济北王女子竖,奉剑从王之厕。王去,竖后,王令人召之,即仆于厕,呕血死。病得之
流汗,流汗者同法。(法当春呕血死也)病内重,毛发色泽、脉不衰。
脾可割可补,故脾虽伤而毛发色泽脉不衰。惟大忌呕血,大忌流汗。医遇此症,贸然进
药者多矣。吾愿举是以晓之。(樊阿注)
齐中大夫病龋齿。臣意灸其左阳明脉,即为苦参汤,日漱三升,出入五、六日,病已。
得之风及卧开口,食而不漱。
食后宜漱口,为保齿秘诀。况卧时受风,风将内袭,即醒而咀嚼,使风聚而不散,齿故
先病,至于缺朽。苦参子涩敛,漱之用风解而齿固,此牙科丹方之一也。
川王美人,怀子而不乳。召臣意,臣意往。饮以莨砀药一撮,以酒饮之,旋乳。臣意
复诊其脉而脉躁,躁者有余病,即饮以硝石(芒硝、石膏),一剂出(便也)血,血如豆,
比五六枚,(莨砀今无买,可用穿甲代之)。
肠胃内燥,血气不流行,是以无乳。饮以硝石,则热降而燥润,瘀去而新生矣。医生多
治标而不知治本,如治无乳,则仅通乳而已,必罔顾其余病。若治至出血,病家且将大咎医
生。由是医生多用酬方,有宿疾者,永不可去。中国医途,可见一斑矣。(樊阿注)
齐丞相舍人奴,病得之流汗数出,灸于火而以出,见大风也望之杀。然黄黄者土气也,
土不胜木。当至春,隔塞不通,不能食饮,法至夏,泄血死。众医以为大虫,不知其伤脾气
也。
医不能望色,即不能辨症,自并生死不能决矣。若再诀治,势必加剧。若此症众医以为
大虫,必投泻药化虫药无疑,故成伤脾。否则流汗见风,病在皮孔,何以伤及脾气哉?且伤
脾不比伤肺伤肝,况当能食,治之尤易。乃知其病而无方,则亦何贵乎有名医。不惟舍人不
幸,当时病者亦皆不幸也。(樊阿注)
济北王的侍女竖,拿着剑跟随大王去厕所。大王离开后,竖跟在后面,大王派人叫她,她随即倒在厕所里,因呕血而死。这个病是由于流汗引起的,凡是因流汗得此病的,治疗方法相同。(按照规律,应当在春季因呕血而死。)病情内部严重,但毛发色泽和脉象没有衰败。因为脾脏是可以切除也可以修补的,所以虽然脾脏受伤,但毛发色泽和脉象不衰。唯独大忌呕血和大忌流汗。医生遇到这种病症,贸然进药的很多了。我希望通过这件事来阐明这个道理。(樊阿注)
齐国中大夫患有龋齿。我(淳于意)用艾灸他的左侧阳明经脉,并让他服用苦参汤,每天漱口三次,每次三升,经过五到六天,病就好了。这个病是因为受风以及睡觉时张口,吃东西后不漱口造成的。
饭后应该漱口,这是保护牙齿的秘诀。何况睡觉时受风,风邪将内侵,如果醒来后立即咀嚼,会使风邪聚集而不散,牙齿因此先生病,直到缺损腐朽。苦参子具有涩敛的作用,用它漱口可以解风邪而坚固牙齿,这是牙科秘方之一。
川王的宠妃,怀孕却不下奶。召见我(淳于意),我前往诊治。给她喝一撮莨菪药,用酒送服,很快就有乳汁分泌。我又诊察她的脉象,发现脉象躁动,脉躁说明体内有余病,于是给她服用硝石(芒硝、石膏),一剂药后排出(大便)血,血量像豆子一样大小,大约五六枚。(莨菪现在买不到,可以用穿山甲代替)。
肠胃内部干燥,气血运行不畅,所以没有乳汁。服用硝石,则热降而燥润,瘀血去除而新血生成。医生多治标而不知治本,比如治疗无乳,仅仅通乳而已,必定不顾及其他疾病。如果治疗导致出血,病人家属将会大大责怪医生。因此医生多用保守的处方,有旧疾的人,永远无法根除。中国医生的医术水平,由此可见一斑。(樊阿注)
齐丞相家奴,患病是因为多次流汗,在火烤后出汗,又见到大风,看起来像是被风邪所伤。面色黄黄的,这是土气(脾色),土不胜木(肝木克脾土)。应当到了春天,出现隔塞不通,不能饮食,按照规律到了夏天,会因便血而死。众医生认为是寄生虫病,不知道他是伤了脾气。
医生如果不能观察面色,就不能辨别症状,连生死都不能判断了。如果再错误地治疗,势必加重病情。如果像众医生那样认为是寄生虫,必定会投用泻药或化虫药,这无疑会造成脾脏损伤。否则,流汗见风,病在皮毛孔穴,怎么会伤及脾气呢?况且伤脾不比伤肺伤肝,何况当时还能进食,治疗尤其容易。如果知道了病因却没有正确的方剂,那名医又有什么可贵之处呢?不仅这个家奴不幸,当时的患者也都不幸啊。(樊阿注)
King Ji Bei's maid, Shu, carrying a sword, followed the King to the latrine. After the King left, Shu remained behind. When the King sent someone to summon her, she collapsed in the latrine and died from vomiting blood. This disease was contracted through sweating; those who contract it via sweating follow the same pattern. (According to the pattern, death by vomiting blood should occur in spring.) The internal pathology is severe, yet the hair luster and pulse remain un-declined. Because the spleen can be resected or supplemented, even though the spleen is injured, the hair luster and pulse do not decline. However, vomiting blood and excessive sweating are strictly contraindicated. Many physicians have rashly administered medication for this condition. I wish to elucidate this principle through this case. (Commentary by Fan A)
The Grand Master of Qi suffered from dental caries. I (Chunyu Yi) moxibusted his left Yangming meridian and prescribed Kushen Decoction (Sophora Flavescens Decoction), instructing him to rinse his mouth three times daily with three sheng (approx. 600ml). After five to six days, the disease was cured. The etiology was exposure to wind while sleeping with an open mouth, and eating without rinsing afterwards.
Rinsing the mouth after meals is a secret method for preserving teeth. Moreover, when wind invades during sleep, if one chews upon waking, the wind pathogen gathers and does not disperse, causing the teeth to become diseased first, eventually leading to decay and loss. Kushen Zi (Sophora Seed) has astringent properties; using it for mouth rinsing resolves wind pathogens and strengthens teeth. This is one of the secret prescriptions for dentistry.
The favorite concubine of the King of Chuan was pregnant but failed to lactate. She summoned me (Chunyu Yi), and I went to treat her. I administered a pinch of Langdang medicine (Datura seed preparation) dissolved in wine, and lactation resumed shortly thereafter. Upon re-examining her pulse, I found it rapid and restless (Zao), indicating residual pathogenic factors. I then administered Xiaoshi (Natrii Sulfas / Mirabilite and Gypsum). After one dose, she passed blood in the stool, resembling bean-sized clots, about five or six pieces. (Langdang is currently unavailable for purchase; Chuanjia [Squama Manis] may be used as a substitute.)
Internal dryness of the intestines and stomach, coupled with stagnant Qi and Blood, resulted in the absence of milk. Administering Xiaoshi reduces heat and moistens dryness, dispelling stasis and generating new blood. Physicians often treat the symptoms rather than the root cause. For example, treating agalactia merely involves promoting lactation, ignoring other underlying conditions. If treatment leads to hemorrhage, the patient's family will severely blame the physician. Consequently, physicians tend to use conservative formulas, leaving chronic diseases incurable. This reflects the state of medical practice in China. (Commentary by Fan A)
A servant of the Chancellor of Qi fell ill due to frequent sweating. He was exposed to fire-induced sweating and then encountered strong wind, appearing as if struck by wind pathogen. His complexion was yellowish, representing Earth Qi (the color of the Spleen), where Earth fails to overcome Wood (Liver Wood overacting on Spleen Earth). It was predicted that by spring, he would suffer from obstruction and inability to eat or drink, and according to the pattern, he would die from hematochezia in summer. The majority of physicians diagnosed him with intestinal parasites, failing to recognize that his Spleen Qi was injured.
If a physician cannot observe the complexion, they cannot differentiate the syndrome and cannot even determine life or death. Incorrect treatment would inevitably exacerbate the condition. If, like the other physicians, they had diagnosed intestinal parasites, they undoubtedly would have administered purgatives or vermifuges, which would certainly injure the Spleen. Otherwise, how could wind exposure at the skin pores injure the Spleen Qi? Furthermore, injuring the Spleen is different from injuring the Lungs or Liver; moreover, since the patient could still eat, the treatment would be relatively easy. If one knows the disease but lacks the correct formula, what value is there in being a famous physician? Not only was the servant unfortunate, but all patients at that time were also unfortunate. (Commentary by Fan A)