丹溪治一少年。暑月。因大劳而渴。恣饮梅浆。又连大惊。妄言妄见。病似邪鬼。脉虚
弦而带沉数。数为有热。虚弦是惊。又梅浆停郁中脘。宜补虚清热。导去淡滞乃可。遂与参
术、陈皮、茯苓、芩、连。并入竹沥、姜汁。旬日未效。乃虚未回。痰未导也。以前药入
荆沥。又旬日而安。
又治浦江郑姓者。年二十余。秋间大发热。口渴。妄言妄见。病似邪鬼。七八日后。请
朱治之。脉之。两手洪数而实。视其形肥。面赤带白。却喜露筋。脉本不实。凉药所致。此
因劳倦成病。与温补药自安。曰。柴胡七八帖矣。以黄 附子汤冷与之。饮三帖后。困倦鼾
睡。微汗而解。脉亦稍软。继以黄 白术汤。至十日。脉渐收敛而小。又与半月而安。
虞恒德治一妇。年近三十。有姿色。得一证。如醉如痴。颊赤面青。略有潮热。饮食不
美。其脉乍疏乍数而虚。每夜见白衣少年与睡。一医与八物汤。服数十帖不效。虞见其家有
白狗。卧枕户阈。虞曰。必此所为。命杀狗取其心血及胆汁。丸安神定志之药。以八物汤舌
下。丸药用远志、石菖蒲、川归、黄连、茯神、朱砂、侧柏叶、草龙胆等药。
震按此三条甚奇。却难效法。首条若在今日。惟有清热导痰耳。敢用人参耶。丹溪则以
脉之虚弦。因之大劳。认得清。故虽旬日未效。仍守前药。设有游移。则前功尽弃。病不痊
而谤随之矣。次条脉证。俱似实热。乃云脉本不实。凉药所致。苟非具大本领者。谁敢道此
然用 、附、术。而不用人参。想其审证处。必另有会心也。第三条诚系邪魅。然以白衣
疑及白狗。近于诡幻。倘仍不效。能无雉罹于罗之叹。汇而录之。以备考订。
张路玉治文学黄稚洁。谵妄颠仆。数月以来。或六七日一发。或二三日一发。或一日二
三发。发则大吐涎水血沫。或一日半日而苏。或二三时而苏。医祷不灵。近于邪祟。术士皆
言宿孽所致。昼夜恒见亡婢仆妇二鬼缠绵。或时昏愦不省。或时妄言妄见。精气不时下脱。
不能收摄。服二冬、二地、连、柏、金樱、石莲之属无算。反加作泻不食。后延张诊之。脉
来寸盛尺微。前大后小。按之忽无。举之忽有。知为神气浮散之候。因与六君子加龙齿、菖
蒲、远志。送养正丹。间续而进。前后共三七服。是后谵妄颠仆。绝不复发。邪祟亦不复见
惟梦泄为平时痼疾。不能霍然。更与平补镇心丹。两月而安。其尊人及昆弟亲戚。咸谓金
石之药。能镇鬼神。曷知从前谵妄。皆神气浮散之故。得养正镇摄之功。当无神魂飞越之患
矣。因识此以破杯影弓蛇之惑。
震按鬼祟岂能病患。不过病似鬼祟耳。或痰或虚。从其脉象以施治法。诸案皆先资之助
也。
Zhu Danxi treated a young man. It was the summer season, and due to excessive labor, he felt thirsty and drank plum syrup indiscriminately. He then suffered repeated frights, resulting in delirious speech and visual hallucinations; his condition resembled possession by evil spirits. His pulse was deficient, wiry, and carried a deep, rapid quality. A rapid pulse indicates heat; a deficient and wiry pulse indicates fright. Additionally, the plum syrup had stagnated and obstructed the middle jiao (middle burner). The treatment should have been to tonify deficiency, clear heat, and guide out phlegm-dampness stagnation. Therefore, he was prescribed Ginseng Radix et Rhizoma (Renshen), Atractylodis Macrocephalae Rhizoma (Baizhu), Citri Reticulatae Pericarpium (Chenpi), Poria (Fuling), Scutellariae Radix (Huangqin), and Coptidis Rhizoma (Huanglian), combined with Bamboo Sap (Zhuli) and Ginger Juice (Jiangzhi). After ten days, there was no improvement. This was because the deficiency had not yet recovered, and the phlegm had not yet been guided out. Jingshe (Arisaema Cum Bile) was added to the previous prescription. After another ten days, the patient stabilized.
He also treated a Mr. Zheng from Pujiang. In his early twenties, during autumn, he suffered sudden high fever, thirst, delirious speech, and visual hallucinations; his condition seemed like evil spirit affliction. Seven or eight days later, Zhu Danxi was invited to treat him. Palpating the pulse, both hands showed a surging, rapid, and full/excess quality. Observing his physique, he was fat, with a red face showing white patches, yet he liked to expose his veins (indicating thin subcutaneous tissue or prominent vessels); the pulse was actually not truly excess, but caused by the administration of cooling medicines. This illness resulted from fatigue and overwork; administering warming and tonifying medicines would naturally bring peace. At that time, he had already taken seven or eight doses of Bupleuri Radix (Chaihu) decoction. Instead, Fuzi Decoction (Fuzi Tang) was given cold. After drinking three doses, he felt drowsy, slept with snoring, and resolved with slight sweating. The pulse became slightly softer. Subsequently, Astragali Radix et Atractylodis Macrocephalae Rhizoma Decoction (Huangqi Baizhu Tang) was administered. By the tenth day, the pulse gradually converged and became smaller. After another half month of medication, he recovered.
Yu Hengde treated a woman near thirty years old, who was attractive. She suffered from a condition where she appeared intoxicated and foolish, with reddish cheeks and bluish complexion, slight tidal fever, and poor appetite. Her pulse was intermittently sparse and rapid, yet deficient. Every night, she dreamed of sleeping with a youth in white clothes. One physician prescribed Eight-Ingredient Decoction (Bawu Tang), but after dozens of doses, there was no effect. Yu Hengde noticed a white dog lying on the threshold at her home. Yu said, "This must be caused by this animal." He ordered the dog to be killed, and its heart blood and bile were collected to make pills for calming the mind and stabilizing the will, administered with Bawu Tang. The pills contained Polygalae Radix (Yuanzhi), Acori Tatarinowii Rhizoma (Shichangpu), Angelicae Sinensis Radix (Chuan Gui), Coptidis Rhizoma (Huanglian), Poria (Fushen), Cinnabaris (Zhusha), Platycladi Cacumen (Cebaiye), and Gentianae Macrophytae Radix (Caolongdan).
Commentary by Yu Zhen: These three cases are very strange and difficult to emulate. If the first case were treated today, one would only use methods to clear heat and resolve phlegm; how could one dare to use Ginseng? Danxi, recognizing the deficient and wiry pulse in the context of great labor, had a clear understanding. Thus, even though there was no effect after ten days, he stuck to the original prescription. Had he hesitated, all previous efforts would have been wasted, the disease would not have cured, and slander would have followed. The second case's pulse and symptoms both resembled excess heat, yet he stated the pulse was originally not excess, caused by cooling medicines. Only someone with great skill would dare to say this. Although Huangqi, Fuzi, and Baizhu were used, without Renshen, it is likely he had a specific insight into the syndrome differentiation. The third case indeed seems like demonic influence, but suspecting a white dog based on the "white-clad" dream is somewhat fanciful. If it still failed, one might sigh about being trapped like a pheasant in a net. These cases are compiled for reference and verification.
Zhang Luyu treated a scholar, Huang Zhijie. He suffered from delirious madness and falling/collapsing episodes for several months. Episodes occurred every six to seven days, or two to three days, or twice or three times a day. During attacks, he vomited large amounts of saliva and bloody foam, recovering consciousness after half a day, a day and a half, or two to three shichen (hours). Medical prayers were ineffective, resembling evil spirit affliction. Fortune tellers claimed it was due to past-life sins, stating he saw ghosts of deceased maidservants and female servants day and night entangling him. Sometimes he was confused and unconscious, sometimes delirious and hallucinating. Essence and qi leaked out uncontrollably. He took countless doses of Asparagi Radix (Donggu), Ophiopogonis Radix (Dongshen), Rehmanniae Radix Preparata (Dishu), Scutellariae Radix (Huangqin), Phellodendri Cortex (Huangbai), Cornus Officinalis Fructus (Jinyingzi), and Nelumbinis Semen (Shilian), which worsened diarrhea and loss of appetite. Later, Zhang Luyu was consulted. The pulse was strong at the Cun (inch) position and weak at the Chi (cubit) position, large anteriorly and small posteriorly; pressing deeply made it vanish, while light pressure made it appear. This indicated floating and scattering of Shen (Spirit). He prescribed Six-Ingredient Pill with Ginseng (Liujunzi San) plus Long Gu (Dragon Bone), Shichangpu, and Yuanzhi, delivered with Yangzheng Dan (Nourishing Righteousness Pill). Taken intermittently, totaling twenty-one doses, the delirium and collapsing stopped completely, and the ghost visions disappeared. Only nocturnal emission remained as a chronic ailment, not fully cured. Pingbu Zhenxin Dan (Calming and Tonifying Heart Pill) was then given, and he stabilized after two months. His father, brothers, and relatives believed mineral drugs could suppress ghosts, unaware that the prior delirium was due to floating Shen. With the function of nourishing righteousness and suppressing floating, there was no danger of Shen flying away. This record is written to dispel illusions like the bow reflected in a cup.
Commentary by Yu Zhen: How can ghosts cause illness? The condition merely resembles ghost affliction. It is either phlegm or deficiency; treatment is applied according to the pulse image. These cases serve as references.