吴球治一人。暑月远行。渴饮泉水。至晚以单席阴地上睡。顷间。寒热。吐泻不得。身
痛如刀刮。医曰。此中暑也。进黄连香薷饮及六和汤。随服随厥。吴诊其脉细紧而伏。曰。
此中寒也。众皆笑曰。六月中寒。有是事乎。吴曰。人肥白。素畏热。好服黄连及益元散等
凉剂。况途中饮水既多。又单席卧地。寒邪深入。当以附子理中汤。大服乃济。用之果效。
震按中寒一门。喻嘉言论之最精。然此证易辨。无甚诡幻。惟内寒外热格阳戴阳者。不
可认错。此又当于伤寒门细研之。盖中寒与伤寒不同也。类案载一木商。久立风雨湿地。衣
服尽濡。患寒热交作。遍身胀痛。欲人击打。莫知为何病。服药罔效。忽思烧酒。热饮数杯
觉快。数饮至醉而愈。可见中寒之易治矣。又载吴御医治富翁中寒。用生附子三枚。重三
两。作一剂。他医减半进之。病遂已。吴复诊。已知之。曰。何减吾成药也。吾投三枚。将
使活三年。今止活年半耳。后年余。复发而卒。此等邪说。殊不可信。夫药以治病。中病即
止。太过则变生他病矣。是人服附子枚半。病已愈。则不宜多至三枚也。若必须三枚。则枚
半未能愈其病也。乃云吾投三枚。使活三年。是以之延年。非以之治病。何不投三十枚。俾
活三十年乎。
Wu Qiu treated a patient. During the hot summer months, he traveled a long distance and, thirsty, drank spring water. In the evening, he slept alone on a thin mat placed on the cool ground. After a short while, he developed alternating chills and fever, intractable vomiting and diarrhea, and body pain as if scraped by knives. The physician diagnosed this as heatstroke (Zhongshu) and administered Huanglian Xiangru Yin (Coptis and Elsholtzia Decoction) and Liuhe Tang (Six-Harmony Decoction). Following administration, the patient immediately developed limb coldness (Jue). Wu Qiu palpated the pulse, finding it fine, tight, and deep-hidden, and stated, "This is cold-stroke (Zhonghan)." Everyone laughed and said, "Can cold-stroke occur in the sixth lunar month?" Wu Qiu replied, "This person has a fat and fair complexion, is naturally afraid of heat, and likes to take cooling agents such as Huanglian (Coptidis Rhizoma) and Yiyuan San (Benefit-Primordial Powder). Moreover, having drunk much water during the journey and lying alone on the ground, pathogenic cold has penetrated deeply. One should use Fuzi Lizhong Tang (Aconite Decoction for Regulating the Middle) and administer it in large doses to achieve relief." The treatment proved effective.
Yu Zhen commented: Regarding the category of cold-stroke, Yu Jiayan's discussion is most refined. However, this syndrome is easy to differentiate and lacks obscurity. Only cases of internal cold with external heat, floating yang (Ge Yang), or floating face (Dai Yang) must not be misdiagnosed. These require careful study within the category of cold damage (Shanghan), as cold-stroke differs from cold damage. *Lei An* records a case of a timber merchant who stood for a long time in wind, rain, and damp places, with his clothes completely soaked. He suffered from alternating chills and fever, generalized distending pain, and an urge to have people strike him. He did not know what disease he had, and medications were ineffective. Suddenly craving distilled liquor, he drank several cups hot and felt relieved. After drinking repeatedly until intoxicated, he recovered. This shows that cold-stroke is easy to treat. Another record describes Physician Wu Yuzhi treating a wealthy man with cold-stroke using three raw Fuzi (Aconiti Lateralis Radix Preparata), weighing three taels, as a single dose. Other physicians halved the dose, and the illness resolved. Upon re-examination, Wu Qiu already knew of this and said, "Why did you reduce my prescribed dosage? I would have administered three pieces to make him live for three years. Now he lives only half a year." More than a year later, the disease recurred, and he died. Such talk is heretical and highly unreliable. Medicines are used to cure diseases; once the disease is addressed, administration should stop. Excessiveness leads to other illnesses. If this person took one and a half pieces of Fuzi and the disease was cured, there was no need to increase to three pieces. If three pieces were necessary, then one and a half pieces would not have cured the disease. To say "I administered three pieces to make him live three years" implies using them for longevity, not for curing disease. Why not administer thirty pieces to make him live thirty years?