典藏书目

A vegetable vendor surnamed Lin, my neighbor, suffered from Shanghan (Cold Damage) for six days in the early spring of the Guiwei year of the Chongzhen era (1643), becoming critically ill. Initially, a physician was summoned. Due to the patient's poverty, the physician lacked the motivation to examine him in detail and often declined treatment before leaving. I happened to return from an outing and heard his mother weeping bitterly, so I went in to inspect him. The patient had his eyes closed and ears deafened, a yellow and dry tongue coating, extreme thirst with a desire for water, had not eaten for two days, cried out upon slight movement, and experienced pain throughout the chest, abdomen, and hypochondrium. His stool consisted of red-brown watery discharge, and his urine was red and scanty/painful. Fortunately, his scrotum was not retracted, and his pulse was deep and slow. I administered Dachaihu Tang (Minor Bupleurum and Rhubarb Decoction) via灌下 (forced ingestion). After a short while, he passed dry feces, opened his eyes, and could hear again. He then took three doses of Xiaochaihu Tang (Minor Bupleurum Decoction) and made a complete recovery. This demonstrates that life and death are predetermined; otherwise, he would have been misled by the opinions of other physicians. Here, symptoms of all three Yin meridians were present. Who says there is no combined disease (Hebing) of the Three Yin? Medical texts state that there is no combined disease of the Three Yin; this is an example of believing books too literally, which is worse than having no books at all.

Lianggan (Double Impact) differs from Jiayin (Clamped Yin). Lianggan involves the simultaneous contraction of cold pathogenic factors in both the exterior and interior. Jiayin involves external contraction of cold pathogenic factors and internal injury caused by consuming cold substances. Therefore, Lianggan is mostly treated with Acrid-Cool methods, while Jiayin must be treated with Warm-Hot methods. If Lianggan does not respond to Acrid-Cool treatments, or if Jiayin does not respond to Warm-Hot treatments, both constitute fatal conditions.

In mid-winter of the Jiashen year (1644), a man surnamed Wang at Xishuiguan, aged over twenty, suffered from the aforementioned condition. He experienced headache and eye pain, fever burning like fire, thirst, dryness, irritability, chest stuffiness, and abdominal distension. His pulse was floating and tight, and deep pressure revealed fullness and solidity. The illness had lasted only two days when he sought my consultation. At that time, an elderly physician mistakenly diagnosed it as Baihu Tang Syndrome (White Tiger Decoction Syndrome). I said: Baihu Tang Syndrome should present without high fever, merely with dry mouth and thirst, or spontaneous sweating, irritability, and slight aversion to cold on the back. Only then can it be considered Baihu Tang Syndrome. If it were a combined disease of Taiyang and Yangming, there should be a symptom of diarrhea with heat binding among the exterior and interior symptoms; only then would it be a combined disease. This is clearly Daqinglong Tang Syndrome (Major Blue-Green Dragon Decoction Syndrome). Hence, on the first day, there was headache and fever, but only dry mouth and chest fullness; today, nasal dryness, insomnia, irritability, thirst, and abdominal distension have increased. Is this not a case where Taiyang and Taiyin are diseased on the first day, and Yangming and Shaoyin are diseased on the second day? Why do you not read the *Shanghan Lun* (Treatise on Cold Damage)? Fortunately, the patient was young and vigorous, and his symptoms had not yet progressed to curling up and lying still, so he was still salvageable. I prescribed Daqinglong Tang added with Chaihu (Bupleuri Radix), Shaoyao (Paeoniae Radix), Chenpi (Citri Reticulatae Pericarpium), and Banxia (Pinelliae Rhizoma). One dose resulted in immediate recovery.

On the seventeenth day of the twelfth lunar month of that winter, another sedan-chair porter suffered from the same condition. Initial treatments used mild exterior-releasing agents. After four days, I happened to return from an outing and inspected him. Upon detailed inquiry into previous symptoms and review of previous prescriptions, none matched the current condition. All six pulses were slippery, large, and powerless. He experienced vomiting, thirst, scrotal retraction, and unconsciousness. I judged that he would die on the sixth day. They continued to consult other physicians who attributed it to wind-phlegm and used emetic therapy. He died the next day. The former condition was extremely critical and dangerous; ancient and modern experts alike called it untreatable. However, I believed that if constitution is robust, the new pathogen has just invaded, and there has been no misuse of drugs, the Stomach Qi remains intact, making it treatable, as was the case with the man at Xishuiguan. Conversely, if physical strength declines, pathogens penetrate deeply, and incorrect medications are taken, leading to the depletion of True Qi, this explains why the porter perished due to medical intervention. Although Daqinglong Tang is considered a harsh/decoction, one must use the appropriate medicine for the specific disease. Why did Li Dongyuan (from the Yishui School) merely substitute it with Qianghuo Chonghe Tang (Notopterygium and Harmonizing Decoction)? This was also a fault of timidity, failing to thoroughly investigate the subtle principles of Zhang Zhongjing's formula construction.