王敬泉头晕且痛,起则倒仆,胸膈胀闷如绳束缚,呕吐而食饮皆不得入,六脉俱涩,此
痰饮挟木火之势而作晕也。先以济生竹茹汤而吐不止,且烦躁发
、发热。再与芦根汤,连进二碗,气 稍定。再以吴茱萸一两为末,
以鸡子心调涂两足心,引火下行,外用二陈汤加姜汁炒黄芩、黄连、旋复花、枇杷叶、丁香
、白豆仁、槟榔、柴胡,水煎服之。服后热退,大便亦行,头晕呕吐皆止。惟胃脘有一块作
痛,仍与前药两剂,而块亦消。
张二官发热头痛,口渴,大便秘结三日未行,脉洪大,此阳明少阳二经之症。用大柴胡
汤行
三五次,所下者皆黑粪,夜出臭汗,次日清爽,惟额上仍热。用白虎汤加葛根、天花粉。
因食粥太早,复发热咳嗽,口渴殊甚,且恶心。用小柴胡加枳实、山栀子、麦芽。次日渴不
可当。改以白虎汤加麦门冬、天花粉,外与辰砂益元散以井水调下五钱,热始退,渴始定。
不虞夜睡失盖,复受寒邪,天明又大发热,不知人事,急用小柴胡汤加升麻、葛根、前胡、
薄荷进之而汗出热退,神思大瘁,四肢皆冷,语言懒倦,且咳嗽。以生脉散加石斛、百合、
大枣、白芍药,服后咳嗽寻止,精神日加,饮食进而向安矣。
大司马潘印川第三令子室,尚书蒋公孙女也。年二十五,体素弱,语言端谨。因难产伤力,
继以生女拂意,后又女死悲戚,实时晕厥,醒而神思咪昧,手足螈 ,目作上视。予更后始
至,因螈 不能诊脉,细询之,自
女落地,恶露绝无,比有女医在旁,乃昔所亲信者,时与人参大嚼,及独参汤并粥乱进,参
与粥皆壅塞膈上不下,以故神昏螈 不已也。予教以手于喉中探而吐之,喜其随手吐出痰饮
、粥、药盈盆,螈 方定。乃与川芎、山楂、泽兰叶、陈皮、半夏、茯苓、香附进之,稍得
睡。予亦出中堂就寝。不虞女医又私与补药二帖。子丑时,陡然狂乱如降神之状,口中乱语
云∶我是观音大士降坛。所言皆儒雅官话,问答如流,声甚壮厉,殊无产后不足之态。生平
不谙汉声,至是出语如生成者,人皆异之,目为神附,禳祷百般。予独诤之,语诸左右曰∶
此恶露不尽,乃蓄血如见鬼之症,非真有神佛相附也。徐以正言叱之即缄默,继以清魂散加
滑石、童便与之。至天明小水乃行,狂乱皆定。迨予出房少顷,讵知女医意欲要功,又不知
与何药服之,少刻狂乱如前。再与川芎一钱五分,当归四钱,泽兰叶、益母草各一钱,临服
加童便,连饮二帖不效。予逆思之,胸中必有余痰作滞,前剂中无佐、使之品,故药力不行
也。即用前剂大加山楂与之,恶露稍行,神思即静,嗣后稍睡少时,手足微动,或自以手掌
其面,或自以手捶其胸,昏乱不息。诊其脉近虚,早间面红而光,申酉时面色白,此血行火
退,故脉虚而当补矣。与人参、川芎、泽兰叶各一钱,当归、山楂各二钱,茯苓、陈皮各八
分,卷荷叶一片,煎熟调琥珀末子五分,服下半时许,嗳气二声。予喜曰∶此清阳升而浊阴
降矣,自兹安静。夜中恶露行,大便亦利,乃索粥饮。问其昨日汉声何来?答曰∶不知也。
诸君始信蓄血如见鬼之言为不诬。昔秦越人有言曰∶病有六不治,信巫不信医一不治也。古
称用药如用兵。以郭子仪之英明,而以鱼朝恩监之,便不成功。予固非郭令公之俦,彼女医
之误,则又有过于鱼朝恩矣。噫!宁不慎哉?
王敬泉感到头晕且头痛,起身时便跌倒,胸膈部胀闷如同被绳子捆绑束缚,呕吐严重导致饮食无法进入,六脉均呈现涩象,这是痰饮挟带肝木与心火之势而引发的眩晕。起初使用济生竹茹汤治疗,但呕吐不止,反而出现烦躁、惊悸和发热症状。随后改用芦根汤,连续服用两碗后,气逆稍平。接着取吴茱萸一两研成粉末,用鸡蛋清调和涂抹于双足心,以引火下行;外用二陈汤加入姜汁炒制的黄芩、黄连、旋复花、枇杷叶、丁香、白豆仁、槟榔、柴胡,水煎服用。服药后热退,大便通畅,头晕和呕吐全部停止。仅剩下胃脘部有一块疼痛,继续给予前药两剂,肿块也随之消散。
张二官出现发热、头痛、口渴,大便秘结三日未解,脉象洪大,这是阳明经和少阳经的病症。使用大柴胡汤通下三到五次,排出的都是黑色粪便,夜间排出臭汗,次日感觉清爽,只有额头仍然发热。于是使用白虎汤加入葛根、天花粉。因为过早喝粥,再次出现发热、咳嗽,口渴非常严重,且伴有恶心。改用小柴胡汤加入枳实、山栀子、麦芽。次日口渴难忍。改为白虎汤加入麦门冬、天花粉,同时外服辰砂益元散,用井水调服五钱,热势才退,口渴才止。没想到夜间睡觉没有盖好被子,再次受寒邪侵袭,天亮时又大发热,神志不清,紧急使用小柴胡汤加入升麻、葛根、前胡、薄荷服用,出汗后热退,但精神极度疲惫,四肢发冷,语言懒倦,且伴有咳嗽。使用生脉散加入石斛、百合、大枣、白芍药,服药后咳嗽很快停止,精神日渐恢复,饮食增加,病情趋向安定。
大司马潘印川的第三房妾室,是尚书蒋公的孙女。年龄二十五岁,体质素来虚弱,言语端庄谨慎。因难产耗伤体力,继而生女不如意,后又因女儿夭折而悲伤,当时突然晕厥,醒来后神志昏昧,手足抽搐,眼球上翻。我到达时已是产后不久,因患者抽搐无法诊脉,仔细询问得知,自从婴儿落地,恶露完全没有排出,旁边有一位女医,是以前亲信的人,此时让人给患者大量吃人参,并灌独参汤及粥,人参和粥都壅塞在膈上不下行,因此神志昏迷、抽搐不止。我教她用手指探入喉咙催吐,庆幸她随手吐出痰饮、粥、药物盈满一盆,抽搐才停止。于是给予川芎、山楂、泽兰叶、陈皮、半夏、茯苓、香附服用,患者稍得睡眠。我也走出中堂去休息。没想到女医又私自给予补药两帖。子丑时(凌晨1-3点),突然狂乱如降神附体状,口中乱语说:“我是观音大士降临坛场。”所说的都是儒雅的文人官话,问答流利,声音壮厉,完全没有产后虚弱的状态。平生不懂汉地语音,至此却说出如同天生般的语言,人们都感到惊奇,认为是神灵附体,进行各种祈祷驱邪。我独自争辩,对周围的人说:“这是恶露不尽,属于蓄血如见鬼的病症,并非真有神佛附体。”慢慢用正言呵斥她,她便沉默了,接着给予清魂散加入滑石、童便服用。到天明小便才通畅,狂乱完全平息。等我离开房间片刻,谁知女医想要邀功,又不知给了什么药,片刻后狂乱如前。再给予川芎一钱五分,当归四钱,泽兰叶、益母草各一钱,临服用时加入童便,连服两帖无效。我推测思考,胸中必有残留痰浊阻滞,前剂中没有佐使药,所以药力不行。立即用前剂大幅加重山楂用量给予,恶露稍行,神志即静,随后稍睡片刻,手足微动,有时自己用手掌抚摸脸部,有时自己用手捶打胸部,昏乱不停。诊其脉象近于虚,早晨面色红亮,申酉时(下午3-7点)面色白,这是血行火退,所以脉虚应当进补。给予人参、川芎、泽兰叶各一钱,当归、山楂各二钱,茯苓、陈皮各八分,卷荷叶一片,煎熟调服琥珀末五分,服用约半小时,嗳气两声。我高兴地说:“这是清阳上升而浊阴下降啊,从此安静。”夜间恶露排出,大便也通畅,于是索要粥饮。问她昨天说的汉地语音从哪来?回答说不清楚。众人才相信蓄血如见鬼的说法不是虚假的。昔日秦越人说:“病有六种情况难以治愈,信巫不信医是其中之一。”古人称用药如用兵。以郭子仪的英明,如果让鱼朝恩监军,就不能成功。我固然不是郭令公那样的人物,那女医的错误,则比鱼朝恩更严重。唉!怎能不谨慎呢?
Wang Jingquan suffered from dizziness and headache, falling down upon rising. His chest and diaphragm felt distended and stifled as if bound by a rope, with vomiting preventing any food or drink from entering. All six pulses were choppy (Se). This is dizziness caused by Phlegm-Fluids (Tan Yin) carrying the momentum of Liver Wood and Heart Fire. Initially treated with Jisheng Zhuru Tang (Life-Sustaining Bamboo Shavings Decoction), but vomiting persisted, accompanied by irritability, palpitations, and fever. Then Lugen Tang (Reed Rhizome Decoction) was administered; after two bowls, the rebellious Qi slightly settled. Next, one liang of Wuzhuyu (Evodiae Fructus) was powdered, mixed with egg white, and applied to both soles to guide Fire downward. Externally, Erchen Tang (Two-Cured Decoction) was modified with Jiangzhi Chao Huangqin (Ginger-fried Scutellariae Radix), Huanglian (Coptidis Rhizoma), Xuanfuhua (Inulae Flos), Pipaye (Eriobotryae Folium), Dingxiang (Caryophylli Flos), Baidouren (Amomi Fructus Rotundus), Binglang (Arecae Semen), and Chaihu (Bupleuri Radix), decocted in water and taken orally. After ingestion, fever subsided, stool passed, and dizziness and vomiting ceased. Only a painful mass remained in the epigastrium; continuing the previous prescription for two doses resolved the mass.
Zhang Erguan presented with fever, headache, thirst, and constipation for three days without bowel movement. The pulse was surging (Hong) and large (Da), indicating symptoms of the Yangming and Shaoyang meridians. Dachaihu Tang (Major Bupleurum Decoction) was used to promote purgation three to five times. The discharged matter was black stool. At night, foul-smelling sweat appeared. The next day he felt refreshed, except for residual heat on the forehead. Baihu Tang (White Tiger Decoction) was modified with Gegen (Puerariae Radix) and Tianhuafen (Trichosanthis Radix). Due to consuming porridge too early, fever and cough recurred with severe thirst and nausea. Xiaochaihu Tang (Minor Bupleurum Decoction) was modified with Zhishi (Aurantii Fructus Immaturus), Shanzhizi (Gardeniae Fructus), and Maiya (Hordei Fructus Germinatus). The next day, thirst became unbearable. The prescription was changed to Baihu Tang (White Tiger Decoction) plus Maidong (Ophiopogonis Radix) and Tianhuafen (Trichosanthis Radix). Additionally, Chensha Yiyuan San (Cinnabar and Primrose Powder) was taken externally, mixed well-water and ingested (5 qian). Fever then subsided, and thirst stabilized. Unexpectedly, due to uncovered sleep at night, cold pathogen invaded again. By dawn, high fever returned with loss of consciousness. Urgently, Xiaochaihu Tang (Minor Bupleurum Decoction) was modified with Shengma (Cimicifugae Rhizoma), Gegen (Puerariae Radix), Qianhu (Peucedani Radix), and Bohe (Menthae Haplocalycis Herba). Sweating occurred, fever retreated, but spirit was exhausted, limbs cold, speech lazy and fatigued, with cough. Shengmai San (Generate Pulse Powder) was modified with Shihu (Dendrobii Caulis), Baihe (Lilii Bulbus), Dazao (Jujubae Fructus), and Baishao Yao (Paeoniae Radix Alba). Cough stopped quickly, spirit improved daily, diet increased, and condition stabilized.
The third concubine of Grand Marshal Pan Yinchuan, granddaughter of Minister Jiang Gong, aged 25, was constitutionally weak and spoke decorously. Difficult labor depleted her strength. Subsequent disappointment over giving birth to a daughter, followed by grief over the infant's death, led to sudden syncope. Upon waking, she was mentally confused, with convulsions of hands and feet, and eyes rolling upward. I arrived after the event; unable to take pulse due to convulsions, I inquired carefully. Since delivery, lochia had completely ceased. A female physician present, formerly trusted, had fed her large amounts of Renshen (Ginseng Radix et Rhizoma), Du Shen Tang (Single Ginseng Decoction), and porridge. The ginseng and porridge obstructed the diaphragm, causing coma and persistent convulsions. I instructed her to induce vomiting by probing the throat. Fortunately, phlegm-fluids, porridge, and medicine filled the basin, stopping convulsions. Then Chuanxiong (Chuanxiong Rhizoma), Shanzha (Crataegi Fructus), Zelan Ye (Lycopus Herba), Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma Praeparatum), Fuling (Poria), and Xiangfu (Cyperi Rhizoma) were administered. She slept slightly. I retired. Unexpectedly, the female physician privately gave two doses of tonics. At Zi-Chou hours (1-5 AM), she suddenly became manic like spirit possession, babbling: "I am Guanyin Bodhisattva descending." She spoke elegant official language fluently with a strong voice, showing no signs of postpartum deficiency. She never knew Han dialect, yet spoke naturally. People were amazed, believing it divine possession, praying and exorcising. I argued alone, telling attendants: "This is incomplete lochia, a syndrome of Blood Stasis resembling seeing ghosts, not true deity possession." Calmly scolding her silenced her. Qinghun San (Clear Soul Powder) plus Huashi (Talcum) and Tongbian (Child's Urine) was given. By dawn, urination resumed, mania settled. Shortly after I left, the female physician, seeking credit, gave unknown medicine. Mania returned. Chuanxiong 1.5 qian, Danggui 4 qian, Zelan Ye 1 qian, Yimucao 1 qian, with Tongbian added before administration, taken twice without effect. I reasoned that residual phlegm stagnation existed in the chest; the previous formula lacked assistant/guide herbs, so efficacy failed. I used the previous formula adding large amounts of Shanzha. Lochia moved slightly, mind quieted. She slept briefly, moving limbs, touching face, beating chest, remaining confused. Pulse near deficient. Morning face red and shiny; evening face pale. Blood moved, fire retreated, hence pulse deficient requiring tonification. Renshen, Chuanxiong, Zelan Ye each 1 qian, Danggui, Shanzha each 2 qian, Fuling, Chenpi each 0.8 fen, Juan Heye (Lotus Leaf) 1 piece, decocted, mixed with Hupo Mozi (Amber Powder) 0.5 fen. After half an hour, two belches occurred. I rejoiced: "Clear Yang rises, turbid Yin descends." From then on, calm. Nightly lochia flowed, stool cleared, requesting porridge. Asked about yesterday's Han dialect source? Answered: Don't know. Everyone believed the statement on blood stasis resembling ghost vision was true. Qin Yue-ren once said: "Six types of untreatable diseases include trusting sorcerers over physicians." Ancients said prescribing medicine is like using troops. With Guo Ziyi's brilliance, appointing Yu Chaoen as supervisor would lead to failure. I am no Guo Linggong, but this female physician's error exceeded Yu Chaoen. Alas! How can one not be cautious?