吴添官生母。时多暴怒。以致经行复止。入秋以来。渐觉气逆上厥。如畏舟船之状。动辄晕去。久久卧
于床中。时若天翻地覆。不能强起。百般医治不效。因用人参三五分。略宁片刻。最后服至五钱一剂。日费数
金。意图旦夕苟安。以视稚子。究竟家产尽费。病转凶危。大热引饮。脑间有如刀劈。食少泻多。已治
木无他望矣。闻余返娄。延诊过。许以可救。因委命以听焉。余以怒甚则血菀于上。而气不返于下者。名曰厥
巅疾。厥者逆也。巅者高也。气与血俱逆于高巅。故动辄眩晕也。又以上盛下虚者。过在少阳。少阳者足少阳
胆也。胆之穴皆络于脑。郁怒之火。上攻于脑。得补而炽。其痛如劈。同为厥巅之疾也。风火相
煽。故振摇而热蒸。土木相凌。故艰食而多泻也。于是会内经铁
落镇坠之意。以代赭石龙胆草芦荟黄连之属。降其上逆之气。以蜀漆丹皮赤芍之属。行其上菀之血。以牡蛎龙
骨五味之属。敛其浮游之神。最要在每剂药中。生入猪胆汁二枚。盖以少阳热炽。胆汁必干。亟以同类之物
济之。资其持危扶颠之用。病者药一入口。便若神返其舍。忘其苦口。连进十余剂。服猪胆二十
余枚。热退身凉。饮食有加。便泻自止。始能起床行动数步。然尚觉身轻如叶。不能久支。仆恐药味太苦。
不宜多服。减去猪胆及芦龙等药。加入当归一钱。人参三分。姜枣为引。平调数日而全愈。母病愈而添官即得
腹痛之病。彻夜叫喊不绝。小水全无。以茱连汤加玄胡索投之。痛始安。又因伤食复发。病至二十余
日。肌肉瘦削。眼胞下陷。才得略宁。适遭家难。症变壮热。目红腮肿。全似外感有余之候。余知其为激动真
火上焚。令服六味地黄加知柏三十余剂。其火始退。退后遍身疮痍黄肿。腹中急欲得食。不能少待片顷。整日
哭烦。余为勉慰其母曰。旬日后腹稍充。气稍固。即不哭烦矣。服二冬膏而全瘳。此母子二人。皆
极难辨治之症。竟得相保。不大快哉。
胡卣臣先生曰。二病最多。此案深足嘉惠来学。
吴添官的生母。平时经常暴怒，导致月经来潮后又停止。入秋以来，逐渐感到气逆上冲发厥，像害怕乘船一样的感觉，动不动就晕倒，长久卧床不起，时常感觉天翻地覆，不能勉强起身。百般医治都不见效，于是用人参三五分，稍微安静片刻。最后服至五钱一剂，每天花费数金，企图苟且偷安，以抚养年幼的孩子。结果家产耗尽，病情反而凶险危急。出现大热引水而饮，头部疼痛如刀劈，食少泻多，已经治疗无望，没有其他希望了。听说我返回娄县，邀请我去诊治，许诺说可以救治，于是把性命托付给我听候安排。我认为大怒则血郁积于上部，而气不回归下部，名为厥巅疾。厥就是逆，巅就是高，气与血都逆乱于高巅，所以动不动就眩晕。又因为上盛下虚，病在少阳。少阳是足少阳胆经，胆的穴位都联络于脑，郁怒之火，上攻于脑，得到补益后火势更炽盛，其痛如刀劈，同属厥巅之疾。风火相互煽动，所以身体振摇而热蒸；土木相互凌犯，所以进食困难而多腹泻。于是领会《内经》中铁落镇坠的意思，用代赭石、龙胆草、芦荟、黄连等药，降其上逆之气；用蜀漆、丹皮、赤芍等药，行其上郁之血；用牡蛎、龙骨、五味子等药，敛其浮游之神。最关键的是每剂药中，生加入猪胆汁两枚。因为少阳热炽盛，胆汁必然干枯，急需以同类之物救济它，资助其持危扶颠的作用。病人药一入口，便好像神灵返回居所，忘记了药的苦口。连续服用十余剂，服用猪胆二十余枚，热退身凉，饮食增加，腹泻自止，才能起床行动几步。然而还觉得身体轻如树叶，不能久撑。我恐怕药味太苦，不宜多服，减去猪胆及芦根、龙骨等药，加入当归一钱，人参三分，姜枣为引，平调数日而痊愈。母亲病愈后，添官即得腹痛的病，彻夜叫喊不绝，小便全无，用茱连汤加玄胡索投之，疼痛才安定。又因伤食复发，病至二十余日，肌肉瘦削，眼胞下陷，才得略微安宁。适逢遭遇家难，症状变为壮热，目红腮肿，全似外感有余的证候。我知道这是激动真火上焚，令服六味地黄丸加知母、黄柏三十余剂，其火才退。退后遍身疮痍黄肿，腹中急欲得食，不能稍待片刻，整日哭烦。我为他宽慰他的母亲说：旬日后腹部稍充，气稍固，就不哭烦了。服用二冬膏而完全康复。这对母子二人，都是极难辨治的症候，竟然得以保全，不是很痛快吗？
胡卣臣先生说：这两种病最多见，此案深足以嘉惠后来学者。
The mother of Wu Tian'guan. She often experienced violent anger in the past, which led to her menstruation stopping after it had started. Since entering autumn, she gradually felt qi rebelling and rushing upward causing Jue (syncope/reversal cold) syndrome, resembling a state of fear of riding on boats, fainting at every move. She lay in bed for a long time, feeling as if heaven and earth were overturning, unable to force herself to rise. Various treatments were ineffective. She then used 3-5 fen of Renshen (Ginseng Radix), which only provided momentary relief. Finally, she took one dose containing 5 qian, costing several taels of gold per day, attempting to survive temporarily to raise her young child. Ultimately, her family fortune was exhausted, and her condition became critical. She exhibited intense heat with excessive thirst, pain in the head as if split by a knife, poor appetite, and frequent diarrhea. Treatment seemed hopeless. Upon hearing that I returned to Lou County, she invited me to diagnose her, promising recovery, and entrusted her life to my care. I reasoned that severe anger causes blood to stagnate in the upper body while qi fails to descend, a condition named "Jue Dian Ji" (Reversal Disease of the Vertex). "Jue" means reversal; "Dian" means high. When both qi and blood reverse to the high vertex, dizziness and vertigo occur frequently. Furthermore, due to excess above and deficiency below, the pathology lies in the Shaoyang (Lesser Yang) channel. Shaoyang refers to the Foot-Shaoyang Gallbladder Meridian. The acupoints of the gallbladder connect to the brain. Fire from repressed anger attacks the brain upward; when tonified, the fire flares up, causing pain like splitting. This is also a form of Jue Dian disease. Wind and fire fanning each other cause tremors and steaming heat; Wood and Earth conflicting result in difficulty eating and frequent diarrhea. Thus, drawing upon the concept of iron filings having a heavy, settling nature from the *Neijing* (Classic of Internal Medicine), I used herbs such as Daizheshi (Ochre), Longdancao (Gentian Root), Lvhua (Aloe), and Huanglian (Coptis Rhizome) to direct the rebellious qi downward. I employed Shuqi (Polygala Tuber), Danpi (Moutan Cortex), and Chishao (Red Peony Root) to move the stagnant blood. I used Muli (Oyster Shell), Longgu (Fossilized Bone), and Wuweizi (Schisandra Fruit) to gather the floating spirit. Most crucially, I added two raw Pig Bile (Zhudanshi) to each decoction. Because the Shaoyang heat was intense, the bile must have been dried up; thus, using a substance of the same kind to supplement it aided in stabilizing the critical condition. As soon as the medicine entered her mouth, it was as if her spirit returned to its residence, forgetting the bitter taste. After taking more than ten doses and over twenty pig bile units, the heat subsided, the body cooled, appetite increased, and diarrhea stopped spontaneously. She could finally get up and walk a few steps. However, she still felt light as a leaf and could not sustain this for long. Fearing the medicine was too bitter for prolonged use, I reduced the dosage of Zhudanshi, Lvhua, and Longgu, adding Danggui (Angelica Sinensis Root) 1 qian, Renshen 3 fen, and using Jiang (Ginger) and Zao (Jujube) as guides. After several days of harmonizing treatment, she fully recovered.
After the mother's illness resolved, Tian'guan developed abdominal pain, shouting incessantly throughout the night with no urination. I administered Zhulian Tang (Evodia and Coptis Decoction) augmented with Xiansuo (Cyperi Rhizoma) and Curcumae Radix (Yanzhusu), after which the pain stabilized. Later, due to food stagnation recurrence, the illness lasted over twenty days, resulting in emaciation and sunken eye sockets, before he found slight relief. Coinciding with a family disaster, his symptoms changed to high fever, red eyes, and swollen cheeks, resembling an exterior excess pattern. I recognized this as true fire being stirred and burning internally, and prescribed Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) supplemented with Zhimu (Anemarrhena Rhizome) and Huangbai (Phellodendron Bark) for over thirty doses, after which the fire subsided. Following the reduction of fire, he developed widespread sores, yellow swelling, and an urgent desire to eat, unable to wait even briefly, crying and fretting all day. I comforted his mother, saying that after ten days, his abdomen would fill slightly, qi would stabilize, and the crying would cease. He was completely cured after consuming Er Dong Gao (Asparagus and Ophiopogon Paste). These two cases of mother and son were extremely difficult to differentiate and treat, yet they were preserved. Is this not gratifying?
Mr. Hu Youchen stated: These two diseases are very common. This case study is deeply beneficial for future learners.