浓兄病愈,其女三岁,发热目赤,医谓证属因风生热,投以羌活荆防,目肿如李,眵流
如脓
,热甚搐搦。尊公君扬翁,嘱予治之。予曰∶此因热生风证也,非清不可。方用生地、丹皮
、山栀、生甘草、菊花、桑叶、石决明、羚羊角,服之热退搐定,目肿亦消。君翁疑而问曰
∶小孙女之病,医云因风生热,子云因热生风,同一风耳。风则当散,何服散剂而病反增,
服清剂而病旋愈?此曷故也?予曰∶风热二字,不可概言,须知内外标本之别。因风生热者,
乃外入之风,风胜则热遏,散其风,而热自解,所谓火郁发之。此风为本,热为标也。因热
生风者,乃内出之风,热胜则风,旋清其热,而风自熄,所谓热者寒之,此热为本,风为标
也。医家因风热二字,义未解明,模棱施治,是以多误。翁喟然曰∶医患不明理,理明则
治病视诸掌矣。
安波按∶卓论也。
君翁盛纪,年将二旬。暮春之初,始觉头筋抽痛,旋见口眼歪斜,肢凉脉细。以为风寒
外感
,药投温散,其病益剧,肢掣头昏,心悸汗浆,君翁令舁至舍,嘱为延医,按诸风眩掉,皆
属于肝。春深时强木长,水不涵木,阳化内风,乘虚绕络。凡治风须分内外,外入之风则可
散,内出之风,散之益助其升腾鼓动之势。现下左肢螈 ,防变痉厥神迷。议以滋水涵木,
和阳熄风。方用炙甘草、黑参、熟地、麦冬、阿胶、芝麻、茯神、枣仁、五味子、牡蛎、小
麦、南枣,初服四剂,势已减轻,更加白芍、当归、葳蕤服至廿剂,病瘥。虚犹未复,令制
丸药,数阅月,始得元复如初。
After Brother Nong's illness was cured, his three-year-old daughter developed fever and red eyes. The physician diagnosed it as a heat syndrome caused by wind pathogen and prescribed Qianghuo Jingfang (Notopterygii Rhizoma et Radix with Saposhnikoviae Radix and Bupleuri Radix). Consequently, her eyes swelled like plums, discharge flowed like pus, fever intensified, and convulsions occurred. Her grandfather, Mr. Junyang, instructed me to treat her. I said: This is a syndrome of wind generated from heat; it must be cleared. The prescription consisted of Shengdi Huang (Rehmanniae Radix Preparata), Danpi (Moutan Cortex), Shanzhi (Gardeniae Fructus), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), Juhua (Chrysanthemi Flos), Sangye (Mori Folium), Shijueming (Concha Arcae), and Lingyangjiao (Saigae Tataricae Cornu). After taking the medicine, the fever subsided, convulsions ceased, and eye swelling disappeared. Mr. Junyang asked doubtfully: "My granddaughter's illness was diagnosed by another doctor as heat caused by wind, but you say it is wind caused by heat. Both involve 'wind'. Wind should be dispersed; why did dispersing agents worsen the condition while clearing agents resolved it quickly? What is the reason?" I replied: "The terms 'wind' and 'heat' cannot be used generally; one must distinguish between internal/external origins and root/branch relationships. In 'heat caused by wind', the wind is an external pathogen. When wind is excessive, heat is constrained. Dispersing the wind resolves the heat, which is known as 'releasing fire stagnation'. Here, wind is the root, and heat is the branch. In 'wind caused by heat', the wind arises internally. When heat is excessive, wind is generated. Clearing the heat extinguishes the wind, which is known as 'treating heat with cold'. Here, heat is the root, and wind is the branch." Physicians often err because they do not clearly understand the meanings of 'wind' and 'heat' and apply ambiguous treatments. Mr. Junyang sighed and said: "If both patients and physicians do not understand the principles, once the principles are clear, treating diseases becomes as easy as looking at one's palm."
An Bo commented: This is a profound insight.
Mr. Junyang's servant, Sheng Ji, was nearly twenty years old. At the beginning of late spring, he initially felt twitching pain in the head tendons, followed by deviation of the mouth and eyes, cool limbs, and a fine pulse. He was treated for external contraction of wind-cold with warming and dispersing herbs, but the condition worsened, presenting with limb jerking, dizziness, palpitations, and profuse sweating like syrup. Mr. Junyang had him carried to my residence and instructed me to provide medical care. According to the principle that all wind-related vertigo and tremors belong to the Liver, during deep spring when Wood energy grows strongly, if Water fails to nourish Wood, Yang transforms into internal wind, which invades the collaterals vacuously. In treating wind syndromes, one must distinguish between internal and external origins. External wind can be dispersed, but internal wind, if dispersed, only exacerbates its ascending and stirring momentum. Currently, there is twitching in the left limb, risking progression to spasm, coma, or loss of consciousness. The proposed treatment is to nourish Water to nourish Wood and harmonize Yang to extinguish wind. The prescription included Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma), Heishen (Black Ginseng), Shudi Huang (Prepared Rehmanniae Radix), Maidong (Ophiopogonis Tuber), Ejiao (Donkey-hide Gelatin), Zhima (Sesamum Fructus), Fushen (Poria with Hostwood), Zaoren (Ziziphi Spinosomi Semen), Wuweizi (Schisandrae Fructus), Muli (Concha Ostreae), Xiaomai (Tritici Fructus), and Nanzao (Jujubae Fructus). After four doses, the condition improved. White Shaoyao (Paeoniae Radix Alba), Danggui (Angelicae Sinensis Radix), and Weirui (Polygonati Odorati Rhizoma) were added. After twenty doses, the disease was cured. However, deficiency remained, so pills were prepared. After several months, his original vitality was restored.