薛立斋治一小儿,睾丸作痛,小便赤涩,寒热作呕,乃肝脾之症,用小柴胡汤加山栀、车前、茯苓而愈。
一小儿睾丸肿硬,小便黄涩,用小柴胡汤加山栀、车前,并芦荟丸而消。
万密斋治梁大尹子病疝,右睾丸肿大如鸡卵,长约五寸,络脉旁下抵阴囊硬痛,大小便不通,用当归、川
芎、木香、青皮、山栀仁、山楂子、小茴香、川楝子、泽泻,二剂而安。
一小儿肠痛,(即小肠疝也。)用《诸症辩疑》内一方,五苓散加川楝子、小茴香,入盐一捻神效。
张子和治霍秀才之子,年十二岁,睾丸一旁肿胀。张见之曰∶此因惊恐得之。惊之为病,上行则为呕血,
下则肾伤而为水肿。以琥珀丸、通经散,一泻而消散。
高存之幼郎,病内伤,大小便俱红。诸医竞用红花、桃仁,病愈甚。仲淳曰∶桃仁之类,疏其瘀也。血且
行,奈何又重伤之?伤则补之而已,以生地四钱,续断及杜仲、牛膝等饮之稍平,而腹痛不已。仲淳曰∶是在
《内经》强者气行则愈,弱者着而成病。加人参二钱,一剂而愈。(《广笔记》。)
汤某治郑都丞子,患七年摇头,三年下血,已服百余方,前后所服,治摇头者,无非风药,止血者,或在
肠风,俱不效。视之,亦不明其标本。退而思之,乃肝血盛,外有风热乘之。(谓肝病则得之矣,谓血病盛
而风热外乘,则未必然耳。)肝属木,盛而脾土为木所克,脾与肺是子母,俱为肝所胜,而血遂溃于大便,故便
血不止,遂处一方,但损肝祛风而益脾。初亦一时之见,只数服而愈。十余日后,血止而下白脓,遂安。用犀
角屑、甘草各一钱,栝蒌半两,蛇蜕炙一钱,防风五钱,钩藤一钱,麻黄去节一钱,炙 半两,羌活、白芍各
半两,为末,枣肉丸,食后薄荷汤下。只二服已效,头摇即止,便血随愈。次开服胃风汤,数日顿除。沈舍人子
服之亦效。
蒋仲芳治周忠介公孙女,年七八岁,大便下血不止。有用黄连、犀角者,有用人参、阿胶者,俱不效。诊
得气口沉紧,服末子三进而血止。问故,曰∶人但知脾虚不能摄血,不知饮食伤脾,亦不摄血。今用消导之剂,
食去则脾气复,而血自摄,焉得不愈?其末子,即沉香末也。
薛立斋治疗一名小儿,睾丸疼痛,小便赤红且排尿涩滞,伴有寒热往来和呕吐症状,这是肝脾同病的证候,使用小柴胡汤加入山栀、车前子、茯苓而痊愈。
另一名小儿睾丸肿胀坚硬,小便黄赤且排尿涩滞,使用小柴胡汤加入山栀、车前子,并配合服用芦荟丸,肿块得以消散。
万密斋治疗梁大尹的儿子患疝气病,右侧睾丸肿大如鸡蛋大小,长约五寸,脉络旁侧下行抵至阴囊,硬痛难忍,大小便不通畅,使用当归、川芎、木香、青皮、山栀仁、山楂子、小茴香、川楝子、泽泻,服用两剂后病情安定。
另一名小儿患肠痈(即小肠疝),使用《诸症辩疑》中的一方,以五苓散加入川楝子、小茴香,再放入一捻盐,效果神妙。
张子和治疗霍秀才的儿子,十二岁,一侧睾丸肿胀。张子和见到后说:这是由于惊恐导致的疾病。惊骇致病,向上则导致呕血,向下则损伤肾脏而导致水肿。使用琥珀丸、通经散,通过泻下法一次就使肿胀消散。
高存之的幼子,患内伤,大小便均见红色出血。众医生竞相使用红花、桃仁等活血化瘀药,病情反而加重。仲淳说:桃仁之类药物是疏通瘀血的。血液已经运行,为何又严重损伤正气?损伤了就应当补益,于是使用生地四钱,续断、杜仲、牛膝等煎服,病情稍平,但腹痛不止。仲淳说:这符合《内经》中“强者气行则愈,弱者着而成病”的理论。加入人参二钱,服用一剂后痊愈。(出自《广笔记》。)
汤某治疗郑都丞的儿子,患摇头病七年,便血三年,已服用百余方。此前所服的方剂,治摇头的无非是风药,止血的或是针对肠风,都不见效。观察病情,也不明白标本所在。退下来思考,认为是肝血盛,外有风热乘虚而入。(认为肝病则得此病是对的,但认为血病盛而风热外乘,则未必如此。)肝属木,旺盛时克制脾土,脾与肺是母子关系,都被肝所胜,于是血液溃散于大便,导致便血不止。于是开一方,旨在损肝祛风而益脾。起初也是一时的见解,只服几剂就痊愈了。十多天后,血止住但排出白色脓液,随后安然无恙。处方用犀角屑、甘草各一钱,栝蒌半两,蛇蜕炙一钱,防风五钱,钩藤一钱,麻黄去节一钱,炙草半两,羌活、白芍各半两,研为末,枣肉为丸,食后用薄荷汤送下。只服两剂已见效,头摇立即停止,便血随之痊愈。之后服用开胃风汤,数日后彻底除根。沈舍人的儿子服用也有效。
蒋仲芳治疗周忠介的公孙女,七八岁,大便下血不止。有用黄连、犀角的,有用的人参、阿胶的,都不见效。诊察发现气口脉沉紧,服用沉香末三进后血止。询问原因,回答说:人们只知道脾虚不能摄血,不知道饮食损伤脾脏,也不能摄血。现在使用消导药剂,食积去除则脾气恢复,血液自然能固摄,怎么能不愈呢?所谓的末子,就是沉香末。
Xue Lizhai treated a child with pain in the testicles, red and scanty urine (dysuria), alternating chills and fever, and vomiting. This was identified as a syndrome involving both the Liver and Spleen. He prescribed Xiao Chai Hu Tang (Minor Bupleurum Decoction) with added Gardenia Fruit (Shanzhi), Plantago Seed (Cheqianzi), and Poria (Fuling), resulting in a cure.
Another child presented with swollen and hard testicles and yellow, scanty urine. Xiao Chai Hu Tang (Minor Bupleurum Decoction) with added Gardenia Fruit (Shanzhi) and Plantago Seed (Cheqianzi), along with Lu Hui Wan (Aloe Pill), was used to resolve the swelling.
Wan Mizhai treated the son of Vice-Intendant Liang for hernia disease. The right testicle was swollen as large as a chicken egg, approximately five cun long, with collateral vessels extending downwards to the scrotum, causing hardness and severe pain. Urination and defecation were obstructed. He prescribed Angelica Root (Danggui), Ligusticum Rhizome (Chuanxiong), Aucklandia Root (Muxiang), Green Tangerine Peel (Qingpi), Gardenia Kernel (Shanzhiren), Hawthorn Fruit (Shanzhazhi), Fennel Seed (Xiaohuixiang), Sichuan Chinaberry Fruit (Chuanlianzi), and Alisma Rhizome (Zexie). After two doses, the condition stabilized.
Another child suffered from intestinal abscess (i.e., small intestine hernia). Using a formula from *Zhuzheng Bianyi* (Differentiation of Various Symptoms), Wuling San (Five-Ingredient Powder with Poria) with added Sichuan Chinaberry Fruit (Chuanlianzi) and Fennel Seed (Xiaohuixeng), plus a pinch of salt, proved miraculous.
Zhang Zihe treated the twelve-year-old son of Scholar Huo, who had unilateral testicular swelling. Zhang observed and stated: "This is caused by fright and alarm." Fright-induced illness, if it moves upward, causes hematemesis; if it moves downward, it damages the Kidney leading to edema. He used Hu Po Wan (Amber Pill) and Tong Jing San (Unblocking Collaterals Powder), achieving resolution through purgation in one instance.
Gao Cunzhi's young son suffered from internal injury, presenting with blood in both stool and urine. Other physicians aggressively used Red Sage Root (Honghua) and Peach Kernel (Taoren) to invigorate blood and remove stasis, worsening the condition. Zhongchun remarked: "Peach Kernel and similar herbs are for resolving stasis. If blood is already moving, why further injure the body? Injury requires tonification." He prescribed Rehmannia Root (Shengdi, 4 qian), Dipsacus Root (Xuduan), Eucommia Bark (Duzhong), and Achyranthes Root (Niuxi) decocted together. The condition slightly improved, but abdominal pain persisted. Zhongchun cited the *Neijing*: "When strong, Qi flows and recovery occurs; when weak, stagnation leads to disease." He added Ginseng Root (Renshen, 2 qian), resulting in a cure after one dose. (From *Guang Biji*.)
Tang treated the son of Vice-Marshal Zheng, who had suffered from head-shaking for seven years and hematochezia for three years, having taken over a hundred prescriptions. Previous treatments for head-shaking relied solely on wind-dispelling herbs, and those for bleeding targeted intestinal wind, all without effect. Upon examination, the root and branch were unclear. Reflecting later, he concluded it was due to excessive Liver Blood with external Wind-Heat invading. (While attributing it to Liver disease is correct, attributing it to excessive blood and external wind-heat invasion is debatable.) The Liver belongs to Wood; when excessive, it overacts on Spleen Earth. Since Spleen and Lung are in a mother-son relationship, both are subdued by the Liver, causing blood to rupture into the large intestine, leading to persistent hematochezia. Thus, he formulated a prescription aimed at subduing the Liver, dispelling wind, and tonifying the Spleen. Initially a tentative approach, only a few doses resulted in a cure. Ten days later, bleeding stopped, but white pus was discharged, after which the patient recovered. The formula consisted of Rhinoceros Horn (Xijiao) and Licorice Root (Gancao), each 1 qian; Trichosanthes Fruit (Gualou), half liang; Snake Slough (Shetui), roasted, 1 qian; Saposhnikovia Root (Fangfeng), 5 qian; Uncaria Ramulus cum Uncis (Gouteng), 1 qian; Ephedra Stem (Mahuang), nodes removed, 1 qian; Roasted Licorice Root (Zhi Gancao), half liang; Notopterygium Rhizome and Root (Qianghuo) and White Peony Root (Baishao), each half liang. These were powdered and formed into pills with jujube flesh, taken after meals with Mint Decoction. Only two doses were effective; head-shaking ceased immediately, and hematochezia resolved subsequently. Thereafter, Kai Wei Feng Tang (Stomach-Opening Wind-Dispelling Decoction) was administered, completely eliminating the disease within several days. It was also effective for the son of Secretary Shen.
Jiang Zhongfang treated the granddaughter of Zhou Zhongjie, aged seven or eight, with persistent hematochezia. Treatments using Coptis Rhizome (Huanglian) and Rhinoceros Horn (Xijiao), or Ginseng Root (Renshen) and Donkey-hide Gelatin (Ejiao), were ineffective. Pulse diagnosis revealed a deep and tight pulse at the Qi Kou position. Administration of Agarwood Powder (Chenxiang Mo) in three doses stopped the bleeding. When asked for the rationale, he replied: "People only know that Spleen deficiency fails to control blood, but do not realize that dietary injury to the Spleen also impairs its ability to control blood. Now, using digestive and guiding agents removes food stagnation, restoring Spleen Qi, which naturally controls the blood. How could it not heal?" The powder used was simply Agarwood Powder (Chenxiang Mo).