经云。暴怒伤阴。怒则气逆。阴出之阳则怒。血并于上。气并于下。心烦冤善怒。
怒属肝胆。经云。在藏为肝。在志为怒。又云。肝藏血。血有余则怒是也。生铁洛饮、大小
柴胡、柴胡疏肝、四七、四磨、越鞠、七气、沉香降气等。皆治善怒致病之药。丹溪治怒方。香
附末六两。甘草末一两。和匀。白汤调下二钱。日再服。
经云。精气并于肺则悲。在藏为肺。在志为悲。悲。肺之志也。金本燥。能令燥者。火也。
心火主于热。善痛。故悲痛苦
恼者。心神烦热躁乱而非清净也。所以悲哭而五液俱出者。火热亢极。而反兼水化制之也。
金匮云。妇人脏燥。善悲伤欲哭。有如神灵所作。数欠伸。甘麦大枣汤主之。
脏燥者。火盛烁津。肺失其润。心系了戾而然。故用甘草缓心系之急而润肺燥。大枣行脾胃
之津。小麦降肝火之逆。火降则肺不燥而悲自已也。
戴人云。少阳相火。凌烁肺金。金受屈制。无所投告。肺主悲。故但欲痛哭为快耳。
石顽石。凡肺燥悲愁欲哭。宜润肺气降心火为主。余尝用生脉散、二冬膏。并加姜、枣治之。
未尝不随手而效。若作颠疾。用金石药则误矣。
经云。东方青色。入通于肝。开窍于目。其病发惊骇。诸病 肿。疼酸惊骇。皆属于火。足
阳明之脉病。恶人与火。闻木音则惕然而惊。惊则心无所归。虑无所定。故气乱矣。身体日减。
气虚无精。病虚无气。洒洒然如惊。惊者平之。
夫惊虽主于心。而肝胆脾胃皆有之。惊是火热烁动其心。心动而神乱也。若因内气先虚。故
触事易惊。或卒然闻响大声。目击异物。遇险临危。皆使人有惕惕之状也。惊则气乱。郁而生火
生涎。涎与气搏。变生诸证。或短气。或自汗。或眠多异梦。随即惊觉。并宜温胆汤加熟枣仁。
如远志丸妙香散、平补正心丹、龙齿清魂散皆可选用。卧多惊魇。口
中有声。温胆汤下远志丸。卧多惊魇遗溲者。补胆防风汤加羌活、桂枝。此下焦风寒。宜风药行
经也。若气郁生痰而惊悸不眠者。四七汤加茯神、远志石、菖蒲。大抵惊则神出于舍。舍空则痰
饮乘虚袭入。其神不得归焉。亦有肝虚风袭之者。本事方治卧则魂梦飞扬。惊悸多魇。通夕不寐。
先用独活汤数剂。后用珍珠母丸神效。盖因肝脏本虚。虚风内袭。所以魂游无定。肝藏魂者也。
风气水饮。乘虚袭入于肝。是以魂不宁而飞扬。若离体状。若作心血虚治必殆。此证最易愠怒。
小怒则惊悸转剧。虚火不时上升。岂非肝脏受困之验欤。二方非深明木盛生风。木槁生火之理。
不能识其奥妙。不能用以建功也。
〔诊〕寸口脉动为惊。惊者其脉止而复来。其人目睛不转。不能呼气。
石顽治河南督学汪缄庵媳。产后病虚无气。洒洒然如惊。常时咳青黑结痰。欲咳则心中
大动。咳则浑身麻木。心神不知所之。偶闻一声响。则头面哄热微汗。神魂如飞越状。专事妇科
者屡用补养心血之剂罔效。虚羸转剧。邀石顽诊之。脉浮微弦而芤。独左寸厥厥动摇。此必胎前
先伤风热。坐草时迸力过甚。痰血随气上逆。冲过膈膜而流入心包也。朝用异功散加童便 淬蛤
粉。以清理痰气。夕用大剂独参汤下来复丹。以搜涤瘀积。盖痰在膈膜之上。非焰硝无以透之。
血在膈膜之上。非五灵无以浚之。然非藉人参相反之性。不能激之使出也。服数日。神识渐宁。
形神渐旺。改用归脾汤加龙齿、沉香。调理而康。
又治吴昭如室。年壮体丰。而素有呕血腹胀脾约便难之恙。两遭回禄。忧恚频承。近于失血
之后。忽然神气愦乱。口噤目瞠。乃尊周渭文秉烛相邀。诊其气口数盛而促。人迎弦大而芤。形
神不能自主。似有撮空之状。渭老以为
证犯条款。不出五日当毙。予谓不然。若是撮空。必然手势散漫。今拈着衣被。尽力扯摘。定为
挟惊挟怒无疑。爪者筋之余。非惊怒而何。况脉来见促。当是痰气中结。殊非代脉之比。询其病
因。惊怒俱有。遂勒一方。用钩藤钩一两。煎成入竹沥半盏。姜汁五匕。连夜制服。明日复延往
候。云服药后。即得安寐。六脉亦已稍平。但促未退。仍用前方减半。调牛黄末一分。其夕大解
三度。共去结粪五六十枚。腹胀顿减。脉静人安。稀糜渐进。数日之间。平复如常。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: Sudden anger injures Yin. Anger causes Qi to rebel. When Yin emerges into Yang, it manifests as anger. Blood accumulates in the upper part, while Qi stagnates in the lower part, leading to vexation, a sense of grievance, and irritability.
Anger is associated with the Liver and Gallbladder. The *Neijing* states: In the Zang organs, it corresponds to the Liver; in the emotions, it corresponds to anger. It also states: The Liver stores Blood; when Blood is in excess, it manifests as anger. Shengtie Luo Yin (Iron Lo Drink), Da Chaihu Tang (Major Bupleurum Decoction), Xiao Chaihu Tang (Minor Bupleurum Decoction), Chaihu Shugan San (Bupleurum Powder for Soothing the Liver), Siqi Tang (Four-Seven Decoction), Simo Tang (Four-Mortar Decoction), Yueju Wan (Overcome Depression Pill), Qiqi Tang (Seven-Qi Decoction), and Chenxiang Jiangqi San (Aucklandia Powder for Descending Qi) are all formulas used to treat diseases caused by excessive anger. Zhu Danxi’s formula for treating anger consists of Xiangfu Mo (Cyperi Rhizoma powder) 6 liang and Gancao Mo (Glycyrrhizae Radix et Rhizoma powder) 1 liang, mixed evenly, taken with warm water, 2 qian per dose, twice daily.
The *Neijing* states: When Jing-Essence merges with the Lung, sadness arises. In the Zang organs, it corresponds to the Lung; in the emotions, it corresponds to sadness. Sadness is the emotion of the Lung. Metal (Lung) is inherently dry; what makes it dry is Fire. Heart Fire governs heat and tends to cause pain. Therefore, those who feel悲痛 (deep sorrow) and distress have a Heart Spirit that is vexed, hot, restless, and chaotic, rather than clear and tranquil. Thus, when crying, the five body fluids are all discharged because Fire-Heat has reached its extreme, triggering an opposing Water transformation to restrain it.
The *Jingui Yaolue* (Essential Prescriptions from the Golden Cabinet) states: Women suffering from Zang-Cao (Visceral Dryness) easily feel sad and want to cry, as if possessed by spirits, often yawning and stretching. Ganyao Maihao Dazao Tang (Licorice, Wheat, and Jujube Decoction) is indicated.
Zang-Cao refers to a condition where excessive Fire scorches Body Fluids, causing the Lung to lose moisture and the Heart Tie (connection) to become contracted and twisted. Therefore, Gancao (Licorice) is used to relieve the urgency of the Heart Tie and moisten Lung dryness; Dazao (Jujube) promotes the flow of fluids in the Spleen and Stomach; Xiaomai (Wheat) descends rebellious Liver Fire. When Fire descends, the Lung is no longer dry, and sadness ceases naturally.
Dairen (Zhang Congzheng) stated: Shaoyang Ministerial Fire insults and scorches Lung Metal. The Lung, constrained and wronged, has nowhere to appeal. Since the Lung governs sadness, the patient simply desires to weep bitterly to find relief.
Shiweng (Luo Mei) stated: For cases of Lung dryness causing sadness, grief, and a desire to cry, the primary treatment should be to moisten the Lung Qi and descend Heart Fire. I have frequently used Shengmai San (Generate the Pulse Powder) and Erdong Gao (Two Winter Fritillaria Paste), adding Ginger and Jujube, achieving immediate efficacy. Treating this as Dianji (mania/epilepsy) using mineral drugs would be a mistake.
The *Neijing* states: The color of the East is Green, which communicates internally with the Liver and opens into the Eyes. Its pathological manifestation includes fright and terror. Various conditions involving swelling, painful soreness, and fright are attributed to Fire. When the Foot-Yangming Meridian is diseased, the patient fears people and fire, and startles at the sound of wood. Fright causes the Heart Spirit to have no refuge and thoughts to lack stability, resulting in chaotic Qi. The body diminishes day by day; Qi deficiency leads to Essence depletion; disease without Qi results in shivering as if frightened. Fright should be treated by calming it.
Although fright primarily belongs to the Heart, it also involves the Liver, Gallbladder, Spleen, and Stomach. Fright is caused by Fire-Heat agitating the Heart; when the Heart moves, the Shen (Spirit) becomes chaotic. If internal Qi was previously deficient, contact with events easily triggers fright. Alternatively, suddenly hearing loud noises, seeing strange objects, or encountering danger can induce a state of timidity. Fright causes Qi chaos, leading to stagnation, Fire generation, and Phlegm-Saliva formation. Saliva and Qi contend, generating various symptoms such as shortness of breath, spontaneous sweating, or excessive dreaming with sudden awakening. Wen Dan Tang (Warm the Gallbladder Decoction) added with Shu Zaoren (Prepared Semen Juglandis) is suitable. Yuanzhi Wan (Polygala Pill), Miaoxiang San (Wonderful Fragrance Powder), Pingbu Zhengxin Dan (Neutralizing the Heart Pill), and Longchi Qinghun San (Dragon Tooth Calming Soul Powder) are also可选 (optional). For sleep disturbances with nightmares and sounds in the mouth, Wen Dan Tang administered with Yuanzhi Wan is used. For nightmares accompanied by enuresis, Budan Fangfeng Tang (Gallbladder-Reinforcing Saposhnikovia Decoction) added with Qianghuo (Notopterygii Rhizoma et Radix) and Guizhi (Cinnamon Twig) is indicated. This is Wind-Cold in the Lower Jiao, requiring wind-dispelling herbs to unblock the meridians. For fright palpitations and insomnia due to Qi stagnation generating Phlegm, Siqi Tang added with Fushen (Poria with Hostwood), Yuanzhi (Polygalae Radix), and Changpu (Acori Tatarinowii Rhizoma) is used. Generally, fright causes the Shen to leave its residence; an empty residence allows Phlegm-Fluids to invade vacuity, preventing the Shen from returning. There are also cases of Liver deficiency with Wind invasion. The *Ben Shi Fang* treats sleep with flying dreams, fright palpitations, frequent nightmares, and total insomnia by first administering Duohuo Tang (Angelica Pubescens Decoction) for several doses, followed by Zhennumu Wan (Pearl Mother-of-Pearl Pill) for miraculous effect. This is because the Liver is originally deficient, allowing Deficient Wind to invade internally, causing the Hun (Ethereal Soul) to wander不定 (unfixed). The Liver stores the Hun. Wind-Qi and Water-Fluids invading the Liver vacuously cause the Hun to be unsettled and fly about, resembling separation from the body. Treating this as Heart Blood deficiency would be perilous. This syndrome is prone to irritability; slight anger exacerbates palpitations, and Deficient Fire rises intermittently, confirming Liver constraint. These two formulas require a deep understanding of "Wood excess generates Wind" and "Wood dryness generates Fire" to grasp their subtleties and achieve therapeutic success.
[Diagnosis] Pulsation at the Cun Kou (Radial Artery) indicates Fright. In fright, the pulse stops and then returns. The patient’s eyes do not move freely, and they cannot exhale normally.
Shiweng treated the daughter-in-law of Wang Jian’an, Inspector of Henan Province. Postpartum, she suffered from Qi deficiency and weakness, shivering as if frightened. She habitually coughed up dark green-black phlegm clots; before coughing, her heart palpitated violently; during coughing, her whole body went numb, and her Shen felt lost. Upon hearing a sudden noise, her face flushed with slight sweating, and her Shen seemed to fly away. Gynecologists repeatedly used blood-nourishing formulas without effect, worsening her emaciation. Shiweng diagnosed a floating, fine, wiry, and hollow pulse, with only the Left Cun pulsating vigorously. He determined that Wind-Heat had been contracted during pregnancy, and excessive straining during delivery caused Phlegm-Blood to rebel upward, piercing the diaphragm and entering the Pericardium. Morning treatment: Yigong San (Yi Gong Powder) plus Tongbian (Child’s Urine) quenched Ge Fen (Clam Shell Powder) to clear Phlegm-Qi. Evening treatment: A large dose of Renshen Tang (Ginseng Decoction) followed by Laifu Dan (Reviving Pellet) to scour and eliminate stasis. Phlegm above the diaphragm requires Yanxiao (Saltpeter) to penetrate; Blood above the diaphragm requires Wulingzhi (Trogopteri Dung) to dredge. However, without the antagonistic property of Renshen to stimulate expulsion, these could not be removed. After several days, mental clarity returned, and physical strength improved. Treatment switched to Guipi Tang (Restore the Spleen Decoction) added with Longchi (Dragon Tooth) and Chenxiang (Aquilaria Lignum) for recovery.
He also treated the wife of Wu Zhaoru. Young and robust, she suffered from hematemesis, abdominal distension, and constipation due to Spleen restriction. Following two fires and continuous worry and resentment, after recent blood loss, she suddenly experienced mental confusion, locked jaw, and staring eyes. Her father, Zhou Weiwen, invited Shiweng by candlelight. The Qi Kou pulse was rapid, abundant, and hurried; the Ren Ying pulse was wiry, large, and hollow. Her form and spirit were uncontrollable, exhibiting signs of grasping at empty air. Mr. Zhou believed this violated prognostic rules and predicted death within five days. Shiweng disagreed: "If it were true grasping-at-air, the hand movements would be scattered. Here, she grips clothes and bedding, pulling forcefully. This is undoubtedly complicated by Fright and Anger. Nails are the surplus of Tendons; how else could this be? Moreover, the hurried pulse indicates Phlegm-Qi knotting, distinct from the Dai (Knotted) pulse." Inquiry confirmed both Fright and Anger. Prescription: Gouteng Gou (Uncaria Ramulus cum Uncis) 1 liang, decocted, mixed with Zhuli (Bambusae Succus) half zhan and Jiangzhi (Zingiberis Recensis Succus) five bi, taken overnight. Next day, she slept peacefully, pulses slightly normalized but still hurried. Same formula halved, mixed with Niuhuang Mo (Bovis Calculus powder) one fen. That night, three bowel movements occurred, expelling 50-60 hard fecal pellets. Abdominal distension reduced instantly, pulse calmed, patient peaceful, soft gruel gradually resumed. Within days, she recovered completely.