济北王女子竖,奉剑从王之厕。王去,竖后,王令人召之,即仆于厕,呕血死。病得之
流汗,流汗者同法。(法当春呕血死也)病内重,毛发色泽、脉不衰。
脾可割可补,故脾虽伤而毛发色泽脉不衰。惟大忌呕血,大忌流汗。医遇此症,贸然进
药者多矣。吾愿举是以晓之。(樊阿注)
齐中大夫病龋齿。臣意灸其左阳明脉,即为苦参汤,日漱三升,出入五、六日,病已。
得之风及卧开口,食而不漱。
食后宜漱口,为保齿秘诀。况卧时受风,风将内袭,即醒而咀嚼,使风聚而不散,齿故
先病,至于缺朽。苦参子涩敛,漱之用风解而齿固,此牙科丹方之一也。
川王美人,怀子而不乳。召臣意,臣意往。饮以莨砀药一撮,以酒饮之,旋乳。臣意
复诊其脉而脉躁,躁者有余病,即饮以硝石(芒硝、石膏),一剂出(便也)血,血如豆,
比五六枚,(莨砀今无买,可用穿甲代之)。
肠胃内燥,血气不流行,是以无乳。饮以硝石,则热降而燥润,瘀去而新生矣。医生多
治标而不知治本,如治无乳,则仅通乳而已,必罔顾其余病。若治至出血,病家且将大咎医
生。由是医生多用酬方,有宿疾者,永不可去。中国医途,可见一斑矣。(樊阿注)
齐丞相舍人奴,病得之流汗数出,灸于火而以出,见大风也望之杀。然黄黄者土气也,
土不胜木。当至春,隔塞不通,不能食饮,法至夏,泄血死。众医以为大虫,不知其伤脾气
也。
医不能望色,即不能辨症,自并生死不能决矣。若再诀治,势必加剧。若此症众医以为
大虫,必投泻药化虫药无疑,故成伤脾。否则流汗见风,病在皮孔,何以伤及脾气哉?且伤
脾不比伤肺伤肝,况当能食,治之尤易。乃知其病而无方,则亦何贵乎有名医。不惟舍人不
幸,当时病者亦皆不幸也。(樊阿注)
King Ji Bei's maid, Shu, carrying a sword, followed the King to the latrine. After the King left, Shu remained behind. When the King sent someone to summon her, she collapsed in the latrine and died from vomiting blood. This disease was contracted through sweating; those who contract it via sweating follow the same pattern. (According to the pattern, death by vomiting blood should occur in spring.) The internal pathology is severe, yet the hair luster and pulse remain un-declined. Because the spleen can be resected or supplemented, even though the spleen is injured, the hair luster and pulse do not decline. However, vomiting blood and excessive sweating are strictly contraindicated. Many physicians have rashly administered medication for this condition. I wish to elucidate this principle through this case. (Commentary by Fan A)
The Grand Master of Qi suffered from dental caries. I (Chunyu Yi) moxibusted his left Yangming meridian and prescribed Kushen Decoction (Sophora Flavescens Decoction), instructing him to rinse his mouth three times daily with three sheng (approx. 600ml). After five to six days, the disease was cured. The etiology was exposure to wind while sleeping with an open mouth, and eating without rinsing afterwards.
Rinsing the mouth after meals is a secret method for preserving teeth. Moreover, when wind invades during sleep, if one chews upon waking, the wind pathogen gathers and does not disperse, causing the teeth to become diseased first, eventually leading to decay and loss. Kushen Zi (Sophora Seed) has astringent properties; using it for mouth rinsing resolves wind pathogens and strengthens teeth. This is one of the secret prescriptions for dentistry.
The favorite concubine of the King of Chuan was pregnant but failed to lactate. She summoned me (Chunyu Yi), and I went to treat her. I administered a pinch of Langdang medicine (Datura seed preparation) dissolved in wine, and lactation resumed shortly thereafter. Upon re-examining her pulse, I found it rapid and restless (Zao), indicating residual pathogenic factors. I then administered Xiaoshi (Natrii Sulfas / Mirabilite and Gypsum). After one dose, she passed blood in the stool, resembling bean-sized clots, about five or six pieces. (Langdang is currently unavailable for purchase; Chuanjia [Squama Manis] may be used as a substitute.)
Internal dryness of the intestines and stomach, coupled with stagnant Qi and Blood, resulted in the absence of milk. Administering Xiaoshi reduces heat and moistens dryness, dispelling stasis and generating new blood. Physicians often treat the symptoms rather than the root cause. For example, treating agalactia merely involves promoting lactation, ignoring other underlying conditions. If treatment leads to hemorrhage, the patient's family will severely blame the physician. Consequently, physicians tend to use conservative formulas, leaving chronic diseases incurable. This reflects the state of medical practice in China. (Commentary by Fan A)
A servant of the Chancellor of Qi fell ill due to frequent sweating. He was exposed to fire-induced sweating and then encountered strong wind, appearing as if struck by wind pathogen. His complexion was yellowish, representing Earth Qi (the color of the Spleen), where Earth fails to overcome Wood (Liver Wood overacting on Spleen Earth). It was predicted that by spring, he would suffer from obstruction and inability to eat or drink, and according to the pattern, he would die from hematochezia in summer. The majority of physicians diagnosed him with intestinal parasites, failing to recognize that his Spleen Qi was injured.
If a physician cannot observe the complexion, they cannot differentiate the syndrome and cannot even determine life or death. Incorrect treatment would inevitably exacerbate the condition. If, like the other physicians, they had diagnosed intestinal parasites, they undoubtedly would have administered purgatives or vermifuges, which would certainly injure the Spleen. Otherwise, how could wind exposure at the skin pores injure the Spleen Qi? Furthermore, injuring the Spleen is different from injuring the Lungs or Liver; moreover, since the patient could still eat, the treatment would be relatively easy. If one knows the disease but lacks the correct formula, what value is there in being a famous physician? Not only was the servant unfortunate, but all patients at that time were also unfortunate. (Commentary by Fan A)