李大富而极鄙吝,唇生肉须一尺长,痛不可忍。或云用刀,或云用药。邻有金先生者,曰∶我能治,须讲
定谢金方医。众亲友讲以十两为谢。金用末药一匕,炉中烧烟熏之,即落去一寸。袖手索谢,李先付一两。五
日已好,及讲完前约,乃坚不与矣。金笑曰∶逆知其然也,明年必发,即百金不用药。后果发,遂死焉。(扁鹊谓
重财者,为六不治之一。见《续金陵琐事》。)
晋魏咏之,生而兔缺,有善相者谓之曰∶卿当富贵。年十八,闻荆州刺史殷仲堪帐下有名医能疗之,贫无
行装,谓家人曰∶残丑如此,用活何为?遂 数斛米西上,以投仲堪。既至,造门自通,仲堪与语,嘉其盛意,
召医视之。医曰∶可割而补之,但须百日进粥,不得笑语。咏之曰∶半生不语,而有半生,亦当疗之,况百日
耶。仲堪于是处之别室,令医善疗之,遂闭口不语,惟食薄粥,百日而瘥。(《槎庵小乘》。)
薛立斋治一妇人,怀抱久郁,患茧唇。杂治消痰降火,虚症悉具,盗汗如雨。此气血虚而有热也,用当归
六黄汤,内黄芩、连、柏,俱炒黑,二剂而盗汗顿止。仍用归脾汤、八珍散兼服,元气渐复。更以逍遥散加归
脾汤间服,百余剂唇亦瘥。
一妇人唇裂内热二年矣,每作服寒凉之剂,时出血水,益增他症。此胃火伤血,而药伤元气也,用加味清
胃散而愈。后因怒,唇口肿胀,寒热作呕。此属肝木乘脾土,用小柴胡加山栀、茯苓、桔梗,诸症顿愈。复以
加味逍遥散,调补元气而愈。
一妇人生育多胎,月经不调,两足发热。至年余而身亦热,劳则足腿酸疼。又年余,唇肿裂痛。又半年,
唇裂出血,形体瘦倦,饮食无味,月水不通,唇下肿如黑枣。此肝脾血虚火盛也,彼不信,用通经药而殁。
一妇人忿怒而唇肿,或用消毒之药,唇肿出血年余矣。此肝木克脾土而血伤也,须养脾胃,滋化源为主。
彼执用前药,反进蚀,状如翻花瘤而殁。
一妇人怀抱久郁,或时胃口嘈辣,胸膈不利,月水不调,晡热食少,体倦唇肿,已年余矣。此脾经郁火伤
血,用归脾汤加姜汁炒黄连、山栀,少佐吴茱萸,嘈辣顿去,饮食稍进。乃去黄连,加贝母、远志,胸膈通利,
饮食如常。又用加味逍遥散、归脾汤间服百余剂,月水调而唇肿愈。
州守刘克新患茧唇,时出血水,内热口干,吐痰体瘦,肾虚之症悉具,用济阴地黄丸,年许而愈。
一儒者因劳役感暑,唇生疮,或用四物汤加知、柏之类而愈。后复作,彼仍用前药益甚,腹中阴冷,乃用
补中益气汤加茯苓、半夏,治之而愈。
一男子素善怒,唇肿胀,服清胃等药,时出血水,形体骨立。用补中益气汤加半夏、茯苓、桔梗,月余唇
肿渐消,元气渐复。又以四物加柴胡、炒栀、丹皮、升麻、甘草,数剂乃去栀,加参、术而愈。
一男子内热作渴,咳唾痰涎,大便干涩,自喜壮实。此脾肾阴亏,阳旺之症,当壮水之主。不信,自服二
陈、芩、连之类,次年下唇渐肿,小便赤涩。执守前药,唇出血,大便黑块,小便淋沥。再求治,曰∶大便黑
结,小便淋沥,肝肾败也,唇口肿白,脾气败也。辞不赴,竟殁。
李大富非常吝啬,嘴唇上长出一尺长的肉须,疼痛难忍。有人建议用刀割,有人建议用药治。邻居金先生说:“我能治好,但必须先商定酬谢的金钱。”众亲友商议后决定以十两银子作为酬谢。金先生用一匙药末,在炉中燃烧熏烤患处,肉须立即脱落一寸。金先生袖手站立索要酬劳,李大富先付了一两银子。五天后病好了,等到要结清之前的约定时,李大富却坚决不再支付了。金先生笑着说:“早就料到你会这样,明年一定会复发,即使给一百两银子也不用药了。”后果然复发,李大富因此死去。(扁鹊认为重视财物是“六不治”之一。见《续金陵琐事》。)
晋朝人魏咏之,生来就有兔唇(先天性唇裂),有位擅长相面的人对他说:“你将来会富贵。”十八岁时,他听说荆州刺史殷仲堪帐下有名医能治疗此病,因贫穷没有路费,便对家人说:“残缺丑陋到这种地步,活着有什么用?”于是运了几斛米向西进发,去投奔殷仲堪。到达后,登门自我介绍,殷仲堪与他交谈,赞赏他的盛情,召来医生诊治。医生说:“可以手术切除并修补,但需要一百天内只喝粥,不能说话和笑。”魏咏之说:“我半辈子不说话,现在还有半辈子,也应当治疗,何况只是一百天呢。”殷仲堪于是为他安排一间别室,让医生精心治疗,他便闭口不语,只吃稀粥,一百天后痊愈。(出自《槎庵小乘》。)
薛立斋治疗一位妇人,长期心情抑郁,患茧唇(一种唇部赘生物)。经过各种治疗消除痰火后,虚证全部显现,盗汗如雨。这是气血虚弱且有内热的表现,使用当归六黄汤,其中黄芩、黄连、黄柏都炒黑,服用两剂后盗汗立刻停止。随后继续使用归脾汤、八珍散兼服,元气逐渐恢复。后来再用逍遥散与归脾汤交替服用,一百多剂后唇部病症也痊愈了。
另一位妇人唇裂伴有内热两年了,每次发作都服用寒凉药物,时常流出血水,反而增加了其他症状。这是胃火损伤血液,而药物又损伤元气的结果,使用加味清胃散而治愈。后来因为生气,导致唇口肿胀,出现寒热往来和呕吐。这属于肝木克制脾土,使用小柴胡汤加入山栀、茯苓、桔梗,诸症立刻痊愈。随后再用加味逍遥散,调理补益元气而康复。
还有一位妇人生育过多胎次,月经不调,双脚发热。过了一年多全身也发热,劳累则腿足酸痛。又过了一年多,嘴唇肿胀破裂疼痛。再过半年,唇裂出血,身体消瘦疲倦,饮食无味,月经不通,唇下肿胀像黑枣一样。这是肝脾血虚火旺的表现,患者不信从医嘱,自行服用通经药而死。
另一位妇人因愤怒导致唇肿,有人用消毒药物治疗,唇肿出血长达一年多。这是肝木克制脾土导致血液受损,必须以养脾胃、滋生化之源为主。患者固执地使用前药,反而导致腐蚀加重,形状像翻花瘤而死。
还有一位妇人长期心情抑郁,有时胃口嘈杂辛辣,胸膈不畅,月经不调,午后发热,食少体倦,唇肿,病程已一年多。这是脾经郁火伤血,使用归脾汤加入姜汁炒黄连、山栀,稍加吴茱萸,嘈杂感立刻去除,饮食稍进。然后去掉黄连,加入贝母、远志,胸膈通畅,饮食恢复正常。后来又用加味逍遥散、归脾汤交替服用一百多剂,月经调顺,唇肿痊愈。
州守刘克新患茧唇,时常流出血水,内热口干,吐痰身体消瘦,肾虚症状齐全,使用济阴地黄丸,一年左右痊愈。
一位读书人因劳累受暑,嘴唇生疮,有人用四物汤加入知母、黄柏等药而治愈。后来复发,他仍用前药,病情反而加重,腹中感到阴冷,于是使用补中益气汤加入茯苓、半夏,治疗后痊愈。
一名男子素来易怒,嘴唇肿胀,服用清胃等药,时常流出血水,身体瘦骨嶙峋。使用补中益气汤加入半夏、茯苓、桔梗,一个多月后唇肿逐渐消退,元气逐渐恢复。后又用四物汤加入柴胡、炒栀子、丹皮、升麻、甘草,几剂后去掉栀子,加入人参、白术而痊愈。
一名男子内热口渴,咳嗽吐痰涎,大便干涩,自认为身体壮实。这是脾肾阴亏,阳气偏旺的症状,应当滋补肾阴(壮水之主)。患者不信,自行服用二陈汤及黄芩、黄连等药,次年下唇逐渐肿胀,小便赤涩。坚持服用前药,导致唇出血,大便有黑块,小便淋漓不尽。再次求治时,医生说:“大便黑结,小便淋漓,是肝肾败坏;唇口肿白,是脾气败坏。”患者拒绝治疗,最终死亡。
Li Dafu was extremely wealthy but miserly. A fleshy growth, one chi long, grew on his lips, causing unbearable pain. Some suggested using a knife, others suggested medication. A neighbor, Mr. Jin, said, "I can cure this, but we must agree on the monetary reward first." Relatives and friends negotiated a reward of ten taels of silver. Mr. Jin used a spoonful of powdered medicine, burned it in a stove to smoke the affected area, and the growth immediately fell off by one cun. Standing with hands behind his back, he demanded payment. Li paid only one tael initially. Five days later, he was cured, but when it came time to settle the previous agreement, Li firmly refused to pay further. Mr. Jin smiled and said, "I knew this would happen. It will recur next year, and even with a hundred taels, I will not use medicine." Indeed, it recurred, and Li died from it. (Bian Que stated that valuing wealth is one of the "Six Untreatable Conditions." See *Xu Jinling Suoshi*.)
Wei Yongzhi of the Jin Dynasty was born with a harelip. A physiognomist told him, "You will be noble and rich." At eighteen, he heard that a famous physician under the command of Yin Zhengan, Inspector of Jingzhou, could treat this condition. Poor and lacking travel funds, he told his family, "With such deformity and ugliness, what is the point of living?" He then transported several hu of rice westward to seek out Yin Zhengan. Upon arrival, he introduced himself at the door. Yin Zhengan conversed with him, appreciated his earnestness, and summoned a physician for examination. The physician said, "It can be cut and repaired, but you must consume only gruel for one hundred days and must not speak or laugh." Wei Yongzhi said, "I have not spoken for half my life; there is still half a life left, so I should certainly undergo treatment, let alone for just one hundred days." Yin Zhengan arranged a separate room for him, ordered the physician to treat him carefully, and Wei kept silent, eating only thin gruel, and was cured after one hundred days. (*Chaan Xiaocheng*.)
Xue Lizhai treated a woman who had suffered from long-term emotional depression and developed a silkworm lip (a type of lip tumor). After various treatments to resolve phlegm and clear fire, deficiency symptoms fully manifested, including night sweats profuse as rain. This indicated Qi and Blood deficiency with internal heat. He prescribed Danggui Liu Huang Tang (Angelica Six-Huang Decoction), where Huangqin, Lianhua, and Huangbai were all charred. After two doses, the night sweats stopped abruptly. Subsequently, Guipi Tang (Restore the Spleen Decoction) and Bazhen San (Eight-Treasure Powder) were taken concurrently, gradually restoring Yuan Qi (Original Qi). Later, Xiaoyao San (Free and Easy Wanderer Powder) was alternated with Guipi Tang for over a hundred doses, and the lip lesion healed.
Another woman had suffered from cracked lips with internal heat for two years. Each time she took cold-natured medicines, blood and fluid leaked, exacerbating other symptoms. This was due to Stomach Fire damaging the Blood, compounded by medications injuring Yuan Qi. She was cured with Jiawei Qingwei San (Modified Clear the Stomach Powder). Later, due to anger, her lips and mouth swelled, accompanied by alternating chills and fever and vomiting. This belonged to Liver Wood overacting on Spleen Earth. She was treated with Xiao Chai Hu Tang (Minor Bupleurum Decoction) added with Shanzhi, Fuling, and Jiegeng, and all symptoms resolved instantly. She subsequently recovered after taking Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) to regulate and tonify Yuan Qi.
A woman who had given birth to many fetuses suffered from irregular menstruation and hot feet. Over a year later, her whole body became hot, and fatigue caused soreness in the legs. Another year passed, and her lips swelled, cracked, and hurt. Half a year later, her lips bled, her body became emaciated and fatigued, food lost its taste, menstruation ceased, and swelling under the lips resembled black dates. This was Liver and Spleen Blood deficiency with flourishing Fire. Disbelieving the diagnosis, she took menstrual-regulating drugs and died.
Another woman’s lips swelled due to anger. Using detoxifying drugs, her lips swelled and bled for over a year. This was Liver Wood overcoming Spleen Earth, damaging the Blood. The primary treatment should have been nourishing the Spleen and Stomach and nourishing the source of transformation and production. Insisting on the previous medications, the condition worsened into an ulcer resembling a cauliflower tumor, and she died.
Another woman suffered from long-term depression, occasional burning sensation in the stomach, chest oppression, irregular menstruation, afternoon fever, poor appetite, fatigue, and lip swelling for over a year. This was Spleen Meridian depressed Fire damaging the Blood. She was treated with Guipi Tang added with Jiangzhi fried Huanglian and Shanzhi, with a small amount of Wuzhuyu. The burning sensation vanished, and appetite improved slightly. Then Huanglian was removed, and Beimu and Yuanzhi were added, clearing the chest and diaphragm, restoring normal diet. Later, Jiawei Xiaoyao San and Guipi Tang were alternated for over a hundred doses, regulating menstruation and curing the lip swelling.
Prefect Liu Kexin suffered from silkworm lip, leaking blood and fluid, internal heat, dry mouth, expectoration, emaciation, and complete Kidney deficiency symptoms. He was treated with Ji Yin Dihuang Wan (Nourish Yin Rehmannia Pills) and cured after about a year.
A scholar contracted summerheat due to labor, developing ulcers on his lips. He was cured using Siwu Tang (Four-Substance Decoction) added with Zhimu and Huangbai. When it recurred, he continued using the previous formula, which aggravated the condition, causing coldness in the abdomen. He was then cured using Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Fuling and Banxia.
A man prone to anger suffered from swollen lips. After taking Qingwei-type drugs, he leaked blood and fluid, becoming skeletal. He was treated with Buzhong Yiqi Tang added with Banxia, Fuling, and Jiegeng. After more than a month, the lip swelling gradually subsided, and Yuan Qi recovered. Subsequently, Siwu Tang was used added with Chaihu, fried Zhizi, Danpi, Shengma, and Gancao. After a few doses, Zhizi was removed, and Renshen and Baizhu were added, leading to recovery.
A man suffered from internal heat, thirst, coughing up salivary phlegm, and dry stool, yet considered himself robust. This was a pattern of Spleen and Kidney Yin deficiency with hyperactive Yang, requiring the strengthening of the root of Water (nourishing Kidney Yin). Disbelieving this, he self-medicated with Erchen Tang and Huangqin, Huanglian. The following year, his lower lip gradually swelled, and urination became red and difficult. Insisting on the previous meds, his lips bled, stools contained black clots, and urination became dribbling. Seeking treatment again, the doctor said, "Black clotted stools and dribbling urine indicate failure of Liver and Kidney; white swollen lips and mouth indicate failure of Spleen Qi." Refusing treatment, he eventually died.