死生。六脉结滞,或五七至中一止,十余至中一止,两更实实。凡劳症脉当芤细、弦牢、短促,今见痰脉,非
劳脉也。以导痰汤,枳实、半夏、胆星、苍术、茯苓、陈皮、白芥子各一钱,甘草三分,加熟大黄二钱,二三
剂,下痰少许。身体困极,以参汤调理渐安,令服八珍汤而愈。
刘云密曰∶愚于戊戌岁冬深,终之气主气寒水,既与司天相合,而客湿土,又与在泉相合,更加于主气
寒水之上,其病于阳气甚矣。气乃肺主之,故肺易受寒邪。既病于主气之肺阳,阳气益不得施化,而水中之阳
化更微,致湿淫滋患。故湿痰生聚于胃而不行,是湿痰愈覆其阳,则肺生郁热,遂口舌为燥,而肺所治之上焦
亦俱不爽,且移于所合之大肠而化风矣。治之者宜麻黄、杏仁辈以散寒,炒干姜、制白术以除湿。第所郁之火,
骤以姜、术投之,适益其势耳。乃散寒以麻、杏,而除湿暂用二陈,加南星乃入蛤粉于中,以镇阴僭而散阳郁,
其痰渐化而热亦行。徐以干姜、白术辈理中,乃得全愈。
孙兆治俞伯道,忽患微热,心中满,头有汗不能解。众医以为湿病用表药,有谓食在膈者,治之皆不效。
召孙至,曰∶用半夏茯苓汤遂瘥。众问故,曰∶头有汗,心下满,非湿症,乃水结胸膈也。水既去,其病乃愈。
且如湿气心下满,自当遍身汗。若有食心满,头岂得有汗?若言是表,身又不疼不恶寒,表症何在?故凡水结
胸膈胁,头必有汗耳。(雄按∶此案已列卷一伤寒门。)
张子和曰∶有一妇人年三十余,病滑泄经年。皆云虚中有积,以无忧散,五七日一服,至二十服不效。又
服缠积丹、软金丹丸,诸药皆不效。其人服药愈速,病势愈甚,饮食日减。人或谓曰∶此休息痢也,宜灸中脘,
及左右穴也。下气海及膀胱穴,以三里引之,每年当冬至日、夏至日灸之,前后计万余壮。忽门外或者曰∶此
病我屡识,盖伤饮之故。即日桃花正开,俟其落时,以长棘针刺之,得数十萼,勿犯人手,以白面和作饼子,
文武火烧令熟,嚼烂以米饮汤下之。病患如言,服之不一二时,泻如倾。前后六七日,计数十行,昏困无所知
觉,惟索冷水徐徐而饮。至六七日少省后,食日进,神日昌,气血日和,不数年生二子。
子和治郭敬之留饮,面目浮肿,不能食,脚肿连肾囊痛,先以苦剂涌之,后以舟车丸、浚川散泻之,病去
如拾遗。又一田叟姓杨,其病呕酸臭水十余年,本留饮,诸医皆以燥剂燥之,中脘脐 以火艾燔针刺之,疮未
尝合。张以苦剂越之,其涎如胶,乃出二三升,谈笑而愈。
李七老病涌水症,面黄而喘,两足皆肿,按之陷而复起,行则濯濯有声,常欲饮水,不能睡卧。张令上
涌去痰而汗之,次以舟车丸、浚川散下之,以益肾散复下之,以分阴阳利水道之剂调之,水尽瘥。
一妇从少年时,因大哭罢,饮冰困卧,水停心下,渐发痛闷,咸以为冷积,治以温热之剂,及禁食冷物,
一闻茶气,病辄内作。如此数年,燎灸烧艾,疮孔数千。十余年后,小大便秘闷,两目如昏,积水转甚,流于
两胁,世谓水癖,或谓支饮, 、漆、棱、莪攻磨之药,竟施之矣。食日衰,积日茂,上至鸠尾,旁至两胁及脐
下。但发之时,按之如水声,心腹结硬,手不可近者,月发五次,甚则欲死,已二十余年。张诊其脉,寸口独
沉而迟,此胸中有痰。先以瓜蒂散涌痰五七升,不数日再越痰水及斗,又数日上涌数升。凡三涌三下,汗如水
者亦三,其积皆去。以流湿饮调之,月余大瘥。
中丞常子正苦痰饮,每食饱或阴晴节变,率十日一发,头痛背寒,呕吐酸汁,即数日伏枕不食,服药罔效。
宣和初为顺昌司录,于太守蔡达道席上,得吴仙丹方服之,遂不再作。每遇饮食过多,腹觉满胀,服五七十丸
便已。少顷,小便作茱萸气,酒饮皆随小水而去,前后痰药甚众,无及此者。用茱萸汤泡七次,茯苓等分为末,
炼蜜丸梧子大,每热水下五十丸,其效如神。(《朱氏集验方》、《本草纲目》。)
陆养愚治施南石,二十九岁,患晡热,至天明方退,夜热尤甚,咳嗽无痰,咳则痛引胸胁,热甚则咳亦甚,
咳甚则痛亦甚。初服芎苏散,喘急殊甚,易以前胡、杏仁、桑皮、苏子辈亦不效。后以阴虚治之,二冬、二母
服数月,饮食渐减,肌肉羸瘦。或谓劳瘵已成,不可疗矣。最后一医诊得脉弦数,左关尤甚,此肝火也。用柴
胡、青皮、黄连、赤芍、山栀、白芥子数剂亦无验。于是苦于药饵,不延医。三月诊之,六脉沉数而滑,右关
尺更有力,其胁痛,若从右而应乎左。因思仲景云∶饮在胁下,咳则引痛,谓之悬饮。今咳痛明是其症,第十
枣汤非常用之方,且病患野狼狈已极,亦必不肯服。乃以润字丸料加入甘遂和丸,令一二分一服,日二服,每日
加一分,加至五分一服。使便出稠痰碗许,中有一块,半硬半软如鸡子大,胁痛如失,热嗽减之十之六七。
又用人参、白术、归、芍、茯苓、贝母、甘草作煎剂,与丸药间服,丸药仍减一分,直待便中无痰始止丸药,
用前煎药日一帖,调月余全安。(雄按∶体虚病实,深得缓攻之法,迨衰其半,又合寓攻于通补之道。)
陈三农治一妇,患眩晕腰痛,过寅卯二时,则日夜昏迷,不省人事,身如在浮云中,脉细数弦滑。细为湿,
数为热,弦为饮。湿热痰饮,留滞胸膈,随气升降,上涌则为眩晕,下坠则为腰痛,痰饮沃心包,致窍不通,
故昏不省人事。至巳午时,心火助其湿热,鼓击痰涎,故昏痴益甚也。此必痛饮所致,叩之果然。遂以稀涎散
涌酸臭痰数升,仍以舟车丸泄如漏屋水者五六次,诸症均愈。
一贵妇患溢饮,遍身虚肿,用金沸草散一剂,汗出肿减。继以泽泻汤加枳实、旋复花、前胡,四剂而安。
一妇患时疫,饮水过多,胸膈坚痞,咳逆倚息,短气不卧,汤饮入而吐出,诸药罔效。作停饮治,以五苓
散一剂愈。
一妇患霍乱,饮阴阳水,左腹坚硬痛极,作留饮治,以半夏、旋复花各三钱,泽泻、青皮、枳实、白术、
干姜各一钱,吴茱萸二分,一剂愈。
李士材治秦景明,素有痰饮,每岁必四五发,发即呕吐不能食。此病久结成窠囊,非大涌之弗愈也。须先
进补中益气,十日后以瓜蒂频投。投涌如赤豆沙者数升,已而复得水晶色者升许。如是者,七补之,七涌之,
百日而窠囊始尽。专服六君子、八味丸,经年不辍。
吴孚先治西商王某,气体甚浓,病留饮,得利反快,心下积坚满,鼻色鲜明,脉沉,此留饮欲去而不能尽
去也。用甘遂、甘草、半夏、白芍,加白蜜五匙顿服,前症悉痊。或问∶甘遂与甘草,其性相反,用之无害而
反奏效,何也?曰∶正取其性之相反,使自相攻击,以成疏瀹决排之功。(西人赋性浓,尤当用之。)
张景岳尊人,早年善饮,后及四旬,遂得痰饮之疾,呕酸胀满,饮食日减,眩晕不支,惊惕恍惚,痰疟等
症相继迭出,百方治痰无效。因慕张子和吐法之妙,遵而用之。初用独圣散、茶调散及 汁之类,一吐稍效,
再吐再效,自此屡用不止,虽诸症渐退,而元气勿复也。如此年余,渐觉纯熟,忽悟其理,遂全不用药,但于
五鼓睡醒时,仰卧用嗳提气,气有不充,则咽气为嗳,随咽随提,痰涎必随气至,虽最深之痰,无不可取。其
最后出者,形色臭味紫气,酸恶不堪言状。每吐后或至唇咽肿痛,但以凉水一二口漱咽解之。吐毕早膳,用屏
五味,用薄粥一二碗,以养胃气。自四旬后绝不用酒,行吐法四十余年,自六旬外,则一月或半月必行一次。
凡吐后神气必倍旺,阳道必勃然,一切内伤外感无不尽却。盖道用督,此则用任,所用不同,所归一也。不惟
却病,而且延年。后至八旬外,犹能登山,及灯下抄录古书,无病而卒。(叶天士曰∶按张子和《儒门事亲》
云,凡人之病,自外而入,由内而起,皆邪气也。邪气加诸身,速攻之可也。及其闻攻则不悦,闻补则乐之。
至于无邪无积之人,始可议补。有邪有积而议补者,如鲧湮洪水之徒也。故立汗、吐、下三法以去病。病在表
者汗之,在上者吐之,在下者下之,以病去为先,病去之后,以谷肉果菜补之,非药补也。景岳言子和吐法之妙,
不知汗、下之法更妙。然以法惟在上者吐之,非一概可吐也。又有补论一篇,甚言误补之害。惟庸医治病,纯
讲补其虚,不敢治其实,世人皆以为平稳而自误。景岳但见其吐法,不见其补论一篇乎。子和之学,亦宗河间与
东垣、丹溪,并传大用寒凉攻击以治病,毫不用补,以补之适足为害也。景岳重子和而毁河间、丹溪,岂子和
另有温补之书,抑不敢议其非欤?)
张三锡治一人,肩背与膝相引而痛,寸脉弦,知痰饮为患也。投小胃丹一服,吐痰半升。间日再进一服,
泻痰小有如胶者一升许,病良已。
张子和治一人,病留饮者数十年不愈。诊之,左寸脉三部皆微而小,右手脉三部皆滑而大。微小为寒,滑
大为燥。以瓜蒂散涌其寒痰数升,汗出如沃。次以导水禹功去肠中燥垢亦数升,其人半愈。然后以痰剂流其余
蕴,以降火之剂开其胃口,不逾月愈。
朱丹溪治一人,素耽于酒,患遍身关节肿痛,此愈彼剧,胸膈不宽。此酒湿症,痰饮在胃,流注经络,即
流饮症也。用二陈汤加酒芩、苍术、羌活、威灵仙、泽泻,倍葛根而愈。
许叔微自患饮 三十年。始因少年夜坐写文,左向伏几,是以饮食多坠左边,中夜必饮酒数杯,又向左卧。
壮时不觉,三五年后,觉酒从左下有声,胁痛食减嘈杂,饮酒半盏即止。十数日必呕酸水数升,暑月止右边有
汗,左边绝无。遍访名医及海上方,间或中病愈,得月余复作。其补如天雄、附子、矾石,利如牵牛、甘遂、
大戟,备尝之矣。自揣必有 囊,如水之有科臼,不盈科不行,但清者可行,而浊者停滞,无路以决之,故积
至五七日必呕而去。脾土恶湿,而水则不流,莫若燥脾以去湿,崇土以填科臼。乃制苍术丸,服三月而疾除。
苍术一斤,去皮,切片末之,用白芝麻半两,水盏研滤取汁,大枣十五枚,烂煮去皮核,以麻汁匀研成稀膏,
搜和入臼熟杵,丸如桐子大,干之。每日空腹温汤吞下五十丸,加至百丸。忌桃、李、雀、鸽,初服时必膈微
燥,且以茅术制之,觉燥甚即进山栀散一服,久之则不燥也。山栀散用山栀一味,干之为末,沸汤点服。
马元仪治沈表侄,因悲哀劳役,面色枯白,形体憔悴,右胁有块,凝结作痛,痛则呕,手足厥逆,饮食不
思,大便时溏时结,吐出痰饮,动辄盈盆,或一日一发,或间日一发,苦楚万状。诊其脉,左三部弦而劲急,
右三部虚微无力。方用附子理中加桂汤,稍安。越三日又发,与前方不应,乃倍加附子,甚安。后复发,前方
又不应。因思仲景伤寒治法,有用真武汤一法,原以真火飞越,水气上逆,故用此以复阳收阴,坐镇少阴北方
之位。究其功用,全在行水醒脾之妙。今因劳郁所伤,中气损甚,由是所胜之木乘脾,所不胜之水侮之而逆。
木横则痞结作呕,水逆则痰饮泛溢。若非真武,何以摄元阳而镇阴邪耶?遂用此方倍加分两,多用人参,连进
三十余剂,呕渐已,痰渐少。令早服八味丸,晚服附桂理中丸调理,诸症悉愈。惟结块不除,则以久积阴寒难
解,恐成痼疾也。(用真武汤甚合法,而多加人参未免又沿俗。盖参性腻滞,最不宜于饮症也。此症元气复后,即
宜间用攻剂,以尽根株,徒事温补,安能望结块之去耶?)
缪仲淳治丹阳葛文学字十内人,因作家劳郁患饮,每每发呕吐不已,肠如欲出,所吐俱清水,动以盆桶计,
日夜不止,不思饮食。就医金坛,诸医以健脾行气,理郁清痰药投之,愈剧,困顿待毙,计无复之矣。缪视脉
审病,知为饮无疑,乃用姜制半夏四两,广皮四两,茯苓四两,猪苓二两,泽泻米泔浸炒二两,旋复花三两,
浓朴姜汁炒一两五钱,白术二两,枳实面炒一两,川连一两,木香五钱,加人参一两三钱。一剂吐止,再剂霍
然,随啖粥糜,脾气渐复。至今每病作,检方服之即平。(此丸方也,用稀米糊加姜汁和丸如绿豆大,每服五钱,
淡姜汤下。如作煎剂,取二十倍中一倍,加白蔻仁末、木香汁、姜汁和服。因寒湿者,加苍术二两,木香五钱,
白豆蔻五钱。因郁者加紫苏四钱,去苍术。)
云间康孟修患寒热不食,久之势甚危,以治寒热剂投不应。遍检方书,与王宇泰议投五饮丸立瘥。盖饮症
原有作寒热之条,故治饮,病自退矣。(《广笔记》。)
吴桥治汪钱,始壮辄患呕逆,胸膈痛,诸医悉以膈治,骨立而羸,久之随绝,而汗如流,水浆不能入口。
诊其脉,即浮濡不任按,无他端,曰∶此停饮尔。误以膈治,病者心悸则气涩于胸中,血从气行,气阻则血亦
阻矣。此二缶撞钟惑也。第先屏二缶,然后治之,瘀血当下。病者怃然为间,曰∶敬如公言,遂修行气一
剂饮之,饮未毕而痛止,徐下黑粪,瘀血毕,病乃平。(《太函集》。)
Life and death are at stake. The six pulses are knotted and stagnant; or there is a pause after every five to seven beats, or after more than ten beats, with alternating excess conditions in both positions. In cases of consumption (Lao Zheng), the pulse should be hollow and fine (Kou Xi), wiry and firm (Xian Lao), or short and rapid (Duan Cu). Now seeing a phlegm pulse, it is not a consumption pulse. Use Dao Tan Tang (Phlegm-Resolving Decoction) containing Zhi Shi (Immature Bitter Orange Fruit), Ban Xia (Pinellia Tuber), Dan Xing (Fried Phragmites Rhizome processed with Pig Gall), Cang Zhu (Atractylodes Rhizome), Fu Ling (Poria), Chen Pi (Tangerine Peel), and Bai Jie Zi (White Mustard Seed), each one qian (approx. 3g); Gan Cao (Licorice Root), three fen (approx. 0.9g); add Shu Da Huang (Prepared Rhubarb), two qian (approx. 6g). After two or three doses, some phlegm will be discharged. The body feels extremely fatigued; regulate with Ren Shen Tang (Ginseng Decoction) until gradually stable, then instruct to take Ba Zhen Tang (Eight-Treasure Decoction) for recovery.
Liu Yunmi stated: In the deep winter of the Wuxu year, during the final Qi phase, the dominant Qi was Cold Water, which combined with the ruling Heaven Qi, while the guest Qi was Damp Earth, combining with the ruling Earth Qi below, further adding to the dominant Cold Water. This severely affected Yang Qi. Qi is governed by the Lung, so the Lung is easily affected by Cold Evil. Once the Lung Yang is diseased due to the dominant Qi, Yang Qi cannot transform effectively, making the transformation of Yang within Water even weaker, leading to excessive Dampness causing disasters. Thus, Damp-Phlegm gathers in the Stomach but does not move. As Damp-Phlegm covers Yang further, Liver Fire stagnates in the Lung, causing dryness in the mouth and tongue. The Upper Jiao (Upper Burner), governed by the Lung, becomes dysfunctional, and this shifts to the paired Large Intestine, transforming into Wind. Treatment should use Ma Huang (Ephedra Herb) and Xing Ren (Apricot Seed) to disperse Cold, Chao Gan Jiang (Stir-fried Dried Ginger) and Zhi Bai Zhu (Processed Atractylodes Rhizome) to remove Dampness. However, the stagnant Fire would only increase if suddenly treated with Gan Jiang and Bai Zhu. Therefore, disperse Cold with Ma Huang and Xing Ren, temporarily remove Dampness with Er Chen Tang (Two-Aged Decoction), add Nan Xing (Arisaema Tuber), and include Ge Fen (Clam Shell Powder) to suppress Yin rebellion and dissipate Yang stagnation. The phlegm gradually transforms, and Heat moves. Slowly regulate the Middle Jiao with Gan Jiang and Bai Zhu to achieve full recovery.
Sun Zhao treated Yu Bodao, who suddenly suffered from slight fever, fullness in the heart/chest, and sweating on the head that did not resolve. Many physicians considered it a Damp disease and used exterior-releasing medicines; others suggested food retention in the diaphragm. Treatments were ineffective. Sun was summoned and said: "Use Ban Xia Fu Ling Tang (Pinellia and Poria Decoction), and the patient will recover." When asked why, he said: "Sweating on the head and fullness below the heart indicate not a Damp disease, but Water Knotting in the Chest and Diaphragm. Once the Water is removed, the disease heals. If it were Dampness causing fullness below the heart, there would be sweating all over the body. If it were food retention causing fullness, how could there be sweating only on the head? If it were an exterior syndrome, the body would not hurt, nor would there be aversion to cold; where is the exterior syndrome? Therefore, whenever Water knots in the chest, diaphragm, or hypochondrium, there must be sweating on the head." (Note: This case is already listed in Volume One, Shang Han Department.)
Zhang Hezi said: There was a woman in her thirties suffering from slippery diarrhea for years. Everyone said there was accumulation within deficiency. She took Wu You San (Worry-Free Powder) once every five to seven days; after twenty doses, it was ineffective. She also took Chan Ji Dan (Accumulation-Entangling Pellets) and Ruan Jin Dan Wan (Soft Gold Pellets); all medicines were ineffective. The faster she took medicine, the worse the condition became, and her diet decreased daily. Someone told her: "This is Resting Dysentery (Xiu Xi Li). You should moxa Zhong Wan (CV12) and its surrounding points, as well as Qi Hai (CV6) and Pang Guang Shu (BL28), guided by Zu San Li (ST36). Moxa these points annually on the Winter Solstice and Summer Solstice, totaling over ten thousand moxa cones." Suddenly, someone outside said: "I have seen this disease often; it is caused by injured Drinking Fluids. Peach blossoms are blooming now. Wait until they fall, prick them with long thorns to collect dozens of calyxes, do not let them touch human hands. Mix with white flour to make cakes, cook slowly over mild fire until ripe, chew thoroughly, and swallow with rice water soup. The patient followed instructions. Within one or two hours, diarrhea poured out. Over six or seven days, she defecated dozens of times, becoming unconscious and confused, only asking for cold water to drink slowly. After six or seven days, when she slightly regained consciousness, her appetite increased daily, spirit revived, and Qi and Blood harmonized. Within a few years, she gave birth to two children.
Zhang Hezi treated Guo Jingzhi's retained drinking fluid (Liu Yin), presenting with facial and eye swelling, inability to eat, foot swelling extending to the scrotum with pain. First, he induced vomiting with bitter agents, then purged with Zhou Che Wan (Boat Cart Pellets) and Jun Chuan San (River-Clearing Powder). The disease left as easily as picking up something lost. Another old farmer surnamed Yang had vomited sour, foul-smelling water for over ten years. It was originally retained drinking fluid, but other physicians treated it with drying agents, applying burning moxa needles to Zhong Wan (CV12) and the umbilicus; the sores never healed. Zhang induced vomiting with bitter agents; his saliva came out like glue, amounting to two or three sheng (approx. 400-600ml). He recovered while chatting and laughing.
Li Qilao suffered from Yong Shui Syndrome (Surging Water Syndrome), presenting with yellow complexion, wheezing, bilateral leg swelling that indented upon pressure and rebounded, gurgling sounds when walking, constant desire to drink water, and inability to sleep or lie down. Zhang ordered upper vomiting to expel phlegm and induce sweating, then purged with Zhou Che Wan and Jun Chuan San, followed by Yi Shen San (Kidney-Benefiting Powder) to purge again, and regulated with agents separating Yin and Yang and benefiting water pathways. All water was eliminated, and the disease resolved.
A woman, since her youth, after crying bitterly, drank ice and lay down drowsily. Water stopped in the heart/lower chest, gradually developing pain and oppression. Everyone considered it Cold Accumulation, treating it with warm-hot agents and forbidding cold foods. Upon smelling tea, the illness would flare internally. For several years, she underwent cauterization and moxibustion, resulting in thousands of sores. Over ten years later, constipation and urinary difficulty developed, eyes dimmed, water accumulation worsened, flowing into both hypochondria. The world calls this Water Bi (Shui Pi) or Branch Drinking (Zhi Yin). Attacks using Po Qi (Croton Seed), Leng Niu (Spurge Root), Lei Gong Teng (Tripterygium Wilfordii), and E Zhu (Curcuma Zedoary) were applied. Food intake declined daily, accumulation grew daily, extending up to Jiu Wei (CV15), sideways to the hypochondria and below the umbilicus. Whenever it flared, pressing felt like water sound, heart and abdomen knotted hard, untouchable. It occurred five times a month, sometimes nearly fatal. This lasted over twenty years. Zhang diagnosed her pulse: Cun Kou (Radial artery at wrist) alone was deep and slow, indicating phlegm in the chest. First, he used Gua Di San (Melon Sepal Powder) to vomit five to seven sheng of phlegm. Within a few days, he vomited another dou (approx. 10 liters) of phlegm-water. Several days later, he vomited several sheng again. In total, three upper vomiting sessions and three purgative sessions, plus three episodes of profuse sweating like water, all accumulations were removed. Regulated with Liu Shi Yin (Damp-Draining Drink). After more than a month, significant recovery.
Chancellor Chang Zizheng suffered bitterly from Phlegm-Drinking. Every time he ate full or weather changed, it flared roughly every ten days: headache, back chills, vomiting sour juice, lying in bed without eating for several days. Medicines were ineffective. Early in Xuanhe era, serving as Shunchang Sili, at the banquet of Taishou Cai Dadao, he obtained the formula for Wu Xian Dan (Immortal Wu Pellets) and took it, so it never recurred. Whenever he ate too much and felt abdominal fullness, taking fifty to seventy pellets resolved it. Soon after, urine smelled like Cornus officinalis (Shan Zhu Yu), and alcohol/drinks exited via urination. Many previous phlegm medicines could not match this effect. Use Cornus officinalis soaked seven times, equal parts Poria powder, refined honey pellets sized like wu zi (walnut seeds), take fifty pellets with hot water. Effect was miraculous. (From *Zhu Shi Ji Yan Fang* and *Ben Cao Gang Mu*.)
Lu Yangyu treated Shi Nanshi, aged twenty-nine, suffering from afternoon fever (Bu Re) resolving only at dawn, night fever especially severe, cough without phlegm, coughing pulling pain to chest and hypochondria, fever severity correlated with cough intensity, and pain severity with cough intensity. Initially took Xiong Su San (Sichuan Lovage and Perilla Powder), asthma urgency was extreme. Changed to Qian Hu (Peucedanum Root), Xing Ren, Sang Bai Pi (Mulberry Root Bark), Su Zi (Perilla Fruit), etc., also ineffective. Later treated as Yin Deficiency, taking Dong Hua Gen (Adenophora Root) and Dong Ting Li (Fritillaria Thunbergii Bulb) for months, diet decreased, muscles wasted. Some said Consumption (Lao Zhai) was established, incurable. The last physician diagnosed wiry and rapid pulse, especially at Left Guan (Liver position), indicating Liver Fire. Used Chai Hu (Bupleurum Root), Qing Pi (Aurantii Fructus Immaturus), Huang Lian (Coptis Rhizome), Chi Shao (Red Peony Root), Shan Zhi (Gardenia Fruit), Bai Jie Zi for several doses, also no effect. Thus, suffering from medication, he stopped seeking doctors. Diagnosed in March: six pulses deep, rapid, and slippery, Right Guan and Chi positions more forceful. Hypochondriac pain seemed to correspond from right to left. Recalling Zhang Zhongjing: "Drinking in the hypochondria, coughing pulls pain, called Suspended Drinking (Xuan Yin)." Now cough and pain clearly indicate this symptom. Shi Zao Tang (Ten Date Decoction) is not a routine formula, and the patient was extremely destitute and unwilling to take it. So, he added Gan Sui (Kansui Root) to Run Zi Wan (Moistening Pellet) ingredients, made into pills, dose one to two fen (approx. 0.3-0.6g) per administration, twice daily, increasing by one fen daily up to five fen per dose. This caused passage of about a bowl of thick phlegm in stool, containing one mass, half hard half soft like a chicken egg. Hypochondriac pain vanished, fever and cough reduced by 60-70%. Then used Ren Shen (Ginseng), Bai Zhu (Atractylodes Macrocephala Rhizome), Dang Gui (Angelica Sinensis), Bai Shao (White Peony Root), Fu Ling (Poria), Bei Mu (Fritillaria Cirrhosa Bulb), Gan Cao (Licorice Root) as decoction, taken alternately with pills. Pills still reduced by one fen daily, stopping pills only when no phlegm in stool. Continue decoction once daily, regulating for over a month until fully recovered. (Note: Body deficient, disease excess, deeply understands the method of slow attack. When disease is halved, combine attack with tonifying unblocking.)
Chen Sansan treated a woman suffering from vertigo and lower back pain. Between Yin and Mao hours (3 AM - 7 AM), she fell into day-and-night coma, losing consciousness, feeling like floating in clouds. Pulse was fine, rapid, wiry, and slippery. Fine indicates Dampness, Rapid indicates Heat, Wiry indicates Drinking. Damp-Heat and Phlegm-Drinking stagnated in the chest/diaphragm, rising and falling with Qi. Rising upward caused vertigo, sinking downward caused lower back pain. Phlegm-Drinking flooded the Pericardium, blocking orifices, hence coma and loss of consciousness. At Si and Wu hours (9 AM - 1 PM), Heart Fire aided Damp-Heat, beating phlegm-saliva, so confusion worsened. This must be caused by heavy drinking, confirmed by inquiry. Then used Xi Xian San (Saliva-Thinning Powder) to vomit several sheng of sour-stinky phlegm, still used Zhou Che Wan to purge leaking-house-water-like stool five or six times. All symptoms resolved.
A noble lady suffered from Yi Yin (Overflowing Drinking), generalized edema. One dose of Jin Fei Cao San (Golden Fern Grass Powder) induced sweating and reduced swelling. Followed by Ze Xie Tang (Alisma Decoction) added with Zhi Shi (Immature Bitter Orange), Xuan Fu Hua (Inula Flower), Qian Hu (Peucedanum Root), four doses until stable.
A woman suffered from seasonal epidemic, drank too much water, hard obstruction in chest/diaphragm, coughing backward leaning on support, shortness of breath unable to lie flat, swallowed liquids vomited out, all medicines ineffective. Treated as Retained Drinking, one dose of Wu Ling San (Five-Ingredient Powder with Poria) cured.
A woman suffered from Cholera, drank Yin-Yang Water (mixed hot/cold water), left abdomen hard and extremely painful. Treated as Retained Drinking, using Ban Xia (Pinellia), Xuan Fu Hua (Inula Flower) each three qian, Ze Xie (Alisma), Qing Pi (Aurantii Fructus Immaturus), Zhi Shi (Immature Bitter Orange), Bai Zhu (Atractylodes Macrocephala Rhizome), Gan Jiang (Dried Ginger) each one qian, Wu Zhu Yu (Evodia Fruit) two fen. One dose cured.
Li Shicai treated Qin Jingming, who had chronic Phlegm-Drinking, flaring four to five times yearly, vomiting and inability to eat upon flare. This disease formed nests/sacs over time, requiring massive vomiting to cure. Must first tonify with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), after ten days frequently administer Gua Di San (Melon Sepal Powder). Vomited several sheng of red bean paste-like substance, then crystal-colored liquid about one sheng. Did this seven times tonifying, seven times vomiting. After one hundred days, nests finally cleared. Specifically took Liu Jun Zi Tang (Six-Gentlemen Decoction) and Ba Wei Wan (Eight-Ingredient Pellets) continuously for a year.
Wu Fuxian treated Western merchant Wang Mou, constitution very dense, suffering from Retained Drinking, feeling better after defecation, hardness/fullness below heart, bright nasal color, deep pulse. This indicated Retained Drinking wanting to exit but unable to completely leave. Used Gan Sui (Kansui Root), Gan Cao (Licorice Root), Ban Xia (Pinellia Tuber), Bai Shao (White Peony Root), add five spoons of white honey, taken in one dose. Previous symptoms all resolved. Asked: Gan Sui and Gan Cao have contrary natures; using them causes no harm but achieves effect, why? Answer: Precisely because their natures are contrary, making them attack each other, achieving the function of dredging and draining. (Western people have dense constitutions, especially suitable for this.)
Zhang Jingyue's father, fond of drinking in early years, by age forty developed Phlegm-Drinking disease: vomiting sour, distension/fullness, decreasing diet, vertigo unable to support, palpitations,恍惚 (trance/confusion), Phlegm-Malaria etc. emerged successively. Hundred remedies for phlegm ineffective. Admiring Zhang Hezi's vomiting method, he followed it. Initially used Du Sheng San (Unique Holy Powder), Cha Tiao San (Tea-Regulating Powder) and similar juices. One vomiting slightly effective, second vomiting more effective, thus used repeatedly. Although symptoms gradually retreated, Yuan Qi (Primal Qi) did not recover. For over a year, became proficient, suddenly understood the principle, completely stopped using medicine. Only when waking at fifth watch (3-5 AM), lying supine, used belching to lift Qi. If Qi insufficient, swallowed air to belch, lifting as swallowing, phlegm-saliva must follow Qi. Even deepest phlegm could be extracted. The last exiting ones had purple color/smell/taste, extremely sour and foul. After vomiting, lips/throat sometimes swollen/painful, rinsed/swallowed with one or two mouthfuls cool water to relieve. After vomiting, early meal, avoided five flavors, ate one or two bowls of thin porridge to nourish Stomach Qi. Since age forty, absolutely no alcohol. Practiced vomiting method for over forty years. From age sixty, practiced once a month or half-month. After vomiting, spirit/Qi doubled, Yang path vigorous, all internal injuries and external infections completely expelled. Dao uses Du Mai (Governor Vessel), this uses Ren Mai (Conception Vessel). Different methods, same destination. Not only expels disease, but extends life. Until over eighty, still able to climb mountains, copy ancient books by lamplight, died without illness. (Ye Tianshi said: According to Zhang Hezi's *Ru Men Shi Qin*, all diseases entering from outside or arising from inside are Evil Qi. Evil Qi added to the body, attack quickly is good. But hearing attack makes them unhappy, hearing tonification makes them happy. Only for those without evil/accumulation can tonification be discussed. Discussing tonification for those with evil/accumulation is like Gun damming floods. Thus established Sweating, Vomiting, Purging three methods to remove disease. Disease in exterior sweat it, above vomit it, below purge it. Prioritize disease removal, after disease removal, tonify with grains/meat/fruits/vegetables, not medicine. Jingyue speaks of Zhang Hezi's vomiting miracle, unaware Sweating/Purging methods are more miraculous. However, vomiting is only for above, not universally applicable. Also has a Tonification Essay, greatly speaking of harm of mistaken tonification. Only quack doctors treat disease, purely discussing tonifying deficiency, dare not treat excess. World thinks it steady and harms themselves. Jingyue only sees vomiting method, does he see the Tonification Essay? Zhang Hezi's learning also follows He Jian, Dong Yuan, Dan Xi, transmitting great use of cold/cool attacking to treat disease, absolutely no tonification, as tonification is sufficient harm. Jingyue values Zhang Hezi and destroys He Jian/Dan Xi, does Zhang Hezi have another warm-tonifying book, or dare not discuss their errors?)
Zhang Sanxi treated a man, shoulder/back pulling pain to knees, Cun pulse wiry, knew it was Phlegm-Drinking disaster. Administered Xiao Wei Dan (Small Stomach Pellets) one dose, vomited half sheng of phlegm. Every other day advanced one dose, purged small amount of glue-like phlegm about one sheng, disease largely healed.
Zhang Hezi treated a man suffering from Retained Drinking for decades without cure. Diagnosed: Left Cun pulse three positions all micro and small, Right Hand pulse three positions all slippery and large. Micro/small indicates Cold, Slippery/large indicates Dryness. Used Gua Di San (Melon Sepal Powder) to vomit several sheng of Cold-Phlegm, sweating profusely. Then used Dao Shui Yu Gong (Water-Dredging Yu Gong) to remove intestinal dry filth also several sheng, person half recovered. Then used phlegm agents to drain remaining essence, used fire-descending agents to open stomach gate, recovered within one month.
Zhu Danxi treated a man, addicted to wine, suffering from joint swelling/pain all over body, this heals while that worsens, chest/diaphragm not wide. This is Wine-Dampness Syndrome, Phlegm-Drinking in Stomach, flowing into meridians, i.e., Flowing Drinking Syndrome. Used Er Chen Tang (Two-Aged Decoction) added with Jiu Qin (Wine-processed Coptis), Cang Zhu (Atractylodes Rhizome), Qiang Huo (Notopterygium Rhizome), Wei Ling Xian (Clematis Root), Ze Xie (Alisma), double Ge Gen (Kudzu Root) and recovered.
Xu Shimwei himself suffered from Drinking for thirty years. Initially because young night sitting writing, leaning left on desk, so food mostly fell to left side, midnight must drink several cups of wine, also slept left. Young strength unaware, three-five years later, felt wine sound from lower left, hypochondriac pain, decreased diet,嘈杂 (burning/discomfort), stopped drinking after half cup. Every ten-plus days must vomit several sheng of sour water. Summer months only right side sweats, left side absolutely none. Visited famous doctors and sea prescriptions, occasionally hit disease and recovered, returned after one month. Tonics like Tian Xiong (Aconite), Fu Zi (Prepared Aconite Child Root), Fan Shi (Alum), purges like Qian Niu (Morning Glory Seed), Gan Sui (Kansui Root), Da Ji (Spurge Root), tried all. Self-assumed must have sacs/nests, like water having basins, not filling basin not flowing, only clear can flow, turbid stagnates, no way to drain, so accumulation every five-seven days must vomit away. Spleen Earth hates Dampness, Water does not flow, better to dry Spleen to remove Dampness, build Earth to fill basins. So made Cang Zhu Wan (Atractylodes Pellets), took three months and disease removed. Cang Zhu one jin (approx. 500g), peel skin, slice, powder, use white sesame half liang (approx. 15g), water cup grind filter extract juice, jujube fifteen pieces, rotten boil peel pit, mix sesame juice evenly grind into thin paste, search and mix into mortar ripe pound, pellet like tung zi (tung seed) size, dry. Daily empty stomach warm water swallow fifty pellets, add to hundred pellets. Avoid peach, plum, sparrow, pigeon. Initial服用 must chest slightly dry, and use Mao Zhu (Wild Atractylodes) to process, feel very dry then advance Shan Zhi San (Gardenia Powder) one dose, long time then not dry. Shan Zhi San uses only Shan Zhi (Gardenia Fruit), dry powder, boiling water point serve.
Ma Yuanyi treated Shen Biao's nephew, due to sorrow and labor, face withered pale, body emaciated, right hypochondrium mass, knotting pain, pain causes vomiting, extremities cold, no desire for food, stool sometimes loose sometimes bound, vomiting Phlegm-Drinking, often fills basin, either once daily or every other day, suffering ten thousand states. Diagnosed pulse: Left three positions wiry and tense, Right three positions deficient micro powerless. Formula used Fu Zi Li Zhong Jia Gui Tang (Aconite Regulate Middle Add Cinnamon Twig Decoction), slightly stable. Three days later relapsed, former formula not responding, then doubled Fu Zi, very stable. Later relapsed, former formula not responding. Recalled Zhang Zhongjing Shang Han treatment method, there is Zhen Wu Tang (True Warrior Decoction) method, originally because True Fire flying away, Water Qi reversing upward, thus use this to restore Yang gather Yin, sit guard Shaoyin North position. Investigating its function, entirely lies in moving Water awakening Spleen wonder. Now due to labor/depression injury, Middle Qi severely damaged, thus conquering Wood attacks Spleen, conquered Water insults and reverses. Wood horizontal then obstruction/vomiting, Water reverse then Phlegm-Drinking flooding. If not Zhen Wu, how to capture Primal Yang and suppress Yin Evil? So used this formula doubled dosage, added much Ren Shen (Ginseng), continuously advanced thirty-plus doses, vomiting gradually stopped, phlegm gradually less. Instructed morning take Ba Wei Wan (Eight-Ingredient Pellets), evening take Fu Gui Li Zhong Wan (Aconite Cinnamon Regulate Middle Pellets) to regulate, all symptoms completely healed. Only mass not removed, because long accumulated Yin Cold hard to resolve, fear becoming stubborn disease. (Using Zhen Wu Tang very legal, but adding much Ren Shen somewhat follows custom. Because Ren Shen nature sticky/stagnant, most unsuitable for Drinking disease. This disease after Yuan Qi recovers, should intermittently use attacking agents to exhaust root, merely doing warm tonification, how can hope mass removal?)
Miao Zhongchun treated Danyang Ge Wenxue's wife, due to housework labor/depression suffered Drinking, often vomiting endlessly, intestines like wanting to exit, vomited all clear water, often counted by basin/bucket, day and night non-stop, no desire for food. Seek doctor in Jintan, many physicians use strengthen Spleen move Qi, regulate depression clear phlegm medicines administered, worsened, exhausted waiting for death, no plan left. Miao viewed pulse examined disease, knew it was Drinking undoubtedly, then used Ginger-processed Ban Xia (Pinellia Tuber) four liang, Guang Pi (Tangerine Peel) four liang, Fu Ling (Poria) four liang, Zhu Ling (Polyporus) two liang, Ze Xie (Alisma) rice water soak stir-fry two liang, Xuan Fu Hua (Inula Flower) three liang, Hou Po (Magnolia Bark) ginger juice stir-fry one liang five qian, Bai Zhu (Atractylodes Macrocephala Rhizome) two liang, Zhi Shi (Immature Bitter Orange) flour stir-fry one liang, Chuan Lian Zi (Toosendan Fruit) one liang, Mu Xiang (Aucklandia Root) five qian, add Ren Shen (Ginseng) one liang three qian. One dose vomiting stops, second dose sudden recovery, immediately eat porridge/gruel, Spleen Qi gradually recovers. To this day every disease flare, check formula take it then calm. (This is pill formula, use thin rice paste add ginger juice mix pellet like mung bean size, each take five qian, light ginger water down. If make decoction, take one-twentieth of twenty times, add Bai Dou Kou (Cardamom) powder, Mu Xiang juice, ginger juice mix serve. Due to Cold-Damp add Cang Zhu two liang, Mu Xiang five qian, Bai Dou Kou five qian. Due to Depression add Zi Su (Perilla Leaf) four qian, remove Cang Zhu.)
Yunjian Kang Mengxiu suffered Cold/Hot non-eating, long time condition critical, use Cold/Hot treatment agent administer not responding. Search prescription books, discuss with Wang Yutai administer Wu Yin Wan (Five Drinking Pellets) immediately recover. Because Drinking disease originally has making Cold/Hot clause, thus treat Drinking, disease naturally retreats. (From *Guang Bi Ji*.)
Wu Qiao treated Wang Qian, initially strong immediately suffer vomiting/reversal, chest/diaphragm pain, many physicians all treat as Diaphragm disease, bone standing and emaciated, long time then cut off, sweat like flowing, water/gruel cannot enter mouth. Diagnose pulse, just floating soft not bear press, no other end, say: This is Retained Drinking. Mistakenly treat as Diaphragm disease, patient heart palpitation then Qi stucks in chest, blood follows Qi movement, Qi blocked then blood also blocked. This is two jars hitting bell confusion. First screen two jars, then treat it, Blood Stasis must descend. Patient puzzled interval, say: Respectfully follow your words, then practice Xing Qi (Move Qi) one dose drink, drink not finished then pain stops, slowly pass black stool, Blood Stasis finished, disease then calm. (From *Tai Han Ji*.)