汤氏曰∶身软时醒者为痫,身强直反张如弓,不时醒者为痉,痉候,十无一生。
〔汤〕肝风摇头,诸方不载,郑都丞子患七年摇头,三年下血,已服百余方,前
后所服治摇头者,无非风药,止血者,或作痢,或作肠风,百药无效。予既视其病,
又知其详,亦不明其标本,退而思之,乃肝血液盛,外有风热乘之,肝属木,盛而
脾土为木所克,脾与肺是子母,俱为肝所胜,而血遂渍于大便,故便血不止,遂处
一方,但损肝祛风而益脾,初亦一时之见,只数服而愈,十余日后,血止而下白脓,
遂得以安。
清肝益胃丸
犀角屑 甘草(各一分) 栝蒌根 黄 (蜜炙) 羌活 白芍药(冬半两) 蛇蜕皮(炙赤)
钓藤钩 麻黄(去节。各一钱) 防风(五两)
上为末,枣肉丸。食后薄荷汤下。只二服,作效,头摇即止,便血随愈,次间
服胃风汤,数日顿除。沈舍人子服之亦验。
〔薛〕经曰∶诸风掉眩,皆属肝木。木得风则摇动,乃肝经火盛而生虚风也。便
血者,风木摇动,则土受凌疟而不能统血也,或食酸味过多,以益其脾,致令阴结,
经曰∶结阴者便血一升,再结二升,三结三升。又,邪在五脏则阴脉不和,阴脉不
和则血留之。结阴之病,阴气内结,不得外行,渗入肠间,故便血也。血亦有乳母
而摇头不止,后一老医至,于常服药中加入紫河车,实时愈。按∶紫河车,草名,
《神农本经》名早休。《唐本》名金线重楼。《钱氏方》名白甘遂。主治惊痫摇头弄舌,
乃《本经》正文,古人谓遵白字疗病,多效。不虚也。
身体向后反折如弓状。在鼻根上方入发际三分处,施灸三壮。在大椎穴下方的节间,施灸三壮。
汤氏说:身体柔软且时常清醒的是痫病,身体强直、背部反张如弓状且不时清醒的是痉病,出现痉病的症状,十个人中没有能活下来的。
〔汤〕肝风引起的摇头,其他医方中未记载。郑都丞的儿子患摇头病七年,便血三年,已经服用了百余种药方。之前所服用的治疗摇头的药,无非是祛风药;治疗止血的,有的按痢疾治,有的按肠风治,百药无效。我诊治他的病情后,又了解其详细情况,起初也不明白其根本原因,回去后思考,认为是肝血过盛,外有风热侵袭。肝属木,肝气过盛会克制脾土,脾与肺是母子关系,都被肝所克制,于是血液渗入大便,导致便血不止。于是开出一个方子,只损伤肝气、祛除风邪并补益脾气,这起初只是一时的见解,只服了几剂就好了。十多天后,血止住了,但排出白色脓液,随后得以安宁。
清肝益胃丸
犀角屑、甘草(各一分),栝蒌根、黄芩(蜜炙)、羌活、白芍药(冬季用半两)、蛇蜕皮(炙至赤色)、钩藤、麻黄(去节,各一钱)、防风(五两)。
以上药物研为细末,用枣肉制成丸剂。饭后用薄荷汤送服。仅服两剂见效,头摇立即停止,便血随之痊愈。之后间歇服用胃风汤,数日后彻底治愈。沈舍人的儿子服用此方也有效。
〔薛〕《内经》说:各种风证引起的震颤眩晕,都属于肝木。木遇到风就会摇动,这是肝经火盛而生虚风所致。便血是因为风木摇动,导致脾土受凌辱而不能统摄血液,或者因为食用过多酸味食物以补脾,导致阴气凝结。《内经》说:结阴病便血一升,再次凝结便血二升,三次凝结便血三升。另外,邪气在五脏则阴脉不和,阴脉不和则血液停滞。结阴的病,是阴气在内凝结,不能向外运行,渗入肠道之间,所以便血。也有因乳母而导致的婴儿摇头不止,后来一位老医生到来,在常服的药中加入紫河车,随即痊愈。按:紫河车是一种草药名,《神农本草经》名为重楼(注:此处原文可能有误或通假,通常紫河车为人胎盘,但文中明确说是草名且列出了重楼等别名,依原文翻译),《唐本草》名为金线重楼,《钱氏方》名为白甘遂。主治惊痫、摇头弄舌,这是《本经》正文内容,古人说遵循“白”字来治病,多有效验。并非虚假。
Opisthotonos (body stiffened and arched backward like a bow). Moxibustion, three moxa cones, at the point 3 cun above the root of the nose into the hairline. Moxibustion, three moxa cones, at the interspace below the Dazhui (GV14) vertebra.
Mr. Tang said: When the body is soft and the patient wakes up occasionally, it is Epilepsy (Xian); when the body is rigid and arched backward like a bow and the patient does not wake up frequently, it is Tetanus (Jing). For those presenting with Tetanus symptoms, ten out of ten do not survive.
[Tang] Head shaking caused by Liver Wind is not recorded in other medical formulas. The son of Cheng Zheng suffered from head shaking for seven years and hematochezia (blood in stool) for three years. He had already taken over a hundred prescriptions. The previous treatments for head shaking were exclusively wind-dispelling herbs; treatments for stopping bleeding were categorized either as dysentery or intestinal wind. All medicines proved ineffective. After examining his condition and knowing the details, I initially did not understand the root cause. Upon reflection, I determined that the Liver blood was excessive, and external wind-heat invaded. The Liver belongs to Wood; when Wood is excessive, it overacts on Spleen Earth. Since the Spleen and Lung are in a mother-child relationship, both were subdued by the Liver, causing blood to seep into the large intestine, resulting in persistent hematochezia. Therefore, I prescribed a formula that only reduced Liver Qi, dispelled wind, and tonified the Spleen. This was initially just a tentative insight, but after taking only a few doses, he recovered. More than ten days later, the bleeding stopped, but white pus was discharged, after which he became stable.
Qinggan Yiwai Wan (Clear Liver and Benefit Stomach Pill)
* Xijiao Xie (Rhinoceros Horn Shavings), Gancao (Licorice Root) (each 1 fen)
* Gualugen (Trichosanthes Root)
* Huangqin (Scutellaria Root) (honey-fried)
* Qianghuo (Notopterygium Rhizome)
* Baishao Yao (White Peony Root) (0.5 liang in winter)
* Shetui Pi (Snake Slough) (fried until red)
* Gouteng Hook (Uncaria Ramulus cum Uncis)
* Mahuang (Ephedrae Herba) (nodes removed, each 1 qian)
* Fangfeng (Saposhnikoviae Radix) (5 liang)
Grind all ingredients into powder, form pills with jujube paste. Take with mint decoction after meals. Only two doses were needed to show effect; head shaking ceased immediately, and hematochezia healed subsequently. Intermittently take Weifeng Tang (Stomach Wind Decoction), and within a few days, the disease was completely cured. The son of She Ren also showed efficacy with this prescription.
[Xue] The Classic says: "All wind syndromes characterized by tremors and dizziness belong to Liver Wood." Wood shakes when exposed to wind; this is due to excess fire in the Liver meridian generating deficient wind. Hematochezia occurs because wind-Wood agitation causes Earth (Spleen) to be overwhelmed and unable to control blood, or due to excessive consumption of sour flavors which benefits the Spleen but leads to Yin condensation. The Classic states: "In Jieyin syndrome, one sheng of blood is passed in stool; if condensation recurs, two sheng are passed; if it recurs again, three sheng are passed." Furthermore, pathogenic factors in the five zang organs cause disharmony in the Yin vessels; disharmony in Yin vessels leads to blood stasis. In Jieyin disease, Yin qi condenses internally and cannot circulate outward, seeping into the intestines, thus causing hematochezia. There are also cases of infants suffering from persistent head shaking due to their wet nurses. Later, an old physician arrived and added Ziheche (Human Placenta) to the usual medication, resulting in immediate recovery. Note: Ziheche is described here as a herb name. In *Shennong Ben Cao Jing*, it is named Chonglou (Paris Polyphylla); in *Tang Bencao*, it is named Jinxian Chonglou; in *Qian's Formulas*, it is named Baigansui. It treats convulsions, epilepsy, head shaking, and tongue protrusion, as stated in the main text of *Ben Cao Jing*. The ancients said that following the character "Bai" (White) for treatment yields many effective results. This is not false.