堂妹年二旬,因情怀忧郁,致患吐证。每餐鬲间哽哽,少顷即吐,轻则只吐数口,甚则
所食
之物,倾囊而出。温中调气,清火解郁,治俱不应,予用安胃制肝法,亦不验。只得停药,
越十余年,疾仍如故。肌肉不瘦,产育如常。予见此证数人,药皆罔效,然亦无损。复有梅
氏女一证,案载辑录卷中,其候更加经期阻闭,缠绵数年,咸目为殆,出室后得自愈。可见
情志之病,药饵难疗。至于病久而血气无损者,良由胃为多气多血之经,腑病较脏病轻耳。
若果脏真损伤,焉能久延不坏乎?
安波按∶古人云∶师尼寡妇,必须异治。愚谓室女之治,较师尼寡妇为尤甚。盖室女
人道
未周,情窦早露,以致窒塞之郁,百变百幻。结离后,诸病霍然。余亦有见之者。马陆氏女
也,年过久笄,识书算,谈吐渊博,知药性,貌亦加常人一等,后得肝厥一症,每月如死者
一二次,及合卺有时,而适逢厥来,从此好事多磨者有二次。余至,以疏肝息风为事,然虽
救目前之急,奈终身痼产,总少妙术,忽忽三年,婿突至,完姻迄今,沉 若失,而瓜瓞已
三四矣。
萃翁公郎葆晨兄,禀质素弱,曩患滑精,予为治愈,案载初集中。斯病之始,偶因登山
跌仆
伤足。吾乡专科接骨颇善,但其药狠,弱者每不能胜。葆兄缘伤重,欲图速效,日服其药,
已戕胃气。又患腹痛,更服温肝行气活血等方,胃气益伤,神疲倦卧,痛呕不止,药食不纳
,邀予诊视,脉虚细涩,气怯言微,面青自汗。谓萃翁曰∶公郎病候,乃药戕胃气,恐蹈脱
机。人以胃气为本,安谷则昌,治先救胃,冀其呕止谷安,然后以大补气血之剂继之,不徒
愈病,且足得血而能步矣。但治呕吐之药,最宜详辨气味,不独苦劣腥臊不能受,即微郁微
酸,亦不能受,惟人参力大气味和平,胃伤已极,非此莫可扶持,而单味独用,分两需多,
购办不易,姑以高丽参代之。日用数钱,陈米水煎,缓缓呷之,守服数日,呕止食纳,神采
略转。接服大补元煎,渐可下床,移步尚苦,筋脉牵强,行动艰难,翁虑成跛。予曰∶无忧
,血气未复耳。仍服前方,半载后步履如常。
安波按∶味单则力峻,古人所以独参名汤也,而其用专。
堂妹二十岁时,因心情忧郁,导致患上呕吐证。每顿饭时胸膈间感到哽噎不适,过了一会儿就会呕吐,轻的只吐出几口,重的则把吃进去的食物全部吐出来。使用温中调气、清火解郁的方法治疗,都没有效果;我采用安胃制肝法治疗,也不见效。只好停止用药,过了十多年,病情依然如故。但她的肌肉没有消瘦,生育功能也正常。我见过这种病例数人,用药都无效,但也未造成损害。另有梅家女一例,记载在辑录卷中,她的症状更加严重,伴有月经闭止,缠绵数年,大家都认为危险,出嫁后自然痊愈。由此可见,情志引起的疾病,药物难以治愈。至于病久但气血没有受损的,大概是因为胃是多气多血的经络,腑病比脏病轻罢了。如果真是脏腑真气损伤,怎么能长久拖延而不败坏呢?
安波按:古人说:尼姑、寡妇必须用不同的方法治疗。我认为少女的治疗,比尼姑、寡妇更为困难。因为少女的人道(指婚育之事)尚未周全,情窦早开,导致气机窒塞之郁结,变化多端。一旦结婚,各种病症霍然消失。我也见过这样的例子。马陆氏的女儿,年龄超过十五岁(及笄之年),通晓书算,谈吐渊博,懂药性,容貌也比常人高一等,后来得了肝厥症,每月像死了一两次,等到结婚时,恰逢发作,从此好事多磨,有两次这种情况。我去诊治,以疏肝息风为主要手段,虽然救了眼前的急症,但对于终身难产的痼疾,始终缺少妙术,匆匆三年,女婿突然到来,完婚至今,沉疴若失,而且已经生了三四个孩子了。
萃翁公之子葆晨兄,体质素来虚弱,从前患滑精症,我为他治愈,案例记载在初集中。这个病的起因,偶然因为登山跌倒伤足。我们乡里的专科接骨医生很擅长,但他们的药性猛烈,体弱者往往不能承受。葆兄因为伤势重,想求速效,每天服用那些药,已经戕害了胃气。又患腹痛,更服用温肝行气活血等方剂,胃气进一步受伤,精神疲倦嗜卧,疼痛呕吐不止,药食无法进入体内,邀请我诊视,脉象虚细涩,气怯声微,面色青白自汗。我对萃翁说:令郎的病候,是药物戕害了胃气,恐怕会陷入脱证的危机。人以胃气为本,能进食则昌盛,治疗先要救胃,希望他能止呕安谷,然后用大补气血的药剂接续治疗,不仅能治好病,而且得血滋养就能行走。但是治疗呕吐的药物,最宜详细辨别气味,不仅苦劣腥臊不能接受,就是微郁微酸,也不能接受,只有人参力气大且气味和平,胃伤已极,非此不可扶持,而单味独用,分量需多,购买不易,暂且用高丽参代替。每天用数钱,陈米水煎煮,缓缓饮用,守服数日,呕吐停止,饮食纳入,神采略微好转。接着服用大补元煎,渐渐可以下床,移步还痛苦,筋脉牵强,行动艰难,老翁担心变成跛脚。我说:不用担心,只是气血未恢复罢了。仍服前方,半年后步履如常。
安波按:味道单一则药力峻猛,这就是古人所以用独参汤的原因,而且其作用专一。
The younger sister of my father's brother was twenty years old when she developed a vomiting syndrome due to emotional depression. During each meal, she felt a choking sensation in the chest and diaphragm, and vomited shortly after; mildly, only a few mouthfuls were vomited, but severely, all the food consumed was emptied out. Treatments using methods to warm the middle and regulate qi, clear fire and resolve depression, as well as my own method of calming the stomach and subduing the liver, were all ineffective. Medication was stopped, and over ten years passed with the condition remaining unchanged. However, her muscles did not emaciate, and her reproductive function remained normal. I have seen several such cases where medication was ineffective but caused no harm. There is also a case of a young woman from the Mei family recorded in the compiled volume; her symptoms were more severe, accompanied by amenorrhea, lingering for several years, and everyone considered it critical, yet she recovered spontaneously after marriage. This shows that diseases caused by emotional factors are difficult to treat with herbs. As for those whose illness persists for a long time without damaging qi and blood, it is likely because the Stomach meridian is rich in both qi and blood, and fu-organ diseases are lighter than zang-organ diseases. If the true qi of the zang organs were truly damaged, how could it persist for so long without deterioration?
An Bo notes: The ancients said that nuns and widows require different treatments. I believe that treating young unmarried women is even more difficult than treating nuns and widows. This is because young women have not yet fully experienced marital life (ren dao), their emotional desires awaken early, leading to obstructed depression of qi mechanism, which manifests in myriad变幻 forms. After marriage, various illnesses disappear suddenly. I have also witnessed such cases. A daughter of the Ma Lu family, past the age of fifteen (ji ji), knowledgeable in books and arithmetic, eloquent, familiar with herbal properties, and beautiful beyond ordinary people, later suffered from Liver Jue syndrome, appearing dead once or twice a month. When she married, the attack coincided with the wedding, causing repeated delays and obstacles. Upon my consultation, I treated primarily by soothing the liver and extinguishing wind. Although this relieved the immediate emergency, there was little effective remedy for her lifelong difficulty in childbirth. Three years passed hastily until her groom arrived unexpectedly. Since the consummation of the marriage, her chronic ailment has vanished, and she has already borne three or four children.
Brother Baochen, son of Elder Cuizeng, had always possessed a weak constitution. Previously, he suffered from spermatorrhea, which I cured (recorded in the first collection). The origin of this disease was an accidental fall while climbing a mountain, injuring his foot. Local bone-setting specialists were skilled, but their medicines were harsh, and weak individuals often could not tolerate them. Because Brother Bao's injury was severe and he sought rapid results, he took these medicines daily, thereby damaging his stomach qi. He subsequently developed abdominal pain and took further prescriptions for warming the liver, moving qi, and invigorating blood, further injuring his stomach qi. He became listless and sleepy, with incessant pain and vomiting, unable to retain any medicine or food. Upon invitation to consult, his pulse was deficient, fine, and choppy; his qi was timid and voice faint; his complexion was bluish-green with spontaneous sweating. I told Elder Cuizeng: "Your son's condition is due to medicinal damage to the stomach qi, and there is fear of falling into a collapse syndrome. Humans rely on stomach qi as their foundation; ability to digest food leads to prosperity. Treatment must first rescue the stomach, hoping for cessation of vomiting and stabilization of digestion, followed by strong tonics for qi and blood. This will not only cure the disease but also enable walking through blood nourishment. However, medicines for vomiting must be carefully selected for their flavor and aroma. Not only bitter, foul, fishy, or pungent substances are unacceptable, but even slightly sour or fermented tastes are intolerable. Only Ginseng possesses strong power and a mild, harmonious flavor. With extreme stomach damage, nothing else can support him. Single-substance use requires large doses, which are hard to procure, so we shall substitute with Korean Ginseng. Use a few qian daily, decoct with aged rice water, and sip slowly. Adhering to this for several days, vomiting ceased, food intake resumed, and spirit slightly improved. Subsequently taking Da Bu Yuan Jian, he gradually got out of bed, though movement was still painful, with tendon stiffness and difficulty walking. The elder worried about permanent lameness. I said: 'Do not worry, it is merely that qi and blood have not yet recovered.' Continue the previous prescription. After half a year, his gait returned to normal."
An Bo notes: Single-flavor formulas exert potent force, which is why the ancients used Du Shen Tang (Single Ginseng Decoction), and its action is specialized.