凡胃寒者多为呕吐,而中寒毒者,又必吐而兼泻。余在燕都,尝治一吴参军者,因见鲜
蘑菇肥嫩可爱,令庖人贸而羹之,以致大吐大泻。延彼乡医治之,咸谓速宜解毒,乃以黄连
、黑豆、桔梗、甘草、枳实之属连进之,而病益甚,遂至胸腹大胀,气喘,水饮皆不能受,
危窘已甚,延救于余。投以人参、白术、甘草、干姜、附子、茯苓之类,彼疑不敢用,曰∶
腹胀气急,口干如此,安敢再服此药。乃停一日,而病愈剧,若朝露矣。因而再恳,与药如
前,彼且疑且畏,而决别于内阃,曰∶必若如此,则活我者此也,杀我者亦此也,余之生死
,在此一举矣。遂不得已含泪吞之,一剂而呕少止,再剂而胀少杀,随大加熟地黄,以兼救
其泻亡之阴,前后凡二十余剂,复元如故。彼因问曰∶余本中毒致病,乡人以解毒而反剧,
先生以不解毒而反愈者何也?余曰∶毒有不同,岂必如黄连、甘、桔之类乃可解耶?即如蘑菇
一物,必产于深坑枯井,或沉寒极阴之处乃有之,此其得阴气之最盛,故肥白最嫩也,公中
此阴寒之毒,而复解以黄连之寒,其谓之何?兹用姜附,非所以解寒毒乎?用人参、熟地,非
所以解毒伤元气乎?然则彼所谓解毒者,适所以助毒也,余所谓不解毒者,正所以解毒也。
理本甚明,而人弗能辨。凡诸病之误治者,无非皆此类耳。公顿首愀然叹曰∶信哉!使非吾
丈,几为衔冤之魄矣,祈寿诸梓,以为后人之鉴云。
凡是胃寒的人,大多会出现呕吐症状;而感受中寒毒的人,则必然在呕吐的同时兼有腹泻。
我在京城时,曾治疗一位吴姓参军。他因为看到鲜蘑菇长得肥嫩可爱,便让厨师买来煮汤食用,结果导致剧烈呕吐和腹泻。
后来请当地的医生治疗,大家都认为应当迅速解毒,于是连续服用黄连、黑豆、桔梗、甘草、枳实等寒凉药物,结果病情反而加重,发展到胸腹部严重胀满,气喘吁急,连水饮都无法接受,情况危急窘迫到了极点,于是来找我求救。
我投以人参、白术、甘草、干姜、附子、茯苓等温补药物,他却怀疑不敢服用,说:“腹胀气急,口干如此严重,怎么敢再服用这些热药呢?”
于是停药一天,结果病情更加严重,如同早晨的露水一样即将消逝(生命垂危)。因此再次恳求救治,我仍按前法给药,他一边怀疑一边畏惧,但在内室与妻子诀别时说:“如果真是这样,救我的也是这些药,杀我的也是这些药,我的生死就在此一举了。”
于是不得已含泪服下,一剂药后呕吐稍止,两剂药后胀满稍减,随后大量加入熟地黄,以兼顾救治因腹泻亡失的阴液,前后共服用二十多剂,身体恢复如常。
他于是问道:“我本是中毒致病,乡下的医生用解毒的方法反而使病情加重,先生不用解毒的方法反而痊愈,这是为什么呢?”
我说:“毒的性质各不相同,难道一定要像黄连、甘草、桔梗这类寒凉药物才能解毒吗?就拿蘑菇这一种东西来说,它必定生长在深坑枯井或沉寒极阴的地方才有,这是因为得到了最盛的阴气,所以长得肥大洁白且最嫩。您中了这种阴寒之毒,再用黄连的寒性去解,这叫什么道理呢?现在使用干姜、附子,不就是解除寒毒的方法吗?使用人参、熟地黄,不就是保护被毒邪损伤的元气的方法吗?那么他们所谓的‘解毒’,恰恰是在助长毒邪;我所谓的‘不解毒’,正是真正的解毒啊。道理本来很清楚,但人们不能辨别。凡是各种疾病被误治的情况,无非都是这一类罢了。”
他叩头悲伤地感叹道:“确实如此!如果不是您,我几乎就要成为含冤而死的人了,希望您将这些刻印出版,作为后人的借鉴。”
In cases of Stomach Cold (Wei Han), vomiting is common; however, in cases of contracting Central Cold Toxin (Zhong Han Du), vomiting must be accompanied by diarrhea.
While in the capital, I once treated a military officer surnamed Wu. Having seen fresh mushrooms that were plump and tender, he instructed his cook to prepare them as a soup, which resulted in severe vomiting and diarrhea.
He then consulted local physicians, who all believed that rapid detoxification was necessary. Consequently, they administered a continuous course of cold-natured herbs such as Huanglian (Coptidis Rhizoma), Heidou (Soybean), Jiegeng (Platycodonis Radix), Gancao (Glycyrrhizae Radix et Rhizoma), and Zhishi (Aurantii Fructus Immaturus). The condition worsened, leading to severe distension of the chest and abdomen, panting, and an inability to tolerate even water or fluids. The situation became critical and distressing, prompting him to seek my help.
I prescribed a decoction containing Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Ganjiang (Zingiberis Rhizoma), Fuzi (Aconiti Lateralis Radix Praeparata), and Fuling (Poria). However, he doubted and refused to take it, saying, "With abdominal distension,急促 breathing, and such severe dry mouth, how can I dare to take these hot medicines?"
He stopped medication for one day, after which his condition deteriorated further, becoming as fleeting as morning dew (life hanging by a thread). He then earnestly requested treatment again. I maintained the previous prescription. Although he remained suspicious and fearful, he bid farewell to his wife in the inner chambers, stating, "If this is true, these medicines will either save me or kill me; my life depends entirely on this decision." Reluctantly, he swallowed the medicine with tears. After one dose, the vomiting subsided slightly; after two doses, the distension decreased slightly. Subsequently, I significantly increased the dosage of Shudihuang (Rehmanniae Radix Praeparata) to simultaneously rescue the Yin fluid lost through diarrhea. In total, he took more than twenty doses, and his health returned to normal.
He then asked, "My illness was caused by toxin ingestion. The local doctors' attempt to detoxify made it worse, yet your method of not explicitly detoxifying led to recovery. Why is this so?"
I replied, "Toxins vary in nature; does one always need cold herbs like Huanglian, Gancao, and Jiegeng to detoxify? Take mushrooms, for instance. They grow in deep pits, dry wells, or places of extreme cold and Yin. This is because they absorb the most intense Yin Qi (Vital Energy), resulting in their plump, white, and tender appearance. You have contracted this Yin-Cold toxin, yet you use the cold property of Huanglian to treat it. What kind of logic is this? Now, using Ganjiang and Fuzi is precisely the method to resolve cold toxins. Using Renshen and Shudihuang is precisely the method to protect the Yuan Qi (Original Qi) damaged by the toxin. Therefore, what they call 'detoxification' actually assists the toxin, while what I call 'not detoxifying' is the true detoxification. The principle is clear, but people fail to distinguish it. All instances of misdiagnosis and mistreatment of diseases are essentially of this category."
He bowed deeply and sighed sorrowfully, saying, "Truly so! If not for you, I would have died as a wronged spirit. Please have this engraved and published as a warning for future generations."