一书办年过五十,糟酒纵欲无惮,忽患下消之症,一日夜小便二十余度,清白而长,味
且甜
,少顷凝结如脂,色有油光。治半年不验,腰膝以下皆软弱,载身不起,饮食减半,神色大
瘁。脉之六部大而无力。书云∶脉至而从,按之不鼓,诸阳皆然,法当温补下焦。以熟地黄
六两为君,鹿角霜、
山茱萸各四两,桑螵蛸、鹿角胶、人
参、白茯苓、枸杞子、远志、菟丝子、怀山药各
三两为臣,益智仁一两为佐,大附子、桂心各
七钱为使,炼蜜为丸,梧桐子大,每早晚淡
盐汤送下七八十丸,不终剂而愈。或曰∶凡云消者皆热症也。始公具方,人多议之,今果以
温补成功,此何故哉?予曰∶病由下元不足,无气升腾于上,故渴而多饮。以饮多,小便亦
多也。今大补下元,使阳气充盛,熏蒸于上,口自不干。譬之釜盖,釜虽有水,若底下无火
,则水气不得上升,釜盖干而不润。必釜底有火,则釜中水气升腾。熏蒸于上,盖才湿润不
干也。予已详着《医旨绪余》中,兹不多赘。
佥宪韩约斋老先生令子室,每动怒则夜卧不安
,如见鬼魅,小水淋沥,今又大便秘结,腹中疼痛,腰胯胀坠如生产状,坐卧不安,因痛而
脉多不应指。此肝经郁火所致,法当通利。以杏仁、桃仁各三钱, 树根皮、山栀仁、青皮
各一钱,槟榔五分,枳壳八分,水煎服之。少顷大便通,痛胀随减。
孙书办年过五十,因沉溺于酒色且毫无节制,突然患上“下消”这一病症。他一天一夜小便二十多次,尿液清澈细长,味道甘甜,不久后凝结得像油脂一样,表面泛着油光。治疗半年没有见效,腰部及膝盖以下都软弱无力,身体无法支撑站立,饮食减少了一半,神色极度疲惫。诊脉发现六部脉象都大而无力。古籍《内经》记载:脉象看似顺从(指浮取可见),但重按却无鼓动之力,所有阳脉都是如此,治疗方法应当温补下焦。方中以熟地黄六两为君药,鹿角霜、山茱萸各四两,桑螵蛸、鹿角胶、人参、白茯苓、枸杞子、远志、菟丝子、怀山药各三两作为臣药,益智仁一两作为佐药,大附子、桂心各七钱作为使药,用炼蜜制成丸药,大小如梧桐子,早晚各用淡盐水送服七八十丸,尚未服完一剂病就好了。有人问:凡是称为“消”的病,通常都是热症。起初您开出这个方子时,很多人议论纷纷,现在果然靠温补治好了,这是什么原因呢?我回答说:此病是由于下元(肾与命门)不足,元气不能升腾到上部,所以口渴而多饮。因为饮水多,小便自然也多。现在大力补益下元,使阳气充盛,向上熏蒸,口自然就不会干燥了。这就好比锅的盖子,锅里虽然有水,如果底下没有火,水汽就无法上升,锅盖就会干而不润。必须锅底有火,锅中的水汽才能升腾,向上熏蒸,锅盖才会湿润不干。我已经详细写在《医旨绪余》这本书里了,这里不再赘述。
佥宪韩约斋老先生的儿媳,每次发怒后就夜间睡眠不安稳,好像看见鬼怪一样,小便淋漓不尽,如今又大便秘结,腹部疼痛,腰部和胯部胀坠感如同临产一般,坐卧不宁,因为疼痛导致脉搏大多摸不到。这是肝经郁火所致,治疗方法应当通利。方中以杏仁、桃仁各三钱,树皮根皮(注:原文为树根皮,疑指特定树皮或笔误,此处保留原意)、山栀仁、青皮各一钱,槟榔五分,枳壳八分,用水煎服。过了一会儿大便通畅,疼痛和胀满随即减轻。
Sun Shuban, over fifty years old, indulged in alcohol and sexual activity without restraint, and suddenly suffered from Xiaoxiao (Lower Wasting-Thirst syndrome). He urinated more than twenty times a day and night; the urine was clear, long, sweet-tasting, and soon coagulated like fat with an oily sheen. After half a year of treatment with no effect, his waist and knees below were weak and soft, unable to support his body; his food intake was halved, and his spirit and complexion were greatly exhausted. Palpation revealed that the pulses in all six positions were large but powerless. The classic text states: "When the pulse appears compliant upon superficial palpation but fails to throb upon deep pressure, this applies to all Yang pulses." The method should be to warm and tonify the Lower Jiao (Lower Burner). Prepared Rehmanniae Radix Praeparata (Shu Dihuang) 6 liang served as the Sovereign herb; Deer Antler Frost (Lujiaoshuang) and Cornus Officinalis Fructus (Shanzhuyu), each 4 liang, along with Mantis Egg Case (Sangpiaoxiao), Deer Antler Glue (Lujiaojiao), Ginseng Radix et Rhizoma (Renshen), Poria (Baifuling), Lycii Fructus (Gouqizi), Polygalae Radix (Yuanzhi), Cuscutae Semen (Tusizi), and Dioscoreae Rhizoma (Huai Shanyao), each 3 liang, served as the Minister herbs; Alpinia Oxyphylla Fruit (Yizhiren) 1 liang served as the Assistant herb; Aconiti Lateralis Radix Praeparata (Da Fuzi) and Cinnamomi Cortex (Guixin), each 7 qian, served as the Guide herbs. These were processed with refined honey into pills, sized like Sophora japonica seeds, taken morning and evening with light salt water, 70-80 pills per dose. The illness was cured before the course of medication was finished. Someone asked: "All conditions termed 'Xiao' (Wasting-Thirst) are typically Heat syndromes. When you first prescribed this formula, many people criticized it. Now it has indeed succeeded through warming and tonifying. Why is this?" I replied: "The disease arises from deficiency of the Lower Yuan (Kidney and Mingmen). Qi lacks the strength to ascend to the upper part, causing thirst and excessive drinking. Due to excessive drinking, urination is also excessive. Now, by greatly tonifying the Lower Yuan, Yang Qi becomes abundant and steams upward, so the mouth naturally does not feel dry. It is like a pot lid: although there is water in the pot, if there is no fire underneath, the water vapor cannot rise, and the lid remains dry. Only when there is fire at the bottom can the water vapor in the pot rise and steam upward, making the lid moist and not dry. I have detailed this in my book *Yizhi Xuyu*, so I will not repeat it here."
The wife of the son of Elder Han Yuezhai, who held the title of Jinxian, experienced restless sleep at night whenever she became angry, feeling as though she saw ghosts or demons. Her urination was dribbling and scanty. Currently, she also suffers from severe constipation, abdominal pain, and a distending and bearing-down sensation in the waist and hips resembling labor pains. She is restless sitting or lying down due to the pain, and her pulse is often imperceptible due to the pain. This is caused by Stagnant Fire in the Liver Meridian. The method should be to promote free flow and unblock. Apricot Seed (Xingren) and Peach Kernel (Taoren), each 3 qian, Bark Root (Shugenpi - likely referring to a specific bark, kept as literal translation), Gardenia Seed (Shanzhiren), and Green Tangerine Peel (Qingpi), each 1 qian, Areca Seed (Binglang) 5 fen, and Aurantium Fructus Immaturum (Zhiqiao) 8 fen were decocted in water and administered. Shortly after, bowel movement was unblocked, and the pain and distension decreased accordingly.