咫旭乃室病膈气。二十余日。饮粒全不入口。延余诊时。尺脉已绝而不至矣。询其二便。自病起至今。
从未一通。止是一味痰沫上涌。厌厌待尽。无法以处。邑庠有施姓者。善决生死。谓其脉已离根。顷刻当坏。
余曰。不然。脉经明有开活一款云。上部有脉。下部无脉。其人当吐。不吐者死。是吐则未必死也。但得
天气下降。则地道自通。故此症倍宜治中。以气高不返。中无开阖。因成危候。待吾以法缓缓治之。自然逐
日见效。于是始独任以观验否。乃遂变旋复代赭成法。而用其意。不泥其方。缘女病至尺脉全无。则莫可验
其受孕。万一有而不求。以赭石干姜辈伤之。呼吸立断矣。姑阙疑。以赤石脂易赭石。煨姜易干姜。用
六君子汤加旋复花煎调。服下呕即稍定。其岳父见用人参。以为劫病而致憾。余曰。无恐也。治此不愈。愿
以三十金为罚。如愈一文不取。乃全神照应。药必亲调。始与服之。三日后。渐渐不呕。又三日后。粥饮
渐加。举家称快。但病者全不大便。至是已月余矣。一则忧病之未除。再则忧食之不运。刻刻以通利为
嘱。余曰。脏气久结。食饮入胃。每日止能透下肠中一二节。食饮积之既久。脏气自然通透。原议缓治。
何得急图耶。举家佥以余为不情。每进诊脉。辄闻病者鼻息之扬。但未至发声相詈耳。盖余以归地润肠之药。
恐滞膈而作呕。硝石大黄通肠之药。恐伤胎而殒命。姑拂其请。坚持三五日。果气下肠通而病全瘳矣。
病瘳而其家窃议曰。一便且不能通。曷贵于医耶。月余。腹中之
孕。果渐形着。又议曰。一孕且不能知。安所称高耶。吁嗟。余之设诚而行。以全人夫妻子母。而反以得谤也。
岂有他哉。惟余得谤。当世之所谓医者。然后乃得名耳。
胡卣臣先生曰。议病入理之深。自然入俗之浅。如中无开阖之语。及脏气逐日渐通之语。岂堪向寻常索解耶。
Hu Zhixu's wife suffered from *geqi* (obstruction in the diaphragm/chest). For more than twenty days, she could not take even a single grain of food or sip of liquid. When I was consulted for diagnosis, her *chimai* (cunameter pulse, located at the distal end of the radial artery) had already vanished and was imperceptible. Upon inquiring about her urination and defecation, it was found that since the onset of the illness, there had been no passage at all; instead, there was only a continuous surging up of phlegm foam. She appeared listless and on the verge of death, with no apparent remedy. A local scholar named Shi, who was skilled at predicting life and death, stated that her pulse had detached from its root and that she would perish within moments. I replied, "Not so. The *Maijing* (Classic of Pulse Diagnosis) explicitly contains a section on vital signs: 'If there is pulse in the upper part but none in the lower part, the patient should vomit; if they do not vomit, they will die.' This indicates that vomiting does not necessarily signify death. If the Qi of Heaven (Lung Qi) descends, then the pathways of Earth (Intestinal channels) will naturally open. Therefore, this condition is particularly suitable for treatment focusing on the Middle Jiao (Middle Burner), because the Qi is high and failing to return, and the Middle Jiao has lost its opening and closing functions, leading to a critical state. Let me treat it slowly with specific methods, and it will naturally show improvement day by day." Thus, I took sole responsibility to observe whether the treatment would be effective.
I then altered the established formula of *Xuanfu Daizhe Tang* (Inula and Hematite Decoction), adopting its principle without being bound by its composition. Since the female patient's *chimai* was completely absent, it was impossible to verify pregnancy. If there were a pregnancy and we failed to recognize it, using substances like *Daizhishi* (Hematite) and *Ganjiang* (Dried Ginger) could cause immediate cessation of respiration. Therefore, I suspended judgment regarding pregnancy and substituted *Daizhishi* with *Chishizhi* (Red Halloysite) and *Ganjiang* with *Weijiang* (Baked Ginger). I prescribed *Liujunzi Tang* (Six Gentlemen Decoction) added with *Xuanfuhua* (Inula Flower) and administered it as a decoction. After taking the medicine, the vomiting subsided slightly. Her father-in-law, seeing the use of *Renshen* (Ginseng Root), believed it was depleting the disease-causing pathogen and causing resentment towards me. I said, "Do not fear. If this is not cured, I am willing to pay a penalty of thirty taels of gold; if cured, I will accept not a single coin." I then attended to her with full concentration and personally prepared the medicines before allowing her to take them. After three days, the vomiting gradually ceased. Three days later, her intake of porridge and drinks gradually increased, bringing joy to the whole family. However, the patient still had no bowel movement, which had persisted for over a month. On one hand, they worried that the illness was not removed; on the other, they worried that food was not being transported. They constantly urged me to promote unblocking and purgation. I said, "The Zang-organ Qi has been knotted for a long time. Food and drink entering the Stomach can only penetrate down one or two sections of the intestines each day. Once food and drink have accumulated for a long time, the Zang-organ Qi will naturally become clear and unobstructed. The original plan was slow treatment; how can one seek urgent results?" The entire family thought I was unreasonable. Every time I went to diagnose her pulse, I could hear her nasal breathing becoming loud, though she had not yet reached the point of cursing aloud. This was likely because I used moistening intestinal herbs such as *Shudihuang* (Prepared Rehmannia Root) and *Danggui* (Angelica Sinensis Root), fearing they might stagnate the Diaphragm and induce vomiting; and I avoided purgative herbs like *Xiaoshi* (Niter) and *Dahuang* (Rhubarb Root), fearing they might damage the fetus and cause death. I temporarily disregarded their requests and persisted for three or five days. Indeed, the Qi descended, the intestines became unobstructed, and the illness was completely cured.
After the cure, the family discussed privately among themselves: "She could not pass stool even once; what value is there in the doctor?" More than a month later, the pregnancy in her abdomen indeed gradually became apparent. They then discussed again: "You did not even know about the pregnancy; how can you be called eminent?" Alas! I acted with sincerity to preserve the lives of the husband, wife, mother, and child, yet I was slandered. Is there any other reason? Only when I am slandered can the so-called doctors of the world gain fame.
Mr. Hu Youchen said: "Analyzing the disease with profound understanding naturally leads to avoiding superficial worldly views. Phrases such as 'the Middle Jiao lacks opening and closing' and 'Zang-organ Qi becomes clear and unobstructed day by day' are certainly beyond the comprehension of ordinary people seeking simple explanations."