黄曙修与乃翁起潜。春月同时病温。乃翁年老而势轻。曙修年富而势重。势重者。以冬不藏精。体虚
不任病耳。余见其头重着枕。身重着席。不能转侧。气止一丝。不能言语。畏闻声响。于表汗药中。用人参
七分。伊芳表侄施济卿。恐其家妇女得知。不与进药。暗赠人参入药。服后汗出势减。次日再于和解药中。赠
人参一钱与服。服后即大便一次。曙修颇觉轻爽。然疑药下之早也。遣人致问。余告以此证表已解矣。里已
和矣。今后缓调。即日向安。不必再虑。往诊见老翁病尚未愈。头面甚红。谓曰。望八老翁。下元虚惫。阳浮
于上。与在表之邪相合。所谓戴阳之证也。阳已戴于头面。不知者更行表散。则孤阳飞越。而危殆立
至矣。此证从古至今。只有陶节庵立法甚妙。以人参附子等药。收拾阳气。归于下元。而加葱白透表以散外
邪。如法用之即愈。万不宜迟。渠家父子俱病。无人敢主。且骇为偏僻之说。旋即更医。投以表药。顷刻阳
气升腾。肌肤粟起。又顷刻寒颤切牙。浑身冻裂而逝。翁虽海滨一氓。留心管晏富国之略。而 志以没
也。良足悼矣。其医于曙修调理药仍行克伐。致元气日削。谢绝医药。静养六十余日。方起于床。愈后。
凡遇戚友家。见余用药。率多诋訾。设知当日解表和中。俱用人参。肯舍命从我乎。是其
所以得全者。藉于济卿之权巧矣。
附伤寒戴阳证 石开晓病伤风咳嗽。未尝发热。日觉急迫欲死。呼吸不能相续。求余诊之。余见其头面赤
红。躁扰不歇。脉亦豁大而空。谓曰。此证颇奇。全似伤寒戴阳证。何以伤风小恙亦有之。急宜用人参附子
等药。温补下元。收回阳气。不然子丑时一身大汗。脱阳而死矣。渠不以为然。及日落。阳不用事。
愈慌乱不能少支。忙服前药。服后稍宁片刻。又为床侧添同寝一人。逼出其汗如雨。再用一剂。汗止身安。
咳嗽俱不作。询其所繇。云连服麻黄药四剂。遂尔躁急欲死。然后知伤风亦有戴
阳证。与伤寒无别。总因其人平素下虚。是以真阳易于上越耳。
胡卣臣先生曰。戴阳一证。剖析精详。有功来学。
Huang Shuxiu and his father, Huang Qiqian, contracted warm disease (Wen Bing, 温病) simultaneously in spring. The father was advanced in age but the condition was mild; Shuxiu was young and vigorous but the condition was severe. The severity in Shuxiu's case was due to failing to store essence during winter, resulting in a constitution too weak to withstand pathogenic factors. I observed that his head lay heavily on the pillow, his body weighed heavily on the mat, he could not turn or shift position, his breath was faint as a single thread, he could not speak, and he feared hearing sounds. In the exterior-releasing diaphoretic formula, I added seven fen of Renshen (Ginseng Radix et Rhizoma). His cousin-in-law, Shi Jiqing, fearing that the women of the household would object if they knew, did not allow him to administer the medicine, but secretly gifted Ginseng to be added to the decoction. After taking it, perspiration occurred and the condition alleviated. The next day, in a harmonizing formula, one qian of Ginseng was gifted and administered. After ingestion, there was one bowel movement, and Shuxiu felt considerably refreshed. However, he suspected the medication was administered too early and sent someone to inquire. I informed him that the exterior pathogen had been resolved and the interior harmonized; with gradual regulation henceforth, he would recover that very day, requiring no further worry.
Upon visiting the elder gentleman, I found his illness unresolved, with his face and head appearing very red. I said to him, "An eighty-year-old man suffers from deficiency and exhaustion of the lower origin (Kidney and Mingmen), causing Yang Qi to float upward and combine with exterior pathogens. This is what is known as the Dai Yang (Floating Yang) syndrome. Since Yang has already floated to the head and face, those unaware might mistakenly apply exterior-releasing dispersal methods, causing solitary Yang to fly away and disperse, leading to immediate peril." Throughout history, only Tao Jian'an formulated a brilliant method for this syndrome: using herbs such as Renshen (Ginseng Radix et Rhizoma) and Fuzi (Aconiti Lateralis Radix Praeparata) to gather Yang Qi and return it to the lower origin, while adding Congbai (Allii Fistulosi Bulbus) to penetrate the exterior and scatter external pathogens. Following this method leads to recovery; delay is inadvisable. With both father and son ill, no one dared to take charge, and they were alarmed by what they considered an eccentric theory, subsequently changing physicians who administered exterior-releasing drugs. Instantly, Yang Qi surged, skin became goosefleshed, followed by chills and teeth-grinding, and he died with his body feeling as if frozen and cracking. Although the old gentleman was merely a commoner by the sea, he paid attention to the statecraft of Guan Zhong and Yan Ying, yet passed away with unfulfilled ambitions, which is truly lamentable.
Regarding Shuxiu, the physician continued to use draining and attacking methods in his conditioning formulas, causing Yuan Qi (Primary Qi) to decline daily. He refused medical treatment and rested quietly for over sixty days before getting out of bed. After recovery, whenever he visited relatives or friends and saw my prescriptions, he mostly disparaged them. If they had known that Ginseng was used for both resolving the exterior and harmonizing the middle at that time, would they have risked their lives to follow me? The reason he survived was due to Shi Jiqing's opportunistic cleverness.
Appendix: Case of Dai Yang Syndrome in Shang Han
Shi Kaixiao suffered from wind-stroke cough without fever, feeling increasingly desperate daily, unable to sustain respiration. Seeking my diagnosis, I observed his face and head were red, he was restless and agitated incessantly, and his pulse was vast and empty (Huo Da Er Kong). I said, "This syndrome is peculiar, resembling Dai Yang syndrome in Shang Han perfectly. Why does a minor wind-strike also present this way? It urgently requires Renshen (Ginseng Radix et Rhizoma) and Fuzi (Aconiti Lateralis Radix Praeparata) to warm and tonify the lower origin and retrieve Yang Qi. Otherwise, profuse sweating will occur during the Zi-Chou hours (11 PM - 3 AM), leading to death from Yang collapse." He did not agree. As sunset approached, Yang Qi ceased its activity, and he became more panicked, barely able to endure. He hurriedly took the previous prescription, which provided brief relief. Another person was added to sleep beside him to force out sweat like rain. After another dose, sweating stopped, the body was peaceful, and coughing ceased. Upon inquiry, he stated that after taking four doses of Mahuang (Ephedrae Herba), he became agitated and desperate. Thus, it was realized that wind-strike can also present Dai Yang syndrome, indistinguishable from Shang Han. Ultimately, it is because the person usually has deficiency in the lower origin, making True Yang prone to floating upward.
Mr. Hu Youchen stated: "The analysis of Dai Yang syndrome is precise and detailed, benefiting future scholars."