡实)胡桃肉。
洪(吴江,二十七岁) 肌肉日瘦,竟夜内热,是内损阴虚,渐挨劳怯,安逸可久,天暖
气泄病加(阴损将及阳矣,故气暖病加。)
早服乳酪一杯,另服补阴丸。
王(宁波,四十八岁) 七疝肝病为多,有声响为气疝。寒入募络,积疝坚硬下坠,中年
不可从张子和用八味加大茴香、葫芦巴(声响乃气之所鼓,寒气凝阻正气渊乎微妙,不到中
年以后,那知病情如是耶?)
雍(枫桥,二十七岁) 眩晕呕水,心中热,神迷若痫,皆操持运机,易于升举,蒙冒清
神。生姜辛可通神,但气温先升,佐入凉降剂中乃可。
沈(南浔,三十三岁) 凡外邪入肺而咳嗽者,可用表散肺气。若内伤累及于肺致咳者,
必从内伤治(此系中虚咳嗽,用药纯粹以精。)汗之则泄阳气,肺痿食减音低,显然药误。
黄 米仁 黄精 白芨
痰饮乃积滞久留,吐出为安。若浊粘涎沫,是身中脏腑津液,所以奉养躯命者,倘被阴
火燔灼,上逼咽喉吐出,是肾脏不纳,乃为重病。
金(运漕,四十四岁) 冬藏失司,嗽吐涎沫,是肾病也(识力清老脉必两尺不固。)医见
嗽咸以肺药治之,年余无效。
范某(无锡人,29岁):全身肌肉如织梭般抽动,因过度劳累导致气血耗伤,左侧胁肋部疼痛,出现吐血、呕血症状,这是肝络受损且有瘀血阻滞,病程长久则病情加重。
炒桃仁 延胡索 新绛屑 降香末 炒丹皮 钩藤
沈某(湖州人,29岁):病后身体未能恢复元气,因壮年时期缺乏保养,拖延成劳嗽(慢性咳嗽伴虚损),但胃气尚好,可以采用填补精髓、固摄下焦的方法治疗。
都气丸法去掉牡丹皮和泽泻,加入水陆二仙丹(金樱子、芡实)和胡桃肉。
洪某(吴江人,27岁):肌肉日渐消瘦,整夜感到内热,这是内伤阴虚,逐渐发展为劳怯(虚劳羸弱),若能安逸休养可维持较久;天气暖和时病情反而加重(这是因为阴精亏损即将波及阳气,所以气温升高时病情加剧)。
早晨服用一杯乳酪,另外服用补阴丸。
王某(宁波人,48岁):七种疝气中肝病居多,伴有声响的称为气疝。寒气侵入募原之络,积聚的疝气坚硬且向下坠胀,中年以后不可再像张子和那样使用八味丸加大茴香、葫芦巴(因为声响是气机鼓动所致,寒气凝滞阻碍正气,其机理深奥微妙,不到中年以后,怎知病情如此呢?)
雍某(枫桥人,27岁):眩晕、呕吐清水,心中烦热,神志昏迷类似痫证,这都是因为操持心机过度,导致气机易于升举,蒙蔽清灵之神明。生姜辛温可以通阳醒神,但其性温热先升,需配合凉降的药物一起使用才行。
沈某(南浔人,33岁):凡是外邪侵入肺部导致的咳嗽,可以使用发散表邪、宣肺气的方法。如果是内伤累及肺部导致的咳嗽,必须从内伤角度治疗(这属于中气虚弱引起的咳嗽,用药纯粹以滋养精气为主)。如果用发汗法则会泄伤阳气,导致肺痿、食欲减退、声音低微,这显然是用药错误。
黄芪 薏苡仁 黄精 白及
痰饮是由于积滞长久停留形成的,将其吐出则安适。如果是浑浊粘稠的涎沫,这是体内脏腑的津液,是用来供养躯体的生命物质,如果被阴火焚烧灼伤,向上逼迫咽喉而吐出,这是肾脏不能纳气,属于重病。
金某(运漕人,44岁):冬季封藏功能失职,咳嗽并吐出涎沫,这是肾病(诊断依据清晰老练,脉象必定两尺部不稳固)。医生见到咳嗽就用治肺的药来治疗,一年多无效。
Fan (Wuxi, 29 years old): The muscles of the whole body twitch like a weaving shuttle. Overwork has consumed Qi and Blood, causing pain in the left hypochondrium, hematemesis, and vomiting blood. This indicates injury to the Liver collaterals with blood stasis; prolonged occurrence leads to severe conditions.
Fried Peach Kernel (Persicae Semen), Corydalis Rhizome (Yanhusuo), Xinjiang powder, Powdered Aquilaria Lignum Resinatum (Xiang), Fried Moutan Cortex (Mudanpi), Uncaria Ramulus cum Uncis (Gouteng).
Shen (Huzhou, 29 years old): The body has not recovered its vitality after illness. Due to lack of preservation during his prime, it has dragged on into chronic cough with deficiency (Lao Sou). However, Stomach Qi is quite good, so one can employ methods to tonify Essence and secure the Lower Jiao.
Duqi Wan formula, removing Moutan Cortex (Danpi) and Alisma Rhizoma (Zexie), adding Shuilu Erxian Dan (Chamaerops fruit [Jinyingzi] and Euryale Seed [Qianshi]) and Walnut Meat (Hetao Rou).
Hong (Wujiang, 27 years old): Muscles are wasting away day by day, with internal heat throughout the night. This is internal damage with Yin deficiency, gradually advancing towards consumptive disease (Lao Qie). Rest and ease can sustain life for a long time; however, when the weather warms, the condition worsens (because Yin damage is approaching Yang deficiency, hence the condition aggravates with warm air).
Take a cup of milk and cheese in the morning, and separately take Buyin Wan.
Wang (Ningbo, 48 years old): Among the seven types of Hernia (Qi Shi), Liver diseases are most common. Those accompanied by sound are called Qi Hernia. Cold enters the Mu-collaterals, accumulating as hard hernias that hang down. In middle age, one should not follow Zhang Hezi's method of using Babai Wan plus Fennel Fruit (Dahuixiang) and Fenugreek Seed (Huluba) (The sound is driven by Qi; cold condenses and obstructs the righteous Qi, which is profound and subtle. Only after middle age does one realize how the condition is?)
Yong (Fengqiao, 27 years old): Vertigo, vomiting clear water, heat in the heart, and mental confusion resembling epilepsy. All these result from excessive mental exertion, causing Qi mechanism to easily ascend and cloud the clear Spirit. Ginger's pungency can unblock the Spirit, but its warmth ascends first; it must be assisted by cooling and descending agents to be effective.
Shen (Nanxun, 33 years old): For cough caused by external pathogens entering the Lung, dispersing the exterior and diffusing Lung Qi can be used. If cough results from internal injury affecting the Lung, it must be treated from the perspective of internal injury (This is cough due to Middle Deficiency; medication should purely nourish Essence). Sweating will leak Yang Qi, leading to Lung萎 (Fei Wei), reduced appetite, and low voice, which is clearly a medication error.
Astragali Radix (Huangqi), Coix Seed (Yiren), Polygonatum Rhizoma (Huangjing), Bletillae Rhizoma (Baiji).
Phlegm-fluid retention accumulates from long-standing stagnation; vomiting it out brings relief. If turbid, sticky saliva and foam are vomited, this is the body's Zong-Jin-Ye (body fluids) from organs and collaterals, which nourish the physique and life. If scorched by Yin-fire and forced up to the throat to be vomited, it indicates Kidney failing to grasp Qi, constituting a serious disease.
Jin (Yunchao, 44 years old): Failure of Winter storage function leads to cough and spitting of saliva/foam; this is a Kidney disease (Clear diagnostic insight: pulse must be unstable at both Chi positions). Physicians seeing cough always treat with Lung medicines, resulting in no effect for over a year.