遵先生耶?答曰∶治初患之疟,邪气方盛,正气未虚,可以迎其锐而击之。久患之疟,邪气深陷,正气已虚,
则不可耳。故于未发用补,补其正气,正气旺,则邪自衰,不用击而疟自罢矣。
伏暑过服辛温改用清凉而愈
武林陈某,素信于丰,一日忽作寒热,来邀延医,因被雨阻未往。伊芳有同事知医,遂用辛散风寒之药,
得大汗而热退尽。讵知次日午刻,热势仍燃,汗多口渴,痰喘宿恙又萌,脉象举取滑而有力,沉取数甚,舌
苔黄黑无津。丰曰∶此伏暑病也。理当先用微辛,以透其表,荆、防、羌、芷,过于辛温,宜乎劫津夺
液矣。今之见证,伏邪已化为火,金脏被其所刑。当用清凉涤暑法去扁豆、通草,加细地、洋参。服二剂,舌
苔转润,渴饮亦减,惟午后尚有微烧,姑照旧方,更佐蝉衣、荷叶。又服二剂,热从汗解,但痰喘依然,
夜卧不能安枕,改用二陈加苏、葶、旋、杏,服之又中病机。后议补养常方, 载归里矣。
产后伏暑
城东孔某之室,素来多病,其体本孱,分娩三朝,忽然头痛难忍,寒热无汗,大渴引饮,脉来浮大之
象,此肌表重感秋凉,而曩伏之暑热,触动而继起矣。询知恶露匀行,腹无胀痛,生化成方,可勿用耳。即
以白芷、青蒿、秦艽、荆芥、当归、川芎,加败酱草合为一剂。盖白芷为产后疏风妙药,青蒿乃产后却
热最宜,秦艽、荆芥活血散风,当归、川芎生新去瘀,本草谓败酱草味苦而平,主治产后诸病。此方最稳,
请服二煎,其热从汗而退。次日邀诊,脉象顿平,询之口亦不渴,惟觉神倦少眠。此伏暑已随秋凉而解,心脾
被邪扰攘而亏,当守原方去白芷之香燥、荆芥之辛散,加茯神、柏子以安神,神安自熟寐矣;又加
西潞、炙草以扶元,元复自强健矣。后用八珍损益,未及半月而康。
遵循先生的观点吗?回答说:治疗初发的疟疾,邪气正盛,正气尚未虚弱,可以趁其锐气而攻击它。久患的疟疾,邪气已经深陷,正气已经虚弱,则不可以这样做了。所以在未发作时采用补法,补益正气,正气旺盛,邪气自然衰退,不用攻击疟疾自然停止。
伏暑病因过服辛温药物后改用清凉药而痊愈
武林(今杭州)陈某,一向信任雷丰。一天突然发生寒热往来,邀请雷丰去诊治,因为被雨阻挡未能前往。他有一位同事懂医术,于是使用了辛散风寒的药物,导致大汗淋漓而热退尽。谁知第二天中午,热势再次燃烧,汗多口渴,痰喘的旧病又发作,脉象轻取滑而有力,重取数而甚,舌苔黄黑且无津液。雷丰说:这是伏暑病。理应先使用微辛的药物,以透达表邪,荆芥、防风、羌活、白芷过于辛温,适宜于劫夺津液了。现在的证候显示,伏留的邪气已化为火邪,肺脏受到火邪的克制。应当使用清凉涤暑法,去掉扁豆、通草,加入细生地、西洋参。服用两剂后,舌苔转为润泽,口渴饮水也减少,只是午后还有轻微发热,暂且照旧方,再加蝉蜕、荷叶。又服用两剂,热从汗解,但痰喘依然如故,夜间卧床不能安枕,改用二陈汤加紫苏、葶苈子、旋覆花、杏仁,服用后又切中病机。后来商议用补养的常规方剂,载送他回乡了。
城东孔某的妻子,向来多病,体质本来孱弱。分娩三天后,忽然头痛难忍,寒热无汗,大渴引饮,脉来呈现浮大的象,这是肌表再次感受秋凉,而先前伏留的暑热被触动继而发作。询问得知恶露均匀排出,腹部没有胀痛,生化汤成方,可以不用。即用白芷、青蒿、秦艽、荆芥、当归、川芎,加上败酱草合为一剂。因为白芷是产后疏风的妙药,青蒿是产后退热最适宜的,秦艽、荆芥活血散风,当归、川芎生新去瘀,本草记载败酱草味苦而平,主治产后各种疾病。此方最稳妥,请服用两煎,其热从汗而退。第二天邀请诊视,脉象顿时平和,询问口也不渴,只觉得神倦少眠。这是伏暑已随秋凉而解,心脾被邪气扰乱而亏损,应当守原方去掉白芷的香燥、荆芥的辛散,加入茯神、柏子仁以安神,神安自然熟睡;又加入西潞党参、炙甘草以扶助元气,元气恢复自然强健了。后来用八珍汤加减损益,不到半个月就康复了。
Do you follow the Master's view? The answer is: For malaria in its initial stage, when the pathogenic factor is strong and the healthy qi (Zhengqi) has not yet become deficient, one can attack it while it is at its peak. For chronic malaria, where the pathogenic factor has sunk deeply and the healthy qi is already deficient, this approach should not be used. Therefore, tonification is applied before the onset of symptoms to strengthen the healthy qi; when the healthy qi is robust, the pathogenic factor naturally declines, and the malaria subsides without direct attack.
Fu Shu (Latent Summerheat) cured by switching from acrid-warm herbs to cooling ones after excessive use
Mr. Chen from Wulin (modern Hangzhou) had long trusted Lei Feng. One day, he suddenly experienced alternating chills and fever and invited Lei Feng for consultation, but Lei was delayed by rain. A colleague of his who knew medicine prescribed acrid-dispersing herbs for wind-cold, resulting in profuse sweating and complete resolution of fever. However, by noon the next day, the fever flared up again, accompanied by profuse sweating, thirst, and a recurrence of chronic phlegm-panting. The pulse was slippery and forceful on light pressure, and rapid on deep pressure; the tongue coating was yellow-black and devoid of fluids. Lei Feng said: This is Fu Shu (Latent Summerheat). Theoretically, mild acrid herbs should first be used to release the exterior. Jingjie (Schizonepeta), Fangfeng (Saposhnikovia), Qianghuo (Notopterygium), and Baizhi (Angelica dahurica) are too acrid and warm, likely having depleted body fluids. The current manifestations indicate that the latent pathogen has transformed into fire, damaging the Lung organ (Metal). One should use Qingliang Dishu Fa (Cooling and Clearing Summerheat Method), removing Dougeng (Dolichos Bean) and Tongcao (Tetrapanax Pith), and adding Xidi (Radix Rehmanniae Preparata) and Yangshen (Panax quinquefolius). After two doses, the tongue coating became moist, and thirst decreased. However, there was still slight fever in the afternoon. The prescription remained unchanged, supplemented with Chan Yi (Cicada Slough) and Heye (Lotus Leaf). After another two doses, the heat resolved through sweating, but phlegm-panting persisted, preventing restful sleep at night. The formula was changed to Erchen Tang (Two-Cured Decoction) plus Zisu (Perilla Leaf), Tinglizi (Lepidium Seed), Xuanshen (Inula Flower), and Xingren (Apricot Seed), which effectively targeted the pathology. Subsequently, a routine tonic formula was discussed, and he was sent home.
Postpartum Fu Shu (Latent Summerheat)
The wife of Mr. Kong in the eastern city was generally prone to illness and had a frail constitution. Three days after childbirth, she suddenly suffered unbearable headache, chills and fever without sweating, and intense thirst with desire to drink. The pulse appeared floating and large. This indicated that the exterior was re-exposed to autumn coolness, triggering the previously latent summerheat to resurface. Upon inquiry, lochia was discharging evenly, and there was no abdominal distension or pain; thus, Shenghua Tang (Generation of Transformation Decoction) was deemed unnecessary. The prescription consisted of Baizhi (Angelica dahurica), Qinghao (Artemisia Annua), Qinjiao (Gentiana Macrophylla), Jingjie (Schizonepeta), Danggui (Angelica Sinensis), Chuanxiong (Ligusticum Chuanxiong), combined with Baijiangcao (Patrinia Herb). Baizhi is an excellent herb for dispelling wind postpartum; Qinghao is most suitable for clearing heat postpartum; Qinjiao and Jingjie invigorate blood and dispel wind; Danggui and Chuanxiong generate new blood and eliminate stasis; Materia Medica states that Baijiangcao is bitter and neutral, primarily treating various postpartum conditions. This formula is very safe. After two decoctions, the heat receded through sweating. On the following day, upon consultation, the pulse had normalized, and she reported no thirst, only mental fatigue and insomnia. This indicated that the latent summerheat had resolved with the autumn coolness, but the Heart and Spleen were depleted due to pathogenic disturbance. The original prescription should be maintained, removing the aromatic-drying Baizhi and acrid-dispersing Jingjie, adding Fushen (Poria with Hostwood) and Baiziren (Biota Seed) to calm the spirit, allowing for natural sleep; additionally, Xilu (Codonopsis Pilosula) and Zhigancao (Prepared Licorice Root) were added to support primal qi, restoring strength. Later, Bazhen Tang (Eight-Treasure Decoction) was modified as needed, and she recovered within half a month.