万密斋治一儿四岁,忽作喘,气逆痰壅,鼻孔开张。万曰∶此马脾风也。(以鼻煽命名也。)如胸高肩耸,汗出发
润,(皆下脱也。)则不可治。须急治之,以葶苈丸去防己,加大黄,除肺之热,合小陷胸汤,除肺之痰。碾为细末,
竹沥调服。(作实治,服法精当。)
一儿病,两腮红,上气喘急,脉浮缓而濡。此得之伤食,食伤脾,脾虚则不能养肺,母病子亦病也。两腮
红者,虚热也。上气喘急者,肺虚也。脉浮缓而濡,气虚也。时医咸以惊风为治,用抱龙丸、牛黄丸、苏合丸,
不效。闻其言皆匿笑,乃以阿胶炒成珠,煎苏叶乌梅汤化服,三剂而瘳。(观其治法,乃肺虚之喘,以阿胶
补肺阴,兼用一散一敛之法,其用意甚巧。伤食云云,乃英雄欺人语,未足为据也。)
一富室小儿,先病泻,医以药服之,乃作喘,归咎于医。万曰∶非医之误,乃冷伤脾作泻,脾传肺作喘。
脾为母,肺为子,传其所生也。用陈氏芎葛散,一服喘止而安。后用此方,治泻后喘者良验。
一女子素有喘病,发则多痰,用补肾地黄丸。或曰∶喘者,肺病也,今补肾何也?曰∶肺主气,肾则纳而
藏之。痰涎者,肾之津液所生也。哮喘吐痰,乃气不归元,津涎无所受也。果服此而安。
朱丹溪治一女,年十二,自小喘嗽。白术、陈皮、青皮各五钱,麻黄、茯苓、木通、片芩各三钱,苍术、
桔梗各二钱,干姜一钱,甘草五分,每帖一钱半煎服。
龚子才治一小儿,外感风邪,服表散之剂,汗出作喘,此邪风去而脾虚也。用异功散而汗喘止,再剂而乳
食进。
冯楚瞻治同姓子,三岁,平时面色 白,囟门宽大,颅骨开解。一夕,忽发微喘,不能睡倒,抱起稍可。
至二三日,虽抱起而喘急不减,出多入少,两便亦急。(肝肾大亏。)理宜用上病疗下之法,恐不肯轻服,乃
设词曰∶喘已多日,肺气虚矣,当以人参钱许,配生脉饮作汤,化服启脾丸乃愈也。急归寓,以八味丸杵作
大丸代之,服下喘日减。四五日后,本症悉平,精神倍长,屡索启脾丸,而囟门颅骨俱长满矣。
吴孚先治一小儿,气急而喘,喉中声如水鸡叫,用三拗汤而愈。
钱国宾治中翰六登之次子,自幼吼喘,日夜不绝,今八岁莫愈,身体无病。诊右寸浮滑,主肺窍有痰喘吼。
三白丸∶ 白砒、贝母、桔梗各三分,饭丸黍米大,每睡时,冷茶送下五丸。至五日,此子索物不厌,其母嗔
之,猛然一呛,吐出黑痰一块,如圆眼大,其臭满室,剖开,内包大黑瓜子一枚,尖小破,从此吼喘即止,举
家感激,除此子一生之患矣。及问其故,曰∶肺有六叶两耳,四垂如华盖,清虚之脏,一尘不染。因乳子误吞
瓜子,入于肺缝,久则痰胶,阻碍呼吸之气,作吼喘声也。今药力攻出,肺清而金不鸣则无声,痰出而呼吸利,
则无吼喘症矣。
万密斋治疗一名四岁的患儿,突然发作喘证,气逆痰多壅塞,鼻孔张开。万氏说:这是马脾风。(因鼻翼扇动而得名。)如果伴有胸部高耸、肩膀耸起、出汗且汗出湿润皮肤,(这些都是正气下脱的危象。)则不可治愈。必须紧急治疗,使用葶苈丸去掉防己,加入大黄,以清除肺部的热邪,配合小陷胸汤,以清除肺部的痰浊。将药物碾成细末,用竹沥调服。(按实证治疗,服药方法精当。)
另一名患儿患病,两腮发红,上气喘促急促,脉象浮缓而濡软。此病源于伤食,饮食损伤脾胃,脾虚则不能滋养肺脏,母病及子,故肺亦受病。两腮发红,是虚热的表现;上气喘促,是肺气虚的表现;脉象浮缓而濡,是气虚的表现。当时的医生都按照惊风来治疗,使用抱龙丸、牛黄丸、苏合香丸,但无效。听到他们的言论后,万氏暗自发笑,于是用阿胶炒至珠状,煎煮苏叶乌梅汤送服,服用三剂后痊愈。(观察其治疗方法,是针对肺虚之喘,用阿胶补益肺阴,兼用发散与收敛相结合的方法,用意非常巧妙。所谓伤食的论述,不过是医家掩饰无能的托词,不足为据。)
一名富贵人家的患儿,先前患有泄泻,医生用药治疗后,反而出现喘证,家属归咎于医生的失误。万氏说:并非医生的失误,而是寒邪损伤脾胃导致泄泻,脾病传变至肺导致喘证。脾为母脏,肺为子脏,这是母子相传的关系。使用陈氏芎葛散,服用一剂后喘止而安。后来用此方治疗泄泻后出现的喘证,疗效很好。
一名女子素有喘病,发作时多痰,使用补肾地黄丸。有人问:喘证是肺的病,现在补肾做什么呢?万氏说:肺主气,肾则纳气而藏之。痰涎,是由肾的津液所化生。哮喘吐痰,是因为气不归元,津液和涎沫无所依附。果然服用此药后病情安定。
朱丹溪治疗一名十二岁的女子,从小就有喘咳。处方:白术、陈皮、青皮各五钱,麻黄、茯苓、木通、黄芩各三钱,苍术、桔梗各二钱,干姜一钱,甘草五分。每帖取一钱半煎服。
龚子才治疗一名小儿,外感风邪,服用解表发散的药物后,出汗并出现喘证,这是邪风已去但脾气虚弱所致。使用异功散,汗止喘平,再服用两剂后乳食进增。
冯楚瞻治疗同宗族的侄子,三岁,平时面色苍白,囟门宽大,颅骨缝隙未闭合。一天夜里,突然发作轻微喘促,无法躺下睡觉,抱起稍好。到了第二三天,即使抱起,喘急也不见减轻,呼气多吸气少,大小便也急促。(这是肝肾大亏的表现。)按理应该采用上病下治的方法,但担心家属不肯轻易服用重剂,于是编造理由说:喘症已经多天,肺气虚了,应当用人参少许,配伍生脉饮做成汤剂,送服启脾丸才能痊愈。急忙回到寓所,用八味丸捣碎制成大丸代替,服用后喘症日渐减轻。四五日后,本症完全平息,精神倍增,多次索要启脾丸,而囟门和颅骨缝隙也都长满了。
吴孚先治疗一名小儿,气急而喘,喉中声音像水鸡叫,使用三拗汤而痊愈。
钱国宾治疗中翰六登之次子,自幼吼喘,日夜不停,如今八岁仍未痊愈,身体其他方面无病。诊察右寸脉浮滑,主肺窍有痰导致的喘吼。处方三白丸:白砒、贝母、桔梗各三分,用米饭制成如黍米大小的丸药,每次睡觉时,用冷茶送服五丸。到了第五天,这个孩子索求食物不知满足,他的母亲责备他,猛然呛咳,吐出一块黑痰,如龙眼大小,臭味充满房间,剖开一看,里面包裹着一枚大黑瓜子,尖端有小破口,从此吼喘立即停止,全家感激,除去了这孩子一生的病患。问及原因,回答说:肺有六叶两耳,四周下垂如华盖,是清虚之脏,一尘不染。因为吃奶时误吞瓜子,进入肺缝,日久痰液胶结,阻碍呼吸之气,发出吼喘声。现在药力攻出异物,肺清肃则金不鸣故无声,痰出则呼吸通畅,就没有吼喘症了。
Wan Mizhai treated a four-year-old child who suddenly developed asthma (asthma), with rebellious Qi, phlegm obstruction, and flaring nostrils. Wan said: This is Ma Pi Feng (Horse Spleen Wind, named for nasal flapping). If accompanied by a high chest, shrugging shoulders, sweating with moist skin, (all signs of sinking of the righteous Qi), it is incurable. It must be treated urgently using Tingli Wan (Descurainia Seed Pill) with Fangji removed and Dahuang added, to clear heat from the Lungs, combined with Xiaoxianxiong Tang (Minor Inverted Chest Decoction) to clear phlegm from the Lungs. The medicine was ground into fine powder and taken mixed with Zhuli (Bamboo Sap). (Treated as an excess syndrome; the method of administration was precise.)
Another child suffered from redness on both cheeks, upper respiratory distress, and a floating, slow, and soggy pulse. This resulted from food injury; food damaged the Spleen, and when the Spleen is deficient, it cannot nourish the Lung; the mother organ's disease affects the child organ. Redness on the cheeks indicates deficiency heat. Upper respiratory distress indicates Lung Qi deficiency. A floating, slow, and soggy pulse indicates Qi deficiency. Contemporary physicians all treated it as Jing Feng (Wind Convulsion), using Baolong Wan (Embrace Dragon Pill), Niuhuang Wan (Calculus Bovis Pill), and Suhexiang Wan (Styrax Pill), but without effect. Hearing their discussions, Wan secretly smiled, then used Ejiao (Donkey-hide Gelatin) fried until pearl-like, decocted in Zisu Wumei Tang (Perilla Leaf and Mume Fruit Decoction) for administration. After three doses, the condition resolved. (Observing the treatment method, it addressed Lung deficiency asthma; using Ejiao to tonify Lung Yin, combined with a dispersing and astringent method, the intention was very clever. The claim about food injury was merely an excuse by physicians to cover incompetence and should not be relied upon.)
A wealthy family's child first suffered from diarrhea. After medication administered by a physician, asthma developed, and the family blamed the doctor. Wan said: It is not the doctor's error; rather, cold injured the Spleen causing diarrhea, which transmitted to the Lung causing asthma. The Spleen is the mother, the Lung is the child; this is transmission through the generating relationship. Chen Shi Xionggie San (Chen's Ligusticum and Pueraria Powder) was used, and after one dose, the asthma stopped and the child was calm. Later, this formula proved effective for treating asthma following diarrhea.
A woman had a chronic history of asthma, producing much phlegm during attacks. She used Bushen Dihuang Wan (Kidney-Tonifying Rehmannia Pill). Someone asked: Asthma is a Lung disease; why tonify the Kidney now? He replied: The Lung governs Qi, while the Kidney grasps and stores it. Phlegm and saliva are generated from the fluids of the Kidney. Asthma with expectoration occurs because Qi does not return to its root, and fluids/saliva have no place to reside. Indeed, after taking this medicine, she became stable.
Zhu Danxi treated a twelve-year-old girl who had suffered from asthma and cough since childhood. Formula: Baizhu (Atractylodis Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Qingpi (Citri Reticulatae Pericarpium Viride) each 5 qian; Mahuang (Ephedrae Herba), Fuling (Poria), Mutong (Akebiae Caulis), Pianqin (Scutellariae Radix) each 3 qian; Cangzhu (Atractylodis Rhizomatis), Jiegeng (Platycodonis Radix) each 2 qian; Ganjiang (Zingiberis Rhizoma) 1 qian; Gancao (Glycyrrhizae Radix et Rhizoma) 0.5 qian. Each prescription, take 1.5 qian for decoction and ingestion.
Gong Zicai treated a pediatric patient who contracted external wind pathogen. After taking exterior-releasing agents, sweating occurred followed by asthma; this indicated that the wind pathogen had departed but the Spleen Qi was deficient. Yigong San (Extraordinary Power Powder) was used, stopping the sweating and asthma; after two more doses, milk and food intake improved.
Feng Chuzhan treated a nephew of the same clan, aged three. Normally, his complexion was pale, the fontanelle was wide, and the cranial sutures were open. One night, he suddenly developed mild asthma, unable to lie down to sleep, feeling slightly better when held upright. By the second or third day, even when held upright, the rapid breathing did not decrease, with excessive exhalation and insufficient inhalation, and urgency in urination and defecation. (This indicates severe deficiency of Liver and Kidney.) According to principle, the "treat upper disease by lowering" method should be used, but fearing the family would not easily accept heavy medication, he fabricated a story saying: The asthma has lasted many days, indicating Lung Qi deficiency. One should use a small amount of Ren Shen (Ginseng Radix et Rhizoma), compound with Shengmai Yin (Generate Pulse Drink) as a decoction, and administer Qipi Wan (Spleen-Regulating Pill) to achieve cure. Rushing back to his residence, he substituted Bawei Wan (Eight-Ingredient Pill) pounded into large pills. After ingestion, the asthma decreased daily. After four or five days, the main symptoms completely subsided, spirit increased significantly, and although repeatedly asking for Qipi Wan, the fontanelle and cranial sutures had grown closed.
Wu Fuxian treated a child with rapid breathing and asthma, with sounds in the throat like a water chicken croaking. San'ao Tang (Three Unobstructed Decoction) was used, resulting in recovery.
Qian Guobin treated the second son of Zhonghan Liudeng, who had suffered from roaring asthma since infancy, day and night without cessation. Now eight years old and still uncured, yet otherwise healthy. Palpation of the right Cun position revealed floating and slippery qualities, indicating phlegm in the Lung orifice causing asthmatic roaring. Formula Sanbai Wan (Three White Pills): Bai Bi (Arsenicum Rubrum), Beimu (Fritillariae Bulbus), Jiegeng (Platycodonis Radix) each 3 fen. Made into pills the size of millet grains using rice paste. At bedtime, swallow five pills with cold tea. On the fifth day, the child demanded food insatiably. His mother scolded him, causing a sudden choking fit, from which he expectorated a piece of black phlegm, the size of a longan fruit, smelling foul throughout the room. Upon dissection, it contained a large black melon seed, broken at the tip. From then on, the roaring asthma ceased immediately. The whole family was grateful, as this cured the child of a lifelong affliction. When asked for the cause, he explained: The Lung has six lobes and two ears, hanging down like a canopy, a pure and empty organ, untouched by dust. Because the infant accidentally swallowed a melon seed while nursing, it entered the lung fissures. Over time, phlegm adhered, obstructing respiratory Qi, producing roaring asthma sounds. Now, the medicinal power expelled the foreign body; the Lung is cleared, so Metal does not ring (no sound); phlegm is out, respiration is smooth, thus the roaring asthma symptom is gone.