薛立斋治一妊妇,嗽则小便自出。此肺气不足,肾气亏损,不能司摄。用补中益气汤以培土生金,六味
丸加五味以生肾气而愈。
一妊妇咳嗽,其痰上涌,日五六碗许,诸药不应。此水泛为痰,用六味丸料及四君子汤,各一剂稍愈,数剂而安。
一妊妇因怒,咳嗽吐痰,两胁作痛,此肝火伤肺金。以小柴胡汤加山栀、枳壳、白术、茯苓治之而愈。但
欲作呕,此肝侮脾也。用六君子汤加柴胡、升麻而愈。
沈尧封曰∶钱彬安室人,内热,咳呛涎痰,夜不能卧,脉细且数,呼吸七至。邀余诊视,问及经事,答言
向来不准,今过期不至。余因邻近,素知伊芳禀怯弱,不敢用药。就诊于吴门叶氏,云∶此百日劳,不治。妇延
本邑浦书亭疗之,投逍遥散不应,更葳蕤汤亦不应。曰∶病本无药可治,但不药必骇病者,可与六味汤。因取
六味丸料二十分之一煎服,一剂咳减,二剂热退,四剂霍然。惟觉腹中有块,日大一日,弥月生一女,母女俱
安。越二十余年,女嫁母故。后以此法,治怀妊咳呛涎痰,或内热或不内热,或脉数或脉不数,五月以内者俱
效。五月以外者,有效有不效。
沈尧封治一妇,妊七八月,痰嗽不止,有时呕浓痰数碗。投二陈、旋复不应,用清肺滋阴愈甚。遂不服药,
弥月而产,痰嗽如故,日夜不寐。三朝后,用二陈加胆星、竹茹,吐出浓痰数碗,嗽仍不止。更用二陈加旋复、
当归少减,稍可吃饭。因嗽不减,痰渐变薄,加入生地四钱。食顿减,嗽转甚,通身汗出,脉象微弦,用归身
三钱,茯苓二钱,炒甘草一钱,紫石英三钱。因汗欲用黄 ,因嗽又止。推敲半晌,仍用炒黄 三钱,一服汗
止,嗽亦大减,十剂而安。
薛立斋治疗一位孕妇,咳嗽时小便不由自主地流出。这是肺气不足、肾气亏损,无法固摄所致。使用补中益气汤来培补脾胃以生肺金(培土生金),配合六味丸加入五味子以滋生肾气,从而痊愈。
另一位孕妇咳嗽,痰液上涌,每天约五六碗之多,服用各种药物均无效。这是水湿泛滥化为痰饮,使用六味丸药料及四君子汤,各服一剂后症状稍有好转,服用数剂后病情安定。
还有一位孕妇因愤怒导致咳嗽吐痰,两胁疼痛,这是肝火损伤肺金。用小柴胡汤加入山栀、枳壳、白术、茯苓治疗而痊愈。但患者仍有想呕吐的感觉,这是肝木克制脾土的表现。使用六君子汤加入柴胡、升麻治疗后痊愈。
沈尧封说:钱彬安的妻子,体内发热,呛咳并吐出涎痰,夜间无法躺卧,脉象细且快,呼吸频率达到七次(指脉搏跳动与呼吸比例异常或脉率极快)。询问月经情况,回答说向来不准,如今过期未来。我因为与她家邻近,素知她体质怯弱,不敢轻易用药。于是前往吴门叶氏处就诊,叶氏说:这是百日劳损之症,无法治愈。妇人随后延请本邑浦书亭治疗,投用逍遥散无效,改用葳蕤汤也无效。浦书亭说:病根本无药可治,但不给药必定会让病人惊恐,可以给予六味汤。于是取六味丸药料的二十分之一煎服,一剂后咳嗽减轻,二剂后热退,四剂后霍然痊愈。只感觉腹中有肿块,一天比一天大,满月后生下一女,母女平安。过了二十多年,女儿出嫁,母亲去世。后来我用这种方法,治疗怀孕期呛咳吐涎痰,无论体内是否有热,无论脉象是否快速,妊娠五个月以内的都有效。五个月以上的,有的有效,有的无效。
沈尧封治疗一位妇女,怀孕七八个月,痰嗽不止,有时呕吐浓痰数碗。投用二陈汤、旋复花无效,使用清肺滋阴的方法反而加重。于是停止服药,直到足月生产,痰嗽依旧,日夜无法入睡。产后第三天,使用二陈汤加入胆南星、竹茹,吐出浓痰数碗,咳嗽仍不停止。又改用二陈汤加入旋复花、当归,症状稍减,勉强能吃饭。因为咳嗽不减,痰液逐渐变稀薄,加入生地四钱。进食顿时减少,咳嗽反而加重,全身出汗,脉象微弦。使用归身三钱,茯苓二钱,炒甘草一钱,紫石英三钱。因为出汗本想用黄芪,但因为咳嗽又停用了。推敲半晌,最终仍用炒黄芪三钱,一服后汗止,咳嗽也大幅减轻,十剂后病情安定。
Xue Lizhai treated a pregnant woman who experienced involuntary urination when coughing. This was due to insufficiency of Lung Qi and deficiency of Kidney Qi, failing to maintain control. He used Buzhong Yiqi Tang (Supplement the Middle and Boost the Qi Decoction) to strengthen the Spleen to generate Lung Metal (strengthening Earth to nourish Metal), combined with Liuwei Wan (Six-Ingredient Pill with Rehmannia) added with Wuweizi (Schisandrae Fructus) to generate Kidney Qi, resulting in recovery.
Another pregnant woman suffered from coughing with excessive phlegm surging upward, amounting to five or six bowls per day, without response to various medications. This was caused by water flooding and transforming into phlegm. He used the ingredients of Liuwei Wan and Sijunzi Tang (Four Gentlemen Decoction), each administered for one dose, leading to slight improvement, and after several doses, the condition stabilized.
A third pregnant woman, due to anger, developed coughing with expectoration and pain in both hypochondriac regions. This indicated Liver Fire injuring Lung Metal. She was treated with Xiaochaihu Tang (Minor Bupleurum Decoction) added with Zhizi (Gardeniae Fructus), Zhike (Aurantii Fructus), Baizhu (Atractylodis Macrocephalae Rhizoma), and Fuling (Poria) until she recovered. However, she still had the urge to vomit, indicating Liver Wood overacting on Spleen Earth. She was then treated with Liujunzi Tang (Six-Gentlemen Decoction) added with Chaihu (Bupleuri Radix) and Shengma (Cimicifugae Rhizoma), resulting in recovery.
Shen Yaofeng stated: The wife of Qian Bin'an suffered from internal heat, choking cough with salivary phlegm, inability to lie down at night, a fine and rapid pulse, and a respiration rate of seven beats per breath cycle. Upon asking about her menstruation, she replied that it had always been irregular and was now overdue. Knowing her constitution was inherently weak due to proximity, I dared not prescribe medication. I consulted Ye Shi in Wumen, who said this was a hundred-day labor injury, incurable. The woman then sought treatment from Pu Shuting in our county. Xiaoyao San (Free and Easy Wanderer Powder) was ineffective, and Weirui Tang (Polygonatum Decoction) was also ineffective. Pu Shuting said, "The disease has no curative medicine, but withholding treatment would surely frighten the patient. One may administer Liuwei Tang." Thus, he took one-twentieth of the ingredients of Liuwei Wan, decocted and administered them. After one dose, cough decreased; after two doses, fever subsided; after four doses, she recovered completely. She only felt a mass in her abdomen, growing larger daily. At full term, she gave birth to a daughter, and both mother and child were safe. Over twenty years later, the daughter married and the mother passed away. Later, I used this method to treat pregnancy-related choking cough with salivary phlegm, whether with or without internal heat, whether with rapid or non-rapid pulses, within five months of gestation, all showed efficacy. For those beyond five months, some responded, others did not.
Shen Yaofeng treated a woman at seven or eight months of pregnancy with incessant phlegm-cough, occasionally vomiting several bowls of thick phlegm. Erchen Tang (Two-Aged Decoction) and Xuanfuhua (Inulae Flos) were ineffective. Using methods to clear Lung heat and nourish Yin worsened the condition. She stopped taking medicine and delivered at term, yet the phlegm-cough persisted, causing sleeplessness day and night. Three days postpartum, Erchen Tang added with Danningxing (Arisaematis Cum Bile) and Zhuru (Bambusae Folium) was used, expelling several bowls of thick phlegm, but cough continued. Then, Erchen Tang added with Xuanfuhua and Danggui (Angelicae Sinensis Radix) slightly reduced symptoms, allowing minimal food intake. As cough persisted and phlegm became thinner, Shengdi (Rehmanniae Radix) 4 qian was added. Food intake dropped sharply, cough worsened, whole-body sweating occurred, and the pulse became slightly wiry. Guishen (Angelicae Sinensis Radix) 3 qian, Fuling 2 qian, fried Gancao (Glycyrrhizae Radix et Rhizoma) 1 qian, and Zhiyuanshi (Fluorite) 3 qian were used. Although Huangqi (Astragali Radix) was considered for sweating, it was withheld due to cough. After deliberation, fried Huangqi 3 qan was finally used. One dose stopped sweating and greatly reduced cough; ten doses led to stability.