盛用敬诊道士顾本初病失音。医以厥阴伤寒治之。盛至曰∶内伤外感,无可为者,某日当汗,某日死。既
而果然。人问其故?曰∶肺属金主声,肺散则失音,且面黧黑,肾气竭也。某日属火,火乘金位,真阳既夺,
不死何待?(《吴江县志》。)
孙文垣治徐检庵,以正月内食新蒜炒肉,又冒风寒,因咳嗽喉痛声哑。此原有痰火,又为外邪所束,不得
发越所至,当润肺化痰调气,以祛其本,兼散邪解表,以治其标,庶痛可除而声可复矣。先与栝蒌仁、橘红、
桔梗、甘草、薄荷、桑皮、地骨皮、葛根、前胡,四帖,复以滚痰丸同七制化痰丸两帖,夜服,诸症除而声
音亮矣。此釜底抽薪法也。
张路玉治一西客,触寒来苏,忽然喘逆声喑,咽喉肿痛。察其形体丰盛,饮啖如常。切其脉象浮软,按之
益劲。此必寒包热邪,伤犯肺络也。遂以麻杏甘石汤加半夏、细辛,加大剂葳蕤,二服喘止声出。但呼吸尚有
微喑,更与二陈加枳、桔、葳蕤,二服调理而安。
王唯一数年前虽有血症,而年壮力强,四月间,忽患咳嗽,服发散药后,痰中见血数口。继服滋阴药过多,
遂声飒而哑,时觉胸中气塞,迁延月余。诊之脉虽沉涩,按之有力,举之应指,且体肥色润,绝非阴虚之候。
盖此之声哑,是金实不鸣,非金破不鸣之比,因与导痰汤加人中黄、泽泻,专一涤痰为务。四剂后,痰中见紫
血数块,其声渐出,而飒未除。更以秋石兼人中黄、枣肉,丸服经月,而声音清朗,始终未尝用清理肺气,调
养荣血也。
张飞畴治郭代工,午日少食角黍,倦怠作泻,曾用清克不效。因圊跌仆,即昏迷不省。数日后邀诊之,六
脉虚微欲脱,右臂不能转动,声喑无闻。时有用大黄之剂者,急止之曰∶此脾肺虚惫,安能任此?惟粥饮参汤,
庶为合宜,所谓浆粥入则虚者活。依言调之,泻止神宁,声音渐出而苏。能食后,亦惟用独参汤调理,不药而愈。
字廷肃治一妇人,娠八月卧不语,众医敛手。 曰∶此《内经》所谓胎喑也,十月当不药而愈。
(《嘉善县志》。)
万历时京口名医何继充,世业也。方成童犹在家塾,适镇江道有幼子忽噤口不能言,召其父诊视,值父远
出,召者不及待,令继充往。遂诊曰∶公子无病,勿药也。但多令妇人以气呵入口中耳,遂更迭呵之,半晌后
果能言。人问故,曰∶顷衙内多妇人,而公子貌甚美秀,妇人爱其美也,提抱之时,必多吸其口,令少阳之气
乍夺,第令呵以还之耳。其匪夷所思类若此。(《张氏卮言》。)
陆肖愚治范麓令郎,浓味奉养,而酒量极高,性尤偏嗜,沉 多怒。初患吐血,服犀角地黄等汤,月余不
愈,更增溺血咳嗽。一日忽声哑,然肌肉如故,饮食不减,群作瘵治,无一效。脉之,左关洪大而弦,右关滑
大而数,乃有余之火症,非不足之瘵症也。因浓味生痰,醇酒助火,火炎痰涌,瘀于胸中,所以声哑。其血之
上行者,怒则伤肝,肝脉挟舌本而络阴器,龙雷之火一动,血随之而上逆下泄矣。法宜清热降气,化痰导血归
原,十日可愈。若认为瘵,而以地黄、二冬投之则左矣。用真霞天曲、山楂,理胃家湿痰为君;杏仁、橘红,
利肺窍;桃仁、郁金,行肝滞为臣;山栀、生甘草,清上焦为佐;滑石、车前,清下焦为使。又用茅根煎汤煎
药,数剂而血止声清,不十日诸症如失。
薛立斋治一膏粱之人,素不慎起居,忽失音不语,神思昏愦,痰涎上涌,此肾经虚寒气厥,不能上接清阳
之气故也。须用地黄饮子,否则后必啮舌。经曰∶少阴气至则啮舌,少阳气至则啮颊。不信,仍用风药,后果
啮舌,急用前汤而安。
雄按∶今冬蒋敬堂室患头偏左痛,筋掣泛愆,数日后不言不食不便,小便间日一行,唇焦舌黑,医投牛
黄丸、紫雪丹、犀角、竹沥等药,渐不识人。乃兄周雨禾延余视之,面色青黄,舌色黑腻,脉来迟软,予
地黄饮子五剂,而一语出识人,八剂而更衣,十余剂而起矣。其人春夏两次堕胎,秋间又病忧劳,盖荣阴
大虚,而内风陡动也。
一妇人忽然不语半年矣,诸药不应,两尺浮数,先用六味丸料加肉桂,数剂稍愈。乃以地黄饮子,三十余
剂而痊。男子多此症,亦用此方治之。
一妇人因怒仆地,痰涌不语,灌牛黄清心丸稍苏,用神仙解语丹加山栀、柴胡、桔梗渐愈,又用六君加枳
壳而痊。神仙解语丹∶
白附子、石菖蒲、远志、天麻、全蝎、羌活、南星、木香。惟木香半两,余皆一两,辰砂为衣。
贵溪湖山夏公明道二郡行县,访虞文靖公伯生于山中,道临川章伯明之医云∶其子尝忽不能言,而无他苦,
群医环视莫究其端,难于用药。伯明视之曰∶此热症也。徐解之自愈。又其仆人得寒热,一医以常用之药。伯
明视之曰∶此热极也,治之莫及矣,舁还其家。仆起拜辞,登舆而去,行未至家,果及夕而毙。(归日稿。)
魏玉横曰∶严铁桥天姿英迈人也,豪于诗酒,自前夏忽患失音,咳嗽时作,守不药之戒。至八月初,余偶
过斋头,谈次,有小青衣,持药瓯至。余曰∶君谓不药,今乃药乎?第医作何治?所用何药?出方验之,乃前
胡、桔梗、杏仁、苏子等伤风剂也。曰∶君病岂宜服此?世安有伤风百日者乎?肝肾久病,相火刑金,惟集灵、
左归、六味为对症耳。幸勿误。再就二人诊,则皆劝服六味,后服至三四十剂,忽发肛痔,痔发而音复。盖肺
脏之病,传大肠腑也,是为佳兆。惟痔痛盛剧,宛转床第月余,亦以服药太迟,且六味不宜根据古方也。病愈数
年,豪饮如故,后登贤书。明年远馆于闽,患疟疾,既数月,始得归,已成损症,遂不起。自失音至是,凡十
年,年三十七,惜哉!
宋辉章翁年六十余,素有豪饮,咳嗽失音,医作伤风治转剧。余与生熟地、麦冬、沙参、栝蒌仁、杞子,
服二十余剂,亦发肛痔,而咳嗽失音皆愈。后数年,以事入都,于山左遇大水,上至腹,行水中数里。初病愈,
其痔遇劳则发,否亦时有脓水。至是痔忽顿愈,而咳嗽失音复作。抵都治疗不瘳,归而延诊,其脉弦涩而数。
语之曰∶初病以发痔而愈,脏传腑也为顺,今痔愈而病发;则腑传脏矣为逆。逾数月而终。
徐灵胎曰∶久嗽失音,必由药误。麦冬、五味,此失音之灵丹也,服之久无不失音者。若至全失,即使其
人力如虎而走如马,半年之后,无有不死。若风寒痰火,偶尔失音者,即不治亦愈。但更加以麦冬、五味,则
弄假成真矣。
盛用敬诊治道士顾本初,患失音症。其他医生按厥阴伤寒治疗。盛用敬到达后说:“这是内伤兼外感,病情已无法挽回,某日会出汗,某日就会死亡。”后来果然如此。有人问他原因,他说:“肺属金,主司声音,肺气耗散则导致失音,且患者面色黧黑,是肾气枯竭的表现。某日属火,火克金(火乘金位),真阳被夺,不死还等什么?”(出自《吴江县志》。)
孙文垣治疗徐检庵,因正月里吃了新蒜炒肉,又冒受风寒,导致咳嗽、喉痛、声音嘶哑。此人原本体内有痰火,又被外邪束缚,导致邪气不得发散所致。应当润肺化痰、调理气机,以祛除病根;同时兼以疏散邪气、解表,以治其标,这样疼痛可除而声音可恢复。先给予栝蒌仁、橘红、桔梗、甘草、薄荷、桑白皮、地骨皮、葛根、前胡,服用四帖药后,再用滚痰丸配合七制化痰丸,连续两帖夜间服用,诸症消除,声音变得洪亮。这是“釜底抽薪”的治疗方法。
张路玉治疗一位来自西部的客商,因受寒来到苏州,突然喘息逆上、声音喑哑,咽喉肿痛。观察其形体丰盛,饮食如常。切脉象浮软,重按却更加强劲有力。这一定是寒邪包裹热邪,损伤肺络所致。于是使用麻杏甘石汤加入半夏、细辛,并重用葳蕤(玉竹),服用两剂后喘息停止,声音发出。但呼吸时仍有轻微喑哑,再给予二陈汤加入枳实、桔梗、葳蕤,服用两剂调理后痊愈。
王唯一诊治的患者数年前虽有血症,但年轻力壮。四月间,忽然患咳嗽,服用发散药后,痰中带血几口。随后服用滋阴药过多,导致声音飒然变哑,时常感觉胸中气塞,拖延了一个多月。诊察其脉虽沉涩,但重按有力,轻举应指,且身体肥胖、肤色润泽,绝非阴虚的证候。大概这种声哑,属于“金实不鸣”,而非“金破不鸣”。因此给予导痰汤加入人中黄、泽泻,专门致力于涤除痰浊。服用四剂后,痰中带出几块紫血,声音逐渐恢复,但嗓音仍不纯净。后来又用秋石配合人中黄、枣肉制成丸药,服用一个月,声音变得清朗,从头到尾未曾使用清理肺气、调养营血的药物。
张飞畴治疗郭代工,端午节吃得少,倦怠腹泻,曾用清热攻下的药物无效。因上厕所时跌倒,随即昏迷不省人事。几天后邀请他诊治,六脉虚微欲脱,右臂不能转动,声音喑哑听不见。当时有人建议使用大黄之类的方剂,张飞畴急忙制止说:“这是脾肺极度虚弱,怎么能承受这种攻伐?只有米粥和人参汤,才比较合适,所谓‘浆粥入胃,则虚者活’。”依照他的建议调理,腹泻停止,神志安宁,声音逐渐恢复而苏醒。能进食后,也只用独参汤调理,未用其他药物而痊愈。
字廷肃诊治一位妇人,怀孕八个月卧床不语,众医束手无策。他说:“这是《内经》所说的‘胎喑’,到十月分娩时不需服药即可自愈。”(出自《嘉善县志》。)
万历年间,京口名医何继充,世代行医。他在少年时期还在家塾读书时,恰逢镇江道台的小儿子突然噤口不能说话,派人去请他父亲诊治,正值其父远出,使者等不及,便让何继充前往。何继充诊察后说:“公子没有病,不要用药。只需多让妇人气息呵入他口中即可。”于是轮流呵气,半晌后果然能说话了。有人问原因,他说:“刚才衙门内有很多妇人,而公子相貌非常俊美,妇人喜爱他的美貌,在抱持时,必定会多吸吮他的口,导致少阳之气暂时被夺,只需呵气来恢复它罢了。”这类匪夷所思的事情就像这样。(出自《张氏卮言》。)
陆肖愚治疗范麓令郎,平时饮食浓厚,酒量极高,性格偏激易怒。起初患吐血,服用犀角地黄汤等药,月余不愈,反而增加了尿血、咳嗽。一天突然声音嘶哑,然而肌肉如故,饮食不减,众人当作痨瘵(肺结核)治疗,无一有效。诊脉,左关洪大而弦,右关滑大而数,这是有余的火症,不是不足的瘵症。因为饮食浓厚生痰,醇酒助火,火炎痰涌,瘀阻于胸中,所以声音嘶哑。血液上行,是因为愤怒伤肝,肝脉挟持舌根并联络阴器,龙雷之火一动,血随之而上逆下泄。治法宜清热降气,化痰导血归原,十日可愈。如果认为是瘵症,而用地黄、天冬、麦冬投药就错了。使用真霞天曲、山楂,作为理胃家湿痰的主药;杏仁、橘红,利肺窍为臣药;桃仁、郁金,行肝滞为辅佐;山栀、生甘草,清上焦为使药;滑石、车前子,清下焦。又用茅根煎汤煎药,数剂后血止声清,不到十天诸症消失。
薛立斋治疗一位富贵之人,平时不注意起居,突然失音不语,神思昏愦,痰涎上涌,这是肾经虚寒气厥,不能上接清阳之气所致。必须使用地黄饮子,否则后来一定会咬舌头。经书说:“少阴气至则咬舌头,少阳气至则咬脸颊。”他不信,仍用风药,后果然咬舌头,紧急使用前汤(地黄饮子)而安。
雄按:今年冬天蒋敬堂的妻子患头偏向左侧疼痛,筋脉抽搐泛苦,几天后不言、不食、不便,小便隔日一次,嘴唇焦裂、舌色黑,医生投用牛黄丸、紫雪丹、犀角、竹沥等药,病人渐渐不认识人。乃兄周雨禾请我诊治,面色青黄,舌色黑腻,脉来迟软,予地黄饮子五剂,一语出而识人,八剂而排便,十余剂而起身。其人春夏两次堕胎,秋季又病忧劳,大概是营阴大虚,而内风陡动。
一妇人突然不语半年了,各种药物无效,两尺脉浮数,先用六味丸料加肉桂,数剂稍愈。后用地黄饮子,三十余剂而痊愈。男子多有此症,也用此方治疗。
一妇人因发怒跌倒在地,痰涌不语,灌服牛黄清心丸稍苏,用神仙解语丹加山栀、柴胡、桔梗渐愈,又用六君子汤加枳壳而痊愈。神仙解语丹:白附子、石菖蒲、远志、天麻、全蝎、羌活、南星、木香。只有木香半两,其余都是一两,辰砂为衣。
贵溪湖山夏公明道二郡巡行各县,在山中拜访虞文靖公伯生,谈到临川章伯明的医术:章伯明的儿子曾经突然不能说话,而没有其他痛苦,群医围观无法探究病因,难以用药。章伯明看后说:“这是热症。”慢慢解除它自然会好。另外他的仆人得寒热病,一个医生用常用的药。章伯明看后说:“这是热极,治疗来不及了,抬回家吧。”仆人起来拜辞,登车离去,走到没到家,果然当晚就死了。(出自《归日稿》。)
魏玉横说:严铁桥是天资英迈的人,豪放于诗酒,自从前夏天忽然患失音,咳嗽时作,遵守不药的戒律。到八月初,我偶然经过他的书房,谈话间,有小丫鬟端着药碗过来。我说:“你说不药,现在怎么吃药了?只是医生怎么治?用了什么药?”拿出方子验证,原来是前胡、桔梗、杏仁、苏子等伤风剂。我说:“你的病哪里适合吃这个?世上哪有伤风百日的呢?肝肾久病,相火刑金,只有集灵膏、左归丸、六味地黄丸是对症的。千万不要误服。”再看另一位医生,也是劝服六味地黄丸,后来服到三四十剂,忽然发作肛痔,痔疮发作而声音恢复。大概是肺脏的病,传到大肠腑了,这是佳兆。只是痔疮疼痛剧烈,辗转床第一个多月,也是因为服药太迟,而且六味地黄丸不宜完全照搬古方。病愈几年后,豪饮如故,后来考中举人。第二年远赴福建做馆师,患疟疾,几个月后才回来,已成损症,最终不治。从失音到这里,共十年,年三十七岁,可惜啊!
宋辉章老先生六十多岁,素来豪饮,咳嗽失音,医生当作伤风治疗反而加重。我用生熟地、麦冬、沙参、栝蒌仁、枸杞子,服用二十余剂,也发作肛痔,而咳嗽失音都好了。几年后,因事入京,在山左遇到大水,水淹到腹部,在水中走几里。起初病愈,其痔疮遇劳累则发作,否则也有脓水。至此痔疮忽然顿愈,而咳嗽失音复发。抵京治疗后不愈,回家延请诊治,其脉弦涩而数。我对他说:“起初发病以痔疮发作而愈,脏传腑为顺;现在痔疮愈而病发,则是腑传脏,为逆。过了几个月就去世了。”
徐灵胎说:久咳失音,必定是由药物误治引起的。麦冬、五味子,这是导致失音的“灵丹”,服用久了无不导致失音的。如果到了完全失音,即使让他力气如虎、行走如马,半年之后,没有不死的。如果是风寒痰火偶尔导致的失音,即使不治疗也会好。但如果加上麦冬、五味子,就把假病弄成真病了。
Sheng Yongjing treated Daoist Gu Benchu, who suffered from aphonia. Other physicians had treated him for Jueyin Cold Damage (Jueyin Shanghan). Upon arrival, Sheng said: "This is a combination of internal injury and external contraction; the condition is incurable. He will sweat on a certain day and die on another." This proved to be true. When asked for the reason, he explained: "The Lung belongs to Metal and governs voice. When Lung Qi scatters, aphonia occurs. Moreover, his dark complexion indicates exhaustion of Kidney Qi. The specific day corresponds to Fire, which overcomes Metal (Fire attacking Metal position). With the True Yang seized, death is inevitable." (From *Wujiang County Annals*.)
Sun Wen Yuan treated Xu Jian'an, who, after eating new garlic stir-fried with meat in the first lunar month and being exposed to wind-cold, developed cough, sore throat, and hoarseness. This patient originally had phlegm-fire, which was constrained by external pathogens, preventing their dispersal. Treatment should moisten the Lung, resolve phlegm, and regulate Qi to address the root, while simultaneously releasing the exterior and dispersing pathogens to treat the branch. Only then can pain be removed and voice restored. Initially, he was given Trichosanthis Semen (Gualou Ren), Tangerine Peel (Juhong), Platycodon Root (Jiegeng), Licorice Root (Gancao), Mint (Bohe), Mulberry Bark (Sangbai Pi), Ground Tallow Tree Root Bark (Digupi), Kudzu Root (Gegen), and Peucedanum Root (Qianhu) for four doses. Subsequently, he took Phlegm-Expelling Pills (Guntan Wan) combined with Seven-Processed Phlegm-Resolving Pills (Qizhi Huatan Wan) for two doses at night. All symptoms resolved, and his voice became clear. This is the method of "removing firewood from under the cauldron" (treating the root cause).
Zhang Luyu treated a merchant from the west who, after catching cold upon arriving in Suzhou, suddenly developed wheezing, aphonia, and swollen, painful throat. His physique was robust, and his appetite was normal. His pulse was floating and soft but became firm upon deep pressure. This indicated cold enveloping heat pathogens, damaging the Lung collaterals. He prescribed Mahuang Xingren Gancao Shigao Decoction (Ephedra, Apricot Seed, Licorice, and Gypsum Decoction) added with Pinellia Rhizome (Banxia) and Asarum Root (Xixin), along with a large dose of Polygonatum Rhizome (Weirui/Yuzhu). After two doses, wheezing ceased and voice returned. However, slight aphonia remained during respiration. He then administered Erchen Tang (Two-Cured Decoction) added with Immature Bitter Orange (Zhishi), Platycodon Root (Jiegeng), and Polygonatum Rhizome (Weirui). After two doses of regulation, the patient recovered.
Wang Weiyi treated a patient who had experienced hemoptysis years prior but was young and strong. In April, he suddenly developed a cough. After taking diaphoretic herbs, blood appeared in his sputum. Subsequent excessive use of yin-nourishing herbs led to a raspy, hoarse voice and a sensation of chest oppression, persisting for over a month. His pulse was deep and choppy but forceful upon pressure, and responsive upon light touch. His body was fat and skin lustrous, clearly not a Yin deficiency pattern. This type of hoarseness is "Metal fullness causing silence" (Jin Shi Bu Ming), distinct from "Metal fracture causing silence" (Jin Po Bu Ming). Therefore, he prescribed Daotan Tang (Phlegm-Guiding Decoction) added with Human Manure Yellow (Renzhonghuang) and Alumen (Zexie), focusing solely on resolving phlegm. After four doses, purple blood clots appeared in the sputum, and the voice gradually returned, though still imperfect. He then used Stone Autumn (Qiushi) combined with Renzhonghuang and jujube flesh made into pills, taken for one month, resulting in a clear voice. Throughout, no Lung-clearing or Ying-blood-nourishing herbs were used.
Zhang Feichou treated Guo Daigong, who ate little on the Dragon Boat Festival, felt fatigued, and suffered diarrhea. Clearing and purging treatments had failed. After falling while defecating, he fell into a coma. Days later, when consulted, his six pulses were faint and nearly vanished, his right arm was immobile, and he was aphonic. Someone suggested using Rhubarb (Dahuang); Zhang urgently stopped this, saying: "This is extreme deficiency of Spleen and Lung Qi; how can it withstand such attack? Only rice gruel and Ginseng Soup are appropriate. As the saying goes, 'If gruel enters the stomach, the deficient will survive.'" Following this advice, diarrhea stopped, consciousness returned, and voice gradually recovered. After regaining ability to eat, only Dushen Tang (Single Ginseng Decoction) was used for regulation, leading to recovery without further medication.
Zi Tingsu treated a woman at eight months of pregnancy who lay mute. Physicians gave up. He stated: "This is what the *Neijing* calls 'Fetal Aphonia' (Tai Yin). She will recover without medicine by the tenth month." (From * Jiashan County Annals*.)
During the Wanli era, He Jichong, a renowned physician from Jingkou from a medical family, was still a student at home. The son of the Prefect of Zhenjiang suddenly lost his speech. The envoy sent for He's father, who was away, so He Jichong went instead. He diagnosed: "The young master has no disease; do not use medicine. Simply have women breathe air into his mouth repeatedly." They did so, and after half an hour, he could speak. Asked why, he replied: "There were many women in the yamen, and the young master was very handsome. The women, admiring him, likely sucked his mouth while holding him, temporarily seizing Shaoyang Qi. Breathing restores it." Such incidents were extraordinary. (From *Zhangshi Zhiyan*.)
Lu Xiaoyu treated Fan Lu's son, who indulged in rich foods and alcohol, and had a irritable temperament. Initially suffering hemoptysis, he took Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) for over a month without improvement, developing hematuria and cough. Suddenly, he became hoarse, yet his muscles and appetite remained normal. Others treated him as consumption (Lai Zhai) with no effect. His left Guan pulse was surging and wiry; right Guan was slippery, large, and rapid. This was an excess Fire pattern, not deficiency-based consumption. Rich food generated phlegm; alcohol aided fire. Fire flared, phlegm surged, and stasis obstructed the chest, causing hoarseness. Anger injured the Liver; Liver channel connects to the tongue base and genitalia. Dragon-Lei fire moving caused blood to rebel upward and leak downward. Treatment should clear heat, descend Qi, resolve phlegm, and guide blood back to its source. Recovery in ten days was expected. Using Rehmannia, Anemarrhena, and Asparagus would be wrong. He used Zhenxia Tianqu and Hawthorn Fruit (Shanzha) to resolve Stomach damp-phlegm as sovereign; Apricot Kernel (Xingren) and Tangerine Peel (Juhong) to benefit Lung orifices as minister; Peach Kernel (Taoren) and Turmeric Tuber (Yujin) to move Liver stagnation as assistant; Gardenia (Shanzhi) and Raw Licorice (Sheng Gancao) to clear Upper Jiao as envoy; Talcum (Huashi) and Plantago Seed (Cheqian) to clear Lower Jiao. Reed Rhizome (Maogen) decoction was used to boil the herbs. After several doses, bleeding stopped, voice cleared, and all symptoms vanished within ten days.
Xue Lizai treated a wealthy man who neglected his lifestyle, suddenly losing his voice and becoming confused with surging phlegm-saliva. This was Kidney Meridian deficiency-cold and Qi reversal, failing to connect with Clear Yang. He prescribed Dihuang Yinzi (Rehmannia Infusion). Otherwise, biting the tongue would follow. The Classics state: "When Shaoyin Qi arrives, the tongue is bitten; when Shaoyang Qi arrives, the cheek is bitten." The patient refused, using wind-dispelling herbs, and indeed bit his tongue. Emergency use of Dihuang Yinzi brought peace.
Xiong's Note: This winter, Jiang Jingtang's wife suffered left-sided headache, muscle spasms, and distress. Days later, she was mute, anorexic, and constipated, with urination every other day, cracked lips, and black tongue. Doctors used Niuhuang Wan (Calculus Bovis Pill), Zixue Dan (Purple Snow Elixir), Rhinoceros Horn, and Bamboo Sap, leading to confusion. Her brother Zhou Yuhe consulted me. Her face was greenish-yellow, tongue black and greasy, pulse slow and soft. I gave Dihuang Yinzi for five doses; she spoke and recognized people. Eight doses led to bowel movement; ten-plus doses led to recovery. She had two miscarriages in spring/summer and illness from worry/labor in autumn. Ying-Yin was greatly deficient, causing sudden internal wind.
A woman had been mute for half a year, unresponsive to various drugs. Her Chi pulses were floating and rapid. Initially, Liuwei Wan (Six-Ingredient Pill) material added with Cinnamon Bark (Rougui) was used for several doses, showing slight improvement. Then Dihuang Yinzi was used for thirty-plus doses, leading to cure. Men with this symptom also respond to this formula.
A woman fell due to anger, with surging phlegm and muteness. Niuhuang Qingxin Wan (Calculus Bovis Heart-Clearing Pill) revived her slightly. Shenxian Jieyu Dan (Immortal Speech-Unblocking Pill) added Gardenia (Shanzhi), Bupleurum Root (Chaihu), and Platycodon Root (Jiegeng) gradually improved her. Finally, Liujun Zi Tang (Six-Gentlemen Decoction) added with Aurantium (Zhike) cured her. Shenxian Jieyu Dan composition: Aconite Tuber (Baifuzi), Acorus Rhizome (Shichangpu), Polygala Root (Yuanzhi), Gastrodia Tuber (Tianma), Scorpion (Quanxie), Notopterygium Rhizome (Qianghuo), Pinellia Tuber (Nanxing), Costus Root (Muxiang). Muxiang is 0.5 liang; others are 1 liang, coated with Cinnabar (Chensha).
Xia Gongmingdao, governing Hushan and Guiqi, visited Yu Wanjingsheng Bosheng in the mountains and discussed Zhang Boming of Linchuan's medical skills. Zhang's son suddenly lost speech without other discomforts. Physicians were baffled. Zhang said: "This is a heat pattern." Slow resolution leads to self-healing. Also, his servant had chills and fever. One doctor used common herbs. Zhang said: "Heat is extreme; treatment is futile. Take him home." The servant bowed, left, and died that evening before reaching home. (From *Guidi Gao*.)
Wei Yuheng said: Yan Tieqiao was talented and bold in poetry and wine. Last summer, he suddenly lost his voice with intermittent cough, adhering to the rule of no medicine. In early August, I visited him. A maid brought medicine. I asked: "You said no medicine, now you take it? What treatment? What herbs?" The prescription contained Peucedanum Root (Qianhu), Platycodon Root (Jiegeng), Apricot Kernel (Xingren), Perilla Fruit (Suzi)—wind-cold formulas. I said: "Your condition does not suit this. Can wind-cold last a hundred days? Long-standing Liver-Kidney disease, Ministerial Fire punishing Metal requires Jiling Gao, Zuogui Wan, or Liuwei Dihuang Wan. Do not err." Another doctor also advised Liuwei Dihuang Wan. After 30-40 doses, hemorrhoids suddenly appeared, and voice returned. Lung disease transmitting to Large Intestine is a good sign. However, severe hemorrhoid pain lasted over a month due to late treatment and rigid adherence to ancient formulas for Liuwei Dihuang Wan. Years later, he drank heavily, passed the provincial exam, and went to Fujian as a tutor. He contracted malaria, returned months later with consumptive disease, and died. From aphonia to death was ten years; he was 37. Regrettable!
Old Man Song Huizhang, over sixty, habitual drinker, suffered cough and aphonia. Doctors treated as wind-cold, worsening condition. I used Raw and Prepared Rehmannia (Sheng/Di Huang), Ophiopogon Tuber (Maidong), Glehnia Root (Shashen), Trichosanthis Semen (Gualou Ren), and Goji Berry (Qizi). After twenty-plus doses, hemorrhoids appeared, and cough/aphonia healed. Years later, traveling to Beijing through floodwaters, hemorrhoids recurred with labor/pus. At this point, hemorrhoids suddenly healed, but cough/aphonia returned. Treatment in Beijing failed. Pulse was wiry, choppy, and rapid. I told him: "Initially, healing via hemorrhoids was organ-to-meridian transmission (Shun/Favorable). Now, healing of hemorrhoids with disease recurrence is meridian-to-organ transmission (Ni/Unfavorable)." He died months later.
Xu Lingtai said: Chronic cough leading to aphonia is always due to medicinal error. Ophiopogon Tuber (Maidong) and Schisandra Berry (Wuweizi) are the "miracle pills" for causing aphonia; long-term use invariably leads to loss of voice. If total aphonia occurs, even if the person is strong as a tiger and fast as a horse, they will die within six months. If aphonia is occasional due to wind-cold, phlegm, or fire, it may heal spontaneously. But adding Maidong and Wuweizi turns false illness into true disease.