天津张姓幼女,年五岁,于孟秋得痢证。
病因 暑日恣食瓜果,脾胃有伤,入秋以来则先泻后痢。
证候 前因泄泻旬日,身体已羸弱,继又变泻为痢,日下十余次,赤白参半,下坠腹疼。屡次服
药不愈,身益羸弱,其脉象亦弱,而左脉之力似略胜于右。
诊断 按其左右脉皆弱者,气血两虚也。而左脉之力似略胜于右脉者,知其肝胆虚而挟热,是
以痢久不愈。然此热非纯系实热,不可用过凉之药,因其虚而挟热,其虚又不受补,是必
所用之补品兼能泻热,俾肝胆之虚热皆愈而痢自愈矣。
处方 鸭肝一具,调以食料,烹熟服之,日服二次。
效果 如法将鸭肝烹食两日全愈,此方愚在辽宁得之友人齐×
×。尝阅李氏《本草纲目》,鸭肉性凉善治痢,鸭蛋之腌咸
者亦善治痢,而未尝言及鸭肝。然痢之为病,多系肝火下迫肠中,鸭肉凉想鸭肝亦凉,此证先
泻后痢,身体羸弱,其肝经热而且虚可知,以鸭肝泻肝之热,即以鸭肝补肝之虚,此
所谓脏器疗法,是以奏效甚速也。且又香美适口,以治孺子之苦于服药者为尤宜也。
天津郑××,年五旬,于孟秋得下痢证。
病因 连日劳心过度,心中有热,多食瓜果,遂至病痢。
证候 腹疼后重,下痢赤白参半,一日夜七八次,其脉左部弦而
有力,右部浮而濡重按不实,病已八日,饮食减少,肢体酸软。
诊断 证脉合参,当系肝胆因劳心生热,脾胃因生冷有伤,冷热相搏,遂致成痢。当清其肝
胆之热,兼顾其脾胃之虚。
处方 生怀山药(一两) 生杭芍(一两) 当归(六钱) 炒薏米(六钱)
金银花(四钱) 竹茹(三钱碎者) 甘草(三钱) 生姜(三钱)
共煎汤一大盅,温服。
复诊 服药两剂,腹疼后重皆除,下痢次数亦减,且纯变为白痢。再诊脉左部已和平如常,而
右部之脉仍如从前,斯再投以温补脾胃之剂当愈。
处方 生怀山药(一两) 炒薏米(五钱) 龙眼肉(五钱) 山楂片(三钱)
干姜(二钱) 生杭芍(二钱)
共煎汤一大盅,温服。
效果 将药煎汤服两剂痢遂全愈。
帮助 按欲温补其脾胃而复用芍药者,防其肝胆因温补复生热
也。用山楂片者,以其能化白痢之滞,且与甘草同用则酸甘化合,实有健运脾胃之功效也。
天津有一位姓张的幼女,五岁,在初秋时节患上了痢疾。
病因:暑天里恣意食用瓜果,导致脾胃受损,入秋以来先是腹泻,随后转变为痢疾。
证候:此前因腹泻十天,身体已经变得瘦弱,接着又由腹泻转为痢疾,每天排便十多次,红白脓血参半,伴有肛门下坠感和腹部疼痛。屡次服药未能痊愈,身体更加瘦弱,脉象也虚弱,但左脉的力量似乎略胜于右脉。
诊断:按其左右脉皆虚弱来看,是气血两虚的表现。而左脉力量似乎略胜于右脉,说明肝胆虚损且夹杂热邪,因此痢疾久治不愈。然而这种热并非纯粹的实热,不可使用过于寒凉的药物治疗,因为其体质虚损而夹杂热邪,且虚弱的体质无法承受单纯的补益,所以必须选用既能补益又能清泻热邪的药物,使肝胆的虚热得以消除,痢疾自然痊愈。
处方:取鸭肝一副,用调料调味,煮熟后服用,每日服用两次。
效果:按照方法烹食鸭肝两天后完全痊愈。此方是我在辽宁从友人齐某某处得来的。曾查阅李时珍的《本草纲目》,其中记载鸭肉性凉,善于治疗痢疾,腌制的咸鸭蛋也善于治疗痢疾,但未提及鸭肝。然而痢疾这一疾病,多是由于肝火下迫肠道所致,鸭肉性凉,推测鸭肝亦性凉。此症先腹泻后痢疾,身体瘦弱,可知其肝经既有热又有虚。用鸭肝清泻肝热,同时也以鸭肝补益肝虚,这就是所谓的脏器疗法,因此见效迅速。而且鸭肝香美可口,对于难以服药的儿童来说尤为适宜。
天津郑某某,五十岁,在初秋时节患了下痢证。
病因:连日劳心过度,心中生热,加之多食瓜果,从而导致罹患痢疾。
证候:腹痛且肛门重坠感(后重),下痢红白脓血参半,一昼夜七八次,脉象左部弦而有力,右部浮而濡软,重按不实,病已八日,饮食减少,肢体酸软无力。
诊断:结合症状与脉象分析,应当是肝胆因劳心生热,脾胃因生冷食物受损,冷热邪气相互搏结,从而形成痢疾。应当清泻肝胆之热,同时兼顾脾胃之虚。
处方:生怀山药(一两)、生杭芍(一两)、当归(六钱)、炒薏米(六钱)、金银花(四钱)、竹茹(三钱,捣碎)、甘草(三钱)、生姜(三钱)。共煎煮成一大盅汤剂,温服。
复诊:服用两剂药后,腹痛和后重感均消失,下痢次数也减少,且大便纯变为白色脓液。再次诊察,左部脉象已平和如常,而右部脉象仍像从前一样。此时再投予温补脾胃的药剂即可痊愈。
处方:生怀山药(一两)、炒薏米(五钱)、龙眼肉(五钱)、山楂片(三钱)、干姜(二钱)、生杭芍(二钱)。共煎煮成一大盅汤剂,温服。
效果:将药煎汤服用两剂后,痢疾完全痊愈。
按语:想要温补脾胃却再次使用芍药的原因,是防止肝胆因温补而复生热邪。使用山楂片的原因,是因为它能化解白痢中的积滞,且与甘草同用时,酸甘化合,确实具有健运脾胃的功效。
A five-year-old girl surnamed Zhang in Tianjin contracted dysentery in early autumn.
Etiology: Indulging in melons and fruits during the hot summer days injured the Spleen and Stomach. Since entering autumn, she first experienced diarrhea, which then transformed into dysentery.
Symptoms: Due to ten days of prior diarrhea, her body had already become emaciated. Subsequently, the diarrhea turned into dysentery, with more than ten bowel movements per day consisting of half red blood and half white pus, accompanied by a sensation of bearing down (tenesmus) and abdominal pain. Repeated medication failed to cure her, her body became increasingly emaciated, and her pulse was weak. However, the force of the left pulse seemed slightly stronger than that of the right pulse.
Diagnosis: The weakness of both left and right pulses indicates deficiency of both Qi and Blood. The fact that the left pulse seems slightly stronger than the right suggests Liver and Gallbladder deficiency complicated by Heat, which is why the dysentery has persisted for a long time. However, this Heat is not purely Excess Heat; therefore, overly cooling medications should not be used. Because her constitution is deficient yet complicated by Heat, and her deficiency cannot tolerate pure tonification, the prescribed items must possess both tonifying and heat-clearing properties. This will eliminate the Deficient Heat in the Liver and Gallbladder, allowing the dysentery to heal spontaneously.
Prescription: One duck liver, seasoned with condiments, cooked thoroughly, and consumed. Taken twice daily.
Outcome: Following this method of cooking and consuming the duck liver, she recovered completely in two days. I obtained this prescription from my friend Mr. Qi XX in Liaoning. I have read Li Shizhen's *Compendium of Materia Medica*, which states that duck meat is cool in nature and effective in treating dysentery, and salted duck eggs are also effective. However, it does not mention duck liver. Dysentery is often caused by Liver Fire pressing downward into the intestines. Since duck meat is cool, it can be inferred that duck liver is also cool. In this case, where diarrhea preceded dysentery and the body was emaciated, it is evident that the Liver Meridian suffered from both Heat and Deficiency. Using duck liver to clear Liver Heat simultaneously tonifies Liver Deficiency. This is known as organ therapy, which explains its rapid efficacy. Moreover, it is delicious and palatable, making it particularly suitable for children who struggle with taking medicine.
Mr. Zheng XX from Tianjin, aged fifty, contracted lower dysentery in early autumn.
Etiology: Overwork and excessive mental exertion over several days generated Heat in the Heart. Combined with excessive consumption of melons and fruits, this led to dysentery.
Symptoms: Abdominal pain and tenesmus, with dysentery consisting of half red blood and half white pus, occurring seven or eight times per day and night. The pulse on the left side was wiry and forceful, while the pulse on the right side was floating and soggy, becoming empty upon heavy pressure. The illness had lasted for eight days, with reduced appetite and soreness and weakness in the limbs.
Diagnosis: Correlating symptoms and pulse, the condition arises from Heat generated in the Liver and Gallbladder due to mental overwork, and injury to the Spleen and Stomach caused by cold and raw foods. The conflict between Cold and Heat results in dysentery. Treatment should clear the Heat of the Liver and Gallbladder while attending to the deficiency of the Spleen and Stomach.
Prescription: Raw Huai Shan Yao (Dioscoreae Rhizoma, 1 liang), Raw Hang Shao (Paeoniae Radix Alba, 1 liang), Dang Gui (Angelicae Sinensis Radix, 6 qian), Fried Yi Mi (Coicis Semen, 6 qian), Jin Yin Hua (Lonicerae Flos, 4 qian), Zhu Ru (Bambusae Caulis in Taenia, 3 qian, crushed), Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 qian), Sheng Jiang (Zingiberis Rhizoma Recens, 3 qian). Decoct together in a large cup of water, take warm.
Second Visit: After taking two doses, abdominal pain and tenesmus were eliminated, and the frequency of dysentery decreased, with stools turning purely white pus. Upon re-examination, the left pulse had returned to normal peacefulness, but the right pulse remained unchanged. At this point, administering a formula to warm and tonify the Spleen and Stomach should lead to recovery.
Prescription: Raw Huai Shan Yao (Dioscoreae Rhizoma, 1 liang), Fried Yi Mi (Coicis Semen, 5 qian), Long Yan Rou (Longan Aril, 5 qian), Shan Zha Pian (Crataegi Fructus slices, 3 qian), Gan Jiang (Zingiberis Rhizoma, 2 qian), Raw Hang Shao (Paeoniae Radix Alba, 2 qian). Decoct together in a large cup of water, take warm.
Outcome: After taking two doses of the decoction, the dysentery was completely cured.
Commentary: The reason for using Shao Yao (Paeoniae Radix) again when intending to warm and tonify the Spleen and Stomach is to prevent the Liver and Gallbladder from generating Heat anew due to the warming tonification. The reason for using Shan Zha (Crataegi Fructus) is its ability to resolve stagnation in white dysentery. When used together with Gan Cao, the combination of Sour and Sweet flavors effectively strengthens and regulates the Spleen and Stomach.