太塘程晓山,程松谷从弟也。客湖州,年四十,悬弧之日,湖中亲友举贺,征妓行酒
,宴乐
月余。一日忽言曰∶近觉两手小指及无名指掉硬不舒,也不为用。口角一边常牵扯引动,幸
为诊之。六脉皆滑大而数,浮而不敛。其体肥,其面色苍紫。予曰∶据脉滑大为痰、数为热
、
浮为风。盖湿生痰、痰生热、热生风也。君善饮,故多湿。近又荒于色,故真阴竭而脉浮,
此手指不舒,口角牵扯,中风之症已兆也。所喜面色苍紫,其神藏,虽病犹可治。切宜戒酒
色,以自保爱。为立一方,以二陈汤加滑石为君,芩连为臣,健脾消痰,撤湿热从小便出;
加胆星、天麻以定其风,用竹沥、姜汁三拌三晒,仍以竹沥打糊为丸,取竹沥引诸药入经
络化痰。外又以天麻丸滋补其筋骨,标本两治。服二料,几半年,不惟病痊,且至十年无恙
。迨行年五十,湖之贺者如旧,召妓宴乐者亦如旧,甘酒嗜音,荒淫而忘其旧之致病也。手
指、口角牵引、掉硬尤甚,月余中风,左体瘫痪矣(瘫痪俗所谓半身不遂也)。归而逆予诊之
,脉
皆洪大不敛,汗多不收,呼吸气促。予曰∶此下虚上竭之候。盖肾虚不能纳气归原,故汗
出如油喘而不休,虽和缓无能为矣,阅二十日而卒。
程晓山中风,归而逆予诊时,其子仅七岁,中麻(西吴呼为 子,姑苏呼为沙子)一月
余矣。
发热如故,咳嗽声哑,肌削骨立,头发尽秃。众医束手,举家也堕泪而已。余以诊晓山见之
,曰∶举家惊惶,谓此儿不保耶?此疳症,疳因麻后虚热而发,以大芦荟丸治之,可获万全
。君家初不问予者,谓予非幼科专门也。不知此特大方家余事耳。为制药服之,药未尽而病
瘳。松谷君语其乡人曰∶东宿公见病而决死生,治病而随俗为变,一秦越人也,孙真人后
身非耶?予闻之而三谢不敏。
太塘的程晓山,是程松谷的堂弟。他客居湖州时四十岁,在他生日那天,湖中的亲友都来祝贺,召歌妓劝酒,宴饮享乐了一个多月。有一天他突然说:“最近觉得两只手的小指和无名指颤抖僵硬、不舒服,也不听使唤。嘴角的一边经常不由自主地牵拉抽动,请先生为我诊治。”我诊察发现他的六脉都滑大且数,浮取明显而按之收敛不足。他身体肥胖,面色苍紫。我说:“根据脉象,滑大为痰湿,数为热邪,浮为风邪。大概是湿气生痰,痰生热,热生风。您喜欢饮酒,所以体内多湿。近来又纵欲过度,导致真阴枯竭而脉象浮越。这手指不舒、口角牵扯,已经是中风的先兆了。庆幸的是面色苍紫,说明神气内藏,虽然病了还可以治疗。务必戒除酒色,以保养身体。”于是开了一方子,以二陈汤加滑石为主药,黄芩、黄连为辅药,健脾消痰,通过小便排出湿热;加入胆南星、天麻以平息内风,用竹沥、姜汁三拌三晒,仍以竹沥打糊制成丸药,取竹沥引导诸药进入经络化痰。外用天麻丸滋补筋骨,标本兼治。服用两料药后,将近半年,不仅病愈,而且十年平安无事。等到年届五十,湖州为他祝寿的人依旧如旧,召妓宴乐也依旧如旧,沉迷酒色音乐,荒淫无度而忘记了过去致病的原因。手指、口角的牵引、颤抖僵硬更加严重,一个多月后中风,左侧身体瘫痪了(瘫痪俗称半身不遂)。回家后迎接我诊治,脉象皆洪大不收敛,汗多不止,呼吸急促。我说:“这是下虚上竭的征候。大概肾虚不能纳气归元,所以汗出如油、喘息不停,即使华佗在世也无能为力了。”过了二十天就去世了。
程晓山中风,回家让我诊治时,他的儿子才七岁,出麻疹(西吴称为“子”,姑苏称为“沙子”)已经一个多月了。发热依旧,咳嗽声音嘶哑,肌肉消瘦、骨骼显露,头发全部脱落。众医生束手无策,全家只是流泪罢了。我因为给程晓山看病顺便见到这孩子,说:“全家惊慌,认为这个孩子保不住了吗?这是疳症,疳症是因为出麻疹后虚热引发的,用大芦荟丸治疗,可以完全治愈。你们家起初不问我,是认为我不是儿科专家。不知道这不过是高明医生的余事罢了。”我为他制药让他服用,药还没吃完病就好了。程松谷对乡人说:“东宿公(孙一奎号)看病能判断死生,治病能随俗变通,真是扁鹊再世,难道是孙思邈转世吗?”我听到这话,再三谢罪说自己不够聪敏。
Cheng Xiaoshan of Taitang was the younger cousin of Cheng Songgu. When he was forty years old and residing in Huzhou, on his birthday (xuán hú, referring to a man's birth), relatives and friends from Huzhou came to congratulate him, summoning female musicians to serve wine. The banquet and music lasted for over a month. One day, he suddenly said, "Recently, I have felt trembling and stiffness in the little fingers and ring fingers of both hands, making them uncooperative. One side of my mouth corner is constantly being pulled and twitched. Please examine me." Upon examination, all six pulses were slippery, large, and rapid, floating without gathering upon pressure. His physique was fat, and his complexion was dark purple. I said, "According to the pulse, slippery and large indicates phlegm-dampness (tán shī), rapid indicates heat (rè), and floating indicates wind (fēng). It is likely that dampness generates phlegm, phlegm generates heat, and heat generates wind. You enjoy drinking, hence there is much dampness in your body. Recently, you have indulged in sexual activities, causing exhaustion of true yin (zhēn yīn) and a floating pulse. These symptoms of finger discomfort and mouth corner pulling are already omens of stroke (zhòng fēng). Fortunately, your dark purple complexion suggests that your spirit (shén) is contained; although ill, it is still treatable. You must abstain from alcohol and sex to protect yourself." I prescribed a formula: Er Chen Tang (Two-Cured Decoction) with Hua Shi (Talcum) as the sovereign drug, Huang Qin (Scutellaria Root) and Huang Lian (Coptis Rhizome) as minister drugs, to strengthen the spleen, eliminate phlegm, and drain damp-heat through urination; added Dan Nan Xing (Arisaema Cum Bile) and Tian Ma (Gastrodia Rhizome) to settle internal wind; processed with Zhu Li (Bamboo Sap) and Jiang Zhi (Ginger Juice) three times mixed and dried, finally made into pills using bamboo sap as a binder, taking advantage of bamboo sap to guide the herbs into the meridians to resolve phlegm. Externally, Tian Ma Wan (Gastrodia Pill) was used to nourish sinews and bones, treating both root and branch. After taking two doses, nearly half a year passed; not only did the illness recover, but he remained healthy for ten years. However, when he reached fifty, the people of Huzhou celebrated for him as before, and he summoned musicians and feasted as usual, indulging in wine and music, forgetting the cause of his previous illness. The pulling, trembling, and stiffness of his fingers and mouth corner became even more severe. Within a month, he suffered a stroke and became paralyzed on the left side (paralysis, commonly known as hemiplegia). Upon returning home, I examined him again. The pulses were all surging, large, and unrestrained, with profuse sweating that would not stop, and shortness of breath. I said, "This is a sign of deficiency below and exhaustion above. Kidney deficiency fails to grasp qi and return it to its origin, hence sweat flows like oil and panting continues incessantly. Even if Hua Tuo were alive, he could do nothing." He died twenty days later.
When Cheng Xiaoshan returned home for my examination after his stroke, his son was only seven years old and had been suffering from measles (called 'zi' in Xi Wu, 'shazi' in Gusu) for over a month. Fever persisted, coughing with hoarseness, emaciation with visible bones, and complete hair loss. All physicians were at a loss, and the whole family could only shed tears. Because I was visiting for Cheng Xiaoshan's case, I saw the child and said, "The whole family is panicked, believing this child cannot be saved? This is gan syndrome (gān zhèng), which arises from deficient heat following measles. Treating it with Da Lu Hui Wan (Large Aloe Pill) can ensure a complete cure. Your family initially did not ask me because you thought I was not a specialist in pediatrics. Little do they know that this is merely a supplementary skill for an expert physician." I prepared medicine for him, and the illness improved before the medicine was finished. Mr. Songgu told his townspeople, "Mr. Dongsu (Sun Yikui's courtesy name) can judge life and death by examining the disease and adapts treatment to local customs; is he not Bian Que reborn, or perhaps Sun Simiao reincarnated?" Hearing this, I repeatedly apologized for my lack of talent.