方氏妇本体血虚,偶患目疾,眼科认为实火,初用芩连清之,更用大黄下之。饮药一盏
,顷
忽晕去,舌吐唇外,不能缩入,肢厥脉伏。时已薄暮,急延予诊,谓曰∶寒下耗伤真阳,阳
气暴脱,势属可畏,速投温补,希冀挽回。方疏通脉四逆汤,药熟不能下咽,令取艾火炙气
海关元数壮,身始动,舌始收,忙灌药一盅,移时又厥,仍令再炙。厥回,复进前药,守至
黎明始苏,续进左归饮,及滋肾生肝诸剂,病痊目亦明矣。
闵某处境艰难,向多忧虑,脘痛经岁,诸治不瘳。望色萎黄,切脉细弱,问痛喜按乎?
曰然
,得食痛缓乎?曰然。予曰∶此虚痛也。古云∶痛无补法,此特为强实者言,非概论也。为
订归脾汤,嘱多服乃效。如言服廿剂有应,百剂获痊。后一丐者患同,某检方与之,服数十
剂亦愈。
许细长,石工也。病起少腹胀痛,坚硬如石,医用消导药,转致吐蛔,便溺俱闭,更医
目为
寒凝厥阴,投以姜附吴萸,痛剧而厥,肢冷脉伏。急来延予,予以手按其少腹,见其眉攒难
忍之状,谓其妇曰∶此食厥证也。妇曰∶病果因食冷面而起,然已服过消导药无效,或药力
不及,亦未可知。第停食小恙,何至厥逆吐蛔便溺俱闭。予曰∶谷食下行,由少腹右角后出
广肠,今食积不下,故大便不通,直肠紧胀,撑迫膀胱,小溲因而不利,下既不通,气反上
行,故为呕吐。呕多胃逆,蛔必上攻,是以随呕而出,务得大便一通,通则不痛,诸证自释
矣。但病经多日,凝冱已坚,非精锐之品,不能奏绩。旋进备急丸三钱,顷之腹中雷鸣,下
结粪数枚,再与钱半,复泻十余行,厥回脉出,痛减腹软,观者动色,惊有神助。后畏药不
服,将息而起。
方氏妇人原本体质血虚,偶然患上眼疾。眼科医生认为是实火,起初用黄芩、黄连清热,又用大黄泻下。她喝下一盏药后,不久突然晕倒,舌头伸出嘴唇外无法缩回,四肢厥冷,脉搏潜伏摸不到。当时已是傍晚,急忙请我去诊治。我对她说:“寒凉攻下的药物耗伤了真阳,阳气突然脱失,形势令人畏惧,必须迅速投用温补之法,希望能挽回生机。”于是开具疏通脉四逆汤(此处指以四逆汤为基础加减以通脉的方剂),药煮好后患者却无法咽下,便让人取艾火在气海穴和关元穴各灸数壮,身体才开始有动静,舌头才收回。急忙灌下一盅药,过了一会儿再次出现厥逆,仍命令继续艾灸。厥逆缓解后,再次服用前面的药物,守护到黎明时分患者才苏醒,随后继续服用左归饮以及滋肾生肝等方剂,病愈眼睛也明亮了。
闵某处境艰难,一向多忧虑,脘部疼痛持续一年,各种治疗都没有痊愈。观察面色萎黄,切脉细弱,询问疼痛是否喜欢按压?回答说喜欢。问进食后疼痛是否缓解?回答说缓解。我说:“这是虚性疼痛。”古人说:“痛无补法”,这仅仅是针对实证而言的,并非普遍规律。于是为他拟定归脾汤,嘱咐多服才能见效。按照说法服用二十剂有了效果,服用一百剂获得痊愈。后来有一个乞丐患同样的病,某人检查方子给他,服用几十剂也好了。
许细长,是石匠。病症起于小腹胀痛,坚硬如石头。医生使用消食导滞的药物,反而导致吐蛔虫,大小便全部闭塞。另一位医生认为是寒凝厥阴经,投用干姜、附子、吴茱萸,结果疼痛加剧并出现厥逆,四肢冰冷,脉搏潜伏。急忙来请我诊治,我用手按压他的少腹,见他眉头紧锁难以忍受的样子,对他的妻子说:“这是食厥证。”他的妻子说:“病确实是因为吃冷面引起的,但是已经服用过消导药无效,也许是药力不够,也未可知。只是停食这种小病,怎么会发展到厥逆、吐蛔、大小便全部闭塞的地步呢?”我说:“谷物食物下行,从小腹右角后方排出至广肠(大肠末端),现在食积不能下行,所以大便不通,直肠紧张胀满,压迫膀胱,小便因此不利。下部既不通畅,气机反而上行,所以发生呕吐。呕吐频繁则胃气上逆,蛔虫必定向上攻冲,因此随呕吐而出。务必使大便通畅,通则不痛,各种症状自然解除。”但是病情已经持续多天,凝结冰冻已很坚固,不是精锐猛烈的药物,不能奏效。随即进服备急丸三钱,不久腹中雷鸣,排出结硬的粪便几枚,再给一钱半,又腹泻十多次,厥逆回阳,脉搏复出,疼痛减轻腹部变软,旁观者神色变动,惊讶有神助。后来因为害怕药物的猛烈而不服药,静养后起身康复。
Ms. Fang’s constitution was originally deficient in Blood. She accidentally developed an eye disease. The ophthalmologist considered it to be Excess Fire (Shi Huo), initially using Huangqin and Huanglian to clear heat, followed by Dahuang to purge downward. After drinking one cup of the medicine, she suddenly fainted shortly thereafter, her tongue protruding outside the lips unable to retract, with cold limbs and a submerged pulse (Mai Fu). It was already dusk when I was urgently summoned to diagnose her. I said to her family: "Cold purgatives have damaged the True Yang (Zhen Yang), and Yang Qi has suddenly collapsed; the situation is formidable. We must rapidly administer warming and tonifying methods to hope for recovery." Therefore, I prescribed Tongmai Sini Tang (Pulse-Resuscitating Four Reversal Decoction). However, after the medicine was prepared, she could not swallow it. I ordered moxibustion to be applied at Qihai (CV6) and Guanyuan (CV4) acupoints for several moxa cones. Only then did her body begin to move, and her tongue retracted. I hastily forced down one cup of the medicine, but after a while, she fell into coldness again. I ordered further moxibustion. Once the coldness receded, she took the previous medicine again. I guarded her until dawn, when she finally regained consciousness. Subsequently, she continued taking Zuogui Yin (Left Restoring Drink) and other prescriptions nourishing Kidney and generating Liver, after which her illness resolved and her vision cleared.
Mr. Min faced difficult circumstances and had always been prone to worry. He suffered from epigastric pain for a year, and various treatments failed to cure him. His complexion was sallow, and his pulse was fine and weak. I asked if the pain was relieved by pressure; he answered yes. I asked if eating relieved the pain; he answered yes. I said, "This is Deficiency Pain (Xu Tong)." The ancients said, "There is no tonification method for pain," but this statement applies specifically to Excess patterns, not as a general rule. Therefore, I formulated Guipi Tang (Restore the Spleen Decoction) and advised taking it in large quantities for efficacy. Following the advice, he took twenty doses with some effect, and hundred doses resulted in a complete cure. Later, a beggar suffered from the same condition; someone provided him with the prescription, and after taking dozens of doses, he also recovered.
Xu Xichang was a stone mason. His illness began with distending pain in the lower abdomen, which felt hard as stone. Physicians used digestive-promoting medicines, which instead caused him to vomit roundworms and resulted in total obstruction of urination and defecation. Another physician diagnosed Cold Coagulation in the Jueyin channel and administered Ganjiang, Fuzi, and Wuzhuyu, resulting in intensified pain and cold extremities with a submerged pulse. He urgently sought my consultation. I palpated his lower abdomen and saw him grimacing in unbearable pain. I told his wife, "This is Food-Jue Syndrome (Shi Jue)." His wife said, "The illness indeed started from eating cold noodles, but we have already taken digestive medicines without effect. Perhaps the medicinal power was insufficient, who knows? However, how can simple food stagnation lead to Jue, vomiting roundworms, and total obstruction of urine and stool?" I said, "Grain and food descend through the posterior outlet behind the right corner of the lower abdomen into the Changchang (large intestine). Now, because food accumulation cannot descend, there is constipation. The rectum becomes tense and distended, compressing the bladder, causing dysuria. Since the lower orifices are blocked, Qi rebels upward, causing vomiting. Frequent vomiting indicates rebellious Stomach Qi, causing roundworms to attack upward, thus being vomited out. It is imperative to unblock the bowels; once unblocked, pain ceases, and all symptoms will resolve." However, the illness had persisted for many days, and the coagulation was severe. Without potent medicines, no result could be achieved. I immediately administered Beiji Wan (Emergency Rescue Pills), three qian. Soon, borborygmus was heard in the abdomen, and several pieces of hard feces were passed. I gave another 1.5 qian, resulting in more than ten diarrheal episodes. The coldness receded, the pulse emerged, pain decreased, and the abdomen softened. Observers were startled, amazed as if aided by spirits. Later, fearing the potency of the medicine, he refused to take it and recovered after rest.