大宗伯董浔老,年六十七,有脾胃疾,翁以过啖瓜果而胸膈胀痛,时当处暑也。延予治。诊其脉,寸关弦
紧,观其色,神
藏气固。翁门下蒋虹桥、沈乐闲者,多艺人也,翁素亲信二公,诘余曰∶症脉何如?予曰∶
症脉虽胸腹胀痛,然易瘳也。二公曰∶翁生平不能素食,食辍泻。今不茹荤者半月,燕居好
弈,好看书,好作诗文,即盛暑亦手一编不言倦,日永亦不瞌,今不亲笔砚者月余,不栉沐
者
七日,它一切无所事事,倦极矣。诸名家如沈竹亭、沈春宇、金樗丘者,剂备尝之无益也。
而公何言易?予曰∶诸公不过用二陈平胃,加山楂、麦芽等消导剂耳,与症何涉。盖翁伤于
瓜果,而为寒湿淫胜。经云∶寒淫所胜,治以辛温。然瓜果非麝香、肉桂
不能消,此诸公所以不能愈翁疾也。予以高良姜、香附各一两为君,肉桂五钱为臣,麝香一
钱为佐,每服二钱,酒调下之。药入腹,胸次便宽,再而知饿,三服而巾栉,交接宾客如
未病者。翁语沈、蒋曰∶孙君所见所养,度越诸人若是。往闻治张氏子,气绝两日而能活之
,今于活吾病益信,诚临淄虢国之遗,特书一轴以彰其高,因以纪一时之良遇云。
大宗伯郎君董龙山公夫人,为宪副茅鹿门公女,年三十五而病便血,日二三下,腹不疼
,诸医延医者三年不效。予诊之,左脉沉涩,右脉漏出关外,诊不应病。予窃谓,血既久下
,且当益其气而升提之,以探其症。乃用补中益气汤,加阿胶、地榆、侧柏叶,服八剂,血
不下者半月。彼自喜病愈矣。偶因劳而血复下,因索前药。予语龙山公曰∶夫人之病,必
有瘀血积于经隧,前药因右脉漏关难凭,故以升提兼补兼涩者,以探虚实耳。今得病情,法
当下而除其根也。龙山公曰∶三年间便血,虽一日二三下,而月汛之期不爽,每行且五日,如此尚
有瘀血停蓄耶?
予曰∶此予因其日下月至而知其必有瘀血停蓄也。
经云∶不塞不流,不行不止。今之瘀,实由塞之行也,不可再涩。古人治
痢,必先下之,亦此意也。公曰∶明日试卜之。予曰∶卜以决疑,不疑何卜?公随以语夫人
,
夫人曰∶孙先生非误人者,识见往往出寻常,宜惟命。盖夫人读书能文,聪明谋断,不啻丈
夫,故言下便能了悟。即用桃仁承气汤,加丹参、五灵脂、荷叶蒂,水煎,夜服之,五更下
黑瘀血半桶,其日血竟不来,复令人索下药。予曰∶姑以理脾药养之,病根已动,俟五
日而再下未晚也。至期复用下剂,又下黑血如前者半,继用补中益气汤、参苓白术散,调理
痊愈。
Grand Secretary Dong Xunyang, aged sixty-seven, suffered from a spleen and stomach disorder. Due to excessive consumption of fruits and melons, he experienced distension and pain in the chest and diaphragm; this occurred during the Chushu (End of Heat) solar term. He invited me for treatment. Upon palpating his pulse, the Cun (inch) and Guan (bar) positions were wiry and tight. Observing his complexion, his Shen (Spirit) was contained, and his Yuan Qi (Original Qi) was solid. Two of his disciples, Jiang Hongqiao and Shen Lexian, were men of many talents whom he trusted and favored. They asked me, "What are the symptoms and pulse like?" I replied, "Although the symptoms involve chest and abdominal distension and pain, it is easy to cure." The two gentlemen said, "My master has never been able to eat a vegetarian diet; if he stops eating meat, he suffers diarrhea. For half a month now, he has abstained from meat. In his leisure, he enjoys playing chess, reading books, and composing poetry and prose. Even in the height of summer, he holds a book without tiring, and long days do not make him drowsy. For over a month, he has not touched pen and ink, and for seven days, he has not combed his hair or bathed. He does nothing else and is extremely fatigued. Renowned physicians such as Shen Zhuting, Shen Chunyu, and Jin Chuqiu have tried various prescriptions with no effect. Why do you say it is easy to cure?" I said, "Those doctors merely used Er Chen Tang (Two-Aged Decoction) and Ping Wei San (Calm the Stomach Powder), adding Hawthorn Fruit and Malt as digestive aids. This has little relevance to the actual condition. The master's injury stems from fruits and melons, leading to an excess of Cold-Dampness. The Classic states: 'When Cold is in excess, treat with Pungent-Warm herbs.' However, fruits and melons cannot be digested without Moschus (Musk) and Cinnamon Twig. This is why those doctors could not cure my master." I prescribed Galangal Rhizome and Cyperus Rhizome, each one liang, as the Sovereign herb; Cinnamon Twig, five qian, as the Minister herb; and Moschus, one qian, as the Assistant herb. Each dose was two qian, taken with wine mixed in. After taking the medicine, his chest felt immediately relieved. By the second day, he felt hungry. After three doses, he combed his hair and received guests as if he had never been ill. The master told Shen and Jiang, "Dr. Sun's insight and nurturing methods surpass others so greatly. I once heard he revived Zhang's son who had been clinically dead for two days. Now, seeing him cure my illness, I truly believe this is the legacy of Bian Que, the divine physician of Guo State. I have written a scroll to honor his high medical skill, recording this fortunate encounter."
The wife of Dong Longshan, Grand Secretary's son, was the daughter of Vice Commissioner Mao Lumen. At thirty-five, she suffered from hematochezia (blood in stool), passing blood two or three times daily, without abdominal pain. Various physicians treated her for three years without success. I palpated her pulse: the Left pulse was deep and choppy, and the Right pulse leaked beyond the Guan position, appearing inconsistent with the disease. I secretly reasoned that since bleeding had persisted for a long time, I should tonify Qi and lift Yang to probe the nature of the syndrome. Thus, I used Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), added Donkey-Hide Gelatin, Sanguisorba Root, and Biota Leaf, and administered eight doses. The bleeding stopped for half a month. She rejoiced, believing herself cured. Accidentally, due to exertion, the bleeding recurred, and she requested the previous prescription. I told Mr. Longshan, "Madam's illness must involve stagnant Blood accumulated in the meridians. Previously, because the Right pulse leaking beyond the Guan made diagnosis difficult, I used lifting, tonifying, and astringing methods to probe the deficiency and excess. Now that I understand the pathology, the method requires purging to remove the root cause." Mr. Longshan said, "For three years she has had bloody stools, though only two or three times a day, her menstrual cycle has been regular, lasting five days each time. How can there still be stagnant Blood?" I said, "I deduced the presence of stagnant Blood based on her daily bleeding until the end of the month. The Classic states: 'If blocked, flow ceases; if not flowing, it will not stop.' The current stasis is indeed caused by blockage preventing flow; we must not use further astringents. Ancient practitioners treating dysentery would first purge, which reflects this same principle." Mr. Longshan said, "Let us consult divination tomorrow." I said, "Divination resolves doubt; if there is no doubt, why divinate?" Mr. Longshan conveyed this to Madam. She said, "Mr. Sun is not one who harms people; his insights often exceed the ordinary. We should obey his command." Since Madam was literate, intelligent, and decisive, comparable to her husband, she understood immediately upon hearing this. I immediately prescribed Tao Ren Cheng Qi Tang (Peach Kernel Draining the Yin Decoction), added Salvia Root, Trogopterus Dung, and Lotus Seed Pod Peduncle, decocted in water, and administered at night. At dawn (Wugeng), she passed half a bucket of black, stagnant Blood. On that day, no more blood appeared, and she requested further purgatives. I said, "Temporarily use spleen-regulating herbs to nourish the body. The root of the disease has been stirred; it is not too late to purge again after five days." When the time came, another purgative was used, resulting in half the amount of black blood as before. Subsequently, Bu Zhong Yi Qi Tang and Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) were used for regulation, leading to a complete recovery.