Library

In the year of Wushen, while participating in the class examination at Shanyang, an official suffered from Shanghan (Cold Damage) for eight or nine days. He experienced deafness and could not hear anything. A physician from Chu treated him according to Shaoyang disease, reasoning that Zhang Zhongjing stated that when Shaoyang is affected, there would be hypochondriac pain and deafness. I examined his pulse and said, "The pulses in both hands are weak and powerless; this is not a Shaoyang syndrome. If it were Shaoyang, there would be thirst with desire to drink, vexation, a tendency to sleep, and sore throat. None of these symptoms are present here. Instead, there is profuse sweating and palpitations, which must be caused by excessive sweating." Zhang Zhongjing wrote, "Before taking the pulse, ask the patient to cough. If they do not cough, it indicates bilateral deafness." The reason for this is that heavy sweating has depleted the body's Qi, leading to such symptoms. The patient's family reported that the physician had previously induced heavy sweating. Therefore, I administered formulas such as Zhenwu Tang (True Warrior Decoction) and Baizhu Fuzi Tang (Atractylodes Macrocephala and Aconite Decoction). After several days, his hearing recovered, and he was cured.

In the year of Jiyu, Wang Zhongxian suffered from Shanghan, presenting with fever, headache, aversion to wind absent, absence of sweat on the body, vexation and oppression, and a floating and tight pulse. These symptoms persisted for eight or nine days without receding. I examined him and said, "This is a Mahuang Tang (Ephedra Decoction) syndrome. The pathogenic factor contracted is predominantly heat, hence the irritability." I prescribed three doses of Mahuang Tang. By evening, the vexation worsened, and his hands and feet became restless, tossing and turning incessantly. Some believed he was going mad and required cold-natured medicines. I argued against this, saying, "This is a sign that sweating will occur. Do not worry. It is crucial to avoid administering random medications. Wait for one shichen (two hours), and he should stabilize. When he falls asleep for a short while, he will sweat." Zhang Zhongjing stated, "When reaching six or seven days, if the pulses in all three positions are large and the hands and feet are restless, the disease is about to resolve." This refers to such cases. If cold-natured agents were used, it would certainly result in medical malpractice leading to death.

A woman in the south of the city presented with abdominal fullness, heaviness of the body, urinary incontinence, and abnormal speech. Other physicians declared, "It is untreatable; the Kidney Qi is exhausted." Her family was panicked and distressed, so they secretly summoned me. Upon arrival, the other physician was still present. I examined her and asked, "Why do you say the Kidney is exhausted?" The physician replied, "Zhang Zhongjing stated that loss of urine and stool, delirium, reversed eyes, and fixed gaze constitute Kidney exhaustion." I said, "Currently, the pulse is floating, large, and long. This is a combination of the Three Yang channels. Why call it Kidney exhaustion? Zhang Zhongjing wrote, 'Abdominal fullness, body heaviness, difficulty in turning over, insensitivity of the mouth, delirium, and urinary incontinence. If sweating is induced, delirium ensues; if purgation is used, sweat appears on the forehead, and the hands and feet become cold. This is a Baihu Tang (White Tiger Decoction) syndrome.' The current delirium in the patient resulted from inappropriate sweating therapy, not from the specific signs of delirium, reversed eyes, and fixed gaze that necessitate a diagnosis of Kidney exhaustion based on pulse characteristics." I then administered Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng). After several doses, all symptoms disappeared.