余急告葛君曰:此孩恐难保矣。若手足不厥,气息不见咻咻,尚较有把握。今既如此危险,难处方矣。葛君惶极,仍求余处方,即不效而殇,绝无异言也。余于无可奈何之时,勉为处一温补内托之方,因定名日温阳益气汤,令速多灌之。生死关头,于今夜卜之,如服药之后,能于夜间转机,阳气一回,体温渐渐增高,手足渐渐转暖,咻咻之气一平,则痘自可出,而命可保全矣。否则不过明日午夜,必致危矣。且看服药之情形如何,余即起辞而去。
当日晚间服药,在七时左右。头煎分二次服,每二小时一次。至十一时左右,再服二煎,亦间二小时,更服其余。
至夜半后,次晨三时余,渐觉微烦,而体温亦渐增高,手足亦渐暖矣。但仍喃喃不安。再次则身有微汗,渐则安静。次晨视之,痘粒已起胀矣。至十时复延余诊,余见状大喜。即以原方去川芎,加云苓、甘草,连服一帖,而痘势更形起发。至第九日,浆水赶足而竟全功,此亦幸而得全也。
温阳益气汤方上肉桂五分(炖冲)炮附子一钱炮姜炭五分潞党参三钱绵黄芪生炙各一钱土炒白术二钱秋桔梗一钱炒僵蚕一钱全当归二钱川芎一钱生白芍一钱五分此方服后,次晨痘即起涨。因去川芎,加云茯苓一钱五分,甘草生炙各五分,而竟全功。
漏经多年漏经证妇人以产后失调,患漏经证。所下不多,时断时续,或昨有而今无,或朝无而夕有,日以继月,月以继年,诸医罔效。他无所苦,嗣则绝药不治,亦无进退。延经十二年之久,试以地榆苦酒煎,四剂而痊。
唐家湾有钱连源者,为苏北永兴集人,旅沪多年。其妻年当32岁时,以产后失调,续患漏经证。虽所下不多,而断续不已。延医诊治,数易其医,而均无效。如此一年有余,所费颇可观。以其下血不多,或昨有而今无,或朝无而夕有,遂忿恨而绝药,于是不信医矣。年复一年,延至十二年之久,病者已四旬有四岁,而病依然如旧。
其时余初来沪开业。余戚有韩荣光者,与钱为友好,因介就余诊。钱当拒之曰:“老年医生,专门妇科,且久治不愈,少年医生,必不能治。此病已十二年之久,病根深矣,治必无效。”韩因强之曰:“余医生为余之戚,汝为我之友,必不以诊金计者。治之而效,是其应有之责,治之不效,汝之所费亦无几,盍一试之。”因来就余诊。余闻悉其状,并索问前方。钱曰:“方在十年之前,因其不效,早已付之焚如矣。”余思前医之方,必复方也,因思以单方试之。曾记《医宗金鉴·妇科心法》中,有地榆苦酒煎一方。姑一试以瞻其效否。因为处方如次,嘱其如法服之。每剂分早晚二次服,计四剂八服而痊。
钱夫妇大喜过望,偕韩君同来致谢。揖余而告曰:“先生处方,价极廉而效极大,内子已霍然矣,感恩无极。”余告之曰:此方载在《金鉴》妇科中,余亦未尝试过。因推想前医之方,必为复方,我若行其故道,亦必无效,故用此单方也。不意其效如此之速,是真单方一味,气煞名医矣。惟一般时医拘于复方汤头之旧习,不屑用此不值钱之单方耳。
今既有效,余愿偿矣。后余于丁氏《化学实验新本草》中,见亦载此方,惟方名地榆酽醋方,系译自东瀛医书,煎法亦少异。所谓酽醋,即苦酒也。后照法施于他人之患漏经者,亦有良效,特并存之如次。
地榆苦酒煎方地榆一两陈醋六两煎滚,再慢火熬片时,次晨空心,炖温服之。
按:《金鉴》妇科中,此方醋无分量,余酌定之。
地榆酽醋方地榆根一两酽醋半斤用砂锅熬至四两,候十二点钟,滤渣,每服一两至二两。
产后漏血证妇人产后,始则恶露不清,继则漏血不止。量虽不多,断续不已。医以止血剂注射之,而弥月后,依然如旧。改延他医治之,亦无效。余知在产前数月,殇其三岁之幼子,投以清肝养血汤,五剂而痊。
有宏道中学校长廉建中者,与余为文字交,订翰墨缘。
其妻惠毓明女士,亦书画俱佳。在抗战期间之第六年,以孕已足月,觉有腹痛,乃人其友人叶某私人医院,平安产一男孩。约一星期后,恶露应清而未清,时有少量血液,断续下行。医察其血色正常,且不夹恶露中之半腐败物,乃为之注射止血针药,每日二次至三次,均无效。再增量注射之,亦无效。乃易药以注射之,仍然无效。如此弥月不愈,医告以可回家休养,且其量不多,可无碍也。病者无法,只得返家。改延他医,续治旬日,不愈亦不增剧。盖其夫妇为教育界人,受西方文化影响,不信中医也。
某日下午,余以事往访廉先生。坐谈片时,始知其夫人已生产一男孩,当致贺辞。廉又蹙额而告余曰:“内子产后,今已四旬左右,而漏血不止,何耶?中医有妙法否,敢请一诊。”余询其病之情况,试为诊之。他无所苦,量虽少而始终断续不停。因思其数月之前,曾殇其三岁之次子,父母之心,人皆有之,而妇人爱子之心,甚于丈夫。且殇子为时不远,中心蕴结,肝郁不舒。今当产后,恶露虽清,而血因肝郁,逼而从下漏矣。
因笑渭之曰:“汝夫妇脑筋至新,故自始至终,未延一中医疗治,故余不得与于其列。今始询及于余,余试为处方,可一瞻其效与否也。”乃握笔为书清肝养血汤方,令连服三帖,再作加减。并阴告廉先生,以有肝郁之因,而有漏血之果。孰意三服之后,即见减少。再服二帖,即告痊愈。
廉先生夫妇大喜过望。后隔月余,惠女士自绘白头枝上双楱图一幅,廉先生自书七律新诗一幅,裱好送来,以作纪念。
在白头双楱图上,惠书“白首怀思”四字。廉之七律一幅,其辞日,“廿年风雨许知音,当代名医夙所钦,志在活人宗仲景,学堪传世迈千金,文章旧价宏仁术,桃李新阴满杏林,一药山荆欣病愈,用伸感谢志微忱。”清肝养血汤方粉丹皮四钱春柴胡三钱夏枯草三钱于地黄五钱京赤芍三钱当归身三钱紫丹参三钱广郁金三钱佛手柑三钱姜、枣引阴挺贫农妇人,产后三日,即往田间工作。饥饱不均,劳动过度,忽少腹坠重,阴门胀急,如将产状,渐至阴挺下脱。
经日医施还纳手术,外施以托子宫器护持之,静卧三周日,不效。余以大剂补中益气汤与之,三剂则升而不坠,六剂则其病如失。
沪东之引翔乡,有陈姓贫农之妇人,于八月问产一男孩。因田中秋收在即,至第三日,便往田中劳作。田虽距家较近,然田中劳作数小时,又须返家为小儿哺乳,往返频劳,且又食无定时,饥饱不均,产后营养,更无论矣。晚间即觉少腹坠重,而次日仍照常田中工作,于是腹坠更甚,阴门胀急,忽然阴挺下脱,渐大如瓠,几如男子之颓疝焉。
先经中医治之,无效。嗣即送至引翔医院之平民诊疗部,时在抗战之后五年。此引翔医院,为日人所创办,经日医施行还纳手术,外以托子宫器托之,再施以三角巾之紧束,令其静卧一星期,虽大小便亦仰卧于床上,以粪器承之,并为之内服及注射补剂。一星期后,试去托子宫器,令其下床步行。奈行未数步,又觉腹内坠重,陈妇惊惧,告之日医。立命仍卧于床,续行疗养两周日。过两周之后,依然不效。
陈农偶与安乐坊之刘训才谈及,因改就余诊。余以阴挺之症,发于产后,其因气血双亏,毫无疑义。医书中虽载之,而临床遭遇较少。当与气虚脱肛,同其治法。令其解裤视之,则翻出之粘膜,有数处之磨破。询其大便,则云干燥异常,他无所苦。乃决以补中益气汤大剂与之,方中党参、黄芪及当归,分量尤重。盖病已二十余日,非大补气血不为功,且大便干燥,当归又为润肠之剂,故重用之也。并嘱其连服三剂,再来复诊。
过三日之后,病者又来,下车入门时,步履较健,两腿已不开张,询之果有效矣。当大便未润时,小腹仍胀,即再剂后,大便频爽,则少腹即不坠矣,因连连称谢不已。后再为之略减其量,续服三帖,即恢复健康,其病如失。以函告余,余恐有反复,函嘱再服三四帖。其服否虽不知,而后未再来,其彻底痊愈,可想而知也。
补中益气汤方西党参五钱炙黄芪六钱炙甘草四钱土炒白术四钱广陈皮三钱全当归五钱炙升麻三钱春柴胡三钱生姜五片大枣十枚疔痈疔疮走黄险证妇人患生指疔,初则肿若纺锤,溃烂出脓,腐臭不堪,痛楚几绝。延及半月,旁又增生,红肿蔓延,迅至手腕至肘关节,皆发赤肿。再二三日,手掌、手背、手腕等处,又溃穿十余处,此疔毒走黄也。与以疔疮丸,连续大泻而痊。后试之于痈证,其效亦良。因易其名日痈疔百效丸。
余当少壮之时,初业医于乡里,兼充三区小学校长。适有邻村邓藻芳之妇,年41岁,患生疔疮,来就余诊。第察其患,原在左手中指中节,蔓延至手掌手背手腕,又破溃十余处,连及小臂亦有浮肿,有更将蔓延之势。而破溃处,脓水之恶臭,红丝之蜿蜒,殊可惧也。询其起始情形,则谓初于中指腹部,疼痛肿胀,渐至化脓,继则手指背亦肿,形若纺锤。经外科专家李某治之,内服外敷,均无功效。延及半月.肿势则渐见走窜。昨夜忽疼痛更甚,迅至手掌手背手腕,均发肿胀,而今则破溃不堪矣。
余因索阅前医之方,亦颇对证,而竟无效,是亦证重药轻使然。心忖证至于此时,业已走黄危险,若用通用之方,必难获效。曾记陈修园《医学三字经》篇末,载有疔毒丸一方,谓于疔疮有特效,虽走黄者亦可救治。但从未试过,今可一试之矣。因立即如法制成,即以湿丸十粒与之,嘱其用热水送服,如得四五次之大泻,即以冷开水一杯,服下止之。
病家如言,不二小时,即得大泻一次。再后于二小时内,连泻四次。每泻一次,则肿胀疼痛即随之减轻一次。其效之神奇有如此者,惟体力渐觉不支,即于最末一次泻后,立即饮冷开水一杯,果然泻不再作,人亦神安睡去。迨次晨一觉醒来,肿痛消其六七,脓水淋漓,而各破溃皮肤之表面,已大形起皱矣。再诊之时,复与六丸,使之再泻数次,以清余孽。及红肿消清,痛楚全无,改服解余毒、扶正气之剂,外敷提毒生肌散,而完全就治。
项疽及诸痈证又有许北山者,年45岁,精拳棒,以武术闻。忽发一偏项疽,即俗称之“偏对口”是也。初只局部发痒,以手搔之,渐至肿一小粒,麻痒相兼,亦不介意。次日则肿势渐大,麻痒更兼疼痛,乃惧而求医。医以药膏贴之,冀其消散,而绝不得效。第三日则肿痛更甚,头项且不能转动矣,改就余诊。余思此偏项疽证,较之正项疽尤险。起已三足日,内脓虽未成,但普通方剂,必不易散。疔毒丸治疗,既效而且捷,今以此痈疽之大证试之,不知其有效否也。
复思病者为武术家,体素强健,即服此丸,必能当之,而无危险。乃决与以十丸,令服如法,许君从之。服药大泻四次,而肿痛渐消,仅于初起之未老先白头处,稍出黄白色之水而已。由此以后,凡遇实热证之痈疽疡疖,均用此丸治之,不论初起已溃,皆有奇功,不独治各种疔疮而已也。因改名之日痈疔百效丸。后又于《中国医学大辞典》亦见载有此丸,云系卢成琰氏方,但不知卢为何代人,有无其他著作,尚希知者有以告我。
痈疔百效丸方(原名疔毒丸。卢成琰氏方。)巴豆三钱(去皮膜)明雄黄三钱生大黄三钱上各研细末,再共研极细,加飞罗面醋糊为丸,如梧桐子大。轻者每服六七丸,重者十丸左右,用白开水送下,俟泻三至五次,再以冷粥汤一小碗,服下止之。
肝痈病者右胁内部作痛,初尚轻微,继则加重。胁下作肿,累及左肋亦觉胀满。渐至右胁更形肿痛,突出如拳,但无大寒热。医断为肝脏肿毒,必须开胁割治,病者惧之。余闻其肿才四日,扪之其硬如石,尚未化脓。以牡丹汤合龙胆泻肝汤加减与之,一服而大泻肿减,再服而连泻肿消。再为加减,计四服而痊。
患者邵梅生,住长寿路梅芳里,在厂中作工。1948年夏季,由厂中归来,即觉微有寒热,右胁隐隐作痛,而左胁亦觉微胀。次日请假休息,而胁下肿胀更甚,当请附近医生治之。医与小柴胡汤,因时在夏季,柴胡只用一钱,服之无效。第三日右胁肿痛之处,渐形突出,其大如拳,按之则痛牵胸腋。至第四日,至沪西平民医院求诊。经医诊察之下,断为肝脏发炎,有化脓之可能,须速行开刀,住院疗养。能于开刀后不发手术后炎症,则可日渐痊愈,否则有发生意外危险之可能。病家要求,保证开刀无险,方敢住院,而医师不可。病者本人,亦反对开刀。于是返家,另行延医治疗。
服药打针,均无寸效,而局部之肿胀则更甚。
至第五日,谋之于余之外甥王成龙,以电话招余往诊。
余见其肿在右胁,突出于肋下,如拳如瓜,以其人体质本瘦,在肋骨条条可数下,更形明显。扪之则其坚如石,上下左右,四围均硬,毫不柔软,决为尚未成脓。问其大便,已四日未解,即平常之大便,亦干燥者多。其他口苦咽干,舌苔根黄,尖及边部均绛,口干欲饮,而小便黄赤,头亦觉眩,而时则眼火闪发。综合许多症候,有用泻下之必要。当此时肝体发炎,尚未化脓。设因一泻而肿消,未尝非意中事也,姑一试之。乃为之处方,以牡丹汤合龙胆泻肝汤,以为加减。盖体虽较弱,而证则大实,且肝热颇重,可以夺其实而泻其热也。
我急忙告诉葛先生说:“这个孩子恐怕难以保全了。如果手脚不冰冷,呼吸没有急促喘息的声音,还比较有把握。现在既然如此危险,很难开方子了。”葛先生非常恐慌,仍然请求我开方,即使无效导致夭折,也绝对没有任何怨言。我在无可奈何的时候,勉强开了一个温补内托的方子,因此定名为“温阳益气汤”,让他赶快多次灌服。生死攸关的时刻,就在今晚决定,如果服药之后,能在夜间出现转机,阳气回复,体温渐渐升高,手脚渐渐转暖,喘息之声平息,那么痘疹自然可以发出,性命就可以保全了。否则不超过明天午夜,必定危及生命。且看服药的情况如何,我便起身告辞离开。
当天晚上服药,大约在七点左右。第一煎分两次服用,每两小时一次。到十一点左右,再服第二煎,也是间隔两小时,然后服完剩下的药液。
到了半夜以后,次日凌晨三点多,病人渐渐觉得有些烦躁,而体温也渐渐升高,手脚也渐渐暖和了。但仍然喃喃自语、不安稳。再次观察则身上有微微出汗,渐渐地安静下来。第二天早晨查看,痘粒已经起胀了。到十点又请我去诊察,我见到这种情况非常高兴。于是就用原方去掉川芎,加入云茯苓、甘草,连续服用一帖,痘势更加起发。到了第九天,浆水充足而竟然完全治愈,这也是侥幸得以保全啊。
【温阳益气汤方】上肉桂五分(炖后冲服),炮附子一钱,炮姜炭五分,潞党参三钱,绵黄芪(生用和炙用)各一钱,土炒白术二钱,秋桔梗一钱,炒僵蚕一钱,全当归二钱,川芎一钱,生白芍一钱五分。此方服用后,次日早晨痘疹即起涨。因为去掉了川芎,加入了云茯苓一钱五分,甘草(生用和炙用)各五分,而竟然完全治愈。
漏经证:多年漏经的妇人,因产后调理不当,患上了漏经证。阴道出血量不多,时断时续,或者昨天有今天无,或者早上无晚上有,日复一日,月复一月,年复一年,各位医生都没有效果。没有其他痛苦,后来停止服药不治,病情也没有进退。延续经过十二年之久,试用地榆苦酒煎剂,四剂而痊愈。
唐家湾有钱连源这个人,是苏北永兴集人,在上海旅居多年。他的妻子32岁时,因产后调理不当,接着患上漏经证。虽然出血量不多,但断续不停。请医生诊治,换了好几个医生,都没有效果。这样一年多,花费相当可观。因为她出血不多,或者昨天有今天无,或者早上无晚上有,于是愤恨而停止服药,从此不再相信医生。年复一年,延续到十二年之久,病人已经四十四岁,而病情依然如旧。
当时我刚来上海开业。我的亲戚韩荣光,与钱某是好朋友,因此介绍他来找我诊治。钱某当时拒绝说:“老年医生,专门看妇科,而且久治不愈;年轻医生,一定不能治好。这个病已经十二年了,病根很深,治疗一定无效。”韩某因此强迫他说:“余医生是我的亲戚,你是我的老朋友,一定不会计较诊金。治疗有效,是他应尽的责任;治疗无效,你花费的也不多,何不试一试呢?”于是来找我诊治。我询问了解了病情,并索要之前的处方。钱某说:“方子在十年前,因为无效,早已烧掉了。”我思考前医的方子,一定是复方,因此思考用单方试试。曾记得《医宗金鉴·妇科心法》中,有一个地榆苦酒煎的方子。姑且试用来看看效果如何。因此开出如下处方,嘱咐她按方法服用。每剂分早晚两次服用,共四剂八服而痊愈。
钱某夫妇大喜过望,带着韩君一起来致谢。向我作揖说道:“先生开的方子,价格极其低廉而效果极大,内人已经霍然痊愈了,感激不尽。”我告诉他们:“这个方子记载在《金鉴》妇科中,我也未曾尝试过。因为推测前医的方子,必然是复方,如果我沿袭他们的老路,也必然无效,所以用这个单方。没想到效果这么快,真是单方一味药,气煞名医啊。只是通常的时医拘泥于复方汤头的旧习,不屑使用这种不值钱的单方罢了。”
既然有效,我愿意偿还(指分享知识)。后来我在丁氏的《化学实验新本草》中也看到记载了这个方子,只是方名叫地榆酽醋方,是从日本医书翻译过来的,煎法也稍有不同。所谓酽醋,就是苦酒(醋)。后来按照这个方法施用于其他患漏经的人,也有很好的疗效,特此并存如下。
【地榆苦酒煎方】地榆一两,陈醋六两。煎滚后,再用慢火熬片刻,次日清晨空腹,炖温服用。
按语:《金鉴》妇科中,此方醋没有分量,我酌情确定的。
【地榆酽醋方】地榆根一两,酽醋半斤。用砂锅熬至四两,候十二点钟,滤去渣滓,每次服用一两至二两。
产后漏血证:妇人产后,开始恶露不清,接着漏血不止。量虽然不多,但断续不停。医生用止血剂注射,满月后,依然如旧。改请其他医生治疗,也没有效果。我知道她在产前几个月,殇亡了她三岁的幼子,投以清肝养血汤,五剂而痊愈。
有宏道中学校长廉建中,与我为文字之交,订下翰墨缘分。
他的妻子惠毓明女士,书画都很好。在抗战期间的第六年,因为怀孕足月,觉得腹痛,于是进入她的朋友叶某的私人医院,平安产下一个男孩。大约一个星期后,恶露应该清除却没有清除,时有少量血液,断续下行。医生观察血色正常,且不夹杂恶露中的半腐败物,于是为她注射止血针药,每天二次至三次,都无效。再增加剂量注射,也无效。于是换药注射,仍然无效。这样满月不愈,医生告诉她可以回家休养,而且量不多,没有关系。病人没有办法,只得回家。改请其他医生,继续治疗十天,不愈也不加重。大概因为他们夫妇是教育界人士,受西方文化影响,不相信中医。
某个下午,我因为有事去拜访廉先生。坐谈片刻,才知道他夫人已经生产了一个男孩,于是致贺辞。廉先生又皱眉头告诉我:“内人产后,现在已经四十天左右,而漏血不止,为什么呢?中医有妙法吗,敢请您诊察一下。”我询问她的病情情况,试着为她诊脉。她没有其他痛苦,量虽然少但始终断续不停。我思考她在几个月之前,曾经殇亡了她三岁的次子,父母之心,人人都有,而妇人爱子之心,甚于丈夫。而且殇子时间不远,心中郁结,肝气郁结不舒。现在正当产后,恶露虽然清了,但血因为肝郁,逼迫而从下面漏出。
因此笑着对他说:“你们夫妇脑筋很新,所以从头到尾,没有延请一位中医治疗,所以我不能参与其中。现在开始咨询于我,我试着开方,可以看一看效果如何。”于是提笔写下清肝养血汤方,令其连续服用三帖,再做加减。并私下告诉廉先生,因为有肝郁的原因,而有漏血的后果。谁料想三服之后,即见减少。再服两帖,即告痊愈。
廉先生夫妇大喜过望。后来隔一个多月,惠女士自己绘制了一幅白头枝上双鹩图,廉先生自己书写了一首七律新诗,裱好后送来,作为纪念。
在白首双鹩图上,惠女士题写“白首怀思”四个字。廉先生的七律一幅,辞曰:“廿年风雨许知音,当代名医夙所钦,志在活人宗仲景,学堪传世迈千金,文章旧价宏仁术,桃李新阴满杏林,一药山荆欣病愈,用伸感谢志微忱。”
【清肝养血汤方】粉丹皮四钱,春柴胡三钱,夏枯草三钱,干地黄五钱,京赤芍三钱,当归身三钱,紫丹参三钱,广郁金三钱,佛手柑三钱,生姜、大枣为引。
阴挺:贫农妇人,产后三天,就去田间工作。饥饱不均,劳动过度,忽然少腹坠重,阴门胀急,像将要生产的状况,渐渐发展到阴挺下脱。
经过日医施行还纳手术,外用托子宫器护持,静卧三十天,无效。我用大剂量的补中益气汤给她,三剂则提升而不坠落,六剂则病如消失。
沪东之引翔乡,有个姓陈的贫农妇人,在八月间产下一个男孩。因为田里秋收在即,到第三天,便去田中劳作。田地虽然离家较近,但在田中劳作数小时后,又要回家给小儿哺乳,往返频繁劳累,而且饮食没有定时,饥饱不均,产后的营养更不用说了。晚上就觉得少腹坠重,而第二天仍照常去田中工作,于是腹坠更严重,阴门胀急,忽然阴挺下脱,渐渐大如葫芦,几乎像男子的颓疝一样。
先经过中医治疗,无效。随后送到引翔医院的平民诊疗部,那时是在抗战之后的第五年。这个引翔医院,是日本人创办的,经过日医施行还纳手术,外用托子宫器托住,再施以三角巾紧束,令其静卧一星期,虽然大小便也仰卧在床上,用粪器承接,并且内服及注射补剂。一星期后,试着去掉托子宫器,令其下床步行。无奈走了没几步,又觉得腹内坠重,陈妇惊恐害怕,告诉日医。立即命令仍卧床,继续疗养两周。过了两周之后,依然无效。
陈农偶然与安乐坊的刘训才谈及,因此改来找我诊治。我以阴挺之症,发于产后,其原因是气血双亏,毫无疑义。医书中虽然记载,而临床遭遇较少。应当与气虚脱肛,用同样的治法。令其解开裤子查看,则翻出的粘膜,有几处磨破。询问她大便,则说干燥异常,没有其他痛苦。于是决定用大剂量的补中益气汤给她,方中党参、黄芪及当归,分量尤其重。因为病已二十多天,不是大补气血不能成功,而且大便干燥,当归又是润肠的药物,所以重用。并嘱咐她连续服用三剂,再来复诊。
过了三天之后,病人又来,下车进门时,步履比较稳健,两腿已不张开,询问果然有效。当大便未润时,小腹仍胀,即再服两剂后,大便频频通畅,则少腹就不坠了,因此连连称谢不已。后来又为她稍微减量,续服三帖,即恢复健康,病如消失。以信件告知我,我恐有反复,函嘱再服三四帖。她是否服用不知道,但后来没再来,彻底痊愈,可想而知。
【补中益气汤方】西党参五钱,炙黄芪六钱,炙甘草四钱,土炒白术四钱,广陈皮三钱,全当归五钱,炙升麻三钱,春柴胡三钱,生姜五片,大枣十枚。
疔痈:疔疮走黄的险证。妇人患生指疔,起初肿胀像纺锤,溃烂出脓,腐臭不堪,痛楚几乎绝顶。延续半个月,旁边又增生,红肿蔓延,迅速到手腕至肘关节,都发红肿胀。再过两三天,手掌、手背、手腕等处,又溃穿十余处,这是疔毒走黄。给予疔疮丸,连续大泻而痊愈。后来试用于痈证,效果也很好。因此改名为痈疔百效丸。
当我年轻力壮时,初开始在乡里行医,兼充三区小学校长。恰好有邻村邓藻芳的妇人,41岁,患生疔疮,来找我诊治。我看她的患处,原本在左手中指中节,蔓延到手掌手背手腕,又破溃十余处,连及小臂也有浮肿,更有蔓延之势。而破溃处,脓水的恶臭,红丝的蜿蜒,确实可怕。询问起始情形,则说最初在中指腹部,疼痛肿胀,渐渐化脓,接着手指背也肿,形如纺锤。经过外科专家李某治疗,内服外敷,都没有功效。延续半个月,肿势渐渐走窜。昨夜忽然疼痛更甚,迅速到手掌手背手腕,都发肿胀,而现在则破溃不堪了。
我因此索取前医的方子,也很对症,却竟然无效,这也是证重药轻使然。心里想证候到了这个时候,已经走黄危险,如果用通用的方子,必然难获效。曾记得陈修园《医学三字经》篇末,载有疔毒丸一方,说对于疔疮有特效,即使是走黄的也可以救治。但从未试过,现在可以试一试了。因此立即按法制成,即以湿丸十粒给她,嘱咐她用热水送服,如果得到四五次的大泻,就用一杯冷开水,服下止之。
病家照做,不到两小时,即得大泻一次。再后在两小时内,连泻四次。每泻一次,则肿胀疼痛即随之减轻一次。效果的神奇有如此者,只是体力渐渐觉得不支,就在最后一次泻后,立即饮冷开水一杯,果然泻不再发作,人也神安睡去。等到第二天早晨一觉醒来,肿痛消了其六七,脓水淋漓,而各破溃皮肤表面,已大形起皱。再诊之时,又给予六丸,使之再泻数次,以清除残余邪毒。等到红肿消清,痛楚全无,改服解余毒、扶正气的药剂,外敷提毒生肌散,而完全治愈。
项疽及诸痈证:又有许北山这个人,45岁,精通拳棒,以武术闻名。忽然发一偏项疽,即俗称的“偏对口”。起初只局部发痒,用手搔之,渐渐肿一小粒,麻痒相兼,也不介意。第二天则肿势渐大,麻痒更兼疼痛,于是害怕求医。医生用药膏贴之,希望其消散,却绝对不得效。第三天则肿痛更甚,头项甚至不能转动了,改来找我诊治。我思考这个偏项疽证,比正项疽更危险。起病已经三天多,内脓虽未成,但普通方剂,必然不易散。疔毒丸治疗,既有效而且快捷,现在以此痈疽的大证试之,不知道是否有有效。
又想到病者是武术家,体质素来强健,即使服用此丸,必然能承受,而没有危险。于是决定给予十丸,令其按法服用,许君听从。服药大泻四次,而肿痛渐渐消退,仅在初起未老先白头处,稍出黄白色的水而已。由此以后,凡遇实热证的痈疽疡疖,都用此丸治疗,不论初起已溃,都有奇功,不独治各种疔疮而已。因此改名为痈疔百效丸。后来又在《中国医学大辞典》中也见到记载有此丸,说是卢成琰的方子,但不知道卢是哪个朝代的人,有没有其他著作,尚希望知道的人告诉我。
【痈疔百效丸方】(原名疔毒丸。卢成琰氏方。)巴豆三钱(去皮膜),明雄黄三钱,生大黄三钱。以上各研细末,再共同研极细,加飞罗面醋糊为丸,如梧桐子大。轻者每服六七丸,重者十丸左右,用白开水送下,等泻三至五次,再以冷粥汤一小碗,服下止之。
肝痈:患者右胁内部作痛,起初尚轻微,接着加重。胁下作肿,累及左肋也觉得胀满。渐渐右胁更形肿痛,突出如拳,但没有大寒热。医生断定为肝脏肿毒,必须开胁割治,病人害怕。我听说他肿胀才四天,摸之其硬如石,尚未化脓。用牡丹汤合龙胆泻肝汤加减给他,一服而大泻肿减,再服而连泻肿消。再为加减,计四服而痊愈。
患者邵梅生,住长寿路梅芳里,在厂中做工。1948年夏季,从厂中归来,即觉得微有寒热,右胁隐隐作痛,而左胁也觉得微胀。第二天请假休息,而胁下肿胀更甚,当时请附近医生治疗。医生给小柴胡汤,因为时在夏季,柴胡只用一钱,服用无效。第三天右胁肿痛之处,渐渐突出,其大如拳,按之则痛牵胸腋。到第四天,到沪西平民医院求诊。经过医生诊察之下,断定为肝脏发炎,有化脓的可能,须速行开刀,住院疗养。能在开刀后不发生手术后炎症,则可日渐痊愈,否则有发生意外危险的可能。病家要求保证开刀无险,才敢住院,而医师不可。病人本人,也反对开刀。于是返家,另行延医治疗。
服药打针,均无寸效,而局部的肿胀则更甚。
到第五天,谋之于我的外甥王成龙,以电话招我前往诊治。
我看到他肿胀在右胁,突出于肋下,如拳如瓜,因为他人体质本瘦,在肋骨条条可数的情况下,更形明显。摸之则其坚如石,上下左右,四围均硬,毫不柔软,断定是尚未成脓。问他大便,已四天未解,即平常的大便,也多是干燥的。其他口苦咽干,舌苔根黄,尖及边部均绛,口干欲饮,而小便黄赤,头也觉得眩,而时时眼火闪发。综合许多症候,有用泻下的必要。当此时肝体发炎,尚未化脓。假如因为一泻而肿消,未尝不是意料中的事,姑且试一试。于是为他处方,以牡丹汤合龙胆泻肝汤,以为加减。盖身体虽较弱,而证候则大实,且肝热颇重,可以夺其实而泻其热也。
I urgently told Mr. Ge, "This child is likely difficult to save. If his hands and feet were not cold, and his breath did not show rapid panting (Xiu Xiu), there would still be some certainty. Now that it is so dangerous, it is difficult to prescribe." Mr. Ge was extremely panicked but still requested I prescribe medicine, stating he would have no objections even if it failed and the child died. In a helpless situation, I reluctantly prescribed a warming, tonifying, and internal-expelling formula, naming it Wenyang Yiqi Tang (Warming Yang and Boosting Qi Decoction), and instructed him to administer it frequently. The decision of life or death would be made tonight; if after taking the medicine there is a turnaround during the night, with Yang Qi returning, body temperature gradually rising, hands and feet gradually warming, and panting subsiding, then the smallpox lesions will naturally erupt, and life can be preserved. Otherwise, by midnight tomorrow, it will surely become critical. Let us see how the medication goes, and I will take my leave.
Medication was administered that evening, around 7:00 PM. The first decoction was divided into two doses, taken every two hours. Around 11:00 PM, the second decoction was taken, also at two-hour intervals, followed by the remainder.
After midnight, around 3:00 AM the next morning, the patient gradually felt slightly irritable, while body temperature rose and hands and feet warmed. However, he remained muttering and restless. Subsequently, slight sweating appeared, and he gradually became quiet. Upon examination the next morning, the smallpox papules had begun to swell. At 10:00 AM, I was called again. Seeing this, I was greatly pleased. I used the original formula, removing Chuanxiong Rhizoma (Chuanxiong), adding Poria Cocos (Fuling) and Glycyrrhizae Radix et Rhizoma (Gancao), and administered one dose continuously, causing the smallpox eruption to develop further. By the ninth day, the pustular fluid was sufficient, and complete recovery occurred; this was indeed fortunate preservation.
[Wenyang Yiqi Tang Formula] Rougui Cortex Cinnamomi (Stewed and mixed in) 5 fen, Paofuzi Radix Aconiti Lateralis Preparata (Prepared Lateral Root of Monkshood) 1 qian, Paojiangtan Radix Zingiberis Preparata (Charred Ginger Root) 5 fen, Lu Dangshen Radix Codonopsis (Codonopsis) 3 qian, Mian Huangqi Radix Astragali (Raw and Prepared Astragalus) 1 qian each, Tucha Bai Zhu Rhizoma Atractylodis Macrocephalae (Earth-fried Atractylodes) 2 qian, Qiu Jiegeng Radix Platycodonis (Platycodon) 1 qian, Chao Jiangcan Bombyx Batryticatus (Stir-fried Metempusa) 1 qian, Quan Danggui Radix Angelicae Sinensis (Whole Angelica) 2 qian, Chuanxiong Rhizoma (Chuanxiong) 1 qian, Sheng Baishao Radix Paeoniae Alba (Raw White Peony Root) 1.5 qian. After taking this formula, the smallpox papules swelled the next morning. Because Chuanxiong was removed and added Fuling 1.5 qian and Gancao (Raw and Prepared) 5 fen each, complete recovery was achieved.
Leaking Menstruation Syndrome: A woman suffering from leaking menstruation for many years due to improper postpartum regulation developed this syndrome. The vaginal discharge was scanty, intermittent, sometimes present yesterday but absent today, or absent in the morning but present in the evening, continuing day after day, month after month, year after year, with various doctors proving ineffective. She suffered no other discomfort. Later, she stopped medication, yet the condition neither improved nor worsened. This persisted for twelve years. I tried a decoction of Sanguisorbae Radix (Diyu) and Kujiu (Vinegar), which cured her in four doses.
Qian Lianyuan of Tangjiawan, originally from Yongxingji, Northern Jiangsu, had lived in Shanghai for many years. His wife, aged 32, developed leaking menstruation syndrome following improper postpartum regulation. Although the discharge was scanty, it was continuous. Various doctors were consulted without success. For over a year, considerable expenses were incurred. Since the bleeding was light and intermittent, she grew resentful, stopped medication, and lost faith in doctors. Year after year, this lasted twelve years until she was 44, with the condition unchanged.
At that time, I had just started practicing in Shanghai. My relative, Han Rongguang, who was friends with Qian, introduced him to me. Qian initially refused, saying, "An old doctor specializing in gynecology could not cure it; a young doctor certainly cannot. The disease has persisted for twelve years with deep roots; treatment will be ineffective." Han insisted, "Dr. Yu is my relative, and you are my friend; he will not charge excessively. If effective, it is his duty; if not, your cost is minimal. Why not try?" So Qian came to me. After inquiring about the condition and requesting previous prescriptions, Qian said they had been burned ten years prior due to ineffectiveness. I reasoned that previous prescriptions were likely compound formulas, so I decided to try a single-herb formula. I recalled a formula named Diyukujiu Jian (Sanguisorba and Vinegar Decoction) in *Yizong Jinjian* (Golden Mirror of Medicine) Gynecology section. I tried it to observe its efficacy. The prescription was as follows: Take each dose twice daily, morning and evening. Four doses (eight servings) resulted in a cure.
Mr. and Mrs. Qian were overjoyed and thanked me with Mr. Han. They bowed and said, "Your prescription was extremely inexpensive yet highly effective; my wife has recovered completely. We are infinitely grateful." I replied, "This formula is recorded in the Gynecology section of *Jinjian*, but I had never tried it. I presumed previous compound formulas would fail, so I used this single-herb formula. I did not expect such rapid efficacy; truly, a single herb shames famous doctors. However, contemporary physicians are bound by the habit of using compound decoctions and disdain such cheap single-herb formulas."
Since it was effective, I wished to share it. Later, I saw this formula recorded in Ding's *Huaxue Shiyan Xin Bencao* (New Materia Medica of Chemical Experiments) under the name Diyu Yan Cu Fang (Sanguisorba and Strong Vinegar Formula), translated from Japanese medical texts, with slightly different preparation methods. "Yan Cu" refers to Kujiu (Vinegar). I later applied this method to other patients with leaking menstruation with good results, so I record it here.
[Diyu Kujiu Jian Formula] Sanguisorbae Radix (Diyu) 1 liang, Chen Cu (Aged Vinegar) 6 liang. Boil, then simmer slowly for a while. Drink warm on an empty stomach the next morning.
Note: The *Jinjian* does not specify the amount of vinegar; I determined it myself.
[Diyu Yan Cu Formula] Sanguisorbae Radix (Diyu Gen) 1 liang, Yan Cu (Strong Vinegar) half jin. Simmer in a clay pot until reduced to 4 liang. Wait for 12 hours, filter dregs. Take 1 to 2 liang per dose.
Postpartum Bleeding Leakage Syndrome: After childbirth, a woman initially had unclear lochia, followed by continuous bleeding leakage. Although scanty, it was intermittent. Doctors injected hemostatic agents, but after a month, the condition remained unchanged. Other doctors were consulted without effect. Knowing that months earlier she had lost her three-year-old son, I prescribed Qinggan Yangxue Tang (Clear Liver and Nourish Blood Decoction), curing her in five doses.
Lian Jianzhong, principal of Hongdao Middle School, was a literary friend of mine. His wife, Ms. Hui Yuming, was skilled in calligraphy and painting. In the sixth year of the Anti-Japanese War, at full term, she experienced abdominal pain and delivered a boy safely at a private hospital owned by her friend, Ye. About a week later, lochia should have cleared but did not; small amounts of blood leaked intermittently. Doctors observed normal blood color without putrid lochia debris and injected hemostatic drugs twice or thrice daily without effect. Increasing the dosage also failed. Changing drugs still yielded no result. After a month, doctors advised going home to rest, noting the volume was low and harmless. Unable to find other options, she returned home. Other doctors treated her for ten days without improvement or worsening. As educators influenced by Western culture, they did not believe in Traditional Chinese Medicine.
One afternoon, I visited Mr. Lian. After chatting, I congratulated him on the birth. Mr. Lian frowned and said, "My wife has been leaking blood for about forty days postpartum. Why? Does TCM have a miraculous method? Please examine her." I inquired about the condition and palpated her pulse. She had no other discomfort; the flow was scanty but continuous. I recalled she had lost her three-year-old second son months prior. Parents love their children, and women's attachment is often stronger. With recent bereavement, emotional stagnation leads to Liver Qi constraint. Postpartum, although lochia cleared, blood was forced downward by Liver constraint.
Smiling, I said, "You are modern-minded, hence avoiding TCM until now. I will prescribe and we shall see." I wrote Qinggan Yangxue Tang, instructing three doses with adjustments. Privately, I explained to Mr. Lian that Liver constraint caused the bleeding. Unexpectedly, after three doses, bleeding decreased. After two more doses, she recovered completely.
The Liangs were overjoyed. Over a month later, Ms. Hui presented a painting of two birds on a white-headed branch, and Mr. Lian presented a seven-character regulated verse poem, framed as a memento. On the painting, Ms. Hui wrote "White Heads Cherishing Memories." Mr. Lian's poem read: "Twenty years of wind and rain, granting a confidant; / A renowned doctor of our age, long admired. / Ambition to save lives follows Zhongjing; / Learning worthy of passing down surpasses gold. / Articles reflect ancient value and benevolent art; / New shade of peaches and plums fills the apricot grove. / One herb brings joy to my humble wife's recovery; / Expressing gratitude with sincere feelings."
[Qingan Yangxue Tang Formula] Fen Danpi Cortex Moutan (Moutan Bark) 4 qian, Chun Chaihu Radix Bupleuri (Spring Bupleurum) 3 qian, Xiakucao Herba Prunellae (Selfheal Spike) 3 qian, Sheng Dihuang Radix Rehmanniae Preparata (Prepared Rehmannia Root) 5 qian, Jing Chishao Radix Paeoniae Rubra (Red Peony Root) 3 qian, Danggui Shen Radix Angelicae Sinensis (Angelica Body) 3 qian, Zi Danshen Radix Salviae Miltiorrhizae (Salvia) 3 qian, Guang Yujin Rhizoma Curcumae (Curcuma) 3 qian, Foshougan Fructus Citri Sarcodactylis (Buddha's Hand) 3 qian, Ginger and Jujube as guides.
Uterine Prolapse: A poor peasant woman went to field work three days postpartum. Due to irregular meals and excessive labor, she suddenly felt heavy bearing down in the lower abdomen and swelling/urgency in the vulva, resembling labor pains, progressing to uterine prolapse.
Japanese doctors performed reduction surgery and used a uterine support device, advising bed rest for thirty days without effect. I prescribed a large dose of Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction); after three doses, the uterus lifted and did not fall; after six doses, the illness vanished.
In Yinxiang Township, Pudong, Shanghai, a poor peasant surnamed Chen gave birth to a boy in August. With autumn harvest approaching, she worked in the fields on the third day. Though close to home, frequent trips back to breastfeed caused fatigue. Irregular meals and poor postpartum nutrition led to evening sensations of lower abdominal heaviness. Continuing field work the next day worsened the bearing-down sensation and vulvar urgency, resulting in sudden uterine prolapse, enlarging like a gourd, resembling a male hernia.
Initial TCM treatment failed. She was sent to the People's Clinic of Yinxiang Hospital (founded by Japanese, five years post-war). Japanese doctors performed reduction, used a uterine support device, tight bandaging, and strict bed rest for a week, including bedpan use for excretion, along with oral and injected tonics. After a week, removing the support device allowed walking, but stepping few times caused heavy bearing down. Fearful, she reported this. Ordered back to bed for two more weeks of convalescence, still ineffective.
Chen discussed this with Liu Xuncai of Anle Fang, who referred her to me. Uterine prolapse postpartum is undoubtedly due to dual deficiency of Qi and Blood. Though recorded in medical texts, it is rare clinically. It should be treated similarly to Qi-deficiency rectal prolapse. Examining her revealed abrasions on the protruding mucosa. Stool was abnormally dry; otherwise, no discomfort. I decided on a large dose of Buzhong Yiqi Tang, emphasizing heavy doses of Dangshen Radix Codonopsis, Huangqi Radix Astragali, and Danggui Radix Angelicae Sinensis. After twenty-plus days, only strong tonification of Qi and Blood would succeed. Additionally, Danggui moistens intestines, addressing constipation. I instructed three doses before follow-up.
Three days later, she returned walking steadily with legs not spread apart, confirming efficacy. When stool was not yet soft, lower abdomen remained distended; after two more doses, frequent bowel movements relieved the bearing-down sensation. She thanked me profusely. Dosage was slightly reduced for three more doses, restoring health completely. She informed me by letter. Fearing relapse, I advised three to four more doses. Whether she took them is unknown, but she never returned, implying complete recovery.
[Buzhong Yiqi Tang Formula] Xidangshen Radix Codonopsis (Western Codonopsis) 5 qian, Zhi Huangqi Radix Astragali (Honey-fried Astragalus) 6 qian, Zhi Gancao Radix et Rhizoma Glycyrrhizae (Honey-fried Licorice) 4 qian, Tucha Bai Zhu Rhizoma Atractylodis Macrocephalae (Earth-fried Atractylodes) 4 qian, Guang Chenpi Pericarpium Citri Reticulatae (Tangerine Peel) 3 qian, Quan Danggui Radix Angelicae Sinensis (Whole Angelica) 5 qian, Zhi Shengma Rhizoma Cimicifugae (Honey-fried Cimicifuga) 3 qian, Chun Chaihu Radix Bupleuri (Spring Bupleurum) 3 qian, Shengjiang Rhizoma Zingiberis Recens (Fresh Ginger) 5 slices, Dazao Fructus Jujubae (Jujube) 10 pieces.
Ding Carbuncle with Zouhuang (Spreading Toxin): A dangerous condition. A woman developed a finger ding (carbuncle), initially spindle-shaped swelling, ulcerating with foul-smelling pus, nearly unbearable pain. Half a month later, new growths appeared, redness and swelling spreading rapidly to wrist and elbow joints. Two or three days later, palms, dorsum of hand, and wrists ulcerated over ten places. This is Ding Toxin Spreading Yellow (Zouhuang). I administered Dingchuang Wan (Carbuncle Pill), causing continuous severe diarrhea, leading to cure. Later tested on general carbuncles with good results, renaming it Yongding Baixiao Wan (Carbuncle and Ding Hundred-Efficacy Pill).
In my youth, practicing in my village and serving as a primary school principal, a neighbor, Deng Zaofang's wife (41), sought treatment for a carbuncle. The lesion started at the middle joint of the left middle finger, spreading to palm, dorsum, wrist, with ten ulcers and forearm edema, threatening further spread. Pus was foul, and red streaks wound dangerously. Initially, pain and swelling at the finger pad progressed to suppuration and dorsal swelling (spindle shape). Specialist Li treated it internally and externally without effect. After half a month, swelling spread. Last night, pain intensified, spreading to hand/wrist with massive swelling and ulceration.
Previous prescriptions seemed appropriate but failed, likely due to weak dosage against severe pathology. Recognizing the danger of Zouhuang, common formulas would fail. I recalled Dingdu Wan (Ding Toxin Pill) from Chen Xiuyuan's *Yixue Sanzijing* (Three Character Classic of Medicine), claimed effective even for Zouhuang. Having never tried it, I prepared it immediately. I gave ten wet pills, instructing hot water administration. If severe diarrhea occurred 4-5 times, stop with a cup of cold boiled water.
Following instructions, she had one severe diarrhea within two hours, then four more within the next two hours. Each diarrhea reduced swelling and pain. Effectively miraculous, though strength waned. After the last diarrhea, cold water stopped it, and she slept peacefully. Next morning, swelling and pain reduced by 60-70%; pus drained, skin wrinkled. I gave six more pills to clear residual toxins via repeated mild diarrhea. Once redness/swelling cleared and pain ceased, I switched to detoxifying and Qi-nourishing herbs, applying Tidushengji San (Extract Toxin and Generate Flesh Powder) externally, achieving complete cure.
Neck Abscess and Other Carbuncles: Xu Beishan, 45, a martial artist, developed a lateral neck abscess ("Pian Duikou"). Initially local itching, scratching led to a small lump with numbness and itching. Ignored initially. Next day, swelling increased with pain/fear. Ointments failed. Third day, severe pain/swelling prevented neck movement. He sought me. I considered lateral neck abscesses more dangerous than central ones. After three days, internal pus not formed; ordinary formulas unlikely to resolve. Dingdu Wan was effective and fast; testing it on this major abscess was worth trying. Knowing he was strong, he could tolerate the pill safely. I gave ten pills. Four severe diarrheas reduced pain/swelling; only slight yellow-white fluid exuded from the initial site. Thereafter, I used this pill for all excess-heat carbuncles/boils, whether early stage or ulcerated, finding it miraculous beyond just ding carbuncles. Renamed Yongding Baixiao Wan. Later found in *Chinese Medical Dictionary* attributed to Lu Chengyan, though his era/work remains unknown.
[Yongding Baixiao Wan Formula] (Original name: Dingdu Wan. Formula of Lu Chengyan.) Badou Semen Crotonis (Croton Seed) 3 qian (peeled), Ming Xionghuang Realgar (Realgar) 3 qian, Sheng Dahuang Radix et Rhizoma Rhei (Raw Rhubarb) 3 qian. Grind each to fine powder, mix thoroughly. Add refined flour and vinegar paste to form pills the size of paulownia seeds. Mild cases: 6-7 pills; severe cases: ~10 pills. Wash down with plain water. After 3-5 diarrheas, stop with a small bowl of cold rice soup.
Liver Abscess: Patient complained of right hypochondriac pain, initially mild, then worsening. Swelling below the ribs extended to the left side. Right hypochondrium became severely swollen/painful, protruding like a fist, without significant fever/chills. Doctors diagnosed liver abscess/toxicity requiring surgical incision. Patient feared surgery. I learned swelling was only four days old; hard as stone, no pus yet. I prescribed modified Mudan Tang (Peony Decoction) combined with Longdan Xiegan Tang (Gentian Liver-Draining Decoction). One dose caused severe diarrhea and reduced swelling; a second dose continued diarrhea and eliminated swelling. Adjustments over four doses led to cure.
Patient Shao Meisheng, working in a factory near Meifangli, Changshou Road. Summer 1948, returning from work, felt slight chills/fever and dull right hypochondriac pain with left-sided distension. Resting the next day worsened swelling. Local doctor prescribed Xiao Chaihu Tang (Minor Bupleurum Decoction); due to summer, Chaihu dose was only 1 qian, ineffective. Day three, right hypochondrium protruded like a fist, painful upon pressure radiating to chest/axilla. Day four, sought care at Xihu People's Hospital. Diagnosed with hepatitis, possible abscess, requiring immediate surgery/hospitalization. Survival depended on avoiding post-op inflammation. Patient demanded safety guarantee; doctor refused. Patient opposed surgery, returned home.
Medication/injections failed; swelling worsened.
Day five, nephew Wang Chenglong summoned me. Swelling in right hypochondrium protruded like a fist/gourd, prominent due to patient's thinness. Hard as stone, rigid surrounding tissue indicated no pus formation. Stool unconsummated for four days, usually dry. Symptoms included bitter taste, dry throat, yellow root tongue coating, crimson tip/sides, thirst, dark urine, dizziness, eye fire flashes. Synthesizing symptoms, purgation was necessary. Liver inflammation existed but no pus. Reducing swelling via purgation was plausible. I prescribed modified Mudan Tang combined with Longdan Xiegan Tang. Though constitution weak, pathology was excess; severe Liver Heat required draining excess and clearing heat.