兄质亏多病,予为调治,所用药剂,不外归脾汤、补元煎之属。一日遣使相促,至时
将薄
暮, 兄蜷卧榻上,起告予曰∶早晨齿牙忽痛甚,不可耐,予至今不止,恐挟风热外因,
故
停前药。相烦诊视,暂解标邪,切脉沉细无力,见证形寒足冷,谓曰∶此属虚寒,非关外感
,不徒用补,更须从温,爰仿古方八味地黄汤,加骨碎补,一服痛已。
智翁令孙三岁,痘后左手曲池穴侧鬼肿,溃经年余,外科疗治,不能收口,逆予商之。
维时
伊芳兄朗玉翁,及同事叶殿扬兄在座,二公俱知医理,予视毕告曰∶毒生手足,固不害命,然
溃久脓水流多,气血受伤,面黄肌瘦,神形疲倦,目无精采,天柱骨垂,一派大虚之象,最
为可虑。溃口收否,无暇计也。朗翁云∶证既属虚,虚则当补。予曰∶不但用补,且须用温
。智翁云∶时下炎暑如蒸,过温恐其难受。予曰∶医家治病,盛夏遇寒证,用热药,隆冬遇
热证,用凉药。所谓舍时从证也。病若虚而不寒,单补亦可见功,今虚而兼寒,非温补莫能
奏效。爰定人参养营汤,加附子、鹿茸、枸杞、杜仲,合乎《内经》形不足者,温之以气,
精不足者,补之以味之义。二公见方称善。初服精神略转,再服颈骨不倾,守服数十剂,气
血恢复,溃口亦敛,此证获痊。虽予之执理不阿,亦赖二公赞襄之力也。
我兄长体质虚弱且多病,我为他调理治疗,所使用的药剂,不外乎归脾汤、补元煎这一类。一天,他派人来催促我去诊治,到达时将近傍晚,我兄长蜷缩躺在床上,起身告诉我道:“早晨牙齿突然剧烈疼痛,难以忍受,到现在还没停止,恐怕是夹杂了风热这种外因,所以暂停了之前的药物。麻烦您诊视一下,暂时解除表面的邪气。”我切脉发现脉象沉细无力,观察症状有形体畏寒、双脚冰冷,便说道:“这属于虚寒证,与外感无关,不能仅仅使用补法,还必须从温法入手。”于是仿照古方八味地黄汤,加入骨碎补,服用一剂后疼痛消失。
智翁的孙子三岁时,出痘疮后左手曲池穴旁边长了“鬼肿”(一种痈疽),溃烂经过了一年多,外科医生治疗,伤口无法愈合,便找我商量。当时他的哥哥朗玉先生,以及同事叶殿扬先生在座,这两位都懂医理,我诊察完毕后告诉他们道:“毒邪生于手足部位,本来不危及生命,但是溃烂日久,脓水流淌过多,导致气血受损,面色发黄,肌肉消瘦,精神形体疲倦,目光无神,天柱骨(颈部支撑力弱)下垂,这是一派严重虚弱的征象,最为令人担忧。至于溃口能否收敛,暂且顾不上考虑。”朗翁说:“病症既然属于虚证,虚证就应当用补法。”我说:“不仅要用补法,而且必须用温法。”智翁说:“现在正值盛夏酷暑如蒸笼般炎热,用药过温恐怕患者难以忍受。”我说:“医生治病,在盛夏遇到寒证,使用热药;隆冬遇到热证,使用凉药。这就是所谓的‘舍时从证’(舍弃季节气候因素而顺从病症本质)。如果病证只是虚而不寒,单用补法也能见效,如今是虚证兼有寒证,不用温补之法就不能奏效。”于是确定使用人参养营汤,加入附子、鹿茸、枸杞、杜仲,符合《内经》中“形体不足的,用气分药来温煦它;精气不足的,用味厚的药来填补它”的道理。两位先生看到方子称赞好。初次服药后精神略微好转,再次服药后颈骨不再倾斜,坚持服用几十剂后,气血恢复,溃口也收敛了,这个病症得以痊愈。虽然是我坚持医理不阿谀附和,但也依赖两位先生的协助之力。
My elder brother had a constitutionally deficient physique and suffered from frequent illnesses. In my treatment to regulate his health, the prescriptions used were none other than those of Guipi Tang (Restore the Spleen Decoction) or Buyuan Jian (Tonify the Origin Decoction). One day, he sent a messenger to urge me to visit. Upon arrival, it was nearing dusk. My brother was curled up in bed; he rose and told me, "This morning, my teeth suddenly began to ache severely, unbearable to endure, and the pain has persisted until now. I fear it is complicated by wind-heat as an external pathogen, so I have suspended the previous medications. I trouble you to examine me, to temporarily resolve the exterior pathogens." I palpated his pulse and found it deep, fine, and powerless. Observing his symptoms of aversion to cold and cold feet, I said, "This belongs to deficiency-cold, not related to external contraction. Merely using tonification is insufficient; one must also employ warming methods." Therefore, I imitated the ancient formula Shengdi Huang Wan (Eight-Ingredient Rehmannia Pill), adding Gusuibu (Drynariae Rhizoma). After one dose, the pain ceased.
The grandson of Mr. Zhi was three years old. After recovering from smallpox, he developed a 'Ghost Swelling' (a type of abscess) on the side of the Quchi (LI11) acupoint on his left hand. The lesion ulcerated for over a year. Surgical treatments failed to close the wound, so he consulted me. At that time, his elder brother, Mr. Langyu, and colleague Mr. Ye Dianyáng were present. Both gentlemen understood medical principles. After examining the patient, I informed them, "Pathogenic toxins arising in the hands and feet generally do not endanger life. However, prolonged ulceration with excessive discharge of pus injures Qi and Blood. His complexion is sallow, muscles are emaciated, spirit and form are fatigued, eyes lack luster, and the Tianzhu bone (cervical spine support) droops. This presents a picture of severe deficiency, which is most concerning. Whether the ulcer can heal is secondary." Mr. Langyu said, "Since the syndrome is deficiency, deficiency should be treated with tonification." I replied, "Not only tonification, but also warming is required." Mr. Zhi said, "Currently, the summer heat is steaming hot; using overly warm herbs may cause the patient discomfort." I said, "When treating diseases, if a physician encounters a cold syndrome in midsummer, they use hot medicines; if encountering a heat syndrome in deep winter, they use cool medicines. This is known as 'abandoning the season to follow the syndrome.'" If the disease is deficient but not cold, simple tonification might yield results. Now, since it is deficient and accompanied by cold, only warming-tonification can achieve efficacy. Thus, I prescribed Renshen Yangying Tang (Ginseng Nourishing Ying Decoction), adding Fuzi (Aconiti Lateralis Radix Praeparata), Lurong (Cervi Cornu Degelatinatum), Gouqi (Lycii Fructus), and Duzhong (Eucommiae Cortex). This aligns with the meaning in *Neijing* (The Yellow Emperor's Inner Canon): "For those whose form is deficient, warm them with Qi [acrid/warm substances]; for those whose essence is deficient, tonify them with Flavor [sweet/heavy substances]." The two gentlemen saw the prescription and praised it. After the first dose, his spirit slightly improved; after the second dose, his neck bone no longer tilted. He continued taking dozens of doses. As Qi and Blood recovered, the ulcer closed, and this case was cured. Although my adherence to principle without flattery played a role, it also relied on the assistance of these two gentlemen.