〔子和〕陈州长史一小儿病,寐而不寤三日。诸医作睡惊治之,或欲以艾火灸之,或以大惊丸及水
银饼子治之。其父曰∶此子平日无疾,何骤有惊乎?以子之病问戴人,戴人诊其两手脉,皆平和。
戴人曰∶若惊风之脉,当洪大而强,今则平和,非惊风也。戴人窃问其乳母,尔三日前曾饮酒醉否?
蘧然笑曰∶夫人以煮酒见饷,酒味甚美,三饮一罂而睡。夫陈酒味甘而恋膈,酒气满乳,儿亦醉也。
乃锉甘草、干葛、葛花、缩砂仁、贯众煎汁,啜之立醒。
运气 多睡皆属内热。经云∶阳明司天之政,初之气,阴始凝,气始肃,病中热,善眠是也。
〔《怪穴》〕困睡多∶无名指第二节尖。(灸一壮,屈手指取之。)
经云∶一阴一阳结,谓之喉痹。又云∶肝者,中之将也,取决于胆,咽为之使。故以喉咽入肝
胆部。
〔《素》〕喉主天气,咽主地气。(太阳阳明论)地气通于嗌。(全文见五脏。咽喉下接连胸中肺
叶之间。嗌即咽之低处也,咽即嗌之高处也。)
咽喉者,水谷之道也。喉咙者,气之所以上下者也。会厌者,音声之户也。悬壅者,音声之关也。(全文见喑。)
〔子和〕咽与喉,会厌与舌,此四者同在一门,而其用各异。喉以纳气,故喉气通于天。咽以纳
食,故咽气通于地。会厌管乎其上,以司开辟,掩其喉,则其食下。不掩之,其喉错。必舌抵上 ,则
会厌能闭其喉矣。四者交相为用,阙一则饮食废而死矣。
【张子和】陈州长史的一个孩子患病,昏睡三天无法醒来。各位医生当作“睡惊”(因受惊吓导致的睡眠障碍)来治疗,有的想用艾火灸治,有的想用“大惊丸”及“水银饼子”治疗。孩子的父亲说:“这个孩子平时没有疾病,怎么会突然受到惊吓呢?”于是向戴人(张子和的号)询问孩子的病情。戴人诊察他双手的脉象,都平和正常。戴人说:“如果是惊风病,脉象应当洪大且强劲,现在脉象平和,不是惊风。”戴人私下询问他的乳母:“你三天前曾经饮酒喝醉过吗?”乳母忽然笑着说:“夫人用煮好的酒招待我,酒味很美,我喝了三大罐就睡着了。陈年的酒味甘厚且滞留在胸膈,酒气充满乳汁,孩子也因此醉了。”于是切碎甘草、干葛(葛根)、葛花、缩砂仁(砂仁)、贯众煎煮成汁,让孩子喝下,立刻苏醒。
运气学说认为:多睡都属于内热。《内经》说:“阳明司天之政,初之气时,阴气开始凝结,气候开始肃杀,病症表现为中热,容易嗜睡,就是这种情况。”
【《怪穴》】困倦多睡症:无名指第二节指尖。(灸一壮,弯曲手指取穴。)
《内经》说:“一阴一阳结聚,称为喉痹。”又说:“肝是体内的将领,取决于胆,咽喉是它的使者。”因此将咽喉归入肝胆部讨论。
【《素问》】喉主管天气,咽主管地气。(见《太阳阳明论》)地气通于嗌(咽的下部)。(全文见五脏篇。咽喉位于下,连接着胸中肺叶之间。嗌就是咽的低处,咽就是嗌的高处。)
咽喉是水谷进入的通道。喉咙是气上下通行的地方。会厌是声音发出的门户。悬雍垂(小舌头)是声音发出的关卡。(全文见失音篇。)
【张子和】咽与喉,会厌与舌,这四个部位同在一个门户,但功能各不相同。喉用来接纳气息,所以喉气通天。咽用来接纳食物,所以咽气通地。会厌管理上方,负责开合,掩住喉部,食物就能下行。如果不掩住,喉部就错位。必须舌尖抵住上颚,会厌才能关闭喉部。这四者相互为用,缺少任何一个,饮食就会废绝而死亡。
[He Zi (Zhang Zijian)] A child of the Longshi (Chief Clerk) of Chenzhou fell ill and remained in a deep sleep for three days without waking. Various physicians treated it as "sleeping fright" (a sleep disorder caused by fright). Some wished to treat it with moxibustion, while others proposed using Dajing Wan (Great Fright Pill) or Shuiyin Bingzi (Mercury Tablet). The father said, "This child has been healthy usually; how could he suddenly suffer from fright?" He asked Dairen (Zhang Zijian's courtesy name) about his son's condition. Dairen palpated the pulses at both wrists and found them all peaceful and normal. Dairen said, "If this were wind-stroke due to fright, the pulse should be surging and strong. Now that it is peaceful, it is not wind-stroke." Dairen secretly asked the wet nurse, "Did you drink alcohol to intoxication three days ago?" She suddenly laughed and replied, "The lady treated me with boiled wine; the taste was very fine. I drank three jars and then slept. Old wine has a sweet taste and lingers in the chest and diaphragm; its qi filled the breast milk, and the child also became intoxicated." They then chopped Gancao (Licorice Root), Gange (Kudzu Root), Ge Hua (Kudzu Flower), Suosharen (Amomum Fruit), and Guanzhong (Cyathulae Radix), decocted them into juice, and had the child sip it. The child woke up immediately.
Regarding Yunqi (Six Qi Movement): Excessive sleeping all belongs to internal heat. The Classic says: "When Yangming governs the heaven's mandate, during the first Qi period, yin begins to congeal, the climate becomes solemn, the disease presents as middle-heat, and excessive sleep occurs."
[From *Guai Xue*] For drowsiness and excessive sleep: Wuzhimijie (Tip of the second joint of the ring finger). (Moxibustion, one cone; locate by flexing the finger.)
The Classic says: "When one yin and one yang knot together, it is called Hou Bi (throat obstruction)." It also says: "The Liver is the general within; it depends on the Gallbladder, and the pharynx serves as its envoy." Therefore, the throat and pharynx are discussed in the section on the Liver and Gallbladder.
[From *Suwen*] The Larynx (Hou) governs Heaven Qi, and the Pharynx (Yan) governs Earth Qi. (See *Taiyang Yangming Lun*). Earth Qi connects to Yi (the lower part of the pharynx). (Full text see Five Zang Organs. The throat and pharynx connect below to the lung lobes between the chest. Yi refers to the lower part of the pharynx, while Yan refers to the higher part.)
The throat and pharynx are the pathways for water and food. The larynx is where Qi ascends and descends. The epiglottis is the gatehouse of sound. The uvula is the barrier of sound. (Full text see Aphonia.)
[He Zi (Zhang Zijian)] The pharynx and larynx, the epiglottis and the tongue—these four reside in the same gateway but have different functions. The larynx receives Qi, thus its Qi connects to Heaven. The pharynx receives food, thus its Qi connects to Earth. The epiglottis manages the upper aspect, controlling opening and closing; when it covers the larynx, food descends. If it does not cover it, the laryngeal passage is obstructed. One must press the tongue against the palate for the epiglottis to close the larynx effectively. These four interact mutually; if any one is missing, eating and drinking will cease, leading to death.