仆子孙安,空晨出门,途次食面三碗,饥劳感疫,因内伤,表里皆热。及至绩溪衙中,
昏闷
谵语,头痛,身疼,腹痛。医不察为劳倦感疫,遽以遇仙丹下之,大便泄三四十行,邪因陷
下
,而为挟热下利之候。急归视之。舌沉香色,额痛,口干燥渴,烦闷,昏昏愦愦。脉左弦数
,右洪数,但不克指,知为误下坏症。以柴胡、石膏各三钱,白芍药、黄芩、竹茹、葛根各
一钱,天花粉、甘草各五分,山栀子、枳实各七分,葱白五茎,水煎服之。后半夜吐蛔一条
,乃稍得睡。次早大便犹泻二次,呕吐酸水,腹乃痛。改用小柴胡加滑石、竹茹。夜热甚,
与丝瓜汁一碗,饮既神顿清爽。少顷药力过时,烦热如前,再以丝瓜汁一大碗进之,即大发
战。予谓此战非寒战,乃作汗之征耳。不移时,汗果出而热犹然。忆《活人书》云∶再三
汗
下,热不退,以人参白虎汤加苍术一钱如神。迹此,再加玄参、升麻、柴胡、白芍药、黄连
饮后,身上之斑,先发者紫,后发者红。中夜后乃得睡而热散,斑寻退去。腹中微疼,肠鸣
口渴,右脉尚滑,左脉已和,再与竹叶石膏汤加白芍药、苍术,服后睡安,腹仍微痛。用柴
胡、芍药各一钱,人参、酒芩、陈皮、半夏各六分,甘草三分,乌梅一枚,服此腹痛渐减,
精神 长矣。惟两跨痛不能转动,此大病后汗多而筋失养之故,宜当补益。人参、黄
、白芍药、桑寄生、枸杞子、薏苡仁、桂心、牛膝、熟地黄,水煎服。后加木瓜、黄柏、当
归,减去桂心,调养而痊。
My son, Sun An, went out early in the morning and ate three bowls of noodles on the way. Due to hunger and fatigue, he contracted an epidemic pathogen, resulting in internal injury with heat in both the interior and exterior. Upon arriving at the Jixi government office, he became drowsy and confused, delirious, suffering from headache, body ache, and abdominal pain. The physician failed to recognize this as a condition caused by fatigue and epidemic infection, and hastily administered Yuxian Dan (Encounter Immortal Pill) to purge the bowels. This resulted in thirty to forty episodes of diarrhea, causing the pathogenic factor to sink downward, manifesting as dysentery with heat. I hurried back to examine him. His tongue coating was dark yellowish-brown like sandalwood; he suffered from forehead pain, dry mouth with intense thirst, irritability, and mental confusion. The pulse was wiry and rapid on the left, and large and rapid on the right, but weak upon pressure. I diagnosed this as a complication arising from erroneous purgation. I prescribed Chai Hu (Bupleuri Radix) and Shí Gāo (Gypsum Fibrosum), each 3 qian, Bái Sháo Yào (Paeoniae Radix Alba), Huáng Qín (Scutellariae Radix), Zhú Rú (Bambusae Caulis in Taeniam), and Gé Gēn (Puerariae Lobatae Radix), each 1 qian, Tiān Huā Fěn (Trichosanthis Radix), and Gān Cǎo (Glycyrrhizae Radix et Rhizoma), each 5 fen, Shān Zhī Zi (Gardeniae Fructus) and Zhǐ Shí (Aurantii Fructus Immaturus), each 7 fen, along with five stalks of Cōng Bái (Allii Fistulosi Bulbus), decocted in water for oral administration. In the middle of the night, he vomited one roundworm and then managed to sleep slightly. Early the next morning, he still had two bowel movements, vomited sour fluid, and experienced abdominal pain. I changed the prescription to Xiǎo Chái Hú Tāng (Minor Bupleurum Decoction) with added Huá Shí (Talcum) and Zhú Rú (Bambusae Caulis in Taeniam). Night fever was severe, so I gave him one bowl of Sī Guā Zhī (Luffa Fruit Juice); after drinking it, his spirit refreshed instantly. Shortly after, when the medicinal effect waned, the irritability and heat returned as before. I administered another large bowl of Luffa Fruit Juice, which immediately triggered a violent shivering fit. I stated that this shivering was not due to cold, but rather a sign of impending sweating. Indeed, within no time, sweat appeared, yet the heat persisted. Recalling the statement in *Huo Ren Shu* (Book of Vitality): "If heat persists after repeated sweating and purging, use Rén Shēn Bái Hǔ Tāng (Ginseng White Tiger Decoction) with 1 qian of Cāng Zhú (Atractylodis Rhizoma) for miraculous effect." Based on this, I added Xuán Shēn (Scrophulariae Radix), Shēng Má (Cimicifugae Rhizoma), Chái Hú (Bupleuri Radix), Bái Sháo Yào (Paeoniae Radix Alba), and Huáng Lián (Coptidis Rhizoma). After ingestion, the macules appearing on his body were purple where they first emerged and red where they appeared later. He finally slept after midnight, the heat dissipated, and the macules faded shortly thereafter. There was slight abdominal pain, borborygmus, and thirst. The right pulse remained slippery, while the left pulse had harmonized. I prescribed Zhú Yè Shí Gāo Tāng (Bamboo Leaf and Gypsum Decoction) with added Bái Sháo Yào (Paeoniae Radix Alba) and Cāng Zhú (Atractylodis Rhizoma). After taking it, he slept peacefully, though slight abdominal pain persisted. I then used Chái Hú (Bupleuri Radix) and Sháo Yào (Paeoniae Radix), each 1 qian; Rén Shēn (Ginseng Radix et Rhizoma), Jiǔ Huáng Qín (Scutellariae Radix processed with wine), Chén Pí (Citri Reticulatae Pericarpium), and Bàn Xià (Pinelliae Rhizoma Praeparatum), each 6 fen; Gān Cǎo (Glycyrrhizae Radix et Rhizoma) 3 fen; and one Wū Méi (Mume Fructus). After taking this, abdominal pain gradually decreased, and his spirit recovered. However, his hips were painful and immobile. This was due to excessive sweating during the severe illness leading to malnourishment of the sinews, requiring tonification. I prescribed Rén Shēn (Ginseng Radix et Rhizoma), Huáng Qí (Astragali Radix), Bái Sháo Yào (Paeoniae Radix Alba), Sāng Jì Shēng (Taxilli Herba), Gǒu Qǐ Zǐ (Lycii Fructus), Yì Yǐ Rén (Coicis Semen), Guì Xīn (Cinnamomi Ramulus Cortex), Niú Xī (Achyranthis Bidentatae Radix), and Shú Dì Huáng (Rehmanniae Radix Praeparata), decocted in water. Later, Mù Guā (Chaenomelis Fructus), Huáng Bǎi (Phellodendri Cortex), and Dāng Guī (Angelicae Sinensis Radix) were added, while Guì Xīn (Cinnamomi Ramulus Cortex) was removed. Through recuperative care, he fully recovered.