长林胡某,延诊妇病,据述证经半载,外无寒热,饭食月事如常,惟时时
悲泣
,劝之不止,询其何故,伊芳不自知。延医多人,有云抑郁,用逍遥散者,有云痰火,用温胆
汤者,药俱不效。又疑邪祟,禳祷无灵,咸称怪证,恳为延医。视毕出语某曰∶易治耳。立
方药用甘草小麦大枣。某问病名及用药方法,予曰∶病名脏躁,方乃甘麦大枣汤,详载《金
匮玉函》中,未见是书,不识病名,焉知治法,宜乎目为怪证也。某曰∶适承指教,足见高
明,但拙荆病久,诸治无功,尊方药只三味,且皆平淡,未卜果能去疾否。予曰∶此仲圣祖
方。神化莫测,必效无疑。服之果验。
安波按∶有时法于古而不泥于古,有时竟法于古而泥于古,此之谓良工也。
振兄乃郎,出胎两月,突然肢搐目斜,超时乃定,乳食如常,以为偶然,次日又发。幼
科作
胎惊治,药用疏风镇惊不应,发经数日,俱在巳午时候。予视之,曰此非胎惊,乃胎痫也。
振兄云∶胎惊则尝闻之矣,胎痫之名,请问出于何典?予曰∶名出《内经》。帝曰∶人生而
有癫疾者,病名曰何?安所得之?岐伯曰∶名为胎病。此得之在母腹中时,其母有所大惊,故
令子发为癫疾也。注云∶癫痫也。夫惊之搐搦无定,痫之发作有时,大人之痫疾亦然。惟其
发作有时,故较惊稍轻耳。爱用茯神远志麦冬丹参甘草白芍菊花钩藤桑寄生以安神定志,养
肝熄风,少入橘红、半夏曲以涤扰心之痰涎。盖疾由母腹受惊而得,病在心肝二脏,神安风
熄,其疾自平。妄行疏散,则风益动,襁褓胃气薄弱,金石镇坠,尤非所宜。服药其发渐轻
,未几而定。所见数儿证同,皆照此法治愈。
安波按∶斯症迩来幼医辄以抱龙等丸从事,从不知孩提之负屈者,岂止恒河沙数乎。
长林有一位姓胡的人,邀请我为他的妻子诊治疾病。据他描述,病情已经持续了半年,体表没有寒热症状,饮食和月经也都正常,只是时常不由自主地悲伤哭泣,劝也劝不住。询问原因,她自己也不知道为什么这样。请过很多医生,有的说是抑郁,用了逍遥散;有的说是痰火,用了温胆汤,但药物都没有效果。又怀疑是邪祟作怪,进行祈祷驱邪也没有灵验,大家都称这是怪病,恳请我去诊治。
诊视完毕后,我出来对胡某说:“这病容易治。”立即开方用药:甘草、小麦、大枣。胡某问这是什么病名以及用药方法,我说:“病名叫脏躁(一种以精神忧郁、心神不宁为主要表现的病证),方子是甘麦大枣汤,详细记载在《金匮玉函》中。你们没看过这本书,不认识这个病名,怎么会知道治疗方法呢?难怪把它当作怪病看待。”胡某说:“刚才承蒙指教,足见您高明。但我妻子病久,各种治疗都无效,您的方子只有三味药,而且都很平淡,不知道是否真的能去除疾病。”我说:“这是张仲景的祖传名方。其疗效神妙莫测,必定有效,毫无疑问。”服用后果然见效。
安波按语:有时效法古人但不拘泥于古人,有时竟效法古人而拘泥于古人,这就叫做良医。
振如兄的儿子,出生两个月时,突然四肢抽搐、眼睛斜视,过了很长时间才平静下来,吃奶吃饭像往常一样,起初以为是偶然现象,第二天又发作了。儿科医生按胎惊治疗,用疏风镇惊的药物没有反应,发作经过几天,都是在巳时和午时(上午9点至下午3点之间)。我看后说:“这不是胎惊,而是胎痫(胎儿期受惊导致的癫痫类疾病)。”振如兄说:“胎惊倒是听说过,胎痫这个名字,请问出自哪本典籍?”我说:“名字出自《内经》。黄帝问:人生来就有癫疾的,病名叫什么?是怎么得的?岐伯回答:名叫胎病。这是在母腹中时,母亲受到大惊吓所致,所以导致孩子出生后发为癫疾。”注释说:这就是癫痫。惊风的抽搐是没有固定规律的,而痫证的发作是有时间规律的,成年人的痫疾也是如此。正因为发作有定时,所以比惊风稍微轻一些。因此我用茯神、远志、麦冬、丹参、甘草、白芍、菊花、钩藤、桑寄生来安神定志、养肝熄风,少量加入橘红、半夏曲来清除扰乱心神的痰涎。因为疾病是由于在母腹中受惊而得,病位在心、肝两脏,心神安宁、肝风熄灭,疾病自然平复。如果妄用疏散风邪的药物,则风邪会更动;婴儿胃气薄弱,使用金石类的重镇坠降药物尤其不合适。服药后发作逐渐减轻,不久就痊愈了。我所见到的几个患儿症状相同,都是照此法治愈的。
安波按语:这种病症近来儿科医生往往用抱龙丸等药物治疗,却不知道那些在孩童时期遭受委屈(或惊吓)的孩子,难道只有恒河沙数那么多吗(意指非常多)。
Changlin, a man surnamed Hu, invited me to treat his wife's illness. According to his account, the condition had persisted for half a year. There were no exterior symptoms of chills or fever, and her appetite and menstruation remained normal. However, she frequently wept with sorrow involuntarily; no matter how much she was comforted, she could not stop. When asked the reason, she herself did not know why. Many doctors had been consulted: some diagnosed it as depression (Yu Yi) and prescribed Xiaoyao San (Free and Easy Wanderer Powder); others diagnosed it as phlegm-fire (Tan Huo) and prescribed Wendan Tang (Warm the Gallbladder Decoction), but none of the medications were effective. It was also suspected to be caused by evil spirits, so exorcism and prayers were performed without success. Everyone called it a strange disease and earnestly requested my medical attention.
After examination, I came out and told Mr. Hu, "This is easy to treat." I immediately prescribed a formula consisting of Gancao (Licorice Root, *Glycyrrhizae Radix*), Xiaomai (Wheat Grain, *Tritici Fructus*), and Dazao (Jujube Fruit, *Ziziphi Jujubae*). Mr. Hu asked for the disease name and the rationale behind the medication. I replied, "The disease is named Zang Zao (Visceral Agitation, a syndrome characterized by mental depression and restlessness). The formula is Ganmai Dazao Tang (Licorice, Wheat, and Jujube Decoction), which is detailed in the *Jingui Yufan* (Golden Chamber Jade Box). Since you have not seen this book and do not recognize the disease name, how could you possibly know the treatment method? No wonder you regard it as a strange disease." Mr. Hu said, "I appreciate your guidance, which demonstrates your high expertise. However, my wife has been ill for a long time, and all previous treatments failed. Your prescription contains only three ingredients, all of which are mild and plain. I am unsure if it can truly cure the disease." I said, "This is an ancestral formula from Zhang Zhongjing (the Ancestor of Clinical Medicine). Its efficacy is miraculous and unpredictable; it will certainly work without doubt." Upon taking the medicine, it indeed proved effective.
An Bo commented: Sometimes one follows the ancients without being bound by them; sometimes one follows the ancients but becomes rigidly bound by them. This distinction defines a skilled physician.
Brother Zhenru's son, at two months old, suddenly experienced limb convulsions and eye deviation, which subsided only after a long time. His feeding and eating habits remained normal. Initially thought to be a chance occurrence, it recurred the next day. Pediatricians treated him for Tai Jing (Fetal Startle) using wind-dispersing and spirit-calming medications, but there was no response. For several days, the episodes occurred specifically during the Si and Wu hours (9:00 AM to 3:00 PM). Upon examination, I said, "This is not Fetal Startle, but Tai Xian (Fetal Epilepsy)." Brother Zhenru said, "I have heard of Fetal Startle, but where does the term 'Fetal Epilepsy' originate?" I replied, "It originates from the *Neijing* (Inner Canon). The Yellow Emperor asked: If a person is born with dian-ji (epileptic seizures), what is the disease name? How is it acquired? Qibo answered: It is named Tai Bing (Fetal Disease). This results from severe fright suffered by the mother while in the womb, causing the child to develop dian-ji after birth. The commentary states: This refers to epilepsy. The convulsions of startle are irregular, whereas the attacks of epilepsy occur at fixed times. This holds true for adults as well. Because the attacks are timed, they are slightly milder than those of startle. Therefore, I used Fushen (Poria with Hostwood, *Polyporus*), Yuanzhi (Polygala Root, *Polygalae Radix*), Maidong (Ophiopogon Tuber, *Ophiopogonis Tuber*), Danshen (Salvia Root, *Salviae Miltiorrhizae Radix*), Gancao (Licorice Root, *Glycyrrhizae Radix*), Baishao (White Peony Root, *Paeoniae Radix Alba*), Juhua (Chrysanthemum Flower, *Chrysanthemi Flos*), Gouteng (Uncaria Ramulus cum Uncis, *Uncariae Ramulus Cum Uncis*), and Sangjisheng (Taxillus Stem, *Taxilli Caulis*) to calm the spirit and stabilize the mind, nourish the liver, and extinguish wind. A small amount of Juhong (Citrus Reticulata Pericarpium Rubrum, *Citri Reticulatae Pericarpium Rubrum*) and Banxiaqu (Pinellia Fermented Paste, *Pinelliae Praeparatum*) was added to clear the phlegm-fluid disturbing the heart. Since the disease originated from fright in the womb, the pathological location lies in the Heart and Liver. Once the spirit is calm and the wind is extinguished, the disease naturally subsides. Indiscriminate use of wind-dispersing agents would agitate the wind further; given the infant's weak stomach qi, the use of heavy mineral sedatives is particularly inappropriate. After taking the medicine, the attacks gradually lessened and ceased shortly thereafter. Several other children with identical symptoms were cured using this same method.
An Bo commented: Recently, pediatricians often treat such cases with pills like Baolong Wan (Embrace Dragon Pill), unaware that the number of infants suffering from hidden trauma or fright is as countless as the sands of the Ganges.