吉长乃室。新秋病洒淅恶寒。寒已发热。渐生咳嗽。然病未甚也。服表散药不愈。体日瘦羸。延至初冬。
饮以参术补剂。转觉厌厌欲绝。食饮不思。有咳无声。泻利不止。危在旦暮。医者
议以人参五钱。附子三钱。加入姜桂白术之属。作一剂服。以止泻补虚。而收背水之捷。吉长 徨无措。延
仆诊毕。未及交语。前医自外亟至。见仆在坐。即令疏方。仆飘然而出。盖以渠见既讹。难与语至理耳。吉
长辞去前医。坚请用药。仆因谓曰。是病总繇误药所致。始先皮毛间洒淅恶寒发热。肺金为时令之燥所
伤也。用表散已为非法。至用参术补之。则肺气闭锢。而咳嗽之声不扬。胸腹饱胀。不思食饮。肺中之热无
处可宣。急奔大肠。食入则不待运化而直出。食不入。则肠中之垢污。亦随气奔而出。是以泻利无休也。
今以润肺之药兼润其肠。则源流俱清。寒热咳嗽泄泻。一齐俱止矣。但取药四剂。服之必安。不足虑也。
方用黄芩地骨皮甘草杏仁阿胶。初进一剂。泻即少止。四剂毕。而寒热俱除。再数剂而咳嗽俱全愈矣。设当
日与时辈商之。彼方执参附为是。能从我乎。又乡中王氏妇。秋月亦病寒热。服参术后。亦厌厌一息。但无
咳嗽。十余日不进粒米。亦无大便。时时晕去。不省人事。其夫来寓中。详述其症。求发补剂归服。余
以大黄芒硝石膏甘草四味。为粗末与之。彼不能辨。归而煎服。其妻云。此药甚咸。夫喜曰。咸果补药。
遂将二剂连服。顷之腹中努痛。下结粪数块。绝而复苏。进粥二盏。前病已如失矣。乡人致谢忱始知之。凡
此素有定见于中。故不为临歧所炫也。姑存是案。为治病者广其识焉。
胡卣臣先生曰。毫厘有差。千里悬绝。案中治法。似乎与症相反。究竟不爽。大难大难。
Wu Jichang's wife. In early autumn, she fell ill with chills and shivering (Saxi). After the chills subsided, fever developed. Gradually, a cough emerged. However, the condition was not severe. She took exterior-releasing and dispersing medicines without recovery. Her body became increasingly emaciated and weak. The illness dragged on until early winter.
She was given tonifying decoctions containing Ginseng Radix et Rhizoma (Renshen) and Atractylodis Macrocephalae Rhizoma (Baizhu). Instead of improving, she felt increasingly lethargic and near death. She had no appetite for food or drink. She had a cough but no voice. Diarrhea continued incessantly. Her life was in imminent danger. Physicians
discussed prescribing five qian of Ginseng Radix et Rhizoma (Renshen) and three qian of Aconiti Lateralis Radix Preparata (Fuzi), added to ingredients such as Zingiberis Rhizoma (Shengjiang), Cinnamomi Ramulus (Guizhi), and Atractylodis Macrocephalae Rhizoma (Baizhu). They intended to prepare one dose to stop diarrhea and tonify deficiency, aiming for a decisive victory against a desperate situation. Wu Jichang was panicked and at a loss. He invited me to diagnose her. After finishing the diagnosis, before any conversation could take place, the previous physician rushed in from outside. Seeing me present, he immediately asked me to prescribe. I left casually. This was because their diagnostic view was already erroneous, making it difficult to discuss profound principles with them. Wu Jichang dismissed the previous physician and firmly requested medication. I then said to him, "This illness is entirely caused by misprescription. Initially, the chills, shivering, and fever at the skin and hair level indicated that Lung Metal was injured by the seasonal dryness pathogen. Using exterior-releasing methods was already incorrect. Subsequently, using Ginseng Radix et Rhizoma (Renshen) and Atractylodis Macrocephalae Rhizoma (Baizhu) for tonification caused Lung Qi to become closed and obstructed, resulting in a muffled cough sound, chest and abdominal fullness, and lack of desire for food and drink. The heat within the Lung had nowhere to vent, so it rushed urgently into the Large Intestine. When food entered, it was not transformed and digested but passed through directly. When no food entered, the filth within the intestines also exited along with the rushing Qi. Hence, the diarrhea was unceasing.
Now, by using herbs that moisten the Lung while simultaneously moistening the intestines, both the source and the branches will be cleared. The cold, heat, cough, and diarrhea will all cease together. Just obtain four doses; upon taking them, she will surely recover. There is no need to worry."
The prescription consisted of Scutellariae Radix (Huangqin), Lycii Cortex (Digupi), Glycyrrhizae Radix et Rhizoma (Gancao), Armeniacae Semen Amarum (Xingren), and Equisetum Herba? No, Ophiopogonis Radix? No, Asini Corii Colla (Ejiao). Specifically: Huangqin, Digupi, Gancao, Xingren, Ejiao. Upon taking the first dose, the diarrhea stopped slightly. After completing four doses, the cold and heat were completely eliminated. After several more doses, the cough was fully cured. If I had consulted with those mediocre physicians on that day, they would have insisted that Ginseng Radix et Rhizoma (Renshen) and Aconiti Lateralis Radix Preparata (Fuzi) were correct. Would they have followed my advice?
Furthermore, a woman surnamed Wang in the same village also suffered from alternating chills and fever in autumn. After taking Ginseng Radix et Rhizoma (Renshen) and Atractylodis Macrocephalae Rhizoma (Baizhu), she too became lethargic with only a faint breath. However, she did not have a cough. For over ten days, she consumed no rice grains and had no bowel movements. She frequently fainted and lost consciousness. Her husband came to my residence, detailed her symptoms, and requested a tonifying prescription to take home. I prepared a coarse powder of Rheum Palmatum (Dahuang), Natrii Sulfas (Mangxiao), Gypsum Fibrosum (Shigao), and Glycyrrhizae Radix et Rhizoma (Gancao) for her. She could not distinguish the herbs. She returned home, decocted, and administered them. Her wife remarked, "This medicine is very salty." Her husband rejoiced, saying, "Salty indeed is a tonifying property." Thus, they took two doses consecutively. Soon, she experienced abdominal straining pain and passed several hard fecal masses. She fainted and then revived. After drinking two bowls of porridge, her previous ailments seemed to have vanished. The villagers expressed their gratitude only after learning this. All these cases demonstrate that having firm convictions internally prevents one from being dazzled by external confusion during critical moments. I preserve this case here to broaden the knowledge of those who treat diseases.
Mr. Hu Youchen stated, "A difference of a hair's breadth leads to a divergence of a thousand miles. The treatment method in this case seems contrary to the symptoms, yet ultimately it is flawless. It is truly difficult, truly difficult."