叶茂卿乃郎。出痘未大成浆。其壳甚薄。两月后尚有着肉不脱者。一夕腹痛。大叫而绝。余取梨汁入温汤
灌之。少苏。顷复痛绝。灌之复苏。遂以黄芩二两煎汤。和梨汁与服。痛止。令制膏子药频服。不听。其后忽
肚大无伦。一夕痛叫。小肠突出脐外五寸。交纽各二寸半。如竹节壶顶状。茎物绞折长八九寸。明亮如灯笼。
外症从来不经闻见。余以知之素审。仍为治之。以黄芩阿胶二味。日进十余剂。三日后始得小水。五日后水道
清利。脐收肿缩而愈。门人骇而问曰。此等治法。顽钝一毫莫解。乞明示用药大意。答曰。夫人一身之气。全
关于肺。肺清则气行。肺浊则气壅。肺主皮毛。痘不成浆。肺热而津不行也。壳着于肉。名曰甲错。甲错者多
生肺痈。痈者壅也。岂非肺气壅而然与。腹痛叫绝者。壅之甚也。壅甚则并水道亦闭。是以其气横行于脐
中。而小肠且为突出。至于外肾弛长。尤其剩事矣。吾以黄芩阿
胶清肺之热。润肺之燥。治其源也。气行而壅自通。源清斯流清
矣。缘病已极中之极。惟单味多用。可以下行取效。故立方甚平。而奏功甚捷耳。试以格物之学。为子广之。
凡禽畜之类。有肺者有尿。无肺者无尿。故水道不利而成肿满。以清肺为急。此义前人阐发不到。后之以五苓
五皮八正等方治水者。总之未悟此旨。至于车水放塘。种种劫夺膀胱之剂。则杀人之事矣。可不辨之于蚤欤。
赵我完孝廉次郎。秋月肺气不能下行。两足肿溃。而小水全无。脐中之痛。不可名状。以手揉左。则痛攻
于右。揉右则痛攻于左。当脐揉熨。则满脐俱痛。叫喊不绝。利水之药。服数十剂不效。用敷脐法。及单服
琥珀末至两许。亦不效。昌见时弥留已极。无可救药矣。伤哉。
胡卣臣先生曰。凡求同理者。必不求同俗。嘉言之韬光匿采。宁甘讪
谤。曾不令人窥识者。无意求知也。岂见此而有不心折者耶。
The son of Ye Maoqing. After suffering from smallpox, pus did not fully form. The scabs were very thin. Two months later, some still adhered to the flesh and had not detached. One night, he suffered from abdominal pain, cried out loudly, and then fainted. I took pear juice, mixed it with warm water, and administered it by force-feeding. He slightly revived. Shortly after, he fainted again due to severe pain. After administering the mixture again, he recovered. Then, I decocted two liang of Huangqin (Scutellariae Radix, 黄芩) in water, mixed it with pear juice, and gave it to him to drink. The pain stopped. I instructed someone to prepare a paste medicine for frequent administration. He did not listen. Later, his abdomen suddenly became disproportionately large. One night, he cried out in pain. His small intestine protruded five cun outside the umbilicus, twisting and knotting, each part about two and a half cun long, resembling bamboo nodes or the top of a pot. His genitals were twisted and elongated, eight or nine cun long, bright like a lantern. Such external symptoms had never been seen before. Because I understood the condition well, I continued to treat him. Using only Huangqin (Scutellariae Radix, 黄芩) and Ejiao (Colla Corii Asini, 阿胶), he took more than ten doses daily. Only after three days did urination begin. After five days, the urinary tract cleared, the umbilicus retracted, swelling subsided, and he recovered. Disciples asked in amazement, "This treatment method is utterly incomprehensible to us. Please explain the main idea behind the medication." I replied, "The Qi of the entire body is entirely related to the Lung. When the Lung is clear, Qi moves; when the Lung is turbid, Qi becomes obstructed. The Lung governs the skin and hair. The failure of smallpox to form pus indicates Lung heat and the failure of fluids to circulate. Scabs adhering to the flesh are called 'Jiacuo' (cracked, scaly skin). People with Jiacuo often develop Feiyong (Lung Abscess, 肺痈). 'Yong' means obstruction. Is this not caused by Lung Qi obstruction? Severe abdominal pain and fainting indicate extreme obstruction. Extreme obstruction also blocks the urinary pathway. Thus, Qi rushes horizontally through the umbilicus, causing the small intestine to protrude. Elongation of the external genitalia is merely a secondary consequence. I used Huangqin (Scutellariae Radix, 黄芩) and Ejiao (Colla Corii Asini, 6阿胶) to clear Lung heat and moisten Lung dryness, treating the root cause. Once Qi moves, obstruction clears naturally. If the source is clear, the flow will be clear. Since the disease had reached an extreme degree, using single herbs in high doses was necessary to guide the pathogenic factors downward and achieve efficacy. Therefore, the prescription was mild, yet the effect was rapid. Let me elaborate using the study of things (Gewu, 格物). Among birds and beasts, those with lungs have urine; those without lungs do not have urine. Thus, when the urinary pathway is blocked, edema and fullness result. Clearing the Lung is urgent. This principle was not fully expounded by predecessors. Those who later treated water retention with formulas such as Wuling San (Five-Ling Powder, 五苓散), Wupi Yin (Five-Peel Decoction, 五皮饮), and Bazheng San (Eight-Righteous Powder, 八正散) failed to grasp this essence. Methods that forcibly drain the Bladder, akin to draining ponds, are acts of killing. Should one not distinguish this early?"
The second son of Zhao Wowan, a Xiucai, suffered from Lung Qi failing to descend in autumn. His feet swelled and ulcerated, and he had no urine at all. The pain in his umbilicus was indescribable. Rubbing the left side caused pain to shift to the right; rubbing the right caused pain to shift to the left. Rubbing and warming the umbilicus caused pain throughout the entire navel area. He cried out incessantly. Diuretic medicines taken for dozens of doses were ineffective. Applying patches to the umbilicus and taking single-dose Hupo (Succinum, 琥珀) powder up to one liang also proved ineffective. Yu Chang saw that the patient was in extremis and beyond saving. How tragic.
Mr. Hu Youchen said, "Those who seek shared principles must not seek conformity with common customs. Jiayan (Yu Chang's courtesy name) concealed his brilliance and talents, preferring slander and defamation rather than allowing others to fully comprehend him. He sought no fame. Who could see this and not be convinced?"