碗。病因饮水不节,或积病发,又饮冷水,伤胃成虚,伤肺成痰。白术一钱半,人参、陈皮、川芎各一钱,白
芍、黄芩、桔梗、炙草各五分,作二帖,煎取八分,入竹沥二分,再煎沸,热饮,下龙荟丸二十丸,如嗽三十丸。
立斋治一妇人,素勤苦,冬初,患咳嗽发热,久而吐血盗汗,经水两三月一至,遍身作痛。或用化痰降火,
口噤筋挛。此血虚而药损耳,遂用加减八味丸,及补中益气加参、冬、五味、山药治之,年余而愈。
柳叔度言∶吾养生无他术,但不以元气佐喜怒,使气海常温耳。今人既不能不以气海佐喜怒矣。若能时灸
气海使温,亦其次也。予旧多病,常苦气短,医者教灸气海,气遂不促。自是每岁须一二次灸之,以气怯故也。
(《资生经》。)
罗谦甫云∶丙辰秋,楚邱县贾君次子二十七岁,病四肢困倦,躁热自汗,气短,饮食减少,咳嗽痰涎,胸
膈不利,大便闭,形体羸削,一岁间更数医不愈。或曰∶明医不如福医,某处某医,虽不精方书,不明脉候,
看症极多,治无不效,人因之曰福医。谚曰∶饶你读得王叔和,不如我见过病症多。颇有可信,试令治之。医
至,诊其脉曰∶此病予饱谙矣,治之必效。于肺 各灸三十壮,以蠲饮枳实丸消痰导滞,不数服,大便溏泄无
度,加腹痛,食不进,愈添困笃。其子谓父曰∶病久瘦弱,不任其药,病剧卒。冬,予从军回,其父以告予。
予曰∶《内经》云,形气不足,病气不足,此阴阳俱不足,泻之则重不足。此阴阳俱竭,血气皆尽,五脏空虚,
筋骨髓枯,老者绝减,壮者不复矣。故曰不足,此其理也。令嗣久病羸瘦,乃形不足,气短促,乃气不足。病
渐作,时嗜卧,四肢困倦,懒言语,乃气血皆不足也。补之惟恐不及,反以小毒之剂泻之,虚之愈虚,损之又
损,不死何待?贾君叹息而去。予感其事,略陈其理∶夫高医愈疾,先审岁时太过不及之运,察人血食布衣勇
怯之殊。病有浅深,在经在脏之别;药有君臣佐使,大小奇偶之制;治有缓急,因用引用返正之则。孙真人云∶
凡为太医,必须谙《甲乙》、《素问》、《黄帝针经》、明堂流注、十二经、三部九候、五脏六腑、表里孔穴、
本草、药对、仲景、叔和诸部经方。又须妙解五行阴阳,精熟《周易》,如此方可谓太医。不尔,则如无目夜游,
动致颠殒。正五音者,必取师旷之律吕,而后五音得以正;为方圆者,必取公输之规矩,而后方圆得以成。五
音方圆,特未技者,尚取精于其事者,况医者人之司命,列于四科,非五音方圆之比。不精不医,不通不脉,
不观诸经本草,幸而运通命达,而号为福医,病家遂委命于庸人之手,岂不痛哉。噫!医者之福,福于渠
者也。渠之福,安能消病者之患焉?世人不明此理,而委命于福医,至于伤生丧命,终不能悟,此惑之甚者也,悲夫!
薛立斋云∶辛丑年,余在嘉兴屠渐山第,有林二守,不时昏愦,请治之。谵语不绝,六脉按之如无,此阳
虚之症也,当用参附汤治之。有原医者,阳喜而迎曰∶先得我心之同然,遂服之,即静睡,觉而进食。午后再
剂,神思如故,其脉烦敛。余返后,又诈云∶用附子多矣,吾以黄连解之,阴仍用参附汤。观仲景先生治伤寒
云∶桂枝下咽,阳甚即毙;硝、黄入胃,阴甚乃亡。不辨而自明矣。吾恐前言致误患者,故表而出之。
薛甥居宏,年十四而娶,至二十,形体丰浓,发热作渴,面赤作胀。或外而砭血,内用降火,肢体倦
怠,痰涎愈多,脉洪数鼓指。用六味丸及大补汤加麦冬、五味而痊。
马元仪治汪周拔子,患弱症经年,诸治不效。诊其脉,两寸浮大而虚,关尺虚小,咳嗽梦泄,面色枯白,
不任风寒,曰∶两寸浮虚,卫外之真阳不固;两尺虚涩,肾中之真阳亦弱。较阴虚咳嗽之症,不啻天渊。拟玉
屏风散,多加人参,以益真气而充腠理。不数剂,而咳嗽渐已,稍可当风。兼令早进七味丸,以养肾气而主蛰
藏;兼服大造归脾丸,补心脾而充血气。如是调两月而安。
何继武患寒热躁烦,足冷如冰,汗出如注,两脉虚微。形气病气,俱属不足,责之脾肾二经亏损,虚寒内
伏。虽见寒热,有似表邪,而躁烦自汗足冷,已兆虚阳欲脱之机。况两脉虚微,尤非表邪可散之比。若行表散,
是速其阳之亡也。法当大温大补,和养中州,生发阳气,方可图愈。因与附子理中汤二大剂,汗止足温,寒热
渐已,数剂霍然。
沈氏仆恶寒发热,时躁烦,两脉空大,自觉气从耳鼻冲出,洞然若无关闸,此脾肺亏损,阴火内动也。凡
人受天之气,必先入肺,乃行于下,其别气走于耳,宗气出于鼻,亦从胸中注于肺,以行其上,是肺实居气之
要路,以行治节。肺脏亏损,则气之出入皆失其常,法当补脾敛肺,而气自治矣。黄 、白术各五钱,炙草、
防风各一钱,二剂,脉稍敛,热稍减,四剂而燥已,耳鼻间气治如常。再以七味地黄丸,补养水脏而愈。
王维春年三十,携妓纵恣月余,内虚之下,不耐烦暑,当夜露坐,明日遂寒热躁烦,自汗不止,面赤如妆,
两脉虚微。此阴虚阳暴绝也,非夏月伤暑,脉虚而身热自汗之比。若行表散,气浮不返矣。用人参一两,附子
二钱,回阳返本。服后,汗止神清,躁烦俱息。明日诊之,两脉转为洪数,但重按少力,此脉症无可虑矣。但
阴虚之极,恐阳气无偶,终亦散亡,治法不可救阳而贼阴,但当养阴以恋阳,得其平而已。用生首乌、人参、
甘草、橘红、黄芩、知母等,四剂寒热平而愈。
张子和曰∶尝过鸣鹿邸中,闻有人呻吟声息,瘦削痿然无力。余视之,乃五虚症,急以圣散子二帖作一服
服之,此症非三钱二钱可塞也。续以胃风汤、五苓散等各作大剂,使顿服,注泻方止,而浆粥入胃,不数日而
其人起矣。故五虚之人,不加峻塞,不可得实也。庸工治症,草草补泻,如一杯水救一车薪之火,竟无成功,
反曰虚者不可补,实者不可泻,此何语也?吁!不虚者强补,不实者强攻,自是庸工不识虚实之罪,岂有虚者
不可补,实者不可泻哉?(五虚者,脉细、皮寒、少气、泄利前后、饮食不入也。)
缪仲淳治陆作先乃正,咳嗽饱胀痰喘,水火不通,眠食俱废。人参君、白芍臣、苏子炒研极细佐、枇杷叶三
大片、茯苓使,二服得眠,大小便通,啖粥。(《广笔记》。)
湖广张仲虎,客邸耽于青楼,且多拂意之事,至冬底,发大寒热咳嗽。吴中医者,皆以外感治之,发表和
解,无不遍试。毛子晋拉缪视之,见其神色消耗,脉气虚,数中时复一结,咳嗽有血,卧不贴席。缪谓子晋曰∶
此阴虚内伤症也。阴精亏竭,故脉见虚数;内有瘀血,故结脉时见;肺肝叶损,所以卧不能下。此不治之症,
况误认外感,多服发散,复蹈虚虚之戒耶。不数日而殁。
太学许韬美,形体卑弱,神气短少,且素耽酒色,时常齿衄。辛未春,偶患右乳傍及肩背作痛异常,手不
可近,扪之如火,日夜不眠。医以内伤治之,服桃仁、红花、乳、没、延胡、灵脂等药,二十余剂不效。诊之,
六脉虚数,肝肾为甚,断为阴虚火旺之症,当滋阴养血,扶持脾胃,俾阴血渐生,虚火降下,则痛不求止而止
矣。如必以和伤治痛为急,则徒败胃气,克削真元,非所宜也。用生地、丹皮、白芍、牛膝、枸杞、续断、石
斛、甘草、桑枝、麦冬、苏子,嘱其服十剂方有效,以阴无骤补之法也。八剂后复诊,其脉气渐和,精神渐旺,
虽痛未尽除,而生机跃然矣。惜其欲速太过,惑于群小,复以前药杂进。一月后,胃气果败,呕逆,阴血愈耗,
潮热腹胀,再半月而死。
顾季昭患阴虚内热,仲淳曰∶法当用甘寒,不当用苦寒,然非百余剂不可,慎勿更吾方。欲加减,使吾徒
略加增损可也。果百剂而安。天冬、麦冬、桑皮、贝母、枇杷叶、白芍、苏子、车前各二钱,地骨皮、鳖甲各
三钱,五味子一钱。
姚公远内子病,延仲淳入诊,其继母乘便亦求诊。仲淳语伯道曰∶妇病不足虑,嫂不救矣。闻者骇甚,曰∶
吾方新婚,亡大恙,何至是耶?仲淳曰∶脉弦数,真弱症也。不半岁,夜热咳嗽,势渐剧,仓皇扩展淳至,疏
方与之,曰∶此尽余心尔,病不起矣。逾年,医家百药杂试,竟夭。(《广笔记》。)
瞿元立夫人素清 ,不耐烦劳。一日谓仲淳曰∶弟妇未生子而弱,烦兄为诊其故。次日仲淳往,诊得其脉
细无神。赵文肃公问曰∶兄从元立许来,诊其嫂得何脉?曰∶今虽无恙,必不久矣。文肃顿足曰∶有是哉!天
胡厄善人甚耶。此丙戌四月事也,至秋,夫人殁。(同上。)
祝氏妇年五十余,患中满腹胀,兼崩漏下,清上则下虚弥甚,实下则上胀弥甚。仲淳为立二方∶以苏子、
石斛、陈皮、贝母、元参、人参、白芍治其上,以地榆、阿胶、木瓜、牛膝、杜仲、茜根、椿皮治其下,各为
丸,分食前后服之,寻愈。(同上。)
来天培治周殿先室,年近古稀,每病胸中痞塞背寒,或时气逆呕吐,有块在胸下,饮食不思,数日稍痊。
或用山栀、黄连、木香、香附、吴萸等药,勿效。诊之,六脉浮细而软。曰∶此肝肾气虚上逆之症,宜滋肝益
肾,养血扶脾,引火归源之剂。用牛膝、泽泻、归、芍、枸杞、茯苓、山药、萸肉、沉香、肉桂,二剂诸症霍
然。后复作,服此即痊。
有士人观书忘食,有紫衣人立前曰∶公不久思,思则我死矣。问其何人。曰∶我谷神也。于是绝思,而食
如故。(《医说续编》。)
吴桥治方生,年二十五,内而早起,枵腹而服劳,无何而发热头痛。医以为内热,乃用清凉。三日,
汗流昏愦欲绝。桥诊六脉,皆不应指,甚则微若蛛丝,语其父曰∶郎君甚危,此虚脱也,急宜重剂温补,即稍
缓无及矣。父惟唯唯,一剂而愈,近日乃大安。(《太函集》。)
方勉孝丁年病孱,面生赤,食与肌降序矣,即内即遗皆不害。或病作,日三四,溺亦如常。第多一行,则
自项领以上,凡在头颅面目发肤,忽若崩颓,昏眩不支,嗒焉欲丧。递进补剂,久而无功也。桥诊之,心肾微
数无力,曰∶病得之既内而临小溲,忽受惊恐,法当分治。病者俯首唯唯,于是早剂补肾,晚剂补心,旬月而
愈。(同上。)
琼玉膏,治虚劳干咳。生地自然汁四斤,白茯苓十二两,白蜜二斤,人参六两。( 仙加沉香、血珀各一
钱五分。)上以地黄汁同蜜煎沸,用绢滤过,将参为细末,入煎汁和匀,以瓷瓶用绵十数层,加箬叶封好,入砂
锅内,以长流水浸没瓶颈,桑柴火煮三昼夜,取出纸封扎口,以蜡封固,悬井中一日取出,仍煮半日,汤调服。
徐灵胎曰∶此为血症第一方。干生地四两浸透,可取自然汁一两,若淅地则十斤,只取自然汁一斤,须三十斤方
可配诸药,故修之方,必随时地交通也。
集灵膏,西洋参,刮去皮,饭上蒸,晒干九次,杞子、怀牛膝酒蒸、天冬、麦冬、怀地、仙灵脾等分熬膏,
白汤或温酒调服。此方始见于《广笔记》,无仙灵脾,云出内府。又于《治法汇》并无牛膝,方后注血虚加当
归,脾虚加白术,且云治一切气血虚,身热咳嗽者,皆获效。凡少年但觉气弱倦怠,津液短少,虚火上炎,正
合服之,免成劳病。《理虚元鉴》治咳嗽,去参、膝,加杞子、甘、桔、元参,峻补肝肾之阴,实无出此之上者。
十灰散,治吐血,咯血,嗽血,先用此药止之。大蓟、小蓟、荷叶、侧柏叶、白茅根、茜草根、栀子、川
大黄、丹皮、棕榈皮等分,烧灰存性,研极细末,以纸包,置泥地上一夕出火毒。每服五钱,藕汁或莱菔汁,
或京墨汁半碗调服。周杨俊云∶治吐血者,首推葛氏。而先以此方止血,明明劫剂,毫无顾忌,细玩始知先生
意之到,理之深也。人生于阳,根于阴,阴气亏则阳自胜,上气为之喘促,咳吐痰沫,发热面红,无不相因而
生。故留得一分自家之血,即减得一分上升之火,易为收拾。何今日之医,动以引火归经为谈,不可概用止血之
味。甚至有吐之为美,壅反为害之说,遂令迁延时日,阴虚阳旺,煎熬不止,至于不救,果谁之咎乎?引经而
缓时日,冀复元神,有形之血,岂能使之即生?而无偶之阳,何法使之即降?此先生所以急于止血之大旨也。
雄按∶诸药烧灰,皆能止血,故以十灰名方。但止涩之品,棕榈一味,余皆清热行滞破瘀之器,难保止
血而无兜涩留瘀之弊。雄每用之,并无后患,何可视为劫剂乎?
太平丸,治久咳嗽,肺痿肺痈。天冬、麦冬、知母、贝母、款冬花各二两,杏仁、当归、熟生地、黄连各
二两五钱,蒲黄、京墨、桔梗、薄荷各一两。上十四味,研细末和匀,以白蜜四两,于银石器中炼熟,再入阿
胶二两五钱,俟烊后,下诸药末搅匀,再入麝香少许,熬三五沸,即弹丸子大。食后细嚼一丸,薄荷汤缓化下。
临卧噙此丸仰卧,使药气入肺窍,则肺清嗽止。凡咳嗽服此,七日即痊。
Bowl. The etiology is unregulated water intake, or the onset of accumulation disease followed by drinking cold water, damaging the Stomach to cause deficiency, and damaging the Lung to produce phlegm. Baizhu (Atractylodis Macrocephalae Rhizoma) 1.5 qian, Renshen (Ginseng Radix), Chenpi (Citri Reticulatae Pericarpium), Chuanxiong (Chuanxiong Rhizoma) each 1 qian, Baishao (Paeoniae Radix Alba), Huangqin (Scutellariae Radix), Jiegeng (Platycodonis Radix), Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata) each 0.5 qian. Prepare as two doses, decoct to obtain 8 fen of liquid, add Zhuli (Bambusae Sap) 2 fen, boil again, drink hot, and take Longhui Wan (Longhui Pill) 20 pills; if cough is severe, take 30 pills.
Lizhai treated a woman who was usually diligent and hardworking. In early winter, she suffered from cough and fever. After a long time, she developed hemoptysis and night sweats, her menstruation occurred only once every two or three months, and her whole body ached. Someone used methods to resolve phlegm and descend fire, which resulted in lockjaw and tendon spasms. This was blood deficiency damaged by medication. He then used Jiajian Bawei Wan (Modified Eight-Ingredient Pill) and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Renshen (Ginseng Radix), Dongqu (Dongchong Xiacao, Cordyceps), Wuweizi (Schisandrae Chinensis Fructus), and Shanyao (Dioscoreae Rhizoma) to treat her. She recovered after more than a year.
Liu Shudu said: "My method of health preservation has no other trick, but simply not allowing Yuanqi (Primal Qi) to assist anger and joy, so that the Qihai (Sea of Qi, CV6) remains warm. Now that people cannot help but use Qihai to assist anger and joy, if they can moxa Qihai occasionally to keep it warm, that is also a secondary method." I used to be often ill and often suffered from shortness of breath. A doctor taught me to moxa Qihai, and my breathing ceased to be rapid. Since then, I have needed to moxa it once or twice a year because of my weak Qi. (Zisheng Jing.)
Luo Qianfu said: In the autumn of Bingchen year, the second son of Merchant Jia from Chuqiu County, aged twenty-seven, suffered from fatigue in the four limbs, irritability and heat, spontaneous sweating, shortness of breath, decreased appetite, cough with sputum, chest and diaphragm discomfort, constipation, and emaciation. He had seen many doctors over a year without recovery. Someone said: "Famous doctors are not as good as 'Fortunate Doctors' (doctors lucky in practice). Doctor X at place Y, although not proficient in medical books and unfamiliar with pulse diagnosis, sees many cases and treats them all effectively, so people call him a Fortunate Doctor. The proverb says: 'Even if you have read Wang Shuhe's [Maijing], it is not as good as seeing many diseases myself.' This is quite credible; let us try letting him treat it." The doctor arrived, palpated his pulse, and said: "I am very familiar with this disease; treatment will certainly be effective." He moxed Feishu (BL13) thirty zhuang on each side, used Juan Yin Zhishi Wan (Juan Yin Zhishi Pill) to resolve phlegm and guide stagnation. After a few doses, he had profuse loose stools, abdominal pain, could not eat, and became increasingly weak and critical. His son said to his father: "The illness has been long, he is thin and weak, and cannot tolerate the medicine. The condition worsened, and he died." In winter, I returned from military service, and his father told me. I said: "The Neijing states: If both form-Qi and disease-Qi are insufficient, this indicates insufficiency of both Yin and Yang. To purge would be to increase the insufficiency. This is exhaustion of both Yin and Yang, depletion of blood and Qi, emptiness of the five Zang organs, and withering of tendons, bones, and marrow. The elderly will perish, and even the strong will not recover. Thus, it is called insufficiency; this is the principle. Your son has been ill for a long time and is emaciated, which is insufficiency of form; shortness of breath is insufficiency of Qi. As the disease progressed, he desired sleep, felt fatigue in the four limbs, and was reluctant to speak, indicating insufficiency of both blood and Qi. One should supplement, fearing it is not enough, yet instead small toxic purgatives were used. The deficient became more deficient, and the damaged more damaged. How could he not die? Merchant Jia sighed and left. I was moved by this incident and briefly expounded the principle: Excellent physicians, when curing diseases, first examine the excess or deficiency of seasonal influences, and observe the differences in constitution based on diet, clothing, and courage. Diseases have depth, differing between meridians and Zang organs; medicines have Sovereign, Minister, Assistant, and Envoy roles, and varying sizes and odd/even formulations; treatments have urgency, following principles of guidance and return to normality. Sun Simiao said: 'To be a Grand Physician, one must master the Jiayi Jing, Suwen, Huangdi Zhenjing, Mingtang Liuzhu, Twelve Meridians, Three Regions and Nine Pulses, Five Zang and Six Fu organs, interior-exterior acupoints, Bencao, Drug Pairs, Zhang Zhongjing and Wang Shuhe's classic formulas. One must also profoundly understand Five Phases and Yin-Yang, and be proficient in the Zhouyi. Only then can one be called a Grand Physician. Otherwise, it is like wandering at night blindfolded, inevitably stumbling and falling. To correct the five tones, one must take Shi Kuang's pitch pipes as standard, so the five tones become correct; to make squares and circles, one must take Gongshu Ban's compasses and set squares as standard, so squares and circles are formed. The five tones and shapes are merely skills, yet still require experts in their field. How much more so for physicians, who hold the lives of men, ranked among the four disciplines, incomparable to tones and shapes? Without proficiency, one cannot practice medicine; without understanding, one cannot feel the pulse. Without studying the classics and materia medica, even if fortunate in luck and destiny and hailed as a 'Fortunate Doctor,' patients entrust their lives to incompetent hands. Is this not painful? Alas! A physician's fortune lies in himself. His personal fortune cannot eliminate the patient's disaster. People do not understand this principle and entrust their lives to 'Fortunate Doctors,' leading to injury and death, yet never realizing their error. This is a great delusion, how sad!"
Xue Lizhai said: In the Xinchi year, I was at the residence of Tu Jianshan in Jiaxing. Lin Ershou suffered from occasional confusion and dizziness. I treated him. He had continuous delirious speech, and his six pulses were imperceptible upon pressure. This is a symptom of Yang deficiency, and should be treated with Shenfu Tang (Ginseng and Aconite Decoction). The original physician, pleased with Yang-tonifying herbs, welcomed it saying: "You have expressed what I thought." He took it, fell into quiet sleep, woke up, and ate food. After another dose at noon, his spirit remained normal, but his pulse became restless and constricted. After I returned, he falsely claimed: "I used too much Fuzi (Prepared Aconite Root); I used Huanglian (Coptidis Rhizoma) to counteract it, but still used Shenfu Tang for Yin." Looking at Zhang Zhongjing's treatment of Shanghan (Cold Damage): "Once Guizhi Tang (Cinnamon Twig Decoction) enters the throat, if Yang is excessive, death ensues; once Muxie and Dahuang (Rhei Radix et Rhizoma) enter the stomach, if Yin is excessive, death ensues." This clarifies matters without need for debate. I fear my previous words misled the patient, so I state this clearly.
Xue's nephew Ju Hong married at fourteen. By age twenty, his body was plump, he had fever and thirst, red face, and distension. Someone used external bloodletting and internal fire-descending methods. His limbs became fatigued, sputum increased, and his pulse was surging, rapid, and forceful. He recovered using Liuwei Wan (Six-Ingredient Pill with Rehmannia) and Dabu Tang (Great Tonifying Decoction) added with Maidong (Ophiopogonis Radix) and Wuweizi (Schisandrae Chinensis Fructus).
Ma Yuanyi treated the son of Wang Zhuba, who had suffered from a wasting syndrome for a year with no effect from various treatments. Palpating his pulse, the Cun positions on both sides were floating, large, and empty; Guan and Chi positions were empty and small. He had cough and nocturnal emission, withered white complexion, and intolerance to wind and cold. Ma said: "Floating and empty Cun positions indicate insecure Wei Yang (Defensive Yang) protecting the exterior; empty and choppy Chi positions indicate weak True Yang in the Kidney. Compared to cough due to Yin deficiency, the difference is vast. I prescribed Yupingfeng San (Jade Windscreen Powder) with added Renshen (Ginseng Radix) to benefit True Qi and fill the Couli (pores). After a few doses, the cough gradually stopped, and he could tolerate wind slightly. He was also instructed to take Qiwei Wan (Seven-Ingredient Pill) early in the day to nourish Kidney Qi and govern hibernation/storage; and take Dazao Guipi Wan (Great Creation and Spleen-Tonifying Pill) to tonify Heart and Spleen and replenish blood and Qi. After regulating for two months, he stabilized.
He Jiwu suffered from alternating chills and fever, irritability, feet cold as ice, profuse sweating, and empty, minute pulses on both sides. Both Form-Qi and Disease-Qi were insufficient, attributed to deficiency and decline of the Spleen and Kidney meridians, with latent deficiency-cold. Although chills and fever appeared resembling exterior pathogens, the irritability, spontaneous sweating, and cold feet indicated the mechanism of vacuous Yang about to escape. Moreover, the empty and minute pulses were far from those of an exterior pathogen that could be dispersed. If exterior-dispersing methods were used, it would hasten the loss of Yang. The method should be major warming and tonification, harmonizing and nourishing the Central Region, generating and raising Yang Qi, to hope for recovery. Therefore, Fuzi Lizhong Tang (Aconite and Magnolia Root Decoction) was given in two large doses. Sweating stopped, feet warmed, chills and fever gradually ceased, and after several doses, he recovered completely.
Shi's servant suffered from aversion to cold and fever, occasional irritability, empty and large pulses on both sides, and felt Qi rushing out from nose and ears, seemingly without gates. This is Spleen and Lung deficiency with internal movement of Yin Fire. When humans receive Heaven's Qi, it first enters the Lung, then moves downward. Its branch Qi goes to the ears, and Zong Qi (Gathering Qi) emerges from the nose, also flowing from the chest into the Lung to move upward. Thus, the Lung occupies the crucial path of Qi, governing regulation. Lung deficiency causes abnormal entry and exit of Qi. The method should tonify Spleen and astringe Lung, so Qi regulates itself. Huangqi (Astragali Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma) each 5 qian, Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata) and Fangfeng (Saposhnikoviae Radix) each 1 qian. After two doses, the pulse slightly constricted, heat slightly reduced. After four doses, dryness ceased, and Qi flow from nose and ears normalized. Then, Qiwei Dihuang Wan (Seven-Ingredient Pill with Rehmannia) was used to nourish the Water Organ (Kidney), leading to recovery.
Wang Weichun, aged thirty, indulged with courtesans for over a month. Under internal deficiency, he could not bear summer heat. He slept exposed to dew at night. The next day, he suffered from alternating chills and fever, irritability, continuous spontaneous sweating, red face like makeup, and empty, minute pulses on both sides. This is extreme Yin deficiency with sudden collapse of Yang, not comparable to summerheat injury in summer where pulse is empty, body hot, and sweating occurs. If exterior-dispersing methods were used, floating Qi would not return. Ren Shen (Ginseng Radix) 1 liang and Fuzi (Prepared Aconite Root) 2 qian were used to restore Yang and return to the root. After taking it, sweating stopped, spirit cleared, and irritability ceased. The next day, the pulse turned surging and rapid, but weak upon heavy pressure. This pulse-symptom combination was no longer worrying. However, extreme Yin deficiency fears Yang having no companion, eventually dissipating. Treatment should not save Yang while harming Yin, but rather nourish Yin to retain Yang, achieving balance. Sheng Shouwu (Polygoni Multiflori Radix), Renshen (Ginseng Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Juhong (Citri Reticulatae Pericarpium Rubrum), Huangqin (Scutellariae Radix), and Zhimu (Anemarrhenae Rhizoma) were used. After four doses, chills and fever normalized, and he recovered.
Zhang Zihe said: I once passed through the Mingu Mansion and heard groaning sounds. The person was emaciated, flaccid, and powerless. I viewed him and saw it was Wuxu Syndrome (Five Deficiencies). I urgently gave Shengsanzi (Holy Dispersion Substances) two doses taken together. This condition cannot be filled with doses of three or two qian. Subsequently, Weifeng Tang (Stomach Wind Decoction) and Wuling San (Five-Ling Powder) were prepared in large doses and taken in one gulp. Profuse diarrhea stopped, gruel entered the stomach, and within a few days, the person rose. Thus, for those with Wuxu, without strong astringents, solidity cannot be achieved. Incompetent doctors treat symptoms with careless tonification or purgation, like saving a cartload of burning wood with a cup of water, achieving nothing, yet claiming "deficient cannot be tonified, excess cannot be purged." What nonsense! Forcing tonification on the non-deficient and forcing purgation on the non-excess is the fault of incompetent doctors failing to recognize deficiency and excess. How can it be said that the deficient cannot be tonified and the excess cannot be purged? (Wuxu refers to: fine pulse, cold skin, shortness of breath, diarrhea and urinary incontinence, inability to eat.)
Miu Zhongchun treated Lu Zuoxian's son, Lu Zheng, who suffered from cough, fullness, distension, phlegm, and wheezing, with obstruction of Water and Fire, and loss of sleep and appetite. Renshen (Ginseng Radix) as Sovereign, Baishao (Paeoniae Radix Alba) as Minister, Chao Yan Su Zi (Fried and Ground Perilla Seed) as Assistant, Pipaye (Loquat Leaf) three large slices, and Fuling (Poria) as Envoy. After two doses, he slept, bowel and bladder movements resumed, and he ate gruel. (Guang Biji.)
Zhang Zhonghu from Hubei, staying in an inn, indulged in brothels and experienced many frustrations. By late winter, he developed severe chills, fever, and cough. Physicians in Wu treated it as exterior contraction, using exterior-releasing and harmonizing methods, trying everything. Mao Zijin invited Miu to examine him. Miu saw his spirit and color were depleted, pulse Qi was weak, rapid with intermittent intermissions, cough with blood, and unable to lie flat. Miu told Zijin: "This is Yin deficiency with internal injury. Yin essence is exhausted, hence the weak and rapid pulse; internal blood stasis causes intermittent pulse; Lung and Liver lobes are damaged, hence inability to lie flat. This is an incurable condition. Moreover, mistaking it for exterior contraction and taking many dispersing agents repeats the mistake of damaging the deficient." He died within a few days.
Tai Xue Xu Taomei had a weak physique and short spirit. He usually indulged in alcohol and sex and often had epistaxis. In spring of Xinwei year, he suddenly suffered from severe pain in the right breast area and shoulder/back, intolerable to touch, feeling hot like fire, unable to sleep day or night. Physicians treated it as internal injury, administering Tao Ren (Persicae Semen), Honghua (Carthami Flos), Rush xiang (Boswellia), Moyao (Myrrha), Yanhusuo (Corydalis Rhizoma), and Lingzhi (Lantern Fish Bone) for over twenty doses without effect. Palpation showed weak and rapid pulses in all six positions, especially Liver and Kidney. It was diagnosed as Yin deficiency with hyperactive fire. The method should nourish Yin and tonify blood, support Spleen and Stomach, so Yin and blood gradually generate, and deficient fire descends, then pain stops without seeking to stop it. If one insists on treating pain by harmonizing injury, it merely damages Stomach Qi and depletes True Yuan, which is inappropriate. Sheng Di (Rehmanniae Radix), Dan Pi (Moutan Cortex), Baishao (Paeoniae Radix Alba), Niuxi (Achyranthis Bidentatae Radix), Gouqi (Lycii Fructus), Xuduan (Dipsaci Radix), Shihu (Dendrobii Caulis), Gancao (Glycyrrhizae Radix et Rhizoma), Sangzhi (Mori Ramulus), Maidong (Ophiopogonis Radix), and Su Zi (Perillae Fructus) were used. He was advised that ten doses are needed for effect, as Yin cannot be rapidly tonified. After eight doses, pulse Qi gradually harmonized, spirit strengthened. Although pain was not fully removed, vitality emerged. Regrettably, he was too impatient, confused by others, and mixed previous medicines. After a month, Stomach Qi failed, vomiting occurred, Yin blood further depleted, tidal fever and abdominal distension appeared, and he died half a month later.
Gu Jizhao suffered from Yin deficiency with internal heat. Zhongchun said: "The method should use Sweet-Cold herbs, not Bitter-Cold. However, it requires over a hundred doses. Do not change my prescription. If adjustments are desired, let my disciples make slight additions or subtractions." Indeed, he recovered after a hundred doses. Tiantong (Asparagi Radix), Maidong (Ophiopogonis Radix), Sangbai Pi (Moutan Cortex - *Note: Text says Sangpi, likely Sangbai Pi*), Beimu (Fritillariae Thunbergii Bulbus), Pipaye (Loquat Leaf), Baishao (Paeoniae Radix Alba), Su Zi (Perillae Fructus), Cheqian (Plantaginis Semen) each 2 qian; Digupi (Lycii Cortex), Biejia (Trionycis Carapax et Plastrum) each 3 qian; Wuweizi (Schisandrae Chinensis Fructus) 1 qian.
Yao Gongyuan's wife was ill. Zhongchun was invited to diagnose. Her stepmother also asked for a diagnosis. Zhongchun told Bodao: "The wife's illness is not worrying; the sister-in-law cannot be saved." Listeners were shocked. She said: "I just got married, have no major illness, why reach this point?" Zhongchun said: "Pulse is string-like and rapid; this is true weakness." Within half a year, night fever and cough worsened. In panic, they expanded the invitation to Zhongchun. He prescribed a formula, saying: "This is all my heart can do; the illness will not rise." Over a year later, various doctors tried hundreds of medicines, and she died prematurely. (Guang Biji.)
Qu Yuanli's wife was naturally clear and delicate, intolerant of labor. One day she told Zhongchun: "My sister-in-law is weak without having borne children; please brother diagnose the cause." The next day Zhongchun went and found her pulse fine and lacking spirit. Duke Zhao Wensu asked: "Brother came from Yuanli's house, what pulse did you find in your sister-in-law?" He said: "Although she is well now, she will not live long." Wensu stamped his foot and said: "Is this so! Why does Heaven afflict good people so severely?" This was in April of Bingxu year. In autumn, the wife died. (Ibid.)
Madam Zhu, over fifty years old, suffered from middle-fullness and abdominal distension, accompanied by metrorrhagia and leukorrhea. Clearing the upper makes lower deficiency worse; solidifying the lower makes upper distension worse. Zhongchun established two formulas: Using Su Zi (Perillae Fructus), Shihu (Dendrobii Caulis), Chenpi (Citri Reticulatae Pericarpium), Beimu (Fritillariae Thunbergii Bulbus), Yuan Shen (Scrophulariae Radix), Renshen (Ginseng Radix), and Baishao (Paeoniae Radix Alba) to treat the upper; using Diyu (Sanguisorbae Radix), Ejiao (Asini Corii Colla), Mugua (Chaenomelis Fructus), Niuxi (Achyranthis Bidentatae Radix), Duzhong (Eucommiae Cortex), Qian Gen (Rubiae Radix et Rhizoma), and Chunpi (Toosendan Cortex) to treat the lower. Each made into pills, taken before and after meals respectively. She soon recovered. (Ibid.)
Lai Tianpei treated the wife of Zhou Dianxian, near seventy years old. She often suffered from chest stuffiness and back cold, or occasional rebellious Qi with vomiting, with a mass below the chest, no desire for food, recovering slightly after a few days. Using Zhizi (Gardeniae Fructus), Huanglian (Coptidis Rhizoma), Muxiang (Aucklandiae Radix), Xiangfu (Cyperi Rhizoma), and Wuyu (Evodiae Fructus) had no effect. Palpation showed floating, fine, and soft pulses in all six positions. He said: "This is Liver and Kidney Qi deficiency with rebellious ascent. The method should nourish Liver and tonify Kidney, tonify blood and support Spleen, and guide fire back to its source." Niuxi (Achyranthis Bidentatae Radix), Zexie (Alismatis Rhizoma), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Gouqi (Lycii Fructus), Fuling (Poria), Shanyao (Dioscoreae Rhizoma), Yurou (Corni Fructus), Chenxiang (Aquilariae Lignum Resinatum), and Rougui (Cinnamomi Cortex) were used. After two doses, all symptoms resolved. Later recurrences were cured by taking this.
A scholar reading books forgot to eat. A man in purple robes stood before him and said: "Sir, if you think of me for long, I will die." He asked who he was. He said: "I am the God of Grain Spirit." Thus, he ceased thinking, and eating returned to normal. (Yishuo Xubian.)
Wu Qiao treated Fang Sheng, aged twenty-five. Rising early internally, working on an empty stomach, he soon developed fever and headache. Physicians considered it internal heat and used cooling herbs. After three days, he sweated profusely, became confused, and nearly died. Qiao palpated the six pulses, none responding to the finger, some faint as spider threads. He told his father: "Your son is very critical. This is deficiency collapse. Urgently use heavy doses of warming and tonifying herbs, or even slight delay will be too late." The father agreed. One dose cured him, and recently he was very safe. (Taihan Ji.)
Fang Mianxiao Ding suffered from frailty in his youth. His face was red, food and muscle declined in sequence, but internal retention and seminal emission did not harm him. Sometimes the illness acted up, three or four times a day, urination was normal. But after one more bowel movement, from the neck upwards, including head, face, skin, and hair, suddenly seemed to collapse, causing dizziness and inability to support himself, looking like he wanted to die. Gradually advancing tonifying agents yielded no result over time. Qiao palpated his Heart and Kidney pulses: slightly rapid and powerless. He said: "The illness arises from internal retention during urination, suddenly suffering fright and terror. The method should treat separately." The patient bowed in agreement. Thus, morning doses tonified Kidney, evening doses tonified Heart. After ten days to a month, he recovered. (Ibid.)
Qiongyu Gao (Jade Dew Paste) treats deficiency consumption with dry cough. Shengdi (Rehmanniae Radix) natural juice 4 jin, Baifuling (Poria) 12 liang, Bai Mi (White Honey) 2 jin, Renshen (Ginseng Radix) 6 liang. (Add Chenxiang (Aquilariae Lignum Resinatum) and Xuepo (Succinum) each 1.5 qian.) Boil Rehmannia juice with honey, filter through silk, grind Ginseng into fine powder, mix into the decoction. Use a porcelain bottle lined with dozens of layers of cotton, seal with bamboo leaves, place in a clay pot, submerge the neck in running water, and boil with mulberry wood fire for three days and nights. Take out, seal mouth with paper, seal with wax, hang in a well for one day, take out, and boil for half a day. Mix with soup and take.
Xu Lingtai said: "This is the first formula for blood disorders. Dry Shengdi (Rehmanniae Radix) 4 liang soaked thoroughly can yield 1 liang of natural juice. If pressed, ten jin yields only 1 jin of juice, requiring thirty jin to prepare with other drugs. Thus, preparing this formula must communicate with time and place."
Jiling Gao (Gathering Spirit Paste): Xiyangshen (American Ginseng), scrape off skin, steam over rice, sun-dry nine times. Qizi (Lycii Fructus), Huainiu Xi (Wine-steamed Achyranthes Root), Tiandong (Asparagi Radix), Maidong (Ophiopogonis Radix), Huaidi (Prepared Rehmannia Root), Xianlingpi (Epimedii Folium) in equal parts,熬 (decoct into paste). Take with plain water or warm wine. This formula first appeared in Guang Biji, without Xianlingpi, said to come from the Imperial Household. Also, in Zhi Fa Hui, there is no Niuxi. Post-formula note: add Danggui (Angelicae Sinensis Radix) for blood deficiency, add Baizhu (Atractylodis Macrocephalae Rhizoma) for Spleen deficiency. It claims to treat all Qi and Blood deficiency, body heat, and cough, all obtaining efficacy. Whenever youths feel weak and fatigued, short of fluids, with deficient fire flaming upward, this is exactly suitable for taking, preventing labor disease. Li Xu Yuan Jian treats cough by removing Renshen and Niuxi, adding Qizi (Lycii Fructus), Gancao (Glycyrrhizae Radix et Rhizoma), Jiegeng (Platycodonis Radix), and Yuan Shen (Scrophulariae Radix) to severely tonify Liver and Kidney Yin. Truly, nothing surpasses this.
Shihui San (Ten Ashes Powder) treats hematemesis, hemoptysis, and coughing blood. First use this medicine to stop bleeding. Daji (Cirsii Japonici Herba), Xiaoji (Cirsii Herba), Heye (Nelumbinis Folium), Cebaiye (Platycladi Cacumen), Baimaogen (Imperatae Rhizoma), Qianggen (Rubiae Radix et Rhizoma), Zhizi (Gardeniae Fructus), Chuan Dahuang (Rhei Radix et Rhizoma), Danpi (Moutan Cortex), Zonglupi (Livistonae Petiolus) in equal parts. Burn to ash, preserve nature, grind into extremely fine powder. Wrap in paper, place on mud ground overnight to remove fire toxicity. Take 5 qian per dose, mix with Lotus Root Juice, Radish Juice, or Beijing Ink Juice half bowl. Zhou Yangjun said: "For treating hematemesis, Ge Shi is recommended first. And stopping bleeding with this formula first is obviously a drastic measure, without scruples. Careful study reveals the Master's profound intent and principle. Humans are born from Yang, rooted in Yin. If Yin Qi is deficient, Yang naturally prevails. Upper Qi becomes panting, coughing up frothy sputum, fever, and red face, all arising consequently. Thus, retaining one part of one's own blood reduces one part of ascending fire, making it easier to manage. Why do today's physicians constantly talk about guiding fire back to its meridian, and cannot generally use hemostatic flavors? Some even say vomiting is beautiful, and blocking is harmful, thus delaying time, Yin deficiency and Yang hyperactivity continue to simmer until incurable. Whose fault is it? Guiding meridians and delaying time, hoping to restore Primordial Spirit, how can shaped blood be generated immediately? And how can unpaired Yang be descended immediately? This is the main purpose of the Master's urgency in stopping bleeding."
Xiong An: All medicines burned to ash can stop bleeding, hence the name Ten Ashes Formula. But among astringent items, only Zonglupi (Livistonae Petiolus) is astringent; the rest are clearing heat, moving stagnation, and breaking stasis instruments. It is hard to guarantee stopping bleeding without the drawback of astringing and retaining stasis. I always use it without sequelae. How can it be regarded as a drastic measure?
Taiping Wan (Peaceful Pill) treats chronic cough, Lung萎 (Flaccidity), and Lung Abscess. Tiandong (Asparagi Radix), Maidong (Ophiopogonis Radix), Zhimu (Anemarrhenae Rhizoma), Beimu (Fritillariae Thunbergii Bulbus), Kuidonghua (Adenophorae Flos) each 2 liang. Xingren (Armeniacae Semen Amarum), Danggui (Angelicae Sinensis Radix), Shu Shengdi (Prepared Rehmanniae Radix), Huanglian (Coptidis Rhizoma) each 2.5 liang. Puhuang (Typhae Pollen), Jingmo (Beijing Ink), Jiegeng (Platycodonis Radix), Bohe (Menthae Haplocalycis Herba) each 1 liang. The above fourteen ingredients, grind into fine powder and mix evenly. Refine 4 liang of White Honey in a silver or earthenware vessel, then add 2.5 liang of Ejiao (Asini Corii Colla). Wait until melted, add herb powders, stir evenly, add a little Mosiang (Musk), boil for three to five boils, form pills the size of beans. Chew one pill slowly after meals, dissolve slowly with Mint Soup. Before sleep, hold this pill supine, letting medicinal Qi enter Lung orifices, so Lung clears and cough stops. For any cough, taking this cures in seven days.