盐山刘××,年二十五岁,得瘀血短气证。
病因 因出外修工,努力抬重物,当时觉胁下作疼,数日疼愈,仍觉胁下有物妨碍呼吸。
证候 身形素强壮,自受病之后,迟延半载,渐渐羸弱,常觉右胁之下有物阻碍呼吸之气,与
人言时恒半句而止,候至气上达再言,若偶忿怒则益甚,脉象近和平,惟稍弱不能条畅。
诊断 此因努力太过,致肝经有不归经之血瘀经络之间,阻塞气息升降之道路也。喜其脉
虽稍弱,犹能支持,可但用化瘀血之药,徐徐化其瘀结,气息自能调顺。
处方 广三七(四两)
轧为细末,每服钱半,用生麦芽三钱煎汤送下,日再服。
方解 三七为止血妄行之圣药,又为化瘀血之圣药,且又化瘀血不伤新血,单服久服无碍,此
乃药中特异之品,其妙处直不可令人思议。愚恒用以消积久之瘀血,皆能奏效。至麦芽原
为消食之品,生煮服之则善舒肝气,且亦能化瘀者也。是以用之煎汤,以送服三七也。
效果 服药四日后,自鼻孔中出紫血一条,呼吸较顺,继又服至药尽,遂脱然全愈。
或问 人之呼吸在于肺,今谓肝经积有瘀血,即可妨碍呼吸,其
义何居?答曰∶按生理之学,人之呼吸可达于冲任,方书又谓呼出心肺,吸入肝肾,若谓呼吸皆在
于肺,是以上两说皆可废也。盖心、肺、肝,原一系相连,下又连于冲任,而心肺相连之系,其中
原有两管,一为血脉管,一为回血管,血脉管下行,回血管上行。肺为发动呼吸之机关,非呼吸即限
于肺也,是以吸入之气可由血脉管下达,呼出之气可由回血管上达,无论气之上达下达,皆从
肝经过,是以血瘀肝经,即有妨于升降之气息也。据斯以论呼吸之关于肺者固多,而
心肺相连之系亦司呼吸之分支也。
病因:因外出做工,用力抬举重物,当时感觉胁下疼痛,几天后疼痛痊愈,但仍觉得胁下有异物阻碍呼吸。
证候:身体向来强壮,自患病以来,拖延了半年,逐渐变得消瘦虚弱,常觉得右胁下有物体阻碍气息的进出,与人说话时常常说到半句就停止,等到气顺上来再继续说,如果偶尔发怒则症状加重,脉象接近平和,只是稍微偏弱,不能条达通畅。
诊断:这是因为用力过度,导致肝经中有不循常道的血液瘀滞在经络之间,阻塞了气息升降的道路。庆幸的是脉象虽然稍弱,但还能支撑,可以只用化瘀血的药物,慢慢化解瘀结,气息自然能够调顺。
处方:广三七(四两)
研成细末,每次服用一钱半,用生麦芽三钱煎汤送服,每天服用两次。
方解:三七是制止血液妄行出血的圣药,也是化解瘀血的圣药,而且化解瘀血不损伤新血,单味药长期服用也无妨碍,这是药物中特异的一类,其妙处简直不可思议。我常用它来消除久积的瘀血,都能奏效。至于麦芽原本是用来消食的药物,生煮服用则善于舒展肝气,并且也能化瘀。因此用它煎汤,来送服三七。
效果:服药四天后,从鼻孔中排出一条紫黑色的血,呼吸变得顺畅,接着继续服药直到药尽,于是彻底痊愈。
有人问:人的呼吸在于肺,现在说肝经积聚有瘀血,就可以妨碍呼吸,其中的道理何在?回答说:按照生理学的知识,人的呼吸之气可达于冲脉和任脉,医书又说是呼出由心肺主管,吸入由肝肾主管,如果说呼吸仅仅局限于肺,那么以上两种说法都可以废弃了。大概心、肺、肝,原本是一系相连的,下面又连接于冲脉和任脉,而在心肺相连的系统之中,原有两条管道,一条是血脉管,一条是回血管,血脉管向下行,回血管向上行。肺是发动呼吸的机关,但呼吸并不仅限于肺,所以吸入之气可由血脉管下达,呼出之气可由回血管上达,无论气之上达还是下达,都要经过肝脏,所以血瘀在肝经,就会妨碍气息的升降。根据这个理论,呼吸与肺的关系固然很多,而心肺相连的系统也主管呼吸的分支。
Liu XX from Yanshan, aged 25, suffered from shortness of Qi (Shortness of Breath) caused by blood stasis.
Etiology: Due to working outdoors and exerting effort to lift heavy objects, he initially felt pain in the hypochondrium. After a few days, the pain subsided, but he continued to feel an obstruction in the hypochondrium hindering respiration.
Symptoms: His physique was originally robust. Since falling ill, after delaying for half a year, he gradually became emaciated and weak. He often felt an object obstructing the flow of Qi under the right hypochondrium. When speaking with others, he would often stop at half a sentence, waiting for the Qi to rise before continuing. If he became angry occasionally, the symptoms worsened. The pulse was near normal, but slightly weak and lacking smoothness.
Diagnosis: This is due to excessive exertion, causing blood that does not follow its normal course to stagnate within the meridians of the Liver Channel (Liver Meridian), blocking the pathway for the ascending and descending of Qi. Fortunately, although the pulse is slightly weak, it still has strength to support the body. One can use only herbs that resolve blood stasis to slowly dissolve the stasis, and the Qi will naturally become regulated.
Prescription: Panax Notoginseng Radix et Rhizoma (Guang Sanqi) (4 liang)
Pulverized into fine powder. Take 1 qian and 5 fen per dose, delivered with decoction made from 3 qian of raw Maltae Fructus (Sheng Maiya). Administer twice daily.
Formula Analysis: Panax Notoginseng Radix et Rhizoma is a supreme herb for stopping abnormal bleeding and also for resolving blood stasis. Moreover, it resolves stasis without damaging new blood; taking it alone for a long time causes no harm. It is a unique category among herbs, its efficacy being truly inconceivable. I have frequently used it to eliminate long-standing blood stasis, always achieving success. As for Maltae Fructus (Maiya), it is originally used for digesting food; when boiled raw, it is good at soothing Liver Qi and can also resolve stasis. Therefore, it is used as a decoction to deliver the Panax Notoginseng Radix et Rhizoma.
Outcome: After four days of taking the medicine, a strand of purple blood was discharged from the nostrils, and breathing became smoother. Continuing to take the medicine until it was exhausted, he recovered completely.
Interrogation: Someone asked, "Respiration resides in the Lung, yet you now say that accumulated blood stasis in the Liver Channel can hinder respiration. What is the rationale?" I replied: "According to physiology, respiratory Qi can reach the Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel). Medical texts also state that exhalation is governed by the Heart and Lung, while inhalation is governed by the Kidney and Liver. If one claims that respiration is limited solely to the Lung, then both aforementioned statements could be discarded. In fact, the Heart, Lung, and Liver are originally connected in a system, which further connects downward to the Chong and Ren vessels. Within the connection between the Heart and Lung, there are originally two tubes: one is the arterial tube (blood vessel), and the other is the venous tube (return vessel). The arterial tube descends, and the venous tube ascends. The Lung is the organ initiating respiration, but respiration is not limited to the Lung. Thus, inhaled Qi can descend via the arterial tube, and exhaled Qi can ascend via the venous tube. Regardless of whether Qi ascends or descends, it passes through the Liver. Therefore, blood stasis in the Liver Channel hinders the ascending and descending of Qi. Based on this argument, while respiration relates greatly to the Lung, the system connecting the Heart and Lung also manages branches of respiration."