一妇以毒药去胎后,当脐右结块,块痛甚则寒热,
块与脐高一寸,痛不可按,脉洪数,谓曰∶止瘀血流溢于肠外肓膜之间,聚结为痈也。遂用补气血、
行结滞、排脓之剂、三日决一锋针,脓血大出,内如粪状者臭甚。病妇惊怕,予谓气血生肌则内外之窍
自合。不旬日而愈。
一人肩井后肿痛、身热且嗽,其肿按之不坚,此乃湿痰流结也。遂用南星、半夏、栝蒌、葛根、芩、
连、竹沥作煎饮之,烧葱根 肿上;另用白芥子、白矾作小丸,用煎药吞二十丸。须臾痰随嗽出,半日约
去三四碗而愈。
凡治病必分其主治之药,先之以经气∶在阳明治湿热,锻石、柏皮之属;在厥阴治火热,腊茶、脑、
射之属。次从所得之因∶食积加芦荟;磕伤加韭汁、没药。疮脓溃而不出,加轻粉取之,无不愈。
人之阳常有余,阴常不足,故金、水二脏必保养
之,使水不竭、金不亏,则木有制不猖狂矣。经曰∶诸逆冲上,皆属于火。《原病式》曰∶五志色欲之
动,皆属相火水衰,火无所畏,得以冲逆于肺,其水莫能救母之鬼贼,则肺之阴愈亏,必须泻火益水以救
金可也。如姜、桂、半夏辛温燥热之剂,皆不宜用。然于泻火,虽不比外邪郁发而为风寒暑湿之至者,亦须
分四脏所动之本气,各欲安之。且火不惟伤肺之阴。甚则亦害元阳,又必辨其所伤之阴阳孰轻孰重。此条止
论虚者用参、术,其于益阴,如天麦门冬之属无有也。至若治寒加细辛、干姜之属,亦无有也。是皆要者,
尚且不备,况分经之剂乎?
一位妇女在服用毒药堕胎后,肚脐右侧出现结块,当结块疼痛剧烈时会出现寒战和高热。肿块高度与肚脐平齐,高出约一寸,触痛明显且不可按压,脉象洪大而数。我诊断说:这是瘀血溢出到肠外的肓膜(腹腔内包裹脏腑的薄膜)之间,聚集凝结而成痈肿。于是使用补益气血、行气散结、排脓的药物,每三天用锋针穿刺一次,排出大量脓血,内部物质状如粪便,气味极臭。患病妇女惊恐害怕,我对她说:气血生肌长肉,则内外创口自然愈合。不到十天便痊愈了。
另一人肩井穴后方肿痛,身体发热且咳嗽,肿胀处按之不坚硬,这是湿痰流注凝结所致。于是使用天南星、半夏、瓜蒌、葛根、黄芩、黄连、竹沥煎煮成汤剂服用,并用烧热的葱根熨烫肿胀部位;另外用白芥子、白矾制成小药丸,用煎好的药汤送服二十丸。不久之后,痰液随着咳嗽排出,半天大约排出了三四碗痰液,病即痊愈。
大凡治病必须分清主治药物,首先依据经络之气:在阳明经治疗湿热,使用煅石、黄柏之类;在厥阴经治疗火热,使用腊茶、冰片、射干之类。其次根据病因:食积加上芦荟;磕碰外伤加上韭汁、没药。疮疡脓液溃破但排不出来,加入轻粉以促其排出,没有不愈的。
人的阳气常常有余,阴气常常不足,所以肺(金)、肾(水)两脏必须保养,使肾水不枯竭、肺金不亏损,那么肝木就有制约而不猖狂妄动。《内经》说:各种逆气冲上的病症,都属于火。《原病式》说:五志和色欲的发动,都归属于相火。由于肾水衰弱,火无所畏惧,得以冲逆于肺,肾水不能救助被肺金克制的水(母),导致肺之阴更加亏损,必须泻火补水来救肺金才行。像生姜、肉桂、半夏等辛温燥热的药物,都不宜使用。然而在泻火方面,虽然不像外邪郁结而引发的风寒暑湿致病那样,但也必须分辨四脏所动的本气,分别加以安抚。而且火不仅损伤肺之阴,严重时也会伤害元阳,又必须辨别所伤的阴阳孰轻孰重。这一条只论述了虚证用人参、白术,对于滋阴的药物,如天门冬、麦门冬之类却没有涉及。至于治疗寒证加细辛、干姜之类,也没有提及。这些都是重要的内容,尚且不完备,何况分经治疗的方剂呢?
A woman, after using toxic drugs to induce abortion, developed a mass on the right side of her umbilicus. When the pain in the mass was severe, she experienced chills and fever. The mass was level with the umbilicus but protruded about one cun (inch), and it was extremely tender to touch and could not be pressed. Her pulse was surging and rapid. I diagnosed: This is stasis blood overflowing into the *huangmo* (membrane between the intestines) outside the intestines, gathering and condensing to form an abscess. Therefore, I prescribed decoctions to tonify Qi and Blood, move stagnation, and drain pus. Every three days, I punctured it with a sharp needle, discharging a large amount of pus and blood. The internal material resembled feces and had a very foul odor. The patient was terrified. I told her: As Qi and Blood generate flesh, the internal and external orifices will naturally close. She recovered within ten days.
Another person suffered from swelling and pain behind the Jianjing (GB21) acupoint, accompanied by fever and cough. The swelling was soft upon palpation. This was due to the accumulation of damp-phlegm. I prescribed a decoction of Arisaemae Rhizoma (Nanxing), Pinelliae Rhizoma (Banxia), Trichosanthis Fructus (Gualou), Puerariae Radix (Gegen), Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), and Bamboo Juice (Zhuli). I also applied hot moxibustion using burnt scallion roots to the swollen area. Additionally, I prepared small pills made of Sinapis Semen (Baijiezi) and Alum (Baifan), which were taken with the decoction, twenty pills at a time. Soon after, phlegm was expectorated with coughing. In half a day, approximately three to four bowls of phlegm were expelled, and the illness was cured.
In treating diseases, one must distinguish the primary medicinal herbs, starting with the meridian Qi: For Damp-Heat in the Yangming Meridian, use calcined stone and Phellodendri Cortex (Baipi); for Fire-Heat in the Jueyin Meridian, use aged tea, Borneolum Syntheticum (Naoshena), and Belamcandae Rhizoma (Shegan). Secondly, consider the etiology: Add Aloe (Luhui) for food retention; add Allium Tuberosum Juice (Jiuji) and Myrrha (Moyao) for trauma. If pus forms in a sore but does not discharge, add Calomelas (Qingfen) to promote discharge, and recovery is assured.
Human Yang is often in excess, while Yin is often deficient. Therefore, the Lung (Metal) and Kidney (Water) organs must be preserved so that Kidney Water is not exhausted and Lung Metal is not depleted, thereby ensuring Liver Wood is controlled and does not act recklessly. The Classic states: "All rebellious upward movements belong to Fire." The *Yuanbing Shi* states: "Movements of the Five Emotions and sexual desire all pertain to Ministerial Fire. Due to Kidney Water deficiency, Fire has no fear and rebels upward against the Lung. Since Water cannot rescue its mother (Metal) from the 'ghost thief' (excessive Metal controlling Water), Lung Yin becomes further depleted. One must purge Fire and benefit Water to save Lung Metal." Decoctions such as Zingiberis Rhizoma (Shengjiang), Cinnamomi Ramulus (Guizhi), and Pinelliae Rhizoma (Banxia), which are pungent, warm, and drying, should not be used. However, when purging Fire, although it differs from exterior pathogens causing Wind-Cold or Summer-Heat-Dampness, one must still differentiate the root Qi moving in the Four Zang organs and soothe them individually. Furthermore, Fire not only damages Lung Yin but can severely harm Yuan Yang (Primordial Yang). One must distinguish whether the injury to Yin or Yang is lighter or heavier. This passage only discusses using Ginseng Radix et Rhizoma (Renshen) and Atractylodis Macrocephalae Rhizoma (Baizhu) for deficiency, without mentioning Yin-nourishing herbs like Asparagi Radix (Tianmendong) and Ophiopogonis Radix (Maidong). Nor does it mention adding Acroniti Radix (Xixin) or Zingiberis Rhizoma Recens (Ganjiang) for Cold. These are essential points, yet they are incomplete, let alone formulas differentiated by meridians.