《宋史·庞安常传》、《明史·凌云传》皆载治产妇胎不下,隔腹针儿手而得生。《扬
州府
志》之记殷矩,《嘉兴府志》之记孙浦,则产妇皆已死,见其血而令启棺,隔腹针之而复生
,此于情理未合,不足深信。
《曲礼》云∶医不三世,不服其药。郑氏注云∶慎物齐也。孔氏疏云∶凡人病疾,盖以
筋血
不调,故服药以治之,其药不慎于物,必无其征,故宜戒之。择其父子相承至三世也,是慎
物调齐也。又说云∶三世者,一曰《黄帝针灸》,二曰《神农本草》,三曰《素女脉诀》。
又云∶《夫子脉诀》。若不习此三世之书,不得服食其药。然郑云慎物齐也,则非为《本草
》、《针灸》、《脉诀》,于理不当,其义非也。按∶此则所谓三世者,注疏因主父子相承
之说也,近世有专主通于三世之书,而以三世相承为俗解之误,殆未读注疏耳,且经书文义
虽古,而辞无不达,既谓通于三世之书,何以不明言之,而日医不三世?故作此不了语,以
炫惑后世乎?
王朴庄谓古方一两者,今之七分六厘,一升者,今之六杓七杪。《东医宝鉴》谓古方一
,今之三钱二分五厘,一升者,今之二合五杓。如仲景炙甘草汤,药料最多,共曰十六两,
用酒七升,水八升。准于王说,为今之三两四钱九分六厘,今之七合有零,则酒水太少,如
《东医宝鉴》之说,为今之十四两九钱五分,今之三升七合五杓,则药料太多,似当从王之
两数,《东医宝鉴》之升数,乃为得之。
湖州费星甫野语云∶儒医张梦庐之舅氏沈翁,以外科着,有女大腹隆起,中有结块,俨若私
胎,迁延日久,腹益膨 ,梦庐诊其脉曰∶此乃肠痈,无术以治之,危矣。沈遂悟,扶女足
板凳之两头,出其不意,将女腹重踢,倒地昏晕,其痈内破,脓从大小便出数斗,遂按法
疗治获痊。余谓肠痈脓已成者,《金匮》、《千金》皆有成法可遵,何必出奇行险以治之?
且《经》云∶肠痈为病不可惊,惊则肠断而死。此女患痈日久,又加之以重踢,其肠有不断
乎?此传讹之辞,未可信也。
《夷坚志》谓台州狱囚遭讯拷,肺伤呕血,用白芨为末,米饮日服,后其囚凌迟,刽者剖其
胸,见肺间窍穴数十处,皆白芨填补,色犹不变。此说李东璧采入《本草纲目》,医家皆信
之,独进贤舒驰远昭《伤寒集注》谓∶隔诸脊骨,不得伤肺,何肺拷坏而骨不坏耶?且白芨
由食管入胃,不得由气管入肺,其诳显然云云。因思古方催生用鼠肾丸、兔脑丸云,其药从
儿手中出,由舒氏之说推之,则胎在肠外,药入胃中,何以得入儿手乎?然观《徐灵胎医案
》横泾钱氏女腿痈成管,管中有饭粒流出,长兴周氏子臂疽经年,所食米粒有从疽中出者,
又《槐西杂志》治折伤接骨,用开元通宝钱烧而醋淬,研细为末,以酒调下,铜末自结而为
圈,周束折处,曾以折足鸡试之果然。此皆理之不可解者,是则昔人之说,未可竟斥为非矣
张 《朝野佥载》云∶洛州有士人患应声,语即喉中应之,良医张文仲令取《本草》读之皆
应,至其所畏者即无声,乃录取药合和为丸服之,应时而止。其后《遁斋间览》载杨 腹中
应声,读《本草》至雷丸不应,服数粒而愈。《泊宅编》载毛景喉中有物应声,诵《本草》
至蓝不应,饮汁吐虫而愈。其说皆为方书所征引,窃意虫之应声,乖气所感,非有知觉之灵
,岂能闻所畏之物而遂不作声乎?殆皆小说家附会之辞。
《灵枢经》谓人呼吸定息,气行六寸,一日夜行八百一十丈,计一万三千万百息。河西
池以
为伪说,人一日夜岂止一万三千五百息。余尝静坐数息,以时辰表验之,每刻约二百四十息
,一日夜百刻,当有二万四千息,虽人之息长短不同,而相去不甚远,必不止一万三千五百
息,然则何氏之说为不虚,而《经》所云未足据矣。尽信书不如无书,此之谓也。
哕嗳之说,诸家各异,王氏《准绳》援据《内经》,正李东垣、王海藏(以哕为干呕)、
陈无
择(以哕为咳逆)之误,而从成无己、许叔微之说,以哕为呃逆,以嗳为噫气,此可为定论。
徐灵胎批《临证指南》噫嗳篇云∶噫,即呃逆,病者最忌;嗳,为饱食气,非病也。何可并
为一证?王孟英《潜斋医话》訾之,谓噫不读为如字,乃于介切,饱食息也。以噫、嗳各篇
,于义实赘,徐氏误作二种,殊失考,况噫有不因饱食而作者,亦病也。仲景立旋复代赭汤
,治病后噫气,徐氏误噫为哕,谓即呃逆,盖此汤原可推展而用,凡呕吐呃逆之属,中虚寒
饮为病者皆可治。余尝以治噫气频年者数人,投之辄愈,益见徐氏之仅泥为饱食气未当也,
是盖宗王氏之说,而其义更融澈矣。
The "History of Song: Biography of Pang Anchang" and the "History of Ming: Biography of Ling Yun" both record cases of treating postpartum retention of the placenta by needling the fetus's hand through the mother's abdomen, resulting in survival. The records of Yin Ju in the "Yangzhou Prefecture Gazetteer" and Sun Pu in the "Jiaxing Prefecture Gazetteer" describe situations where the mothers had already died; upon seeing blood, coffins were opened, and needling through the abdomen led to revival. These accounts are inconsistent with reason and logic and are not worthy of deep belief.
The "Book of Rites: Qu Li" states: "If a physician has not practiced for three generations, do not take his medicine." Zheng Xuan's commentary explains: "This refers to being cautious about substances and prescriptions." Kong Yingda's subcommentary elaborates: "Human diseases generally arise from disharmony of sinews and blood, so medication is used to treat them. If one is not cautious regarding medicinal properties, there will inevitably be no therapeutic effect; thus, such carelessness should be avoided. Selecting physicians whose knowledge is passed down from father to son for three generations ensures caution in substances and harmony in prescriptions." It is further stated that the "Three Generations" refer to: first, the *Huangdi Zhenjiu* (Yellow Emperor's Acupuncture); second, the *Shennong Bencao* (Divine Farmer's Materia Medica); and third, the *Sunü Maijue* (Lady Sun's Pulse Diagnosis). Another version cites the *Fuzi Maijue*. If one does not study these three texts, one should not consume his medicines. However, since Zheng Xuan mentioned "caution in substances and prescriptions," this interpretation cannot be limited solely to the *Bencao*, *Zhenjiu*, and *Maijue*; logically, this meaning is incorrect. According to my analysis, the "Three Generations" here, as explained in the commentaries, stems from the theory of hereditary transmission within families. In recent times, some scholars insist on mastering the three specific books and dismiss the idea of hereditary transmission as a vulgar misunderstanding, likely having not read the commentaries. Moreover, although the language of classics is ancient, its meaning is always clear. If it meant mastering three books, why not state it explicitly rather than saying "physician not three generations"? Was this ambiguous phrasing intended to dazzle and confuse later generations?
Wang Puzhuang asserted that one tael in ancient prescriptions equals approximately 7 fen 6 li in modern measures, and one sheng equals 6 shao 7 miao. The *Dongui Bogam* (Eastern Medical Precious Mirror) states that one ancient tael equals 3 qian 2 fen 5 li, and one sheng equals 2 he 5 shao. For example, Zhang Zhongjing's Zhi Gancao Tang (Honey-Fried Licorice Decoction), which contains the most ingredients, totals sixteen taels, using seven sheng of wine and eight sheng of water. Based on Wang's conversion, this would be 3 tael 4 qian 9 fen 6 li of herbs, and slightly over 7 he of liquids, implying too little liquid. Based on the *Dongui Bogam*'s conversion, it would be 14 tael 9 qian 5 fen of herbs and 3 sheng 7 he 5 shao of liquids, implying too many herbs. It seems appropriate to adopt Wang's weight measurements and the *Dongui Bogam*'s volume measurements, which appears to be the correct approach.
Fei Xingfu's anecdotes from Huzhou recount: The uncle of Confucian physician Zhang Menglu, Mr. Shen, was renowned for surgery. His daughter had a distended abdomen with a lump, resembling an illicit pregnancy. After prolonged duration, her abdomen swelled further. Zhang Menglu diagnosed her pulse and said, "This is Changyong (Intestinal Abscess). There is no treatment available; it is critical." Shen then understood, placed his daughter standing on the ends of a bench, and unexpectedly kicked her abdomen heavily. She fell and fainted. The abscess ruptured internally, and pus discharged through urination and defecation in large quantities. Subsequently, she recovered following standard treatment protocols. I argue that for intestinal abscesses with formed pus, the *Jinkui Yaolue* (Essential Prescriptions from the Golden Cabinet) and *Qianjin Fang* (Prescriptions Worth a Thousand Gold) provide established methods. Why resort to risky and unconventional measures? Furthermore, the *Neijing* (Inner Canon) states: "In intestinal abscess disease, one must avoid fright; if frightened, the intestines may rupture, leading to death." This woman suffered from the abscess for a long time and endured heavy kicking; could her intestines remain intact? This is a transmitted error and should not be believed.
The *Yijian Zhi* (Records of Yijian) reports that a prisoner in Taizhou, after severe interrogation and beating, injured his lungs and vomited blood. He was given powdered Biejiu (Bletilla Rhizome) taken with rice water daily. Later, when he was executed by lingchi (death by a thousand cuts), the executioner cut open his chest and found dozens of holes in the lungs filled with Biejiu, which retained its color. This account was included by Li Shizhen in the *Bencao Gangmu* (Compendium of Materia Medica), and physicians generally accepted it. However, Shu Chi Yuanzhao of Jinxian, in his *Shanghan Jizhu* (Commentary on Cold Damage Treatise), argued: "Separated by spinal vertebrae, how could the lungs be injured while the bones remained unharmed?" Additionally, Biejiu enters the stomach via the esophagus and cannot enter the lungs via the trachea; this deception is obvious. Reflecting on this, ancient parturition-inducing formulas like Shushen Wan (Mouse Kidney Pill) or Tunaowan (Rabbit Brain Pill) claim the medicine exits through the fetus's hand. Applying Shu's logic, if the fetus is outside the intestines and the medicine enters the stomach, how can it reach the fetus's hand? However, observing Xu Lingtai's medical cases: Qian's daughter from Hengjing had a leg abscess forming a sinus tract from which rice grains were discharged; Zhou's son from Changxing had an arm carbuncle lasting a year, from which eaten rice grains emerged; and the *Huai Xi Zazhi* records treating fractures by burning Kaiyuan Tongbao coins, quenching them in vinegar, grinding them into powder, and administering with wine. The copper powder naturally formed rings around the fracture site. Testing this on chickens with broken legs proved effective. These phenomena are difficult to explain rationally, suggesting that ancient claims should not be entirely dismissed as false.
Zhang Zhuo's *Chaoye Qianzai* (Miscellaneous Records from the Court and the Wild) states: A scholar in Luozhou suffered from "echoing voice," where his throat repeated whatever he said. Physician Zhang Wenzhong instructed him to read from the *Bencao* until he reached a herb that did not trigger an echo, identifying it as the substance he feared. He compounded this herb into pills, which cured the condition promptly. Later, *Dunzhai Jianlan* recorded Yang suffering from abdominal echoing; reading the *Bencao* revealed no echo at Leiwan (Polyporus), and taking several grains cured him. *Bozhai Bian* recorded Mao Jing having an object in his throat causing echoing; chanting the *Bencao* showed no echo at Lan (Isatis Leaf), and drinking the juice expelled worms, curing him. These accounts are cited in medical texts. I suspect that insects echoing is due to qi disturbance, lacking conscious perception. How could they cease responding upon hearing something they fear? These are likely fictional embellishments.
The *Lingshu Jing* (Spiritual Pivot) states that with each breath cycle, qi moves six cun, traveling 810 zhang in a day and night, totaling 103,500,000 breath cycles (Note: Text implies a specific calculation, often interpreted as ~13,500 breaths in other contexts, but here the text argues against a low number). He Xi Chi considered this a false statement, arguing humans breathe more than 13,500 times a day. I once counted my breaths while sitting quietly, verifying with a clock. Each ke (approx. 15 mins) had about 240 breaths. Over 100 ke in a day and night, there should be 24,000 breaths. Although breath depth varies, the difference is not significant, certainly not as low as 13,500. Thus, He's assertion is not false, and the *Jing*'s figure is insufficient as evidence. "To believe all books is better than having no books" applies here.
Definitions of Yue (hiccups/dry heaves) and Ai (belching) vary among schools. Wang Ken-tang's *Zhunshe* cites the *Neijing* to correct errors by Li Dongyuan (who defined Yue as dry heaves) and Chen Wuze (who defined Yue as coughing/wheezing), aligning instead with Cheng Wuji and Xu Shuwei, defining Yue as hiccup (Eni) and Ai as belching (Yiqi). This can be considered the definitive conclusion. Xu Lingtai, commenting on the "Yi Ai" chapter of *Linzheng Zhinan*, stated: "Yi" is hiccup, which patients dread; "Ai" is belching after fullness, not a disease. How can they be grouped as one syndrome? Wang Mengying criticized this in *Qianzhai Yihua*, stating "Yi" is pronounced differently (yu jie), referring to sighing after eating. Listing Yi and Ai separately is redundant; Xu mistakenly separated them, lacking rigorous examination. Moreover, Yi can occur without fullness and is also pathological. Zhang Zhongjing created Xuanfu Daizhe Tang to treat post-illness Yi Qi (belching). Xu mistakenly equated Yi with Yue (hiccup), claiming this decoction could be extended to treat vomiting and hiccups caused by middle-jiao deficiency and cold-fluid retention. I have treated several patients with chronic belching using this formula with success. This further proves Xu's view that Yi is merely belching after eating is inadequate. This interpretation follows Wang's theory but offers a more profound understanding.