七味白术散,治小儿久泻脾虚者最灵。震泽泥水匠贺凤山孙二岁,泄泻两月,身热少食
,面色痿黄,夜睡时惊,幼科用青蒿、扁豆、二芩、浓朴、枳壳、陈皮等药,日就危笃,求余治之
,令服七味白术散,(党参二钱,焦白术、茯苓二钱,炙甘草四分,木香四分,煨葛根四分
,藿香七分,煨姜三分),四剂,泻止身凉。改方去葛根,加炒扁豆二钱,炒苡仁三钱,砂
仁三分,桔梗四分,四剂全愈。
四苓散治疝有极验者。周克庵于丁巳岁病痰火痊后,忽睾丸起块如鸡卵,坚硬重坠不能
行,
始服治疝药,如川楝子、荔枝核等,反作痛,自揣是岁寓吴江时,常于酒后至茶肆,饮茶过
多,殆水气流入膀胱所致,与肝经无涉,改服四苓散,泄泻数次而疝全愈。
《客尘医话》云∶咳嗽大半由于火来克金,谓之贼邪,最难速愈。因风寒外袭,而内生
实火
,急宜泻之,若失于提解,久之传变生疾,误服阴药,反成劳瘵。此数语甚的。又云∶如果
系虚火,惟壮水一法。但养阴之药,又皆阻气滞痰,是在治之者灵也。如生脉六君汤、金水
六君煎之类,最为妥当。余按∶金水六君煎,景岳以治肺肾虚寒,水泛为痰,而《景岳全书
发挥》訾其立方杂乱,(二陈、地、归),且为水泛为痰而用二陈,于理不通,当用地黄汤,
至壮水之法,六君汤亦非所宜。薛生白有案云∶此由金水不相承挹,故咳久不愈,切勿理肺
,肺为娇脏,愈理愈虚,亦不可泛然滋阴,方
用整玉竹、川石斛、甜杏仁、生扁豆、北沙参、云茯神,迥胜于生脉六君汤、金水六君煎。
余仿此以治久嗽阴伤,无不获效。
咳嗽有寒热之别,不可误治。感寒者,鼻塞流涕,或微恶寒,宜服生姜、葱白。(日二
次,
不宜常服。)挟热者,夜嗽较甚,喉痒,口或微渴,宜服淡盐汤,(可常服代茶。)初起服此
者,不致久延,余家用之恒验。
Qiwei Baizhu San (Seven-Ingredient White Atractylodes Macrocephala Decoction) is most effective in treating prolonged diarrhea due to Spleen deficiency in children. The grandson of He Fengshan, a plasterer from Zhenze, was two years old and had suffered from diarrhea for two months. He presented with fever, poor appetite, sallow complexion, and night terrors during sleep. Pediatricians prescribed herbs such as Qinghao (Artemisiae Annuae Herba), Bian Dou (Dolichoris Semen), Er Qin (Huangqin [Scutellariae Radix] and Huangbai [Phellodendri Cortex]), Hou Po (Magnoliae Officinalis Cortex), Zhi Qiao (Aurantii Fructus), and Chen Pi (Citri Reticulatae Pericarpium), but his condition deteriorated daily. Seeking my treatment, I instructed him to take Qiwei Baizhu San (Dang Shen [Codonopsis Radix] 2 qian, Jiao Baizhu [Fried Atractylodis Macrocephalae Rhizoma] and Fu Ling [Poria] each 2 qian, Zhi Gancao [Prepared Licorice Root] 4 fen, Mu Xiang [Aucklandiae Radix] 4 fen, Wei Gegen [Steamed Puerariae Lobatae Radix] 4 fen, Huo Xiang [Agastaches Herba] 7 fen, Wei Jiang [Steamed Ginger] 3 fen). After four doses, the diarrhea ceased and body temperature normalized. The prescription was then modified by removing Gegen and adding Chao Bian Dou [Stir-fried Dolichoris Semen] 2 qian, Chao Yiyi Ren [Stir-fried Coicis Semen] 3 qian, Sha Ren [Amomi Fructus Rotundus] 3 fen, and Jie Geng [Platycodonis Radix] 4 fen. After another four doses, he recovered completely.
Siling San (Four-Ingredient Poria Decoction) has extremely verified efficacy in treating hernia. Mr. Zhou Ken'an, after recovering from Phlegm-Fire syndrome in the Ding Si year, suddenly developed a testicular mass the size of a chicken egg, which was hard, heavy, and dragging, making walking impossible. Initially, he took hernia remedies such as Chuan Lian Zi (Toosendan Fructus) and Lizhi He (Litchi Seed), which aggravated the pain. He reasoned that while residing in Wujiang that year, he often drank excessive tea at teahouses after consuming alcohol, suggesting that Water Qi had flowed into the Bladder rather than involving the Liver Meridian. He switched to Siling San, and after several episodes of diarrhea, the hernia was completely cured.
*Kechen Yihua* states: "Most coughs result from Fire overacting on Metal (Lung), termed 'Thief Evil,' and are difficult to cure quickly. When Wind-Cold attacks externally, it generates internal Excess Fire, which should be purged urgently. If the opportunity to resolve the exterior is missed, the condition may transform over time, leading to other diseases. Misusing Yin-nourishing (cooling/yin-deficiency) medicines can instead lead to Lao Zhai (consumption disease)." These words are very accurate. It further states: "If it is indeed Deficient Fire, only the method of Zhuang Shui (strengthening Water/nourishing Kidney Yin) applies. However, Yin-nourishing medicines tend to obstruct Qi flow and stagnate Phlegm; this depends on the practitioner's flexibility. Formulas such as Shengmai Liujun Tang (Six Gentlemen Decoction with Shengmai Powder) and Jinshui Liujun Jian (Six Gentlemen Decoction for Metal and Water) are most appropriate." My commentary notes: Jinshui Liujun Jian, used by Zhang Jingyue to treat Lung-Kidney Deficient Cold with Water Flooding transforming into Phlegm, was criticized in *Jingyue Quanshu Fahui* for its chaotic formulation (combining Er Chen Tang with Dihuang [Rehmanniae Radix] and Guibai [Angelicae Sinensis Radix]). Moreover, using Er Chen Tang for Water Flooding transforming into Phlegm is theoretically inconsistent; one should use Dihuang Tang. Regarding the method of strengthening Water, Liujun Tang is also unsuitable. Xue Shengbai recorded a case stating: "This arises because Metal and Water do not support each other, causing chronic cough. Do not merely treat the Lung; the Lung is a Delicate Organ, and treating it directly makes it more deficient. One must not indiscriminately nourish Yin. The prescription uses Zheng Yuzhu [Polygonati Odorati Rhizoma], Chuan Shihu [Dendrobii Nobile Caulis], Tian Xingren [Pruni Armeniacae Semen], Sheng Bian Dou [Fresh Dolichoris Semen], Bei Shashen [Glehniae Radix], and Yun Fushen [Poria with Hostwood]. This far surpasses Shengmai Liujun Tang and Jinshui Liujun Jian." I imitated this method to treat chronic cough with Yin injury, achieving consistent success.
Coughs differ between Cold and Heat patterns and must not be misdiagnosed. For those affected by Cold, presenting with nasal congestion, runny nose, or slight aversion to cold, fresh Ginger and Scallion White are suitable. (Take twice daily; do not use long-term.) For those with Heat involvement, coughing is worse at night, accompanied by throat itching and slight thirst; light salt water is suitable. (Can be taken regularly as tea substitute.) Using these methods at the onset prevents prolonged illness; my family has found them consistently effective.