邑中王××之女,年十五岁,于仲春得温病久不愈。
病因 仲春上旬,感受风温,医者延医失宜,迁延旬余,病益增剧,医者诿为不治,始延愚为诊视。
证候 心下胀满甚剧,喘不能卧,自言心中干甚,似难支持。其舌苔白而微黄。小便赤少,大便
从前滑泻,此时虽不滑泻,然仍每日下行。脉搏一息五至强,左部弦而有力,右部似大而有力,
然皆不任重按。
诊断 此其温病之热,本不甚剧。因病久真阴亏损致小便不利,所饮之水停于肠胃则胀满,迫
于心下则作喘。其心中自觉干甚,固系温病之热未清,亦足征其真阴亏损阴精不能上奉也
(《内经》谓阴精上奉,其人寿)。当滋其真阴,利其小便,真阴足则以水济火,而心中自然不干;
小便利则水从下消,而胀满喘促自愈。至于些些温病之余热,亦可皆随小便泻出而不治自愈矣。
处方 鲜白茅根去净皮及节间细根(六两锉碎),用水三大碗,煎一沸,俟半点钟,视其茅根
若不沉水底,再煎一沸,至茅根皆沉水底其汤即成。去渣当茶,徐徐温饮之。
效果 如法煎饮茅根两日,其病霍然全愈。盖白茅根凉润滋阴,
又善治肝肾有热,小便不利,且具有发表之性,能透温病之热外出。一药而三善备,故单用之而
能立建奇功也。然必剖取鲜者用之,且复如此煎法(过煎则无效)方能有效。
凡药之性,能利水者多不
能滋阴,能下降者多不能上升,能清里者多不能达表。惟茅根既善滋阴,又善利水,既善引
水气下行,又善助肾阴上升。且内清脏腑之热,外托肌表之邪,而尤善清肺利痰定其喘逆。
The daughter of Mr. Wang in my county, aged fifteen, contracted a warm disease (Wen Bing) in mid-spring that failed to resolve after a long period.
Etiology: In the early days of mid-spring, she was affected by wind-warmth (Feng Wen). The attending physicians provided inappropriate treatment, allowing the condition to linger for over ten days, during which it worsened significantly. The doctors declared it incurable and referred her to me.
Symptoms: Severe distension and fullness in the epigastrium (Xin Xia), accompanied by panting so severe that she could not lie flat. She reported extreme dryness in the heart region, feeling as though she could barely sustain herself. Her tongue coating was white with a slight yellow tint. Urine was scanty and dark red. Previously, she had suffered from slippery diarrhea; although this had ceased, she still passed stool daily. The pulse beat five times per respiration or more. The left pulse was wiry and forceful, while the right pulse appeared large and forceful, yet neither could withstand heavy pressure.
Diagnosis: The heat pathogen of the warm disease was originally not severe. However, due to prolonged illness causing depletion of True Yin (Zhen Yin), urination became difficult. The ingested water stagnated in the intestines and stomach, causing distension, and pressed upon the epigastrium, inducing panting. The sensation of extreme dryness in the heart region is indeed due to residual heat from the warm disease, but it also evidences the depletion of True Yin, where Yin essence fails to ascend (as stated in the *Nei Jing*, when Yin essence ascends, longevity is achieved). The treatment should focus on nourishing True Yin and promoting diuresis. When True Yin is sufficient, Water will control Fire, and the heart dryness will naturally resolve; when urination becomes free, water dampness will dissipate downward, and distension and panting will heal spontaneously. Any remaining mild heat from the warm disease can be expelled through urine and resolve without further specific treatment.
Prescription: Fresh Rhizoma Imperatae (Ba Mao Gen), peeled and cleaned of fine roots at the nodes (six liang, chopped), boiled in three large bowls of water until boiling once. Let stand for half an hour. If the rhizome does not sink to the bottom, boil again until all pieces sink. The decoction is then ready. Strain and drink as tea, slowly and warm.
Outcome: Following this method for two days, she recovered completely. Rhizoma Imperatae is cool, moistening, and nourishes Yin; it is effective for heat in the Liver and Kidney with difficult urination, and possesses dispersing properties that allow it to vent warm disease heat outward. This single herb combines three beneficial actions, thus achieving remarkable results when used alone. It must be fresh and prepared specifically as described (over-boiling renders it ineffective). Generally, herbs that promote diuresis often fail to nourish Yin; those that descend rarely ascend; those that clear interior heat rarely reach the exterior. Only Rhizoma Imperatae both nourishes Yin and promotes diuresis, guides water Qi downward, and assists Kidney Yin upward. Furthermore, it clears internal organ heat externally while expelling exterior pathogens, and is particularly effective in clearing Lung heat, resolving phlegm, and arresting panting.