一妇年逾七十。腰生一 。作痒异常。疑虫虱所毒。诊脉浮数。齐氏曰。脉浮数反恶寒
疮也。翌日复诊。脉乃弱。予谓未溃而脉先弱。何以收敛。况大便不通。则真气已竭。治之
无功。固请不得已。用六君子(二)加藿香神曲。饮食渐进。大便始通。更用峻补之剂。溃而
脓清作渴。再用参、 、归、 、麦门、五味而渴止。喜曰可无虞矣。予曰不然。不能收敛
。先入之言也。彼疑更医。果殁。
一人年十九。腰间肿一块。无头不痛。色不变。三月不溃。饮食少思。肌肉日瘦。此气
理。荣气不行。郁而为肿。名曰湿毒流注。元戎曰。若人饮食疏。精神衰。气血弱。肌肉消
瘦。荣卫之气。短促而涩滞。故寒抟腠理。闭郁为痈者。当补以接虚怯之气。遂以十全大补
汤(十三)加香附、陈皮三十余剂。始针出白脓一碗许。仍用药倍加参、 。仍灸以豆豉饼渐
愈。彼乃惑于速效。内服败毒。外贴凉药。反致食少脓稀。患处色紫。复请予治。喜得精气
未衰。仍以前药加远志、贝母、白蔹百剂而愈。此或久而不愈。或脓水清稀。当服内塞散(
五二)及附子饼灸。然后可愈。
一妇年逾二十腰间突肿寸许。肉色不变。微痛不溃。发热脉大。此七情所损。气血凝滞
而然。当益气血。开郁结。更以香附饼熨之。使气血充畅。内自消散。若尔。虽溃亦无危。
不听。乃服十宣流气之药。气血愈虚。溃出清脓。不敛而死。按此脉大。非七情脉也。当时
必有所见。
一妇产后腰间肿。两腿尤甚。此瘀血滞于经络而然。不早治。必作痈。遂与桃仁汤二剂
。更没药丸(五六)数服而痊。亦有恶血未尽。脐腹刺痛。或流注四肢。或注股内。痛如锥刺
。或两股肿痛。此由冷热不调。或思虑动作。气乃壅遏。血蓄经络而然。宜没药丸(五二)治
之。亦有或因水湿所触。经水不行而肿痛者宜当归丸(五七)治之。
凡恶血停滞。为患匪轻。治之稍缓。则为流注。为骨疽。多致不救。
一老人患痢。骤用涩药。致大肠经分作痛。此湿毒流于经隧而然。以四物加桃仁、酒芩
、红花、升麻、枳壳、陈皮、甘草治之渐愈。因年高胃弱竟殁。
一人年二十。遍身微痛。腰间作肿痛甚。以补中益气汤(十六)加羌活四剂少可。又去羌
活十余剂而愈。
此条以虚治。当时于形色脉上必有所见。
一人逾四十。患腰痛。服流气饮寄生汤不应。以热手熨之少可。其脉沉弦。肾虚所致。
肾丸(四六)而愈。此因脉沉弦。且据服攻剂不应。故知虚也。弦则不软。如物无水不柔软之
A woman over seventy years old developed a carbuncle on her waist, suffering from extreme itching. It was suspected to be poisoned by insects or lice. The pulse was floating and rapid. Qi Shi said, "A floating and rapid pulse with aversion to cold indicates a Yin-type sore." On the second day, upon re-examination, the pulse had become weak. I said to him, "If the pulse becomes weak before the sore has ulcerated, how can one expect it to heal? Moreover, constipation indicates that the True Qi is exhausted; treatment will be ineffective." The family insisted on treatment, so out of reluctance, I prescribed Liu Jun Zi Tang (Six Gentlemen Decoction) with Huo Xiang (Patchouli Herb) and Shen Qu (Medicated Leaven). Her diet gradually improved, and her bowels began to move. Subsequently, strong tonifying agents were used. After ulceration, the pus was clear, and she felt thirsty. Shen (Ginseng), Huang Qi (Astragalus Root), Dang Gui (Angelica Sinensis), Bai Zhu (Atractylodes Rhizome), Mai Men Dong (Ophiopogon Tuber), and Wu Wei Zi (Schisandra Fruit) were added, and the thirst ceased. She rejoiced, saying there was no danger. I replied, "Not so. The wound cannot granulate; my previous assessment was incorrect." They doubted further medical advice, and she indeed died.
A nineteen-year-old man had a swelling on his waist without a head or pain, with unchanged skin color, which did not ulcerate for three months. His appetite decreased, and he wasted away daily. This was due to Qi deficiency and impaired Ying Qi circulation, leading to stagnation and swelling, named Shidu Liuzhu (Damp-Toxic Flowing Deposit). Yuan Rong stated, "If a person has poor diet, depleted spirit, weak Qi and Blood, and emaciated muscles, their Ying and Wei Qi are short and stagnant. Thus, Cold condenses in the Cou Li (pores/skin-muscle intervals), causing closure and stagnation into an abscess. One should tonify to support deficient Qi." Therefore, Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) with Xiang Fu (Cyperus Rhizome) and Chen Pi (Tangerine Peel) was administered for over thirty doses. Only then was about a bowl of white pus drained via needling. The medication was continued with doubled amounts of Ren Shen (Ginseng) and Huang Qi (Astragalus Root). Dou Chi Bing Jiu (Fermented Soybean Cake Moxibustion) was also applied, leading to gradual recovery. Confused by the desire for quick results, he took internal detoxifying herbs and applied cooling external plasters, which worsened his condition, causing poor appetite, thin pus, and purple discoloration at the site. He requested my treatment again. Fortunately, his Jing Qi (Essence-Qi) was not yet exhausted. I used the previous formula with Yuan Zhi (Polygala Root), Bei Mu (Fritillaria Bulb), and Bai Lian (Bletilla Rhizome) for a hundred doses, resulting in a cure. In cases where ulcers fail to heal for a long time or have thin pus, Ne Sai San (Internal Plugging Powder) and Fu Zi Bing Jiu (Aconite Cake Moxibustion) should be used for recovery.
A woman over twenty years old had a sudden inch-high swelling on her waist, with unchanged skin color, slight pain, no ulceration, fever, and a large pulse. This was caused by emotional injury leading to Qi and Blood stagnation. Treatment should tonify Qi and Blood, resolve stagnation, and apply Xiang Fu Bing (Cyperus Cake) moxibustion to promote smooth Qi and Blood flow, allowing internal resolution. Even if it ulcerated, there would be no danger. She refused, taking Shi Xuan Liu Qi drugs (Ten Manifestations Qi-Flowing Medicines), which further depleted her Qi and Blood. She ulcerated with clear pus, failed to granulate, and died. A large pulse is not typical of emotional disorders; there must have been other visible signs at the time.
A postpartum woman had swelling on her waist, worse in both legs. This was due to Stasis Blood blocking the meridians. If not treated early, it would become an abscess. Tao Ren Tang (Peach Kernel Decoction) was given for two doses, followed by several doses of Mo Yao Wan (Myrrh Pill), leading to recovery. There are also cases where lochia remains incomplete, causing stabbing pain in the umbilical/abdominal region, or flowing to the limbs, or accumulating in the inner thighs, with pain like needle pricks, or swelling and pain in both thighs. This results from imbalance of Cold and Heat, excessive worry, or physical exertion, causing Qi obstruction and Blood accumulation in the meridians. Mo Yao Wan (Myrrh Pill) is suitable. In cases triggered by water-dampness invasion with amenorrhea and swelling/pain, Dang Gui Wan (Angelica Pill) is appropriate.
Stagnant Stasis Blood causes significant harm; delayed treatment leads to Liuzhu (Flowing Deposits) or Gu Ju (Bone Carbuncles), often resulting in untreatable conditions.
An elderly man suffered from dysentery. Sudden use of astringent drugs caused pain in the Large Intestine meridian distribution. This was due to Damp-Toxin flowing into the meridians. Si Wu Tang (Four Substance Decoction) with Tao Ren (Peach Kernel), Jiu Huang Qin (Wine-processed Scutellaria Root), Hong Hua (Safflower), Sheng Ma (Cimicifuga Rhizome), Zhi Ke (Aurantium Fruit), Chen Pi (Tangerine Peel), and Gan Cao (Licorice Root) was used, leading to gradual improvement. However, due to advanced age and weak stomach, he eventually died.
A twenty-year-old man had mild body pain and severe swelling/pain in the waist. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with Qiang Huo (Notopterygium Rhizome) for four doses provided slight relief. Removing Qiang Huo and continuing for over ten doses resulted in a cure. This case was treated as deficiency; there must have been specific indications in complexion, form, and pulse at the time.
A man over forty suffered from lower back pain. Liu Qi Yin Ji Sheng Tang (Qi-Flowing Drink with Loranthus Decoction) was ineffective. Hot hand rubbing provided slight relief. His pulse was deep and wiry, indicating Kidney Deficiency. Shen Wan (Kidney Pill) cured him. The deep-wiry pulse and ineffectiveness of attacking formulas indicated deficiency. A wiry pulse lacks softness, just as objects lack softness without water.