典藏书目

In treating diseases, there is no fixed treatment method, yet there must be a fixed body of learning. For instance, the same disease may be treated by some physicians who advocate the theory of supporting Yang (Fu Yang), using methods to support Yang; while others advocate the theory of nourishing Yin (Zi Yin), using methods to nourish Yin. However, both aim for the same result. The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "When physicians treat diseases, the same illness may be treated with different methods," which conveys this very meaning. However, superficial physicians only glimpse one corner and insist on this while denying that, which is hardly a discourse that explores the root and reaches the origin. Now, examining Shen Rou's medical cases in conjunction with his medical theory, they fit together like a tally. Thus, nothing fails to be effective. If one were to rigidly adhere to Shen Rou's medical practice to generalize all medicine under heaven, how dare I? As for rigidly adhering to the medicine of all under heaven to criticize Shen Rou's medicine, since this book has been printed and published to the world, transmitted for thousands of generations, there will naturally be discerning individuals to make definitive judgments; I need not add more. Shen Rou has passed away, and his manuscripts were once burned. Now, unable to keep them secret any longer, they shine forth like the sun and stars. This is also the will of Heaven, not human effort. What merit do I have?

The mother of Cai Changqing, a Xiucai (scholar) from Jintan, was over sixty years old. All six pulses were rapid, beating eight times per respiration. Upon deep pressure, the pulses were slippery and solid. Only the Liver and Kidney pulses were surging and large. Her eyes were closed, hands and feet twitched, and her body shook. Her complexion alternated between red and white. Her entire body felt as if attacked by hot fire causing stabbing pain. She reported feeling dizzy and stifled in her heart, and her four limbs were swollen, hard, and firm. These are all manifestations of wind and fire agitation, representing symptoms of Yin deficiency and Yang hyperactivity. As the classics state: "Excess heat causes swelling; excess wind causes movement." The appropriate treatment is to nourish Yin and suppress Yang. Use Si Wu Tang (Four Substances Decoction) as the sovereign herb to nourish blood, add Dioscoreae Rhizoma (Shan Yao) as the minister herb to support Middle Qi (Spleen/Stomach energy), use Corni Fructus (Shan Yu Rou) as an assistant to aid Yin and nourish the Liver, and use Phellodendri Cortex (Hei Bai Pi) in small dosage as a guide drug. Chenpi (Tangerine Peel) regulates Stomach Qi as an adjunct. After two doses, upon examination, the rapid pulse decreased by one beat per respiration. After another four doses, it decreased by another beat, and the previous deficient and surging quality had slightly converged, showing spirit in the pulse. Externally, the swelling and hardness of the four limbs gradually flattened, the stabbing sensation ceased, and she no longer felt dizzy or stifled in her heart. After another four doses, the previously hard and slippery qualities became empty and soft, and the rapid pulse decreased further. However, True Yang had not yet recovered, and pathogenic fire had not completely subsided. Use Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) ingredients totaling four liang as one dose, taken at once. The surging and large pulse of the Kidmeridian fully converged, and the fire subsided. Later, due to excessive cooling at night, she felt cold in the afternoon, and her lips turned dark purple/black. This indicated that after the pathogenic fire subsided, both Yin and Yang were deficient. Urgently prescribe Ren Shen (Ginseng Root) 3 qian, Atractylodis Macrocephalae Rhizoma (Bai Zhu) 1 qian, Glycyrrhizae Radix et Rhizoma (Gan Cao) 3 fen, Poria (Bai Fu Ling) 2 qian, Angelicae Sinensis Radix (Dang Gui) 2 qian, Aconiti Lateralis Radix Praeparata (Fu Zi) 1.8 qian, and Cinnamomi Cortex (Guan Gui) 2 fen. After consuming about one teacupful, (the previous formula did not fully match the condition, and this new formula was even less targeted; recovery was fortunate, relying on the patient's strong constitution rather than the efficacy of the medicine.) she felt intense heat in her body, dry mouth, frequent desire for water, and fever. This occurred because the True Qi was deficient and uncoordinated, preventing the harmonious descent of Qi. At the first watch, upon examination, all six pulses were fine, urgent, short, and rapid, lacking any harmonious quality. I considered the condition critical. By the next day, upon re-examination, there was spirit in the pulse, still exceeding six beats per respiration. This indicated that Yin and Yang had not fully restored, and Yuan Qi (Original Qi) was not yet充盈 (full). Instructed her to take Liu Wei Di Huang Wan 1.5 qian in the morning, and Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) every other day. After dozens of doses, she recovered.

The wife of Mr. Liu, around thirty years old, had a constitution originally weak. Ten days before falling ill, she felt unstable as if walking in a boat. Suddenly, she experienced generalized body pain, pain below the umbilicus, locked jaw unable to speak, staring eyes with sweating, and obstruction of urination and defecation, accompanied by body heat. (This is lower jiao cold rising upward, with blood following rebellious Qi, clashing and failing to descend.) I examined her, finding all pulses floating and fine, irregular, beating more than ten times per respiration, and disappearing upon deep pressure. Reflecting later, the external signs all belonged to Yang deficiency, and the pulse lacked spirit. The severe pain below the umbilicus and the near-death staring eyes indicated that the harmonious Yang Qi was about to perish. Due to deficient Stomach Qi and dysfunction of ascending and descending mechanisms, urination and defecation were obstructed. Furthermore, Li Dongyuan stated: "Interior deficiency leads to urgency." Considering this, both interior and exterior were deficient. It was appropriate to first establish the Middle Jiao. Modify Si Jun Zi Tang (Four Gentlemen Decoction) by removing Poria, adding Dang Gui and Chuan Xiong each 2 qian, and Shu Fu Zi (Prepared Aconite) 2 fen. Take one dose at noon. Generalized body pain eased slightly, and urination resumed. At Shen hour (3-5 PM), administer the previous prescription again. Sweating stopped, generalized body pain resolved, and defecation resumed. However, pain below the umbilicus persisted, along with hypochondriac pain, indicating Yang deficiency and severe cold. Add Fu Zi 5 fen. Pain below the umbilicus ceased. However, defecation was incomplete, with a sensation of wanting to pass stool but being unable to. This corresponds to Li Dongyuan's concept of Blood deficiency. Add Dang Gui Shen (Body of Angelica Sinensis). One dose led to recovery.

Li Zicai, over forty years old. His nature was typically irritable. Suddenly, due to anger, he fainted. (Likely because his anger was not vented.) The pulse was floating and middle-level without a deep component; pressing revealed a rapid pulse of six beats per respiration. This is a syndrome of Yang deficiency sinking into Yin. Use Bu Zhong Yi Qi Tang with a small amount of Liu Wei Di Huang Wan ingredients. Four doses led to recovery.

A young man suddenly lost his appetite and felt nauseous. Coinciding with an examination period, he forced himself to write essays for a day. That evening, he suffered from dizziness and vomiting. I examined his pulse: both Cun (inch) positions were surging and slow. I attributed it to fatigue stirring Heart Fire. Prescribe Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) for two doses. Vomiting continued, he refused food, and the illness did not improve. That year, the months of Zheng, Er, San, and Si (first four lunar months) had continuous rain. This was caused by excess Dampness. (Dampness entered from above, obstructing Clear Yang.) Prescribe Tai Wu Shen Shu San (Tai Wu Divine Artus Powder) for one dose. Nausea and vomiting ceased, but dizziness remained. Both Cun pulses were still as before, showing a quality resembling flames about to erupt. Use the previous formula plus Perillae Folium (Zi Su) and Saposhnikoviae Radix (Fang Feng) to induce slight sweating. Dizziness resolved, and the pulse retreated. He still lacked appetite. Prescribe Liu Jun Zi Tang (Six Gentlemen Decoction) for one dose. Diet returned to normal.

Zhou Jin'an's daughter, nineteen years old. Redness and swelling below the left ear, with fever and pain. Pulse examination showed all six positions rapid, eight beats per respiration, lacking spirit. She was constitutionally weak and had irregular menstruation. I said: This is a disorder related to the Six Qi (Yun Qi). Use Xiao Chai Hu Tang (Minor Bupleurum Decoction) combined with Si Wu Tang, adding Arctii Fructus (Niu Bang Zi). Use Huang Qin (Scutellaria Root) stir-fried with wine. Four doses led to recovery.

(This case also involved) Zhou Jin'an's daughter-in-law, over twenty years old. Redness and swelling below both ears, severe pain, fever, and a frightening appearance. Physicians used Da Huang (Rhubarb Root) for purgation several times and applied external plasters, but she felt restless sitting and lying down. This was also a Yun Qi disorder. Examination showed all six pulses fine, rapid, and weak. She had nausea and poor appetite. First, use Ren Shen Bai Du San (Ginseng Detoxifying Powder) for one dose to release the exterior. Then use Gan Cao (Licorice) and Scrophulariae Radix (Jie Geng) plus Niu Bang Zi, Belamcandae Rhizoma (She Gan), Chenpi, and Pinelliae Tuber (Ban Xia) for gargling. Next, use Xiao Chai Hu Tang with added Niu Bang Zi. Six doses reduced the swelling. Appetite remained poor. Use Yi Gong San (Extraordinary Efficacy Powder) with added Niu Bang Zi. Four to five doses strengthened the Spleen and Stomach, leading to full recovery.

Xu Yunsuo from Mashan, in June, suffered from heat and labor, and drank alcohol. Suddenly, he felt discomfort in the upper chest/diaphragm area like stabbing pain, with dizziness and heaviness. He believed it was due to overeating and induced vomiting with his finger. Consequently, he could not lie on a pillow and could only sit. I examined him: both Cun pulses were surging, slow, and forceful. Guan and Chi pulses were weak and wiry. This indicated Damp-Heat invading the region of Clear Yang, causing dizziness, heaviness, and chest/diaphragm pain. This is a seasonal pattern. Use Ping Wei San (Calm the Stomach Powder) plus Ban Xia, Huang Qin, Zi Su, and Aucklandiae Radix (Mu Xiang) to induce slight sweating. The symptoms immediately receded.

A guest from Huai'an, over thirty years old, suffered from Dan Malaria (Febrile Malaria) in late summer. Symptoms included fever without chills, occurring daily in the afternoon with restlessness and delirious speech, resolving only at dawn the next day. Several days later, sudden abdominal pain occurred continuously day and night. He could not swallow a drop of water, crying out in despair. During malaria attacks, he would faint. Other physicians' treatments failed. I examined him: the pulse was wiry, fine, and soggy. I said: Wiry and fine indicate deficiency and Summerheat; soggy indicates Dampness. Likely, Summerheat pathogen caused the malaria, and Damp-Heat sank inward due to deficiency, causing abdominal pain. Use Bai Shao (White Peony Root) stir-fried with wine and Zhi Gan Cao (Honey-fried Licorice) 5 fen, decocted in water, mixed with Tian Shui San (Tianshui Powder) 5 qian. After taking it, abdominal pain vanished instantly. The next day, the malaria did not recur. (This case seems ordinary, but requires an experienced physician. The analysis and medication are very solid. However, pain and syncope often involve Blood stasis; perhaps Tao Ren (Peach Kernel) and Danshen should be酌情 added...)