易思兰治瑞州一妇。产后半月余。胃中有清水作逆而吐。以为胃寒。煎姜椒汤饮之。初
觉相宜。至三五日。清水愈多。口气渐冷。四肢发逆。腹中冷气难堪。有时战栗。以四物汤
加人参、炮姜。初服少安。久则不应。易诊之。六脉俱无。以三指按至尺后。脉来实数有力
左右皆同。发言壮厉。一气可说四五句。唇焦颊赤。大便五六日一次。小便赤少。此实热
症也。询之。其俗产后食胡椒炒鸡为补。此妇日食三次。半月后遂得疾。蓄热明矣。其口冷
吐水发厥者。热极似水耳。战栗者。热入血室。热盛生风也。用三黄汤连投之。六脉俱现。
清水渐减。姜椒汤不欲食矣。服四日。口中热气上升。口舌发黄小粟疮。大便八日不通。以
四苓合凉膈散空心一服。至午不动。又以甘草煎汤。调元明粉五钱。热服一时许。腹中微鸣
吐出酸水一二碗。大便连去二次。仍以四苓散、三黄、山栀、枳壳调理。一月全愈。大凡
诊脉。遇极大极微者。最宜斟酌。如极大而无力。须防阳气浮散于外。如极微之脉久久寻而
得之于指。稍稍加力。按之至骨愈坚牢者。不可认作虚寒。今此证六部皆无脉。尺后则实数
有力。所谓伏匿脉也。阳匿于下。亢之极矣。岂可泥于产后。禁用寒凉者。
震按易公之案甚多。此为第一。观其发明脉理。可谓仙传秘诀。
一妇人产后。日食茶粥二十余碗。一月后。遍身有冰冷数块。若以指按冷处。即冷从指
下上应至心。如是者二年。诸治不效。以八物汤去地黄。加橘红。入姜汁、竹沥一酒钟。十
服乃温。
震按此是痰饮流注肌肉。原非奇病。但按之而使不病者。冷应于心则奇矣。盖其人气血
已虚。痰饮留伏之处。营卫所不到。此数块即系死肉。治病之药。全仗姜汁、竹沥各一杯。
然非八物。何以助营卫之流行。去地黄恶其滞。加橘红取其通也。似宜再加南星、白芥子等
药。
易思兰诊治瑞州的一位妇人。产后半个多月，胃中有清水上逆而呕吐，（医生）认为是胃寒，煎煮姜椒汤让她服用。起初觉得适宜，到了三五天，清水越来越多，口气逐渐变冷，四肢发凉，腹中冷气难以忍受，有时出现战栗。（之前医生用）四物汤加入人参、炮姜。初服时稍见安宁，久了则不再见效。易思兰诊察后，发现六脉均摸不到，他用三指按压至尺部之后，脉搏来势实数有力，左右手相同。患者说话声音洪亮壮厉，一口气能说四五句话，嘴唇焦干，脸颊发红，大便五六天一次，小便短赤。这是实热证。询问得知，当地习俗认为产后吃胡椒炒鸡是进补，这位妇人每天吃三次，半个月后就得了这个病，蓄积的热邪非常明显。她口冷、吐水、发厥，是因为热极似水（真热假寒）。战栗是因为热入血室，热盛生风。于是使用三黄汤连续投服。六脉全部显现，清水逐渐减少，也不再想喝姜椒汤了。服药四天，口中热气上升，口舌长出黄色小粟疮。大便八天不通畅，用四苓散合凉膈散空腹服用一次。到中午仍未排便，又用甘草煎汤，调元明粉五钱，热服约一小时。腹中轻微鸣响，吐出酸水一两碗，大便接连排出两次。随后仍以四苓散、三黄汤、山栀、枳壳调理，一个月完全痊愈。大凡诊脉，遇到极大或极微的脉象，最应该仔细斟酌。如果脉象极大但无力，须防备阳气浮散于外；如果脉象极微，久久在指下寻得，稍稍加重力量，按至骨头处感觉更加坚牢的，不可认作虚寒。如今这个病例六部皆无脉，尺部之后则实数有力，这就是所谓的伏匿脉。阳气隐匿于下，亢盛到了极点，岂可拘泥于产后，禁用寒凉药物？
俞震按：易公的医案很多，这是第一例。看他阐明脉理，可以说是仙传秘诀。
另一位妇人产后，每天喝茶粥二十多碗。一个月后，全身有冰冷如块的区域，如果用手指按压冷处，就会感到冷意从指下向上传导至心脏。像这样的情况持续了两年，各种治疗都无效。用八物汤去掉地黄，加入橘红，调入姜汁、竹沥一酒杯的量。服用十剂后才变暖。
俞震按：这是痰饮流注于肌肉，原本不是奇病。但按压它却使不生病的人感到冷意应于心，这就奇怪了。大概是因为此人气血已虚，痰饮留伏之处，营卫之气所不能到达，这几块地方就是死肉。治病之药，全靠姜汁、竹沥各一杯。然而如果没有八物汤，凭什么帮助营卫之气的流行？去掉地黄是厌恶它的滋腻滞碍，加入橘红是取它通利的作用。似乎还应该再加南星、白芥子等药。
Yi Silan treated a woman from Ruizhou. More than half a month postpartum, she experienced vomiting of clear fluid rising from the stomach, which was initially diagnosed as Stomach Cold (Wei Han). A decoction of Ginger and Pepper was prepared for her to drink. Initially, she felt relief, but after three to five days, the amount of clear fluid increased, her breath became cold, her four limbs turned cold, abdominal coldness became unbearable, and she occasionally experienced shivering. The previous physician had used Siwu Tang (Four Substances Decoction) with added Ginseng Radix et Rhizoma (Renshen) and Processed Ginger Rhizome (Paojiang). While there was slight relief upon initial intake, it eventually became ineffective. Yi Silan examined her and found no pulse in all six positions. Pressing deeply with three fingers beyond the Chi position, he detected a solid, rapid, and forceful pulse, identical on both sides. Her voice was loud and vigorous; she could speak four or five sentences in one breath. Her lips were dry and cracked, cheeks red, bowel movements occurred once every five to six days, and urine was scanty and dark red. This indicated a Excess Heat syndrome (Shi Re Zheng). Upon inquiry, Yi learned that local custom regarded chicken stir-fried with pepper as a tonic for postpartum women. This patient consumed this dish three times daily, leading to the illness after half a month, clearly indicating accumulated heat. Her cold mouth, vomiting of water, and Jue syndrome (cold extremities/fainting) were due to extreme heat mimicking water (True Heat, False Cold). The shivering was caused by heat entering the Blood Chamber (Xue Shi) and wind generated by excessive heat. Yi prescribed Sanhuang Tang (Three Yellows Decoction) continuously. All six pulses became palpable, the clear fluid gradually decreased, and she lost the desire to consume the Ginger-Pepper decoction. After four days of medication, heat rose from the mouth, and small yellow millet-like sores appeared on the tongue and mouth. Bowel movement had not occurred for eight days. He administered Sizheng San (Four Poria Powder) combined with Liangge San (Cool the Chest Powder) on an empty stomach. By noon, there was still no movement. He then prepared a decoction of Licorice Root (Gancao), mixed with five qian of Yuanming Fen (Natrii Sulfas), and administered it hot. After about an hour, mild borborygmus occurred in the abdomen, followed by vomiting of one to two bowls of sour fluid, and two consecutive bowel movements. Subsequently, she was regulated with Sizheng San, Sanhuang Tang, Gardenia Fruit (Shanzhi), and Aurantium Fructus (Zhike). She recovered completely after one month. Generally, when diagnosing the pulse, if it is extremely large or extremely minute, great caution is required. If the pulse is extremely large but weak, one must guard against Yang Qi floating outward. If the pulse is extremely minute, found only after prolonged searching under the fingers, and feels firmer when pressed to the bone with slightly increased pressure, it should not be mistaken for Deficiency Cold. In this case, the pulse was absent in all six positions but was solid, rapid, and forceful behind the Chi position. This is known as the Hidden Pulse (Fu Ni Mai). Yang Qi is hidden below, reaching extreme hyperactivity. How can one rigidly adhere to the notion that postpartum conditions prohibit the use of Cold-Cooling herbs?
Yu Zhen commented: Master Yi has many medical cases, and this is the first. His elucidation of pulse theory can be considered a secret transmission from immortals.
Another woman, postpartum, drank over twenty bowls of tea and porridge daily. After one month, several patches of ice-cold areas appeared all over her body. When pressed with a finger, the cold sensation would travel upward from the finger through to the heart. This condition persisted for two years, and various treatments failed. She was treated with Bawu Tang (Eight Substances Decoction) minus Rehmanniae Radix Preparata (Dihuang), plus Citri Reticulatae Pericarpium (Juhong), mixed with Ginger Juice (Jiangzhi) and Bamboo Sap (Zhuli) equivalent to one wine cup. After ten doses, warmth returned.
Yu Zhen commented: This is Phlegm-Fluid (Tan Yin) flowing into the muscles; originally, it was not a strange disease. However, the phenomenon where pressing causes coldness to resonate in the heart of the observer is indeed peculiar. It is likely that because her Qi and Blood were already deficient, the areas where Phlegm-Fluid stagnated were places where Ying and Wei Qi could not reach; these patches are essentially "dead flesh." The medicinal efficacy relied entirely on Ginger Juice and Bamboo Sap, each one cup. Without Bawu Tang, how could the circulation of Ying and Wei Qi be assisted? Dihuang was removed to avoid its cloying nature, and Juhong was added for its penetrating quality. It seems appropriate to additionally add Arisaema Cum Bile (Nanxing) and Sinapis Semen (Baijiezi) and other herbs.