一人病伤寒期月体兢兢而振齿相击不能成语医环视束手仲宾后至诊之曰急取羊肉来群医
曰
伤寒大忌羊肉仲宾曰诸君无哓哓以羊肉斤许熟之取中大脔别用水煮良久取汁一升与病患服须
臾战止汗大出而愈(王止仲文集)
平江张省 病伤寒眼赤舌缩唇口破裂气喘失音大便自利势甚危笃诸医皆欲先止其泻适有
秀州
医僧宝鉴者过苏张延视诊脉乃投以茵陈五苓散白虎汤而愈诸医问故僧曰仲景云五脏实者死今
大肠通更止之死可立待五苓以导其小便白虎以导其邪气此则医家之通晓也何难之有(云麓漫
抄)
世谓伤寒汗吐下三法差谬名曰坏症昔张致和用独参汤救治一人垂死手足俱冷气息将
绝口张不能言致和以人参一两去芦加附子一钱于石铫内煎至一碗以新汲水浸之若冰冷一服而
尽少顷病患汗从鼻粱尖上涓涓如水此其验也盖鼻粱上应脾若鼻端有汗者可救以土在身中周遍
故也近陆同妇产后患疫症二十余日气虚脉弱即同坏症亦以此汤治之遂愈孙真人云人参汤须得
长流水煎服若用井水则不验盖长流水取其性之通达耳
世俗尝言头无寒疼腹无热痛此不经之说也黄帝问曰病头痛以数岁不已此何说岐伯对曰当
有
所犯大寒内至骨髓髓者以脑为主脑逆故令头痛齿亦痛也余昔治杨氏妇年五十余病头痛历岁侵
久或治以风或治以痰皆不效余脉之左寸沉迟而芤曰此气血两虚也用当归二两附子三钱一服减
半二服其病如失更不复发用药对症不啻影响有如是乎一妇人偏头痛久不愈医用大承气汤即瘳
何也盖阳明燥金胜乘肝气郁气郁则血壅血壅则上下不通故燥结以承气汤疏通之则气血流行而
肝气通矣伤寒治例云少阳偏头痛多便闭宜下之此为新病者设若久病元气不足者更作处治
有一位患者患伤寒病长达一个月,身体颤抖且牙齿打颤,无法说清话语。周围的医生环顾四周,束手无策。仲宾后来到了,诊察后说:“赶快取羊肉来。”众医生说:“伤寒病最忌讳吃羊肉。”仲宾说:“各位不要多嘴。”将一斤多羊肉煮熟,取其中间大块部分,另用水煮很久,取汁一升给患者服用。不久,患者的战栗停止,大汗出而痊愈。(出自《王止仲文集》)
平江人张省患伤寒,出现眼睛发红、舌头收缩、嘴唇破裂、气喘、失音、大便自泄等症状,病情非常危重。众医生都想先止住他的腹泻。恰好有秀州的医僧宝鉴路过苏州,张省邀请他诊治。宝鉴诊脉后,投以茵陈五苓散和白虎汤,患者痊愈。众医生询问原因,僧人说:“张仲景说五脏实证者死,如今大肠通畅,如果强行止泻,死亡就在眼前。五苓散用来引导小便排出水湿,白虎汤用来引导邪气外出,这是医家通晓的道理,有什么难的?”(出自《云麓漫抄》)
世人认为伤寒汗、吐、下三法如果差错,称为“坏证”。过去张致和曾用独参汤救治一名垂死之人,患者手足俱冷,气息将绝,口张不能言。张致和人参一两(去芦头),加附子一钱,在石铫内煎至一碗,用新汲水浸冷后,让患者一次服完。不久,患者汗水从鼻梁尖上涓涓流出,这就是验征。因为鼻梁上部对应脾脏,若鼻端有汗,说明脾气尚存,土气在体内周遍流通,所以可救。最近陆同的妻子产后患疫病二十多天,气虚脉弱,也属于类似坏证的情况,也用此汤治愈。孙真人说:人参汤必须用长流水煎服,如果用井水则无效。因为长流水取其性质通达的缘故。
世俗常说“头无寒痛,腹无热痛”,这是不经过考证的说法。黄帝问:头痛病多年不愈,这是什么道理?岐伯回答:这可能是遭受了大寒之邪,寒气深入骨髓。骨髓以脑为主,寒气逆乱导致头痛,牙齿也会痛。我以前治疗杨姓妇人,五十多岁,患头痛多年,久治不愈。有的用治风的方法,有的用治痰的方法,都不见效。我诊察她的脉象,左寸脉沉迟而芤,说这是气血两虚。于是用当归二两、附子三钱,服用一次后症状减半,服用两次后病如消失,更未复发。用药对症,效果就像影随形一样迅速。还有一位妇女偏头痛久治不愈,医生用大承气汤即愈。为什么呢?因为阳明燥金之气过盛,乘袭肝气,导致肝气郁结;气郁则血壅滞,血壅则上下不通。所以用承气汤疏通燥结,则气血流行,肝气也就通畅了。《伤寒治例》说:少阳经偏头痛多伴有大便闭塞,适宜用下法。这是针对新病者设立的。如果是久病元气不足的人,则应另行处置。
A patient suffered from Shanghan (Cold Damage) for a month, trembling with teeth chattering, unable to speak clearly. The surrounding physicians looked at each other, helpless. Zhongbin arrived later, examined the pulse, and said, "Quickly fetch mutton." The other physicians said, "Mutton is strictly contraindicated in Shanghan." Zhongbin replied, "Do not chatter." He took over a jin (approx. 500g) of mutton, boiled it until cooked, selected the central large piece, boiled it again in fresh water for a long time, obtained one sheng (approx. 200ml) of broth, and administered it to the patient. Soon, the tremors ceased, profuse sweating occurred, and the patient recovered. (From *Wang Zhizhong's Collected Works*)
Zhang Sheng from Pingjiang suffered from Shanghan, presenting with red eyes, retracted tongue, cracked lips, asthma, loss of voice, and spontaneous diarrhea, with critical condition. The physicians wished to first stop the diarrhea. Coincidentally, Monk Baojian, a physician from Xiuzhou, passed through Suzhou. Zhang invited him to examine. After taking the pulse, Baojian prescribed Yinchen Wuling San (Artemisiae Scopariae Five-Ingredient Powder) combined with Baihu Tang (White Tiger Decoction), and the patient recovered. When asked for the rationale, the monk said, "Zhang Zhongjing stated that excess patterns in the five zang organs lead to death. Now that the large intestine is open, stopping the diarrhea would lead to immediate death. Wuling San guides the excretion of dampness via urination, while Baihu Tang guides out the pathogenic heat. This is a fundamental understanding of medicine; what difficulty is there?" (From *Yunlu Mancao*)
It is commonly believed that errors in the three methods of sweating, vomiting, and purging in Shanghan treatment result in "ruined syndromes" (bad outcomes). In the past, Zhang Zhihe used Dushen Tang (Single Ginseng Decoction) to save a dying patient who had cold hands and feet, nearly absent breath, and an open mouth unable to speak. Zhang Zhihe decocted one liang (approx. 30g) of Ren Shen (Ginseng Root, de-rooted) with one qian (approx. 3g) of Fu Zi (Aconite Lateral Root) in a clay pot until reduced to one bowl. It was cooled in fresh well water, and the patient drank it all at once. Soon, sweat trickled from the tip of the nasal bridge. This is a diagnostic sign: the upper part of the nasal bridge corresponds to the Spleen. If sweat appears on the nose tip, it indicates that Spleen Qi remains and Earth Qi circulates within the body, thus salvation is possible. Recently, Lu Tong's wife, suffering from an epidemic disease for over twenty days postpartum, presented with deficient Qi and weak pulse, resembling a ruined syndrome. She was also cured with this decoction. Sun Simiao stated that Ren Shen Tang must be decocted with flowing river water; using well water renders it ineffective because flowing water possesses the property of promoting free flow.
Secular wisdom claims "the head has no cold pain, the abdomen has no heat pain," which is an unverified assertion. The Yellow Emperor asked: "Why does headache persist for years? What is the explanation?" Qibo answered: "This may be due to severe cold invasion penetrating deep into the bone marrow. Since the brain is the master of the marrow, cold counterflow causes headache and toothache. I once treated a woman surnamed Yang, aged fifty-something, suffering from chronic headache for years. Treatments targeting wind or phlegm were ineffective. Her left cun (inch) pulse was deep, slow, and hollow (Kou), indicating deficiency of both Qi and Blood. I prescribed Dang Gui (Angelica Sinensis Root) two liang and Fu Zi three qian. After one dose, symptoms halved; after two doses, the illness vanished without recurrence. When medication matches the syndrome, efficacy is as swift as shadow following form. Another woman with chronic migraines was cured by Da Chengqi Tang (Major Order the Qi Decoction). Why? Because excessive Dryness Metal of the Yangming channel overacts on Liver Qi, causing stagnation. Stagnation leads to blood obstruction, blocking upper and lower circulation. Thus, Da Chengqi Tang unblocks dryness accumulation, allowing Qi and Blood to flow freely, thereby unblocking Liver Qi. *Shanghan Zhili* states: Shaoyang channel migraines often accompany constipation and are suitable for purgation. This applies to new diseases. For chronic cases with insufficient Yuan Qi, different management is required."