文学张云门三令郎,丁年偶发寒热,右胁有一块降起,疼痛,手不可近,下午至夜尤甚
,额颅
手心皆热,脉右关洪滑,两尺尤有力,日夜不得睡。乃仿推气散例,姜黄、桔梗、川芎各一
钱五分,枳实二钱,白芍药一钱,粉草五分,姜、枣煎服,外以当归龙荟丸。其夜大便行一
次,颇得睡。三更后,先发寒战,徐热,至五更微汗,而胁痛寒热悉减。再诊之,左脉略弦
,舌有黄白浓苔,两胁重按微疼,大便燥结不行,以小柴胡汤减半夏,倍加栝蒌、鳖甲、牡
蛎、胁疼全瘳,睾丸略硬痛,彼自以为无后恙矣。予语渠姐夫徐仲子伟曰∶“病先起胁下,
顾
胁下为肝之经,后及睾丸硬疼,其睾丸亦肝之地,此余热未尽彻故也。而彼已厌药,以小愈
为全安,不出浃旬,必有奇疾。”徐仲之曰∶“奇者若何?”余曰∶“此君性急好胜,若勉强作
文,遇劳而发,憎寒壮热,非疟即囊痈也。予倘东行,子宜识之。”别后半月,果因作文,
夜发寒热,囊渐肿大,其热如火。及予至,诊之六部皆数,两尺且近于洪,知其脓已成,必
溃而后已。彼心甚恐,予曰∶“无伤,易与耳。”急以营卫返魂汤加金银花为君,两帖而脓
溃。再加人参,又两帖而肌生,十日痊愈。方用何首乌、赤芍药、当归、小茴香、甘草节、
木通、金银花、贝母、枳壳、白芷,水与酒共煎服之。此方加独活治流注尤神。
The third son of the scholar Zhang Yunmen, at the age of sixteen (Ding year), occasionally experienced chills and fever. There was a raised mass in the right hypochondrium accompanied by pain, intolerable to touch, worsening from afternoon into night. The forehead, head, and palms were hot. The pulse at the right Guan position was surging and slippery, with the two Chi positions being particularly forceful. He could not sleep day or night. Following the example of Tuiqi San (Pushing Qi Decoction), Jianghuang (Curcuma Longae Rhizoma), Jiegeng (Platycodonis Radix), and Chuanxiong (Ligustici Chuanxiong Rhizoma) were each used in 1.5 qian, Zhishi (Aurantii Fructus Immaturus) in 2 qian, Baishao Yao (Paeoniae Radix Alba) in 1 qian, and Fencacao (Glycyrrhizae Radix et Rhizoma Preparatum) in 0.5 qian, decocted with Shengjiang (Zingiberis Rhizoma Recens) and Dazao (Jujubae Fructus). Externally, Danggui Longhui Wan (Angelica Sinensis and Bile Pill) was applied. That night, he had one bowel movement and slept better. After the third watch, he first experienced chills, followed by gradual heat. By the fifth watch, he sweated slightly, and the hypochondriac pain and chills/fever subsided completely. Upon re-examination, the left pulse was slightly wiry, the tongue coating was thick yellow-white, and slight tenderness on deep pressure was felt in both hypochondria. Stool was dry and constipated. Xiaochaihu Tang (Minor Bupleurum Decoction) was used with Banxia (Pinelliae Rhizoma) removed, and Gualou (Trichosanthis Fructus), Biejia (Testudinis Carapax et Plastrum), and Muli (Ostreae Concha) doubled. The hypochondriac pain was completely cured, but the testicles remained slightly hard and painful. The patient believed there would be no further issues. I said to his brother-in-law, Xu Zhongzi Wei: "The disease originated in the hypochondrium. The hypochondrium is the pathway of the Liver Meridian; subsequently, the testicles became hard and painful, which also belongs to the domain of the Liver. This indicates that residual heat has not been fully cleared. However, he is already weary of taking medicine, considering slight improvement as complete recovery. Within ten days, a strange illness will surely occur." Xu Zhong asked: "What will be strange about it?" I replied: "This gentleman has an impatient and competitive nature. If he forces himself to write essays, upon exertion, he will develop aversion to cold and high fever. It will be either malaria or scrotal abscess. If I travel eastward, you should keep this in mind." Half a month after parting, indeed, due to writing essays, he developed chills and fever at night. The scrotum gradually swelled, feeling hot as fire. When I arrived, all six pulse positions were rapid, and the two Chi positions approached surging. Knowing that pus had formed, I determined it must rupture before healing. He was very fearful. I said: "Do not worry, it is easy to treat." Urgently, Yingwei Fanhun Tang (Yingwei Returning Soul Decoction) was administered with Jinyinhua (Lonicerae Japonicae Flos) as the chief herb. After two doses, the pus ruptured. Ren Shen (Ginseng Radix et Rhizoma) was then added, and after another two doses, flesh regenerated. He recovered in ten days. The formula consisted of Heshouwu (Polygoni Multiflori Radix), Chishaoyao (Paeoniae Radix Rubra), Danggui (Angelicae Sinensis Radix), Xiaohuixiang (Foeniculi Fructus), Gancao Jie (Glycyrrhizae Radix et Rhizoma Joint), Mutong (Akebiae Caulis), Jinyinhua (Lonicerae Japonicae Flos), Beimu (Fritillariae Thunbergii Bulbus), Zhiqiao (Aurantii Fructus), and Baizhi (Angelicae Dahuricae Radix), decocted with water and wine. Adding Du Huo (Angelicae Pubescentis Radix) to this formula for treating Liuzhu (flowing deposits/chronic abscesses) is particularly miraculous.