浓兄病愈,其女三岁,发热目赤,医谓证属因风生热,投以羌活荆防,目肿如李,眵流
如脓
,热甚搐搦。尊公君扬翁,嘱予治之。予曰∶此因热生风证也,非清不可。方用生地、丹皮
、山栀、生甘草、菊花、桑叶、石决明、羚羊角,服之热退搐定,目肿亦消。君翁疑而问曰
∶小孙女之病,医云因风生热,子云因热生风,同一风耳。风则当散,何服散剂而病反增,
服清剂而病旋愈?此曷故也?予曰∶风热二字,不可概言,须知内外标本之别。因风生热者,
乃外入之风,风胜则热遏,散其风,而热自解,所谓火郁发之。此风为本,热为标也。因热
生风者,乃内出之风,热胜则风,旋清其热,而风自熄,所谓热者寒之,此热为本,风为标
也。医家因风热二字,义未解明,模棱施治,是以多误。翁喟然曰∶医患不明理,理明则
治病视诸掌矣。
安波按∶卓论也。
君翁盛纪,年将二旬。暮春之初,始觉头筋抽痛,旋见口眼歪斜,肢凉脉细。以为风寒
外感
,药投温散,其病益剧,肢掣头昏,心悸汗浆,君翁令舁至舍,嘱为延医,按诸风眩掉,皆
属于肝。春深时强木长,水不涵木,阳化内风,乘虚绕络。凡治风须分内外,外入之风则可
散,内出之风,散之益助其升腾鼓动之势。现下左肢螈 ,防变痉厥神迷。议以滋水涵木,
和阳熄风。方用炙甘草、黑参、熟地、麦冬、阿胶、芝麻、茯神、枣仁、五味子、牡蛎、小
麦、南枣,初服四剂,势已减轻,更加白芍、当归、葳蕤服至廿剂,病瘥。虚犹未复,令制
丸药,数阅月,始得元复如初。
浓卿兄的病痊愈后,他的女儿三岁,出现发热、眼睛红肿的症状。医生认为这是因风邪导致的热证,使用了羌活、荆芥、防风等药物,结果导致眼睛肿胀得像李子一样大,眼屎流出如同脓液,高热严重并伴有抽搐。她的祖父君扬老翁,嘱咐我治疗这个孩子。我说:这是因热生风的证候,必须用清热的方法治疗。方剂使用生地、丹皮、山栀、生甘草、菊花、桑叶、石决明、羚羊角,服用后热退抽搐停止,眼睛肿胀也消退了。君翁疑惑地问:小孙女的病,医生说因风生热,你说因热生风,同样是“风”证。风邪应当疏散,为什么服用疏散药病情反而加重,服用清热药病情随即好转呢?这是什么缘故呢?我说:“风”和“热”这两个字,不能笼统地说,必须分清内外标本的区别。因风生热的,是外来的风邪,风邪盛则热邪被遏制,疏散风邪,热邪自然解除,这就是所谓“火郁发之”。这种情形下,风是本,热是标。因热生风的,是内部产生的风邪,热邪盛则生风,清除热邪,风邪自然熄灭,这就是所谓“热者寒之”,这种情形下,热是本,风是标。医生因为对“风热”二字的含义理解不明确,采取模棱两可的治疗方法,所以大多误治。老翁感叹道:医患如果不明白医理,明白了医理,治病就像看手掌一样容易了。
安波按语:这是高明的见解。
君翁的仆人盛纪,年龄将近二十岁。暮春之初,刚开始觉得头部筋脉抽痛,随后出现口眼歪斜,四肢发凉,脉象细弱。以为是风寒外感,用药进行温散治疗,病情更加严重,出现肢体抽搐、头晕,心悸,出汗如浆。君翁让人把他抬到我这里,嘱咐我为他延请医生诊治。根据各种风眩、震颤的症状,都属于肝经病变。春深时节,肝木之气旺盛生长,肾水不足无法涵养肝木,阳气化为内风,乘虚侵袭经络。凡是治疗风证,必须区分内外,外来的风邪可以疏散,内部产生的风邪,如果再用疏散法,只会助长其升腾鼓动的势头。现在左肢抽搐,防止变为痉厥、神志昏迷。议定采用滋水涵木,调和阳气以熄风的方法。方剂使用炙甘草、黑参、熟地、麦冬、阿胶、芝麻、茯神、枣仁、五味子、牡蛎、小麦、南枣,初服四剂,病情已经减轻,又加入白芍、当归、葳蕤,共服用二十剂,疾病痊愈。身体仍然虚弱未恢复,让他制作丸药,过了几个月,才恢复元气如初。
After Brother Nong's illness was cured, his three-year-old daughter developed fever and red eyes. The physician diagnosed it as a heat syndrome caused by wind pathogen and prescribed Qianghuo Jingfang (Notopterygii Rhizoma et Radix with Saposhnikoviae Radix and Bupleuri Radix). Consequently, her eyes swelled like plums, discharge flowed like pus, fever intensified, and convulsions occurred. Her grandfather, Mr. Junyang, instructed me to treat her. I said: This is a syndrome of wind generated from heat; it must be cleared. The prescription consisted of Shengdi Huang (Rehmanniae Radix Preparata), Danpi (Moutan Cortex), Shanzhi (Gardeniae Fructus), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), Juhua (Chrysanthemi Flos), Sangye (Mori Folium), Shijueming (Concha Arcae), and Lingyangjiao (Saigae Tataricae Cornu). After taking the medicine, the fever subsided, convulsions ceased, and eye swelling disappeared. Mr. Junyang asked doubtfully: "My granddaughter's illness was diagnosed by another doctor as heat caused by wind, but you say it is wind caused by heat. Both involve 'wind'. Wind should be dispersed; why did dispersing agents worsen the condition while clearing agents resolved it quickly? What is the reason?" I replied: "The terms 'wind' and 'heat' cannot be used generally; one must distinguish between internal/external origins and root/branch relationships. In 'heat caused by wind', the wind is an external pathogen. When wind is excessive, heat is constrained. Dispersing the wind resolves the heat, which is known as 'releasing fire stagnation'. Here, wind is the root, and heat is the branch. In 'wind caused by heat', the wind arises internally. When heat is excessive, wind is generated. Clearing the heat extinguishes the wind, which is known as 'treating heat with cold'. Here, heat is the root, and wind is the branch." Physicians often err because they do not clearly understand the meanings of 'wind' and 'heat' and apply ambiguous treatments. Mr. Junyang sighed and said: "If both patients and physicians do not understand the principles, once the principles are clear, treating diseases becomes as easy as looking at one's palm."
An Bo commented: This is a profound insight.
Mr. Junyang's servant, Sheng Ji, was nearly twenty years old. At the beginning of late spring, he initially felt twitching pain in the head tendons, followed by deviation of the mouth and eyes, cool limbs, and a fine pulse. He was treated for external contraction of wind-cold with warming and dispersing herbs, but the condition worsened, presenting with limb jerking, dizziness, palpitations, and profuse sweating like syrup. Mr. Junyang had him carried to my residence and instructed me to provide medical care. According to the principle that all wind-related vertigo and tremors belong to the Liver, during deep spring when Wood energy grows strongly, if Water fails to nourish Wood, Yang transforms into internal wind, which invades the collaterals vacuously. In treating wind syndromes, one must distinguish between internal and external origins. External wind can be dispersed, but internal wind, if dispersed, only exacerbates its ascending and stirring momentum. Currently, there is twitching in the left limb, risking progression to spasm, coma, or loss of consciousness. The proposed treatment is to nourish Water to nourish Wood and harmonize Yang to extinguish wind. The prescription included Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma), Heishen (Black Ginseng), Shudi Huang (Prepared Rehmanniae Radix), Maidong (Ophiopogonis Tuber), Ejiao (Donkey-hide Gelatin), Zhima (Sesamum Fructus), Fushen (Poria with Hostwood), Zaoren (Ziziphi Spinosomi Semen), Wuweizi (Schisandrae Fructus), Muli (Concha Ostreae), Xiaomai (Tritici Fructus), and Nanzao (Jujubae Fructus). After four doses, the condition improved. White Shaoyao (Paeoniae Radix Alba), Danggui (Angelicae Sinensis Radix), and Weirui (Polygonati Odorati Rhizoma) were added. After twenty doses, the disease was cured. However, deficiency remained, so pills were prepared. After several months, his original vitality was restored.