江篁南治一壮年。患鼻 。胸膈不利。医用苦寒驱风败血之剂。服之年余。其人倦怠
甚
目不欲开。江诊视。右寸脉浮洪带结。余部皆沉细而软。曰。鼻 虽是多酒所伤。然苦寒
驱风败血之药。岂宜常服。经曰。苦伤气。又曰。苦伤血。况风药多燥。燥胜血。服之积久
安得不倦怠耶。且目得血而能视。目不欲开者。血伤。倦怠者。气伤也。所谓虚其虚。误
矣。治宜化滞血。生新血。四物加炒片芩、红花、茯苓、陈皮、甘草、黄 煎服。兼服固本
丸。日就强健。鼻 亦愈。
震按前医未必无功。但苦于只守一法而不知变通耳。江公方亦平淡。即能强健。且鼻
皆愈者。以前药原对病。服之太久。致伤气血。却只是倦怠。目不欲开。无太虚证。故略与
更张。稍兼补养。便可霍然。至其化滞血。生新血。四物加片芩、红花。实鼻 良法。
江应宿治王晓。鼻塞。气不通利。浊涕稠粘。屡药不效。已经三年。宿诊视。两寸浮数
曰。郁火病也。患者曰。昔医皆作脑寒主治。子何悬绝若是耶。经曰。诸气 郁。皆属于
肺。河间云。肺热甚则出涕。故热结郁滞。壅塞而气不通也。投以升阳散火汤十数剂。病如
失。
震按韩懋治鼻息。臭而痛。以白矾末加 少许。吹之。化水而消。其药太峻。又谓此浓
味壅湿热。蒸于肺门。如雨霁之地。突生芝菌。乃用胜湿汤加泻白散。二剂而愈。其说甚是
至于类案所载鼻中毛出长一二尺。渐粗如绳。又鼻流腥臭水。碗盛之有铁色虾鱼走跃。此
则莫须有矣。
祝茹穹治游成宇。患一证。遍身畏寒。夏月亦须棉袄。夜即烘火。鼻中全然不闻香臭。
鼻孔有一物如豆大。痒极。若以手爪入则又痛极。怀以黄泥入鼻。知为土气。常半月不开口
无医能治。祝曰。证有奇证。医有奇方。令觅一间极小房。四面砌砖
不许漏风。而四面俱锥一孔。地下掘一小坑。仅盘大。可容人面。然后锁闭病患于房内。
用艾百斤。渐从四面孔内烧入。自晨至午烧至三四十斤。烟塞满房。不能容鼻。遂伏地而寻
空隙。得盘大之小坑。以鼻抵之。须臾觉鼻息通畅。自午至子。遍身热极。将棉袄俱脱。天
明开门看时。其鼻中赘疣已落。不畏风寒。服补中益气汤。十剂全愈。究此病所以。因居楼
上。木气太甚。冬月用火太多。无缝可泄。木又生火。积久成痼。热在脏腑。寒在皮肤。用
艾以炙皮肤之寒。而通脏腑之窍。木入土而朽。火入土而烬。观其病时惟闻有土气。固已得
治法矣。
震按此法甚奇。然亦甚险。不可学也。夫人生于气。如鱼生于水。若以十笏小房。闭人
于内。四面糊之。不通一窍。半日而人死矣。以其与天地之气隔绝也。今虽四面有孔。孔既
极小。又以艾烟熏入。掘地之坑仅容人面。恐呼吸皆烟。闷极无逃。岂不危殆。
江篁南诊治一位壮年男子。患有鼻息肉（鼻中赘生物）。胸膈部感觉不畅利。医生使用苦寒、祛风、败血类的药剂。患者服用了一年多。此人极度疲倦乏力，眼睛不想睁开。江篁南诊察后说：右寸脉浮洪且带有结象，其余部位的脉象都沉细而软弱。他说：鼻息肉虽然多因饮酒过度损伤所致，但是苦寒、祛风、败血的药物，怎么可以长期服用呢？《内经》说：苦味伤气。又说：苦味伤血。况且风药大多燥烈，燥胜则耗伤血液，服用久了，怎么能不导致疲倦乏力呢？而且眼睛得到血液的滋养才能视物，眼睛不想睁开，是因为血受伤；疲倦乏力，是因为气受伤。这叫做使虚者更虚，是错误的。治疗应当化解瘀滞之血，生成新血。用四物汤加入炒制的黄芩、红花、茯苓、陈皮、甘草、黄连煎服。同时服用固本丸。日渐强健，鼻息肉也痊愈了。
俞震按语：前医未必没有功效，只是苦于只坚守一种治法而不知变通罢了。江公的方子也很平淡，既然能让人强健，且鼻息肉都痊愈，是因为之前的药原本对症，但服用时间太长，导致气血受损，却仅仅表现为疲倦、眼睛不想睁开，并没有太严重的虚证表现，所以稍微更改一下方案，稍加补养，就可以立刻痊愈。至于化解瘀滞之血、生成新血，用四物汤加黄芩、红花，确实是治疗鼻息肉的好方法。
江应宿诊治王晓。鼻塞，气息不通畅，鼻涕浑浊粘稠，多次用药无效。已经三年了。江应宿诊察后说：两寸脉浮数。他说：这是郁火病。患者说：以前的医生都把此病当作脑寒来主治，您为什么相差如此之大呢？《内经》说：各种气机郁结，都属于肺。刘河间说：肺热严重就会流涕。所以热邪结聚郁滞，壅塞而导致气机不通。投以升阳散火汤十几剂，病像消失了一样。
俞震按语：韩懋治疗鼻息（鼻中恶臭），气味臭且痛，用白矾末加少许冰片，吹入鼻腔，化水而消。这种药太峻猛。他又说这是浓味壅滞湿热，蒸腾于肺门，就像雨后初晴的地面，突然生出灵芝菌类。于是使用胜湿汤加泻白散，两剂而愈。他的说法很有道理。至于类案中所记载的鼻中长出毛发长达一二尺，逐渐变粗如绳子，以及鼻子流出腥臭的水，碗盛起来有铁色虾鱼跳跃，这些恐怕是虚构的吧。
祝茹穹诊治游成宇。患有一种病症，全身畏寒，即使在夏天也必须穿棉袄，晚上就要烤火。鼻中完全闻不到香臭。鼻孔里有一个像豆子大小的东西，极痒，如果用手爪去抠则又极痛。怀某人用黄泥塞入鼻中，知道是土气的作用，常常半个月不开口说话，没有医生能治好。祝茹穹说：病症有奇症，医生有奇方。让人找一间极小的房子，四面砌砖，不许漏风，而在四面各锥一个孔。地下挖一个小坑，仅盘子大小，可容纳人脸。然后把病人锁在房内。用艾草一百斤，渐渐从四面孔内烧入。从早晨到中午，烧到三四十斤，烟塞满房间，无法呼吸。病人于是趴在地上寻找空隙，找到盘子大小的小坑，用鼻子抵住小坑。一会儿觉得鼻息通畅。从中午到半夜，全身热极了，把棉袄都脱掉。天亮开门看时，鼻中的赘疣已经脱落，不再畏惧风寒。服用补中益气汤，十剂后完全痊愈。探究这个病的起因，是因为居住在楼上，木气太盛，冬天用火太多，没有缝隙可以宣泄，木又生火，积久成为痼疾。热在脏腑，寒在皮肤。用艾草熏炙皮肤的寒邪，从而打通脏腑的窍道。木入土而朽，火入土而烬。观察他发病时只闻到土气，说明已经得到了正确的治疗方法。
俞震按语：这种方法很奇特，但也极其危险，不可模仿学习。人生于气，就像鱼生于水。如果用十笏见方的小房子，把人关在里面，四面糊住，不通一窍，半天人就会死掉。因为与天地之气隔绝了。现在虽然四面有孔，孔既极小，又以艾烟熏入，挖掘的地坑仅容人脸，恐怕呼吸的都是烟，闷极无处可逃，难道不危险吗？
Jiang Huangnan treated a young man who suffered from nasal polyps (growths in the nose) and a sensation of fullness and discomfort in the chest and diaphragm. The physician prescribed bitter-cold, wind-dispelling, and blood-altering agents. After taking them for over a year, the patient became extremely fatigued and reluctant to open his eyes. Upon examination, Jiang found the pulse at the right Cun position to be floating, forceful, and irregular (Jie pulse), while pulses at other positions were deep, thin, and soft. He stated: "Although nasal polyps are often caused by excessive alcohol consumption, it is inappropriate to take bitter-cold, wind-dispelling, and blood-altering medicines for such a long time. The *Classic* states that bitterness damages Qi and also damages Blood. Moreover, wind-dispelling herbs are generally drying; dryness prevails and consumes Blood. How could one not become fatigued after prolonged use? Furthermore, the eyes require Blood nourishment to see. Reluctance to open the eyes indicates Blood damage; fatigue indicates Qi damage. This practice has made the deficiency worse, which is an error. Treatment should focus on resolving stagnant Blood and generating new Blood. Use Siwu Tang (Four Substance Decoction) added with stir-fried Huangqin (Scutellariae Radix), Honghua (Carthami Flos), Fuling (Poria), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma), and Huanglian (Coptidis Rhizoma), decocted and taken orally. Concurrently administer Guben Wan (Solidify the Root Pill). The patient gradually regained strength, and the nasal polyps healed."
Yu Zhen commented: "The previous physician may not have been entirely ineffective, but was limited by adhering rigidly to one method without flexibility. Dr. Jiang’s prescription was also mild. It strengthened the patient and cured the nasal polyps because the previous medication was originally appropriate for the disease, but its prolonged use damaged Qi and Blood. However, the symptoms were merely fatigue and reluctance to open the eyes, without severe deficiency signs. Thus, a slight adjustment with some tonification led to a swift recovery. Regarding resolving stagnant Blood and generating new Blood using Siwu Tang plus Huangqin and Honghua, this is indeed an excellent method for treating nasal polyps."
Jiang Yingsu treated Wang Xiao, who suffered from nasal congestion, obstructed breathing, and thick, sticky turbid discharge. Multiple treatments had failed over three years. Jiang examined him and noted floating and rapid pulses at both Cun positions, diagnosing it as a disorder of constrained Fire. The patient asked, "Previous physicians treated this as cold in the brain. Why is your diagnosis so different?" Jiang replied, "The *Classic* states that all Qi constraints belong to the Lung. Liu Hejian said that severe Lung Heat causes rhinorrhea. Therefore, heat accumulation and stagnation cause obstruction and impaired Qi flow." He prescribed Shengyang Sanhuo Tang (Ascending Yang and Dispersing Fire Decoction) for more than ten doses, resulting in complete resolution of the illness.
Yu Zhen commented: "Han Mao treated nasal fetor (stenosis with foul odor) characterized by foul smell and pain by insufflating a mixture of Baifan (Alumen) and a small amount of Bingpian (Borneolum Syntheticum) into the nose, causing the growth to dissolve. This remedy was too harsh. He explained that rich flavors cause damp-heat stagnation steaming at the Lung gate, likening it to mushrooms sprouting on rain-washed ground. He used Shengshi Tang (Defeating Dampness Decoction) combined with Xiebai San (Draining White Powder), curing the patient in two doses. His theory is sound. However, case records describing hair growing one or two chi long from the nose, thickening like a rope, or nosebleeds containing iron-colored shrimp and fish jumping in a bowl, are likely fictitious."
Zhu Ruqiong treated You Chengyu, who suffered from generalized aversion to cold, requiring cotton-padded jackets even in summer and heating fires at night. He had lost all sense of smell and taste through the nose. A bean-sized object inside the nostril caused extreme itching; scratching it induced severe pain. Huai used yellow mud inserted into the nose, recognizing the influence of Earth Qi. The patient remained silent for half a month, and no physician could cure him. Zhu said, "There are extraordinary diseases and extraordinary prescriptions." He instructed someone to find a very small room, brick-built with no leaks, having four small holes drilled in the walls. A pit dug in the floor, only plate-sized, large enough to fit a face. The patient was locked inside. One hundred jin of Aiye (Artemisiae Argyi Folium) were burned slowly through the wall holes from morning until noon, consuming thirty to forty jin. Smoke filled the room, making breathing impossible. The patient crawled on the floor seeking air, found the pit, and pressed his nose against it. Soon, nasal breathing cleared. From noon until midnight, the patient became extremely hot, removing all cotton clothes. At dawn, upon opening the door, the nasal wart had fallen off, and the patient no longer feared wind or cold. He took Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) for ten doses and recovered completely. Investigating the cause, Zhu reasoned that living upstairs allowed Wood Qi to become excessive. Excessive fire use in winter, with no venting, caused Wood to generate Fire, leading to entrenched pathology. Heat resided in the Zang-Fu organs, while cold remained in the skin. Moxibustion with Aiye warmed the skin’s cold and opened the Zang-Fu orifices. Wood rots in Earth, and Fire turns to ash in Earth. Observing that only Earth Qi was detected during the illness confirmed the correctness of the treatment method.
Yu Zhen commented: "This method is peculiar but extremely dangerous and should not be imitated. Humans live on Qi, just as fish live in water. If a person is confined in a tiny room sealed tightly with no ventilation, they will die within half a day due to isolation from Heaven and Earth’s Qi. Although this room had small holes, they were minimal, and moxa smoke was pumped in. The pit was barely large enough for a face. Breathing would involve inhaling mostly smoke, leading to suffocation with no escape. Is this not perilous?"