胡氏女及笄后患吐血,每吐碗余,下午倦怠,夜分潮热,呕恶不食,便秘。时师谓阴虚火动,投滋阴之剂,
反加饱闷,背心胀痛。脉之,两寸洪大,两尺弱。知其有瘀血凝滞,致新血不得归经,故满而倒溢也。先以龙
荟丸通之,更以石膏、橘红、半夏、神曲、黄连、茜根、竹茹、枳壳各一钱,茯苓八分,甘草三分,服后大便
行三次,吐止食进。后用二陈汤加滑石、丹参、丹皮、茜根、白芍、香附,二十帖经调而愈。(此吐血亦经逆也,
当与龚子才治魏宪副外家案参阅。雄按∶今春余治朱生甫五令媳,患证与此略同。医皆作损治,广服滋阴之药,
反咳嗽便溏,卧床已匝月矣。余用沙参、丹参、竹茹、石斛、滑石、茜根、海螵蛸、桃仁、丝瓜络、苇茎、茅
根、蛤壳治之愈矣。)
喻嘉言治杨季登长女及笄,经闭年余,发热食少,肌削多汗,而成劳怯。医见汗多,误谓虚也,投以参、
术,其血愈锢。喻诊时,见汗出如蒸笼气水,谓曰∶此症可疗处全在有汗。盖经血内闭,止有从皮毛透出一路,
以汗亦血也。设无汗而血不流,则皮毛干槁而死矣。宜用极苦之药,以引其血入内,俾下通于冲脉,则热退经
胡氏的女儿在成年后出现吐血症状,每次呕吐量约一碗,下午感到倦怠,半夜有潮热感,伴有恶心、食欲不振和大便秘结。当时的医生认为是阴虚火旺,投用滋阴的药物,反而导致腹胀闷痛,背部胀痛。诊脉发现两寸脉洪大,两尺脉弱。判断其体内有瘀血凝滞,导致新血不能归入经脉,因此充满而倒溢出来。先用龙荟丸通导瘀滞,再用石膏、橘红、半夏、神曲、黄连、茜根、竹茹、枳壳各一钱,茯苓八分,甘草三分,服用后大便通行三次,吐血停止,食欲恢复。后来使用二陈汤(燥湿化痰、理气和中的基础方剂)加滑石、丹参、丹皮、茜根、白芍、香附,服用二十帖后月经调畅而痊愈。(这种吐血也是经气逆乱所致,应当参考龚子才治疗魏宪副岳母一案。按语:今年春天我治疗朱生甫五令媳,患病情况与此大致相同。其他医生都当作虚损病治疗,广泛服用滋阴药物,反而导致咳嗽、大便溏薄,卧床已近一个月。我用沙参、丹参、竹茹、石斛、滑石、茜根、海螵蛸、桃仁、丝瓜络、苇茎、茅根、蛤壳治疗,使其痊愈。)
喻嘉言治疗杨季登的长女,成年后,闭经一年多,发热、食少,肌肉消瘦、多汗,从而形成劳怯(虚劳羸弱之证)。医生见其汗多,误认为是虚证,投用人参、白术,导致血液更加凝滞不通。喻嘉言诊察时,见其汗出如蒸笼上的水汽,说道:“此症可治的关键全在于有汗。”因为经血内闭,只有从皮毛透出一路,因为汗也是血的一种表现。如果没有汗且血液不流通,那么皮毛干枯槁死就会死亡了。适宜用极苦味的药物,以引导血液向内,使之下通于冲脉,则热退经行。
The daughter of Mr. Hu suffered from hematemesis (vomiting blood) after reaching adulthood, vomiting about a bowl each time. She experienced fatigue in the afternoon, tidal fever (fever that rises at a specific time, often evening or night) at midnight, nausea, loss of appetite, and constipation. The physicians at the time diagnosed it as Yin deficiency with hyperactive fire (Yin Xu Huo Dong) and administered yin-nourishing agents. However, this aggravated her condition, causing abdominal fullness and distension, as well as pain and swelling in the back region. Upon pulse diagnosis, the pulses at both Cun (inch) positions were flooding (Hong Da), while those at both Chi (cubit) positions were weak. It was determined that there was stagnant blood coagulation, preventing new blood from returning to its vessels, thus causing fullness and regurgitation. Initially, Long Hui Wan (Dragon Bile Pill) was used to unblock the stagnation. Subsequently, a prescription containing Shi Gao (Gypsum Fibrosum), Ju Hong (Citri Reticulatae Pericarpium Rubrum), Ban Xia (Pinelliae Rhizoma), Shen Qu (Massae Fermentatae Medicinalis), Huang Lian (Coptidis Rhizoma), Qian Gen (Rubia Cordifoliae Radix et Rhizoma), Zhu Ru (Bambusae Caulis in Taeniam), Zhi Ke (Aurantii Fructus Immaturus) each at one qian, Fu Ling (Poria) at eight fen, and Gan Cao (Glycyrrhizae Radix et Rhizoma) at three fen was administered. After taking the medicine, bowel movements occurred three times, hematemesis ceased, and appetite returned. Later, Er Chen Tang (Two-Cured Decoction) was modified with Hua Shi (Talcum), Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma), Dan Pi (Moutan Cortex), Qian Gen, Bai Shao (Paeoniae Radix Alba), and Xiang Fu (Cyperi Rhizoma). After twenty doses, menstruation became regular, and she recovered. (This type of hematemesis is also due to rebellious menstrual qi; it should be referred to the case of Gong Zicai treating the mother-in-law of Vice Minister Wei. Note: This spring, I treated the fifth wife of Scholar Zhu Shengfu, whose symptoms were similar to this case. Other physicians treated it as a consumptive disease and widely administered yin-nourishing medicines, which instead caused coughing and loose stools, leaving her bedridden for nearly a month. I cured her using Sha Shen (Glehniae Radix), Dan Shen, Zhu Ru, Shi Hu (Dendrobii Caulis), Hua Shi, Qian Gen, Hai Piao Xiao (Sepiae Endoconcha), Tao Ren (Persicae Semen), Si Gua Luo (Luffae Fructus Retinervus), Wei Jing (Arundinis Rhizoma), Mao Gen (Imperatae Rhizoma), and Ge Qiao (Tridacnitis Concha).)
Yu Jiayan treated the eldest daughter of Yang Jideng, who had amenorrhea (cessation of menstruation) for over a year since adulthood, accompanied by fever, poor appetite, emaciation, and excessive sweating, leading to Lao Qie (consumptive weakness). Seeing the excessive sweating, the physician mistakenly diagnosed it as a deficiency syndrome and administered Ren Shen (Ginseng Radix et Rhizoma) and Bai Zhu (Atractylodis Macrocephalae Rhizoma), which further bound the blood. When Yu Jiayan examined the patient, he observed sweat resembling steam from a steamer and stated, "The treatable aspect of this case lies entirely in the presence of sweating." Since menstrual blood is internally blocked, there is only one path for it to emerge through the skin and hair, because sweat is also a form of blood. If there were no sweat and blood did not flow, the skin and hair would become dry and brittle, leading to death. It is appropriate to use extremely bitter medicines to guide the blood inward, allowing it to connect downward to the Chong Mai (Penetrating Vessel), thereby reducing the fever and restoring menstruation.