李思萱室人有孕。冬日感寒。至春而发。初不觉也。连食鸡
面鸡子。遂成夹食伤寒。一月才愈。又伤食物。吐泻交作。前后七十日。共反五次。遂成膈症。滴饮不入。
延诊时。其脉上涌而乱。重按全无。呕哕连绵不绝。声细如虫鸣。久久方大呕一声。余曰。病者胃中全无水谷。
已翻空向外。此不可救之症也。思萱必求良治。以免余憾。余筹画良久。因曰。万不得已。必多用人
参。但才入胃中。即从肠出。有日费斗金。不勾西风一浪之譬。奈何。渠曰。尽在十日之内。尚可勉备。
余曰。足矣。乃煎人参汤。调赤石脂末。以坠安其翻出之胃。病者气若稍回。少顷大
便。气即脱去。凡三日服过人参五两。赤石脂末一斤。俱从大便泻出。得食仍呕。但不呕药耳。因思必以药之渣
滓。如粞粥之类与服。方可望其少停胃中。顷之传下。又可望其少停肠中。于是以人参陈橘皮二味。剪如芥
子大。和粟米同煎作粥。与服半盏。不呕。良久又与半盏。如是再三日。始得胃舍稍安。但大肠之
空。尚未填实。复以赤石脂末为丸。每用人参汤吞两许。如是再三日。大便亦稀。此三日参橘粥内。已加入
陈仓米。每进一盏。日进十余次。人事遂大安矣。仍用四君子汤丸调理。通共享人参九两全愈。然此亦因
其胎尚未堕。有一线生气可续。故为此法以续其生耳。不然者用参虽多。安能回元气于无何有之乡哉。
后生一子。小甚。缘母疾百日失荫之故。
附叶氏妇治验 叶氏妇。亦伤寒将发。误食鸡面鸡子。大热喘胀。余怜其贫。乘病正传阳明胃经。日
间与彼双表去邪。夜间即以酒大黄玄明粉。连下三次。大便凡十六行。胎仍不动。次早即轻安。薄粥将养。
数日全愈。此盖乘其一日骤病。元气大旺。尽驱宿物以免缠绵也。设泥有孕。而用四物药和合下之。则
滞药反为食积树党矣
胡卣臣先生曰。前治神矣。后治复不减。盖前治明。后治良也。行所明以持危扶颠。藉有天幸者多矣。此嘉言所以
昭述其事。亦曰不得已欤。
Li Sixuan's wife was pregnant. In winter, she contracted cold pathogens, which manifested in spring, though initially unnoticed. After continuously consuming chicken, noodles, and eggs, she developed Shanghan with food retention (a condition of exterior cold invasion complicated by dietary stagnation). It took a month to recover. Subsequently, due to further dietary injury, vomiting and diarrhea occurred alternately. This persisted for seventy days, with five episodes of regurgitation, eventually evolving into Ge disease (a syndrome characterized by difficulty swallowing or rejection of food and fluids), where not even a drop of liquid could be retained.
When I was consulted, her pulse surged superficially and was chaotic, while deep pressure revealed complete emptiness. Her retching and hiccups were continuous, with sounds as faint as insect chirping, followed by a violent vomit only after a long interval. I stated, "The patient's stomach is completely devoid of food and fluids; the Stomach Qi has inverted and is protruding outward. This is an incurable condition." Li Sixuan insisted on seeking effective treatment to avoid regret. After much deliberation, I said, "If there is no other choice, we must use large doses of Renshen (Ginseng Root). However, once it enters the stomach, it will pass directly through the intestines. This is like spending a peck of gold daily yet failing to withstand a single wave of the west wind. What can be done?" He replied, "I can prepare it within ten days." I said, "That is sufficient." Thus, I decocted Renshen soup and mixed it with powder of Chishizhi (Halloysitum Rubrum) to anchor and stabilize the inverted Stomach Qi. The patient's Qi slightly recovered, and shortly after, she had a bowel movement, after which her Qi immediately collapsed. Over three days, she consumed five taels of Renshen and one jin of Chishizhi powder, all excreted via stool. She still vomited upon eating but did not vomit the medicine. I reasoned that the medicinal dregs must be processed into something resembling broken rice porridge before administration, so that the medicine might stay in the stomach briefly, then move to the intestines and stay there temporarily. Therefore, I cut Renshen and Chenjupi (Citrus Reticulatae Pericarpium) into particles the size of mustard seeds, cooked them together with millet into porridge, and administered half a cup. There was no vomiting. After a while, another half cup was given. This continued for three days, until the Stomach house finally settled somewhat. However, the emptiness of the Large Intestine was not yet filled. I then made pills from Chishizhi powder, administering each pill with about one tael of Renshen soup. After another three days, her stool became loose. During these three days, Chen Cangmi (aged Coix Seed) was added to the Renshen and Chenjupi porridge. Each intake was one cup, taken more than ten times a day, after which her general condition stabilized significantly. Subsequently, Sijunzi Tang (Four Gentlemen Decoction) was used in pill form for regulation. In total, nine taels of Renshen were consumed, leading to full recovery. However, this success was possible because the fetus had not miscarried, leaving a thread of vital Qi to sustain life. Hence, this method was employed to prolong life. Otherwise, even with massive doses of Renshen, how could Yuan Qi (Original Qi) be restored from the state of non-existence? Later, she gave birth to a son who was very small, due to the loss of maternal nourishment during her hundred-day illness.
Supplementary Case: Treatment of Mrs. Ye
Mrs. Ye also suffered from impending Shanghan. Mistakenly consuming chicken, noodles, and eggs, she developed high fever, panting, and abdominal distension. Pitying her poverty, I treated her while the pathogen was transmitting to the Yangming Stomach channel. During the day, I used dual-releasing methods to expel pathogens; at night, I administered Jiuhuangqi (Rhubarb prepared with wine) and Xuanmingfen (Mirabilite) for purgation, three times consecutively. She had sixteen bowel movements, yet the fetus remained unaffected. By the next morning, she felt relieved and comfortable. She was nourished with thin congee and fully recovered in a few days. This worked because her sudden acute illness left her Yuan Qi still robust, allowing us to drive out accumulated pathogens and prevent lingering disease. If we had adhered strictly to the pregnancy and used Siwu Tang (Four Substances Decoction) combined with purgatives, the stagnant herbs would have merely allied with the food stagnation.
Mr. Hu Youchen commented: "The previous treatment was divine, and the latter was no less excellent. The former was clear-minded, and the latter was well-executed. Applying clarity to manage critical situations often relies on heavenly fortune. This is why Jiayan (Yu Chang's courtesy name) recorded these events in detail, stating it was a measure of last resort."