有一患者,患处胀痛,悲哀忿怒,此厥阳之火,为七情激之而然耳,遂砭去瘀血,以小
柴胡汤加山栀、黄连、桔梗而安。后用生肝血、养脾气之药,疮溃而敛。
有一患者,患处胀痛,发热欲呕,两胁热胀,肝脉洪大。余曰∶肝火之症也。但令饮童
便,并小柴胡汤加黄连、山栀、归梢、红花,诸症果退。此症若左关脉浮而无力,以手按其
腹,反不胀者,此血虚而肝胀也,当以四物、参、苓、青皮、甘草之类治之。若左关脉洪而
有力,胸胁胀痛者,按之亦痛,此怒气伤肝之症也,以小柴胡、芎、归、青皮、芍药、桔梗
、枳壳主之。盖此症不必论其受责之轻重,问其患处去血之曾否,但被人扭按甚重努力恚怒
,以伤其气血,瘀血归肝,多致前症。甚则胸胁胀满,气逆不通,或血溢口鼻,卒至不救。
有一患者,愈后口苦,腰胁胀痛。服补肾行气等药不愈。余按其肝脉浮而无力,此属肝
胆气血虚而然耳,用参、 、归身、地黄、白术、麦门、五味,治之而愈。
有一患者,杖后服四物、红花、桃仁、大黄等剂,以逐瘀血,腹反痛,更服一剂痛益甚
,按其腹不痛。余曰∶此血虚也,故喜按而不痛,宜温补之剂。遂以归身、白术、参、 、
炙草二剂,痛即止。
有一患者,瘀血已去,饮食少思,死肉不溃,用托里之药,脓稍溃而清,此血气虚也,
非大补不可。彼不从。余强用大补之剂,饮食进而死肉溃,但少寐,以归脾汤加山栀二剂而
寐,因劳心烦躁作渴,脉浮洪大,以当归补血汤二剂而安。
有一位患者,患处感到胀痛,情绪悲哀且愤怒,这是厥阳之火,因七情(喜、怒、忧、思、悲、恐、惊)激惹所致。于是用砭石刺破排出瘀血,服用小柴胡汤(和解少阳的代表方剂)加入山栀、黄连、桔梗后痊愈。之后使用生养肝血、补益脾气的药物,疮口溃破并愈合。
有一位患者,患处胀痛,发热想呕吐,两胁部感觉热胀,肝脉呈现洪大之象。我说:这是肝火的病症。只让他饮用童便(健康儿童的小便,中医认为有滋阴降火、凉血散瘀之效),并服用小柴胡汤加入黄连、山栀、当归梢、红花,各种症状果然消退。如果此症左关脉(候肝胆)浮而无力,用手按压腹部,反而不觉得胀痛,这是血虚导致的肝胀,应当用四物汤(补血调血的基础方)、人参、茯苓、青皮、甘草等药物治疗。如果左关脉洪大有力,胸胁胀痛,按压时也痛,这是怒气伤肝的病症,用小柴胡汤加上川芎、当归、青皮、芍药、桔梗、枳壳为主治疗。大概这种病症不必讨论受杖责的轻重,也不必询问患处是否排出了瘀血,只要被人扭按很重并努力憋气发怒,从而损伤气血,导致瘀血归聚于肝,大多引起上述症状。严重时出现胸胁胀满,气逆不通,或者血液从口鼻溢出,突然致死无法救治。
有一位患者,病愈后口苦,腰胁部胀痛。服用补肾行气等药物没有治愈。我按压其肝脉,发现浮而无力,这属于肝胆气血虚弱所致,用人参、[原文缺字,据语境推测为黄芪或类似补气药]、当归身、地黄、白术、麦门冬、五味子治疗而痊愈。
有一位患者,受杖刑后服用四物汤、红花、桃仁、大黄等药剂,以驱逐瘀血,腹部反而疼痛,再服一剂疼痛更加严重。按压其腹部却不痛。我说:这是血虚的缘故,所以喜欢按压且不痛,适宜用温补的药剂。于是用当归身、白术、人参、[原文缺字]、炙甘草,服用两剂后,疼痛立即停止。
有一位患者,瘀血已经去除,饮食减少不想进食,坏死的肌肉不溃烂,使用托里透脓的药物,脓液稍微溃出但质地清稀,这是气血虚弱,非大补不可。他不听从。我强行使用大补的药剂,饮食增加且坏死肌肉溃破,只是睡眠较少,用归脾汤(益气补血、健脾养心的方剂)加入山栀,服用两剂后入睡。因为劳心烦躁口渴,脉象浮洪大,用当归补血汤(补气生血的方剂)两剂后安定。
A patient presented with distending pain in the affected area, accompanied by sorrow and anger. This was due to Fire of Jueyang (Jue-Yang Zhi Huo), triggered by the Seven Emotions (Qi Qing). The practitioner used Bian stones (Bian Shi) to puncture and drain the stagnant blood, then administered Xiao Chai Hu Tang (Minor Bupleurum Decoction) with added Gardenia (Shan Zhi), Coptis (Huang Lian), and Platycodon (Jie Geng), resulting in recovery. Subsequently, herbs that nourish Liver Blood and tonify Spleen Qi were used, leading to the ulceration and healing of the sore.
Another patient presented with distending pain in the affected area, fever, nausea, heat and distension in both hypochondriac regions, and a洪大 (Hong Da, surging and large) pulse at the Liver position. I stated: "This is a syndrome of Liver Fire." I instructed him to drink Child's Urine (Tong Bian) and take Xiao Chai Hu Tang with added Coptis (Huang Lian), Gardenia (Shan Zhi), Angelica Sinensis tip (Gui Shao), and Carthamus (Hong Hua). All symptoms indeed subsided. If, in this syndrome, the left Guan pulse (reflecting Liver/Gallbladder) is floating and weak, and pressing the abdomen does not cause pain or distension, it indicates Liver distension due to Blood deficiency. It should be treated with Si Wu Tang (Four Substance Decoction), Ginseng (Ren Shen), Poria (Fu Ling), Tangerine Peel (Qing Pi), and Licorice (Gan Cao). If the left Guan pulse is surging and forceful, accompanied by chest and hypochondriac distending pain that worsens upon pressure, it is a syndrome of Liver injury caused by anger. It should be treated primarily with Xiao Chai Hu Tang combined with Ligusticum (Xiong Qiong), Angelica Sinensis (Dang Gui), Tangerine Peel (Qing Pi), Peony (Shao Yao), Platycodon (Jie Geng), and Aurantium (Zhi Ke). Generally, for this syndrome, one need not discuss the severity of the beating received, nor whether stagnant blood has been expelled from the wound. As long as the person was twisted and pressed heavily, exerted effort, and became angry, damaging Qi and Blood, causing stagnant blood to return to the Liver, the aforementioned symptoms often result. In severe cases, there may be chest and hypochondriac fullness, counterflow of Qi and obstruction, or bleeding from the mouth and nose, leading to sudden death without rescue.
A patient, after recovery, experienced bitter taste in the mouth and distending pain in the lower back and hypochondrium. Treatment with Kidney-tonifying and Qi-moving herbs failed. Upon palpating the Liver pulse, I found it floating and weak, indicating deficiency of Qi and Blood in the Liver and Gallbladder. I treated him with Ginseng (Ren Shen), [missing character, likely Huang Qi], Angelica Sinensis root body (Gui Shen), Rehmannia (Di Huang), Atractylodes (Bai Zhu), Ophiopogon (Mai Men Dong), and Schisandra (Wu Wei Zi), resulting in a cure.
A patient, after receiving corporal punishment (caning), took formulas containing Si Wu Tang (Four Substance Decoction), Carthamus (Hong Hua), Peach Kernel (Tao Ren), and Rhubarb (Da Huang) to expel stagnant blood. However, abdominal pain ensued. After taking another dose, the pain intensified. Palpation of the abdomen revealed no tenderness. I stated: "This is Blood deficiency; therefore, the abdomen prefers pressure and is not tender. Warm-tonifying agents are appropriate." Consequently, I prescribed Angelica Sinensis root body (Gui Shen), Atractylodes (Bai Zhu), Ginseng (Ren Shen), [missing character], and Honey-fried Licorice (Zhi Gan Cao). After two doses, the pain ceased immediately.
A patient had already expelled stagnant blood but suffered from poor appetite and lack of desire to eat, and necrotic tissue did not ulcerate. Using interior-supporting (Tuo Li) herbs resulted in slight ulceration with thin pus, indicating Qi and Blood deficiency requiring strong tonification. The patient refused. I insisted on using strong tonifying agents. Food intake increased, and necrotic tissue ulcerated. However, insomnia persisted. Guipi Tang (Restore the Spleen Decoction) with added Gardenia (Shan Zhi) was taken for two doses, restoring sleep. Due to mental fatigue, irritability, thirst, and a floating, surging, large pulse, Danggui Buxue Tang (Angelica Tonifies the Blood Decoction) was administered for two doses, bringing stability.