一夫病痰厥不知人,牙关紧急,诸药不能下,候死而已。戴人见之,问侍病者∶
口中曾有涎否?曰∶有。戴人先以防风、藜芦煎汤,调瓜蒂末灌之。口中不能下,乃取长蛤
甲磨去刃,以纸裹其尖,灌于右鼻窍中, 然下咽有声。后
灌其左窍亦然。戴人曰∶可治矣。良久涎不出。遂以砒石一钱,又投之鼻中。忽偃然仰面,
似觉有痛,斯须吐哕,吐胶涎数升,颇腥。砒石寻常勿用,以其病大,非如此莫能动。然无
瓜蒂,亦不可便用,宜消息之。大凡中风涎塞,往往只断为风,专求风药,灵宝、至宝,误
人多矣。刘河间治风,舍风不论,先论二火,故令将此法实于火形中。
麻先生妻,当七月间,病脏腑滑泄。以祛湿降火之药治之,少愈。后腹胀及乳痛
,状如吹乳,痛重壮热,面如渥丹,寒热往来,嗌干呕逆,胸胁痛不能转侧,耳鸣,食不可
下,又复泻。余欲泻其火,脏腑已滑数日矣;欲以温剂止痢,又禁上焦已热。实不得其法。
使人就诸葛寺,礼请戴人。比及戴人至,因检刘河间方,惟益元散正对此证,能降火解表,止渴利小
便,定利安神。以青黛、薄荷末,调二升,置之枕右,使作数次服之。夜半遍身冷汗如
洗。元觉足冷如冰,至此足大暖,头顿轻,肌凉痛减,呕定痢止。及戴人至,余告之已解。
戴人曰∶益元固宜。此是少阳证也,能使人寒热遍剧,他经纵有寒热,亦不至甚,既热而有
痢,不欲再下,何不以黄连解毒汤服之?乃令诊脉。戴人曰∶娘子病来,心常欲痛哭为快否?
妇曰∶欲如此,余亦不知所谓。戴人曰∶少阳相火,凌烁肺金,金受屈制,无所投告。肺主
悲,但欲痛哭而为快也。麻先生曰∶余家诸亲,无不敬服。脉初洪数有力,自服益元
散后已半,又闻戴人之言,使以当归、芍药,以解毒汤中数味服之,大瘥矣。
有一位患者患痰厥,昏迷不省人事,牙关紧闭,各种药物都无法灌服,只能等待死亡。戴人(张从正)见到这种情况,询问陪护的人:“患者口中曾经有涎沫吗?”回答说:“有。”戴人先用防风、藜芦煎汤,调和瓜蒂末进行灌服。因为患者口中无法吞咽,于是取长蛤甲,磨去边缘的锋利处,用纸包裹尖端,灌入右侧鼻孔中,随后听到药液下咽的声音。接着灌入左侧鼻孔也是如此。戴人说:“可以治疗了。”过了很久,涎沫仍未吐出。于是用一钱砒石,再次投入鼻中。忽然患者仰卧面部朝上,似乎感觉到疼痛,片刻之后开始呕吐,吐出胶状涎沫数升,气味很腥。砒石平时不要使用,因为病情严重,不用这种方法不能触动病邪。然而如果没有瓜蒂,也不宜直接使用砒石,应当斟酌情况而定。大凡中风导致的涎沫阻塞,往往只断定为风证,专门寻求风药,导致使用灵宝丹、至宝丹等药物误人多矣。刘河间治疗风证,抛开风证不论,先论述二火,因此让将此法应用于火形体质中。
麻先生的妻子,在七月期间,患病脏腑滑泄(腹泻不止)。用祛湿降火的药物治疗,稍微好转。后来出现腹胀及乳房疼痛,症状如同吹乳(急性乳腺炎),疼痛剧烈且高热,面色红赤如涂丹砂,寒热往来,咽喉干燥并伴有呕逆,胸胁疼痛不能翻身侧卧,耳鸣,饮食无法下行,又再次发生腹泻。我想用泻火的方法,但脏腑已经滑泄多日;想用温补的药物止痢,但又禁止用于上焦已有热邪的情况。实在找不到合适的方法。派人前往诸葛寺,礼请戴人前来。等到戴人到达时,我查阅刘河间的方书,只有益元散正好对应此证,能降火解表,止渴利小便,定利安神。我用青黛、薄荷末,调和两升益元散,放在枕头右边,让患者分几次服用。半夜时分,全身冷汗如洗。原本觉得脚冷如冰,至此双脚变得非常温暖,头部顿时轻松,肌肉凉痛减轻,呕吐停止,腹泻也止住了。等到戴人到来,我告诉他病情已经缓解。戴人说:“益元散固然适宜。这是少阳证,能让人寒热症状加剧,其他经络即使有寒热,也不会这么严重,既然发热且有痢疾,不想再攻下,为什么不用黄连解毒汤服用呢?”于是让我诊脉。戴人说:“这位娘子生病以来,心里是否常常想痛哭一场才痛快?”妇女说:“确实想这样,但我也不知道是什么缘故。”戴人说:“少阳相火,灼伤肺金,肺金受到委屈制约,无处申诉。肺主悲,所以只想痛哭而感到痛快。”麻先生说:“我家亲属,无不敬重佩服。脉象起初洪数有力,自服益元散后已减半,又听了戴人的话,让用当归、芍药,配合解毒汤中的几味药服用,大病痊愈了。”
A patient suffered from Phlegm Jue (Phlegm-induced syncope), losing consciousness, with the jaw clenched tightly, making it impossible to administer any medicine orally; they could only wait for death. Dai Ren (Zhang Congzheng) saw this and asked the attendant: "Has there been saliva in the mouth?" The attendant replied: "Yes." Dai Ren first decocted Fangfeng (Saposhnikoviae Radix) and Lili (Veratrum Nigrum Rhizoma), mixed the powder of Gudi (Melon Seed), and attempted to instill it. Since the patient could not swallow, he took a long clam shell, ground off the sharp edges, wrapped the tip in paper, and inserted it into the right nostril, after which a swallowing sound was heard. He then did the same with the left nostril. Dai Ren said: "It can be treated." After a long time, no saliva came out. So, one qian of Pishi (Arsenic Trioxide) was used again and inserted into the nose. Suddenly, the patient lay supine, appearing to feel pain, and shortly thereafter vomited, expelling several sheng of gelatinous saliva, which had a strong fishy odor. Pishi should not be used routinely because the condition is severe and requires such a potent method to move the pathogen. However, without Gudi, Pishi should not be used directly; one must exercise discretion. Generally, when stroke causes phlegm obstruction, it is often diagnosed merely as Wind, leading to an exclusive search for Wind-expelling medicines, causing many to be misled by Lingbao Dan and Zhibao Dan. Liu Hejian, when treating Wind, disregarded Wind itself and focused on the Two Fires (Fire and Heat); thus, this method is applied within the context of Fire constitution.
The wife of Mr. Ma, during July, suffered from intestinal sliding diarrhea (chronic dysentery/diarrhea). She was treated with herbs that dispel dampness and descend fire, showing slight improvement. Later, abdominal distension and breast pain developed, resembling Chuiru (acute mastitis), with severe pain, high fever, a face red as cinnabar, alternating chills and fever, dry throat with regurgitation, chest and hypochondriac pain preventing turning over, tinnitus, inability to take food, and recurrence of diarrhea. I wished to purge the fire, but the intestines had been sliding for days; I wished to use warm agents to stop dysentery, but the upper jiao was already hot, making this contraindicated. I found myself at a loss for a method. I sent someone to Zhuge Temple to respectfully invite Dai Ren. By the time Dai Ren arrived, I consulted Liu Hejian's formulas and found that Yiyuan San (Benefit the Origin Powder) perfectly matched this syndrome, capable of descending fire, releasing the exterior, stopping thirst, promoting urination, and calming the spirit. I mixed Qingdai (Indigo Naturalis) and Bohe (Menthae Haplocalycis Herba) powders with two sheng of Yiyuan San, placed it by the pillow, and instructed her to take it in several doses. At midnight, she sweated profusely all over like being washed. Previously, her feet felt cold as ice; now they became very warm, her head felt suddenly light, muscle soreness and pain decreased, vomiting stopped, and diarrhea ceased. When Dai Ren arrived, I informed him that the condition had resolved. Dai Ren said: "Yiyuan San is indeed appropriate. This is Shaoyang Syndrome (Lesser Yang Syndrome), which causes severe chills and fever; even if other meridians have chills and fever, they would not be so severe. Since there is heat accompanied by dysentery, and you do not wish to purge further, why not use Huanglian Jiedu Tang (Coptis Decoction to Relieve Toxicity)?" He then asked me to palpate the pulse. Dai Ren said: "Since the onset of this lady's illness, has she often desired to weep bitterly to find relief?" The woman replied: "I do desire to do so, though I do not know why." Dai Ren said: "Shaoyang Ministerial Fire scorches Lung Metal; Lung Metal, constrained and wronged, has nowhere to complain. The Lung governs grief; thus, she desires to weep bitterly to find relief." Mr. Ma said: "All my relatives respect and admire him. The pulse was initially surging, rapid, and forceful; after taking Yiyuan San, it halved. Hearing Dai Ren's words, I administered Danggui (Angelicae Sinensis Radix) and Shaoyao (Paeoniae Radix Alba) along with several ingredients from the Jiedu Tang, resulting in significant recovery."